hospital_name,last_updated_on,version,hospital_location,hospital_address,license_number|IL,"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.",financial_aid_policy,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Gibson Area Hospital & Health Services,6/24/2024,2.0.0,Gibson Area Hospital & Health Services,"1120 N Melvin St, Gibson City, IL 60936",836,TRUE,https://www.gibsonhospital.org/services-and-conditions/profile/financial-services,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
description,code|1,code|1|type,code|2,code|2|type,code|3,code|3|type,setting,modifiers,standard_charge|gross,standard_charge|discounted_cash,standard_charge|Aetna|negotiated_dollar,estimated_amount|Aetna,standard_charge|Aetna|negotiated_percentage,standard_charge|Aetna|negotiated_algorithm,standard_charge|Aetna|methodology,additional_payer_notes|Aetna,standard_charge|Aetna|Medicare|negotiated_dollar,estimated_amount|Aetna|Medicare,standard_charge|Aetna|Medicare|negotiated_percentage,standard_charge|Aetna|Medicare|negotiated_algorithm,standard_charge|Aetna|Medicare|methodology,additional_payer_notes|Aetna|Medicare,standard_charge|Aetna|Medicaid|negotiated_dollar,estimated_amount|Aetna|Medicaid,standard_charge|Aetna|Medicaid|negotiated_percentage,standard_charge|Aetna|Medicaid|negotiated_algorithm,standard_charge|Aetna|Medicaid|methodology,additional_payer_notes|Aetna|Medicaid,standard_charge|Aetna|Rental_Network|negotiated_dollar,estimated_amount|Aetna|Rental_Network,standard_charge|Aetna|Rental_Network|negotiated_percentage,standard_charge|Aetna|Rental_Network|negotiated_algorithm,standard_charge|Aetna|Rental_Network|methodology,additional_payer_notes|Aetna|Rental_Network,standard_charge|BCBS|PPO|negotiated_dollar,estimated_amount|BCBS|PPO,standard_charge|BCBS|PPO|negotiated_percentage,standard_charge|BCBS|PPO|negotiated_algorithm,standard_charge|BCBS|PPO|methodology,additional_payer_notes|BCBS|PPO,standard_charge|BCBS|Blue_Choice|negotiated_dollar,estimated_amount|BCBS|Blue_Choice,standard_charge|BCBS|Blue_Choice|negotiated_percentage,standard_charge|BCBS|Blue_Choice|negotiated_algorithm,standard_charge|BCBS|Blue_Choice|methodology,additional_payer_notes|BCBS|Blue_Choice,standard_charge|Blue_Cross_Community_Health_Plan|Medicaid|negotiated_dollar,estimated_amount|Blue_Cross_Community_Health_Plan|Medicaid,standard_charge|Blue_Cross_Community_Health_Plan|Medicaid|negotiated_percentage,standard_charge|Blue_Cross_Community_Health_Plan|Medicaid|negotiated_algorithm,standard_charge|Blue_Cross_Community_Health_Plan|Medicaid|methodology,additional_payer_notes|Blue_Cross_Community_Health_Plan|Medicaid,standard_charge|Community_Partners_Health_Plans|negotiated_dollar,estimated_amount|Community_Partners_Health_Plans,standard_charge|Community_Partners_Health_Plans|negotiated_percentage,standard_charge|Community_Partners_Health_Plans|negotiated_algorithm,standard_charge|Community_Partners_Health_Plans|methodology,additional_payer_notes|Community_Partners_Health_Plans,standard_charge|Dentaquest|negotiated_dollar,estimated_amount|Dentaquest,standard_charge|Dentaquest|negotiated_percentage,standard_charge|Dentaquest|negotiated_algorithm,standard_charge|Dentaquest|methodology,additional_payer_notes|Dentaquest,standard_charge|Health_Alliance|negotiated_dollar,estimated_amount|Health_Alliance,standard_charge|Health_Alliance|negotiated_percentage,standard_charge|Health_Alliance|negotiated_algorithm,standard_charge|Health_Alliance|methodology,additional_payer_notes|Health_Alliance,standard_charge|Health_Alliance|Medicare_HMO|negotiated_dollar,estimated_amount|Health_Alliance|Medicare_HMO,standard_charge|Health_Alliance|Medicare_HMO|negotiated_percentage,standard_charge|Health_Alliance|Medicare_HMO|negotiated_algorithm,standard_charge|Health_Alliance|Medicare_HMO|methodology,additional_payer_notes|Health_Alliance|Medicare_HMO,standard_charge|Health_Alliance|Medicare_PPO|negotiated_dollar,estimated_amount|Health_Alliance|Medicare_PPO,standard_charge|Health_Alliance|Medicare_PPO|negotiated_percentage,standard_charge|Health_Alliance|Medicare_PPO|negotiated_algorithm,standard_charge|Health_Alliance|Medicare_PPO|methodology,additional_payer_notes|Health_Alliance|Medicare_PPO,standard_charge|HFN_Inc|negotiated_dollar,estimated_amount|HFN_Inc,standard_charge|HFN_Inc|negotiated_percentage,standard_charge|HFN_Inc|negotiated_algorithm,standard_charge|HFN_Inc|methodology,additional_payer_notes|HFN_Inc,standard_charge|HFN_Inc|Workers_Compensation|negotiated_dollar,estimated_amount|HFN_Inc|Workers_Compensation,standard_charge|HFN_Inc|Workers_Compensation|negotiated_percentage,standard_charge|HFN_Inc|Workers_Compensation|negotiated_algorithm,standard_charge|HFN_Inc|Workers_Compensation|methodology,additional_payer_notes|HFN_Inc|Workers_Compensation,standard_charge|HFN_Inc|Supplental_Product|negotiated_dollar,estimated_amount|HFN_Inc|Supplental_Product,standard_charge|HFN_Inc|Supplental_Product|negotiated_percentage,standard_charge|HFN_Inc|Supplental_Product|negotiated_algorithm,standard_charge|HFN_Inc|Supplental_Product|methodology,additional_payer_notes|HFN_Inc|Supplental_Product,standard_charge|Interplan_Health_Group|negotiated_dollar,estimated_amount|Interplan_Health_Group,standard_charge|Interplan_Health_Group|negotiated_percentage,standard_charge|Interplan_Health_Group|negotiated_algorithm,standard_charge|Interplan_Health_Group|methodology,additional_payer_notes|Interplan_Health_Group,standard_charge|Meridian_Health_Plan|negotiated_dollar,estimated_amount|Meridian_Health_Plan,standard_charge|Meridian_Health_Plan|negotiated_percentage,standard_charge|Meridian_Health_Plan|negotiated_algorithm,standard_charge|Meridian_Health_Plan|methodology,additional_payer_notes|Meridian_Health_Plan,standard_charge|Molina|negotiated_dollar,estimated_amount|Molina,standard_charge|Molina|negotiated_percentage,standard_charge|Molina|negotiated_algorithm,standard_charge|Molina|methodology,additional_payer_notes|Molina,standard_charge|Multiplan|negotiated_dollar,estimated_amount|Multiplan,standard_charge|Multiplan|negotiated_percentage,standard_charge|Multiplan|negotiated_algorithm,standard_charge|Multiplan|methodology,additional_payer_notes|Multiplan,standard_charge|NPPN|negotiated_dollar,estimated_amount|NPPN,standard_charge|NPPN|negotiated_percentage,standard_charge|NPPN|negotiated_algorithm,standard_charge|NPPN|methodology,additional_payer_notes|NPPN,standard_charge|Prime_Health_Services|negotiated_dollar,estimated_amount|Prime_Health_Services,standard_charge|Prime_Health_Services|negotiated_percentage,standard_charge|Prime_Health_Services|negotiated_algorithm,standard_charge|Prime_Health_Services|methodology,additional_payer_notes|Prime_Health_Services,standard_charge|SIHO_Network_LLC|negotiated_dollar,estimated_amount|SIHO_Network_LLC,standard_charge|SIHO_Network_LLC|negotiated_percentage,standard_charge|SIHO_Network_LLC|negotiated_algorithm,standard_charge|SIHO_Network_LLC|methodology,additional_payer_notes|SIHO_Network_LLC,standard_charge|Quanex_Employees|negotiated_dollar,estimated_amount|Quanex_Employees,standard_charge|Quanex_Employees|negotiated_percentage,standard_charge|Quanex_Employees|negotiated_algorithm,standard_charge|Quanex_Employees|methodology,additional_payer_notes|Quanex_Employees,standard_charge|Three_Rivers|negotiated_dollar,estimated_amount|Three_Rivers,standard_charge|Three_Rivers|negotiated_percentage,standard_charge|Three_Rivers|negotiated_algorithm,standard_charge|Three_Rivers|methodology,additional_payer_notes|Three_Rivers,standard_charge|United_Healthcare|negotiated_dollar,estimated_amount|United_Healthcare,standard_charge|United_Healthcare|negotiated_percentage,standard_charge|United_Healthcare|negotiated_algorithm,standard_charge|United_Healthcare|methodology,additional_payer_notes|United_Healthcare,standard_charge|min,standard_charge|max,additional_generic_notes
ALS EMERGENCY TRANSPORT,2152019,CDM,A0427,HCPCS,540,RC,inpatient,,3213.64,3213.64,,2728.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,193.45,,,,fee schedule,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2423.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2731.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2828,88,,percent of total billed charges,,193.45,,,,fee schedule,,,2455.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,193.45,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2924.41,91,,percent of total billed charges,,,3052.96,95,,percent of total billed charges,,,2667.32,83,,percent of total billed charges,,,2667.32,83,,percent of total billed charges,,,,,,,,,,,,,,,2667.32,83,,percent of total billed charges,,,3052.96,95,,percent of total billed charges,,,2892.28,90,,percent of total billed charges,,,2892.28,90,,percent of total billed charges,,,2635.18,82,,percent of total billed charges,,,2892.28,90,,percent of total billed charges,,,2731.59,85,,percent of total billed charges,,193.45,3052.96,
ALS EMERGENCY TRANSPORT LEVEL 2,2152020,CDM,A0433,HCPCS,540,RC,inpatient,,3260.19,3260.19,,2767.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,193.45,,,,fee schedule,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2458.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2771.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2868.97,88,,percent of total billed charges,,193.45,,,,fee schedule,,,2490.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,193.45,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2966.77,91,,percent of total billed charges,,,3097.18,95,,percent of total billed charges,,,2705.96,83,,percent of total billed charges,,,2705.96,83,,percent of total billed charges,,,,,,,,,,,,,,,2705.96,83,,percent of total billed charges,,,3097.18,95,,percent of total billed charges,,,2934.17,90,,percent of total billed charges,,,2934.17,90,,percent of total billed charges,,,2673.36,82,,percent of total billed charges,,,2934.17,90,,percent of total billed charges,,,2771.16,85,,percent of total billed charges,,193.45,3097.18,
BLS NON EMERGENCY TRANSPORT,2152027,CDM,A0428,HCPCS,540,RC,inpatient,,2482.91,2482.91,,2107.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,113.76,,,,fee schedule,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1872.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2110.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2184.96,88,,percent of total billed charges,,113.76,,,,fee schedule,,,1896.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,113.76,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2259.45,91,,percent of total billed charges,,,2358.76,95,,percent of total billed charges,,,2060.82,83,,percent of total billed charges,,,2060.82,83,,percent of total billed charges,,,,,,,,,,,,,,,2060.82,83,,percent of total billed charges,,,2358.76,95,,percent of total billed charges,,,2234.62,90,,percent of total billed charges,,,2234.62,90,,percent of total billed charges,,,2035.99,82,,percent of total billed charges,,,2234.62,90,,percent of total billed charges,,,2110.47,85,,percent of total billed charges,,113.76,2358.76,
BLS EMERGENCY TRANSPORT,2152030,CDM,A0429,HCPCS,540,RC,inpatient,,2583.7,2583.7,,2193.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,113.76,,,,fee schedule,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1948.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2196.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2273.66,88,,percent of total billed charges,,113.76,,,,fee schedule,,,1973.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,113.76,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2351.17,91,,percent of total billed charges,,,2454.52,95,,percent of total billed charges,,,2144.47,83,,percent of total billed charges,,,2144.47,83,,percent of total billed charges,,,,,,,,,,,,,,,2144.47,83,,percent of total billed charges,,,2454.52,95,,percent of total billed charges,,,2325.33,90,,percent of total billed charges,,,2325.33,90,,percent of total billed charges,,,2118.63,82,,percent of total billed charges,,,2325.33,90,,percent of total billed charges,,,2196.15,85,,percent of total billed charges,,113.76,2454.52,
ALS EMERGENCY W/SPECIAL SERV,2154023,CDM,A0434,HCPCS,540,RC,inpatient,,3390.58,3390.58,,2878.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,261.04,,,,fee schedule,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2556.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2881.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2983.71,88,,percent of total billed charges,,261.04,,,,fee schedule,,,2590.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,261.04,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3085.43,91,,percent of total billed charges,,,3221.05,95,,percent of total billed charges,,,2814.18,83,,percent of total billed charges,,,2814.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2814.18,83,,percent of total billed charges,,,3221.05,95,,percent of total billed charges,,,3051.52,90,,percent of total billed charges,,,3051.52,90,,percent of total billed charges,,,2780.28,82,,percent of total billed charges,,,3051.52,90,,percent of total billed charges,,,2881.99,85,,percent of total billed charges,,261.04,3221.05,
GROUND MILEAGE,2155012,CDM,A0425,HCPCS,540,RC,inpatient,,47.51,47.51,,40.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,5.6,,,,fee schedule,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.81,88,,percent of total billed charges,,5.6,,,,fee schedule,,,36.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.23,91,,percent of total billed charges,,,45.13,95,,percent of total billed charges,,,39.43,83,,percent of total billed charges,,,39.43,83,,percent of total billed charges,,,,,,,,,,,,,,,39.43,83,,percent of total billed charges,,,45.13,95,,percent of total billed charges,,,42.76,90,,percent of total billed charges,,,42.76,90,,percent of total billed charges,,,38.96,82,,percent of total billed charges,,,42.76,90,,percent of total billed charges,,,40.38,85,,percent of total billed charges,,5.6,45.13,
MED-SURG ROOM - LEVEL I,890040,CDM,,,111,RC,inpatient,,2800,2800,,2377.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2111.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2380,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2464,88,,percent of total billed charges,,,,,,,,,2139.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2548,91,,percent of total billed charges,,,2660,95,,percent of total billed charges,,,2324,83,,percent of total billed charges,,,2324,83,,percent of total billed charges,,,,,,,,,,,,,,,2324,83,,percent of total billed charges,,,2660,95,,percent of total billed charges,,,2520,90,,percent of total billed charges,,,2520,90,,percent of total billed charges,,,2296,82,,percent of total billed charges,,,2520,90,,percent of total billed charges,,,2380,85,,percent of total billed charges,,1668,5410.4,
MED-SURG ROOM - LEVEL II,890041,CDM,,,111,RC,inpatient,,3263,3263,,2770.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2460.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2773.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2871.44,88,,percent of total billed charges,,,,,,,,,2492.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2969.33,91,,percent of total billed charges,,,3099.85,95,,percent of total billed charges,,,2708.29,83,,percent of total billed charges,,,2708.29,83,,percent of total billed charges,,,,,,,,,,,,,,,2708.29,83,,percent of total billed charges,,,3099.85,95,,percent of total billed charges,,,2936.7,90,,percent of total billed charges,,,2936.7,90,,percent of total billed charges,,,2675.66,82,,percent of total billed charges,,,2936.7,90,,percent of total billed charges,,,2773.55,85,,percent of total billed charges,,1668,5410.4,
MED-SURG ROOM - LEVEL III,890042,CDM,,,111,RC,inpatient,,4272,4272,,3626.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3221.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3631.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3759.36,88,,percent of total billed charges,,,,,,,,,3263.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3887.52,91,,percent of total billed charges,,,4058.4,95,,percent of total billed charges,,,3545.76,83,,percent of total billed charges,,,3545.76,83,,percent of total billed charges,,,,,,,,,,,,,,,3545.76,83,,percent of total billed charges,,,4058.4,95,,percent of total billed charges,,,3844.8,90,,percent of total billed charges,,,3844.8,90,,percent of total billed charges,,,3503.04,82,,percent of total billed charges,,,3844.8,90,,percent of total billed charges,,,3631.2,85,,percent of total billed charges,,1668,5410.4,
MED-SURG ROOM - LEVEL IV,890043,CDM,,,111,RC,inpatient,,4680,4680,,3973.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3528.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3978,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4118.4,88,,percent of total billed charges,,,,,,,,,3575.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4258.8,91,,percent of total billed charges,,,4446,95,,percent of total billed charges,,,3884.4,83,,percent of total billed charges,,,3884.4,83,,percent of total billed charges,,,,,,,,,,,,,,,3884.4,83,,percent of total billed charges,,,4446,95,,percent of total billed charges,,,4212,90,,percent of total billed charges,,,4212,90,,percent of total billed charges,,,3837.6,82,,percent of total billed charges,,,4212,90,,percent of total billed charges,,,3978,85,,percent of total billed charges,,1668,5410.4,
LONG TERM CARE,890054,CDM,,,111,RC,inpatient,,295,295,,250.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,222.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,250.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,259.6,88,,percent of total billed charges,,,,,,,,,225.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,268.45,91,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,,,,,,,,,,,,,244.85,83,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,241.9,82,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,222.43,5410.4,
TREATMENT ROOM - OB,830081,CDM,G0463,HCPCS,510,RC,inpatient,,536,536,,455.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,404.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,455.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,471.68,88,,percent of total billed charges,,,,,,,,,409.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,487.76,91,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,,,,,,,,,,,,,444.88,83,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,439.52,82,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,404.14,5410.4,
OB ROOM - LEVEL I,830050,CDM,,,111,RC,inpatient,,2620,2620,,2224.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1975.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2227,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2305.6,88,,percent of total billed charges,,,,,,,,,2001.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2384.2,91,,percent of total billed charges,,,2489,95,,percent of total billed charges,,,2174.6,83,,percent of total billed charges,,,2174.6,83,,percent of total billed charges,,,,,,,,,,,,,,,2174.6,83,,percent of total billed charges,,,2489,95,,percent of total billed charges,,,2358,90,,percent of total billed charges,,,2358,90,,percent of total billed charges,,,2148.4,82,,percent of total billed charges,,,2358,90,,percent of total billed charges,,,2227,85,,percent of total billed charges,,1668,5410.4,
OB ROOM - LEVEL II,830051,CDM,,,111,RC,inpatient,,3028,3028,,2570.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2283.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2573.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2664.64,88,,percent of total billed charges,,,,,,,,,2313.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2755.48,91,,percent of total billed charges,,,2876.6,95,,percent of total billed charges,,,2513.24,83,,percent of total billed charges,,,2513.24,83,,percent of total billed charges,,,,,,,,,,,,,,,2513.24,83,,percent of total billed charges,,,2876.6,95,,percent of total billed charges,,,2725.2,90,,percent of total billed charges,,,2725.2,90,,percent of total billed charges,,,2482.96,82,,percent of total billed charges,,,2725.2,90,,percent of total billed charges,,,2573.8,85,,percent of total billed charges,,1668,5410.4,
OB ROOM - LEVEL III,830052,CDM,,,111,RC,inpatient,,3852,3852,,3270.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2904.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3274.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3389.76,88,,percent of total billed charges,,,,,,,,,2942.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3505.32,91,,percent of total billed charges,,,3659.4,95,,percent of total billed charges,,,3197.16,83,,percent of total billed charges,,,3197.16,83,,percent of total billed charges,,,,,,,,,,,,,,,3197.16,83,,percent of total billed charges,,,3659.4,95,,percent of total billed charges,,,3466.8,90,,percent of total billed charges,,,3466.8,90,,percent of total billed charges,,,3158.64,82,,percent of total billed charges,,,3466.8,90,,percent of total billed charges,,,3274.2,85,,percent of total billed charges,,1668,5410.4,
OB ROOM - LEVEL IV,830053,CDM,,,111,RC,inpatient,,4256,4256,,3613.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3209.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3617.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3745.28,88,,percent of total billed charges,,,,,,,,,3251.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3872.96,91,,percent of total billed charges,,,4043.2,95,,percent of total billed charges,,,3532.48,83,,percent of total billed charges,,,3532.48,83,,percent of total billed charges,,,,,,,,,,,,,,,3532.48,83,,percent of total billed charges,,,4043.2,95,,percent of total billed charges,,,3830.4,90,,percent of total billed charges,,,3830.4,90,,percent of total billed charges,,,3489.92,82,,percent of total billed charges,,,3830.4,90,,percent of total billed charges,,,3617.6,85,,percent of total billed charges,,1668,5410.4,
ORTHO ROOM - LEVEL I,880030,CDM,,,111,RC,inpatient,,2940,2940,,2496.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2216.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2499,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2587.2,88,,percent of total billed charges,,,,,,,,,2246.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2675.4,91,,percent of total billed charges,,,2793,95,,percent of total billed charges,,,2440.2,83,,percent of total billed charges,,,2440.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2440.2,83,,percent of total billed charges,,,2793,95,,percent of total billed charges,,,2646,90,,percent of total billed charges,,,2646,90,,percent of total billed charges,,,2410.8,82,,percent of total billed charges,,,2646,90,,percent of total billed charges,,,2499,85,,percent of total billed charges,,1668,5410.4,
ORTHO ROOM - LEVEL II,880031,CDM,,,111,RC,inpatient,,3426,3426,,2908.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2583.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2912.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3014.88,88,,percent of total billed charges,,,,,,,,,2617.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3117.66,91,,percent of total billed charges,,,3254.7,95,,percent of total billed charges,,,2843.58,83,,percent of total billed charges,,,2843.58,83,,percent of total billed charges,,,,,,,,,,,,,,,2843.58,83,,percent of total billed charges,,,3254.7,95,,percent of total billed charges,,,3083.4,90,,percent of total billed charges,,,3083.4,90,,percent of total billed charges,,,2809.32,82,,percent of total billed charges,,,3083.4,90,,percent of total billed charges,,,2912.1,85,,percent of total billed charges,,1668,5410.4,
ORTHO ROOM - LEVEL III,880032,CDM,,,111,RC,inpatient,,4486,4486,,3808.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3382.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3813.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3947.68,88,,percent of total billed charges,,,,,,,,,3427.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4082.26,91,,percent of total billed charges,,,4261.7,95,,percent of total billed charges,,,3723.38,83,,percent of total billed charges,,,3723.38,83,,percent of total billed charges,,,,,,,,,,,,,,,3723.38,83,,percent of total billed charges,,,4261.7,95,,percent of total billed charges,,,4037.4,90,,percent of total billed charges,,,4037.4,90,,percent of total billed charges,,,3678.52,82,,percent of total billed charges,,,4037.4,90,,percent of total billed charges,,,3813.1,85,,percent of total billed charges,,1668,5410.4,
ORTHO ROOM - LEVEL IV,880033,CDM,,,111,RC,inpatient,,4914,4914,,4171.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3705.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4176.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4324.32,88,,percent of total billed charges,,,,,,,,,3754.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4471.74,91,,percent of total billed charges,,,4668.3,95,,percent of total billed charges,,,4078.62,83,,percent of total billed charges,,,4078.62,83,,percent of total billed charges,,,,,,,,,,,,,,,4078.62,83,,percent of total billed charges,,,4668.3,95,,percent of total billed charges,,,4422.6,90,,percent of total billed charges,,,4422.6,90,,percent of total billed charges,,,4029.48,82,,percent of total billed charges,,,4422.6,90,,percent of total billed charges,,,4176.9,85,,percent of total billed charges,,1668,5410.4,
SEMI-PRIVATE ROOM - LEVEL I,890050,CDM,,,120,RC,inpatient,,2035,2035,,1727.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1534.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1729.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1790.8,88,,percent of total billed charges,,,,,,,,,1554.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1851.85,91,,percent of total billed charges,,,1933.25,95,,percent of total billed charges,,,1689.05,83,,percent of total billed charges,,,1689.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1689.05,83,,percent of total billed charges,,,1933.25,95,,percent of total billed charges,,,1831.5,90,,percent of total billed charges,,,1831.5,90,,percent of total billed charges,,,1668.7,82,,percent of total billed charges,,,1831.5,90,,percent of total billed charges,,,1729.75,85,,percent of total billed charges,,1534.39,5410.4,
SEMI-PRIVATE ROOM - LEVEL II,890051,CDM,,,120,RC,inpatient,,2364,2364,,2007.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1782.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2009.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2080.32,88,,percent of total billed charges,,,,,,,,,1806.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2151.24,91,,percent of total billed charges,,,2245.8,95,,percent of total billed charges,,,1962.12,83,,percent of total billed charges,,,1962.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1962.12,83,,percent of total billed charges,,,2245.8,95,,percent of total billed charges,,,2127.6,90,,percent of total billed charges,,,2127.6,90,,percent of total billed charges,,,1938.48,82,,percent of total billed charges,,,2127.6,90,,percent of total billed charges,,,2009.4,85,,percent of total billed charges,,1668,5410.4,
SEMI-PRIVATE ROOM - LEVEL III,890052,CDM,,,120,RC,inpatient,,3035,3035,,2576.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2288.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2579.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2670.8,88,,percent of total billed charges,,,,,,,,,2318.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2761.85,91,,percent of total billed charges,,,2883.25,95,,percent of total billed charges,,,2519.05,83,,percent of total billed charges,,,2519.05,83,,percent of total billed charges,,,,,,,,,,,,,,,2519.05,83,,percent of total billed charges,,,2883.25,95,,percent of total billed charges,,,2731.5,90,,percent of total billed charges,,,2731.5,90,,percent of total billed charges,,,2488.7,82,,percent of total billed charges,,,2731.5,90,,percent of total billed charges,,,2579.75,85,,percent of total billed charges,,1668,5410.4,
SEMI-PRIVATE ROOM - LEVEL IV,890053,CDM,,,120,RC,inpatient,,3354,3354,,2847.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2528.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2850.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2951.52,88,,percent of total billed charges,,,,,,,,,2562.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3052.14,91,,percent of total billed charges,,,3186.3,95,,percent of total billed charges,,,2783.82,83,,percent of total billed charges,,,2783.82,83,,percent of total billed charges,,,,,,,,,,,,,,,2783.82,83,,percent of total billed charges,,,3186.3,95,,percent of total billed charges,,,3018.6,90,,percent of total billed charges,,,3018.6,90,,percent of total billed charges,,,2750.28,82,,percent of total billed charges,,,3018.6,90,,percent of total billed charges,,,2850.9,85,,percent of total billed charges,,1668,5410.4,
NEWBORN LEVEL I,831100,CDM,,,171,RC,inpatient,,1734,1734,,1472.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1307.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1473.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1525.92,88,,percent of total billed charges,,,,,,,,,1324.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1577.94,91,,percent of total billed charges,,,1647.3,95,,percent of total billed charges,,,1439.22,83,,percent of total billed charges,,,1439.22,83,,percent of total billed charges,,,,,,,,,,,,,,,1439.22,83,,percent of total billed charges,,,1647.3,95,,percent of total billed charges,,,1560.6,90,,percent of total billed charges,,,1560.6,90,,percent of total billed charges,,,1421.88,82,,percent of total billed charges,,,1560.6,90,,percent of total billed charges,,,1473.9,85,,percent of total billed charges,,1307.44,5410.4,
NEWBORN LEVEL II,831101,CDM,,,172,RC,inpatient,,2246,2246,,1906.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1693.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1909.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1976.48,88,,percent of total billed charges,,,,,,,,,1715.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2043.86,91,,percent of total billed charges,,,2133.7,95,,percent of total billed charges,,,1864.18,83,,percent of total billed charges,,,1864.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1864.18,83,,percent of total billed charges,,,2133.7,95,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,1841.72,82,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,1909.1,85,,percent of total billed charges,,1668,5410.4,
NEWBORN LEVEL III,831102,CDM,,,173,RC,inpatient,,2882,2882,,2446.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2173.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2449.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2536.16,88,,percent of total billed charges,,,,,,,,,2201.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2622.62,91,,percent of total billed charges,,,2737.9,95,,percent of total billed charges,,,2392.06,83,,percent of total billed charges,,,2392.06,83,,percent of total billed charges,,,,,,,,,,,,,,,2392.06,83,,percent of total billed charges,,,2737.9,95,,percent of total billed charges,,,2593.8,90,,percent of total billed charges,,,2593.8,90,,percent of total billed charges,,,2363.24,82,,percent of total billed charges,,,2593.8,90,,percent of total billed charges,,,2449.7,85,,percent of total billed charges,,1668,5410.4,
NEWBORN LEVEL IV,831103,CDM,,,174,RC,inpatient,,3391,3391,,2878.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2556.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2882.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2984.08,88,,percent of total billed charges,,,,,,,,,2590.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3085.81,91,,percent of total billed charges,,,3221.45,95,,percent of total billed charges,,,2814.53,83,,percent of total billed charges,,,2814.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2814.53,83,,percent of total billed charges,,,3221.45,95,,percent of total billed charges,,,3051.9,90,,percent of total billed charges,,,3051.9,90,,percent of total billed charges,,,2780.62,82,,percent of total billed charges,,,3051.9,90,,percent of total billed charges,,,2882.35,85,,percent of total billed charges,,1668,5410.4,
DELIVERY LEVEL I,831051,CDM,,,722,RC,inpatient,,2502,2502,,2124.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1886.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2126.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2201.76,88,,percent of total billed charges,,,,,,,,,1911.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2276.82,91,,percent of total billed charges,,,2376.9,95,,percent of total billed charges,,,2076.66,83,,percent of total billed charges,,,2076.66,83,,percent of total billed charges,,,,,,,,,,,,,,,2076.66,83,,percent of total billed charges,,,2376.9,95,,percent of total billed charges,,,2251.8,90,,percent of total billed charges,,,2251.8,90,,percent of total billed charges,,,2051.64,82,,percent of total billed charges,,,2251.8,90,,percent of total billed charges,,,2126.7,85,,percent of total billed charges,,1668,5410.4,
DELIVERY LEVEL II,831052,CDM,,,722,RC,inpatient,,3708,3708,,3148.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,1668,,,,per diem,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2795.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3151.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3263.04,88,,percent of total billed charges,,,,,,,,,2832.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,5410.4,,,,per diem,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3374.28,91,,percent of total billed charges,,,3522.6,95,,percent of total billed charges,,,3077.64,83,,percent of total billed charges,,,3077.64,83,,percent of total billed charges,,,,,,,,,,,,,,,3077.64,83,,percent of total billed charges,,,3522.6,95,,percent of total billed charges,,,3337.2,90,,percent of total billed charges,,,3337.2,90,,percent of total billed charges,,,3040.56,82,,percent of total billed charges,,,3337.2,90,,percent of total billed charges,,,3151.8,85,,percent of total billed charges,,1668,5410.4,
EPIDURAL INJECTION,18601004,CDM,,,360,RC,inpatient,,9809,9809,,8327.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7395.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8337.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8631.92,88,,percent of total billed charges,,,,,,,,,7494.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8926.19,91,,percent of total billed charges,,,9318.55,95,,percent of total billed charges,,,8141.47,83,,percent of total billed charges,,,8141.47,83,,percent of total billed charges,,,,,,,,,,,,,,,8141.47,83,,percent of total billed charges,,,9318.55,95,,percent of total billed charges,,,8828.1,90,,percent of total billed charges,,,8828.1,90,,percent of total billed charges,,,8043.38,82,,percent of total billed charges,,,8828.1,90,,percent of total billed charges,,,8337.65,85,,percent of total billed charges,,7395.99,9318.55,
INJN TRT OF NERVE CRYOANALGESIA LT KNEE,18601005,CDM,64640,CPT,360,RC,inpatient,LT,3932,3932,,3338.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2964.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3342.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3460.16,88,,percent of total billed charges,,,,,,,,,3004.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3578.12,91,,percent of total billed charges,,,3735.4,95,,percent of total billed charges,,,3263.56,83,,percent of total billed charges,,,3263.56,83,,percent of total billed charges,,,,,,,,,,,,,,,3263.56,83,,percent of total billed charges,,,3735.4,95,,percent of total billed charges,,,3538.8,90,,percent of total billed charges,,,3538.8,90,,percent of total billed charges,,,3224.24,82,,percent of total billed charges,,,3538.8,90,,percent of total billed charges,,,3342.2,85,,percent of total billed charges,,2964.73,3735.4,
INJN TRT OF NERVE CRYOANALGESIA RT KNEE,18601006,CDM,64640,CPT,360,RC,inpatient,RT,3932,3932,,3338.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2964.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3342.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3460.16,88,,percent of total billed charges,,,,,,,,,3004.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3578.12,91,,percent of total billed charges,,,3735.4,95,,percent of total billed charges,,,3263.56,83,,percent of total billed charges,,,3263.56,83,,percent of total billed charges,,,,,,,,,,,,,,,3263.56,83,,percent of total billed charges,,,3735.4,95,,percent of total billed charges,,,3538.8,90,,percent of total billed charges,,,3538.8,90,,percent of total billed charges,,,3224.24,82,,percent of total billed charges,,,3538.8,90,,percent of total billed charges,,,3342.2,85,,percent of total billed charges,,2964.73,3735.4,
ARTERIAL CATHERT PERCUTANEOUS,33036620,CDM,36620,CPT,360,RC,inpatient,,1682,1682,,1428.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1268.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1429.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1480.16,88,,percent of total billed charges,,,,,,,,,1285.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1530.62,91,,percent of total billed charges,,,1597.9,95,,percent of total billed charges,,,1396.06,83,,percent of total billed charges,,,1396.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1396.06,83,,percent of total billed charges,,,1597.9,95,,percent of total billed charges,,,1513.8,90,,percent of total billed charges,,,1513.8,90,,percent of total billed charges,,,1379.24,82,,percent of total billed charges,,,1513.8,90,,percent of total billed charges,,,1429.7,85,,percent of total billed charges,,1268.23,1597.9,
BRACHIAL PLEXUS CONT INFUS BY CATHETER,33602061,CDM,64416,CPT,360,RC,inpatient,,1139,1139,,967.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,858.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,968.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1002.32,88,,percent of total billed charges,,,,,,,,,870.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,,,,,,,,,,,,,945.37,83,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,933.98,82,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,858.81,1082.05,
NERVE BLOCK INJ PUDENDAL,33602064,CDM,64430,CPT,360,RC,inpatient,,2098,2098,,1781.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1581.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1783.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1846.24,88,,percent of total billed charges,,,,,,,,,1602.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1909.18,91,,percent of total billed charges,,,1993.1,95,,percent of total billed charges,,,1741.34,83,,percent of total billed charges,,,1741.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1741.34,83,,percent of total billed charges,,,1993.1,95,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1720.36,82,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1783.3,85,,percent of total billed charges,,1581.89,1993.1,
SCIATIC NERVE CONT INFUS BY CATHETER,33602066,CDM,64446,CPT,360,RC,inpatient,,1139,1139,,967.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,858.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,968.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1002.32,88,,percent of total billed charges,,,,,,,,,870.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,,,,,,,,,,,,,945.37,83,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,933.98,82,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,858.81,1082.05,
INJ ANESTHETIC AGENT FEMORAL NERVE,33602067,CDM,64447,CPT,360,RC,inpatient,,1818,1818,,1543.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1370.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1545.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1599.84,88,,percent of total billed charges,,,,,,,,,1388.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1654.38,91,,percent of total billed charges,,,1727.1,95,,percent of total billed charges,,,1508.94,83,,percent of total billed charges,,,1508.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1508.94,83,,percent of total billed charges,,,1727.1,95,,percent of total billed charges,,,1636.2,90,,percent of total billed charges,,,1636.2,90,,percent of total billed charges,,,1490.76,82,,percent of total billed charges,,,1636.2,90,,percent of total billed charges,,,1545.3,85,,percent of total billed charges,,1370.77,1727.1,
FEMORAL NERVE CONT INFUS BY CATHETER,33602068,CDM,64448,CPT,360,RC,inpatient,,8930,8930,,7581.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6733.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7590.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7858.4,88,,percent of total billed charges,,,,,,,,,6822.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8126.3,91,,percent of total billed charges,,,8483.5,95,,percent of total billed charges,,,7411.9,83,,percent of total billed charges,,,7411.9,83,,percent of total billed charges,,,,,,,,,,,,,,,7411.9,83,,percent of total billed charges,,,8483.5,95,,percent of total billed charges,,,8037,90,,percent of total billed charges,,,8037,90,,percent of total billed charges,,,7322.6,82,,percent of total billed charges,,,8037,90,,percent of total billed charges,,,7590.5,85,,percent of total billed charges,,6733.22,8483.5,
LUMBAR PLEXUS POST APPR CONT INF CATHETR,33602069,CDM,64449,CPT,360,RC,inpatient,,1913,1913,,1624.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1442.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1626.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1683.44,88,,percent of total billed charges,,,,,,,,,1461.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1740.83,91,,percent of total billed charges,,,1817.35,95,,percent of total billed charges,,,1587.79,83,,percent of total billed charges,,,1587.79,83,,percent of total billed charges,,,,,,,,,,,,,,,1587.79,83,,percent of total billed charges,,,1817.35,95,,percent of total billed charges,,,1721.7,90,,percent of total billed charges,,,1721.7,90,,percent of total billed charges,,,1568.66,82,,percent of total billed charges,,,1721.7,90,,percent of total billed charges,,,1626.05,85,,percent of total billed charges,,1442.4,1817.35,
INSERT NON-TUNNEL CV CATH,33636556,CDM,36556,CPT,360,RC,inpatient,,3536,3536,,3002.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2666.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3005.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3111.68,88,,percent of total billed charges,,,,,,,,,2701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3217.76,91,,percent of total billed charges,,,3359.2,95,,percent of total billed charges,,,2934.88,83,,percent of total billed charges,,,2934.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2934.88,83,,percent of total billed charges,,,3359.2,95,,percent of total billed charges,,,3182.4,90,,percent of total billed charges,,,3182.4,90,,percent of total billed charges,,,2899.52,82,,percent of total billed charges,,,3182.4,90,,percent of total billed charges,,,3005.6,85,,percent of total billed charges,,2666.14,3359.2,
INJ ANESTHESIA INTERLAMINAR CRV/THRC,33662321,CDM,62321,CPT,360,RC,inpatient,,3822,3822,,3244.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2881.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3248.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3363.36,88,,percent of total billed charges,,,,,,,,,2920.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3478.02,91,,percent of total billed charges,,,3630.9,95,,percent of total billed charges,,,3172.26,83,,percent of total billed charges,,,3172.26,83,,percent of total billed charges,,,,,,,,,,,,,,,3172.26,83,,percent of total billed charges,,,3630.9,95,,percent of total billed charges,,,3439.8,90,,percent of total billed charges,,,3439.8,90,,percent of total billed charges,,,3134.04,82,,percent of total billed charges,,,3439.8,90,,percent of total billed charges,,,3248.7,85,,percent of total billed charges,,2881.79,3630.9,
INJ ANESTHESIA BRACHIAL PLEXUS SINGLE,33664415,CDM,64415,CPT,360,RC,inpatient,,2179,2179,,1849.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1642.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1852.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1917.52,88,,percent of total billed charges,,,,,,,,,1664.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1982.89,91,,percent of total billed charges,,,2070.05,95,,percent of total billed charges,,,1808.57,83,,percent of total billed charges,,,1808.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1808.57,83,,percent of total billed charges,,,2070.05,95,,percent of total billed charges,,,1961.1,90,,percent of total billed charges,,,1961.1,90,,percent of total billed charges,,,1786.78,82,,percent of total billed charges,,,1961.1,90,,percent of total billed charges,,,1852.15,85,,percent of total billed charges,,1642.97,2070.05,
INJECTION ANESTH SCIATIC SINGLE,33664445,CDM,64445,CPT,360,RC,inpatient,,2099,2099,,1782.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1582.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1784.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1847.12,88,,percent of total billed charges,,,,,,,,,1603.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1910.09,91,,percent of total billed charges,,,1994.05,95,,percent of total billed charges,,,1742.17,83,,percent of total billed charges,,,1742.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1742.17,83,,percent of total billed charges,,,1994.05,95,,percent of total billed charges,,,1889.1,90,,percent of total billed charges,,,1889.1,90,,percent of total billed charges,,,1721.18,82,,percent of total billed charges,,,1889.1,90,,percent of total billed charges,,,1784.15,85,,percent of total billed charges,,1582.65,1994.05,
INJECTION ANESTH FEMORAL SINGLE,33664447,CDM,64447,CPT,360,RC,inpatient,,1139,1139,,967.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,858.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,968.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1002.32,88,,percent of total billed charges,,,,,,,,,870.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,,,,,,,,,,,,,945.37,83,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,933.98,82,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,858.81,1082.05,
INJ ANESTH AGENT OTHER PERPHL BRANCH,33664450,CDM,64450,CPT,360,RC,inpatient,,3005,3005,,2551.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2265.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2554.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2644.4,88,,percent of total billed charges,,,,,,,,,2295.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2734.55,91,,percent of total billed charges,,,2854.75,95,,percent of total billed charges,,,2494.15,83,,percent of total billed charges,,,2494.15,83,,percent of total billed charges,,,,,,,,,,,,,,,2494.15,83,,percent of total billed charges,,,2854.75,95,,percent of total billed charges,,,2704.5,90,,percent of total billed charges,,,2704.5,90,,percent of total billed charges,,,2464.1,82,,percent of total billed charges,,,2704.5,90,,percent of total billed charges,,,2554.25,85,,percent of total billed charges,,2265.77,2854.75,
TAP BLOCK UNILATERAL BY INJECTION,33664486,CDM,64486,CPT,360,RC,inpatient,,3210,3210,,2725.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2420.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2728.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2824.8,88,,percent of total billed charges,,,,,,,,,2452.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2921.1,91,,percent of total billed charges,,,3049.5,95,,percent of total billed charges,,,2664.3,83,,percent of total billed charges,,,2664.3,83,,percent of total billed charges,,,,,,,,,,,,,,,2664.3,83,,percent of total billed charges,,,3049.5,95,,percent of total billed charges,,,2889,90,,percent of total billed charges,,,2889,90,,percent of total billed charges,,,2632.2,82,,percent of total billed charges,,,2889,90,,percent of total billed charges,,,2728.5,85,,percent of total billed charges,,2420.34,3049.5,
US VESSEL ACCESS REQ US,33676937,CDM,76937,CPT,370,RC,inpatient,,939,939,,797.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,708.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,798.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,826.32,88,,percent of total billed charges,,,,,,,,,717.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,854.49,91,,percent of total billed charges,,,892.05,95,,percent of total billed charges,,,779.37,83,,percent of total billed charges,,,779.37,83,,percent of total billed charges,,,,,,,,,,,,,,,779.37,83,,percent of total billed charges,,,892.05,95,,percent of total billed charges,,,845.1,90,,percent of total billed charges,,,845.1,90,,percent of total billed charges,,,769.98,82,,percent of total billed charges,,,845.1,90,,percent of total billed charges,,,798.15,85,,percent of total billed charges,,708.01,892.05,
UL NDL PLCMNT US GUIDANCE,33676942,CDM,76942,CPT,402,RC,inpatient,TC,1569,1569,,1332.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1183.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1333.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1380.72,88,,percent of total billed charges,,,,,,,,,1198.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1427.79,91,,percent of total billed charges,,,1490.55,95,,percent of total billed charges,,,1302.27,83,,percent of total billed charges,,,1302.27,83,,percent of total billed charges,,,,,,,,,,,,,,,1302.27,83,,percent of total billed charges,,,1490.55,95,,percent of total billed charges,,,1412.1,90,,percent of total billed charges,,,1412.1,90,,percent of total billed charges,,,1286.58,82,,percent of total billed charges,,,1412.1,90,,percent of total billed charges,,,1333.65,85,,percent of total billed charges,,1183.03,1490.55,
INJECTION ANESTHETIC AXILLARY NERVE,33700000,CDM,64417,CPT,360,RC,inpatient,,1749,1749,,1484.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1318.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1486.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1539.12,88,,percent of total billed charges,,,,,,,,,1336.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1591.59,91,,percent of total billed charges,,,1661.55,95,,percent of total billed charges,,,1451.67,83,,percent of total billed charges,,,1451.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1451.67,83,,percent of total billed charges,,,1661.55,95,,percent of total billed charges,,,1574.1,90,,percent of total billed charges,,,1574.1,90,,percent of total billed charges,,,1434.18,82,,percent of total billed charges,,,1574.1,90,,percent of total billed charges,,,1486.65,85,,percent of total billed charges,,1318.75,1661.55,
LABOR EPIDURAL/ITN,33700015,CDM,1967,CPT,964,RC,inpatient,QZ,2270,2270,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
"ARTERIAL CATHETERIZATION TRANSF, SAMPLE",33700020,CDM,36620,CPT,360,RC,inpatient,,530,530,,449.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466.4,88,,percent of total billed charges,,,,,,,,,404.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,,,,,,,,,,,,,439.9,83,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,434.6,82,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,399.62,503.5,
ANESTHESIA CHG UNIT CPT 00100,33700100,CDM,100,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00102,33700102,CDM,102,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00103,33700103,CDM,103,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00104,33700104,CDM,104,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00120,33700120,CDM,120,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00124,33700124,CDM,124,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00126,33700126,CDM,126,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00140,33700140,CDM,140,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00142,33700142,CDM,142,CPT,964,RC,inpatient,QZ,384,384,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00144,33700144,CDM,144,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00145,33700145,CDM,145,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00160,33700160,CDM,160,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00162,33700162,CDM,162,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00164,33700164,CDM,164,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00170,33700170,CDM,170,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00172,33700172,CDM,172,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00174,33700174,CDM,174,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00176,33700176,CDM,176,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00190,33700190,CDM,190,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00192,33700192,CDM,192,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00210,33700210,CDM,210,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00212,33700212,CDM,212,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00214,33700214,CDM,214,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00215,33700215,CDM,215,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00216,33700216,CDM,216,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00218,33700218,CDM,218,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00220,33700220,CDM,220,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00222,33700222,CDM,222,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00300,33700300,CDM,300,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00320QZ,33700320,CDM,320,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00322,33700322,CDM,322,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00350,33700350,CDM,350,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00352,33700352,CDM,352,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00400,33700400,CDM,400,CPT,964,RC,inpatient,QZ,431,431,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00402,33700402,CDM,402,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00404,33700404,CDM,404,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00406,33700406,CDM,406,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00410,33700410,CDM,410,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00450,33700450,CDM,450,CPT,964,RC,inpatient,,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00452,33700452,CDM,452,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00454,33700454,CDM,454,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00470,33700470,CDM,470,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00472,33700472,CDM,472,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00474,33700474,CDM,474,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00500,33700500,CDM,500,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00520,33700520,CDM,520,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00522,33700522,CDM,522,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00524,33700524,CDM,524,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00528,33700528,CDM,528,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00530,33700530,CDM,530,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00532,33700532,CDM,532,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00537,33700537,CDM,537,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00540,33700540,CDM,540,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00542,33700542,CDM,542,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00546,33700546,CDM,546,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00548,33700548,CDM,548,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00600,33700600,CDM,600,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00604,33700604,CDM,604,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00620,33700620,CDM,620,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00622,33700622,CDM,622,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00630,33700630,CDM,630,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00632,33700632,CDM,632,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00634,33700634,CDM,634,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
DX LUMBAR PUNCTURE,33700635,CDM,635,CPT,964,RC,inpatient,QZ,636,636,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
"ANESTH, MANIPULATION CHG UNIT CPT 00640",33700640,CDM,640,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00670,33700670,CDM,670,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00700,33700700,CDM,700,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00702,33700702,CDM,702,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00730,33700730,CDM,730,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00740,33700740,CDM,731,CPT,964,RC,inpatient,QZ,466,466,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00750,33700750,CDM,750,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00752,33700752,CDM,752,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00754,33700754,CDM,754,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00756,33700756,CDM,756,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00770,33700770,CDM,770,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00790,33700790,CDM,790,CPT,964,RC,inpatient,QZ,498,498,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00792,33700792,CDM,792,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00794,33700794,CDM,794,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00800,33700800,CDM,800,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00802,33700802,CDM,802,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00810,33700810,CDM,811,CPT,964,RC,inpatient,QZ,498,498,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00820,33700820,CDM,820,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00830,33700830,CDM,830,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00832,33700832,CDM,832,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00840,33700840,CDM,840,CPT,964,RC,inpatient,QZ,459,459,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00842,33700842,CDM,842,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00844,33700844,CDM,844,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00846,33700846,CDM,846,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00848,33700848,CDM,848,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00851,33700851,CDM,851,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00860,33700860,CDM,860,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00862,33700862,CDM,862,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00864,33700864,CDM,864,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00866,33700866,CDM,866,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00870,33700870,CDM,870,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00872,33700872,CDM,872,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00873,33700873,CDM,873,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00880,33700880,CDM,880,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00882,33700882,CDM,882,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00902,33700902,CDM,902,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00904,33700904,CDM,904,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00906,33700906,CDM,906,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00908,33700908,CDM,908,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00910,33700910,CDM,910,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00912,33700912,CDM,912,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00914,33700914,CDM,914,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00916,33700916,CDM,916,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00918,33700918,CDM,918,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00920,33700920,CDM,920,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00921,33700921,CDM,921,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00922,33700922,CDM,922,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00924,33700924,CDM,924,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00926,33700926,CDM,926,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00928,33700928,CDM,928,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00930,33700930,CDM,930,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00932,33700932,CDM,932,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00934,33700934,CDM,934,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00936,33700936,CDM,936,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00938,33700938,CDM,938,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00940,33700940,CDM,940,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00942,33700942,CDM,942,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00944,33700944,CDM,944,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00948,33700948,CDM,948,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00950,33700950,CDM,950,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00952,33700952,CDM,952,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00100,33701100,CDM,100,CPT,964,RC,inpatient,,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01112,33701110,CDM,1112,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01120,33701120,CDM,1120,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01130,33701130,CDM,1130,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01140,33701140,CDM,1140,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01150,33701150,CDM,1150,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01160,33701160,CDM,1160,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01170,33701170,CDM,1170,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01180,33701180,CDM,1180,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01190,33701190,CDM,1190,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01200,33701200,CDM,1200,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01202,33701202,CDM,1202,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01210,33701210,CDM,1210,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01212,33701212,CDM,1212,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01214,33701214,CDM,1214,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01215,33701215,CDM,1215,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01220,33701220,CDM,1220,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01230,33701230,CDM,1230,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01232,33701232,CDM,1232,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01234,33701234,CDM,1234,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01250,33701250,CDM,1250,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01260,33701260,CDM,1260,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01270,33701270,CDM,1270,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01272,33701272,CDM,1272,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01274,33701274,CDM,1274,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01320,33701320,CDM,1320,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01340,33701340,CDM,1340,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01360,33701360,CDM,1360,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01380,33701380,CDM,1380,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01382,33701382,CDM,1382,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01390,33701390,CDM,1390,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01392,33701392,CDM,1392,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01400,33701400,CDM,1400,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01402,33701402,CDM,1402,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01404,33701404,CDM,1404,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01420,33701420,CDM,1420,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01430,33701430,CDM,1430,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01432,33701432,CDM,1432,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01440,33701440,CDM,1440,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01442,33701442,CDM,1442,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01444,33701444,CDM,1444,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01462,33701462,CDM,1462,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01464,33701464,CDM,1464,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01470,33701470,CDM,1470,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01472,33701472,CDM,1472,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01474,33701474,CDM,1474,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01480,33701480,CDM,1480,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01482,33701482,CDM,1482,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01484,33701484,CDM,1484,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01486,33701486,CDM,1486,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01490,33701490,CDM,1490,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01500,33701500,CDM,1500,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01502,33701502,CDM,1502,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01520,33701520,CDM,1520,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01522,33701522,CDM,1522,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01610,33701610,CDM,1610,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01620,33701620,CDM,1620,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01622,33701622,CDM,1622,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01630,33701630,CDM,1630,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01634,33701634,CDM,1634,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01636,33701636,CDM,1636,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01638,33701638,CDM,1638,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01650,33701650,CDM,1650,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01652,33701652,CDM,1652,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01654,33701654,CDM,1654,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01656,33701656,CDM,1656,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01670,33701670,CDM,1670,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01680,33701680,CDM,1680,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01682,33701682,CDM,1682,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01710,33701710,CDM,1710,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01712,33701712,CDM,1712,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01714,33701714,CDM,1714,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01716,33701716,CDM,1716,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01730,33701730,CDM,1730,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01732,33701732,CDM,1732,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01740,33701740,CDM,1740,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01742,33701742,CDM,1742,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01744,33701744,CDM,1744,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01756,33701756,CDM,1756,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01758,33701758,CDM,1758,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01760,33701760,CDM,1760,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01770,33701770,CDM,1770,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01772,33701772,CDM,1772,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01780,33701780,CDM,1780,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01782,33701782,CDM,1782,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01810,33701810,CDM,1810,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01820,33701820,CDM,1820,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01830,33701830,CDM,1830,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01832,33701832,CDM,1832,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01840,33701840,CDM,1840,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01842,33701842,CDM,1842,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01844,33701844,CDM,1844,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01850,33701850,CDM,1850,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01852,33701852,CDM,1852,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01860,33701860,CDM,1860,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01916,33701916,CDM,1916,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01920,33701920,CDM,1920,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01922,33701922,CDM,1922,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01924,33701924,CDM,1924,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01926,33701926,CDM,1926,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01930,33701930,CDM,1930,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01935 DIAGNOSTIC,33701935,CDM,1937,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01936 THERAPUTIC,33701936,CDM,1938,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT 01958,33701958,CDM,1958,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01961,33701961,CDM,1961,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01963,33701963,CDM,1963,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA MISSED OR INCOMPLETE AB,33701965,CDM,1965,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHARGE UNIT 01966,33701966,CDM,1966,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA LABOR EPIDURAL UNIT 01967,33701967,CDM,1967,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHARGE UNIT 01968,33701968,CDM,1968,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01990,33701990,CDM,1990,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA NERVE BLK OTHER THAN PRONE,33701991,CDM,1991,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA NERVE BLOCK PRONE,33701992,CDM,1992,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01992,33701994,CDM,1992,CPT,964,RC,inpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHARGE UNIT 01996,33701996,CDM,1996,CPT,964,RC,inpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
CATH UMBILICAL ARTERYNEWB DIAG THER,33736660,CDM,36660,CPT,361,RC,inpatient,,590,590,,500.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,444.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,501.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,519.2,88,,percent of total billed charges,,,,,,,,,450.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,536.9,91,,percent of total billed charges,,,560.5,95,,percent of total billed charges,,,489.7,83,,percent of total billed charges,,,489.7,83,,percent of total billed charges,,,,,,,,,,,,,,,489.7,83,,percent of total billed charges,,,560.5,95,,percent of total billed charges,,,531,90,,percent of total billed charges,,,531,90,,percent of total billed charges,,,483.8,82,,percent of total billed charges,,,531,90,,percent of total billed charges,,,501.5,85,,percent of total billed charges,,444.86,560.5,
EPIDURAL BLOOD PATCH,33762273,CDM,62273,CPT,360,RC,inpatient,,2398,2398,,2035.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1808.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2038.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2110.24,88,,percent of total billed charges,,,,,,,,,1832.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2182.18,91,,percent of total billed charges,,,2278.1,95,,percent of total billed charges,,,1990.34,83,,percent of total billed charges,,,1990.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1990.34,83,,percent of total billed charges,,,2278.1,95,,percent of total billed charges,,,2158.2,90,,percent of total billed charges,,,2158.2,90,,percent of total billed charges,,,1966.36,82,,percent of total billed charges,,,2158.2,90,,percent of total billed charges,,,2038.3,85,,percent of total billed charges,,1808.09,2278.1,
ESI LUMBAR EPIDURAL,33762311,CDM,62322,CPT,360,RC,inpatient,TC,7269,7269,,6171.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5480.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6178.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6396.72,88,,percent of total billed charges,,,,,,,,,5553.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6614.79,91,,percent of total billed charges,,,6905.55,95,,percent of total billed charges,,,6033.27,83,,percent of total billed charges,,,6033.27,83,,percent of total billed charges,,,,,,,,,,,,,,,6033.27,83,,percent of total billed charges,,,6905.55,95,,percent of total billed charges,,,6542.1,90,,percent of total billed charges,,,6542.1,90,,percent of total billed charges,,,5960.58,82,,percent of total billed charges,,,6542.1,90,,percent of total billed charges,,,6178.65,85,,percent of total billed charges,,5480.83,6905.55,
LUMBAR SURGICAL EPIDURAL,33762319,CDM,62326,CPT,360,RC,inpatient,,5334,5334,,4528.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4021.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4533.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4693.92,88,,percent of total billed charges,,,,,,,,,4075.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4853.94,91,,percent of total billed charges,,,5067.3,95,,percent of total billed charges,,,4427.22,83,,percent of total billed charges,,,4427.22,83,,percent of total billed charges,,,,,,,,,,,,,,,4427.22,83,,percent of total billed charges,,,5067.3,95,,percent of total billed charges,,,4800.6,90,,percent of total billed charges,,,4800.6,90,,percent of total billed charges,,,4373.88,82,,percent of total billed charges,,,4800.6,90,,percent of total billed charges,,,4533.9,85,,percent of total billed charges,,4021.84,5067.3,
INTERCOSTAL NERVE BLOCK,33764421,CDM,64421,CPT,360,RC,inpatient,,2924,2924,,2482.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2204.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2485.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2573.12,88,,percent of total billed charges,,,,,,,,,2233.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2660.84,91,,percent of total billed charges,,,2777.8,95,,percent of total billed charges,,,2426.92,83,,percent of total billed charges,,,2426.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2426.92,83,,percent of total billed charges,,,2777.8,95,,percent of total billed charges,,,2631.6,90,,percent of total billed charges,,,2631.6,90,,percent of total billed charges,,,2397.68,82,,percent of total billed charges,,,2631.6,90,,percent of total billed charges,,,2485.4,85,,percent of total billed charges,,2204.7,2777.8,
ANESTHESIA PREP SET UP,33771234,CDM,,,370,RC,inpatient,,523,523,,444.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,394.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,444.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,460.24,88,,percent of total billed charges,,,,,,,,,399.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,475.93,91,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,,,,,,,,,,,,,434.09,83,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,428.86,82,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,444.55,85,,percent of total billed charges,,394.34,496.85,
ANESTHESIA CHG UNIT CPT 93312,33793312,CDM,1922,CPT,964,RC,inpatient,QZ,466,466,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00103,33800103,CDM,103,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00126,33800126,CDM,126,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00142,33800142,CDM,142,CPT,963,RC,inpatient,AA,384,384,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00160,33800160,CDM,160,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00170,33800170,CDM,170,CPT,964,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00300,33800300,CDM,300,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00322,33800322,CDM,322,CPT,964,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00400,33800400,CDM,400,CPT,963,RC,inpatient,AA,431,431,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00402,33800402,CDM,402,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00404,33800404,CDM,404,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00410,33800410,CDM,410,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00450,33800450,CDM,450,CPT,964,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00520,33800520,CDM,520,CPT,964,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00524,33800524,CDM,524,CPT,964,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00530,33800530,CDM,530,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00532,33800532,CDM,532,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00600,33800600,CDM,600,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00620,33800620,CDM,620,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00630,33800630,CDM,630,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00670,33800670,CDM,670,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00702,33800702,CDM,702,CPT,964,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00740,33800740,CDM,731,CPT,963,RC,inpatient,AA,466,466,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00752,33800752,CDM,752,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00790,33800790,CDM,790,CPT,963,RC,inpatient,AA,416,416,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00800,33800800,CDM,800,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00810,33800810,CDM,811,CPT,963,RC,inpatient,AA,498,498,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00830,33800830,CDM,830,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00832,33800832,CDM,832,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00840,33800840,CDM,840,CPT,963,RC,inpatient,AA,459,459,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00851,33800851,CDM,851,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00860,33800860,CDM,860,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00873,33800873,CDM,873,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00902,33800902,CDM,902,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00910,33800910,CDM,910,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00912,33800912,CDM,912,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00914,33800914,CDM,914,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00918,33800918,CDM,918,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00920,33800920,CDM,920,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00942,33800942,CDM,942,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00944,33800944,CDM,944,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 00952,33800952,CDM,952,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01112,33801110,CDM,1112,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01200,33801200,CDM,1200,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01210,33801210,CDM,1210,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01214,33801214,CDM,1214,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01215,33801215,CDM,1215,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01232,33801232,CDM,1232,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01320,33801320,CDM,1320,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01360,33801360,CDM,1360,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01380,33801380,CDM,1380,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01382,33801382,CDM,1382,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01390,33801390,CDM,1390,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01392,33801392,CDM,1392,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01400,33801400,CDM,1400,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01402,33801402,CDM,1402,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01462,33801462,CDM,1462,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01470,33801470,CDM,1470,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01472,33801472,CDM,1472,CPT,964,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01480,33801480,CDM,1480,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01610,33801610,CDM,1610,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01620,33801620,CDM,1620,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01630,33801630,CDM,1630,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01638,33801638,CDM,1638,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01710,33801710,CDM,1710,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01730,33801730,CDM,1730,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01740,33801740,CDM,1740,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01770,33801770,CDM,1770,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01810,33801810,CDM,1810,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01820,33801820,CDM,1820,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01830,33801830,CDM,1830,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01916,33801916,CDM,1916,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01922,33801922,CDM,1922,CPT,964,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01924,33801924,CDM,1924,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01930,33801930,CDM,1930,CPT,964,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01935 DIAGNOSTIC,33801935,CDM,1937,CPT,964,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01936 THERAPUTIC,33801936,CDM,1938,CPT,964,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 01961,33801961,CDM,1961,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA MISSED OR INCOMPLETE AB,33801965,CDM,1965,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA LABOR EPIDURAL UNIT 01967,33801967,CDM,1967,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHARGE UNIT 01968,33801968,CDM,1968,CPT,963,RC,inpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA NERVE BLK OTHER THAN PRONE,33801991,CDM,1991,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA NERVE BLOCK PRONE,33801992,CDM,1992,CPT,963,RC,inpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
ANESTHESIA CHG UNIT CPT 93312,33893312,CDM,1922,CPT,963,RC,inpatient,AA,466,466,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
BB AUTOLOGOUS UNIT PROCESSING ONLY,25201822,CDM,86890,CPT,300,RC,inpatient,,569,569,,483.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,429.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,483.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,500.72,88,,percent of total billed charges,,,,,,,,,434.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,517.79,91,,percent of total billed charges,,,540.55,95,,percent of total billed charges,,,472.27,83,,percent of total billed charges,,,472.27,83,,percent of total billed charges,,,,,,,,,,,,,,,472.27,83,,percent of total billed charges,,,540.55,95,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,466.58,82,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,483.65,85,,percent of total billed charges,,429.03,540.55,
BB AUTOLOGOUS UNIT TRANSFUSED,25201823,CDM,P9016,HCPCS,300,RC,inpatient,,2098,2098,,1781.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1581.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1783.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1846.24,88,,percent of total billed charges,,,,,,,,,1602.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1909.18,91,,percent of total billed charges,,,1993.1,95,,percent of total billed charges,,,1741.34,83,,percent of total billed charges,,,1741.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1741.34,83,,percent of total billed charges,,,1993.1,95,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1720.36,82,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1783.3,85,,percent of total billed charges,,1581.89,1993.1,
BB FRESH FROZEN PLASMA,25202374,CDM,P9017,HCPCS,390,RC,inpatient,,393,393,,333.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,334.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.84,88,,percent of total billed charges,,,,,,,,,300.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.63,91,,percent of total billed charges,,,373.35,95,,percent of total billed charges,,,326.19,83,,percent of total billed charges,,,326.19,83,,percent of total billed charges,,,,,,,,,,,,,,,326.19,83,,percent of total billed charges,,,373.35,95,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,322.26,82,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,334.05,85,,percent of total billed charges,,296.32,373.35,
BB RED BLOOD CELLS EACH UNIT,25203018,CDM,P9016,HCPCS,390,RC,inpatient,,2098,2098,,1781.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1581.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1783.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1846.24,88,,percent of total billed charges,,,,,,,,,1602.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1909.18,91,,percent of total billed charges,,,1993.1,95,,percent of total billed charges,,,1741.34,83,,percent of total billed charges,,,1741.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1741.34,83,,percent of total billed charges,,,1993.1,95,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1720.36,82,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1783.3,85,,percent of total billed charges,,1581.89,1993.1,
BB CRYOPRECIPITATE,25203019,CDM,P9012,HCPCS,390,RC,inpatient,,148,148,,125.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,111.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,125.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,130.24,88,,percent of total billed charges,,,,,,,,,113.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,,,,,,,,,,,,,122.84,83,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,121.36,82,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,111.59,140.6,
"CARDIAC REHAB, PHASE II",15802090,CDM,93798,CPT,943,RC,inpatient,,596,596,,506,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,449.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,506.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,524.48,88,,percent of total billed charges,,,,,,,,,455.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,542.36,91,,percent of total billed charges,,,566.2,95,,percent of total billed charges,,,494.68,83,,percent of total billed charges,,,494.68,83,,percent of total billed charges,,,,,,,,,,,,,,,494.68,83,,percent of total billed charges,,,566.2,95,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,488.72,82,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,506.6,85,,percent of total billed charges,,449.38,566.2,
"CARDIAC REHAB, PHASE I(V-5-17)",15802091,CDM,93798,CPT,943,RC,inpatient,,264,264,,224.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,199.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,224.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,232.32,88,,percent of total billed charges,,,,,,,,,201.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,240.24,91,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,,,,,,,,,,,,,219.12,83,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,216.48,82,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,199.06,250.8,
CARDIAC REHAB NON ECG MONITOR,15802092,CDM,93797,CPT,943,RC,inpatient,,596,596,,506,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,449.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,506.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,524.48,88,,percent of total billed charges,,,,,,,,,455.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,542.36,91,,percent of total billed charges,,,566.2,95,,percent of total billed charges,,,494.68,83,,percent of total billed charges,,,494.68,83,,percent of total billed charges,,,,,,,,,,,,,,,494.68,83,,percent of total billed charges,,,566.2,95,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,488.72,82,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,506.6,85,,percent of total billed charges,,449.38,566.2,
"CARDIAC REHAB, PHASE III",15802093,CDM,93798,CPT,943,RC,inpatient,,5,5,,4.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4.4,88,,percent of total billed charges,,,,,,,,,3.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4.55,91,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4.15,83,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.1,82,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,3.77,4.75,
"CARDIAC REHAB, PHASE II WITH MODIFIER",15802094,CDM,93798,CPT,943,RC,inpatient,KX,596,596,,506,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,449.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,506.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,524.48,88,,percent of total billed charges,,,,,,,,,455.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,542.36,91,,percent of total billed charges,,,566.2,95,,percent of total billed charges,,,494.68,83,,percent of total billed charges,,,494.68,83,,percent of total billed charges,,,,,,,,,,,,,,,494.68,83,,percent of total billed charges,,,566.2,95,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,488.72,82,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,506.6,85,,percent of total billed charges,,449.38,566.2,
EDUCATION TRAINING PATIENT SELF MGT,15802095,CDM,98960,CPT,942,RC,inpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,37.7,47.5,
PULMONARY EXERCISE SESSION GROUP(V-5-17),16000065,CDM,G0239,HCPCS,410,RC,inpatient,,310,310,,263.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,233.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,263.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,272.8,88,,percent of total billed charges,,,,,,,,,236.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,282.1,91,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,,,,,,,,,,,,,257.3,83,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,279,90,,percent of total billed charges,,,279,90,,percent of total billed charges,,,254.2,82,,percent of total billed charges,,,279,90,,percent of total billed charges,,,263.5,85,,percent of total billed charges,,233.74,294.5,
PULMONARY REHAB PER HOUR PER SESSION,16000067,CDM,94625,CPT,948,RC,inpatient,,349,349,,296.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,263.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,296.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,307.12,88,,percent of total billed charges,,,,,,,,,266.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,317.59,91,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,,,,,,,,,,,,,289.67,83,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,286.18,82,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,263.15,331.55,
PULMONARY REHAB PHASE III,16000068,CDM,94625,CPT,948,RC,inpatient,,5,5,,4.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4.4,88,,percent of total billed charges,,,,,,,,,3.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4.55,91,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4.15,83,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.1,82,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,3.77,4.75,
*DO NOT USE PULM REHAB MULTIPLE PULSE OX,16000070,CDM,94761,CPT,410,RC,inpatient,,143,143,,121.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,107.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,121.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,125.84,88,,percent of total billed charges,,,,,,,,,109.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,130.13,91,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,,,,,,,,,,,,,118.69,83,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,117.26,82,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,121.55,85,,percent of total billed charges,,107.82,135.85,
PULMONARY REHAB PER HOUR PER SESSION MOD,16000071,CDM,94625,CPT,948,RC,inpatient,KX,349,349,,296.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,263.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,296.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,307.12,88,,percent of total billed charges,,,,,,,,,266.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,317.59,91,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,,,,,,,,,,,,,289.67,83,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,286.18,82,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,263.15,331.55,
MINI HEART NEB FIRST HOUR,12800003,CDM,94644,CPT,410,RC,inpatient,,489,489,,415.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,368.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,415.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,430.32,88,,percent of total billed charges,,,,,,,,,373.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,444.99,91,,percent of total billed charges,,,464.55,95,,percent of total billed charges,,,405.87,83,,percent of total billed charges,,,405.87,83,,percent of total billed charges,,,,,,,,,,,,,,,405.87,83,,percent of total billed charges,,,464.55,95,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,400.98,82,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,415.65,85,,percent of total billed charges,,368.71,464.55,
HEART NEB 2 24 HOUR,12800005,CDM,94645,CPT,410,RC,inpatient,,689,689,,584.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,519.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,585.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,606.32,88,,percent of total billed charges,,,,,,,,,526.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,,,,,,,,,,,,,571.87,83,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,564.98,82,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,519.51,654.55,
PULSE OXIMETRY CONTINUOUS,12800010,CDM,94762,CPT,410,RC,inpatient,,654,654,,555.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,493.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,555.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,575.52,88,,percent of total billed charges,,,,,,,,,499.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,595.14,91,,percent of total billed charges,,,621.3,95,,percent of total billed charges,,,542.82,83,,percent of total billed charges,,,542.82,83,,percent of total billed charges,,,,,,,,,,,,,,,542.82,83,,percent of total billed charges,,,621.3,95,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,536.28,82,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,555.9,85,,percent of total billed charges,,493.12,621.3,
VENT VISION INITIAL,12800014,CDM,94002,CPT,410,RC,inpatient,,2840,2840,,2411.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2141.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2414,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2499.2,88,,percent of total billed charges,,,,,,,,,2169.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2584.4,91,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2357.2,83,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2328.8,82,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2414,85,,percent of total billed charges,,2141.36,2698,
VENT VISION SUBSEQUENT,12800015,CDM,94003,CPT,410,RC,inpatient,,2499,2499,,2121.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1884.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2124.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2199.12,88,,percent of total billed charges,,,,,,,,,1909.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2274.09,91,,percent of total billed charges,,,2374.05,95,,percent of total billed charges,,,2074.17,83,,percent of total billed charges,,,2074.17,83,,percent of total billed charges,,,,,,,,,,,,,,,2074.17,83,,percent of total billed charges,,,2374.05,95,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2049.18,82,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2124.15,85,,percent of total billed charges,,1884.25,2374.05,
VPAP INITIAL,12800020,CDM,94002,CPT,410,RC,inpatient,,2840,2840,,2411.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2141.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2414,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2499.2,88,,percent of total billed charges,,,,,,,,,2169.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2584.4,91,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2357.2,83,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2328.8,82,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2414,85,,percent of total billed charges,,2141.36,2698,
VPAP SUBSEQUENT,12800021,CDM,94003,CPT,410,RC,inpatient,,2499,2499,,2121.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1884.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2124.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2199.12,88,,percent of total billed charges,,,,,,,,,1909.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2274.09,91,,percent of total billed charges,,,2374.05,95,,percent of total billed charges,,,2074.17,83,,percent of total billed charges,,,2074.17,83,,percent of total billed charges,,,,,,,,,,,,,,,2074.17,83,,percent of total billed charges,,,2374.05,95,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2049.18,82,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2124.15,85,,percent of total billed charges,,1884.25,2374.05,
CPT SUBSEQUENT,12800037,CDM,94668,CPT,410,RC,inpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,261.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,294.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,261.64,329.65,
VENT ASTRAL INITIAL,12800046,CDM,94002,CPT,410,RC,inpatient,,2840,2840,,2411.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2141.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2414,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2499.2,88,,percent of total billed charges,,,,,,,,,2169.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2584.4,91,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2357.2,83,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2328.8,82,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2414,85,,percent of total billed charges,,2141.36,2698,
VPAP VENTILATOR SUBSEQUENT,12800050,CDM,94002,CPT,410,RC,inpatient,,2840,2840,,2411.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2141.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2414,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2499.2,88,,percent of total billed charges,,,,,,,,,2169.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2584.4,91,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2357.2,83,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2328.8,82,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2414,85,,percent of total billed charges,,2141.36,2698,
VENT CROSSVENT INITIAL,12800051,CDM,94002,CPT,410,RC,inpatient,,2679,2679,,2274.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2019.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2277.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2357.52,88,,percent of total billed charges,,,,,,,,,2046.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2437.89,91,,percent of total billed charges,,,2545.05,95,,percent of total billed charges,,,2223.57,83,,percent of total billed charges,,,2223.57,83,,percent of total billed charges,,,,,,,,,,,,,,,2223.57,83,,percent of total billed charges,,,2545.05,95,,percent of total billed charges,,,2411.1,90,,percent of total billed charges,,,2411.1,90,,percent of total billed charges,,,2196.78,82,,percent of total billed charges,,,2411.1,90,,percent of total billed charges,,,2277.15,85,,percent of total billed charges,,2019.97,2545.05,
VENT ASTRAL SUBSEQUENT,12800053,CDM,94003,CPT,410,RC,inpatient,,2499,2499,,2121.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1884.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2124.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2199.12,88,,percent of total billed charges,,,,,,,,,1909.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2274.09,91,,percent of total billed charges,,,2374.05,95,,percent of total billed charges,,,2074.17,83,,percent of total billed charges,,,2074.17,83,,percent of total billed charges,,,,,,,,,,,,,,,2074.17,83,,percent of total billed charges,,,2374.05,95,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2049.18,82,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2124.15,85,,percent of total billed charges,,1884.25,2374.05,
VENT CROSSVENT SUBSEQUENT,12800055,CDM,94003,CPT,410,RC,inpatient,,2840,2840,,2411.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2141.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2414,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2499.2,88,,percent of total billed charges,,,,,,,,,2169.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2584.4,91,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2357.2,83,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2328.8,82,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2414,85,,percent of total billed charges,,2141.36,2698,
CROUP TENT DAILY CHARGE,12800078,CDM,,,270,RC,inpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,2.26,2.85,
CPAP PER 16 HOURS,12800095,CDM,94660,CPT,410,RC,inpatient,,544,544,,461.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,410.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,462.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,478.72,88,,percent of total billed charges,,,,,,,,,415.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,495.04,91,,percent of total billed charges,,,516.8,95,,percent of total billed charges,,,451.52,83,,percent of total billed charges,,,451.52,83,,percent of total billed charges,,,,,,,,,,,,,,,451.52,83,,percent of total billed charges,,,516.8,95,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,446.08,82,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,462.4,85,,percent of total billed charges,,410.18,516.8,
CPAP PER 24 HOURS,12800096,CDM,94660,CPT,410,RC,inpatient,,680,680,,577.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,512.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,578,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,598.4,88,,percent of total billed charges,,,,,,,,,519.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,618.8,91,,percent of total billed charges,,,646,95,,percent of total billed charges,,,564.4,83,,percent of total billed charges,,,564.4,83,,percent of total billed charges,,,,,,,,,,,,,,,564.4,83,,percent of total billed charges,,,646,95,,percent of total billed charges,,,612,90,,percent of total billed charges,,,612,90,,percent of total billed charges,,,557.6,82,,percent of total billed charges,,,612,90,,percent of total billed charges,,,578,85,,percent of total billed charges,,512.72,646,
CPAP PER 8 HOURS,12800102,CDM,94660,CPT,410,RC,inpatient,,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,330.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,372.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,330.25,416.1,
ACAPELLA SUBSEQUENT,12800105,CDM,94668,CPT,410,RC,inpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,261.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,294.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,261.64,329.65,
IS SUBSEQUENT,12800115,CDM,,,410,RC,inpatient,,113,113,,95.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,99.44,88,,percent of total billed charges,,,,,,,,,86.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,92.66,82,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,85.2,107.35,
EZ PAP TREATMENT,12800200,CDM,94640,CPT,410,RC,inpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,132.7,167.2,
NEBULIZER SUBSEQUENT,12800219,CDM,94640,CPT,410,RC,inpatient,76,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
NEBULIZER PRN,12800220,CDM,94640,CPT,410,RC,inpatient,,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
CPR UP TO 1 HOUR,12801001,CDM,92950,CPT,480,RC,inpatient,,1580,1580,,1341.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1191.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1343,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1390.4,88,,percent of total billed charges,,,,,,,,,1207.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1437.8,91,,percent of total billed charges,,,1501,95,,percent of total billed charges,,,1311.4,83,,percent of total billed charges,,,1311.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1311.4,83,,percent of total billed charges,,,1501,95,,percent of total billed charges,,,1422,90,,percent of total billed charges,,,1422,90,,percent of total billed charges,,,1295.6,82,,percent of total billed charges,,,1422,90,,percent of total billed charges,,,1343,85,,percent of total billed charges,,1191.32,1501,
CPR UP TO 2 HOURS,12801010,CDM,92950,CPT,480,RC,inpatient,,775,775,,657.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,584.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,658.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,682,88,,percent of total billed charges,,,,,,,,,592.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,705.25,91,,percent of total billed charges,,,736.25,95,,percent of total billed charges,,,643.25,83,,percent of total billed charges,,,643.25,83,,percent of total billed charges,,,,,,,,,,,,,,,643.25,83,,percent of total billed charges,,,736.25,95,,percent of total billed charges,,,697.5,90,,percent of total billed charges,,,697.5,90,,percent of total billed charges,,,635.5,82,,percent of total billed charges,,,697.5,90,,percent of total billed charges,,,658.75,85,,percent of total billed charges,,584.35,736.25,
CPR UP TO 3 HOURS,12801011,CDM,92950,CPT,480,RC,inpatient,,967,967,,820.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,729.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,821.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,850.96,88,,percent of total billed charges,,,,,,,,,738.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,879.97,91,,percent of total billed charges,,,918.65,95,,percent of total billed charges,,,802.61,83,,percent of total billed charges,,,802.61,83,,percent of total billed charges,,,,,,,,,,,,,,,802.61,83,,percent of total billed charges,,,918.65,95,,percent of total billed charges,,,870.3,90,,percent of total billed charges,,,870.3,90,,percent of total billed charges,,,792.94,82,,percent of total billed charges,,,870.3,90,,percent of total billed charges,,,821.95,85,,percent of total billed charges,,729.12,918.65,
SUCTIONING,12801019,CDM,31720,CPT,410,RC,inpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,198.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,198.3,249.85,
CROUP TENT SET UP,12801068,CDM,,,270,RC,inpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,2.26,2.85,
INITIAL PERCUSSIVE NEBULIZER,12801070,CDM,94664,CPT,410,RC,inpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,261.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,294.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,261.64,329.65,
SUBSEQUENT PERCUSSIVE NEBULIZER,12801071,CDM,94640,CPT,410,RC,inpatient,76,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
NEBULIZER INITIAL,12801092,CDM,94664,CPT,410,RC,inpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,261.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,294.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,261.64,329.65,
EZ PAP INITIAL,12801093,CDM,94640,CPT,410,RC,inpatient,,295,295,,250.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,222.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,250.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,259.6,88,,percent of total billed charges,,,,,,,,,225.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,268.45,91,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,,,,,,,,,,,,,244.85,83,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,241.9,82,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,222.43,280.25,
CPT INITIAL,12801126,CDM,94667,CPT,410,RC,inpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,261.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,294.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,261.64,329.65,
TREATMENT ROOM,12801500,CDM,G0463,HCPCS,510,RC,inpatient,,155,155,,131.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,131.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,136.4,88,,percent of total billed charges,,,,,,,,,118.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,127.1,82,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,116.87,147.25,
PULSE OX CHECK,12801506,CDM,94760,CPT,460,RC,inpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,135.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,135.72,171,
PULSE OX MULTIPLE FOR HOME O2 QUALIFY,12801507,CDM,94761,CPT,460,RC,inpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,179.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,159.09,200.45,
PFT-SCREENING,12801522,CDM,94010,CPT,460,RC,inpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,347.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,391.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,347.59,437.95,
PFT-COMPLETE,12801530,CDM,94060,CPT,460,RC,inpatient,,992,992,,842.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,747.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,843.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,872.96,88,,percent of total billed charges,,,,,,,,,757.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,902.72,91,,percent of total billed charges,,,942.4,95,,percent of total billed charges,,,823.36,83,,percent of total billed charges,,,823.36,83,,percent of total billed charges,,,,,,,,,,,,,,,823.36,83,,percent of total billed charges,,,942.4,95,,percent of total billed charges,,,892.8,90,,percent of total billed charges,,,892.8,90,,percent of total billed charges,,,813.44,82,,percent of total billed charges,,,892.8,90,,percent of total billed charges,,,843.2,85,,percent of total billed charges,,747.97,942.4,
ABG(V-4-19),12801563,CDM,82803,CPT,300,RC,inpatient,,722,722,,612.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,544.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,613.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,635.36,88,,percent of total billed charges,,,,,,,,,551.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,657.02,91,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,,,,,,,,,,,,,599.26,83,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,592.04,82,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,613.7,85,,percent of total billed charges,,544.39,685.9,
ARTERIAL PUNCTURE,12801564,CDM,36600,CPT,361,RC,inpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
CORD VEIN GAS(V-12-20),12801565,CDM,82803,CPT,300,RC,inpatient,,349,349,,296.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,263.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,296.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,307.12,88,,percent of total billed charges,,,,,,,,,266.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,317.59,91,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,,,,,,,,,,,,,289.67,83,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,286.18,82,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,263.15,331.55,
CORD ARTERY GAS(V-12-20),12801566,CDM,82803,CPT,300,RC,inpatient,,349,349,,296.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,263.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,296.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,307.12,88,,percent of total billed charges,,,,,,,,,266.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,317.59,91,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,,,,,,,,,,,,,289.67,83,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,286.18,82,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,263.15,331.55,
ABG WITH LACTIC,12801567,CDM,83605,CPT,300,RC,inpatient,TC,978,978,,830.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,737.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,831.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,860.64,88,,percent of total billed charges,,,,,,,,,747.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,889.98,91,,percent of total billed charges,,,929.1,95,,percent of total billed charges,,,811.74,83,,percent of total billed charges,,,811.74,83,,percent of total billed charges,,,,,,,,,,,,,,,811.74,83,,percent of total billed charges,,,929.1,95,,percent of total billed charges,,,880.2,90,,percent of total billed charges,,,880.2,90,,percent of total billed charges,,,801.96,82,,percent of total billed charges,,,880.2,90,,percent of total billed charges,,,831.3,85,,percent of total billed charges,,737.41,929.1,
CAPILLARY BLOOD GAS,12801568,CDM,82803,CPT,300,RC,inpatient,,463,463,,393.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,393.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,407.44,88,,percent of total billed charges,,,,,,,,,353.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,421.33,91,,percent of total billed charges,,,439.85,95,,percent of total billed charges,,,384.29,83,,percent of total billed charges,,,384.29,83,,percent of total billed charges,,,,,,,,,,,,,,,384.29,83,,percent of total billed charges,,,439.85,95,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,379.66,82,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,393.55,85,,percent of total billed charges,,349.1,439.85,
CARBON MONOXIDE,12801576,CDM,82375,CPT,300,RC,inpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
ABG-ISTAT(V-6-20),12801580,CDM,82803,CPT,300,RC,inpatient,TC,722,722,,612.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,544.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,613.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,635.36,88,,percent of total billed charges,,,,,,,,,551.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,657.02,91,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,,,,,,,,,,,,,599.26,83,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,592.04,82,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,613.7,85,,percent of total billed charges,,544.39,685.9,
CORD VEIN GAS-ISTAT,12801581,CDM,82803,CPT,300,RC,inpatient,TC,349,349,,296.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,263.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,296.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,307.12,88,,percent of total billed charges,,,,,,,,,266.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,317.59,91,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,,,,,,,,,,,,,289.67,83,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,286.18,82,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,263.15,331.55,
CORD ARTERY GAS-ISTAT,12801582,CDM,82803,CPT,300,RC,inpatient,TC,349,349,,296.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,263.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,296.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,307.12,88,,percent of total billed charges,,,,,,,,,266.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,317.59,91,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,,,,,,,,,,,,,289.67,83,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,286.18,82,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,263.15,331.55,
ABG WITH LACTIC-ISTAT,12801583,CDM,83605,CPT,300,RC,inpatient,TC,978,978,,830.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,737.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,831.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,860.64,88,,percent of total billed charges,,,,,,,,,747.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,889.98,91,,percent of total billed charges,,,929.1,95,,percent of total billed charges,,,811.74,83,,percent of total billed charges,,,811.74,83,,percent of total billed charges,,,,,,,,,,,,,,,811.74,83,,percent of total billed charges,,,929.1,95,,percent of total billed charges,,,880.2,90,,percent of total billed charges,,,880.2,90,,percent of total billed charges,,,801.96,82,,percent of total billed charges,,,880.2,90,,percent of total billed charges,,,831.3,85,,percent of total billed charges,,737.41,929.1,
ACAPELLA INITIAL,12801600,CDM,94667,CPT,410,RC,inpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,261.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,294.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,261.64,329.65,
PEAK FLOW CHECK,12801605,CDM,94010,CPT,460,RC,inpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,347.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,391.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,347.59,437.95,
* AEROSOL MASK (V1004),12802009,CDM,,,270,RC,inpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,37.7,47.5,
MDI SUBSEQUENT,12802223,CDM,94640,CPT,410,RC,inpatient,76,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
MDI INITIAL,12802224,CDM,94664,CPT,410,RC,inpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,261.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,294.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,261.64,329.65,
PH GAS ONLY,12802400,CDM,82800,CPT,410,RC,inpatient,,163,163,,138.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,122.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,138.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,143.44,88,,percent of total billed charges,,,,,,,,,124.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,,,,,,,,,,,,,135.29,83,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,133.66,82,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,122.9,154.85,
NITROGEN WASHOUT,12803000,CDM,94727,CPT,460,RC,inpatient,,575,575,,488.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,433.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,488.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,506,88,,percent of total billed charges,,,,,,,,,439.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,523.25,91,,percent of total billed charges,,,546.25,95,,percent of total billed charges,,,477.25,83,,percent of total billed charges,,,477.25,83,,percent of total billed charges,,,,,,,,,,,,,,,477.25,83,,percent of total billed charges,,,546.25,95,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,471.5,82,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,488.75,85,,percent of total billed charges,,433.55,546.25,
DLCO,12803001,CDM,94729,CPT,460,RC,inpatient,,589,589,,500.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,444.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,500.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,518.32,88,,percent of total billed charges,,,,,,,,,450,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,535.99,91,,percent of total billed charges,,,559.55,95,,percent of total billed charges,,,488.87,83,,percent of total billed charges,,,488.87,83,,percent of total billed charges,,,,,,,,,,,,,,,488.87,83,,percent of total billed charges,,,559.55,95,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,482.98,82,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,500.65,85,,percent of total billed charges,,444.11,559.55,
VITAL CAPACITY TEST,12803002,CDM,94150,CPT,460,RC,inpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,198.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,198.3,249.85,
PFT WITH BODY BOX,12803003,CDM,94726,CPT,460,RC,inpatient,,1498,1498,,1271.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1129.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1273.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1318.24,88,,percent of total billed charges,,,,,,,,,1144.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1363.18,91,,percent of total billed charges,,,1423.1,95,,percent of total billed charges,,,1243.34,83,,percent of total billed charges,,,1243.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1243.34,83,,percent of total billed charges,,,1423.1,95,,percent of total billed charges,,,1348.2,90,,percent of total billed charges,,,1348.2,90,,percent of total billed charges,,,1228.36,82,,percent of total billed charges,,,1348.2,90,,percent of total billed charges,,,1273.3,85,,percent of total billed charges,,1129.49,1423.1,
METHACHOLINE CHALLENGE,12803004,CDM,94070,CPT,460,RC,inpatient,,1454,1454,,1234.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1096.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1235.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1279.52,88,,percent of total billed charges,,,,,,,,,1110.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1323.14,91,,percent of total billed charges,,,1381.3,95,,percent of total billed charges,,,1206.82,83,,percent of total billed charges,,,1206.82,83,,percent of total billed charges,,,,,,,,,,,,,,,1206.82,83,,percent of total billed charges,,,1381.3,95,,percent of total billed charges,,,1308.6,90,,percent of total billed charges,,,1308.6,90,,percent of total billed charges,,,1192.28,82,,percent of total billed charges,,,1308.6,90,,percent of total billed charges,,,1235.9,85,,percent of total billed charges,,1096.32,1381.3,
NEBULIZER WITH PEAK FLOW,12803005,CDM,94640,CPT,410,RC,inpatient,,541,541,,459.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,407.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,459.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,476.08,88,,percent of total billed charges,,,,,,,,,413.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,492.31,91,,percent of total billed charges,,,513.95,95,,percent of total billed charges,,,449.03,83,,percent of total billed charges,,,449.03,83,,percent of total billed charges,,,,,,,,,,,,,,,449.03,83,,percent of total billed charges,,,513.95,95,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,443.62,82,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,459.85,85,,percent of total billed charges,,407.91,513.95,
CT BONE MARROW ASPIRATION,29100080,CDM,38220,CPT,352,RC,inpatient,TC,4766,4766,,4046.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3593.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4051.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4194.08,88,,percent of total billed charges,,,,,,,,,3641.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4337.06,91,,percent of total billed charges,,,4527.7,95,,percent of total billed charges,,,3955.78,83,,percent of total billed charges,,,3955.78,83,,percent of total billed charges,,,,,,,,,,,,,,,3955.78,83,,percent of total billed charges,,,4527.7,95,,percent of total billed charges,,,4289.4,90,,percent of total billed charges,,,4289.4,90,,percent of total billed charges,,,3908.12,82,,percent of total billed charges,,,4289.4,90,,percent of total billed charges,,,4051.1,85,,percent of total billed charges,,3593.56,4527.7,
CT BONE MARROW BIOPSY,29100081,CDM,38221,CPT,352,RC,inpatient,TC,3852,3852,,3270.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2904.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3274.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3389.76,88,,percent of total billed charges,,,,,,,,,2942.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3505.32,91,,percent of total billed charges,,,3659.4,95,,percent of total billed charges,,,3197.16,83,,percent of total billed charges,,,3197.16,83,,percent of total billed charges,,,,,,,,,,,,,,,3197.16,83,,percent of total billed charges,,,3659.4,95,,percent of total billed charges,,,3466.8,90,,percent of total billed charges,,,3466.8,90,,percent of total billed charges,,,3158.64,82,,percent of total billed charges,,,3466.8,90,,percent of total billed charges,,,3274.2,85,,percent of total billed charges,,2904.41,3659.4,
CT BONE MARROW ASPIRATION/BIOPSY,29100082,CDM,38222,CPT,352,RC,inpatient,TC,4939,4939,,4193.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3724.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4198.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4346.32,88,,percent of total billed charges,,,,,,,,,3773.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4494.49,91,,percent of total billed charges,,,4692.05,95,,percent of total billed charges,,,4099.37,83,,percent of total billed charges,,,4099.37,83,,percent of total billed charges,,,,,,,,,,,,,,,4099.37,83,,percent of total billed charges,,,4692.05,95,,percent of total billed charges,,,4445.1,90,,percent of total billed charges,,,4445.1,90,,percent of total billed charges,,,4049.98,82,,percent of total billed charges,,,4445.1,90,,percent of total billed charges,,,4198.15,85,,percent of total billed charges,,3724.01,4692.05,
CT BONE MINERL DENSITY STUDY 1/> SITS AX,29100090,CDM,77078,CPT,352,RC,inpatient,TC,950,950,,806.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,716.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,807.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,836,88,,percent of total billed charges,,,,,,,,,725.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,864.5,91,,percent of total billed charges,,,902.5,95,,percent of total billed charges,,,788.5,83,,percent of total billed charges,,,788.5,83,,percent of total billed charges,,,,,,,,,,,,,,,788.5,83,,percent of total billed charges,,,902.5,95,,percent of total billed charges,,,855,90,,percent of total billed charges,,,855,90,,percent of total billed charges,,,779,82,,percent of total billed charges,,,855,90,,percent of total billed charges,,,807.5,85,,percent of total billed charges,,716.3,902.5,
CT BONE (DEEP) BIOPSY TROCAR/NEEDLE,29100100,CDM,20225,CPT,352,RC,inpatient,TC,4424,4424,,3755.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3335.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3760.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3893.12,88,,percent of total billed charges,,,,,,,,,3379.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4025.84,91,,percent of total billed charges,,,4202.8,95,,percent of total billed charges,,,3671.92,83,,percent of total billed charges,,,3671.92,83,,percent of total billed charges,,,,,,,,,,,,,,,3671.92,83,,percent of total billed charges,,,4202.8,95,,percent of total billed charges,,,3981.6,90,,percent of total billed charges,,,3981.6,90,,percent of total billed charges,,,3627.68,82,,percent of total billed charges,,,3981.6,90,,percent of total billed charges,,,3760.4,85,,percent of total billed charges,,3335.7,4202.8,
CT BONE (SUPERFICI) BIOPSY TROCAR/NEEDLE,29100101,CDM,20220,CPT,352,RC,inpatient,TC,2947,2947,,2502,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2222.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2504.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2593.36,88,,percent of total billed charges,,,,,,,,,2251.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2681.77,91,,percent of total billed charges,,,2799.65,95,,percent of total billed charges,,,2446.01,83,,percent of total billed charges,,,2446.01,83,,percent of total billed charges,,,,,,,,,,,,,,,2446.01,83,,percent of total billed charges,,,2799.65,95,,percent of total billed charges,,,2652.3,90,,percent of total billed charges,,,2652.3,90,,percent of total billed charges,,,2416.54,82,,percent of total billed charges,,,2652.3,90,,percent of total billed charges,,,2504.95,85,,percent of total billed charges,,2222.04,2799.65,
CT LUNG PERCUT BX/MEDIASTINUM,29100102,CDM,32408,CPT,360,RC,inpatient,TC,3199,3199,,2715.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2412.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2719.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2815.12,88,,percent of total billed charges,,,,,,,,,2444.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2911.09,91,,percent of total billed charges,,,3039.05,95,,percent of total billed charges,,,2655.17,83,,percent of total billed charges,,,2655.17,83,,percent of total billed charges,,,,,,,,,,,,,,,2655.17,83,,percent of total billed charges,,,3039.05,95,,percent of total billed charges,,,2879.1,90,,percent of total billed charges,,,2879.1,90,,percent of total billed charges,,,2623.18,82,,percent of total billed charges,,,2879.1,90,,percent of total billed charges,,,2719.15,85,,percent of total billed charges,,2412.05,3039.05,
CT LIVER NEEDLE BIOPSY,29100103,CDM,47000,CPT,352,RC,inpatient,TC,3257,3257,,2765.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2455.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2768.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2866.16,88,,percent of total billed charges,,,,,,,,,2488.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2963.87,91,,percent of total billed charges,,,3094.15,95,,percent of total billed charges,,,2703.31,83,,percent of total billed charges,,,2703.31,83,,percent of total billed charges,,,,,,,,,,,,,,,2703.31,83,,percent of total billed charges,,,3094.15,95,,percent of total billed charges,,,2931.3,90,,percent of total billed charges,,,2931.3,90,,percent of total billed charges,,,2670.74,82,,percent of total billed charges,,,2931.3,90,,percent of total billed charges,,,2768.45,85,,percent of total billed charges,,2455.78,3094.15,
CT ABDOMINAL BIOPSY,29100104,CDM,49180,CPT,361,RC,inpatient,TC,3040,3040,,2580.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2292.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2584,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2675.2,88,,percent of total billed charges,,,,,,,,,2322.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2766.4,91,,percent of total billed charges,,,2888,95,,percent of total billed charges,,,2523.2,83,,percent of total billed charges,,,2523.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2523.2,83,,percent of total billed charges,,,2888,95,,percent of total billed charges,,,2736,90,,percent of total billed charges,,,2736,90,,percent of total billed charges,,,2492.8,82,,percent of total billed charges,,,2736,90,,percent of total billed charges,,,2584,85,,percent of total billed charges,,2292.16,2888,
CT RENAL BIOPSY PERQ,29100105,CDM,50200,CPT,352,RC,inpatient,TC,3440,3440,,2920.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2593.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2924,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3027.2,88,,percent of total billed charges,,,,,,,,,2628.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3130.4,91,,percent of total billed charges,,,3268,95,,percent of total billed charges,,,2855.2,83,,percent of total billed charges,,,2855.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2855.2,83,,percent of total billed charges,,,3268,95,,percent of total billed charges,,,3096,90,,percent of total billed charges,,,3096,90,,percent of total billed charges,,,2820.8,82,,percent of total billed charges,,,3096,90,,percent of total billed charges,,,2924,85,,percent of total billed charges,,2593.76,3268,
CT SOFT TISSUE (DEEP) BIOPSY,29100106,CDM,27041,CPT,352,RC,inpatient,TC,4531,4531,,3846.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3416.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3851.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3987.28,88,,percent of total billed charges,,,,,,,,,3461.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4123.21,91,,percent of total billed charges,,,4304.45,95,,percent of total billed charges,,,3760.73,83,,percent of total billed charges,,,3760.73,83,,percent of total billed charges,,,,,,,,,,,,,,,3760.73,83,,percent of total billed charges,,,4304.45,95,,percent of total billed charges,,,4077.9,90,,percent of total billed charges,,,4077.9,90,,percent of total billed charges,,,3715.42,82,,percent of total billed charges,,,4077.9,90,,percent of total billed charges,,,3851.35,85,,percent of total billed charges,,3416.37,4304.45,
CT THORAX W/DYE,29100199,CDM,71260,CPT,352,RC,inpatient,TC,4379,4379,,3717.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3301.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3722.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3853.52,88,,percent of total billed charges,,,,,,,,,3345.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3984.89,91,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,,,,,,,,,,,,,3634.57,83,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3590.78,82,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,3301.77,4160.05,
CT THORAX W/DYE PE,29100200,CDM,71260,CPT,352,RC,inpatient,TC,4379,4379,,3717.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3301.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3722.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3853.52,88,,percent of total billed charges,,,,,,,,,3345.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3984.89,91,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,,,,,,,,,,,,,3634.57,83,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3590.78,82,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,3301.77,4160.05,
CT STONE (ABD/PELV W/O),29100201,CDM,74176,CPT,352,RC,inpatient,TC,6170,6170,,5238.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4652.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5244.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5429.6,88,,percent of total billed charges,,,,,,,,,4713.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5614.7,91,,percent of total billed charges,,,5861.5,95,,percent of total billed charges,,,5121.1,83,,percent of total billed charges,,,5121.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5121.1,83,,percent of total billed charges,,,5861.5,95,,percent of total billed charges,,,5553,90,,percent of total billed charges,,,5553,90,,percent of total billed charges,,,5059.4,82,,percent of total billed charges,,,5553,90,,percent of total billed charges,,,5244.5,85,,percent of total billed charges,,4652.18,5861.5,
CT ABD/PELV W/WO,29100203,CDM,74178,CPT,352,RC,inpatient,TC,8550,8550,,7258.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6446.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7267.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7524,88,,percent of total billed charges,,,,,,,,,6532.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7780.5,91,,percent of total billed charges,,,8122.5,95,,percent of total billed charges,,,7096.5,83,,percent of total billed charges,,,7096.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7096.5,83,,percent of total billed charges,,,8122.5,95,,percent of total billed charges,,,7695,90,,percent of total billed charges,,,7695,90,,percent of total billed charges,,,7011,82,,percent of total billed charges,,,7695,90,,percent of total billed charges,,,7267.5,85,,percent of total billed charges,,6446.7,8122.5,
CT ABD/PELV WITH,29100205,CDM,74177,CPT,352,RC,inpatient,TC,7335,7335,,6227.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5530.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6234.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6454.8,88,,percent of total billed charges,,,,,,,,,5603.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6674.85,91,,percent of total billed charges,,,6968.25,95,,percent of total billed charges,,,6088.05,83,,percent of total billed charges,,,6088.05,83,,percent of total billed charges,,,,,,,,,,,,,,,6088.05,83,,percent of total billed charges,,,6968.25,95,,percent of total billed charges,,,6601.5,90,,percent of total billed charges,,,6601.5,90,,percent of total billed charges,,,6014.7,82,,percent of total billed charges,,,6601.5,90,,percent of total billed charges,,,6234.75,85,,percent of total billed charges,,5530.59,6968.25,
CT ABD/PELV W/O,29100206,CDM,74176,CPT,352,RC,inpatient,TC,6170,6170,,5238.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4652.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5244.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5429.6,88,,percent of total billed charges,,,,,,,,,4713.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5614.7,91,,percent of total billed charges,,,5861.5,95,,percent of total billed charges,,,5121.1,83,,percent of total billed charges,,,5121.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5121.1,83,,percent of total billed charges,,,5861.5,95,,percent of total billed charges,,,5553,90,,percent of total billed charges,,,5553,90,,percent of total billed charges,,,5059.4,82,,percent of total billed charges,,,5553,90,,percent of total billed charges,,,5244.5,85,,percent of total billed charges,,4652.18,5861.5,
CT UROGRAM,29100207,CDM,74178,CPT,352,RC,inpatient,TC,8550,8550,,7258.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6446.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7267.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7524,88,,percent of total billed charges,,,,,,,,,6532.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7780.5,91,,percent of total billed charges,,,8122.5,95,,percent of total billed charges,,,7096.5,83,,percent of total billed charges,,,7096.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7096.5,83,,percent of total billed charges,,,8122.5,95,,percent of total billed charges,,,7695,90,,percent of total billed charges,,,7695,90,,percent of total billed charges,,,7011,82,,percent of total billed charges,,,7695,90,,percent of total billed charges,,,7267.5,85,,percent of total billed charges,,6446.7,8122.5,
CT SELLA W/,29100300,CDM,70481,CPT,350,RC,inpatient,,3751,3751,,3184.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2828.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3188.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3300.88,88,,percent of total billed charges,,,,,,,,,2865.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3413.41,91,,percent of total billed charges,,,3563.45,95,,percent of total billed charges,,,3113.33,83,,percent of total billed charges,,,3113.33,83,,percent of total billed charges,,,,,,,,,,,,,,,3113.33,83,,percent of total billed charges,,,3563.45,95,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3075.82,82,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3188.35,85,,percent of total billed charges,,2828.25,3563.45,
CT SELLA W/WO,29100301,CDM,70482,CPT,350,RC,inpatient,,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3310.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3732.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,3310.81,4171.45,
CT SELLA W/O,29100302,CDM,70480,CPT,350,RC,inpatient,TC,3397,3397,,2884.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2561.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2887.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2989.36,88,,percent of total billed charges,,,,,,,,,2595.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3091.27,91,,percent of total billed charges,,,3227.15,95,,percent of total billed charges,,,2819.51,83,,percent of total billed charges,,,2819.51,83,,percent of total billed charges,,,,,,,,,,,,,,,2819.51,83,,percent of total billed charges,,,3227.15,95,,percent of total billed charges,,,3057.3,90,,percent of total billed charges,,,3057.3,90,,percent of total billed charges,,,2785.54,82,,percent of total billed charges,,,3057.3,90,,percent of total billed charges,,,2887.45,85,,percent of total billed charges,,2561.34,3227.15,
CT C SPINE W/,29100479,CDM,72126,CPT,352,RC,inpatient,,4379,4379,,3717.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3301.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3722.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3853.52,88,,percent of total billed charges,,,,,,,,,3345.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3984.89,91,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,,,,,,,,,,,,,3634.57,83,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3590.78,82,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,3301.77,4160.05,
CT LOW EXT W LT,29100495,CDM,73701,CPT,350,RC,inpatient,,3869,3869,,3284.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2917.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3288.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3404.72,88,,percent of total billed charges,,,,,,,,,2955.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3520.79,91,,percent of total billed charges,,,3675.55,95,,percent of total billed charges,,,3211.27,83,,percent of total billed charges,,,3211.27,83,,percent of total billed charges,,,,,,,,,,,,,,,3211.27,83,,percent of total billed charges,,,3675.55,95,,percent of total billed charges,,,3482.1,90,,percent of total billed charges,,,3482.1,90,,percent of total billed charges,,,3172.58,82,,percent of total billed charges,,,3482.1,90,,percent of total billed charges,,,3288.65,85,,percent of total billed charges,,2917.23,3675.55,
CT LOW EXT W RT,29100496,CDM,73701,CPT,350,RC,inpatient,,3869,3869,,3284.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2917.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3288.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3404.72,88,,percent of total billed charges,,,,,,,,,2955.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3520.79,91,,percent of total billed charges,,,3675.55,95,,percent of total billed charges,,,3211.27,83,,percent of total billed charges,,,3211.27,83,,percent of total billed charges,,,,,,,,,,,,,,,3211.27,83,,percent of total billed charges,,,3675.55,95,,percent of total billed charges,,,3482.1,90,,percent of total billed charges,,,3482.1,90,,percent of total billed charges,,,3172.58,82,,percent of total billed charges,,,3482.1,90,,percent of total billed charges,,,3288.65,85,,percent of total billed charges,,2917.23,3675.55,
CT LOW EXT W/WO LEFT,29100511,CDM,73702,CPT,350,RC,inpatient,LT,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3310.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3732.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,3310.81,4171.45,
CT LOW EXT W/WO RIGHT,29100512,CDM,73702,CPT,350,RC,inpatient,RT,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3310.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3732.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,3310.81,4171.45,
CTA LOW EXT RT W/WO/REPROC,29100513,CDM,73706,CPT,350,RC,inpatient,RT,5225,5225,,4436.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3939.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4441.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4598,88,,percent of total billed charges,,,,,,,,,3991.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4754.75,91,,percent of total billed charges,,,4963.75,95,,percent of total billed charges,,,4336.75,83,,percent of total billed charges,,,4336.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4336.75,83,,percent of total billed charges,,,4963.75,95,,percent of total billed charges,,,4702.5,90,,percent of total billed charges,,,4702.5,90,,percent of total billed charges,,,4284.5,82,,percent of total billed charges,,,4702.5,90,,percent of total billed charges,,,4441.25,85,,percent of total billed charges,,3939.65,4963.75,
CTA LOW EXT LT W/WO/REPROC,29100514,CDM,73706,CPT,350,RC,inpatient,LT,5225,5225,,4436.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3939.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4441.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4598,88,,percent of total billed charges,,,,,,,,,3991.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4754.75,91,,percent of total billed charges,,,4963.75,95,,percent of total billed charges,,,4336.75,83,,percent of total billed charges,,,4336.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4336.75,83,,percent of total billed charges,,,4963.75,95,,percent of total billed charges,,,4702.5,90,,percent of total billed charges,,,4702.5,90,,percent of total billed charges,,,4284.5,82,,percent of total billed charges,,,4702.5,90,,percent of total billed charges,,,4441.25,85,,percent of total billed charges,,3939.65,4963.75,
CTA LOW EXTBILATW/WO/REPRC,29100515,CDM,73706,CPT,350,RC,inpatient,50,10449,10449,,8871.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7878.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8881.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9195.12,88,,percent of total billed charges,,,,,,,,,7983.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9508.59,91,,percent of total billed charges,,,9926.55,95,,percent of total billed charges,,,8672.67,83,,percent of total billed charges,,,8672.67,83,,percent of total billed charges,,,,,,,,,,,,,,,8672.67,83,,percent of total billed charges,,,9926.55,95,,percent of total billed charges,,,9404.1,90,,percent of total billed charges,,,9404.1,90,,percent of total billed charges,,,8568.18,82,,percent of total billed charges,,,9404.1,90,,percent of total billed charges,,,8881.65,85,,percent of total billed charges,,7878.55,9926.55,
CTA ABD (W OR W/O),29100516,CDM,74175,CPT,350,RC,inpatient,TC,6339,6339,,5381.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4779.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5388.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5578.32,88,,percent of total billed charges,,,,,,,,,4843,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5768.49,91,,percent of total billed charges,,,6022.05,95,,percent of total billed charges,,,5261.37,83,,percent of total billed charges,,,5261.37,83,,percent of total billed charges,,,,,,,,,,,,,,,5261.37,83,,percent of total billed charges,,,6022.05,95,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5197.98,82,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5388.15,85,,percent of total billed charges,,4779.61,6022.05,
CTA CHEST W/WO/REPROC,29100517,CDM,71275,CPT,350,RC,inpatient,TC,6339,6339,,5381.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4779.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5388.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5578.32,88,,percent of total billed charges,,,,,,,,,4843,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5768.49,91,,percent of total billed charges,,,6022.05,95,,percent of total billed charges,,,5261.37,83,,percent of total billed charges,,,5261.37,83,,percent of total billed charges,,,,,,,,,,,,,,,5261.37,83,,percent of total billed charges,,,6022.05,95,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5197.98,82,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5388.15,85,,percent of total billed charges,,4779.61,6022.05,
CTA RUNOFAORTA/LEGSW/WOREP,29100518,CDM,75635,CPT,350,RC,inpatient,TC,6339,6339,,5381.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4779.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5388.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5578.32,88,,percent of total billed charges,,,,,,,,,4843,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5768.49,91,,percent of total billed charges,,,6022.05,95,,percent of total billed charges,,,5261.37,83,,percent of total billed charges,,,5261.37,83,,percent of total billed charges,,,,,,,,,,,,,,,5261.37,83,,percent of total billed charges,,,6022.05,95,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5197.98,82,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5388.15,85,,percent of total billed charges,,4779.61,6022.05,
CTA PELV W/WO/REPROC,29100519,CDM,72191,CPT,350,RC,inpatient,TC,6354,6354,,5394.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4790.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5400.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5591.52,88,,percent of total billed charges,,,,,,,,,4854.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5782.14,91,,percent of total billed charges,,,6036.3,95,,percent of total billed charges,,,5273.82,83,,percent of total billed charges,,,5273.82,83,,percent of total billed charges,,,,,,,,,,,,,,,5273.82,83,,percent of total billed charges,,,6036.3,95,,percent of total billed charges,,,5718.6,90,,percent of total billed charges,,,5718.6,90,,percent of total billed charges,,,5210.28,82,,percent of total billed charges,,,5718.6,90,,percent of total billed charges,,,5400.9,85,,percent of total billed charges,,4790.92,6036.3,
CTA UP EXT BIL W/WO/REPROC,29100520,CDM,73206,CPT,350,RC,inpatient,TC,6354,6354,,5394.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4790.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5400.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5591.52,88,,percent of total billed charges,,,,,,,,,4854.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5782.14,91,,percent of total billed charges,,,6036.3,95,,percent of total billed charges,,,5273.82,83,,percent of total billed charges,,,5273.82,83,,percent of total billed charges,,,,,,,,,,,,,,,5273.82,83,,percent of total billed charges,,,6036.3,95,,percent of total billed charges,,,5718.6,90,,percent of total billed charges,,,5718.6,90,,percent of total billed charges,,,5210.28,82,,percent of total billed charges,,,5718.6,90,,percent of total billed charges,,,5400.9,85,,percent of total billed charges,,4790.92,6036.3,
*DNU CTA NECK/CAROTID W/WO/REPROC PFA),29100522,CDM,70498,CPT,351,RC,inpatient,TC,3736,3736,,3171.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2816.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3175.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3287.68,88,,percent of total billed charges,,,,,,,,,2854.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3399.76,91,,percent of total billed charges,,,3549.2,95,,percent of total billed charges,,,3100.88,83,,percent of total billed charges,,,3100.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3100.88,83,,percent of total billed charges,,,3549.2,95,,percent of total billed charges,,,3362.4,90,,percent of total billed charges,,,3362.4,90,,percent of total billed charges,,,3063.52,82,,percent of total billed charges,,,3362.4,90,,percent of total billed charges,,,3175.6,85,,percent of total billed charges,,2816.94,3549.2,
CTA ABD&PELV W/O&W/DYE,29100523,CDM,74174,CPT,350,RC,inpatient,TC,7012,7012,,5953.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5287.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5960.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6170.56,88,,percent of total billed charges,,,,,,,,,5357.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6380.92,91,,percent of total billed charges,,,6661.4,95,,percent of total billed charges,,,5819.96,83,,percent of total billed charges,,,5819.96,83,,percent of total billed charges,,,,,,,,,,,,,,,5819.96,83,,percent of total billed charges,,,6661.4,95,,percent of total billed charges,,,6310.8,90,,percent of total billed charges,,,6310.8,90,,percent of total billed charges,,,5749.84,82,,percent of total billed charges,,,6310.8,90,,percent of total billed charges,,,5960.2,85,,percent of total billed charges,,5287.05,6661.4,
CTA NECK/CAROTIDW/WO/REPRC,29100600,CDM,70498,CPT,351,RC,inpatient,TC,5789,5789,,4914.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4364.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4920.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5094.32,88,,percent of total billed charges,,,,,,,,,4422.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5267.99,91,,percent of total billed charges,,,5499.55,95,,percent of total billed charges,,,4804.87,83,,percent of total billed charges,,,4804.87,83,,percent of total billed charges,,,,,,,,,,,,,,,4804.87,83,,percent of total billed charges,,,5499.55,95,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,4746.98,82,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,4920.65,85,,percent of total billed charges,,4364.91,5499.55,
CTA HEAD(COW)W/WO/REPROC,29100601,CDM,70496,CPT,351,RC,inpatient,TC,5789,5789,,4914.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4364.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4920.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5094.32,88,,percent of total billed charges,,,,,,,,,4422.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5267.99,91,,percent of total billed charges,,,5499.55,95,,percent of total billed charges,,,4804.87,83,,percent of total billed charges,,,4804.87,83,,percent of total billed charges,,,,,,,,,,,,,,,4804.87,83,,percent of total billed charges,,,5499.55,95,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,4746.98,82,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,4920.65,85,,percent of total billed charges,,4364.91,5499.55,
CTA HEAD/NECK/CAROTID W W/O REPROCESSING,29100602,CDM,70498,CPT,351,RC,inpatient,TC,5789,5789,,4914.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4364.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4920.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5094.32,88,,percent of total billed charges,,,,,,,,,4422.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5267.99,91,,percent of total billed charges,,,5499.55,95,,percent of total billed charges,,,4804.87,83,,percent of total billed charges,,,4804.87,83,,percent of total billed charges,,,,,,,,,,,,,,,4804.87,83,,percent of total billed charges,,,5499.55,95,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,4746.98,82,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,4920.65,85,,percent of total billed charges,,4364.91,5499.55,
CT UP EXT LT W/WO,29100644,CDM,73202,CPT,350,RC,inpatient,,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3310.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3732.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,3310.81,4171.45,
CT UP EXT RT W/WO,29100645,CDM,73202,CPT,350,RC,inpatient,,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3310.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3732.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,3310.81,4171.45,
CT HEAD W/WO,29100909,CDM,70470,CPT,351,RC,inpatient,TC,4437,4437,,3767.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3345.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3771.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3904.56,88,,percent of total billed charges,,,,,,,,,3389.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4037.67,91,,percent of total billed charges,,,4215.15,95,,percent of total billed charges,,,3682.71,83,,percent of total billed charges,,,3682.71,83,,percent of total billed charges,,,,,,,,,,,,,,,3682.71,83,,percent of total billed charges,,,4215.15,95,,percent of total billed charges,,,3993.3,90,,percent of total billed charges,,,3993.3,90,,percent of total billed charges,,,3638.34,82,,percent of total billed charges,,,3993.3,90,,percent of total billed charges,,,3771.45,85,,percent of total billed charges,,3345.5,4215.15,
CT C SPINE W/O,29100990,CDM,72125,CPT,352,RC,inpatient,TC,3830,3830,,3251.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2887.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3255.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3370.4,88,,percent of total billed charges,,,,,,,,,2926.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3485.3,91,,percent of total billed charges,,,3638.5,95,,percent of total billed charges,,,3178.9,83,,percent of total billed charges,,,3178.9,83,,percent of total billed charges,,,,,,,,,,,,,,,3178.9,83,,percent of total billed charges,,,3638.5,95,,percent of total billed charges,,,3447,90,,percent of total billed charges,,,3447,90,,percent of total billed charges,,,3140.6,82,,percent of total billed charges,,,3447,90,,percent of total billed charges,,,3255.5,85,,percent of total billed charges,,2887.82,3638.5,
CT FACIAL BONES W/O,29101121,CDM,70486,CPT,351,RC,inpatient,TC,3616,3616,,3069.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2726.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3073.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3182.08,88,,percent of total billed charges,,,,,,,,,2762.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3290.56,91,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,,,,,,,,,,,,,3001.28,83,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,2965.12,82,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3073.6,85,,percent of total billed charges,,2726.46,3435.2,
CT FACIAL BONES W/,29101122,CDM,70487,CPT,350,RC,inpatient,TC,3751,3751,,3184.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2828.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3188.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3300.88,88,,percent of total billed charges,,,,,,,,,2865.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3413.41,91,,percent of total billed charges,,,3563.45,95,,percent of total billed charges,,,3113.33,83,,percent of total billed charges,,,3113.33,83,,percent of total billed charges,,,,,,,,,,,,,,,3113.33,83,,percent of total billed charges,,,3563.45,95,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3075.82,82,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3188.35,85,,percent of total billed charges,,2828.25,3563.45,
CT FACIAL BONES W/WO,29101123,CDM,70488,CPT,350,RC,inpatient,,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3310.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3732.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,3310.81,4171.45,
CT T SPINE W/O,29101220,CDM,72128,CPT,352,RC,inpatient,TC,3655,3655,,3103.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2755.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3106.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3216.4,88,,percent of total billed charges,,,,,,,,,2792.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3326.05,91,,percent of total billed charges,,,3472.25,95,,percent of total billed charges,,,3033.65,83,,percent of total billed charges,,,3033.65,83,,percent of total billed charges,,,,,,,,,,,,,,,3033.65,83,,percent of total billed charges,,,3472.25,95,,percent of total billed charges,,,3289.5,90,,percent of total billed charges,,,3289.5,90,,percent of total billed charges,,,2997.1,82,,percent of total billed charges,,,3289.5,90,,percent of total billed charges,,,3106.75,85,,percent of total billed charges,,2755.87,3472.25,
CT LTD OR FOLLOW-UP,29101386,CDM,76380,CPT,350,RC,inpatient,TC,2427,2427,,2060.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1829.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2062.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2135.76,88,,percent of total billed charges,,,,,,,,,1854.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2208.57,91,,percent of total billed charges,,,2305.65,95,,percent of total billed charges,,,2014.41,83,,percent of total billed charges,,,2014.41,83,,percent of total billed charges,,,,,,,,,,,,,,,2014.41,83,,percent of total billed charges,,,2305.65,95,,percent of total billed charges,,,2184.3,90,,percent of total billed charges,,,2184.3,90,,percent of total billed charges,,,1990.14,82,,percent of total billed charges,,,2184.3,90,,percent of total billed charges,,,2062.95,85,,percent of total billed charges,,1829.96,2305.65,
CT 3D RENDERING,29101395,CDM,76376,CPT,350,RC,inpatient,TC,1339,1339,,1136.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1009.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1138.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1178.32,88,,percent of total billed charges,,,,,,,,,1023,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1218.49,91,,percent of total billed charges,,,1272.05,95,,percent of total billed charges,,,1111.37,83,,percent of total billed charges,,,1111.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1111.37,83,,percent of total billed charges,,,1272.05,95,,percent of total billed charges,,,1205.1,90,,percent of total billed charges,,,1205.1,90,,percent of total billed charges,,,1097.98,82,,percent of total billed charges,,,1205.1,90,,percent of total billed charges,,,1138.15,85,,percent of total billed charges,,1009.61,1272.05,
CT IAC W/WO,29101428,CDM,70482,CPT,351,RC,inpatient,,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3310.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3732.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,3310.81,4171.45,
CT IAC W/,29101436,CDM,70481,CPT,351,RC,inpatient,,3857,3857,,3274.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2908.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3278.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3394.16,88,,percent of total billed charges,,,,,,,,,2946.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3509.87,91,,percent of total billed charges,,,3664.15,95,,percent of total billed charges,,,3201.31,83,,percent of total billed charges,,,3201.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3201.31,83,,percent of total billed charges,,,3664.15,95,,percent of total billed charges,,,3471.3,90,,percent of total billed charges,,,3471.3,90,,percent of total billed charges,,,3162.74,82,,percent of total billed charges,,,3471.3,90,,percent of total billed charges,,,3278.45,85,,percent of total billed charges,,2908.18,3664.15,
CT TEMPORAL BONES W/,29101437,CDM,70481,CPT,351,RC,inpatient,,3751,3751,,3184.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2828.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3188.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3300.88,88,,percent of total billed charges,,,,,,,,,2865.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3413.41,91,,percent of total billed charges,,,3563.45,95,,percent of total billed charges,,,3113.33,83,,percent of total billed charges,,,3113.33,83,,percent of total billed charges,,,,,,,,,,,,,,,3113.33,83,,percent of total billed charges,,,3563.45,95,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3075.82,82,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3188.35,85,,percent of total billed charges,,2828.25,3563.45,
CT TEMPORAL BONES W/WO,29101438,CDM,70482,CPT,351,RC,inpatient,,4379,4379,,3717.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3301.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3722.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3853.52,88,,percent of total billed charges,,,,,,,,,3345.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3984.89,91,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,,,,,,,,,,,,,3634.57,83,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3590.78,82,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,3301.77,4160.05,
CT TEMPORAL BONES W/O,29101439,CDM,70480,CPT,351,RC,inpatient,TC,3388,3388,,2876.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2554.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2879.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2981.44,88,,percent of total billed charges,,,,,,,,,2588.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3083.08,91,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,,,,,,,,,,,,,2812.04,83,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2778.16,82,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,2554.55,3218.6,
CT INJ TRANSFORAMINAL EPIDURAL C/T SINGL,29101950,CDM,64479,CPT,360,RC,inpatient,TC,3928,3928,,3334.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2961.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3338.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3456.64,88,,percent of total billed charges,,,,,,,,,3000.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3574.48,91,,percent of total billed charges,,,3731.6,95,,percent of total billed charges,,,3260.24,83,,percent of total billed charges,,,3260.24,83,,percent of total billed charges,,,,,,,,,,,,,,,3260.24,83,,percent of total billed charges,,,3731.6,95,,percent of total billed charges,,,3535.2,90,,percent of total billed charges,,,3535.2,90,,percent of total billed charges,,,3220.96,82,,percent of total billed charges,,,3535.2,90,,percent of total billed charges,,,3338.8,85,,percent of total billed charges,,2961.71,3731.6,
CT INJ TRANSFORAMINAL EPIDURAL C/T EACH,29101951,CDM,64480,CPT,360,RC,inpatient,TC,2387,2387,,2026.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1799.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2028.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2100.56,88,,percent of total billed charges,,,,,,,,,1823.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2172.17,91,,percent of total billed charges,,,2267.65,95,,percent of total billed charges,,,1981.21,83,,percent of total billed charges,,,1981.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1981.21,83,,percent of total billed charges,,,2267.65,95,,percent of total billed charges,,,2148.3,90,,percent of total billed charges,,,2148.3,90,,percent of total billed charges,,,1957.34,82,,percent of total billed charges,,,2148.3,90,,percent of total billed charges,,,2028.95,85,,percent of total billed charges,,1799.8,2267.65,
CT ASPIRATION & INJECTION KIDNEY CYST,29101980,CDM,50390,CPT,360,RC,inpatient,TC,3212,3212,,2726.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2421.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2730.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2826.56,88,,percent of total billed charges,,,,,,,,,2453.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2922.92,91,,percent of total billed charges,,,3051.4,95,,percent of total billed charges,,,2665.96,83,,percent of total billed charges,,,2665.96,83,,percent of total billed charges,,,,,,,,,,,,,,,2665.96,83,,percent of total billed charges,,,3051.4,95,,percent of total billed charges,,,2890.8,90,,percent of total billed charges,,,2890.8,90,,percent of total billed charges,,,2633.84,82,,percent of total billed charges,,,2890.8,90,,percent of total billed charges,,,2730.2,85,,percent of total billed charges,,2421.85,3051.4,
CT GUIDED ASPIRATION/INJ BONE CYST,29101981,CDM,20615,CPT,360,RC,inpatient,TC,4261,4261,,3617.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3212.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3621.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3749.68,88,,percent of total billed charges,,,,,,,,,3255.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3877.51,91,,percent of total billed charges,,,4047.95,95,,percent of total billed charges,,,3536.63,83,,percent of total billed charges,,,3536.63,83,,percent of total billed charges,,,,,,,,,,,,,,,3536.63,83,,percent of total billed charges,,,4047.95,95,,percent of total billed charges,,,3834.9,90,,percent of total billed charges,,,3834.9,90,,percent of total billed charges,,,3494.02,82,,percent of total billed charges,,,3834.9,90,,percent of total billed charges,,,3621.85,85,,percent of total billed charges,,3212.79,4047.95,
CT FACET INJ C/T,29101982,CDM,64490,CPT,360,RC,inpatient,TC,3545,3545,,3009.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2672.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3013.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3119.6,88,,percent of total billed charges,,,,,,,,,2708.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3225.95,91,,percent of total billed charges,,,3367.75,95,,percent of total billed charges,,,2942.35,83,,percent of total billed charges,,,2942.35,83,,percent of total billed charges,,,,,,,,,,,,,,,2942.35,83,,percent of total billed charges,,,3367.75,95,,percent of total billed charges,,,3190.5,90,,percent of total billed charges,,,3190.5,90,,percent of total billed charges,,,2906.9,82,,percent of total billed charges,,,3190.5,90,,percent of total billed charges,,,3013.25,85,,percent of total billed charges,,2672.93,3367.75,
CT PUDENDAL NERVE BLOCK,29101983,CDM,64430,CPT,360,RC,inpatient,TC,4178,4178,,3547.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3150.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3551.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3676.64,88,,percent of total billed charges,,,,,,,,,3191.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3801.98,91,,percent of total billed charges,,,3969.1,95,,percent of total billed charges,,,3467.74,83,,percent of total billed charges,,,3467.74,83,,percent of total billed charges,,,,,,,,,,,,,,,3467.74,83,,percent of total billed charges,,,3969.1,95,,percent of total billed charges,,,3760.2,90,,percent of total billed charges,,,3760.2,90,,percent of total billed charges,,,3425.96,82,,percent of total billed charges,,,3760.2,90,,percent of total billed charges,,,3551.3,85,,percent of total billed charges,,3150.21,3969.1,
CT OCCIPITAL NERVE INJECTION,29101984,CDM,64405,CPT,360,RC,inpatient,TC,2116,2116,,1796.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1595.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1798.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1862.08,88,,percent of total billed charges,,,,,,,,,1616.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1925.56,91,,percent of total billed charges,,,2010.2,95,,percent of total billed charges,,,1756.28,83,,percent of total billed charges,,,1756.28,83,,percent of total billed charges,,,,,,,,,,,,,,,1756.28,83,,percent of total billed charges,,,2010.2,95,,percent of total billed charges,,,1904.4,90,,percent of total billed charges,,,1904.4,90,,percent of total billed charges,,,1735.12,82,,percent of total billed charges,,,1904.4,90,,percent of total billed charges,,,1798.6,85,,percent of total billed charges,,1595.46,2010.2,
CT PARACERVICAL NERVE BLOCK,29101985,CDM,64435,CPT,360,RC,inpatient,TC,4249,4249,,3607.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3203.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3611.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3739.12,88,,percent of total billed charges,,,,,,,,,3246.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3866.59,91,,percent of total billed charges,,,4036.55,95,,percent of total billed charges,,,3526.67,83,,percent of total billed charges,,,3526.67,83,,percent of total billed charges,,,,,,,,,,,,,,,3526.67,83,,percent of total billed charges,,,4036.55,95,,percent of total billed charges,,,3824.1,90,,percent of total billed charges,,,3824.1,90,,percent of total billed charges,,,3484.18,82,,percent of total billed charges,,,3824.1,90,,percent of total billed charges,,,3611.65,85,,percent of total billed charges,,3203.75,4036.55,
CT CRYO ABLATION RENAL TUMOR,29101990,CDM,50593,CPT,359,RC,inpatient,TC,17488,17488,,14847.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13185.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14864.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15389.44,88,,percent of total billed charges,,,,,,,,,13360.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15914.08,91,,percent of total billed charges,,,16613.6,95,,percent of total billed charges,,,14515.04,83,,percent of total billed charges,,,14515.04,83,,percent of total billed charges,,,,,,,,,,,,,,,14515.04,83,,percent of total billed charges,,,16613.6,95,,percent of total billed charges,,,15739.2,90,,percent of total billed charges,,,15739.2,90,,percent of total billed charges,,,14340.16,82,,percent of total billed charges,,,15739.2,90,,percent of total billed charges,,,14864.8,85,,percent of total billed charges,,13185.95,16613.6,
CT CHANGE OF PERC DRAIN CATH,29101993,CDM,75984,CPT,359,RC,inpatient,TC,4405,4405,,3739.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3321.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3744.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3876.4,88,,percent of total billed charges,,,,,,,,,3365.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4008.55,91,,percent of total billed charges,,,4184.75,95,,percent of total billed charges,,,3656.15,83,,percent of total billed charges,,,3656.15,83,,percent of total billed charges,,,,,,,,,,,,,,,3656.15,83,,percent of total billed charges,,,4184.75,95,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3612.1,82,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3744.25,85,,percent of total billed charges,,3321.37,4184.75,
CT ESI C/T SPINE,29101994,CDM,62321,CPT,360,RC,inpatient,TC,4678,4678,,3971.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3527.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3976.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4116.64,88,,percent of total billed charges,,,,,,,,,3573.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4256.98,91,,percent of total billed charges,,,4444.1,95,,percent of total billed charges,,,3882.74,83,,percent of total billed charges,,,3882.74,83,,percent of total billed charges,,,,,,,,,,,,,,,3882.74,83,,percent of total billed charges,,,4444.1,95,,percent of total billed charges,,,4210.2,90,,percent of total billed charges,,,4210.2,90,,percent of total billed charges,,,3835.96,82,,percent of total billed charges,,,4210.2,90,,percent of total billed charges,,,3976.3,85,,percent of total billed charges,,3527.21,4444.1,
CT NEEDLE PLACEMENT CT GUIDANCE,29101995,CDM,77012,CPT,359,RC,inpatient,TC,4527,4527,,3843.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3413.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3847.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3983.76,88,,percent of total billed charges,,,,,,,,,3458.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4119.57,91,,percent of total billed charges,,,4300.65,95,,percent of total billed charges,,,3757.41,83,,percent of total billed charges,,,3757.41,83,,percent of total billed charges,,,,,,,,,,,,,,,3757.41,83,,percent of total billed charges,,,4300.65,95,,percent of total billed charges,,,4074.3,90,,percent of total billed charges,,,4074.3,90,,percent of total billed charges,,,3712.14,82,,percent of total billed charges,,,4074.3,90,,percent of total billed charges,,,3847.95,85,,percent of total billed charges,,3413.36,4300.65,
CT GUIDE PERC DRAIN W/CATH,29101996,CDM,75989,CPT,359,RC,inpatient,TC,4405,4405,,3739.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3321.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3744.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3876.4,88,,percent of total billed charges,,,,,,,,,3365.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4008.55,91,,percent of total billed charges,,,4184.75,95,,percent of total billed charges,,,3656.15,83,,percent of total billed charges,,,3656.15,83,,percent of total billed charges,,,,,,,,,,,,,,,3656.15,83,,percent of total billed charges,,,4184.75,95,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3612.1,82,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3744.25,85,,percent of total billed charges,,3321.37,4184.75,
* DNU CT GUIDE NEEDLE BX(V0107),29101998,CDM,76360,CPT,359,RC,inpatient,,4405,4405,,3739.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3321.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3744.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3876.4,88,,percent of total billed charges,,,,,,,,,3365.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4008.55,91,,percent of total billed charges,,,4184.75,95,,percent of total billed charges,,,3656.15,83,,percent of total billed charges,,,3656.15,83,,percent of total billed charges,,,,,,,,,,,,,,,3656.15,83,,percent of total billed charges,,,4184.75,95,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3612.1,82,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3744.25,85,,percent of total billed charges,,3321.37,4184.75,
CT DRAINAGE OF OVARIAN CYST,29102000,CDM,49407,CPT,360,RC,inpatient,TC,6924,6924,,5878.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5220.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5885.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6093.12,88,,percent of total billed charges,,,,,,,,,5289.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6300.84,91,,percent of total billed charges,,,6577.8,95,,percent of total billed charges,,,5746.92,83,,percent of total billed charges,,,5746.92,83,,percent of total billed charges,,,,,,,,,,,,,,,5746.92,83,,percent of total billed charges,,,6577.8,95,,percent of total billed charges,,,6231.6,90,,percent of total billed charges,,,6231.6,90,,percent of total billed charges,,,5677.68,82,,percent of total billed charges,,,6231.6,90,,percent of total billed charges,,,5885.4,85,,percent of total billed charges,,5220.7,6577.8,
CT HEAD W/O,29102004,CDM,70450,CPT,351,RC,inpatient,TC,3784,3784,,3212.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2853.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3216.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3329.92,88,,percent of total billed charges,,,,,,,,,2890.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3443.44,91,,percent of total billed charges,,,3594.8,95,,percent of total billed charges,,,3140.72,83,,percent of total billed charges,,,3140.72,83,,percent of total billed charges,,,,,,,,,,,,,,,3140.72,83,,percent of total billed charges,,,3594.8,95,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3102.88,82,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3216.4,85,,percent of total billed charges,,2853.14,3594.8,
CT HEAD W/,29102020,CDM,70460,CPT,351,RC,inpatient,TC,3908,3908,,3317.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2946.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3321.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3439.04,88,,percent of total billed charges,,,,,,,,,2985.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3556.28,91,,percent of total billed charges,,,3712.6,95,,percent of total billed charges,,,3243.64,83,,percent of total billed charges,,,3243.64,83,,percent of total billed charges,,,,,,,,,,,,,,,3243.64,83,,percent of total billed charges,,,3712.6,95,,percent of total billed charges,,,3517.2,90,,percent of total billed charges,,,3517.2,90,,percent of total billed charges,,,3204.56,82,,percent of total billed charges,,,3517.2,90,,percent of total billed charges,,,3321.8,85,,percent of total billed charges,,2946.63,3712.6,
CT ORBIT W/O,29102038,CDM,70480,CPT,351,RC,inpatient,TC,3358,3358,,2850.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2531.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2854.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2955.04,88,,percent of total billed charges,,,,,,,,,2565.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3055.78,91,,percent of total billed charges,,,3190.1,95,,percent of total billed charges,,,2787.14,83,,percent of total billed charges,,,2787.14,83,,percent of total billed charges,,,,,,,,,,,,,,,2787.14,83,,percent of total billed charges,,,3190.1,95,,percent of total billed charges,,,3022.2,90,,percent of total billed charges,,,3022.2,90,,percent of total billed charges,,,2753.56,82,,percent of total billed charges,,,3022.2,90,,percent of total billed charges,,,2854.3,85,,percent of total billed charges,,2531.93,3190.1,
CT ORBIT W/WO,29102046,CDM,70482,CPT,351,RC,inpatient,,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3310.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3732.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,3310.81,4171.45,
CT ORBIT W/,29102053,CDM,70481,CPT,351,RC,inpatient,,3857,3857,,3274.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2908.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3278.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3394.16,88,,percent of total billed charges,,,,,,,,,2946.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3509.87,91,,percent of total billed charges,,,3664.15,95,,percent of total billed charges,,,3201.31,83,,percent of total billed charges,,,3201.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3201.31,83,,percent of total billed charges,,,3664.15,95,,percent of total billed charges,,,3471.3,90,,percent of total billed charges,,,3471.3,90,,percent of total billed charges,,,3162.74,82,,percent of total billed charges,,,3471.3,90,,percent of total billed charges,,,3278.45,85,,percent of total billed charges,,2908.18,3664.15,
CT NECK W/O (SOFT TISSUE),29102061,CDM,70490,CPT,351,RC,inpatient,TC,3388,3388,,2876.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2554.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2879.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2981.44,88,,percent of total billed charges,,,,,,,,,2588.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3083.08,91,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,,,,,,,,,,,,,2812.04,83,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2778.16,82,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,2554.55,3218.6,
CT NECK W/WO(SOFTTISSUE),29102079,CDM,70492,CPT,351,RC,inpatient,TC,4527,4527,,3843.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3413.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3847.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3983.76,88,,percent of total billed charges,,,,,,,,,3458.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4119.57,91,,percent of total billed charges,,,4300.65,95,,percent of total billed charges,,,3757.41,83,,percent of total billed charges,,,3757.41,83,,percent of total billed charges,,,,,,,,,,,,,,,3757.41,83,,percent of total billed charges,,,4300.65,95,,percent of total billed charges,,,4074.3,90,,percent of total billed charges,,,4074.3,90,,percent of total billed charges,,,3712.14,82,,percent of total billed charges,,,4074.3,90,,percent of total billed charges,,,3847.95,85,,percent of total billed charges,,3413.36,4300.65,
CT NECK W/(SOFT TISSUE),29102087,CDM,70491,CPT,351,RC,inpatient,TC,3920,3920,,3328.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2955.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3332,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3449.6,88,,percent of total billed charges,,,,,,,,,2994.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3567.2,91,,percent of total billed charges,,,3724,95,,percent of total billed charges,,,3253.6,83,,percent of total billed charges,,,3253.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3253.6,83,,percent of total billed charges,,,3724,95,,percent of total billed charges,,,3528,90,,percent of total billed charges,,,3528,90,,percent of total billed charges,,,3214.4,82,,percent of total billed charges,,,3528,90,,percent of total billed charges,,,3332,85,,percent of total billed charges,,2955.68,3724,
CT THORAX W/O DYE,29102095,CDM,71250,CPT,352,RC,inpatient,TC,3616,3616,,3069.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2726.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3073.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3182.08,88,,percent of total billed charges,,,,,,,,,2762.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3290.56,91,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,,,,,,,,,,,,,3001.28,83,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,2965.12,82,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3073.6,85,,percent of total billed charges,,2726.46,3435.2,
CT LOW DOSE LUNG SCREENING,29102096,CDM,71271,CPT,352,RC,inpatient,TC,3616,3616,,3069.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2726.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3073.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3182.08,88,,percent of total billed charges,,,,,,,,,2762.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3290.56,91,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,,,,,,,,,,,,,3001.28,83,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,2965.12,82,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3073.6,85,,percent of total billed charges,,2726.46,3435.2,
CT THORAX W/O & W/DYE,29102103,CDM,71270,CPT,352,RC,inpatient,TC,4849,4849,,4116.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3656.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4121.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4267.12,88,,percent of total billed charges,,,,,,,,,3704.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4412.59,91,,percent of total billed charges,,,4606.55,95,,percent of total billed charges,,,4024.67,83,,percent of total billed charges,,,4024.67,83,,percent of total billed charges,,,,,,,,,,,,,,,4024.67,83,,percent of total billed charges,,,4606.55,95,,percent of total billed charges,,,4364.1,90,,percent of total billed charges,,,4364.1,90,,percent of total billed charges,,,3976.18,82,,percent of total billed charges,,,4364.1,90,,percent of total billed charges,,,4121.65,85,,percent of total billed charges,,3656.15,4606.55,
CT THORAX W/DYE,29102111,CDM,71260,CPT,352,RC,inpatient,TC,4379,4379,,3717.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3301.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3722.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3853.52,88,,percent of total billed charges,,,,,,,,,3345.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3984.89,91,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,,,,,,,,,,,,,3634.57,83,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3590.78,82,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,3301.77,4160.05,
CT PELVIS W/O,29102129,CDM,72192,CPT,352,RC,inpatient,TC,3784,3784,,3212.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2853.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3216.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3329.92,88,,percent of total billed charges,,,,,,,,,2890.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3443.44,91,,percent of total billed charges,,,3594.8,95,,percent of total billed charges,,,3140.72,83,,percent of total billed charges,,,3140.72,83,,percent of total billed charges,,,,,,,,,,,,,,,3140.72,83,,percent of total billed charges,,,3594.8,95,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3102.88,82,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3216.4,85,,percent of total billed charges,,2853.14,3594.8,
CT PELVIS W/WO,29102137,CDM,72194,CPT,352,RC,inpatient,TC,5573,5573,,4731.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4202.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4737.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4904.24,88,,percent of total billed charges,,,,,,,,,4257.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5071.43,91,,percent of total billed charges,,,5294.35,95,,percent of total billed charges,,,4625.59,83,,percent of total billed charges,,,4625.59,83,,percent of total billed charges,,,,,,,,,,,,,,,4625.59,83,,percent of total billed charges,,,5294.35,95,,percent of total billed charges,,,5015.7,90,,percent of total billed charges,,,5015.7,90,,percent of total billed charges,,,4569.86,82,,percent of total billed charges,,,5015.7,90,,percent of total billed charges,,,4737.05,85,,percent of total billed charges,,4202.04,5294.35,
CT PELVIS W/,29102145,CDM,72193,CPT,352,RC,inpatient,TC,4379,4379,,3717.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3301.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3722.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3853.52,88,,percent of total billed charges,,,,,,,,,3345.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3984.89,91,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,,,,,,,,,,,,,3634.57,83,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3590.78,82,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,3301.77,4160.05,
CT ABDOMEN W/O,29102152,CDM,74150,CPT,352,RC,inpatient,TC,3784,3784,,3212.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2853.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3216.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3329.92,88,,percent of total billed charges,,,,,,,,,2890.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3443.44,91,,percent of total billed charges,,,3594.8,95,,percent of total billed charges,,,3140.72,83,,percent of total billed charges,,,3140.72,83,,percent of total billed charges,,,,,,,,,,,,,,,3140.72,83,,percent of total billed charges,,,3594.8,95,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3102.88,82,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3216.4,85,,percent of total billed charges,,2853.14,3594.8,
CT ABDOMEN W/WO,29102160,CDM,74170,CPT,352,RC,inpatient,TC,5093,5093,,4323.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3840.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4329.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4481.84,88,,percent of total billed charges,,,,,,,,,3891.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4634.63,91,,percent of total billed charges,,,4838.35,95,,percent of total billed charges,,,4227.19,83,,percent of total billed charges,,,4227.19,83,,percent of total billed charges,,,,,,,,,,,,,,,4227.19,83,,percent of total billed charges,,,4838.35,95,,percent of total billed charges,,,4583.7,90,,percent of total billed charges,,,4583.7,90,,percent of total billed charges,,,4176.26,82,,percent of total billed charges,,,4583.7,90,,percent of total billed charges,,,4329.05,85,,percent of total billed charges,,3840.12,4838.35,
CT ABDOMEN W/,29102178,CDM,74160,CPT,352,RC,inpatient,TC,4404,4404,,3739,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3320.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3743.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3875.52,88,,percent of total billed charges,,,,,,,,,3364.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4007.64,91,,percent of total billed charges,,,4183.8,95,,percent of total billed charges,,,3655.32,83,,percent of total billed charges,,,3655.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3655.32,83,,percent of total billed charges,,,4183.8,95,,percent of total billed charges,,,3963.6,90,,percent of total billed charges,,,3963.6,90,,percent of total billed charges,,,3611.28,82,,percent of total billed charges,,,3963.6,90,,percent of total billed charges,,,3743.4,85,,percent of total billed charges,,3320.62,4183.8,
CT L SPINE W/O,29102186,CDM,72131,CPT,352,RC,inpatient,TC,3830,3830,,3251.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2887.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3255.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3370.4,88,,percent of total billed charges,,,,,,,,,2926.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3485.3,91,,percent of total billed charges,,,3638.5,95,,percent of total billed charges,,,3178.9,83,,percent of total billed charges,,,3178.9,83,,percent of total billed charges,,,,,,,,,,,,,,,3178.9,83,,percent of total billed charges,,,3638.5,95,,percent of total billed charges,,,3447,90,,percent of total billed charges,,,3447,90,,percent of total billed charges,,,3140.6,82,,percent of total billed charges,,,3447,90,,percent of total billed charges,,,3255.5,85,,percent of total billed charges,,2887.82,3638.5,
CT L SPINE W/WO,29102194,CDM,72133,CPT,352,RC,inpatient,,4967,4967,,4216.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3745.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4221.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4370.96,88,,percent of total billed charges,,,,,,,,,3794.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4519.97,91,,percent of total billed charges,,,4718.65,95,,percent of total billed charges,,,4122.61,83,,percent of total billed charges,,,4122.61,83,,percent of total billed charges,,,,,,,,,,,,,,,4122.61,83,,percent of total billed charges,,,4718.65,95,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4072.94,82,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4221.95,85,,percent of total billed charges,,3745.12,4718.65,
CT L SPINE W,29102202,CDM,72132,CPT,352,RC,inpatient,,4470,4470,,3795.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3370.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3799.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3933.6,88,,percent of total billed charges,,,,,,,,,3415.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4067.7,91,,percent of total billed charges,,,4246.5,95,,percent of total billed charges,,,3710.1,83,,percent of total billed charges,,,3710.1,83,,percent of total billed charges,,,,,,,,,,,,,,,3710.1,83,,percent of total billed charges,,,4246.5,95,,percent of total billed charges,,,4023,90,,percent of total billed charges,,,4023,90,,percent of total billed charges,,,3665.4,82,,percent of total billed charges,,,4023,90,,percent of total billed charges,,,3799.5,85,,percent of total billed charges,,3370.38,4246.5,
CT IAC W/O,29102228,CDM,70480,CPT,351,RC,inpatient,TC,3405,3405,,2890.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2567.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2894.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2996.4,88,,percent of total billed charges,,,,,,,,,2601.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3098.55,91,,percent of total billed charges,,,3234.75,95,,percent of total billed charges,,,2826.15,83,,percent of total billed charges,,,2826.15,83,,percent of total billed charges,,,,,,,,,,,,,,,2826.15,83,,percent of total billed charges,,,3234.75,95,,percent of total billed charges,,,3064.5,90,,percent of total billed charges,,,3064.5,90,,percent of total billed charges,,,2792.1,82,,percent of total billed charges,,,3064.5,90,,percent of total billed charges,,,2894.25,85,,percent of total billed charges,,2567.37,3234.75,
CT C SPINE W/WO,29102251,CDM,72127,CPT,352,RC,inpatient,,4967,4967,,4216.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3745.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4221.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4370.96,88,,percent of total billed charges,,,,,,,,,3794.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4519.97,91,,percent of total billed charges,,,4718.65,95,,percent of total billed charges,,,4122.61,83,,percent of total billed charges,,,4122.61,83,,percent of total billed charges,,,,,,,,,,,,,,,4122.61,83,,percent of total billed charges,,,4718.65,95,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4072.94,82,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4221.95,85,,percent of total billed charges,,3745.12,4718.65,
CT UP EXT LT W,29102269,CDM,73201,CPT,350,RC,inpatient,,4016,4016,,3409.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3028.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3413.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3534.08,88,,percent of total billed charges,,,,,,,,,3068.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3654.56,91,,percent of total billed charges,,,3815.2,95,,percent of total billed charges,,,3333.28,83,,percent of total billed charges,,,3333.28,83,,percent of total billed charges,,,,,,,,,,,,,,,3333.28,83,,percent of total billed charges,,,3815.2,95,,percent of total billed charges,,,3614.4,90,,percent of total billed charges,,,3614.4,90,,percent of total billed charges,,,3293.12,82,,percent of total billed charges,,,3614.4,90,,percent of total billed charges,,,3413.6,85,,percent of total billed charges,,3028.06,3815.2,
CT UP EXT RT W,29102270,CDM,73201,CPT,350,RC,inpatient,TC,4016,4016,,3409.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3028.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3413.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3534.08,88,,percent of total billed charges,,,,,,,,,3068.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3654.56,91,,percent of total billed charges,,,3815.2,95,,percent of total billed charges,,,3333.28,83,,percent of total billed charges,,,3333.28,83,,percent of total billed charges,,,,,,,,,,,,,,,3333.28,83,,percent of total billed charges,,,3815.2,95,,percent of total billed charges,,,3614.4,90,,percent of total billed charges,,,3614.4,90,,percent of total billed charges,,,3293.12,82,,percent of total billed charges,,,3614.4,90,,percent of total billed charges,,,3413.6,85,,percent of total billed charges,,3028.06,3815.2,
CT T SPINE W/WO,29102277,CDM,72130,CPT,352,RC,inpatient,,4967,4967,,4216.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3745.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4221.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4370.96,88,,percent of total billed charges,,,,,,,,,3794.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4519.97,91,,percent of total billed charges,,,4718.65,95,,percent of total billed charges,,,4122.61,83,,percent of total billed charges,,,4122.61,83,,percent of total billed charges,,,,,,,,,,,,,,,4122.61,83,,percent of total billed charges,,,4718.65,95,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4072.94,82,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4221.95,85,,percent of total billed charges,,3745.12,4718.65,
CT UP EXT LEFT W/O,29102285,CDM,73200,CPT,350,RC,inpatient,LT,3388,3388,,2876.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2554.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2879.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2981.44,88,,percent of total billed charges,,,,,,,,,2588.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3083.08,91,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,,,,,,,,,,,,,2812.04,83,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2778.16,82,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,2554.55,3218.6,
CT UP EXT RIGHT W/O,29102286,CDM,73200,CPT,350,RC,inpatient,RT,3388,3388,,2876.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2554.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2879.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2981.44,88,,percent of total billed charges,,,,,,,,,2588.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3083.08,91,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,,,,,,,,,,,,,2812.04,83,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2778.16,82,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,2554.55,3218.6,
CT T SPINE W,29102293,CDM,72129,CPT,352,RC,inpatient,TC,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3310.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3732.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,3310.81,4171.45,
CT SINUSES W/O,29102301,CDM,70486,CPT,351,RC,inpatient,TC,3616,3616,,3069.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2726.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3073.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3182.08,88,,percent of total billed charges,,,,,,,,,2762.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3290.56,91,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,,,,,,,,,,,,,3001.28,83,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,2965.12,82,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3073.6,85,,percent of total billed charges,,2726.46,3435.2,
CT SINUSES W/,29102302,CDM,70487,CPT,350,RC,inpatient,,3842,3842,,3261.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2896.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3265.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3380.96,88,,percent of total billed charges,,,,,,,,,2935.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3496.22,91,,percent of total billed charges,,,3649.9,95,,percent of total billed charges,,,3188.86,83,,percent of total billed charges,,,3188.86,83,,percent of total billed charges,,,,,,,,,,,,,,,3188.86,83,,percent of total billed charges,,,3649.9,95,,percent of total billed charges,,,3457.8,90,,percent of total billed charges,,,3457.8,90,,percent of total billed charges,,,3150.44,82,,percent of total billed charges,,,3457.8,90,,percent of total billed charges,,,3265.7,85,,percent of total billed charges,,2896.87,3649.9,
CT SINUSES W/WO,29102303,CDM,70488,CPT,350,RC,inpatient,TC,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3310.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3732.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,3310.81,4171.45,
CT PARACENTESIS W/IMAGING,29102349,CDM,49083,CPT,360,RC,inpatient,TC,2973,2973,,2524.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2241.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2527.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2616.24,88,,percent of total billed charges,,,,,,,,,2271.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2705.43,91,,percent of total billed charges,,,2824.35,95,,percent of total billed charges,,,2467.59,83,,percent of total billed charges,,,2467.59,83,,percent of total billed charges,,,,,,,,,,,,,,,2467.59,83,,percent of total billed charges,,,2824.35,95,,percent of total billed charges,,,2675.7,90,,percent of total billed charges,,,2675.7,90,,percent of total billed charges,,,2437.86,82,,percent of total billed charges,,,2675.7,90,,percent of total billed charges,,,2527.05,85,,percent of total billed charges,,2241.64,2824.35,
CT PANCREAS BX,29102350,CDM,48102,CPT,360,RC,inpatient,TC,3989,3989,,3386.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3007.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3390.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3510.32,88,,percent of total billed charges,,,,,,,,,3047.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3629.99,91,,percent of total billed charges,,,3789.55,95,,percent of total billed charges,,,3310.87,83,,percent of total billed charges,,,3310.87,83,,percent of total billed charges,,,,,,,,,,,,,,,3310.87,83,,percent of total billed charges,,,3789.55,95,,percent of total billed charges,,,3590.1,90,,percent of total billed charges,,,3590.1,90,,percent of total billed charges,,,3270.98,82,,percent of total billed charges,,,3590.1,90,,percent of total billed charges,,,3390.65,85,,percent of total billed charges,,3007.71,3789.55,
CT LOW EXT LEFT W/O,29104166,CDM,73700,CPT,350,RC,inpatient,LT,3388,3388,,2876.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2554.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2879.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2981.44,88,,percent of total billed charges,,,,,,,,,2588.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3083.08,91,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,,,,,,,,,,,,,2812.04,83,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2778.16,82,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,2554.55,3218.6,
CT LOW EXT RIGHT W/O,29104167,CDM,73700,CPT,350,RC,inpatient,RT,3388,3388,,2876.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2554.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2879.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2981.44,88,,percent of total billed charges,,,,,,,,,2588.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3083.08,91,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,,,,,,,,,,,,,2812.04,83,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2778.16,82,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,2554.55,3218.6,
CT GUIDED THORACENTESIS,29104170,CDM,,,352,RC,inpatient,,2965,2965,,2517.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2235.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2520.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2609.2,88,,percent of total billed charges,,,,,,,,,2265.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2698.15,91,,percent of total billed charges,,,2816.75,95,,percent of total billed charges,,,2460.95,83,,percent of total billed charges,,,2460.95,83,,percent of total billed charges,,,,,,,,,,,,,,,2460.95,83,,percent of total billed charges,,,2816.75,95,,percent of total billed charges,,,2668.5,90,,percent of total billed charges,,,2668.5,90,,percent of total billed charges,,,2431.3,82,,percent of total billed charges,,,2668.5,90,,percent of total billed charges,,,2520.25,85,,percent of total billed charges,,2235.61,2816.75,
CT SCLEROTHERAPY FLUID COLLECTION W/IMG,29104171,CDM,49185,CPT,360,RC,inpatient,,3574,3574,,3034.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2694.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3037.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3145.12,88,,percent of total billed charges,,,,,,,,,2730.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3252.34,91,,percent of total billed charges,,,3395.3,95,,percent of total billed charges,,,2966.42,83,,percent of total billed charges,,,2966.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2966.42,83,,percent of total billed charges,,,3395.3,95,,percent of total billed charges,,,3216.6,90,,percent of total billed charges,,,3216.6,90,,percent of total billed charges,,,2930.68,82,,percent of total billed charges,,,3216.6,90,,percent of total billed charges,,,3037.9,85,,percent of total billed charges,,2694.8,3395.3,
CT SI JTARTHOSTEROIDINJRT,29104180,CDM,27096,CPT,350,RC,inpatient,RT,1757,1757,,1491.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1324.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1493.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1546.16,88,,percent of total billed charges,,,,,,,,,1342.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1598.87,91,,percent of total billed charges,,,1669.15,95,,percent of total billed charges,,,1458.31,83,,percent of total billed charges,,,1458.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1458.31,83,,percent of total billed charges,,,1669.15,95,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1440.74,82,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1493.45,85,,percent of total billed charges,,1324.78,1669.15,
CT SI JTARTHOSTEROIDINJLT,29104181,CDM,27096,CPT,350,RC,inpatient,LT,1757,1757,,1491.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1324.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1493.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1546.16,88,,percent of total billed charges,,,,,,,,,1342.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1598.87,91,,percent of total billed charges,,,1669.15,95,,percent of total billed charges,,,1458.31,83,,percent of total billed charges,,,1458.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1458.31,83,,percent of total billed charges,,,1669.15,95,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1440.74,82,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1493.45,85,,percent of total billed charges,,1324.78,1669.15,
CT SI JTARTHOSTEROIDINJBIL,29104182,CDM,27096,CPT,350,RC,inpatient,50,3513,3513,,2982.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2648.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2986.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3091.44,88,,percent of total billed charges,,,,,,,,,2683.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3196.83,91,,percent of total billed charges,,,3337.35,95,,percent of total billed charges,,,2915.79,83,,percent of total billed charges,,,2915.79,83,,percent of total billed charges,,,,,,,,,,,,,,,2915.79,83,,percent of total billed charges,,,3337.35,95,,percent of total billed charges,,,3161.7,90,,percent of total billed charges,,,3161.7,90,,percent of total billed charges,,,2880.66,82,,percent of total billed charges,,,3161.7,90,,percent of total billed charges,,,2986.05,85,,percent of total billed charges,,2648.8,3337.35,
CT LOW EXT BILATERAL W/O,29104199,CDM,73700,CPT,350,RC,inpatient,50,6647,6647,,5643.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5011.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5649.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5849.36,88,,percent of total billed charges,,,,,,,,,5078.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6048.77,91,,percent of total billed charges,,,6314.65,95,,percent of total billed charges,,,5517.01,83,,percent of total billed charges,,,5517.01,83,,percent of total billed charges,,,,,,,,,,,,,,,5517.01,83,,percent of total billed charges,,,6314.65,95,,percent of total billed charges,,,5982.3,90,,percent of total billed charges,,,5982.3,90,,percent of total billed charges,,,5450.54,82,,percent of total billed charges,,,5982.3,90,,percent of total billed charges,,,5649.95,85,,percent of total billed charges,,5011.84,6314.65,
CT INSERTION OF SUPRAPUBIC CATH,29104200,CDM,51102,CPT,360,RC,inpatient,TC,8003,8003,,6794.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6034.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6802.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7042.64,88,,percent of total billed charges,,,,,,,,,6114.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7282.73,91,,percent of total billed charges,,,7602.85,95,,percent of total billed charges,,,6642.49,83,,percent of total billed charges,,,6642.49,83,,percent of total billed charges,,,,,,,,,,,,,,,6642.49,83,,percent of total billed charges,,,7602.85,95,,percent of total billed charges,,,7202.7,90,,percent of total billed charges,,,7202.7,90,,percent of total billed charges,,,6562.46,82,,percent of total billed charges,,,7202.7,90,,percent of total billed charges,,,6802.55,85,,percent of total billed charges,,6034.26,7602.85,
CT CARDIAC SCORING,29523668,CDM,75571,CPT,352,RC,inpatient,TC,101,101,,85.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88.88,88,,percent of total billed charges,,,,,,,,,77.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,82.82,82,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,76.15,95.95,
PROCEDURE TRAY,932510,CDM,,,270,RC,inpatient,,118,118,,100.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,88.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,100.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,103.84,88,,percent of total billed charges,,,,,,,,,90.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,107.38,91,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,,,,,,,,,,,,,97.94,83,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,96.76,82,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,88.97,112.1,
DELIVERY INSTRUMENTS,2332600,CDM,,,270,RC,inpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
PEEP VALVE,2382047,CDM,,,270,RC,inpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,38.45,48.45,
PUMP BREAST HAND HELD,8300001,CDM,,,270,RC,inpatient,,215,215,,182.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,162.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,182.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,189.2,88,,percent of total billed charges,,,,,,,,,164.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,195.65,91,,percent of total billed charges,,,204.25,95,,percent of total billed charges,,,178.45,83,,percent of total billed charges,,,178.45,83,,percent of total billed charges,,,,,,,,,,,,,,,178.45,83,,percent of total billed charges,,,204.25,95,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,176.3,82,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,182.75,85,,percent of total billed charges,,162.11,204.25,
CPAP MASK,12801191,CDM,,,270,RC,inpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,58.81,74.1,
MDI SPACER,12801670,CDM,,,270,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
DISPOSABLE OXYHOOD,12802210,CDM,,,270,RC,inpatient,,56,56,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.28,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,45.92,82,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,42.22,53.2,
POSTOP EYE KIT,18300271,CDM,,,270,RC,inpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,41.47,52.25,
S&N CONQUEST FX FEM COMP SZ13,18300285,CDM,,,278,RC,inpatient,,9315.28,9315.28,,7908.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7023.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7917.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8197.45,88,,percent of total billed charges,,,,,,,,,7116.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8476.9,91,,percent of total billed charges,,,8849.52,95,,percent of total billed charges,,,7731.68,83,,percent of total billed charges,,,7731.68,83,,percent of total billed charges,,,,,,,,,,,,,,,7731.68,83,,percent of total billed charges,,,8849.52,95,,percent of total billed charges,,,8383.75,90,,percent of total billed charges,,,8383.75,90,,percent of total billed charges,,,7638.53,82,,percent of total billed charges,,,8383.75,90,,percent of total billed charges,,,7917.99,85,,percent of total billed charges,,7023.72,8849.52,
RETRACTOR C-SECTION LGE 9 x 14,18300287,CDM,,,270,RC,inpatient,,602,602,,511.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,453.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,511.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,529.76,88,,percent of total billed charges,,,,,,,,,459.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,547.82,91,,percent of total billed charges,,,571.9,95,,percent of total billed charges,,,499.66,83,,percent of total billed charges,,,499.66,83,,percent of total billed charges,,,,,,,,,,,,,,,499.66,83,,percent of total billed charges,,,571.9,95,,percent of total billed charges,,,541.8,90,,percent of total billed charges,,,541.8,90,,percent of total billed charges,,,493.64,82,,percent of total billed charges,,,541.8,90,,percent of total billed charges,,,511.7,85,,percent of total billed charges,,453.91,571.9,
RETRACTOR C-SECTION XLG 11 x 17,18300288,CDM,,,270,RC,inpatient,,623,623,,528.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,469.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,529.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,548.24,88,,percent of total billed charges,,,,,,,,,475.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,566.93,91,,percent of total billed charges,,,591.85,95,,percent of total billed charges,,,517.09,83,,percent of total billed charges,,,517.09,83,,percent of total billed charges,,,,,,,,,,,,,,,517.09,83,,percent of total billed charges,,,591.85,95,,percent of total billed charges,,,560.7,90,,percent of total billed charges,,,560.7,90,,percent of total billed charges,,,510.86,82,,percent of total billed charges,,,560.7,90,,percent of total billed charges,,,529.55,85,,percent of total billed charges,,469.74,591.85,
LEEP SQUARE ELECTRODE,18300289,CDM,,,270,RC,inpatient,,189.6,189.6,,160.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,142.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,161.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,166.85,88,,percent of total billed charges,,,,,,,,,144.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,172.54,91,,percent of total billed charges,,,180.12,95,,percent of total billed charges,,,157.37,83,,percent of total billed charges,,,157.37,83,,percent of total billed charges,,,,,,,,,,,,,,,157.37,83,,percent of total billed charges,,,180.12,95,,percent of total billed charges,,,170.64,90,,percent of total billed charges,,,170.64,90,,percent of total billed charges,,,155.47,82,,percent of total billed charges,,,170.64,90,,percent of total billed charges,,,161.16,85,,percent of total billed charges,,142.96,180.12,
LEEP BALL ELECTRODE,18300290,CDM,,,270,RC,inpatient,,189.68,189.68,,161.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,143.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,161.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,166.92,88,,percent of total billed charges,,,,,,,,,144.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,172.61,91,,percent of total billed charges,,,180.2,95,,percent of total billed charges,,,157.43,83,,percent of total billed charges,,,157.43,83,,percent of total billed charges,,,,,,,,,,,,,,,157.43,83,,percent of total billed charges,,,180.2,95,,percent of total billed charges,,,170.71,90,,percent of total billed charges,,,170.71,90,,percent of total billed charges,,,155.54,82,,percent of total billed charges,,,170.71,90,,percent of total billed charges,,,161.23,85,,percent of total billed charges,,143.02,180.2,
LEEP RADIUS ELECTRODE 20 X 10,18300291,CDM,,,270,RC,inpatient,,185.06,185.06,,157.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,139.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,157.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,162.85,88,,percent of total billed charges,,,,,,,,,141.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,168.4,91,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,,,,,,,,,,,,,153.6,83,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,151.75,82,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,157.3,85,,percent of total billed charges,,139.54,175.81,
NEEDLE BIOPSY TRU CUT 18G X 6,18300295,CDM,,,270,RC,inpatient,,124.08,124.08,,105.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.19,88,,percent of total billed charges,,,,,,,,,94.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.91,91,,percent of total billed charges,,,117.88,95,,percent of total billed charges,,,102.99,83,,percent of total billed charges,,,102.99,83,,percent of total billed charges,,,,,,,,,,,,,,,102.99,83,,percent of total billed charges,,,117.88,95,,percent of total billed charges,,,111.67,90,,percent of total billed charges,,,111.67,90,,percent of total billed charges,,,101.75,82,,percent of total billed charges,,,111.67,90,,percent of total billed charges,,,105.47,85,,percent of total billed charges,,93.56,117.88,
LEEP RADIUS ELECTRODE 2.0 X 0.8,18300296,CDM,,,270,RC,inpatient,,185.06,185.06,,157.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,139.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,157.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,162.85,88,,percent of total billed charges,,,,,,,,,141.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,168.4,91,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,,,,,,,,,,,,,153.6,83,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,151.75,82,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,157.3,85,,percent of total billed charges,,139.54,175.81,
LEEP RADIUS ELECTRODE 1.5 X .5CM,18300297,CDM,,,270,RC,inpatient,,185.06,185.06,,157.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,139.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,157.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,162.85,88,,percent of total billed charges,,,,,,,,,141.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,168.4,91,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,,,,,,,,,,,,,153.6,83,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,151.75,82,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,157.3,85,,percent of total billed charges,,139.54,175.81,
VIGILON WOUND DRESSING,18304053,CDM,,,270,RC,inpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.92,88,,percent of total billed charges,,,,,,,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,44.49,56.05,
ENDO TROCAR GRIP       0,18307744,CDM,,,270,RC,inpatient,,30,30,,25.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.4,88,,percent of total billed charges,,,,,,,,,22.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,24.9,83,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,24.6,82,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,22.62,28.5,
Q HIP REFLECTION LINER (REG),18307928,CDM,,,270,RC,inpatient,,2209,2209,,1875.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1665.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1877.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1943.92,88,,percent of total billed charges,,,,,,,,,1687.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2010.19,91,,percent of total billed charges,,,2098.55,95,,percent of total billed charges,,,1833.47,83,,percent of total billed charges,,,1833.47,83,,percent of total billed charges,,,,,,,,,,,,,,,1833.47,83,,percent of total billed charges,,,2098.55,95,,percent of total billed charges,,,1988.1,90,,percent of total billed charges,,,1988.1,90,,percent of total billed charges,,,1811.38,82,,percent of total billed charges,,,1988.1,90,,percent of total billed charges,,,1877.65,85,,percent of total billed charges,,1665.59,2098.55,
Q HIP REFLECTION CUP,18307929,CDM,,,270,RC,inpatient,,5099,5099,,4329.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3844.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4334.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4487.12,88,,percent of total billed charges,,,,,,,,,3895.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4640.09,91,,percent of total billed charges,,,4844.05,95,,percent of total billed charges,,,4232.17,83,,percent of total billed charges,,,4232.17,83,,percent of total billed charges,,,,,,,,,,,,,,,4232.17,83,,percent of total billed charges,,,4844.05,95,,percent of total billed charges,,,4589.1,90,,percent of total billed charges,,,4589.1,90,,percent of total billed charges,,,4181.18,82,,percent of total billed charges,,,4589.1,90,,percent of total billed charges,,,4334.15,85,,percent of total billed charges,,3844.65,4844.05,
Q UNIVERSAL BI-POLAR 45 MM OD,18307932,CDM,,,270,RC,inpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,198.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,198.3,249.85,
Q HIP BIPOLAR UNIV. SHELL,18307933,CDM,,,270,RC,inpatient,,4565,4565,,3875.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3442.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3880.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4017.2,88,,percent of total billed charges,,,,,,,,,3487.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4154.15,91,,percent of total billed charges,,,4336.75,95,,percent of total billed charges,,,3788.95,83,,percent of total billed charges,,,3788.95,83,,percent of total billed charges,,,,,,,,,,,,,,,3788.95,83,,percent of total billed charges,,,4336.75,95,,percent of total billed charges,,,4108.5,90,,percent of total billed charges,,,4108.5,90,,percent of total billed charges,,,3743.3,82,,percent of total billed charges,,,4108.5,90,,percent of total billed charges,,,3880.25,85,,percent of total billed charges,,3442.01,4336.75,
SHELL,18307934,CDM,,,270,RC,inpatient,,1646,1646,,1397.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1241.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1399.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1448.48,88,,percent of total billed charges,,,,,,,,,1257.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1497.86,91,,percent of total billed charges,,,1563.7,95,,percent of total billed charges,,,1366.18,83,,percent of total billed charges,,,1366.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1366.18,83,,percent of total billed charges,,,1563.7,95,,percent of total billed charges,,,1481.4,90,,percent of total billed charges,,,1481.4,90,,percent of total billed charges,,,1349.72,82,,percent of total billed charges,,,1481.4,90,,percent of total billed charges,,,1399.1,85,,percent of total billed charges,,1241.08,1563.7,
Q HIP DISTAL CENTRALIZER,18307942,CDM,,,270,RC,inpatient,,555,555,,471.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,418.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,471.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,488.4,88,,percent of total billed charges,,,,,,,,,424.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,505.05,91,,percent of total billed charges,,,527.25,95,,percent of total billed charges,,,460.65,83,,percent of total billed charges,,,460.65,83,,percent of total billed charges,,,,,,,,,,,,,,,460.65,83,,percent of total billed charges,,,527.25,95,,percent of total billed charges,,,499.5,90,,percent of total billed charges,,,499.5,90,,percent of total billed charges,,,455.1,82,,percent of total billed charges,,,499.5,90,,percent of total billed charges,,,471.75,85,,percent of total billed charges,,418.47,527.25,
Q PREP IM TOTAL,18307975,CDM,,,270,RC,inpatient,,837,837,,710.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,631.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,711.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,736.56,88,,percent of total billed charges,,,,,,,,,639.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,761.67,91,,percent of total billed charges,,,795.15,95,,percent of total billed charges,,,694.71,83,,percent of total billed charges,,,694.71,83,,percent of total billed charges,,,,,,,,,,,,,,,694.71,83,,percent of total billed charges,,,795.15,95,,percent of total billed charges,,,753.3,90,,percent of total billed charges,,,753.3,90,,percent of total billed charges,,,686.34,82,,percent of total billed charges,,,753.3,90,,percent of total billed charges,,,711.45,85,,percent of total billed charges,,631.1,795.15,
MIXING BOWL,18307983,CDM,,,270,RC,inpatient,,298,298,,253,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,224.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,253.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,262.24,88,,percent of total billed charges,,,,,,,,,227.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,271.18,91,,percent of total billed charges,,,283.1,95,,percent of total billed charges,,,247.34,83,,percent of total billed charges,,,247.34,83,,percent of total billed charges,,,,,,,,,,,,,,,247.34,83,,percent of total billed charges,,,283.1,95,,percent of total billed charges,,,268.2,90,,percent of total billed charges,,,268.2,90,,percent of total billed charges,,,244.36,82,,percent of total billed charges,,,268.2,90,,percent of total billed charges,,,253.3,85,,percent of total billed charges,,224.69,283.1,
ARTHROTOME,18601088,CDM,,,360,RC,inpatient,,441,441,,374.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,332.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,374.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.08,88,,percent of total billed charges,,,,,,,,,336.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,401.31,91,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,,,,,,,,,,,,,366.03,83,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,361.62,82,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,374.85,85,,percent of total billed charges,,332.51,418.95,
LEEP ACCESSORY,18602005,CDM,,,360,RC,inpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,58.06,73.15,
HYPERTHERMIA BLANKET,19604033,CDM,,,270,RC,inpatient,,35,35,,29.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.8,88,,percent of total billed charges,,,,,,,,,26.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31.85,91,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,,,,,,,,,,,,,29.05,83,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,28.7,82,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,26.39,33.25,
NIPPLE SHIELD,23150017,CDM,,,270,RC,inpatient,,31.05,31.05,,26.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.32,88,,percent of total billed charges,,,,,,,,,23.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.26,91,,percent of total billed charges,,,29.5,95,,percent of total billed charges,,,25.77,83,,percent of total billed charges,,,25.77,83,,percent of total billed charges,,,,,,,,,,,,,,,25.77,83,,percent of total billed charges,,,29.5,95,,percent of total billed charges,,,27.95,90,,percent of total billed charges,,,27.95,90,,percent of total billed charges,,,25.46,82,,percent of total billed charges,,,27.95,90,,percent of total billed charges,,,26.39,85,,percent of total billed charges,,23.41,29.5,
*DUO DERM GRANULES,23300038,CDM,,,270,RC,inpatient,,34,34,,28.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.92,88,,percent of total billed charges,,,,,,,,,25.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,,,,,,,,,,,,,28.22,83,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,27.88,82,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,25.64,32.3,
CAPNOGRAPHY MICROSTREAM TUBING H,23300093,CDM,,,270,RC,inpatient,,111.31,111.31,,94.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,83.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,97.95,88,,percent of total billed charges,,,,,,,,,85.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.29,91,,percent of total billed charges,,,105.74,95,,percent of total billed charges,,,92.39,83,,percent of total billed charges,,,92.39,83,,percent of total billed charges,,,,,,,,,,,,,,,92.39,83,,percent of total billed charges,,,105.74,95,,percent of total billed charges,,,100.18,90,,percent of total billed charges,,,100.18,90,,percent of total billed charges,,,91.27,82,,percent of total billed charges,,,100.18,90,,percent of total billed charges,,,94.61,85,,percent of total billed charges,,83.93,105.74,
RESQPOD CIRCULATORY ENHANCER,23300200,CDM,,,270,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
BARD UROLOGIST'S TRAY HEYMAN,23300315,CDM,,,270,RC,inpatient,,1498.19,1498.19,,1271.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1129.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1273.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1318.41,88,,percent of total billed charges,,,,,,,,,1144.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1363.35,91,,percent of total billed charges,,,1423.28,95,,percent of total billed charges,,,1243.5,83,,percent of total billed charges,,,1243.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1243.5,83,,percent of total billed charges,,,1423.28,95,,percent of total billed charges,,,1348.37,90,,percent of total billed charges,,,1348.37,90,,percent of total billed charges,,,1228.52,82,,percent of total billed charges,,,1348.37,90,,percent of total billed charges,,,1273.46,85,,percent of total billed charges,,1129.64,1423.28,
TRAY ARTHOGRAM,23300376,CDM,,,270,RC,inpatient,,75.17,75.17,,63.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,63.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66.15,88,,percent of total billed charges,,,,,,,,,57.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,68.4,91,,percent of total billed charges,,,71.41,95,,percent of total billed charges,,,62.39,83,,percent of total billed charges,,,62.39,83,,percent of total billed charges,,,,,,,,,,,,,,,62.39,83,,percent of total billed charges,,,71.41,95,,percent of total billed charges,,,67.65,90,,percent of total billed charges,,,67.65,90,,percent of total billed charges,,,61.64,82,,percent of total billed charges,,,67.65,90,,percent of total billed charges,,,63.89,85,,percent of total billed charges,,56.68,71.41,
*BRIEFS PROTECTIVE LG,23300422,CDM,,,270,RC,inpatient,,6,6,,5.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.28,88,,percent of total billed charges,,,,,,,,,4.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4.98,83,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,4.92,82,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,4.52,5.7,
BRACE ANKLE REG UNIVERSAL,23300566,CDM,,,270,RC,inpatient,,81.18,81.18,,68.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.44,88,,percent of total billed charges,,,,,,,,,62.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.87,91,,percent of total billed charges,,,77.12,95,,percent of total billed charges,,,67.38,83,,percent of total billed charges,,,67.38,83,,percent of total billed charges,,,,,,,,,,,,,,,67.38,83,,percent of total billed charges,,,77.12,95,,percent of total billed charges,,,73.06,90,,percent of total billed charges,,,73.06,90,,percent of total billed charges,,,66.57,82,,percent of total billed charges,,,73.06,90,,percent of total billed charges,,,69,85,,percent of total billed charges,,61.21,77.12,
*RETROGRADE CAPS,23300574,CDM,,,270,RC,inpatient,,2,2,,1.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1.76,88,,percent of total billed charges,,,,,,,,,1.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1.82,91,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,,,,,,,,,,,,,1.66,83,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.64,82,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.7,85,,percent of total billed charges,,1.51,1.9,
AMS SPARC SLING SYSTEM,23300575,CDM,,,270,RC,inpatient,,4810,4810,,4083.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3626.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4088.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4232.8,88,,percent of total billed charges,,,,,,,,,3674.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4377.1,91,,percent of total billed charges,,,4569.5,95,,percent of total billed charges,,,3992.3,83,,percent of total billed charges,,,3992.3,83,,percent of total billed charges,,,,,,,,,,,,,,,3992.3,83,,percent of total billed charges,,,4569.5,95,,percent of total billed charges,,,4329,90,,percent of total billed charges,,,4329,90,,percent of total billed charges,,,3944.2,82,,percent of total billed charges,,,4329,90,,percent of total billed charges,,,4088.5,85,,percent of total billed charges,,3626.74,4569.5,
AMS STRAIGHT-IN SYSTEM,23300576,CDM,,,270,RC,inpatient,,9717.5,9717.5,,8250.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7327,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8259.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8551.4,88,,percent of total billed charges,,,,,,,,,7424.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8842.93,91,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,,,,,,,,,,,,,8065.53,83,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,7968.35,82,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8259.88,85,,percent of total billed charges,,7327,9231.63,
FEEDING TUBE KANGAROO,23300673,CDM,,,270,RC,inpatient,,40.39,40.39,,34.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.54,88,,percent of total billed charges,,,,,,,,,30.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.75,91,,percent of total billed charges,,,38.37,95,,percent of total billed charges,,,33.52,83,,percent of total billed charges,,,33.52,83,,percent of total billed charges,,,,,,,,,,,,,,,33.52,83,,percent of total billed charges,,,38.37,95,,percent of total billed charges,,,36.35,90,,percent of total billed charges,,,36.35,90,,percent of total billed charges,,,33.12,82,,percent of total billed charges,,,36.35,90,,percent of total billed charges,,,34.33,85,,percent of total billed charges,,30.45,38.37,
FEEDING TUBE 8 FR,23300674,CDM,,,270,RC,inpatient,,38.25,38.25,,32.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33.66,88,,percent of total billed charges,,,,,,,,,29.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.81,91,,percent of total billed charges,,,36.34,95,,percent of total billed charges,,,31.75,83,,percent of total billed charges,,,31.75,83,,percent of total billed charges,,,,,,,,,,,,,,,31.75,83,,percent of total billed charges,,,36.34,95,,percent of total billed charges,,,34.43,90,,percent of total billed charges,,,34.43,90,,percent of total billed charges,,,31.37,82,,percent of total billed charges,,,34.43,90,,percent of total billed charges,,,32.51,85,,percent of total billed charges,,28.84,36.34,
FEEDING TUBE 5 FR,23300676,CDM,,,270,RC,inpatient,,8.01,8.01,,6.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.05,88,,percent of total billed charges,,,,,,,,,6.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.29,91,,percent of total billed charges,,,7.61,95,,percent of total billed charges,,,6.65,83,,percent of total billed charges,,,6.65,83,,percent of total billed charges,,,,,,,,,,,,,,,6.65,83,,percent of total billed charges,,,7.61,95,,percent of total billed charges,,,7.21,90,,percent of total billed charges,,,7.21,90,,percent of total billed charges,,,6.57,82,,percent of total billed charges,,,7.21,90,,percent of total billed charges,,,6.81,85,,percent of total billed charges,,6.04,7.61,
FEEDING TUBE KANGAROO 12FR X 43,23300680,CDM,,,270,RC,inpatient,,66.73,66.73,,56.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.72,88,,percent of total billed charges,,,,,,,,,50.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.72,91,,percent of total billed charges,,,63.39,95,,percent of total billed charges,,,55.39,83,,percent of total billed charges,,,55.39,83,,percent of total billed charges,,,,,,,,,,,,,,,55.39,83,,percent of total billed charges,,,63.39,95,,percent of total billed charges,,,60.06,90,,percent of total billed charges,,,60.06,90,,percent of total billed charges,,,54.72,82,,percent of total billed charges,,,60.06,90,,percent of total billed charges,,,56.72,85,,percent of total billed charges,,50.31,63.39,
FEEDING TUBE ATTACHMENT (FTAD),23300685,CDM,,,270,RC,inpatient,,24.93,24.93,,21.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.94,88,,percent of total billed charges,,,,,,,,,19.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.69,91,,percent of total billed charges,,,23.68,95,,percent of total billed charges,,,20.69,83,,percent of total billed charges,,,20.69,83,,percent of total billed charges,,,,,,,,,,,,,,,20.69,83,,percent of total billed charges,,,23.68,95,,percent of total billed charges,,,22.44,90,,percent of total billed charges,,,22.44,90,,percent of total billed charges,,,20.44,82,,percent of total billed charges,,,22.44,90,,percent of total billed charges,,,21.19,85,,percent of total billed charges,,18.8,23.68,
HEEL ELEVATOR UNIVERSAL,23300731,CDM,,,270,RC,inpatient,,218.23,218.23,,185.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,192.04,88,,percent of total billed charges,,,,,,,,,166.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,198.59,91,,percent of total billed charges,,,207.32,95,,percent of total billed charges,,,181.13,83,,percent of total billed charges,,,181.13,83,,percent of total billed charges,,,,,,,,,,,,,,,181.13,83,,percent of total billed charges,,,207.32,95,,percent of total billed charges,,,196.41,90,,percent of total billed charges,,,196.41,90,,percent of total billed charges,,,178.95,82,,percent of total billed charges,,,196.41,90,,percent of total billed charges,,,185.5,85,,percent of total billed charges,,164.55,207.32,
TRAY IRRIGATION,23300806,CDM,,,270,RC,inpatient,,14.58,14.58,,12.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.83,88,,percent of total billed charges,,,,,,,,,11.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.27,91,,percent of total billed charges,,,13.85,95,,percent of total billed charges,,,12.1,83,,percent of total billed charges,,,12.1,83,,percent of total billed charges,,,,,,,,,,,,,,,12.1,83,,percent of total billed charges,,,13.85,95,,percent of total billed charges,,,13.12,90,,percent of total billed charges,,,13.12,90,,percent of total billed charges,,,11.96,82,,percent of total billed charges,,,13.12,90,,percent of total billed charges,,,12.39,85,,percent of total billed charges,,10.99,13.85,
STOMA PASTE ADAPT 2OZ,23300822,CDM,,,270,RC,inpatient,,13.41,13.41,,11.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.8,88,,percent of total billed charges,,,,,,,,,10.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.2,91,,percent of total billed charges,,,12.74,95,,percent of total billed charges,,,11.13,83,,percent of total billed charges,,,11.13,83,,percent of total billed charges,,,,,,,,,,,,,,,11.13,83,,percent of total billed charges,,,12.74,95,,percent of total billed charges,,,12.07,90,,percent of total billed charges,,,12.07,90,,percent of total billed charges,,,11,82,,percent of total billed charges,,,12.07,90,,percent of total billed charges,,,11.4,85,,percent of total billed charges,,10.11,12.74,
*PAIN SOAKER,23300832,CDM,,,270,RC,inpatient,,1093,1093,,927.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,824.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,929.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,961.84,88,,percent of total billed charges,,,,,,,,,835.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,994.63,91,,percent of total billed charges,,,1038.35,95,,percent of total billed charges,,,907.19,83,,percent of total billed charges,,,907.19,83,,percent of total billed charges,,,,,,,,,,,,,,,907.19,83,,percent of total billed charges,,,1038.35,95,,percent of total billed charges,,,983.7,90,,percent of total billed charges,,,983.7,90,,percent of total billed charges,,,896.26,82,,percent of total billed charges,,,983.7,90,,percent of total billed charges,,,929.05,85,,percent of total billed charges,,824.12,1038.35,
NASO-GASTRIC TUBE HOLDER DALE,23301040,CDM,,,270,RC,inpatient,,32.67,32.67,,27.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28.75,88,,percent of total billed charges,,,,,,,,,24.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29.73,91,,percent of total billed charges,,,31.04,95,,percent of total billed charges,,,27.12,83,,percent of total billed charges,,,27.12,83,,percent of total billed charges,,,,,,,,,,,,,,,27.12,83,,percent of total billed charges,,,31.04,95,,percent of total billed charges,,,29.4,90,,percent of total billed charges,,,29.4,90,,percent of total billed charges,,,26.79,82,,percent of total billed charges,,,29.4,90,,percent of total billed charges,,,27.77,85,,percent of total billed charges,,24.63,31.04,
SLING ARM UNIVERSAL,23301177,CDM,,,270,RC,inpatient,,31.95,31.95,,27.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28.12,88,,percent of total billed charges,,,,,,,,,24.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29.07,91,,percent of total billed charges,,,30.35,95,,percent of total billed charges,,,26.52,83,,percent of total billed charges,,,26.52,83,,percent of total billed charges,,,,,,,,,,,,,,,26.52,83,,percent of total billed charges,,,30.35,95,,percent of total billed charges,,,28.76,90,,percent of total billed charges,,,28.76,90,,percent of total billed charges,,,26.2,82,,percent of total billed charges,,,28.76,90,,percent of total billed charges,,,27.16,85,,percent of total billed charges,,24.09,30.35,
SLING ARM PEDIATRIC,23301180,CDM,,,270,RC,inpatient,,36.63,36.63,,31.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.23,88,,percent of total billed charges,,,,,,,,,27.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.33,91,,percent of total billed charges,,,34.8,95,,percent of total billed charges,,,30.4,83,,percent of total billed charges,,,30.4,83,,percent of total billed charges,,,,,,,,,,,,,,,30.4,83,,percent of total billed charges,,,34.8,95,,percent of total billed charges,,,32.97,90,,percent of total billed charges,,,32.97,90,,percent of total billed charges,,,30.04,82,,percent of total billed charges,,,32.97,90,,percent of total billed charges,,,31.14,85,,percent of total billed charges,,27.62,34.8,
CLIPVAC TUBING DISP.,23301205,CDM,,,270,RC,inpatient,,74.38,74.38,,63.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,63.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,65.45,88,,percent of total billed charges,,,,,,,,,56.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,67.69,91,,percent of total billed charges,,,70.66,95,,percent of total billed charges,,,61.74,83,,percent of total billed charges,,,61.74,83,,percent of total billed charges,,,,,,,,,,,,,,,61.74,83,,percent of total billed charges,,,70.66,95,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,60.99,82,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,63.22,85,,percent of total billed charges,,56.08,70.66,
*TRAY SPINAL - LIDOCAINE,23301219,CDM,,,270,RC,inpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,65.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,65.6,82.65,
TRAY SPINAL - PENCAN,23301220,CDM,,,270,RC,inpatient,,174.61,174.61,,148.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,131.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,148.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,153.66,88,,percent of total billed charges,,,,,,,,,133.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,158.9,91,,percent of total billed charges,,,165.88,95,,percent of total billed charges,,,144.93,83,,percent of total billed charges,,,144.93,83,,percent of total billed charges,,,,,,,,,,,,,,,144.93,83,,percent of total billed charges,,,165.88,95,,percent of total billed charges,,,157.15,90,,percent of total billed charges,,,157.15,90,,percent of total billed charges,,,143.18,82,,percent of total billed charges,,,157.15,90,,percent of total billed charges,,,148.42,85,,percent of total billed charges,,131.66,165.88,
SPLINT WRIST COLLES ADULT LF,23301237,CDM,,,270,RC,inpatient,,38.7,38.7,,32.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34.06,88,,percent of total billed charges,,,,,,,,,29.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35.22,91,,percent of total billed charges,,,36.77,95,,percent of total billed charges,,,32.12,83,,percent of total billed charges,,,32.12,83,,percent of total billed charges,,,,,,,,,,,,,,,32.12,83,,percent of total billed charges,,,36.77,95,,percent of total billed charges,,,34.83,90,,percent of total billed charges,,,34.83,90,,percent of total billed charges,,,31.73,82,,percent of total billed charges,,,34.83,90,,percent of total billed charges,,,32.9,85,,percent of total billed charges,,29.18,36.77,
SPLINT WRIST COLLES ADULT RT,23301238,CDM,,,270,RC,inpatient,,38.7,38.7,,32.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34.06,88,,percent of total billed charges,,,,,,,,,29.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35.22,91,,percent of total billed charges,,,36.77,95,,percent of total billed charges,,,32.12,83,,percent of total billed charges,,,32.12,83,,percent of total billed charges,,,,,,,,,,,,,,,32.12,83,,percent of total billed charges,,,36.77,95,,percent of total billed charges,,,34.83,90,,percent of total billed charges,,,34.83,90,,percent of total billed charges,,,31.73,82,,percent of total billed charges,,,34.83,90,,percent of total billed charges,,,32.9,85,,percent of total billed charges,,29.18,36.77,
*SPLINT WRIST COLLES YOUTH R,23301239,CDM,,,270,RC,inpatient,,42,42,,35.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36.96,88,,percent of total billed charges,,,,,,,,,32.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38.22,91,,percent of total billed charges,,,39.9,95,,percent of total billed charges,,,34.86,83,,percent of total billed charges,,,34.86,83,,percent of total billed charges,,,,,,,,,,,,,,,34.86,83,,percent of total billed charges,,,39.9,95,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,34.44,82,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,35.7,85,,percent of total billed charges,,31.67,39.9,
ENDOSCOPIC CAPS,23301267,CDM,,,270,RC,inpatient,,51.43,51.43,,43.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.26,88,,percent of total billed charges,,,,,,,,,39.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.8,91,,percent of total billed charges,,,48.86,95,,percent of total billed charges,,,42.69,83,,percent of total billed charges,,,42.69,83,,percent of total billed charges,,,,,,,,,,,,,,,42.69,83,,percent of total billed charges,,,48.86,95,,percent of total billed charges,,,46.29,90,,percent of total billed charges,,,46.29,90,,percent of total billed charges,,,42.17,82,,percent of total billed charges,,,46.29,90,,percent of total billed charges,,,43.72,85,,percent of total billed charges,,38.78,48.86,
CAMERA COVER 9 X 96,23301268,CDM,,,270,RC,inpatient,,47.69,47.69,,40.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.97,88,,percent of total billed charges,,,,,,,,,36.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.4,91,,percent of total billed charges,,,45.31,95,,percent of total billed charges,,,39.58,83,,percent of total billed charges,,,39.58,83,,percent of total billed charges,,,,,,,,,,,,,,,39.58,83,,percent of total billed charges,,,45.31,95,,percent of total billed charges,,,42.92,90,,percent of total billed charges,,,42.92,90,,percent of total billed charges,,,39.11,82,,percent of total billed charges,,,42.92,90,,percent of total billed charges,,,40.54,85,,percent of total billed charges,,35.96,45.31,
CATH SUCTION INFANT 5/6FR,23301325,CDM,,,270,RC,inpatient,,2.27,2.27,,1.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2,88,,percent of total billed charges,,,,,,,,,1.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.07,91,,percent of total billed charges,,,2.16,95,,percent of total billed charges,,,1.88,83,,percent of total billed charges,,,1.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1.88,83,,percent of total billed charges,,,2.16,95,,percent of total billed charges,,,2.04,90,,percent of total billed charges,,,2.04,90,,percent of total billed charges,,,1.86,82,,percent of total billed charges,,,2.04,90,,percent of total billed charges,,,1.93,85,,percent of total billed charges,,1.71,2.16,
* SUTURE K831H (V0605),23301384,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE 815H CHROMIC GUT 3 0 (V0205),23301391,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE 1744-41 (V0106),23301400,CDM,,,270,RC,inpatient,,20,20,,16.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.6,88,,percent of total billed charges,,,,,,,,,15.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.2,91,,percent of total billed charges,,,19,95,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,,,,,,,,,,,,,16.6,83,,percent of total billed charges,,,19,95,,percent of total billed charges,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,16.4,82,,percent of total billed charges,,,18,90,,percent of total billed charges,,,17,85,,percent of total billed charges,,15.08,19,
* SUTURE*1741-31 (V0205),23301401,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE 1665G (V0205),23301403,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE 8661G PROLENE 5 0 (V0205),23301405,CDM,,,270,RC,inpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
* SUTURE*1744-31 (V0605),23301413,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE VD-871 (V0205),23301414,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
GUIDEWIRE URO PTFE .038,23301424,CDM,,,270,RC,inpatient,,109.76,109.76,,93.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,93.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,96.59,88,,percent of total billed charges,,,,,,,,,83.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.88,91,,percent of total billed charges,,,104.27,95,,percent of total billed charges,,,91.1,83,,percent of total billed charges,,,91.1,83,,percent of total billed charges,,,,,,,,,,,,,,,91.1,83,,percent of total billed charges,,,104.27,95,,percent of total billed charges,,,98.78,90,,percent of total billed charges,,,98.78,90,,percent of total billed charges,,,90,82,,percent of total billed charges,,,98.78,90,,percent of total billed charges,,,93.3,85,,percent of total billed charges,,82.76,104.27,
"* VACUUM EXTRACTION, BODY (V0904)",23301429,CDM,93012,CPT,732,RC,inpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
* VACUUM ATTACHMENT (V0904),23301430,CDM,93012,CPT,732,RC,inpatient,,58,58,,49.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.04,88,,percent of total billed charges,,,,,,,,,44.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52.78,91,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,,,,,,,,,,,,,48.14,83,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,47.56,82,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,43.73,55.1,
TRAY TRACH CARE,23301499,CDM,,,270,RC,inpatient,,11.97,11.97,,10.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.53,88,,percent of total billed charges,,,,,,,,,9.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.89,91,,percent of total billed charges,,,11.37,95,,percent of total billed charges,,,9.94,83,,percent of total billed charges,,,9.94,83,,percent of total billed charges,,,,,,,,,,,,,,,9.94,83,,percent of total billed charges,,,11.37,95,,percent of total billed charges,,,10.77,90,,percent of total billed charges,,,10.77,90,,percent of total billed charges,,,9.82,82,,percent of total billed charges,,,10.77,90,,percent of total billed charges,,,10.17,85,,percent of total billed charges,,9.03,11.37,
* CENTRAL VENOUS PRESS MONITOR (V0605),23301600,CDM,,,270,RC,inpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,34.68,43.7,
FLOSEAL,23301649,CDM,,,270,RC,inpatient,,1192.75,1192.75,,1012.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,899.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1013.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1049.62,88,,percent of total billed charges,,,,,,,,,911.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1085.4,91,,percent of total billed charges,,,1133.11,95,,percent of total billed charges,,,989.98,83,,percent of total billed charges,,,989.98,83,,percent of total billed charges,,,,,,,,,,,,,,,989.98,83,,percent of total billed charges,,,1133.11,95,,percent of total billed charges,,,1073.48,90,,percent of total billed charges,,,1073.48,90,,percent of total billed charges,,,978.06,82,,percent of total billed charges,,,1073.48,90,,percent of total billed charges,,,1013.84,85,,percent of total billed charges,,899.33,1133.11,
*TUBE T 18FR,23301673,CDM,,,270,RC,inpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,52.03,65.55,
*TUBE T 24FR,23301676,CDM,,,270,RC,inpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,52.03,65.55,
*URETERAL CATHETER ADAPTORS,23301718,CDM,,,270,RC,inpatient,,5,5,,4.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4.4,88,,percent of total billed charges,,,,,,,,,3.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4.55,91,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4.15,83,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.1,82,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,3.77,4.75,
*URETERAL CATHETER WHISTLE 4,23301719,CDM,,,270,RC,inpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.92,88,,percent of total billed charges,,,,,,,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,44.49,56.05,
IV EXTENSION SET W/3-WAY STOPCOCK,23301741,CDM,,,270,RC,inpatient,,23.76,23.76,,20.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.91,88,,percent of total billed charges,,,,,,,,,18.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.62,91,,percent of total billed charges,,,22.57,95,,percent of total billed charges,,,19.72,83,,percent of total billed charges,,,19.72,83,,percent of total billed charges,,,,,,,,,,,,,,,19.72,83,,percent of total billed charges,,,22.57,95,,percent of total billed charges,,,21.38,90,,percent of total billed charges,,,21.38,90,,percent of total billed charges,,,19.48,82,,percent of total billed charges,,,21.38,90,,percent of total billed charges,,,20.2,85,,percent of total billed charges,,17.92,22.57,
* Z/OR (V0405),23301805,CDM,,,270,RC,inpatient,,5476,5476,,4649.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4128.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4654.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4818.88,88,,percent of total billed charges,,,,,,,,,4183.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4983.16,91,,percent of total billed charges,,,5202.2,95,,percent of total billed charges,,,4545.08,83,,percent of total billed charges,,,4545.08,83,,percent of total billed charges,,,,,,,,,,,,,,,4545.08,83,,percent of total billed charges,,,5202.2,95,,percent of total billed charges,,,4928.4,90,,percent of total billed charges,,,4928.4,90,,percent of total billed charges,,,4490.32,82,,percent of total billed charges,,,4928.4,90,,percent of total billed charges,,,4654.6,85,,percent of total billed charges,,4128.9,5202.2,
* Z/OR (V0405),23301806,CDM,,,270,RC,inpatient,,1872,1872,,1589.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1411.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1591.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1647.36,88,,percent of total billed charges,,,,,,,,,1430.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1703.52,91,,percent of total billed charges,,,1778.4,95,,percent of total billed charges,,,1553.76,83,,percent of total billed charges,,,1553.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1553.76,83,,percent of total billed charges,,,1778.4,95,,percent of total billed charges,,,1684.8,90,,percent of total billed charges,,,1684.8,90,,percent of total billed charges,,,1535.04,82,,percent of total billed charges,,,1684.8,90,,percent of total billed charges,,,1591.2,85,,percent of total billed charges,,1411.49,1778.4,
* Z/OR (V0405),23301807,CDM,,,270,RC,inpatient,,1144,1144,,971.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,862.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,972.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1006.72,88,,percent of total billed charges,,,,,,,,,874.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1041.04,91,,percent of total billed charges,,,1086.8,95,,percent of total billed charges,,,949.52,83,,percent of total billed charges,,,949.52,83,,percent of total billed charges,,,,,,,,,,,,,,,949.52,83,,percent of total billed charges,,,1086.8,95,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,938.08,82,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,972.4,85,,percent of total billed charges,,862.58,1086.8,
* Z/OR (V0405),23301808,CDM,,,270,RC,inpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,345.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,306.12,385.7,
* Z/OR (V0405),23301836,CDM,,,270,RC,inpatient,,204,204,,173.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,173.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,179.52,88,,percent of total billed charges,,,,,,,,,155.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,185.64,91,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,,,,,,,,,,,,,169.32,83,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,167.28,82,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,173.4,85,,percent of total billed charges,,153.82,193.8,
* Z/OR (V0405),23301839,CDM,,,270,RC,inpatient,,705,705,,598.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,531.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,599.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,620.4,88,,percent of total billed charges,,,,,,,,,538.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,641.55,91,,percent of total billed charges,,,669.75,95,,percent of total billed charges,,,585.15,83,,percent of total billed charges,,,585.15,83,,percent of total billed charges,,,,,,,,,,,,,,,585.15,83,,percent of total billed charges,,,669.75,95,,percent of total billed charges,,,634.5,90,,percent of total billed charges,,,634.5,90,,percent of total billed charges,,,578.1,82,,percent of total billed charges,,,634.5,90,,percent of total billed charges,,,599.25,85,,percent of total billed charges,,531.57,669.75,
* Z/OR (V0405),23301840,CDM,,,270,RC,inpatient,,1430,1430,,1214.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1078.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1215.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1258.4,88,,percent of total billed charges,,,,,,,,,1092.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1301.3,91,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1186.9,83,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1172.6,82,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,1078.22,1358.5,
* Z/OR (V0405),23301841,CDM,,,270,RC,inpatient,,5605,5605,,4758.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4226.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4764.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4932.4,88,,percent of total billed charges,,,,,,,,,4282.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5100.55,91,,percent of total billed charges,,,5324.75,95,,percent of total billed charges,,,4652.15,83,,percent of total billed charges,,,4652.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4652.15,83,,percent of total billed charges,,,5324.75,95,,percent of total billed charges,,,5044.5,90,,percent of total billed charges,,,5044.5,90,,percent of total billed charges,,,4596.1,82,,percent of total billed charges,,,5044.5,90,,percent of total billed charges,,,4764.25,85,,percent of total billed charges,,4226.17,5324.75,
* Z/OR (V0405),23301842,CDM,,,270,RC,inpatient,,749,749,,635.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,564.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,636.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,659.12,88,,percent of total billed charges,,,,,,,,,572.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,681.59,91,,percent of total billed charges,,,711.55,95,,percent of total billed charges,,,621.67,83,,percent of total billed charges,,,621.67,83,,percent of total billed charges,,,,,,,,,,,,,,,621.67,83,,percent of total billed charges,,,711.55,95,,percent of total billed charges,,,674.1,90,,percent of total billed charges,,,674.1,90,,percent of total billed charges,,,614.18,82,,percent of total billed charges,,,674.1,90,,percent of total billed charges,,,636.65,85,,percent of total billed charges,,564.75,711.55,
* Z/OR (V0405),23301843,CDM,,,270,RC,inpatient,,116,116,,98.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,87.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,98.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,102.08,88,,percent of total billed charges,,,,,,,,,88.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,105.56,91,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,,,,,,,,,,,,,96.28,83,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,95.12,82,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,98.6,85,,percent of total billed charges,,87.46,110.2,
* Z/OR (V0405),23301844,CDM,,,270,RC,inpatient,,1207,1207,,1024.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,910.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1025.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1062.16,88,,percent of total billed charges,,,,,,,,,922.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1098.37,91,,percent of total billed charges,,,1146.65,95,,percent of total billed charges,,,1001.81,83,,percent of total billed charges,,,1001.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1001.81,83,,percent of total billed charges,,,1146.65,95,,percent of total billed charges,,,1086.3,90,,percent of total billed charges,,,1086.3,90,,percent of total billed charges,,,989.74,82,,percent of total billed charges,,,1086.3,90,,percent of total billed charges,,,1025.95,85,,percent of total billed charges,,910.08,1146.65,
* Z/OR (V0405),23301845,CDM,,,270,RC,inpatient,,1001,1001,,849.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,754.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,850.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,880.88,88,,percent of total billed charges,,,,,,,,,764.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,910.91,91,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,,,,,,,,,,,,,830.83,83,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,820.82,82,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,754.75,950.95,
*PENROSE TUBING 5/8,23301945,CDM,,,270,RC,inpatient,,17,17,,14.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.96,88,,percent of total billed charges,,,,,,,,,12.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.47,91,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,,,,,,,,,,,,,14.11,83,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,13.94,82,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,14.45,85,,percent of total billed charges,,12.82,16.15,
*PENROSE TUBING 1,23301946,CDM,,,270,RC,inpatient,,7,7,,5.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6.16,88,,percent of total billed charges,,,,,,,,,5.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6.37,91,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,,,,,,,,,,,,,5.81,83,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.74,82,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,5.28,6.65,
DRAIN PENROSE TUBING 1/2,23301947,CDM,,,270,RC,inpatient,,9.27,9.27,,7.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8.16,88,,percent of total billed charges,,,,,,,,,7.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8.44,91,,percent of total billed charges,,,8.81,95,,percent of total billed charges,,,7.69,83,,percent of total billed charges,,,7.69,83,,percent of total billed charges,,,,,,,,,,,,,,,7.69,83,,percent of total billed charges,,,8.81,95,,percent of total billed charges,,,8.34,90,,percent of total billed charges,,,8.34,90,,percent of total billed charges,,,7.6,82,,percent of total billed charges,,,8.34,90,,percent of total billed charges,,,7.88,85,,percent of total billed charges,,6.99,8.81,
DRAIN PENROSE TUBING 1,23301949,CDM,,,270,RC,inpatient,,13.86,13.86,,11.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.2,88,,percent of total billed charges,,,,,,,,,10.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.61,91,,percent of total billed charges,,,13.17,95,,percent of total billed charges,,,11.5,83,,percent of total billed charges,,,11.5,83,,percent of total billed charges,,,,,,,,,,,,,,,11.5,83,,percent of total billed charges,,,13.17,95,,percent of total billed charges,,,12.47,90,,percent of total billed charges,,,12.47,90,,percent of total billed charges,,,11.37,82,,percent of total billed charges,,,12.47,90,,percent of total billed charges,,,11.78,85,,percent of total billed charges,,10.45,13.17,
*SARATOGA SUMP DRAIN 12FR 48,23301965,CDM,,,270,RC,inpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
*SARATOGA SUMP DRAIN 14FR 48,23301966,CDM,,,270,RC,inpatient,,171,171,,145.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,128.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,145.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,150.48,88,,percent of total billed charges,,,,,,,,,130.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,,,,,,,,,,,,,141.93,83,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,140.22,82,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,128.93,162.45,
*BILE BAG SMALL,23301994,CDM,,,270,RC,inpatient,,85,85,,72.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,72.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.8,88,,percent of total billed charges,,,,,,,,,64.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,,,,,,,,,,,,,70.55,83,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,69.7,82,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,64.09,80.75,
*TRACH 3.0 CUFFED,23302018,CDM,,,270,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
TRACH 4.0 CUFFED,23302020,CDM,,,270,RC,inpatient,,15.55,15.55,,13.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.68,88,,percent of total billed charges,,,,,,,,,11.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.15,91,,percent of total billed charges,,,14.77,95,,percent of total billed charges,,,12.91,83,,percent of total billed charges,,,12.91,83,,percent of total billed charges,,,,,,,,,,,,,,,12.91,83,,percent of total billed charges,,,14.77,95,,percent of total billed charges,,,14,90,,percent of total billed charges,,,14,90,,percent of total billed charges,,,12.75,82,,percent of total billed charges,,,14,90,,percent of total billed charges,,,13.22,85,,percent of total billed charges,,11.72,14.77,
TRACH 4.5 CUFFED,23302021,CDM,,,270,RC,inpatient,,16.79,16.79,,14.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.78,88,,percent of total billed charges,,,,,,,,,12.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.28,91,,percent of total billed charges,,,15.95,95,,percent of total billed charges,,,13.94,83,,percent of total billed charges,,,13.94,83,,percent of total billed charges,,,,,,,,,,,,,,,13.94,83,,percent of total billed charges,,,15.95,95,,percent of total billed charges,,,15.11,90,,percent of total billed charges,,,15.11,90,,percent of total billed charges,,,13.77,82,,percent of total billed charges,,,15.11,90,,percent of total billed charges,,,14.27,85,,percent of total billed charges,,12.66,15.95,
TRACH 5.0 UNCUFFED,23302022,CDM,,,270,RC,inpatient,,16.2,16.2,,13.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.26,88,,percent of total billed charges,,,,,,,,,12.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.74,91,,percent of total billed charges,,,15.39,95,,percent of total billed charges,,,13.45,83,,percent of total billed charges,,,13.45,83,,percent of total billed charges,,,,,,,,,,,,,,,13.45,83,,percent of total billed charges,,,15.39,95,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,13.28,82,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,13.77,85,,percent of total billed charges,,12.21,15.39,
TRACH 5.5 CUFFED,23302023,CDM,,,270,RC,inpatient,,24.71,24.71,,20.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.74,88,,percent of total billed charges,,,,,,,,,18.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.49,91,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,,,,,,,,,,,,,20.51,83,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,20.26,82,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,21,85,,percent of total billed charges,,18.63,23.47,
TRACH 6.0 CUFFED,23302024,CDM,,,270,RC,inpatient,,24.71,24.71,,20.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.74,88,,percent of total billed charges,,,,,,,,,18.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.49,91,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,,,,,,,,,,,,,20.51,83,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,20.26,82,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,21,85,,percent of total billed charges,,18.63,23.47,
TRACH 7.0 CUFFED,23302027,CDM,,,270,RC,inpatient,,24.71,24.71,,20.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.74,88,,percent of total billed charges,,,,,,,,,18.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.49,91,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,,,,,,,,,,,,,20.51,83,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,20.26,82,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,21,85,,percent of total billed charges,,18.63,23.47,
TRACH 7.5 CUFFED,23302028,CDM,,,270,RC,inpatient,,24.71,24.71,,20.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.74,88,,percent of total billed charges,,,,,,,,,18.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.49,91,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,,,,,,,,,,,,,20.51,83,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,20.26,82,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,21,85,,percent of total billed charges,,18.63,23.47,
TRACH 8.0 CUFFED,23302029,CDM,,,270,RC,inpatient,,24.71,24.71,,20.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.74,88,,percent of total billed charges,,,,,,,,,18.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.49,91,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,,,,,,,,,,,,,20.51,83,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,20.26,82,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,21,85,,percent of total billed charges,,18.63,23.47,
*TRACH 8.5 CUFFED,23302030,CDM,,,270,RC,inpatient,,15,15,,12.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.2,88,,percent of total billed charges,,,,,,,,,11.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.65,91,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,,,,,,,,,,,,,12.45,83,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.3,82,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,11.31,14.25,
*TRACH 2.0  CUFFED,23302032,CDM,,,270,RC,inpatient,,8,8,,6.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.04,88,,percent of total billed charges,,,,,,,,,6.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.28,91,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,,,,,,,,,,,,,6.64,83,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.56,82,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.8,85,,percent of total billed charges,,6.03,7.6,
TRACH 3.0 UNCUFFED,23302035,CDM,,,270,RC,inpatient,,8.63,8.63,,7.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.59,88,,percent of total billed charges,,,,,,,,,6.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.85,91,,percent of total billed charges,,,8.2,95,,percent of total billed charges,,,7.16,83,,percent of total billed charges,,,7.16,83,,percent of total billed charges,,,,,,,,,,,,,,,7.16,83,,percent of total billed charges,,,8.2,95,,percent of total billed charges,,,7.77,90,,percent of total billed charges,,,7.77,90,,percent of total billed charges,,,7.08,82,,percent of total billed charges,,,7.77,90,,percent of total billed charges,,,7.34,85,,percent of total billed charges,,6.51,8.2,
TRACH 5.0 CUFFED,23302037,CDM,,,270,RC,inpatient,,24.71,24.71,,20.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.74,88,,percent of total billed charges,,,,,,,,,18.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.49,91,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,,,,,,,,,,,,,20.51,83,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,20.26,82,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,21,85,,percent of total billed charges,,18.63,23.47,
TRACH 2.5 UNCUFFED,23302040,CDM,,,270,RC,inpatient,,29.29,29.29,,24.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.78,88,,percent of total billed charges,,,,,,,,,22.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.65,91,,percent of total billed charges,,,27.83,95,,percent of total billed charges,,,24.31,83,,percent of total billed charges,,,24.31,83,,percent of total billed charges,,,,,,,,,,,,,,,24.31,83,,percent of total billed charges,,,27.83,95,,percent of total billed charges,,,26.36,90,,percent of total billed charges,,,26.36,90,,percent of total billed charges,,,24.02,82,,percent of total billed charges,,,26.36,90,,percent of total billed charges,,,24.9,85,,percent of total billed charges,,22.08,27.83,
TRACH 3.5 UNCUFFED,23302041,CDM,,,270,RC,inpatient,,9.99,9.99,,8.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8.79,88,,percent of total billed charges,,,,,,,,,7.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9.09,91,,percent of total billed charges,,,9.49,95,,percent of total billed charges,,,8.29,83,,percent of total billed charges,,,8.29,83,,percent of total billed charges,,,,,,,,,,,,,,,8.29,83,,percent of total billed charges,,,9.49,95,,percent of total billed charges,,,8.99,90,,percent of total billed charges,,,8.99,90,,percent of total billed charges,,,8.19,82,,percent of total billed charges,,,8.99,90,,percent of total billed charges,,,8.49,85,,percent of total billed charges,,7.53,9.49,
TRACH 4.5 UNCUFFED,23302043,CDM,,,270,RC,inpatient,,16.2,16.2,,13.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.26,88,,percent of total billed charges,,,,,,,,,12.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.74,91,,percent of total billed charges,,,15.39,95,,percent of total billed charges,,,13.45,83,,percent of total billed charges,,,13.45,83,,percent of total billed charges,,,,,,,,,,,,,,,13.45,83,,percent of total billed charges,,,15.39,95,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,13.28,82,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,13.77,85,,percent of total billed charges,,12.21,15.39,
*U CYSTOFLO URINE DRAIN BAG,23302059,CDM,,,270,RC,inpatient,,26,26,,22.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.88,88,,percent of total billed charges,,,,,,,,,19.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.66,91,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,,,,,,,,,,,,,21.58,83,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,21.32,82,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,19.6,24.7,
URETERAL DILATATION SET,23302067,CDM,,,270,RC,inpatient,,1605,1605,,1362.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1210.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1364.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1412.4,88,,percent of total billed charges,,,,,,,,,1226.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1460.55,91,,percent of total billed charges,,,1524.75,95,,percent of total billed charges,,,1332.15,83,,percent of total billed charges,,,1332.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1332.15,83,,percent of total billed charges,,,1524.75,95,,percent of total billed charges,,,1444.5,90,,percent of total billed charges,,,1444.5,90,,percent of total billed charges,,,1316.1,82,,percent of total billed charges,,,1444.5,90,,percent of total billed charges,,,1364.25,85,,percent of total billed charges,,1210.17,1524.75,
URO DRAIN BAG (CASTLE),23302076,CDM,,,270,RC,inpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,58.06,73.15,
TAPE UMBILICAL 1/8 X 30,23302117,CDM,,,270,RC,inpatient,,12.98,12.98,,11.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.42,88,,percent of total billed charges,,,,,,,,,9.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.81,91,,percent of total billed charges,,,12.33,95,,percent of total billed charges,,,10.77,83,,percent of total billed charges,,,10.77,83,,percent of total billed charges,,,,,,,,,,,,,,,10.77,83,,percent of total billed charges,,,12.33,95,,percent of total billed charges,,,11.68,90,,percent of total billed charges,,,11.68,90,,percent of total billed charges,,,10.64,82,,percent of total billed charges,,,11.68,90,,percent of total billed charges,,,11.03,85,,percent of total billed charges,,9.79,12.33,
*TROCAR CATHETER 24FR 16,23302148,CDM,,,270,RC,inpatient,,136,136,,115.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,102.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,115.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,119.68,88,,percent of total billed charges,,,,,,,,,103.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,123.76,91,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,,,,,,,,,,,,,112.88,83,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,111.52,82,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,102.54,129.2,
MESH PERFIX PLUG LARGE,23302380,CDM,,,270,RC,inpatient,,962,962,,816.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,725.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,817.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,846.56,88,,percent of total billed charges,,,,,,,,,734.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,875.42,91,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,,,,,,,,,,,,,798.46,83,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,788.84,82,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,817.7,85,,percent of total billed charges,,725.35,913.9,
MESH PERFIX PLUG SMALL,23302385,CDM,,,270,RC,inpatient,,932.75,932.75,,791.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,703.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,792.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,820.82,88,,percent of total billed charges,,,,,,,,,712.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,848.8,91,,percent of total billed charges,,,886.11,95,,percent of total billed charges,,,774.18,83,,percent of total billed charges,,,774.18,83,,percent of total billed charges,,,,,,,,,,,,,,,774.18,83,,percent of total billed charges,,,886.11,95,,percent of total billed charges,,,839.48,90,,percent of total billed charges,,,839.48,90,,percent of total billed charges,,,764.86,82,,percent of total billed charges,,,839.48,90,,percent of total billed charges,,,792.84,85,,percent of total billed charges,,703.29,886.11,
SPLINT NASAL DOYLE II,23302430,CDM,,,270,RC,inpatient,,532,532,,451.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,401.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,452.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,468.16,88,,percent of total billed charges,,,,,,,,,406.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,484.12,91,,percent of total billed charges,,,505.4,95,,percent of total billed charges,,,441.56,83,,percent of total billed charges,,,441.56,83,,percent of total billed charges,,,,,,,,,,,,,,,441.56,83,,percent of total billed charges,,,505.4,95,,percent of total billed charges,,,478.8,90,,percent of total billed charges,,,478.8,90,,percent of total billed charges,,,436.24,82,,percent of total billed charges,,,478.8,90,,percent of total billed charges,,,452.2,85,,percent of total billed charges,,401.13,505.4,
TOURNI-COT SIZE LARGE,23302450,CDM,,,270,RC,inpatient,,28.33,28.33,,24.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.93,88,,percent of total billed charges,,,,,,,,,21.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.78,91,,percent of total billed charges,,,26.91,95,,percent of total billed charges,,,23.51,83,,percent of total billed charges,,,23.51,83,,percent of total billed charges,,,,,,,,,,,,,,,23.51,83,,percent of total billed charges,,,26.91,95,,percent of total billed charges,,,25.5,90,,percent of total billed charges,,,25.5,90,,percent of total billed charges,,,23.23,82,,percent of total billed charges,,,25.5,90,,percent of total billed charges,,,24.08,85,,percent of total billed charges,,21.36,26.91,
*RUBBER BAND STERILE 3,23302497,CDM,,,270,RC,inpatient,,4,4,,3.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3.52,88,,percent of total billed charges,,,,,,,,,3.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3.64,91,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3.32,83,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.28,82,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,3.02,3.8,
TRAY THORACENTESIS - ARROW,23302505,CDM,,,270,RC,inpatient,,667.88,667.88,,567.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,503.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,567.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,587.73,88,,percent of total billed charges,,,,,,,,,510.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,607.77,91,,percent of total billed charges,,,634.49,95,,percent of total billed charges,,,554.34,83,,percent of total billed charges,,,554.34,83,,percent of total billed charges,,,,,,,,,,,,,,,554.34,83,,percent of total billed charges,,,634.49,95,,percent of total billed charges,,,601.09,90,,percent of total billed charges,,,601.09,90,,percent of total billed charges,,,547.66,82,,percent of total billed charges,,,601.09,90,,percent of total billed charges,,,567.7,85,,percent of total billed charges,,503.58,634.49,
TUBE EAR REUTER BOBBIN BLUE 1.14MM,23302580,CDM,,,270,RC,inpatient,,195.2,195.2,,165.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,165.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,171.78,88,,percent of total billed charges,,,,,,,,,149.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,177.63,91,,percent of total billed charges,,,185.44,95,,percent of total billed charges,,,162.02,83,,percent of total billed charges,,,162.02,83,,percent of total billed charges,,,,,,,,,,,,,,,162.02,83,,percent of total billed charges,,,185.44,95,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,160.06,82,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,165.92,85,,percent of total billed charges,,147.18,185.44,
TUBE EAR GOODE-T 1.14MM X 6MM,23302596,CDM,,,270,RC,inpatient,,348,348,,295.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,262.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,295.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,306.24,88,,percent of total billed charges,,,,,,,,,265.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,316.68,91,,percent of total billed charges,,,330.6,95,,percent of total billed charges,,,288.84,83,,percent of total billed charges,,,288.84,83,,percent of total billed charges,,,,,,,,,,,,,,,288.84,83,,percent of total billed charges,,,330.6,95,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,285.36,82,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,295.8,85,,percent of total billed charges,,262.39,330.6,
TUBE EAR RICHARDS 1.32MM,23302598,CDM,,,270,RC,inpatient,,193.12,193.12,,163.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,145.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,169.95,88,,percent of total billed charges,,,,,,,,,147.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,175.74,91,,percent of total billed charges,,,183.46,95,,percent of total billed charges,,,160.29,83,,percent of total billed charges,,,160.29,83,,percent of total billed charges,,,,,,,,,,,,,,,160.29,83,,percent of total billed charges,,,183.46,95,,percent of total billed charges,,,173.81,90,,percent of total billed charges,,,173.81,90,,percent of total billed charges,,,158.36,82,,percent of total billed charges,,,173.81,90,,percent of total billed charges,,,164.15,85,,percent of total billed charges,,145.61,183.46,
TRACTION BOOT UNIVERSAL,23302729,CDM,,,270,RC,inpatient,,104.48,104.48,,88.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,78.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,88.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,91.94,88,,percent of total billed charges,,,,,,,,,79.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,95.08,91,,percent of total billed charges,,,99.26,95,,percent of total billed charges,,,86.72,83,,percent of total billed charges,,,86.72,83,,percent of total billed charges,,,,,,,,,,,,,,,86.72,83,,percent of total billed charges,,,99.26,95,,percent of total billed charges,,,94.03,90,,percent of total billed charges,,,94.03,90,,percent of total billed charges,,,85.67,82,,percent of total billed charges,,,94.03,90,,percent of total billed charges,,,88.81,85,,percent of total billed charges,,78.78,99.26,
ABDUCTION PILLOW  HIP UNIVERSAL,23302802,CDM,,,270,RC,inpatient,,129.84,129.84,,110.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,97.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,110.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,114.26,88,,percent of total billed charges,,,,,,,,,99.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,118.15,91,,percent of total billed charges,,,123.35,95,,percent of total billed charges,,,107.77,83,,percent of total billed charges,,,107.77,83,,percent of total billed charges,,,,,,,,,,,,,,,107.77,83,,percent of total billed charges,,,123.35,95,,percent of total billed charges,,,116.86,90,,percent of total billed charges,,,116.86,90,,percent of total billed charges,,,106.47,82,,percent of total billed charges,,,116.86,90,,percent of total billed charges,,,110.36,85,,percent of total billed charges,,97.9,123.35,
AIRWAY NASO PVC 26FR,23302835,CDM,,,270,RC,inpatient,,21.04,21.04,,17.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.52,88,,percent of total billed charges,,,,,,,,,16.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.15,91,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,,,,,,,,,,,,,17.46,83,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.25,82,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,15.86,19.99,
AIRWAY NASO PVC 30FR,23302836,CDM,,,270,RC,inpatient,,24.68,24.68,,20.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.72,88,,percent of total billed charges,,,,,,,,,18.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.46,91,,percent of total billed charges,,,23.45,95,,percent of total billed charges,,,20.48,83,,percent of total billed charges,,,20.48,83,,percent of total billed charges,,,,,,,,,,,,,,,20.48,83,,percent of total billed charges,,,23.45,95,,percent of total billed charges,,,22.21,90,,percent of total billed charges,,,22.21,90,,percent of total billed charges,,,20.24,82,,percent of total billed charges,,,22.21,90,,percent of total billed charges,,,20.98,85,,percent of total billed charges,,18.61,23.45,
AIRWAY GUEDEL 50MM,23302838,CDM,,,270,RC,inpatient,,3.56,3.56,,3.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3.13,88,,percent of total billed charges,,,,,,,,,2.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3.24,91,,percent of total billed charges,,,3.38,95,,percent of total billed charges,,,2.95,83,,percent of total billed charges,,,2.95,83,,percent of total billed charges,,,,,,,,,,,,,,,2.95,83,,percent of total billed charges,,,3.38,95,,percent of total billed charges,,,3.2,90,,percent of total billed charges,,,3.2,90,,percent of total billed charges,,,2.92,82,,percent of total billed charges,,,3.2,90,,percent of total billed charges,,,3.03,85,,percent of total billed charges,,2.68,3.38,
AIRWAY NASO PVC 24FR,23302840,CDM,,,270,RC,inpatient,,21.04,21.04,,17.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.52,88,,percent of total billed charges,,,,,,,,,16.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.15,91,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,,,,,,,,,,,,,17.46,83,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.25,82,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,15.86,19.99,
AIRWAY NASO PVC 28FR,23302841,CDM,,,270,RC,inpatient,,21.04,21.04,,17.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.52,88,,percent of total billed charges,,,,,,,,,16.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.15,91,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,,,,,,,,,,,,,17.46,83,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.25,82,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,15.86,19.99,
AIRWAY NASO PVC 20FR,23302842,CDM,,,270,RC,inpatient,,21.04,21.04,,17.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.52,88,,percent of total billed charges,,,,,,,,,16.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.15,91,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,,,,,,,,,,,,,17.46,83,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.25,82,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,15.86,19.99,
AIRWAY NASO PVC 22FR,23302843,CDM,,,270,RC,inpatient,,21.04,21.04,,17.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.52,88,,percent of total billed charges,,,,,,,,,16.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.15,91,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,,,,,,,,,,,,,17.46,83,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.25,82,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,15.86,19.99,
PEAK FLOW METER W/ INSTRUCTIONS,23302901,CDM,,,270,RC,inpatient,,67.61,67.61,,57.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.5,88,,percent of total billed charges,,,,,,,,,51.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.53,91,,percent of total billed charges,,,64.23,95,,percent of total billed charges,,,56.12,83,,percent of total billed charges,,,56.12,83,,percent of total billed charges,,,,,,,,,,,,,,,56.12,83,,percent of total billed charges,,,64.23,95,,percent of total billed charges,,,60.85,90,,percent of total billed charges,,,60.85,90,,percent of total billed charges,,,55.44,82,,percent of total billed charges,,,60.85,90,,percent of total billed charges,,,57.47,85,,percent of total billed charges,,50.98,64.23,
CERVICAL COLLAR UNIVERSAL,23302920,CDM,,,270,RC,inpatient,,23.49,23.49,,19.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.67,88,,percent of total billed charges,,,,,,,,,17.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.38,91,,percent of total billed charges,,,22.32,95,,percent of total billed charges,,,19.5,83,,percent of total billed charges,,,19.5,83,,percent of total billed charges,,,,,,,,,,,,,,,19.5,83,,percent of total billed charges,,,22.32,95,,percent of total billed charges,,,21.14,90,,percent of total billed charges,,,21.14,90,,percent of total billed charges,,,19.26,82,,percent of total billed charges,,,21.14,90,,percent of total billed charges,,,19.97,85,,percent of total billed charges,,17.71,22.32,
PLEUREVAC DRAIN SET,23302927,CDM,,,270,RC,inpatient,,250.1,250.1,,212.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220.09,88,,percent of total billed charges,,,,,,,,,191.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.59,91,,percent of total billed charges,,,237.6,95,,percent of total billed charges,,,207.58,83,,percent of total billed charges,,,207.58,83,,percent of total billed charges,,,,,,,,,,,,,,,207.58,83,,percent of total billed charges,,,237.6,95,,percent of total billed charges,,,225.09,90,,percent of total billed charges,,,225.09,90,,percent of total billed charges,,,205.08,82,,percent of total billed charges,,,225.09,90,,percent of total billed charges,,,212.59,85,,percent of total billed charges,,188.58,237.6,
*STOMA POWDER ADAPT 1OZ,23302968,CDM,,,270,RC,inpatient,,30,30,,25.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.4,88,,percent of total billed charges,,,,,,,,,22.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,24.9,83,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,24.6,82,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,22.62,28.5,
*SOCK AID,23303012,CDM,,,270,RC,inpatient,,52,52,,44.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.76,88,,percent of total billed charges,,,,,,,,,39.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,42.64,82,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,39.21,49.4,
REACHER 26  LONG,23303014,CDM,,,270,RC,inpatient,,35.19,35.19,,29.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.97,88,,percent of total billed charges,,,,,,,,,26.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.02,91,,percent of total billed charges,,,33.43,95,,percent of total billed charges,,,29.21,83,,percent of total billed charges,,,29.21,83,,percent of total billed charges,,,,,,,,,,,,,,,29.21,83,,percent of total billed charges,,,33.43,95,,percent of total billed charges,,,31.67,90,,percent of total billed charges,,,31.67,90,,percent of total billed charges,,,28.86,82,,percent of total billed charges,,,31.67,90,,percent of total billed charges,,,29.91,85,,percent of total billed charges,,26.53,33.43,
*DIALYSIS TRAY,23303016,CDM,,,270,RC,inpatient,,114,114,,96.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,100.32,88,,percent of total billed charges,,,,,,,,,87.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,103.74,91,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,,,,,,,,,,,,,94.62,83,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,93.48,82,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,96.9,85,,percent of total billed charges,,85.96,108.3,
LEG LIFTER NAVY 42  REGULAR,23303018,CDM,,,270,RC,inpatient,,72.25,72.25,,61.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,54.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,61.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,63.58,88,,percent of total billed charges,,,,,,,,,55.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,65.75,91,,percent of total billed charges,,,68.64,95,,percent of total billed charges,,,59.97,83,,percent of total billed charges,,,59.97,83,,percent of total billed charges,,,,,,,,,,,,,,,59.97,83,,percent of total billed charges,,,68.64,95,,percent of total billed charges,,,65.03,90,,percent of total billed charges,,,65.03,90,,percent of total billed charges,,,59.25,82,,percent of total billed charges,,,65.03,90,,percent of total billed charges,,,61.41,85,,percent of total billed charges,,54.48,68.64,
*TOILET SEAT RAISED,23303024,CDM,,,270,RC,inpatient,,182,182,,154.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,154.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,160.16,88,,percent of total billed charges,,,,,,,,,139.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,149.24,82,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,137.23,172.9,
*COMBIDERM 6X10,23303119,CDM,,,270,RC,inpatient,,52,52,,44.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.76,88,,percent of total billed charges,,,,,,,,,39.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,42.64,82,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,39.21,49.4,
*COMBIDERM 4X4 W/BORDER,23303120,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
*COMBIDERM 6X7,23303121,CDM,,,270,RC,inpatient,,38,38,,32.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33.44,88,,percent of total billed charges,,,,,,,,,29.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.58,91,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,,,,,,,,,,,,,31.54,83,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,31.16,82,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,28.65,36.1,
*COMBIDERM 5.25 X 5.25,23303122,CDM,,,270,RC,inpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.92,88,,percent of total billed charges,,,,,,,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,44.49,56.05,
*COMBIDERM 5.25 X 5.25 W/BORDER,23303124,CDM,,,270,RC,inpatient,,31,31,,26.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.28,88,,percent of total billed charges,,,,,,,,,23.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,,,,,,,,,,,,,25.73,83,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,25.42,82,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,23.37,29.45,
KCI CANISTER M6275063,23303129,CDM,,,270,RC,inpatient,,318.68,318.68,,270.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,240.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,270.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,280.44,88,,percent of total billed charges,,,,,,,,,243.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,290,91,,percent of total billed charges,,,302.75,95,,percent of total billed charges,,,264.5,83,,percent of total billed charges,,,264.5,83,,percent of total billed charges,,,,,,,,,,,,,,,264.5,83,,percent of total billed charges,,,302.75,95,,percent of total billed charges,,,286.81,90,,percent of total billed charges,,,286.81,90,,percent of total billed charges,,,261.32,82,,percent of total billed charges,,,286.81,90,,percent of total billed charges,,,270.88,85,,percent of total billed charges,,240.28,302.75,
KCI GRANUFOAM SM M6275051,23303132,CDM,,,270,RC,inpatient,,300.08,300.08,,254.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264.07,88,,percent of total billed charges,,,,,,,,,229.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273.07,91,,percent of total billed charges,,,285.08,95,,percent of total billed charges,,,249.07,83,,percent of total billed charges,,,249.07,83,,percent of total billed charges,,,,,,,,,,,,,,,249.07,83,,percent of total billed charges,,,285.08,95,,percent of total billed charges,,,270.07,90,,percent of total billed charges,,,270.07,90,,percent of total billed charges,,,246.07,82,,percent of total billed charges,,,270.07,90,,percent of total billed charges,,,255.07,85,,percent of total billed charges,,226.26,285.08,
KCI VERSAFOAM WHITE SM M6275033,23303133,CDM,,,270,RC,inpatient,,83.02,83.02,,70.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.06,88,,percent of total billed charges,,,,,,,,,63.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.55,91,,percent of total billed charges,,,78.87,95,,percent of total billed charges,,,68.91,83,,percent of total billed charges,,,68.91,83,,percent of total billed charges,,,,,,,,,,,,,,,68.91,83,,percent of total billed charges,,,78.87,95,,percent of total billed charges,,,74.72,90,,percent of total billed charges,,,74.72,90,,percent of total billed charges,,,68.08,82,,percent of total billed charges,,,74.72,90,,percent of total billed charges,,,70.57,85,,percent of total billed charges,,62.6,78.87,
KCI GRANUFOAM LG M6275053,23303134,CDM,,,270,RC,inpatient,,425.53,425.53,,361.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,320.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,361.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,374.47,88,,percent of total billed charges,,,,,,,,,325.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,387.23,91,,percent of total billed charges,,,404.25,95,,percent of total billed charges,,,353.19,83,,percent of total billed charges,,,353.19,83,,percent of total billed charges,,,,,,,,,,,,,,,353.19,83,,percent of total billed charges,,,404.25,95,,percent of total billed charges,,,382.98,90,,percent of total billed charges,,,382.98,90,,percent of total billed charges,,,348.93,82,,percent of total billed charges,,,382.98,90,,percent of total billed charges,,,361.7,85,,percent of total billed charges,,320.85,404.25,
*KCI HEEL FOAM,23303135,CDM,,,270,RC,inpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,283.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,319.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,283.5,357.2,
KCI GRANUFOAM MED M6275052,23303136,CDM,,,270,RC,inpatient,,352.8,352.8,,299.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,266.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,299.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,310.46,88,,percent of total billed charges,,,,,,,,,269.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,321.05,91,,percent of total billed charges,,,335.16,95,,percent of total billed charges,,,292.82,83,,percent of total billed charges,,,292.82,83,,percent of total billed charges,,,,,,,,,,,,,,,292.82,83,,percent of total billed charges,,,335.16,95,,percent of total billed charges,,,317.52,90,,percent of total billed charges,,,317.52,90,,percent of total billed charges,,,289.3,82,,percent of total billed charges,,,317.52,90,,percent of total billed charges,,,299.88,85,,percent of total billed charges,,266.01,335.16,
KCI GRANUFOAM SILVER MED M8275096,23303137,CDM,,,270,RC,inpatient,,477.44,477.44,,405.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,359.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,405.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,420.15,88,,percent of total billed charges,,,,,,,,,364.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,434.47,91,,percent of total billed charges,,,453.57,95,,percent of total billed charges,,,396.28,83,,percent of total billed charges,,,396.28,83,,percent of total billed charges,,,,,,,,,,,,,,,396.28,83,,percent of total billed charges,,,453.57,95,,percent of total billed charges,,,429.7,90,,percent of total billed charges,,,429.7,90,,percent of total billed charges,,,391.5,82,,percent of total billed charges,,,429.7,90,,percent of total billed charges,,,405.82,85,,percent of total billed charges,,359.99,453.57,
STAPLER SKIN PROXIMATE 35W,23303214,CDM,,,270,RC,inpatient,,53.41,53.41,,45.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47,88,,percent of total billed charges,,,,,,,,,40.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,48.6,91,,percent of total billed charges,,,50.74,95,,percent of total billed charges,,,44.33,83,,percent of total billed charges,,,44.33,83,,percent of total billed charges,,,,,,,,,,,,,,,44.33,83,,percent of total billed charges,,,50.74,95,,percent of total billed charges,,,48.07,90,,percent of total billed charges,,,48.07,90,,percent of total billed charges,,,43.8,82,,percent of total billed charges,,,48.07,90,,percent of total billed charges,,,45.4,85,,percent of total billed charges,,40.27,50.74,
STAPLER REMOVER SKIN,23303222,CDM,,,270,RC,inpatient,,130.44,130.44,,110.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,110.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,114.79,88,,percent of total billed charges,,,,,,,,,99.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,118.7,91,,percent of total billed charges,,,123.92,95,,percent of total billed charges,,,108.27,83,,percent of total billed charges,,,108.27,83,,percent of total billed charges,,,,,,,,,,,,,,,108.27,83,,percent of total billed charges,,,123.92,95,,percent of total billed charges,,,117.4,90,,percent of total billed charges,,,117.4,90,,percent of total billed charges,,,106.96,82,,percent of total billed charges,,,117.4,90,,percent of total billed charges,,,110.87,85,,percent of total billed charges,,98.35,123.92,
* IV CATHETER JELCO 20 NO WINGS (V0904),23303236,CDM,,,270,RC,inpatient,,4,4,,3.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3.52,88,,percent of total billed charges,,,,,,,,,3.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3.64,91,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3.32,83,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.28,82,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,3.02,3.8,
ENDO LOC ADULT,23303420,CDM,,,270,RC,inpatient,,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,33.93,42.75,
ENDO LOC PED,23303421,CDM,,,270,RC,inpatient,,36,36,,30.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31.68,88,,percent of total billed charges,,,,,,,,,27.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,,,,,,,,,,,,,29.88,83,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,29.52,82,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,27.14,34.2,
*EXTENSION TUBE 14' DISP,23303462,CDM,,,270,RC,inpatient,,6,6,,5.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.28,88,,percent of total billed charges,,,,,,,,,4.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4.98,83,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,4.92,82,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,4.52,5.7,
*EXTENSION TUBE 21' DISP,23303463,CDM,,,270,RC,inpatient,,6,6,,5.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.28,88,,percent of total billed charges,,,,,,,,,4.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4.98,83,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,4.92,82,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,4.52,5.7,
URINARY DRAINAGE BAG W METER,23303537,CDM,,,270,RC,inpatient,,51.34,51.34,,43.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.18,88,,percent of total billed charges,,,,,,,,,39.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.72,91,,percent of total billed charges,,,48.77,95,,percent of total billed charges,,,42.61,83,,percent of total billed charges,,,42.61,83,,percent of total billed charges,,,,,,,,,,,,,,,42.61,83,,percent of total billed charges,,,48.77,95,,percent of total billed charges,,,46.21,90,,percent of total billed charges,,,46.21,90,,percent of total billed charges,,,42.1,82,,percent of total billed charges,,,46.21,90,,percent of total billed charges,,,43.64,85,,percent of total billed charges,,38.71,48.77,
GUIDEWIRE COONS BENSON,23303554,CDM,,,270,RC,inpatient,,199.95,199.95,,169.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,169.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,175.96,88,,percent of total billed charges,,,,,,,,,152.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,181.95,91,,percent of total billed charges,,,189.95,95,,percent of total billed charges,,,165.96,83,,percent of total billed charges,,,165.96,83,,percent of total billed charges,,,,,,,,,,,,,,,165.96,83,,percent of total billed charges,,,189.95,95,,percent of total billed charges,,,179.96,90,,percent of total billed charges,,,179.96,90,,percent of total billed charges,,,163.96,82,,percent of total billed charges,,,179.96,90,,percent of total billed charges,,,169.96,85,,percent of total billed charges,,150.76,189.95,
GLIDEWIRE URO 150 X 3MM,23303555,CDM,,,270,RC,inpatient,,371.07,371.07,,315.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,279.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,315.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,326.54,88,,percent of total billed charges,,,,,,,,,283.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,337.67,91,,percent of total billed charges,,,352.52,95,,percent of total billed charges,,,307.99,83,,percent of total billed charges,,,307.99,83,,percent of total billed charges,,,,,,,,,,,,,,,307.99,83,,percent of total billed charges,,,352.52,95,,percent of total billed charges,,,333.96,90,,percent of total billed charges,,,333.96,90,,percent of total billed charges,,,304.28,82,,percent of total billed charges,,,333.96,90,,percent of total billed charges,,,315.41,85,,percent of total billed charges,,279.79,352.52,
AIRWAY I-GEL SUPRAGLOTTIC  #4,23303694,CDM,,,270,RC,inpatient,,76.87,76.87,,65.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,57.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.65,88,,percent of total billed charges,,,,,,,,,58.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,69.95,91,,percent of total billed charges,,,73.03,95,,percent of total billed charges,,,63.8,83,,percent of total billed charges,,,63.8,83,,percent of total billed charges,,,,,,,,,,,,,,,63.8,83,,percent of total billed charges,,,73.03,95,,percent of total billed charges,,,69.18,90,,percent of total billed charges,,,69.18,90,,percent of total billed charges,,,63.03,82,,percent of total billed charges,,,69.18,90,,percent of total billed charges,,,65.34,85,,percent of total billed charges,,57.96,73.03,
AIRWAY I-GEL SUPRAGLOTTIC #5,23303695,CDM,,,270,RC,inpatient,,76.87,76.87,,65.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,57.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.65,88,,percent of total billed charges,,,,,,,,,58.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,69.95,91,,percent of total billed charges,,,73.03,95,,percent of total billed charges,,,63.8,83,,percent of total billed charges,,,63.8,83,,percent of total billed charges,,,,,,,,,,,,,,,63.8,83,,percent of total billed charges,,,73.03,95,,percent of total billed charges,,,69.18,90,,percent of total billed charges,,,69.18,90,,percent of total billed charges,,,63.03,82,,percent of total billed charges,,,69.18,90,,percent of total billed charges,,,65.34,85,,percent of total billed charges,,57.96,73.03,
AIRWAY I-GEL SUPRAGLOTTIC  #3,23303696,CDM,,,270,RC,inpatient,,76.84,76.84,,65.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,57.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.62,88,,percent of total billed charges,,,,,,,,,58.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,69.92,91,,percent of total billed charges,,,73,95,,percent of total billed charges,,,63.78,83,,percent of total billed charges,,,63.78,83,,percent of total billed charges,,,,,,,,,,,,,,,63.78,83,,percent of total billed charges,,,73,95,,percent of total billed charges,,,69.16,90,,percent of total billed charges,,,69.16,90,,percent of total billed charges,,,63.01,82,,percent of total billed charges,,,69.16,90,,percent of total billed charges,,,65.31,85,,percent of total billed charges,,57.94,73,
TRAY BONE MARROW JAMSHIDE,23303842,CDM,,,270,RC,inpatient,,207.83,207.83,,176.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,156.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,176.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,182.89,88,,percent of total billed charges,,,,,,,,,158.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,189.13,91,,percent of total billed charges,,,197.44,95,,percent of total billed charges,,,172.5,83,,percent of total billed charges,,,172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,172.5,83,,percent of total billed charges,,,197.44,95,,percent of total billed charges,,,187.05,90,,percent of total billed charges,,,187.05,90,,percent of total billed charges,,,170.42,82,,percent of total billed charges,,,187.05,90,,percent of total billed charges,,,176.66,85,,percent of total billed charges,,156.7,197.44,
TRAY LUMBAR PUNCTURE,23303917,CDM,,,270,RC,inpatient,,189.53,189.53,,160.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,142.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,161.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,166.79,88,,percent of total billed charges,,,,,,,,,144.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,172.47,91,,percent of total billed charges,,,180.05,95,,percent of total billed charges,,,157.31,83,,percent of total billed charges,,,157.31,83,,percent of total billed charges,,,,,,,,,,,,,,,157.31,83,,percent of total billed charges,,,180.05,95,,percent of total billed charges,,,170.58,90,,percent of total billed charges,,,170.58,90,,percent of total billed charges,,,155.41,82,,percent of total billed charges,,,170.58,90,,percent of total billed charges,,,161.1,85,,percent of total billed charges,,142.91,180.05,
TRAY LUMBAR PUNCTURE - PEDS,23303925,CDM,,,270,RC,inpatient,,184.16,184.16,,156.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,138.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,156.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,162.06,88,,percent of total billed charges,,,,,,,,,140.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,167.59,91,,percent of total billed charges,,,174.95,95,,percent of total billed charges,,,152.85,83,,percent of total billed charges,,,152.85,83,,percent of total billed charges,,,,,,,,,,,,,,,152.85,83,,percent of total billed charges,,,174.95,95,,percent of total billed charges,,,165.74,90,,percent of total billed charges,,,165.74,90,,percent of total billed charges,,,151.01,82,,percent of total billed charges,,,165.74,90,,percent of total billed charges,,,156.54,85,,percent of total billed charges,,138.86,174.95,
TRAY PUDENDAL BLOCK,23303941,CDM,,,270,RC,inpatient,,57.15,57.15,,48.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.29,88,,percent of total billed charges,,,,,,,,,43.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52.01,91,,percent of total billed charges,,,54.29,95,,percent of total billed charges,,,47.43,83,,percent of total billed charges,,,47.43,83,,percent of total billed charges,,,,,,,,,,,,,,,47.43,83,,percent of total billed charges,,,54.29,95,,percent of total billed charges,,,51.44,90,,percent of total billed charges,,,51.44,90,,percent of total billed charges,,,46.86,82,,percent of total billed charges,,,51.44,90,,percent of total billed charges,,,48.58,85,,percent of total billed charges,,43.09,54.29,
*THORACENTESIS PARACENTESIS TRAY(ARROW),23303959,CDM,,,270,RC,inpatient,,166,166,,140.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,146.08,88,,percent of total billed charges,,,,,,,,,126.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,,,,,,,,,,,,,137.78,83,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,136.12,82,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,125.16,157.7,
* TRACHEOSTOMY TUBE CUFF #6 (V0106),23303993,CDM,,,270,RC,inpatient,,235,235,,199.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,177.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,199.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,206.8,88,,percent of total billed charges,,,,,,,,,179.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,213.85,91,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,,,,,,,,,,,,,195.05,83,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,192.7,82,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,199.75,85,,percent of total billed charges,,177.19,223.25,
WARMING BLANKET FULL BODY,23304003,CDM,,,270,RC,inpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,58.81,74.1,
BLOOD TRANSFUSION FILTER,23304029,CDM,,,270,RC,inpatient,,49.05,49.05,,41.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,43.16,88,,percent of total billed charges,,,,,,,,,37.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,44.64,91,,percent of total billed charges,,,46.6,95,,percent of total billed charges,,,40.71,83,,percent of total billed charges,,,40.71,83,,percent of total billed charges,,,,,,,,,,,,,,,40.71,83,,percent of total billed charges,,,46.6,95,,percent of total billed charges,,,44.15,90,,percent of total billed charges,,,44.15,90,,percent of total billed charges,,,40.22,82,,percent of total billed charges,,,44.15,90,,percent of total billed charges,,,41.69,85,,percent of total billed charges,,36.98,46.6,
NEEDLE DRAIN CATH,23304080,CDM,,,270,RC,inpatient,,177,177,,150.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,133.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,150.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,155.76,88,,percent of total billed charges,,,,,,,,,135.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,,,,,,,,,,,,,146.91,83,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,145.14,82,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,133.46,168.15,
*BASIN SET LG,23304089,CDM,,,270,RC,inpatient,,22,22,,18.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.36,88,,percent of total billed charges,,,,,,,,,16.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.02,91,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,,,,,,,,,,,,,18.26,83,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.04,82,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,16.59,20.9,
CONTAMINATION CONTROL DEVICE TRAY,23304090,CDM,,,270,RC,inpatient,,158.64,158.64,,134.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,134.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.6,88,,percent of total billed charges,,,,,,,,,121.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,144.36,91,,percent of total billed charges,,,150.71,95,,percent of total billed charges,,,131.67,83,,percent of total billed charges,,,131.67,83,,percent of total billed charges,,,,,,,,,,,,,,,131.67,83,,percent of total billed charges,,,150.71,95,,percent of total billed charges,,,142.78,90,,percent of total billed charges,,,142.78,90,,percent of total billed charges,,,130.08,82,,percent of total billed charges,,,142.78,90,,percent of total billed charges,,,134.84,85,,percent of total billed charges,,119.61,150.71,
LIGACLIP MEDIUM LS-200,23304105,CDM,,,270,RC,inpatient,,27.63,27.63,,23.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.31,88,,percent of total billed charges,,,,,,,,,21.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.14,91,,percent of total billed charges,,,26.25,95,,percent of total billed charges,,,22.93,83,,percent of total billed charges,,,22.93,83,,percent of total billed charges,,,,,,,,,,,,,,,22.93,83,,percent of total billed charges,,,26.25,95,,percent of total billed charges,,,24.87,90,,percent of total billed charges,,,24.87,90,,percent of total billed charges,,,22.66,82,,percent of total billed charges,,,24.87,90,,percent of total billed charges,,,23.49,85,,percent of total billed charges,,20.83,26.25,
LIGACLIP LARGE LS-400,23304113,CDM,,,270,RC,inpatient,,45.73,45.73,,38.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.24,88,,percent of total billed charges,,,,,,,,,34.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.61,91,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,,,,,,,,,,,,,37.96,83,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,37.5,82,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,34.48,43.44,
STOMA POUCH W/CLAMP 2-1/4,23304226,CDM,,,270,RC,inpatient,,2.84,2.84,,2.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.5,88,,percent of total billed charges,,,,,,,,,2.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.58,91,,percent of total billed charges,,,2.7,95,,percent of total billed charges,,,2.36,83,,percent of total billed charges,,,2.36,83,,percent of total billed charges,,,,,,,,,,,,,,,2.36,83,,percent of total billed charges,,,2.7,95,,percent of total billed charges,,,2.56,90,,percent of total billed charges,,,2.56,90,,percent of total billed charges,,,2.33,82,,percent of total billed charges,,,2.56,90,,percent of total billed charges,,,2.41,85,,percent of total billed charges,,2.14,2.7,
STOMA POUCH 2-3/4 DISPOSABLE,23304227,CDM,,,270,RC,inpatient,,2.84,2.84,,2.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.5,88,,percent of total billed charges,,,,,,,,,2.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.58,91,,percent of total billed charges,,,2.7,95,,percent of total billed charges,,,2.36,83,,percent of total billed charges,,,2.36,83,,percent of total billed charges,,,,,,,,,,,,,,,2.36,83,,percent of total billed charges,,,2.7,95,,percent of total billed charges,,,2.56,90,,percent of total billed charges,,,2.56,90,,percent of total billed charges,,,2.33,82,,percent of total billed charges,,,2.56,90,,percent of total billed charges,,,2.41,85,,percent of total billed charges,,2.14,2.7,
*ELEC/SURG PENCIL W/SMOKE EVAC,23304255,CDM,,,270,RC,inpatient,,27,27,,22.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23.76,88,,percent of total billed charges,,,,,,,,,20.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,,,,,,,,,,,,,22.41,83,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.14,82,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,20.36,25.65,
ELEC/SURG GROUND PAD PEDIATRIC,23304256,CDM,,,270,RC,inpatient,,40.86,40.86,,34.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.96,88,,percent of total billed charges,,,,,,,,,31.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37.18,91,,percent of total billed charges,,,38.82,95,,percent of total billed charges,,,33.91,83,,percent of total billed charges,,,33.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33.91,83,,percent of total billed charges,,,38.82,95,,percent of total billed charges,,,36.77,90,,percent of total billed charges,,,36.77,90,,percent of total billed charges,,,33.51,82,,percent of total billed charges,,,36.77,90,,percent of total billed charges,,,34.73,85,,percent of total billed charges,,30.81,38.82,
LIGACLIP SMALL LS-100,23304261,CDM,,,270,RC,inpatient,,23.58,23.58,,20.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.75,88,,percent of total billed charges,,,,,,,,,18.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.46,91,,percent of total billed charges,,,22.4,95,,percent of total billed charges,,,19.57,83,,percent of total billed charges,,,19.57,83,,percent of total billed charges,,,,,,,,,,,,,,,19.57,83,,percent of total billed charges,,,22.4,95,,percent of total billed charges,,,21.22,90,,percent of total billed charges,,,21.22,90,,percent of total billed charges,,,19.34,82,,percent of total billed charges,,,21.22,90,,percent of total billed charges,,,20.04,85,,percent of total billed charges,,17.78,22.4,
CATH COUDE 20F 30CC,23304387,CDM,,,270,RC,inpatient,,79.31,79.31,,67.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.79,88,,percent of total billed charges,,,,,,,,,60.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.17,91,,percent of total billed charges,,,75.34,95,,percent of total billed charges,,,65.83,83,,percent of total billed charges,,,65.83,83,,percent of total billed charges,,,,,,,,,,,,,,,65.83,83,,percent of total billed charges,,,75.34,95,,percent of total billed charges,,,71.38,90,,percent of total billed charges,,,71.38,90,,percent of total billed charges,,,65.03,82,,percent of total billed charges,,,71.38,90,,percent of total billed charges,,,67.41,85,,percent of total billed charges,,59.8,75.34,
KNEE IMMOBILIZER 18,23304427,CDM,,,270,RC,inpatient,,111.6,111.6,,94.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.21,88,,percent of total billed charges,,,,,,,,,85.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.56,91,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,,,,,,,,,,,,,92.63,83,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,91.51,82,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,84.15,106.02,
KNEE IMMOBILIZER 22,23304428,CDM,,,270,RC,inpatient,,111.6,111.6,,94.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.21,88,,percent of total billed charges,,,,,,,,,85.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.56,91,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,,,,,,,,,,,,,92.63,83,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,91.51,82,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,84.15,106.02,
KNEE IMMOBILIZER 24,23304429,CDM,,,270,RC,inpatient,,111.6,111.6,,94.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.21,88,,percent of total billed charges,,,,,,,,,85.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.56,91,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,,,,,,,,,,,,,92.63,83,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,91.51,82,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,84.15,106.02,
MASK FACE ANES SMALL,23304436,CDM,,,270,RC,inpatient,,17.51,17.51,,14.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.41,88,,percent of total billed charges,,,,,,,,,13.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.93,91,,percent of total billed charges,,,16.63,95,,percent of total billed charges,,,14.53,83,,percent of total billed charges,,,14.53,83,,percent of total billed charges,,,,,,,,,,,,,,,14.53,83,,percent of total billed charges,,,16.63,95,,percent of total billed charges,,,15.76,90,,percent of total billed charges,,,15.76,90,,percent of total billed charges,,,14.36,82,,percent of total billed charges,,,15.76,90,,percent of total billed charges,,,14.88,85,,percent of total billed charges,,13.2,16.63,
KNEE IMMOBILIZER 14,23304437,CDM,,,270,RC,inpatient,,111.6,111.6,,94.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.21,88,,percent of total billed charges,,,,,,,,,85.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.56,91,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,,,,,,,,,,,,,92.63,83,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,91.51,82,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,84.15,106.02,
KNEE IMMOBILIZER 20,23304439,CDM,,,270,RC,inpatient,,111.6,111.6,,94.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.21,88,,percent of total billed charges,,,,,,,,,85.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.56,91,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,,,,,,,,,,,,,92.63,83,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,91.51,82,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,84.15,106.02,
KNEE IMMOBILIZER 16,23304440,CDM,,,270,RC,inpatient,,111.6,111.6,,94.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.21,88,,percent of total billed charges,,,,,,,,,85.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.56,91,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,,,,,,,,,,,,,92.63,83,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,91.51,82,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,84.15,106.02,
*FACE MASK MEDIUM ANESTHESIA,23304446,CDM,,,270,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
*FACE MASK LARGE ANESTHESIA,23304447,CDM,,,270,RC,inpatient,,17,17,,14.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.96,88,,percent of total billed charges,,,,,,,,,12.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.47,91,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,,,,,,,,,,,,,14.11,83,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,13.94,82,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,14.45,85,,percent of total billed charges,,12.82,16.15,
MASK FACE ANES INFANT,23304448,CDM,,,270,RC,inpatient,,17.23,17.23,,14.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.16,88,,percent of total billed charges,,,,,,,,,13.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.68,91,,percent of total billed charges,,,16.37,95,,percent of total billed charges,,,14.3,83,,percent of total billed charges,,,14.3,83,,percent of total billed charges,,,,,,,,,,,,,,,14.3,83,,percent of total billed charges,,,16.37,95,,percent of total billed charges,,,15.51,90,,percent of total billed charges,,,15.51,90,,percent of total billed charges,,,14.13,82,,percent of total billed charges,,,15.51,90,,percent of total billed charges,,,14.65,85,,percent of total billed charges,,12.99,16.37,
MASK FACE ANES CHILD,23304449,CDM,,,270,RC,inpatient,,16.74,16.74,,14.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.73,88,,percent of total billed charges,,,,,,,,,12.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.23,91,,percent of total billed charges,,,15.9,95,,percent of total billed charges,,,13.89,83,,percent of total billed charges,,,13.89,83,,percent of total billed charges,,,,,,,,,,,,,,,13.89,83,,percent of total billed charges,,,15.9,95,,percent of total billed charges,,,15.07,90,,percent of total billed charges,,,15.07,90,,percent of total billed charges,,,13.73,82,,percent of total billed charges,,,15.07,90,,percent of total billed charges,,,14.23,85,,percent of total billed charges,,12.62,15.9,
SUPPORTER MALE ATHLETIC - LGE,23304535,CDM,,,270,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
SUPPORTER MALE ATHLETIC - XLG,23304536,CDM,,,270,RC,inpatient,,76.76,76.76,,65.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,57.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.55,88,,percent of total billed charges,,,,,,,,,58.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,69.85,91,,percent of total billed charges,,,72.92,95,,percent of total billed charges,,,63.71,83,,percent of total billed charges,,,63.71,83,,percent of total billed charges,,,,,,,,,,,,,,,63.71,83,,percent of total billed charges,,,72.92,95,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,62.94,82,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,65.25,85,,percent of total billed charges,,57.88,72.92,
LAP CHOLE ACCESSORY KIT,23304691,CDM,,,270,RC,inpatient,,1647.04,1647.04,,1398.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1241.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1399.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1449.4,88,,percent of total billed charges,,,,,,,,,1258.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1498.81,91,,percent of total billed charges,,,1564.69,95,,percent of total billed charges,,,1367.04,83,,percent of total billed charges,,,1367.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1367.04,83,,percent of total billed charges,,,1564.69,95,,percent of total billed charges,,,1482.34,90,,percent of total billed charges,,,1482.34,90,,percent of total billed charges,,,1350.57,82,,percent of total billed charges,,,1482.34,90,,percent of total billed charges,,,1399.98,85,,percent of total billed charges,,1241.87,1564.69,
NEEDLE VERES PNEUMO 120MM,23304692,CDM,,,270,RC,inpatient,,98.88,98.88,,83.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,74.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,84.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,87.01,88,,percent of total billed charges,,,,,,,,,75.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,89.98,91,,percent of total billed charges,,,93.94,95,,percent of total billed charges,,,82.07,83,,percent of total billed charges,,,82.07,83,,percent of total billed charges,,,,,,,,,,,,,,,82.07,83,,percent of total billed charges,,,93.94,95,,percent of total billed charges,,,88.99,90,,percent of total billed charges,,,88.99,90,,percent of total billed charges,,,81.08,82,,percent of total billed charges,,,88.99,90,,percent of total billed charges,,,84.05,85,,percent of total billed charges,,74.56,93.94,
LAPAROSCOPIC REDUCER CAP,23304693,CDM,,,270,RC,inpatient,,40.77,40.77,,34.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.88,88,,percent of total billed charges,,,,,,,,,31.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37.1,91,,percent of total billed charges,,,38.73,95,,percent of total billed charges,,,33.84,83,,percent of total billed charges,,,33.84,83,,percent of total billed charges,,,,,,,,,,,,,,,33.84,83,,percent of total billed charges,,,38.73,95,,percent of total billed charges,,,36.69,90,,percent of total billed charges,,,36.69,90,,percent of total billed charges,,,33.43,82,,percent of total billed charges,,,36.69,90,,percent of total billed charges,,,34.65,85,,percent of total billed charges,,30.74,38.73,
*TUBING BLOOD WARMING,23304725,CDM,,,270,RC,inpatient,,22,22,,18.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.36,88,,percent of total billed charges,,,,,,,,,16.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.02,91,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,,,,,,,,,,,,,18.26,83,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.04,82,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,16.59,20.9,
BALLOON URETERAL DILATATION,23304741,CDM,,,270,RC,inpatient,,1485.84,1485.84,,1261.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1120.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1262.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1307.54,88,,percent of total billed charges,,,,,,,,,1135.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1352.11,91,,percent of total billed charges,,,1411.55,95,,percent of total billed charges,,,1233.25,83,,percent of total billed charges,,,1233.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1233.25,83,,percent of total billed charges,,,1411.55,95,,percent of total billed charges,,,1337.26,90,,percent of total billed charges,,,1337.26,90,,percent of total billed charges,,,1218.39,82,,percent of total billed charges,,,1337.26,90,,percent of total billed charges,,,1262.96,85,,percent of total billed charges,,1120.32,1411.55,
SPLINT WRIST & FOREARM UNIV/LT,23304758,CDM,,,270,RC,inpatient,,65.2,65.2,,55.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.38,88,,percent of total billed charges,,,,,,,,,49.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.33,91,,percent of total billed charges,,,61.94,95,,percent of total billed charges,,,54.12,83,,percent of total billed charges,,,54.12,83,,percent of total billed charges,,,,,,,,,,,,,,,54.12,83,,percent of total billed charges,,,61.94,95,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,53.46,82,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,55.42,85,,percent of total billed charges,,49.16,61.94,
SPLINT WRIST & FOREARM UNIV/RT,23304761,CDM,,,270,RC,inpatient,,65.2,65.2,,55.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.38,88,,percent of total billed charges,,,,,,,,,49.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.33,91,,percent of total billed charges,,,61.94,95,,percent of total billed charges,,,54.12,83,,percent of total billed charges,,,54.12,83,,percent of total billed charges,,,,,,,,,,,,,,,54.12,83,,percent of total billed charges,,,61.94,95,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,53.46,82,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,55.42,85,,percent of total billed charges,,49.16,61.94,
SPLINT WRIST & FOREARM LF PED,23304765,CDM,,,270,RC,inpatient,,67.15,67.15,,57.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.09,88,,percent of total billed charges,,,,,,,,,51.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.11,91,,percent of total billed charges,,,63.79,95,,percent of total billed charges,,,55.73,83,,percent of total billed charges,,,55.73,83,,percent of total billed charges,,,,,,,,,,,,,,,55.73,83,,percent of total billed charges,,,63.79,95,,percent of total billed charges,,,60.44,90,,percent of total billed charges,,,60.44,90,,percent of total billed charges,,,55.06,82,,percent of total billed charges,,,60.44,90,,percent of total billed charges,,,57.08,85,,percent of total billed charges,,50.63,63.79,
* BREAST PUMP MEDELA (V1104),23304881,CDM,,,270,RC,inpatient,,66,66,,56.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.08,88,,percent of total billed charges,,,,,,,,,50.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.06,91,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,,,,,,,,,,,,,54.78,83,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,54.12,82,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,49.76,62.7,
STAPLER SKIN PRECISE VISTA 15W,23304900,CDM,,,270,RC,inpatient,,69.96,69.96,,59.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,59.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,61.56,88,,percent of total billed charges,,,,,,,,,53.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,63.66,91,,percent of total billed charges,,,66.46,95,,percent of total billed charges,,,58.07,83,,percent of total billed charges,,,58.07,83,,percent of total billed charges,,,,,,,,,,,,,,,58.07,83,,percent of total billed charges,,,66.46,95,,percent of total billed charges,,,62.96,90,,percent of total billed charges,,,62.96,90,,percent of total billed charges,,,57.37,82,,percent of total billed charges,,,62.96,90,,percent of total billed charges,,,59.47,85,,percent of total billed charges,,52.75,66.46,
CHOLANGIOGRAM KIT 10FR,23304907,CDM,,,270,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
STAPLER SKIN 15R,23304915,CDM,,,270,RC,inpatient,,43.72,43.72,,37.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.47,88,,percent of total billed charges,,,,,,,,,33.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,39.79,91,,percent of total billed charges,,,41.53,95,,percent of total billed charges,,,36.29,83,,percent of total billed charges,,,36.29,83,,percent of total billed charges,,,,,,,,,,,,,,,36.29,83,,percent of total billed charges,,,41.53,95,,percent of total billed charges,,,39.35,90,,percent of total billed charges,,,39.35,90,,percent of total billed charges,,,35.85,82,,percent of total billed charges,,,39.35,90,,percent of total billed charges,,,37.16,85,,percent of total billed charges,,32.96,41.53,
STAPLER SKIN PRECISE VISTA 15R,23304916,CDM,,,270,RC,inpatient,,33.37,33.37,,28.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.37,88,,percent of total billed charges,,,,,,,,,25.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.37,91,,percent of total billed charges,,,31.7,95,,percent of total billed charges,,,27.7,83,,percent of total billed charges,,,27.7,83,,percent of total billed charges,,,,,,,,,,,,,,,27.7,83,,percent of total billed charges,,,31.7,95,,percent of total billed charges,,,30.03,90,,percent of total billed charges,,,30.03,90,,percent of total billed charges,,,27.36,82,,percent of total billed charges,,,30.03,90,,percent of total billed charges,,,28.36,85,,percent of total billed charges,,25.16,31.7,
ULTRASLING III BLACK MEDIUM,23305085,CDM,,,270,RC,inpatient,,373.95,373.95,,317.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,281.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,317.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,329.08,88,,percent of total billed charges,,,,,,,,,285.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,340.29,91,,percent of total billed charges,,,355.25,95,,percent of total billed charges,,,310.38,83,,percent of total billed charges,,,310.38,83,,percent of total billed charges,,,,,,,,,,,,,,,310.38,83,,percent of total billed charges,,,355.25,95,,percent of total billed charges,,,336.56,90,,percent of total billed charges,,,336.56,90,,percent of total billed charges,,,306.64,82,,percent of total billed charges,,,336.56,90,,percent of total billed charges,,,317.86,85,,percent of total billed charges,,281.96,355.25,
SPLINT WRIST RIGHT PEDIATRIC,23305090,CDM,,,270,RC,inpatient,,59.5,59.5,,50.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.36,88,,percent of total billed charges,,,,,,,,,45.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,54.15,91,,percent of total billed charges,,,56.53,95,,percent of total billed charges,,,49.39,83,,percent of total billed charges,,,49.39,83,,percent of total billed charges,,,,,,,,,,,,,,,49.39,83,,percent of total billed charges,,,56.53,95,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,48.79,82,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,50.58,85,,percent of total billed charges,,44.86,56.53,
*SPLINT WRIST RIGHT MEDIUM,23305091,CDM,,,270,RC,inpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,61.07,76.95,
SHOULDER IMMOBILIZER MEN XLG,23305293,CDM,,,270,RC,inpatient,,65.2,65.2,,55.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.38,88,,percent of total billed charges,,,,,,,,,49.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.33,91,,percent of total billed charges,,,61.94,95,,percent of total billed charges,,,54.12,83,,percent of total billed charges,,,54.12,83,,percent of total billed charges,,,,,,,,,,,,,,,54.12,83,,percent of total billed charges,,,61.94,95,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,53.46,82,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,55.42,85,,percent of total billed charges,,49.16,61.94,
SHOULDER IMMOBILIZER WOMEN LG,23305296,CDM,,,270,RC,inpatient,,64.43,64.43,,54.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.7,88,,percent of total billed charges,,,,,,,,,49.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.63,91,,percent of total billed charges,,,61.21,95,,percent of total billed charges,,,53.48,83,,percent of total billed charges,,,53.48,83,,percent of total billed charges,,,,,,,,,,,,,,,53.48,83,,percent of total billed charges,,,61.21,95,,percent of total billed charges,,,57.99,90,,percent of total billed charges,,,57.99,90,,percent of total billed charges,,,52.83,82,,percent of total billed charges,,,57.99,90,,percent of total billed charges,,,54.77,85,,percent of total billed charges,,48.58,61.21,
*SHOULDER IMMOBILIZER MEN SM,23305297,CDM,,,270,RC,inpatient,,101,101,,85.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88.88,88,,percent of total billed charges,,,,,,,,,77.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,82.82,82,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,76.15,95.95,
*SHOULDER IMMOBILIZER MEN MED,23305298,CDM,,,270,RC,inpatient,,60,60,,50.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,45.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.8,88,,percent of total billed charges,,,,,,,,,45.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,,,,,,,,,,,,,49.8,83,,percent of total billed charges,,,57,95,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,49.2,82,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,45.24,57,
SHOULDER IMMOBILIZER MEN LG,23305299,CDM,,,270,RC,inpatient,,65.2,65.2,,55.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.38,88,,percent of total billed charges,,,,,,,,,49.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.33,91,,percent of total billed charges,,,61.94,95,,percent of total billed charges,,,54.12,83,,percent of total billed charges,,,54.12,83,,percent of total billed charges,,,,,,,,,,,,,,,54.12,83,,percent of total billed charges,,,61.94,95,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,53.46,82,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,55.42,85,,percent of total billed charges,,49.16,61.94,
SHOULDER IMMOBILIZER UNIVERSAL,23305300,CDM,,,270,RC,inpatient,,56.44,56.44,,47.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.67,88,,percent of total billed charges,,,,,,,,,43.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.36,91,,percent of total billed charges,,,53.62,95,,percent of total billed charges,,,46.85,83,,percent of total billed charges,,,46.85,83,,percent of total billed charges,,,,,,,,,,,,,,,46.85,83,,percent of total billed charges,,,53.62,95,,percent of total billed charges,,,50.8,90,,percent of total billed charges,,,50.8,90,,percent of total billed charges,,,46.28,82,,percent of total billed charges,,,50.8,90,,percent of total billed charges,,,47.97,85,,percent of total billed charges,,42.56,53.62,
*FINGER SPLINT VELCRO PED,23305318,CDM,,,270,RC,inpatient,,47,47,,39.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.36,88,,percent of total billed charges,,,,,,,,,35.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,,,,,,,,,,,,,39.01,83,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,38.54,82,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,35.44,44.65,
*FINGER SPLINT VELCRO MED,23305319,CDM,,,270,RC,inpatient,,35,35,,29.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.8,88,,percent of total billed charges,,,,,,,,,26.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31.85,91,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,,,,,,,,,,,,,29.05,83,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,28.7,82,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,26.39,33.25,
FINGER/THUMB SPLINT LG/XLG RIGHT,23305320,CDM,,,270,RC,inpatient,,83.3,83.3,,70.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.3,88,,percent of total billed charges,,,,,,,,,63.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.8,91,,percent of total billed charges,,,79.14,95,,percent of total billed charges,,,69.14,83,,percent of total billed charges,,,69.14,83,,percent of total billed charges,,,,,,,,,,,,,,,69.14,83,,percent of total billed charges,,,79.14,95,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,68.31,82,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,70.81,85,,percent of total billed charges,,62.81,79.14,
FINGER/THUMB SPLINT SM/MD RIGHT,23305321,CDM,,,270,RC,inpatient,,83.3,83.3,,70.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.3,88,,percent of total billed charges,,,,,,,,,63.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.8,91,,percent of total billed charges,,,79.14,95,,percent of total billed charges,,,69.14,83,,percent of total billed charges,,,69.14,83,,percent of total billed charges,,,,,,,,,,,,,,,69.14,83,,percent of total billed charges,,,79.14,95,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,68.31,82,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,70.81,85,,percent of total billed charges,,62.81,79.14,
SPLINT FINGER PLASTIC,23305322,CDM,,,270,RC,inpatient,,17.55,17.55,,14.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.44,88,,percent of total billed charges,,,,,,,,,13.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.97,91,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14.57,83,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.39,82,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.92,85,,percent of total billed charges,,13.23,16.67,
FINGER/THUMB SPLINT LG/XLG LEFT,23305324,CDM,,,270,RC,inpatient,,83.3,83.3,,70.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.3,88,,percent of total billed charges,,,,,,,,,63.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.8,91,,percent of total billed charges,,,79.14,95,,percent of total billed charges,,,69.14,83,,percent of total billed charges,,,69.14,83,,percent of total billed charges,,,,,,,,,,,,,,,69.14,83,,percent of total billed charges,,,79.14,95,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,68.31,82,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,70.81,85,,percent of total billed charges,,62.81,79.14,
FINGER/THUMB SPLINT SM/MD LEFT,23305325,CDM,,,270,RC,inpatient,,83.3,83.3,,70.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.3,88,,percent of total billed charges,,,,,,,,,63.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.8,91,,percent of total billed charges,,,79.14,95,,percent of total billed charges,,,69.14,83,,percent of total billed charges,,,69.14,83,,percent of total billed charges,,,,,,,,,,,,,,,69.14,83,,percent of total billed charges,,,79.14,95,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,68.31,82,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,70.81,85,,percent of total billed charges,,62.81,79.14,
SPLINT CLAVICAL SM,23305342,CDM,,,270,RC,inpatient,,58.57,58.57,,49.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.54,88,,percent of total billed charges,,,,,,,,,44.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.3,91,,percent of total billed charges,,,55.64,95,,percent of total billed charges,,,48.61,83,,percent of total billed charges,,,48.61,83,,percent of total billed charges,,,,,,,,,,,,,,,48.61,83,,percent of total billed charges,,,55.64,95,,percent of total billed charges,,,52.71,90,,percent of total billed charges,,,52.71,90,,percent of total billed charges,,,48.03,82,,percent of total billed charges,,,52.71,90,,percent of total billed charges,,,49.78,85,,percent of total billed charges,,44.16,55.64,
SPLINT CLAVICLE LG,23305344,CDM,,,270,RC,inpatient,,42.84,42.84,,36.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37.7,88,,percent of total billed charges,,,,,,,,,32.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38.98,91,,percent of total billed charges,,,40.7,95,,percent of total billed charges,,,35.56,83,,percent of total billed charges,,,35.56,83,,percent of total billed charges,,,,,,,,,,,,,,,35.56,83,,percent of total billed charges,,,40.7,95,,percent of total billed charges,,,38.56,90,,percent of total billed charges,,,38.56,90,,percent of total billed charges,,,35.13,82,,percent of total billed charges,,,38.56,90,,percent of total billed charges,,,36.41,85,,percent of total billed charges,,32.3,40.7,
SPLINT CLAVICLE XLG,23305345,CDM,,,270,RC,inpatient,,44.28,44.28,,37.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.97,88,,percent of total billed charges,,,,,,,,,33.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.29,91,,percent of total billed charges,,,42.07,95,,percent of total billed charges,,,36.75,83,,percent of total billed charges,,,36.75,83,,percent of total billed charges,,,,,,,,,,,,,,,36.75,83,,percent of total billed charges,,,42.07,95,,percent of total billed charges,,,39.85,90,,percent of total billed charges,,,39.85,90,,percent of total billed charges,,,36.31,82,,percent of total billed charges,,,39.85,90,,percent of total billed charges,,,37.64,85,,percent of total billed charges,,33.39,42.07,
* SPLINT POSTERIOR TIBIA YOUTH (V0106),23305383,CDM,,,270,RC,inpatient,,183,183,,155.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,155.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,161.04,88,,percent of total billed charges,,,,,,,,,139.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,,,,,,,,,,,,,151.89,83,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,150.06,82,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,137.98,173.85,
*VISCERA RETAINER MEDIUM,23305482,CDM,,,270,RC,inpatient,,158,158,,134.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,134.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.04,88,,percent of total billed charges,,,,,,,,,120.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,143.78,91,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,,,,,,,,,,,,,131.14,83,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,129.56,82,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,119.13,150.1,
BREATHING CIRCUIT W/FILTER,23305508,CDM,,,270,RC,inpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,53.39,67.27,
BREATHING CIRCUIT PED.,23305509,CDM,,,270,RC,inpatient,,63.61,63.61,,54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.98,88,,percent of total billed charges,,,,,,,,,48.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.89,91,,percent of total billed charges,,,60.43,95,,percent of total billed charges,,,52.8,83,,percent of total billed charges,,,52.8,83,,percent of total billed charges,,,,,,,,,,,,,,,52.8,83,,percent of total billed charges,,,60.43,95,,percent of total billed charges,,,57.25,90,,percent of total billed charges,,,57.25,90,,percent of total billed charges,,,52.16,82,,percent of total billed charges,,,57.25,90,,percent of total billed charges,,,54.07,85,,percent of total billed charges,,47.96,60.43,
* LMA USE (V0904),23305510,CDM,,,270,RC,inpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,980.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1105,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,980.2,1235,
*ELEC/SURG SHOULDER ARTHROSCOPY,23305567,CDM,,,270,RC,inpatient,,6,6,,5.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.28,88,,percent of total billed charges,,,,,,,,,4.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4.98,83,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,4.92,82,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,4.52,5.7,
CAST BUCKET,23305758,CDM,,,270,RC,inpatient,,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,129.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,129.69,163.4,
SUCTION SIMPULSE IRRIGATION,23305797,CDM,,,270,RC,inpatient,,339.77,339.77,,288.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,256.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,288.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,299,88,,percent of total billed charges,,,,,,,,,259.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,309.19,91,,percent of total billed charges,,,322.78,95,,percent of total billed charges,,,282.01,83,,percent of total billed charges,,,282.01,83,,percent of total billed charges,,,,,,,,,,,,,,,282.01,83,,percent of total billed charges,,,322.78,95,,percent of total billed charges,,,305.79,90,,percent of total billed charges,,,305.79,90,,percent of total billed charges,,,278.61,82,,percent of total billed charges,,,305.79,90,,percent of total billed charges,,,288.8,85,,percent of total billed charges,,256.19,322.78,
*INFANT HEEL WARMER,23305804,CDM,,,270,RC,inpatient,,4,4,,3.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3.52,88,,percent of total billed charges,,,,,,,,,3.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3.64,91,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3.32,83,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.28,82,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,3.02,3.8,
* PAD WHEELCHAIR AIR CUSHION (V1104),23305904,CDM,,,270,RC,inpatient,,143,143,,121.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,107.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,121.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,125.84,88,,percent of total billed charges,,,,,,,,,109.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,130.13,91,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,,,,,,,,,,,,,118.69,83,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,117.26,82,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,121.55,85,,percent of total billed charges,,107.82,135.85,
INTERCEED 4  X 3,23305952,CDM,,,270,RC,inpatient,,2409.63,2409.63,,2045.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1816.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2048.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2120.47,88,,percent of total billed charges,,,,,,,,,1840.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2192.76,91,,percent of total billed charges,,,2289.15,95,,percent of total billed charges,,,1999.99,83,,percent of total billed charges,,,1999.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1999.99,83,,percent of total billed charges,,,2289.15,95,,percent of total billed charges,,,2168.67,90,,percent of total billed charges,,,2168.67,90,,percent of total billed charges,,,1975.9,82,,percent of total billed charges,,,2168.67,90,,percent of total billed charges,,,2048.19,85,,percent of total billed charges,,1816.86,2289.15,
CATH GROSHONG 9.5F,23306019,CDM,,,270,RC,inpatient,,4872.08,4872.08,,4136.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3673.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4141.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4287.43,88,,percent of total billed charges,,,,,,,,,3722.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4433.59,91,,percent of total billed charges,,,4628.48,95,,percent of total billed charges,,,4043.83,83,,percent of total billed charges,,,4043.83,83,,percent of total billed charges,,,,,,,,,,,,,,,4043.83,83,,percent of total billed charges,,,4628.48,95,,percent of total billed charges,,,4384.87,90,,percent of total billed charges,,,4384.87,90,,percent of total billed charges,,,3995.11,82,,percent of total billed charges,,,4384.87,90,,percent of total billed charges,,,4141.27,85,,percent of total billed charges,,3673.55,4628.48,
ABDOMINAL BINDER MED/LG 30  - 45,23306068,CDM,,,270,RC,inpatient,,74.55,74.55,,63.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,63.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,65.6,88,,percent of total billed charges,,,,,,,,,56.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,67.84,91,,percent of total billed charges,,,70.82,95,,percent of total billed charges,,,61.88,83,,percent of total billed charges,,,61.88,83,,percent of total billed charges,,,,,,,,,,,,,,,61.88,83,,percent of total billed charges,,,70.82,95,,percent of total billed charges,,,67.1,90,,percent of total billed charges,,,67.1,90,,percent of total billed charges,,,61.13,82,,percent of total billed charges,,,67.1,90,,percent of total billed charges,,,63.37,85,,percent of total billed charges,,56.21,70.82,
ABDOMINAL BINDER XLG 45  - 62,23306069,CDM,,,270,RC,inpatient,,75.23,75.23,,63.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,63.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66.2,88,,percent of total billed charges,,,,,,,,,57.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,68.46,91,,percent of total billed charges,,,71.47,95,,percent of total billed charges,,,62.44,83,,percent of total billed charges,,,62.44,83,,percent of total billed charges,,,,,,,,,,,,,,,62.44,83,,percent of total billed charges,,,71.47,95,,percent of total billed charges,,,67.71,90,,percent of total billed charges,,,67.71,90,,percent of total billed charges,,,61.69,82,,percent of total billed charges,,,67.71,90,,percent of total billed charges,,,63.95,85,,percent of total billed charges,,56.72,71.47,
*BLADDER CARE W METER NO CATH,23306100,CDM,,,270,RC,inpatient,,52,52,,44.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.76,88,,percent of total billed charges,,,,,,,,,39.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,42.64,82,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,39.21,49.4,
TRAY EPIDURAL W/17GA NEEDLE,23306192,CDM,,,270,RC,inpatient,,201.9,201.9,,171.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,171.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,177.67,88,,percent of total billed charges,,,,,,,,,154.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,183.73,91,,percent of total billed charges,,,191.81,95,,percent of total billed charges,,,167.58,83,,percent of total billed charges,,,167.58,83,,percent of total billed charges,,,,,,,,,,,,,,,167.58,83,,percent of total billed charges,,,191.81,95,,percent of total billed charges,,,181.71,90,,percent of total billed charges,,,181.71,90,,percent of total billed charges,,,165.56,82,,percent of total billed charges,,,181.71,90,,percent of total billed charges,,,171.62,85,,percent of total billed charges,,152.23,191.81,
MESH MERSILENE 12 X 12,23306218,CDM,,,270,RC,inpatient,,4987.39,4987.39,,4234.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3760.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4239.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4388.9,88,,percent of total billed charges,,,,,,,,,3810.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4538.52,91,,percent of total billed charges,,,4738.02,95,,percent of total billed charges,,,4139.53,83,,percent of total billed charges,,,4139.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4139.53,83,,percent of total billed charges,,,4738.02,95,,percent of total billed charges,,,4488.65,90,,percent of total billed charges,,,4488.65,90,,percent of total billed charges,,,4089.66,82,,percent of total billed charges,,,4488.65,90,,percent of total billed charges,,,4239.28,85,,percent of total billed charges,,3760.49,4738.02,
*SUCTION MOUTH SWAB,23306225,CDM,,,270,RC,inpatient,,11,11,,9.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9.68,88,,percent of total billed charges,,,,,,,,,8.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,,,,,,,,,,,,,9.13,83,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.02,82,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,8.29,10.45,
PEG TUBE KIT,23306308,CDM,,,270,RC,inpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,316.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,357,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,316.68,399,
TRAY CENTRAL VENOUS CATH 3-LUMEN,23306316,CDM,,,270,RC,inpatient,,874.93,874.93,,742.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,659.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,743.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,769.94,88,,percent of total billed charges,,,,,,,,,668.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,796.19,91,,percent of total billed charges,,,831.18,95,,percent of total billed charges,,,726.19,83,,percent of total billed charges,,,726.19,83,,percent of total billed charges,,,,,,,,,,,,,,,726.19,83,,percent of total billed charges,,,831.18,95,,percent of total billed charges,,,787.44,90,,percent of total billed charges,,,787.44,90,,percent of total billed charges,,,717.44,82,,percent of total billed charges,,,787.44,90,,percent of total billed charges,,,743.69,85,,percent of total billed charges,,659.7,831.18,
* ECG MONITOR (V0904),23306324,CDM,,,732,RC,inpatient,,70,70,,59.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,59.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,61.6,88,,percent of total billed charges,,,,,,,,,53.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,63.7,91,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,,,,,,,,,,,,,58.1,83,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,57.4,82,,percent of total billed charges,,,63,90,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,52.78,66.5,
* STOMA O R SETS 70MM (V0605),23306365,CDM,,,270,RC,inpatient,,38,38,,32.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33.44,88,,percent of total billed charges,,,,,,,,,29.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.58,91,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,,,,,,,,,,,,,31.54,83,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,31.16,82,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,28.65,36.1,
* Z/OR (V0405),23306416,CDM,,,270,RC,inpatient,,10780,10780,,9152.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8128.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9163,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9486.4,88,,percent of total billed charges,,,,,,,,,8235.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9809.8,91,,percent of total billed charges,,,10241,95,,percent of total billed charges,,,8947.4,83,,percent of total billed charges,,,8947.4,83,,percent of total billed charges,,,,,,,,,,,,,,,8947.4,83,,percent of total billed charges,,,10241,95,,percent of total billed charges,,,9702,90,,percent of total billed charges,,,9702,90,,percent of total billed charges,,,8839.6,82,,percent of total billed charges,,,9702,90,,percent of total billed charges,,,9163,85,,percent of total billed charges,,8128.12,10241,
* ILC LASER (V1004),23306417,CDM,,,360,RC,inpatient,,2111,2111,,1792.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1591.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1794.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1857.68,88,,percent of total billed charges,,,,,,,,,1612.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1921.01,91,,percent of total billed charges,,,2005.45,95,,percent of total billed charges,,,1752.13,83,,percent of total billed charges,,,1752.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1752.13,83,,percent of total billed charges,,,2005.45,95,,percent of total billed charges,,,1899.9,90,,percent of total billed charges,,,1899.9,90,,percent of total billed charges,,,1731.02,82,,percent of total billed charges,,,1899.9,90,,percent of total billed charges,,,1794.35,85,,percent of total billed charges,,1591.69,2005.45,
* PVP LASER FEE (V1004),23306419,CDM,,,360,RC,inpatient,,2413,2413,,2048.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1819.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2051.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2123.44,88,,percent of total billed charges,,,,,,,,,1843.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2195.83,91,,percent of total billed charges,,,2292.35,95,,percent of total billed charges,,,2002.79,83,,percent of total billed charges,,,2002.79,83,,percent of total billed charges,,,,,,,,,,,,,,,2002.79,83,,percent of total billed charges,,,2292.35,95,,percent of total billed charges,,,2171.7,90,,percent of total billed charges,,,2171.7,90,,percent of total billed charges,,,1978.66,82,,percent of total billed charges,,,2171.7,90,,percent of total billed charges,,,2051.05,85,,percent of total billed charges,,1819.4,2292.35,
* PVP FIBER FEE (V1004),23306420,CDM,,,360,RC,inpatient,,2111,2111,,1792.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1591.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1794.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1857.68,88,,percent of total billed charges,,,,,,,,,1612.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1921.01,91,,percent of total billed charges,,,2005.45,95,,percent of total billed charges,,,1752.13,83,,percent of total billed charges,,,1752.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1752.13,83,,percent of total billed charges,,,2005.45,95,,percent of total billed charges,,,1899.9,90,,percent of total billed charges,,,1899.9,90,,percent of total billed charges,,,1731.02,82,,percent of total billed charges,,,1899.9,90,,percent of total billed charges,,,1794.35,85,,percent of total billed charges,,1591.69,2005.45,
ELECTRODE DEFIB PEDS EDGE QUICK-COMBO,23306457,CDM,,,270,RC,inpatient,,215.18,215.18,,182.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,162.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,182.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,189.36,88,,percent of total billed charges,,,,,,,,,164.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,195.81,91,,percent of total billed charges,,,204.42,95,,percent of total billed charges,,,178.6,83,,percent of total billed charges,,,178.6,83,,percent of total billed charges,,,,,,,,,,,,,,,178.6,83,,percent of total billed charges,,,204.42,95,,percent of total billed charges,,,193.66,90,,percent of total billed charges,,,193.66,90,,percent of total billed charges,,,176.45,82,,percent of total billed charges,,,193.66,90,,percent of total billed charges,,,182.9,85,,percent of total billed charges,,162.25,204.42,
CAST SHOE DARCO WOMEN MEDIUM,23306481,CDM,,,270,RC,inpatient,,46.5,46.5,,39.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.92,88,,percent of total billed charges,,,,,,,,,35.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.32,91,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,,,,,,,,,,,,,38.6,83,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,38.13,82,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,35.06,44.18,
CAST SHOE DARCO WOMEN LG,23306482,CDM,,,270,RC,inpatient,,46.5,46.5,,39.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.92,88,,percent of total billed charges,,,,,,,,,35.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.32,91,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,,,,,,,,,,,,,38.6,83,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,38.13,82,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,35.06,44.18,
CAST SHOE DARCO MEN SMALL,23306483,CDM,,,270,RC,inpatient,,46.5,46.5,,39.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.92,88,,percent of total billed charges,,,,,,,,,35.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.32,91,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,,,,,,,,,,,,,38.6,83,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,38.13,82,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,35.06,44.18,
CAST SHOE DARCO MEN MEDIUM,23306484,CDM,,,270,RC,inpatient,,46.5,46.5,,39.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.92,88,,percent of total billed charges,,,,,,,,,35.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.32,91,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,,,,,,,,,,,,,38.6,83,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,38.13,82,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,35.06,44.18,
CAST SHOE DARCO MEN LG,23306485,CDM,,,270,RC,inpatient,,46.5,46.5,,39.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.92,88,,percent of total billed charges,,,,,,,,,35.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.32,91,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,,,,,,,,,,,,,38.6,83,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,38.13,82,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,35.06,44.18,
CAST SHOE DARCO MEN XLG,23306486,CDM,,,270,RC,inpatient,,46.5,46.5,,39.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.92,88,,percent of total billed charges,,,,,,,,,35.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.32,91,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,,,,,,,,,,,,,38.6,83,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,38.13,82,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,35.06,44.18,
STOMA FLANGE HOL 14803,23306511,CDM,,,270,RC,inpatient,,8.51,8.51,,7.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.49,88,,percent of total billed charges,,,,,,,,,6.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.74,91,,percent of total billed charges,,,8.08,95,,percent of total billed charges,,,7.06,83,,percent of total billed charges,,,7.06,83,,percent of total billed charges,,,,,,,,,,,,,,,7.06,83,,percent of total billed charges,,,8.08,95,,percent of total billed charges,,,7.66,90,,percent of total billed charges,,,7.66,90,,percent of total billed charges,,,6.98,82,,percent of total billed charges,,,7.66,90,,percent of total billed charges,,,7.23,85,,percent of total billed charges,,6.42,8.08,
STOMA FLANGE FLAT 2-3/4,23306518,CDM,,,270,RC,inpatient,,4.5,4.5,,3.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3.96,88,,percent of total billed charges,,,,,,,,,3.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4.1,91,,percent of total billed charges,,,4.28,95,,percent of total billed charges,,,3.74,83,,percent of total billed charges,,,3.74,83,,percent of total billed charges,,,,,,,,,,,,,,,3.74,83,,percent of total billed charges,,,4.28,95,,percent of total billed charges,,,4.05,90,,percent of total billed charges,,,4.05,90,,percent of total billed charges,,,3.69,82,,percent of total billed charges,,,4.05,90,,percent of total billed charges,,,3.83,85,,percent of total billed charges,,3.39,4.28,
*STOMA POUCH W/CLAMP 1-3/4 (DISCONTINU,23306536,CDM,,,270,RC,inpatient,,8,8,,6.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.04,88,,percent of total billed charges,,,,,,,,,6.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.28,91,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,,,,,,,,,,,,,6.64,83,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.56,82,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.8,85,,percent of total billed charges,,6.03,7.6,
INTUBATION STYLET 14FR,23306605,CDM,,,270,RC,inpatient,,33.44,33.44,,28.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.43,88,,percent of total billed charges,,,,,,,,,25.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.43,91,,percent of total billed charges,,,31.77,95,,percent of total billed charges,,,27.76,83,,percent of total billed charges,,,27.76,83,,percent of total billed charges,,,,,,,,,,,,,,,27.76,83,,percent of total billed charges,,,31.77,95,,percent of total billed charges,,,30.1,90,,percent of total billed charges,,,30.1,90,,percent of total billed charges,,,27.42,82,,percent of total billed charges,,,30.1,90,,percent of total billed charges,,,28.42,85,,percent of total billed charges,,25.21,31.77,
* ADAPTIC DRESSING 3  X 8 (DUP) (V0605),23306627,CDM,,,270,RC,inpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,2.26,2.85,
EYE IRRIGATION LENS MORGAN,23306712,CDM,,,270,RC,inpatient,,404.6,404.6,,343.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,305.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,343.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,356.05,88,,percent of total billed charges,,,,,,,,,309.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,368.19,91,,percent of total billed charges,,,384.37,95,,percent of total billed charges,,,335.82,83,,percent of total billed charges,,,335.82,83,,percent of total billed charges,,,,,,,,,,,,,,,335.82,83,,percent of total billed charges,,,384.37,95,,percent of total billed charges,,,364.14,90,,percent of total billed charges,,,364.14,90,,percent of total billed charges,,,331.77,82,,percent of total billed charges,,,364.14,90,,percent of total billed charges,,,343.91,85,,percent of total billed charges,,305.07,384.37,
*PROMOGRAM DRESSING,23306787,CDM,,,270,RC,inpatient,,60,60,,50.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,45.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.8,88,,percent of total billed charges,,,,,,,,,45.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,,,,,,,,,,,,,49.8,83,,percent of total billed charges,,,57,95,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,49.2,82,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,45.24,57,
* EPI LOCK 4X4 (V0605),23306795,CDM,,,270,RC,inpatient,,139,139,,118.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,118.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,122.32,88,,percent of total billed charges,,,,,,,,,106.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,126.49,91,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,,,,,,,,,,,,,115.37,83,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,113.98,82,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,118.15,85,,percent of total billed charges,,104.81,132.05,
DRAIN JACKSON PRATT 10FR 7MM W/TROCAR,23306829,CDM,,,270,RC,inpatient,,82.88,82.88,,70.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,72.93,88,,percent of total billed charges,,,,,,,,,63.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.42,91,,percent of total billed charges,,,78.74,95,,percent of total billed charges,,,68.79,83,,percent of total billed charges,,,68.79,83,,percent of total billed charges,,,,,,,,,,,,,,,68.79,83,,percent of total billed charges,,,78.74,95,,percent of total billed charges,,,74.59,90,,percent of total billed charges,,,74.59,90,,percent of total billed charges,,,67.96,82,,percent of total billed charges,,,74.59,90,,percent of total billed charges,,,70.45,85,,percent of total billed charges,,62.49,78.74,
RESERVOIR WOUND DRAIN 400CC,23306850,CDM,,,270,RC,inpatient,,77.31,77.31,,65.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.03,88,,percent of total billed charges,,,,,,,,,59.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.35,91,,percent of total billed charges,,,73.44,95,,percent of total billed charges,,,64.17,83,,percent of total billed charges,,,64.17,83,,percent of total billed charges,,,,,,,,,,,,,,,64.17,83,,percent of total billed charges,,,73.44,95,,percent of total billed charges,,,69.58,90,,percent of total billed charges,,,69.58,90,,percent of total billed charges,,,63.39,82,,percent of total billed charges,,,69.58,90,,percent of total billed charges,,,65.71,85,,percent of total billed charges,,58.29,73.44,
DRAIN WOUND EVACUATOR 100CC,23306852,CDM,,,270,RC,inpatient,,67.12,67.12,,56.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.07,88,,percent of total billed charges,,,,,,,,,51.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.08,91,,percent of total billed charges,,,63.76,95,,percent of total billed charges,,,55.71,83,,percent of total billed charges,,,55.71,83,,percent of total billed charges,,,,,,,,,,,,,,,55.71,83,,percent of total billed charges,,,63.76,95,,percent of total billed charges,,,60.41,90,,percent of total billed charges,,,60.41,90,,percent of total billed charges,,,55.04,82,,percent of total billed charges,,,60.41,90,,percent of total billed charges,,,57.05,85,,percent of total billed charges,,50.61,63.76,
HOT PACK DISPOSABLE,23306886,CDM,,,270,RC,inpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,2.26,2.85,
* BIOPSY NEEDLE PROSTATIC DISP (V0106),23306936,CDM,,,270,RC,inpatient,,177,177,,150.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,133.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,150.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,155.76,88,,percent of total billed charges,,,,,,,,,135.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,,,,,,,,,,,,,146.91,83,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,145.14,82,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,133.46,168.15,
DUOVISC 0.55 ML,23307015,CDM,,,270,RC,inpatient,,617.75,617.75,,524.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,465.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,525.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,543.62,88,,percent of total billed charges,,,,,,,,,471.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,562.15,91,,percent of total billed charges,,,586.86,95,,percent of total billed charges,,,512.73,83,,percent of total billed charges,,,512.73,83,,percent of total billed charges,,,,,,,,,,,,,,,512.73,83,,percent of total billed charges,,,586.86,95,,percent of total billed charges,,,555.98,90,,percent of total billed charges,,,555.98,90,,percent of total billed charges,,,506.56,82,,percent of total billed charges,,,555.98,90,,percent of total billed charges,,,525.09,85,,percent of total billed charges,,465.78,586.86,
EYE LENS IMPLANT (BAUSCH & LOMB),23307017,CDM,,,270,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
TRACH 5.5 UNCUFFED,23307023,CDM,,,270,RC,inpatient,,16.2,16.2,,13.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.26,88,,percent of total billed charges,,,,,,,,,12.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.74,91,,percent of total billed charges,,,15.39,95,,percent of total billed charges,,,13.45,83,,percent of total billed charges,,,13.45,83,,percent of total billed charges,,,,,,,,,,,,,,,13.45,83,,percent of total billed charges,,,15.39,95,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,13.28,82,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,13.77,85,,percent of total billed charges,,12.21,15.39,
* SUTURE CM830 (V0205),23307027,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
*PACK EYE - BAUSCH & LOMB,23307033,CDM,,,270,RC,inpatient,,34.74,34.74,,29.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.57,88,,percent of total billed charges,,,,,,,,,26.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31.61,91,,percent of total billed charges,,,33,95,,percent of total billed charges,,,28.83,83,,percent of total billed charges,,,28.83,83,,percent of total billed charges,,,,,,,,,,,,,,,28.83,83,,percent of total billed charges,,,33,95,,percent of total billed charges,,,31.27,90,,percent of total billed charges,,,31.27,90,,percent of total billed charges,,,28.49,82,,percent of total billed charges,,,31.27,90,,percent of total billed charges,,,29.53,85,,percent of total billed charges,,26.19,33,
SYNTHES DRILL BIT 2.0MM 310.19,23307055,CDM,,,270,RC,inpatient,,803.25,803.25,,681.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,605.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,682.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,706.86,88,,percent of total billed charges,,,,,,,,,613.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,730.96,91,,percent of total billed charges,,,763.09,95,,percent of total billed charges,,,666.7,83,,percent of total billed charges,,,666.7,83,,percent of total billed charges,,,,,,,,,,,,,,,666.7,83,,percent of total billed charges,,,763.09,95,,percent of total billed charges,,,722.93,90,,percent of total billed charges,,,722.93,90,,percent of total billed charges,,,658.67,82,,percent of total billed charges,,,722.93,90,,percent of total billed charges,,,682.76,85,,percent of total billed charges,,605.65,763.09,
* SACRO BELT LARGE (V0106),23307066,CDM,,,270,RC,inpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110.88,88,,percent of total billed charges,,,,,,,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,95,119.7,
SPLINT THUMB UNIV,23307082,CDM,,,270,RC,inpatient,,51.43,51.43,,43.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.26,88,,percent of total billed charges,,,,,,,,,39.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.8,91,,percent of total billed charges,,,48.86,95,,percent of total billed charges,,,42.69,83,,percent of total billed charges,,,42.69,83,,percent of total billed charges,,,,,,,,,,,,,,,42.69,83,,percent of total billed charges,,,48.86,95,,percent of total billed charges,,,46.29,90,,percent of total billed charges,,,46.29,90,,percent of total billed charges,,,42.17,82,,percent of total billed charges,,,46.29,90,,percent of total billed charges,,,43.72,85,,percent of total billed charges,,38.78,48.86,
*THUMB SPLINT LEFT,23307083,CDM,,,270,RC,inpatient,,171,171,,145.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,128.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,145.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,150.48,88,,percent of total billed charges,,,,,,,,,130.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,,,,,,,,,,,,,141.93,83,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,140.22,82,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,128.93,162.45,
*DRESSING DUODERM GEL,23307116,CDM,,,270,RC,inpatient,,24.57,24.57,,20.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.62,88,,percent of total billed charges,,,,,,,,,18.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.36,91,,percent of total billed charges,,,23.34,95,,percent of total billed charges,,,20.39,83,,percent of total billed charges,,,20.39,83,,percent of total billed charges,,,,,,,,,,,,,,,20.39,83,,percent of total billed charges,,,23.34,95,,percent of total billed charges,,,22.11,90,,percent of total billed charges,,,22.11,90,,percent of total billed charges,,,20.15,82,,percent of total billed charges,,,22.11,90,,percent of total billed charges,,,20.88,85,,percent of total billed charges,,18.53,23.34,
*DUODERM 4X4 W/BORDER/HYDRO,23307124,CDM,,,270,RC,inpatient,,26,26,,22.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.88,88,,percent of total billed charges,,,,,,,,,19.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.66,91,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,,,,,,,,,,,,,21.58,83,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,21.32,82,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,19.6,24.7,
MERINA INTRAUTERINE SYSTEM (NC),23307200,CDM,,,270,RC,inpatient,,6820.06,6820.06,,5790.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5142.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5797.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6001.65,88,,percent of total billed charges,,,,,,,,,5210.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6206.25,91,,percent of total billed charges,,,6479.06,95,,percent of total billed charges,,,5660.65,83,,percent of total billed charges,,,5660.65,83,,percent of total billed charges,,,,,,,,,,,,,,,5660.65,83,,percent of total billed charges,,,6479.06,95,,percent of total billed charges,,,6138.05,90,,percent of total billed charges,,,6138.05,90,,percent of total billed charges,,,5592.45,82,,percent of total billed charges,,,6138.05,90,,percent of total billed charges,,,5797.05,85,,percent of total billed charges,,5142.33,6479.06,
NEXPLANON (IUD),23307205,CDM,,,270,RC,inpatient,,2723.18,2723.18,,2311.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2053.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2314.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2396.4,88,,percent of total billed charges,,,,,,,,,2080.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2478.09,91,,percent of total billed charges,,,2587.02,95,,percent of total billed charges,,,2260.24,83,,percent of total billed charges,,,2260.24,83,,percent of total billed charges,,,,,,,,,,,,,,,2260.24,83,,percent of total billed charges,,,2587.02,95,,percent of total billed charges,,,2450.86,90,,percent of total billed charges,,,2450.86,90,,percent of total billed charges,,,2233.01,82,,percent of total billed charges,,,2450.86,90,,percent of total billed charges,,,2314.7,85,,percent of total billed charges,,2053.28,2587.02,
ENDO CLIP APPLIER,23307215,CDM,,,270,RC,inpatient,,2059.53,2059.53,,1748.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1552.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1750.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1812.39,88,,percent of total billed charges,,,,,,,,,1573.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1874.17,91,,percent of total billed charges,,,1956.55,95,,percent of total billed charges,,,1709.41,83,,percent of total billed charges,,,1709.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1709.41,83,,percent of total billed charges,,,1956.55,95,,percent of total billed charges,,,1853.58,90,,percent of total billed charges,,,1853.58,90,,percent of total billed charges,,,1688.81,82,,percent of total billed charges,,,1853.58,90,,percent of total billed charges,,,1750.6,85,,percent of total billed charges,,1552.89,1956.55,
TROCAR ENDO BLUNT 10/12MM,23307256,CDM,,,270,RC,inpatient,,195.04,195.04,,165.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,165.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,171.64,88,,percent of total billed charges,,,,,,,,,149.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,177.49,91,,percent of total billed charges,,,185.29,95,,percent of total billed charges,,,161.88,83,,percent of total billed charges,,,161.88,83,,percent of total billed charges,,,,,,,,,,,,,,,161.88,83,,percent of total billed charges,,,185.29,95,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,159.93,82,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,165.78,85,,percent of total billed charges,,147.06,185.29,
ENDO LOOP LIGATOR PDS,23307298,CDM,,,270,RC,inpatient,,287.97,287.97,,244.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,244.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,253.41,88,,percent of total billed charges,,,,,,,,,220.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.05,91,,percent of total billed charges,,,273.57,95,,percent of total billed charges,,,239.02,83,,percent of total billed charges,,,239.02,83,,percent of total billed charges,,,,,,,,,,,,,,,239.02,83,,percent of total billed charges,,,273.57,95,,percent of total billed charges,,,259.17,90,,percent of total billed charges,,,259.17,90,,percent of total billed charges,,,236.14,82,,percent of total billed charges,,,259.17,90,,percent of total billed charges,,,244.77,85,,percent of total billed charges,,217.13,273.57,
ENDO DISSECTORS ROUND PEANUTS,23307299,CDM,,,270,RC,inpatient,,117.73,117.73,,99.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,88.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,100.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,103.6,88,,percent of total billed charges,,,,,,,,,89.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,107.13,91,,percent of total billed charges,,,111.84,95,,percent of total billed charges,,,97.72,83,,percent of total billed charges,,,97.72,83,,percent of total billed charges,,,,,,,,,,,,,,,97.72,83,,percent of total billed charges,,,111.84,95,,percent of total billed charges,,,105.96,90,,percent of total billed charges,,,105.96,90,,percent of total billed charges,,,96.54,82,,percent of total billed charges,,,105.96,90,,percent of total billed charges,,,100.07,85,,percent of total billed charges,,88.77,111.84,
DRAIN WOUND 15 FR,23307306,CDM,,,270,RC,inpatient,,66.1,66.1,,56.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.17,88,,percent of total billed charges,,,,,,,,,50.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.15,91,,percent of total billed charges,,,62.8,95,,percent of total billed charges,,,54.86,83,,percent of total billed charges,,,54.86,83,,percent of total billed charges,,,,,,,,,,,,,,,54.86,83,,percent of total billed charges,,,62.8,95,,percent of total billed charges,,,59.49,90,,percent of total billed charges,,,59.49,90,,percent of total billed charges,,,54.2,82,,percent of total billed charges,,,59.49,90,,percent of total billed charges,,,56.19,85,,percent of total billed charges,,49.84,62.8,
PROCLUDE 6X6,23307330,CDM,,,270,RC,inpatient,,9,9,,7.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.92,88,,percent of total billed charges,,,,,,,,,6.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.38,82,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,6.79,8.55,
AIRWAY NASAL LATEX FREE 16FR,23307397,CDM,,,270,RC,inpatient,,91.04,91.04,,77.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.12,88,,percent of total billed charges,,,,,,,,,69.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.85,91,,percent of total billed charges,,,86.49,95,,percent of total billed charges,,,75.56,83,,percent of total billed charges,,,75.56,83,,percent of total billed charges,,,,,,,,,,,,,,,75.56,83,,percent of total billed charges,,,86.49,95,,percent of total billed charges,,,81.94,90,,percent of total billed charges,,,81.94,90,,percent of total billed charges,,,74.65,82,,percent of total billed charges,,,81.94,90,,percent of total billed charges,,,77.38,85,,percent of total billed charges,,68.64,86.49,
*PROFORE,23307440,CDM,,,270,RC,inpatient,,96,96,,81.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,72.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,81.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,84.48,88,,percent of total billed charges,,,,,,,,,73.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,87.36,91,,percent of total billed charges,,,91.2,95,,percent of total billed charges,,,79.68,83,,percent of total billed charges,,,79.68,83,,percent of total billed charges,,,,,,,,,,,,,,,79.68,83,,percent of total billed charges,,,91.2,95,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,78.72,82,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,81.6,85,,percent of total billed charges,,72.38,91.2,
STAPLER MULTI FIRE GIA,23307512,CDM,,,270,RC,inpatient,,1716.85,1716.85,,1457.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1294.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1459.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1510.83,88,,percent of total billed charges,,,,,,,,,1311.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1562.33,91,,percent of total billed charges,,,1631.01,95,,percent of total billed charges,,,1424.99,83,,percent of total billed charges,,,1424.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1424.99,83,,percent of total billed charges,,,1631.01,95,,percent of total billed charges,,,1545.17,90,,percent of total billed charges,,,1545.17,90,,percent of total billed charges,,,1407.82,82,,percent of total billed charges,,,1545.17,90,,percent of total billed charges,,,1459.32,85,,percent of total billed charges,,1294.5,1631.01,
*SPLINT MASON ALLEN SMALL,23307546,CDM,,,270,RC,inpatient,,88.32,88.32,,74.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,75.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.72,88,,percent of total billed charges,,,,,,,,,67.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.37,91,,percent of total billed charges,,,83.9,95,,percent of total billed charges,,,73.31,83,,percent of total billed charges,,,73.31,83,,percent of total billed charges,,,,,,,,,,,,,,,73.31,83,,percent of total billed charges,,,83.9,95,,percent of total billed charges,,,79.49,90,,percent of total billed charges,,,79.49,90,,percent of total billed charges,,,72.42,82,,percent of total billed charges,,,79.49,90,,percent of total billed charges,,,75.07,85,,percent of total billed charges,,66.59,83.9,
*SPLINT MASON ALLEN LG,23307547,CDM,,,270,RC,inpatient,,88.32,88.32,,74.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,75.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.72,88,,percent of total billed charges,,,,,,,,,67.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.37,91,,percent of total billed charges,,,83.9,95,,percent of total billed charges,,,73.31,83,,percent of total billed charges,,,73.31,83,,percent of total billed charges,,,,,,,,,,,,,,,73.31,83,,percent of total billed charges,,,83.9,95,,percent of total billed charges,,,79.49,90,,percent of total billed charges,,,79.49,90,,percent of total billed charges,,,72.42,82,,percent of total billed charges,,,79.49,90,,percent of total billed charges,,,75.07,85,,percent of total billed charges,,66.59,83.9,
ACMI FALOPE RINGS,23307553,CDM,,,270,RC,inpatient,,618.33,618.33,,524.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,466.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,525.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,544.13,88,,percent of total billed charges,,,,,,,,,472.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,562.68,91,,percent of total billed charges,,,587.41,95,,percent of total billed charges,,,513.21,83,,percent of total billed charges,,,513.21,83,,percent of total billed charges,,,,,,,,,,,,,,,513.21,83,,percent of total billed charges,,,587.41,95,,percent of total billed charges,,,556.5,90,,percent of total billed charges,,,556.5,90,,percent of total billed charges,,,507.03,82,,percent of total billed charges,,,556.5,90,,percent of total billed charges,,,525.58,85,,percent of total billed charges,,466.22,587.41,
*HYDROSORB 8X8,23307596,CDM,,,270,RC,inpatient,,64,64,,54.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.32,88,,percent of total billed charges,,,,,,,,,48.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,,,,,,,,,,,,,53.12,83,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,52.48,82,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,48.26,60.8,
CO2 DETECTOR PEDIATRIC,23307654,CDM,,,270,RC,inpatient,,81.16,81.16,,68.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.42,88,,percent of total billed charges,,,,,,,,,62.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.86,91,,percent of total billed charges,,,77.1,95,,percent of total billed charges,,,67.36,83,,percent of total billed charges,,,67.36,83,,percent of total billed charges,,,,,,,,,,,,,,,67.36,83,,percent of total billed charges,,,77.1,95,,percent of total billed charges,,,73.04,90,,percent of total billed charges,,,73.04,90,,percent of total billed charges,,,66.55,82,,percent of total billed charges,,,73.04,90,,percent of total billed charges,,,68.99,85,,percent of total billed charges,,61.19,77.1,
TRAY PNEUMOTHORAX - ARROW,23307660,CDM,,,270,RC,inpatient,,1368.95,1368.95,,1162.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1032.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1163.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1204.68,88,,percent of total billed charges,,,,,,,,,1045.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1245.74,91,,percent of total billed charges,,,1300.5,95,,percent of total billed charges,,,1136.23,83,,percent of total billed charges,,,1136.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1136.23,83,,percent of total billed charges,,,1300.5,95,,percent of total billed charges,,,1232.06,90,,percent of total billed charges,,,1232.06,90,,percent of total billed charges,,,1122.54,82,,percent of total billed charges,,,1232.06,90,,percent of total billed charges,,,1163.61,85,,percent of total billed charges,,1032.19,1300.5,
LAPAFLATOR TUBING 201,23307678,CDM,,,270,RC,inpatient,,77.52,77.52,,65.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.22,88,,percent of total billed charges,,,,,,,,,59.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.54,91,,percent of total billed charges,,,73.64,95,,percent of total billed charges,,,64.34,83,,percent of total billed charges,,,64.34,83,,percent of total billed charges,,,,,,,,,,,,,,,64.34,83,,percent of total billed charges,,,73.64,95,,percent of total billed charges,,,69.77,90,,percent of total billed charges,,,69.77,90,,percent of total billed charges,,,63.57,82,,percent of total billed charges,,,69.77,90,,percent of total billed charges,,,65.89,85,,percent of total billed charges,,58.45,73.64,
ENDO RETRACTOR,23307777,CDM,,,270,RC,inpatient,,1745.45,1745.45,,1481.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1316.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1483.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1536,88,,percent of total billed charges,,,,,,,,,1333.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1588.36,91,,percent of total billed charges,,,1658.18,95,,percent of total billed charges,,,1448.72,83,,percent of total billed charges,,,1448.72,83,,percent of total billed charges,,,,,,,,,,,,,,,1448.72,83,,percent of total billed charges,,,1658.18,95,,percent of total billed charges,,,1570.91,90,,percent of total billed charges,,,1570.91,90,,percent of total billed charges,,,1431.27,82,,percent of total billed charges,,,1570.91,90,,percent of total billed charges,,,1483.63,85,,percent of total billed charges,,1316.07,1658.18,
GYRUS ENDO CUTTING FORECPS,23307778,CDM,,,270,RC,inpatient,,1813.5,1813.5,,1539.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1367.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1541.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1595.88,88,,percent of total billed charges,,,,,,,,,1385.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1650.29,91,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.21,83,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1487.07,82,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1541.48,85,,percent of total billed charges,,1367.38,1722.83,
FORCEPS MACRO,23307801,CDM,,,270,RC,inpatient,,494,494,,419.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,372.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,419.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,434.72,88,,percent of total billed charges,,,,,,,,,377.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,449.54,91,,percent of total billed charges,,,469.3,95,,percent of total billed charges,,,410.02,83,,percent of total billed charges,,,410.02,83,,percent of total billed charges,,,,,,,,,,,,,,,410.02,83,,percent of total billed charges,,,469.3,95,,percent of total billed charges,,,444.6,90,,percent of total billed charges,,,444.6,90,,percent of total billed charges,,,405.08,82,,percent of total billed charges,,,444.6,90,,percent of total billed charges,,,419.9,85,,percent of total billed charges,,372.48,469.3,
* Z/OR (V0405),23307872,CDM,,,270,RC,inpatient,,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,129.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,129.69,163.4,
* Z/OR (V0405),23307875,CDM,,,270,RC,inpatient,,2060,2060,,1748.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1553.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1751,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1812.8,88,,percent of total billed charges,,,,,,,,,1573.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1874.6,91,,percent of total billed charges,,,1957,95,,percent of total billed charges,,,1709.8,83,,percent of total billed charges,,,1709.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1709.8,83,,percent of total billed charges,,,1957,95,,percent of total billed charges,,,1854,90,,percent of total billed charges,,,1854,90,,percent of total billed charges,,,1689.2,82,,percent of total billed charges,,,1854,90,,percent of total billed charges,,,1751,85,,percent of total billed charges,,1553.24,1957,
* Z/OR (V0405),23307878,CDM,,,270,RC,inpatient,,270,270,,229.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,203.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,229.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,237.6,88,,percent of total billed charges,,,,,,,,,206.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,245.7,91,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,,,,,,,,,,,,,224.1,83,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,243,90,,percent of total billed charges,,,243,90,,percent of total billed charges,,,221.4,82,,percent of total billed charges,,,243,90,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,203.58,256.5,
* Z/OR (V0405),23307879,CDM,,,270,RC,inpatient,,374,374,,317.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,317.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,329.12,88,,percent of total billed charges,,,,,,,,,285.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,340.34,91,,percent of total billed charges,,,355.3,95,,percent of total billed charges,,,310.42,83,,percent of total billed charges,,,310.42,83,,percent of total billed charges,,,,,,,,,,,,,,,310.42,83,,percent of total billed charges,,,355.3,95,,percent of total billed charges,,,336.6,90,,percent of total billed charges,,,336.6,90,,percent of total billed charges,,,306.68,82,,percent of total billed charges,,,336.6,90,,percent of total billed charges,,,317.9,85,,percent of total billed charges,,282,355.3,
* Z/OR (V0405),23307880,CDM,,,270,RC,inpatient,,1170,1170,,993.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,882.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,994.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1029.6,88,,percent of total billed charges,,,,,,,,,893.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1064.7,91,,percent of total billed charges,,,1111.5,95,,percent of total billed charges,,,971.1,83,,percent of total billed charges,,,971.1,83,,percent of total billed charges,,,,,,,,,,,,,,,971.1,83,,percent of total billed charges,,,1111.5,95,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,959.4,82,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,994.5,85,,percent of total billed charges,,882.18,1111.5,
* Z/OR (V0405),23307886,CDM,,,270,RC,inpatient,,5953,5953,,5054.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4488.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5060.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5238.64,88,,percent of total billed charges,,,,,,,,,4548.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5417.23,91,,percent of total billed charges,,,5655.35,95,,percent of total billed charges,,,4940.99,83,,percent of total billed charges,,,4940.99,83,,percent of total billed charges,,,,,,,,,,,,,,,4940.99,83,,percent of total billed charges,,,5655.35,95,,percent of total billed charges,,,5357.7,90,,percent of total billed charges,,,5357.7,90,,percent of total billed charges,,,4881.46,82,,percent of total billed charges,,,5357.7,90,,percent of total billed charges,,,5060.05,85,,percent of total billed charges,,4488.56,5655.35,
* Z/OR (V0405),23307887,CDM,,,270,RC,inpatient,,3001,3001,,2547.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2262.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2550.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2640.88,88,,percent of total billed charges,,,,,,,,,2292.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2730.91,91,,percent of total billed charges,,,2850.95,95,,percent of total billed charges,,,2490.83,83,,percent of total billed charges,,,2490.83,83,,percent of total billed charges,,,,,,,,,,,,,,,2490.83,83,,percent of total billed charges,,,2850.95,95,,percent of total billed charges,,,2700.9,90,,percent of total billed charges,,,2700.9,90,,percent of total billed charges,,,2460.82,82,,percent of total billed charges,,,2700.9,90,,percent of total billed charges,,,2550.85,85,,percent of total billed charges,,2262.75,2850.95,
* STERI DRAPE #1060,23307918,CDM,,,270,RC,inpatient,,9,9,,7.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.92,88,,percent of total billed charges,,,,,,,,,6.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.38,82,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,6.79,8.55,
* Z/OR (V0405),23308075,CDM,,,270,RC,inpatient,,1825,1825,,1549.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1376.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1551.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1606,88,,percent of total billed charges,,,,,,,,,1394.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1660.75,91,,percent of total billed charges,,,1733.75,95,,percent of total billed charges,,,1514.75,83,,percent of total billed charges,,,1514.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1514.75,83,,percent of total billed charges,,,1733.75,95,,percent of total billed charges,,,1642.5,90,,percent of total billed charges,,,1642.5,90,,percent of total billed charges,,,1496.5,82,,percent of total billed charges,,,1642.5,90,,percent of total billed charges,,,1551.25,85,,percent of total billed charges,,1376.05,1733.75,
* SUTURE CP-412 (V0205),23308151,CDM,,,270,RC,inpatient,,308,308,,261.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,232.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,261.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,271.04,88,,percent of total billed charges,,,,,,,,,235.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,280.28,91,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,,,,,,,,,,,,,255.64,83,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,252.56,82,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,232.23,292.6,
AIRWAY BERMAN 90MM,23308164,CDM,,,270,RC,inpatient,,6.3,6.3,,5.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.54,88,,percent of total billed charges,,,,,,,,,4.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.73,91,,percent of total billed charges,,,5.99,95,,percent of total billed charges,,,5.23,83,,percent of total billed charges,,,5.23,83,,percent of total billed charges,,,,,,,,,,,,,,,5.23,83,,percent of total billed charges,,,5.99,95,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.17,82,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.36,85,,percent of total billed charges,,4.75,5.99,
AIRWAY KING LTD #3(NON-STOCK),23308179,CDM,,,270,RC,inpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,345.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,306.12,385.7,
AIRWAY KING LTD #5(NON-STOCK),23308181,CDM,,,270,RC,inpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,345.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,306.12,385.7,
AIRWAY BERMAN 100MM,23308182,CDM,,,270,RC,inpatient,,4.02,4.02,,3.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3.54,88,,percent of total billed charges,,,,,,,,,3.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3.66,91,,percent of total billed charges,,,3.82,95,,percent of total billed charges,,,3.34,83,,percent of total billed charges,,,3.34,83,,percent of total billed charges,,,,,,,,,,,,,,,3.34,83,,percent of total billed charges,,,3.82,95,,percent of total billed charges,,,3.62,90,,percent of total billed charges,,,3.62,90,,percent of total billed charges,,,3.3,82,,percent of total billed charges,,,3.62,90,,percent of total billed charges,,,3.42,85,,percent of total billed charges,,3.03,3.82,
NG TUBE W/REFLUX 12F,23310052,CDM,,,270,RC,inpatient,,45.14,45.14,,38.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.72,88,,percent of total billed charges,,,,,,,,,34.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.08,91,,percent of total billed charges,,,42.88,95,,percent of total billed charges,,,37.47,83,,percent of total billed charges,,,37.47,83,,percent of total billed charges,,,,,,,,,,,,,,,37.47,83,,percent of total billed charges,,,42.88,95,,percent of total billed charges,,,40.63,90,,percent of total billed charges,,,40.63,90,,percent of total billed charges,,,37.01,82,,percent of total billed charges,,,40.63,90,,percent of total billed charges,,,38.37,85,,percent of total billed charges,,34.04,42.88,
NG TUBE W/REFLUX 14F,23310053,CDM,,,270,RC,inpatient,,43.65,43.65,,37.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.41,88,,percent of total billed charges,,,,,,,,,33.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,39.72,91,,percent of total billed charges,,,41.47,95,,percent of total billed charges,,,36.23,83,,percent of total billed charges,,,36.23,83,,percent of total billed charges,,,,,,,,,,,,,,,36.23,83,,percent of total billed charges,,,41.47,95,,percent of total billed charges,,,39.29,90,,percent of total billed charges,,,39.29,90,,percent of total billed charges,,,35.79,82,,percent of total billed charges,,,39.29,90,,percent of total billed charges,,,37.1,85,,percent of total billed charges,,32.91,41.47,
NG TUBE W/REFLUX 16F,23310054,CDM,,,270,RC,inpatient,,24.19,24.19,,20.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.29,88,,percent of total billed charges,,,,,,,,,18.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.01,91,,percent of total billed charges,,,22.98,95,,percent of total billed charges,,,20.08,83,,percent of total billed charges,,,20.08,83,,percent of total billed charges,,,,,,,,,,,,,,,20.08,83,,percent of total billed charges,,,22.98,95,,percent of total billed charges,,,21.77,90,,percent of total billed charges,,,21.77,90,,percent of total billed charges,,,19.84,82,,percent of total billed charges,,,21.77,90,,percent of total billed charges,,,20.56,85,,percent of total billed charges,,18.24,22.98,
NG TUBE W/REFLUX 18F,23310055,CDM,,,270,RC,inpatient,,28.75,28.75,,24.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.3,88,,percent of total billed charges,,,,,,,,,21.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.16,91,,percent of total billed charges,,,27.31,95,,percent of total billed charges,,,23.86,83,,percent of total billed charges,,,23.86,83,,percent of total billed charges,,,,,,,,,,,,,,,23.86,83,,percent of total billed charges,,,27.31,95,,percent of total billed charges,,,25.88,90,,percent of total billed charges,,,25.88,90,,percent of total billed charges,,,23.58,82,,percent of total billed charges,,,25.88,90,,percent of total billed charges,,,24.44,85,,percent of total billed charges,,21.68,27.31,
*TONSIL SPONGE 1 1/4,23660062,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
*TUBE GAUZE 1  X 50YDS,23660064,CDM,,,270,RC,inpatient,,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,110.84,139.65,
*TUBE GAUZE 5/8,23660065,CDM,,,270,RC,inpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,52.03,65.55,
TUBE GAUZE 7/8,23660091,CDM,,,270,RC,inpatient,,270,270,,229.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,203.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,229.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,237.6,88,,percent of total billed charges,,,,,,,,,206.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,245.7,91,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,,,,,,,,,,,,,224.1,83,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,243,90,,percent of total billed charges,,,243,90,,percent of total billed charges,,,221.4,82,,percent of total billed charges,,,243,90,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,203.58,256.5,
*URETERAL CATH WHISTLE 6 FR,23670111,CDM,,,270,RC,inpatient,,22,22,,18.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.36,88,,percent of total billed charges,,,,,,,,,16.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.02,91,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,,,,,,,,,,,,,18.26,83,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.04,82,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,16.59,20.9,
* SACRO BELT XSM (V0106),23700192,CDM,,,270,RC,inpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110.88,88,,percent of total billed charges,,,,,,,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,95,119.7,
* SACRO BELT SMALL (V0106),23700193,CDM,,,270,RC,inpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110.88,88,,percent of total billed charges,,,,,,,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,95,119.7,
* SACRO BELT MEDIUM (V0106),23700194,CDM,,,270,RC,inpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110.88,88,,percent of total billed charges,,,,,,,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,95,119.7,
* SACRO BELT SMALL MED (V0106),23700195,CDM,,,270,RC,inpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110.88,88,,percent of total billed charges,,,,,,,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,95,119.7,
* SACRO BELT XLARGE (V0106),23700196,CDM,,,270,RC,inpatient,,133,133,,112.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,100.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,113.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,117.04,88,,percent of total billed charges,,,,,,,,,101.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,,,,,,,,,,,,,110.39,83,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,109.06,82,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,100.28,126.35,
* SACRO BELT XXLG (V0106),23700199,CDM,,,270,RC,inpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,108.58,136.8,
* SUTURE 628H (V0205),23720001,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
SUTURE 1670H (V0605),23720007,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE J344H (V0205),23720009,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE 1673G (V0205),23720029,CDM,,,270,RC,inpatient,,86,86,,73.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,75.68,88,,percent of total billed charges,,,,,,,,,65.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,78.26,91,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,,,,,,,,,,,,,71.38,83,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,70.52,82,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,64.84,81.7,
* SUTURE CL 922(V0205),23720034,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE 3027-79 (V0205),23720036,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE S102H (V0205),23720037,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE H822G (V0205),23720042,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
SUTURE 2-0 ETHILON FS 664G,23720044,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE GL 62 M (V0205),23720047,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE L113G (V0605),23720052,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE N862H (V0605),23720054,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE 583-41 (V0205),23720061,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE CG 813 (V0205),23720064,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE*636G (V0205),23720070,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE CL 831 (418H) (V0205),23720075,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE J214H (V0605),23720085,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE J493G (V0205),23720088,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE 9268-71 & CL-955 (V0205),23720103,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE 519H (V0205),23720110,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE B-518H (V0205),23720111,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE G202 (V0205),23720112,CDM,,,270,RC,inpatient,,245,245,,208.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,184.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,208.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,215.6,88,,percent of total billed charges,,,,,,,,,187.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,222.95,91,,percent of total billed charges,,,232.75,95,,percent of total billed charges,,,203.35,83,,percent of total billed charges,,,203.35,83,,percent of total billed charges,,,,,,,,,,,,,,,203.35,83,,percent of total billed charges,,,232.75,95,,percent of total billed charges,,,220.5,90,,percent of total billed charges,,,220.5,90,,percent of total billed charges,,,200.9,82,,percent of total billed charges,,,220.5,90,,percent of total billed charges,,,208.25,85,,percent of total billed charges,,184.73,232.75,
SUTURE SILK BLACK (V0205),23720114,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE GG 123 (V0205),23720117,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE J274H (V0205),23720127,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE J663H (V0205),23720129,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE J416H (V0205),23720141,CDM,,,270,RC,inpatient,,15,15,,12.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.2,88,,percent of total billed charges,,,,,,,,,11.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.65,91,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,,,,,,,,,,,,,12.45,83,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.3,82,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,11.31,14.25,
* SUTURE GL 322 (V0205),23720144,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE J443H (V0605),23720147,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE 518-52 (V0205),23720149,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE N862H (V0205),23720152,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE 663H (V0205),23720153,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE J868H (V0205),23720157,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE J218H (V0605),23720159,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE J870H (V0205),23720165,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
* SUTURE X519H (V0605),23720166,CDM,,,270,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
NEEDLE SURGICAL ANCHOR 10D (NC),23730009,CDM,,,270,RC,inpatient,,169.2,169.2,,143.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,127.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,143.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,148.9,88,,percent of total billed charges,,,,,,,,,129.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,153.97,91,,percent of total billed charges,,,160.74,95,,percent of total billed charges,,,140.44,83,,percent of total billed charges,,,140.44,83,,percent of total billed charges,,,,,,,,,,,,,,,140.44,83,,percent of total billed charges,,,160.74,95,,percent of total billed charges,,,152.28,90,,percent of total billed charges,,,152.28,90,,percent of total billed charges,,,138.74,82,,percent of total billed charges,,,152.28,90,,percent of total billed charges,,,143.82,85,,percent of total billed charges,,127.58,160.74,
* THREE WAY STOPCOCK WO TUBE (V0605),23750024,CDM,,,270,RC,inpatient,,4,4,,3.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3.52,88,,percent of total billed charges,,,,,,,,,3.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3.64,91,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3.32,83,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.28,82,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,3.02,3.8,
*STOMACH EVACUATOR EWALD TYPE,23770094,CDM,,,270,RC,inpatient,,187,187,,158.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,158.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,164.56,88,,percent of total billed charges,,,,,,,,,142.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,153.34,82,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,141,177.65,
ELECTRODE DEFIB ADULT EDGE QUICK-COMBO,23780021,CDM,,,270,RC,inpatient,,200.4,200.4,,170.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,151.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176.35,88,,percent of total billed charges,,,,,,,,,153.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182.36,91,,percent of total billed charges,,,190.38,95,,percent of total billed charges,,,166.33,83,,percent of total billed charges,,,166.33,83,,percent of total billed charges,,,,,,,,,,,,,,,166.33,83,,percent of total billed charges,,,190.38,95,,percent of total billed charges,,,180.36,90,,percent of total billed charges,,,180.36,90,,percent of total billed charges,,,164.33,82,,percent of total billed charges,,,180.36,90,,percent of total billed charges,,,170.34,85,,percent of total billed charges,,151.1,190.38,
ELECTRODE DEFIB PAD ZOLL,23780030,CDM,,,270,RC,inpatient,,578.34,578.34,,491.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,436.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,491.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,508.94,88,,percent of total billed charges,,,,,,,,,441.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,526.29,91,,percent of total billed charges,,,549.42,95,,percent of total billed charges,,,480.02,83,,percent of total billed charges,,,480.02,83,,percent of total billed charges,,,,,,,,,,,,,,,480.02,83,,percent of total billed charges,,,549.42,95,,percent of total billed charges,,,520.51,90,,percent of total billed charges,,,520.51,90,,percent of total billed charges,,,474.24,82,,percent of total billed charges,,,520.51,90,,percent of total billed charges,,,491.59,85,,percent of total billed charges,,436.07,549.42,
*ELEC/SURG HOLSTER,23780037,CDM,,,270,RC,inpatient,,6,6,,5.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.28,88,,percent of total billed charges,,,,,,,,,4.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4.98,83,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,4.92,82,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,4.52,5.7,
AIRWAY BERMAN 80MM,23790100,CDM,,,270,RC,inpatient,,2.22,2.22,,1.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1.95,88,,percent of total billed charges,,,,,,,,,1.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.02,91,,percent of total billed charges,,,2.11,95,,percent of total billed charges,,,1.84,83,,percent of total billed charges,,,1.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1.84,83,,percent of total billed charges,,,2.11,95,,percent of total billed charges,,,2,90,,percent of total billed charges,,,2,90,,percent of total billed charges,,,1.82,82,,percent of total billed charges,,,2,90,,percent of total billed charges,,,1.89,85,,percent of total billed charges,,1.67,2.11,
*AIRFLOW MATTRESS PLASTIC,23790101,CDM,,,270,RC,inpatient,,189,189,,160.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,142.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,160.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,166.32,88,,percent of total billed charges,,,,,,,,,144.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,,,,,,,,,,,,,156.87,83,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,154.98,82,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,142.51,179.55,
AIRWAY BERMAN 40MM,23790102,CDM,,,270,RC,inpatient,,5.49,5.49,,4.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4.83,88,,percent of total billed charges,,,,,,,,,4.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5,91,,percent of total billed charges,,,5.22,95,,percent of total billed charges,,,4.56,83,,percent of total billed charges,,,4.56,83,,percent of total billed charges,,,,,,,,,,,,,,,4.56,83,,percent of total billed charges,,,5.22,95,,percent of total billed charges,,,4.94,90,,percent of total billed charges,,,4.94,90,,percent of total billed charges,,,4.5,82,,percent of total billed charges,,,4.94,90,,percent of total billed charges,,,4.67,85,,percent of total billed charges,,4.14,5.22,
*U STONE RETRIVER 4 WIRE 8MM,23790186,CDM,,,270,RC,inpatient,,584,584,,495.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,440.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,496.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,513.92,88,,percent of total billed charges,,,,,,,,,446.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,531.44,91,,percent of total billed charges,,,554.8,95,,percent of total billed charges,,,484.72,83,,percent of total billed charges,,,484.72,83,,percent of total billed charges,,,,,,,,,,,,,,,484.72,83,,percent of total billed charges,,,554.8,95,,percent of total billed charges,,,525.6,90,,percent of total billed charges,,,525.6,90,,percent of total billed charges,,,478.88,82,,percent of total billed charges,,,525.6,90,,percent of total billed charges,,,496.4,85,,percent of total billed charges,,440.34,554.8,
*U STONE RETRIEVER 4 WIRE 11MM,23790187,CDM,,,270,RC,inpatient,,331,331,,281.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,249.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,281.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,291.28,88,,percent of total billed charges,,,,,,,,,252.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,301.21,91,,percent of total billed charges,,,314.45,95,,percent of total billed charges,,,274.73,83,,percent of total billed charges,,,274.73,83,,percent of total billed charges,,,,,,,,,,,,,,,274.73,83,,percent of total billed charges,,,314.45,95,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,271.42,82,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,281.35,85,,percent of total billed charges,,249.57,314.45,
*U STONE RETRIEVER WIRE 8MM,23790188,CDM,,,270,RC,inpatient,,632,632,,536.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,476.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,537.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,556.16,88,,percent of total billed charges,,,,,,,,,482.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,575.12,91,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,,,,,,,,,,,,,524.56,83,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,518.24,82,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,537.2,85,,percent of total billed charges,,476.53,600.4,
*U STONE RETREIVER 6 WIRE 11MM,23790189,CDM,,,270,RC,inpatient,,344,344,,292.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,259.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,292.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,302.72,88,,percent of total billed charges,,,,,,,,,262.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,313.04,91,,percent of total billed charges,,,326.8,95,,percent of total billed charges,,,285.52,83,,percent of total billed charges,,,285.52,83,,percent of total billed charges,,,,,,,,,,,,,,,285.52,83,,percent of total billed charges,,,326.8,95,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,282.08,82,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,292.4,85,,percent of total billed charges,,259.38,326.8,
AIRWAY GUEDEL 60MM,23790203,CDM,,,270,RC,inpatient,,6.57,6.57,,5.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.78,88,,percent of total billed charges,,,,,,,,,5.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.98,91,,percent of total billed charges,,,6.24,95,,percent of total billed charges,,,5.45,83,,percent of total billed charges,,,5.45,83,,percent of total billed charges,,,,,,,,,,,,,,,5.45,83,,percent of total billed charges,,,6.24,95,,percent of total billed charges,,,5.91,90,,percent of total billed charges,,,5.91,90,,percent of total billed charges,,,5.39,82,,percent of total billed charges,,,5.91,90,,percent of total billed charges,,,5.58,85,,percent of total billed charges,,4.95,6.24,
BETADINE SURGICAL SCRUB 4 OZ,23790214,CDM,,,270,RC,inpatient,,10.71,10.71,,9.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9.42,88,,percent of total billed charges,,,,,,,,,8.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9.75,91,,percent of total billed charges,,,10.17,95,,percent of total billed charges,,,8.89,83,,percent of total billed charges,,,8.89,83,,percent of total billed charges,,,,,,,,,,,,,,,8.89,83,,percent of total billed charges,,,10.17,95,,percent of total billed charges,,,9.64,90,,percent of total billed charges,,,9.64,90,,percent of total billed charges,,,8.78,82,,percent of total billed charges,,,9.64,90,,percent of total billed charges,,,9.1,85,,percent of total billed charges,,8.08,10.17,
*INTUBATION STYLET 6FR,23790220,CDM,,,270,RC,inpatient,,33,33,,28.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.04,88,,percent of total billed charges,,,,,,,,,25.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.03,91,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,,,,,,,,,,,,,27.39,83,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,27.06,82,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,28.05,85,,percent of total billed charges,,24.88,31.35,
AIRWAY BERMAN 60MM,23790269,CDM,,,270,RC,inpatient,,5.15,5.15,,4.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4.53,88,,percent of total billed charges,,,,,,,,,3.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4.69,91,,percent of total billed charges,,,4.89,95,,percent of total billed charges,,,4.27,83,,percent of total billed charges,,,4.27,83,,percent of total billed charges,,,,,,,,,,,,,,,4.27,83,,percent of total billed charges,,,4.89,95,,percent of total billed charges,,,4.64,90,,percent of total billed charges,,,4.64,90,,percent of total billed charges,,,4.22,82,,percent of total billed charges,,,4.64,90,,percent of total billed charges,,,4.38,85,,percent of total billed charges,,3.88,4.89,
AIRWAY BERMAN 70MM,23790273,CDM,,,270,RC,inpatient,,2.7,2.7,,2.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.38,88,,percent of total billed charges,,,,,,,,,2.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.46,91,,percent of total billed charges,,,2.57,95,,percent of total billed charges,,,2.24,83,,percent of total billed charges,,,2.24,83,,percent of total billed charges,,,,,,,,,,,,,,,2.24,83,,percent of total billed charges,,,2.57,95,,percent of total billed charges,,,2.43,90,,percent of total billed charges,,,2.43,90,,percent of total billed charges,,,2.21,82,,percent of total billed charges,,,2.43,90,,percent of total billed charges,,,2.3,85,,percent of total billed charges,,2.04,2.57,
AIRWAY GUEDEL 110MM,23790274,CDM,,,270,RC,inpatient,,2.61,2.61,,2.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.3,88,,percent of total billed charges,,,,,,,,,1.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.38,91,,percent of total billed charges,,,2.48,95,,percent of total billed charges,,,2.17,83,,percent of total billed charges,,,2.17,83,,percent of total billed charges,,,,,,,,,,,,,,,2.17,83,,percent of total billed charges,,,2.48,95,,percent of total billed charges,,,2.35,90,,percent of total billed charges,,,2.35,90,,percent of total billed charges,,,2.14,82,,percent of total billed charges,,,2.35,90,,percent of total billed charges,,,2.22,85,,percent of total billed charges,,1.97,2.48,
AIRWAY GUEDEL 100MM,23790294,CDM,,,270,RC,inpatient,,14.16,14.16,,12.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.46,88,,percent of total billed charges,,,,,,,,,10.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.89,91,,percent of total billed charges,,,13.45,95,,percent of total billed charges,,,11.75,83,,percent of total billed charges,,,11.75,83,,percent of total billed charges,,,,,,,,,,,,,,,11.75,83,,percent of total billed charges,,,13.45,95,,percent of total billed charges,,,12.74,90,,percent of total billed charges,,,12.74,90,,percent of total billed charges,,,11.61,82,,percent of total billed charges,,,12.74,90,,percent of total billed charges,,,12.04,85,,percent of total billed charges,,10.68,13.45,
AIRWAY GUEDEL 80MM,23790295,CDM,,,270,RC,inpatient,,4.08,4.08,,3.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3.59,88,,percent of total billed charges,,,,,,,,,3.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3.71,91,,percent of total billed charges,,,3.88,95,,percent of total billed charges,,,3.39,83,,percent of total billed charges,,,3.39,83,,percent of total billed charges,,,,,,,,,,,,,,,3.39,83,,percent of total billed charges,,,3.88,95,,percent of total billed charges,,,3.67,90,,percent of total billed charges,,,3.67,90,,percent of total billed charges,,,3.35,82,,percent of total billed charges,,,3.67,90,,percent of total billed charges,,,3.47,85,,percent of total billed charges,,3.08,3.88,
AIRWAY GUEDEL 90MM,23790297,CDM,,,270,RC,inpatient,,9.1,9.1,,7.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8.01,88,,percent of total billed charges,,,,,,,,,6.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8.28,91,,percent of total billed charges,,,8.65,95,,percent of total billed charges,,,7.55,83,,percent of total billed charges,,,7.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7.55,83,,percent of total billed charges,,,8.65,95,,percent of total billed charges,,,8.19,90,,percent of total billed charges,,,8.19,90,,percent of total billed charges,,,7.46,82,,percent of total billed charges,,,8.19,90,,percent of total billed charges,,,7.74,85,,percent of total billed charges,,6.86,8.65,
BILI EYE PATCHES,23790298,CDM,,,270,RC,inpatient,,10.8,10.8,,9.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9.5,88,,percent of total billed charges,,,,,,,,,8.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9.83,91,,percent of total billed charges,,,10.26,95,,percent of total billed charges,,,8.96,83,,percent of total billed charges,,,8.96,83,,percent of total billed charges,,,,,,,,,,,,,,,8.96,83,,percent of total billed charges,,,10.26,95,,percent of total billed charges,,,9.72,90,,percent of total billed charges,,,9.72,90,,percent of total billed charges,,,8.86,82,,percent of total billed charges,,,9.72,90,,percent of total billed charges,,,9.18,85,,percent of total billed charges,,8.14,10.26,
"* GLUCOSE, MEDISCAN PAPER (V0106)",23790319,CDM,,,270,RC,inpatient,,15,15,,12.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.2,88,,percent of total billed charges,,,,,,,,,11.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.65,91,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,,,,,,,,,,,,,12.45,83,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.3,82,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,11.31,14.25,
SCRUB KIT EXIDINE 4% CHG,23790365,CDM,,,270,RC,inpatient,,50.65,50.65,,43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.57,88,,percent of total billed charges,,,,,,,,,38.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.09,91,,percent of total billed charges,,,48.12,95,,percent of total billed charges,,,42.04,83,,percent of total billed charges,,,42.04,83,,percent of total billed charges,,,,,,,,,,,,,,,42.04,83,,percent of total billed charges,,,48.12,95,,percent of total billed charges,,,45.59,90,,percent of total billed charges,,,45.59,90,,percent of total billed charges,,,41.53,82,,percent of total billed charges,,,45.59,90,,percent of total billed charges,,,43.05,85,,percent of total billed charges,,38.19,48.12,
*TUBING CONNECTING 7',23790552,CDM,,,270,RC,inpatient,,8,8,,6.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.04,88,,percent of total billed charges,,,,,,,,,6.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.28,91,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,,,,,,,,,,,,,6.64,83,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.56,82,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.8,85,,percent of total billed charges,,6.03,7.6,
* LOOP OSTOMY SET 2 3/4 209 33 (V0605),23800066,CDM,,,270,RC,inpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,62.58,78.85,
*O2 MASK ADULT W/7' TUBING,23801192,CDM,,,270,RC,inpatient,,4,4,,3.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3.52,88,,percent of total billed charges,,,,,,,,,3.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3.64,91,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3.32,83,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.28,82,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,3.02,3.8,
POCKET CHAMBER/METERED DOSE INHALER,23801670,CDM,,,270,RC,inpatient,,52.11,52.11,,44.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.86,88,,percent of total billed charges,,,,,,,,,39.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47.42,91,,percent of total billed charges,,,49.5,95,,percent of total billed charges,,,43.25,83,,percent of total billed charges,,,43.25,83,,percent of total billed charges,,,,,,,,,,,,,,,43.25,83,,percent of total billed charges,,,49.5,95,,percent of total billed charges,,,46.9,90,,percent of total billed charges,,,46.9,90,,percent of total billed charges,,,42.73,82,,percent of total billed charges,,,46.9,90,,percent of total billed charges,,,44.29,85,,percent of total billed charges,,39.29,49.5,
*CPAP VALVE,23802027,CDM,,,270,RC,inpatient,,56,56,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.28,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,45.92,82,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,42.22,53.2,
*O2 CPAP 10CM,23802028,CDM,,,270,RC,inpatient,,60,60,,50.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,45.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.8,88,,percent of total billed charges,,,,,,,,,45.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,,,,,,,,,,,,,49.8,83,,percent of total billed charges,,,57,95,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,49.2,82,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,45.24,57,
*FILTER,23802029,CDM,,,270,RC,inpatient,,56,56,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.28,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,45.92,82,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,42.22,53.2,
O2 CPAP ADJ. VALUE,23802030,CDM,,,270,RC,inpatient,,66,66,,56.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.08,88,,percent of total billed charges,,,,,,,,,50.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.06,91,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,,,,,,,,,,,,,54.78,83,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,54.12,82,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,49.76,62.7,
CANOPY TENT,23802035,CDM,,,270,RC,inpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,92.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,82.19,103.55,
DISPOSABLE OXYHOOD,23802037,CDM,,,270,RC,inpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,58.81,74.1,
HAND HELD CIRCUIT,23802039,CDM,,,270,RC,inpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,76.91,96.9,
MINI HEART NEBULIZER CIRCUIT,23802040,CDM,,,270,RC,inpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,61.07,76.95,
IPPB CIRCUIT DISPOSABLE,23802042,CDM,,,270,RC,inpatient,,74,74,,62.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,55.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,62.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,65.12,88,,percent of total billed charges,,,,,,,,,56.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,,,,,,,,,,,,,61.42,83,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,60.68,82,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,55.8,70.3,
IS DISPOSABLE,23802043,CDM,,,270,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
MASKS NON REBREATHER,23802044,CDM,,,270,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
MECHANICAL VENTILATOR CIRCUIT,23802046,CDM,,,270,RC,inpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,108.58,136.8,
*O2 MASK NON-REBREATHER,23802116,CDM,,,270,RC,inpatient,,8,8,,6.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.04,88,,percent of total billed charges,,,,,,,,,6.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.28,91,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,,,,,,,,,,,,,6.64,83,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.56,82,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.8,85,,percent of total billed charges,,6.03,7.6,
INTRAUTERINE PRESSURE CATHETER,23910257,CDM,59899,CPT,270,RC,inpatient,,474,474,,402.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,357.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,402.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,417.12,88,,percent of total billed charges,,,,,,,,,362.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,431.34,91,,percent of total billed charges,,,450.3,95,,percent of total billed charges,,,393.42,83,,percent of total billed charges,,,393.42,83,,percent of total billed charges,,,,,,,,,,,,,,,393.42,83,,percent of total billed charges,,,450.3,95,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,388.68,82,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,402.9,85,,percent of total billed charges,,357.4,450.3,
HYSTRO TRAY,26100786,CDM,,,270,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
H/S CATHETER SET,26100787,CDM,,,270,RC,inpatient,,19,19,,16.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16.72,88,,percent of total billed charges,,,,,,,,,14.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.29,91,,percent of total billed charges,,,18.05,95,,percent of total billed charges,,,15.77,83,,percent of total billed charges,,,15.77,83,,percent of total billed charges,,,,,,,,,,,,,,,15.77,83,,percent of total billed charges,,,18.05,95,,percent of total billed charges,,,17.1,90,,percent of total billed charges,,,17.1,90,,percent of total billed charges,,,15.58,82,,percent of total billed charges,,,17.1,90,,percent of total billed charges,,,16.15,85,,percent of total billed charges,,14.33,18.05,
TRANSFER TUBING,26307769,CDM,,,270,RC,inpatient,,5,5,,4.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4.4,88,,percent of total billed charges,,,,,,,,,3.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4.55,91,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4.15,83,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.1,82,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,3.77,4.75,
NEEDLE COAX BX,29101997,CDM,,,270,RC,inpatient,,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,217.91,274.55,
NEEDLE CIBA,29101999,CDM,,,270,RC,inpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,109.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,123.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,109.33,137.75,
*BOOT SOF-CARE HEEL CARE,30040003,CDM,,,270,RC,inpatient,,148.4,148.4,,125.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,111.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,126.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,130.59,88,,percent of total billed charges,,,,,,,,,113.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,135.04,91,,percent of total billed charges,,,140.98,95,,percent of total billed charges,,,123.17,83,,percent of total billed charges,,,123.17,83,,percent of total billed charges,,,,,,,,,,,,,,,123.17,83,,percent of total billed charges,,,140.98,95,,percent of total billed charges,,,133.56,90,,percent of total billed charges,,,133.56,90,,percent of total billed charges,,,121.69,82,,percent of total billed charges,,,133.56,90,,percent of total billed charges,,,126.14,85,,percent of total billed charges,,111.89,140.98,
*BOOT SOF-CARE HEEL CARE SM. LONG,30040004,CDM,,,270,RC,inpatient,,160.72,160.72,,136.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,121.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,141.43,88,,percent of total billed charges,,,,,,,,,122.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,146.26,91,,percent of total billed charges,,,152.68,95,,percent of total billed charges,,,133.4,83,,percent of total billed charges,,,133.4,83,,percent of total billed charges,,,,,,,,,,,,,,,133.4,83,,percent of total billed charges,,,152.68,95,,percent of total billed charges,,,144.65,90,,percent of total billed charges,,,144.65,90,,percent of total billed charges,,,131.79,82,,percent of total billed charges,,,144.65,90,,percent of total billed charges,,,136.61,85,,percent of total billed charges,,121.18,152.68,
*BOOT SOF-CARE HEEL CARE LG. LONG,30040005,CDM,,,270,RC,inpatient,,160.8,160.8,,136.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,121.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,141.5,88,,percent of total billed charges,,,,,,,,,122.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,146.33,91,,percent of total billed charges,,,152.76,95,,percent of total billed charges,,,133.46,83,,percent of total billed charges,,,133.46,83,,percent of total billed charges,,,,,,,,,,,,,,,133.46,83,,percent of total billed charges,,,152.76,95,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,131.86,82,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,136.68,85,,percent of total billed charges,,121.24,152.76,
*BOOT SOF-CARE HEEL CARE MED. LONG,30040006,CDM,,,270,RC,inpatient,,160.8,160.8,,136.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,121.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,141.5,88,,percent of total billed charges,,,,,,,,,122.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,146.33,91,,percent of total billed charges,,,152.76,95,,percent of total billed charges,,,133.46,83,,percent of total billed charges,,,133.46,83,,percent of total billed charges,,,,,,,,,,,,,,,133.46,83,,percent of total billed charges,,,152.76,95,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,131.86,82,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,136.68,85,,percent of total billed charges,,121.24,152.76,
*DRESSING MAXORB AG EXTRA,30040007,CDM,,,270,RC,inpatient,,55.76,55.76,,47.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.07,88,,percent of total billed charges,,,,,,,,,42.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.74,91,,percent of total billed charges,,,52.97,95,,percent of total billed charges,,,46.28,83,,percent of total billed charges,,,46.28,83,,percent of total billed charges,,,,,,,,,,,,,,,46.28,83,,percent of total billed charges,,,52.97,95,,percent of total billed charges,,,50.18,90,,percent of total billed charges,,,50.18,90,,percent of total billed charges,,,45.72,82,,percent of total billed charges,,,50.18,90,,percent of total billed charges,,,47.4,85,,percent of total billed charges,,42.04,52.97,
"ADDITION TO LOWER EXTREMITY, TORSION CON",30040018,CDM,,,270,RC,inpatient,,940.42,940.42,,798.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,709.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,799.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,827.57,88,,percent of total billed charges,,,,,,,,,718.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,855.78,91,,percent of total billed charges,,,893.4,95,,percent of total billed charges,,,780.55,83,,percent of total billed charges,,,780.55,83,,percent of total billed charges,,,,,,,,,,,,,,,780.55,83,,percent of total billed charges,,,893.4,95,,percent of total billed charges,,,846.38,90,,percent of total billed charges,,,846.38,90,,percent of total billed charges,,,771.14,82,,percent of total billed charges,,,846.38,90,,percent of total billed charges,,,799.36,85,,percent of total billed charges,,709.08,893.4,
"*HIP KNEE ANKLE FOOT ORTHOSIS,TORSION",30040019,CDM,,,270,RC,inpatient,,3550.95,3550.95,,3014.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2677.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3018.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3124.84,88,,percent of total billed charges,,,,,,,,,2712.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3231.36,91,,percent of total billed charges,,,3373.4,95,,percent of total billed charges,,,2947.29,83,,percent of total billed charges,,,2947.29,83,,percent of total billed charges,,,,,,,,,,,,,,,2947.29,83,,percent of total billed charges,,,3373.4,95,,percent of total billed charges,,,3195.86,90,,percent of total billed charges,,,3195.86,90,,percent of total billed charges,,,2911.78,82,,percent of total billed charges,,,3195.86,90,,percent of total billed charges,,,3018.31,85,,percent of total billed charges,,2677.42,3373.4,
KCI GRANUFOAM DRSG BLACK MED,30040029,CDM,,,270,RC,inpatient,,311.08,311.08,,264.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,234.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,264.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,273.75,88,,percent of total billed charges,,,,,,,,,237.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,283.08,91,,percent of total billed charges,,,295.53,95,,percent of total billed charges,,,258.2,83,,percent of total billed charges,,,258.2,83,,percent of total billed charges,,,,,,,,,,,,,,,258.2,83,,percent of total billed charges,,,295.53,95,,percent of total billed charges,,,279.97,90,,percent of total billed charges,,,279.97,90,,percent of total billed charges,,,255.09,82,,percent of total billed charges,,,279.97,90,,percent of total billed charges,,,264.42,85,,percent of total billed charges,,234.55,295.53,
KCI GRANUFOAM DRSG BLACK SM,30040032,CDM,,,270,RC,inpatient,,278.06,278.06,,236.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,236.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.69,88,,percent of total billed charges,,,,,,,,,212.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,253.03,91,,percent of total billed charges,,,264.16,95,,percent of total billed charges,,,230.79,83,,percent of total billed charges,,,230.79,83,,percent of total billed charges,,,,,,,,,,,,,,,230.79,83,,percent of total billed charges,,,264.16,95,,percent of total billed charges,,,250.25,90,,percent of total billed charges,,,250.25,90,,percent of total billed charges,,,228.01,82,,percent of total billed charges,,,250.25,90,,percent of total billed charges,,,236.35,85,,percent of total billed charges,,209.66,264.16,
KCI CANISTERS NO GEL,30040033,CDM,,,270,RC,inpatient,,214.96,214.96,,182.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,162.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,182.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,189.16,88,,percent of total billed charges,,,,,,,,,164.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,195.61,91,,percent of total billed charges,,,204.21,95,,percent of total billed charges,,,178.42,83,,percent of total billed charges,,,178.42,83,,percent of total billed charges,,,,,,,,,,,,,,,178.42,83,,percent of total billed charges,,,204.21,95,,percent of total billed charges,,,193.46,90,,percent of total billed charges,,,193.46,90,,percent of total billed charges,,,176.27,82,,percent of total billed charges,,,193.46,90,,percent of total billed charges,,,182.72,85,,percent of total billed charges,,162.08,204.21,
FIBRACOL PLUS,30040034,CDM,,,270,RC,inpatient,,33.84,33.84,,28.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.78,88,,percent of total billed charges,,,,,,,,,25.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.79,91,,percent of total billed charges,,,32.15,95,,percent of total billed charges,,,28.09,83,,percent of total billed charges,,,28.09,83,,percent of total billed charges,,,,,,,,,,,,,,,28.09,83,,percent of total billed charges,,,32.15,95,,percent of total billed charges,,,30.46,90,,percent of total billed charges,,,30.46,90,,percent of total billed charges,,,27.75,82,,percent of total billed charges,,,30.46,90,,percent of total billed charges,,,28.76,85,,percent of total billed charges,,25.52,32.15,
WOUND V.A.C. DAILY RATE,30040035,CDM,,,270,RC,inpatient,,407.33,407.33,,345.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,307.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,346.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,358.45,88,,percent of total billed charges,,,,,,,,,311.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,370.67,91,,percent of total billed charges,,,386.96,95,,percent of total billed charges,,,338.08,83,,percent of total billed charges,,,338.08,83,,percent of total billed charges,,,,,,,,,,,,,,,338.08,83,,percent of total billed charges,,,386.96,95,,percent of total billed charges,,,366.6,90,,percent of total billed charges,,,366.6,90,,percent of total billed charges,,,334.01,82,,percent of total billed charges,,,366.6,90,,percent of total billed charges,,,346.23,85,,percent of total billed charges,,307.13,386.96,
FLEXI-SEAL FECAL MANAGEMENT KIT,30040044,CDM,,,270,RC,inpatient,,1219.53,1219.53,,1035.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,919.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1036.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1073.19,88,,percent of total billed charges,,,,,,,,,931.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1109.77,91,,percent of total billed charges,,,1158.55,95,,percent of total billed charges,,,1012.21,83,,percent of total billed charges,,,1012.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1012.21,83,,percent of total billed charges,,,1158.55,95,,percent of total billed charges,,,1097.58,90,,percent of total billed charges,,,1097.58,90,,percent of total billed charges,,,1000.01,82,,percent of total billed charges,,,1097.58,90,,percent of total billed charges,,,1036.6,85,,percent of total billed charges,,919.53,1158.55,
*FEEDING SET KANGAROO EPUMP SPIKE SAFETY,30040046,CDM,,,270,RC,inpatient,,41.36,41.36,,35.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36.4,88,,percent of total billed charges,,,,,,,,,31.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37.64,91,,percent of total billed charges,,,39.29,95,,percent of total billed charges,,,34.33,83,,percent of total billed charges,,,34.33,83,,percent of total billed charges,,,,,,,,,,,,,,,34.33,83,,percent of total billed charges,,,39.29,95,,percent of total billed charges,,,37.22,90,,percent of total billed charges,,,37.22,90,,percent of total billed charges,,,33.92,82,,percent of total billed charges,,,37.22,90,,percent of total billed charges,,,35.16,85,,percent of total billed charges,,31.19,39.29,
CUSHION WAFFLE MATTRESS PAD,30040048,CDM,,,270,RC,inpatient,,300.11,300.11,,254.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264.1,88,,percent of total billed charges,,,,,,,,,229.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273.1,91,,percent of total billed charges,,,285.1,95,,percent of total billed charges,,,249.09,83,,percent of total billed charges,,,249.09,83,,percent of total billed charges,,,,,,,,,,,,,,,249.09,83,,percent of total billed charges,,,285.1,95,,percent of total billed charges,,,270.1,90,,percent of total billed charges,,,270.1,90,,percent of total billed charges,,,246.09,82,,percent of total billed charges,,,270.1,90,,percent of total billed charges,,,255.09,85,,percent of total billed charges,,226.28,285.1,
CUSHION WAFFLE 16X16X2,30040049,CDM,,,270,RC,inpatient,,141.11,141.11,,119.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,106.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,119.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,124.18,88,,percent of total billed charges,,,,,,,,,107.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,128.41,91,,percent of total billed charges,,,134.05,95,,percent of total billed charges,,,117.12,83,,percent of total billed charges,,,117.12,83,,percent of total billed charges,,,,,,,,,,,,,,,117.12,83,,percent of total billed charges,,,134.05,95,,percent of total billed charges,,,127,90,,percent of total billed charges,,,127,90,,percent of total billed charges,,,115.71,82,,percent of total billed charges,,,127,90,,percent of total billed charges,,,119.94,85,,percent of total billed charges,,106.4,134.05,
KCI SENSATRACK PAD,30040052,CDM,,,270,RC,inpatient,,148.72,148.72,,126.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,112.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,126.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,130.87,88,,percent of total billed charges,,,,,,,,,113.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,135.34,91,,percent of total billed charges,,,141.28,95,,percent of total billed charges,,,123.44,83,,percent of total billed charges,,,123.44,83,,percent of total billed charges,,,,,,,,,,,,,,,123.44,83,,percent of total billed charges,,,141.28,95,,percent of total billed charges,,,133.85,90,,percent of total billed charges,,,133.85,90,,percent of total billed charges,,,121.95,82,,percent of total billed charges,,,133.85,90,,percent of total billed charges,,,126.41,85,,percent of total billed charges,,112.13,141.28,
KCI GRANUFOAM DRSG BRIDGE XG,30040053,CDM,,,270,RC,inpatient,,401.87,401.87,,341.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,303.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,341.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,353.65,88,,percent of total billed charges,,,,,,,,,307.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,365.7,91,,percent of total billed charges,,,381.78,95,,percent of total billed charges,,,333.55,83,,percent of total billed charges,,,333.55,83,,percent of total billed charges,,,,,,,,,,,,,,,333.55,83,,percent of total billed charges,,,381.78,95,,percent of total billed charges,,,361.68,90,,percent of total billed charges,,,361.68,90,,percent of total billed charges,,,329.53,82,,percent of total billed charges,,,361.68,90,,percent of total billed charges,,,341.59,85,,percent of total billed charges,,303.01,381.78,
EAR SENSOR MASIMO LNCS E1,30040055,CDM,,,270,RC,inpatient,,187.87,187.87,,159.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,159.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,165.33,88,,percent of total billed charges,,,,,,,,,143.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,170.96,91,,percent of total billed charges,,,178.48,95,,percent of total billed charges,,,155.93,83,,percent of total billed charges,,,155.93,83,,percent of total billed charges,,,,,,,,,,,,,,,155.93,83,,percent of total billed charges,,,178.48,95,,percent of total billed charges,,,169.08,90,,percent of total billed charges,,,169.08,90,,percent of total billed charges,,,154.05,82,,percent of total billed charges,,,169.08,90,,percent of total billed charges,,,159.69,85,,percent of total billed charges,,141.65,178.48,
P.O.S. FOREARM CUFFS EXT FLEX,30048001,CDM,,,270,RC,inpatient,,4849.59,4849.59,,4117.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3656.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4122.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4267.64,88,,percent of total billed charges,,,,,,,,,3705.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4413.13,91,,percent of total billed charges,,,4607.11,95,,percent of total billed charges,,,4025.16,83,,percent of total billed charges,,,4025.16,83,,percent of total billed charges,,,,,,,,,,,,,,,4025.16,83,,percent of total billed charges,,,4607.11,95,,percent of total billed charges,,,4364.63,90,,percent of total billed charges,,,4364.63,90,,percent of total billed charges,,,3976.66,82,,percent of total billed charges,,,4364.63,90,,percent of total billed charges,,,4122.15,85,,percent of total billed charges,,3656.59,4607.11,
P.O.S. UPP EXT FX ORTHOSIS HUMERAL,30048002,CDM,,,270,RC,inpatient,,2070.06,2070.06,,1757.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1560.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1759.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1821.65,88,,percent of total billed charges,,,,,,,,,1581.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1883.75,91,,percent of total billed charges,,,1966.56,95,,percent of total billed charges,,,1718.15,83,,percent of total billed charges,,,1718.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1718.15,83,,percent of total billed charges,,,1966.56,95,,percent of total billed charges,,,1863.05,90,,percent of total billed charges,,,1863.05,90,,percent of total billed charges,,,1697.45,82,,percent of total billed charges,,,1863.05,90,,percent of total billed charges,,,1759.55,85,,percent of total billed charges,,1560.83,1966.56,
P.O S. FORK STRAP BELOW KNEE,30048003,CDM,,,270,RC,inpatient,,450.73,450.73,,382.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,339.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,383.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,396.64,88,,percent of total billed charges,,,,,,,,,344.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,410.16,91,,percent of total billed charges,,,428.19,95,,percent of total billed charges,,,374.11,83,,percent of total billed charges,,,374.11,83,,percent of total billed charges,,,,,,,,,,,,,,,374.11,83,,percent of total billed charges,,,428.19,95,,percent of total billed charges,,,405.66,90,,percent of total billed charges,,,405.66,90,,percent of total billed charges,,,369.6,82,,percent of total billed charges,,,405.66,90,,percent of total billed charges,,,383.12,85,,percent of total billed charges,,339.85,428.19,
P.O.S. WAIST BELT WEBBING BELOW KNEE,30048004,CDM,,,270,RC,inpatient,,575.68,575.68,,488.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,434.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,489.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,506.6,88,,percent of total billed charges,,,,,,,,,439.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,523.87,91,,percent of total billed charges,,,546.9,95,,percent of total billed charges,,,477.81,83,,percent of total billed charges,,,477.81,83,,percent of total billed charges,,,,,,,,,,,,,,,477.81,83,,percent of total billed charges,,,546.9,95,,percent of total billed charges,,,518.11,90,,percent of total billed charges,,,518.11,90,,percent of total billed charges,,,472.06,82,,percent of total billed charges,,,518.11,90,,percent of total billed charges,,,489.33,85,,percent of total billed charges,,434.06,546.9,
P.O.S. FOREARM CUFFS FREE MOTION,30048005,CDM,,,270,RC,inpatient,,3656.06,3656.06,,3103.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2756.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3107.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3217.33,88,,percent of total billed charges,,,,,,,,,2793.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3327.01,91,,percent of total billed charges,,,3473.26,95,,percent of total billed charges,,,3034.53,83,,percent of total billed charges,,,3034.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3034.53,83,,percent of total billed charges,,,3473.26,95,,percent of total billed charges,,,3290.45,90,,percent of total billed charges,,,3290.45,90,,percent of total billed charges,,,2997.97,82,,percent of total billed charges,,,3290.45,90,,percent of total billed charges,,,3107.65,85,,percent of total billed charges,,2756.67,3473.26,
P.O.S. KAFO FEMORAL FX CAST RIGID,30048006,CDM,,,270,RC,inpatient,,7653.62,7653.62,,6497.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5770.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6505.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6735.19,88,,percent of total billed charges,,,,,,,,,5847.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6964.79,91,,percent of total billed charges,,,7270.94,95,,percent of total billed charges,,,6352.5,83,,percent of total billed charges,,,6352.5,83,,percent of total billed charges,,,,,,,,,,,,,,,6352.5,83,,percent of total billed charges,,,7270.94,95,,percent of total billed charges,,,6888.26,90,,percent of total billed charges,,,6888.26,90,,percent of total billed charges,,,6275.97,82,,percent of total billed charges,,,6888.26,90,,percent of total billed charges,,,6505.58,85,,percent of total billed charges,,5770.83,7270.94,
P.O.S. ADJ MOTION KNEE JNT LERMAN,30048007,CDM,,,270,RC,inpatient,,1811.29,1811.29,,1537.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1365.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1539.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1593.94,88,,percent of total billed charges,,,,,,,,,1383.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1648.27,91,,percent of total billed charges,,,1720.73,95,,percent of total billed charges,,,1503.37,83,,percent of total billed charges,,,1503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1503.37,83,,percent of total billed charges,,,1720.73,95,,percent of total billed charges,,,1630.16,90,,percent of total billed charges,,,1630.16,90,,percent of total billed charges,,,1485.26,82,,percent of total billed charges,,,1630.16,90,,percent of total billed charges,,,1539.6,85,,percent of total billed charges,,1365.71,1720.73,
P.O.S. PELVIC BAND & BELT THIGH,30048008,CDM,,,270,RC,inpatient,,2023.32,2023.32,,1717.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1525.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1719.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1780.52,88,,percent of total billed charges,,,,,,,,,1545.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1841.22,91,,percent of total billed charges,,,1922.15,95,,percent of total billed charges,,,1679.36,83,,percent of total billed charges,,,1679.36,83,,percent of total billed charges,,,,,,,,,,,,,,,1679.36,83,,percent of total billed charges,,,1922.15,95,,percent of total billed charges,,,1820.99,90,,percent of total billed charges,,,1820.99,90,,percent of total billed charges,,,1659.12,82,,percent of total billed charges,,,1820.99,90,,percent of total billed charges,,,1719.82,85,,percent of total billed charges,,1525.58,1922.15,
P.O.S. PLAS SHOE INSESRT W/ANK JOINT,30048009,CDM,,,270,RC,inpatient,,866.46,866.46,,735.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,653.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,736.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,762.48,88,,percent of total billed charges,,,,,,,,,661.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,788.48,91,,percent of total billed charges,,,823.14,95,,percent of total billed charges,,,719.16,83,,percent of total billed charges,,,719.16,83,,percent of total billed charges,,,,,,,,,,,,,,,719.16,83,,percent of total billed charges,,,823.14,95,,percent of total billed charges,,,779.81,90,,percent of total billed charges,,,779.81,90,,percent of total billed charges,,,710.5,82,,percent of total billed charges,,,779.81,90,,percent of total billed charges,,,736.49,85,,percent of total billed charges,,653.31,823.14,
P.O.S. SURGICAL BOOT,30048011,CDM,,,270,RC,inpatient,,241.65,241.65,,205.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,182.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,205.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,212.65,88,,percent of total billed charges,,,,,,,,,184.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,219.9,91,,percent of total billed charges,,,229.57,95,,percent of total billed charges,,,200.57,83,,percent of total billed charges,,,200.57,83,,percent of total billed charges,,,,,,,,,,,,,,,200.57,83,,percent of total billed charges,,,229.57,95,,percent of total billed charges,,,217.49,90,,percent of total billed charges,,,217.49,90,,percent of total billed charges,,,198.15,82,,percent of total billed charges,,,217.49,90,,percent of total billed charges,,,205.4,85,,percent of total billed charges,,182.2,229.57,
P.O.S. KAFO FEM FX CAST MOLDED TO PT,30048012,CDM,,,270,RC,inpatient,,9427.02,9427.02,,8003.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7107.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8012.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8295.78,88,,percent of total billed charges,,,,,,,,,7202.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8578.59,91,,percent of total billed charges,,,8955.67,95,,percent of total billed charges,,,7824.43,83,,percent of total billed charges,,,7824.43,83,,percent of total billed charges,,,,,,,,,,,,,,,7824.43,83,,percent of total billed charges,,,8955.67,95,,percent of total billed charges,,,8484.32,90,,percent of total billed charges,,,8484.32,90,,percent of total billed charges,,,7730.16,82,,percent of total billed charges,,,8484.32,90,,percent of total billed charges,,,8012.97,85,,percent of total billed charges,,7107.97,8955.67,
P.O.S. AFO POS SOLID ANK PLASTIC MO,30048013,CDM,,,270,RC,inpatient,,3732.04,3732.04,,3168.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2813.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3172.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3284.2,88,,percent of total billed charges,,,,,,,,,2851.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3396.16,91,,percent of total billed charges,,,3545.44,95,,percent of total billed charges,,,3097.59,83,,percent of total billed charges,,,3097.59,83,,percent of total billed charges,,,,,,,,,,,,,,,3097.59,83,,percent of total billed charges,,,3545.44,95,,percent of total billed charges,,,3358.84,90,,percent of total billed charges,,,3358.84,90,,percent of total billed charges,,,3060.27,82,,percent of total billed charges,,,3358.84,90,,percent of total billed charges,,,3172.23,85,,percent of total billed charges,,2813.96,3545.44,
P.O.S. PROSTHETIC TYPE SOCKET MOLD,30048014,CDM,,,270,RC,inpatient,,5016.25,5016.25,,4258.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3782.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4263.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4414.3,88,,percent of total billed charges,,,,,,,,,3832.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4564.79,91,,percent of total billed charges,,,4765.44,95,,percent of total billed charges,,,4163.49,83,,percent of total billed charges,,,4163.49,83,,percent of total billed charges,,,,,,,,,,,,,,,4163.49,83,,percent of total billed charges,,,4765.44,95,,percent of total billed charges,,,4514.63,90,,percent of total billed charges,,,4514.63,90,,percent of total billed charges,,,4113.33,82,,percent of total billed charges,,,4514.63,90,,percent of total billed charges,,,4263.81,85,,percent of total billed charges,,3782.25,4765.44,
P.O.S. PADDING BELOW KNEE INTERFACE,30048015,CDM,,,270,RC,inpatient,,530.74,530.74,,450.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,400.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,451.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,467.05,88,,percent of total billed charges,,,,,,,,,405.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,482.97,91,,percent of total billed charges,,,504.2,95,,percent of total billed charges,,,440.51,83,,percent of total billed charges,,,440.51,83,,percent of total billed charges,,,,,,,,,,,,,,,440.51,83,,percent of total billed charges,,,504.2,95,,percent of total billed charges,,,477.67,90,,percent of total billed charges,,,477.67,90,,percent of total billed charges,,,435.21,82,,percent of total billed charges,,,477.67,90,,percent of total billed charges,,,451.13,85,,percent of total billed charges,,400.18,504.2,
P.O.S. TIBIAL LENGTH SOCK FX OR EQU,30048016,CDM,,,270,RC,inpatient,,559.3,559.3,,474.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,421.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,475.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,492.18,88,,percent of total billed charges,,,,,,,,,427.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,508.96,91,,percent of total billed charges,,,531.34,95,,percent of total billed charges,,,464.22,83,,percent of total billed charges,,,464.22,83,,percent of total billed charges,,,,,,,,,,,,,,,464.22,83,,percent of total billed charges,,,531.34,95,,percent of total billed charges,,,503.37,90,,percent of total billed charges,,,503.37,90,,percent of total billed charges,,,458.63,82,,percent of total billed charges,,,503.37,90,,percent of total billed charges,,,475.41,85,,percent of total billed charges,,421.71,531.34,
P.O.S. ORTHO DEVICE REPAIR,30048021,CDM,,,270,RC,inpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,527.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,595,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,527.8,665,
P.O.S. AFO MOLDED TO PATIENT PLASTI,30048022,CDM,,,270,RC,inpatient,,2863.19,2863.19,,2430.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2158.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2433.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2519.61,88,,percent of total billed charges,,,,,,,,,2187.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2605.5,91,,percent of total billed charges,,,2720.03,95,,percent of total billed charges,,,2376.45,83,,percent of total billed charges,,,2376.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2376.45,83,,percent of total billed charges,,,2720.03,95,,percent of total billed charges,,,2576.87,90,,percent of total billed charges,,,2576.87,90,,percent of total billed charges,,,2347.82,82,,percent of total billed charges,,,2576.87,90,,percent of total billed charges,,,2433.71,85,,percent of total billed charges,,2158.85,2720.03,
P.O.S. KO SINGLE UPRIGHT CUSTOM FIT,30048023,CDM,,,270,RC,inpatient,,5445.38,5445.38,,4623.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4105.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4628.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4791.93,88,,percent of total billed charges,,,,,,,,,4160.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4955.3,91,,percent of total billed charges,,,5173.11,95,,percent of total billed charges,,,4519.67,83,,percent of total billed charges,,,4519.67,83,,percent of total billed charges,,,,,,,,,,,,,,,4519.67,83,,percent of total billed charges,,,5173.11,95,,percent of total billed charges,,,4900.84,90,,percent of total billed charges,,,4900.84,90,,percent of total billed charges,,,4465.21,82,,percent of total billed charges,,,4900.84,90,,percent of total billed charges,,,4628.57,85,,percent of total billed charges,,4105.82,5173.11,
P.O.S. AFO TIBIAL FRACTURE RIGID,30048024,CDM,,,270,RC,inpatient,,4677.53,4677.53,,3971.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3526.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3975.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4116.23,88,,percent of total billed charges,,,,,,,,,3573.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4256.55,91,,percent of total billed charges,,,4443.65,95,,percent of total billed charges,,,3882.35,83,,percent of total billed charges,,,3882.35,83,,percent of total billed charges,,,,,,,,,,,,,,,3882.35,83,,percent of total billed charges,,,4443.65,95,,percent of total billed charges,,,4209.78,90,,percent of total billed charges,,,4209.78,90,,percent of total billed charges,,,3835.57,82,,percent of total billed charges,,,4209.78,90,,percent of total billed charges,,,3975.9,85,,percent of total billed charges,,3526.86,4443.65,
P.O.S. SOCK FRACTURE,30048025,CDM,,,270,RC,inpatient,,261.75,261.75,,222.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,222.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,230.34,88,,percent of total billed charges,,,,,,,,,199.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.19,91,,percent of total billed charges,,,248.66,95,,percent of total billed charges,,,217.25,83,,percent of total billed charges,,,217.25,83,,percent of total billed charges,,,,,,,,,,,,,,,217.25,83,,percent of total billed charges,,,248.66,95,,percent of total billed charges,,,235.58,90,,percent of total billed charges,,,235.58,90,,percent of total billed charges,,,214.64,82,,percent of total billed charges,,,235.58,90,,percent of total billed charges,,,222.49,85,,percent of total billed charges,,197.36,248.66,
OMNI KNEE ANKLE FOOT ORTHOSIS FULL PLAST,30048026,CDM,,,270,RC,inpatient,,14184.82,14184.82,,12042.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10695.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12057.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12482.64,88,,percent of total billed charges,,,,,,,,,10837.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12908.19,91,,percent of total billed charges,,,13475.58,95,,percent of total billed charges,,,11773.4,83,,percent of total billed charges,,,11773.4,83,,percent of total billed charges,,,,,,,,,,,,,,,11773.4,83,,percent of total billed charges,,,13475.58,95,,percent of total billed charges,,,12766.34,90,,percent of total billed charges,,,12766.34,90,,percent of total billed charges,,,11631.55,82,,percent of total billed charges,,,12766.34,90,,percent of total billed charges,,,12057.1,85,,percent of total billed charges,,10695.35,13475.58,
OMNI ADDITION TO LOWER EXTREMITY STRAIGH,30048027,CDM,,,270,RC,inpatient,,1124.31,1124.31,,954.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,847.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,955.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,989.39,88,,percent of total billed charges,,,,,,,,,858.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1023.12,91,,percent of total billed charges,,,1068.09,95,,percent of total billed charges,,,933.18,83,,percent of total billed charges,,,933.18,83,,percent of total billed charges,,,,,,,,,,,,,,,933.18,83,,percent of total billed charges,,,1068.09,95,,percent of total billed charges,,,1011.88,90,,percent of total billed charges,,,1011.88,90,,percent of total billed charges,,,921.93,82,,percent of total billed charges,,,1011.88,90,,percent of total billed charges,,,955.66,85,,percent of total billed charges,,847.73,1068.09,
OMNI ADDITION TO KNEE LOCK W/INTEGRATED,30048028,CDM,,,270,RC,inpatient,,929.57,929.57,,789.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,700.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,790.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,818.02,88,,percent of total billed charges,,,,,,,,,710.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,845.91,91,,percent of total billed charges,,,883.09,95,,percent of total billed charges,,,771.54,83,,percent of total billed charges,,,771.54,83,,percent of total billed charges,,,,,,,,,,,,,,,771.54,83,,percent of total billed charges,,,883.09,95,,percent of total billed charges,,,836.61,90,,percent of total billed charges,,,836.61,90,,percent of total billed charges,,,762.25,82,,percent of total billed charges,,,836.61,90,,percent of total billed charges,,,790.13,85,,percent of total billed charges,,700.9,883.09,
P.O.S. KNEE JOINT DROP LOCK,30048031,CDM,,,270,RC,inpatient,,340.05,340.05,,288.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,256.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,289.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,299.24,88,,percent of total billed charges,,,,,,,,,259.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,309.45,91,,percent of total billed charges,,,323.05,95,,percent of total billed charges,,,282.24,83,,percent of total billed charges,,,282.24,83,,percent of total billed charges,,,,,,,,,,,,,,,282.24,83,,percent of total billed charges,,,323.05,95,,percent of total billed charges,,,306.05,90,,percent of total billed charges,,,306.05,90,,percent of total billed charges,,,278.84,82,,percent of total billed charges,,,306.05,90,,percent of total billed charges,,,289.04,85,,percent of total billed charges,,256.4,323.05,
P.O.S. KNEE DISCDIAL LOCK ADJ FLEX,30048032,CDM,,,270,RC,inpatient,,717.15,717.15,,608.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,540.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,609.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,631.09,88,,percent of total billed charges,,,,,,,,,547.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,652.61,91,,percent of total billed charges,,,681.29,95,,percent of total billed charges,,,595.23,83,,percent of total billed charges,,,595.23,83,,percent of total billed charges,,,,,,,,,,,,,,,595.23,83,,percent of total billed charges,,,681.29,95,,percent of total billed charges,,,645.44,90,,percent of total billed charges,,,645.44,90,,percent of total billed charges,,,588.06,82,,percent of total billed charges,,,645.44,90,,percent of total billed charges,,,609.58,85,,percent of total billed charges,,540.73,681.29,
OMNI PROSTHETIC SHRINKER ABOVE KNEE,30048034,CDM,,,270,RC,inpatient,,958.36,958.36,,813.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,722.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,814.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,843.36,88,,percent of total billed charges,,,,,,,,,732.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,872.11,91,,percent of total billed charges,,,910.44,95,,percent of total billed charges,,,795.44,83,,percent of total billed charges,,,795.44,83,,percent of total billed charges,,,,,,,,,,,,,,,795.44,83,,percent of total billed charges,,,910.44,95,,percent of total billed charges,,,862.52,90,,percent of total billed charges,,,862.52,90,,percent of total billed charges,,,785.86,82,,percent of total billed charges,,,862.52,90,,percent of total billed charges,,,814.61,85,,percent of total billed charges,,722.6,910.44,
KNEE ORTHOSIS ADJUSTABLE JOINTS,30048035,CDM,,,270,RC,inpatient,,4951.12,4951.12,,4203.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3733.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4208.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4356.99,88,,percent of total billed charges,,,,,,,,,3782.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4505.52,91,,percent of total billed charges,,,4703.56,95,,percent of total billed charges,,,4109.43,83,,percent of total billed charges,,,4109.43,83,,percent of total billed charges,,,,,,,,,,,,,,,4109.43,83,,percent of total billed charges,,,4703.56,95,,percent of total billed charges,,,4456.01,90,,percent of total billed charges,,,4456.01,90,,percent of total billed charges,,,4059.92,82,,percent of total billed charges,,,4456.01,90,,percent of total billed charges,,,4208.45,85,,percent of total billed charges,,3733.14,4703.56,
OMNI TLSO BRACE,30048036,CDM,,,270,RC,inpatient,,7925.26,7925.26,,6728.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5975.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6736.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6974.23,88,,percent of total billed charges,,,,,,,,,6054.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7211.99,91,,percent of total billed charges,,,7529,95,,percent of total billed charges,,,6577.97,83,,percent of total billed charges,,,6577.97,83,,percent of total billed charges,,,,,,,,,,,,,,,6577.97,83,,percent of total billed charges,,,7529,95,,percent of total billed charges,,,7132.73,90,,percent of total billed charges,,,7132.73,90,,percent of total billed charges,,,6498.71,82,,percent of total billed charges,,,7132.73,90,,percent of total billed charges,,,6736.47,85,,percent of total billed charges,,5975.65,7529,
OMNI HO POST-OP HIP ABDUCTION,30048037,CDM,,,270,RC,inpatient,,7466.68,7466.68,,6339.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5629.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6346.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6570.68,88,,percent of total billed charges,,,,,,,,,5704.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6794.68,91,,percent of total billed charges,,,7093.35,95,,percent of total billed charges,,,6197.34,83,,percent of total billed charges,,,6197.34,83,,percent of total billed charges,,,,,,,,,,,,,,,6197.34,83,,percent of total billed charges,,,7093.35,95,,percent of total billed charges,,,6720.01,90,,percent of total billed charges,,,6720.01,90,,percent of total billed charges,,,6122.68,82,,percent of total billed charges,,,6720.01,90,,percent of total billed charges,,,6346.68,85,,percent of total billed charges,,5629.88,7093.35,
OMNI LOWER EXTREMITY ADDITION,30048038,CDM,,,270,RC,inpatient,,3109.21,3109.21,,2639.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2344.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2642.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2736.1,88,,percent of total billed charges,,,,,,,,,2375.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2829.38,91,,percent of total billed charges,,,2953.75,95,,percent of total billed charges,,,2580.64,83,,percent of total billed charges,,,2580.64,83,,percent of total billed charges,,,,,,,,,,,,,,,2580.64,83,,percent of total billed charges,,,2953.75,95,,percent of total billed charges,,,2798.29,90,,percent of total billed charges,,,2798.29,90,,percent of total billed charges,,,2549.55,82,,percent of total billed charges,,,2798.29,90,,percent of total billed charges,,,2642.83,85,,percent of total billed charges,,2344.34,2953.75,
TORSION CONTROL LOWER EXTREMITY ADDITION,30048039,CDM,,,270,RC,inpatient,,835.94,835.94,,709.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,630.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,710.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,735.63,88,,percent of total billed charges,,,,,,,,,638.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,760.71,91,,percent of total billed charges,,,794.14,95,,percent of total billed charges,,,693.83,83,,percent of total billed charges,,,693.83,83,,percent of total billed charges,,,,,,,,,,,,,,,693.83,83,,percent of total billed charges,,,794.14,95,,percent of total billed charges,,,752.35,90,,percent of total billed charges,,,752.35,90,,percent of total billed charges,,,685.47,82,,percent of total billed charges,,,752.35,90,,percent of total billed charges,,,710.55,85,,percent of total billed charges,,630.3,794.14,
OMNI HIP ABDUCTION BRACE LEFT,30048040,CDM,,,270,RC,inpatient,,11050,11050,,9381.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8331.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9392.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9724,88,,percent of total billed charges,,,,,,,,,8442.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10055.5,91,,percent of total billed charges,,,10497.5,95,,percent of total billed charges,,,9171.5,83,,percent of total billed charges,,,9171.5,83,,percent of total billed charges,,,,,,,,,,,,,,,9171.5,83,,percent of total billed charges,,,10497.5,95,,percent of total billed charges,,,9945,90,,percent of total billed charges,,,9945,90,,percent of total billed charges,,,9061,82,,percent of total billed charges,,,9945,90,,percent of total billed charges,,,9392.5,85,,percent of total billed charges,,8331.7,10497.5,
*DRESSING POLYMEM OVAL #5,30050012,CDM,,,270,RC,inpatient,,28.44,28.44,,24.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.03,88,,percent of total billed charges,,,,,,,,,21.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.88,91,,percent of total billed charges,,,27.02,95,,percent of total billed charges,,,23.61,83,,percent of total billed charges,,,23.61,83,,percent of total billed charges,,,,,,,,,,,,,,,23.61,83,,percent of total billed charges,,,27.02,95,,percent of total billed charges,,,25.6,90,,percent of total billed charges,,,25.6,90,,percent of total billed charges,,,23.32,82,,percent of total billed charges,,,25.6,90,,percent of total billed charges,,,24.17,85,,percent of total billed charges,,21.44,27.02,
*DRESSING POLYMEM OVAL #3,30050013,CDM,,,270,RC,inpatient,,198.08,198.08,,168.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.31,88,,percent of total billed charges,,,,,,,,,151.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.25,91,,percent of total billed charges,,,188.18,95,,percent of total billed charges,,,164.41,83,,percent of total billed charges,,,164.41,83,,percent of total billed charges,,,,,,,,,,,,,,,164.41,83,,percent of total billed charges,,,188.18,95,,percent of total billed charges,,,178.27,90,,percent of total billed charges,,,178.27,90,,percent of total billed charges,,,162.43,82,,percent of total billed charges,,,178.27,90,,percent of total billed charges,,,168.37,85,,percent of total billed charges,,149.35,188.18,
PLEURX PERITONEAL KIT & CATHETER,30050027,CDM,,,270,RC,inpatient,,5512,5512,,4679.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4156.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4685.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4850.56,88,,percent of total billed charges,,,,,,,,,4211.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5015.92,91,,percent of total billed charges,,,5236.4,95,,percent of total billed charges,,,4574.96,83,,percent of total billed charges,,,4574.96,83,,percent of total billed charges,,,,,,,,,,,,,,,4574.96,83,,percent of total billed charges,,,5236.4,95,,percent of total billed charges,,,4960.8,90,,percent of total billed charges,,,4960.8,90,,percent of total billed charges,,,4519.84,82,,percent of total billed charges,,,4960.8,90,,percent of total billed charges,,,4685.2,85,,percent of total billed charges,,4156.05,5236.4,
PLEURX  PERITONEAL CATHETER,30050028,CDM,,,270,RC,inpatient,,5484.38,5484.38,,4656.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4135.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4661.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4826.25,88,,percent of total billed charges,,,,,,,,,4190.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4990.79,91,,percent of total billed charges,,,5210.16,95,,percent of total billed charges,,,4552.04,83,,percent of total billed charges,,,4552.04,83,,percent of total billed charges,,,,,,,,,,,,,,,4552.04,83,,percent of total billed charges,,,5210.16,95,,percent of total billed charges,,,4935.94,90,,percent of total billed charges,,,4935.94,90,,percent of total billed charges,,,4497.19,82,,percent of total billed charges,,,4935.94,90,,percent of total billed charges,,,4661.72,85,,percent of total billed charges,,4135.22,5210.16,
*SENSOR SPO2 NEONATAL,30080003,CDM,,,270,RC,inpatient,,142.8,142.8,,121.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,107.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,121.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,125.66,88,,percent of total billed charges,,,,,,,,,109.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,129.95,91,,percent of total billed charges,,,135.66,95,,percent of total billed charges,,,118.52,83,,percent of total billed charges,,,118.52,83,,percent of total billed charges,,,,,,,,,,,,,,,118.52,83,,percent of total billed charges,,,135.66,95,,percent of total billed charges,,,128.52,90,,percent of total billed charges,,,128.52,90,,percent of total billed charges,,,117.1,82,,percent of total billed charges,,,128.52,90,,percent of total billed charges,,,121.38,85,,percent of total billed charges,,107.67,135.66,
*OBSTETRICAL VACUUM DELIVERY KIT 60MM,30080026,CDM,,,270,RC,inpatient,,168,168,,142.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,126.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,142.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,147.84,88,,percent of total billed charges,,,,,,,,,128.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,,,,,,,,,,,,,139.44,83,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,137.76,82,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,126.67,159.6,
INTRAUTERINE PRESSURE MONITOR - INTRON,30080031,CDM,,,270,RC,inpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,169.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,191.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,169.65,213.75,
BREAST PUMP ACCESSORY KIT,30080039,CDM,,,270,RC,inpatient,,191.42,191.42,,162.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.45,88,,percent of total billed charges,,,,,,,,,146.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.19,91,,percent of total billed charges,,,181.85,95,,percent of total billed charges,,,158.88,83,,percent of total billed charges,,,158.88,83,,percent of total billed charges,,,,,,,,,,,,,,,158.88,83,,percent of total billed charges,,,181.85,95,,percent of total billed charges,,,172.28,90,,percent of total billed charges,,,172.28,90,,percent of total billed charges,,,156.96,82,,percent of total billed charges,,,172.28,90,,percent of total billed charges,,,162.71,85,,percent of total billed charges,,144.33,181.85,
NIPPLE SHIELD CONTACT 20MM,30080052,CDM,,,270,RC,inpatient,,36.63,36.63,,31.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.23,88,,percent of total billed charges,,,,,,,,,27.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.33,91,,percent of total billed charges,,,34.8,95,,percent of total billed charges,,,30.4,83,,percent of total billed charges,,,30.4,83,,percent of total billed charges,,,,,,,,,,,,,,,30.4,83,,percent of total billed charges,,,34.8,95,,percent of total billed charges,,,32.97,90,,percent of total billed charges,,,32.97,90,,percent of total billed charges,,,30.04,82,,percent of total billed charges,,,32.97,90,,percent of total billed charges,,,31.14,85,,percent of total billed charges,,27.62,34.8,
*ELECTRODE ECG SMART TRACE NEO/PED,30080056,CDM,,,270,RC,inpatient,,29.07,29.07,,24.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.58,88,,percent of total billed charges,,,,,,,,,22.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.45,91,,percent of total billed charges,,,27.62,95,,percent of total billed charges,,,24.13,83,,percent of total billed charges,,,24.13,83,,percent of total billed charges,,,,,,,,,,,,,,,24.13,83,,percent of total billed charges,,,27.62,95,,percent of total billed charges,,,26.16,90,,percent of total billed charges,,,26.16,90,,percent of total billed charges,,,23.84,82,,percent of total billed charges,,,26.16,90,,percent of total billed charges,,,24.71,85,,percent of total billed charges,,21.92,27.62,
MASK CPAP NEONATE 50MM DISPOSABLE,30080057,CDM,,,270,RC,inpatient,,52.19,52.19,,44.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.93,88,,percent of total billed charges,,,,,,,,,39.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47.49,91,,percent of total billed charges,,,49.58,95,,percent of total billed charges,,,43.32,83,,percent of total billed charges,,,43.32,83,,percent of total billed charges,,,,,,,,,,,,,,,43.32,83,,percent of total billed charges,,,49.58,95,,percent of total billed charges,,,46.97,90,,percent of total billed charges,,,46.97,90,,percent of total billed charges,,,42.8,82,,percent of total billed charges,,,46.97,90,,percent of total billed charges,,,44.36,85,,percent of total billed charges,,39.35,49.58,
MASK CPAP NEONATE 60MM DISPOSABLE,30080058,CDM,,,270,RC,inpatient,,56.22,56.22,,47.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.47,88,,percent of total billed charges,,,,,,,,,42.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.16,91,,percent of total billed charges,,,53.41,95,,percent of total billed charges,,,46.66,83,,percent of total billed charges,,,46.66,83,,percent of total billed charges,,,,,,,,,,,,,,,46.66,83,,percent of total billed charges,,,53.41,95,,percent of total billed charges,,,50.6,90,,percent of total billed charges,,,50.6,90,,percent of total billed charges,,,46.1,82,,percent of total billed charges,,,50.6,90,,percent of total billed charges,,,47.79,85,,percent of total billed charges,,42.39,53.41,
KIT RESUS. T - PIECE CIRCUIT NEOPUFF,30080059,CDM,,,270,RC,inpatient,,55.25,55.25,,46.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.62,88,,percent of total billed charges,,,,,,,,,42.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.28,91,,percent of total billed charges,,,52.49,95,,percent of total billed charges,,,45.86,83,,percent of total billed charges,,,45.86,83,,percent of total billed charges,,,,,,,,,,,,,,,45.86,83,,percent of total billed charges,,,52.49,95,,percent of total billed charges,,,49.73,90,,percent of total billed charges,,,49.73,90,,percent of total billed charges,,,45.31,82,,percent of total billed charges,,,49.73,90,,percent of total billed charges,,,46.96,85,,percent of total billed charges,,41.66,52.49,
AIRWAY LMA UNIQUE SIZE 1,30080064,CDM,,,270,RC,inpatient,,114.48,114.48,,97.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,86.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,97.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,100.74,88,,percent of total billed charges,,,,,,,,,87.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,104.18,91,,percent of total billed charges,,,108.76,95,,percent of total billed charges,,,95.02,83,,percent of total billed charges,,,95.02,83,,percent of total billed charges,,,,,,,,,,,,,,,95.02,83,,percent of total billed charges,,,108.76,95,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,93.87,82,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,97.31,85,,percent of total billed charges,,86.32,108.76,
*BREAST PUMP MEDELA HARMONY MANUAL,30080065,CDM,,,270,RC,inpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
KIWI OMNICUP W/TRACTION FORCE INDICATOR,30080085,CDM,,,270,RC,inpatient,,256.8,256.8,,218.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,193.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,218.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,225.98,88,,percent of total billed charges,,,,,,,,,196.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,233.69,91,,percent of total billed charges,,,243.96,95,,percent of total billed charges,,,213.14,83,,percent of total billed charges,,,213.14,83,,percent of total billed charges,,,,,,,,,,,,,,,213.14,83,,percent of total billed charges,,,243.96,95,,percent of total billed charges,,,231.12,90,,percent of total billed charges,,,231.12,90,,percent of total billed charges,,,210.58,82,,percent of total billed charges,,,231.12,90,,percent of total billed charges,,,218.28,85,,percent of total billed charges,,193.63,243.96,
INTUBATION STYLET 2.5 - 4.5MM,30080086,CDM,,,270,RC,inpatient,,42.93,42.93,,36.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37.78,88,,percent of total billed charges,,,,,,,,,32.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,39.07,91,,percent of total billed charges,,,40.78,95,,percent of total billed charges,,,35.63,83,,percent of total billed charges,,,35.63,83,,percent of total billed charges,,,,,,,,,,,,,,,35.63,83,,percent of total billed charges,,,40.78,95,,percent of total billed charges,,,38.64,90,,percent of total billed charges,,,38.64,90,,percent of total billed charges,,,35.2,82,,percent of total billed charges,,,38.64,90,,percent of total billed charges,,,36.49,85,,percent of total billed charges,,32.37,40.78,
QWIK CONNECT PLUS SPIRAL ELECTRODE,30080087,CDM,,,270,RC,inpatient,,31.1,31.1,,26.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.37,88,,percent of total billed charges,,,,,,,,,23.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.3,91,,percent of total billed charges,,,29.55,95,,percent of total billed charges,,,25.81,83,,percent of total billed charges,,,25.81,83,,percent of total billed charges,,,,,,,,,,,,,,,25.81,83,,percent of total billed charges,,,29.55,95,,percent of total billed charges,,,27.99,90,,percent of total billed charges,,,27.99,90,,percent of total billed charges,,,25.5,82,,percent of total billed charges,,,27.99,90,,percent of total billed charges,,,26.44,85,,percent of total billed charges,,23.45,29.55,
KOALA INTERUTERINE PRESSURE CATHETER,30080088,CDM,,,270,RC,inpatient,,299.55,299.55,,254.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,225.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,254.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,263.6,88,,percent of total billed charges,,,,,,,,,228.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,272.59,91,,percent of total billed charges,,,284.57,95,,percent of total billed charges,,,248.63,83,,percent of total billed charges,,,248.63,83,,percent of total billed charges,,,,,,,,,,,,,,,248.63,83,,percent of total billed charges,,,284.57,95,,percent of total billed charges,,,269.6,90,,percent of total billed charges,,,269.6,90,,percent of total billed charges,,,245.63,82,,percent of total billed charges,,,269.6,90,,percent of total billed charges,,,254.62,85,,percent of total billed charges,,225.86,284.57,
ELECTRODE ATTCHMENT,30080090,CDM,,,270,RC,inpatient,,3.33,3.33,,2.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.93,88,,percent of total billed charges,,,,,,,,,2.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3.03,91,,percent of total billed charges,,,3.16,95,,percent of total billed charges,,,2.76,83,,percent of total billed charges,,,2.76,83,,percent of total billed charges,,,,,,,,,,,,,,,2.76,83,,percent of total billed charges,,,3.16,95,,percent of total billed charges,,,3,90,,percent of total billed charges,,,3,90,,percent of total billed charges,,,2.73,82,,percent of total billed charges,,,3,90,,percent of total billed charges,,,2.83,85,,percent of total billed charges,,2.51,3.16,
SMALL BORE EXTENSION SET,30080091,CDM,,,270,RC,inpatient,,17.73,17.73,,15.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.6,88,,percent of total billed charges,,,,,,,,,13.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.13,91,,percent of total billed charges,,,16.84,95,,percent of total billed charges,,,14.72,83,,percent of total billed charges,,,14.72,83,,percent of total billed charges,,,,,,,,,,,,,,,14.72,83,,percent of total billed charges,,,16.84,95,,percent of total billed charges,,,15.96,90,,percent of total billed charges,,,15.96,90,,percent of total billed charges,,,14.54,82,,percent of total billed charges,,,15.96,90,,percent of total billed charges,,,15.07,85,,percent of total billed charges,,13.37,16.84,
BALLOON TAMPANADE CATH POST PARTUM,30080096,CDM,,,270,RC,inpatient,,812,812,,689.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,612.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,690.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,714.56,88,,percent of total billed charges,,,,,,,,,620.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,738.92,91,,percent of total billed charges,,,771.4,95,,percent of total billed charges,,,673.96,83,,percent of total billed charges,,,673.96,83,,percent of total billed charges,,,,,,,,,,,,,,,673.96,83,,percent of total billed charges,,,771.4,95,,percent of total billed charges,,,730.8,90,,percent of total billed charges,,,730.8,90,,percent of total billed charges,,,665.84,82,,percent of total billed charges,,,730.8,90,,percent of total billed charges,,,690.2,85,,percent of total billed charges,,612.25,771.4,
NEOTECH MECONIUM ASPRIATOR,30080099,CDM,,,270,RC,inpatient,,33.41,33.41,,28.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.4,88,,percent of total billed charges,,,,,,,,,25.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.4,91,,percent of total billed charges,,,31.74,95,,percent of total billed charges,,,27.73,83,,percent of total billed charges,,,27.73,83,,percent of total billed charges,,,,,,,,,,,,,,,27.73,83,,percent of total billed charges,,,31.74,95,,percent of total billed charges,,,30.07,90,,percent of total billed charges,,,30.07,90,,percent of total billed charges,,,27.4,82,,percent of total billed charges,,,30.07,90,,percent of total billed charges,,,28.4,85,,percent of total billed charges,,25.19,31.74,
*SENSOR SPO2 INFANT,30080102,CDM,,,270,RC,inpatient,,92.43,92.43,,78.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,69.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,78.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.34,88,,percent of total billed charges,,,,,,,,,70.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.11,91,,percent of total billed charges,,,87.81,95,,percent of total billed charges,,,76.72,83,,percent of total billed charges,,,76.72,83,,percent of total billed charges,,,,,,,,,,,,,,,76.72,83,,percent of total billed charges,,,87.81,95,,percent of total billed charges,,,83.19,90,,percent of total billed charges,,,83.19,90,,percent of total billed charges,,,75.79,82,,percent of total billed charges,,,83.19,90,,percent of total billed charges,,,78.57,85,,percent of total billed charges,,69.69,87.81,
TENDERCARE HYDROGEL PADS,30080103,CDM,,,270,RC,inpatient,,10.35,10.35,,8.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9.11,88,,percent of total billed charges,,,,,,,,,7.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9.42,91,,percent of total billed charges,,,9.83,95,,percent of total billed charges,,,8.59,83,,percent of total billed charges,,,8.59,83,,percent of total billed charges,,,,,,,,,,,,,,,8.59,83,,percent of total billed charges,,,9.83,95,,percent of total billed charges,,,9.32,90,,percent of total billed charges,,,9.32,90,,percent of total billed charges,,,8.49,82,,percent of total billed charges,,,9.32,90,,percent of total billed charges,,,8.8,85,,percent of total billed charges,,7.8,9.83,
THERASHELLS BREAST SHELLS,30080104,CDM,,,270,RC,inpatient,,68.85,68.85,,58.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.59,88,,percent of total billed charges,,,,,,,,,52.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.65,91,,percent of total billed charges,,,65.41,95,,percent of total billed charges,,,57.15,83,,percent of total billed charges,,,57.15,83,,percent of total billed charges,,,,,,,,,,,,,,,57.15,83,,percent of total billed charges,,,65.41,95,,percent of total billed charges,,,61.97,90,,percent of total billed charges,,,61.97,90,,percent of total billed charges,,,56.46,82,,percent of total billed charges,,,61.97,90,,percent of total billed charges,,,58.52,85,,percent of total billed charges,,51.91,65.41,
FISHER&PAYKEL NEO WRAP,30080106,CDM,,,270,RC,inpatient,,23.13,23.13,,19.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.35,88,,percent of total billed charges,,,,,,,,,17.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.05,91,,percent of total billed charges,,,21.97,95,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19.2,83,,percent of total billed charges,,,21.97,95,,percent of total billed charges,,,20.82,90,,percent of total billed charges,,,20.82,90,,percent of total billed charges,,,18.97,82,,percent of total billed charges,,,20.82,90,,percent of total billed charges,,,19.66,85,,percent of total billed charges,,17.44,21.97,
COOK CERVICAL RIPENING BALLOON W/STYLET,30080115,CDM,,,270,RC,inpatient,,316.88,316.88,,269.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,238.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,269.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,278.85,88,,percent of total billed charges,,,,,,,,,242.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,288.36,91,,percent of total billed charges,,,301.04,95,,percent of total billed charges,,,263.01,83,,percent of total billed charges,,,263.01,83,,percent of total billed charges,,,,,,,,,,,,,,,263.01,83,,percent of total billed charges,,,301.04,95,,percent of total billed charges,,,285.19,90,,percent of total billed charges,,,285.19,90,,percent of total billed charges,,,259.84,82,,percent of total billed charges,,,285.19,90,,percent of total billed charges,,,269.35,85,,percent of total billed charges,,238.93,301.04,
CIRCUIT T-PIECE NEONATAL,30080119,CDM,,,270,RC,inpatient,,90.38,90.38,,76.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,76.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.53,88,,percent of total billed charges,,,,,,,,,69.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.25,91,,percent of total billed charges,,,85.86,95,,percent of total billed charges,,,75.02,83,,percent of total billed charges,,,75.02,83,,percent of total billed charges,,,,,,,,,,,,,,,75.02,83,,percent of total billed charges,,,85.86,95,,percent of total billed charges,,,81.34,90,,percent of total billed charges,,,81.34,90,,percent of total billed charges,,,74.11,82,,percent of total billed charges,,,81.34,90,,percent of total billed charges,,,76.82,85,,percent of total billed charges,,68.15,85.86,
TRANSWARMER TRANSPORT MATTRESS,30080122,CDM,,,270,RC,inpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,149.29,188.1,
BILIBAND EYE PROTECTION REG.,30080123,CDM,,,270,RC,inpatient,,31.43,31.43,,26.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.66,88,,percent of total billed charges,,,,,,,,,24.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.6,91,,percent of total billed charges,,,29.86,95,,percent of total billed charges,,,26.09,83,,percent of total billed charges,,,26.09,83,,percent of total billed charges,,,,,,,,,,,,,,,26.09,83,,percent of total billed charges,,,29.86,95,,percent of total billed charges,,,28.29,90,,percent of total billed charges,,,28.29,90,,percent of total billed charges,,,25.77,82,,percent of total billed charges,,,28.29,90,,percent of total billed charges,,,26.72,85,,percent of total billed charges,,23.7,29.86,
MITYSOFT BELL CUP VACUUM-ASSIST DELIVERY,30080124,CDM,,,270,RC,inpatient,,358.22,358.22,,304.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,270.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,304.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,315.23,88,,percent of total billed charges,,,,,,,,,273.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,325.98,91,,percent of total billed charges,,,340.31,95,,percent of total billed charges,,,297.32,83,,percent of total billed charges,,,297.32,83,,percent of total billed charges,,,,,,,,,,,,,,,297.32,83,,percent of total billed charges,,,340.31,95,,percent of total billed charges,,,322.4,90,,percent of total billed charges,,,322.4,90,,percent of total billed charges,,,293.74,82,,percent of total billed charges,,,322.4,90,,percent of total billed charges,,,304.49,85,,percent of total billed charges,,270.1,340.31,
TRAY UMBILICAL VENOUS CATHETER,30080126,CDM,,,270,RC,inpatient,,351.54,351.54,,298.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,265.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,298.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,309.36,88,,percent of total billed charges,,,,,,,,,268.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,319.9,91,,percent of total billed charges,,,333.96,95,,percent of total billed charges,,,291.78,83,,percent of total billed charges,,,291.78,83,,percent of total billed charges,,,,,,,,,,,,,,,291.78,83,,percent of total billed charges,,,333.96,95,,percent of total billed charges,,,316.39,90,,percent of total billed charges,,,316.39,90,,percent of total billed charges,,,288.26,82,,percent of total billed charges,,,316.39,90,,percent of total billed charges,,,298.81,85,,percent of total billed charges,,265.06,333.96,
SENSOR SPO2 INF-3,30080129,CDM,,,270,RC,inpatient,,163.3,163.3,,138.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,123.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,138.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,143.7,88,,percent of total billed charges,,,,,,,,,124.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,148.6,91,,percent of total billed charges,,,155.14,95,,percent of total billed charges,,,135.54,83,,percent of total billed charges,,,135.54,83,,percent of total billed charges,,,,,,,,,,,,,,,135.54,83,,percent of total billed charges,,,155.14,95,,percent of total billed charges,,,146.97,90,,percent of total billed charges,,,146.97,90,,percent of total billed charges,,,133.91,82,,percent of total billed charges,,,146.97,90,,percent of total billed charges,,,138.81,85,,percent of total billed charges,,123.13,155.14,
ELECTRODE ARRAY LABOR VIEW,30080130,CDM,,,270,RC,inpatient,,483,483,,410.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,364.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,410.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,425.04,88,,percent of total billed charges,,,,,,,,,369.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,439.53,91,,percent of total billed charges,,,458.85,95,,percent of total billed charges,,,400.89,83,,percent of total billed charges,,,400.89,83,,percent of total billed charges,,,,,,,,,,,,,,,400.89,83,,percent of total billed charges,,,458.85,95,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,396.06,82,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,410.55,85,,percent of total billed charges,,364.18,458.85,
INCENTIVE SPIROMETER,30120001,CDM,,,270,RC,inpatient,,23.2,23.2,,19.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.42,88,,percent of total billed charges,,,,,,,,,17.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.11,91,,percent of total billed charges,,,22.04,95,,percent of total billed charges,,,19.26,83,,percent of total billed charges,,,19.26,83,,percent of total billed charges,,,,,,,,,,,,,,,19.26,83,,percent of total billed charges,,,22.04,95,,percent of total billed charges,,,20.88,90,,percent of total billed charges,,,20.88,90,,percent of total billed charges,,,19.02,82,,percent of total billed charges,,,20.88,90,,percent of total billed charges,,,19.72,85,,percent of total billed charges,,17.49,22.04,
RESUSCITATOR W/ MANOMETER,30120007,CDM,,,270,RC,inpatient,,437.5,437.5,,371.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,329.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,371.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,385,88,,percent of total billed charges,,,,,,,,,334.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,398.13,91,,percent of total billed charges,,,415.63,95,,percent of total billed charges,,,363.13,83,,percent of total billed charges,,,363.13,83,,percent of total billed charges,,,,,,,,,,,,,,,363.13,83,,percent of total billed charges,,,415.63,95,,percent of total billed charges,,,393.75,90,,percent of total billed charges,,,393.75,90,,percent of total billed charges,,,358.75,82,,percent of total billed charges,,,393.75,90,,percent of total billed charges,,,371.88,85,,percent of total billed charges,,329.88,415.63,
ACAPELLA DM BLUE MOUTHPIECE,30120017,CDM,,,270,RC,inpatient,,322.5,322.5,,273.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,243.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,274.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.8,88,,percent of total billed charges,,,,,,,,,246.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,293.48,91,,percent of total billed charges,,,306.38,95,,percent of total billed charges,,,267.68,83,,percent of total billed charges,,,267.68,83,,percent of total billed charges,,,,,,,,,,,,,,,267.68,83,,percent of total billed charges,,,306.38,95,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,264.45,82,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,274.13,85,,percent of total billed charges,,243.17,306.38,
ACAPELLA DM GREEN MOUTHPIECE,30120018,CDM,,,270,RC,inpatient,,321.05,321.05,,272.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,272.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,282.52,88,,percent of total billed charges,,,,,,,,,245.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,292.16,91,,percent of total billed charges,,,305,95,,percent of total billed charges,,,266.47,83,,percent of total billed charges,,,266.47,83,,percent of total billed charges,,,,,,,,,,,,,,,266.47,83,,percent of total billed charges,,,305,95,,percent of total billed charges,,,288.95,90,,percent of total billed charges,,,288.95,90,,percent of total billed charges,,,263.26,82,,percent of total billed charges,,,288.95,90,,percent of total billed charges,,,272.89,85,,percent of total billed charges,,242.07,305,
HIGH FLO CAN,30120021,CDM,,,270,RC,inpatient,,26.1,26.1,,22.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.97,88,,percent of total billed charges,,,,,,,,,19.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.75,91,,percent of total billed charges,,,24.8,95,,percent of total billed charges,,,21.66,83,,percent of total billed charges,,,21.66,83,,percent of total billed charges,,,,,,,,,,,,,,,21.66,83,,percent of total billed charges,,,24.8,95,,percent of total billed charges,,,23.49,90,,percent of total billed charges,,,23.49,90,,percent of total billed charges,,,21.4,82,,percent of total billed charges,,,23.49,90,,percent of total billed charges,,,22.19,85,,percent of total billed charges,,19.68,24.8,
HIGH FLO HUM,30120022,CDM,,,270,RC,inpatient,,35.64,35.64,,30.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31.36,88,,percent of total billed charges,,,,,,,,,27.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.43,91,,percent of total billed charges,,,33.86,95,,percent of total billed charges,,,29.58,83,,percent of total billed charges,,,29.58,83,,percent of total billed charges,,,,,,,,,,,,,,,29.58,83,,percent of total billed charges,,,33.86,95,,percent of total billed charges,,,32.08,90,,percent of total billed charges,,,32.08,90,,percent of total billed charges,,,29.22,82,,percent of total billed charges,,,32.08,90,,percent of total billed charges,,,30.29,85,,percent of total billed charges,,26.87,33.86,
AMBU BAG PEDIATRIC-PLUS,30120025,CDM,,,270,RC,inpatient,,191.7,191.7,,162.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.7,88,,percent of total billed charges,,,,,,,,,146.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.45,91,,percent of total billed charges,,,182.12,95,,percent of total billed charges,,,159.11,83,,percent of total billed charges,,,159.11,83,,percent of total billed charges,,,,,,,,,,,,,,,159.11,83,,percent of total billed charges,,,182.12,95,,percent of total billed charges,,,172.53,90,,percent of total billed charges,,,172.53,90,,percent of total billed charges,,,157.19,82,,percent of total billed charges,,,172.53,90,,percent of total billed charges,,,162.95,85,,percent of total billed charges,,144.54,182.12,
*MASK VENTURI DUAL DIAL ADULT,30120032,CDM,,,270,RC,inpatient,,10.17,10.17,,8.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8.95,88,,percent of total billed charges,,,,,,,,,7.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9.25,91,,percent of total billed charges,,,9.66,95,,percent of total billed charges,,,8.44,83,,percent of total billed charges,,,8.44,83,,percent of total billed charges,,,,,,,,,,,,,,,8.44,83,,percent of total billed charges,,,9.66,95,,percent of total billed charges,,,9.15,90,,percent of total billed charges,,,9.15,90,,percent of total billed charges,,,8.34,82,,percent of total billed charges,,,9.15,90,,percent of total billed charges,,,8.64,85,,percent of total billed charges,,7.67,9.66,
EZ PAP POSITIVE AIRWAY,30120033,CDM,,,270,RC,inpatient,,169.22,169.22,,143.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,127.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,143.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,148.91,88,,percent of total billed charges,,,,,,,,,129.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,153.99,91,,percent of total billed charges,,,160.76,95,,percent of total billed charges,,,140.45,83,,percent of total billed charges,,,140.45,83,,percent of total billed charges,,,,,,,,,,,,,,,140.45,83,,percent of total billed charges,,,160.76,95,,percent of total billed charges,,,152.3,90,,percent of total billed charges,,,152.3,90,,percent of total billed charges,,,138.76,82,,percent of total billed charges,,,152.3,90,,percent of total billed charges,,,143.84,85,,percent of total billed charges,,127.59,160.76,
HIGH-FLO SET,30120041,CDM,,,270,RC,inpatient,,25.38,25.38,,21.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.33,88,,percent of total billed charges,,,,,,,,,19.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.1,91,,percent of total billed charges,,,24.11,95,,percent of total billed charges,,,21.07,83,,percent of total billed charges,,,21.07,83,,percent of total billed charges,,,,,,,,,,,,,,,21.07,83,,percent of total billed charges,,,24.11,95,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,20.81,82,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,21.57,85,,percent of total billed charges,,19.14,24.11,
JET NEBULIZER 350ML,30120042,CDM,,,270,RC,inpatient,,14.31,14.31,,12.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.59,88,,percent of total billed charges,,,,,,,,,10.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.02,91,,percent of total billed charges,,,13.59,95,,percent of total billed charges,,,11.88,83,,percent of total billed charges,,,11.88,83,,percent of total billed charges,,,,,,,,,,,,,,,11.88,83,,percent of total billed charges,,,13.59,95,,percent of total billed charges,,,12.88,90,,percent of total billed charges,,,12.88,90,,percent of total billed charges,,,11.73,82,,percent of total billed charges,,,12.88,90,,percent of total billed charges,,,12.16,85,,percent of total billed charges,,10.79,13.59,
VENTILATORS DISPOSABLE,30120043,CDM,,,270,RC,inpatient,,575.75,575.75,,488.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,434.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,489.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,506.66,88,,percent of total billed charges,,,,,,,,,439.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,523.93,91,,percent of total billed charges,,,546.96,95,,percent of total billed charges,,,477.87,83,,percent of total billed charges,,,477.87,83,,percent of total billed charges,,,,,,,,,,,,,,,477.87,83,,percent of total billed charges,,,546.96,95,,percent of total billed charges,,,518.18,90,,percent of total billed charges,,,518.18,90,,percent of total billed charges,,,472.12,82,,percent of total billed charges,,,518.18,90,,percent of total billed charges,,,489.39,85,,percent of total billed charges,,434.12,546.96,
MASK VPAP SMALL,30120044,CDM,,,270,RC,inpatient,,207.53,207.53,,176.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,156.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,176.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,182.63,88,,percent of total billed charges,,,,,,,,,158.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,188.85,91,,percent of total billed charges,,,197.15,95,,percent of total billed charges,,,172.25,83,,percent of total billed charges,,,172.25,83,,percent of total billed charges,,,,,,,,,,,,,,,172.25,83,,percent of total billed charges,,,197.15,95,,percent of total billed charges,,,186.78,90,,percent of total billed charges,,,186.78,90,,percent of total billed charges,,,170.17,82,,percent of total billed charges,,,186.78,90,,percent of total billed charges,,,176.4,85,,percent of total billed charges,,156.48,197.15,
MASK VPAP MEDIUM,30120045,CDM,,,270,RC,inpatient,,214.65,214.65,,182.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,182.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.89,88,,percent of total billed charges,,,,,,,,,163.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,195.33,91,,percent of total billed charges,,,203.92,95,,percent of total billed charges,,,178.16,83,,percent of total billed charges,,,178.16,83,,percent of total billed charges,,,,,,,,,,,,,,,178.16,83,,percent of total billed charges,,,203.92,95,,percent of total billed charges,,,193.19,90,,percent of total billed charges,,,193.19,90,,percent of total billed charges,,,176.01,82,,percent of total billed charges,,,193.19,90,,percent of total billed charges,,,182.45,85,,percent of total billed charges,,161.85,203.92,
MASK VPAP LARGE,30120046,CDM,,,270,RC,inpatient,,214.65,214.65,,182.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,182.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.89,88,,percent of total billed charges,,,,,,,,,163.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,195.33,91,,percent of total billed charges,,,203.92,95,,percent of total billed charges,,,178.16,83,,percent of total billed charges,,,178.16,83,,percent of total billed charges,,,,,,,,,,,,,,,178.16,83,,percent of total billed charges,,,203.92,95,,percent of total billed charges,,,193.19,90,,percent of total billed charges,,,193.19,90,,percent of total billed charges,,,176.01,82,,percent of total billed charges,,,193.19,90,,percent of total billed charges,,,182.45,85,,percent of total billed charges,,161.85,203.92,
VPAP CIRCUIT,30120047,CDM,,,270,RC,inpatient,,63.75,63.75,,54.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.1,88,,percent of total billed charges,,,,,,,,,48.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.01,91,,percent of total billed charges,,,60.56,95,,percent of total billed charges,,,52.91,83,,percent of total billed charges,,,52.91,83,,percent of total billed charges,,,,,,,,,,,,,,,52.91,83,,percent of total billed charges,,,60.56,95,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,52.28,82,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,54.19,85,,percent of total billed charges,,48.07,60.56,
MASK FACE TENT DISP,30120049,CDM,,,270,RC,inpatient,,4.68,4.68,,3.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4.12,88,,percent of total billed charges,,,,,,,,,3.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4.26,91,,percent of total billed charges,,,4.45,95,,percent of total billed charges,,,3.88,83,,percent of total billed charges,,,3.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3.88,83,,percent of total billed charges,,,4.45,95,,percent of total billed charges,,,4.21,90,,percent of total billed charges,,,4.21,90,,percent of total billed charges,,,3.84,82,,percent of total billed charges,,,4.21,90,,percent of total billed charges,,,3.98,85,,percent of total billed charges,,3.53,4.45,
MASK AERO UNDER CHIN PEDIATRIC ELONG.,30120055,CDM,,,270,RC,inpatient,,4.23,4.23,,3.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3.72,88,,percent of total billed charges,,,,,,,,,3.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3.85,91,,percent of total billed charges,,,4.02,95,,percent of total billed charges,,,3.51,83,,percent of total billed charges,,,3.51,83,,percent of total billed charges,,,,,,,,,,,,,,,3.51,83,,percent of total billed charges,,,4.02,95,,percent of total billed charges,,,3.81,90,,percent of total billed charges,,,3.81,90,,percent of total billed charges,,,3.47,82,,percent of total billed charges,,,3.81,90,,percent of total billed charges,,,3.6,85,,percent of total billed charges,,3.19,4.02,
NASAL ASPIRATOR DEVICE,30120056,CDM,,,270,RC,inpatient,,17.19,17.19,,14.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.13,88,,percent of total billed charges,,,,,,,,,13.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.64,91,,percent of total billed charges,,,16.33,95,,percent of total billed charges,,,14.27,83,,percent of total billed charges,,,14.27,83,,percent of total billed charges,,,,,,,,,,,,,,,14.27,83,,percent of total billed charges,,,16.33,95,,percent of total billed charges,,,15.47,90,,percent of total billed charges,,,15.47,90,,percent of total billed charges,,,14.1,82,,percent of total billed charges,,,15.47,90,,percent of total billed charges,,,14.61,85,,percent of total billed charges,,12.96,16.33,
EZ PAP SYSTEM W/MEDIUM MASK,30120057,CDM,,,270,RC,inpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,132.7,167.2,
EZ PAP SYSTEM W/MOUTHPIECE,30120058,CDM,,,270,RC,inpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,150.8,190,
HME FILTER W/GAS SAMPLING PORT,30120059,CDM,,,270,RC,inpatient,,17.1,17.1,,14.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.05,88,,percent of total billed charges,,,,,,,,,13.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.56,91,,percent of total billed charges,,,16.25,95,,percent of total billed charges,,,14.19,83,,percent of total billed charges,,,14.19,83,,percent of total billed charges,,,,,,,,,,,,,,,14.19,83,,percent of total billed charges,,,16.25,95,,percent of total billed charges,,,15.39,90,,percent of total billed charges,,,15.39,90,,percent of total billed charges,,,14.02,82,,percent of total billed charges,,,15.39,90,,percent of total billed charges,,,14.54,85,,percent of total billed charges,,12.89,16.25,
MASK NEBULIZER SYSTEM ADULT,30120060,CDM,,,270,RC,inpatient,,107.28,107.28,,91.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,80.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,94.41,88,,percent of total billed charges,,,,,,,,,81.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,97.62,91,,percent of total billed charges,,,101.92,95,,percent of total billed charges,,,89.04,83,,percent of total billed charges,,,89.04,83,,percent of total billed charges,,,,,,,,,,,,,,,89.04,83,,percent of total billed charges,,,101.92,95,,percent of total billed charges,,,96.55,90,,percent of total billed charges,,,96.55,90,,percent of total billed charges,,,87.97,82,,percent of total billed charges,,,96.55,90,,percent of total billed charges,,,91.19,85,,percent of total billed charges,,80.89,101.92,
*HEART NEB CIRCUIT,30120061,CDM,,,270,RC,inpatient,,53.72,53.72,,45.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47.27,88,,percent of total billed charges,,,,,,,,,41.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,48.89,91,,percent of total billed charges,,,51.03,95,,percent of total billed charges,,,44.59,83,,percent of total billed charges,,,44.59,83,,percent of total billed charges,,,,,,,,,,,,,,,44.59,83,,percent of total billed charges,,,51.03,95,,percent of total billed charges,,,48.35,90,,percent of total billed charges,,,48.35,90,,percent of total billed charges,,,44.05,82,,percent of total billed charges,,,48.35,90,,percent of total billed charges,,,45.66,85,,percent of total billed charges,,40.5,51.03,
SENSOR FINGER NEONATE,30120062,CDM,,,270,RC,inpatient,,83.9,83.9,,71.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.83,88,,percent of total billed charges,,,,,,,,,64.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.35,91,,percent of total billed charges,,,79.71,95,,percent of total billed charges,,,69.64,83,,percent of total billed charges,,,69.64,83,,percent of total billed charges,,,,,,,,,,,,,,,69.64,83,,percent of total billed charges,,,79.71,95,,percent of total billed charges,,,75.51,90,,percent of total billed charges,,,75.51,90,,percent of total billed charges,,,68.8,82,,percent of total billed charges,,,75.51,90,,percent of total billed charges,,,71.32,85,,percent of total billed charges,,63.26,79.71,
MASK BIPAP/CPAP ADULT MED. FULL FACE,30120064,CDM,,,270,RC,inpatient,,197.63,197.63,,167.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.91,88,,percent of total billed charges,,,,,,,,,150.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.84,91,,percent of total billed charges,,,187.75,95,,percent of total billed charges,,,164.03,83,,percent of total billed charges,,,164.03,83,,percent of total billed charges,,,,,,,,,,,,,,,164.03,83,,percent of total billed charges,,,187.75,95,,percent of total billed charges,,,177.87,90,,percent of total billed charges,,,177.87,90,,percent of total billed charges,,,162.06,82,,percent of total billed charges,,,177.87,90,,percent of total billed charges,,,167.99,85,,percent of total billed charges,,149.01,187.75,
VENT CROSSVENT CIR,30120065,CDM,,,270,RC,inpatient,,79.48,79.48,,67.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.94,88,,percent of total billed charges,,,,,,,,,60.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.33,91,,percent of total billed charges,,,75.51,95,,percent of total billed charges,,,65.97,83,,percent of total billed charges,,,65.97,83,,percent of total billed charges,,,,,,,,,,,,,,,65.97,83,,percent of total billed charges,,,75.51,95,,percent of total billed charges,,,71.53,90,,percent of total billed charges,,,71.53,90,,percent of total billed charges,,,65.17,82,,percent of total billed charges,,,71.53,90,,percent of total billed charges,,,67.56,85,,percent of total billed charges,,59.93,75.51,
VENT VISION MASK S,30120068,CDM,,,270,RC,inpatient,,197.63,197.63,,167.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.91,88,,percent of total billed charges,,,,,,,,,150.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.84,91,,percent of total billed charges,,,187.75,95,,percent of total billed charges,,,164.03,83,,percent of total billed charges,,,164.03,83,,percent of total billed charges,,,,,,,,,,,,,,,164.03,83,,percent of total billed charges,,,187.75,95,,percent of total billed charges,,,177.87,90,,percent of total billed charges,,,177.87,90,,percent of total billed charges,,,162.06,82,,percent of total billed charges,,,177.87,90,,percent of total billed charges,,,167.99,85,,percent of total billed charges,,149.01,187.75,
VENT VISION MASK M,30120069,CDM,,,270,RC,inpatient,,197.7,197.7,,167.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.98,88,,percent of total billed charges,,,,,,,,,151.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.91,91,,percent of total billed charges,,,187.82,95,,percent of total billed charges,,,164.09,83,,percent of total billed charges,,,164.09,83,,percent of total billed charges,,,,,,,,,,,,,,,164.09,83,,percent of total billed charges,,,187.82,95,,percent of total billed charges,,,177.93,90,,percent of total billed charges,,,177.93,90,,percent of total billed charges,,,162.11,82,,percent of total billed charges,,,177.93,90,,percent of total billed charges,,,168.05,85,,percent of total billed charges,,149.07,187.82,
VENT VISION MASK L,30120070,CDM,,,270,RC,inpatient,,211.88,211.88,,179.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.45,88,,percent of total billed charges,,,,,,,,,161.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.81,91,,percent of total billed charges,,,201.29,95,,percent of total billed charges,,,175.86,83,,percent of total billed charges,,,175.86,83,,percent of total billed charges,,,,,,,,,,,,,,,175.86,83,,percent of total billed charges,,,201.29,95,,percent of total billed charges,,,190.69,90,,percent of total billed charges,,,190.69,90,,percent of total billed charges,,,173.74,82,,percent of total billed charges,,,190.69,90,,percent of total billed charges,,,180.1,85,,percent of total billed charges,,159.76,201.29,
VENT VISION CIRCUIT,30120071,CDM,,,270,RC,inpatient,,96.8,96.8,,82.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,72.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,82.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,85.18,88,,percent of total billed charges,,,,,,,,,73.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,88.09,91,,percent of total billed charges,,,91.96,95,,percent of total billed charges,,,80.34,83,,percent of total billed charges,,,80.34,83,,percent of total billed charges,,,,,,,,,,,,,,,80.34,83,,percent of total billed charges,,,91.96,95,,percent of total billed charges,,,87.12,90,,percent of total billed charges,,,87.12,90,,percent of total billed charges,,,79.38,82,,percent of total billed charges,,,87.12,90,,percent of total billed charges,,,82.28,85,,percent of total billed charges,,72.99,91.96,
MASK AERO CHAMBER SM,30120073,CDM,,,270,RC,inpatient,,107.68,107.68,,91.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,94.76,88,,percent of total billed charges,,,,,,,,,82.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,97.99,91,,percent of total billed charges,,,102.3,95,,percent of total billed charges,,,89.37,83,,percent of total billed charges,,,89.37,83,,percent of total billed charges,,,,,,,,,,,,,,,89.37,83,,percent of total billed charges,,,102.3,95,,percent of total billed charges,,,96.91,90,,percent of total billed charges,,,96.91,90,,percent of total billed charges,,,88.3,82,,percent of total billed charges,,,96.91,90,,percent of total billed charges,,,91.53,85,,percent of total billed charges,,81.19,102.3,
MASK AERO CHAMBER MED,30120074,CDM,,,270,RC,inpatient,,107.68,107.68,,91.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,94.76,88,,percent of total billed charges,,,,,,,,,82.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,97.99,91,,percent of total billed charges,,,102.3,95,,percent of total billed charges,,,89.37,83,,percent of total billed charges,,,89.37,83,,percent of total billed charges,,,,,,,,,,,,,,,89.37,83,,percent of total billed charges,,,102.3,95,,percent of total billed charges,,,96.91,90,,percent of total billed charges,,,96.91,90,,percent of total billed charges,,,88.3,82,,percent of total billed charges,,,96.91,90,,percent of total billed charges,,,91.53,85,,percent of total billed charges,,81.19,102.3,
MASK AERO CHAMBER LGE,30120075,CDM,,,270,RC,inpatient,,111.12,111.12,,94.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,83.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,97.79,88,,percent of total billed charges,,,,,,,,,84.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.12,91,,percent of total billed charges,,,105.56,95,,percent of total billed charges,,,92.23,83,,percent of total billed charges,,,92.23,83,,percent of total billed charges,,,,,,,,,,,,,,,92.23,83,,percent of total billed charges,,,105.56,95,,percent of total billed charges,,,100.01,90,,percent of total billed charges,,,100.01,90,,percent of total billed charges,,,91.12,82,,percent of total billed charges,,,100.01,90,,percent of total billed charges,,,94.45,85,,percent of total billed charges,,83.78,105.56,
MASK OXYMASK ADULT PLUS,30120078,CDM,,,270,RC,inpatient,,38.94,38.94,,33.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34.27,88,,percent of total billed charges,,,,,,,,,29.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35.44,91,,percent of total billed charges,,,36.99,95,,percent of total billed charges,,,32.32,83,,percent of total billed charges,,,32.32,83,,percent of total billed charges,,,,,,,,,,,,,,,32.32,83,,percent of total billed charges,,,36.99,95,,percent of total billed charges,,,35.05,90,,percent of total billed charges,,,35.05,90,,percent of total billed charges,,,31.93,82,,percent of total billed charges,,,35.05,90,,percent of total billed charges,,,33.1,85,,percent of total billed charges,,29.36,36.99,
TRACHE TEE OXYGENATOR,30120079,CDM,,,270,RC,inpatient,,5.9,5.9,,5.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.19,88,,percent of total billed charges,,,,,,,,,4.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.37,91,,percent of total billed charges,,,5.61,95,,percent of total billed charges,,,4.9,83,,percent of total billed charges,,,4.9,83,,percent of total billed charges,,,,,,,,,,,,,,,4.9,83,,percent of total billed charges,,,5.61,95,,percent of total billed charges,,,5.31,90,,percent of total billed charges,,,5.31,90,,percent of total billed charges,,,4.84,82,,percent of total billed charges,,,5.31,90,,percent of total billed charges,,,5.02,85,,percent of total billed charges,,4.45,5.61,
BREATHING CIRCUIT FOR IVENT 201,30120081,CDM,,,270,RC,inpatient,,109.51,109.51,,92.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,93.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,96.37,88,,percent of total billed charges,,,,,,,,,83.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.65,91,,percent of total billed charges,,,104.03,95,,percent of total billed charges,,,90.89,83,,percent of total billed charges,,,90.89,83,,percent of total billed charges,,,,,,,,,,,,,,,90.89,83,,percent of total billed charges,,,104.03,95,,percent of total billed charges,,,98.56,90,,percent of total billed charges,,,98.56,90,,percent of total billed charges,,,89.8,82,,percent of total billed charges,,,98.56,90,,percent of total billed charges,,,93.08,85,,percent of total billed charges,,82.57,104.03,
VENT VISION MASK LARGE,30120082,CDM,,,270,RC,inpatient,,54.78,54.78,,46.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.21,88,,percent of total billed charges,,,,,,,,,41.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.85,91,,percent of total billed charges,,,52.04,95,,percent of total billed charges,,,45.47,83,,percent of total billed charges,,,45.47,83,,percent of total billed charges,,,,,,,,,,,,,,,45.47,83,,percent of total billed charges,,,52.04,95,,percent of total billed charges,,,49.3,90,,percent of total billed charges,,,49.3,90,,percent of total billed charges,,,44.92,82,,percent of total billed charges,,,49.3,90,,percent of total billed charges,,,46.56,85,,percent of total billed charges,,41.3,52.04,
ABBOTT VASCULAR SUPERA 5.5X100X120,30143000,CDM,,,278,RC,inpatient,,18713.5,18713.5,,15887.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14109.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15906.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16467.88,88,,percent of total billed charges,,,,,,,,,14297.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17029.29,91,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,,,,,,,,,,,,,15532.21,83,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15345.07,82,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,14109.98,17777.83,
ABBOTT VASCULAR SUPERA 6X100X120,30143001,CDM,,,278,RC,inpatient,,18713.5,18713.5,,15887.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14109.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15906.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16467.88,88,,percent of total billed charges,,,,,,,,,14297.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17029.29,91,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,,,,,,,,,,,,,15532.21,83,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15345.07,82,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,14109.98,17777.83,
ABBOTT VASCULAR SUPERA 5.5X80X120,30143002,CDM,,,278,RC,inpatient,,18713.5,18713.5,,15887.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14109.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15906.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16467.88,88,,percent of total billed charges,,,,,,,,,14297.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17029.29,91,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,,,,,,,,,,,,,15532.21,83,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15345.07,82,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,14109.98,17777.83,
ABBOTT VASCULAR SUPERA 5.0X100X120,30143003,CDM,,,278,RC,inpatient,,18713.5,18713.5,,15887.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14109.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15906.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16467.88,88,,percent of total billed charges,,,,,,,,,14297.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17029.29,91,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,,,,,,,,,,,,,15532.21,83,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15345.07,82,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,14109.98,17777.83,
ABBOTT VASCULAR SUPERA 6X60X120,30143004,CDM,,,278,RC,inpatient,,18713.5,18713.5,,15887.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14109.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15906.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16467.88,88,,percent of total billed charges,,,,,,,,,14297.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17029.29,91,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,,,,,,,,,,,,,15532.21,83,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15345.07,82,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,14109.98,17777.83,
ABBOTT VASCULAR SUPERA 5.0X80X120,30143005,CDM,,,278,RC,inpatient,,17274,17274,,14665.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13024.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14682.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15201.12,88,,percent of total billed charges,,,,,,,,,13197.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15719.34,91,,percent of total billed charges,,,16410.3,95,,percent of total billed charges,,,14337.42,83,,percent of total billed charges,,,14337.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14337.42,83,,percent of total billed charges,,,16410.3,95,,percent of total billed charges,,,15546.6,90,,percent of total billed charges,,,15546.6,90,,percent of total billed charges,,,14164.68,82,,percent of total billed charges,,,15546.6,90,,percent of total billed charges,,,14682.9,85,,percent of total billed charges,,13024.6,16410.3,
ABBOTT VASCULAR SUPERA 6X40X120,30143006,CDM,,,278,RC,inpatient,,18713.5,18713.5,,15887.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14109.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15906.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16467.88,88,,percent of total billed charges,,,,,,,,,14297.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17029.29,91,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,,,,,,,,,,,,,15532.21,83,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15345.07,82,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,14109.98,17777.83,
AMPLATZ SNARE GOOSENECK 6X102X120X15,30143007,CDM,,,270,RC,inpatient,,2017.99,2017.99,,1713.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1521.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1715.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1775.83,88,,percent of total billed charges,,,,,,,,,1541.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1836.37,91,,percent of total billed charges,,,1917.09,95,,percent of total billed charges,,,1674.93,83,,percent of total billed charges,,,1674.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1674.93,83,,percent of total billed charges,,,1917.09,95,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1654.75,82,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1715.29,85,,percent of total billed charges,,1521.56,1917.09,
AMPLATZ SNARE GOOSENECK 6X102X120X20,30143008,CDM,,,270,RC,inpatient,,2017.99,2017.99,,1713.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1521.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1715.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1775.83,88,,percent of total billed charges,,,,,,,,,1541.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1836.37,91,,percent of total billed charges,,,1917.09,95,,percent of total billed charges,,,1674.93,83,,percent of total billed charges,,,1674.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1674.93,83,,percent of total billed charges,,,1917.09,95,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1654.75,82,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1715.29,85,,percent of total billed charges,,1521.56,1917.09,
AMPLATZ SNARE GOOSENECK 6X102X120X25,30143009,CDM,,,270,RC,inpatient,,2017.99,2017.99,,1713.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1521.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1715.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1775.83,88,,percent of total billed charges,,,,,,,,,1541.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1836.37,91,,percent of total billed charges,,,1917.09,95,,percent of total billed charges,,,1674.93,83,,percent of total billed charges,,,1674.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1674.93,83,,percent of total billed charges,,,1917.09,95,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1654.75,82,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1715.29,85,,percent of total billed charges,,1521.56,1917.09,
VIABAHN 7F X 6MM X 10CM,30143010,CDM,,,270,RC,inpatient,,25499.5,25499.5,,21649.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19226.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21674.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22439.56,88,,percent of total billed charges,,,,,,,,,19481.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23204.55,91,,percent of total billed charges,,,24224.53,95,,percent of total billed charges,,,21164.59,83,,percent of total billed charges,,,21164.59,83,,percent of total billed charges,,,,,,,,,,,,,,,21164.59,83,,percent of total billed charges,,,24224.53,95,,percent of total billed charges,,,22949.55,90,,percent of total billed charges,,,22949.55,90,,percent of total billed charges,,,20909.59,82,,percent of total billed charges,,,22949.55,90,,percent of total billed charges,,,21674.58,85,,percent of total billed charges,,19226.62,24224.53,
VIABAHN 8F X 8MM X 5CM,30143011,CDM,,,270,RC,inpatient,,23712,23712,,20131.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17878.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20155.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20866.56,88,,percent of total billed charges,,,,,,,,,18115.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21577.92,91,,percent of total billed charges,,,22526.4,95,,percent of total billed charges,,,19680.96,83,,percent of total billed charges,,,19680.96,83,,percent of total billed charges,,,,,,,,,,,,,,,19680.96,83,,percent of total billed charges,,,22526.4,95,,percent of total billed charges,,,21340.8,90,,percent of total billed charges,,,21340.8,90,,percent of total billed charges,,,19443.84,82,,percent of total billed charges,,,21340.8,90,,percent of total billed charges,,,20155.2,85,,percent of total billed charges,,17878.85,22526.4,
VIABAHN 8F X 10MM X 5CM,30143012,CDM,,,270,RC,inpatient,,23712,23712,,20131.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17878.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20155.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20866.56,88,,percent of total billed charges,,,,,,,,,18115.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21577.92,91,,percent of total billed charges,,,22526.4,95,,percent of total billed charges,,,19680.96,83,,percent of total billed charges,,,19680.96,83,,percent of total billed charges,,,,,,,,,,,,,,,19680.96,83,,percent of total billed charges,,,22526.4,95,,percent of total billed charges,,,21340.8,90,,percent of total billed charges,,,21340.8,90,,percent of total billed charges,,,19443.84,82,,percent of total billed charges,,,21340.8,90,,percent of total billed charges,,,20155.2,85,,percent of total billed charges,,17878.85,22526.4,
VIABAHN 8F X 11MM X 59MM,30143013,CDM,,,270,RC,inpatient,,26507,26507,,22504.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19986.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22530.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23326.16,88,,percent of total billed charges,,,,,,,,,20251.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24121.37,91,,percent of total billed charges,,,25181.65,95,,percent of total billed charges,,,22000.81,83,,percent of total billed charges,,,22000.81,83,,percent of total billed charges,,,,,,,,,,,,,,,22000.81,83,,percent of total billed charges,,,25181.65,95,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,21735.74,82,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,22530.95,85,,percent of total billed charges,,19986.28,25181.65,
VIABAHN 8F X 11MM X 79MM,30143014,CDM,,,270,RC,inpatient,,26507,26507,,22504.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19986.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22530.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23326.16,88,,percent of total billed charges,,,,,,,,,20251.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24121.37,91,,percent of total billed charges,,,25181.65,95,,percent of total billed charges,,,22000.81,83,,percent of total billed charges,,,22000.81,83,,percent of total billed charges,,,,,,,,,,,,,,,22000.81,83,,percent of total billed charges,,,25181.65,95,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,21735.74,82,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,22530.95,85,,percent of total billed charges,,19986.28,25181.65,
ROTH FOREIGN BODY NET 2.5MM,30180002,CDM,,,270,RC,inpatient,,605.93,605.93,,514.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,456.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,515.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,533.22,88,,percent of total billed charges,,,,,,,,,462.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,551.4,91,,percent of total billed charges,,,575.63,95,,percent of total billed charges,,,502.92,83,,percent of total billed charges,,,502.92,83,,percent of total billed charges,,,,,,,,,,,,,,,502.92,83,,percent of total billed charges,,,575.63,95,,percent of total billed charges,,,545.34,90,,percent of total billed charges,,,545.34,90,,percent of total billed charges,,,496.86,82,,percent of total billed charges,,,545.34,90,,percent of total billed charges,,,515.04,85,,percent of total billed charges,,456.87,575.63,
CLO TEST,30180003,CDM,,,270,RC,inpatient,,90.18,90.18,,76.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,76.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.36,88,,percent of total billed charges,,,,,,,,,68.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.06,91,,percent of total billed charges,,,85.67,95,,percent of total billed charges,,,74.85,83,,percent of total billed charges,,,74.85,83,,percent of total billed charges,,,,,,,,,,,,,,,74.85,83,,percent of total billed charges,,,85.67,95,,percent of total billed charges,,,81.16,90,,percent of total billed charges,,,81.16,90,,percent of total billed charges,,,73.95,82,,percent of total billed charges,,,81.16,90,,percent of total billed charges,,,76.65,85,,percent of total billed charges,,68,85.67,
LAP CHOLE KIT,30180004,CDM,,,270,RC,inpatient,,2280.01,2280.01,,1935.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1719.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1938.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2006.41,88,,percent of total billed charges,,,,,,,,,1741.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2074.81,91,,percent of total billed charges,,,2166.01,95,,percent of total billed charges,,,1892.41,83,,percent of total billed charges,,,1892.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1892.41,83,,percent of total billed charges,,,2166.01,95,,percent of total billed charges,,,2052.01,90,,percent of total billed charges,,,2052.01,90,,percent of total billed charges,,,1869.61,82,,percent of total billed charges,,,2052.01,90,,percent of total billed charges,,,1938.01,85,,percent of total billed charges,,1719.13,2166.01,
TROCAR ENDO DILATING TIP 7/8,30180007,CDM,,,270,RC,inpatient,,195.04,195.04,,165.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,165.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,171.64,88,,percent of total billed charges,,,,,,,,,149.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,177.49,91,,percent of total billed charges,,,185.29,95,,percent of total billed charges,,,161.88,83,,percent of total billed charges,,,161.88,83,,percent of total billed charges,,,,,,,,,,,,,,,161.88,83,,percent of total billed charges,,,185.29,95,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,159.93,82,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,165.78,85,,percent of total billed charges,,147.06,185.29,
LIGAMAX CLIP APPLIER 5MM,30180008,CDM,,,270,RC,inpatient,,943.06,943.06,,800.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,711.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,801.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,829.89,88,,percent of total billed charges,,,,,,,,,720.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,858.18,91,,percent of total billed charges,,,895.91,95,,percent of total billed charges,,,782.74,83,,percent of total billed charges,,,782.74,83,,percent of total billed charges,,,,,,,,,,,,,,,782.74,83,,percent of total billed charges,,,895.91,95,,percent of total billed charges,,,848.75,90,,percent of total billed charges,,,848.75,90,,percent of total billed charges,,,773.31,82,,percent of total billed charges,,,848.75,90,,percent of total billed charges,,,801.6,85,,percent of total billed charges,,711.07,895.91,
STAPLER EEA INTRALUMINAL 25MM,30180009,CDM,,,270,RC,inpatient,,2023.58,2023.58,,1718.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1525.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1720.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1780.75,88,,percent of total billed charges,,,,,,,,,1546.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1841.46,91,,percent of total billed charges,,,1922.4,95,,percent of total billed charges,,,1679.57,83,,percent of total billed charges,,,1679.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1679.57,83,,percent of total billed charges,,,1922.4,95,,percent of total billed charges,,,1821.22,90,,percent of total billed charges,,,1821.22,90,,percent of total billed charges,,,1659.34,82,,percent of total billed charges,,,1821.22,90,,percent of total billed charges,,,1720.04,85,,percent of total billed charges,,1525.78,1922.4,
STAPLER EEA INTRALUMINAL 29MM,30180010,CDM,,,270,RC,inpatient,,1805.83,1805.83,,1533.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1361.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1534.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1589.13,88,,percent of total billed charges,,,,,,,,,1379.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1643.31,91,,percent of total billed charges,,,1715.54,95,,percent of total billed charges,,,1498.84,83,,percent of total billed charges,,,1498.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1498.84,83,,percent of total billed charges,,,1715.54,95,,percent of total billed charges,,,1625.25,90,,percent of total billed charges,,,1625.25,90,,percent of total billed charges,,,1480.78,82,,percent of total billed charges,,,1625.25,90,,percent of total billed charges,,,1534.96,85,,percent of total billed charges,,1361.6,1715.54,
STAPLER TA CUTTER CURVED,30180012,CDM,,,270,RC,inpatient,,2924.03,2924.03,,2482.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2204.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2485.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2573.15,88,,percent of total billed charges,,,,,,,,,2233.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2660.87,91,,percent of total billed charges,,,2777.83,95,,percent of total billed charges,,,2426.94,83,,percent of total billed charges,,,2426.94,83,,percent of total billed charges,,,,,,,,,,,,,,,2426.94,83,,percent of total billed charges,,,2777.83,95,,percent of total billed charges,,,2631.63,90,,percent of total billed charges,,,2631.63,90,,percent of total billed charges,,,2397.7,82,,percent of total billed charges,,,2631.63,90,,percent of total billed charges,,,2485.43,85,,percent of total billed charges,,2204.72,2777.83,
STAPLER LIGACLIP ENDO ERCA M/L 10MM,30180013,CDM,,,270,RC,inpatient,,597.33,597.33,,507.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,450.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,507.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,525.65,88,,percent of total billed charges,,,,,,,,,456.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,543.57,91,,percent of total billed charges,,,567.46,95,,percent of total billed charges,,,495.78,83,,percent of total billed charges,,,495.78,83,,percent of total billed charges,,,,,,,,,,,,,,,495.78,83,,percent of total billed charges,,,567.46,95,,percent of total billed charges,,,537.6,90,,percent of total billed charges,,,537.6,90,,percent of total billed charges,,,489.81,82,,percent of total billed charges,,,537.6,90,,percent of total billed charges,,,507.73,85,,percent of total billed charges,,450.39,567.46,
NEEDLE VERES PNEUMO 150MM,30180014,CDM,,,270,RC,inpatient,,98.88,98.88,,83.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,74.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,84.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,87.01,88,,percent of total billed charges,,,,,,,,,75.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,89.98,91,,percent of total billed charges,,,93.94,95,,percent of total billed charges,,,82.07,83,,percent of total billed charges,,,82.07,83,,percent of total billed charges,,,,,,,,,,,,,,,82.07,83,,percent of total billed charges,,,93.94,95,,percent of total billed charges,,,88.99,90,,percent of total billed charges,,,88.99,90,,percent of total billed charges,,,81.08,82,,percent of total billed charges,,,88.99,90,,percent of total billed charges,,,84.05,85,,percent of total billed charges,,74.56,93.94,
STAPLER HEMORRHOID 33MM,30180015,CDM,,,270,RC,inpatient,,2583.95,2583.95,,2193.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1948.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2196.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2273.88,88,,percent of total billed charges,,,,,,,,,1974.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2351.39,91,,percent of total billed charges,,,2454.75,95,,percent of total billed charges,,,2144.68,83,,percent of total billed charges,,,2144.68,83,,percent of total billed charges,,,,,,,,,,,,,,,2144.68,83,,percent of total billed charges,,,2454.75,95,,percent of total billed charges,,,2325.56,90,,percent of total billed charges,,,2325.56,90,,percent of total billed charges,,,2118.84,82,,percent of total billed charges,,,2325.56,90,,percent of total billed charges,,,2196.36,85,,percent of total billed charges,,1948.3,2454.75,
STAPLER GIA RELOAD 55MM,30180016,CDM,,,270,RC,inpatient,,365.19,365.19,,310.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,275.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,310.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,321.37,88,,percent of total billed charges,,,,,,,,,279.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,332.32,91,,percent of total billed charges,,,346.93,95,,percent of total billed charges,,,303.11,83,,percent of total billed charges,,,303.11,83,,percent of total billed charges,,,,,,,,,,,,,,,303.11,83,,percent of total billed charges,,,346.93,95,,percent of total billed charges,,,328.67,90,,percent of total billed charges,,,328.67,90,,percent of total billed charges,,,299.46,82,,percent of total billed charges,,,328.67,90,,percent of total billed charges,,,310.41,85,,percent of total billed charges,,275.35,346.93,
STAPLER GIA RELOAD 75MM,30180017,CDM,,,270,RC,inpatient,,514.61,514.61,,436.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,388.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,437.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,452.86,88,,percent of total billed charges,,,,,,,,,393.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,468.3,91,,percent of total billed charges,,,488.88,95,,percent of total billed charges,,,427.13,83,,percent of total billed charges,,,427.13,83,,percent of total billed charges,,,,,,,,,,,,,,,427.13,83,,percent of total billed charges,,,488.88,95,,percent of total billed charges,,,463.15,90,,percent of total billed charges,,,463.15,90,,percent of total billed charges,,,421.98,82,,percent of total billed charges,,,463.15,90,,percent of total billed charges,,,437.42,85,,percent of total billed charges,,388.02,488.88,
STAPLER GIA CUTTER 75MM,30180019,CDM,,,270,RC,inpatient,,896.07,896.07,,760.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,675.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,761.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,788.54,88,,percent of total billed charges,,,,,,,,,684.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,815.42,91,,percent of total billed charges,,,851.27,95,,percent of total billed charges,,,743.74,83,,percent of total billed charges,,,743.74,83,,percent of total billed charges,,,,,,,,,,,,,,,743.74,83,,percent of total billed charges,,,851.27,95,,percent of total billed charges,,,806.46,90,,percent of total billed charges,,,806.46,90,,percent of total billed charges,,,734.78,82,,percent of total billed charges,,,806.46,90,,percent of total billed charges,,,761.66,85,,percent of total billed charges,,675.64,851.27,
STAPLER GIA ENDO RELOAD 45MM THIN,30180021,CDM,,,270,RC,inpatient,,884.59,884.59,,751.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,666.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,751.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,778.44,88,,percent of total billed charges,,,,,,,,,675.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,804.98,91,,percent of total billed charges,,,840.36,95,,percent of total billed charges,,,734.21,83,,percent of total billed charges,,,734.21,83,,percent of total billed charges,,,,,,,,,,,,,,,734.21,83,,percent of total billed charges,,,840.36,95,,percent of total billed charges,,,796.13,90,,percent of total billed charges,,,796.13,90,,percent of total billed charges,,,725.36,82,,percent of total billed charges,,,796.13,90,,percent of total billed charges,,,751.9,85,,percent of total billed charges,,666.98,840.36,
STAPLER TA PROX LIN 30MM,30180024,CDM,,,270,RC,inpatient,,635.9,635.9,,539.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,479.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,540.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,559.59,88,,percent of total billed charges,,,,,,,,,485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,578.67,91,,percent of total billed charges,,,604.11,95,,percent of total billed charges,,,527.8,83,,percent of total billed charges,,,527.8,83,,percent of total billed charges,,,,,,,,,,,,,,,527.8,83,,percent of total billed charges,,,604.11,95,,percent of total billed charges,,,572.31,90,,percent of total billed charges,,,572.31,90,,percent of total billed charges,,,521.44,82,,percent of total billed charges,,,572.31,90,,percent of total billed charges,,,540.52,85,,percent of total billed charges,,479.47,604.11,
STAPLER TA PROX LIN 60MM BLUE,30180025,CDM,,,270,RC,inpatient,,645.1,645.1,,547.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,486.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,548.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,567.69,88,,percent of total billed charges,,,,,,,,,492.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,587.04,91,,percent of total billed charges,,,612.85,95,,percent of total billed charges,,,535.43,83,,percent of total billed charges,,,535.43,83,,percent of total billed charges,,,,,,,,,,,,,,,535.43,83,,percent of total billed charges,,,612.85,95,,percent of total billed charges,,,580.59,90,,percent of total billed charges,,,580.59,90,,percent of total billed charges,,,528.98,82,,percent of total billed charges,,,580.59,90,,percent of total billed charges,,,548.34,85,,percent of total billed charges,,486.41,612.85,
STAPLER TA PROX LIN 60MM GREEN,30180026,CDM,,,270,RC,inpatient,,671.86,671.86,,570.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,506.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,571.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,591.24,88,,percent of total billed charges,,,,,,,,,513.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,611.39,91,,percent of total billed charges,,,638.27,95,,percent of total billed charges,,,557.64,83,,percent of total billed charges,,,557.64,83,,percent of total billed charges,,,,,,,,,,,,,,,557.64,83,,percent of total billed charges,,,638.27,95,,percent of total billed charges,,,604.67,90,,percent of total billed charges,,,604.67,90,,percent of total billed charges,,,550.93,82,,percent of total billed charges,,,604.67,90,,percent of total billed charges,,,571.08,85,,percent of total billed charges,,506.58,638.27,
DRAIN SATATOGA SUMP 28FR,30180029,CDM,,,270,RC,inpatient,,114.96,114.96,,97.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,86.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,97.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,101.16,88,,percent of total billed charges,,,,,,,,,87.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,104.61,91,,percent of total billed charges,,,109.21,95,,percent of total billed charges,,,95.42,83,,percent of total billed charges,,,95.42,83,,percent of total billed charges,,,,,,,,,,,,,,,95.42,83,,percent of total billed charges,,,109.21,95,,percent of total billed charges,,,103.46,90,,percent of total billed charges,,,103.46,90,,percent of total billed charges,,,94.27,82,,percent of total billed charges,,,103.46,90,,percent of total billed charges,,,97.72,85,,percent of total billed charges,,86.68,109.21,
STAPLER RELOADS FOR 60MM BLUE,30180030,CDM,,,270,RC,inpatient,,355.13,355.13,,301.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,267.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,301.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,312.51,88,,percent of total billed charges,,,,,,,,,271.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,323.17,91,,percent of total billed charges,,,337.37,95,,percent of total billed charges,,,294.76,83,,percent of total billed charges,,,294.76,83,,percent of total billed charges,,,,,,,,,,,,,,,294.76,83,,percent of total billed charges,,,337.37,95,,percent of total billed charges,,,319.62,90,,percent of total billed charges,,,319.62,90,,percent of total billed charges,,,291.21,82,,percent of total billed charges,,,319.62,90,,percent of total billed charges,,,301.86,85,,percent of total billed charges,,267.77,337.37,
STAPLER TA CUTTER 90MM,30180031,CDM,,,270,RC,inpatient,,731.45,731.45,,621,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,551.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,621.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,643.68,88,,percent of total billed charges,,,,,,,,,558.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,665.62,91,,percent of total billed charges,,,694.88,95,,percent of total billed charges,,,607.1,83,,percent of total billed charges,,,607.1,83,,percent of total billed charges,,,,,,,,,,,,,,,607.1,83,,percent of total billed charges,,,694.88,95,,percent of total billed charges,,,658.31,90,,percent of total billed charges,,,658.31,90,,percent of total billed charges,,,599.79,82,,percent of total billed charges,,,658.31,90,,percent of total billed charges,,,621.73,85,,percent of total billed charges,,551.51,694.88,
FLUID WARMER COVER OPEN TOP 44 X 44,30180036,CDM,,,270,RC,inpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,169.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,191.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,169.65,213.75,
ENDO POUCH RETRIEVER 10MM,30180039,CDM,,,270,RC,inpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,226.2,285,
LAPAFLATOR TUBING HIGH FLOW,30180051,CDM,,,270,RC,inpatient,,63.75,63.75,,54.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.1,88,,percent of total billed charges,,,,,,,,,48.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.01,91,,percent of total billed charges,,,60.56,95,,percent of total billed charges,,,52.91,83,,percent of total billed charges,,,52.91,83,,percent of total billed charges,,,,,,,,,,,,,,,52.91,83,,percent of total billed charges,,,60.56,95,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,52.28,82,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,54.19,85,,percent of total billed charges,,48.07,60.56,
STRYKER SUCTION IRRIGATOR,30180056,CDM,,,270,RC,inpatient,,452.17,452.17,,383.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,340.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,384.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,397.91,88,,percent of total billed charges,,,,,,,,,345.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,411.47,91,,percent of total billed charges,,,429.56,95,,percent of total billed charges,,,375.3,83,,percent of total billed charges,,,375.3,83,,percent of total billed charges,,,,,,,,,,,,,,,375.3,83,,percent of total billed charges,,,429.56,95,,percent of total billed charges,,,406.95,90,,percent of total billed charges,,,406.95,90,,percent of total billed charges,,,370.78,82,,percent of total billed charges,,,406.95,90,,percent of total billed charges,,,384.34,85,,percent of total billed charges,,340.94,429.56,
LAPROSCOPIC MORCELLATOR,30180060,CDM,,,270,RC,inpatient,,3411.2,3411.2,,2896.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2572.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2899.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3001.86,88,,percent of total billed charges,,,,,,,,,2606.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3104.19,91,,percent of total billed charges,,,3240.64,95,,percent of total billed charges,,,2831.3,83,,percent of total billed charges,,,2831.3,83,,percent of total billed charges,,,,,,,,,,,,,,,2831.3,83,,percent of total billed charges,,,3240.64,95,,percent of total billed charges,,,3070.08,90,,percent of total billed charges,,,3070.08,90,,percent of total billed charges,,,2797.18,82,,percent of total billed charges,,,3070.08,90,,percent of total billed charges,,,2899.52,85,,percent of total billed charges,,2572.04,3240.64,
ELECTRODE TWIZZLE TIP,30180061,CDM,,,270,RC,inpatient,,2343.9,2343.9,,1989.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1767.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1992.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2062.63,88,,percent of total billed charges,,,,,,,,,1790.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2132.95,91,,percent of total billed charges,,,2226.71,95,,percent of total billed charges,,,1945.44,83,,percent of total billed charges,,,1945.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1945.44,83,,percent of total billed charges,,,2226.71,95,,percent of total billed charges,,,2109.51,90,,percent of total billed charges,,,2109.51,90,,percent of total billed charges,,,1922,82,,percent of total billed charges,,,2109.51,90,,percent of total billed charges,,,1992.32,85,,percent of total billed charges,,1767.3,2226.71,
ELECTRODE LOOP,30180062,CDM,,,270,RC,inpatient,,2145,2145,,1821.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1617.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1823.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1887.6,88,,percent of total billed charges,,,,,,,,,1638.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1951.95,91,,percent of total billed charges,,,2037.75,95,,percent of total billed charges,,,1780.35,83,,percent of total billed charges,,,1780.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1780.35,83,,percent of total billed charges,,,2037.75,95,,percent of total billed charges,,,1930.5,90,,percent of total billed charges,,,1930.5,90,,percent of total billed charges,,,1758.9,82,,percent of total billed charges,,,1930.5,90,,percent of total billed charges,,,1823.25,85,,percent of total billed charges,,1617.33,2037.75,
ELECTRODE 0-DEG VAPORIZING,30180063,CDM,,,270,RC,inpatient,,2607.35,2607.35,,2213.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1965.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2216.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2294.47,88,,percent of total billed charges,,,,,,,,,1992.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2372.69,91,,percent of total billed charges,,,2476.98,95,,percent of total billed charges,,,2164.1,83,,percent of total billed charges,,,2164.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2164.1,83,,percent of total billed charges,,,2476.98,95,,percent of total billed charges,,,2346.62,90,,percent of total billed charges,,,2346.62,90,,percent of total billed charges,,,2138.03,82,,percent of total billed charges,,,2346.62,90,,percent of total billed charges,,,2216.25,85,,percent of total billed charges,,1965.94,2476.98,
MESH PERFIX PLUG MEDIUM,30180070,CDM,,,270,RC,inpatient,,942.5,942.5,,800.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,710.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,801.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,829.4,88,,percent of total billed charges,,,,,,,,,720.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,857.68,91,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,,,,,,,,,,,,,782.28,83,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,772.85,82,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,801.13,85,,percent of total billed charges,,710.65,895.38,
S&N CONQUEST FX FEM COMP SZ16,30180074,CDM,,,278,RC,inpatient,,8788,8788,,7461.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6626.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7469.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7733.44,88,,percent of total billed charges,,,,,,,,,6714.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7997.08,91,,percent of total billed charges,,,8348.6,95,,percent of total billed charges,,,7294.04,83,,percent of total billed charges,,,7294.04,83,,percent of total billed charges,,,,,,,,,,,,,,,7294.04,83,,percent of total billed charges,,,8348.6,95,,percent of total billed charges,,,7909.2,90,,percent of total billed charges,,,7909.2,90,,percent of total billed charges,,,7206.16,82,,percent of total billed charges,,,7909.2,90,,percent of total billed charges,,,7469.8,85,,percent of total billed charges,,6626.15,8348.6,
TROCAR ENDO BLADELESS 5MM,30180102,CDM,,,270,RC,inpatient,,195.04,195.04,,165.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,165.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,171.64,88,,percent of total billed charges,,,,,,,,,149.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,177.49,91,,percent of total billed charges,,,185.29,95,,percent of total billed charges,,,161.88,83,,percent of total billed charges,,,161.88,83,,percent of total billed charges,,,,,,,,,,,,,,,161.88,83,,percent of total billed charges,,,185.29,95,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,159.93,82,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,165.78,85,,percent of total billed charges,,147.06,185.29,
PROLIFT POSTERIOR,30180124,CDM,,,270,RC,inpatient,,9392.5,9392.5,,7974.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7081.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7983.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8265.4,88,,percent of total billed charges,,,,,,,,,7175.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8547.18,91,,percent of total billed charges,,,8922.88,95,,percent of total billed charges,,,7795.78,83,,percent of total billed charges,,,7795.78,83,,percent of total billed charges,,,,,,,,,,,,,,,7795.78,83,,percent of total billed charges,,,8922.88,95,,percent of total billed charges,,,8453.25,90,,percent of total billed charges,,,8453.25,90,,percent of total billed charges,,,7701.85,82,,percent of total billed charges,,,8453.25,90,,percent of total billed charges,,,7983.63,85,,percent of total billed charges,,7081.95,8922.88,
PROLIFT TOTAL,30180125,CDM,,,270,RC,inpatient,,12512.5,12512.5,,10623.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9434.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10635.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11011,88,,percent of total billed charges,,,,,,,,,9559.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11386.38,91,,percent of total billed charges,,,11886.88,95,,percent of total billed charges,,,10385.38,83,,percent of total billed charges,,,10385.38,83,,percent of total billed charges,,,,,,,,,,,,,,,10385.38,83,,percent of total billed charges,,,11886.88,95,,percent of total billed charges,,,11261.25,90,,percent of total billed charges,,,11261.25,90,,percent of total billed charges,,,10260.25,82,,percent of total billed charges,,,11261.25,90,,percent of total billed charges,,,10635.63,85,,percent of total billed charges,,9434.43,11886.88,
TVTO SYSTEM TENSION-FREE,30180131,CDM,,,270,RC,inpatient,,10865.6,10865.6,,9224.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8192.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9235.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9561.73,88,,percent of total billed charges,,,,,,,,,8301.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9887.7,91,,percent of total billed charges,,,10322.32,95,,percent of total billed charges,,,9018.45,83,,percent of total billed charges,,,9018.45,83,,percent of total billed charges,,,,,,,,,,,,,,,9018.45,83,,percent of total billed charges,,,10322.32,95,,percent of total billed charges,,,9779.04,90,,percent of total billed charges,,,9779.04,90,,percent of total billed charges,,,8909.79,82,,percent of total billed charges,,,9779.04,90,,percent of total billed charges,,,9235.76,85,,percent of total billed charges,,8192.66,10322.32,
COBLATOR WAND,30180134,CDM,,,270,RC,inpatient,,2007.85,2007.85,,1704.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1513.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1706.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1766.91,88,,percent of total billed charges,,,,,,,,,1534,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.14,91,,percent of total billed charges,,,1907.46,95,,percent of total billed charges,,,1666.52,83,,percent of total billed charges,,,1666.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1666.52,83,,percent of total billed charges,,,1907.46,95,,percent of total billed charges,,,1807.07,90,,percent of total billed charges,,,1807.07,90,,percent of total billed charges,,,1646.44,82,,percent of total billed charges,,,1807.07,90,,percent of total billed charges,,,1706.67,85,,percent of total billed charges,,1513.92,1907.46,
LAPROSCOPIC CHOLANGIOGRAM CATHETER 19GA,30180143,CDM,,,270,RC,inpatient,,261.75,261.75,,222.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,222.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,230.34,88,,percent of total billed charges,,,,,,,,,199.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.19,91,,percent of total billed charges,,,248.66,95,,percent of total billed charges,,,217.25,83,,percent of total billed charges,,,217.25,83,,percent of total billed charges,,,,,,,,,,,,,,,217.25,83,,percent of total billed charges,,,248.66,95,,percent of total billed charges,,,235.58,90,,percent of total billed charges,,,235.58,90,,percent of total billed charges,,,214.64,82,,percent of total billed charges,,,235.58,90,,percent of total billed charges,,,222.49,85,,percent of total billed charges,,197.36,248.66,
PROLIFT ANTERIOR,30180144,CDM,,,270,RC,inpatient,,9912.5,9912.5,,8415.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7474.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8425.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8723,88,,percent of total billed charges,,,,,,,,,7573.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9020.38,91,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,,,,,,,,,,,,,8227.38,83,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8128.25,82,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,7474.03,9416.88,
ESSURE BIRTH CONTROL SYSTEM,30180152,CDM,,,270,RC,inpatient,,6012.5,6012.5,,5104.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4533.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5110.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5291,88,,percent of total billed charges,,,,,,,,,4593.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5471.38,91,,percent of total billed charges,,,5711.88,95,,percent of total billed charges,,,4990.38,83,,percent of total billed charges,,,4990.38,83,,percent of total billed charges,,,,,,,,,,,,,,,4990.38,83,,percent of total billed charges,,,5711.88,95,,percent of total billed charges,,,5411.25,90,,percent of total billed charges,,,5411.25,90,,percent of total billed charges,,,4930.25,82,,percent of total billed charges,,,5411.25,90,,percent of total billed charges,,,5110.63,85,,percent of total billed charges,,4533.43,5711.88,
CONTRAST OMNIPAQUE-300 10ML,30180154,CDM,,,270,RC,inpatient,,138.14,138.14,,117.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.56,88,,percent of total billed charges,,,,,,,,,105.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.71,91,,percent of total billed charges,,,131.23,95,,percent of total billed charges,,,114.66,83,,percent of total billed charges,,,114.66,83,,percent of total billed charges,,,,,,,,,,,,,,,114.66,83,,percent of total billed charges,,,131.23,95,,percent of total billed charges,,,124.33,90,,percent of total billed charges,,,124.33,90,,percent of total billed charges,,,113.27,82,,percent of total billed charges,,,124.33,90,,percent of total billed charges,,,117.42,85,,percent of total billed charges,,104.16,131.23,
VERICES INJECTOR NEEDLE ACU-JECT,30180155,CDM,,,270,RC,inpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,226.2,285,
GYNECARE TVT SECURE SYSTEM,30180180,CDM,,,270,RC,inpatient,,6476.93,6476.93,,5498.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4883.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5505.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5699.7,88,,percent of total billed charges,,,,,,,,,4948.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5894.01,91,,percent of total billed charges,,,6153.08,95,,percent of total billed charges,,,5375.85,83,,percent of total billed charges,,,5375.85,83,,percent of total billed charges,,,,,,,,,,,,,,,5375.85,83,,percent of total billed charges,,,6153.08,95,,percent of total billed charges,,,5829.24,90,,percent of total billed charges,,,5829.24,90,,percent of total billed charges,,,5311.08,82,,percent of total billed charges,,,5829.24,90,,percent of total billed charges,,,5505.39,85,,percent of total billed charges,,4883.61,6153.08,
NERVE BLOCK PAIN PACK,30180199,CDM,,,270,RC,inpatient,,148,148,,125.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,111.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,125.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,130.24,88,,percent of total billed charges,,,,,,,,,113.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,,,,,,,,,,,,,122.84,83,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,121.36,82,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,111.59,140.6,
TUBE EAR PAPARELLA 1 VENT,30180200,CDM,,,270,RC,inpatient,,176.8,176.8,,150.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,133.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,150.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,155.58,88,,percent of total billed charges,,,,,,,,,135.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.89,91,,percent of total billed charges,,,167.96,95,,percent of total billed charges,,,146.74,83,,percent of total billed charges,,,146.74,83,,percent of total billed charges,,,,,,,,,,,,,,,146.74,83,,percent of total billed charges,,,167.96,95,,percent of total billed charges,,,159.12,90,,percent of total billed charges,,,159.12,90,,percent of total billed charges,,,144.98,82,,percent of total billed charges,,,159.12,90,,percent of total billed charges,,,150.28,85,,percent of total billed charges,,133.31,167.96,
CONTRAST RENOGRAFIN-30 50ML,30180211,CDM,,,270,RC,inpatient,,28.26,28.26,,23.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.87,88,,percent of total billed charges,,,,,,,,,21.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.72,91,,percent of total billed charges,,,26.85,95,,percent of total billed charges,,,23.46,83,,percent of total billed charges,,,23.46,83,,percent of total billed charges,,,,,,,,,,,,,,,23.46,83,,percent of total billed charges,,,26.85,95,,percent of total billed charges,,,25.43,90,,percent of total billed charges,,,25.43,90,,percent of total billed charges,,,23.17,82,,percent of total billed charges,,,25.43,90,,percent of total billed charges,,,24.02,85,,percent of total billed charges,,21.31,26.85,
CARTER THOMASON CLOSURE SYSTEM,30180213,CDM,,,270,RC,inpatient,,808.5,808.5,,686.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,609.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,687.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,711.48,88,,percent of total billed charges,,,,,,,,,617.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,735.74,91,,percent of total billed charges,,,768.08,95,,percent of total billed charges,,,671.06,83,,percent of total billed charges,,,671.06,83,,percent of total billed charges,,,,,,,,,,,,,,,671.06,83,,percent of total billed charges,,,768.08,95,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,662.97,82,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,687.23,85,,percent of total billed charges,,609.61,768.08,
TRAY LAP CHOLE FLEX,30180214,CDM,,,270,RC,inpatient,,1747.22,1747.22,,1483.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1317.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1485.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1537.55,88,,percent of total billed charges,,,,,,,,,1334.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1589.97,91,,percent of total billed charges,,,1659.86,95,,percent of total billed charges,,,1450.19,83,,percent of total billed charges,,,1450.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1450.19,83,,percent of total billed charges,,,1659.86,95,,percent of total billed charges,,,1572.5,90,,percent of total billed charges,,,1572.5,90,,percent of total billed charges,,,1432.72,82,,percent of total billed charges,,,1572.5,90,,percent of total billed charges,,,1485.14,85,,percent of total billed charges,,1317.4,1659.86,
S&N COFIELD-2 ECCRNTRIC HEAD 24MM,30180228,CDM,,,278,RC,inpatient,,7635.42,7635.42,,6482.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5757.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6490.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6719.17,88,,percent of total billed charges,,,,,,,,,5833.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6948.23,91,,percent of total billed charges,,,7253.65,95,,percent of total billed charges,,,6337.4,83,,percent of total billed charges,,,6337.4,83,,percent of total billed charges,,,,,,,,,,,,,,,6337.4,83,,percent of total billed charges,,,7253.65,95,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6261.04,82,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6490.11,85,,percent of total billed charges,,5757.11,7253.65,
MESH DAVOL FLAT 2 X 4,30180237,CDM,,,270,RC,inpatient,,342.53,342.53,,290.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,258.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,291.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,301.43,88,,percent of total billed charges,,,,,,,,,261.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,311.7,91,,percent of total billed charges,,,325.4,95,,percent of total billed charges,,,284.3,83,,percent of total billed charges,,,284.3,83,,percent of total billed charges,,,,,,,,,,,,,,,284.3,83,,percent of total billed charges,,,325.4,95,,percent of total billed charges,,,308.28,90,,percent of total billed charges,,,308.28,90,,percent of total billed charges,,,280.87,82,,percent of total billed charges,,,308.28,90,,percent of total billed charges,,,291.15,85,,percent of total billed charges,,258.27,325.4,
S&N COFIELD-2 ECCRNTRIC HEAD 46MM,30180243,CDM,,,278,RC,inpatient,,7635.42,7635.42,,6482.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5757.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6490.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6719.17,88,,percent of total billed charges,,,,,,,,,5833.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6948.23,91,,percent of total billed charges,,,7253.65,95,,percent of total billed charges,,,6337.4,83,,percent of total billed charges,,,6337.4,83,,percent of total billed charges,,,,,,,,,,,,,,,6337.4,83,,percent of total billed charges,,,7253.65,95,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6261.04,82,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6490.11,85,,percent of total billed charges,,5757.11,7253.65,
STAPLER RELOADS FOR 60MM GREEN,30180249,CDM,,,270,RC,inpatient,,345.53,345.53,,293.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,260.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,293.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,304.07,88,,percent of total billed charges,,,,,,,,,263.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,314.43,91,,percent of total billed charges,,,328.25,95,,percent of total billed charges,,,286.79,83,,percent of total billed charges,,,286.79,83,,percent of total billed charges,,,,,,,,,,,,,,,286.79,83,,percent of total billed charges,,,328.25,95,,percent of total billed charges,,,310.98,90,,percent of total billed charges,,,310.98,90,,percent of total billed charges,,,283.33,82,,percent of total billed charges,,,310.98,90,,percent of total billed charges,,,293.7,85,,percent of total billed charges,,260.53,328.25,
CATHETER RACZ 24IN 610MM,30180250,CDM,,,270,RC,inpatient,,533.61,533.61,,453.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,402.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,453.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,469.58,88,,percent of total billed charges,,,,,,,,,407.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,485.59,91,,percent of total billed charges,,,506.93,95,,percent of total billed charges,,,442.9,83,,percent of total billed charges,,,442.9,83,,percent of total billed charges,,,,,,,,,,,,,,,442.9,83,,percent of total billed charges,,,506.93,95,,percent of total billed charges,,,480.25,90,,percent of total billed charges,,,480.25,90,,percent of total billed charges,,,437.56,82,,percent of total billed charges,,,480.25,90,,percent of total billed charges,,,453.57,85,,percent of total billed charges,,402.34,506.93,
GYRUS CUTTING FORCEP 33CM,30180251,CDM,,,270,RC,inpatient,,3146,3146,,2670.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2372.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2674.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2768.48,88,,percent of total billed charges,,,,,,,,,2403.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2862.86,91,,percent of total billed charges,,,2988.7,95,,percent of total billed charges,,,2611.18,83,,percent of total billed charges,,,2611.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2611.18,83,,percent of total billed charges,,,2988.7,95,,percent of total billed charges,,,2831.4,90,,percent of total billed charges,,,2831.4,90,,percent of total billed charges,,,2579.72,82,,percent of total billed charges,,,2831.4,90,,percent of total billed charges,,,2674.1,85,,percent of total billed charges,,2372.08,2988.7,
GYRUS PLASMA SEAL FORCEP 25CM,30180252,CDM,,,270,RC,inpatient,,1943.5,1943.5,,1650.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1465.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1651.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1710.28,88,,percent of total billed charges,,,,,,,,,1484.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1768.59,91,,percent of total billed charges,,,1846.33,95,,percent of total billed charges,,,1613.11,83,,percent of total billed charges,,,1613.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1613.11,83,,percent of total billed charges,,,1846.33,95,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1593.67,82,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1651.98,85,,percent of total billed charges,,1465.4,1846.33,
GYRUS PKS SEAL,30180257,CDM,,,270,RC,inpatient,,2822.3,2822.3,,2396.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2128.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2398.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2483.62,88,,percent of total billed charges,,,,,,,,,2156.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2568.29,91,,percent of total billed charges,,,2681.19,95,,percent of total billed charges,,,2342.51,83,,percent of total billed charges,,,2342.51,83,,percent of total billed charges,,,,,,,,,,,,,,,2342.51,83,,percent of total billed charges,,,2681.19,95,,percent of total billed charges,,,2540.07,90,,percent of total billed charges,,,2540.07,90,,percent of total billed charges,,,2314.29,82,,percent of total billed charges,,,2540.07,90,,percent of total billed charges,,,2398.96,85,,percent of total billed charges,,2128.01,2681.19,
DRAPE UROLOGICAL 23-1/2,30180294,CDM,,,270,RC,inpatient,,38.07,38.07,,32.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33.5,88,,percent of total billed charges,,,,,,,,,29.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.64,91,,percent of total billed charges,,,36.17,95,,percent of total billed charges,,,31.6,83,,percent of total billed charges,,,31.6,83,,percent of total billed charges,,,,,,,,,,,,,,,31.6,83,,percent of total billed charges,,,36.17,95,,percent of total billed charges,,,34.26,90,,percent of total billed charges,,,34.26,90,,percent of total billed charges,,,31.22,82,,percent of total billed charges,,,34.26,90,,percent of total billed charges,,,32.36,85,,percent of total billed charges,,28.7,36.17,
S&N COFIELD-2 ECCRNTRIC HEAD 18MM,30180304,CDM,,,278,RC,inpatient,,7635.42,7635.42,,6482.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5757.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6490.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6719.17,88,,percent of total billed charges,,,,,,,,,5833.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6948.23,91,,percent of total billed charges,,,7253.65,95,,percent of total billed charges,,,6337.4,83,,percent of total billed charges,,,6337.4,83,,percent of total billed charges,,,,,,,,,,,,,,,6337.4,83,,percent of total billed charges,,,7253.65,95,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6261.04,82,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6490.11,85,,percent of total billed charges,,5757.11,7253.65,
FILSHIE CLIP,30180307,CDM,,,270,RC,inpatient,,534.66,534.66,,453.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,403.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,454.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,470.5,88,,percent of total billed charges,,,,,,,,,408.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,486.54,91,,percent of total billed charges,,,507.93,95,,percent of total billed charges,,,443.77,83,,percent of total billed charges,,,443.77,83,,percent of total billed charges,,,,,,,,,,,,,,,443.77,83,,percent of total billed charges,,,507.93,95,,percent of total billed charges,,,481.19,90,,percent of total billed charges,,,481.19,90,,percent of total billed charges,,,438.42,82,,percent of total billed charges,,,481.19,90,,percent of total billed charges,,,454.46,85,,percent of total billed charges,,403.13,507.93,
TUBING ARTHROSCOPY IRRIGATION,30180314,CDM,,,270,RC,inpatient,,315,315,,267.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,237.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,267.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,277.2,88,,percent of total billed charges,,,,,,,,,240.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,286.65,91,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,,,,,,,,,,,,,261.45,83,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,258.3,82,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,237.51,299.25,
SURGICEL 2 X 14,30180316,CDM,,,270,RC,inpatient,,1323.81,1323.81,,1123.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,998.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1125.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1164.95,88,,percent of total billed charges,,,,,,,,,1011.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1204.67,91,,percent of total billed charges,,,1257.62,95,,percent of total billed charges,,,1098.76,83,,percent of total billed charges,,,1098.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1098.76,83,,percent of total billed charges,,,1257.62,95,,percent of total billed charges,,,1191.43,90,,percent of total billed charges,,,1191.43,90,,percent of total billed charges,,,1085.52,82,,percent of total billed charges,,,1191.43,90,,percent of total billed charges,,,1125.24,85,,percent of total billed charges,,998.15,1257.62,
LEEP PATIENT RETURN PAD,30180317,CDM,,,270,RC,inpatient,,71.3,71.3,,60.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.74,88,,percent of total billed charges,,,,,,,,,54.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.88,91,,percent of total billed charges,,,67.74,95,,percent of total billed charges,,,59.18,83,,percent of total billed charges,,,59.18,83,,percent of total billed charges,,,,,,,,,,,,,,,59.18,83,,percent of total billed charges,,,67.74,95,,percent of total billed charges,,,64.17,90,,percent of total billed charges,,,64.17,90,,percent of total billed charges,,,58.47,82,,percent of total billed charges,,,64.17,90,,percent of total billed charges,,,60.61,85,,percent of total billed charges,,53.76,67.74,
LEEP ELECTRODE HANDPIECE,30180318,CDM,,,270,RC,inpatient,,38.61,38.61,,32.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33.98,88,,percent of total billed charges,,,,,,,,,29.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35.14,91,,percent of total billed charges,,,36.68,95,,percent of total billed charges,,,32.05,83,,percent of total billed charges,,,32.05,83,,percent of total billed charges,,,,,,,,,,,,,,,32.05,83,,percent of total billed charges,,,36.68,95,,percent of total billed charges,,,34.75,90,,percent of total billed charges,,,34.75,90,,percent of total billed charges,,,31.66,82,,percent of total billed charges,,,34.75,90,,percent of total billed charges,,,32.82,85,,percent of total billed charges,,29.11,36.68,
S&N CONQUEST FX FEM COMP SZ15,30180325,CDM,,,278,RC,inpatient,,8788,8788,,7461.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6626.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7469.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7733.44,88,,percent of total billed charges,,,,,,,,,6714.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7997.08,91,,percent of total billed charges,,,8348.6,95,,percent of total billed charges,,,7294.04,83,,percent of total billed charges,,,7294.04,83,,percent of total billed charges,,,,,,,,,,,,,,,7294.04,83,,percent of total billed charges,,,8348.6,95,,percent of total billed charges,,,7909.2,90,,percent of total billed charges,,,7909.2,90,,percent of total billed charges,,,7206.16,82,,percent of total billed charges,,,7909.2,90,,percent of total billed charges,,,7469.8,85,,percent of total billed charges,,6626.15,8348.6,
CONTRAST RENOGRAFIN-60 50ML,30180327,CDM,,,270,RC,inpatient,,24.03,24.03,,20.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.15,88,,percent of total billed charges,,,,,,,,,18.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.87,91,,percent of total billed charges,,,22.83,95,,percent of total billed charges,,,19.94,83,,percent of total billed charges,,,19.94,83,,percent of total billed charges,,,,,,,,,,,,,,,19.94,83,,percent of total billed charges,,,22.83,95,,percent of total billed charges,,,21.63,90,,percent of total billed charges,,,21.63,90,,percent of total billed charges,,,19.7,82,,percent of total billed charges,,,21.63,90,,percent of total billed charges,,,20.43,85,,percent of total billed charges,,18.12,22.83,
NOVASURE DISPOSABLE HANDPIECE,30180328,CDM,,,270,RC,inpatient,,6467.5,6467.5,,5490.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4876.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5497.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5691.4,88,,percent of total billed charges,,,,,,,,,4941.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5885.43,91,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,,,,,,,,,,,,,5368.03,83,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5303.35,82,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,4876.5,6144.13,
LEEP REDI KIT,30180335,CDM,,,270,RC,inpatient,,253.05,253.05,,214.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,222.68,88,,percent of total billed charges,,,,,,,,,193.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,230.28,91,,percent of total billed charges,,,240.4,95,,percent of total billed charges,,,210.03,83,,percent of total billed charges,,,210.03,83,,percent of total billed charges,,,,,,,,,,,,,,,210.03,83,,percent of total billed charges,,,240.4,95,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,207.5,82,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,215.09,85,,percent of total billed charges,,190.8,240.4,
MESH DAVOL FLAT 10 X 14,30180344,CDM,,,270,RC,inpatient,,665.7,665.7,,565.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.82,88,,percent of total billed charges,,,,,,,,,508.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.79,91,,percent of total billed charges,,,632.42,95,,percent of total billed charges,,,552.53,83,,percent of total billed charges,,,552.53,83,,percent of total billed charges,,,,,,,,,,,,,,,552.53,83,,percent of total billed charges,,,632.42,95,,percent of total billed charges,,,599.13,90,,percent of total billed charges,,,599.13,90,,percent of total billed charges,,,545.87,82,,percent of total billed charges,,,599.13,90,,percent of total billed charges,,,565.85,85,,percent of total billed charges,,501.94,632.42,
NOVASURE DEVICE KIT,30180348,CDM,,,270,RC,inpatient,,7290.83,7290.83,,6189.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5497.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6197.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6415.93,88,,percent of total billed charges,,,,,,,,,5570.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6634.66,91,,percent of total billed charges,,,6926.29,95,,percent of total billed charges,,,6051.39,83,,percent of total billed charges,,,6051.39,83,,percent of total billed charges,,,,,,,,,,,,,,,6051.39,83,,percent of total billed charges,,,6926.29,95,,percent of total billed charges,,,6561.75,90,,percent of total billed charges,,,6561.75,90,,percent of total billed charges,,,5978.48,82,,percent of total billed charges,,,6561.75,90,,percent of total billed charges,,,6197.21,85,,percent of total billed charges,,5497.29,6926.29,
S&N COFIELD-2 ECCRNTRIC HEAD 20MM,30180358,CDM,,,278,RC,inpatient,,7635.42,7635.42,,6482.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5757.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6490.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6719.17,88,,percent of total billed charges,,,,,,,,,5833.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6948.23,91,,percent of total billed charges,,,7253.65,95,,percent of total billed charges,,,6337.4,83,,percent of total billed charges,,,6337.4,83,,percent of total billed charges,,,,,,,,,,,,,,,6337.4,83,,percent of total billed charges,,,7253.65,95,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6261.04,82,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6490.11,85,,percent of total billed charges,,5757.11,7253.65,
ZIMMER GIGLI SAW BLADE,30180362,CDM,,,270,RC,inpatient,,169.09,169.09,,143.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,127.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,143.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,148.8,88,,percent of total billed charges,,,,,,,,,129.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,153.87,91,,percent of total billed charges,,,160.64,95,,percent of total billed charges,,,140.34,83,,percent of total billed charges,,,140.34,83,,percent of total billed charges,,,,,,,,,,,,,,,140.34,83,,percent of total billed charges,,,160.64,95,,percent of total billed charges,,,152.18,90,,percent of total billed charges,,,152.18,90,,percent of total billed charges,,,138.65,82,,percent of total billed charges,,,152.18,90,,percent of total billed charges,,,143.73,85,,percent of total billed charges,,127.49,160.64,
SURECLIP 22MM HEMOSTATSIS CLIP,30180363,CDM,,,270,RC,inpatient,,978.15,978.15,,830.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,737.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,831.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,860.77,88,,percent of total billed charges,,,,,,,,,747.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,890.12,91,,percent of total billed charges,,,929.24,95,,percent of total billed charges,,,811.86,83,,percent of total billed charges,,,811.86,83,,percent of total billed charges,,,,,,,,,,,,,,,811.86,83,,percent of total billed charges,,,929.24,95,,percent of total billed charges,,,880.34,90,,percent of total billed charges,,,880.34,90,,percent of total billed charges,,,802.08,82,,percent of total billed charges,,,880.34,90,,percent of total billed charges,,,831.43,85,,percent of total billed charges,,737.53,929.24,
COBLATOR WAND FLEX ULTRA,30180367,CDM,,,270,RC,inpatient,,1430,1430,,1214.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1078.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1215.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1258.4,88,,percent of total billed charges,,,,,,,,,1092.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1301.3,91,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1186.9,83,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1172.6,82,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,1078.22,1358.5,
CATH THORACIC STRAIGHT 24F 8.0M,30180371,CDM,,,270,RC,inpatient,,45.73,45.73,,38.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.24,88,,percent of total billed charges,,,,,,,,,34.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.61,91,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,,,,,,,,,,,,,37.96,83,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,37.5,82,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,34.48,43.44,
STRYKER SHAVER PLUS 5.0,30180373,CDM,,,270,RC,inpatient,,410.45,410.45,,348.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,309.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,348.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,361.2,88,,percent of total billed charges,,,,,,,,,313.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,373.51,91,,percent of total billed charges,,,389.93,95,,percent of total billed charges,,,340.67,83,,percent of total billed charges,,,340.67,83,,percent of total billed charges,,,,,,,,,,,,,,,340.67,83,,percent of total billed charges,,,389.93,95,,percent of total billed charges,,,369.41,90,,percent of total billed charges,,,369.41,90,,percent of total billed charges,,,336.57,82,,percent of total billed charges,,,369.41,90,,percent of total billed charges,,,348.88,85,,percent of total billed charges,,309.48,389.93,
CRYO SHOULDER CUFF,30180381,CDM,,,270,RC,inpatient,,329.78,329.78,,279.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,248.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,280.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,290.21,88,,percent of total billed charges,,,,,,,,,251.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,300.1,91,,percent of total billed charges,,,313.29,95,,percent of total billed charges,,,273.72,83,,percent of total billed charges,,,273.72,83,,percent of total billed charges,,,,,,,,,,,,,,,273.72,83,,percent of total billed charges,,,313.29,95,,percent of total billed charges,,,296.8,90,,percent of total billed charges,,,296.8,90,,percent of total billed charges,,,270.42,82,,percent of total billed charges,,,296.8,90,,percent of total billed charges,,,280.31,85,,percent of total billed charges,,248.65,313.29,
SYNTHES SCREW CORTEX 3.5X14MM,30180382,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
SYNTHES SCREW CORTEX 3.5X16MM,30180383,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
SYNTHES SCREW CORTEX 3.5X18MM,30180384,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
SYNTHES SCREW CORTEX 3.5X22MM,30180385,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
*PAIN PUMP 250ML 5  CATH (DUPLICATE),30180392,CDM,,,270,RC,inpatient,,701,701,,595.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,528.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,595.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,616.88,88,,percent of total billed charges,,,,,,,,,535.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,637.91,91,,percent of total billed charges,,,665.95,95,,percent of total billed charges,,,581.83,83,,percent of total billed charges,,,581.83,83,,percent of total billed charges,,,,,,,,,,,,,,,581.83,83,,percent of total billed charges,,,665.95,95,,percent of total billed charges,,,630.9,90,,percent of total billed charges,,,630.9,90,,percent of total billed charges,,,574.82,82,,percent of total billed charges,,,630.9,90,,percent of total billed charges,,,595.85,85,,percent of total billed charges,,528.55,665.95,
STRYKER BLADE XL WIDE  34.5 X 12,30180393,CDM,,,270,RC,inpatient,,307.28,307.28,,260.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,231.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,261.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,270.41,88,,percent of total billed charges,,,,,,,,,234.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,279.62,91,,percent of total billed charges,,,291.92,95,,percent of total billed charges,,,255.04,83,,percent of total billed charges,,,255.04,83,,percent of total billed charges,,,,,,,,,,,,,,,255.04,83,,percent of total billed charges,,,291.92,95,,percent of total billed charges,,,276.55,90,,percent of total billed charges,,,276.55,90,,percent of total billed charges,,,251.97,82,,percent of total billed charges,,,276.55,90,,percent of total billed charges,,,261.19,85,,percent of total billed charges,,231.69,291.92,
CRYO ANKLE CUFF,30180394,CDM,,,270,RC,inpatient,,274.8,274.8,,233.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,207.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,233.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,241.82,88,,percent of total billed charges,,,,,,,,,209.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,250.07,91,,percent of total billed charges,,,261.06,95,,percent of total billed charges,,,228.08,83,,percent of total billed charges,,,228.08,83,,percent of total billed charges,,,,,,,,,,,,,,,228.08,83,,percent of total billed charges,,,261.06,95,,percent of total billed charges,,,247.32,90,,percent of total billed charges,,,247.32,90,,percent of total billed charges,,,225.34,82,,percent of total billed charges,,,247.32,90,,percent of total billed charges,,,233.58,85,,percent of total billed charges,,207.2,261.06,
CRYO KNEE CUFF S,30180395,CDM,,,270,RC,inpatient,,274.8,274.8,,233.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,207.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,233.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,241.82,88,,percent of total billed charges,,,,,,,,,209.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,250.07,91,,percent of total billed charges,,,261.06,95,,percent of total billed charges,,,228.08,83,,percent of total billed charges,,,228.08,83,,percent of total billed charges,,,,,,,,,,,,,,,228.08,83,,percent of total billed charges,,,261.06,95,,percent of total billed charges,,,247.32,90,,percent of total billed charges,,,247.32,90,,percent of total billed charges,,,225.34,82,,percent of total billed charges,,,247.32,90,,percent of total billed charges,,,233.58,85,,percent of total billed charges,,207.2,261.06,
CRYO KNEE CUFF M,30180396,CDM,,,270,RC,inpatient,,269.33,269.33,,228.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,203.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,228.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,237.01,88,,percent of total billed charges,,,,,,,,,205.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,245.09,91,,percent of total billed charges,,,255.86,95,,percent of total billed charges,,,223.54,83,,percent of total billed charges,,,223.54,83,,percent of total billed charges,,,,,,,,,,,,,,,223.54,83,,percent of total billed charges,,,255.86,95,,percent of total billed charges,,,242.4,90,,percent of total billed charges,,,242.4,90,,percent of total billed charges,,,220.85,82,,percent of total billed charges,,,242.4,90,,percent of total billed charges,,,228.93,85,,percent of total billed charges,,203.07,255.86,
CRYO KNEE CUFF L,30180397,CDM,,,270,RC,inpatient,,255.38,255.38,,216.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,192.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,217.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,224.73,88,,percent of total billed charges,,,,,,,,,195.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,232.4,91,,percent of total billed charges,,,242.61,95,,percent of total billed charges,,,211.97,83,,percent of total billed charges,,,211.97,83,,percent of total billed charges,,,,,,,,,,,,,,,211.97,83,,percent of total billed charges,,,242.61,95,,percent of total billed charges,,,229.84,90,,percent of total billed charges,,,229.84,90,,percent of total billed charges,,,209.41,82,,percent of total billed charges,,,229.84,90,,percent of total billed charges,,,217.07,85,,percent of total billed charges,,192.56,242.61,
CRYO SHOULDER CUFF W/ XL STRAP,30180399,CDM,,,270,RC,inpatient,,312.75,312.75,,265.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,235.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,265.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,275.22,88,,percent of total billed charges,,,,,,,,,238.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,284.6,91,,percent of total billed charges,,,297.11,95,,percent of total billed charges,,,259.58,83,,percent of total billed charges,,,259.58,83,,percent of total billed charges,,,,,,,,,,,,,,,259.58,83,,percent of total billed charges,,,297.11,95,,percent of total billed charges,,,281.48,90,,percent of total billed charges,,,281.48,90,,percent of total billed charges,,,256.46,82,,percent of total billed charges,,,281.48,90,,percent of total billed charges,,,265.84,85,,percent of total billed charges,,235.81,297.11,
CRYO CUFF IC COOLER,30180400,CDM,,,270,RC,inpatient,,383.6,383.6,,325.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,289.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,326.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,337.57,88,,percent of total billed charges,,,,,,,,,293.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,349.08,91,,percent of total billed charges,,,364.42,95,,percent of total billed charges,,,318.39,83,,percent of total billed charges,,,318.39,83,,percent of total billed charges,,,,,,,,,,,,,,,318.39,83,,percent of total billed charges,,,364.42,95,,percent of total billed charges,,,345.24,90,,percent of total billed charges,,,345.24,90,,percent of total billed charges,,,314.55,82,,percent of total billed charges,,,345.24,90,,percent of total billed charges,,,326.06,85,,percent of total billed charges,,289.23,364.42,
AV IMPULSE PAD REG,30180402,CDM,,,270,RC,inpatient,,408.77,408.77,,347.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,308.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,347.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,359.72,88,,percent of total billed charges,,,,,,,,,312.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,371.98,91,,percent of total billed charges,,,388.33,95,,percent of total billed charges,,,339.28,83,,percent of total billed charges,,,339.28,83,,percent of total billed charges,,,,,,,,,,,,,,,339.28,83,,percent of total billed charges,,,388.33,95,,percent of total billed charges,,,367.89,90,,percent of total billed charges,,,367.89,90,,percent of total billed charges,,,335.19,82,,percent of total billed charges,,,367.89,90,,percent of total billed charges,,,347.45,85,,percent of total billed charges,,308.21,388.33,
AV IMPULSE PAD LG,30180403,CDM,,,270,RC,inpatient,,408.77,408.77,,347.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,308.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,347.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,359.72,88,,percent of total billed charges,,,,,,,,,312.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,371.98,91,,percent of total billed charges,,,388.33,95,,percent of total billed charges,,,339.28,83,,percent of total billed charges,,,339.28,83,,percent of total billed charges,,,,,,,,,,,,,,,339.28,83,,percent of total billed charges,,,388.33,95,,percent of total billed charges,,,367.89,90,,percent of total billed charges,,,367.89,90,,percent of total billed charges,,,335.19,82,,percent of total billed charges,,,367.89,90,,percent of total billed charges,,,347.45,85,,percent of total billed charges,,308.21,388.33,
CPM UNIVERSAL PAD SET,30180404,CDM,,,270,RC,inpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,108.58,136.8,
ARTHROSCOPY TUBING,30180405,CDM,,,270,RC,inpatient,,463.7,463.7,,393.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.06,88,,percent of total billed charges,,,,,,,,,354.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,421.97,91,,percent of total billed charges,,,440.52,95,,percent of total billed charges,,,384.87,83,,percent of total billed charges,,,384.87,83,,percent of total billed charges,,,,,,,,,,,,,,,384.87,83,,percent of total billed charges,,,440.52,95,,percent of total billed charges,,,417.33,90,,percent of total billed charges,,,417.33,90,,percent of total billed charges,,,380.23,82,,percent of total billed charges,,,417.33,90,,percent of total billed charges,,,394.15,85,,percent of total billed charges,,349.63,440.52,
SHOULDER ABDUCTION SLING - MED,30180407,CDM,,,270,RC,inpatient,,36.99,36.99,,31.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.55,88,,percent of total billed charges,,,,,,,,,28.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.66,91,,percent of total billed charges,,,35.14,95,,percent of total billed charges,,,30.7,83,,percent of total billed charges,,,30.7,83,,percent of total billed charges,,,,,,,,,,,,,,,30.7,83,,percent of total billed charges,,,35.14,95,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,30.33,82,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,31.44,85,,percent of total billed charges,,27.89,35.14,
SHOULDER ABDUCTION SLING - LGE,30180408,CDM,,,270,RC,inpatient,,36.99,36.99,,31.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.55,88,,percent of total billed charges,,,,,,,,,28.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.66,91,,percent of total billed charges,,,35.14,95,,percent of total billed charges,,,30.7,83,,percent of total billed charges,,,30.7,83,,percent of total billed charges,,,,,,,,,,,,,,,30.7,83,,percent of total billed charges,,,35.14,95,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,30.33,82,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,31.44,85,,percent of total billed charges,,27.89,35.14,
STRYKER BUR 4.0 FLUTED,30180433,CDM,,,270,RC,inpatient,,492.49,492.49,,418.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,371.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,418.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,433.39,88,,percent of total billed charges,,,,,,,,,376.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,448.17,91,,percent of total billed charges,,,467.87,95,,percent of total billed charges,,,408.77,83,,percent of total billed charges,,,408.77,83,,percent of total billed charges,,,,,,,,,,,,,,,408.77,83,,percent of total billed charges,,,467.87,95,,percent of total billed charges,,,443.24,90,,percent of total billed charges,,,443.24,90,,percent of total billed charges,,,403.84,82,,percent of total billed charges,,,443.24,90,,percent of total billed charges,,,418.62,85,,percent of total billed charges,,371.34,467.87,
STRYKER BUR 5.0 FLUTED,30180434,CDM,,,270,RC,inpatient,,492.49,492.49,,418.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,371.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,418.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,433.39,88,,percent of total billed charges,,,,,,,,,376.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,448.17,91,,percent of total billed charges,,,467.87,95,,percent of total billed charges,,,408.77,83,,percent of total billed charges,,,408.77,83,,percent of total billed charges,,,,,,,,,,,,,,,408.77,83,,percent of total billed charges,,,467.87,95,,percent of total billed charges,,,443.24,90,,percent of total billed charges,,,443.24,90,,percent of total billed charges,,,403.84,82,,percent of total billed charges,,,443.24,90,,percent of total billed charges,,,418.62,85,,percent of total billed charges,,371.34,467.87,
S&N ENDO FAST KIT CURVED,30180440,CDM,,,270,RC,inpatient,,1956.5,1956.5,,1661.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1475.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1663.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1721.72,88,,percent of total billed charges,,,,,,,,,1494.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1780.42,91,,percent of total billed charges,,,1858.68,95,,percent of total billed charges,,,1623.9,83,,percent of total billed charges,,,1623.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1623.9,83,,percent of total billed charges,,,1858.68,95,,percent of total billed charges,,,1760.85,90,,percent of total billed charges,,,1760.85,90,,percent of total billed charges,,,1604.33,82,,percent of total billed charges,,,1760.85,90,,percent of total billed charges,,,1663.03,85,,percent of total billed charges,,1475.2,1858.68,
S&N ENDO SUTURE CUTTER,30180442,CDM,,,270,RC,inpatient,,913.9,913.9,,775.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,689.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,776.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,804.23,88,,percent of total billed charges,,,,,,,,,698.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,831.65,91,,percent of total billed charges,,,868.21,95,,percent of total billed charges,,,758.54,83,,percent of total billed charges,,,758.54,83,,percent of total billed charges,,,,,,,,,,,,,,,758.54,83,,percent of total billed charges,,,868.21,95,,percent of total billed charges,,,822.51,90,,percent of total billed charges,,,822.51,90,,percent of total billed charges,,,749.4,82,,percent of total billed charges,,,822.51,90,,percent of total billed charges,,,776.82,85,,percent of total billed charges,,689.08,868.21,
SYNTHES SCREW CORTEX 3.5X20MM,30180448,CDM,,,278,RC,inpatient,,267.75,267.75,,227.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,201.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,227.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,235.62,88,,percent of total billed charges,,,,,,,,,204.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,243.65,91,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,,,,,,,,,,,,,222.23,83,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,219.56,82,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,227.59,85,,percent of total billed charges,,201.88,254.36,
SYNTHES SCREW CANCEL F-THD 4.0X22MM,30180449,CDM,,,278,RC,inpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,168.24,211.97,
DEPUY FRACTURE HEAD HIP BALL 53MM,30180462,CDM,,,278,RC,inpatient,,4693.78,4693.78,,3985.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3539.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3989.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4130.53,88,,percent of total billed charges,,,,,,,,,3586.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4271.34,91,,percent of total billed charges,,,4459.09,95,,percent of total billed charges,,,3895.84,83,,percent of total billed charges,,,3895.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3895.84,83,,percent of total billed charges,,,4459.09,95,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,3848.9,82,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,3989.71,85,,percent of total billed charges,,3539.11,4459.09,
DEPUY SPACER 12/14 MMLGT +5,30180463,CDM,,,278,RC,inpatient,,1935.57,1935.57,,1643.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1459.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1645.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1703.3,88,,percent of total billed charges,,,,,,,,,1478.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1761.37,91,,percent of total billed charges,,,1838.79,95,,percent of total billed charges,,,1606.52,83,,percent of total billed charges,,,1606.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1606.52,83,,percent of total billed charges,,,1838.79,95,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1587.17,82,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1645.23,85,,percent of total billed charges,,1459.42,1838.79,
GYRUS PLASMA SPATULA,30180466,CDM,,,270,RC,inpatient,,2509,2509,,2130.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1891.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2132.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2207.92,88,,percent of total billed charges,,,,,,,,,1916.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2283.19,91,,percent of total billed charges,,,2383.55,95,,percent of total billed charges,,,2082.47,83,,percent of total billed charges,,,2082.47,83,,percent of total billed charges,,,,,,,,,,,,,,,2082.47,83,,percent of total billed charges,,,2383.55,95,,percent of total billed charges,,,2258.1,90,,percent of total billed charges,,,2258.1,90,,percent of total billed charges,,,2057.38,82,,percent of total billed charges,,,2258.1,90,,percent of total billed charges,,,2132.65,85,,percent of total billed charges,,1891.79,2383.55,
DEPUY STEM SUMMIT PRESSFIT SZ4,30180469,CDM,,,278,RC,inpatient,,11591.45,11591.45,,9841.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8739.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9852.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10200.48,88,,percent of total billed charges,,,,,,,,,8855.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10548.22,91,,percent of total billed charges,,,11011.88,95,,percent of total billed charges,,,9620.9,83,,percent of total billed charges,,,9620.9,83,,percent of total billed charges,,,,,,,,,,,,,,,9620.9,83,,percent of total billed charges,,,11011.88,95,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,9504.99,82,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,9852.73,85,,percent of total billed charges,,8739.95,11011.88,
DEPUY BIPOLAR CUP 45MM,30180470,CDM,,,278,RC,inpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,6126.3,7718.82,
DEPUY FEMORAL HEAD 28 +1.5,30180471,CDM,,,278,RC,inpatient,,7289.17,7289.17,,6188.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5496.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6195.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6414.47,88,,percent of total billed charges,,,,,,,,,5568.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6633.14,91,,percent of total billed charges,,,6924.71,95,,percent of total billed charges,,,6050.01,83,,percent of total billed charges,,,6050.01,83,,percent of total billed charges,,,,,,,,,,,,,,,6050.01,83,,percent of total billed charges,,,6924.71,95,,percent of total billed charges,,,6560.25,90,,percent of total billed charges,,,6560.25,90,,percent of total billed charges,,,5977.12,82,,percent of total billed charges,,,6560.25,90,,percent of total billed charges,,,6195.79,85,,percent of total billed charges,,5496.03,6924.71,
SYNTHES SCREW LOCKING 3.5X18MM,30180476,CDM,,,278,RC,inpatient,,1217.84,1217.84,,1033.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,918.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1035.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1071.7,88,,percent of total billed charges,,,,,,,,,930.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1108.23,91,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1010.81,83,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,998.63,82,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,918.25,1156.95,
SYNTHES SCREW LOCKING 3.5X20MM,30180477,CDM,,,278,RC,inpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,945.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1066.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,945.79,1191.65,
SYNTHES SCREW LOCKING 3.5X30MM,30180478,CDM,,,278,RC,inpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,945.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1066.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,945.79,1191.65,
SYNTHES PLATE LCP 8-HOLE 3.5MM,30180480,CDM,,,278,RC,inpatient,,3193.45,3193.45,,2711.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2407.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2714.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2810.24,88,,percent of total billed charges,,,,,,,,,2439.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2906.04,91,,percent of total billed charges,,,3033.78,95,,percent of total billed charges,,,2650.56,83,,percent of total billed charges,,,2650.56,83,,percent of total billed charges,,,,,,,,,,,,,,,2650.56,83,,percent of total billed charges,,,3033.78,95,,percent of total billed charges,,,2874.11,90,,percent of total billed charges,,,2874.11,90,,percent of total billed charges,,,2618.63,82,,percent of total billed charges,,,2874.11,90,,percent of total billed charges,,,2714.43,85,,percent of total billed charges,,2407.86,3033.78,
ARTHREX FIBERTAPE #2,30180501,CDM,,,270,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
SYNTHES SCREW CORTEX 3.5X12MM,30180503,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
SYNTHES SCREW CORTEX 3.5X30MM,30180504,CDM,,,278,RC,inpatient,,267.75,267.75,,227.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,201.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,227.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,235.62,88,,percent of total billed charges,,,,,,,,,204.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,243.65,91,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,,,,,,,,,,,,,222.23,83,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,219.56,82,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,227.59,85,,percent of total billed charges,,201.88,254.36,
MAGNUM WIRE WITH NEEDLE,30180509,CDM,,,270,RC,inpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,169.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,191.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,169.65,213.75,
S&N ENDO ARTHROPIERCE STR,30180511,CDM,,,278,RC,inpatient,,5569.2,5569.2,,4728.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4199.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4733.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4900.9,88,,percent of total billed charges,,,,,,,,,4254.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5067.97,91,,percent of total billed charges,,,5290.74,95,,percent of total billed charges,,,4622.44,83,,percent of total billed charges,,,4622.44,83,,percent of total billed charges,,,,,,,,,,,,,,,4622.44,83,,percent of total billed charges,,,5290.74,95,,percent of total billed charges,,,5012.28,90,,percent of total billed charges,,,5012.28,90,,percent of total billed charges,,,4566.74,82,,percent of total billed charges,,,5012.28,90,,percent of total billed charges,,,4733.82,85,,percent of total billed charges,,4199.18,5290.74,
ARTHREX KNOT PUSHER CUTTER,30180518,CDM,,,270,RC,inpatient,,875,875,,742.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,659.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,743.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,770,88,,percent of total billed charges,,,,,,,,,668.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,796.25,91,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,,,,,,,,,,,,,726.25,83,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,717.5,82,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,659.75,831.25,
ARTHREX MENISCUS CINCH,30180523,CDM,,,270,RC,inpatient,,1852.5,1852.5,,1572.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1396.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1574.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1630.2,88,,percent of total billed charges,,,,,,,,,1415.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1685.78,91,,percent of total billed charges,,,1759.88,95,,percent of total billed charges,,,1537.58,83,,percent of total billed charges,,,1537.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1537.58,83,,percent of total billed charges,,,1759.88,95,,percent of total billed charges,,,1667.25,90,,percent of total billed charges,,,1667.25,90,,percent of total billed charges,,,1519.05,82,,percent of total billed charges,,,1667.25,90,,percent of total billed charges,,,1574.63,85,,percent of total billed charges,,1396.79,1759.88,
ARTHREX SUTURE LASSO 30 STR,30180524,CDM,,,270,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
ARTHREX SUTURE LASSO 90 LEFT,30180526,CDM,,,270,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
ARTHREX SUTURE LASSO 90 RIGHT,30180527,CDM,,,270,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
ARTHREX SUTURE LASSO 25 LEFT,30180528,CDM,,,270,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
ARTHREX SUTURE LASSO 25 RIGHT,30180529,CDM,,,270,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
ARTHREX FIBERWIRE 2MM 18,30180531,CDM,,,270,RC,inpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,132.7,167.2,
SYNTHES SCREW CORTEX 3.5X38MM,30180533,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
DEPUY PINNACLE CUP 54MM,30180540,CDM,,,278,RC,inpatient,,14472.9,14472.9,,12287.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10912.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12301.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12736.15,88,,percent of total billed charges,,,,,,,,,11057.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13170.34,91,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12012.51,83,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,11867.78,82,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,10912.57,13749.26,
DEPUY HOLE ELININATOR-PS,30180541,CDM,,,278,RC,inpatient,,1557.27,1557.27,,1322.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1174.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1323.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1370.4,88,,percent of total billed charges,,,,,,,,,1189.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1417.12,91,,percent of total billed charges,,,1479.41,95,,percent of total billed charges,,,1292.53,83,,percent of total billed charges,,,1292.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1292.53,83,,percent of total billed charges,,,1479.41,95,,percent of total billed charges,,,1401.54,90,,percent of total billed charges,,,1401.54,90,,percent of total billed charges,,,1276.96,82,,percent of total billed charges,,,1401.54,90,,percent of total billed charges,,,1323.68,85,,percent of total billed charges,,1174.18,1479.41,
DEPUY LINER ALTRX +4 NEUT 36 X 54,30180542,CDM,,,278,RC,inpatient,,14161.81,14161.81,,12023.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10678,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12037.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12462.39,88,,percent of total billed charges,,,,,,,,,10819.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12887.25,91,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,,,,,,,,,,,,,11754.3,83,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,11612.68,82,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,10678,13453.72,
DEPUY FEMORAL HEAD 36MM +8.5,30180543,CDM,,,278,RC,inpatient,,15642.97,15642.97,,13280.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11794.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13296.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13765.81,88,,percent of total billed charges,,,,,,,,,11951.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14235.1,91,,percent of total billed charges,,,14860.82,95,,percent of total billed charges,,,12983.67,83,,percent of total billed charges,,,12983.67,83,,percent of total billed charges,,,,,,,,,,,,,,,12983.67,83,,percent of total billed charges,,,14860.82,95,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,12827.24,82,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,13296.52,85,,percent of total billed charges,,11794.8,14860.82,
DEPUY STEM CORAIL STD SZ11,30180544,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY FEMUR POROUS LT SZ4,30180547,CDM,,,278,RC,inpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27261.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30732.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,27261.42,34347.94,
DEPUY INSERT SIGMA XLK 4 X 8,30180548,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY FEMUR POROUS RT SZ4,30180550,CDM,,,278,RC,inpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27261.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30732.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,27261.42,34347.94,
CRYO HAND/WRIST CUFF,30180552,CDM,,,270,RC,inpatient,,269.33,269.33,,228.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,203.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,228.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,237.01,88,,percent of total billed charges,,,,,,,,,205.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,245.09,91,,percent of total billed charges,,,255.86,95,,percent of total billed charges,,,223.54,83,,percent of total billed charges,,,223.54,83,,percent of total billed charges,,,,,,,,,,,,,,,223.54,83,,percent of total billed charges,,,255.86,95,,percent of total billed charges,,,242.4,90,,percent of total billed charges,,,242.4,90,,percent of total billed charges,,,220.85,82,,percent of total billed charges,,,242.4,90,,percent of total billed charges,,,228.93,85,,percent of total billed charges,,203.07,255.86,
ENCORE TIBIAL INSERT POLY,30180555,CDM,,,270,RC,inpatient,,7787,7787,,6611.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5871.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6618.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6852.56,88,,percent of total billed charges,,,,,,,,,5949.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7086.17,91,,percent of total billed charges,,,7397.65,95,,percent of total billed charges,,,6463.21,83,,percent of total billed charges,,,6463.21,83,,percent of total billed charges,,,,,,,,,,,,,,,6463.21,83,,percent of total billed charges,,,7397.65,95,,percent of total billed charges,,,7008.3,90,,percent of total billed charges,,,7008.3,90,,percent of total billed charges,,,6385.34,82,,percent of total billed charges,,,7008.3,90,,percent of total billed charges,,,6618.95,85,,percent of total billed charges,,5871.4,7397.65,
ENCORE FEMUR RT SZ4,30180556,CDM,,,270,RC,inpatient,,16135.28,16135.28,,13698.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12166,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13714.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14199.05,88,,percent of total billed charges,,,,,,,,,12327.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14683.1,91,,percent of total billed charges,,,15328.52,95,,percent of total billed charges,,,13392.28,83,,percent of total billed charges,,,13392.28,83,,percent of total billed charges,,,,,,,,,,,,,,,13392.28,83,,percent of total billed charges,,,15328.52,95,,percent of total billed charges,,,14521.75,90,,percent of total billed charges,,,14521.75,90,,percent of total billed charges,,,13230.93,82,,percent of total billed charges,,,14521.75,90,,percent of total billed charges,,,13714.99,85,,percent of total billed charges,,12166,15328.52,
ENCORE TIBIA RT SZ4,30180557,CDM,,,270,RC,inpatient,,10351.25,10351.25,,8788.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7804.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8798.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9109.1,88,,percent of total billed charges,,,,,,,,,7908.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9419.64,91,,percent of total billed charges,,,9833.69,95,,percent of total billed charges,,,8591.54,83,,percent of total billed charges,,,8591.54,83,,percent of total billed charges,,,,,,,,,,,,,,,8591.54,83,,percent of total billed charges,,,9833.69,95,,percent of total billed charges,,,9316.13,90,,percent of total billed charges,,,9316.13,90,,percent of total billed charges,,,8488.03,82,,percent of total billed charges,,,9316.13,90,,percent of total billed charges,,,8798.56,85,,percent of total billed charges,,7804.84,9833.69,
ENCORE PATELLA 29MM,30180558,CDM,,,270,RC,inpatient,,4486.95,4486.95,,3809.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3383.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3813.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3948.52,88,,percent of total billed charges,,,,,,,,,3428.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4083.12,91,,percent of total billed charges,,,4262.6,95,,percent of total billed charges,,,3724.17,83,,percent of total billed charges,,,3724.17,83,,percent of total billed charges,,,,,,,,,,,,,,,3724.17,83,,percent of total billed charges,,,4262.6,95,,percent of total billed charges,,,4038.26,90,,percent of total billed charges,,,4038.26,90,,percent of total billed charges,,,3679.3,82,,percent of total billed charges,,,4038.26,90,,percent of total billed charges,,,3813.91,85,,percent of total billed charges,,3383.16,4262.6,
ENCORE SAW BLADE,30180559,CDM,,,270,RC,inpatient,,751.45,751.45,,637.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,566.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,638.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,661.28,88,,percent of total billed charges,,,,,,,,,574.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,683.82,91,,percent of total billed charges,,,713.88,95,,percent of total billed charges,,,623.7,83,,percent of total billed charges,,,623.7,83,,percent of total billed charges,,,,,,,,,,,,,,,623.7,83,,percent of total billed charges,,,713.88,95,,percent of total billed charges,,,676.31,90,,percent of total billed charges,,,676.31,90,,percent of total billed charges,,,616.19,82,,percent of total billed charges,,,676.31,90,,percent of total billed charges,,,638.73,85,,percent of total billed charges,,566.59,713.88,
CONTRAST OMNIPAQUE-300 50ML,30180565,CDM,,,270,RC,inpatient,,349.28,349.28,,296.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,263.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,296.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,307.37,88,,percent of total billed charges,,,,,,,,,266.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,317.84,91,,percent of total billed charges,,,331.82,95,,percent of total billed charges,,,289.9,83,,percent of total billed charges,,,289.9,83,,percent of total billed charges,,,,,,,,,,,,,,,289.9,83,,percent of total billed charges,,,331.82,95,,percent of total billed charges,,,314.35,90,,percent of total billed charges,,,314.35,90,,percent of total billed charges,,,286.41,82,,percent of total billed charges,,,314.35,90,,percent of total billed charges,,,296.89,85,,percent of total billed charges,,263.36,331.82,
S&N ENDO FAST KIT STRAIGHT,30180566,CDM,,,270,RC,inpatient,,1392.5,1392.5,,1182.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1049.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1183.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1225.4,88,,percent of total billed charges,,,,,,,,,1063.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1267.18,91,,percent of total billed charges,,,1322.88,95,,percent of total billed charges,,,1155.78,83,,percent of total billed charges,,,1155.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1155.78,83,,percent of total billed charges,,,1322.88,95,,percent of total billed charges,,,1253.25,90,,percent of total billed charges,,,1253.25,90,,percent of total billed charges,,,1141.85,82,,percent of total billed charges,,,1253.25,90,,percent of total billed charges,,,1183.63,85,,percent of total billed charges,,1049.95,1322.88,
APERFIX FEMORAL IMPLANT 9 X 29,30180567,CDM,,,270,RC,inpatient,,4182.75,4182.75,,3551.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3153.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3555.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3680.82,88,,percent of total billed charges,,,,,,,,,3195.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3806.3,91,,percent of total billed charges,,,3973.61,95,,percent of total billed charges,,,3471.68,83,,percent of total billed charges,,,3471.68,83,,percent of total billed charges,,,,,,,,,,,,,,,3471.68,83,,percent of total billed charges,,,3973.61,95,,percent of total billed charges,,,3764.48,90,,percent of total billed charges,,,3764.48,90,,percent of total billed charges,,,3429.86,82,,percent of total billed charges,,,3764.48,90,,percent of total billed charges,,,3555.34,85,,percent of total billed charges,,3153.79,3973.61,
APERFIX GUIDEWIRE 14,30180568,CDM,,,270,RC,inpatient,,787.5,787.5,,668.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,593.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,669.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,693,88,,percent of total billed charges,,,,,,,,,601.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,716.63,91,,percent of total billed charges,,,748.13,95,,percent of total billed charges,,,653.63,83,,percent of total billed charges,,,653.63,83,,percent of total billed charges,,,,,,,,,,,,,,,653.63,83,,percent of total billed charges,,,748.13,95,,percent of total billed charges,,,708.75,90,,percent of total billed charges,,,708.75,90,,percent of total billed charges,,,645.75,82,,percent of total billed charges,,,708.75,90,,percent of total billed charges,,,669.38,85,,percent of total billed charges,,593.78,748.13,
APERFIX TIBIAL IMPLANT 9 X 30,30180569,CDM,,,270,RC,inpatient,,2018.25,2018.25,,1713.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1521.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1715.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1776.06,88,,percent of total billed charges,,,,,,,,,1541.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1836.61,91,,percent of total billed charges,,,1917.34,95,,percent of total billed charges,,,1675.15,83,,percent of total billed charges,,,1675.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1675.15,83,,percent of total billed charges,,,1917.34,95,,percent of total billed charges,,,1816.43,90,,percent of total billed charges,,,1816.43,90,,percent of total billed charges,,,1654.97,82,,percent of total billed charges,,,1816.43,90,,percent of total billed charges,,,1715.51,85,,percent of total billed charges,,1521.76,1917.34,
DEPUY FEMUR CEMENTED RT SZ3,30180570,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
DEPUY INSERT SIGMA XLK 4 X 10,30180571,CDM,,,278,RC,inpatient,,12163.26,12163.26,,10326.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9171.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10338.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10703.67,88,,percent of total billed charges,,,,,,,,,9292.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11068.57,91,,percent of total billed charges,,,11555.1,95,,percent of total billed charges,,,10095.51,83,,percent of total billed charges,,,10095.51,83,,percent of total billed charges,,,,,,,,,,,,,,,10095.51,83,,percent of total billed charges,,,11555.1,95,,percent of total billed charges,,,10946.93,90,,percent of total billed charges,,,10946.93,90,,percent of total billed charges,,,9973.87,82,,percent of total billed charges,,,10946.93,90,,percent of total billed charges,,,10338.77,85,,percent of total billed charges,,9171.1,11555.1,
DEPUY PATELLA 3-PEG 41MM,30180572,CDM,,,278,RC,inpatient,,5578.95,5578.95,,4736.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4206.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4742.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4909.48,88,,percent of total billed charges,,,,,,,,,4262.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5076.84,91,,percent of total billed charges,,,5300,95,,percent of total billed charges,,,4630.53,83,,percent of total billed charges,,,4630.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4630.53,83,,percent of total billed charges,,,5300,95,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,4574.74,82,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,4742.11,85,,percent of total billed charges,,4206.53,5300,
DEPUY FEMUR CEMENTED RT SZ4,30180573,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
DEPUY PINNACLE CUP 50MM,30180579,CDM,,,278,RC,inpatient,,14472.9,14472.9,,12287.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10912.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12301.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12736.15,88,,percent of total billed charges,,,,,,,,,11057.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13170.34,91,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12012.51,83,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,11867.78,82,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,10912.57,13749.26,
DEPUY LINER ALTRX +4 NUET 50 X 32,30180580,CDM,,,278,RC,inpatient,,11494.99,11494.99,,9759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8667.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9770.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10115.59,88,,percent of total billed charges,,,,,,,,,8782.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10460.44,91,,percent of total billed charges,,,10920.24,95,,percent of total billed charges,,,9540.84,83,,percent of total billed charges,,,9540.84,83,,percent of total billed charges,,,,,,,,,,,,,,,9540.84,83,,percent of total billed charges,,,10920.24,95,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,9425.89,82,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,9770.74,85,,percent of total billed charges,,8667.22,10920.24,
DEPUY FEMORAL HEAD 32 +5,30180581,CDM,,,278,RC,inpatient,,5683.54,5683.54,,4825.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4285.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4831.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5001.52,88,,percent of total billed charges,,,,,,,,,4342.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5172.02,91,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,,,,,,,,,,,,,4717.34,83,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4660.5,82,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4831.01,85,,percent of total billed charges,,4285.39,5399.36,
DEPUY STEM CORAIL STD SZ10,30180582,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY LINER ALTRX NEUT 36 X 62,30180584,CDM,,,278,RC,inpatient,,13197.15,13197.15,,11204.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9950.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11217.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11613.49,88,,percent of total billed charges,,,,,,,,,10082.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12009.41,91,,percent of total billed charges,,,12537.29,95,,percent of total billed charges,,,10953.63,83,,percent of total billed charges,,,10953.63,83,,percent of total billed charges,,,,,,,,,,,,,,,10953.63,83,,percent of total billed charges,,,12537.29,95,,percent of total billed charges,,,11877.44,90,,percent of total billed charges,,,11877.44,90,,percent of total billed charges,,,10821.66,82,,percent of total billed charges,,,11877.44,90,,percent of total billed charges,,,11217.58,85,,percent of total billed charges,,9950.65,12537.29,
DEPUY BIOLOX HEAD 36MM +1.5,30180585,CDM,,,278,RC,inpatient,,15642.67,15642.67,,13280.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11794.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13296.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13765.55,88,,percent of total billed charges,,,,,,,,,11951,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14234.83,91,,percent of total billed charges,,,14860.54,95,,percent of total billed charges,,,12983.42,83,,percent of total billed charges,,,12983.42,83,,percent of total billed charges,,,,,,,,,,,,,,,12983.42,83,,percent of total billed charges,,,14860.54,95,,percent of total billed charges,,,14078.4,90,,percent of total billed charges,,,14078.4,90,,percent of total billed charges,,,12826.99,82,,percent of total billed charges,,,14078.4,90,,percent of total billed charges,,,13296.27,85,,percent of total billed charges,,11794.57,14860.54,
DEPUY STEM CORAIL STD SZ15,30180586,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY PINNACLE CUP 60MM,30180587,CDM,,,278,RC,inpatient,,14472.9,14472.9,,12287.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10912.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12301.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12736.15,88,,percent of total billed charges,,,,,,,,,11057.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13170.34,91,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12012.51,83,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,11867.78,82,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,10912.57,13749.26,
DEPUY LINER ALTRX NEUT 36 X 60,30180588,CDM,,,278,RC,inpatient,,12874.42,12874.42,,10930.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9707.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10943.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11329.49,88,,percent of total billed charges,,,,,,,,,9836.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11715.72,91,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,,,,,,,,,,,,,10685.77,83,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10557.02,82,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10943.26,85,,percent of total billed charges,,9707.31,12230.7,
DEPUY PINNACLE CUP 56MM,30180589,CDM,,,278,RC,inpatient,,14472.9,14472.9,,12287.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10912.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12301.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12736.15,88,,percent of total billed charges,,,,,,,,,11057.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13170.34,91,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12012.51,83,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,11867.78,82,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,10912.57,13749.26,
DEPUY LINER ALTRX NEUT 36 X 56,30180590,CDM,,,278,RC,inpatient,,12874.42,12874.42,,10930.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9707.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10943.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11329.49,88,,percent of total billed charges,,,,,,,,,9836.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11715.72,91,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,,,,,,,,,,,,,10685.77,83,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10557.02,82,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10943.26,85,,percent of total billed charges,,9707.31,12230.7,
DEPUY FEMORAL HEAD 36MM +5,30180591,CDM,,,278,RC,inpatient,,8569.34,8569.34,,7275.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6461.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7283.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7541.02,88,,percent of total billed charges,,,,,,,,,6546.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7798.1,91,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7112.55,83,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7026.86,82,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,6461.28,8140.87,
DEPUY STEM CORAIL STD SZ18,30180592,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY STEM CORAIL STD SZ13,30180593,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY FEMUR CEMENTED LT SZ3,30180600,CDM,,,278,RC,inpatient,,20746.18,20746.18,,17613.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15642.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17634.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18256.64,88,,percent of total billed charges,,,,,,,,,15850.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18879.02,91,,percent of total billed charges,,,19708.87,95,,percent of total billed charges,,,17219.33,83,,percent of total billed charges,,,17219.33,83,,percent of total billed charges,,,,,,,,,,,,,,,17219.33,83,,percent of total billed charges,,,19708.87,95,,percent of total billed charges,,,18671.56,90,,percent of total billed charges,,,18671.56,90,,percent of total billed charges,,,17011.87,82,,percent of total billed charges,,,18671.56,90,,percent of total billed charges,,,17634.25,85,,percent of total billed charges,,15642.62,19708.87,
DEPUY INSERT SIGMA XLK 3 X 15,30180601,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY INSERT SIGMA XLK 3 X 8,30180602,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY PATELLA 3-PEG 35MM,30180603,CDM,,,278,RC,inpatient,,5578.95,5578.95,,4736.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4206.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4742.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4909.48,88,,percent of total billed charges,,,,,,,,,4262.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5076.84,91,,percent of total billed charges,,,5300,95,,percent of total billed charges,,,4630.53,83,,percent of total billed charges,,,4630.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4630.53,83,,percent of total billed charges,,,5300,95,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,4574.74,82,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,4742.11,85,,percent of total billed charges,,4206.53,5300,
DEPUY TIBIAL TRAY SZ3,30180604,CDM,,,270,RC,inpatient,,17711.46,17711.46,,15037.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13354.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15054.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15586.08,88,,percent of total billed charges,,,,,,,,,13531.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16117.43,91,,percent of total billed charges,,,16825.89,95,,percent of total billed charges,,,14700.51,83,,percent of total billed charges,,,14700.51,83,,percent of total billed charges,,,,,,,,,,,,,,,14700.51,83,,percent of total billed charges,,,16825.89,95,,percent of total billed charges,,,15940.31,90,,percent of total billed charges,,,15940.31,90,,percent of total billed charges,,,14523.4,82,,percent of total billed charges,,,15940.31,90,,percent of total billed charges,,,15054.74,85,,percent of total billed charges,,13354.44,16825.89,
RELIEVA SINUS GUIDE CATHETER 0 DEGREE,30180607,CDM,,,270,RC,inpatient,,2886,2886,,2450.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2176.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2453.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2539.68,88,,percent of total billed charges,,,,,,,,,2204.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2626.26,91,,percent of total billed charges,,,2741.7,95,,percent of total billed charges,,,2395.38,83,,percent of total billed charges,,,2395.38,83,,percent of total billed charges,,,,,,,,,,,,,,,2395.38,83,,percent of total billed charges,,,2741.7,95,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2366.52,82,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2453.1,85,,percent of total billed charges,,2176.04,2741.7,
RELIEVA SINUS BALLOON CATHETER 7X16,30180608,CDM,,,270,RC,inpatient,,6115.2,6115.2,,5191.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4610.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5197.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5381.38,88,,percent of total billed charges,,,,,,,,,4672.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5564.83,91,,percent of total billed charges,,,5809.44,95,,percent of total billed charges,,,5075.62,83,,percent of total billed charges,,,5075.62,83,,percent of total billed charges,,,,,,,,,,,,,,,5075.62,83,,percent of total billed charges,,,5809.44,95,,percent of total billed charges,,,5503.68,90,,percent of total billed charges,,,5503.68,90,,percent of total billed charges,,,5014.46,82,,percent of total billed charges,,,5503.68,90,,percent of total billed charges,,,5197.92,85,,percent of total billed charges,,4610.86,5809.44,
RELIEVA SINUS GUIDE CATHETER M-110,30180610,CDM,,,270,RC,inpatient,,2886,2886,,2450.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2176.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2453.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2539.68,88,,percent of total billed charges,,,,,,,,,2204.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2626.26,91,,percent of total billed charges,,,2741.7,95,,percent of total billed charges,,,2395.38,83,,percent of total billed charges,,,2395.38,83,,percent of total billed charges,,,,,,,,,,,,,,,2395.38,83,,percent of total billed charges,,,2741.7,95,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2366.52,82,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2453.1,85,,percent of total billed charges,,2176.04,2741.7,
RELIEVA LUMA SENTRY ILLUMINATION SYSTEM,30180612,CDM,,,270,RC,inpatient,,3346.2,3346.2,,2840.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2523.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2844.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2944.66,88,,percent of total billed charges,,,,,,,,,2556.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3045.04,91,,percent of total billed charges,,,3178.89,95,,percent of total billed charges,,,2777.35,83,,percent of total billed charges,,,2777.35,83,,percent of total billed charges,,,,,,,,,,,,,,,2777.35,83,,percent of total billed charges,,,3178.89,95,,percent of total billed charges,,,3011.58,90,,percent of total billed charges,,,3011.58,90,,percent of total billed charges,,,2743.88,82,,percent of total billed charges,,,3011.58,90,,percent of total billed charges,,,2844.27,85,,percent of total billed charges,,2523.03,3178.89,
RELIEVA BALLOON INFLATION DEVICE,30180614,CDM,,,270,RC,inpatient,,521.85,521.85,,443.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,393.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,443.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,459.23,88,,percent of total billed charges,,,,,,,,,398.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,474.88,91,,percent of total billed charges,,,495.76,95,,percent of total billed charges,,,433.14,83,,percent of total billed charges,,,433.14,83,,percent of total billed charges,,,,,,,,,,,,,,,433.14,83,,percent of total billed charges,,,495.76,95,,percent of total billed charges,,,469.67,90,,percent of total billed charges,,,469.67,90,,percent of total billed charges,,,427.92,82,,percent of total billed charges,,,469.67,90,,percent of total billed charges,,,443.57,85,,percent of total billed charges,,393.47,495.76,
DEPUY CROSSLINK FIN GLENOID SZ52,30180616,CDM,,,278,RC,inpatient,,14866.35,14866.35,,12621.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11209.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12636.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13082.39,88,,percent of total billed charges,,,,,,,,,11357.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13528.38,91,,percent of total billed charges,,,14123.03,95,,percent of total billed charges,,,12339.07,83,,percent of total billed charges,,,12339.07,83,,percent of total billed charges,,,,,,,,,,,,,,,12339.07,83,,percent of total billed charges,,,14123.03,95,,percent of total billed charges,,,13379.72,90,,percent of total billed charges,,,13379.72,90,,percent of total billed charges,,,12190.41,82,,percent of total billed charges,,,13379.72,90,,percent of total billed charges,,,12636.4,85,,percent of total billed charges,,11209.23,14123.03,
DEPUY STEM GLOBAL HUMERAL 52 X 18,30180617,CDM,,,278,RC,inpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13297.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14990.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,13297.64,16754.32,
DEPUY STEM GLOBAL ADVANTAGE PC 12MM,30180618,CDM,,,278,RC,inpatient,,36482.49,36482.49,,30973.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27507.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31010.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32104.59,88,,percent of total billed charges,,,,,,,,,27872.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33199.07,91,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,,,,,,,,,,,,,30280.47,83,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,29915.64,82,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,31010.12,85,,percent of total billed charges,,27507.8,34658.37,
DEPUY FEMUR POROUS C/R LT SZ3,30180619,CDM,,,278,RC,inpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27261.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30732.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,27261.42,34347.94,
DEPUY INSERT SIGMA XLK 3 X 10,30180620,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY FLUTED FEMORAL STEM 5DEG 20X125M,30180621,CDM,,,278,RC,inpatient,,8217.3,8217.3,,6976.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6195.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6984.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7231.22,88,,percent of total billed charges,,,,,,,,,6278.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7477.74,91,,percent of total billed charges,,,7806.44,95,,percent of total billed charges,,,6820.36,83,,percent of total billed charges,,,6820.36,83,,percent of total billed charges,,,,,,,,,,,,,,,6820.36,83,,percent of total billed charges,,,7806.44,95,,percent of total billed charges,,,7395.57,90,,percent of total billed charges,,,7395.57,90,,percent of total billed charges,,,6738.19,82,,percent of total billed charges,,,7395.57,90,,percent of total billed charges,,,6984.71,85,,percent of total billed charges,,6195.84,7806.44,
DEPUY FEMORAL STEM BOLT,30180622,CDM,,,278,RC,inpatient,,1474.2,1474.2,,1251.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1111.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1253.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1297.3,88,,percent of total billed charges,,,,,,,,,1126.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1341.52,91,,percent of total billed charges,,,1400.49,95,,percent of total billed charges,,,1223.59,83,,percent of total billed charges,,,1223.59,83,,percent of total billed charges,,,,,,,,,,,,,,,1223.59,83,,percent of total billed charges,,,1400.49,95,,percent of total billed charges,,,1326.78,90,,percent of total billed charges,,,1326.78,90,,percent of total billed charges,,,1208.84,82,,percent of total billed charges,,,1326.78,90,,percent of total billed charges,,,1253.07,85,,percent of total billed charges,,1111.55,1400.49,
DEPUY FEMUR TC3 LT SZ3,30180623,CDM,,,278,RC,inpatient,,36489.7,36489.7,,30979.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27513.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31016.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32110.94,88,,percent of total billed charges,,,,,,,,,27878.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33205.63,91,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,,,,,,,,,,,,,30286.45,83,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,29921.55,82,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,27513.23,34665.22,
DEPUY DISTAL AUGMENT LT 4MM SZ3.0,30180624,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
DEPUY POSTERIOR AUGMENT 4MM SZ3.0,30180625,CDM,,,278,RC,inpatient,,6245.14,6245.14,,5302.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4708.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5308.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5495.72,88,,percent of total billed charges,,,,,,,,,4771.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5683.08,91,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,,,,,,,,,,,,,5183.47,83,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5121.01,82,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,4708.84,5932.88,
DEPUY INSERT TC3 RP 15MM SZ3,30180626,CDM,,,278,RC,inpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17430.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19649.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,17430.21,21961.14,
DEPUY MBT REVISION TIBIAL TRAY SZ5,30180627,CDM,,,278,RC,inpatient,,28838.62,28838.62,,24483.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21744.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24512.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25377.99,88,,percent of total billed charges,,,,,,,,,22032.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26243.14,91,,percent of total billed charges,,,27396.69,95,,percent of total billed charges,,,23936.05,83,,percent of total billed charges,,,23936.05,83,,percent of total billed charges,,,,,,,,,,,,,,,23936.05,83,,percent of total billed charges,,,27396.69,95,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,23647.67,82,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,24512.83,85,,percent of total billed charges,,21744.32,27396.69,
DEPUY SLEEVE METAPHYSICAL 29MM,30180628,CDM,,,278,RC,inpatient,,12860.84,12860.84,,10918.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9697.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10931.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11317.54,88,,percent of total billed charges,,,,,,,,,9825.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11703.36,91,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10674.5,83,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10545.89,82,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10931.71,85,,percent of total billed charges,,9697.07,12217.8,
DEPUY FLUTED TIBIAL ROD 14X75MM,30180629,CDM,,,278,RC,inpatient,,6279,6279,,5330.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4734.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5337.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5525.52,88,,percent of total billed charges,,,,,,,,,4797.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5713.89,91,,percent of total billed charges,,,5965.05,95,,percent of total billed charges,,,5211.57,83,,percent of total billed charges,,,5211.57,83,,percent of total billed charges,,,,,,,,,,,,,,,5211.57,83,,percent of total billed charges,,,5965.05,95,,percent of total billed charges,,,5651.1,90,,percent of total billed charges,,,5651.1,90,,percent of total billed charges,,,5148.78,82,,percent of total billed charges,,,5651.1,90,,percent of total billed charges,,,5337.15,85,,percent of total billed charges,,4734.37,5965.05,
DEPUY BONE CEMENT W/ANTIBIOTIC 50-500,30180630,CDM,,,278,RC,inpatient,,1827.87,1827.87,,1551.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1378.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1553.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1608.53,88,,percent of total billed charges,,,,,,,,,1396.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1663.36,91,,percent of total billed charges,,,1736.48,95,,percent of total billed charges,,,1517.13,83,,percent of total billed charges,,,1517.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1517.13,83,,percent of total billed charges,,,1736.48,95,,percent of total billed charges,,,1645.08,90,,percent of total billed charges,,,1645.08,90,,percent of total billed charges,,,1498.85,82,,percent of total billed charges,,,1645.08,90,,percent of total billed charges,,,1553.69,85,,percent of total billed charges,,1378.21,1736.48,
DEPUY BLADE STABLECUT 13 X 90 (500),30180631,CDM,,,270,RC,inpatient,,594.58,594.58,,504.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,448.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,505.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,523.23,88,,percent of total billed charges,,,,,,,,,454.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,541.07,91,,percent of total billed charges,,,564.85,95,,percent of total billed charges,,,493.5,83,,percent of total billed charges,,,493.5,83,,percent of total billed charges,,,,,,,,,,,,,,,493.5,83,,percent of total billed charges,,,564.85,95,,percent of total billed charges,,,535.12,90,,percent of total billed charges,,,535.12,90,,percent of total billed charges,,,487.56,82,,percent of total billed charges,,,535.12,90,,percent of total billed charges,,,505.39,85,,percent of total billed charges,,448.31,564.85,
DEPUY FLEXABLE OSTEOTOME 10MM,30180633,CDM,,,278,RC,inpatient,,978.38,978.38,,830.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,737.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,831.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,860.97,88,,percent of total billed charges,,,,,,,,,747.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,890.33,91,,percent of total billed charges,,,929.46,95,,percent of total billed charges,,,812.06,83,,percent of total billed charges,,,812.06,83,,percent of total billed charges,,,,,,,,,,,,,,,812.06,83,,percent of total billed charges,,,929.46,95,,percent of total billed charges,,,880.54,90,,percent of total billed charges,,,880.54,90,,percent of total billed charges,,,802.27,82,,percent of total billed charges,,,880.54,90,,percent of total billed charges,,,831.62,85,,percent of total billed charges,,737.7,929.46,
SYNTHES DRILL BIT QUICK COUPLING 3.2MM,30180638,CDM,,,270,RC,inpatient,,782.74,782.74,,664.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,590.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,665.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,688.81,88,,percent of total billed charges,,,,,,,,,598.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,712.29,91,,percent of total billed charges,,,743.6,95,,percent of total billed charges,,,649.67,83,,percent of total billed charges,,,649.67,83,,percent of total billed charges,,,,,,,,,,,,,,,649.67,83,,percent of total billed charges,,,743.6,95,,percent of total billed charges,,,704.47,90,,percent of total billed charges,,,704.47,90,,percent of total billed charges,,,641.85,82,,percent of total billed charges,,,704.47,90,,percent of total billed charges,,,665.33,85,,percent of total billed charges,,590.19,743.6,
DEPUY PINNACLE CUP 52MM,30180665,CDM,,,278,RC,inpatient,,14472.9,14472.9,,12287.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10912.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12301.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12736.15,88,,percent of total billed charges,,,,,,,,,11057.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13170.34,91,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12012.51,83,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,11867.78,82,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,10912.57,13749.26,
DEPUY LINER ALTRX +4 NEUT 36 X 52,30180666,CDM,,,278,RC,inpatient,,14161.81,14161.81,,12023.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10678,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12037.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12462.39,88,,percent of total billed charges,,,,,,,,,10819.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12887.25,91,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,,,,,,,,,,,,,11754.3,83,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,11612.68,82,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,10678,13453.72,
DEPUY SECTOR II CUP 52MM,30180667,CDM,,,278,RC,inpatient,,14472.9,14472.9,,12287.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10912.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12301.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12736.15,88,,percent of total billed charges,,,,,,,,,11057.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13170.34,91,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12012.51,83,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,11867.78,82,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,10912.57,13749.26,
DEPUY PINNACLE SCREW 6.5 X 40,30180668,CDM,,,278,RC,inpatient,,1244.95,1244.95,,1056.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,938.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1058.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1095.56,88,,percent of total billed charges,,,,,,,,,951.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1132.9,91,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.31,83,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1020.86,82,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,938.69,1182.7,
DEPUY PINNACLE SCREW 6.5 X 15,30180669,CDM,,,278,RC,inpatient,,1244.95,1244.95,,1056.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,938.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1058.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1095.56,88,,percent of total billed charges,,,,,,,,,951.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1132.9,91,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.31,83,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1020.86,82,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,938.69,1182.7,
DEPUY ARTICUL/EZE BALL 36MM +8.5,30180670,CDM,,,278,RC,inpatient,,8569.34,8569.34,,7275.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6461.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7283.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7541.02,88,,percent of total billed charges,,,,,,,,,6546.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7798.1,91,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7112.55,83,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7026.86,82,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,6461.28,8140.87,
DEPUY FEMUR POROUS C/R LT SZ4,30180671,CDM,,,278,RC,inpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27261.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30732.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,27261.42,34347.94,
DEPUY FEMUR POROUS C/R RT SZ4N,30180672,CDM,,,278,RC,inpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27261.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30732.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,27261.42,34347.94,
DEPUY FEMUR CEMENTED LT SZ5,30180673,CDM,,,278,RC,inpatient,,20746.18,20746.18,,17613.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15642.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17634.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18256.64,88,,percent of total billed charges,,,,,,,,,15850.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18879.02,91,,percent of total billed charges,,,19708.87,95,,percent of total billed charges,,,17219.33,83,,percent of total billed charges,,,17219.33,83,,percent of total billed charges,,,,,,,,,,,,,,,17219.33,83,,percent of total billed charges,,,19708.87,95,,percent of total billed charges,,,18671.56,90,,percent of total billed charges,,,18671.56,90,,percent of total billed charges,,,17011.87,82,,percent of total billed charges,,,18671.56,90,,percent of total billed charges,,,17634.25,85,,percent of total billed charges,,15642.62,19708.87,
DEPUY FEMUR CEMENTED RT SZ5,30180674,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
DEPUY PATELLA 3-PEG 32MM,30180675,CDM,,,278,RC,inpatient,,6022.25,6022.25,,5112.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4540.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5118.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5299.58,88,,percent of total billed charges,,,,,,,,,4601,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5480.25,91,,percent of total billed charges,,,5721.14,95,,percent of total billed charges,,,4998.47,83,,percent of total billed charges,,,4998.47,83,,percent of total billed charges,,,,,,,,,,,,,,,4998.47,83,,percent of total billed charges,,,5721.14,95,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,4938.25,82,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,5118.91,85,,percent of total billed charges,,4540.78,5721.14,
DEPUY SELF CENT HIP 49X28 BRN,30180676,CDM,,,278,RC,inpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,6126.3,7718.82,
DEPUY FEMORAL HEAD 28 +5,30180677,CDM,,,278,RC,inpatient,,6922.18,6922.18,,5876.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5219.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5883.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6091.52,88,,percent of total billed charges,,,,,,,,,5288.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6299.18,91,,percent of total billed charges,,,6576.07,95,,percent of total billed charges,,,5745.41,83,,percent of total billed charges,,,5745.41,83,,percent of total billed charges,,,,,,,,,,,,,,,5745.41,83,,percent of total billed charges,,,6576.07,95,,percent of total billed charges,,,6229.96,90,,percent of total billed charges,,,6229.96,90,,percent of total billed charges,,,5676.19,82,,percent of total billed charges,,,6229.96,90,,percent of total billed charges,,,5883.85,85,,percent of total billed charges,,5219.32,6576.07,
S&N HEWSON SUTURE RETRIVER,30180679,CDM,,,270,RC,inpatient,,814.24,814.24,,691.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,613.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,692.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,716.53,88,,percent of total billed charges,,,,,,,,,622.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,740.96,91,,percent of total billed charges,,,773.53,95,,percent of total billed charges,,,675.82,83,,percent of total billed charges,,,675.82,83,,percent of total billed charges,,,,,,,,,,,,,,,675.82,83,,percent of total billed charges,,,773.53,95,,percent of total billed charges,,,732.82,90,,percent of total billed charges,,,732.82,90,,percent of total billed charges,,,667.68,82,,percent of total billed charges,,,732.82,90,,percent of total billed charges,,,692.1,85,,percent of total billed charges,,613.94,773.53,
SYNTHES PLATE LCP 6-HOLE 69MM,30180689,CDM,,,278,RC,inpatient,,1585.68,1585.68,,1346.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1195.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1347.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1395.4,88,,percent of total billed charges,,,,,,,,,1211.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1442.97,91,,percent of total billed charges,,,1506.4,95,,percent of total billed charges,,,1316.11,83,,percent of total billed charges,,,1316.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1316.11,83,,percent of total billed charges,,,1506.4,95,,percent of total billed charges,,,1427.11,90,,percent of total billed charges,,,1427.11,90,,percent of total billed charges,,,1300.26,82,,percent of total billed charges,,,1427.11,90,,percent of total billed charges,,,1347.83,85,,percent of total billed charges,,1195.6,1506.4,
SYNTHES DRILL BIT 3.5MM 110MM,30180690,CDM,,,270,RC,inpatient,,852.18,852.18,,723.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,642.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,724.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,749.92,88,,percent of total billed charges,,,,,,,,,651.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,775.48,91,,percent of total billed charges,,,809.57,95,,percent of total billed charges,,,707.31,83,,percent of total billed charges,,,707.31,83,,percent of total billed charges,,,,,,,,,,,,,,,707.31,83,,percent of total billed charges,,,809.57,95,,percent of total billed charges,,,766.96,90,,percent of total billed charges,,,766.96,90,,percent of total billed charges,,,698.79,82,,percent of total billed charges,,,766.96,90,,percent of total billed charges,,,724.35,85,,percent of total billed charges,,642.54,809.57,
DEPUY INSERT SIGMA XLK 2.5 X 15,30180691,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY TIBIAL TRAY SZ2.5,30180692,CDM,,,270,RC,inpatient,,18568.29,18568.29,,15764.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14000.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15783.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16340.1,88,,percent of total billed charges,,,,,,,,,14186.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16897.14,91,,percent of total billed charges,,,17639.88,95,,percent of total billed charges,,,15411.68,83,,percent of total billed charges,,,15411.68,83,,percent of total billed charges,,,,,,,,,,,,,,,15411.68,83,,percent of total billed charges,,,17639.88,95,,percent of total billed charges,,,16711.46,90,,percent of total billed charges,,,16711.46,90,,percent of total billed charges,,,15226,82,,percent of total billed charges,,,16711.46,90,,percent of total billed charges,,,15783.05,85,,percent of total billed charges,,14000.49,17639.88,
DEPUY FEMORAL HEAD 36MM +1.5,30180693,CDM,,,278,RC,inpatient,,8569.34,8569.34,,7275.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6461.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7283.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7541.02,88,,percent of total billed charges,,,,,,,,,6546.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7798.1,91,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7112.55,83,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7026.86,82,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,6461.28,8140.87,
DEPUY STEM CORAIL STD SZ14,30180694,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY FEMUR POROUS RT SZ1.5,30180695,CDM,,,278,RC,inpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27261.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30732.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,27261.42,34347.94,
DEPUY INSERT SIGMA XLK 5 X 10,30180696,CDM,,,278,RC,inpatient,,12163.26,12163.26,,10326.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9171.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10338.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10703.67,88,,percent of total billed charges,,,,,,,,,9292.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11068.57,91,,percent of total billed charges,,,11555.1,95,,percent of total billed charges,,,10095.51,83,,percent of total billed charges,,,10095.51,83,,percent of total billed charges,,,,,,,,,,,,,,,10095.51,83,,percent of total billed charges,,,11555.1,95,,percent of total billed charges,,,10946.93,90,,percent of total billed charges,,,10946.93,90,,percent of total billed charges,,,9973.87,82,,percent of total billed charges,,,10946.93,90,,percent of total billed charges,,,10338.77,85,,percent of total billed charges,,9171.1,11555.1,
DEPUY TIBIAL TRAY SZ5,30180697,CDM,,,270,RC,inpatient,,17711.46,17711.46,,15037.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13354.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15054.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15586.08,88,,percent of total billed charges,,,,,,,,,13531.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16117.43,91,,percent of total billed charges,,,16825.89,95,,percent of total billed charges,,,14700.51,83,,percent of total billed charges,,,14700.51,83,,percent of total billed charges,,,,,,,,,,,,,,,14700.51,83,,percent of total billed charges,,,16825.89,95,,percent of total billed charges,,,15940.31,90,,percent of total billed charges,,,15940.31,90,,percent of total billed charges,,,14523.4,82,,percent of total billed charges,,,15940.31,90,,percent of total billed charges,,,15054.74,85,,percent of total billed charges,,13354.44,16825.89,
DEPUY PFC SIG CR FEM LT SZ4N,30180698,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
SYNTHES DRILL BIT 1.8MM 310.509,30180705,CDM,,,270,RC,inpatient,,1518.14,1518.14,,1288.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1144.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1290.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1335.96,88,,percent of total billed charges,,,,,,,,,1159.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1381.51,91,,percent of total billed charges,,,1442.23,95,,percent of total billed charges,,,1260.06,83,,percent of total billed charges,,,1260.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1260.06,83,,percent of total billed charges,,,1442.23,95,,percent of total billed charges,,,1366.33,90,,percent of total billed charges,,,1366.33,90,,percent of total billed charges,,,1244.87,82,,percent of total billed charges,,,1366.33,90,,percent of total billed charges,,,1290.42,85,,percent of total billed charges,,1144.68,1442.23,
SYNTHES SCREW CORTEX S-T 2.4X16MM,30180710,CDM,,,278,RC,inpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,452.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,509.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,452.17,569.71,
SYNTHES SCREW CORTEX S-T 2.4X22MM,30180711,CDM,,,278,RC,inpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,452.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,509.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,452.17,569.71,
DEPUY INSERT SIGMA XLK 2.5 X 12.5,30180718,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
PREP KIT BONE BIOPREP,30180724,CDM,,,270,RC,inpatient,,728.27,728.27,,618.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,549.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,619.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,640.88,88,,percent of total billed charges,,,,,,,,,556.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,662.73,91,,percent of total billed charges,,,691.86,95,,percent of total billed charges,,,604.46,83,,percent of total billed charges,,,604.46,83,,percent of total billed charges,,,,,,,,,,,,,,,604.46,83,,percent of total billed charges,,,691.86,95,,percent of total billed charges,,,655.44,90,,percent of total billed charges,,,655.44,90,,percent of total billed charges,,,597.18,82,,percent of total billed charges,,,655.44,90,,percent of total billed charges,,,619.03,85,,percent of total billed charges,,549.12,691.86,
DEPUY STEM GLOBAL FX PC 10MM,30180725,CDM,,,278,RC,inpatient,,38704.58,38704.58,,32860.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29183.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32898.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34060.03,88,,percent of total billed charges,,,,,,,,,29570.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35221.17,91,,percent of total billed charges,,,36769.35,95,,percent of total billed charges,,,32124.8,83,,percent of total billed charges,,,32124.8,83,,percent of total billed charges,,,,,,,,,,,,,,,32124.8,83,,percent of total billed charges,,,36769.35,95,,percent of total billed charges,,,34834.12,90,,percent of total billed charges,,,34834.12,90,,percent of total billed charges,,,31737.76,82,,percent of total billed charges,,,34834.12,90,,percent of total billed charges,,,32898.89,85,,percent of total billed charges,,29183.25,36769.35,
DEPUY STEM GLOBAL HUMERAL 44 X 18,30180726,CDM,,,278,RC,inpatient,,15560.09,15560.09,,13210.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11732.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13226.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13692.88,88,,percent of total billed charges,,,,,,,,,11887.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14159.68,91,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12914.87,83,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,12759.27,82,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,11732.31,14782.09,
DEPUY PFC SIG CR FEM RT SZ4N,30180732,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
DEPUY INSERT SIGMA XLK 3 X 12.5,30180733,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
EYE LENS IMPLANT (ALCON),30180734,CDM,,,278,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
CATH URETERAL ACCESS 6FR OPEN END,30180736,CDM,,,270,RC,inpatient,,81.84,81.84,,69.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,69.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,72.02,88,,percent of total billed charges,,,,,,,,,62.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,74.47,91,,percent of total billed charges,,,77.75,95,,percent of total billed charges,,,67.93,83,,percent of total billed charges,,,67.93,83,,percent of total billed charges,,,,,,,,,,,,,,,67.93,83,,percent of total billed charges,,,77.75,95,,percent of total billed charges,,,73.66,90,,percent of total billed charges,,,73.66,90,,percent of total billed charges,,,67.11,82,,percent of total billed charges,,,73.66,90,,percent of total billed charges,,,69.56,85,,percent of total billed charges,,61.71,77.75,
DEPUY STEM TRI-LOCK HI OFFSET SZ0,30180740,CDM,,,278,RC,inpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30697.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34606.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,30697.71,38677.48,
DEPUY DURALOC CUP OPTION SZ54,30180742,CDM,,,278,RC,inpatient,,10985.85,10985.85,,9326.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8283.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9337.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9667.55,88,,percent of total billed charges,,,,,,,,,8393.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9997.12,91,,percent of total billed charges,,,10436.56,95,,percent of total billed charges,,,9118.26,83,,percent of total billed charges,,,9118.26,83,,percent of total billed charges,,,,,,,,,,,,,,,9118.26,83,,percent of total billed charges,,,10436.56,95,,percent of total billed charges,,,9887.27,90,,percent of total billed charges,,,9887.27,90,,percent of total billed charges,,,9008.4,82,,percent of total billed charges,,,9887.27,90,,percent of total billed charges,,,9337.97,85,,percent of total billed charges,,8283.33,10436.56,
DEPUY ARTICUL/EZE BALL 32MM +5,30180743,CDM,,,278,RC,inpatient,,7271.29,7271.29,,6173.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5482.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6180.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6398.74,88,,percent of total billed charges,,,,,,,,,5555.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6616.87,91,,percent of total billed charges,,,6907.73,95,,percent of total billed charges,,,6035.17,83,,percent of total billed charges,,,6035.17,83,,percent of total billed charges,,,,,,,,,,,,,,,6035.17,83,,percent of total billed charges,,,6907.73,95,,percent of total billed charges,,,6544.16,90,,percent of total billed charges,,,6544.16,90,,percent of total billed charges,,,5962.46,82,,percent of total billed charges,,,6544.16,90,,percent of total billed charges,,,6180.6,85,,percent of total billed charges,,5482.55,6907.73,
DEPUY STEM TRI-LOCK STD OFFSET SZ7,30180745,CDM,,,278,RC,inpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30697.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34606.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,30697.71,38677.48,
DEPUY STEM TRI-LOCK STD OFFSET SZ6,30180746,CDM,,,278,RC,inpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30697.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34606.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,30697.71,38677.48,
"DEPUY DURALOC INSERT 32/58,60",30180747,CDM,,,278,RC,inpatient,,8870.1,8870.1,,7530.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6688.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7539.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7805.69,88,,percent of total billed charges,,,,,,,,,6776.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8071.79,91,,percent of total billed charges,,,8426.6,95,,percent of total billed charges,,,7362.18,83,,percent of total billed charges,,,7362.18,83,,percent of total billed charges,,,,,,,,,,,,,,,7362.18,83,,percent of total billed charges,,,8426.6,95,,percent of total billed charges,,,7983.09,90,,percent of total billed charges,,,7983.09,90,,percent of total billed charges,,,7273.48,82,,percent of total billed charges,,,7983.09,90,,percent of total billed charges,,,7539.59,85,,percent of total billed charges,,6688.06,8426.6,
DEPUY DURALOC CUP OPTION SZ58,30180748,CDM,,,278,RC,inpatient,,8277.04,8277.04,,7027.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6240.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7035.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7283.8,88,,percent of total billed charges,,,,,,,,,6323.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7532.11,91,,percent of total billed charges,,,7863.19,95,,percent of total billed charges,,,6869.94,83,,percent of total billed charges,,,6869.94,83,,percent of total billed charges,,,,,,,,,,,,,,,6869.94,83,,percent of total billed charges,,,7863.19,95,,percent of total billed charges,,,7449.34,90,,percent of total billed charges,,,7449.34,90,,percent of total billed charges,,,6787.17,82,,percent of total billed charges,,,7449.34,90,,percent of total billed charges,,,7035.48,85,,percent of total billed charges,,6240.89,7863.19,
DEPUY ARTICUL/EZE BALL 32MM +1,30180749,CDM,,,278,RC,inpatient,,9650.62,9650.62,,8193.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7276.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8203.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8492.55,88,,percent of total billed charges,,,,,,,,,7373.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8782.06,91,,percent of total billed charges,,,9168.09,95,,percent of total billed charges,,,8010.01,83,,percent of total billed charges,,,8010.01,83,,percent of total billed charges,,,,,,,,,,,,,,,8010.01,83,,percent of total billed charges,,,9168.09,95,,percent of total billed charges,,,8685.56,90,,percent of total billed charges,,,8685.56,90,,percent of total billed charges,,,7913.51,82,,percent of total billed charges,,,8685.56,90,,percent of total billed charges,,,8203.03,85,,percent of total billed charges,,7276.57,9168.09,
DEPUY STEM SUMMIT TAPER SZ6 HI OFF,30180752,CDM,,,278,RC,inpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26584.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29969.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,26584.74,33495.37,
DEPUY SELF CENT HIP 48X28 BRN,30180756,CDM,,,278,RC,inpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,6126.3,7718.82,
DEPUY FEMUR CEMENTED LT SZ4,30180757,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
DEPUY INSERT SIGMA XLK 4 X 12.5,30180758,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY INSERT SIGMA XLK 4 X 15,30180759,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
POLYSORB SOFT TISSUE ANCHOR 2MM,30180760,CDM,,,270,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
ARTELON CMC SPACER,30180761,CDM,,,270,RC,inpatient,,12148.5,12148.5,,10314.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9159.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10326.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10690.68,88,,percent of total billed charges,,,,,,,,,9281.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11055.14,91,,percent of total billed charges,,,11541.08,95,,percent of total billed charges,,,10083.26,83,,percent of total billed charges,,,10083.26,83,,percent of total billed charges,,,,,,,,,,,,,,,10083.26,83,,percent of total billed charges,,,11541.08,95,,percent of total billed charges,,,10933.65,90,,percent of total billed charges,,,10933.65,90,,percent of total billed charges,,,9961.77,82,,percent of total billed charges,,,10933.65,90,,percent of total billed charges,,,10326.23,85,,percent of total billed charges,,9159.97,11541.08,
SYNTHES ROD REAMER 2.5MM,30180764,CDM,,,270,RC,inpatient,,1172.28,1172.28,,995.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,883.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,996.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1031.61,88,,percent of total billed charges,,,,,,,,,895.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1066.77,91,,percent of total billed charges,,,1113.67,95,,percent of total billed charges,,,972.99,83,,percent of total billed charges,,,972.99,83,,percent of total billed charges,,,,,,,,,,,,,,,972.99,83,,percent of total billed charges,,,1113.67,95,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,961.27,82,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,996.44,85,,percent of total billed charges,,883.9,1113.67,
STENT URETERAL CONTOUR 6 X 22,30180773,CDM,,,270,RC,inpatient,,917.28,917.28,,778.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,691.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,779.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,807.21,88,,percent of total billed charges,,,,,,,,,700.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,834.72,91,,percent of total billed charges,,,871.42,95,,percent of total billed charges,,,761.34,83,,percent of total billed charges,,,761.34,83,,percent of total billed charges,,,,,,,,,,,,,,,761.34,83,,percent of total billed charges,,,871.42,95,,percent of total billed charges,,,825.55,90,,percent of total billed charges,,,825.55,90,,percent of total billed charges,,,752.17,82,,percent of total billed charges,,,825.55,90,,percent of total billed charges,,,779.69,85,,percent of total billed charges,,691.63,871.42,
SYNTHES SCREW STARDRIVE 4.0X34MM,30180783,CDM,,,278,RC,inpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1697.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1913.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,1697.12,2138.28,
SYNTHES GUIDEWIRE 3.2MM,30180784,CDM,,,278,RC,inpatient,,984.75,984.75,,836.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,742.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,837.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,866.58,88,,percent of total billed charges,,,,,,,,,752.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,896.12,91,,percent of total billed charges,,,935.51,95,,percent of total billed charges,,,817.34,83,,percent of total billed charges,,,817.34,83,,percent of total billed charges,,,,,,,,,,,,,,,817.34,83,,percent of total billed charges,,,935.51,95,,percent of total billed charges,,,886.28,90,,percent of total billed charges,,,886.28,90,,percent of total billed charges,,,807.5,82,,percent of total billed charges,,,886.28,90,,percent of total billed charges,,,837.04,85,,percent of total billed charges,,742.5,935.51,
SHOULDER ABDUCTION SLING - XLGE,30180790,CDM,,,270,RC,inpatient,,36.99,36.99,,31.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.55,88,,percent of total billed charges,,,,,,,,,28.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.66,91,,percent of total billed charges,,,35.14,95,,percent of total billed charges,,,30.7,83,,percent of total billed charges,,,30.7,83,,percent of total billed charges,,,,,,,,,,,,,,,30.7,83,,percent of total billed charges,,,35.14,95,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,30.33,82,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,31.44,85,,percent of total billed charges,,27.89,35.14,
ARTHREX CANNULA 7MM,30180792,CDM,,,270,RC,inpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,150.8,190,
HAND TRAP,30180795,CDM,,,270,RC,inpatient,,213.75,213.75,,181.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.1,88,,percent of total billed charges,,,,,,,,,163.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.51,91,,percent of total billed charges,,,203.06,95,,percent of total billed charges,,,177.41,83,,percent of total billed charges,,,177.41,83,,percent of total billed charges,,,,,,,,,,,,,,,177.41,83,,percent of total billed charges,,,203.06,95,,percent of total billed charges,,,192.38,90,,percent of total billed charges,,,192.38,90,,percent of total billed charges,,,175.28,82,,percent of total billed charges,,,192.38,90,,percent of total billed charges,,,181.69,85,,percent of total billed charges,,161.17,203.06,
ARTHREX FIBERSTICK #2,30180801,CDM,,,270,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
ARTHREX CANNULA 8.25M,30180817,CDM,,,270,RC,inpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,150.8,190,
NOVASURE ABLATION KIT,30180818,CDM,,,270,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
STRYKER DISP 18X4 QUICK TOURN CUFF,30180819,CDM,,,270,RC,inpatient,,181.24,181.24,,153.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,154.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.49,88,,percent of total billed charges,,,,,,,,,138.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.93,91,,percent of total billed charges,,,172.18,95,,percent of total billed charges,,,150.43,83,,percent of total billed charges,,,150.43,83,,percent of total billed charges,,,,,,,,,,,,,,,150.43,83,,percent of total billed charges,,,172.18,95,,percent of total billed charges,,,163.12,90,,percent of total billed charges,,,163.12,90,,percent of total billed charges,,,148.62,82,,percent of total billed charges,,,163.12,90,,percent of total billed charges,,,154.05,85,,percent of total billed charges,,136.65,172.18,
STRYKER DISP 12X2 QUICK TOURN CUFF,30180820,CDM,,,270,RC,inpatient,,122.24,122.24,,103.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,92.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,103.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,107.57,88,,percent of total billed charges,,,,,,,,,93.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.24,91,,percent of total billed charges,,,116.13,95,,percent of total billed charges,,,101.46,83,,percent of total billed charges,,,101.46,83,,percent of total billed charges,,,,,,,,,,,,,,,101.46,83,,percent of total billed charges,,,116.13,95,,percent of total billed charges,,,110.02,90,,percent of total billed charges,,,110.02,90,,percent of total billed charges,,,100.24,82,,percent of total billed charges,,,110.02,90,,percent of total billed charges,,,103.9,85,,percent of total billed charges,,92.17,116.13,
STRYKER DISP 34X4 QUICK TOURN CUFF,30180821,CDM,,,270,RC,inpatient,,221.56,221.56,,188.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,167.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,188.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,194.97,88,,percent of total billed charges,,,,,,,,,169.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,201.62,91,,percent of total billed charges,,,210.48,95,,percent of total billed charges,,,183.89,83,,percent of total billed charges,,,183.89,83,,percent of total billed charges,,,,,,,,,,,,,,,183.89,83,,percent of total billed charges,,,210.48,95,,percent of total billed charges,,,199.4,90,,percent of total billed charges,,,199.4,90,,percent of total billed charges,,,181.68,82,,percent of total billed charges,,,199.4,90,,percent of total billed charges,,,188.33,85,,percent of total billed charges,,167.06,210.48,
STRYKER DISP 44X4 QUICK TOURN CUFF,30180822,CDM,,,270,RC,inpatient,,241.96,241.96,,205.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,182.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,205.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,212.92,88,,percent of total billed charges,,,,,,,,,184.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,220.18,91,,percent of total billed charges,,,229.86,95,,percent of total billed charges,,,200.83,83,,percent of total billed charges,,,200.83,83,,percent of total billed charges,,,,,,,,,,,,,,,200.83,83,,percent of total billed charges,,,229.86,95,,percent of total billed charges,,,217.76,90,,percent of total billed charges,,,217.76,90,,percent of total billed charges,,,198.41,82,,percent of total billed charges,,,217.76,90,,percent of total billed charges,,,205.67,85,,percent of total billed charges,,182.44,229.86,
STRYKER DISP 24X4 QUICK TOURN CUFF,30180823,CDM,,,270,RC,inpatient,,190.76,190.76,,161.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,143.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,167.87,88,,percent of total billed charges,,,,,,,,,145.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,173.59,91,,percent of total billed charges,,,181.22,95,,percent of total billed charges,,,158.33,83,,percent of total billed charges,,,158.33,83,,percent of total billed charges,,,,,,,,,,,,,,,158.33,83,,percent of total billed charges,,,181.22,95,,percent of total billed charges,,,171.68,90,,percent of total billed charges,,,171.68,90,,percent of total billed charges,,,156.42,82,,percent of total billed charges,,,171.68,90,,percent of total billed charges,,,162.15,85,,percent of total billed charges,,143.83,181.22,
STRYKER DISP 30X4 QUICK TOURN CUFF,30180824,CDM,,,270,RC,inpatient,,206.16,206.16,,175.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,155.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,181.42,88,,percent of total billed charges,,,,,,,,,157.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,187.61,91,,percent of total billed charges,,,195.85,95,,percent of total billed charges,,,171.11,83,,percent of total billed charges,,,171.11,83,,percent of total billed charges,,,,,,,,,,,,,,,171.11,83,,percent of total billed charges,,,195.85,95,,percent of total billed charges,,,185.54,90,,percent of total billed charges,,,185.54,90,,percent of total billed charges,,,169.05,82,,percent of total billed charges,,,185.54,90,,percent of total billed charges,,,175.24,85,,percent of total billed charges,,155.44,195.85,
CARTILAGE BIOPSY TRANSPORT KIT,30180828,CDM,,,270,RC,inpatient,,3692,3692,,3134.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2783.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3138.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3248.96,88,,percent of total billed charges,,,,,,,,,2820.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3359.72,91,,percent of total billed charges,,,3507.4,95,,percent of total billed charges,,,3064.36,83,,percent of total billed charges,,,3064.36,83,,percent of total billed charges,,,,,,,,,,,,,,,3064.36,83,,percent of total billed charges,,,3507.4,95,,percent of total billed charges,,,3322.8,90,,percent of total billed charges,,,3322.8,90,,percent of total billed charges,,,3027.44,82,,percent of total billed charges,,,3322.8,90,,percent of total billed charges,,,3138.2,85,,percent of total billed charges,,2783.77,3507.4,
DEPUY STEM TRI-LOCK STD OFFSET SZ4,30180829,CDM,,,278,RC,inpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30697.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34606.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,30697.71,38677.48,
DEPUY ARTICUL/EZE BALL 32MM +13,30180830,CDM,,,278,RC,inpatient,,5683.54,5683.54,,4825.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4285.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4831.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5001.52,88,,percent of total billed charges,,,,,,,,,4342.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5172.02,91,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,,,,,,,,,,,,,4717.34,83,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4660.5,82,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4831.01,85,,percent of total billed charges,,4285.39,5399.36,
DEPUY PINNACLE CUP 64MM,30180831,CDM,,,278,RC,inpatient,,14472.9,14472.9,,12287.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10912.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12301.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12736.15,88,,percent of total billed charges,,,,,,,,,11057.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13170.34,91,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12012.51,83,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,11867.78,82,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,10912.57,13749.26,
DEPUY LINER ALTRX NEUT 36 X 64,30180832,CDM,,,278,RC,inpatient,,13197.15,13197.15,,11204.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9950.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11217.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11613.49,88,,percent of total billed charges,,,,,,,,,10082.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12009.41,91,,percent of total billed charges,,,12537.29,95,,percent of total billed charges,,,10953.63,83,,percent of total billed charges,,,10953.63,83,,percent of total billed charges,,,,,,,,,,,,,,,10953.63,83,,percent of total billed charges,,,12537.29,95,,percent of total billed charges,,,11877.44,90,,percent of total billed charges,,,11877.44,90,,percent of total billed charges,,,10821.66,82,,percent of total billed charges,,,11877.44,90,,percent of total billed charges,,,11217.58,85,,percent of total billed charges,,9950.65,12537.29,
DEPUY LINER ALTRX +4 NEUT 36 X 64,30180833,CDM,,,278,RC,inpatient,,14543.23,14543.23,,12347.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10965.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12361.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12798.04,88,,percent of total billed charges,,,,,,,,,11111.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13234.34,91,,percent of total billed charges,,,13816.07,95,,percent of total billed charges,,,12070.88,83,,percent of total billed charges,,,12070.88,83,,percent of total billed charges,,,,,,,,,,,,,,,12070.88,83,,percent of total billed charges,,,13816.07,95,,percent of total billed charges,,,13088.91,90,,percent of total billed charges,,,13088.91,90,,percent of total billed charges,,,11925.45,82,,percent of total billed charges,,,13088.91,90,,percent of total billed charges,,,12361.75,85,,percent of total billed charges,,10965.6,13816.07,
DEPUY STEM CORAIL STD SZ12,30180834,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY LINER ALTRX +4 36 X 64,30180835,CDM,,,278,RC,inpatient,,14543.23,14543.23,,12347.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10965.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12361.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12798.04,88,,percent of total billed charges,,,,,,,,,11111.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13234.34,91,,percent of total billed charges,,,13816.07,95,,percent of total billed charges,,,12070.88,83,,percent of total billed charges,,,12070.88,83,,percent of total billed charges,,,,,,,,,,,,,,,12070.88,83,,percent of total billed charges,,,13816.07,95,,percent of total billed charges,,,13088.91,90,,percent of total billed charges,,,13088.91,90,,percent of total billed charges,,,11925.45,82,,percent of total billed charges,,,13088.91,90,,percent of total billed charges,,,12361.75,85,,percent of total billed charges,,10965.6,13816.07,
SYNTHES DRILL BIT TAPERED 10X4MM,30180842,CDM,,,278,RC,inpatient,,1939.28,1939.28,,1646.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1462.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1648.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1706.57,88,,percent of total billed charges,,,,,,,,,1481.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1764.74,91,,percent of total billed charges,,,1842.32,95,,percent of total billed charges,,,1609.6,83,,percent of total billed charges,,,1609.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1609.6,83,,percent of total billed charges,,,1842.32,95,,percent of total billed charges,,,1745.35,90,,percent of total billed charges,,,1745.35,90,,percent of total billed charges,,,1590.21,82,,percent of total billed charges,,,1745.35,90,,percent of total billed charges,,,1648.39,85,,percent of total billed charges,,1462.22,1842.32,
DEPUY INSERT SIGMA XLK 5 X 15,30180843,CDM,,,278,RC,inpatient,,14248.07,14248.07,,12096.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12110.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.3,88,,percent of total billed charges,,,,,,,,,10885.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12965.74,91,,percent of total billed charges,,,13535.67,95,,percent of total billed charges,,,11825.9,83,,percent of total billed charges,,,11825.9,83,,percent of total billed charges,,,,,,,,,,,,,,,11825.9,83,,percent of total billed charges,,,13535.67,95,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,11683.42,82,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,12110.86,85,,percent of total billed charges,,10743.04,13535.67,
SYNTHES SCREW LOCKING 3.5X16MM,30180847,CDM,,,278,RC,inpatient,,1217.84,1217.84,,1033.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,918.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1035.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1071.7,88,,percent of total billed charges,,,,,,,,,930.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1108.23,91,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1010.81,83,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,998.63,82,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,918.25,1156.95,
SYNTHES DRILL BIT 2.0MM 310.21,30180849,CDM,,,270,RC,inpatient,,832.33,832.33,,706.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.45,88,,percent of total billed charges,,,,,,,,,635.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.42,91,,percent of total billed charges,,,790.71,95,,percent of total billed charges,,,690.83,83,,percent of total billed charges,,,690.83,83,,percent of total billed charges,,,,,,,,,,,,,,,690.83,83,,percent of total billed charges,,,790.71,95,,percent of total billed charges,,,749.1,90,,percent of total billed charges,,,749.1,90,,percent of total billed charges,,,682.51,82,,percent of total billed charges,,,749.1,90,,percent of total billed charges,,,707.48,85,,percent of total billed charges,,627.58,790.71,
SYNTHES PLATE LCP TUBULAR 5-HOLE,30180850,CDM,,,278,RC,inpatient,,1585.68,1585.68,,1346.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1195.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1347.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1395.4,88,,percent of total billed charges,,,,,,,,,1211.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1442.97,91,,percent of total billed charges,,,1506.4,95,,percent of total billed charges,,,1316.11,83,,percent of total billed charges,,,1316.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1316.11,83,,percent of total billed charges,,,1506.4,95,,percent of total billed charges,,,1427.11,90,,percent of total billed charges,,,1427.11,90,,percent of total billed charges,,,1300.26,82,,percent of total billed charges,,,1427.11,90,,percent of total billed charges,,,1347.83,85,,percent of total billed charges,,1195.6,1506.4,
SYNTHES K-WIRE 2.0MM,30180851,CDM,,,278,RC,inpatient,,105.4,105.4,,89.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,89.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,92.75,88,,percent of total billed charges,,,,,,,,,80.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,95.91,91,,percent of total billed charges,,,100.13,95,,percent of total billed charges,,,87.48,83,,percent of total billed charges,,,87.48,83,,percent of total billed charges,,,,,,,,,,,,,,,87.48,83,,percent of total billed charges,,,100.13,95,,percent of total billed charges,,,94.86,90,,percent of total billed charges,,,94.86,90,,percent of total billed charges,,,86.43,82,,percent of total billed charges,,,94.86,90,,percent of total billed charges,,,89.59,85,,percent of total billed charges,,79.47,100.13,
DEPUY ARTICUL/EZE BALL 32MM +17,30180856,CDM,,,278,RC,inpatient,,4752.22,4752.22,,4034.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3583.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4039.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4181.95,88,,percent of total billed charges,,,,,,,,,3630.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4324.52,91,,percent of total billed charges,,,4514.61,95,,percent of total billed charges,,,3944.34,83,,percent of total billed charges,,,3944.34,83,,percent of total billed charges,,,,,,,,,,,,,,,3944.34,83,,percent of total billed charges,,,4514.61,95,,percent of total billed charges,,,4277,90,,percent of total billed charges,,,4277,90,,percent of total billed charges,,,3896.82,82,,percent of total billed charges,,,4277,90,,percent of total billed charges,,,4039.39,85,,percent of total billed charges,,3583.17,4514.61,
DEPUY STATURE AML 12MM X 6IN,30180857,CDM,,,278,RC,inpatient,,38122.11,38122.11,,32365.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28744.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32403.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33547.46,88,,percent of total billed charges,,,,,,,,,29125.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34691.12,91,,percent of total billed charges,,,36216,95,,percent of total billed charges,,,31641.35,83,,percent of total billed charges,,,31641.35,83,,percent of total billed charges,,,,,,,,,,,,,,,31641.35,83,,percent of total billed charges,,,36216,95,,percent of total billed charges,,,34309.9,90,,percent of total billed charges,,,34309.9,90,,percent of total billed charges,,,31260.13,82,,percent of total billed charges,,,34309.9,90,,percent of total billed charges,,,32403.79,85,,percent of total billed charges,,28744.07,36216,
DEPUY HIP POROUS - CAPITATED (691),30180858,CDM,,,278,RC,inpatient,,30294.81,30294.81,,25720.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22842.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25750.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26659.43,88,,percent of total billed charges,,,,,,,,,23145.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27568.28,91,,percent of total billed charges,,,28780.07,95,,percent of total billed charges,,,25144.69,83,,percent of total billed charges,,,25144.69,83,,percent of total billed charges,,,,,,,,,,,,,,,25144.69,83,,percent of total billed charges,,,28780.07,95,,percent of total billed charges,,,27265.33,90,,percent of total billed charges,,,27265.33,90,,percent of total billed charges,,,24841.74,82,,percent of total billed charges,,,27265.33,90,,percent of total billed charges,,,25750.59,85,,percent of total billed charges,,22842.29,28780.07,
DEPUY FEMORAL HEAD 36MM LGE METAL,30180859,CDM,,,278,RC,inpatient,,1729,1729,,1467.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1303.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1469.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1521.52,88,,percent of total billed charges,,,,,,,,,1320.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1573.39,91,,percent of total billed charges,,,1642.55,95,,percent of total billed charges,,,1435.07,83,,percent of total billed charges,,,1435.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1435.07,83,,percent of total billed charges,,,1642.55,95,,percent of total billed charges,,,1556.1,90,,percent of total billed charges,,,1556.1,90,,percent of total billed charges,,,1417.78,82,,percent of total billed charges,,,1556.1,90,,percent of total billed charges,,,1469.65,85,,percent of total billed charges,,1303.67,1642.55,
DEPUY LINER ALTRX X-LINK (669),30180860,CDM,,,278,RC,inpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2082.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2348.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,2082.93,2624.38,
SYNTHES CABLE W/CRIMP 1.7M TI,30180861,CDM,,,278,RC,inpatient,,4947.09,4947.09,,4200.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3730.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4205.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4353.44,88,,percent of total billed charges,,,,,,,,,3779.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4501.85,91,,percent of total billed charges,,,4699.74,95,,percent of total billed charges,,,4106.08,83,,percent of total billed charges,,,4106.08,83,,percent of total billed charges,,,,,,,,,,,,,,,4106.08,83,,percent of total billed charges,,,4699.74,95,,percent of total billed charges,,,4452.38,90,,percent of total billed charges,,,4452.38,90,,percent of total billed charges,,,4056.61,82,,percent of total billed charges,,,4452.38,90,,percent of total billed charges,,,4205.03,85,,percent of total billed charges,,3730.11,4699.74,
SYNTHES GUIDEWIRE 722,30180886,CDM,,,278,RC,inpatient,,351.68,351.68,,298.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,265.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,298.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,309.48,88,,percent of total billed charges,,,,,,,,,268.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,320.03,91,,percent of total billed charges,,,334.1,95,,percent of total billed charges,,,291.89,83,,percent of total billed charges,,,291.89,83,,percent of total billed charges,,,,,,,,,,,,,,,291.89,83,,percent of total billed charges,,,334.1,95,,percent of total billed charges,,,316.51,90,,percent of total billed charges,,,316.51,90,,percent of total billed charges,,,288.38,82,,percent of total billed charges,,,316.51,90,,percent of total billed charges,,,298.93,85,,percent of total billed charges,,265.17,334.1,
SYNTHES DRILL BIT CANNULATED 2.7MM,30180887,CDM,,,278,RC,inpatient,,4519.19,4519.19,,3836.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3407.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3841.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3976.89,88,,percent of total billed charges,,,,,,,,,3452.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4112.46,91,,percent of total billed charges,,,4293.23,95,,percent of total billed charges,,,3750.93,83,,percent of total billed charges,,,3750.93,83,,percent of total billed charges,,,,,,,,,,,,,,,3750.93,83,,percent of total billed charges,,,4293.23,95,,percent of total billed charges,,,4067.27,90,,percent of total billed charges,,,4067.27,90,,percent of total billed charges,,,3705.74,82,,percent of total billed charges,,,4067.27,90,,percent of total billed charges,,,3841.31,85,,percent of total billed charges,,3407.47,4293.23,
DEPUY INSERT SIGMA XLK 5 X 12.5,30180892,CDM,,,278,RC,inpatient,,14248.07,14248.07,,12096.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12110.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.3,88,,percent of total billed charges,,,,,,,,,10885.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12965.74,91,,percent of total billed charges,,,13535.67,95,,percent of total billed charges,,,11825.9,83,,percent of total billed charges,,,11825.9,83,,percent of total billed charges,,,,,,,,,,,,,,,11825.9,83,,percent of total billed charges,,,13535.67,95,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,11683.42,82,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,12110.86,85,,percent of total billed charges,,10743.04,13535.67,
DEPUY KNEE POROUS - CAPITATED (704),30180893,CDM,,,278,RC,inpatient,,26914.88,26914.88,,22850.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20293.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22877.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23685.09,88,,percent of total billed charges,,,,,,,,,20562.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24492.54,91,,percent of total billed charges,,,25569.14,95,,percent of total billed charges,,,22339.35,83,,percent of total billed charges,,,22339.35,83,,percent of total billed charges,,,,,,,,,,,,,,,22339.35,83,,percent of total billed charges,,,25569.14,95,,percent of total billed charges,,,24223.39,90,,percent of total billed charges,,,24223.39,90,,percent of total billed charges,,,22070.2,82,,percent of total billed charges,,,24223.39,90,,percent of total billed charges,,,22877.65,85,,percent of total billed charges,,20293.82,25569.14,
DEPUY LINER ALTRX X-LINK (712),30180894,CDM,,,278,RC,inpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1715.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1933.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,1715.35,2161.25,
DEPUY KNEE HYBRID - CAPITATED (703),30180895,CDM,,,278,RC,inpatient,,25239.57,25239.57,,21428.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19030.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21453.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22210.82,88,,percent of total billed charges,,,,,,,,,19283.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22968.01,91,,percent of total billed charges,,,23977.59,95,,percent of total billed charges,,,20948.84,83,,percent of total billed charges,,,20948.84,83,,percent of total billed charges,,,,,,,,,,,,,,,20948.84,83,,percent of total billed charges,,,23977.59,95,,percent of total billed charges,,,22715.61,90,,percent of total billed charges,,,22715.61,90,,percent of total billed charges,,,20696.45,82,,percent of total billed charges,,,22715.61,90,,percent of total billed charges,,,21453.63,85,,percent of total billed charges,,19030.64,23977.59,
DEPUY UPCHARGE PORCOAT FEMUR(735),30180896,CDM,,,278,RC,inpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,980.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1105,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,980.2,1235,
DEPUY UPCHARGE XLINK INSERT(736),30180897,CDM,,,278,RC,inpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1715.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1933.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,1715.35,2161.25,
SYNTHES SCREW CORTEX 4.5X30MM,30180898,CDM,,,278,RC,inpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,222.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,197.08,248.31,
DEPUY UPCHARGE CERAMIC HEAD(695),30180908,CDM,,,278,RC,inpatient,,4225,4225,,3587.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3185.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3591.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3718,88,,percent of total billed charges,,,,,,,,,3227.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3844.75,91,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,,,,,,,,,,,,,3506.75,83,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3464.5,82,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,3185.65,4013.75,
SYNTHES K-WIRE 1.25MM,30180910,CDM,,,278,RC,inpatient,,111.82,111.82,,94.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,95.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.4,88,,percent of total billed charges,,,,,,,,,85.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.76,91,,percent of total billed charges,,,106.23,95,,percent of total billed charges,,,92.81,83,,percent of total billed charges,,,92.81,83,,percent of total billed charges,,,,,,,,,,,,,,,92.81,83,,percent of total billed charges,,,106.23,95,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,91.69,82,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,95.05,85,,percent of total billed charges,,84.31,106.23,
SYNTHES SCREW STARDRIVE 3.5X10MM,30180914,CDM,,,278,RC,inpatient,,1217.84,1217.84,,1033.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,918.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1035.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1071.7,88,,percent of total billed charges,,,,,,,,,930.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1108.23,91,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1010.81,83,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,998.63,82,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,918.25,1156.95,
SYNTHES SCREW STARDRIVE 3.5X12MM,30180915,CDM,,,278,RC,inpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,945.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1066.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,945.79,1191.65,
ARTHREX SCREW ANCHOR 5.5 W/FIBERWIRE,30180919,CDM,,,270,RC,inpatient,,1657.5,1657.5,,1407.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1249.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1408.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1458.6,88,,percent of total billed charges,,,,,,,,,1266.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1508.33,91,,percent of total billed charges,,,1574.63,95,,percent of total billed charges,,,1375.73,83,,percent of total billed charges,,,1375.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1375.73,83,,percent of total billed charges,,,1574.63,95,,percent of total billed charges,,,1491.75,90,,percent of total billed charges,,,1491.75,90,,percent of total billed charges,,,1359.15,82,,percent of total billed charges,,,1491.75,90,,percent of total billed charges,,,1408.88,85,,percent of total billed charges,,1249.76,1574.63,
DEPUY PATELLA BLADE MED,30180920,CDM,,,278,RC,inpatient,,1748.5,1748.5,,1484.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1318.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1486.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1538.68,88,,percent of total billed charges,,,,,,,,,1335.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1591.14,91,,percent of total billed charges,,,1661.08,95,,percent of total billed charges,,,1451.26,83,,percent of total billed charges,,,1451.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1451.26,83,,percent of total billed charges,,,1661.08,95,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1433.77,82,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1486.23,85,,percent of total billed charges,,1318.37,1661.08,
DEPUY UPCHARGE PORCOAT FEMUR(711),30180921,CDM,,,278,RC,inpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,980.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1105,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,980.2,1235,
DEPUY UPCHARGE CERAMIC LINER(696),30180922,CDM,,,278,RC,inpatient,,4225,4225,,3587.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3185.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3591.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3718,88,,percent of total billed charges,,,,,,,,,3227.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3844.75,91,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,,,,,,,,,,,,,3506.75,83,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3464.5,82,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,3185.65,4013.75,
DEPUY PATELLA BLADE SM,30180923,CDM,,,278,RC,inpatient,,1878.5,1878.5,,1594.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1416.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1596.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1653.08,88,,percent of total billed charges,,,,,,,,,1435.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1709.44,91,,percent of total billed charges,,,1784.58,95,,percent of total billed charges,,,1559.16,83,,percent of total billed charges,,,1559.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1559.16,83,,percent of total billed charges,,,1784.58,95,,percent of total billed charges,,,1690.65,90,,percent of total billed charges,,,1690.65,90,,percent of total billed charges,,,1540.37,82,,percent of total billed charges,,,1690.65,90,,percent of total billed charges,,,1596.73,85,,percent of total billed charges,,1416.39,1784.58,
DEPUY KNEE CEMENTED - CAPITATED (702),30180924,CDM,,,278,RC,inpatient,,23564.26,23564.26,,20006.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17767.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20029.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20736.55,88,,percent of total billed charges,,,,,,,,,18003.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21443.48,91,,percent of total billed charges,,,22386.05,95,,percent of total billed charges,,,19558.34,83,,percent of total billed charges,,,19558.34,83,,percent of total billed charges,,,,,,,,,,,,,,,19558.34,83,,percent of total billed charges,,,22386.05,95,,percent of total billed charges,,,21207.83,90,,percent of total billed charges,,,21207.83,90,,percent of total billed charges,,,19322.69,82,,percent of total billed charges,,,21207.83,90,,percent of total billed charges,,,20029.62,85,,percent of total billed charges,,17767.45,22386.05,
DEPUY PINNACLE CUP SECTOR II 60MM,30180926,CDM,,,278,RC,inpatient,,18892.32,18892.32,,16039.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14244.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16058.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16625.24,88,,percent of total billed charges,,,,,,,,,14433.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17192.01,91,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15680.63,83,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,15491.7,82,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,14244.81,17947.7,
DEPUY PINNACLE CUP INSERT 40 X 60,30180927,CDM,,,278,RC,inpatient,,17516.2,17516.2,,14871.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13207.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14888.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15414.26,88,,percent of total billed charges,,,,,,,,,13382.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15939.74,91,,percent of total billed charges,,,16640.39,95,,percent of total billed charges,,,14538.45,83,,percent of total billed charges,,,14538.45,83,,percent of total billed charges,,,,,,,,,,,,,,,14538.45,83,,percent of total billed charges,,,16640.39,95,,percent of total billed charges,,,15764.58,90,,percent of total billed charges,,,15764.58,90,,percent of total billed charges,,,14363.28,82,,percent of total billed charges,,,15764.58,90,,percent of total billed charges,,,14888.77,85,,percent of total billed charges,,13207.21,16640.39,
DEPUY FEMORAL HEAD 40MM +15.5,30180928,CDM,,,278,RC,inpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10650.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12006.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,10650.51,13419.08,
DEPUY PINNACLE MAR +4 10D 32 X 54,30180930,CDM,,,278,RC,inpatient,,10342.15,10342.15,,8780.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7797.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8790.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9101.09,88,,percent of total billed charges,,,,,,,,,7901.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9411.36,91,,percent of total billed charges,,,9825.04,95,,percent of total billed charges,,,8583.98,83,,percent of total billed charges,,,8583.98,83,,percent of total billed charges,,,,,,,,,,,,,,,8583.98,83,,percent of total billed charges,,,9825.04,95,,percent of total billed charges,,,9307.94,90,,percent of total billed charges,,,9307.94,90,,percent of total billed charges,,,8480.56,82,,percent of total billed charges,,,9307.94,90,,percent of total billed charges,,,8790.83,85,,percent of total billed charges,,7797.98,9825.04,
DEPUY PINNACLE MAR +4 10D 32 X 50,30180931,CDM,,,278,RC,inpatient,,10342.15,10342.15,,8780.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7797.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8790.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9101.09,88,,percent of total billed charges,,,,,,,,,7901.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9411.36,91,,percent of total billed charges,,,9825.04,95,,percent of total billed charges,,,8583.98,83,,percent of total billed charges,,,8583.98,83,,percent of total billed charges,,,,,,,,,,,,,,,8583.98,83,,percent of total billed charges,,,9825.04,95,,percent of total billed charges,,,9307.94,90,,percent of total billed charges,,,9307.94,90,,percent of total billed charges,,,8480.56,82,,percent of total billed charges,,,9307.94,90,,percent of total billed charges,,,8790.83,85,,percent of total billed charges,,7797.98,9825.04,
GORTEX SOFT TISSUE PATCH 10CM X 15CM,30180934,CDM,,,270,RC,inpatient,,4381,4381,,3719.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3303.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3723.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3855.28,88,,percent of total billed charges,,,,,,,,,3347.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3986.71,91,,percent of total billed charges,,,4161.95,95,,percent of total billed charges,,,3636.23,83,,percent of total billed charges,,,3636.23,83,,percent of total billed charges,,,,,,,,,,,,,,,3636.23,83,,percent of total billed charges,,,4161.95,95,,percent of total billed charges,,,3942.9,90,,percent of total billed charges,,,3942.9,90,,percent of total billed charges,,,3592.42,82,,percent of total billed charges,,,3942.9,90,,percent of total billed charges,,,3723.85,85,,percent of total billed charges,,3303.27,4161.95,
RAPID RHINO STAMMBERGER FOAM DRESSING,30180935,CDM,,,270,RC,inpatient,,483.07,483.07,,410.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,364.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,410.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,425.1,88,,percent of total billed charges,,,,,,,,,369.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,439.59,91,,percent of total billed charges,,,458.92,95,,percent of total billed charges,,,400.95,83,,percent of total billed charges,,,400.95,83,,percent of total billed charges,,,,,,,,,,,,,,,400.95,83,,percent of total billed charges,,,458.92,95,,percent of total billed charges,,,434.76,90,,percent of total billed charges,,,434.76,90,,percent of total billed charges,,,396.12,82,,percent of total billed charges,,,434.76,90,,percent of total billed charges,,,410.61,85,,percent of total billed charges,,364.23,458.92,
BARD AVAULTA SOLO ANTERIOR SYSTEM,30180937,CDM,,,270,RC,inpatient,,9262.5,9262.5,,7863.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6983.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7873.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8151,88,,percent of total billed charges,,,,,,,,,7076.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8428.88,91,,percent of total billed charges,,,8799.38,95,,percent of total billed charges,,,7687.88,83,,percent of total billed charges,,,7687.88,83,,percent of total billed charges,,,,,,,,,,,,,,,7687.88,83,,percent of total billed charges,,,8799.38,95,,percent of total billed charges,,,8336.25,90,,percent of total billed charges,,,8336.25,90,,percent of total billed charges,,,7595.25,82,,percent of total billed charges,,,8336.25,90,,percent of total billed charges,,,7873.13,85,,percent of total billed charges,,6983.93,8799.38,
BARD AVAULTA SOLO POSTERIOR SYSTEM,30180938,CDM,,,270,RC,inpatient,,9262.5,9262.5,,7863.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6983.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7873.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8151,88,,percent of total billed charges,,,,,,,,,7076.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8428.88,91,,percent of total billed charges,,,8799.38,95,,percent of total billed charges,,,7687.88,83,,percent of total billed charges,,,7687.88,83,,percent of total billed charges,,,,,,,,,,,,,,,7687.88,83,,percent of total billed charges,,,8799.38,95,,percent of total billed charges,,,8336.25,90,,percent of total billed charges,,,8336.25,90,,percent of total billed charges,,,7595.25,82,,percent of total billed charges,,,8336.25,90,,percent of total billed charges,,,7873.13,85,,percent of total billed charges,,6983.93,8799.38,
SYNTHES SCREW CORTEX 3.5X26MM,30180939,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
SYNTHES DRILL BIT 2.7MM,30180941,CDM,,,270,RC,inpatient,,1178.13,1178.13,,1000.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,888.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1001.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1036.75,88,,percent of total billed charges,,,,,,,,,900.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1072.1,91,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,,,,,,,,,,,,,977.85,83,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,966.07,82,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,888.31,1119.22,
STRYKER BLADE MICRO 18X.51X5.5MM,30180946,CDM,,,270,RC,inpatient,,307.28,307.28,,260.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,231.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,261.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,270.41,88,,percent of total billed charges,,,,,,,,,234.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,279.62,91,,percent of total billed charges,,,291.92,95,,percent of total billed charges,,,255.04,83,,percent of total billed charges,,,255.04,83,,percent of total billed charges,,,,,,,,,,,,,,,255.04,83,,percent of total billed charges,,,291.92,95,,percent of total billed charges,,,276.55,90,,percent of total billed charges,,,276.55,90,,percent of total billed charges,,,251.97,82,,percent of total billed charges,,,276.55,90,,percent of total billed charges,,,261.19,85,,percent of total billed charges,,231.69,291.92,
SYNTHES SCREW CORTEX 3.5X32MM,30180950,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
SYNTHES SCREW CORTEX 3.5X34MM,30180951,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
SYNTHES SCREW CORTEX 3.5X36MM,30180952,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
SYNTHES SCREW CORTEX 3.5X40MM,30180953,CDM,,,278,RC,inpatient,,267.75,267.75,,227.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,201.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,227.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,235.62,88,,percent of total billed charges,,,,,,,,,204.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,243.65,91,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,,,,,,,,,,,,,222.23,83,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,219.56,82,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,227.59,85,,percent of total billed charges,,201.88,254.36,
SYNTHES SCREW CANCEL F-THD 4.0X26MM,30180956,CDM,,,278,RC,inpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,178.47,224.87,
SYNTHES PLATE TUBULAR 8-HOLE,30180964,CDM,,,278,RC,inpatient,,1811.23,1811.23,,1537.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1365.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1539.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1593.88,88,,percent of total billed charges,,,,,,,,,1383.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1648.22,91,,percent of total billed charges,,,1720.67,95,,percent of total billed charges,,,1503.32,83,,percent of total billed charges,,,1503.32,83,,percent of total billed charges,,,,,,,,,,,,,,,1503.32,83,,percent of total billed charges,,,1720.67,95,,percent of total billed charges,,,1630.11,90,,percent of total billed charges,,,1630.11,90,,percent of total billed charges,,,1485.21,82,,percent of total billed charges,,,1630.11,90,,percent of total billed charges,,,1539.55,85,,percent of total billed charges,,1365.67,1720.67,
DEPUY KNEE CEMENTED - CAPITATED (017),30180966,CDM,,,278,RC,inpatient,,25218.18,25218.18,,21410.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19014.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21435.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22192,88,,percent of total billed charges,,,,,,,,,19266.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22948.54,91,,percent of total billed charges,,,23957.27,95,,percent of total billed charges,,,20931.09,83,,percent of total billed charges,,,20931.09,83,,percent of total billed charges,,,,,,,,,,,,,,,20931.09,83,,percent of total billed charges,,,23957.27,95,,percent of total billed charges,,,22696.36,90,,percent of total billed charges,,,22696.36,90,,percent of total billed charges,,,20678.91,82,,percent of total billed charges,,,22696.36,90,,percent of total billed charges,,,21435.45,85,,percent of total billed charges,,19014.51,23957.27,
DEPUY UPCHARGE XLINK POLY(027),30180967,CDM,,,278,RC,inpatient,,2434.71,2434.71,,2067.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1835.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2069.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2142.54,88,,percent of total billed charges,,,,,,,,,1860.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2215.59,91,,percent of total billed charges,,,2312.97,95,,percent of total billed charges,,,2020.81,83,,percent of total billed charges,,,2020.81,83,,percent of total billed charges,,,,,,,,,,,,,,,2020.81,83,,percent of total billed charges,,,2312.97,95,,percent of total billed charges,,,2191.24,90,,percent of total billed charges,,,2191.24,90,,percent of total billed charges,,,1996.46,82,,percent of total billed charges,,,2191.24,90,,percent of total billed charges,,,2069.5,85,,percent of total billed charges,,1835.77,2312.97,
AQUAMANTYS BIPOLAR SEALER 6.0,30180968,CDM,,,270,RC,inpatient,,4953,4953,,4205.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3734.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4210.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4358.64,88,,percent of total billed charges,,,,,,,,,3784.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4507.23,91,,percent of total billed charges,,,4705.35,95,,percent of total billed charges,,,4110.99,83,,percent of total billed charges,,,4110.99,83,,percent of total billed charges,,,,,,,,,,,,,,,4110.99,83,,percent of total billed charges,,,4705.35,95,,percent of total billed charges,,,4457.7,90,,percent of total billed charges,,,4457.7,90,,percent of total billed charges,,,4061.46,82,,percent of total billed charges,,,4457.7,90,,percent of total billed charges,,,4210.05,85,,percent of total billed charges,,3734.56,4705.35,
AQUAMANTYS BIPOLAR SEALER 2.3,30180969,CDM,,,270,RC,inpatient,,3458,3458,,2935.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2607.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2939.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3043.04,88,,percent of total billed charges,,,,,,,,,2641.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3146.78,91,,percent of total billed charges,,,3285.1,95,,percent of total billed charges,,,2870.14,83,,percent of total billed charges,,,2870.14,83,,percent of total billed charges,,,,,,,,,,,,,,,2870.14,83,,percent of total billed charges,,,3285.1,95,,percent of total billed charges,,,3112.2,90,,percent of total billed charges,,,3112.2,90,,percent of total billed charges,,,2835.56,82,,percent of total billed charges,,,3112.2,90,,percent of total billed charges,,,2939.3,85,,percent of total billed charges,,2607.33,3285.1,
AQUAMANTYS BIPOLAR SEALER MALLEABLE,30180970,CDM,,,270,RC,inpatient,,3718,3718,,3156.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2803.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3160.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3271.84,88,,percent of total billed charges,,,,,,,,,2840.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3383.38,91,,percent of total billed charges,,,3532.1,95,,percent of total billed charges,,,3085.94,83,,percent of total billed charges,,,3085.94,83,,percent of total billed charges,,,,,,,,,,,,,,,3085.94,83,,percent of total billed charges,,,3532.1,95,,percent of total billed charges,,,3346.2,90,,percent of total billed charges,,,3346.2,90,,percent of total billed charges,,,3048.76,82,,percent of total billed charges,,,3346.2,90,,percent of total billed charges,,,3160.3,85,,percent of total billed charges,,2803.37,3532.1,
AQUAMANTYS EPIDURAL VEIN SEALER,30180971,CDM,,,270,RC,inpatient,,4143.75,4143.75,,3518.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3124.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3522.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3646.5,88,,percent of total billed charges,,,,,,,,,3165.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3770.81,91,,percent of total billed charges,,,3936.56,95,,percent of total billed charges,,,3439.31,83,,percent of total billed charges,,,3439.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3439.31,83,,percent of total billed charges,,,3936.56,95,,percent of total billed charges,,,3729.38,90,,percent of total billed charges,,,3729.38,90,,percent of total billed charges,,,3397.88,82,,percent of total billed charges,,,3729.38,90,,percent of total billed charges,,,3522.19,85,,percent of total billed charges,,3124.39,3936.56,
SYNTHES SCREW CORTEX 4.5X40MM,30180972,CDM,,,278,RC,inpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,222.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,197.08,248.31,
DEPUY PINNACLE SCREW 6.5 X 35,30180978,CDM,,,278,RC,inpatient,,1075.49,1075.49,,913.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,810.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,914.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,946.43,88,,percent of total billed charges,,,,,,,,,821.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,978.7,91,,percent of total billed charges,,,1021.72,95,,percent of total billed charges,,,892.66,83,,percent of total billed charges,,,892.66,83,,percent of total billed charges,,,,,,,,,,,,,,,892.66,83,,percent of total billed charges,,,1021.72,95,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,881.9,82,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,914.17,85,,percent of total billed charges,,810.92,1021.72,
DEPUY LERE BONE MILL RENTAL 5415-00,30180983,CDM,,,278,RC,inpatient,,4257.5,4257.5,,3614.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3210.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3618.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3746.6,88,,percent of total billed charges,,,,,,,,,3252.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3874.33,91,,percent of total billed charges,,,4044.63,95,,percent of total billed charges,,,3533.73,83,,percent of total billed charges,,,3533.73,83,,percent of total billed charges,,,,,,,,,,,,,,,3533.73,83,,percent of total billed charges,,,4044.63,95,,percent of total billed charges,,,3831.75,90,,percent of total billed charges,,,3831.75,90,,percent of total billed charges,,,3491.15,82,,percent of total billed charges,,,3831.75,90,,percent of total billed charges,,,3618.88,85,,percent of total billed charges,,3210.16,4044.63,
DEPUY HEAD LARGE HIP (007),30180984,CDM,,,278,RC,inpatient,,43728.75,43728.75,,37125.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32971.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37169.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38481.3,88,,percent of total billed charges,,,,,,,,,33408.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,39793.16,91,,percent of total billed charges,,,41542.31,95,,percent of total billed charges,,,36294.86,83,,percent of total billed charges,,,36294.86,83,,percent of total billed charges,,,,,,,,,,,,,,,36294.86,83,,percent of total billed charges,,,41542.31,95,,percent of total billed charges,,,39355.88,90,,percent of total billed charges,,,39355.88,90,,percent of total billed charges,,,35857.58,82,,percent of total billed charges,,,39355.88,90,,percent of total billed charges,,,37169.44,85,,percent of total billed charges,,32971.48,41542.31,
VASCULAR LOOPS,30180993,CDM,,,270,RC,inpatient,,11.7,11.7,,9.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.3,88,,percent of total billed charges,,,,,,,,,8.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.65,91,,percent of total billed charges,,,11.12,95,,percent of total billed charges,,,9.71,83,,percent of total billed charges,,,9.71,83,,percent of total billed charges,,,,,,,,,,,,,,,9.71,83,,percent of total billed charges,,,11.12,95,,percent of total billed charges,,,10.53,90,,percent of total billed charges,,,10.53,90,,percent of total billed charges,,,9.59,82,,percent of total billed charges,,,10.53,90,,percent of total billed charges,,,9.95,85,,percent of total billed charges,,8.82,11.12,
SYNTHES K-WIRE 28MM,30180996,CDM,,,278,RC,inpatient,,504.98,504.98,,428.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,380.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,429.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,444.38,88,,percent of total billed charges,,,,,,,,,385.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,459.53,91,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,,,,,,,,,,,,,419.13,83,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,414.08,82,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,380.75,479.73,
SYNTHES DRILL BIT CANNULATED 5.0MM,30181000,CDM,,,270,RC,inpatient,,4460.56,4460.56,,3787.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3363.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3791.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3925.29,88,,percent of total billed charges,,,,,,,,,3407.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4059.11,91,,percent of total billed charges,,,4237.53,95,,percent of total billed charges,,,3702.26,83,,percent of total billed charges,,,3702.26,83,,percent of total billed charges,,,,,,,,,,,,,,,3702.26,83,,percent of total billed charges,,,4237.53,95,,percent of total billed charges,,,4014.5,90,,percent of total billed charges,,,4014.5,90,,percent of total billed charges,,,3657.66,82,,percent of total billed charges,,,4014.5,90,,percent of total billed charges,,,3791.48,85,,percent of total billed charges,,3363.26,4237.53,
DEPUY INSERT SIGMA XLK 2.5X10MM,30181003,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY FEMUR CEMENTED RT SZ2.5,30181004,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
DEPUY FEMUR CEMENTED LT SZ2.5,30181005,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
DEPUY KNEE POROUS - CAPITATED (019),30181008,CDM,,,278,RC,inpatient,,27856.92,27856.92,,23650.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21004.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23678.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24514.09,88,,percent of total billed charges,,,,,,,,,21282.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25349.8,91,,percent of total billed charges,,,26464.07,95,,percent of total billed charges,,,23121.24,83,,percent of total billed charges,,,23121.24,83,,percent of total billed charges,,,,,,,,,,,,,,,23121.24,83,,percent of total billed charges,,,26464.07,95,,percent of total billed charges,,,25071.23,90,,percent of total billed charges,,,25071.23,90,,percent of total billed charges,,,22842.67,82,,percent of total billed charges,,,25071.23,90,,percent of total billed charges,,,23678.38,85,,percent of total billed charges,,21004.12,26464.07,
DEPUY UPCHARGE PORCOAT FEMUR(026),30181009,CDM,,,278,RC,inpatient,,1391.26,1391.26,,1181.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1049.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1182.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1224.31,88,,percent of total billed charges,,,,,,,,,1062.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1266.05,91,,percent of total billed charges,,,1321.7,95,,percent of total billed charges,,,1154.75,83,,percent of total billed charges,,,1154.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1154.75,83,,percent of total billed charges,,,1321.7,95,,percent of total billed charges,,,1252.13,90,,percent of total billed charges,,,1252.13,90,,percent of total billed charges,,,1140.83,82,,percent of total billed charges,,,1252.13,90,,percent of total billed charges,,,1182.57,85,,percent of total billed charges,,1049.01,1321.7,
NEEDLE SPINAL 18GA 6,30181010,CDM,,,270,RC,inpatient,,24.03,24.03,,20.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.15,88,,percent of total billed charges,,,,,,,,,18.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.87,91,,percent of total billed charges,,,22.83,95,,percent of total billed charges,,,19.94,83,,percent of total billed charges,,,19.94,83,,percent of total billed charges,,,,,,,,,,,,,,,19.94,83,,percent of total billed charges,,,22.83,95,,percent of total billed charges,,,21.63,90,,percent of total billed charges,,,21.63,90,,percent of total billed charges,,,19.7,82,,percent of total billed charges,,,21.63,90,,percent of total billed charges,,,20.43,85,,percent of total billed charges,,18.12,22.83,
DEPUY HIP POROUS - CAPITATED (006),30181016,CDM,,,278,RC,inpatient,,32421.22,32421.22,,27525.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24445.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27558.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28530.67,88,,percent of total billed charges,,,,,,,,,24769.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29503.31,91,,percent of total billed charges,,,30800.16,95,,percent of total billed charges,,,26909.61,83,,percent of total billed charges,,,26909.61,83,,percent of total billed charges,,,,,,,,,,,,,,,26909.61,83,,percent of total billed charges,,,30800.16,95,,percent of total billed charges,,,29179.1,90,,percent of total billed charges,,,29179.1,90,,percent of total billed charges,,,26585.4,82,,percent of total billed charges,,,29179.1,90,,percent of total billed charges,,,27558.04,85,,percent of total billed charges,,24445.6,30800.16,
DEPUY UPCHARGE METAL HEAD (009),30181017,CDM,,,278,RC,inpatient,,1850.36,1850.36,,1570.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1395.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1572.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1628.32,88,,percent of total billed charges,,,,,,,,,1413.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1683.83,91,,percent of total billed charges,,,1757.84,95,,percent of total billed charges,,,1535.8,83,,percent of total billed charges,,,1535.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1535.8,83,,percent of total billed charges,,,1757.84,95,,percent of total billed charges,,,1665.32,90,,percent of total billed charges,,,1665.32,90,,percent of total billed charges,,,1517.3,82,,percent of total billed charges,,,1665.32,90,,percent of total billed charges,,,1572.81,85,,percent of total billed charges,,1395.17,1757.84,
DEPUY LINER ALTRX X-LINK (014),30181018,CDM,,,278,RC,inpatient,,2956.46,2956.46,,2510.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2229.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2512.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2601.68,88,,percent of total billed charges,,,,,,,,,2258.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2690.38,91,,percent of total billed charges,,,2808.64,95,,percent of total billed charges,,,2453.86,83,,percent of total billed charges,,,2453.86,83,,percent of total billed charges,,,,,,,,,,,,,,,2453.86,83,,percent of total billed charges,,,2808.64,95,,percent of total billed charges,,,2660.81,90,,percent of total billed charges,,,2660.81,90,,percent of total billed charges,,,2424.3,82,,percent of total billed charges,,,2660.81,90,,percent of total billed charges,,,2512.99,85,,percent of total billed charges,,2229.17,2808.64,
DEPUY INSERT SIGMA XLK 5 X 8,30181022,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY PATELLA BLADE LGE,30181024,CDM,,,278,RC,inpatient,,1748.5,1748.5,,1484.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1318.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1486.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1538.68,88,,percent of total billed charges,,,,,,,,,1335.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1591.14,91,,percent of total billed charges,,,1661.08,95,,percent of total billed charges,,,1451.26,83,,percent of total billed charges,,,1451.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1451.26,83,,percent of total billed charges,,,1661.08,95,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1433.77,82,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1486.23,85,,percent of total billed charges,,1318.37,1661.08,
SYNTHES SCREW CANNUL 4.0X48MM,30181031,CDM,,,278,RC,inpatient,,2003.17,2003.17,,1700.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1510.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1702.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1762.79,88,,percent of total billed charges,,,,,,,,,1530.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1822.88,91,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1662.63,83,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1642.6,82,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,1510.39,1903.01,
SYNTHES SCREW CANNUL 4.0X50MM,30181032,CDM,,,278,RC,inpatient,,2063.23,2063.23,,1751.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1555.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1753.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1815.64,88,,percent of total billed charges,,,,,,,,,1576.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1877.54,91,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1712.48,83,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1691.85,82,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,1555.68,1960.07,
SYNTHES WASHER 7.0MM,30181033,CDM,,,270,RC,inpatient,,290.85,290.85,,246.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,219.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,247.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,255.95,88,,percent of total billed charges,,,,,,,,,222.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,264.67,91,,percent of total billed charges,,,276.31,95,,percent of total billed charges,,,241.41,83,,percent of total billed charges,,,241.41,83,,percent of total billed charges,,,,,,,,,,,,,,,241.41,83,,percent of total billed charges,,,276.31,95,,percent of total billed charges,,,261.77,90,,percent of total billed charges,,,261.77,90,,percent of total billed charges,,,238.5,82,,percent of total billed charges,,,261.77,90,,percent of total billed charges,,,247.22,85,,percent of total billed charges,,219.3,276.31,
ZIMMER BLADE EXPLANT 58MM X 10,30181037,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
ZIMMER BLADE EXPLANT 58MM X 20,30181038,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
DEPUY PINNACLE CUP REVISION 62MM,30181039,CDM,,,278,RC,inpatient,,33437.04,33437.04,,28388.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25211.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28421.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29424.6,88,,percent of total billed charges,,,,,,,,,25545.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30427.71,91,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,,,,,,,,,,,,,27752.74,83,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,27418.37,82,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,25211.53,31765.19,
DEPUY 5.0MM DIA TPRD HD PER SCRW 40,30181040,CDM,,,278,RC,inpatient,,930,930,,789.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,701.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,790.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,818.4,88,,percent of total billed charges,,,,,,,,,710.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,846.3,91,,percent of total billed charges,,,883.5,95,,percent of total billed charges,,,771.9,83,,percent of total billed charges,,,771.9,83,,percent of total billed charges,,,,,,,,,,,,,,,771.9,83,,percent of total billed charges,,,883.5,95,,percent of total billed charges,,,837,90,,percent of total billed charges,,,837,90,,percent of total billed charges,,,762.6,82,,percent of total billed charges,,,837,90,,percent of total billed charges,,,790.5,85,,percent of total billed charges,,701.22,883.5,
DEPUY SCREW TAPER 30 X 5.0,30181041,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
DEPUY PINNACLE SCREW 6.5 X 50,30181042,CDM,,,278,RC,inpatient,,1244.95,1244.95,,1056.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,938.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1058.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1095.56,88,,percent of total billed charges,,,,,,,,,951.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1132.9,91,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.31,83,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1020.86,82,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,938.69,1182.7,
DEPUY LINER ALTRX +4 NEUT 36 X 56,30181043,CDM,,,278,RC,inpatient,,14161.81,14161.81,,12023.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10678,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12037.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12462.39,88,,percent of total billed charges,,,,,,,,,10819.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12887.25,91,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,,,,,,,,,,,,,11754.3,83,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,11612.68,82,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,10678,13453.72,
DEPUY KNEE HYBRID - CAPITATED (018),30181044,CDM,,,278,RC,inpatient,,27011.14,27011.14,,22932.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20366.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22959.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23769.8,88,,percent of total billed charges,,,,,,,,,20636.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24580.14,91,,percent of total billed charges,,,25660.58,95,,percent of total billed charges,,,22419.25,83,,percent of total billed charges,,,22419.25,83,,percent of total billed charges,,,,,,,,,,,,,,,22419.25,83,,percent of total billed charges,,,25660.58,95,,percent of total billed charges,,,24310.03,90,,percent of total billed charges,,,24310.03,90,,percent of total billed charges,,,22149.13,82,,percent of total billed charges,,,24310.03,90,,percent of total billed charges,,,22959.47,85,,percent of total billed charges,,20366.4,25660.58,
DEPUY PINNACLE CUP 58MM,30181052,CDM,,,278,RC,inpatient,,14472.9,14472.9,,12287.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10912.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12301.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12736.15,88,,percent of total billed charges,,,,,,,,,11057.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13170.34,91,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12012.51,83,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,11867.78,82,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,10912.57,13749.26,
DEPUY LINER ALTRX +4 NEUT 36 X 58,30181053,CDM,,,278,RC,inpatient,,14161.81,14161.81,,12023.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10678,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12037.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12462.39,88,,percent of total billed charges,,,,,,,,,10819.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12887.25,91,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,,,,,,,,,,,,,11754.3,83,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,11612.68,82,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,10678,13453.72,
DEPUY FEMORAL HEAD 40MM +5,30181054,CDM,,,278,RC,inpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10650.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12006.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,10650.51,13419.08,
DEPUY HEAD METAL LGE =/>40MM,30181055,CDM,,,278,RC,inpatient,,4032.6,4032.6,,3423.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3040.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3427.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3548.69,88,,percent of total billed charges,,,,,,,,,3080.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3669.67,91,,percent of total billed charges,,,3830.97,95,,percent of total billed charges,,,3347.06,83,,percent of total billed charges,,,3347.06,83,,percent of total billed charges,,,,,,,,,,,,,,,3347.06,83,,percent of total billed charges,,,3830.97,95,,percent of total billed charges,,,3629.34,90,,percent of total billed charges,,,3629.34,90,,percent of total billed charges,,,3306.73,82,,percent of total billed charges,,,3629.34,90,,percent of total billed charges,,,3427.71,85,,percent of total billed charges,,3040.58,3830.97,
DEPUY LINER ALTRX +4 NEUT 36 X 60,30181056,CDM,,,278,RC,inpatient,,14161.81,14161.81,,12023.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10678,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12037.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12462.39,88,,percent of total billed charges,,,,,,,,,10819.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12887.25,91,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,,,,,,,,,,,,,11754.3,83,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,11612.68,82,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,10678,13453.72,
DEPUY STEM SUMMIT TAPER SZ7 HI OFF,30181057,CDM,,,278,RC,inpatient,,35147,35147,,29839.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26500.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29874.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30929.36,88,,percent of total billed charges,,,,,,,,,26852.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31983.77,91,,percent of total billed charges,,,33389.65,95,,percent of total billed charges,,,29172.01,83,,percent of total billed charges,,,29172.01,83,,percent of total billed charges,,,,,,,,,,,,,,,29172.01,83,,percent of total billed charges,,,33389.65,95,,percent of total billed charges,,,31632.3,90,,percent of total billed charges,,,31632.3,90,,percent of total billed charges,,,28820.54,82,,percent of total billed charges,,,31632.3,90,,percent of total billed charges,,,29874.95,85,,percent of total billed charges,,26500.84,33389.65,
MEDSOURCE RADIAL STEM 9.0X4.0MM,30181065,CDM,,,278,RC,inpatient,,10504,10504,,8917.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7920.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8928.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9243.52,88,,percent of total billed charges,,,,,,,,,8025.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9558.64,91,,percent of total billed charges,,,9978.8,95,,percent of total billed charges,,,8718.32,83,,percent of total billed charges,,,8718.32,83,,percent of total billed charges,,,,,,,,,,,,,,,8718.32,83,,percent of total billed charges,,,9978.8,95,,percent of total billed charges,,,9453.6,90,,percent of total billed charges,,,9453.6,90,,percent of total billed charges,,,8613.28,82,,percent of total billed charges,,,9453.6,90,,percent of total billed charges,,,8928.4,85,,percent of total billed charges,,7920.02,9978.8,
MEDSOURCE RADIAL HEAD 24.0MM RIGHT,30181066,CDM,,,278,RC,inpatient,,16796,16796,,14259.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12664.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14276.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14780.48,88,,percent of total billed charges,,,,,,,,,12832.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15284.36,91,,percent of total billed charges,,,15956.2,95,,percent of total billed charges,,,13940.68,83,,percent of total billed charges,,,13940.68,83,,percent of total billed charges,,,,,,,,,,,,,,,13940.68,83,,percent of total billed charges,,,15956.2,95,,percent of total billed charges,,,15116.4,90,,percent of total billed charges,,,15116.4,90,,percent of total billed charges,,,13772.72,82,,percent of total billed charges,,,15116.4,90,,percent of total billed charges,,,14276.6,85,,percent of total billed charges,,12664.18,15956.2,
SINGLE TITANIUM PORT SYSTEM,30181069,CDM,,,270,RC,inpatient,,2502.5,2502.5,,2124.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1886.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2127.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2202.2,88,,percent of total billed charges,,,,,,,,,1911.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2277.28,91,,percent of total billed charges,,,2377.38,95,,percent of total billed charges,,,2077.08,83,,percent of total billed charges,,,2077.08,83,,percent of total billed charges,,,,,,,,,,,,,,,2077.08,83,,percent of total billed charges,,,2377.38,95,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2052.05,82,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2127.13,85,,percent of total billed charges,,1886.89,2377.38,
ANTERIOR TIBIALIS TENDON,30181081,CDM,,,270,RC,inpatient,,5720,5720,,4856.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4312.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4862,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5033.6,88,,percent of total billed charges,,,,,,,,,4370.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5205.2,91,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4747.6,83,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4690.4,82,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4862,85,,percent of total billed charges,,4312.88,5434,
DEPUY FEMUR CEMENTED LT SZ2,30181082,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
DEPUY INSERT SIGMA XLK 2 X 15,30181083,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY LINER ALTRX +4 NEUT 44 X 64,30181084,CDM,,,278,RC,inpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13270.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14960.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,13270.78,16720.48,
DEPUY FEMORAL HEAD 44MM +8.5,30181086,CDM,,,278,RC,inpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10650.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12006.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,10650.51,13419.08,
DEPUY STEM CORAIL HI OFFSET SZ18,30181087,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
S&N RESURFACING PATELLA 35MM,30181088,CDM,,,278,RC,inpatient,,6584.24,6584.24,,5590.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4964.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5596.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5794.13,88,,percent of total billed charges,,,,,,,,,5030.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5991.66,91,,percent of total billed charges,,,6255.03,95,,percent of total billed charges,,,5464.92,83,,percent of total billed charges,,,5464.92,83,,percent of total billed charges,,,,,,,,,,,,,,,5464.92,83,,percent of total billed charges,,,6255.03,95,,percent of total billed charges,,,5925.82,90,,percent of total billed charges,,,5925.82,90,,percent of total billed charges,,,5399.08,82,,percent of total billed charges,,,5925.82,90,,percent of total billed charges,,,5596.6,85,,percent of total billed charges,,4964.52,6255.03,
SYNTHES SCREW CORTEX S-T 2.7X14MM,30181089,CDM,,,278,RC,inpatient,,410.27,410.27,,348.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,309.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,348.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,361.04,88,,percent of total billed charges,,,,,,,,,313.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,373.35,91,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,,,,,,,,,,,,,340.52,83,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,336.42,82,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,348.73,85,,percent of total billed charges,,309.34,389.76,
SYNTHES SCREW DISTAL RADIUS 2.4X22MM,30181092,CDM,,,278,RC,inpatient,,1276.28,1276.28,,1083.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,962.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1084.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1123.13,88,,percent of total billed charges,,,,,,,,,975.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1161.41,91,,percent of total billed charges,,,1212.47,95,,percent of total billed charges,,,1059.31,83,,percent of total billed charges,,,1059.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1059.31,83,,percent of total billed charges,,,1212.47,95,,percent of total billed charges,,,1148.65,90,,percent of total billed charges,,,1148.65,90,,percent of total billed charges,,,1046.55,82,,percent of total billed charges,,,1148.65,90,,percent of total billed charges,,,1084.84,85,,percent of total billed charges,,962.32,1212.47,
SYNTHES SCREW DISTAL RADIUS 2.4X18MM,30181093,CDM,,,278,RC,inpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1020.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1150.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,1020.93,1286.32,
SYNTHES SCREW DISTAL RADIUS 2.4X16MM,30181094,CDM,,,278,RC,inpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1020.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1150.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,1020.93,1286.32,
SYNTHES SCREW DISTAL RADIUS 2.4X20MM,30181095,CDM,,,278,RC,inpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1020.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1150.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,1020.93,1286.32,
SYNTHES SCREW CORTEX S-T 2.4X20MM,30181096,CDM,,,278,RC,inpatient,,565.25,565.25,,479.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,426.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,480.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,497.42,88,,percent of total billed charges,,,,,,,,,431.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,514.38,91,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,,,,,,,,,,,,,469.16,83,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,463.51,82,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,480.46,85,,percent of total billed charges,,426.2,536.99,
DEPUY LINER ALTRX NEUT 36 X 58,30181101,CDM,,,278,RC,inpatient,,12874.42,12874.42,,10930.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9707.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10943.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11329.49,88,,percent of total billed charges,,,,,,,,,9836.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11715.72,91,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,,,,,,,,,,,,,10685.77,83,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10557.02,82,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10943.26,85,,percent of total billed charges,,9707.31,12230.7,
DEPUY UPCHARGE CERAMIC HEAD(010),30181102,CDM,,,278,RC,inpatient,,4521.53,4521.53,,3838.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3409.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3843.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3978.95,88,,percent of total billed charges,,,,,,,,,3454.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4114.59,91,,percent of total billed charges,,,4295.45,95,,percent of total billed charges,,,3752.87,83,,percent of total billed charges,,,3752.87,83,,percent of total billed charges,,,,,,,,,,,,,,,3752.87,83,,percent of total billed charges,,,4295.45,95,,percent of total billed charges,,,4069.38,90,,percent of total billed charges,,,4069.38,90,,percent of total billed charges,,,3707.65,82,,percent of total billed charges,,,4069.38,90,,percent of total billed charges,,,3843.3,85,,percent of total billed charges,,3409.23,4295.45,
SYNTHES SCREW CORTEX S-T 2.4X18MM,30181103,CDM,,,278,RC,inpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,452.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,509.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,452.17,569.71,
STRYKER BONE CLEANING TIP,30181114,CDM,,,270,RC,inpatient,,96,96,,81.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,72.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,81.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,84.48,88,,percent of total billed charges,,,,,,,,,73.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,87.36,91,,percent of total billed charges,,,91.2,95,,percent of total billed charges,,,79.68,83,,percent of total billed charges,,,79.68,83,,percent of total billed charges,,,,,,,,,,,,,,,79.68,83,,percent of total billed charges,,,91.2,95,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,78.72,82,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,81.6,85,,percent of total billed charges,,72.38,91.2,
BIOMET BONE HEALING STIMULATOR,30181115,CDM,,,278,RC,inpatient,,40839.5,40839.5,,34672.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30792.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34713.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35938.76,88,,percent of total billed charges,,,,,,,,,31201.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37163.95,91,,percent of total billed charges,,,38797.53,95,,percent of total billed charges,,,33896.79,83,,percent of total billed charges,,,33896.79,83,,percent of total billed charges,,,,,,,,,,,,,,,33896.79,83,,percent of total billed charges,,,38797.53,95,,percent of total billed charges,,,36755.55,90,,percent of total billed charges,,,36755.55,90,,percent of total billed charges,,,33488.39,82,,percent of total billed charges,,,36755.55,90,,percent of total billed charges,,,34713.58,85,,percent of total billed charges,,30792.98,38797.53,
DEPUY PINNACLE SCREW 6.5 X 55,30181135,CDM,,,278,RC,inpatient,,1244.95,1244.95,,1056.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,938.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1058.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1095.56,88,,percent of total billed charges,,,,,,,,,951.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1132.9,91,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.31,83,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1020.86,82,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,938.69,1182.7,
DEPUY SELF CENT HIP 51X28 BRN,30181136,CDM,,,278,RC,inpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,6126.3,7718.82,
DEPUY ARTICUL/EZE BALL 28MM +8.5,30181137,CDM,,,278,RC,inpatient,,7289.17,7289.17,,6188.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5496.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6195.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6414.47,88,,percent of total billed charges,,,,,,,,,5568.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6633.14,91,,percent of total billed charges,,,6924.71,95,,percent of total billed charges,,,6050.01,83,,percent of total billed charges,,,6050.01,83,,percent of total billed charges,,,,,,,,,,,,,,,6050.01,83,,percent of total billed charges,,,6924.71,95,,percent of total billed charges,,,6560.25,90,,percent of total billed charges,,,6560.25,90,,percent of total billed charges,,,5977.12,82,,percent of total billed charges,,,6560.25,90,,percent of total billed charges,,,6195.79,85,,percent of total billed charges,,5496.03,6924.71,
DEPUY-MITEK MICROFIX ANCHOR #2/0,30181138,CDM,,,278,RC,inpatient,,4270.5,4270.5,,3625.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3219.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3629.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3758.04,88,,percent of total billed charges,,,,,,,,,3262.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3886.16,91,,percent of total billed charges,,,4056.98,95,,percent of total billed charges,,,3544.52,83,,percent of total billed charges,,,3544.52,83,,percent of total billed charges,,,,,,,,,,,,,,,3544.52,83,,percent of total billed charges,,,4056.98,95,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3501.81,82,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3629.93,85,,percent of total billed charges,,3219.96,4056.98,
DEMINERALIZED BONE MATRIX 30ML,30181139,CDM,,,270,RC,inpatient,,4547.4,4547.4,,3860.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3428.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3865.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4001.71,88,,percent of total billed charges,,,,,,,,,3474.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4138.13,91,,percent of total billed charges,,,4320.03,95,,percent of total billed charges,,,3774.34,83,,percent of total billed charges,,,3774.34,83,,percent of total billed charges,,,,,,,,,,,,,,,3774.34,83,,percent of total billed charges,,,4320.03,95,,percent of total billed charges,,,4092.66,90,,percent of total billed charges,,,4092.66,90,,percent of total billed charges,,,3728.87,82,,percent of total billed charges,,,4092.66,90,,percent of total billed charges,,,3865.29,85,,percent of total billed charges,,3428.74,4320.03,
DEPUY CROSSLINK ANC GLENOID SZ48,30181144,CDM,,,278,RC,inpatient,,17098.9,17098.9,,14516.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12892.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14534.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15047.03,88,,percent of total billed charges,,,,,,,,,13063.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15560,91,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,,,,,,,,,,,,,14192.09,83,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14021.1,82,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14534.07,85,,percent of total billed charges,,12892.57,16243.96,
DEPUY STEM GLOBAL HUMERAL 48 X 21,30181145,CDM,,,278,RC,inpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13297.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14990.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,13297.64,16754.32,
DEPUY GLOBAL ADVANTAGE PC STEM 14MM,30181146,CDM,,,278,RC,inpatient,,36482.49,36482.49,,30973.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27507.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31010.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32104.59,88,,percent of total billed charges,,,,,,,,,27872.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33199.07,91,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,,,,,,,,,,,,,30280.47,83,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,29915.64,82,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,31010.12,85,,percent of total billed charges,,27507.8,34658.37,
DEPUY PINNACLE CUP REVISION 72MM,30181148,CDM,,,278,RC,inpatient,,33437.04,33437.04,,28388.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25211.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28421.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29424.6,88,,percent of total billed charges,,,,,,,,,25545.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30427.71,91,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,,,,,,,,,,,,,27752.74,83,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,27418.37,82,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,25211.53,31765.19,
DEPUY PINNACLE SCREW 6.5 X 45,30181149,CDM,,,278,RC,inpatient,,1244.95,1244.95,,1056.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,938.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1058.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1095.56,88,,percent of total billed charges,,,,,,,,,951.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1132.9,91,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.31,83,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1020.86,82,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,938.69,1182.7,
DEPUY PINNACLE SCREW 6.5 X 20,30181150,CDM,,,278,RC,inpatient,,1075.49,1075.49,,913.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,810.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,914.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,946.43,88,,percent of total billed charges,,,,,,,,,821.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,978.7,91,,percent of total billed charges,,,1021.72,95,,percent of total billed charges,,,892.66,83,,percent of total billed charges,,,892.66,83,,percent of total billed charges,,,,,,,,,,,,,,,892.66,83,,percent of total billed charges,,,1021.72,95,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,881.9,82,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,914.17,85,,percent of total billed charges,,810.92,1021.72,
DEPUY SCREW TAPER 45 X 5.0,30181151,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
DEPUY PINNACLE CUP INSERT 44 X 66,30181152,CDM,,,278,RC,inpatient,,18531.63,18531.63,,15733.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13972.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15751.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16307.83,88,,percent of total billed charges,,,,,,,,,14158.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16863.78,91,,percent of total billed charges,,,17605.05,95,,percent of total billed charges,,,15381.25,83,,percent of total billed charges,,,15381.25,83,,percent of total billed charges,,,,,,,,,,,,,,,15381.25,83,,percent of total billed charges,,,17605.05,95,,percent of total billed charges,,,16678.47,90,,percent of total billed charges,,,16678.47,90,,percent of total billed charges,,,15195.94,82,,percent of total billed charges,,,16678.47,90,,percent of total billed charges,,,15751.89,85,,percent of total billed charges,,13972.85,17605.05,
DEPUY STEM TRI-LOCK HI OFFSET SZ3,30181157,CDM,,,278,RC,inpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30697.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34606.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,30697.71,38677.48,
DEPUY STEM SUMMIT PRESSFIT SZ6,30181158,CDM,,,278,RC,inpatient,,11591.45,11591.45,,9841.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8739.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9852.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10200.48,88,,percent of total billed charges,,,,,,,,,8855.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10548.22,91,,percent of total billed charges,,,11011.88,95,,percent of total billed charges,,,9620.9,83,,percent of total billed charges,,,9620.9,83,,percent of total billed charges,,,,,,,,,,,,,,,9620.9,83,,percent of total billed charges,,,11011.88,95,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,9504.99,82,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,9852.73,85,,percent of total billed charges,,8739.95,11011.88,
DEPUY ORTHOSORB RESORBABLE PIN,30181159,CDM,,,278,RC,inpatient,,3095.95,3095.95,,2628.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2334.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2631.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2724.44,88,,percent of total billed charges,,,,,,,,,2365.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2817.31,91,,percent of total billed charges,,,2941.15,95,,percent of total billed charges,,,2569.64,83,,percent of total billed charges,,,2569.64,83,,percent of total billed charges,,,,,,,,,,,,,,,2569.64,83,,percent of total billed charges,,,2941.15,95,,percent of total billed charges,,,2786.36,90,,percent of total billed charges,,,2786.36,90,,percent of total billed charges,,,2538.68,82,,percent of total billed charges,,,2786.36,90,,percent of total billed charges,,,2631.56,85,,percent of total billed charges,,2334.35,2941.15,
ELECTRODE CUTTING MONO 22-24FR,30181160,CDM,,,270,RC,inpatient,,658.35,658.35,,558.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,496.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,559.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,579.35,88,,percent of total billed charges,,,,,,,,,502.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,599.1,91,,percent of total billed charges,,,625.43,95,,percent of total billed charges,,,546.43,83,,percent of total billed charges,,,546.43,83,,percent of total billed charges,,,,,,,,,,,,,,,546.43,83,,percent of total billed charges,,,625.43,95,,percent of total billed charges,,,592.52,90,,percent of total billed charges,,,592.52,90,,percent of total billed charges,,,539.85,82,,percent of total billed charges,,,592.52,90,,percent of total billed charges,,,559.6,85,,percent of total billed charges,,496.4,625.43,
ELECTRODE CUTTING MONO 24FR,30181161,CDM,,,270,RC,inpatient,,648.45,648.45,,550.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,488.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,551.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,570.64,88,,percent of total billed charges,,,,,,,,,495.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,590.09,91,,percent of total billed charges,,,616.03,95,,percent of total billed charges,,,538.21,83,,percent of total billed charges,,,538.21,83,,percent of total billed charges,,,,,,,,,,,,,,,538.21,83,,percent of total billed charges,,,616.03,95,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,531.73,82,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,551.18,85,,percent of total billed charges,,488.93,616.03,
SYNTHES PLATE LCP RT 2.7MM,30181164,CDM,,,278,RC,inpatient,,6318.65,6318.65,,5364.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4764.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5370.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5560.41,88,,percent of total billed charges,,,,,,,,,4827.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5749.97,91,,percent of total billed charges,,,6002.72,95,,percent of total billed charges,,,5244.48,83,,percent of total billed charges,,,5244.48,83,,percent of total billed charges,,,,,,,,,,,,,,,5244.48,83,,percent of total billed charges,,,6002.72,95,,percent of total billed charges,,,5686.79,90,,percent of total billed charges,,,5686.79,90,,percent of total billed charges,,,5181.29,82,,percent of total billed charges,,,5686.79,90,,percent of total billed charges,,,5370.85,85,,percent of total billed charges,,4764.26,6002.72,
GUIDEWIRE ENDOSCOPY .038IN,30181165,CDM,,,270,RC,inpatient,,109.76,109.76,,93.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,93.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,96.59,88,,percent of total billed charges,,,,,,,,,83.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.88,91,,percent of total billed charges,,,104.27,95,,percent of total billed charges,,,91.1,83,,percent of total billed charges,,,91.1,83,,percent of total billed charges,,,,,,,,,,,,,,,91.1,83,,percent of total billed charges,,,104.27,95,,percent of total billed charges,,,98.78,90,,percent of total billed charges,,,98.78,90,,percent of total billed charges,,,90,82,,percent of total billed charges,,,98.78,90,,percent of total billed charges,,,93.3,85,,percent of total billed charges,,82.76,104.27,
SYNTHES SCREW CORTEX S-T 2.7X18MM,30181178,CDM,,,278,RC,inpatient,,410.27,410.27,,348.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,309.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,348.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,361.04,88,,percent of total billed charges,,,,,,,,,313.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,373.35,91,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,,,,,,,,,,,,,340.52,83,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,336.42,82,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,348.73,85,,percent of total billed charges,,309.34,389.76,
SYNTHES PLATE DISTAL RADIUS 2.4MM,30181180,CDM,,,278,RC,inpatient,,8878.68,8878.68,,7538,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6694.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7546.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7813.24,88,,percent of total billed charges,,,,,,,,,6783.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8079.6,91,,percent of total billed charges,,,8434.75,95,,percent of total billed charges,,,7369.3,83,,percent of total billed charges,,,7369.3,83,,percent of total billed charges,,,,,,,,,,,,,,,7369.3,83,,percent of total billed charges,,,8434.75,95,,percent of total billed charges,,,7990.81,90,,percent of total billed charges,,,7990.81,90,,percent of total billed charges,,,7280.52,82,,percent of total billed charges,,,7990.81,90,,percent of total billed charges,,,7546.88,85,,percent of total billed charges,,6694.52,8434.75,
DEPUY LINER ALTRX +4 40 X 60,30181181,CDM,,,278,RC,inpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13270.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14960.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,13270.78,16720.48,
DEPUY LINER ALTRX +4 NEUT 40 X 60,30181182,CDM,,,278,RC,inpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13270.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14960.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,13270.78,16720.48,
CAPIO SUTURE CAPTURE DEVICE,30181183,CDM,,,270,RC,inpatient,,2250.63,2250.63,,1910.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1696.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1913.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1980.55,88,,percent of total billed charges,,,,,,,,,1719.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2048.07,91,,percent of total billed charges,,,2138.1,95,,percent of total billed charges,,,1868.02,83,,percent of total billed charges,,,1868.02,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.02,83,,percent of total billed charges,,,2138.1,95,,percent of total billed charges,,,2025.57,90,,percent of total billed charges,,,2025.57,90,,percent of total billed charges,,,1845.52,82,,percent of total billed charges,,,2025.57,90,,percent of total billed charges,,,1913.04,85,,percent of total billed charges,,1696.98,2138.1,
CAPIO SUTURE BONDEK 3.5 X 90CM,30181184,CDM,,,270,RC,inpatient,,228.15,228.15,,193.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,172.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.77,88,,percent of total billed charges,,,,,,,,,174.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.62,91,,percent of total billed charges,,,216.74,95,,percent of total billed charges,,,189.36,83,,percent of total billed charges,,,189.36,83,,percent of total billed charges,,,,,,,,,,,,,,,189.36,83,,percent of total billed charges,,,216.74,95,,percent of total billed charges,,,205.34,90,,percent of total billed charges,,,205.34,90,,percent of total billed charges,,,187.08,82,,percent of total billed charges,,,205.34,90,,percent of total billed charges,,,193.93,85,,percent of total billed charges,,172.03,216.74,
CAPIO SUTURE BONDEK 3.5 X 122CM,30181185,CDM,,,270,RC,inpatient,,228.15,228.15,,193.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,172.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.77,88,,percent of total billed charges,,,,,,,,,174.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.62,91,,percent of total billed charges,,,216.74,95,,percent of total billed charges,,,189.36,83,,percent of total billed charges,,,189.36,83,,percent of total billed charges,,,,,,,,,,,,,,,189.36,83,,percent of total billed charges,,,216.74,95,,percent of total billed charges,,,205.34,90,,percent of total billed charges,,,205.34,90,,percent of total billed charges,,,187.08,82,,percent of total billed charges,,,205.34,90,,percent of total billed charges,,,193.93,85,,percent of total billed charges,,172.03,216.74,
RTI GRAFT MATRIX HD 4 X 5CM,30181186,CDM,,,270,RC,inpatient,,10335,10335,,8774.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7792.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8784.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9094.8,88,,percent of total billed charges,,,,,,,,,7895.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9404.85,91,,percent of total billed charges,,,9818.25,95,,percent of total billed charges,,,8578.05,83,,percent of total billed charges,,,8578.05,83,,percent of total billed charges,,,,,,,,,,,,,,,8578.05,83,,percent of total billed charges,,,9818.25,95,,percent of total billed charges,,,9301.5,90,,percent of total billed charges,,,9301.5,90,,percent of total billed charges,,,8474.7,82,,percent of total billed charges,,,9301.5,90,,percent of total billed charges,,,8784.75,85,,percent of total billed charges,,7792.59,9818.25,
DEPUY TIBIAL TRAY SZ2,30181187,CDM,,,270,RC,inpatient,,18568.29,18568.29,,15764.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14000.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15783.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16340.1,88,,percent of total billed charges,,,,,,,,,14186.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16897.14,91,,percent of total billed charges,,,17639.88,95,,percent of total billed charges,,,15411.68,83,,percent of total billed charges,,,15411.68,83,,percent of total billed charges,,,,,,,,,,,,,,,15411.68,83,,percent of total billed charges,,,17639.88,95,,percent of total billed charges,,,16711.46,90,,percent of total billed charges,,,16711.46,90,,percent of total billed charges,,,15226,82,,percent of total billed charges,,,16711.46,90,,percent of total billed charges,,,15783.05,85,,percent of total billed charges,,14000.49,17639.88,
DEPUY KNEE CEMENTED - CAPITATED (004),30181188,CDM,,,278,RC,inpatient,,20035.08,20035.08,,17009.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15106.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17029.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17630.87,88,,percent of total billed charges,,,,,,,,,15306.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18231.92,91,,percent of total billed charges,,,19033.33,95,,percent of total billed charges,,,16629.12,83,,percent of total billed charges,,,16629.12,83,,percent of total billed charges,,,,,,,,,,,,,,,16629.12,83,,percent of total billed charges,,,19033.33,95,,percent of total billed charges,,,18031.57,90,,percent of total billed charges,,,18031.57,90,,percent of total billed charges,,,16428.77,82,,percent of total billed charges,,,18031.57,90,,percent of total billed charges,,,17029.82,85,,percent of total billed charges,,15106.45,19033.33,
RTI GRAFT MATRIX HD 8 X 5CM,30181190,CDM,,,270,RC,inpatient,,19981,19981,,16963.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15065.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16983.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17583.28,88,,percent of total billed charges,,,,,,,,,15265.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18182.71,91,,percent of total billed charges,,,18981.95,95,,percent of total billed charges,,,16584.23,83,,percent of total billed charges,,,16584.23,83,,percent of total billed charges,,,,,,,,,,,,,,,16584.23,83,,percent of total billed charges,,,18981.95,95,,percent of total billed charges,,,17982.9,90,,percent of total billed charges,,,17982.9,90,,percent of total billed charges,,,16384.42,82,,percent of total billed charges,,,17982.9,90,,percent of total billed charges,,,16983.85,85,,percent of total billed charges,,15065.67,18981.95,
SYNTHES GUIDEWIRE 2.5MM,30181202,CDM,,,278,RC,inpatient,,131.24,131.24,,111.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,111.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,115.49,88,,percent of total billed charges,,,,,,,,,100.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,119.43,91,,percent of total billed charges,,,124.68,95,,percent of total billed charges,,,108.93,83,,percent of total billed charges,,,108.93,83,,percent of total billed charges,,,,,,,,,,,,,,,108.93,83,,percent of total billed charges,,,124.68,95,,percent of total billed charges,,,118.12,90,,percent of total billed charges,,,118.12,90,,percent of total billed charges,,,107.62,82,,percent of total billed charges,,,118.12,90,,percent of total billed charges,,,111.55,85,,percent of total billed charges,,98.95,124.68,
SYNTHES GUIDEWIRE 2.0MM,30181203,CDM,,,278,RC,inpatient,,245.78,245.78,,208.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,185.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,208.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,216.29,88,,percent of total billed charges,,,,,,,,,187.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,223.66,91,,percent of total billed charges,,,233.49,95,,percent of total billed charges,,,204,83,,percent of total billed charges,,,204,83,,percent of total billed charges,,,,,,,,,,,,,,,204,83,,percent of total billed charges,,,233.49,95,,percent of total billed charges,,,221.2,90,,percent of total billed charges,,,221.2,90,,percent of total billed charges,,,201.54,82,,percent of total billed charges,,,221.2,90,,percent of total billed charges,,,208.91,85,,percent of total billed charges,,185.32,233.49,
SYNTHES DRILL BIT 3.2MM,30181204,CDM,,,270,RC,inpatient,,2227.36,2227.36,,1891.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1679.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1893.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1960.08,88,,percent of total billed charges,,,,,,,,,1701.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2026.9,91,,percent of total billed charges,,,2115.99,95,,percent of total billed charges,,,1848.71,83,,percent of total billed charges,,,1848.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1848.71,83,,percent of total billed charges,,,2115.99,95,,percent of total billed charges,,,2004.62,90,,percent of total billed charges,,,2004.62,90,,percent of total billed charges,,,1826.44,82,,percent of total billed charges,,,2004.62,90,,percent of total billed charges,,,1893.26,85,,percent of total billed charges,,1679.43,2115.99,
SYNTHES DRILL BIT CALIBRATED 3.2MM,30181205,CDM,,,270,RC,inpatient,,2924.87,2924.87,,2483.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2573.89,88,,percent of total billed charges,,,,,,,,,2234.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.63,91,,percent of total billed charges,,,2778.63,95,,percent of total billed charges,,,2427.64,83,,percent of total billed charges,,,2427.64,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.64,83,,percent of total billed charges,,,2778.63,95,,percent of total billed charges,,,2632.38,90,,percent of total billed charges,,,2632.38,90,,percent of total billed charges,,,2398.39,82,,percent of total billed charges,,,2632.38,90,,percent of total billed charges,,,2486.14,85,,percent of total billed charges,,2205.35,2778.63,
SYNTHES CANNULA W/STOP 4.5MM,30181207,CDM,,,278,RC,inpatient,,3408.93,3408.93,,2894.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2570.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2897.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2999.86,88,,percent of total billed charges,,,,,,,,,2604.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3102.13,91,,percent of total billed charges,,,3238.48,95,,percent of total billed charges,,,2829.41,83,,percent of total billed charges,,,2829.41,83,,percent of total billed charges,,,,,,,,,,,,,,,2829.41,83,,percent of total billed charges,,,3238.48,95,,percent of total billed charges,,,3068.04,90,,percent of total billed charges,,,3068.04,90,,percent of total billed charges,,,2795.32,82,,percent of total billed charges,,,3068.04,90,,percent of total billed charges,,,2897.59,85,,percent of total billed charges,,2570.33,3238.48,
SYNTHES TIBIAL END CAP 0MM,30181208,CDM,,,278,RC,inpatient,,1795.63,1795.63,,1524.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1353.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1526.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1580.15,88,,percent of total billed charges,,,,,,,,,1371.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1634.02,91,,percent of total billed charges,,,1705.85,95,,percent of total billed charges,,,1490.37,83,,percent of total billed charges,,,1490.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1490.37,83,,percent of total billed charges,,,1705.85,95,,percent of total billed charges,,,1616.07,90,,percent of total billed charges,,,1616.07,90,,percent of total billed charges,,,1472.42,82,,percent of total billed charges,,,1616.07,90,,percent of total billed charges,,,1526.29,85,,percent of total billed charges,,1353.91,1705.85,
DEPUY LINER ALTRX +4 NEUT 40 X 58,30181209,CDM,,,278,RC,inpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13270.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14960.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,13270.78,16720.48,
DEPUY FEMORAL HEAD 40MM +0.5,30181210,CDM,,,278,RC,inpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10650.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12006.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,10650.51,13419.08,
DEPUY SUMMIT STD SZ7,30181211,CDM,,,278,RC,inpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26584.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29969.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,26584.74,33495.37,
DEPUY STEM SUMMIT PRESSFIT SZ7,30181212,CDM,,,278,RC,inpatient,,11591.45,11591.45,,9841.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8739.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9852.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10200.48,88,,percent of total billed charges,,,,,,,,,8855.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10548.22,91,,percent of total billed charges,,,11011.88,95,,percent of total billed charges,,,9620.9,83,,percent of total billed charges,,,9620.9,83,,percent of total billed charges,,,,,,,,,,,,,,,9620.9,83,,percent of total billed charges,,,11011.88,95,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,9504.99,82,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,9852.73,85,,percent of total billed charges,,8739.95,11011.88,
DEPUY STEM TRI-LOCK HI OFFSET SZ1,30181221,CDM,,,278,RC,inpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30697.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34606.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,30697.71,38677.48,
DEPUY SELF CENT HIP 53X28 BRN,30181224,CDM,,,278,RC,inpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,6126.3,7718.82,
RTI GRACILIUS TENDON,30181226,CDM,,,270,RC,inpatient,,8937.5,8937.5,,7587.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6738.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7596.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7865,88,,percent of total billed charges,,,,,,,,,6828.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8133.13,91,,percent of total billed charges,,,8490.63,95,,percent of total billed charges,,,7418.13,83,,percent of total billed charges,,,7418.13,83,,percent of total billed charges,,,,,,,,,,,,,,,7418.13,83,,percent of total billed charges,,,8490.63,95,,percent of total billed charges,,,8043.75,90,,percent of total billed charges,,,8043.75,90,,percent of total billed charges,,,7328.75,82,,percent of total billed charges,,,8043.75,90,,percent of total billed charges,,,7596.88,85,,percent of total billed charges,,6738.88,8490.63,
SYNTHES DRILL BIT 2.8MM 165MM,30181228,CDM,,,270,RC,inpatient,,920.27,920.27,,781.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,693.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,782.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,809.84,88,,percent of total billed charges,,,,,,,,,703.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,837.45,91,,percent of total billed charges,,,874.26,95,,percent of total billed charges,,,763.82,83,,percent of total billed charges,,,763.82,83,,percent of total billed charges,,,,,,,,,,,,,,,763.82,83,,percent of total billed charges,,,874.26,95,,percent of total billed charges,,,828.24,90,,percent of total billed charges,,,828.24,90,,percent of total billed charges,,,754.62,82,,percent of total billed charges,,,828.24,90,,percent of total billed charges,,,782.23,85,,percent of total billed charges,,693.88,874.26,
SYNTHES PLATE TUBULAR 3-HOLE 90MM,30181230,CDM,,,278,RC,inpatient,,14477.84,14477.84,,12291.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12306.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12740.5,88,,percent of total billed charges,,,,,,,,,11061.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13174.83,91,,percent of total billed charges,,,13753.95,95,,percent of total billed charges,,,12016.61,83,,percent of total billed charges,,,12016.61,83,,percent of total billed charges,,,,,,,,,,,,,,,12016.61,83,,percent of total billed charges,,,13753.95,95,,percent of total billed charges,,,13030.06,90,,percent of total billed charges,,,13030.06,90,,percent of total billed charges,,,11871.83,82,,percent of total billed charges,,,13030.06,90,,percent of total billed charges,,,12306.16,85,,percent of total billed charges,,10916.29,13753.95,
DEPUY FEMUR CEMENTED RT SZ2,30181239,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
SYNTHES SCREW HEX HEAD 5.0X36MM,30181240,CDM,,,278,RC,inpatient,,2160.28,2160.28,,1834.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1628.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1836.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1901.05,88,,percent of total billed charges,,,,,,,,,1650.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1965.85,91,,percent of total billed charges,,,2052.27,95,,percent of total billed charges,,,1793.03,83,,percent of total billed charges,,,1793.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1793.03,83,,percent of total billed charges,,,2052.27,95,,percent of total billed charges,,,1944.25,90,,percent of total billed charges,,,1944.25,90,,percent of total billed charges,,,1771.43,82,,percent of total billed charges,,,1944.25,90,,percent of total billed charges,,,1836.24,85,,percent of total billed charges,,1628.85,2052.27,
MEGADYNE E-Z CLEAN NEEDLE 2.75,30181243,CDM,,,270,RC,inpatient,,47.6,47.6,,40.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.89,88,,percent of total billed charges,,,,,,,,,36.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.32,91,,percent of total billed charges,,,45.22,95,,percent of total billed charges,,,39.51,83,,percent of total billed charges,,,39.51,83,,percent of total billed charges,,,,,,,,,,,,,,,39.51,83,,percent of total billed charges,,,45.22,95,,percent of total billed charges,,,42.84,90,,percent of total billed charges,,,42.84,90,,percent of total billed charges,,,39.03,82,,percent of total billed charges,,,42.84,90,,percent of total billed charges,,,40.46,85,,percent of total billed charges,,35.89,45.22,
AMS ELEVATE KIT ANTERIOR,30181244,CDM,,,278,RC,inpatient,,13056.55,13056.55,,11085.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9844.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11098.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11489.76,88,,percent of total billed charges,,,,,,,,,9975.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11881.46,91,,percent of total billed charges,,,12403.72,95,,percent of total billed charges,,,10836.94,83,,percent of total billed charges,,,10836.94,83,,percent of total billed charges,,,,,,,,,,,,,,,10836.94,83,,percent of total billed charges,,,12403.72,95,,percent of total billed charges,,,11750.9,90,,percent of total billed charges,,,11750.9,90,,percent of total billed charges,,,10706.37,82,,percent of total billed charges,,,11750.9,90,,percent of total billed charges,,,11098.07,85,,percent of total billed charges,,9844.64,12403.72,
AMS ELEVATE KIT POSTERIOR,30181245,CDM,,,278,RC,inpatient,,10989.55,10989.55,,9330.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8286.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9341.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9670.8,88,,percent of total billed charges,,,,,,,,,8396.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10000.49,91,,percent of total billed charges,,,10440.07,95,,percent of total billed charges,,,9121.33,83,,percent of total billed charges,,,9121.33,83,,percent of total billed charges,,,,,,,,,,,,,,,9121.33,83,,percent of total billed charges,,,10440.07,95,,percent of total billed charges,,,9890.6,90,,percent of total billed charges,,,9890.6,90,,percent of total billed charges,,,9011.43,82,,percent of total billed charges,,,9890.6,90,,percent of total billed charges,,,9341.12,85,,percent of total billed charges,,8286.12,10440.07,
MESH SOLYX SLING,30181247,CDM,,,270,RC,inpatient,,11752.65,11752.65,,9978,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8861.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9989.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10342.33,88,,percent of total billed charges,,,,,,,,,8979.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10694.91,91,,percent of total billed charges,,,11165.02,95,,percent of total billed charges,,,9754.7,83,,percent of total billed charges,,,9754.7,83,,percent of total billed charges,,,,,,,,,,,,,,,9754.7,83,,percent of total billed charges,,,11165.02,95,,percent of total billed charges,,,10577.39,90,,percent of total billed charges,,,10577.39,90,,percent of total billed charges,,,9637.17,82,,percent of total billed charges,,,10577.39,90,,percent of total billed charges,,,9989.75,85,,percent of total billed charges,,8861.5,11165.02,
SYNTHES SCREW DISTAL RADIUS 2.4X28MM,30181251,CDM,,,278,RC,inpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1020.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1150.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,1020.93,1286.32,
JURGAN BALL - GR,30181253,CDM,,,270,RC,inpatient,,48.2,48.2,,40.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.42,88,,percent of total billed charges,,,,,,,,,36.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.86,91,,percent of total billed charges,,,45.79,95,,percent of total billed charges,,,40.01,83,,percent of total billed charges,,,40.01,83,,percent of total billed charges,,,,,,,,,,,,,,,40.01,83,,percent of total billed charges,,,45.79,95,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,39.52,82,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,40.97,85,,percent of total billed charges,,36.34,45.79,
JURGAN BALL - BL,30181254,CDM,,,270,RC,inpatient,,45.31,45.31,,38.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.87,88,,percent of total billed charges,,,,,,,,,34.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.23,91,,percent of total billed charges,,,43.04,95,,percent of total billed charges,,,37.61,83,,percent of total billed charges,,,37.61,83,,percent of total billed charges,,,,,,,,,,,,,,,37.61,83,,percent of total billed charges,,,43.04,95,,percent of total billed charges,,,40.78,90,,percent of total billed charges,,,40.78,90,,percent of total billed charges,,,37.15,82,,percent of total billed charges,,,40.78,90,,percent of total billed charges,,,38.51,85,,percent of total billed charges,,34.16,43.04,
JURGAN BALL - CR,30181255,CDM,,,270,RC,inpatient,,48.2,48.2,,40.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.42,88,,percent of total billed charges,,,,,,,,,36.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.86,91,,percent of total billed charges,,,45.79,95,,percent of total billed charges,,,40.01,83,,percent of total billed charges,,,40.01,83,,percent of total billed charges,,,,,,,,,,,,,,,40.01,83,,percent of total billed charges,,,45.79,95,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,39.52,82,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,40.97,85,,percent of total billed charges,,36.34,45.79,
JURGAN BALL - YL,30181256,CDM,,,270,RC,inpatient,,55.25,55.25,,46.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.62,88,,percent of total billed charges,,,,,,,,,42.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.28,91,,percent of total billed charges,,,52.49,95,,percent of total billed charges,,,45.86,83,,percent of total billed charges,,,45.86,83,,percent of total billed charges,,,,,,,,,,,,,,,45.86,83,,percent of total billed charges,,,52.49,95,,percent of total billed charges,,,49.73,90,,percent of total billed charges,,,49.73,90,,percent of total billed charges,,,45.31,82,,percent of total billed charges,,,49.73,90,,percent of total billed charges,,,46.96,85,,percent of total billed charges,,41.66,52.49,
SYNTHES DRILL BIT CANNULATED 3.2MM,30181263,CDM,,,270,RC,inpatient,,4176.9,4176.9,,3546.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3149.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3550.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3675.67,88,,percent of total billed charges,,,,,,,,,3191.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3800.98,91,,percent of total billed charges,,,3968.06,95,,percent of total billed charges,,,3466.83,83,,percent of total billed charges,,,3466.83,83,,percent of total billed charges,,,,,,,,,,,,,,,3466.83,83,,percent of total billed charges,,,3968.06,95,,percent of total billed charges,,,3759.21,90,,percent of total billed charges,,,3759.21,90,,percent of total billed charges,,,3425.06,82,,percent of total billed charges,,,3759.21,90,,percent of total billed charges,,,3550.37,85,,percent of total billed charges,,3149.38,3968.06,
RTI SEMITENDINOSIS TENDON 200MM,30181265,CDM,,,278,RC,inpatient,,8612.5,8612.5,,7312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6493.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7320.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7579,88,,percent of total billed charges,,,,,,,,,6579.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7837.38,91,,percent of total billed charges,,,8181.88,95,,percent of total billed charges,,,7148.38,83,,percent of total billed charges,,,7148.38,83,,percent of total billed charges,,,,,,,,,,,,,,,7148.38,83,,percent of total billed charges,,,8181.88,95,,percent of total billed charges,,,7751.25,90,,percent of total billed charges,,,7751.25,90,,percent of total billed charges,,,7062.25,82,,percent of total billed charges,,,7751.25,90,,percent of total billed charges,,,7320.63,85,,percent of total billed charges,,6493.83,8181.88,
CATH URETERAL OPEN END 5FR,30181273,CDM,,,270,RC,inpatient,,86.24,86.24,,73.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,65.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,75.89,88,,percent of total billed charges,,,,,,,,,65.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,78.48,91,,percent of total billed charges,,,81.93,95,,percent of total billed charges,,,71.58,83,,percent of total billed charges,,,71.58,83,,percent of total billed charges,,,,,,,,,,,,,,,71.58,83,,percent of total billed charges,,,81.93,95,,percent of total billed charges,,,77.62,90,,percent of total billed charges,,,77.62,90,,percent of total billed charges,,,70.72,82,,percent of total billed charges,,,77.62,90,,percent of total billed charges,,,73.3,85,,percent of total billed charges,,65.02,81.93,
DEPUY HEAD 40MM +8.5,30181278,CDM,,,278,RC,inpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10650.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12006.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,10650.51,13419.08,
DEPUY STEM SUMMIT TAPER SZ5 HI OFF,30181279,CDM,,,278,RC,inpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26584.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29969.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,26584.74,33495.37,
S&N ENDO NEEDLE XL,30181284,CDM,,,270,RC,inpatient,,556.5,556.5,,472.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,419.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,473.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,489.72,88,,percent of total billed charges,,,,,,,,,425.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,506.42,91,,percent of total billed charges,,,528.68,95,,percent of total billed charges,,,461.9,83,,percent of total billed charges,,,461.9,83,,percent of total billed charges,,,,,,,,,,,,,,,461.9,83,,percent of total billed charges,,,528.68,95,,percent of total billed charges,,,500.85,90,,percent of total billed charges,,,500.85,90,,percent of total billed charges,,,456.33,82,,percent of total billed charges,,,500.85,90,,percent of total billed charges,,,473.03,85,,percent of total billed charges,,419.6,528.68,
S&N ENDO ABLATOR,30181287,CDM,,,278,RC,inpatient,,3280.36,3280.36,,2785.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2473.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2788.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2886.72,88,,percent of total billed charges,,,,,,,,,2506.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2985.13,91,,percent of total billed charges,,,3116.34,95,,percent of total billed charges,,,2722.7,83,,percent of total billed charges,,,2722.7,83,,percent of total billed charges,,,,,,,,,,,,,,,2722.7,83,,percent of total billed charges,,,3116.34,95,,percent of total billed charges,,,2952.32,90,,percent of total billed charges,,,2952.32,90,,percent of total billed charges,,,2689.9,82,,percent of total billed charges,,,2952.32,90,,percent of total billed charges,,,2788.31,85,,percent of total billed charges,,2473.39,3116.34,
DEPUY PINNACLE 100 CUP W/CRIPTION 60MM,30181299,CDM,,,278,RC,inpatient,,20679.88,20679.88,,17557.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15592.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17577.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18198.29,88,,percent of total billed charges,,,,,,,,,15799.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18818.69,91,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17164.3,83,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,16957.5,82,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,15592.63,19645.89,
DEPUY UPCHARGE GRIPTON CUP(016),30181300,CDM,,,278,RC,inpatient,,2608.65,2608.65,,2214.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1966.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2217.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2295.61,88,,percent of total billed charges,,,,,,,,,1993.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2373.87,91,,percent of total billed charges,,,2478.22,95,,percent of total billed charges,,,2165.18,83,,percent of total billed charges,,,2165.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2165.18,83,,percent of total billed charges,,,2478.22,95,,percent of total billed charges,,,2347.79,90,,percent of total billed charges,,,2347.79,90,,percent of total billed charges,,,2139.09,82,,percent of total billed charges,,,2347.79,90,,percent of total billed charges,,,2217.35,85,,percent of total billed charges,,1966.92,2478.22,
DEPUY STEM SUMMIT STD SZ4,30181307,CDM,,,278,RC,inpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26584.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29969.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,26584.74,33495.37,
SYNTHES ROD REAMER 3MM 351.76S,30181309,CDM,,,278,RC,inpatient,,1674.08,1674.08,,1421.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1262.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1422.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1473.19,88,,percent of total billed charges,,,,,,,,,1279,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1523.41,91,,percent of total billed charges,,,1590.38,95,,percent of total billed charges,,,1389.49,83,,percent of total billed charges,,,1389.49,83,,percent of total billed charges,,,,,,,,,,,,,,,1389.49,83,,percent of total billed charges,,,1590.38,95,,percent of total billed charges,,,1506.67,90,,percent of total billed charges,,,1506.67,90,,percent of total billed charges,,,1372.75,82,,percent of total billed charges,,,1506.67,90,,percent of total billed charges,,,1422.97,85,,percent of total billed charges,,1262.26,1590.38,
DEPUY STEM GLOBAL FX PC 6MM,30181314,CDM,,,278,RC,inpatient,,38704.58,38704.58,,32860.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29183.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32898.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34060.03,88,,percent of total billed charges,,,,,,,,,29570.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35221.17,91,,percent of total billed charges,,,36769.35,95,,percent of total billed charges,,,32124.8,83,,percent of total billed charges,,,32124.8,83,,percent of total billed charges,,,,,,,,,,,,,,,32124.8,83,,percent of total billed charges,,,36769.35,95,,percent of total billed charges,,,34834.12,90,,percent of total billed charges,,,34834.12,90,,percent of total billed charges,,,31737.76,82,,percent of total billed charges,,,34834.12,90,,percent of total billed charges,,,32898.89,85,,percent of total billed charges,,29183.25,36769.35,
GYRUS GAUZE SACK,30181315,CDM,,,270,RC,inpatient,,10.96,10.96,,9.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9.64,88,,percent of total billed charges,,,,,,,,,8.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9.97,91,,percent of total billed charges,,,10.41,95,,percent of total billed charges,,,9.1,83,,percent of total billed charges,,,9.1,83,,percent of total billed charges,,,,,,,,,,,,,,,9.1,83,,percent of total billed charges,,,10.41,95,,percent of total billed charges,,,9.86,90,,percent of total billed charges,,,9.86,90,,percent of total billed charges,,,8.99,82,,percent of total billed charges,,,9.86,90,,percent of total billed charges,,,9.32,85,,percent of total billed charges,,8.26,10.41,
SYNTHES SCREW LOCKING 2.7X16MM,30181316,CDM,,,278,RC,inpatient,,1178.13,1178.13,,1000.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,888.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1001.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1036.75,88,,percent of total billed charges,,,,,,,,,900.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1072.1,91,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,,,,,,,,,,,,,977.85,83,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,966.07,82,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,888.31,1119.22,
SYNTHES SCREW LOCKING 2.7X14MM,30181317,CDM,,,278,RC,inpatient,,1178.13,1178.13,,1000.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,888.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1001.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1036.75,88,,percent of total billed charges,,,,,,,,,900.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1072.1,91,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,,,,,,,,,,,,,977.85,83,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,966.07,82,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,888.31,1119.22,
SYNTHES DRILL BIT 2.0MM 323.062,30181319,CDM,,,270,RC,inpatient,,1518.14,1518.14,,1288.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1144.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1290.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1335.96,88,,percent of total billed charges,,,,,,,,,1159.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1381.51,91,,percent of total billed charges,,,1442.23,95,,percent of total billed charges,,,1260.06,83,,percent of total billed charges,,,1260.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1260.06,83,,percent of total billed charges,,,1442.23,95,,percent of total billed charges,,,1366.33,90,,percent of total billed charges,,,1366.33,90,,percent of total billed charges,,,1244.87,82,,percent of total billed charges,,,1366.33,90,,percent of total billed charges,,,1290.42,85,,percent of total billed charges,,1144.68,1442.23,
DEPUY SCREW TAPER HD 50 X 5.0,30181321,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
DEPUY SCREW TAPER 35 X 5.0,30181322,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
DEPUY LINER ALTRX +4 NEUT 40 X 56,30181323,CDM,,,278,RC,inpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13270.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14960.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,13270.78,16720.48,
DEPUY FEMORAL HEAD 40MM +9,30181324,CDM,,,278,RC,inpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10650.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12006.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,10650.51,13419.08,
DEPUY INSERT TIBIA TC3 12.5MM SZ2.5,30181326,CDM,,,278,RC,inpatient,,17187.04,17187.04,,14591.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12959.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14608.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15124.6,88,,percent of total billed charges,,,,,,,,,13130.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15640.21,91,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,,,,,,,,,,,,,14265.24,83,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14093.37,82,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14608.98,85,,percent of total billed charges,,12959.03,16327.69,
DEPUY FEMUR TC3 RT SZ2,30181327,CDM,,,278,RC,inpatient,,48160.65,48160.65,,40888.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36313.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40936.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42381.37,88,,percent of total billed charges,,,,,,,,,36794.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43826.19,91,,percent of total billed charges,,,45752.62,95,,percent of total billed charges,,,39973.34,83,,percent of total billed charges,,,39973.34,83,,percent of total billed charges,,,,,,,,,,,,,,,39973.34,83,,percent of total billed charges,,,45752.62,95,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,39491.73,82,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,40936.55,85,,percent of total billed charges,,36313.13,45752.62,
DEPUY DISTAL AUGMENT RT 4MM SZ2.0,30181328,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
DEPUY STEM GLOBAL HUMERAL 48 X 18,30181340,CDM,,,278,RC,inpatient,,15560.09,15560.09,,13210.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11732.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13226.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13692.88,88,,percent of total billed charges,,,,,,,,,11887.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14159.68,91,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12914.87,83,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,12759.27,82,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,11732.31,14782.09,
DEPUY FIXATION PINS,30181341,CDM,,,278,RC,inpatient,,1898,1898,,1611.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1431.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1613.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1670.24,88,,percent of total billed charges,,,,,,,,,1450.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1727.18,91,,percent of total billed charges,,,1803.1,95,,percent of total billed charges,,,1575.34,83,,percent of total billed charges,,,1575.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1575.34,83,,percent of total billed charges,,,1803.1,95,,percent of total billed charges,,,1708.2,90,,percent of total billed charges,,,1708.2,90,,percent of total billed charges,,,1556.36,82,,percent of total billed charges,,,1708.2,90,,percent of total billed charges,,,1613.3,85,,percent of total billed charges,,1431.09,1803.1,
DEPUY CROSSLINK FIN GLENOID SZ40,30181344,CDM,,,278,RC,inpatient,,14866.35,14866.35,,12621.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11209.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12636.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13082.39,88,,percent of total billed charges,,,,,,,,,11357.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13528.38,91,,percent of total billed charges,,,14123.03,95,,percent of total billed charges,,,12339.07,83,,percent of total billed charges,,,12339.07,83,,percent of total billed charges,,,,,,,,,,,,,,,12339.07,83,,percent of total billed charges,,,14123.03,95,,percent of total billed charges,,,13379.72,90,,percent of total billed charges,,,13379.72,90,,percent of total billed charges,,,12190.41,82,,percent of total billed charges,,,13379.72,90,,percent of total billed charges,,,12636.4,85,,percent of total billed charges,,11209.23,14123.03,
DEPUY STEM GLOBAL HUMERAL 40 X 21,30181345,CDM,,,278,RC,inpatient,,15560.09,15560.09,,13210.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11732.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13226.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13692.88,88,,percent of total billed charges,,,,,,,,,11887.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14159.68,91,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12914.87,83,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,12759.27,82,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,11732.31,14782.09,
DEPUY STEM GLOBAL ADVANTAGE PC 10MM,30181346,CDM,,,278,RC,inpatient,,36482.49,36482.49,,30973.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27507.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31010.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32104.59,88,,percent of total billed charges,,,,,,,,,27872.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33199.07,91,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,,,,,,,,,,,,,30280.47,83,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,29915.64,82,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,31010.12,85,,percent of total billed charges,,27507.8,34658.37,
DEPUY ANCHOR PEG DRILL BIT,30181347,CDM,,,278,RC,inpatient,,1384.5,1384.5,,1175.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1043.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1176.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1218.36,88,,percent of total billed charges,,,,,,,,,1057.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1259.9,91,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1149.14,83,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1135.29,82,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1176.83,85,,percent of total billed charges,,1043.91,1315.28,
DEPUY DRILL BIT KEELED GLENOID,30181348,CDM,,,278,RC,inpatient,,1092,1092,,927.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,823.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,928.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,960.96,88,,percent of total billed charges,,,,,,,,,834.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,993.72,91,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,,,,,,,,,,,,,906.36,83,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,895.44,82,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,928.2,85,,percent of total billed charges,,823.37,1037.4,
STRYKER BLADE SAGITAL SYSTEM 6,30181349,CDM,,,270,RC,inpatient,,469.21,469.21,,398.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,353.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,398.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,412.9,88,,percent of total billed charges,,,,,,,,,358.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,426.98,91,,percent of total billed charges,,,445.75,95,,percent of total billed charges,,,389.44,83,,percent of total billed charges,,,389.44,83,,percent of total billed charges,,,,,,,,,,,,,,,389.44,83,,percent of total billed charges,,,445.75,95,,percent of total billed charges,,,422.29,90,,percent of total billed charges,,,422.29,90,,percent of total billed charges,,,384.75,82,,percent of total billed charges,,,422.29,90,,percent of total billed charges,,,398.83,85,,percent of total billed charges,,353.78,445.75,
DEPUY FEMORAL HEAD 40MM +5.0,30181353,CDM,,,278,RC,inpatient,,15414.23,15414.23,,13086.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11622.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13102.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13564.52,88,,percent of total billed charges,,,,,,,,,11776.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14026.95,91,,percent of total billed charges,,,14643.52,95,,percent of total billed charges,,,12793.81,83,,percent of total billed charges,,,12793.81,83,,percent of total billed charges,,,,,,,,,,,,,,,12793.81,83,,percent of total billed charges,,,14643.52,95,,percent of total billed charges,,,13872.81,90,,percent of total billed charges,,,13872.81,90,,percent of total billed charges,,,12639.67,82,,percent of total billed charges,,,13872.81,90,,percent of total billed charges,,,13102.1,85,,percent of total billed charges,,11622.33,14643.52,
DEPUY PINNACLE CUP 100 W/GRIPTION 62MM,30181354,CDM,,,278,RC,inpatient,,20679.88,20679.88,,17557.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15592.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17577.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18198.29,88,,percent of total billed charges,,,,,,,,,15799.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18818.69,91,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17164.3,83,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,16957.5,82,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,15592.63,19645.89,
DEPUY LINER ALTRX +4 NEUT 44 X 62,30181355,CDM,,,278,RC,inpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13270.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14960.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,13270.78,16720.48,
S&N PATELLAR COMPONENT 32MM,30181358,CDM,,,278,RC,inpatient,,4250.48,4250.48,,3608.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3204.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3612.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3740.42,88,,percent of total billed charges,,,,,,,,,3247.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3867.94,91,,percent of total billed charges,,,4037.96,95,,percent of total billed charges,,,3527.9,83,,percent of total billed charges,,,3527.9,83,,percent of total billed charges,,,,,,,,,,,,,,,3527.9,83,,percent of total billed charges,,,4037.96,95,,percent of total billed charges,,,3825.43,90,,percent of total billed charges,,,3825.43,90,,percent of total billed charges,,,3485.39,82,,percent of total billed charges,,,3825.43,90,,percent of total billed charges,,,3612.91,85,,percent of total billed charges,,3204.86,4037.96,
DEPUY CERAMIC HEAD 36MM +5,30181360,CDM,,,278,RC,inpatient,,15642.97,15642.97,,13280.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11794.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13296.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13765.81,88,,percent of total billed charges,,,,,,,,,11951.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14235.1,91,,percent of total billed charges,,,14860.82,95,,percent of total billed charges,,,12983.67,83,,percent of total billed charges,,,12983.67,83,,percent of total billed charges,,,,,,,,,,,,,,,12983.67,83,,percent of total billed charges,,,14860.82,95,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,12827.24,82,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,13296.52,85,,percent of total billed charges,,11794.8,14860.82,
DEPUY INSERT TC3 RP 10MM SZ3,30181362,CDM,,,278,RC,inpatient,,15465.58,15465.58,,13130.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11661.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13145.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13609.71,88,,percent of total billed charges,,,,,,,,,11815.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14073.68,91,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,,,,,,,,,,,,,12836.43,83,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,12681.78,82,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13145.74,85,,percent of total billed charges,,11661.05,14692.3,
DEPUY MBT REVISION TIBIAL TRAY SZ4,30181363,CDM,,,278,RC,inpatient,,28838.62,28838.62,,24483.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21744.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24512.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25377.99,88,,percent of total billed charges,,,,,,,,,22032.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26243.14,91,,percent of total billed charges,,,27396.69,95,,percent of total billed charges,,,23936.05,83,,percent of total billed charges,,,23936.05,83,,percent of total billed charges,,,,,,,,,,,,,,,23936.05,83,,percent of total billed charges,,,27396.69,95,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,23647.67,82,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,24512.83,85,,percent of total billed charges,,21744.32,27396.69,
MEDSOURCE RADIAL HEAD 28.0MM RIGHT,30181372,CDM,,,278,RC,inpatient,,17888,17888,,15186.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13487.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15204.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15741.44,88,,percent of total billed charges,,,,,,,,,13666.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16278.08,91,,percent of total billed charges,,,16993.6,95,,percent of total billed charges,,,14847.04,83,,percent of total billed charges,,,14847.04,83,,percent of total billed charges,,,,,,,,,,,,,,,14847.04,83,,percent of total billed charges,,,16993.6,95,,percent of total billed charges,,,16099.2,90,,percent of total billed charges,,,16099.2,90,,percent of total billed charges,,,14668.16,82,,percent of total billed charges,,,16099.2,90,,percent of total billed charges,,,15204.8,85,,percent of total billed charges,,13487.55,16993.6,
RTI FEMORAL HEAD,30181377,CDM,,,278,RC,inpatient,,9646,9646,,8189.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7273.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8199.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8488.48,88,,percent of total billed charges,,,,,,,,,7369.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8777.86,91,,percent of total billed charges,,,9163.7,95,,percent of total billed charges,,,8006.18,83,,percent of total billed charges,,,8006.18,83,,percent of total billed charges,,,,,,,,,,,,,,,8006.18,83,,percent of total billed charges,,,9163.7,95,,percent of total billed charges,,,8681.4,90,,percent of total billed charges,,,8681.4,90,,percent of total billed charges,,,7909.72,82,,percent of total billed charges,,,8681.4,90,,percent of total billed charges,,,8199.1,85,,percent of total billed charges,,7273.08,9163.7,
DEPUY FEMORAL HEAD 40MM +12,30181378,CDM,,,278,RC,inpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10650.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12006.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,10650.51,13419.08,
DEPUY GUIDEWIRE BALL NOSE 3.0 X 100CM,30181379,CDM,,,278,RC,inpatient,,682.43,682.43,,579.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,514.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,580.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,600.54,88,,percent of total billed charges,,,,,,,,,521.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,621.01,91,,percent of total billed charges,,,648.31,95,,percent of total billed charges,,,566.42,83,,percent of total billed charges,,,566.42,83,,percent of total billed charges,,,,,,,,,,,,,,,566.42,83,,percent of total billed charges,,,648.31,95,,percent of total billed charges,,,614.19,90,,percent of total billed charges,,,614.19,90,,percent of total billed charges,,,559.59,82,,percent of total billed charges,,,614.19,90,,percent of total billed charges,,,580.07,85,,percent of total billed charges,,514.55,648.31,
DEPUY STEM GLOBAL HUMERAL 44 X 18 ECC,30181380,CDM,,,278,RC,inpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13297.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14990.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,13297.64,16754.32,
DEPUY SMALL GOLD DRILL BIT,30181381,CDM,,,278,RC,inpatient,,1384.5,1384.5,,1175.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1043.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1176.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1218.36,88,,percent of total billed charges,,,,,,,,,1057.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1259.9,91,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1149.14,83,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1135.29,82,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1176.83,85,,percent of total billed charges,,1043.91,1315.28,
DEPUY DRILL BIT LGE ANCHOR,30181382,CDM,,,278,RC,inpatient,,1384.5,1384.5,,1175.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1043.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1176.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1218.36,88,,percent of total billed charges,,,,,,,,,1057.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1259.9,91,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1149.14,83,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1135.29,82,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1176.83,85,,percent of total billed charges,,1043.91,1315.28,
DEPUY PINNACLE CUP 100 W/GRIPTION 50MM,30181383,CDM,,,278,RC,inpatient,,21679.88,21679.88,,18406.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16346.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18427.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19078.29,88,,percent of total billed charges,,,,,,,,,16563.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19728.69,91,,percent of total billed charges,,,20595.89,95,,percent of total billed charges,,,17994.3,83,,percent of total billed charges,,,17994.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17994.3,83,,percent of total billed charges,,,20595.89,95,,percent of total billed charges,,,19511.89,90,,percent of total billed charges,,,19511.89,90,,percent of total billed charges,,,17777.5,82,,percent of total billed charges,,,19511.89,90,,percent of total billed charges,,,18427.9,85,,percent of total billed charges,,16346.63,20595.89,
DEPUY LINER ALTRX X-LINK (008),30181385,CDM,,,278,RC,inpatient,,4372.88,4372.88,,3712.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3297.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3716.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3848.13,88,,percent of total billed charges,,,,,,,,,3340.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3979.32,91,,percent of total billed charges,,,4154.24,95,,percent of total billed charges,,,3629.49,83,,percent of total billed charges,,,3629.49,83,,percent of total billed charges,,,,,,,,,,,,,,,3629.49,83,,percent of total billed charges,,,4154.24,95,,percent of total billed charges,,,3935.59,90,,percent of total billed charges,,,3935.59,90,,percent of total billed charges,,,3585.76,82,,percent of total billed charges,,,3935.59,90,,percent of total billed charges,,,3716.95,85,,percent of total billed charges,,3297.15,4154.24,
DEPUY FEMUR TC3 RT SZ5,30181386,CDM,,,278,RC,inpatient,,48160.65,48160.65,,40888.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36313.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40936.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42381.37,88,,percent of total billed charges,,,,,,,,,36794.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43826.19,91,,percent of total billed charges,,,45752.62,95,,percent of total billed charges,,,39973.34,83,,percent of total billed charges,,,39973.34,83,,percent of total billed charges,,,,,,,,,,,,,,,39973.34,83,,percent of total billed charges,,,45752.62,95,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,39491.73,82,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,40936.55,85,,percent of total billed charges,,36313.13,45752.62,
DEPUY FEMORAL ADAPTER BOLT,30181387,CDM,,,278,RC,inpatient,,1765.6,1765.6,,1498.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1331.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1500.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1553.73,88,,percent of total billed charges,,,,,,,,,1348.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1606.7,91,,percent of total billed charges,,,1677.32,95,,percent of total billed charges,,,1465.45,83,,percent of total billed charges,,,1465.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.45,83,,percent of total billed charges,,,1677.32,95,,percent of total billed charges,,,1589.04,90,,percent of total billed charges,,,1589.04,90,,percent of total billed charges,,,1447.79,82,,percent of total billed charges,,,1589.04,90,,percent of total billed charges,,,1500.76,85,,percent of total billed charges,,1331.26,1677.32,
DEPUY FEMORAL ADAPTER 5DEG,30181388,CDM,,,278,RC,inpatient,,12849.85,12849.85,,10909.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9688.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10922.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11307.87,88,,percent of total billed charges,,,,,,,,,9817.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11693.36,91,,percent of total billed charges,,,12207.36,95,,percent of total billed charges,,,10665.38,83,,percent of total billed charges,,,10665.38,83,,percent of total billed charges,,,,,,,,,,,,,,,10665.38,83,,percent of total billed charges,,,12207.36,95,,percent of total billed charges,,,11564.87,90,,percent of total billed charges,,,11564.87,90,,percent of total billed charges,,,10536.88,82,,percent of total billed charges,,,11564.87,90,,percent of total billed charges,,,10922.37,85,,percent of total billed charges,,9688.79,12207.36,
DEPUY CEMENTED STEM,30181389,CDM,,,278,RC,inpatient,,6179.68,6179.68,,5246.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4659.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5252.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5438.12,88,,percent of total billed charges,,,,,,,,,4721.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5623.51,91,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5129.13,83,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5067.34,82,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5252.73,85,,percent of total billed charges,,4659.48,5870.7,
DEPUY INSERT TIBIA TC3 12.5MM SZ5,30181390,CDM,,,278,RC,inpatient,,17187.04,17187.04,,14591.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12959.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14608.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15124.6,88,,percent of total billed charges,,,,,,,,,13130.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15640.21,91,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,,,,,,,,,,,,,14265.24,83,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14093.37,82,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14608.98,85,,percent of total billed charges,,12959.03,16327.69,
DEPUY SCREW CANNULATED 5.0X30MM,30181391,CDM,,,278,RC,inpatient,,838.11,838.11,,711.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,631.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,712.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,737.54,88,,percent of total billed charges,,,,,,,,,640.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,762.68,91,,percent of total billed charges,,,796.2,95,,percent of total billed charges,,,695.63,83,,percent of total billed charges,,,695.63,83,,percent of total billed charges,,,,,,,,,,,,,,,695.63,83,,percent of total billed charges,,,796.2,95,,percent of total billed charges,,,754.3,90,,percent of total billed charges,,,754.3,90,,percent of total billed charges,,,687.25,82,,percent of total billed charges,,,754.3,90,,percent of total billed charges,,,712.39,85,,percent of total billed charges,,631.93,796.2,
DEPUY SCREW CANNULATED 5.0X50MM,30181392,CDM,,,278,RC,inpatient,,838.11,838.11,,711.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,631.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,712.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,737.54,88,,percent of total billed charges,,,,,,,,,640.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,762.68,91,,percent of total billed charges,,,796.2,95,,percent of total billed charges,,,695.63,83,,percent of total billed charges,,,695.63,83,,percent of total billed charges,,,,,,,,,,,,,,,695.63,83,,percent of total billed charges,,,796.2,95,,percent of total billed charges,,,754.3,90,,percent of total billed charges,,,754.3,90,,percent of total billed charges,,,687.25,82,,percent of total billed charges,,,754.3,90,,percent of total billed charges,,,712.39,85,,percent of total billed charges,,631.93,796.2,
DEPUY SCREW CANNULATED 36 X 4.5,30181393,CDM,,,278,RC,inpatient,,710.99,710.99,,603.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,536.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,604.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,625.67,88,,percent of total billed charges,,,,,,,,,543.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,647,91,,percent of total billed charges,,,675.44,95,,percent of total billed charges,,,590.12,83,,percent of total billed charges,,,590.12,83,,percent of total billed charges,,,,,,,,,,,,,,,590.12,83,,percent of total billed charges,,,675.44,95,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,583.01,82,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,604.34,85,,percent of total billed charges,,536.09,675.44,
DEPUY SCREW CANNULATED 40 X 4.5,30181394,CDM,,,278,RC,inpatient,,710.99,710.99,,603.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,536.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,604.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,625.67,88,,percent of total billed charges,,,,,,,,,543.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,647,91,,percent of total billed charges,,,675.44,95,,percent of total billed charges,,,590.12,83,,percent of total billed charges,,,590.12,83,,percent of total billed charges,,,,,,,,,,,,,,,590.12,83,,percent of total billed charges,,,675.44,95,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,583.01,82,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,604.34,85,,percent of total billed charges,,536.09,675.44,
DEPUY SCREW CANNULATED 50 X 4.5,30181395,CDM,,,278,RC,inpatient,,710.99,710.99,,603.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,536.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,604.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,625.67,88,,percent of total billed charges,,,,,,,,,543.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,647,91,,percent of total billed charges,,,675.44,95,,percent of total billed charges,,,590.12,83,,percent of total billed charges,,,590.12,83,,percent of total billed charges,,,,,,,,,,,,,,,590.12,83,,percent of total billed charges,,,675.44,95,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,583.01,82,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,604.34,85,,percent of total billed charges,,536.09,675.44,
DEPUY PINNACLE CUP REVISION 60MM,30181396,CDM,,,278,RC,inpatient,,33437.04,33437.04,,28388.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25211.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28421.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29424.6,88,,percent of total billed charges,,,,,,,,,25545.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30427.71,91,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,,,,,,,,,,,,,27752.74,83,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,27418.37,82,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,25211.53,31765.19,
DEPUY LINER ALTRX +4 35 X 45,30181397,CDM,,,278,RC,inpatient,,11806.99,11806.99,,10024.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8902.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10035.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10390.15,88,,percent of total billed charges,,,,,,,,,9020.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10744.36,91,,percent of total billed charges,,,11216.64,95,,percent of total billed charges,,,9799.8,83,,percent of total billed charges,,,9799.8,83,,percent of total billed charges,,,,,,,,,,,,,,,9799.8,83,,percent of total billed charges,,,11216.64,95,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,9681.73,82,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,10035.94,85,,percent of total billed charges,,8902.47,11216.64,
DEPUY LERE BONE MILL RENTAL 2902-0213,30181398,CDM,,,278,RC,inpatient,,4296.5,4296.5,,3647.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3239.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3652.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3780.92,88,,percent of total billed charges,,,,,,,,,3282.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3909.82,91,,percent of total billed charges,,,4081.68,95,,percent of total billed charges,,,3566.1,83,,percent of total billed charges,,,3566.1,83,,percent of total billed charges,,,,,,,,,,,,,,,3566.1,83,,percent of total billed charges,,,4081.68,95,,percent of total billed charges,,,3866.85,90,,percent of total billed charges,,,3866.85,90,,percent of total billed charges,,,3523.13,82,,percent of total billed charges,,,3866.85,90,,percent of total billed charges,,,3652.03,85,,percent of total billed charges,,3239.56,4081.68,
DEPUY PINNACLE CUP SECTOR II 48MM,30181401,CDM,,,278,RC,inpatient,,18892.32,18892.32,,16039.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14244.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16058.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16625.24,88,,percent of total billed charges,,,,,,,,,14433.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17192.01,91,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15680.63,83,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,15491.7,82,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,14244.81,17947.7,
DEPUY LINER ALTRX +4 32 X 48,30181402,CDM,,,278,RC,inpatient,,11806.99,11806.99,,10024.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8902.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10035.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10390.15,88,,percent of total billed charges,,,,,,,,,9020.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10744.36,91,,percent of total billed charges,,,11216.64,95,,percent of total billed charges,,,9799.8,83,,percent of total billed charges,,,9799.8,83,,percent of total billed charges,,,,,,,,,,,,,,,9799.8,83,,percent of total billed charges,,,11216.64,95,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,9681.73,82,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,10035.94,85,,percent of total billed charges,,8902.47,11216.64,
DEPUY STEM CORAIL HI OFFSET SZ12,30181405,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
GUIDEWIRE CORE COONS BENSON,30181406,CDM,,,270,RC,inpatient,,199.95,199.95,,169.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,169.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,175.96,88,,percent of total billed charges,,,,,,,,,152.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,181.95,91,,percent of total billed charges,,,189.95,95,,percent of total billed charges,,,165.96,83,,percent of total billed charges,,,165.96,83,,percent of total billed charges,,,,,,,,,,,,,,,165.96,83,,percent of total billed charges,,,189.95,95,,percent of total billed charges,,,179.96,90,,percent of total billed charges,,,179.96,90,,percent of total billed charges,,,163.96,82,,percent of total billed charges,,,179.96,90,,percent of total billed charges,,,169.96,85,,percent of total billed charges,,150.76,189.95,
STRYKER SAGITTAL BLADE 21X90X1.19MM,30181418,CDM,,,270,RC,inpatient,,478.73,478.73,,406.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,360.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,406.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,421.28,88,,percent of total billed charges,,,,,,,,,365.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,435.64,91,,percent of total billed charges,,,454.79,95,,percent of total billed charges,,,397.35,83,,percent of total billed charges,,,397.35,83,,percent of total billed charges,,,,,,,,,,,,,,,397.35,83,,percent of total billed charges,,,454.79,95,,percent of total billed charges,,,430.86,90,,percent of total billed charges,,,430.86,90,,percent of total billed charges,,,392.56,82,,percent of total billed charges,,,430.86,90,,percent of total billed charges,,,406.92,85,,percent of total billed charges,,360.96,454.79,
DEPUY PINNACLE CUP 100 W/GRIPTION 56MM,30181419,CDM,,,278,RC,inpatient,,20679.88,20679.88,,17557.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15592.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17577.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18198.29,88,,percent of total billed charges,,,,,,,,,15799.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18818.69,91,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17164.3,83,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,16957.5,82,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,15592.63,19645.89,
SYNTHES SCREW LOCKING 2.7X10MM,30181421,CDM,,,278,RC,inpatient,,1110.53,1110.53,,942.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,837.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,943.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,977.27,88,,percent of total billed charges,,,,,,,,,848.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1010.58,91,,percent of total billed charges,,,1055,95,,percent of total billed charges,,,921.74,83,,percent of total billed charges,,,921.74,83,,percent of total billed charges,,,,,,,,,,,,,,,921.74,83,,percent of total billed charges,,,1055,95,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,910.63,82,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,943.95,85,,percent of total billed charges,,837.34,1055,
SYNTHES SCREW LOCKING 2.7X12MM,30181422,CDM,,,278,RC,inpatient,,1178.13,1178.13,,1000.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,888.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1001.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1036.75,88,,percent of total billed charges,,,,,,,,,900.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1072.1,91,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,,,,,,,,,,,,,977.85,83,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,966.07,82,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,888.31,1119.22,
DEPUY PINNACLE CUP 100 W/GRIPTION 54MM,30181430,CDM,,,278,RC,inpatient,,20679.88,20679.88,,17557.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15592.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17577.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18198.29,88,,percent of total billed charges,,,,,,,,,15799.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18818.69,91,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17164.3,83,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,16957.5,82,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,15592.63,19645.89,
DEPUY FEMORAL HEAD 36MM -2,30181431,CDM,,,278,RC,inpatient,,8569.34,8569.34,,7275.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6461.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7283.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7541.02,88,,percent of total billed charges,,,,,,,,,6546.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7798.1,91,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7112.55,83,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7026.86,82,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,6461.28,8140.87,
DEPUY STEM BOWED SZ13.5 X 9,30181432,CDM,,,278,RC,inpatient,,67359.5,67359.5,,57188.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50789.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57255.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59276.36,88,,percent of total billed charges,,,,,,,,,51462.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61297.15,91,,percent of total billed charges,,,63991.53,95,,percent of total billed charges,,,55908.39,83,,percent of total billed charges,,,55908.39,83,,percent of total billed charges,,,,,,,,,,,,,,,55908.39,83,,percent of total billed charges,,,63991.53,95,,percent of total billed charges,,,60623.55,90,,percent of total billed charges,,,60623.55,90,,percent of total billed charges,,,55234.79,82,,percent of total billed charges,,,60623.55,90,,percent of total billed charges,,,57255.58,85,,percent of total billed charges,,50789.06,63991.53,
RTI PERONEAL TENDON,30181433,CDM,,,270,RC,inpatient,,16536,16536,,14039.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12468.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14055.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14551.68,88,,percent of total billed charges,,,,,,,,,12633.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15047.76,91,,percent of total billed charges,,,15709.2,95,,percent of total billed charges,,,13724.88,83,,percent of total billed charges,,,13724.88,83,,percent of total billed charges,,,,,,,,,,,,,,,13724.88,83,,percent of total billed charges,,,15709.2,95,,percent of total billed charges,,,14882.4,90,,percent of total billed charges,,,14882.4,90,,percent of total billed charges,,,13559.52,82,,percent of total billed charges,,,14882.4,90,,percent of total billed charges,,,14055.6,85,,percent of total billed charges,,12468.14,15709.2,
DEPUY STEM CORAIL HI OFFSET SZ15,30181438,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY STEM CALCAR SZ15.0 X 9,30181439,CDM,,,278,RC,inpatient,,41578.1,41578.1,,35299.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31349.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35341.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36588.73,88,,percent of total billed charges,,,,,,,,,31765.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37836.07,91,,percent of total billed charges,,,39499.2,95,,percent of total billed charges,,,34509.82,83,,percent of total billed charges,,,34509.82,83,,percent of total billed charges,,,,,,,,,,,,,,,34509.82,83,,percent of total billed charges,,,39499.2,95,,percent of total billed charges,,,37420.29,90,,percent of total billed charges,,,37420.29,90,,percent of total billed charges,,,34094.04,82,,percent of total billed charges,,,37420.29,90,,percent of total billed charges,,,35341.39,85,,percent of total billed charges,,31349.89,39499.2,
DEPUY PINNACLE CUP SECTOR II 58MM,30181440,CDM,,,278,RC,inpatient,,18892.32,18892.32,,16039.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14244.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16058.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16625.24,88,,percent of total billed charges,,,,,,,,,14433.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17192.01,91,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15680.63,83,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,15491.7,82,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,14244.81,17947.7,
DEPUY PINNACLE SCREW 6.5 X 30,30181441,CDM,,,278,RC,inpatient,,1075.49,1075.49,,913.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,810.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,914.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,946.43,88,,percent of total billed charges,,,,,,,,,821.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,978.7,91,,percent of total billed charges,,,1021.72,95,,percent of total billed charges,,,892.66,83,,percent of total billed charges,,,892.66,83,,percent of total billed charges,,,,,,,,,,,,,,,892.66,83,,percent of total billed charges,,,1021.72,95,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,881.9,82,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,914.17,85,,percent of total billed charges,,810.92,1021.72,
DEPUY PINNACLE CUP INSERT 40 X 58,30181442,CDM,,,278,RC,inpatient,,17516.2,17516.2,,14871.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13207.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14888.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15414.26,88,,percent of total billed charges,,,,,,,,,13382.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15939.74,91,,percent of total billed charges,,,16640.39,95,,percent of total billed charges,,,14538.45,83,,percent of total billed charges,,,14538.45,83,,percent of total billed charges,,,,,,,,,,,,,,,14538.45,83,,percent of total billed charges,,,16640.39,95,,percent of total billed charges,,,15764.58,90,,percent of total billed charges,,,15764.58,90,,percent of total billed charges,,,14363.28,82,,percent of total billed charges,,,15764.58,90,,percent of total billed charges,,,14888.77,85,,percent of total billed charges,,13207.21,16640.39,
DEPUY FEMORAL HEAD 40MM +8.5,30181443,CDM,,,278,RC,inpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14425.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16261.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,14425.07,18174.82,
RIGID URETERAL DILATION SYSTEM,30181444,CDM,,,270,RC,inpatient,,1111.44,1111.44,,943.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,838.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,944.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,978.07,88,,percent of total billed charges,,,,,,,,,849.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1011.41,91,,percent of total billed charges,,,1055.87,95,,percent of total billed charges,,,922.5,83,,percent of total billed charges,,,922.5,83,,percent of total billed charges,,,,,,,,,,,,,,,922.5,83,,percent of total billed charges,,,1055.87,95,,percent of total billed charges,,,1000.3,90,,percent of total billed charges,,,1000.3,90,,percent of total billed charges,,,911.38,82,,percent of total billed charges,,,1000.3,90,,percent of total billed charges,,,944.72,85,,percent of total billed charges,,838.03,1055.87,
BALLOON UROMAX ULTRA DILATATION,30181445,CDM,,,270,RC,inpatient,,2068.63,2068.63,,1756.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1559.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1758.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1820.39,88,,percent of total billed charges,,,,,,,,,1580.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1882.45,91,,percent of total billed charges,,,1965.2,95,,percent of total billed charges,,,1716.96,83,,percent of total billed charges,,,1716.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1716.96,83,,percent of total billed charges,,,1965.2,95,,percent of total billed charges,,,1861.77,90,,percent of total billed charges,,,1861.77,90,,percent of total billed charges,,,1696.28,82,,percent of total billed charges,,,1861.77,90,,percent of total billed charges,,,1758.34,85,,percent of total billed charges,,1559.75,1965.2,
DEPUY KNEE UNI-FIXED BEARING,30181447,CDM,,,278,RC,inpatient,,18806,18806,,15966.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14179.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15985.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16549.28,88,,percent of total billed charges,,,,,,,,,14367.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17113.46,91,,percent of total billed charges,,,17865.7,95,,percent of total billed charges,,,15608.98,83,,percent of total billed charges,,,15608.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15608.98,83,,percent of total billed charges,,,17865.7,95,,percent of total billed charges,,,16925.4,90,,percent of total billed charges,,,16925.4,90,,percent of total billed charges,,,15420.92,82,,percent of total billed charges,,,16925.4,90,,percent of total billed charges,,,15985.1,85,,percent of total billed charges,,14179.72,17865.7,
DEPUY INSERT SIGMA HP UNIVERSAL,30181448,CDM,,,278,RC,inpatient,,3909.43,3909.43,,3319.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2947.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3323.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3440.3,88,,percent of total billed charges,,,,,,,,,2986.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3557.58,91,,percent of total billed charges,,,3713.96,95,,percent of total billed charges,,,3244.83,83,,percent of total billed charges,,,3244.83,83,,percent of total billed charges,,,,,,,,,,,,,,,3244.83,83,,percent of total billed charges,,,3713.96,95,,percent of total billed charges,,,3518.49,90,,percent of total billed charges,,,3518.49,90,,percent of total billed charges,,,3205.73,82,,percent of total billed charges,,,3518.49,90,,percent of total billed charges,,,3323.02,85,,percent of total billed charges,,2947.71,3713.96,
DEPUY SAWBLADE 13 X 70,30181452,CDM,,,278,RC,inpatient,,1074.06,1074.06,,911.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,809.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,912.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,945.17,88,,percent of total billed charges,,,,,,,,,820.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,977.39,91,,percent of total billed charges,,,1020.36,95,,percent of total billed charges,,,891.47,83,,percent of total billed charges,,,891.47,83,,percent of total billed charges,,,,,,,,,,,,,,,891.47,83,,percent of total billed charges,,,1020.36,95,,percent of total billed charges,,,966.65,90,,percent of total billed charges,,,966.65,90,,percent of total billed charges,,,880.73,82,,percent of total billed charges,,,966.65,90,,percent of total billed charges,,,912.95,85,,percent of total billed charges,,809.84,1020.36,
DEPUY STEM CORAIL KLA SZ12,30181454,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY STEM HUMERAL SZ10,30181455,CDM,,,278,RC,inpatient,,35653.09,35653.09,,30269.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26882.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30305.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31374.72,88,,percent of total billed charges,,,,,,,,,27238.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32444.31,91,,percent of total billed charges,,,33870.44,95,,percent of total billed charges,,,29592.06,83,,percent of total billed charges,,,29592.06,83,,percent of total billed charges,,,,,,,,,,,,,,,29592.06,83,,percent of total billed charges,,,33870.44,95,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,29235.53,82,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,30305.13,85,,percent of total billed charges,,26882.43,33870.44,
DEPUY ECC GLENOSPHERE 38MM,30181456,CDM,,,278,RC,inpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14941.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16844.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,14941.68,18825.72,
DEPUY SCREW NON LOCKING 18MM,30181457,CDM,,,278,RC,inpatient,,1330.16,1330.16,,1129.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1002.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1130.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1170.54,88,,percent of total billed charges,,,,,,,,,1016.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1210.45,91,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1104.03,83,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1090.73,82,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1130.64,85,,percent of total billed charges,,1002.94,1263.65,
DEPUY SCREW LOCKING 30MM,30181458,CDM,,,278,RC,inpatient,,2237.76,2237.76,,1899.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1687.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1902.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1969.23,88,,percent of total billed charges,,,,,,,,,1709.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2036.36,91,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1857.34,83,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1834.96,82,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,1687.27,2125.87,
DEPUY SCREW LOCKING 42MM,30181459,CDM,,,278,RC,inpatient,,2237.76,2237.76,,1899.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1687.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1902.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1969.23,88,,percent of total billed charges,,,,,,,,,1709.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2036.36,91,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1857.34,83,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1834.96,82,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,1687.27,2125.87,
DEPUY METAGLENE,30181460,CDM,,,278,RC,inpatient,,13765.7,13765.7,,11687.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10379.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11700.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12113.82,88,,percent of total billed charges,,,,,,,,,10516.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12526.79,91,,percent of total billed charges,,,13077.42,95,,percent of total billed charges,,,11425.53,83,,percent of total billed charges,,,11425.53,83,,percent of total billed charges,,,,,,,,,,,,,,,11425.53,83,,percent of total billed charges,,,13077.42,95,,percent of total billed charges,,,12389.13,90,,percent of total billed charges,,,12389.13,90,,percent of total billed charges,,,11287.87,82,,percent of total billed charges,,,12389.13,90,,percent of total billed charges,,,11700.85,85,,percent of total billed charges,,10379.34,13077.42,
DEPUY HUMERAL CUP 38+6,30181461,CDM,,,278,RC,inpatient,,10688.08,10688.08,,9074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8058.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9084.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9405.51,88,,percent of total billed charges,,,,,,,,,8165.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9726.15,91,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,,,,,,,,,,,,,8871.11,83,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,8764.23,82,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,8058.81,10153.68,
DEPUY GUIDE PIN 2.0MM,30181462,CDM,,,278,RC,inpatient,,1105,1105,,938.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,833.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,939.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,972.4,88,,percent of total billed charges,,,,,,,,,844.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1005.55,91,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,,,,,,,,,,,,,917.15,83,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,906.1,82,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,833.17,1049.75,
DEPUY GUIDE PIN GLENOSPHERE,30181463,CDM,,,278,RC,inpatient,,1105,1105,,938.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,833.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,939.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,972.4,88,,percent of total billed charges,,,,,,,,,844.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1005.55,91,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,,,,,,,,,,,,,917.15,83,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,906.1,82,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,833.17,1049.75,
DEPUY GUIDE PIN SCREW,30181464,CDM,,,278,RC,inpatient,,2021.5,2021.5,,1716.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1524.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1718.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1778.92,88,,percent of total billed charges,,,,,,,,,1544.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1839.57,91,,percent of total billed charges,,,1920.43,95,,percent of total billed charges,,,1677.85,83,,percent of total billed charges,,,1677.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1677.85,83,,percent of total billed charges,,,1920.43,95,,percent of total billed charges,,,1819.35,90,,percent of total billed charges,,,1819.35,90,,percent of total billed charges,,,1657.63,82,,percent of total billed charges,,,1819.35,90,,percent of total billed charges,,,1718.28,85,,percent of total billed charges,,1524.21,1920.43,
DEPUY DRILL BIT 2.0,30181465,CDM,,,278,RC,inpatient,,1833,1833,,1556.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1382.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1558.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1613.04,88,,percent of total billed charges,,,,,,,,,1400.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1668.03,91,,percent of total billed charges,,,1741.35,95,,percent of total billed charges,,,1521.39,83,,percent of total billed charges,,,1521.39,83,,percent of total billed charges,,,,,,,,,,,,,,,1521.39,83,,percent of total billed charges,,,1741.35,95,,percent of total billed charges,,,1649.7,90,,percent of total billed charges,,,1649.7,90,,percent of total billed charges,,,1503.06,82,,percent of total billed charges,,,1649.7,90,,percent of total billed charges,,,1558.05,85,,percent of total billed charges,,1382.08,1741.35,
DEPUY STEM GLOBAL HUMERAL 52 X 15,30181466,CDM,,,278,RC,inpatient,,15560.09,15560.09,,13210.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11732.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13226.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13692.88,88,,percent of total billed charges,,,,,,,,,11887.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14159.68,91,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12914.87,83,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,12759.27,82,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,11732.31,14782.09,
SYNTHES SCREW CANNUL 4.0X30MM,30181470,CDM,,,278,RC,inpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1466.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1653.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,1466.38,1847.56,
SYNTHES SCREW CANNUL 4.0X32MM,30181471,CDM,,,278,RC,inpatient,,2003.17,2003.17,,1700.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1510.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1702.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1762.79,88,,percent of total billed charges,,,,,,,,,1530.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1822.88,91,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1662.63,83,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1642.6,82,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,1510.39,1903.01,
GYRUS MESH 2X3,30181472,CDM,,,270,RC,inpatient,,1946.75,1946.75,,1652.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1467.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1654.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1713.14,88,,percent of total billed charges,,,,,,,,,1487.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1771.54,91,,percent of total billed charges,,,1849.41,95,,percent of total billed charges,,,1615.8,83,,percent of total billed charges,,,1615.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1615.8,83,,percent of total billed charges,,,1849.41,95,,percent of total billed charges,,,1752.08,90,,percent of total billed charges,,,1752.08,90,,percent of total billed charges,,,1596.34,82,,percent of total billed charges,,,1752.08,90,,percent of total billed charges,,,1654.74,85,,percent of total billed charges,,1467.85,1849.41,
MESH HERNIA REBOUND 3.94  X 5.03,30181473,CDM,,,270,RC,inpatient,,4631.25,4631.25,,3931.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3491.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3936.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4075.5,88,,percent of total billed charges,,,,,,,,,3538.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4214.44,91,,percent of total billed charges,,,4399.69,95,,percent of total billed charges,,,3843.94,83,,percent of total billed charges,,,3843.94,83,,percent of total billed charges,,,,,,,,,,,,,,,3843.94,83,,percent of total billed charges,,,4399.69,95,,percent of total billed charges,,,4168.13,90,,percent of total billed charges,,,4168.13,90,,percent of total billed charges,,,3797.63,82,,percent of total billed charges,,,4168.13,90,,percent of total billed charges,,,3936.56,85,,percent of total billed charges,,3491.96,4399.69,
DRAIN JACKSON PRATT FLAT 7MM,30181474,CDM,,,270,RC,inpatient,,55.85,55.85,,47.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.15,88,,percent of total billed charges,,,,,,,,,42.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.82,91,,percent of total billed charges,,,53.06,95,,percent of total billed charges,,,46.36,83,,percent of total billed charges,,,46.36,83,,percent of total billed charges,,,,,,,,,,,,,,,46.36,83,,percent of total billed charges,,,53.06,95,,percent of total billed charges,,,50.27,90,,percent of total billed charges,,,50.27,90,,percent of total billed charges,,,45.8,82,,percent of total billed charges,,,50.27,90,,percent of total billed charges,,,47.47,85,,percent of total billed charges,,42.11,53.06,
DRAIN JACKSON PRATT FLAT 10MM,30181475,CDM,,,270,RC,inpatient,,54.06,54.06,,45.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47.57,88,,percent of total billed charges,,,,,,,,,41.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.19,91,,percent of total billed charges,,,51.36,95,,percent of total billed charges,,,44.87,83,,percent of total billed charges,,,44.87,83,,percent of total billed charges,,,,,,,,,,,,,,,44.87,83,,percent of total billed charges,,,51.36,95,,percent of total billed charges,,,48.65,90,,percent of total billed charges,,,48.65,90,,percent of total billed charges,,,44.33,82,,percent of total billed charges,,,48.65,90,,percent of total billed charges,,,45.95,85,,percent of total billed charges,,40.76,51.36,
SYNTHES SCREW LOCKING 2.7X18MM,30181477,CDM,,,278,RC,inpatient,,1178.13,1178.13,,1000.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,888.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1001.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1036.75,88,,percent of total billed charges,,,,,,,,,900.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1072.1,91,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,,,,,,,,,,,,,977.85,83,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,966.07,82,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,888.31,1119.22,
DEPUY FEMORAL HEAD 40MM -2,30181481,CDM,,,278,RC,inpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10650.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12006.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,10650.51,13419.08,
DEPUY STEM BOWED SZ18.0 X 8,30181482,CDM,,,278,RC,inpatient,,67789.22,67789.22,,57553.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51113.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57620.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59654.51,88,,percent of total billed charges,,,,,,,,,51790.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61688.19,91,,percent of total billed charges,,,64399.76,95,,percent of total billed charges,,,56265.05,83,,percent of total billed charges,,,56265.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56265.05,83,,percent of total billed charges,,,64399.76,95,,percent of total billed charges,,,61010.3,90,,percent of total billed charges,,,61010.3,90,,percent of total billed charges,,,55587.16,82,,percent of total billed charges,,,61010.3,90,,percent of total billed charges,,,57620.84,85,,percent of total billed charges,,51113.07,64399.76,
DEPUY MORELAND RENTAL 2902-04-000,30181483,CDM,,,278,RC,inpatient,,4550,4550,,3862.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3430.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3867.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4004,88,,percent of total billed charges,,,,,,,,,3476.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4140.5,91,,percent of total billed charges,,,4322.5,95,,percent of total billed charges,,,3776.5,83,,percent of total billed charges,,,3776.5,83,,percent of total billed charges,,,,,,,,,,,,,,,3776.5,83,,percent of total billed charges,,,4322.5,95,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,3731,82,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,3867.5,85,,percent of total billed charges,,3430.7,4322.5,
DEPUY OSTEOTOME THIN 10MM X 3,30181484,CDM,,,270,RC,inpatient,,3672.5,3672.5,,3117.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2769.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3121.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3231.8,88,,percent of total billed charges,,,,,,,,,2805.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3341.98,91,,percent of total billed charges,,,3488.88,95,,percent of total billed charges,,,3048.18,83,,percent of total billed charges,,,3048.18,83,,percent of total billed charges,,,,,,,,,,,,,,,3048.18,83,,percent of total billed charges,,,3488.88,95,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3011.45,82,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3121.63,85,,percent of total billed charges,,2769.07,3488.88,
DEPUY OSTEOTOME THIN 10MM X 5,30181485,CDM,,,278,RC,inpatient,,3861,3861,,3277.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2911.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3281.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3397.68,88,,percent of total billed charges,,,,,,,,,2949.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3513.51,91,,percent of total billed charges,,,3667.95,95,,percent of total billed charges,,,3204.63,83,,percent of total billed charges,,,3204.63,83,,percent of total billed charges,,,,,,,,,,,,,,,3204.63,83,,percent of total billed charges,,,3667.95,95,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3166.02,82,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3281.85,85,,percent of total billed charges,,2911.19,3667.95,
TISSEEL FIBRIN SEALANT 4ML PRIMA,30181490,CDM,,,278,RC,inpatient,,1564.1,1564.1,,1327.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1179.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1329.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1376.41,88,,percent of total billed charges,,,,,,,,,1194.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1423.33,91,,percent of total billed charges,,,1485.9,95,,percent of total billed charges,,,1298.2,83,,percent of total billed charges,,,1298.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1298.2,83,,percent of total billed charges,,,1485.9,95,,percent of total billed charges,,,1407.69,90,,percent of total billed charges,,,1407.69,90,,percent of total billed charges,,,1282.56,82,,percent of total billed charges,,,1407.69,90,,percent of total billed charges,,,1329.49,85,,percent of total billed charges,,1179.33,1485.9,
ELASTIC STAY 5MM,30181498,CDM,,,270,RC,inpatient,,49.22,49.22,,41.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,43.31,88,,percent of total billed charges,,,,,,,,,37.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,44.79,91,,percent of total billed charges,,,46.76,95,,percent of total billed charges,,,40.85,83,,percent of total billed charges,,,40.85,83,,percent of total billed charges,,,,,,,,,,,,,,,40.85,83,,percent of total billed charges,,,46.76,95,,percent of total billed charges,,,44.3,90,,percent of total billed charges,,,44.3,90,,percent of total billed charges,,,40.36,82,,percent of total billed charges,,,44.3,90,,percent of total billed charges,,,41.84,85,,percent of total billed charges,,37.11,46.76,
STRYKER SHAVER AGGRESSIVE PLUS 4.0,30181504,CDM,,,270,RC,inpatient,,365.6,365.6,,310.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,275.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,310.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,321.73,88,,percent of total billed charges,,,,,,,,,279.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,332.7,91,,percent of total billed charges,,,347.32,95,,percent of total billed charges,,,303.45,83,,percent of total billed charges,,,303.45,83,,percent of total billed charges,,,,,,,,,,,,,,,303.45,83,,percent of total billed charges,,,347.32,95,,percent of total billed charges,,,329.04,90,,percent of total billed charges,,,329.04,90,,percent of total billed charges,,,299.79,82,,percent of total billed charges,,,329.04,90,,percent of total billed charges,,,310.76,85,,percent of total billed charges,,275.66,347.32,
DEPUY LINER ALTRX +4 NEUT 32 X 48,30181506,CDM,,,278,RC,inpatient,,11494.99,11494.99,,9759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8667.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9770.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10115.59,88,,percent of total billed charges,,,,,,,,,8782.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10460.44,91,,percent of total billed charges,,,10920.24,95,,percent of total billed charges,,,9540.84,83,,percent of total billed charges,,,9540.84,83,,percent of total billed charges,,,,,,,,,,,,,,,9540.84,83,,percent of total billed charges,,,10920.24,95,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,9425.89,82,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,9770.74,85,,percent of total billed charges,,8667.22,10920.24,
DEPUY FEMORAL HEAD 32MM +1,30181507,CDM,,,278,RC,inpatient,,5683.54,5683.54,,4825.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4285.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4831.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5001.52,88,,percent of total billed charges,,,,,,,,,4342.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5172.02,91,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,,,,,,,,,,,,,4717.34,83,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4660.5,82,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4831.01,85,,percent of total billed charges,,4285.39,5399.36,
DEPUY FEMUR TC3 RT SZ2.5,30181508,CDM,,,278,RC,inpatient,,36489.7,36489.7,,30979.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27513.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31016.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32110.94,88,,percent of total billed charges,,,,,,,,,27878.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33205.63,91,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,,,,,,,,,,,,,30286.45,83,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,29921.55,82,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,27513.23,34665.22,
DEPUY POSTERIOR AUGMENT 4MM SZ2.5,30181509,CDM,,,278,RC,inpatient,,6245.14,6245.14,,5302.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4708.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5308.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5495.72,88,,percent of total billed charges,,,,,,,,,4771.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5683.08,91,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,,,,,,,,,,,,,5183.47,83,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5121.01,82,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,4708.84,5932.88,
DEPUY DISTAL AUGMENT RT 12MM SZ2.5,30181510,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
DEPUY STEM CEMENTED 13 X 90,30181511,CDM,,,278,RC,inpatient,,8116.23,8116.23,,6890.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6119.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6898.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7142.28,88,,percent of total billed charges,,,,,,,,,6200.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7385.77,91,,percent of total billed charges,,,7710.42,95,,percent of total billed charges,,,6736.47,83,,percent of total billed charges,,,6736.47,83,,percent of total billed charges,,,,,,,,,,,,,,,6736.47,83,,percent of total billed charges,,,7710.42,95,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,6655.31,82,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,6898.8,85,,percent of total billed charges,,6119.64,7710.42,
DEPUY INSERT TC3 RP 30MM SZ2.5,30181512,CDM,,,278,RC,inpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17430.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19649.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,17430.21,21961.14,
DEPUY MBT REVISION TIBIAL TRAY SZ2.5,30181513,CDM,,,278,RC,inpatient,,28838.62,28838.62,,24483.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21744.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24512.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25377.99,88,,percent of total billed charges,,,,,,,,,22032.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26243.14,91,,percent of total billed charges,,,27396.69,95,,percent of total billed charges,,,23936.05,83,,percent of total billed charges,,,23936.05,83,,percent of total billed charges,,,,,,,,,,,,,,,23936.05,83,,percent of total billed charges,,,27396.69,95,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,23647.67,82,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,24512.83,85,,percent of total billed charges,,21744.32,27396.69,
DEPUY MBT TRAY SLEEVE 37MM,30181514,CDM,,,278,RC,inpatient,,12860.84,12860.84,,10918.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9697.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10931.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11317.54,88,,percent of total billed charges,,,,,,,,,9825.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11703.36,91,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10674.5,83,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10545.89,82,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10931.71,85,,percent of total billed charges,,9697.07,12217.8,
DEPUY OSTEOTOME FLEX 12MM X 3,30181515,CDM,,,278,RC,inpatient,,1352,1352,,1147.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1019.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1149.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1189.76,88,,percent of total billed charges,,,,,,,,,1032.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1230.32,91,,percent of total billed charges,,,1284.4,95,,percent of total billed charges,,,1122.16,83,,percent of total billed charges,,,1122.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1122.16,83,,percent of total billed charges,,,1284.4,95,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1108.64,82,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1149.2,85,,percent of total billed charges,,1019.41,1284.4,
DEPUY BONE CEMENT W/ANTIBIOTIC 35-500,30181516,CDM,,,270,RC,inpatient,,1527.5,1527.5,,1296.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1151.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1298.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1344.2,88,,percent of total billed charges,,,,,,,,,1167.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1390.03,91,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1267.83,83,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1252.55,82,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,1151.74,1451.13,
BIOGUIDE PATCH 40/50,30181518,CDM,,,270,RC,inpatient,,2687.1,2687.1,,2281.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2026.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2284.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2364.65,88,,percent of total billed charges,,,,,,,,,2052.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2445.26,91,,percent of total billed charges,,,2552.75,95,,percent of total billed charges,,,2230.29,83,,percent of total billed charges,,,2230.29,83,,percent of total billed charges,,,,,,,,,,,,,,,2230.29,83,,percent of total billed charges,,,2552.75,95,,percent of total billed charges,,,2418.39,90,,percent of total billed charges,,,2418.39,90,,percent of total billed charges,,,2203.42,82,,percent of total billed charges,,,2418.39,90,,percent of total billed charges,,,2284.04,85,,percent of total billed charges,,2026.07,2552.75,
DEPUY INSERT SIGMA XLK 3 X 17,30181519,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY STEM CORAIL HI OFFSET SZ13,30181522,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY PINNACLE CUP INSERT 44 X 62,30181523,CDM,,,278,RC,inpatient,,18531.63,18531.63,,15733.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13972.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15751.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16307.83,88,,percent of total billed charges,,,,,,,,,14158.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16863.78,91,,percent of total billed charges,,,17605.05,95,,percent of total billed charges,,,15381.25,83,,percent of total billed charges,,,15381.25,83,,percent of total billed charges,,,,,,,,,,,,,,,15381.25,83,,percent of total billed charges,,,17605.05,95,,percent of total billed charges,,,16678.47,90,,percent of total billed charges,,,16678.47,90,,percent of total billed charges,,,15195.94,82,,percent of total billed charges,,,16678.47,90,,percent of total billed charges,,,15751.89,85,,percent of total billed charges,,13972.85,17605.05,
DEPUY CERAMIC HEAD 44MM +5,30181524,CDM,,,278,RC,inpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14425.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16261.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,14425.07,18174.82,
DEPUY STEM SUMMIT BASIC SZ8,30181525,CDM,,,278,RC,inpatient,,11591.45,11591.45,,9841.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8739.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9852.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10200.48,88,,percent of total billed charges,,,,,,,,,8855.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10548.22,91,,percent of total billed charges,,,11011.88,95,,percent of total billed charges,,,9620.9,83,,percent of total billed charges,,,9620.9,83,,percent of total billed charges,,,,,,,,,,,,,,,9620.9,83,,percent of total billed charges,,,11011.88,95,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,9504.99,82,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,9852.73,85,,percent of total billed charges,,8739.95,11011.88,
DEPUY SCREW LOCKING 36MM,30181526,CDM,,,278,RC,inpatient,,2237.76,2237.76,,1899.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1687.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1902.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1969.23,88,,percent of total billed charges,,,,,,,,,1709.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2036.36,91,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1857.34,83,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1834.96,82,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,1687.27,2125.87,
DEPUY SCREW NON LOCKING 24MM,30181527,CDM,,,278,RC,inpatient,,1330.16,1330.16,,1129.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1002.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1130.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1170.54,88,,percent of total billed charges,,,,,,,,,1016.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1210.45,91,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1104.03,83,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1090.73,82,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1130.64,85,,percent of total billed charges,,1002.94,1263.65,
DEPUY HUMERAL CUP 38+3,30181528,CDM,,,278,RC,inpatient,,10688.08,10688.08,,9074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8058.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9084.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9405.51,88,,percent of total billed charges,,,,,,,,,8165.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9726.15,91,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,,,,,,,,,,,,,8871.11,83,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,8764.23,82,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,8058.81,10153.68,
DEPUY CEMENTLESS EPIPHYSIS SZ1,30181529,CDM,,,278,RC,inpatient,,33055.36,33055.36,,28064,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24923.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28097.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29088.72,88,,percent of total billed charges,,,,,,,,,25254.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30080.38,91,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,,,,,,,,,,,,,27435.95,83,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,27105.4,82,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,28097.06,85,,percent of total billed charges,,24923.74,31402.59,
DEPUY STEM HUMERAL SZ0,30181530,CDM,,,278,RC,inpatient,,17244.96,17244.96,,14640.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13002.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14658.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15175.56,88,,percent of total billed charges,,,,,,,,,13175.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15692.91,91,,percent of total billed charges,,,16382.71,95,,percent of total billed charges,,,14313.32,83,,percent of total billed charges,,,14313.32,83,,percent of total billed charges,,,,,,,,,,,,,,,14313.32,83,,percent of total billed charges,,,16382.71,95,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,14140.87,82,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,14658.22,85,,percent of total billed charges,,13002.7,16382.71,
DEPUY BONE CEMENT W/ANTIBIOTIC 50-501,30181531,CDM,,,270,RC,inpatient,,1879.61,1879.61,,1595.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1417.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1597.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1654.06,88,,percent of total billed charges,,,,,,,,,1436.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1710.45,91,,percent of total billed charges,,,1785.63,95,,percent of total billed charges,,,1560.08,83,,percent of total billed charges,,,1560.08,83,,percent of total billed charges,,,,,,,,,,,,,,,1560.08,83,,percent of total billed charges,,,1785.63,95,,percent of total billed charges,,,1691.65,90,,percent of total billed charges,,,1691.65,90,,percent of total billed charges,,,1541.28,82,,percent of total billed charges,,,1691.65,90,,percent of total billed charges,,,1597.67,85,,percent of total billed charges,,1417.23,1785.63,
DEPUY DRILL BIT 2.5,30181532,CDM,,,278,RC,inpatient,,553,553,,469.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,416.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,470.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,486.64,88,,percent of total billed charges,,,,,,,,,422.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,503.23,91,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,,,,,,,,,,,,,458.99,83,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,453.46,82,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,416.96,525.35,
DEPUY DRILL BIT 3.2,30181533,CDM,,,278,RC,inpatient,,335.18,335.18,,284.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,252.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,284.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,294.96,88,,percent of total billed charges,,,,,,,,,256.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,305.01,91,,percent of total billed charges,,,318.42,95,,percent of total billed charges,,,278.2,83,,percent of total billed charges,,,278.2,83,,percent of total billed charges,,,,,,,,,,,,,,,278.2,83,,percent of total billed charges,,,318.42,95,,percent of total billed charges,,,301.66,90,,percent of total billed charges,,,301.66,90,,percent of total billed charges,,,274.85,82,,percent of total billed charges,,,301.66,90,,percent of total billed charges,,,284.9,85,,percent of total billed charges,,252.73,318.42,
ENDO STITCH 10MM SUTURING DEVICE,30181534,CDM,,,270,RC,inpatient,,2733.51,2733.51,,2320.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2061.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2323.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2405.49,88,,percent of total billed charges,,,,,,,,,2088.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2487.49,91,,percent of total billed charges,,,2596.83,95,,percent of total billed charges,,,2268.81,83,,percent of total billed charges,,,2268.81,83,,percent of total billed charges,,,,,,,,,,,,,,,2268.81,83,,percent of total billed charges,,,2596.83,95,,percent of total billed charges,,,2460.16,90,,percent of total billed charges,,,2460.16,90,,percent of total billed charges,,,2241.48,82,,percent of total billed charges,,,2460.16,90,,percent of total billed charges,,,2323.48,85,,percent of total billed charges,,2061.07,2596.83,
S&N ENDO RAP PAC 1.5,30181539,CDM,,,278,RC,inpatient,,1687.14,1687.14,,1432.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1272.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1434.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1484.68,88,,percent of total billed charges,,,,,,,,,1288.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1535.3,91,,percent of total billed charges,,,1602.78,95,,percent of total billed charges,,,1400.33,83,,percent of total billed charges,,,1400.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1400.33,83,,percent of total billed charges,,,1602.78,95,,percent of total billed charges,,,1518.43,90,,percent of total billed charges,,,1518.43,90,,percent of total billed charges,,,1383.45,82,,percent of total billed charges,,,1518.43,90,,percent of total billed charges,,,1434.07,85,,percent of total billed charges,,1272.1,1602.78,
S&N ENDO PAC,30181540,CDM,,,270,RC,inpatient,,3416.47,3416.47,,2900.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2576.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2904,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3006.49,88,,percent of total billed charges,,,,,,,,,2610.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3108.99,91,,percent of total billed charges,,,3245.65,95,,percent of total billed charges,,,2835.67,83,,percent of total billed charges,,,2835.67,83,,percent of total billed charges,,,,,,,,,,,,,,,2835.67,83,,percent of total billed charges,,,3245.65,95,,percent of total billed charges,,,3074.82,90,,percent of total billed charges,,,3074.82,90,,percent of total billed charges,,,2801.51,82,,percent of total billed charges,,,3074.82,90,,percent of total billed charges,,,2904,85,,percent of total billed charges,,2576.02,3245.65,
S&N ENDO PROBE 30MM,30181543,CDM,,,270,RC,inpatient,,1475.5,1475.5,,1252.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1112.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1254.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1298.44,88,,percent of total billed charges,,,,,,,,,1127.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1342.71,91,,percent of total billed charges,,,1401.73,95,,percent of total billed charges,,,1224.67,83,,percent of total billed charges,,,1224.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1224.67,83,,percent of total billed charges,,,1401.73,95,,percent of total billed charges,,,1327.95,90,,percent of total billed charges,,,1327.95,90,,percent of total billed charges,,,1209.91,82,,percent of total billed charges,,,1327.95,90,,percent of total billed charges,,,1254.18,85,,percent of total billed charges,,1112.53,1401.73,
RETRACTOR ALEXIS WOUND MED 5 X 9,30181546,CDM,,,270,RC,inpatient,,364,364,,309.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,274.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,309.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,320.32,88,,percent of total billed charges,,,,,,,,,278.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,331.24,91,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,,,,,,,,,,,,,302.12,83,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,298.48,82,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,309.4,85,,percent of total billed charges,,274.46,345.8,
CLIP APPLIER SURGICLIP S-9.0IN,30181548,CDM,,,270,RC,inpatient,,1182.55,1182.55,,1003.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,891.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1005.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1040.64,88,,percent of total billed charges,,,,,,,,,903.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1076.12,91,,percent of total billed charges,,,1123.42,95,,percent of total billed charges,,,981.52,83,,percent of total billed charges,,,981.52,83,,percent of total billed charges,,,,,,,,,,,,,,,981.52,83,,percent of total billed charges,,,1123.42,95,,percent of total billed charges,,,1064.3,90,,percent of total billed charges,,,1064.3,90,,percent of total billed charges,,,969.69,82,,percent of total billed charges,,,1064.3,90,,percent of total billed charges,,,1005.17,85,,percent of total billed charges,,891.64,1123.42,
CLIP APPLIER SURGICLIP M-9.75IN,30181549,CDM,,,270,RC,inpatient,,1167.01,1167.01,,990.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,879.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,991.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1026.97,88,,percent of total billed charges,,,,,,,,,891.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1061.98,91,,percent of total billed charges,,,1108.66,95,,percent of total billed charges,,,968.62,83,,percent of total billed charges,,,968.62,83,,percent of total billed charges,,,,,,,,,,,,,,,968.62,83,,percent of total billed charges,,,1108.66,95,,percent of total billed charges,,,1050.31,90,,percent of total billed charges,,,1050.31,90,,percent of total billed charges,,,956.95,82,,percent of total billed charges,,,1050.31,90,,percent of total billed charges,,,991.96,85,,percent of total billed charges,,879.93,1108.66,
MARGIN MAP W/5MM CHARM,30181550,CDM,,,270,RC,inpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,108.58,136.8,
RTI HEMI FEMORAL SHAFT 131MM-165MM,30181551,CDM,,,278,RC,inpatient,,7923.5,7923.5,,6727.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5974.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6734.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6972.68,88,,percent of total billed charges,,,,,,,,,6053.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7210.39,91,,percent of total billed charges,,,7527.33,95,,percent of total billed charges,,,6576.51,83,,percent of total billed charges,,,6576.51,83,,percent of total billed charges,,,,,,,,,,,,,,,6576.51,83,,percent of total billed charges,,,7527.33,95,,percent of total billed charges,,,7131.15,90,,percent of total billed charges,,,7131.15,90,,percent of total billed charges,,,6497.27,82,,percent of total billed charges,,,7131.15,90,,percent of total billed charges,,,6734.98,85,,percent of total billed charges,,5974.32,7527.33,
DEPUY LINER ALTRX +4 40 X 56,30181552,CDM,,,278,RC,inpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13270.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14960.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,13270.78,16720.48,
DEPUY CERAMIC HEAD 40MM +12,30181553,CDM,,,278,RC,inpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14425.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16261.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,14425.07,18174.82,
DEPUY STEM BOWED SZ15.0 X 9,30181554,CDM,,,278,RC,inpatient,,41578.1,41578.1,,35299.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31349.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35341.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36588.73,88,,percent of total billed charges,,,,,,,,,31765.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37836.07,91,,percent of total billed charges,,,39499.2,95,,percent of total billed charges,,,34509.82,83,,percent of total billed charges,,,34509.82,83,,percent of total billed charges,,,,,,,,,,,,,,,34509.82,83,,percent of total billed charges,,,39499.2,95,,percent of total billed charges,,,37420.29,90,,percent of total billed charges,,,37420.29,90,,percent of total billed charges,,,34094.04,82,,percent of total billed charges,,,37420.29,90,,percent of total billed charges,,,35341.39,85,,percent of total billed charges,,31349.89,39499.2,
DEPUY OSTEOTOME FLEX 8MM X 5,30181555,CDM,,,278,RC,inpatient,,3861,3861,,3277.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2911.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3281.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3397.68,88,,percent of total billed charges,,,,,,,,,2949.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3513.51,91,,percent of total billed charges,,,3667.95,95,,percent of total billed charges,,,3204.63,83,,percent of total billed charges,,,3204.63,83,,percent of total billed charges,,,,,,,,,,,,,,,3204.63,83,,percent of total billed charges,,,3667.95,95,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3166.02,82,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3281.85,85,,percent of total billed charges,,2911.19,3667.95,
DEPUY LERE BONE MILL RENTAL 290-202B,30181556,CDM,,,278,RC,inpatient,,4524,4524,,3840.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3411.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3845.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3981.12,88,,percent of total billed charges,,,,,,,,,3456.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4116.84,91,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,,,,,,,,,,,,,3754.92,83,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3709.68,82,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3845.4,85,,percent of total billed charges,,3411.1,4297.8,
DEPUY MORELAND RENTAL 290-204B,30181557,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
ZIMMER BLADE EXPLANT 56MM X 20,30181558,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
ORTHADAPT BIOIMPLANT 3CM X 3CM,30181569,CDM,,,270,RC,inpatient,,14434.55,14434.55,,12254.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10883.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12269.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12702.4,88,,percent of total billed charges,,,,,,,,,11028,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13135.44,91,,percent of total billed charges,,,13712.82,95,,percent of total billed charges,,,11980.68,83,,percent of total billed charges,,,11980.68,83,,percent of total billed charges,,,,,,,,,,,,,,,11980.68,83,,percent of total billed charges,,,13712.82,95,,percent of total billed charges,,,12991.1,90,,percent of total billed charges,,,12991.1,90,,percent of total billed charges,,,11836.33,82,,percent of total billed charges,,,12991.1,90,,percent of total billed charges,,,12269.37,85,,percent of total billed charges,,10883.65,13712.82,
MESH HERNIA REBOUND 1.97,30181570,CDM,,,270,RC,inpatient,,3181.75,3181.75,,2701.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2399.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2704.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2799.94,88,,percent of total billed charges,,,,,,,,,2430.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2895.39,91,,percent of total billed charges,,,3022.66,95,,percent of total billed charges,,,2640.85,83,,percent of total billed charges,,,2640.85,83,,percent of total billed charges,,,,,,,,,,,,,,,2640.85,83,,percent of total billed charges,,,3022.66,95,,percent of total billed charges,,,2863.58,90,,percent of total billed charges,,,2863.58,90,,percent of total billed charges,,,2609.04,82,,percent of total billed charges,,,2863.58,90,,percent of total billed charges,,,2704.49,85,,percent of total billed charges,,2399.04,3022.66,
MESH HERNIA REBOUND 3.94,30181571,CDM,,,270,RC,inpatient,,4631.25,4631.25,,3931.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3491.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3936.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4075.5,88,,percent of total billed charges,,,,,,,,,3538.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4214.44,91,,percent of total billed charges,,,4399.69,95,,percent of total billed charges,,,3843.94,83,,percent of total billed charges,,,3843.94,83,,percent of total billed charges,,,,,,,,,,,,,,,3843.94,83,,percent of total billed charges,,,4399.69,95,,percent of total billed charges,,,4168.13,90,,percent of total billed charges,,,4168.13,90,,percent of total billed charges,,,3797.63,82,,percent of total billed charges,,,4168.13,90,,percent of total billed charges,,,3936.56,85,,percent of total billed charges,,3491.96,4399.69,
STAPLER GIA ENDO ARTICULATING 45MM,30181572,CDM,,,270,RC,inpatient,,1775.87,1775.87,,1507.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1339.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1509.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1562.77,88,,percent of total billed charges,,,,,,,,,1356.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1616.04,91,,percent of total billed charges,,,1687.08,95,,percent of total billed charges,,,1473.97,83,,percent of total billed charges,,,1473.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1473.97,83,,percent of total billed charges,,,1687.08,95,,percent of total billed charges,,,1598.28,90,,percent of total billed charges,,,1598.28,90,,percent of total billed charges,,,1456.21,82,,percent of total billed charges,,,1598.28,90,,percent of total billed charges,,,1509.49,85,,percent of total billed charges,,1339.01,1687.08,
DEPUY FEMORAL HEAD 40MM +1.5,30181574,CDM,,,278,RC,inpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14425.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16261.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,14425.07,18174.82,
DEPUY STEM CORAIL COLLARED SZ15,30181575,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
GRANEE NEEDLE,30181576,CDM,,,278,RC,inpatient,,378,378,,320.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,285.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,321.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,332.64,88,,percent of total billed charges,,,,,,,,,288.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,343.98,91,,percent of total billed charges,,,359.1,95,,percent of total billed charges,,,313.74,83,,percent of total billed charges,,,313.74,83,,percent of total billed charges,,,,,,,,,,,,,,,313.74,83,,percent of total billed charges,,,359.1,95,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,309.96,82,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,321.3,85,,percent of total billed charges,,285.01,359.1,
MESH PERFIX PLUG MEDIUM,30181577,CDM,,,278,RC,inpatient,,1168.05,1168.05,,991.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,880.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,992.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1027.88,88,,percent of total billed charges,,,,,,,,,892.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1062.93,91,,percent of total billed charges,,,1109.65,95,,percent of total billed charges,,,969.48,83,,percent of total billed charges,,,969.48,83,,percent of total billed charges,,,,,,,,,,,,,,,969.48,83,,percent of total billed charges,,,1109.65,95,,percent of total billed charges,,,1051.25,90,,percent of total billed charges,,,1051.25,90,,percent of total billed charges,,,957.8,82,,percent of total billed charges,,,1051.25,90,,percent of total billed charges,,,992.84,85,,percent of total billed charges,,880.71,1109.65,
ALLOPAC 50CC NON-PURGED,30181578,CDM,,,278,RC,inpatient,,7735,7735,,6567.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5832.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6574.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6806.8,88,,percent of total billed charges,,,,,,,,,5909.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7038.85,91,,percent of total billed charges,,,7348.25,95,,percent of total billed charges,,,6420.05,83,,percent of total billed charges,,,6420.05,83,,percent of total billed charges,,,,,,,,,,,,,,,6420.05,83,,percent of total billed charges,,,7348.25,95,,percent of total billed charges,,,6961.5,90,,percent of total billed charges,,,6961.5,90,,percent of total billed charges,,,6342.7,82,,percent of total billed charges,,,6961.5,90,,percent of total billed charges,,,6574.75,85,,percent of total billed charges,,5832.19,7348.25,
MESH PREFIX PLUG LARGE,30181579,CDM,,,278,RC,inpatient,,1179.75,1179.75,,1001.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,889.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1002.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1038.18,88,,percent of total billed charges,,,,,,,,,901.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1073.57,91,,percent of total billed charges,,,1120.76,95,,percent of total billed charges,,,979.19,83,,percent of total billed charges,,,979.19,83,,percent of total billed charges,,,,,,,,,,,,,,,979.19,83,,percent of total billed charges,,,1120.76,95,,percent of total billed charges,,,1061.78,90,,percent of total billed charges,,,1061.78,90,,percent of total billed charges,,,967.4,82,,percent of total billed charges,,,1061.78,90,,percent of total billed charges,,,1002.79,85,,percent of total billed charges,,889.53,1120.76,
MESH PROLOOP XLGE,30181580,CDM,,,278,RC,inpatient,,893.75,893.75,,758.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,673.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,759.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,786.5,88,,percent of total billed charges,,,,,,,,,682.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,813.31,91,,percent of total billed charges,,,849.06,95,,percent of total billed charges,,,741.81,83,,percent of total billed charges,,,741.81,83,,percent of total billed charges,,,,,,,,,,,,,,,741.81,83,,percent of total billed charges,,,849.06,95,,percent of total billed charges,,,804.38,90,,percent of total billed charges,,,804.38,90,,percent of total billed charges,,,732.88,82,,percent of total billed charges,,,804.38,90,,percent of total billed charges,,,759.69,85,,percent of total billed charges,,673.89,849.06,
ATRIUM MESH PROLOOP ONLAY,30181581,CDM,,,278,RC,inpatient,,329.1,329.1,,279.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,248.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,279.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,289.61,88,,percent of total billed charges,,,,,,,,,251.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,299.48,91,,percent of total billed charges,,,312.65,95,,percent of total billed charges,,,273.15,83,,percent of total billed charges,,,273.15,83,,percent of total billed charges,,,,,,,,,,,,,,,273.15,83,,percent of total billed charges,,,312.65,95,,percent of total billed charges,,,296.19,90,,percent of total billed charges,,,296.19,90,,percent of total billed charges,,,269.86,82,,percent of total billed charges,,,296.19,90,,percent of total billed charges,,,279.74,85,,percent of total billed charges,,248.14,312.65,
DEPUY STEM CORAIL KLA SZ13,30181582,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY SCREW NON LOCKING 42MM,30181583,CDM,,,278,RC,inpatient,,1330.16,1330.16,,1129.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1002.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1130.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1170.54,88,,percent of total billed charges,,,,,,,,,1016.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1210.45,91,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1104.03,83,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1090.73,82,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1130.64,85,,percent of total billed charges,,1002.94,1263.65,
DEPUY CEMENTLESS EPIPHSYIS SZ1 RT,30181584,CDM,,,278,RC,inpatient,,33055.36,33055.36,,28064,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24923.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28097.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29088.72,88,,percent of total billed charges,,,,,,,,,25254.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30080.38,91,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,,,,,,,,,,,,,27435.95,83,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,27105.4,82,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,28097.06,85,,percent of total billed charges,,24923.74,31402.59,
DEPUY STEM HUMERAL SZ12,30181585,CDM,,,278,RC,inpatient,,17244.96,17244.96,,14640.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13002.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14658.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15175.56,88,,percent of total billed charges,,,,,,,,,13175.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15692.91,91,,percent of total billed charges,,,16382.71,95,,percent of total billed charges,,,14313.32,83,,percent of total billed charges,,,14313.32,83,,percent of total billed charges,,,,,,,,,,,,,,,14313.32,83,,percent of total billed charges,,,16382.71,95,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,14140.87,82,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,14658.22,85,,percent of total billed charges,,13002.7,16382.71,
DEPUY GUIDE PIN METAGLENE,30181586,CDM,,,278,RC,inpatient,,784,784,,665.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,591.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,666.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,689.92,88,,percent of total billed charges,,,,,,,,,598.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,713.44,91,,percent of total billed charges,,,744.8,95,,percent of total billed charges,,,650.72,83,,percent of total billed charges,,,650.72,83,,percent of total billed charges,,,,,,,,,,,,,,,650.72,83,,percent of total billed charges,,,744.8,95,,percent of total billed charges,,,705.6,90,,percent of total billed charges,,,705.6,90,,percent of total billed charges,,,642.88,82,,percent of total billed charges,,,705.6,90,,percent of total billed charges,,,666.4,85,,percent of total billed charges,,591.14,744.8,
SYNTHES GUIDEWIRE 721,30181587,CDM,,,278,RC,inpatient,,312.38,312.38,,265.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,235.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,265.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,274.89,88,,percent of total billed charges,,,,,,,,,238.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,284.27,91,,percent of total billed charges,,,296.76,95,,percent of total billed charges,,,259.28,83,,percent of total billed charges,,,259.28,83,,percent of total billed charges,,,,,,,,,,,,,,,259.28,83,,percent of total billed charges,,,296.76,95,,percent of total billed charges,,,281.14,90,,percent of total billed charges,,,281.14,90,,percent of total billed charges,,,256.15,82,,percent of total billed charges,,,281.14,90,,percent of total billed charges,,,265.52,85,,percent of total billed charges,,235.53,296.76,
DEPUY OSTEOTOME FLEX 8MM X 2.5,30181590,CDM,,,278,RC,inpatient,,4602,4602,,3907.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3469.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3911.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4049.76,88,,percent of total billed charges,,,,,,,,,3515.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4187.82,91,,percent of total billed charges,,,4371.9,95,,percent of total billed charges,,,3819.66,83,,percent of total billed charges,,,3819.66,83,,percent of total billed charges,,,,,,,,,,,,,,,3819.66,83,,percent of total billed charges,,,4371.9,95,,percent of total billed charges,,,4141.8,90,,percent of total billed charges,,,4141.8,90,,percent of total billed charges,,,3773.64,82,,percent of total billed charges,,,4141.8,90,,percent of total billed charges,,,3911.7,85,,percent of total billed charges,,3469.91,4371.9,
DEPUY MBT REVISION TIBIAL TRAY SZ3.25,30181591,CDM,,,278,RC,inpatient,,62809.5,62809.5,,53325.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47358.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,53388.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55272.36,88,,percent of total billed charges,,,,,,,,,47986.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57156.65,91,,percent of total billed charges,,,59669.03,95,,percent of total billed charges,,,52131.89,83,,percent of total billed charges,,,52131.89,83,,percent of total billed charges,,,,,,,,,,,,,,,52131.89,83,,percent of total billed charges,,,59669.03,95,,percent of total billed charges,,,56528.55,90,,percent of total billed charges,,,56528.55,90,,percent of total billed charges,,,51503.79,82,,percent of total billed charges,,,56528.55,90,,percent of total billed charges,,,53388.08,85,,percent of total billed charges,,47358.36,59669.03,
DEPUY INSERT TC3 RP 12.5MM SZ4,30181592,CDM,,,278,RC,inpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17430.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19649.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,17430.21,21961.14,
DEPUY FEMUR TC3 RT SZ5,30181593,CDM,,,278,RC,inpatient,,36489.7,36489.7,,30979.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27513.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31016.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32110.94,88,,percent of total billed charges,,,,,,,,,27878.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33205.63,91,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,,,,,,,,,,,,,30286.45,83,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,29921.55,82,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,27513.23,34665.22,
DEPUY DISTAL AUGMENT RT 8MM SZ4.0,30181594,CDM,,,278,RC,inpatient,,6245.14,6245.14,,5302.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4708.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5308.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5495.72,88,,percent of total billed charges,,,,,,,,,4771.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5683.08,91,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,,,,,,,,,,,,,5183.47,83,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5121.01,82,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,4708.84,5932.88,
DEPUY FEMORAL STEM 15X30MM,30181595,CDM,,,278,RC,inpatient,,6179.68,6179.68,,5246.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4659.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5252.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5438.12,88,,percent of total billed charges,,,,,,,,,4721.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5623.51,91,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5129.13,83,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5067.34,82,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5252.73,85,,percent of total billed charges,,4659.48,5870.7,
DEPUY OSTEOTOME THIN 8MM X 3,30181597,CDM,,,270,RC,inpatient,,3464.5,3464.5,,2941.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2612.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2944.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3048.76,88,,percent of total billed charges,,,,,,,,,2646.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3152.7,91,,percent of total billed charges,,,3291.28,95,,percent of total billed charges,,,2875.54,83,,percent of total billed charges,,,2875.54,83,,percent of total billed charges,,,,,,,,,,,,,,,2875.54,83,,percent of total billed charges,,,3291.28,95,,percent of total billed charges,,,3118.05,90,,percent of total billed charges,,,3118.05,90,,percent of total billed charges,,,2840.89,82,,percent of total billed charges,,,3118.05,90,,percent of total billed charges,,,2944.83,85,,percent of total billed charges,,2612.23,3291.28,
DEPUY PINNACLE CUP INSERT 36 X 54,30181599,CDM,,,278,RC,inpatient,,12108.98,12108.98,,10280.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9130.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10292.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10655.9,88,,percent of total billed charges,,,,,,,,,9251.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11019.17,91,,percent of total billed charges,,,11503.53,95,,percent of total billed charges,,,10050.45,83,,percent of total billed charges,,,10050.45,83,,percent of total billed charges,,,,,,,,,,,,,,,10050.45,83,,percent of total billed charges,,,11503.53,95,,percent of total billed charges,,,10898.08,90,,percent of total billed charges,,,10898.08,90,,percent of total billed charges,,,9929.36,82,,percent of total billed charges,,,10898.08,90,,percent of total billed charges,,,10292.63,85,,percent of total billed charges,,9130.17,11503.53,
DEPUY STEM CORAIL HI OFFSET SZ11,30181600,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY SMARTMIX TOWER,30181605,CDM,,,270,RC,inpatient,,828.17,828.17,,703.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,624.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,703.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,728.79,88,,percent of total billed charges,,,,,,,,,632.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,753.63,91,,percent of total billed charges,,,786.76,95,,percent of total billed charges,,,687.38,83,,percent of total billed charges,,,687.38,83,,percent of total billed charges,,,,,,,,,,,,,,,687.38,83,,percent of total billed charges,,,786.76,95,,percent of total billed charges,,,745.35,90,,percent of total billed charges,,,745.35,90,,percent of total billed charges,,,679.1,82,,percent of total billed charges,,,745.35,90,,percent of total billed charges,,,703.94,85,,percent of total billed charges,,624.44,786.76,
DEPUY STEM CORAIL COLLARED SZ11,30181606,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
SYNTHES SCREW CORTEX 3.5X50MM,30181618,CDM,,,278,RC,inpatient,,267.75,267.75,,227.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,201.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,227.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,235.62,88,,percent of total billed charges,,,,,,,,,204.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,243.65,91,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,,,,,,,,,,,,,222.23,83,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,219.56,82,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,227.59,85,,percent of total billed charges,,201.88,254.36,
SYNTHES SCREW CANCEL F-THD 4.0X35MM,30181621,CDM,,,278,RC,inpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,168.24,211.97,
SYNTHES SCREW CANCEL F-THD 4.0X55MM,30181623,CDM,,,278,RC,inpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,168.24,211.97,
SYNTHES SCREW CANCEL F-THD 4.0X60MM,30181624,CDM,,,278,RC,inpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,178.47,224.87,
BIOMET ROUND FAST CUTTING BUR,30181626,CDM,,,270,RC,inpatient,,434,434,,368.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,327.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,368.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,381.92,88,,percent of total billed charges,,,,,,,,,331.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,394.94,91,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,,,,,,,,,,,,,360.22,83,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,355.88,82,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,368.9,85,,percent of total billed charges,,327.24,412.3,
BIOMET TISSUE BUR,30181627,CDM,,,270,RC,inpatient,,490,490,,416.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,369.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,416.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,431.2,88,,percent of total billed charges,,,,,,,,,374.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,445.9,91,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,,,,,,,,,,,,,406.7,83,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,401.8,82,,percent of total billed charges,,,441,90,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,369.46,465.5,
BIOMET KNEE FEMORAL COMPONENT 54MM,30181628,CDM,,,278,RC,inpatient,,25012,25012,,21235.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18859.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21260.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22010.56,88,,percent of total billed charges,,,,,,,,,19109.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22760.92,91,,percent of total billed charges,,,23761.4,95,,percent of total billed charges,,,20759.96,83,,percent of total billed charges,,,20759.96,83,,percent of total billed charges,,,,,,,,,,,,,,,20759.96,83,,percent of total billed charges,,,23761.4,95,,percent of total billed charges,,,22510.8,90,,percent of total billed charges,,,22510.8,90,,percent of total billed charges,,,20509.84,82,,percent of total billed charges,,,22510.8,90,,percent of total billed charges,,,21260.2,85,,percent of total billed charges,,18859.05,23761.4,
BIOMET KNEE TIBIAL COMPONENT 37 X 6.5,30181629,CDM,,,278,RC,inpatient,,9087,9087,,7714.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6851.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7723.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7996.56,88,,percent of total billed charges,,,,,,,,,6942.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8269.17,91,,percent of total billed charges,,,8632.65,95,,percent of total billed charges,,,7542.21,83,,percent of total billed charges,,,7542.21,83,,percent of total billed charges,,,,,,,,,,,,,,,7542.21,83,,percent of total billed charges,,,8632.65,95,,percent of total billed charges,,,8178.3,90,,percent of total billed charges,,,8178.3,90,,percent of total billed charges,,,7451.34,82,,percent of total billed charges,,,8178.3,90,,percent of total billed charges,,,7723.95,85,,percent of total billed charges,,6851.6,8632.65,
ZIMMER BLADE EXPLANT 52MM X 10,30181631,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
DEPUY PINNACLE CUP SECTOR II 56MM,30181632,CDM,,,278,RC,inpatient,,18892.32,18892.32,,16039.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14244.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16058.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16625.24,88,,percent of total billed charges,,,,,,,,,14433.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17192.01,91,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15680.63,83,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,15491.7,82,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,14244.81,17947.7,
DEPUY PINNACLE CUP REVISION 64MM,30181635,CDM,,,278,RC,inpatient,,33437.04,33437.04,,28388.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25211.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28421.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29424.6,88,,percent of total billed charges,,,,,,,,,25545.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30427.71,91,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,,,,,,,,,,,,,27752.74,83,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,27418.37,82,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,25211.53,31765.19,
DEPUY SCREW PINNACLE 6.5X25MM,30181636,CDM,,,278,RC,inpatient,,1075.49,1075.49,,913.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,810.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,914.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,946.43,88,,percent of total billed charges,,,,,,,,,821.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,978.7,91,,percent of total billed charges,,,1021.72,95,,percent of total billed charges,,,892.66,83,,percent of total billed charges,,,892.66,83,,percent of total billed charges,,,,,,,,,,,,,,,892.66,83,,percent of total billed charges,,,1021.72,95,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,881.9,82,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,914.17,85,,percent of total billed charges,,810.92,1021.72,
MTF DBX PUTTY 5CC,30181637,CDM,,,278,RC,inpatient,,5954.33,5954.33,,5055.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4489.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5061.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5239.81,88,,percent of total billed charges,,,,,,,,,4549.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5418.44,91,,percent of total billed charges,,,5656.61,95,,percent of total billed charges,,,4942.09,83,,percent of total billed charges,,,4942.09,83,,percent of total billed charges,,,,,,,,,,,,,,,4942.09,83,,percent of total billed charges,,,5656.61,95,,percent of total billed charges,,,5358.9,90,,percent of total billed charges,,,5358.9,90,,percent of total billed charges,,,4882.55,82,,percent of total billed charges,,,5358.9,90,,percent of total billed charges,,,5061.18,85,,percent of total billed charges,,4489.56,5656.61,
ALLOSOURCE- ACHILLES TENDON,30181644,CDM,,,278,RC,inpatient,,18844.93,18844.93,,15999.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14209.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16018.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16583.54,88,,percent of total billed charges,,,,,,,,,14397.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17148.89,91,,percent of total billed charges,,,17902.68,95,,percent of total billed charges,,,15641.29,83,,percent of total billed charges,,,15641.29,83,,percent of total billed charges,,,,,,,,,,,,,,,15641.29,83,,percent of total billed charges,,,17902.68,95,,percent of total billed charges,,,16960.44,90,,percent of total billed charges,,,16960.44,90,,percent of total billed charges,,,15452.84,82,,percent of total billed charges,,,16960.44,90,,percent of total billed charges,,,16018.19,85,,percent of total billed charges,,14209.08,17902.68,
DEPUY PINNACLE CUP SECTOR II 64MM,30181649,CDM,,,278,RC,inpatient,,20679.88,20679.88,,17557.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15592.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17577.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18198.29,88,,percent of total billed charges,,,,,,,,,15799.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18818.69,91,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17164.3,83,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,16957.5,82,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,15592.63,19645.89,
DEPUY LINER ALTRX +4 44 X 64,30181650,CDM,,,278,RC,inpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13270.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14960.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,13270.78,16720.48,
DEPUY FEMORAL HEAD 44MM +1.5,30181651,CDM,,,278,RC,inpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10650.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12006.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,10650.51,13419.08,
DEPUY STEM BOWED SZ13.5 X 8,30181652,CDM,,,278,RC,inpatient,,67789.22,67789.22,,57553.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51113.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57620.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59654.51,88,,percent of total billed charges,,,,,,,,,51790.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61688.19,91,,percent of total billed charges,,,64399.76,95,,percent of total billed charges,,,56265.05,83,,percent of total billed charges,,,56265.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56265.05,83,,percent of total billed charges,,,64399.76,95,,percent of total billed charges,,,61010.3,90,,percent of total billed charges,,,61010.3,90,,percent of total billed charges,,,55587.16,82,,percent of total billed charges,,,61010.3,90,,percent of total billed charges,,,57620.84,85,,percent of total billed charges,,51113.07,64399.76,
APPLIED LAP TROCAR 5MM 10CM,30181653,CDM,,,270,RC,inpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,108.58,136.8,
APPLIED LAP TROCAR SHEATH 5MM,30181654,CDM,,,270,RC,inpatient,,68,68,,57.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.84,88,,percent of total billed charges,,,,,,,,,51.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,,,,,,,,,,,,,56.44,83,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,55.76,82,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,51.27,64.6,
APPLIED LAP TROCAR SHEATH 12MM,30181655,CDM,,,270,RC,inpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,132.7,167.2,
DEPUY OSTEOTOME FLEX 10MM X 5,30181657,CDM,,,278,RC,inpatient,,2158,2158,,1832.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1627.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1834.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1899.04,88,,percent of total billed charges,,,,,,,,,1648.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1963.78,91,,percent of total billed charges,,,2050.1,95,,percent of total billed charges,,,1791.14,83,,percent of total billed charges,,,1791.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1791.14,83,,percent of total billed charges,,,2050.1,95,,percent of total billed charges,,,1942.2,90,,percent of total billed charges,,,1942.2,90,,percent of total billed charges,,,1769.56,82,,percent of total billed charges,,,1942.2,90,,percent of total billed charges,,,1834.3,85,,percent of total billed charges,,1627.13,2050.1,
DEPUY INSERT TC3 RP 25MM SZ2.5,30181658,CDM,,,278,RC,inpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17430.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19649.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,17430.21,21961.14,
DEPUY DISTAL AUGMENT RT 4MM SZ2.5,30181659,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
LATERAL POSITIONER PADS,30181662,CDM,,,270,RC,inpatient,,193.73,193.73,,164.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.48,88,,percent of total billed charges,,,,,,,,,148.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.29,91,,percent of total billed charges,,,184.04,95,,percent of total billed charges,,,160.8,83,,percent of total billed charges,,,160.8,83,,percent of total billed charges,,,,,,,,,,,,,,,160.8,83,,percent of total billed charges,,,184.04,95,,percent of total billed charges,,,174.36,90,,percent of total billed charges,,,174.36,90,,percent of total billed charges,,,158.86,82,,percent of total billed charges,,,174.36,90,,percent of total billed charges,,,164.67,85,,percent of total billed charges,,146.07,184.04,
DEPUY DISTAL AUGMENT RT 8MM SZ2.5,30181665,CDM,,,278,RC,inpatient,,6245.14,6245.14,,5302.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4708.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5308.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5495.72,88,,percent of total billed charges,,,,,,,,,4771.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5683.08,91,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,,,,,,,,,,,,,5183.47,83,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5121.01,82,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,4708.84,5932.88,
DEPUY POSTERIOR AUGMENT 8MM SZ2.5,30181666,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
DEPUY INSERT TC3 12.5MM SZ2.5,30181667,CDM,,,278,RC,inpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17430.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19649.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,17430.21,21961.14,
GRASPER CLUTCH,30181671,CDM,,,270,RC,inpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,980.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1105,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,980.2,1235,
ATRIUM MESH CQUR V-PATCH LGE,30181674,CDM,,,278,RC,inpatient,,3724.5,3724.5,,3162.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2808.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3165.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3277.56,88,,percent of total billed charges,,,,,,,,,2845.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3389.3,91,,percent of total billed charges,,,3538.28,95,,percent of total billed charges,,,3091.34,83,,percent of total billed charges,,,3091.34,83,,percent of total billed charges,,,,,,,,,,,,,,,3091.34,83,,percent of total billed charges,,,3538.28,95,,percent of total billed charges,,,3352.05,90,,percent of total billed charges,,,3352.05,90,,percent of total billed charges,,,3054.09,82,,percent of total billed charges,,,3352.05,90,,percent of total billed charges,,,3165.83,85,,percent of total billed charges,,2808.27,3538.28,
ATRIUM MESH CQUR V-PATCH SML,30181675,CDM,,,278,RC,inpatient,,2262,2262,,1920.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1705.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1922.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1990.56,88,,percent of total billed charges,,,,,,,,,1728.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2058.42,91,,percent of total billed charges,,,2148.9,95,,percent of total billed charges,,,1877.46,83,,percent of total billed charges,,,1877.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1877.46,83,,percent of total billed charges,,,2148.9,95,,percent of total billed charges,,,2035.8,90,,percent of total billed charges,,,2035.8,90,,percent of total billed charges,,,1854.84,82,,percent of total billed charges,,,2035.8,90,,percent of total billed charges,,,1922.7,85,,percent of total billed charges,,1705.55,2148.9,
ATRIUM MESH CQUR V-PATCH MED,30181676,CDM,,,278,RC,inpatient,,2865.2,2865.2,,2432.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2160.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2435.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2521.38,88,,percent of total billed charges,,,,,,,,,2189.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2607.33,91,,percent of total billed charges,,,2721.94,95,,percent of total billed charges,,,2378.12,83,,percent of total billed charges,,,2378.12,83,,percent of total billed charges,,,,,,,,,,,,,,,2378.12,83,,percent of total billed charges,,,2721.94,95,,percent of total billed charges,,,2578.68,90,,percent of total billed charges,,,2578.68,90,,percent of total billed charges,,,2349.46,82,,percent of total billed charges,,,2578.68,90,,percent of total billed charges,,,2435.42,85,,percent of total billed charges,,2160.36,2721.94,
ESOPHYX KIT,30181679,CDM,,,270,RC,inpatient,,22100,22100,,18762.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16663.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18785,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19448,88,,percent of total billed charges,,,,,,,,,16884.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20111,91,,percent of total billed charges,,,20995,95,,percent of total billed charges,,,18343,83,,percent of total billed charges,,,18343,83,,percent of total billed charges,,,,,,,,,,,,,,,18343,83,,percent of total billed charges,,,20995,95,,percent of total billed charges,,,19890,90,,percent of total billed charges,,,19890,90,,percent of total billed charges,,,18122,82,,percent of total billed charges,,,19890,90,,percent of total billed charges,,,18785,85,,percent of total billed charges,,16663.4,20995,
CATH THORACIC STRAIGHT 20FR 16MM,30181680,CDM,,,270,RC,inpatient,,124.4,124.4,,105.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.47,88,,percent of total billed charges,,,,,,,,,95.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,113.2,91,,percent of total billed charges,,,118.18,95,,percent of total billed charges,,,103.25,83,,percent of total billed charges,,,103.25,83,,percent of total billed charges,,,,,,,,,,,,,,,103.25,83,,percent of total billed charges,,,118.18,95,,percent of total billed charges,,,111.96,90,,percent of total billed charges,,,111.96,90,,percent of total billed charges,,,102.01,82,,percent of total billed charges,,,111.96,90,,percent of total billed charges,,,105.74,85,,percent of total billed charges,,93.8,118.18,
DEPUY PINNACLE CUP SECTOR II 50MM,30181683,CDM,,,278,RC,inpatient,,18892.32,18892.32,,16039.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14244.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16058.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16625.24,88,,percent of total billed charges,,,,,,,,,14433.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17192.01,91,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15680.63,83,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,15491.7,82,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,14244.81,17947.7,
DEPUY PINNACLE CUP MULTIHOLE 56MM,30181685,CDM,,,278,RC,inpatient,,26741.78,26741.78,,22703.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20163.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22730.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23532.77,88,,percent of total billed charges,,,,,,,,,20430.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24335.02,91,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,,,,,,,,,,,,,22195.68,83,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,21928.26,82,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,20163.3,25404.69,
ZIMMER BLADE EXPLANT 56MM X 10,30181686,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
ZIMMER BLADE EXPLANT 52MM X 20,30181687,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
S&N ENDO BICEPTOR KIT 9 X 25,30181689,CDM,,,278,RC,inpatient,,1278.55,1278.55,,1085.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,964.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1086.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1125.12,88,,percent of total billed charges,,,,,,,,,976.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1163.48,91,,percent of total billed charges,,,1214.62,95,,percent of total billed charges,,,1061.2,83,,percent of total billed charges,,,1061.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1061.2,83,,percent of total billed charges,,,1214.62,95,,percent of total billed charges,,,1150.7,90,,percent of total billed charges,,,1150.7,90,,percent of total billed charges,,,1048.41,82,,percent of total billed charges,,,1150.7,90,,percent of total billed charges,,,1086.77,85,,percent of total billed charges,,964.03,1214.62,
SYNTHES SCREW CANNUL 16MM 6.5X50MM,30181691,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
DEPUY FEMUR SIGMA PS RT SZ3,30181695,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
DEPUY INSERT STABILIZED 10MM SZ3,30181696,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY FEMUR TC3 LT SZ4,30181697,CDM,,,278,RC,inpatient,,36489.7,36489.7,,30979.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27513.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31016.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32110.94,88,,percent of total billed charges,,,,,,,,,27878.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33205.63,91,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,,,,,,,,,,,,,30286.45,83,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,29921.55,82,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,27513.23,34665.22,
DEPUY DISTAL AUGMENT LT 8MM SZ4.0,30181698,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
DEPUY POSTERIOR AUGMENT 4MM SZ4.0,30181699,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
DEPUY WEDGE STEP 5MM SZ4,30181700,CDM,,,278,RC,inpatient,,15761.79,15761.79,,13381.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11884.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13397.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13870.38,88,,percent of total billed charges,,,,,,,,,12042.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14343.23,91,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,,,,,,,,,,,,,13082.29,83,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,12924.67,82,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,13397.52,85,,percent of total billed charges,,11884.39,14973.7,
ALLOPAC 25CC NON-PURGED,30181701,CDM,,,278,RC,inpatient,,8255,8255,,7008.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6224.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7016.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7264.4,88,,percent of total billed charges,,,,,,,,,6306.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7512.05,91,,percent of total billed charges,,,7842.25,95,,percent of total billed charges,,,6851.65,83,,percent of total billed charges,,,6851.65,83,,percent of total billed charges,,,,,,,,,,,,,,,6851.65,83,,percent of total billed charges,,,7842.25,95,,percent of total billed charges,,,7429.5,90,,percent of total billed charges,,,7429.5,90,,percent of total billed charges,,,6769.1,82,,percent of total billed charges,,,7429.5,90,,percent of total billed charges,,,7016.75,85,,percent of total billed charges,,6224.27,7842.25,
DEPUY OSTEOTOME THIN 10MM X 2.5,30181720,CDM,,,270,RC,inpatient,,5941,5941,,5043.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4479.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5049.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5228.08,88,,percent of total billed charges,,,,,,,,,4538.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5406.31,91,,percent of total billed charges,,,5643.95,95,,percent of total billed charges,,,4931.03,83,,percent of total billed charges,,,4931.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4931.03,83,,percent of total billed charges,,,5643.95,95,,percent of total billed charges,,,5346.9,90,,percent of total billed charges,,,5346.9,90,,percent of total billed charges,,,4871.62,82,,percent of total billed charges,,,5346.9,90,,percent of total billed charges,,,5049.85,85,,percent of total billed charges,,4479.51,5643.95,
DEPUY TIBIAL AUGMENT 10MM SZ2.5,30181721,CDM,,,278,RC,inpatient,,11378.45,11378.45,,9660.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8579.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9671.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10013.04,88,,percent of total billed charges,,,,,,,,,8693.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10354.39,91,,percent of total billed charges,,,10809.53,95,,percent of total billed charges,,,9444.11,83,,percent of total billed charges,,,9444.11,83,,percent of total billed charges,,,,,,,,,,,,,,,9444.11,83,,percent of total billed charges,,,10809.53,95,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,9330.33,82,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,9671.68,85,,percent of total billed charges,,8579.35,10809.53,
DEPUY MBT TRAY SLEEVE 29MM,30181722,CDM,,,278,RC,inpatient,,12860.84,12860.84,,10918.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9697.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10931.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11317.54,88,,percent of total billed charges,,,,,,,,,9825.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11703.36,91,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10674.5,83,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10545.89,82,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10931.71,85,,percent of total billed charges,,9697.07,12217.8,
DEPUY STEM CEMENTED 13 X 60,30181723,CDM,,,278,RC,inpatient,,6179.68,6179.68,,5246.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4659.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5252.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5438.12,88,,percent of total billed charges,,,,,,,,,4721.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5623.51,91,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5129.13,83,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5067.34,82,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5252.73,85,,percent of total billed charges,,4659.48,5870.7,
DEPUY DISTAL AUGMENT 12MM SZ3,30181725,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
DEPUY FEMORAL ADAPTER +2,30181726,CDM,,,278,RC,inpatient,,1765.6,1765.6,,1498.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1331.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1500.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1553.73,88,,percent of total billed charges,,,,,,,,,1348.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1606.7,91,,percent of total billed charges,,,1677.32,95,,percent of total billed charges,,,1465.45,83,,percent of total billed charges,,,1465.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.45,83,,percent of total billed charges,,,1677.32,95,,percent of total billed charges,,,1589.04,90,,percent of total billed charges,,,1589.04,90,,percent of total billed charges,,,1447.79,82,,percent of total billed charges,,,1589.04,90,,percent of total billed charges,,,1500.76,85,,percent of total billed charges,,1331.26,1677.32,
DEPUY STEM CEMENTED 15 X 60,30181727,CDM,,,278,RC,inpatient,,6179.68,6179.68,,5246.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4659.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5252.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5438.12,88,,percent of total billed charges,,,,,,,,,4721.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5623.51,91,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5129.13,83,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5067.34,82,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5252.73,85,,percent of total billed charges,,4659.48,5870.7,
DEPUY INSERT TC3 17.5MM SZ3,30181728,CDM,,,278,RC,inpatient,,15465.58,15465.58,,13130.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11661.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13145.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13609.71,88,,percent of total billed charges,,,,,,,,,11815.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14073.68,91,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,,,,,,,,,,,,,12836.43,83,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,12681.78,82,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13145.74,85,,percent of total billed charges,,11661.05,14692.3,
STRYKER HIP SLEEVE UNIPOLAR -0MM,30181731,CDM,,,278,RC,inpatient,,1415.7,1415.7,,1201.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1067.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1203.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1245.82,88,,percent of total billed charges,,,,,,,,,1081.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1288.29,91,,percent of total billed charges,,,1344.92,95,,percent of total billed charges,,,1175.03,83,,percent of total billed charges,,,1175.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1175.03,83,,percent of total billed charges,,,1344.92,95,,percent of total billed charges,,,1274.13,90,,percent of total billed charges,,,1274.13,90,,percent of total billed charges,,,1160.87,82,,percent of total billed charges,,,1274.13,90,,percent of total billed charges,,,1203.35,85,,percent of total billed charges,,1067.44,1344.92,
SYNTHES SCREW CANCEL 4.0X35MM,30181737,CDM,,,278,RC,inpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,178.47,224.87,
P.O.S. HIP JOINT ABDUCTOR,30181743,CDM,,,270,RC,inpatient,,6545.89,6545.89,,5557.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4935.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5564.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5760.38,88,,percent of total billed charges,,,,,,,,,5001.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5956.76,91,,percent of total billed charges,,,6218.6,95,,percent of total billed charges,,,5433.09,83,,percent of total billed charges,,,5433.09,83,,percent of total billed charges,,,,,,,,,,,,,,,5433.09,83,,percent of total billed charges,,,6218.6,95,,percent of total billed charges,,,5891.3,90,,percent of total billed charges,,,5891.3,90,,percent of total billed charges,,,5367.63,82,,percent of total billed charges,,,5891.3,90,,percent of total billed charges,,,5564.01,85,,percent of total billed charges,,4935.6,6218.6,
DEPUY STEM CORAIL HI OFFSET SZ14,30181747,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY INSERT XLK 8MM SZ3,30181748,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY PINNACLE CUP SECTOR II 52MM,30181749,CDM,,,278,RC,inpatient,,18892.32,18892.32,,16039.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14244.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16058.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16625.24,88,,percent of total billed charges,,,,,,,,,14433.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17192.01,91,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15680.63,83,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,15491.7,82,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,14244.81,17947.7,
RTI BIOCLENSE TIBIALIS POSTERIOR TENDON,30181756,CDM,,,270,RC,inpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12742.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14365,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,12742.6,16055,
NEEDLE TRANSURETHRAL INJECTION 22G,30181761,CDM,,,270,RC,inpatient,,688.31,688.31,,584.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,518.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,585.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,605.71,88,,percent of total billed charges,,,,,,,,,525.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,626.36,91,,percent of total billed charges,,,653.89,95,,percent of total billed charges,,,571.3,83,,percent of total billed charges,,,571.3,83,,percent of total billed charges,,,,,,,,,,,,,,,571.3,83,,percent of total billed charges,,,653.89,95,,percent of total billed charges,,,619.48,90,,percent of total billed charges,,,619.48,90,,percent of total billed charges,,,564.41,82,,percent of total billed charges,,,619.48,90,,percent of total billed charges,,,585.06,85,,percent of total billed charges,,518.99,653.89,
DEPUY-MITEK MICROFIX ANCHOR #4/0,30181770,CDM,,,278,RC,inpatient,,2392,2392,,2030.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1803.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2033.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2104.96,88,,percent of total billed charges,,,,,,,,,1827.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2176.72,91,,percent of total billed charges,,,2272.4,95,,percent of total billed charges,,,1985.36,83,,percent of total billed charges,,,1985.36,83,,percent of total billed charges,,,,,,,,,,,,,,,1985.36,83,,percent of total billed charges,,,2272.4,95,,percent of total billed charges,,,2152.8,90,,percent of total billed charges,,,2152.8,90,,percent of total billed charges,,,1961.44,82,,percent of total billed charges,,,2152.8,90,,percent of total billed charges,,,2033.2,85,,percent of total billed charges,,1803.57,2272.4,
STRYKER FEMORAL HD UNITRAX 48MM,30181772,CDM,,,278,RC,inpatient,,5362.5,5362.5,,4552.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4043.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4558.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4719,88,,percent of total billed charges,,,,,,,,,4096.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4879.88,91,,percent of total billed charges,,,5094.38,95,,percent of total billed charges,,,4450.88,83,,percent of total billed charges,,,4450.88,83,,percent of total billed charges,,,,,,,,,,,,,,,4450.88,83,,percent of total billed charges,,,5094.38,95,,percent of total billed charges,,,4826.25,90,,percent of total billed charges,,,4826.25,90,,percent of total billed charges,,,4397.25,82,,percent of total billed charges,,,4826.25,90,,percent of total billed charges,,,4558.13,85,,percent of total billed charges,,4043.33,5094.38,
DEPUY LINER ALTRX NEUT 32 X 52,30181773,CDM,,,278,RC,inpatient,,10422.17,10422.17,,8848.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7858.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8858.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9171.51,88,,percent of total billed charges,,,,,,,,,7962.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9484.17,91,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,,,,,,,,,,,,,8650.4,83,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8546.18,82,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8858.84,85,,percent of total billed charges,,7858.32,9901.06,
DEPUY STEM CORAIL COLLARED SZ10,30181774,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY FEMORAL HEAD 32MM +9,30181775,CDM,,,278,RC,inpatient,,5683.54,5683.54,,4825.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4285.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4831.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5001.52,88,,percent of total billed charges,,,,,,,,,4342.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5172.02,91,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,,,,,,,,,,,,,4717.34,83,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4660.5,82,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4831.01,85,,percent of total billed charges,,4285.39,5399.36,
DEPUY FEMUR SIGMA PS LT SZ5,30181776,CDM,,,278,RC,inpatient,,23868.72,23868.72,,20264.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17997.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20288.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21004.47,88,,percent of total billed charges,,,,,,,,,18235.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21720.54,91,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19811.04,83,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,19572.35,82,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,17997.01,22675.28,
DEPUY INSERT RP 10MM SZ5,30181778,CDM,,,278,RC,inpatient,,11480.69,11480.69,,9747.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8656.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9758.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10103.01,88,,percent of total billed charges,,,,,,,,,8771.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10447.43,91,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,,,,,,,,,,,,,9528.97,83,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9414.17,82,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,8656.44,10906.66,
DEPUY UPCHARGE PLATFORM TRAY (022),30181781,CDM,,,278,RC,inpatient,,4194.65,4194.65,,3561.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3162.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3565.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3691.29,88,,percent of total billed charges,,,,,,,,,3204.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3817.13,91,,percent of total billed charges,,,3984.92,95,,percent of total billed charges,,,3481.56,83,,percent of total billed charges,,,3481.56,83,,percent of total billed charges,,,,,,,,,,,,,,,3481.56,83,,percent of total billed charges,,,3984.92,95,,percent of total billed charges,,,3775.19,90,,percent of total billed charges,,,3775.19,90,,percent of total billed charges,,,3439.61,82,,percent of total billed charges,,,3775.19,90,,percent of total billed charges,,,3565.45,85,,percent of total billed charges,,3162.77,3984.92,
DEPUY UPCHARGE PLATFORM INSERT (023),30181782,CDM,,,278,RC,inpatient,,3192.93,3192.93,,2710.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2407.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2713.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2809.78,88,,percent of total billed charges,,,,,,,,,2439.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2905.57,91,,percent of total billed charges,,,3033.28,95,,percent of total billed charges,,,2650.13,83,,percent of total billed charges,,,2650.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2650.13,83,,percent of total billed charges,,,3033.28,95,,percent of total billed charges,,,2873.64,90,,percent of total billed charges,,,2873.64,90,,percent of total billed charges,,,2618.2,82,,percent of total billed charges,,,2873.64,90,,percent of total billed charges,,,2713.99,85,,percent of total billed charges,,2407.47,3033.28,
ARIS TOT SLING KIT,30181784,CDM,,,270,RC,inpatient,,7767.5,7767.5,,6594.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5856.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6602.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6835.4,88,,percent of total billed charges,,,,,,,,,5934.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7068.43,91,,percent of total billed charges,,,7379.13,95,,percent of total billed charges,,,6447.03,83,,percent of total billed charges,,,6447.03,83,,percent of total billed charges,,,,,,,,,,,,,,,6447.03,83,,percent of total billed charges,,,7379.13,95,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6369.35,82,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6602.38,85,,percent of total billed charges,,5856.7,7379.13,
DEPUY STEM CORAIL COLLARED SZ9,30181786,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY FEMUR SIGMA PS RT SZ5,30181787,CDM,,,278,RC,inpatient,,23868.72,23868.72,,20264.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17997.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20288.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21004.47,88,,percent of total billed charges,,,,,,,,,18235.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21720.54,91,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19811.04,83,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,19572.35,82,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,17997.01,22675.28,
DEPUY INSERT RP 12.5MM SZ5,30181788,CDM,,,278,RC,inpatient,,11480.69,11480.69,,9747.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8656.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9758.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10103.01,88,,percent of total billed charges,,,,,,,,,8771.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10447.43,91,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,,,,,,,,,,,,,9528.97,83,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9414.17,82,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,8656.44,10906.66,
DEPUY STEM CORAIL COLLARED SZ13,30181795,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
PEG KIT STANDARD PULL METHOD 20FR,30181801,CDM,,,270,RC,inpatient,,852.44,852.44,,723.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,642.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,724.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,750.15,88,,percent of total billed charges,,,,,,,,,651.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,775.72,91,,percent of total billed charges,,,809.82,95,,percent of total billed charges,,,707.53,83,,percent of total billed charges,,,707.53,83,,percent of total billed charges,,,,,,,,,,,,,,,707.53,83,,percent of total billed charges,,,809.82,95,,percent of total billed charges,,,767.2,90,,percent of total billed charges,,,767.2,90,,percent of total billed charges,,,699,82,,percent of total billed charges,,,767.2,90,,percent of total billed charges,,,724.57,85,,percent of total billed charges,,642.74,809.82,
ATRIUM MESH SECURE 15 X 20CM,30181812,CDM,,,278,RC,inpatient,,4192.5,4192.5,,3559.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3161.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3563.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3689.4,88,,percent of total billed charges,,,,,,,,,3203.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3815.18,91,,percent of total billed charges,,,3982.88,95,,percent of total billed charges,,,3479.78,83,,percent of total billed charges,,,3479.78,83,,percent of total billed charges,,,,,,,,,,,,,,,3479.78,83,,percent of total billed charges,,,3982.88,95,,percent of total billed charges,,,3773.25,90,,percent of total billed charges,,,3773.25,90,,percent of total billed charges,,,3437.85,82,,percent of total billed charges,,,3773.25,90,,percent of total billed charges,,,3563.63,85,,percent of total billed charges,,3161.15,3982.88,
ATRIUM MESH SECURE 18 X 23CM,30181813,CDM,,,278,RC,inpatient,,5778.5,5778.5,,4905.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4356.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4911.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5085.08,88,,percent of total billed charges,,,,,,,,,4414.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5258.44,91,,percent of total billed charges,,,5489.58,95,,percent of total billed charges,,,4796.16,83,,percent of total billed charges,,,4796.16,83,,percent of total billed charges,,,,,,,,,,,,,,,4796.16,83,,percent of total billed charges,,,5489.58,95,,percent of total billed charges,,,5200.65,90,,percent of total billed charges,,,5200.65,90,,percent of total billed charges,,,4738.37,82,,percent of total billed charges,,,5200.65,90,,percent of total billed charges,,,4911.73,85,,percent of total billed charges,,4356.99,5489.58,
ATRIUM MESH SECURE 20.5 X 30.5CM,30181814,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
ATRIUM MESH SECURE 25.5 X 35.5CM,30181815,CDM,,,278,RC,inpatient,,9815,9815,,8332.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7400.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8342.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8637.2,88,,percent of total billed charges,,,,,,,,,7498.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8931.65,91,,percent of total billed charges,,,9324.25,95,,percent of total billed charges,,,8146.45,83,,percent of total billed charges,,,8146.45,83,,percent of total billed charges,,,,,,,,,,,,,,,8146.45,83,,percent of total billed charges,,,9324.25,95,,percent of total billed charges,,,8833.5,90,,percent of total billed charges,,,8833.5,90,,percent of total billed charges,,,8048.3,82,,percent of total billed charges,,,8833.5,90,,percent of total billed charges,,,8342.75,85,,percent of total billed charges,,7400.51,9324.25,
ABSORBA 20TACK HERNIA DEVICE 5MM,30181817,CDM,,,270,RC,inpatient,,3893.5,3893.5,,3305.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2935.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3309.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3426.28,88,,percent of total billed charges,,,,,,,,,2974.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3543.09,91,,percent of total billed charges,,,3698.83,95,,percent of total billed charges,,,3231.61,83,,percent of total billed charges,,,3231.61,83,,percent of total billed charges,,,,,,,,,,,,,,,3231.61,83,,percent of total billed charges,,,3698.83,95,,percent of total billed charges,,,3504.15,90,,percent of total billed charges,,,3504.15,90,,percent of total billed charges,,,3192.67,82,,percent of total billed charges,,,3504.15,90,,percent of total billed charges,,,3309.48,85,,percent of total billed charges,,2935.7,3698.83,
DEPUY CUSTOM IMPLANT T-F 64MM RT,30181818,CDM,,,278,RC,inpatient,,64675,64675,,54909.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48764.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54973.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56914,88,,percent of total billed charges,,,,,,,,,49411.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58854.25,91,,percent of total billed charges,,,61441.25,95,,percent of total billed charges,,,53680.25,83,,percent of total billed charges,,,53680.25,83,,percent of total billed charges,,,,,,,,,,,,,,,53680.25,83,,percent of total billed charges,,,61441.25,95,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,53033.5,82,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,54973.75,85,,percent of total billed charges,,48764.95,61441.25,
GLIDEWIRE ANGLED .038 DIAMETER 150CM,30181819,CDM,,,270,RC,inpatient,,218.33,218.33,,185.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,192.13,88,,percent of total billed charges,,,,,,,,,166.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,198.68,91,,percent of total billed charges,,,207.41,95,,percent of total billed charges,,,181.21,83,,percent of total billed charges,,,181.21,83,,percent of total billed charges,,,,,,,,,,,,,,,181.21,83,,percent of total billed charges,,,207.41,95,,percent of total billed charges,,,196.5,90,,percent of total billed charges,,,196.5,90,,percent of total billed charges,,,179.03,82,,percent of total billed charges,,,196.5,90,,percent of total billed charges,,,185.58,85,,percent of total billed charges,,164.62,207.41,
DEPUY INSERT STABILIZED 8MM SZ3,30181822,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY INSERT RP 10MM SZ4,30181824,CDM,,,278,RC,inpatient,,11480.69,11480.69,,9747.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8656.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9758.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10103.01,88,,percent of total billed charges,,,,,,,,,8771.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10447.43,91,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,,,,,,,,,,,,,9528.97,83,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9414.17,82,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,8656.44,10906.66,
DEPUY FEMUR SIGMA PS RT SZ4,30181825,CDM,,,278,RC,inpatient,,23868.72,23868.72,,20264.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17997.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20288.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21004.47,88,,percent of total billed charges,,,,,,,,,18235.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21720.54,91,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19811.04,83,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,19572.35,82,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,17997.01,22675.28,
RTI MATRIX HD 5X8CM,30181827,CDM,,,278,RC,inpatient,,18850,18850,,16003.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14212.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16022.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16588,88,,percent of total billed charges,,,,,,,,,14401.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17153.5,91,,percent of total billed charges,,,17907.5,95,,percent of total billed charges,,,15645.5,83,,percent of total billed charges,,,15645.5,83,,percent of total billed charges,,,,,,,,,,,,,,,15645.5,83,,percent of total billed charges,,,17907.5,95,,percent of total billed charges,,,16965,90,,percent of total billed charges,,,16965,90,,percent of total billed charges,,,15457,82,,percent of total billed charges,,,16965,90,,percent of total billed charges,,,16022.5,85,,percent of total billed charges,,14212.9,17907.5,
DEPUY STEM BOWED SZ13.5 X 11,30181850,CDM,,,278,RC,inpatient,,68800.94,68800.94,,58412,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51875.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58480.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60544.83,88,,percent of total billed charges,,,,,,,,,52563.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62608.86,91,,percent of total billed charges,,,65360.89,95,,percent of total billed charges,,,57104.78,83,,percent of total billed charges,,,57104.78,83,,percent of total billed charges,,,,,,,,,,,,,,,57104.78,83,,percent of total billed charges,,,65360.89,95,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,56416.77,82,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,58480.8,85,,percent of total billed charges,,51875.91,65360.89,
DEPUY RENTAL FEE - INSTRUMENTS 99-000,30181851,CDM,,,270,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
DEPUY LINER CONSTRAINED ESC 36 X 56,30181852,CDM,,,278,RC,inpatient,,36635.17,36635.17,,31103.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27622.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31139.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32238.95,88,,percent of total billed charges,,,,,,,,,27989.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33338,91,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,,,,,,,,,,,,,30407.19,83,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,30040.84,82,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,27622.92,34803.41,
DEPUY STEM BOWED SZ10.5 X 8,30181853,CDM,,,270,RC,inpatient,,66522.3,66522.3,,56477.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50157.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56543.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58539.62,88,,percent of total billed charges,,,,,,,,,50823.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60535.29,91,,percent of total billed charges,,,63196.19,95,,percent of total billed charges,,,55213.51,83,,percent of total billed charges,,,55213.51,83,,percent of total billed charges,,,,,,,,,,,,,,,55213.51,83,,percent of total billed charges,,,63196.19,95,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,54548.29,82,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,56543.96,85,,percent of total billed charges,,50157.81,63196.19,
DEPUY GLENOSPHERE 38MM,30181854,CDM,,,278,RC,inpatient,,17458.81,17458.81,,14822.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13163.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14839.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15363.75,88,,percent of total billed charges,,,,,,,,,13338.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15887.52,91,,percent of total billed charges,,,16585.87,95,,percent of total billed charges,,,14490.81,83,,percent of total billed charges,,,14490.81,83,,percent of total billed charges,,,,,,,,,,,,,,,14490.81,83,,percent of total billed charges,,,16585.87,95,,percent of total billed charges,,,15712.93,90,,percent of total billed charges,,,15712.93,90,,percent of total billed charges,,,14316.22,82,,percent of total billed charges,,,15712.93,90,,percent of total billed charges,,,14839.99,85,,percent of total billed charges,,13163.94,16585.87,
MACROPLASTIQUE IMPLANT 2.5ML,30181855,CDM,,,278,RC,inpatient,,3539.25,3539.25,,3004.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2668.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3008.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3114.54,88,,percent of total billed charges,,,,,,,,,2703.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3220.72,91,,percent of total billed charges,,,3362.29,95,,percent of total billed charges,,,2937.58,83,,percent of total billed charges,,,2937.58,83,,percent of total billed charges,,,,,,,,,,,,,,,2937.58,83,,percent of total billed charges,,,3362.29,95,,percent of total billed charges,,,3185.33,90,,percent of total billed charges,,,3185.33,90,,percent of total billed charges,,,2902.19,82,,percent of total billed charges,,,3185.33,90,,percent of total billed charges,,,3008.36,85,,percent of total billed charges,,2668.59,3362.29,
STONE RETRIEVAL BASKET 1.9FR,30181858,CDM,,,270,RC,inpatient,,1537.58,1537.58,,1305.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1159.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1306.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1353.07,88,,percent of total billed charges,,,,,,,,,1174.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1399.2,91,,percent of total billed charges,,,1460.7,95,,percent of total billed charges,,,1276.19,83,,percent of total billed charges,,,1276.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1276.19,83,,percent of total billed charges,,,1460.7,95,,percent of total billed charges,,,1383.82,90,,percent of total billed charges,,,1383.82,90,,percent of total billed charges,,,1260.82,82,,percent of total billed charges,,,1383.82,90,,percent of total billed charges,,,1306.94,85,,percent of total billed charges,,1159.34,1460.7,
DRAIN JACKSON PRATT FLUTED 19FR,30181865,CDM,,,270,RC,inpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,197.93,249.38,
SYNTHES DRILL BIT 4.3MM 310.431,30181868,CDM,,,270,RC,inpatient,,1217.84,1217.84,,1033.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,918.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1035.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1071.7,88,,percent of total billed charges,,,,,,,,,930.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1108.23,91,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1010.81,83,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,998.63,82,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,918.25,1156.95,
SYNTHES SCREW LOCKING 3.5X14MM,30181871,CDM,,,270,RC,inpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,945.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1066.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,945.79,1191.65,
DEPUY UPCHARGE CERAMIC LINER(011),30181872,CDM,,,278,RC,inpatient,,4521.53,4521.53,,3838.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3409.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3843.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3978.95,88,,percent of total billed charges,,,,,,,,,3454.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4114.59,91,,percent of total billed charges,,,4295.45,95,,percent of total billed charges,,,3752.87,83,,percent of total billed charges,,,3752.87,83,,percent of total billed charges,,,,,,,,,,,,,,,3752.87,83,,percent of total billed charges,,,4295.45,95,,percent of total billed charges,,,4069.38,90,,percent of total billed charges,,,4069.38,90,,percent of total billed charges,,,3707.65,82,,percent of total billed charges,,,4069.38,90,,percent of total billed charges,,,3843.3,85,,percent of total billed charges,,3409.23,4295.45,
SYNTHES SCREW SCHANZ 4.0X25MM,30181885,CDM,,,278,RC,inpatient,,1574.63,1574.63,,1336.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1187.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1338.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1385.67,88,,percent of total billed charges,,,,,,,,,1203.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1432.91,91,,percent of total billed charges,,,1495.9,95,,percent of total billed charges,,,1306.94,83,,percent of total billed charges,,,1306.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1306.94,83,,percent of total billed charges,,,1495.9,95,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1291.2,82,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1338.44,85,,percent of total billed charges,,1187.27,1495.9,
SYNTHES SCREW SCHANZ 4.0X30MM,30181886,CDM,,,278,RC,inpatient,,1670.5,1670.5,,1418.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1259.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1419.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1470.04,88,,percent of total billed charges,,,,,,,,,1276.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1520.16,91,,percent of total billed charges,,,1586.98,95,,percent of total billed charges,,,1386.52,83,,percent of total billed charges,,,1386.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1386.52,83,,percent of total billed charges,,,1586.98,95,,percent of total billed charges,,,1503.45,90,,percent of total billed charges,,,1503.45,90,,percent of total billed charges,,,1369.81,82,,percent of total billed charges,,,1503.45,90,,percent of total billed charges,,,1419.93,85,,percent of total billed charges,,1259.56,1586.98,
SYNTHES CLAMP ADJUSTABLE,30181887,CDM,,,278,RC,inpatient,,8282.24,8282.24,,7031.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6244.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7039.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7288.37,88,,percent of total billed charges,,,,,,,,,6327.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7536.84,91,,percent of total billed charges,,,7868.13,95,,percent of total billed charges,,,6874.26,83,,percent of total billed charges,,,6874.26,83,,percent of total billed charges,,,,,,,,,,,,,,,6874.26,83,,percent of total billed charges,,,7868.13,95,,percent of total billed charges,,,7454.02,90,,percent of total billed charges,,,7454.02,90,,percent of total billed charges,,,6791.44,82,,percent of total billed charges,,,7454.02,90,,percent of total billed charges,,,7039.9,85,,percent of total billed charges,,6244.81,7868.13,
ZIMMER BLADE EXPLANT 54MM X 10,30181891,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
ZIMMER BLADE EXPLANT 54MM X 20,30181892,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
DEPUY STEM CORAIL COLLARED SZ12,30181899,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY-MITEK ANCHOR INSTRUMENT KIT,30181901,CDM,,,270,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
DEPUY-MITEK QUICKANCHOR PLUS GII,30181902,CDM,,,278,RC,inpatient,,2665,2665,,2262.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2009.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2265.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2345.2,88,,percent of total billed charges,,,,,,,,,2036.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2425.15,91,,percent of total billed charges,,,2531.75,95,,percent of total billed charges,,,2211.95,83,,percent of total billed charges,,,2211.95,83,,percent of total billed charges,,,,,,,,,,,,,,,2211.95,83,,percent of total billed charges,,,2531.75,95,,percent of total billed charges,,,2398.5,90,,percent of total billed charges,,,2398.5,90,,percent of total billed charges,,,2185.3,82,,percent of total billed charges,,,2398.5,90,,percent of total billed charges,,,2265.25,85,,percent of total billed charges,,2009.41,2531.75,
DEPUY-MITEK QUICKANCHOR SUPER PLUS,30181903,CDM,,,278,RC,inpatient,,4608.5,4608.5,,3912.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3474.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3917.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4055.48,88,,percent of total billed charges,,,,,,,,,3520.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4193.74,91,,percent of total billed charges,,,4378.08,95,,percent of total billed charges,,,3825.06,83,,percent of total billed charges,,,3825.06,83,,percent of total billed charges,,,,,,,,,,,,,,,3825.06,83,,percent of total billed charges,,,4378.08,95,,percent of total billed charges,,,4147.65,90,,percent of total billed charges,,,4147.65,90,,percent of total billed charges,,,3778.97,82,,percent of total billed charges,,,4147.65,90,,percent of total billed charges,,,3917.23,85,,percent of total billed charges,,3474.81,4378.08,
DEPUY FEMUR SIGMA PS RT SZ2.5,30181904,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
DEPUY INSERT RP 10MM SZ2.5,30181905,CDM,,,278,RC,inpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9811.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11060.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,9811.36,12361.8,
DEPUY MBT KEEL TRAY SZ2.5,30181906,CDM,,,278,RC,inpatient,,22901.45,22901.45,,19443.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17267.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19466.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20153.28,88,,percent of total billed charges,,,,,,,,,17496.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20840.32,91,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19008.2,83,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,18779.19,82,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,19466.23,85,,percent of total billed charges,,17267.69,21756.38,
BIOMET KNEE FEMORAL REPICCI II 54MM,30181907,CDM,,,278,RC,inpatient,,26266.5,26266.5,,22300.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19804.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22326.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23114.52,88,,percent of total billed charges,,,,,,,,,20067.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23902.52,91,,percent of total billed charges,,,24953.18,95,,percent of total billed charges,,,21801.2,83,,percent of total billed charges,,,21801.2,83,,percent of total billed charges,,,,,,,,,,,,,,,21801.2,83,,percent of total billed charges,,,24953.18,95,,percent of total billed charges,,,23639.85,90,,percent of total billed charges,,,23639.85,90,,percent of total billed charges,,,21538.53,82,,percent of total billed charges,,,23639.85,90,,percent of total billed charges,,,22326.53,85,,percent of total billed charges,,19804.94,24953.18,
BIOMET KNEE TIBIAL COMPONENT 37 X 7.5,30181908,CDM,,,278,RC,inpatient,,9542,9542,,8101.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7194.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8110.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8396.96,88,,percent of total billed charges,,,,,,,,,7290.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8683.22,91,,percent of total billed charges,,,9064.9,95,,percent of total billed charges,,,7919.86,83,,percent of total billed charges,,,7919.86,83,,percent of total billed charges,,,,,,,,,,,,,,,7919.86,83,,percent of total billed charges,,,9064.9,95,,percent of total billed charges,,,8587.8,90,,percent of total billed charges,,,8587.8,90,,percent of total billed charges,,,7824.44,82,,percent of total billed charges,,,8587.8,90,,percent of total billed charges,,,8110.7,85,,percent of total billed charges,,7194.67,9064.9,
DEPUY THOCHLEA IMPLANT PFI SZ1,30181909,CDM,,,278,RC,inpatient,,17793.75,17793.75,,15106.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13416.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15124.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15658.5,88,,percent of total billed charges,,,,,,,,,13594.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16192.31,91,,percent of total billed charges,,,16904.06,95,,percent of total billed charges,,,14768.81,83,,percent of total billed charges,,,14768.81,83,,percent of total billed charges,,,,,,,,,,,,,,,14768.81,83,,percent of total billed charges,,,16904.06,95,,percent of total billed charges,,,16014.38,90,,percent of total billed charges,,,16014.38,90,,percent of total billed charges,,,14590.88,82,,percent of total billed charges,,,16014.38,90,,percent of total billed charges,,,15124.69,85,,percent of total billed charges,,13416.49,16904.06,
DEPUY THOCHLEA CUTTING B4,30181911,CDM,,,278,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
DEPUY FEMORAL HEAD 44MM -2,30181917,CDM,,,278,RC,inpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10650.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12006.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,10650.51,13419.08,
DEPUY LINER ALTRX NEUT 28 X 50,30181925,CDM,,,278,RC,inpatient,,10729.29,10729.29,,9109.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8089.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9119.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9441.78,88,,percent of total billed charges,,,,,,,,,8197.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9763.65,91,,percent of total billed charges,,,10192.83,95,,percent of total billed charges,,,8905.31,83,,percent of total billed charges,,,8905.31,83,,percent of total billed charges,,,,,,,,,,,,,,,8905.31,83,,percent of total billed charges,,,10192.83,95,,percent of total billed charges,,,9656.36,90,,percent of total billed charges,,,9656.36,90,,percent of total billed charges,,,8798.02,82,,percent of total billed charges,,,9656.36,90,,percent of total billed charges,,,9119.9,85,,percent of total billed charges,,8089.88,10192.83,
DEPUY STEM ULTIMA SZ3,30181926,CDM,,,278,RC,inpatient,,18959.53,18959.53,,16096.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14295.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16115.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16684.39,88,,percent of total billed charges,,,,,,,,,14485.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17253.17,91,,percent of total billed charges,,,18011.55,95,,percent of total billed charges,,,15736.41,83,,percent of total billed charges,,,15736.41,83,,percent of total billed charges,,,,,,,,,,,,,,,15736.41,83,,percent of total billed charges,,,18011.55,95,,percent of total billed charges,,,17063.58,90,,percent of total billed charges,,,17063.58,90,,percent of total billed charges,,,15546.81,82,,percent of total billed charges,,,17063.58,90,,percent of total billed charges,,,16115.6,85,,percent of total billed charges,,14295.49,18011.55,
DEPUY HEAD PFC 28MM+10,30181927,CDM,,,278,RC,inpatient,,7698.34,7698.34,,6535.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5804.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6543.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6774.54,88,,percent of total billed charges,,,,,,,,,5881.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7005.49,91,,percent of total billed charges,,,7313.42,95,,percent of total billed charges,,,6389.62,83,,percent of total billed charges,,,6389.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6389.62,83,,percent of total billed charges,,,7313.42,95,,percent of total billed charges,,,6928.51,90,,percent of total billed charges,,,6928.51,90,,percent of total billed charges,,,6312.64,82,,percent of total billed charges,,,6928.51,90,,percent of total billed charges,,,6543.59,85,,percent of total billed charges,,5804.55,7313.42,
DEPUY CENTRALIZER 13MM,30181928,CDM,,,278,RC,inpatient,,863.59,863.59,,733.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,651.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,734.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,759.96,88,,percent of total billed charges,,,,,,,,,659.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,785.87,91,,percent of total billed charges,,,820.41,95,,percent of total billed charges,,,716.78,83,,percent of total billed charges,,,716.78,83,,percent of total billed charges,,,,,,,,,,,,,,,716.78,83,,percent of total billed charges,,,820.41,95,,percent of total billed charges,,,777.23,90,,percent of total billed charges,,,777.23,90,,percent of total billed charges,,,708.14,82,,percent of total billed charges,,,777.23,90,,percent of total billed charges,,,734.05,85,,percent of total billed charges,,651.15,820.41,
DEPUY RENTAL FEE - INSTRUMENTS 97-000,30181929,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
DEPUY PINNACLE CUP SECTOR II 54MM,30181930,CDM,,,278,RC,inpatient,,18892.32,18892.32,,16039.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14244.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16058.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16625.24,88,,percent of total billed charges,,,,,,,,,14433.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17192.01,91,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15680.63,83,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,15491.7,82,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,14244.81,17947.7,
DRAIN FLUTE 10FR W/TROCAR,30181931,CDM,,,270,RC,inpatient,,199.94,199.94,,169.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,169.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,175.95,88,,percent of total billed charges,,,,,,,,,152.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,181.95,91,,percent of total billed charges,,,189.94,95,,percent of total billed charges,,,165.95,83,,percent of total billed charges,,,165.95,83,,percent of total billed charges,,,,,,,,,,,,,,,165.95,83,,percent of total billed charges,,,189.94,95,,percent of total billed charges,,,179.95,90,,percent of total billed charges,,,179.95,90,,percent of total billed charges,,,163.95,82,,percent of total billed charges,,,179.95,90,,percent of total billed charges,,,169.95,85,,percent of total billed charges,,150.75,189.94,
DRAIN FLUTE 19FR W/TROCAR,30181932,CDM,,,270,RC,inpatient,,201.93,201.93,,171.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,171.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,177.7,88,,percent of total billed charges,,,,,,,,,154.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,183.76,91,,percent of total billed charges,,,191.83,95,,percent of total billed charges,,,167.6,83,,percent of total billed charges,,,167.6,83,,percent of total billed charges,,,,,,,,,,,,,,,167.6,83,,percent of total billed charges,,,191.83,95,,percent of total billed charges,,,181.74,90,,percent of total billed charges,,,181.74,90,,percent of total billed charges,,,165.58,82,,percent of total billed charges,,,181.74,90,,percent of total billed charges,,,171.64,85,,percent of total billed charges,,152.26,191.83,
DEPUY FEMUR SIGMA PS LT SZ4,30181934,CDM,,,278,RC,inpatient,,23868.72,23868.72,,20264.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17997.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20288.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21004.47,88,,percent of total billed charges,,,,,,,,,18235.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21720.54,91,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19811.04,83,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,19572.35,82,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,17997.01,22675.28,
DEPUY SAWBLADE 90 X 13 (607),30181935,CDM,,,278,RC,inpatient,,550.55,550.55,,467.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,415.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,467.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,484.48,88,,percent of total billed charges,,,,,,,,,420.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,501,91,,percent of total billed charges,,,523.02,95,,percent of total billed charges,,,456.96,83,,percent of total billed charges,,,456.96,83,,percent of total billed charges,,,,,,,,,,,,,,,456.96,83,,percent of total billed charges,,,523.02,95,,percent of total billed charges,,,495.5,90,,percent of total billed charges,,,495.5,90,,percent of total billed charges,,,451.45,82,,percent of total billed charges,,,495.5,90,,percent of total billed charges,,,467.97,85,,percent of total billed charges,,415.11,523.02,
TROCAR MAYO CATGUT 1/2 CIRCLE SZ4D,30181959,CDM,,,270,RC,inpatient,,55.27,55.27,,46.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.64,88,,percent of total billed charges,,,,,,,,,42.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.3,91,,percent of total billed charges,,,52.51,95,,percent of total billed charges,,,45.87,83,,percent of total billed charges,,,45.87,83,,percent of total billed charges,,,,,,,,,,,,,,,45.87,83,,percent of total billed charges,,,52.51,95,,percent of total billed charges,,,49.74,90,,percent of total billed charges,,,49.74,90,,percent of total billed charges,,,45.32,82,,percent of total billed charges,,,49.74,90,,percent of total billed charges,,,46.98,85,,percent of total billed charges,,41.67,52.51,
DEPUY LINER CONSTRAINED +4 SZ52,30181978,CDM,,,278,RC,inpatient,,35737.78,35737.78,,30341.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26946.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30377.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31449.25,88,,percent of total billed charges,,,,,,,,,27303.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32521.38,91,,percent of total billed charges,,,33950.89,95,,percent of total billed charges,,,29662.36,83,,percent of total billed charges,,,29662.36,83,,percent of total billed charges,,,,,,,,,,,,,,,29662.36,83,,percent of total billed charges,,,33950.89,95,,percent of total billed charges,,,32164,90,,percent of total billed charges,,,32164,90,,percent of total billed charges,,,29304.98,82,,percent of total billed charges,,,32164,90,,percent of total billed charges,,,30377.11,85,,percent of total billed charges,,26946.29,33950.89,
DEPUY INSERT RP 12.5MM SZ4,30181980,CDM,,,278,RC,inpatient,,11480.69,11480.69,,9747.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8656.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9758.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10103.01,88,,percent of total billed charges,,,,,,,,,8771.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10447.43,91,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,,,,,,,,,,,,,9528.97,83,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9414.17,82,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,8656.44,10906.66,
DEPUY UPCHARGE GRIPTON CUP(040),30181981,CDM,,,278,RC,inpatient,,2608.65,2608.65,,2214.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1966.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2217.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2295.61,88,,percent of total billed charges,,,,,,,,,1993.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2373.87,91,,percent of total billed charges,,,2478.22,95,,percent of total billed charges,,,2165.18,83,,percent of total billed charges,,,2165.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2165.18,83,,percent of total billed charges,,,2478.22,95,,percent of total billed charges,,,2347.79,90,,percent of total billed charges,,,2347.79,90,,percent of total billed charges,,,2139.09,82,,percent of total billed charges,,,2347.79,90,,percent of total billed charges,,,2217.35,85,,percent of total billed charges,,1966.92,2478.22,
DEPUY INSERT SIGMA XLK 2 X 12.5,30181982,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY WEDGE STEP 10MM SZ2,30181983,CDM,,,278,RC,inpatient,,13166.27,13166.27,,11178.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9927.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11191.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11586.32,88,,percent of total billed charges,,,,,,,,,10059.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11981.31,91,,percent of total billed charges,,,12507.96,95,,percent of total billed charges,,,10928,83,,percent of total billed charges,,,10928,83,,percent of total billed charges,,,,,,,,,,,,,,,10928,83,,percent of total billed charges,,,12507.96,95,,percent of total billed charges,,,11849.64,90,,percent of total billed charges,,,11849.64,90,,percent of total billed charges,,,10796.34,82,,percent of total billed charges,,,11849.64,90,,percent of total billed charges,,,11191.33,85,,percent of total billed charges,,9927.37,12507.96,
DEPUY MODULAR PLUS TIBIAL TRAY SZ2,30181984,CDM,,,278,RC,inpatient,,25576.07,25576.07,,21714.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19284.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21739.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22506.94,88,,percent of total billed charges,,,,,,,,,19540.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23274.22,91,,percent of total billed charges,,,24297.27,95,,percent of total billed charges,,,21228.14,83,,percent of total billed charges,,,21228.14,83,,percent of total billed charges,,,,,,,,,,,,,,,21228.14,83,,percent of total billed charges,,,24297.27,95,,percent of total billed charges,,,23018.46,90,,percent of total billed charges,,,23018.46,90,,percent of total billed charges,,,20972.38,82,,percent of total billed charges,,,23018.46,90,,percent of total billed charges,,,21739.66,85,,percent of total billed charges,,19284.36,24297.27,
SMOKE EVAPORATOR REDUCER,30181986,CDM,,,270,RC,inpatient,,51.04,51.04,,43.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.92,88,,percent of total billed charges,,,,,,,,,38.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.45,91,,percent of total billed charges,,,48.49,95,,percent of total billed charges,,,42.36,83,,percent of total billed charges,,,42.36,83,,percent of total billed charges,,,,,,,,,,,,,,,42.36,83,,percent of total billed charges,,,48.49,95,,percent of total billed charges,,,45.94,90,,percent of total billed charges,,,45.94,90,,percent of total billed charges,,,41.85,82,,percent of total billed charges,,,45.94,90,,percent of total billed charges,,,43.38,85,,percent of total billed charges,,38.48,48.49,
DEPUY MBT REVISION TIBIAL TRAY SZ3,30181987,CDM,,,278,RC,inpatient,,28838.62,28838.62,,24483.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21744.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24512.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25377.99,88,,percent of total billed charges,,,,,,,,,22032.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26243.14,91,,percent of total billed charges,,,27396.69,95,,percent of total billed charges,,,23936.05,83,,percent of total billed charges,,,23936.05,83,,percent of total billed charges,,,,,,,,,,,,,,,23936.05,83,,percent of total billed charges,,,27396.69,95,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,23647.67,82,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,24512.83,85,,percent of total billed charges,,21744.32,27396.69,
DEPUY POSTERIOR AUGMENT 8MM SZ3.0,30181988,CDM,,,278,RC,inpatient,,6245.14,6245.14,,5302.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4708.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5308.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5495.72,88,,percent of total billed charges,,,,,,,,,4771.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5683.08,91,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,,,,,,,,,,,,,5183.47,83,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5121.01,82,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,4708.84,5932.88,
DEPUY MBT STEP WEDGE,30181989,CDM,,,278,RC,inpatient,,11378.45,11378.45,,9660.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8579.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9671.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10013.04,88,,percent of total billed charges,,,,,,,,,8693.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10354.39,91,,percent of total billed charges,,,10809.53,95,,percent of total billed charges,,,9444.11,83,,percent of total billed charges,,,9444.11,83,,percent of total billed charges,,,,,,,,,,,,,,,9444.11,83,,percent of total billed charges,,,10809.53,95,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,9330.33,82,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,9671.68,85,,percent of total billed charges,,8579.35,10809.53,
DEPUY STEM FLUTED UNIV 75 X 14,30181990,CDM,,,278,RC,inpatient,,12911.21,12911.21,,10961.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9735.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10974.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11361.86,88,,percent of total billed charges,,,,,,,,,9864.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11749.2,91,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,,,,,,,,,,,,,10716.3,83,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10587.19,82,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,9735.05,12265.65,
SYNTHES SCREW CANCEL 4.0X20MM,30181992,CDM,,,278,RC,inpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,168.24,211.97,
DEPUY STEM CORAIL COLLERED SZ14,30181995,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
STAPLER LINEAR RELOAD 45MM,30182003,CDM,,,270,RC,inpatient,,884.59,884.59,,751.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,666.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,751.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,778.44,88,,percent of total billed charges,,,,,,,,,675.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,804.98,91,,percent of total billed charges,,,840.36,95,,percent of total billed charges,,,734.21,83,,percent of total billed charges,,,734.21,83,,percent of total billed charges,,,,,,,,,,,,,,,734.21,83,,percent of total billed charges,,,840.36,95,,percent of total billed charges,,,796.13,90,,percent of total billed charges,,,796.13,90,,percent of total billed charges,,,725.36,82,,percent of total billed charges,,,796.13,90,,percent of total billed charges,,,751.9,85,,percent of total billed charges,,666.98,840.36,
DEPUY STEM BOWED SZ18.0 X 10,30182004,CDM,,,278,RC,inpatient,,68800.94,68800.94,,58412,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51875.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58480.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60544.83,88,,percent of total billed charges,,,,,,,,,52563.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62608.86,91,,percent of total billed charges,,,65360.89,95,,percent of total billed charges,,,57104.78,83,,percent of total billed charges,,,57104.78,83,,percent of total billed charges,,,,,,,,,,,,,,,57104.78,83,,percent of total billed charges,,,65360.89,95,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,56416.77,82,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,58480.8,85,,percent of total billed charges,,51875.91,65360.89,
DEPUY FEMUR TC3 LT SZ2.5,30182005,CDM,,,278,RC,inpatient,,36489.7,36489.7,,30979.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27513.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31016.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32110.94,88,,percent of total billed charges,,,,,,,,,27878.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33205.63,91,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,,,,,,,,,,,,,30286.45,83,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,29921.55,82,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,27513.23,34665.22,
DEPUY INSERT TC3 RP 17.5MM SZ2.5,30182006,CDM,,,278,RC,inpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17430.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19649.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,17430.21,21961.14,
DEPUY STEM FLUTED UNIV 75 X 10,30182007,CDM,,,278,RC,inpatient,,12911.21,12911.21,,10961.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9735.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10974.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11361.86,88,,percent of total billed charges,,,,,,,,,9864.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11749.2,91,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,,,,,,,,,,,,,10716.3,83,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10587.19,82,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,9735.05,12265.65,
DEPUY INSERT LPS 14MM X-SMALL,30182008,CDM,,,278,RC,inpatient,,33343.12,33343.12,,28308.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25140.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28341.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29341.95,88,,percent of total billed charges,,,,,,,,,25474.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30342.24,91,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,,,,,,,,,,,,,27674.79,83,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,27341.36,82,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,25140.71,31675.96,
DEPUY DISTAL AUGMENT LT 8MM SZ2.5,30182009,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
BIOMET ULTRADRIVE 180MM,30182010,CDM,,,270,RC,inpatient,,4283.5,4283.5,,3636.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3229.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3640.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3769.48,88,,percent of total billed charges,,,,,,,,,3272.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3897.99,91,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3555.31,83,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3512.47,82,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3640.98,85,,percent of total billed charges,,3229.76,4069.33,
BIOMET ULTRA DRIVE 11MM DISK DRILL,30182011,CDM,,,270,RC,inpatient,,4283.5,4283.5,,3636.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3229.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3640.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3769.48,88,,percent of total billed charges,,,,,,,,,3272.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3897.99,91,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3555.31,83,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3512.47,82,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3640.98,85,,percent of total billed charges,,3229.76,4069.33,
BIOMET ULTRADRIVE 60MM,30182012,CDM,,,270,RC,inpatient,,4524,4524,,3840.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3411.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3845.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3981.12,88,,percent of total billed charges,,,,,,,,,3456.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4116.84,91,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,,,,,,,,,,,,,3754.92,83,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3709.68,82,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3845.4,85,,percent of total billed charges,,3411.1,4297.8,
BIOMET ULTRADRIVE IMPLANT KIT,30182013,CDM,,,270,RC,inpatient,,4283.5,4283.5,,3636.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3229.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3640.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3769.48,88,,percent of total billed charges,,,,,,,,,3272.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3897.99,91,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3555.31,83,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3512.47,82,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3640.98,85,,percent of total billed charges,,3229.76,4069.33,
SPLINT DENVER LARGE,30182016,CDM,,,270,RC,inpatient,,265.5,265.5,,225.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,200.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,225.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,233.64,88,,percent of total billed charges,,,,,,,,,202.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,241.61,91,,percent of total billed charges,,,252.23,95,,percent of total billed charges,,,220.37,83,,percent of total billed charges,,,220.37,83,,percent of total billed charges,,,,,,,,,,,,,,,220.37,83,,percent of total billed charges,,,252.23,95,,percent of total billed charges,,,238.95,90,,percent of total billed charges,,,238.95,90,,percent of total billed charges,,,217.71,82,,percent of total billed charges,,,238.95,90,,percent of total billed charges,,,225.68,85,,percent of total billed charges,,200.19,252.23,
ELECTRODE CUTTING MONO 22FR,30182028,CDM,,,270,RC,inpatient,,648.45,648.45,,550.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,488.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,551.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,570.64,88,,percent of total billed charges,,,,,,,,,495.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,590.09,91,,percent of total billed charges,,,616.03,95,,percent of total billed charges,,,538.21,83,,percent of total billed charges,,,538.21,83,,percent of total billed charges,,,,,,,,,,,,,,,538.21,83,,percent of total billed charges,,,616.03,95,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,531.73,82,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,551.18,85,,percent of total billed charges,,488.93,616.03,
SYNTHES SCREW CANNUL 16MM 6.5X55MM,30182029,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
DEPUY SCREW LOCKING 48MM,30182030,CDM,,,278,RC,inpatient,,2237.76,2237.76,,1899.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1687.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1902.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1969.23,88,,percent of total billed charges,,,,,,,,,1709.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2036.36,91,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1857.34,83,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1834.96,82,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,1687.27,2125.87,
DEPUY HUMERAL CUP HI MOD 38+3,30182031,CDM,,,278,RC,inpatient,,9534.2,9534.2,,8094.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7188.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8104.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8390.1,88,,percent of total billed charges,,,,,,,,,7284.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8676.12,91,,percent of total billed charges,,,9057.49,95,,percent of total billed charges,,,7913.39,83,,percent of total billed charges,,,7913.39,83,,percent of total billed charges,,,,,,,,,,,,,,,7913.39,83,,percent of total billed charges,,,9057.49,95,,percent of total billed charges,,,8580.78,90,,percent of total billed charges,,,8580.78,90,,percent of total billed charges,,,7818.04,82,,percent of total billed charges,,,8580.78,90,,percent of total billed charges,,,8104.07,85,,percent of total billed charges,,7188.79,9057.49,
DEPUY STEM HUMERAL SZ8,30182032,CDM,,,278,RC,inpatient,,35653.09,35653.09,,30269.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26882.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30305.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31374.72,88,,percent of total billed charges,,,,,,,,,27238.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32444.31,91,,percent of total billed charges,,,33870.44,95,,percent of total billed charges,,,29592.06,83,,percent of total billed charges,,,29592.06,83,,percent of total billed charges,,,,,,,,,,,,,,,29592.06,83,,percent of total billed charges,,,33870.44,95,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,29235.53,82,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,30305.13,85,,percent of total billed charges,,26882.43,33870.44,
DEPUY PINNACLE CUP W/GRIPTION 62MM,30182036,CDM,,,278,RC,inpatient,,31783.05,31783.05,,26983.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23964.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27015.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27969.08,88,,percent of total billed charges,,,,,,,,,24282.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28922.58,91,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,,,,,,,,,,,,,26379.93,83,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,26062.1,82,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,27015.59,85,,percent of total billed charges,,23964.42,30193.9,
DEPUY LINER CONSTRAINED +4 SZ56,30182037,CDM,,,278,RC,inpatient,,36991.5,36991.5,,31405.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27891.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31442.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32552.52,88,,percent of total billed charges,,,,,,,,,28261.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33662.27,91,,percent of total billed charges,,,35141.93,95,,percent of total billed charges,,,30702.95,83,,percent of total billed charges,,,30702.95,83,,percent of total billed charges,,,,,,,,,,,,,,,30702.95,83,,percent of total billed charges,,,35141.93,95,,percent of total billed charges,,,33292.35,90,,percent of total billed charges,,,33292.35,90,,percent of total billed charges,,,30333.03,82,,percent of total billed charges,,,33292.35,90,,percent of total billed charges,,,31442.78,85,,percent of total billed charges,,27891.59,35141.93,
DEPUY PINNACLE SCREW 40MM,30182038,CDM,,,278,RC,inpatient,,987.87,987.87,,838.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,744.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,839.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,869.33,88,,percent of total billed charges,,,,,,,,,754.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,898.96,91,,percent of total billed charges,,,938.48,95,,percent of total billed charges,,,819.93,83,,percent of total billed charges,,,819.93,83,,percent of total billed charges,,,,,,,,,,,,,,,819.93,83,,percent of total billed charges,,,938.48,95,,percent of total billed charges,,,889.08,90,,percent of total billed charges,,,889.08,90,,percent of total billed charges,,,810.05,82,,percent of total billed charges,,,889.08,90,,percent of total billed charges,,,839.69,85,,percent of total billed charges,,744.85,938.48,
INTEROCCULAR EYE PACK,30182041,CDM,,,270,RC,inpatient,,353.85,353.85,,300.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,266.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,300.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,311.39,88,,percent of total billed charges,,,,,,,,,270.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,322,91,,percent of total billed charges,,,336.16,95,,percent of total billed charges,,,293.7,83,,percent of total billed charges,,,293.7,83,,percent of total billed charges,,,,,,,,,,,,,,,293.7,83,,percent of total billed charges,,,336.16,95,,percent of total billed charges,,,318.47,90,,percent of total billed charges,,,318.47,90,,percent of total billed charges,,,290.16,82,,percent of total billed charges,,,318.47,90,,percent of total billed charges,,,300.77,85,,percent of total billed charges,,266.8,336.16,
DEPUY INSERT TC3 RP 10MM SZ2.5,30182042,CDM,,,278,RC,inpatient,,15465.58,15465.58,,13130.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11661.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13145.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13609.71,88,,percent of total billed charges,,,,,,,,,11815.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14073.68,91,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,,,,,,,,,,,,,12836.43,83,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,12681.78,82,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13145.74,85,,percent of total billed charges,,11661.05,14692.3,
DEPUY PINNACLE CUP MULTIHOLE 52MM,30182043,CDM,,,278,RC,inpatient,,26741.78,26741.78,,22703.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20163.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22730.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23532.77,88,,percent of total billed charges,,,,,,,,,20430.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24335.02,91,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,,,,,,,,,,,,,22195.68,83,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,21928.26,82,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,20163.3,25404.69,
DEPUY LINER CONSTRAINED +4 32 X 52,30182044,CDM,,,278,RC,inpatient,,36635.17,36635.17,,31103.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27622.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31139.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32238.95,88,,percent of total billed charges,,,,,,,,,27989.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33338,91,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,,,,,,,,,,,,,30407.19,83,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,30040.84,82,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,27622.92,34803.41,
GYRUS BERKELEY VACURETTE 8MM,30182046,CDM,,,270,RC,inpatient,,43.7,43.7,,37.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.46,88,,percent of total billed charges,,,,,,,,,33.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,39.77,91,,percent of total billed charges,,,41.52,95,,percent of total billed charges,,,36.27,83,,percent of total billed charges,,,36.27,83,,percent of total billed charges,,,,,,,,,,,,,,,36.27,83,,percent of total billed charges,,,41.52,95,,percent of total billed charges,,,39.33,90,,percent of total billed charges,,,39.33,90,,percent of total billed charges,,,35.83,82,,percent of total billed charges,,,39.33,90,,percent of total billed charges,,,37.15,85,,percent of total billed charges,,32.95,41.52,
GYRUS FALOPE RING BAND,30182047,CDM,,,270,RC,inpatient,,831.88,831.88,,706.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.05,88,,percent of total billed charges,,,,,,,,,635.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.01,91,,percent of total billed charges,,,790.29,95,,percent of total billed charges,,,690.46,83,,percent of total billed charges,,,690.46,83,,percent of total billed charges,,,,,,,,,,,,,,,690.46,83,,percent of total billed charges,,,790.29,95,,percent of total billed charges,,,748.69,90,,percent of total billed charges,,,748.69,90,,percent of total billed charges,,,682.14,82,,percent of total billed charges,,,748.69,90,,percent of total billed charges,,,707.1,85,,percent of total billed charges,,627.24,790.29,
STRYKER ULTRA PLUME AWAY 6.0,30182051,CDM,,,270,RC,inpatient,,187.58,187.58,,159.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,159.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,165.07,88,,percent of total billed charges,,,,,,,,,143.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,170.7,91,,percent of total billed charges,,,178.2,95,,percent of total billed charges,,,155.69,83,,percent of total billed charges,,,155.69,83,,percent of total billed charges,,,,,,,,,,,,,,,155.69,83,,percent of total billed charges,,,178.2,95,,percent of total billed charges,,,168.82,90,,percent of total billed charges,,,168.82,90,,percent of total billed charges,,,153.82,82,,percent of total billed charges,,,168.82,90,,percent of total billed charges,,,159.44,85,,percent of total billed charges,,141.44,178.2,
DEPUY PINNACLE CUP SECTOR II 62MM,30182054,CDM,,,278,RC,inpatient,,18892.32,18892.32,,16039.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14244.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16058.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16625.24,88,,percent of total billed charges,,,,,,,,,14433.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17192.01,91,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15680.63,83,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,15491.7,82,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,14244.81,17947.7,
INTERSPACE HIP SPACER 54MM,30182055,CDM,,,278,RC,inpatient,,22295,22295,,18928.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16810.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18950.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19619.6,88,,percent of total billed charges,,,,,,,,,17033.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20288.45,91,,percent of total billed charges,,,21180.25,95,,percent of total billed charges,,,18504.85,83,,percent of total billed charges,,,18504.85,83,,percent of total billed charges,,,,,,,,,,,,,,,18504.85,83,,percent of total billed charges,,,21180.25,95,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,18281.9,82,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,18950.75,85,,percent of total billed charges,,16810.43,21180.25,
DEPUY INSERT RP 10MM SZ3,30182057,CDM,,,278,RC,inpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9811.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11060.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,9811.36,12361.8,
DEPUY FEMUR SIGMA PS LT SZ3,30182058,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
BIOMET ULTRA DRIVE 7MM DISK DRILL,30182059,CDM,,,270,RC,inpatient,,4283.5,4283.5,,3636.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3229.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3640.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3769.48,88,,percent of total billed charges,,,,,,,,,3272.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3897.99,91,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3555.31,83,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3512.47,82,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3640.98,85,,percent of total billed charges,,3229.76,4069.33,
DEPUY STEM FLUTED UNIV 150 X 10,30182060,CDM,,,278,RC,inpatient,,12911.21,12911.21,,10961.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9735.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10974.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11361.86,88,,percent of total billed charges,,,,,,,,,9864.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11749.2,91,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,,,,,,,,,,,,,10716.3,83,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10587.19,82,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,9735.05,12265.65,
DEPUY FEMUR TC3 LT SZ2,30182061,CDM,,,278,RC,inpatient,,48160.65,48160.65,,40888.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36313.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40936.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42381.37,88,,percent of total billed charges,,,,,,,,,36794.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43826.19,91,,percent of total billed charges,,,45752.62,95,,percent of total billed charges,,,39973.34,83,,percent of total billed charges,,,39973.34,83,,percent of total billed charges,,,,,,,,,,,,,,,39973.34,83,,percent of total billed charges,,,45752.62,95,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,39491.73,82,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,40936.55,85,,percent of total billed charges,,36313.13,45752.62,
DEPUY INSERT TC3 12.5MM SZ2,30182062,CDM,,,278,RC,inpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17430.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19649.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,17430.21,21961.14,
DEPUY MBT REVISION TIBIAL TRAY SZ2,30182063,CDM,,,278,RC,inpatient,,39076.7,39076.7,,33176.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29463.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33215.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34387.5,88,,percent of total billed charges,,,,,,,,,29854.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35559.8,91,,percent of total billed charges,,,37122.87,95,,percent of total billed charges,,,32433.66,83,,percent of total billed charges,,,32433.66,83,,percent of total billed charges,,,,,,,,,,,,,,,32433.66,83,,percent of total billed charges,,,37122.87,95,,percent of total billed charges,,,35169.03,90,,percent of total billed charges,,,35169.03,90,,percent of total billed charges,,,32042.89,82,,percent of total billed charges,,,35169.03,90,,percent of total billed charges,,,33215.2,85,,percent of total billed charges,,29463.83,37122.87,
DEPUY MODULAR PLUS TIBIAL TRAY SZ2.5,30182086,CDM,,,278,RC,inpatient,,25576.07,25576.07,,21714.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19284.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21739.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22506.94,88,,percent of total billed charges,,,,,,,,,19540.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23274.22,91,,percent of total billed charges,,,24297.27,95,,percent of total billed charges,,,21228.14,83,,percent of total billed charges,,,21228.14,83,,percent of total billed charges,,,,,,,,,,,,,,,21228.14,83,,percent of total billed charges,,,24297.27,95,,percent of total billed charges,,,23018.46,90,,percent of total billed charges,,,23018.46,90,,percent of total billed charges,,,20972.38,82,,percent of total billed charges,,,23018.46,90,,percent of total billed charges,,,21739.66,85,,percent of total billed charges,,19284.36,24297.27,
DEPUY WEDGE STEP 10MM SZ2.5,30182087,CDM,,,278,RC,inpatient,,13166.27,13166.27,,11178.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9927.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11191.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11586.32,88,,percent of total billed charges,,,,,,,,,10059.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11981.31,91,,percent of total billed charges,,,12507.96,95,,percent of total billed charges,,,10928,83,,percent of total billed charges,,,10928,83,,percent of total billed charges,,,,,,,,,,,,,,,10928,83,,percent of total billed charges,,,12507.96,95,,percent of total billed charges,,,11849.64,90,,percent of total billed charges,,,11849.64,90,,percent of total billed charges,,,10796.34,82,,percent of total billed charges,,,11849.64,90,,percent of total billed charges,,,11191.33,85,,percent of total billed charges,,9927.37,12507.96,
DEPUY MBT REVISION TIBIAL TRAY SZ2 15MM,30182088,CDM,,,278,RC,inpatient,,51595.57,51595.57,,43804.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38903.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43856.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45404.1,88,,percent of total billed charges,,,,,,,,,39419.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46951.97,91,,percent of total billed charges,,,49015.79,95,,percent of total billed charges,,,42824.32,83,,percent of total billed charges,,,42824.32,83,,percent of total billed charges,,,,,,,,,,,,,,,42824.32,83,,percent of total billed charges,,,49015.79,95,,percent of total billed charges,,,46436.01,90,,percent of total billed charges,,,46436.01,90,,percent of total billed charges,,,42308.37,82,,percent of total billed charges,,,46436.01,90,,percent of total billed charges,,,43856.23,85,,percent of total billed charges,,38903.06,49015.79,
ALLODERM 6 X 16,30182089,CDM,,,278,RC,inpatient,,24804,24804,,21058.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18702.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21083.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21827.52,88,,percent of total billed charges,,,,,,,,,18950.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22571.64,91,,percent of total billed charges,,,23563.8,95,,percent of total billed charges,,,20587.32,83,,percent of total billed charges,,,20587.32,83,,percent of total billed charges,,,,,,,,,,,,,,,20587.32,83,,percent of total billed charges,,,23563.8,95,,percent of total billed charges,,,22323.6,90,,percent of total billed charges,,,22323.6,90,,percent of total billed charges,,,20339.28,82,,percent of total billed charges,,,22323.6,90,,percent of total billed charges,,,21083.4,85,,percent of total billed charges,,18702.22,23563.8,
ALLERGAN TISSUE EXPANDER,30182090,CDM,,,278,RC,inpatient,,9067.5,9067.5,,7698.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6836.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7707.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7979.4,88,,percent of total billed charges,,,,,,,,,6927.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8251.43,91,,percent of total billed charges,,,8614.13,95,,percent of total billed charges,,,7526.03,83,,percent of total billed charges,,,7526.03,83,,percent of total billed charges,,,,,,,,,,,,,,,7526.03,83,,percent of total billed charges,,,8614.13,95,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,7435.35,82,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,7707.38,85,,percent of total billed charges,,6836.9,8614.13,
ALLERGAN TISSUE EXPANDER 400CC,30182091,CDM,,,278,RC,inpatient,,9067.5,9067.5,,7698.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6836.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7707.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7979.4,88,,percent of total billed charges,,,,,,,,,6927.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8251.43,91,,percent of total billed charges,,,8614.13,95,,percent of total billed charges,,,7526.03,83,,percent of total billed charges,,,7526.03,83,,percent of total billed charges,,,,,,,,,,,,,,,7526.03,83,,percent of total billed charges,,,8614.13,95,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,7435.35,82,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,7707.38,85,,percent of total billed charges,,6836.9,8614.13,
SYNTHES K-WIRE THREADED 2.5MM,30182094,CDM,,,278,RC,inpatient,,203.36,203.36,,172.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.96,88,,percent of total billed charges,,,,,,,,,155.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,185.06,91,,percent of total billed charges,,,193.19,95,,percent of total billed charges,,,168.79,83,,percent of total billed charges,,,168.79,83,,percent of total billed charges,,,,,,,,,,,,,,,168.79,83,,percent of total billed charges,,,193.19,95,,percent of total billed charges,,,183.02,90,,percent of total billed charges,,,183.02,90,,percent of total billed charges,,,166.76,82,,percent of total billed charges,,,183.02,90,,percent of total billed charges,,,172.86,85,,percent of total billed charges,,153.33,193.19,
SYNTHES ROD CARBON FIBER 220MM,30182096,CDM,,,278,RC,inpatient,,1530.43,1530.43,,1299.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1153.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1300.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1346.78,88,,percent of total billed charges,,,,,,,,,1169.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1392.69,91,,percent of total billed charges,,,1453.91,95,,percent of total billed charges,,,1270.26,83,,percent of total billed charges,,,1270.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1270.26,83,,percent of total billed charges,,,1453.91,95,,percent of total billed charges,,,1377.39,90,,percent of total billed charges,,,1377.39,90,,percent of total billed charges,,,1254.95,82,,percent of total billed charges,,,1377.39,90,,percent of total billed charges,,,1300.87,85,,percent of total billed charges,,1153.94,1453.91,
INTERSPACE HIP SPACER 46MM,30182097,CDM,,,278,RC,inpatient,,22295,22295,,18928.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16810.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18950.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19619.6,88,,percent of total billed charges,,,,,,,,,17033.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20288.45,91,,percent of total billed charges,,,21180.25,95,,percent of total billed charges,,,18504.85,83,,percent of total billed charges,,,18504.85,83,,percent of total billed charges,,,,,,,,,,,,,,,18504.85,83,,percent of total billed charges,,,21180.25,95,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,18281.9,82,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,18950.75,85,,percent of total billed charges,,16810.43,21180.25,
DEPUY LINER CONSTRAINED +4 SZ50,30182098,CDM,,,278,RC,inpatient,,33951.78,33951.78,,28825.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25599.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28859.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29877.57,88,,percent of total billed charges,,,,,,,,,25939.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30896.12,91,,percent of total billed charges,,,32254.19,95,,percent of total billed charges,,,28179.98,83,,percent of total billed charges,,,28179.98,83,,percent of total billed charges,,,,,,,,,,,,,,,28179.98,83,,percent of total billed charges,,,32254.19,95,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,27840.46,82,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,28859.01,85,,percent of total billed charges,,25599.64,32254.19,
DEPUY STEM BOWED SZ16.5 X 7,30182099,CDM,,,278,RC,inpatient,,66522.3,66522.3,,56477.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50157.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56543.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58539.62,88,,percent of total billed charges,,,,,,,,,50823.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60535.29,91,,percent of total billed charges,,,63196.19,95,,percent of total billed charges,,,55213.51,83,,percent of total billed charges,,,55213.51,83,,percent of total billed charges,,,,,,,,,,,,,,,55213.51,83,,percent of total billed charges,,,63196.19,95,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,54548.29,82,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,56543.96,85,,percent of total billed charges,,50157.81,63196.19,
TROCAR ENDO DILATING TIP 12MM,30182101,CDM,,,270,RC,inpatient,,184,184,,156.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,138.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,156.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,161.92,88,,percent of total billed charges,,,,,,,,,140.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,,,,,,,,,,,,,152.72,83,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,150.88,82,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,138.74,174.8,
TROCAR ENDO DILATING TIP 5MM,30182102,CDM,,,270,RC,inpatient,,184,184,,156.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,138.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,156.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,161.92,88,,percent of total billed charges,,,,,,,,,140.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,,,,,,,,,,,,,152.72,83,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,150.88,82,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,138.74,174.8,
DEPUY DISTAL AUGMENT LT 12MM SZ3.0,30182103,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
DEPUY ANCHOR PEG GLENOID 44MM,30182104,CDM,,,278,RC,inpatient,,17098.9,17098.9,,14516.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12892.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14534.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15047.03,88,,percent of total billed charges,,,,,,,,,13063.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15560,91,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,,,,,,,,,,,,,14192.09,83,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14021.1,82,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14534.07,85,,percent of total billed charges,,12892.57,16243.96,
REFLUX DISPENSING PIN,30182112,CDM,,,270,RC,inpatient,,18.36,18.36,,15.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16.16,88,,percent of total billed charges,,,,,,,,,14.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.71,91,,percent of total billed charges,,,17.44,95,,percent of total billed charges,,,15.24,83,,percent of total billed charges,,,15.24,83,,percent of total billed charges,,,,,,,,,,,,,,,15.24,83,,percent of total billed charges,,,17.44,95,,percent of total billed charges,,,16.52,90,,percent of total billed charges,,,16.52,90,,percent of total billed charges,,,15.06,82,,percent of total billed charges,,,16.52,90,,percent of total billed charges,,,15.61,85,,percent of total billed charges,,13.84,17.44,
COLOPLAST RESERVOIR,30182127,CDM,,,278,RC,inpatient,,10887.5,10887.5,,9243.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8209.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9254.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9581,88,,percent of total billed charges,,,,,,,,,8318.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9907.63,91,,percent of total billed charges,,,10343.13,95,,percent of total billed charges,,,9036.63,83,,percent of total billed charges,,,9036.63,83,,percent of total billed charges,,,,,,,,,,,,,,,9036.63,83,,percent of total billed charges,,,10343.13,95,,percent of total billed charges,,,9798.75,90,,percent of total billed charges,,,9798.75,90,,percent of total billed charges,,,8927.75,82,,percent of total billed charges,,,9798.75,90,,percent of total billed charges,,,9254.38,85,,percent of total billed charges,,8209.18,10343.13,
COLOPLAST CYLINDERS/PUMP,30182128,CDM,,,278,RC,inpatient,,44616,44616,,37878.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33640.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37923.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39262.08,88,,percent of total billed charges,,,,,,,,,34086.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40600.56,91,,percent of total billed charges,,,42385.2,95,,percent of total billed charges,,,37031.28,83,,percent of total billed charges,,,37031.28,83,,percent of total billed charges,,,,,,,,,,,,,,,37031.28,83,,percent of total billed charges,,,42385.2,95,,percent of total billed charges,,,40154.4,90,,percent of total billed charges,,,40154.4,90,,percent of total billed charges,,,36585.12,82,,percent of total billed charges,,,40154.4,90,,percent of total billed charges,,,37923.6,85,,percent of total billed charges,,33640.46,42385.2,
SYNTHES ROD CARBON FIBER 200MM,30182137,CDM,,,278,RC,inpatient,,1623.64,1623.64,,1378.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1224.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1380.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1428.8,88,,percent of total billed charges,,,,,,,,,1240.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1477.51,91,,percent of total billed charges,,,1542.46,95,,percent of total billed charges,,,1347.62,83,,percent of total billed charges,,,1347.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1347.62,83,,percent of total billed charges,,,1542.46,95,,percent of total billed charges,,,1461.28,90,,percent of total billed charges,,,1461.28,90,,percent of total billed charges,,,1331.38,82,,percent of total billed charges,,,1461.28,90,,percent of total billed charges,,,1380.09,85,,percent of total billed charges,,1224.22,1542.46,
DEPUY DISTAL AUGMENT LT 8MM SZ3.0,30182138,CDM,,,278,RC,inpatient,,6245.14,6245.14,,5302.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4708.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5308.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5495.72,88,,percent of total billed charges,,,,,,,,,4771.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5683.08,91,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,,,,,,,,,,,,,5183.47,83,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5121.01,82,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,4708.84,5932.88,
DEPUY SPACER TAPERED 12/14,30182139,CDM,,,278,RC,inpatient,,1935.57,1935.57,,1643.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1459.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1645.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1703.3,88,,percent of total billed charges,,,,,,,,,1478.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1761.37,91,,percent of total billed charges,,,1838.79,95,,percent of total billed charges,,,1606.52,83,,percent of total billed charges,,,1606.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1606.52,83,,percent of total billed charges,,,1838.79,95,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1587.17,82,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1645.23,85,,percent of total billed charges,,1459.42,1838.79,
DEPUY OSTEOTOME THIN 8MM X 5,30182149,CDM,,,278,RC,inpatient,,2970.5,2970.5,,2521.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2239.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2524.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2614.04,88,,percent of total billed charges,,,,,,,,,2269.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2703.16,91,,percent of total billed charges,,,2821.98,95,,percent of total billed charges,,,2465.52,83,,percent of total billed charges,,,2465.52,83,,percent of total billed charges,,,,,,,,,,,,,,,2465.52,83,,percent of total billed charges,,,2821.98,95,,percent of total billed charges,,,2673.45,90,,percent of total billed charges,,,2673.45,90,,percent of total billed charges,,,2435.81,82,,percent of total billed charges,,,2673.45,90,,percent of total billed charges,,,2524.93,85,,percent of total billed charges,,2239.76,2821.98,
DEPUY LINER ALTRX NEUT 32 X 52,30182161,CDM,,,278,RC,inpatient,,10422.17,10422.17,,8848.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7858.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8858.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9171.51,88,,percent of total billed charges,,,,,,,,,7962.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9484.17,91,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,,,,,,,,,,,,,8650.4,83,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8546.18,82,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8858.84,85,,percent of total billed charges,,7858.32,9901.06,
DEPUY SCREW BONE 60 X 5.0,30182163,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
DEPUY PINNACLE CUP W/GRIPTION 56MM,30182164,CDM,,,278,RC,inpatient,,31783.05,31783.05,,26983.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23964.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27015.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27969.08,88,,percent of total billed charges,,,,,,,,,24282.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28922.58,91,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,,,,,,,,,,,,,26379.93,83,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,26062.1,82,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,27015.59,85,,percent of total billed charges,,23964.42,30193.9,
HIP GRIP COVERSETS ANTERIOR PELVIC,30182165,CDM,,,270,RC,inpatient,,10.89,10.89,,9.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9.58,88,,percent of total billed charges,,,,,,,,,8.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9.91,91,,percent of total billed charges,,,10.35,95,,percent of total billed charges,,,9.04,83,,percent of total billed charges,,,9.04,83,,percent of total billed charges,,,,,,,,,,,,,,,9.04,83,,percent of total billed charges,,,10.35,95,,percent of total billed charges,,,9.8,90,,percent of total billed charges,,,9.8,90,,percent of total billed charges,,,8.93,82,,percent of total billed charges,,,9.8,90,,percent of total billed charges,,,9.26,85,,percent of total billed charges,,8.21,10.35,
DEPUY FEMORAL ROTATING HINGE,30182166,CDM,,,278,RC,inpatient,,52982.02,52982.02,,44981.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39948.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45034.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46624.18,88,,percent of total billed charges,,,,,,,,,40478.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,48213.64,91,,percent of total billed charges,,,50332.92,95,,percent of total billed charges,,,43975.08,83,,percent of total billed charges,,,43975.08,83,,percent of total billed charges,,,,,,,,,,,,,,,43975.08,83,,percent of total billed charges,,,50332.92,95,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,43445.26,82,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,45034.72,85,,percent of total billed charges,,39948.44,50332.92,
DEPUY TIBIAL INSERT HINGE 12MM SM,30182167,CDM,,,278,RC,inpatient,,33343.12,33343.12,,28308.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25140.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28341.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29341.95,88,,percent of total billed charges,,,,,,,,,25474.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30342.24,91,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,,,,,,,,,,,,,27674.79,83,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,27341.36,82,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,25140.71,31675.96,
DEPUY POROUS FEMORAL SLEEVE 216,30182168,CDM,,,278,RC,inpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13618.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15352.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,13618.85,17159.03,
DEPUY STEM FLUTED UNIV 115 X 14,30182169,CDM,,,278,RC,inpatient,,12911.21,12911.21,,10961.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9735.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10974.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11361.86,88,,percent of total billed charges,,,,,,,,,9864.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11749.2,91,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,,,,,,,,,,,,,10716.3,83,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10587.19,82,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,9735.05,12265.65,
DEPUY GUIDEWIRE BALL NOSE 3.0 X 80CM,30182170,CDM,,,278,RC,inpatient,,740.18,740.18,,628.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,558.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,629.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,651.36,88,,percent of total billed charges,,,,,,,,,565.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,673.56,91,,percent of total billed charges,,,703.17,95,,percent of total billed charges,,,614.35,83,,percent of total billed charges,,,614.35,83,,percent of total billed charges,,,,,,,,,,,,,,,614.35,83,,percent of total billed charges,,,703.17,95,,percent of total billed charges,,,666.16,90,,percent of total billed charges,,,666.16,90,,percent of total billed charges,,,606.95,82,,percent of total billed charges,,,666.16,90,,percent of total billed charges,,,629.15,85,,percent of total billed charges,,558.1,703.17,
DEPUY PINNACLE CUP W/GRIPTION 60MM,30182171,CDM,,,278,RC,inpatient,,31783.05,31783.05,,26983.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23964.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27015.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27969.08,88,,percent of total billed charges,,,,,,,,,24282.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28922.58,91,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,,,,,,,,,,,,,26379.93,83,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,26062.1,82,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,27015.59,85,,percent of total billed charges,,23964.42,30193.9,
DEPUY SCREW BONE 55 X 5.0,30182172,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
DEPUY SCREW BONE TAPER 40 X 5.0,30182173,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
DEPUY LINER CONSTRAINED +4 32 X 54,30182174,CDM,,,278,RC,inpatient,,36635.17,36635.17,,31103.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27622.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31139.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32238.95,88,,percent of total billed charges,,,,,,,,,27989.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33338,91,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,,,,,,,,,,,,,30407.19,83,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,30040.84,82,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,27622.92,34803.41,
S&N ENDO BICEPTOR KIT 7 X 25,30182175,CDM,,,270,RC,inpatient,,2579.92,2579.92,,2190.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1945.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2192.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2270.33,88,,percent of total billed charges,,,,,,,,,1971.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2347.73,91,,percent of total billed charges,,,2450.92,95,,percent of total billed charges,,,2141.33,83,,percent of total billed charges,,,2141.33,83,,percent of total billed charges,,,,,,,,,,,,,,,2141.33,83,,percent of total billed charges,,,2450.92,95,,percent of total billed charges,,,2321.93,90,,percent of total billed charges,,,2321.93,90,,percent of total billed charges,,,2115.53,82,,percent of total billed charges,,,2321.93,90,,percent of total billed charges,,,2192.93,85,,percent of total billed charges,,1945.26,2450.92,
LEEP CAUTERY PENCIL,30182176,CDM,,,270,RC,inpatient,,49.56,49.56,,42.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,43.61,88,,percent of total billed charges,,,,,,,,,37.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.1,91,,percent of total billed charges,,,47.08,95,,percent of total billed charges,,,41.13,83,,percent of total billed charges,,,41.13,83,,percent of total billed charges,,,,,,,,,,,,,,,41.13,83,,percent of total billed charges,,,47.08,95,,percent of total billed charges,,,44.6,90,,percent of total billed charges,,,44.6,90,,percent of total billed charges,,,40.64,82,,percent of total billed charges,,,44.6,90,,percent of total billed charges,,,42.13,85,,percent of total billed charges,,37.37,47.08,
ESOPHYX KIT W/O CARTRIDGE SHORT,30182178,CDM,,,270,RC,inpatient,,23237.5,23237.5,,19728.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17521.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19751.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20449,88,,percent of total billed charges,,,,,,,,,17753.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21146.13,91,,percent of total billed charges,,,22075.63,95,,percent of total billed charges,,,19287.13,83,,percent of total billed charges,,,19287.13,83,,percent of total billed charges,,,,,,,,,,,,,,,19287.13,83,,percent of total billed charges,,,22075.63,95,,percent of total billed charges,,,20913.75,90,,percent of total billed charges,,,20913.75,90,,percent of total billed charges,,,19054.75,82,,percent of total billed charges,,,20913.75,90,,percent of total billed charges,,,19751.88,85,,percent of total billed charges,,17521.08,22075.63,
ESOPHYX CARTRIDGE FASTENERS 6.5MM,30182179,CDM,,,270,RC,inpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2082.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2348.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,2082.93,2624.38,
*ESOPHYX CARTRIDGE FASTENERS 7.5MM,30182180,CDM,,,270,RC,inpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2082.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2348.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,2082.93,2624.38,
DEPUY STEM BOWED SZ13.5,30182182,CDM,,,278,RC,inpatient,,66522.3,66522.3,,56477.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50157.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56543.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58539.62,88,,percent of total billed charges,,,,,,,,,50823.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60535.29,91,,percent of total billed charges,,,63196.19,95,,percent of total billed charges,,,55213.51,83,,percent of total billed charges,,,55213.51,83,,percent of total billed charges,,,,,,,,,,,,,,,55213.51,83,,percent of total billed charges,,,63196.19,95,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,54548.29,82,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,56543.96,85,,percent of total billed charges,,50157.81,63196.19,
CELL SAVER SERVICE,30182185,CDM,,,270,RC,inpatient,,4446,4446,,3774.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3352.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3779.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3912.48,88,,percent of total billed charges,,,,,,,,,3396.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4045.86,91,,percent of total billed charges,,,4223.7,95,,percent of total billed charges,,,3690.18,83,,percent of total billed charges,,,3690.18,83,,percent of total billed charges,,,,,,,,,,,,,,,3690.18,83,,percent of total billed charges,,,4223.7,95,,percent of total billed charges,,,4001.4,90,,percent of total billed charges,,,4001.4,90,,percent of total billed charges,,,3645.72,82,,percent of total billed charges,,,4001.4,90,,percent of total billed charges,,,3779.1,85,,percent of total billed charges,,3352.28,4223.7,
GYRUS HALO CUTTING FORCEP,30182193,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
GYRUS PLASMA SORD PKS,30182194,CDM,,,270,RC,inpatient,,4784,4784,,4061.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3607.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4066.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4209.92,88,,percent of total billed charges,,,,,,,,,3654.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4353.44,91,,percent of total billed charges,,,4544.8,95,,percent of total billed charges,,,3970.72,83,,percent of total billed charges,,,3970.72,83,,percent of total billed charges,,,,,,,,,,,,,,,3970.72,83,,percent of total billed charges,,,4544.8,95,,percent of total billed charges,,,4305.6,90,,percent of total billed charges,,,4305.6,90,,percent of total billed charges,,,3922.88,82,,percent of total billed charges,,,4305.6,90,,percent of total billed charges,,,4066.4,85,,percent of total billed charges,,3607.14,4544.8,
DEPUY DISTAL FEM COMPONENT XSM RT,30182195,CDM,,,278,RC,inpatient,,97092.39,97092.39,,82431.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,73207.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,82528.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,85441.3,88,,percent of total billed charges,,,,,,,,,74178.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,88354.07,91,,percent of total billed charges,,,92237.77,95,,percent of total billed charges,,,80586.68,83,,percent of total billed charges,,,80586.68,83,,percent of total billed charges,,,,,,,,,,,,,,,80586.68,83,,percent of total billed charges,,,92237.77,95,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,79615.76,82,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,82528.53,85,,percent of total billed charges,,73207.66,92237.77,
DEPUY SEGMENTAL COMPONENT 25MM,30182196,CDM,,,278,RC,inpatient,,18773.5,18773.5,,15938.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14155.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15957.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16520.68,88,,percent of total billed charges,,,,,,,,,14342.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17083.89,91,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,,,,,,,,,,,,,15582.01,83,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15394.27,82,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,14155.22,17834.83,
DEPUY STEM FEMORAL POROUS 16.5 X 150,30182197,CDM,,,278,RC,inpatient,,48015.11,48015.11,,40764.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36203.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40812.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42253.3,88,,percent of total billed charges,,,,,,,,,36683.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43693.75,91,,percent of total billed charges,,,45614.35,95,,percent of total billed charges,,,39852.54,83,,percent of total billed charges,,,39852.54,83,,percent of total billed charges,,,,,,,,,,,,,,,39852.54,83,,percent of total billed charges,,,45614.35,95,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,39372.39,82,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,40812.84,85,,percent of total billed charges,,36203.39,45614.35,
DEPUY INSERT HINGE 16MM XSM,30182198,CDM,,,278,RC,inpatient,,33343.12,33343.12,,28308.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25140.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28341.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29341.95,88,,percent of total billed charges,,,,,,,,,25474.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30342.24,91,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,,,,,,,,,,,,,27674.79,83,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,27341.36,82,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,25140.71,31675.96,
DEPUY STEM CORAIL STD SZ9,30182200,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY INSERT RP 12.5MM SZ3,30182201,CDM,,,278,RC,inpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9811.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11060.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,9811.36,12361.8,
CARPEL TUNNEL RELEASE BLADE,30182203,CDM,,,270,RC,inpatient,,1352,1352,,1147.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1019.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1149.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1189.76,88,,percent of total billed charges,,,,,,,,,1032.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1230.32,91,,percent of total billed charges,,,1284.4,95,,percent of total billed charges,,,1122.16,83,,percent of total billed charges,,,1122.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1122.16,83,,percent of total billed charges,,,1284.4,95,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1108.64,82,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1149.2,85,,percent of total billed charges,,1019.41,1284.4,
DEPUY GUIDE PIN 3.2MM,30182216,CDM,,,278,RC,inpatient,,270,270,,229.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,203.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,229.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,237.6,88,,percent of total billed charges,,,,,,,,,206.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,245.7,91,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,,,,,,,,,,,,,224.1,83,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,243,90,,percent of total billed charges,,,243,90,,percent of total billed charges,,,221.4,82,,percent of total billed charges,,,243,90,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,203.58,256.5,
DEPUY SCREW CANNULATED 80 X 6.5,30182217,CDM,,,278,RC,inpatient,,2046.33,2046.33,,1737.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1542.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1739.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1800.77,88,,percent of total billed charges,,,,,,,,,1563.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1862.16,91,,percent of total billed charges,,,1944.01,95,,percent of total billed charges,,,1698.45,83,,percent of total billed charges,,,1698.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1698.45,83,,percent of total billed charges,,,1944.01,95,,percent of total billed charges,,,1841.7,90,,percent of total billed charges,,,1841.7,90,,percent of total billed charges,,,1677.99,82,,percent of total billed charges,,,1841.7,90,,percent of total billed charges,,,1739.38,85,,percent of total billed charges,,1542.93,1944.01,
DEPUY SCREW CANNULATED 85 X 6.5,30182218,CDM,,,278,RC,inpatient,,2046.33,2046.33,,1737.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1542.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1739.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1800.77,88,,percent of total billed charges,,,,,,,,,1563.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1862.16,91,,percent of total billed charges,,,1944.01,95,,percent of total billed charges,,,1698.45,83,,percent of total billed charges,,,1698.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1698.45,83,,percent of total billed charges,,,1944.01,95,,percent of total billed charges,,,1841.7,90,,percent of total billed charges,,,1841.7,90,,percent of total billed charges,,,1677.99,82,,percent of total billed charges,,,1841.7,90,,percent of total billed charges,,,1739.38,85,,percent of total billed charges,,1542.93,1944.01,
DEPUY DRILL BIT CANNULATED 5.0,30182219,CDM,,,278,RC,inpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1519.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1712.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,1519.31,1914.25,
COLOPLAST INFRAPUBIC CYLINDER SET W/OTR,30182221,CDM,,,278,RC,inpatient,,44616,44616,,37878.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33640.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37923.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39262.08,88,,percent of total billed charges,,,,,,,,,34086.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40600.56,91,,percent of total billed charges,,,42385.2,95,,percent of total billed charges,,,37031.28,83,,percent of total billed charges,,,37031.28,83,,percent of total billed charges,,,,,,,,,,,,,,,37031.28,83,,percent of total billed charges,,,42385.2,95,,percent of total billed charges,,,40154.4,90,,percent of total billed charges,,,40154.4,90,,percent of total billed charges,,,36585.12,82,,percent of total billed charges,,,40154.4,90,,percent of total billed charges,,,37923.6,85,,percent of total billed charges,,33640.46,42385.2,
SYNTHES SCREW CANCEL 4.0X26MM,30182222,CDM,,,278,RC,inpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,168.24,211.97,
SYNTHES SCREW CORTEX TAP 3.5MM,30182223,CDM,,,278,RC,inpatient,,2077.4,2077.4,,1763.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1566.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1765.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1828.11,88,,percent of total billed charges,,,,,,,,,1587.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1890.43,91,,percent of total billed charges,,,1973.53,95,,percent of total billed charges,,,1724.24,83,,percent of total billed charges,,,1724.24,83,,percent of total billed charges,,,,,,,,,,,,,,,1724.24,83,,percent of total billed charges,,,1973.53,95,,percent of total billed charges,,,1869.66,90,,percent of total billed charges,,,1869.66,90,,percent of total billed charges,,,1703.47,82,,percent of total billed charges,,,1869.66,90,,percent of total billed charges,,,1765.79,85,,percent of total billed charges,,1566.36,1973.53,
S&N ENDO TWINFIX 4.5 W/2 UB,30182224,CDM,,,270,RC,inpatient,,1807,1807,,1534.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1362.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1535.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1590.16,88,,percent of total billed charges,,,,,,,,,1380.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1644.37,91,,percent of total billed charges,,,1716.65,95,,percent of total billed charges,,,1499.81,83,,percent of total billed charges,,,1499.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1499.81,83,,percent of total billed charges,,,1716.65,95,,percent of total billed charges,,,1626.3,90,,percent of total billed charges,,,1626.3,90,,percent of total billed charges,,,1481.74,82,,percent of total billed charges,,,1626.3,90,,percent of total billed charges,,,1535.95,85,,percent of total billed charges,,1362.48,1716.65,
DEPUY FEMUR SIGMA PS LT SZ2.5,30182230,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
DEPUY INSERT STABILIZED 10MM SZ2.5,30182231,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY PINNACLE CUP W/GRIPTION 58MM,30182232,CDM,,,278,RC,inpatient,,31783.05,31783.05,,26983.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23964.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27015.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27969.08,88,,percent of total billed charges,,,,,,,,,24282.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28922.58,91,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,,,,,,,,,,,,,26379.93,83,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,26062.1,82,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,27015.59,85,,percent of total billed charges,,23964.42,30193.9,
DEPUY MBT STEP WEDGE 5MM,30182233,CDM,,,278,RC,inpatient,,15761.79,15761.79,,13381.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11884.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13397.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13870.38,88,,percent of total billed charges,,,,,,,,,12042.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14343.23,91,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,,,,,,,,,,,,,13082.29,83,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,12924.67,82,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,13397.52,85,,percent of total billed charges,,11884.39,14973.7,
DEPUY STEM FLUTTED UNIV 115 X 10,30182234,CDM,,,278,RC,inpatient,,12911.21,12911.21,,10961.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9735.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10974.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11361.86,88,,percent of total billed charges,,,,,,,,,9864.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11749.2,91,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,,,,,,,,,,,,,10716.3,83,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10587.19,82,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,9735.05,12265.65,
DEPUY INSERT RP 15MM SZ2,30182235,CDM,,,278,RC,inpatient,,11793.8,11793.8,,10012.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8892.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10024.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10378.54,88,,percent of total billed charges,,,,,,,,,9010.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10732.36,91,,percent of total billed charges,,,11204.11,95,,percent of total billed charges,,,9788.85,83,,percent of total billed charges,,,9788.85,83,,percent of total billed charges,,,,,,,,,,,,,,,9788.85,83,,percent of total billed charges,,,11204.11,95,,percent of total billed charges,,,10614.42,90,,percent of total billed charges,,,10614.42,90,,percent of total billed charges,,,9670.92,82,,percent of total billed charges,,,10614.42,90,,percent of total billed charges,,,10024.73,85,,percent of total billed charges,,8892.53,11204.11,
SYNTHES SCREW CANNUL 16MM 6.5X70MM,30182242,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES PLATE LCP HOOK 3-HOLE 3.5MM,30182246,CDM,,,278,RC,inpatient,,6657.63,6657.63,,5652.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5019.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5658.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5858.71,88,,percent of total billed charges,,,,,,,,,5086.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6058.44,91,,percent of total billed charges,,,6324.75,95,,percent of total billed charges,,,5525.83,83,,percent of total billed charges,,,5525.83,83,,percent of total billed charges,,,,,,,,,,,,,,,5525.83,83,,percent of total billed charges,,,6324.75,95,,percent of total billed charges,,,5991.87,90,,percent of total billed charges,,,5991.87,90,,percent of total billed charges,,,5459.26,82,,percent of total billed charges,,,5991.87,90,,percent of total billed charges,,,5658.99,85,,percent of total billed charges,,5019.85,6324.75,
BIOMET KNEE OSTEOTOME 6.5MM,30182248,CDM,,,270,RC,inpatient,,4777.5,4777.5,,4056.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3602.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4060.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4204.2,88,,percent of total billed charges,,,,,,,,,3650.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4347.53,91,,percent of total billed charges,,,4538.63,95,,percent of total billed charges,,,3965.33,83,,percent of total billed charges,,,3965.33,83,,percent of total billed charges,,,,,,,,,,,,,,,3965.33,83,,percent of total billed charges,,,4538.63,95,,percent of total billed charges,,,4299.75,90,,percent of total billed charges,,,4299.75,90,,percent of total billed charges,,,3917.55,82,,percent of total billed charges,,,4299.75,90,,percent of total billed charges,,,4060.88,85,,percent of total billed charges,,3602.24,4538.63,
S&N ENDO PROBE 90-DEG WHIRLWIND,30182249,CDM,,,270,RC,inpatient,,1324.05,1324.05,,1124.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,998.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1125.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1165.16,88,,percent of total billed charges,,,,,,,,,1011.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1204.89,91,,percent of total billed charges,,,1257.85,95,,percent of total billed charges,,,1098.96,83,,percent of total billed charges,,,1098.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1098.96,83,,percent of total billed charges,,,1257.85,95,,percent of total billed charges,,,1191.65,90,,percent of total billed charges,,,1191.65,90,,percent of total billed charges,,,1085.72,82,,percent of total billed charges,,,1191.65,90,,percent of total billed charges,,,1125.44,85,,percent of total billed charges,,998.33,1257.85,
DEPUY STEM FEMORAL POROUS 18.5 X 200,30182250,CDM,,,278,RC,inpatient,,48015.11,48015.11,,40764.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36203.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40812.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42253.3,88,,percent of total billed charges,,,,,,,,,36683.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43693.75,91,,percent of total billed charges,,,45614.35,95,,percent of total billed charges,,,39852.54,83,,percent of total billed charges,,,39852.54,83,,percent of total billed charges,,,,,,,,,,,,,,,39852.54,83,,percent of total billed charges,,,45614.35,95,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,39372.39,82,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,40812.84,85,,percent of total billed charges,,36203.39,45614.35,
DEPUY SEGMENTAL COMPONENT 40MM,30182251,CDM,,,278,RC,inpatient,,18773.5,18773.5,,15938.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14155.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15957.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16520.68,88,,percent of total billed charges,,,,,,,,,14342.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17083.89,91,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,,,,,,,,,,,,,15582.01,83,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15394.27,82,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,14155.22,17834.83,
DEPUY FEMUR DISTAL XSM LT,30182252,CDM,,,278,RC,inpatient,,97092.39,97092.39,,82431.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,73207.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,82528.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,85441.3,88,,percent of total billed charges,,,,,,,,,74178.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,88354.07,91,,percent of total billed charges,,,92237.77,95,,percent of total billed charges,,,80586.68,83,,percent of total billed charges,,,80586.68,83,,percent of total billed charges,,,,,,,,,,,,,,,80586.68,83,,percent of total billed charges,,,92237.77,95,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,79615.76,82,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,82528.53,85,,percent of total billed charges,,73207.66,92237.77,
DEPUY INSERT TIBIAL HINGE 12MM XSM,30182253,CDM,,,278,RC,inpatient,,24320.34,24320.34,,20647.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18337.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20672.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21401.9,88,,percent of total billed charges,,,,,,,,,18580.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22131.51,91,,percent of total billed charges,,,23104.32,95,,percent of total billed charges,,,20185.88,83,,percent of total billed charges,,,20185.88,83,,percent of total billed charges,,,,,,,,,,,,,,,20185.88,83,,percent of total billed charges,,,23104.32,95,,percent of total billed charges,,,21888.31,90,,percent of total billed charges,,,21888.31,90,,percent of total billed charges,,,19942.68,82,,percent of total billed charges,,,21888.31,90,,percent of total billed charges,,,20672.29,85,,percent of total billed charges,,18337.54,23104.32,
BIOMET ULTRADRIVE 6MM,30182255,CDM,,,270,RC,inpatient,,4946.5,4946.5,,4199.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3729.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4204.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4352.92,88,,percent of total billed charges,,,,,,,,,3779.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4501.32,91,,percent of total billed charges,,,4699.18,95,,percent of total billed charges,,,4105.6,83,,percent of total billed charges,,,4105.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4105.6,83,,percent of total billed charges,,,4699.18,95,,percent of total billed charges,,,4451.85,90,,percent of total billed charges,,,4451.85,90,,percent of total billed charges,,,4056.13,82,,percent of total billed charges,,,4451.85,90,,percent of total billed charges,,,4204.53,85,,percent of total billed charges,,3729.66,4699.18,
BIOMET ULTRADRIVE 120MM,30182256,CDM,,,270,RC,inpatient,,4524,4524,,3840.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3411.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3845.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3981.12,88,,percent of total billed charges,,,,,,,,,3456.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4116.84,91,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,,,,,,,,,,,,,3754.92,83,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3709.68,82,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3845.4,85,,percent of total billed charges,,3411.1,4297.8,
EYE LENS IMPLANT - TORIC,30182257,CDM,,,278,RC,inpatient,,3217.5,3217.5,,2731.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2426,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2734.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2831.4,88,,percent of total billed charges,,,,,,,,,2458.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2927.93,91,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2670.53,83,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2638.35,82,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,2426,3056.63,
BIOPSY FORCEP 230CM ALLIGATOR W/SPKIE,30182264,CDM,,,270,RC,inpatient,,37.14,37.14,,31.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.68,88,,percent of total billed charges,,,,,,,,,28.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.8,91,,percent of total billed charges,,,35.28,95,,percent of total billed charges,,,30.83,83,,percent of total billed charges,,,30.83,83,,percent of total billed charges,,,,,,,,,,,,,,,30.83,83,,percent of total billed charges,,,35.28,95,,percent of total billed charges,,,33.43,90,,percent of total billed charges,,,33.43,90,,percent of total billed charges,,,30.45,82,,percent of total billed charges,,,33.43,90,,percent of total billed charges,,,31.57,85,,percent of total billed charges,,28,35.28,
BIOPSY FORCEP LARGE CAPACITY ALLIGATOR W,30182265,CDM,,,270,RC,inpatient,,57.77,57.77,,49.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.84,88,,percent of total billed charges,,,,,,,,,44.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52.57,91,,percent of total billed charges,,,54.88,95,,percent of total billed charges,,,47.95,83,,percent of total billed charges,,,47.95,83,,percent of total billed charges,,,,,,,,,,,,,,,47.95,83,,percent of total billed charges,,,54.88,95,,percent of total billed charges,,,51.99,90,,percent of total billed charges,,,51.99,90,,percent of total billed charges,,,47.37,82,,percent of total billed charges,,,51.99,90,,percent of total billed charges,,,49.1,85,,percent of total billed charges,,43.56,54.88,
PROCERVA HTA ABLATION KIT,30182273,CDM,,,270,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
DRESSING ISLAND 4X10,30182279,CDM,,,270,RC,inpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,169.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,191.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,169.65,213.75,
DRESSING ISLAND 4X12,30182280,CDM,,,270,RC,inpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,197.93,249.38,
DEPUY PINNACLE CUP MULTIHOLE 50MM,30182281,CDM,,,278,RC,inpatient,,26741.78,26741.78,,22703.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20163.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22730.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23532.77,88,,percent of total billed charges,,,,,,,,,20430.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24335.02,91,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,,,,,,,,,,,,,22195.68,83,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,21928.26,82,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,20163.3,25404.69,
DEPUY LINER CONSTRAINED +4 28 X 50,30182282,CDM,,,278,RC,inpatient,,36635.17,36635.17,,31103.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27622.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31139.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32238.95,88,,percent of total billed charges,,,,,,,,,27989.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33338,91,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,,,,,,,,,,,,,30407.19,83,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,30040.84,82,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,27622.92,34803.41,
DEPUY FEMUR NEUTRAL STD PROXIMAL,30182283,CDM,,,278,RC,inpatient,,56410.06,56410.06,,47892.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42533.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47948.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49640.85,88,,percent of total billed charges,,,,,,,,,43097.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51333.15,91,,percent of total billed charges,,,53589.56,95,,percent of total billed charges,,,46820.35,83,,percent of total billed charges,,,46820.35,83,,percent of total billed charges,,,,,,,,,,,,,,,46820.35,83,,percent of total billed charges,,,53589.56,95,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,46256.25,82,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,47948.55,85,,percent of total billed charges,,42533.19,53589.56,
DEPUY STEM FEMORAL POROUS 14.5 X 150,30182284,CDM,,,278,RC,inpatient,,48015.11,48015.11,,40764.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36203.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40812.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42253.3,88,,percent of total billed charges,,,,,,,,,36683.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43693.75,91,,percent of total billed charges,,,45614.35,95,,percent of total billed charges,,,39852.54,83,,percent of total billed charges,,,39852.54,83,,percent of total billed charges,,,,,,,,,,,,,,,39852.54,83,,percent of total billed charges,,,45614.35,95,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,39372.39,82,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,40812.84,85,,percent of total billed charges,,36203.39,45614.35,
DEPUY PINNACLE CUP MULTIHOLE 54MM,30182285,CDM,,,278,RC,inpatient,,26741.78,26741.78,,22703.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20163.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22730.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23532.77,88,,percent of total billed charges,,,,,,,,,20430.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24335.02,91,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,,,,,,,,,,,,,22195.68,83,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,21928.26,82,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,20163.3,25404.69,
DEPUY FEMORAL HEAD 32MM +3,30182286,CDM,,,278,RC,inpatient,,6061.9,6061.9,,5146.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4570.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5152.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5334.47,88,,percent of total billed charges,,,,,,,,,4631.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5516.33,91,,percent of total billed charges,,,5758.81,95,,percent of total billed charges,,,5031.38,83,,percent of total billed charges,,,5031.38,83,,percent of total billed charges,,,,,,,,,,,,,,,5031.38,83,,percent of total billed charges,,,5758.81,95,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,4970.76,82,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,5152.62,85,,percent of total billed charges,,4570.67,5758.81,
S&N ENDO BICEPTOR BIOSURE 7 X 15,30182287,CDM,,,278,RC,inpatient,,1584.38,1584.38,,1345.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1194.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1346.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1394.25,88,,percent of total billed charges,,,,,,,,,1210.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1441.79,91,,percent of total billed charges,,,1505.16,95,,percent of total billed charges,,,1315.04,83,,percent of total billed charges,,,1315.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1315.04,83,,percent of total billed charges,,,1505.16,95,,percent of total billed charges,,,1425.94,90,,percent of total billed charges,,,1425.94,90,,percent of total billed charges,,,1299.19,82,,percent of total billed charges,,,1425.94,90,,percent of total billed charges,,,1346.72,85,,percent of total billed charges,,1194.62,1505.16,
BONE-TENDON-BONE PATELLA 40CM W/ BONE,30182291,CDM,,,278,RC,inpatient,,11700,11700,,9933.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8821.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9945,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10296,88,,percent of total billed charges,,,,,,,,,8938.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10647,91,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,,,,,,,,,,,,,9711,83,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9594,82,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9945,85,,percent of total billed charges,,8821.8,11115,
S&N ENDO SHOULDER SUSPENSION KIT,30182292,CDM,,,270,RC,inpatient,,599.34,599.34,,508.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,451.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,509.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,527.42,88,,percent of total billed charges,,,,,,,,,457.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,545.4,91,,percent of total billed charges,,,569.37,95,,percent of total billed charges,,,497.45,83,,percent of total billed charges,,,497.45,83,,percent of total billed charges,,,,,,,,,,,,,,,497.45,83,,percent of total billed charges,,,569.37,95,,percent of total billed charges,,,539.41,90,,percent of total billed charges,,,539.41,90,,percent of total billed charges,,,491.46,82,,percent of total billed charges,,,539.41,90,,percent of total billed charges,,,509.44,85,,percent of total billed charges,,451.9,569.37,
RTI FEMORAL STRUT FRESH FROZEN 6,30182297,CDM,,,278,RC,inpatient,,12584,12584,,10683.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9488.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10696.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11073.92,88,,percent of total billed charges,,,,,,,,,9614.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11451.44,91,,percent of total billed charges,,,11954.8,95,,percent of total billed charges,,,10444.72,83,,percent of total billed charges,,,10444.72,83,,percent of total billed charges,,,,,,,,,,,,,,,10444.72,83,,percent of total billed charges,,,11954.8,95,,percent of total billed charges,,,11325.6,90,,percent of total billed charges,,,11325.6,90,,percent of total billed charges,,,10318.88,82,,percent of total billed charges,,,11325.6,90,,percent of total billed charges,,,10696.4,85,,percent of total billed charges,,9488.34,11954.8,
S&N ENDO BUTTON CL ULTRA 1.2,30182298,CDM,,,270,RC,inpatient,,2383.1,2383.1,,2023.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1796.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2025.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2097.13,88,,percent of total billed charges,,,,,,,,,1820.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2168.62,91,,percent of total billed charges,,,2263.95,95,,percent of total billed charges,,,1977.97,83,,percent of total billed charges,,,1977.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1977.97,83,,percent of total billed charges,,,2263.95,95,,percent of total billed charges,,,2144.79,90,,percent of total billed charges,,,2144.79,90,,percent of total billed charges,,,1954.14,82,,percent of total billed charges,,,2144.79,90,,percent of total billed charges,,,2025.64,85,,percent of total billed charges,,1796.86,2263.95,
S&N ENDO SCREW SOFT SILK 8 X 20,30182299,CDM,,,278,RC,inpatient,,1487.85,1487.85,,1263.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1121.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1264.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1309.31,88,,percent of total billed charges,,,,,,,,,1136.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1353.94,91,,percent of total billed charges,,,1413.46,95,,percent of total billed charges,,,1234.92,83,,percent of total billed charges,,,1234.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1234.92,83,,percent of total billed charges,,,1413.46,95,,percent of total billed charges,,,1339.07,90,,percent of total billed charges,,,1339.07,90,,percent of total billed charges,,,1220.04,82,,percent of total billed charges,,,1339.07,90,,percent of total billed charges,,,1264.67,85,,percent of total billed charges,,1121.84,1413.46,
S&N ENDO SCREW SOFT SILK 7 X 20,30182300,CDM,,,278,RC,inpatient,,1417,1417,,1203.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1068.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1204.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1246.96,88,,percent of total billed charges,,,,,,,,,1082.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1289.47,91,,percent of total billed charges,,,1346.15,95,,percent of total billed charges,,,1176.11,83,,percent of total billed charges,,,1176.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1176.11,83,,percent of total billed charges,,,1346.15,95,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1161.94,82,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1204.45,85,,percent of total billed charges,,1068.42,1346.15,
S&N ENDO ACL RENTAL FEE,30182301,CDM,,,270,RC,inpatient,,6467.5,6467.5,,5490.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4876.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5497.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5691.4,88,,percent of total billed charges,,,,,,,,,4941.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5885.43,91,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,,,,,,,,,,,,,5368.03,83,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5303.35,82,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,4876.5,6144.13,
DEPUY NAIL FUSION TTC,30182302,CDM,,,278,RC,inpatient,,16728.92,16728.92,,14202.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12613.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14219.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14721.45,88,,percent of total billed charges,,,,,,,,,12780.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15223.32,91,,percent of total billed charges,,,15892.47,95,,percent of total billed charges,,,13885,83,,percent of total billed charges,,,13885,83,,percent of total billed charges,,,,,,,,,,,,,,,13885,83,,percent of total billed charges,,,15892.47,95,,percent of total billed charges,,,15056.03,90,,percent of total billed charges,,,15056.03,90,,percent of total billed charges,,,13717.71,82,,percent of total billed charges,,,15056.03,90,,percent of total billed charges,,,14219.58,85,,percent of total billed charges,,12613.61,15892.47,
SYNTHES SCREW CANNUL 16MM 6.5X60MM,30182303,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
ALLERGAN SILICONE BREAST IMPLANT 450CC,30182307,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
ALLERGAN NATRELLE SIZER HIGH PROFILE,30182308,CDM,,,270,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
VENTRALEX HERNIA PATCH SM,30182310,CDM,,,278,RC,inpatient,,2718.6,2718.6,,2308.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2049.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2310.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2392.37,88,,percent of total billed charges,,,,,,,,,2077.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2473.93,91,,percent of total billed charges,,,2582.67,95,,percent of total billed charges,,,2256.44,83,,percent of total billed charges,,,2256.44,83,,percent of total billed charges,,,,,,,,,,,,,,,2256.44,83,,percent of total billed charges,,,2582.67,95,,percent of total billed charges,,,2446.74,90,,percent of total billed charges,,,2446.74,90,,percent of total billed charges,,,2229.25,82,,percent of total billed charges,,,2446.74,90,,percent of total billed charges,,,2310.81,85,,percent of total billed charges,,2049.82,2582.67,
DEPUY INSERT RP 17.5MM SZ4,30182311,CDM,,,278,RC,inpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9811.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11060.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,9811.36,12361.8,
ARISTA 5X3GM,30182313,CDM,,,270,RC,inpatient,,1690,1690,,1434.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1274.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1436.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1487.2,88,,percent of total billed charges,,,,,,,,,1291.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1537.9,91,,percent of total billed charges,,,1605.5,95,,percent of total billed charges,,,1402.7,83,,percent of total billed charges,,,1402.7,83,,percent of total billed charges,,,,,,,,,,,,,,,1402.7,83,,percent of total billed charges,,,1605.5,95,,percent of total billed charges,,,1521,90,,percent of total billed charges,,,1521,90,,percent of total billed charges,,,1385.8,82,,percent of total billed charges,,,1521,90,,percent of total billed charges,,,1436.5,85,,percent of total billed charges,,1274.26,1605.5,
ARISTA 5X5GM,30182314,CDM,,,270,RC,inpatient,,2437.5,2437.5,,2069.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1837.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2071.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2145,88,,percent of total billed charges,,,,,,,,,1862.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2218.13,91,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2023.13,83,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,1998.75,82,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,1837.88,2315.63,
ARISTA FLEXITIP APPLICATOR XL,30182315,CDM,,,270,RC,inpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,150.8,190,
S&N ENDO TWINFIX 5.5 W/3 UB,30182316,CDM,,,270,RC,inpatient,,2003.5,2003.5,,1700.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1510.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1702.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1763.08,88,,percent of total billed charges,,,,,,,,,1530.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1823.19,91,,percent of total billed charges,,,1903.33,95,,percent of total billed charges,,,1662.91,83,,percent of total billed charges,,,1662.91,83,,percent of total billed charges,,,,,,,,,,,,,,,1662.91,83,,percent of total billed charges,,,1903.33,95,,percent of total billed charges,,,1803.15,90,,percent of total billed charges,,,1803.15,90,,percent of total billed charges,,,1642.87,82,,percent of total billed charges,,,1803.15,90,,percent of total billed charges,,,1702.98,85,,percent of total billed charges,,1510.64,1903.33,
S&N ENDO TWINFIX 5.5 W/2 UB,30182317,CDM,,,270,RC,inpatient,,1945.13,1945.13,,1651.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1466.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1653.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1711.71,88,,percent of total billed charges,,,,,,,,,1486.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1770.07,91,,percent of total billed charges,,,1847.87,95,,percent of total billed charges,,,1614.46,83,,percent of total billed charges,,,1614.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.46,83,,percent of total billed charges,,,1847.87,95,,percent of total billed charges,,,1750.62,90,,percent of total billed charges,,,1750.62,90,,percent of total billed charges,,,1595.01,82,,percent of total billed charges,,,1750.62,90,,percent of total billed charges,,,1653.36,85,,percent of total billed charges,,1466.63,1847.87,
S&N ENDO BICEPTOR KIT 7 X 15,30182318,CDM,,,270,RC,inpatient,,2657.27,2657.27,,2256.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2003.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2258.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2338.4,88,,percent of total billed charges,,,,,,,,,2030.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2418.12,91,,percent of total billed charges,,,2524.41,95,,percent of total billed charges,,,2205.53,83,,percent of total billed charges,,,2205.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2205.53,83,,percent of total billed charges,,,2524.41,95,,percent of total billed charges,,,2391.54,90,,percent of total billed charges,,,2391.54,90,,percent of total billed charges,,,2178.96,82,,percent of total billed charges,,,2391.54,90,,percent of total billed charges,,,2258.68,85,,percent of total billed charges,,2003.58,2524.41,
S&N ENDO CROCHET HOOK,30182319,CDM,,,270,RC,inpatient,,1795.11,1795.11,,1524.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1353.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1525.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1579.7,88,,percent of total billed charges,,,,,,,,,1371.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1633.55,91,,percent of total billed charges,,,1705.35,95,,percent of total billed charges,,,1489.94,83,,percent of total billed charges,,,1489.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1489.94,83,,percent of total billed charges,,,1705.35,95,,percent of total billed charges,,,1615.6,90,,percent of total billed charges,,,1615.6,90,,percent of total billed charges,,,1471.99,82,,percent of total billed charges,,,1615.6,90,,percent of total billed charges,,,1525.84,85,,percent of total billed charges,,1353.51,1705.35,
VENTRALEX HERNIA PATCH MED,30182320,CDM,,,278,RC,inpatient,,3521.7,3521.7,,2989.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2655.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2993.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3099.1,88,,percent of total billed charges,,,,,,,,,2690.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3204.75,91,,percent of total billed charges,,,3345.62,95,,percent of total billed charges,,,2923.01,83,,percent of total billed charges,,,2923.01,83,,percent of total billed charges,,,,,,,,,,,,,,,2923.01,83,,percent of total billed charges,,,3345.62,95,,percent of total billed charges,,,3169.53,90,,percent of total billed charges,,,3169.53,90,,percent of total billed charges,,,2887.79,82,,percent of total billed charges,,,3169.53,90,,percent of total billed charges,,,2993.45,85,,percent of total billed charges,,2655.36,3345.62,
VENTRALEX HERNIA PATCH LG,30182321,CDM,,,278,RC,inpatient,,4097.6,4097.6,,3478.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3089.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3482.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3605.89,88,,percent of total billed charges,,,,,,,,,3130.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3728.82,91,,percent of total billed charges,,,3892.72,95,,percent of total billed charges,,,3401.01,83,,percent of total billed charges,,,3401.01,83,,percent of total billed charges,,,,,,,,,,,,,,,3401.01,83,,percent of total billed charges,,,3892.72,95,,percent of total billed charges,,,3687.84,90,,percent of total billed charges,,,3687.84,90,,percent of total billed charges,,,3360.03,82,,percent of total billed charges,,,3687.84,90,,percent of total billed charges,,,3482.96,85,,percent of total billed charges,,3089.59,3892.72,
S&N ENDO ANCHOR TAPERED AWL 3.8,30182322,CDM,,,270,RC,inpatient,,372.83,372.83,,316.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,281.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,316.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,328.09,88,,percent of total billed charges,,,,,,,,,284.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,339.28,91,,percent of total billed charges,,,354.19,95,,percent of total billed charges,,,309.45,83,,percent of total billed charges,,,309.45,83,,percent of total billed charges,,,,,,,,,,,,,,,309.45,83,,percent of total billed charges,,,354.19,95,,percent of total billed charges,,,335.55,90,,percent of total billed charges,,,335.55,90,,percent of total billed charges,,,305.72,82,,percent of total billed charges,,,335.55,90,,percent of total billed charges,,,316.91,85,,percent of total billed charges,,281.11,354.19,
S&N ENDO ANCHOR 4.5,30182324,CDM,,,270,RC,inpatient,,2811.9,2811.9,,2387.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2120.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2390.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2474.47,88,,percent of total billed charges,,,,,,,,,2148.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2558.83,91,,percent of total billed charges,,,2671.31,95,,percent of total billed charges,,,2333.88,83,,percent of total billed charges,,,2333.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2333.88,83,,percent of total billed charges,,,2671.31,95,,percent of total billed charges,,,2530.71,90,,percent of total billed charges,,,2530.71,90,,percent of total billed charges,,,2305.76,82,,percent of total billed charges,,,2530.71,90,,percent of total billed charges,,,2390.12,85,,percent of total billed charges,,2120.17,2671.31,
DEPUY HEAD FX MOD CATH 47MM,30182325,CDM,,,278,RC,inpatient,,4693.78,4693.78,,3985.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3539.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3989.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4130.53,88,,percent of total billed charges,,,,,,,,,3586.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4271.34,91,,percent of total billed charges,,,4459.09,95,,percent of total billed charges,,,3895.84,83,,percent of total billed charges,,,3895.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3895.84,83,,percent of total billed charges,,,4459.09,95,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,3848.9,82,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,3989.71,85,,percent of total billed charges,,3539.11,4459.09,
DEPUY SPACER 3 MODULAR CATHEART,30182326,CDM,,,278,RC,inpatient,,1935.57,1935.57,,1643.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1459.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1645.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1703.3,88,,percent of total billed charges,,,,,,,,,1478.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1761.37,91,,percent of total billed charges,,,1838.79,95,,percent of total billed charges,,,1606.52,83,,percent of total billed charges,,,1606.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1606.52,83,,percent of total billed charges,,,1838.79,95,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1587.17,82,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1645.23,85,,percent of total billed charges,,1459.42,1838.79,
MESH VAGINAL UPHOLD,30182328,CDM,,,270,RC,inpatient,,13097.5,13097.5,,11119.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9875.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11132.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11525.8,88,,percent of total billed charges,,,,,,,,,10006.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11918.73,91,,percent of total billed charges,,,12442.63,95,,percent of total billed charges,,,10870.93,83,,percent of total billed charges,,,10870.93,83,,percent of total billed charges,,,,,,,,,,,,,,,10870.93,83,,percent of total billed charges,,,12442.63,95,,percent of total billed charges,,,11787.75,90,,percent of total billed charges,,,11787.75,90,,percent of total billed charges,,,10739.95,82,,percent of total billed charges,,,11787.75,90,,percent of total billed charges,,,11132.88,85,,percent of total billed charges,,9875.52,12442.63,
PINS DISTRACTION 14MM,30182329,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
DEPUY LINER CONSTRAINED +4 36 X 58,30182335,CDM,,,278,RC,inpatient,,24183.97,24183.97,,20532.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18234.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20556.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21281.89,88,,percent of total billed charges,,,,,,,,,18476.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22007.41,91,,percent of total billed charges,,,22974.77,95,,percent of total billed charges,,,20072.7,83,,percent of total billed charges,,,20072.7,83,,percent of total billed charges,,,,,,,,,,,,,,,20072.7,83,,percent of total billed charges,,,22974.77,95,,percent of total billed charges,,,21765.57,90,,percent of total billed charges,,,21765.57,90,,percent of total billed charges,,,19830.86,82,,percent of total billed charges,,,21765.57,90,,percent of total billed charges,,,20556.37,85,,percent of total billed charges,,18234.71,22974.77,
STRYKER OIL CARTRIDGE,30182337,CDM,,,270,RC,inpatient,,176.4,176.4,,149.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,133.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,155.23,88,,percent of total billed charges,,,,,,,,,134.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.52,91,,percent of total billed charges,,,167.58,95,,percent of total billed charges,,,146.41,83,,percent of total billed charges,,,146.41,83,,percent of total billed charges,,,,,,,,,,,,,,,146.41,83,,percent of total billed charges,,,167.58,95,,percent of total billed charges,,,158.76,90,,percent of total billed charges,,,158.76,90,,percent of total billed charges,,,144.65,82,,percent of total billed charges,,,158.76,90,,percent of total billed charges,,,149.94,85,,percent of total billed charges,,133.01,167.58,
STRYKER DIFFUSER,30182338,CDM,,,270,RC,inpatient,,101.44,101.44,,86.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.27,88,,percent of total billed charges,,,,,,,,,77.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.31,91,,percent of total billed charges,,,96.37,95,,percent of total billed charges,,,84.2,83,,percent of total billed charges,,,84.2,83,,percent of total billed charges,,,,,,,,,,,,,,,84.2,83,,percent of total billed charges,,,96.37,95,,percent of total billed charges,,,91.3,90,,percent of total billed charges,,,91.3,90,,percent of total billed charges,,,83.18,82,,percent of total billed charges,,,91.3,90,,percent of total billed charges,,,86.22,85,,percent of total billed charges,,76.49,96.37,
ALLERGAN SILICONE BREAST IMPLANT 500CC,30182355,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
GABRIELLE VEST,30182356,CDM,,,270,RC,inpatient,,299.63,299.63,,254.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,225.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,254.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,263.67,88,,percent of total billed charges,,,,,,,,,228.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,272.66,91,,percent of total billed charges,,,284.65,95,,percent of total billed charges,,,248.69,83,,percent of total billed charges,,,248.69,83,,percent of total billed charges,,,,,,,,,,,,,,,248.69,83,,percent of total billed charges,,,284.65,95,,percent of total billed charges,,,269.67,90,,percent of total billed charges,,,269.67,90,,percent of total billed charges,,,245.7,82,,percent of total billed charges,,,269.67,90,,percent of total billed charges,,,254.69,85,,percent of total billed charges,,225.92,284.65,
DEPUY HIP POROUS ALTRX 36MM,30182358,CDM,,,278,RC,inpatient,,38243.21,38243.21,,32468.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28835.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32506.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33654.02,88,,percent of total billed charges,,,,,,,,,29217.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34801.32,91,,percent of total billed charges,,,36331.05,95,,percent of total billed charges,,,31741.86,83,,percent of total billed charges,,,31741.86,83,,percent of total billed charges,,,,,,,,,,,,,,,31741.86,83,,percent of total billed charges,,,36331.05,95,,percent of total billed charges,,,34418.89,90,,percent of total billed charges,,,34418.89,90,,percent of total billed charges,,,31359.43,82,,percent of total billed charges,,,34418.89,90,,percent of total billed charges,,,32506.73,85,,percent of total billed charges,,28835.38,36331.05,
DEPUY INSERT RP 12.5MM SZ2.5,30182359,CDM,,,278,RC,inpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9811.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11060.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,9811.36,12361.8,
DEPUY FEMUR TC3 LT SZ5,30182360,CDM,,,278,RC,inpatient,,36489.7,36489.7,,30979.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27513.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31016.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32110.94,88,,percent of total billed charges,,,,,,,,,27878.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33205.63,91,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,,,,,,,,,,,,,30286.45,83,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,29921.55,82,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,27513.23,34665.22,
SYNTHES K-WIRE 2.8MM,30182362,CDM,,,278,RC,inpatient,,1037.47,1037.47,,880.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,782.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,881.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,912.97,88,,percent of total billed charges,,,,,,,,,792.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,944.1,91,,percent of total billed charges,,,985.6,95,,percent of total billed charges,,,861.1,83,,percent of total billed charges,,,861.1,83,,percent of total billed charges,,,,,,,,,,,,,,,861.1,83,,percent of total billed charges,,,985.6,95,,percent of total billed charges,,,933.72,90,,percent of total billed charges,,,933.72,90,,percent of total billed charges,,,850.73,82,,percent of total billed charges,,,933.72,90,,percent of total billed charges,,,881.85,85,,percent of total billed charges,,782.25,985.6,
MESH HERNIA REBOUND 2.44  X 3.03,30182363,CDM,,,270,RC,inpatient,,1946.75,1946.75,,1652.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1467.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1654.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1713.14,88,,percent of total billed charges,,,,,,,,,1487.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1771.54,91,,percent of total billed charges,,,1849.41,95,,percent of total billed charges,,,1615.8,83,,percent of total billed charges,,,1615.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1615.8,83,,percent of total billed charges,,,1849.41,95,,percent of total billed charges,,,1752.08,90,,percent of total billed charges,,,1752.08,90,,percent of total billed charges,,,1596.34,82,,percent of total billed charges,,,1752.08,90,,percent of total billed charges,,,1654.74,85,,percent of total billed charges,,1467.85,1849.41,
DEPUY CUSTOM IMPLANT T-F 74MM RT,30182364,CDM,,,278,RC,inpatient,,64675,64675,,54909.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48764.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54973.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56914,88,,percent of total billed charges,,,,,,,,,49411.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58854.25,91,,percent of total billed charges,,,61441.25,95,,percent of total billed charges,,,53680.25,83,,percent of total billed charges,,,53680.25,83,,percent of total billed charges,,,,,,,,,,,,,,,53680.25,83,,percent of total billed charges,,,61441.25,95,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,53033.5,82,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,54973.75,85,,percent of total billed charges,,48764.95,61441.25,
ARTHREX AC GRAFT ROPE,30182365,CDM,,,278,RC,inpatient,,6454.5,6454.5,,5479.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4866.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5486.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5679.96,88,,percent of total billed charges,,,,,,,,,4931.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5873.6,91,,percent of total billed charges,,,6131.78,95,,percent of total billed charges,,,5357.24,83,,percent of total billed charges,,,5357.24,83,,percent of total billed charges,,,,,,,,,,,,,,,5357.24,83,,percent of total billed charges,,,6131.78,95,,percent of total billed charges,,,5809.05,90,,percent of total billed charges,,,5809.05,90,,percent of total billed charges,,,5292.69,82,,percent of total billed charges,,,5809.05,90,,percent of total billed charges,,,5486.33,85,,percent of total billed charges,,4866.69,6131.78,
S&N ENDO ANCHOR OSTEORAPTOR 2.9,30182367,CDM,,,278,RC,inpatient,,1996.35,1996.35,,1694.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1505.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1696.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1756.79,88,,percent of total billed charges,,,,,,,,,1525.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1816.68,91,,percent of total billed charges,,,1896.53,95,,percent of total billed charges,,,1656.97,83,,percent of total billed charges,,,1656.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1656.97,83,,percent of total billed charges,,,1896.53,95,,percent of total billed charges,,,1796.72,90,,percent of total billed charges,,,1796.72,90,,percent of total billed charges,,,1637.01,82,,percent of total billed charges,,,1796.72,90,,percent of total billed charges,,,1696.9,85,,percent of total billed charges,,1505.25,1896.53,
DEPUY KNEE CEMENTED MTB/RP,30182368,CDM,,,278,RC,inpatient,,32605.76,32605.76,,27682.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24584.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27714.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28693.07,88,,percent of total billed charges,,,,,,,,,24910.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29671.24,91,,percent of total billed charges,,,30975.47,95,,percent of total billed charges,,,27062.78,83,,percent of total billed charges,,,27062.78,83,,percent of total billed charges,,,,,,,,,,,,,,,27062.78,83,,percent of total billed charges,,,30975.47,95,,percent of total billed charges,,,29345.18,90,,percent of total billed charges,,,29345.18,90,,percent of total billed charges,,,26736.72,82,,percent of total billed charges,,,29345.18,90,,percent of total billed charges,,,27714.9,85,,percent of total billed charges,,24584.74,30975.47,
DEPUY KNEE CEMENTED W/XKL,30182369,CDM,,,278,RC,inpatient,,27652.89,27652.89,,23477.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20850.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23504.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24334.54,88,,percent of total billed charges,,,,,,,,,21126.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25164.13,91,,percent of total billed charges,,,26270.25,95,,percent of total billed charges,,,22951.9,83,,percent of total billed charges,,,22951.9,83,,percent of total billed charges,,,,,,,,,,,,,,,22951.9,83,,percent of total billed charges,,,26270.25,95,,percent of total billed charges,,,24887.6,90,,percent of total billed charges,,,24887.6,90,,percent of total billed charges,,,22675.37,82,,percent of total billed charges,,,24887.6,90,,percent of total billed charges,,,23504.96,85,,percent of total billed charges,,20850.28,26270.25,
DEPUY HIP POROUS ALTRX 40/44MM,30182376,CDM,,,278,RC,inpatient,,42018.93,42018.93,,35674.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31682.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35716.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36976.66,88,,percent of total billed charges,,,,,,,,,32102.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38237.23,91,,percent of total billed charges,,,39917.98,95,,percent of total billed charges,,,34875.71,83,,percent of total billed charges,,,34875.71,83,,percent of total billed charges,,,,,,,,,,,,,,,34875.71,83,,percent of total billed charges,,,39917.98,95,,percent of total billed charges,,,37817.04,90,,percent of total billed charges,,,37817.04,90,,percent of total billed charges,,,34455.52,82,,percent of total billed charges,,,37817.04,90,,percent of total billed charges,,,35716.09,85,,percent of total billed charges,,31682.27,39917.98,
DRAIN FLUTE 15FR W/TROCAR,30182382,CDM,,,270,RC,inpatient,,194.29,194.29,,164.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,165.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.98,88,,percent of total billed charges,,,,,,,,,148.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.8,91,,percent of total billed charges,,,184.58,95,,percent of total billed charges,,,161.26,83,,percent of total billed charges,,,161.26,83,,percent of total billed charges,,,,,,,,,,,,,,,161.26,83,,percent of total billed charges,,,184.58,95,,percent of total billed charges,,,174.86,90,,percent of total billed charges,,,174.86,90,,percent of total billed charges,,,159.32,82,,percent of total billed charges,,,174.86,90,,percent of total billed charges,,,165.15,85,,percent of total billed charges,,146.49,184.58,
DEPUY DRILL BIT CANNULATED 5.5,30182383,CDM,,,278,RC,inpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1519.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1712.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,1519.31,1914.25,
STRYKER BLADE RECIP HEAVY DUTY LON,30182384,CDM,,,270,RC,inpatient,,283.65,283.65,,240.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,213.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.61,88,,percent of total billed charges,,,,,,,,,216.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.12,91,,percent of total billed charges,,,269.47,95,,percent of total billed charges,,,235.43,83,,percent of total billed charges,,,235.43,83,,percent of total billed charges,,,,,,,,,,,,,,,235.43,83,,percent of total billed charges,,,269.47,95,,percent of total billed charges,,,255.29,90,,percent of total billed charges,,,255.29,90,,percent of total billed charges,,,232.59,82,,percent of total billed charges,,,255.29,90,,percent of total billed charges,,,241.1,85,,percent of total billed charges,,213.87,269.47,
DEPUY HIP POROUS  ALTRX 28/32MM,30182386,CDM,,,278,RC,inpatient,,37986.33,37986.33,,32250.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28641.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32288.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33427.97,88,,percent of total billed charges,,,,,,,,,29021.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34567.56,91,,percent of total billed charges,,,36087.01,95,,percent of total billed charges,,,31528.65,83,,percent of total billed charges,,,31528.65,83,,percent of total billed charges,,,,,,,,,,,,,,,31528.65,83,,percent of total billed charges,,,36087.01,95,,percent of total billed charges,,,34187.7,90,,percent of total billed charges,,,34187.7,90,,percent of total billed charges,,,31148.79,82,,percent of total billed charges,,,34187.7,90,,percent of total billed charges,,,32288.38,85,,percent of total billed charges,,28641.69,36087.01,
DEPUY LINER ALTRX NEUT 32 X 48,30182387,CDM,,,278,RC,inpatient,,10422.17,10422.17,,8848.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7858.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8858.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9171.51,88,,percent of total billed charges,,,,,,,,,7962.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9484.17,91,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,,,,,,,,,,,,,8650.4,83,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8546.18,82,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8858.84,85,,percent of total billed charges,,7858.32,9901.06,
DEPUY INSERT TC3 15MM SZ2.5,30182388,CDM,,,278,RC,inpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17430.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19649.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,17430.21,21961.14,
DRILL TAP 5.0MM & 3.5MM,30182391,CDM,,,270,RC,inpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,316.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,357,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,316.68,399,
PROXIMAL SCREW 5.0MM X 30.0MM,30182394,CDM,,,278,RC,inpatient,,1196,1196,,1015.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,901.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1016.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1052.48,88,,percent of total billed charges,,,,,,,,,913.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1088.36,91,,percent of total billed charges,,,1136.2,95,,percent of total billed charges,,,992.68,83,,percent of total billed charges,,,992.68,83,,percent of total billed charges,,,,,,,,,,,,,,,992.68,83,,percent of total billed charges,,,1136.2,95,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,980.72,82,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,1016.6,85,,percent of total billed charges,,901.78,1136.2,
CAP SCREW ASSEMBLY,30182396,CDM,,,278,RC,inpatient,,1196,1196,,1015.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,901.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1016.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1052.48,88,,percent of total billed charges,,,,,,,,,913.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1088.36,91,,percent of total billed charges,,,1136.2,95,,percent of total billed charges,,,992.68,83,,percent of total billed charges,,,992.68,83,,percent of total billed charges,,,,,,,,,,,,,,,992.68,83,,percent of total billed charges,,,1136.2,95,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,980.72,82,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,1016.6,85,,percent of total billed charges,,901.78,1136.2,
STRYKER HELIOCOIDAL RASP 3.2MM X 18.3MM,30182400,CDM,,,270,RC,inpatient,,911.82,911.82,,774.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,687.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,775.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,802.4,88,,percent of total billed charges,,,,,,,,,696.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,829.76,91,,percent of total billed charges,,,866.23,95,,percent of total billed charges,,,756.81,83,,percent of total billed charges,,,756.81,83,,percent of total billed charges,,,,,,,,,,,,,,,756.81,83,,percent of total billed charges,,,866.23,95,,percent of total billed charges,,,820.64,90,,percent of total billed charges,,,820.64,90,,percent of total billed charges,,,747.69,82,,percent of total billed charges,,,820.64,90,,percent of total billed charges,,,775.05,85,,percent of total billed charges,,687.51,866.23,
DRILL BIT 2.9MM,30182401,CDM,,,270,RC,inpatient,,1365,1365,,1158.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1029.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1160.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1201.2,88,,percent of total billed charges,,,,,,,,,1042.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1242.15,91,,percent of total billed charges,,,1296.75,95,,percent of total billed charges,,,1132.95,83,,percent of total billed charges,,,1132.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1132.95,83,,percent of total billed charges,,,1296.75,95,,percent of total billed charges,,,1228.5,90,,percent of total billed charges,,,1228.5,90,,percent of total billed charges,,,1119.3,82,,percent of total billed charges,,,1228.5,90,,percent of total billed charges,,,1160.25,85,,percent of total billed charges,,1029.21,1296.75,
SCREW DISTRACTION 12MM STERILE,30182402,CDM,,,270,RC,inpatient,,337.5,337.5,,286.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,254.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,286.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,297,88,,percent of total billed charges,,,,,,,,,257.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,307.13,91,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,,,,,,,,,,,,,280.13,83,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,276.75,82,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,254.48,320.63,
SCREW DISTRACTION 14MM STERILE,30182403,CDM,,,270,RC,inpatient,,337.5,337.5,,286.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,254.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,286.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,297,88,,percent of total billed charges,,,,,,,,,257.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,307.13,91,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,,,,,,,,,,,,,280.13,83,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,276.75,82,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,254.48,320.63,
BIOMET ULTRADRIVE 7MM,30182411,CDM,,,270,RC,inpatient,,4524,4524,,3840.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3411.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3845.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3981.12,88,,percent of total billed charges,,,,,,,,,3456.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4116.84,91,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,,,,,,,,,,,,,3754.92,83,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3709.68,82,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3845.4,85,,percent of total billed charges,,3411.1,4297.8,
DEPUY WEDGE STEP 5MM SZ5,30182412,CDM,,,278,RC,inpatient,,11378.45,11378.45,,9660.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8579.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9671.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10013.04,88,,percent of total billed charges,,,,,,,,,8693.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10354.39,91,,percent of total billed charges,,,10809.53,95,,percent of total billed charges,,,9444.11,83,,percent of total billed charges,,,9444.11,83,,percent of total billed charges,,,,,,,,,,,,,,,9444.11,83,,percent of total billed charges,,,10809.53,95,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,9330.33,82,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,9671.68,85,,percent of total billed charges,,8579.35,10809.53,
DEPUY STEM CORAIL SZ18,30182416,CDM,,,278,RC,inpatient,,33799.35,33799.35,,28695.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25484.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28729.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29743.43,88,,percent of total billed charges,,,,,,,,,25822.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30757.41,91,,percent of total billed charges,,,32109.38,95,,percent of total billed charges,,,28053.46,83,,percent of total billed charges,,,28053.46,83,,percent of total billed charges,,,,,,,,,,,,,,,28053.46,83,,percent of total billed charges,,,32109.38,95,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,27715.47,82,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,28729.45,85,,percent of total billed charges,,25484.71,32109.38,
DURASEAL EXACT 5ML,30182423,CDM,,,270,RC,inpatient,,4355,4355,,3697.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3283.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3701.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3832.4,88,,percent of total billed charges,,,,,,,,,3327.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3963.05,91,,percent of total billed charges,,,4137.25,95,,percent of total billed charges,,,3614.65,83,,percent of total billed charges,,,3614.65,83,,percent of total billed charges,,,,,,,,,,,,,,,3614.65,83,,percent of total billed charges,,,4137.25,95,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3571.1,82,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3701.75,85,,percent of total billed charges,,3283.67,4137.25,
DURASEAL EXTENDED TIP APPLICATOR,30182424,CDM,,,270,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
BIOMET ULTRADRIVE 5MM,30182425,CDM,,,270,RC,inpatient,,4524,4524,,3840.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3411.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3845.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3981.12,88,,percent of total billed charges,,,,,,,,,3456.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4116.84,91,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,,,,,,,,,,,,,3754.92,83,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3709.68,82,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3845.4,85,,percent of total billed charges,,3411.1,4297.8,
NEUROMONITOR SERVICE - MIDWEST,30182435,CDM,,,270,RC,inpatient,,5525,5525,,4690.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4165.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4696.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4862,88,,percent of total billed charges,,,,,,,,,4221.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5027.75,91,,percent of total billed charges,,,5248.75,95,,percent of total billed charges,,,4585.75,83,,percent of total billed charges,,,4585.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4585.75,83,,percent of total billed charges,,,5248.75,95,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4530.5,82,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4696.25,85,,percent of total billed charges,,4165.85,5248.75,
SYNTHES DRILL BIT CANNULATED 2.5MM,30182436,CDM,,,270,RC,inpatient,,832.33,832.33,,706.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.45,88,,percent of total billed charges,,,,,,,,,635.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.42,91,,percent of total billed charges,,,790.71,95,,percent of total billed charges,,,690.83,83,,percent of total billed charges,,,690.83,83,,percent of total billed charges,,,,,,,,,,,,,,,690.83,83,,percent of total billed charges,,,790.71,95,,percent of total billed charges,,,749.1,90,,percent of total billed charges,,,749.1,90,,percent of total billed charges,,,682.51,82,,percent of total billed charges,,,749.1,90,,percent of total billed charges,,,707.48,85,,percent of total billed charges,,627.58,790.71,
S&N ENDO ACCUPASS 45-DEG,30182443,CDM,,,278,RC,inpatient,,859.95,859.95,,730.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,648.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,730.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,756.76,88,,percent of total billed charges,,,,,,,,,657,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,782.55,91,,percent of total billed charges,,,816.95,95,,percent of total billed charges,,,713.76,83,,percent of total billed charges,,,713.76,83,,percent of total billed charges,,,,,,,,,,,,,,,713.76,83,,percent of total billed charges,,,816.95,95,,percent of total billed charges,,,773.96,90,,percent of total billed charges,,,773.96,90,,percent of total billed charges,,,705.16,82,,percent of total billed charges,,,773.96,90,,percent of total billed charges,,,730.96,85,,percent of total billed charges,,648.4,816.95,
S&N ENDO ANCHOR OSTEORAPTOR 2.3,30182444,CDM,,,270,RC,inpatient,,2170.35,2170.35,,1842.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1636.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1844.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1909.91,88,,percent of total billed charges,,,,,,,,,1658.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1975.02,91,,percent of total billed charges,,,2061.83,95,,percent of total billed charges,,,1801.39,83,,percent of total billed charges,,,1801.39,83,,percent of total billed charges,,,,,,,,,,,,,,,1801.39,83,,percent of total billed charges,,,2061.83,95,,percent of total billed charges,,,1953.32,90,,percent of total billed charges,,,1953.32,90,,percent of total billed charges,,,1779.69,82,,percent of total billed charges,,,1953.32,90,,percent of total billed charges,,,1844.8,85,,percent of total billed charges,,1636.44,2061.83,
CONMED SUTURE SAVER KIT,30182445,CDM,,,270,RC,inpatient,,267.3,267.3,,226.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,201.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,227.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,235.22,88,,percent of total billed charges,,,,,,,,,204.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,243.24,91,,percent of total billed charges,,,253.94,95,,percent of total billed charges,,,221.86,83,,percent of total billed charges,,,221.86,83,,percent of total billed charges,,,,,,,,,,,,,,,221.86,83,,percent of total billed charges,,,253.94,95,,percent of total billed charges,,,240.57,90,,percent of total billed charges,,,240.57,90,,percent of total billed charges,,,219.19,82,,percent of total billed charges,,,240.57,90,,percent of total billed charges,,,227.21,85,,percent of total billed charges,,201.54,253.94,
SORBAFIX SHOT 30,30182447,CDM,,,270,RC,inpatient,,5037.5,5037.5,,4276.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3798.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4281.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4433,88,,percent of total billed charges,,,,,,,,,3848.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4584.13,91,,percent of total billed charges,,,4785.63,95,,percent of total billed charges,,,4181.13,83,,percent of total billed charges,,,4181.13,83,,percent of total billed charges,,,,,,,,,,,,,,,4181.13,83,,percent of total billed charges,,,4785.63,95,,percent of total billed charges,,,4533.75,90,,percent of total billed charges,,,4533.75,90,,percent of total billed charges,,,4130.75,82,,percent of total billed charges,,,4533.75,90,,percent of total billed charges,,,4281.88,85,,percent of total billed charges,,3798.28,4785.63,
MESH VENTRALIGHT W/ECHO 6X8,30182448,CDM,,,270,RC,inpatient,,11261.25,11261.25,,9560.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8490.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9572.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9909.9,88,,percent of total billed charges,,,,,,,,,8603.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10247.74,91,,percent of total billed charges,,,10698.19,95,,percent of total billed charges,,,9346.84,83,,percent of total billed charges,,,9346.84,83,,percent of total billed charges,,,,,,,,,,,,,,,9346.84,83,,percent of total billed charges,,,10698.19,95,,percent of total billed charges,,,10135.13,90,,percent of total billed charges,,,10135.13,90,,percent of total billed charges,,,9234.23,82,,percent of total billed charges,,,10135.13,90,,percent of total billed charges,,,9572.06,85,,percent of total billed charges,,8490.98,10698.19,
BONE MILL DISPOSABLE - FINE,30182449,CDM,,,270,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
SYNTHES SCREW CORTEX S-T 2.7X16MM,30182451,CDM,,,278,RC,inpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,333.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,375.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,333.15,419.75,
STRYKER BUR ROUND PRECISION 5MM,30182455,CDM,,,270,RC,inpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1715.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1933.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,1715.35,2161.25,
ALLOPATCH HD THICK 5X5 0.8-1.7,30182456,CDM,,,270,RC,inpatient,,9312.68,9312.68,,7906.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7021.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7915.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8195.16,88,,percent of total billed charges,,,,,,,,,7114.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8474.54,91,,percent of total billed charges,,,8847.05,95,,percent of total billed charges,,,7729.52,83,,percent of total billed charges,,,7729.52,83,,percent of total billed charges,,,,,,,,,,,,,,,7729.52,83,,percent of total billed charges,,,8847.05,95,,percent of total billed charges,,,8381.41,90,,percent of total billed charges,,,8381.41,90,,percent of total billed charges,,,7636.4,82,,percent of total billed charges,,,8381.41,90,,percent of total billed charges,,,7915.78,85,,percent of total billed charges,,7021.76,8847.05,
ALLOPATCH HD ULTRA THICK 5X5 1.8-3.9,30182457,CDM,,,270,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
MESH PERFIX PLUG X-LARGE,30182466,CDM,,,270,RC,inpatient,,1121.25,1121.25,,951.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,845.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,953.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,986.7,88,,percent of total billed charges,,,,,,,,,856.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1020.34,91,,percent of total billed charges,,,1065.19,95,,percent of total billed charges,,,930.64,83,,percent of total billed charges,,,930.64,83,,percent of total billed charges,,,,,,,,,,,,,,,930.64,83,,percent of total billed charges,,,1065.19,95,,percent of total billed charges,,,1009.13,90,,percent of total billed charges,,,1009.13,90,,percent of total billed charges,,,919.43,82,,percent of total billed charges,,,1009.13,90,,percent of total billed charges,,,953.06,85,,percent of total billed charges,,845.42,1065.19,
DEPUY INSERT TC3 10MM SZ5,30182477,CDM,,,278,RC,inpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17430.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19649.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,17430.21,21961.14,
DEPUY TIBIAL AUGMENT 5MM SZ2.5,30182478,CDM,,,278,RC,inpatient,,11378.45,11378.45,,9660.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8579.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9671.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10013.04,88,,percent of total billed charges,,,,,,,,,8693.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10354.39,91,,percent of total billed charges,,,10809.53,95,,percent of total billed charges,,,9444.11,83,,percent of total billed charges,,,9444.11,83,,percent of total billed charges,,,,,,,,,,,,,,,9444.11,83,,percent of total billed charges,,,10809.53,95,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,9330.33,82,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,9671.68,85,,percent of total billed charges,,8579.35,10809.53,
DEPUY LINER CONSTRAINED +4 36 X 56,30182480,CDM,,,278,RC,inpatient,,33951.78,33951.78,,28825.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25599.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28859.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29877.57,88,,percent of total billed charges,,,,,,,,,25939.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30896.12,91,,percent of total billed charges,,,32254.19,95,,percent of total billed charges,,,28179.98,83,,percent of total billed charges,,,28179.98,83,,percent of total billed charges,,,,,,,,,,,,,,,28179.98,83,,percent of total billed charges,,,32254.19,95,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,27840.46,82,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,28859.01,85,,percent of total billed charges,,25599.64,32254.19,
APPLIED BLADED OBTURATOR 5MM X 150,30182481,CDM,,,270,RC,inpatient,,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,114.61,144.4,
APPLIED BLADED OBTURATOR 12MM X 150,30182482,CDM,,,270,RC,inpatient,,280.43,280.43,,238.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,211.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,238.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,246.78,88,,percent of total billed charges,,,,,,,,,214.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,255.19,91,,percent of total billed charges,,,266.41,95,,percent of total billed charges,,,232.76,83,,percent of total billed charges,,,232.76,83,,percent of total billed charges,,,,,,,,,,,,,,,232.76,83,,percent of total billed charges,,,266.41,95,,percent of total billed charges,,,252.39,90,,percent of total billed charges,,,252.39,90,,percent of total billed charges,,,229.95,82,,percent of total billed charges,,,252.39,90,,percent of total billed charges,,,238.37,85,,percent of total billed charges,,211.44,266.41,
S&N ENDO CANNULA TWIST 7.0,30182483,CDM,,,270,RC,inpatient,,253.05,253.05,,214.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,222.68,88,,percent of total billed charges,,,,,,,,,193.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,230.28,91,,percent of total billed charges,,,240.4,95,,percent of total billed charges,,,210.03,83,,percent of total billed charges,,,210.03,83,,percent of total billed charges,,,,,,,,,,,,,,,210.03,83,,percent of total billed charges,,,240.4,95,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,207.5,82,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,215.09,85,,percent of total billed charges,,190.8,240.4,
S&N ROD GUIDE BALL TIP 3MM X 1000,30182489,CDM,,,278,RC,inpatient,,1785.55,1785.55,,1515.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1346.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1517.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1571.28,88,,percent of total billed charges,,,,,,,,,1364.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1624.85,91,,percent of total billed charges,,,1696.27,95,,percent of total billed charges,,,1482.01,83,,percent of total billed charges,,,1482.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1482.01,83,,percent of total billed charges,,,1696.27,95,,percent of total billed charges,,,1607,90,,percent of total billed charges,,,1607,90,,percent of total billed charges,,,1464.15,82,,percent of total billed charges,,,1607,90,,percent of total billed charges,,,1517.72,85,,percent of total billed charges,,1346.3,1696.27,
SOLYX SIS SYSTEM,30182505,CDM,,,270,RC,inpatient,,7751.25,7751.25,,6580.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5844.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6588.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6821.1,88,,percent of total billed charges,,,,,,,,,5921.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7053.64,91,,percent of total billed charges,,,7363.69,95,,percent of total billed charges,,,6433.54,83,,percent of total billed charges,,,6433.54,83,,percent of total billed charges,,,,,,,,,,,,,,,6433.54,83,,percent of total billed charges,,,7363.69,95,,percent of total billed charges,,,6976.13,90,,percent of total billed charges,,,6976.13,90,,percent of total billed charges,,,6356.03,82,,percent of total billed charges,,,6976.13,90,,percent of total billed charges,,,6588.56,85,,percent of total billed charges,,5844.44,7363.69,
DEPUY PINNACLE FLANGE CUSTOM RT 66MM,30182506,CDM,,,278,RC,inpatient,,64675,64675,,54909.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48764.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54973.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56914,88,,percent of total billed charges,,,,,,,,,49411.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58854.25,91,,percent of total billed charges,,,61441.25,95,,percent of total billed charges,,,53680.25,83,,percent of total billed charges,,,53680.25,83,,percent of total billed charges,,,,,,,,,,,,,,,53680.25,83,,percent of total billed charges,,,61441.25,95,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,53033.5,82,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,54973.75,85,,percent of total billed charges,,48764.95,61441.25,
STOPCOCK PLUG 3MM,30182509,CDM,,,270,RC,inpatient,,115.6,115.6,,98.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,87.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,98.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,101.73,88,,percent of total billed charges,,,,,,,,,88.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,105.2,91,,percent of total billed charges,,,109.82,95,,percent of total billed charges,,,95.95,83,,percent of total billed charges,,,95.95,83,,percent of total billed charges,,,,,,,,,,,,,,,95.95,83,,percent of total billed charges,,,109.82,95,,percent of total billed charges,,,104.04,90,,percent of total billed charges,,,104.04,90,,percent of total billed charges,,,94.79,82,,percent of total billed charges,,,104.04,90,,percent of total billed charges,,,98.26,85,,percent of total billed charges,,87.16,109.82,
DRAIN FLUTE 7MM FLAT,30182512,CDM,,,270,RC,inpatient,,124.48,124.48,,105.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.54,88,,percent of total billed charges,,,,,,,,,95.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,113.28,91,,percent of total billed charges,,,118.26,95,,percent of total billed charges,,,103.32,83,,percent of total billed charges,,,103.32,83,,percent of total billed charges,,,,,,,,,,,,,,,103.32,83,,percent of total billed charges,,,118.26,95,,percent of total billed charges,,,112.03,90,,percent of total billed charges,,,112.03,90,,percent of total billed charges,,,102.07,82,,percent of total billed charges,,,112.03,90,,percent of total billed charges,,,105.81,85,,percent of total billed charges,,93.86,118.26,
DEPUY DISTAL AUGMENT LT 4MM SZ2.5,30182513,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
ALLERGAN SILICONE BREAST IMPLANT 400CC,30182514,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
DEPUY INSERT TC3 RP 12.5MM SZ3,30182524,CDM,,,278,RC,inpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17430.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19649.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,17430.21,21961.14,
DEPUY INSERT TC3 RP 17.5MM SZ5,30182525,CDM,,,278,RC,inpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17430.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19649.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,17430.21,21961.14,
DEPUY STEM FLUTED UNIV 75 X 24,30182526,CDM,,,278,RC,inpatient,,12911.21,12911.21,,10961.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9735.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10974.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11361.86,88,,percent of total billed charges,,,,,,,,,9864.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11749.2,91,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,,,,,,,,,,,,,10716.3,83,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10587.19,82,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,9735.05,12265.65,
DEPUY DISTAL AUGMENT RT 8MM,30182527,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
DEPUY MBT TRAY SLEEVE 45MM,30182528,CDM,,,270,RC,inpatient,,12860.84,12860.84,,10918.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9697.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10931.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11317.54,88,,percent of total billed charges,,,,,,,,,9825.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11703.36,91,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10674.5,83,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10545.89,82,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10931.71,85,,percent of total billed charges,,9697.07,12217.8,
DRILL TWIST 3.2MM,30182532,CDM,,,270,RC,inpatient,,250.28,250.28,,212.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220.25,88,,percent of total billed charges,,,,,,,,,191.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.75,91,,percent of total billed charges,,,237.77,95,,percent of total billed charges,,,207.73,83,,percent of total billed charges,,,207.73,83,,percent of total billed charges,,,,,,,,,,,,,,,207.73,83,,percent of total billed charges,,,237.77,95,,percent of total billed charges,,,225.25,90,,percent of total billed charges,,,225.25,90,,percent of total billed charges,,,205.23,82,,percent of total billed charges,,,225.25,90,,percent of total billed charges,,,212.74,85,,percent of total billed charges,,188.71,237.77,
DRILL TWIST 4.5MM,30182533,CDM,,,270,RC,inpatient,,250.28,250.28,,212.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220.25,88,,percent of total billed charges,,,,,,,,,191.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.75,91,,percent of total billed charges,,,237.77,95,,percent of total billed charges,,,207.73,83,,percent of total billed charges,,,207.73,83,,percent of total billed charges,,,,,,,,,,,,,,,207.73,83,,percent of total billed charges,,,237.77,95,,percent of total billed charges,,,225.25,90,,percent of total billed charges,,,225.25,90,,percent of total billed charges,,,205.23,82,,percent of total billed charges,,,225.25,90,,percent of total billed charges,,,212.74,85,,percent of total billed charges,,188.71,237.77,
DEPUY DISTAL AUGMENT LT 12MM SZ2.5,30182534,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
AVAMAX PLUS CEMENT DELIVERY,30182549,CDM,,,270,RC,inpatient,,4508.4,4508.4,,3827.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3399.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3832.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3967.39,88,,percent of total billed charges,,,,,,,,,3444.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4102.64,91,,percent of total billed charges,,,4282.98,95,,percent of total billed charges,,,3741.97,83,,percent of total billed charges,,,3741.97,83,,percent of total billed charges,,,,,,,,,,,,,,,3741.97,83,,percent of total billed charges,,,4282.98,95,,percent of total billed charges,,,4057.56,90,,percent of total billed charges,,,4057.56,90,,percent of total billed charges,,,3696.89,82,,percent of total billed charges,,,4057.56,90,,percent of total billed charges,,,3832.14,85,,percent of total billed charges,,3399.33,4282.98,
AVAFLEX PLUS CURVED NEEDLE,30182550,CDM,,,270,RC,inpatient,,2996.57,2996.57,,2544.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2259.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2547.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2636.98,88,,percent of total billed charges,,,,,,,,,2289.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2726.88,91,,percent of total billed charges,,,2846.74,95,,percent of total billed charges,,,2487.15,83,,percent of total billed charges,,,2487.15,83,,percent of total billed charges,,,,,,,,,,,,,,,2487.15,83,,percent of total billed charges,,,2846.74,95,,percent of total billed charges,,,2696.91,90,,percent of total billed charges,,,2696.91,90,,percent of total billed charges,,,2457.19,82,,percent of total billed charges,,,2696.91,90,,percent of total billed charges,,,2547.08,85,,percent of total billed charges,,2259.41,2846.74,
S&N ENDO CANNULA TWIST 8.5,30182551,CDM,,,270,RC,inpatient,,253.05,253.05,,214.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,222.68,88,,percent of total billed charges,,,,,,,,,193.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,230.28,91,,percent of total billed charges,,,240.4,95,,percent of total billed charges,,,210.03,83,,percent of total billed charges,,,210.03,83,,percent of total billed charges,,,,,,,,,,,,,,,210.03,83,,percent of total billed charges,,,240.4,95,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,207.5,82,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,215.09,85,,percent of total billed charges,,190.8,240.4,
MESH VENTRALIGHT W/ECHO 7X9,30182552,CDM,,,278,RC,inpatient,,9912.5,9912.5,,8415.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7474.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8425.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8723,88,,percent of total billed charges,,,,,,,,,7573.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9020.38,91,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,,,,,,,,,,,,,8227.38,83,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8128.25,82,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,7474.03,9416.88,
MESH VENTRALIGHT W/ECHO 8X10,30182553,CDM,,,270,RC,inpatient,,11635,11635,,9878.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8772.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9889.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10238.8,88,,percent of total billed charges,,,,,,,,,8889.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10587.85,91,,percent of total billed charges,,,11053.25,95,,percent of total billed charges,,,9657.05,83,,percent of total billed charges,,,9657.05,83,,percent of total billed charges,,,,,,,,,,,,,,,9657.05,83,,percent of total billed charges,,,11053.25,95,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,9540.7,82,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,9889.75,85,,percent of total billed charges,,8772.79,11053.25,
DEPUY STEM CORAIL KLA SZ10,30182555,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY FEMUR SIGMA PS NL SZ4,30182556,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
DEPUY DISTAL AUGMENT RT 16MM,30182557,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
DEPUY POSTERIOR AUGMENT 8MM,30182558,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
DEPUY MBT STEP WEDGE 10MM SZ4,30182559,CDM,,,278,RC,inpatient,,15761.79,15761.79,,13381.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11884.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13397.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13870.38,88,,percent of total billed charges,,,,,,,,,12042.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14343.23,91,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,,,,,,,,,,,,,13082.29,83,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,12924.67,82,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,13397.52,85,,percent of total billed charges,,11884.39,14973.7,
DEPUY INSERT TC3 RP 20MM SZ5,30182560,CDM,,,278,RC,inpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17430.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19649.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,17430.21,21961.14,
DEPUY SCREW PROTROSIO 52MM,30182566,CDM,,,278,RC,inpatient,,21625.7,21625.7,,18360.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16305.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18381.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19030.62,88,,percent of total billed charges,,,,,,,,,16522.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19679.39,91,,percent of total billed charges,,,20544.42,95,,percent of total billed charges,,,17949.33,83,,percent of total billed charges,,,17949.33,83,,percent of total billed charges,,,,,,,,,,,,,,,17949.33,83,,percent of total billed charges,,,20544.42,95,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,17733.07,82,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,18381.85,85,,percent of total billed charges,,16305.78,20544.42,
DEPUY SCREW SELF TAP 45MM,30182567,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
DEPUY SCREW SELF TAP 40MM,30182568,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
DEPUY SCREW SELF TAP 35MM,30182569,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
DEPUY SCREW SELF TAP 25MM,30182570,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
DEPUY SCREW SELF TAP 30MM,30182571,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
DEPUY STEM BOWED SZ16.5 X 11,30182572,CDM,,,278,RC,inpatient,,68800.94,68800.94,,58412,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51875.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58480.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60544.83,88,,percent of total billed charges,,,,,,,,,52563.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62608.86,91,,percent of total billed charges,,,65360.89,95,,percent of total billed charges,,,57104.78,83,,percent of total billed charges,,,57104.78,83,,percent of total billed charges,,,,,,,,,,,,,,,57104.78,83,,percent of total billed charges,,,65360.89,95,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,56416.77,82,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,58480.8,85,,percent of total billed charges,,51875.91,65360.89,
SYNTHES SCREW CANCEL 4.0X40MM,30182573,CDM,,,278,RC,inpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,168.24,211.97,
STRYKER BLADE SAGITTAL DUAL CUT,30182575,CDM,,,270,RC,inpatient,,355.32,355.32,,301.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,267.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,302.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,312.68,88,,percent of total billed charges,,,,,,,,,271.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,323.34,91,,percent of total billed charges,,,337.55,95,,percent of total billed charges,,,294.92,83,,percent of total billed charges,,,294.92,83,,percent of total billed charges,,,,,,,,,,,,,,,294.92,83,,percent of total billed charges,,,337.55,95,,percent of total billed charges,,,319.79,90,,percent of total billed charges,,,319.79,90,,percent of total billed charges,,,291.36,82,,percent of total billed charges,,,319.79,90,,percent of total billed charges,,,302.02,85,,percent of total billed charges,,267.91,337.55,
DEPUY LINER CONSTRAINED +4 40 X 66,30182586,CDM,,,278,RC,inpatient,,39314.21,39314.21,,33377.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29642.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33417.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34596.5,88,,percent of total billed charges,,,,,,,,,30036.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35775.93,91,,percent of total billed charges,,,37348.5,95,,percent of total billed charges,,,32630.79,83,,percent of total billed charges,,,32630.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32630.79,83,,percent of total billed charges,,,37348.5,95,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,32237.65,82,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,33417.08,85,,percent of total billed charges,,29642.91,37348.5,
DEPUY SCREW SELF TAP 50MM,30182587,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
DEPUY SCREW SELF TAP 60MM,30182588,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
DEPUY SCREW SELF TAP 55MM,30182589,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
BACKSTOP CLEAR GEL X 3FR CATH KIT,30182595,CDM,,,270,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
BALLOON DILATATION CATH KIT 18FR,30182596,CDM,,,270,RC,inpatient,,2506.73,2506.73,,2128.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1890.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2130.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2205.92,88,,percent of total billed charges,,,,,,,,,1915.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2281.12,91,,percent of total billed charges,,,2381.39,95,,percent of total billed charges,,,2080.59,83,,percent of total billed charges,,,2080.59,83,,percent of total billed charges,,,,,,,,,,,,,,,2080.59,83,,percent of total billed charges,,,2381.39,95,,percent of total billed charges,,,2256.06,90,,percent of total billed charges,,,2256.06,90,,percent of total billed charges,,,2055.52,82,,percent of total billed charges,,,2256.06,90,,percent of total billed charges,,,2130.72,85,,percent of total billed charges,,1890.07,2381.39,
GYRUS THUNDERBEAT 5M 35CM,30182602,CDM,,,270,RC,inpatient,,6251.7,6251.7,,5307.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4713.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5313.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5501.5,88,,percent of total billed charges,,,,,,,,,4776.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5689.05,91,,percent of total billed charges,,,5939.12,95,,percent of total billed charges,,,5188.91,83,,percent of total billed charges,,,5188.91,83,,percent of total billed charges,,,,,,,,,,,,,,,5188.91,83,,percent of total billed charges,,,5939.12,95,,percent of total billed charges,,,5626.53,90,,percent of total billed charges,,,5626.53,90,,percent of total billed charges,,,5126.39,82,,percent of total billed charges,,,5626.53,90,,percent of total billed charges,,,5313.95,85,,percent of total billed charges,,4713.78,5939.12,
STRYKER BLADE MICRO SAGITAL LONG MED,30182603,CDM,,,270,RC,inpatient,,314.48,314.48,,266.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,237.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,267.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,276.74,88,,percent of total billed charges,,,,,,,,,240.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,286.18,91,,percent of total billed charges,,,298.76,95,,percent of total billed charges,,,261.02,83,,percent of total billed charges,,,261.02,83,,percent of total billed charges,,,,,,,,,,,,,,,261.02,83,,percent of total billed charges,,,298.76,95,,percent of total billed charges,,,283.03,90,,percent of total billed charges,,,283.03,90,,percent of total billed charges,,,257.87,82,,percent of total billed charges,,,283.03,90,,percent of total billed charges,,,267.31,85,,percent of total billed charges,,237.12,298.76,
MESH OVAL MEDIUM 4.3 X 5.5,30182606,CDM,,,278,RC,inpatient,,5791.5,5791.5,,4916.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4366.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4922.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5096.52,88,,percent of total billed charges,,,,,,,,,4424.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5270.27,91,,percent of total billed charges,,,5501.93,95,,percent of total billed charges,,,4806.95,83,,percent of total billed charges,,,4806.95,83,,percent of total billed charges,,,,,,,,,,,,,,,4806.95,83,,percent of total billed charges,,,5501.93,95,,percent of total billed charges,,,5212.35,90,,percent of total billed charges,,,5212.35,90,,percent of total billed charges,,,4749.03,82,,percent of total billed charges,,,5212.35,90,,percent of total billed charges,,,4922.78,85,,percent of total billed charges,,4366.79,5501.93,
MESH OVAL LARGE 5.4 X 7.0,30182607,CDM,,,278,RC,inpatient,,7637.5,7637.5,,6484.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5758.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6491.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6721,88,,percent of total billed charges,,,,,,,,,5835.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6950.13,91,,percent of total billed charges,,,7255.63,95,,percent of total billed charges,,,6339.13,83,,percent of total billed charges,,,6339.13,83,,percent of total billed charges,,,,,,,,,,,,,,,6339.13,83,,percent of total billed charges,,,7255.63,95,,percent of total billed charges,,,6873.75,90,,percent of total billed charges,,,6873.75,90,,percent of total billed charges,,,6262.75,82,,percent of total billed charges,,,6873.75,90,,percent of total billed charges,,,6491.88,85,,percent of total billed charges,,5758.68,7255.63,
DEPUY INSERT TC3 12.5MM SZ3,30182608,CDM,,,278,RC,inpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17430.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19649.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,17430.21,21961.14,
DEPUY BONE CEMENT ENDURANCE,30182609,CDM,,,278,RC,inpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,527.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,595,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,527.8,665,
DEPUY KNEE CEMENTED W/AOX,30182611,CDM,,,278,RC,inpatient,,35205.76,35205.76,,29889.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26545.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29924.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30981.07,88,,percent of total billed charges,,,,,,,,,26897.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32037.24,91,,percent of total billed charges,,,33445.47,95,,percent of total billed charges,,,29220.78,83,,percent of total billed charges,,,29220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,29220.78,83,,percent of total billed charges,,,33445.47,95,,percent of total billed charges,,,31685.18,90,,percent of total billed charges,,,31685.18,90,,percent of total billed charges,,,28868.72,82,,percent of total billed charges,,,31685.18,90,,percent of total billed charges,,,29924.9,85,,percent of total billed charges,,26545.14,33445.47,
DEPUY INSERT TIBIAL AOX 20MM SZ5,30182612,CDM,,,278,RC,inpatient,,17068.29,17068.29,,14490.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12869.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14508.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15020.1,88,,percent of total billed charges,,,,,,,,,13040.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15532.14,91,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,,,,,,,,,,,,,14166.68,83,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,13996,82,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,12869.49,16214.88,
I.L.A. NICRON FIBER 200,30182615,CDM,,,270,RC,inpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,980.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1105,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,980.2,1235,
STRYKER BUR 4.0 EGG,30182617,CDM,,,270,RC,inpatient,,472.01,472.01,,400.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,355.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,401.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,415.37,88,,percent of total billed charges,,,,,,,,,360.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,429.53,91,,percent of total billed charges,,,448.41,95,,percent of total billed charges,,,391.77,83,,percent of total billed charges,,,391.77,83,,percent of total billed charges,,,,,,,,,,,,,,,391.77,83,,percent of total billed charges,,,448.41,95,,percent of total billed charges,,,424.81,90,,percent of total billed charges,,,424.81,90,,percent of total billed charges,,,387.05,82,,percent of total billed charges,,,424.81,90,,percent of total billed charges,,,401.21,85,,percent of total billed charges,,355.9,448.41,
INTEGRA ACCELL EVO3C 10CC,30182629,CDM,,,278,RC,inpatient,,16508.12,16508.12,,14015.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12447.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14031.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14527.15,88,,percent of total billed charges,,,,,,,,,12612.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15022.39,91,,percent of total billed charges,,,15682.71,95,,percent of total billed charges,,,13701.74,83,,percent of total billed charges,,,13701.74,83,,percent of total billed charges,,,,,,,,,,,,,,,13701.74,83,,percent of total billed charges,,,15682.71,95,,percent of total billed charges,,,14857.31,90,,percent of total billed charges,,,14857.31,90,,percent of total billed charges,,,13536.66,82,,percent of total billed charges,,,14857.31,90,,percent of total billed charges,,,14031.9,85,,percent of total billed charges,,12447.12,15682.71,
INTEGRA  MOZAIK STRIP 15CC,30182630,CDM,,,278,RC,inpatient,,11235.51,11235.51,,9538.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8471.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9550.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9887.25,88,,percent of total billed charges,,,,,,,,,8583.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10224.31,91,,percent of total billed charges,,,10673.73,95,,percent of total billed charges,,,9325.47,83,,percent of total billed charges,,,9325.47,83,,percent of total billed charges,,,,,,,,,,,,,,,9325.47,83,,percent of total billed charges,,,10673.73,95,,percent of total billed charges,,,10111.96,90,,percent of total billed charges,,,10111.96,90,,percent of total billed charges,,,9213.12,82,,percent of total billed charges,,,10111.96,90,,percent of total billed charges,,,9550.18,85,,percent of total billed charges,,8471.57,10673.73,
INTEGRA ASPIREX PLUS BONE MARROW KIT,30182631,CDM,,,270,RC,inpatient,,883.42,883.42,,750.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,666.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,750.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,777.41,88,,percent of total billed charges,,,,,,,,,674.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,803.91,91,,percent of total billed charges,,,839.25,95,,percent of total billed charges,,,733.24,83,,percent of total billed charges,,,733.24,83,,percent of total billed charges,,,,,,,,,,,,,,,733.24,83,,percent of total billed charges,,,839.25,95,,percent of total billed charges,,,795.08,90,,percent of total billed charges,,,795.08,90,,percent of total billed charges,,,724.4,82,,percent of total billed charges,,,795.08,90,,percent of total billed charges,,,750.91,85,,percent of total billed charges,,666.1,839.25,
DEPUY NAIL HUMERAL 9 X 220,30182632,CDM,,,278,RC,inpatient,,12857,12857,,10915.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9694.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10928.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11314.16,88,,percent of total billed charges,,,,,,,,,9822.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11699.87,91,,percent of total billed charges,,,12214.15,95,,percent of total billed charges,,,10671.31,83,,percent of total billed charges,,,10671.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10671.31,83,,percent of total billed charges,,,12214.15,95,,percent of total billed charges,,,11571.3,90,,percent of total billed charges,,,11571.3,90,,percent of total billed charges,,,10542.74,82,,percent of total billed charges,,,11571.3,90,,percent of total billed charges,,,10928.45,85,,percent of total billed charges,,9694.18,12214.15,
DEPUY NAIL PROXIMAL 10 X 15,30182633,CDM,,,278,RC,inpatient,,6854.25,6854.25,,5819.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5168.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5826.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6031.74,88,,percent of total billed charges,,,,,,,,,5236.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6237.37,91,,percent of total billed charges,,,6511.54,95,,percent of total billed charges,,,5689.03,83,,percent of total billed charges,,,5689.03,83,,percent of total billed charges,,,,,,,,,,,,,,,5689.03,83,,percent of total billed charges,,,6511.54,95,,percent of total billed charges,,,6168.83,90,,percent of total billed charges,,,6168.83,90,,percent of total billed charges,,,5620.49,82,,percent of total billed charges,,,6168.83,90,,percent of total billed charges,,,5826.11,85,,percent of total billed charges,,5168.1,6511.54,
DEPUY NAIL HUMERAL 9 X 300,30182634,CDM,,,278,RC,inpatient,,6428.5,6428.5,,5457.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4847.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5464.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5657.08,88,,percent of total billed charges,,,,,,,,,4911.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5849.94,91,,percent of total billed charges,,,6107.08,95,,percent of total billed charges,,,5335.66,83,,percent of total billed charges,,,5335.66,83,,percent of total billed charges,,,,,,,,,,,,,,,5335.66,83,,percent of total billed charges,,,6107.08,95,,percent of total billed charges,,,5785.65,90,,percent of total billed charges,,,5785.65,90,,percent of total billed charges,,,5271.37,82,,percent of total billed charges,,,5785.65,90,,percent of total billed charges,,,5464.23,85,,percent of total billed charges,,4847.09,6107.08,
DEPUY POROUS FEMORAL SLEEVE 245,30182635,CDM,,,278,RC,inpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13618.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15352.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,13618.85,17159.03,
DEPUY SLEEVE ADAPTER LPS +0MM,30182636,CDM,,,278,RC,inpatient,,6309.03,6309.03,,5356.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4757.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5362.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5551.95,88,,percent of total billed charges,,,,,,,,,4820.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5741.22,91,,percent of total billed charges,,,5993.58,95,,percent of total billed charges,,,5236.49,83,,percent of total billed charges,,,5236.49,83,,percent of total billed charges,,,,,,,,,,,,,,,5236.49,83,,percent of total billed charges,,,5993.58,95,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5173.4,82,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5362.68,85,,percent of total billed charges,,4757.01,5993.58,
DEPUY MBT TRAY SLEEVE 53MM,30182637,CDM,,,278,RC,inpatient,,12860.84,12860.84,,10918.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9697.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10931.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11317.54,88,,percent of total billed charges,,,,,,,,,9825.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11703.36,91,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10674.5,83,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10545.89,82,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10931.71,85,,percent of total billed charges,,9697.07,12217.8,
DEPUY FEMUR DISTAL XXSM RT,30182638,CDM,,,278,RC,inpatient,,97092.39,97092.39,,82431.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,73207.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,82528.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,85441.3,88,,percent of total billed charges,,,,,,,,,74178.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,88354.07,91,,percent of total billed charges,,,92237.77,95,,percent of total billed charges,,,80586.68,83,,percent of total billed charges,,,80586.68,83,,percent of total billed charges,,,,,,,,,,,,,,,80586.68,83,,percent of total billed charges,,,92237.77,95,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,79615.76,82,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,82528.53,85,,percent of total billed charges,,73207.66,92237.77,
DEPUY INSERT LPS XXSM 12MM,30182639,CDM,,,278,RC,inpatient,,27579.5,27579.5,,23415,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20794.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23442.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24269.96,88,,percent of total billed charges,,,,,,,,,21070.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25097.35,91,,percent of total billed charges,,,26200.53,95,,percent of total billed charges,,,22890.99,83,,percent of total billed charges,,,22890.99,83,,percent of total billed charges,,,,,,,,,,,,,,,22890.99,83,,percent of total billed charges,,,26200.53,95,,percent of total billed charges,,,24821.55,90,,percent of total billed charges,,,24821.55,90,,percent of total billed charges,,,22615.19,82,,percent of total billed charges,,,24821.55,90,,percent of total billed charges,,,23442.58,85,,percent of total billed charges,,20794.94,26200.53,
DEPUY STEM CEMENTED 13 X 120,30182640,CDM,,,278,RC,inpatient,,8116.23,8116.23,,6890.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6119.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6898.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7142.28,88,,percent of total billed charges,,,,,,,,,6200.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7385.77,91,,percent of total billed charges,,,7710.42,95,,percent of total billed charges,,,6736.47,83,,percent of total billed charges,,,6736.47,83,,percent of total billed charges,,,,,,,,,,,,,,,6736.47,83,,percent of total billed charges,,,7710.42,95,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,6655.31,82,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,6898.8,85,,percent of total billed charges,,6119.64,7710.42,
DEPUY STEM CEMENTED 13 X 30,30182641,CDM,,,278,RC,inpatient,,6179.68,6179.68,,5246.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4659.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5252.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5438.12,88,,percent of total billed charges,,,,,,,,,4721.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5623.51,91,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5129.13,83,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5067.34,82,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5252.73,85,,percent of total billed charges,,4659.48,5870.7,
DEPUY FRACTURE HEAD HIP BALL 41MM,30182643,CDM,,,278,RC,inpatient,,4693.78,4693.78,,3985.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3539.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3989.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4130.53,88,,percent of total billed charges,,,,,,,,,3586.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4271.34,91,,percent of total billed charges,,,4459.09,95,,percent of total billed charges,,,3895.84,83,,percent of total billed charges,,,3895.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3895.84,83,,percent of total billed charges,,,4459.09,95,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,3848.9,82,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,3989.71,85,,percent of total billed charges,,3539.11,4459.09,
S&N ENDO BIORAPTOR KIT 2.9,30182645,CDM,,,270,RC,inpatient,,1910.55,1910.55,,1622.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1440.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1623.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1681.28,88,,percent of total billed charges,,,,,,,,,1459.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1738.6,91,,percent of total billed charges,,,1815.02,95,,percent of total billed charges,,,1585.76,83,,percent of total billed charges,,,1585.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1585.76,83,,percent of total billed charges,,,1815.02,95,,percent of total billed charges,,,1719.5,90,,percent of total billed charges,,,1719.5,90,,percent of total billed charges,,,1566.65,82,,percent of total billed charges,,,1719.5,90,,percent of total billed charges,,,1623.97,85,,percent of total billed charges,,1440.55,1815.02,
AVAMAX VERTEBRAL BALLOON TRAY,30182646,CDM,,,270,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
AUTOLOGOUS CULTURED CHONDROCYTES,30182650,CDM,,,278,RC,inpatient,,225981.6,225981.6,,191858.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,170390.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192084.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198863.81,88,,percent of total billed charges,,,,,,,,,172649.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,205643.26,91,,percent of total billed charges,,,214682.52,95,,percent of total billed charges,,,187564.73,83,,percent of total billed charges,,,187564.73,83,,percent of total billed charges,,,,,,,,,,,,,,,187564.73,83,,percent of total billed charges,,,214682.52,95,,percent of total billed charges,,,203383.44,90,,percent of total billed charges,,,203383.44,90,,percent of total billed charges,,,185304.91,82,,percent of total billed charges,,,203383.44,90,,percent of total billed charges,,,192084.36,85,,percent of total billed charges,,170390.13,214682.52,
DEPUY RENTAL FEE - MORELAND 98-000,30182652,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
DEPUY PINNACLE CUP MULTIHOLE 58MM,30182653,CDM,,,278,RC,inpatient,,16354,16354,,13884.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12330.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13900.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14391.52,88,,percent of total billed charges,,,,,,,,,12494.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14882.14,91,,percent of total billed charges,,,15536.3,95,,percent of total billed charges,,,13573.82,83,,percent of total billed charges,,,13573.82,83,,percent of total billed charges,,,,,,,,,,,,,,,13573.82,83,,percent of total billed charges,,,15536.3,95,,percent of total billed charges,,,14718.6,90,,percent of total billed charges,,,14718.6,90,,percent of total billed charges,,,13410.28,82,,percent of total billed charges,,,14718.6,90,,percent of total billed charges,,,13900.9,85,,percent of total billed charges,,12330.92,15536.3,
MICROPORT ADVANCE PATELLA 10MM X 38MM,30182655,CDM,,,278,RC,inpatient,,7163,7163,,6081.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5400.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6088.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6303.44,88,,percent of total billed charges,,,,,,,,,5472.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6518.33,91,,percent of total billed charges,,,6804.85,95,,percent of total billed charges,,,5945.29,83,,percent of total billed charges,,,5945.29,83,,percent of total billed charges,,,,,,,,,,,,,,,5945.29,83,,percent of total billed charges,,,6804.85,95,,percent of total billed charges,,,6446.7,90,,percent of total billed charges,,,6446.7,90,,percent of total billed charges,,,5873.66,82,,percent of total billed charges,,,6446.7,90,,percent of total billed charges,,,6088.55,85,,percent of total billed charges,,5400.9,6804.85,
DEPUY INSERT,30182657,CDM,,,278,RC,inpatient,,6061.9,6061.9,,5146.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4570.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5152.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5334.47,88,,percent of total billed charges,,,,,,,,,4631.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5516.33,91,,percent of total billed charges,,,5758.81,95,,percent of total billed charges,,,5031.38,83,,percent of total billed charges,,,5031.38,83,,percent of total billed charges,,,,,,,,,,,,,,,5031.38,83,,percent of total billed charges,,,5758.81,95,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,4970.76,82,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,5152.62,85,,percent of total billed charges,,4570.67,5758.81,
MESH VENTRALIGHT W/ECHO 3X3,30182660,CDM,,,278,RC,inpatient,,3315,3315,,2814.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2499.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2817.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2917.2,88,,percent of total billed charges,,,,,,,,,2532.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3016.65,91,,percent of total billed charges,,,3149.25,95,,percent of total billed charges,,,2751.45,83,,percent of total billed charges,,,2751.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2751.45,83,,percent of total billed charges,,,3149.25,95,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2718.3,82,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2817.75,85,,percent of total billed charges,,2499.51,3149.25,
DRILL BIT SENTINEL CANNULATED 10X229MM,30182663,CDM,,,270,RC,inpatient,,864.76,864.76,,734.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,652.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,735.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,760.99,88,,percent of total billed charges,,,,,,,,,660.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,786.93,91,,percent of total billed charges,,,821.52,95,,percent of total billed charges,,,717.75,83,,percent of total billed charges,,,717.75,83,,percent of total billed charges,,,,,,,,,,,,,,,717.75,83,,percent of total billed charges,,,821.52,95,,percent of total billed charges,,,778.28,90,,percent of total billed charges,,,778.28,90,,percent of total billed charges,,,709.1,82,,percent of total billed charges,,,778.28,90,,percent of total billed charges,,,735.05,85,,percent of total billed charges,,652.03,821.52,
DRILL BIT Y-KNOT,30182665,CDM,,,270,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
DEPUY STEM HUMERAL SZ11,30182666,CDM,,,278,RC,inpatient,,49679.57,49679.57,,42177.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37458.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42227.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,43718.02,88,,percent of total billed charges,,,,,,,,,37955.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45208.41,91,,percent of total billed charges,,,47195.59,95,,percent of total billed charges,,,41234.04,83,,percent of total billed charges,,,41234.04,83,,percent of total billed charges,,,,,,,,,,,,,,,41234.04,83,,percent of total billed charges,,,47195.59,95,,percent of total billed charges,,,44711.61,90,,percent of total billed charges,,,44711.61,90,,percent of total billed charges,,,40737.25,82,,percent of total billed charges,,,44711.61,90,,percent of total billed charges,,,42227.63,85,,percent of total billed charges,,37458.4,47195.59,
DEPUY ECC GLENOSPHERE 42MM,30182667,CDM,,,278,RC,inpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14941.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16844.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,14941.68,18825.72,
DEPUY SPACER +9,30182668,CDM,,,278,RC,inpatient,,16003.46,16003.46,,13586.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12066.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13602.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14083.04,88,,percent of total billed charges,,,,,,,,,12226.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14563.15,91,,percent of total billed charges,,,15203.29,95,,percent of total billed charges,,,13282.87,83,,percent of total billed charges,,,13282.87,83,,percent of total billed charges,,,,,,,,,,,,,,,13282.87,83,,percent of total billed charges,,,15203.29,95,,percent of total billed charges,,,14403.11,90,,percent of total billed charges,,,14403.11,90,,percent of total billed charges,,,13122.84,82,,percent of total billed charges,,,14403.11,90,,percent of total billed charges,,,13602.94,85,,percent of total billed charges,,12066.61,15203.29,
DEPUY HUMERAL CUP 42+6,30182669,CDM,,,278,RC,inpatient,,13066.69,13066.69,,11093.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9852.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11106.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11498.69,88,,percent of total billed charges,,,,,,,,,9982.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11890.69,91,,percent of total billed charges,,,12413.36,95,,percent of total billed charges,,,10845.35,83,,percent of total billed charges,,,10845.35,83,,percent of total billed charges,,,,,,,,,,,,,,,10845.35,83,,percent of total billed charges,,,12413.36,95,,percent of total billed charges,,,11760.02,90,,percent of total billed charges,,,11760.02,90,,percent of total billed charges,,,10714.69,82,,percent of total billed charges,,,11760.02,90,,percent of total billed charges,,,11106.69,85,,percent of total billed charges,,9852.28,12413.36,
RTI HUMERUS PROXIMAL RIGHT,30182670,CDM,,,278,RC,inpatient,,20150,20150,,17107.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15193.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17127.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17732,88,,percent of total billed charges,,,,,,,,,15394.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18336.5,91,,percent of total billed charges,,,19142.5,95,,percent of total billed charges,,,16724.5,83,,percent of total billed charges,,,16724.5,83,,percent of total billed charges,,,,,,,,,,,,,,,16724.5,83,,percent of total billed charges,,,19142.5,95,,percent of total billed charges,,,18135,90,,percent of total billed charges,,,18135,90,,percent of total billed charges,,,16523,82,,percent of total billed charges,,,18135,90,,percent of total billed charges,,,17127.5,85,,percent of total billed charges,,15193.1,19142.5,
INTEGRA ACCELL EVO3C 5CC,30182671,CDM,,,270,RC,inpatient,,8885.11,8885.11,,7543.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6699.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7552.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7818.9,88,,percent of total billed charges,,,,,,,,,6788.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8085.45,91,,percent of total billed charges,,,8440.85,95,,percent of total billed charges,,,7374.64,83,,percent of total billed charges,,,7374.64,83,,percent of total billed charges,,,,,,,,,,,,,,,7374.64,83,,percent of total billed charges,,,8440.85,95,,percent of total billed charges,,,7996.6,90,,percent of total billed charges,,,7996.6,90,,percent of total billed charges,,,7285.79,82,,percent of total billed charges,,,7996.6,90,,percent of total billed charges,,,7552.34,85,,percent of total billed charges,,6699.37,8440.85,
AMNIOTIC ALLOGRAFT 3CM X 3CM,30182672,CDM,,,278,RC,inpatient,,8092.5,8092.5,,6870.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6101.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6878.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7121.4,88,,percent of total billed charges,,,,,,,,,6182.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7364.18,91,,percent of total billed charges,,,7687.88,95,,percent of total billed charges,,,6716.78,83,,percent of total billed charges,,,6716.78,83,,percent of total billed charges,,,,,,,,,,,,,,,6716.78,83,,percent of total billed charges,,,7687.88,95,,percent of total billed charges,,,7283.25,90,,percent of total billed charges,,,7283.25,90,,percent of total billed charges,,,6635.85,82,,percent of total billed charges,,,7283.25,90,,percent of total billed charges,,,6878.63,85,,percent of total billed charges,,6101.75,7687.88,
DEPUY DISTAL AUGMENT RT 8MM SZ3.0,30182676,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
SYNTHES SCREW CANNUL 6.5X70MM,30182677,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANNUL 6.5X85MM,30182678,CDM,,,278,RC,inpatient,,2696.27,2696.27,,2289.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2032.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2291.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2372.72,88,,percent of total billed charges,,,,,,,,,2059.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2453.61,91,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2237.9,83,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2210.94,82,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,2032.99,2561.46,
DEPUY FEMUR TC3 RT SZ3,30182682,CDM,,,278,RC,inpatient,,36489.7,36489.7,,30979.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27513.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31016.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32110.94,88,,percent of total billed charges,,,,,,,,,27878.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33205.63,91,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,,,,,,,,,,,,,30286.45,83,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,29921.55,82,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,27513.23,34665.22,
DEPUY INSERT TIBIAL AOX 10MM SZ4,30182685,CDM,,,278,RC,inpatient,,17068.29,17068.29,,14490.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12869.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14508.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15020.1,88,,percent of total billed charges,,,,,,,,,13040.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15532.14,91,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,,,,,,,,,,,,,14166.68,83,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,13996,82,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,12869.49,16214.88,
SYNTHES GUIDEWIRE 1.6MM,30182693,CDM,,,270,RC,inpatient,,446.25,446.25,,378.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,336.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,379.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,392.7,88,,percent of total billed charges,,,,,,,,,340.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,406.09,91,,percent of total billed charges,,,423.94,95,,percent of total billed charges,,,370.39,83,,percent of total billed charges,,,370.39,83,,percent of total billed charges,,,,,,,,,,,,,,,370.39,83,,percent of total billed charges,,,423.94,95,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,365.93,82,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,379.31,85,,percent of total billed charges,,336.47,423.94,
CARTICEL ESSENTIALS KIT,30182694,CDM,,,270,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
DEPUY STEM SUMMIT BASIC SZ3,30182695,CDM,,,278,RC,inpatient,,10372.96,10372.96,,8806.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7821.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8817.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9128.2,88,,percent of total billed charges,,,,,,,,,7924.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9439.39,91,,percent of total billed charges,,,9854.31,95,,percent of total billed charges,,,8609.56,83,,percent of total billed charges,,,8609.56,83,,percent of total billed charges,,,,,,,,,,,,,,,8609.56,83,,percent of total billed charges,,,9854.31,95,,percent of total billed charges,,,9335.66,90,,percent of total billed charges,,,9335.66,90,,percent of total billed charges,,,8505.83,82,,percent of total billed charges,,,9335.66,90,,percent of total billed charges,,,8817.02,85,,percent of total billed charges,,7821.21,9854.31,
DEPUY OSTEOTOME RADIAL 10MM X 5,30182696,CDM,,,278,RC,inpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3896.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4392.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,3896.3,4909.13,
ZIMMER DRILL BIT 4.5MM,30182698,CDM,,,270,RC,inpatient,,230.7,230.7,,195.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,173.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.02,88,,percent of total billed charges,,,,,,,,,176.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,209.94,91,,percent of total billed charges,,,219.17,95,,percent of total billed charges,,,191.48,83,,percent of total billed charges,,,191.48,83,,percent of total billed charges,,,,,,,,,,,,,,,191.48,83,,percent of total billed charges,,,219.17,95,,percent of total billed charges,,,207.63,90,,percent of total billed charges,,,207.63,90,,percent of total billed charges,,,189.17,82,,percent of total billed charges,,,207.63,90,,percent of total billed charges,,,196.1,85,,percent of total billed charges,,173.95,219.17,
INTEGRA ACCELL EVO3C 2.5CC,30182699,CDM,,,270,RC,inpatient,,5074.29,5074.29,,4308.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3826.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4313.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4465.38,88,,percent of total billed charges,,,,,,,,,3876.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4617.6,91,,percent of total billed charges,,,4820.58,95,,percent of total billed charges,,,4211.66,83,,percent of total billed charges,,,4211.66,83,,percent of total billed charges,,,,,,,,,,,,,,,4211.66,83,,percent of total billed charges,,,4820.58,95,,percent of total billed charges,,,4566.86,90,,percent of total billed charges,,,4566.86,90,,percent of total billed charges,,,4160.92,82,,percent of total billed charges,,,4566.86,90,,percent of total billed charges,,,4313.15,85,,percent of total billed charges,,3826.01,4820.58,
DEPUY DISTAL AUGMENT RT 4MM SZ4.0,30182701,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
ALLOSOURCE 1/3 FEMORAL STRUT 20CM,30182702,CDM,,,278,RC,inpatient,,4043,4043,,3432.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3048.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3436.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3557.84,88,,percent of total billed charges,,,,,,,,,3088.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3679.13,91,,percent of total billed charges,,,3840.85,95,,percent of total billed charges,,,3355.69,83,,percent of total billed charges,,,3355.69,83,,percent of total billed charges,,,,,,,,,,,,,,,3355.69,83,,percent of total billed charges,,,3840.85,95,,percent of total billed charges,,,3638.7,90,,percent of total billed charges,,,3638.7,90,,percent of total billed charges,,,3315.26,82,,percent of total billed charges,,,3638.7,90,,percent of total billed charges,,,3436.55,85,,percent of total billed charges,,3048.42,3840.85,
ALLOSOURCE 1/3 FEMORAL STRUT 30CM,30182703,CDM,,,278,RC,inpatient,,5011.5,5011.5,,4254.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3778.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4259.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4410.12,88,,percent of total billed charges,,,,,,,,,3828.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4560.47,91,,percent of total billed charges,,,4760.93,95,,percent of total billed charges,,,4159.55,83,,percent of total billed charges,,,4159.55,83,,percent of total billed charges,,,,,,,,,,,,,,,4159.55,83,,percent of total billed charges,,,4760.93,95,,percent of total billed charges,,,4510.35,90,,percent of total billed charges,,,4510.35,90,,percent of total billed charges,,,4109.43,82,,percent of total billed charges,,,4510.35,90,,percent of total billed charges,,,4259.78,85,,percent of total billed charges,,3778.67,4760.93,
MTF AFT STRAIGHT TUBE,30182720,CDM,,,278,RC,inpatient,,1092,1092,,927.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,823.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,928.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,960.96,88,,percent of total billed charges,,,,,,,,,834.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,993.72,91,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,,,,,,,,,,,,,906.36,83,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,895.44,82,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,928.2,85,,percent of total billed charges,,823.37,1037.4,
MTF AFT DIVERTED TUBE,30182721,CDM,,,278,RC,inpatient,,1612,1612,,1368.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1215.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1370.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1418.56,88,,percent of total billed charges,,,,,,,,,1231.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1466.92,91,,percent of total billed charges,,,1531.4,95,,percent of total billed charges,,,1337.96,83,,percent of total billed charges,,,1337.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1337.96,83,,percent of total billed charges,,,1531.4,95,,percent of total billed charges,,,1450.8,90,,percent of total billed charges,,,1450.8,90,,percent of total billed charges,,,1321.84,82,,percent of total billed charges,,,1450.8,90,,percent of total billed charges,,,1370.2,85,,percent of total billed charges,,1215.45,1531.4,
SYNTHES SCREW LOCKING 3.5X34MM,30182723,CDM,,,278,RC,inpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,945.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1066.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,945.79,1191.65,
SYNTHES SCREW LOCKING 3.5X38MM,30182724,CDM,,,278,RC,inpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,945.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1066.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,945.79,1191.65,
SYNTHES SCREW LOCKING 3.5X50MM,30182725,CDM,,,278,RC,inpatient,,1217.84,1217.84,,1033.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,918.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1035.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1071.7,88,,percent of total billed charges,,,,,,,,,930.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1108.23,91,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1010.81,83,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,998.63,82,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,918.25,1156.95,
DIOMED SCREW SET 9.9MM,30182729,CDM,,,278,RC,inpatient,,1488.5,1488.5,,1263.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1122.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1265.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1309.88,88,,percent of total billed charges,,,,,,,,,1137.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1354.54,91,,percent of total billed charges,,,1414.08,95,,percent of total billed charges,,,1235.46,83,,percent of total billed charges,,,1235.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1235.46,83,,percent of total billed charges,,,1414.08,95,,percent of total billed charges,,,1339.65,90,,percent of total billed charges,,,1339.65,90,,percent of total billed charges,,,1220.57,82,,percent of total billed charges,,,1339.65,90,,percent of total billed charges,,,1265.23,85,,percent of total billed charges,,1122.33,1414.08,
BIOGIDE PATCH 40X50MM,30182736,CDM,,,278,RC,inpatient,,2535,2535,,2152.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1911.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2154.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2230.8,88,,percent of total billed charges,,,,,,,,,1936.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2306.85,91,,percent of total billed charges,,,2408.25,95,,percent of total billed charges,,,2104.05,83,,percent of total billed charges,,,2104.05,83,,percent of total billed charges,,,,,,,,,,,,,,,2104.05,83,,percent of total billed charges,,,2408.25,95,,percent of total billed charges,,,2281.5,90,,percent of total billed charges,,,2281.5,90,,percent of total billed charges,,,2078.7,82,,percent of total billed charges,,,2281.5,90,,percent of total billed charges,,,2154.75,85,,percent of total billed charges,,1911.39,2408.25,
DEPUY DISTAL AUGMENT LT 4MM SZ4.0,30182737,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
ALLERGAN NATRELLE SIZER 339CC,30182738,CDM,,,270,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
DEPUY PINNACLE CUP REVISION 58MM,30182739,CDM,,,278,RC,inpatient,,33437.04,33437.04,,28388.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25211.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28421.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29424.6,88,,percent of total billed charges,,,,,,,,,25545.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30427.71,91,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,,,,,,,,,,,,,27752.74,83,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,27418.37,82,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,25211.53,31765.19,
DEPUY CERAMIC HEAD 32MM +1MM TS,30182740,CDM,,,278,RC,inpatient,,14631.05,14631.05,,12421.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11031.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12436.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12875.32,88,,percent of total billed charges,,,,,,,,,11178.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13314.26,91,,percent of total billed charges,,,13899.5,95,,percent of total billed charges,,,12143.77,83,,percent of total billed charges,,,12143.77,83,,percent of total billed charges,,,,,,,,,,,,,,,12143.77,83,,percent of total billed charges,,,13899.5,95,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,11997.46,82,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,12436.39,85,,percent of total billed charges,,11031.81,13899.5,
OBTRYX HALO SLING,30182745,CDM,,,270,RC,inpatient,,9109.1,9109.1,,7733.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6868.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7742.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8016.01,88,,percent of total billed charges,,,,,,,,,6959.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8289.28,91,,percent of total billed charges,,,8653.65,95,,percent of total billed charges,,,7560.55,83,,percent of total billed charges,,,7560.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7560.55,83,,percent of total billed charges,,,8653.65,95,,percent of total billed charges,,,8198.19,90,,percent of total billed charges,,,8198.19,90,,percent of total billed charges,,,7469.46,82,,percent of total billed charges,,,8198.19,90,,percent of total billed charges,,,7742.74,85,,percent of total billed charges,,6868.26,8653.65,
SURGICAL PATTIES 1/2 X 1.5,30182746,CDM,,,270,RC,inpatient,,21.56,21.56,,18.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.97,88,,percent of total billed charges,,,,,,,,,16.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.62,91,,percent of total billed charges,,,20.48,95,,percent of total billed charges,,,17.89,83,,percent of total billed charges,,,17.89,83,,percent of total billed charges,,,,,,,,,,,,,,,17.89,83,,percent of total billed charges,,,20.48,95,,percent of total billed charges,,,19.4,90,,percent of total billed charges,,,19.4,90,,percent of total billed charges,,,17.68,82,,percent of total billed charges,,,19.4,90,,percent of total billed charges,,,18.33,85,,percent of total billed charges,,16.26,20.48,
I.L.A. LASER END-FIRE,30182748,CDM,,,270,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
MTF AFT DIVERTED BONE TUBE,30182749,CDM,,,278,RC,inpatient,,1612,1612,,1368.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1215.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1370.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1418.56,88,,percent of total billed charges,,,,,,,,,1231.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1466.92,91,,percent of total billed charges,,,1531.4,95,,percent of total billed charges,,,1337.96,83,,percent of total billed charges,,,1337.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1337.96,83,,percent of total billed charges,,,1531.4,95,,percent of total billed charges,,,1450.8,90,,percent of total billed charges,,,1450.8,90,,percent of total billed charges,,,1321.84,82,,percent of total billed charges,,,1450.8,90,,percent of total billed charges,,,1370.2,85,,percent of total billed charges,,1215.45,1531.4,
CAPIO DELIVERY DEVICE,30182761,CDM,,,270,RC,inpatient,,9301.5,9301.5,,7896.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7013.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7906.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8185.32,88,,percent of total billed charges,,,,,,,,,7106.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8464.37,91,,percent of total billed charges,,,8836.43,95,,percent of total billed charges,,,7720.25,83,,percent of total billed charges,,,7720.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7720.25,83,,percent of total billed charges,,,8836.43,95,,percent of total billed charges,,,8371.35,90,,percent of total billed charges,,,8371.35,90,,percent of total billed charges,,,7627.23,82,,percent of total billed charges,,,8371.35,90,,percent of total billed charges,,,7906.28,85,,percent of total billed charges,,7013.33,8836.43,
ARIS PROCESSED DERMIS 6X12CM,30182763,CDM,,,270,RC,inpatient,,12740,12740,,10816.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9605.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10829,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11211.2,88,,percent of total billed charges,,,,,,,,,9733.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11593.4,91,,percent of total billed charges,,,12103,95,,percent of total billed charges,,,10574.2,83,,percent of total billed charges,,,10574.2,83,,percent of total billed charges,,,,,,,,,,,,,,,10574.2,83,,percent of total billed charges,,,12103,95,,percent of total billed charges,,,11466,90,,percent of total billed charges,,,11466,90,,percent of total billed charges,,,10446.8,82,,percent of total billed charges,,,11466,90,,percent of total billed charges,,,10829,85,,percent of total billed charges,,9605.96,12103,
ALLERGAN SILICONE BREAST IMPLANT 650CC,30182764,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
GUIDEWIRE CORE URO PTFE .038,30182765,CDM,,,270,RC,inpatient,,149.68,149.68,,127.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,112.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,127.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,131.72,88,,percent of total billed charges,,,,,,,,,114.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,136.21,91,,percent of total billed charges,,,142.2,95,,percent of total billed charges,,,124.23,83,,percent of total billed charges,,,124.23,83,,percent of total billed charges,,,,,,,,,,,,,,,124.23,83,,percent of total billed charges,,,142.2,95,,percent of total billed charges,,,134.71,90,,percent of total billed charges,,,134.71,90,,percent of total billed charges,,,122.74,82,,percent of total billed charges,,,134.71,90,,percent of total billed charges,,,127.23,85,,percent of total billed charges,,112.86,142.2,
MYOSURE TISSUE REMOVAL DEVICE,30182768,CDM,,,270,RC,inpatient,,8417.5,8417.5,,7146.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6346.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7154.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7407.4,88,,percent of total billed charges,,,,,,,,,6430.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7659.93,91,,percent of total billed charges,,,7996.63,95,,percent of total billed charges,,,6986.53,83,,percent of total billed charges,,,6986.53,83,,percent of total billed charges,,,,,,,,,,,,,,,6986.53,83,,percent of total billed charges,,,7996.63,95,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,6902.35,82,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,7154.88,85,,percent of total billed charges,,6346.8,7996.63,
DEPUY LINER CONSTRAINED +4 36 X 60,30182769,CDM,,,278,RC,inpatient,,33951.78,33951.78,,28825.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25599.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28859.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29877.57,88,,percent of total billed charges,,,,,,,,,25939.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30896.12,91,,percent of total billed charges,,,32254.19,95,,percent of total billed charges,,,28179.98,83,,percent of total billed charges,,,28179.98,83,,percent of total billed charges,,,,,,,,,,,,,,,28179.98,83,,percent of total billed charges,,,32254.19,95,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,27840.46,82,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,28859.01,85,,percent of total billed charges,,25599.64,32254.19,
DEPUY CERAMIC HEAD 36MM +12,30182770,CDM,,,278,RC,inpatient,,8767.27,8767.27,,7443.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6610.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7452.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7715.2,88,,percent of total billed charges,,,,,,,,,6698.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7978.22,91,,percent of total billed charges,,,8328.91,95,,percent of total billed charges,,,7276.83,83,,percent of total billed charges,,,7276.83,83,,percent of total billed charges,,,,,,,,,,,,,,,7276.83,83,,percent of total billed charges,,,8328.91,95,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7189.16,82,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7452.18,85,,percent of total billed charges,,6610.52,8328.91,
AMNIOTIC ALLOGRAFT 2CM X 3CM,30182773,CDM,,,278,RC,inpatient,,6142.5,6142.5,,5214.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4631.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5221.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5405.4,88,,percent of total billed charges,,,,,,,,,4692.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5589.68,91,,percent of total billed charges,,,5835.38,95,,percent of total billed charges,,,5098.28,83,,percent of total billed charges,,,5098.28,83,,percent of total billed charges,,,,,,,,,,,,,,,5098.28,83,,percent of total billed charges,,,5835.38,95,,percent of total billed charges,,,5528.25,90,,percent of total billed charges,,,5528.25,90,,percent of total billed charges,,,5036.85,82,,percent of total billed charges,,,5528.25,90,,percent of total billed charges,,,5221.13,85,,percent of total billed charges,,4631.45,5835.38,
DEPUY LINER ALTRX NEUT 36 X 54,30182775,CDM,,,278,RC,inpatient,,12874.42,12874.42,,10930.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9707.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10943.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11329.49,88,,percent of total billed charges,,,,,,,,,9836.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11715.72,91,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,,,,,,,,,,,,,10685.77,83,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10557.02,82,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10943.26,85,,percent of total billed charges,,9707.31,12230.7,
MESH VENTRALIGHT W/ECHO 6X10,30182776,CDM,,,270,RC,inpatient,,9067.5,9067.5,,7698.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6836.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7707.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7979.4,88,,percent of total billed charges,,,,,,,,,6927.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8251.43,91,,percent of total billed charges,,,8614.13,95,,percent of total billed charges,,,7526.03,83,,percent of total billed charges,,,7526.03,83,,percent of total billed charges,,,,,,,,,,,,,,,7526.03,83,,percent of total billed charges,,,8614.13,95,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,7435.35,82,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,7707.38,85,,percent of total billed charges,,6836.9,8614.13,
MESH VENTRALIGHT W/ECHO 10x13,30182777,CDM,,,270,RC,inpatient,,14787.5,14787.5,,12554.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11149.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12569.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13013,88,,percent of total billed charges,,,,,,,,,11297.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13456.63,91,,percent of total billed charges,,,14048.13,95,,percent of total billed charges,,,12273.63,83,,percent of total billed charges,,,12273.63,83,,percent of total billed charges,,,,,,,,,,,,,,,12273.63,83,,percent of total billed charges,,,14048.13,95,,percent of total billed charges,,,13308.75,90,,percent of total billed charges,,,13308.75,90,,percent of total billed charges,,,12125.75,82,,percent of total billed charges,,,13308.75,90,,percent of total billed charges,,,12569.38,85,,percent of total billed charges,,11149.78,14048.13,
MESH VENTRALIGHT STD 8X10,30182778,CDM,,,278,RC,inpatient,,8385,8385,,7118.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6322.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7127.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7378.8,88,,percent of total billed charges,,,,,,,,,6406.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7630.35,91,,percent of total billed charges,,,7965.75,95,,percent of total billed charges,,,6959.55,83,,percent of total billed charges,,,6959.55,83,,percent of total billed charges,,,,,,,,,,,,,,,6959.55,83,,percent of total billed charges,,,7965.75,95,,percent of total billed charges,,,7546.5,90,,percent of total billed charges,,,7546.5,90,,percent of total billed charges,,,6875.7,82,,percent of total billed charges,,,7546.5,90,,percent of total billed charges,,,7127.25,85,,percent of total billed charges,,6322.29,7965.75,
DEPUY STEM CORAIL SZ16,30182779,CDM,,,278,RC,inpatient,,33799.35,33799.35,,28695.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25484.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28729.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29743.43,88,,percent of total billed charges,,,,,,,,,25822.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30757.41,91,,percent of total billed charges,,,32109.38,95,,percent of total billed charges,,,28053.46,83,,percent of total billed charges,,,28053.46,83,,percent of total billed charges,,,,,,,,,,,,,,,28053.46,83,,percent of total billed charges,,,32109.38,95,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,27715.47,82,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,28729.45,85,,percent of total billed charges,,25484.71,32109.38,
S&N ENDO ANCHOR 2.9,30182784,CDM,,,270,RC,inpatient,,2255.5,2255.5,,1914.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1700.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1917.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1984.84,88,,percent of total billed charges,,,,,,,,,1723.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2052.51,91,,percent of total billed charges,,,2142.73,95,,percent of total billed charges,,,1872.07,83,,percent of total billed charges,,,1872.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1872.07,83,,percent of total billed charges,,,2142.73,95,,percent of total billed charges,,,2029.95,90,,percent of total billed charges,,,2029.95,90,,percent of total billed charges,,,1849.51,82,,percent of total billed charges,,,2029.95,90,,percent of total billed charges,,,1917.18,85,,percent of total billed charges,,1700.65,2142.73,
DEPUY FEMORAL HEAD 36MM +12,30182785,CDM,,,278,RC,inpatient,,8569.34,8569.34,,7275.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6461.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7283.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7541.02,88,,percent of total billed charges,,,,,,,,,6546.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7798.1,91,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7112.55,83,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7026.86,82,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,6461.28,8140.87,
DOUBLE ARMED SUTURE NEEDLE - 8538,30182786,CDM,,,270,RC,inpatient,,193.28,193.28,,164.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,145.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.09,88,,percent of total billed charges,,,,,,,,,147.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,175.88,91,,percent of total billed charges,,,183.62,95,,percent of total billed charges,,,160.42,83,,percent of total billed charges,,,160.42,83,,percent of total billed charges,,,,,,,,,,,,,,,160.42,83,,percent of total billed charges,,,183.62,95,,percent of total billed charges,,,173.95,90,,percent of total billed charges,,,173.95,90,,percent of total billed charges,,,158.49,82,,percent of total billed charges,,,173.95,90,,percent of total billed charges,,,164.29,85,,percent of total billed charges,,145.73,183.62,
RTI PATELLAR TENDON  GRAFT 11MMX100,30182787,CDM,,,278,RC,inpatient,,23400,23400,,19866.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17643.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19890,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20592,88,,percent of total billed charges,,,,,,,,,17877.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21294,91,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,,,,,,,,,,,,,19422,83,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19188,82,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19890,85,,percent of total billed charges,,17643.6,22230,
BALLOON DILATATION UROMAXULTRA,30182793,CDM,,,270,RC,inpatient,,1576.9,1576.9,,1338.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1188.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1340.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1387.67,88,,percent of total billed charges,,,,,,,,,1204.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1434.98,91,,percent of total billed charges,,,1498.06,95,,percent of total billed charges,,,1308.83,83,,percent of total billed charges,,,1308.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1308.83,83,,percent of total billed charges,,,1498.06,95,,percent of total billed charges,,,1419.21,90,,percent of total billed charges,,,1419.21,90,,percent of total billed charges,,,1293.06,82,,percent of total billed charges,,,1419.21,90,,percent of total billed charges,,,1340.37,85,,percent of total billed charges,,1188.98,1498.06,
STONE RETRIEVAL BASKET1.9FRX120CM,30182794,CDM,,,270,RC,inpatient,,1344.2,1344.2,,1141.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1013.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1142.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1182.9,88,,percent of total billed charges,,,,,,,,,1026.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1223.22,91,,percent of total billed charges,,,1276.99,95,,percent of total billed charges,,,1115.69,83,,percent of total billed charges,,,1115.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1115.69,83,,percent of total billed charges,,,1276.99,95,,percent of total billed charges,,,1209.78,90,,percent of total billed charges,,,1209.78,90,,percent of total billed charges,,,1102.24,82,,percent of total billed charges,,,1209.78,90,,percent of total billed charges,,,1142.57,85,,percent of total billed charges,,1013.53,1276.99,
ZIMMER CEMENT PALACOS-R,30182799,CDM,,,278,RC,inpatient,,1235,1235,,1048.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,931.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1049.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1086.8,88,,percent of total billed charges,,,,,,,,,943.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1123.85,91,,percent of total billed charges,,,1173.25,95,,percent of total billed charges,,,1025.05,83,,percent of total billed charges,,,1025.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1025.05,83,,percent of total billed charges,,,1173.25,95,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1012.7,82,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1049.75,85,,percent of total billed charges,,931.19,1173.25,
GENESYS HTA KIT,30182800,CDM,,,270,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ESU PENCIL WAND STERILE SMALL TIP,30182801,CDM,,,270,RC,inpatient,,243.75,243.75,,206.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,183.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,207.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,214.5,88,,percent of total billed charges,,,,,,,,,186.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,221.81,91,,percent of total billed charges,,,231.56,95,,percent of total billed charges,,,202.31,83,,percent of total billed charges,,,202.31,83,,percent of total billed charges,,,,,,,,,,,,,,,202.31,83,,percent of total billed charges,,,231.56,95,,percent of total billed charges,,,219.38,90,,percent of total billed charges,,,219.38,90,,percent of total billed charges,,,199.88,82,,percent of total billed charges,,,219.38,90,,percent of total billed charges,,,207.19,85,,percent of total billed charges,,183.79,231.56,
S&N ENDO SCREW SOFT SILK 8 X 25,30182802,CDM,,,278,RC,inpatient,,1417,1417,,1203.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1068.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1204.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1246.96,88,,percent of total billed charges,,,,,,,,,1082.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1289.47,91,,percent of total billed charges,,,1346.15,95,,percent of total billed charges,,,1176.11,83,,percent of total billed charges,,,1176.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1176.11,83,,percent of total billed charges,,,1346.15,95,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1161.94,82,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1204.45,85,,percent of total billed charges,,1068.42,1346.15,
S&N ENDO DRILL BIT 10.0,30182803,CDM,,,270,RC,inpatient,,3120,3120,,2648.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2352.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2652,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2745.6,88,,percent of total billed charges,,,,,,,,,2383.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2839.2,91,,percent of total billed charges,,,2964,95,,percent of total billed charges,,,2589.6,83,,percent of total billed charges,,,2589.6,83,,percent of total billed charges,,,,,,,,,,,,,,,2589.6,83,,percent of total billed charges,,,2964,95,,percent of total billed charges,,,2808,90,,percent of total billed charges,,,2808,90,,percent of total billed charges,,,2558.4,82,,percent of total billed charges,,,2808,90,,percent of total billed charges,,,2652,85,,percent of total billed charges,,2352.48,2964,
BONE PUTTY OS-401,30182814,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
BONE PUTTY APPLIER,30182815,CDM,,,278,RC,inpatient,,2593.5,2593.5,,2201.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1955.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2204.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2282.28,88,,percent of total billed charges,,,,,,,,,1981.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2360.09,91,,percent of total billed charges,,,2463.83,95,,percent of total billed charges,,,2152.61,83,,percent of total billed charges,,,2152.61,83,,percent of total billed charges,,,,,,,,,,,,,,,2152.61,83,,percent of total billed charges,,,2463.83,95,,percent of total billed charges,,,2334.15,90,,percent of total billed charges,,,2334.15,90,,percent of total billed charges,,,2126.67,82,,percent of total billed charges,,,2334.15,90,,percent of total billed charges,,,2204.48,85,,percent of total billed charges,,1955.5,2463.83,
S&N ENDO PROCEDURE KIT,30182816,CDM,,,270,RC,inpatient,,2288,2288,,1942.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1725.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1944.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2013.44,88,,percent of total billed charges,,,,,,,,,1748.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2082.08,91,,percent of total billed charges,,,2173.6,95,,percent of total billed charges,,,1899.04,83,,percent of total billed charges,,,1899.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1899.04,83,,percent of total billed charges,,,2173.6,95,,percent of total billed charges,,,2059.2,90,,percent of total billed charges,,,2059.2,90,,percent of total billed charges,,,1876.16,82,,percent of total billed charges,,,2059.2,90,,percent of total billed charges,,,1944.8,85,,percent of total billed charges,,1725.15,2173.6,
S&N ENDO BLADE SHAVER 2.9,30182817,CDM,,,270,RC,inpatient,,4283.5,4283.5,,3636.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3229.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3640.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3769.48,88,,percent of total billed charges,,,,,,,,,3272.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3897.99,91,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3555.31,83,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3512.47,82,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3640.98,85,,percent of total billed charges,,3229.76,4069.33,
DEPUY PINNACLE CUP MULTIHOLE 60MM,30182820,CDM,,,278,RC,inpatient,,26741.78,26741.78,,22703.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20163.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22730.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23532.77,88,,percent of total billed charges,,,,,,,,,20430.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24335.02,91,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,,,,,,,,,,,,,22195.68,83,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,21928.26,82,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,20163.3,25404.69,
DEPUY ALTRX HIP CAP W/GRIPTRON 36MM,30182824,CDM,,,278,RC,inpatient,,39836.68,39836.68,,33821.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30036.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33861.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35056.28,88,,percent of total billed charges,,,,,,,,,30435.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36251.38,91,,percent of total billed charges,,,37844.85,95,,percent of total billed charges,,,33064.44,83,,percent of total billed charges,,,33064.44,83,,percent of total billed charges,,,,,,,,,,,,,,,33064.44,83,,percent of total billed charges,,,37844.85,95,,percent of total billed charges,,,35853.01,90,,percent of total billed charges,,,35853.01,90,,percent of total billed charges,,,32666.08,82,,percent of total billed charges,,,35853.01,90,,percent of total billed charges,,,33861.18,85,,percent of total billed charges,,30036.86,37844.85,
DEPUY POROUS FEMORAL SLEEVE SZ15,30182826,CDM,,,278,RC,inpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13618.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15352.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,13618.85,17159.03,
DEPUY POSTERIOR AUGMENT 8MM SZ4.0,30182827,CDM,,,278,RC,inpatient,,6245.14,6245.14,,5302.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4708.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5308.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5495.72,88,,percent of total billed charges,,,,,,,,,4771.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5683.08,91,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,,,,,,,,,,,,,5183.47,83,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5121.01,82,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,4708.84,5932.88,
DEPUY INSERT TC3 RP 17.5MM SZ4,30182828,CDM,,,278,RC,inpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17430.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19649.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,17430.21,21961.14,
INTEGRA  MOZAIK STRIP 10CC,30182829,CDM,,,278,RC,inpatient,,9351.16,9351.16,,7939.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7050.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7948.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8229.02,88,,percent of total billed charges,,,,,,,,,7144.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8509.56,91,,percent of total billed charges,,,8883.6,95,,percent of total billed charges,,,7761.46,83,,percent of total billed charges,,,7761.46,83,,percent of total billed charges,,,,,,,,,,,,,,,7761.46,83,,percent of total billed charges,,,8883.6,95,,percent of total billed charges,,,8416.04,90,,percent of total billed charges,,,8416.04,90,,percent of total billed charges,,,7667.95,82,,percent of total billed charges,,,8416.04,90,,percent of total billed charges,,,7948.49,85,,percent of total billed charges,,7050.77,8883.6,
CONTRAST OMNIPAQUE-180 10ML,30182841,CDM,,,270,RC,inpatient,,137.61,137.61,,116.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,103.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,116.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.1,88,,percent of total billed charges,,,,,,,,,105.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.23,91,,percent of total billed charges,,,130.73,95,,percent of total billed charges,,,114.22,83,,percent of total billed charges,,,114.22,83,,percent of total billed charges,,,,,,,,,,,,,,,114.22,83,,percent of total billed charges,,,130.73,95,,percent of total billed charges,,,123.85,90,,percent of total billed charges,,,123.85,90,,percent of total billed charges,,,112.84,82,,percent of total billed charges,,,123.85,90,,percent of total billed charges,,,116.97,85,,percent of total billed charges,,103.76,130.73,
NEEDLE WEISS 20GA X 3-1/2,30182843,CDM,,,270,RC,inpatient,,88.98,88.98,,75.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,75.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,78.3,88,,percent of total billed charges,,,,,,,,,67.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.97,91,,percent of total billed charges,,,84.53,95,,percent of total billed charges,,,73.85,83,,percent of total billed charges,,,73.85,83,,percent of total billed charges,,,,,,,,,,,,,,,73.85,83,,percent of total billed charges,,,84.53,95,,percent of total billed charges,,,80.08,90,,percent of total billed charges,,,80.08,90,,percent of total billed charges,,,72.96,82,,percent of total billed charges,,,80.08,90,,percent of total billed charges,,,75.63,85,,percent of total billed charges,,67.09,84.53,
STRYKER VAS SYSTEM KIT 15MM,30182845,CDM,,,270,RC,inpatient,,8233.36,8233.36,,6990.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6207.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6998.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7245.36,88,,percent of total billed charges,,,,,,,,,6290.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7492.36,91,,percent of total billed charges,,,7821.69,95,,percent of total billed charges,,,6833.69,83,,percent of total billed charges,,,6833.69,83,,percent of total billed charges,,,,,,,,,,,,,,,6833.69,83,,percent of total billed charges,,,7821.69,95,,percent of total billed charges,,,7410.02,90,,percent of total billed charges,,,7410.02,90,,percent of total billed charges,,,6751.36,82,,percent of total billed charges,,,7410.02,90,,percent of total billed charges,,,6998.36,85,,percent of total billed charges,,6207.95,7821.69,
DEPUY PINNACLE CUP MULTIHOLE 62MM,30182849,CDM,,,278,RC,inpatient,,26741.78,26741.78,,22703.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20163.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22730.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23532.77,88,,percent of total billed charges,,,,,,,,,20430.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24335.02,91,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,,,,,,,,,,,,,22195.68,83,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,21928.26,82,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,20163.3,25404.69,
DEPUY LINER CONSTRAINED +4 40 X 62,30182850,CDM,,,278,RC,inpatient,,39314.21,39314.21,,33377.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29642.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33417.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34596.5,88,,percent of total billed charges,,,,,,,,,30036.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35775.93,91,,percent of total billed charges,,,37348.5,95,,percent of total billed charges,,,32630.79,83,,percent of total billed charges,,,32630.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32630.79,83,,percent of total billed charges,,,37348.5,95,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,32237.65,82,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,33417.08,85,,percent of total billed charges,,29642.91,37348.5,
CELL SAVER FILTER 40 MICRON,30182863,CDM,,,270,RC,inpatient,,122.96,122.96,,104.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,92.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,104.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,108.2,88,,percent of total billed charges,,,,,,,,,93.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.89,91,,percent of total billed charges,,,116.81,95,,percent of total billed charges,,,102.06,83,,percent of total billed charges,,,102.06,83,,percent of total billed charges,,,,,,,,,,,,,,,102.06,83,,percent of total billed charges,,,116.81,95,,percent of total billed charges,,,110.66,90,,percent of total billed charges,,,110.66,90,,percent of total billed charges,,,100.83,82,,percent of total billed charges,,,110.66,90,,percent of total billed charges,,,104.52,85,,percent of total billed charges,,92.71,116.81,
STAPLER CUTTER CONTOUR CURVED,30182865,CDM,,,270,RC,inpatient,,3011.78,3011.78,,2557,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2270.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2560.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2650.37,88,,percent of total billed charges,,,,,,,,,2301,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2740.72,91,,percent of total billed charges,,,2861.19,95,,percent of total billed charges,,,2499.78,83,,percent of total billed charges,,,2499.78,83,,percent of total billed charges,,,,,,,,,,,,,,,2499.78,83,,percent of total billed charges,,,2861.19,95,,percent of total billed charges,,,2710.6,90,,percent of total billed charges,,,2710.6,90,,percent of total billed charges,,,2469.66,82,,percent of total billed charges,,,2710.6,90,,percent of total billed charges,,,2560.01,85,,percent of total billed charges,,2270.88,2861.19,
NEEDLE RIGID ENDOSCOPIC 20G,30182866,CDM,,,270,RC,inpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,169.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,191.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,169.65,213.75,
STRYKER FEMORAL HD 36MM 5+,30182867,CDM,,,278,RC,inpatient,,13968.5,13968.5,,11859.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10532.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11873.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12292.28,88,,percent of total billed charges,,,,,,,,,10671.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12711.34,91,,percent of total billed charges,,,13270.08,95,,percent of total billed charges,,,11593.86,83,,percent of total billed charges,,,11593.86,83,,percent of total billed charges,,,,,,,,,,,,,,,11593.86,83,,percent of total billed charges,,,13270.08,95,,percent of total billed charges,,,12571.65,90,,percent of total billed charges,,,12571.65,90,,percent of total billed charges,,,11454.17,82,,percent of total billed charges,,,12571.65,90,,percent of total billed charges,,,11873.23,85,,percent of total billed charges,,10532.25,13270.08,
DEPUY PINNACLE CUP W/GRIPTION 64MM,30182868,CDM,,,278,RC,inpatient,,31783.05,31783.05,,26983.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23964.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27015.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27969.08,88,,percent of total billed charges,,,,,,,,,24282.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28922.58,91,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,,,,,,,,,,,,,26379.93,83,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,26062.1,82,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,27015.59,85,,percent of total billed charges,,23964.42,30193.9,
DEPUY PATELLA 3-PEG 38MM,30182878,CDM,,,278,RC,inpatient,,5578.95,5578.95,,4736.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4206.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4742.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4909.48,88,,percent of total billed charges,,,,,,,,,4262.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5076.84,91,,percent of total billed charges,,,5300,95,,percent of total billed charges,,,4630.53,83,,percent of total billed charges,,,4630.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4630.53,83,,percent of total billed charges,,,5300,95,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,4574.74,82,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,4742.11,85,,percent of total billed charges,,4206.53,5300,
DEPUY HEAD LARGE TAPER 36 +5,30182879,CDM,,,278,RC,inpatient,,12858.43,12858.43,,10916.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9695.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10929.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11315.42,88,,percent of total billed charges,,,,,,,,,9823.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11701.17,91,,percent of total billed charges,,,12215.51,95,,percent of total billed charges,,,10672.5,83,,percent of total billed charges,,,10672.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10672.5,83,,percent of total billed charges,,,12215.51,95,,percent of total billed charges,,,11572.59,90,,percent of total billed charges,,,11572.59,90,,percent of total billed charges,,,10543.91,82,,percent of total billed charges,,,11572.59,90,,percent of total billed charges,,,10929.67,85,,percent of total billed charges,,9695.26,12215.51,
ZIMMER BLADE EXPLANT 60MM X 20,30182880,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
DEPUY STEM GLOBAL HUMERAL 44 X 23,30182887,CDM,,,278,RC,inpatient,,24474.65,24474.65,,20778.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18453.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20803.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21537.69,88,,percent of total billed charges,,,,,,,,,18698.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22271.93,91,,percent of total billed charges,,,23250.92,95,,percent of total billed charges,,,20313.96,83,,percent of total billed charges,,,20313.96,83,,percent of total billed charges,,,,,,,,,,,,,,,20313.96,83,,percent of total billed charges,,,23250.92,95,,percent of total billed charges,,,22027.19,90,,percent of total billed charges,,,22027.19,90,,percent of total billed charges,,,20069.21,82,,percent of total billed charges,,,22027.19,90,,percent of total billed charges,,,20803.45,85,,percent of total billed charges,,18453.89,23250.92,
DEPUY INSERT XLK 8MM SZ2.5,30182888,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY SAWBLADE 13 X 90 (130),30182890,CDM,,,278,RC,inpatient,,550.55,550.55,,467.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,415.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,467.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,484.48,88,,percent of total billed charges,,,,,,,,,420.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,501,91,,percent of total billed charges,,,523.02,95,,percent of total billed charges,,,456.96,83,,percent of total billed charges,,,456.96,83,,percent of total billed charges,,,,,,,,,,,,,,,456.96,83,,percent of total billed charges,,,523.02,95,,percent of total billed charges,,,495.5,90,,percent of total billed charges,,,495.5,90,,percent of total billed charges,,,451.45,82,,percent of total billed charges,,,495.5,90,,percent of total billed charges,,,467.97,85,,percent of total billed charges,,415.11,523.02,
DEPUY INSERT XLK 10MM SZ2.5,30182891,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
ALLERGAN SILICONE BREAST IMPLANT 457CC,30182895,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
ALLERGAN TISSUE EXPANDER 500CC,30182900,CDM,,,278,RC,inpatient,,9067.5,9067.5,,7698.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6836.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7707.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7979.4,88,,percent of total billed charges,,,,,,,,,6927.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8251.43,91,,percent of total billed charges,,,8614.13,95,,percent of total billed charges,,,7526.03,83,,percent of total billed charges,,,7526.03,83,,percent of total billed charges,,,,,,,,,,,,,,,7526.03,83,,percent of total billed charges,,,8614.13,95,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,7435.35,82,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,7707.38,85,,percent of total billed charges,,6836.9,8614.13,
DOUBLE ARMED SUTURE NEEDLE - 8535,30182901,CDM,,,270,RC,inpatient,,193.28,193.28,,164.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,145.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.09,88,,percent of total billed charges,,,,,,,,,147.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,175.88,91,,percent of total billed charges,,,183.62,95,,percent of total billed charges,,,160.42,83,,percent of total billed charges,,,160.42,83,,percent of total billed charges,,,,,,,,,,,,,,,160.42,83,,percent of total billed charges,,,183.62,95,,percent of total billed charges,,,173.95,90,,percent of total billed charges,,,173.95,90,,percent of total billed charges,,,158.49,82,,percent of total billed charges,,,173.95,90,,percent of total billed charges,,,164.29,85,,percent of total billed charges,,145.73,183.62,
SYNTHES SCREW CANNUL 16MM 6.5X85MM,30182909,CDM,,,278,RC,inpatient,,2696.27,2696.27,,2289.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2032.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2291.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2372.72,88,,percent of total billed charges,,,,,,,,,2059.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2453.61,91,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2237.9,83,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2210.94,82,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,2032.99,2561.46,
DEPUY STEM CORAIL KLA SZ11,30182912,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DRAPE INCISE EYE POUCH INVISISHIELD,30182913,CDM,,,270,RC,inpatient,,49.64,49.64,,42.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,43.68,88,,percent of total billed charges,,,,,,,,,37.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.17,91,,percent of total billed charges,,,47.16,95,,percent of total billed charges,,,41.2,83,,percent of total billed charges,,,41.2,83,,percent of total billed charges,,,,,,,,,,,,,,,41.2,83,,percent of total billed charges,,,47.16,95,,percent of total billed charges,,,44.68,90,,percent of total billed charges,,,44.68,90,,percent of total billed charges,,,40.7,82,,percent of total billed charges,,,44.68,90,,percent of total billed charges,,,42.19,85,,percent of total billed charges,,37.43,47.16,
ALCON DUOVISC VISOELASTIC SYSTEM SM .40,30182914,CDM,,,278,RC,inpatient,,577.78,577.78,,490.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,435.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,491.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,508.45,88,,percent of total billed charges,,,,,,,,,441.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,525.78,91,,percent of total billed charges,,,548.89,95,,percent of total billed charges,,,479.56,83,,percent of total billed charges,,,479.56,83,,percent of total billed charges,,,,,,,,,,,,,,,479.56,83,,percent of total billed charges,,,548.89,95,,percent of total billed charges,,,520,90,,percent of total billed charges,,,520,90,,percent of total billed charges,,,473.78,82,,percent of total billed charges,,,520,90,,percent of total billed charges,,,491.11,85,,percent of total billed charges,,435.65,548.89,
DEPUY BODY RECLAIM PROXIMAL 21 X 95,30182915,CDM,,,278,RC,inpatient,,38548.77,38548.77,,32727.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29065.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32766.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33922.92,88,,percent of total billed charges,,,,,,,,,29451.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35079.38,91,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,,,,,,,,,,,,,31995.48,83,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,31609.99,82,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,32766.45,85,,percent of total billed charges,,29065.77,36621.33,
DEPUY STEM DISTAL 21 X 140,30182916,CDM,,,278,RC,inpatient,,31338.78,31338.78,,26606.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23629.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26637.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27578.13,88,,percent of total billed charges,,,,,,,,,23942.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28518.29,91,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,,,,,,,,,,,,,26011.19,83,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,25697.8,82,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,26637.96,85,,percent of total billed charges,,23629.44,29771.84,
AMNIOTIC ALLOGRAFT 4CM X 6CM,30182928,CDM,,,278,RC,inpatient,,13942.5,13942.5,,11837.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10512.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11851.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12269.4,88,,percent of total billed charges,,,,,,,,,10652.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12687.68,91,,percent of total billed charges,,,13245.38,95,,percent of total billed charges,,,11572.28,83,,percent of total billed charges,,,11572.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11572.28,83,,percent of total billed charges,,,13245.38,95,,percent of total billed charges,,,12548.25,90,,percent of total billed charges,,,12548.25,90,,percent of total billed charges,,,11432.85,82,,percent of total billed charges,,,12548.25,90,,percent of total billed charges,,,11851.13,85,,percent of total billed charges,,10512.65,13245.38,
DEPUY GLOBAL ADVANTAGE ECC HD 56 X 18,30182930,CDM,,,278,RC,inpatient,,23402.93,23402.93,,19869.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17645.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19892.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20594.58,88,,percent of total billed charges,,,,,,,,,17879.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21296.67,91,,percent of total billed charges,,,22232.78,95,,percent of total billed charges,,,19424.43,83,,percent of total billed charges,,,19424.43,83,,percent of total billed charges,,,,,,,,,,,,,,,19424.43,83,,percent of total billed charges,,,22232.78,95,,percent of total billed charges,,,21062.64,90,,percent of total billed charges,,,21062.64,90,,percent of total billed charges,,,19190.4,82,,percent of total billed charges,,,21062.64,90,,percent of total billed charges,,,19892.49,85,,percent of total billed charges,,17645.81,22232.78,
S&N ENDO BUTTON,30182938,CDM,,,278,RC,inpatient,,2143.05,2143.05,,1819.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1615.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1821.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1885.88,88,,percent of total billed charges,,,,,,,,,1637.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1950.18,91,,percent of total billed charges,,,2035.9,95,,percent of total billed charges,,,1778.73,83,,percent of total billed charges,,,1778.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1778.73,83,,percent of total billed charges,,,2035.9,95,,percent of total billed charges,,,1928.75,90,,percent of total billed charges,,,1928.75,90,,percent of total billed charges,,,1757.3,82,,percent of total billed charges,,,1928.75,90,,percent of total billed charges,,,1821.59,85,,percent of total billed charges,,1615.86,2035.9,
MTF TRINITY EVOLUTION 10CC,30182940,CDM,,,278,RC,inpatient,,28919.8,28919.8,,24552.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21805.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25449.42,88,,percent of total billed charges,,,,,,,,,22094.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26317.02,91,,percent of total billed charges,,,27473.81,95,,percent of total billed charges,,,24003.43,83,,percent of total billed charges,,,24003.43,83,,percent of total billed charges,,,,,,,,,,,,,,,24003.43,83,,percent of total billed charges,,,27473.81,95,,percent of total billed charges,,,26027.82,90,,percent of total billed charges,,,26027.82,90,,percent of total billed charges,,,23714.24,82,,percent of total billed charges,,,26027.82,90,,percent of total billed charges,,,24581.83,85,,percent of total billed charges,,21805.53,27473.81,
MTF TRINITY EVOLUTION 15CC,30182941,CDM,,,278,RC,inpatient,,36149.75,36149.75,,30691.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27256.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30727.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31811.78,88,,percent of total billed charges,,,,,,,,,27618.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32896.27,91,,percent of total billed charges,,,34342.26,95,,percent of total billed charges,,,30004.29,83,,percent of total billed charges,,,30004.29,83,,percent of total billed charges,,,,,,,,,,,,,,,30004.29,83,,percent of total billed charges,,,34342.26,95,,percent of total billed charges,,,32534.78,90,,percent of total billed charges,,,32534.78,90,,percent of total billed charges,,,29642.8,82,,percent of total billed charges,,,32534.78,90,,percent of total billed charges,,,30727.29,85,,percent of total billed charges,,27256.91,34342.26,
MTF TRINITY EVOLUTION 5CC,30182950,CDM,,,278,RC,inpatient,,15893.15,15893.15,,13493.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11983.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13509.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13985.97,88,,percent of total billed charges,,,,,,,,,12142.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14462.77,91,,percent of total billed charges,,,15098.49,95,,percent of total billed charges,,,13191.31,83,,percent of total billed charges,,,13191.31,83,,percent of total billed charges,,,,,,,,,,,,,,,13191.31,83,,percent of total billed charges,,,15098.49,95,,percent of total billed charges,,,14303.84,90,,percent of total billed charges,,,14303.84,90,,percent of total billed charges,,,13032.38,82,,percent of total billed charges,,,14303.84,90,,percent of total billed charges,,,13509.18,85,,percent of total billed charges,,11983.44,15098.49,
DEPUY FEMUR SIGMA PS LT SZ2.0,30182951,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
DEPUY INSERT RP 10MM SZ2,30182952,CDM,,,278,RC,inpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9811.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11060.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,9811.36,12361.8,
I-STOP FEMALE INCONTINENCE DEVICE,30182959,CDM,,,270,RC,inpatient,,6175,6175,,5242.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4655.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5248.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5434,88,,percent of total billed charges,,,,,,,,,4717.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5619.25,91,,percent of total billed charges,,,5866.25,95,,percent of total billed charges,,,5125.25,83,,percent of total billed charges,,,5125.25,83,,percent of total billed charges,,,,,,,,,,,,,,,5125.25,83,,percent of total billed charges,,,5866.25,95,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5063.5,82,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5248.75,85,,percent of total billed charges,,4655.95,5866.25,
TRAY PLEXUFIX NERVE BLOCK,30182960,CDM,,,270,RC,inpatient,,178,178,,151.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,134.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,151.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,156.64,88,,percent of total billed charges,,,,,,,,,135.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,161.98,91,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,,,,,,,,,,,,,147.74,83,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,145.96,82,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,134.21,169.1,
MESH VENTRALIGHT W/ECHO 12X14,30182961,CDM,,,270,RC,inpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12742.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14365,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,12742.6,16055,
DEPUY INSERT RP 15MM SZ2.5,30182962,CDM,,,278,RC,inpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9811.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11060.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,9811.36,12361.8,
DEPUY LINER ALTRX NEUT 36 X 52,30182965,CDM,,,278,RC,inpatient,,12874.42,12874.42,,10930.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9707.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10943.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11329.49,88,,percent of total billed charges,,,,,,,,,9836.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11715.72,91,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,,,,,,,,,,,,,10685.77,83,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10557.02,82,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10943.26,85,,percent of total billed charges,,9707.31,12230.7,
DEPUY LINER CONSTRAINED +4 36 X 58,30182966,CDM,,,278,RC,inpatient,,24183.97,24183.97,,20532.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18234.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20556.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21281.89,88,,percent of total billed charges,,,,,,,,,18476.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22007.41,91,,percent of total billed charges,,,22974.77,95,,percent of total billed charges,,,20072.7,83,,percent of total billed charges,,,20072.7,83,,percent of total billed charges,,,,,,,,,,,,,,,20072.7,83,,percent of total billed charges,,,22974.77,95,,percent of total billed charges,,,21765.57,90,,percent of total billed charges,,,21765.57,90,,percent of total billed charges,,,19830.86,82,,percent of total billed charges,,,21765.57,90,,percent of total billed charges,,,20556.37,85,,percent of total billed charges,,18234.71,22974.77,
STENT URETERAL FIRM 5 X 22,30182968,CDM,,,270,RC,inpatient,,682.36,682.36,,579.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,514.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,580.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,600.48,88,,percent of total billed charges,,,,,,,,,521.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,620.95,91,,percent of total billed charges,,,648.24,95,,percent of total billed charges,,,566.36,83,,percent of total billed charges,,,566.36,83,,percent of total billed charges,,,,,,,,,,,,,,,566.36,83,,percent of total billed charges,,,648.24,95,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,559.54,82,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,580.01,85,,percent of total billed charges,,514.5,648.24,
STENT URETERAL FIRM 5 X 24,30182969,CDM,,,270,RC,inpatient,,682.36,682.36,,579.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,514.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,580.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,600.48,88,,percent of total billed charges,,,,,,,,,521.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,620.95,91,,percent of total billed charges,,,648.24,95,,percent of total billed charges,,,566.36,83,,percent of total billed charges,,,566.36,83,,percent of total billed charges,,,,,,,,,,,,,,,566.36,83,,percent of total billed charges,,,648.24,95,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,559.54,82,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,580.01,85,,percent of total billed charges,,514.5,648.24,
DEPUY INSERT XLK 8MM SZ5,30182973,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
MAXCORE BIOPSY CORE INST 18X20,30182975,CDM,,,270,RC,inpatient,,356.1,356.1,,302.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,268.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,302.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,313.37,88,,percent of total billed charges,,,,,,,,,272.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,324.05,91,,percent of total billed charges,,,338.3,95,,percent of total billed charges,,,295.56,83,,percent of total billed charges,,,295.56,83,,percent of total billed charges,,,,,,,,,,,,,,,295.56,83,,percent of total billed charges,,,338.3,95,,percent of total billed charges,,,320.49,90,,percent of total billed charges,,,320.49,90,,percent of total billed charges,,,292,82,,percent of total billed charges,,,320.49,90,,percent of total billed charges,,,302.69,85,,percent of total billed charges,,268.5,338.3,
STONE BASKET DAKOTA 1.9X120 8MM,30182976,CDM,,,270,RC,inpatient,,1324.05,1324.05,,1124.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,998.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1125.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1165.16,88,,percent of total billed charges,,,,,,,,,1011.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1204.89,91,,percent of total billed charges,,,1257.85,95,,percent of total billed charges,,,1098.96,83,,percent of total billed charges,,,1098.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1098.96,83,,percent of total billed charges,,,1257.85,95,,percent of total billed charges,,,1191.65,90,,percent of total billed charges,,,1191.65,90,,percent of total billed charges,,,1085.72,82,,percent of total billed charges,,,1191.65,90,,percent of total billed charges,,,1125.44,85,,percent of total billed charges,,998.33,1257.85,
STRYKER K-WIRE 3.2 X 450MM,30182978,CDM,,,278,RC,inpatient,,1301.3,1301.3,,1104.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,981.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1106.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1145.14,88,,percent of total billed charges,,,,,,,,,994.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1184.18,91,,percent of total billed charges,,,1236.24,95,,percent of total billed charges,,,1080.08,83,,percent of total billed charges,,,1080.08,83,,percent of total billed charges,,,,,,,,,,,,,,,1080.08,83,,percent of total billed charges,,,1236.24,95,,percent of total billed charges,,,1171.17,90,,percent of total billed charges,,,1171.17,90,,percent of total billed charges,,,1067.07,82,,percent of total billed charges,,,1171.17,90,,percent of total billed charges,,,1106.11,85,,percent of total billed charges,,981.18,1236.24,
STRYKER REAMER 8.0 X 448MM,30182979,CDM,,,278,RC,inpatient,,3013.01,3013.01,,2558.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2271.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2561.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2651.45,88,,percent of total billed charges,,,,,,,,,2301.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2741.84,91,,percent of total billed charges,,,2862.36,95,,percent of total billed charges,,,2500.8,83,,percent of total billed charges,,,2500.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2500.8,83,,percent of total billed charges,,,2862.36,95,,percent of total billed charges,,,2711.71,90,,percent of total billed charges,,,2711.71,90,,percent of total billed charges,,,2470.67,82,,percent of total billed charges,,,2711.71,90,,percent of total billed charges,,,2561.06,85,,percent of total billed charges,,2271.81,2862.36,
SYNTHES SCREW CANCEL P-THD 4.0MM,30182982,CDM,,,278,RC,inpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,168.24,211.97,
DEPUY SELF CENT HIP 47X28 BRN,30182985,CDM,,,278,RC,inpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,6126.3,7718.82,
DEPUY CENTRALIZER 10.5MM,30182986,CDM,,,278,RC,inpatient,,919.36,919.36,,780.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,693.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,781.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,809.04,88,,percent of total billed charges,,,,,,,,,702.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,836.62,91,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,,,,,,,,,,,,,763.07,83,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,753.88,82,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,781.46,85,,percent of total billed charges,,693.2,873.39,
DEPUY INSERT TC3 RP 10MM SZ4,30182987,CDM,,,278,RC,inpatient,,15465.58,15465.58,,13130.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11661.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13145.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13609.71,88,,percent of total billed charges,,,,,,,,,11815.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14073.68,91,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,,,,,,,,,,,,,12836.43,83,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,12681.78,82,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13145.74,85,,percent of total billed charges,,11661.05,14692.3,
DEPUY STEM GLOBAL HUMERAL 48 X 15,30182988,CDM,,,278,RC,inpatient,,15560.09,15560.09,,13210.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11732.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13226.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13692.88,88,,percent of total billed charges,,,,,,,,,11887.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14159.68,91,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12914.87,83,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,12759.27,82,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,11732.31,14782.09,
STRYKER PAIN ELECTRODE PAD,30182995,CDM,,,270,RC,inpatient,,337.5,337.5,,286.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,254.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,286.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,297,88,,percent of total billed charges,,,,,,,,,257.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,307.13,91,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,,,,,,,,,,,,,280.13,83,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,276.75,82,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,254.48,320.63,
S&N ENDO ACCUPASS SUTURE,30182996,CDM,,,278,RC,inpatient,,825.5,825.5,,700.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,622.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,701.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,726.44,88,,percent of total billed charges,,,,,,,,,630.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,751.21,91,,percent of total billed charges,,,784.23,95,,percent of total billed charges,,,685.17,83,,percent of total billed charges,,,685.17,83,,percent of total billed charges,,,,,,,,,,,,,,,685.17,83,,percent of total billed charges,,,784.23,95,,percent of total billed charges,,,742.95,90,,percent of total billed charges,,,742.95,90,,percent of total billed charges,,,676.91,82,,percent of total billed charges,,,742.95,90,,percent of total billed charges,,,701.68,85,,percent of total billed charges,,622.43,784.23,
DEPUY OSTEOTOME FLEX 12MM X 2.5,30182997,CDM,,,270,RC,inpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3675.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4143.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,3675.75,4631.25,
DEPUY DISTAL AUGMENT 4MM SZ3.0,30182998,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
DEPUY DISTAL AUGMENT 4MM SZ5,30182999,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
DEPUY POSTERIOR AUGMENT 4MM SZ5.0,30183000,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
CELL SAVER AUTOFUSION BAG,30183001,CDM,,,270,RC,inpatient,,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,33.93,42.75,
AMNIOFX NERVE WRAP 4CM X 6CM,30183002,CDM,,,278,RC,inpatient,,13942.5,13942.5,,11837.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10512.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11851.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12269.4,88,,percent of total billed charges,,,,,,,,,10652.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12687.68,91,,percent of total billed charges,,,13245.38,95,,percent of total billed charges,,,11572.28,83,,percent of total billed charges,,,11572.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11572.28,83,,percent of total billed charges,,,13245.38,95,,percent of total billed charges,,,12548.25,90,,percent of total billed charges,,,12548.25,90,,percent of total billed charges,,,11432.85,82,,percent of total billed charges,,,12548.25,90,,percent of total billed charges,,,11851.13,85,,percent of total billed charges,,10512.65,13245.38,
S&N ENDO BICEPTOR BIOSURE 7 X 25,30183008,CDM,,,278,RC,inpatient,,1638,1638,,1390.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1235.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1392.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1441.44,88,,percent of total billed charges,,,,,,,,,1251.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1490.58,91,,percent of total billed charges,,,1556.1,95,,percent of total billed charges,,,1359.54,83,,percent of total billed charges,,,1359.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1359.54,83,,percent of total billed charges,,,1556.1,95,,percent of total billed charges,,,1474.2,90,,percent of total billed charges,,,1474.2,90,,percent of total billed charges,,,1343.16,82,,percent of total billed charges,,,1474.2,90,,percent of total billed charges,,,1392.3,85,,percent of total billed charges,,1235.05,1556.1,
DEPUY INSERT STABILIZED 12.5MM SZ4,30183016,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
STRYKER GUIDEWIRE 3 X 800MM,30183018,CDM,,,278,RC,inpatient,,1911.91,1911.91,,1623.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1441.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1625.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1682.48,88,,percent of total billed charges,,,,,,,,,1460.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1739.84,91,,percent of total billed charges,,,1816.31,95,,percent of total billed charges,,,1586.89,83,,percent of total billed charges,,,1586.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1586.89,83,,percent of total billed charges,,,1816.31,95,,percent of total billed charges,,,1720.72,90,,percent of total billed charges,,,1720.72,90,,percent of total billed charges,,,1567.77,82,,percent of total billed charges,,,1720.72,90,,percent of total billed charges,,,1625.12,85,,percent of total billed charges,,1441.58,1816.31,
DEPUY CERAMIC HEAD 32MM +5MM TS,30183022,CDM,,,278,RC,inpatient,,14631.05,14631.05,,12421.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11031.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12436.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12875.32,88,,percent of total billed charges,,,,,,,,,11178.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13314.26,91,,percent of total billed charges,,,13899.5,95,,percent of total billed charges,,,12143.77,83,,percent of total billed charges,,,12143.77,83,,percent of total billed charges,,,,,,,,,,,,,,,12143.77,83,,percent of total billed charges,,,13899.5,95,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,11997.46,82,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,12436.39,85,,percent of total billed charges,,11031.81,13899.5,
DEPUY CROSSLINK FIN GLENOID SZ56,30183023,CDM,,,278,RC,inpatient,,17098.9,17098.9,,14516.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12892.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14534.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15047.03,88,,percent of total billed charges,,,,,,,,,13063.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15560,91,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,,,,,,,,,,,,,14192.09,83,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14021.1,82,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14534.07,85,,percent of total billed charges,,12892.57,16243.96,
DEPUY STEM HUMERAL ECCENTRIC 56 X 21,30183024,CDM,,,278,RC,inpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13297.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14990.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,13297.64,16754.32,
DEPUY STEM GLOBAL ADVANTAGE 16MM,30183025,CDM,,,278,RC,inpatient,,36482.49,36482.49,,30973.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27507.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31010.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32104.59,88,,percent of total billed charges,,,,,,,,,27872.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33199.07,91,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,,,,,,,,,,,,,30280.47,83,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,29915.64,82,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,31010.12,85,,percent of total billed charges,,27507.8,34658.37,
GYRUS VACURETTE 7MM CURVED,30183026,CDM,,,270,RC,inpatient,,46.22,46.22,,39.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.67,88,,percent of total billed charges,,,,,,,,,35.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.06,91,,percent of total billed charges,,,43.91,95,,percent of total billed charges,,,38.36,83,,percent of total billed charges,,,38.36,83,,percent of total billed charges,,,,,,,,,,,,,,,38.36,83,,percent of total billed charges,,,43.91,95,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,37.9,82,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,39.29,85,,percent of total billed charges,,34.85,43.91,
GYRUS VACURETTE 7MM STRAIGHT,30183027,CDM,,,270,RC,inpatient,,44.45,44.45,,37.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.12,88,,percent of total billed charges,,,,,,,,,33.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.45,91,,percent of total billed charges,,,42.23,95,,percent of total billed charges,,,36.89,83,,percent of total billed charges,,,36.89,83,,percent of total billed charges,,,,,,,,,,,,,,,36.89,83,,percent of total billed charges,,,42.23,95,,percent of total billed charges,,,40.01,90,,percent of total billed charges,,,40.01,90,,percent of total billed charges,,,36.45,82,,percent of total billed charges,,,40.01,90,,percent of total billed charges,,,37.78,85,,percent of total billed charges,,33.52,42.23,
GYRUS VACURETTE 5MM FTIP,30183028,CDM,,,270,RC,inpatient,,40.5,40.5,,34.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.64,88,,percent of total billed charges,,,,,,,,,30.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.86,91,,percent of total billed charges,,,38.48,95,,percent of total billed charges,,,33.62,83,,percent of total billed charges,,,33.62,83,,percent of total billed charges,,,,,,,,,,,,,,,33.62,83,,percent of total billed charges,,,38.48,95,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,33.21,82,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,34.43,85,,percent of total billed charges,,30.54,38.48,
GYRUS VACURETTE 6MM FTIP,30183029,CDM,,,270,RC,inpatient,,46.22,46.22,,39.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.67,88,,percent of total billed charges,,,,,,,,,35.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.06,91,,percent of total billed charges,,,43.91,95,,percent of total billed charges,,,38.36,83,,percent of total billed charges,,,38.36,83,,percent of total billed charges,,,,,,,,,,,,,,,38.36,83,,percent of total billed charges,,,43.91,95,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,37.9,82,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,39.29,85,,percent of total billed charges,,34.85,43.91,
S&N DRILL BIT LONG 4.0MM,30183036,CDM,,,278,RC,inpatient,,1924.13,1924.13,,1633.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1450.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1635.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1693.23,88,,percent of total billed charges,,,,,,,,,1470.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1750.96,91,,percent of total billed charges,,,1827.92,95,,percent of total billed charges,,,1597.03,83,,percent of total billed charges,,,1597.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1597.03,83,,percent of total billed charges,,,1827.92,95,,percent of total billed charges,,,1731.72,90,,percent of total billed charges,,,1731.72,90,,percent of total billed charges,,,1577.79,82,,percent of total billed charges,,,1731.72,90,,percent of total billed charges,,,1635.51,85,,percent of total billed charges,,1450.79,1827.92,
ALLERGAN SILICONE BREAST IMPLANT 350CC,30183039,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
SYNTHES SCREW CANNUL 16MM 6.5X65MM,30183040,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
RESERVOIR 3 LITER 150 MICRO,30183042,CDM,,,270,RC,inpatient,,551.04,551.04,,467.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,415.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,468.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,484.92,88,,percent of total billed charges,,,,,,,,,420.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,501.45,91,,percent of total billed charges,,,523.49,95,,percent of total billed charges,,,457.36,83,,percent of total billed charges,,,457.36,83,,percent of total billed charges,,,,,,,,,,,,,,,457.36,83,,percent of total billed charges,,,523.49,95,,percent of total billed charges,,,495.94,90,,percent of total billed charges,,,495.94,90,,percent of total billed charges,,,451.85,82,,percent of total billed charges,,,495.94,90,,percent of total billed charges,,,468.38,85,,percent of total billed charges,,415.48,523.49,
BOWL CS5 125ML HI SPEED FOR CS,30183044,CDM,,,270,RC,inpatient,,839.48,839.48,,712.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,632.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,713.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,738.74,88,,percent of total billed charges,,,,,,,,,641.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,763.93,91,,percent of total billed charges,,,797.51,95,,percent of total billed charges,,,696.77,83,,percent of total billed charges,,,696.77,83,,percent of total billed charges,,,,,,,,,,,,,,,696.77,83,,percent of total billed charges,,,797.51,95,,percent of total billed charges,,,755.53,90,,percent of total billed charges,,,755.53,90,,percent of total billed charges,,,688.37,82,,percent of total billed charges,,,755.53,90,,percent of total billed charges,,,713.56,85,,percent of total billed charges,,632.97,797.51,
NUCELL LARGE,30183045,CDM,,,278,RC,inpatient,,32500,32500,,27592.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24505,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27625,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28600,88,,percent of total billed charges,,,,,,,,,24830,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29575,91,,percent of total billed charges,,,30875,95,,percent of total billed charges,,,26975,83,,percent of total billed charges,,,26975,83,,percent of total billed charges,,,,,,,,,,,,,,,26975,83,,percent of total billed charges,,,30875,95,,percent of total billed charges,,,29250,90,,percent of total billed charges,,,29250,90,,percent of total billed charges,,,26650,82,,percent of total billed charges,,,29250,90,,percent of total billed charges,,,27625,85,,percent of total billed charges,,24505,30875,
CATH PLEURX PLEURAL,30183047,CDM,,,270,RC,inpatient,,3737.5,3737.5,,3173.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2818.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3176.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3289,88,,percent of total billed charges,,,,,,,,,2855.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3401.13,91,,percent of total billed charges,,,3550.63,95,,percent of total billed charges,,,3102.13,83,,percent of total billed charges,,,3102.13,83,,percent of total billed charges,,,,,,,,,,,,,,,3102.13,83,,percent of total billed charges,,,3550.63,95,,percent of total billed charges,,,3363.75,90,,percent of total billed charges,,,3363.75,90,,percent of total billed charges,,,3064.75,82,,percent of total billed charges,,,3363.75,90,,percent of total billed charges,,,3176.88,85,,percent of total billed charges,,2818.08,3550.63,
PLEURX DRAINAGE BOTTLE KIT 1000ML,30183048,CDM,,,270,RC,inpatient,,806.96,806.96,,685.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,608.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,685.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,710.12,88,,percent of total billed charges,,,,,,,,,616.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,734.33,91,,percent of total billed charges,,,766.61,95,,percent of total billed charges,,,669.78,83,,percent of total billed charges,,,669.78,83,,percent of total billed charges,,,,,,,,,,,,,,,669.78,83,,percent of total billed charges,,,766.61,95,,percent of total billed charges,,,726.26,90,,percent of total billed charges,,,726.26,90,,percent of total billed charges,,,661.71,82,,percent of total billed charges,,,726.26,90,,percent of total billed charges,,,685.92,85,,percent of total billed charges,,608.45,766.61,
DRAINAGE BOTTLE HOME STARTER KIT,30183049,CDM,,,270,RC,inpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1458.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1643.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,1458.05,1837.06,
PUTTY 10CC H GENIN,30183050,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
DEPUY SLEEVE FEMORAL 34MM,30183051,CDM,,,278,RC,inpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13618.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15352.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,13618.85,17159.03,
DEPUY SLEEVE FEMORAL 40MM,30183052,CDM,,,278,RC,inpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13618.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15352.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,13618.85,17159.03,
DEPUY TRAY THICK SX 3 15MM,30183053,CDM,,,278,RC,inpatient,,62809.5,62809.5,,53325.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47358.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,53388.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55272.36,88,,percent of total billed charges,,,,,,,,,47986.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57156.65,91,,percent of total billed charges,,,59669.03,95,,percent of total billed charges,,,52131.89,83,,percent of total billed charges,,,52131.89,83,,percent of total billed charges,,,,,,,,,,,,,,,52131.89,83,,percent of total billed charges,,,59669.03,95,,percent of total billed charges,,,56528.55,90,,percent of total billed charges,,,56528.55,90,,percent of total billed charges,,,51503.79,82,,percent of total billed charges,,,56528.55,90,,percent of total billed charges,,,53388.08,85,,percent of total billed charges,,47358.36,59669.03,
DEPUY STEM TIBIAL 75 X 12MM,30183054,CDM,,,278,RC,inpatient,,12911.21,12911.21,,10961.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9735.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10974.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11361.86,88,,percent of total billed charges,,,,,,,,,9864.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11749.2,91,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,,,,,,,,,,,,,10716.3,83,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10587.19,82,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,9735.05,12265.65,
PUTTY 2.5CC H-GENIN,30183057,CDM,,,278,RC,inpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1715.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1933.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,1715.35,2161.25,
NUCELL SMALL,30183058,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
NUCELL X-LARGE,30183059,CDM,,,278,RC,inpatient,,52000,52000,,44148,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39208,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44200,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45760,88,,percent of total billed charges,,,,,,,,,39728,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47320,91,,percent of total billed charges,,,49400,95,,percent of total billed charges,,,43160,83,,percent of total billed charges,,,43160,83,,percent of total billed charges,,,,,,,,,,,,,,,43160,83,,percent of total billed charges,,,49400,95,,percent of total billed charges,,,46800,90,,percent of total billed charges,,,46800,90,,percent of total billed charges,,,42640,82,,percent of total billed charges,,,46800,90,,percent of total billed charges,,,44200,85,,percent of total billed charges,,39208,49400,
CAPSULE MINIONE 20FR,30183069,CDM,,,270,RC,inpatient,,1105,1105,,938.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,833.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,939.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,972.4,88,,percent of total billed charges,,,,,,,,,844.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1005.55,91,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,,,,,,,,,,,,,917.15,83,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,906.1,82,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,833.17,1049.75,
MINIONE FEEDING SET 12,30183070,CDM,,,270,RC,inpatient,,68,68,,57.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.84,88,,percent of total billed charges,,,,,,,,,51.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,,,,,,,,,,,,,56.44,83,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,55.76,82,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,51.27,64.6,
DEPUY BIOLOX DELTA TS HEAD,30183071,CDM,,,278,RC,inpatient,,15329.8,15329.8,,13015,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11558.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13030.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13490.22,88,,percent of total billed charges,,,,,,,,,11711.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13950.12,91,,percent of total billed charges,,,14563.31,95,,percent of total billed charges,,,12723.73,83,,percent of total billed charges,,,12723.73,83,,percent of total billed charges,,,,,,,,,,,,,,,12723.73,83,,percent of total billed charges,,,14563.31,95,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,12570.44,82,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,13030.33,85,,percent of total billed charges,,11558.67,14563.31,
RTI PATELLAR TENDON  GRAFT 10MM,30183073,CDM,,,278,RC,inpatient,,23400,23400,,19866.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17643.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19890,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20592,88,,percent of total billed charges,,,,,,,,,17877.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21294,91,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,,,,,,,,,,,,,19422,83,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19188,82,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19890,85,,percent of total billed charges,,17643.6,22230,
SYNTHES SCREW CANCEL 4.0X45MM,30183074,CDM,,,278,RC,inpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,168.24,211.97,
UPHOLD  VAGINAL SUPPORT SYSTEM,30183077,CDM,,,270,RC,inpatient,,16275.35,16275.35,,13817.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12271.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13834.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14322.31,88,,percent of total billed charges,,,,,,,,,12434.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14810.57,91,,percent of total billed charges,,,15461.58,95,,percent of total billed charges,,,13508.54,83,,percent of total billed charges,,,13508.54,83,,percent of total billed charges,,,,,,,,,,,,,,,13508.54,83,,percent of total billed charges,,,15461.58,95,,percent of total billed charges,,,14647.82,90,,percent of total billed charges,,,14647.82,90,,percent of total billed charges,,,13345.79,82,,percent of total billed charges,,,14647.82,90,,percent of total billed charges,,,13834.05,85,,percent of total billed charges,,12271.61,15461.58,
HOLMIUM LASER LOW WATTAGE SERVICE FEE,30183078,CDM,,,270,RC,inpatient,,4218.5,4218.5,,3581.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3180.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3585.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3712.28,88,,percent of total billed charges,,,,,,,,,3222.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3838.84,91,,percent of total billed charges,,,4007.58,95,,percent of total billed charges,,,3501.36,83,,percent of total billed charges,,,3501.36,83,,percent of total billed charges,,,,,,,,,,,,,,,3501.36,83,,percent of total billed charges,,,4007.58,95,,percent of total billed charges,,,3796.65,90,,percent of total billed charges,,,3796.65,90,,percent of total billed charges,,,3459.17,82,,percent of total billed charges,,,3796.65,90,,percent of total billed charges,,,3585.73,85,,percent of total billed charges,,3180.75,4007.58,
HOLMIUM 200 MICRON FIBER,30183079,CDM,,,270,RC,inpatient,,1482,1482,,1258.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1117.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1259.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1304.16,88,,percent of total billed charges,,,,,,,,,1132.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1348.62,91,,percent of total billed charges,,,1407.9,95,,percent of total billed charges,,,1230.06,83,,percent of total billed charges,,,1230.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1230.06,83,,percent of total billed charges,,,1407.9,95,,percent of total billed charges,,,1333.8,90,,percent of total billed charges,,,1333.8,90,,percent of total billed charges,,,1215.24,82,,percent of total billed charges,,,1333.8,90,,percent of total billed charges,,,1259.7,85,,percent of total billed charges,,1117.43,1407.9,
DEPUY DELTA HEAD 36+ 1.5MM,30183080,CDM,,,278,RC,inpatient,,15329.8,15329.8,,13015,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11558.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13030.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13490.22,88,,percent of total billed charges,,,,,,,,,11711.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13950.12,91,,percent of total billed charges,,,14563.31,95,,percent of total billed charges,,,12723.73,83,,percent of total billed charges,,,12723.73,83,,percent of total billed charges,,,,,,,,,,,,,,,12723.73,83,,percent of total billed charges,,,14563.31,95,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,12570.44,82,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,13030.33,85,,percent of total billed charges,,11558.67,14563.31,
ENDO STITCH 7,30183082,CDM,,,270,RC,inpatient,,407.89,407.89,,346.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,307.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,346.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,358.94,88,,percent of total billed charges,,,,,,,,,311.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,371.18,91,,percent of total billed charges,,,387.5,95,,percent of total billed charges,,,338.55,83,,percent of total billed charges,,,338.55,83,,percent of total billed charges,,,,,,,,,,,,,,,338.55,83,,percent of total billed charges,,,387.5,95,,percent of total billed charges,,,367.1,90,,percent of total billed charges,,,367.1,90,,percent of total billed charges,,,334.47,82,,percent of total billed charges,,,367.1,90,,percent of total billed charges,,,346.71,85,,percent of total billed charges,,307.55,387.5,
STRYKER BUR NEURO SOFTTOUCH 3.0,30183085,CDM,,,270,RC,inpatient,,1202.5,1202.5,,1020.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,906.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1022.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1058.2,88,,percent of total billed charges,,,,,,,,,918.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1094.28,91,,percent of total billed charges,,,1142.38,95,,percent of total billed charges,,,998.08,83,,percent of total billed charges,,,998.08,83,,percent of total billed charges,,,,,,,,,,,,,,,998.08,83,,percent of total billed charges,,,1142.38,95,,percent of total billed charges,,,1082.25,90,,percent of total billed charges,,,1082.25,90,,percent of total billed charges,,,986.05,82,,percent of total billed charges,,,1082.25,90,,percent of total billed charges,,,1022.13,85,,percent of total billed charges,,906.69,1142.38,
SYNTHES PROTECTIVE CAP FOR 4.0MM FIXATIO,30183087,CDM,,,270,RC,inpatient,,81.25,81.25,,68.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,69.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.5,88,,percent of total billed charges,,,,,,,,,62.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.94,91,,percent of total billed charges,,,77.19,95,,percent of total billed charges,,,67.44,83,,percent of total billed charges,,,67.44,83,,percent of total billed charges,,,,,,,,,,,,,,,67.44,83,,percent of total billed charges,,,77.19,95,,percent of total billed charges,,,73.13,90,,percent of total billed charges,,,73.13,90,,percent of total billed charges,,,66.63,82,,percent of total billed charges,,,73.13,90,,percent of total billed charges,,,69.06,85,,percent of total billed charges,,61.26,77.19,
TROCAR ENDO BLADLESS 150MM X 12MM,30183090,CDM,,,270,RC,inpatient,,230.55,230.55,,195.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,173.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,195.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,202.88,88,,percent of total billed charges,,,,,,,,,176.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,209.8,91,,percent of total billed charges,,,219.02,95,,percent of total billed charges,,,191.36,83,,percent of total billed charges,,,191.36,83,,percent of total billed charges,,,,,,,,,,,,,,,191.36,83,,percent of total billed charges,,,219.02,95,,percent of total billed charges,,,207.5,90,,percent of total billed charges,,,207.5,90,,percent of total billed charges,,,189.05,82,,percent of total billed charges,,,207.5,90,,percent of total billed charges,,,195.97,85,,percent of total billed charges,,173.83,219.02,
DEPUY DELTA HEAD 36+ 8.5MM,30183091,CDM,,,278,RC,inpatient,,15329.8,15329.8,,13015,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11558.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13030.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13490.22,88,,percent of total billed charges,,,,,,,,,11711.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13950.12,91,,percent of total billed charges,,,14563.31,95,,percent of total billed charges,,,12723.73,83,,percent of total billed charges,,,12723.73,83,,percent of total billed charges,,,,,,,,,,,,,,,12723.73,83,,percent of total billed charges,,,14563.31,95,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,12570.44,82,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,13030.33,85,,percent of total billed charges,,11558.67,14563.31,
DEPUY BIOLOX FEM HD 36MM +12,30183093,CDM,,,278,RC,inpatient,,15329.8,15329.8,,13015,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11558.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13030.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13490.22,88,,percent of total billed charges,,,,,,,,,11711.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13950.12,91,,percent of total billed charges,,,14563.31,95,,percent of total billed charges,,,12723.73,83,,percent of total billed charges,,,12723.73,83,,percent of total billed charges,,,,,,,,,,,,,,,12723.73,83,,percent of total billed charges,,,14563.31,95,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,12570.44,82,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,13030.33,85,,percent of total billed charges,,11558.67,14563.31,
DEPUY BODY RECLAIM PROXIMAL 24 X 55,30183098,CDM,,,278,RC,inpatient,,38548.77,38548.77,,32727.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29065.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32766.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33922.92,88,,percent of total billed charges,,,,,,,,,29451.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35079.38,91,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,,,,,,,,,,,,,31995.48,83,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,31609.99,82,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,32766.45,85,,percent of total billed charges,,29065.77,36621.33,
CATH STRAIGHT FILIFORM TIP 6FR,30183100,CDM,,,270,RC,inpatient,,307.58,307.58,,261.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,231.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,261.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,270.67,88,,percent of total billed charges,,,,,,,,,234.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,279.9,91,,percent of total billed charges,,,292.2,95,,percent of total billed charges,,,255.29,83,,percent of total billed charges,,,255.29,83,,percent of total billed charges,,,,,,,,,,,,,,,255.29,83,,percent of total billed charges,,,292.2,95,,percent of total billed charges,,,276.82,90,,percent of total billed charges,,,276.82,90,,percent of total billed charges,,,252.22,82,,percent of total billed charges,,,276.82,90,,percent of total billed charges,,,261.44,85,,percent of total billed charges,,231.92,292.2,
CATH WOVEN PHILLIPS FOLLOWER 22FR,30183104,CDM,,,270,RC,inpatient,,752.78,752.78,,639.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,567.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,639.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,662.45,88,,percent of total billed charges,,,,,,,,,575.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,685.03,91,,percent of total billed charges,,,715.14,95,,percent of total billed charges,,,624.81,83,,percent of total billed charges,,,624.81,83,,percent of total billed charges,,,,,,,,,,,,,,,624.81,83,,percent of total billed charges,,,715.14,95,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,617.28,82,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,639.86,85,,percent of total billed charges,,567.6,715.14,
DEPUY POROUS FEMORAL SLEEVE SZ20,30183107,CDM,,,278,RC,inpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13618.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15352.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,13618.85,17159.03,
DEPUY LINER ALTRX +4 NEUT 44 X 66,30183108,CDM,,,278,RC,inpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13270.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14960.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,13270.78,16720.48,
DEPUY FEMORAL HEAD 44MM +15.5,30183109,CDM,,,278,RC,inpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10650.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12006.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,10650.51,13419.08,
DEPUY BODY RECLAIM PROXIMAL 28 X 95,30183110,CDM,,,278,RC,inpatient,,38548.77,38548.77,,32727.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29065.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32766.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33922.92,88,,percent of total billed charges,,,,,,,,,29451.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35079.38,91,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,,,,,,,,,,,,,31995.48,83,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,31609.99,82,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,32766.45,85,,percent of total billed charges,,29065.77,36621.33,
DEPUY STEM RECLAIM ANGLED 21 X 190,30183111,CDM,,,278,RC,inpatient,,31338.78,31338.78,,26606.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23629.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26637.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27578.13,88,,percent of total billed charges,,,,,,,,,23942.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28518.29,91,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,,,,,,,,,,,,,26011.19,83,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,25697.8,82,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,26637.96,85,,percent of total billed charges,,23629.44,29771.84,
ARTHREX TIGHT ROPE SYNDE REPAIR,30183115,CDM,,,270,RC,inpatient,,5525,5525,,4690.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4165.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4696.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4862,88,,percent of total billed charges,,,,,,,,,4221.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5027.75,91,,percent of total billed charges,,,5248.75,95,,percent of total billed charges,,,4585.75,83,,percent of total billed charges,,,4585.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4585.75,83,,percent of total billed charges,,,5248.75,95,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4530.5,82,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4696.25,85,,percent of total billed charges,,4165.85,5248.75,
ARTHREX PLATE 6-HOLE LOCKING DISTAL FIB,30183116,CDM,,,270,RC,inpatient,,4712.5,4712.5,,4000.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3553.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4005.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4147,88,,percent of total billed charges,,,,,,,,,3600.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4288.38,91,,percent of total billed charges,,,4476.88,95,,percent of total billed charges,,,3911.38,83,,percent of total billed charges,,,3911.38,83,,percent of total billed charges,,,,,,,,,,,,,,,3911.38,83,,percent of total billed charges,,,4476.88,95,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,3864.25,82,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,4005.63,85,,percent of total billed charges,,3553.23,4476.88,
ARTHREX SCREW LOCKING 12MM X 2.7,30183117,CDM,,,278,RC,inpatient,,735,735,,624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,554.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,624.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,646.8,88,,percent of total billed charges,,,,,,,,,561.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,,,,,,,,,,,,,610.05,83,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,602.7,82,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,554.19,698.25,
ARTHREX SCREW LOCKING 14MM X 2.7,30183118,CDM,,,278,RC,inpatient,,735,735,,624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,554.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,624.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,646.8,88,,percent of total billed charges,,,,,,,,,561.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,,,,,,,,,,,,,610.05,83,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,602.7,82,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,554.19,698.25,
ARTHREX SCREW LOCKING 20MM X 2.7,30183119,CDM,,,278,RC,inpatient,,735,735,,624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,554.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,624.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,646.8,88,,percent of total billed charges,,,,,,,,,561.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,,,,,,,,,,,,,610.05,83,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,602.7,82,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,554.19,698.25,
ARTHREX SCREW LOCKING 12MM X 3.5,30183120,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW CORTICAL 12MM X 3.5,30183121,CDM,,,278,RC,inpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,197.93,249.38,
ARTHREX SCREW CORTICAL 14MM X 3.5,30183122,CDM,,,278,RC,inpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,197.93,249.38,
ARTHREX SCREW CORTICAL 16MM X 3.5,30183123,CDM,,,278,RC,inpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,197.93,249.38,
ARTHREX SCREW CORTICAL 18MM X 3.5,30183124,CDM,,,278,RC,inpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,197.93,249.38,
ARTHREX DRILL BIT CANNULATED 2.0MM,30183125,CDM,,,270,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
ARTHREX DRILL BIT CANNULATED 2.5MM,30183126,CDM,,,270,RC,inpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,448.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,505.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,448.63,565.25,
ARTHREX DRILL BIT CANNULATED 2.6MM,30183127,CDM,,,270,RC,inpatient,,805,805,,683.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,606.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,684.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,708.4,88,,percent of total billed charges,,,,,,,,,615.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,732.55,91,,percent of total billed charges,,,764.75,95,,percent of total billed charges,,,668.15,83,,percent of total billed charges,,,668.15,83,,percent of total billed charges,,,,,,,,,,,,,,,668.15,83,,percent of total billed charges,,,764.75,95,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,660.1,82,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,684.25,85,,percent of total billed charges,,606.97,764.75,
ARTHREX DRILL BIT 2.5MM,30183128,CDM,,,270,RC,inpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,448.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,505.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,448.63,565.25,
ARTHREX BB-TAK,30183129,CDM,,,278,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
ARTHREX GUIDEWIRE 130MM X 1.35,30183130,CDM,,,278,RC,inpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,120.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,120.64,152,
PRODY DRAINAGE BULB HOLDER,30183133,CDM,,,270,RC,inpatient,,122.16,122.16,,103.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,92.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,103.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,107.5,88,,percent of total billed charges,,,,,,,,,93.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.17,91,,percent of total billed charges,,,116.05,95,,percent of total billed charges,,,101.39,83,,percent of total billed charges,,,101.39,83,,percent of total billed charges,,,,,,,,,,,,,,,101.39,83,,percent of total billed charges,,,116.05,95,,percent of total billed charges,,,109.94,90,,percent of total billed charges,,,109.94,90,,percent of total billed charges,,,100.17,82,,percent of total billed charges,,,109.94,90,,percent of total billed charges,,,103.84,85,,percent of total billed charges,,92.11,116.05,
NEUROMONITORING DEFINITIVE,30183137,CDM,,,270,RC,inpatient,,5200,5200,,4414.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3920.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4420,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4576,88,,percent of total billed charges,,,,,,,,,3972.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4732,91,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,,,,,,,,,,,,,4316,83,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4264,82,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4420,85,,percent of total billed charges,,3920.8,4940,
DEPUY STEM GLOBAL ADVANTAGE PC 8MM,30183148,CDM,,,278,RC,inpatient,,36482.49,36482.49,,30973.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27507.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31010.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32104.59,88,,percent of total billed charges,,,,,,,,,27872.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33199.07,91,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,,,,,,,,,,,,,30280.47,83,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,29915.64,82,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,31010.12,85,,percent of total billed charges,,27507.8,34658.37,
HEAD HALTERS/CERVICAL TRACTION STANDARD,30183149,CDM,,,270,RC,inpatient,,116.56,116.56,,98.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,87.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,99.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,102.57,88,,percent of total billed charges,,,,,,,,,89.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,106.07,91,,percent of total billed charges,,,110.73,95,,percent of total billed charges,,,96.74,83,,percent of total billed charges,,,96.74,83,,percent of total billed charges,,,,,,,,,,,,,,,96.74,83,,percent of total billed charges,,,110.73,95,,percent of total billed charges,,,104.9,90,,percent of total billed charges,,,104.9,90,,percent of total billed charges,,,95.58,82,,percent of total billed charges,,,104.9,90,,percent of total billed charges,,,99.08,85,,percent of total billed charges,,87.89,110.73,
BIOMET HUMERAL NAIL 8MM X 260MM,30183151,CDM,,,278,RC,inpatient,,12857,12857,,10915.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9694.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10928.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11314.16,88,,percent of total billed charges,,,,,,,,,9822.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11699.87,91,,percent of total billed charges,,,12214.15,95,,percent of total billed charges,,,10671.31,83,,percent of total billed charges,,,10671.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10671.31,83,,percent of total billed charges,,,12214.15,95,,percent of total billed charges,,,11571.3,90,,percent of total billed charges,,,11571.3,90,,percent of total billed charges,,,10542.74,82,,percent of total billed charges,,,11571.3,90,,percent of total billed charges,,,10928.45,85,,percent of total billed charges,,9694.18,12214.15,
BIOMET HUMERAL NAIL 8MM X 280MM,30183154,CDM,,,278,RC,inpatient,,16380,16380,,13906.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12350.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13923,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14414.4,88,,percent of total billed charges,,,,,,,,,12514.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14905.8,91,,percent of total billed charges,,,15561,95,,percent of total billed charges,,,13595.4,83,,percent of total billed charges,,,13595.4,83,,percent of total billed charges,,,,,,,,,,,,,,,13595.4,83,,percent of total billed charges,,,15561,95,,percent of total billed charges,,,14742,90,,percent of total billed charges,,,14742,90,,percent of total billed charges,,,13431.6,82,,percent of total billed charges,,,14742,90,,percent of total billed charges,,,13923,85,,percent of total billed charges,,12350.52,15561,
CELL SAVER SERVICE - CANCELLATION FEES,30183155,CDM,,,270,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
ARTHREX PLATE 6-HOLE LOCKING DISTAL-R,30183158,CDM,,,270,RC,inpatient,,4225,4225,,3587.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3185.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3591.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3718,88,,percent of total billed charges,,,,,,,,,3227.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3844.75,91,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,,,,,,,,,,,,,3506.75,83,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3464.5,82,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,3185.65,4013.75,
ARTHREX SCREW LOCKING 16MM X 2.7,30183159,CDM,,,278,RC,inpatient,,735,735,,624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,554.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,624.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,646.8,88,,percent of total billed charges,,,,,,,,,561.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,,,,,,,,,,,,,610.05,83,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,602.7,82,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,554.19,698.25,
ARTHREX SCREW LOCKING 14MM X 3.5,30183160,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW LOCKING 20MM X 3.5,30183161,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
STRYKER SCREW LAG 10.5 X 90MM,30183167,CDM,,,278,RC,inpatient,,5200.33,5200.33,,4415.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3921.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4420.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4576.29,88,,percent of total billed charges,,,,,,,,,3973.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4732.3,91,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,,,,,,,,,,,,,4316.27,83,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4264.27,82,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4420.28,85,,percent of total billed charges,,3921.05,4940.31,
AMVISC PLUS 0.8ML,30183170,CDM,,,270,RC,inpatient,,385,385,,326.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,290.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,327.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,338.8,88,,percent of total billed charges,,,,,,,,,294.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,350.35,91,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,,,,,,,,,,,,,319.55,83,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,315.7,82,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,290.29,365.75,
RTI PATELLAR TENDON  10MM BTB PRESHAPE,30183180,CDM,,,278,RC,inpatient,,23400,23400,,19866.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17643.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19890,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20592,88,,percent of total billed charges,,,,,,,,,17877.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21294,91,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,,,,,,,,,,,,,19422,83,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19188,82,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19890,85,,percent of total billed charges,,17643.6,22230,
DEPUY STEM CORAIL SZ12,30183181,CDM,,,278,RC,inpatient,,33799.35,33799.35,,28695.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25484.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28729.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29743.43,88,,percent of total billed charges,,,,,,,,,25822.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30757.41,91,,percent of total billed charges,,,32109.38,95,,percent of total billed charges,,,28053.46,83,,percent of total billed charges,,,28053.46,83,,percent of total billed charges,,,,,,,,,,,,,,,28053.46,83,,percent of total billed charges,,,32109.38,95,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,27715.47,82,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,28729.45,85,,percent of total billed charges,,25484.71,32109.38,
GYRUS THUNDERBEAT 5M 20CM INLINE GRIP,30183182,CDM,,,270,RC,inpatient,,5954,5954,,5054.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4489.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5060.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5239.52,88,,percent of total billed charges,,,,,,,,,4548.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5418.14,91,,percent of total billed charges,,,5656.3,95,,percent of total billed charges,,,4941.82,83,,percent of total billed charges,,,4941.82,83,,percent of total billed charges,,,,,,,,,,,,,,,4941.82,83,,percent of total billed charges,,,5656.3,95,,percent of total billed charges,,,5358.6,90,,percent of total billed charges,,,5358.6,90,,percent of total billed charges,,,4882.28,82,,percent of total billed charges,,,5358.6,90,,percent of total billed charges,,,5060.9,85,,percent of total billed charges,,4489.32,5656.3,
GYRUS THUNDERBEAT 5M 10CM INLINE GRIP,30183183,CDM,,,270,RC,inpatient,,6251.7,6251.7,,5307.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4713.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5313.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5501.5,88,,percent of total billed charges,,,,,,,,,4776.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5689.05,91,,percent of total billed charges,,,5939.12,95,,percent of total billed charges,,,5188.91,83,,percent of total billed charges,,,5188.91,83,,percent of total billed charges,,,,,,,,,,,,,,,5188.91,83,,percent of total billed charges,,,5939.12,95,,percent of total billed charges,,,5626.53,90,,percent of total billed charges,,,5626.53,90,,percent of total billed charges,,,5126.39,82,,percent of total billed charges,,,5626.53,90,,percent of total billed charges,,,5313.95,85,,percent of total billed charges,,4713.78,5939.12,
DEPUY BIPOLAR HEAD 40 X28CM,30183185,CDM,,,278,RC,inpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,6126.3,7718.82,
AQUAMANTYS MINI EVS,30183187,CDM,,,270,RC,inpatient,,4143.75,4143.75,,3518.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3124.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3522.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3646.5,88,,percent of total billed charges,,,,,,,,,3165.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3770.81,91,,percent of total billed charges,,,3936.56,95,,percent of total billed charges,,,3439.31,83,,percent of total billed charges,,,3439.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3439.31,83,,percent of total billed charges,,,3936.56,95,,percent of total billed charges,,,3729.38,90,,percent of total billed charges,,,3729.38,90,,percent of total billed charges,,,3397.88,82,,percent of total billed charges,,,3729.38,90,,percent of total billed charges,,,3522.19,85,,percent of total billed charges,,3124.39,3936.56,
DEPUY EPAK PINNING SYSTEM,30183203,CDM,,,278,RC,inpatient,,3542.5,3542.5,,3007.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2671.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3011.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3117.4,88,,percent of total billed charges,,,,,,,,,2706.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3223.68,91,,percent of total billed charges,,,3365.38,95,,percent of total billed charges,,,2940.28,83,,percent of total billed charges,,,2940.28,83,,percent of total billed charges,,,,,,,,,,,,,,,2940.28,83,,percent of total billed charges,,,3365.38,95,,percent of total billed charges,,,3188.25,90,,percent of total billed charges,,,3188.25,90,,percent of total billed charges,,,2904.85,82,,percent of total billed charges,,,3188.25,90,,percent of total billed charges,,,3011.13,85,,percent of total billed charges,,2671.05,3365.38,
DEPUY PATELLA ATTUNE DOME 41MM,30183204,CDM,,,278,RC,inpatient,,6897.67,6897.67,,5856.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5200.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5863.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6069.95,88,,percent of total billed charges,,,,,,,,,5269.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6276.88,91,,percent of total billed charges,,,6552.79,95,,percent of total billed charges,,,5725.07,83,,percent of total billed charges,,,5725.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5725.07,83,,percent of total billed charges,,,6552.79,95,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,5656.09,82,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,5863.02,85,,percent of total billed charges,,5200.84,6552.79,
DEPUY FEMUR ATTUNE PS SZ 6 L,30183205,CDM,,,278,RC,inpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21324.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24039.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,21324.5,26867.74,
DEPUY INSERT AOX PS FB SZ 6 7MM,30183206,CDM,,,278,RC,inpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9407.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10605.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,9407.86,11853.41,
DEPUY ATTUNE FB W/DOME PATELLA,30183208,CDM,,,278,RC,inpatient,,37440,37440,,31786.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28229.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31824,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32947.2,88,,percent of total billed charges,,,,,,,,,28604.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34070.4,91,,percent of total billed charges,,,35568,95,,percent of total billed charges,,,31075.2,83,,percent of total billed charges,,,31075.2,83,,percent of total billed charges,,,,,,,,,,,,,,,31075.2,83,,percent of total billed charges,,,35568,95,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,30700.8,82,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,31824,85,,percent of total billed charges,,28229.76,35568,
DEPUY-MITEK DRILL BIT 2.4MM,30183209,CDM,,,270,RC,inpatient,,1079,1079,,916.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,813.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,917.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,949.52,88,,percent of total billed charges,,,,,,,,,824.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,981.89,91,,percent of total billed charges,,,1025.05,95,,percent of total billed charges,,,895.57,83,,percent of total billed charges,,,895.57,83,,percent of total billed charges,,,,,,,,,,,,,,,895.57,83,,percent of total billed charges,,,1025.05,95,,percent of total billed charges,,,971.1,90,,percent of total billed charges,,,971.1,90,,percent of total billed charges,,,884.78,82,,percent of total billed charges,,,971.1,90,,percent of total billed charges,,,917.15,85,,percent of total billed charges,,813.57,1025.05,
DEPUY SCREW BONE 6.5 X 25,30183225,CDM,,,278,RC,inpatient,,1244.95,1244.95,,1056.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,938.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1058.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1095.56,88,,percent of total billed charges,,,,,,,,,951.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1132.9,91,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.31,83,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1020.86,82,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,938.69,1182.7,
DEPUY SCREW BONE 6.5 X 20,30183226,CDM,,,278,RC,inpatient,,1244.95,1244.95,,1056.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,938.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1058.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1095.56,88,,percent of total billed charges,,,,,,,,,951.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1132.9,91,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.31,83,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1020.86,82,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,938.69,1182.7,
DEPUY HIP CERAMIC ON CERAMIC,30183227,CDM,,,278,RC,inpatient,,41464.28,41464.28,,35203.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31264.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35244.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36488.57,88,,percent of total billed charges,,,,,,,,,31678.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37732.49,91,,percent of total billed charges,,,39391.07,95,,percent of total billed charges,,,34415.35,83,,percent of total billed charges,,,34415.35,83,,percent of total billed charges,,,,,,,,,,,,,,,34415.35,83,,percent of total billed charges,,,39391.07,95,,percent of total billed charges,,,37317.85,90,,percent of total billed charges,,,37317.85,90,,percent of total billed charges,,,34000.71,82,,percent of total billed charges,,,37317.85,90,,percent of total billed charges,,,35244.64,85,,percent of total billed charges,,31264.07,39391.07,
SYNTHES NORIAN INJECTABLE DRILLABLE 5CC,30183228,CDM,,,270,RC,inpatient,,12895.35,12895.35,,10948.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9723.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10961.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11347.91,88,,percent of total billed charges,,,,,,,,,9852.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11734.77,91,,percent of total billed charges,,,12250.58,95,,percent of total billed charges,,,10703.14,83,,percent of total billed charges,,,10703.14,83,,percent of total billed charges,,,,,,,,,,,,,,,10703.14,83,,percent of total billed charges,,,12250.58,95,,percent of total billed charges,,,11605.82,90,,percent of total billed charges,,,11605.82,90,,percent of total billed charges,,,10574.19,82,,percent of total billed charges,,,11605.82,90,,percent of total billed charges,,,10961.05,85,,percent of total billed charges,,9723.09,12250.58,
XPS GREENLIGHT LASER SERVICE FEE,30183233,CDM,,,270,RC,inpatient,,5200,5200,,4414.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3920.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4420,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4576,88,,percent of total billed charges,,,,,,,,,3972.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4732,91,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,,,,,,,,,,,,,4316,83,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4264,82,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4420,85,,percent of total billed charges,,3920.8,4940,
XPS MOXY FIBER,30183234,CDM,,,270,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
MESH VENTRALIGHT STD 6X8,30183235,CDM,,,278,RC,inpatient,,5460,5460,,4635.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4116.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4641,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4804.8,88,,percent of total billed charges,,,,,,,,,4171.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4968.6,91,,percent of total billed charges,,,5187,95,,percent of total billed charges,,,4531.8,83,,percent of total billed charges,,,4531.8,83,,percent of total billed charges,,,,,,,,,,,,,,,4531.8,83,,percent of total billed charges,,,5187,95,,percent of total billed charges,,,4914,90,,percent of total billed charges,,,4914,90,,percent of total billed charges,,,4477.2,82,,percent of total billed charges,,,4914,90,,percent of total billed charges,,,4641,85,,percent of total billed charges,,4116.84,5187,
BODY REST MOD PROX CONE 25X0MM STD,30183238,CDM,,,278,RC,inpatient,,21391.5,21391.5,,18161.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16129.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18182.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18824.52,88,,percent of total billed charges,,,,,,,,,16343.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19466.27,91,,percent of total billed charges,,,20321.93,95,,percent of total billed charges,,,17754.95,83,,percent of total billed charges,,,17754.95,83,,percent of total billed charges,,,,,,,,,,,,,,,17754.95,83,,percent of total billed charges,,,20321.93,95,,percent of total billed charges,,,19252.35,90,,percent of total billed charges,,,19252.35,90,,percent of total billed charges,,,17541.03,82,,percent of total billed charges,,,19252.35,90,,percent of total billed charges,,,18182.78,85,,percent of total billed charges,,16129.19,20321.93,
HEAD V40 COCR LFIT 28MM +4,30183240,CDM,,,278,RC,inpatient,,4647.5,4647.5,,3945.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3504.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3950.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4089.8,88,,percent of total billed charges,,,,,,,,,3550.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4229.23,91,,percent of total billed charges,,,4415.13,95,,percent of total billed charges,,,3857.43,83,,percent of total billed charges,,,3857.43,83,,percent of total billed charges,,,,,,,,,,,,,,,3857.43,83,,percent of total billed charges,,,4415.13,95,,percent of total billed charges,,,4182.75,90,,percent of total billed charges,,,4182.75,90,,percent of total billed charges,,,3810.95,82,,percent of total billed charges,,,4182.75,90,,percent of total billed charges,,,3950.38,85,,percent of total billed charges,,3504.22,4415.13,
BODY REST MOD PROX CONE 25MM +10,30183243,CDM,,,278,RC,inpatient,,35594.65,35594.65,,30219.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26838.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30255.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31323.29,88,,percent of total billed charges,,,,,,,,,27194.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32391.13,91,,percent of total billed charges,,,33814.92,95,,percent of total billed charges,,,29543.56,83,,percent of total billed charges,,,29543.56,83,,percent of total billed charges,,,,,,,,,,,,,,,29543.56,83,,percent of total billed charges,,,33814.92,95,,percent of total billed charges,,,32035.19,90,,percent of total billed charges,,,32035.19,90,,percent of total billed charges,,,29187.61,82,,percent of total billed charges,,,32035.19,90,,percent of total billed charges,,,30255.45,85,,percent of total billed charges,,26838.37,33814.92,
DEPUY DISTAL AUGMENT 4MM SZ4.0 LEFT,30183244,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
DEPUY BUILD UP TRAY 15MM SZ 4,30183245,CDM,,,278,RC,inpatient,,51595.57,51595.57,,43804.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38903.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43856.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45404.1,88,,percent of total billed charges,,,,,,,,,39419.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46951.97,91,,percent of total billed charges,,,49015.79,95,,percent of total billed charges,,,42824.32,83,,percent of total billed charges,,,42824.32,83,,percent of total billed charges,,,,,,,,,,,,,,,42824.32,83,,percent of total billed charges,,,49015.79,95,,percent of total billed charges,,,46436.01,90,,percent of total billed charges,,,46436.01,90,,percent of total billed charges,,,42308.37,82,,percent of total billed charges,,,46436.01,90,,percent of total billed charges,,,43856.23,85,,percent of total billed charges,,38903.06,49015.79,
NEUROMONITORING EMG 1 EXT W/OR W/O PARA,30183246,CDM,,,270,RC,inpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1715.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1933.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,1715.35,2161.25,
NEUROMONITORING TCMEP UPPER & LOWER,30183247,CDM,,,270,RC,inpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1715.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1933.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,1715.35,2161.25,
STRYKER RADIOFREQUENCY GENERATOR,30183256,CDM,,,270,RC,inpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7351.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8287.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,7351.5,9262.5,
STRYKER STERILIZATION BOX W/ELECTRODES,30183257,CDM,,,270,RC,inpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3675.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4143.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,3675.75,4631.25,
STRYKER ACTIVE TIP 100MM 18G 10MM,30183258,CDM,,,270,RC,inpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7351.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8287.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,7351.5,9262.5,
NEEDLE TUOHY EPIDURAL 18G X 3.5,30183261,CDM,,,270,RC,inpatient,,25.61,25.61,,21.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.54,88,,percent of total billed charges,,,,,,,,,19.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.31,91,,percent of total billed charges,,,24.33,95,,percent of total billed charges,,,21.26,83,,percent of total billed charges,,,21.26,83,,percent of total billed charges,,,,,,,,,,,,,,,21.26,83,,percent of total billed charges,,,24.33,95,,percent of total billed charges,,,23.05,90,,percent of total billed charges,,,23.05,90,,percent of total billed charges,,,21,82,,percent of total billed charges,,,23.05,90,,percent of total billed charges,,,21.77,85,,percent of total billed charges,,19.31,24.33,
KYPHON XPANDER INFLATION SYRINGE,30183263,CDM,,,270,RC,inpatient,,929.5,929.5,,789.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,700.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,790.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,817.96,88,,percent of total billed charges,,,,,,,,,710.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,845.85,91,,percent of total billed charges,,,883.03,95,,percent of total billed charges,,,771.49,83,,percent of total billed charges,,,771.49,83,,percent of total billed charges,,,,,,,,,,,,,,,771.49,83,,percent of total billed charges,,,883.03,95,,percent of total billed charges,,,836.55,90,,percent of total billed charges,,,836.55,90,,percent of total billed charges,,,762.19,82,,percent of total billed charges,,,836.55,90,,percent of total billed charges,,,790.08,85,,percent of total billed charges,,700.84,883.03,
NEEDLE TUOHY EPIDURAL 22G X 3.5,30183264,CDM,,,270,RC,inpatient,,84.24,84.24,,71.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.13,88,,percent of total billed charges,,,,,,,,,64.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.66,91,,percent of total billed charges,,,80.03,95,,percent of total billed charges,,,69.92,83,,percent of total billed charges,,,69.92,83,,percent of total billed charges,,,,,,,,,,,,,,,69.92,83,,percent of total billed charges,,,80.03,95,,percent of total billed charges,,,75.82,90,,percent of total billed charges,,,75.82,90,,percent of total billed charges,,,69.08,82,,percent of total billed charges,,,75.82,90,,percent of total billed charges,,,71.6,85,,percent of total billed charges,,63.52,80.03,
NEEDLE SPINAL CHIBA 22G X 6IN,30183265,CDM,,,270,RC,inpatient,,46.92,46.92,,39.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.29,88,,percent of total billed charges,,,,,,,,,35.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.7,91,,percent of total billed charges,,,44.57,95,,percent of total billed charges,,,38.94,83,,percent of total billed charges,,,38.94,83,,percent of total billed charges,,,,,,,,,,,,,,,38.94,83,,percent of total billed charges,,,44.57,95,,percent of total billed charges,,,42.23,90,,percent of total billed charges,,,42.23,90,,percent of total billed charges,,,38.47,82,,percent of total billed charges,,,42.23,90,,percent of total billed charges,,,39.88,85,,percent of total billed charges,,35.38,44.57,
DEPUY SLEEVE DISTAL POROUS 31MM,30183266,CDM,,,278,RC,inpatient,,12552.61,12552.61,,10657.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9464.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10669.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11046.3,88,,percent of total billed charges,,,,,,,,,9590.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11422.88,91,,percent of total billed charges,,,11924.98,95,,percent of total billed charges,,,10418.67,83,,percent of total billed charges,,,10418.67,83,,percent of total billed charges,,,,,,,,,,,,,,,10418.67,83,,percent of total billed charges,,,11924.98,95,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,10293.14,82,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,10669.72,85,,percent of total billed charges,,9464.67,11924.98,
DEPUY ATTUNE FEMUR PS SZ 6 RT,30183267,CDM,,,278,RC,inpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21324.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24039.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,21324.5,26867.74,
DEPUY PATELLA MEDIALIZED DOME 38MM,30183268,CDM,,,278,RC,inpatient,,6238.64,6238.64,,5296.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4703.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5302.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5490,88,,percent of total billed charges,,,,,,,,,4766.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5677.16,91,,percent of total billed charges,,,5926.71,95,,percent of total billed charges,,,5178.07,83,,percent of total billed charges,,,5178.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5178.07,83,,percent of total billed charges,,,5926.71,95,,percent of total billed charges,,,5614.78,90,,percent of total billed charges,,,5614.78,90,,percent of total billed charges,,,5115.68,82,,percent of total billed charges,,,5614.78,90,,percent of total billed charges,,,5302.84,85,,percent of total billed charges,,4703.93,5926.71,
DEPUY TRAY TIBIAL SZ 5,30183269,CDM,,,278,RC,inpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14425.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16261.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,14425.07,18174.82,
PAD COVER ALLEN BOW FRAME,30183276,CDM,,,270,RC,inpatient,,560,560,,475.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,422.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,476,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,492.8,88,,percent of total billed charges,,,,,,,,,427.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,509.6,91,,percent of total billed charges,,,532,95,,percent of total billed charges,,,464.8,83,,percent of total billed charges,,,464.8,83,,percent of total billed charges,,,,,,,,,,,,,,,464.8,83,,percent of total billed charges,,,532,95,,percent of total billed charges,,,504,90,,percent of total billed charges,,,504,90,,percent of total billed charges,,,459.2,82,,percent of total billed charges,,,504,90,,percent of total billed charges,,,476,85,,percent of total billed charges,,422.24,532,
CELL SAVER ANTICOAGULATION/ASPIRATION AS,30183280,CDM,,,270,RC,inpatient,,136,136,,115.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,102.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,115.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,119.68,88,,percent of total billed charges,,,,,,,,,103.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,123.76,91,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,,,,,,,,,,,,,112.88,83,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,111.52,82,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,102.54,129.2,
SYNTHES SCREW LOCKING VA 2.7MM X 20MM,30183284,CDM,,,278,RC,inpatient,,1371.5,1371.5,,1164.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1034.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1165.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1206.92,88,,percent of total billed charges,,,,,,,,,1047.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1248.07,91,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.35,83,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1124.63,82,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,1034.11,1302.93,
CELL SAVER CARDIOTOMY RESERVOIR,30183286,CDM,,,270,RC,inpatient,,455,455,,386.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,343.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,386.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,400.4,88,,percent of total billed charges,,,,,,,,,347.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,414.05,91,,percent of total billed charges,,,432.25,95,,percent of total billed charges,,,377.65,83,,percent of total billed charges,,,377.65,83,,percent of total billed charges,,,,,,,,,,,,,,,377.65,83,,percent of total billed charges,,,432.25,95,,percent of total billed charges,,,409.5,90,,percent of total billed charges,,,409.5,90,,percent of total billed charges,,,373.1,82,,percent of total billed charges,,,409.5,90,,percent of total billed charges,,,386.75,85,,percent of total billed charges,,343.07,432.25,
ARTHREX SCREW LOCKING 18MM X 2.7,30183290,CDM,,,278,RC,inpatient,,735,735,,624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,554.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,624.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,646.8,88,,percent of total billed charges,,,,,,,,,561.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,,,,,,,,,,,,,610.05,83,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,602.7,82,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,554.19,698.25,
ARTHREX SCREW CORTICAL 30MM X 3.5,30183291,CDM,,,278,RC,inpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,197.93,249.38,
ARTHREX PLATE 5-HOLE LOCKING DISTAL FIB,30183292,CDM,,,270,RC,inpatient,,4225,4225,,3587.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3185.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3591.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3718,88,,percent of total billed charges,,,,,,,,,3227.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3844.75,91,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,,,,,,,,,,,,,3506.75,83,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3464.5,82,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,3185.65,4013.75,
DEPUY FEMUR ATTUNE PS SZ 5 LFT,30183297,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY INSERT AOX PS 7MM SZ 5,30183298,CDM,,,278,RC,inpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9407.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10605.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,9407.86,11853.41,
DEPUY HUMERAL CUP 42MM +3,30183299,CDM,,,278,RC,inpatient,,10688.08,10688.08,,9074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8058.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9084.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9405.51,88,,percent of total billed charges,,,,,,,,,8165.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9726.15,91,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,,,,,,,,,,,,,8871.11,83,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,8764.23,82,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,8058.81,10153.68,
DEPUY HUMERAL STEM 14 DIA MODULAR,30183300,CDM,,,278,RC,inpatient,,17244.96,17244.96,,14640.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13002.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14658.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15175.56,88,,percent of total billed charges,,,,,,,,,13175.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15692.91,91,,percent of total billed charges,,,16382.71,95,,percent of total billed charges,,,14313.32,83,,percent of total billed charges,,,14313.32,83,,percent of total billed charges,,,,,,,,,,,,,,,14313.32,83,,percent of total billed charges,,,16382.71,95,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,14140.87,82,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,14658.22,85,,percent of total billed charges,,13002.7,16382.71,
DEPUY EPIPHYSIS MODULAR SZ 1,30183301,CDM,,,278,RC,inpatient,,33055.36,33055.36,,28064,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24923.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28097.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29088.72,88,,percent of total billed charges,,,,,,,,,25254.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30080.38,91,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,,,,,,,,,,,,,27435.95,83,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,27105.4,82,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,28097.06,85,,percent of total billed charges,,24923.74,31402.59,
STOPCOCK EXTENSION SET 12,30183302,CDM,,,270,RC,inpatient,,8.64,8.64,,7.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.6,88,,percent of total billed charges,,,,,,,,,6.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.86,91,,percent of total billed charges,,,8.21,95,,percent of total billed charges,,,7.17,83,,percent of total billed charges,,,7.17,83,,percent of total billed charges,,,,,,,,,,,,,,,7.17,83,,percent of total billed charges,,,8.21,95,,percent of total billed charges,,,7.78,90,,percent of total billed charges,,,7.78,90,,percent of total billed charges,,,7.08,82,,percent of total billed charges,,,7.78,90,,percent of total billed charges,,,7.34,85,,percent of total billed charges,,6.51,8.21,
S&N SUTURE PASSER 70 DEG UPWARD,30183303,CDM,,,270,RC,inpatient,,892.78,892.78,,757.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,673.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,758.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,785.65,88,,percent of total billed charges,,,,,,,,,682.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,812.43,91,,percent of total billed charges,,,848.14,95,,percent of total billed charges,,,741.01,83,,percent of total billed charges,,,741.01,83,,percent of total billed charges,,,,,,,,,,,,,,,741.01,83,,percent of total billed charges,,,848.14,95,,percent of total billed charges,,,803.5,90,,percent of total billed charges,,,803.5,90,,percent of total billed charges,,,732.08,82,,percent of total billed charges,,,803.5,90,,percent of total billed charges,,,758.86,85,,percent of total billed charges,,673.16,848.14,
DEPUY ATTUNE FEMUR PS SZ 4 LEFT,30183316,CDM,,,278,RC,inpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21324.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24039.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,21324.5,26867.74,
DEPUY ATTUNE FEMUR RIGHT SZ 4,30183317,CDM,,,278,RC,inpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21324.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24039.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,21324.5,26867.74,
DEPUY ATTUNE PATELLA DOME SZ 32,30183320,CDM,,,278,RC,inpatient,,6897.67,6897.67,,5856.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5200.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5863.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6069.95,88,,percent of total billed charges,,,,,,,,,5269.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6276.88,91,,percent of total billed charges,,,6552.79,95,,percent of total billed charges,,,5725.07,83,,percent of total billed charges,,,5725.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5725.07,83,,percent of total billed charges,,,6552.79,95,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,5656.09,82,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,5863.02,85,,percent of total billed charges,,5200.84,6552.79,
DEPUY ATTUNE INSERT TIBIAL SZ 5 6MM,30183321,CDM,,,278,RC,inpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9407.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10605.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,9407.86,11853.41,
DEPUY ATTUNE PATELLA 35MM,30183322,CDM,,,278,RC,inpatient,,6238.64,6238.64,,5296.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4703.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5302.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5490,88,,percent of total billed charges,,,,,,,,,4766.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5677.16,91,,percent of total billed charges,,,5926.71,95,,percent of total billed charges,,,5178.07,83,,percent of total billed charges,,,5178.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5178.07,83,,percent of total billed charges,,,5926.71,95,,percent of total billed charges,,,5614.78,90,,percent of total billed charges,,,5614.78,90,,percent of total billed charges,,,5115.68,82,,percent of total billed charges,,,5614.78,90,,percent of total billed charges,,,5302.84,85,,percent of total billed charges,,4703.93,5926.71,
DEPUY HIP BALL MOD 43MM,30183323,CDM,,,278,RC,inpatient,,4693.78,4693.78,,3985.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3539.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3989.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4130.53,88,,percent of total billed charges,,,,,,,,,3586.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4271.34,91,,percent of total billed charges,,,4459.09,95,,percent of total billed charges,,,3895.84,83,,percent of total billed charges,,,3895.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3895.84,83,,percent of total billed charges,,,4459.09,95,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,3848.9,82,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,3989.71,85,,percent of total billed charges,,3539.11,4459.09,
SURGICAL PATTIES 1/2 X 1,30183325,CDM,,,270,RC,inpatient,,23.74,23.74,,20.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.89,88,,percent of total billed charges,,,,,,,,,18.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.6,91,,percent of total billed charges,,,22.55,95,,percent of total billed charges,,,19.7,83,,percent of total billed charges,,,19.7,83,,percent of total billed charges,,,,,,,,,,,,,,,19.7,83,,percent of total billed charges,,,22.55,95,,percent of total billed charges,,,21.37,90,,percent of total billed charges,,,21.37,90,,percent of total billed charges,,,19.47,82,,percent of total billed charges,,,21.37,90,,percent of total billed charges,,,20.18,85,,percent of total billed charges,,17.9,22.55,
DEPUY FEMUR SZ 7 L PS,30183326,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY INSERT AOX SZ 7 6MM,30183327,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY INSERT AOX PS SZ 5 5MM,30183329,CDM,,,278,RC,inpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9407.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10605.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,9407.86,11853.41,
SYNTHES SCREW LOCKING 3.5X22MM,30183332,CDM,,,278,RC,inpatient,,1182.35,1182.35,,1003.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,891.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1005,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1040.47,88,,percent of total billed charges,,,,,,,,,903.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1075.94,91,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,,,,,,,,,,,,,981.35,83,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,969.53,82,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1005,85,,percent of total billed charges,,891.49,1123.23,
SYNTHES DRILL BIT 2.8MM,30183336,CDM,,,270,RC,inpatient,,1764.3,1764.3,,1497.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1330.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1499.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1552.58,88,,percent of total billed charges,,,,,,,,,1347.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1605.51,91,,percent of total billed charges,,,1676.09,95,,percent of total billed charges,,,1464.37,83,,percent of total billed charges,,,1464.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1464.37,83,,percent of total billed charges,,,1676.09,95,,percent of total billed charges,,,1587.87,90,,percent of total billed charges,,,1587.87,90,,percent of total billed charges,,,1446.73,82,,percent of total billed charges,,,1587.87,90,,percent of total billed charges,,,1499.66,85,,percent of total billed charges,,1330.28,1676.09,
SYNTHES SCREW LOCKING 3.5 X 75MM,30183339,CDM,,,278,RC,inpatient,,1182.35,1182.35,,1003.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,891.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1005,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1040.47,88,,percent of total billed charges,,,,,,,,,903.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1075.94,91,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,,,,,,,,,,,,,981.35,83,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,969.53,82,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1005,85,,percent of total billed charges,,891.49,1123.23,
SYNTHES SCREW LOCKING 3.5 X 80MM,30183340,CDM,,,278,RC,inpatient,,1182.35,1182.35,,1003.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,891.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1005,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1040.47,88,,percent of total billed charges,,,,,,,,,903.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1075.94,91,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,,,,,,,,,,,,,981.35,83,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,969.53,82,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1005,85,,percent of total billed charges,,891.49,1123.23,
ESWL SERVICES UNILATERAL,30183345,CDM,,,270,RC,inpatient,,11375,11375,,9657.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8576.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9668.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10010,88,,percent of total billed charges,,,,,,,,,8690.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10351.25,91,,percent of total billed charges,,,10806.25,95,,percent of total billed charges,,,9441.25,83,,percent of total billed charges,,,9441.25,83,,percent of total billed charges,,,,,,,,,,,,,,,9441.25,83,,percent of total billed charges,,,10806.25,95,,percent of total billed charges,,,10237.5,90,,percent of total billed charges,,,10237.5,90,,percent of total billed charges,,,9327.5,82,,percent of total billed charges,,,10237.5,90,,percent of total billed charges,,,9668.75,85,,percent of total billed charges,,8576.75,10806.25,
SYNTHES PLATE LCP 3.5MM RIGHT ANGLE,30183346,CDM,,,278,RC,inpatient,,2945.15,2945.15,,2500.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2220.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2503.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2591.73,88,,percent of total billed charges,,,,,,,,,2250.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2680.09,91,,percent of total billed charges,,,2797.89,95,,percent of total billed charges,,,2444.47,83,,percent of total billed charges,,,2444.47,83,,percent of total billed charges,,,,,,,,,,,,,,,2444.47,83,,percent of total billed charges,,,2797.89,95,,percent of total billed charges,,,2650.64,90,,percent of total billed charges,,,2650.64,90,,percent of total billed charges,,,2415.02,82,,percent of total billed charges,,,2650.64,90,,percent of total billed charges,,,2503.38,85,,percent of total billed charges,,2220.64,2797.89,
SYNTHES SCREW CANCEL 28MM,30183351,CDM,,,278,RC,inpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,168.24,211.97,
MYOSURE CLASSIC,30183353,CDM,,,270,RC,inpatient,,9737,9737,,8266.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7341.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8276.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8568.56,88,,percent of total billed charges,,,,,,,,,7439.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8860.67,91,,percent of total billed charges,,,9250.15,95,,percent of total billed charges,,,8081.71,83,,percent of total billed charges,,,8081.71,83,,percent of total billed charges,,,,,,,,,,,,,,,8081.71,83,,percent of total billed charges,,,9250.15,95,,percent of total billed charges,,,8763.3,90,,percent of total billed charges,,,8763.3,90,,percent of total billed charges,,,7984.34,82,,percent of total billed charges,,,8763.3,90,,percent of total billed charges,,,8276.45,85,,percent of total billed charges,,7341.7,9250.15,
MYOSURE SCOPE SEALS,30183354,CDM,,,270,RC,inpatient,,80.75,80.75,,68.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.06,88,,percent of total billed charges,,,,,,,,,61.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.48,91,,percent of total billed charges,,,76.71,95,,percent of total billed charges,,,67.02,83,,percent of total billed charges,,,67.02,83,,percent of total billed charges,,,,,,,,,,,,,,,67.02,83,,percent of total billed charges,,,76.71,95,,percent of total billed charges,,,72.68,90,,percent of total billed charges,,,72.68,90,,percent of total billed charges,,,66.22,82,,percent of total billed charges,,,72.68,90,,percent of total billed charges,,,68.64,85,,percent of total billed charges,,60.89,76.71,
DEPUY WEDGE STEP 10MM SZ3,30183366,CDM,,,278,RC,inpatient,,15761.79,15761.79,,13381.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11884.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13397.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13870.38,88,,percent of total billed charges,,,,,,,,,12042.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14343.23,91,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,,,,,,,,,,,,,13082.29,83,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,12924.67,82,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,13397.52,85,,percent of total billed charges,,11884.39,14973.7,
DEPUY INSERT PS SZ 4 6MM,30183367,CDM,,,278,RC,inpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9407.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10605.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,9407.86,11853.41,
DEPUY ATTUNE INSERT AOX SZ 6 8MM,30183368,CDM,,,278,RC,inpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9407.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10605.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,9407.86,11853.41,
DEPUY ATTUNE FEMUR PS SZ 5 RT,30183369,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY ATTUNE INSERT AOX PS SZ 5 8MM,30183370,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
COVERS ALLEN COMFORT,30183372,CDM,,,270,RC,inpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,316.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,357,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,316.68,399,
STRYKER BLADE RECIP DBL SIDED OFFSET,30183381,CDM,,,270,RC,inpatient,,343.88,343.88,,291.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,259.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,292.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,302.61,88,,percent of total billed charges,,,,,,,,,262.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,312.93,91,,percent of total billed charges,,,326.69,95,,percent of total billed charges,,,285.42,83,,percent of total billed charges,,,285.42,83,,percent of total billed charges,,,,,,,,,,,,,,,285.42,83,,percent of total billed charges,,,326.69,95,,percent of total billed charges,,,309.49,90,,percent of total billed charges,,,309.49,90,,percent of total billed charges,,,281.98,82,,percent of total billed charges,,,309.49,90,,percent of total billed charges,,,292.3,85,,percent of total billed charges,,259.29,326.69,
S&N ENDO TAPERED AWL 3.8MM,30183382,CDM,,,278,RC,inpatient,,360,360,,305.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,271.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,306,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,316.8,88,,percent of total billed charges,,,,,,,,,275.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,327.6,91,,percent of total billed charges,,,342,95,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,,,,,,,,,,,,,298.8,83,,percent of total billed charges,,,342,95,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,295.2,82,,percent of total billed charges,,,324,90,,percent of total billed charges,,,306,85,,percent of total billed charges,,271.44,342,
ALEXIS WOUND PROTECOTR/RETRACTOR,30183389,CDM,,,270,RC,inpatient,,306.6,306.6,,260.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,231.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,260.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,269.81,88,,percent of total billed charges,,,,,,,,,234.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,279.01,91,,percent of total billed charges,,,291.27,95,,percent of total billed charges,,,254.48,83,,percent of total billed charges,,,254.48,83,,percent of total billed charges,,,,,,,,,,,,,,,254.48,83,,percent of total billed charges,,,291.27,95,,percent of total billed charges,,,275.94,90,,percent of total billed charges,,,275.94,90,,percent of total billed charges,,,251.41,82,,percent of total billed charges,,,275.94,90,,percent of total billed charges,,,260.61,85,,percent of total billed charges,,231.18,291.27,
CORTICAL STRUTS 2 X 11CM - 24CM,30183392,CDM,,,278,RC,inpatient,,2580.5,2580.5,,2190.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1945.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2193.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2270.84,88,,percent of total billed charges,,,,,,,,,1971.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2348.26,91,,percent of total billed charges,,,2451.48,95,,percent of total billed charges,,,2141.82,83,,percent of total billed charges,,,2141.82,83,,percent of total billed charges,,,,,,,,,,,,,,,2141.82,83,,percent of total billed charges,,,2451.48,95,,percent of total billed charges,,,2322.45,90,,percent of total billed charges,,,2322.45,90,,percent of total billed charges,,,2116.01,82,,percent of total billed charges,,,2322.45,90,,percent of total billed charges,,,2193.43,85,,percent of total billed charges,,1945.7,2451.48,
GLIDEWIRE UROLOGIC STRAIGHT 150CM,30183401,CDM,,,270,RC,inpatient,,389.27,389.27,,330.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,293.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,330.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,342.56,88,,percent of total billed charges,,,,,,,,,297.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.24,91,,percent of total billed charges,,,369.81,95,,percent of total billed charges,,,323.09,83,,percent of total billed charges,,,323.09,83,,percent of total billed charges,,,,,,,,,,,,,,,323.09,83,,percent of total billed charges,,,369.81,95,,percent of total billed charges,,,350.34,90,,percent of total billed charges,,,350.34,90,,percent of total billed charges,,,319.2,82,,percent of total billed charges,,,350.34,90,,percent of total billed charges,,,330.88,85,,percent of total billed charges,,293.51,369.81,
CYSTO TABLE DRAIN BAG,30183403,CDM,,,270,RC,inpatient,,143.56,143.56,,121.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.33,88,,percent of total billed charges,,,,,,,,,109.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,130.64,91,,percent of total billed charges,,,136.38,95,,percent of total billed charges,,,119.15,83,,percent of total billed charges,,,119.15,83,,percent of total billed charges,,,,,,,,,,,,,,,119.15,83,,percent of total billed charges,,,136.38,95,,percent of total billed charges,,,129.2,90,,percent of total billed charges,,,129.2,90,,percent of total billed charges,,,117.72,82,,percent of total billed charges,,,129.2,90,,percent of total billed charges,,,122.03,85,,percent of total billed charges,,108.24,136.38,
NAIL FEMORAL KNEE FUSION 11.5 X 70MM,30183405,CDM,,,278,RC,inpatient,,30225,30225,,25661.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22789.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25691.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26598,88,,percent of total billed charges,,,,,,,,,23091.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27504.75,91,,percent of total billed charges,,,28713.75,95,,percent of total billed charges,,,25086.75,83,,percent of total billed charges,,,25086.75,83,,percent of total billed charges,,,,,,,,,,,,,,,25086.75,83,,percent of total billed charges,,,28713.75,95,,percent of total billed charges,,,27202.5,90,,percent of total billed charges,,,27202.5,90,,percent of total billed charges,,,24784.5,82,,percent of total billed charges,,,27202.5,90,,percent of total billed charges,,,25691.25,85,,percent of total billed charges,,22789.65,28713.75,
DEPUY GRIPTION CUP REVISION 66MM,30183407,CDM,,,278,RC,inpatient,,33437.04,33437.04,,28388.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25211.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28421.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29424.6,88,,percent of total billed charges,,,,,,,,,25545.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30427.71,91,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,,,,,,,,,,,,,27752.74,83,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,27418.37,82,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,25211.53,31765.19,
DEPUY LINER PINN CONSTRAINED 60MM,30183408,CDM,,,278,RC,inpatient,,36635.17,36635.17,,31103.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27622.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31139.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32238.95,88,,percent of total billed charges,,,,,,,,,27989.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33338,91,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,,,,,,,,,,,,,30407.19,83,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,30040.84,82,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,27622.92,34803.41,
MENTOR MEMORYGEL BREAST IMPLANT SMOOTH,30183409,CDM,,,278,RC,inpatient,,6370,6370,,5408.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4802.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5414.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5605.6,88,,percent of total billed charges,,,,,,,,,4866.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5796.7,91,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5287.1,83,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5223.4,82,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5414.5,85,,percent of total billed charges,,4802.98,6051.5,
MENTOR BREAST SIZER ROUND HIGH PROFILE,30183410,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
DEPUY FEMUR ATTUNE PS R SZ 7,30183411,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY INSERT AOX SZ 7 5MM,30183412,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
CYSTOGRAPHIN 300ML BTL,30183413,CDM,,,270,RC,inpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,81.43,102.6,
DEPUY CERAMIC HEAD 32MM +9 TS,30183415,CDM,,,278,RC,inpatient,,14631.05,14631.05,,12421.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11031.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12436.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12875.32,88,,percent of total billed charges,,,,,,,,,11178.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13314.26,91,,percent of total billed charges,,,13899.5,95,,percent of total billed charges,,,12143.77,83,,percent of total billed charges,,,12143.77,83,,percent of total billed charges,,,,,,,,,,,,,,,12143.77,83,,percent of total billed charges,,,13899.5,95,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,11997.46,82,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,12436.39,85,,percent of total billed charges,,11031.81,13899.5,
ROTATABLE SNARE SMALL COLD,30183422,CDM,,,270,RC,inpatient,,115.2,115.2,,97.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,86.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,97.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,101.38,88,,percent of total billed charges,,,,,,,,,88.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,104.83,91,,percent of total billed charges,,,109.44,95,,percent of total billed charges,,,95.62,83,,percent of total billed charges,,,95.62,83,,percent of total billed charges,,,,,,,,,,,,,,,95.62,83,,percent of total billed charges,,,109.44,95,,percent of total billed charges,,,103.68,90,,percent of total billed charges,,,103.68,90,,percent of total billed charges,,,94.46,82,,percent of total billed charges,,,103.68,90,,percent of total billed charges,,,97.92,85,,percent of total billed charges,,86.86,109.44,
DRAIN PENROSE SILICONE LF 5/8X18,30183428,CDM,,,270,RC,inpatient,,31.86,31.86,,27.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28.04,88,,percent of total billed charges,,,,,,,,,24.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.99,91,,percent of total billed charges,,,30.27,95,,percent of total billed charges,,,26.44,83,,percent of total billed charges,,,26.44,83,,percent of total billed charges,,,,,,,,,,,,,,,26.44,83,,percent of total billed charges,,,30.27,95,,percent of total billed charges,,,28.67,90,,percent of total billed charges,,,28.67,90,,percent of total billed charges,,,26.13,82,,percent of total billed charges,,,28.67,90,,percent of total billed charges,,,27.08,85,,percent of total billed charges,,24.02,30.27,
XPS LASER SERVICE FEE,30183429,CDM,,,270,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
ARTHREX SCREW TENODESIS 5.5 X 10MM,30183430,CDM,,,278,RC,inpatient,,2652,2652,,2251.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1999.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2254.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2333.76,88,,percent of total billed charges,,,,,,,,,2026.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2413.32,91,,percent of total billed charges,,,2519.4,95,,percent of total billed charges,,,2201.16,83,,percent of total billed charges,,,2201.16,83,,percent of total billed charges,,,,,,,,,,,,,,,2201.16,83,,percent of total billed charges,,,2519.4,95,,percent of total billed charges,,,2386.8,90,,percent of total billed charges,,,2386.8,90,,percent of total billed charges,,,2174.64,82,,percent of total billed charges,,,2386.8,90,,percent of total billed charges,,,2254.2,85,,percent of total billed charges,,1999.61,2519.4,
DEPUY INSERT AOX PS FB SZ 6 5MM,30183432,CDM,,,278,RC,inpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9407.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10605.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,9407.86,11853.41,
DEPUY INSERT AOX PS FB SZ 6 10MM,30183433,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY PIN HEADED,30183436,CDM,,,278,RC,inpatient,,5141.5,5141.5,,4365.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3876.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4370.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4524.52,88,,percent of total billed charges,,,,,,,,,3928.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4678.77,91,,percent of total billed charges,,,4884.43,95,,percent of total billed charges,,,4267.45,83,,percent of total billed charges,,,4267.45,83,,percent of total billed charges,,,,,,,,,,,,,,,4267.45,83,,percent of total billed charges,,,4884.43,95,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4216.03,82,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4370.28,85,,percent of total billed charges,,3876.69,4884.43,
DEPUY PIN THREADED,30183437,CDM,,,278,RC,inpatient,,5141.5,5141.5,,4365.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3876.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4370.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4524.52,88,,percent of total billed charges,,,,,,,,,3928.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4678.77,91,,percent of total billed charges,,,4884.43,95,,percent of total billed charges,,,4267.45,83,,percent of total billed charges,,,4267.45,83,,percent of total billed charges,,,,,,,,,,,,,,,4267.45,83,,percent of total billed charges,,,4884.43,95,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4216.03,82,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4370.28,85,,percent of total billed charges,,3876.69,4884.43,
ZIMMER BLADE EXPLANT 60MM X 10,30183439,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
DEPUY INSERT AOT SZ 6 6MM,30183441,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
SUTURE ETHICON 0-VICRYL,30183442,CDM,,,270,RC,inpatient,,235.15,235.15,,199.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,177.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,199.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,206.93,88,,percent of total billed charges,,,,,,,,,179.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,213.99,91,,percent of total billed charges,,,223.39,95,,percent of total billed charges,,,195.17,83,,percent of total billed charges,,,195.17,83,,percent of total billed charges,,,,,,,,,,,,,,,195.17,83,,percent of total billed charges,,,223.39,95,,percent of total billed charges,,,211.64,90,,percent of total billed charges,,,211.64,90,,percent of total billed charges,,,192.82,82,,percent of total billed charges,,,211.64,90,,percent of total billed charges,,,199.88,85,,percent of total billed charges,,177.3,223.39,
NEUROMONITORING EMG 2 EXT,30183443,CDM,,,270,RC,inpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1715.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1933.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,1715.35,2161.25,
MEDTRONIC ACCESSORY KIT,30183454,CDM,,,270,RC,inpatient,,337.5,337.5,,286.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,254.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,286.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,297,88,,percent of total billed charges,,,,,,,,,257.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,307.13,91,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,,,,,,,,,,,,,280.13,83,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,276.75,82,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,254.48,320.63,
MEDTRONIC COMPACT 1X8 TRIAL LEAD KIT,30183455,CDM,,,270,RC,inpatient,,7280,7280,,6180.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5489.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6188,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6406.4,88,,percent of total billed charges,,,,,,,,,5561.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6624.8,91,,percent of total billed charges,,,6916,95,,percent of total billed charges,,,6042.4,83,,percent of total billed charges,,,6042.4,83,,percent of total billed charges,,,,,,,,,,,,,,,6042.4,83,,percent of total billed charges,,,6916,95,,percent of total billed charges,,,6552,90,,percent of total billed charges,,,6552,90,,percent of total billed charges,,,5969.6,82,,percent of total billed charges,,,6552,90,,percent of total billed charges,,,6188,85,,percent of total billed charges,,5489.12,6916,
MEDTRONIC LEAD KIT2,30183456,CDM,,,270,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
APPLIED ORTHOPAEDIC PROTECTOR SMALL/MEDI,30183457,CDM,,,270,RC,inpatient,,942.5,942.5,,800.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,710.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,801.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,829.4,88,,percent of total billed charges,,,,,,,,,720.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,857.68,91,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,,,,,,,,,,,,,782.28,83,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,772.85,82,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,801.13,85,,percent of total billed charges,,710.65,895.38,
DEPUY FEMUR RT SZ 8,30183459,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY INSERT 5MM SZ 8,30183461,CDM,,,278,RC,inpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9407.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10605.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,9407.86,11853.41,
DEPUY STEM MICRO CORAIL SZ6,30183462,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
STRYKER IN-LINE SPECIMENT TRAP,30183465,CDM,,,270,RC,inpatient,,112.77,112.77,,95.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,95.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,99.24,88,,percent of total billed charges,,,,,,,,,86.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,102.62,91,,percent of total billed charges,,,107.13,95,,percent of total billed charges,,,93.6,83,,percent of total billed charges,,,93.6,83,,percent of total billed charges,,,,,,,,,,,,,,,93.6,83,,percent of total billed charges,,,107.13,95,,percent of total billed charges,,,101.49,90,,percent of total billed charges,,,101.49,90,,percent of total billed charges,,,92.47,82,,percent of total billed charges,,,101.49,90,,percent of total billed charges,,,95.85,85,,percent of total billed charges,,85.03,107.13,
DEPUY INSERT STAB 6MM SZ 8,30183466,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
MICROPORT BASE TIBIAL NONPOROUS SZ 4,30183467,CDM,,,278,RC,inpatient,,23933,23933,,20319.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18045.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20343.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21061.04,88,,percent of total billed charges,,,,,,,,,18284.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21779.03,91,,percent of total billed charges,,,22736.35,95,,percent of total billed charges,,,19864.39,83,,percent of total billed charges,,,19864.39,83,,percent of total billed charges,,,,,,,,,,,,,,,19864.39,83,,percent of total billed charges,,,22736.35,95,,percent of total billed charges,,,21539.7,90,,percent of total billed charges,,,21539.7,90,,percent of total billed charges,,,19625.06,82,,percent of total billed charges,,,21539.7,90,,percent of total billed charges,,,20343.05,85,,percent of total billed charges,,18045.48,22736.35,
MENTOR TISSUE EXPANDER CPX2,30183476,CDM,,,278,RC,inpatient,,9555,9555,,8112.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7204.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8121.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8408.4,88,,percent of total billed charges,,,,,,,,,7300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8695.05,91,,percent of total billed charges,,,9077.25,95,,percent of total billed charges,,,7930.65,83,,percent of total billed charges,,,7930.65,83,,percent of total billed charges,,,,,,,,,,,,,,,7930.65,83,,percent of total billed charges,,,9077.25,95,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,7835.1,82,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,8121.75,85,,percent of total billed charges,,7204.47,9077.25,
KITTNER DISSECTOR SPONGES,30183477,CDM,,,270,RC,inpatient,,222.08,222.08,,188.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,167.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,188.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,195.43,88,,percent of total billed charges,,,,,,,,,169.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,202.09,91,,percent of total billed charges,,,210.98,95,,percent of total billed charges,,,184.33,83,,percent of total billed charges,,,184.33,83,,percent of total billed charges,,,,,,,,,,,,,,,184.33,83,,percent of total billed charges,,,210.98,95,,percent of total billed charges,,,199.87,90,,percent of total billed charges,,,199.87,90,,percent of total billed charges,,,182.11,82,,percent of total billed charges,,,199.87,90,,percent of total billed charges,,,188.77,85,,percent of total billed charges,,167.45,210.98,
DEPUY LINER ALTRX NEUT 32 X 54,30183481,CDM,,,278,RC,inpatient,,10422.17,10422.17,,8848.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7858.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8858.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9171.51,88,,percent of total billed charges,,,,,,,,,7962.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9484.17,91,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,,,,,,,,,,,,,8650.4,83,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8546.18,82,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8858.84,85,,percent of total billed charges,,7858.32,9901.06,
DEPUY SCREW NON LOCKING 36MM,30183482,CDM,,,278,RC,inpatient,,1330.16,1330.16,,1129.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1002.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1130.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1170.54,88,,percent of total billed charges,,,,,,,,,1016.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1210.45,91,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1104.03,83,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1090.73,82,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1130.64,85,,percent of total billed charges,,1002.94,1263.65,
DEPUY GLENOSPHERE 42MM,30183483,CDM,,,278,RC,inpatient,,17458.81,17458.81,,14822.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13163.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14839.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15363.75,88,,percent of total billed charges,,,,,,,,,13338.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15887.52,91,,percent of total billed charges,,,16585.87,95,,percent of total billed charges,,,14490.81,83,,percent of total billed charges,,,14490.81,83,,percent of total billed charges,,,,,,,,,,,,,,,14490.81,83,,percent of total billed charges,,,16585.87,95,,percent of total billed charges,,,15712.93,90,,percent of total billed charges,,,15712.93,90,,percent of total billed charges,,,14316.22,82,,percent of total billed charges,,,15712.93,90,,percent of total billed charges,,,14839.99,85,,percent of total billed charges,,13163.94,16585.87,
STOPCOCK 4-WAY LRG BORE EXTENSION SETS,30183484,CDM,,,270,RC,inpatient,,13.23,13.23,,11.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.64,88,,percent of total billed charges,,,,,,,,,10.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.04,91,,percent of total billed charges,,,12.57,95,,percent of total billed charges,,,10.98,83,,percent of total billed charges,,,10.98,83,,percent of total billed charges,,,,,,,,,,,,,,,10.98,83,,percent of total billed charges,,,12.57,95,,percent of total billed charges,,,11.91,90,,percent of total billed charges,,,11.91,90,,percent of total billed charges,,,10.85,82,,percent of total billed charges,,,11.91,90,,percent of total billed charges,,,11.25,85,,percent of total billed charges,,9.98,12.57,
STRYKER DRILL BIT 4.2 X 180,30183486,CDM,,,270,RC,inpatient,,1941.94,1941.94,,1648.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1464.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1650.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1708.91,88,,percent of total billed charges,,,,,,,,,1483.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1767.17,91,,percent of total billed charges,,,1844.84,95,,percent of total billed charges,,,1611.81,83,,percent of total billed charges,,,1611.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1611.81,83,,percent of total billed charges,,,1844.84,95,,percent of total billed charges,,,1747.75,90,,percent of total billed charges,,,1747.75,90,,percent of total billed charges,,,1592.39,82,,percent of total billed charges,,,1747.75,90,,percent of total billed charges,,,1650.65,85,,percent of total billed charges,,1464.22,1844.84,
DEPUY ATTUNE INSERT AOX SZ 7 7MM,30183490,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY ATTUNE FEMUR PS SZ 8 LT,30183491,CDM,,,278,RC,inpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21324.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24039.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,21324.5,26867.74,
DEPUY OSTEOTOME FLEX 12MM X 5,30183496,CDM,,,278,RC,inpatient,,5687.5,5687.5,,4828.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4288.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4834.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5005,88,,percent of total billed charges,,,,,,,,,4345.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5175.63,91,,percent of total billed charges,,,5403.13,95,,percent of total billed charges,,,4720.63,83,,percent of total billed charges,,,4720.63,83,,percent of total billed charges,,,,,,,,,,,,,,,4720.63,83,,percent of total billed charges,,,5403.13,95,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,4663.75,82,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,4834.38,85,,percent of total billed charges,,4288.38,5403.13,
RAPID CURE 20CC,30183500,CDM,,,270,RC,inpatient,,15210,15210,,12913.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11468.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12928.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13384.8,88,,percent of total billed charges,,,,,,,,,11620.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13841.1,91,,percent of total billed charges,,,14449.5,95,,percent of total billed charges,,,12624.3,83,,percent of total billed charges,,,12624.3,83,,percent of total billed charges,,,,,,,,,,,,,,,12624.3,83,,percent of total billed charges,,,14449.5,95,,percent of total billed charges,,,13689,90,,percent of total billed charges,,,13689,90,,percent of total billed charges,,,12472.2,82,,percent of total billed charges,,,13689,90,,percent of total billed charges,,,12928.5,85,,percent of total billed charges,,11468.34,14449.5,
DEPUY FEMORAL HEAD 36MM +15.5,30183501,CDM,,,278,RC,inpatient,,8569.34,8569.34,,7275.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6461.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7283.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7541.02,88,,percent of total billed charges,,,,,,,,,6546.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7798.1,91,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7112.55,83,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7026.86,82,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,6461.28,8140.87,
DEPUY STEM DISTAL RECLAIM 15 X 140,30183502,CDM,,,278,RC,inpatient,,31338.78,31338.78,,26606.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23629.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26637.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27578.13,88,,percent of total billed charges,,,,,,,,,23942.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28518.29,91,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,,,,,,,,,,,,,26011.19,83,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,25697.8,82,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,26637.96,85,,percent of total billed charges,,23629.44,29771.84,
SYNTHES SCREW LOCKING 3.5X24MM,30183504,CDM,,,278,RC,inpatient,,1217.84,1217.84,,1033.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,918.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1035.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1071.7,88,,percent of total billed charges,,,,,,,,,930.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1108.23,91,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1010.81,83,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,998.63,82,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,918.25,1156.95,
CATH 30CC 22FR 3-WAY SILICONE,30183505,CDM,,,270,RC,inpatient,,83.36,83.36,,70.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.36,88,,percent of total billed charges,,,,,,,,,63.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.86,91,,percent of total billed charges,,,79.19,95,,percent of total billed charges,,,69.19,83,,percent of total billed charges,,,69.19,83,,percent of total billed charges,,,,,,,,,,,,,,,69.19,83,,percent of total billed charges,,,79.19,95,,percent of total billed charges,,,75.02,90,,percent of total billed charges,,,75.02,90,,percent of total billed charges,,,68.36,82,,percent of total billed charges,,,75.02,90,,percent of total billed charges,,,70.86,85,,percent of total billed charges,,62.85,79.19,
ERBE FIAPC CIRCUMFERENTIAL PROBE O.D. 2.,30183507,CDM,,,270,RC,inpatient,,1524.25,1524.25,,1294.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1149.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1295.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1341.34,88,,percent of total billed charges,,,,,,,,,1164.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1387.07,91,,percent of total billed charges,,,1448.04,95,,percent of total billed charges,,,1265.13,83,,percent of total billed charges,,,1265.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1265.13,83,,percent of total billed charges,,,1448.04,95,,percent of total billed charges,,,1371.83,90,,percent of total billed charges,,,1371.83,90,,percent of total billed charges,,,1249.89,82,,percent of total billed charges,,,1371.83,90,,percent of total billed charges,,,1295.61,85,,percent of total billed charges,,1149.28,1448.04,
APPLIED GELPOINT LAPAROSCOPIC SYSTEM,30183509,CDM,,,270,RC,inpatient,,4225,4225,,3587.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3185.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3591.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3718,88,,percent of total billed charges,,,,,,,,,3227.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3844.75,91,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,,,,,,,,,,,,,3506.75,83,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3464.5,82,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,3185.65,4013.75,
DEPUY FEMUR ATTUNE 5N RIGHT,30183519,CDM,,,278,RC,inpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21324.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24039.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,21324.5,26867.74,
DEPUY CAGE CEMENTED 56 RIGHT PROTRUSIO,30183521,CDM,,,278,RC,inpatient,,21625.7,21625.7,,18360.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16305.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18381.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19030.62,88,,percent of total billed charges,,,,,,,,,16522.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19679.39,91,,percent of total billed charges,,,20544.42,95,,percent of total billed charges,,,17949.33,83,,percent of total billed charges,,,17949.33,83,,percent of total billed charges,,,,,,,,,,,,,,,17949.33,83,,percent of total billed charges,,,20544.42,95,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,17733.07,82,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,18381.85,85,,percent of total billed charges,,16305.78,20544.42,
DEPUY SCREW SELF TAP 20MM,30183522,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
STOPCOCK LUER LOCK MALE CONNECTOR,30183524,CDM,,,270,RC,inpatient,,483,483,,410.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,364.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,410.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,425.04,88,,percent of total billed charges,,,,,,,,,369.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,439.53,91,,percent of total billed charges,,,458.85,95,,percent of total billed charges,,,400.89,83,,percent of total billed charges,,,400.89,83,,percent of total billed charges,,,,,,,,,,,,,,,400.89,83,,percent of total billed charges,,,458.85,95,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,396.06,82,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,410.55,85,,percent of total billed charges,,364.18,458.85,
DEPUY FEMUR S-ROM X-SMALL LEFT,30183525,CDM,,,278,RC,inpatient,,30424.94,30424.94,,25830.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22940.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25861.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26773.95,88,,percent of total billed charges,,,,,,,,,23244.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27686.7,91,,percent of total billed charges,,,28903.69,95,,percent of total billed charges,,,25252.7,83,,percent of total billed charges,,,25252.7,83,,percent of total billed charges,,,,,,,,,,,,,,,25252.7,83,,percent of total billed charges,,,28903.69,95,,percent of total billed charges,,,27382.45,90,,percent of total billed charges,,,27382.45,90,,percent of total billed charges,,,24948.45,82,,percent of total billed charges,,,27382.45,90,,percent of total billed charges,,,25861.2,85,,percent of total billed charges,,22940.4,28903.69,
DEPUY AUGMENT DISTAL 5MM,30183526,CDM,,,278,RC,inpatient,,6506.18,6506.18,,5523.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4905.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5530.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5725.44,88,,percent of total billed charges,,,,,,,,,4970.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5920.62,91,,percent of total billed charges,,,6180.87,95,,percent of total billed charges,,,5400.13,83,,percent of total billed charges,,,5400.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5400.13,83,,percent of total billed charges,,,6180.87,95,,percent of total billed charges,,,5855.56,90,,percent of total billed charges,,,5855.56,90,,percent of total billed charges,,,5335.07,82,,percent of total billed charges,,,5855.56,90,,percent of total billed charges,,,5530.25,85,,percent of total billed charges,,4905.66,6180.87,
SYNTHES SCREW CORTEX 3.5X40MM,30183528,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
SYNTHES SCREW CORTEX 3.5X45MM,30183529,CDM,,,278,RC,inpatient,,325.13,325.13,,276.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,245.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,276.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,286.11,88,,percent of total billed charges,,,,,,,,,248.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,295.87,91,,percent of total billed charges,,,308.87,95,,percent of total billed charges,,,269.86,83,,percent of total billed charges,,,269.86,83,,percent of total billed charges,,,,,,,,,,,,,,,269.86,83,,percent of total billed charges,,,308.87,95,,percent of total billed charges,,,292.62,90,,percent of total billed charges,,,292.62,90,,percent of total billed charges,,,266.61,82,,percent of total billed charges,,,292.62,90,,percent of total billed charges,,,276.36,85,,percent of total billed charges,,245.15,308.87,
SYNTHES PLATE LOW PROFILE 3.5MM CRVD REC,30183530,CDM,,,278,RC,inpatient,,5094.05,5094.05,,4324.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3840.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4329.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4482.76,88,,percent of total billed charges,,,,,,,,,3891.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4635.59,91,,percent of total billed charges,,,4839.35,95,,percent of total billed charges,,,4228.06,83,,percent of total billed charges,,,4228.06,83,,percent of total billed charges,,,,,,,,,,,,,,,4228.06,83,,percent of total billed charges,,,4839.35,95,,percent of total billed charges,,,4584.65,90,,percent of total billed charges,,,4584.65,90,,percent of total billed charges,,,4177.12,82,,percent of total billed charges,,,4584.65,90,,percent of total billed charges,,,4329.94,85,,percent of total billed charges,,3840.91,4839.35,
SYNTHES SCREW SHANZ 6.0MM,30183531,CDM,,,278,RC,inpatient,,928.2,928.2,,788.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,699.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,788.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,816.82,88,,percent of total billed charges,,,,,,,,,709.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,844.66,91,,percent of total billed charges,,,881.79,95,,percent of total billed charges,,,770.41,83,,percent of total billed charges,,,770.41,83,,percent of total billed charges,,,,,,,,,,,,,,,770.41,83,,percent of total billed charges,,,881.79,95,,percent of total billed charges,,,835.38,90,,percent of total billed charges,,,835.38,90,,percent of total billed charges,,,761.12,82,,percent of total billed charges,,,835.38,90,,percent of total billed charges,,,788.97,85,,percent of total billed charges,,699.86,881.79,
SYNTHES TEMPLATE BENDING 88MM 3.5,30183532,CDM,,,278,RC,inpatient,,1110.53,1110.53,,942.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,837.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,943.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,977.27,88,,percent of total billed charges,,,,,,,,,848.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1010.58,91,,percent of total billed charges,,,1055,95,,percent of total billed charges,,,921.74,83,,percent of total billed charges,,,921.74,83,,percent of total billed charges,,,,,,,,,,,,,,,921.74,83,,percent of total billed charges,,,1055,95,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,910.63,82,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,943.95,85,,percent of total billed charges,,837.34,1055,
SYNTHES DRILL BIT 3.5MM,30183533,CDM,,,278,RC,inpatient,,844.9,844.9,,717.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,637.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,718.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,743.51,88,,percent of total billed charges,,,,,,,,,645.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,768.86,91,,percent of total billed charges,,,802.66,95,,percent of total billed charges,,,701.27,83,,percent of total billed charges,,,701.27,83,,percent of total billed charges,,,,,,,,,,,,,,,701.27,83,,percent of total billed charges,,,802.66,95,,percent of total billed charges,,,760.41,90,,percent of total billed charges,,,760.41,90,,percent of total billed charges,,,692.82,82,,percent of total billed charges,,,760.41,90,,percent of total billed charges,,,718.17,85,,percent of total billed charges,,637.05,802.66,
ZIMMER NEXGEN COMPLETE KNEE SOLUTION LAR,30183535,CDM,,,278,RC,inpatient,,21097.77,21097.77,,17912.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15907.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17933.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18566.04,88,,percent of total billed charges,,,,,,,,,16118.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19198.97,91,,percent of total billed charges,,,20042.88,95,,percent of total billed charges,,,17511.15,83,,percent of total billed charges,,,17511.15,83,,percent of total billed charges,,,,,,,,,,,,,,,17511.15,83,,percent of total billed charges,,,20042.88,95,,percent of total billed charges,,,18987.99,90,,percent of total billed charges,,,18987.99,90,,percent of total billed charges,,,17300.17,82,,percent of total billed charges,,,18987.99,90,,percent of total billed charges,,,17933.1,85,,percent of total billed charges,,15907.72,20042.88,
NEEDLE SURGICAL ANCHOR 8DC,30183536,CDM,,,270,RC,inpatient,,21.6,21.6,,18.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.01,88,,percent of total billed charges,,,,,,,,,16.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.66,91,,percent of total billed charges,,,20.52,95,,percent of total billed charges,,,17.93,83,,percent of total billed charges,,,17.93,83,,percent of total billed charges,,,,,,,,,,,,,,,17.93,83,,percent of total billed charges,,,20.52,95,,percent of total billed charges,,,19.44,90,,percent of total billed charges,,,19.44,90,,percent of total billed charges,,,17.71,82,,percent of total billed charges,,,19.44,90,,percent of total billed charges,,,18.36,85,,percent of total billed charges,,16.29,20.52,
NEEDLE SURGICAL ANCHOR 7DC,30183537,CDM,,,270,RC,inpatient,,21.6,21.6,,18.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.01,88,,percent of total billed charges,,,,,,,,,16.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.66,91,,percent of total billed charges,,,20.52,95,,percent of total billed charges,,,17.93,83,,percent of total billed charges,,,17.93,83,,percent of total billed charges,,,,,,,,,,,,,,,17.93,83,,percent of total billed charges,,,20.52,95,,percent of total billed charges,,,19.44,90,,percent of total billed charges,,,19.44,90,,percent of total billed charges,,,17.71,82,,percent of total billed charges,,,19.44,90,,percent of total billed charges,,,18.36,85,,percent of total billed charges,,16.29,20.52,
DEPUY STEM FLUTED UNIV 75 X 16,30183538,CDM,,,278,RC,inpatient,,9024.34,9024.34,,7661.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6804.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7670.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7941.42,88,,percent of total billed charges,,,,,,,,,6894.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8212.15,91,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,,,,,,,,,,,,,7490.2,83,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7399.96,82,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,6804.35,8573.12,
DEPUY FEMUR S-ROM X-SMALL KEFT,30183539,CDM,,,278,RC,inpatient,,52982.02,52982.02,,44981.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39948.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45034.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46624.18,88,,percent of total billed charges,,,,,,,,,40478.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,48213.64,91,,percent of total billed charges,,,50332.92,95,,percent of total billed charges,,,43975.08,83,,percent of total billed charges,,,43975.08,83,,percent of total billed charges,,,,,,,,,,,,,,,43975.08,83,,percent of total billed charges,,,50332.92,95,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,43445.26,82,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,45034.72,85,,percent of total billed charges,,39948.44,50332.92,
DEPUY TIBIA PROXIMAL LPS X-SMALL,30183540,CDM,,,278,RC,inpatient,,87360.07,87360.07,,74168.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,65869.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74256.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,76876.86,88,,percent of total billed charges,,,,,,,,,66743.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,79497.66,91,,percent of total billed charges,,,82992.07,95,,percent of total billed charges,,,72508.86,83,,percent of total billed charges,,,72508.86,83,,percent of total billed charges,,,,,,,,,,,,,,,72508.86,83,,percent of total billed charges,,,82992.07,95,,percent of total billed charges,,,78624.06,90,,percent of total billed charges,,,78624.06,90,,percent of total billed charges,,,71635.26,82,,percent of total billed charges,,,78624.06,90,,percent of total billed charges,,,74256.06,85,,percent of total billed charges,,65869.49,82992.07,
DEPUY STEM POROUS 13.5 X 125MM,30183541,CDM,,,278,RC,inpatient,,45577.22,45577.22,,38695.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34365.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38740.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40107.95,88,,percent of total billed charges,,,,,,,,,34821,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41475.27,91,,percent of total billed charges,,,43298.36,95,,percent of total billed charges,,,37829.09,83,,percent of total billed charges,,,37829.09,83,,percent of total billed charges,,,,,,,,,,,,,,,37829.09,83,,percent of total billed charges,,,43298.36,95,,percent of total billed charges,,,41019.5,90,,percent of total billed charges,,,41019.5,90,,percent of total billed charges,,,37373.32,82,,percent of total billed charges,,,41019.5,90,,percent of total billed charges,,,38740.64,85,,percent of total billed charges,,34365.22,43298.36,
PCMX 3.3% CLEANSING SOLUTION,30183548,CDM,,,270,RC,inpatient,,15.3,15.3,,12.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.46,88,,percent of total billed charges,,,,,,,,,11.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.92,91,,percent of total billed charges,,,14.54,95,,percent of total billed charges,,,12.7,83,,percent of total billed charges,,,12.7,83,,percent of total billed charges,,,,,,,,,,,,,,,12.7,83,,percent of total billed charges,,,14.54,95,,percent of total billed charges,,,13.77,90,,percent of total billed charges,,,13.77,90,,percent of total billed charges,,,12.55,82,,percent of total billed charges,,,13.77,90,,percent of total billed charges,,,13.01,85,,percent of total billed charges,,11.54,14.54,
DJO TIBIA POROUS DOWN RIGHT 3D FK 10,30183555,CDM,,,278,RC,inpatient,,19987.5,19987.5,,16969.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15070.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16989.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17589,88,,percent of total billed charges,,,,,,,,,15270.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18188.63,91,,percent of total billed charges,,,18988.13,95,,percent of total billed charges,,,16589.63,83,,percent of total billed charges,,,16589.63,83,,percent of total billed charges,,,,,,,,,,,,,,,16589.63,83,,percent of total billed charges,,,18988.13,95,,percent of total billed charges,,,17988.75,90,,percent of total billed charges,,,17988.75,90,,percent of total billed charges,,,16389.75,82,,percent of total billed charges,,,17988.75,90,,percent of total billed charges,,,16989.38,85,,percent of total billed charges,,15070.58,18988.13,
DJO INSERT 9MM 12 RIGHT 3D E-PLUS,30183556,CDM,,,278,RC,inpatient,,5980,5980,,5077.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4508.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5083,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5262.4,88,,percent of total billed charges,,,,,,,,,4568.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5441.8,91,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4963.4,83,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,4903.6,82,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5083,85,,percent of total billed charges,,4508.92,5681,
DJO SCREW CANCELLOUS 50MM,30183557,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
DJO FEMUR POROUS 3D 2 RIGHT,30183558,CDM,,,278,RC,inpatient,,18232.5,18232.5,,15479.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13747.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15497.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16044.6,88,,percent of total billed charges,,,,,,,,,13929.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16591.58,91,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15132.98,83,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,14950.65,82,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,13747.31,17320.88,
DJO SAWBLADE 1MM,30183559,CDM,,,270,RC,inpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,980.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1105,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,980.2,1235,
SYNTHES PLATE 4HOLE RT MEDIAL LCP 3.5MM,30183560,CDM,,,278,RC,inpatient,,10319.4,10319.4,,8761.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7780.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8771.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9081.07,88,,percent of total billed charges,,,,,,,,,7884.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9390.65,91,,percent of total billed charges,,,9803.43,95,,percent of total billed charges,,,8565.1,83,,percent of total billed charges,,,8565.1,83,,percent of total billed charges,,,,,,,,,,,,,,,8565.1,83,,percent of total billed charges,,,9803.43,95,,percent of total billed charges,,,9287.46,90,,percent of total billed charges,,,9287.46,90,,percent of total billed charges,,,8461.91,82,,percent of total billed charges,,,9287.46,90,,percent of total billed charges,,,8771.49,85,,percent of total billed charges,,7780.83,9803.43,
SYNTHES SCREW LOCKING 3.7X40MM,30183561,CDM,,,278,RC,inpatient,,1345.5,1345.5,,1142.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1014.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1143.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1184.04,88,,percent of total billed charges,,,,,,,,,1027.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1224.41,91,,percent of total billed charges,,,1278.23,95,,percent of total billed charges,,,1116.77,83,,percent of total billed charges,,,1116.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1116.77,83,,percent of total billed charges,,,1278.23,95,,percent of total billed charges,,,1210.95,90,,percent of total billed charges,,,1210.95,90,,percent of total billed charges,,,1103.31,82,,percent of total billed charges,,,1210.95,90,,percent of total billed charges,,,1143.68,85,,percent of total billed charges,,1014.51,1278.23,
SYNTHES SCREW LOCKING 3.7X52MM,30183562,CDM,,,278,RC,inpatient,,1784.58,1784.58,,1515.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1345.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1516.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1570.43,88,,percent of total billed charges,,,,,,,,,1363.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1623.97,91,,percent of total billed charges,,,1695.35,95,,percent of total billed charges,,,1481.2,83,,percent of total billed charges,,,1481.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1481.2,83,,percent of total billed charges,,,1695.35,95,,percent of total billed charges,,,1606.12,90,,percent of total billed charges,,,1606.12,90,,percent of total billed charges,,,1463.36,82,,percent of total billed charges,,,1606.12,90,,percent of total billed charges,,,1516.89,85,,percent of total billed charges,,1345.57,1695.35,
SYNTHES SCREW LOCKING 3.7X60MM,30183563,CDM,,,278,RC,inpatient,,1784.58,1784.58,,1515.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1345.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1516.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1570.43,88,,percent of total billed charges,,,,,,,,,1363.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1623.97,91,,percent of total billed charges,,,1695.35,95,,percent of total billed charges,,,1481.2,83,,percent of total billed charges,,,1481.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1481.2,83,,percent of total billed charges,,,1695.35,95,,percent of total billed charges,,,1606.12,90,,percent of total billed charges,,,1606.12,90,,percent of total billed charges,,,1463.36,82,,percent of total billed charges,,,1606.12,90,,percent of total billed charges,,,1516.89,85,,percent of total billed charges,,1345.57,1695.35,
DEPUY HEAD ECCENTRIC 44 X 21,30183565,CDM,,,278,RC,inpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13297.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14990.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,13297.64,16754.32,
MENTOR TISSUE EXPANDER 350CC,30183566,CDM,,,278,RC,inpatient,,9555,9555,,8112.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7204.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8121.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8408.4,88,,percent of total billed charges,,,,,,,,,7300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8695.05,91,,percent of total billed charges,,,9077.25,95,,percent of total billed charges,,,7930.65,83,,percent of total billed charges,,,7930.65,83,,percent of total billed charges,,,,,,,,,,,,,,,7930.65,83,,percent of total billed charges,,,9077.25,95,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,7835.1,82,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,8121.75,85,,percent of total billed charges,,7204.47,9077.25,
ZIMMER LINER 40MM I.D. SIZE NN,30183573,CDM,,,278,RC,inpatient,,11399.05,11399.05,,9677.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8594.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9689.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10031.16,88,,percent of total billed charges,,,,,,,,,8708.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10373.14,91,,percent of total billed charges,,,10829.1,95,,percent of total billed charges,,,9461.21,83,,percent of total billed charges,,,9461.21,83,,percent of total billed charges,,,,,,,,,,,,,,,9461.21,83,,percent of total billed charges,,,10829.1,95,,percent of total billed charges,,,10259.15,90,,percent of total billed charges,,,10259.15,90,,percent of total billed charges,,,9347.22,82,,percent of total billed charges,,,10259.15,90,,percent of total billed charges,,,9689.19,85,,percent of total billed charges,,8594.88,10829.1,
ZIMMER LINER BIPOLAR CUP 22MM I.D.,30183574,CDM,,,278,RC,inpatient,,4550,4550,,3862.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3430.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3867.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4004,88,,percent of total billed charges,,,,,,,,,3476.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4140.5,91,,percent of total billed charges,,,4322.5,95,,percent of total billed charges,,,3776.5,83,,percent of total billed charges,,,3776.5,83,,percent of total billed charges,,,,,,,,,,,,,,,3776.5,83,,percent of total billed charges,,,4322.5,95,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,3731,82,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,3867.5,85,,percent of total billed charges,,3430.7,4322.5,
ZIMMER SHELL BIPOLAR CUP 40MM O.D.,30183575,CDM,,,278,RC,inpatient,,7605,7605,,6456.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5734.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6464.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6692.4,88,,percent of total billed charges,,,,,,,,,5810.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6920.55,91,,percent of total billed charges,,,7224.75,95,,percent of total billed charges,,,6312.15,83,,percent of total billed charges,,,6312.15,83,,percent of total billed charges,,,,,,,,,,,,,,,6312.15,83,,percent of total billed charges,,,7224.75,95,,percent of total billed charges,,,6844.5,90,,percent of total billed charges,,,6844.5,90,,percent of total billed charges,,,6236.1,82,,percent of total billed charges,,,6844.5,90,,percent of total billed charges,,,6464.25,85,,percent of total billed charges,,5734.17,7224.75,
ZIMMER HEAD FEMORAL 22MM 12/14 +3.0MM NE,30183576,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
DEPUY ATTUNE FEMUR 6N L,30183578,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
GLIDEWIRE URO 150 X 3.5MM,30183580,CDM,,,270,RC,inpatient,,371.07,371.07,,315.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,279.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,315.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,326.54,88,,percent of total billed charges,,,,,,,,,283.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,337.67,91,,percent of total billed charges,,,352.52,95,,percent of total billed charges,,,307.99,83,,percent of total billed charges,,,307.99,83,,percent of total billed charges,,,,,,,,,,,,,,,307.99,83,,percent of total billed charges,,,352.52,95,,percent of total billed charges,,,333.96,90,,percent of total billed charges,,,333.96,90,,percent of total billed charges,,,304.28,82,,percent of total billed charges,,,333.96,90,,percent of total billed charges,,,315.41,85,,percent of total billed charges,,279.79,352.52,
DJO FEMUR POROUS 3D 8 RIGHT,30183581,CDM,,,278,RC,inpatient,,18232.5,18232.5,,15479.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13747.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15497.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16044.6,88,,percent of total billed charges,,,,,,,,,13929.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16591.58,91,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15132.98,83,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,14950.65,82,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,13747.31,17320.88,
DJO INSERT 13MM 8 RIGHT 3D E-PLUS,30183582,CDM,,,278,RC,inpatient,,5980,5980,,5077.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4508.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5083,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5262.4,88,,percent of total billed charges,,,,,,,,,4568.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5441.8,91,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4963.4,83,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,4903.6,82,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5083,85,,percent of total billed charges,,4508.92,5681,
DJO TIBIA STEMMED 3D POROUS 8 RIGHT,30183583,CDM,,,278,RC,inpatient,,13487.5,13487.5,,11450.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10169.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11464.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11869,88,,percent of total billed charges,,,,,,,,,10304.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12273.63,91,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,,,,,,,,,,,,,11194.63,83,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11059.75,82,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,10169.58,12813.13,
DJO INSERT 9MM 6 RIGHT 3D E-PLUS,30183584,CDM,,,278,RC,inpatient,,5980,5980,,5077.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4508.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5083,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5262.4,88,,percent of total billed charges,,,,,,,,,4568.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5441.8,91,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4963.4,83,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,4903.6,82,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5083,85,,percent of total billed charges,,4508.92,5681,
DJO FEMUR POROUS 3D 6 RIGHT,30183585,CDM,,,278,RC,inpatient,,18232.5,18232.5,,15479.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13747.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15497.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16044.6,88,,percent of total billed charges,,,,,,,,,13929.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16591.58,91,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15132.98,83,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,14950.65,82,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,13747.31,17320.88,
DJO STEM 150 X 16MM TIBIAL REVISION,30183586,CDM,,,278,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
DJO TIBIA STEMMED REV NON-POROUS 4 RIGHT,30183587,CDM,,,278,RC,inpatient,,11537.5,11537.5,,9795.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8699.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9806.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10153,88,,percent of total billed charges,,,,,,,,,8814.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10499.13,91,,percent of total billed charges,,,10960.63,95,,percent of total billed charges,,,9576.13,83,,percent of total billed charges,,,9576.13,83,,percent of total billed charges,,,,,,,,,,,,,,,9576.13,83,,percent of total billed charges,,,10960.63,95,,percent of total billed charges,,,10383.75,90,,percent of total billed charges,,,10383.75,90,,percent of total billed charges,,,9460.75,82,,percent of total billed charges,,,10383.75,90,,percent of total billed charges,,,9806.88,85,,percent of total billed charges,,8699.28,10960.63,
ENDOCUT SCISSOR TIP DISP.,30183588,CDM,,,270,RC,inpatient,,288.75,288.75,,245.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.1,88,,percent of total billed charges,,,,,,,,,220.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.76,91,,percent of total billed charges,,,274.31,95,,percent of total billed charges,,,239.66,83,,percent of total billed charges,,,239.66,83,,percent of total billed charges,,,,,,,,,,,,,,,239.66,83,,percent of total billed charges,,,274.31,95,,percent of total billed charges,,,259.88,90,,percent of total billed charges,,,259.88,90,,percent of total billed charges,,,236.78,82,,percent of total billed charges,,,259.88,90,,percent of total billed charges,,,245.44,85,,percent of total billed charges,,217.72,274.31,
DJO STEM 150 X 14MM TIBIAL REVISION,30183590,CDM,,,278,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
DJO INSERT 9MM 8 RIGHT 3D E-PLUS,30183591,CDM,,,278,RC,inpatient,,5980,5980,,5077.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4508.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5083,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5262.4,88,,percent of total billed charges,,,,,,,,,4568.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5441.8,91,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4963.4,83,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,4903.6,82,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5083,85,,percent of total billed charges,,4508.92,5681,
DJO STEMMED TIBIA BASE 6 RIGHT NON-POROU,30183592,CDM,,,278,RC,inpatient,,14306.5,14306.5,,12146.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10787.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12160.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12589.72,88,,percent of total billed charges,,,,,,,,,10930.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13018.92,91,,percent of total billed charges,,,13591.18,95,,percent of total billed charges,,,11874.4,83,,percent of total billed charges,,,11874.4,83,,percent of total billed charges,,,,,,,,,,,,,,,11874.4,83,,percent of total billed charges,,,13591.18,95,,percent of total billed charges,,,12875.85,90,,percent of total billed charges,,,12875.85,90,,percent of total billed charges,,,11731.33,82,,percent of total billed charges,,,12875.85,90,,percent of total billed charges,,,12160.53,85,,percent of total billed charges,,10787.1,13591.18,
SYNTHES PLATE 6 HOLE LEFT LOW BEND PROX,30183593,CDM,,,278,RC,inpatient,,13381.55,13381.55,,11360.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10089.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11374.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11775.76,88,,percent of total billed charges,,,,,,,,,10223.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12177.21,91,,percent of total billed charges,,,12712.47,95,,percent of total billed charges,,,11106.69,83,,percent of total billed charges,,,11106.69,83,,percent of total billed charges,,,,,,,,,,,,,,,11106.69,83,,percent of total billed charges,,,12712.47,95,,percent of total billed charges,,,12043.4,90,,percent of total billed charges,,,12043.4,90,,percent of total billed charges,,,10972.87,82,,percent of total billed charges,,,12043.4,90,,percent of total billed charges,,,11374.32,85,,percent of total billed charges,,10089.69,12712.47,
SYNTHES SCREW LOCKING 3.5 X 70MM,30183594,CDM,,,278,RC,inpatient,,1182.35,1182.35,,1003.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,891.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1005,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1040.47,88,,percent of total billed charges,,,,,,,,,903.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1075.94,91,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,,,,,,,,,,,,,981.35,83,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,969.53,82,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1005,85,,percent of total billed charges,,891.49,1123.23,
SYNTHES SCREW LOCKING 3.5 X 60MM,30183595,CDM,,,278,RC,inpatient,,1182.35,1182.35,,1003.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,891.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1005,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1040.47,88,,percent of total billed charges,,,,,,,,,903.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1075.94,91,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,,,,,,,,,,,,,981.35,83,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,969.53,82,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1005,85,,percent of total billed charges,,891.49,1123.23,
DJO INSERT 11MM 8 RIGHT 3D E-PLUS,30183596,CDM,,,278,RC,inpatient,,5980,5980,,5077.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4508.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5083,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5262.4,88,,percent of total billed charges,,,,,,,,,4568.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5441.8,91,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4963.4,83,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,4903.6,82,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5083,85,,percent of total billed charges,,4508.92,5681,
ARTHREX IMPLANT DELIVERY SYSTEM,30183597,CDM,,,270,RC,inpatient,,5525,5525,,4690.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4165.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4696.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4862,88,,percent of total billed charges,,,,,,,,,4221.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5027.75,91,,percent of total billed charges,,,5248.75,95,,percent of total billed charges,,,4585.75,83,,percent of total billed charges,,,4585.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4585.75,83,,percent of total billed charges,,,5248.75,95,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4530.5,82,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4696.25,85,,percent of total billed charges,,4165.85,5248.75,
ARTHREX REEMER 8MM LP,30183598,CDM,,,270,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
ARTHREX SUTURE PASSING WIRE,30183599,CDM,,,270,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
DEPUY MBT TRAY SLEEVE 46MM,30183600,CDM,,,270,RC,inpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13618.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15352.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,13618.85,17159.03,
ERBE APC MEMBRANE FILTER,30183602,CDM,,,270,RC,inpatient,,87.6,87.6,,74.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.09,88,,percent of total billed charges,,,,,,,,,66.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,79.72,91,,percent of total billed charges,,,83.22,95,,percent of total billed charges,,,72.71,83,,percent of total billed charges,,,72.71,83,,percent of total billed charges,,,,,,,,,,,,,,,72.71,83,,percent of total billed charges,,,83.22,95,,percent of total billed charges,,,78.84,90,,percent of total billed charges,,,78.84,90,,percent of total billed charges,,,71.83,82,,percent of total billed charges,,,78.84,90,,percent of total billed charges,,,74.46,85,,percent of total billed charges,,66.05,83.22,
NEUROMONITORING EMG ET,30183606,CDM,,,270,RC,inpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1715.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1933.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,1715.35,2161.25,
RELIEVA SINUS GUIDE CATHETER F-70C,30183607,CDM,,,270,RC,inpatient,,2886,2886,,2450.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2176.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2453.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2539.68,88,,percent of total billed charges,,,,,,,,,2204.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2626.26,91,,percent of total billed charges,,,2741.7,95,,percent of total billed charges,,,2395.38,83,,percent of total billed charges,,,2395.38,83,,percent of total billed charges,,,,,,,,,,,,,,,2395.38,83,,percent of total billed charges,,,2741.7,95,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2366.52,82,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2453.1,85,,percent of total billed charges,,2176.04,2741.7,
ESWL SERVICES UNILATERAL- UNITED SHOCKWA,30183608,CDM,,,270,RC,inpatient,,13650,13650,,11588.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10292.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11602.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12012,88,,percent of total billed charges,,,,,,,,,10428.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12421.5,91,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,,,,,,,,,,,,,11329.5,83,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11193,82,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,10292.1,12967.5,
STRYKER HEAD V40 COCR LFIT 36MM +0,30183609,CDM,,,278,RC,inpatient,,4647.5,4647.5,,3945.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3504.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3950.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4089.8,88,,percent of total billed charges,,,,,,,,,3550.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4229.23,91,,percent of total billed charges,,,4415.13,95,,percent of total billed charges,,,3857.43,83,,percent of total billed charges,,,3857.43,83,,percent of total billed charges,,,,,,,,,,,,,,,3857.43,83,,percent of total billed charges,,,4415.13,95,,percent of total billed charges,,,4182.75,90,,percent of total billed charges,,,4182.75,90,,percent of total billed charges,,,3810.95,82,,percent of total billed charges,,,4182.75,90,,percent of total billed charges,,,3950.38,85,,percent of total billed charges,,3504.22,4415.13,
ESOPHYX SEROSAFUSE IMPLANT FASTNR KIT,30183612,CDM,,,270,RC,inpatient,,27397.5,27397.5,,23260.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20657.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23287.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24109.8,88,,percent of total billed charges,,,,,,,,,20931.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24931.73,91,,percent of total billed charges,,,26027.63,95,,percent of total billed charges,,,22739.93,83,,percent of total billed charges,,,22739.93,83,,percent of total billed charges,,,,,,,,,,,,,,,22739.93,83,,percent of total billed charges,,,26027.63,95,,percent of total billed charges,,,24657.75,90,,percent of total billed charges,,,24657.75,90,,percent of total billed charges,,,22465.95,82,,percent of total billed charges,,,24657.75,90,,percent of total billed charges,,,23287.88,85,,percent of total billed charges,,20657.72,26027.63,
ENDO POUCH RETRIEVER 5MM,30183613,CDM,,,270,RC,inpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,226.2,285,
S&N SCREW INTERNAL HEX 80MM,30183615,CDM,,,278,RC,inpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1176.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1326,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,1176.24,1482,
DEPUY INSERT PS SZ 4 7MM,30183617,CDM,,,278,RC,inpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9407.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10605.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,9407.86,11853.41,
MEDTRONIC REVEAL LOOP RECORDER,30183619,CDM,,,278,RC,inpatient,,27950,27950,,23729.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21074.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23757.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24596,88,,percent of total billed charges,,,,,,,,,21353.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25434.5,91,,percent of total billed charges,,,26552.5,95,,percent of total billed charges,,,23198.5,83,,percent of total billed charges,,,23198.5,83,,percent of total billed charges,,,,,,,,,,,,,,,23198.5,83,,percent of total billed charges,,,26552.5,95,,percent of total billed charges,,,25155,90,,percent of total billed charges,,,25155,90,,percent of total billed charges,,,22919,82,,percent of total billed charges,,,25155,90,,percent of total billed charges,,,23757.5,85,,percent of total billed charges,,21074.3,26552.5,
DJO UNIPOLAR SLEEVE NEUTRAL,30183620,CDM,,,278,RC,inpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,784.16,988,
DJO STEM HA 470 12MM POROUS,30183621,CDM,,,278,RC,inpatient,,29250,29250,,24833.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22054.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24862.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25740,88,,percent of total billed charges,,,,,,,,,22347,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26617.5,91,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,,,,,,,,,,,,,24277.5,83,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,23985,82,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,22054.5,27787.5,
DJO HEAD UNIPOLAR 45,30183622,CDM,,,278,RC,inpatient,,3848,3848,,3266.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2901.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3270.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3386.24,88,,percent of total billed charges,,,,,,,,,2939.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3501.68,91,,percent of total billed charges,,,3655.6,95,,percent of total billed charges,,,3193.84,83,,percent of total billed charges,,,3193.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3193.84,83,,percent of total billed charges,,,3655.6,95,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3155.36,82,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3270.8,85,,percent of total billed charges,,2901.39,3655.6,
DEPUY LINER NEUTRAL 32 X 54MM +4,30183623,CDM,,,278,RC,inpatient,,11806.99,11806.99,,10024.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8902.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10035.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10390.15,88,,percent of total billed charges,,,,,,,,,9020.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10744.36,91,,percent of total billed charges,,,11216.64,95,,percent of total billed charges,,,9799.8,83,,percent of total billed charges,,,9799.8,83,,percent of total billed charges,,,,,,,,,,,,,,,9799.8,83,,percent of total billed charges,,,11216.64,95,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,9681.73,82,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,10035.94,85,,percent of total billed charges,,8902.47,11216.64,
DRAIN PENROSE TUBING 1/4,30183625,CDM,,,270,RC,inpatient,,7.43,7.43,,6.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6.54,88,,percent of total billed charges,,,,,,,,,5.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6.76,91,,percent of total billed charges,,,7.06,95,,percent of total billed charges,,,6.17,83,,percent of total billed charges,,,6.17,83,,percent of total billed charges,,,,,,,,,,,,,,,6.17,83,,percent of total billed charges,,,7.06,95,,percent of total billed charges,,,6.69,90,,percent of total billed charges,,,6.69,90,,percent of total billed charges,,,6.09,82,,percent of total billed charges,,,6.69,90,,percent of total billed charges,,,6.32,85,,percent of total billed charges,,5.6,7.06,
SYNTHES PLATE FEMUR HOOK 10-HOLE 4.5PROX,30183626,CDM,,,278,RC,inpatient,,18558.48,18558.48,,15756.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13993.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15774.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16331.46,88,,percent of total billed charges,,,,,,,,,14178.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16888.22,91,,percent of total billed charges,,,17630.56,95,,percent of total billed charges,,,15403.54,83,,percent of total billed charges,,,15403.54,83,,percent of total billed charges,,,,,,,,,,,,,,,15403.54,83,,percent of total billed charges,,,17630.56,95,,percent of total billed charges,,,16702.63,90,,percent of total billed charges,,,16702.63,90,,percent of total billed charges,,,15217.95,82,,percent of total billed charges,,,16702.63,90,,percent of total billed charges,,,15774.71,85,,percent of total billed charges,,13993.09,17630.56,
ALLOSOURCE PRESHAPED PATELLA LIGAMENT BT,30183627,CDM,,,278,RC,inpatient,,25867.6,25867.6,,21961.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19504.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21987.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22763.49,88,,percent of total billed charges,,,,,,,,,19762.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23539.52,91,,percent of total billed charges,,,24574.22,95,,percent of total billed charges,,,21470.11,83,,percent of total billed charges,,,21470.11,83,,percent of total billed charges,,,,,,,,,,,,,,,21470.11,83,,percent of total billed charges,,,24574.22,95,,percent of total billed charges,,,23280.84,90,,percent of total billed charges,,,23280.84,90,,percent of total billed charges,,,21211.43,82,,percent of total billed charges,,,23280.84,90,,percent of total billed charges,,,21987.46,85,,percent of total billed charges,,19504.17,24574.22,
DJO HEAD UNIPOLAR 44,30183628,CDM,,,278,RC,inpatient,,3848,3848,,3266.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2901.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3270.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3386.24,88,,percent of total billed charges,,,,,,,,,2939.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3501.68,91,,percent of total billed charges,,,3655.6,95,,percent of total billed charges,,,3193.84,83,,percent of total billed charges,,,3193.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3193.84,83,,percent of total billed charges,,,3655.6,95,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3155.36,82,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3270.8,85,,percent of total billed charges,,2901.39,3655.6,
DJO STEM HA 470 10.5MM POROUS,30183629,CDM,,,278,RC,inpatient,,29250,29250,,24833.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22054.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24862.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25740,88,,percent of total billed charges,,,,,,,,,22347,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26617.5,91,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,,,,,,,,,,,,,24277.5,83,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,23985,82,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,22054.5,27787.5,
SYNTHES SCREW LOCKING 2.7X8MM,30183632,CDM,,,278,RC,inpatient,,1178.13,1178.13,,1000.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,888.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1001.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1036.75,88,,percent of total billed charges,,,,,,,,,900.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1072.1,91,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,,,,,,,,,,,,,977.85,83,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,966.07,82,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,888.31,1119.22,
BIOMET ULTRADRIVE 180MM TIP EXTENDER,30183634,CDM,,,270,RC,inpatient,,4946.5,4946.5,,4199.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3729.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4204.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4352.92,88,,percent of total billed charges,,,,,,,,,3779.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4501.32,91,,percent of total billed charges,,,4699.18,95,,percent of total billed charges,,,4105.6,83,,percent of total billed charges,,,4105.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4105.6,83,,percent of total billed charges,,,4699.18,95,,percent of total billed charges,,,4451.85,90,,percent of total billed charges,,,4451.85,90,,percent of total billed charges,,,4056.13,82,,percent of total billed charges,,,4451.85,90,,percent of total billed charges,,,4204.53,85,,percent of total billed charges,,3729.66,4699.18,
STRYKER CANNULA VENOM 18G 100MM 10MM,30183638,CDM,,,270,RC,inpatient,,511.25,511.25,,434.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,385.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,434.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,449.9,88,,percent of total billed charges,,,,,,,,,390.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,465.24,91,,percent of total billed charges,,,485.69,95,,percent of total billed charges,,,424.34,83,,percent of total billed charges,,,424.34,83,,percent of total billed charges,,,,,,,,,,,,,,,424.34,83,,percent of total billed charges,,,485.69,95,,percent of total billed charges,,,460.13,90,,percent of total billed charges,,,460.13,90,,percent of total billed charges,,,419.23,82,,percent of total billed charges,,,460.13,90,,percent of total billed charges,,,434.56,85,,percent of total billed charges,,385.48,485.69,
ARTHREX KNIFE BLADE,30183639,CDM,,,270,RC,inpatient,,472.5,472.5,,401.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,356.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,401.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,415.8,88,,percent of total billed charges,,,,,,,,,360.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,429.98,91,,percent of total billed charges,,,448.88,95,,percent of total billed charges,,,392.18,83,,percent of total billed charges,,,392.18,83,,percent of total billed charges,,,,,,,,,,,,,,,392.18,83,,percent of total billed charges,,,448.88,95,,percent of total billed charges,,,425.25,90,,percent of total billed charges,,,425.25,90,,percent of total billed charges,,,387.45,82,,percent of total billed charges,,,425.25,90,,percent of total billed charges,,,401.63,85,,percent of total billed charges,,356.27,448.88,
ARTHREX 10.5LP,30183640,CDM,,,278,RC,inpatient,,1813.5,1813.5,,1539.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1367.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1541.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1595.88,88,,percent of total billed charges,,,,,,,,,1385.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1650.29,91,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.21,83,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1487.07,82,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1541.48,85,,percent of total billed charges,,1367.38,1722.83,
ARTHREX SCREW BIOCOMPOSITE 8+23,30183641,CDM,,,278,RC,inpatient,,1527.5,1527.5,,1296.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1151.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1298.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1344.2,88,,percent of total billed charges,,,,,,,,,1167.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1390.03,91,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1267.83,83,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1252.55,82,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,1151.74,1451.13,
ARTHREX SCREW BIOCOMPOSITE 10+28,30183642,CDM,,,278,RC,inpatient,,1527.5,1527.5,,1296.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1151.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1298.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1344.2,88,,percent of total billed charges,,,,,,,,,1167.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1390.03,91,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1267.83,83,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1252.55,82,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,1151.74,1451.13,
BRACE CERVICAL COLLAR,30183643,CDM,,,270,RC,inpatient,,337.5,337.5,,286.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,254.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,286.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,297,88,,percent of total billed charges,,,,,,,,,257.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,307.13,91,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,,,,,,,,,,,,,280.13,83,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,276.75,82,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,254.48,320.63,
BRACE QUICK DRAW LG BLK,30183644,CDM,,,270,RC,inpatient,,559.65,559.65,,475.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,421.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,475.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,492.49,88,,percent of total billed charges,,,,,,,,,427.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,509.28,91,,percent of total billed charges,,,531.67,95,,percent of total billed charges,,,464.51,83,,percent of total billed charges,,,464.51,83,,percent of total billed charges,,,,,,,,,,,,,,,464.51,83,,percent of total billed charges,,,531.67,95,,percent of total billed charges,,,503.69,90,,percent of total billed charges,,,503.69,90,,percent of total billed charges,,,458.91,82,,percent of total billed charges,,,503.69,90,,percent of total billed charges,,,475.7,85,,percent of total billed charges,,421.98,531.67,
SYNTHES PLATE TUBULAR 5-HOLE 114MM,30183647,CDM,,,278,RC,inpatient,,14935.05,14935.05,,12679.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11261.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12694.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13142.84,88,,percent of total billed charges,,,,,,,,,11410.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13590.9,91,,percent of total billed charges,,,14188.3,95,,percent of total billed charges,,,12396.09,83,,percent of total billed charges,,,12396.09,83,,percent of total billed charges,,,,,,,,,,,,,,,12396.09,83,,percent of total billed charges,,,14188.3,95,,percent of total billed charges,,,13441.55,90,,percent of total billed charges,,,13441.55,90,,percent of total billed charges,,,12246.74,82,,percent of total billed charges,,,13441.55,90,,percent of total billed charges,,,12694.79,85,,percent of total billed charges,,11261.03,14188.3,
HOLMIUM 365 FORTEC FIBER,30183648,CDM,,,270,RC,inpatient,,1397.5,1397.5,,1186.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1053.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1187.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1229.8,88,,percent of total billed charges,,,,,,,,,1067.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1271.73,91,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1159.93,83,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1145.95,82,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,1053.72,1327.63,
SYNTHES PLATE DISTAL RADIUS 2.4MM VA 6X3,30183649,CDM,,,278,RC,inpatient,,9762.68,9762.68,,8288.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7361.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8298.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8591.16,88,,percent of total billed charges,,,,,,,,,7458.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8884.04,91,,percent of total billed charges,,,9274.55,95,,percent of total billed charges,,,8103.02,83,,percent of total billed charges,,,8103.02,83,,percent of total billed charges,,,,,,,,,,,,,,,8103.02,83,,percent of total billed charges,,,9274.55,95,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8005.4,82,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8298.28,85,,percent of total billed charges,,7361.06,9274.55,
SYNTHES SCREW CORTEX 2.7MM X 12MM,30183650,CDM,,,278,RC,inpatient,,410.27,410.27,,348.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,309.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,348.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,361.04,88,,percent of total billed charges,,,,,,,,,313.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,373.35,91,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,,,,,,,,,,,,,340.52,83,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,336.42,82,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,348.73,85,,percent of total billed charges,,309.34,389.76,
ELECTRODE COAG MONO 22-24FR,30183653,CDM,,,270,RC,inpatient,,557.58,557.58,,473.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,420.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,473.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,490.67,88,,percent of total billed charges,,,,,,,,,425.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,507.4,91,,percent of total billed charges,,,529.7,95,,percent of total billed charges,,,462.79,83,,percent of total billed charges,,,462.79,83,,percent of total billed charges,,,,,,,,,,,,,,,462.79,83,,percent of total billed charges,,,529.7,95,,percent of total billed charges,,,501.82,90,,percent of total billed charges,,,501.82,90,,percent of total billed charges,,,457.22,82,,percent of total billed charges,,,501.82,90,,percent of total billed charges,,,473.94,85,,percent of total billed charges,,420.42,529.7,
DJO UNIPOLAR HEAD 51MM,30183654,CDM,,,278,RC,inpatient,,3848,3848,,3266.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2901.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3270.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3386.24,88,,percent of total billed charges,,,,,,,,,2939.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3501.68,91,,percent of total billed charges,,,3655.6,95,,percent of total billed charges,,,3193.84,83,,percent of total billed charges,,,3193.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3193.84,83,,percent of total billed charges,,,3655.6,95,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3155.36,82,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3270.8,85,,percent of total billed charges,,2901.39,3655.6,
DJO STEM LIMA REVISION DISTAL 20 X 140MM,30183655,CDM,,,278,RC,inpatient,,39838.5,39838.5,,33822.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30038.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33862.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35057.88,88,,percent of total billed charges,,,,,,,,,30436.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36253.04,91,,percent of total billed charges,,,37846.58,95,,percent of total billed charges,,,33065.96,83,,percent of total billed charges,,,33065.96,83,,percent of total billed charges,,,,,,,,,,,,,,,33065.96,83,,percent of total billed charges,,,37846.58,95,,percent of total billed charges,,,35854.65,90,,percent of total billed charges,,,35854.65,90,,percent of total billed charges,,,32667.57,82,,percent of total billed charges,,,35854.65,90,,percent of total billed charges,,,33862.73,85,,percent of total billed charges,,30038.23,37846.58,
DJO BODY LIMA REVISION LAT. 70MM,30183656,CDM,,,278,RC,inpatient,,37492,37492,,31830.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28268.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31868.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32992.96,88,,percent of total billed charges,,,,,,,,,28643.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34117.72,91,,percent of total billed charges,,,35617.4,95,,percent of total billed charges,,,31118.36,83,,percent of total billed charges,,,31118.36,83,,percent of total billed charges,,,,,,,,,,,,,,,31118.36,83,,percent of total billed charges,,,35617.4,95,,percent of total billed charges,,,33742.8,90,,percent of total billed charges,,,33742.8,90,,percent of total billed charges,,,30743.44,82,,percent of total billed charges,,,33742.8,90,,percent of total billed charges,,,31868.2,85,,percent of total billed charges,,28268.97,35617.4,
ARTHROCARE REFLEX ULTRA 45,30183657,CDM,,,270,RC,inpatient,,1430,1430,,1214.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1078.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1215.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1258.4,88,,percent of total billed charges,,,,,,,,,1092.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1301.3,91,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1186.9,83,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1172.6,82,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,1078.22,1358.5,
MEDTRONIC PULSE GENERATOR LEAD 140,30183668,CDM,,,270,RC,inpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1372.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1547,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,1372.28,1729,
MEDTRONIC PULSE GENERATOR LEAD 100,30183669,CDM,,,270,RC,inpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1372.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1547,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,1372.28,1729,
MEDTRONIC PACEMAKER,30183670,CDM,,,278,RC,inpatient,,40670.5,40670.5,,34529.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30665.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34569.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35790.04,88,,percent of total billed charges,,,,,,,,,31072.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37010.16,91,,percent of total billed charges,,,38636.98,95,,percent of total billed charges,,,33756.52,83,,percent of total billed charges,,,33756.52,83,,percent of total billed charges,,,,,,,,,,,,,,,33756.52,83,,percent of total billed charges,,,38636.98,95,,percent of total billed charges,,,36603.45,90,,percent of total billed charges,,,36603.45,90,,percent of total billed charges,,,33349.81,82,,percent of total billed charges,,,36603.45,90,,percent of total billed charges,,,34569.93,85,,percent of total billed charges,,30665.56,38636.98,
MEDTRONIC RV LEAD,30183671,CDM,,,278,RC,inpatient,,4829.5,4829.5,,4100.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3641.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4105.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4249.96,88,,percent of total billed charges,,,,,,,,,3689.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4394.85,91,,percent of total billed charges,,,4588.03,95,,percent of total billed charges,,,4008.49,83,,percent of total billed charges,,,4008.49,83,,percent of total billed charges,,,,,,,,,,,,,,,4008.49,83,,percent of total billed charges,,,4588.03,95,,percent of total billed charges,,,4346.55,90,,percent of total billed charges,,,4346.55,90,,percent of total billed charges,,,3960.19,82,,percent of total billed charges,,,4346.55,90,,percent of total billed charges,,,4105.08,85,,percent of total billed charges,,3641.44,4588.03,
GREENLIGHT XPS LASER FEE- UNITED SHOCK,30183672,CDM,,,270,RC,inpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3896.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4392.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,3896.3,4909.13,
GREENLIGHT XPS FIBER,30183673,CDM,,,270,RC,inpatient,,6825,6825,,5794.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5146.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5801.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6006,88,,percent of total billed charges,,,,,,,,,5214.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6210.75,91,,percent of total billed charges,,,6483.75,95,,percent of total billed charges,,,5664.75,83,,percent of total billed charges,,,5664.75,83,,percent of total billed charges,,,,,,,,,,,,,,,5664.75,83,,percent of total billed charges,,,6483.75,95,,percent of total billed charges,,,6142.5,90,,percent of total billed charges,,,6142.5,90,,percent of total billed charges,,,5596.5,82,,percent of total billed charges,,,6142.5,90,,percent of total billed charges,,,5801.25,85,,percent of total billed charges,,5146.05,6483.75,
MEDARTIS SCREW CANNULATED 28MM,30183674,CDM,,,278,RC,inpatient,,2047.5,2047.5,,1738.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1543.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1740.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1801.8,88,,percent of total billed charges,,,,,,,,,1564.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1863.23,91,,percent of total billed charges,,,1945.13,95,,percent of total billed charges,,,1699.43,83,,percent of total billed charges,,,1699.43,83,,percent of total billed charges,,,,,,,,,,,,,,,1699.43,83,,percent of total billed charges,,,1945.13,95,,percent of total billed charges,,,1842.75,90,,percent of total billed charges,,,1842.75,90,,percent of total billed charges,,,1678.95,82,,percent of total billed charges,,,1842.75,90,,percent of total billed charges,,,1740.38,85,,percent of total billed charges,,1543.82,1945.13,
MEDARTIS K-WIRE 0.8MM,30183675,CDM,,,270,RC,inpatient,,195.75,195.75,,166.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,166.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,172.26,88,,percent of total billed charges,,,,,,,,,149.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,178.13,91,,percent of total billed charges,,,185.96,95,,percent of total billed charges,,,162.47,83,,percent of total billed charges,,,162.47,83,,percent of total billed charges,,,,,,,,,,,,,,,162.47,83,,percent of total billed charges,,,185.96,95,,percent of total billed charges,,,176.18,90,,percent of total billed charges,,,176.18,90,,percent of total billed charges,,,160.52,82,,percent of total billed charges,,,176.18,90,,percent of total billed charges,,,166.39,85,,percent of total billed charges,,147.6,185.96,
MEDARTIS K-WIRE 1.1MM,30183676,CDM,,,270,RC,inpatient,,195.75,195.75,,166.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,166.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,172.26,88,,percent of total billed charges,,,,,,,,,149.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,178.13,91,,percent of total billed charges,,,185.96,95,,percent of total billed charges,,,162.47,83,,percent of total billed charges,,,162.47,83,,percent of total billed charges,,,,,,,,,,,,,,,162.47,83,,percent of total billed charges,,,185.96,95,,percent of total billed charges,,,176.18,90,,percent of total billed charges,,,176.18,90,,percent of total billed charges,,,160.52,82,,percent of total billed charges,,,176.18,90,,percent of total billed charges,,,166.39,85,,percent of total billed charges,,147.6,185.96,
SAFE SHEATH 7FR 13CM,30183677,CDM,,,270,RC,inpatient,,534.8,534.8,,454.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,403.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,454.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,470.62,88,,percent of total billed charges,,,,,,,,,408.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,486.67,91,,percent of total billed charges,,,508.06,95,,percent of total billed charges,,,443.88,83,,percent of total billed charges,,,443.88,83,,percent of total billed charges,,,,,,,,,,,,,,,443.88,83,,percent of total billed charges,,,508.06,95,,percent of total billed charges,,,481.32,90,,percent of total billed charges,,,481.32,90,,percent of total billed charges,,,438.54,82,,percent of total billed charges,,,481.32,90,,percent of total billed charges,,,454.58,85,,percent of total billed charges,,403.24,508.06,
DEPUY REVISE AUGMENT 10MM 50/52MM,30183678,CDM,,,278,RC,inpatient,,21066.96,21066.96,,17885.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15884.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17906.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18538.92,88,,percent of total billed charges,,,,,,,,,16095.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19170.93,91,,percent of total billed charges,,,20013.61,95,,percent of total billed charges,,,17485.58,83,,percent of total billed charges,,,17485.58,83,,percent of total billed charges,,,,,,,,,,,,,,,17485.58,83,,percent of total billed charges,,,20013.61,95,,percent of total billed charges,,,18960.26,90,,percent of total billed charges,,,18960.26,90,,percent of total billed charges,,,17274.91,82,,percent of total billed charges,,,18960.26,90,,percent of total billed charges,,,17906.92,85,,percent of total billed charges,,15884.49,20013.61,
DEPUY SCREW TF 65MM,30183679,CDM,,,278,RC,inpatient,,1266.92,1266.92,,1075.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1076.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1114.89,88,,percent of total billed charges,,,,,,,,,967.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1152.9,91,,percent of total billed charges,,,1203.57,95,,percent of total billed charges,,,1051.54,83,,percent of total billed charges,,,1051.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1051.54,83,,percent of total billed charges,,,1203.57,95,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1038.87,82,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1076.88,85,,percent of total billed charges,,955.26,1203.57,
DEPUY SCREW TF 55MM,30183680,CDM,,,278,RC,inpatient,,1266.92,1266.92,,1075.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1076.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1114.89,88,,percent of total billed charges,,,,,,,,,967.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1152.9,91,,percent of total billed charges,,,1203.57,95,,percent of total billed charges,,,1051.54,83,,percent of total billed charges,,,1051.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1051.54,83,,percent of total billed charges,,,1203.57,95,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1038.87,82,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1076.88,85,,percent of total billed charges,,955.26,1203.57,
DEPUY SCREW TF 50MM,30183681,CDM,,,278,RC,inpatient,,1266.92,1266.92,,1075.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1076.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1114.89,88,,percent of total billed charges,,,,,,,,,967.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1152.9,91,,percent of total billed charges,,,1203.57,95,,percent of total billed charges,,,1051.54,83,,percent of total billed charges,,,1051.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1051.54,83,,percent of total billed charges,,,1203.57,95,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1038.87,82,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1076.88,85,,percent of total billed charges,,955.26,1203.57,
DEPUY HEAD TAPER 36 +0  11/13,30183682,CDM,,,278,RC,inpatient,,8767.27,8767.27,,7443.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6610.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7452.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7715.2,88,,percent of total billed charges,,,,,,,,,6698.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7978.22,91,,percent of total billed charges,,,8328.91,95,,percent of total billed charges,,,7276.83,83,,percent of total billed charges,,,7276.83,83,,percent of total billed charges,,,,,,,,,,,,,,,7276.83,83,,percent of total billed charges,,,8328.91,95,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7189.16,82,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7452.18,85,,percent of total billed charges,,6610.52,8328.91,
DJO HEAD UNIPOLAR 54,30183683,CDM,,,278,RC,inpatient,,3848,3848,,3266.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2901.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3270.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3386.24,88,,percent of total billed charges,,,,,,,,,2939.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3501.68,91,,percent of total billed charges,,,3655.6,95,,percent of total billed charges,,,3193.84,83,,percent of total billed charges,,,3193.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3193.84,83,,percent of total billed charges,,,3655.6,95,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3155.36,82,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3270.8,85,,percent of total billed charges,,2901.39,3655.6,
DJO STEM PRESS FIT POROUS HA 16.5MM,30183684,CDM,,,278,RC,inpatient,,29250,29250,,24833.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22054.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24862.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25740,88,,percent of total billed charges,,,,,,,,,22347,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26617.5,91,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,,,,,,,,,,,,,24277.5,83,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,23985,82,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,22054.5,27787.5,
STRYKER ELECTRODE VENOM MONOP 100MM,30183685,CDM,,,270,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
SYNTHES REAMER TUBE SPARE FOR HOLLOW REA,30183686,CDM,,,270,RC,inpatient,,2491.78,2491.78,,2115.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1878.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2118.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2192.77,88,,percent of total billed charges,,,,,,,,,1903.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2267.52,91,,percent of total billed charges,,,2367.19,95,,percent of total billed charges,,,2068.18,83,,percent of total billed charges,,,2068.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2068.18,83,,percent of total billed charges,,,2367.19,95,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2043.26,82,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2118.01,85,,percent of total billed charges,,1878.8,2367.19,
SYNTHES CONICAL EXTRACTION DEVICE,30183687,CDM,,,270,RC,inpatient,,1508.33,1508.33,,1280.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1137.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1282.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1327.33,88,,percent of total billed charges,,,,,,,,,1152.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1372.58,91,,percent of total billed charges,,,1432.91,95,,percent of total billed charges,,,1251.91,83,,percent of total billed charges,,,1251.91,83,,percent of total billed charges,,,,,,,,,,,,,,,1251.91,83,,percent of total billed charges,,,1432.91,95,,percent of total billed charges,,,1357.5,90,,percent of total billed charges,,,1357.5,90,,percent of total billed charges,,,1236.83,82,,percent of total billed charges,,,1357.5,90,,percent of total billed charges,,,1282.08,85,,percent of total billed charges,,1137.28,1432.91,
STOPCOCK 3-WAY LRG BORE EXTENSION SETS,30183688,CDM,,,270,RC,inpatient,,4.79,4.79,,4.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4.22,88,,percent of total billed charges,,,,,,,,,3.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4.36,91,,percent of total billed charges,,,4.55,95,,percent of total billed charges,,,3.98,83,,percent of total billed charges,,,3.98,83,,percent of total billed charges,,,,,,,,,,,,,,,3.98,83,,percent of total billed charges,,,4.55,95,,percent of total billed charges,,,4.31,90,,percent of total billed charges,,,4.31,90,,percent of total billed charges,,,3.93,82,,percent of total billed charges,,,4.31,90,,percent of total billed charges,,,4.07,85,,percent of total billed charges,,3.61,4.55,
DEPUY ATTUNE FEMUR 5N L,30183689,CDM,,,278,RC,inpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21324.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24039.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,21324.5,26867.74,
AESCULAP TIBIA T2- REVISION,30183690,CDM,,,278,RC,inpatient,,31330,31330,,26599.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23622.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26630.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27570.4,88,,percent of total billed charges,,,,,,,,,23936.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28510.3,91,,percent of total billed charges,,,29763.5,95,,percent of total billed charges,,,26003.9,83,,percent of total billed charges,,,26003.9,83,,percent of total billed charges,,,,,,,,,,,,,,,26003.9,83,,percent of total billed charges,,,29763.5,95,,percent of total billed charges,,,28197,90,,percent of total billed charges,,,28197,90,,percent of total billed charges,,,25690.6,82,,percent of total billed charges,,,28197,90,,percent of total billed charges,,,26630.5,85,,percent of total billed charges,,23622.82,29763.5,
AESCULAP TIBIA AUGMENT T2 8MM,30183691,CDM,,,278,RC,inpatient,,20891,20891,,17736.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15751.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17757.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18384.08,88,,percent of total billed charges,,,,,,,,,15960.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19010.81,91,,percent of total billed charges,,,19846.45,95,,percent of total billed charges,,,17339.53,83,,percent of total billed charges,,,17339.53,83,,percent of total billed charges,,,,,,,,,,,,,,,17339.53,83,,percent of total billed charges,,,19846.45,95,,percent of total billed charges,,,18801.9,90,,percent of total billed charges,,,18801.9,90,,percent of total billed charges,,,17130.62,82,,percent of total billed charges,,,18801.9,90,,percent of total billed charges,,,17757.35,85,,percent of total billed charges,,15751.81,19846.45,
AESCULAP TIBIA AUGMENT T2 8MM,30183692,CDM,,,278,RC,inpatient,,20891,20891,,17736.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15751.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17757.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18384.08,88,,percent of total billed charges,,,,,,,,,15960.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19010.81,91,,percent of total billed charges,,,19846.45,95,,percent of total billed charges,,,17339.53,83,,percent of total billed charges,,,17339.53,83,,percent of total billed charges,,,,,,,,,,,,,,,17339.53,83,,percent of total billed charges,,,19846.45,95,,percent of total billed charges,,,18801.9,90,,percent of total billed charges,,,18801.9,90,,percent of total billed charges,,,17130.62,82,,percent of total billed charges,,,18801.9,90,,percent of total billed charges,,,17757.35,85,,percent of total billed charges,,15751.81,19846.45,
AESCULAP STEM 92MM,30183693,CDM,,,278,RC,inpatient,,14378,14378,,12206.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10841.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12221.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12652.64,88,,percent of total billed charges,,,,,,,,,10984.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13083.98,91,,percent of total billed charges,,,13659.1,95,,percent of total billed charges,,,11933.74,83,,percent of total billed charges,,,11933.74,83,,percent of total billed charges,,,,,,,,,,,,,,,11933.74,83,,percent of total billed charges,,,13659.1,95,,percent of total billed charges,,,12940.2,90,,percent of total billed charges,,,12940.2,90,,percent of total billed charges,,,11789.96,82,,percent of total billed charges,,,12940.2,90,,percent of total billed charges,,,12221.3,85,,percent of total billed charges,,10841.01,13659.1,
AESCULAP VEGA POLY- REV,30183694,CDM,,,278,RC,inpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3675.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4143.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,3675.75,4631.25,
DEPUY FEMUR ATTUNE 6N RIGHT,30183696,CDM,,,278,RC,inpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21324.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24039.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,21324.5,26867.74,
DEPUY BODY RECLAIM PROXIMAL 20 X 75,30183697,CDM,,,278,RC,inpatient,,38548.77,38548.77,,32727.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29065.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32766.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33922.92,88,,percent of total billed charges,,,,,,,,,29451.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35079.38,91,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,,,,,,,,,,,,,31995.48,83,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,31609.99,82,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,32766.45,85,,percent of total billed charges,,29065.77,36621.33,
DEPUY STEM DISTAL RECLAIM 16 X 140,30183698,CDM,,,278,RC,inpatient,,31338.78,31338.78,,26606.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23629.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26637.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27578.13,88,,percent of total billed charges,,,,,,,,,23942.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28518.29,91,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,,,,,,,,,,,,,26011.19,83,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,25697.8,82,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,26637.96,85,,percent of total billed charges,,23629.44,29771.84,
APPLIED TROCAR ADV. FIXATION 5X100MM,30183699,CDM,,,270,RC,inpatient,,156,156,,132.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,117.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,132.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,137.28,88,,percent of total billed charges,,,,,,,,,119.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,141.96,91,,percent of total billed charges,,,148.2,95,,percent of total billed charges,,,129.48,83,,percent of total billed charges,,,129.48,83,,percent of total billed charges,,,,,,,,,,,,,,,129.48,83,,percent of total billed charges,,,148.2,95,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,127.92,82,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,132.6,85,,percent of total billed charges,,117.62,148.2,
APPLIED TROCAR ADV. FIXATION 5X150MM,30183700,CDM,,,270,RC,inpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
DJO STEM 150 X 18MM TIBIAL REVISION,30183704,CDM,,,278,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
STRYKER LONG NAIL KIT R1/5 TI RIGHT 11X3,30183705,CDM,,,278,RC,inpatient,,22854,22854,,19403.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17231.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19425.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20111.52,88,,percent of total billed charges,,,,,,,,,17460.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20797.14,91,,percent of total billed charges,,,21711.3,95,,percent of total billed charges,,,18968.82,83,,percent of total billed charges,,,18968.82,83,,percent of total billed charges,,,,,,,,,,,,,,,18968.82,83,,percent of total billed charges,,,21711.3,95,,percent of total billed charges,,,20568.6,90,,percent of total billed charges,,,20568.6,90,,percent of total billed charges,,,18740.28,82,,percent of total billed charges,,,20568.6,90,,percent of total billed charges,,,19425.9,85,,percent of total billed charges,,17231.92,21711.3,
STRYKER SCREW LOCKING T2 F/T 5X47.5MM,30183706,CDM,,,278,RC,inpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1372.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1547,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,1372.28,1729,
DEPUY STEM CORAIL COLLARED SZ16,30183707,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
MICROPORT INSERT TIBIAL 14MM SZ4 RT,30183710,CDM,,,278,RC,inpatient,,5980,5980,,5077.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4508.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5083,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5262.4,88,,percent of total billed charges,,,,,,,,,4568.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5441.8,91,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4963.4,83,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,4903.6,82,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5083,85,,percent of total billed charges,,4508.92,5681,
MICROPORT STEM 15X30MM,30183711,CDM,,,278,RC,inpatient,,10868,10868,,9226.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8194.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9237.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9563.84,88,,percent of total billed charges,,,,,,,,,8303.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9889.88,91,,percent of total billed charges,,,10324.6,95,,percent of total billed charges,,,9020.44,83,,percent of total billed charges,,,9020.44,83,,percent of total billed charges,,,,,,,,,,,,,,,9020.44,83,,percent of total billed charges,,,10324.6,95,,percent of total billed charges,,,9781.2,90,,percent of total billed charges,,,9781.2,90,,percent of total billed charges,,,8911.76,82,,percent of total billed charges,,,9781.2,90,,percent of total billed charges,,,9237.8,85,,percent of total billed charges,,8194.47,10324.6,
MICROPORT AUGMENT TIBIAL SZ 4/3+ 5MM,30183712,CDM,,,278,RC,inpatient,,10939.5,10939.5,,9287.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8248.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9298.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9626.76,88,,percent of total billed charges,,,,,,,,,8357.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9954.95,91,,percent of total billed charges,,,10392.53,95,,percent of total billed charges,,,9079.79,83,,percent of total billed charges,,,9079.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9079.79,83,,percent of total billed charges,,,10392.53,95,,percent of total billed charges,,,9845.55,90,,percent of total billed charges,,,9845.55,90,,percent of total billed charges,,,8970.39,82,,percent of total billed charges,,,9845.55,90,,percent of total billed charges,,,9298.58,85,,percent of total billed charges,,8248.38,10392.53,
DJO HEAD CERAMIC 36MM,30183713,CDM,,,278,RC,inpatient,,20085,20085,,17052.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15144.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17072.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17674.8,88,,percent of total billed charges,,,,,,,,,15344.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18277.35,91,,percent of total billed charges,,,19080.75,95,,percent of total billed charges,,,16670.55,83,,percent of total billed charges,,,16670.55,83,,percent of total billed charges,,,,,,,,,,,,,,,16670.55,83,,percent of total billed charges,,,19080.75,95,,percent of total billed charges,,,18076.5,90,,percent of total billed charges,,,18076.5,90,,percent of total billed charges,,,16469.7,82,,percent of total billed charges,,,18076.5,90,,percent of total billed charges,,,17072.25,85,,percent of total billed charges,,15144.09,19080.75,
DJO LINER 20DEG HOODED NEUTRAL MP7 HXE-P,30183714,CDM,,,278,RC,inpatient,,18772,18772,,15937.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14154.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15956.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16519.36,88,,percent of total billed charges,,,,,,,,,14341.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17082.52,91,,percent of total billed charges,,,17833.4,95,,percent of total billed charges,,,15580.76,83,,percent of total billed charges,,,15580.76,83,,percent of total billed charges,,,,,,,,,,,,,,,15580.76,83,,percent of total billed charges,,,17833.4,95,,percent of total billed charges,,,16894.8,90,,percent of total billed charges,,,16894.8,90,,percent of total billed charges,,,15393.04,82,,percent of total billed charges,,,16894.8,90,,percent of total billed charges,,,15956.2,85,,percent of total billed charges,,14154.09,17833.4,
DJO SHELL W/SCREW HOLES 52MM W/P2 COATIN,30183715,CDM,,,278,RC,inpatient,,18778.5,18778.5,,15942.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14158.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15961.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16525.08,88,,percent of total billed charges,,,,,,,,,14346.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17088.44,91,,percent of total billed charges,,,17839.58,95,,percent of total billed charges,,,15586.16,83,,percent of total billed charges,,,15586.16,83,,percent of total billed charges,,,,,,,,,,,,,,,15586.16,83,,percent of total billed charges,,,17839.58,95,,percent of total billed charges,,,16900.65,90,,percent of total billed charges,,,16900.65,90,,percent of total billed charges,,,15398.37,82,,percent of total billed charges,,,16900.65,90,,percent of total billed charges,,,15961.73,85,,percent of total billed charges,,14158.99,17839.58,
DJO SCREW CANCELLOUS 25MM,30183716,CDM,,,278,RC,inpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,784.16,988,
ZIMMER TIBIAL PLATE WEDGE SZ 5,30183717,CDM,,,278,RC,inpatient,,17084.28,17084.28,,14504.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12881.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14521.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15034.17,88,,percent of total billed charges,,,,,,,,,13052.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15546.69,91,,percent of total billed charges,,,16230.07,95,,percent of total billed charges,,,14179.95,83,,percent of total billed charges,,,14179.95,83,,percent of total billed charges,,,,,,,,,,,,,,,14179.95,83,,percent of total billed charges,,,16230.07,95,,percent of total billed charges,,,15375.85,90,,percent of total billed charges,,,15375.85,90,,percent of total billed charges,,,14009.11,82,,percent of total billed charges,,,15375.85,90,,percent of total billed charges,,,14521.64,85,,percent of total billed charges,,12881.55,16230.07,
ZIMMER TIBIAL BLOCK 5MM,30183718,CDM,,,278,RC,inpatient,,7107.88,7107.88,,6034.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5359.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6041.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6254.93,88,,percent of total billed charges,,,,,,,,,5430.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6468.17,91,,percent of total billed charges,,,6752.49,95,,percent of total billed charges,,,5899.54,83,,percent of total billed charges,,,5899.54,83,,percent of total billed charges,,,,,,,,,,,,,,,5899.54,83,,percent of total billed charges,,,6752.49,95,,percent of total billed charges,,,6397.09,90,,percent of total billed charges,,,6397.09,90,,percent of total billed charges,,,5828.46,82,,percent of total billed charges,,,6397.09,90,,percent of total billed charges,,,6041.7,85,,percent of total billed charges,,5359.34,6752.49,
ZIMMER STEM EXTENSION OFFSET 12X100MM,30183719,CDM,,,278,RC,inpatient,,20150,20150,,17107.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15193.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17127.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17732,88,,percent of total billed charges,,,,,,,,,15394.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18336.5,91,,percent of total billed charges,,,19142.5,95,,percent of total billed charges,,,16724.5,83,,percent of total billed charges,,,16724.5,83,,percent of total billed charges,,,,,,,,,,,,,,,16724.5,83,,percent of total billed charges,,,19142.5,95,,percent of total billed charges,,,18135,90,,percent of total billed charges,,,18135,90,,percent of total billed charges,,,16523,82,,percent of total billed charges,,,18135,90,,percent of total billed charges,,,17127.5,85,,percent of total billed charges,,15193.1,19142.5,
ZIMMER SURFACE ARTICULAR 14MM EF,30183720,CDM,,,278,RC,inpatient,,16770,16770,,14237.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12644.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14254.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14757.6,88,,percent of total billed charges,,,,,,,,,12812.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15260.7,91,,percent of total billed charges,,,15931.5,95,,percent of total billed charges,,,13919.1,83,,percent of total billed charges,,,13919.1,83,,percent of total billed charges,,,,,,,,,,,,,,,13919.1,83,,percent of total billed charges,,,15931.5,95,,percent of total billed charges,,,15093,90,,percent of total billed charges,,,15093,90,,percent of total billed charges,,,13751.4,82,,percent of total billed charges,,,15093,90,,percent of total billed charges,,,14254.5,85,,percent of total billed charges,,12644.58,15931.5,
SYNTHES 4.0MM/2.5MM 80MM LENGTH,30183721,CDM,,,278,RC,inpatient,,1574.63,1574.63,,1336.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1187.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1338.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1385.67,88,,percent of total billed charges,,,,,,,,,1203.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1432.91,91,,percent of total billed charges,,,1495.9,95,,percent of total billed charges,,,1306.94,83,,percent of total billed charges,,,1306.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1306.94,83,,percent of total billed charges,,,1495.9,95,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1291.2,82,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1338.44,85,,percent of total billed charges,,1187.27,1495.9,
SYNTHES 4.0MM/3.5MM 80MM LENGTH,30183722,CDM,,,278,RC,inpatient,,1756.95,1756.95,,1491.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1324.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1493.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1546.12,88,,percent of total billed charges,,,,,,,,,1342.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1598.82,91,,percent of total billed charges,,,1669.1,95,,percent of total billed charges,,,1458.27,83,,percent of total billed charges,,,1458.27,83,,percent of total billed charges,,,,,,,,,,,,,,,1458.27,83,,percent of total billed charges,,,1669.1,95,,percent of total billed charges,,,1581.26,90,,percent of total billed charges,,,1581.26,90,,percent of total billed charges,,,1440.7,82,,percent of total billed charges,,,1581.26,90,,percent of total billed charges,,,1493.41,85,,percent of total billed charges,,1324.74,1669.1,
LDR ROI-C LORDOTIC IMPLANT H 8MM 12X14MM,30183724,CDM,,,278,RC,inpatient,,21937.5,21937.5,,18624.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16540.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18646.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19305,88,,percent of total billed charges,,,,,,,,,16760.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19963.13,91,,percent of total billed charges,,,20840.63,95,,percent of total billed charges,,,18208.13,83,,percent of total billed charges,,,18208.13,83,,percent of total billed charges,,,,,,,,,,,,,,,18208.13,83,,percent of total billed charges,,,20840.63,95,,percent of total billed charges,,,19743.75,90,,percent of total billed charges,,,19743.75,90,,percent of total billed charges,,,17988.75,82,,percent of total billed charges,,,19743.75,90,,percent of total billed charges,,,18646.88,85,,percent of total billed charges,,16540.88,20840.63,
LDR ROI-C LONG ANCHORING PLATE,30183725,CDM,,,278,RC,inpatient,,21937.5,21937.5,,18624.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16540.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18646.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19305,88,,percent of total billed charges,,,,,,,,,16760.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19963.13,91,,percent of total billed charges,,,20840.63,95,,percent of total billed charges,,,18208.13,83,,percent of total billed charges,,,18208.13,83,,percent of total billed charges,,,,,,,,,,,,,,,18208.13,83,,percent of total billed charges,,,20840.63,95,,percent of total billed charges,,,19743.75,90,,percent of total billed charges,,,19743.75,90,,percent of total billed charges,,,17988.75,82,,percent of total billed charges,,,19743.75,90,,percent of total billed charges,,,18646.88,85,,percent of total billed charges,,16540.88,20840.63,
SYNTHES PLATE LCP 3.5MM RIGHT ANGLE T PL,30183726,CDM,,,278,RC,inpatient,,3353.58,3353.58,,2847.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2528.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2850.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2951.15,88,,percent of total billed charges,,,,,,,,,2562.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3051.76,91,,percent of total billed charges,,,3185.9,95,,percent of total billed charges,,,2783.47,83,,percent of total billed charges,,,2783.47,83,,percent of total billed charges,,,,,,,,,,,,,,,2783.47,83,,percent of total billed charges,,,3185.9,95,,percent of total billed charges,,,3018.22,90,,percent of total billed charges,,,3018.22,90,,percent of total billed charges,,,2749.94,82,,percent of total billed charges,,,3018.22,90,,percent of total billed charges,,,2850.54,85,,percent of total billed charges,,2528.6,3185.9,
DEPUY STEM CEMENTED 15 X 90,30183727,CDM,,,278,RC,inpatient,,8116.23,8116.23,,6890.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6119.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6898.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7142.28,88,,percent of total billed charges,,,,,,,,,6200.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7385.77,91,,percent of total billed charges,,,7710.42,95,,percent of total billed charges,,,6736.47,83,,percent of total billed charges,,,6736.47,83,,percent of total billed charges,,,,,,,,,,,,,,,6736.47,83,,percent of total billed charges,,,7710.42,95,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,6655.31,82,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,6898.8,85,,percent of total billed charges,,6119.64,7710.42,
DEPUY SLEEVE FEMORAL 34MM,30183728,CDM,,,278,RC,inpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13618.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15352.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,13618.85,17159.03,
DEPUY DISTAL AUGMENT FEM SZ 5 8MM,30183729,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
*APPLIED CLIP APPLIER M/L,30183730,CDM,,,270,RC,inpatient,,735,735,,624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,554.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,624.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,646.8,88,,percent of total billed charges,,,,,,,,,561.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,,,,,,,,,,,,,610.05,83,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,602.7,82,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,554.19,698.25,
STRYKER BLADE SAGITAL 90DEG.,30183731,CDM,,,270,RC,inpatient,,359.17,359.17,,304.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,270.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,305.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,316.07,88,,percent of total billed charges,,,,,,,,,274.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,326.84,91,,percent of total billed charges,,,341.21,95,,percent of total billed charges,,,298.11,83,,percent of total billed charges,,,298.11,83,,percent of total billed charges,,,,,,,,,,,,,,,298.11,83,,percent of total billed charges,,,341.21,95,,percent of total billed charges,,,323.25,90,,percent of total billed charges,,,323.25,90,,percent of total billed charges,,,294.52,82,,percent of total billed charges,,,323.25,90,,percent of total billed charges,,,305.29,85,,percent of total billed charges,,270.81,341.21,
S&N DRILL BIT 2.3,30183732,CDM,,,278,RC,inpatient,,1131,1131,,960.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,852.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,961.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,995.28,88,,percent of total billed charges,,,,,,,,,864.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1029.21,91,,percent of total billed charges,,,1074.45,95,,percent of total billed charges,,,938.73,83,,percent of total billed charges,,,938.73,83,,percent of total billed charges,,,,,,,,,,,,,,,938.73,83,,percent of total billed charges,,,1074.45,95,,percent of total billed charges,,,1017.9,90,,percent of total billed charges,,,1017.9,90,,percent of total billed charges,,,927.42,82,,percent of total billed charges,,,1017.9,90,,percent of total billed charges,,,961.35,85,,percent of total billed charges,,852.77,1074.45,
DEPUY INSERT PS 10MM SZ 5,30183733,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY INSERT AOX 5MM SZ 6,30183735,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
SYNTHES SCREW CANNULATED 6.5X70MM,30183736,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANNULATED 6.5X80MM,30183737,CDM,,,278,RC,inpatient,,2696.27,2696.27,,2289.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2032.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2291.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2372.72,88,,percent of total billed charges,,,,,,,,,2059.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2453.61,91,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2237.9,83,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2210.94,82,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,2032.99,2561.46,
SYNTHES SCREW CANNULATED 6.5X90MM,30183738,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
RAPID CURE 10CC,30183739,CDM,,,278,RC,inpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7106.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8011.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,7106.45,8953.75,
S&N DRILL GUIDE,30183741,CDM,,,278,RC,inpatient,,2658.5,2658.5,,2257.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2004.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2259.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2339.48,88,,percent of total billed charges,,,,,,,,,2031.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2419.24,91,,percent of total billed charges,,,2525.58,95,,percent of total billed charges,,,2206.56,83,,percent of total billed charges,,,2206.56,83,,percent of total billed charges,,,,,,,,,,,,,,,2206.56,83,,percent of total billed charges,,,2525.58,95,,percent of total billed charges,,,2392.65,90,,percent of total billed charges,,,2392.65,90,,percent of total billed charges,,,2179.97,82,,percent of total billed charges,,,2392.65,90,,percent of total billed charges,,,2259.73,85,,percent of total billed charges,,2004.51,2525.58,
S&N TROCHAR BLUNT TIP,30183742,CDM,,,278,RC,inpatient,,1131,1131,,960.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,852.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,961.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,995.28,88,,percent of total billed charges,,,,,,,,,864.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1029.21,91,,percent of total billed charges,,,1074.45,95,,percent of total billed charges,,,938.73,83,,percent of total billed charges,,,938.73,83,,percent of total billed charges,,,,,,,,,,,,,,,938.73,83,,percent of total billed charges,,,1074.45,95,,percent of total billed charges,,,1017.9,90,,percent of total billed charges,,,1017.9,90,,percent of total billed charges,,,927.42,82,,percent of total billed charges,,,1017.9,90,,percent of total billed charges,,,961.35,85,,percent of total billed charges,,852.77,1074.45,
S&N TROCHAR SHARP TIP,30183743,CDM,,,278,RC,inpatient,,1033.5,1033.5,,877.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,779.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,878.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,909.48,88,,percent of total billed charges,,,,,,,,,789.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,940.49,91,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,,,,,,,,,,,,,857.81,83,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,847.47,82,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,779.26,981.83,
BIOMET HUMERAL NAIL 8MM X 300MM,30183744,CDM,,,278,RC,inpatient,,16380,16380,,13906.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12350.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13923,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14414.4,88,,percent of total billed charges,,,,,,,,,12514.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14905.8,91,,percent of total billed charges,,,15561,95,,percent of total billed charges,,,13595.4,83,,percent of total billed charges,,,13595.4,83,,percent of total billed charges,,,,,,,,,,,,,,,13595.4,83,,percent of total billed charges,,,15561,95,,percent of total billed charges,,,14742,90,,percent of total billed charges,,,14742,90,,percent of total billed charges,,,13431.6,82,,percent of total billed charges,,,14742,90,,percent of total billed charges,,,13923,85,,percent of total billed charges,,12350.52,15561,
DEPUY INSERT AOX 6MM SZ 5,30183748,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
SYNTHES NAIL HUMERAL 9MM TI 210MM CANNUL,30183749,CDM,,,278,RC,inpatient,,16525.28,16525.28,,14029.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12460.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14046.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14542.25,88,,percent of total billed charges,,,,,,,,,12625.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15038,91,,percent of total billed charges,,,15699.02,95,,percent of total billed charges,,,13715.98,83,,percent of total billed charges,,,13715.98,83,,percent of total billed charges,,,,,,,,,,,,,,,13715.98,83,,percent of total billed charges,,,15699.02,95,,percent of total billed charges,,,14872.75,90,,percent of total billed charges,,,14872.75,90,,percent of total billed charges,,,13550.73,82,,percent of total billed charges,,,14872.75,90,,percent of total billed charges,,,14046.49,85,,percent of total billed charges,,12460.06,15699.02,
SYNTHES SCREW LOCKING 4.0 X 30MM,30183750,CDM,,,278,RC,inpatient,,1640.93,1640.93,,1393.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1237.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1394.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1444.02,88,,percent of total billed charges,,,,,,,,,1253.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1493.25,91,,percent of total billed charges,,,1558.88,95,,percent of total billed charges,,,1361.97,83,,percent of total billed charges,,,1361.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1361.97,83,,percent of total billed charges,,,1558.88,95,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1345.56,82,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1394.79,85,,percent of total billed charges,,1237.26,1558.88,
SYNTHES BLADE SPIRAL 34MM,30183751,CDM,,,278,RC,inpatient,,5060.9,5060.9,,4296.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3815.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4301.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4453.59,88,,percent of total billed charges,,,,,,,,,3866.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4605.42,91,,percent of total billed charges,,,4807.86,95,,percent of total billed charges,,,4200.55,83,,percent of total billed charges,,,4200.55,83,,percent of total billed charges,,,,,,,,,,,,,,,4200.55,83,,percent of total billed charges,,,4807.86,95,,percent of total billed charges,,,4554.81,90,,percent of total billed charges,,,4554.81,90,,percent of total billed charges,,,4149.94,82,,percent of total billed charges,,,4554.81,90,,percent of total billed charges,,,4301.77,85,,percent of total billed charges,,3815.92,4807.86,
INVUITY PHONTONSABER Y METAL TIP,30183752,CDM,,,270,RC,inpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1592.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1795.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,1592.83,2006.88,
GRACILIS TENDON STRAND,30183753,CDM,,,270,RC,inpatient,,5720,5720,,4856.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4312.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4862,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5033.6,88,,percent of total billed charges,,,,,,,,,4370.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5205.2,91,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4747.6,83,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4690.4,82,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4862,85,,percent of total billed charges,,4312.88,5434,
INVUITY PHOTONSABER Y TAPER TIP,30183754,CDM,,,270,RC,inpatient,,1982.5,1982.5,,1683.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1494.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1685.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1744.6,88,,percent of total billed charges,,,,,,,,,1514.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1804.08,91,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1645.48,83,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1625.65,82,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,1494.81,1883.38,
DEPUY STEM FLUTED UNIV 75 X 18,30183755,CDM,,,278,RC,inpatient,,9024.34,9024.34,,7661.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6804.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7670.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7941.42,88,,percent of total billed charges,,,,,,,,,6894.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8212.15,91,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,,,,,,,,,,,,,7490.2,83,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7399.96,82,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,6804.35,8573.12,
STRYKER CANNULA VENOM 18G 150MM 10MM,30183757,CDM,,,270,RC,inpatient,,511.25,511.25,,434.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,385.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,434.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,449.9,88,,percent of total billed charges,,,,,,,,,390.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,465.24,91,,percent of total billed charges,,,485.69,95,,percent of total billed charges,,,424.34,83,,percent of total billed charges,,,424.34,83,,percent of total billed charges,,,,,,,,,,,,,,,424.34,83,,percent of total billed charges,,,485.69,95,,percent of total billed charges,,,460.13,90,,percent of total billed charges,,,460.13,90,,percent of total billed charges,,,419.23,82,,percent of total billed charges,,,460.13,90,,percent of total billed charges,,,434.56,85,,percent of total billed charges,,385.48,485.69,
MEDTRONIC RV LEAD 52CM,30183758,CDM,,,278,RC,inpatient,,5310.5,5310.5,,4508.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4004.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4513.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4673.24,88,,percent of total billed charges,,,,,,,,,4057.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4832.56,91,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4407.72,83,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4354.61,82,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4513.93,85,,percent of total billed charges,,4004.12,5044.98,
MEDTRONIC ATRIAL LEAD 45CM,30183759,CDM,,,278,RC,inpatient,,5310.5,5310.5,,4508.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4004.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4513.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4673.24,88,,percent of total billed charges,,,,,,,,,4057.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4832.56,91,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4407.72,83,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4354.61,82,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4513.93,85,,percent of total billed charges,,4004.12,5044.98,
MEDTRONIC PULSE GENERATOR,30183760,CDM,,,278,RC,inpatient,,36517,36517,,31002.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27533.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31039.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32134.96,88,,percent of total billed charges,,,,,,,,,27898.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33230.47,91,,percent of total billed charges,,,34691.15,95,,percent of total billed charges,,,30309.11,83,,percent of total billed charges,,,30309.11,83,,percent of total billed charges,,,,,,,,,,,,,,,30309.11,83,,percent of total billed charges,,,34691.15,95,,percent of total billed charges,,,32865.3,90,,percent of total billed charges,,,32865.3,90,,percent of total billed charges,,,29943.94,82,,percent of total billed charges,,,32865.3,90,,percent of total billed charges,,,31039.45,85,,percent of total billed charges,,27533.82,34691.15,
CONMED SMART NAIL 1.5 X 16,30183761,CDM,,,278,RC,inpatient,,955.96,955.96,,811.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,720.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,812.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,841.24,88,,percent of total billed charges,,,,,,,,,730.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,869.92,91,,percent of total billed charges,,,908.16,95,,percent of total billed charges,,,793.45,83,,percent of total billed charges,,,793.45,83,,percent of total billed charges,,,,,,,,,,,,,,,793.45,83,,percent of total billed charges,,,908.16,95,,percent of total billed charges,,,860.36,90,,percent of total billed charges,,,860.36,90,,percent of total billed charges,,,783.89,82,,percent of total billed charges,,,860.36,90,,percent of total billed charges,,,812.57,85,,percent of total billed charges,,720.79,908.16,
JURGAN BALL - DRK BLUE,30183762,CDM,,,270,RC,inpatient,,48.2,48.2,,40.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.42,88,,percent of total billed charges,,,,,,,,,36.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.86,91,,percent of total billed charges,,,45.79,95,,percent of total billed charges,,,40.01,83,,percent of total billed charges,,,40.01,83,,percent of total billed charges,,,,,,,,,,,,,,,40.01,83,,percent of total billed charges,,,45.79,95,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,39.52,82,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,40.97,85,,percent of total billed charges,,36.34,45.79,
SYNTHES L PLATE 3 HOLE 2.7LCP 2 HOLE HEA,30183763,CDM,,,278,RC,inpatient,,3674.13,3674.13,,3119.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2770.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3123.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3233.23,88,,percent of total billed charges,,,,,,,,,2807.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3343.46,91,,percent of total billed charges,,,3490.42,95,,percent of total billed charges,,,3049.53,83,,percent of total billed charges,,,3049.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3049.53,83,,percent of total billed charges,,,3490.42,95,,percent of total billed charges,,,3306.72,90,,percent of total billed charges,,,3306.72,90,,percent of total billed charges,,,3012.79,82,,percent of total billed charges,,,3306.72,90,,percent of total billed charges,,,3123.01,85,,percent of total billed charges,,2770.29,3490.42,
SYNTHES NORIAN INJECTABLE DRILLABLE 5CC,30183765,CDM,,,270,RC,inpatient,,12895.35,12895.35,,10948.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9723.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10961.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11347.91,88,,percent of total billed charges,,,,,,,,,9852.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11734.77,91,,percent of total billed charges,,,12250.58,95,,percent of total billed charges,,,10703.14,83,,percent of total billed charges,,,10703.14,83,,percent of total billed charges,,,,,,,,,,,,,,,10703.14,83,,percent of total billed charges,,,12250.58,95,,percent of total billed charges,,,11605.82,90,,percent of total billed charges,,,11605.82,90,,percent of total billed charges,,,10574.19,82,,percent of total billed charges,,,11605.82,90,,percent of total billed charges,,,10961.05,85,,percent of total billed charges,,9723.09,12250.58,
HICKMAN 9FR DUAL LUMEN CATHETER W/INTROD,30183766,CDM,,,270,RC,inpatient,,1227.2,1227.2,,1041.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,925.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1043.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1079.94,88,,percent of total billed charges,,,,,,,,,937.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1116.75,91,,percent of total billed charges,,,1165.84,95,,percent of total billed charges,,,1018.58,83,,percent of total billed charges,,,1018.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1018.58,83,,percent of total billed charges,,,1165.84,95,,percent of total billed charges,,,1104.48,90,,percent of total billed charges,,,1104.48,90,,percent of total billed charges,,,1006.3,82,,percent of total billed charges,,,1104.48,90,,percent of total billed charges,,,1043.12,85,,percent of total billed charges,,925.31,1165.84,
BREG BRACE T SCOPE KNEE LG,30183767,CDM,,,270,RC,inpatient,,530.18,530.18,,450.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466.56,88,,percent of total billed charges,,,,,,,,,405.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,482.46,91,,percent of total billed charges,,,503.67,95,,percent of total billed charges,,,440.05,83,,percent of total billed charges,,,440.05,83,,percent of total billed charges,,,,,,,,,,,,,,,440.05,83,,percent of total billed charges,,,503.67,95,,percent of total billed charges,,,477.16,90,,percent of total billed charges,,,477.16,90,,percent of total billed charges,,,434.75,82,,percent of total billed charges,,,477.16,90,,percent of total billed charges,,,450.65,85,,percent of total billed charges,,399.76,503.67,
BREG BRACE T SCOPE KNEE XLG,30183768,CDM,,,270,RC,inpatient,,686.28,686.28,,582.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,517.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,583.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,603.93,88,,percent of total billed charges,,,,,,,,,524.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,624.51,91,,percent of total billed charges,,,651.97,95,,percent of total billed charges,,,569.61,83,,percent of total billed charges,,,569.61,83,,percent of total billed charges,,,,,,,,,,,,,,,569.61,83,,percent of total billed charges,,,651.97,95,,percent of total billed charges,,,617.65,90,,percent of total billed charges,,,617.65,90,,percent of total billed charges,,,562.75,82,,percent of total billed charges,,,617.65,90,,percent of total billed charges,,,583.34,85,,percent of total billed charges,,517.46,651.97,
DEPUY FEMUR SIGMA PS RT SZ6,30183769,CDM,,,278,RC,inpatient,,23868.72,23868.72,,20264.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17997.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20288.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21004.47,88,,percent of total billed charges,,,,,,,,,18235.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21720.54,91,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19811.04,83,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,19572.35,82,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,17997.01,22675.28,
DEPUY STEM CORAIL COLLARED SZ8,30183770,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
ELECTRODE CUTTING MONO 26FR,30183771,CDM,,,270,RC,inpatient,,648.45,648.45,,550.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,488.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,551.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,570.64,88,,percent of total billed charges,,,,,,,,,495.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,590.09,91,,percent of total billed charges,,,616.03,95,,percent of total billed charges,,,538.21,83,,percent of total billed charges,,,538.21,83,,percent of total billed charges,,,,,,,,,,,,,,,538.21,83,,percent of total billed charges,,,616.03,95,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,531.73,82,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,551.18,85,,percent of total billed charges,,488.93,616.03,
ESWL SERVICES BILATERAL- UNITED SHOCKWA,30183772,CDM,,,270,RC,inpatient,,13650,13650,,11588.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10292.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11602.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12012,88,,percent of total billed charges,,,,,,,,,10428.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12421.5,91,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,,,,,,,,,,,,,11329.5,83,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11193,82,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,10292.1,12967.5,
SYNTHES SCREW LOCKING 5.0X30MM,30183773,CDM,,,278,RC,inpatient,,1370.2,1370.2,,1163.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1033.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1164.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1205.78,88,,percent of total billed charges,,,,,,,,,1046.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1246.88,91,,percent of total billed charges,,,1301.69,95,,percent of total billed charges,,,1137.27,83,,percent of total billed charges,,,1137.27,83,,percent of total billed charges,,,,,,,,,,,,,,,1137.27,83,,percent of total billed charges,,,1301.69,95,,percent of total billed charges,,,1233.18,90,,percent of total billed charges,,,1233.18,90,,percent of total billed charges,,,1123.56,82,,percent of total billed charges,,,1233.18,90,,percent of total billed charges,,,1164.67,85,,percent of total billed charges,,1033.13,1301.69,
SYNTHES PLATE NARROW 7-HOLE 4.5MM,30183774,CDM,,,278,RC,inpatient,,4248.73,4248.73,,3607.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3203.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3611.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3738.88,88,,percent of total billed charges,,,,,,,,,3246.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3866.34,91,,percent of total billed charges,,,4036.29,95,,percent of total billed charges,,,3526.45,83,,percent of total billed charges,,,3526.45,83,,percent of total billed charges,,,,,,,,,,,,,,,3526.45,83,,percent of total billed charges,,,4036.29,95,,percent of total billed charges,,,3823.86,90,,percent of total billed charges,,,3823.86,90,,percent of total billed charges,,,3483.96,82,,percent of total billed charges,,,3823.86,90,,percent of total billed charges,,,3611.42,85,,percent of total billed charges,,3203.54,4036.29,
ZIMMER SCREW HEX DRIVER 2MM DISP.,30183775,CDM,,,270,RC,inpatient,,845,845,,717.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,637.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,718.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,743.6,88,,percent of total billed charges,,,,,,,,,645.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,768.95,91,,percent of total billed charges,,,802.75,95,,percent of total billed charges,,,701.35,83,,percent of total billed charges,,,701.35,83,,percent of total billed charges,,,,,,,,,,,,,,,701.35,83,,percent of total billed charges,,,802.75,95,,percent of total billed charges,,,760.5,90,,percent of total billed charges,,,760.5,90,,percent of total billed charges,,,692.9,82,,percent of total billed charges,,,760.5,90,,percent of total billed charges,,,718.25,85,,percent of total billed charges,,637.13,802.75,
ZIMMER FEMUR RIGHT SZ E,30183776,CDM,,,278,RC,inpatient,,40306.83,40306.83,,34220.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30391.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34260.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35470.01,88,,percent of total billed charges,,,,,,,,,30794.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36679.22,91,,percent of total billed charges,,,38291.49,95,,percent of total billed charges,,,33454.67,83,,percent of total billed charges,,,33454.67,83,,percent of total billed charges,,,,,,,,,,,,,,,33454.67,83,,percent of total billed charges,,,38291.49,95,,percent of total billed charges,,,36276.15,90,,percent of total billed charges,,,36276.15,90,,percent of total billed charges,,,33051.6,82,,percent of total billed charges,,,36276.15,90,,percent of total billed charges,,,34260.81,85,,percent of total billed charges,,30391.35,38291.49,
ZIMMER LOCK ART SURG 14MM EF 5-6/GREEN,30183777,CDM,,,278,RC,inpatient,,13533.13,13533.13,,11489.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10203.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11503.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11909.15,88,,percent of total billed charges,,,,,,,,,10339.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12315.15,91,,percent of total billed charges,,,12856.47,95,,percent of total billed charges,,,11232.5,83,,percent of total billed charges,,,11232.5,83,,percent of total billed charges,,,,,,,,,,,,,,,11232.5,83,,percent of total billed charges,,,12856.47,95,,percent of total billed charges,,,12179.82,90,,percent of total billed charges,,,12179.82,90,,percent of total billed charges,,,11097.17,82,,percent of total billed charges,,,12179.82,90,,percent of total billed charges,,,11503.16,85,,percent of total billed charges,,10203.98,12856.47,
ZIMMER AUGMENT BLOCK SZ E 5MM,30183778,CDM,,,278,RC,inpatient,,7107.88,7107.88,,6034.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5359.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6041.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6254.93,88,,percent of total billed charges,,,,,,,,,5430.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6468.17,91,,percent of total billed charges,,,6752.49,95,,percent of total billed charges,,,5899.54,83,,percent of total billed charges,,,5899.54,83,,percent of total billed charges,,,,,,,,,,,,,,,5899.54,83,,percent of total billed charges,,,6752.49,95,,percent of total billed charges,,,6397.09,90,,percent of total billed charges,,,6397.09,90,,percent of total billed charges,,,5828.46,82,,percent of total billed charges,,,6397.09,90,,percent of total billed charges,,,6041.7,85,,percent of total billed charges,,5359.34,6752.49,
ZIMMER STEM EXT. STRAIGHT 15X30,30183779,CDM,,,278,RC,inpatient,,7652.97,7652.97,,6497.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5770.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6505.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6734.61,88,,percent of total billed charges,,,,,,,,,5846.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6964.2,91,,percent of total billed charges,,,7270.32,95,,percent of total billed charges,,,6351.97,83,,percent of total billed charges,,,6351.97,83,,percent of total billed charges,,,,,,,,,,,,,,,6351.97,83,,percent of total billed charges,,,7270.32,95,,percent of total billed charges,,,6887.67,90,,percent of total billed charges,,,6887.67,90,,percent of total billed charges,,,6275.44,82,,percent of total billed charges,,,6887.67,90,,percent of total billed charges,,,6505.02,85,,percent of total billed charges,,5770.34,7270.32,
SUTURE GORTEX 4N16A CV-4 36  1/2 TAPER P,30183780,CDM,,,270,RC,inpatient,,184,184,,156.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,138.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,156.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,161.92,88,,percent of total billed charges,,,,,,,,,140.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,,,,,,,,,,,,,152.72,83,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,150.88,82,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,138.74,174.8,
BIOMET HUMERAL VERSAMIL NAIL 8MM X 200MM,30183782,CDM,,,278,RC,inpatient,,14384.5,14384.5,,12212.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10845.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12226.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12658.36,88,,percent of total billed charges,,,,,,,,,10989.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13089.9,91,,percent of total billed charges,,,13665.28,95,,percent of total billed charges,,,11939.14,83,,percent of total billed charges,,,11939.14,83,,percent of total billed charges,,,,,,,,,,,,,,,11939.14,83,,percent of total billed charges,,,13665.28,95,,percent of total billed charges,,,12946.05,90,,percent of total billed charges,,,12946.05,90,,percent of total billed charges,,,11795.29,82,,percent of total billed charges,,,12946.05,90,,percent of total billed charges,,,12226.83,85,,percent of total billed charges,,10845.91,13665.28,
ARTHREX FIBERWIRE #2 36.6MM 1/2 CIRCLE,30183783,CDM,,,270,RC,inpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,132.7,167.2,
MEDTRONIC PACEMAKER,30183785,CDM,,,278,RC,inpatient,,39659.82,39659.82,,33671.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29903.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33710.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34900.64,88,,percent of total billed charges,,,,,,,,,30300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36090.44,91,,percent of total billed charges,,,37676.83,95,,percent of total billed charges,,,32917.65,83,,percent of total billed charges,,,32917.65,83,,percent of total billed charges,,,,,,,,,,,,,,,32917.65,83,,percent of total billed charges,,,37676.83,95,,percent of total billed charges,,,35693.84,90,,percent of total billed charges,,,35693.84,90,,percent of total billed charges,,,32521.05,82,,percent of total billed charges,,,35693.84,90,,percent of total billed charges,,,33710.85,85,,percent of total billed charges,,29903.5,37676.83,
SYNTHES PLATE DISTAL 5-HOLE LEFT,30183786,CDM,,,278,RC,inpatient,,6400.75,6400.75,,5434.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4826.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5440.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5632.66,88,,percent of total billed charges,,,,,,,,,4890.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5824.68,91,,percent of total billed charges,,,6080.71,95,,percent of total billed charges,,,5312.62,83,,percent of total billed charges,,,5312.62,83,,percent of total billed charges,,,,,,,,,,,,,,,5312.62,83,,percent of total billed charges,,,6080.71,95,,percent of total billed charges,,,5760.68,90,,percent of total billed charges,,,5760.68,90,,percent of total billed charges,,,5248.62,82,,percent of total billed charges,,,5760.68,90,,percent of total billed charges,,,5440.64,85,,percent of total billed charges,,4826.17,6080.71,
DEPUY HEAD BIOLOX TS 28MM +15,30183787,CDM,,,278,RC,inpatient,,13897.78,13897.78,,11799.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10478.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11813.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12230.05,88,,percent of total billed charges,,,,,,,,,10617.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12646.98,91,,percent of total billed charges,,,13202.89,95,,percent of total billed charges,,,11535.16,83,,percent of total billed charges,,,11535.16,83,,percent of total billed charges,,,,,,,,,,,,,,,11535.16,83,,percent of total billed charges,,,13202.89,95,,percent of total billed charges,,,12508,90,,percent of total billed charges,,,12508,90,,percent of total billed charges,,,11396.18,82,,percent of total billed charges,,,12508,90,,percent of total billed charges,,,11813.11,85,,percent of total billed charges,,10478.93,13202.89,
DEPUY SCREW NON LOCKING 30MM,30183788,CDM,,,278,RC,inpatient,,1330.16,1330.16,,1129.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1002.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1130.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1170.54,88,,percent of total billed charges,,,,,,,,,1016.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1210.45,91,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1104.03,83,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1090.73,82,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1130.64,85,,percent of total billed charges,,1002.94,1263.65,
SYNTHES PLATE DISTAL TIBIAL 6 HOLE RIGHT,30183789,CDM,,,278,RC,inpatient,,13039,13039,,11070.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9831.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11083.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11474.32,88,,percent of total billed charges,,,,,,,,,9961.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11865.49,91,,percent of total billed charges,,,12387.05,95,,percent of total billed charges,,,10822.37,83,,percent of total billed charges,,,10822.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10822.37,83,,percent of total billed charges,,,12387.05,95,,percent of total billed charges,,,11735.1,90,,percent of total billed charges,,,11735.1,90,,percent of total billed charges,,,10691.98,82,,percent of total billed charges,,,11735.1,90,,percent of total billed charges,,,11083.15,85,,percent of total billed charges,,9831.41,12387.05,
SYNTHES SCREW LOCKING 3.5 X 26MM,30183790,CDM,,,278,RC,inpatient,,274.13,274.13,,232.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,206.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,233.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,241.23,88,,percent of total billed charges,,,,,,,,,209.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,249.46,91,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,,,,,,,,,,,,,227.53,83,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,224.79,82,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,233.01,85,,percent of total billed charges,,206.69,260.42,
SYNTHES SCREW LOCKING 3.5 X 45MM,30183791,CDM,,,278,RC,inpatient,,274.13,274.13,,232.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,206.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,233.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,241.23,88,,percent of total billed charges,,,,,,,,,209.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,249.46,91,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,,,,,,,,,,,,,227.53,83,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,224.79,82,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,233.01,85,,percent of total billed charges,,206.69,260.42,
SYNTHES SCREW LOCKING 3.5 X 40MM,30183792,CDM,,,278,RC,inpatient,,274.13,274.13,,232.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,206.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,233.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,241.23,88,,percent of total billed charges,,,,,,,,,209.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,249.46,91,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,,,,,,,,,,,,,227.53,83,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,224.79,82,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,233.01,85,,percent of total billed charges,,206.69,260.42,
SYNTHES SCREW LOCKING 3.5 X 32MM,30183793,CDM,,,278,RC,inpatient,,274.13,274.13,,232.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,206.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,233.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,241.23,88,,percent of total billed charges,,,,,,,,,209.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,249.46,91,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,,,,,,,,,,,,,227.53,83,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,224.79,82,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,233.01,85,,percent of total billed charges,,206.69,260.42,
SYNTHES SCREW LOCKING 3.5 X 28MM,30183794,CDM,,,278,RC,inpatient,,274.13,274.13,,232.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,206.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,233.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,241.23,88,,percent of total billed charges,,,,,,,,,209.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,249.46,91,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,,,,,,,,,,,,,227.53,83,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,224.79,82,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,233.01,85,,percent of total billed charges,,206.69,260.42,
DEPUY LINER CONSTRAINED +4 28 X 48,30183795,CDM,,,278,RC,inpatient,,36635.17,36635.17,,31103.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27622.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31139.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32238.95,88,,percent of total billed charges,,,,,,,,,27989.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33338,91,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,,,,,,,,,,,,,30407.19,83,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,30040.84,82,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,27622.92,34803.41,
S&N ENDO SCREW SOFT SILK 9 X 20,30183796,CDM,,,278,RC,inpatient,,1417,1417,,1203.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1068.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1204.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1246.96,88,,percent of total billed charges,,,,,,,,,1082.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1289.47,91,,percent of total billed charges,,,1346.15,95,,percent of total billed charges,,,1176.11,83,,percent of total billed charges,,,1176.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1176.11,83,,percent of total billed charges,,,1346.15,95,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1161.94,82,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1204.45,85,,percent of total billed charges,,1068.42,1346.15,
MENTOR MEMORYGEL BREAST IMPLANT RND MODE,30183797,CDM,,,278,RC,inpatient,,6370,6370,,5408.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4802.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5414.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5605.6,88,,percent of total billed charges,,,,,,,,,4866.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5796.7,91,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5287.1,83,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5223.4,82,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5414.5,85,,percent of total billed charges,,4802.98,6051.5,
STRYKER ELECTRODE VENOM MONOP 150MM,30183800,CDM,,,270,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
DEPUY BONE CEMENT 3,30183802,CDM,,,270,RC,inpatient,,430.71,430.71,,365.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,324.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,366.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,379.02,88,,percent of total billed charges,,,,,,,,,329.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,391.95,91,,percent of total billed charges,,,409.17,95,,percent of total billed charges,,,357.49,83,,percent of total billed charges,,,357.49,83,,percent of total billed charges,,,,,,,,,,,,,,,357.49,83,,percent of total billed charges,,,409.17,95,,percent of total billed charges,,,387.64,90,,percent of total billed charges,,,387.64,90,,percent of total billed charges,,,353.18,82,,percent of total billed charges,,,387.64,90,,percent of total billed charges,,,366.1,85,,percent of total billed charges,,324.76,409.17,
SYNTHES SCREW LOCKING VA 2.4 X 12MM,30183803,CDM,,,278,RC,inpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1020.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1150.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,1020.93,1286.32,
SYNTHES PLATE 8 HOLE 112MM 3.5MM,30183807,CDM,,,278,RC,inpatient,,5116.15,5116.15,,4343.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3857.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4348.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4502.21,88,,percent of total billed charges,,,,,,,,,3908.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4655.7,91,,percent of total billed charges,,,4860.34,95,,percent of total billed charges,,,4246.4,83,,percent of total billed charges,,,4246.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4246.4,83,,percent of total billed charges,,,4860.34,95,,percent of total billed charges,,,4604.54,90,,percent of total billed charges,,,4604.54,90,,percent of total billed charges,,,4195.24,82,,percent of total billed charges,,,4604.54,90,,percent of total billed charges,,,4348.73,85,,percent of total billed charges,,3857.58,4860.34,
SYNTHES TAP FOR SCREW CANCELLOUS 4.0,30183808,CDM,,,278,RC,inpatient,,2077.4,2077.4,,1763.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1566.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1765.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1828.11,88,,percent of total billed charges,,,,,,,,,1587.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1890.43,91,,percent of total billed charges,,,1973.53,95,,percent of total billed charges,,,1724.24,83,,percent of total billed charges,,,1724.24,83,,percent of total billed charges,,,,,,,,,,,,,,,1724.24,83,,percent of total billed charges,,,1973.53,95,,percent of total billed charges,,,1869.66,90,,percent of total billed charges,,,1869.66,90,,percent of total billed charges,,,1703.47,82,,percent of total billed charges,,,1869.66,90,,percent of total billed charges,,,1765.79,85,,percent of total billed charges,,1566.36,1973.53,
DEPUY FEMUR SZ 5 NARROW CR L,30183809,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY BONE CEMENT 1,30183810,CDM,,,270,RC,inpatient,,1352,1352,,1147.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1019.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1149.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1189.76,88,,percent of total billed charges,,,,,,,,,1032.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1230.32,91,,percent of total billed charges,,,1284.4,95,,percent of total billed charges,,,1122.16,83,,percent of total billed charges,,,1122.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1122.16,83,,percent of total billed charges,,,1284.4,95,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1108.64,82,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1149.2,85,,percent of total billed charges,,1019.41,1284.4,
DEPUY INSERT CR 5MM SZ 5,30183811,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY STEM FEMORAL 115X16MM,30183812,CDM,,,278,RC,inpatient,,9024.34,9024.34,,7661.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6804.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7670.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7941.42,88,,percent of total billed charges,,,,,,,,,6894.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8212.15,91,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,,,,,,,,,,,,,7490.2,83,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7399.96,82,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,6804.35,8573.12,
DEPUY BONE HV CEMENT,30183813,CDM,,,270,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
SYNTHES SCREW CORTEX SELF TAPPING 1.5 X,30183814,CDM,,,278,RC,inpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,313.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,278.15,350.46,
SYNTHES SCREW CORTEX 1.5 X 11MM SELF TAP,30183815,CDM,,,278,RC,inpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,313.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,278.15,350.46,
SYNTHES SCREW CORTEX 2.0 X 9MM SELF TAP,30183816,CDM,,,278,RC,inpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,313.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,278.15,350.46,
SYNTHES SCREW CORTEX 1.5 X 9MM SELF TAP,30183817,CDM,,,278,RC,inpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,313.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,278.15,350.46,
SYNTHES SCREW CORTEX 1.5 X 12MM SELF TAP,30183818,CDM,,,278,RC,inpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,313.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,278.15,350.46,
SYNTHES SCREW CORTEX 1.5 X 13MM SELF TAP,30183819,CDM,,,278,RC,inpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,313.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,278.15,350.46,
SYNTHES DRILL BIT J-LATCH 1.0MM,30183820,CDM,,,278,RC,inpatient,,943.67,943.67,,801.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,711.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,802.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,830.43,88,,percent of total billed charges,,,,,,,,,720.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,858.74,91,,percent of total billed charges,,,896.49,95,,percent of total billed charges,,,783.25,83,,percent of total billed charges,,,783.25,83,,percent of total billed charges,,,,,,,,,,,,,,,783.25,83,,percent of total billed charges,,,896.49,95,,percent of total billed charges,,,849.3,90,,percent of total billed charges,,,849.3,90,,percent of total billed charges,,,773.81,82,,percent of total billed charges,,,849.3,90,,percent of total billed charges,,,802.12,85,,percent of total billed charges,,711.53,896.49,
SYNTHES DRILL BIT J-LATCH 1.3MM,30183821,CDM,,,278,RC,inpatient,,767.55,767.55,,651.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,578.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,652.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,675.44,88,,percent of total billed charges,,,,,,,,,586.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,698.47,91,,percent of total billed charges,,,729.17,95,,percent of total billed charges,,,637.07,83,,percent of total billed charges,,,637.07,83,,percent of total billed charges,,,,,,,,,,,,,,,637.07,83,,percent of total billed charges,,,729.17,95,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,629.39,82,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,652.42,85,,percent of total billed charges,,578.73,729.17,
SYNTHES DRILL BIT J-LATCH 1.5MM,30183822,CDM,,,278,RC,inpatient,,767.55,767.55,,651.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,578.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,652.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,675.44,88,,percent of total billed charges,,,,,,,,,586.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,698.47,91,,percent of total billed charges,,,729.17,95,,percent of total billed charges,,,637.07,83,,percent of total billed charges,,,637.07,83,,percent of total billed charges,,,,,,,,,,,,,,,637.07,83,,percent of total billed charges,,,729.17,95,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,629.39,82,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,652.42,85,,percent of total billed charges,,578.73,729.17,
DEPUY INSERT RP PS 15MM SZ 5,30183823,CDM,,,278,RC,inpatient,,11480.69,11480.69,,9747.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8656.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9758.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10103.01,88,,percent of total billed charges,,,,,,,,,8771.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10447.43,91,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,,,,,,,,,,,,,9528.97,83,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9414.17,82,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,8656.44,10906.66,
DEPUY FEMUR CR  SZ 6 NARROW,30183824,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY FEMUR CR  SZ 6 NARROW LEFT,30183825,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
SYNTHES PLATE DORSAL L 2.4MM 2X3HOLE,30183827,CDM,,,278,RC,inpatient,,6022.25,6022.25,,5112.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4540.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5118.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5299.58,88,,percent of total billed charges,,,,,,,,,4601,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5480.25,91,,percent of total billed charges,,,5721.14,95,,percent of total billed charges,,,4998.47,83,,percent of total billed charges,,,4998.47,83,,percent of total billed charges,,,,,,,,,,,,,,,4998.47,83,,percent of total billed charges,,,5721.14,95,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,4938.25,82,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,5118.91,85,,percent of total billed charges,,4540.78,5721.14,
SYNTHES PLATE DORSAL L 2.4MM 2X5HOLE,30183828,CDM,,,278,RC,inpatient,,6337.18,6337.18,,5380.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4778.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5386.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5576.72,88,,percent of total billed charges,,,,,,,,,4841.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5766.83,91,,percent of total billed charges,,,6020.32,95,,percent of total billed charges,,,5259.86,83,,percent of total billed charges,,,5259.86,83,,percent of total billed charges,,,,,,,,,,,,,,,5259.86,83,,percent of total billed charges,,,6020.32,95,,percent of total billed charges,,,5703.46,90,,percent of total billed charges,,,5703.46,90,,percent of total billed charges,,,5196.49,82,,percent of total billed charges,,,5703.46,90,,percent of total billed charges,,,5386.6,85,,percent of total billed charges,,4778.23,6020.32,
SYNTHES PLATE DORSAL R 2.4MM 22MM,30183829,CDM,,,278,RC,inpatient,,6491.88,6491.88,,5511.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4894.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5518.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5712.85,88,,percent of total billed charges,,,,,,,,,4959.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5907.61,91,,percent of total billed charges,,,6167.29,95,,percent of total billed charges,,,5388.26,83,,percent of total billed charges,,,5388.26,83,,percent of total billed charges,,,,,,,,,,,,,,,5388.26,83,,percent of total billed charges,,,6167.29,95,,percent of total billed charges,,,5842.69,90,,percent of total billed charges,,,5842.69,90,,percent of total billed charges,,,5323.34,82,,percent of total billed charges,,,5842.69,90,,percent of total billed charges,,,5518.1,85,,percent of total billed charges,,4894.88,6167.29,
DJO PATELLA E+9 X 38MM,30183830,CDM,,,278,RC,inpatient,,9217,9217,,7825.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6949.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7834.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8110.96,88,,percent of total billed charges,,,,,,,,,7041.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8387.47,91,,percent of total billed charges,,,8756.15,95,,percent of total billed charges,,,7650.11,83,,percent of total billed charges,,,7650.11,83,,percent of total billed charges,,,,,,,,,,,,,,,7650.11,83,,percent of total billed charges,,,8756.15,95,,percent of total billed charges,,,8295.3,90,,percent of total billed charges,,,8295.3,90,,percent of total billed charges,,,7557.94,82,,percent of total billed charges,,,8295.3,90,,percent of total billed charges,,,7834.45,85,,percent of total billed charges,,6949.62,8756.15,
DJO INSERT 15MM 12 RIGHT,30183831,CDM,,,278,RC,inpatient,,18089.5,18089.5,,15357.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13639.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15376.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15918.76,88,,percent of total billed charges,,,,,,,,,13820.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16461.45,91,,percent of total billed charges,,,17185.03,95,,percent of total billed charges,,,15014.29,83,,percent of total billed charges,,,15014.29,83,,percent of total billed charges,,,,,,,,,,,,,,,15014.29,83,,percent of total billed charges,,,17185.03,95,,percent of total billed charges,,,16280.55,90,,percent of total billed charges,,,16280.55,90,,percent of total billed charges,,,14833.39,82,,percent of total billed charges,,,16280.55,90,,percent of total billed charges,,,15376.08,85,,percent of total billed charges,,13639.48,17185.03,
DJO STEM 100 X 16MM TIBIAL REVISION,30183832,CDM,,,278,RC,inpatient,,10042.5,10042.5,,8526.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7572.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8536.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8837.4,88,,percent of total billed charges,,,,,,,,,7672.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9138.68,91,,percent of total billed charges,,,9540.38,95,,percent of total billed charges,,,8335.28,83,,percent of total billed charges,,,8335.28,83,,percent of total billed charges,,,,,,,,,,,,,,,8335.28,83,,percent of total billed charges,,,9540.38,95,,percent of total billed charges,,,9038.25,90,,percent of total billed charges,,,9038.25,90,,percent of total billed charges,,,8234.85,82,,percent of total billed charges,,,9038.25,90,,percent of total billed charges,,,8536.13,85,,percent of total billed charges,,7572.05,9540.38,
DJO BASE STEM TIBIAL REV 10 RIGHT,30183833,CDM,,,278,RC,inpatient,,26110.5,26110.5,,22167.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19687.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22193.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22977.24,88,,percent of total billed charges,,,,,,,,,19948.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23760.56,91,,percent of total billed charges,,,24804.98,95,,percent of total billed charges,,,21671.72,83,,percent of total billed charges,,,21671.72,83,,percent of total billed charges,,,,,,,,,,,,,,,21671.72,83,,percent of total billed charges,,,24804.98,95,,percent of total billed charges,,,23499.45,90,,percent of total billed charges,,,23499.45,90,,percent of total billed charges,,,21410.61,82,,percent of total billed charges,,,23499.45,90,,percent of total billed charges,,,22193.93,85,,percent of total billed charges,,19687.32,24804.98,
ZIMMER LPS ART SURFACE 12MM EF 3-4,30183834,CDM,,,278,RC,inpatient,,12733.57,12733.57,,10810.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9601.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10823.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11205.54,88,,percent of total billed charges,,,,,,,,,9728.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11587.55,91,,percent of total billed charges,,,12096.89,95,,percent of total billed charges,,,10568.86,83,,percent of total billed charges,,,10568.86,83,,percent of total billed charges,,,,,,,,,,,,,,,10568.86,83,,percent of total billed charges,,,12096.89,95,,percent of total billed charges,,,11460.21,90,,percent of total billed charges,,,11460.21,90,,percent of total billed charges,,,10441.53,82,,percent of total billed charges,,,11460.21,90,,percent of total billed charges,,,10823.53,85,,percent of total billed charges,,9601.11,12096.89,
DEPUY DISTAL AUGMENT 5MM,30183837,CDM,,,278,RC,inpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6166.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6951.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,6166.1,7768.96,
DEPUY ATTUNE FEMUR CR SZ 4 LT,30183840,CDM,,,278,RC,inpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21324.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24039.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,21324.5,26867.74,
DEPUY PINS THREADED STERILE,30183842,CDM,,,278,RC,inpatient,,2944.5,2944.5,,2499.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2220.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2502.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2591.16,88,,percent of total billed charges,,,,,,,,,2249.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2679.5,91,,percent of total billed charges,,,2797.28,95,,percent of total billed charges,,,2443.94,83,,percent of total billed charges,,,2443.94,83,,percent of total billed charges,,,,,,,,,,,,,,,2443.94,83,,percent of total billed charges,,,2797.28,95,,percent of total billed charges,,,2650.05,90,,percent of total billed charges,,,2650.05,90,,percent of total billed charges,,,2414.49,82,,percent of total billed charges,,,2650.05,90,,percent of total billed charges,,,2502.83,85,,percent of total billed charges,,2220.15,2797.28,
BANDAGE CONFORM STERILE 1,30183843,CDM,,,270,RC,inpatient,,11.81,11.81,,10.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.39,88,,percent of total billed charges,,,,,,,,,9.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.75,91,,percent of total billed charges,,,11.22,95,,percent of total billed charges,,,9.8,83,,percent of total billed charges,,,9.8,83,,percent of total billed charges,,,,,,,,,,,,,,,9.8,83,,percent of total billed charges,,,11.22,95,,percent of total billed charges,,,10.63,90,,percent of total billed charges,,,10.63,90,,percent of total billed charges,,,9.68,82,,percent of total billed charges,,,10.63,90,,percent of total billed charges,,,10.04,85,,percent of total billed charges,,8.9,11.22,
STRYKER FULL RADIUS CUTTER 2.5,30183844,CDM,,,270,RC,inpatient,,351.4,351.4,,298.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,264.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,298.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,309.23,88,,percent of total billed charges,,,,,,,,,268.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,319.77,91,,percent of total billed charges,,,333.83,95,,percent of total billed charges,,,291.66,83,,percent of total billed charges,,,291.66,83,,percent of total billed charges,,,,,,,,,,,,,,,291.66,83,,percent of total billed charges,,,333.83,95,,percent of total billed charges,,,316.26,90,,percent of total billed charges,,,316.26,90,,percent of total billed charges,,,288.15,82,,percent of total billed charges,,,316.26,90,,percent of total billed charges,,,298.69,85,,percent of total billed charges,,264.96,333.83,
STRYKER BUR HOODED ABRASION 2.0,30183845,CDM,,,270,RC,inpatient,,387.87,387.87,,329.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,292.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,329.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,341.33,88,,percent of total billed charges,,,,,,,,,296.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,352.96,91,,percent of total billed charges,,,368.48,95,,percent of total billed charges,,,321.93,83,,percent of total billed charges,,,321.93,83,,percent of total billed charges,,,,,,,,,,,,,,,321.93,83,,percent of total billed charges,,,368.48,95,,percent of total billed charges,,,349.08,90,,percent of total billed charges,,,349.08,90,,percent of total billed charges,,,318.05,82,,percent of total billed charges,,,349.08,90,,percent of total billed charges,,,329.69,85,,percent of total billed charges,,292.45,368.48,
STRYKER BUR HOODED ABRASION 3.0,30183846,CDM,,,270,RC,inpatient,,354.9,354.9,,301.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,267.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,301.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,312.31,88,,percent of total billed charges,,,,,,,,,271.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,322.96,91,,percent of total billed charges,,,337.16,95,,percent of total billed charges,,,294.57,83,,percent of total billed charges,,,294.57,83,,percent of total billed charges,,,,,,,,,,,,,,,294.57,83,,percent of total billed charges,,,337.16,95,,percent of total billed charges,,,319.41,90,,percent of total billed charges,,,319.41,90,,percent of total billed charges,,,291.02,82,,percent of total billed charges,,,319.41,90,,percent of total billed charges,,,301.67,85,,percent of total billed charges,,267.59,337.16,
DEPUY INSERT 4 X 5MM FIXED BEARING CR,30183848,CDM,,,278,RC,inpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9407.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10605.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,9407.86,11853.41,
DEPUY FEMUR CR  SZ 5N RIGHT,30183849,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
ZIMMER ULNA ASSEMBLY C/M PLASMA SML LT,30183850,CDM,,,278,RC,inpatient,,30023.5,30023.5,,25489.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22637.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25519.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26420.68,88,,percent of total billed charges,,,,,,,,,22937.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27321.39,91,,percent of total billed charges,,,28522.33,95,,percent of total billed charges,,,24919.51,83,,percent of total billed charges,,,24919.51,83,,percent of total billed charges,,,,,,,,,,,,,,,24919.51,83,,percent of total billed charges,,,28522.33,95,,percent of total billed charges,,,27021.15,90,,percent of total billed charges,,,27021.15,90,,percent of total billed charges,,,24619.27,82,,percent of total billed charges,,,27021.15,90,,percent of total billed charges,,,25519.98,85,,percent of total billed charges,,22637.72,28522.33,
ZIMMER HUMERAL ASSEMBLY C/M 6IN SML LON,30183851,CDM,,,278,RC,inpatient,,34090.03,34090.03,,28942.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25703.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28976.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29999.23,88,,percent of total billed charges,,,,,,,,,26044.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31021.93,91,,percent of total billed charges,,,32385.53,95,,percent of total billed charges,,,28294.72,83,,percent of total billed charges,,,28294.72,83,,percent of total billed charges,,,,,,,,,,,,,,,28294.72,83,,percent of total billed charges,,,32385.53,95,,percent of total billed charges,,,30681.03,90,,percent of total billed charges,,,30681.03,90,,percent of total billed charges,,,27953.82,82,,percent of total billed charges,,,30681.03,90,,percent of total billed charges,,,28976.53,85,,percent of total billed charges,,25703.88,32385.53,
ZIMMER PLUG W/NOZZLE C/M 16MM & 25MM,30183852,CDM,,,278,RC,inpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1666.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1878.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,1666.34,2099.5,
ZIMMER CEMENT MIXING SYSTEM VACUUM,30183853,CDM,,,270,RC,inpatient,,863.72,863.72,,733.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,651.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,734.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,760.07,88,,percent of total billed charges,,,,,,,,,659.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,785.99,91,,percent of total billed charges,,,820.53,95,,percent of total billed charges,,,716.89,83,,percent of total billed charges,,,716.89,83,,percent of total billed charges,,,,,,,,,,,,,,,716.89,83,,percent of total billed charges,,,820.53,95,,percent of total billed charges,,,777.35,90,,percent of total billed charges,,,777.35,90,,percent of total billed charges,,,708.25,82,,percent of total billed charges,,,777.35,90,,percent of total billed charges,,,734.16,85,,percent of total billed charges,,651.24,820.53,
ZIMMER PALACOS LV+G W/GENTAMICIN,30183854,CDM,,,270,RC,inpatient,,2771.15,2771.15,,2352.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2089.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2355.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2438.61,88,,percent of total billed charges,,,,,,,,,2117.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2521.75,91,,percent of total billed charges,,,2632.59,95,,percent of total billed charges,,,2300.05,83,,percent of total billed charges,,,2300.05,83,,percent of total billed charges,,,,,,,,,,,,,,,2300.05,83,,percent of total billed charges,,,2632.59,95,,percent of total billed charges,,,2494.04,90,,percent of total billed charges,,,2494.04,90,,percent of total billed charges,,,2272.34,82,,percent of total billed charges,,,2494.04,90,,percent of total billed charges,,,2355.48,85,,percent of total billed charges,,2089.45,2632.59,
GUIDE WIRE .045 X 6 ST,30183856,CDM,,,270,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
MINI ACUTRAK 2 DRILL LONG,30183857,CDM,,,270,RC,inpatient,,1911,1911,,1622.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1440.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1624.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1681.68,88,,percent of total billed charges,,,,,,,,,1460,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1739.01,91,,percent of total billed charges,,,1815.45,95,,percent of total billed charges,,,1586.13,83,,percent of total billed charges,,,1586.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1586.13,83,,percent of total billed charges,,,1815.45,95,,percent of total billed charges,,,1719.9,90,,percent of total billed charges,,,1719.9,90,,percent of total billed charges,,,1567.02,82,,percent of total billed charges,,,1719.9,90,,percent of total billed charges,,,1624.35,85,,percent of total billed charges,,1440.89,1815.45,
MINI ACUTRAK 2 BONE SCREW 24MM,30183858,CDM,,,270,RC,inpatient,,3432,3432,,2913.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2587.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2917.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3020.16,88,,percent of total billed charges,,,,,,,,,2622.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3123.12,91,,percent of total billed charges,,,3260.4,95,,percent of total billed charges,,,2848.56,83,,percent of total billed charges,,,2848.56,83,,percent of total billed charges,,,,,,,,,,,,,,,2848.56,83,,percent of total billed charges,,,3260.4,95,,percent of total billed charges,,,3088.8,90,,percent of total billed charges,,,3088.8,90,,percent of total billed charges,,,2814.24,82,,percent of total billed charges,,,3088.8,90,,percent of total billed charges,,,2917.2,85,,percent of total billed charges,,2587.73,3260.4,
SYNTHES PLATE DORSAL 2.4MM VA 3X5 HOLE,30183859,CDM,,,278,RC,inpatient,,6337.18,6337.18,,5380.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4778.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5386.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5576.72,88,,percent of total billed charges,,,,,,,,,4841.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5766.83,91,,percent of total billed charges,,,6020.32,95,,percent of total billed charges,,,5259.86,83,,percent of total billed charges,,,5259.86,83,,percent of total billed charges,,,,,,,,,,,,,,,5259.86,83,,percent of total billed charges,,,6020.32,95,,percent of total billed charges,,,5703.46,90,,percent of total billed charges,,,5703.46,90,,percent of total billed charges,,,5196.49,82,,percent of total billed charges,,,5703.46,90,,percent of total billed charges,,,5386.6,85,,percent of total billed charges,,4778.23,6020.32,
SYNTHES SCREW LOCKING VA 2.4 X 10MM,30183860,CDM,,,278,RC,inpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1020.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1150.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,1020.93,1286.32,
SYNTHES PLATE DORSAL L 2.4MM 2X3HOLE,30183861,CDM,,,278,RC,inpatient,,6022.25,6022.25,,5112.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4540.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5118.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5299.58,88,,percent of total billed charges,,,,,,,,,4601,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5480.25,91,,percent of total billed charges,,,5721.14,95,,percent of total billed charges,,,4998.47,83,,percent of total billed charges,,,4998.47,83,,percent of total billed charges,,,,,,,,,,,,,,,4998.47,83,,percent of total billed charges,,,5721.14,95,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,4938.25,82,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,5118.91,85,,percent of total billed charges,,4540.78,5721.14,
SYNTHES PLATE VOLAC DISTAL RADIUS 2.4,30183862,CDM,,,278,RC,inpatient,,9392.5,9392.5,,7974.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7081.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7983.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8265.4,88,,percent of total billed charges,,,,,,,,,7175.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8547.18,91,,percent of total billed charges,,,8922.88,95,,percent of total billed charges,,,7795.78,83,,percent of total billed charges,,,7795.78,83,,percent of total billed charges,,,,,,,,,,,,,,,7795.78,83,,percent of total billed charges,,,8922.88,95,,percent of total billed charges,,,8453.25,90,,percent of total billed charges,,,8453.25,90,,percent of total billed charges,,,7701.85,82,,percent of total billed charges,,,8453.25,90,,percent of total billed charges,,,7983.63,85,,percent of total billed charges,,7081.95,8922.88,
SYNTHES SCREW LOCKING VA 2.4 X 14MM,30183863,CDM,,,278,RC,inpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1020.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1150.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,1020.93,1286.32,
DEPUY CUP PROSTALAC 42X32,30183864,CDM,,,278,RC,inpatient,,6303.83,6303.83,,5351.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4753.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5358.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5547.37,88,,percent of total billed charges,,,,,,,,,4816.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5736.49,91,,percent of total billed charges,,,5988.64,95,,percent of total billed charges,,,5232.18,83,,percent of total billed charges,,,5232.18,83,,percent of total billed charges,,,,,,,,,,,,,,,5232.18,83,,percent of total billed charges,,,5988.64,95,,percent of total billed charges,,,5673.45,90,,percent of total billed charges,,,5673.45,90,,percent of total billed charges,,,5169.14,82,,percent of total billed charges,,,5673.45,90,,percent of total billed charges,,,5358.26,85,,percent of total billed charges,,4753.09,5988.64,
DEPUY STEM FEMORAL SZ 3 300MM,30183865,CDM,,,278,RC,inpatient,,24918.92,24918.92,,21156.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18788.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21181.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21928.65,88,,percent of total billed charges,,,,,,,,,19038.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22676.22,91,,percent of total billed charges,,,23672.97,95,,percent of total billed charges,,,20682.7,83,,percent of total billed charges,,,20682.7,83,,percent of total billed charges,,,,,,,,,,,,,,,20682.7,83,,percent of total billed charges,,,23672.97,95,,percent of total billed charges,,,22427.03,90,,percent of total billed charges,,,22427.03,90,,percent of total billed charges,,,20433.51,82,,percent of total billed charges,,,22427.03,90,,percent of total billed charges,,,21181.08,85,,percent of total billed charges,,18788.87,23672.97,
STRYKER TAPERED SERRATED DRILL,30183868,CDM,,,270,RC,inpatient,,368.06,368.06,,312.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.89,88,,percent of total billed charges,,,,,,,,,281.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.93,91,,percent of total billed charges,,,349.66,95,,percent of total billed charges,,,305.49,83,,percent of total billed charges,,,305.49,83,,percent of total billed charges,,,,,,,,,,,,,,,305.49,83,,percent of total billed charges,,,349.66,95,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,301.81,82,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,312.85,85,,percent of total billed charges,,277.52,349.66,
STRYKER LINDEMANN DRILL,30183869,CDM,,,270,RC,inpatient,,940.16,940.16,,798.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,708.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,799.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,827.34,88,,percent of total billed charges,,,,,,,,,718.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,855.55,91,,percent of total billed charges,,,893.15,95,,percent of total billed charges,,,780.33,83,,percent of total billed charges,,,780.33,83,,percent of total billed charges,,,,,,,,,,,,,,,780.33,83,,percent of total billed charges,,,893.15,95,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,770.93,82,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,799.14,85,,percent of total billed charges,,708.88,893.15,
DEPUY FEMUR SIGMA RT SZ 6,30183871,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
SAFE SHEATH 6FR 13CM,30183872,CDM,,,270,RC,inpatient,,534.8,534.8,,454.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,403.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,454.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,470.62,88,,percent of total billed charges,,,,,,,,,408.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,486.67,91,,percent of total billed charges,,,508.06,95,,percent of total billed charges,,,443.88,83,,percent of total billed charges,,,443.88,83,,percent of total billed charges,,,,,,,,,,,,,,,443.88,83,,percent of total billed charges,,,508.06,95,,percent of total billed charges,,,481.32,90,,percent of total billed charges,,,481.32,90,,percent of total billed charges,,,438.54,82,,percent of total billed charges,,,481.32,90,,percent of total billed charges,,,454.58,85,,percent of total billed charges,,403.24,508.06,
BIOMET HEAD MODULAR 36MM,30183875,CDM,,,278,RC,inpatient,,10309,10309,,8752.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7772.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8762.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9071.92,88,,percent of total billed charges,,,,,,,,,7876.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9381.19,91,,percent of total billed charges,,,9793.55,95,,percent of total billed charges,,,8556.47,83,,percent of total billed charges,,,8556.47,83,,percent of total billed charges,,,,,,,,,,,,,,,8556.47,83,,percent of total billed charges,,,9793.55,95,,percent of total billed charges,,,9278.1,90,,percent of total billed charges,,,9278.1,90,,percent of total billed charges,,,8453.38,82,,percent of total billed charges,,,9278.1,90,,percent of total billed charges,,,8762.65,85,,percent of total billed charges,,7772.99,9793.55,
SYNTHES SCREW CANNUL 16MM 6.5X100MM,30183876,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
NEEDLE SPINAL QUINKE 25GX3.5  ORANGE,30183879,CDM,,,270,RC,inpatient,,12.98,12.98,,11.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.42,88,,percent of total billed charges,,,,,,,,,9.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.81,91,,percent of total billed charges,,,12.33,95,,percent of total billed charges,,,10.77,83,,percent of total billed charges,,,10.77,83,,percent of total billed charges,,,,,,,,,,,,,,,10.77,83,,percent of total billed charges,,,12.33,95,,percent of total billed charges,,,11.68,90,,percent of total billed charges,,,11.68,90,,percent of total billed charges,,,10.64,82,,percent of total billed charges,,,11.68,90,,percent of total billed charges,,,11.03,85,,percent of total billed charges,,9.79,12.33,
DEPUY ATTUNE TKA FB,30183881,CDM,,,278,RC,inpatient,,37440,37440,,31786.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28229.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31824,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32947.2,88,,percent of total billed charges,,,,,,,,,28604.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34070.4,91,,percent of total billed charges,,,35568,95,,percent of total billed charges,,,31075.2,83,,percent of total billed charges,,,31075.2,83,,percent of total billed charges,,,,,,,,,,,,,,,31075.2,83,,percent of total billed charges,,,35568,95,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,30700.8,82,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,31824,85,,percent of total billed charges,,28229.76,35568,
CURVED PHACO TIP 30 DEG,30183882,CDM,,,270,RC,inpatient,,788.5,788.5,,669.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,594.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,670.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,693.88,88,,percent of total billed charges,,,,,,,,,602.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,717.54,91,,percent of total billed charges,,,749.08,95,,percent of total billed charges,,,654.46,83,,percent of total billed charges,,,654.46,83,,percent of total billed charges,,,,,,,,,,,,,,,654.46,83,,percent of total billed charges,,,749.08,95,,percent of total billed charges,,,709.65,90,,percent of total billed charges,,,709.65,90,,percent of total billed charges,,,646.57,82,,percent of total billed charges,,,709.65,90,,percent of total billed charges,,,670.23,85,,percent of total billed charges,,594.53,749.08,
SYNTHES TAP 6.5MM,30183883,CDM,,,270,RC,inpatient,,4607.85,4607.85,,3912.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3474.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3916.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4054.91,88,,percent of total billed charges,,,,,,,,,3520.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4193.14,91,,percent of total billed charges,,,4377.46,95,,percent of total billed charges,,,3824.52,83,,percent of total billed charges,,,3824.52,83,,percent of total billed charges,,,,,,,,,,,,,,,3824.52,83,,percent of total billed charges,,,4377.46,95,,percent of total billed charges,,,4147.07,90,,percent of total billed charges,,,4147.07,90,,percent of total billed charges,,,3778.44,82,,percent of total billed charges,,,4147.07,90,,percent of total billed charges,,,3916.67,85,,percent of total billed charges,,3474.32,4377.46,
SYNTHES SCREW BONE 6.5 X 32MM,30183884,CDM,,,270,RC,inpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,323.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,364.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,323.01,406.98,
DEPUY ATTUNE FEMUR CR SZ 4 RT,30183885,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
FORTEC HOLMIUM LASER LOW WATTAGE,30183890,CDM,,,270,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
BRAVO CF CAPSULE DELIVERY DEVICE,30183896,CDM,,,270,RC,inpatient,,2018.9,2018.9,,1714.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1522.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1716.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1776.63,88,,percent of total billed charges,,,,,,,,,1542.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1837.2,91,,percent of total billed charges,,,1917.96,95,,percent of total billed charges,,,1675.69,83,,percent of total billed charges,,,1675.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1675.69,83,,percent of total billed charges,,,1917.96,95,,percent of total billed charges,,,1817.01,90,,percent of total billed charges,,,1817.01,90,,percent of total billed charges,,,1655.5,82,,percent of total billed charges,,,1817.01,90,,percent of total billed charges,,,1716.07,85,,percent of total billed charges,,1522.25,1917.96,
CIVCO NEEDLE GUIDE SHEATH KIT,30183934,CDM,,,270,RC,inpatient,,128.33,128.33,,108.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,96.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,109.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,112.93,88,,percent of total billed charges,,,,,,,,,98.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,116.78,91,,percent of total billed charges,,,121.91,95,,percent of total billed charges,,,106.51,83,,percent of total billed charges,,,106.51,83,,percent of total billed charges,,,,,,,,,,,,,,,106.51,83,,percent of total billed charges,,,121.91,95,,percent of total billed charges,,,115.5,90,,percent of total billed charges,,,115.5,90,,percent of total billed charges,,,105.23,82,,percent of total billed charges,,,115.5,90,,percent of total billed charges,,,109.08,85,,percent of total billed charges,,96.76,121.91,
MEDTRONIC PACEMAKER ADVISA DR MRI SURESC,30183935,CDM,,,278,RC,inpatient,,46949.11,46949.11,,39859.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35399.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39906.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41315.22,88,,percent of total billed charges,,,,,,,,,35869.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42723.69,91,,percent of total billed charges,,,44601.65,95,,percent of total billed charges,,,38967.76,83,,percent of total billed charges,,,38967.76,83,,percent of total billed charges,,,,,,,,,,,,,,,38967.76,83,,percent of total billed charges,,,44601.65,95,,percent of total billed charges,,,42254.2,90,,percent of total billed charges,,,42254.2,90,,percent of total billed charges,,,38498.27,82,,percent of total billed charges,,,42254.2,90,,percent of total billed charges,,,39906.74,85,,percent of total billed charges,,35399.63,44601.65,
MEDTRONIC LEAD 45CM MRI CONDITIONAL,30183936,CDM,,,270,RC,inpatient,,5178.55,5178.55,,4396.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3904.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4401.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4557.12,88,,percent of total billed charges,,,,,,,,,3956.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4712.48,91,,percent of total billed charges,,,4919.62,95,,percent of total billed charges,,,4298.2,83,,percent of total billed charges,,,4298.2,83,,percent of total billed charges,,,,,,,,,,,,,,,4298.2,83,,percent of total billed charges,,,4919.62,95,,percent of total billed charges,,,4660.7,90,,percent of total billed charges,,,4660.7,90,,percent of total billed charges,,,4246.41,82,,percent of total billed charges,,,4660.7,90,,percent of total billed charges,,,4401.77,85,,percent of total billed charges,,3904.63,4919.62,
MEDTRONIC LEAD 52CM MRI CONDITIONAL,30183937,CDM,,,278,RC,inpatient,,5178.55,5178.55,,4396.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3904.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4401.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4557.12,88,,percent of total billed charges,,,,,,,,,3956.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4712.48,91,,percent of total billed charges,,,4919.62,95,,percent of total billed charges,,,4298.2,83,,percent of total billed charges,,,4298.2,83,,percent of total billed charges,,,,,,,,,,,,,,,4298.2,83,,percent of total billed charges,,,4919.62,95,,percent of total billed charges,,,4660.7,90,,percent of total billed charges,,,4660.7,90,,percent of total billed charges,,,4246.41,82,,percent of total billed charges,,,4660.7,90,,percent of total billed charges,,,4401.77,85,,percent of total billed charges,,3904.63,4919.62,
S&N ENDO ANKLE STRAP PES TALARIS,30183944,CDM,,,270,RC,inpatient,,830.2,830.2,,704.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,625.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,705.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,730.58,88,,percent of total billed charges,,,,,,,,,634.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,755.48,91,,percent of total billed charges,,,788.69,95,,percent of total billed charges,,,689.07,83,,percent of total billed charges,,,689.07,83,,percent of total billed charges,,,,,,,,,,,,,,,689.07,83,,percent of total billed charges,,,788.69,95,,percent of total billed charges,,,747.18,90,,percent of total billed charges,,,747.18,90,,percent of total billed charges,,,680.76,82,,percent of total billed charges,,,747.18,90,,percent of total billed charges,,,705.67,85,,percent of total billed charges,,625.97,788.69,
CATH STRAIGHT FILIFORM TIP 5FR,30183945,CDM,,,270,RC,inpatient,,501.62,501.62,,425.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,378.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,426.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,441.43,88,,percent of total billed charges,,,,,,,,,383.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,456.47,91,,percent of total billed charges,,,476.54,95,,percent of total billed charges,,,416.34,83,,percent of total billed charges,,,416.34,83,,percent of total billed charges,,,,,,,,,,,,,,,416.34,83,,percent of total billed charges,,,476.54,95,,percent of total billed charges,,,451.46,90,,percent of total billed charges,,,451.46,90,,percent of total billed charges,,,411.33,82,,percent of total billed charges,,,451.46,90,,percent of total billed charges,,,426.38,85,,percent of total billed charges,,378.22,476.54,
CATH WOVEN PHILLIPS FOLLOWER 24FR,30183946,CDM,,,270,RC,inpatient,,752.78,752.78,,639.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,567.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,639.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,662.45,88,,percent of total billed charges,,,,,,,,,575.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,685.03,91,,percent of total billed charges,,,715.14,95,,percent of total billed charges,,,624.81,83,,percent of total billed charges,,,624.81,83,,percent of total billed charges,,,,,,,,,,,,,,,624.81,83,,percent of total billed charges,,,715.14,95,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,617.28,82,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,639.86,85,,percent of total billed charges,,567.6,715.14,
STENT URETERAL 5FR X 18CM,30183947,CDM,,,270,RC,inpatient,,904.8,904.8,,768.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,682.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,769.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,796.22,88,,percent of total billed charges,,,,,,,,,691.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,823.37,91,,percent of total billed charges,,,859.56,95,,percent of total billed charges,,,750.98,83,,percent of total billed charges,,,750.98,83,,percent of total billed charges,,,,,,,,,,,,,,,750.98,83,,percent of total billed charges,,,859.56,95,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,741.94,82,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,769.08,85,,percent of total billed charges,,682.22,859.56,
S&N SCREWDRIVER RELEASE HANDLE,30183948,CDM,,,270,RC,inpatient,,1391.13,1391.13,,1181.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1048.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1182.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1224.19,88,,percent of total billed charges,,,,,,,,,1062.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1265.93,91,,percent of total billed charges,,,1321.57,95,,percent of total billed charges,,,1154.64,83,,percent of total billed charges,,,1154.64,83,,percent of total billed charges,,,,,,,,,,,,,,,1154.64,83,,percent of total billed charges,,,1321.57,95,,percent of total billed charges,,,1252.02,90,,percent of total billed charges,,,1252.02,90,,percent of total billed charges,,,1140.73,82,,percent of total billed charges,,,1252.02,90,,percent of total billed charges,,,1182.46,85,,percent of total billed charges,,1048.91,1321.57,
S&N NAIL TROCHANTERIC 11.5MM X 40CM 130D,30183949,CDM,,,278,RC,inpatient,,15190.5,15190.5,,12896.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11453.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12911.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13367.64,88,,percent of total billed charges,,,,,,,,,11605.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13823.36,91,,percent of total billed charges,,,14430.98,95,,percent of total billed charges,,,12608.12,83,,percent of total billed charges,,,12608.12,83,,percent of total billed charges,,,,,,,,,,,,,,,12608.12,83,,percent of total billed charges,,,14430.98,95,,percent of total billed charges,,,13671.45,90,,percent of total billed charges,,,13671.45,90,,percent of total billed charges,,,12456.21,82,,percent of total billed charges,,,13671.45,90,,percent of total billed charges,,,12911.93,85,,percent of total billed charges,,11453.64,14430.98,
S&N DRILL PILOT 4.0MM LONG AO,30183950,CDM,,,278,RC,inpatient,,1796.21,1796.21,,1524.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1354.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1526.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1580.66,88,,percent of total billed charges,,,,,,,,,1372.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1634.55,91,,percent of total billed charges,,,1706.4,95,,percent of total billed charges,,,1490.85,83,,percent of total billed charges,,,1490.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1490.85,83,,percent of total billed charges,,,1706.4,95,,percent of total billed charges,,,1616.59,90,,percent of total billed charges,,,1616.59,90,,percent of total billed charges,,,1472.89,82,,percent of total billed charges,,,1616.59,90,,percent of total billed charges,,,1526.78,85,,percent of total billed charges,,1354.34,1706.4,
S&N GUIDE PIN THREADED 3.2MM X 343MM,30183951,CDM,,,278,RC,inpatient,,1177.93,1177.93,,1000.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,888.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1001.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1036.58,88,,percent of total billed charges,,,,,,,,,899.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1071.92,91,,percent of total billed charges,,,1119.03,95,,percent of total billed charges,,,977.68,83,,percent of total billed charges,,,977.68,83,,percent of total billed charges,,,,,,,,,,,,,,,977.68,83,,percent of total billed charges,,,1119.03,95,,percent of total billed charges,,,1060.14,90,,percent of total billed charges,,,1060.14,90,,percent of total billed charges,,,965.9,82,,percent of total billed charges,,,1060.14,90,,percent of total billed charges,,,1001.24,85,,percent of total billed charges,,888.16,1119.03,
S&N SCREW LP 5MM X 60MM TRIGEN,30183952,CDM,,,278,RC,inpatient,,1726.92,1726.92,,1466.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1302.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1467.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1519.69,88,,percent of total billed charges,,,,,,,,,1319.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1571.5,91,,percent of total billed charges,,,1640.57,95,,percent of total billed charges,,,1433.34,83,,percent of total billed charges,,,1433.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1433.34,83,,percent of total billed charges,,,1640.57,95,,percent of total billed charges,,,1554.23,90,,percent of total billed charges,,,1554.23,90,,percent of total billed charges,,,1416.07,82,,percent of total billed charges,,,1554.23,90,,percent of total billed charges,,,1467.88,85,,percent of total billed charges,,1302.1,1640.57,
S&N SCREW HEX RECON 6.4MM X 100MM,30183953,CDM,,,278,RC,inpatient,,2782.56,2782.56,,2362.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2098.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2365.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2448.65,88,,percent of total billed charges,,,,,,,,,2125.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2532.13,91,,percent of total billed charges,,,2643.43,95,,percent of total billed charges,,,2309.52,83,,percent of total billed charges,,,2309.52,83,,percent of total billed charges,,,,,,,,,,,,,,,2309.52,83,,percent of total billed charges,,,2643.43,95,,percent of total billed charges,,,2504.3,90,,percent of total billed charges,,,2504.3,90,,percent of total billed charges,,,2281.7,82,,percent of total billed charges,,,2504.3,90,,percent of total billed charges,,,2365.18,85,,percent of total billed charges,,2098.05,2643.43,
S&N SCREW HEX RECON 6.4MM X 90MM,30183954,CDM,,,278,RC,inpatient,,2782.26,2782.26,,2362.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2097.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2364.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2448.39,88,,percent of total billed charges,,,,,,,,,2125.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2531.86,91,,percent of total billed charges,,,2643.15,95,,percent of total billed charges,,,2309.28,83,,percent of total billed charges,,,2309.28,83,,percent of total billed charges,,,,,,,,,,,,,,,2309.28,83,,percent of total billed charges,,,2643.15,95,,percent of total billed charges,,,2504.03,90,,percent of total billed charges,,,2504.03,90,,percent of total billed charges,,,2281.45,82,,percent of total billed charges,,,2504.03,90,,percent of total billed charges,,,2364.92,85,,percent of total billed charges,,2097.82,2643.15,
DEPUY INSERT RP 15MM SZ3,30183955,CDM,,,278,RC,inpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9811.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11060.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,9811.36,12361.8,
SYNTHES SCREW CANNUL 85MM X 6.5MM,30183956,CDM,,,278,RC,inpatient,,2795.65,2795.65,,2373.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2107.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2376.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2460.17,88,,percent of total billed charges,,,,,,,,,2135.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2544.04,91,,percent of total billed charges,,,2655.87,95,,percent of total billed charges,,,2320.39,83,,percent of total billed charges,,,2320.39,83,,percent of total billed charges,,,,,,,,,,,,,,,2320.39,83,,percent of total billed charges,,,2655.87,95,,percent of total billed charges,,,2516.09,90,,percent of total billed charges,,,2516.09,90,,percent of total billed charges,,,2292.43,82,,percent of total billed charges,,,2516.09,90,,percent of total billed charges,,,2376.3,85,,percent of total billed charges,,2107.92,2655.87,
BARD PHILLIPS 8FR THREADED FOLLOWER,30183957,CDM,,,270,RC,inpatient,,752.78,752.78,,639.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,567.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,639.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,662.45,88,,percent of total billed charges,,,,,,,,,575.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,685.03,91,,percent of total billed charges,,,715.14,95,,percent of total billed charges,,,624.81,83,,percent of total billed charges,,,624.81,83,,percent of total billed charges,,,,,,,,,,,,,,,624.81,83,,percent of total billed charges,,,715.14,95,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,617.28,82,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,639.86,85,,percent of total billed charges,,567.6,715.14,
SYNTHES SCREW CANNUL 16MM 6.5X75MM,30183958,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
ACUTRAK MICRO DRILL,30183959,CDM,,,270,RC,inpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1514.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1707.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,1514.41,1908.08,
ACUTRAK WIRE .035 X 6 SINGLE,30183960,CDM,,,270,RC,inpatient,,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,269.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,303.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,269.18,339.15,
SYNTHES SCREW CANNULATED 6.5X75MM,30183961,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES 7 HOLE RECON PLATE,30183963,CDM,,,278,RC,inpatient,,4900.68,4900.68,,4160.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3695.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4165.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4312.6,88,,percent of total billed charges,,,,,,,,,3744.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4459.62,91,,percent of total billed charges,,,4655.65,95,,percent of total billed charges,,,4067.56,83,,percent of total billed charges,,,4067.56,83,,percent of total billed charges,,,,,,,,,,,,,,,4067.56,83,,percent of total billed charges,,,4655.65,95,,percent of total billed charges,,,4410.61,90,,percent of total billed charges,,,4410.61,90,,percent of total billed charges,,,4018.56,82,,percent of total billed charges,,,4410.61,90,,percent of total billed charges,,,4165.58,85,,percent of total billed charges,,3695.11,4655.65,
DEPUY INSERT AOX SZ 8 7MM,30183965,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY LINER ALTRX NEUT 28 X 48,30183966,CDM,,,278,RC,inpatient,,10729.29,10729.29,,9109.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8089.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9119.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9441.78,88,,percent of total billed charges,,,,,,,,,8197.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9763.65,91,,percent of total billed charges,,,10192.83,95,,percent of total billed charges,,,8905.31,83,,percent of total billed charges,,,8905.31,83,,percent of total billed charges,,,,,,,,,,,,,,,8905.31,83,,percent of total billed charges,,,10192.83,95,,percent of total billed charges,,,9656.36,90,,percent of total billed charges,,,9656.36,90,,percent of total billed charges,,,8798.02,82,,percent of total billed charges,,,9656.36,90,,percent of total billed charges,,,9119.9,85,,percent of total billed charges,,8089.88,10192.83,
DEPUY BIOLOX TS HEAD 28MM +5,30183967,CDM,,,278,RC,inpatient,,13897.78,13897.78,,11799.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10478.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11813.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12230.05,88,,percent of total billed charges,,,,,,,,,10617.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12646.98,91,,percent of total billed charges,,,13202.89,95,,percent of total billed charges,,,11535.16,83,,percent of total billed charges,,,11535.16,83,,percent of total billed charges,,,,,,,,,,,,,,,11535.16,83,,percent of total billed charges,,,13202.89,95,,percent of total billed charges,,,12508,90,,percent of total billed charges,,,12508,90,,percent of total billed charges,,,11396.18,82,,percent of total billed charges,,,12508,90,,percent of total billed charges,,,11813.11,85,,percent of total billed charges,,10478.93,13202.89,
CONFORMIS IUNI G2 RIGHT MEDIAL IMPLANT K,30183971,CDM,,,278,RC,inpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29406,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33150,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,29406,37050,
BARD CATHETER/ELECTRODE BALLOON PACING,30183972,CDM,,,270,RC,inpatient,,1400.69,1400.69,,1189.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1056.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1190.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1232.61,88,,percent of total billed charges,,,,,,,,,1070.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1274.63,91,,percent of total billed charges,,,1330.66,95,,percent of total billed charges,,,1162.57,83,,percent of total billed charges,,,1162.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1162.57,83,,percent of total billed charges,,,1330.66,95,,percent of total billed charges,,,1260.62,90,,percent of total billed charges,,,1260.62,90,,percent of total billed charges,,,1148.57,82,,percent of total billed charges,,,1260.62,90,,percent of total billed charges,,,1190.59,85,,percent of total billed charges,,1056.12,1330.66,
BARD CATHETER/ELECTRODE NBIH BIPOLAR PAC,30183973,CDM,,,270,RC,inpatient,,1144,1144,,971.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,862.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,972.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1006.72,88,,percent of total billed charges,,,,,,,,,874.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1041.04,91,,percent of total billed charges,,,1086.8,95,,percent of total billed charges,,,949.52,83,,percent of total billed charges,,,949.52,83,,percent of total billed charges,,,,,,,,,,,,,,,949.52,83,,percent of total billed charges,,,1086.8,95,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,938.08,82,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,972.4,85,,percent of total billed charges,,862.58,1086.8,
BARD CATHETER/ELECTRODE NBIH BIPOLAR PAC,30183974,CDM,,,270,RC,inpatient,,1144,1144,,971.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,862.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,972.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1006.72,88,,percent of total billed charges,,,,,,,,,874.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1041.04,91,,percent of total billed charges,,,1086.8,95,,percent of total billed charges,,,949.52,83,,percent of total billed charges,,,949.52,83,,percent of total billed charges,,,,,,,,,,,,,,,949.52,83,,percent of total billed charges,,,1086.8,95,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,938.08,82,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,972.4,85,,percent of total billed charges,,862.58,1086.8,
ZIMMER K-WIRE .035 6  STYLE 7,30183976,CDM,,,278,RC,inpatient,,88.08,88.08,,74.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.51,88,,percent of total billed charges,,,,,,,,,67.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.15,91,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,,,,,,,,,,,,,73.11,83,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,72.23,82,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,66.41,83.68,
ZIMMER K-WIRE .035 9,30183977,CDM,,,278,RC,inpatient,,88.08,88.08,,74.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.51,88,,percent of total billed charges,,,,,,,,,67.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.15,91,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,,,,,,,,,,,,,73.11,83,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,72.23,82,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,66.41,83.68,
ZIMMER K-WIRE .045 6  STYLE 7,30183978,CDM,,,278,RC,inpatient,,88.08,88.08,,74.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.51,88,,percent of total billed charges,,,,,,,,,67.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.15,91,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,,,,,,,,,,,,,73.11,83,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,72.23,82,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,66.41,83.68,
ZIMMER K-WIRE .045 9,30183979,CDM,,,278,RC,inpatient,,88.08,88.08,,74.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.51,88,,percent of total billed charges,,,,,,,,,67.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.15,91,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,,,,,,,,,,,,,73.11,83,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,72.23,82,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,66.41,83.68,
ZIMMER K-WIRE .062 6,30183980,CDM,,,278,RC,inpatient,,88.08,88.08,,74.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.51,88,,percent of total billed charges,,,,,,,,,67.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.15,91,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,,,,,,,,,,,,,73.11,83,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,72.23,82,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,66.41,83.68,
ZIMMER K-WIRE .062 9,30183981,CDM,,,278,RC,inpatient,,88.08,88.08,,74.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.51,88,,percent of total billed charges,,,,,,,,,67.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.15,91,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,,,,,,,,,,,,,73.11,83,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,72.23,82,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,66.41,83.68,
DEPUY FEMUR ATTUNE SZ 6 LT CR,30183982,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY INSERT XLK SZ 5 15MM,30183983,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
LEEP RADIUS LOOP ELECTRODE 2.0 X 2.0,30183984,CDM,,,270,RC,inpatient,,185.06,185.06,,157.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,139.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,157.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,162.85,88,,percent of total billed charges,,,,,,,,,141.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,168.4,91,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,,,,,,,,,,,,,153.6,83,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,151.75,82,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,157.3,85,,percent of total billed charges,,139.54,175.81,
LEEP RADIUS LOOP ELECTRODE 1.0 X 1.0,30183985,CDM,,,270,RC,inpatient,,189.68,189.68,,161.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,143.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,161.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,166.92,88,,percent of total billed charges,,,,,,,,,144.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,172.61,91,,percent of total billed charges,,,180.2,95,,percent of total billed charges,,,157.43,83,,percent of total billed charges,,,157.43,83,,percent of total billed charges,,,,,,,,,,,,,,,157.43,83,,percent of total billed charges,,,180.2,95,,percent of total billed charges,,,170.71,90,,percent of total billed charges,,,170.71,90,,percent of total billed charges,,,155.54,82,,percent of total billed charges,,,170.71,90,,percent of total billed charges,,,161.23,85,,percent of total billed charges,,143.02,180.2,
LEEP RADIUS LOOP ELECTRODE 1.5 X 1.5,30183986,CDM,,,270,RC,inpatient,,185.06,185.06,,157.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,139.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,157.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,162.85,88,,percent of total billed charges,,,,,,,,,141.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,168.4,91,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,,,,,,,,,,,,,153.6,83,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,151.75,82,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,157.3,85,,percent of total billed charges,,139.54,175.81,
SYNTHES BLADE HELICAL 11MM X 95MM,30183987,CDM,,,278,RC,inpatient,,6630,6630,,5628.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4999.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5635.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5834.4,88,,percent of total billed charges,,,,,,,,,5065.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6033.3,91,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,,,,,,,,,,,,,5502.9,83,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5436.6,82,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,4999.02,6298.5,
SYNTHES SCREW LOCKING TI 5.0MM X 34MM,30183988,CDM,,,278,RC,inpatient,,2160.28,2160.28,,1834.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1628.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1836.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1901.05,88,,percent of total billed charges,,,,,,,,,1650.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1965.85,91,,percent of total billed charges,,,2052.27,95,,percent of total billed charges,,,1793.03,83,,percent of total billed charges,,,1793.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1793.03,83,,percent of total billed charges,,,2052.27,95,,percent of total billed charges,,,1944.25,90,,percent of total billed charges,,,1944.25,90,,percent of total billed charges,,,1771.43,82,,percent of total billed charges,,,1944.25,90,,percent of total billed charges,,,1836.24,85,,percent of total billed charges,,1628.85,2052.27,
SYNTHES SCREW CORTEX 1.3 X 9MM SELF TAP,30183989,CDM,,,278,RC,inpatient,,856.8,856.8,,727.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,646.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,728.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,753.98,88,,percent of total billed charges,,,,,,,,,654.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,779.69,91,,percent of total billed charges,,,813.96,95,,percent of total billed charges,,,711.14,83,,percent of total billed charges,,,711.14,83,,percent of total billed charges,,,,,,,,,,,,,,,711.14,83,,percent of total billed charges,,,813.96,95,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,702.58,82,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,728.28,85,,percent of total billed charges,,646.03,813.96,
SYNTHES SCREW CORTEX 1.3 X 10MM,30183990,CDM,,,278,RC,inpatient,,856.8,856.8,,727.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,646.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,728.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,753.98,88,,percent of total billed charges,,,,,,,,,654.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,779.69,91,,percent of total billed charges,,,813.96,95,,percent of total billed charges,,,711.14,83,,percent of total billed charges,,,711.14,83,,percent of total billed charges,,,,,,,,,,,,,,,711.14,83,,percent of total billed charges,,,813.96,95,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,702.58,82,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,728.28,85,,percent of total billed charges,,646.03,813.96,
SYNTHES SCREW CORTEX 1.5 X 8MM SELF TAP,30183991,CDM,,,278,RC,inpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,313.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,278.15,350.46,
SYNTHES SCREW CORTEX 2.0 X 10MM SELF TAP,30183992,CDM,,,278,RC,inpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,313.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,278.15,350.46,
SYNTHES SCREW CORTEX 2.0 X 12MM SELF TAP,30183993,CDM,,,278,RC,inpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,313.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,278.15,350.46,
SYNTHES DRILL BIT 1.1MM,30183994,CDM,,,278,RC,inpatient,,795.34,795.34,,675.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,599.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,676.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,699.9,88,,percent of total billed charges,,,,,,,,,607.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,723.76,91,,percent of total billed charges,,,755.57,95,,percent of total billed charges,,,660.13,83,,percent of total billed charges,,,660.13,83,,percent of total billed charges,,,,,,,,,,,,,,,660.13,83,,percent of total billed charges,,,755.57,95,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,652.18,82,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,676.04,85,,percent of total billed charges,,599.69,755.57,
SYNTHES DRILL BIT 1.5MM,30183995,CDM,,,278,RC,inpatient,,767.55,767.55,,651.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,578.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,652.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,675.44,88,,percent of total billed charges,,,,,,,,,586.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,698.47,91,,percent of total billed charges,,,729.17,95,,percent of total billed charges,,,637.07,83,,percent of total billed charges,,,637.07,83,,percent of total billed charges,,,,,,,,,,,,,,,637.07,83,,percent of total billed charges,,,729.17,95,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,629.39,82,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,652.42,85,,percent of total billed charges,,578.73,729.17,
DEPUY HEAD HUMERAL 44 X 15,30183996,CDM,,,278,RC,inpatient,,15560.09,15560.09,,13210.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11732.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13226.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13692.88,88,,percent of total billed charges,,,,,,,,,11887.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14159.68,91,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12914.87,83,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,12759.27,82,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,11732.31,14782.09,
DEPUY STEM HUMERAL SZ 16,30183997,CDM,,,278,RC,inpatient,,17244.96,17244.96,,14640.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13002.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14658.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15175.56,88,,percent of total billed charges,,,,,,,,,13175.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15692.91,91,,percent of total billed charges,,,16382.71,95,,percent of total billed charges,,,14313.32,83,,percent of total billed charges,,,14313.32,83,,percent of total billed charges,,,,,,,,,,,,,,,14313.32,83,,percent of total billed charges,,,16382.71,95,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,14140.87,82,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,14658.22,85,,percent of total billed charges,,13002.7,16382.71,
ALLOSOURCE PATELLA TENDON ASCEPTIC PRESH,30183998,CDM,,,278,RC,inpatient,,18232.5,18232.5,,15479.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13747.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15497.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16044.6,88,,percent of total billed charges,,,,,,,,,13929.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16591.58,91,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15132.98,83,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,14950.65,82,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,13747.31,17320.88,
FORCEP DISP. POLYGRAB 20MM,30183999,CDM,,,270,RC,inpatient,,468.2,468.2,,397.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,353.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,397.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,412.02,88,,percent of total billed charges,,,,,,,,,357.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,426.06,91,,percent of total billed charges,,,444.79,95,,percent of total billed charges,,,388.61,83,,percent of total billed charges,,,388.61,83,,percent of total billed charges,,,,,,,,,,,,,,,388.61,83,,percent of total billed charges,,,444.79,95,,percent of total billed charges,,,421.38,90,,percent of total billed charges,,,421.38,90,,percent of total billed charges,,,383.92,82,,percent of total billed charges,,,421.38,90,,percent of total billed charges,,,397.97,85,,percent of total billed charges,,353.02,444.79,
SYNTHES SCREW LOCKING 4.0MM X 38,30184000,CDM,,,278,RC,inpatient,,1640.93,1640.93,,1393.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1237.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1394.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1444.02,88,,percent of total billed charges,,,,,,,,,1253.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1493.25,91,,percent of total billed charges,,,1558.88,95,,percent of total billed charges,,,1361.97,83,,percent of total billed charges,,,1361.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1361.97,83,,percent of total billed charges,,,1558.88,95,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1345.56,82,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1394.79,85,,percent of total billed charges,,1237.26,1558.88,
S&N DRILL GUIDE 2.9MM,30184002,CDM,,,270,RC,inpatient,,2710.5,2710.5,,2301.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2043.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2303.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2385.24,88,,percent of total billed charges,,,,,,,,,2070.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2466.56,91,,percent of total billed charges,,,2574.98,95,,percent of total billed charges,,,2249.72,83,,percent of total billed charges,,,2249.72,83,,percent of total billed charges,,,,,,,,,,,,,,,2249.72,83,,percent of total billed charges,,,2574.98,95,,percent of total billed charges,,,2439.45,90,,percent of total billed charges,,,2439.45,90,,percent of total billed charges,,,2222.61,82,,percent of total billed charges,,,2439.45,90,,percent of total billed charges,,,2303.93,85,,percent of total billed charges,,2043.72,2574.98,
SYNTHES SCREW CANCEL 6.5X35MM,30184003,CDM,,,278,RC,inpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,296.1,373.07,
SYNTHES SCREW CANCEL 6.5X25MM,30184004,CDM,,,278,RC,inpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,296.1,373.07,
S&N ENDO SCREW 7 X 20,30184005,CDM,,,278,RC,inpatient,,1235,1235,,1048.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,931.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1049.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1086.8,88,,percent of total billed charges,,,,,,,,,943.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1123.85,91,,percent of total billed charges,,,1173.25,95,,percent of total billed charges,,,1025.05,83,,percent of total billed charges,,,1025.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1025.05,83,,percent of total billed charges,,,1173.25,95,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1012.7,82,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1049.75,85,,percent of total billed charges,,931.19,1173.25,
STONE SWEEPING PARACHUTE 90 CM,30184008,CDM,,,270,RC,inpatient,,2068.63,2068.63,,1756.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1559.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1758.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1820.39,88,,percent of total billed charges,,,,,,,,,1580.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1882.45,91,,percent of total billed charges,,,1965.2,95,,percent of total billed charges,,,1716.96,83,,percent of total billed charges,,,1716.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1716.96,83,,percent of total billed charges,,,1965.2,95,,percent of total billed charges,,,1861.77,90,,percent of total billed charges,,,1861.77,90,,percent of total billed charges,,,1696.28,82,,percent of total billed charges,,,1861.77,90,,percent of total billed charges,,,1758.34,85,,percent of total billed charges,,1559.75,1965.2,
STONE BASKET ESCAPE 90CM,30184009,CDM,,,270,RC,inpatient,,2704.65,2704.65,,2296.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2039.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2298.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2380.09,88,,percent of total billed charges,,,,,,,,,2066.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2461.23,91,,percent of total billed charges,,,2569.42,95,,percent of total billed charges,,,2244.86,83,,percent of total billed charges,,,2244.86,83,,percent of total billed charges,,,,,,,,,,,,,,,2244.86,83,,percent of total billed charges,,,2569.42,95,,percent of total billed charges,,,2434.19,90,,percent of total billed charges,,,2434.19,90,,percent of total billed charges,,,2217.81,82,,percent of total billed charges,,,2434.19,90,,percent of total billed charges,,,2298.95,85,,percent of total billed charges,,2039.31,2569.42,
S&N SCREW CANN 1.5 8X20 SOFT SILK,30184011,CDM,,,278,RC,inpatient,,1235,1235,,1048.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,931.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1049.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1086.8,88,,percent of total billed charges,,,,,,,,,943.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1123.85,91,,percent of total billed charges,,,1173.25,95,,percent of total billed charges,,,1025.05,83,,percent of total billed charges,,,1025.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1025.05,83,,percent of total billed charges,,,1173.25,95,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1012.7,82,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1049.75,85,,percent of total billed charges,,931.19,1173.25,
DEPUY LINER CONSTRAINED +4 40 X 64,30184014,CDM,,,278,RC,inpatient,,39314.21,39314.21,,33377.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29642.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33417.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34596.5,88,,percent of total billed charges,,,,,,,,,30036.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35775.93,91,,percent of total billed charges,,,37348.5,95,,percent of total billed charges,,,32630.79,83,,percent of total billed charges,,,32630.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32630.79,83,,percent of total billed charges,,,37348.5,95,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,32237.65,82,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,33417.08,85,,percent of total billed charges,,29642.91,37348.5,
ZIMMER FEMORAL HEAD 40MM +3.5,30184015,CDM,,,278,RC,inpatient,,6648.98,6648.98,,5644.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5013.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5651.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5851.1,88,,percent of total billed charges,,,,,,,,,5079.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6050.57,91,,percent of total billed charges,,,6316.53,95,,percent of total billed charges,,,5518.65,83,,percent of total billed charges,,,5518.65,83,,percent of total billed charges,,,,,,,,,,,,,,,5518.65,83,,percent of total billed charges,,,6316.53,95,,percent of total billed charges,,,5984.08,90,,percent of total billed charges,,,5984.08,90,,percent of total billed charges,,,5452.16,82,,percent of total billed charges,,,5984.08,90,,percent of total billed charges,,,5651.63,85,,percent of total billed charges,,5013.33,6316.53,
BRAVO BUFFER PH 7.01 500ML,30184016,CDM,,,270,RC,inpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,150.8,190,
BRAVO BUFFER PH 1.07 500ML,30184017,CDM,,,270,RC,inpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,150.8,190,
COUDE CATH 22FR LUBRICATH,30184019,CDM,,,270,RC,inpatient,,88.72,88.72,,75.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,75.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,78.07,88,,percent of total billed charges,,,,,,,,,67.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.74,91,,percent of total billed charges,,,84.28,95,,percent of total billed charges,,,73.64,83,,percent of total billed charges,,,73.64,83,,percent of total billed charges,,,,,,,,,,,,,,,73.64,83,,percent of total billed charges,,,84.28,95,,percent of total billed charges,,,79.85,90,,percent of total billed charges,,,79.85,90,,percent of total billed charges,,,72.75,82,,percent of total billed charges,,,79.85,90,,percent of total billed charges,,,75.41,85,,percent of total billed charges,,66.89,84.28,
3FR OLIVE TIP URETERAL CATHETER,30184020,CDM,,,270,RC,inpatient,,610.89,610.89,,518.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,460.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,519.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,537.58,88,,percent of total billed charges,,,,,,,,,466.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,555.91,91,,percent of total billed charges,,,580.35,95,,percent of total billed charges,,,507.04,83,,percent of total billed charges,,,507.04,83,,percent of total billed charges,,,,,,,,,,,,,,,507.04,83,,percent of total billed charges,,,580.35,95,,percent of total billed charges,,,549.8,90,,percent of total billed charges,,,549.8,90,,percent of total billed charges,,,500.93,82,,percent of total billed charges,,,549.8,90,,percent of total billed charges,,,519.26,85,,percent of total billed charges,,460.61,580.35,
ZIMMER STEM REV. WAGNER 135 NK ANGLE 14X,30184021,CDM,,,278,RC,inpatient,,73125,73125,,62083.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,55136.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,62156.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,64350,88,,percent of total billed charges,,,,,,,,,55867.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,66543.75,91,,percent of total billed charges,,,69468.75,95,,percent of total billed charges,,,60693.75,83,,percent of total billed charges,,,60693.75,83,,percent of total billed charges,,,,,,,,,,,,,,,60693.75,83,,percent of total billed charges,,,69468.75,95,,percent of total billed charges,,,65812.5,90,,percent of total billed charges,,,65812.5,90,,percent of total billed charges,,,59962.5,82,,percent of total billed charges,,,65812.5,90,,percent of total billed charges,,,62156.25,85,,percent of total billed charges,,55136.25,69468.75,
ZIMMER HEAD FEMORAL 40MM 12/14 +3.5,30184022,CDM,,,278,RC,inpatient,,6648.98,6648.98,,5644.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5013.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5651.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5851.1,88,,percent of total billed charges,,,,,,,,,5079.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6050.57,91,,percent of total billed charges,,,6316.53,95,,percent of total billed charges,,,5518.65,83,,percent of total billed charges,,,5518.65,83,,percent of total billed charges,,,,,,,,,,,,,,,5518.65,83,,percent of total billed charges,,,6316.53,95,,percent of total billed charges,,,5984.08,90,,percent of total billed charges,,,5984.08,90,,percent of total billed charges,,,5452.16,82,,percent of total billed charges,,,5984.08,90,,percent of total billed charges,,,5651.63,85,,percent of total billed charges,,5013.33,6316.53,
S&N Q-FIX 1.8MM MINI SUTURE ANCHOR,30184023,CDM,,,278,RC,inpatient,,4854.85,4854.85,,4121.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3660.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4126.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4272.27,88,,percent of total billed charges,,,,,,,,,3709.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4417.91,91,,percent of total billed charges,,,4612.11,95,,percent of total billed charges,,,4029.53,83,,percent of total billed charges,,,4029.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4029.53,83,,percent of total billed charges,,,4612.11,95,,percent of total billed charges,,,4369.37,90,,percent of total billed charges,,,4369.37,90,,percent of total billed charges,,,3980.98,82,,percent of total billed charges,,,4369.37,90,,percent of total billed charges,,,4126.62,85,,percent of total billed charges,,3660.56,4612.11,
S&N KIT DISP. FOR 1.8MM Q-FIX,30184024,CDM,,,278,RC,inpatient,,3783,3783,,3211.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2852.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3215.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3329.04,88,,percent of total billed charges,,,,,,,,,2890.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3442.53,91,,percent of total billed charges,,,3593.85,95,,percent of total billed charges,,,3139.89,83,,percent of total billed charges,,,3139.89,83,,percent of total billed charges,,,,,,,,,,,,,,,3139.89,83,,percent of total billed charges,,,3593.85,95,,percent of total billed charges,,,3404.7,90,,percent of total billed charges,,,3404.7,90,,percent of total billed charges,,,3102.06,82,,percent of total billed charges,,,3404.7,90,,percent of total billed charges,,,3215.55,85,,percent of total billed charges,,2852.38,3593.85,
S&N Q-FIX 2.8MM,30184025,CDM,,,278,RC,inpatient,,3984.5,3984.5,,3382.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3004.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3386.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3506.36,88,,percent of total billed charges,,,,,,,,,3044.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3625.9,91,,percent of total billed charges,,,3785.28,95,,percent of total billed charges,,,3307.14,83,,percent of total billed charges,,,3307.14,83,,percent of total billed charges,,,,,,,,,,,,,,,3307.14,83,,percent of total billed charges,,,3785.28,95,,percent of total billed charges,,,3586.05,90,,percent of total billed charges,,,3586.05,90,,percent of total billed charges,,,3267.29,82,,percent of total billed charges,,,3586.05,90,,percent of total billed charges,,,3386.83,85,,percent of total billed charges,,3004.31,3785.28,
S&N KIT DISP. FOR 2.8MM Q-FIX,30184026,CDM,,,278,RC,inpatient,,3315,3315,,2814.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2499.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2817.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2917.2,88,,percent of total billed charges,,,,,,,,,2532.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3016.65,91,,percent of total billed charges,,,3149.25,95,,percent of total billed charges,,,2751.45,83,,percent of total billed charges,,,2751.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2751.45,83,,percent of total billed charges,,,3149.25,95,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2718.3,82,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2817.75,85,,percent of total billed charges,,2499.51,3149.25,
ARTHREX WIRE LOOP NITINOL,30184027,CDM,,,270,RC,inpatient,,210,210,,178.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,158.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,178.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,184.8,88,,percent of total billed charges,,,,,,,,,160.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,,,,,,,,,,,,,174.3,83,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,172.2,82,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,158.34,199.5,
SYNTHES PLATE LC-DCP 6 HOLE 2.0MM,30184028,CDM,,,278,RC,inpatient,,4187.95,4187.95,,3555.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3157.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3559.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3685.4,88,,percent of total billed charges,,,,,,,,,3199.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3811.03,91,,percent of total billed charges,,,3978.55,95,,percent of total billed charges,,,3476,83,,percent of total billed charges,,,3476,83,,percent of total billed charges,,,,,,,,,,,,,,,3476,83,,percent of total billed charges,,,3978.55,95,,percent of total billed charges,,,3769.16,90,,percent of total billed charges,,,3769.16,90,,percent of total billed charges,,,3434.12,82,,percent of total billed charges,,,3769.16,90,,percent of total billed charges,,,3559.76,85,,percent of total billed charges,,3157.71,3978.55,
SYNTHES SCREW CORTEX 2.0 X 11MM SELF TAP,30184029,CDM,,,278,RC,inpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,313.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,278.15,350.46,
SYNTHES DRILL BIT MQC 1.3MM,30184030,CDM,,,278,RC,inpatient,,767.55,767.55,,651.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,578.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,652.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,675.44,88,,percent of total billed charges,,,,,,,,,586.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,698.47,91,,percent of total billed charges,,,729.17,95,,percent of total billed charges,,,637.07,83,,percent of total billed charges,,,637.07,83,,percent of total billed charges,,,,,,,,,,,,,,,637.07,83,,percent of total billed charges,,,729.17,95,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,629.39,82,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,652.42,85,,percent of total billed charges,,578.73,729.17,
SYNTHES SCREW CORTEX 1.3 X 11MM,30184031,CDM,,,278,RC,inpatient,,856.8,856.8,,727.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,646.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,728.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,753.98,88,,percent of total billed charges,,,,,,,,,654.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,779.69,91,,percent of total billed charges,,,813.96,95,,percent of total billed charges,,,711.14,83,,percent of total billed charges,,,711.14,83,,percent of total billed charges,,,,,,,,,,,,,,,711.14,83,,percent of total billed charges,,,813.96,95,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,702.58,82,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,728.28,85,,percent of total billed charges,,646.03,813.96,
ALLODERM 9.6X19.3CM FENESTRATED CONTOURE,30184032,CDM,,,278,RC,inpatient,,41119,41119,,34910.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31003.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34951.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36184.72,88,,percent of total billed charges,,,,,,,,,31414.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37418.29,91,,percent of total billed charges,,,39063.05,95,,percent of total billed charges,,,34128.77,83,,percent of total billed charges,,,34128.77,83,,percent of total billed charges,,,,,,,,,,,,,,,34128.77,83,,percent of total billed charges,,,39063.05,95,,percent of total billed charges,,,37007.1,90,,percent of total billed charges,,,37007.1,90,,percent of total billed charges,,,33717.58,82,,percent of total billed charges,,,37007.1,90,,percent of total billed charges,,,34951.15,85,,percent of total billed charges,,31003.73,39063.05,
STRYKER SHAVER LONG HIP AGGR. PLUS 4.0,30184033,CDM,,,270,RC,inpatient,,641.62,641.62,,544.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,483.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,545.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,564.63,88,,percent of total billed charges,,,,,,,,,490.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,583.87,91,,percent of total billed charges,,,609.54,95,,percent of total billed charges,,,532.54,83,,percent of total billed charges,,,532.54,83,,percent of total billed charges,,,,,,,,,,,,,,,532.54,83,,percent of total billed charges,,,609.54,95,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,526.13,82,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,545.38,85,,percent of total billed charges,,483.78,609.54,
STRYKER BURR  BARREL 5.5,30184034,CDM,,,270,RC,inpatient,,680.4,680.4,,577.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,513.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,578.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,598.75,88,,percent of total billed charges,,,,,,,,,519.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,619.16,91,,percent of total billed charges,,,646.38,95,,percent of total billed charges,,,564.73,83,,percent of total billed charges,,,564.73,83,,percent of total billed charges,,,,,,,,,,,,,,,564.73,83,,percent of total billed charges,,,646.38,95,,percent of total billed charges,,,612.36,90,,percent of total billed charges,,,612.36,90,,percent of total billed charges,,,557.93,82,,percent of total billed charges,,,612.36,90,,percent of total billed charges,,,578.34,85,,percent of total billed charges,,513.02,646.38,
S&N PERINEAL PAD SUPINE,30184035,CDM,,,270,RC,inpatient,,639.45,639.45,,542.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,482.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.72,88,,percent of total billed charges,,,,,,,,,488.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.9,91,,percent of total billed charges,,,607.48,95,,percent of total billed charges,,,530.74,83,,percent of total billed charges,,,530.74,83,,percent of total billed charges,,,,,,,,,,,,,,,530.74,83,,percent of total billed charges,,,607.48,95,,percent of total billed charges,,,575.51,90,,percent of total billed charges,,,575.51,90,,percent of total billed charges,,,524.35,82,,percent of total billed charges,,,575.51,90,,percent of total billed charges,,,543.53,85,,percent of total billed charges,,482.15,607.48,
S&N HIP PAC DISP.,30184036,CDM,,,270,RC,inpatient,,1808.63,1808.63,,1535.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1363.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1537.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1591.59,88,,percent of total billed charges,,,,,,,,,1381.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1645.85,91,,percent of total billed charges,,,1718.2,95,,percent of total billed charges,,,1501.16,83,,percent of total billed charges,,,1501.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1501.16,83,,percent of total billed charges,,,1718.2,95,,percent of total billed charges,,,1627.77,90,,percent of total billed charges,,,1627.77,90,,percent of total billed charges,,,1483.08,82,,percent of total billed charges,,,1627.77,90,,percent of total billed charges,,,1537.34,85,,percent of total billed charges,,1363.71,1718.2,
S&N BEAVER BLADE,30184037,CDM,,,270,RC,inpatient,,256.8,256.8,,218.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,193.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,218.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,225.98,88,,percent of total billed charges,,,,,,,,,196.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,233.69,91,,percent of total billed charges,,,243.96,95,,percent of total billed charges,,,213.14,83,,percent of total billed charges,,,213.14,83,,percent of total billed charges,,,,,,,,,,,,,,,213.14,83,,percent of total billed charges,,,243.96,95,,percent of total billed charges,,,231.12,90,,percent of total billed charges,,,231.12,90,,percent of total billed charges,,,210.58,82,,percent of total billed charges,,,231.12,90,,percent of total billed charges,,,218.28,85,,percent of total billed charges,,193.63,243.96,
S&N WAND 50 DEG CROSS RF-S,30184038,CDM,,,270,RC,inpatient,,1261,1261,,1070.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,950.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1071.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1109.68,88,,percent of total billed charges,,,,,,,,,963.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1147.51,91,,percent of total billed charges,,,1197.95,95,,percent of total billed charges,,,1046.63,83,,percent of total billed charges,,,1046.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1046.63,83,,percent of total billed charges,,,1197.95,95,,percent of total billed charges,,,1134.9,90,,percent of total billed charges,,,1134.9,90,,percent of total billed charges,,,1034.02,82,,percent of total billed charges,,,1134.9,90,,percent of total billed charges,,,1071.85,85,,percent of total billed charges,,950.79,1197.95,
S&N SUTURE ANCHOR KNOTLESS BIORAPTOR,30184039,CDM,,,270,RC,inpatient,,2736.83,2736.83,,2323.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2063.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2326.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2408.41,88,,percent of total billed charges,,,,,,,,,2090.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2490.52,91,,percent of total billed charges,,,2599.99,95,,percent of total billed charges,,,2271.57,83,,percent of total billed charges,,,2271.57,83,,percent of total billed charges,,,,,,,,,,,,,,,2271.57,83,,percent of total billed charges,,,2599.99,95,,percent of total billed charges,,,2463.15,90,,percent of total billed charges,,,2463.15,90,,percent of total billed charges,,,2244.2,82,,percent of total billed charges,,,2463.15,90,,percent of total billed charges,,,2326.31,85,,percent of total billed charges,,2063.57,2599.99,
S&N ULTRABRAID #2,30184040,CDM,,,270,RC,inpatient,,157.6,157.6,,133.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,118.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,133.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,138.69,88,,percent of total billed charges,,,,,,,,,120.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,143.42,91,,percent of total billed charges,,,149.72,95,,percent of total billed charges,,,130.81,83,,percent of total billed charges,,,130.81,83,,percent of total billed charges,,,,,,,,,,,,,,,130.81,83,,percent of total billed charges,,,149.72,95,,percent of total billed charges,,,141.84,90,,percent of total billed charges,,,141.84,90,,percent of total billed charges,,,129.23,82,,percent of total billed charges,,,141.84,90,,percent of total billed charges,,,133.96,85,,percent of total billed charges,,118.83,149.72,
S&N HIP CANNULA 7X90 CLEAR TRAC,30184041,CDM,,,270,RC,inpatient,,240.68,240.68,,204.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,181.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.8,88,,percent of total billed charges,,,,,,,,,183.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,219.02,91,,percent of total billed charges,,,228.65,95,,percent of total billed charges,,,199.76,83,,percent of total billed charges,,,199.76,83,,percent of total billed charges,,,,,,,,,,,,,,,199.76,83,,percent of total billed charges,,,228.65,95,,percent of total billed charges,,,216.61,90,,percent of total billed charges,,,216.61,90,,percent of total billed charges,,,197.36,82,,percent of total billed charges,,,216.61,90,,percent of total billed charges,,,204.58,85,,percent of total billed charges,,181.47,228.65,
DEPUY PINNACLE SHELL DPX REVISION 54MM,30184043,CDM,,,278,RC,inpatient,,33437.04,33437.04,,28388.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25211.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28421.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29424.6,88,,percent of total billed charges,,,,,,,,,25545.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30427.71,91,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,,,,,,,,,,,,,27752.74,83,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,27418.37,82,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,25211.53,31765.19,
DEPUY SCREW TF 5x60MM,30184044,CDM,,,278,RC,inpatient,,987.87,987.87,,838.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,744.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,839.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,869.33,88,,percent of total billed charges,,,,,,,,,754.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,898.96,91,,percent of total billed charges,,,938.48,95,,percent of total billed charges,,,819.93,83,,percent of total billed charges,,,819.93,83,,percent of total billed charges,,,,,,,,,,,,,,,819.93,83,,percent of total billed charges,,,938.48,95,,percent of total billed charges,,,889.08,90,,percent of total billed charges,,,889.08,90,,percent of total billed charges,,,810.05,82,,percent of total billed charges,,,889.08,90,,percent of total billed charges,,,839.69,85,,percent of total billed charges,,744.85,938.48,
DEPUY INSERT AOX CR SZ 6 6MM,30184047,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY ANCHOR PEG GLENOID SZ52,30184048,CDM,,,278,RC,inpatient,,17098.9,17098.9,,14516.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12892.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14534.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15047.03,88,,percent of total billed charges,,,,,,,,,13063.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15560,91,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,,,,,,,,,,,,,14192.09,83,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14021.1,82,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14534.07,85,,percent of total billed charges,,12892.57,16243.96,
ARTHREX IMPLANT SYSTEM BIO-COMP ACHILLES,30184049,CDM,,,278,RC,inpatient,,11310,11310,,9602.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8527.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9613.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9952.8,88,,percent of total billed charges,,,,,,,,,8640.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10292.1,91,,percent of total billed charges,,,10744.5,95,,percent of total billed charges,,,9387.3,83,,percent of total billed charges,,,9387.3,83,,percent of total billed charges,,,,,,,,,,,,,,,9387.3,83,,percent of total billed charges,,,10744.5,95,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,9274.2,82,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,9613.5,85,,percent of total billed charges,,8527.74,10744.5,
CROSSBOW FASCIAL CLOSTURE,30184051,CDM,,,270,RC,inpatient,,560,560,,475.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,422.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,476,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,492.8,88,,percent of total billed charges,,,,,,,,,427.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,509.6,91,,percent of total billed charges,,,532,95,,percent of total billed charges,,,464.8,83,,percent of total billed charges,,,464.8,83,,percent of total billed charges,,,,,,,,,,,,,,,464.8,83,,percent of total billed charges,,,532,95,,percent of total billed charges,,,504,90,,percent of total billed charges,,,504,90,,percent of total billed charges,,,459.2,82,,percent of total billed charges,,,504,90,,percent of total billed charges,,,476,85,,percent of total billed charges,,422.24,532,
TRI-FUNNEL REPLACEMENT GASTROSTOMY TUBE,30184052,CDM,,,270,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
CATH STRAIGHT FILIFORM TIP 3FR,30184053,CDM,,,270,RC,inpatient,,501.62,501.62,,425.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,378.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,426.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,441.43,88,,percent of total billed charges,,,,,,,,,383.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,456.47,91,,percent of total billed charges,,,476.54,95,,percent of total billed charges,,,416.34,83,,percent of total billed charges,,,416.34,83,,percent of total billed charges,,,,,,,,,,,,,,,416.34,83,,percent of total billed charges,,,476.54,95,,percent of total billed charges,,,451.46,90,,percent of total billed charges,,,451.46,90,,percent of total billed charges,,,411.33,82,,percent of total billed charges,,,451.46,90,,percent of total billed charges,,,426.38,85,,percent of total billed charges,,378.22,476.54,
SUTURE ETHIBOND EXCEL OS-4 30,30184059,CDM,,,270,RC,inpatient,,22.19,22.19,,18.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.53,88,,percent of total billed charges,,,,,,,,,16.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.19,91,,percent of total billed charges,,,21.08,95,,percent of total billed charges,,,18.42,83,,percent of total billed charges,,,18.42,83,,percent of total billed charges,,,,,,,,,,,,,,,18.42,83,,percent of total billed charges,,,21.08,95,,percent of total billed charges,,,19.97,90,,percent of total billed charges,,,19.97,90,,percent of total billed charges,,,18.2,82,,percent of total billed charges,,,19.97,90,,percent of total billed charges,,,18.86,85,,percent of total billed charges,,16.73,21.08,
DEPUY PINNACLE 100 CUP SECTOR II 52MM,30184070,CDM,,,278,RC,inpatient,,20679.88,20679.88,,17557.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15592.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17577.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18198.29,88,,percent of total billed charges,,,,,,,,,15799.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18818.69,91,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17164.3,83,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,16957.5,82,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,15592.63,19645.89,
DEPUY LINER CERAMIC CESAMAX 52X36,30184071,CDM,,,278,RC,inpatient,,18915.85,18915.85,,16059.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14262.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16078.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16645.95,88,,percent of total billed charges,,,,,,,,,14451.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17213.42,91,,percent of total billed charges,,,17970.06,95,,percent of total billed charges,,,15700.16,83,,percent of total billed charges,,,15700.16,83,,percent of total billed charges,,,,,,,,,,,,,,,15700.16,83,,percent of total billed charges,,,17970.06,95,,percent of total billed charges,,,17024.27,90,,percent of total billed charges,,,17024.27,90,,percent of total billed charges,,,15511,82,,percent of total billed charges,,,17024.27,90,,percent of total billed charges,,,16078.47,85,,percent of total billed charges,,14262.55,17970.06,
LEXION PNEUVIEW XE,30184076,CDM,,,270,RC,inpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,120.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,120.64,152,
SYNTHES SCREW CORTEX S-T 2.7X10MM,30184078,CDM,,,278,RC,inpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,314.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,354.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,314.04,395.68,
SYNTHES SCREW CORTEX S-T 2.7X12MM,30184079,CDM,,,278,RC,inpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,333.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,375.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,333.15,419.75,
SYNTHES SCREW CORTEX S-T 2.7X26MM,30184081,CDM,,,278,RC,inpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,333.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,375.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,333.15,419.75,
SYNTHES SCREW CORTEX S-T 2.7X28MM,30184082,CDM,,,278,RC,inpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,333.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,375.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,333.15,419.75,
SYNTHES SCREW CORTEX S-T 2.7X30MM,30184083,CDM,,,278,RC,inpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,314.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,354.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,314.04,395.68,
SYNTHES SCREW CORTEX S-T 2.7X32MM,30184084,CDM,,,278,RC,inpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,314.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,354.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,314.04,395.68,
SYNTHES SCREW CORTEX S-T 2.7X34MM,30184085,CDM,,,278,RC,inpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,314.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,354.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,314.04,395.68,
SYNTHES SCREW CORTEX S-T 2.7X36MM,30184086,CDM,,,278,RC,inpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,333.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,375.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,333.15,419.75,
SYNTHES SCREW CORTEX S-T 2.7X38MM,30184087,CDM,,,278,RC,inpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,333.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,375.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,333.15,419.75,
SYNTHES SCREW CORTEX S-T 2.7X40MM,30184088,CDM,,,278,RC,inpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,314.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,354.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,314.04,395.68,
SYNTHES SCREW CORTEX S-T 2.7X45MM,30184089,CDM,,,278,RC,inpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,314.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,354.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,314.04,395.68,
SYNTHES SCREW CORTEX S-T 2.7X50MM,30184090,CDM,,,278,RC,inpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,314.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,354.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,314.04,395.68,
SYNTHES SCREW CORTEX S-T 2.7X55MM,30184091,CDM,,,278,RC,inpatient,,481.95,481.95,,409.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,363.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,409.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,424.12,88,,percent of total billed charges,,,,,,,,,368.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,438.57,91,,percent of total billed charges,,,457.85,95,,percent of total billed charges,,,400.02,83,,percent of total billed charges,,,400.02,83,,percent of total billed charges,,,,,,,,,,,,,,,400.02,83,,percent of total billed charges,,,457.85,95,,percent of total billed charges,,,433.76,90,,percent of total billed charges,,,433.76,90,,percent of total billed charges,,,395.2,82,,percent of total billed charges,,,433.76,90,,percent of total billed charges,,,409.66,85,,percent of total billed charges,,363.39,457.85,
SYNTHES SCREW LOCKING S-T 2.7X24MM W/STA,30184092,CDM,,,278,RC,inpatient,,1143.87,1143.87,,971.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,862.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,972.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1006.61,88,,percent of total billed charges,,,,,,,,,873.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1040.92,91,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,,,,,,,,,,,,,949.41,83,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,937.97,82,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,972.29,85,,percent of total billed charges,,862.48,1086.68,
SYNTHES SCREW LOCKING S-T 2.7X26MM W/STA,30184093,CDM,,,278,RC,inpatient,,1143.87,1143.87,,971.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,862.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,972.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1006.61,88,,percent of total billed charges,,,,,,,,,873.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1040.92,91,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,,,,,,,,,,,,,949.41,83,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,937.97,82,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,972.29,85,,percent of total billed charges,,862.48,1086.68,
SYNTHES SCREW CANCELLOUS 4X5MM,30184095,CDM,,,278,RC,inpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,178.47,224.87,
SYNTHES SCREW CANN. 4X12MM SHORT THREAD,30184096,CDM,,,278,RC,inpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1466.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1653.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,1466.38,1847.56,
SYNTHES SCREW CANN. 4X14MM SHORT THREAD,30184097,CDM,,,278,RC,inpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1466.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1653.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,1466.38,1847.56,
SYNTHES SCREW CANN. 4X20MM SHORT THREAD,30184098,CDM,,,278,RC,inpatient,,2063.23,2063.23,,1751.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1555.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1753.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1815.64,88,,percent of total billed charges,,,,,,,,,1576.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1877.54,91,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1712.48,83,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1691.85,82,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,1555.68,1960.07,
SYNTHES SCREW CANN. 6.5X30MM 16MM THREAD,30184099,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X35MM 16MM THREAD,30184100,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X40MM 16MM THREAD,30184101,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X45MM 16MM THREAD,30184102,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X90MM 16MM THREAD,30184103,CDM,,,278,RC,inpatient,,2696.27,2696.27,,2289.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2032.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2291.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2372.72,88,,percent of total billed charges,,,,,,,,,2059.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2453.61,91,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2237.9,83,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2210.94,82,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,2032.99,2561.46,
SYNTHES SCREW CANN. 6.5X95MM 16MM THREAD,30184104,CDM,,,278,RC,inpatient,,2696.27,2696.27,,2289.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2032.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2291.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2372.72,88,,percent of total billed charges,,,,,,,,,2059.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2453.61,91,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2237.9,83,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2210.94,82,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,2032.99,2561.46,
SYNTHES SCREW CANN. 6.5X105MM 16MM THRE,30184105,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X110MM 16MM THRE,30184106,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X115MM 16MM THRE,30184107,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X120MM 16MM THRE,30184108,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X125MM 16MM THRE,30184109,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X130MM 16MM THRE,30184110,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X50MM 32MM THRE,30184111,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X55MM 32MM THREAD,30184112,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X95MM 32MM THRE,30184113,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X100MM 32MM THRE,30184114,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X100MM 32MM THRE,30184115,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X110MM 32MM THRE,30184116,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X115MM 32MM THRE,30184117,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X120MM 32MM THRE,30184118,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X125MM 32MM THRE,30184119,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANN. 6.5X130MM 32MM THRE,30184120,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW LOCKING S-T 3.5X55MM W/STA,30184122,CDM,,,278,RC,inpatient,,1182.35,1182.35,,1003.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,891.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1005,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1040.47,88,,percent of total billed charges,,,,,,,,,903.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1075.94,91,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,,,,,,,,,,,,,981.35,83,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,969.53,82,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1005,85,,percent of total billed charges,,891.49,1123.23,
SYNTHES SCREW CORTEX S-T 4.5X22MM,30184123,CDM,,,278,RC,inpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,222.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,197.08,248.31,
SYNTHES SCREW CORTEX S-T 4.5X24MM,30184124,CDM,,,278,RC,inpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,222.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,197.08,248.31,
SYNTHES SCREW CORTEX S-T 4.5X26MM,30184125,CDM,,,278,RC,inpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,222.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,197.08,248.31,
SYNTHES SCREW CORTEX S-T 4.5X58MM,30184126,CDM,,,278,RC,inpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,222.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,197.08,248.31,
SYNTHES SCREW CANCELLOUS 6.5X45MM 16MM T,30184134,CDM,,,278,RC,inpatient,,916.5,916.5,,778.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,691.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,779.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,806.52,88,,percent of total billed charges,,,,,,,,,700.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,834.02,91,,percent of total billed charges,,,870.68,95,,percent of total billed charges,,,760.7,83,,percent of total billed charges,,,760.7,83,,percent of total billed charges,,,,,,,,,,,,,,,760.7,83,,percent of total billed charges,,,870.68,95,,percent of total billed charges,,,824.85,90,,percent of total billed charges,,,824.85,90,,percent of total billed charges,,,751.53,82,,percent of total billed charges,,,824.85,90,,percent of total billed charges,,,779.03,85,,percent of total billed charges,,691.04,870.68,
SYNTHES SCREW CANCELLOUS 6.5X50MM 16MM T,30184135,CDM,,,278,RC,inpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,296.1,373.07,
SYNTHES SCREW CANCELLOUS 6.5X55MM 16MM T,30184136,CDM,,,278,RC,inpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,296.1,373.07,
SYNTHES SCREW CANCELLOUS 6.5X60MM 16MM T,30184137,CDM,,,278,RC,inpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,296.1,373.07,
SYNTHES SCREW CANCELLOUS 6.5X65MM 16MM T,30184138,CDM,,,278,RC,inpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,296.1,373.07,
SYNTHES SCREW CANCELLOUS 6.5X70MM 16MM T,30184139,CDM,,,278,RC,inpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,296.1,373.07,
SYNTHES SCREW CANCELLOUS 6.5X75MM 16MM T,30184140,CDM,,,278,RC,inpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,296.1,373.07,
SYNTHES SCREW CANCELLOUS 6.5X80MM 16MM T,30184141,CDM,,,278,RC,inpatient,,416.64,416.64,,353.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,314.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,354.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,366.64,88,,percent of total billed charges,,,,,,,,,318.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,379.14,91,,percent of total billed charges,,,395.81,95,,percent of total billed charges,,,345.81,83,,percent of total billed charges,,,345.81,83,,percent of total billed charges,,,,,,,,,,,,,,,345.81,83,,percent of total billed charges,,,395.81,95,,percent of total billed charges,,,374.98,90,,percent of total billed charges,,,374.98,90,,percent of total billed charges,,,341.64,82,,percent of total billed charges,,,374.98,90,,percent of total billed charges,,,354.14,85,,percent of total billed charges,,314.15,395.81,
SYNTHES SCREW CANCELLOUS 6.5X85MM 16MM T,30184142,CDM,,,278,RC,inpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,323.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,364.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,323.01,406.98,
SYNTHES SCREW CANCELLOUS 6.5X90MM 16MM T,30184143,CDM,,,278,RC,inpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,323.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,364.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,323.01,406.98,
SYNTHES SCREW CANCELLOUS 6.5X100MM 16MM,30184144,CDM,,,278,RC,inpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,323.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,364.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,323.01,406.98,
SYNTHES SCREW CANCELLOUS 6.5X105MM 16MM,30184145,CDM,,,278,RC,inpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,323.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,364.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,323.01,406.98,
SYNTHES SCREW CANCELLOUS 6.5X110MM 16MM,30184146,CDM,,,278,RC,inpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,323.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,364.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,323.01,406.98,
SYNTHES PLATE LCP 9 HOLE 3.5X124MM,30184147,CDM,,,278,RC,inpatient,,3326.05,3326.05,,2823.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2507.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2827.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2926.92,88,,percent of total billed charges,,,,,,,,,2541.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3026.71,91,,percent of total billed charges,,,3159.75,95,,percent of total billed charges,,,2760.62,83,,percent of total billed charges,,,2760.62,83,,percent of total billed charges,,,,,,,,,,,,,,,2760.62,83,,percent of total billed charges,,,3159.75,95,,percent of total billed charges,,,2993.45,90,,percent of total billed charges,,,2993.45,90,,percent of total billed charges,,,2727.36,82,,percent of total billed charges,,,2993.45,90,,percent of total billed charges,,,2827.14,85,,percent of total billed charges,,2507.84,3159.75,
SYNTHES PLATE LCP 10 HOLE 3.5X137MM,30184148,CDM,,,278,RC,inpatient,,3528.27,3528.27,,2995.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2660.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2999.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3104.88,88,,percent of total billed charges,,,,,,,,,2695.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3210.73,91,,percent of total billed charges,,,3351.86,95,,percent of total billed charges,,,2928.46,83,,percent of total billed charges,,,2928.46,83,,percent of total billed charges,,,,,,,,,,,,,,,2928.46,83,,percent of total billed charges,,,3351.86,95,,percent of total billed charges,,,3175.44,90,,percent of total billed charges,,,3175.44,90,,percent of total billed charges,,,2893.18,82,,percent of total billed charges,,,3175.44,90,,percent of total billed charges,,,2999.03,85,,percent of total billed charges,,2660.32,3351.86,
SYNTHES PLATE LCP 12 HOLE 3.5X163MM,30184149,CDM,,,278,RC,inpatient,,3779.1,3779.1,,3208.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2849.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3212.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3325.61,88,,percent of total billed charges,,,,,,,,,2887.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3438.98,91,,percent of total billed charges,,,3590.15,95,,percent of total billed charges,,,3136.65,83,,percent of total billed charges,,,3136.65,83,,percent of total billed charges,,,,,,,,,,,,,,,3136.65,83,,percent of total billed charges,,,3590.15,95,,percent of total billed charges,,,3401.19,90,,percent of total billed charges,,,3401.19,90,,percent of total billed charges,,,3098.86,82,,percent of total billed charges,,,3401.19,90,,percent of total billed charges,,,3212.24,85,,percent of total billed charges,,2849.44,3590.15,
SYNTHES PLATE LCP 14 HOLE 3.5X189MM,30184150,CDM,,,278,RC,inpatient,,5668.65,5668.65,,4812.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4274.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4818.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4988.41,88,,percent of total billed charges,,,,,,,,,4330.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5158.47,91,,percent of total billed charges,,,5385.22,95,,percent of total billed charges,,,4704.98,83,,percent of total billed charges,,,4704.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4704.98,83,,percent of total billed charges,,,5385.22,95,,percent of total billed charges,,,5101.79,90,,percent of total billed charges,,,5101.79,90,,percent of total billed charges,,,4648.29,82,,percent of total billed charges,,,5101.79,90,,percent of total billed charges,,,4818.35,85,,percent of total billed charges,,4274.16,5385.22,
SYNTHES SCREW CANCELLOUS 6.5X45MM 32MM T,30184151,CDM,,,278,RC,inpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,296.1,373.07,
SYNTHES SCREW CANCELLOUS 6.5X65MM 32MM T,30184152,CDM,,,278,RC,inpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,296.1,373.07,
SYNTHES SCREW CANCELLOUS 6.5X70MM 32MM T,30184153,CDM,,,278,RC,inpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,296.1,373.07,
SYNTHES SCREW CANCELLOUS 6.5X75MM 32MM T,30184154,CDM,,,278,RC,inpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,296.1,373.07,
SYNTHES SCREW CANCELLOUS 6.5X80MM 32MM T,30184155,CDM,,,278,RC,inpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,296.1,373.07,
SYNTHES SCREW CANCELLOUS 6.5X85MM 32MM T,30184156,CDM,,,278,RC,inpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,323.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,364.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,323.01,406.98,
SYNTHES SCREW CANCELLOUS 6.5X90MM 32MM T,30184157,CDM,,,278,RC,inpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,323.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,364.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,323.01,406.98,
SYNTHES SCREW CANCELLOUS 6.5X95MM 32MM T,30184158,CDM,,,278,RC,inpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,323.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,364.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,323.01,406.98,
SYNTHES SCREW CANCELLOUS 6.5X100MM 32MM,30184159,CDM,,,278,RC,inpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,323.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,364.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,323.01,406.98,
SYNTHES SCREW CANCELLOUS 6.5X110MM 32MM,30184161,CDM,,,278,RC,inpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,323.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,364.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,323.01,406.98,
SYNTHES SCREW CANCELLOUS 6.5X30MM FULLY,30184162,CDM,,,278,RC,inpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,296.1,373.07,
SYNTHES SCREW LOCKING S-T 4X16MM,30184163,CDM,,,278,RC,inpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1012.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1141.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,1012.31,1275.45,
SYNTHES SCREW LOCKING S-T 4X18MM,30184164,CDM,,,278,RC,inpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1012.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1141.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,1012.31,1275.45,
SYNTHES SCREW LOCKING S-T 4X22MM,30184165,CDM,,,278,RC,inpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1012.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1141.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,1012.31,1275.45,
SYNTHES SCREW LOCKING S-T 4X46MM,30184166,CDM,,,278,RC,inpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1012.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1141.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,1012.31,1275.45,
SYNTHES SCREW LOCKING S-T 4X50MM,30184167,CDM,,,278,RC,inpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1012.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1141.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,1012.31,1275.45,
SYNTHES SCREW LOCKING S-T 4X54MM,30184168,CDM,,,278,RC,inpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1012.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1141.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,1012.31,1275.45,
SYNTHES SCREW LOCKING S-T 4X58MM,30184169,CDM,,,278,RC,inpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1012.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1141.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,1012.31,1275.45,
SYNTHES SCREW LOCKING S-T 4X62MM,30184170,CDM,,,278,RC,inpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1012.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1141.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,1012.31,1275.45,
SYNTHES PLATE LCP 4 HOLE 3.5X112MM RIGHT,30184171,CDM,,,278,RC,inpatient,,10199.15,10199.15,,8659.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7690.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8669.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8975.25,88,,percent of total billed charges,,,,,,,,,7792.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9281.23,91,,percent of total billed charges,,,9689.19,95,,percent of total billed charges,,,8465.29,83,,percent of total billed charges,,,8465.29,83,,percent of total billed charges,,,,,,,,,,,,,,,8465.29,83,,percent of total billed charges,,,9689.19,95,,percent of total billed charges,,,9179.24,90,,percent of total billed charges,,,9179.24,90,,percent of total billed charges,,,8363.3,82,,percent of total billed charges,,,9179.24,90,,percent of total billed charges,,,8669.28,85,,percent of total billed charges,,7690.16,9689.19,
SYNTHES PLATE LCP 4 HOLE 3.5X112MM LEFT,30184172,CDM,,,278,RC,inpatient,,10199.15,10199.15,,8659.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7690.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8669.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8975.25,88,,percent of total billed charges,,,,,,,,,7792.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9281.23,91,,percent of total billed charges,,,9689.19,95,,percent of total billed charges,,,8465.29,83,,percent of total billed charges,,,8465.29,83,,percent of total billed charges,,,,,,,,,,,,,,,8465.29,83,,percent of total billed charges,,,9689.19,95,,percent of total billed charges,,,9179.24,90,,percent of total billed charges,,,9179.24,90,,percent of total billed charges,,,8363.3,82,,percent of total billed charges,,,9179.24,90,,percent of total billed charges,,,8669.28,85,,percent of total billed charges,,7690.16,9689.19,
SYNTHES PLATE LCP 2 HOLE 3.5X86MM RIGHT,30184173,CDM,,,278,RC,inpatient,,9773.73,9773.73,,8297.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7369.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8307.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8600.88,88,,percent of total billed charges,,,,,,,,,7467.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8894.09,91,,percent of total billed charges,,,9285.04,95,,percent of total billed charges,,,8112.2,83,,percent of total billed charges,,,8112.2,83,,percent of total billed charges,,,,,,,,,,,,,,,8112.2,83,,percent of total billed charges,,,9285.04,95,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8014.46,82,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8307.67,85,,percent of total billed charges,,7369.39,9285.04,
SYNTHES PLATE LCP 2 HOLE 3.5X86MM LEFT,30184174,CDM,,,278,RC,inpatient,,9773.73,9773.73,,8297.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7369.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8307.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8600.88,88,,percent of total billed charges,,,,,,,,,7467.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8894.09,91,,percent of total billed charges,,,9285.04,95,,percent of total billed charges,,,8112.2,83,,percent of total billed charges,,,8112.2,83,,percent of total billed charges,,,,,,,,,,,,,,,8112.2,83,,percent of total billed charges,,,9285.04,95,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8014.46,82,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8307.67,85,,percent of total billed charges,,7369.39,9285.04,
SYNTHES PLATE LCP RECON. 3.5X84MM 6 HOLE,30184175,CDM,,,278,RC,inpatient,,4958.79,4958.79,,4210.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3738.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4214.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4363.74,88,,percent of total billed charges,,,,,,,,,3788.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4512.5,91,,percent of total billed charges,,,4710.85,95,,percent of total billed charges,,,4115.8,83,,percent of total billed charges,,,4115.8,83,,percent of total billed charges,,,,,,,,,,,,,,,4115.8,83,,percent of total billed charges,,,4710.85,95,,percent of total billed charges,,,4462.91,90,,percent of total billed charges,,,4462.91,90,,percent of total billed charges,,,4066.21,82,,percent of total billed charges,,,4462.91,90,,percent of total billed charges,,,4214.97,85,,percent of total billed charges,,3738.93,4710.85,
SYNTHES PLATE LCP RECON. 3.5X140MM 10HOL,30184176,CDM,,,278,RC,inpatient,,5304,5304,,4503.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3999.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4508.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4667.52,88,,percent of total billed charges,,,,,,,,,4052.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4826.64,91,,percent of total billed charges,,,5038.8,95,,percent of total billed charges,,,4402.32,83,,percent of total billed charges,,,4402.32,83,,percent of total billed charges,,,,,,,,,,,,,,,4402.32,83,,percent of total billed charges,,,5038.8,95,,percent of total billed charges,,,4773.6,90,,percent of total billed charges,,,4773.6,90,,percent of total billed charges,,,4349.28,82,,percent of total billed charges,,,4773.6,90,,percent of total billed charges,,,4508.4,85,,percent of total billed charges,,3999.22,5038.8,
SYNTHES T-PLATE LCP OBLIQE RT 3.5X63,30184177,CDM,,,278,RC,inpatient,,3464.18,3464.18,,2941.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2611.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2944.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3048.48,88,,percent of total billed charges,,,,,,,,,2646.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3152.4,91,,percent of total billed charges,,,3290.97,95,,percent of total billed charges,,,2875.27,83,,percent of total billed charges,,,2875.27,83,,percent of total billed charges,,,,,,,,,,,,,,,2875.27,83,,percent of total billed charges,,,3290.97,95,,percent of total billed charges,,,3117.76,90,,percent of total billed charges,,,3117.76,90,,percent of total billed charges,,,2840.63,82,,percent of total billed charges,,,3117.76,90,,percent of total billed charges,,,2944.55,85,,percent of total billed charges,,2611.99,3290.97,
SYNTHES T-PLATE LCP OBLIQUE RT 3.5X74,30184178,CDM,,,278,RC,inpatient,,3618.88,3618.88,,3072.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2728.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3076.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3184.61,88,,percent of total billed charges,,,,,,,,,2764.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3293.18,91,,percent of total billed charges,,,3437.94,95,,percent of total billed charges,,,3003.67,83,,percent of total billed charges,,,3003.67,83,,percent of total billed charges,,,,,,,,,,,,,,,3003.67,83,,percent of total billed charges,,,3437.94,95,,percent of total billed charges,,,3256.99,90,,percent of total billed charges,,,3256.99,90,,percent of total billed charges,,,2967.48,82,,percent of total billed charges,,,3256.99,90,,percent of total billed charges,,,3076.05,85,,percent of total billed charges,,2728.64,3437.94,
SYNTHES T-PLATE LCP OBLIQUE RT 3.5X96,30184179,CDM,,,278,RC,inpatient,,3928.28,3928.28,,3335.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2961.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3339.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3456.89,88,,percent of total billed charges,,,,,,,,,3001.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3574.73,91,,percent of total billed charges,,,3731.87,95,,percent of total billed charges,,,3260.47,83,,percent of total billed charges,,,3260.47,83,,percent of total billed charges,,,,,,,,,,,,,,,3260.47,83,,percent of total billed charges,,,3731.87,95,,percent of total billed charges,,,3535.45,90,,percent of total billed charges,,,3535.45,90,,percent of total billed charges,,,3221.19,82,,percent of total billed charges,,,3535.45,90,,percent of total billed charges,,,3339.04,85,,percent of total billed charges,,2961.92,3731.87,
SYNTHES T-PLATE LCP OBLIQUE LT 3.5X52MM,30184180,CDM,,,278,RC,inpatient,,3320.53,3320.53,,2819.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2503.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2822.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2922.07,88,,percent of total billed charges,,,,,,,,,2536.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3021.68,91,,percent of total billed charges,,,3154.5,95,,percent of total billed charges,,,2756.04,83,,percent of total billed charges,,,2756.04,83,,percent of total billed charges,,,,,,,,,,,,,,,2756.04,83,,percent of total billed charges,,,3154.5,95,,percent of total billed charges,,,2988.48,90,,percent of total billed charges,,,2988.48,90,,percent of total billed charges,,,2722.83,82,,percent of total billed charges,,,2988.48,90,,percent of total billed charges,,,2822.45,85,,percent of total billed charges,,2503.68,3154.5,
SYNTHES T-PLATE LCP OBLIQUE LT 3.5X63MM,30184181,CDM,,,278,RC,inpatient,,3475.23,3475.23,,2950.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2620.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2953.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3058.2,88,,percent of total billed charges,,,,,,,,,2655.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3162.46,91,,percent of total billed charges,,,3301.47,95,,percent of total billed charges,,,2884.44,83,,percent of total billed charges,,,2884.44,83,,percent of total billed charges,,,,,,,,,,,,,,,2884.44,83,,percent of total billed charges,,,3301.47,95,,percent of total billed charges,,,3127.71,90,,percent of total billed charges,,,3127.71,90,,percent of total billed charges,,,2849.69,82,,percent of total billed charges,,,3127.71,90,,percent of total billed charges,,,2953.95,85,,percent of total billed charges,,2620.32,3301.47,
SYNTHES T-PLATE LCP OBLIQUE LT 3.5X74MM,30184182,CDM,,,278,RC,inpatient,,3629.93,3629.93,,3081.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2736.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3085.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3194.34,88,,percent of total billed charges,,,,,,,,,2773.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3303.24,91,,percent of total billed charges,,,3448.43,95,,percent of total billed charges,,,3012.84,83,,percent of total billed charges,,,3012.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3012.84,83,,percent of total billed charges,,,3448.43,95,,percent of total billed charges,,,3266.94,90,,percent of total billed charges,,,3266.94,90,,percent of total billed charges,,,2976.54,82,,percent of total billed charges,,,3266.94,90,,percent of total billed charges,,,3085.44,85,,percent of total billed charges,,2736.97,3448.43,
SYNTHES T-PLATE LCP OBLIQUE LT 3.5X96MM,30184183,CDM,,,278,RC,inpatient,,3933.8,3933.8,,3339.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2966.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3343.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3461.74,88,,percent of total billed charges,,,,,,,,,3005.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3579.76,91,,percent of total billed charges,,,3737.11,95,,percent of total billed charges,,,3265.05,83,,percent of total billed charges,,,3265.05,83,,percent of total billed charges,,,,,,,,,,,,,,,3265.05,83,,percent of total billed charges,,,3737.11,95,,percent of total billed charges,,,3540.42,90,,percent of total billed charges,,,3540.42,90,,percent of total billed charges,,,3225.72,82,,percent of total billed charges,,,3540.42,90,,percent of total billed charges,,,3343.73,85,,percent of total billed charges,,2966.09,3737.11,
SYNTHES T-PLATE LCP RT ANGLE 3.5X56MM 4H,30184184,CDM,,,278,RC,inpatient,,3055.33,3055.33,,2593.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2303.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2597.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2688.69,88,,percent of total billed charges,,,,,,,,,2334.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2780.35,91,,percent of total billed charges,,,2902.56,95,,percent of total billed charges,,,2535.92,83,,percent of total billed charges,,,2535.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2535.92,83,,percent of total billed charges,,,2902.56,95,,percent of total billed charges,,,2749.8,90,,percent of total billed charges,,,2749.8,90,,percent of total billed charges,,,2505.37,82,,percent of total billed charges,,,2749.8,90,,percent of total billed charges,,,2597.03,85,,percent of total billed charges,,2303.72,2902.56,
SYNTHES T-PLATE LCP RT ANGLE 3.5X78MM 6H,30184185,CDM,,,278,RC,inpatient,,3911.7,3911.7,,3321.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2949.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3324.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3442.3,88,,percent of total billed charges,,,,,,,,,2988.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3559.65,91,,percent of total billed charges,,,3716.12,95,,percent of total billed charges,,,3246.71,83,,percent of total billed charges,,,3246.71,83,,percent of total billed charges,,,,,,,,,,,,,,,3246.71,83,,percent of total billed charges,,,3716.12,95,,percent of total billed charges,,,3520.53,90,,percent of total billed charges,,,3520.53,90,,percent of total billed charges,,,3207.59,82,,percent of total billed charges,,,3520.53,90,,percent of total billed charges,,,3324.95,85,,percent of total billed charges,,2949.42,3716.12,
SYNTHES T-PLATE LCP RT ANGLE 3.5X87MM 7H,30184186,CDM,,,278,RC,inpatient,,4895.15,4895.15,,4155.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3690.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4160.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4307.73,88,,percent of total billed charges,,,,,,,,,3739.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4454.59,91,,percent of total billed charges,,,4650.39,95,,percent of total billed charges,,,4062.97,83,,percent of total billed charges,,,4062.97,83,,percent of total billed charges,,,,,,,,,,,,,,,4062.97,83,,percent of total billed charges,,,4650.39,95,,percent of total billed charges,,,4405.64,90,,percent of total billed charges,,,4405.64,90,,percent of total billed charges,,,4014.02,82,,percent of total billed charges,,,4405.64,90,,percent of total billed charges,,,4160.88,85,,percent of total billed charges,,3690.94,4650.39,
SYNTHES PLATE PROX. FEMUR LCP 4.5X133 2H,30184187,CDM,,,278,RC,inpatient,,16536.33,16536.33,,14039.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12468.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14055.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14551.97,88,,percent of total billed charges,,,,,,,,,12633.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15048.06,91,,percent of total billed charges,,,15709.51,95,,percent of total billed charges,,,13725.15,83,,percent of total billed charges,,,13725.15,83,,percent of total billed charges,,,,,,,,,,,,,,,13725.15,83,,percent of total billed charges,,,15709.51,95,,percent of total billed charges,,,14882.7,90,,percent of total billed charges,,,14882.7,90,,percent of total billed charges,,,13559.79,82,,percent of total billed charges,,,14882.7,90,,percent of total billed charges,,,14055.88,85,,percent of total billed charges,,12468.39,15709.51,
SYNTHES PLATE PROX. FEMUR LCP 4.5X169 4H,30184188,CDM,,,278,RC,inpatient,,16762.85,16762.85,,14231.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12639.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14248.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14751.31,88,,percent of total billed charges,,,,,,,,,12806.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15254.19,91,,percent of total billed charges,,,15924.71,95,,percent of total billed charges,,,13913.17,83,,percent of total billed charges,,,13913.17,83,,percent of total billed charges,,,,,,,,,,,,,,,13913.17,83,,percent of total billed charges,,,15924.71,95,,percent of total billed charges,,,15086.57,90,,percent of total billed charges,,,15086.57,90,,percent of total billed charges,,,13745.54,82,,percent of total billed charges,,,15086.57,90,,percent of total billed charges,,,14248.42,85,,percent of total billed charges,,12639.19,15924.71,
SYNTHES PLATE PROX. FEMUR LCP 4.5X205 6H,30184189,CDM,,,278,RC,inpatient,,17033.58,17033.58,,14461.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12843.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14478.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14989.55,88,,percent of total billed charges,,,,,,,,,13013.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15500.56,91,,percent of total billed charges,,,16181.9,95,,percent of total billed charges,,,14137.87,83,,percent of total billed charges,,,14137.87,83,,percent of total billed charges,,,,,,,,,,,,,,,14137.87,83,,percent of total billed charges,,,16181.9,95,,percent of total billed charges,,,15330.22,90,,percent of total billed charges,,,15330.22,90,,percent of total billed charges,,,13967.54,82,,percent of total billed charges,,,15330.22,90,,percent of total billed charges,,,14478.54,85,,percent of total billed charges,,12843.32,16181.9,
SYNTHES PLATE PROX. FEMUR LCP 4.5X241 8H,30184190,CDM,,,278,RC,inpatient,,17657.9,17657.9,,14991.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13314.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15009.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15538.95,88,,percent of total billed charges,,,,,,,,,13490.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16068.69,91,,percent of total billed charges,,,16775.01,95,,percent of total billed charges,,,14656.06,83,,percent of total billed charges,,,14656.06,83,,percent of total billed charges,,,,,,,,,,,,,,,14656.06,83,,percent of total billed charges,,,16775.01,95,,percent of total billed charges,,,15892.11,90,,percent of total billed charges,,,15892.11,90,,percent of total billed charges,,,14479.48,82,,percent of total billed charges,,,15892.11,90,,percent of total billed charges,,,15009.22,85,,percent of total billed charges,,13314.06,16775.01,
SYNTHES PLATE PROX. FEMUR LCP 4.5X313 12,30184192,CDM,,,278,RC,inpatient,,19166.23,19166.23,,16272.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14451.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16291.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16866.28,88,,percent of total billed charges,,,,,,,,,14643,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17441.27,91,,percent of total billed charges,,,18207.92,95,,percent of total billed charges,,,15907.97,83,,percent of total billed charges,,,15907.97,83,,percent of total billed charges,,,,,,,,,,,,,,,15907.97,83,,percent of total billed charges,,,18207.92,95,,percent of total billed charges,,,17249.61,90,,percent of total billed charges,,,17249.61,90,,percent of total billed charges,,,15716.31,82,,percent of total billed charges,,,17249.61,90,,percent of total billed charges,,,16291.3,85,,percent of total billed charges,,14451.34,18207.92,
SYNTHES PLATE PROX. FEMUR LCP 4.5X349 14,30184193,CDM,,,278,RC,inpatient,,19392.75,19392.75,,16464.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14622.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16483.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17065.62,88,,percent of total billed charges,,,,,,,,,14816.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17647.4,91,,percent of total billed charges,,,18423.11,95,,percent of total billed charges,,,16095.98,83,,percent of total billed charges,,,16095.98,83,,percent of total billed charges,,,,,,,,,,,,,,,16095.98,83,,percent of total billed charges,,,18423.11,95,,percent of total billed charges,,,17453.48,90,,percent of total billed charges,,,17453.48,90,,percent of total billed charges,,,15902.06,82,,percent of total billed charges,,,17453.48,90,,percent of total billed charges,,,16483.84,85,,percent of total billed charges,,14622.13,18423.11,
SYNTHES PLATE PROX. FEMUR LCP 4.5X385 16,30184194,CDM,,,278,RC,inpatient,,20033.65,20033.65,,17008.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15105.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17028.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17629.61,88,,percent of total billed charges,,,,,,,,,15305.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18230.62,91,,percent of total billed charges,,,19031.97,95,,percent of total billed charges,,,16627.93,83,,percent of total billed charges,,,16627.93,83,,percent of total billed charges,,,,,,,,,,,,,,,16627.93,83,,percent of total billed charges,,,19031.97,95,,percent of total billed charges,,,18030.29,90,,percent of total billed charges,,,18030.29,90,,percent of total billed charges,,,16427.59,82,,percent of total billed charges,,,18030.29,90,,percent of total billed charges,,,17028.6,85,,percent of total billed charges,,15105.37,19031.97,
SYNTHES PLATE PROX. FEMUR LCP 4.5X421 18,30184195,CDM,,,278,RC,inpatient,,20674.55,20674.55,,17552.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15588.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17573.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18193.6,88,,percent of total billed charges,,,,,,,,,15795.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18813.84,91,,percent of total billed charges,,,19640.82,95,,percent of total billed charges,,,17159.88,83,,percent of total billed charges,,,17159.88,83,,percent of total billed charges,,,,,,,,,,,,,,,17159.88,83,,percent of total billed charges,,,19640.82,95,,percent of total billed charges,,,18607.1,90,,percent of total billed charges,,,18607.1,90,,percent of total billed charges,,,16953.13,82,,percent of total billed charges,,,18607.1,90,,percent of total billed charges,,,17573.37,85,,percent of total billed charges,,15588.61,19640.82,
SYNTHES CERCLAGE POSITIONING PIN 4.5MM,30184196,CDM,,,278,RC,inpatient,,1792.57,1792.57,,1521.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1351.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1523.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1577.46,88,,percent of total billed charges,,,,,,,,,1369.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1631.24,91,,percent of total billed charges,,,1702.94,95,,percent of total billed charges,,,1487.83,83,,percent of total billed charges,,,1487.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1487.83,83,,percent of total billed charges,,,1702.94,95,,percent of total billed charges,,,1613.31,90,,percent of total billed charges,,,1613.31,90,,percent of total billed charges,,,1469.91,82,,percent of total billed charges,,,1613.31,90,,percent of total billed charges,,,1523.68,85,,percent of total billed charges,,1351.6,1702.94,
SYNTHES PLATE LCP CURVED 4.5X247MM 13HOL,30184197,CDM,,,278,RC,inpatient,,7077.53,7077.53,,6008.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5336.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6015.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6228.23,88,,percent of total billed charges,,,,,,,,,5407.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6440.55,91,,percent of total billed charges,,,6723.65,95,,percent of total billed charges,,,5874.35,83,,percent of total billed charges,,,5874.35,83,,percent of total billed charges,,,,,,,,,,,,,,,5874.35,83,,percent of total billed charges,,,6723.65,95,,percent of total billed charges,,,6369.78,90,,percent of total billed charges,,,6369.78,90,,percent of total billed charges,,,5803.57,82,,percent of total billed charges,,,6369.78,90,,percent of total billed charges,,,6015.9,85,,percent of total billed charges,,5336.46,6723.65,
SYNTHES PLATE LCP CURVED 4.5X265MM 14HOL,30184198,CDM,,,278,RC,inpatient,,7436.65,7436.65,,6313.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5607.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6321.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6544.25,88,,percent of total billed charges,,,,,,,,,5681.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6767.35,91,,percent of total billed charges,,,7064.82,95,,percent of total billed charges,,,6172.42,83,,percent of total billed charges,,,6172.42,83,,percent of total billed charges,,,,,,,,,,,,,,,6172.42,83,,percent of total billed charges,,,7064.82,95,,percent of total billed charges,,,6692.99,90,,percent of total billed charges,,,6692.99,90,,percent of total billed charges,,,6098.05,82,,percent of total billed charges,,,6692.99,90,,percent of total billed charges,,,6321.15,85,,percent of total billed charges,,5607.23,7064.82,
SYNTHES PLATE LCP CURVED 4.5X282MM 15HOL,30184199,CDM,,,278,RC,inpatient,,8254.35,8254.35,,7007.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6223.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7016.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7263.83,88,,percent of total billed charges,,,,,,,,,6306.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7511.46,91,,percent of total billed charges,,,7841.63,95,,percent of total billed charges,,,6851.11,83,,percent of total billed charges,,,6851.11,83,,percent of total billed charges,,,,,,,,,,,,,,,6851.11,83,,percent of total billed charges,,,7841.63,95,,percent of total billed charges,,,7428.92,90,,percent of total billed charges,,,7428.92,90,,percent of total billed charges,,,6768.57,82,,percent of total billed charges,,,7428.92,90,,percent of total billed charges,,,7016.2,85,,percent of total billed charges,,6223.78,7841.63,
SYNTHES PLATE LCP CURVED 4.5X300MM 16HOL,30184200,CDM,,,278,RC,inpatient,,9033.38,9033.38,,7669.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6811.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7678.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7949.37,88,,percent of total billed charges,,,,,,,,,6901.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8220.38,91,,percent of total billed charges,,,8581.71,95,,percent of total billed charges,,,7497.71,83,,percent of total billed charges,,,7497.71,83,,percent of total billed charges,,,,,,,,,,,,,,,7497.71,83,,percent of total billed charges,,,8581.71,95,,percent of total billed charges,,,8130.04,90,,percent of total billed charges,,,8130.04,90,,percent of total billed charges,,,7407.37,82,,percent of total billed charges,,,8130.04,90,,percent of total billed charges,,,7678.37,85,,percent of total billed charges,,6811.17,8581.71,
SYNTHES PLATE LCP CURVED 4.5X318MM 17HOL,30184201,CDM,,,278,RC,inpatient,,9469.85,9469.85,,8039.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7140.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8049.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8333.47,88,,percent of total billed charges,,,,,,,,,7234.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8617.56,91,,percent of total billed charges,,,8996.36,95,,percent of total billed charges,,,7859.98,83,,percent of total billed charges,,,7859.98,83,,percent of total billed charges,,,,,,,,,,,,,,,7859.98,83,,percent of total billed charges,,,8996.36,95,,percent of total billed charges,,,8522.87,90,,percent of total billed charges,,,8522.87,90,,percent of total billed charges,,,7765.28,82,,percent of total billed charges,,,8522.87,90,,percent of total billed charges,,,8049.37,85,,percent of total billed charges,,7140.27,8996.36,
SYNTHES PLATE LCP CURVED 4.5X336MM 18HOL,30184202,CDM,,,278,RC,inpatient,,10315.18,10315.18,,8757.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7777.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8767.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9077.36,88,,percent of total billed charges,,,,,,,,,7880.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9386.81,91,,percent of total billed charges,,,9799.42,95,,percent of total billed charges,,,8561.6,83,,percent of total billed charges,,,8561.6,83,,percent of total billed charges,,,,,,,,,,,,,,,8561.6,83,,percent of total billed charges,,,9799.42,95,,percent of total billed charges,,,9283.66,90,,percent of total billed charges,,,9283.66,90,,percent of total billed charges,,,8458.45,82,,percent of total billed charges,,,9283.66,90,,percent of total billed charges,,,8767.9,85,,percent of total billed charges,,7777.65,9799.42,
SYNTHES CERCALGE POSITIONING PIN 4.5MM,30184203,CDM,,,278,RC,inpatient,,1740.38,1740.38,,1477.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1312.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1479.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1531.53,88,,percent of total billed charges,,,,,,,,,1329.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1583.75,91,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.52,83,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1427.11,82,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,1312.25,1653.36,
SYNTHES TROCHANTERIC REATTCHMENT DEVICE,30184205,CDM,,,278,RC,inpatient,,18420.35,18420.35,,15638.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13888.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15657.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16209.91,88,,percent of total billed charges,,,,,,,,,14073.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16762.52,91,,percent of total billed charges,,,17499.33,95,,percent of total billed charges,,,15288.89,83,,percent of total billed charges,,,15288.89,83,,percent of total billed charges,,,,,,,,,,,,,,,15288.89,83,,percent of total billed charges,,,17499.33,95,,percent of total billed charges,,,16578.32,90,,percent of total billed charges,,,16578.32,90,,percent of total billed charges,,,15104.69,82,,percent of total billed charges,,,16578.32,90,,percent of total billed charges,,,15657.3,85,,percent of total billed charges,,13888.94,17499.33,
SYNTHES TROCHANTERIC REATTCHMENT W/LONG,30184206,CDM,,,278,RC,inpatient,,26547.63,26547.63,,22538.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20016.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22565.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23361.91,88,,percent of total billed charges,,,,,,,,,20282.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24158.34,91,,percent of total billed charges,,,25220.25,95,,percent of total billed charges,,,22034.53,83,,percent of total billed charges,,,22034.53,83,,percent of total billed charges,,,,,,,,,,,,,,,22034.53,83,,percent of total billed charges,,,25220.25,95,,percent of total billed charges,,,23892.87,90,,percent of total billed charges,,,23892.87,90,,percent of total billed charges,,,21769.06,82,,percent of total billed charges,,,23892.87,90,,percent of total billed charges,,,22565.49,85,,percent of total billed charges,,20016.91,25220.25,
SYNTHES PLATE DISTAL FIBULA 3H LT 2.7/3.,30184207,CDM,,,278,RC,inpatient,,5850.98,5850.98,,4967.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4411.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4973.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148.86,88,,percent of total billed charges,,,,,,,,,4470.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5324.39,91,,percent of total billed charges,,,5558.43,95,,percent of total billed charges,,,4856.31,83,,percent of total billed charges,,,4856.31,83,,percent of total billed charges,,,,,,,,,,,,,,,4856.31,83,,percent of total billed charges,,,5558.43,95,,percent of total billed charges,,,5265.88,90,,percent of total billed charges,,,5265.88,90,,percent of total billed charges,,,4797.8,82,,percent of total billed charges,,,5265.88,90,,percent of total billed charges,,,4973.33,85,,percent of total billed charges,,4411.64,5558.43,
SYNTHES PLATE DISTAL FIBULA 6H LT 2.7/3.,30184208,CDM,,,278,RC,inpatient,,6311.05,6311.05,,5358.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4758.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5364.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5553.72,88,,percent of total billed charges,,,,,,,,,4821.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5743.06,91,,percent of total billed charges,,,5995.5,95,,percent of total billed charges,,,5238.17,83,,percent of total billed charges,,,5238.17,83,,percent of total billed charges,,,,,,,,,,,,,,,5238.17,83,,percent of total billed charges,,,5995.5,95,,percent of total billed charges,,,5679.95,90,,percent of total billed charges,,,5679.95,90,,percent of total billed charges,,,5175.06,82,,percent of total billed charges,,,5679.95,90,,percent of total billed charges,,,5364.39,85,,percent of total billed charges,,4758.53,5995.5,
SYNTHES PLATE DISTAL FIBULA 7H RT 2.7/3.,30184209,CDM,,,278,RC,inpatient,,6396.39,6396.39,,5430.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4822.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5436.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5628.82,88,,percent of total billed charges,,,,,,,,,4886.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5820.71,91,,percent of total billed charges,,,6076.57,95,,percent of total billed charges,,,5309,83,,percent of total billed charges,,,5309,83,,percent of total billed charges,,,,,,,,,,,,,,,5309,83,,percent of total billed charges,,,6076.57,95,,percent of total billed charges,,,5756.75,90,,percent of total billed charges,,,5756.75,90,,percent of total billed charges,,,5245.04,82,,percent of total billed charges,,,5756.75,90,,percent of total billed charges,,,5436.93,85,,percent of total billed charges,,4822.88,6076.57,
SYNTHES PLATE DISTAL FIBULA 7H LT 2.7/3.,30184210,CDM,,,278,RC,inpatient,,6588.27,6588.27,,5593.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4967.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5600.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5797.68,88,,percent of total billed charges,,,,,,,,,5033.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5995.33,91,,percent of total billed charges,,,6258.86,95,,percent of total billed charges,,,5468.26,83,,percent of total billed charges,,,5468.26,83,,percent of total billed charges,,,,,,,,,,,,,,,5468.26,83,,percent of total billed charges,,,6258.86,95,,percent of total billed charges,,,5929.44,90,,percent of total billed charges,,,5929.44,90,,percent of total billed charges,,,5402.38,82,,percent of total billed charges,,,5929.44,90,,percent of total billed charges,,,5600.03,85,,percent of total billed charges,,4967.56,6258.86,
SYNTHES PLATE DISTAL FIBULA 9H RT 2.7/3.,30184211,CDM,,,278,RC,inpatient,,6519.5,6519.5,,5535.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4915.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5541.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5737.16,88,,percent of total billed charges,,,,,,,,,4980.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5932.75,91,,percent of total billed charges,,,6193.53,95,,percent of total billed charges,,,5411.19,83,,percent of total billed charges,,,5411.19,83,,percent of total billed charges,,,,,,,,,,,,,,,5411.19,83,,percent of total billed charges,,,6193.53,95,,percent of total billed charges,,,5867.55,90,,percent of total billed charges,,,5867.55,90,,percent of total billed charges,,,5345.99,82,,percent of total billed charges,,,5867.55,90,,percent of total billed charges,,,5541.58,85,,percent of total billed charges,,4915.7,6193.53,
SYNTHES PLATE DISTAL FIBULA 8H LT 2.7/3.,30184212,CDM,,,278,RC,inpatient,,6519.5,6519.5,,5535.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4915.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5541.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5737.16,88,,percent of total billed charges,,,,,,,,,4980.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5932.75,91,,percent of total billed charges,,,6193.53,95,,percent of total billed charges,,,5411.19,83,,percent of total billed charges,,,5411.19,83,,percent of total billed charges,,,,,,,,,,,,,,,5411.19,83,,percent of total billed charges,,,6193.53,95,,percent of total billed charges,,,5867.55,90,,percent of total billed charges,,,5867.55,90,,percent of total billed charges,,,5345.99,82,,percent of total billed charges,,,5867.55,90,,percent of total billed charges,,,5541.58,85,,percent of total billed charges,,4915.7,6193.53,
SYNTHES PLATE DISTAL FIBULA 11H RT 2.7/,30184213,CDM,,,278,RC,inpatient,,6618.95,6618.95,,5619.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4990.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5626.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5824.68,88,,percent of total billed charges,,,,,,,,,5056.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6023.24,91,,percent of total billed charges,,,6288,95,,percent of total billed charges,,,5493.73,83,,percent of total billed charges,,,5493.73,83,,percent of total billed charges,,,,,,,,,,,,,,,5493.73,83,,percent of total billed charges,,,6288,95,,percent of total billed charges,,,5957.06,90,,percent of total billed charges,,,5957.06,90,,percent of total billed charges,,,5427.54,82,,percent of total billed charges,,,5957.06,90,,percent of total billed charges,,,5626.11,85,,percent of total billed charges,,4990.69,6288,
SYNTHES PLATE DISTAL FIBULA 11H LT 2.7/,30184214,CDM,,,278,RC,inpatient,,6618.95,6618.95,,5619.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4990.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5626.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5824.68,88,,percent of total billed charges,,,,,,,,,5056.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6023.24,91,,percent of total billed charges,,,6288,95,,percent of total billed charges,,,5493.73,83,,percent of total billed charges,,,5493.73,83,,percent of total billed charges,,,,,,,,,,,,,,,5493.73,83,,percent of total billed charges,,,6288,95,,percent of total billed charges,,,5957.06,90,,percent of total billed charges,,,5957.06,90,,percent of total billed charges,,,5427.54,82,,percent of total billed charges,,,5957.06,90,,percent of total billed charges,,,5626.11,85,,percent of total billed charges,,4990.69,6288,
DUPLOTIP APPLICATOR 320 FOR TISSEEL,30184215,CDM,,,270,RC,inpatient,,402.15,402.15,,341.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,303.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,341.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,353.89,88,,percent of total billed charges,,,,,,,,,307.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,365.96,91,,percent of total billed charges,,,382.04,95,,percent of total billed charges,,,333.78,83,,percent of total billed charges,,,333.78,83,,percent of total billed charges,,,,,,,,,,,,,,,333.78,83,,percent of total billed charges,,,382.04,95,,percent of total billed charges,,,361.94,90,,percent of total billed charges,,,361.94,90,,percent of total billed charges,,,329.76,82,,percent of total billed charges,,,361.94,90,,percent of total billed charges,,,341.83,85,,percent of total billed charges,,303.22,382.04,
ARTHREX SUTURE ANCHOR BC 4.75 X 24.5MM,30184224,CDM,,,278,RC,inpatient,,2730,2730,,2317.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2058.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2320.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2402.4,88,,percent of total billed charges,,,,,,,,,2085.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2484.3,91,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2265.9,83,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2238.6,82,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,2058.42,2593.5,
*SYNTHES SCREW CORTEX ST TI 2.4MM X 12,30184225,CDM,,,278,RC,inpatient,,1105,1105,,938.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,833.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,939.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,972.4,88,,percent of total billed charges,,,,,,,,,844.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1005.55,91,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,,,,,,,,,,,,,917.15,83,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,906.1,82,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,833.17,1049.75,
S&N GUIDE WIRE TIP THREADED 3.2MM,30184235,CDM,,,270,RC,inpatient,,1406.02,1406.02,,1193.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1060.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1195.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1237.3,88,,percent of total billed charges,,,,,,,,,1074.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1279.48,91,,percent of total billed charges,,,1335.72,95,,percent of total billed charges,,,1167,83,,percent of total billed charges,,,1167,83,,percent of total billed charges,,,,,,,,,,,,,,,1167,83,,percent of total billed charges,,,1335.72,95,,percent of total billed charges,,,1265.42,90,,percent of total billed charges,,,1265.42,90,,percent of total billed charges,,,1152.94,82,,percent of total billed charges,,,1265.42,90,,percent of total billed charges,,,1195.12,85,,percent of total billed charges,,1060.14,1335.72,
CATH SPIRAL FILIFORM TIP 4FR,30184243,CDM,,,270,RC,inpatient,,593.6,593.6,,503.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,447.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,504.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,522.37,88,,percent of total billed charges,,,,,,,,,453.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,540.18,91,,percent of total billed charges,,,563.92,95,,percent of total billed charges,,,492.69,83,,percent of total billed charges,,,492.69,83,,percent of total billed charges,,,,,,,,,,,,,,,492.69,83,,percent of total billed charges,,,563.92,95,,percent of total billed charges,,,534.24,90,,percent of total billed charges,,,534.24,90,,percent of total billed charges,,,486.75,82,,percent of total billed charges,,,534.24,90,,percent of total billed charges,,,504.56,85,,percent of total billed charges,,447.57,563.92,
ALLOFUSE DBM PUTTY 10CC,30184255,CDM,,,278,RC,inpatient,,6305,6305,,5352.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4753.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5359.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5548.4,88,,percent of total billed charges,,,,,,,,,4817.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5737.55,91,,percent of total billed charges,,,5989.75,95,,percent of total billed charges,,,5233.15,83,,percent of total billed charges,,,5233.15,83,,percent of total billed charges,,,,,,,,,,,,,,,5233.15,83,,percent of total billed charges,,,5989.75,95,,percent of total billed charges,,,5674.5,90,,percent of total billed charges,,,5674.5,90,,percent of total billed charges,,,5170.1,82,,percent of total billed charges,,,5674.5,90,,percent of total billed charges,,,5359.25,85,,percent of total billed charges,,4753.97,5989.75,
ALLOSOURCE CORTICAL STRUT 2 X 25 CM (FRO,30184258,CDM,,,278,RC,inpatient,,4563,4563,,3873.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3440.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3878.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4015.44,88,,percent of total billed charges,,,,,,,,,3486.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4152.33,91,,percent of total billed charges,,,4334.85,95,,percent of total billed charges,,,3787.29,83,,percent of total billed charges,,,3787.29,83,,percent of total billed charges,,,,,,,,,,,,,,,3787.29,83,,percent of total billed charges,,,4334.85,95,,percent of total billed charges,,,4106.7,90,,percent of total billed charges,,,4106.7,90,,percent of total billed charges,,,3741.66,82,,percent of total billed charges,,,4106.7,90,,percent of total billed charges,,,3878.55,85,,percent of total billed charges,,3440.5,4334.85,
S&N FEMUR OX SZ 6 RT P/S,30184259,CDM,,,278,RC,inpatient,,25285,25285,,21466.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19064.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21492.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22250.8,88,,percent of total billed charges,,,,,,,,,19317.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23009.35,91,,percent of total billed charges,,,24020.75,95,,percent of total billed charges,,,20986.55,83,,percent of total billed charges,,,20986.55,83,,percent of total billed charges,,,,,,,,,,,,,,,20986.55,83,,percent of total billed charges,,,24020.75,95,,percent of total billed charges,,,22756.5,90,,percent of total billed charges,,,22756.5,90,,percent of total billed charges,,,20733.7,82,,percent of total billed charges,,,22756.5,90,,percent of total billed charges,,,21492.25,85,,percent of total billed charges,,19064.89,24020.75,
S&N TIBIA RT SZ 6,30184260,CDM,,,278,RC,inpatient,,12122.5,12122.5,,10292,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9140.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10304.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10667.8,88,,percent of total billed charges,,,,,,,,,9261.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11031.48,91,,percent of total billed charges,,,11516.38,95,,percent of total billed charges,,,10061.68,83,,percent of total billed charges,,,10061.68,83,,percent of total billed charges,,,,,,,,,,,,,,,10061.68,83,,percent of total billed charges,,,11516.38,95,,percent of total billed charges,,,10910.25,90,,percent of total billed charges,,,10910.25,90,,percent of total billed charges,,,9940.45,82,,percent of total billed charges,,,10910.25,90,,percent of total billed charges,,,10304.13,85,,percent of total billed charges,,9140.37,11516.38,
S&N INSERT SZ 5-6 15MM LEGION PS XLPE,30184261,CDM,,,278,RC,inpatient,,14299.55,14299.55,,12140.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10781.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12154.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12583.6,88,,percent of total billed charges,,,,,,,,,10924.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13012.59,91,,percent of total billed charges,,,13584.57,95,,percent of total billed charges,,,11868.63,83,,percent of total billed charges,,,11868.63,83,,percent of total billed charges,,,,,,,,,,,,,,,11868.63,83,,percent of total billed charges,,,13584.57,95,,percent of total billed charges,,,12869.6,90,,percent of total billed charges,,,12869.6,90,,percent of total billed charges,,,11725.63,82,,percent of total billed charges,,,12869.6,90,,percent of total billed charges,,,12154.62,85,,percent of total billed charges,,10781.86,13584.57,
SYNTHES PLATE VA-LCP 4.5MM CURVED 14 HOL,30184264,CDM,,,278,RC,inpatient,,20762.95,20762.95,,17627.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15655.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17648.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18271.4,88,,percent of total billed charges,,,,,,,,,15862.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18894.28,91,,percent of total billed charges,,,19724.8,95,,percent of total billed charges,,,17233.25,83,,percent of total billed charges,,,17233.25,83,,percent of total billed charges,,,,,,,,,,,,,,,17233.25,83,,percent of total billed charges,,,19724.8,95,,percent of total billed charges,,,18686.66,90,,percent of total billed charges,,,18686.66,90,,percent of total billed charges,,,17025.62,82,,percent of total billed charges,,,18686.66,90,,percent of total billed charges,,,17648.51,85,,percent of total billed charges,,15655.26,19724.8,
SYNTHES SCREW LOCKING 5.0 X 10MM,30184265,CDM,,,278,RC,inpatient,,2900.63,2900.63,,2462.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2187.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2465.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2552.55,88,,percent of total billed charges,,,,,,,,,2216.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2639.57,91,,percent of total billed charges,,,2755.6,95,,percent of total billed charges,,,2407.52,83,,percent of total billed charges,,,2407.52,83,,percent of total billed charges,,,,,,,,,,,,,,,2407.52,83,,percent of total billed charges,,,2755.6,95,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2378.52,82,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2465.54,85,,percent of total billed charges,,2187.08,2755.6,
SYNTHES SCREW LOCKING 5.0 X 12MM,30184266,CDM,,,278,RC,inpatient,,2900.63,2900.63,,2462.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2187.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2465.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2552.55,88,,percent of total billed charges,,,,,,,,,2216.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2639.57,91,,percent of total billed charges,,,2755.6,95,,percent of total billed charges,,,2407.52,83,,percent of total billed charges,,,2407.52,83,,percent of total billed charges,,,,,,,,,,,,,,,2407.52,83,,percent of total billed charges,,,2755.6,95,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2378.52,82,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2465.54,85,,percent of total billed charges,,2187.08,2755.6,
SYNTHES SCREW LOCKING 5.0 X 14MM,30184267,CDM,,,278,RC,inpatient,,2900.63,2900.63,,2462.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2187.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2465.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2552.55,88,,percent of total billed charges,,,,,,,,,2216.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2639.57,91,,percent of total billed charges,,,2755.6,95,,percent of total billed charges,,,2407.52,83,,percent of total billed charges,,,2407.52,83,,percent of total billed charges,,,,,,,,,,,,,,,2407.52,83,,percent of total billed charges,,,2755.6,95,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2378.52,82,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2465.54,85,,percent of total billed charges,,2187.08,2755.6,
SYNTHES SCREW CONICAL CONNULATED 5.0MM,30184268,CDM,,,278,RC,inpatient,,1618.83,1618.83,,1374.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1220.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1376.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1424.57,88,,percent of total billed charges,,,,,,,,,1236.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1473.14,91,,percent of total billed charges,,,1537.89,95,,percent of total billed charges,,,1343.63,83,,percent of total billed charges,,,1343.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1343.63,83,,percent of total billed charges,,,1537.89,95,,percent of total billed charges,,,1456.95,90,,percent of total billed charges,,,1456.95,90,,percent of total billed charges,,,1327.44,82,,percent of total billed charges,,,1456.95,90,,percent of total billed charges,,,1376.01,85,,percent of total billed charges,,1220.6,1537.89,
SYNTHES SCREW LOCKING 5 X 26MM ANGLED,30184269,CDM,,,278,RC,inpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1321.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1489.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,1321.56,1665.09,
SYNTHES SCREW LOCKING 5 X 30MM ANGLE,30184270,CDM,,,278,RC,inpatient,,1701.7,1701.7,,1444.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1283.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1446.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1497.5,88,,percent of total billed charges,,,,,,,,,1300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1548.55,91,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1412.41,83,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1395.39,82,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,1283.08,1616.62,
SYNTHES SCREW LOCKING 5 X 65MM ANGLE,30184271,CDM,,,278,RC,inpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1321.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1489.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,1321.56,1665.09,
SYNTHES SCREW LOCKING 5 X85MM ANGLED,30184272,CDM,,,278,RC,inpatient,,1701.7,1701.7,,1444.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1283.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1446.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1497.5,88,,percent of total billed charges,,,,,,,,,1300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1548.55,91,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1412.41,83,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1395.39,82,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,1283.08,1616.62,
SYNTHES SCREW LOCKING 5 X 75MM ANGLED,30184273,CDM,,,278,RC,inpatient,,1701.7,1701.7,,1444.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1283.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1446.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1497.5,88,,percent of total billed charges,,,,,,,,,1300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1548.55,91,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1412.41,83,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1395.39,82,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,1283.08,1616.62,
SYNTHES DRILL TIP GUIDE WIRE 2.5 X 200MM,30184274,CDM,,,278,RC,inpatient,,672.35,672.35,,570.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,506.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,571.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,591.67,88,,percent of total billed charges,,,,,,,,,513.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,611.84,91,,percent of total billed charges,,,638.73,95,,percent of total billed charges,,,558.05,83,,percent of total billed charges,,,558.05,83,,percent of total billed charges,,,,,,,,,,,,,,,558.05,83,,percent of total billed charges,,,638.73,95,,percent of total billed charges,,,605.12,90,,percent of total billed charges,,,605.12,90,,percent of total billed charges,,,551.33,82,,percent of total billed charges,,,605.12,90,,percent of total billed charges,,,571.5,85,,percent of total billed charges,,506.95,638.73,
SYNTHES DRILL BIT 4.3MM,30184275,CDM,,,278,RC,inpatient,,1789.13,1789.13,,1518.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1349,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1520.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1574.43,88,,percent of total billed charges,,,,,,,,,1366.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1628.11,91,,percent of total billed charges,,,1699.67,95,,percent of total billed charges,,,1484.98,83,,percent of total billed charges,,,1484.98,83,,percent of total billed charges,,,,,,,,,,,,,,,1484.98,83,,percent of total billed charges,,,1699.67,95,,percent of total billed charges,,,1610.22,90,,percent of total billed charges,,,1610.22,90,,percent of total billed charges,,,1467.09,82,,percent of total billed charges,,,1610.22,90,,percent of total billed charges,,,1520.76,85,,percent of total billed charges,,1349,1699.67,
SYNTHES DRILL BIT QC 2.5,30184276,CDM,,,270,RC,inpatient,,795.34,795.34,,675.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,599.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,676.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,699.9,88,,percent of total billed charges,,,,,,,,,607.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,723.76,91,,percent of total billed charges,,,755.57,95,,percent of total billed charges,,,660.13,83,,percent of total billed charges,,,660.13,83,,percent of total billed charges,,,,,,,,,,,,,,,660.13,83,,percent of total billed charges,,,755.57,95,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,652.18,82,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,676.04,85,,percent of total billed charges,,599.69,755.57,
SYNTHES PLATE PROX HUMERUS 3.5MM 3 HOLE,30184277,CDM,,,278,RC,inpatient,,18299.52,18299.52,,15536.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13797.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15554.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16103.58,88,,percent of total billed charges,,,,,,,,,13980.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16652.56,91,,percent of total billed charges,,,17384.54,95,,percent of total billed charges,,,15188.6,83,,percent of total billed charges,,,15188.6,83,,percent of total billed charges,,,,,,,,,,,,,,,15188.6,83,,percent of total billed charges,,,17384.54,95,,percent of total billed charges,,,16469.57,90,,percent of total billed charges,,,16469.57,90,,percent of total billed charges,,,15005.61,82,,percent of total billed charges,,,16469.57,90,,percent of total billed charges,,,15554.59,85,,percent of total billed charges,,13797.84,17384.54,
DEPUY STEM CORAIL KLA SZ 14,30184278,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY STEM SUMMIT CEMENTED SZ 3,30184279,CDM,,,278,RC,inpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19184.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21627.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,19184.82,24171.86,
DEPUY CEMENTRALIZERR 9.25,30184280,CDM,,,278,RC,inpatient,,919.36,919.36,,780.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,693.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,781.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,809.04,88,,percent of total billed charges,,,,,,,,,702.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,836.62,91,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,,,,,,,,,,,,,763.07,83,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,753.88,82,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,781.46,85,,percent of total billed charges,,693.2,873.39,
DEPUY STEM CORAIL COLLERED VESUS SZ 9,30184282,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
SYNTHES PLATE 5-HOLE 2MM,30184283,CDM,,,278,RC,inpatient,,2646.48,2646.48,,2246.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1995.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2249.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2328.9,88,,percent of total billed charges,,,,,,,,,2021.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2408.3,91,,percent of total billed charges,,,2514.16,95,,percent of total billed charges,,,2196.58,83,,percent of total billed charges,,,2196.58,83,,percent of total billed charges,,,,,,,,,,,,,,,2196.58,83,,percent of total billed charges,,,2514.16,95,,percent of total billed charges,,,2381.83,90,,percent of total billed charges,,,2381.83,90,,percent of total billed charges,,,2170.11,82,,percent of total billed charges,,,2381.83,90,,percent of total billed charges,,,2249.51,85,,percent of total billed charges,,1995.45,2514.16,
SYNTHES PLATE 6-HOLE 2MM,30184284,CDM,,,278,RC,inpatient,,2646.48,2646.48,,2246.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1995.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2249.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2328.9,88,,percent of total billed charges,,,,,,,,,2021.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2408.3,91,,percent of total billed charges,,,2514.16,95,,percent of total billed charges,,,2196.58,83,,percent of total billed charges,,,2196.58,83,,percent of total billed charges,,,,,,,,,,,,,,,2196.58,83,,percent of total billed charges,,,2514.16,95,,percent of total billed charges,,,2381.83,90,,percent of total billed charges,,,2381.83,90,,percent of total billed charges,,,2170.11,82,,percent of total billed charges,,,2381.83,90,,percent of total billed charges,,,2249.51,85,,percent of total billed charges,,1995.45,2514.16,
SYNTHES PLATE 7-HOLE 2MM,30184285,CDM,,,278,RC,inpatient,,7939.43,7939.43,,6740.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5986.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6748.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6986.7,88,,percent of total billed charges,,,,,,,,,6065.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7224.88,91,,percent of total billed charges,,,7542.46,95,,percent of total billed charges,,,6589.73,83,,percent of total billed charges,,,6589.73,83,,percent of total billed charges,,,,,,,,,,,,,,,6589.73,83,,percent of total billed charges,,,7542.46,95,,percent of total billed charges,,,7145.49,90,,percent of total billed charges,,,7145.49,90,,percent of total billed charges,,,6510.33,82,,percent of total billed charges,,,7145.49,90,,percent of total billed charges,,,6748.52,85,,percent of total billed charges,,5986.33,7542.46,
SYNTHES SCREW CORTEX 10 X 2MM,30184286,CDM,,,278,RC,inpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,399.28,503.07,
SYNTHES SCREW CORTEX 12 X 2MM,30184287,CDM,,,278,RC,inpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,399.28,503.07,
SYNTHES SCREW CORTEX 14 X 2MM,30184288,CDM,,,278,RC,inpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,399.28,503.07,
SYNTHES SCREW CORTEX 16 X 2MM,30184289,CDM,,,278,RC,inpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,399.28,503.07,
SYNTHES SCREW CORTEX 18 X 2MM,30184290,CDM,,,278,RC,inpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,399.28,503.07,
SYNTHES SCREW LOCKING 9 X 2MM,30184291,CDM,,,278,RC,inpatient,,1187.88,1187.88,,1008.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,895.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1009.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1045.33,88,,percent of total billed charges,,,,,,,,,907.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1080.97,91,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,,,,,,,,,,,,,985.94,83,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,974.06,82,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1009.7,85,,percent of total billed charges,,895.66,1128.49,
SYNTHES SCREW LOCKING 10 X 2MM,30184292,CDM,,,278,RC,inpatient,,1187.88,1187.88,,1008.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,895.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1009.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1045.33,88,,percent of total billed charges,,,,,,,,,907.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1080.97,91,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,,,,,,,,,,,,,985.94,83,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,974.06,82,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1009.7,85,,percent of total billed charges,,895.66,1128.49,
SYNTHES SCREW LOCKING 11 X 2MM,30184293,CDM,,,278,RC,inpatient,,1187.88,1187.88,,1008.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,895.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1009.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1045.33,88,,percent of total billed charges,,,,,,,,,907.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1080.97,91,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,,,,,,,,,,,,,985.94,83,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,974.06,82,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1009.7,85,,percent of total billed charges,,895.66,1128.49,
SYNTHES SCREW LOCKING 14 X 2MM,30184294,CDM,,,278,RC,inpatient,,1187.88,1187.88,,1008.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,895.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1009.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1045.33,88,,percent of total billed charges,,,,,,,,,907.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1080.97,91,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,,,,,,,,,,,,,985.94,83,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,974.06,82,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1009.7,85,,percent of total billed charges,,895.66,1128.49,
SYNTHES SCREW LOCKING 16 X 2MM,30184295,CDM,,,278,RC,inpatient,,1187.88,1187.88,,1008.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,895.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1009.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1045.33,88,,percent of total billed charges,,,,,,,,,907.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1080.97,91,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,,,,,,,,,,,,,985.94,83,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,974.06,82,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1009.7,85,,percent of total billed charges,,895.66,1128.49,
SYNTHES DRILL BIT CALIBRATED 1.5MM,30184296,CDM,,,270,RC,inpatient,,1430.98,1430.98,,1214.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1078.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1216.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1259.26,88,,percent of total billed charges,,,,,,,,,1093.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1302.19,91,,percent of total billed charges,,,1359.43,95,,percent of total billed charges,,,1187.71,83,,percent of total billed charges,,,1187.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1187.71,83,,percent of total billed charges,,,1359.43,95,,percent of total billed charges,,,1287.88,90,,percent of total billed charges,,,1287.88,90,,percent of total billed charges,,,1173.4,82,,percent of total billed charges,,,1287.88,90,,percent of total billed charges,,,1216.33,85,,percent of total billed charges,,1078.96,1359.43,
MEDTRONIC LEAD BISIL STEROID FIX 58,30184297,CDM,,,278,RC,inpatient,,5310.5,5310.5,,4508.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4004.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4513.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4673.24,88,,percent of total billed charges,,,,,,,,,4057.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4832.56,91,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4407.72,83,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4354.61,82,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4513.93,85,,percent of total billed charges,,4004.12,5044.98,
HIP ORTHOSIS ABDUCTION CONTROL BRACE,30184298,CDM,,,270,RC,inpatient,,5911.3,5911.3,,5018.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4457.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5024.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5201.94,88,,percent of total billed charges,,,,,,,,,4516.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5379.28,91,,percent of total billed charges,,,5615.74,95,,percent of total billed charges,,,4906.38,83,,percent of total billed charges,,,4906.38,83,,percent of total billed charges,,,,,,,,,,,,,,,4906.38,83,,percent of total billed charges,,,5615.74,95,,percent of total billed charges,,,5320.17,90,,percent of total billed charges,,,5320.17,90,,percent of total billed charges,,,4847.27,82,,percent of total billed charges,,,5320.17,90,,percent of total billed charges,,,5024.61,85,,percent of total billed charges,,4457.12,5615.74,
HIP BRACE- LOWER EXTREMITY PELVIC CONTRO,30184299,CDM,,,278,RC,inpatient,,2461.55,2461.55,,2089.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1856.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2092.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2166.16,88,,percent of total billed charges,,,,,,,,,1880.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2240.01,91,,percent of total billed charges,,,2338.47,95,,percent of total billed charges,,,2043.09,83,,percent of total billed charges,,,2043.09,83,,percent of total billed charges,,,,,,,,,,,,,,,2043.09,83,,percent of total billed charges,,,2338.47,95,,percent of total billed charges,,,2215.4,90,,percent of total billed charges,,,2215.4,90,,percent of total billed charges,,,2018.47,82,,percent of total billed charges,,,2215.4,90,,percent of total billed charges,,,2092.32,85,,percent of total billed charges,,1856.01,2338.47,
MEDTRONIC SPINAL CORD STIMULATION ELECTR,30184300,CDM,,,270,RC,inpatient,,7280,7280,,6180.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5489.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6188,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6406.4,88,,percent of total billed charges,,,,,,,,,5561.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6624.8,91,,percent of total billed charges,,,6916,95,,percent of total billed charges,,,6042.4,83,,percent of total billed charges,,,6042.4,83,,percent of total billed charges,,,,,,,,,,,,,,,6042.4,83,,percent of total billed charges,,,6916,95,,percent of total billed charges,,,6552,90,,percent of total billed charges,,,6552,90,,percent of total billed charges,,,5969.6,82,,percent of total billed charges,,,6552,90,,percent of total billed charges,,,6188,85,,percent of total billed charges,,5489.12,6916,
SYTHES SCREW CANNULATED 4.0 X 24MM LONG,30184301,CDM,,,270,RC,inpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1466.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1653.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,1466.38,1847.56,
CONFORMIS IUNI G2 FEOMORAL IMPLANT LEFT,30184302,CDM,,,278,RC,inpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29406,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33150,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,29406,37050,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184303,CDM,,,278,RC,inpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1466.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1653.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,1466.38,1847.56,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184304,CDM,,,278,RC,inpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1466.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1653.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,1466.38,1847.56,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184305,CDM,,,278,RC,inpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1466.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1653.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,1466.38,1847.56,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184306,CDM,,,278,RC,inpatient,,2003.17,2003.17,,1700.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1510.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1702.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1762.79,88,,percent of total billed charges,,,,,,,,,1530.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1822.88,91,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1662.63,83,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1642.6,82,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,1510.39,1903.01,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184307,CDM,,,278,RC,inpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1466.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1653.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,1466.38,1847.56,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184308,CDM,,,278,RC,inpatient,,2063.23,2063.23,,1751.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1555.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1753.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1815.64,88,,percent of total billed charges,,,,,,,,,1576.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1877.54,91,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1712.48,83,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1691.85,82,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,1555.68,1960.07,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184309,CDM,,,278,RC,inpatient,,2003.17,2003.17,,1700.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1510.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1702.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1762.79,88,,percent of total billed charges,,,,,,,,,1530.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1822.88,91,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1662.63,83,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1642.6,82,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,1510.39,1903.01,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184310,CDM,,,278,RC,inpatient,,2063.23,2063.23,,1751.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1555.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1753.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1815.64,88,,percent of total billed charges,,,,,,,,,1576.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1877.54,91,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1712.48,83,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1691.85,82,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,1555.68,1960.07,
SYNTHES SCREW CANNULATED SORT THREAD 4 X,30184311,CDM,,,278,RC,inpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1466.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1653.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,1466.38,1847.56,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184312,CDM,,,278,RC,inpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1466.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1653.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,1466.38,1847.56,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184313,CDM,,,278,RC,inpatient,,2003.17,2003.17,,1700.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1510.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1702.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1762.79,88,,percent of total billed charges,,,,,,,,,1530.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1822.88,91,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1662.63,83,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1642.6,82,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,1510.39,1903.01,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184314,CDM,,,278,RC,inpatient,,2043.73,2043.73,,1735.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1540.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1737.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1798.48,88,,percent of total billed charges,,,,,,,,,1561.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1859.79,91,,percent of total billed charges,,,1941.54,95,,percent of total billed charges,,,1696.3,83,,percent of total billed charges,,,1696.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1696.3,83,,percent of total billed charges,,,1941.54,95,,percent of total billed charges,,,1839.36,90,,percent of total billed charges,,,1839.36,90,,percent of total billed charges,,,1675.86,82,,percent of total billed charges,,,1839.36,90,,percent of total billed charges,,,1737.17,85,,percent of total billed charges,,1540.97,1941.54,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184315,CDM,,,278,RC,inpatient,,2063.23,2063.23,,1751.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1555.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1753.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1815.64,88,,percent of total billed charges,,,,,,,,,1576.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1877.54,91,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1712.48,83,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1691.85,82,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,1555.68,1960.07,
ZIMMER BLADE EXPLANT 50MM LONG,30184316,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
ZIMMER BLADE EXPLANT 50MM SHORT,30184317,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
FULL COVERAGE SUPPORT BRA MEDIUM,30184318,CDM,,,270,RC,inpatient,,311.63,311.63,,264.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,234.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,264.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,274.23,88,,percent of total billed charges,,,,,,,,,238.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,283.58,91,,percent of total billed charges,,,296.05,95,,percent of total billed charges,,,258.65,83,,percent of total billed charges,,,258.65,83,,percent of total billed charges,,,,,,,,,,,,,,,258.65,83,,percent of total billed charges,,,296.05,95,,percent of total billed charges,,,280.47,90,,percent of total billed charges,,,280.47,90,,percent of total billed charges,,,255.54,82,,percent of total billed charges,,,280.47,90,,percent of total billed charges,,,264.89,85,,percent of total billed charges,,234.97,296.05,
FULL COVERAGE SUPPORT BRA LARGE,30184319,CDM,,,270,RC,inpatient,,311.63,311.63,,264.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,234.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,264.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,274.23,88,,percent of total billed charges,,,,,,,,,238.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,283.58,91,,percent of total billed charges,,,296.05,95,,percent of total billed charges,,,258.65,83,,percent of total billed charges,,,258.65,83,,percent of total billed charges,,,,,,,,,,,,,,,258.65,83,,percent of total billed charges,,,296.05,95,,percent of total billed charges,,,280.47,90,,percent of total billed charges,,,280.47,90,,percent of total billed charges,,,255.54,82,,percent of total billed charges,,,280.47,90,,percent of total billed charges,,,264.89,85,,percent of total billed charges,,234.97,296.05,
FULL COVERAGE SUPPORT BRA X-LARGE,30184320,CDM,,,270,RC,inpatient,,360.5,360.5,,306.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,271.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,306.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,317.24,88,,percent of total billed charges,,,,,,,,,275.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,328.06,91,,percent of total billed charges,,,342.48,95,,percent of total billed charges,,,299.22,83,,percent of total billed charges,,,299.22,83,,percent of total billed charges,,,,,,,,,,,,,,,299.22,83,,percent of total billed charges,,,342.48,95,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,295.61,82,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,306.43,85,,percent of total billed charges,,271.82,342.48,
FULL COVERAGE SUPPORT BRA XX-LARGE,30184321,CDM,,,270,RC,inpatient,,360.85,360.85,,306.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,272.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,306.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,317.55,88,,percent of total billed charges,,,,,,,,,275.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,328.37,91,,percent of total billed charges,,,342.81,95,,percent of total billed charges,,,299.51,83,,percent of total billed charges,,,299.51,83,,percent of total billed charges,,,,,,,,,,,,,,,299.51,83,,percent of total billed charges,,,342.81,95,,percent of total billed charges,,,324.77,90,,percent of total billed charges,,,324.77,90,,percent of total billed charges,,,295.9,82,,percent of total billed charges,,,324.77,90,,percent of total billed charges,,,306.72,85,,percent of total billed charges,,272.08,342.81,
KIRSCHNER WIRE DIA .035 9IN,30184324,CDM,,,270,RC,inpatient,,90.72,90.72,,77.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.83,88,,percent of total billed charges,,,,,,,,,69.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.56,91,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,,,,,,,,,,,,,75.3,83,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,74.39,82,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,68.4,86.18,
KIRSCHNER WIRE DIA .035 6,30184325,CDM,,,270,RC,inpatient,,90.72,90.72,,77.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.83,88,,percent of total billed charges,,,,,,,,,69.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.56,91,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,,,,,,,,,,,,,75.3,83,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,74.39,82,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,68.4,86.18,
KIRSCHNER WIRE DIA .045 X 9IN,30184326,CDM,,,270,RC,inpatient,,88.08,88.08,,74.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.51,88,,percent of total billed charges,,,,,,,,,67.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.15,91,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,,,,,,,,,,,,,73.11,83,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,72.23,82,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,66.41,83.68,
KIRSCHNER WIRE DIA .045 6IN,30184327,CDM,,,270,RC,inpatient,,90.72,90.72,,77.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.83,88,,percent of total billed charges,,,,,,,,,69.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.56,91,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,,,,,,,,,,,,,75.3,83,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,74.39,82,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,68.4,86.18,
KIRSCHNER WIRE DIA .062 9IN,30184328,CDM,,,270,RC,inpatient,,90.72,90.72,,77.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.83,88,,percent of total billed charges,,,,,,,,,69.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.56,91,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,,,,,,,,,,,,,75.3,83,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,74.39,82,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,68.4,86.18,
KIRSCHNER WIRE DIA .062 6IN,30184329,CDM,,,270,RC,inpatient,,90.72,90.72,,77.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.83,88,,percent of total billed charges,,,,,,,,,69.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.56,91,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,,,,,,,,,,,,,75.3,83,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,74.39,82,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,68.4,86.18,
SYNTHES KWIRE THREADED TIP 100MM X 1.6,30184330,CDM,,,270,RC,inpatient,,474.25,474.25,,402.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,357.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,403.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,417.34,88,,percent of total billed charges,,,,,,,,,362.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,431.57,91,,percent of total billed charges,,,450.54,95,,percent of total billed charges,,,393.63,83,,percent of total billed charges,,,393.63,83,,percent of total billed charges,,,,,,,,,,,,,,,393.63,83,,percent of total billed charges,,,450.54,95,,percent of total billed charges,,,426.83,90,,percent of total billed charges,,,426.83,90,,percent of total billed charges,,,388.89,82,,percent of total billed charges,,,426.83,90,,percent of total billed charges,,,403.11,85,,percent of total billed charges,,357.58,450.54,
SYNTHES HOLDING CLAMP 1.6MM,30184331,CDM,,,270,RC,inpatient,,7160.4,7160.4,,6079.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5398.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6086.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6301.15,88,,percent of total billed charges,,,,,,,,,5470.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6515.96,91,,percent of total billed charges,,,6802.38,95,,percent of total billed charges,,,5943.13,83,,percent of total billed charges,,,5943.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5943.13,83,,percent of total billed charges,,,6802.38,95,,percent of total billed charges,,,6444.36,90,,percent of total billed charges,,,6444.36,90,,percent of total billed charges,,,5871.53,82,,percent of total billed charges,,,6444.36,90,,percent of total billed charges,,,6086.34,85,,percent of total billed charges,,5398.94,6802.38,
SYNTHES CONNECTING CLAMP 3.0MM,30184332,CDM,,,270,RC,inpatient,,6657.63,6657.63,,5652.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5019.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5658.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5858.71,88,,percent of total billed charges,,,,,,,,,5086.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6058.44,91,,percent of total billed charges,,,6324.75,95,,percent of total billed charges,,,5525.83,83,,percent of total billed charges,,,5525.83,83,,percent of total billed charges,,,,,,,,,,,,,,,5525.83,83,,percent of total billed charges,,,6324.75,95,,percent of total billed charges,,,5991.87,90,,percent of total billed charges,,,5991.87,90,,percent of total billed charges,,,5459.26,82,,percent of total billed charges,,,5991.87,90,,percent of total billed charges,,,5658.99,85,,percent of total billed charges,,5019.85,6324.75,
SYNTHES ROD CARBON FIBER 3.0 X 75MM,30184333,CDM,,,278,RC,inpatient,,446.25,446.25,,378.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,336.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,379.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,392.7,88,,percent of total billed charges,,,,,,,,,340.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,406.09,91,,percent of total billed charges,,,423.94,95,,percent of total billed charges,,,370.39,83,,percent of total billed charges,,,370.39,83,,percent of total billed charges,,,,,,,,,,,,,,,370.39,83,,percent of total billed charges,,,423.94,95,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,365.93,82,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,379.31,85,,percent of total billed charges,,336.47,423.94,
ZIMMER DRILL BIT STRAIGHT SHANK 2.0MM,30184336,CDM,,,270,RC,inpatient,,224.03,224.03,,190.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,190.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,197.15,88,,percent of total billed charges,,,,,,,,,171.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.87,91,,percent of total billed charges,,,212.83,95,,percent of total billed charges,,,185.94,83,,percent of total billed charges,,,185.94,83,,percent of total billed charges,,,,,,,,,,,,,,,185.94,83,,percent of total billed charges,,,212.83,95,,percent of total billed charges,,,201.63,90,,percent of total billed charges,,,201.63,90,,percent of total billed charges,,,183.7,82,,percent of total billed charges,,,201.63,90,,percent of total billed charges,,,190.43,85,,percent of total billed charges,,168.92,212.83,
STRYKER SHAVER LONG HIP,30184337,CDM,,,270,RC,inpatient,,641.59,641.59,,544.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,483.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,545.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,564.6,88,,percent of total billed charges,,,,,,,,,490.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,583.85,91,,percent of total billed charges,,,609.51,95,,percent of total billed charges,,,532.52,83,,percent of total billed charges,,,532.52,83,,percent of total billed charges,,,,,,,,,,,,,,,532.52,83,,percent of total billed charges,,,609.51,95,,percent of total billed charges,,,577.43,90,,percent of total billed charges,,,577.43,90,,percent of total billed charges,,,526.1,82,,percent of total billed charges,,,577.43,90,,percent of total billed charges,,,545.35,85,,percent of total billed charges,,483.76,609.51,
SYNTHES PLATE LCP ONE-THIRD TUBLAR 7 HOL,30184338,CDM,,,278,RC,inpatient,,1613.3,1613.3,,1369.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1216.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1371.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1419.7,88,,percent of total billed charges,,,,,,,,,1232.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1468.1,91,,percent of total billed charges,,,1532.64,95,,percent of total billed charges,,,1339.04,83,,percent of total billed charges,,,1339.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1339.04,83,,percent of total billed charges,,,1532.64,95,,percent of total billed charges,,,1451.97,90,,percent of total billed charges,,,1451.97,90,,percent of total billed charges,,,1322.91,82,,percent of total billed charges,,,1451.97,90,,percent of total billed charges,,,1371.31,85,,percent of total billed charges,,1216.43,1532.64,
DEPUY STEM CORAIL KA8,30184342,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY STEM STD CEMENTED SUMMIT SZ 3,30184343,CDM,,,278,RC,inpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19184.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21627.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,19184.82,24171.86,
SYNTHES PLATE LCP 5 HOLE 99MM RIGHT,30184344,CDM,,,278,RC,inpatient,,6400.75,6400.75,,5434.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4826.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5440.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5632.66,88,,percent of total billed charges,,,,,,,,,4890.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5824.68,91,,percent of total billed charges,,,6080.71,95,,percent of total billed charges,,,5312.62,83,,percent of total billed charges,,,5312.62,83,,percent of total billed charges,,,,,,,,,,,,,,,5312.62,83,,percent of total billed charges,,,6080.71,95,,percent of total billed charges,,,5760.68,90,,percent of total billed charges,,,5760.68,90,,percent of total billed charges,,,5248.62,82,,percent of total billed charges,,,5760.68,90,,percent of total billed charges,,,5440.64,85,,percent of total billed charges,,4826.17,6080.71,
SYNTHES SCREW CORTEX ST 3.5 X 45MM,30184345,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
SYNTHES PLATE DISTAL RADIUS 2.4MM VA 6HO,30184346,CDM,,,278,RC,inpatient,,10357.23,10357.23,,8793.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7809.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8803.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9114.36,88,,percent of total billed charges,,,,,,,,,7912.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9425.08,91,,percent of total billed charges,,,9839.37,95,,percent of total billed charges,,,8596.5,83,,percent of total billed charges,,,8596.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8596.5,83,,percent of total billed charges,,,9839.37,95,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,8492.93,82,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,8803.65,85,,percent of total billed charges,,7809.35,9839.37,
SYNTHES SCREW LOCKING VA 2.4 X 22MM,30184347,CDM,,,278,RC,inpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1020.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1150.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,1020.93,1286.32,
SYNTHES SCREW CORTEX 2.7 X 16MM,30184348,CDM,,,278,RC,inpatient,,410.27,410.27,,348.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,309.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,348.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,361.04,88,,percent of total billed charges,,,,,,,,,313.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,373.35,91,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,,,,,,,,,,,,,340.52,83,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,336.42,82,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,348.73,85,,percent of total billed charges,,309.34,389.76,
S&N SUTURE ANCHOR HEALICOIL 4.5MM,30184349,CDM,,,270,RC,inpatient,,2544.75,2544.75,,2160.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1918.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2163.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2239.38,88,,percent of total billed charges,,,,,,,,,1944.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2315.72,91,,percent of total billed charges,,,2417.51,95,,percent of total billed charges,,,2112.14,83,,percent of total billed charges,,,2112.14,83,,percent of total billed charges,,,,,,,,,,,,,,,2112.14,83,,percent of total billed charges,,,2417.51,95,,percent of total billed charges,,,2290.28,90,,percent of total billed charges,,,2290.28,90,,percent of total billed charges,,,2086.7,82,,percent of total billed charges,,,2290.28,90,,percent of total billed charges,,,2163.04,85,,percent of total billed charges,,1918.74,2417.51,
S&N FIRSTPASS ST SUTURE PASSER,30184350,CDM,,,270,RC,inpatient,,3102.84,3102.84,,2634.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2339.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2637.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2730.5,88,,percent of total billed charges,,,,,,,,,2370.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2823.58,91,,percent of total billed charges,,,2947.7,95,,percent of total billed charges,,,2575.36,83,,percent of total billed charges,,,2575.36,83,,percent of total billed charges,,,,,,,,,,,,,,,2575.36,83,,percent of total billed charges,,,2947.7,95,,percent of total billed charges,,,2792.56,90,,percent of total billed charges,,,2792.56,90,,percent of total billed charges,,,2544.33,82,,percent of total billed charges,,,2792.56,90,,percent of total billed charges,,,2637.41,85,,percent of total billed charges,,2339.54,2947.7,
S&N BLADE MENISCETOMY 3.0 SHARP,30184351,CDM,,,270,RC,inpatient,,329.18,329.18,,279.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,248.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,279.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,289.68,88,,percent of total billed charges,,,,,,,,,251.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,299.55,91,,percent of total billed charges,,,312.72,95,,percent of total billed charges,,,273.22,83,,percent of total billed charges,,,273.22,83,,percent of total billed charges,,,,,,,,,,,,,,,273.22,83,,percent of total billed charges,,,312.72,95,,percent of total billed charges,,,296.26,90,,percent of total billed charges,,,296.26,90,,percent of total billed charges,,,269.93,82,,percent of total billed charges,,,296.26,90,,percent of total billed charges,,,279.8,85,,percent of total billed charges,,248.2,312.72,
S&N HIP DISTRACTOR RENTAL TRAY,30184352,CDM,,,270,RC,inpatient,,3867.5,3867.5,,3283.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2916.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3287.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3403.4,88,,percent of total billed charges,,,,,,,,,2954.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3519.43,91,,percent of total billed charges,,,3674.13,95,,percent of total billed charges,,,3210.03,83,,percent of total billed charges,,,3210.03,83,,percent of total billed charges,,,,,,,,,,,,,,,3210.03,83,,percent of total billed charges,,,3674.13,95,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3171.35,82,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3287.38,85,,percent of total billed charges,,2916.1,3674.13,
SYNTHES SCREW CANCELLOUS 4.0 X 28MM,30184357,CDM,,,278,RC,inpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,168.24,211.97,
SYNTHES PLATE 3.5LCP 5 HOLE 72MM,30184358,CDM,,,278,RC,inpatient,,2919.02,2919.02,,2478.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2200.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2481.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2568.74,88,,percent of total billed charges,,,,,,,,,2230.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2656.31,91,,percent of total billed charges,,,2773.07,95,,percent of total billed charges,,,2422.79,83,,percent of total billed charges,,,2422.79,83,,percent of total billed charges,,,,,,,,,,,,,,,2422.79,83,,percent of total billed charges,,,2773.07,95,,percent of total billed charges,,,2627.12,90,,percent of total billed charges,,,2627.12,90,,percent of total billed charges,,,2393.6,82,,percent of total billed charges,,,2627.12,90,,percent of total billed charges,,,2481.17,85,,percent of total billed charges,,2200.94,2773.07,
DEPUY LINER NEUTRAL 32 X 50MM,30184359,CDM,,,278,RC,inpatient,,10422.17,10422.17,,8848.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7858.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8858.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9171.51,88,,percent of total billed charges,,,,,,,,,7962.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9484.17,91,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,,,,,,,,,,,,,8650.4,83,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8546.18,82,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8858.84,85,,percent of total billed charges,,7858.32,9901.06,
DEPUY LINER 40 X 56MM +4 / 10DEGREE,30184360,CDM,,,278,RC,inpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13270.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14960.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,13270.78,16720.48,
DEPUY HEAD 36MM +3,30184361,CDM,,,278,RC,inpatient,,8767.27,8767.27,,7443.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6610.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7452.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7715.2,88,,percent of total billed charges,,,,,,,,,6698.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7978.22,91,,percent of total billed charges,,,8328.91,95,,percent of total billed charges,,,7276.83,83,,percent of total billed charges,,,7276.83,83,,percent of total billed charges,,,,,,,,,,,,,,,7276.83,83,,percent of total billed charges,,,8328.91,95,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7189.16,82,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7452.18,85,,percent of total billed charges,,6610.52,8328.91,
MEDTRONIC LEAD KIT VECTRIS SURESCAN,30184362,CDM,,,270,RC,inpatient,,14592.5,14592.5,,12389.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11002.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12403.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12841.4,88,,percent of total billed charges,,,,,,,,,11148.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13279.18,91,,percent of total billed charges,,,13862.88,95,,percent of total billed charges,,,12111.78,83,,percent of total billed charges,,,12111.78,83,,percent of total billed charges,,,,,,,,,,,,,,,12111.78,83,,percent of total billed charges,,,13862.88,95,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,11965.85,82,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,12403.63,85,,percent of total billed charges,,11002.75,13862.88,
MEDTRONIC NEURO STIMULATOR SURESSCAN SEN,30184363,CDM,,,278,RC,inpatient,,103350,103350,,87744.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77925.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87847.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90948,88,,percent of total billed charges,,,,,,,,,78959.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,94048.5,91,,percent of total billed charges,,,98182.5,95,,percent of total billed charges,,,85780.5,83,,percent of total billed charges,,,85780.5,83,,percent of total billed charges,,,,,,,,,,,,,,,85780.5,83,,percent of total billed charges,,,98182.5,95,,percent of total billed charges,,,93015,90,,percent of total billed charges,,,93015,90,,percent of total billed charges,,,84747,82,,percent of total billed charges,,,93015,90,,percent of total billed charges,,,87847.5,85,,percent of total billed charges,,77925.9,98182.5,
MEDTRONIC PATIENT PROGRAMMER,30184364,CDM,,,270,RC,inpatient,,6792.5,6792.5,,5766.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5121.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5773.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5977.4,88,,percent of total billed charges,,,,,,,,,5189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6181.18,91,,percent of total billed charges,,,6452.88,95,,percent of total billed charges,,,5637.78,83,,percent of total billed charges,,,5637.78,83,,percent of total billed charges,,,,,,,,,,,,,,,5637.78,83,,percent of total billed charges,,,6452.88,95,,percent of total billed charges,,,6113.25,90,,percent of total billed charges,,,6113.25,90,,percent of total billed charges,,,5569.85,82,,percent of total billed charges,,,6113.25,90,,percent of total billed charges,,,5773.63,85,,percent of total billed charges,,5121.55,6452.88,
MEDTRONIC PATIENT RECHARGER,30184365,CDM,,,270,RC,inpatient,,13000,13000,,11037,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9802,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11050,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11440,88,,percent of total billed charges,,,,,,,,,9932,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11830,91,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,,,,,,,,,,,,,10790,83,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,10660,82,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11050,85,,percent of total billed charges,,9802,12350,
EYE LENS IMPLANT ALCON MTA4U0,30184366,CDM,,,278,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
ANTERIOR VITRECTOMY PACK 6 DP,30184367,CDM,,,270,RC,inpatient,,848.51,848.51,,720.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,639.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,721.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,746.69,88,,percent of total billed charges,,,,,,,,,648.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,772.14,91,,percent of total billed charges,,,806.08,95,,percent of total billed charges,,,704.26,83,,percent of total billed charges,,,704.26,83,,percent of total billed charges,,,,,,,,,,,,,,,704.26,83,,percent of total billed charges,,,806.08,95,,percent of total billed charges,,,763.66,90,,percent of total billed charges,,,763.66,90,,percent of total billed charges,,,695.78,82,,percent of total billed charges,,,763.66,90,,percent of total billed charges,,,721.23,85,,percent of total billed charges,,639.78,806.08,
ZIMMER SAWBLADE OXF,30184369,CDM,,,270,RC,inpatient,,2522,2522,,2141.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1901.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2143.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2219.36,88,,percent of total billed charges,,,,,,,,,1926.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2295.02,91,,percent of total billed charges,,,2395.9,95,,percent of total billed charges,,,2093.26,83,,percent of total billed charges,,,2093.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2093.26,83,,percent of total billed charges,,,2395.9,95,,percent of total billed charges,,,2269.8,90,,percent of total billed charges,,,2269.8,90,,percent of total billed charges,,,2068.04,82,,percent of total billed charges,,,2269.8,90,,percent of total billed charges,,,2143.7,85,,percent of total billed charges,,1901.59,2395.9,
ZIMMER DRILL PINS 1/8 QUICK REL,30184370,CDM,,,270,RC,inpatient,,644,644,,546.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,485.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,547.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,566.72,88,,percent of total billed charges,,,,,,,,,492.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,586.04,91,,percent of total billed charges,,,611.8,95,,percent of total billed charges,,,534.52,83,,percent of total billed charges,,,534.52,83,,percent of total billed charges,,,,,,,,,,,,,,,534.52,83,,percent of total billed charges,,,611.8,95,,percent of total billed charges,,,579.6,90,,percent of total billed charges,,,579.6,90,,percent of total billed charges,,,528.08,82,,percent of total billed charges,,,579.6,90,,percent of total billed charges,,,547.4,85,,percent of total billed charges,,485.58,611.8,
ZIMMER BEARING OXF LT LG SZ 4MM,30184371,CDM,,,270,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
ZIMMER TIBIA SZ E LM UNI,30184372,CDM,,,270,RC,inpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10218.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11519.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,10218.59,12874.88,
ZIMMER FEMUR LARGE OXF TWIN PED CMNTD,30184373,CDM,,,278,RC,inpatient,,20345,20345,,17272.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15340.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17293.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17903.6,88,,percent of total billed charges,,,,,,,,,15543.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18513.95,91,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,,,,,,,,,,,,,16886.35,83,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,16682.9,82,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,17293.25,85,,percent of total billed charges,,15340.13,19327.75,
DEPUY MOP POROUS ALTREX/GRIPTON 36MM,30184375,CDM,,,278,RC,inpatient,,38243.21,38243.21,,32468.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28835.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32506.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33654.02,88,,percent of total billed charges,,,,,,,,,29217.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34801.32,91,,percent of total billed charges,,,36331.05,95,,percent of total billed charges,,,31741.86,83,,percent of total billed charges,,,31741.86,83,,percent of total billed charges,,,,,,,,,,,,,,,31741.86,83,,percent of total billed charges,,,36331.05,95,,percent of total billed charges,,,34418.89,90,,percent of total billed charges,,,34418.89,90,,percent of total billed charges,,,31359.43,82,,percent of total billed charges,,,34418.89,90,,percent of total billed charges,,,32506.73,85,,percent of total billed charges,,28835.38,36331.05,
SYNTHES SCREW CORTEX ST 2.7MM,30184376,CDM,,,278,RC,inpatient,,386.75,386.75,,328.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.34,88,,percent of total billed charges,,,,,,,,,295.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.94,91,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,321,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,,,,,,,,,,,,,,321,83,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,317.14,82,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,291.61,367.41,
SYNTHES DRILL BIT QC 2.7 X 100MM,30184377,CDM,,,278,RC,inpatient,,795.34,795.34,,675.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,599.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,676.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,699.9,88,,percent of total billed charges,,,,,,,,,607.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,723.76,91,,percent of total billed charges,,,755.57,95,,percent of total billed charges,,,660.13,83,,percent of total billed charges,,,660.13,83,,percent of total billed charges,,,,,,,,,,,,,,,660.13,83,,percent of total billed charges,,,755.57,95,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,652.18,82,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,676.04,85,,percent of total billed charges,,599.69,755.57,
SYNTHES PLATE DISTAL RADIUS VA 2.4MM 7 H,30184378,CDM,,,278,RC,inpatient,,9210.18,9210.18,,7819.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6944.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7828.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8104.96,88,,percent of total billed charges,,,,,,,,,7036.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8381.26,91,,percent of total billed charges,,,8749.67,95,,percent of total billed charges,,,7644.45,83,,percent of total billed charges,,,7644.45,83,,percent of total billed charges,,,,,,,,,,,,,,,7644.45,83,,percent of total billed charges,,,8749.67,95,,percent of total billed charges,,,8289.16,90,,percent of total billed charges,,,8289.16,90,,percent of total billed charges,,,7552.35,82,,percent of total billed charges,,,8289.16,90,,percent of total billed charges,,,7828.65,85,,percent of total billed charges,,6944.48,8749.67,
SYNTHES SCREW CORTEX 2.4 X 14MM,30184379,CDM,,,278,RC,inpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,452.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,509.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,452.17,569.71,
SYNTHES SCREW CANNULATED 6.5 X 95MM,30184380,CDM,,,278,RC,inpatient,,2795.65,2795.65,,2373.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2107.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2376.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2460.17,88,,percent of total billed charges,,,,,,,,,2135.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2544.04,91,,percent of total billed charges,,,2655.87,95,,percent of total billed charges,,,2320.39,83,,percent of total billed charges,,,2320.39,83,,percent of total billed charges,,,,,,,,,,,,,,,2320.39,83,,percent of total billed charges,,,2655.87,95,,percent of total billed charges,,,2516.09,90,,percent of total billed charges,,,2516.09,90,,percent of total billed charges,,,2292.43,82,,percent of total billed charges,,,2516.09,90,,percent of total billed charges,,,2376.3,85,,percent of total billed charges,,2107.92,2655.87,
SYNTHES SCREW LOCKING VA 44MM,30184381,CDM,,,278,RC,inpatient,,1469.65,1469.65,,1247.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1108.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1249.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1293.29,88,,percent of total billed charges,,,,,,,,,1122.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1337.38,91,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1219.81,83,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1205.11,82,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1249.2,85,,percent of total billed charges,,1108.12,1396.17,
SYNTHES SCREW LOCKING VA 40MM,30184382,CDM,,,278,RC,inpatient,,1469.65,1469.65,,1247.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1108.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1249.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1293.29,88,,percent of total billed charges,,,,,,,,,1122.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1337.38,91,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1219.81,83,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1205.11,82,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1249.2,85,,percent of total billed charges,,1108.12,1396.17,
SYNTHES SCREW LOCKING VA 36MM,30184383,CDM,,,278,RC,inpatient,,1469.65,1469.65,,1247.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1108.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1249.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1293.29,88,,percent of total billed charges,,,,,,,,,1122.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1337.38,91,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1219.81,83,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1205.11,82,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1249.2,85,,percent of total billed charges,,1108.12,1396.17,
SYNTHES SCREW LOCKING VA 30MM,30184384,CDM,,,278,RC,inpatient,,1469.65,1469.65,,1247.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1108.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1249.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1293.29,88,,percent of total billed charges,,,,,,,,,1122.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1337.38,91,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1219.81,83,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1205.11,82,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1249.2,85,,percent of total billed charges,,1108.12,1396.17,
SYNTHES SCREW LOCKING VA 28MM,30184385,CDM,,,278,RC,inpatient,,1469.65,1469.65,,1247.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1108.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1249.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1293.29,88,,percent of total billed charges,,,,,,,,,1122.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1337.38,91,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1219.81,83,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1205.11,82,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1249.2,85,,percent of total billed charges,,1108.12,1396.17,
SYNTHES PLATE CALCANEAL,30184386,CDM,,,278,RC,inpatient,,10188.1,10188.1,,8649.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7681.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8659.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8965.53,88,,percent of total billed charges,,,,,,,,,7783.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9271.17,91,,percent of total billed charges,,,9678.7,95,,percent of total billed charges,,,8456.12,83,,percent of total billed charges,,,8456.12,83,,percent of total billed charges,,,,,,,,,,,,,,,8456.12,83,,percent of total billed charges,,,9678.7,95,,percent of total billed charges,,,9169.29,90,,percent of total billed charges,,,9169.29,90,,percent of total billed charges,,,8354.24,82,,percent of total billed charges,,,9169.29,90,,percent of total billed charges,,,8659.89,85,,percent of total billed charges,,7681.83,9678.7,
ARTHREX BB-TAK THREADED,30184387,CDM,,,278,RC,inpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,448.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,505.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,448.63,565.25,
ARTHREX DRILL BIT 2.4MM,30184388,CDM,,,278,RC,inpatient,,553,553,,469.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,416.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,470.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,486.64,88,,percent of total billed charges,,,,,,,,,422.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,503.23,91,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,,,,,,,,,,,,,458.99,83,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,453.46,82,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,416.96,525.35,
ARTHREX SCREW CORTEX LP 2.4 X 10MM,30184389,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW CORTEX LP 2.4 X 12MM,30184390,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW CORTEX LP 2.4 X 14MM,30184391,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW CORTEX LP 2.4 X 16MM,30184392,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW LOCKING LP 2.4 X 8MM,30184393,CDM,,,278,RC,inpatient,,875,875,,742.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,659.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,743.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,770,88,,percent of total billed charges,,,,,,,,,668.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,796.25,91,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,,,,,,,,,,,,,726.25,83,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,717.5,82,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,659.75,831.25,
ARTHREX SCREW LOCKING LP 2.4 X 10MM,30184394,CDM,,,278,RC,inpatient,,875,875,,742.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,659.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,743.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,770,88,,percent of total billed charges,,,,,,,,,668.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,796.25,91,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,,,,,,,,,,,,,726.25,83,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,717.5,82,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,659.75,831.25,
ARTHREX SCREW LOCKING LP 2.4 X 12MM,30184395,CDM,,,278,RC,inpatient,,875,875,,742.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,659.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,743.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,770,88,,percent of total billed charges,,,,,,,,,668.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,796.25,91,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,,,,,,,,,,,,,726.25,83,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,717.5,82,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,659.75,831.25,
ARTHREX SCREW LOCKING LP 2.4 X 14MM,30184396,CDM,,,278,RC,inpatient,,875,875,,742.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,659.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,743.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,770,88,,percent of total billed charges,,,,,,,,,668.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,796.25,91,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,,,,,,,,,,,,,726.25,83,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,717.5,82,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,659.75,831.25,
ARTHREX G-WIRE W/TRCR TIP .045  W/LASER,30184397,CDM,,,278,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
ARTHREX DRILL BIT 1.7MM,30184398,CDM,,,278,RC,inpatient,,553,553,,469.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,416.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,470.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,486.64,88,,percent of total billed charges,,,,,,,,,422.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,503.23,91,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,,,,,,,,,,,,,458.99,83,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,453.46,82,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,416.96,525.35,
ARTHREX GUIDE WIRE W/TROCAR TIP .062,30184399,CDM,,,278,RC,inpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,132.7,167.2,
ARTHREX PLATE LO-PRO STR 2.4MM 6 HOLE,30184400,CDM,,,278,RC,inpatient,,4517.5,4517.5,,3835.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3406.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3839.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3975.4,88,,percent of total billed charges,,,,,,,,,3451.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4110.93,91,,percent of total billed charges,,,4291.63,95,,percent of total billed charges,,,3749.53,83,,percent of total billed charges,,,3749.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3749.53,83,,percent of total billed charges,,,4291.63,95,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,3704.35,82,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,3839.88,85,,percent of total billed charges,,3406.2,4291.63,
ARTHREX PLATE LO-PRO STR 2.4MM 7 HOLE,30184401,CDM,,,278,RC,inpatient,,4517.5,4517.5,,3835.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3406.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3839.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3975.4,88,,percent of total billed charges,,,,,,,,,3451.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4110.93,91,,percent of total billed charges,,,4291.63,95,,percent of total billed charges,,,3749.53,83,,percent of total billed charges,,,3749.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3749.53,83,,percent of total billed charges,,,4291.63,95,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,3704.35,82,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,3839.88,85,,percent of total billed charges,,3406.2,4291.63,
ARTHREX DRILL CANNULATED 3.5MM,30184402,CDM,,,278,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
ARTHREX BONE TAP CANNULATED 4.5MM,30184403,CDM,,,278,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
ARTHREX BONE TAP CANNULATED 5.5MM,30184404,CDM,,,278,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
ARTHREX GUIDEWIRE W/TRCR TIP .078 X8,30184405,CDM,,,278,RC,inpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,150.8,190,
ARTHREX SCREW PT THD LO-PRO T1 5.5 X 50M,30184406,CDM,,,278,RC,inpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3896.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4392.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,3896.3,4909.13,
S&N ULTRATAPE 2MM BLUE 38,30184407,CDM,,,270,RC,inpatient,,386.75,386.75,,328.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.34,88,,percent of total billed charges,,,,,,,,,295.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.94,91,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,321,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,,,,,,,,,,,,,,321,83,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,317.14,82,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,291.61,367.41,
S&N HEALICOIL SA PK 5.5MM,30184408,CDM,,,270,RC,inpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1519.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1712.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,1519.31,1914.25,
S&N MULTIFIX S PEEK 5.5MM,30184409,CDM,,,270,RC,inpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1519.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1712.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,1519.31,1914.25,
S&N HEALICOIL PK 5.5MM W/UB2-CBR BLK UTP,30184410,CDM,,,270,RC,inpatient,,2269.8,2269.8,,1927.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1711.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1929.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1997.42,88,,percent of total billed charges,,,,,,,,,1734.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2065.52,91,,percent of total billed charges,,,2156.31,95,,percent of total billed charges,,,1883.93,83,,percent of total billed charges,,,1883.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1883.93,83,,percent of total billed charges,,,2156.31,95,,percent of total billed charges,,,2042.82,90,,percent of total billed charges,,,2042.82,90,,percent of total billed charges,,,1861.24,82,,percent of total billed charges,,,2042.82,90,,percent of total billed charges,,,1929.33,85,,percent of total billed charges,,1711.43,2156.31,
DEPUY STEM SUMMIT STD SZ 5,30184411,CDM,,,278,RC,inpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26584.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29969.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,26584.74,33495.37,
DEPUY FEMUR LPS PROXIMAL 15 DEG RT,30184412,CDM,,,278,RC,inpatient,,56410.06,56410.06,,47892.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42533.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47948.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49640.85,88,,percent of total billed charges,,,,,,,,,43097.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51333.15,91,,percent of total billed charges,,,53589.56,95,,percent of total billed charges,,,46820.35,83,,percent of total billed charges,,,46820.35,83,,percent of total billed charges,,,,,,,,,,,,,,,46820.35,83,,percent of total billed charges,,,53589.56,95,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,46256.25,82,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,47948.55,85,,percent of total billed charges,,42533.19,53589.56,
DEPUY OSTEOTOME RADIAL 14MM X 5,30184413,CDM,,,278,RC,inpatient,,5687.5,5687.5,,4828.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4288.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4834.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5005,88,,percent of total billed charges,,,,,,,,,4345.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5175.63,91,,percent of total billed charges,,,5403.13,95,,percent of total billed charges,,,4720.63,83,,percent of total billed charges,,,4720.63,83,,percent of total billed charges,,,,,,,,,,,,,,,4720.63,83,,percent of total billed charges,,,5403.13,95,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,4663.75,82,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,4834.38,85,,percent of total billed charges,,4288.38,5403.13,
DEPUY TREPHINES 14MM,30184414,CDM,,,278,RC,inpatient,,3549,3549,,3013.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2675.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3016.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3123.12,88,,percent of total billed charges,,,,,,,,,2711.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3229.59,91,,percent of total billed charges,,,3371.55,95,,percent of total billed charges,,,2945.67,83,,percent of total billed charges,,,2945.67,83,,percent of total billed charges,,,,,,,,,,,,,,,2945.67,83,,percent of total billed charges,,,3371.55,95,,percent of total billed charges,,,3194.1,90,,percent of total billed charges,,,3194.1,90,,percent of total billed charges,,,2910.18,82,,percent of total billed charges,,,3194.1,90,,percent of total billed charges,,,3016.65,85,,percent of total billed charges,,2675.95,3371.55,
DEPUY TREPHINES 14.5MM,30184415,CDM,,,278,RC,inpatient,,3549,3549,,3013.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2675.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3016.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3123.12,88,,percent of total billed charges,,,,,,,,,2711.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3229.59,91,,percent of total billed charges,,,3371.55,95,,percent of total billed charges,,,2945.67,83,,percent of total billed charges,,,2945.67,83,,percent of total billed charges,,,,,,,,,,,,,,,2945.67,83,,percent of total billed charges,,,3371.55,95,,percent of total billed charges,,,3194.1,90,,percent of total billed charges,,,3194.1,90,,percent of total billed charges,,,2910.18,82,,percent of total billed charges,,,3194.1,90,,percent of total billed charges,,,3016.65,85,,percent of total billed charges,,2675.95,3371.55,
S&N FEMUR OXINIUM PS SZ 5 RT,30184416,CDM,,,278,RC,inpatient,,32523.99,32523.99,,27612.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24523.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27645.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28621.11,88,,percent of total billed charges,,,,,,,,,24848.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29596.83,91,,percent of total billed charges,,,30897.79,95,,percent of total billed charges,,,26994.91,83,,percent of total billed charges,,,26994.91,83,,percent of total billed charges,,,,,,,,,,,,,,,26994.91,83,,percent of total billed charges,,,30897.79,95,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,26669.67,82,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,27645.39,85,,percent of total billed charges,,24523.09,30897.79,
S&N LGN PS HIGH FLEX XLPE SZ 5-6 13MM,30184417,CDM,,,278,RC,inpatient,,11895,11895,,10098.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8968.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10110.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10467.6,88,,percent of total billed charges,,,,,,,,,9087.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10824.45,91,,percent of total billed charges,,,11300.25,95,,percent of total billed charges,,,9872.85,83,,percent of total billed charges,,,9872.85,83,,percent of total billed charges,,,,,,,,,,,,,,,9872.85,83,,percent of total billed charges,,,11300.25,95,,percent of total billed charges,,,10705.5,90,,percent of total billed charges,,,10705.5,90,,percent of total billed charges,,,9753.9,82,,percent of total billed charges,,,10705.5,90,,percent of total billed charges,,,10110.75,85,,percent of total billed charges,,8968.83,11300.25,
S&N PLATE TIBIA BASE GENISIS II SZ 5 RT,30184418,CDM,,,278,RC,inpatient,,15593.11,15593.11,,13238.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11757.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13254.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13721.94,88,,percent of total billed charges,,,,,,,,,11913.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14189.73,91,,percent of total billed charges,,,14813.45,95,,percent of total billed charges,,,12942.28,83,,percent of total billed charges,,,12942.28,83,,percent of total billed charges,,,,,,,,,,,,,,,12942.28,83,,percent of total billed charges,,,14813.45,95,,percent of total billed charges,,,14033.8,90,,percent of total billed charges,,,14033.8,90,,percent of total billed charges,,,12786.35,82,,percent of total billed charges,,,14033.8,90,,percent of total billed charges,,,13254.14,85,,percent of total billed charges,,11757.2,14813.45,
S&N GENESIS PIN & DRILL SET,30184419,CDM,,,270,RC,inpatient,,876.33,876.33,,744,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,660.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,744.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,771.17,88,,percent of total billed charges,,,,,,,,,669.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,797.46,91,,percent of total billed charges,,,832.51,95,,percent of total billed charges,,,727.35,83,,percent of total billed charges,,,727.35,83,,percent of total billed charges,,,,,,,,,,,,,,,727.35,83,,percent of total billed charges,,,832.51,95,,percent of total billed charges,,,788.7,90,,percent of total billed charges,,,788.7,90,,percent of total billed charges,,,718.59,82,,percent of total billed charges,,,788.7,90,,percent of total billed charges,,,744.88,85,,percent of total billed charges,,660.75,832.51,
S&N FEMUR OXINIUM PS SZ 5 LT,30184420,CDM,,,278,RC,inpatient,,27300,27300,,23177.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20584.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23205,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24024,88,,percent of total billed charges,,,,,,,,,20857.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24843,91,,percent of total billed charges,,,25935,95,,percent of total billed charges,,,22659,83,,percent of total billed charges,,,22659,83,,percent of total billed charges,,,,,,,,,,,,,,,22659,83,,percent of total billed charges,,,25935,95,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,22386,82,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,23205,85,,percent of total billed charges,,20584.2,25935,
LEXION INSUFLOW,30184421,CDM,,,270,RC,inpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,448.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,505.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,448.63,565.25,
DEPUY INSERT TCS RP 15MM SZ 5,30184422,CDM,,,278,RC,inpatient,,15465.58,15465.58,,13130.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11661.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13145.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13609.71,88,,percent of total billed charges,,,,,,,,,11815.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14073.68,91,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,,,,,,,,,,,,,12836.43,83,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,12681.78,82,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13145.74,85,,percent of total billed charges,,11661.05,14692.3,
DEPUY FEMUR PS SIGMA LT SZ 6,30184423,CDM,,,278,RC,inpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18972.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21388.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,18972.51,23904.36,
DEPUY INSERT RP 10MM SZ 6,30184424,CDM,,,278,RC,inpatient,,11480.69,11480.69,,9747.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8656.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9758.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10103.01,88,,percent of total billed charges,,,,,,,,,8771.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10447.43,91,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,,,,,,,,,,,,,9528.97,83,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9414.17,82,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,8656.44,10906.66,
ALLOSOURCE ANTERIOR TIBIALIS,30184425,CDM,,,278,RC,inpatient,,18396.24,18396.24,,15618.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13870.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15636.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16188.69,88,,percent of total billed charges,,,,,,,,,14054.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16740.58,91,,percent of total billed charges,,,17476.43,95,,percent of total billed charges,,,15268.88,83,,percent of total billed charges,,,15268.88,83,,percent of total billed charges,,,,,,,,,,,,,,,15268.88,83,,percent of total billed charges,,,17476.43,95,,percent of total billed charges,,,16556.62,90,,percent of total billed charges,,,16556.62,90,,percent of total billed charges,,,15084.92,82,,percent of total billed charges,,,16556.62,90,,percent of total billed charges,,,15636.8,85,,percent of total billed charges,,13870.76,17476.43,
ESOPHYX2 2-LINK,30184426,CDM,,,270,RC,inpatient,,23237.5,23237.5,,19728.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17521.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19751.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20449,88,,percent of total billed charges,,,,,,,,,17753.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21146.13,91,,percent of total billed charges,,,22075.63,95,,percent of total billed charges,,,19287.13,83,,percent of total billed charges,,,19287.13,83,,percent of total billed charges,,,,,,,,,,,,,,,19287.13,83,,percent of total billed charges,,,22075.63,95,,percent of total billed charges,,,20913.75,90,,percent of total billed charges,,,20913.75,90,,percent of total billed charges,,,19054.75,82,,percent of total billed charges,,,20913.75,90,,percent of total billed charges,,,19751.88,85,,percent of total billed charges,,17521.08,22075.63,
ZIMMER FEMUR OXFORD TWIN PEG,30184427,CDM,,,278,RC,inpatient,,20345,20345,,17272.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15340.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17293.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17903.6,88,,percent of total billed charges,,,,,,,,,15543.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18513.95,91,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,,,,,,,,,,,,,16886.35,83,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,16682.9,82,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,17293.25,85,,percent of total billed charges,,15340.13,19327.75,
ZIMMER TIBIAL TRAY RT MEDIAL,30184428,CDM,,,278,RC,inpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10218.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11519.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,10218.59,12874.88,
ZIMMER BEARING ANATOMIC MENISCAL RT MEDI,30184429,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
DEPUY ATTUNE RP TOTAL KNEE,30184432,CDM,,,278,RC,inpatient,,37440,37440,,31786.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28229.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31824,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32947.2,88,,percent of total billed charges,,,,,,,,,28604.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34070.4,91,,percent of total billed charges,,,35568,95,,percent of total billed charges,,,31075.2,83,,percent of total billed charges,,,31075.2,83,,percent of total billed charges,,,,,,,,,,,,,,,31075.2,83,,percent of total billed charges,,,35568,95,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,30700.8,82,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,31824,85,,percent of total billed charges,,28229.76,35568,
SYNTHES SCREW LOCKING S-T 3.5 X 28MM,30184433,CDM,,,278,RC,inpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,945.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1066.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,945.79,1191.65,
SYNTHES SCREW LOCKING S-T 3.5 X 45MM,30184434,CDM,,,278,RC,inpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,945.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1066.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,945.79,1191.65,
SYNTHES SCREW CORTEX 3.5 X 24MM,30184435,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
SYNTHES SCREW CORTEX 3.5 X 28MM,30184436,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
SYNTHES K-WIRE 1.6MM 5MM THREAD,30184437,CDM,,,278,RC,inpatient,,195.46,195.46,,165.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,166.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,172,88,,percent of total billed charges,,,,,,,,,149.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,177.87,91,,percent of total billed charges,,,185.69,95,,percent of total billed charges,,,162.23,83,,percent of total billed charges,,,162.23,83,,percent of total billed charges,,,,,,,,,,,,,,,162.23,83,,percent of total billed charges,,,185.69,95,,percent of total billed charges,,,175.91,90,,percent of total billed charges,,,175.91,90,,percent of total billed charges,,,160.28,82,,percent of total billed charges,,,175.91,90,,percent of total billed charges,,,166.14,85,,percent of total billed charges,,147.38,185.69,
DEPUY ATTUNE FB TOTAL KNEE,30184438,CDM,,,278,RC,inpatient,,37440,37440,,31786.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28229.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31824,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32947.2,88,,percent of total billed charges,,,,,,,,,28604.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34070.4,91,,percent of total billed charges,,,35568,95,,percent of total billed charges,,,31075.2,83,,percent of total billed charges,,,31075.2,83,,percent of total billed charges,,,,,,,,,,,,,,,31075.2,83,,percent of total billed charges,,,35568,95,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,30700.8,82,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,31824,85,,percent of total billed charges,,28229.76,35568,
DEPUY HEAD TAPER 28 +0 14/16,30184439,CDM,,,278,RC,inpatient,,7623.56,7623.56,,6472.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5748.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6480.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6708.73,88,,percent of total billed charges,,,,,,,,,5824.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6937.44,91,,percent of total billed charges,,,7242.38,95,,percent of total billed charges,,,6327.55,83,,percent of total billed charges,,,6327.55,83,,percent of total billed charges,,,,,,,,,,,,,,,6327.55,83,,percent of total billed charges,,,7242.38,95,,percent of total billed charges,,,6861.2,90,,percent of total billed charges,,,6861.2,90,,percent of total billed charges,,,6251.32,82,,percent of total billed charges,,,6861.2,90,,percent of total billed charges,,,6480.03,85,,percent of total billed charges,,5748.16,7242.38,
ALLOSOURCE FIBULA RIGHT WHOLE,30184440,CDM,,,278,RC,inpatient,,10335,10335,,8774.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7792.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8784.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9094.8,88,,percent of total billed charges,,,,,,,,,7895.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9404.85,91,,percent of total billed charges,,,9818.25,95,,percent of total billed charges,,,8578.05,83,,percent of total billed charges,,,8578.05,83,,percent of total billed charges,,,,,,,,,,,,,,,8578.05,83,,percent of total billed charges,,,9818.25,95,,percent of total billed charges,,,9301.5,90,,percent of total billed charges,,,9301.5,90,,percent of total billed charges,,,8474.7,82,,percent of total billed charges,,,9301.5,90,,percent of total billed charges,,,8784.75,85,,percent of total billed charges,,7792.59,9818.25,
DEPUY CAGE PROTROSIS 56 OD,30184441,CDM,,,278,RC,inpatient,,21625.7,21625.7,,18360.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16305.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18381.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19030.62,88,,percent of total billed charges,,,,,,,,,16522.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19679.39,91,,percent of total billed charges,,,20544.42,95,,percent of total billed charges,,,17949.33,83,,percent of total billed charges,,,17949.33,83,,percent of total billed charges,,,,,,,,,,,,,,,17949.33,83,,percent of total billed charges,,,20544.42,95,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,17733.07,82,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,18381.85,85,,percent of total billed charges,,16305.78,20544.42,
DEPUY SCREW BONE 15MM,30184442,CDM,,,278,RC,inpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1160.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1308.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,1160.95,1462.73,
ARTHREX TIGHTROPE ABS BUTTON ROUND,30184443,CDM,,,278,RC,inpatient,,1391,1391,,1180.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1048.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1182.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1224.08,88,,percent of total billed charges,,,,,,,,,1062.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1265.81,91,,percent of total billed charges,,,1321.45,95,,percent of total billed charges,,,1154.53,83,,percent of total billed charges,,,1154.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1154.53,83,,percent of total billed charges,,,1321.45,95,,percent of total billed charges,,,1251.9,90,,percent of total billed charges,,,1251.9,90,,percent of total billed charges,,,1140.62,82,,percent of total billed charges,,,1251.9,90,,percent of total billed charges,,,1182.35,85,,percent of total billed charges,,1048.81,1321.45,
ARTHREX TIGHTROPE ABS IMPLANT OPEN,30184444,CDM,,,278,RC,inpatient,,1261,1261,,1070.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,950.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1071.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1109.68,88,,percent of total billed charges,,,,,,,,,963.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1147.51,91,,percent of total billed charges,,,1197.95,95,,percent of total billed charges,,,1046.63,83,,percent of total billed charges,,,1046.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1046.63,83,,percent of total billed charges,,,1197.95,95,,percent of total billed charges,,,1134.9,90,,percent of total billed charges,,,1134.9,90,,percent of total billed charges,,,1034.02,82,,percent of total billed charges,,,1134.9,90,,percent of total billed charges,,,1071.85,85,,percent of total billed charges,,950.79,1197.95,
ARTHREX ACL TIGHTROPE RT,30184445,CDM,,,278,RC,inpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1715.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1933.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,1715.35,2161.25,
DEPUY HEAD HUMERAL GLOBAL 40 X 15,30184446,CDM,,,278,RC,inpatient,,15528.76,15528.76,,13183.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11708.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13199.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13665.31,88,,percent of total billed charges,,,,,,,,,11863.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14131.17,91,,percent of total billed charges,,,14752.32,95,,percent of total billed charges,,,12888.87,83,,percent of total billed charges,,,12888.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12888.87,83,,percent of total billed charges,,,14752.32,95,,percent of total billed charges,,,13975.88,90,,percent of total billed charges,,,13975.88,90,,percent of total billed charges,,,12733.58,82,,percent of total billed charges,,,13975.88,90,,percent of total billed charges,,,13199.45,85,,percent of total billed charges,,11708.69,14752.32,
DEPUY BODY PROX ANATOMIC UNITE SZ 6/8,30184447,CDM,,,278,RC,inpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9541.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10756.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,9541.61,12021.93,
DEPUY STEM STD UNITE SZ 10,30184448,CDM,,,278,RC,inpatient,,26023.86,26023.86,,22094.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19621.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22120.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22901,88,,percent of total billed charges,,,,,,,,,19882.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23681.71,91,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21599.8,83,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,21339.57,82,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,19621.99,24722.67,
DEPUY BODY PROX ANATOMIC UNITE SZ 10,30184449,CDM,,,278,RC,inpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9541.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10756.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,9541.61,12021.93,
SYNTHES PLATE VOLAR DISTAL RADIUS 2.4MM,30184450,CDM,,,278,RC,inpatient,,9056,9056,,7688.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6828.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7697.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7969.28,88,,percent of total billed charges,,,,,,,,,6918.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8240.96,91,,percent of total billed charges,,,8603.2,95,,percent of total billed charges,,,7516.48,83,,percent of total billed charges,,,7516.48,83,,percent of total billed charges,,,,,,,,,,,,,,,7516.48,83,,percent of total billed charges,,,8603.2,95,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,7425.92,82,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,7697.6,85,,percent of total billed charges,,6828.22,8603.2,
SYNTHES SCREW CORTEX S-T 2.7 X 24MM,30184451,CDM,,,278,RC,inpatient,,386.75,386.75,,328.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.34,88,,percent of total billed charges,,,,,,,,,295.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.94,91,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,321,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,,,,,,,,,,,,,,321,83,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,317.14,82,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,291.61,367.41,
SYNTHES SCREW CORTEX S-T 2.7 X 20MM,30184452,CDM,,,278,RC,inpatient,,386.75,386.75,,328.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.34,88,,percent of total billed charges,,,,,,,,,295.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.94,91,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,321,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,,,,,,,,,,,,,,321,83,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,317.14,82,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,291.61,367.41,
SYNTHES SCREW LOCKING ANGLE 2.4 X 26MM,30184453,CDM,,,278,RC,inpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1020.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1150.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,1020.93,1286.32,
ZIMMER HEAD FEMORAL 12/14 28MM +3.5,30184454,CDM,,,278,RC,inpatient,,7988.5,7988.5,,6782.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6023.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6790.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7029.88,88,,percent of total billed charges,,,,,,,,,6103.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7269.54,91,,percent of total billed charges,,,7589.08,95,,percent of total billed charges,,,6630.46,83,,percent of total billed charges,,,6630.46,83,,percent of total billed charges,,,,,,,,,,,,,,,6630.46,83,,percent of total billed charges,,,7589.08,95,,percent of total billed charges,,,7189.65,90,,percent of total billed charges,,,7189.65,90,,percent of total billed charges,,,6550.57,82,,percent of total billed charges,,,7189.65,90,,percent of total billed charges,,,6790.23,85,,percent of total billed charges,,6023.33,7589.08,
ARTHREX REAMER LOW PROFILE 11MM,30184456,CDM,,,278,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
ARTHREX TIGHTROPE BTB,30184457,CDM,,,278,RC,inpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2082.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2348.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,2082.93,2624.38,
ARTHREXTRANS-TIB ACL W/SAWBLD KIT,30184458,CDM,,,278,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
ARTHREX CUTTER II FLIP 10.0 MM,30184459,CDM,,,278,RC,inpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1592.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1795.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,1592.83,2006.88,
ARTHREX FIBERSTICK 2-0 FIBERWIRE 2-0,30184460,CDM,,,278,RC,inpatient,,285,285,,241.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,242.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,250.8,88,,percent of total billed charges,,,,,,,,,217.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,259.35,91,,percent of total billed charges,,,270.75,95,,percent of total billed charges,,,236.55,83,,percent of total billed charges,,,236.55,83,,percent of total billed charges,,,,,,,,,,,,,,,236.55,83,,percent of total billed charges,,,270.75,95,,percent of total billed charges,,,256.5,90,,percent of total billed charges,,,256.5,90,,percent of total billed charges,,,233.7,82,,percent of total billed charges,,,256.5,90,,percent of total billed charges,,,242.25,85,,percent of total billed charges,,214.89,270.75,
ARTHREX ANCHOR SUTURE BIO-SWVLK C,30184461,CDM,,,278,RC,inpatient,,2437.5,2437.5,,2069.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1837.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2071.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2145,88,,percent of total billed charges,,,,,,,,,1862.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2218.13,91,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2023.13,83,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,1998.75,82,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,1837.88,2315.63,
ARTHREX REAMER LOW PROFILE 5MM,30184462,CDM,,,278,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
SYNTHES PLATE ANTERIOR ARTHRODESIS ANKLE,30184463,CDM,,,278,RC,inpatient,,9641.13,9641.13,,8185.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7269.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8194.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8484.19,88,,percent of total billed charges,,,,,,,,,7365.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8773.43,91,,percent of total billed charges,,,9159.07,95,,percent of total billed charges,,,8002.14,83,,percent of total billed charges,,,8002.14,83,,percent of total billed charges,,,,,,,,,,,,,,,8002.14,83,,percent of total billed charges,,,9159.07,95,,percent of total billed charges,,,8677.02,90,,percent of total billed charges,,,8677.02,90,,percent of total billed charges,,,7905.73,82,,percent of total billed charges,,,8677.02,90,,percent of total billed charges,,,8194.96,85,,percent of total billed charges,,7269.41,9159.07,
SYNTHES GUIDE WIRE NON THREADED 2.0MM,30184464,CDM,,,278,RC,inpatient,,398.65,398.65,,338.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,300.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,338.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,350.81,88,,percent of total billed charges,,,,,,,,,304.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,362.77,91,,percent of total billed charges,,,378.72,95,,percent of total billed charges,,,330.88,83,,percent of total billed charges,,,330.88,83,,percent of total billed charges,,,,,,,,,,,,,,,330.88,83,,percent of total billed charges,,,378.72,95,,percent of total billed charges,,,358.79,90,,percent of total billed charges,,,358.79,90,,percent of total billed charges,,,326.89,82,,percent of total billed charges,,,358.79,90,,percent of total billed charges,,,338.85,85,,percent of total billed charges,,300.58,378.72,
SYNTHES SCREW CORTEX 4.5 X 32MM,30184465,CDM,,,278,RC,inpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,222.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,197.08,248.31,
SYNTHES SCREW CORTEX 4.5 X 34MM,30184466,CDM,,,278,RC,inpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,222.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,197.08,248.31,
SYNTHES SCREW CORTEX 4.5 X 46MM,30184467,CDM,,,278,RC,inpatient,,277.28,277.28,,235.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,235.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.01,88,,percent of total billed charges,,,,,,,,,211.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.32,91,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,,,,,,,,,,,,,230.14,83,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,227.37,82,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,209.07,263.42,
SYNTHES SCREW CORTEX 4.5 X 42MM,30184468,CDM,,,278,RC,inpatient,,277.28,277.28,,235.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,235.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.01,88,,percent of total billed charges,,,,,,,,,211.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.32,91,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,,,,,,,,,,,,,230.14,83,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,227.37,82,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,209.07,263.42,
SYNTHES SCREW CORTEX 4.5 X  50MM,30184469,CDM,,,278,RC,inpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,222.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,197.08,248.31,
SYNTHES SCREW LOCKING 5.0 X 42MM,30184470,CDM,,,278,RC,inpatient,,1453.66,1453.66,,1234.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1096.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1235.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1279.22,88,,percent of total billed charges,,,,,,,,,1110.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1322.83,91,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1206.54,83,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1192,82,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1235.61,85,,percent of total billed charges,,1096.06,1380.98,
DEPUY INSERT TC3 SZ 5 12.5MM,30184471,CDM,,,278,RC,inpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17430.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19649.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,17430.21,21961.14,
ARTHREX CUTTER FLIP II 8.5MM,30184472,CDM,,,270,RC,inpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1592.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1795.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,1592.83,2006.88,
ARTHREX CUTTER FLIP II 9.0MM,30184473,CDM,,,270,RC,inpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1592.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1795.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,1592.83,2006.88,
ARTHREX REAMER LOW PROFILE 9.5MM,30184474,CDM,,,270,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
ARTHREX TIGHTROPE ABS IMPLANT,30184475,CDM,,,278,RC,inpatient,,1196,1196,,1015.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,901.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1016.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1052.48,88,,percent of total billed charges,,,,,,,,,913.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1088.36,91,,percent of total billed charges,,,1136.2,95,,percent of total billed charges,,,992.68,83,,percent of total billed charges,,,992.68,83,,percent of total billed charges,,,,,,,,,,,,,,,992.68,83,,percent of total billed charges,,,1136.2,95,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,980.72,82,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,1016.6,85,,percent of total billed charges,,901.78,1136.2,
ARTHREX TIGERSTICK #2 TIGERWIRE,30184476,CDM,,,278,RC,inpatient,,500.5,500.5,,424.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440.44,88,,percent of total billed charges,,,,,,,,,382.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455.46,91,,percent of total billed charges,,,475.48,95,,percent of total billed charges,,,415.42,83,,percent of total billed charges,,,415.42,83,,percent of total billed charges,,,,,,,,,,,,,,,415.42,83,,percent of total billed charges,,,475.48,95,,percent of total billed charges,,,450.45,90,,percent of total billed charges,,,450.45,90,,percent of total billed charges,,,410.41,82,,percent of total billed charges,,,450.45,90,,percent of total billed charges,,,425.43,85,,percent of total billed charges,,377.38,475.48,
ARTHREX FIBERWIRE #1 BLUE 38,30184477,CDM,,,278,RC,inpatient,,136,136,,115.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,102.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,115.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,119.68,88,,percent of total billed charges,,,,,,,,,103.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,123.76,91,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,,,,,,,,,,,,,112.88,83,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,111.52,82,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,102.54,129.2,
ARTHREX FIBERLOOP #2 BLUE,30184478,CDM,,,278,RC,inpatient,,500.5,500.5,,424.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440.44,88,,percent of total billed charges,,,,,,,,,382.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455.46,91,,percent of total billed charges,,,475.48,95,,percent of total billed charges,,,415.42,83,,percent of total billed charges,,,415.42,83,,percent of total billed charges,,,,,,,,,,,,,,,415.42,83,,percent of total billed charges,,,475.48,95,,percent of total billed charges,,,450.45,90,,percent of total billed charges,,,450.45,90,,percent of total billed charges,,,410.41,82,,percent of total billed charges,,,450.45,90,,percent of total billed charges,,,425.43,85,,percent of total billed charges,,377.38,475.48,
APPLIED EPIX LAPAROSCOPIC GRASPER,30184479,CDM,,,270,RC,inpatient,,337.5,337.5,,286.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,254.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,286.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,297,88,,percent of total billed charges,,,,,,,,,257.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,307.13,91,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,,,,,,,,,,,,,280.13,83,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,276.75,82,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,254.48,320.63,
ZIMMER OXF BEARING LEFT MEDIAL MENISCAL,30184481,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
ZIMMER OXF FEMORAL MEDIUM PMA,30184482,CDM,,,278,RC,inpatient,,20345,20345,,17272.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15340.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17293.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17903.6,88,,percent of total billed charges,,,,,,,,,15543.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18513.95,91,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,,,,,,,,,,,,,16886.35,83,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,16682.9,82,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,17293.25,85,,percent of total billed charges,,15340.13,19327.75,
ZIMMER TRAY TIBIAL LEFT MEDIAL,30184483,CDM,,,278,RC,inpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10218.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11519.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,10218.59,12874.88,
S&N FEMUR LEGION OX CONSTRAINED SZ 5 LT,30184484,CDM,,,278,RC,inpatient,,53956.5,53956.5,,45809.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40683.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45863.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47481.72,88,,percent of total billed charges,,,,,,,,,41222.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49100.42,91,,percent of total billed charges,,,51258.68,95,,percent of total billed charges,,,44783.9,83,,percent of total billed charges,,,44783.9,83,,percent of total billed charges,,,,,,,,,,,,,,,44783.9,83,,percent of total billed charges,,,51258.68,95,,percent of total billed charges,,,48560.85,90,,percent of total billed charges,,,48560.85,90,,percent of total billed charges,,,44244.33,82,,percent of total billed charges,,,48560.85,90,,percent of total billed charges,,,45863.03,85,,percent of total billed charges,,40683.2,51258.68,
S&N TIBIA LT SZ 5,30184485,CDM,,,278,RC,inpatient,,14573,14573,,12372.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10988.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12387.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12824.24,88,,percent of total billed charges,,,,,,,,,11133.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13261.43,91,,percent of total billed charges,,,13844.35,95,,percent of total billed charges,,,12095.59,83,,percent of total billed charges,,,12095.59,83,,percent of total billed charges,,,,,,,,,,,,,,,12095.59,83,,percent of total billed charges,,,13844.35,95,,percent of total billed charges,,,13115.7,90,,percent of total billed charges,,,13115.7,90,,percent of total billed charges,,,11949.86,82,,percent of total billed charges,,,13115.7,90,,percent of total billed charges,,,12387.05,85,,percent of total billed charges,,10988.04,13844.35,
S&N STEM 10 X 120MM,30184486,CDM,,,278,RC,inpatient,,9984,9984,,8476.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7527.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8486.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8785.92,88,,percent of total billed charges,,,,,,,,,7627.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9085.44,91,,percent of total billed charges,,,9484.8,95,,percent of total billed charges,,,8286.72,83,,percent of total billed charges,,,8286.72,83,,percent of total billed charges,,,,,,,,,,,,,,,8286.72,83,,percent of total billed charges,,,9484.8,95,,percent of total billed charges,,,8985.6,90,,percent of total billed charges,,,8985.6,90,,percent of total billed charges,,,8186.88,82,,percent of total billed charges,,,8985.6,90,,percent of total billed charges,,,8486.4,85,,percent of total billed charges,,7527.94,9484.8,
S&N INSERT XLPE SZ 5/6,30184487,CDM,,,278,RC,inpatient,,15198.11,15198.11,,12903.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11459.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12918.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13374.34,88,,percent of total billed charges,,,,,,,,,11611.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13830.28,91,,percent of total billed charges,,,14438.2,95,,percent of total billed charges,,,12614.43,83,,percent of total billed charges,,,12614.43,83,,percent of total billed charges,,,,,,,,,,,,,,,12614.43,83,,percent of total billed charges,,,14438.2,95,,percent of total billed charges,,,13678.3,90,,percent of total billed charges,,,13678.3,90,,percent of total billed charges,,,12462.45,82,,percent of total billed charges,,,13678.3,90,,percent of total billed charges,,,12918.39,85,,percent of total billed charges,,11459.37,14438.2,
DEPUY LINER 42MM +6,30184488,CDM,,,278,RC,inpatient,,10688.08,10688.08,,9074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8058.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9084.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9405.51,88,,percent of total billed charges,,,,,,,,,8165.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9726.15,91,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,,,,,,,,,,,,,8871.11,83,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,8764.23,82,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,8058.81,10153.68,
STOPCOCK 3-WAY SWIVEL MALE LL,30184489,CDM,,,270,RC,inpatient,,4.14,4.14,,3.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3.64,88,,percent of total billed charges,,,,,,,,,3.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3.77,91,,percent of total billed charges,,,3.93,95,,percent of total billed charges,,,3.44,83,,percent of total billed charges,,,3.44,83,,percent of total billed charges,,,,,,,,,,,,,,,3.44,83,,percent of total billed charges,,,3.93,95,,percent of total billed charges,,,3.73,90,,percent of total billed charges,,,3.73,90,,percent of total billed charges,,,3.39,82,,percent of total billed charges,,,3.73,90,,percent of total billed charges,,,3.52,85,,percent of total billed charges,,3.12,3.93,
STAPLER RELOAD ECHELON (BLUE),30184490,CDM,,,270,RC,inpatient,,1250.91,1250.91,,1062.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,943.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1063.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1100.8,88,,percent of total billed charges,,,,,,,,,955.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1138.33,91,,percent of total billed charges,,,1188.36,95,,percent of total billed charges,,,1038.26,83,,percent of total billed charges,,,1038.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1038.26,83,,percent of total billed charges,,,1188.36,95,,percent of total billed charges,,,1125.82,90,,percent of total billed charges,,,1125.82,90,,percent of total billed charges,,,1025.75,82,,percent of total billed charges,,,1125.82,90,,percent of total billed charges,,,1063.27,85,,percent of total billed charges,,943.19,1188.36,
STAPLER RELOAD ECHELON (WHITE),30184491,CDM,,,270,RC,inpatient,,1250.91,1250.91,,1062.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,943.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1063.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1100.8,88,,percent of total billed charges,,,,,,,,,955.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1138.33,91,,percent of total billed charges,,,1188.36,95,,percent of total billed charges,,,1038.26,83,,percent of total billed charges,,,1038.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1038.26,83,,percent of total billed charges,,,1188.36,95,,percent of total billed charges,,,1125.82,90,,percent of total billed charges,,,1125.82,90,,percent of total billed charges,,,1025.75,82,,percent of total billed charges,,,1125.82,90,,percent of total billed charges,,,1063.27,85,,percent of total billed charges,,943.19,1188.36,
STAPLER PWRD ECHELON FLEX 45MM,30184492,CDM,,,270,RC,inpatient,,2367.08,2367.08,,2009.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1784.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2012.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2083.03,88,,percent of total billed charges,,,,,,,,,1808.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2154.04,91,,percent of total billed charges,,,2248.73,95,,percent of total billed charges,,,1964.68,83,,percent of total billed charges,,,1964.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1964.68,83,,percent of total billed charges,,,2248.73,95,,percent of total billed charges,,,2130.37,90,,percent of total billed charges,,,2130.37,90,,percent of total billed charges,,,1941.01,82,,percent of total billed charges,,,2130.37,90,,percent of total billed charges,,,2012.02,85,,percent of total billed charges,,1784.78,2248.73,
DEPUY INSERT RP SZ 6 12MM,30184493,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY TIBIA ATTUNE RP SZ 5,30184494,CDM,,,278,RC,inpatient,,21286.98,21286.98,,18072.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16050.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18093.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18732.54,88,,percent of total billed charges,,,,,,,,,16263.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19371.15,91,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,,,,,,,,,,,,,17668.19,83,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,17455.32,82,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,16050.38,20222.63,
DEPUY STEM ENDURANCE SZ 2,30184495,CDM,,,278,RC,inpatient,,24918.92,24918.92,,21156.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18788.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21181.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21928.65,88,,percent of total billed charges,,,,,,,,,19038.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22676.22,91,,percent of total billed charges,,,23672.97,95,,percent of total billed charges,,,20682.7,83,,percent of total billed charges,,,20682.7,83,,percent of total billed charges,,,,,,,,,,,,,,,20682.7,83,,percent of total billed charges,,,23672.97,95,,percent of total billed charges,,,22427.03,90,,percent of total billed charges,,,22427.03,90,,percent of total billed charges,,,20433.51,82,,percent of total billed charges,,,22427.03,90,,percent of total billed charges,,,21181.08,85,,percent of total billed charges,,18788.87,23672.97,
ARTHREX SUTURE TAK BIOCOMPOSITE 3 X 14.5,30184496,CDM,,,278,RC,inpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1592.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1795.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,1592.83,2006.88,
ARTHREX SUTURE TAK DISPOSABLE KIT,30184497,CDM,,,278,RC,inpatient,,942.5,942.5,,800.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,710.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,801.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,829.4,88,,percent of total billed charges,,,,,,,,,720.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,857.68,91,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,,,,,,,,,,,,,782.28,83,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,772.85,82,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,801.13,85,,percent of total billed charges,,710.65,895.38,
ALLOSOURCE CANCELLOUS CUBES 30ML,30184498,CDM,,,278,RC,inpatient,,5375.5,5375.5,,4563.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4053.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4569.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4730.44,88,,percent of total billed charges,,,,,,,,,4106.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4891.71,91,,percent of total billed charges,,,5106.73,95,,percent of total billed charges,,,4461.67,83,,percent of total billed charges,,,4461.67,83,,percent of total billed charges,,,,,,,,,,,,,,,4461.67,83,,percent of total billed charges,,,5106.73,95,,percent of total billed charges,,,4837.95,90,,percent of total billed charges,,,4837.95,90,,percent of total billed charges,,,4407.91,82,,percent of total billed charges,,,4837.95,90,,percent of total billed charges,,,4569.18,85,,percent of total billed charges,,4053.13,5106.73,
DEPUY INSERT PS SZ 6 18MM,30184499,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY BODY ANATOMIC PROXIMAL 16MM,30184500,CDM,,,278,RC,inpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9541.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10756.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,9541.61,12021.93,
DEPUY STEM HUMERAL 16MM,30184501,CDM,,,278,RC,inpatient,,26023.86,26023.86,,22094.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19621.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22120.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22901,88,,percent of total billed charges,,,,,,,,,19882.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23681.71,91,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21599.8,83,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,21339.57,82,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,19621.99,24722.67,
DEPUY HEAD ECCENTRIC 52MM X 18MM,30184502,CDM,,,278,RC,inpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13297.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14990.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,13297.64,16754.32,
DEPUY GUIDE PINS BREAK AWAY,30184503,CDM,,,278,RC,inpatient,,1755,1755,,1490,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1323.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1491.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1544.4,88,,percent of total billed charges,,,,,,,,,1340.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1597.05,91,,percent of total billed charges,,,1667.25,95,,percent of total billed charges,,,1456.65,83,,percent of total billed charges,,,1456.65,83,,percent of total billed charges,,,,,,,,,,,,,,,1456.65,83,,percent of total billed charges,,,1667.25,95,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1439.1,82,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1491.75,85,,percent of total billed charges,,1323.27,1667.25,
BIS ADULT SENSOR,30184504,CDM,,,270,RC,inpatient,,185.59,185.59,,157.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,139.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,157.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,163.32,88,,percent of total billed charges,,,,,,,,,141.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,168.89,91,,percent of total billed charges,,,176.31,95,,percent of total billed charges,,,154.04,83,,percent of total billed charges,,,154.04,83,,percent of total billed charges,,,,,,,,,,,,,,,154.04,83,,percent of total billed charges,,,176.31,95,,percent of total billed charges,,,167.03,90,,percent of total billed charges,,,167.03,90,,percent of total billed charges,,,152.18,82,,percent of total billed charges,,,167.03,90,,percent of total billed charges,,,157.75,85,,percent of total billed charges,,139.93,176.31,
SYNTHES WASHER 13MM,30184505,CDM,,,278,RC,inpatient,,324.6,324.6,,275.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,244.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,275.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,285.65,88,,percent of total billed charges,,,,,,,,,247.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,295.39,91,,percent of total billed charges,,,308.37,95,,percent of total billed charges,,,269.42,83,,percent of total billed charges,,,269.42,83,,percent of total billed charges,,,,,,,,,,,,,,,269.42,83,,percent of total billed charges,,,308.37,95,,percent of total billed charges,,,292.14,90,,percent of total billed charges,,,292.14,90,,percent of total billed charges,,,266.17,82,,percent of total billed charges,,,292.14,90,,percent of total billed charges,,,275.91,85,,percent of total billed charges,,244.75,308.37,
STRYKER BURR TPS ELITE 3.0,30184506,CDM,,,270,RC,inpatient,,940.16,940.16,,798.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,708.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,799.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,827.34,88,,percent of total billed charges,,,,,,,,,718.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,855.55,91,,percent of total billed charges,,,893.15,95,,percent of total billed charges,,,780.33,83,,percent of total billed charges,,,780.33,83,,percent of total billed charges,,,,,,,,,,,,,,,780.33,83,,percent of total billed charges,,,893.15,95,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,770.93,82,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,799.14,85,,percent of total billed charges,,708.88,893.15,
STRYKER BURR TPS ELITE HELICOIDAL RASP,30184507,CDM,,,270,RC,inpatient,,940.16,940.16,,798.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,708.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,799.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,827.34,88,,percent of total billed charges,,,,,,,,,718.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,855.55,91,,percent of total billed charges,,,893.15,95,,percent of total billed charges,,,780.33,83,,percent of total billed charges,,,780.33,83,,percent of total billed charges,,,,,,,,,,,,,,,780.33,83,,percent of total billed charges,,,893.15,95,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,770.93,82,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,799.14,85,,percent of total billed charges,,708.88,893.15,
SURGICAL PATTIES 1/2 X 1/2,30184508,CDM,,,270,RC,inpatient,,20.18,20.18,,17.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.76,88,,percent of total billed charges,,,,,,,,,15.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.36,91,,percent of total billed charges,,,19.17,95,,percent of total billed charges,,,16.75,83,,percent of total billed charges,,,16.75,83,,percent of total billed charges,,,,,,,,,,,,,,,16.75,83,,percent of total billed charges,,,19.17,95,,percent of total billed charges,,,18.16,90,,percent of total billed charges,,,18.16,90,,percent of total billed charges,,,16.55,82,,percent of total billed charges,,,18.16,90,,percent of total billed charges,,,17.15,85,,percent of total billed charges,,15.22,19.17,
ZIMMER TIBIA TRAY OXF UNI SZ C,30184510,CDM,,,278,RC,inpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10218.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11519.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,10218.59,12874.88,
S&N SUTURE ULTRABRAID #2,30184511,CDM,,,270,RC,inpatient,,157.12,157.12,,133.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,118.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,133.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,138.27,88,,percent of total billed charges,,,,,,,,,120.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,142.98,91,,percent of total billed charges,,,149.26,95,,percent of total billed charges,,,130.41,83,,percent of total billed charges,,,130.41,83,,percent of total billed charges,,,,,,,,,,,,,,,130.41,83,,percent of total billed charges,,,149.26,95,,percent of total billed charges,,,141.41,90,,percent of total billed charges,,,141.41,90,,percent of total billed charges,,,128.84,82,,percent of total billed charges,,,141.41,90,,percent of total billed charges,,,133.55,85,,percent of total billed charges,,118.47,149.26,
DEPUY FEMUR LPS XX-SMALL LEFT,30184512,CDM,,,278,RC,inpatient,,97092.39,97092.39,,82431.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,73207.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,82528.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,85441.3,88,,percent of total billed charges,,,,,,,,,74178.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,88354.07,91,,percent of total billed charges,,,92237.77,95,,percent of total billed charges,,,80586.68,83,,percent of total billed charges,,,80586.68,83,,percent of total billed charges,,,,,,,,,,,,,,,80586.68,83,,percent of total billed charges,,,92237.77,95,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,79615.76,82,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,82528.53,85,,percent of total billed charges,,73207.66,92237.77,
DEPUY SLEEVE LPS +10MM,30184513,CDM,,,278,RC,inpatient,,6309.03,6309.03,,5356.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4757.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5362.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5551.95,88,,percent of total billed charges,,,,,,,,,4820.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5741.22,91,,percent of total billed charges,,,5993.58,95,,percent of total billed charges,,,5236.49,83,,percent of total billed charges,,,5236.49,83,,percent of total billed charges,,,,,,,,,,,,,,,5236.49,83,,percent of total billed charges,,,5993.58,95,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5173.4,82,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5362.68,85,,percent of total billed charges,,4757.01,5993.58,
DEPUY INSERT XX-SMALL 16MM,30184514,CDM,,,278,RC,inpatient,,33343.12,33343.12,,28308.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25140.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28341.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29341.95,88,,percent of total billed charges,,,,,,,,,25474.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30342.24,91,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,,,,,,,,,,,,,27674.79,83,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,27341.36,82,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,25140.71,31675.96,
V-LOC ESTCH NON ABSORABLE 2-0,30184515,CDM,,,270,RC,inpatient,,740.88,740.88,,629.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,558.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,629.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,651.97,88,,percent of total billed charges,,,,,,,,,566.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,674.2,91,,percent of total billed charges,,,703.84,95,,percent of total billed charges,,,614.93,83,,percent of total billed charges,,,614.93,83,,percent of total billed charges,,,,,,,,,,,,,,,614.93,83,,percent of total billed charges,,,703.84,95,,percent of total billed charges,,,666.79,90,,percent of total billed charges,,,666.79,90,,percent of total billed charges,,,607.52,82,,percent of total billed charges,,,666.79,90,,percent of total billed charges,,,629.75,85,,percent of total billed charges,,558.62,703.84,
V-LOC ESTICH 180 ABSORABLE 2-0,30184516,CDM,,,270,RC,inpatient,,810.55,810.55,,688.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,611.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,688.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,713.28,88,,percent of total billed charges,,,,,,,,,619.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,737.6,91,,percent of total billed charges,,,770.02,95,,percent of total billed charges,,,672.76,83,,percent of total billed charges,,,672.76,83,,percent of total billed charges,,,,,,,,,,,,,,,672.76,83,,percent of total billed charges,,,770.02,95,,percent of total billed charges,,,729.5,90,,percent of total billed charges,,,729.5,90,,percent of total billed charges,,,664.65,82,,percent of total billed charges,,,729.5,90,,percent of total billed charges,,,688.97,85,,percent of total billed charges,,611.15,770.02,
CLIP HEM-O-LOK XL,30184518,CDM,,,270,RC,inpatient,,221.79,221.79,,188.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,167.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,188.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,195.18,88,,percent of total billed charges,,,,,,,,,169.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,201.83,91,,percent of total billed charges,,,210.7,95,,percent of total billed charges,,,184.09,83,,percent of total billed charges,,,184.09,83,,percent of total billed charges,,,,,,,,,,,,,,,184.09,83,,percent of total billed charges,,,210.7,95,,percent of total billed charges,,,199.61,90,,percent of total billed charges,,,199.61,90,,percent of total billed charges,,,181.87,82,,percent of total billed charges,,,199.61,90,,percent of total billed charges,,,188.52,85,,percent of total billed charges,,167.23,210.7,
GYRUS VACURETTE STRAIGHT 8MM,30184519,CDM,,,270,RC,inpatient,,42.92,42.92,,36.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37.77,88,,percent of total billed charges,,,,,,,,,32.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,39.06,91,,percent of total billed charges,,,40.77,95,,percent of total billed charges,,,35.62,83,,percent of total billed charges,,,35.62,83,,percent of total billed charges,,,,,,,,,,,,,,,35.62,83,,percent of total billed charges,,,40.77,95,,percent of total billed charges,,,38.63,90,,percent of total billed charges,,,38.63,90,,percent of total billed charges,,,35.19,82,,percent of total billed charges,,,38.63,90,,percent of total billed charges,,,36.48,85,,percent of total billed charges,,32.36,40.77,
CONFORMIS UNI MEDIAL LEFT IMPLANT KIT,30184520,CDM,,,278,RC,inpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29406,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33150,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,29406,37050,
PROGENIX PLUS 10CC,30184524,CDM,,,278,RC,inpatient,,10263.5,10263.5,,8713.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7738.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8723.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9031.88,88,,percent of total billed charges,,,,,,,,,7841.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9339.79,91,,percent of total billed charges,,,9750.33,95,,percent of total billed charges,,,8518.71,83,,percent of total billed charges,,,8518.71,83,,percent of total billed charges,,,,,,,,,,,,,,,8518.71,83,,percent of total billed charges,,,9750.33,95,,percent of total billed charges,,,9237.15,90,,percent of total billed charges,,,9237.15,90,,percent of total billed charges,,,8416.07,82,,percent of total billed charges,,,9237.15,90,,percent of total billed charges,,,8723.98,85,,percent of total billed charges,,7738.68,9750.33,
MENTOR MEMORYGEL BREAST IMPLANT 4000 SMO,30184525,CDM,,,278,RC,inpatient,,6370,6370,,5408.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4802.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5414.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5605.6,88,,percent of total billed charges,,,,,,,,,4866.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5796.7,91,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5287.1,83,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5223.4,82,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5414.5,85,,percent of total billed charges,,4802.98,6051.5,
MENTOR MEMORYGEL SIZER HIGH PROFILE 450,30184526,CDM,,,270,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
EDGE INSULATED BLADE ELECTRODE 2.75,30184527,CDM,,,270,RC,inpatient,,62.69,62.69,,53.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,53.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.17,88,,percent of total billed charges,,,,,,,,,47.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.05,91,,percent of total billed charges,,,59.56,95,,percent of total billed charges,,,52.03,83,,percent of total billed charges,,,52.03,83,,percent of total billed charges,,,,,,,,,,,,,,,52.03,83,,percent of total billed charges,,,59.56,95,,percent of total billed charges,,,56.42,90,,percent of total billed charges,,,56.42,90,,percent of total billed charges,,,51.41,82,,percent of total billed charges,,,56.42,90,,percent of total billed charges,,,53.29,85,,percent of total billed charges,,47.27,59.56,
STRYKER BUR PRECISION ROUND 4.0MM,30184528,CDM,,,270,RC,inpatient,,1665.17,1665.17,,1413.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1255.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1415.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1465.35,88,,percent of total billed charges,,,,,,,,,1272.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1515.3,91,,percent of total billed charges,,,1581.91,95,,percent of total billed charges,,,1382.09,83,,percent of total billed charges,,,1382.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1382.09,83,,percent of total billed charges,,,1581.91,95,,percent of total billed charges,,,1498.65,90,,percent of total billed charges,,,1498.65,90,,percent of total billed charges,,,1365.44,82,,percent of total billed charges,,,1498.65,90,,percent of total billed charges,,,1415.39,85,,percent of total billed charges,,1255.54,1581.91,
SCREW POLYAXIAL 7.0 X 50MM,30184530,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SCREW POLYAXIAL 7.0 X 55MM,30184531,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ROD 6.0 X 90MM,30184532,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
DEPUY WEDGE MBT 5MM SZ 5,30184535,CDM,,,278,RC,inpatient,,15761.79,15761.79,,13381.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11884.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13397.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13870.38,88,,percent of total billed charges,,,,,,,,,12042.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14343.23,91,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,,,,,,,,,,,,,13082.29,83,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,12924.67,82,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,13397.52,85,,percent of total billed charges,,11884.39,14973.7,
DEPUY CUP PINNACLE REVISION SZ 56,30184536,CDM,,,278,RC,inpatient,,33437.04,33437.04,,28388.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25211.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28421.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29424.6,88,,percent of total billed charges,,,,,,,,,25545.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30427.71,91,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,,,,,,,,,,,,,27752.74,83,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,27418.37,82,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,25211.53,31765.19,
ARTHREX INSUFLATION TUBING,30184537,CDM,,,270,RC,inpatient,,567,567,,481.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,427.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,481.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,498.96,88,,percent of total billed charges,,,,,,,,,433.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,,,,,,,,,,,,,470.61,83,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,464.94,82,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,427.52,538.65,
ZIMMER NECK J MODULAR KINECTIV,30184539,CDM,,,278,RC,inpatient,,14475.5,14475.5,,12289.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10914.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12304.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12738.44,88,,percent of total billed charges,,,,,,,,,11059.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13172.71,91,,percent of total billed charges,,,13751.73,95,,percent of total billed charges,,,12014.67,83,,percent of total billed charges,,,12014.67,83,,percent of total billed charges,,,,,,,,,,,,,,,12014.67,83,,percent of total billed charges,,,13751.73,95,,percent of total billed charges,,,13027.95,90,,percent of total billed charges,,,13027.95,90,,percent of total billed charges,,,11869.91,82,,percent of total billed charges,,,13027.95,90,,percent of total billed charges,,,12304.18,85,,percent of total billed charges,,10914.53,13751.73,
ZIMMER HEAD FEMORAL BIOLOX DELTA 32MM +0,30184540,CDM,,,278,RC,inpatient,,17946.5,17946.5,,15236.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13531.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15254.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15792.92,88,,percent of total billed charges,,,,,,,,,13711.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16331.32,91,,percent of total billed charges,,,17049.18,95,,percent of total billed charges,,,14895.6,83,,percent of total billed charges,,,14895.6,83,,percent of total billed charges,,,,,,,,,,,,,,,14895.6,83,,percent of total billed charges,,,17049.18,95,,percent of total billed charges,,,16151.85,90,,percent of total billed charges,,,16151.85,90,,percent of total billed charges,,,14716.13,82,,percent of total billed charges,,,16151.85,90,,percent of total billed charges,,,15254.53,85,,percent of total billed charges,,13531.66,17049.18,
SAWBLADE CEMENTED OXF,30184541,CDM,,,270,RC,inpatient,,4992,4992,,4238.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3763.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4243.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4392.96,88,,percent of total billed charges,,,,,,,,,3813.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4542.72,91,,percent of total billed charges,,,4742.4,95,,percent of total billed charges,,,4143.36,83,,percent of total billed charges,,,4143.36,83,,percent of total billed charges,,,,,,,,,,,,,,,4143.36,83,,percent of total billed charges,,,4742.4,95,,percent of total billed charges,,,4492.8,90,,percent of total billed charges,,,4492.8,90,,percent of total billed charges,,,4093.44,82,,percent of total billed charges,,,4492.8,90,,percent of total billed charges,,,4243.2,85,,percent of total billed charges,,3763.97,4742.4,
SAWBLADE KEEL CEMENTED OXF,30184542,CDM,,,270,RC,inpatient,,3445,3445,,2924.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2597.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2928.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3031.6,88,,percent of total billed charges,,,,,,,,,2631.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3134.95,91,,percent of total billed charges,,,3272.75,95,,percent of total billed charges,,,2859.35,83,,percent of total billed charges,,,2859.35,83,,percent of total billed charges,,,,,,,,,,,,,,,2859.35,83,,percent of total billed charges,,,3272.75,95,,percent of total billed charges,,,3100.5,90,,percent of total billed charges,,,3100.5,90,,percent of total billed charges,,,2824.9,82,,percent of total billed charges,,,3100.5,90,,percent of total billed charges,,,2928.25,85,,percent of total billed charges,,2597.53,3272.75,
ZIMMER TIBIAL TRAY SZ B LM PMA OXF,30184543,CDM,,,278,RC,inpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10218.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11519.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,10218.59,12874.88,
ARTHREX CANNULA SMOOTH 7 X7 MM,30184545,CDM,,,270,RC,inpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,150.8,190,
ARTHREX SWIVELOCK CLOSED EYELET,30184546,CDM,,,270,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
ARTHREX TIGERTAPE,30184547,CDM,,,270,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
DEPUY STEM CORAIL KLS 15,30184548,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
ZIMMER TRAY TIBIAL UNI SZ C RM PMA,30184550,CDM,,,278,RC,inpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10218.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11519.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,10218.59,12874.88,
ZIMMER INSERT BEARING SZ 4 MD RT,30184551,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
SYNTHES SCREW CORTEX ST 2.0MM X 10MM,30184552,CDM,,,278,RC,inpatient,,476,476,,404.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,358.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,404.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,418.88,88,,percent of total billed charges,,,,,,,,,363.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,433.16,91,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,,,,,,,,,,,,,395.08,83,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,390.32,82,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,358.9,452.2,
SYNTHES SCREW CORTEX ST 2.0 X 20MM,30184553,CDM,,,278,RC,inpatient,,476,476,,404.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,358.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,404.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,418.88,88,,percent of total billed charges,,,,,,,,,363.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,433.16,91,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,,,,,,,,,,,,,395.08,83,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,390.32,82,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,358.9,452.2,
SYNTHES SCREW LOCKING ST 2.0 X 14MM,30184554,CDM,,,278,RC,inpatient,,1077.38,1077.38,,914.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,812.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,915.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,948.09,88,,percent of total billed charges,,,,,,,,,823.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,980.42,91,,percent of total billed charges,,,1023.51,95,,percent of total billed charges,,,894.23,83,,percent of total billed charges,,,894.23,83,,percent of total billed charges,,,,,,,,,,,,,,,894.23,83,,percent of total billed charges,,,1023.51,95,,percent of total billed charges,,,969.64,90,,percent of total billed charges,,,969.64,90,,percent of total billed charges,,,883.45,82,,percent of total billed charges,,,969.64,90,,percent of total billed charges,,,915.77,85,,percent of total billed charges,,812.34,1023.51,
SYNTHES SCREW LOCKING ST 2.0 X 18MM,30184555,CDM,,,278,RC,inpatient,,1077.38,1077.38,,914.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,812.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,915.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,948.09,88,,percent of total billed charges,,,,,,,,,823.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,980.42,91,,percent of total billed charges,,,1023.51,95,,percent of total billed charges,,,894.23,83,,percent of total billed charges,,,894.23,83,,percent of total billed charges,,,,,,,,,,,,,,,894.23,83,,percent of total billed charges,,,1023.51,95,,percent of total billed charges,,,969.64,90,,percent of total billed charges,,,969.64,90,,percent of total billed charges,,,883.45,82,,percent of total billed charges,,,969.64,90,,percent of total billed charges,,,915.77,85,,percent of total billed charges,,812.34,1023.51,
SYNTHES SHAFT LCP DISTAL RADIUS 5H,30184556,CDM,,,278,RC,inpatient,,15945.15,15945.15,,13537.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12022.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13553.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14031.73,88,,percent of total billed charges,,,,,,,,,12182.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14510.09,91,,percent of total billed charges,,,15147.89,95,,percent of total billed charges,,,13234.47,83,,percent of total billed charges,,,13234.47,83,,percent of total billed charges,,,,,,,,,,,,,,,13234.47,83,,percent of total billed charges,,,15147.89,95,,percent of total billed charges,,,14350.64,90,,percent of total billed charges,,,14350.64,90,,percent of total billed charges,,,13075.02,82,,percent of total billed charges,,,14350.64,90,,percent of total billed charges,,,13553.38,85,,percent of total billed charges,,12022.64,15147.89,
SYNTHES PLATE LCP ULNA 2.0MM 7H,30184557,CDM,,,278,RC,inpatient,,7293,7293,,6191.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5498.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6199.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6417.84,88,,percent of total billed charges,,,,,,,,,5571.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6636.63,91,,percent of total billed charges,,,6928.35,95,,percent of total billed charges,,,6053.19,83,,percent of total billed charges,,,6053.19,83,,percent of total billed charges,,,,,,,,,,,,,,,6053.19,83,,percent of total billed charges,,,6928.35,95,,percent of total billed charges,,,6563.7,90,,percent of total billed charges,,,6563.7,90,,percent of total billed charges,,,5980.26,82,,percent of total billed charges,,,6563.7,90,,percent of total billed charges,,,6199.05,85,,percent of total billed charges,,5498.92,6928.35,
SYNTHES SCREW LOCKING ST 2.4 X 16MM,30184558,CDM,,,278,RC,inpatient,,1166.43,1166.43,,990.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,879.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,991.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1026.46,88,,percent of total billed charges,,,,,,,,,891.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1061.45,91,,percent of total billed charges,,,1108.11,95,,percent of total billed charges,,,968.14,83,,percent of total billed charges,,,968.14,83,,percent of total billed charges,,,,,,,,,,,,,,,968.14,83,,percent of total billed charges,,,1108.11,95,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,956.47,82,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,991.47,85,,percent of total billed charges,,879.49,1108.11,
SYNTHES SCREW LOCKING ST 2.4 X 18MM,30184559,CDM,,,278,RC,inpatient,,1166.43,1166.43,,990.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,879.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,991.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1026.46,88,,percent of total billed charges,,,,,,,,,891.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1061.45,91,,percent of total billed charges,,,1108.11,95,,percent of total billed charges,,,968.14,83,,percent of total billed charges,,,968.14,83,,percent of total billed charges,,,,,,,,,,,,,,,968.14,83,,percent of total billed charges,,,1108.11,95,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,956.47,82,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,991.47,85,,percent of total billed charges,,879.49,1108.11,
SYNTHES SCREW LOCKING 2.4 X 20MM,30184560,CDM,,,278,RC,inpatient,,1099.48,1099.48,,933.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,829.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,934.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,967.54,88,,percent of total billed charges,,,,,,,,,840,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1000.53,91,,percent of total billed charges,,,1044.51,95,,percent of total billed charges,,,912.57,83,,percent of total billed charges,,,912.57,83,,percent of total billed charges,,,,,,,,,,,,,,,912.57,83,,percent of total billed charges,,,1044.51,95,,percent of total billed charges,,,989.53,90,,percent of total billed charges,,,989.53,90,,percent of total billed charges,,,901.57,82,,percent of total billed charges,,,989.53,90,,percent of total billed charges,,,934.56,85,,percent of total billed charges,,829.01,1044.51,
SYNTHES SCREW LOCKING ST 2.4 X 14MM,30184561,CDM,,,278,RC,inpatient,,1099.48,1099.48,,933.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,829.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,934.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,967.54,88,,percent of total billed charges,,,,,,,,,840,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1000.53,91,,percent of total billed charges,,,1044.51,95,,percent of total billed charges,,,912.57,83,,percent of total billed charges,,,912.57,83,,percent of total billed charges,,,,,,,,,,,,,,,912.57,83,,percent of total billed charges,,,1044.51,95,,percent of total billed charges,,,989.53,90,,percent of total billed charges,,,989.53,90,,percent of total billed charges,,,901.57,82,,percent of total billed charges,,,989.53,90,,percent of total billed charges,,,934.56,85,,percent of total billed charges,,829.01,1044.51,
ALLOSOURCE CANCELLOUS CHIPS 30CC,30184562,CDM,,,278,RC,inpatient,,3399.5,3399.5,,2886.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2563.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2889.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2991.56,88,,percent of total billed charges,,,,,,,,,2597.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3093.55,91,,percent of total billed charges,,,3229.53,95,,percent of total billed charges,,,2821.59,83,,percent of total billed charges,,,2821.59,83,,percent of total billed charges,,,,,,,,,,,,,,,2821.59,83,,percent of total billed charges,,,3229.53,95,,percent of total billed charges,,,3059.55,90,,percent of total billed charges,,,3059.55,90,,percent of total billed charges,,,2787.59,82,,percent of total billed charges,,,3059.55,90,,percent of total billed charges,,,2889.58,85,,percent of total billed charges,,2563.22,3229.53,
STRYKER PENCIL SMOKE EVAC,30184563,CDM,,,270,RC,inpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,169.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,191.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,169.65,213.75,
DEPUY INSERT ATTUNE RP 14MM SZ 6,30184564,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
STRYKER GEL DBM 5CC,30184566,CDM,,,278,RC,inpatient,,8247.2,8247.2,,7001.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6218.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7010.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7257.54,88,,percent of total billed charges,,,,,,,,,6300.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7504.95,91,,percent of total billed charges,,,7834.84,95,,percent of total billed charges,,,6845.18,83,,percent of total billed charges,,,6845.18,83,,percent of total billed charges,,,,,,,,,,,,,,,6845.18,83,,percent of total billed charges,,,7834.84,95,,percent of total billed charges,,,7422.48,90,,percent of total billed charges,,,7422.48,90,,percent of total billed charges,,,6762.7,82,,percent of total billed charges,,,7422.48,90,,percent of total billed charges,,,7010.12,85,,percent of total billed charges,,6218.39,7834.84,
ARTHREX IMPLANT SYSTEM SPEED BRIDGE SELF,30184567,CDM,,,278,RC,inpatient,,11570,11570,,9822.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8723.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9834.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10181.6,88,,percent of total billed charges,,,,,,,,,8839.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10528.7,91,,percent of total billed charges,,,10991.5,95,,percent of total billed charges,,,9603.1,83,,percent of total billed charges,,,9603.1,83,,percent of total billed charges,,,,,,,,,,,,,,,9603.1,83,,percent of total billed charges,,,10991.5,95,,percent of total billed charges,,,10413,90,,percent of total billed charges,,,10413,90,,percent of total billed charges,,,9487.4,82,,percent of total billed charges,,,10413,90,,percent of total billed charges,,,9834.5,85,,percent of total billed charges,,8723.78,10991.5,
DEPUY BODY RECLAIM PROXIMAL 20 X85,30184568,CDM,,,278,RC,inpatient,,38548.77,38548.77,,32727.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29065.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32766.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33922.92,88,,percent of total billed charges,,,,,,,,,29451.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35079.38,91,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,,,,,,,,,,,,,31995.48,83,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,31609.99,82,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,32766.45,85,,percent of total billed charges,,29065.77,36621.33,
DEPUY STEM RECLAIM DISTAL 14 X 190,30184569,CDM,,,278,RC,inpatient,,31338.78,31338.78,,26606.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23629.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26637.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27578.13,88,,percent of total billed charges,,,,,,,,,23942.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28518.29,91,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,,,,,,,,,,,,,26011.19,83,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,25697.8,82,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,26637.96,85,,percent of total billed charges,,23629.44,29771.84,
STRYKER BOWL MIXVAC 3,30184570,CDM,,,270,RC,inpatient,,362.36,362.36,,307.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,273.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,308.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,318.88,88,,percent of total billed charges,,,,,,,,,276.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,329.75,91,,percent of total billed charges,,,344.24,95,,percent of total billed charges,,,300.76,83,,percent of total billed charges,,,300.76,83,,percent of total billed charges,,,,,,,,,,,,,,,300.76,83,,percent of total billed charges,,,344.24,95,,percent of total billed charges,,,326.12,90,,percent of total billed charges,,,326.12,90,,percent of total billed charges,,,297.14,82,,percent of total billed charges,,,326.12,90,,percent of total billed charges,,,308.01,85,,percent of total billed charges,,273.22,344.24,
MEDTRONIC GRAFTON 1CC PUTTY,30184571,CDM,,,270,RC,inpatient,,1488.5,1488.5,,1263.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1122.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1265.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1309.88,88,,percent of total billed charges,,,,,,,,,1137.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1354.54,91,,percent of total billed charges,,,1414.08,95,,percent of total billed charges,,,1235.46,83,,percent of total billed charges,,,1235.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1235.46,83,,percent of total billed charges,,,1414.08,95,,percent of total billed charges,,,1339.65,90,,percent of total billed charges,,,1339.65,90,,percent of total billed charges,,,1220.57,82,,percent of total billed charges,,,1339.65,90,,percent of total billed charges,,,1265.23,85,,percent of total billed charges,,1122.33,1414.08,
ZIMMER BEARING LEFT MEDIAL LARGE 3MM,30184572,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
SYNTHES TFN LEFT 11MM 130DEG X 360,30184573,CDM,,,278,RC,inpatient,,21149.7,21149.7,,17956.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15946.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17977.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18611.74,88,,percent of total billed charges,,,,,,,,,16158.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19246.23,91,,percent of total billed charges,,,20092.22,95,,percent of total billed charges,,,17554.25,83,,percent of total billed charges,,,17554.25,83,,percent of total billed charges,,,,,,,,,,,,,,,17554.25,83,,percent of total billed charges,,,20092.22,95,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,17342.75,82,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,17977.25,85,,percent of total billed charges,,15946.87,20092.22,
SYNTHES BALDE HELICAL 85MM,30184574,CDM,,,270,RC,inpatient,,6630,6630,,5628.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4999.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5635.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5834.4,88,,percent of total billed charges,,,,,,,,,5065.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6033.3,91,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,,,,,,,,,,,,,5502.9,83,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5436.6,82,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,4999.02,6298.5,
SYNTHES DRILL BIT 4.2MM X 145,30184575,CDM,,,270,RC,inpatient,,2227.36,2227.36,,1891.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1679.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1893.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1960.08,88,,percent of total billed charges,,,,,,,,,1701.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2026.9,91,,percent of total billed charges,,,2115.99,95,,percent of total billed charges,,,1848.71,83,,percent of total billed charges,,,1848.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1848.71,83,,percent of total billed charges,,,2115.99,95,,percent of total billed charges,,,2004.62,90,,percent of total billed charges,,,2004.62,90,,percent of total billed charges,,,1826.44,82,,percent of total billed charges,,,2004.62,90,,percent of total billed charges,,,1893.26,85,,percent of total billed charges,,1679.43,2115.99,
SYNTHES SCREW LOCKING 5.0 X 46MM,30184576,CDM,,,278,RC,inpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1697.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1913.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,1697.12,2138.28,
SYNTHES SCREW LOCKING 5.0MM X 42MM,30184577,CDM,,,278,RC,inpatient,,2121.6,2121.6,,1801.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1599.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1803.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1867.01,88,,percent of total billed charges,,,,,,,,,1620.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1930.66,91,,percent of total billed charges,,,2015.52,95,,percent of total billed charges,,,1760.93,83,,percent of total billed charges,,,1760.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1760.93,83,,percent of total billed charges,,,2015.52,95,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1739.71,82,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1803.36,85,,percent of total billed charges,,1599.69,2015.52,
HOLMIUM LASER FEE,30184578,CDM,,,270,RC,inpatient,,4712.5,4712.5,,4000.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3553.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4005.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4147,88,,percent of total billed charges,,,,,,,,,3600.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4288.38,91,,percent of total billed charges,,,4476.88,95,,percent of total billed charges,,,3911.38,83,,percent of total billed charges,,,3911.38,83,,percent of total billed charges,,,,,,,,,,,,,,,3911.38,83,,percent of total billed charges,,,4476.88,95,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,3864.25,82,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,4005.63,85,,percent of total billed charges,,3553.23,4476.88,
HOLMIUM LASER FIBER 200MC,30184579,CDM,,,270,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
ARTHREX HEATED INSULFATION TUBING,30184580,CDM,,,270,RC,inpatient,,303.75,303.75,,257.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,229.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,258.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,267.3,88,,percent of total billed charges,,,,,,,,,232.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,276.41,91,,percent of total billed charges,,,288.56,95,,percent of total billed charges,,,252.11,83,,percent of total billed charges,,,252.11,83,,percent of total billed charges,,,,,,,,,,,,,,,252.11,83,,percent of total billed charges,,,288.56,95,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,249.08,82,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,258.19,85,,percent of total billed charges,,229.03,288.56,
ALLOSOURCE SEMI-T SINGLE STRAND TENDON,30184581,CDM,,,278,RC,inpatient,,5720,5720,,4856.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4312.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4862,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5033.6,88,,percent of total billed charges,,,,,,,,,4370.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5205.2,91,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4747.6,83,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4690.4,82,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4862,85,,percent of total billed charges,,4312.88,5434,
ARTHREX BIOCOMPOSITE IMPLANT SYSTEM MPFL,30184582,CDM,,,278,RC,inpatient,,9665.5,9665.5,,8206.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7287.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8215.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8505.64,88,,percent of total billed charges,,,,,,,,,7384.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8795.61,91,,percent of total billed charges,,,9182.23,95,,percent of total billed charges,,,8022.37,83,,percent of total billed charges,,,8022.37,83,,percent of total billed charges,,,,,,,,,,,,,,,8022.37,83,,percent of total billed charges,,,9182.23,95,,percent of total billed charges,,,8698.95,90,,percent of total billed charges,,,8698.95,90,,percent of total billed charges,,,7925.71,82,,percent of total billed charges,,,8698.95,90,,percent of total billed charges,,,8215.68,85,,percent of total billed charges,,7287.79,9182.23,
SPINECRAFT OR10 12 X 15 X 6MM,30184583,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
SPINECRAFT SCREW FIXED 4.0 X 14MM,30184584,CDM,,,278,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
SPINECRAFT VELOX 1 LEVE 14MM,30184585,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER NEEDLE VENOM CURVED 100MM 20G,30184586,CDM,,,270,RC,inpatient,,511.28,511.28,,434.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,385.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,434.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,449.93,88,,percent of total billed charges,,,,,,,,,390.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,465.26,91,,percent of total billed charges,,,485.72,95,,percent of total billed charges,,,424.36,83,,percent of total billed charges,,,424.36,83,,percent of total billed charges,,,,,,,,,,,,,,,424.36,83,,percent of total billed charges,,,485.72,95,,percent of total billed charges,,,460.15,90,,percent of total billed charges,,,460.15,90,,percent of total billed charges,,,419.25,82,,percent of total billed charges,,,460.15,90,,percent of total billed charges,,,434.59,85,,percent of total billed charges,,385.51,485.72,
DEPUY BIPOLAR 28ID X 40 OD,30184587,CDM,,,278,RC,inpatient,,5424.97,5424.97,,4605.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4090.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4611.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4773.97,88,,percent of total billed charges,,,,,,,,,4144.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4936.72,91,,percent of total billed charges,,,5153.72,95,,percent of total billed charges,,,4502.73,83,,percent of total billed charges,,,4502.73,83,,percent of total billed charges,,,,,,,,,,,,,,,4502.73,83,,percent of total billed charges,,,5153.72,95,,percent of total billed charges,,,4882.47,90,,percent of total billed charges,,,4882.47,90,,percent of total billed charges,,,4448.48,82,,percent of total billed charges,,,4882.47,90,,percent of total billed charges,,,4611.22,85,,percent of total billed charges,,4090.43,5153.72,
FLOSEAL FAST PREP 5ML,30184588,CDM,,,270,RC,inpatient,,1503.59,1503.59,,1276.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1133.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1278.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1323.16,88,,percent of total billed charges,,,,,,,,,1148.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1368.27,91,,percent of total billed charges,,,1428.41,95,,percent of total billed charges,,,1247.98,83,,percent of total billed charges,,,1247.98,83,,percent of total billed charges,,,,,,,,,,,,,,,1247.98,83,,percent of total billed charges,,,1428.41,95,,percent of total billed charges,,,1353.23,90,,percent of total billed charges,,,1353.23,90,,percent of total billed charges,,,1232.94,82,,percent of total billed charges,,,1353.23,90,,percent of total billed charges,,,1278.05,85,,percent of total billed charges,,1133.71,1428.41,
DEPUY INSERT PFC 8MM SZ 3,30184589,CDM,,,278,RC,inpatient,,11969.75,11969.75,,10162.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9025.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10174.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10533.38,88,,percent of total billed charges,,,,,,,,,9144.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10892.47,91,,percent of total billed charges,,,11371.26,95,,percent of total billed charges,,,9934.89,83,,percent of total billed charges,,,9934.89,83,,percent of total billed charges,,,,,,,,,,,,,,,9934.89,83,,percent of total billed charges,,,11371.26,95,,percent of total billed charges,,,10772.78,90,,percent of total billed charges,,,10772.78,90,,percent of total billed charges,,,9815.2,82,,percent of total billed charges,,,10772.78,90,,percent of total billed charges,,,10174.29,85,,percent of total billed charges,,9025.19,11371.26,
DEPUY LINER ALTRIX 40 X 60MM,30184590,CDM,,,278,RC,inpatient,,14377.35,14377.35,,12206.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10840.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12220.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12652.07,88,,percent of total billed charges,,,,,,,,,10984.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13083.39,91,,percent of total billed charges,,,13658.48,95,,percent of total billed charges,,,11933.2,83,,percent of total billed charges,,,11933.2,83,,percent of total billed charges,,,,,,,,,,,,,,,11933.2,83,,percent of total billed charges,,,13658.48,95,,percent of total billed charges,,,12939.62,90,,percent of total billed charges,,,12939.62,90,,percent of total billed charges,,,11789.43,82,,percent of total billed charges,,,12939.62,90,,percent of total billed charges,,,12220.75,85,,percent of total billed charges,,10840.52,13658.48,
DEPUY STEM SUMMIT SZ 2,30184592,CDM,,,278,RC,inpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26584.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29969.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,26584.74,33495.37,
ALLOSOURCE CORTICAL STRUT 29CM,30184593,CDM,,,278,RC,inpatient,,4563,4563,,3873.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3440.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3878.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4015.44,88,,percent of total billed charges,,,,,,,,,3486.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4152.33,91,,percent of total billed charges,,,4334.85,95,,percent of total billed charges,,,3787.29,83,,percent of total billed charges,,,3787.29,83,,percent of total billed charges,,,,,,,,,,,,,,,3787.29,83,,percent of total billed charges,,,4334.85,95,,percent of total billed charges,,,4106.7,90,,percent of total billed charges,,,4106.7,90,,percent of total billed charges,,,3741.66,82,,percent of total billed charges,,,4106.7,90,,percent of total billed charges,,,3878.55,85,,percent of total billed charges,,3440.5,4334.85,
GRAFT PRESTITCHED 9MM DIAMETER 220MM LEN,30184594,CDM,,,278,RC,inpatient,,15112.5,15112.5,,12830.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11394.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12845.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13299,88,,percent of total billed charges,,,,,,,,,11545.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13752.38,91,,percent of total billed charges,,,14356.88,95,,percent of total billed charges,,,12543.38,83,,percent of total billed charges,,,12543.38,83,,percent of total billed charges,,,,,,,,,,,,,,,12543.38,83,,percent of total billed charges,,,14356.88,95,,percent of total billed charges,,,13601.25,90,,percent of total billed charges,,,13601.25,90,,percent of total billed charges,,,12392.25,82,,percent of total billed charges,,,13601.25,90,,percent of total billed charges,,,12845.63,85,,percent of total billed charges,,11394.83,14356.88,
DEPUY SEGMENTAL COMPONENT 30MM,30184595,CDM,,,278,RC,inpatient,,18773.5,18773.5,,15938.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14155.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15957.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16520.68,88,,percent of total billed charges,,,,,,,,,14342.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17083.89,91,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,,,,,,,,,,,,,15582.01,83,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15394.27,82,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,14155.22,17834.83,
MESH HERNIA PRE CUT 6 X 13CM,30184596,CDM,,,278,RC,inpatient,,476,476,,404.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,358.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,404.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,418.88,88,,percent of total billed charges,,,,,,,,,363.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,433.16,91,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,,,,,,,,,,,,,395.08,83,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,390.32,82,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,358.9,452.2,
ARTHREX PLATE MTP LOW PROFILE STANDARD,30184597,CDM,,,278,RC,inpatient,,5817.5,5817.5,,4939.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4386.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4944.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5119.4,88,,percent of total billed charges,,,,,,,,,4444.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5293.93,91,,percent of total billed charges,,,5526.63,95,,percent of total billed charges,,,4828.53,83,,percent of total billed charges,,,4828.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4828.53,83,,percent of total billed charges,,,5526.63,95,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,4770.35,82,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,4944.88,85,,percent of total billed charges,,4386.4,5526.63,
ARTHREX PLATE MTP LOW PROFILE STANDARD R,30184598,CDM,,,278,RC,inpatient,,5200,5200,,4414.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3920.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4420,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4576,88,,percent of total billed charges,,,,,,,,,3972.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4732,91,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,,,,,,,,,,,,,4316,83,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4264,82,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4420,85,,percent of total billed charges,,3920.8,4940,
ARTHREX SCREW LOCKING CORTICAL 3MM X 12M,30184599,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW LOCKING CORTICAL 3MM X 16M,30184601,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW LOCKING CORTICAL 3MM X 18M,30184602,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW LOCKING CORTICAL 3MM X 20M,30184603,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW LOCKING CORTICAL 3MM X 24M,30184604,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW CORTICAL 3MM X 14MM,30184605,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW CORTICAL 3MM X 18MM,30184606,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW PT CANNULATED 3MM X 28MM,30184607,CDM,,,278,RC,inpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,633.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,714,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,633.36,798,
ARTHREX DRILL BIT 2MM,30184608,CDM,,,278,RC,inpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,448.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,505.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,448.63,565.25,
ARTHREX DRILL BIT CANNULATED 2MM,30184609,CDM,,,278,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
ARTHREX K-WIRE .045,30184610,CDM,,,270,RC,inpatient,,59.5,59.5,,50.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.36,88,,percent of total billed charges,,,,,,,,,45.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,54.15,91,,percent of total billed charges,,,56.53,95,,percent of total billed charges,,,49.39,83,,percent of total billed charges,,,49.39,83,,percent of total billed charges,,,,,,,,,,,,,,,49.39,83,,percent of total billed charges,,,56.53,95,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,48.79,82,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,50.58,85,,percent of total billed charges,,44.86,56.53,
STRYKER PROXIMAL INTERPHALANGEAL IMPLANT,30184612,CDM,,,278,RC,inpatient,,17252,17252,,14646.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13008.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14664.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15181.76,88,,percent of total billed charges,,,,,,,,,13180.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15699.32,91,,percent of total billed charges,,,16389.4,95,,percent of total billed charges,,,14319.16,83,,percent of total billed charges,,,14319.16,83,,percent of total billed charges,,,,,,,,,,,,,,,14319.16,83,,percent of total billed charges,,,16389.4,95,,percent of total billed charges,,,15526.8,90,,percent of total billed charges,,,15526.8,90,,percent of total billed charges,,,14146.64,82,,percent of total billed charges,,,15526.8,90,,percent of total billed charges,,,14664.2,85,,percent of total billed charges,,13008.01,16389.4,
ARTHREX SCREW BIOCOMPOSITE 10 X 28MM,30184614,CDM,,,278,RC,inpatient,,1527.5,1527.5,,1296.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1151.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1298.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1344.2,88,,percent of total billed charges,,,,,,,,,1167.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1390.03,91,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1267.83,83,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1252.55,82,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,1151.74,1451.13,
ARTHREX REAMER 10MM,30184615,CDM,,,278,RC,inpatient,,1092,1092,,927.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,823.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,928.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,960.96,88,,percent of total billed charges,,,,,,,,,834.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,993.72,91,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,,,,,,,,,,,,,906.36,83,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,895.44,82,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,928.2,85,,percent of total billed charges,,823.37,1037.4,
S&N FAST-FIX 360 STRAIGHT NDL DELIVERY S,30184616,CDM,,,270,RC,inpatient,,3177.46,3177.46,,2697.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2395.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2700.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2796.16,88,,percent of total billed charges,,,,,,,,,2427.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2891.49,91,,percent of total billed charges,,,3018.59,95,,percent of total billed charges,,,2637.29,83,,percent of total billed charges,,,2637.29,83,,percent of total billed charges,,,,,,,,,,,,,,,2637.29,83,,percent of total billed charges,,,3018.59,95,,percent of total billed charges,,,2859.71,90,,percent of total billed charges,,,2859.71,90,,percent of total billed charges,,,2605.52,82,,percent of total billed charges,,,2859.71,90,,percent of total billed charges,,,2700.84,85,,percent of total billed charges,,2395.8,3018.59,
S&N FAST-FIX 360 CURVED NDL DELIVERY SYS,30184617,CDM,,,270,RC,inpatient,,3177.46,3177.46,,2697.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2395.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2700.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2796.16,88,,percent of total billed charges,,,,,,,,,2427.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2891.49,91,,percent of total billed charges,,,3018.59,95,,percent of total billed charges,,,2637.29,83,,percent of total billed charges,,,2637.29,83,,percent of total billed charges,,,,,,,,,,,,,,,2637.29,83,,percent of total billed charges,,,3018.59,95,,percent of total billed charges,,,2859.71,90,,percent of total billed charges,,,2859.71,90,,percent of total billed charges,,,2605.52,82,,percent of total billed charges,,,2859.71,90,,percent of total billed charges,,,2700.84,85,,percent of total billed charges,,2395.8,3018.59,
S&N FAST-FIX 360 CANNULA KPSC & SLOTTED,30184618,CDM,,,270,RC,inpatient,,977.15,977.15,,829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,736.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,830.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,859.89,88,,percent of total billed charges,,,,,,,,,746.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,889.21,91,,percent of total billed charges,,,928.29,95,,percent of total billed charges,,,811.03,83,,percent of total billed charges,,,811.03,83,,percent of total billed charges,,,,,,,,,,,,,,,811.03,83,,percent of total billed charges,,,928.29,95,,percent of total billed charges,,,879.44,90,,percent of total billed charges,,,879.44,90,,percent of total billed charges,,,801.26,82,,percent of total billed charges,,,879.44,90,,percent of total billed charges,,,830.58,85,,percent of total billed charges,,736.77,928.29,
STRYKER BUR SWANSON PILOT POINT 3.0MM,30184619,CDM,,,270,RC,inpatient,,368.06,368.06,,312.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.89,88,,percent of total billed charges,,,,,,,,,281.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.93,91,,percent of total billed charges,,,349.66,95,,percent of total billed charges,,,305.49,83,,percent of total billed charges,,,305.49,83,,percent of total billed charges,,,,,,,,,,,,,,,305.49,83,,percent of total billed charges,,,349.66,95,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,301.81,82,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,312.85,85,,percent of total billed charges,,277.52,349.66,
STRYKER BUR SWANSON PILOT POINT 2.0MM,30184620,CDM,,,270,RC,inpatient,,368.06,368.06,,312.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.89,88,,percent of total billed charges,,,,,,,,,281.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.93,91,,percent of total billed charges,,,349.66,95,,percent of total billed charges,,,305.49,83,,percent of total billed charges,,,305.49,83,,percent of total billed charges,,,,,,,,,,,,,,,305.49,83,,percent of total billed charges,,,349.66,95,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,301.81,82,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,312.85,85,,percent of total billed charges,,277.52,349.66,
COSEAL SURGICAL SEALANT,30184622,CDM,,,270,RC,inpatient,,3903.97,3903.97,,3314.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2943.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3318.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3435.49,88,,percent of total billed charges,,,,,,,,,2982.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3552.61,91,,percent of total billed charges,,,3708.77,95,,percent of total billed charges,,,3240.3,83,,percent of total billed charges,,,3240.3,83,,percent of total billed charges,,,,,,,,,,,,,,,3240.3,83,,percent of total billed charges,,,3708.77,95,,percent of total billed charges,,,3513.57,90,,percent of total billed charges,,,3513.57,90,,percent of total billed charges,,,3201.26,82,,percent of total billed charges,,,3513.57,90,,percent of total billed charges,,,3318.37,85,,percent of total billed charges,,2943.59,3708.77,
MITEK MINI QUICKANCHOR PLUS #0 SUTURE,30184623,CDM,,,270,RC,inpatient,,3185,3185,,2704.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2401.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2707.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2802.8,88,,percent of total billed charges,,,,,,,,,2433.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2898.35,91,,percent of total billed charges,,,3025.75,95,,percent of total billed charges,,,2643.55,83,,percent of total billed charges,,,2643.55,83,,percent of total billed charges,,,,,,,,,,,,,,,2643.55,83,,percent of total billed charges,,,3025.75,95,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2611.7,82,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2707.25,85,,percent of total billed charges,,2401.49,3025.75,
JRF TENDON ALLOGRAFT GRACILIS 4MM X 23CM,30184624,CDM,,,278,RC,inpatient,,8391.5,8391.5,,7124.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6327.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7132.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7384.52,88,,percent of total billed charges,,,,,,,,,6411.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7636.27,91,,percent of total billed charges,,,7971.93,95,,percent of total billed charges,,,6964.95,83,,percent of total billed charges,,,6964.95,83,,percent of total billed charges,,,,,,,,,,,,,,,6964.95,83,,percent of total billed charges,,,7971.93,95,,percent of total billed charges,,,7552.35,90,,percent of total billed charges,,,7552.35,90,,percent of total billed charges,,,6881.03,82,,percent of total billed charges,,,7552.35,90,,percent of total billed charges,,,7132.78,85,,percent of total billed charges,,6327.19,7971.93,
SYNTHES SCREW CORTEX ST 2.4MM T8 STARDRI,30184627,CDM,,,278,RC,inpatient,,565.25,565.25,,479.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,426.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,480.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,497.42,88,,percent of total billed charges,,,,,,,,,431.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,514.38,91,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,,,,,,,,,,,,,469.16,83,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,463.51,82,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,480.46,85,,percent of total billed charges,,426.2,536.99,
DEPUY INSERT RP STAB 6MM,30184628,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
STRYKER ANTIBIOTIC BONE CEMENT,30184629,CDM,,,278,RC,inpatient,,2748.2,2748.2,,2333.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2072.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2335.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2418.42,88,,percent of total billed charges,,,,,,,,,2099.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2500.86,91,,percent of total billed charges,,,2610.79,95,,percent of total billed charges,,,2281.01,83,,percent of total billed charges,,,2281.01,83,,percent of total billed charges,,,,,,,,,,,,,,,2281.01,83,,percent of total billed charges,,,2610.79,95,,percent of total billed charges,,,2473.38,90,,percent of total billed charges,,,2473.38,90,,percent of total billed charges,,,2253.52,82,,percent of total billed charges,,,2473.38,90,,percent of total billed charges,,,2335.97,85,,percent of total billed charges,,2072.14,2610.79,
ARTHREX BIO-COMP SWVLK SP 5.5X24.5MM,30184630,CDM,,,270,RC,inpatient,,2730,2730,,2317.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2058.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2320.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2402.4,88,,percent of total billed charges,,,,,,,,,2085.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2484.3,91,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2265.9,83,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2238.6,82,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,2058.42,2593.5,
ARTHREX FIBERLINK,30184631,CDM,,,270,RC,inpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,448.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,505.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,448.63,565.25,
ARTHREX GEMINI SR8,30184632,CDM,,,270,RC,inpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
SPINECRAFT SCREW VELOX VARIABLE 4.0 X 14,30184634,CDM,,,278,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
SPINECRAFT CAGE ORIO W/PEEK 12X15X8MM,30184635,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
SPINECRAFT DRILL BIT 12MM,30184636,CDM,,,278,RC,inpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1666.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1878.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,1666.34,2099.5,
SYNTHES PLATE LCP DISTAL FIBIA 2.7 X 3.5,30184637,CDM,,,278,RC,inpatient,,6500.39,6500.39,,5518.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720.34,88,,percent of total billed charges,,,,,,,,,4966.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915.35,91,,percent of total billed charges,,,6175.37,95,,percent of total billed charges,,,5395.32,83,,percent of total billed charges,,,5395.32,83,,percent of total billed charges,,,,,,,,,,,,,,,5395.32,83,,percent of total billed charges,,,6175.37,95,,percent of total billed charges,,,5850.35,90,,percent of total billed charges,,,5850.35,90,,percent of total billed charges,,,5330.32,82,,percent of total billed charges,,,5850.35,90,,percent of total billed charges,,,5525.33,85,,percent of total billed charges,,4901.29,6175.37,
SYNTHES SCREW CORTEX 3.5MM,30184638,CDM,,,278,RC,inpatient,,267.75,267.75,,227.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,201.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,227.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,235.62,88,,percent of total billed charges,,,,,,,,,204.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,243.65,91,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,,,,,,,,,,,,,222.23,83,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,219.56,82,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,227.59,85,,percent of total billed charges,,201.88,254.36,
SYNTHES SCREW CANNCELLOUS 4.0MM,30184639,CDM,,,278,RC,inpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,168.24,211.97,
MESH PERFIX PLUG SMALL,30184640,CDM,,,278,RC,inpatient,,1727.05,1727.05,,1466.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1302.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1467.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1519.8,88,,percent of total billed charges,,,,,,,,,1319.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1571.62,91,,percent of total billed charges,,,1640.7,95,,percent of total billed charges,,,1433.45,83,,percent of total billed charges,,,1433.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1433.45,83,,percent of total billed charges,,,1640.7,95,,percent of total billed charges,,,1554.35,90,,percent of total billed charges,,,1554.35,90,,percent of total billed charges,,,1416.18,82,,percent of total billed charges,,,1554.35,90,,percent of total billed charges,,,1467.99,85,,percent of total billed charges,,1302.2,1640.7,
DEPUY HEAD BIPOLAR 28X46,30184641,CDM,,,278,RC,inpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,6126.3,7718.82,
DEPUY BIPOLAR PRIMARY CAP,30184642,CDM,,,278,RC,inpatient,,31200,31200,,26488.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23524.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26520,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27456,88,,percent of total billed charges,,,,,,,,,23836.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28392,91,,percent of total billed charges,,,29640,95,,percent of total billed charges,,,25896,83,,percent of total billed charges,,,25896,83,,percent of total billed charges,,,,,,,,,,,,,,,25896,83,,percent of total billed charges,,,29640,95,,percent of total billed charges,,,28080,90,,percent of total billed charges,,,28080,90,,percent of total billed charges,,,25584,82,,percent of total billed charges,,,28080,90,,percent of total billed charges,,,26520,85,,percent of total billed charges,,23524.8,29640,
ARTHREX SCREW BC INTER-FERENCE 10X23,30184643,CDM,,,278,RC,inpatient,,1527.5,1527.5,,1296.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1151.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1298.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1344.2,88,,percent of total billed charges,,,,,,,,,1167.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1390.03,91,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1267.83,83,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1252.55,82,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,1151.74,1451.13,
ARTHREX SCREW PT 3.0 X 38MM,30184644,CDM,,,278,RC,inpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,633.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,714,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,633.36,798,
ARTHREX SCREW CORTICAL 3.0 X 16MM,30184645,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
SCREW POLYAXIAL 6.5 X 50MM,30184646,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SCREW POLYAXIAL 6.5 X 55MM,30184647,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SCREW POLYAXIAL 6.5 X 60MM,30184648,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SCREW POLYAXIAL 7.5 X 55MM,30184649,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SCREW SET,30184650,CDM,,,278,RC,inpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,527.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,595,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,527.8,665,
ROD 6.0 X 440MM,30184651,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
PEEK HORNET 25 X 11 X 9MM 0DEG,30184652,CDM,,,278,RC,inpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12742.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14365,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,12742.6,16055,
PEEK HORNET 25 X 11 X 11MM 0DEG,30184653,CDM,,,278,RC,inpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12742.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14365,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,12742.6,16055,
ARTHREX BUTTON ABS 8 X 12,30184654,CDM,,,278,RC,inpatient,,929.5,929.5,,789.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,700.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,790.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,817.96,88,,percent of total billed charges,,,,,,,,,710.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,845.85,91,,percent of total billed charges,,,883.03,95,,percent of total billed charges,,,771.49,83,,percent of total billed charges,,,771.49,83,,percent of total billed charges,,,,,,,,,,,,,,,771.49,83,,percent of total billed charges,,,883.03,95,,percent of total billed charges,,,836.55,90,,percent of total billed charges,,,836.55,90,,percent of total billed charges,,,762.19,82,,percent of total billed charges,,,836.55,90,,percent of total billed charges,,,790.08,85,,percent of total billed charges,,700.84,883.03,
SPINECRAFT PLATE VELOX 48MM 3 LEVELS,30184655,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
MESH VITA RECTANGLE 12X12,30184656,CDM,,,270,RC,inpatient,,1160.25,1160.25,,985.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,874.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,986.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1021.02,88,,percent of total billed charges,,,,,,,,,886.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1055.83,91,,percent of total billed charges,,,1102.24,95,,percent of total billed charges,,,963.01,83,,percent of total billed charges,,,963.01,83,,percent of total billed charges,,,,,,,,,,,,,,,963.01,83,,percent of total billed charges,,,1102.24,95,,percent of total billed charges,,,1044.23,90,,percent of total billed charges,,,1044.23,90,,percent of total billed charges,,,951.41,82,,percent of total billed charges,,,1044.23,90,,percent of total billed charges,,,986.21,85,,percent of total billed charges,,874.83,1102.24,
MESH MOSAIC 15CM ROUND,30184657,CDM,,,270,RC,inpatient,,3524.89,3524.89,,2992.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2657.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2996.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3101.9,88,,percent of total billed charges,,,,,,,,,2693.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3207.65,91,,percent of total billed charges,,,3348.65,95,,percent of total billed charges,,,2925.66,83,,percent of total billed charges,,,2925.66,83,,percent of total billed charges,,,,,,,,,,,,,,,2925.66,83,,percent of total billed charges,,,3348.65,95,,percent of total billed charges,,,3172.4,90,,percent of total billed charges,,,3172.4,90,,percent of total billed charges,,,2890.41,82,,percent of total billed charges,,,3172.4,90,,percent of total billed charges,,,2996.16,85,,percent of total billed charges,,2657.77,3348.65,
MESH MOSAIC 4X6 OBLONG,30184658,CDM,,,270,RC,inpatient,,2150.01,2150.01,,1825.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1621.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1827.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1892.01,88,,percent of total billed charges,,,,,,,,,1642.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1956.51,91,,percent of total billed charges,,,2042.51,95,,percent of total billed charges,,,1784.51,83,,percent of total billed charges,,,1784.51,83,,percent of total billed charges,,,,,,,,,,,,,,,1784.51,83,,percent of total billed charges,,,2042.51,95,,percent of total billed charges,,,1935.01,90,,percent of total billed charges,,,1935.01,90,,percent of total billed charges,,,1763.01,82,,percent of total billed charges,,,1935.01,90,,percent of total billed charges,,,1827.51,85,,percent of total billed charges,,1621.11,2042.51,
DEPUY FEMUR ATTUNE PS 9 RIGHT,30184659,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY SUMMIT STD CEMENTED SZ 4,30184662,CDM,,,278,RC,inpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19184.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21627.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,19184.82,24171.86,
DEPUY PRIMARY BIPOLAR CAP,30184663,CDM,,,278,RC,inpatient,,31200,31200,,26488.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23524.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26520,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27456,88,,percent of total billed charges,,,,,,,,,23836.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28392,91,,percent of total billed charges,,,29640,95,,percent of total billed charges,,,25896,83,,percent of total billed charges,,,25896,83,,percent of total billed charges,,,,,,,,,,,,,,,25896,83,,percent of total billed charges,,,29640,95,,percent of total billed charges,,,28080,90,,percent of total billed charges,,,28080,90,,percent of total billed charges,,,25584,82,,percent of total billed charges,,,28080,90,,percent of total billed charges,,,26520,85,,percent of total billed charges,,23524.8,29640,
SCREW POLYAXIAL 6.5 X 40MM,30184664,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SCREW RESUCTION 6.5 X 50MM,30184665,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ROD LORDOSES 6.0 X 50MM,30184666,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
PEEK CORTINA 9 X 25 X 9MM,30184667,CDM,,,278,RC,inpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12742.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14365,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,12742.6,16055,
SCREW POLYAXIAL 6.5 X 45MM,30184668,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
PEEK HORNET 11 X 25 X 11 MM 0 DEG,30184669,CDM,,,278,RC,inpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12742.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14365,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,12742.6,16055,
SYNTHES PLATE DISTAL RADIUS 7X3,30184671,CDM,,,278,RC,inpatient,,9762.68,9762.68,,8288.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7361.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8298.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8591.16,88,,percent of total billed charges,,,,,,,,,7458.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8884.04,91,,percent of total billed charges,,,9274.55,95,,percent of total billed charges,,,8103.02,83,,percent of total billed charges,,,8103.02,83,,percent of total billed charges,,,,,,,,,,,,,,,8103.02,83,,percent of total billed charges,,,9274.55,95,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8005.4,82,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8298.28,85,,percent of total billed charges,,7361.06,9274.55,
SYNTHES SCREW CORTEX 2.4 X 30MM,30184672,CDM,,,278,RC,inpatient,,565.25,565.25,,479.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,426.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,480.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,497.42,88,,percent of total billed charges,,,,,,,,,431.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,514.38,91,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,,,,,,,,,,,,,469.16,83,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,463.51,82,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,480.46,85,,percent of total billed charges,,426.2,536.99,
SYNTHES PLATE T DORSAL 2.4MM VA,30184673,CDM,,,278,RC,inpatient,,6226.68,6226.68,,5286.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4694.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5292.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5479.48,88,,percent of total billed charges,,,,,,,,,4757.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5666.28,91,,percent of total billed charges,,,5915.35,95,,percent of total billed charges,,,5168.14,83,,percent of total billed charges,,,5168.14,83,,percent of total billed charges,,,,,,,,,,,,,,,5168.14,83,,percent of total billed charges,,,5915.35,95,,percent of total billed charges,,,5604.01,90,,percent of total billed charges,,,5604.01,90,,percent of total billed charges,,,5105.88,82,,percent of total billed charges,,,5604.01,90,,percent of total billed charges,,,5292.68,85,,percent of total billed charges,,4694.92,5915.35,
STRYKER  CEMENT TOWER REVOLUTION,30184674,CDM,,,270,RC,inpatient,,674.98,674.98,,573.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,508.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,573.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,593.98,88,,percent of total billed charges,,,,,,,,,515.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,614.23,91,,percent of total billed charges,,,641.23,95,,percent of total billed charges,,,560.23,83,,percent of total billed charges,,,560.23,83,,percent of total billed charges,,,,,,,,,,,,,,,560.23,83,,percent of total billed charges,,,641.23,95,,percent of total billed charges,,,607.48,90,,percent of total billed charges,,,607.48,90,,percent of total billed charges,,,553.48,82,,percent of total billed charges,,,607.48,90,,percent of total billed charges,,,573.73,85,,percent of total billed charges,,508.93,641.23,
MEDIVATORS ENDOCUFF GREEN - ADULT,30184675,CDM,,,270,RC,inpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,169.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,191.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,169.65,213.75,
DEPUY FEMUR SIGMA SZ 4N RIGHT,30184677,CDM,,,278,RC,inpatient,,23868.72,23868.72,,20264.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17997.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20288.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21004.47,88,,percent of total billed charges,,,,,,,,,18235.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21720.54,91,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19811.04,83,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,19572.35,82,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,17997.01,22675.28,
DEPUY GLENOID SZ 40,30184678,CDM,,,278,RC,inpatient,,17098.9,17098.9,,14516.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12892.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14534.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15047.03,88,,percent of total billed charges,,,,,,,,,13063.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15560,91,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,,,,,,,,,,,,,14192.09,83,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14021.1,82,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14534.07,85,,percent of total billed charges,,12892.57,16243.96,
NEUROMONITORING SPECIALTYCARE,30184679,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
DEPUY SUMMIT CEMENTED SZ 5 STD,30184682,CDM,,,278,RC,inpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19184.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21627.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,19184.82,24171.86,
DEPUY STEM CENTRALIZER 12MM,30184683,CDM,,,278,RC,inpatient,,904.8,904.8,,768.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,682.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,769.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,796.22,88,,percent of total billed charges,,,,,,,,,691.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,823.37,91,,percent of total billed charges,,,859.56,95,,percent of total billed charges,,,750.98,83,,percent of total billed charges,,,750.98,83,,percent of total billed charges,,,,,,,,,,,,,,,750.98,83,,percent of total billed charges,,,859.56,95,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,741.94,82,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,769.08,85,,percent of total billed charges,,682.22,859.56,
BRACE INNOVATOR DLX+ COOL,30184684,CDM,,,270,RC,inpatient,,641.27,641.27,,544.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,483.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,545.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,564.32,88,,percent of total billed charges,,,,,,,,,489.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,583.56,91,,percent of total billed charges,,,609.21,95,,percent of total billed charges,,,532.25,83,,percent of total billed charges,,,532.25,83,,percent of total billed charges,,,,,,,,,,,,,,,532.25,83,,percent of total billed charges,,,609.21,95,,percent of total billed charges,,,577.14,90,,percent of total billed charges,,,577.14,90,,percent of total billed charges,,,525.84,82,,percent of total billed charges,,,577.14,90,,percent of total billed charges,,,545.08,85,,percent of total billed charges,,483.52,609.21,
SYNTHES DRILL TIP WIRE 2.5 X 300MM,30184685,CDM,,,270,RC,inpatient,,714,714,,606.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,538.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,606.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,628.32,88,,percent of total billed charges,,,,,,,,,545.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,649.74,91,,percent of total billed charges,,,678.3,95,,percent of total billed charges,,,592.62,83,,percent of total billed charges,,,592.62,83,,percent of total billed charges,,,,,,,,,,,,,,,592.62,83,,percent of total billed charges,,,678.3,95,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,585.48,82,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,606.9,85,,percent of total billed charges,,538.36,678.3,
SYNTHES DRILL BIT CANNULATED 4.3MM,30184686,CDM,,,278,RC,inpatient,,3364.73,3364.73,,2856.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2537.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2860.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2960.96,88,,percent of total billed charges,,,,,,,,,2570.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3061.9,91,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2792.73,83,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2759.08,82,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2860.02,85,,percent of total billed charges,,2537.01,3196.49,
SYNTHES K-WIRE THREADED 2.0MM,30184687,CDM,,,278,RC,inpatient,,410.55,410.55,,348.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,309.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,348.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,361.28,88,,percent of total billed charges,,,,,,,,,313.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,373.6,91,,percent of total billed charges,,,390.02,95,,percent of total billed charges,,,340.76,83,,percent of total billed charges,,,340.76,83,,percent of total billed charges,,,,,,,,,,,,,,,340.76,83,,percent of total billed charges,,,390.02,95,,percent of total billed charges,,,369.5,90,,percent of total billed charges,,,369.5,90,,percent of total billed charges,,,336.65,82,,percent of total billed charges,,,369.5,90,,percent of total billed charges,,,348.97,85,,percent of total billed charges,,309.55,390.02,
SYNTHES SCREW LOCKING 5 X 80MM ANGLED,30184688,CDM,,,278,RC,inpatient,,1701.7,1701.7,,1444.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1283.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1446.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1497.5,88,,percent of total billed charges,,,,,,,,,1300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1548.55,91,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1412.41,83,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1395.39,82,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,1283.08,1616.62,
SYNTHES SCREW LOCKING 5 X 46MM ANGLED,30184689,CDM,,,278,RC,inpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1321.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1489.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,1321.56,1665.09,
SYNTHES SCREW LOCKING 5 X 44MM ANGLED,30184690,CDM,,,278,RC,inpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1321.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1489.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,1321.56,1665.09,
SYNTHES SCREW LOCKING 5 X 40MM ANGLED,30184691,CDM,,,278,RC,inpatient,,1701.7,1701.7,,1444.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1283.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1446.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1497.5,88,,percent of total billed charges,,,,,,,,,1300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1548.55,91,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1412.41,83,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1395.39,82,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,1283.08,1616.62,
SYNTHES SCREW LOCKING 5 X 20MM ANGLED,30184692,CDM,,,278,RC,inpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1321.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1489.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,1321.56,1665.09,
SYNTHES PLATE VA 4.5MM 16 HOLE CONDYLAR,30184693,CDM,,,278,RC,inpatient,,21171.8,21171.8,,17974.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15963.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17996.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18631.18,88,,percent of total billed charges,,,,,,,,,16175.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19266.34,91,,percent of total billed charges,,,20113.21,95,,percent of total billed charges,,,17572.59,83,,percent of total billed charges,,,17572.59,83,,percent of total billed charges,,,,,,,,,,,,,,,17572.59,83,,percent of total billed charges,,,20113.21,95,,percent of total billed charges,,,19054.62,90,,percent of total billed charges,,,19054.62,90,,percent of total billed charges,,,17360.88,82,,percent of total billed charges,,,19054.62,90,,percent of total billed charges,,,17996.03,85,,percent of total billed charges,,15963.54,20113.21,
DEPUY FEMUR SIGMA PS SZ 5 LEFT,30184694,CDM,,,278,RC,inpatient,,23868.72,23868.72,,20264.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17997.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20288.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21004.47,88,,percent of total billed charges,,,,,,,,,18235.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21720.54,91,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19811.04,83,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,19572.35,82,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,17997.01,22675.28,
ZIMMER OXF TIBIAL BEARING MEDIUM,30184695,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
DEPUY LINER ALTRX +4 NEUT 36 X 62,30184696,CDM,,,278,RC,inpatient,,14161.81,14161.81,,12023.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10678,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12037.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12462.39,88,,percent of total billed charges,,,,,,,,,10819.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12887.25,91,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,,,,,,,,,,,,,11754.3,83,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,11612.68,82,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,10678,13453.72,
SYNTHES SCREW CORTEX 2.4 X 30MM,30184697,CDM,,,278,RC,inpatient,,472.5,472.5,,401.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,356.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,401.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,415.8,88,,percent of total billed charges,,,,,,,,,360.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,429.98,91,,percent of total billed charges,,,448.88,95,,percent of total billed charges,,,392.18,83,,percent of total billed charges,,,392.18,83,,percent of total billed charges,,,,,,,,,,,,,,,392.18,83,,percent of total billed charges,,,448.88,95,,percent of total billed charges,,,425.25,90,,percent of total billed charges,,,425.25,90,,percent of total billed charges,,,387.45,82,,percent of total billed charges,,,425.25,90,,percent of total billed charges,,,401.63,85,,percent of total billed charges,,356.27,448.88,
SYNTHES SCREW CORTEX 2.4 X 12MM,30184698,CDM,,,278,RC,inpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,452.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,509.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,452.17,569.71,
HOOD PROTECTOR FOREIGN BODY,30184699,CDM,,,270,RC,inpatient,,283.8,283.8,,240.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,213.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.74,88,,percent of total billed charges,,,,,,,,,216.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.26,91,,percent of total billed charges,,,269.61,95,,percent of total billed charges,,,235.55,83,,percent of total billed charges,,,235.55,83,,percent of total billed charges,,,,,,,,,,,,,,,235.55,83,,percent of total billed charges,,,269.61,95,,percent of total billed charges,,,255.42,90,,percent of total billed charges,,,255.42,90,,percent of total billed charges,,,232.72,82,,percent of total billed charges,,,255.42,90,,percent of total billed charges,,,241.23,85,,percent of total billed charges,,213.99,269.61,
ENDOSCOPIC SPRAY SET 360DEG APPLICATOR,30184703,CDM,,,270,RC,inpatient,,931.36,931.36,,790.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,702.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,791.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,819.6,88,,percent of total billed charges,,,,,,,,,711.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,847.54,91,,percent of total billed charges,,,884.79,95,,percent of total billed charges,,,773.03,83,,percent of total billed charges,,,773.03,83,,percent of total billed charges,,,,,,,,,,,,,,,773.03,83,,percent of total billed charges,,,884.79,95,,percent of total billed charges,,,838.22,90,,percent of total billed charges,,,838.22,90,,percent of total billed charges,,,763.72,82,,percent of total billed charges,,,838.22,90,,percent of total billed charges,,,791.66,85,,percent of total billed charges,,702.25,884.79,
TISSEEL SPRAY SET,30184704,CDM,,,270,RC,inpatient,,368.48,368.48,,312.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,313.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,324.26,88,,percent of total billed charges,,,,,,,,,281.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,335.32,91,,percent of total billed charges,,,350.06,95,,percent of total billed charges,,,305.84,83,,percent of total billed charges,,,305.84,83,,percent of total billed charges,,,,,,,,,,,,,,,305.84,83,,percent of total billed charges,,,350.06,95,,percent of total billed charges,,,331.63,90,,percent of total billed charges,,,331.63,90,,percent of total billed charges,,,302.15,82,,percent of total billed charges,,,331.63,90,,percent of total billed charges,,,313.21,85,,percent of total billed charges,,277.83,350.06,
SYNTHES SCREW CORTEX S-T 2.4X12MM STERIL,30184705,CDM,,,278,RC,inpatient,,827.05,827.05,,702.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,623.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,702.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,727.8,88,,percent of total billed charges,,,,,,,,,631.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,752.62,91,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,,,,,,,,,,,,,686.45,83,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,678.18,82,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,623.6,785.7,
SYNTHES SCREW CORTEX S-T 2.4X24MM,30184706,CDM,,,278,RC,inpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,452.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,509.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,452.17,569.71,
ZIMMER NECK MODULAR SZ R,30184708,CDM,,,278,RC,inpatient,,15060.5,15060.5,,12786.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11355.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12801.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13253.24,88,,percent of total billed charges,,,,,,,,,11506.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13705.06,91,,percent of total billed charges,,,14307.48,95,,percent of total billed charges,,,12500.22,83,,percent of total billed charges,,,12500.22,83,,percent of total billed charges,,,,,,,,,,,,,,,12500.22,83,,percent of total billed charges,,,14307.48,95,,percent of total billed charges,,,13554.45,90,,percent of total billed charges,,,13554.45,90,,percent of total billed charges,,,12349.61,82,,percent of total billed charges,,,13554.45,90,,percent of total billed charges,,,12801.43,85,,percent of total billed charges,,11355.62,14307.48,
DEPUY LINER 40 X 60 N,30184709,CDM,,,278,RC,inpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13270.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14960.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,13270.78,16720.48,
DEPUY STEM CORAIL KLA,30184710,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY HEAD SROM 32MM +0,30184711,CDM,,,278,RC,inpatient,,6061.9,6061.9,,5146.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4570.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5152.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5334.47,88,,percent of total billed charges,,,,,,,,,4631.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5516.33,91,,percent of total billed charges,,,5758.81,95,,percent of total billed charges,,,5031.38,83,,percent of total billed charges,,,5031.38,83,,percent of total billed charges,,,,,,,,,,,,,,,5031.38,83,,percent of total billed charges,,,5758.81,95,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,4970.76,82,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,5152.62,85,,percent of total billed charges,,4570.67,5758.81,
SYNTHES DRILL BIT 4.5MM QUICK CONNECT,30184712,CDM,,,270,RC,inpatient,,782.74,782.74,,664.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,590.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,665.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,688.81,88,,percent of total billed charges,,,,,,,,,598.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,712.29,91,,percent of total billed charges,,,743.6,95,,percent of total billed charges,,,649.67,83,,percent of total billed charges,,,649.67,83,,percent of total billed charges,,,,,,,,,,,,,,,649.67,83,,percent of total billed charges,,,743.6,95,,percent of total billed charges,,,704.47,90,,percent of total billed charges,,,704.47,90,,percent of total billed charges,,,641.85,82,,percent of total billed charges,,,704.47,90,,percent of total billed charges,,,665.33,85,,percent of total billed charges,,590.19,743.6,
SPINECRAFT CAGE ORIO W/PEEK 7MM,30184713,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
SPINECRAFT PLATE VELOX 1 LEVE 12MM,30184714,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
SYNTHES BLADE HELICAL TFNA 100MM,30184715,CDM,,,278,RC,inpatient,,6630,6630,,5628.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4999.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5635.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5834.4,88,,percent of total billed charges,,,,,,,,,5065.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6033.3,91,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,,,,,,,,,,,,,5502.9,83,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5436.6,82,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,4999.02,6298.5,
SYNTHES TFNA 12MM X 400MM 130DEG RT,30184716,CDM,,,278,RC,inpatient,,21149.7,21149.7,,17956.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15946.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17977.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18611.74,88,,percent of total billed charges,,,,,,,,,16158.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19246.23,91,,percent of total billed charges,,,20092.22,95,,percent of total billed charges,,,17554.25,83,,percent of total billed charges,,,17554.25,83,,percent of total billed charges,,,,,,,,,,,,,,,17554.25,83,,percent of total billed charges,,,20092.22,95,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,17342.75,82,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,17977.25,85,,percent of total billed charges,,15946.87,20092.22,
SYNTHES COUNTERSINK 2.7MM,30184717,CDM,,,278,RC,inpatient,,2640.95,2640.95,,2242.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1991.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2244.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2324.04,88,,percent of total billed charges,,,,,,,,,2017.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2403.26,91,,percent of total billed charges,,,2508.9,95,,percent of total billed charges,,,2191.99,83,,percent of total billed charges,,,2191.99,83,,percent of total billed charges,,,,,,,,,,,,,,,2191.99,83,,percent of total billed charges,,,2508.9,95,,percent of total billed charges,,,2376.86,90,,percent of total billed charges,,,2376.86,90,,percent of total billed charges,,,2165.58,82,,percent of total billed charges,,,2376.86,90,,percent of total billed charges,,,2244.81,85,,percent of total billed charges,,1991.28,2508.9,
SYNTHES SCREW CORTEX 2.7 X 28MM,30184718,CDM,,,278,RC,inpatient,,386.75,386.75,,328.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.34,88,,percent of total billed charges,,,,,,,,,295.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.94,91,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,321,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,,,,,,,,,,,,,,321,83,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,317.14,82,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,291.61,367.41,
ZIMMER INSERT BEARING SZ 4 SM RT,30184720,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
DEPUY SCREW LOCKING 24MM,30184721,CDM,,,278,RC,inpatient,,2237.76,2237.76,,1899.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1687.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1902.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1969.23,88,,percent of total billed charges,,,,,,,,,1709.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2036.36,91,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1857.34,83,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1834.96,82,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,1687.27,2125.87,
SYNTHES CLAMP HOLDING 1.25MM,30184723,CDM,,,270,RC,inpatient,,7160.4,7160.4,,6079.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5398.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6086.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6301.15,88,,percent of total billed charges,,,,,,,,,5470.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6515.96,91,,percent of total billed charges,,,6802.38,95,,percent of total billed charges,,,5943.13,83,,percent of total billed charges,,,5943.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5943.13,83,,percent of total billed charges,,,6802.38,95,,percent of total billed charges,,,6444.36,90,,percent of total billed charges,,,6444.36,90,,percent of total billed charges,,,5871.53,82,,percent of total billed charges,,,6444.36,90,,percent of total billed charges,,,6086.34,85,,percent of total billed charges,,5398.94,6802.38,
SYNTHES ROD CARBON 3.0 X 60MM,30184724,CDM,,,270,RC,inpatient,,446.25,446.25,,378.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,336.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,379.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,392.7,88,,percent of total billed charges,,,,,,,,,340.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,406.09,91,,percent of total billed charges,,,423.94,95,,percent of total billed charges,,,370.39,83,,percent of total billed charges,,,370.39,83,,percent of total billed charges,,,,,,,,,,,,,,,370.39,83,,percent of total billed charges,,,423.94,95,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,365.93,82,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,379.31,85,,percent of total billed charges,,336.47,423.94,
SYNTHES KWIRE THREADED TIP 1.25 X 100MM,30184725,CDM,,,270,RC,inpatient,,474.22,474.22,,402.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,357.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,403.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,417.31,88,,percent of total billed charges,,,,,,,,,362.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,431.54,91,,percent of total billed charges,,,450.51,95,,percent of total billed charges,,,393.6,83,,percent of total billed charges,,,393.6,83,,percent of total billed charges,,,,,,,,,,,,,,,393.6,83,,percent of total billed charges,,,450.51,95,,percent of total billed charges,,,426.8,90,,percent of total billed charges,,,426.8,90,,percent of total billed charges,,,388.86,82,,percent of total billed charges,,,426.8,90,,percent of total billed charges,,,403.09,85,,percent of total billed charges,,357.56,450.51,
ROD LORDOSES 6.0 X 60MM,30184726,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
DEPUY INSERT AOX RP 5MM,30184727,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
PROCLAIM 7 ELITE CONTROL SYSTEM,30184731,CDM,,,278,RC,inpatient,,143000,143000,,121407,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,107822,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,121550,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,125840,88,,percent of total billed charges,,,,,,,,,109252,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,130130,91,,percent of total billed charges,,,135850,95,,percent of total billed charges,,,118690,83,,percent of total billed charges,,,118690,83,,percent of total billed charges,,,,,,,,,,,,,,,118690,83,,percent of total billed charges,,,135850,95,,percent of total billed charges,,,128700,90,,percent of total billed charges,,,128700,90,,percent of total billed charges,,,117260,82,,percent of total billed charges,,,128700,90,,percent of total billed charges,,,121550,85,,percent of total billed charges,,107822,135850,
DEPUY INSERT RP SZ 6 10MM,30184732,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
STRYKER FEMORAL HD 28MM 0+,30184733,CDM,,,278,RC,inpatient,,6715.8,6715.8,,5701.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5063.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5708.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5909.9,88,,percent of total billed charges,,,,,,,,,5130.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6111.38,91,,percent of total billed charges,,,6380.01,95,,percent of total billed charges,,,5574.11,83,,percent of total billed charges,,,5574.11,83,,percent of total billed charges,,,,,,,,,,,,,,,5574.11,83,,percent of total billed charges,,,6380.01,95,,percent of total billed charges,,,6044.22,90,,percent of total billed charges,,,6044.22,90,,percent of total billed charges,,,5506.96,82,,percent of total billed charges,,,6044.22,90,,percent of total billed charges,,,5708.43,85,,percent of total billed charges,,5063.71,6380.01,
SYNTHES SCREW CORTEX S-T 2.7X10MM,30184736,CDM,,,278,RC,inpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,333.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,375.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,333.15,419.75,
SYNTHES SCREW CORTEX S-T 2.7X14MM,30184737,CDM,,,278,RC,inpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,333.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,375.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,333.15,419.75,
SYNTHES PLATE LCP 6-HOLE 3.5MM 85MM,30184738,CDM,,,278,RC,inpatient,,2928.25,2928.25,,2486.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2207.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2489.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2576.86,88,,percent of total billed charges,,,,,,,,,2237.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2664.71,91,,percent of total billed charges,,,2781.84,95,,percent of total billed charges,,,2430.45,83,,percent of total billed charges,,,2430.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2430.45,83,,percent of total billed charges,,,2781.84,95,,percent of total billed charges,,,2635.43,90,,percent of total billed charges,,,2635.43,90,,percent of total billed charges,,,2401.17,82,,percent of total billed charges,,,2635.43,90,,percent of total billed charges,,,2489.01,85,,percent of total billed charges,,2207.9,2781.84,
SYNTHES COUNTERSINK,30184739,CDM,,,278,RC,inpatient,,2640.95,2640.95,,2242.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1991.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2244.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2324.04,88,,percent of total billed charges,,,,,,,,,2017.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2403.26,91,,percent of total billed charges,,,2508.9,95,,percent of total billed charges,,,2191.99,83,,percent of total billed charges,,,2191.99,83,,percent of total billed charges,,,,,,,,,,,,,,,2191.99,83,,percent of total billed charges,,,2508.9,95,,percent of total billed charges,,,2376.86,90,,percent of total billed charges,,,2376.86,90,,percent of total billed charges,,,2165.58,82,,percent of total billed charges,,,2376.86,90,,percent of total billed charges,,,2244.81,85,,percent of total billed charges,,1991.28,2508.9,
S&N DRILL BIT SHORT 2.7MM W/QC,30184740,CDM,,,278,RC,inpatient,,994.5,994.5,,844.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,749.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,845.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,875.16,88,,percent of total billed charges,,,,,,,,,759.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,905,91,,percent of total billed charges,,,944.78,95,,percent of total billed charges,,,825.44,83,,percent of total billed charges,,,825.44,83,,percent of total billed charges,,,,,,,,,,,,,,,825.44,83,,percent of total billed charges,,,944.78,95,,percent of total billed charges,,,895.05,90,,percent of total billed charges,,,895.05,90,,percent of total billed charges,,,815.49,82,,percent of total billed charges,,,895.05,90,,percent of total billed charges,,,845.33,85,,percent of total billed charges,,749.85,944.78,
S&N PLATE 7 HOLE RT 107MM,30184741,CDM,,,278,RC,inpatient,,7702.5,7702.5,,6539.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5807.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6547.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6778.2,88,,percent of total billed charges,,,,,,,,,5884.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7009.28,91,,percent of total billed charges,,,7317.38,95,,percent of total billed charges,,,6393.08,83,,percent of total billed charges,,,6393.08,83,,percent of total billed charges,,,,,,,,,,,,,,,6393.08,83,,percent of total billed charges,,,7317.38,95,,percent of total billed charges,,,6932.25,90,,percent of total billed charges,,,6932.25,90,,percent of total billed charges,,,6316.05,82,,percent of total billed charges,,,6932.25,90,,percent of total billed charges,,,6547.13,85,,percent of total billed charges,,5807.69,7317.38,
S&N SCREW CORTEX 2.7MM S-T 16MM,30184742,CDM,,,278,RC,inpatient,,233.1,233.1,,197.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,175.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,198.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,205.13,88,,percent of total billed charges,,,,,,,,,178.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,212.12,91,,percent of total billed charges,,,221.45,95,,percent of total billed charges,,,193.47,83,,percent of total billed charges,,,193.47,83,,percent of total billed charges,,,,,,,,,,,,,,,193.47,83,,percent of total billed charges,,,221.45,95,,percent of total billed charges,,,209.79,90,,percent of total billed charges,,,209.79,90,,percent of total billed charges,,,191.14,82,,percent of total billed charges,,,209.79,90,,percent of total billed charges,,,198.14,85,,percent of total billed charges,,175.76,221.45,
S&N SCREW CORTEX 2.7MM S-T 18MM,30184743,CDM,,,278,RC,inpatient,,286.13,286.13,,242.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,215.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,243.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,251.79,88,,percent of total billed charges,,,,,,,,,218.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,260.38,91,,percent of total billed charges,,,271.82,95,,percent of total billed charges,,,237.49,83,,percent of total billed charges,,,237.49,83,,percent of total billed charges,,,,,,,,,,,,,,,237.49,83,,percent of total billed charges,,,271.82,95,,percent of total billed charges,,,257.52,90,,percent of total billed charges,,,257.52,90,,percent of total billed charges,,,234.63,82,,percent of total billed charges,,,257.52,90,,percent of total billed charges,,,243.21,85,,percent of total billed charges,,215.74,271.82,
S&N SCREW CORTEX 2.7MM S-T 20MM,30184744,CDM,,,278,RC,inpatient,,217.88,217.88,,184.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,191.73,88,,percent of total billed charges,,,,,,,,,166.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,198.27,91,,percent of total billed charges,,,206.99,95,,percent of total billed charges,,,180.84,83,,percent of total billed charges,,,180.84,83,,percent of total billed charges,,,,,,,,,,,,,,,180.84,83,,percent of total billed charges,,,206.99,95,,percent of total billed charges,,,196.09,90,,percent of total billed charges,,,196.09,90,,percent of total billed charges,,,178.66,82,,percent of total billed charges,,,196.09,90,,percent of total billed charges,,,185.2,85,,percent of total billed charges,,164.28,206.99,
S&N SCREW LOCKING 3.5MM X 10MM,30184745,CDM,,,278,RC,inpatient,,1352,1352,,1147.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1019.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1149.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1189.76,88,,percent of total billed charges,,,,,,,,,1032.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1230.32,91,,percent of total billed charges,,,1284.4,95,,percent of total billed charges,,,1122.16,83,,percent of total billed charges,,,1122.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1122.16,83,,percent of total billed charges,,,1284.4,95,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1108.64,82,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1149.2,85,,percent of total billed charges,,1019.41,1284.4,
S&N SCREW LOCKING 3.5MM X 12MM,30184746,CDM,,,278,RC,inpatient,,1035.84,1035.84,,879.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,781.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,880.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,911.54,88,,percent of total billed charges,,,,,,,,,791.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,942.61,91,,percent of total billed charges,,,984.05,95,,percent of total billed charges,,,859.75,83,,percent of total billed charges,,,859.75,83,,percent of total billed charges,,,,,,,,,,,,,,,859.75,83,,percent of total billed charges,,,984.05,95,,percent of total billed charges,,,932.26,90,,percent of total billed charges,,,932.26,90,,percent of total billed charges,,,849.39,82,,percent of total billed charges,,,932.26,90,,percent of total billed charges,,,880.46,85,,percent of total billed charges,,781.02,984.05,
S&N SCREW CORTEX S-T 3.5MM X 16MM,30184747,CDM,,,278,RC,inpatient,,213.83,213.83,,181.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.17,88,,percent of total billed charges,,,,,,,,,163.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.59,91,,percent of total billed charges,,,203.14,95,,percent of total billed charges,,,177.48,83,,percent of total billed charges,,,177.48,83,,percent of total billed charges,,,,,,,,,,,,,,,177.48,83,,percent of total billed charges,,,203.14,95,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,175.34,82,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,181.76,85,,percent of total billed charges,,161.23,203.14,
S&N SCREW CORTEX S-T 3.5MM X 18MM,30184748,CDM,,,278,RC,inpatient,,213.83,213.83,,181.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.17,88,,percent of total billed charges,,,,,,,,,163.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.59,91,,percent of total billed charges,,,203.14,95,,percent of total billed charges,,,177.48,83,,percent of total billed charges,,,177.48,83,,percent of total billed charges,,,,,,,,,,,,,,,177.48,83,,percent of total billed charges,,,203.14,95,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,175.34,82,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,181.76,85,,percent of total billed charges,,161.23,203.14,
S&N SCREW CORTEX S-T 3.5MM X 12MM,30184749,CDM,,,278,RC,inpatient,,278.25,278.25,,236.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,236.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.86,88,,percent of total billed charges,,,,,,,,,212.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,253.21,91,,percent of total billed charges,,,264.34,95,,percent of total billed charges,,,230.95,83,,percent of total billed charges,,,230.95,83,,percent of total billed charges,,,,,,,,,,,,,,,230.95,83,,percent of total billed charges,,,264.34,95,,percent of total billed charges,,,250.43,90,,percent of total billed charges,,,250.43,90,,percent of total billed charges,,,228.17,82,,percent of total billed charges,,,250.43,90,,percent of total billed charges,,,236.51,85,,percent of total billed charges,,209.8,264.34,
S&N SCREW CORTEX S-T 3.5MM X 42MM,30184750,CDM,,,278,RC,inpatient,,213.83,213.83,,181.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.17,88,,percent of total billed charges,,,,,,,,,163.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.59,91,,percent of total billed charges,,,203.14,95,,percent of total billed charges,,,177.48,83,,percent of total billed charges,,,177.48,83,,percent of total billed charges,,,,,,,,,,,,,,,177.48,83,,percent of total billed charges,,,203.14,95,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,175.34,82,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,181.76,85,,percent of total billed charges,,161.23,203.14,
S&N SCREW CORTEX S-T 3.5MM X 40MM,30184751,CDM,,,278,RC,inpatient,,213.83,213.83,,181.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.17,88,,percent of total billed charges,,,,,,,,,163.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.59,91,,percent of total billed charges,,,203.14,95,,percent of total billed charges,,,177.48,83,,percent of total billed charges,,,177.48,83,,percent of total billed charges,,,,,,,,,,,,,,,177.48,83,,percent of total billed charges,,,203.14,95,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,175.34,82,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,181.76,85,,percent of total billed charges,,161.23,203.14,
S&N DRILL BIT SHORT 3.5MM W/QC,30184752,CDM,,,278,RC,inpatient,,1378,1378,,1169.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1039.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1171.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1212.64,88,,percent of total billed charges,,,,,,,,,1052.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1253.98,91,,percent of total billed charges,,,1309.1,95,,percent of total billed charges,,,1143.74,83,,percent of total billed charges,,,1143.74,83,,percent of total billed charges,,,,,,,,,,,,,,,1143.74,83,,percent of total billed charges,,,1309.1,95,,percent of total billed charges,,,1240.2,90,,percent of total billed charges,,,1240.2,90,,percent of total billed charges,,,1129.96,82,,percent of total billed charges,,,1240.2,90,,percent of total billed charges,,,1171.3,85,,percent of total billed charges,,1039.01,1309.1,
S&N DRILL BIT 2.0MM W/QC,30184753,CDM,,,278,RC,inpatient,,994.5,994.5,,844.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,749.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,845.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,875.16,88,,percent of total billed charges,,,,,,,,,759.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,905,91,,percent of total billed charges,,,944.78,95,,percent of total billed charges,,,825.44,83,,percent of total billed charges,,,825.44,83,,percent of total billed charges,,,,,,,,,,,,,,,825.44,83,,percent of total billed charges,,,944.78,95,,percent of total billed charges,,,895.05,90,,percent of total billed charges,,,895.05,90,,percent of total billed charges,,,815.49,82,,percent of total billed charges,,,895.05,90,,percent of total billed charges,,,845.33,85,,percent of total billed charges,,749.85,944.78,
SPINECRAFT PLATE VELOX 30MM 2 LEVELS,30184754,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
SPINECRAFT PLATE VELOX 32MM 2 LEVELS,30184755,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER NAIL GAMMA 11X180X125 DEG,30184756,CDM,,,278,RC,inpatient,,13727.55,13727.55,,11654.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10350.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11668.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12080.24,88,,percent of total billed charges,,,,,,,,,10487.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12492.07,91,,percent of total billed charges,,,13041.17,95,,percent of total billed charges,,,11393.87,83,,percent of total billed charges,,,11393.87,83,,percent of total billed charges,,,,,,,,,,,,,,,11393.87,83,,percent of total billed charges,,,13041.17,95,,percent of total billed charges,,,12354.8,90,,percent of total billed charges,,,12354.8,90,,percent of total billed charges,,,11256.59,82,,percent of total billed charges,,,12354.8,90,,percent of total billed charges,,,11668.42,85,,percent of total billed charges,,10350.57,13041.17,
STRYKER SCREW LAG 10.5 X 85MM,30184757,CDM,,,278,RC,inpatient,,5200.33,5200.33,,4415.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3921.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4420.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4576.29,88,,percent of total billed charges,,,,,,,,,3973.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4732.3,91,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,,,,,,,,,,,,,4316.27,83,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4264.27,82,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4420.28,85,,percent of total billed charges,,3921.05,4940.31,
STRYKER SCREW LOCKING 5 X 35MM,30184758,CDM,,,278,RC,inpatient,,1774,1774,,1506.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1337.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1507.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1561.12,88,,percent of total billed charges,,,,,,,,,1355.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1614.34,91,,percent of total billed charges,,,1685.3,95,,percent of total billed charges,,,1472.42,83,,percent of total billed charges,,,1472.42,83,,percent of total billed charges,,,,,,,,,,,,,,,1472.42,83,,percent of total billed charges,,,1685.3,95,,percent of total billed charges,,,1596.6,90,,percent of total billed charges,,,1596.6,90,,percent of total billed charges,,,1454.68,82,,percent of total billed charges,,,1596.6,90,,percent of total billed charges,,,1507.9,85,,percent of total billed charges,,1337.6,1685.3,
STRYKER K-WIRE 3 X 285MM,30184759,CDM,,,278,RC,inpatient,,1251.25,1251.25,,1062.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,943.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1063.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1101.1,88,,percent of total billed charges,,,,,,,,,955.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1138.64,91,,percent of total billed charges,,,1188.69,95,,percent of total billed charges,,,1038.54,83,,percent of total billed charges,,,1038.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1038.54,83,,percent of total billed charges,,,1188.69,95,,percent of total billed charges,,,1126.13,90,,percent of total billed charges,,,1126.13,90,,percent of total billed charges,,,1026.03,82,,percent of total billed charges,,,1126.13,90,,percent of total billed charges,,,1063.56,85,,percent of total billed charges,,943.44,1188.69,
STRYKER DRILL 4.2 X 300MM,30184760,CDM,,,278,RC,inpatient,,1886.89,1886.89,,1601.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1422.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1603.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1660.46,88,,percent of total billed charges,,,,,,,,,1441.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1717.07,91,,percent of total billed charges,,,1792.55,95,,percent of total billed charges,,,1566.12,83,,percent of total billed charges,,,1566.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1566.12,83,,percent of total billed charges,,,1792.55,95,,percent of total billed charges,,,1698.2,90,,percent of total billed charges,,,1698.2,90,,percent of total billed charges,,,1547.25,82,,percent of total billed charges,,,1698.2,90,,percent of total billed charges,,,1603.86,85,,percent of total billed charges,,1422.72,1792.55,
STAPLER RELOAD 45 W/TRU-STAPLE TECH,30184761,CDM,,,270,RC,inpatient,,2850.28,2850.28,,2419.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2149.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2422.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2508.25,88,,percent of total billed charges,,,,,,,,,2177.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2593.75,91,,percent of total billed charges,,,2707.77,95,,percent of total billed charges,,,2365.73,83,,percent of total billed charges,,,2365.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2365.73,83,,percent of total billed charges,,,2707.77,95,,percent of total billed charges,,,2565.25,90,,percent of total billed charges,,,2565.25,90,,percent of total billed charges,,,2337.23,82,,percent of total billed charges,,,2565.25,90,,percent of total billed charges,,,2422.74,85,,percent of total billed charges,,2149.11,2707.77,
STAPLER RELOAD 60MM W/TRI-STAPLE,30184762,CDM,,,270,RC,inpatient,,3033.51,3033.51,,2575.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2287.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2578.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2669.49,88,,percent of total billed charges,,,,,,,,,2317.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2760.49,91,,percent of total billed charges,,,2881.83,95,,percent of total billed charges,,,2517.81,83,,percent of total billed charges,,,2517.81,83,,percent of total billed charges,,,,,,,,,,,,,,,2517.81,83,,percent of total billed charges,,,2881.83,95,,percent of total billed charges,,,2730.16,90,,percent of total billed charges,,,2730.16,90,,percent of total billed charges,,,2487.48,82,,percent of total billed charges,,,2730.16,90,,percent of total billed charges,,,2578.48,85,,percent of total billed charges,,2287.27,2881.83,
STAPLER GIA 4 HANDLE,30184763,CDM,,,270,RC,inpatient,,2345.74,2345.74,,1991.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1768.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1993.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2064.25,88,,percent of total billed charges,,,,,,,,,1792.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2134.62,91,,percent of total billed charges,,,2228.45,95,,percent of total billed charges,,,1946.96,83,,percent of total billed charges,,,1946.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1946.96,83,,percent of total billed charges,,,2228.45,95,,percent of total billed charges,,,2111.17,90,,percent of total billed charges,,,2111.17,90,,percent of total billed charges,,,1923.51,82,,percent of total billed charges,,,2111.17,90,,percent of total billed charges,,,1993.88,85,,percent of total billed charges,,1768.69,2228.45,
S&N BLADE SERRATED 3.0,30184764,CDM,,,270,RC,inpatient,,329.18,329.18,,279.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,248.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,279.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,289.68,88,,percent of total billed charges,,,,,,,,,251.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,299.55,91,,percent of total billed charges,,,312.72,95,,percent of total billed charges,,,273.22,83,,percent of total billed charges,,,273.22,83,,percent of total billed charges,,,,,,,,,,,,,,,273.22,83,,percent of total billed charges,,,312.72,95,,percent of total billed charges,,,296.26,90,,percent of total billed charges,,,296.26,90,,percent of total billed charges,,,269.93,82,,percent of total billed charges,,,296.26,90,,percent of total billed charges,,,279.8,85,,percent of total billed charges,,248.2,312.72,
S&N HIP CANNULA 7X110 CLEAR TRAC,30184765,CDM,,,270,RC,inpatient,,239.33,239.33,,203.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,203.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,210.61,88,,percent of total billed charges,,,,,,,,,182.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,217.79,91,,percent of total billed charges,,,227.36,95,,percent of total billed charges,,,198.64,83,,percent of total billed charges,,,198.64,83,,percent of total billed charges,,,,,,,,,,,,,,,198.64,83,,percent of total billed charges,,,227.36,95,,percent of total billed charges,,,215.4,90,,percent of total billed charges,,,215.4,90,,percent of total billed charges,,,196.25,82,,percent of total billed charges,,,215.4,90,,percent of total billed charges,,,203.43,85,,percent of total billed charges,,180.45,227.36,
S&N HIP SYSTEM GENERAL UC,30184766,CDM,,,270,RC,inpatient,,3867.5,3867.5,,3283.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2916.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3287.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3403.4,88,,percent of total billed charges,,,,,,,,,2954.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3519.43,91,,percent of total billed charges,,,3674.13,95,,percent of total billed charges,,,3210.03,83,,percent of total billed charges,,,3210.03,83,,percent of total billed charges,,,,,,,,,,,,,,,3210.03,83,,percent of total billed charges,,,3674.13,95,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3171.35,82,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3287.38,85,,percent of total billed charges,,2916.1,3674.13,
ZIMMER TRABECULAR METAL OSTEONECROSIS,30184767,CDM,,,278,RC,inpatient,,22109.62,22109.62,,18771.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16670.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18793.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19456.47,88,,percent of total billed charges,,,,,,,,,16891.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20119.75,91,,percent of total billed charges,,,21004.14,95,,percent of total billed charges,,,18350.98,83,,percent of total billed charges,,,18350.98,83,,percent of total billed charges,,,,,,,,,,,,,,,18350.98,83,,percent of total billed charges,,,21004.14,95,,percent of total billed charges,,,19898.66,90,,percent of total billed charges,,,19898.66,90,,percent of total billed charges,,,18129.89,82,,percent of total billed charges,,,19898.66,90,,percent of total billed charges,,,18793.18,85,,percent of total billed charges,,16670.65,21004.14,
CONFORMIS INSERT KIT POLY 6MM,30184768,CDM,,,278,RC,inpatient,,8417.5,8417.5,,7146.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6346.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7154.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7407.4,88,,percent of total billed charges,,,,,,,,,6430.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7659.93,91,,percent of total billed charges,,,7996.63,95,,percent of total billed charges,,,6986.53,83,,percent of total billed charges,,,6986.53,83,,percent of total billed charges,,,,,,,,,,,,,,,6986.53,83,,percent of total billed charges,,,7996.63,95,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,6902.35,82,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,7154.88,85,,percent of total billed charges,,6346.8,7996.63,
ZIMMER DRILL BIT 3.2MM,30184769,CDM,,,270,RC,inpatient,,230.7,230.7,,195.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,173.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.02,88,,percent of total billed charges,,,,,,,,,176.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,209.94,91,,percent of total billed charges,,,219.17,95,,percent of total billed charges,,,191.48,83,,percent of total billed charges,,,191.48,83,,percent of total billed charges,,,,,,,,,,,,,,,191.48,83,,percent of total billed charges,,,219.17,95,,percent of total billed charges,,,207.63,90,,percent of total billed charges,,,207.63,90,,percent of total billed charges,,,189.17,82,,percent of total billed charges,,,207.63,90,,percent of total billed charges,,,196.1,85,,percent of total billed charges,,173.95,219.17,
SCREW REDUCTION 6.5 X 45MM,30184770,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
SCREW POLYAXIAL 7.5 X 50MM,30184771,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ROD LORDOSED 70MM,30184772,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
PEEK CORTINA 8 X 25 X 9MM 0 DEG,30184773,CDM,,,278,RC,inpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12742.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14365,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,12742.6,16055,
BARD POWERPORT MRI IMIPLANTABLE PORT,30184775,CDM,,,270,RC,inpatient,,5674.5,5674.5,,4817.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4278.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4823.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4993.56,88,,percent of total billed charges,,,,,,,,,4335.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5163.8,91,,percent of total billed charges,,,5390.78,95,,percent of total billed charges,,,4709.84,83,,percent of total billed charges,,,4709.84,83,,percent of total billed charges,,,,,,,,,,,,,,,4709.84,83,,percent of total billed charges,,,5390.78,95,,percent of total billed charges,,,5107.05,90,,percent of total billed charges,,,5107.05,90,,percent of total billed charges,,,4653.09,82,,percent of total billed charges,,,5107.05,90,,percent of total billed charges,,,4823.33,85,,percent of total billed charges,,4278.57,5390.78,
SPINECRAFT PEEK CERVICAL OR10 5MM,30184776,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
SPINECRAFT PEEK CERVICAL OR10 4MM,30184777,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
SYNTHES SCREW LOCKING 2.7X10MM,30184778,CDM,,,278,RC,inpatient,,1178.13,1178.13,,1000.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,888.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1001.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1036.75,88,,percent of total billed charges,,,,,,,,,900.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1072.1,91,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,,,,,,,,,,,,,977.85,83,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,966.07,82,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,888.31,1119.22,
SYNTHES SCREW LOCKING 2.7X22MM,30184779,CDM,,,278,RC,inpatient,,1143.87,1143.87,,971.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,862.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,972.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1006.61,88,,percent of total billed charges,,,,,,,,,873.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1040.92,91,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,,,,,,,,,,,,,949.41,83,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,937.97,82,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,972.29,85,,percent of total billed charges,,862.48,1086.68,
ZIMMER TIBIA UNI SZ E,30184780,CDM,,,278,RC,inpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10218.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11519.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,10218.59,12874.88,
ZIMMER BEARING LG RT SZ 3,30184781,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
SYNTHES SCREW CORTEX S-T 2.7X18MM,30184787,CDM,,,278,RC,inpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,333.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,375.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,333.15,419.75,
SYNTHES SCREW CORTEX S-T 2.7X20MM,30184788,CDM,,,278,RC,inpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,333.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,375.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,333.15,419.75,
SYNTHES SCREW CORTEX S-T 2.7X22MM,30184789,CDM,,,278,RC,inpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,333.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,375.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,333.15,419.75,
SYNTHES SCREW LOCKING 2.7X12MM,30184790,CDM,,,278,RC,inpatient,,1178.13,1178.13,,1000.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,888.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1001.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1036.75,88,,percent of total billed charges,,,,,,,,,900.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1072.1,91,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,,,,,,,,,,,,,977.85,83,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,966.07,82,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,888.31,1119.22,
SYNTHES DRILL BIT CANNULATED 7.3MM,30184791,CDM,,,278,RC,inpatient,,4270.83,4270.83,,3625.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3220.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3630.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3758.33,88,,percent of total billed charges,,,,,,,,,3262.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3886.46,91,,percent of total billed charges,,,4057.29,95,,percent of total billed charges,,,3544.79,83,,percent of total billed charges,,,3544.79,83,,percent of total billed charges,,,,,,,,,,,,,,,3544.79,83,,percent of total billed charges,,,4057.29,95,,percent of total billed charges,,,3843.75,90,,percent of total billed charges,,,3843.75,90,,percent of total billed charges,,,3502.08,82,,percent of total billed charges,,,3843.75,90,,percent of total billed charges,,,3630.21,85,,percent of total billed charges,,3220.21,4057.29,
CARBOJET CO2 TUBESET W/HANDPIECE,30184792,CDM,,,270,RC,inpatient,,1748.5,1748.5,,1484.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1318.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1486.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1538.68,88,,percent of total billed charges,,,,,,,,,1335.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1591.14,91,,percent of total billed charges,,,1661.08,95,,percent of total billed charges,,,1451.26,83,,percent of total billed charges,,,1451.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1451.26,83,,percent of total billed charges,,,1661.08,95,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1433.77,82,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1486.23,85,,percent of total billed charges,,1318.37,1661.08,
SYNTHES BLADE HELICAL TFNA 95MM,30184793,CDM,,,278,RC,inpatient,,6630,6630,,5628.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4999.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5635.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5834.4,88,,percent of total billed charges,,,,,,,,,5065.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6033.3,91,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,,,,,,,,,,,,,5502.9,83,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5436.6,82,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,4999.02,6298.5,
SYNTHES TFNA 11MM X 130DEG,30184794,CDM,,,278,RC,inpatient,,16019.38,16019.38,,13600.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12078.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13616.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14097.05,88,,percent of total billed charges,,,,,,,,,12238.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14577.64,91,,percent of total billed charges,,,15218.41,95,,percent of total billed charges,,,13296.09,83,,percent of total billed charges,,,13296.09,83,,percent of total billed charges,,,,,,,,,,,,,,,13296.09,83,,percent of total billed charges,,,15218.41,95,,percent of total billed charges,,,14417.44,90,,percent of total billed charges,,,14417.44,90,,percent of total billed charges,,,13135.89,82,,percent of total billed charges,,,14417.44,90,,percent of total billed charges,,,13616.47,85,,percent of total billed charges,,12078.61,15218.41,
SYNTHES SCREW LOCKING 5.0MM X 22MM,30184795,CDM,,,278,RC,inpatient,,2185.24,2185.24,,1855.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1647.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1857.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1923.01,88,,percent of total billed charges,,,,,,,,,1669.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1988.57,91,,percent of total billed charges,,,2075.98,95,,percent of total billed charges,,,1813.75,83,,percent of total billed charges,,,1813.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1813.75,83,,percent of total billed charges,,,2075.98,95,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1791.9,82,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1857.45,85,,percent of total billed charges,,1647.67,2075.98,
SYNTHES DRILL BIT 4.2MM,30184796,CDM,,,270,RC,inpatient,,2924.87,2924.87,,2483.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2573.89,88,,percent of total billed charges,,,,,,,,,2234.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.63,91,,percent of total billed charges,,,2778.63,95,,percent of total billed charges,,,2427.64,83,,percent of total billed charges,,,2427.64,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.64,83,,percent of total billed charges,,,2778.63,95,,percent of total billed charges,,,2632.38,90,,percent of total billed charges,,,2632.38,90,,percent of total billed charges,,,2398.39,82,,percent of total billed charges,,,2632.38,90,,percent of total billed charges,,,2486.14,85,,percent of total billed charges,,2205.35,2778.63,
DEPUY INSERT SZ 6 8MM,30184797,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
STENT URETERAL FIRM 5 X 26,30184798,CDM,,,270,RC,inpatient,,682.36,682.36,,579.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,514.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,580.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,600.48,88,,percent of total billed charges,,,,,,,,,521.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,620.95,91,,percent of total billed charges,,,648.24,95,,percent of total billed charges,,,566.36,83,,percent of total billed charges,,,566.36,83,,percent of total billed charges,,,,,,,,,,,,,,,566.36,83,,percent of total billed charges,,,648.24,95,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,559.54,82,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,580.01,85,,percent of total billed charges,,514.5,648.24,
SYNTHES PLATE VA LCP DISTAL RADIUS 2.4MM,30184799,CDM,,,278,RC,inpatient,,9419.41,9419.41,,7997.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7102.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8006.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8289.08,88,,percent of total billed charges,,,,,,,,,7196.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8571.66,91,,percent of total billed charges,,,8948.44,95,,percent of total billed charges,,,7818.11,83,,percent of total billed charges,,,7818.11,83,,percent of total billed charges,,,,,,,,,,,,,,,7818.11,83,,percent of total billed charges,,,8948.44,95,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,7723.92,82,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,8006.5,85,,percent of total billed charges,,7102.24,8948.44,
SYNTHES SCREW LOCKING 5.0MM X 34MM,30184800,CDM,,,278,RC,inpatient,,2185.24,2185.24,,1855.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1647.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1857.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1923.01,88,,percent of total billed charges,,,,,,,,,1669.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1988.57,91,,percent of total billed charges,,,2075.98,95,,percent of total billed charges,,,1813.75,83,,percent of total billed charges,,,1813.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1813.75,83,,percent of total billed charges,,,2075.98,95,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1791.9,82,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1857.45,85,,percent of total billed charges,,1647.67,2075.98,
SYNTHES PLATE LCP RT DISTAL RADIUS,30184801,CDM,,,278,RC,inpatient,,15945.15,15945.15,,13537.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12022.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13553.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14031.73,88,,percent of total billed charges,,,,,,,,,12182.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14510.09,91,,percent of total billed charges,,,15147.89,95,,percent of total billed charges,,,13234.47,83,,percent of total billed charges,,,13234.47,83,,percent of total billed charges,,,,,,,,,,,,,,,13234.47,83,,percent of total billed charges,,,15147.89,95,,percent of total billed charges,,,14350.64,90,,percent of total billed charges,,,14350.64,90,,percent of total billed charges,,,13075.02,82,,percent of total billed charges,,,14350.64,90,,percent of total billed charges,,,13553.38,85,,percent of total billed charges,,12022.64,15147.89,
SPINECRAFT PLATE VELOX 28MM 2 LEVELS,30184802,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
SPINECRAFT PLATE VELOX 14MM 1 LEVEL,30184804,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
DEPUY PE CUP 38MM+9,30184805,CDM,,,278,RC,inpatient,,10688.08,10688.08,,9074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8058.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9084.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9405.51,88,,percent of total billed charges,,,,,,,,,8165.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9726.15,91,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,,,,,,,,,,,,,8871.11,83,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,8764.23,82,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,8058.81,10153.68,
CYSTOSCOPE - CONTINUOUS FLOW,30184806,CDM,,,270,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
SYNTHES PLATE DISTAL RADIUS 2.4MM 6 HOLE,30184807,CDM,,,278,RC,inpatient,,9419.41,9419.41,,7997.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7102.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8006.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8289.08,88,,percent of total billed charges,,,,,,,,,7196.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8571.66,91,,percent of total billed charges,,,8948.44,95,,percent of total billed charges,,,7818.11,83,,percent of total billed charges,,,7818.11,83,,percent of total billed charges,,,,,,,,,,,,,,,7818.11,83,,percent of total billed charges,,,8948.44,95,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,7723.92,82,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,8006.5,85,,percent of total billed charges,,7102.24,8948.44,
ARTHREX SUTURE ANCHOR 5.5 X 14.7MM BIOCO,30184808,CDM,,,270,RC,inpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1592.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1795.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,1592.83,2006.88,
ARTHREX SUTURE ANCHOR 5.5 X 14.7MM TRIPL,30184809,CDM,,,270,RC,inpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1666.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1878.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,1666.34,2099.5,
CANNISTER LIPOSUCTION 2000CC,30184810,CDM,,,270,RC,inpatient,,80.75,80.75,,68.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.06,88,,percent of total billed charges,,,,,,,,,61.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.48,91,,percent of total billed charges,,,76.71,95,,percent of total billed charges,,,67.02,83,,percent of total billed charges,,,67.02,83,,percent of total billed charges,,,,,,,,,,,,,,,67.02,83,,percent of total billed charges,,,76.71,95,,percent of total billed charges,,,72.68,90,,percent of total billed charges,,,72.68,90,,percent of total billed charges,,,66.22,82,,percent of total billed charges,,,72.68,90,,percent of total billed charges,,,68.64,85,,percent of total billed charges,,60.89,76.71,
TUBING ASPIRATION SET,30184811,CDM,,,270,RC,inpatient,,104,104,,88.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,78.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,88.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,91.52,88,,percent of total billed charges,,,,,,,,,79.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,94.64,91,,percent of total billed charges,,,98.8,95,,percent of total billed charges,,,86.32,83,,percent of total billed charges,,,86.32,83,,percent of total billed charges,,,,,,,,,,,,,,,86.32,83,,percent of total billed charges,,,98.8,95,,percent of total billed charges,,,93.6,90,,percent of total billed charges,,,93.6,90,,percent of total billed charges,,,85.28,82,,percent of total billed charges,,,93.6,90,,percent of total billed charges,,,88.4,85,,percent of total billed charges,,78.42,98.8,
TUBING ASPIRATION- NON STERILE,30184812,CDM,,,270,RC,inpatient,,22.5,22.5,,19.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.8,88,,percent of total billed charges,,,,,,,,,17.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.48,91,,percent of total billed charges,,,21.38,95,,percent of total billed charges,,,18.68,83,,percent of total billed charges,,,18.68,83,,percent of total billed charges,,,,,,,,,,,,,,,18.68,83,,percent of total billed charges,,,21.38,95,,percent of total billed charges,,,20.25,90,,percent of total billed charges,,,20.25,90,,percent of total billed charges,,,18.45,82,,percent of total billed charges,,,20.25,90,,percent of total billed charges,,,19.13,85,,percent of total billed charges,,16.97,21.38,
TUBING INFILTRATION SINGLE-SPIKE,30184813,CDM,,,270,RC,inpatient,,85,85,,72.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,72.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.8,88,,percent of total billed charges,,,,,,,,,64.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,,,,,,,,,,,,,70.55,83,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,69.7,82,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,64.09,80.75,
LIPOFILTER,30184814,CDM,,,270,RC,inpatient,,1235,1235,,1048.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,931.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1049.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1086.8,88,,percent of total billed charges,,,,,,,,,943.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1123.85,91,,percent of total billed charges,,,1173.25,95,,percent of total billed charges,,,1025.05,83,,percent of total billed charges,,,1025.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1025.05,83,,percent of total billed charges,,,1173.25,95,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1012.7,82,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1049.75,85,,percent of total billed charges,,931.19,1173.25,
DEPUY LINER ALTRX 40 X 56,30184815,CDM,,,278,RC,inpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13270.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14960.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,13270.78,16720.48,
DEPUY FEMORAL HEAD 28MM +12,30184816,CDM,,,278,RC,inpatient,,5683.54,5683.54,,4825.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4285.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4831.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5001.52,88,,percent of total billed charges,,,,,,,,,4342.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5172.02,91,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,,,,,,,,,,,,,4717.34,83,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4660.5,82,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4831.01,85,,percent of total billed charges,,4285.39,5399.36,
DEPUY SEGMENT LPS 85MM,30184817,CDM,,,278,RC,inpatient,,18773.5,18773.5,,15938.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14155.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15957.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16520.68,88,,percent of total billed charges,,,,,,,,,14342.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17083.89,91,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,,,,,,,,,,,,,15582.01,83,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15394.27,82,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,14155.22,17834.83,
DEPUY STEM CEMENTED LPS 13 X 200MM,30184818,CDM,,,278,RC,inpatient,,44982.15,44982.15,,38189.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33916.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38234.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39584.29,88,,percent of total billed charges,,,,,,,,,34366.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40933.76,91,,percent of total billed charges,,,42733.04,95,,percent of total billed charges,,,37335.18,83,,percent of total billed charges,,,37335.18,83,,percent of total billed charges,,,,,,,,,,,,,,,37335.18,83,,percent of total billed charges,,,42733.04,95,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,36885.36,82,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,38234.83,85,,percent of total billed charges,,33916.54,42733.04,
ZIMMER BLADE EXPLANT 48MM X 10,30184819,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
ZIMMER BLADE EXPLANT 48MM X 20,30184820,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
SYNTHES SCREW LAG 95MM,30184821,CDM,,,278,RC,inpatient,,6298.5,6298.5,,5347.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4749.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5353.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5542.68,88,,percent of total billed charges,,,,,,,,,4812.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5731.64,91,,percent of total billed charges,,,5983.58,95,,percent of total billed charges,,,5227.76,83,,percent of total billed charges,,,5227.76,83,,percent of total billed charges,,,,,,,,,,,,,,,5227.76,83,,percent of total billed charges,,,5983.58,95,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5164.77,82,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5353.73,85,,percent of total billed charges,,4749.07,5983.58,
SYNTHES TFNA NAIL 11MM X 380MM,30184822,CDM,,,278,RC,inpatient,,22437.74,22437.74,,19049.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16918.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19072.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19745.21,88,,percent of total billed charges,,,,,,,,,17142.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20418.34,91,,percent of total billed charges,,,21315.85,95,,percent of total billed charges,,,18623.32,83,,percent of total billed charges,,,18623.32,83,,percent of total billed charges,,,,,,,,,,,,,,,18623.32,83,,percent of total billed charges,,,21315.85,95,,percent of total billed charges,,,20193.97,90,,percent of total billed charges,,,20193.97,90,,percent of total billed charges,,,18398.95,82,,percent of total billed charges,,,20193.97,90,,percent of total billed charges,,,19072.08,85,,percent of total billed charges,,16918.06,21315.85,
SYNTHES SCREW LOCKING 5.0MM X 38MM,30184823,CDM,,,278,RC,inpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1697.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1913.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,1697.12,2138.28,
SYNTHES SCREW LOCKING 5.0MM X 50MM,30184824,CDM,,,278,RC,inpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1697.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1913.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,1697.12,2138.28,
SYNTHES EX FIX KIT LARGE,30184825,CDM,,,278,RC,inpatient,,36067.2,36067.2,,30621.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27194.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30657.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31739.14,88,,percent of total billed charges,,,,,,,,,27555.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32821.15,91,,percent of total billed charges,,,34263.84,95,,percent of total billed charges,,,29935.78,83,,percent of total billed charges,,,29935.78,83,,percent of total billed charges,,,,,,,,,,,,,,,29935.78,83,,percent of total billed charges,,,34263.84,95,,percent of total billed charges,,,32460.48,90,,percent of total billed charges,,,32460.48,90,,percent of total billed charges,,,29575.1,82,,percent of total billed charges,,,32460.48,90,,percent of total billed charges,,,30657.12,85,,percent of total billed charges,,27194.67,34263.84,
SYNTHES PIN SCHANTZ 5.0,30184826,CDM,,,278,RC,inpatient,,1740.38,1740.38,,1477.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1312.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1479.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1531.53,88,,percent of total billed charges,,,,,,,,,1329.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1583.75,91,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.52,83,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1427.11,82,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,1312.25,1653.36,
SYNTHES ROD ATTACHMENT FOR MULTI PIN,30184827,CDM,,,278,RC,inpatient,,4254.25,4254.25,,3611.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3207.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3616.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3743.74,88,,percent of total billed charges,,,,,,,,,3250.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3871.37,91,,percent of total billed charges,,,4041.54,95,,percent of total billed charges,,,3531.03,83,,percent of total billed charges,,,3531.03,83,,percent of total billed charges,,,,,,,,,,,,,,,3531.03,83,,percent of total billed charges,,,4041.54,95,,percent of total billed charges,,,3828.83,90,,percent of total billed charges,,,3828.83,90,,percent of total billed charges,,,3488.49,82,,percent of total billed charges,,,3828.83,90,,percent of total billed charges,,,3616.11,85,,percent of total billed charges,,3207.7,4041.54,
SYNTHES CLAMP ADJUSTABLE LARGE OPEN,30184828,CDM,,,278,RC,inpatient,,5497.38,5497.38,,4667.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4145.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4672.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4837.69,88,,percent of total billed charges,,,,,,,,,4200,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5002.62,91,,percent of total billed charges,,,5222.51,95,,percent of total billed charges,,,4562.83,83,,percent of total billed charges,,,4562.83,83,,percent of total billed charges,,,,,,,,,,,,,,,4562.83,83,,percent of total billed charges,,,5222.51,95,,percent of total billed charges,,,4947.64,90,,percent of total billed charges,,,4947.64,90,,percent of total billed charges,,,4507.85,82,,percent of total billed charges,,,4947.64,90,,percent of total billed charges,,,4672.77,85,,percent of total billed charges,,4145.02,5222.51,
SYNTHES ROD CARBON FIBER 11 X 250MM,30184829,CDM,,,278,RC,inpatient,,2447.58,2447.58,,2078,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1845.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2080.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2153.87,88,,percent of total billed charges,,,,,,,,,1869.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2227.3,91,,percent of total billed charges,,,2325.2,95,,percent of total billed charges,,,2031.49,83,,percent of total billed charges,,,2031.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2031.49,83,,percent of total billed charges,,,2325.2,95,,percent of total billed charges,,,2202.82,90,,percent of total billed charges,,,2202.82,90,,percent of total billed charges,,,2007.02,82,,percent of total billed charges,,,2202.82,90,,percent of total billed charges,,,2080.44,85,,percent of total billed charges,,1845.48,2325.2,
WRIGHT INSERT REVISION CCK,30184830,CDM,,,278,RC,inpatient,,19643,19643,,16676.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14810.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16696.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17285.84,88,,percent of total billed charges,,,,,,,,,15007.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17875.13,91,,percent of total billed charges,,,18660.85,95,,percent of total billed charges,,,16303.69,83,,percent of total billed charges,,,16303.69,83,,percent of total billed charges,,,,,,,,,,,,,,,16303.69,83,,percent of total billed charges,,,18660.85,95,,percent of total billed charges,,,17678.7,90,,percent of total billed charges,,,17678.7,90,,percent of total billed charges,,,16107.26,82,,percent of total billed charges,,,17678.7,90,,percent of total billed charges,,,16696.55,85,,percent of total billed charges,,14810.82,18660.85,
ARTHREX SUTURE ANCHOR BC 3.5 X 19.5MM,30184833,CDM,,,278,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
ARTHREX SUTURE ANCHOR BC 3 X 14.5MM,30184834,CDM,,,278,RC,inpatient,,1982.5,1982.5,,1683.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1494.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1685.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1744.6,88,,percent of total billed charges,,,,,,,,,1514.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1804.08,91,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1645.48,83,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1625.65,82,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,1494.81,1883.38,
ARTHREX DRILL KIT PUSH LOCK,30184835,CDM,,,278,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
ARTHREX DRILL KIT SUTURE TAK,30184836,CDM,,,278,RC,inpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,784.16,988,
PEEK IMPLANT 8 MM X 12 MM X 9 MM,30184837,CDM,,,278,RC,inpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12742.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14365,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,12742.6,16055,
DEPUY FEMORAL HEAD 28MM +3,30184838,CDM,,,278,RC,inpatient,,6922.18,6922.18,,5876.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5219.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5883.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6091.52,88,,percent of total billed charges,,,,,,,,,5288.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6299.18,91,,percent of total billed charges,,,6576.07,95,,percent of total billed charges,,,5745.41,83,,percent of total billed charges,,,5745.41,83,,percent of total billed charges,,,,,,,,,,,,,,,5745.41,83,,percent of total billed charges,,,6576.07,95,,percent of total billed charges,,,6229.96,90,,percent of total billed charges,,,6229.96,90,,percent of total billed charges,,,5676.19,82,,percent of total billed charges,,,6229.96,90,,percent of total billed charges,,,5883.85,85,,percent of total billed charges,,5219.32,6576.07,
SYNTHES SCREW LOCKING 5.0MM X 36MM,30184839,CDM,,,278,RC,inpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1697.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1913.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,1697.12,2138.28,
ZIMMER BEARING LG LT SZ 7,30184840,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
ZIMMER STEM EXT OFFSET 14MM X 145MM,30184841,CDM,,,278,RC,inpatient,,18538,18538,,15738.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13977.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15757.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16313.44,88,,percent of total billed charges,,,,,,,,,14163.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16869.58,91,,percent of total billed charges,,,17611.1,95,,percent of total billed charges,,,15386.54,83,,percent of total billed charges,,,15386.54,83,,percent of total billed charges,,,,,,,,,,,,,,,15386.54,83,,percent of total billed charges,,,17611.1,95,,percent of total billed charges,,,16684.2,90,,percent of total billed charges,,,16684.2,90,,percent of total billed charges,,,15201.16,82,,percent of total billed charges,,,16684.2,90,,percent of total billed charges,,,15757.3,85,,percent of total billed charges,,13977.65,17611.1,
ZIMMER AUGMENT TIBIAL FULL BLOCK 10MM SZ,30184842,CDM,,,278,RC,inpatient,,17810,17810,,15120.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13428.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15138.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15672.8,88,,percent of total billed charges,,,,,,,,,13606.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16207.1,91,,percent of total billed charges,,,16919.5,95,,percent of total billed charges,,,14782.3,83,,percent of total billed charges,,,14782.3,83,,percent of total billed charges,,,,,,,,,,,,,,,14782.3,83,,percent of total billed charges,,,16919.5,95,,percent of total billed charges,,,16029,90,,percent of total billed charges,,,16029,90,,percent of total billed charges,,,14604.2,82,,percent of total billed charges,,,16029,90,,percent of total billed charges,,,15138.5,85,,percent of total billed charges,,13428.74,16919.5,
ZIMMER PLATE TIBIAL WEDGED A/P SZ4,30184843,CDM,,,278,RC,inpatient,,30680,30680,,26047.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23132.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26078,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26998.4,88,,percent of total billed charges,,,,,,,,,23439.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27918.8,91,,percent of total billed charges,,,29146,95,,percent of total billed charges,,,25464.4,83,,percent of total billed charges,,,25464.4,83,,percent of total billed charges,,,,,,,,,,,,,,,25464.4,83,,percent of total billed charges,,,29146,95,,percent of total billed charges,,,27612,90,,percent of total billed charges,,,27612,90,,percent of total billed charges,,,25157.6,82,,percent of total billed charges,,,27612,90,,percent of total billed charges,,,26078,85,,percent of total billed charges,,23132.72,29146,
ZIMMER SURFACE LPS-FLEX FIXED 3-4 10MM,30184844,CDM,,,278,RC,inpatient,,15762.5,15762.5,,13382.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11884.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13398.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13871,88,,percent of total billed charges,,,,,,,,,12042.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14343.88,91,,percent of total billed charges,,,14974.38,95,,percent of total billed charges,,,13082.88,83,,percent of total billed charges,,,13082.88,83,,percent of total billed charges,,,,,,,,,,,,,,,13082.88,83,,percent of total billed charges,,,14974.38,95,,percent of total billed charges,,,14186.25,90,,percent of total billed charges,,,14186.25,90,,percent of total billed charges,,,12925.25,82,,percent of total billed charges,,,14186.25,90,,percent of total billed charges,,,13398.13,85,,percent of total billed charges,,11884.93,14974.38,
ZIMMER SURFACE LPS-FLEX FIXED 3-4 12MM,30184845,CDM,,,278,RC,inpatient,,15762.5,15762.5,,13382.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11884.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13398.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13871,88,,percent of total billed charges,,,,,,,,,12042.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14343.88,91,,percent of total billed charges,,,14974.38,95,,percent of total billed charges,,,13082.88,83,,percent of total billed charges,,,13082.88,83,,percent of total billed charges,,,,,,,,,,,,,,,13082.88,83,,percent of total billed charges,,,14974.38,95,,percent of total billed charges,,,14186.25,90,,percent of total billed charges,,,14186.25,90,,percent of total billed charges,,,12925.25,82,,percent of total billed charges,,,14186.25,90,,percent of total billed charges,,,13398.13,85,,percent of total billed charges,,11884.93,14974.38,
ALLODERM TISSUE MATRIX PERF. SM 77SQ CM,30184846,CDM,,,278,RC,inpatient,,22386,22386,,19005.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16879.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19028.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19699.68,88,,percent of total billed charges,,,,,,,,,17102.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20371.26,91,,percent of total billed charges,,,21266.7,95,,percent of total billed charges,,,18580.38,83,,percent of total billed charges,,,18580.38,83,,percent of total billed charges,,,,,,,,,,,,,,,18580.38,83,,percent of total billed charges,,,21266.7,95,,percent of total billed charges,,,20147.4,90,,percent of total billed charges,,,20147.4,90,,percent of total billed charges,,,18356.52,82,,percent of total billed charges,,,20147.4,90,,percent of total billed charges,,,19028.1,85,,percent of total billed charges,,16879.04,21266.7,
SCREW POLYAXIAL 3.5 X 12MM,30184847,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
SCREW SET- IR SURGICAL,30184848,CDM,,,278,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
ROD 3.5 X 50MM,30184849,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
SCREW POLYAXIAL 3.5 X 24MM,30184850,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
LINQ IMPLANTABLE CARDIAC MONITOR,30184851,CDM,,,278,RC,inpatient,,30192.5,30192.5,,25633.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22765.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25663.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26569.4,88,,percent of total billed charges,,,,,,,,,23067.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27475.18,91,,percent of total billed charges,,,28682.88,95,,percent of total billed charges,,,25059.78,83,,percent of total billed charges,,,25059.78,83,,percent of total billed charges,,,,,,,,,,,,,,,25059.78,83,,percent of total billed charges,,,28682.88,95,,percent of total billed charges,,,27173.25,90,,percent of total billed charges,,,27173.25,90,,percent of total billed charges,,,24757.85,82,,percent of total billed charges,,,27173.25,90,,percent of total billed charges,,,25663.63,85,,percent of total billed charges,,22765.15,28682.88,
HOLMIUM FIBER 200-2,30184852,CDM,,,270,RC,inpatient,,1397.5,1397.5,,1186.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1053.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1187.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1229.8,88,,percent of total billed charges,,,,,,,,,1067.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1271.73,91,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1159.93,83,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1145.95,82,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,1053.72,1327.63,
LINEAR ST 50CM 8 CONTACT,30184853,CDM,,,270,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
O.R. CABLE 2X8 61CM,30184854,CDM,,,270,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
PATIENT TRIAL KIT 52,30184855,CDM,,,270,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
LINEAR ST 70CM 8 CONTACT,30184856,CDM,,,270,RC,inpatient,,12350,12350,,10485.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9311.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10497.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10868,88,,percent of total billed charges,,,,,,,,,9435.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11238.5,91,,percent of total billed charges,,,11732.5,95,,percent of total billed charges,,,10250.5,83,,percent of total billed charges,,,10250.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10250.5,83,,percent of total billed charges,,,11732.5,95,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,10127,82,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,10497.5,85,,percent of total billed charges,,9311.9,11732.5,
CHOICE SPINE PLATE 3-LEVEL 54MM,30184858,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
CHOICE SPINE DRILL 2.7MM X 12MM,30184859,CDM,,,278,RC,inpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1666.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1878.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,1666.34,2099.5,
CHOICE SPINE SCREW VARIABLE ANGLE 4.0X14,30184860,CDM,,,278,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
CHOICE SPINE PEEK STEALTH 7MM 6DEG 12X14,30184861,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
CHOICE SPINE PEEK STEALTH 7MM 6DEG 14X16,30184862,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
CHOICE SPINE PEEK STEALTH 8MM 6DEG 14X16,30184863,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
CHOICE SPINE SCREW VARIABLE ANGLE 4X16MM,30184864,CDM,,,278,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
CHOICE SPINE DRILL 2.7 X 10MM,30184865,CDM,,,278,RC,inpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1666.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1878.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,1666.34,2099.5,
CHOICE SPINE PLATE 2-LEVEL 30MM,30184866,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
CHOICE SPINE SCREW S-D VARIABLE ANGLE 12,30184867,CDM,,,278,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
DEPUY STEM FLUTED UNIV 75 X 22,30184868,CDM,,,278,RC,inpatient,,9024.34,9024.34,,7661.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6804.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7670.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7941.42,88,,percent of total billed charges,,,,,,,,,6894.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8212.15,91,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,,,,,,,,,,,,,7490.2,83,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7399.96,82,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,6804.35,8573.12,
SYNTHES SCREW CORTEX 3.5 X 50MM SELF TAP,30184871,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
SYNTHES SCREW CANNUL 6.5X60MM,30184872,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
ZIMMER SCP KIT W/ACCUPORT SIDE-DELIVERY,30184873,CDM,,,278,RC,inpatient,,23725,23725,,20142.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17888.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20166.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20878,88,,percent of total billed charges,,,,,,,,,18125.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21589.75,91,,percent of total billed charges,,,22538.75,95,,percent of total billed charges,,,19691.75,83,,percent of total billed charges,,,19691.75,83,,percent of total billed charges,,,,,,,,,,,,,,,19691.75,83,,percent of total billed charges,,,22538.75,95,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,19454.5,82,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,20166.25,85,,percent of total billed charges,,17888.65,22538.75,
ZIMMER ACCUMIX MIXING SYSTEM,30184874,CDM,,,270,RC,inpatient,,1885,1885,,1600.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1421.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1602.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1658.8,88,,percent of total billed charges,,,,,,,,,1440.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1715.35,91,,percent of total billed charges,,,1790.75,95,,percent of total billed charges,,,1564.55,83,,percent of total billed charges,,,1564.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1564.55,83,,percent of total billed charges,,,1790.75,95,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1545.7,82,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1602.25,85,,percent of total billed charges,,1421.29,1790.75,
S&N ENDO SCREW SOFT SILK 2.0 7MM X 25MM,30184875,CDM,,,278,RC,inpatient,,1487.85,1487.85,,1263.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1121.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1264.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1309.31,88,,percent of total billed charges,,,,,,,,,1136.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1353.94,91,,percent of total billed charges,,,1413.46,95,,percent of total billed charges,,,1234.92,83,,percent of total billed charges,,,1234.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1234.92,83,,percent of total billed charges,,,1413.46,95,,percent of total billed charges,,,1339.07,90,,percent of total billed charges,,,1339.07,90,,percent of total billed charges,,,1220.04,82,,percent of total billed charges,,,1339.07,90,,percent of total billed charges,,,1264.67,85,,percent of total billed charges,,1121.84,1413.46,
DEPUY SHELL BIPOLAR 57,30184876,CDM,,,278,RC,inpatient,,6675.44,6675.44,,5667.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5033.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5674.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5874.39,88,,percent of total billed charges,,,,,,,,,5100.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6074.65,91,,percent of total billed charges,,,6341.67,95,,percent of total billed charges,,,5540.62,83,,percent of total billed charges,,,5540.62,83,,percent of total billed charges,,,,,,,,,,,,,,,5540.62,83,,percent of total billed charges,,,6341.67,95,,percent of total billed charges,,,6007.9,90,,percent of total billed charges,,,6007.9,90,,percent of total billed charges,,,5473.86,82,,percent of total billed charges,,,6007.9,90,,percent of total billed charges,,,5674.12,85,,percent of total billed charges,,5033.28,6341.67,
DEPUY STEM SUMMIT CEMENTED SZ 7 STD,30184877,CDM,,,278,RC,inpatient,,25228.19,25228.19,,21418.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19022.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21443.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22200.81,88,,percent of total billed charges,,,,,,,,,19274.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22957.65,91,,percent of total billed charges,,,23966.78,95,,percent of total billed charges,,,20939.4,83,,percent of total billed charges,,,20939.4,83,,percent of total billed charges,,,,,,,,,,,,,,,20939.4,83,,percent of total billed charges,,,23966.78,95,,percent of total billed charges,,,22705.37,90,,percent of total billed charges,,,22705.37,90,,percent of total billed charges,,,20687.12,82,,percent of total billed charges,,,22705.37,90,,percent of total billed charges,,,21443.96,85,,percent of total billed charges,,19022.06,23966.78,
DEPUY STEM GLOBAL UNITED SZ 8,30184878,CDM,,,278,RC,inpatient,,26023.86,26023.86,,22094.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19621.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22120.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22901,88,,percent of total billed charges,,,,,,,,,19882.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23681.71,91,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21599.8,83,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,21339.57,82,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,19621.99,24722.67,
MONTAGE MRI 16 IMPLANTABLE GENERATOR KIT,30184879,CDM,,,278,RC,inpatient,,110500,110500,,93814.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,83317,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,93925,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,97240,88,,percent of total billed charges,,,,,,,,,84422,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,100555,91,,percent of total billed charges,,,104975,95,,percent of total billed charges,,,91715,83,,percent of total billed charges,,,91715,83,,percent of total billed charges,,,,,,,,,,,,,,,91715,83,,percent of total billed charges,,,104975,95,,percent of total billed charges,,,99450,90,,percent of total billed charges,,,99450,90,,percent of total billed charges,,,90610,82,,percent of total billed charges,,,99450,90,,percent of total billed charges,,,93925,85,,percent of total billed charges,,83317,104975,
AVISTA MRI LEAD KIT 74CM 8 CONTACT,30184880,CDM,,,278,RC,inpatient,,18200,18200,,15451.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13722.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15470,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16016,88,,percent of total billed charges,,,,,,,,,13904.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16562,91,,percent of total billed charges,,,17290,95,,percent of total billed charges,,,15106,83,,percent of total billed charges,,,15106,83,,percent of total billed charges,,,,,,,,,,,,,,,15106,83,,percent of total billed charges,,,17290,95,,percent of total billed charges,,,16380,90,,percent of total billed charges,,,16380,90,,percent of total billed charges,,,14924,82,,percent of total billed charges,,,16380,90,,percent of total billed charges,,,15470,85,,percent of total billed charges,,13722.8,17290,
PRECISION CHARGING SYSTEM KIT,30184881,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
PRECISION REMOTE CONTROL KIT,30184882,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
CLIK X MRI ANCHOR,30184883,CDM,,,270,RC,inpatient,,2193.75,2193.75,,1862.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1654.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1864.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1930.5,88,,percent of total billed charges,,,,,,,,,1676.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1996.31,91,,percent of total billed charges,,,2084.06,95,,percent of total billed charges,,,1820.81,83,,percent of total billed charges,,,1820.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1820.81,83,,percent of total billed charges,,,2084.06,95,,percent of total billed charges,,,1974.38,90,,percent of total billed charges,,,1974.38,90,,percent of total billed charges,,,1798.88,82,,percent of total billed charges,,,1974.38,90,,percent of total billed charges,,,1864.69,85,,percent of total billed charges,,1654.09,2084.06,
TUNNELING TOOL LONG 35CM,30184884,CDM,,,270,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
PEEK CAGE 10MM,30184885,CDM,,,278,RC,inpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12742.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14365,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,12742.6,16055,
DEPUY BIPOLAR SHELL 40OD,30184886,CDM,,,278,RC,inpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,6126.3,7718.82,
DEPUY PRIMARY BIPOLAR METAL HEAD CAP,30184887,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
DEPUY STEM CEMENTED PRIMARY FX CAP,30184888,CDM,,,278,RC,inpatient,,12350,12350,,10485.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9311.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10497.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10868,88,,percent of total billed charges,,,,,,,,,9435.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11238.5,91,,percent of total billed charges,,,11732.5,95,,percent of total billed charges,,,10250.5,83,,percent of total billed charges,,,10250.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10250.5,83,,percent of total billed charges,,,11732.5,95,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,10127,82,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,10497.5,85,,percent of total billed charges,,9311.9,11732.5,
SYNTHES SCREW CANNUL 4.0X50MM,30184891,CDM,,,278,RC,inpatient,,2063.23,2063.23,,1751.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1555.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1753.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1815.64,88,,percent of total billed charges,,,,,,,,,1576.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1877.54,91,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1712.48,83,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1691.85,82,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,1555.68,1960.07,
ARTHREX REAMER 10MM COW PRO,30184892,CDM,,,278,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
ARTHREX SPEED CINCH,30184893,CDM,,,270,RC,inpatient,,2567.5,2567.5,,2179.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1935.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2182.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2259.4,88,,percent of total billed charges,,,,,,,,,1961.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2336.43,91,,percent of total billed charges,,,2439.13,95,,percent of total billed charges,,,2131.03,83,,percent of total billed charges,,,2131.03,83,,percent of total billed charges,,,,,,,,,,,,,,,2131.03,83,,percent of total billed charges,,,2439.13,95,,percent of total billed charges,,,2310.75,90,,percent of total billed charges,,,2310.75,90,,percent of total billed charges,,,2105.35,82,,percent of total billed charges,,,2310.75,90,,percent of total billed charges,,,2182.38,85,,percent of total billed charges,,1935.9,2439.13,
SCREW POLYAXIAL 5.5 X 45MM,30184894,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
MEDTRONIC PACER,30184895,CDM,,,278,RC,inpatient,,31018,31018,,26334.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23387.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26365.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27295.84,88,,percent of total billed charges,,,,,,,,,23697.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28226.38,91,,percent of total billed charges,,,29467.1,95,,percent of total billed charges,,,25744.94,83,,percent of total billed charges,,,25744.94,83,,percent of total billed charges,,,,,,,,,,,,,,,25744.94,83,,percent of total billed charges,,,29467.1,95,,percent of total billed charges,,,27916.2,90,,percent of total billed charges,,,27916.2,90,,percent of total billed charges,,,25434.76,82,,percent of total billed charges,,,27916.2,90,,percent of total billed charges,,,26365.3,85,,percent of total billed charges,,23387.57,29467.1,
DEPUY FEMUR ATTUNE CR SZ 5 RT,30184896,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
INVUITY PHOTONGUIDE WIDE/FLAT,30184897,CDM,,,270,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
SYNTHES SCREW CORTEX S-T 2.7 X 22MM,30184898,CDM,,,278,RC,inpatient,,386.75,386.75,,328.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.34,88,,percent of total billed charges,,,,,,,,,295.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.94,91,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,321,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,,,,,,,,,,,,,,321,83,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,317.14,82,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,291.61,367.41,
SYNTHES K-WIRE 1.6MM,30184899,CDM,,,278,RC,inpatient,,111.82,111.82,,94.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,95.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.4,88,,percent of total billed charges,,,,,,,,,85.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.76,91,,percent of total billed charges,,,106.23,95,,percent of total billed charges,,,92.81,83,,percent of total billed charges,,,92.81,83,,percent of total billed charges,,,,,,,,,,,,,,,92.81,83,,percent of total billed charges,,,106.23,95,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,91.69,82,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,95.05,85,,percent of total billed charges,,84.31,106.23,
ARTHREX CALIBLATOR COOLCUT,30184901,CDM,,,278,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
ARTHREX KIT TENO DISPS 3X8MM,30184902,CDM,,,278,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
ARTHREX SCREW TENO BIO-COMP 3X8MM,30184903,CDM,,,278,RC,inpatient,,2632.5,2632.5,,2234.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1984.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2237.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2316.6,88,,percent of total billed charges,,,,,,,,,2011.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2395.58,91,,percent of total billed charges,,,2500.88,95,,percent of total billed charges,,,2184.98,83,,percent of total billed charges,,,2184.98,83,,percent of total billed charges,,,,,,,,,,,,,,,2184.98,83,,percent of total billed charges,,,2500.88,95,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2158.65,82,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2237.63,85,,percent of total billed charges,,1984.91,2500.88,
SYNTHES PLATE LCP RECON. 3.5X84MM 5 HOLE,30184904,CDM,,,278,RC,inpatient,,4044.3,4044.3,,3433.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3049.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3437.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3558.98,88,,percent of total billed charges,,,,,,,,,3089.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3680.31,91,,percent of total billed charges,,,3842.09,95,,percent of total billed charges,,,3356.77,83,,percent of total billed charges,,,3356.77,83,,percent of total billed charges,,,,,,,,,,,,,,,3356.77,83,,percent of total billed charges,,,3842.09,95,,percent of total billed charges,,,3639.87,90,,percent of total billed charges,,,3639.87,90,,percent of total billed charges,,,3316.33,82,,percent of total billed charges,,,3639.87,90,,percent of total billed charges,,,3437.66,85,,percent of total billed charges,,3049.4,3842.09,
SYNTHES SCREW CORTEX 3.5X10MM,30184905,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
SYNTHES PLATE OLEARANON VA 2.7 X 3.5,30184906,CDM,,,278,RC,inpatient,,9464.33,9464.33,,8035.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7136.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8044.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8328.61,88,,percent of total billed charges,,,,,,,,,7230.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8612.54,91,,percent of total billed charges,,,8991.11,95,,percent of total billed charges,,,7855.39,83,,percent of total billed charges,,,7855.39,83,,percent of total billed charges,,,,,,,,,,,,,,,7855.39,83,,percent of total billed charges,,,8991.11,95,,percent of total billed charges,,,8517.9,90,,percent of total billed charges,,,8517.9,90,,percent of total billed charges,,,7760.75,82,,percent of total billed charges,,,8517.9,90,,percent of total billed charges,,,8044.68,85,,percent of total billed charges,,7136.1,8991.11,
SYNTHES SCREW CORTEX 2.7 X 14MM,30184907,CDM,,,278,RC,inpatient,,492.38,492.38,,418.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,371.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,418.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,433.29,88,,percent of total billed charges,,,,,,,,,376.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,448.07,91,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,,,,,,,,,,,,,408.68,83,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,403.75,82,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,371.25,467.76,
SYNTHES SCREW LOCKING VA 2.7MM X 10MM,30184908,CDM,,,278,RC,inpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1065.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1200.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,1065.14,1342.02,
SYNTHES SCREW LOCKING VA 2.7MM X 12MM,30184909,CDM,,,278,RC,inpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1065.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1200.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,1065.14,1342.02,
SYNTHES SCREW LOCKING VA 2.7MM X 14MM,30184910,CDM,,,278,RC,inpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1065.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1200.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,1065.14,1342.02,
SYNTHES SCREW LOCKING VA 2.7MM X 22MM,30184911,CDM,,,278,RC,inpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1065.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1200.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,1065.14,1342.02,
SYNTHES SCREW LOCKING VA 2.7MM X 40MM,30184912,CDM,,,278,RC,inpatient,,1331.53,1331.53,,1130.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1003.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1131.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1171.75,88,,percent of total billed charges,,,,,,,,,1017.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1211.69,91,,percent of total billed charges,,,1264.95,95,,percent of total billed charges,,,1105.17,83,,percent of total billed charges,,,1105.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1105.17,83,,percent of total billed charges,,,1264.95,95,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1091.85,82,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1131.8,85,,percent of total billed charges,,1003.97,1264.95,
SYNTHES SCREW LOCKING VA 2.7MM X 50MM,30184913,CDM,,,278,RC,inpatient,,1371.5,1371.5,,1164.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1034.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1165.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1206.92,88,,percent of total billed charges,,,,,,,,,1047.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1248.07,91,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.35,83,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1124.63,82,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,1034.11,1302.93,
CAPSULAR TENSION RING EYEJET CTR,30184914,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
ZIMMER KNEE KIT SUBCHONDROPLASTY W/SIDE,30184915,CDM,,,278,RC,inpatient,,23725,23725,,20142.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17888.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20166.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20878,88,,percent of total billed charges,,,,,,,,,18125.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21589.75,91,,percent of total billed charges,,,22538.75,95,,percent of total billed charges,,,19691.75,83,,percent of total billed charges,,,19691.75,83,,percent of total billed charges,,,,,,,,,,,,,,,19691.75,83,,percent of total billed charges,,,22538.75,95,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,19454.5,82,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,20166.25,85,,percent of total billed charges,,17888.65,22538.75,
ZIMMER BEARING LG LT SZ 5,30184916,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
DEPUY INSERT SIGMA 2.5 X 10MM STABILIZED,30184917,CDM,,,278,RC,inpatient,,17187.04,17187.04,,14591.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12959.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14608.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15124.6,88,,percent of total billed charges,,,,,,,,,13130.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15640.21,91,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,,,,,,,,,,,,,14265.24,83,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14093.37,82,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14608.98,85,,percent of total billed charges,,12959.03,16327.69,
PEEK CAGE 0DEG 25X09X11,30184918,CDM,,,278,RC,inpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12742.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14365,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,12742.6,16055,
SYNTHES PLATE VOLAR DIST. RAD. 2.4MM 3 H,30184919,CDM,,,278,RC,inpatient,,9762.68,9762.68,,8288.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7361.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8298.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8591.16,88,,percent of total billed charges,,,,,,,,,7458.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8884.04,91,,percent of total billed charges,,,9274.55,95,,percent of total billed charges,,,8103.02,83,,percent of total billed charges,,,8103.02,83,,percent of total billed charges,,,,,,,,,,,,,,,8103.02,83,,percent of total billed charges,,,9274.55,95,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8005.4,82,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8298.28,85,,percent of total billed charges,,7361.06,9274.55,
DEPUY HUMERAL STEM CEMENTED SZ 12 STD,30184920,CDM,,,278,RC,inpatient,,35653.09,35653.09,,30269.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26882.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30305.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31374.72,88,,percent of total billed charges,,,,,,,,,27238.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32444.31,91,,percent of total billed charges,,,33870.44,95,,percent of total billed charges,,,29592.06,83,,percent of total billed charges,,,29592.06,83,,percent of total billed charges,,,,,,,,,,,,,,,29592.06,83,,percent of total billed charges,,,33870.44,95,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,29235.53,82,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,30305.13,85,,percent of total billed charges,,26882.43,33870.44,
DEPUY LINER ALTRX +4 10DEG SZ 58,30184921,CDM,,,278,RC,inpatient,,14161.81,14161.81,,12023.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10678,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12037.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12462.39,88,,percent of total billed charges,,,,,,,,,10819.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12887.25,91,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,,,,,,,,,,,,,11754.3,83,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,11612.68,82,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,10678,13453.72,
SYNTHES SCREW CORTEX 3.5X30MM,30184922,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
ALLOSOURCE PATELLA HEMI BTB ALLOGRAFT,30184923,CDM,,,278,RC,inpatient,,12480,12480,,10595.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9409.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10608,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10982.4,88,,percent of total billed charges,,,,,,,,,9534.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11356.8,91,,percent of total billed charges,,,11856,95,,percent of total billed charges,,,10358.4,83,,percent of total billed charges,,,10358.4,83,,percent of total billed charges,,,,,,,,,,,,,,,10358.4,83,,percent of total billed charges,,,11856,95,,percent of total billed charges,,,11232,90,,percent of total billed charges,,,11232,90,,percent of total billed charges,,,10233.6,82,,percent of total billed charges,,,11232,90,,percent of total billed charges,,,10608,85,,percent of total billed charges,,9409.92,11856,
DEPUY INSERT LPS MEDIUM 12MM,30184924,CDM,,,278,RC,inpatient,,24320.34,24320.34,,20647.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18337.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20672.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21401.9,88,,percent of total billed charges,,,,,,,,,18580.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22131.51,91,,percent of total billed charges,,,23104.32,95,,percent of total billed charges,,,20185.88,83,,percent of total billed charges,,,20185.88,83,,percent of total billed charges,,,,,,,,,,,,,,,20185.88,83,,percent of total billed charges,,,23104.32,95,,percent of total billed charges,,,21888.31,90,,percent of total billed charges,,,21888.31,90,,percent of total billed charges,,,19942.68,82,,percent of total billed charges,,,21888.31,90,,percent of total billed charges,,,20672.29,85,,percent of total billed charges,,18337.54,23104.32,
DEPUY SLEEVE FEMORAL 34MM,30184925,CDM,,,278,RC,inpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13618.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15352.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,13618.85,17159.03,
DEPUY FEMUR S-ROM LEFT,30184926,CDM,,,278,RC,inpatient,,37437.86,37437.86,,31784.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28228.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31822.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32945.32,88,,percent of total billed charges,,,,,,,,,28602.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34068.45,91,,percent of total billed charges,,,35565.97,95,,percent of total billed charges,,,31073.42,83,,percent of total billed charges,,,31073.42,83,,percent of total billed charges,,,,,,,,,,,,,,,31073.42,83,,percent of total billed charges,,,35565.97,95,,percent of total billed charges,,,33694.07,90,,percent of total billed charges,,,33694.07,90,,percent of total billed charges,,,30699.05,82,,percent of total billed charges,,,33694.07,90,,percent of total billed charges,,,31822.18,85,,percent of total billed charges,,28228.15,35565.97,
SYNTHES ROD REAMER 2.5MM,30184927,CDM,,,278,RC,inpatient,,1171.3,1171.3,,994.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,883.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,995.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1030.74,88,,percent of total billed charges,,,,,,,,,894.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1065.88,91,,percent of total billed charges,,,1112.74,95,,percent of total billed charges,,,972.18,83,,percent of total billed charges,,,972.18,83,,percent of total billed charges,,,,,,,,,,,,,,,972.18,83,,percent of total billed charges,,,1112.74,95,,percent of total billed charges,,,1054.17,90,,percent of total billed charges,,,1054.17,90,,percent of total billed charges,,,960.47,82,,percent of total billed charges,,,1054.17,90,,percent of total billed charges,,,995.61,85,,percent of total billed charges,,883.16,1112.74,
SYNTHES ROD TIBIA 9MM X 345,30184928,CDM,,,278,RC,inpatient,,15439.13,15439.13,,13107.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11641.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13123.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13586.43,88,,percent of total billed charges,,,,,,,,,11795.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14049.61,91,,percent of total billed charges,,,14667.17,95,,percent of total billed charges,,,12814.48,83,,percent of total billed charges,,,12814.48,83,,percent of total billed charges,,,,,,,,,,,,,,,12814.48,83,,percent of total billed charges,,,14667.17,95,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,12660.09,82,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,13123.26,85,,percent of total billed charges,,11641.1,14667.17,
SYNTHES SCREW LOCKING 4.0MM X 26MM,30184929,CDM,,,278,RC,inpatient,,1248,1248,,1059.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,940.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1060.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1098.24,88,,percent of total billed charges,,,,,,,,,953.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1135.68,91,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1035.84,83,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1023.36,82,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,940.99,1185.6,
SYNTHES SCREW LOCKING 4.0MM X 30MM,30184930,CDM,,,278,RC,inpatient,,1248,1248,,1059.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,940.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1060.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1098.24,88,,percent of total billed charges,,,,,,,,,953.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1135.68,91,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1035.84,83,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1023.36,82,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,940.99,1185.6,
SYNTHES SCREW LOCKING 4.0MM X 40MM,30184931,CDM,,,278,RC,inpatient,,1248,1248,,1059.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,940.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1060.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1098.24,88,,percent of total billed charges,,,,,,,,,953.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1135.68,91,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1035.84,83,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1023.36,82,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,940.99,1185.6,
SYNTHES SCREW LOCKING 4.0MM X 44MM,30184932,CDM,,,278,RC,inpatient,,1248,1248,,1059.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,940.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1060.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1098.24,88,,percent of total billed charges,,,,,,,,,953.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1135.68,91,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1035.84,83,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1023.36,82,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,940.99,1185.6,
SYNTHES SCREW LOCKING 4.0MM X 50MM,30184933,CDM,,,278,RC,inpatient,,1248,1248,,1059.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,940.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1060.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1098.24,88,,percent of total billed charges,,,,,,,,,953.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1135.68,91,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1035.84,83,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1023.36,82,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,940.99,1185.6,
SYNTHES SCREW LOCKING 4.0MM X 60MM,30184934,CDM,,,278,RC,inpatient,,1248,1248,,1059.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,940.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1060.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1098.24,88,,percent of total billed charges,,,,,,,,,953.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1135.68,91,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1035.84,83,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1023.36,82,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,940.99,1185.6,
ZIMMER SIDE DELIVERY CANNULA,30184935,CDM,,,278,RC,inpatient,,3640,3640,,3090.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2744.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3094,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3203.2,88,,percent of total billed charges,,,,,,,,,2780.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3312.4,91,,percent of total billed charges,,,3458,95,,percent of total billed charges,,,3021.2,83,,percent of total billed charges,,,3021.2,83,,percent of total billed charges,,,,,,,,,,,,,,,3021.2,83,,percent of total billed charges,,,3458,95,,percent of total billed charges,,,3276,90,,percent of total billed charges,,,3276,90,,percent of total billed charges,,,2984.8,82,,percent of total billed charges,,,3276,90,,percent of total billed charges,,,3094,85,,percent of total billed charges,,2744.56,3458,
ARTHREX ACL DISPOSABLE KIT,30184936,CDM,,,270,RC,inpatient,,942.5,942.5,,800.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,710.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,801.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,829.4,88,,percent of total billed charges,,,,,,,,,720.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,857.68,91,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,,,,,,,,,,,,,782.28,83,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,772.85,82,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,801.13,85,,percent of total billed charges,,710.65,895.38,
ZIMMER TIBIAL TRAY OXFORD LM SZ F,30184937,CDM,,,278,RC,inpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10218.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11519.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,10218.59,12874.88,
AVISTA MRI LEAD KIT 56CM 8 CONTACT,30184938,CDM,,,278,RC,inpatient,,18200,18200,,15451.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13722.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15470,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16016,88,,percent of total billed charges,,,,,,,,,13904.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16562,91,,percent of total billed charges,,,17290,95,,percent of total billed charges,,,15106,83,,percent of total billed charges,,,15106,83,,percent of total billed charges,,,,,,,,,,,,,,,15106,83,,percent of total billed charges,,,17290,95,,percent of total billed charges,,,16380,90,,percent of total billed charges,,,16380,90,,percent of total billed charges,,,14924,82,,percent of total billed charges,,,16380,90,,percent of total billed charges,,,15470,85,,percent of total billed charges,,13722.8,17290,
SYNTHES PLATE TUBULAR 10-HOLE 1/3,30184939,CDM,,,278,RC,inpatient,,1811.23,1811.23,,1537.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1365.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1539.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1593.88,88,,percent of total billed charges,,,,,,,,,1383.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1648.22,91,,percent of total billed charges,,,1720.67,95,,percent of total billed charges,,,1503.32,83,,percent of total billed charges,,,1503.32,83,,percent of total billed charges,,,,,,,,,,,,,,,1503.32,83,,percent of total billed charges,,,1720.67,95,,percent of total billed charges,,,1630.11,90,,percent of total billed charges,,,1630.11,90,,percent of total billed charges,,,1485.21,82,,percent of total billed charges,,,1630.11,90,,percent of total billed charges,,,1539.55,85,,percent of total billed charges,,1365.67,1720.67,
ZIMMER FEMUR OXFORD TWIN-PEG LG,30184940,CDM,,,278,RC,inpatient,,20345,20345,,17272.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15340.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17293.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17903.6,88,,percent of total billed charges,,,,,,,,,15543.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18513.95,91,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,,,,,,,,,,,,,16886.35,83,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,16682.9,82,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,17293.25,85,,percent of total billed charges,,15340.13,19327.75,
ZIMMER BEARING RM MENISCAL 4MM LG,30184941,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
FLOSEAL FIBRIN 10ML,30184942,CDM,,,270,RC,inpatient,,2444.13,2444.13,,2075.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1842.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2077.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2150.83,88,,percent of total billed charges,,,,,,,,,1867.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2224.16,91,,percent of total billed charges,,,2321.92,95,,percent of total billed charges,,,2028.63,83,,percent of total billed charges,,,2028.63,83,,percent of total billed charges,,,,,,,,,,,,,,,2028.63,83,,percent of total billed charges,,,2321.92,95,,percent of total billed charges,,,2199.72,90,,percent of total billed charges,,,2199.72,90,,percent of total billed charges,,,2004.19,82,,percent of total billed charges,,,2199.72,90,,percent of total billed charges,,,2077.51,85,,percent of total billed charges,,1842.87,2321.92,
MENTOR TISSUE EXPANDER CPX4 350CC,30184944,CDM,,,278,RC,inpatient,,10692.5,10692.5,,9077.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8062.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9088.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9409.4,88,,percent of total billed charges,,,,,,,,,8169.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9730.18,91,,percent of total billed charges,,,10157.88,95,,percent of total billed charges,,,8874.78,83,,percent of total billed charges,,,8874.78,83,,percent of total billed charges,,,,,,,,,,,,,,,8874.78,83,,percent of total billed charges,,,10157.88,95,,percent of total billed charges,,,9623.25,90,,percent of total billed charges,,,9623.25,90,,percent of total billed charges,,,8767.85,82,,percent of total billed charges,,,9623.25,90,,percent of total billed charges,,,9088.63,85,,percent of total billed charges,,8062.15,10157.88,
OSTEOAMP GRANULES 2-4MM 5.0CC,30184945,CDM,,,278,RC,inpatient,,7237.1,7237.1,,6144.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5456.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6151.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6368.65,88,,percent of total billed charges,,,,,,,,,5529.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6585.76,91,,percent of total billed charges,,,6875.25,95,,percent of total billed charges,,,6006.79,83,,percent of total billed charges,,,6006.79,83,,percent of total billed charges,,,,,,,,,,,,,,,6006.79,83,,percent of total billed charges,,,6875.25,95,,percent of total billed charges,,,6513.39,90,,percent of total billed charges,,,6513.39,90,,percent of total billed charges,,,5934.42,82,,percent of total billed charges,,,6513.39,90,,percent of total billed charges,,,6151.54,85,,percent of total billed charges,,5456.77,6875.25,
CTL CEZANNE II TLIP 11X30X10,30184946,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
CTL SCREW PICASSO II 6.5X40,30184947,CDM,,,278,RC,inpatient,,11137.1,11137.1,,9455.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8397.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9466.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9800.65,88,,percent of total billed charges,,,,,,,,,8508.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10134.76,91,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9243.79,83,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9132.42,82,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,8397.37,10580.25,
CTL SCREW PICASSO II 6.5X45,30184948,CDM,,,278,RC,inpatient,,11137.1,11137.1,,9455.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8397.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9466.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9800.65,88,,percent of total billed charges,,,,,,,,,8508.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10134.76,91,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9243.79,83,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9132.42,82,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,8397.37,10580.25,
CTL ROD MLS CURVED 40MM,30184949,CDM,,,278,RC,inpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1669.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1881.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,1669.28,2103.21,
CTL SCREW SET,30184950,CDM,,,278,RC,inpatient,,1605.5,1605.5,,1363.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1210.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1364.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1412.84,88,,percent of total billed charges,,,,,,,,,1226.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1461.01,91,,percent of total billed charges,,,1525.23,95,,percent of total billed charges,,,1332.57,83,,percent of total billed charges,,,1332.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1332.57,83,,percent of total billed charges,,,1525.23,95,,percent of total billed charges,,,1444.95,90,,percent of total billed charges,,,1444.95,90,,percent of total billed charges,,,1316.51,82,,percent of total billed charges,,,1444.95,90,,percent of total billed charges,,,1364.68,85,,percent of total billed charges,,1210.55,1525.23,
CTL GUIDE WIRE,30184951,CDM,,,278,RC,inpatient,,893.75,893.75,,758.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,673.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,759.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,786.5,88,,percent of total billed charges,,,,,,,,,682.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,813.31,91,,percent of total billed charges,,,849.06,95,,percent of total billed charges,,,741.81,83,,percent of total billed charges,,,741.81,83,,percent of total billed charges,,,,,,,,,,,,,,,741.81,83,,percent of total billed charges,,,849.06,95,,percent of total billed charges,,,804.38,90,,percent of total billed charges,,,804.38,90,,percent of total billed charges,,,732.88,82,,percent of total billed charges,,,804.38,90,,percent of total billed charges,,,759.69,85,,percent of total billed charges,,673.89,849.06,
CTL JAMSHIDI 11G X 15,30184952,CDM,,,278,RC,inpatient,,1056.25,1056.25,,896.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,796.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,897.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,929.5,88,,percent of total billed charges,,,,,,,,,806.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,961.19,91,,percent of total billed charges,,,1003.44,95,,percent of total billed charges,,,876.69,83,,percent of total billed charges,,,876.69,83,,percent of total billed charges,,,,,,,,,,,,,,,876.69,83,,percent of total billed charges,,,1003.44,95,,percent of total billed charges,,,950.63,90,,percent of total billed charges,,,950.63,90,,percent of total billed charges,,,866.13,82,,percent of total billed charges,,,950.63,90,,percent of total billed charges,,,897.81,85,,percent of total billed charges,,796.41,1003.44,
CTL JAMSHIDI 11G X 15,30184953,CDM,,,278,RC,inpatient,,1056.25,1056.25,,896.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,796.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,897.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,929.5,88,,percent of total billed charges,,,,,,,,,806.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,961.19,91,,percent of total billed charges,,,1003.44,95,,percent of total billed charges,,,876.69,83,,percent of total billed charges,,,876.69,83,,percent of total billed charges,,,,,,,,,,,,,,,876.69,83,,percent of total billed charges,,,1003.44,95,,percent of total billed charges,,,950.63,90,,percent of total billed charges,,,950.63,90,,percent of total billed charges,,,866.13,82,,percent of total billed charges,,,950.63,90,,percent of total billed charges,,,897.81,85,,percent of total billed charges,,796.41,1003.44,
ALLOSOURCE CANCELLOUS CRUSHED 1-4MM 15CC,30184954,CDM,,,278,RC,inpatient,,1722.5,1722.5,,1462.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1298.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1464.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1515.8,88,,percent of total billed charges,,,,,,,,,1315.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1567.48,91,,percent of total billed charges,,,1636.38,95,,percent of total billed charges,,,1429.68,83,,percent of total billed charges,,,1429.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1429.68,83,,percent of total billed charges,,,1636.38,95,,percent of total billed charges,,,1550.25,90,,percent of total billed charges,,,1550.25,90,,percent of total billed charges,,,1412.45,82,,percent of total billed charges,,,1550.25,90,,percent of total billed charges,,,1464.13,85,,percent of total billed charges,,1298.77,1636.38,
OSTEOAMP GRANULES 2-4MM 1.0CC,30184955,CDM,,,278,RC,inpatient,,2870.73,2870.73,,2437.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2164.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2440.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2526.24,88,,percent of total billed charges,,,,,,,,,2193.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2612.36,91,,percent of total billed charges,,,2727.19,95,,percent of total billed charges,,,2382.71,83,,percent of total billed charges,,,2382.71,83,,percent of total billed charges,,,,,,,,,,,,,,,2382.71,83,,percent of total billed charges,,,2727.19,95,,percent of total billed charges,,,2583.66,90,,percent of total billed charges,,,2583.66,90,,percent of total billed charges,,,2354,82,,percent of total billed charges,,,2583.66,90,,percent of total billed charges,,,2440.12,85,,percent of total billed charges,,2164.53,2727.19,
CAGE STALIF C-TI 12X6.5 TAPERED,30184956,CDM,,,278,RC,inpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14703,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16575,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,14703,18525,
SCREW STALIF C ABO 4.0 X 14MM,30184957,CDM,,,278,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
CTL CAGE TLIF CEZANNE 11X30X11,30184958,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
SYNTHES SCREW CANNUL 6.5X75MM,30184959,CDM,,,278,RC,inpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1916.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,1916.29,2414.43,
SYNTHES SCREW CANNUL 16MM 6.5X80MM,30184960,CDM,,,278,RC,inpatient,,2696.27,2696.27,,2289.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2032.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2291.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2372.72,88,,percent of total billed charges,,,,,,,,,2059.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2453.61,91,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2237.9,83,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2210.94,82,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,2032.99,2561.46,
OSTEOAMP GRANULES <2MM 2.5CC,30184961,CDM,,,278,RC,inpatient,,4583.54,4583.54,,3891.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3455.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3896.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4033.52,88,,percent of total billed charges,,,,,,,,,3501.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4171.02,91,,percent of total billed charges,,,4354.36,95,,percent of total billed charges,,,3804.34,83,,percent of total billed charges,,,3804.34,83,,percent of total billed charges,,,,,,,,,,,,,,,3804.34,83,,percent of total billed charges,,,4354.36,95,,percent of total billed charges,,,4125.19,90,,percent of total billed charges,,,4125.19,90,,percent of total billed charges,,,3758.5,82,,percent of total billed charges,,,4125.19,90,,percent of total billed charges,,,3896.01,85,,percent of total billed charges,,3455.99,4354.36,
CAGE STALIF C-TI 14X7.5 TAPERED,30184962,CDM,,,278,RC,inpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14703,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16575,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,14703,18525,
CAGE STALIF C-TI 14X6.5 TAPERED,30184963,CDM,,,278,RC,inpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14703,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16575,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,14703,18525,
SCREW STALIF C ABO 4.0 X 15MM,30184964,CDM,,,278,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
STRYKER MATCHSTICK 3.0MM PRECISION NEURO,30184965,CDM,,,270,RC,inpatient,,919.04,919.04,,780.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,692.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,781.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,808.76,88,,percent of total billed charges,,,,,,,,,702.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,836.33,91,,percent of total billed charges,,,873.09,95,,percent of total billed charges,,,762.8,83,,percent of total billed charges,,,762.8,83,,percent of total billed charges,,,,,,,,,,,,,,,762.8,83,,percent of total billed charges,,,873.09,95,,percent of total billed charges,,,827.14,90,,percent of total billed charges,,,827.14,90,,percent of total billed charges,,,753.61,82,,percent of total billed charges,,,827.14,90,,percent of total billed charges,,,781.18,85,,percent of total billed charges,,692.96,873.09,
SURGICAL PATTIES 1  X 1,30184966,CDM,,,270,RC,inpatient,,21.83,21.83,,18.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.21,88,,percent of total billed charges,,,,,,,,,16.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.87,91,,percent of total billed charges,,,20.74,95,,percent of total billed charges,,,18.12,83,,percent of total billed charges,,,18.12,83,,percent of total billed charges,,,,,,,,,,,,,,,18.12,83,,percent of total billed charges,,,20.74,95,,percent of total billed charges,,,19.65,90,,percent of total billed charges,,,19.65,90,,percent of total billed charges,,,17.9,82,,percent of total billed charges,,,19.65,90,,percent of total billed charges,,,18.56,85,,percent of total billed charges,,16.46,20.74,
ALLOSOURCE PASTE DBM PLUS 8ML,30184967,CDM,,,278,RC,inpatient,,5232.5,5232.5,,4442.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3945.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4447.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4604.6,88,,percent of total billed charges,,,,,,,,,3997.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4761.58,91,,percent of total billed charges,,,4970.88,95,,percent of total billed charges,,,4342.98,83,,percent of total billed charges,,,4342.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4342.98,83,,percent of total billed charges,,,4970.88,95,,percent of total billed charges,,,4709.25,90,,percent of total billed charges,,,4709.25,90,,percent of total billed charges,,,4290.65,82,,percent of total billed charges,,,4709.25,90,,percent of total billed charges,,,4447.63,85,,percent of total billed charges,,3945.31,4970.88,
ELECTRODE BLADE BLUESILK 4  PTFE-INS,30184969,CDM,,,270,RC,inpatient,,70.53,70.53,,59.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,59.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.07,88,,percent of total billed charges,,,,,,,,,53.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.18,91,,percent of total billed charges,,,67,95,,percent of total billed charges,,,58.54,83,,percent of total billed charges,,,58.54,83,,percent of total billed charges,,,,,,,,,,,,,,,58.54,83,,percent of total billed charges,,,67,95,,percent of total billed charges,,,63.48,90,,percent of total billed charges,,,63.48,90,,percent of total billed charges,,,57.83,82,,percent of total billed charges,,,63.48,90,,percent of total billed charges,,,59.95,85,,percent of total billed charges,,53.18,67,
S&N EXTRACTOR NAIL LARGE,30184970,CDM,,,270,RC,inpatient,,6597.5,6597.5,,5601.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4974.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5607.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5805.8,88,,percent of total billed charges,,,,,,,,,5040.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6003.73,91,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,,,,,,,,,,,,,5475.93,83,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5409.95,82,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5607.88,85,,percent of total billed charges,,4974.52,6267.63,
S&N NAIL META-TAN 10MM X 36CM RT,30184971,CDM,,,278,RC,inpatient,,19110,19110,,16224.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14408.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16243.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16816.8,88,,percent of total billed charges,,,,,,,,,14600.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17390.1,91,,percent of total billed charges,,,18154.5,95,,percent of total billed charges,,,15861.3,83,,percent of total billed charges,,,15861.3,83,,percent of total billed charges,,,,,,,,,,,,,,,15861.3,83,,percent of total billed charges,,,18154.5,95,,percent of total billed charges,,,17199,90,,percent of total billed charges,,,17199,90,,percent of total billed charges,,,15670.2,82,,percent of total billed charges,,,17199,90,,percent of total billed charges,,,16243.5,85,,percent of total billed charges,,14408.94,18154.5,
S&N SCREW LOCKING PROXIMAL 5.0 X 75MM,30184972,CDM,,,278,RC,inpatient,,1865.5,1865.5,,1583.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1406.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1585.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1641.64,88,,percent of total billed charges,,,,,,,,,1425.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1697.61,91,,percent of total billed charges,,,1772.23,95,,percent of total billed charges,,,1548.37,83,,percent of total billed charges,,,1548.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1548.37,83,,percent of total billed charges,,,1772.23,95,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1529.71,82,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1585.68,85,,percent of total billed charges,,1406.59,1772.23,
S&N SCREW LOCKING PROXIMAL 5.0 X 35MM,30184973,CDM,,,278,RC,inpatient,,1865.5,1865.5,,1583.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1406.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1585.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1641.64,88,,percent of total billed charges,,,,,,,,,1425.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1697.61,91,,percent of total billed charges,,,1772.23,95,,percent of total billed charges,,,1548.37,83,,percent of total billed charges,,,1548.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1548.37,83,,percent of total billed charges,,,1772.23,95,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1529.71,82,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1585.68,85,,percent of total billed charges,,1406.59,1772.23,
CAGE STALIF C-TI 14X5.5 TAPERED,30184974,CDM,,,278,RC,inpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14703,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16575,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,14703,18525,
CTL SCREW PICASSO II 6.5X35,30184975,CDM,,,278,RC,inpatient,,11137.1,11137.1,,9455.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8397.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9466.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9800.65,88,,percent of total billed charges,,,,,,,,,8508.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10134.76,91,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9243.79,83,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9132.42,82,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,8397.37,10580.25,
CTL SCREW PICASSO II 7.5X35,30184976,CDM,,,278,RC,inpatient,,11137.1,11137.1,,9455.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8397.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9466.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9800.65,88,,percent of total billed charges,,,,,,,,,8508.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10134.76,91,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9243.79,83,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9132.42,82,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,8397.37,10580.25,
CTL SCREW PICASSO II 7.5X45,30184977,CDM,,,278,RC,inpatient,,11137.1,11137.1,,9455.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8397.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9466.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9800.65,88,,percent of total billed charges,,,,,,,,,8508.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10134.76,91,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9243.79,83,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9132.42,82,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,8397.37,10580.25,
CTL ROD 6.0 X 35,30184978,CDM,,,278,RC,inpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1669.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1881.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,1669.28,2103.21,
CAGE CAGE TLIF CEZANNE II 26X9X11,30184979,CDM,,,278,RC,inpatient,,21125,21125,,17935.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15928.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17956.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18590,88,,percent of total billed charges,,,,,,,,,16139.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19223.75,91,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,,,,,,,,,,,,,17533.75,83,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17322.5,82,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17956.25,85,,percent of total billed charges,,15928.25,20068.75,
SYNTHES PLATE VA CONDYLER 12 HOLE RIGHT,30184980,CDM,,,278,RC,inpatient,,17691.05,17691.05,,15019.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13339.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15037.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15568.12,88,,percent of total billed charges,,,,,,,,,13515.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16098.86,91,,percent of total billed charges,,,16806.5,95,,percent of total billed charges,,,14683.57,83,,percent of total billed charges,,,14683.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14683.57,83,,percent of total billed charges,,,16806.5,95,,percent of total billed charges,,,15921.95,90,,percent of total billed charges,,,15921.95,90,,percent of total billed charges,,,14506.66,82,,percent of total billed charges,,,15921.95,90,,percent of total billed charges,,,15037.39,85,,percent of total billed charges,,13339.05,16806.5,
SYNTHES SCREW LOCKING 5 X 16MM ANGLED,30184981,CDM,,,278,RC,inpatient,,2503.93,2503.93,,2125.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1887.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2128.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2203.46,88,,percent of total billed charges,,,,,,,,,1913,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2278.58,91,,percent of total billed charges,,,2378.73,95,,percent of total billed charges,,,2078.26,83,,percent of total billed charges,,,2078.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2078.26,83,,percent of total billed charges,,,2378.73,95,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2053.22,82,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2128.34,85,,percent of total billed charges,,1887.96,2378.73,
SYNTHES SCREW LOCKING 5 X 22MM ANGLED,30184982,CDM,,,278,RC,inpatient,,1701.7,1701.7,,1444.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1283.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1446.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1497.5,88,,percent of total billed charges,,,,,,,,,1300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1548.55,91,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1412.41,83,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1395.39,82,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,1283.08,1616.62,
SYNTHES SCREW LOCKING 5 X 38MM ANGLED,30184983,CDM,,,278,RC,inpatient,,1701.7,1701.7,,1444.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1283.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1446.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1497.5,88,,percent of total billed charges,,,,,,,,,1300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1548.55,91,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1412.41,83,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1395.39,82,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,1283.08,1616.62,
SYNTHES SCREW LOCKING 5 X 50MM ANGLED,30184984,CDM,,,278,RC,inpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1321.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1489.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,1321.56,1665.09,
SYNTHES SCREW LOCKING 5 X 55MM ANGLED,30184985,CDM,,,278,RC,inpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1321.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1489.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,1321.56,1665.09,
SYNTHES SCREW LOCKING 5 X 60MM ANGLED,30184986,CDM,,,278,RC,inpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1321.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1489.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,1321.56,1665.09,
SYNTHES SCREW LOCKING 5 X 70MM ANGLED,30184987,CDM,,,278,RC,inpatient,,1701.7,1701.7,,1444.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1283.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1446.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1497.5,88,,percent of total billed charges,,,,,,,,,1300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1548.55,91,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1412.41,83,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1395.39,82,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,1283.08,1616.62,
SYNTHES SCREW CORTEX 4.5 X 36MM,30184988,CDM,,,278,RC,inpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,222.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,197.08,248.31,
SYNTHES SCREW CORTEX 4.5 X 44MM,30184989,CDM,,,278,RC,inpatient,,277.28,277.28,,235.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,235.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.01,88,,percent of total billed charges,,,,,,,,,211.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.32,91,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,,,,,,,,,,,,,230.14,83,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,227.37,82,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,209.07,263.42,
ARTHREX DX SWIVELOCK DISP. KIT,30184990,CDM,,,270,RC,inpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1347.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1519.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,1347.78,1698.13,
ARTHREX DX SWIVELOCK W/FORK EYELET,30184991,CDM,,,270,RC,inpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2082.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2348.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,2082.93,2624.38,
ARTHREX SUTURETAPE 1.3MM,30184992,CDM,,,270,RC,inpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,197.93,249.38,
ZIMMER SCREW BONE ST 6.5 X 40MM,30184993,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
ZIMMER SCREW BONE ST 6.5 X 30MM,30184994,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
ZIMMER HEAD FEM COCR 6 DEG 28MM +3.5,30184995,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
ZIMMER DRILL BIT 3.2 X 40MM,30184996,CDM,,,270,RC,inpatient,,728,728,,618.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,548.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,618.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,640.64,88,,percent of total billed charges,,,,,,,,,556.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,662.48,91,,percent of total billed charges,,,691.6,95,,percent of total billed charges,,,604.24,83,,percent of total billed charges,,,604.24,83,,percent of total billed charges,,,,,,,,,,,,,,,604.24,83,,percent of total billed charges,,,691.6,95,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,596.96,82,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,618.8,85,,percent of total billed charges,,548.91,691.6,
ZIMMER BEARING HIP ACT ARTIC 28X50MM,30184997,CDM,,,278,RC,inpatient,,23400,23400,,19866.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17643.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19890,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20592,88,,percent of total billed charges,,,,,,,,,17877.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21294,91,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,,,,,,,,,,,,,19422,83,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19188,82,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19890,85,,percent of total billed charges,,17643.6,22230,
ZIMMER LINER DUAL MOBILITY G7 50MM H,30184998,CDM,,,278,RC,inpatient,,9912.5,9912.5,,8415.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7474.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8425.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8723,88,,percent of total billed charges,,,,,,,,,7573.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9020.38,91,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,,,,,,,,,,,,,8227.38,83,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8128.25,82,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,7474.03,9416.88,
ZIMMER SHELL OSSEOTI G7 62MM H,30184999,CDM,,,278,RC,inpatient,,41145,41145,,34932.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31023.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34973.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36207.6,88,,percent of total billed charges,,,,,,,,,31434.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37441.95,91,,percent of total billed charges,,,39087.75,95,,percent of total billed charges,,,34150.35,83,,percent of total billed charges,,,34150.35,83,,percent of total billed charges,,,,,,,,,,,,,,,34150.35,83,,percent of total billed charges,,,39087.75,95,,percent of total billed charges,,,37030.5,90,,percent of total billed charges,,,37030.5,90,,percent of total billed charges,,,33738.9,82,,percent of total billed charges,,,37030.5,90,,percent of total billed charges,,,34973.25,85,,percent of total billed charges,,31023.33,39087.75,
PEEK CAGE 12 X 9 25MM,30185000,CDM,,,278,RC,inpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12742.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14365,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,12742.6,16055,
PEEK CAGE 9 X 9 X 25MM,30185001,CDM,,,278,RC,inpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12742.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14365,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,12742.6,16055,
ZIMMER TIBIA SZ D RM UNI,30185002,CDM,,,278,RC,inpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10218.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11519.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,10218.59,12874.88,
DEPUY EPI IMPLANT SZ 2,30185003,CDM,,,278,RC,inpatient,,33055.36,33055.36,,28064,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24923.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28097.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29088.72,88,,percent of total billed charges,,,,,,,,,25254.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30080.38,91,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,,,,,,,,,,,,,27435.95,83,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,27105.4,82,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,28097.06,85,,percent of total billed charges,,24923.74,31402.59,
SCREW STALIF C ABO 4.0 X 16MM,30185004,CDM,,,278,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
CTL CAGE PEEK TLIF CEZANNE 11X30X8,30185005,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
MYOSURE REACH DEVICE,30185006,CDM,,,270,RC,inpatient,,10010,10010,,8498.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7547.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8508.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8808.8,88,,percent of total billed charges,,,,,,,,,7647.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9109.1,91,,percent of total billed charges,,,9509.5,95,,percent of total billed charges,,,8308.3,83,,percent of total billed charges,,,8308.3,83,,percent of total billed charges,,,,,,,,,,,,,,,8308.3,83,,percent of total billed charges,,,9509.5,95,,percent of total billed charges,,,9009,90,,percent of total billed charges,,,9009,90,,percent of total billed charges,,,8208.2,82,,percent of total billed charges,,,9009,90,,percent of total billed charges,,,8508.5,85,,percent of total billed charges,,7547.54,9509.5,
SCREW POLYAXIAL 7.5 X 45MM,30185007,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SCREW POLYAXIAL 4.5 X 45MM,30185008,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SCREW POLYAXIAL 5.5 X 40MM,30185009,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ARTHREX PUNCH DISP. KIT FOR CORKSREW FT,30185010,CDM,,,270,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
DURASEAL EXACT SPINE SEALANT 5ML,30185011,CDM,,,270,RC,inpatient,,8561.53,8561.53,,7268.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6455.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7277.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7534.15,88,,percent of total billed charges,,,,,,,,,6541.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7790.99,91,,percent of total billed charges,,,8133.45,95,,percent of total billed charges,,,7106.07,83,,percent of total billed charges,,,7106.07,83,,percent of total billed charges,,,,,,,,,,,,,,,7106.07,83,,percent of total billed charges,,,8133.45,95,,percent of total billed charges,,,7705.38,90,,percent of total billed charges,,,7705.38,90,,percent of total billed charges,,,7020.45,82,,percent of total billed charges,,,7705.38,90,,percent of total billed charges,,,7277.3,85,,percent of total billed charges,,6455.39,8133.45,
DURASEAL EXTENDED TIP APPLICATOR 8CM,30185012,CDM,,,270,RC,inpatient,,1665.72,1665.72,,1414.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1255.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1415.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1465.83,88,,percent of total billed charges,,,,,,,,,1272.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1515.81,91,,percent of total billed charges,,,1582.43,95,,percent of total billed charges,,,1382.55,83,,percent of total billed charges,,,1382.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1382.55,83,,percent of total billed charges,,,1582.43,95,,percent of total billed charges,,,1499.15,90,,percent of total billed charges,,,1499.15,90,,percent of total billed charges,,,1365.89,82,,percent of total billed charges,,,1499.15,90,,percent of total billed charges,,,1415.86,85,,percent of total billed charges,,1255.95,1582.43,
DURAGEN SECURE 3X3 REGENERATION MATRIX,30185013,CDM,,,270,RC,inpatient,,5614.9,5614.9,,4767.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4233.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4772.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4941.11,88,,percent of total billed charges,,,,,,,,,4289.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5109.56,91,,percent of total billed charges,,,5334.16,95,,percent of total billed charges,,,4660.37,83,,percent of total billed charges,,,4660.37,83,,percent of total billed charges,,,,,,,,,,,,,,,4660.37,83,,percent of total billed charges,,,5334.16,95,,percent of total billed charges,,,5053.41,90,,percent of total billed charges,,,5053.41,90,,percent of total billed charges,,,4604.22,82,,percent of total billed charges,,,5053.41,90,,percent of total billed charges,,,4772.67,85,,percent of total billed charges,,4233.63,5334.16,
NEUROMONITORING SERVICES - ANS,30185014,CDM,,,270,RC,inpatient,,4550,4550,,3862.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3430.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3867.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4004,88,,percent of total billed charges,,,,,,,,,3476.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4140.5,91,,percent of total billed charges,,,4322.5,95,,percent of total billed charges,,,3776.5,83,,percent of total billed charges,,,3776.5,83,,percent of total billed charges,,,,,,,,,,,,,,,3776.5,83,,percent of total billed charges,,,4322.5,95,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,3731,82,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,3867.5,85,,percent of total billed charges,,3430.7,4322.5,
ZIMMER DRILL BIT 3.2 X 30MM,30185015,CDM,,,270,RC,inpatient,,728,728,,618.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,548.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,618.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,640.64,88,,percent of total billed charges,,,,,,,,,556.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,662.48,91,,percent of total billed charges,,,691.6,95,,percent of total billed charges,,,604.24,83,,percent of total billed charges,,,604.24,83,,percent of total billed charges,,,,,,,,,,,,,,,604.24,83,,percent of total billed charges,,,691.6,95,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,596.96,82,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,618.8,85,,percent of total billed charges,,548.91,691.6,
ZIMMER SHELL OSSEOTI G7 54MM F,30185016,CDM,,,278,RC,inpatient,,41145,41145,,34932.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31023.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34973.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36207.6,88,,percent of total billed charges,,,,,,,,,31434.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37441.95,91,,percent of total billed charges,,,39087.75,95,,percent of total billed charges,,,34150.35,83,,percent of total billed charges,,,34150.35,83,,percent of total billed charges,,,,,,,,,,,,,,,34150.35,83,,percent of total billed charges,,,39087.75,95,,percent of total billed charges,,,37030.5,90,,percent of total billed charges,,,37030.5,90,,percent of total billed charges,,,33738.9,82,,percent of total billed charges,,,37030.5,90,,percent of total billed charges,,,34973.25,85,,percent of total billed charges,,31023.33,39087.75,
ZIMMER LINER DUAL MOBILITY G7 44MM F,30185017,CDM,,,278,RC,inpatient,,9912.5,9912.5,,8415.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7474.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8425.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8723,88,,percent of total billed charges,,,,,,,,,7573.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9020.38,91,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,,,,,,,,,,,,,8227.38,83,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8128.25,82,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,7474.03,9416.88,
ZIMMER BEARING HIP ACT ARTIC 28X44MM,30185018,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
S&N INSERT CONSTRAINED GENESIS 15MM SZ 5,30185019,CDM,,,278,RC,inpatient,,18018,18018,,15297.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13585.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15315.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15855.84,88,,percent of total billed charges,,,,,,,,,13765.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16396.38,91,,percent of total billed charges,,,17117.1,95,,percent of total billed charges,,,14954.94,83,,percent of total billed charges,,,14954.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14954.94,83,,percent of total billed charges,,,17117.1,95,,percent of total billed charges,,,16216.2,90,,percent of total billed charges,,,16216.2,90,,percent of total billed charges,,,14774.76,82,,percent of total billed charges,,,16216.2,90,,percent of total billed charges,,,15315.3,85,,percent of total billed charges,,13585.57,17117.1,
SYNTHES SCREW CORTEX S-T 2.7X24MM,30185020,CDM,,,278,RC,inpatient,,429.03,429.03,,364.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,323.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,364.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,377.55,88,,percent of total billed charges,,,,,,,,,327.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,390.42,91,,percent of total billed charges,,,407.58,95,,percent of total billed charges,,,356.09,83,,percent of total billed charges,,,356.09,83,,percent of total billed charges,,,,,,,,,,,,,,,356.09,83,,percent of total billed charges,,,407.58,95,,percent of total billed charges,,,386.13,90,,percent of total billed charges,,,386.13,90,,percent of total billed charges,,,351.8,82,,percent of total billed charges,,,386.13,90,,percent of total billed charges,,,364.68,85,,percent of total billed charges,,323.49,407.58,
DEPUY INSERT RP 6MM SZ 8,30185022,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
CTL ROD MIS 6.0 X 70MM,30185023,CDM,,,278,RC,inpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1669.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1881.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,1669.28,2103.21,
ZIMMER HEAD BIOLOX 36MM + OMM,30185025,CDM,,,278,RC,inpatient,,24700,24700,,20970.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18623.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20995,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21736,88,,percent of total billed charges,,,,,,,,,18870.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22477,91,,percent of total billed charges,,,23465,95,,percent of total billed charges,,,20501,83,,percent of total billed charges,,,20501,83,,percent of total billed charges,,,,,,,,,,,,,,,20501,83,,percent of total billed charges,,,23465,95,,percent of total billed charges,,,22230,90,,percent of total billed charges,,,22230,90,,percent of total billed charges,,,20254,82,,percent of total billed charges,,,22230,90,,percent of total billed charges,,,20995,85,,percent of total billed charges,,18623.8,23465,
ZIMMER LINER NUETRAL VIVACIT-E JJ 36X54,30185026,CDM,,,278,RC,inpatient,,22295,22295,,18928.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16810.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18950.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19619.6,88,,percent of total billed charges,,,,,,,,,17033.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20288.45,91,,percent of total billed charges,,,21180.25,95,,percent of total billed charges,,,18504.85,83,,percent of total billed charges,,,18504.85,83,,percent of total billed charges,,,,,,,,,,,,,,,18504.85,83,,percent of total billed charges,,,21180.25,95,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,18281.9,82,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,18950.75,85,,percent of total billed charges,,16810.43,21180.25,
SYNTHES SCREW CANCEL F-THD 4.0X20MM,30185028,CDM,,,278,RC,inpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,178.47,224.87,
S&N SCREW SOFTSLK 1.5 7X20,30185029,CDM,,,270,RC,inpatient,,1265.36,1265.36,,1074.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,954.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1075.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1113.52,88,,percent of total billed charges,,,,,,,,,966.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1151.48,91,,percent of total billed charges,,,1202.09,95,,percent of total billed charges,,,1050.25,83,,percent of total billed charges,,,1050.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1050.25,83,,percent of total billed charges,,,1202.09,95,,percent of total billed charges,,,1138.82,90,,percent of total billed charges,,,1138.82,90,,percent of total billed charges,,,1037.6,82,,percent of total billed charges,,,1138.82,90,,percent of total billed charges,,,1075.56,85,,percent of total billed charges,,954.08,1202.09,
S&N SCREW SOFTSLK 1.5 8X20,30185030,CDM,,,270,RC,inpatient,,1265.36,1265.36,,1074.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,954.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1075.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1113.52,88,,percent of total billed charges,,,,,,,,,966.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1151.48,91,,percent of total billed charges,,,1202.09,95,,percent of total billed charges,,,1050.25,83,,percent of total billed charges,,,1050.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1050.25,83,,percent of total billed charges,,,1202.09,95,,percent of total billed charges,,,1138.82,90,,percent of total billed charges,,,1138.82,90,,percent of total billed charges,,,1037.6,82,,percent of total billed charges,,,1138.82,90,,percent of total billed charges,,,1075.56,85,,percent of total billed charges,,954.08,1202.09,
ARTHREX SUTURE ANCHOR BC SL 4.75 X 22MM,30185031,CDM,,,278,RC,inpatient,,2710.5,2710.5,,2301.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2043.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2303.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2385.24,88,,percent of total billed charges,,,,,,,,,2070.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2466.56,91,,percent of total billed charges,,,2574.98,95,,percent of total billed charges,,,2249.72,83,,percent of total billed charges,,,2249.72,83,,percent of total billed charges,,,,,,,,,,,,,,,2249.72,83,,percent of total billed charges,,,2574.98,95,,percent of total billed charges,,,2439.45,90,,percent of total billed charges,,,2439.45,90,,percent of total billed charges,,,2222.61,82,,percent of total billed charges,,,2439.45,90,,percent of total billed charges,,,2303.93,85,,percent of total billed charges,,2043.72,2574.98,
ARTHREX FLIPCUTTER II 10MM,30185032,CDM,,,278,RC,inpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1592.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1795.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,1592.83,2006.88,
FORTEC HOLMIUM LASER HIGH WATTAGE,30185033,CDM,,,270,RC,inpatient,,5070,5070,,4304.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3822.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4309.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4461.6,88,,percent of total billed charges,,,,,,,,,3873.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4613.7,91,,percent of total billed charges,,,4816.5,95,,percent of total billed charges,,,4208.1,83,,percent of total billed charges,,,4208.1,83,,percent of total billed charges,,,,,,,,,,,,,,,4208.1,83,,percent of total billed charges,,,4816.5,95,,percent of total billed charges,,,4563,90,,percent of total billed charges,,,4563,90,,percent of total billed charges,,,4157.4,82,,percent of total billed charges,,,4563,90,,percent of total billed charges,,,4309.5,85,,percent of total billed charges,,3822.78,4816.5,
FORTEC HOLMIUM FIBER 365,30185034,CDM,,,270,RC,inpatient,,1482,1482,,1258.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1117.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1259.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1304.16,88,,percent of total billed charges,,,,,,,,,1132.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1348.62,91,,percent of total billed charges,,,1407.9,95,,percent of total billed charges,,,1230.06,83,,percent of total billed charges,,,1230.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1230.06,83,,percent of total billed charges,,,1407.9,95,,percent of total billed charges,,,1333.8,90,,percent of total billed charges,,,1333.8,90,,percent of total billed charges,,,1215.24,82,,percent of total billed charges,,,1333.8,90,,percent of total billed charges,,,1259.7,85,,percent of total billed charges,,1117.43,1407.9,
S&N PLATE PRIM RIGHT MTP VLP 2.7MM,30185035,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
S&N K-WIRE 1.1MM X 150MM,30185036,CDM,,,278,RC,inpatient,,728,728,,618.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,548.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,618.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,640.64,88,,percent of total billed charges,,,,,,,,,556.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,662.48,91,,percent of total billed charges,,,691.6,95,,percent of total billed charges,,,604.24,83,,percent of total billed charges,,,604.24,83,,percent of total billed charges,,,,,,,,,,,,,,,604.24,83,,percent of total billed charges,,,691.6,95,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,596.96,82,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,618.8,85,,percent of total billed charges,,548.91,691.6,
S&N KWIRE 1.6MM X 150MM,30185037,CDM,,,278,RC,inpatient,,562.45,562.45,,477.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,424.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,478.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,494.96,88,,percent of total billed charges,,,,,,,,,429.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,511.83,91,,percent of total billed charges,,,534.33,95,,percent of total billed charges,,,466.83,83,,percent of total billed charges,,,466.83,83,,percent of total billed charges,,,,,,,,,,,,,,,466.83,83,,percent of total billed charges,,,534.33,95,,percent of total billed charges,,,506.21,90,,percent of total billed charges,,,506.21,90,,percent of total billed charges,,,461.21,82,,percent of total billed charges,,,506.21,90,,percent of total billed charges,,,478.08,85,,percent of total billed charges,,424.09,534.33,
S&N DRILL 2.0MM X 130MM,30185038,CDM,,,278,RC,inpatient,,968.5,968.5,,822.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,730.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,823.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,852.28,88,,percent of total billed charges,,,,,,,,,739.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,881.34,91,,percent of total billed charges,,,920.08,95,,percent of total billed charges,,,803.86,83,,percent of total billed charges,,,803.86,83,,percent of total billed charges,,,,,,,,,,,,,,,803.86,83,,percent of total billed charges,,,920.08,95,,percent of total billed charges,,,871.65,90,,percent of total billed charges,,,871.65,90,,percent of total billed charges,,,794.17,82,,percent of total billed charges,,,871.65,90,,percent of total billed charges,,,823.23,85,,percent of total billed charges,,730.25,920.08,
S&N SCREW CORTEX 2.7MM S-T 14MM,30185039,CDM,,,278,RC,inpatient,,233.1,233.1,,197.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,175.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,198.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,205.13,88,,percent of total billed charges,,,,,,,,,178.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,212.12,91,,percent of total billed charges,,,221.45,95,,percent of total billed charges,,,193.47,83,,percent of total billed charges,,,193.47,83,,percent of total billed charges,,,,,,,,,,,,,,,193.47,83,,percent of total billed charges,,,221.45,95,,percent of total billed charges,,,209.79,90,,percent of total billed charges,,,209.79,90,,percent of total billed charges,,,191.14,82,,percent of total billed charges,,,209.79,90,,percent of total billed charges,,,198.14,85,,percent of total billed charges,,175.76,221.45,
S&N SCREW CORTEXST VLP 2.7 X 12MM,30185040,CDM,,,278,RC,inpatient,,1417,1417,,1203.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1068.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1204.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1246.96,88,,percent of total billed charges,,,,,,,,,1082.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1289.47,91,,percent of total billed charges,,,1346.15,95,,percent of total billed charges,,,1176.11,83,,percent of total billed charges,,,1176.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1176.11,83,,percent of total billed charges,,,1346.15,95,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1161.94,82,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1204.45,85,,percent of total billed charges,,1068.42,1346.15,
S&N SCREW CANNULATED 3.0 X 30MM,30185041,CDM,,,278,RC,inpatient,,2333.5,2333.5,,1981.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1759.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1983.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2053.48,88,,percent of total billed charges,,,,,,,,,1782.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2123.49,91,,percent of total billed charges,,,2216.83,95,,percent of total billed charges,,,1936.81,83,,percent of total billed charges,,,1936.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1936.81,83,,percent of total billed charges,,,2216.83,95,,percent of total billed charges,,,2100.15,90,,percent of total billed charges,,,2100.15,90,,percent of total billed charges,,,1913.47,82,,percent of total billed charges,,,2100.15,90,,percent of total billed charges,,,1983.48,85,,percent of total billed charges,,1759.46,2216.83,
DEPUY LINER ALTRX 32X52 +4,30185042,CDM,,,278,RC,inpatient,,11494.99,11494.99,,9759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8667.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9770.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10115.59,88,,percent of total billed charges,,,,,,,,,8782.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10460.44,91,,percent of total billed charges,,,10920.24,95,,percent of total billed charges,,,9540.84,83,,percent of total billed charges,,,9540.84,83,,percent of total billed charges,,,,,,,,,,,,,,,9540.84,83,,percent of total billed charges,,,10920.24,95,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,9425.89,82,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,9770.74,85,,percent of total billed charges,,8667.22,10920.24,
ZIMMER SHELL OSSEOTI G7 54MM F 4 HOLE,30185043,CDM,,,278,RC,inpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14580.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16436.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,14580.48,18370.63,
ZIMMER DRILL BIT 3.2 X 50MM RNGLC + ACET,30185044,CDM,,,278,RC,inpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,784.16,988,
ZIMMER SCREW BONE ST 6.5 X 25MM,30185045,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
SYNTHES PLATE LOCKING PROX. LAT. 3.5MM 6,30185046,CDM,,,278,RC,inpatient,,14724.13,14724.13,,12500.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11101.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12515.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12957.23,88,,percent of total billed charges,,,,,,,,,11249.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13398.96,91,,percent of total billed charges,,,13987.92,95,,percent of total billed charges,,,12221.03,83,,percent of total billed charges,,,12221.03,83,,percent of total billed charges,,,,,,,,,,,,,,,12221.03,83,,percent of total billed charges,,,13987.92,95,,percent of total billed charges,,,13251.72,90,,percent of total billed charges,,,13251.72,90,,percent of total billed charges,,,12073.79,82,,percent of total billed charges,,,13251.72,90,,percent of total billed charges,,,12515.51,85,,percent of total billed charges,,11101.99,13987.92,
ARTHREX IMPLANT SYS. SPEED BRIDGE BC 4.7,30185047,CDM,,,278,RC,inpatient,,11310,11310,,9602.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8527.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9613.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9952.8,88,,percent of total billed charges,,,,,,,,,8640.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10292.1,91,,percent of total billed charges,,,10744.5,95,,percent of total billed charges,,,9387.3,83,,percent of total billed charges,,,9387.3,83,,percent of total billed charges,,,,,,,,,,,,,,,9387.3,83,,percent of total billed charges,,,10744.5,95,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,9274.2,82,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,9613.5,85,,percent of total billed charges,,8527.74,10744.5,
ARTHREX CANNULA TRIPLE DAM 8.25 X 7MM,30185048,CDM,,,278,RC,inpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
WRIGHT AUGMENT BONE GRAFT 3CC KIT,30185049,CDM,,,278,RC,inpatient,,22717.5,22717.5,,19287.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17129,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19309.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19991.4,88,,percent of total billed charges,,,,,,,,,17356.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20672.93,91,,percent of total billed charges,,,21581.63,95,,percent of total billed charges,,,18855.53,83,,percent of total billed charges,,,18855.53,83,,percent of total billed charges,,,,,,,,,,,,,,,18855.53,83,,percent of total billed charges,,,21581.63,95,,percent of total billed charges,,,20445.75,90,,percent of total billed charges,,,20445.75,90,,percent of total billed charges,,,18628.35,82,,percent of total billed charges,,,20445.75,90,,percent of total billed charges,,,19309.88,85,,percent of total billed charges,,17129,21581.63,
ARTHREX G-WIRE W/TRCR TIP .086MM,30185050,CDM,,,278,RC,inpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,132.7,167.2,
ARTHREX DRILL BIT 2.0MM CMP FT CALIBRATE,30185051,CDM,,,278,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
ARTHREX DRILL PROFILE CANNULATED,30185052,CDM,,,278,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
ARTHREX G-WIRE 0.86MM W/LASER LINE SS,30185053,CDM,,,270,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
ARTHREX DRILL BIT 1.7MM CANNULATED,30185054,CDM,,,278,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
ARTHREX G-WIRE 0.86MM W/LASER LINE THRE,30185055,CDM,,,270,RC,inpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,120.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,120.64,152,
ARTHREX COUNTERSINK 2.0/2.4MM CANNULATED,30185056,CDM,,,278,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
ARTHREX SCREW QUICKFIX TI CANN 2.0 X 8MM,30185057,CDM,,,278,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
ARTHREX SCREW MICRO 2.5 10MM COMPR FT,30185058,CDM,,,278,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
ARTHREX SCREW MICRO 2.5 8MM COMPR FT,30185059,CDM,,,278,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
ROD LORDOSES 6.0 X 40MM,30185060,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
SYNTHES SCREW LOCKING S-T 3.5 X 26MM,30185061,CDM,,,278,RC,inpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,945.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1066.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,945.79,1191.65,
MICROPORT LINER CLASS A 40MM F,30185062,CDM,,,278,RC,inpatient,,20598.5,20598.5,,17488.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15531.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17508.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18126.68,88,,percent of total billed charges,,,,,,,,,15737.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18744.64,91,,percent of total billed charges,,,19568.58,95,,percent of total billed charges,,,17096.76,83,,percent of total billed charges,,,17096.76,83,,percent of total billed charges,,,,,,,,,,,,,,,17096.76,83,,percent of total billed charges,,,19568.58,95,,percent of total billed charges,,,18538.65,90,,percent of total billed charges,,,18538.65,90,,percent of total billed charges,,,16890.77,82,,percent of total billed charges,,,18538.65,90,,percent of total billed charges,,,17508.73,85,,percent of total billed charges,,15531.27,19568.58,
MICROPORT HEAD FEMORAL BCH 40MM,30185063,CDM,,,278,RC,inpatient,,39065,39065,,33166.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29455.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33205.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34377.2,88,,percent of total billed charges,,,,,,,,,29845.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35549.15,91,,percent of total billed charges,,,37111.75,95,,percent of total billed charges,,,32423.95,83,,percent of total billed charges,,,32423.95,83,,percent of total billed charges,,,,,,,,,,,,,,,32423.95,83,,percent of total billed charges,,,37111.75,95,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,32033.3,82,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,33205.25,85,,percent of total billed charges,,29455.01,37111.75,
MICROPORT NECK SHORT SLT 12/14,30185064,CDM,,,278,RC,inpatient,,28964,28964,,24590.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21838.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24619.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25488.32,88,,percent of total billed charges,,,,,,,,,22128.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26357.24,91,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,,,,,,,,,,,,,24040.12,83,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,23750.48,82,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,24619.4,85,,percent of total billed charges,,21838.86,27515.8,
MICROPORT NECK SLEEVE CONSERVE X-LONG,30185065,CDM,,,278,RC,inpatient,,8177,8177,,6942.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6165.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6950.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7195.76,88,,percent of total billed charges,,,,,,,,,6247.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7441.07,91,,percent of total billed charges,,,7768.15,95,,percent of total billed charges,,,6786.91,83,,percent of total billed charges,,,6786.91,83,,percent of total billed charges,,,,,,,,,,,,,,,6786.91,83,,percent of total billed charges,,,7768.15,95,,percent of total billed charges,,,7359.3,90,,percent of total billed charges,,,7359.3,90,,percent of total billed charges,,,6705.14,82,,percent of total billed charges,,,7359.3,90,,percent of total billed charges,,,6950.45,85,,percent of total billed charges,,6165.46,7768.15,
FORTEC HOLMIUM FIBER 550,30185066,CDM,,,270,RC,inpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1176.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1326,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,1176.24,1482,
CTL CAGE PEEK TLIF CEZANNE 9X30X11,30185067,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
CTL SCREW PICASSO MIS 5.5X40,30185068,CDM,,,278,RC,inpatient,,11137.1,11137.1,,9455.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8397.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9466.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9800.65,88,,percent of total billed charges,,,,,,,,,8508.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10134.76,91,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9243.79,83,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9132.42,82,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,8397.37,10580.25,
CTL ROD MIS 90MM,30185069,CDM,,,278,RC,inpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1666.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1878.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,1666.34,2099.5,
SYNTHES DRILL BIT 1.5MM 110MM,30185070,CDM,,,278,RC,inpatient,,772.17,772.17,,655.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,582.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,656.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,679.51,88,,percent of total billed charges,,,,,,,,,589.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,702.67,91,,percent of total billed charges,,,733.56,95,,percent of total billed charges,,,640.9,83,,percent of total billed charges,,,640.9,83,,percent of total billed charges,,,,,,,,,,,,,,,640.9,83,,percent of total billed charges,,,733.56,95,,percent of total billed charges,,,694.95,90,,percent of total billed charges,,,694.95,90,,percent of total billed charges,,,633.18,82,,percent of total billed charges,,,694.95,90,,percent of total billed charges,,,656.34,85,,percent of total billed charges,,582.22,733.56,
SYNTHES DRILL BIT 2.7MM 125MM,30185071,CDM,,,278,RC,inpatient,,844.9,844.9,,717.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,637.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,718.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,743.51,88,,percent of total billed charges,,,,,,,,,645.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,768.86,91,,percent of total billed charges,,,802.66,95,,percent of total billed charges,,,701.27,83,,percent of total billed charges,,,701.27,83,,percent of total billed charges,,,,,,,,,,,,,,,701.27,83,,percent of total billed charges,,,802.66,95,,percent of total billed charges,,,760.41,90,,percent of total billed charges,,,760.41,90,,percent of total billed charges,,,692.82,82,,percent of total billed charges,,,760.41,90,,percent of total billed charges,,,718.17,85,,percent of total billed charges,,637.05,802.66,
MENISCAL GUN,30185074,CDM,,,270,RC,inpatient,,1865.5,1865.5,,1583.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1406.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1585.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1641.64,88,,percent of total billed charges,,,,,,,,,1425.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1697.61,91,,percent of total billed charges,,,1772.23,95,,percent of total billed charges,,,1548.37,83,,percent of total billed charges,,,1548.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1548.37,83,,percent of total billed charges,,,1772.23,95,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1529.71,82,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1585.68,85,,percent of total billed charges,,1406.59,1772.23,
CTL ROD MIS 95MM,30185075,CDM,,,278,RC,inpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1669.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1881.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,1669.28,2103.21,
SYNTHES SCREW CORTEX 3.5X20MM,30185076,CDM,,,278,RC,inpatient,,275.78,275.78,,234.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,207.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,234.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,242.69,88,,percent of total billed charges,,,,,,,,,210.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,250.96,91,,percent of total billed charges,,,261.99,95,,percent of total billed charges,,,228.9,83,,percent of total billed charges,,,228.9,83,,percent of total billed charges,,,,,,,,,,,,,,,228.9,83,,percent of total billed charges,,,261.99,95,,percent of total billed charges,,,248.2,90,,percent of total billed charges,,,248.2,90,,percent of total billed charges,,,226.14,82,,percent of total billed charges,,,248.2,90,,percent of total billed charges,,,234.41,85,,percent of total billed charges,,207.94,261.99,
SPINECRAFT BOLT ILLIAC 7.75 X 70MM,30185077,CDM,,,278,RC,inpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7106.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8011.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,7106.45,8953.75,
SPINECRAFT CONNECTOR ILLIAC 26MM,30185078,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
SPINECRAFT SCREW SET LARGE,30185079,CDM,,,278,RC,inpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,527.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,595,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,527.8,665,
SPINECRAFT SCREW SET REGULAR,30185080,CDM,,,278,RC,inpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,527.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,595,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,527.8,665,
S&N COUPLER OFFSET 6MM,30185081,CDM,,,278,RC,inpatient,,13168.48,13168.48,,11180.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9929.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11193.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11588.26,88,,percent of total billed charges,,,,,,,,,10060.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11983.32,91,,percent of total billed charges,,,12510.06,95,,percent of total billed charges,,,10929.84,83,,percent of total billed charges,,,10929.84,83,,percent of total billed charges,,,,,,,,,,,,,,,10929.84,83,,percent of total billed charges,,,12510.06,95,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,10798.15,82,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,11193.21,85,,percent of total billed charges,,9929.03,12510.06,
S&N WEDGES DIGITAL 10MM SZ 5,30185082,CDM,,,278,RC,inpatient,,10647,10647,,9039.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8027.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9049.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9369.36,88,,percent of total billed charges,,,,,,,,,8134.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9688.77,91,,percent of total billed charges,,,10114.65,95,,percent of total billed charges,,,8837.01,83,,percent of total billed charges,,,8837.01,83,,percent of total billed charges,,,,,,,,,,,,,,,8837.01,83,,percent of total billed charges,,,10114.65,95,,percent of total billed charges,,,9582.3,90,,percent of total billed charges,,,9582.3,90,,percent of total billed charges,,,8730.54,82,,percent of total billed charges,,,9582.3,90,,percent of total billed charges,,,9049.95,85,,percent of total billed charges,,8027.84,10114.65,
S&N STEM PRESSFIT 20 X 120MM,30185083,CDM,,,278,RC,inpatient,,10483.2,10483.2,,8900.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7904.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8910.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9225.22,88,,percent of total billed charges,,,,,,,,,8009.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9539.71,91,,percent of total billed charges,,,9959.04,95,,percent of total billed charges,,,8701.06,83,,percent of total billed charges,,,8701.06,83,,percent of total billed charges,,,,,,,,,,,,,,,8701.06,83,,percent of total billed charges,,,9959.04,95,,percent of total billed charges,,,9434.88,90,,percent of total billed charges,,,9434.88,90,,percent of total billed charges,,,8596.22,82,,percent of total billed charges,,,9434.88,90,,percent of total billed charges,,,8910.72,85,,percent of total billed charges,,7904.33,9959.04,
S&N PLATE BASE REVISION SZ 4 LT,30185084,CDM,,,278,RC,inpatient,,22645.35,22645.35,,19225.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17074.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19248.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19927.91,88,,percent of total billed charges,,,,,,,,,17301.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20607.27,91,,percent of total billed charges,,,21513.08,95,,percent of total billed charges,,,18795.64,83,,percent of total billed charges,,,18795.64,83,,percent of total billed charges,,,,,,,,,,,,,,,18795.64,83,,percent of total billed charges,,,21513.08,95,,percent of total billed charges,,,20380.82,90,,percent of total billed charges,,,20380.82,90,,percent of total billed charges,,,18569.19,82,,percent of total billed charges,,,20380.82,90,,percent of total billed charges,,,19248.55,85,,percent of total billed charges,,17074.59,21513.08,
S&N WEDGE TIB. MEDIAL LT 5MM SZ 3/4,30185085,CDM,,,278,RC,inpatient,,12018.83,12018.83,,10203.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9062.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10216.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10576.57,88,,percent of total billed charges,,,,,,,,,9182.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10937.14,91,,percent of total billed charges,,,11417.89,95,,percent of total billed charges,,,9975.63,83,,percent of total billed charges,,,9975.63,83,,percent of total billed charges,,,,,,,,,,,,,,,9975.63,83,,percent of total billed charges,,,11417.89,95,,percent of total billed charges,,,10816.95,90,,percent of total billed charges,,,10816.95,90,,percent of total billed charges,,,9855.44,82,,percent of total billed charges,,,10816.95,90,,percent of total billed charges,,,10216.01,85,,percent of total billed charges,,9062.2,11417.89,
S&N WEDGE TIB. LATERAL LT 5MM SZ 3/4,30185086,CDM,,,278,RC,inpatient,,12018.83,12018.83,,10203.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9062.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10216.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10576.57,88,,percent of total billed charges,,,,,,,,,9182.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10937.14,91,,percent of total billed charges,,,11417.89,95,,percent of total billed charges,,,9975.63,83,,percent of total billed charges,,,9975.63,83,,percent of total billed charges,,,,,,,,,,,,,,,9975.63,83,,percent of total billed charges,,,11417.89,95,,percent of total billed charges,,,10816.95,90,,percent of total billed charges,,,10816.95,90,,percent of total billed charges,,,9855.44,82,,percent of total billed charges,,,10816.95,90,,percent of total billed charges,,,10216.01,85,,percent of total billed charges,,9062.2,11417.89,
S&N STEM PRESSFIT 16MM X 160MM,30185087,CDM,,,278,RC,inpatient,,10776.35,10776.35,,9149.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8125.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9159.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9483.19,88,,percent of total billed charges,,,,,,,,,8233.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9806.48,91,,percent of total billed charges,,,10237.53,95,,percent of total billed charges,,,8944.37,83,,percent of total billed charges,,,8944.37,83,,percent of total billed charges,,,,,,,,,,,,,,,8944.37,83,,percent of total billed charges,,,10237.53,95,,percent of total billed charges,,,9698.72,90,,percent of total billed charges,,,9698.72,90,,percent of total billed charges,,,8836.61,82,,percent of total billed charges,,,9698.72,90,,percent of total billed charges,,,9159.9,85,,percent of total billed charges,,8125.37,10237.53,
S&N INSERT CONSTRAINED 11MM SZ 3/4,30185088,CDM,,,278,RC,inpatient,,23176.47,23176.47,,19676.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17475.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19700,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20395.29,88,,percent of total billed charges,,,,,,,,,17706.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21090.59,91,,percent of total billed charges,,,22017.65,95,,percent of total billed charges,,,19236.47,83,,percent of total billed charges,,,19236.47,83,,percent of total billed charges,,,,,,,,,,,,,,,19236.47,83,,percent of total billed charges,,,22017.65,95,,percent of total billed charges,,,20858.82,90,,percent of total billed charges,,,20858.82,90,,percent of total billed charges,,,19004.71,82,,percent of total billed charges,,,20858.82,90,,percent of total billed charges,,,19700,85,,percent of total billed charges,,17475.06,22017.65,
S&N PINS HEADLESS 65MM,30185089,CDM,,,278,RC,inpatient,,59.33,59.33,,50.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.21,88,,percent of total billed charges,,,,,,,,,45.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.99,91,,percent of total billed charges,,,56.36,95,,percent of total billed charges,,,49.24,83,,percent of total billed charges,,,49.24,83,,percent of total billed charges,,,,,,,,,,,,,,,49.24,83,,percent of total billed charges,,,56.36,95,,percent of total billed charges,,,53.4,90,,percent of total billed charges,,,53.4,90,,percent of total billed charges,,,48.65,82,,percent of total billed charges,,,53.4,90,,percent of total billed charges,,,50.43,85,,percent of total billed charges,,44.73,56.36,
S&N PINS RIMMED 65MM,30185090,CDM,,,278,RC,inpatient,,59.33,59.33,,50.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.21,88,,percent of total billed charges,,,,,,,,,45.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.99,91,,percent of total billed charges,,,56.36,95,,percent of total billed charges,,,49.24,83,,percent of total billed charges,,,49.24,83,,percent of total billed charges,,,,,,,,,,,,,,,49.24,83,,percent of total billed charges,,,56.36,95,,percent of total billed charges,,,53.4,90,,percent of total billed charges,,,53.4,90,,percent of total billed charges,,,48.65,82,,percent of total billed charges,,,53.4,90,,percent of total billed charges,,,50.43,85,,percent of total billed charges,,44.73,56.36,
S&N PINS RIMMED 45MM,30185091,CDM,,,278,RC,inpatient,,167.52,167.52,,142.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,126.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,142.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,147.42,88,,percent of total billed charges,,,,,,,,,127.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,152.44,91,,percent of total billed charges,,,159.14,95,,percent of total billed charges,,,139.04,83,,percent of total billed charges,,,139.04,83,,percent of total billed charges,,,,,,,,,,,,,,,139.04,83,,percent of total billed charges,,,159.14,95,,percent of total billed charges,,,150.77,90,,percent of total billed charges,,,150.77,90,,percent of total billed charges,,,137.37,82,,percent of total billed charges,,,150.77,90,,percent of total billed charges,,,142.39,85,,percent of total billed charges,,126.31,159.14,
SNARE LARIAT,30185092,CDM,,,270,RC,inpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,150.8,190,
SYNTHES PLATE DISTAL RADIUS 3 HOLE LEFT,30185095,CDM,,,278,RC,inpatient,,9762.68,9762.68,,8288.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7361.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8298.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8591.16,88,,percent of total billed charges,,,,,,,,,7458.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8884.04,91,,percent of total billed charges,,,9274.55,95,,percent of total billed charges,,,8103.02,83,,percent of total billed charges,,,8103.02,83,,percent of total billed charges,,,,,,,,,,,,,,,8103.02,83,,percent of total billed charges,,,9274.55,95,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8005.4,82,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8298.28,85,,percent of total billed charges,,7361.06,9274.55,
SYNTHES SCREW CORTEX TI 2.7 X 14MM,30185096,CDM,,,278,RC,inpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,323.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,364.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,323.01,406.98,
SYNTHES SCREW CORTEX TI 2.7 X 26MM,30185097,CDM,,,278,RC,inpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,323.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,364.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,323.01,406.98,
SYNTHES SCREW LOCKING VA TI 2.4 X 12MM,30185098,CDM,,,278,RC,inpatient,,1408.88,1408.88,,1196.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1062.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1197.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1239.81,88,,percent of total billed charges,,,,,,,,,1076.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1282.08,91,,percent of total billed charges,,,1338.44,95,,percent of total billed charges,,,1169.37,83,,percent of total billed charges,,,1169.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1169.37,83,,percent of total billed charges,,,1338.44,95,,percent of total billed charges,,,1267.99,90,,percent of total billed charges,,,1267.99,90,,percent of total billed charges,,,1155.28,82,,percent of total billed charges,,,1267.99,90,,percent of total billed charges,,,1197.55,85,,percent of total billed charges,,1062.3,1338.44,
SYNTHES SCREW LOCKING VA TI 2.4 X 14MM,30185099,CDM,,,278,RC,inpatient,,1408.88,1408.88,,1196.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1062.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1197.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1239.81,88,,percent of total billed charges,,,,,,,,,1076.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1282.08,91,,percent of total billed charges,,,1338.44,95,,percent of total billed charges,,,1169.37,83,,percent of total billed charges,,,1169.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1169.37,83,,percent of total billed charges,,,1338.44,95,,percent of total billed charges,,,1267.99,90,,percent of total billed charges,,,1267.99,90,,percent of total billed charges,,,1155.28,82,,percent of total billed charges,,,1267.99,90,,percent of total billed charges,,,1197.55,85,,percent of total billed charges,,1062.3,1338.44,
SYNTHES SCREW LOCKING VA TI 2.4 X 18MM,30185100,CDM,,,278,RC,inpatient,,1494.68,1494.68,,1268.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1126.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1270.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1315.32,88,,percent of total billed charges,,,,,,,,,1141.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1360.16,91,,percent of total billed charges,,,1419.95,95,,percent of total billed charges,,,1240.58,83,,percent of total billed charges,,,1240.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1240.58,83,,percent of total billed charges,,,1419.95,95,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1225.64,82,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1270.48,85,,percent of total billed charges,,1126.99,1419.95,
SYNTHES SCREW LOCKING VA TI 2.4 X 20MM,30185101,CDM,,,278,RC,inpatient,,1494.68,1494.68,,1268.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1126.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1270.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1315.32,88,,percent of total billed charges,,,,,,,,,1141.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1360.16,91,,percent of total billed charges,,,1419.95,95,,percent of total billed charges,,,1240.58,83,,percent of total billed charges,,,1240.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1240.58,83,,percent of total billed charges,,,1419.95,95,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1225.64,82,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1270.48,85,,percent of total billed charges,,1126.99,1419.95,
SYNTHES K-WIRE TI 1.25 X 150M,30185102,CDM,,,278,RC,inpatient,,1049.23,1049.23,,890.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,791.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,891.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,923.32,88,,percent of total billed charges,,,,,,,,,801.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,954.8,91,,percent of total billed charges,,,996.77,95,,percent of total billed charges,,,870.86,83,,percent of total billed charges,,,870.86,83,,percent of total billed charges,,,,,,,,,,,,,,,870.86,83,,percent of total billed charges,,,996.77,95,,percent of total billed charges,,,944.31,90,,percent of total billed charges,,,944.31,90,,percent of total billed charges,,,860.37,82,,percent of total billed charges,,,944.31,90,,percent of total billed charges,,,891.85,85,,percent of total billed charges,,791.12,996.77,
ZIMMER HEAD FEMORAL 12/14 28MM +10.5,30185103,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
CHOICE SPINE PEEK STEALTH 6MM 6DEG 14X16,30185104,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
CHOICE SPINE PLATE FOUR LEVEL 76MM,30185105,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
WRIGHT SCREW PEEK INTERFERENCE,30185106,CDM,,,278,RC,inpatient,,4641,4641,,3940.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3499.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3944.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4084.08,88,,percent of total billed charges,,,,,,,,,3545.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4223.31,91,,percent of total billed charges,,,4408.95,95,,percent of total billed charges,,,3852.03,83,,percent of total billed charges,,,3852.03,83,,percent of total billed charges,,,,,,,,,,,,,,,3852.03,83,,percent of total billed charges,,,4408.95,95,,percent of total billed charges,,,4176.9,90,,percent of total billed charges,,,4176.9,90,,percent of total billed charges,,,3805.62,82,,percent of total billed charges,,,4176.9,90,,percent of total billed charges,,,3944.85,85,,percent of total billed charges,,3499.31,4408.95,
WRIGHT SUTURE LOOP GUIDE ROD,30185107,CDM,,,278,RC,inpatient,,1631.5,1631.5,,1385.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1230.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1386.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1435.72,88,,percent of total billed charges,,,,,,,,,1246.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1484.67,91,,percent of total billed charges,,,1549.93,95,,percent of total billed charges,,,1354.15,83,,percent of total billed charges,,,1354.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1354.15,83,,percent of total billed charges,,,1549.93,95,,percent of total billed charges,,,1468.35,90,,percent of total billed charges,,,1468.35,90,,percent of total billed charges,,,1337.83,82,,percent of total billed charges,,,1468.35,90,,percent of total billed charges,,,1386.78,85,,percent of total billed charges,,1230.15,1549.93,
WRIGHT REAMER CANNULATED 5MM,30185108,CDM,,,278,RC,inpatient,,3874,3874,,3289.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2921,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3292.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3409.12,88,,percent of total billed charges,,,,,,,,,2959.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3525.34,91,,percent of total billed charges,,,3680.3,95,,percent of total billed charges,,,3215.42,83,,percent of total billed charges,,,3215.42,83,,percent of total billed charges,,,,,,,,,,,,,,,3215.42,83,,percent of total billed charges,,,3680.3,95,,percent of total billed charges,,,3486.6,90,,percent of total billed charges,,,3486.6,90,,percent of total billed charges,,,3176.68,82,,percent of total billed charges,,,3486.6,90,,percent of total billed charges,,,3292.9,85,,percent of total billed charges,,2921,3680.3,
WRIGHT K-WIRE JONES 228MM,30185109,CDM,,,278,RC,inpatient,,307.5,307.5,,261.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,231.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,261.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,270.6,88,,percent of total billed charges,,,,,,,,,234.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,279.83,91,,percent of total billed charges,,,292.13,95,,percent of total billed charges,,,255.23,83,,percent of total billed charges,,,255.23,83,,percent of total billed charges,,,,,,,,,,,,,,,255.23,83,,percent of total billed charges,,,292.13,95,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,252.15,82,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,261.38,85,,percent of total billed charges,,231.86,292.13,
WRIGHT BEAM SALVATION 7.0 X 80MM,30185110,CDM,,,278,RC,inpatient,,12987,12987,,11025.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9792.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11038.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11428.56,88,,percent of total billed charges,,,,,,,,,9922.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11818.17,91,,percent of total billed charges,,,12337.65,95,,percent of total billed charges,,,10779.21,83,,percent of total billed charges,,,10779.21,83,,percent of total billed charges,,,,,,,,,,,,,,,10779.21,83,,percent of total billed charges,,,12337.65,95,,percent of total billed charges,,,11688.3,90,,percent of total billed charges,,,11688.3,90,,percent of total billed charges,,,10649.34,82,,percent of total billed charges,,,11688.3,90,,percent of total billed charges,,,11038.95,85,,percent of total billed charges,,9792.2,12337.65,
WRIGHT DRILL BIT SALVATION 5.0MM,30185111,CDM,,,278,RC,inpatient,,2619.5,2619.5,,2223.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1975.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2226.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2305.16,88,,percent of total billed charges,,,,,,,,,2001.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2383.75,91,,percent of total billed charges,,,2488.53,95,,percent of total billed charges,,,2174.19,83,,percent of total billed charges,,,2174.19,83,,percent of total billed charges,,,,,,,,,,,,,,,2174.19,83,,percent of total billed charges,,,2488.53,95,,percent of total billed charges,,,2357.55,90,,percent of total billed charges,,,2357.55,90,,percent of total billed charges,,,2147.99,82,,percent of total billed charges,,,2357.55,90,,percent of total billed charges,,,2226.58,85,,percent of total billed charges,,1975.1,2488.53,
WRIGHT PLATE FUSION LG,30185112,CDM,,,278,RC,inpatient,,18869.5,18869.5,,16020.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14227.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16039.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16605.16,88,,percent of total billed charges,,,,,,,,,14416.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17171.25,91,,percent of total billed charges,,,17926.03,95,,percent of total billed charges,,,15661.69,83,,percent of total billed charges,,,15661.69,83,,percent of total billed charges,,,,,,,,,,,,,,,15661.69,83,,percent of total billed charges,,,17926.03,95,,percent of total billed charges,,,16982.55,90,,percent of total billed charges,,,16982.55,90,,percent of total billed charges,,,15472.99,82,,percent of total billed charges,,,16982.55,90,,percent of total billed charges,,,16039.08,85,,percent of total billed charges,,14227.6,17926.03,
WRIGHT SCREW LOCKING 3.5 X 22MM,30185113,CDM,,,278,RC,inpatient,,2385.5,2385.5,,2025.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1798.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2027.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2099.24,88,,percent of total billed charges,,,,,,,,,1822.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2170.81,91,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1979.97,83,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,1956.11,82,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,1798.67,2266.23,
WRIGHT SCREW LOCKING 3.5 X 26MM,30185114,CDM,,,278,RC,inpatient,,2385.5,2385.5,,2025.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1798.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2027.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2099.24,88,,percent of total billed charges,,,,,,,,,1822.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2170.81,91,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1979.97,83,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,1956.11,82,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,1798.67,2266.23,
WRIGHT SCREW LOCKING 3.5 X 36MM,30185115,CDM,,,278,RC,inpatient,,2385.5,2385.5,,2025.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1798.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2027.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2099.24,88,,percent of total billed charges,,,,,,,,,1822.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2170.81,91,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1979.97,83,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,1956.11,82,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,1798.67,2266.23,
WRIGHT SCREW LOCKING 3.5 X 46MM,30185116,CDM,,,278,RC,inpatient,,2385.5,2385.5,,2025.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1798.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2027.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2099.24,88,,percent of total billed charges,,,,,,,,,1822.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2170.81,91,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1979.97,83,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,1956.11,82,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,1798.67,2266.23,
WRIGHT SCREW LOW-PRO CORT 3.5 X 36MM,30185117,CDM,,,278,RC,inpatient,,1215.5,1215.5,,1031.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,916.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1033.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1069.64,88,,percent of total billed charges,,,,,,,,,928.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1106.11,91,,percent of total billed charges,,,1154.73,95,,percent of total billed charges,,,1008.87,83,,percent of total billed charges,,,1008.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1008.87,83,,percent of total billed charges,,,1154.73,95,,percent of total billed charges,,,1093.95,90,,percent of total billed charges,,,1093.95,90,,percent of total billed charges,,,996.71,82,,percent of total billed charges,,,1093.95,90,,percent of total billed charges,,,1033.18,85,,percent of total billed charges,,916.49,1154.73,
WRIGHT PIN FIXATION 1.4MM LG,30185118,CDM,,,278,RC,inpatient,,861,861,,730.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,649.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,731.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,757.68,88,,percent of total billed charges,,,,,,,,,657.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,783.51,91,,percent of total billed charges,,,817.95,95,,percent of total billed charges,,,714.63,83,,percent of total billed charges,,,714.63,83,,percent of total billed charges,,,,,,,,,,,,,,,714.63,83,,percent of total billed charges,,,817.95,95,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,706.02,82,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,731.85,85,,percent of total billed charges,,649.19,817.95,
WRIGHT DRILL BIT 2.8 X 60MM,30185119,CDM,,,278,RC,inpatient,,1774.5,1774.5,,1506.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1337.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1508.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1561.56,88,,percent of total billed charges,,,,,,,,,1355.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1614.8,91,,percent of total billed charges,,,1685.78,95,,percent of total billed charges,,,1472.84,83,,percent of total billed charges,,,1472.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1472.84,83,,percent of total billed charges,,,1685.78,95,,percent of total billed charges,,,1597.05,90,,percent of total billed charges,,,1597.05,90,,percent of total billed charges,,,1455.09,82,,percent of total billed charges,,,1597.05,90,,percent of total billed charges,,,1508.33,85,,percent of total billed charges,,1337.97,1685.78,
ARTHREX BIOCOMPOSITE SUTURETAK,30185120,CDM,,,278,RC,inpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1666.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1878.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,1666.34,2099.5,
ARTHREX SUTURE LASSO 45 LEFT,30185121,CDM,,,270,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
ACUMED BONE GRAFT DRILL ASSY. 7MM,30185122,CDM,,,270,RC,inpatient,,2801.5,2801.5,,2378.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2112.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2381.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2465.32,88,,percent of total billed charges,,,,,,,,,2140.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2549.37,91,,percent of total billed charges,,,2661.43,95,,percent of total billed charges,,,2325.25,83,,percent of total billed charges,,,2325.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2325.25,83,,percent of total billed charges,,,2661.43,95,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2297.23,82,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2381.28,85,,percent of total billed charges,,2112.33,2661.43,
ACUMED GRAFT REMOVAL PADDLE ASSY. 6MM,30185123,CDM,,,270,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
WRAP LARGE ARM SUPPORT,30185124,CDM,,,270,RC,inpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,197.93,249.38,
ZIMMER LINER DUAL MOBILITY G7 40MM D,30185126,CDM,,,278,RC,inpatient,,9912.5,9912.5,,8415.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7474.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8425.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8723,88,,percent of total billed charges,,,,,,,,,7573.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9020.38,91,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,,,,,,,,,,,,,8227.38,83,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8128.25,82,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,7474.03,9416.88,
ZIMMER BEARING HIP ACT ARTIC 28X40MM,30185127,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
ZIMMER SHELL OSSEOTI G7 50MM D 3 HOLE,30185128,CDM,,,278,RC,inpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14580.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16436.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,14580.48,18370.63,
WRIGHT HEAD FEMORAL 36MM 12/14,30185129,CDM,,,278,RC,inpatient,,39065,39065,,33166.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29455.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33205.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34377.2,88,,percent of total billed charges,,,,,,,,,29845.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35549.15,91,,percent of total billed charges,,,37111.75,95,,percent of total billed charges,,,32423.95,83,,percent of total billed charges,,,32423.95,83,,percent of total billed charges,,,,,,,,,,,,,,,32423.95,83,,percent of total billed charges,,,37111.75,95,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,32033.3,82,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,33205.25,85,,percent of total billed charges,,29455.01,37111.75,
WRIGHT NECK MODULAR LONG/STRAIGHT 12/14,30185130,CDM,,,278,RC,inpatient,,28964,28964,,24590.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21838.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24619.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25488.32,88,,percent of total billed charges,,,,,,,,,22128.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26357.24,91,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,,,,,,,,,,,,,24040.12,83,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,23750.48,82,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,24619.4,85,,percent of total billed charges,,21838.86,27515.8,
ZIMMER SHELL OSSEOTI G7 58MM G,30185131,CDM,,,278,RC,inpatient,,42640,42640,,36201.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32150.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36244,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37523.2,88,,percent of total billed charges,,,,,,,,,32576.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38802.4,91,,percent of total billed charges,,,40508,95,,percent of total billed charges,,,35391.2,83,,percent of total billed charges,,,35391.2,83,,percent of total billed charges,,,,,,,,,,,,,,,35391.2,83,,percent of total billed charges,,,40508,95,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,34964.8,82,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,36244,85,,percent of total billed charges,,32150.56,40508,
ZIMMER LINER DUAL MOBILITY G7 46MM G,30185132,CDM,,,278,RC,inpatient,,9912.5,9912.5,,8415.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7474.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8425.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8723,88,,percent of total billed charges,,,,,,,,,7573.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9020.38,91,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,,,,,,,,,,,,,8227.38,83,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8128.25,82,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,7474.03,9416.88,
ZIMMER BEARING HIP ACT ARTIC 28X46MM,30185133,CDM,,,278,RC,inpatient,,23400,23400,,19866.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17643.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19890,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20592,88,,percent of total billed charges,,,,,,,,,17877.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21294,91,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,,,,,,,,,,,,,19422,83,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19188,82,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19890,85,,percent of total billed charges,,17643.6,22230,
BONE MILL DISPOSABLE - MEDIUM,30185134,CDM,,,270,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
CAGE STALIF C-T 16 X 5.5MM,30185135,CDM,,,278,RC,inpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14703,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16575,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,14703,18525,
CTL SPACER CORTICAL CERVICAL 5MM,30185136,CDM,,,278,RC,inpatient,,12231.38,12231.38,,10384.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9222.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10396.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10763.61,88,,percent of total billed charges,,,,,,,,,9344.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11130.56,91,,percent of total billed charges,,,11619.81,95,,percent of total billed charges,,,10152.05,83,,percent of total billed charges,,,10152.05,83,,percent of total billed charges,,,,,,,,,,,,,,,10152.05,83,,percent of total billed charges,,,11619.81,95,,percent of total billed charges,,,11008.24,90,,percent of total billed charges,,,11008.24,90,,percent of total billed charges,,,10029.73,82,,percent of total billed charges,,,11008.24,90,,percent of total billed charges,,,10396.67,85,,percent of total billed charges,,9222.46,11619.81,
CTL PLATE VANGOGH CERVICAL 12MM,30185137,CDM,,,278,RC,inpatient,,8957,8957,,7604.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6753.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7613.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7882.16,88,,percent of total billed charges,,,,,,,,,6843.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8150.87,91,,percent of total billed charges,,,8509.15,95,,percent of total billed charges,,,7434.31,83,,percent of total billed charges,,,7434.31,83,,percent of total billed charges,,,,,,,,,,,,,,,7434.31,83,,percent of total billed charges,,,8509.15,95,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,7344.74,82,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,7613.45,85,,percent of total billed charges,,6753.58,8509.15,
CTL SCREW ST VARIABLE 4.0 X 14,30185138,CDM,,,278,RC,inpatient,,1521,1521,,1291.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1146.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1292.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1338.48,88,,percent of total billed charges,,,,,,,,,1162.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1384.11,91,,percent of total billed charges,,,1444.95,95,,percent of total billed charges,,,1262.43,83,,percent of total billed charges,,,1262.43,83,,percent of total billed charges,,,,,,,,,,,,,,,1262.43,83,,percent of total billed charges,,,1444.95,95,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1247.22,82,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1292.85,85,,percent of total billed charges,,1146.83,1444.95,
CTL SCREW PICASSO II 6.5 X 50,30185139,CDM,,,278,RC,inpatient,,11137.1,11137.1,,9455.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8397.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9466.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9800.65,88,,percent of total billed charges,,,,,,,,,8508.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10134.76,91,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9243.79,83,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9132.42,82,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,8397.37,10580.25,
CTL ROD MIS 95MM,30185140,CDM,,,278,RC,inpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1669.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1881.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,1669.28,2103.21,
CTL ROD MIS 90MM,30185141,CDM,,,278,RC,inpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1669.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1881.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,1669.28,2103.21,
ZIMMER SCREW BONE ST 6.5 X 35MM,30185142,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
ZIMMER HEAD FEMORAL BIOLOX DELTA 28MM +3,30185143,CDM,,,278,RC,inpatient,,18525,18525,,15727.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13967.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15746.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16302,88,,percent of total billed charges,,,,,,,,,14153.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16857.75,91,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,,,,,,,,,,,,,15375.75,83,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15190.5,82,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15746.25,85,,percent of total billed charges,,13967.85,17598.75,
ZIMMER INSERT BEARING SZ 3 MD RT,30185144,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
CORTICAL STRUT 2.0 X 18CM FROZEN,30185145,CDM,,,278,RC,inpatient,,4062.5,4062.5,,3449.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3063.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3453.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3575,88,,percent of total billed charges,,,,,,,,,3103.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3696.88,91,,percent of total billed charges,,,3859.38,95,,percent of total billed charges,,,3371.88,83,,percent of total billed charges,,,3371.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3371.88,83,,percent of total billed charges,,,3859.38,95,,percent of total billed charges,,,3656.25,90,,percent of total billed charges,,,3656.25,90,,percent of total billed charges,,,3331.25,82,,percent of total billed charges,,,3656.25,90,,percent of total billed charges,,,3453.13,85,,percent of total billed charges,,3063.13,3859.38,
STRYKER BUR 3.0MM MATCH HEAD,30185146,CDM,,,270,RC,inpatient,,1312.42,1312.42,,1114.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,989.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1115.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1154.93,88,,percent of total billed charges,,,,,,,,,1002.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1194.3,91,,percent of total billed charges,,,1246.8,95,,percent of total billed charges,,,1089.31,83,,percent of total billed charges,,,1089.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1089.31,83,,percent of total billed charges,,,1246.8,95,,percent of total billed charges,,,1181.18,90,,percent of total billed charges,,,1181.18,90,,percent of total billed charges,,,1076.18,82,,percent of total billed charges,,,1181.18,90,,percent of total billed charges,,,1115.56,85,,percent of total billed charges,,989.56,1246.8,
CHOICE SPINE PLATE 1-LEVEL 12MM,30185148,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
CHOICE SPINE SCREW 4.0 X 14MM,30185149,CDM,,,278,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
CHOICE SPINE DRILL 2.7MM X 12MM,30185150,CDM,,,278,RC,inpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1666.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1878.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,1666.34,2099.5,
S&N TIBIAL GNS II CMT SZ 6 LEFT,30185151,CDM,,,278,RC,inpatient,,14573,14573,,12372.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10988.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12387.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12824.24,88,,percent of total billed charges,,,,,,,,,11133.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13261.43,91,,percent of total billed charges,,,13844.35,95,,percent of total billed charges,,,12095.59,83,,percent of total billed charges,,,12095.59,83,,percent of total billed charges,,,,,,,,,,,,,,,12095.59,83,,percent of total billed charges,,,13844.35,95,,percent of total billed charges,,,13115.7,90,,percent of total billed charges,,,13115.7,90,,percent of total billed charges,,,11949.86,82,,percent of total billed charges,,,13115.7,90,,percent of total billed charges,,,12387.05,85,,percent of total billed charges,,10988.04,13844.35,
S&N FEMUR LEGION PS OXIN SZ 7 LEFT,30185152,CDM,,,278,RC,inpatient,,30396.28,30396.28,,25806.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22918.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25836.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26748.73,88,,percent of total billed charges,,,,,,,,,23222.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27660.61,91,,percent of total billed charges,,,28876.47,95,,percent of total billed charges,,,25228.91,83,,percent of total billed charges,,,25228.91,83,,percent of total billed charges,,,,,,,,,,,,,,,25228.91,83,,percent of total billed charges,,,28876.47,95,,percent of total billed charges,,,27356.65,90,,percent of total billed charges,,,27356.65,90,,percent of total billed charges,,,24924.95,82,,percent of total billed charges,,,27356.65,90,,percent of total billed charges,,,25836.84,85,,percent of total billed charges,,22918.8,28876.47,
DEPUY BASE TIBIAL MOD SZ 5,30185153,CDM,,,278,RC,inpatient,,25954.31,25954.31,,22035.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19569.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22061.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22839.79,88,,percent of total billed charges,,,,,,,,,19829.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23618.42,91,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,,,,,,,,,,,,,21542.08,83,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,21282.53,82,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,19569.55,24656.59,
DEPUY ATTUNE TIBIA REVISION FB SZ 6,30185154,CDM,,,278,RC,inpatient,,25954.31,25954.31,,22035.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19569.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22061.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22839.79,88,,percent of total billed charges,,,,,,,,,19829.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23618.42,91,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,,,,,,,,,,,,,21542.08,83,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,21282.53,82,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,19569.55,24656.59,
DEPUY STEM CEMENTED 14 X 50,30185155,CDM,,,278,RC,inpatient,,8336.19,8336.19,,7077.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6285.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7085.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7335.85,88,,percent of total billed charges,,,,,,,,,6368.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7585.93,91,,percent of total billed charges,,,7919.38,95,,percent of total billed charges,,,6919.04,83,,percent of total billed charges,,,6919.04,83,,percent of total billed charges,,,,,,,,,,,,,,,6919.04,83,,percent of total billed charges,,,7919.38,95,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,6835.68,82,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,7085.76,85,,percent of total billed charges,,6285.49,7919.38,
SYNTHES BLADE HELICAL TFNA 105MM,30185156,CDM,,,278,RC,inpatient,,6630,6630,,5628.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4999.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5635.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5834.4,88,,percent of total billed charges,,,,,,,,,5065.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6033.3,91,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,,,,,,,,,,,,,5502.9,83,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5436.6,82,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,4999.02,6298.5,
VTI INTERFUSE S 9MM X 20MM 0DEG,30185157,CDM,,,278,RC,inpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29406,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33150,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,29406,37050,
MENTOR MEMORYGEL BREAST SMOOTH 480CC,30185158,CDM,,,278,RC,inpatient,,6532.5,6532.5,,5546.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4925.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5552.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5748.6,88,,percent of total billed charges,,,,,,,,,4990.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5944.58,91,,percent of total billed charges,,,6205.88,95,,percent of total billed charges,,,5421.98,83,,percent of total billed charges,,,5421.98,83,,percent of total billed charges,,,,,,,,,,,,,,,5421.98,83,,percent of total billed charges,,,6205.88,95,,percent of total billed charges,,,5879.25,90,,percent of total billed charges,,,5879.25,90,,percent of total billed charges,,,5356.65,82,,percent of total billed charges,,,5879.25,90,,percent of total billed charges,,,5552.63,85,,percent of total billed charges,,4925.51,6205.88,
CAGE STALIF C-TI 12X5.5 TAPERED,30185159,CDM,,,278,RC,inpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14703,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16575,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,14703,18525,
CTL ROD MIS 6.0 X 65MM,30185161,CDM,,,278,RC,inpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1669.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1881.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,1669.28,2103.21,
ZIMMER BEARING RT LG SZ 5,30185162,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
CTL SCREW PICASSO II MIS 7.5 X 45,30185163,CDM,,,278,RC,inpatient,,11137.1,11137.1,,9455.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8397.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9466.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9800.65,88,,percent of total billed charges,,,,,,,,,8508.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10134.76,91,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9243.79,83,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9132.42,82,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,8397.37,10580.25,
SYNTHES TFNA 11 X 170 125DEG,30185164,CDM,,,278,RC,inpatient,,15099.83,15099.83,,12819.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11385.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12834.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13287.85,88,,percent of total billed charges,,,,,,,,,11536.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13740.85,91,,percent of total billed charges,,,14344.84,95,,percent of total billed charges,,,12532.86,83,,percent of total billed charges,,,12532.86,83,,percent of total billed charges,,,,,,,,,,,,,,,12532.86,83,,percent of total billed charges,,,14344.84,95,,percent of total billed charges,,,13589.85,90,,percent of total billed charges,,,13589.85,90,,percent of total billed charges,,,12381.86,82,,percent of total billed charges,,,13589.85,90,,percent of total billed charges,,,12834.86,85,,percent of total billed charges,,11385.27,14344.84,
SYNTHES SCREW LOCKING 5.0MM X 40MM,30185165,CDM,,,278,RC,inpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1697.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1913.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,1697.12,2138.28,
SYNTHES GUIDEWIRE 3.2,30185166,CDM,,,270,RC,inpatient,,1121.58,1121.58,,952.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,845.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,953.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,986.99,88,,percent of total billed charges,,,,,,,,,856.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1020.64,91,,percent of total billed charges,,,1065.5,95,,percent of total billed charges,,,930.91,83,,percent of total billed charges,,,930.91,83,,percent of total billed charges,,,,,,,,,,,,,,,930.91,83,,percent of total billed charges,,,1065.5,95,,percent of total billed charges,,,1009.42,90,,percent of total billed charges,,,1009.42,90,,percent of total billed charges,,,919.7,82,,percent of total billed charges,,,1009.42,90,,percent of total billed charges,,,953.34,85,,percent of total billed charges,,845.67,1065.5,
ROD LORDOSED 80MM,30185167,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
VTI INTERFUSE S 10MM 0DEG,30185168,CDM,,,278,RC,inpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29406,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33150,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,29406,37050,
DEPUY BASE TIBIAL MOD SZ 4,30185169,CDM,,,278,RC,inpatient,,25954.31,25954.31,,22035.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19569.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22061.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22839.79,88,,percent of total billed charges,,,,,,,,,19829.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23618.42,91,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,,,,,,,,,,,,,21542.08,83,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,21282.53,82,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,19569.55,24656.59,
CTL SPACER CORTICAL CERVICAL 6MM,30185170,CDM,,,278,RC,inpatient,,12231.38,12231.38,,10384.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9222.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10396.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10763.61,88,,percent of total billed charges,,,,,,,,,9344.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11130.56,91,,percent of total billed charges,,,11619.81,95,,percent of total billed charges,,,10152.05,83,,percent of total billed charges,,,10152.05,83,,percent of total billed charges,,,,,,,,,,,,,,,10152.05,83,,percent of total billed charges,,,11619.81,95,,percent of total billed charges,,,11008.24,90,,percent of total billed charges,,,11008.24,90,,percent of total billed charges,,,10029.73,82,,percent of total billed charges,,,11008.24,90,,percent of total billed charges,,,10396.67,85,,percent of total billed charges,,9222.46,11619.81,
CTL SCREW ST VARIABLE 4.0 X 12,30185171,CDM,,,278,RC,inpatient,,1521,1521,,1291.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1146.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1292.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1338.48,88,,percent of total billed charges,,,,,,,,,1162.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1384.11,91,,percent of total billed charges,,,1444.95,95,,percent of total billed charges,,,1262.43,83,,percent of total billed charges,,,1262.43,83,,percent of total billed charges,,,,,,,,,,,,,,,1262.43,83,,percent of total billed charges,,,1444.95,95,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1247.22,82,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1292.85,85,,percent of total billed charges,,1146.83,1444.95,
CTL DRILL BIT 10MM,30185172,CDM,,,278,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
V-LOC REVERSE CUTTING 1/2 CIRCLE 37MM GS,30185173,CDM,,,270,RC,inpatient,,211.28,211.28,,179.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,179.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,185.93,88,,percent of total billed charges,,,,,,,,,161.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.26,91,,percent of total billed charges,,,200.72,95,,percent of total billed charges,,,175.36,83,,percent of total billed charges,,,175.36,83,,percent of total billed charges,,,,,,,,,,,,,,,175.36,83,,percent of total billed charges,,,200.72,95,,percent of total billed charges,,,190.15,90,,percent of total billed charges,,,190.15,90,,percent of total billed charges,,,173.25,82,,percent of total billed charges,,,190.15,90,,percent of total billed charges,,,179.59,85,,percent of total billed charges,,159.31,200.72,
ZIMMER HEAD BIOLOX 28MM + 7MM,30185174,CDM,,,278,RC,inpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17447.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19669,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,17447.56,21983,
ZIMMER SCREW BONE ST 6.5 X 20MM,30185175,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
WRIGHT NECK MODULAR SHORT 12/14,30185176,CDM,,,278,RC,inpatient,,28964,28964,,24590.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21838.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24619.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25488.32,88,,percent of total billed charges,,,,,,,,,22128.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26357.24,91,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,,,,,,,,,,,,,24040.12,83,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,23750.48,82,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,24619.4,85,,percent of total billed charges,,21838.86,27515.8,
ARTHREX SCREW ANCHOR 4.5 X 14MM CORKSCRE,30185177,CDM,,,270,RC,inpatient,,1495,1495,,1269.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1127.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1270.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1315.6,88,,percent of total billed charges,,,,,,,,,1142.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1360.45,91,,percent of total billed charges,,,1420.25,95,,percent of total billed charges,,,1240.85,83,,percent of total billed charges,,,1240.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1240.85,83,,percent of total billed charges,,,1420.25,95,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1225.9,82,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1270.75,85,,percent of total billed charges,,1127.23,1420.25,
CHOICE SPINE PLATE 1-LEVEL 16MM,30185178,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
KYPHON FIRST FRACTURE KIT,30185179,CDM,,,278,RC,inpatient,,24888.5,24888.5,,21130.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18765.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21155.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21901.88,88,,percent of total billed charges,,,,,,,,,19014.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22648.54,91,,percent of total billed charges,,,23644.08,95,,percent of total billed charges,,,20657.46,83,,percent of total billed charges,,,20657.46,83,,percent of total billed charges,,,,,,,,,,,,,,,20657.46,83,,percent of total billed charges,,,23644.08,95,,percent of total billed charges,,,22399.65,90,,percent of total billed charges,,,22399.65,90,,percent of total billed charges,,,20408.57,82,,percent of total billed charges,,,22399.65,90,,percent of total billed charges,,,21155.23,85,,percent of total billed charges,,18765.93,23644.08,
KYPHON HVR CEMENT,30185180,CDM,,,278,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
SYNTHES SCREW LOCKING 5.0MM X 30MM,30185181,CDM,,,278,RC,inpatient,,2121.6,2121.6,,1801.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1599.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1803.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1867.01,88,,percent of total billed charges,,,,,,,,,1620.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1930.66,91,,percent of total billed charges,,,2015.52,95,,percent of total billed charges,,,1760.93,83,,percent of total billed charges,,,1760.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1760.93,83,,percent of total billed charges,,,2015.52,95,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1739.71,82,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1803.36,85,,percent of total billed charges,,1599.69,2015.52,
NOVADAQ KIT,30185182,CDM,,,270,RC,inpatient,,991.25,991.25,,841.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,747.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,842.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,872.3,88,,percent of total billed charges,,,,,,,,,757.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,902.04,91,,percent of total billed charges,,,941.69,95,,percent of total billed charges,,,822.74,83,,percent of total billed charges,,,822.74,83,,percent of total billed charges,,,,,,,,,,,,,,,822.74,83,,percent of total billed charges,,,941.69,95,,percent of total billed charges,,,892.13,90,,percent of total billed charges,,,892.13,90,,percent of total billed charges,,,812.83,82,,percent of total billed charges,,,892.13,90,,percent of total billed charges,,,842.56,85,,percent of total billed charges,,747.4,941.69,
CHOICE SPINE PLATE 1-LEVEL 14MM,30185183,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
CHOICE SPINE PEEK STEALTH 6MM 6DEG 12X14,30185184,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
TUBE GASTROSTOMY MOSS 18FR,30185185,CDM,,,270,RC,inpatient,,1657.5,1657.5,,1407.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1249.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1408.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1458.6,88,,percent of total billed charges,,,,,,,,,1266.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1508.33,91,,percent of total billed charges,,,1574.63,95,,percent of total billed charges,,,1375.73,83,,percent of total billed charges,,,1375.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1375.73,83,,percent of total billed charges,,,1574.63,95,,percent of total billed charges,,,1491.75,90,,percent of total billed charges,,,1491.75,90,,percent of total billed charges,,,1359.15,82,,percent of total billed charges,,,1491.75,90,,percent of total billed charges,,,1408.88,85,,percent of total billed charges,,1249.76,1574.63,
ALLOSOURCE- ACHILLES TENDON PRE-SHAPED,30185186,CDM,,,278,RC,inpatient,,18232.5,18232.5,,15479.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13747.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15497.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16044.6,88,,percent of total billed charges,,,,,,,,,13929.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16591.58,91,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15132.98,83,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,14950.65,82,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,13747.31,17320.88,
ARTHREX RF APOLLO MULTIPORT 90,30185187,CDM,,,270,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
DEPUY SLEEVE FEMORAL 20MM,30185188,CDM,,,278,RC,inpatient,,12552.61,12552.61,,10657.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9464.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10669.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11046.3,88,,percent of total billed charges,,,,,,,,,9590.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11422.88,91,,percent of total billed charges,,,11924.98,95,,percent of total billed charges,,,10418.67,83,,percent of total billed charges,,,10418.67,83,,percent of total billed charges,,,,,,,,,,,,,,,10418.67,83,,percent of total billed charges,,,11924.98,95,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,10293.14,82,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,10669.72,85,,percent of total billed charges,,9464.67,11924.98,
DEPUY STEM FLUTED UNIV 115 X 22,30185189,CDM,,,278,RC,inpatient,,9024.34,9024.34,,7661.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6804.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7670.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7941.42,88,,percent of total billed charges,,,,,,,,,6894.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8212.15,91,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,,,,,,,,,,,,,7490.2,83,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7399.96,82,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,6804.35,8573.12,
ALPHATEC SCREW MIS 6.5 X 50MM,30185190,CDM,,,278,RC,inpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7694.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8674.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,7694.57,9694.75,
ALPHATEC ROD MIS COCR 45MM,30185191,CDM,,,278,RC,inpatient,,3243.5,3243.5,,2753.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2445.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2756.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2854.28,88,,percent of total billed charges,,,,,,,,,2478.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2951.59,91,,percent of total billed charges,,,3081.33,95,,percent of total billed charges,,,2692.11,83,,percent of total billed charges,,,2692.11,83,,percent of total billed charges,,,,,,,,,,,,,,,2692.11,83,,percent of total billed charges,,,3081.33,95,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2659.67,82,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2756.98,85,,percent of total billed charges,,2445.6,3081.33,
ALPHATEC SCREW SET,30185192,CDM,,,278,RC,inpatient,,1358.5,1358.5,,1153.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1024.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1154.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1195.48,88,,percent of total billed charges,,,,,,,,,1037.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1236.24,91,,percent of total billed charges,,,1290.58,95,,percent of total billed charges,,,1127.56,83,,percent of total billed charges,,,1127.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1127.56,83,,percent of total billed charges,,,1290.58,95,,percent of total billed charges,,,1222.65,90,,percent of total billed charges,,,1222.65,90,,percent of total billed charges,,,1113.97,82,,percent of total billed charges,,,1222.65,90,,percent of total billed charges,,,1154.73,85,,percent of total billed charges,,1024.31,1290.58,
ALPHATEC JAMSHIDI TARGET NEEDLE,30185193,CDM,,,270,RC,inpatient,,777,777,,659.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,585.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,660.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,683.76,88,,percent of total billed charges,,,,,,,,,593.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,707.07,91,,percent of total billed charges,,,738.15,95,,percent of total billed charges,,,644.91,83,,percent of total billed charges,,,644.91,83,,percent of total billed charges,,,,,,,,,,,,,,,644.91,83,,percent of total billed charges,,,738.15,95,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,637.14,82,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,660.45,85,,percent of total billed charges,,585.86,738.15,
ALPHATEC GUIDE WIRE,30185194,CDM,,,270,RC,inpatient,,455,455,,386.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,343.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,386.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,400.4,88,,percent of total billed charges,,,,,,,,,347.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,414.05,91,,percent of total billed charges,,,432.25,95,,percent of total billed charges,,,377.65,83,,percent of total billed charges,,,377.65,83,,percent of total billed charges,,,,,,,,,,,,,,,377.65,83,,percent of total billed charges,,,432.25,95,,percent of total billed charges,,,409.5,90,,percent of total billed charges,,,409.5,90,,percent of total billed charges,,,373.1,82,,percent of total billed charges,,,409.5,90,,percent of total billed charges,,,386.75,85,,percent of total billed charges,,343.07,432.25,
CHOICE SPINE PLATE 3-LEVEL 50MM,30185196,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
CHOICE SPINE CAGE 8MM 6DEG 12X14,30185197,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
SYNTHES GUIDEWIRE 2.0MM 150MM,30185198,CDM,,,278,RC,inpatient,,111.82,111.82,,94.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,95.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.4,88,,percent of total billed charges,,,,,,,,,85.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.76,91,,percent of total billed charges,,,106.23,95,,percent of total billed charges,,,92.81,83,,percent of total billed charges,,,92.81,83,,percent of total billed charges,,,,,,,,,,,,,,,92.81,83,,percent of total billed charges,,,106.23,95,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,91.69,82,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,95.05,85,,percent of total billed charges,,84.31,106.23,
S&N UC HIP ACCESS TRAY,30185199,CDM,,,270,RC,inpatient,,4550,4550,,3862.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3430.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3867.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4004,88,,percent of total billed charges,,,,,,,,,3476.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4140.5,91,,percent of total billed charges,,,4322.5,95,,percent of total billed charges,,,3776.5,83,,percent of total billed charges,,,3776.5,83,,percent of total billed charges,,,,,,,,,,,,,,,3776.5,83,,percent of total billed charges,,,4322.5,95,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,3731,82,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,3867.5,85,,percent of total billed charges,,3430.7,4322.5,
MYOSURE LITE,30185200,CDM,,,270,RC,inpatient,,3559.83,3559.83,,3022.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2684.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3025.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3132.65,88,,percent of total billed charges,,,,,,,,,2719.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3239.45,91,,percent of total billed charges,,,3381.84,95,,percent of total billed charges,,,2954.66,83,,percent of total billed charges,,,2954.66,83,,percent of total billed charges,,,,,,,,,,,,,,,2954.66,83,,percent of total billed charges,,,3381.84,95,,percent of total billed charges,,,3203.85,90,,percent of total billed charges,,,3203.85,90,,percent of total billed charges,,,2919.06,82,,percent of total billed charges,,,3203.85,90,,percent of total billed charges,,,3025.86,85,,percent of total billed charges,,2684.11,3381.84,
DEPUY STEM FLUTED UNIV 115 X 18,30185201,CDM,,,278,RC,inpatient,,9024.34,9024.34,,7661.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6804.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7670.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7941.42,88,,percent of total billed charges,,,,,,,,,6894.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8212.15,91,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,,,,,,,,,,,,,7490.2,83,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7399.96,82,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,6804.35,8573.12,
DEPUY DISTAL AUGMENT 16MM,30185202,CDM,,,278,RC,inpatient,,6245.14,6245.14,,5302.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4708.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5308.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5495.72,88,,percent of total billed charges,,,,,,,,,4771.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5683.08,91,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,,,,,,,,,,,,,5183.47,83,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5121.01,82,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,4708.84,5932.88,
VTI INTERFUSE S INTERVERTEBRAL BODY DEVI,30185203,CDM,,,278,RC,inpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29406,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33150,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,29406,37050,
SCREW REDUCTION 6.5 X 40MM,30185204,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
REVEAL DISTAL ATTACHMENT CAP 13.4MM,30185205,CDM,,,270,RC,inpatient,,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,114.61,144.4,
ZIMMER SHELL OSSEOTI G7 52MM E,30185206,CDM,,,278,RC,inpatient,,20962.5,20962.5,,17797.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15805.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17818.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18447,88,,percent of total billed charges,,,,,,,,,16015.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19075.88,91,,percent of total billed charges,,,19914.38,95,,percent of total billed charges,,,17398.88,83,,percent of total billed charges,,,17398.88,83,,percent of total billed charges,,,,,,,,,,,,,,,17398.88,83,,percent of total billed charges,,,19914.38,95,,percent of total billed charges,,,18866.25,90,,percent of total billed charges,,,18866.25,90,,percent of total billed charges,,,17189.25,82,,percent of total billed charges,,,18866.25,90,,percent of total billed charges,,,17818.13,85,,percent of total billed charges,,15805.73,19914.38,
ZIMMER LINER DUAL MOBILITY G7 42MM E,30185207,CDM,,,278,RC,inpatient,,9912.5,9912.5,,8415.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7474.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8425.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8723,88,,percent of total billed charges,,,,,,,,,7573.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9020.38,91,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,,,,,,,,,,,,,8227.38,83,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8128.25,82,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,7474.03,9416.88,
ZIMMER BEARING HIP ACT ARTIC 28X42MM,30185208,CDM,,,278,RC,inpatient,,23400,23400,,19866.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17643.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19890,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20592,88,,percent of total billed charges,,,,,,,,,17877.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21294,91,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,,,,,,,,,,,,,19422,83,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19188,82,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19890,85,,percent of total billed charges,,17643.6,22230,
MYOSURE XL,30185209,CDM,,,270,RC,inpatient,,10829,10829,,9193.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8165.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9204.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9529.52,88,,percent of total billed charges,,,,,,,,,8273.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9854.39,91,,percent of total billed charges,,,10287.55,95,,percent of total billed charges,,,8988.07,83,,percent of total billed charges,,,8988.07,83,,percent of total billed charges,,,,,,,,,,,,,,,8988.07,83,,percent of total billed charges,,,10287.55,95,,percent of total billed charges,,,9746.1,90,,percent of total billed charges,,,9746.1,90,,percent of total billed charges,,,8879.78,82,,percent of total billed charges,,,9746.1,90,,percent of total billed charges,,,9204.65,85,,percent of total billed charges,,8165.07,10287.55,
STRYKER BUR ROUND DIAMOND 4.0MM,30185210,CDM,,,270,RC,inpatient,,940.16,940.16,,798.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,708.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,799.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,827.34,88,,percent of total billed charges,,,,,,,,,718.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,855.55,91,,percent of total billed charges,,,893.15,95,,percent of total billed charges,,,780.33,83,,percent of total billed charges,,,780.33,83,,percent of total billed charges,,,,,,,,,,,,,,,780.33,83,,percent of total billed charges,,,893.15,95,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,770.93,82,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,799.14,85,,percent of total billed charges,,708.88,893.15,
STEERING KIT ENHANCED W/STYLET CAP 70CM,30185212,CDM,,,270,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
CLIK ANCHOR HEX WRENCH 7.6CM,30185213,CDM,,,270,RC,inpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,226.2,285,
BOSTON INTRODUCER,30185214,CDM,,,270,RC,inpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,226.2,285,
DEPUY LINER ALTRX +4 10DEG 32X56,30185216,CDM,,,278,RC,inpatient,,11495.12,11495.12,,9759.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8667.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9770.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10115.71,88,,percent of total billed charges,,,,,,,,,8782.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10460.56,91,,percent of total billed charges,,,10920.36,95,,percent of total billed charges,,,9540.95,83,,percent of total billed charges,,,9540.95,83,,percent of total billed charges,,,,,,,,,,,,,,,9540.95,83,,percent of total billed charges,,,10920.36,95,,percent of total billed charges,,,10345.61,90,,percent of total billed charges,,,10345.61,90,,percent of total billed charges,,,9426,82,,percent of total billed charges,,,10345.61,90,,percent of total billed charges,,,9770.85,85,,percent of total billed charges,,8667.32,10920.36,
SYNTHES SCREW CORTICAL 2.7 X 14,30185217,CDM,,,278,RC,inpatient,,386.75,386.75,,328.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.34,88,,percent of total billed charges,,,,,,,,,295.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.94,91,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,321,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,,,,,,,,,,,,,,321,83,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,317.14,82,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,291.61,367.41,
SYNTHES GUIDEWIRE 1.0,30185218,CDM,,,270,RC,inpatient,,111.82,111.82,,94.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,95.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.4,88,,percent of total billed charges,,,,,,,,,85.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.76,91,,percent of total billed charges,,,106.23,95,,percent of total billed charges,,,92.81,83,,percent of total billed charges,,,92.81,83,,percent of total billed charges,,,,,,,,,,,,,,,92.81,83,,percent of total billed charges,,,106.23,95,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,91.69,82,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,95.05,85,,percent of total billed charges,,84.31,106.23,
SYNTHES K-WIRE .045MM,30185219,CDM,,,270,RC,inpatient,,91.84,91.84,,77.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,69.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,78.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.82,88,,percent of total billed charges,,,,,,,,,70.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,83.57,91,,percent of total billed charges,,,87.25,95,,percent of total billed charges,,,76.23,83,,percent of total billed charges,,,76.23,83,,percent of total billed charges,,,,,,,,,,,,,,,76.23,83,,percent of total billed charges,,,87.25,95,,percent of total billed charges,,,82.66,90,,percent of total billed charges,,,82.66,90,,percent of total billed charges,,,75.31,82,,percent of total billed charges,,,82.66,90,,percent of total billed charges,,,78.06,85,,percent of total billed charges,,69.25,87.25,
CARSON PERINEAL POST PAD,30185220,CDM,,,270,RC,inpatient,,483,483,,410.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,364.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,410.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,425.04,88,,percent of total billed charges,,,,,,,,,369.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,439.53,91,,percent of total billed charges,,,458.85,95,,percent of total billed charges,,,400.89,83,,percent of total billed charges,,,400.89,83,,percent of total billed charges,,,,,,,,,,,,,,,400.89,83,,percent of total billed charges,,,458.85,95,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,396.06,82,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,410.55,85,,percent of total billed charges,,364.18,458.85,
ZIMMER SHELL OSSEOTI G7 56MM F,30185221,CDM,,,278,RC,inpatient,,43940,43940,,37305.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33130.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37349,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38667.2,88,,percent of total billed charges,,,,,,,,,33570.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,39985.4,91,,percent of total billed charges,,,41743,95,,percent of total billed charges,,,36470.2,83,,percent of total billed charges,,,36470.2,83,,percent of total billed charges,,,,,,,,,,,,,,,36470.2,83,,percent of total billed charges,,,41743,95,,percent of total billed charges,,,39546,90,,percent of total billed charges,,,39546,90,,percent of total billed charges,,,36030.8,82,,percent of total billed charges,,,39546,90,,percent of total billed charges,,,37349,85,,percent of total billed charges,,33130.76,41743,
SYNTHES DRILL BIT 1.8MM,30185222,CDM,,,270,RC,inpatient,,1514.5,1514.5,,1285.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1141.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1287.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1332.76,88,,percent of total billed charges,,,,,,,,,1157.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1378.2,91,,percent of total billed charges,,,1438.78,95,,percent of total billed charges,,,1257.04,83,,percent of total billed charges,,,1257.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1257.04,83,,percent of total billed charges,,,1438.78,95,,percent of total billed charges,,,1363.05,90,,percent of total billed charges,,,1363.05,90,,percent of total billed charges,,,1241.89,82,,percent of total billed charges,,,1363.05,90,,percent of total billed charges,,,1287.33,85,,percent of total billed charges,,1141.93,1438.78,
DEPUY STEM CENTRALIZER 11MM,30185223,CDM,,,278,RC,inpatient,,904.8,904.8,,768.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,682.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,769.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,796.22,88,,percent of total billed charges,,,,,,,,,691.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,823.37,91,,percent of total billed charges,,,859.56,95,,percent of total billed charges,,,750.98,83,,percent of total billed charges,,,750.98,83,,percent of total billed charges,,,,,,,,,,,,,,,750.98,83,,percent of total billed charges,,,859.56,95,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,741.94,82,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,769.08,85,,percent of total billed charges,,682.22,859.56,
SYNTHES SCREW CANNULATED ST 4 X 40MM,30185227,CDM,,,278,RC,inpatient,,2063.23,2063.23,,1751.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1555.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1753.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1815.64,88,,percent of total billed charges,,,,,,,,,1576.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1877.54,91,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1712.48,83,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1691.85,82,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,1555.68,1960.07,
CTL SPACER CERVICAL CORTICAL 7MM,30185228,CDM,,,278,RC,inpatient,,10725,10725,,9105.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8086.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9116.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9438,88,,percent of total billed charges,,,,,,,,,8193.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9759.75,91,,percent of total billed charges,,,10188.75,95,,percent of total billed charges,,,8901.75,83,,percent of total billed charges,,,8901.75,83,,percent of total billed charges,,,,,,,,,,,,,,,8901.75,83,,percent of total billed charges,,,10188.75,95,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,8794.5,82,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,9116.25,85,,percent of total billed charges,,8086.65,10188.75,
CTL SPACER CERVICAL CORTICAL 6MM,30185229,CDM,,,278,RC,inpatient,,5362.5,5362.5,,4552.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4043.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4558.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4719,88,,percent of total billed charges,,,,,,,,,4096.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4879.88,91,,percent of total billed charges,,,5094.38,95,,percent of total billed charges,,,4450.88,83,,percent of total billed charges,,,4450.88,83,,percent of total billed charges,,,,,,,,,,,,,,,4450.88,83,,percent of total billed charges,,,5094.38,95,,percent of total billed charges,,,4826.25,90,,percent of total billed charges,,,4826.25,90,,percent of total billed charges,,,4397.25,82,,percent of total billed charges,,,4826.25,90,,percent of total billed charges,,,4558.13,85,,percent of total billed charges,,4043.33,5094.38,
DEPUY FEMUR ATTUNE 9 LEFT,30185230,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY INSERT ATTUNE SZ 9,30185231,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
CHOICE SPINE PLATE 2-LEVEL 32MM,30185233,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER FLOWPORT CANNULA,30185234,CDM,,,270,RC,inpatient,,2619.76,2619.76,,2224.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2226.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2305.39,88,,percent of total billed charges,,,,,,,,,2001.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2383.98,91,,percent of total billed charges,,,2488.77,95,,percent of total billed charges,,,2174.4,83,,percent of total billed charges,,,2174.4,83,,percent of total billed charges,,,,,,,,,,,,,,,2174.4,83,,percent of total billed charges,,,2488.77,95,,percent of total billed charges,,,2357.78,90,,percent of total billed charges,,,2357.78,90,,percent of total billed charges,,,2148.2,82,,percent of total billed charges,,,2357.78,90,,percent of total billed charges,,,2226.8,85,,percent of total billed charges,,1975.3,2488.77,
STRYKER PORTAL ENTRY KIT,30185235,CDM,,,270,RC,inpatient,,2182.05,2182.05,,1852.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1645.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1854.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1920.2,88,,percent of total billed charges,,,,,,,,,1667.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1985.67,91,,percent of total billed charges,,,2072.95,95,,percent of total billed charges,,,1811.1,83,,percent of total billed charges,,,1811.1,83,,percent of total billed charges,,,,,,,,,,,,,,,1811.1,83,,percent of total billed charges,,,2072.95,95,,percent of total billed charges,,,1963.85,90,,percent of total billed charges,,,1963.85,90,,percent of total billed charges,,,1789.28,82,,percent of total billed charges,,,1963.85,90,,percent of total billed charges,,,1854.74,85,,percent of total billed charges,,1645.27,2072.95,
STRYKER CINCHLOCK ANCHOR,30185236,CDM,,,270,RC,inpatient,,3287.77,3287.77,,2791.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2478.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2794.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2893.24,88,,percent of total billed charges,,,,,,,,,2511.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2991.87,91,,percent of total billed charges,,,3123.38,95,,percent of total billed charges,,,2728.85,83,,percent of total billed charges,,,2728.85,83,,percent of total billed charges,,,,,,,,,,,,,,,2728.85,83,,percent of total billed charges,,,3123.38,95,,percent of total billed charges,,,2958.99,90,,percent of total billed charges,,,2958.99,90,,percent of total billed charges,,,2695.97,82,,percent of total billed charges,,,2958.99,90,,percent of total billed charges,,,2794.6,85,,percent of total billed charges,,2478.98,3123.38,
STRYKER CINCHLOCK DRILL,30185237,CDM,,,270,RC,inpatient,,1248.33,1248.33,,1059.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,941.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1061.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1098.53,88,,percent of total billed charges,,,,,,,,,953.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1135.98,91,,percent of total billed charges,,,1185.91,95,,percent of total billed charges,,,1036.11,83,,percent of total billed charges,,,1036.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1036.11,83,,percent of total billed charges,,,1185.91,95,,percent of total billed charges,,,1123.5,90,,percent of total billed charges,,,1123.5,90,,percent of total billed charges,,,1023.63,82,,percent of total billed charges,,,1123.5,90,,percent of total billed charges,,,1061.08,85,,percent of total billed charges,,941.24,1185.91,
STRYKER SUTURE X-BRAID,30185238,CDM,,,270,RC,inpatient,,868.14,868.14,,737.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,654.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,737.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,763.96,88,,percent of total billed charges,,,,,,,,,663.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,790.01,91,,percent of total billed charges,,,824.73,95,,percent of total billed charges,,,720.56,83,,percent of total billed charges,,,720.56,83,,percent of total billed charges,,,,,,,,,,,,,,,720.56,83,,percent of total billed charges,,,824.73,95,,percent of total billed charges,,,781.33,90,,percent of total billed charges,,,781.33,90,,percent of total billed charges,,,711.87,82,,percent of total billed charges,,,781.33,90,,percent of total billed charges,,,737.92,85,,percent of total billed charges,,654.58,824.73,
STRYKER SLINGSHOT 45 DEG,30185239,CDM,,,270,RC,inpatient,,2313.87,2313.87,,1964.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1744.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1966.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2036.21,88,,percent of total billed charges,,,,,,,,,1767.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2105.62,91,,percent of total billed charges,,,2198.18,95,,percent of total billed charges,,,1920.51,83,,percent of total billed charges,,,1920.51,83,,percent of total billed charges,,,,,,,,,,,,,,,1920.51,83,,percent of total billed charges,,,2198.18,95,,percent of total billed charges,,,2082.48,90,,percent of total billed charges,,,2082.48,90,,percent of total billed charges,,,1897.37,82,,percent of total billed charges,,,2082.48,90,,percent of total billed charges,,,1966.79,85,,percent of total billed charges,,1744.66,2198.18,
"STRYKER TRANSPORT CANNULA 4,5,6",30185240,CDM,,,270,RC,inpatient,,653.87,653.87,,555.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,493.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,555.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,575.41,88,,percent of total billed charges,,,,,,,,,499.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,595.02,91,,percent of total billed charges,,,621.18,95,,percent of total billed charges,,,542.71,83,,percent of total billed charges,,,542.71,83,,percent of total billed charges,,,,,,,,,,,,,,,542.71,83,,percent of total billed charges,,,621.18,95,,percent of total billed charges,,,588.48,90,,percent of total billed charges,,,588.48,90,,percent of total billed charges,,,536.17,82,,percent of total billed charges,,,588.48,90,,percent of total billed charges,,,555.79,85,,percent of total billed charges,,493.02,621.18,
DEPUY STEM CORAIL REVISION SZ14 STD,30185241,CDM,,,278,RC,inpatient,,59386.99,59386.99,,50419.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44777.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50478.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52260.55,88,,percent of total billed charges,,,,,,,,,45371.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,54042.16,91,,percent of total billed charges,,,56417.64,95,,percent of total billed charges,,,49291.2,83,,percent of total billed charges,,,49291.2,83,,percent of total billed charges,,,,,,,,,,,,,,,49291.2,83,,percent of total billed charges,,,56417.64,95,,percent of total billed charges,,,53448.29,90,,percent of total billed charges,,,53448.29,90,,percent of total billed charges,,,48697.33,82,,percent of total billed charges,,,53448.29,90,,percent of total billed charges,,,50478.94,85,,percent of total billed charges,,44777.79,56417.64,
DEPUY BLADE CHISEL 12X5,30185242,CDM,,,278,RC,inpatient,,3861,3861,,3277.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2911.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3281.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3397.68,88,,percent of total billed charges,,,,,,,,,2949.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3513.51,91,,percent of total billed charges,,,3667.95,95,,percent of total billed charges,,,3204.63,83,,percent of total billed charges,,,3204.63,83,,percent of total billed charges,,,,,,,,,,,,,,,3204.63,83,,percent of total billed charges,,,3667.95,95,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3166.02,82,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3281.85,85,,percent of total billed charges,,2911.19,3667.95,
DEPUY STEM CORAIL COLLARED SZ12,30185243,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
GRAFT TISSUE HUMAN DERMIS,30185244,CDM,,,278,RC,inpatient,,24014.58,24014.58,,20388.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18106.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20412.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21132.83,88,,percent of total billed charges,,,,,,,,,18347.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21853.27,91,,percent of total billed charges,,,22813.85,95,,percent of total billed charges,,,19932.1,83,,percent of total billed charges,,,19932.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19932.1,83,,percent of total billed charges,,,22813.85,95,,percent of total billed charges,,,21613.12,90,,percent of total billed charges,,,21613.12,90,,percent of total billed charges,,,19691.96,82,,percent of total billed charges,,,21613.12,90,,percent of total billed charges,,,20412.39,85,,percent of total billed charges,,18106.99,22813.85,
ARTHREX PASSPORT CANNULA 12MM,30185245,CDM,,,278,RC,inpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,316.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,357,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,316.68,399,
ARTHREX LASSO QUICKPASS 90DEG STRAIGHT,30185246,CDM,,,278,RC,inpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,784.16,988,
STRYKER ACL DISPOSABLE PACK,30185247,CDM,,,278,RC,inpatient,,1673.75,1673.75,,1421.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1262.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1422.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1472.9,88,,percent of total billed charges,,,,,,,,,1278.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1523.11,91,,percent of total billed charges,,,1590.06,95,,percent of total billed charges,,,1389.21,83,,percent of total billed charges,,,1389.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1389.21,83,,percent of total billed charges,,,1590.06,95,,percent of total billed charges,,,1506.38,90,,percent of total billed charges,,,1506.38,90,,percent of total billed charges,,,1372.48,82,,percent of total billed charges,,,1506.38,90,,percent of total billed charges,,,1422.69,85,,percent of total billed charges,,1262.01,1590.06,
STRYKER SCREW INTERFERENCE ACL 7X20MM,30185248,CDM,,,278,RC,inpatient,,693,693,,588.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,522.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,589.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,609.84,88,,percent of total billed charges,,,,,,,,,529.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,630.63,91,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,,,,,,,,,,,,,575.19,83,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,568.26,82,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,589.05,85,,percent of total billed charges,,522.52,658.35,
STRYKER SCREW INTERFERENCE ACL 8X20MM,30185249,CDM,,,278,RC,inpatient,,693,693,,588.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,522.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,589.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,609.84,88,,percent of total billed charges,,,,,,,,,529.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,630.63,91,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,,,,,,,,,,,,,575.19,83,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,568.26,82,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,589.05,85,,percent of total billed charges,,522.52,658.35,
SYNTHES REAMER TUBE SPARE FOR HOLLOW REA,30185250,CDM,,,270,RC,inpatient,,2491.78,2491.78,,2115.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1878.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2118.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2192.77,88,,percent of total billed charges,,,,,,,,,1903.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2267.52,91,,percent of total billed charges,,,2367.19,95,,percent of total billed charges,,,2068.18,83,,percent of total billed charges,,,2068.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2068.18,83,,percent of total billed charges,,,2367.19,95,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2043.26,82,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2118.01,85,,percent of total billed charges,,1878.8,2367.19,
SYNTHES REAMER TUBE SPARE FOR HOLLOW REA,30185251,CDM,,,270,RC,inpatient,,2491.78,2491.78,,2115.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1878.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2118.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2192.77,88,,percent of total billed charges,,,,,,,,,1903.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2267.52,91,,percent of total billed charges,,,2367.19,95,,percent of total billed charges,,,2068.18,83,,percent of total billed charges,,,2068.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2068.18,83,,percent of total billed charges,,,2367.19,95,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2043.26,82,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2118.01,85,,percent of total billed charges,,1878.8,2367.19,
SYNTHES BLADE HECLICAL 110MM,30185252,CDM,,,278,RC,inpatient,,6630,6630,,5628.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4999.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5635.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5834.4,88,,percent of total billed charges,,,,,,,,,5065.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6033.3,91,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,,,,,,,,,,,,,5502.9,83,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5436.6,82,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,4999.02,6298.5,
SYNTHES SCREW LAG 100MM,30185253,CDM,,,278,RC,inpatient,,6298.5,6298.5,,5347.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4749.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5353.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5542.68,88,,percent of total billed charges,,,,,,,,,4812.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5731.64,91,,percent of total billed charges,,,5983.58,95,,percent of total billed charges,,,5227.76,83,,percent of total billed charges,,,5227.76,83,,percent of total billed charges,,,,,,,,,,,,,,,5227.76,83,,percent of total billed charges,,,5983.58,95,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5164.77,82,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5353.73,85,,percent of total billed charges,,4749.07,5983.58,
LATERA ABSORABLE NASAL IMPLANT SYSTEM,30185254,CDM,,,278,RC,inpatient,,6467.5,6467.5,,5490.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4876.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5497.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5691.4,88,,percent of total billed charges,,,,,,,,,4941.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5885.43,91,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,,,,,,,,,,,,,5368.03,83,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5303.35,82,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,4876.5,6144.13,
DEPUY STEM CORAIL HI OFFSET SZ16,30185255,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
SCREW POLYAXIAL 7.5 X 40MM,30185256,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
NASOPORE EXTRAFIRM 8CM,30185258,CDM,,,270,RC,inpatient,,1398.11,1398.11,,1187,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1054.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1188.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1230.34,88,,percent of total billed charges,,,,,,,,,1068.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1272.28,91,,percent of total billed charges,,,1328.2,95,,percent of total billed charges,,,1160.43,83,,percent of total billed charges,,,1160.43,83,,percent of total billed charges,,,,,,,,,,,,,,,1160.43,83,,percent of total billed charges,,,1328.2,95,,percent of total billed charges,,,1258.3,90,,percent of total billed charges,,,1258.3,90,,percent of total billed charges,,,1146.45,82,,percent of total billed charges,,,1258.3,90,,percent of total billed charges,,,1188.39,85,,percent of total billed charges,,1054.17,1328.2,
SURGICAL PATTIES .5 X 3,30185259,CDM,,,270,RC,inpatient,,23.43,23.43,,19.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.62,88,,percent of total billed charges,,,,,,,,,17.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.32,91,,percent of total billed charges,,,22.26,95,,percent of total billed charges,,,19.45,83,,percent of total billed charges,,,19.45,83,,percent of total billed charges,,,,,,,,,,,,,,,19.45,83,,percent of total billed charges,,,22.26,95,,percent of total billed charges,,,21.09,90,,percent of total billed charges,,,21.09,90,,percent of total billed charges,,,19.21,82,,percent of total billed charges,,,21.09,90,,percent of total billed charges,,,19.92,85,,percent of total billed charges,,17.67,22.26,
NEXSTAT TOPICAL HEMOSTATIC POWDER 3G,30185260,CDM,,,270,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
PROPEL STENT REGULAR,30185261,CDM,,,270,RC,inpatient,,8684,8684,,7372.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6547.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7381.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7641.92,88,,percent of total billed charges,,,,,,,,,6634.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7902.44,91,,percent of total billed charges,,,8249.8,95,,percent of total billed charges,,,7207.72,83,,percent of total billed charges,,,7207.72,83,,percent of total billed charges,,,,,,,,,,,,,,,7207.72,83,,percent of total billed charges,,,8249.8,95,,percent of total billed charges,,,7815.6,90,,percent of total billed charges,,,7815.6,90,,percent of total billed charges,,,7120.88,82,,percent of total billed charges,,,7815.6,90,,percent of total billed charges,,,7381.4,85,,percent of total billed charges,,6547.74,8249.8,
PROPEL STENT MINI,30185262,CDM,,,270,RC,inpatient,,7767.5,7767.5,,6594.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5856.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6602.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6835.4,88,,percent of total billed charges,,,,,,,,,5934.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7068.43,91,,percent of total billed charges,,,7379.13,95,,percent of total billed charges,,,6447.03,83,,percent of total billed charges,,,6447.03,83,,percent of total billed charges,,,,,,,,,,,,,,,6447.03,83,,percent of total billed charges,,,7379.13,95,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6369.35,82,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6602.38,85,,percent of total billed charges,,5856.7,7379.13,
PROPEL STENT CONTOUR,30185263,CDM,,,270,RC,inpatient,,7767.5,7767.5,,6594.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5856.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6602.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6835.4,88,,percent of total billed charges,,,,,,,,,5934.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7068.43,91,,percent of total billed charges,,,7379.13,95,,percent of total billed charges,,,6447.03,83,,percent of total billed charges,,,6447.03,83,,percent of total billed charges,,,,,,,,,,,,,,,6447.03,83,,percent of total billed charges,,,7379.13,95,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6369.35,82,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6602.38,85,,percent of total billed charges,,5856.7,7379.13,
CTL PLATE CERVICAL VAN GOGH 14MM,30185264,CDM,,,278,RC,inpatient,,8957,8957,,7604.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6753.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7613.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7882.16,88,,percent of total billed charges,,,,,,,,,6843.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8150.87,91,,percent of total billed charges,,,8509.15,95,,percent of total billed charges,,,7434.31,83,,percent of total billed charges,,,7434.31,83,,percent of total billed charges,,,,,,,,,,,,,,,7434.31,83,,percent of total billed charges,,,8509.15,95,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,7344.74,82,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,7613.45,85,,percent of total billed charges,,6753.58,8509.15,
CTL DRILL BIT 12MM,30185265,CDM,,,278,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
WRIGHT PIN INBONE STEINMANN 2.4MM,30185266,CDM,,,278,RC,inpatient,,307.5,307.5,,261.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,231.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,261.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,270.6,88,,percent of total billed charges,,,,,,,,,234.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,279.83,91,,percent of total billed charges,,,292.13,95,,percent of total billed charges,,,255.23,83,,percent of total billed charges,,,255.23,83,,percent of total billed charges,,,,,,,,,,,,,,,255.23,83,,percent of total billed charges,,,292.13,95,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,252.15,82,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,261.38,85,,percent of total billed charges,,231.86,292.13,
WRIGHT BEAM SALVATION 7.0 X 75MM,30185267,CDM,,,278,RC,inpatient,,12987,12987,,11025.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9792.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11038.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11428.56,88,,percent of total billed charges,,,,,,,,,9922.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11818.17,91,,percent of total billed charges,,,12337.65,95,,percent of total billed charges,,,10779.21,83,,percent of total billed charges,,,10779.21,83,,percent of total billed charges,,,,,,,,,,,,,,,10779.21,83,,percent of total billed charges,,,12337.65,95,,percent of total billed charges,,,11688.3,90,,percent of total billed charges,,,11688.3,90,,percent of total billed charges,,,10649.34,82,,percent of total billed charges,,,11688.3,90,,percent of total billed charges,,,11038.95,85,,percent of total billed charges,,9792.2,12337.65,
WRIGHT TROCAR WIRE SINGLE 1.6 X 150MM,30185268,CDM,,,278,RC,inpatient,,307.5,307.5,,261.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,231.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,261.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,270.6,88,,percent of total billed charges,,,,,,,,,234.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,279.83,91,,percent of total billed charges,,,292.13,95,,percent of total billed charges,,,255.23,83,,percent of total billed charges,,,255.23,83,,percent of total billed charges,,,,,,,,,,,,,,,255.23,83,,percent of total billed charges,,,292.13,95,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,252.15,82,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,261.38,85,,percent of total billed charges,,231.86,292.13,
WRIGHT SCREW LOCKING 3.5 X 18MM,30185269,CDM,,,278,RC,inpatient,,2385.5,2385.5,,2025.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1798.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2027.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2099.24,88,,percent of total billed charges,,,,,,,,,1822.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2170.81,91,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1979.97,83,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,1956.11,82,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,1798.67,2266.23,
WRIGHT SCREW LOCKING 3.5 X 24MM,30185270,CDM,,,278,RC,inpatient,,2385.5,2385.5,,2025.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1798.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2027.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2099.24,88,,percent of total billed charges,,,,,,,,,1822.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2170.81,91,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1979.97,83,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,1956.11,82,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,1798.67,2266.23,
WRIGHT SCREW CORTEX LOW-PRO 3.5 X 28MM,30185271,CDM,,,278,RC,inpatient,,1215.5,1215.5,,1031.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,916.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1033.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1069.64,88,,percent of total billed charges,,,,,,,,,928.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1106.11,91,,percent of total billed charges,,,1154.73,95,,percent of total billed charges,,,1008.87,83,,percent of total billed charges,,,1008.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1008.87,83,,percent of total billed charges,,,1154.73,95,,percent of total billed charges,,,1093.95,90,,percent of total billed charges,,,1093.95,90,,percent of total billed charges,,,996.71,82,,percent of total billed charges,,,1093.95,90,,percent of total billed charges,,,1033.18,85,,percent of total billed charges,,916.49,1154.73,
WRIGHT PIN TEMP FIX 1.1MM SM,30185272,CDM,,,278,RC,inpatient,,861,861,,730.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,649.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,731.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,757.68,88,,percent of total billed charges,,,,,,,,,657.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,783.51,91,,percent of total billed charges,,,817.95,95,,percent of total billed charges,,,714.63,83,,percent of total billed charges,,,714.63,83,,percent of total billed charges,,,,,,,,,,,,,,,714.63,83,,percent of total billed charges,,,817.95,95,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,706.02,82,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,731.85,85,,percent of total billed charges,,649.19,817.95,
WRIGHT K-WIRE 1.2 X 150MM,30185273,CDM,,,278,RC,inpatient,,307.5,307.5,,261.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,231.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,261.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,270.6,88,,percent of total billed charges,,,,,,,,,234.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,279.83,91,,percent of total billed charges,,,292.13,95,,percent of total billed charges,,,255.23,83,,percent of total billed charges,,,255.23,83,,percent of total billed charges,,,,,,,,,,,,,,,255.23,83,,percent of total billed charges,,,292.13,95,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,252.15,82,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,261.38,85,,percent of total billed charges,,231.86,292.13,
WRIGHT DRILL BIT CANNULATED 2.3MM,30185274,CDM,,,278,RC,inpatient,,1943.5,1943.5,,1650.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1465.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1651.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1710.28,88,,percent of total billed charges,,,,,,,,,1484.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1768.59,91,,percent of total billed charges,,,1846.33,95,,percent of total billed charges,,,1613.11,83,,percent of total billed charges,,,1613.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1613.11,83,,percent of total billed charges,,,1846.33,95,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1593.67,82,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1651.98,85,,percent of total billed charges,,1465.4,1846.33,
WRIGHT SCREW DARCO HEADED SHORT 4.0X42,30185275,CDM,,,278,RC,inpatient,,2801.5,2801.5,,2378.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2112.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2381.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2465.32,88,,percent of total billed charges,,,,,,,,,2140.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2549.37,91,,percent of total billed charges,,,2661.43,95,,percent of total billed charges,,,2325.25,83,,percent of total billed charges,,,2325.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2325.25,83,,percent of total billed charges,,,2661.43,95,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2297.23,82,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2381.28,85,,percent of total billed charges,,2112.33,2661.43,
WRIGHT SCREW DARCO HEADED SHORT 4.0X44,30185276,CDM,,,278,RC,inpatient,,2801.5,2801.5,,2378.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2112.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2381.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2465.32,88,,percent of total billed charges,,,,,,,,,2140.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2549.37,91,,percent of total billed charges,,,2661.43,95,,percent of total billed charges,,,2325.25,83,,percent of total billed charges,,,2325.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2325.25,83,,percent of total billed charges,,,2661.43,95,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2297.23,82,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2381.28,85,,percent of total billed charges,,2112.33,2661.43,
WRIGHT SCREW PEEK INTERFERENCE,30185277,CDM,,,278,RC,inpatient,,4641,4641,,3940.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3499.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3944.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4084.08,88,,percent of total billed charges,,,,,,,,,3545.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4223.31,91,,percent of total billed charges,,,4408.95,95,,percent of total billed charges,,,3852.03,83,,percent of total billed charges,,,3852.03,83,,percent of total billed charges,,,,,,,,,,,,,,,3852.03,83,,percent of total billed charges,,,4408.95,95,,percent of total billed charges,,,4176.9,90,,percent of total billed charges,,,4176.9,90,,percent of total billed charges,,,3805.62,82,,percent of total billed charges,,,4176.9,90,,percent of total billed charges,,,3944.85,85,,percent of total billed charges,,3499.31,4408.95,
WRIGHT DRILL CANNULATED 4MM,30185278,CDM,,,278,RC,inpatient,,1943.5,1943.5,,1650.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1465.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1651.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1710.28,88,,percent of total billed charges,,,,,,,,,1484.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1768.59,91,,percent of total billed charges,,,1846.33,95,,percent of total billed charges,,,1613.11,83,,percent of total billed charges,,,1613.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1613.11,83,,percent of total billed charges,,,1846.33,95,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1593.67,82,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1651.98,85,,percent of total billed charges,,1465.4,1846.33,
HOLMIUM 1000-2 FORTEC FIBER,30185279,CDM,,,270,RC,inpatient,,2177.5,2177.5,,1848.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1641.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1850.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1916.2,88,,percent of total billed charges,,,,,,,,,1663.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1981.53,91,,percent of total billed charges,,,2068.63,95,,percent of total billed charges,,,1807.33,83,,percent of total billed charges,,,1807.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1807.33,83,,percent of total billed charges,,,2068.63,95,,percent of total billed charges,,,1959.75,90,,percent of total billed charges,,,1959.75,90,,percent of total billed charges,,,1785.55,82,,percent of total billed charges,,,1959.75,90,,percent of total billed charges,,,1850.88,85,,percent of total billed charges,,1641.84,2068.63,
COBLATOR WAND ULTRA REFLEX 35-PTR,30185280,CDM,,,270,RC,inpatient,,1827.8,1827.8,,1551.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1378.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1553.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1608.46,88,,percent of total billed charges,,,,,,,,,1396.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1663.3,91,,percent of total billed charges,,,1736.41,95,,percent of total billed charges,,,1517.07,83,,percent of total billed charges,,,1517.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1517.07,83,,percent of total billed charges,,,1736.41,95,,percent of total billed charges,,,1645.02,90,,percent of total billed charges,,,1645.02,90,,percent of total billed charges,,,1498.8,82,,percent of total billed charges,,,1645.02,90,,percent of total billed charges,,,1553.63,85,,percent of total billed charges,,1378.16,1736.41,
STRYKER BUR DIAMOND 5.5MM,30185281,CDM,,,270,RC,inpatient,,1874.6,1874.6,,1591.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1413.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1593.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1649.65,88,,percent of total billed charges,,,,,,,,,1432.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1705.89,91,,percent of total billed charges,,,1780.87,95,,percent of total billed charges,,,1555.92,83,,percent of total billed charges,,,1555.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1555.92,83,,percent of total billed charges,,,1780.87,95,,percent of total billed charges,,,1687.14,90,,percent of total billed charges,,,1687.14,90,,percent of total billed charges,,,1537.17,82,,percent of total billed charges,,,1687.14,90,,percent of total billed charges,,,1593.41,85,,percent of total billed charges,,1413.45,1780.87,
PHACO PACK,30185282,CDM,,,270,RC,inpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,186.62,235.13,
BLADE STAB 15DEG,30185283,CDM,,,270,RC,inpatient,,63.75,63.75,,54.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.1,88,,percent of total billed charges,,,,,,,,,48.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.01,91,,percent of total billed charges,,,60.56,95,,percent of total billed charges,,,52.91,83,,percent of total billed charges,,,52.91,83,,percent of total billed charges,,,,,,,,,,,,,,,52.91,83,,percent of total billed charges,,,60.56,95,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,52.28,82,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,54.19,85,,percent of total billed charges,,48.07,60.56,
BLADE TRAPEZOID ANG 2.0 X 2.2MM,30185284,CDM,,,270,RC,inpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,132.7,167.2,
KNIFE CC & TRAP 2.75 X 3.2 ANG,30185285,CDM,,,270,RC,inpatient,,147.36,147.36,,125.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,111.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,125.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.68,88,,percent of total billed charges,,,,,,,,,112.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,134.1,91,,percent of total billed charges,,,139.99,95,,percent of total billed charges,,,122.31,83,,percent of total billed charges,,,122.31,83,,percent of total billed charges,,,,,,,,,,,,,,,122.31,83,,percent of total billed charges,,,139.99,95,,percent of total billed charges,,,132.62,90,,percent of total billed charges,,,132.62,90,,percent of total billed charges,,,120.84,82,,percent of total billed charges,,,132.62,90,,percent of total billed charges,,,125.26,85,,percent of total billed charges,,111.11,139.99,
NEEDLE 27G ANTERIOR CHAMBER,30185286,CDM,,,270,RC,inpatient,,17.55,17.55,,14.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.44,88,,percent of total billed charges,,,,,,,,,13.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.97,91,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14.57,83,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.39,82,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.92,85,,percent of total billed charges,,13.23,16.67,
ZIMMER SHELL OSSEOTI G7 52MM E 3 HOLE,30185287,CDM,,,278,RC,inpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14580.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16436.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,14580.48,18370.63,
DEPUY ATTUNE FEMUR CR SZ 9 LEFT,30185289,CDM,,,278,RC,inpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21324.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24039.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,21324.5,26867.74,
DEPUY ATTUNE INSERT CR 7MM,30185290,CDM,,,278,RC,inpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9407.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10605.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,9407.86,11853.41,
DEPUY ATTUNE REVISION TIB TRAY FB SZ 8,30185291,CDM,,,278,RC,inpatient,,25954.31,25954.31,,22035.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19569.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22061.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22839.79,88,,percent of total billed charges,,,,,,,,,19829.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23618.42,91,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,,,,,,,,,,,,,21542.08,83,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,21282.53,82,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,19569.55,24656.59,
VTI INTERFUSE S 8MM X 20MM 0DEG,30185294,CDM,,,278,RC,inpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29406,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33150,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,29406,37050,
ZIMMER BEARING PMA RT LARGE SZ 6,30185296,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
DEPUY INSERT ATTUNE 7MM,30185297,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
S&N INSERT LEGION 9MM SZ 5-6,30185298,CDM,,,278,RC,inpatient,,19279.26,19279.26,,16368.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14536.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16387.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16965.75,88,,percent of total billed charges,,,,,,,,,14729.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17544.13,91,,percent of total billed charges,,,18315.3,95,,percent of total billed charges,,,16001.79,83,,percent of total billed charges,,,16001.79,83,,percent of total billed charges,,,,,,,,,,,,,,,16001.79,83,,percent of total billed charges,,,18315.3,95,,percent of total billed charges,,,17351.33,90,,percent of total billed charges,,,17351.33,90,,percent of total billed charges,,,15808.99,82,,percent of total billed charges,,,17351.33,90,,percent of total billed charges,,,16387.37,85,,percent of total billed charges,,14536.56,18315.3,
S&N RESURFACING PATELLAR COMPONENT 32MM,30185299,CDM,,,278,RC,inpatient,,5460,5460,,4635.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4116.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4641,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4804.8,88,,percent of total billed charges,,,,,,,,,4171.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4968.6,91,,percent of total billed charges,,,5187,95,,percent of total billed charges,,,4531.8,83,,percent of total billed charges,,,4531.8,83,,percent of total billed charges,,,,,,,,,,,,,,,4531.8,83,,percent of total billed charges,,,5187,95,,percent of total billed charges,,,4914,90,,percent of total billed charges,,,4914,90,,percent of total billed charges,,,4477.2,82,,percent of total billed charges,,,4914,90,,percent of total billed charges,,,4641,85,,percent of total billed charges,,4116.84,5187,
S&N STEM LONG 12MM X 100MM,30185300,CDM,,,278,RC,inpatient,,10735.08,10735.08,,9114.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8094.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9124.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9446.87,88,,percent of total billed charges,,,,,,,,,8201.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9768.92,91,,percent of total billed charges,,,10198.33,95,,percent of total billed charges,,,8910.12,83,,percent of total billed charges,,,8910.12,83,,percent of total billed charges,,,,,,,,,,,,,,,8910.12,83,,percent of total billed charges,,,10198.33,95,,percent of total billed charges,,,9661.57,90,,percent of total billed charges,,,9661.57,90,,percent of total billed charges,,,8802.77,82,,percent of total billed charges,,,9661.57,90,,percent of total billed charges,,,9124.82,85,,percent of total billed charges,,8094.25,10198.33,
STRYKER BURR DIAMOND,30185301,CDM,,,270,RC,inpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1372.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1547,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,1372.28,1729,
STRYKER CINCHLOCK FLEX DRILL BIT,30185302,CDM,,,270,RC,inpatient,,1686.49,1686.49,,1431.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1271.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1433.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1484.11,88,,percent of total billed charges,,,,,,,,,1288.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1534.71,91,,percent of total billed charges,,,1602.17,95,,percent of total billed charges,,,1399.79,83,,percent of total billed charges,,,1399.79,83,,percent of total billed charges,,,,,,,,,,,,,,,1399.79,83,,percent of total billed charges,,,1602.17,95,,percent of total billed charges,,,1517.84,90,,percent of total billed charges,,,1517.84,90,,percent of total billed charges,,,1382.92,82,,percent of total billed charges,,,1517.84,90,,percent of total billed charges,,,1433.52,85,,percent of total billed charges,,1271.61,1602.17,
STRYKER CINCHLOCK ANCHOR,30185303,CDM,,,270,RC,inpatient,,4216.29,4216.29,,3579.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3179.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3583.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3710.34,88,,percent of total billed charges,,,,,,,,,3221.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3836.82,91,,percent of total billed charges,,,4005.48,95,,percent of total billed charges,,,3499.52,83,,percent of total billed charges,,,3499.52,83,,percent of total billed charges,,,,,,,,,,,,,,,3499.52,83,,percent of total billed charges,,,4005.48,95,,percent of total billed charges,,,3794.66,90,,percent of total billed charges,,,3794.66,90,,percent of total billed charges,,,3457.36,82,,percent of total billed charges,,,3794.66,90,,percent of total billed charges,,,3583.85,85,,percent of total billed charges,,3179.08,4005.48,
STRYKER NANOPASS CRESCENT,30185304,CDM,,,270,RC,inpatient,,1916.07,1916.07,,1626.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1444.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1628.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1686.14,88,,percent of total billed charges,,,,,,,,,1463.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1743.62,91,,percent of total billed charges,,,1820.27,95,,percent of total billed charges,,,1590.34,83,,percent of total billed charges,,,1590.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1590.34,83,,percent of total billed charges,,,1820.27,95,,percent of total billed charges,,,1724.46,90,,percent of total billed charges,,,1724.46,90,,percent of total billed charges,,,1571.18,82,,percent of total billed charges,,,1724.46,90,,percent of total billed charges,,,1628.66,85,,percent of total billed charges,,1444.72,1820.27,
ARTHREX SCREW FT 4.0 X 40MM,30185305,CDM,,,278,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
ARTHREX GUIDEWIRE W/TROCAR TIP 1.35MM,30185306,CDM,,,278,RC,inpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,120.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,120.64,152,
ARTHREX DRILL BIT 3.2MM FT,30185307,CDM,,,278,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
ARTHREX WASHER 6.0MM TI,30185308,CDM,,,278,RC,inpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,197.93,249.38,
ARTHREX SCREW CORTEX LP 2.4 X 24MM,30185309,CDM,,,278,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
ARTHREX SCREW CORTEX LP 2.4 X 30MM,30185310,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
SYNTHES PUTTY FAST SET 10CC,30185311,CDM,,,278,RC,inpatient,,26886.6,26886.6,,22826.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20272.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22853.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23660.21,88,,percent of total billed charges,,,,,,,,,20541.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24466.81,91,,percent of total billed charges,,,25542.27,95,,percent of total billed charges,,,22315.88,83,,percent of total billed charges,,,22315.88,83,,percent of total billed charges,,,,,,,,,,,,,,,22315.88,83,,percent of total billed charges,,,25542.27,95,,percent of total billed charges,,,24197.94,90,,percent of total billed charges,,,24197.94,90,,percent of total billed charges,,,22047.01,82,,percent of total billed charges,,,24197.94,90,,percent of total billed charges,,,22853.61,85,,percent of total billed charges,,20272.5,25542.27,
SYNTHES PLATE LCP CLAVICLE 7 HOLE LEFT S,30185312,CDM,,,278,RC,inpatient,,10368.93,10368.93,,8803.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7818.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8813.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9124.66,88,,percent of total billed charges,,,,,,,,,7921.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9435.73,91,,percent of total billed charges,,,9850.48,95,,percent of total billed charges,,,8606.21,83,,percent of total billed charges,,,8606.21,83,,percent of total billed charges,,,,,,,,,,,,,,,8606.21,83,,percent of total billed charges,,,9850.48,95,,percent of total billed charges,,,9332.04,90,,percent of total billed charges,,,9332.04,90,,percent of total billed charges,,,8502.52,82,,percent of total billed charges,,,9332.04,90,,percent of total billed charges,,,8813.59,85,,percent of total billed charges,,7818.17,9850.48,
ZIMMER STEM REV. WAGNER 135 NK ANGLE 14X,30185313,CDM,,,278,RC,inpatient,,73125,73125,,62083.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,55136.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,62156.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,64350,88,,percent of total billed charges,,,,,,,,,55867.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,66543.75,91,,percent of total billed charges,,,69468.75,95,,percent of total billed charges,,,60693.75,83,,percent of total billed charges,,,60693.75,83,,percent of total billed charges,,,,,,,,,,,,,,,60693.75,83,,percent of total billed charges,,,69468.75,95,,percent of total billed charges,,,65812.5,90,,percent of total billed charges,,,65812.5,90,,percent of total billed charges,,,59962.5,82,,percent of total billed charges,,,65812.5,90,,percent of total billed charges,,,62156.25,85,,percent of total billed charges,,55136.25,69468.75,
ZIMMER SCREW BONE ST 6.5 X 50MM,30185314,CDM,,,278,RC,inpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1176.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1326,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,1176.24,1482,
ZIMMER SUCTION CUP STERIL G7,30185315,CDM,,,270,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
ZIMMER LINER ARCOMXL G7 10 DEG 40MM F,30185316,CDM,,,278,RC,inpatient,,17875,17875,,15175.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13477.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15193.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15730,88,,percent of total billed charges,,,,,,,,,13656.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16266.25,91,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14836.25,83,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,14657.5,82,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,13477.75,16981.25,
ARTHREX IMPLANT SYSTEM ACHILLES SPEEDBRI,30185318,CDM,,,278,RC,inpatient,,12967.5,12967.5,,11009.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9777.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11022.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11411.4,88,,percent of total billed charges,,,,,,,,,9907.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11800.43,91,,percent of total billed charges,,,12319.13,95,,percent of total billed charges,,,10763.03,83,,percent of total billed charges,,,10763.03,83,,percent of total billed charges,,,,,,,,,,,,,,,10763.03,83,,percent of total billed charges,,,12319.13,95,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,10633.35,82,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,11022.38,85,,percent of total billed charges,,9777.5,12319.13,
DEPUY STEM PROSTALAC RT SZ 3 200MM,30185319,CDM,,,278,RC,inpatient,,32843.27,32843.27,,27883.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24763.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27916.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28902.08,88,,percent of total billed charges,,,,,,,,,25092.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29887.38,91,,percent of total billed charges,,,31201.11,95,,percent of total billed charges,,,27259.91,83,,percent of total billed charges,,,27259.91,83,,percent of total billed charges,,,,,,,,,,,,,,,27259.91,83,,percent of total billed charges,,,31201.11,95,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,26931.48,82,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,27916.78,85,,percent of total billed charges,,24763.83,31201.11,
SYNTHES GUIDE WIRE 2.8MM THREADED,30185320,CDM,,,278,RC,inpatient,,821.1,821.1,,697.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,619.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,697.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,722.57,88,,percent of total billed charges,,,,,,,,,627.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,747.2,91,,percent of total billed charges,,,780.05,95,,percent of total billed charges,,,681.51,83,,percent of total billed charges,,,681.51,83,,percent of total billed charges,,,,,,,,,,,,,,,681.51,83,,percent of total billed charges,,,780.05,95,,percent of total billed charges,,,738.99,90,,percent of total billed charges,,,738.99,90,,percent of total billed charges,,,673.3,82,,percent of total billed charges,,,738.99,90,,percent of total billed charges,,,697.94,85,,percent of total billed charges,,619.11,780.05,
SYNTHES SCREW CORTEX 2.4 X 26MM,30185321,CDM,,,278,RC,inpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,452.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,509.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,452.17,569.71,
SYNTHES SCREW CORTEX 2.4X20MM,30185322,CDM,,,278,RC,inpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,452.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,509.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,452.17,569.71,
CHOICE SPINE PLATE 2-LEVEL 28MM,30185323,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
ZIMMER BEARING MD RT SZ 5,30185324,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
LOWER EXTREMITY ADDITION SOFT INTERFACE,30185325,CDM,,,270,RC,inpatient,,596.82,596.82,,506.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,450,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,507.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,525.2,88,,percent of total billed charges,,,,,,,,,455.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,543.11,91,,percent of total billed charges,,,566.98,95,,percent of total billed charges,,,495.36,83,,percent of total billed charges,,,495.36,83,,percent of total billed charges,,,,,,,,,,,,,,,495.36,83,,percent of total billed charges,,,566.98,95,,percent of total billed charges,,,537.14,90,,percent of total billed charges,,,537.14,90,,percent of total billed charges,,,489.39,82,,percent of total billed charges,,,537.14,90,,percent of total billed charges,,,507.3,85,,percent of total billed charges,,450,566.98,
LOWER EXTREMITY ADDITION FRACTURE ORTHOS,30185326,CDM,,,270,RC,inpatient,,827.26,827.26,,702.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,623.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,703.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,727.99,88,,percent of total billed charges,,,,,,,,,632.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,752.81,91,,percent of total billed charges,,,785.9,95,,percent of total billed charges,,,686.63,83,,percent of total billed charges,,,686.63,83,,percent of total billed charges,,,,,,,,,,,,,,,686.63,83,,percent of total billed charges,,,785.9,95,,percent of total billed charges,,,744.53,90,,percent of total billed charges,,,744.53,90,,percent of total billed charges,,,678.35,82,,percent of total billed charges,,,744.53,90,,percent of total billed charges,,,703.17,85,,percent of total billed charges,,623.75,785.9,
LOWER EXTREMITY ADJ MOTION KNEE JOINT,30185327,CDM,,,270,RC,inpatient,,961.16,961.16,,816.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,724.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,816.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,845.82,88,,percent of total billed charges,,,,,,,,,734.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,874.66,91,,percent of total billed charges,,,913.1,95,,percent of total billed charges,,,797.76,83,,percent of total billed charges,,,797.76,83,,percent of total billed charges,,,,,,,,,,,,,,,797.76,83,,percent of total billed charges,,,913.1,95,,percent of total billed charges,,,865.04,90,,percent of total billed charges,,,865.04,90,,percent of total billed charges,,,788.15,82,,percent of total billed charges,,,865.04,90,,percent of total billed charges,,,816.99,85,,percent of total billed charges,,724.71,913.1,
SCREW POLY AXIAL 7.5 X 55,30185328,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SCREW POLY AXIAL 7.5 X 50,30185329,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SCREW POLY AXIAL 8.5 X 55,30185330,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
XLINK MEDIUM,30185331,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
GUARDIAN TIBIAL HINGE BASE,30185332,CDM,,,278,RC,inpatient,,26650,26650,,22625.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20094.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22652.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23452,88,,percent of total billed charges,,,,,,,,,20360.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24251.5,91,,percent of total billed charges,,,25317.5,95,,percent of total billed charges,,,22119.5,83,,percent of total billed charges,,,22119.5,83,,percent of total billed charges,,,,,,,,,,,,,,,22119.5,83,,percent of total billed charges,,,25317.5,95,,percent of total billed charges,,,23985,90,,percent of total billed charges,,,23985,90,,percent of total billed charges,,,21853,82,,percent of total billed charges,,,23985,90,,percent of total billed charges,,,22652.5,85,,percent of total billed charges,,20094.1,25317.5,
GUARDIAN TIBIAL POLY SPACER,30185333,CDM,,,278,RC,inpatient,,19597.5,19597.5,,16638.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14776.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16657.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17245.8,88,,percent of total billed charges,,,,,,,,,14972.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17833.73,91,,percent of total billed charges,,,18617.63,95,,percent of total billed charges,,,16265.93,83,,percent of total billed charges,,,16265.93,83,,percent of total billed charges,,,,,,,,,,,,,,,16265.93,83,,percent of total billed charges,,,18617.63,95,,percent of total billed charges,,,17637.75,90,,percent of total billed charges,,,17637.75,90,,percent of total billed charges,,,16069.95,82,,percent of total billed charges,,,17637.75,90,,percent of total billed charges,,,16657.88,85,,percent of total billed charges,,14776.52,18617.63,
GUARDIAN DISTAL FEMUR PIN KIT,30185334,CDM,,,278,RC,inpatient,,20182.5,20182.5,,17134.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15217.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17155.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17760.6,88,,percent of total billed charges,,,,,,,,,15419.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18366.08,91,,percent of total billed charges,,,19173.38,95,,percent of total billed charges,,,16751.48,83,,percent of total billed charges,,,16751.48,83,,percent of total billed charges,,,,,,,,,,,,,,,16751.48,83,,percent of total billed charges,,,19173.38,95,,percent of total billed charges,,,18164.25,90,,percent of total billed charges,,,18164.25,90,,percent of total billed charges,,,16549.65,82,,percent of total billed charges,,,18164.25,90,,percent of total billed charges,,,17155.13,85,,percent of total billed charges,,15217.61,19173.38,
DEPUY MODULER EPIPHYSIS SZ 2 RT,30185335,CDM,,,278,RC,inpatient,,33055.36,33055.36,,28064,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24923.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28097.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29088.72,88,,percent of total billed charges,,,,,,,,,25254.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30080.38,91,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,,,,,,,,,,,,,27435.95,83,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,27105.4,82,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,28097.06,85,,percent of total billed charges,,24923.74,31402.59,
ACUMED GUIDE WIRE ST .035 X 6,30185337,CDM,,,278,RC,inpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,120.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,120.64,152,
ACUMED BIOTRAK MINI DRILL,30185338,CDM,,,270,RC,inpatient,,2372.5,2372.5,,2014.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1788.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2016.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2087.8,88,,percent of total billed charges,,,,,,,,,1812.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2158.98,91,,percent of total billed charges,,,2253.88,95,,percent of total billed charges,,,1969.18,83,,percent of total billed charges,,,1969.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1969.18,83,,percent of total billed charges,,,2253.88,95,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,1945.45,82,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,2016.63,85,,percent of total billed charges,,1788.87,2253.88,
ACUMED GUIDE WIRE ST .045 X 6,30185339,CDM,,,278,RC,inpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,108.58,136.8,
ACUMED BIOTRAK DRILL,30185340,CDM,,,270,RC,inpatient,,2372.5,2372.5,,2014.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1788.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2016.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2087.8,88,,percent of total billed charges,,,,,,,,,1812.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2158.98,91,,percent of total billed charges,,,2253.88,95,,percent of total billed charges,,,1969.18,83,,percent of total billed charges,,,1969.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1969.18,83,,percent of total billed charges,,,2253.88,95,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,1945.45,82,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,2016.63,85,,percent of total billed charges,,1788.87,2253.88,
ACUMED SCREW BIOTRAK 24MM,30185341,CDM,,,278,RC,inpatient,,4270.5,4270.5,,3625.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3219.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3629.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3758.04,88,,percent of total billed charges,,,,,,,,,3262.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3886.16,91,,percent of total billed charges,,,4056.98,95,,percent of total billed charges,,,3544.52,83,,percent of total billed charges,,,3544.52,83,,percent of total billed charges,,,,,,,,,,,,,,,3544.52,83,,percent of total billed charges,,,4056.98,95,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3501.81,82,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3629.93,85,,percent of total billed charges,,3219.96,4056.98,
ACUMED SCREW BIOTRAK MINI 24MM,30185342,CDM,,,278,RC,inpatient,,4270.5,4270.5,,3625.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3219.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3629.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3758.04,88,,percent of total billed charges,,,,,,,,,3262.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3886.16,91,,percent of total billed charges,,,4056.98,95,,percent of total billed charges,,,3544.52,83,,percent of total billed charges,,,3544.52,83,,percent of total billed charges,,,,,,,,,,,,,,,3544.52,83,,percent of total billed charges,,,4056.98,95,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3501.81,82,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3629.93,85,,percent of total billed charges,,3219.96,4056.98,
ACUMED SCREW BIOTRAK MINI 22MM,30185343,CDM,,,278,RC,inpatient,,4270.5,4270.5,,3625.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3219.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3629.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3758.04,88,,percent of total billed charges,,,,,,,,,3262.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3886.16,91,,percent of total billed charges,,,4056.98,95,,percent of total billed charges,,,3544.52,83,,percent of total billed charges,,,3544.52,83,,percent of total billed charges,,,,,,,,,,,,,,,3544.52,83,,percent of total billed charges,,,4056.98,95,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3501.81,82,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3629.93,85,,percent of total billed charges,,3219.96,4056.98,
SYNTHES TFNA NAIL 11MM X 380MM 130DEG,30185344,CDM,,,278,RC,inpatient,,21784.17,21784.17,,18494.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16425.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18516.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19170.07,88,,percent of total billed charges,,,,,,,,,16643.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19823.59,91,,percent of total billed charges,,,20694.96,95,,percent of total billed charges,,,18080.86,83,,percent of total billed charges,,,18080.86,83,,percent of total billed charges,,,,,,,,,,,,,,,18080.86,83,,percent of total billed charges,,,20694.96,95,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,17863.02,82,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,18516.54,85,,percent of total billed charges,,16425.26,20694.96,
SYNTHES SCREW 48MM,30185345,CDM,,,278,RC,inpatient,,2121.6,2121.6,,1801.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1599.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1803.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1867.01,88,,percent of total billed charges,,,,,,,,,1620.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1930.66,91,,percent of total billed charges,,,2015.52,95,,percent of total billed charges,,,1760.93,83,,percent of total billed charges,,,1760.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1760.93,83,,percent of total billed charges,,,2015.52,95,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1739.71,82,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1803.36,85,,percent of total billed charges,,1599.69,2015.52,
SYNTHES SCREW 58MM,30185346,CDM,,,278,RC,inpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1697.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1913.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,1697.12,2138.28,
SYNTHES DRILL BIT 2.5MM,30185347,CDM,,,270,RC,inpatient,,1242.61,1242.61,,1054.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,936.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1056.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1093.5,88,,percent of total billed charges,,,,,,,,,949.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1130.78,91,,percent of total billed charges,,,1180.48,95,,percent of total billed charges,,,1031.37,83,,percent of total billed charges,,,1031.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1031.37,83,,percent of total billed charges,,,1180.48,95,,percent of total billed charges,,,1118.35,90,,percent of total billed charges,,,1118.35,90,,percent of total billed charges,,,1018.94,82,,percent of total billed charges,,,1118.35,90,,percent of total billed charges,,,1056.22,85,,percent of total billed charges,,936.93,1180.48,
SYNTHES PLATE MEDIAL DISTAL TIBIA 2.7 X,30185348,CDM,,,278,RC,inpatient,,17215.12,17215.12,,14615.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12980.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14632.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15149.31,88,,percent of total billed charges,,,,,,,,,13152.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15665.76,91,,percent of total billed charges,,,16354.36,95,,percent of total billed charges,,,14288.55,83,,percent of total billed charges,,,14288.55,83,,percent of total billed charges,,,,,,,,,,,,,,,14288.55,83,,percent of total billed charges,,,16354.36,95,,percent of total billed charges,,,15493.61,90,,percent of total billed charges,,,15493.61,90,,percent of total billed charges,,,14116.4,82,,percent of total billed charges,,,15493.61,90,,percent of total billed charges,,,14632.85,85,,percent of total billed charges,,12980.2,16354.36,
SYNTHES SCREW CORTEX 3.5 X 30MM,30185349,CDM,,,278,RC,inpatient,,362.95,362.95,,308.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,273.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,308.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,319.4,88,,percent of total billed charges,,,,,,,,,277.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,330.28,91,,percent of total billed charges,,,344.8,95,,percent of total billed charges,,,301.25,83,,percent of total billed charges,,,301.25,83,,percent of total billed charges,,,,,,,,,,,,,,,301.25,83,,percent of total billed charges,,,344.8,95,,percent of total billed charges,,,326.66,90,,percent of total billed charges,,,326.66,90,,percent of total billed charges,,,297.62,82,,percent of total billed charges,,,326.66,90,,percent of total billed charges,,,308.51,85,,percent of total billed charges,,273.66,344.8,
SYNTHES SCREW LOCKING VA 3.5 X 24MM,30185350,CDM,,,278,RC,inpatient,,1456.85,1456.85,,1236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1098.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1238.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1282.03,88,,percent of total billed charges,,,,,,,,,1113.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1325.73,91,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1209.19,83,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1194.62,82,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,1098.46,1384.01,
SYNTHES SCREW LOCKING VA 3.5 X 26MM,30185351,CDM,,,278,RC,inpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1131.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1275.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,1131.4,1425.5,
SYNTHES SCREW LOCKING VA 2.7 X 32MM,30185352,CDM,,,278,RC,inpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1065.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1200.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,1065.14,1342.02,
SYNTHES SCREW LOCKING VA 2.7 X 34MM,30185353,CDM,,,278,RC,inpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1065.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1200.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,1065.14,1342.02,
SYNTHES SCREW LOCKING VA 2.7 X 36MM,30185354,CDM,,,278,RC,inpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1065.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1200.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,1065.14,1342.02,
SYNTHES SCREW LOCKING VA 2.7 X 38MM,30185355,CDM,,,278,RC,inpatient,,1371.5,1371.5,,1164.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1034.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1165.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1206.92,88,,percent of total billed charges,,,,,,,,,1047.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1248.07,91,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.35,83,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1124.63,82,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,1034.11,1302.93,
SYNTHES SCREW LOCKING VA 2.7 X 42MM,30185356,CDM,,,278,RC,inpatient,,1371.5,1371.5,,1164.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1034.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1165.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1206.92,88,,percent of total billed charges,,,,,,,,,1047.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1248.07,91,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.35,83,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1124.63,82,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,1034.11,1302.93,
ZIMMER CUP 7MM OFFSET LINER LONGEVITY,30185357,CDM,,,278,RC,inpatient,,16315,16315,,13851.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12301.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13867.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14357.2,88,,percent of total billed charges,,,,,,,,,12464.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14846.65,91,,percent of total billed charges,,,15499.25,95,,percent of total billed charges,,,13541.45,83,,percent of total billed charges,,,13541.45,83,,percent of total billed charges,,,,,,,,,,,,,,,13541.45,83,,percent of total billed charges,,,15499.25,95,,percent of total billed charges,,,14683.5,90,,percent of total billed charges,,,14683.5,90,,percent of total billed charges,,,13378.3,82,,percent of total billed charges,,,14683.5,90,,percent of total billed charges,,,13867.75,85,,percent of total billed charges,,12301.51,15499.25,
ZIMMER HEAD BIOLOX 32MM +0MM,30185358,CDM,,,278,RC,inpatient,,21645,21645,,18376.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16320.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18398.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19047.6,88,,percent of total billed charges,,,,,,,,,16536.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19696.95,91,,percent of total billed charges,,,20562.75,95,,percent of total billed charges,,,17965.35,83,,percent of total billed charges,,,17965.35,83,,percent of total billed charges,,,,,,,,,,,,,,,17965.35,83,,percent of total billed charges,,,20562.75,95,,percent of total billed charges,,,19480.5,90,,percent of total billed charges,,,19480.5,90,,percent of total billed charges,,,17748.9,82,,percent of total billed charges,,,19480.5,90,,percent of total billed charges,,,18398.25,85,,percent of total billed charges,,16320.33,20562.75,
SYNTHES DRILL CANNULATED 2.0,30185359,CDM,,,278,RC,inpatient,,4148.56,4148.56,,3522.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3128.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3526.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3650.73,88,,percent of total billed charges,,,,,,,,,3169.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3775.19,91,,percent of total billed charges,,,3941.13,95,,percent of total billed charges,,,3443.3,83,,percent of total billed charges,,,3443.3,83,,percent of total billed charges,,,,,,,,,,,,,,,3443.3,83,,percent of total billed charges,,,3941.13,95,,percent of total billed charges,,,3733.7,90,,percent of total billed charges,,,3733.7,90,,percent of total billed charges,,,3401.82,82,,percent of total billed charges,,,3733.7,90,,percent of total billed charges,,,3526.28,85,,percent of total billed charges,,3128.01,3941.13,
SYNTHES GUIDE PIN 1.1 THD,30185360,CDM,,,278,RC,inpatient,,341.48,341.48,,289.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,257.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,290.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,300.5,88,,percent of total billed charges,,,,,,,,,260.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,310.75,91,,percent of total billed charges,,,324.41,95,,percent of total billed charges,,,283.43,83,,percent of total billed charges,,,283.43,83,,percent of total billed charges,,,,,,,,,,,,,,,283.43,83,,percent of total billed charges,,,324.41,95,,percent of total billed charges,,,307.33,90,,percent of total billed charges,,,307.33,90,,percent of total billed charges,,,280.01,82,,percent of total billed charges,,,307.33,90,,percent of total billed charges,,,290.26,85,,percent of total billed charges,,257.48,324.41,
SYNTHES SCREW HEADLESS COMRESSION 3 X 26,30185361,CDM,,,278,RC,inpatient,,3364.73,3364.73,,2856.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2537.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2860.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2960.96,88,,percent of total billed charges,,,,,,,,,2570.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3061.9,91,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2792.73,83,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2759.08,82,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2860.02,85,,percent of total billed charges,,2537.01,3196.49,
SYNTHES SCREW HEADLESS COMRESSION 3 X 29,30185362,CDM,,,278,RC,inpatient,,3364.73,3364.73,,2856.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2537.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2860.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2960.96,88,,percent of total billed charges,,,,,,,,,2570.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3061.9,91,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2792.73,83,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2759.08,82,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2860.02,85,,percent of total billed charges,,2537.01,3196.49,
SYNTHES TAP CORTEX 4.5MM,30185363,CDM,,,270,RC,inpatient,,2110.55,2110.55,,1791.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1591.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1793.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1857.28,88,,percent of total billed charges,,,,,,,,,1612.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1920.6,91,,percent of total billed charges,,,2005.02,95,,percent of total billed charges,,,1751.76,83,,percent of total billed charges,,,1751.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1751.76,83,,percent of total billed charges,,,2005.02,95,,percent of total billed charges,,,1899.5,90,,percent of total billed charges,,,1899.5,90,,percent of total billed charges,,,1730.65,82,,percent of total billed charges,,,1899.5,90,,percent of total billed charges,,,1793.97,85,,percent of total billed charges,,1591.35,2005.02,
ZIMMER INSERT CD 17MM LPS FLEX,30185364,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
STRYKER TUBING 10FT W/WAND,30185365,CDM,,,270,RC,inpatient,,153.94,153.94,,130.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.47,88,,percent of total billed charges,,,,,,,,,117.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.09,91,,percent of total billed charges,,,146.24,95,,percent of total billed charges,,,127.77,83,,percent of total billed charges,,,127.77,83,,percent of total billed charges,,,,,,,,,,,,,,,127.77,83,,percent of total billed charges,,,146.24,95,,percent of total billed charges,,,138.55,90,,percent of total billed charges,,,138.55,90,,percent of total billed charges,,,126.23,82,,percent of total billed charges,,,138.55,90,,percent of total billed charges,,,130.85,85,,percent of total billed charges,,116.07,146.24,
SUTURE ETHIBOND EXCEL CX12D,30185366,CDM,,,270,RC,inpatient,,81.31,81.31,,69.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,69.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.55,88,,percent of total billed charges,,,,,,,,,62.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.99,91,,percent of total billed charges,,,77.24,95,,percent of total billed charges,,,67.49,83,,percent of total billed charges,,,67.49,83,,percent of total billed charges,,,,,,,,,,,,,,,67.49,83,,percent of total billed charges,,,77.24,95,,percent of total billed charges,,,73.18,90,,percent of total billed charges,,,73.18,90,,percent of total billed charges,,,66.67,82,,percent of total billed charges,,,73.18,90,,percent of total billed charges,,,69.11,85,,percent of total billed charges,,61.31,77.24,
DEPUY ATTUNE TIBIA SZ 6 FB,30185367,CDM,,,278,RC,inpatient,,19747.26,19747.26,,16765.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14889.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16785.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17377.59,88,,percent of total billed charges,,,,,,,,,15086.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17970.01,91,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,,,,,,,,,,,,,16390.23,83,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16192.75,82,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,14889.43,18759.9,
SYNTHES INST. KIT 2.4MM VA LCP,30185368,CDM,,,278,RC,inpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2082.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2348.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,2082.93,2624.38,
SYNTHES PLATE DIST. RAD. VA LT 5H SHAFT,30185369,CDM,,,278,RC,inpatient,,10508.55,10508.55,,8921.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7923.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8932.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9247.52,88,,percent of total billed charges,,,,,,,,,8028.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9562.78,91,,percent of total billed charges,,,9983.12,95,,percent of total billed charges,,,8722.1,83,,percent of total billed charges,,,8722.1,83,,percent of total billed charges,,,,,,,,,,,,,,,8722.1,83,,percent of total billed charges,,,9983.12,95,,percent of total billed charges,,,9457.7,90,,percent of total billed charges,,,9457.7,90,,percent of total billed charges,,,8617.01,82,,percent of total billed charges,,,9457.7,90,,percent of total billed charges,,,8932.27,85,,percent of total billed charges,,7923.45,9983.12,
STRYKER SAMURAI BLADE FULL RADIUS,30185370,CDM,,,270,RC,inpatient,,1624.87,1624.87,,1379.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1429.89,88,,percent of total billed charges,,,,,,,,,1241.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.63,91,,percent of total billed charges,,,1543.63,95,,percent of total billed charges,,,1348.64,83,,percent of total billed charges,,,1348.64,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.64,83,,percent of total billed charges,,,1543.63,95,,percent of total billed charges,,,1462.38,90,,percent of total billed charges,,,1462.38,90,,percent of total billed charges,,,1332.39,82,,percent of total billed charges,,,1462.38,90,,percent of total billed charges,,,1381.14,85,,percent of total billed charges,,1225.15,1543.63,
STRYKER SERFAX 50-S XL,30185371,CDM,,,270,RC,inpatient,,1483.3,1483.3,,1259.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1118.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1260.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1305.3,88,,percent of total billed charges,,,,,,,,,1133.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1349.8,91,,percent of total billed charges,,,1409.14,95,,percent of total billed charges,,,1231.14,83,,percent of total billed charges,,,1231.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1231.14,83,,percent of total billed charges,,,1409.14,95,,percent of total billed charges,,,1334.97,90,,percent of total billed charges,,,1334.97,90,,percent of total billed charges,,,1216.31,82,,percent of total billed charges,,,1334.97,90,,percent of total billed charges,,,1260.81,85,,percent of total billed charges,,1118.41,1409.14,
STRYKER SLINGSHOT 70DEG,30185372,CDM,,,270,RC,inpatient,,2361,2361,,2004.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1780.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2006.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2077.68,88,,percent of total billed charges,,,,,,,,,1803.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2148.51,91,,percent of total billed charges,,,2242.95,95,,percent of total billed charges,,,1959.63,83,,percent of total billed charges,,,1959.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1959.63,83,,percent of total billed charges,,,2242.95,95,,percent of total billed charges,,,2124.9,90,,percent of total billed charges,,,2124.9,90,,percent of total billed charges,,,1936.02,82,,percent of total billed charges,,,2124.9,90,,percent of total billed charges,,,2006.85,85,,percent of total billed charges,,1780.19,2242.95,
STRYKER HIP INSTRUMENTATION SYSTEM USAGE,30185373,CDM,,,270,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
STRYKER PIVOT TRAY USAGE,30185374,CDM,,,270,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
SYNTHES DSTL RAD RT STERILE KIT 2.4MM VA,30185375,CDM,,,278,RC,inpatient,,18232.5,18232.5,,15479.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13747.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15497.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16044.6,88,,percent of total billed charges,,,,,,,,,13929.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16591.58,91,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15132.98,83,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,14950.65,82,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,13747.31,17320.88,
SYNTHES SCREW CORTEX 22 X 2.4MM STERILE,30185376,CDM,,,278,RC,inpatient,,827.05,827.05,,702.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,623.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,702.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,727.8,88,,percent of total billed charges,,,,,,,,,631.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,752.62,91,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,,,,,,,,,,,,,686.45,83,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,678.18,82,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,623.6,785.7,
SYNTHES SCREW LOCKING VA 12 X 2.4MM STER,30185377,CDM,,,278,RC,inpatient,,1635.4,1635.4,,1388.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1233.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1390.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1439.15,88,,percent of total billed charges,,,,,,,,,1249.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1488.21,91,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1357.38,83,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1341.03,82,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1390.09,85,,percent of total billed charges,,1233.09,1553.63,
SYNTHES SCREW LOCKING VA 16 X 2.4MM STER,30185378,CDM,,,278,RC,inpatient,,1635.4,1635.4,,1388.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1233.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1390.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1439.15,88,,percent of total billed charges,,,,,,,,,1249.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1488.21,91,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1357.38,83,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1341.03,82,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1390.09,85,,percent of total billed charges,,1233.09,1553.63,
SYNTHES PLATES DIST. RAD 2.4MM VA,30185379,CDM,,,278,RC,inpatient,,1105,1105,,938.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,833.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,939.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,972.4,88,,percent of total billed charges,,,,,,,,,844.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1005.55,91,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,,,,,,,,,,,,,917.15,83,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,906.1,82,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,833.17,1049.75,
OLYMPUS PK CUTTING FORCEP,30185380,CDM,,,270,RC,inpatient,,5119.4,5119.4,,4346.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3860.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4351.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4505.07,88,,percent of total billed charges,,,,,,,,,3911.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4658.65,91,,percent of total billed charges,,,4863.43,95,,percent of total billed charges,,,4249.1,83,,percent of total billed charges,,,4249.1,83,,percent of total billed charges,,,,,,,,,,,,,,,4249.1,83,,percent of total billed charges,,,4863.43,95,,percent of total billed charges,,,4607.46,90,,percent of total billed charges,,,4607.46,90,,percent of total billed charges,,,4197.91,82,,percent of total billed charges,,,4607.46,90,,percent of total billed charges,,,4351.49,85,,percent of total billed charges,,3860.03,4863.43,
AMNIOFILL 500MG,30185383,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
DEPUY HEAD FEMORAL CERAMIC 28MM + 8.5,30185384,CDM,,,278,RC,inpatient,,18783.9,18783.9,,15947.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14163.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15966.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16529.83,88,,percent of total billed charges,,,,,,,,,14350.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17093.35,91,,percent of total billed charges,,,17844.71,95,,percent of total billed charges,,,15590.64,83,,percent of total billed charges,,,15590.64,83,,percent of total billed charges,,,,,,,,,,,,,,,15590.64,83,,percent of total billed charges,,,17844.71,95,,percent of total billed charges,,,16905.51,90,,percent of total billed charges,,,16905.51,90,,percent of total billed charges,,,15402.8,82,,percent of total billed charges,,,16905.51,90,,percent of total billed charges,,,15966.32,85,,percent of total billed charges,,14163.06,17844.71,
DEPUY STEM FEMORAL CEMENTLESS SZ 18,30185385,CDM,,,278,RC,inpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50336.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56745.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,50336.9,63421.82,
ZIMMER INSERT BEARING SZ 5 SM RT,30185386,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
ZIMMER TRAY TIBIAL SZ AA OXFORD,30185387,CDM,,,278,RC,inpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10218.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11519.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,10218.59,12874.88,
ZIMMER SHELL OSSEOTI G7 60MM G,30185388,CDM,,,278,RC,inpatient,,42640,42640,,36201.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32150.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36244,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37523.2,88,,percent of total billed charges,,,,,,,,,32576.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38802.4,91,,percent of total billed charges,,,40508,95,,percent of total billed charges,,,35391.2,83,,percent of total billed charges,,,35391.2,83,,percent of total billed charges,,,,,,,,,,,,,,,35391.2,83,,percent of total billed charges,,,40508,95,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,34964.8,82,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,36244,85,,percent of total billed charges,,32150.56,40508,
CTL ROD MIS 80MM,30185389,CDM,,,278,RC,inpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1669.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1881.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,1669.28,2103.21,
CTL ROD MIS 75MM,30185390,CDM,,,278,RC,inpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1669.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1881.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,1669.28,2103.21,
CATH FOLEY SILICONE L-F 22F 10ML,30185391,CDM,,,270,RC,inpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,41.47,52.25,
ALPHATEC SCREW MIS 6.5 X 45MM,30185392,CDM,,,278,RC,inpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7694.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8674.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,7694.57,9694.75,
ALPHATEC SCREW MIS 6.5 X 40MM,30185393,CDM,,,278,RC,inpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7694.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8674.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,7694.57,9694.75,
ZIMMER TIBIAL TRAY SZ A RM/LL OXF,30185394,CDM,,,278,RC,inpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10218.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11519.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,10218.59,12874.88,
S&N FEMORAL COMPONENT SZ 6N LEFT,30185395,CDM,,,278,RC,inpatient,,32523.99,32523.99,,27612.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24523.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27645.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28621.11,88,,percent of total billed charges,,,,,,,,,24848.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29596.83,91,,percent of total billed charges,,,30897.79,95,,percent of total billed charges,,,26994.91,83,,percent of total billed charges,,,26994.91,83,,percent of total billed charges,,,,,,,,,,,,,,,26994.91,83,,percent of total billed charges,,,30897.79,95,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,26669.67,82,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,27645.39,85,,percent of total billed charges,,24523.09,30897.79,
BLADE TRICUT 11 X 4,30185396,CDM,,,270,RC,inpatient,,1714.7,1714.7,,1455.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1292.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1457.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1508.94,88,,percent of total billed charges,,,,,,,,,1310.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1560.38,91,,percent of total billed charges,,,1628.97,95,,percent of total billed charges,,,1423.2,83,,percent of total billed charges,,,1423.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1423.2,83,,percent of total billed charges,,,1628.97,95,,percent of total billed charges,,,1543.23,90,,percent of total billed charges,,,1543.23,90,,percent of total billed charges,,,1406.05,82,,percent of total billed charges,,,1543.23,90,,percent of total billed charges,,,1457.5,85,,percent of total billed charges,,1292.88,1628.97,
BLADE RAD 90 3.5MM,30185397,CDM,,,270,RC,inpatient,,2283.67,2283.67,,1938.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1721.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1941.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2009.63,88,,percent of total billed charges,,,,,,,,,1744.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2078.14,91,,percent of total billed charges,,,2169.49,95,,percent of total billed charges,,,1895.45,83,,percent of total billed charges,,,1895.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1895.45,83,,percent of total billed charges,,,2169.49,95,,percent of total billed charges,,,2055.3,90,,percent of total billed charges,,,2055.3,90,,percent of total billed charges,,,1872.61,82,,percent of total billed charges,,,2055.3,90,,percent of total billed charges,,,1941.12,85,,percent of total billed charges,,1721.89,2169.49,
BLADE CURVED SINUS 11X4MM,30185398,CDM,,,270,RC,inpatient,,1905.8,1905.8,,1618.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1436.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1619.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1677.1,88,,percent of total billed charges,,,,,,,,,1456.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1734.28,91,,percent of total billed charges,,,1810.51,95,,percent of total billed charges,,,1581.81,83,,percent of total billed charges,,,1581.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1581.81,83,,percent of total billed charges,,,1810.51,95,,percent of total billed charges,,,1715.22,90,,percent of total billed charges,,,1715.22,90,,percent of total billed charges,,,1562.76,82,,percent of total billed charges,,,1715.22,90,,percent of total billed charges,,,1619.93,85,,percent of total billed charges,,1436.97,1810.51,
DEPUY HEAD BIOLOX TS 28MM +12,30185399,CDM,,,278,RC,inpatient,,18783.9,18783.9,,15947.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14163.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15966.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16529.83,88,,percent of total billed charges,,,,,,,,,14350.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17093.35,91,,percent of total billed charges,,,17844.71,95,,percent of total billed charges,,,15590.64,83,,percent of total billed charges,,,15590.64,83,,percent of total billed charges,,,,,,,,,,,,,,,15590.64,83,,percent of total billed charges,,,17844.71,95,,percent of total billed charges,,,16905.51,90,,percent of total billed charges,,,16905.51,90,,percent of total billed charges,,,15402.8,82,,percent of total billed charges,,,16905.51,90,,percent of total billed charges,,,15966.32,85,,percent of total billed charges,,14163.06,17844.71,
STRYKER NEEDLE INJECTOR,30185402,CDM,,,270,RC,inpatient,,1955.2,1955.2,,1659.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1474.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1661.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1720.58,88,,percent of total billed charges,,,,,,,,,1493.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1779.23,91,,percent of total billed charges,,,1857.44,95,,percent of total billed charges,,,1622.82,83,,percent of total billed charges,,,1622.82,83,,percent of total billed charges,,,,,,,,,,,,,,,1622.82,83,,percent of total billed charges,,,1857.44,95,,percent of total billed charges,,,1759.68,90,,percent of total billed charges,,,1759.68,90,,percent of total billed charges,,,1603.26,82,,percent of total billed charges,,,1759.68,90,,percent of total billed charges,,,1661.92,85,,percent of total billed charges,,1474.22,1857.44,
WRIGHT HEAD DELTA,30185403,CDM,,,278,RC,inpatient,,39065,39065,,33166.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29455.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33205.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34377.2,88,,percent of total billed charges,,,,,,,,,29845.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35549.15,91,,percent of total billed charges,,,37111.75,95,,percent of total billed charges,,,32423.95,83,,percent of total billed charges,,,32423.95,83,,percent of total billed charges,,,,,,,,,,,,,,,32423.95,83,,percent of total billed charges,,,37111.75,95,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,32033.3,82,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,33205.25,85,,percent of total billed charges,,29455.01,37111.75,
WRIGHT MODULAR NECK,30185404,CDM,,,278,RC,inpatient,,28964,28964,,24590.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21838.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24619.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25488.32,88,,percent of total billed charges,,,,,,,,,22128.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26357.24,91,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,,,,,,,,,,,,,24040.12,83,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,23750.48,82,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,24619.4,85,,percent of total billed charges,,21838.86,27515.8,
SYNTHES SCREW CORTEX 3.5 X 60MM,30185405,CDM,,,278,RC,inpatient,,275.78,275.78,,234.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,207.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,234.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,242.69,88,,percent of total billed charges,,,,,,,,,210.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,250.96,91,,percent of total billed charges,,,261.99,95,,percent of total billed charges,,,228.9,83,,percent of total billed charges,,,228.9,83,,percent of total billed charges,,,,,,,,,,,,,,,228.9,83,,percent of total billed charges,,,261.99,95,,percent of total billed charges,,,248.2,90,,percent of total billed charges,,,248.2,90,,percent of total billed charges,,,226.14,82,,percent of total billed charges,,,248.2,90,,percent of total billed charges,,,234.41,85,,percent of total billed charges,,207.94,261.99,
SYNTHES SCREW CANCEL 4.0X50MM,30185406,CDM,,,278,RC,inpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,168.24,211.97,
DEPUY LINER ALTRX +4 32 X 50 10DEG,30185407,CDM,,,278,RC,inpatient,,11806.99,11806.99,,10024.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8902.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10035.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10390.15,88,,percent of total billed charges,,,,,,,,,9020.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10744.36,91,,percent of total billed charges,,,11216.64,95,,percent of total billed charges,,,9799.8,83,,percent of total billed charges,,,9799.8,83,,percent of total billed charges,,,,,,,,,,,,,,,9799.8,83,,percent of total billed charges,,,11216.64,95,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,9681.73,82,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,10035.94,85,,percent of total billed charges,,8902.47,11216.64,
WRIGHT HEAD DELTA SZ 28MM 12/14,30185408,CDM,,,278,RC,inpatient,,39065,39065,,33166.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29455.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33205.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34377.2,88,,percent of total billed charges,,,,,,,,,29845.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35549.15,91,,percent of total billed charges,,,37111.75,95,,percent of total billed charges,,,32423.95,83,,percent of total billed charges,,,32423.95,83,,percent of total billed charges,,,,,,,,,,,,,,,32423.95,83,,percent of total billed charges,,,37111.75,95,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,32033.3,82,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,33205.25,85,,percent of total billed charges,,29455.01,37111.75,
WRIGHT NECK 8DEG SHORT,30185409,CDM,,,278,RC,inpatient,,28964,28964,,24590.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21838.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24619.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25488.32,88,,percent of total billed charges,,,,,,,,,22128.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26357.24,91,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,,,,,,,,,,,,,24040.12,83,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,23750.48,82,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,24619.4,85,,percent of total billed charges,,21838.86,27515.8,
CTL ROD MIS 6.0 X 60MM,30185410,CDM,,,278,RC,inpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1669.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1881.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,1669.28,2103.21,
ARTHREX BTB TIGHTROPE,30185411,CDM,,,270,RC,inpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2082.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2348.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,2082.93,2624.38,
ARTHREX SECONDARY FIXATION KIT ACL/PCL R,30185412,CDM,,,270,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
ARTHREX CUTTER FLIP II 11.0MM,30185413,CDM,,,270,RC,inpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1592.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1795.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,1592.83,2006.88,
ARTHREX SUTURE ANCHOR BC 2.4 X 11.3MM,30185414,CDM,,,278,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
ARTHREX INSERT KIT PERCUTANEOUS 2.9MM,30185415,CDM,,,278,RC,inpatient,,1430,1430,,1214.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1078.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1215.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1258.4,88,,percent of total billed charges,,,,,,,,,1092.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1301.3,91,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1186.9,83,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1172.6,82,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,1078.22,1358.5,
ARTHREX DISTAL BICEP IMPLANT SYS BC,30185416,CDM,,,270,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
SYNTHES PLATE DISTAL RADIUS VA LCP 2.4MM,30185417,CDM,,,278,RC,inpatient,,18232.5,18232.5,,15479.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13747.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15497.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16044.6,88,,percent of total billed charges,,,,,,,,,13929.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16591.58,91,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15132.98,83,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,14950.65,82,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,13747.31,17320.88,
SYNTHES SCREW CORTEX 2.4 X 14MM,30185418,CDM,,,278,RC,inpatient,,827.05,827.05,,702.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,623.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,702.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,727.8,88,,percent of total billed charges,,,,,,,,,631.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,752.62,91,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,,,,,,,,,,,,,686.45,83,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,678.18,82,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,623.6,785.7,
MENTOR MEMORYGEL BREAST IMPLANT 4000 SMO,30185419,CDM,,,278,RC,inpatient,,6370,6370,,5408.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4802.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5414.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5605.6,88,,percent of total billed charges,,,,,,,,,4866.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5796.7,91,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5287.1,83,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5223.4,82,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5414.5,85,,percent of total billed charges,,4802.98,6051.5,
DEPUY REVISION TIBIAL TRAY SZ 7,30185421,CDM,,,278,RC,inpatient,,25954.31,25954.31,,22035.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19569.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22061.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22839.79,88,,percent of total billed charges,,,,,,,,,19829.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23618.42,91,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,,,,,,,,,,,,,21542.08,83,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,21282.53,82,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,19569.55,24656.59,
ZIMMER SHELL OSSEOTI 4 HOLE G7 58MM G,30185422,CDM,,,278,RC,inpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14580.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16436.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,14580.48,18370.63,
ZIMMER ACT ARTIC HD ARCOM XL 28X46MM,30185423,CDM,,,278,RC,inpatient,,18070,18070,,15341.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13624.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15359.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15901.6,88,,percent of total billed charges,,,,,,,,,13805.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16443.7,91,,percent of total billed charges,,,17166.5,95,,percent of total billed charges,,,14998.1,83,,percent of total billed charges,,,14998.1,83,,percent of total billed charges,,,,,,,,,,,,,,,14998.1,83,,percent of total billed charges,,,17166.5,95,,percent of total billed charges,,,16263,90,,percent of total billed charges,,,16263,90,,percent of total billed charges,,,14817.4,82,,percent of total billed charges,,,16263,90,,percent of total billed charges,,,15359.5,85,,percent of total billed charges,,13624.78,17166.5,
SYNTHES PLATE LCP RT 4HOLE,30185424,CDM,,,278,RC,inpatient,,6318.65,6318.65,,5364.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4764.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5370.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5560.41,88,,percent of total billed charges,,,,,,,,,4827.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5749.97,91,,percent of total billed charges,,,6002.72,95,,percent of total billed charges,,,5244.48,83,,percent of total billed charges,,,5244.48,83,,percent of total billed charges,,,,,,,,,,,,,,,5244.48,83,,percent of total billed charges,,,6002.72,95,,percent of total billed charges,,,5686.79,90,,percent of total billed charges,,,5686.79,90,,percent of total billed charges,,,5181.29,82,,percent of total billed charges,,,5686.79,90,,percent of total billed charges,,,5370.85,85,,percent of total billed charges,,4764.26,6002.72,
SYNTHES BALDE HELICAL 75MM,30185425,CDM,,,270,RC,inpatient,,6630,6630,,5628.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4999.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5635.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5834.4,88,,percent of total billed charges,,,,,,,,,5065.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6033.3,91,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,,,,,,,,,,,,,5502.9,83,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5436.6,82,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,4999.02,6298.5,
SYNTHES ENDCAP 0MM,30185426,CDM,,,278,RC,inpatient,,2331.55,2331.55,,1979.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1757.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1981.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2051.76,88,,percent of total billed charges,,,,,,,,,1781.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2121.71,91,,percent of total billed charges,,,2214.97,95,,percent of total billed charges,,,1935.19,83,,percent of total billed charges,,,1935.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1935.19,83,,percent of total billed charges,,,2214.97,95,,percent of total billed charges,,,2098.4,90,,percent of total billed charges,,,2098.4,90,,percent of total billed charges,,,1911.87,82,,percent of total billed charges,,,2098.4,90,,percent of total billed charges,,,1981.82,85,,percent of total billed charges,,1757.99,2214.97,
SYNTHES GUIDE WIRE NON-THREADED,30185427,CDM,,,278,RC,inpatient,,321.75,321.75,,273.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,273.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.14,88,,percent of total billed charges,,,,,,,,,245.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,292.79,91,,percent of total billed charges,,,305.66,95,,percent of total billed charges,,,267.05,83,,percent of total billed charges,,,267.05,83,,percent of total billed charges,,,,,,,,,,,,,,,267.05,83,,percent of total billed charges,,,305.66,95,,percent of total billed charges,,,289.58,90,,percent of total billed charges,,,289.58,90,,percent of total billed charges,,,263.84,82,,percent of total billed charges,,,289.58,90,,percent of total billed charges,,,273.49,85,,percent of total billed charges,,242.6,305.66,
SYNTHES SCREW LNG THD HEADLESS 3.0X40MM,30185428,CDM,,,278,RC,inpatient,,3364.73,3364.73,,2856.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2537.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2860.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2960.96,88,,percent of total billed charges,,,,,,,,,2570.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3061.9,91,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2792.73,83,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2759.08,82,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2860.02,85,,percent of total billed charges,,2537.01,3196.49,
SYNTHES SCREW LNG THD HEADLESS 3.0X34MM,30185429,CDM,,,278,RC,inpatient,,3364.73,3364.73,,2856.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2537.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2860.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2960.96,88,,percent of total billed charges,,,,,,,,,2570.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3061.9,91,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2792.73,83,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2759.08,82,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2860.02,85,,percent of total billed charges,,2537.01,3196.49,
CTL ROD MIS 45MM,30185430,CDM,,,278,RC,inpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1669.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1881.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,1669.28,2103.21,
CTL ROD MIS 35MM,30185431,CDM,,,278,RC,inpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1669.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1881.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,1669.28,2103.21,
SYNTHES PLATE PROX. LAT 4HOLE LONG BEND,30185432,CDM,,,278,RC,inpatient,,16138.53,16138.53,,13701.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12168.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13717.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14201.91,88,,percent of total billed charges,,,,,,,,,12329.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14686.06,91,,percent of total billed charges,,,15331.6,95,,percent of total billed charges,,,13394.98,83,,percent of total billed charges,,,13394.98,83,,percent of total billed charges,,,,,,,,,,,,,,,13394.98,83,,percent of total billed charges,,,15331.6,95,,percent of total billed charges,,,14524.68,90,,percent of total billed charges,,,14524.68,90,,percent of total billed charges,,,13233.59,82,,percent of total billed charges,,,14524.68,90,,percent of total billed charges,,,13717.75,85,,percent of total billed charges,,12168.45,15331.6,
SYNTHES SCREW LOCKING VA 3.5 X 34MM,30185433,CDM,,,278,RC,inpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1131.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1275.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,1131.4,1425.5,
SYNTHES SCREW LOCKING VA 3.5 X 50MM,30185434,CDM,,,278,RC,inpatient,,1414.4,1414.4,,1200.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1066.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1202.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1244.67,88,,percent of total billed charges,,,,,,,,,1080.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1287.1,91,,percent of total billed charges,,,1343.68,95,,percent of total billed charges,,,1173.95,83,,percent of total billed charges,,,1173.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1173.95,83,,percent of total billed charges,,,1343.68,95,,percent of total billed charges,,,1272.96,90,,percent of total billed charges,,,1272.96,90,,percent of total billed charges,,,1159.81,82,,percent of total billed charges,,,1272.96,90,,percent of total billed charges,,,1202.24,85,,percent of total billed charges,,1066.46,1343.68,
SYNTHES SCREW LOCKING VA 3.5 X 54MM,30185435,CDM,,,278,RC,inpatient,,1414.4,1414.4,,1200.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1066.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1202.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1244.67,88,,percent of total billed charges,,,,,,,,,1080.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1287.1,91,,percent of total billed charges,,,1343.68,95,,percent of total billed charges,,,1173.95,83,,percent of total billed charges,,,1173.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1173.95,83,,percent of total billed charges,,,1343.68,95,,percent of total billed charges,,,1272.96,90,,percent of total billed charges,,,1272.96,90,,percent of total billed charges,,,1159.81,82,,percent of total billed charges,,,1272.96,90,,percent of total billed charges,,,1202.24,85,,percent of total billed charges,,1066.46,1343.68,
SYNTHES SCREW LOCKING VA 3.5 X 56MM,30185436,CDM,,,278,RC,inpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1131.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1275.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,1131.4,1425.5,
SYNTHES SCREW LOCKING VA 3.5 X 65MM,30185437,CDM,,,278,RC,inpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1131.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1275.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,1131.4,1425.5,
SYNTHES SCREW LOCKING VA 3.5 X 70MM,30185438,CDM,,,278,RC,inpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1131.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1275.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,1131.4,1425.5,
DEPUY ATTUNE STEM CEMENTED 16X80,30185439,CDM,,,278,RC,inpatient,,8336.19,8336.19,,7077.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6285.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7085.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7335.85,88,,percent of total billed charges,,,,,,,,,6368.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7585.93,91,,percent of total billed charges,,,7919.38,95,,percent of total billed charges,,,6919.04,83,,percent of total billed charges,,,6919.04,83,,percent of total billed charges,,,,,,,,,,,,,,,6919.04,83,,percent of total billed charges,,,7919.38,95,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,6835.68,82,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,7085.76,85,,percent of total billed charges,,6285.49,7919.38,
DEPUY ATTUNE FEMUR REV. SZ 7 L,30185440,CDM,,,278,RC,inpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39636.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44683.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,39636.69,49940.13,
DEPUY ATTUNE INSERT REV. FB 6MM,30185441,CDM,,,278,RC,inpatient,,19355.77,19355.77,,16433.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14594.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16452.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17033.08,88,,percent of total billed charges,,,,,,,,,14787.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17613.75,91,,percent of total billed charges,,,18387.98,95,,percent of total billed charges,,,16065.29,83,,percent of total billed charges,,,16065.29,83,,percent of total billed charges,,,,,,,,,,,,,,,16065.29,83,,percent of total billed charges,,,18387.98,95,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,15871.73,82,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,16452.4,85,,percent of total billed charges,,14594.25,18387.98,
ARTHREX LASSO QUICKPASS 25DEG LEFT TIGHT,30185442,CDM,,,278,RC,inpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,784.16,988,
ARTHREX LASSO QUICKPASS 25DEG RIGHT TIGH,30185443,CDM,,,278,RC,inpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,784.16,988,
SCREW LATERAL MASS 14 X 3.5MM,30185444,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
SCREW LATERAL MASS 16 X 3.5MM,30185445,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
SCREW LATERAL MASS 26 X 4.0MM,30185446,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
SCREW PEDICLE 30 X 4.5MM,30185447,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ROD STRAIGHT 240MM,30185448,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
LOCKING NUT,30185449,CDM,,,278,RC,inpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,527.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,595,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,527.8,665,
CTL PARALLEL MATISSE 6MM 17X14,30185450,CDM,,,278,RC,inpatient,,10708.75,10708.75,,9091.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8074.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9102.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9423.7,88,,percent of total billed charges,,,,,,,,,8181.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9744.96,91,,percent of total billed charges,,,10173.31,95,,percent of total billed charges,,,8888.26,83,,percent of total billed charges,,,8888.26,83,,percent of total billed charges,,,,,,,,,,,,,,,8888.26,83,,percent of total billed charges,,,10173.31,95,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,8781.18,82,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,9102.44,85,,percent of total billed charges,,8074.4,10173.31,
CTL PLATE VAN GOGH CERVICAL 14MM X-LONG,30185451,CDM,,,278,RC,inpatient,,8957,8957,,7604.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6753.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7613.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7882.16,88,,percent of total billed charges,,,,,,,,,6843.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8150.87,91,,percent of total billed charges,,,8509.15,95,,percent of total billed charges,,,7434.31,83,,percent of total billed charges,,,7434.31,83,,percent of total billed charges,,,,,,,,,,,,,,,7434.31,83,,percent of total billed charges,,,8509.15,95,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,7344.74,82,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,7613.45,85,,percent of total billed charges,,6753.58,8509.15,
DEPUY CAP COP W/GRIPTION,30185452,CDM,,,278,RC,inpatient,,56452.5,56452.5,,47928.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42565.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47984.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49678.2,88,,percent of total billed charges,,,,,,,,,43129.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51371.78,91,,percent of total billed charges,,,53629.88,95,,percent of total billed charges,,,46855.58,83,,percent of total billed charges,,,46855.58,83,,percent of total billed charges,,,,,,,,,,,,,,,46855.58,83,,percent of total billed charges,,,53629.88,95,,percent of total billed charges,,,50807.25,90,,percent of total billed charges,,,50807.25,90,,percent of total billed charges,,,46291.05,82,,percent of total billed charges,,,50807.25,90,,percent of total billed charges,,,47984.63,85,,percent of total billed charges,,42565.19,53629.88,
SYNTHES PLATE VA OLECRANON 2H LT,30185453,CDM,,,270,RC,inpatient,,10721.36,10721.36,,9102.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8083.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9113.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9434.8,88,,percent of total billed charges,,,,,,,,,8191.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9756.44,91,,percent of total billed charges,,,10185.29,95,,percent of total billed charges,,,8898.73,83,,percent of total billed charges,,,8898.73,83,,percent of total billed charges,,,,,,,,,,,,,,,8898.73,83,,percent of total billed charges,,,10185.29,95,,percent of total billed charges,,,9649.22,90,,percent of total billed charges,,,9649.22,90,,percent of total billed charges,,,8791.52,82,,percent of total billed charges,,,9649.22,90,,percent of total billed charges,,,9113.16,85,,percent of total billed charges,,8083.91,10185.29,
SYNTHES SCREW LOCKING VA 2.7MM X 18MM,30185454,CDM,,,278,RC,inpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1065.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1200.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,1065.14,1342.02,
SYNTHES SCREW LOCKING VA 2.7MM X 28MM,30185455,CDM,,,278,RC,inpatient,,1371.5,1371.5,,1164.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1034.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1165.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1206.92,88,,percent of total billed charges,,,,,,,,,1047.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1248.07,91,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.35,83,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1124.63,82,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,1034.11,1302.93,
SYNTHES SCREW LOCKING VA 2.7MM X 44MM,30185456,CDM,,,278,RC,inpatient,,1371.5,1371.5,,1164.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1034.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1165.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1206.92,88,,percent of total billed charges,,,,,,,,,1047.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1248.07,91,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.35,83,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1124.63,82,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,1034.11,1302.93,
CAGE C-TI STALIF,30185457,CDM,,,278,RC,inpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14703,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16575,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,14703,18525,
ARTHREX GUIDE WIRE TROCAR .045  THREADED,30185458,CDM,,,278,RC,inpatient,,195,195,,165.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,165.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,171.6,88,,percent of total billed charges,,,,,,,,,148.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,177.45,91,,percent of total billed charges,,,185.25,95,,percent of total billed charges,,,161.85,83,,percent of total billed charges,,,161.85,83,,percent of total billed charges,,,,,,,,,,,,,,,161.85,83,,percent of total billed charges,,,185.25,95,,percent of total billed charges,,,175.5,90,,percent of total billed charges,,,175.5,90,,percent of total billed charges,,,159.9,82,,percent of total billed charges,,,175.5,90,,percent of total billed charges,,,165.75,85,,percent of total billed charges,,147.03,185.25,
ARTHREX PROFILE DRILL STANDARD CMP FT,30185459,CDM,,,278,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
ARTHREX GUIDE WIRE W/TRCR TIP .045  W/LA,30185460,CDM,,,278,RC,inpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,120.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,120.64,152,
ARTHREX DRILL BIT CANNULATED 3MM,30185461,CDM,,,270,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
ARTHREX SCREW CANC. QCKFIX 3 X 32MM,30185462,CDM,,,270,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
ARTHREX SCREW CANC. QCKFIX 3 X 22MM,30185463,CDM,,,270,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
CTL ROD MIS 40MM,30185464,CDM,,,278,RC,inpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1669.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1881.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,1669.28,2103.21,
SYNTHES SCREW CORTEX T8 24MM STERILE,30185465,CDM,,,278,RC,inpatient,,827.05,827.05,,702.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,623.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,702.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,727.8,88,,percent of total billed charges,,,,,,,,,631.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,752.62,91,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,,,,,,,,,,,,,686.45,83,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,678.18,82,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,623.6,785.7,
ARTHREX SWIVELOCK ANCHOR 5.5 X 19.1MM,30185466,CDM,,,270,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
ARTHREX TENO SCREW KIT,30185467,CDM,,,270,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
ARTHREX TENO SWVLK BC 7 X 19.5MM,30185468,CDM,,,278,RC,inpatient,,2827.5,2827.5,,2400.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2131.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2403.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2488.2,88,,percent of total billed charges,,,,,,,,,2160.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2573.03,91,,percent of total billed charges,,,2686.13,95,,percent of total billed charges,,,2346.83,83,,percent of total billed charges,,,2346.83,83,,percent of total billed charges,,,,,,,,,,,,,,,2346.83,83,,percent of total billed charges,,,2686.13,95,,percent of total billed charges,,,2544.75,90,,percent of total billed charges,,,2544.75,90,,percent of total billed charges,,,2318.55,82,,percent of total billed charges,,,2544.75,90,,percent of total billed charges,,,2403.38,85,,percent of total billed charges,,2131.94,2686.13,
SYNTHES KIT PLATE DISTAL RADIUS 7X3,30185469,CDM,,,278,RC,inpatient,,18232.5,18232.5,,15479.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13747.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15497.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16044.6,88,,percent of total billed charges,,,,,,,,,13929.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16591.58,91,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15132.98,83,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,14950.65,82,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,13747.31,17320.88,
SYNTHES SCREW LOCKING VA 18 X 2.4MM STER,30185470,CDM,,,278,RC,inpatient,,1635.4,1635.4,,1388.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1233.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1390.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1439.15,88,,percent of total billed charges,,,,,,,,,1249.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1488.21,91,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1357.38,83,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1341.03,82,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1390.09,85,,percent of total billed charges,,1233.09,1553.63,
IR SCREW POLY 6.5 X 40MM,30185471,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
IR SCREW REDUCTION 7.5 X 45MM,30185472,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
IR SCREW REDUCTION 7.5 X 50MM,30185473,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
IR SCREW SET,30185474,CDM,,,278,RC,inpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,527.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,595,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,527.8,665,
IR LORDOSED PRE-BENT 5.5 - 50,30185475,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
IR SCREW POLY 7.5 X 45MM,30185476,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
IR SCREW POLY 5.5 X 40MM,30185477,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
IR SCREW POLY 5.5 X 45MM,30185478,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
IR SCREW POLY 6.5 X 45MM,30185479,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
IR SCREW POLY 6.5 X 50MM,30185480,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
IR ROD LONG 450MM,30185481,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
ARTHREX REAMER METATARSAL 22MM,30185482,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
ARTHREX REAMER PHALANGEAL 22MM,30185483,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
ARTHREX REAMER CIRCULAR MTP 22MM,30185484,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
ARTHREX SCREW CORTICAL 3MM X 20MM,30185485,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW VARIABLE LOCKING 3X16MM,30185486,CDM,,,278,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
ARTHREX SCREW VARIABLE LOCKING 3X22MM,30185487,CDM,,,278,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
ARTHREX FLIPCUTTER II 9.5MM,30185488,CDM,,,278,RC,inpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1592.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1795.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,1592.83,2006.88,
MERETE KNEE SPACER IKA OSTEOBRIDGE,30185489,CDM,,,278,RC,inpatient,,96525,96525,,81949.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,72779.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,82046.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,84942,88,,percent of total billed charges,,,,,,,,,73745.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,87837.75,91,,percent of total billed charges,,,91698.75,95,,percent of total billed charges,,,80115.75,83,,percent of total billed charges,,,80115.75,83,,percent of total billed charges,,,,,,,,,,,,,,,80115.75,83,,percent of total billed charges,,,91698.75,95,,percent of total billed charges,,,86872.5,90,,percent of total billed charges,,,86872.5,90,,percent of total billed charges,,,79150.5,82,,percent of total billed charges,,,86872.5,90,,percent of total billed charges,,,82046.25,85,,percent of total billed charges,,72779.85,91698.75,
MERETE KNEE NAIL W/OUT COLLAR 200 X 20MM,30185490,CDM,,,278,RC,inpatient,,17875,17875,,15175.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13477.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15193.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15730,88,,percent of total billed charges,,,,,,,,,13656.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16266.25,91,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14836.25,83,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,14657.5,82,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,13477.75,16981.25,
MERETE KNEE SCREW INTERLOCKING 5 X 38MM,30185491,CDM,,,278,RC,inpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2129.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2400.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,2129.48,2683.04,
MERETE KNEE SCREW INTERLOCKING 5 X 46MM,30185492,CDM,,,278,RC,inpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2129.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2400.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,2129.48,2683.04,
MERETE KNEE SCREW INTERLOCKING 5 X 48MM,30185493,CDM,,,278,RC,inpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2129.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2400.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,2129.48,2683.04,
MERETE KNEE DRILL BIT IKS 4.5MM,30185494,CDM,,,278,RC,inpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2129.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2400.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,2129.48,2683.04,
SYNTHES DRILL BIT 1.1,30185495,CDM,,,278,RC,inpatient,,868.7,868.7,,737.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,655,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,738.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,764.46,88,,percent of total billed charges,,,,,,,,,663.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,790.52,91,,percent of total billed charges,,,825.27,95,,percent of total billed charges,,,721.02,83,,percent of total billed charges,,,721.02,83,,percent of total billed charges,,,,,,,,,,,,,,,721.02,83,,percent of total billed charges,,,825.27,95,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,712.33,82,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,738.4,85,,percent of total billed charges,,655,825.27,
SYNTHES K-WIRE TI 0.8 X 70M,30185496,CDM,,,278,RC,inpatient,,988.98,988.98,,839.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,745.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,840.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,870.3,88,,percent of total billed charges,,,,,,,,,755.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,899.97,91,,percent of total billed charges,,,939.53,95,,percent of total billed charges,,,820.85,83,,percent of total billed charges,,,820.85,83,,percent of total billed charges,,,,,,,,,,,,,,,820.85,83,,percent of total billed charges,,,939.53,95,,percent of total billed charges,,,890.08,90,,percent of total billed charges,,,890.08,90,,percent of total billed charges,,,810.96,82,,percent of total billed charges,,,890.08,90,,percent of total billed charges,,,840.63,85,,percent of total billed charges,,745.69,939.53,
SYNTHES PLATE TI 1.5MM RT PHALANGEAL HEA,30185497,CDM,,,278,RC,inpatient,,4370.28,4370.28,,3710.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3295.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3714.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3845.85,88,,percent of total billed charges,,,,,,,,,3338.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3976.95,91,,percent of total billed charges,,,4151.77,95,,percent of total billed charges,,,3627.33,83,,percent of total billed charges,,,3627.33,83,,percent of total billed charges,,,,,,,,,,,,,,,3627.33,83,,percent of total billed charges,,,4151.77,95,,percent of total billed charges,,,3933.25,90,,percent of total billed charges,,,3933.25,90,,percent of total billed charges,,,3583.63,82,,percent of total billed charges,,,3933.25,90,,percent of total billed charges,,,3714.74,85,,percent of total billed charges,,3295.19,4151.77,
SYNTHES SCREW CORTEX 1.5 X 11MM,30185498,CDM,,,278,RC,inpatient,,523.6,523.6,,444.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,394.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,445.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,460.77,88,,percent of total billed charges,,,,,,,,,400.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,476.48,91,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,,,,,,,,,,,,,434.59,83,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,429.35,82,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,394.79,497.42,
SYNTHES SCREW CORTEX 1.5 X 12MM,30185499,CDM,,,278,RC,inpatient,,523.6,523.6,,444.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,394.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,445.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,460.77,88,,percent of total billed charges,,,,,,,,,400.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,476.48,91,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,,,,,,,,,,,,,434.59,83,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,429.35,82,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,394.79,497.42,
SYNTHES SCREW LOCKING 1.5 X 11MM,30185500,CDM,,,278,RC,inpatient,,1221.03,1221.03,,1036.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,920.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1037.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1074.51,88,,percent of total billed charges,,,,,,,,,932.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1111.14,91,,percent of total billed charges,,,1159.98,95,,percent of total billed charges,,,1013.45,83,,percent of total billed charges,,,1013.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1013.45,83,,percent of total billed charges,,,1159.98,95,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1001.24,82,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1037.88,85,,percent of total billed charges,,920.66,1159.98,
SYNTHES SCREW LOCKING 1.5 X 12MM,30185501,CDM,,,278,RC,inpatient,,1221.03,1221.03,,1036.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,920.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1037.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1074.51,88,,percent of total billed charges,,,,,,,,,932.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1111.14,91,,percent of total billed charges,,,1159.98,95,,percent of total billed charges,,,1013.45,83,,percent of total billed charges,,,1013.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1013.45,83,,percent of total billed charges,,,1159.98,95,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1001.24,82,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1037.88,85,,percent of total billed charges,,920.66,1159.98,
SYNTHES SCREW LOCKING 1.5 X 15MM,30185502,CDM,,,278,RC,inpatient,,1221.03,1221.03,,1036.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,920.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1037.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1074.51,88,,percent of total billed charges,,,,,,,,,932.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1111.14,91,,percent of total billed charges,,,1159.98,95,,percent of total billed charges,,,1013.45,83,,percent of total billed charges,,,1013.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1013.45,83,,percent of total billed charges,,,1159.98,95,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1001.24,82,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1037.88,85,,percent of total billed charges,,920.66,1159.98,
DEPUY IRRISEPT WOUND RINSE,30185503,CDM,,,270,RC,inpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,316.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,357,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,316.68,399,
DEPUY CAP HIP POROUS GRIPTION TS CERAMIC,30185504,CDM,,,278,RC,inpatient,,56452.5,56452.5,,47928.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42565.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47984.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49678.2,88,,percent of total billed charges,,,,,,,,,43129.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51371.78,91,,percent of total billed charges,,,53629.88,95,,percent of total billed charges,,,46855.58,83,,percent of total billed charges,,,46855.58,83,,percent of total billed charges,,,,,,,,,,,,,,,46855.58,83,,percent of total billed charges,,,53629.88,95,,percent of total billed charges,,,50807.25,90,,percent of total billed charges,,,50807.25,90,,percent of total billed charges,,,46291.05,82,,percent of total billed charges,,,50807.25,90,,percent of total billed charges,,,47984.63,85,,percent of total billed charges,,42565.19,53629.88,
DEPUY SMARTMIX CTS BOWL,30185505,CDM,,,270,RC,inpatient,,1176.5,1176.5,,998.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,887.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1000.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1035.32,88,,percent of total billed charges,,,,,,,,,898.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1070.62,91,,percent of total billed charges,,,1117.68,95,,percent of total billed charges,,,976.5,83,,percent of total billed charges,,,976.5,83,,percent of total billed charges,,,,,,,,,,,,,,,976.5,83,,percent of total billed charges,,,1117.68,95,,percent of total billed charges,,,1058.85,90,,percent of total billed charges,,,1058.85,90,,percent of total billed charges,,,964.73,82,,percent of total billed charges,,,1058.85,90,,percent of total billed charges,,,1000.03,85,,percent of total billed charges,,887.08,1117.68,
S&N JOURNEY UNI TIBINRT S1-2LM/RL10MM,30185506,CDM,,,270,RC,inpatient,,5988.26,5988.26,,5084.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4515.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5090.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5269.67,88,,percent of total billed charges,,,,,,,,,4575.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5449.32,91,,percent of total billed charges,,,5688.85,95,,percent of total billed charges,,,4970.26,83,,percent of total billed charges,,,4970.26,83,,percent of total billed charges,,,,,,,,,,,,,,,4970.26,83,,percent of total billed charges,,,5688.85,95,,percent of total billed charges,,,5389.43,90,,percent of total billed charges,,,5389.43,90,,percent of total billed charges,,,4910.37,82,,percent of total billed charges,,,5389.43,90,,percent of total billed charges,,,5090.02,85,,percent of total billed charges,,4515.15,5688.85,
S&N JUNI OX FB FEM SZ 3 LM RL,30185507,CDM,,,278,RC,inpatient,,23770.44,23770.44,,20181.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17922.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20204.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20917.99,88,,percent of total billed charges,,,,,,,,,18160.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21631.1,91,,percent of total billed charges,,,22581.92,95,,percent of total billed charges,,,19729.47,83,,percent of total billed charges,,,19729.47,83,,percent of total billed charges,,,,,,,,,,,,,,,19729.47,83,,percent of total billed charges,,,22581.92,95,,percent of total billed charges,,,21393.4,90,,percent of total billed charges,,,21393.4,90,,percent of total billed charges,,,19491.76,82,,percent of total billed charges,,,21393.4,90,,percent of total billed charges,,,20204.87,85,,percent of total billed charges,,17922.91,22581.92,
S&N JRNY UNI TIBIAL BASE LM/RL SZ 2,30185508,CDM,,,278,RC,inpatient,,11374.09,11374.09,,9656.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8576.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9667.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10009.2,88,,percent of total billed charges,,,,,,,,,8689.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10350.42,91,,percent of total billed charges,,,10805.39,95,,percent of total billed charges,,,9440.49,83,,percent of total billed charges,,,9440.49,83,,percent of total billed charges,,,,,,,,,,,,,,,9440.49,83,,percent of total billed charges,,,10805.39,95,,percent of total billed charges,,,10236.68,90,,percent of total billed charges,,,10236.68,90,,percent of total billed charges,,,9326.75,82,,percent of total billed charges,,,10236.68,90,,percent of total billed charges,,,9667.98,85,,percent of total billed charges,,8576.06,10805.39,
COBLATOR II WAND PROCISE EZ,30185509,CDM,,,270,RC,inpatient,,1930.5,1930.5,,1638.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1455.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1640.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1698.84,88,,percent of total billed charges,,,,,,,,,1474.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1756.76,91,,percent of total billed charges,,,1833.98,95,,percent of total billed charges,,,1602.32,83,,percent of total billed charges,,,1602.32,83,,percent of total billed charges,,,,,,,,,,,,,,,1602.32,83,,percent of total billed charges,,,1833.98,95,,percent of total billed charges,,,1737.45,90,,percent of total billed charges,,,1737.45,90,,percent of total billed charges,,,1583.01,82,,percent of total billed charges,,,1737.45,90,,percent of total billed charges,,,1640.93,85,,percent of total billed charges,,1455.6,1833.98,
ARTHREX SCREW CANC. QCKFIX 3 X 36MM PT,30185510,CDM,,,270,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
ARTHREX SCREW COMPR 3.5 MINI 34MM FT,30185511,CDM,,,270,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
ARTHREX SCREW LO-PRO 3X22MM TI,30185512,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW VARIABLE LOCKING 3X14MM,30185513,CDM,,,278,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
ARTHREX SCREW VARIABLE LOCKING 3X18MM,30185514,CDM,,,278,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
BLADE RAD 60DEG,30185515,CDM,,,270,RC,inpatient,,1749.8,1749.8,,1485.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1319.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1487.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1539.82,88,,percent of total billed charges,,,,,,,,,1336.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1592.32,91,,percent of total billed charges,,,1662.31,95,,percent of total billed charges,,,1452.33,83,,percent of total billed charges,,,1452.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1452.33,83,,percent of total billed charges,,,1662.31,95,,percent of total billed charges,,,1574.82,90,,percent of total billed charges,,,1574.82,90,,percent of total billed charges,,,1434.84,82,,percent of total billed charges,,,1574.82,90,,percent of total billed charges,,,1487.33,85,,percent of total billed charges,,1319.35,1662.31,
ALLOSOURCE ILIUM 1/3RD WEDGE FROZEN,30185516,CDM,,,270,RC,inpatient,,12246,12246,,10396.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9233.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10409.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10776.48,88,,percent of total billed charges,,,,,,,,,9355.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11143.86,91,,percent of total billed charges,,,11633.7,95,,percent of total billed charges,,,10164.18,83,,percent of total billed charges,,,10164.18,83,,percent of total billed charges,,,,,,,,,,,,,,,10164.18,83,,percent of total billed charges,,,11633.7,95,,percent of total billed charges,,,11021.4,90,,percent of total billed charges,,,11021.4,90,,percent of total billed charges,,,10041.72,82,,percent of total billed charges,,,11021.4,90,,percent of total billed charges,,,10409.1,85,,percent of total billed charges,,9233.48,11633.7,
SYNTHES TIBIAL NAIL 11MM X 360,30185517,CDM,,,278,RC,inpatient,,14552.85,14552.85,,12355.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10972.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12369.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12806.51,88,,percent of total billed charges,,,,,,,,,11118.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13243.09,91,,percent of total billed charges,,,13825.21,95,,percent of total billed charges,,,12078.87,83,,percent of total billed charges,,,12078.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12078.87,83,,percent of total billed charges,,,13825.21,95,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,11933.34,82,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,12369.92,85,,percent of total billed charges,,10972.85,13825.21,
SYNTHES SCREW LOCKING 5.0 X 50MM,30185518,CDM,,,278,RC,inpatient,,1861.93,1861.93,,1580.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1403.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1582.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1638.5,88,,percent of total billed charges,,,,,,,,,1422.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1694.36,91,,percent of total billed charges,,,1768.83,95,,percent of total billed charges,,,1545.4,83,,percent of total billed charges,,,1545.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1545.4,83,,percent of total billed charges,,,1768.83,95,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1526.78,82,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1582.64,85,,percent of total billed charges,,1403.9,1768.83,
SYNTHES DRILL BIT CALIBRATED 4.3,30185519,CDM,,,278,RC,inpatient,,2281.83,2281.83,,1937.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1720.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1939.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2008.01,88,,percent of total billed charges,,,,,,,,,1743.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2076.47,91,,percent of total billed charges,,,2167.74,95,,percent of total billed charges,,,1893.92,83,,percent of total billed charges,,,1893.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1893.92,83,,percent of total billed charges,,,2167.74,95,,percent of total billed charges,,,2053.65,90,,percent of total billed charges,,,2053.65,90,,percent of total billed charges,,,1871.1,82,,percent of total billed charges,,,2053.65,90,,percent of total billed charges,,,1939.56,85,,percent of total billed charges,,1720.5,2167.74,
SYNTHES DRILL BIT 4.2,30185520,CDM,,,278,RC,inpatient,,1624.35,1624.35,,1379.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1224.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1380.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1429.43,88,,percent of total billed charges,,,,,,,,,1241,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.16,91,,percent of total billed charges,,,1543.13,95,,percent of total billed charges,,,1348.21,83,,percent of total billed charges,,,1348.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.21,83,,percent of total billed charges,,,1543.13,95,,percent of total billed charges,,,1461.92,90,,percent of total billed charges,,,1461.92,90,,percent of total billed charges,,,1331.97,82,,percent of total billed charges,,,1461.92,90,,percent of total billed charges,,,1380.7,85,,percent of total billed charges,,1224.76,1543.13,
ROD LORDORED 3.5 X 90MM,30185521,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
SYNTHES GUIDE WIRE 3.2MM,30185522,CDM,,,270,RC,inpatient,,984.75,984.75,,836.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,742.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,837.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,866.58,88,,percent of total billed charges,,,,,,,,,752.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,896.12,91,,percent of total billed charges,,,935.51,95,,percent of total billed charges,,,817.34,83,,percent of total billed charges,,,817.34,83,,percent of total billed charges,,,,,,,,,,,,,,,817.34,83,,percent of total billed charges,,,935.51,95,,percent of total billed charges,,,886.28,90,,percent of total billed charges,,,886.28,90,,percent of total billed charges,,,807.5,82,,percent of total billed charges,,,886.28,90,,percent of total billed charges,,,837.04,85,,percent of total billed charges,,742.5,935.51,
SYNTHES HELICAL BLADE 105MM,30185523,CDM,,,278,RC,inpatient,,7033.78,7033.78,,5971.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5303.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5978.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6189.73,88,,percent of total billed charges,,,,,,,,,5373.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6400.74,91,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,,,,,,,,,,,,,5838.04,83,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5767.7,82,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5978.71,85,,percent of total billed charges,,5303.47,6682.09,
SYNTHES INJECTION CANNULA,30185524,CDM,,,278,RC,inpatient,,3699.02,3699.02,,3140.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2789.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3144.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3255.14,88,,percent of total billed charges,,,,,,,,,2826.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3366.11,91,,percent of total billed charges,,,3514.07,95,,percent of total billed charges,,,3070.19,83,,percent of total billed charges,,,3070.19,83,,percent of total billed charges,,,,,,,,,,,,,,,3070.19,83,,percent of total billed charges,,,3514.07,95,,percent of total billed charges,,,3329.12,90,,percent of total billed charges,,,3329.12,90,,percent of total billed charges,,,3033.2,82,,percent of total billed charges,,,3329.12,90,,percent of total billed charges,,,3144.17,85,,percent of total billed charges,,2789.06,3514.07,
SYNTHES CEMENT TRAUMACEM V+,30185525,CDM,,,278,RC,inpatient,,4097.34,4097.34,,3478.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3089.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3482.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3605.66,88,,percent of total billed charges,,,,,,,,,3130.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3728.58,91,,percent of total billed charges,,,3892.47,95,,percent of total billed charges,,,3400.79,83,,percent of total billed charges,,,3400.79,83,,percent of total billed charges,,,,,,,,,,,,,,,3400.79,83,,percent of total billed charges,,,3892.47,95,,percent of total billed charges,,,3687.61,90,,percent of total billed charges,,,3687.61,90,,percent of total billed charges,,,3359.82,82,,percent of total billed charges,,,3687.61,90,,percent of total billed charges,,,3482.74,85,,percent of total billed charges,,3089.39,3892.47,
SYNTHES SYRINGE KIT TRAUMACEM V+,30185526,CDM,,,278,RC,inpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1176.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1326,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,1176.24,1482,
CHOICE SPINE SCREW 4.0 X 16MM,30185527,CDM,,,278,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
CHOICE SPINE SCREW 4.5 X 16MM,30185528,CDM,,,278,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
ZIMMER TIBIAL TRAY SZ A LM/RL OXF PMA,30185529,CDM,,,278,RC,inpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10218.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11519.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,10218.59,12874.88,
IMPLANET JEZZ BAND,30185530,CDM,,,278,RC,inpatient,,5720,5720,,4856.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4312.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4862,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5033.6,88,,percent of total billed charges,,,,,,,,,4370.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5205.2,91,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4747.6,83,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4690.4,82,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4862,85,,percent of total billed charges,,4312.88,5434,
IMPLANET JEZZ LOCK,30185531,CDM,,,278,RC,inpatient,,18850,18850,,16003.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14212.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16022.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16588,88,,percent of total billed charges,,,,,,,,,14401.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17153.5,91,,percent of total billed charges,,,17907.5,95,,percent of total billed charges,,,15645.5,83,,percent of total billed charges,,,15645.5,83,,percent of total billed charges,,,,,,,,,,,,,,,15645.5,83,,percent of total billed charges,,,17907.5,95,,percent of total billed charges,,,16965,90,,percent of total billed charges,,,16965,90,,percent of total billed charges,,,15457,82,,percent of total billed charges,,,16965,90,,percent of total billed charges,,,16022.5,85,,percent of total billed charges,,14212.9,17907.5,
INFUSE LARGE BONE GRAFT KIT,30185532,CDM,,,278,RC,inpatient,,42705,42705,,36256.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32199.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36299.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37580.4,88,,percent of total billed charges,,,,,,,,,32626.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38861.55,91,,percent of total billed charges,,,40569.75,95,,percent of total billed charges,,,35445.15,83,,percent of total billed charges,,,35445.15,83,,percent of total billed charges,,,,,,,,,,,,,,,35445.15,83,,percent of total billed charges,,,40569.75,95,,percent of total billed charges,,,38434.5,90,,percent of total billed charges,,,38434.5,90,,percent of total billed charges,,,35018.1,82,,percent of total billed charges,,,38434.5,90,,percent of total billed charges,,,36299.25,85,,percent of total billed charges,,32199.57,40569.75,
DEPUY INSERT STAB RP 15MM SZ4,30185533,CDM,,,278,RC,inpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9811.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11060.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,9811.36,12361.8,
STRYKER RENTAL HIP INSTRUMENTS,30185534,CDM,,,270,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
STRYKER RENTAL HIP ACCESS TRAY,30185535,CDM,,,270,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
DEPUY INSERT FB PLUS SZ. 2.5 15MM,30185537,CDM,,,278,RC,inpatient,,17187.04,17187.04,,14591.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12959.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14608.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15124.6,88,,percent of total billed charges,,,,,,,,,13130.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15640.21,91,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,,,,,,,,,,,,,14265.24,83,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14093.37,82,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14608.98,85,,percent of total billed charges,,12959.03,16327.69,
SYNTHES NAIL TIBIAL TI 10X300,30185538,CDM,,,278,RC,inpatient,,14552.85,14552.85,,12355.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10972.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12369.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12806.51,88,,percent of total billed charges,,,,,,,,,11118.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13243.09,91,,percent of total billed charges,,,13825.21,95,,percent of total billed charges,,,12078.87,83,,percent of total billed charges,,,12078.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12078.87,83,,percent of total billed charges,,,13825.21,95,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,11933.34,82,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,12369.92,85,,percent of total billed charges,,10972.85,13825.21,
SYNTHES SCREW DUAL CORE 5 X 30MM,30185539,CDM,,,278,RC,inpatient,,1861.93,1861.93,,1580.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1403.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1582.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1638.5,88,,percent of total billed charges,,,,,,,,,1422.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1694.36,91,,percent of total billed charges,,,1768.83,95,,percent of total billed charges,,,1545.4,83,,percent of total billed charges,,,1545.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1545.4,83,,percent of total billed charges,,,1768.83,95,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1526.78,82,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1582.64,85,,percent of total billed charges,,1403.9,1768.83,
SYNTHES SCREW DUAL CORE 5 X 35MM,30185540,CDM,,,278,RC,inpatient,,1861.93,1861.93,,1580.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1403.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1582.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1638.5,88,,percent of total billed charges,,,,,,,,,1422.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1694.36,91,,percent of total billed charges,,,1768.83,95,,percent of total billed charges,,,1545.4,83,,percent of total billed charges,,,1545.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1545.4,83,,percent of total billed charges,,,1768.83,95,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1526.78,82,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1582.64,85,,percent of total billed charges,,1403.9,1768.83,
SYNTHES SCREW LOCKING 5 X 26MM,30185541,CDM,,,278,RC,inpatient,,1640.93,1640.93,,1393.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1237.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1394.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1444.02,88,,percent of total billed charges,,,,,,,,,1253.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1493.25,91,,percent of total billed charges,,,1558.88,95,,percent of total billed charges,,,1361.97,83,,percent of total billed charges,,,1361.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1361.97,83,,percent of total billed charges,,,1558.88,95,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1345.56,82,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1394.79,85,,percent of total billed charges,,1237.26,1558.88,
SYNTHES SCREW LOCKING 4.0 X 34MM,30185542,CDM,,,278,RC,inpatient,,1740.83,1740.83,,1477.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1312.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1479.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1531.93,88,,percent of total billed charges,,,,,,,,,1329.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1584.16,91,,percent of total billed charges,,,1653.79,95,,percent of total billed charges,,,1444.89,83,,percent of total billed charges,,,1444.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.89,83,,percent of total billed charges,,,1653.79,95,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1427.48,82,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1479.71,85,,percent of total billed charges,,1312.59,1653.79,
SYNTHES PROTECTION SLEEVE 12.0,30185543,CDM,,,270,RC,inpatient,,1016.6,1016.6,,863.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,766.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,864.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,894.61,88,,percent of total billed charges,,,,,,,,,776.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,925.11,91,,percent of total billed charges,,,965.77,95,,percent of total billed charges,,,843.78,83,,percent of total billed charges,,,843.78,83,,percent of total billed charges,,,,,,,,,,,,,,,843.78,83,,percent of total billed charges,,,965.77,95,,percent of total billed charges,,,914.94,90,,percent of total billed charges,,,914.94,90,,percent of total billed charges,,,833.61,82,,percent of total billed charges,,,914.94,90,,percent of total billed charges,,,864.11,85,,percent of total billed charges,,766.52,965.77,
MEDTRONIC AZURE DR MRI SURESCAN,30185544,CDM,,,278,RC,inpatient,,46949.11,46949.11,,39859.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35399.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39906.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41315.22,88,,percent of total billed charges,,,,,,,,,35869.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42723.69,91,,percent of total billed charges,,,44601.65,95,,percent of total billed charges,,,38967.76,83,,percent of total billed charges,,,38967.76,83,,percent of total billed charges,,,,,,,,,,,,,,,38967.76,83,,percent of total billed charges,,,44601.65,95,,percent of total billed charges,,,42254.2,90,,percent of total billed charges,,,42254.2,90,,percent of total billed charges,,,38498.27,82,,percent of total billed charges,,,42254.2,90,,percent of total billed charges,,,39906.74,85,,percent of total billed charges,,35399.63,44601.65,
INFUSE SMALL BONE GRAFT KIT,30185546,CDM,,,278,RC,inpatient,,24017.5,24017.5,,20390.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18109.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20414.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21135.4,88,,percent of total billed charges,,,,,,,,,18349.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21855.93,91,,percent of total billed charges,,,22816.63,95,,percent of total billed charges,,,19934.53,83,,percent of total billed charges,,,19934.53,83,,percent of total billed charges,,,,,,,,,,,,,,,19934.53,83,,percent of total billed charges,,,22816.63,95,,percent of total billed charges,,,21615.75,90,,percent of total billed charges,,,21615.75,90,,percent of total billed charges,,,19694.35,82,,percent of total billed charges,,,21615.75,90,,percent of total billed charges,,,20414.88,85,,percent of total billed charges,,18109.2,22816.63,
ALPHATEC ROD MIS 45MM,30185547,CDM,,,278,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
SYNTHES SCREW CORTEX 20 X 2.4MM STERILE,30185548,CDM,,,278,RC,inpatient,,827.05,827.05,,702.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,623.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,702.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,727.8,88,,percent of total billed charges,,,,,,,,,631.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,752.62,91,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,,,,,,,,,,,,,686.45,83,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,678.18,82,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,623.6,785.7,
SYNTHES PLATE LAT EXT 4 HOLE LT SUP ANT,30185549,CDM,,,278,RC,inpatient,,9259.9,9259.9,,7861.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6981.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7870.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8148.71,88,,percent of total billed charges,,,,,,,,,7074.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8426.51,91,,percent of total billed charges,,,8796.91,95,,percent of total billed charges,,,7685.72,83,,percent of total billed charges,,,7685.72,83,,percent of total billed charges,,,,,,,,,,,,,,,7685.72,83,,percent of total billed charges,,,8796.91,95,,percent of total billed charges,,,8333.91,90,,percent of total billed charges,,,8333.91,90,,percent of total billed charges,,,7593.12,82,,percent of total billed charges,,,8333.91,90,,percent of total billed charges,,,7870.92,85,,percent of total billed charges,,6981.96,8796.91,
ZIMMER BEARING LEFT MEDIAL SMALL SZ 3,30185550,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
MENTOR TISSUE EXPANDER CPX4 MED. 350CC,30185551,CDM,,,278,RC,inpatient,,10172.5,10172.5,,8636.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7670.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8646.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8951.8,88,,percent of total billed charges,,,,,,,,,7771.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9256.98,91,,percent of total billed charges,,,9663.88,95,,percent of total billed charges,,,8443.18,83,,percent of total billed charges,,,8443.18,83,,percent of total billed charges,,,,,,,,,,,,,,,8443.18,83,,percent of total billed charges,,,9663.88,95,,percent of total billed charges,,,9155.25,90,,percent of total billed charges,,,9155.25,90,,percent of total billed charges,,,8341.45,82,,percent of total billed charges,,,9155.25,90,,percent of total billed charges,,,8646.63,85,,percent of total billed charges,,7670.07,9663.88,
MESH VENTRALIGHT STD 4X6,30185552,CDM,,,278,RC,inpatient,,3714.1,3714.1,,3153.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2800.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3156.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3268.41,88,,percent of total billed charges,,,,,,,,,2837.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3379.83,91,,percent of total billed charges,,,3528.4,95,,percent of total billed charges,,,3082.7,83,,percent of total billed charges,,,3082.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3082.7,83,,percent of total billed charges,,,3528.4,95,,percent of total billed charges,,,3342.69,90,,percent of total billed charges,,,3342.69,90,,percent of total billed charges,,,3045.56,82,,percent of total billed charges,,,3342.69,90,,percent of total billed charges,,,3156.99,85,,percent of total billed charges,,2800.43,3528.4,
MESH VENTRALIGHT ST 6IN,30185553,CDM,,,278,RC,inpatient,,7039.5,7039.5,,5976.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5307.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5983.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6194.76,88,,percent of total billed charges,,,,,,,,,5378.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6405.95,91,,percent of total billed charges,,,6687.53,95,,percent of total billed charges,,,5842.79,83,,percent of total billed charges,,,5842.79,83,,percent of total billed charges,,,,,,,,,,,,,,,5842.79,83,,percent of total billed charges,,,6687.53,95,,percent of total billed charges,,,6335.55,90,,percent of total billed charges,,,6335.55,90,,percent of total billed charges,,,5772.39,82,,percent of total billed charges,,,6335.55,90,,percent of total billed charges,,,5983.58,85,,percent of total billed charges,,5307.78,6687.53,
MESH BARD 1X4,30185554,CDM,,,278,RC,inpatient,,518.7,518.7,,440.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,440.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,456.46,88,,percent of total billed charges,,,,,,,,,396.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,472.02,91,,percent of total billed charges,,,492.77,95,,percent of total billed charges,,,430.52,83,,percent of total billed charges,,,430.52,83,,percent of total billed charges,,,,,,,,,,,,,,,430.52,83,,percent of total billed charges,,,492.77,95,,percent of total billed charges,,,466.83,90,,percent of total billed charges,,,466.83,90,,percent of total billed charges,,,425.33,82,,percent of total billed charges,,,466.83,90,,percent of total billed charges,,,440.9,85,,percent of total billed charges,,391.1,492.77,
MESH BARD 3X6,30185555,CDM,,,278,RC,inpatient,,719.6,719.6,,610.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,542.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,611.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,633.25,88,,percent of total billed charges,,,,,,,,,549.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,654.84,91,,percent of total billed charges,,,683.62,95,,percent of total billed charges,,,597.27,83,,percent of total billed charges,,,597.27,83,,percent of total billed charges,,,,,,,,,,,,,,,597.27,83,,percent of total billed charges,,,683.62,95,,percent of total billed charges,,,647.64,90,,percent of total billed charges,,,647.64,90,,percent of total billed charges,,,590.07,82,,percent of total billed charges,,,647.64,90,,percent of total billed charges,,,611.66,85,,percent of total billed charges,,542.58,683.62,
MESH BARD 6X6,30185556,CDM,,,278,RC,inpatient,,613.2,613.2,,520.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,462.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,521.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,539.62,88,,percent of total billed charges,,,,,,,,,468.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,558.01,91,,percent of total billed charges,,,582.54,95,,percent of total billed charges,,,508.96,83,,percent of total billed charges,,,508.96,83,,percent of total billed charges,,,,,,,,,,,,,,,508.96,83,,percent of total billed charges,,,582.54,95,,percent of total billed charges,,,551.88,90,,percent of total billed charges,,,551.88,90,,percent of total billed charges,,,502.82,82,,percent of total billed charges,,,551.88,90,,percent of total billed charges,,,521.22,85,,percent of total billed charges,,462.35,582.54,
MESH PERFIX PLUG X-LARGE,30185557,CDM,,,278,RC,inpatient,,1379.95,1379.95,,1171.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1040.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1172.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1214.36,88,,percent of total billed charges,,,,,,,,,1054.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1255.75,91,,percent of total billed charges,,,1310.95,95,,percent of total billed charges,,,1145.36,83,,percent of total billed charges,,,1145.36,83,,percent of total billed charges,,,,,,,,,,,,,,,1145.36,83,,percent of total billed charges,,,1310.95,95,,percent of total billed charges,,,1241.96,90,,percent of total billed charges,,,1241.96,90,,percent of total billed charges,,,1131.56,82,,percent of total billed charges,,,1241.96,90,,percent of total billed charges,,,1172.96,85,,percent of total billed charges,,1040.48,1310.95,
DEPUY BODY ANATOMIC PROXIMAL SZ 14,30185558,CDM,,,278,RC,inpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9541.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10756.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,9541.61,12021.93,
DEPUY STEM GLOBAL UNITE SZ 14,30185559,CDM,,,278,RC,inpatient,,26023.86,26023.86,,22094.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19621.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22120.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22901,88,,percent of total billed charges,,,,,,,,,19882.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23681.71,91,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21599.8,83,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,21339.57,82,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,19621.99,24722.67,
ZIMMER PLATE STEMMED TIBIAL SZ 5,30185560,CDM,,,278,RC,inpatient,,23205,23205,,19701.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17496.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19724.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20420.4,88,,percent of total billed charges,,,,,,,,,17728.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21116.55,91,,percent of total billed charges,,,22044.75,95,,percent of total billed charges,,,19260.15,83,,percent of total billed charges,,,19260.15,83,,percent of total billed charges,,,,,,,,,,,,,,,19260.15,83,,percent of total billed charges,,,22044.75,95,,percent of total billed charges,,,20884.5,90,,percent of total billed charges,,,20884.5,90,,percent of total billed charges,,,19028.1,82,,percent of total billed charges,,,20884.5,90,,percent of total billed charges,,,19724.25,85,,percent of total billed charges,,17496.57,22044.75,
ZIMMER AUGMENT TIBIAL FULL BLOCK SZ 5,30185561,CDM,,,278,RC,inpatient,,17615,17615,,14955.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13281.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14972.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15501.2,88,,percent of total billed charges,,,,,,,,,13457.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16029.65,91,,percent of total billed charges,,,16734.25,95,,percent of total billed charges,,,14620.45,83,,percent of total billed charges,,,14620.45,83,,percent of total billed charges,,,,,,,,,,,,,,,14620.45,83,,percent of total billed charges,,,16734.25,95,,percent of total billed charges,,,15853.5,90,,percent of total billed charges,,,15853.5,90,,percent of total billed charges,,,14444.3,82,,percent of total billed charges,,,15853.5,90,,percent of total billed charges,,,14972.75,85,,percent of total billed charges,,13281.71,16734.25,
ZIMMER INSERT LPS 10M SZ E/F,30185562,CDM,,,278,RC,inpatient,,16575,16575,,14072.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12497.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14088.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14586,88,,percent of total billed charges,,,,,,,,,12663.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15083.25,91,,percent of total billed charges,,,15746.25,95,,percent of total billed charges,,,13757.25,83,,percent of total billed charges,,,13757.25,83,,percent of total billed charges,,,,,,,,,,,,,,,13757.25,83,,percent of total billed charges,,,15746.25,95,,percent of total billed charges,,,14917.5,90,,percent of total billed charges,,,14917.5,90,,percent of total billed charges,,,13591.5,82,,percent of total billed charges,,,14917.5,90,,percent of total billed charges,,,14088.75,85,,percent of total billed charges,,12497.55,15746.25,
STRYKER PRECISION BLADE FALCON,30185563,CDM,,,270,RC,inpatient,,3048.5,3048.5,,2588.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2298.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2591.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2682.68,88,,percent of total billed charges,,,,,,,,,2329.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2774.14,91,,percent of total billed charges,,,2896.08,95,,percent of total billed charges,,,2530.26,83,,percent of total billed charges,,,2530.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2530.26,83,,percent of total billed charges,,,2896.08,95,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2499.77,82,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2591.23,85,,percent of total billed charges,,2298.57,2896.08,
CHOICE SPINE PLATE 2-LEVEL 34MM,30185564,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
CHOICE SPINE PLATE 2-LEVEL 32MM,30185565,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
NEEDLE BMA MAXX REGEN BONE MARROW ASPIRA,30185566,CDM,,,278,RC,inpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7351.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8287.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,7351.5,9262.5,
DEPUY STEM ENDWANU SZ 3 300MM,30185567,CDM,,,278,RC,inpatient,,35499.75,35499.75,,30139.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26766.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30174.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31239.78,88,,percent of total billed charges,,,,,,,,,27121.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32304.77,91,,percent of total billed charges,,,33724.76,95,,percent of total billed charges,,,29464.79,83,,percent of total billed charges,,,29464.79,83,,percent of total billed charges,,,,,,,,,,,,,,,29464.79,83,,percent of total billed charges,,,33724.76,95,,percent of total billed charges,,,31949.78,90,,percent of total billed charges,,,31949.78,90,,percent of total billed charges,,,29109.8,82,,percent of total billed charges,,,31949.78,90,,percent of total billed charges,,,30174.79,85,,percent of total billed charges,,26766.81,33724.76,
ZIMMER DRILL BIT 2.7MM PERIPHERAL,30185568,CDM,,,270,RC,inpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1519.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1712.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,1519.31,1914.25,
ZIMMER PIN STEINMANN 9IN,30185569,CDM,,,278,RC,inpatient,,1885,1885,,1600.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1421.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1602.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1658.8,88,,percent of total billed charges,,,,,,,,,1440.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1715.35,91,,percent of total billed charges,,,1790.75,95,,percent of total billed charges,,,1564.55,83,,percent of total billed charges,,,1564.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1564.55,83,,percent of total billed charges,,,1790.75,95,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1545.7,82,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1602.25,85,,percent of total billed charges,,1421.29,1790.75,
ZIMMER DRILL BIT 302MM CENTER,30185570,CDM,,,270,RC,inpatient,,1430,1430,,1214.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1078.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1215.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1258.4,88,,percent of total billed charges,,,,,,,,,1092.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1301.3,91,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1186.9,83,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1172.6,82,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,1078.22,1358.5,
ZIMMER GLENISPHERE TITANIUM 36MM,30185571,CDM,,,278,RC,inpatient,,27755,27755,,23564,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20927.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23591.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24424.4,88,,percent of total billed charges,,,,,,,,,21204.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25257.05,91,,percent of total billed charges,,,26367.25,95,,percent of total billed charges,,,23036.65,83,,percent of total billed charges,,,23036.65,83,,percent of total billed charges,,,,,,,,,,,,,,,23036.65,83,,percent of total billed charges,,,26367.25,95,,percent of total billed charges,,,24979.5,90,,percent of total billed charges,,,24979.5,90,,percent of total billed charges,,,22759.1,82,,percent of total billed charges,,,24979.5,90,,percent of total billed charges,,,23591.75,85,,percent of total billed charges,,20927.27,26367.25,
ZIMMER SCREW LOCKING 4.75 X 35MM,30185572,CDM,,,278,RC,inpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1372.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1547,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,1372.28,1729,
ZIMMER SCREW LOCKING 4.75 X 40MM,30185573,CDM,,,278,RC,inpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1372.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1547,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,1372.28,1729,
ZIMMER STEM PRIMARY MINI HUMERAL SZ 9MM,30185574,CDM,,,278,RC,inpatient,,46020,46020,,39070.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34699.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39117,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40497.6,88,,percent of total billed charges,,,,,,,,,35159.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41878.2,91,,percent of total billed charges,,,43719,95,,percent of total billed charges,,,38196.6,83,,percent of total billed charges,,,38196.6,83,,percent of total billed charges,,,,,,,,,,,,,,,38196.6,83,,percent of total billed charges,,,43719,95,,percent of total billed charges,,,41418,90,,percent of total billed charges,,,41418,90,,percent of total billed charges,,,37736.4,82,,percent of total billed charges,,,41418,90,,percent of total billed charges,,,39117,85,,percent of total billed charges,,34699.08,43719,
ZIMMER BASEPLATE W/ADAPTOR MINI 25MM,30185575,CDM,,,278,RC,inpatient,,21125,21125,,17935.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15928.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17956.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18590,88,,percent of total billed charges,,,,,,,,,16139.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19223.75,91,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,,,,,,,,,,,,,17533.75,83,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17322.5,82,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17956.25,85,,percent of total billed charges,,15928.25,20068.75,
ZIMMER TRAY HUMERAL +5MM,30185576,CDM,,,278,RC,inpatient,,21060,21060,,17879.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15879.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17901,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18532.8,88,,percent of total billed charges,,,,,,,,,16089.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19164.6,91,,percent of total billed charges,,,20007,95,,percent of total billed charges,,,17479.8,83,,percent of total billed charges,,,17479.8,83,,percent of total billed charges,,,,,,,,,,,,,,,17479.8,83,,percent of total billed charges,,,20007,95,,percent of total billed charges,,,18954,90,,percent of total billed charges,,,18954,90,,percent of total billed charges,,,17269.2,82,,percent of total billed charges,,,18954,90,,percent of total billed charges,,,17901,85,,percent of total billed charges,,15879.24,20007,
ZIMMER BEARING HUMERAL E1 36MM,30185577,CDM,,,278,RC,inpatient,,17160,17160,,14568.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12938.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14586,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15100.8,88,,percent of total billed charges,,,,,,,,,13110.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15615.6,91,,percent of total billed charges,,,16302,95,,percent of total billed charges,,,14242.8,83,,percent of total billed charges,,,14242.8,83,,percent of total billed charges,,,,,,,,,,,,,,,14242.8,83,,percent of total billed charges,,,16302,95,,percent of total billed charges,,,15444,90,,percent of total billed charges,,,15444,90,,percent of total billed charges,,,14071.2,82,,percent of total billed charges,,,15444,90,,percent of total billed charges,,,14586,85,,percent of total billed charges,,12938.64,16302,
HEMACLEAR B&W X-LARGE,30185578,CDM,,,270,RC,inpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,277.1,349.13,
"STRYKER CANNULA TRANSPORT 7, 8, 9",30185579,CDM,,,270,RC,inpatient,,496.79,496.79,,421.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,374.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,422.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,437.18,88,,percent of total billed charges,,,,,,,,,379.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,452.08,91,,percent of total billed charges,,,471.95,95,,percent of total billed charges,,,412.34,83,,percent of total billed charges,,,412.34,83,,percent of total billed charges,,,,,,,,,,,,,,,412.34,83,,percent of total billed charges,,,471.95,95,,percent of total billed charges,,,447.11,90,,percent of total billed charges,,,447.11,90,,percent of total billed charges,,,407.37,82,,percent of total billed charges,,,447.11,90,,percent of total billed charges,,,422.27,85,,percent of total billed charges,,374.58,471.95,
SYNTHES SCREW CORTEX S-T 2.7X364M,30185580,CDM,,,278,RC,inpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,314.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,354.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,314.04,395.68,
SYNTHES DRILL BIT 1.5MM,30185581,CDM,,,270,RC,inpatient,,830.83,830.83,,705.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,626.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,706.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,731.13,88,,percent of total billed charges,,,,,,,,,634.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,756.06,91,,percent of total billed charges,,,789.29,95,,percent of total billed charges,,,689.59,83,,percent of total billed charges,,,689.59,83,,percent of total billed charges,,,,,,,,,,,,,,,689.59,83,,percent of total billed charges,,,789.29,95,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,681.28,82,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,706.21,85,,percent of total billed charges,,626.45,789.29,
SYNTHES SCREW CORTEX ST 2.0 X 16MM,30185582,CDM,,,278,RC,inpatient,,490.28,490.28,,416.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,369.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,416.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,431.45,88,,percent of total billed charges,,,,,,,,,374.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,446.15,91,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,,,,,,,,,,,,,406.93,83,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,402.03,82,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,416.74,85,,percent of total billed charges,,369.67,465.77,
SYNTHES CLAMP COMBINATION 8.0/11.0MM,30185583,CDM,,,270,RC,inpatient,,6210.1,6210.1,,5272.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4682.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5278.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5464.89,88,,percent of total billed charges,,,,,,,,,4744.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5651.19,91,,percent of total billed charges,,,5899.6,95,,percent of total billed charges,,,5154.38,83,,percent of total billed charges,,,5154.38,83,,percent of total billed charges,,,,,,,,,,,,,,,5154.38,83,,percent of total billed charges,,,5899.6,95,,percent of total billed charges,,,5589.09,90,,percent of total billed charges,,,5589.09,90,,percent of total billed charges,,,5092.28,82,,percent of total billed charges,,,5589.09,90,,percent of total billed charges,,,5278.59,85,,percent of total billed charges,,4682.42,5899.6,
SYNTHES ROD ATTACHEMENT MEDIUM,30185584,CDM,,,278,RC,inpatient,,3757,3757,,3189.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2832.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3193.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3306.16,88,,percent of total billed charges,,,,,,,,,2870.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3418.87,91,,percent of total billed charges,,,3569.15,95,,percent of total billed charges,,,3118.31,83,,percent of total billed charges,,,3118.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3118.31,83,,percent of total billed charges,,,3569.15,95,,percent of total billed charges,,,3381.3,90,,percent of total billed charges,,,3381.3,90,,percent of total billed charges,,,3080.74,82,,percent of total billed charges,,,3381.3,90,,percent of total billed charges,,,3193.45,85,,percent of total billed charges,,2832.78,3569.15,
SYNTHES CLAMP OPEN ADJ. MEDIUM,30185585,CDM,,,270,RC,inpatient,,4458.68,4458.68,,3785.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3361.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3789.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3923.64,88,,percent of total billed charges,,,,,,,,,3406.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4057.4,91,,percent of total billed charges,,,4235.75,95,,percent of total billed charges,,,3700.7,83,,percent of total billed charges,,,3700.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3700.7,83,,percent of total billed charges,,,4235.75,95,,percent of total billed charges,,,4012.81,90,,percent of total billed charges,,,4012.81,90,,percent of total billed charges,,,3656.12,82,,percent of total billed charges,,,4012.81,90,,percent of total billed charges,,,3789.88,85,,percent of total billed charges,,3361.84,4235.75,
SYNTHES CLAMP MULTI-PIN MEDIUM,30185586,CDM,,,270,RC,inpatient,,7116.2,7116.2,,6041.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5365.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6048.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6262.26,88,,percent of total billed charges,,,,,,,,,5436.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6475.74,91,,percent of total billed charges,,,6760.39,95,,percent of total billed charges,,,5906.45,83,,percent of total billed charges,,,5906.45,83,,percent of total billed charges,,,,,,,,,,,,,,,5906.45,83,,percent of total billed charges,,,6760.39,95,,percent of total billed charges,,,6404.58,90,,percent of total billed charges,,,6404.58,90,,percent of total billed charges,,,5835.28,82,,percent of total billed charges,,,6404.58,90,,percent of total billed charges,,,6048.77,85,,percent of total billed charges,,5365.61,6760.39,
SYNTHES ROD 8 X 280MM,30185587,CDM,,,278,RC,inpatient,,1547,1547,,1313.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1166.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1314.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1361.36,88,,percent of total billed charges,,,,,,,,,1181.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1407.77,91,,percent of total billed charges,,,1469.65,95,,percent of total billed charges,,,1284.01,83,,percent of total billed charges,,,1284.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1284.01,83,,percent of total billed charges,,,1469.65,95,,percent of total billed charges,,,1392.3,90,,percent of total billed charges,,,1392.3,90,,percent of total billed charges,,,1268.54,82,,percent of total billed charges,,,1392.3,90,,percent of total billed charges,,,1314.95,85,,percent of total billed charges,,1166.44,1469.65,
SYNTHES ROD 8 X 240MM,30185588,CDM,,,278,RC,inpatient,,1530.43,1530.43,,1299.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1153.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1300.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1346.78,88,,percent of total billed charges,,,,,,,,,1169.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1392.69,91,,percent of total billed charges,,,1453.91,95,,percent of total billed charges,,,1270.26,83,,percent of total billed charges,,,1270.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1270.26,83,,percent of total billed charges,,,1453.91,95,,percent of total billed charges,,,1377.39,90,,percent of total billed charges,,,1377.39,90,,percent of total billed charges,,,1254.95,82,,percent of total billed charges,,,1377.39,90,,percent of total billed charges,,,1300.87,85,,percent of total billed charges,,1153.94,1453.91,
SYNTHES SCREW SCHANZ 125MM,30185589,CDM,,,278,RC,inpatient,,1574.63,1574.63,,1336.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1187.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1338.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1385.67,88,,percent of total billed charges,,,,,,,,,1203.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1432.91,91,,percent of total billed charges,,,1495.9,95,,percent of total billed charges,,,1306.94,83,,percent of total billed charges,,,1306.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1306.94,83,,percent of total billed charges,,,1495.9,95,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1291.2,82,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1338.44,85,,percent of total billed charges,,1187.27,1495.9,
SYNTHES SCREW SCHANZ 150MM,30185590,CDM,,,278,RC,inpatient,,1574.63,1574.63,,1336.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1187.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1338.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1385.67,88,,percent of total billed charges,,,,,,,,,1203.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1432.91,91,,percent of total billed charges,,,1495.9,95,,percent of total billed charges,,,1306.94,83,,percent of total billed charges,,,1306.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1306.94,83,,percent of total billed charges,,,1495.9,95,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1291.2,82,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1338.44,85,,percent of total billed charges,,1187.27,1495.9,
SYNTHES PIN STEINMANN W/THREAD 5 X 200MM,30185591,CDM,,,278,RC,inpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1012.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1141.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,1012.31,1275.45,
SYNTHES PROTECTIVE CAP FOR 5.0MM FIXATIO,30185592,CDM,,,270,RC,inpatient,,71.49,71.49,,60.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.91,88,,percent of total billed charges,,,,,,,,,54.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,65.06,91,,percent of total billed charges,,,67.92,95,,percent of total billed charges,,,59.34,83,,percent of total billed charges,,,59.34,83,,percent of total billed charges,,,,,,,,,,,,,,,59.34,83,,percent of total billed charges,,,67.92,95,,percent of total billed charges,,,64.34,90,,percent of total billed charges,,,64.34,90,,percent of total billed charges,,,58.62,82,,percent of total billed charges,,,64.34,90,,percent of total billed charges,,,60.77,85,,percent of total billed charges,,53.9,67.92,
ARTHREX MINI TIGHTROPE 1.1MM,30185593,CDM,,,270,RC,inpatient,,5817.5,5817.5,,4939.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4386.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4944.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5119.4,88,,percent of total billed charges,,,,,,,,,4444.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5293.93,91,,percent of total billed charges,,,5526.63,95,,percent of total billed charges,,,4828.53,83,,percent of total billed charges,,,4828.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4828.53,83,,percent of total billed charges,,,5526.63,95,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,4770.35,82,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,4944.88,85,,percent of total billed charges,,4386.4,5526.63,
DEPUY ATTUNE FEMUR CR SZ 8 LEFT,30185594,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY ATTUNE INSERT CR AOX 7MM,30185595,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY LINER ALTRX N 40 X 62,30185596,CDM,,,278,RC,inpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13270.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14960.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,13270.78,16720.48,
GUARD TEETH BITE BLOCK,30185602,CDM,,,270,RC,inpatient,,78.88,78.88,,66.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.41,88,,percent of total billed charges,,,,,,,,,60.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.78,91,,percent of total billed charges,,,74.94,95,,percent of total billed charges,,,65.47,83,,percent of total billed charges,,,65.47,83,,percent of total billed charges,,,,,,,,,,,,,,,65.47,83,,percent of total billed charges,,,74.94,95,,percent of total billed charges,,,70.99,90,,percent of total billed charges,,,70.99,90,,percent of total billed charges,,,64.68,82,,percent of total billed charges,,,70.99,90,,percent of total billed charges,,,67.05,85,,percent of total billed charges,,59.48,74.94,
BERKELEY KIT,30185603,CDM,,,270,RC,inpatient,,294.3,294.3,,249.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,221.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,250.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,258.98,88,,percent of total billed charges,,,,,,,,,224.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,267.81,91,,percent of total billed charges,,,279.59,95,,percent of total billed charges,,,244.27,83,,percent of total billed charges,,,244.27,83,,percent of total billed charges,,,,,,,,,,,,,,,244.27,83,,percent of total billed charges,,,279.59,95,,percent of total billed charges,,,264.87,90,,percent of total billed charges,,,264.87,90,,percent of total billed charges,,,241.33,82,,percent of total billed charges,,,264.87,90,,percent of total billed charges,,,250.16,85,,percent of total billed charges,,221.9,279.59,
SYNTHES SCREW LOCKING 2.4 X 20MM,30185604,CDM,,,278,RC,inpatient,,1635.4,1635.4,,1388.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1233.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1390.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1439.15,88,,percent of total billed charges,,,,,,,,,1249.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1488.21,91,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1357.38,83,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1341.03,82,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1390.09,85,,percent of total billed charges,,1233.09,1553.63,
DEPUY INSERT ATTUNE TIBIAL RP PS 6X5MM,30185605,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
SYNTHES SCREW CORTEX 11 X 2MM,30185606,CDM,,,278,RC,inpatient,,545.44,545.44,,463.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,411.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,463.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,479.99,88,,percent of total billed charges,,,,,,,,,416.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,496.35,91,,percent of total billed charges,,,518.17,95,,percent of total billed charges,,,452.72,83,,percent of total billed charges,,,452.72,83,,percent of total billed charges,,,,,,,,,,,,,,,452.72,83,,percent of total billed charges,,,518.17,95,,percent of total billed charges,,,490.9,90,,percent of total billed charges,,,490.9,90,,percent of total billed charges,,,447.26,82,,percent of total billed charges,,,490.9,90,,percent of total billed charges,,,463.62,85,,percent of total billed charges,,411.26,518.17,
SYNTHES DRILL BIT 1.5MM X 57MM,30185607,CDM,,,270,RC,inpatient,,868.7,868.7,,737.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,655,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,738.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,764.46,88,,percent of total billed charges,,,,,,,,,663.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,790.52,91,,percent of total billed charges,,,825.27,95,,percent of total billed charges,,,721.02,83,,percent of total billed charges,,,721.02,83,,percent of total billed charges,,,,,,,,,,,,,,,721.02,83,,percent of total billed charges,,,825.27,95,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,712.33,82,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,738.4,85,,percent of total billed charges,,655,825.27,
ARTHREX SPEEDBRG IMPLANT SYS 4.75X19.1MM,30185608,CDM,,,278,RC,inpatient,,11310,11310,,9602.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8527.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9613.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9952.8,88,,percent of total billed charges,,,,,,,,,8640.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10292.1,91,,percent of total billed charges,,,10744.5,95,,percent of total billed charges,,,9387.3,83,,percent of total billed charges,,,9387.3,83,,percent of total billed charges,,,,,,,,,,,,,,,9387.3,83,,percent of total billed charges,,,10744.5,95,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,9274.2,82,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,9613.5,85,,percent of total billed charges,,8527.74,10744.5,
PROCLAIM MULTILEAD TRIAL CABLE,30185610,CDM,,,278,RC,inpatient,,1430,1430,,1214.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1078.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1215.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1258.4,88,,percent of total billed charges,,,,,,,,,1092.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1301.3,91,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1186.9,83,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1172.6,82,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,1078.22,1358.5,
ECHO PS POSITIONING SYSTEM MESH 4.5IN,30185611,CDM,,,278,RC,inpatient,,7595.25,7595.25,,6448.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5726.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6455.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6683.82,88,,percent of total billed charges,,,,,,,,,5802.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6911.68,91,,percent of total billed charges,,,7215.49,95,,percent of total billed charges,,,6304.06,83,,percent of total billed charges,,,6304.06,83,,percent of total billed charges,,,,,,,,,,,,,,,6304.06,83,,percent of total billed charges,,,7215.49,95,,percent of total billed charges,,,6835.73,90,,percent of total billed charges,,,6835.73,90,,percent of total billed charges,,,6228.11,82,,percent of total billed charges,,,6835.73,90,,percent of total billed charges,,,6455.96,85,,percent of total billed charges,,5726.82,7215.49,
ECHO PS POSITIONING SYSTEM,30185612,CDM,,,278,RC,inpatient,,1092,1092,,927.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,823.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,928.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,960.96,88,,percent of total billed charges,,,,,,,,,834.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,993.72,91,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,,,,,,,,,,,,,906.36,83,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,895.44,82,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,928.2,85,,percent of total billed charges,,823.37,1037.4,
GLENOID WIRE,30185613,CDM,,,270,RC,inpatient,,851.5,851.5,,722.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,642.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,723.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,749.32,88,,percent of total billed charges,,,,,,,,,650.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,774.87,91,,percent of total billed charges,,,808.93,95,,percent of total billed charges,,,706.75,83,,percent of total billed charges,,,706.75,83,,percent of total billed charges,,,,,,,,,,,,,,,706.75,83,,percent of total billed charges,,,808.93,95,,percent of total billed charges,,,766.35,90,,percent of total billed charges,,,766.35,90,,percent of total billed charges,,,698.23,82,,percent of total billed charges,,,766.35,90,,percent of total billed charges,,,723.78,85,,percent of total billed charges,,642.03,808.93,
DRILL KIT EQUINOXE REVERSE SHOULDER,30185614,CDM,,,270,RC,inpatient,,4732,4732,,4017.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3567.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4022.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4164.16,88,,percent of total billed charges,,,,,,,,,3615.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4306.12,91,,percent of total billed charges,,,4495.4,95,,percent of total billed charges,,,3927.56,83,,percent of total billed charges,,,3927.56,83,,percent of total billed charges,,,,,,,,,,,,,,,3927.56,83,,percent of total billed charges,,,4495.4,95,,percent of total billed charges,,,4258.8,90,,percent of total billed charges,,,4258.8,90,,percent of total billed charges,,,3880.24,82,,percent of total billed charges,,,4258.8,90,,percent of total billed charges,,,4022.2,85,,percent of total billed charges,,3567.93,4495.4,
PLATE GLENOID EQ REV,30185615,CDM,,,270,RC,inpatient,,25707.5,25707.5,,21825.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19383.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21851.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22622.6,88,,percent of total billed charges,,,,,,,,,19640.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23393.83,91,,percent of total billed charges,,,24422.13,95,,percent of total billed charges,,,21337.23,83,,percent of total billed charges,,,21337.23,83,,percent of total billed charges,,,,,,,,,,,,,,,21337.23,83,,percent of total billed charges,,,24422.13,95,,percent of total billed charges,,,23136.75,90,,percent of total billed charges,,,23136.75,90,,percent of total billed charges,,,21080.15,82,,percent of total billed charges,,,23136.75,90,,percent of total billed charges,,,21851.38,85,,percent of total billed charges,,19383.46,24422.13,
SCREW GLENOSPHERE LOCKING EQ REV,30185616,CDM,,,278,RC,inpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1514.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1707.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,1514.41,1908.08,
SCREW LOCKING CAP KIT 4.5X26MM,30185617,CDM,,,278,RC,inpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1514.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1707.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,1514.41,1908.08,
SCREW LOCKING CAP KIT 4.5X34MM,30185618,CDM,,,278,RC,inpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1514.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1707.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,1514.41,1908.08,
SCREW LOCKING CAP KIT 4.5X22MM,30185619,CDM,,,278,RC,inpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1514.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1707.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,1514.41,1908.08,
LINER HUMERAL EQ REVERSE 42MM +2.5,30185620,CDM,,,270,RC,inpatient,,13487.5,13487.5,,11450.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10169.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11464.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11869,88,,percent of total billed charges,,,,,,,,,10304.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12273.63,91,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,,,,,,,,,,,,,11194.63,83,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11059.75,82,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,10169.58,12813.13,
PLATE TRAY +5 EQ REVERSE,30185621,CDM,,,270,RC,inpatient,,30160,30160,,25605.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22740.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25636,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26540.8,88,,percent of total billed charges,,,,,,,,,23042.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27445.6,91,,percent of total billed charges,,,28652,95,,percent of total billed charges,,,25032.8,83,,percent of total billed charges,,,25032.8,83,,percent of total billed charges,,,,,,,,,,,,,,,25032.8,83,,percent of total billed charges,,,28652,95,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,24731.2,82,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,25636,85,,percent of total billed charges,,22740.64,28652,
STEM HUMERAL EQ PRESS FIT 15MM,30185622,CDM,,,270,RC,inpatient,,34008,34008,,28872.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25642.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28906.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29927.04,88,,percent of total billed charges,,,,,,,,,25982.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30947.28,91,,percent of total billed charges,,,32307.6,95,,percent of total billed charges,,,28226.64,83,,percent of total billed charges,,,28226.64,83,,percent of total billed charges,,,,,,,,,,,,,,,28226.64,83,,percent of total billed charges,,,32307.6,95,,percent of total billed charges,,,30607.2,90,,percent of total billed charges,,,30607.2,90,,percent of total billed charges,,,27886.56,82,,percent of total billed charges,,,30607.2,90,,percent of total billed charges,,,28906.8,85,,percent of total billed charges,,25642.03,32307.6,
GLENOSPHERE RS EXPANDED 42MM +4MM OFFSET,30185623,CDM,,,270,RC,inpatient,,34242,34242,,29071.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25818.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29105.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30132.96,88,,percent of total billed charges,,,,,,,,,26160.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31160.22,91,,percent of total billed charges,,,32529.9,95,,percent of total billed charges,,,28420.86,83,,percent of total billed charges,,,28420.86,83,,percent of total billed charges,,,,,,,,,,,,,,,28420.86,83,,percent of total billed charges,,,32529.9,95,,percent of total billed charges,,,30817.8,90,,percent of total billed charges,,,30817.8,90,,percent of total billed charges,,,28078.44,82,,percent of total billed charges,,,30817.8,90,,percent of total billed charges,,,29105.7,85,,percent of total billed charges,,25818.47,32529.9,
SCREW KIT EQ REVERSE TORQUE DEFINING,30185624,CDM,,,278,RC,inpatient,,4335.5,4335.5,,3680.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3268.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3685.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3815.24,88,,percent of total billed charges,,,,,,,,,3312.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3945.31,91,,percent of total billed charges,,,4118.73,95,,percent of total billed charges,,,3598.47,83,,percent of total billed charges,,,3598.47,83,,percent of total billed charges,,,,,,,,,,,,,,,3598.47,83,,percent of total billed charges,,,4118.73,95,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3555.11,82,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3685.18,85,,percent of total billed charges,,3268.97,4118.73,
CTL ROD MIS 45MM,30185625,CDM,,,278,RC,inpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1669.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1881.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,1669.28,2103.21,
MTF STRUT CORTICAL FEMORAL HALVED 250MM,30185626,CDM,,,278,RC,inpatient,,11797.5,11797.5,,10016.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8895.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10027.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10381.8,88,,percent of total billed charges,,,,,,,,,9013.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10735.73,91,,percent of total billed charges,,,11207.63,95,,percent of total billed charges,,,9791.93,83,,percent of total billed charges,,,9791.93,83,,percent of total billed charges,,,,,,,,,,,,,,,9791.93,83,,percent of total billed charges,,,11207.63,95,,percent of total billed charges,,,10617.75,90,,percent of total billed charges,,,10617.75,90,,percent of total billed charges,,,9673.95,82,,percent of total billed charges,,,10617.75,90,,percent of total billed charges,,,10027.88,85,,percent of total billed charges,,8895.32,11207.63,
CHOICE SPINE PEEK CAGE 6 X 12 14MM,30185627,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
CHOICE SPINE PEEK CAGE 7 X 12 14MM,30185628,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
SYNTHES PLATE PHALANGEAL BASE 2 HOLES 2M,30185629,CDM,,,278,RC,inpatient,,5895.18,5895.18,,5005.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4444.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5010.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5187.76,88,,percent of total billed charges,,,,,,,,,4503.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5364.61,91,,percent of total billed charges,,,5600.42,95,,percent of total billed charges,,,4893,83,,percent of total billed charges,,,4893,83,,percent of total billed charges,,,,,,,,,,,,,,,4893,83,,percent of total billed charges,,,5600.42,95,,percent of total billed charges,,,5305.66,90,,percent of total billed charges,,,5305.66,90,,percent of total billed charges,,,4834.05,82,,percent of total billed charges,,,5305.66,90,,percent of total billed charges,,,5010.9,85,,percent of total billed charges,,4444.97,5600.42,
SYNTHES SCREW CORTEX 8 X 2MM,30185630,CDM,,,278,RC,inpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,399.28,503.07,
SYNTHES SCREW LOCKING VA 2 X 8MM,30185631,CDM,,,278,RC,inpatient,,1265.23,1265.23,,1074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,953.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1075.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1113.4,88,,percent of total billed charges,,,,,,,,,966.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1151.36,91,,percent of total billed charges,,,1201.97,95,,percent of total billed charges,,,1050.14,83,,percent of total billed charges,,,1050.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1050.14,83,,percent of total billed charges,,,1201.97,95,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1037.49,82,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1075.45,85,,percent of total billed charges,,953.98,1201.97,
SYNTHES SCREW LOCKING VA 2 X 11MM,30185632,CDM,,,278,RC,inpatient,,1265.23,1265.23,,1074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,953.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1075.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1113.4,88,,percent of total billed charges,,,,,,,,,966.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1151.36,91,,percent of total billed charges,,,1201.97,95,,percent of total billed charges,,,1050.14,83,,percent of total billed charges,,,1050.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1050.14,83,,percent of total billed charges,,,1201.97,95,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1037.49,82,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1075.45,85,,percent of total billed charges,,953.98,1201.97,
SYNTHES SCREW LOCKING VA 2 X 12MM,30185633,CDM,,,278,RC,inpatient,,1265.23,1265.23,,1074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,953.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1075.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1113.4,88,,percent of total billed charges,,,,,,,,,966.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1151.36,91,,percent of total billed charges,,,1201.97,95,,percent of total billed charges,,,1050.14,83,,percent of total billed charges,,,1050.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1050.14,83,,percent of total billed charges,,,1201.97,95,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1037.49,82,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1075.45,85,,percent of total billed charges,,953.98,1201.97,
SYNTHES SCREW LOCKING VA 2 X 13MM,30185634,CDM,,,278,RC,inpatient,,1265.23,1265.23,,1074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,953.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1075.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1113.4,88,,percent of total billed charges,,,,,,,,,966.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1151.36,91,,percent of total billed charges,,,1201.97,95,,percent of total billed charges,,,1050.14,83,,percent of total billed charges,,,1050.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1050.14,83,,percent of total billed charges,,,1201.97,95,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1037.49,82,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1075.45,85,,percent of total billed charges,,953.98,1201.97,
SYNTHES SCREW CANNULATED 4X44MM,30185635,CDM,,,278,RC,inpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1466.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1653.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,1466.38,1847.56,
SYNTHES SCREW CANNULATED 4X50MM,30185636,CDM,,,278,RC,inpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1466.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1653.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,1466.38,1847.56,
DEPUY STEM CORAIL REVISION SZ. 14,30185637,CDM,,,278,RC,inpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50336.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56745.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,50336.9,63421.82,
SYNTHES HELICAL BLADE 90MM,30185638,CDM,,,278,RC,inpatient,,6828.9,6828.9,,5797.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5148.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5804.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6009.43,88,,percent of total billed charges,,,,,,,,,5217.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6214.3,91,,percent of total billed charges,,,6487.46,95,,percent of total billed charges,,,5667.99,83,,percent of total billed charges,,,5667.99,83,,percent of total billed charges,,,,,,,,,,,,,,,5667.99,83,,percent of total billed charges,,,6487.46,95,,percent of total billed charges,,,6146.01,90,,percent of total billed charges,,,6146.01,90,,percent of total billed charges,,,5599.7,82,,percent of total billed charges,,,6146.01,90,,percent of total billed charges,,,5804.57,85,,percent of total billed charges,,5148.99,6487.46,
STRYKER FLOWPORT II CANNULA W/OBTURATOR,30185639,CDM,,,270,RC,inpatient,,2664.68,2664.68,,2262.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2009.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2264.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2344.92,88,,percent of total billed charges,,,,,,,,,2035.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2424.86,91,,percent of total billed charges,,,2531.45,95,,percent of total billed charges,,,2211.68,83,,percent of total billed charges,,,2211.68,83,,percent of total billed charges,,,,,,,,,,,,,,,2211.68,83,,percent of total billed charges,,,2531.45,95,,percent of total billed charges,,,2398.21,90,,percent of total billed charges,,,2398.21,90,,percent of total billed charges,,,2185.04,82,,percent of total billed charges,,,2398.21,90,,percent of total billed charges,,,2264.98,85,,percent of total billed charges,,2009.17,2531.45,
STRYKER SERFAX 90-S XL,30185640,CDM,,,270,RC,inpatient,,1421.49,1421.49,,1206.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1071.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1208.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1250.91,88,,percent of total billed charges,,,,,,,,,1086.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1293.56,91,,percent of total billed charges,,,1350.42,95,,percent of total billed charges,,,1179.84,83,,percent of total billed charges,,,1179.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1179.84,83,,percent of total billed charges,,,1350.42,95,,percent of total billed charges,,,1279.34,90,,percent of total billed charges,,,1279.34,90,,percent of total billed charges,,,1165.62,82,,percent of total billed charges,,,1279.34,90,,percent of total billed charges,,,1208.27,85,,percent of total billed charges,,1071.8,1350.42,
INSIGHT MULTI BAND LIGATOR,30185641,CDM,,,270,RC,inpatient,,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,353.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,398.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,353.63,445.55,
SYNTHES K-WIRE TI 1.0,30185642,CDM,,,278,RC,inpatient,,1018.62,1018.62,,864.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,768.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,865.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,896.39,88,,percent of total billed charges,,,,,,,,,778.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,926.94,91,,percent of total billed charges,,,967.69,95,,percent of total billed charges,,,845.45,83,,percent of total billed charges,,,845.45,83,,percent of total billed charges,,,,,,,,,,,,,,,845.45,83,,percent of total billed charges,,,967.69,95,,percent of total billed charges,,,916.76,90,,percent of total billed charges,,,916.76,90,,percent of total billed charges,,,835.27,82,,percent of total billed charges,,,916.76,90,,percent of total billed charges,,,865.83,85,,percent of total billed charges,,768.04,967.69,
SYNTHES DRILL BIT 1.1MM,30185643,CDM,,,270,RC,inpatient,,949,949,,805.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,715.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,806.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,835.12,88,,percent of total billed charges,,,,,,,,,725.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,863.59,91,,percent of total billed charges,,,901.55,95,,percent of total billed charges,,,787.67,83,,percent of total billed charges,,,787.67,83,,percent of total billed charges,,,,,,,,,,,,,,,787.67,83,,percent of total billed charges,,,901.55,95,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,778.18,82,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,806.65,85,,percent of total billed charges,,715.55,901.55,
SYNTHES SCREW CORTEX ST 1.5 X 16MM,30185644,CDM,,,278,RC,inpatient,,523.6,523.6,,444.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,394.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,445.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,460.77,88,,percent of total billed charges,,,,,,,,,400.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,476.48,91,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,,,,,,,,,,,,,434.59,83,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,429.35,82,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,394.79,497.42,
SYNTHES SCREW CORTEX ST 1.5 X 18MM,30185645,CDM,,,278,RC,inpatient,,523.6,523.6,,444.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,394.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,445.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,460.77,88,,percent of total billed charges,,,,,,,,,400.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,476.48,91,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,,,,,,,,,,,,,434.59,83,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,429.35,82,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,394.79,497.42,
S&N INSERT XLPE PS 13MM SZ 3/4,30185646,CDM,,,278,RC,inpatient,,13364.07,13364.07,,11346.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10076.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11359.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11760.38,88,,percent of total billed charges,,,,,,,,,10210.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12161.3,91,,percent of total billed charges,,,12695.87,95,,percent of total billed charges,,,11092.18,83,,percent of total billed charges,,,11092.18,83,,percent of total billed charges,,,,,,,,,,,,,,,11092.18,83,,percent of total billed charges,,,12695.87,95,,percent of total billed charges,,,12027.66,90,,percent of total billed charges,,,12027.66,90,,percent of total billed charges,,,10958.54,82,,percent of total billed charges,,,12027.66,90,,percent of total billed charges,,,11359.46,85,,percent of total billed charges,,10076.51,12695.87,
DEPUY STEM CEMENTED 14 X 30MM,30185647,CDM,,,278,RC,inpatient,,8336.19,8336.19,,7077.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6285.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7085.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7335.85,88,,percent of total billed charges,,,,,,,,,6368.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7585.93,91,,percent of total billed charges,,,7919.38,95,,percent of total billed charges,,,6919.04,83,,percent of total billed charges,,,6919.04,83,,percent of total billed charges,,,,,,,,,,,,,,,6919.04,83,,percent of total billed charges,,,7919.38,95,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,6835.68,82,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,7085.76,85,,percent of total billed charges,,6285.49,7919.38,
DEPUY ATTUNE CRS FEMORAL RT SZ 6 CEM,30185648,CDM,,,278,RC,inpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39636.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44683.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,39636.69,49940.13,
DEPUY BASE PLATE REVISION RP SZ 6 CEM,30185649,CDM,,,278,RC,inpatient,,39503.36,39503.36,,33538.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29785.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33577.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34762.96,88,,percent of total billed charges,,,,,,,,,30180.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35948.06,91,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32787.79,83,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,32392.76,82,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,29785.53,37528.19,
DEPUY INSERT ATTUNE CRS RP 6MM,30185650,CDM,,,278,RC,inpatient,,23578.82,23578.82,,20018.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17778.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20042,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20749.36,88,,percent of total billed charges,,,,,,,,,18014.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21456.73,91,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,,,,,,,,,,,,,19570.42,83,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,19334.63,82,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,20042,85,,percent of total billed charges,,17778.43,22399.88,
ZIMMER SHELL MULTIHOLE OSSEOTI G7 70MM,30185651,CDM,,,278,RC,inpatient,,42640,42640,,36201.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32150.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36244,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37523.2,88,,percent of total billed charges,,,,,,,,,32576.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38802.4,91,,percent of total billed charges,,,40508,95,,percent of total billed charges,,,35391.2,83,,percent of total billed charges,,,35391.2,83,,percent of total billed charges,,,,,,,,,,,,,,,35391.2,83,,percent of total billed charges,,,40508,95,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,34964.8,82,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,36244,85,,percent of total billed charges,,32150.56,40508,
ZIMMER LINER DUAL MOBILITY G7 54MM,30185652,CDM,,,278,RC,inpatient,,24180,24180,,20528.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18231.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20553,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21278.4,88,,percent of total billed charges,,,,,,,,,18473.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22003.8,91,,percent of total billed charges,,,22971,95,,percent of total billed charges,,,20069.4,83,,percent of total billed charges,,,20069.4,83,,percent of total billed charges,,,,,,,,,,,,,,,20069.4,83,,percent of total billed charges,,,22971,95,,percent of total billed charges,,,21762,90,,percent of total billed charges,,,21762,90,,percent of total billed charges,,,19827.6,82,,percent of total billed charges,,,21762,90,,percent of total billed charges,,,20553,85,,percent of total billed charges,,18231.72,22971,
ZIMMER BEARING HIP ACT ARTIC 28X54MM,30185653,CDM,,,278,RC,inpatient,,23400,23400,,19866.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17643.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19890,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20592,88,,percent of total billed charges,,,,,,,,,17877.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21294,91,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,,,,,,,,,,,,,19422,83,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19188,82,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19890,85,,percent of total billed charges,,17643.6,22230,
STRYKER HEAD FEMORAL 28MM +5MM,30185654,CDM,,,278,RC,inpatient,,9119.5,9119.5,,7742.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6876.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7751.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8025.16,88,,percent of total billed charges,,,,,,,,,6967.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8298.75,91,,percent of total billed charges,,,8663.53,95,,percent of total billed charges,,,7569.19,83,,percent of total billed charges,,,7569.19,83,,percent of total billed charges,,,,,,,,,,,,,,,7569.19,83,,percent of total billed charges,,,8663.53,95,,percent of total billed charges,,,8207.55,90,,percent of total billed charges,,,8207.55,90,,percent of total billed charges,,,7477.99,82,,percent of total billed charges,,,8207.55,90,,percent of total billed charges,,,7751.58,85,,percent of total billed charges,,6876.1,8663.53,
SYNTHES NAIL ELASTIC TI 4.0 X 440MM,30185655,CDM,,,278,RC,inpatient,,3442.08,3442.08,,2922.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2595.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2925.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3029.03,88,,percent of total billed charges,,,,,,,,,2629.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3132.29,91,,percent of total billed charges,,,3269.98,95,,percent of total billed charges,,,2856.93,83,,percent of total billed charges,,,2856.93,83,,percent of total billed charges,,,,,,,,,,,,,,,2856.93,83,,percent of total billed charges,,,3269.98,95,,percent of total billed charges,,,3097.87,90,,percent of total billed charges,,,3097.87,90,,percent of total billed charges,,,2822.51,82,,percent of total billed charges,,,3097.87,90,,percent of total billed charges,,,2925.77,85,,percent of total billed charges,,2595.33,3269.98,
BREAST IMPLANT NATRELLE INSPIRA 600CC,30185656,CDM,,,278,RC,inpatient,,6675.5,6675.5,,5667.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5033.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5674.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5874.44,88,,percent of total billed charges,,,,,,,,,5100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6074.71,91,,percent of total billed charges,,,6341.73,95,,percent of total billed charges,,,5540.67,83,,percent of total billed charges,,,5540.67,83,,percent of total billed charges,,,,,,,,,,,,,,,5540.67,83,,percent of total billed charges,,,6341.73,95,,percent of total billed charges,,,6007.95,90,,percent of total billed charges,,,6007.95,90,,percent of total billed charges,,,5473.91,82,,percent of total billed charges,,,6007.95,90,,percent of total billed charges,,,5674.18,85,,percent of total billed charges,,5033.33,6341.73,
DEPUY BONE MV CEMENT,30185657,CDM,,,270,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
PARAGON PLATE STRAIGHT 6 HOLE W/COMPRESS,30185658,CDM,,,278,RC,inpatient,,9717.5,9717.5,,8250.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7327,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8259.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8551.4,88,,percent of total billed charges,,,,,,,,,7424.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8842.93,91,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,,,,,,,,,,,,,8065.53,83,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,7968.35,82,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8259.88,85,,percent of total billed charges,,7327,9231.63,
PARAGON SCREW BG NON-LOCKING 2.5X16MM,30185659,CDM,,,278,RC,inpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1176.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1326,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,1176.24,1482,
PARAGON SCREW BG NON-LOCKING 2.5X18MM,30185660,CDM,,,278,RC,inpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1176.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1326,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,1176.24,1482,
PARAGON SCREW BG LOCKING 2.5X22MM,30185661,CDM,,,278,RC,inpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1519.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1712.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,1519.31,1914.25,
PARAGON SCREW BG LOCKING 2.5X12MM,30185662,CDM,,,278,RC,inpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1519.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1712.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,1519.31,1914.25,
PARAGON SCREW BG LOCKING 2.5X10MM,30185663,CDM,,,278,RC,inpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1519.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1712.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,1519.31,1914.25,
PARAGON DRILL SOLID AO 1.3 X 100MM,30185664,CDM,,,270,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
PARAGON WIRE OLIVE SMOOTH 1.3MM,30185665,CDM,,,278,RC,inpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,784.16,988,
SYNTHES KIT PLATE DISTL RAD 2.4MM VA LCP,30185666,CDM,,,278,RC,inpatient,,19144.13,19144.13,,16253.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14434.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16272.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16846.83,88,,percent of total billed charges,,,,,,,,,14626.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17421.16,91,,percent of total billed charges,,,18186.92,95,,percent of total billed charges,,,15889.63,83,,percent of total billed charges,,,15889.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15889.63,83,,percent of total billed charges,,,18186.92,95,,percent of total billed charges,,,17229.72,90,,percent of total billed charges,,,17229.72,90,,percent of total billed charges,,,15698.19,82,,percent of total billed charges,,,17229.72,90,,percent of total billed charges,,,16272.51,85,,percent of total billed charges,,14434.67,18186.92,
SYNTHES PLATE TI 1.5MM 10 HOLE,30185667,CDM,,,278,RC,inpatient,,5492.5,5492.5,,4663.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4141.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4668.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4833.4,88,,percent of total billed charges,,,,,,,,,4196.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4998.18,91,,percent of total billed charges,,,5217.88,95,,percent of total billed charges,,,4558.78,83,,percent of total billed charges,,,4558.78,83,,percent of total billed charges,,,,,,,,,,,,,,,4558.78,83,,percent of total billed charges,,,5217.88,95,,percent of total billed charges,,,4943.25,90,,percent of total billed charges,,,4943.25,90,,percent of total billed charges,,,4503.85,82,,percent of total billed charges,,,4943.25,90,,percent of total billed charges,,,4668.63,85,,percent of total billed charges,,4141.35,5217.88,
SYNTHES SCREW CORTEX 1.5 X 6MM,30185668,CDM,,,278,RC,inpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,464.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,523.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,464.46,585.2,
SYNTHES SCREW CORTEX 1.5 X 7MM,30185669,CDM,,,278,RC,inpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,464.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,523.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,464.46,585.2,
SYNTHES SCREW CORTEX 1.5 X 9MM,30185670,CDM,,,278,RC,inpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,464.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,523.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,464.46,585.2,
SYNTHES SCREW CORTEX 1.5 X 10MM,30185671,CDM,,,278,RC,inpatient,,539.28,539.28,,457.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,406.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,458.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,474.57,88,,percent of total billed charges,,,,,,,,,412.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,490.74,91,,percent of total billed charges,,,512.32,95,,percent of total billed charges,,,447.6,83,,percent of total billed charges,,,447.6,83,,percent of total billed charges,,,,,,,,,,,,,,,447.6,83,,percent of total billed charges,,,512.32,95,,percent of total billed charges,,,485.35,90,,percent of total billed charges,,,485.35,90,,percent of total billed charges,,,442.21,82,,percent of total billed charges,,,485.35,90,,percent of total billed charges,,,458.39,85,,percent of total billed charges,,406.62,512.32,
SYNTHES SCREW CORTEX 1.5 X 13MM,30185672,CDM,,,278,RC,inpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,464.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,523.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,464.46,585.2,
S&N BASE TIBIAL MED LT SZ 3,30185673,CDM,,,278,RC,inpatient,,11374.09,11374.09,,9656.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8576.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9667.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10009.2,88,,percent of total billed charges,,,,,,,,,8689.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10350.42,91,,percent of total billed charges,,,10805.39,95,,percent of total billed charges,,,9440.49,83,,percent of total billed charges,,,9440.49,83,,percent of total billed charges,,,,,,,,,,,,,,,9440.49,83,,percent of total billed charges,,,10805.39,95,,percent of total billed charges,,,10236.68,90,,percent of total billed charges,,,10236.68,90,,percent of total billed charges,,,9326.75,82,,percent of total billed charges,,,10236.68,90,,percent of total billed charges,,,9667.98,85,,percent of total billed charges,,8576.06,10805.39,
S&N INSERT TIBIAL MED LT 8MM SZ 3-4,30185674,CDM,,,278,RC,inpatient,,5988.26,5988.26,,5084.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4515.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5090.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5269.67,88,,percent of total billed charges,,,,,,,,,4575.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5449.32,91,,percent of total billed charges,,,5688.85,95,,percent of total billed charges,,,4970.26,83,,percent of total billed charges,,,4970.26,83,,percent of total billed charges,,,,,,,,,,,,,,,4970.26,83,,percent of total billed charges,,,5688.85,95,,percent of total billed charges,,,5389.43,90,,percent of total billed charges,,,5389.43,90,,percent of total billed charges,,,4910.37,82,,percent of total billed charges,,,5389.43,90,,percent of total billed charges,,,5090.02,85,,percent of total billed charges,,4515.15,5688.85,
STRYKER BUR DIAMOND 4.0MM,30185675,CDM,,,270,RC,inpatient,,1874.6,1874.6,,1591.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1413.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1593.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1649.65,88,,percent of total billed charges,,,,,,,,,1432.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1705.89,91,,percent of total billed charges,,,1780.87,95,,percent of total billed charges,,,1555.92,83,,percent of total billed charges,,,1555.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1555.92,83,,percent of total billed charges,,,1780.87,95,,percent of total billed charges,,,1687.14,90,,percent of total billed charges,,,1687.14,90,,percent of total billed charges,,,1537.17,82,,percent of total billed charges,,,1687.14,90,,percent of total billed charges,,,1593.41,85,,percent of total billed charges,,1413.45,1780.87,
HEMACLEAR ORANGE LARGE,30185676,CDM,,,270,RC,inpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,277.1,349.13,
DEPUY HUMERAL CUP PE 38+3,30185677,CDM,,,278,RC,inpatient,,9988.88,9988.88,,8480.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7531.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8490.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8790.21,88,,percent of total billed charges,,,,,,,,,7631.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9089.88,91,,percent of total billed charges,,,9489.44,95,,percent of total billed charges,,,8290.77,83,,percent of total billed charges,,,8290.77,83,,percent of total billed charges,,,,,,,,,,,,,,,8290.77,83,,percent of total billed charges,,,9489.44,95,,percent of total billed charges,,,8989.99,90,,percent of total billed charges,,,8989.99,90,,percent of total billed charges,,,8190.88,82,,percent of total billed charges,,,8989.99,90,,percent of total billed charges,,,8490.55,85,,percent of total billed charges,,7531.62,9489.44,
SYNTHES SCREW CORTEX 16 X 2.4MM STERILE,30185678,CDM,,,278,RC,inpatient,,903.5,903.5,,767.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,681.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,767.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,795.08,88,,percent of total billed charges,,,,,,,,,690.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,822.19,91,,percent of total billed charges,,,858.33,95,,percent of total billed charges,,,749.91,83,,percent of total billed charges,,,749.91,83,,percent of total billed charges,,,,,,,,,,,,,,,749.91,83,,percent of total billed charges,,,858.33,95,,percent of total billed charges,,,813.15,90,,percent of total billed charges,,,813.15,90,,percent of total billed charges,,,740.87,82,,percent of total billed charges,,,813.15,90,,percent of total billed charges,,,767.98,85,,percent of total billed charges,,681.24,858.33,
SYNTHES SCREW CORTEX 18 X 2.4MM STERILE,30185679,CDM,,,278,RC,inpatient,,903.5,903.5,,767.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,681.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,767.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,795.08,88,,percent of total billed charges,,,,,,,,,690.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,822.19,91,,percent of total billed charges,,,858.33,95,,percent of total billed charges,,,749.91,83,,percent of total billed charges,,,749.91,83,,percent of total billed charges,,,,,,,,,,,,,,,749.91,83,,percent of total billed charges,,,858.33,95,,percent of total billed charges,,,813.15,90,,percent of total billed charges,,,813.15,90,,percent of total billed charges,,,740.87,82,,percent of total billed charges,,,813.15,90,,percent of total billed charges,,,767.98,85,,percent of total billed charges,,681.24,858.33,
GRAFT REPAIR BIODESIGN OTOLOGIC 2.5X2.5,30185680,CDM,,,278,RC,inpatient,,1742,1742,,1478.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1313.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1480.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1532.96,88,,percent of total billed charges,,,,,,,,,1330.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1585.22,91,,percent of total billed charges,,,1654.9,95,,percent of total billed charges,,,1445.86,83,,percent of total billed charges,,,1445.86,83,,percent of total billed charges,,,,,,,,,,,,,,,1445.86,83,,percent of total billed charges,,,1654.9,95,,percent of total billed charges,,,1567.8,90,,percent of total billed charges,,,1567.8,90,,percent of total billed charges,,,1428.44,82,,percent of total billed charges,,,1567.8,90,,percent of total billed charges,,,1480.7,85,,percent of total billed charges,,1313.47,1654.9,
ULRICH CAGE 12 X 14 X 7MM 6DEG.,30185682,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
ULRICH PLATE UNION 1 LEVEL 12MM,30185683,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
ULRICH SCREW SELF DRILLING 4.0 X 14MM,30185684,CDM,,,278,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
ULRICH SCREW SELF DRILLING 4.0 X 12MM,30185685,CDM,,,278,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
MEDTRONIC ICD BI VENTRICULAR,30185687,CDM,,,278,RC,inpatient,,199059.84,199059.84,,169001.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150091.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,169200.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,175172.66,88,,percent of total billed charges,,,,,,,,,152081.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,181144.45,91,,percent of total billed charges,,,189106.85,95,,percent of total billed charges,,,165219.67,83,,percent of total billed charges,,,165219.67,83,,percent of total billed charges,,,,,,,,,,,,,,,165219.67,83,,percent of total billed charges,,,189106.85,95,,percent of total billed charges,,,179153.86,90,,percent of total billed charges,,,179153.86,90,,percent of total billed charges,,,163229.07,82,,percent of total billed charges,,,179153.86,90,,percent of total billed charges,,,169200.86,85,,percent of total billed charges,,150091.12,189106.85,
STRYKER DRILL ICONIX 1.4MM,30185688,CDM,,,270,RC,inpatient,,1296.88,1296.88,,1101.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,977.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1102.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1141.25,88,,percent of total billed charges,,,,,,,,,990.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1180.16,91,,percent of total billed charges,,,1232.04,95,,percent of total billed charges,,,1076.41,83,,percent of total billed charges,,,1076.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1076.41,83,,percent of total billed charges,,,1232.04,95,,percent of total billed charges,,,1167.19,90,,percent of total billed charges,,,1167.19,90,,percent of total billed charges,,,1063.44,82,,percent of total billed charges,,,1167.19,90,,percent of total billed charges,,,1102.35,85,,percent of total billed charges,,977.85,1232.04,
STRYKER ANCHOR 1.4MM W/XBRAID 1.2MM,30185689,CDM,,,270,RC,inpatient,,3474.19,3474.19,,2949.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2619.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2953.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3057.29,88,,percent of total billed charges,,,,,,,,,2654.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3161.51,91,,percent of total billed charges,,,3300.48,95,,percent of total billed charges,,,2883.58,83,,percent of total billed charges,,,2883.58,83,,percent of total billed charges,,,,,,,,,,,,,,,2883.58,83,,percent of total billed charges,,,3300.48,95,,percent of total billed charges,,,3126.77,90,,percent of total billed charges,,,3126.77,90,,percent of total billed charges,,,2848.84,82,,percent of total billed charges,,,3126.77,90,,percent of total billed charges,,,2953.06,85,,percent of total billed charges,,2619.54,3300.48,
ZIMMER SHELL MULTIHOLE OSSEOTI G7 68MM I,30185691,CDM,,,278,RC,inpatient,,42640,42640,,36201.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32150.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36244,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37523.2,88,,percent of total billed charges,,,,,,,,,32576.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38802.4,91,,percent of total billed charges,,,40508,95,,percent of total billed charges,,,35391.2,83,,percent of total billed charges,,,35391.2,83,,percent of total billed charges,,,,,,,,,,,,,,,35391.2,83,,percent of total billed charges,,,40508,95,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,34964.8,82,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,36244,85,,percent of total billed charges,,32150.56,40508,
DEPUY FEMORAL BODY PROXIMAL LPS 15DEG LE,30185692,CDM,,,278,RC,inpatient,,56410.06,56410.06,,47892.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42533.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47948.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49640.85,88,,percent of total billed charges,,,,,,,,,43097.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51333.15,91,,percent of total billed charges,,,53589.56,95,,percent of total billed charges,,,46820.35,83,,percent of total billed charges,,,46820.35,83,,percent of total billed charges,,,,,,,,,,,,,,,46820.35,83,,percent of total billed charges,,,53589.56,95,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,46256.25,82,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,47948.55,85,,percent of total billed charges,,42533.19,53589.56,
DEPUY STEM CEMENTED LPS 11 X 200MM,30185693,CDM,,,278,RC,inpatient,,44982.15,44982.15,,38189.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33916.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38234.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39584.29,88,,percent of total billed charges,,,,,,,,,34366.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40933.76,91,,percent of total billed charges,,,42733.04,95,,percent of total billed charges,,,37335.18,83,,percent of total billed charges,,,37335.18,83,,percent of total billed charges,,,,,,,,,,,,,,,37335.18,83,,percent of total billed charges,,,42733.04,95,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,36885.36,82,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,38234.83,85,,percent of total billed charges,,33916.54,42733.04,
DEPUY INSERT RP 12.5MM,30185694,CDM,,,278,RC,inpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9811.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11060.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,9811.36,12361.8,
ORTHOFIX OSCAR 2 SYSTEM,30185695,CDM,,,270,RC,inpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7351.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8287.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,7351.5,9262.5,
ORTHOFIX PROBE PIERCER 8MM,30185696,CDM,,,270,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
ORTHOFIX OSTEOTOME 6MM CURVED SERRATED,30185697,CDM,,,270,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
DURAGEN SECURE 2X2 REGENERATION MATRIX,30185698,CDM,,,270,RC,inpatient,,3567.53,3567.53,,3028.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2689.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3032.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3139.43,88,,percent of total billed charges,,,,,,,,,2725.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3246.45,91,,percent of total billed charges,,,3389.15,95,,percent of total billed charges,,,2961.05,83,,percent of total billed charges,,,2961.05,83,,percent of total billed charges,,,,,,,,,,,,,,,2961.05,83,,percent of total billed charges,,,3389.15,95,,percent of total billed charges,,,3210.78,90,,percent of total billed charges,,,3210.78,90,,percent of total billed charges,,,2925.37,82,,percent of total billed charges,,,3210.78,90,,percent of total billed charges,,,3032.4,85,,percent of total billed charges,,2689.92,3389.15,
ZIMMER FEMUR XL OXFORD TWIN PEG,30185699,CDM,,,278,RC,inpatient,,20345,20345,,17272.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15340.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17293.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17903.6,88,,percent of total billed charges,,,,,,,,,15543.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18513.95,91,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,,,,,,,,,,,,,16886.35,83,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,16682.9,82,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,17293.25,85,,percent of total billed charges,,15340.13,19327.75,
ZIMMER BEARING ANATOMIC MENISCAL XL SZ 5,30185700,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
ZIMMER BEARING XL 5MM,30185702,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
DEPUY LINER ALTRX +4 40 X 64,30185703,CDM,,,278,RC,inpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13270.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14960.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,13270.78,16720.48,
SYNTHES PLATE LCP SUP ANT CLAVICLE 6H RT,30185704,CDM,,,278,RC,inpatient,,10192,10192,,8653.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7684.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8663.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8968.96,88,,percent of total billed charges,,,,,,,,,7786.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9274.72,91,,percent of total billed charges,,,9682.4,95,,percent of total billed charges,,,8459.36,83,,percent of total billed charges,,,8459.36,83,,percent of total billed charges,,,,,,,,,,,,,,,8459.36,83,,percent of total billed charges,,,9682.4,95,,percent of total billed charges,,,9172.8,90,,percent of total billed charges,,,9172.8,90,,percent of total billed charges,,,8357.44,82,,percent of total billed charges,,,9172.8,90,,percent of total billed charges,,,8663.2,85,,percent of total billed charges,,7684.77,9682.4,
ROD LORDOSED 6.0 X 90MM,30185705,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ZIMMER SHELL OSSEOTI G7 4 HOLE 60MM G,30185706,CDM,,,278,RC,inpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14580.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16436.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,14580.48,18370.63,
DEPUY STEM CEMENTED LPS 12 X 125,30185707,CDM,,,278,RC,inpatient,,42441.95,42441.95,,36033.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32001.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36075.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37348.92,88,,percent of total billed charges,,,,,,,,,32425.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38622.17,91,,percent of total billed charges,,,40319.85,95,,percent of total billed charges,,,35226.82,83,,percent of total billed charges,,,35226.82,83,,percent of total billed charges,,,,,,,,,,,,,,,35226.82,83,,percent of total billed charges,,,40319.85,95,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,34802.4,82,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,36075.66,85,,percent of total billed charges,,32001.23,40319.85,
DEPUY SEGMENTAL COMPONENT 35MM,30185708,CDM,,,278,RC,inpatient,,18773.5,18773.5,,15938.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14155.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15957.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16520.68,88,,percent of total billed charges,,,,,,,,,14342.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17083.89,91,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,,,,,,,,,,,,,15582.01,83,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15394.27,82,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,14155.22,17834.83,
DEPUY INSERT LPS XX-SM 12MM,30185709,CDM,,,278,RC,inpatient,,33343.12,33343.12,,28308.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25140.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28341.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29341.95,88,,percent of total billed charges,,,,,,,,,25474.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30342.24,91,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,,,,,,,,,,,,,27674.79,83,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,27341.36,82,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,25140.71,31675.96,
ULRICH DRILL BIT 12MM,30185710,CDM,,,270,RC,inpatient,,2340,2340,,1986.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1764.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1989,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2059.2,88,,percent of total billed charges,,,,,,,,,1787.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2129.4,91,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1942.2,83,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1918.8,82,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1989,85,,percent of total billed charges,,1764.36,2223,
ULRICH PEEK CERVICAL 6MM 15 X 13 6DEG,30185711,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
ULRICH PLATE  3 LEVEL 45MM,30185712,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
ULRICH PEEK CERVICAL 7MM 15 X 13 6DEG,30185713,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
ULRICH PLATE 2 LEVEL 30MM,30185714,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
KYPHON 15/2 EXPRESS FIRST FRACTURE KIT,30185715,CDM,,,278,RC,inpatient,,25961,25961,,22040.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19574.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22066.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22845.68,88,,percent of total billed charges,,,,,,,,,19834.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23624.51,91,,percent of total billed charges,,,24662.95,95,,percent of total billed charges,,,21547.63,83,,percent of total billed charges,,,21547.63,83,,percent of total billed charges,,,,,,,,,,,,,,,21547.63,83,,percent of total billed charges,,,24662.95,95,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,21288.02,82,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,22066.85,85,,percent of total billed charges,,19574.59,24662.95,
KYPHON CEMENT BONE HV-R,30185716,CDM,,,278,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
STRYKER FEMUR TRIATHLON PS RT SZ 6,30185717,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
STRYKER INSERT TRIATHLON PS X3 6-9MM,30185718,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER TIBIA TRIATHLON TRITANIUM SZ 6,30185719,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
SYNTHES SCREW CORTEX S-T 2.7 X 20MM,30185720,CDM,,,278,RC,inpatient,,410.27,410.27,,348.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,309.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,348.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,361.04,88,,percent of total billed charges,,,,,,,,,313.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,373.35,91,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,,,,,,,,,,,,,340.52,83,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,336.42,82,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,348.73,85,,percent of total billed charges,,309.34,389.76,
SYNTHES SCREW LOCKING 2.7X20MM,30185721,CDM,,,278,RC,inpatient,,1143.87,1143.87,,971.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,862.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,972.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1006.61,88,,percent of total billed charges,,,,,,,,,873.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1040.92,91,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,,,,,,,,,,,,,949.41,83,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,937.97,82,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,972.29,85,,percent of total billed charges,,862.48,1086.68,
SYNTHES LCP PLATE 4 HOLE 40MM,30185722,CDM,,,278,RC,inpatient,,4556.5,4556.5,,3868.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3435.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3873.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4009.72,88,,percent of total billed charges,,,,,,,,,3481.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4146.42,91,,percent of total billed charges,,,4328.68,95,,percent of total billed charges,,,3781.9,83,,percent of total billed charges,,,3781.9,83,,percent of total billed charges,,,,,,,,,,,,,,,3781.9,83,,percent of total billed charges,,,4328.68,95,,percent of total billed charges,,,4100.85,90,,percent of total billed charges,,,4100.85,90,,percent of total billed charges,,,3736.33,82,,percent of total billed charges,,,4100.85,90,,percent of total billed charges,,,3873.03,85,,percent of total billed charges,,3435.6,4328.68,
SYNTHES SCREW LOCKING S-T 3.5 X 32MM,30185723,CDM,,,278,RC,inpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,945.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1066.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,945.79,1191.65,
SYNTHES SCREW LOCKING S-T 3.5 X 40MM,30185724,CDM,,,278,RC,inpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,945.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1066.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,945.79,1191.65,
SYNTHES DRILL BIT QC 2.8 248MM LONG 95MM,30185725,CDM,,,278,RC,inpatient,,1564.94,1564.94,,1328.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1179.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1330.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1377.15,88,,percent of total billed charges,,,,,,,,,1195.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1424.1,91,,percent of total billed charges,,,1486.69,95,,percent of total billed charges,,,1298.9,83,,percent of total billed charges,,,1298.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1298.9,83,,percent of total billed charges,,,1486.69,95,,percent of total billed charges,,,1408.45,90,,percent of total billed charges,,,1408.45,90,,percent of total billed charges,,,1283.25,82,,percent of total billed charges,,,1408.45,90,,percent of total billed charges,,,1330.2,85,,percent of total billed charges,,1179.96,1486.69,
SYNTHES SCREW LOCKING S-T 2.7X22MM W/STA,30185726,CDM,,,278,RC,inpatient,,1110.53,1110.53,,942.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,837.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,943.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,977.27,88,,percent of total billed charges,,,,,,,,,848.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1010.58,91,,percent of total billed charges,,,1055,95,,percent of total billed charges,,,921.74,83,,percent of total billed charges,,,921.74,83,,percent of total billed charges,,,,,,,,,,,,,,,921.74,83,,percent of total billed charges,,,1055,95,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,910.63,82,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,943.95,85,,percent of total billed charges,,837.34,1055,
SYNTHES SCREW CORTEX S-T 2.7 X 22MM,30185727,CDM,,,278,RC,inpatient,,386.75,386.75,,328.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.34,88,,percent of total billed charges,,,,,,,,,295.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.94,91,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,321,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,,,,,,,,,,,,,,321,83,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,317.14,82,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,291.61,367.41,
SYNTHES PLATE TIBIA 4 HOLE RT SMALL BEND,30185728,CDM,,,278,RC,inpatient,,14668.88,14668.88,,12453.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11060.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12468.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12908.61,88,,percent of total billed charges,,,,,,,,,11207.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13348.68,91,,percent of total billed charges,,,13935.44,95,,percent of total billed charges,,,12175.17,83,,percent of total billed charges,,,12175.17,83,,percent of total billed charges,,,,,,,,,,,,,,,12175.17,83,,percent of total billed charges,,,13935.44,95,,percent of total billed charges,,,13201.99,90,,percent of total billed charges,,,13201.99,90,,percent of total billed charges,,,12028.48,82,,percent of total billed charges,,,13201.99,90,,percent of total billed charges,,,12468.55,85,,percent of total billed charges,,11060.34,13935.44,
SYNTHES SCREW LOCKING VA 3.5 X 30MM,30185729,CDM,,,278,RC,inpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1131.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1275.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,1131.4,1425.5,
SYNTHES SCREW LOCKING VA 3.5 X 32MM,30185730,CDM,,,278,RC,inpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1131.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1275.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,1131.4,1425.5,
SYNTHES SCREW LOCKING VA 3.5 X 40MM,30185731,CDM,,,278,RC,inpatient,,1456.85,1456.85,,1236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1098.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1238.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1282.03,88,,percent of total billed charges,,,,,,,,,1113.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1325.73,91,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1209.19,83,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1194.62,82,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,1098.46,1384.01,
SYNTHES SCREW LOCKING VA 3.5 X 60MM,30185732,CDM,,,278,RC,inpatient,,1456.85,1456.85,,1236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1098.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1238.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1282.03,88,,percent of total billed charges,,,,,,,,,1113.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1325.73,91,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1209.19,83,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1194.62,82,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,1098.46,1384.01,
OLYMPUS HEMOSTATIS DEVICE (EN) VN,30185733,CDM,,,270,RC,inpatient,,635.4,635.4,,539.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,479.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,540.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,559.15,88,,percent of total billed charges,,,,,,,,,485.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,578.21,91,,percent of total billed charges,,,603.63,95,,percent of total billed charges,,,527.38,83,,percent of total billed charges,,,527.38,83,,percent of total billed charges,,,,,,,,,,,,,,,527.38,83,,percent of total billed charges,,,603.63,95,,percent of total billed charges,,,571.86,90,,percent of total billed charges,,,571.86,90,,percent of total billed charges,,,521.03,82,,percent of total billed charges,,,571.86,90,,percent of total billed charges,,,540.09,85,,percent of total billed charges,,479.09,603.63,
CANNULA MERCEDES 4MM SHORT FLARED,30185734,CDM,,,270,RC,inpatient,,434,434,,368.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,327.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,368.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,381.92,88,,percent of total billed charges,,,,,,,,,331.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,394.94,91,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,,,,,,,,,,,,,360.22,83,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,355.88,82,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,368.9,85,,percent of total billed charges,,327.24,412.3,
CANNULA MERCEDES 4MM LONG FLARED,30185735,CDM,,,270,RC,inpatient,,434,434,,368.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,327.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,368.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,381.92,88,,percent of total billed charges,,,,,,,,,331.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,394.94,91,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,,,,,,,,,,,,,360.22,83,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,355.88,82,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,368.9,85,,percent of total billed charges,,327.24,412.3,
CANNULA MERCEDES 4MM  X 30MM,30185736,CDM,,,270,RC,inpatient,,360.5,360.5,,306.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,271.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,306.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,317.24,88,,percent of total billed charges,,,,,,,,,275.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,328.06,91,,percent of total billed charges,,,342.48,95,,percent of total billed charges,,,299.22,83,,percent of total billed charges,,,299.22,83,,percent of total billed charges,,,,,,,,,,,,,,,299.22,83,,percent of total billed charges,,,342.48,95,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,295.61,82,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,306.43,85,,percent of total billed charges,,271.82,342.48,
CANNULA MERCEDES 4MM X 22MM,30185737,CDM,,,270,RC,inpatient,,385,385,,326.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,290.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,327.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,338.8,88,,percent of total billed charges,,,,,,,,,294.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,350.35,91,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,,,,,,,,,,,,,319.55,83,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,315.7,82,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,290.29,365.75,
CANNULA MERCEDES 3MM X 15MM,30185738,CDM,,,270,RC,inpatient,,360.5,360.5,,306.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,271.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,306.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,317.24,88,,percent of total billed charges,,,,,,,,,275.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,328.06,91,,percent of total billed charges,,,342.48,95,,percent of total billed charges,,,299.22,83,,percent of total billed charges,,,299.22,83,,percent of total billed charges,,,,,,,,,,,,,,,299.22,83,,percent of total billed charges,,,342.48,95,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,295.61,82,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,306.43,85,,percent of total billed charges,,271.82,342.48,
CANNULA MERCEDES 3MM X 22MM,30185739,CDM,,,270,RC,inpatient,,360.5,360.5,,306.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,271.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,306.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,317.24,88,,percent of total billed charges,,,,,,,,,275.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,328.06,91,,percent of total billed charges,,,342.48,95,,percent of total billed charges,,,299.22,83,,percent of total billed charges,,,299.22,83,,percent of total billed charges,,,,,,,,,,,,,,,299.22,83,,percent of total billed charges,,,342.48,95,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,295.61,82,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,306.43,85,,percent of total billed charges,,271.82,342.48,
SYNTHES NAIL ELASTIC TI 3.0 X 440MM,30185740,CDM,,,278,RC,inpatient,,3033.23,3033.23,,2575.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2287.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2578.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2669.24,88,,percent of total billed charges,,,,,,,,,2317.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2760.24,91,,percent of total billed charges,,,2881.57,95,,percent of total billed charges,,,2517.58,83,,percent of total billed charges,,,2517.58,83,,percent of total billed charges,,,,,,,,,,,,,,,2517.58,83,,percent of total billed charges,,,2881.57,95,,percent of total billed charges,,,2729.91,90,,percent of total billed charges,,,2729.91,90,,percent of total billed charges,,,2487.25,82,,percent of total billed charges,,,2729.91,90,,percent of total billed charges,,,2578.25,85,,percent of total billed charges,,2287.06,2881.57,
SYNTHES DRILL BIT 4.5 X 195MM,30185741,CDM,,,270,RC,inpatient,,1326,1326,,1125.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,999.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1127.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1166.88,88,,percent of total billed charges,,,,,,,,,1013.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1206.66,91,,percent of total billed charges,,,1259.7,95,,percent of total billed charges,,,1100.58,83,,percent of total billed charges,,,1100.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1100.58,83,,percent of total billed charges,,,1259.7,95,,percent of total billed charges,,,1193.4,90,,percent of total billed charges,,,1193.4,90,,percent of total billed charges,,,1087.32,82,,percent of total billed charges,,,1193.4,90,,percent of total billed charges,,,1127.1,85,,percent of total billed charges,,999.8,1259.7,
ZIMMER CEMENT BONE R,30185742,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
SPINECRAFT SCREW 8.5 X 40MM,30185743,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT SCREW 8.5 X 45MM,30185744,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT SCREW 7.5 X 45MM,30185745,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT SCREW 9.5 X 45MM,30185746,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT SCREW 7.5 X 40MM,30185747,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT SCREW SET,30185748,CDM,,,278,RC,inpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,527.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,595,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,527.8,665,
SPINECRAFT WASHER,30185749,CDM,,,278,RC,inpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,527.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,595,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,527.8,665,
SPINECRAFT ROD TITANIUM 6.0 X 300,30185750,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
SPINECRAFT ROD LOWDOSED 6.0 X 90,30185751,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
SPINECRAFT CAGE 10MM 0DEG X 22MM,30185752,CDM,,,278,RC,inpatient,,13000,13000,,11037,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9802,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11050,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11440,88,,percent of total billed charges,,,,,,,,,9932,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11830,91,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,,,,,,,,,,,,,10790,83,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,10660,82,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11050,85,,percent of total billed charges,,9802,12350,
DEPUY ATTUNE TIBIA RP REVISION SZ 8,30185753,CDM,,,278,RC,inpatient,,39503.36,39503.36,,33538.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29785.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33577.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34762.96,88,,percent of total billed charges,,,,,,,,,30180.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35948.06,91,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32787.79,83,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,32392.76,82,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,29785.53,37528.19,
ULRICH PLATE  2 LEVEL 34MM,30185754,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
ULRICH DRILL BIT 14MM,30185755,CDM,,,270,RC,inpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1666.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1878.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,1666.34,2099.5,
ULRICH SCREWS 4.0 X 16MM,30185756,CDM,,,278,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
IR SCREW REDUCTION 6.5 X 40MM,30185757,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
IR SCREW POLY 6.5 X 45MM,30185758,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
IR ROD LORDOSED 5.5 X 50MM,30185759,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
IR ROD LORDOSED 5.5 X 40MM,30185760,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
IR SCREW SET,30185761,CDM,,,278,RC,inpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,527.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,595,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,527.8,665,
DEPUY HEAD HUMERAL 48X18,30185960,CDM,,,278,RC,inpatient,,15528.76,15528.76,,13183.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11708.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13199.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13665.31,88,,percent of total billed charges,,,,,,,,,11863.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14131.17,91,,percent of total billed charges,,,14752.32,95,,percent of total billed charges,,,12888.87,83,,percent of total billed charges,,,12888.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12888.87,83,,percent of total billed charges,,,14752.32,95,,percent of total billed charges,,,13975.88,90,,percent of total billed charges,,,13975.88,90,,percent of total billed charges,,,12733.58,82,,percent of total billed charges,,,13975.88,90,,percent of total billed charges,,,13199.45,85,,percent of total billed charges,,11708.69,14752.32,
SCREW POLYAXIAL 6.5 X 35MM,30185961,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ARTHREX SPEEDBRIDGE KIT,30185962,CDM,,,270,RC,inpatient,,12415,12415,,10540.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9360.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10552.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10925.2,88,,percent of total billed charges,,,,,,,,,9485.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11297.65,91,,percent of total billed charges,,,11794.25,95,,percent of total billed charges,,,10304.45,83,,percent of total billed charges,,,10304.45,83,,percent of total billed charges,,,,,,,,,,,,,,,10304.45,83,,percent of total billed charges,,,11794.25,95,,percent of total billed charges,,,11173.5,90,,percent of total billed charges,,,11173.5,90,,percent of total billed charges,,,10180.3,82,,percent of total billed charges,,,11173.5,90,,percent of total billed charges,,,10552.75,85,,percent of total billed charges,,9360.91,11794.25,
EX-FUSE DBM PUTTY 5CC,30185963,CDM,,,278,RC,inpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3675.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4143.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,3675.75,4631.25,
ZIMMER OXF BEARING LEFT MEDIAL SZ 4,30185964,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
MEDTRONIC VISIA AF MRI VR SURESCAN,30185965,CDM,,,278,RC,inpatient,,166738,166738,,141560.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125720.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141727.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,146729.44,88,,percent of total billed charges,,,,,,,,,127387.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,151731.58,91,,percent of total billed charges,,,158401.1,95,,percent of total billed charges,,,138392.54,83,,percent of total billed charges,,,138392.54,83,,percent of total billed charges,,,,,,,,,,,,,,,138392.54,83,,percent of total billed charges,,,158401.1,95,,percent of total billed charges,,,150064.2,90,,percent of total billed charges,,,150064.2,90,,percent of total billed charges,,,136725.16,82,,percent of total billed charges,,,150064.2,90,,percent of total billed charges,,,141727.3,85,,percent of total billed charges,,125720.45,158401.1,
MEDTRONIC RV LEAD 55CM,30185966,CDM,,,278,RC,inpatient,,40287.33,40287.33,,34203.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30376.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34244.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35452.85,88,,percent of total billed charges,,,,,,,,,30779.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36661.47,91,,percent of total billed charges,,,38272.96,95,,percent of total billed charges,,,33438.48,83,,percent of total billed charges,,,33438.48,83,,percent of total billed charges,,,,,,,,,,,,,,,33438.48,83,,percent of total billed charges,,,38272.96,95,,percent of total billed charges,,,36258.6,90,,percent of total billed charges,,,36258.6,90,,percent of total billed charges,,,33035.61,82,,percent of total billed charges,,,36258.6,90,,percent of total billed charges,,,34244.23,85,,percent of total billed charges,,30376.65,38272.96,
EX-FUSE DBM .5CC PUTTY,30185967,CDM,,,278,RC,inpatient,,1170,1170,,993.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,882.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,994.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1029.6,88,,percent of total billed charges,,,,,,,,,893.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1064.7,91,,percent of total billed charges,,,1111.5,95,,percent of total billed charges,,,971.1,83,,percent of total billed charges,,,971.1,83,,percent of total billed charges,,,,,,,,,,,,,,,971.1,83,,percent of total billed charges,,,1111.5,95,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,959.4,82,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,994.5,85,,percent of total billed charges,,882.18,1111.5,
EXACTECH LINER +2.5,30185968,CDM,,,278,RC,inpatient,,13221,13221,,11224.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9968.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11237.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11634.48,88,,percent of total billed charges,,,,,,,,,10100.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12031.11,91,,percent of total billed charges,,,12559.95,95,,percent of total billed charges,,,10973.43,83,,percent of total billed charges,,,10973.43,83,,percent of total billed charges,,,,,,,,,,,,,,,10973.43,83,,percent of total billed charges,,,12559.95,95,,percent of total billed charges,,,11898.9,90,,percent of total billed charges,,,11898.9,90,,percent of total billed charges,,,10841.22,82,,percent of total billed charges,,,11898.9,90,,percent of total billed charges,,,11237.85,85,,percent of total billed charges,,9968.63,12559.95,
EXACTECH GLENOSPHERE 38,30185969,CDM,,,278,RC,inpatient,,24102,24102,,20462.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18172.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20486.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21209.76,88,,percent of total billed charges,,,,,,,,,18413.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21932.82,91,,percent of total billed charges,,,22896.9,95,,percent of total billed charges,,,20004.66,83,,percent of total billed charges,,,20004.66,83,,percent of total billed charges,,,,,,,,,,,,,,,20004.66,83,,percent of total billed charges,,,22896.9,95,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,19763.64,82,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,20486.7,85,,percent of total billed charges,,18172.91,22896.9,
EXACTECH STEM HUMORAL 13MM,30185970,CDM,,,278,RC,inpatient,,35366.5,35366.5,,30026.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26666.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30061.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31122.52,88,,percent of total billed charges,,,,,,,,,27020.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32183.52,91,,percent of total billed charges,,,33598.18,95,,percent of total billed charges,,,29354.2,83,,percent of total billed charges,,,29354.2,83,,percent of total billed charges,,,,,,,,,,,,,,,29354.2,83,,percent of total billed charges,,,33598.18,95,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,29000.53,82,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,30061.53,85,,percent of total billed charges,,26666.34,33598.18,
EXACTECH HUMERAL TRAY +0,30185971,CDM,,,278,RC,inpatient,,30160,30160,,25605.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22740.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25636,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26540.8,88,,percent of total billed charges,,,,,,,,,23042.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27445.6,91,,percent of total billed charges,,,28652,95,,percent of total billed charges,,,25032.8,83,,percent of total billed charges,,,25032.8,83,,percent of total billed charges,,,,,,,,,,,,,,,25032.8,83,,percent of total billed charges,,,28652,95,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,24731.2,82,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,25636,85,,percent of total billed charges,,22740.64,28652,
SCREW LOCKING CAP KIT 4.5X18MM,30185972,CDM,,,278,RC,inpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1514.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1707.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,1514.41,1908.08,
SCREW LOCKING CAP KIT 4.5X30MM,30185973,CDM,,,278,RC,inpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1514.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1707.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,1514.41,1908.08,
DEPUY NARROW CEMENT NOZZLE,30185974,CDM,,,270,RC,inpatient,,427,427,,362.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,321.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,362.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,375.76,88,,percent of total billed charges,,,,,,,,,326.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,388.57,91,,percent of total billed charges,,,405.65,95,,percent of total billed charges,,,354.41,83,,percent of total billed charges,,,354.41,83,,percent of total billed charges,,,,,,,,,,,,,,,354.41,83,,percent of total billed charges,,,405.65,95,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,350.14,82,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,362.95,85,,percent of total billed charges,,321.96,405.65,
AUTOPLEX W/VERTEPLEX HV,30185975,CDM,,,270,RC,inpatient,,6765.98,6765.98,,5744.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5101.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5751.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5954.06,88,,percent of total billed charges,,,,,,,,,5169.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6157.04,91,,percent of total billed charges,,,6427.68,95,,percent of total billed charges,,,5615.76,83,,percent of total billed charges,,,5615.76,83,,percent of total billed charges,,,,,,,,,,,,,,,5615.76,83,,percent of total billed charges,,,6427.68,95,,percent of total billed charges,,,6089.38,90,,percent of total billed charges,,,6089.38,90,,percent of total billed charges,,,5548.1,82,,percent of total billed charges,,,6089.38,90,,percent of total billed charges,,,5751.08,85,,percent of total billed charges,,5101.55,6427.68,
DEPUY INSERT SIGMA PS PLUS SZ 4 10MM,30185976,CDM,,,278,RC,inpatient,,17187.04,17187.04,,14591.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12959.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14608.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15124.6,88,,percent of total billed charges,,,,,,,,,13130.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15640.21,91,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,,,,,,,,,,,,,14265.24,83,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14093.37,82,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14608.98,85,,percent of total billed charges,,12959.03,16327.69,
ZIMMER BEARING LG 6MM,30185977,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
ZIMMER BLADE EXPLANT TRUNCATED 62MM,30185978,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
ZIMMER BLADE EXPLANT FULL 62MM,30185979,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
ZIMMER TAPER ADAPTER +6MM,30185980,CDM,,,270,RC,inpatient,,2860,2860,,2428.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2156.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2431,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2516.8,88,,percent of total billed charges,,,,,,,,,2185.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2602.6,91,,percent of total billed charges,,,2717,95,,percent of total billed charges,,,2373.8,83,,percent of total billed charges,,,2373.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2373.8,83,,percent of total billed charges,,,2717,95,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2345.2,82,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2431,85,,percent of total billed charges,,2156.44,2717,
ZIMMER HEAD CERAMIC HD 28MM,30185981,CDM,,,278,RC,inpatient,,29900,29900,,25385.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22544.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25415,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26312,88,,percent of total billed charges,,,,,,,,,22843.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27209,91,,percent of total billed charges,,,28405,95,,percent of total billed charges,,,24817,83,,percent of total billed charges,,,24817,83,,percent of total billed charges,,,,,,,,,,,,,,,24817,83,,percent of total billed charges,,,28405,95,,percent of total billed charges,,,26910,90,,percent of total billed charges,,,26910,90,,percent of total billed charges,,,24518,82,,percent of total billed charges,,,26910,90,,percent of total billed charges,,,25415,85,,percent of total billed charges,,22544.6,28405,
STRYKER SHELL RESTORATION ANATOMIC SZ 66,30185982,CDM,,,278,RC,inpatient,,25132.25,25132.25,,21337.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18949.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21362.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22116.38,88,,percent of total billed charges,,,,,,,,,19201.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22870.35,91,,percent of total billed charges,,,23875.64,95,,percent of total billed charges,,,20859.77,83,,percent of total billed charges,,,20859.77,83,,percent of total billed charges,,,,,,,,,,,,,,,20859.77,83,,percent of total billed charges,,,23875.64,95,,percent of total billed charges,,,22619.03,90,,percent of total billed charges,,,22619.03,90,,percent of total billed charges,,,20608.45,82,,percent of total billed charges,,,22619.03,90,,percent of total billed charges,,,21362.41,85,,percent of total billed charges,,18949.72,23875.64,
STRYKER SCREW BONE OSTEOLOCK 40MM,30185983,CDM,,,278,RC,inpatient,,946.4,946.4,,803.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,713.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,804.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,832.83,88,,percent of total billed charges,,,,,,,,,723.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,861.22,91,,percent of total billed charges,,,899.08,95,,percent of total billed charges,,,785.51,83,,percent of total billed charges,,,785.51,83,,percent of total billed charges,,,,,,,,,,,,,,,785.51,83,,percent of total billed charges,,,899.08,95,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,776.05,82,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,804.44,85,,percent of total billed charges,,713.59,899.08,
STRYKER SCREW BONE OSTEOLOCK 30MM,30185984,CDM,,,278,RC,inpatient,,946.4,946.4,,803.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,713.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,804.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,832.83,88,,percent of total billed charges,,,,,,,,,723.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,861.22,91,,percent of total billed charges,,,899.08,95,,percent of total billed charges,,,785.51,83,,percent of total billed charges,,,785.51,83,,percent of total billed charges,,,,,,,,,,,,,,,785.51,83,,percent of total billed charges,,,899.08,95,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,776.05,82,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,804.44,85,,percent of total billed charges,,713.59,899.08,
STRYKER LINER 46MM F,30185985,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER INSERT ADM 28MM OD 52MM,30185986,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
MITEK HEALIX ADVANCE 5.5,30185987,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
MITEK HEALIX ADVANCE KNOTLESS 5.5,30185988,CDM,,,278,RC,inpatient,,3770,3770,,3200.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2842.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3204.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3317.6,88,,percent of total billed charges,,,,,,,,,2880.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3430.7,91,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,,,,,,,,,,,,,3129.1,83,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3091.4,82,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3204.5,85,,percent of total billed charges,,2842.58,3581.5,
MITEK HEALIX ADVANCE KNOTLESS 4.75,30185989,CDM,,,278,RC,inpatient,,3770,3770,,3200.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2842.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3204.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3317.6,88,,percent of total billed charges,,,,,,,,,2880.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3430.7,91,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,,,,,,,,,,,,,3129.1,83,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3091.4,82,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3204.5,85,,percent of total billed charges,,2842.58,3581.5,
SYNTHES PLATE LCP CLAVICLE 6 HOLE LEFT,30185990,CDM,,,278,RC,inpatient,,9525.1,9525.1,,8086.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7181.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8096.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8382.09,88,,percent of total billed charges,,,,,,,,,7277.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8667.84,91,,percent of total billed charges,,,9048.85,95,,percent of total billed charges,,,7905.83,83,,percent of total billed charges,,,7905.83,83,,percent of total billed charges,,,,,,,,,,,,,,,7905.83,83,,percent of total billed charges,,,9048.85,95,,percent of total billed charges,,,8572.59,90,,percent of total billed charges,,,8572.59,90,,percent of total billed charges,,,7810.58,82,,percent of total billed charges,,,8572.59,90,,percent of total billed charges,,,8096.34,85,,percent of total billed charges,,7181.93,9048.85,
IR SCREW POLY 6.5X45,30185991,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
IR SCREW POLY 6.5X50,30185992,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
IR SCREW POLY 7.5X45,30185993,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
IR SCREW POLY 7.5X50,30185994,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
IR SCREW REDUCTION 6.5 X 40,30185995,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
IR SCREW REDUCTION 6.5 X 45,30185996,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
IR ROD LORDOSED 5.5 X 70MM,30185997,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
IR RODS 3.5 X 80MM,30185998,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
IR SCREW POLY 7.5X55,30185999,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
CAGE STALIF C-TI,30186001,CDM,,,278,RC,inpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14703,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16575,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,14703,18525,
PATIENT TRACKER ENT,30186002,CDM,,,270,RC,inpatient,,1566.5,1566.5,,1329.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1181.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1331.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1378.52,88,,percent of total billed charges,,,,,,,,,1196.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1425.52,91,,percent of total billed charges,,,1488.18,95,,percent of total billed charges,,,1300.2,83,,percent of total billed charges,,,1300.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1300.2,83,,percent of total billed charges,,,1488.18,95,,percent of total billed charges,,,1409.85,90,,percent of total billed charges,,,1409.85,90,,percent of total billed charges,,,1284.53,82,,percent of total billed charges,,,1409.85,90,,percent of total billed charges,,,1331.53,85,,percent of total billed charges,,1181.14,1488.18,
MALLEABLE SUCTION STD TIP 7FR,30186003,CDM,,,270,RC,inpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1519.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1712.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,1519.31,1914.25,
INSTRUMENT TRACKER ENT,30186004,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
SUTURE SHUTTLE 45DEG L IDEAL,30186005,CDM,,,270,RC,inpatient,,1989,1989,,1688.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1499.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1690.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1750.32,88,,percent of total billed charges,,,,,,,,,1519.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1809.99,91,,percent of total billed charges,,,1889.55,95,,percent of total billed charges,,,1650.87,83,,percent of total billed charges,,,1650.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1650.87,83,,percent of total billed charges,,,1889.55,95,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1630.98,82,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1690.65,85,,percent of total billed charges,,1499.71,1889.55,
SYNTHES PLATE LCP CLAVICLE 7 HOLE LEFT S,30186006,CDM,,,278,RC,inpatient,,9773.73,9773.73,,8297.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7369.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8307.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8600.88,88,,percent of total billed charges,,,,,,,,,7467.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8894.09,91,,percent of total billed charges,,,9285.04,95,,percent of total billed charges,,,8112.2,83,,percent of total billed charges,,,8112.2,83,,percent of total billed charges,,,,,,,,,,,,,,,8112.2,83,,percent of total billed charges,,,9285.04,95,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8014.46,82,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8307.67,85,,percent of total billed charges,,7369.39,9285.04,
SYNTHES DRILL BIT 2.5MM 110MM,30186007,CDM,,,270,RC,inpatient,,795.34,795.34,,675.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,599.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,676.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,699.9,88,,percent of total billed charges,,,,,,,,,607.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,723.76,91,,percent of total billed charges,,,755.57,95,,percent of total billed charges,,,660.13,83,,percent of total billed charges,,,660.13,83,,percent of total billed charges,,,,,,,,,,,,,,,660.13,83,,percent of total billed charges,,,755.57,95,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,652.18,82,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,676.04,85,,percent of total billed charges,,599.69,755.57,
ZIMMER SCREW BONE ST 6.5 X 15MM,30186008,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
ZIMMER SHELL OSSEOTI G7 48MM C 3 HOLE,30186009,CDM,,,278,RC,inpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14580.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16436.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,14580.48,18370.63,
ZIMMER BEARING HIP ACT ARTIC 28X38MM,30186010,CDM,,,278,RC,inpatient,,23400,23400,,19866.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17643.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19890,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20592,88,,percent of total billed charges,,,,,,,,,17877.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21294,91,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,,,,,,,,,,,,,19422,83,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19188,82,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19890,85,,percent of total billed charges,,17643.6,22230,
ZIMMER LINER DUAL MOBILITY G7 38MM C,30186011,CDM,,,278,RC,inpatient,,9912.5,9912.5,,8415.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7474.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8425.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8723,88,,percent of total billed charges,,,,,,,,,7573.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9020.38,91,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,,,,,,,,,,,,,8227.38,83,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8128.25,82,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,7474.03,9416.88,
IR SCREW POLY 6.5X40,30186012,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
STRYKER ANCHOR SUTURE NANOTACK 1.4MM,30186013,CDM,,,278,RC,inpatient,,4091.36,4091.36,,3473.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3084.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3477.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3600.4,88,,percent of total billed charges,,,,,,,,,3125.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3723.14,91,,percent of total billed charges,,,3886.79,95,,percent of total billed charges,,,3395.83,83,,percent of total billed charges,,,3395.83,83,,percent of total billed charges,,,,,,,,,,,,,,,3395.83,83,,percent of total billed charges,,,3886.79,95,,percent of total billed charges,,,3682.22,90,,percent of total billed charges,,,3682.22,90,,percent of total billed charges,,,3354.92,82,,percent of total billed charges,,,3682.22,90,,percent of total billed charges,,,3477.66,85,,percent of total billed charges,,3084.89,3886.79,
DEPUY STEM CORAIL REVISION SZ12 STD,30186014,CDM,,,278,RC,inpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50336.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56745.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,50336.9,63421.82,
DEPUY INSERT AOX RP 5MM,30186015,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
MERETE NAIL IKA WITHOUT COLLAR 150 X16,30186016,CDM,,,278,RC,inpatient,,25025,25025,,21246.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18868.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21271.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22022,88,,percent of total billed charges,,,,,,,,,19119.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22772.75,91,,percent of total billed charges,,,23773.75,95,,percent of total billed charges,,,20770.75,83,,percent of total billed charges,,,20770.75,83,,percent of total billed charges,,,,,,,,,,,,,,,20770.75,83,,percent of total billed charges,,,23773.75,95,,percent of total billed charges,,,22522.5,90,,percent of total billed charges,,,22522.5,90,,percent of total billed charges,,,20520.5,82,,percent of total billed charges,,,22522.5,90,,percent of total billed charges,,,21271.25,85,,percent of total billed charges,,18868.85,23773.75,
MERETE NAIL IKA WITHOUT COLLAR 150 X14,30186017,CDM,,,278,RC,inpatient,,17875,17875,,15175.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13477.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15193.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15730,88,,percent of total billed charges,,,,,,,,,13656.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16266.25,91,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14836.25,83,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,14657.5,82,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,13477.75,16981.25,
MERETE SCREW INTERLOCKING 36MM,30186018,CDM,,,278,RC,inpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2129.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2400.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,2129.48,2683.04,
MERETE SCREW INTERLOCKING 40MM,30186019,CDM,,,278,RC,inpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2129.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2400.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,2129.48,2683.04,
MERETE SCREW INTERLOCKING 36MM,30186020,CDM,,,278,RC,inpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2129.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2400.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,2129.48,2683.04,
MERETE SCREW INTERLOCKING 44MM,30186021,CDM,,,278,RC,inpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2129.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2400.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,2129.48,2683.04,
SYNTHES CLAMP COMBINATION MR-CONDITIONAL,30186025,CDM,,,278,RC,inpatient,,6641.05,6641.05,,5638.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5007.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5644.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5844.12,88,,percent of total billed charges,,,,,,,,,5073.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6043.36,91,,percent of total billed charges,,,6309,95,,percent of total billed charges,,,5512.07,83,,percent of total billed charges,,,5512.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5512.07,83,,percent of total billed charges,,,6309,95,,percent of total billed charges,,,5976.95,90,,percent of total billed charges,,,5976.95,90,,percent of total billed charges,,,5445.66,82,,percent of total billed charges,,,5976.95,90,,percent of total billed charges,,,5644.89,85,,percent of total billed charges,,5007.35,6309,
SYNTHES CLAMP PIN 6-POSITION MR-CONDITIO,30186026,CDM,,,278,RC,inpatient,,4729.4,4729.4,,4015.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3565.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4019.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4161.87,88,,percent of total billed charges,,,,,,,,,3613.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4303.75,91,,percent of total billed charges,,,4492.93,95,,percent of total billed charges,,,3925.4,83,,percent of total billed charges,,,3925.4,83,,percent of total billed charges,,,,,,,,,,,,,,,3925.4,83,,percent of total billed charges,,,4492.93,95,,percent of total billed charges,,,4256.46,90,,percent of total billed charges,,,4256.46,90,,percent of total billed charges,,,3878.11,82,,percent of total billed charges,,,4256.46,90,,percent of total billed charges,,,4019.99,85,,percent of total billed charges,,3565.97,4492.93,
SYNTHES ROD CARBON FIBER 11 X 100MM,30186027,CDM,,,278,RC,inpatient,,2281.83,2281.83,,1937.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1720.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1939.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2008.01,88,,percent of total billed charges,,,,,,,,,1743.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2076.47,91,,percent of total billed charges,,,2167.74,95,,percent of total billed charges,,,1893.92,83,,percent of total billed charges,,,1893.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1893.92,83,,percent of total billed charges,,,2167.74,95,,percent of total billed charges,,,2053.65,90,,percent of total billed charges,,,2053.65,90,,percent of total billed charges,,,1871.1,82,,percent of total billed charges,,,2053.65,90,,percent of total billed charges,,,1939.56,85,,percent of total billed charges,,1720.5,2167.74,
SYNTHES SCREW SCHANZ 5.0 X 150MM,30186028,CDM,,,278,RC,inpatient,,1773.53,1773.53,,1505.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1337.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1507.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1560.71,88,,percent of total billed charges,,,,,,,,,1354.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1613.91,91,,percent of total billed charges,,,1684.85,95,,percent of total billed charges,,,1472.03,83,,percent of total billed charges,,,1472.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1472.03,83,,percent of total billed charges,,,1684.85,95,,percent of total billed charges,,,1596.18,90,,percent of total billed charges,,,1596.18,90,,percent of total billed charges,,,1454.29,82,,percent of total billed charges,,,1596.18,90,,percent of total billed charges,,,1507.5,85,,percent of total billed charges,,1337.24,1684.85,
SYNTHES ROD CARBON FIBER 11 X 350MM,30186029,CDM,,,278,RC,inpatient,,2447.58,2447.58,,2078,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1845.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2080.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2153.87,88,,percent of total billed charges,,,,,,,,,1869.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2227.3,91,,percent of total billed charges,,,2325.2,95,,percent of total billed charges,,,2031.49,83,,percent of total billed charges,,,2031.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2031.49,83,,percent of total billed charges,,,2325.2,95,,percent of total billed charges,,,2202.82,90,,percent of total billed charges,,,2202.82,90,,percent of total billed charges,,,2007.02,82,,percent of total billed charges,,,2202.82,90,,percent of total billed charges,,,2080.44,85,,percent of total billed charges,,1845.48,2325.2,
SPINECRAFT SCREW 7.0 X 55MM,30186031,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT SCREW 7.0 X 50MM,30186032,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT ROD LOWDOSED 6.0 X 100,30186033,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ZIMMER LINER NEU +5MM E1 32MM C,30186034,CDM,,,278,RC,inpatient,,23595,23595,,20032.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17790.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20055.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20763.6,88,,percent of total billed charges,,,,,,,,,18026.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21471.45,91,,percent of total billed charges,,,22415.25,95,,percent of total billed charges,,,19583.85,83,,percent of total billed charges,,,19583.85,83,,percent of total billed charges,,,,,,,,,,,,,,,19583.85,83,,percent of total billed charges,,,22415.25,95,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,19347.9,82,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,20055.75,85,,percent of total billed charges,,17790.63,22415.25,
ULRICH PEEK CERVICAL 12X14X10MM,30186035,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
ULRICH PLATE 1 LEVEL 20MM,30186036,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
SPINECRAFT ROD LOWDOSED 6.0 X 70,30186037,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ZIMMER BEARING LEFT LRG SZ 9,30186038,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
STRYKER DRILL ICONIX,30186041,CDM,,,270,RC,inpatient,,1538.16,1538.16,,1305.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1159.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1307.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1353.58,88,,percent of total billed charges,,,,,,,,,1175.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1399.73,91,,percent of total billed charges,,,1461.25,95,,percent of total billed charges,,,1276.67,83,,percent of total billed charges,,,1276.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1276.67,83,,percent of total billed charges,,,1461.25,95,,percent of total billed charges,,,1384.34,90,,percent of total billed charges,,,1384.34,90,,percent of total billed charges,,,1261.29,82,,percent of total billed charges,,,1384.34,90,,percent of total billed charges,,,1307.44,85,,percent of total billed charges,,1159.77,1461.25,
DEPUY TIBIA ATTUNE RP SZ 6,30186042,CDM,,,278,RC,inpatient,,22629.36,22629.36,,19212.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17062.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19234.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19913.84,88,,percent of total billed charges,,,,,,,,,17288.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20592.72,91,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,,,,,,,,,,,,,18782.37,83,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,18556.08,82,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,17062.54,21497.89,
SYNTHES SCREW LOCKING S-T 3.5 X 36MM,30186043,CDM,,,278,RC,inpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,945.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1066.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,945.79,1191.65,
DEPUY STEM PRESS FIT 14X110,30186044,CDM,,,278,RC,inpatient,,13175.11,13175.11,,11185.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9934.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11198.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11594.1,88,,percent of total billed charges,,,,,,,,,10065.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11989.35,91,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,,,,,,,,,,,,,10935.34,83,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,10803.59,82,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,9934.03,12516.35,
DEPUY ATTUNE FEMUR REV. SZ 6 L,30186045,CDM,,,278,RC,inpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39636.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44683.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,39636.69,49940.13,
DEPUY HEAD HUMERAL ECCENTRIC 44X15,30186046,CDM,,,278,RC,inpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13297.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14990.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,13297.64,16754.32,
ZIMMER ACT ARTIC HD ARCOM XL 28X40MM,30186047,CDM,,,278,RC,inpatient,,18525,18525,,15727.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13967.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15746.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16302,88,,percent of total billed charges,,,,,,,,,14153.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16857.75,91,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,,,,,,,,,,,,,15375.75,83,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15190.5,82,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15746.25,85,,percent of total billed charges,,13967.85,17598.75,
STRYKER FEMUR TRIATHLON PS SZ 7 LEFT,30186048,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
STRYKER INSERT TRIATHLON PS SZ 7-9MM,30186049,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER TIBIA INSERT TRIATHLON PS SZ 7,30186050,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER FEMUR TRIATHLON PS SZ 8 LEFT,30186051,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
STRYKER INSERT TRIATHLON PS SZ 8,30186052,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER TIBIA INSERT TRIATHLON CR SZ 8-9,30186053,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
NEEDLE CARR-LOCKE INJECTION 23G,30186054,CDM,,,270,RC,inpatient,,282.27,282.27,,239.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,212.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,239.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,248.4,88,,percent of total billed charges,,,,,,,,,215.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,256.87,91,,percent of total billed charges,,,268.16,95,,percent of total billed charges,,,234.28,83,,percent of total billed charges,,,234.28,83,,percent of total billed charges,,,,,,,,,,,,,,,234.28,83,,percent of total billed charges,,,268.16,95,,percent of total billed charges,,,254.04,90,,percent of total billed charges,,,254.04,90,,percent of total billed charges,,,231.46,82,,percent of total billed charges,,,254.04,90,,percent of total billed charges,,,239.93,85,,percent of total billed charges,,212.83,268.16,
SPINECRAFT SCREW REDUCTION 7.0 50MM,30186055,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
SPINECRAFT SCREW 7.0 X 45MM,30186056,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ARTHREX SCREW BIOCOMP 8X20,30186057,CDM,,,270,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
SYNTHES SCREW CORTEX TI 2.7 X 12MM,30186058,CDM,,,278,RC,inpatient,,458.15,458.15,,388.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,345.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,389.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,403.17,88,,percent of total billed charges,,,,,,,,,350.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,416.92,91,,percent of total billed charges,,,435.24,95,,percent of total billed charges,,,380.26,83,,percent of total billed charges,,,380.26,83,,percent of total billed charges,,,,,,,,,,,,,,,380.26,83,,percent of total billed charges,,,435.24,95,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,375.68,82,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,389.43,85,,percent of total billed charges,,345.45,435.24,
SYNTHES SCREW CORTEX TI 2.7 X 16MM,30186059,CDM,,,278,RC,inpatient,,458.15,458.15,,388.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,345.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,389.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,403.17,88,,percent of total billed charges,,,,,,,,,350.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,416.92,91,,percent of total billed charges,,,435.24,95,,percent of total billed charges,,,380.26,83,,percent of total billed charges,,,380.26,83,,percent of total billed charges,,,,,,,,,,,,,,,380.26,83,,percent of total billed charges,,,435.24,95,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,375.68,82,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,389.43,85,,percent of total billed charges,,345.45,435.24,
SYNTHES SCREW CORTEX TI 2.7 X 18MM,30186060,CDM,,,278,RC,inpatient,,458.15,458.15,,388.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,345.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,389.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,403.17,88,,percent of total billed charges,,,,,,,,,350.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,416.92,91,,percent of total billed charges,,,435.24,95,,percent of total billed charges,,,380.26,83,,percent of total billed charges,,,380.26,83,,percent of total billed charges,,,,,,,,,,,,,,,380.26,83,,percent of total billed charges,,,435.24,95,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,375.68,82,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,389.43,85,,percent of total billed charges,,345.45,435.24,
SYNTHES SCREW LOCKING TI 3.5X10MM,30186061,CDM,,,278,RC,inpatient,,1389.18,1389.18,,1179.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1047.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1180.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1222.48,88,,percent of total billed charges,,,,,,,,,1061.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1264.15,91,,percent of total billed charges,,,1319.72,95,,percent of total billed charges,,,1153.02,83,,percent of total billed charges,,,1153.02,83,,percent of total billed charges,,,,,,,,,,,,,,,1153.02,83,,percent of total billed charges,,,1319.72,95,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1139.13,82,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1180.8,85,,percent of total billed charges,,1047.44,1319.72,
SYNTHES SCREW LOCKING TI 3.5X16MM,30186062,CDM,,,278,RC,inpatient,,1389.18,1389.18,,1179.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1047.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1180.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1222.48,88,,percent of total billed charges,,,,,,,,,1061.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1264.15,91,,percent of total billed charges,,,1319.72,95,,percent of total billed charges,,,1153.02,83,,percent of total billed charges,,,1153.02,83,,percent of total billed charges,,,,,,,,,,,,,,,1153.02,83,,percent of total billed charges,,,1319.72,95,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1139.13,82,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1180.8,85,,percent of total billed charges,,1047.44,1319.72,
SYNTHES SCREW CORTEX TI 3.5 X 10MM,30186063,CDM,,,278,RC,inpatient,,293.25,293.25,,248.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,221.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,249.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,258.06,88,,percent of total billed charges,,,,,,,,,224.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,266.86,91,,percent of total billed charges,,,278.59,95,,percent of total billed charges,,,243.4,83,,percent of total billed charges,,,243.4,83,,percent of total billed charges,,,,,,,,,,,,,,,243.4,83,,percent of total billed charges,,,278.59,95,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,240.47,82,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,249.26,85,,percent of total billed charges,,221.11,278.59,
SYNTHES SCREW CORTEX TI 3.5 X 12MM,30186064,CDM,,,278,RC,inpatient,,311.1,311.1,,264.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,234.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,264.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,273.77,88,,percent of total billed charges,,,,,,,,,237.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,283.1,91,,percent of total billed charges,,,295.55,95,,percent of total billed charges,,,258.21,83,,percent of total billed charges,,,258.21,83,,percent of total billed charges,,,,,,,,,,,,,,,258.21,83,,percent of total billed charges,,,295.55,95,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,255.1,82,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,264.44,85,,percent of total billed charges,,234.57,295.55,
SYNTHES SCREW CORTEX TI 3.5 X 14MM,30186065,CDM,,,278,RC,inpatient,,311.1,311.1,,264.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,234.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,264.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,273.77,88,,percent of total billed charges,,,,,,,,,237.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,283.1,91,,percent of total billed charges,,,295.55,95,,percent of total billed charges,,,258.21,83,,percent of total billed charges,,,258.21,83,,percent of total billed charges,,,,,,,,,,,,,,,258.21,83,,percent of total billed charges,,,295.55,95,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,255.1,82,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,264.44,85,,percent of total billed charges,,234.57,295.55,
SYNTHES SCREW CORTEX TI 3.5 X 16MM,30186066,CDM,,,278,RC,inpatient,,311.1,311.1,,264.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,234.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,264.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,273.77,88,,percent of total billed charges,,,,,,,,,237.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,283.1,91,,percent of total billed charges,,,295.55,95,,percent of total billed charges,,,258.21,83,,percent of total billed charges,,,258.21,83,,percent of total billed charges,,,,,,,,,,,,,,,258.21,83,,percent of total billed charges,,,295.55,95,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,255.1,82,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,264.44,85,,percent of total billed charges,,234.57,295.55,
SYNTHES SCREW CORTEX TI 3.5 X 42MM,30186067,CDM,,,278,RC,inpatient,,293.25,293.25,,248.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,221.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,249.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,258.06,88,,percent of total billed charges,,,,,,,,,224.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,266.86,91,,percent of total billed charges,,,278.59,95,,percent of total billed charges,,,243.4,83,,percent of total billed charges,,,243.4,83,,percent of total billed charges,,,,,,,,,,,,,,,243.4,83,,percent of total billed charges,,,278.59,95,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,240.47,82,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,249.26,85,,percent of total billed charges,,221.11,278.59,
SYNTHES PLATE TUBULAR TI 1/3 10 HOLE,30186068,CDM,,,278,RC,inpatient,,1872.98,1872.98,,1590.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1412.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1592.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1648.22,88,,percent of total billed charges,,,,,,,,,1430.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1704.41,91,,percent of total billed charges,,,1779.33,95,,percent of total billed charges,,,1554.57,83,,percent of total billed charges,,,1554.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1554.57,83,,percent of total billed charges,,,1779.33,95,,percent of total billed charges,,,1685.68,90,,percent of total billed charges,,,1685.68,90,,percent of total billed charges,,,1535.84,82,,percent of total billed charges,,,1685.68,90,,percent of total billed charges,,,1592.03,85,,percent of total billed charges,,1412.23,1779.33,
SYNTHES SCREW CANNULATED TI 4.0 X 42MM,30186069,CDM,,,278,RC,inpatient,,2138.18,2138.18,,1815.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1612.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1817.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1881.6,88,,percent of total billed charges,,,,,,,,,1633.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1945.74,91,,percent of total billed charges,,,2031.27,95,,percent of total billed charges,,,1774.69,83,,percent of total billed charges,,,1774.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1774.69,83,,percent of total billed charges,,,2031.27,95,,percent of total billed charges,,,1924.36,90,,percent of total billed charges,,,1924.36,90,,percent of total billed charges,,,1753.31,82,,percent of total billed charges,,,1924.36,90,,percent of total billed charges,,,1817.45,85,,percent of total billed charges,,1612.19,2031.27,
SYNTHES PLATE MEDIAL DISTAL TIB 3.5 LCP,30186070,CDM,,,278,RC,inpatient,,15663.38,15663.38,,13298.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11810.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13313.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13783.77,88,,percent of total billed charges,,,,,,,,,11966.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14253.68,91,,percent of total billed charges,,,14880.21,95,,percent of total billed charges,,,13000.61,83,,percent of total billed charges,,,13000.61,83,,percent of total billed charges,,,,,,,,,,,,,,,13000.61,83,,percent of total billed charges,,,14880.21,95,,percent of total billed charges,,,14097.04,90,,percent of total billed charges,,,14097.04,90,,percent of total billed charges,,,12843.97,82,,percent of total billed charges,,,14097.04,90,,percent of total billed charges,,,13313.87,85,,percent of total billed charges,,11810.19,14880.21,
SYNTHES SCREW METAPHYSEAL 2.7 X 40MM,30186071,CDM,,,278,RC,inpatient,,464.1,464.1,,394.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.41,88,,percent of total billed charges,,,,,,,,,354.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.33,91,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,,,,,,,,,,,,,385.2,83,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,380.56,82,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,394.49,85,,percent of total billed charges,,349.93,440.9,
SYNTHES PLATE CALC MED RIGHT 2.7 VAL,30186072,CDM,,,278,RC,inpatient,,9193.6,9193.6,,7805.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6931.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7814.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8090.37,88,,percent of total billed charges,,,,,,,,,7023.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8366.18,91,,percent of total billed charges,,,8733.92,95,,percent of total billed charges,,,7630.69,83,,percent of total billed charges,,,7630.69,83,,percent of total billed charges,,,,,,,,,,,,,,,7630.69,83,,percent of total billed charges,,,8733.92,95,,percent of total billed charges,,,8274.24,90,,percent of total billed charges,,,8274.24,90,,percent of total billed charges,,,7538.75,82,,percent of total billed charges,,,8274.24,90,,percent of total billed charges,,,7814.56,85,,percent of total billed charges,,6931.97,8733.92,
SYNTHES SCREW METAPHYSEAL 2.7 X 44MM,30186073,CDM,,,278,RC,inpatient,,464.1,464.1,,394.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.41,88,,percent of total billed charges,,,,,,,,,354.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.33,91,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,,,,,,,,,,,,,385.2,83,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,380.56,82,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,394.49,85,,percent of total billed charges,,349.93,440.9,
SYNTHES SCREW METAPHYSEAL 2.7 X 52MM,30186074,CDM,,,278,RC,inpatient,,464.1,464.1,,394.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.41,88,,percent of total billed charges,,,,,,,,,354.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.33,91,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,,,,,,,,,,,,,385.2,83,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,380.56,82,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,394.49,85,,percent of total billed charges,,349.93,440.9,
SYNTHES SCREW LOCKING VA 2.7 X 56MM,30186075,CDM,,,278,RC,inpatient,,1331.53,1331.53,,1130.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1003.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1131.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1171.75,88,,percent of total billed charges,,,,,,,,,1017.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1211.69,91,,percent of total billed charges,,,1264.95,95,,percent of total billed charges,,,1105.17,83,,percent of total billed charges,,,1105.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1105.17,83,,percent of total billed charges,,,1264.95,95,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1091.85,82,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1131.8,85,,percent of total billed charges,,1003.97,1264.95,
SYNTHES SCREW LOCKING VA 2.7 X 54MM,30186076,CDM,,,278,RC,inpatient,,1331.53,1331.53,,1130.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1003.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1131.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1171.75,88,,percent of total billed charges,,,,,,,,,1017.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1211.69,91,,percent of total billed charges,,,1264.95,95,,percent of total billed charges,,,1105.17,83,,percent of total billed charges,,,1105.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1105.17,83,,percent of total billed charges,,,1264.95,95,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1091.85,82,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1131.8,85,,percent of total billed charges,,1003.97,1264.95,
SYNTHES SCREW LOCKING VA 2.7 X 46MM,30186077,CDM,,,278,RC,inpatient,,1331.53,1331.53,,1130.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1003.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1131.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1171.75,88,,percent of total billed charges,,,,,,,,,1017.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1211.69,91,,percent of total billed charges,,,1264.95,95,,percent of total billed charges,,,1105.17,83,,percent of total billed charges,,,1105.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1105.17,83,,percent of total billed charges,,,1264.95,95,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1091.85,82,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1131.8,85,,percent of total billed charges,,1003.97,1264.95,
SYNTHES SCREW METAPHYSEAL 2.7 X 46MM,30186078,CDM,,,278,RC,inpatient,,464.1,464.1,,394.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.41,88,,percent of total billed charges,,,,,,,,,354.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.33,91,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,,,,,,,,,,,,,385.2,83,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,380.56,82,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,394.49,85,,percent of total billed charges,,349.93,440.9,
SYNTHES SCREW METAPHYSEAL 2.7 X 48MM,30186079,CDM,,,278,RC,inpatient,,464.1,464.1,,394.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.41,88,,percent of total billed charges,,,,,,,,,354.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.33,91,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,,,,,,,,,,,,,385.2,83,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,380.56,82,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,394.49,85,,percent of total billed charges,,349.93,440.9,
SYNTHES CENTERING PIN 1.6MM FOR JOYSTICK,30186080,CDM,,,278,RC,inpatient,,1348.1,1348.1,,1144.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1016.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1145.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1186.33,88,,percent of total billed charges,,,,,,,,,1029.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1226.77,91,,percent of total billed charges,,,1280.7,95,,percent of total billed charges,,,1118.92,83,,percent of total billed charges,,,1118.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1118.92,83,,percent of total billed charges,,,1280.7,95,,percent of total billed charges,,,1213.29,90,,percent of total billed charges,,,1213.29,90,,percent of total billed charges,,,1105.44,82,,percent of total billed charges,,,1213.29,90,,percent of total billed charges,,,1145.89,85,,percent of total billed charges,,1016.47,1280.7,
TOPIFOAM ADHESIVE FOAM PADS,30186081,CDM,,,270,RC,inpatient,,243.75,243.75,,206.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,183.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,207.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,214.5,88,,percent of total billed charges,,,,,,,,,186.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,221.81,91,,percent of total billed charges,,,231.56,95,,percent of total billed charges,,,202.31,83,,percent of total billed charges,,,202.31,83,,percent of total billed charges,,,,,,,,,,,,,,,202.31,83,,percent of total billed charges,,,231.56,95,,percent of total billed charges,,,219.38,90,,percent of total billed charges,,,219.38,90,,percent of total billed charges,,,199.88,82,,percent of total billed charges,,,219.38,90,,percent of total billed charges,,,207.19,85,,percent of total billed charges,,183.79,231.56,
MEDTRONIC PACEMAKER AZURE XT SR MRI SURS,30186082,CDM,,,278,RC,inpatient,,40168.77,40168.77,,34103.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30287.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34143.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35348.52,88,,percent of total billed charges,,,,,,,,,30688.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36553.58,91,,percent of total billed charges,,,38160.33,95,,percent of total billed charges,,,33340.08,83,,percent of total billed charges,,,33340.08,83,,percent of total billed charges,,,,,,,,,,,,,,,33340.08,83,,percent of total billed charges,,,38160.33,95,,percent of total billed charges,,,36151.89,90,,percent of total billed charges,,,36151.89,90,,percent of total billed charges,,,32938.39,82,,percent of total billed charges,,,36151.89,90,,percent of total billed charges,,,34143.45,85,,percent of total billed charges,,30287.25,38160.33,
SYNTHES PLATE LCP 7-HOLE 3.5MM,30186083,CDM,,,278,RC,inpatient,,3038.75,3038.75,,2579.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2291.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2582.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2674.1,88,,percent of total billed charges,,,,,,,,,2321.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2765.26,91,,percent of total billed charges,,,2886.81,95,,percent of total billed charges,,,2522.16,83,,percent of total billed charges,,,2522.16,83,,percent of total billed charges,,,,,,,,,,,,,,,2522.16,83,,percent of total billed charges,,,2886.81,95,,percent of total billed charges,,,2734.88,90,,percent of total billed charges,,,2734.88,90,,percent of total billed charges,,,2491.78,82,,percent of total billed charges,,,2734.88,90,,percent of total billed charges,,,2582.94,85,,percent of total billed charges,,2291.22,2886.81,
IR SCREW POLY 6.5 X 5.5MM,30186084,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
IR ROD 300MM 5.5MM,30186085,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
CTL CAGE MATISSE 14X12X6MM,30186086,CDM,,,278,RC,inpatient,,10708.75,10708.75,,9091.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8074.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9102.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9423.7,88,,percent of total billed charges,,,,,,,,,8181.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9744.96,91,,percent of total billed charges,,,10173.31,95,,percent of total billed charges,,,8888.26,83,,percent of total billed charges,,,8888.26,83,,percent of total billed charges,,,,,,,,,,,,,,,8888.26,83,,percent of total billed charges,,,10173.31,95,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,8781.18,82,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,9102.44,85,,percent of total billed charges,,8074.4,10173.31,
CTL CAGE MATISSE 14X12X7MM,30186087,CDM,,,278,RC,inpatient,,10708.75,10708.75,,9091.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8074.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9102.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9423.7,88,,percent of total billed charges,,,,,,,,,8181.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9744.96,91,,percent of total billed charges,,,10173.31,95,,percent of total billed charges,,,8888.26,83,,percent of total billed charges,,,8888.26,83,,percent of total billed charges,,,,,,,,,,,,,,,8888.26,83,,percent of total billed charges,,,10173.31,95,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,8781.18,82,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,9102.44,85,,percent of total billed charges,,8074.4,10173.31,
CTL PLATE CERVICAL 28MM,30186088,CDM,,,278,RC,inpatient,,10816,10816,,9182.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8155.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9193.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9518.08,88,,percent of total billed charges,,,,,,,,,8263.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9842.56,91,,percent of total billed charges,,,10275.2,95,,percent of total billed charges,,,8977.28,83,,percent of total billed charges,,,8977.28,83,,percent of total billed charges,,,,,,,,,,,,,,,8977.28,83,,percent of total billed charges,,,10275.2,95,,percent of total billed charges,,,9734.4,90,,percent of total billed charges,,,9734.4,90,,percent of total billed charges,,,8869.12,82,,percent of total billed charges,,,9734.4,90,,percent of total billed charges,,,9193.6,85,,percent of total billed charges,,8155.26,10275.2,
CTL SCREW ST VARIABLE 4.5 X 14,30186089,CDM,,,278,RC,inpatient,,1521,1521,,1291.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1146.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1292.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1338.48,88,,percent of total billed charges,,,,,,,,,1162.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1384.11,91,,percent of total billed charges,,,1444.95,95,,percent of total billed charges,,,1262.43,83,,percent of total billed charges,,,1262.43,83,,percent of total billed charges,,,,,,,,,,,,,,,1262.43,83,,percent of total billed charges,,,1444.95,95,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1247.22,82,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1292.85,85,,percent of total billed charges,,1146.83,1444.95,
S&N LINER ACETABULAR 32MM +4MM SZ E,30186090,CDM,,,278,RC,inpatient,,36172.5,36172.5,,30710.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27274.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30746.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31831.8,88,,percent of total billed charges,,,,,,,,,27635.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32916.98,91,,percent of total billed charges,,,34363.88,95,,percent of total billed charges,,,30023.18,83,,percent of total billed charges,,,30023.18,83,,percent of total billed charges,,,,,,,,,,,,,,,30023.18,83,,percent of total billed charges,,,34363.88,95,,percent of total billed charges,,,32555.25,90,,percent of total billed charges,,,32555.25,90,,percent of total billed charges,,,29661.45,82,,percent of total billed charges,,,32555.25,90,,percent of total billed charges,,,30746.63,85,,percent of total billed charges,,27274.07,34363.88,
S&N HEAD FEMORAL 32MM +4 CO-CR,30186091,CDM,,,278,RC,inpatient,,15275,15275,,12968.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11517.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12983.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13442,88,,percent of total billed charges,,,,,,,,,11670.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13900.25,91,,percent of total billed charges,,,14511.25,95,,percent of total billed charges,,,12678.25,83,,percent of total billed charges,,,12678.25,83,,percent of total billed charges,,,,,,,,,,,,,,,12678.25,83,,percent of total billed charges,,,14511.25,95,,percent of total billed charges,,,13747.5,90,,percent of total billed charges,,,13747.5,90,,percent of total billed charges,,,12525.5,82,,percent of total billed charges,,,13747.5,90,,percent of total billed charges,,,12983.75,85,,percent of total billed charges,,11517.35,14511.25,
SYNTHES SCREW CORTEX 2.4 X 28MM,30186092,CDM,,,278,RC,inpatient,,827.05,827.05,,702.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,623.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,702.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,727.8,88,,percent of total billed charges,,,,,,,,,631.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,752.62,91,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,,,,,,,,,,,,,686.45,83,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,678.18,82,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,623.6,785.7,
SYNTHES PLATE LCP BROAD 9 HOLE,30186093,CDM,,,278,RC,inpatient,,5497.38,5497.38,,4667.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4145.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4672.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4837.69,88,,percent of total billed charges,,,,,,,,,4200,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5002.62,91,,percent of total billed charges,,,5222.51,95,,percent of total billed charges,,,4562.83,83,,percent of total billed charges,,,4562.83,83,,percent of total billed charges,,,,,,,,,,,,,,,4562.83,83,,percent of total billed charges,,,5222.51,95,,percent of total billed charges,,,4947.64,90,,percent of total billed charges,,,4947.64,90,,percent of total billed charges,,,4507.85,82,,percent of total billed charges,,,4947.64,90,,percent of total billed charges,,,4672.77,85,,percent of total billed charges,,4145.02,5222.51,
SYNTHES SCREW CORTEX 4.5 X 30MM,30186094,CDM,,,278,RC,inpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,222.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,197.08,248.31,
ZIMMER SHELL OSSEOTI 4 HOLE G7 56MM F,30186095,CDM,,,278,RC,inpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14580.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16436.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,14580.48,18370.63,
ZIMMER HEAD FREEDOM MODULAR 36MM -6MM,30186096,CDM,,,278,RC,inpatient,,17810,17810,,15120.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13428.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15138.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15672.8,88,,percent of total billed charges,,,,,,,,,13606.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16207.1,91,,percent of total billed charges,,,16919.5,95,,percent of total billed charges,,,14782.3,83,,percent of total billed charges,,,14782.3,83,,percent of total billed charges,,,,,,,,,,,,,,,14782.3,83,,percent of total billed charges,,,16919.5,95,,percent of total billed charges,,,16029,90,,percent of total billed charges,,,16029,90,,percent of total billed charges,,,14604.2,82,,percent of total billed charges,,,16029,90,,percent of total billed charges,,,15138.5,85,,percent of total billed charges,,13428.74,16919.5,
ZIMMER LINER FREEDOM CONSTRAINED 36MM F,30186097,CDM,,,278,RC,inpatient,,39390,39390,,33442.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29700.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33481.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34663.2,88,,percent of total billed charges,,,,,,,,,30093.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35844.9,91,,percent of total billed charges,,,37420.5,95,,percent of total billed charges,,,32693.7,83,,percent of total billed charges,,,32693.7,83,,percent of total billed charges,,,,,,,,,,,,,,,32693.7,83,,percent of total billed charges,,,37420.5,95,,percent of total billed charges,,,35451,90,,percent of total billed charges,,,35451,90,,percent of total billed charges,,,32299.8,82,,percent of total billed charges,,,35451,90,,percent of total billed charges,,,33481.5,85,,percent of total billed charges,,29700.06,37420.5,
SPINECRAFT ROD LORDOSED 6.0 X 45MM,30186098,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ZIMMER CEMENT BONE REFOBACIN 1X40,30186099,CDM,,,278,RC,inpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1347.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1519.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,1347.78,1698.13,
ZIMMER BONE CEMENT R,30186100,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
SPINECRAFT ROD LORDOSED 5.5 X 40MM,30186101,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
SPINECRAFT SCREW 6.0 X 50MM,30186102,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT SCREW 6.0 X 45MM,30186103,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT SCREW 7.0 X 50MM,30186104,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ARTHREX CUTTER FLIP II 10.5MM,30186105,CDM,,,270,RC,inpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1592.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1795.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,1592.83,2006.88,
ULRICH CAGE PEEK 7MM,30186106,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
PLATE REPLICATOR EQUINOXE 4.5MM,30186107,CDM,,,270,RC,inpatient,,14118,14118,,11986.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10644.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12000.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12423.84,88,,percent of total billed charges,,,,,,,,,10786.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12847.38,91,,percent of total billed charges,,,13412.1,95,,percent of total billed charges,,,11717.94,83,,percent of total billed charges,,,11717.94,83,,percent of total billed charges,,,,,,,,,,,,,,,11717.94,83,,percent of total billed charges,,,13412.1,95,,percent of total billed charges,,,12706.2,90,,percent of total billed charges,,,12706.2,90,,percent of total billed charges,,,11576.76,82,,percent of total billed charges,,,12706.2,90,,percent of total billed charges,,,12000.3,85,,percent of total billed charges,,10644.97,13412.1,
GLENOID CAGE CEMENTED LARGE,30186108,CDM,,,278,RC,inpatient,,29211,29211,,24800.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22025.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24829.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25705.68,88,,percent of total billed charges,,,,,,,,,22317.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26582.01,91,,percent of total billed charges,,,27750.45,95,,percent of total billed charges,,,24245.13,83,,percent of total billed charges,,,24245.13,83,,percent of total billed charges,,,,,,,,,,,,,,,24245.13,83,,percent of total billed charges,,,27750.45,95,,percent of total billed charges,,,26289.9,90,,percent of total billed charges,,,26289.9,90,,percent of total billed charges,,,23953.02,82,,percent of total billed charges,,,26289.9,90,,percent of total billed charges,,,24829.35,85,,percent of total billed charges,,22025.09,27750.45,
SCREW KIT TORQUE DEFINING SQUARE DRIVE,30186109,CDM,,,270,RC,inpatient,,4335.5,4335.5,,3680.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3268.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3685.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3815.24,88,,percent of total billed charges,,,,,,,,,3312.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3945.31,91,,percent of total billed charges,,,4118.73,95,,percent of total billed charges,,,3598.47,83,,percent of total billed charges,,,3598.47,83,,percent of total billed charges,,,,,,,,,,,,,,,3598.47,83,,percent of total billed charges,,,4118.73,95,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3555.11,82,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3685.18,85,,percent of total billed charges,,3268.97,4118.73,
HEAD HUMERAL TALL 44 X 21MM,30186110,CDM,,,278,RC,inpatient,,23088,23088,,19601.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17408.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19624.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20317.44,88,,percent of total billed charges,,,,,,,,,17639.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21010.08,91,,percent of total billed charges,,,21933.6,95,,percent of total billed charges,,,19163.04,83,,percent of total billed charges,,,19163.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19163.04,83,,percent of total billed charges,,,21933.6,95,,percent of total billed charges,,,20779.2,90,,percent of total billed charges,,,20779.2,90,,percent of total billed charges,,,18932.16,82,,percent of total billed charges,,,20779.2,90,,percent of total billed charges,,,19624.8,85,,percent of total billed charges,,17408.35,21933.6,
ZIMMER BEARING LEFT MED 5MM,30186111,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
CAGE STALIF C-T 16 X 7.5MM,30186112,CDM,,,278,RC,inpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14703,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16575,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,14703,18525,
ARTHREX SUTURETAPE FIBERLOOP W/NDL,30186113,CDM,,,270,RC,inpatient,,490,490,,416.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,369.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,416.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,431.2,88,,percent of total billed charges,,,,,,,,,374.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,445.9,91,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,,,,,,,,,,,,,406.7,83,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,401.8,82,,percent of total billed charges,,,441,90,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,369.46,465.5,
DEPUY INSERT TC3 RP 20MM SZ 4,30186114,CDM,,,278,RC,inpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17430.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19649.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,17430.21,21961.14,
DEPUY LINER DURALOC 32X52X4,30186115,CDM,,,278,RC,inpatient,,14450.8,14450.8,,12268.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10895.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12283.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12716.7,88,,percent of total billed charges,,,,,,,,,11040.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13150.23,91,,percent of total billed charges,,,13728.26,95,,percent of total billed charges,,,11994.16,83,,percent of total billed charges,,,11994.16,83,,percent of total billed charges,,,,,,,,,,,,,,,11994.16,83,,percent of total billed charges,,,13728.26,95,,percent of total billed charges,,,13005.72,90,,percent of total billed charges,,,13005.72,90,,percent of total billed charges,,,11849.66,82,,percent of total billed charges,,,13005.72,90,,percent of total billed charges,,,12283.18,85,,percent of total billed charges,,10895.9,13728.26,
DEPUY LOCKING RING DURALOC 52MM,30186116,CDM,,,278,RC,inpatient,,2753.86,2753.86,,2338.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2076.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2340.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2423.4,88,,percent of total billed charges,,,,,,,,,2103.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2506.01,91,,percent of total billed charges,,,2616.17,95,,percent of total billed charges,,,2285.7,83,,percent of total billed charges,,,2285.7,83,,percent of total billed charges,,,,,,,,,,,,,,,2285.7,83,,percent of total billed charges,,,2616.17,95,,percent of total billed charges,,,2478.47,90,,percent of total billed charges,,,2478.47,90,,percent of total billed charges,,,2258.17,82,,percent of total billed charges,,,2478.47,90,,percent of total billed charges,,,2340.78,85,,percent of total billed charges,,2076.41,2616.17,
SYNTHES CONNICAL EXTRACTION SCREW FOR 7.,30186117,CDM,,,278,RC,inpatient,,2502.5,2502.5,,2124.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1886.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2127.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2202.2,88,,percent of total billed charges,,,,,,,,,1911.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2277.28,91,,percent of total billed charges,,,2377.38,95,,percent of total billed charges,,,2077.08,83,,percent of total billed charges,,,2077.08,83,,percent of total billed charges,,,,,,,,,,,,,,,2077.08,83,,percent of total billed charges,,,2377.38,95,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2052.05,82,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2127.13,85,,percent of total billed charges,,1886.89,2377.38,
DEPUY-MITEK HEALIX 4.5 BLUE,30186118,CDM,,,278,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
DEPUY-MITEK HEALIX 4.5 WHITE,30186119,CDM,,,278,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
DEPUY-MITEK HEALIX KNOTLESS 4.75,30186120,CDM,,,278,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
ENDOFLIP CATH NASAL TIP 16CM,30186121,CDM,,,270,RC,inpatient,,2693.6,2693.6,,2286.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2030.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2289.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2370.37,88,,percent of total billed charges,,,,,,,,,2057.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2451.18,91,,percent of total billed charges,,,2558.92,95,,percent of total billed charges,,,2235.69,83,,percent of total billed charges,,,2235.69,83,,percent of total billed charges,,,,,,,,,,,,,,,2235.69,83,,percent of total billed charges,,,2558.92,95,,percent of total billed charges,,,2424.24,90,,percent of total billed charges,,,2424.24,90,,percent of total billed charges,,,2208.75,82,,percent of total billed charges,,,2424.24,90,,percent of total billed charges,,,2289.56,85,,percent of total billed charges,,2030.97,2558.92,
S&N HEALICOIL PK 4.5MM W/1 ULTRATAPE,30186122,CDM,,,270,RC,inpatient,,4728.75,4728.75,,4014.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3565.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4019.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4161.3,88,,percent of total billed charges,,,,,,,,,3612.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4303.16,91,,percent of total billed charges,,,4492.31,95,,percent of total billed charges,,,3924.86,83,,percent of total billed charges,,,3924.86,83,,percent of total billed charges,,,,,,,,,,,,,,,3924.86,83,,percent of total billed charges,,,4492.31,95,,percent of total billed charges,,,4255.88,90,,percent of total billed charges,,,4255.88,90,,percent of total billed charges,,,3877.58,82,,percent of total billed charges,,,4255.88,90,,percent of total billed charges,,,4019.44,85,,percent of total billed charges,,3565.48,4492.31,
S&N HEALICOIL PK 4.5MM W/1 ULTRATAPE BLU,30186123,CDM,,,270,RC,inpatient,,5674.5,5674.5,,4817.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4278.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4823.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4993.56,88,,percent of total billed charges,,,,,,,,,4335.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5163.8,91,,percent of total billed charges,,,5390.78,95,,percent of total billed charges,,,4709.84,83,,percent of total billed charges,,,4709.84,83,,percent of total billed charges,,,,,,,,,,,,,,,4709.84,83,,percent of total billed charges,,,5390.78,95,,percent of total billed charges,,,5107.05,90,,percent of total billed charges,,,5107.05,90,,percent of total billed charges,,,4653.09,82,,percent of total billed charges,,,5107.05,90,,percent of total billed charges,,,4823.33,85,,percent of total billed charges,,4278.57,5390.78,
S&N SUTURE ANCHOR 5.5 KNOTLESS MUTLIFIX,30186124,CDM,,,278,RC,inpatient,,4854.85,4854.85,,4121.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3660.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4126.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4272.27,88,,percent of total billed charges,,,,,,,,,3709.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4417.91,91,,percent of total billed charges,,,4612.11,95,,percent of total billed charges,,,4029.53,83,,percent of total billed charges,,,4029.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4029.53,83,,percent of total billed charges,,,4612.11,95,,percent of total billed charges,,,4369.37,90,,percent of total billed charges,,,4369.37,90,,percent of total billed charges,,,3980.98,82,,percent of total billed charges,,,4369.37,90,,percent of total billed charges,,,4126.62,85,,percent of total billed charges,,3660.56,4612.11,
SPINECRAFT ROD LOWDOSED 6.0 X 100MM,30186125,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
SPINECRAFT ROD LOWDOSED 6.0 X 50MM,30186126,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
SYNTHES DRILL BIT 1.1,30186127,CDM,,,278,RC,inpatient,,830.83,830.83,,705.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,626.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,706.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,731.13,88,,percent of total billed charges,,,,,,,,,634.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,756.06,91,,percent of total billed charges,,,789.29,95,,percent of total billed charges,,,689.59,83,,percent of total billed charges,,,689.59,83,,percent of total billed charges,,,,,,,,,,,,,,,689.59,83,,percent of total billed charges,,,789.29,95,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,681.28,82,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,706.21,85,,percent of total billed charges,,626.45,789.29,
SYNTHES K-WIRE 1.0,30186128,CDM,,,278,RC,inpatient,,988.98,988.98,,839.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,745.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,840.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,870.3,88,,percent of total billed charges,,,,,,,,,755.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,899.97,91,,percent of total billed charges,,,939.53,95,,percent of total billed charges,,,820.85,83,,percent of total billed charges,,,820.85,83,,percent of total billed charges,,,,,,,,,,,,,,,820.85,83,,percent of total billed charges,,,939.53,95,,percent of total billed charges,,,890.08,90,,percent of total billed charges,,,890.08,90,,percent of total billed charges,,,810.96,82,,percent of total billed charges,,,890.08,90,,percent of total billed charges,,,840.63,85,,percent of total billed charges,,745.69,939.53,
SYNTHES SCREW CORTEX ST 1.5 X 14MM,30186129,CDM,,,278,RC,inpatient,,523.6,523.6,,444.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,394.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,445.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,460.77,88,,percent of total billed charges,,,,,,,,,400.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,476.48,91,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,,,,,,,,,,,,,434.59,83,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,429.35,82,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,394.79,497.42,
SYNTHES SCREW CORTEX ST 1.5 X 15MM,30186130,CDM,,,278,RC,inpatient,,523.6,523.6,,444.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,394.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,445.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,460.77,88,,percent of total billed charges,,,,,,,,,400.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,476.48,91,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,,,,,,,,,,,,,434.59,83,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,429.35,82,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,394.79,497.42,
S&N LINER ACETABULAR 36MM +4MM SZ F,30186131,CDM,,,278,RC,inpatient,,30647.5,30647.5,,26019.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23108.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26050.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26969.8,88,,percent of total billed charges,,,,,,,,,23414.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27889.23,91,,percent of total billed charges,,,29115.13,95,,percent of total billed charges,,,25437.43,83,,percent of total billed charges,,,25437.43,83,,percent of total billed charges,,,,,,,,,,,,,,,25437.43,83,,percent of total billed charges,,,29115.13,95,,percent of total billed charges,,,27582.75,90,,percent of total billed charges,,,27582.75,90,,percent of total billed charges,,,25130.95,82,,percent of total billed charges,,,27582.75,90,,percent of total billed charges,,,26050.38,85,,percent of total billed charges,,23108.22,29115.13,
S&N HEAD FEMORAL 36MM +0 12/14,30186132,CDM,,,278,RC,inpatient,,30160,30160,,25605.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22740.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25636,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26540.8,88,,percent of total billed charges,,,,,,,,,23042.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27445.6,91,,percent of total billed charges,,,28652,95,,percent of total billed charges,,,25032.8,83,,percent of total billed charges,,,25032.8,83,,percent of total billed charges,,,,,,,,,,,,,,,25032.8,83,,percent of total billed charges,,,28652,95,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,24731.2,82,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,25636,85,,percent of total billed charges,,22740.64,28652,
MEDTRONIC EVERA MRI DR SURESCAN,30186133,CDM,,,278,RC,inpatient,,191203.16,191203.16,,162331.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144167.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162522.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168258.78,88,,percent of total billed charges,,,,,,,,,146079.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,173994.88,91,,percent of total billed charges,,,181643,95,,percent of total billed charges,,,158698.62,83,,percent of total billed charges,,,158698.62,83,,percent of total billed charges,,,,,,,,,,,,,,,158698.62,83,,percent of total billed charges,,,181643,95,,percent of total billed charges,,,172082.84,90,,percent of total billed charges,,,172082.84,90,,percent of total billed charges,,,156786.59,82,,percent of total billed charges,,,172082.84,90,,percent of total billed charges,,,162522.69,85,,percent of total billed charges,,144167.18,181643,
ARTHREX TIGERLOOP SUTURE,30186134,CDM,,,270,RC,inpatient,,490,490,,416.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,369.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,416.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,431.2,88,,percent of total billed charges,,,,,,,,,374.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,445.9,91,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,,,,,,,,,,,,,406.7,83,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,401.8,82,,percent of total billed charges,,,441,90,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,369.46,465.5,
ARTHREX IMPLANT ACUTE AC REPAIR,30186135,CDM,,,278,RC,inpatient,,10452,10452,,8873.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7880.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8884.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9197.76,88,,percent of total billed charges,,,,,,,,,7985.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9511.32,91,,percent of total billed charges,,,9929.4,95,,percent of total billed charges,,,8675.16,83,,percent of total billed charges,,,8675.16,83,,percent of total billed charges,,,,,,,,,,,,,,,8675.16,83,,percent of total billed charges,,,9929.4,95,,percent of total billed charges,,,9406.8,90,,percent of total billed charges,,,9406.8,90,,percent of total billed charges,,,8570.64,82,,percent of total billed charges,,,9406.8,90,,percent of total billed charges,,,8884.2,85,,percent of total billed charges,,7880.81,9929.4,
STRYKER BLADE ANGLED LONG HIP AGGRESSIVE,30186136,CDM,,,270,RC,inpatient,,552.86,552.86,,469.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,416.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,469.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,486.52,88,,percent of total billed charges,,,,,,,,,422.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,503.1,91,,percent of total billed charges,,,525.22,95,,percent of total billed charges,,,458.87,83,,percent of total billed charges,,,458.87,83,,percent of total billed charges,,,,,,,,,,,,,,,458.87,83,,percent of total billed charges,,,525.22,95,,percent of total billed charges,,,497.57,90,,percent of total billed charges,,,497.57,90,,percent of total billed charges,,,453.35,82,,percent of total billed charges,,,497.57,90,,percent of total billed charges,,,469.93,85,,percent of total billed charges,,416.86,525.22,
STRYKER FEMUR TRIATHLON PS LT SZ 6,30186137,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
ULRICH PLATE 1 LEVEL 14MM,30186138,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
ULRICH SCREW 4.0 X 14MM,30186139,CDM,,,278,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
COAGRASPER MONOPOLAR HEMOSTATIC FORCEP,30186140,CDM,,,270,RC,inpatient,,1722.37,1722.37,,1462.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1298.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1464.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1515.69,88,,percent of total billed charges,,,,,,,,,1315.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1567.36,91,,percent of total billed charges,,,1636.25,95,,percent of total billed charges,,,1429.57,83,,percent of total billed charges,,,1429.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1429.57,83,,percent of total billed charges,,,1636.25,95,,percent of total billed charges,,,1550.13,90,,percent of total billed charges,,,1550.13,90,,percent of total billed charges,,,1412.34,82,,percent of total billed charges,,,1550.13,90,,percent of total billed charges,,,1464.01,85,,percent of total billed charges,,1298.67,1636.25,
SPINECRAFT ROD LORDOSED 6.0 X 40MM,30186142,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
SPINECRAFT ROD LOWDOSED 6.0 X 80,30186143,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ARTHREX FIBERLOOP,30186144,CDM,,,278,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
ARTHREX SCREW VENTED 9X20MM BC IF,30186145,CDM,,,270,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
PARAGON BONE FENESTRATION PERFORATOR,30186146,CDM,,,278,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
PARAGON DRILL AO 2.0 X 110MM SOLID MEASU,30186147,CDM,,,270,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
PARAGON WIRE OLIVE SMOOTH 1.4MM,30186148,CDM,,,278,RC,inpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,784.16,988,
PARAGON PLATE MTP 5DEG MEDIUM RIGHT,30186149,CDM,,,278,RC,inpatient,,15372.5,15372.5,,13051.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11590.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13066.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13527.8,88,,percent of total billed charges,,,,,,,,,11744.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13988.98,91,,percent of total billed charges,,,14603.88,95,,percent of total billed charges,,,12759.18,83,,percent of total billed charges,,,12759.18,83,,percent of total billed charges,,,,,,,,,,,,,,,12759.18,83,,percent of total billed charges,,,14603.88,95,,percent of total billed charges,,,13835.25,90,,percent of total billed charges,,,13835.25,90,,percent of total billed charges,,,12605.45,82,,percent of total billed charges,,,13835.25,90,,percent of total billed charges,,,13066.63,85,,percent of total billed charges,,11590.87,14603.88,
PARAGON K-WIRE 1.60 X 150MM SMOOTH SINGL,30186150,CDM,,,278,RC,inpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,226.2,285,
PARAGON SCREW LOCKING PLATE 2.7 X 10MM R,30186151,CDM,,,278,RC,inpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1519.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1712.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,1519.31,1914.25,
PARAGON SCREW LOCKING PLATE 2.7 X 14MM R,30186152,CDM,,,278,RC,inpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1519.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1712.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,1519.31,1914.25,
PARAGON SCREW LOCKING PLATE 2.7 X 20MM R,30186153,CDM,,,278,RC,inpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1519.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1712.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,1519.31,1914.25,
PARAGON SCREW LOCKING PLATE 2.7 X 22MM R,30186154,CDM,,,278,RC,inpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1519.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1712.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,1519.31,1914.25,
PARAGON SCREW NON-LOCKING PLATE 2.7X16M,30186155,CDM,,,278,RC,inpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1176.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1326,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,1176.24,1482,
PARAGON SCREW NON-LOCKING PLATE 2.7X18M,30186156,CDM,,,278,RC,inpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1176.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1326,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,1176.24,1482,
PARAGON SCREW NON-LOCKING PLATE 3.5X18MM,30186157,CDM,,,278,RC,inpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1176.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1326,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,1176.24,1482,
PARAGON SCREW MINI-MONSTER 3.5 X 22MM,30186158,CDM,,,278,RC,inpatient,,2697.5,2697.5,,2290.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2033.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2292.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2373.8,88,,percent of total billed charges,,,,,,,,,2060.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2454.73,91,,percent of total billed charges,,,2562.63,95,,percent of total billed charges,,,2238.93,83,,percent of total billed charges,,,2238.93,83,,percent of total billed charges,,,,,,,,,,,,,,,2238.93,83,,percent of total billed charges,,,2562.63,95,,percent of total billed charges,,,2427.75,90,,percent of total billed charges,,,2427.75,90,,percent of total billed charges,,,2211.95,82,,percent of total billed charges,,,2427.75,90,,percent of total billed charges,,,2292.88,85,,percent of total billed charges,,2033.92,2562.63,
PARAGON DRILL AO 2.3 X 120MM CANNULATED,30186159,CDM,,,270,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
PARAGON K-WIRE 1.2 X 150MM SMOOTH SINGL,30186160,CDM,,,278,RC,inpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,226.2,285,
S&N FEMORAL COMPONENT SZ 5N LEFT,30186161,CDM,,,278,RC,inpatient,,27300,27300,,23177.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20584.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23205,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24024,88,,percent of total billed charges,,,,,,,,,20857.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24843,91,,percent of total billed charges,,,25935,95,,percent of total billed charges,,,22659,83,,percent of total billed charges,,,22659,83,,percent of total billed charges,,,,,,,,,,,,,,,22659,83,,percent of total billed charges,,,25935,95,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,22386,82,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,23205,85,,percent of total billed charges,,20584.2,25935,
S&N TIBIAL BASE PLATE SZ 4,30186162,CDM,,,278,RC,inpatient,,8190,8190,,6953.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6175.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6961.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7207.2,88,,percent of total billed charges,,,,,,,,,6257.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7452.9,91,,percent of total billed charges,,,7780.5,95,,percent of total billed charges,,,6797.7,83,,percent of total billed charges,,,6797.7,83,,percent of total billed charges,,,,,,,,,,,,,,,6797.7,83,,percent of total billed charges,,,7780.5,95,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,6715.8,82,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,6961.5,85,,percent of total billed charges,,6175.26,7780.5,
S&N INSERT SZ 3-4 9MM,30186163,CDM,,,278,RC,inpatient,,16261.96,16261.96,,13806.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12261.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13822.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14310.52,88,,percent of total billed charges,,,,,,,,,12424.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14798.38,91,,percent of total billed charges,,,15448.86,95,,percent of total billed charges,,,13497.43,83,,percent of total billed charges,,,13497.43,83,,percent of total billed charges,,,,,,,,,,,,,,,13497.43,83,,percent of total billed charges,,,15448.86,95,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,13334.81,82,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,13822.67,85,,percent of total billed charges,,12261.52,15448.86,
SYNTHES HELICAL BLADE 95MM,30186164,CDM,,,278,RC,inpatient,,6828.9,6828.9,,5797.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5148.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5804.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6009.43,88,,percent of total billed charges,,,,,,,,,5217.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6214.3,91,,percent of total billed charges,,,6487.46,95,,percent of total billed charges,,,5667.99,83,,percent of total billed charges,,,5667.99,83,,percent of total billed charges,,,,,,,,,,,,,,,5667.99,83,,percent of total billed charges,,,6487.46,95,,percent of total billed charges,,,6146.01,90,,percent of total billed charges,,,6146.01,90,,percent of total billed charges,,,5599.7,82,,percent of total billed charges,,,6146.01,90,,percent of total billed charges,,,5804.57,85,,percent of total billed charges,,5148.99,6487.46,
SYNTHES TFNA 12MM X 360MM 130DEG RT,30186165,CDM,,,278,RC,inpatient,,21149.7,21149.7,,17956.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15946.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17977.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18611.74,88,,percent of total billed charges,,,,,,,,,16158.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19246.23,91,,percent of total billed charges,,,20092.22,95,,percent of total billed charges,,,17554.25,83,,percent of total billed charges,,,17554.25,83,,percent of total billed charges,,,,,,,,,,,,,,,17554.25,83,,percent of total billed charges,,,20092.22,95,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,17342.75,82,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,17977.25,85,,percent of total billed charges,,15946.87,20092.22,
SYNTHES ROD REAMER 2.5MM,30186166,CDM,,,278,RC,inpatient,,1172.28,1172.28,,995.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,883.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,996.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1031.61,88,,percent of total billed charges,,,,,,,,,895.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1066.77,91,,percent of total billed charges,,,1113.67,95,,percent of total billed charges,,,972.99,83,,percent of total billed charges,,,972.99,83,,percent of total billed charges,,,,,,,,,,,,,,,972.99,83,,percent of total billed charges,,,1113.67,95,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,961.27,82,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,996.44,85,,percent of total billed charges,,883.9,1113.67,
SYNTHES SCREW HC 2.4 X 22 LONG THREAD,30186167,CDM,,,278,RC,inpatient,,3723.85,3723.85,,3161.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2807.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3165.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3276.99,88,,percent of total billed charges,,,,,,,,,2845.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3388.7,91,,percent of total billed charges,,,3537.66,95,,percent of total billed charges,,,3090.8,83,,percent of total billed charges,,,3090.8,83,,percent of total billed charges,,,,,,,,,,,,,,,3090.8,83,,percent of total billed charges,,,3537.66,95,,percent of total billed charges,,,3351.47,90,,percent of total billed charges,,,3351.47,90,,percent of total billed charges,,,3053.56,82,,percent of total billed charges,,,3351.47,90,,percent of total billed charges,,,3165.27,85,,percent of total billed charges,,2807.78,3537.66,
SYNTHES SCREW HC 2.4 X 17 LONG THREAD,30186168,CDM,,,278,RC,inpatient,,3723.85,3723.85,,3161.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2807.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3165.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3276.99,88,,percent of total billed charges,,,,,,,,,2845.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3388.7,91,,percent of total billed charges,,,3537.66,95,,percent of total billed charges,,,3090.8,83,,percent of total billed charges,,,3090.8,83,,percent of total billed charges,,,,,,,,,,,,,,,3090.8,83,,percent of total billed charges,,,3537.66,95,,percent of total billed charges,,,3351.47,90,,percent of total billed charges,,,3351.47,90,,percent of total billed charges,,,3053.56,82,,percent of total billed charges,,,3351.47,90,,percent of total billed charges,,,3165.27,85,,percent of total billed charges,,2807.78,3537.66,
MITEK HEALIX ADVANCE KNOTLESS 4.5,30186169,CDM,,,278,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
DEPUY STEM FEMORAL POROUS 18.5 X 150,30186170,CDM,,,278,RC,inpatient,,48015.11,48015.11,,40764.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36203.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40812.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42253.3,88,,percent of total billed charges,,,,,,,,,36683.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43693.75,91,,percent of total billed charges,,,45614.35,95,,percent of total billed charges,,,39852.54,83,,percent of total billed charges,,,39852.54,83,,percent of total billed charges,,,,,,,,,,,,,,,39852.54,83,,percent of total billed charges,,,45614.35,95,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,39372.39,82,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,40812.84,85,,percent of total billed charges,,36203.39,45614.35,
SPINECRAFT SCREW REDUCTION 6.0 X 50MM,30186172,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
SYNTHES TFN LEFT 11MM 130DEG,30186173,CDM,,,278,RC,inpatient,,21149.7,21149.7,,17956.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15946.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17977.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18611.74,88,,percent of total billed charges,,,,,,,,,16158.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19246.23,91,,percent of total billed charges,,,20092.22,95,,percent of total billed charges,,,17554.25,83,,percent of total billed charges,,,17554.25,83,,percent of total billed charges,,,,,,,,,,,,,,,17554.25,83,,percent of total billed charges,,,20092.22,95,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,17342.75,82,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,17977.25,85,,percent of total billed charges,,15946.87,20092.22,
SYNTHES BLADE HELICAL 70MM,30186174,CDM,,,270,RC,inpatient,,6298.5,6298.5,,5347.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4749.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5353.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5542.68,88,,percent of total billed charges,,,,,,,,,4812.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5731.64,91,,percent of total billed charges,,,5983.58,95,,percent of total billed charges,,,5227.76,83,,percent of total billed charges,,,5227.76,83,,percent of total billed charges,,,,,,,,,,,,,,,5227.76,83,,percent of total billed charges,,,5983.58,95,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5164.77,82,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5353.73,85,,percent of total billed charges,,4749.07,5983.58,
ESOFLIP CATH 20MM,30186176,CDM,,,270,RC,inpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1519.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1712.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,1519.31,1914.25,
SPINECRAFT SCREW 6.0 X 50MM,30186177,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT SCREW 6.0 X 40MM,30186178,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SYNTHES DRILL BIT 1.5,30186180,CDM,,,270,RC,inpatient,,868.7,868.7,,737.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,655,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,738.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,764.46,88,,percent of total billed charges,,,,,,,,,663.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,790.52,91,,percent of total billed charges,,,825.27,95,,percent of total billed charges,,,721.02,83,,percent of total billed charges,,,721.02,83,,percent of total billed charges,,,,,,,,,,,,,,,721.02,83,,percent of total billed charges,,,825.27,95,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,712.33,82,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,738.4,85,,percent of total billed charges,,655,825.27,
ZIMMER TRAY TIBIAL SZ AA OXFORD PMA,30186182,CDM,,,278,RC,inpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10218.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11519.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,10218.59,12874.88,
ZIMMER HEAD BIOLOX 28MM + OMM,30186183,CDM,,,278,RC,inpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17447.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19669,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,17447.56,21983,
ZIMMER STEM REV. WAGNER 135 NK ANGLE 17X,30186184,CDM,,,278,RC,inpatient,,78000,78000,,66222,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58812,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66300,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68640,88,,percent of total billed charges,,,,,,,,,59592,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70980,91,,percent of total billed charges,,,74100,95,,percent of total billed charges,,,64740,83,,percent of total billed charges,,,64740,83,,percent of total billed charges,,,,,,,,,,,,,,,64740,83,,percent of total billed charges,,,74100,95,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,63960,82,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,66300,85,,percent of total billed charges,,58812,74100,
DEPUY STEM SUMMIT CEMENTED SZ 6 STD,30186185,CDM,,,278,RC,inpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19184.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21627.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,19184.82,24171.86,
STRYKER FEMUR TRIATHLON CR SZ 6 RT,30186186,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
STRYKER INSERT TRIATHLON CS SZ 6 11MM,30186187,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER INSERT TIBIA TRIATHLON SZ 7 13MM,30186188,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
SYNTHES PLATE DORSAL R 2.4MM 5 HOLE,30186191,CDM,,,278,RC,inpatient,,5375.83,5375.83,,4564.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4053.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4569.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4730.73,88,,percent of total billed charges,,,,,,,,,4107.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4892.01,91,,percent of total billed charges,,,5107.04,95,,percent of total billed charges,,,4461.94,83,,percent of total billed charges,,,4461.94,83,,percent of total billed charges,,,,,,,,,,,,,,,4461.94,83,,percent of total billed charges,,,5107.04,95,,percent of total billed charges,,,4838.25,90,,percent of total billed charges,,,4838.25,90,,percent of total billed charges,,,4408.18,82,,percent of total billed charges,,,4838.25,90,,percent of total billed charges,,,4569.46,85,,percent of total billed charges,,4053.38,5107.04,
SYNTHES SCREW CORTEX S-T 2.4X28MM,30186192,CDM,,,278,RC,inpatient,,565.25,565.25,,479.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,426.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,480.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,497.42,88,,percent of total billed charges,,,,,,,,,431.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,514.38,91,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,,,,,,,,,,,,,469.16,83,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,463.51,82,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,480.46,85,,percent of total billed charges,,426.2,536.99,
SYNTHES SCREW CORTEX S-T 2.4X30MM,30186193,CDM,,,278,RC,inpatient,,565.25,565.25,,479.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,426.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,480.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,497.42,88,,percent of total billed charges,,,,,,,,,431.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,514.38,91,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,,,,,,,,,,,,,469.16,83,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,463.51,82,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,480.46,85,,percent of total billed charges,,426.2,536.99,
SYNTHES DRILL BIT 1.8MM,30186194,CDM,,,278,RC,inpatient,,1514.5,1514.5,,1285.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1141.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1287.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1332.76,88,,percent of total billed charges,,,,,,,,,1157.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1378.2,91,,percent of total billed charges,,,1438.78,95,,percent of total billed charges,,,1257.04,83,,percent of total billed charges,,,1257.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1257.04,83,,percent of total billed charges,,,1438.78,95,,percent of total billed charges,,,1363.05,90,,percent of total billed charges,,,1363.05,90,,percent of total billed charges,,,1241.89,82,,percent of total billed charges,,,1363.05,90,,percent of total billed charges,,,1287.33,85,,percent of total billed charges,,1141.93,1438.78,
SYNTHES DRILL DRILL GUIDE 2.0MM,30186195,CDM,,,270,RC,inpatient,,6370.33,6370.33,,5408.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4803.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5414.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5605.89,88,,percent of total billed charges,,,,,,,,,4866.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5797,91,,percent of total billed charges,,,6051.81,95,,percent of total billed charges,,,5287.37,83,,percent of total billed charges,,,5287.37,83,,percent of total billed charges,,,,,,,,,,,,,,,5287.37,83,,percent of total billed charges,,,6051.81,95,,percent of total billed charges,,,5733.3,90,,percent of total billed charges,,,5733.3,90,,percent of total billed charges,,,5223.67,82,,percent of total billed charges,,,5733.3,90,,percent of total billed charges,,,5414.78,85,,percent of total billed charges,,4803.23,6051.81,
SYNTHES PLATE DISTAL FIBULA LCP 2.7/3.5,30186196,CDM,,,278,RC,inpatient,,6207.31,6207.31,,5270.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4680.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5276.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5462.43,88,,percent of total billed charges,,,,,,,,,4742.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5648.65,91,,percent of total billed charges,,,5896.94,95,,percent of total billed charges,,,5152.07,83,,percent of total billed charges,,,5152.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5152.07,83,,percent of total billed charges,,,5896.94,95,,percent of total billed charges,,,5586.58,90,,percent of total billed charges,,,5586.58,90,,percent of total billed charges,,,5089.99,82,,percent of total billed charges,,,5586.58,90,,percent of total billed charges,,,5276.21,85,,percent of total billed charges,,4680.31,5896.94,
ULRICH PEEK CERVICAL CAGE 8MM,30186197,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
ULRICH PLATE  2 LEVEL 32MM,30186198,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
IR PLATE LAMINOPLASTY 14MM,30186199,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
IR PLATE LAMINOPLASTY 12MM,30186200,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
IR SCREW DRILLING SET 2.1X4MM,30186201,CDM,,,278,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
IR SCREW DRILLING SET 2.1X6MM,30186202,CDM,,,278,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
CURETTE 11G,30186203,CDM,,,270,RC,inpatient,,3881.48,3881.48,,3295.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2926.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3299.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3415.7,88,,percent of total billed charges,,,,,,,,,2965.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3532.15,91,,percent of total billed charges,,,3687.41,95,,percent of total billed charges,,,3221.63,83,,percent of total billed charges,,,3221.63,83,,percent of total billed charges,,,,,,,,,,,,,,,3221.63,83,,percent of total billed charges,,,3687.41,95,,percent of total billed charges,,,3493.33,90,,percent of total billed charges,,,3493.33,90,,percent of total billed charges,,,3182.81,82,,percent of total billed charges,,,3493.33,90,,percent of total billed charges,,,3299.26,85,,percent of total billed charges,,2926.64,3687.41,
GORE-TEX SOFT TISSUE PATCH OVAL 1X26X34,30186204,CDM,,,278,RC,inpatient,,22743.5,22743.5,,19309.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17148.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19331.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20014.28,88,,percent of total billed charges,,,,,,,,,17376.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20696.59,91,,percent of total billed charges,,,21606.33,95,,percent of total billed charges,,,18877.11,83,,percent of total billed charges,,,18877.11,83,,percent of total billed charges,,,,,,,,,,,,,,,18877.11,83,,percent of total billed charges,,,21606.33,95,,percent of total billed charges,,,20469.15,90,,percent of total billed charges,,,20469.15,90,,percent of total billed charges,,,18649.67,82,,percent of total billed charges,,,20469.15,90,,percent of total billed charges,,,19331.98,85,,percent of total billed charges,,17148.6,21606.33,
MESH VENTRALIGHT ST 12X14 RECTANGLE,30186205,CDM,,,270,RC,inpatient,,11700,11700,,9933.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8821.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9945,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10296,88,,percent of total billed charges,,,,,,,,,8938.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10647,91,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,,,,,,,,,,,,,9711,83,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9594,82,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9945,85,,percent of total billed charges,,8821.8,11115,
IOVERA SMART TIP 3X7,30186206,CDM,,,270,RC,inpatient,,3575,3575,,3035.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2695.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3038.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3146,88,,percent of total billed charges,,,,,,,,,2731.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3253.25,91,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2967.25,83,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,2931.5,82,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,2695.55,3396.25,
SYNTHES PLATE DF LCP 2.7/3.5MM 3 HOLE,30186207,CDM,,,278,RC,inpatient,,8060,8060,,6842.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6077.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6851,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7092.8,88,,percent of total billed charges,,,,,,,,,6157.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7334.6,91,,percent of total billed charges,,,7657,95,,percent of total billed charges,,,6689.8,83,,percent of total billed charges,,,6689.8,83,,percent of total billed charges,,,,,,,,,,,,,,,6689.8,83,,percent of total billed charges,,,7657,95,,percent of total billed charges,,,7254,90,,percent of total billed charges,,,7254,90,,percent of total billed charges,,,6609.2,82,,percent of total billed charges,,,7254,90,,percent of total billed charges,,,6851,85,,percent of total billed charges,,6077.24,7657,
SYNTHES PLATE DF LCP 2.7/3.5MM 4 HOLE,30186208,CDM,,,278,RC,inpatient,,6851,6851,,5816.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5165.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5823.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6028.88,88,,percent of total billed charges,,,,,,,,,5234.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6234.41,91,,percent of total billed charges,,,6508.45,95,,percent of total billed charges,,,5686.33,83,,percent of total billed charges,,,5686.33,83,,percent of total billed charges,,,,,,,,,,,,,,,5686.33,83,,percent of total billed charges,,,6508.45,95,,percent of total billed charges,,,6165.9,90,,percent of total billed charges,,,6165.9,90,,percent of total billed charges,,,5617.82,82,,percent of total billed charges,,,6165.9,90,,percent of total billed charges,,,5823.35,85,,percent of total billed charges,,5165.65,6508.45,
SYNTHES SCREW CORTEX TI 2.7 X 20MM,30186209,CDM,,,278,RC,inpatient,,458.15,458.15,,388.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,345.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,389.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,403.17,88,,percent of total billed charges,,,,,,,,,350.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,416.92,91,,percent of total billed charges,,,435.24,95,,percent of total billed charges,,,380.26,83,,percent of total billed charges,,,380.26,83,,percent of total billed charges,,,,,,,,,,,,,,,380.26,83,,percent of total billed charges,,,435.24,95,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,375.68,82,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,389.43,85,,percent of total billed charges,,345.45,435.24,
SYNTHES SCREW LOCKING 2.7 X 10MM,30186210,CDM,,,278,RC,inpatient,,1301.24,1301.24,,1104.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,981.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1106.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1145.09,88,,percent of total billed charges,,,,,,,,,994.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1184.13,91,,percent of total billed charges,,,1236.18,95,,percent of total billed charges,,,1080.03,83,,percent of total billed charges,,,1080.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1080.03,83,,percent of total billed charges,,,1236.18,95,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1067.02,82,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1106.05,85,,percent of total billed charges,,981.13,1236.18,
SYNTHES SCREW CORTEX TI 3.5 X 18MM,30186211,CDM,,,278,RC,inpatient,,293.25,293.25,,248.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,221.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,249.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,258.06,88,,percent of total billed charges,,,,,,,,,224.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,266.86,91,,percent of total billed charges,,,278.59,95,,percent of total billed charges,,,243.4,83,,percent of total billed charges,,,243.4,83,,percent of total billed charges,,,,,,,,,,,,,,,243.4,83,,percent of total billed charges,,,278.59,95,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,240.47,82,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,249.26,85,,percent of total billed charges,,221.11,278.59,
SYNTHES SCREW LOCKING 2.7 X 12MM,30186212,CDM,,,278,RC,inpatient,,1301.24,1301.24,,1104.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,981.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1106.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1145.09,88,,percent of total billed charges,,,,,,,,,994.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1184.13,91,,percent of total billed charges,,,1236.18,95,,percent of total billed charges,,,1080.03,83,,percent of total billed charges,,,1080.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1080.03,83,,percent of total billed charges,,,1236.18,95,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1067.02,82,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1106.05,85,,percent of total billed charges,,981.13,1236.18,
SYNTHES NAIL TIBIAL TI 9X360,30186213,CDM,,,278,RC,inpatient,,14552.85,14552.85,,12355.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10972.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12369.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12806.51,88,,percent of total billed charges,,,,,,,,,11118.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13243.09,91,,percent of total billed charges,,,13825.21,95,,percent of total billed charges,,,12078.87,83,,percent of total billed charges,,,12078.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12078.87,83,,percent of total billed charges,,,13825.21,95,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,11933.34,82,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,12369.92,85,,percent of total billed charges,,10972.85,13825.21,
SYNTHES SCREW LOCKING 4.0MM X 40,30186214,CDM,,,278,RC,inpatient,,1740.83,1740.83,,1477.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1312.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1479.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1531.93,88,,percent of total billed charges,,,,,,,,,1329.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1584.16,91,,percent of total billed charges,,,1653.79,95,,percent of total billed charges,,,1444.89,83,,percent of total billed charges,,,1444.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.89,83,,percent of total billed charges,,,1653.79,95,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1427.48,82,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1479.71,85,,percent of total billed charges,,1312.59,1653.79,
SYNTHES SCREW LOCKING 4.0MM X 44,30186215,CDM,,,278,RC,inpatient,,1640.93,1640.93,,1393.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1237.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1394.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1444.02,88,,percent of total billed charges,,,,,,,,,1253.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1493.25,91,,percent of total billed charges,,,1558.88,95,,percent of total billed charges,,,1361.97,83,,percent of total billed charges,,,1361.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1361.97,83,,percent of total billed charges,,,1558.88,95,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1345.56,82,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1394.79,85,,percent of total billed charges,,1237.26,1558.88,
SYNTHES END CAP 0MM,30186216,CDM,,,278,RC,inpatient,,1746.75,1746.75,,1482.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1317.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1484.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1537.14,88,,percent of total billed charges,,,,,,,,,1334.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1589.54,91,,percent of total billed charges,,,1659.41,95,,percent of total billed charges,,,1449.8,83,,percent of total billed charges,,,1449.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1449.8,83,,percent of total billed charges,,,1659.41,95,,percent of total billed charges,,,1572.08,90,,percent of total billed charges,,,1572.08,90,,percent of total billed charges,,,1432.34,82,,percent of total billed charges,,,1572.08,90,,percent of total billed charges,,,1484.74,85,,percent of total billed charges,,1317.05,1659.41,
STRYKER FEMUR TRIATHLON PS SZ 7 LEFT,30186217,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
STRYKER TIBIA INSERT TRIATHLON SZ 7 11MM,30186218,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER PATELLA METAL BACK SZ 39,30186219,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
S&N RAP PAC,30186220,CDM,,,278,RC,inpatient,,1799.59,1799.59,,1527.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1356.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1529.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1583.64,88,,percent of total billed charges,,,,,,,,,1374.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1637.63,91,,percent of total billed charges,,,1709.61,95,,percent of total billed charges,,,1493.66,83,,percent of total billed charges,,,1493.66,83,,percent of total billed charges,,,,,,,,,,,,,,,1493.66,83,,percent of total billed charges,,,1709.61,95,,percent of total billed charges,,,1619.63,90,,percent of total billed charges,,,1619.63,90,,percent of total billed charges,,,1475.66,82,,percent of total billed charges,,,1619.63,90,,percent of total billed charges,,,1529.65,85,,percent of total billed charges,,1356.89,1709.61,
S&N SOFTSILK 7MM X 20MM,30186221,CDM,,,278,RC,inpatient,,1532.51,1532.51,,1301.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1155.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1302.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1348.61,88,,percent of total billed charges,,,,,,,,,1170.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1394.58,91,,percent of total billed charges,,,1455.88,95,,percent of total billed charges,,,1271.98,83,,percent of total billed charges,,,1271.98,83,,percent of total billed charges,,,,,,,,,,,,,,,1271.98,83,,percent of total billed charges,,,1455.88,95,,percent of total billed charges,,,1379.26,90,,percent of total billed charges,,,1379.26,90,,percent of total billed charges,,,1256.66,82,,percent of total billed charges,,,1379.26,90,,percent of total billed charges,,,1302.63,85,,percent of total billed charges,,1155.51,1455.88,
S&N SOFTSILK 8MM X 20MM,30186222,CDM,,,278,RC,inpatient,,1532.51,1532.51,,1301.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1155.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1302.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1348.61,88,,percent of total billed charges,,,,,,,,,1170.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1394.58,91,,percent of total billed charges,,,1455.88,95,,percent of total billed charges,,,1271.98,83,,percent of total billed charges,,,1271.98,83,,percent of total billed charges,,,,,,,,,,,,,,,1271.98,83,,percent of total billed charges,,,1455.88,95,,percent of total billed charges,,,1379.26,90,,percent of total billed charges,,,1379.26,90,,percent of total billed charges,,,1256.66,82,,percent of total billed charges,,,1379.26,90,,percent of total billed charges,,,1302.63,85,,percent of total billed charges,,1155.51,1455.88,
SPINECRAFT SCREW 7.0 X 40MM,30186223,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT ROD STRAIGHT 6.0 X 300,30186224,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
SPINECRAFT SCREW 7.5 X 35MM,30186225,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT SCREW 9.5 X 40MM,30186226,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT BOLT ILLIAC 8.5 X 90MM,30186227,CDM,,,278,RC,inpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7106.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8011.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,7106.45,8953.75,
SPINECRAFT SCREW 9.5 X 50MM,30186228,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT ROD LORDOSED 6.0 X 120,30186229,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
SPLINT SEPTAL OVAL SHAPED SILICONE 1MM,30186230,CDM,,,270,RC,inpatient,,511,511,,433.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,385.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,434.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,449.68,88,,percent of total billed charges,,,,,,,,,390.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,465.01,91,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,,,,,,,,,,,,,424.13,83,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,419.02,82,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,385.29,485.45,
STRYKER INSERT TRIATHLON CS SZ 8 11MM,30186231,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER PATELLA METAL BACK SZ 40,30186232,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
DEPUY-MITEK HEALIX ANCHOR 6.5 BLUE,30186233,CDM,,,278,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
SPINECRAFT SCREW 7.0 X 45MM,30186234,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ZIMMER BEARING LEFT MEDIAL MED. SZ 6,30186235,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
DEPUY SLEEVE CEMENTED 20MM,30186236,CDM,,,278,RC,inpatient,,12552.61,12552.61,,10657.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9464.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10669.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11046.3,88,,percent of total billed charges,,,,,,,,,9590.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11422.88,91,,percent of total billed charges,,,11924.98,95,,percent of total billed charges,,,10418.67,83,,percent of total billed charges,,,10418.67,83,,percent of total billed charges,,,,,,,,,,,,,,,10418.67,83,,percent of total billed charges,,,11924.98,95,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,10293.14,82,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,10669.72,85,,percent of total billed charges,,9464.67,11924.98,
DEPUY SLEEVE ADAPTER LPS +5MM,30186237,CDM,,,278,RC,inpatient,,6309.03,6309.03,,5356.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4757.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5362.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5551.95,88,,percent of total billed charges,,,,,,,,,4820.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5741.22,91,,percent of total billed charges,,,5993.58,95,,percent of total billed charges,,,5236.49,83,,percent of total billed charges,,,5236.49,83,,percent of total billed charges,,,,,,,,,,,,,,,5236.49,83,,percent of total billed charges,,,5993.58,95,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5173.4,82,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5362.68,85,,percent of total billed charges,,4757.01,5993.58,
DEPUY INSERT XX-SMALL 14MM,30186239,CDM,,,278,RC,inpatient,,33343.12,33343.12,,28308.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25140.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28341.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29341.95,88,,percent of total billed charges,,,,,,,,,25474.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30342.24,91,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,,,,,,,,,,,,,27674.79,83,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,27341.36,82,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,25140.71,31675.96,
STRYKER FEMUR TRIATHLON CR SZ 8 RT,30186240,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
STRYKER TIBIA INSERT PS SZ 8-9MM,30186241,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
DEPUY INSERT TIBIAL AOX 10MM SZ 2.5,30186242,CDM,,,278,RC,inpatient,,17068.29,17068.29,,14490.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12869.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14508.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15020.1,88,,percent of total billed charges,,,,,,,,,13040.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15532.14,91,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,,,,,,,,,,,,,14166.68,83,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,13996,82,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,12869.49,16214.88,
DEPUY-MITEK HEALIX KNOTLESS 5.5 HA,30186243,CDM,,,278,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
SYNTHES PLATE TIBIA 3.5MM 6 HOLE VA-LCP,30186244,CDM,,,278,RC,inpatient,,15273.96,15273.96,,12967.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11516.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12982.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13441.08,88,,percent of total billed charges,,,,,,,,,11669.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13899.3,91,,percent of total billed charges,,,14510.26,95,,percent of total billed charges,,,12677.39,83,,percent of total billed charges,,,12677.39,83,,percent of total billed charges,,,,,,,,,,,,,,,12677.39,83,,percent of total billed charges,,,14510.26,95,,percent of total billed charges,,,13746.56,90,,percent of total billed charges,,,13746.56,90,,percent of total billed charges,,,12524.65,82,,percent of total billed charges,,,13746.56,90,,percent of total billed charges,,,12982.87,85,,percent of total billed charges,,11516.57,14510.26,
ARTHREX ENDOBLADE PLANTAR FASCIA RELEASE,30186247,CDM,,,270,RC,inpatient,,5817.5,5817.5,,4939.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4386.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4944.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5119.4,88,,percent of total billed charges,,,,,,,,,4444.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5293.93,91,,percent of total billed charges,,,5526.63,95,,percent of total billed charges,,,4828.53,83,,percent of total billed charges,,,4828.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4828.53,83,,percent of total billed charges,,,5526.63,95,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,4770.35,82,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,4944.88,85,,percent of total billed charges,,4386.4,5526.63,
ZIMMER BEARING MED. RT SZ 7,30186248,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
PORT POWER INJECTABLE XCELA,30186249,CDM,,,278,RC,inpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1715.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1933.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,1715.35,2161.25,
MEDTRONIC PACEMAKER AZURE XT DR MRI SURS,30186250,CDM,,,278,RC,inpatient,,50849.11,50849.11,,43170.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38340.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43221.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44747.22,88,,percent of total billed charges,,,,,,,,,38848.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46272.69,91,,percent of total billed charges,,,48306.65,95,,percent of total billed charges,,,42204.76,83,,percent of total billed charges,,,42204.76,83,,percent of total billed charges,,,,,,,,,,,,,,,42204.76,83,,percent of total billed charges,,,48306.65,95,,percent of total billed charges,,,45764.2,90,,percent of total billed charges,,,45764.2,90,,percent of total billed charges,,,41696.27,82,,percent of total billed charges,,,45764.2,90,,percent of total billed charges,,,43221.74,85,,percent of total billed charges,,38340.23,48306.65,
VTI INTERFUSE S INTERVERTEBRAL BODY DEVI,30186251,CDM,,,278,RC,inpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29406,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33150,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,29406,37050,
DEPUY HEAD BIPOLAR 50,30186252,CDM,,,278,RC,inpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,6126.3,7718.82,
SPINECRAFT REVISION SET RENTAL,30186253,CDM,,,270,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
SYNTHES SCREW CANCELLOUS 6.5 X 32 X 135,30186254,CDM,,,278,RC,inpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,399.28,503.07,
SYNTHES SCREW CANCELLOUS 6.5 X 32 X 140,30186255,CDM,,,278,RC,inpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,399.28,503.07,
SYNTHES SCREW CANCELLOUS 6.5 X 32 X 150,30186256,CDM,,,278,RC,inpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,399.28,503.07,
DEPUY INSERT SZ 6 15MM,30186257,CDM,,,278,RC,inpatient,,17068.29,17068.29,,14490.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12869.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14508.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15020.1,88,,percent of total billed charges,,,,,,,,,13040.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15532.14,91,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,,,,,,,,,,,,,14166.68,83,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,13996,82,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,12869.49,16214.88,
SPINECRAFT SCREW 7.5 X 55MM,30186259,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT SCREW 7.5 X 50MM,30186260,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
DEPUY-MITEK QUICKANCHOR GII PLUS,30186261,CDM,,,278,RC,inpatient,,3471,3471,,2946.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2617.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2950.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3054.48,88,,percent of total billed charges,,,,,,,,,2651.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3158.61,91,,percent of total billed charges,,,3297.45,95,,percent of total billed charges,,,2880.93,83,,percent of total billed charges,,,2880.93,83,,percent of total billed charges,,,,,,,,,,,,,,,2880.93,83,,percent of total billed charges,,,3297.45,95,,percent of total billed charges,,,3123.9,90,,percent of total billed charges,,,3123.9,90,,percent of total billed charges,,,2846.22,82,,percent of total billed charges,,,3123.9,90,,percent of total billed charges,,,2950.35,85,,percent of total billed charges,,2617.13,3297.45,
ZIMMER OXF BEARING LEFT MEDIAL SZ 6 SMAL,30186262,CDM,,,278,RC,inpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4783.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5392.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,4783.38,6026.8,
ZIMMER INSERT PSN CPS 14MM VE,30186264,CDM,,,278,RC,inpatient,,28405,28405,,24115.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21417.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24144.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24996.4,88,,percent of total billed charges,,,,,,,,,21701.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25848.55,91,,percent of total billed charges,,,26984.75,95,,percent of total billed charges,,,23576.15,83,,percent of total billed charges,,,23576.15,83,,percent of total billed charges,,,,,,,,,,,,,,,23576.15,83,,percent of total billed charges,,,26984.75,95,,percent of total billed charges,,,25564.5,90,,percent of total billed charges,,,25564.5,90,,percent of total billed charges,,,23292.1,82,,percent of total billed charges,,,25564.5,90,,percent of total billed charges,,,24144.25,85,,percent of total billed charges,,21417.37,26984.75,
SYNTHES PLATE DISTAL MEDIAL TIB 2.7X3.5,30186265,CDM,,,278,RC,inpatient,,15990.07,15990.07,,13575.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12056.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13591.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14071.26,88,,percent of total billed charges,,,,,,,,,12216.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14550.96,91,,percent of total billed charges,,,15190.57,95,,percent of total billed charges,,,13271.76,83,,percent of total billed charges,,,13271.76,83,,percent of total billed charges,,,,,,,,,,,,,,,13271.76,83,,percent of total billed charges,,,15190.57,95,,percent of total billed charges,,,14391.06,90,,percent of total billed charges,,,14391.06,90,,percent of total billed charges,,,13111.86,82,,percent of total billed charges,,,14391.06,90,,percent of total billed charges,,,13591.56,85,,percent of total billed charges,,12056.51,15190.57,
SYNTHES SCREW LOCKING VA 2.7MM X 26MM,30186266,CDM,,,278,RC,inpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1065.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1200.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,1065.14,1342.02,
SYNTHES SCREW LOCKING VA 2.7MM X 30MM,30186267,CDM,,,278,RC,inpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1065.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1200.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,1065.14,1342.02,
SYNTHES SCREW CORTEX 2.7 X 40MM,30186268,CDM,,,278,RC,inpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,333.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,375.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,333.15,419.75,
VTI INTERFUSE BODY FUSION DEVICE 12MM,30186269,CDM,,,278,RC,inpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29406,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33150,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,29406,37050,
EXACTECH LINER CONSTRAINED 38,30186270,CDM,,,278,RC,inpatient,,13487.5,13487.5,,11450.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10169.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11464.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11869,88,,percent of total billed charges,,,,,,,,,10304.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12273.63,91,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,,,,,,,,,,,,,11194.63,83,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11059.75,82,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,10169.58,12813.13,
IVAS ELITE FRACTURE KIT 11G 15MM,30186271,CDM,,,270,RC,inpatient,,17817.09,17817.09,,15126.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13434.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15144.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15679.04,88,,percent of total billed charges,,,,,,,,,13612.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16213.55,91,,percent of total billed charges,,,16926.24,95,,percent of total billed charges,,,14788.18,83,,percent of total billed charges,,,14788.18,83,,percent of total billed charges,,,,,,,,,,,,,,,14788.18,83,,percent of total billed charges,,,16926.24,95,,percent of total billed charges,,,16035.38,90,,percent of total billed charges,,,16035.38,90,,percent of total billed charges,,,14610.01,82,,percent of total billed charges,,,16035.38,90,,percent of total billed charges,,,15144.53,85,,percent of total billed charges,,13434.09,16926.24,
IVAS BIOPSY 11G,30186272,CDM,,,270,RC,inpatient,,608.86,608.86,,516.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,459.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,517.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,535.8,88,,percent of total billed charges,,,,,,,,,465.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,554.06,91,,percent of total billed charges,,,578.42,95,,percent of total billed charges,,,505.35,83,,percent of total billed charges,,,505.35,83,,percent of total billed charges,,,,,,,,,,,,,,,505.35,83,,percent of total billed charges,,,578.42,95,,percent of total billed charges,,,547.97,90,,percent of total billed charges,,,547.97,90,,percent of total billed charges,,,499.27,82,,percent of total billed charges,,,547.97,90,,percent of total billed charges,,,517.53,85,,percent of total billed charges,,459.08,578.42,
ULRICH SCREW RESCUE 4.5 X 14MM,30186273,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
SPINECRAFT SCREW 6.0 X 55MM,30186274,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
GLENOSPHERE RS EXPANDED 42MM,30186275,CDM,,,270,RC,inpatient,,24102,24102,,20462.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18172.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20486.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21209.76,88,,percent of total billed charges,,,,,,,,,18413.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21932.82,91,,percent of total billed charges,,,22896.9,95,,percent of total billed charges,,,20004.66,83,,percent of total billed charges,,,20004.66,83,,percent of total billed charges,,,,,,,,,,,,,,,20004.66,83,,percent of total billed charges,,,22896.9,95,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,19763.64,82,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,20486.7,85,,percent of total billed charges,,18172.91,22896.9,
SCREW GLENOSPHERE LOCKING,30186276,CDM,,,278,RC,inpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1514.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1707.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,1514.41,1908.08,
EXACTECH STEM 15,30186277,CDM,,,278,RC,inpatient,,34008,34008,,28872.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25642.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28906.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29927.04,88,,percent of total billed charges,,,,,,,,,25982.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30947.28,91,,percent of total billed charges,,,32307.6,95,,percent of total billed charges,,,28226.64,83,,percent of total billed charges,,,28226.64,83,,percent of total billed charges,,,,,,,,,,,,,,,28226.64,83,,percent of total billed charges,,,32307.6,95,,percent of total billed charges,,,30607.2,90,,percent of total billed charges,,,30607.2,90,,percent of total billed charges,,,27886.56,82,,percent of total billed charges,,,30607.2,90,,percent of total billed charges,,,28906.8,85,,percent of total billed charges,,25642.03,32307.6,
EXACTECH LINER CONSTRAINED 42,30186278,CDM,,,278,RC,inpatient,,13487.5,13487.5,,11450.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10169.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11464.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11869,88,,percent of total billed charges,,,,,,,,,10304.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12273.63,91,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,,,,,,,,,,,,,11194.63,83,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11059.75,82,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,10169.58,12813.13,
MEDTRONIC VISIA AF MRI VR SURESCAN,30186279,CDM,,,278,RC,inpatient,,166738,166738,,141560.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125720.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141727.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,146729.44,88,,percent of total billed charges,,,,,,,,,127387.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,151731.58,91,,percent of total billed charges,,,158401.1,95,,percent of total billed charges,,,138392.54,83,,percent of total billed charges,,,138392.54,83,,percent of total billed charges,,,,,,,,,,,,,,,138392.54,83,,percent of total billed charges,,,158401.1,95,,percent of total billed charges,,,150064.2,90,,percent of total billed charges,,,150064.2,90,,percent of total billed charges,,,136725.16,82,,percent of total billed charges,,,150064.2,90,,percent of total billed charges,,,141727.3,85,,percent of total billed charges,,125720.45,158401.1,
MEDTRONIC ANTIOBIOTIC POUCH,30186280,CDM,,,278,RC,inpatient,,8417.5,8417.5,,7146.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6346.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7154.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7407.4,88,,percent of total billed charges,,,,,,,,,6430.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7659.93,91,,percent of total billed charges,,,7996.63,95,,percent of total billed charges,,,6986.53,83,,percent of total billed charges,,,6986.53,83,,percent of total billed charges,,,,,,,,,,,,,,,6986.53,83,,percent of total billed charges,,,7996.63,95,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,6902.35,82,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,7154.88,85,,percent of total billed charges,,6346.8,7996.63,
ABSORBA 15TACKS DEVICE ABS FIXATION,30186281,CDM,,,270,RC,inpatient,,3788.4,3788.4,,3216.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2856.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3220.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3333.79,88,,percent of total billed charges,,,,,,,,,2894.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3447.44,91,,percent of total billed charges,,,3598.98,95,,percent of total billed charges,,,3144.37,83,,percent of total billed charges,,,3144.37,83,,percent of total billed charges,,,,,,,,,,,,,,,3144.37,83,,percent of total billed charges,,,3598.98,95,,percent of total billed charges,,,3409.56,90,,percent of total billed charges,,,3409.56,90,,percent of total billed charges,,,3106.49,82,,percent of total billed charges,,,3409.56,90,,percent of total billed charges,,,3220.14,85,,percent of total billed charges,,2856.45,3598.98,
SYNTHES PLATE 4H DCP LC 2.7,30186282,CDM,,,278,RC,inpatient,,3989.25,3989.25,,3386.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3007.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3390.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3510.54,88,,percent of total billed charges,,,,,,,,,3047.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3630.22,91,,percent of total billed charges,,,3789.79,95,,percent of total billed charges,,,3311.08,83,,percent of total billed charges,,,3311.08,83,,percent of total billed charges,,,,,,,,,,,,,,,3311.08,83,,percent of total billed charges,,,3789.79,95,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3271.19,82,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3390.86,85,,percent of total billed charges,,3007.89,3789.79,
ZIMMER SHELL OSSEOTI G7 64MM H,30186283,CDM,,,278,RC,inpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14580.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16436.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,14580.48,18370.63,
CATH SUPRAPUBIC INTRODUCER 16FR,30186284,CDM,,,270,RC,inpatient,,554.4,554.4,,470.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,418.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,471.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,487.87,88,,percent of total billed charges,,,,,,,,,423.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,504.5,91,,percent of total billed charges,,,526.68,95,,percent of total billed charges,,,460.15,83,,percent of total billed charges,,,460.15,83,,percent of total billed charges,,,,,,,,,,,,,,,460.15,83,,percent of total billed charges,,,526.68,95,,percent of total billed charges,,,498.96,90,,percent of total billed charges,,,498.96,90,,percent of total billed charges,,,454.61,82,,percent of total billed charges,,,498.96,90,,percent of total billed charges,,,471.24,85,,percent of total billed charges,,418.02,526.68,
SYNTHES DRILL BIT 2.0MM,30186285,CDM,,,270,RC,inpatient,,830.83,830.83,,705.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,626.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,706.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,731.13,88,,percent of total billed charges,,,,,,,,,634.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,756.06,91,,percent of total billed charges,,,789.29,95,,percent of total billed charges,,,689.59,83,,percent of total billed charges,,,689.59,83,,percent of total billed charges,,,,,,,,,,,,,,,689.59,83,,percent of total billed charges,,,789.29,95,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,681.28,82,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,706.21,85,,percent of total billed charges,,626.45,789.29,
SYNTHES SCREW CORTEX 9 X 2MM,30186286,CDM,,,278,RC,inpatient,,545.44,545.44,,463.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,411.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,463.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,479.99,88,,percent of total billed charges,,,,,,,,,416.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,496.35,91,,percent of total billed charges,,,518.17,95,,percent of total billed charges,,,452.72,83,,percent of total billed charges,,,452.72,83,,percent of total billed charges,,,,,,,,,,,,,,,452.72,83,,percent of total billed charges,,,518.17,95,,percent of total billed charges,,,490.9,90,,percent of total billed charges,,,490.9,90,,percent of total billed charges,,,447.26,82,,percent of total billed charges,,,490.9,90,,percent of total billed charges,,,463.62,85,,percent of total billed charges,,411.26,518.17,
SYNTHES SCREW LOCKING 2.4 X 10MM,30186287,CDM,,,278,RC,inpatient,,1635.4,1635.4,,1388.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1233.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1390.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1439.15,88,,percent of total billed charges,,,,,,,,,1249.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1488.21,91,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1357.38,83,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1341.03,82,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1390.09,85,,percent of total billed charges,,1233.09,1553.63,
ZIMMER LINER NEUTRAL G7 +5MM E1 36MM D,30186288,CDM,,,278,RC,inpatient,,22880,22880,,19425.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17251.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19448,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20134.4,88,,percent of total billed charges,,,,,,,,,17480.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20820.8,91,,percent of total billed charges,,,21736,95,,percent of total billed charges,,,18990.4,83,,percent of total billed charges,,,18990.4,83,,percent of total billed charges,,,,,,,,,,,,,,,18990.4,83,,percent of total billed charges,,,21736,95,,percent of total billed charges,,,20592,90,,percent of total billed charges,,,20592,90,,percent of total billed charges,,,18761.6,82,,percent of total billed charges,,,20592,90,,percent of total billed charges,,,19448,85,,percent of total billed charges,,17251.52,21736,
ZIMMER LINER NEUTRAL G7 E1 36MM D,30186289,CDM,,,278,RC,inpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17447.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19669,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,17447.56,21983,
ZIMMER SHELL OSSEOTI G7 62MM H 4 HOLE,30186290,CDM,,,278,RC,inpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14580.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16436.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,14580.48,18370.63,
MENTOR ULTRAHIGH PROFILE BREAST IMPLANT,30186291,CDM,,,278,RC,inpatient,,6532.5,6532.5,,5546.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4925.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5552.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5748.6,88,,percent of total billed charges,,,,,,,,,4990.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5944.58,91,,percent of total billed charges,,,6205.88,95,,percent of total billed charges,,,5421.98,83,,percent of total billed charges,,,5421.98,83,,percent of total billed charges,,,,,,,,,,,,,,,5421.98,83,,percent of total billed charges,,,6205.88,95,,percent of total billed charges,,,5879.25,90,,percent of total billed charges,,,5879.25,90,,percent of total billed charges,,,5356.65,82,,percent of total billed charges,,,5879.25,90,,percent of total billed charges,,,5552.63,85,,percent of total billed charges,,4925.51,6205.88,
DEPUY STEM PROSTALAC LT SZ 3 150MM,30186292,CDM,,,278,RC,inpatient,,32843.27,32843.27,,27883.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24763.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27916.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28902.08,88,,percent of total billed charges,,,,,,,,,25092.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29887.38,91,,percent of total billed charges,,,31201.11,95,,percent of total billed charges,,,27259.91,83,,percent of total billed charges,,,27259.91,83,,percent of total billed charges,,,,,,,,,,,,,,,27259.91,83,,percent of total billed charges,,,31201.11,95,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,26931.48,82,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,27916.78,85,,percent of total billed charges,,24763.83,31201.11,
FORCEP RESCUE ALLIGATOR LONG GRASPING 9M,30186293,CDM,,,270,RC,inpatient,,614.18,614.18,,521.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,463.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,522.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,540.48,88,,percent of total billed charges,,,,,,,,,469.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,558.9,91,,percent of total billed charges,,,583.47,95,,percent of total billed charges,,,509.77,83,,percent of total billed charges,,,509.77,83,,percent of total billed charges,,,,,,,,,,,,,,,509.77,83,,percent of total billed charges,,,583.47,95,,percent of total billed charges,,,552.76,90,,percent of total billed charges,,,552.76,90,,percent of total billed charges,,,503.63,82,,percent of total billed charges,,,552.76,90,,percent of total billed charges,,,522.05,85,,percent of total billed charges,,463.09,583.47,
SYNTHES PLATE VA-LCP 4.5 18 HOLE,30186294,CDM,,,278,RC,inpatient,,21112.72,21112.72,,17924.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15918.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17945.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18579.19,88,,percent of total billed charges,,,,,,,,,16130.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19212.58,91,,percent of total billed charges,,,20057.08,95,,percent of total billed charges,,,17523.56,83,,percent of total billed charges,,,17523.56,83,,percent of total billed charges,,,,,,,,,,,,,,,17523.56,83,,percent of total billed charges,,,20057.08,95,,percent of total billed charges,,,19001.45,90,,percent of total billed charges,,,19001.45,90,,percent of total billed charges,,,17312.43,82,,percent of total billed charges,,,19001.45,90,,percent of total billed charges,,,17945.81,85,,percent of total billed charges,,15918.99,20057.08,
SYNTHES SCREW PERIPROSTHETIC UA 5.0 X 10,30186295,CDM,,,278,RC,inpatient,,2503.93,2503.93,,2125.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1887.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2128.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2203.46,88,,percent of total billed charges,,,,,,,,,1913,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2278.58,91,,percent of total billed charges,,,2378.73,95,,percent of total billed charges,,,2078.26,83,,percent of total billed charges,,,2078.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2078.26,83,,percent of total billed charges,,,2378.73,95,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2053.22,82,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2128.34,85,,percent of total billed charges,,1887.96,2378.73,
SYNTHES SCREW PERIPROSTHETIC UA 5.0 X 12,30186296,CDM,,,278,RC,inpatient,,2503.93,2503.93,,2125.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1887.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2128.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2203.46,88,,percent of total billed charges,,,,,,,,,1913,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2278.58,91,,percent of total billed charges,,,2378.73,95,,percent of total billed charges,,,2078.26,83,,percent of total billed charges,,,2078.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2078.26,83,,percent of total billed charges,,,2378.73,95,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2053.22,82,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2128.34,85,,percent of total billed charges,,1887.96,2378.73,
SYNTHES SCREW LOCKING 5 X 36MM ANGLED,30186297,CDM,,,278,RC,inpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1321.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1489.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,1321.56,1665.09,
ZIMMER LINER NUETRAL 36MM,30186298,CDM,,,278,RC,inpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17447.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19669,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,17447.56,21983,
OVERSTITCH SX SUTURING SYSTEM ENDOSCOPIC,30186300,CDM,,,270,RC,inpatient,,8664.5,8664.5,,7356.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6533.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7364.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7624.76,88,,percent of total billed charges,,,,,,,,,6619.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7884.7,91,,percent of total billed charges,,,8231.28,95,,percent of total billed charges,,,7191.54,83,,percent of total billed charges,,,7191.54,83,,percent of total billed charges,,,,,,,,,,,,,,,7191.54,83,,percent of total billed charges,,,8231.28,95,,percent of total billed charges,,,7798.05,90,,percent of total billed charges,,,7798.05,90,,percent of total billed charges,,,7104.89,82,,percent of total billed charges,,,7798.05,90,,percent of total billed charges,,,7364.83,85,,percent of total billed charges,,6533.03,8231.28,
OVERSTITCH SUTURE 2-0 POLYPROPYLENE,30186301,CDM,,,270,RC,inpatient,,547.75,547.75,,465.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,413,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,465.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,482.02,88,,percent of total billed charges,,,,,,,,,418.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,498.45,91,,percent of total billed charges,,,520.36,95,,percent of total billed charges,,,454.63,83,,percent of total billed charges,,,454.63,83,,percent of total billed charges,,,,,,,,,,,,,,,454.63,83,,percent of total billed charges,,,520.36,95,,percent of total billed charges,,,492.98,90,,percent of total billed charges,,,492.98,90,,percent of total billed charges,,,449.16,82,,percent of total billed charges,,,492.98,90,,percent of total billed charges,,,465.59,85,,percent of total billed charges,,413,520.36,
OVERSTITCH SUTURE CINCH,30186302,CDM,,,270,RC,inpatient,,661.5,661.5,,561.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,498.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,562.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,582.12,88,,percent of total billed charges,,,,,,,,,505.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,601.97,91,,percent of total billed charges,,,628.43,95,,percent of total billed charges,,,549.05,83,,percent of total billed charges,,,549.05,83,,percent of total billed charges,,,,,,,,,,,,,,,549.05,83,,percent of total billed charges,,,628.43,95,,percent of total billed charges,,,595.35,90,,percent of total billed charges,,,595.35,90,,percent of total billed charges,,,542.43,82,,percent of total billed charges,,,595.35,90,,percent of total billed charges,,,562.28,85,,percent of total billed charges,,498.77,628.43,
ENSIZOR ENDOSCOPIC SCISSORS,30186303,CDM,,,270,RC,inpatient,,2155.83,2155.83,,1830.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1625.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1832.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1897.13,88,,percent of total billed charges,,,,,,,,,1647.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1961.81,91,,percent of total billed charges,,,2048.04,95,,percent of total billed charges,,,1789.34,83,,percent of total billed charges,,,1789.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1789.34,83,,percent of total billed charges,,,2048.04,95,,percent of total billed charges,,,1940.25,90,,percent of total billed charges,,,1940.25,90,,percent of total billed charges,,,1767.78,82,,percent of total billed charges,,,1940.25,90,,percent of total billed charges,,,1832.46,85,,percent of total billed charges,,1625.5,2048.04,
BACTISURE WOUND LAVAGE,30186304,CDM,,,270,RC,inpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3675.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4143.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,3675.75,4631.25,
EVERCROSS 5MM X 80MM,30186305,CDM,,,270,RC,inpatient,,819,819,,695.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,617.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,696.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,720.72,88,,percent of total billed charges,,,,,,,,,625.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,745.29,91,,percent of total billed charges,,,778.05,95,,percent of total billed charges,,,679.77,83,,percent of total billed charges,,,679.77,83,,percent of total billed charges,,,,,,,,,,,,,,,679.77,83,,percent of total billed charges,,,778.05,95,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,671.58,82,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,696.15,85,,percent of total billed charges,,617.53,778.05,
CATHETER BALLOON CHOCOLATE PTA 4.0MM,30186306,CDM,,,270,RC,inpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3896.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4392.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,3896.3,4909.13,
TERUMO GLIDEWIRE ANGLED .035/260,30186307,CDM,,,270,RC,inpatient,,532,532,,451.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,401.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,452.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,468.16,88,,percent of total billed charges,,,,,,,,,406.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,484.12,91,,percent of total billed charges,,,505.4,95,,percent of total billed charges,,,441.56,83,,percent of total billed charges,,,441.56,83,,percent of total billed charges,,,,,,,,,,,,,,,441.56,83,,percent of total billed charges,,,505.4,95,,percent of total billed charges,,,478.8,90,,percent of total billed charges,,,478.8,90,,percent of total billed charges,,,436.24,82,,percent of total billed charges,,,478.8,90,,percent of total billed charges,,,452.2,85,,percent of total billed charges,,401.13,505.4,
COOK FLEXOR INTRODUCER GUIDING SHEATH 6F,30186308,CDM,,,270,RC,inpatient,,383.74,383.74,,325.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,289.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,326.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,337.69,88,,percent of total billed charges,,,,,,,,,293.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,349.2,91,,percent of total billed charges,,,364.55,95,,percent of total billed charges,,,318.5,83,,percent of total billed charges,,,318.5,83,,percent of total billed charges,,,,,,,,,,,,,,,318.5,83,,percent of total billed charges,,,364.55,95,,percent of total billed charges,,,345.37,90,,percent of total billed charges,,,345.37,90,,percent of total billed charges,,,314.67,82,,percent of total billed charges,,,345.37,90,,percent of total billed charges,,,326.18,85,,percent of total billed charges,,289.34,364.55,
MERIT CARDIAC CATH PACK CUSTOM,30186309,CDM,,,270,RC,inpatient,,438.34,438.34,,372.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,330.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,372.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,385.74,88,,percent of total billed charges,,,,,,,,,334.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,398.89,91,,percent of total billed charges,,,416.42,95,,percent of total billed charges,,,363.82,83,,percent of total billed charges,,,363.82,83,,percent of total billed charges,,,,,,,,,,,,,,,363.82,83,,percent of total billed charges,,,416.42,95,,percent of total billed charges,,,394.51,90,,percent of total billed charges,,,394.51,90,,percent of total billed charges,,,359.44,82,,percent of total billed charges,,,394.51,90,,percent of total billed charges,,,372.59,85,,percent of total billed charges,,330.51,416.42,
MERIT INTRODUCER PRO SHEATH PRELUDE 6FR,30186310,CDM,,,270,RC,inpatient,,79.05,79.05,,67.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.56,88,,percent of total billed charges,,,,,,,,,60.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.94,91,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,,,,,,,,,,,,,65.61,83,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,64.82,82,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,67.19,85,,percent of total billed charges,,59.6,75.1,
DRAPE RADPAD YELLOW DADD 4X9 FENESTRATIO,30186311,CDM,,,270,RC,inpatient,,178.64,178.64,,151.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,134.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,151.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,157.2,88,,percent of total billed charges,,,,,,,,,136.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,162.56,91,,percent of total billed charges,,,169.71,95,,percent of total billed charges,,,148.27,83,,percent of total billed charges,,,148.27,83,,percent of total billed charges,,,,,,,,,,,,,,,148.27,83,,percent of total billed charges,,,169.71,95,,percent of total billed charges,,,160.78,90,,percent of total billed charges,,,160.78,90,,percent of total billed charges,,,146.48,82,,percent of total billed charges,,,160.78,90,,percent of total billed charges,,,151.84,85,,percent of total billed charges,,134.69,169.71,
ASAHI GUIDEWIRE GLADIUS PERIPHERAL,30186312,CDM,,,270,RC,inpatient,,1105,1105,,938.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,833.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,939.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,972.4,88,,percent of total billed charges,,,,,,,,,844.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1005.55,91,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,,,,,,,,,,,,,917.15,83,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,906.1,82,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,833.17,1049.75,
CATHETER PIG 5F 65CM SUPER TORQUE ANGIOG,30186313,CDM,,,270,RC,inpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,81.43,102.6,
CATHETER BER 4F 100CM TEMPO 4 ANGIOGRAPH,30186314,CDM,,,270,RC,inpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,81.43,102.6,
CARDIVA VASCADE CLOSURE SYSTEM 6-7FR,30186315,CDM,,,270,RC,inpatient,,1397.5,1397.5,,1186.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1053.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1187.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1229.8,88,,percent of total billed charges,,,,,,,,,1067.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1271.73,91,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1159.93,83,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1145.95,82,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,1053.72,1327.63,
ENDOFLATOR ENCORE 26MT SINGLE,30186316,CDM,,,270,RC,inpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,226.2,285,
FEMSTOP DEVICE,30186317,CDM,,,270,RC,inpatient,,1643.85,1643.85,,1395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1239.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1397.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1446.59,88,,percent of total billed charges,,,,,,,,,1255.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1495.9,91,,percent of total billed charges,,,1561.66,95,,percent of total billed charges,,,1364.4,83,,percent of total billed charges,,,1364.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1364.4,83,,percent of total billed charges,,,1561.66,95,,percent of total billed charges,,,1479.47,90,,percent of total billed charges,,,1479.47,90,,percent of total billed charges,,,1347.96,82,,percent of total billed charges,,,1479.47,90,,percent of total billed charges,,,1397.27,85,,percent of total billed charges,,1239.46,1561.66,
ZIMMER INSERT CR 10MM LEFT,30186318,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ZIMMER SCREW PSN FEMALE 2.5 X 25MM,30186319,CDM,,,278,RC,inpatient,,1072.5,1072.5,,910.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,808.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,911.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,943.8,88,,percent of total billed charges,,,,,,,,,819.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,975.98,91,,percent of total billed charges,,,1018.88,95,,percent of total billed charges,,,890.18,83,,percent of total billed charges,,,890.18,83,,percent of total billed charges,,,,,,,,,,,,,,,890.18,83,,percent of total billed charges,,,1018.88,95,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,879.45,82,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,911.63,85,,percent of total billed charges,,808.67,1018.88,
ZIMMER TIBIA POROUS SZ H LEFT,30186320,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER FEMUR PSN CR SZ 11 LEFT,30186321,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
DEPUY STEM REVISION 18 HO,30186322,CDM,,,278,RC,inpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50336.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56745.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,50336.9,63421.82,
ZIMMER LINER NUETRAL E1 G7 40MM,30186323,CDM,,,278,RC,inpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17447.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19669,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,17447.56,21983,
ZIMMER LINER NUETRAL G7 E1 36MM,30186324,CDM,,,278,RC,inpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17447.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19669,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,17447.56,21983,
ZIMMER LINER NUETRAL G7 E1 40MM,30186325,CDM,,,278,RC,inpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17447.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19669,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,17447.56,21983,
SYNTHES SCREW CORTEX 4.5 X 54MM,30186326,CDM,,,278,RC,inpatient,,269.25,269.25,,228.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,203.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,228.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,236.94,88,,percent of total billed charges,,,,,,,,,205.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,245.02,91,,percent of total billed charges,,,255.79,95,,percent of total billed charges,,,223.48,83,,percent of total billed charges,,,223.48,83,,percent of total billed charges,,,,,,,,,,,,,,,223.48,83,,percent of total billed charges,,,255.79,95,,percent of total billed charges,,,242.33,90,,percent of total billed charges,,,242.33,90,,percent of total billed charges,,,220.79,82,,percent of total billed charges,,,242.33,90,,percent of total billed charges,,,228.86,85,,percent of total billed charges,,203.01,255.79,
TERUMO GLIDEWIRE ANGLED .035/180CM,30186327,CDM,,,270,RC,inpatient,,336.38,336.38,,285.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,253.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,285.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,296.01,88,,percent of total billed charges,,,,,,,,,256.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,306.11,91,,percent of total billed charges,,,319.56,95,,percent of total billed charges,,,279.2,83,,percent of total billed charges,,,279.2,83,,percent of total billed charges,,,,,,,,,,,,,,,279.2,83,,percent of total billed charges,,,319.56,95,,percent of total billed charges,,,302.74,90,,percent of total billed charges,,,302.74,90,,percent of total billed charges,,,275.83,82,,percent of total billed charges,,,302.74,90,,percent of total billed charges,,,285.92,85,,percent of total billed charges,,253.63,319.56,
ARTHREX ACL TIGHTROPE RT W/DEPLOYING SUT,30186328,CDM,,,278,RC,inpatient,,2405,2405,,2041.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1813.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2044.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2116.4,88,,percent of total billed charges,,,,,,,,,1837.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2188.55,91,,percent of total billed charges,,,2284.75,95,,percent of total billed charges,,,1996.15,83,,percent of total billed charges,,,1996.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1996.15,83,,percent of total billed charges,,,2284.75,95,,percent of total billed charges,,,2164.5,90,,percent of total billed charges,,,2164.5,90,,percent of total billed charges,,,1972.1,82,,percent of total billed charges,,,2164.5,90,,percent of total billed charges,,,2044.25,85,,percent of total billed charges,,1813.37,2284.75,
ARTHREX SCREW VENTED 10X30MM BC IF,30186329,CDM,,,278,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
ARTHREX SCREW VENTED 11X30MM BC IF,30186330,CDM,,,278,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
DEPUY INSERT AOX PS FB 10MM,30186331,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY STEM CORAIL REVISION SZ13 STD,30186332,CDM,,,278,RC,inpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50336.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56745.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,50336.9,63421.82,
S&N LINER ACETABULAR 36MM SZ G,30186333,CDM,,,278,RC,inpatient,,32240,32240,,27371.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24308.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27404,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28371.2,88,,percent of total billed charges,,,,,,,,,24631.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29338.4,91,,percent of total billed charges,,,30628,95,,percent of total billed charges,,,26759.2,83,,percent of total billed charges,,,26759.2,83,,percent of total billed charges,,,,,,,,,,,,,,,26759.2,83,,percent of total billed charges,,,30628,95,,percent of total billed charges,,,29016,90,,percent of total billed charges,,,29016,90,,percent of total billed charges,,,26436.8,82,,percent of total billed charges,,,29016,90,,percent of total billed charges,,,27404,85,,percent of total billed charges,,24308.96,30628,
DEPUY TI ROD 480MM,30186334,CDM,,,278,RC,inpatient,,6467.5,6467.5,,5490.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4876.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5497.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5691.4,88,,percent of total billed charges,,,,,,,,,4941.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5885.43,91,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,,,,,,,,,,,,,5368.03,83,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5303.35,82,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,4876.5,6144.13,
DEPUY SCREW SET,30186335,CDM,,,278,RC,inpatient,,2460,2460,,2088.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1854.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2091,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2164.8,88,,percent of total billed charges,,,,,,,,,1879.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2238.6,91,,percent of total billed charges,,,2337,95,,percent of total billed charges,,,2041.8,83,,percent of total billed charges,,,2041.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2041.8,83,,percent of total billed charges,,,2337,95,,percent of total billed charges,,,2214,90,,percent of total billed charges,,,2214,90,,percent of total billed charges,,,2017.2,82,,percent of total billed charges,,,2214,90,,percent of total billed charges,,,2091,85,,percent of total billed charges,,1854.84,2337,
DEPUY CONNECTOR TOP NOTCH 5.5,30186336,CDM,,,278,RC,inpatient,,12870,12870,,10926.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9703.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10939.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11325.6,88,,percent of total billed charges,,,,,,,,,9832.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11711.7,91,,percent of total billed charges,,,12226.5,95,,percent of total billed charges,,,10682.1,83,,percent of total billed charges,,,10682.1,83,,percent of total billed charges,,,,,,,,,,,,,,,10682.1,83,,percent of total billed charges,,,12226.5,95,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,10553.4,82,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,10939.5,85,,percent of total billed charges,,9703.98,12226.5,
DEPUY CONNECTOR END TO END 5.5,30186337,CDM,,,278,RC,inpatient,,12870,12870,,10926.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9703.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10939.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11325.6,88,,percent of total billed charges,,,,,,,,,9832.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11711.7,91,,percent of total billed charges,,,12226.5,95,,percent of total billed charges,,,10682.1,83,,percent of total billed charges,,,10682.1,83,,percent of total billed charges,,,,,,,,,,,,,,,10682.1,83,,percent of total billed charges,,,12226.5,95,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,10553.4,82,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,10939.5,85,,percent of total billed charges,,9703.98,12226.5,
DEPUY TI ROD 120MM,30186338,CDM,,,278,RC,inpatient,,6467.5,6467.5,,5490.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4876.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5497.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5691.4,88,,percent of total billed charges,,,,,,,,,4941.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5885.43,91,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,,,,,,,,,,,,,5368.03,83,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5303.35,82,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,4876.5,6144.13,
DEPUY CONNECTOR END TO END,30186339,CDM,,,278,RC,inpatient,,12870,12870,,10926.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9703.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10939.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11325.6,88,,percent of total billed charges,,,,,,,,,9832.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11711.7,91,,percent of total billed charges,,,12226.5,95,,percent of total billed charges,,,10682.1,83,,percent of total billed charges,,,10682.1,83,,percent of total billed charges,,,,,,,,,,,,,,,10682.1,83,,percent of total billed charges,,,12226.5,95,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,10553.4,82,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,10939.5,85,,percent of total billed charges,,9703.98,12226.5,
INFUSE MEDIUM BONE GRAFT KIT,30186340,CDM,,,278,RC,inpatient,,34450,34450,,29248.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29282.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30316,88,,percent of total billed charges,,,,,,,,,26319.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31349.5,91,,percent of total billed charges,,,32727.5,95,,percent of total billed charges,,,28593.5,83,,percent of total billed charges,,,28593.5,83,,percent of total billed charges,,,,,,,,,,,,,,,28593.5,83,,percent of total billed charges,,,32727.5,95,,percent of total billed charges,,,31005,90,,percent of total billed charges,,,31005,90,,percent of total billed charges,,,28249,82,,percent of total billed charges,,,31005,90,,percent of total billed charges,,,29282.5,85,,percent of total billed charges,,25975.3,32727.5,
ABBOTT PACEMAKER ASSURITY MRI DR RF CELL,30186341,CDM,,,278,RC,inpatient,,33150,33150,,28144.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24995.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28177.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29172,88,,percent of total billed charges,,,,,,,,,25326.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30166.5,91,,percent of total billed charges,,,31492.5,95,,percent of total billed charges,,,27514.5,83,,percent of total billed charges,,,27514.5,83,,percent of total billed charges,,,,,,,,,,,,,,,27514.5,83,,percent of total billed charges,,,31492.5,95,,percent of total billed charges,,,29835,90,,percent of total billed charges,,,29835,90,,percent of total billed charges,,,27183,82,,percent of total billed charges,,,29835,90,,percent of total billed charges,,,28177.5,85,,percent of total billed charges,,24995.1,31492.5,
ABBOTT LEAD TENDRIL STS 46CM MRI,30186342,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
ABBOTT LEAD TENDRIL STS 52CM MRI,30186343,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
ABBOTT INTRODUCER SHEATH PEELAWAY 6F,30186344,CDM,,,270,RC,inpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,448.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,505.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,448.63,565.25,
DEPUY STEM CORAIL REVISION SZ11 STD,30186346,CDM,,,278,RC,inpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50336.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56745.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,50336.9,63421.82,
ZIMMER INSERT MVA 11MM,30186347,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ZIMMER TIBIA PORUS SIZE H RIGHT,30186348,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER FEMUR PORUS CR SZ 11,30186349,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
SCREW LOCKING CAP KIT 4.5X46MM,30186350,CDM,,,278,RC,inpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1514.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1707.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,1514.41,1908.08,
DEPUY OSTEOTOME FLAT LONG,30186351,CDM,,,278,RC,inpatient,,2626,2626,,2229.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1980,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2232.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2310.88,88,,percent of total billed charges,,,,,,,,,2006.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2389.66,91,,percent of total billed charges,,,2494.7,95,,percent of total billed charges,,,2179.58,83,,percent of total billed charges,,,2179.58,83,,percent of total billed charges,,,,,,,,,,,,,,,2179.58,83,,percent of total billed charges,,,2494.7,95,,percent of total billed charges,,,2363.4,90,,percent of total billed charges,,,2363.4,90,,percent of total billed charges,,,2153.32,82,,percent of total billed charges,,,2363.4,90,,percent of total billed charges,,,2232.1,85,,percent of total billed charges,,1980,2494.7,
DEPUY OSTEOTOME FIN SHORT,30186352,CDM,,,278,RC,inpatient,,3256.5,3256.5,,2764.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2455.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2768.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2865.72,88,,percent of total billed charges,,,,,,,,,2487.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2963.42,91,,percent of total billed charges,,,3093.68,95,,percent of total billed charges,,,2702.9,83,,percent of total billed charges,,,2702.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2702.9,83,,percent of total billed charges,,,3093.68,95,,percent of total billed charges,,,2930.85,90,,percent of total billed charges,,,2930.85,90,,percent of total billed charges,,,2670.33,82,,percent of total billed charges,,,2930.85,90,,percent of total billed charges,,,2768.03,85,,percent of total billed charges,,2455.4,3093.68,
ZIMMER LINER NUETRAL 40MM +5 F,30186354,CDM,,,278,RC,inpatient,,24310,24310,,20639.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18329.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20663.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21392.8,88,,percent of total billed charges,,,,,,,,,18572.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22122.1,91,,percent of total billed charges,,,23094.5,95,,percent of total billed charges,,,20177.3,83,,percent of total billed charges,,,20177.3,83,,percent of total billed charges,,,,,,,,,,,,,,,20177.3,83,,percent of total billed charges,,,23094.5,95,,percent of total billed charges,,,21879,90,,percent of total billed charges,,,21879,90,,percent of total billed charges,,,19934.2,82,,percent of total billed charges,,,21879,90,,percent of total billed charges,,,20663.5,85,,percent of total billed charges,,18329.74,23094.5,
ZIMMER FEMUR PSN CR SZ 7 LEFT,30186355,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER INSERT TIBIAL 10MM MC,30186356,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ZIMMER TIBIA LEFT SZ E,30186357,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
MEDTRONIC NEUROSTIMULATOR WIRELESS EXTER,30186358,CDM,,,270,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
ABBOTT LEAD VENTRICULAR 58CM,30186359,CDM,,,278,RC,inpatient,,29250,29250,,24833.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22054.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24862.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25740,88,,percent of total billed charges,,,,,,,,,22347,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26617.5,91,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,,,,,,,,,,,,,24277.5,83,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,23985,82,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,22054.5,27787.5,
ABBOTT INTRODUCER SHEATH PEELAWAY 8F,30186360,CDM,,,270,RC,inpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,448.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,505.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,448.63,565.25,
ABBOTT ICD ELLIPSE MRI DR36 DF4 CONNECTO,30186361,CDM,,,278,RC,inpatient,,94250,94250,,80018.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71064.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80112.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,82940,88,,percent of total billed charges,,,,,,,,,72007,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,85767.5,91,,percent of total billed charges,,,89537.5,95,,percent of total billed charges,,,78227.5,83,,percent of total billed charges,,,78227.5,83,,percent of total billed charges,,,,,,,,,,,,,,,78227.5,83,,percent of total billed charges,,,89537.5,95,,percent of total billed charges,,,84825,90,,percent of total billed charges,,,84825,90,,percent of total billed charges,,,77285,82,,percent of total billed charges,,,84825,90,,percent of total billed charges,,,80112.5,85,,percent of total billed charges,,71064.5,89537.5,
ARTHREX NEEDLE TAPERED W/TANOLOOP,30186362,CDM,,,270,RC,inpatient,,152.16,152.16,,129.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.9,88,,percent of total billed charges,,,,,,,,,116.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.47,91,,percent of total billed charges,,,144.55,95,,percent of total billed charges,,,126.29,83,,percent of total billed charges,,,126.29,83,,percent of total billed charges,,,,,,,,,,,,,,,126.29,83,,percent of total billed charges,,,144.55,95,,percent of total billed charges,,,136.94,90,,percent of total billed charges,,,136.94,90,,percent of total billed charges,,,124.77,82,,percent of total billed charges,,,136.94,90,,percent of total billed charges,,,129.34,85,,percent of total billed charges,,114.73,144.55,
DEPUY GLOBAL UNITE REVERSE FX EPI,30186363,CDM,,,278,RC,inpatient,,40066,40066,,34016.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30209.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34056.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35258.08,88,,percent of total billed charges,,,,,,,,,30610.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36460.06,91,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,,,,,,,,,,,,,33254.78,83,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,32854.12,82,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,34056.1,85,,percent of total billed charges,,30209.76,38062.7,
S&N BIORAPTOR 2.3PK SUTURE ANCHOR,30186364,CDM,,,270,RC,inpatient,,2207.34,2207.34,,1874.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1664.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1876.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1942.46,88,,percent of total billed charges,,,,,,,,,1686.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2008.68,91,,percent of total billed charges,,,2096.97,95,,percent of total billed charges,,,1832.09,83,,percent of total billed charges,,,1832.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1832.09,83,,percent of total billed charges,,,2096.97,95,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1810.02,82,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1876.24,85,,percent of total billed charges,,1664.33,2096.97,
EXACTECH STEM HUMERAL 11MM,30186365,CDM,,,278,RC,inpatient,,35366.5,35366.5,,30026.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26666.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30061.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31122.52,88,,percent of total billed charges,,,,,,,,,27020.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32183.52,91,,percent of total billed charges,,,33598.18,95,,percent of total billed charges,,,29354.2,83,,percent of total billed charges,,,29354.2,83,,percent of total billed charges,,,,,,,,,,,,,,,29354.2,83,,percent of total billed charges,,,33598.18,95,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,29000.53,82,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,30061.53,85,,percent of total billed charges,,26666.34,33598.18,
EXACTECH LINER HUMERAL 42MM +0MM,30186366,CDM,,,278,RC,inpatient,,13487.5,13487.5,,11450.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10169.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11464.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11869,88,,percent of total billed charges,,,,,,,,,10304.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12273.63,91,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,,,,,,,,,,,,,11194.63,83,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11059.75,82,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,10169.58,12813.13,
ZIMMER LINER NUETRAL G7 E1 36MM,30186367,CDM,,,278,RC,inpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17447.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19669,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,17447.56,21983,
ZIMMER FEMUR PSN CR SZ 10 RIGHT,30186368,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER TIBIA RIGHT SZ G,30186369,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER TIBIA LEFT SZ G,30186370,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER FEMUR PSN CR SZ 10 LEFT,30186371,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER INSERT ASF 10MM,30186372,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
MEDTRONIC HAWKONE,30186373,CDM,,,270,RC,inpatient,,24292.13,24292.13,,20624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18316.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20648.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21377.07,88,,percent of total billed charges,,,,,,,,,18559.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22105.84,91,,percent of total billed charges,,,23077.52,95,,percent of total billed charges,,,20162.47,83,,percent of total billed charges,,,20162.47,83,,percent of total billed charges,,,,,,,,,,,,,,,20162.47,83,,percent of total billed charges,,,23077.52,95,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,19919.55,82,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,20648.31,85,,percent of total billed charges,,18316.27,23077.52,
MERIT INTRODUCER PRO SHEATH PRELUDE 5FR,30186374,CDM,,,270,RC,inpatient,,79.05,79.05,,67.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.56,88,,percent of total billed charges,,,,,,,,,60.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.94,91,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,,,,,,,,,,,,,65.61,83,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,64.82,82,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,67.19,85,,percent of total billed charges,,59.6,75.1,
CSI MICROCATHETER TELEPORT 2.1F X 150CM,30186375,CDM,,,270,RC,inpatient,,4225,4225,,3587.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3185.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3591.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3718,88,,percent of total billed charges,,,,,,,,,3227.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3844.75,91,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,,,,,,,,,,,,,3506.75,83,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3464.5,82,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,3185.65,4013.75,
DEPUY FEMUR CR  SZ 9 RIGHT,30186376,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
ZIMMER FEMUR PSN PEG SZ F LEFT,30186377,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER INSERT CR 8MM LEFT,30186378,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER INSERT CR 10MM LEFT,30186379,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
MEDTRONIC GENERATOR INTELLIS,30186380,CDM,,,270,RC,inpatient,,149175,149175,,126649.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,112477.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,126798.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,131274,88,,percent of total billed charges,,,,,,,,,113969.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,135749.25,91,,percent of total billed charges,,,141716.25,95,,percent of total billed charges,,,123815.25,83,,percent of total billed charges,,,123815.25,83,,percent of total billed charges,,,,,,,,,,,,,,,123815.25,83,,percent of total billed charges,,,141716.25,95,,percent of total billed charges,,,134257.5,90,,percent of total billed charges,,,134257.5,90,,percent of total billed charges,,,122323.5,82,,percent of total billed charges,,,134257.5,90,,percent of total billed charges,,,126798.75,85,,percent of total billed charges,,112477.95,141716.25,
MEDTRONIC CONTROLLER,30186381,CDM,,,270,RC,inpatient,,13200,13200,,11206.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9952.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11220,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11616,88,,percent of total billed charges,,,,,,,,,10084.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12012,91,,percent of total billed charges,,,12540,95,,percent of total billed charges,,,10956,83,,percent of total billed charges,,,10956,83,,percent of total billed charges,,,,,,,,,,,,,,,10956,83,,percent of total billed charges,,,12540,95,,percent of total billed charges,,,11880,90,,percent of total billed charges,,,11880,90,,percent of total billed charges,,,10824,82,,percent of total billed charges,,,11880,90,,percent of total billed charges,,,11220,85,,percent of total billed charges,,9952.8,12540,
MEDTRONIC RECHARGER,30186382,CDM,,,270,RC,inpatient,,11050,11050,,9381.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8331.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9392.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9724,88,,percent of total billed charges,,,,,,,,,8442.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10055.5,91,,percent of total billed charges,,,10497.5,95,,percent of total billed charges,,,9171.5,83,,percent of total billed charges,,,9171.5,83,,percent of total billed charges,,,,,,,,,,,,,,,9171.5,83,,percent of total billed charges,,,10497.5,95,,percent of total billed charges,,,9945,90,,percent of total billed charges,,,9945,90,,percent of total billed charges,,,9061,82,,percent of total billed charges,,,9945,90,,percent of total billed charges,,,9392.5,85,,percent of total billed charges,,8331.7,10497.5,
SPINECRAFT SCREW POLY 6.5 X 45MM,30186383,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
IR SURGICAL REMOVAL TRAY RENTAL,30186384,CDM,,,270,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
IOVERA SMART TIP 1 X 90MM,30186385,CDM,,,270,RC,inpatient,,3770,3770,,3200.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2842.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3204.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3317.6,88,,percent of total billed charges,,,,,,,,,2880.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3430.7,91,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,,,,,,,,,,,,,3129.1,83,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3091.4,82,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3204.5,85,,percent of total billed charges,,2842.58,3581.5,
ZIMMER TIBIA PSN CEMENTED SZ G LEFT,30186386,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER FEMUR PSN SZ 12 RIGHT,30186387,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER INSERT PSN 10MM RIGHT,30186388,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
DEPUY ATTUNE FEMUR CRS 5 LEFT,30186389,CDM,,,278,RC,inpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39636.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44683.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,39636.69,49940.13,
DEPUY INSERT ATTUNE CRS 5 X 6MM,30186390,CDM,,,278,RC,inpatient,,23578.82,23578.82,,20018.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17778.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20042,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20749.36,88,,percent of total billed charges,,,,,,,,,18014.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21456.73,91,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,,,,,,,,,,,,,19570.42,83,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,19334.63,82,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,20042,85,,percent of total billed charges,,17778.43,22399.88,
DEPUY ATTUNE TIBIA RP REVISION SZ 5,30186391,CDM,,,278,RC,inpatient,,39503.36,39503.36,,33538.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29785.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33577.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34762.96,88,,percent of total billed charges,,,,,,,,,30180.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35948.06,91,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32787.79,83,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,32392.76,82,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,29785.53,37528.19,
ZIMMER BEARING PSN ASF 11MM,30186393,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ULRICH PEEK CERVICAL 8MM 15 X 13,30186394,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
CATH THORACIC STRAIGHT 20F 20,30186395,CDM,,,270,RC,inpatient,,45.73,45.73,,38.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.24,88,,percent of total billed charges,,,,,,,,,34.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.61,91,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,,,,,,,,,,,,,37.96,83,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,37.5,82,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,34.48,43.44,
CATH THORACIC STRAIGHT 32F 20,30186396,CDM,,,270,RC,inpatient,,45.73,45.73,,38.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.24,88,,percent of total billed charges,,,,,,,,,34.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.61,91,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,,,,,,,,,,,,,37.96,83,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,37.5,82,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,34.48,43.44,
CATH THORACIC STRAIGHT 16F 20,30186397,CDM,,,270,RC,inpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,41.47,52.25,
CATH THORACIC STRAIGHT 28F 20,30186398,CDM,,,270,RC,inpatient,,45.73,45.73,,38.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.24,88,,percent of total billed charges,,,,,,,,,34.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.61,91,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,,,,,,,,,,,,,37.96,83,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,37.5,82,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,34.48,43.44,
CATH THORACIC STRAIGHT 36F 20,30186399,CDM,,,270,RC,inpatient,,45.73,45.73,,38.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.24,88,,percent of total billed charges,,,,,,,,,34.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.61,91,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,,,,,,,,,,,,,37.96,83,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,37.5,82,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,34.48,43.44,
SYNTHES PLATE ANTERIOR CLAVICLE 3.5 5 HO,30186400,CDM,,,278,RC,inpatient,,8820.7,8820.7,,7488.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6650.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7497.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7762.22,88,,percent of total billed charges,,,,,,,,,6739.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8026.84,91,,percent of total billed charges,,,8379.67,95,,percent of total billed charges,,,7321.18,83,,percent of total billed charges,,,7321.18,83,,percent of total billed charges,,,,,,,,,,,,,,,7321.18,83,,percent of total billed charges,,,8379.67,95,,percent of total billed charges,,,7938.63,90,,percent of total billed charges,,,7938.63,90,,percent of total billed charges,,,7232.97,82,,percent of total billed charges,,,7938.63,90,,percent of total billed charges,,,7497.6,85,,percent of total billed charges,,6650.81,8379.67,
SYNTHES PLATE ANTERIOR CLAVICLE 8H RIGHT,30186401,CDM,,,278,RC,inpatient,,9389.77,9389.77,,7971.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7079.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7981.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8263,88,,percent of total billed charges,,,,,,,,,7173.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8544.69,91,,percent of total billed charges,,,8920.28,95,,percent of total billed charges,,,7793.51,83,,percent of total billed charges,,,7793.51,83,,percent of total billed charges,,,,,,,,,,,,,,,7793.51,83,,percent of total billed charges,,,8920.28,95,,percent of total billed charges,,,8450.79,90,,percent of total billed charges,,,8450.79,90,,percent of total billed charges,,,7699.61,82,,percent of total billed charges,,,8450.79,90,,percent of total billed charges,,,7981.3,85,,percent of total billed charges,,7079.89,8920.28,
DEPUY STEM FEMORAL CEMENTLESS SZ 15,30186404,CDM,,,278,RC,inpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50336.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56745.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,50336.9,63421.82,
DEPUY STEM PROSTALAC 150MM,30186405,CDM,,,278,RC,inpatient,,32843.27,32843.27,,27883.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24763.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27916.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28902.08,88,,percent of total billed charges,,,,,,,,,25092.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29887.38,91,,percent of total billed charges,,,31201.11,95,,percent of total billed charges,,,27259.91,83,,percent of total billed charges,,,27259.91,83,,percent of total billed charges,,,,,,,,,,,,,,,27259.91,83,,percent of total billed charges,,,31201.11,95,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,26931.48,82,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,27916.78,85,,percent of total billed charges,,24763.83,31201.11,
MERIT INTRODUCER PRO SHEATH PRELUDE 4FR,30186406,CDM,,,270,RC,inpatient,,79.05,79.05,,67.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.56,88,,percent of total billed charges,,,,,,,,,60.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.94,91,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,,,,,,,,,,,,,65.61,83,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,64.82,82,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,67.19,85,,percent of total billed charges,,59.6,75.1,
MERIT INTRODUCER PRO SHEATH PRELUDE 7FR,30186407,CDM,,,270,RC,inpatient,,79.05,79.05,,67.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.56,88,,percent of total billed charges,,,,,,,,,60.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.94,91,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,,,,,,,,,,,,,65.61,83,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,64.82,82,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,67.19,85,,percent of total billed charges,,59.6,75.1,
MERIT INTRODUCER PRO SHEATH PRELUDE 8FR,30186408,CDM,,,270,RC,inpatient,,79.05,79.05,,67.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.56,88,,percent of total billed charges,,,,,,,,,60.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.94,91,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,,,,,,,,,,,,,65.61,83,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,64.82,82,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,67.19,85,,percent of total billed charges,,59.6,75.1,
TERUMO GLIDEWIRE JWIRE .035/180CM,30186409,CDM,,,270,RC,inpatient,,476,476,,404.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,358.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,404.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,418.88,88,,percent of total billed charges,,,,,,,,,363.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,433.16,91,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,,,,,,,,,,,,,395.08,83,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,390.32,82,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,358.9,452.2,
MERIT S-MAK MINI ACCESS KIT 5FR,30186410,CDM,,,270,RC,inpatient,,270,270,,229.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,203.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,229.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,237.6,88,,percent of total billed charges,,,,,,,,,206.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,245.7,91,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,,,,,,,,,,,,,224.1,83,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,243,90,,percent of total billed charges,,,243,90,,percent of total billed charges,,,221.4,82,,percent of total billed charges,,,243,90,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,203.58,256.5,
ABBOTT GUIDEWIRE COMMAND ES 0.014,30186411,CDM,,,270,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
CARDIVA VASCADE CLOSURE SYSTEM 5FR,30186412,CDM,,,270,RC,inpatient,,1397.5,1397.5,,1186.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1053.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1187.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1229.8,88,,percent of total billed charges,,,,,,,,,1067.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1271.73,91,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1159.93,83,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1145.95,82,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,1053.72,1327.63,
DRAPE RADPAD PERIPHERAL SHIELD,30186413,CDM,,,270,RC,inpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,169.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,191.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,169.65,213.75,
ZIMMER LINER NUETRAL G7 E1 40MM,30186414,CDM,,,278,RC,inpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17447.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19669,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,17447.56,21983,
ZIMMER INSERT TIBIAL 10MM 4-5EF,30186415,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ZIMMER FEMUR CR LEFT SZ 5,30186416,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
TERUMO GLIDEWIRE STIFF .35/260,30186419,CDM,,,270,RC,inpatient,,598.5,598.5,,508.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,451.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,508.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,526.68,88,,percent of total billed charges,,,,,,,,,457.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,544.64,91,,percent of total billed charges,,,568.58,95,,percent of total billed charges,,,496.76,83,,percent of total billed charges,,,496.76,83,,percent of total billed charges,,,,,,,,,,,,,,,496.76,83,,percent of total billed charges,,,568.58,95,,percent of total billed charges,,,538.65,90,,percent of total billed charges,,,538.65,90,,percent of total billed charges,,,490.77,82,,percent of total billed charges,,,538.65,90,,percent of total billed charges,,,508.73,85,,percent of total billed charges,,451.27,568.58,
TERUMO ANGIO SEAL 6FR,30186420,CDM,,,270,RC,inpatient,,2184,2184,,1854.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1646.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1856.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1921.92,88,,percent of total billed charges,,,,,,,,,1668.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1987.44,91,,percent of total billed charges,,,2074.8,95,,percent of total billed charges,,,1812.72,83,,percent of total billed charges,,,1812.72,83,,percent of total billed charges,,,,,,,,,,,,,,,1812.72,83,,percent of total billed charges,,,2074.8,95,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1790.88,82,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1856.4,85,,percent of total billed charges,,1646.74,2074.8,
COOK FLEXOR INTRODUCER GUIDING SHEATH 5F,30186421,CDM,,,270,RC,inpatient,,358.61,358.61,,304.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,270.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,304.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,315.58,88,,percent of total billed charges,,,,,,,,,273.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,326.34,91,,percent of total billed charges,,,340.68,95,,percent of total billed charges,,,297.65,83,,percent of total billed charges,,,297.65,83,,percent of total billed charges,,,,,,,,,,,,,,,297.65,83,,percent of total billed charges,,,340.68,95,,percent of total billed charges,,,322.75,90,,percent of total billed charges,,,322.75,90,,percent of total billed charges,,,294.06,82,,percent of total billed charges,,,322.75,90,,percent of total billed charges,,,304.82,85,,percent of total billed charges,,270.39,340.68,
COOK FLEXOR INTRODUCER SHEATH 6F 90CM,30186422,CDM,,,270,RC,inpatient,,721.63,721.63,,612.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,544.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,613.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,635.03,88,,percent of total billed charges,,,,,,,,,551.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,656.68,91,,percent of total billed charges,,,685.55,95,,percent of total billed charges,,,598.95,83,,percent of total billed charges,,,598.95,83,,percent of total billed charges,,,,,,,,,,,,,,,598.95,83,,percent of total billed charges,,,685.55,95,,percent of total billed charges,,,649.47,90,,percent of total billed charges,,,649.47,90,,percent of total billed charges,,,591.74,82,,percent of total billed charges,,,649.47,90,,percent of total billed charges,,,613.39,85,,percent of total billed charges,,544.11,685.55,
MERIT NEEDLE ANGIOGRAPHIC 18G X 7CM,30186423,CDM,,,270,RC,inpatient,,19.26,19.26,,16.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16.95,88,,percent of total billed charges,,,,,,,,,14.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.53,91,,percent of total billed charges,,,18.3,95,,percent of total billed charges,,,15.99,83,,percent of total billed charges,,,15.99,83,,percent of total billed charges,,,,,,,,,,,,,,,15.99,83,,percent of total billed charges,,,18.3,95,,percent of total billed charges,,,17.33,90,,percent of total billed charges,,,17.33,90,,percent of total billed charges,,,15.79,82,,percent of total billed charges,,,17.33,90,,percent of total billed charges,,,16.37,85,,percent of total billed charges,,14.52,18.3,
MERIT CATH RIM 5FR X 65CM,30186424,CDM,,,270,RC,inpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,150.8,190,
MERIT CATH LEGATO 4FR,30186425,CDM,,,270,RC,inpatient,,292.5,292.5,,248.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,220.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,248.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,257.4,88,,percent of total billed charges,,,,,,,,,223.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,266.18,91,,percent of total billed charges,,,277.88,95,,percent of total billed charges,,,242.78,83,,percent of total billed charges,,,242.78,83,,percent of total billed charges,,,,,,,,,,,,,,,242.78,83,,percent of total billed charges,,,277.88,95,,percent of total billed charges,,,263.25,90,,percent of total billed charges,,,263.25,90,,percent of total billed charges,,,239.85,82,,percent of total billed charges,,,263.25,90,,percent of total billed charges,,,248.63,85,,percent of total billed charges,,220.55,277.88,
FEMORAL INTRODUCER KIT 11FR,30186426,CDM,,,270,RC,inpatient,,159.04,159.04,,135.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,135.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.96,88,,percent of total billed charges,,,,,,,,,121.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,144.73,91,,percent of total billed charges,,,151.09,95,,percent of total billed charges,,,132,83,,percent of total billed charges,,,132,83,,percent of total billed charges,,,,,,,,,,,,,,,132,83,,percent of total billed charges,,,151.09,95,,percent of total billed charges,,,143.14,90,,percent of total billed charges,,,143.14,90,,percent of total billed charges,,,130.41,82,,percent of total billed charges,,,143.14,90,,percent of total billed charges,,,135.18,85,,percent of total billed charges,,119.92,151.09,
SOFT-VU SOS OMNI 5FR,30186427,CDM,,,270,RC,inpatient,,1118,1118,,949.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,842.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,950.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,983.84,88,,percent of total billed charges,,,,,,,,,854.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1017.38,91,,percent of total billed charges,,,1062.1,95,,percent of total billed charges,,,927.94,83,,percent of total billed charges,,,927.94,83,,percent of total billed charges,,,,,,,,,,,,,,,927.94,83,,percent of total billed charges,,,1062.1,95,,percent of total billed charges,,,1006.2,90,,percent of total billed charges,,,1006.2,90,,percent of total billed charges,,,916.76,82,,percent of total billed charges,,,1006.2,90,,percent of total billed charges,,,950.3,85,,percent of total billed charges,,842.97,1062.1,
AMPLATZ SUPER STIFF 75CM,30186428,CDM,,,270,RC,inpatient,,202.5,202.5,,171.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.2,88,,percent of total billed charges,,,,,,,,,154.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.28,91,,percent of total billed charges,,,192.38,95,,percent of total billed charges,,,168.08,83,,percent of total billed charges,,,168.08,83,,percent of total billed charges,,,,,,,,,,,,,,,168.08,83,,percent of total billed charges,,,192.38,95,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,166.05,82,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,172.13,85,,percent of total billed charges,,152.69,192.38,
AMPLATZ SUPER STIFF 145CM,30186429,CDM,,,270,RC,inpatient,,202.5,202.5,,171.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.2,88,,percent of total billed charges,,,,,,,,,154.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.28,91,,percent of total billed charges,,,192.38,95,,percent of total billed charges,,,168.08,83,,percent of total billed charges,,,168.08,83,,percent of total billed charges,,,,,,,,,,,,,,,168.08,83,,percent of total billed charges,,,192.38,95,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,166.05,82,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,172.13,85,,percent of total billed charges,,152.69,192.38,
VESSEL LOOP DEVON YELLOW,30186437,CDM,,,270,RC,inpatient,,10.17,10.17,,8.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8.95,88,,percent of total billed charges,,,,,,,,,7.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9.25,91,,percent of total billed charges,,,9.66,95,,percent of total billed charges,,,8.44,83,,percent of total billed charges,,,8.44,83,,percent of total billed charges,,,,,,,,,,,,,,,8.44,83,,percent of total billed charges,,,9.66,95,,percent of total billed charges,,,9.15,90,,percent of total billed charges,,,9.15,90,,percent of total billed charges,,,8.34,82,,percent of total billed charges,,,9.15,90,,percent of total billed charges,,,8.64,85,,percent of total billed charges,,7.67,9.66,
TIP CANNULA BEVELLED VEIN IRRIG.,30186441,CDM,,,270,RC,inpatient,,191.54,191.54,,162.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.56,88,,percent of total billed charges,,,,,,,,,146.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.3,91,,percent of total billed charges,,,181.96,95,,percent of total billed charges,,,158.98,83,,percent of total billed charges,,,158.98,83,,percent of total billed charges,,,,,,,,,,,,,,,158.98,83,,percent of total billed charges,,,181.96,95,,percent of total billed charges,,,172.39,90,,percent of total billed charges,,,172.39,90,,percent of total billed charges,,,157.06,82,,percent of total billed charges,,,172.39,90,,percent of total billed charges,,,162.81,85,,percent of total billed charges,,144.42,181.96,
SOFTJAW INSERT SET 33MM,30186442,CDM,,,270,RC,inpatient,,351.15,351.15,,298.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,264.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,298.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,309.01,88,,percent of total billed charges,,,,,,,,,268.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,319.55,91,,percent of total billed charges,,,333.59,95,,percent of total billed charges,,,291.45,83,,percent of total billed charges,,,291.45,83,,percent of total billed charges,,,,,,,,,,,,,,,291.45,83,,percent of total billed charges,,,333.59,95,,percent of total billed charges,,,316.04,90,,percent of total billed charges,,,316.04,90,,percent of total billed charges,,,287.94,82,,percent of total billed charges,,,316.04,90,,percent of total billed charges,,,298.48,85,,percent of total billed charges,,264.77,333.59,
STEALTH CLAMP INSERT 60MM,30186443,CDM,,,270,RC,inpatient,,152.8,152.8,,129.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.46,88,,percent of total billed charges,,,,,,,,,116.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,139.05,91,,percent of total billed charges,,,145.16,95,,percent of total billed charges,,,126.82,83,,percent of total billed charges,,,126.82,83,,percent of total billed charges,,,,,,,,,,,,,,,126.82,83,,percent of total billed charges,,,145.16,95,,percent of total billed charges,,,137.52,90,,percent of total billed charges,,,137.52,90,,percent of total billed charges,,,125.3,82,,percent of total billed charges,,,137.52,90,,percent of total billed charges,,,129.88,85,,percent of total billed charges,,115.21,145.16,
VESSEL LOOP MAXI RED 1X406MM,30186444,CDM,,,270,RC,inpatient,,15.75,15.75,,13.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.86,88,,percent of total billed charges,,,,,,,,,12.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.33,91,,percent of total billed charges,,,14.96,95,,percent of total billed charges,,,13.07,83,,percent of total billed charges,,,13.07,83,,percent of total billed charges,,,,,,,,,,,,,,,13.07,83,,percent of total billed charges,,,14.96,95,,percent of total billed charges,,,14.18,90,,percent of total billed charges,,,14.18,90,,percent of total billed charges,,,12.92,82,,percent of total billed charges,,,14.18,90,,percent of total billed charges,,,13.39,85,,percent of total billed charges,,11.88,14.96,
CLIPS LIGATING TITANIUM YELLOW SMALL,30186446,CDM,,,270,RC,inpatient,,103.33,103.33,,87.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.93,88,,percent of total billed charges,,,,,,,,,78.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,94.03,91,,percent of total billed charges,,,98.16,95,,percent of total billed charges,,,85.76,83,,percent of total billed charges,,,85.76,83,,percent of total billed charges,,,,,,,,,,,,,,,85.76,83,,percent of total billed charges,,,98.16,95,,percent of total billed charges,,,93,90,,percent of total billed charges,,,93,90,,percent of total billed charges,,,84.73,82,,percent of total billed charges,,,93,90,,percent of total billed charges,,,87.83,85,,percent of total billed charges,,77.91,98.16,
CLIPS LIGATING TITANIUM MEDIUM,30186447,CDM,,,270,RC,inpatient,,25.34,25.34,,21.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.3,88,,percent of total billed charges,,,,,,,,,19.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.06,91,,percent of total billed charges,,,24.07,95,,percent of total billed charges,,,21.03,83,,percent of total billed charges,,,21.03,83,,percent of total billed charges,,,,,,,,,,,,,,,21.03,83,,percent of total billed charges,,,24.07,95,,percent of total billed charges,,,22.81,90,,percent of total billed charges,,,22.81,90,,percent of total billed charges,,,20.78,82,,percent of total billed charges,,,22.81,90,,percent of total billed charges,,,21.54,85,,percent of total billed charges,,19.11,24.07,
CLIPS LIGATING TITANIUM LARGE,30186448,CDM,,,270,RC,inpatient,,123.04,123.04,,104.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,92.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,104.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,108.28,88,,percent of total billed charges,,,,,,,,,94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.97,91,,percent of total billed charges,,,116.89,95,,percent of total billed charges,,,102.12,83,,percent of total billed charges,,,102.12,83,,percent of total billed charges,,,,,,,,,,,,,,,102.12,83,,percent of total billed charges,,,116.89,95,,percent of total billed charges,,,110.74,90,,percent of total billed charges,,,110.74,90,,percent of total billed charges,,,100.89,82,,percent of total billed charges,,,110.74,90,,percent of total billed charges,,,104.58,85,,percent of total billed charges,,92.77,116.89,
CATH ARTERIAL EMBOLECTOMY 5FR,30186449,CDM,,,270,RC,inpatient,,1245.4,1245.4,,1057.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,939.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1058.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1095.95,88,,percent of total billed charges,,,,,,,,,951.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1133.31,91,,percent of total billed charges,,,1183.13,95,,percent of total billed charges,,,1033.68,83,,percent of total billed charges,,,1033.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.68,83,,percent of total billed charges,,,1183.13,95,,percent of total billed charges,,,1120.86,90,,percent of total billed charges,,,1120.86,90,,percent of total billed charges,,,1021.23,82,,percent of total billed charges,,,1120.86,90,,percent of total billed charges,,,1058.59,85,,percent of total billed charges,,939.03,1183.13,
SHUNT KIT CAROTID ARTERY,30186450,CDM,,,270,RC,inpatient,,197.48,197.48,,167.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.78,88,,percent of total billed charges,,,,,,,,,150.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.71,91,,percent of total billed charges,,,187.61,95,,percent of total billed charges,,,163.91,83,,percent of total billed charges,,,163.91,83,,percent of total billed charges,,,,,,,,,,,,,,,163.91,83,,percent of total billed charges,,,187.61,95,,percent of total billed charges,,,177.73,90,,percent of total billed charges,,,177.73,90,,percent of total billed charges,,,161.93,82,,percent of total billed charges,,,177.73,90,,percent of total billed charges,,,167.86,85,,percent of total billed charges,,148.9,187.61,
CATH EMBOLECTOMY FOGARTY 60CM 2FR,30186451,CDM,,,270,RC,inpatient,,2577.77,2577.77,,2188.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1943.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2191.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2268.44,88,,percent of total billed charges,,,,,,,,,1969.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2345.77,91,,percent of total billed charges,,,2448.88,95,,percent of total billed charges,,,2139.55,83,,percent of total billed charges,,,2139.55,83,,percent of total billed charges,,,,,,,,,,,,,,,2139.55,83,,percent of total billed charges,,,2448.88,95,,percent of total billed charges,,,2319.99,90,,percent of total billed charges,,,2319.99,90,,percent of total billed charges,,,2113.77,82,,percent of total billed charges,,,2319.99,90,,percent of total billed charges,,,2191.1,85,,percent of total billed charges,,1943.64,2448.88,
CATH EMBOLECTOMY FOGARTY 80CM 3FR,30186452,CDM,,,270,RC,inpatient,,1245.53,1245.53,,1057.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,939.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1058.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1096.07,88,,percent of total billed charges,,,,,,,,,951.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1133.43,91,,percent of total billed charges,,,1183.25,95,,percent of total billed charges,,,1033.79,83,,percent of total billed charges,,,1033.79,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.79,83,,percent of total billed charges,,,1183.25,95,,percent of total billed charges,,,1120.98,90,,percent of total billed charges,,,1120.98,90,,percent of total billed charges,,,1021.33,82,,percent of total billed charges,,,1120.98,90,,percent of total billed charges,,,1058.7,85,,percent of total billed charges,,939.13,1183.25,
CATH IRRIGATION FOGARTY 4FR,30186453,CDM,,,270,RC,inpatient,,320.63,320.63,,272.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,241.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,272.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,282.15,88,,percent of total billed charges,,,,,,,,,244.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,291.77,91,,percent of total billed charges,,,304.6,95,,percent of total billed charges,,,266.12,83,,percent of total billed charges,,,266.12,83,,percent of total billed charges,,,,,,,,,,,,,,,266.12,83,,percent of total billed charges,,,304.6,95,,percent of total billed charges,,,288.57,90,,percent of total billed charges,,,288.57,90,,percent of total billed charges,,,262.92,82,,percent of total billed charges,,,288.57,90,,percent of total billed charges,,,272.54,85,,percent of total billed charges,,241.76,304.6,
CATH IRRIGATION FOGARTY 6FR,30186454,CDM,,,270,RC,inpatient,,383.39,383.39,,325.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,289.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,325.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,337.38,88,,percent of total billed charges,,,,,,,,,292.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,348.88,91,,percent of total billed charges,,,364.22,95,,percent of total billed charges,,,318.21,83,,percent of total billed charges,,,318.21,83,,percent of total billed charges,,,,,,,,,,,,,,,318.21,83,,percent of total billed charges,,,364.22,95,,percent of total billed charges,,,345.05,90,,percent of total billed charges,,,345.05,90,,percent of total billed charges,,,314.38,82,,percent of total billed charges,,,345.05,90,,percent of total billed charges,,,325.88,85,,percent of total billed charges,,289.08,364.22,
SYNTHES PLATE PHALANGEAL BASE 1.3 TI,30186455,CDM,,,278,RC,inpatient,,4922.52,4922.52,,4179.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3711.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4184.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4331.82,88,,percent of total billed charges,,,,,,,,,3760.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4479.49,91,,percent of total billed charges,,,4676.39,95,,percent of total billed charges,,,4085.69,83,,percent of total billed charges,,,4085.69,83,,percent of total billed charges,,,,,,,,,,,,,,,4085.69,83,,percent of total billed charges,,,4676.39,95,,percent of total billed charges,,,4430.27,90,,percent of total billed charges,,,4430.27,90,,percent of total billed charges,,,4036.47,82,,percent of total billed charges,,,4430.27,90,,percent of total billed charges,,,4184.14,85,,percent of total billed charges,,3711.58,4676.39,
SYNTHES SCREW CORTEX 10MM,30186456,CDM,,,278,RC,inpatient,,471.87,471.87,,400.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,355.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,401.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,415.25,88,,percent of total billed charges,,,,,,,,,360.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,429.4,91,,percent of total billed charges,,,448.28,95,,percent of total billed charges,,,391.65,83,,percent of total billed charges,,,391.65,83,,percent of total billed charges,,,,,,,,,,,,,,,391.65,83,,percent of total billed charges,,,448.28,95,,percent of total billed charges,,,424.68,90,,percent of total billed charges,,,424.68,90,,percent of total billed charges,,,386.93,82,,percent of total billed charges,,,424.68,90,,percent of total billed charges,,,401.09,85,,percent of total billed charges,,355.79,448.28,
SYNTHES SCREW LOCKING 9MM,30186457,CDM,,,278,RC,inpatient,,1155.25,1155.25,,980.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,871.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,981.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1016.62,88,,percent of total billed charges,,,,,,,,,882.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1051.28,91,,percent of total billed charges,,,1097.49,95,,percent of total billed charges,,,958.86,83,,percent of total billed charges,,,958.86,83,,percent of total billed charges,,,,,,,,,,,,,,,958.86,83,,percent of total billed charges,,,1097.49,95,,percent of total billed charges,,,1039.73,90,,percent of total billed charges,,,1039.73,90,,percent of total billed charges,,,947.31,82,,percent of total billed charges,,,1039.73,90,,percent of total billed charges,,,981.96,85,,percent of total billed charges,,871.06,1097.49,
SYNTHES SCREW LOCKING 10MM,30186458,CDM,,,278,RC,inpatient,,1155.25,1155.25,,980.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,871.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,981.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1016.62,88,,percent of total billed charges,,,,,,,,,882.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1051.28,91,,percent of total billed charges,,,1097.49,95,,percent of total billed charges,,,958.86,83,,percent of total billed charges,,,958.86,83,,percent of total billed charges,,,,,,,,,,,,,,,958.86,83,,percent of total billed charges,,,1097.49,95,,percent of total billed charges,,,1039.73,90,,percent of total billed charges,,,1039.73,90,,percent of total billed charges,,,947.31,82,,percent of total billed charges,,,1039.73,90,,percent of total billed charges,,,981.96,85,,percent of total billed charges,,871.06,1097.49,
SYNTHES SCREW LOCKING 15MM,30186459,CDM,,,278,RC,inpatient,,978.84,978.84,,831.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,738.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,832.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,861.38,88,,percent of total billed charges,,,,,,,,,747.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,890.74,91,,percent of total billed charges,,,929.9,95,,percent of total billed charges,,,812.44,83,,percent of total billed charges,,,812.44,83,,percent of total billed charges,,,,,,,,,,,,,,,812.44,83,,percent of total billed charges,,,929.9,95,,percent of total billed charges,,,880.96,90,,percent of total billed charges,,,880.96,90,,percent of total billed charges,,,802.65,82,,percent of total billed charges,,,880.96,90,,percent of total billed charges,,,832.01,85,,percent of total billed charges,,738.05,929.9,
SYNTHES DRILL BIT 1.0,30186460,CDM,,,278,RC,inpatient,,830.83,830.83,,705.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,626.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,706.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,731.13,88,,percent of total billed charges,,,,,,,,,634.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,756.06,91,,percent of total billed charges,,,789.29,95,,percent of total billed charges,,,689.59,83,,percent of total billed charges,,,689.59,83,,percent of total billed charges,,,,,,,,,,,,,,,689.59,83,,percent of total billed charges,,,789.29,95,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,681.28,82,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,706.21,85,,percent of total billed charges,,626.45,789.29,
SYNTHES PLATE CONDYLER 1.5,30186461,CDM,,,278,RC,inpatient,,4655.04,4655.04,,3952.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3509.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3956.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4096.44,88,,percent of total billed charges,,,,,,,,,3556.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4236.09,91,,percent of total billed charges,,,4422.29,95,,percent of total billed charges,,,3863.68,83,,percent of total billed charges,,,3863.68,83,,percent of total billed charges,,,,,,,,,,,,,,,3863.68,83,,percent of total billed charges,,,4422.29,95,,percent of total billed charges,,,4189.54,90,,percent of total billed charges,,,4189.54,90,,percent of total billed charges,,,3817.13,82,,percent of total billed charges,,,4189.54,90,,percent of total billed charges,,,3956.78,85,,percent of total billed charges,,3509.9,4422.29,
SYNTHES PLATE PHALANGEAL BASE 2.0,30186462,CDM,,,278,RC,inpatient,,5599.69,5599.69,,4754.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4222.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4759.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4927.73,88,,percent of total billed charges,,,,,,,,,4278.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5095.72,91,,percent of total billed charges,,,5319.71,95,,percent of total billed charges,,,4647.74,83,,percent of total billed charges,,,4647.74,83,,percent of total billed charges,,,,,,,,,,,,,,,4647.74,83,,percent of total billed charges,,,5319.71,95,,percent of total billed charges,,,5039.72,90,,percent of total billed charges,,,5039.72,90,,percent of total billed charges,,,4591.75,82,,percent of total billed charges,,,5039.72,90,,percent of total billed charges,,,4759.74,85,,percent of total billed charges,,4222.17,5319.71,
SYNTHES SCREW CORTEX 1.5 X 15MM,30186463,CDM,,,278,RC,inpatient,,504.98,504.98,,428.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,380.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,429.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,444.38,88,,percent of total billed charges,,,,,,,,,385.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,459.53,91,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,,,,,,,,,,,,,419.13,83,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,414.08,82,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,380.75,479.73,
SYNTHES SCREW LOCKING 1.5 X 9MM,30186464,CDM,,,278,RC,inpatient,,1138.15,1138.15,,966.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,858.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,967.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001.57,88,,percent of total billed charges,,,,,,,,,869.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.72,91,,percent of total billed charges,,,1081.24,95,,percent of total billed charges,,,944.66,83,,percent of total billed charges,,,944.66,83,,percent of total billed charges,,,,,,,,,,,,,,,944.66,83,,percent of total billed charges,,,1081.24,95,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,933.28,82,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,967.43,85,,percent of total billed charges,,858.17,1081.24,
SYNTHES SCREW LOCKING 1.5 X 11MM,30186465,CDM,,,278,RC,inpatient,,1138.15,1138.15,,966.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,858.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,967.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001.57,88,,percent of total billed charges,,,,,,,,,869.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.72,91,,percent of total billed charges,,,1081.24,95,,percent of total billed charges,,,944.66,83,,percent of total billed charges,,,944.66,83,,percent of total billed charges,,,,,,,,,,,,,,,944.66,83,,percent of total billed charges,,,1081.24,95,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,933.28,82,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,967.43,85,,percent of total billed charges,,858.17,1081.24,
SYNTHES SCREW LOCKING 1.5 X 14MM,30186466,CDM,,,278,RC,inpatient,,1138.15,1138.15,,966.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,858.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,967.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001.57,88,,percent of total billed charges,,,,,,,,,869.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.72,91,,percent of total billed charges,,,1081.24,95,,percent of total billed charges,,,944.66,83,,percent of total billed charges,,,944.66,83,,percent of total billed charges,,,,,,,,,,,,,,,944.66,83,,percent of total billed charges,,,1081.24,95,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,933.28,82,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,967.43,85,,percent of total billed charges,,858.17,1081.24,
SYNTHES SCREW CORTEX 2.0 x 8MM,30186467,CDM,,,278,RC,inpatient,,490.28,490.28,,416.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,369.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,416.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,431.45,88,,percent of total billed charges,,,,,,,,,374.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,446.15,91,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,,,,,,,,,,,,,406.93,83,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,402.03,82,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,416.74,85,,percent of total billed charges,,369.67,465.77,
SYNTHES SCREW CORTEX 2.0 x 13MM,30186468,CDM,,,278,RC,inpatient,,490.28,490.28,,416.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,369.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,416.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,431.45,88,,percent of total billed charges,,,,,,,,,374.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,446.15,91,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,,,,,,,,,,,,,406.93,83,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,402.03,82,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,416.74,85,,percent of total billed charges,,369.67,465.77,
SYNTHES SCREW LOCKING 2.0 X 9MM,30186469,CDM,,,278,RC,inpatient,,1183.65,1183.65,,1004.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,892.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1006.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1041.61,88,,percent of total billed charges,,,,,,,,,904.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1077.12,91,,percent of total billed charges,,,1124.47,95,,percent of total billed charges,,,982.43,83,,percent of total billed charges,,,982.43,83,,percent of total billed charges,,,,,,,,,,,,,,,982.43,83,,percent of total billed charges,,,1124.47,95,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,970.59,82,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,1006.1,85,,percent of total billed charges,,892.47,1124.47,
SYNTHES SCREW LOCKING 2.0 X 11MM,30186470,CDM,,,278,RC,inpatient,,1183.65,1183.65,,1004.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,892.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1006.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1041.61,88,,percent of total billed charges,,,,,,,,,904.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1077.12,91,,percent of total billed charges,,,1124.47,95,,percent of total billed charges,,,982.43,83,,percent of total billed charges,,,982.43,83,,percent of total billed charges,,,,,,,,,,,,,,,982.43,83,,percent of total billed charges,,,1124.47,95,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,970.59,82,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,1006.1,85,,percent of total billed charges,,892.47,1124.47,
SYNTHES SCREW LOCKING 2.0 X 12MM,30186471,CDM,,,278,RC,inpatient,,1183.65,1183.65,,1004.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,892.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1006.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1041.61,88,,percent of total billed charges,,,,,,,,,904.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1077.12,91,,percent of total billed charges,,,1124.47,95,,percent of total billed charges,,,982.43,83,,percent of total billed charges,,,982.43,83,,percent of total billed charges,,,,,,,,,,,,,,,982.43,83,,percent of total billed charges,,,1124.47,95,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,970.59,82,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,1006.1,85,,percent of total billed charges,,892.47,1124.47,
SYNTHES SCREW LOCKING 2.0 X 15MM,30186472,CDM,,,278,RC,inpatient,,1183.65,1183.65,,1004.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,892.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1006.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1041.61,88,,percent of total billed charges,,,,,,,,,904.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1077.12,91,,percent of total billed charges,,,1124.47,95,,percent of total billed charges,,,982.43,83,,percent of total billed charges,,,982.43,83,,percent of total billed charges,,,,,,,,,,,,,,,982.43,83,,percent of total billed charges,,,1124.47,95,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,970.59,82,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,1006.1,85,,percent of total billed charges,,892.47,1124.47,
TERUMO GLIDEWIRE ANGLED CATH 4FR,30186473,CDM,,,270,RC,inpatient,,577.5,577.5,,490.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,435.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,490.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,508.2,88,,percent of total billed charges,,,,,,,,,441.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,525.53,91,,percent of total billed charges,,,548.63,95,,percent of total billed charges,,,479.33,83,,percent of total billed charges,,,479.33,83,,percent of total billed charges,,,,,,,,,,,,,,,479.33,83,,percent of total billed charges,,,548.63,95,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,473.55,82,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,490.88,85,,percent of total billed charges,,435.44,548.63,
COOK WIRE GUIDE EXTRA STIFF 0.35 X 260CM,30186474,CDM,,,270,RC,inpatient,,828.8,828.8,,703.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,624.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,704.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,729.34,88,,percent of total billed charges,,,,,,,,,633.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,754.21,91,,percent of total billed charges,,,787.36,95,,percent of total billed charges,,,687.9,83,,percent of total billed charges,,,687.9,83,,percent of total billed charges,,,,,,,,,,,,,,,687.9,83,,percent of total billed charges,,,787.36,95,,percent of total billed charges,,,745.92,90,,percent of total billed charges,,,745.92,90,,percent of total billed charges,,,679.62,82,,percent of total billed charges,,,745.92,90,,percent of total billed charges,,,704.48,85,,percent of total billed charges,,624.92,787.36,
COOK CATH BALLOON CODA LP 9FR,30186475,CDM,,,270,RC,inpatient,,2964,2964,,2516.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2234.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2519.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2608.32,88,,percent of total billed charges,,,,,,,,,2264.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2697.24,91,,percent of total billed charges,,,2815.8,95,,percent of total billed charges,,,2460.12,83,,percent of total billed charges,,,2460.12,83,,percent of total billed charges,,,,,,,,,,,,,,,2460.12,83,,percent of total billed charges,,,2815.8,95,,percent of total billed charges,,,2667.6,90,,percent of total billed charges,,,2667.6,90,,percent of total billed charges,,,2430.48,82,,percent of total billed charges,,,2667.6,90,,percent of total billed charges,,,2519.4,85,,percent of total billed charges,,2234.86,2815.8,
COAGRASPER G MONOPOLAR 6.5 X 165 STOMACH,30186477,CDM,,,270,RC,inpatient,,1229.74,1229.74,,1044.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,927.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1045.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1082.17,88,,percent of total billed charges,,,,,,,,,939.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1119.06,91,,percent of total billed charges,,,1168.25,95,,percent of total billed charges,,,1020.68,83,,percent of total billed charges,,,1020.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1020.68,83,,percent of total billed charges,,,1168.25,95,,percent of total billed charges,,,1106.77,90,,percent of total billed charges,,,1106.77,90,,percent of total billed charges,,,1008.39,82,,percent of total billed charges,,,1106.77,90,,percent of total billed charges,,,1045.28,85,,percent of total billed charges,,927.22,1168.25,
ELECTROSURGICAL KNIFE 2.7X1650X2.0MM STO,30186478,CDM,,,270,RC,inpatient,,6623.5,6623.5,,5623.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4994.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5629.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5828.68,88,,percent of total billed charges,,,,,,,,,5060.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6027.39,91,,percent of total billed charges,,,6292.33,95,,percent of total billed charges,,,5497.51,83,,percent of total billed charges,,,5497.51,83,,percent of total billed charges,,,,,,,,,,,,,,,5497.51,83,,percent of total billed charges,,,6292.33,95,,percent of total billed charges,,,5961.15,90,,percent of total billed charges,,,5961.15,90,,percent of total billed charges,,,5431.27,82,,percent of total billed charges,,,5961.15,90,,percent of total billed charges,,,5629.98,85,,percent of total billed charges,,4994.12,6292.33,
ELECTROSURGICAL KNIFE 2.7X2300X1.5MM COL,30186479,CDM,,,270,RC,inpatient,,6623.5,6623.5,,5623.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4994.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5629.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5828.68,88,,percent of total billed charges,,,,,,,,,5060.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6027.39,91,,percent of total billed charges,,,6292.33,95,,percent of total billed charges,,,5497.51,83,,percent of total billed charges,,,5497.51,83,,percent of total billed charges,,,,,,,,,,,,,,,5497.51,83,,percent of total billed charges,,,6292.33,95,,percent of total billed charges,,,5961.15,90,,percent of total billed charges,,,5961.15,90,,percent of total billed charges,,,5431.27,82,,percent of total billed charges,,,5961.15,90,,percent of total billed charges,,,5629.98,85,,percent of total billed charges,,4994.12,6292.33,
DEPUY ATTUNE TIBIA AUGMENT SZ 8 5MM,30186480,CDM,,,278,RC,inpatient,,10997.61,10997.61,,9336.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8292.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9347.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9677.9,88,,percent of total billed charges,,,,,,,,,8402.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10007.83,91,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,,,,,,,,,,,,,9128.02,83,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9018.04,82,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,8292.2,10447.73,
SHEATH INTRODUCER PRELUDE 7FR,30186481,CDM,,,270,RC,inpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,76.91,96.9,
CATH ANGIO PIG 5FR,30186482,CDM,,,270,RC,inpatient,,845,845,,717.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,637.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,718.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,743.6,88,,percent of total billed charges,,,,,,,,,645.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,768.95,91,,percent of total billed charges,,,802.75,95,,percent of total billed charges,,,701.35,83,,percent of total billed charges,,,701.35,83,,percent of total billed charges,,,,,,,,,,,,,,,701.35,83,,percent of total billed charges,,,802.75,95,,percent of total billed charges,,,760.5,90,,percent of total billed charges,,,760.5,90,,percent of total billed charges,,,692.9,82,,percent of total billed charges,,,760.5,90,,percent of total billed charges,,,718.25,85,,percent of total billed charges,,637.13,802.75,
SHEATH CATH CORDIS BRITE TIP 10FR FUSCHI,30186484,CDM,,,270,RC,inpatient,,92,92,,78.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,69.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,78.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.96,88,,percent of total billed charges,,,,,,,,,70.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,,,,,,,,,,,,,76.36,83,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,75.44,82,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,69.37,87.4,
RIGID ARGON PLASMA COAGULATION APPLICATO,30186485,CDM,,,270,RC,inpatient,,1277.9,1277.9,,1084.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,963.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1086.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1124.55,88,,percent of total billed charges,,,,,,,,,976.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1162.89,91,,percent of total billed charges,,,1214.01,95,,percent of total billed charges,,,1060.66,83,,percent of total billed charges,,,1060.66,83,,percent of total billed charges,,,,,,,,,,,,,,,1060.66,83,,percent of total billed charges,,,1214.01,95,,percent of total billed charges,,,1150.11,90,,percent of total billed charges,,,1150.11,90,,percent of total billed charges,,,1047.88,82,,percent of total billed charges,,,1150.11,90,,percent of total billed charges,,,1086.22,85,,percent of total billed charges,,963.54,1214.01,
STRYKER BLADE AGGRESSIVE PLUS XL,30186486,CDM,,,270,RC,inpatient,,641.62,641.62,,544.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,483.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,545.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,564.63,88,,percent of total billed charges,,,,,,,,,490.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,583.87,91,,percent of total billed charges,,,609.54,95,,percent of total billed charges,,,532.54,83,,percent of total billed charges,,,532.54,83,,percent of total billed charges,,,,,,,,,,,,,,,532.54,83,,percent of total billed charges,,,609.54,95,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,526.13,82,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,545.38,85,,percent of total billed charges,,483.78,609.54,
SYNTHES TFNA 11MM X 400MM 130DEG RT,30186487,CDM,,,278,RC,inpatient,,21784.17,21784.17,,18494.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16425.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18516.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19170.07,88,,percent of total billed charges,,,,,,,,,16643.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19823.59,91,,percent of total billed charges,,,20694.96,95,,percent of total billed charges,,,18080.86,83,,percent of total billed charges,,,18080.86,83,,percent of total billed charges,,,,,,,,,,,,,,,18080.86,83,,percent of total billed charges,,,20694.96,95,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,17863.02,82,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,18516.54,85,,percent of total billed charges,,16425.26,20694.96,
SYNTHES TFNA HELICAL BLADE 110MM,30186488,CDM,,,278,RC,inpatient,,7033.78,7033.78,,5971.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5303.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5978.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6189.73,88,,percent of total billed charges,,,,,,,,,5373.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6400.74,91,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,,,,,,,,,,,,,5838.04,83,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5767.7,82,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5978.71,85,,percent of total billed charges,,5303.47,6682.09,
SYNTHES SCREW LOCKING 5.0 X 56MM,30186489,CDM,,,278,RC,inpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1697.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1913.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,1697.12,2138.28,
SYNTHES TRAUMACEM V+ SYRINGE KIT,30186490,CDM,,,270,RC,inpatient,,1365.78,1365.78,,1159.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1029.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1160.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1201.89,88,,percent of total billed charges,,,,,,,,,1043.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1242.86,91,,percent of total billed charges,,,1297.49,95,,percent of total billed charges,,,1133.6,83,,percent of total billed charges,,,1133.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1133.6,83,,percent of total billed charges,,,1297.49,95,,percent of total billed charges,,,1229.2,90,,percent of total billed charges,,,1229.2,90,,percent of total billed charges,,,1119.94,82,,percent of total billed charges,,,1229.2,90,,percent of total billed charges,,,1160.91,85,,percent of total billed charges,,1029.8,1297.49,
ABBOTT PACING CABLES,30186491,CDM,,,270,RC,inpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,169.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,191.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,169.65,213.75,
ABBOTT LEAD VENTRICULAR 65CM,30186492,CDM,,,278,RC,inpatient,,29250,29250,,24833.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22054.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24862.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25740,88,,percent of total billed charges,,,,,,,,,22347,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26617.5,91,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,,,,,,,,,,,,,24277.5,83,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,23985,82,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,22054.5,27787.5,
ABBOTT ICD  FORTIFY ASSURA MRI,30186493,CDM,,,278,RC,inpatient,,94250,94250,,80018.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71064.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80112.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,82940,88,,percent of total billed charges,,,,,,,,,72007,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,85767.5,91,,percent of total billed charges,,,89537.5,95,,percent of total billed charges,,,78227.5,83,,percent of total billed charges,,,78227.5,83,,percent of total billed charges,,,,,,,,,,,,,,,78227.5,83,,percent of total billed charges,,,89537.5,95,,percent of total billed charges,,,84825,90,,percent of total billed charges,,,84825,90,,percent of total billed charges,,,77285,82,,percent of total billed charges,,,84825,90,,percent of total billed charges,,,80112.5,85,,percent of total billed charges,,71064.5,89537.5,
ZIMMER TUBE CORING ON IMPLANT,30186494,CDM,,,278,RC,inpatient,,4603.5,4603.5,,3908.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3471.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3912.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4051.08,88,,percent of total billed charges,,,,,,,,,3517.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4189.19,91,,percent of total billed charges,,,4373.33,95,,percent of total billed charges,,,3820.91,83,,percent of total billed charges,,,3820.91,83,,percent of total billed charges,,,,,,,,,,,,,,,3820.91,83,,percent of total billed charges,,,4373.33,95,,percent of total billed charges,,,4143.15,90,,percent of total billed charges,,,4143.15,90,,percent of total billed charges,,,3774.87,82,,percent of total billed charges,,,4143.15,90,,percent of total billed charges,,,3912.98,85,,percent of total billed charges,,3471.04,4373.33,
GORE VBX BALLOON EXPANDABLE ENDOPROSTHES,30186497,CDM,,,270,RC,inpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17516.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19746.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,17516.17,22069.45,
ENSNARE HEMOSTATIS VALVE ADAPTER,30186498,CDM,,,270,RC,inpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,150.8,190,
EN SNARE SYSTEM 30MM,30186499,CDM,,,270,RC,inpatient,,2632.5,2632.5,,2234.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1984.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2237.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2316.6,88,,percent of total billed charges,,,,,,,,,2011.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2395.58,91,,percent of total billed charges,,,2500.88,95,,percent of total billed charges,,,2184.98,83,,percent of total billed charges,,,2184.98,83,,percent of total billed charges,,,,,,,,,,,,,,,2184.98,83,,percent of total billed charges,,,2500.88,95,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2158.65,82,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2237.63,85,,percent of total billed charges,,1984.91,2500.88,
CATHETER SINGLE LUMEN SHEATH 17FR,30186500,CDM,,,270,RC,inpatient,,3243.5,3243.5,,2753.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2445.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2756.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2854.28,88,,percent of total billed charges,,,,,,,,,2478.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2951.59,91,,percent of total billed charges,,,3081.33,95,,percent of total billed charges,,,2692.11,83,,percent of total billed charges,,,2692.11,83,,percent of total billed charges,,,,,,,,,,,,,,,2692.11,83,,percent of total billed charges,,,3081.33,95,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2659.67,82,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2756.98,85,,percent of total billed charges,,2445.6,3081.33,
STENT BIFURCATED AFX2 28X80MM,30186501,CDM,,,278,RC,inpatient,,94243.5,94243.5,,80012.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71059.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80106.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,82934.28,88,,percent of total billed charges,,,,,,,,,72002.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,85761.59,91,,percent of total billed charges,,,89531.33,95,,percent of total billed charges,,,78222.11,83,,percent of total billed charges,,,78222.11,83,,percent of total billed charges,,,,,,,,,,,,,,,78222.11,83,,percent of total billed charges,,,89531.33,95,,percent of total billed charges,,,84819.15,90,,percent of total billed charges,,,84819.15,90,,percent of total billed charges,,,77279.67,82,,percent of total billed charges,,,84819.15,90,,percent of total billed charges,,,80106.98,85,,percent of total billed charges,,71059.6,89531.33,
VELA SUPRARENAL ENDOGRAFT 34X34MM,30186502,CDM,,,278,RC,inpatient,,35743.5,35743.5,,30346.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26950.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30381.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31454.28,88,,percent of total billed charges,,,,,,,,,27308.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32526.59,91,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,,,,,,,,,,,,,29667.11,83,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,29309.67,82,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,30381.98,85,,percent of total billed charges,,26950.6,33956.33,
FUJI GASTROSCOPE STERILE HOOD,30186503,CDM,,,270,RC,inpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,277.1,349.13,
SYNTHES PLATE CLAVICLE 8 HOLE LEFT,30186504,CDM,,,278,RC,inpatient,,10328.7,10328.7,,8769.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7787.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8779.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9089.26,88,,percent of total billed charges,,,,,,,,,7891.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9399.12,91,,percent of total billed charges,,,9812.27,95,,percent of total billed charges,,,8572.82,83,,percent of total billed charges,,,8572.82,83,,percent of total billed charges,,,,,,,,,,,,,,,8572.82,83,,percent of total billed charges,,,9812.27,95,,percent of total billed charges,,,9295.83,90,,percent of total billed charges,,,9295.83,90,,percent of total billed charges,,,8469.53,82,,percent of total billed charges,,,9295.83,90,,percent of total billed charges,,,8779.4,85,,percent of total billed charges,,7787.84,9812.27,
FUJI CLONOSCOPE STERILE HOOD,30186505,CDM,,,270,RC,inpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,277.1,349.13,
DEPUY ATTUNE PRESSFIT KNEE,30186509,CDM,,,278,RC,inpatient,,42250,42250,,35870.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31856.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35912.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37180,88,,percent of total billed charges,,,,,,,,,32279,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38447.5,91,,percent of total billed charges,,,40137.5,95,,percent of total billed charges,,,35067.5,83,,percent of total billed charges,,,35067.5,83,,percent of total billed charges,,,,,,,,,,,,,,,35067.5,83,,percent of total billed charges,,,40137.5,95,,percent of total billed charges,,,38025,90,,percent of total billed charges,,,38025,90,,percent of total billed charges,,,34645,82,,percent of total billed charges,,,38025,90,,percent of total billed charges,,,35912.5,85,,percent of total billed charges,,31856.5,40137.5,
PERCLOSE,30186510,CDM,,,270,RC,inpatient,,1573,1573,,1335.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1186.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1337.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1384.24,88,,percent of total billed charges,,,,,,,,,1201.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1431.43,91,,percent of total billed charges,,,1494.35,95,,percent of total billed charges,,,1305.59,83,,percent of total billed charges,,,1305.59,83,,percent of total billed charges,,,,,,,,,,,,,,,1305.59,83,,percent of total billed charges,,,1494.35,95,,percent of total billed charges,,,1415.7,90,,percent of total billed charges,,,1415.7,90,,percent of total billed charges,,,1289.86,82,,percent of total billed charges,,,1415.7,90,,percent of total billed charges,,,1337.05,85,,percent of total billed charges,,1186.04,1494.35,
GUIDEWIRE SAFE T.J TIP .035 X 260CM,30186511,CDM,,,270,RC,inpatient,,143.92,143.92,,122.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.65,88,,percent of total billed charges,,,,,,,,,109.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,130.97,91,,percent of total billed charges,,,136.72,95,,percent of total billed charges,,,119.45,83,,percent of total billed charges,,,119.45,83,,percent of total billed charges,,,,,,,,,,,,,,,119.45,83,,percent of total billed charges,,,136.72,95,,percent of total billed charges,,,129.53,90,,percent of total billed charges,,,129.53,90,,percent of total billed charges,,,118.01,82,,percent of total billed charges,,,129.53,90,,percent of total billed charges,,,122.33,85,,percent of total billed charges,,108.52,136.72,
GUIDEWIRE STANDARD BENTSON 0.35 X 260CM,30186512,CDM,,,270,RC,inpatient,,160.8,160.8,,136.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,121.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,141.5,88,,percent of total billed charges,,,,,,,,,122.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,146.33,91,,percent of total billed charges,,,152.76,95,,percent of total billed charges,,,133.46,83,,percent of total billed charges,,,133.46,83,,percent of total billed charges,,,,,,,,,,,,,,,133.46,83,,percent of total billed charges,,,152.76,95,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,131.86,82,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,136.68,85,,percent of total billed charges,,121.24,152.76,
GUIDEWIRE ROSEN 0.35 X 260CM,30186513,CDM,,,270,RC,inpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,108.58,136.8,
KUMPE SOFTVU 4F 100CM X 0.035,30186514,CDM,,,270,RC,inpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,186.62,235.13,
STRYKER BURR ROUND STANDARD 3.0,30186515,CDM,,,270,RC,inpatient,,1312.42,1312.42,,1114.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,989.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1115.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1154.93,88,,percent of total billed charges,,,,,,,,,1002.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1194.3,91,,percent of total billed charges,,,1246.8,95,,percent of total billed charges,,,1089.31,83,,percent of total billed charges,,,1089.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1089.31,83,,percent of total billed charges,,,1246.8,95,,percent of total billed charges,,,1181.18,90,,percent of total billed charges,,,1181.18,90,,percent of total billed charges,,,1076.18,82,,percent of total billed charges,,,1181.18,90,,percent of total billed charges,,,1115.56,85,,percent of total billed charges,,989.56,1246.8,
SCANLAN TUNNELER SHEATH LRG BLUE,30186516,CDM,,,270,RC,inpatient,,392,392,,332.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,295.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.96,88,,percent of total billed charges,,,,,,,,,299.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,356.72,91,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,,,,,,,,,,,,,325.36,83,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,321.44,82,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,295.57,372.4,
SCANLAN TUNNELER SHEATH SM GREEN,30186517,CDM,,,270,RC,inpatient,,392,392,,332.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,295.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.96,88,,percent of total billed charges,,,,,,,,,299.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,356.72,91,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,,,,,,,,,,,,,325.36,83,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,321.44,82,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,295.57,372.4,
SCANLAN TUNNELER SHEATH LRG ORANGE,30186518,CDM,,,270,RC,inpatient,,392,392,,332.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,295.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.96,88,,percent of total billed charges,,,,,,,,,299.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,356.72,91,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,,,,,,,,,,,,,325.36,83,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,321.44,82,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,295.57,372.4,
SCANLAN TUNNELER SHEATH LRG ORANGE CURVE,30186519,CDM,,,270,RC,inpatient,,392,392,,332.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,295.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.96,88,,percent of total billed charges,,,,,,,,,299.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,356.72,91,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,,,,,,,,,,,,,325.36,83,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,321.44,82,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,295.57,372.4,
SCANLAN TUNNELER SHEATH SM YELLOW,30186520,CDM,,,270,RC,inpatient,,392,392,,332.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,295.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.96,88,,percent of total billed charges,,,,,,,,,299.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,356.72,91,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,,,,,,,,,,,,,325.36,83,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,321.44,82,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,295.57,372.4,
SCANLAN TUNNELER SHEATH SM YELLOW CURVED,30186521,CDM,,,270,RC,inpatient,,392,392,,332.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,295.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.96,88,,percent of total billed charges,,,,,,,,,299.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,356.72,91,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,,,,,,,,,,,,,325.36,83,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,321.44,82,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,295.57,372.4,
RIGID ARGON PLASMA COAGULATION APPLICATO,30186522,CDM,,,270,RC,inpatient,,1104.68,1104.68,,937.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,832.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,938.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,972.12,88,,percent of total billed charges,,,,,,,,,843.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1005.26,91,,percent of total billed charges,,,1049.45,95,,percent of total billed charges,,,916.88,83,,percent of total billed charges,,,916.88,83,,percent of total billed charges,,,,,,,,,,,,,,,916.88,83,,percent of total billed charges,,,1049.45,95,,percent of total billed charges,,,994.21,90,,percent of total billed charges,,,994.21,90,,percent of total billed charges,,,905.84,82,,percent of total billed charges,,,994.21,90,,percent of total billed charges,,,938.98,85,,percent of total billed charges,,832.93,1049.45,
DEPUY ATTUNE INSERT CRS FB SZ 6,30186523,CDM,,,278,RC,inpatient,,19355.77,19355.77,,16433.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14594.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16452.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17033.08,88,,percent of total billed charges,,,,,,,,,14787.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17613.75,91,,percent of total billed charges,,,18387.98,95,,percent of total billed charges,,,16065.29,83,,percent of total billed charges,,,16065.29,83,,percent of total billed charges,,,,,,,,,,,,,,,16065.29,83,,percent of total billed charges,,,18387.98,95,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,15871.73,82,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,16452.4,85,,percent of total billed charges,,14594.25,18387.98,
STEALTH FIBRA SPRING CLIP 6MM,30186525,CDM,,,270,RC,inpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,108.58,136.8,
ZIMMER TROCAR DRILL PIN 75MM,30186526,CDM,,,278,RC,inpatient,,2111.85,2111.85,,1792.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1592.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1795.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1858.43,88,,percent of total billed charges,,,,,,,,,1613.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1921.78,91,,percent of total billed charges,,,2006.26,95,,percent of total billed charges,,,1752.84,83,,percent of total billed charges,,,1752.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1752.84,83,,percent of total billed charges,,,2006.26,95,,percent of total billed charges,,,1900.67,90,,percent of total billed charges,,,1900.67,90,,percent of total billed charges,,,1731.72,82,,percent of total billed charges,,,1900.67,90,,percent of total billed charges,,,1795.07,85,,percent of total billed charges,,1592.33,2006.26,
ZIMMER PATELLA TM 10 X 38MM,30186527,CDM,,,278,RC,inpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3675.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4143.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,3675.75,4631.25,
ZIMMER INSERT ASF 10MM 8-11 GH,30186528,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
SPINECRAFT ROD TITANIUM 6.0 X 450MM,30186529,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
SHEATH CATH CORDIS BRITE TIP 10FR FUSCHI,30186531,CDM,,,270,RC,inpatient,,184,184,,156.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,138.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,156.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,161.92,88,,percent of total billed charges,,,,,,,,,140.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,,,,,,,,,,,,,152.72,83,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,150.88,82,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,138.74,174.8,
CORDIS BILIARY STENT 10X39MM 135CM PALMA,30186532,CDM,,,278,RC,inpatient,,5466.83,5466.83,,4641.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4121.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4646.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4810.81,88,,percent of total billed charges,,,,,,,,,4176.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4974.82,91,,percent of total billed charges,,,5193.49,95,,percent of total billed charges,,,4537.47,83,,percent of total billed charges,,,4537.47,83,,percent of total billed charges,,,,,,,,,,,,,,,4537.47,83,,percent of total billed charges,,,5193.49,95,,percent of total billed charges,,,4920.15,90,,percent of total billed charges,,,4920.15,90,,percent of total billed charges,,,4482.8,82,,percent of total billed charges,,,4920.15,90,,percent of total billed charges,,,4646.81,85,,percent of total billed charges,,4121.99,5193.49,
XENOSURE BIOLOGIC PATH 1X10CM,30186533,CDM,,,270,RC,inpatient,,1755,1755,,1490,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1323.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1491.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1544.4,88,,percent of total billed charges,,,,,,,,,1340.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1597.05,91,,percent of total billed charges,,,1667.25,95,,percent of total billed charges,,,1456.65,83,,percent of total billed charges,,,1456.65,83,,percent of total billed charges,,,,,,,,,,,,,,,1456.65,83,,percent of total billed charges,,,1667.25,95,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1439.1,82,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1491.75,85,,percent of total billed charges,,1323.27,1667.25,
XENOSURE BIOLOGIC PATH 2X9CM,30186534,CDM,,,270,RC,inpatient,,2184,2184,,1854.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1646.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1856.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1921.92,88,,percent of total billed charges,,,,,,,,,1668.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1987.44,91,,percent of total billed charges,,,2074.8,95,,percent of total billed charges,,,1812.72,83,,percent of total billed charges,,,1812.72,83,,percent of total billed charges,,,,,,,,,,,,,,,1812.72,83,,percent of total billed charges,,,2074.8,95,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1790.88,82,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1856.4,85,,percent of total billed charges,,1646.74,2074.8,
DEPUY TIBIA REV FB SZ 6,30186535,CDM,,,278,RC,inpatient,,25954.31,25954.31,,22035.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19569.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22061.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22839.79,88,,percent of total billed charges,,,,,,,,,19829.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23618.42,91,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,,,,,,,,,,,,,21542.08,83,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,21282.53,82,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,19569.55,24656.59,
ZIMMER LINER NEUTRAL +5MM G7 40MM H,30186536,CDM,,,278,RC,inpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7694.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8674.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,7694.57,9694.75,
ZIMMER HEAD BIOLOX +7MM 40MM,30186537,CDM,,,278,RC,inpatient,,26390,26390,,22405.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19898.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22431.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23223.2,88,,percent of total billed charges,,,,,,,,,20161.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24014.9,91,,percent of total billed charges,,,25070.5,95,,percent of total billed charges,,,21903.7,83,,percent of total billed charges,,,21903.7,83,,percent of total billed charges,,,,,,,,,,,,,,,21903.7,83,,percent of total billed charges,,,25070.5,95,,percent of total billed charges,,,23751,90,,percent of total billed charges,,,23751,90,,percent of total billed charges,,,21639.8,82,,percent of total billed charges,,,23751,90,,percent of total billed charges,,,22431.5,85,,percent of total billed charges,,19898.06,25070.5,
ZIMMER STEM REV. WAGNER 135 NK ANGLE16X2,30186538,CDM,,,278,RC,inpatient,,78000,78000,,66222,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58812,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66300,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68640,88,,percent of total billed charges,,,,,,,,,59592,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70980,91,,percent of total billed charges,,,74100,95,,percent of total billed charges,,,64740,83,,percent of total billed charges,,,64740,83,,percent of total billed charges,,,,,,,,,,,,,,,64740,83,,percent of total billed charges,,,74100,95,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,63960,82,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,66300,85,,percent of total billed charges,,58812,74100,
ZIMMER LINER NUETRAL 32MM,30186541,CDM,,,278,RC,inpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17447.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19669,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,17447.56,21983,
ARTHREX SCREW BIO TENODESIS W/DRIVER,30186542,CDM,,,270,RC,inpatient,,2632.5,2632.5,,2234.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1984.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2237.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2316.6,88,,percent of total billed charges,,,,,,,,,2011.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2395.58,91,,percent of total billed charges,,,2500.88,95,,percent of total billed charges,,,2184.98,83,,percent of total billed charges,,,2184.98,83,,percent of total billed charges,,,,,,,,,,,,,,,2184.98,83,,percent of total billed charges,,,2500.88,95,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2158.65,82,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2237.63,85,,percent of total billed charges,,1984.91,2500.88,
LIMB EXTENSION OVATION IX 28X45MM,30186543,CDM,,,278,RC,inpatient,,35743.5,35743.5,,30346.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26950.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30381.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31454.28,88,,percent of total billed charges,,,,,,,,,27308.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32526.59,91,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,,,,,,,,,,,,,29667.11,83,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,29309.67,82,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,30381.98,85,,percent of total billed charges,,26950.6,33956.33,
GORE PROPATEN VASCULAR GRAFT,30186544,CDM,,,278,RC,inpatient,,13702,13702,,11633,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10331.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11646.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12057.76,88,,percent of total billed charges,,,,,,,,,10468.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12468.82,91,,percent of total billed charges,,,13016.9,95,,percent of total billed charges,,,11372.66,83,,percent of total billed charges,,,11372.66,83,,percent of total billed charges,,,,,,,,,,,,,,,11372.66,83,,percent of total billed charges,,,13016.9,95,,percent of total billed charges,,,12331.8,90,,percent of total billed charges,,,12331.8,90,,percent of total billed charges,,,11235.64,82,,percent of total billed charges,,,12331.8,90,,percent of total billed charges,,,11646.7,85,,percent of total billed charges,,10331.31,13016.9,
FLEXCIL HIGH PRESSURE INJECTION LINE 72,30186545,CDM,,,270,RC,inpatient,,86.37,86.37,,73.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,65.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,76.01,88,,percent of total billed charges,,,,,,,,,65.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,78.6,91,,percent of total billed charges,,,82.05,95,,percent of total billed charges,,,71.69,83,,percent of total billed charges,,,71.69,83,,percent of total billed charges,,,,,,,,,,,,,,,71.69,83,,percent of total billed charges,,,82.05,95,,percent of total billed charges,,,77.73,90,,percent of total billed charges,,,77.73,90,,percent of total billed charges,,,70.82,82,,percent of total billed charges,,,77.73,90,,percent of total billed charges,,,73.41,85,,percent of total billed charges,,65.12,82.05,
SHEATH CATH CORDIS BRITE TIP 5FR 23CM FU,30186548,CDM,,,270,RC,inpatient,,184,184,,156.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,138.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,156.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,161.92,88,,percent of total billed charges,,,,,,,,,140.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,,,,,,,,,,,,,152.72,83,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,150.88,82,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,138.74,174.8,
SHEATH CATH CORDIS BRITE TIP 6FR 23CM FU,30186549,CDM,,,270,RC,inpatient,,170,170,,144.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,128.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,144.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,149.6,88,,percent of total billed charges,,,,,,,,,129.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,154.7,91,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,,,,,,,,,,,,,141.1,83,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,139.4,82,,percent of total billed charges,,,153,90,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,128.18,161.5,
SHEATH CATH CORDIS BRITE TIP 8FR 23CM FU,30186550,CDM,,,270,RC,inpatient,,170,170,,144.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,128.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,144.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,149.6,88,,percent of total billed charges,,,,,,,,,129.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,154.7,91,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,,,,,,,,,,,,,141.1,83,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,139.4,82,,percent of total billed charges,,,153,90,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,128.18,161.5,
SHEATH CATH CORDIS BRITE TIP 11FR 23CM F,30186551,CDM,,,270,RC,inpatient,,184,184,,156.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,138.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,156.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,161.92,88,,percent of total billed charges,,,,,,,,,140.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,,,,,,,,,,,,,152.72,83,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,150.88,82,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,138.74,174.8,
CATH BERENSTEIN (BERN) 4FR 65CM,30186552,CDM,,,270,RC,inpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,81.43,102.6,
CATH SUPER TORQUE MB PIGTAIL 5FR 65CM,30186553,CDM,,,270,RC,inpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,633.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,714,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,633.36,798,
TERUMO GLIDECATH ANGLED 4FR X 65CM,30186554,CDM,,,270,RC,inpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,291.35,367.08,
TERUMO GLIDECATH STRAIGHT 4FR X 65CM,30186555,CDM,,,270,RC,inpatient,,577.5,577.5,,490.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,435.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,490.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,508.2,88,,percent of total billed charges,,,,,,,,,441.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,525.53,91,,percent of total billed charges,,,548.63,95,,percent of total billed charges,,,479.33,83,,percent of total billed charges,,,479.33,83,,percent of total billed charges,,,,,,,,,,,,,,,479.33,83,,percent of total billed charges,,,548.63,95,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,473.55,82,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,490.88,85,,percent of total billed charges,,435.44,548.63,
KUMPE SOFTVU 4F 65CM,30186556,CDM,,,270,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
ZIMMER LINER NUETRAL G7 E1 32MM,30186558,CDM,,,278,RC,inpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17447.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19669,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,17447.56,21983,
ZIMMER INSERT MC 11MM,30186559,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
GORE INTRO SHEATH DRYSEAL FLEX 12FR 33CM,30186560,CDM,,,270,RC,inpatient,,3048.5,3048.5,,2588.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2298.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2591.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2682.68,88,,percent of total billed charges,,,,,,,,,2329.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2774.14,91,,percent of total billed charges,,,2896.08,95,,percent of total billed charges,,,2530.26,83,,percent of total billed charges,,,2530.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2530.26,83,,percent of total billed charges,,,2896.08,95,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2499.77,82,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2591.23,85,,percent of total billed charges,,2298.57,2896.08,
GORE INTRO SHEATH DRYSEAL FLEX 14FR 33CM,30186561,CDM,,,270,RC,inpatient,,3048.5,3048.5,,2588.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2298.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2591.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2682.68,88,,percent of total billed charges,,,,,,,,,2329.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2774.14,91,,percent of total billed charges,,,2896.08,95,,percent of total billed charges,,,2530.26,83,,percent of total billed charges,,,2530.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2530.26,83,,percent of total billed charges,,,2896.08,95,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2499.77,82,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2591.23,85,,percent of total billed charges,,2298.57,2896.08,
GORE INTRO SHEATH DRYSEAL FLEX 16FR 33CM,30186562,CDM,,,270,RC,inpatient,,3048.5,3048.5,,2588.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2298.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2591.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2682.68,88,,percent of total billed charges,,,,,,,,,2329.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2774.14,91,,percent of total billed charges,,,2896.08,95,,percent of total billed charges,,,2530.26,83,,percent of total billed charges,,,2530.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2530.26,83,,percent of total billed charges,,,2896.08,95,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2499.77,82,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2591.23,85,,percent of total billed charges,,2298.57,2896.08,
GORE INTRO SHEATH DRYSEAL FLEX 18FR 33CM,30186563,CDM,,,270,RC,inpatient,,4121,4121,,3498.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3107.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3502.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3626.48,88,,percent of total billed charges,,,,,,,,,3148.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3750.11,91,,percent of total billed charges,,,3914.95,95,,percent of total billed charges,,,3420.43,83,,percent of total billed charges,,,3420.43,83,,percent of total billed charges,,,,,,,,,,,,,,,3420.43,83,,percent of total billed charges,,,3914.95,95,,percent of total billed charges,,,3708.9,90,,percent of total billed charges,,,3708.9,90,,percent of total billed charges,,,3379.22,82,,percent of total billed charges,,,3708.9,90,,percent of total billed charges,,,3502.85,85,,percent of total billed charges,,3107.23,3914.95,
GORE INTRO SHEATH DRYSEAL FLEX 20FR 33CM,30186564,CDM,,,270,RC,inpatient,,4121,4121,,3498.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3107.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3502.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3626.48,88,,percent of total billed charges,,,,,,,,,3148.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3750.11,91,,percent of total billed charges,,,3914.95,95,,percent of total billed charges,,,3420.43,83,,percent of total billed charges,,,3420.43,83,,percent of total billed charges,,,,,,,,,,,,,,,3420.43,83,,percent of total billed charges,,,3914.95,95,,percent of total billed charges,,,3708.9,90,,percent of total billed charges,,,3708.9,90,,percent of total billed charges,,,3379.22,82,,percent of total billed charges,,,3708.9,90,,percent of total billed charges,,,3502.85,85,,percent of total billed charges,,3107.23,3914.95,
ZIMMER FEMUR POROUS NARROW SZ 11,30186565,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER INSERT ASF MC 12MM,30186566,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ZIMMER BLADE PATELLA REAMER SZ 41,30186568,CDM,,,270,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
EVERCROSS BALLOON 12MM X 40MM,30186569,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
LIMB RIGHT OVATION IX 12X160MM,30186570,CDM,,,278,RC,inpatient,,35743.5,35743.5,,30346.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26950.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30381.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31454.28,88,,percent of total billed charges,,,,,,,,,27308.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32526.59,91,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,,,,,,,,,,,,,29667.11,83,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,29309.67,82,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,30381.98,85,,percent of total billed charges,,26950.6,33956.33,
LIMB EXTENSION OVATION IX 12X80MM,30186571,CDM,,,278,RC,inpatient,,35743.5,35743.5,,30346.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26950.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30381.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31454.28,88,,percent of total billed charges,,,,,,,,,27308.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32526.59,91,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,,,,,,,,,,,,,29667.11,83,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,29309.67,82,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,30381.98,85,,percent of total billed charges,,26950.6,33956.33,
LIMB LT OVATION IX 28X120MM,30186572,CDM,,,278,RC,inpatient,,35743.5,35743.5,,30346.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26950.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30381.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31454.28,88,,percent of total billed charges,,,,,,,,,27308.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32526.59,91,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,,,,,,,,,,,,,29667.11,83,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,29309.67,82,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,30381.98,85,,percent of total billed charges,,26950.6,33956.33,
MAIN BODY OVATION KIX 34MM,30186573,CDM,,,278,RC,inpatient,,81243.5,81243.5,,68975.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61257.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,69056.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71494.28,88,,percent of total billed charges,,,,,,,,,62070.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73931.59,91,,percent of total billed charges,,,77181.33,95,,percent of total billed charges,,,67432.11,83,,percent of total billed charges,,,67432.11,83,,percent of total billed charges,,,,,,,,,,,,,,,67432.11,83,,percent of total billed charges,,,77181.33,95,,percent of total billed charges,,,73119.15,90,,percent of total billed charges,,,73119.15,90,,percent of total billed charges,,,66619.67,82,,percent of total billed charges,,,73119.15,90,,percent of total billed charges,,,69056.98,85,,percent of total billed charges,,61257.6,77181.33,
AUTO INJECTOR,30186574,CDM,,,270,RC,inpatient,,3243.5,3243.5,,2753.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2445.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2756.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2854.28,88,,percent of total billed charges,,,,,,,,,2478.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2951.59,91,,percent of total billed charges,,,3081.33,95,,percent of total billed charges,,,2692.11,83,,percent of total billed charges,,,2692.11,83,,percent of total billed charges,,,,,,,,,,,,,,,2692.11,83,,percent of total billed charges,,,3081.33,95,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2659.67,82,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2756.98,85,,percent of total billed charges,,2445.6,3081.33,
POLYMER CUSTOM SEAL KIT,30186575,CDM,,,270,RC,inpatient,,6493.5,6493.5,,5512.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4896.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5519.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5714.28,88,,percent of total billed charges,,,,,,,,,4961.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5909.09,91,,percent of total billed charges,,,6168.83,95,,percent of total billed charges,,,5389.61,83,,percent of total billed charges,,,5389.61,83,,percent of total billed charges,,,,,,,,,,,,,,,5389.61,83,,percent of total billed charges,,,6168.83,95,,percent of total billed charges,,,5844.15,90,,percent of total billed charges,,,5844.15,90,,percent of total billed charges,,,5324.67,82,,percent of total billed charges,,,5844.15,90,,percent of total billed charges,,,5519.48,85,,percent of total billed charges,,4896.1,6168.83,
KUMPE SOFTVU 4F 40CM,30186576,CDM,,,270,RC,inpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,186.62,235.13,
ZIMMER LINER NUETRAL 36MM +5 F,30186577,CDM,,,278,RC,inpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7694.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8674.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,7694.57,9694.75,
ZIMMER BLADE STRYK-76542K-13/21X90X127V,30186578,CDM,,,270,RC,inpatient,,359.1,359.1,,304.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,270.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,305.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,316.01,88,,percent of total billed charges,,,,,,,,,274.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,326.78,91,,percent of total billed charges,,,341.15,95,,percent of total billed charges,,,298.05,83,,percent of total billed charges,,,298.05,83,,percent of total billed charges,,,,,,,,,,,,,,,298.05,83,,percent of total billed charges,,,341.15,95,,percent of total billed charges,,,323.19,90,,percent of total billed charges,,,323.19,90,,percent of total billed charges,,,294.46,82,,percent of total billed charges,,,323.19,90,,percent of total billed charges,,,305.24,85,,percent of total billed charges,,270.76,341.15,
SCREW LOCKING CAP KIT 4.5X38MM,30186579,CDM,,,278,RC,inpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1514.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1707.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,1514.41,1908.08,
ZIMMER INSERT ASF 12MM 8-11GH,30186580,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
STRYKER BUR ROUND 3MM LILAC,30186581,CDM,,,270,RC,inpatient,,1303.51,1303.51,,1106.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,982.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1107.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1147.09,88,,percent of total billed charges,,,,,,,,,995.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1186.19,91,,percent of total billed charges,,,1238.33,95,,percent of total billed charges,,,1081.91,83,,percent of total billed charges,,,1081.91,83,,percent of total billed charges,,,,,,,,,,,,,,,1081.91,83,,percent of total billed charges,,,1238.33,95,,percent of total billed charges,,,1173.16,90,,percent of total billed charges,,,1173.16,90,,percent of total billed charges,,,1068.88,82,,percent of total billed charges,,,1173.16,90,,percent of total billed charges,,,1107.98,85,,percent of total billed charges,,982.85,1238.33,
ZIMMER LINER NEUTRAL +5MM E1 40MM F,30186582,CDM,,,278,RC,inpatient,,22880,22880,,19425.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17251.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19448,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20134.4,88,,percent of total billed charges,,,,,,,,,17480.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20820.8,91,,percent of total billed charges,,,21736,95,,percent of total billed charges,,,18990.4,83,,percent of total billed charges,,,18990.4,83,,percent of total billed charges,,,,,,,,,,,,,,,18990.4,83,,percent of total billed charges,,,21736,95,,percent of total billed charges,,,20592,90,,percent of total billed charges,,,20592,90,,percent of total billed charges,,,18761.6,82,,percent of total billed charges,,,20592,90,,percent of total billed charges,,,19448,85,,percent of total billed charges,,17251.52,21736,
ZIMMER INSERT MC 14MM LEFT,30186583,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
DEPUY BIPOLAR HEAD 43MM,30186584,CDM,,,278,RC,inpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,6126.3,7718.82,
SPINECRAFT SCREW 6.0 X 35MM,30186585,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT ROD LOWDOSED 6.0 X 60,30186586,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
SPINECRAFT REVISION/REMOVAL SET,30186587,CDM,,,270,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
BREAST IMPLANT MEMORYGEL XTRA 465CC,30186588,CDM,,,278,RC,inpatient,,7982,7982,,6776.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6018.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6784.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7024.16,88,,percent of total billed charges,,,,,,,,,6098.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7263.62,91,,percent of total billed charges,,,7582.9,95,,percent of total billed charges,,,6625.06,83,,percent of total billed charges,,,6625.06,83,,percent of total billed charges,,,,,,,,,,,,,,,6625.06,83,,percent of total billed charges,,,7582.9,95,,percent of total billed charges,,,7183.8,90,,percent of total billed charges,,,7183.8,90,,percent of total billed charges,,,6545.24,82,,percent of total billed charges,,,7183.8,90,,percent of total billed charges,,,6784.7,85,,percent of total billed charges,,6018.43,7582.9,
SYNTHES HELICAL BLADE 100MM,30186589,CDM,,,278,RC,inpatient,,7033.78,7033.78,,5971.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5303.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5978.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6189.73,88,,percent of total billed charges,,,,,,,,,5373.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6400.74,91,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,,,,,,,,,,,,,5838.04,83,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5767.7,82,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5978.71,85,,percent of total billed charges,,5303.47,6682.09,
ABBOTT WRENCH KIT ASSEMBLY,30186590,CDM,,,270,RC,inpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,197.93,249.38,
ABBOTT LEAD RV OPTISUREMRI,30186591,CDM,,,278,RC,inpatient,,29250,29250,,24833.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22054.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24862.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25740,88,,percent of total billed charges,,,,,,,,,22347,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26617.5,91,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,,,,,,,,,,,,,24277.5,83,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,23985,82,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,22054.5,27787.5,
ABBOTT RV STYLET ACCESSORY KIT,30186592,CDM,,,270,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
ABBOTT RV ADAPTER PIN,30186593,CDM,,,270,RC,inpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,633.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,714,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,633.36,798,
NUVASIVE CERVICAL CAGE TI 6X17X14MM 7DEG,30186594,CDM,,,278,RC,inpatient,,52487.5,52487.5,,44561.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39575.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44614.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46189,88,,percent of total billed charges,,,,,,,,,40100.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47763.63,91,,percent of total billed charges,,,49863.13,95,,percent of total billed charges,,,43564.63,83,,percent of total billed charges,,,43564.63,83,,percent of total billed charges,,,,,,,,,,,,,,,43564.63,83,,percent of total billed charges,,,49863.13,95,,percent of total billed charges,,,47238.75,90,,percent of total billed charges,,,47238.75,90,,percent of total billed charges,,,43039.75,82,,percent of total billed charges,,,47238.75,90,,percent of total billed charges,,,44614.38,85,,percent of total billed charges,,39575.58,49863.13,
NUVASIVE DRILL BIT HELIX-R 2.5X10MM POWE,30186595,CDM,,,270,RC,inpatient,,2398.5,2398.5,,2036.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1808.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2038.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2110.68,88,,percent of total billed charges,,,,,,,,,1832.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2182.64,91,,percent of total billed charges,,,2278.58,95,,percent of total billed charges,,,1990.76,83,,percent of total billed charges,,,1990.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1990.76,83,,percent of total billed charges,,,2278.58,95,,percent of total billed charges,,,2158.65,90,,percent of total billed charges,,,2158.65,90,,percent of total billed charges,,,1966.77,82,,percent of total billed charges,,,2158.65,90,,percent of total billed charges,,,2038.73,85,,percent of total billed charges,,1808.47,2278.58,
NUVASIVE PLATE HELIX R 42MM 2-LEVEL,30186596,CDM,,,278,RC,inpatient,,10595,10595,,8995.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7988.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9005.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9323.6,88,,percent of total billed charges,,,,,,,,,8094.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9641.45,91,,percent of total billed charges,,,10065.25,95,,percent of total billed charges,,,8793.85,83,,percent of total billed charges,,,8793.85,83,,percent of total billed charges,,,,,,,,,,,,,,,8793.85,83,,percent of total billed charges,,,10065.25,95,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,8687.9,82,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,9005.75,85,,percent of total billed charges,,7988.63,10065.25,
NUVASIVE SCREW HELIX R 4X15MM,30186597,CDM,,,278,RC,inpatient,,3659.5,3659.5,,3106.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2759.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3110.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3220.36,88,,percent of total billed charges,,,,,,,,,2795.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3330.15,91,,percent of total billed charges,,,3476.53,95,,percent of total billed charges,,,3037.39,83,,percent of total billed charges,,,3037.39,83,,percent of total billed charges,,,,,,,,,,,,,,,3037.39,83,,percent of total billed charges,,,3476.53,95,,percent of total billed charges,,,3293.55,90,,percent of total billed charges,,,3293.55,90,,percent of total billed charges,,,3000.79,82,,percent of total billed charges,,,3293.55,90,,percent of total billed charges,,,3110.58,85,,percent of total billed charges,,2759.26,3476.53,
DEPUY ATTUNE CRS FEMORAL RT SZ 5,30186602,CDM,,,278,RC,inpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39636.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44683.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,39636.69,49940.13,
ZIMMER INSERT RT MC 13MM,30186603,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ZIMMER BLADE EXPLANT 42MM X 20,30186604,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
ZIMMER BLADE EXPLANT 42MM X 10,30186605,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
ZIMMER BLADE EXPLANT 44MM X 20,30186606,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
ZIMMER BLADE EXPLANT 44MM X 10,30186607,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
ZIMMER BLADE EXPLANT 46MM X 20,30186608,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
ZIMMER BLADE EXPLANT 46MM X 10,30186609,CDM,,,270,RC,inpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3234.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3646.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,3234.66,4075.5,
SYNTHES SCREW CANN. 6.5 X 135MM,30186610,CDM,,,278,RC,inpatient,,2617.75,2617.75,,2222.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1973.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2225.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2303.62,88,,percent of total billed charges,,,,,,,,,1999.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2382.15,91,,percent of total billed charges,,,2486.86,95,,percent of total billed charges,,,2172.73,83,,percent of total billed charges,,,2172.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2172.73,83,,percent of total billed charges,,,2486.86,95,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2146.56,82,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2225.09,85,,percent of total billed charges,,1973.78,2486.86,
SYNTHES SCREW CANN. 6.5 X140MM,30186611,CDM,,,278,RC,inpatient,,2617.75,2617.75,,2222.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1973.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2225.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2303.62,88,,percent of total billed charges,,,,,,,,,1999.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2382.15,91,,percent of total billed charges,,,2486.86,95,,percent of total billed charges,,,2172.73,83,,percent of total billed charges,,,2172.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2172.73,83,,percent of total billed charges,,,2486.86,95,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2146.56,82,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2225.09,85,,percent of total billed charges,,1973.78,2486.86,
SYNTHES SCREW CANN. 6.5 X 145MM,30186612,CDM,,,278,RC,inpatient,,2617.75,2617.75,,2222.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1973.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2225.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2303.62,88,,percent of total billed charges,,,,,,,,,1999.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2382.15,91,,percent of total billed charges,,,2486.86,95,,percent of total billed charges,,,2172.73,83,,percent of total billed charges,,,2172.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2172.73,83,,percent of total billed charges,,,2486.86,95,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2146.56,82,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2225.09,85,,percent of total billed charges,,1973.78,2486.86,
SYNTHES SCREW CANN. 6.5 X 150MM,30186613,CDM,,,278,RC,inpatient,,2617.75,2617.75,,2222.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1973.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2225.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2303.62,88,,percent of total billed charges,,,,,,,,,1999.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2382.15,91,,percent of total billed charges,,,2486.86,95,,percent of total billed charges,,,2172.73,83,,percent of total billed charges,,,2172.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2172.73,83,,percent of total billed charges,,,2486.86,95,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2146.56,82,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2225.09,85,,percent of total billed charges,,1973.78,2486.86,
SYNTHES SCREW CANNULATED 6.5X145MM 32MM,30186614,CDM,,,278,RC,inpatient,,2696.27,2696.27,,2289.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2032.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2291.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2372.72,88,,percent of total billed charges,,,,,,,,,2059.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2453.61,91,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2237.9,83,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2210.94,82,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,2032.99,2561.46,
DEPUY ATTUNE INSERT REV. FB 6MM,30186615,CDM,,,278,RC,inpatient,,19355.77,19355.77,,16433.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14594.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16452.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17033.08,88,,percent of total billed charges,,,,,,,,,14787.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17613.75,91,,percent of total billed charges,,,18387.98,95,,percent of total billed charges,,,16065.29,83,,percent of total billed charges,,,16065.29,83,,percent of total billed charges,,,,,,,,,,,,,,,16065.29,83,,percent of total billed charges,,,18387.98,95,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,15871.73,82,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,16452.4,85,,percent of total billed charges,,14594.25,18387.98,
MEDTRONIC INTRODUCER ACCESSORY KIT,30186616,CDM,,,270,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
MEDTRONIC ANCHOR INJEX BUMPY,30186617,CDM,,,270,RC,inpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1347.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1519.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,1347.78,1698.13,
CATHETER RIM 4F X 65CM,30186619,CDM,,,270,RC,inpatient,,273,273,,231.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,205.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,232.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,240.24,88,,percent of total billed charges,,,,,,,,,208.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,248.43,91,,percent of total billed charges,,,259.35,95,,percent of total billed charges,,,226.59,83,,percent of total billed charges,,,226.59,83,,percent of total billed charges,,,,,,,,,,,,,,,226.59,83,,percent of total billed charges,,,259.35,95,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,223.86,82,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,232.05,85,,percent of total billed charges,,205.84,259.35,
ZIMMER LINER NEUTRAL +5MM G7 40MM G,30186620,CDM,,,278,RC,inpatient,,24310,24310,,20639.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18329.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20663.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21392.8,88,,percent of total billed charges,,,,,,,,,18572.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22122.1,91,,percent of total billed charges,,,23094.5,95,,percent of total billed charges,,,20177.3,83,,percent of total billed charges,,,20177.3,83,,percent of total billed charges,,,,,,,,,,,,,,,20177.3,83,,percent of total billed charges,,,23094.5,95,,percent of total billed charges,,,21879,90,,percent of total billed charges,,,21879,90,,percent of total billed charges,,,19934.2,82,,percent of total billed charges,,,21879,90,,percent of total billed charges,,,20663.5,85,,percent of total billed charges,,18329.74,23094.5,
SPINECRAFT ROD LOWDOSED 6.0 X 110MM,30186621,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ARTHREX MENISCAL CINCH II,30186622,CDM,,,270,RC,inpatient,,2567.5,2567.5,,2179.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1935.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2182.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2259.4,88,,percent of total billed charges,,,,,,,,,1961.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2336.43,91,,percent of total billed charges,,,2439.13,95,,percent of total billed charges,,,2131.03,83,,percent of total billed charges,,,2131.03,83,,percent of total billed charges,,,,,,,,,,,,,,,2131.03,83,,percent of total billed charges,,,2439.13,95,,percent of total billed charges,,,2310.75,90,,percent of total billed charges,,,2310.75,90,,percent of total billed charges,,,2105.35,82,,percent of total billed charges,,,2310.75,90,,percent of total billed charges,,,2182.38,85,,percent of total billed charges,,1935.9,2439.13,
ARTHREX SUTURE TENSIONER/CUTTER KNEE,30186623,CDM,,,270,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
ARTHREX PORTAL SKID,30186624,CDM,,,270,RC,inpatient,,337.5,337.5,,286.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,254.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,286.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,297,88,,percent of total billed charges,,,,,,,,,257.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,307.13,91,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,,,,,,,,,,,,,280.13,83,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,276.75,82,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,254.48,320.63,
SYNTHES TFNA HELICAL BLADE 85MM,30186625,CDM,,,278,RC,inpatient,,7033.78,7033.78,,5971.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5303.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5978.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6189.73,88,,percent of total billed charges,,,,,,,,,5373.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6400.74,91,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,,,,,,,,,,,,,5838.04,83,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5767.7,82,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5978.71,85,,percent of total billed charges,,5303.47,6682.09,
SURGICEL FIBRILLAR ABS 4X4,30186626,CDM,,,270,RC,inpatient,,1666.48,1666.48,,1414.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1256.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1416.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1466.5,88,,percent of total billed charges,,,,,,,,,1273.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1516.5,91,,percent of total billed charges,,,1583.16,95,,percent of total billed charges,,,1383.18,83,,percent of total billed charges,,,1383.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1383.18,83,,percent of total billed charges,,,1583.16,95,,percent of total billed charges,,,1499.83,90,,percent of total billed charges,,,1499.83,90,,percent of total billed charges,,,1366.51,82,,percent of total billed charges,,,1499.83,90,,percent of total billed charges,,,1416.51,85,,percent of total billed charges,,1256.53,1583.16,
DEPUY GLENOSPHERE +2 42MM,30186627,CDM,,,278,RC,inpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14941.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16844.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,14941.68,18825.72,
ZIMMER FEMUR POROUS CR SZ 11 RIGHT,30186628,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER FEMUR POROUS CR SZ 9 LEFT,30186629,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
EXACTECH STEM HUMERAL 9MM,30186630,CDM,,,278,RC,inpatient,,35366.5,35366.5,,30026.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26666.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30061.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31122.52,88,,percent of total billed charges,,,,,,,,,27020.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32183.52,91,,percent of total billed charges,,,33598.18,95,,percent of total billed charges,,,29354.2,83,,percent of total billed charges,,,29354.2,83,,percent of total billed charges,,,,,,,,,,,,,,,29354.2,83,,percent of total billed charges,,,33598.18,95,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,29000.53,82,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,30061.53,85,,percent of total billed charges,,26666.34,33598.18,
ARTHREX IMPANT SYS. HAND/WRIST BRACE,30186631,CDM,,,270,RC,inpatient,,13884,13884,,11787.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10468.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11801.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12217.92,88,,percent of total billed charges,,,,,,,,,10607.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12634.44,91,,percent of total billed charges,,,13189.8,95,,percent of total billed charges,,,11523.72,83,,percent of total billed charges,,,11523.72,83,,percent of total billed charges,,,,,,,,,,,,,,,11523.72,83,,percent of total billed charges,,,13189.8,95,,percent of total billed charges,,,12495.6,90,,percent of total billed charges,,,12495.6,90,,percent of total billed charges,,,11384.88,82,,percent of total billed charges,,,12495.6,90,,percent of total billed charges,,,11801.4,85,,percent of total billed charges,,10468.54,13189.8,
ARTHREX TRAPEZIECTOMY TOOL,30186632,CDM,,,270,RC,inpatient,,2327,2327,,1975.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1754.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1977.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2047.76,88,,percent of total billed charges,,,,,,,,,1777.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2117.57,91,,percent of total billed charges,,,2210.65,95,,percent of total billed charges,,,1931.41,83,,percent of total billed charges,,,1931.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1931.41,83,,percent of total billed charges,,,2210.65,95,,percent of total billed charges,,,2094.3,90,,percent of total billed charges,,,2094.3,90,,percent of total billed charges,,,1908.14,82,,percent of total billed charges,,,2094.3,90,,percent of total billed charges,,,1977.95,85,,percent of total billed charges,,1754.56,2210.65,
SYNTHES DRILL BIT 2.8,30186633,CDM,,,270,RC,inpatient,,1236.76,1236.76,,1050.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,932.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1051.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1088.35,88,,percent of total billed charges,,,,,,,,,944.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1125.45,91,,percent of total billed charges,,,1174.92,95,,percent of total billed charges,,,1026.51,83,,percent of total billed charges,,,1026.51,83,,percent of total billed charges,,,,,,,,,,,,,,,1026.51,83,,percent of total billed charges,,,1174.92,95,,percent of total billed charges,,,1113.08,90,,percent of total billed charges,,,1113.08,90,,percent of total billed charges,,,1014.14,82,,percent of total billed charges,,,1113.08,90,,percent of total billed charges,,,1051.25,85,,percent of total billed charges,,932.52,1174.92,
SYNTHES DRILL BIT 2.5,30186634,CDM,,,270,RC,inpatient,,1236.76,1236.76,,1050.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,932.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1051.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1088.35,88,,percent of total billed charges,,,,,,,,,944.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1125.45,91,,percent of total billed charges,,,1174.92,95,,percent of total billed charges,,,1026.51,83,,percent of total billed charges,,,1026.51,83,,percent of total billed charges,,,,,,,,,,,,,,,1026.51,83,,percent of total billed charges,,,1174.92,95,,percent of total billed charges,,,1113.08,90,,percent of total billed charges,,,1113.08,90,,percent of total billed charges,,,1014.14,82,,percent of total billed charges,,,1113.08,90,,percent of total billed charges,,,1051.25,85,,percent of total billed charges,,932.52,1174.92,
SYNTHES PLATE TIBIA LB 64MM,30186635,CDM,,,278,RC,inpatient,,15273.96,15273.96,,12967.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11516.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12982.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13441.08,88,,percent of total billed charges,,,,,,,,,11669.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13899.3,91,,percent of total billed charges,,,14510.26,95,,percent of total billed charges,,,12677.39,83,,percent of total billed charges,,,12677.39,83,,percent of total billed charges,,,,,,,,,,,,,,,12677.39,83,,percent of total billed charges,,,14510.26,95,,percent of total billed charges,,,13746.56,90,,percent of total billed charges,,,13746.56,90,,percent of total billed charges,,,12524.65,82,,percent of total billed charges,,,13746.56,90,,percent of total billed charges,,,12982.87,85,,percent of total billed charges,,11516.57,14510.26,
SYNTHES SCREW LOCKING VA 3.5 X 36MM,30186636,CDM,,,278,RC,inpatient,,1456.85,1456.85,,1236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1098.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1238.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1282.03,88,,percent of total billed charges,,,,,,,,,1113.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1325.73,91,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1209.19,83,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1194.62,82,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,1098.46,1384.01,
SYNTHES SCREW LOCKING VA 3.5 X 38MM,30186637,CDM,,,278,RC,inpatient,,1456.85,1456.85,,1236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1098.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1238.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1282.03,88,,percent of total billed charges,,,,,,,,,1113.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1325.73,91,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1209.19,83,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1194.62,82,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,1098.46,1384.01,
SYNTHES SCREW LOCKING VA 3.5 X 75MM,30186638,CDM,,,278,RC,inpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1131.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1275.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,1131.4,1425.5,
SYNTHES SCREW LOCKING VA 3.5 X 85MM,30186639,CDM,,,278,RC,inpatient,,1456.85,1456.85,,1236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1098.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1238.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1282.03,88,,percent of total billed charges,,,,,,,,,1113.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1325.73,91,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1209.19,83,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1194.62,82,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,1098.46,1384.01,
STRYKER SPINEJACK CASE KIT 50MM,30186640,CDM,,,270,RC,inpatient,,27072.5,27072.5,,22984.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20412.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23011.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23823.8,88,,percent of total billed charges,,,,,,,,,20683.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24635.98,91,,percent of total billed charges,,,25718.88,95,,percent of total billed charges,,,22470.18,83,,percent of total billed charges,,,22470.18,83,,percent of total billed charges,,,,,,,,,,,,,,,22470.18,83,,percent of total billed charges,,,25718.88,95,,percent of total billed charges,,,24365.25,90,,percent of total billed charges,,,24365.25,90,,percent of total billed charges,,,22199.45,82,,percent of total billed charges,,,24365.25,90,,percent of total billed charges,,,23011.63,85,,percent of total billed charges,,20412.67,25718.88,
STRYKER INJECTOR TRANSFER TUBE,30186641,CDM,,,270,RC,inpatient,,461.23,461.23,,391.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,347.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,405.88,88,,percent of total billed charges,,,,,,,,,352.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,419.72,91,,percent of total billed charges,,,438.17,95,,percent of total billed charges,,,382.82,83,,percent of total billed charges,,,382.82,83,,percent of total billed charges,,,,,,,,,,,,,,,382.82,83,,percent of total billed charges,,,438.17,95,,percent of total billed charges,,,415.11,90,,percent of total billed charges,,,415.11,90,,percent of total billed charges,,,378.21,82,,percent of total billed charges,,,415.11,90,,percent of total billed charges,,,392.05,85,,percent of total billed charges,,347.77,438.17,
MENTOR MEMORYGEL BREAST IMPLANT 325CC,30186642,CDM,,,278,RC,inpatient,,6207.5,6207.5,,5270.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4680.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5276.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5462.6,88,,percent of total billed charges,,,,,,,,,4742.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5648.83,91,,percent of total billed charges,,,5897.13,95,,percent of total billed charges,,,5152.23,83,,percent of total billed charges,,,5152.23,83,,percent of total billed charges,,,,,,,,,,,,,,,5152.23,83,,percent of total billed charges,,,5897.13,95,,percent of total billed charges,,,5586.75,90,,percent of total billed charges,,,5586.75,90,,percent of total billed charges,,,5090.15,82,,percent of total billed charges,,,5586.75,90,,percent of total billed charges,,,5276.38,85,,percent of total billed charges,,4680.46,5897.13,
DEPUY PRESSFIT INSERT SZ 6 8MM,30186644,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
EXACTECH CAGE GLENOID CEMENTED MEDIUM BE,30186645,CDM,,,278,RC,inpatient,,29211,29211,,24800.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22025.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24829.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25705.68,88,,percent of total billed charges,,,,,,,,,22317.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26582.01,91,,percent of total billed charges,,,27750.45,95,,percent of total billed charges,,,24245.13,83,,percent of total billed charges,,,24245.13,83,,percent of total billed charges,,,,,,,,,,,,,,,24245.13,83,,percent of total billed charges,,,27750.45,95,,percent of total billed charges,,,26289.9,90,,percent of total billed charges,,,26289.9,90,,percent of total billed charges,,,23953.02,82,,percent of total billed charges,,,26289.9,90,,percent of total billed charges,,,24829.35,85,,percent of total billed charges,,22025.09,27750.45,
EXACTECH PLATE REPLICATOR 4.5MM SHORT,30186646,CDM,,,278,RC,inpatient,,18083,18083,,15352.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13634.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15370.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15913.04,88,,percent of total billed charges,,,,,,,,,13815.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16455.53,91,,percent of total billed charges,,,17178.85,95,,percent of total billed charges,,,15008.89,83,,percent of total billed charges,,,15008.89,83,,percent of total billed charges,,,,,,,,,,,,,,,15008.89,83,,percent of total billed charges,,,17178.85,95,,percent of total billed charges,,,16274.7,90,,percent of total billed charges,,,16274.7,90,,percent of total billed charges,,,14828.06,82,,percent of total billed charges,,,16274.7,90,,percent of total billed charges,,,15370.55,85,,percent of total billed charges,,13634.58,17178.85,
EXACTECH HEAD HUMERAL EXTRA SHORT 47X15M,30186647,CDM,,,278,RC,inpatient,,23088,23088,,19601.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17408.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19624.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20317.44,88,,percent of total billed charges,,,,,,,,,17639.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21010.08,91,,percent of total billed charges,,,21933.6,95,,percent of total billed charges,,,19163.04,83,,percent of total billed charges,,,19163.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19163.04,83,,percent of total billed charges,,,21933.6,95,,percent of total billed charges,,,20779.2,90,,percent of total billed charges,,,20779.2,90,,percent of total billed charges,,,18932.16,82,,percent of total billed charges,,,20779.2,90,,percent of total billed charges,,,19624.8,85,,percent of total billed charges,,17408.35,21933.6,
SPINECRAFT SCREW REDUCTION 6.0 X 45MM,30186648,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
SPINECRAFT ROD LORDOSED 6.0 X 45MM,30186649,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
MITEK HEALIX ADVANCE KNOTLESS 5.5,30186650,CDM,,,278,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
S&N ENDO BICEPTOR KIT SCREW 8 X 15,30186651,CDM,,,270,RC,inpatient,,2657.27,2657.27,,2256.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2003.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2258.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2338.4,88,,percent of total billed charges,,,,,,,,,2030.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2418.12,91,,percent of total billed charges,,,2524.41,95,,percent of total billed charges,,,2205.53,83,,percent of total billed charges,,,2205.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2205.53,83,,percent of total billed charges,,,2524.41,95,,percent of total billed charges,,,2391.54,90,,percent of total billed charges,,,2391.54,90,,percent of total billed charges,,,2178.96,82,,percent of total billed charges,,,2391.54,90,,percent of total billed charges,,,2258.68,85,,percent of total billed charges,,2003.58,2524.41,
EX-FUSE DBM PUTTY 10CC,30186655,CDM,,,278,RC,inpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7351.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8287.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,7351.5,9262.5,
SPINECRAFT CROSS CONNECTOR 39-50MM,30186656,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
VTI INTERFUSE B FUSION DEVICE 10MM,30186657,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT REVISION REMOVAL SET,30186658,CDM,,,270,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
SYNTHES PLATE HUMERUS PROX. LCP 3.5,30186659,CDM,,,278,RC,inpatient,,17944.88,17944.88,,15235.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13530.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15253.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15791.49,88,,percent of total billed charges,,,,,,,,,13709.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16329.84,91,,percent of total billed charges,,,17047.64,95,,percent of total billed charges,,,14894.25,83,,percent of total billed charges,,,14894.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14894.25,83,,percent of total billed charges,,,17047.64,95,,percent of total billed charges,,,16150.39,90,,percent of total billed charges,,,16150.39,90,,percent of total billed charges,,,14714.8,82,,percent of total billed charges,,,16150.39,90,,percent of total billed charges,,,15253.15,85,,percent of total billed charges,,13530.44,17047.64,
SORBAFIX SHOT 15,30186660,CDM,,,270,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
DEPUY CANAL BRUSH,30186661,CDM,,,270,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
DEPUY TREPHINE 16MM,30186662,CDM,,,278,RC,inpatient,,8333,8333,,7074.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6283.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7083.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7333.04,88,,percent of total billed charges,,,,,,,,,6366.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7583.03,91,,percent of total billed charges,,,7916.35,95,,percent of total billed charges,,,6916.39,83,,percent of total billed charges,,,6916.39,83,,percent of total billed charges,,,,,,,,,,,,,,,6916.39,83,,percent of total billed charges,,,7916.35,95,,percent of total billed charges,,,7499.7,90,,percent of total billed charges,,,7499.7,90,,percent of total billed charges,,,6833.06,82,,percent of total billed charges,,,7499.7,90,,percent of total billed charges,,,7083.05,85,,percent of total billed charges,,6283.08,7916.35,
ZIMMER FEMORAL HEAD CERAMIC 36MM -3.0MM,30186663,CDM,,,278,RC,inpatient,,26390,26390,,22405.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19898.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22431.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23223.2,88,,percent of total billed charges,,,,,,,,,20161.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24014.9,91,,percent of total billed charges,,,25070.5,95,,percent of total billed charges,,,21903.7,83,,percent of total billed charges,,,21903.7,83,,percent of total billed charges,,,,,,,,,,,,,,,21903.7,83,,percent of total billed charges,,,25070.5,95,,percent of total billed charges,,,23751,90,,percent of total billed charges,,,23751,90,,percent of total billed charges,,,21639.8,82,,percent of total billed charges,,,23751,90,,percent of total billed charges,,,22431.5,85,,percent of total billed charges,,19898.06,25070.5,
ZIMMER STEM FEMORAL REVISION WAGNER 22X3,30186664,CDM,,,278,RC,inpatient,,78000,78000,,66222,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58812,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66300,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68640,88,,percent of total billed charges,,,,,,,,,59592,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70980,91,,percent of total billed charges,,,74100,95,,percent of total billed charges,,,64740,83,,percent of total billed charges,,,64740,83,,percent of total billed charges,,,,,,,,,,,,,,,64740,83,,percent of total billed charges,,,74100,95,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,63960,82,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,66300,85,,percent of total billed charges,,58812,74100,
ARTHREX MCL 1B,30186665,CDM,,,278,RC,inpatient,,7767.5,7767.5,,6594.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5856.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6602.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6835.4,88,,percent of total billed charges,,,,,,,,,5934.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7068.43,91,,percent of total billed charges,,,7379.13,95,,percent of total billed charges,,,6447.03,83,,percent of total billed charges,,,6447.03,83,,percent of total billed charges,,,,,,,,,,,,,,,6447.03,83,,percent of total billed charges,,,7379.13,95,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6369.35,82,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6602.38,85,,percent of total billed charges,,5856.7,7379.13,
SYNTHES SCREW LOCKING S-T 2.7X28MM W/STA,30186666,CDM,,,278,RC,inpatient,,1143.87,1143.87,,971.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,862.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,972.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1006.61,88,,percent of total billed charges,,,,,,,,,873.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1040.92,91,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,,,,,,,,,,,,,949.41,83,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,937.97,82,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,972.29,85,,percent of total billed charges,,862.48,1086.68,
ZIMMER INSERT CR 10MM RIGHT,30186667,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
SYNTHES SCREW CANNUL 4.0X30MM,30186669,CDM,,,278,RC,inpatient,,2003.17,2003.17,,1700.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1510.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1702.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1762.79,88,,percent of total billed charges,,,,,,,,,1530.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1822.88,91,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1662.63,83,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1642.6,82,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,1510.39,1903.01,
ZIMMER LINER CEMENTED CONSTRAINED 36MM,30186670,CDM,,,278,RC,inpatient,,45630,45630,,38739.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34405.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38785.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40154.4,88,,percent of total billed charges,,,,,,,,,34861.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41523.3,91,,percent of total billed charges,,,43348.5,95,,percent of total billed charges,,,37872.9,83,,percent of total billed charges,,,37872.9,83,,percent of total billed charges,,,,,,,,,,,,,,,37872.9,83,,percent of total billed charges,,,43348.5,95,,percent of total billed charges,,,41067,90,,percent of total billed charges,,,41067,90,,percent of total billed charges,,,37416.6,82,,percent of total billed charges,,,41067,90,,percent of total billed charges,,,38785.5,85,,percent of total billed charges,,34405.02,43348.5,
ZIMMER HEAD FEMORAL 36MM +3.5 6 DEG TAPE,30186671,CDM,,,278,RC,inpatient,,10595,10595,,8995.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7988.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9005.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9323.6,88,,percent of total billed charges,,,,,,,,,8094.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9641.45,91,,percent of total billed charges,,,10065.25,95,,percent of total billed charges,,,8793.85,83,,percent of total billed charges,,,8793.85,83,,percent of total billed charges,,,,,,,,,,,,,,,8793.85,83,,percent of total billed charges,,,10065.25,95,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,8687.9,82,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,9005.75,85,,percent of total billed charges,,7988.63,10065.25,
ZIMMER BLADE STRYK-76542K-19X19X1.19G,30186672,CDM,,,270,RC,inpatient,,371.7,371.7,,315.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,280.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,315.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,327.1,88,,percent of total billed charges,,,,,,,,,283.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,338.25,91,,percent of total billed charges,,,353.12,95,,percent of total billed charges,,,308.51,83,,percent of total billed charges,,,308.51,83,,percent of total billed charges,,,,,,,,,,,,,,,308.51,83,,percent of total billed charges,,,353.12,95,,percent of total billed charges,,,334.53,90,,percent of total billed charges,,,334.53,90,,percent of total billed charges,,,304.79,82,,percent of total billed charges,,,334.53,90,,percent of total billed charges,,,315.95,85,,percent of total billed charges,,280.26,353.12,
SYNTHES SCREW LOCKING 5.0 X 44MM,30186673,CDM,,,278,RC,inpatient,,2121.6,2121.6,,1801.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1599.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1803.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1867.01,88,,percent of total billed charges,,,,,,,,,1620.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1930.66,91,,percent of total billed charges,,,2015.52,95,,percent of total billed charges,,,1760.93,83,,percent of total billed charges,,,1760.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1760.93,83,,percent of total billed charges,,,2015.52,95,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1739.71,82,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1803.36,85,,percent of total billed charges,,1599.69,2015.52,
NUVASIVE SCREW HELIX R 4X13MM,30186674,CDM,,,278,RC,inpatient,,3653,3653,,3101.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2754.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3105.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3214.64,88,,percent of total billed charges,,,,,,,,,2790.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3324.23,91,,percent of total billed charges,,,3470.35,95,,percent of total billed charges,,,3031.99,83,,percent of total billed charges,,,3031.99,83,,percent of total billed charges,,,,,,,,,,,,,,,3031.99,83,,percent of total billed charges,,,3470.35,95,,percent of total billed charges,,,3287.7,90,,percent of total billed charges,,,3287.7,90,,percent of total billed charges,,,2995.46,82,,percent of total billed charges,,,3287.7,90,,percent of total billed charges,,,3105.05,85,,percent of total billed charges,,2754.36,3470.35,
NUVASIVE PLATE HELIX  24MM,30186675,CDM,,,278,RC,inpatient,,10588.5,10588.5,,8989.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7983.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9000.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9317.88,88,,percent of total billed charges,,,,,,,,,8089.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9635.54,91,,percent of total billed charges,,,10059.08,95,,percent of total billed charges,,,8788.46,83,,percent of total billed charges,,,8788.46,83,,percent of total billed charges,,,,,,,,,,,,,,,8788.46,83,,percent of total billed charges,,,10059.08,95,,percent of total billed charges,,,9529.65,90,,percent of total billed charges,,,9529.65,90,,percent of total billed charges,,,8682.57,82,,percent of total billed charges,,,9529.65,90,,percent of total billed charges,,,9000.23,85,,percent of total billed charges,,7983.73,10059.08,
OLYMPUS ELEVIEW,30186677,CDM,,,270,RC,inpatient,,567,567,,481.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,427.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,481.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,498.96,88,,percent of total billed charges,,,,,,,,,433.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,,,,,,,,,,,,,470.61,83,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,464.94,82,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,427.52,538.65,
ZIMMER BEARING MC 12MM,30186678,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
DEPUY HEAD HUMERAL ECCENTRIC 44EZI,30186679,CDM,,,278,RC,inpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13297.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14990.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,13297.64,16754.32,
DEPUY BODY 142 DEG SZ 10,30186680,CDM,,,278,RC,inpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9541.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10756.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,9541.61,12021.93,
DEPUY STEM UNITE STD SZ 10,30186681,CDM,,,278,RC,inpatient,,26023.86,26023.86,,22094.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19621.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22120.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22901,88,,percent of total billed charges,,,,,,,,,19882.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23681.71,91,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21599.8,83,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,21339.57,82,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,19621.99,24722.67,
DEPUY GLENOSPHERE ECCENTRIC 42MM +4,30186682,CDM,,,278,RC,inpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14941.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16844.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,14941.68,18825.72,
ZIMMER TIBIA POROUS 11MM RIGHT,30186683,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER FEMUR POROUS CR SZ 8 RIGHT,30186684,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER INSERT ASF 12MM 7-12 GH RIGHT,30186685,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ABBOTT LOOP RECORDER,30186686,CDM,,,278,RC,inpatient,,33800,33800,,28696.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25485.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28730,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29744,88,,percent of total billed charges,,,,,,,,,25823.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30758,91,,percent of total billed charges,,,32110,95,,percent of total billed charges,,,28054,83,,percent of total billed charges,,,28054,83,,percent of total billed charges,,,,,,,,,,,,,,,28054,83,,percent of total billed charges,,,32110,95,,percent of total billed charges,,,30420,90,,percent of total billed charges,,,30420,90,,percent of total billed charges,,,27716,82,,percent of total billed charges,,,30420,90,,percent of total billed charges,,,28730,85,,percent of total billed charges,,25485.2,32110,
S&N HIP PREP KIT,30186687,CDM,,,270,RC,inpatient,,4602,4602,,3907.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3469.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3911.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4049.76,88,,percent of total billed charges,,,,,,,,,3515.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4187.82,91,,percent of total billed charges,,,4371.9,95,,percent of total billed charges,,,3819.66,83,,percent of total billed charges,,,3819.66,83,,percent of total billed charges,,,,,,,,,,,,,,,3819.66,83,,percent of total billed charges,,,4371.9,95,,percent of total billed charges,,,4141.8,90,,percent of total billed charges,,,4141.8,90,,percent of total billed charges,,,3773.64,82,,percent of total billed charges,,,4141.8,90,,percent of total billed charges,,,3911.7,85,,percent of total billed charges,,3469.91,4371.9,
ZIMMER INSERT TIBIAL 11MM 7-12GH,30186688,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
GLOBUS RISE SPACER 8X22MM 10 DEG,30186689,CDM,,,278,RC,inpatient,,35750,35750,,30351.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26955.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30387.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31460,88,,percent of total billed charges,,,,,,,,,27313,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32532.5,91,,percent of total billed charges,,,33962.5,95,,percent of total billed charges,,,29672.5,83,,percent of total billed charges,,,29672.5,83,,percent of total billed charges,,,,,,,,,,,,,,,29672.5,83,,percent of total billed charges,,,33962.5,95,,percent of total billed charges,,,32175,90,,percent of total billed charges,,,32175,90,,percent of total billed charges,,,29315,82,,percent of total billed charges,,,32175,90,,percent of total billed charges,,,30387.5,85,,percent of total billed charges,,26955.5,33962.5,
NUVASIVE SCREW SHANK 5.5X40MM 2S,30186690,CDM,,,278,RC,inpatient,,11970,11970,,10162.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9025.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10174.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10533.6,88,,percent of total billed charges,,,,,,,,,9145.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10892.7,91,,percent of total billed charges,,,11371.5,95,,percent of total billed charges,,,9935.1,83,,percent of total billed charges,,,9935.1,83,,percent of total billed charges,,,,,,,,,,,,,,,9935.1,83,,percent of total billed charges,,,11371.5,95,,percent of total billed charges,,,10773,90,,percent of total billed charges,,,10773,90,,percent of total billed charges,,,9815.4,82,,percent of total billed charges,,,10773,90,,percent of total billed charges,,,10174.5,85,,percent of total billed charges,,9025.38,11371.5,
NUVASIVE SCREW SHANK 5.5X50MM 2S,30186691,CDM,,,278,RC,inpatient,,12967.5,12967.5,,11009.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9777.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11022.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11411.4,88,,percent of total billed charges,,,,,,,,,9907.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11800.43,91,,percent of total billed charges,,,12319.13,95,,percent of total billed charges,,,10763.03,83,,percent of total billed charges,,,10763.03,83,,percent of total billed charges,,,,,,,,,,,,,,,10763.03,83,,percent of total billed charges,,,12319.13,95,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,10633.35,82,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,11022.38,85,,percent of total billed charges,,9777.5,12319.13,
NUVASIVE  ROD TULIP PPS SPHERX 5.5MM,30186692,CDM,,,278,RC,inpatient,,8339.5,8339.5,,7080.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6287.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7088.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7338.76,88,,percent of total billed charges,,,,,,,,,6371.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7588.95,91,,percent of total billed charges,,,7922.53,95,,percent of total billed charges,,,6921.79,83,,percent of total billed charges,,,6921.79,83,,percent of total billed charges,,,,,,,,,,,,,,,6921.79,83,,percent of total billed charges,,,7922.53,95,,percent of total billed charges,,,7505.55,90,,percent of total billed charges,,,7505.55,90,,percent of total billed charges,,,6838.39,82,,percent of total billed charges,,,7505.55,90,,percent of total billed charges,,,7088.58,85,,percent of total billed charges,,6287.98,7922.53,
NUVASIVE  SCREW LOCK 5.5MM ROD,30186693,CDM,,,278,RC,inpatient,,2444,2444,,2074.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1842.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2077.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2150.72,88,,percent of total billed charges,,,,,,,,,1867.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2224.04,91,,percent of total billed charges,,,2321.8,95,,percent of total billed charges,,,2028.52,83,,percent of total billed charges,,,2028.52,83,,percent of total billed charges,,,,,,,,,,,,,,,2028.52,83,,percent of total billed charges,,,2321.8,95,,percent of total billed charges,,,2199.6,90,,percent of total billed charges,,,2199.6,90,,percent of total billed charges,,,2004.08,82,,percent of total billed charges,,,2199.6,90,,percent of total billed charges,,,2077.4,85,,percent of total billed charges,,1842.78,2321.8,
NUVASIVE  ROD PRE-BENT 5.5X40MM,30186694,CDM,,,278,RC,inpatient,,5401.5,5401.5,,4585.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4072.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4591.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4753.32,88,,percent of total billed charges,,,,,,,,,4126.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4915.37,91,,percent of total billed charges,,,5131.43,95,,percent of total billed charges,,,4483.25,83,,percent of total billed charges,,,4483.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4483.25,83,,percent of total billed charges,,,5131.43,95,,percent of total billed charges,,,4861.35,90,,percent of total billed charges,,,4861.35,90,,percent of total billed charges,,,4429.23,82,,percent of total billed charges,,,4861.35,90,,percent of total billed charges,,,4591.28,85,,percent of total billed charges,,4072.73,5131.43,
NUVASIVE  ROD PRE-BENT 5.5X35MM,30186695,CDM,,,278,RC,inpatient,,5401.5,5401.5,,4585.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4072.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4591.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4753.32,88,,percent of total billed charges,,,,,,,,,4126.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4915.37,91,,percent of total billed charges,,,5131.43,95,,percent of total billed charges,,,4483.25,83,,percent of total billed charges,,,4483.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4483.25,83,,percent of total billed charges,,,5131.43,95,,percent of total billed charges,,,4861.35,90,,percent of total billed charges,,,4861.35,90,,percent of total billed charges,,,4429.23,82,,percent of total billed charges,,,4861.35,90,,percent of total billed charges,,,4591.28,85,,percent of total billed charges,,4072.73,5131.43,
STRYKER CMF SCREW MP SD 2.0 X 6MM,30186696,CDM,,,278,RC,inpatient,,522.06,522.06,,443.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,393.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,443.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,459.41,88,,percent of total billed charges,,,,,,,,,398.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,475.07,91,,percent of total billed charges,,,495.96,95,,percent of total billed charges,,,433.31,83,,percent of total billed charges,,,433.31,83,,percent of total billed charges,,,,,,,,,,,,,,,433.31,83,,percent of total billed charges,,,495.96,95,,percent of total billed charges,,,469.85,90,,percent of total billed charges,,,469.85,90,,percent of total billed charges,,,428.09,82,,percent of total billed charges,,,469.85,90,,percent of total billed charges,,,443.75,85,,percent of total billed charges,,393.63,495.96,
ZIMMER FEMUR PSN SZ 12 LEFT,30186697,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER BLADE STRYK_76542K_25X90X1.19G,30186698,CDM,,,270,RC,inpatient,,359.1,359.1,,304.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,270.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,305.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,316.01,88,,percent of total billed charges,,,,,,,,,274.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,326.78,91,,percent of total billed charges,,,341.15,95,,percent of total billed charges,,,298.05,83,,percent of total billed charges,,,298.05,83,,percent of total billed charges,,,,,,,,,,,,,,,298.05,83,,percent of total billed charges,,,341.15,95,,percent of total billed charges,,,323.19,90,,percent of total billed charges,,,323.19,90,,percent of total billed charges,,,294.46,82,,percent of total billed charges,,,323.19,90,,percent of total billed charges,,,305.24,85,,percent of total billed charges,,270.76,341.15,
DEPUY ATTUNE TIBIA RP REVISION SZ 7,30186700,CDM,,,278,RC,inpatient,,39503.36,39503.36,,33538.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29785.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33577.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34762.96,88,,percent of total billed charges,,,,,,,,,30180.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35948.06,91,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32787.79,83,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,32392.76,82,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,29785.53,37528.19,
DEPUY PRESSFIT FEMUR CEMTLESS SZ 5 LEFT,30186701,CDM,,,278,RC,inpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30299.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34157.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,30299.65,38175.95,
DEPUY INSERT ATTUNE RP PS SZ 9 7MM,30186703,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
SYNTHES PLATE CALC RIGHT 3.5MM 6H,30186704,CDM,,,278,RC,inpatient,,8923.07,8923.07,,7575.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6727.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7584.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7852.3,88,,percent of total billed charges,,,,,,,,,6817.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8119.99,91,,percent of total billed charges,,,8476.92,95,,percent of total billed charges,,,7406.15,83,,percent of total billed charges,,,7406.15,83,,percent of total billed charges,,,,,,,,,,,,,,,7406.15,83,,percent of total billed charges,,,8476.92,95,,percent of total billed charges,,,8030.76,90,,percent of total billed charges,,,8030.76,90,,percent of total billed charges,,,7316.92,82,,percent of total billed charges,,,8030.76,90,,percent of total billed charges,,,7584.61,85,,percent of total billed charges,,6727.99,8476.92,
SYNTHES PLATE TIBIA MEDIAL DISTAL 4H 2.7,30186705,CDM,,,278,RC,inpatient,,15194.34,15194.34,,12899.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11456.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12915.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13371.02,88,,percent of total billed charges,,,,,,,,,11608.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13826.85,91,,percent of total billed charges,,,14434.62,95,,percent of total billed charges,,,12611.3,83,,percent of total billed charges,,,12611.3,83,,percent of total billed charges,,,,,,,,,,,,,,,12611.3,83,,percent of total billed charges,,,14434.62,95,,percent of total billed charges,,,13674.91,90,,percent of total billed charges,,,13674.91,90,,percent of total billed charges,,,12459.36,82,,percent of total billed charges,,,13674.91,90,,percent of total billed charges,,,12915.19,85,,percent of total billed charges,,11456.53,14434.62,
SYNTHES SCREW METAPHYSEAL 2.7 X 30MM,30186706,CDM,,,278,RC,inpatient,,478.03,478.03,,405.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,360.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,406.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,420.67,88,,percent of total billed charges,,,,,,,,,365.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,435.01,91,,percent of total billed charges,,,454.13,95,,percent of total billed charges,,,396.76,83,,percent of total billed charges,,,396.76,83,,percent of total billed charges,,,,,,,,,,,,,,,396.76,83,,percent of total billed charges,,,454.13,95,,percent of total billed charges,,,430.23,90,,percent of total billed charges,,,430.23,90,,percent of total billed charges,,,391.98,82,,percent of total billed charges,,,430.23,90,,percent of total billed charges,,,406.33,85,,percent of total billed charges,,360.43,454.13,
SYNTHES SCREW METAPHYSEAL 2.7 X 38MM,30186707,CDM,,,278,RC,inpatient,,478.03,478.03,,405.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,360.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,406.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,420.67,88,,percent of total billed charges,,,,,,,,,365.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,435.01,91,,percent of total billed charges,,,454.13,95,,percent of total billed charges,,,396.76,83,,percent of total billed charges,,,396.76,83,,percent of total billed charges,,,,,,,,,,,,,,,396.76,83,,percent of total billed charges,,,454.13,95,,percent of total billed charges,,,430.23,90,,percent of total billed charges,,,430.23,90,,percent of total billed charges,,,391.98,82,,percent of total billed charges,,,430.23,90,,percent of total billed charges,,,406.33,85,,percent of total billed charges,,360.43,454.13,
SYNTHES SCREW METAPHYSEAL 2.7 X 36MM,30186708,CDM,,,278,RC,inpatient,,492.38,492.38,,418.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,371.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,418.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,433.29,88,,percent of total billed charges,,,,,,,,,376.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,448.07,91,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,,,,,,,,,,,,,408.68,83,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,403.75,82,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,371.25,467.76,
SPINECRAFT ROD LORDOSED 6.0 X 110,30186709,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
BSS BALANCE SALT SOLUTION 500ML,30186710,CDM,,,270,RC,inpatient,,59.5,59.5,,50.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.36,88,,percent of total billed charges,,,,,,,,,45.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,54.15,91,,percent of total billed charges,,,56.53,95,,percent of total billed charges,,,49.39,83,,percent of total billed charges,,,49.39,83,,percent of total billed charges,,,,,,,,,,,,,,,49.39,83,,percent of total billed charges,,,56.53,95,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,48.79,82,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,50.58,85,,percent of total billed charges,,44.86,56.53,
ZIMMER LINER NEUTRAL G E1 36MM G7,30186711,CDM,,,278,RC,inpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17447.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19669,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,17447.56,21983,
DEPUY ATTUNE TIBIA AUGMENT 5MM,30186712,CDM,,,278,RC,inpatient,,10997.61,10997.61,,9336.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8292.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9347.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9677.9,88,,percent of total billed charges,,,,,,,,,8402.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10007.83,91,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,,,,,,,,,,,,,9128.02,83,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9018.04,82,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,8292.2,10447.73,
DEPUY ATTUNE INSERT CRS 8MM,30186713,CDM,,,278,RC,inpatient,,23578.82,23578.82,,20018.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17778.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20042,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20749.36,88,,percent of total billed charges,,,,,,,,,18014.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21456.73,91,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,,,,,,,,,,,,,19570.42,83,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,19334.63,82,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,20042,85,,percent of total billed charges,,17778.43,22399.88,
DEPUY ATTUNE FEMUR CRS 5MM LEFT,30186714,CDM,,,278,RC,inpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39636.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44683.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,39636.69,49940.13,
ZIMMER PATELLA CEMENTED 41MM,30186715,CDM,,,278,RC,inpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1715.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1933.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,1715.35,2161.25,
ZIMMER STEM EXTENSION 14X30MM,30186716,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
ZIMMER TIBIA PSN CEMENTED SZ H LEFT,30186717,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER INSERT MC 13MM LEFT,30186718,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ZIMMER REAMER BLADE 46MM,30186719,CDM,,,278,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
ZIMMER SCREW HEX 2.5MM,30186720,CDM,,,278,RC,inpatient,,1072.5,1072.5,,910.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,808.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,911.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,943.8,88,,percent of total billed charges,,,,,,,,,819.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,975.98,91,,percent of total billed charges,,,1018.88,95,,percent of total billed charges,,,890.18,83,,percent of total billed charges,,,890.18,83,,percent of total billed charges,,,,,,,,,,,,,,,890.18,83,,percent of total billed charges,,,1018.88,95,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,879.45,82,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,911.63,85,,percent of total billed charges,,808.67,1018.88,
DEPUY ATTUNE TIBIA PRESSFIT RP SZ10,30186721,CDM,,,278,RC,inpatient,,27458.8,27458.8,,23312.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20703.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23339.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24163.74,88,,percent of total billed charges,,,,,,,,,20978.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24987.51,91,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,,,,,,,,,,,,,22790.8,83,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,22516.22,82,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,20703.94,26085.86,
SYNTHES PLATE TIBIA LB 3.5 VA 10H LEFT,30186722,CDM,,,278,RC,inpatient,,17578.73,17578.73,,14924.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13254.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14941.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15469.28,88,,percent of total billed charges,,,,,,,,,13430.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15996.64,91,,percent of total billed charges,,,16699.79,95,,percent of total billed charges,,,14590.35,83,,percent of total billed charges,,,14590.35,83,,percent of total billed charges,,,,,,,,,,,,,,,14590.35,83,,percent of total billed charges,,,16699.79,95,,percent of total billed charges,,,15820.86,90,,percent of total billed charges,,,15820.86,90,,percent of total billed charges,,,14414.56,82,,percent of total billed charges,,,15820.86,90,,percent of total billed charges,,,14941.92,85,,percent of total billed charges,,13254.36,16699.79,
SPINECRAFT ROD TITANIUM 6.0 X 70MM STRAI,30186723,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
SYNTHES SCREW CORTEX 3.5 X 55MM,30186724,CDM,,,278,RC,inpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,214.16,269.83,
S&N FEMUR DX COMP. SZ 5 LT MED/RT LAT,30186725,CDM,,,278,RC,inpatient,,27214.79,27214.79,,23105.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20519.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23132.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23949.02,88,,percent of total billed charges,,,,,,,,,20792.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24765.46,91,,percent of total billed charges,,,25854.05,95,,percent of total billed charges,,,22588.28,83,,percent of total billed charges,,,22588.28,83,,percent of total billed charges,,,,,,,,,,,,,,,22588.28,83,,percent of total billed charges,,,25854.05,95,,percent of total billed charges,,,24493.31,90,,percent of total billed charges,,,24493.31,90,,percent of total billed charges,,,22316.13,82,,percent of total billed charges,,,24493.31,90,,percent of total billed charges,,,23132.57,85,,percent of total billed charges,,20519.95,25854.05,
S&N BASE TIBIAL SZ 5 LT MED/RT LAT,30186726,CDM,,,278,RC,inpatient,,14631.63,14631.63,,12422.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11032.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12436.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12875.83,88,,percent of total billed charges,,,,,,,,,11178.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13314.78,91,,percent of total billed charges,,,13900.05,95,,percent of total billed charges,,,12144.25,83,,percent of total billed charges,,,12144.25,83,,percent of total billed charges,,,,,,,,,,,,,,,12144.25,83,,percent of total billed charges,,,13900.05,95,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,11997.94,82,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,12436.89,85,,percent of total billed charges,,11032.25,13900.05,
S&N INSERT TIBIA SZ 5/6 8MM LT MED/RT LA,30186727,CDM,,,278,RC,inpatient,,6855.94,6855.94,,5820.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5169.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5827.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6033.23,88,,percent of total billed charges,,,,,,,,,5237.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6238.91,91,,percent of total billed charges,,,6513.14,95,,percent of total billed charges,,,5690.43,83,,percent of total billed charges,,,5690.43,83,,percent of total billed charges,,,,,,,,,,,,,,,5690.43,83,,percent of total billed charges,,,6513.14,95,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,5621.87,82,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,5827.55,85,,percent of total billed charges,,5169.38,6513.14,
DEPUY HINGE S-ROM SMALL LEFT,30186728,CDM,,,278,RC,inpatient,,52982.02,52982.02,,44981.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39948.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45034.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46624.18,88,,percent of total billed charges,,,,,,,,,40478.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,48213.64,91,,percent of total billed charges,,,50332.92,95,,percent of total billed charges,,,43975.08,83,,percent of total billed charges,,,43975.08,83,,percent of total billed charges,,,,,,,,,,,,,,,43975.08,83,,percent of total billed charges,,,50332.92,95,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,43445.26,82,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,45034.72,85,,percent of total billed charges,,39948.44,50332.92,
S&N LGN PS HIGH FLEX XLPE SZ 5-6 11MM,30186731,CDM,,,278,RC,inpatient,,16261.96,16261.96,,13806.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12261.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13822.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14310.52,88,,percent of total billed charges,,,,,,,,,12424.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14798.38,91,,percent of total billed charges,,,15448.86,95,,percent of total billed charges,,,13497.43,83,,percent of total billed charges,,,13497.43,83,,percent of total billed charges,,,,,,,,,,,,,,,13497.43,83,,percent of total billed charges,,,15448.86,95,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,13334.81,82,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,13822.67,85,,percent of total billed charges,,12261.52,15448.86,
DEPUY ATTUNE FEMUR REVISION SZ 7 RIGHT,30186732,CDM,,,278,RC,inpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39636.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44683.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,39636.69,49940.13,
DEPUY ATTUNE INSERT RP SZ 7 12MM,30186733,CDM,,,278,RC,inpatient,,23578.82,23578.82,,20018.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17778.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20042,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20749.36,88,,percent of total billed charges,,,,,,,,,18014.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21456.73,91,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,,,,,,,,,,,,,19570.42,83,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,19334.63,82,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,20042,85,,percent of total billed charges,,17778.43,22399.88,
DEPUY SEGMENTAL COMPONENT 105MM,30186734,CDM,,,278,RC,inpatient,,18773.5,18773.5,,15938.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14155.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15957.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16520.68,88,,percent of total billed charges,,,,,,,,,14342.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17083.89,91,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,,,,,,,,,,,,,15582.01,83,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15394.27,82,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,14155.22,17834.83,
DEPUY STEM CEMENTED LPS 17 X 150MM,30186735,CDM,,,278,RC,inpatient,,44982.15,44982.15,,38189.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33916.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38234.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39584.29,88,,percent of total billed charges,,,,,,,,,34366.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40933.76,91,,percent of total billed charges,,,42733.04,95,,percent of total billed charges,,,37335.18,83,,percent of total billed charges,,,37335.18,83,,percent of total billed charges,,,,,,,,,,,,,,,37335.18,83,,percent of total billed charges,,,42733.04,95,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,36885.36,82,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,38234.83,85,,percent of total billed charges,,33916.54,42733.04,
CELL SAVER PROF. FEES,30186736,CDM,,,270,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
CELL SAVER EQUIPMENT FEE,30186737,CDM,,,270,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
CELL SAVER AUTOLOG ONE SOURCE PACK,30186738,CDM,,,270,RC,inpatient,,1331.92,1331.92,,1130.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1004.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1132.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1172.09,88,,percent of total billed charges,,,,,,,,,1017.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1212.05,91,,percent of total billed charges,,,1265.32,95,,percent of total billed charges,,,1105.49,83,,percent of total billed charges,,,1105.49,83,,percent of total billed charges,,,,,,,,,,,,,,,1105.49,83,,percent of total billed charges,,,1265.32,95,,percent of total billed charges,,,1198.73,90,,percent of total billed charges,,,1198.73,90,,percent of total billed charges,,,1092.17,82,,percent of total billed charges,,,1198.73,90,,percent of total billed charges,,,1132.13,85,,percent of total billed charges,,1004.27,1265.32,
ULRICH CAGE CORPECTOMY SMALL,30186739,CDM,,,278,RC,inpatient,,143442,143442,,121782.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108155.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,121925.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126228.96,88,,percent of total billed charges,,,,,,,,,109589.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,130532.22,91,,percent of total billed charges,,,136269.9,95,,percent of total billed charges,,,119056.86,83,,percent of total billed charges,,,119056.86,83,,percent of total billed charges,,,,,,,,,,,,,,,119056.86,83,,percent of total billed charges,,,136269.9,95,,percent of total billed charges,,,129097.8,90,,percent of total billed charges,,,129097.8,90,,percent of total billed charges,,,117622.44,82,,percent of total billed charges,,,129097.8,90,,percent of total billed charges,,,121925.7,85,,percent of total billed charges,,108155.27,136269.9,
ULRICH LOCKING SCREW SET,30186740,CDM,,,270,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
ULRICH PLATE 2 LEVEL 28MM,30186741,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
ULRICH CASSETTE DISP. 12MM,30186742,CDM,,,278,RC,inpatient,,7949.5,7949.5,,6749.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5993.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6757.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6995.56,88,,percent of total billed charges,,,,,,,,,6073.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7234.05,91,,percent of total billed charges,,,7552.03,95,,percent of total billed charges,,,6598.09,83,,percent of total billed charges,,,6598.09,83,,percent of total billed charges,,,,,,,,,,,,,,,6598.09,83,,percent of total billed charges,,,7552.03,95,,percent of total billed charges,,,7154.55,90,,percent of total billed charges,,,7154.55,90,,percent of total billed charges,,,6518.59,82,,percent of total billed charges,,,7154.55,90,,percent of total billed charges,,,6757.08,85,,percent of total billed charges,,5993.92,7552.03,
SYNTHES SCREWDRIVER SHAFT T8,30186743,CDM,,,278,RC,inpatient,,3018.67,3018.67,,2562.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2276.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2565.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2656.43,88,,percent of total billed charges,,,,,,,,,2306.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2746.99,91,,percent of total billed charges,,,2867.74,95,,percent of total billed charges,,,2505.5,83,,percent of total billed charges,,,2505.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2505.5,83,,percent of total billed charges,,,2867.74,95,,percent of total billed charges,,,2716.8,90,,percent of total billed charges,,,2716.8,90,,percent of total billed charges,,,2475.31,82,,percent of total billed charges,,,2716.8,90,,percent of total billed charges,,,2565.87,85,,percent of total billed charges,,2276.08,2867.74,
SYNTHES SCREWDRIVER SHAFT SOLID 2.5MM HE,30186744,CDM,,,278,RC,inpatient,,1007.24,1007.24,,855.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,759.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,856.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,886.37,88,,percent of total billed charges,,,,,,,,,769.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,916.59,91,,percent of total billed charges,,,956.88,95,,percent of total billed charges,,,836.01,83,,percent of total billed charges,,,836.01,83,,percent of total billed charges,,,,,,,,,,,,,,,836.01,83,,percent of total billed charges,,,956.88,95,,percent of total billed charges,,,906.52,90,,percent of total billed charges,,,906.52,90,,percent of total billed charges,,,825.94,82,,percent of total billed charges,,,906.52,90,,percent of total billed charges,,,856.15,85,,percent of total billed charges,,759.46,956.88,
SYNTHES T HANDLE QUICK CONNECT,30186745,CDM,,,270,RC,inpatient,,5463.12,5463.12,,4638.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4119.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4643.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4807.55,88,,percent of total billed charges,,,,,,,,,4173.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4971.44,91,,percent of total billed charges,,,5189.96,95,,percent of total billed charges,,,4534.39,83,,percent of total billed charges,,,4534.39,83,,percent of total billed charges,,,,,,,,,,,,,,,4534.39,83,,percent of total billed charges,,,5189.96,95,,percent of total billed charges,,,4916.81,90,,percent of total billed charges,,,4916.81,90,,percent of total billed charges,,,4479.76,82,,percent of total billed charges,,,4916.81,90,,percent of total billed charges,,,4643.65,85,,percent of total billed charges,,4119.19,5189.96,
ZIMMER LINER NUETRAL 36MM +5 G,30186746,CDM,,,278,RC,inpatient,,23595,23595,,20032.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17790.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20055.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20763.6,88,,percent of total billed charges,,,,,,,,,18026.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21471.45,91,,percent of total billed charges,,,22415.25,95,,percent of total billed charges,,,19583.85,83,,percent of total billed charges,,,19583.85,83,,percent of total billed charges,,,,,,,,,,,,,,,19583.85,83,,percent of total billed charges,,,22415.25,95,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,19347.9,82,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,20055.75,85,,percent of total billed charges,,17790.63,22415.25,
ZIMMER LINER NEUTRAL G7 36MM,30186747,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT ROD LORDOSED 6.0 X 300,30186748,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
SYNTHES SCREW HEADLESS COMRESSION 3 X 16,30186749,CDM,,,278,RC,inpatient,,3465.67,3465.67,,2942.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2613.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2945.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3049.79,88,,percent of total billed charges,,,,,,,,,2647.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3153.76,91,,percent of total billed charges,,,3292.39,95,,percent of total billed charges,,,2876.51,83,,percent of total billed charges,,,2876.51,83,,percent of total billed charges,,,,,,,,,,,,,,,2876.51,83,,percent of total billed charges,,,3292.39,95,,percent of total billed charges,,,3119.1,90,,percent of total billed charges,,,3119.1,90,,percent of total billed charges,,,2841.85,82,,percent of total billed charges,,,3119.1,90,,percent of total billed charges,,,2945.82,85,,percent of total billed charges,,2613.12,3292.39,
ZIMMER FEMUR CR RIGHT SZ 11,30186750,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
ZIMMER TIBIA PSN  SZ G RIGHT,30186751,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER MC POLY 12MM RIGHT,30186752,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
SYNTHES SCREW LOCKING VA 3.5 X 16MM,30186753,CDM,,,278,RC,inpatient,,1456.85,1456.85,,1236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1098.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1238.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1282.03,88,,percent of total billed charges,,,,,,,,,1113.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1325.73,91,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1209.19,83,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1194.62,82,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,1098.46,1384.01,
SYNTHES SCREW LOCKING VA 3.5 X 20MM,30186754,CDM,,,278,RC,inpatient,,1456.85,1456.85,,1236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1098.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1238.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1282.03,88,,percent of total billed charges,,,,,,,,,1113.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1325.73,91,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1209.19,83,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1194.62,82,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,1098.46,1384.01,
SYNTHES SCREW LOCKING VA 3.5 X 80MM,30186755,CDM,,,278,RC,inpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1131.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1275.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,1131.4,1425.5,
DEPUY GLENOSPHERE 38MM +2,30186756,CDM,,,278,RC,inpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14941.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16844.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,14941.68,18825.72,
S&N GRAFIX PL PRIME 5X5 CM,30186757,CDM,,,278,RC,inpatient,,18525,18525,,15727.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13967.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15746.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16302,88,,percent of total billed charges,,,,,,,,,14153.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16857.75,91,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,,,,,,,,,,,,,15375.75,83,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15190.5,82,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15746.25,85,,percent of total billed charges,,13967.85,17598.75,
DEPUY HEAD HUMERAL 56 X 18 ECC,30186758,CDM,,,278,RC,inpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13297.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14990.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,13297.64,16754.32,
DEPUY BODY PROXIMAL ANATOMIE 142 SZ 16,30186759,CDM,,,278,RC,inpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9541.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10756.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,9541.61,12021.93,
ZIMMER LINER NEUTRAL G7 VIT 32MM D,30186760,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ZIMMER HEAD FEMORAL 6DEG COCR 32MM +10.5,30186761,CDM,,,278,RC,inpatient,,10595,10595,,8995.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7988.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9005.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9323.6,88,,percent of total billed charges,,,,,,,,,8094.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9641.45,91,,percent of total billed charges,,,10065.25,95,,percent of total billed charges,,,8793.85,83,,percent of total billed charges,,,8793.85,83,,percent of total billed charges,,,,,,,,,,,,,,,8793.85,83,,percent of total billed charges,,,10065.25,95,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,8687.9,82,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,9005.75,85,,percent of total billed charges,,7988.63,10065.25,
ZIMMER LINER NEUTRAL G HGP 32 ID,30186762,CDM,,,278,RC,inpatient,,19630,19630,,16665.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14801.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16685.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17274.4,88,,percent of total billed charges,,,,,,,,,14997.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17863.3,91,,percent of total billed charges,,,18648.5,95,,percent of total billed charges,,,16292.9,83,,percent of total billed charges,,,16292.9,83,,percent of total billed charges,,,,,,,,,,,,,,,16292.9,83,,percent of total billed charges,,,18648.5,95,,percent of total billed charges,,,17667,90,,percent of total billed charges,,,17667,90,,percent of total billed charges,,,16096.6,82,,percent of total billed charges,,,17667,90,,percent of total billed charges,,,16685.5,85,,percent of total billed charges,,14801.02,18648.5,
ZIMMER LINER NEUTRAL G7 E1 +5MM 32MM D,30186763,CDM,,,278,RC,inpatient,,23595,23595,,20032.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17790.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20055.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20763.6,88,,percent of total billed charges,,,,,,,,,18026.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21471.45,91,,percent of total billed charges,,,22415.25,95,,percent of total billed charges,,,19583.85,83,,percent of total billed charges,,,19583.85,83,,percent of total billed charges,,,,,,,,,,,,,,,19583.85,83,,percent of total billed charges,,,22415.25,95,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,19347.9,82,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,20055.75,85,,percent of total billed charges,,17790.63,22415.25,
SPINECRAFT SCREW  ILLIAC 8.5 X 80MM,30186764,CDM,,,278,RC,inpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7106.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8011.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,7106.45,8953.75,
SPINECRAFT CROSS CONNECTOR 50-75MM,30186765,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
SPINECRAFT LATERAL CONNECTOR 35MM,30186766,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
SPINECRAFT COBALT CHROME 6.0 X 450,30186767,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
SPINECRAFT SCREW SET,30186768,CDM,,,278,RC,inpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,527.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,595,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,527.8,665,
STRYKER FEMUR TRIATHLON PS RT SZ 5,30186769,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER BASEPLATE TIBIAL SZ 4,30186770,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
STRYKER INSERT TIBIAL PS SZ 4 9MM,30186771,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER PATELLA ASYMMETRIC X3 SZ 32,30186772,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
STRYKER CEMENT SPEEDSET,30186773,CDM,,,278,RC,inpatient,,823.55,823.55,,699.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,620.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,724.72,88,,percent of total billed charges,,,,,,,,,629.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,749.43,91,,percent of total billed charges,,,782.37,95,,percent of total billed charges,,,683.55,83,,percent of total billed charges,,,683.55,83,,percent of total billed charges,,,,,,,,,,,,,,,683.55,83,,percent of total billed charges,,,782.37,95,,percent of total billed charges,,,741.2,90,,percent of total billed charges,,,741.2,90,,percent of total billed charges,,,675.31,82,,percent of total billed charges,,,741.2,90,,percent of total billed charges,,,700.02,85,,percent of total billed charges,,620.96,782.37,
DRESSING MEPILEX BORDER AG 4X12IN,30186774,CDM,,,270,RC,inpatient,,250.8,250.8,,212.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,189.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,213.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220.7,88,,percent of total billed charges,,,,,,,,,191.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,228.23,91,,percent of total billed charges,,,238.26,95,,percent of total billed charges,,,208.16,83,,percent of total billed charges,,,208.16,83,,percent of total billed charges,,,,,,,,,,,,,,,208.16,83,,percent of total billed charges,,,238.26,95,,percent of total billed charges,,,225.72,90,,percent of total billed charges,,,225.72,90,,percent of total billed charges,,,205.66,82,,percent of total billed charges,,,225.72,90,,percent of total billed charges,,,213.18,85,,percent of total billed charges,,189.1,238.26,
DEPUY GLENOSPHERE ECCENTRIC 42MM +2,30186776,CDM,,,278,RC,inpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14941.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16844.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,14941.68,18825.72,
DEPUY STEM CEMENTED LPS 11 X 100,30186777,CDM,,,278,RC,inpatient,,42441.95,42441.95,,36033.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32001.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36075.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37348.92,88,,percent of total billed charges,,,,,,,,,32425.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38622.17,91,,percent of total billed charges,,,40319.85,95,,percent of total billed charges,,,35226.82,83,,percent of total billed charges,,,35226.82,83,,percent of total billed charges,,,,,,,,,,,,,,,35226.82,83,,percent of total billed charges,,,40319.85,95,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,34802.4,82,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,36075.66,85,,percent of total billed charges,,32001.23,40319.85,
DEPUY ATTUNE INSERT LPS X-SM 14MM,30186778,CDM,,,278,RC,inpatient,,39351.39,39351.39,,33409.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29670.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33448.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34629.22,88,,percent of total billed charges,,,,,,,,,30064.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35809.76,91,,percent of total billed charges,,,37383.82,95,,percent of total billed charges,,,32661.65,83,,percent of total billed charges,,,32661.65,83,,percent of total billed charges,,,,,,,,,,,,,,,32661.65,83,,percent of total billed charges,,,37383.82,95,,percent of total billed charges,,,35416.25,90,,percent of total billed charges,,,35416.25,90,,percent of total billed charges,,,32268.14,82,,percent of total billed charges,,,35416.25,90,,percent of total billed charges,,,33448.68,85,,percent of total billed charges,,29670.95,37383.82,
DEPUY SCREW LOCKING 36MM,30186782,CDM,,,278,RC,inpatient,,2237.76,2237.76,,1899.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1687.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1902.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1969.23,88,,percent of total billed charges,,,,,,,,,1709.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2036.36,91,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1857.34,83,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1834.96,82,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,1687.27,2125.87,
SYNTHES SCREW LOCKING 5.0 X 54MM,30186783,CDM,,,278,RC,inpatient,,2185.24,2185.24,,1855.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1647.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1857.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1923.01,88,,percent of total billed charges,,,,,,,,,1669.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1988.57,91,,percent of total billed charges,,,2075.98,95,,percent of total billed charges,,,1813.75,83,,percent of total billed charges,,,1813.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1813.75,83,,percent of total billed charges,,,2075.98,95,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1791.9,82,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1857.45,85,,percent of total billed charges,,1647.67,2075.98,
SYNTHES PLATE LCP 5 HOLES 2.7 X 49MM,30186784,CDM,,,278,RC,inpatient,,3989.25,3989.25,,3386.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3007.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3390.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3510.54,88,,percent of total billed charges,,,,,,,,,3047.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3630.22,91,,percent of total billed charges,,,3789.79,95,,percent of total billed charges,,,3311.08,83,,percent of total billed charges,,,3311.08,83,,percent of total billed charges,,,,,,,,,,,,,,,3311.08,83,,percent of total billed charges,,,3789.79,95,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3271.19,82,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3390.86,85,,percent of total billed charges,,3007.89,3789.79,
SYNTHES PLATE LCP 6 HOLES 2.7 X 58MM,30186785,CDM,,,278,RC,inpatient,,3989.25,3989.25,,3386.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3007.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3390.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3510.54,88,,percent of total billed charges,,,,,,,,,3047.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3630.22,91,,percent of total billed charges,,,3789.79,95,,percent of total billed charges,,,3311.08,83,,percent of total billed charges,,,3311.08,83,,percent of total billed charges,,,,,,,,,,,,,,,3311.08,83,,percent of total billed charges,,,3789.79,95,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3271.19,82,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3390.86,85,,percent of total billed charges,,3007.89,3789.79,
SYNTHES SCREW CORTEX 2.7MM X 10MM,30186786,CDM,,,278,RC,inpatient,,398.37,398.37,,338.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,300.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,338.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,350.57,88,,percent of total billed charges,,,,,,,,,304.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,362.52,91,,percent of total billed charges,,,378.45,95,,percent of total billed charges,,,330.65,83,,percent of total billed charges,,,330.65,83,,percent of total billed charges,,,,,,,,,,,,,,,330.65,83,,percent of total billed charges,,,378.45,95,,percent of total billed charges,,,358.53,90,,percent of total billed charges,,,358.53,90,,percent of total billed charges,,,326.66,82,,percent of total billed charges,,,358.53,90,,percent of total billed charges,,,338.61,85,,percent of total billed charges,,300.37,378.45,
SYNTHES PLATE LCP 4 HOLES 2.0 X 31MM,30186787,CDM,,,278,RC,inpatient,,2475.46,2475.46,,2101.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1866.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2104.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2178.4,88,,percent of total billed charges,,,,,,,,,1891.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2252.67,91,,percent of total billed charges,,,2351.69,95,,percent of total billed charges,,,2054.63,83,,percent of total billed charges,,,2054.63,83,,percent of total billed charges,,,,,,,,,,,,,,,2054.63,83,,percent of total billed charges,,,2351.69,95,,percent of total billed charges,,,2227.91,90,,percent of total billed charges,,,2227.91,90,,percent of total billed charges,,,2029.88,82,,percent of total billed charges,,,2227.91,90,,percent of total billed charges,,,2104.14,85,,percent of total billed charges,,1866.5,2351.69,
SYNTHES DRILL BIT 1.5 X 110,30186788,CDM,,,270,RC,inpatient,,1473.88,1473.88,,1251.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1111.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1252.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1297.01,88,,percent of total billed charges,,,,,,,,,1126.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1341.23,91,,percent of total billed charges,,,1400.19,95,,percent of total billed charges,,,1223.32,83,,percent of total billed charges,,,1223.32,83,,percent of total billed charges,,,,,,,,,,,,,,,1223.32,83,,percent of total billed charges,,,1400.19,95,,percent of total billed charges,,,1326.49,90,,percent of total billed charges,,,1326.49,90,,percent of total billed charges,,,1208.58,82,,percent of total billed charges,,,1326.49,90,,percent of total billed charges,,,1252.8,85,,percent of total billed charges,,1111.31,1400.19,
SYNTHES SCREW LOCKING 2.0 X 11MM,30186789,CDM,,,278,RC,inpatient,,1109.68,1109.68,,942.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,836.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,943.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,976.52,88,,percent of total billed charges,,,,,,,,,847.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1009.81,91,,percent of total billed charges,,,1054.2,95,,percent of total billed charges,,,921.03,83,,percent of total billed charges,,,921.03,83,,percent of total billed charges,,,,,,,,,,,,,,,921.03,83,,percent of total billed charges,,,1054.2,95,,percent of total billed charges,,,998.71,90,,percent of total billed charges,,,998.71,90,,percent of total billed charges,,,909.94,82,,percent of total billed charges,,,998.71,90,,percent of total billed charges,,,943.23,85,,percent of total billed charges,,836.7,1054.2,
SYNTHES SCREW CORTEX 2.0 X 6MM,30186790,CDM,,,278,RC,inpatient,,490.28,490.28,,416.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,369.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,416.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,431.45,88,,percent of total billed charges,,,,,,,,,374.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,446.15,91,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,,,,,,,,,,,,,406.93,83,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,402.03,82,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,416.74,85,,percent of total billed charges,,369.67,465.77,
SYNTHES SCREW CORTEX 2.0 X 14MM,30186791,CDM,,,278,RC,inpatient,,490.28,490.28,,416.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,369.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,416.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,431.45,88,,percent of total billed charges,,,,,,,,,374.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,446.15,91,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,,,,,,,,,,,,,406.93,83,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,402.03,82,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,416.74,85,,percent of total billed charges,,369.67,465.77,
DJO CUP EMPOWER,30186792,CDM,,,278,RC,inpatient,,6165.58,6165.58,,5234.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4648.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5240.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5425.71,88,,percent of total billed charges,,,,,,,,,4710.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5610.68,91,,percent of total billed charges,,,5857.3,95,,percent of total billed charges,,,5117.43,83,,percent of total billed charges,,,5117.43,83,,percent of total billed charges,,,,,,,,,,,,,,,5117.43,83,,percent of total billed charges,,,5857.3,95,,percent of total billed charges,,,5549.02,90,,percent of total billed charges,,,5549.02,90,,percent of total billed charges,,,5055.78,82,,percent of total billed charges,,,5549.02,90,,percent of total billed charges,,,5240.74,85,,percent of total billed charges,,4648.85,5857.3,
DJO SCREW BONE 40MM,30186793,CDM,,,278,RC,inpatient,,338.7,338.7,,287.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,255.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,287.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,298.06,88,,percent of total billed charges,,,,,,,,,258.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,308.22,91,,percent of total billed charges,,,321.77,95,,percent of total billed charges,,,281.12,83,,percent of total billed charges,,,281.12,83,,percent of total billed charges,,,,,,,,,,,,,,,281.12,83,,percent of total billed charges,,,321.77,95,,percent of total billed charges,,,304.83,90,,percent of total billed charges,,,304.83,90,,percent of total billed charges,,,277.73,82,,percent of total billed charges,,,304.83,90,,percent of total billed charges,,,287.9,85,,percent of total billed charges,,255.38,321.77,
DJO LINER EMPOWER,30186794,CDM,,,278,RC,inpatient,,5885.56,5885.56,,4996.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4437.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5002.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5179.29,88,,percent of total billed charges,,,,,,,,,4496.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5355.86,91,,percent of total billed charges,,,5591.28,95,,percent of total billed charges,,,4885.01,83,,percent of total billed charges,,,4885.01,83,,percent of total billed charges,,,,,,,,,,,,,,,4885.01,83,,percent of total billed charges,,,5591.28,95,,percent of total billed charges,,,5297,90,,percent of total billed charges,,,5297,90,,percent of total billed charges,,,4826.16,82,,percent of total billed charges,,,5297,90,,percent of total billed charges,,,5002.73,85,,percent of total billed charges,,4437.71,5591.28,
DJO HEAD FEMORAL BIOLOX CERAMIC,30186795,CDM,,,278,RC,inpatient,,6164.08,6164.08,,5233.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4647.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5239.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5424.39,88,,percent of total billed charges,,,,,,,,,4709.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5609.31,91,,percent of total billed charges,,,5855.88,95,,percent of total billed charges,,,5116.19,83,,percent of total billed charges,,,5116.19,83,,percent of total billed charges,,,,,,,,,,,,,,,5116.19,83,,percent of total billed charges,,,5855.88,95,,percent of total billed charges,,,5547.67,90,,percent of total billed charges,,,5547.67,90,,percent of total billed charges,,,5054.55,82,,percent of total billed charges,,,5547.67,90,,percent of total billed charges,,,5239.47,85,,percent of total billed charges,,4647.72,5855.88,
DJO STEM FEMORAL HIP,30186796,CDM,,,278,RC,inpatient,,16947.78,16947.78,,14388.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12778.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14405.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14914.05,88,,percent of total billed charges,,,,,,,,,12948.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15422.48,91,,percent of total billed charges,,,16100.39,95,,percent of total billed charges,,,14066.66,83,,percent of total billed charges,,,14066.66,83,,percent of total billed charges,,,,,,,,,,,,,,,14066.66,83,,percent of total billed charges,,,16100.39,95,,percent of total billed charges,,,15253,90,,percent of total billed charges,,,15253,90,,percent of total billed charges,,,13897.18,82,,percent of total billed charges,,,15253,90,,percent of total billed charges,,,14405.61,85,,percent of total billed charges,,12778.63,16100.39,
DJO CUP EMPOWER 54MM,30186797,CDM,,,278,RC,inpatient,,6165.58,6165.58,,5234.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4648.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5240.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5425.71,88,,percent of total billed charges,,,,,,,,,4710.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5610.68,91,,percent of total billed charges,,,5857.3,95,,percent of total billed charges,,,5117.43,83,,percent of total billed charges,,,5117.43,83,,percent of total billed charges,,,,,,,,,,,,,,,5117.43,83,,percent of total billed charges,,,5857.3,95,,percent of total billed charges,,,5549.02,90,,percent of total billed charges,,,5549.02,90,,percent of total billed charges,,,5055.78,82,,percent of total billed charges,,,5549.02,90,,percent of total billed charges,,,5240.74,85,,percent of total billed charges,,4648.85,5857.3,
DJO SCREW BONE 35MM,30186798,CDM,,,278,RC,inpatient,,338.7,338.7,,287.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,255.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,287.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,298.06,88,,percent of total billed charges,,,,,,,,,258.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,308.22,91,,percent of total billed charges,,,321.77,95,,percent of total billed charges,,,281.12,83,,percent of total billed charges,,,281.12,83,,percent of total billed charges,,,,,,,,,,,,,,,281.12,83,,percent of total billed charges,,,321.77,95,,percent of total billed charges,,,304.83,90,,percent of total billed charges,,,304.83,90,,percent of total billed charges,,,277.73,82,,percent of total billed charges,,,304.83,90,,percent of total billed charges,,,287.9,85,,percent of total billed charges,,255.38,321.77,
DJO LINER EMPOWER,30186799,CDM,,,278,RC,inpatient,,5885.56,5885.56,,4996.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4437.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5002.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5179.29,88,,percent of total billed charges,,,,,,,,,4496.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5355.86,91,,percent of total billed charges,,,5591.28,95,,percent of total billed charges,,,4885.01,83,,percent of total billed charges,,,4885.01,83,,percent of total billed charges,,,,,,,,,,,,,,,4885.01,83,,percent of total billed charges,,,5591.28,95,,percent of total billed charges,,,5297,90,,percent of total billed charges,,,5297,90,,percent of total billed charges,,,4826.16,82,,percent of total billed charges,,,5297,90,,percent of total billed charges,,,5002.73,85,,percent of total billed charges,,4437.71,5591.28,
DJO HEAD CERAMIC 36MM -4,30186800,CDM,,,278,RC,inpatient,,6164.08,6164.08,,5233.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4647.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5239.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5424.39,88,,percent of total billed charges,,,,,,,,,4709.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5609.31,91,,percent of total billed charges,,,5855.88,95,,percent of total billed charges,,,5116.19,83,,percent of total billed charges,,,5116.19,83,,percent of total billed charges,,,,,,,,,,,,,,,5116.19,83,,percent of total billed charges,,,5855.88,95,,percent of total billed charges,,,5547.67,90,,percent of total billed charges,,,5547.67,90,,percent of total billed charges,,,5054.55,82,,percent of total billed charges,,,5547.67,90,,percent of total billed charges,,,5239.47,85,,percent of total billed charges,,4647.72,5855.88,
DJO STEM FEMORAL HIP 11,30186801,CDM,,,278,RC,inpatient,,16947.78,16947.78,,14388.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12778.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14405.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14914.05,88,,percent of total billed charges,,,,,,,,,12948.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15422.48,91,,percent of total billed charges,,,16100.39,95,,percent of total billed charges,,,14066.66,83,,percent of total billed charges,,,14066.66,83,,percent of total billed charges,,,,,,,,,,,,,,,14066.66,83,,percent of total billed charges,,,16100.39,95,,percent of total billed charges,,,15253,90,,percent of total billed charges,,,15253,90,,percent of total billed charges,,,13897.18,82,,percent of total billed charges,,,15253,90,,percent of total billed charges,,,14405.61,85,,percent of total billed charges,,12778.63,16100.39,
SYNTHES DRILL BIT J-LATCH 1.1MM,30186802,CDM,,,270,RC,inpatient,,790.58,790.58,,671.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,596.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,671.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,695.71,88,,percent of total billed charges,,,,,,,,,604,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,719.43,91,,percent of total billed charges,,,751.05,95,,percent of total billed charges,,,656.18,83,,percent of total billed charges,,,656.18,83,,percent of total billed charges,,,,,,,,,,,,,,,656.18,83,,percent of total billed charges,,,751.05,95,,percent of total billed charges,,,711.52,90,,percent of total billed charges,,,711.52,90,,percent of total billed charges,,,648.28,82,,percent of total billed charges,,,711.52,90,,percent of total billed charges,,,671.99,85,,percent of total billed charges,,596.1,751.05,
SYNTHES DRILL BIT QC 1.5MM,30186803,CDM,,,270,RC,inpatient,,772.17,772.17,,655.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,582.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,656.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,679.51,88,,percent of total billed charges,,,,,,,,,589.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,702.67,91,,percent of total billed charges,,,733.56,95,,percent of total billed charges,,,640.9,83,,percent of total billed charges,,,640.9,83,,percent of total billed charges,,,,,,,,,,,,,,,640.9,83,,percent of total billed charges,,,733.56,95,,percent of total billed charges,,,694.95,90,,percent of total billed charges,,,694.95,90,,percent of total billed charges,,,633.18,82,,percent of total billed charges,,,694.95,90,,percent of total billed charges,,,656.34,85,,percent of total billed charges,,582.22,733.56,
SYNTHES PLATE STRAIGHT 6 HOLE 1.5MM,30186804,CDM,,,278,RC,inpatient,,4202.71,4202.71,,3568.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3168.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3572.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3698.38,88,,percent of total billed charges,,,,,,,,,3210.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3824.47,91,,percent of total billed charges,,,3992.57,95,,percent of total billed charges,,,3488.25,83,,percent of total billed charges,,,3488.25,83,,percent of total billed charges,,,,,,,,,,,,,,,3488.25,83,,percent of total billed charges,,,3992.57,95,,percent of total billed charges,,,3782.44,90,,percent of total billed charges,,,3782.44,90,,percent of total billed charges,,,3446.22,82,,percent of total billed charges,,,3782.44,90,,percent of total billed charges,,,3572.3,85,,percent of total billed charges,,3168.84,3992.57,
SYNTHES SCREW CORTEX 1.5 9MM,30186805,CDM,,,278,RC,inpatient,,504.98,504.98,,428.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,380.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,429.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,444.38,88,,percent of total billed charges,,,,,,,,,385.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,459.53,91,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,,,,,,,,,,,,,419.13,83,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,414.08,82,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,380.75,479.73,
SYNTHES SCREW CORTEX 1.5 10MM,30186806,CDM,,,278,RC,inpatient,,504.98,504.98,,428.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,380.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,429.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,444.38,88,,percent of total billed charges,,,,,,,,,385.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,459.53,91,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,,,,,,,,,,,,,419.13,83,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,414.08,82,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,380.75,479.73,
SYNTHES PLATE DISTAL RADIUS 2.4 3HOLES,30186807,CDM,,,278,RC,inpatient,,4759.5,4759.5,,4040.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3588.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4045.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4188.36,88,,percent of total billed charges,,,,,,,,,3636.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4331.15,91,,percent of total billed charges,,,4521.53,95,,percent of total billed charges,,,3950.39,83,,percent of total billed charges,,,3950.39,83,,percent of total billed charges,,,,,,,,,,,,,,,3950.39,83,,percent of total billed charges,,,4521.53,95,,percent of total billed charges,,,4283.55,90,,percent of total billed charges,,,4283.55,90,,percent of total billed charges,,,3902.79,82,,percent of total billed charges,,,4283.55,90,,percent of total billed charges,,,4045.58,85,,percent of total billed charges,,3588.66,4521.53,
SYNTHES SCREW CORTEX 2.4 X 10MM,30186808,CDM,,,278,RC,inpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,452.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,509.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,452.17,569.71,
SYNTHES PLATE OLECRANON 2.7/3.5MM 2HOLE,30186809,CDM,,,278,RC,inpatient,,10641.15,10641.15,,9034.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8023.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9044.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9364.21,88,,percent of total billed charges,,,,,,,,,8129.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9683.45,91,,percent of total billed charges,,,10109.09,95,,percent of total billed charges,,,8832.15,83,,percent of total billed charges,,,8832.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8832.15,83,,percent of total billed charges,,,10109.09,95,,percent of total billed charges,,,9577.04,90,,percent of total billed charges,,,9577.04,90,,percent of total billed charges,,,8725.74,82,,percent of total billed charges,,,9577.04,90,,percent of total billed charges,,,9044.98,85,,percent of total billed charges,,8023.43,10109.09,
SYNTHES SCREW LOCKING VA 2.7MM X 16MM,30186810,CDM,,,278,RC,inpatient,,1371.5,1371.5,,1164.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1034.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1165.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1206.92,88,,percent of total billed charges,,,,,,,,,1047.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1248.07,91,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.35,83,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1124.63,82,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,1034.11,1302.93,
SYNTHES PLATE SUP ANT CLAVICLE 3HOLE RIG,30186811,CDM,,,278,RC,inpatient,,8536.13,8536.13,,7247.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6436.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7255.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7511.79,88,,percent of total billed charges,,,,,,,,,6521.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7767.88,91,,percent of total billed charges,,,8109.32,95,,percent of total billed charges,,,7084.99,83,,percent of total billed charges,,,7084.99,83,,percent of total billed charges,,,,,,,,,,,,,,,7084.99,83,,percent of total billed charges,,,8109.32,95,,percent of total billed charges,,,7682.52,90,,percent of total billed charges,,,7682.52,90,,percent of total billed charges,,,6999.63,82,,percent of total billed charges,,,7682.52,90,,percent of total billed charges,,,7255.71,85,,percent of total billed charges,,6436.24,8109.32,
SYNTHES SCREW LOCKING VA 2.7MM X 24MM,30186812,CDM,,,278,RC,inpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1065.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1200.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,1065.14,1342.02,
ZIMMER INSERT LPS 10MM,30186813,CDM,,,278,RC,inpatient,,16770,16770,,14237.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12644.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14254.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14757.6,88,,percent of total billed charges,,,,,,,,,12812.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15260.7,91,,percent of total billed charges,,,15931.5,95,,percent of total billed charges,,,13919.1,83,,percent of total billed charges,,,13919.1,83,,percent of total billed charges,,,,,,,,,,,,,,,13919.1,83,,percent of total billed charges,,,15931.5,95,,percent of total billed charges,,,15093,90,,percent of total billed charges,,,15093,90,,percent of total billed charges,,,13751.4,82,,percent of total billed charges,,,15093,90,,percent of total billed charges,,,14254.5,85,,percent of total billed charges,,12644.58,15931.5,
DEPUY STEM SUMMIT 6 HI,30186814,CDM,,,278,RC,inpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19184.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21627.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,19184.82,24171.86,
STRYKER 50 S-SWEEP XL,30186815,CDM,,,270,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
DEPUY ATTUNE FEMUR CRS SZ 8 RT,30186816,CDM,,,278,RC,inpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39636.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44683.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,39636.69,49940.13,
DEPUY ATTUNE DISTAL AUGMENT SZ 8 4MM,30186817,CDM,,,278,RC,inpatient,,9677.92,9677.92,,8216.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7297.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8226.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8516.57,88,,percent of total billed charges,,,,,,,,,7393.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8806.91,91,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,,,,,,,,,,,,,8032.67,83,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,7935.89,82,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,7297.15,9194.02,
DEPUY ATTUNE STEM PRESSFIT 20 X 60,30186818,CDM,,,278,RC,inpatient,,13175.11,13175.11,,11185.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9934.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11198.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11594.1,88,,percent of total billed charges,,,,,,,,,10065.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11989.35,91,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,,,,,,,,,,,,,10935.34,83,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,10803.59,82,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,9934.03,12516.35,
DEPUY ATTUNE INSERT CRS RP SZ 8 10MM,30186819,CDM,,,278,RC,inpatient,,23578.82,23578.82,,20018.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17778.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20042,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20749.36,88,,percent of total billed charges,,,,,,,,,18014.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21456.73,91,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,,,,,,,,,,,,,19570.42,83,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,19334.63,82,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,20042,85,,percent of total billed charges,,17778.43,22399.88,
DEPUY ATTUNE TIBIA SLEEVE M/L 29MM,30186820,CDM,,,278,RC,inpatient,,29060.07,29060.07,,24672,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21911.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24701.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25572.86,88,,percent of total billed charges,,,,,,,,,22201.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26444.66,91,,percent of total billed charges,,,27607.07,95,,percent of total billed charges,,,24119.86,83,,percent of total billed charges,,,24119.86,83,,percent of total billed charges,,,,,,,,,,,,,,,24119.86,83,,percent of total billed charges,,,27607.07,95,,percent of total billed charges,,,26154.06,90,,percent of total billed charges,,,26154.06,90,,percent of total billed charges,,,23829.26,82,,percent of total billed charges,,,26154.06,90,,percent of total billed charges,,,24701.06,85,,percent of total billed charges,,21911.29,27607.07,
DEPUY ATTUNE STEM PRESSFIT 16 X 60,30186821,CDM,,,278,RC,inpatient,,13175.11,13175.11,,11185.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9934.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11198.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11594.1,88,,percent of total billed charges,,,,,,,,,10065.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11989.35,91,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,,,,,,,,,,,,,10935.34,83,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,10803.59,82,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,9934.03,12516.35,
ARTHREX SCREW HEADLESS 7.0 X 80MM,30186822,CDM,,,278,RC,inpatient,,4517.2,4517.2,,3835.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3405.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3839.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3975.14,88,,percent of total billed charges,,,,,,,,,3451.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4110.65,91,,percent of total billed charges,,,4291.34,95,,percent of total billed charges,,,3749.28,83,,percent of total billed charges,,,3749.28,83,,percent of total billed charges,,,,,,,,,,,,,,,3749.28,83,,percent of total billed charges,,,4291.34,95,,percent of total billed charges,,,4065.48,90,,percent of total billed charges,,,4065.48,90,,percent of total billed charges,,,3704.1,82,,percent of total billed charges,,,4065.48,90,,percent of total billed charges,,,3839.62,85,,percent of total billed charges,,3405.97,4291.34,
ARTHREX SCREW HEADLESS 7.0 X 85MM,30186823,CDM,,,278,RC,inpatient,,4517.5,4517.5,,3835.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3406.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3839.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3975.4,88,,percent of total billed charges,,,,,,,,,3451.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4110.93,91,,percent of total billed charges,,,4291.63,95,,percent of total billed charges,,,3749.53,83,,percent of total billed charges,,,3749.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3749.53,83,,percent of total billed charges,,,4291.63,95,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,3704.35,82,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,3839.88,85,,percent of total billed charges,,3406.2,4291.63,
ARTHREX SCREW HEADLESS 5.0 X 38MM,30186824,CDM,,,278,RC,inpatient,,3087.5,3087.5,,2621.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2327.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2624.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2717,88,,percent of total billed charges,,,,,,,,,2358.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2809.63,91,,percent of total billed charges,,,2933.13,95,,percent of total billed charges,,,2562.63,83,,percent of total billed charges,,,2562.63,83,,percent of total billed charges,,,,,,,,,,,,,,,2562.63,83,,percent of total billed charges,,,2933.13,95,,percent of total billed charges,,,2778.75,90,,percent of total billed charges,,,2778.75,90,,percent of total billed charges,,,2531.75,82,,percent of total billed charges,,,2778.75,90,,percent of total billed charges,,,2624.38,85,,percent of total billed charges,,2327.98,2933.13,
ARTHREX GUIDEWIRE 1.6MM,30186825,CDM,,,278,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
ARTHREX GUIDEWIRE 2.4MM,30186826,CDM,,,278,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
ARTHREX DRILL BIT 3.2MM,30186827,CDM,,,270,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
ARTHREX DRILL BIT 5.0MM,30186828,CDM,,,270,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
ARTHREX DRILL BIT SYNANITE STAPLE 2.0,30186829,CDM,,,270,RC,inpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,633.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,714,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,633.36,798,
ARTHREX STAPLE SYNANITE MX 20X20,30186830,CDM,,,278,RC,inpatient,,16217.5,16217.5,,13768.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12228,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13784.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14271.4,88,,percent of total billed charges,,,,,,,,,12390.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14757.93,91,,percent of total billed charges,,,15406.63,95,,percent of total billed charges,,,13460.53,83,,percent of total billed charges,,,13460.53,83,,percent of total billed charges,,,,,,,,,,,,,,,13460.53,83,,percent of total billed charges,,,15406.63,95,,percent of total billed charges,,,14595.75,90,,percent of total billed charges,,,14595.75,90,,percent of total billed charges,,,13298.35,82,,percent of total billed charges,,,14595.75,90,,percent of total billed charges,,,13784.88,85,,percent of total billed charges,,12228,15406.63,
ARTHREX FIBERTAK DISP. KIT,30186831,CDM,,,270,RC,inpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1347.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1519.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,1347.78,1698.13,
ARTHREX FIBERTAK SUTURE ANCHOR,30186832,CDM,,,270,RC,inpatient,,3022.5,3022.5,,2566.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2278.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2569.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2659.8,88,,percent of total billed charges,,,,,,,,,2309.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2750.48,91,,percent of total billed charges,,,2871.38,95,,percent of total billed charges,,,2508.68,83,,percent of total billed charges,,,2508.68,83,,percent of total billed charges,,,,,,,,,,,,,,,2508.68,83,,percent of total billed charges,,,2871.38,95,,percent of total billed charges,,,2720.25,90,,percent of total billed charges,,,2720.25,90,,percent of total billed charges,,,2478.45,82,,percent of total billed charges,,,2720.25,90,,percent of total billed charges,,,2569.13,85,,percent of total billed charges,,2278.97,2871.38,
ULRICH PLATE 1 LEVEL 16MM,30186833,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
SPINECRAFT SCREW 5.5 X 45MM,30186834,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ZIMMER SCREW PSN 2.5 X 25MM FEMAL,30186835,CDM,,,278,RC,inpatient,,1072.5,1072.5,,910.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,808.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,911.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,943.8,88,,percent of total billed charges,,,,,,,,,819.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,975.98,91,,percent of total billed charges,,,1018.88,95,,percent of total billed charges,,,890.18,83,,percent of total billed charges,,,890.18,83,,percent of total billed charges,,,,,,,,,,,,,,,890.18,83,,percent of total billed charges,,,1018.88,95,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,879.45,82,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,911.63,85,,percent of total billed charges,,808.67,1018.88,
ZIMMER SCREW MIS HEADED 48MM,30186836,CDM,,,278,RC,inpatient,,535.5,535.5,,454.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,403.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,455.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,471.24,88,,percent of total billed charges,,,,,,,,,409.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,487.31,91,,percent of total billed charges,,,508.73,95,,percent of total billed charges,,,444.47,83,,percent of total billed charges,,,444.47,83,,percent of total billed charges,,,,,,,,,,,,,,,444.47,83,,percent of total billed charges,,,508.73,95,,percent of total billed charges,,,481.95,90,,percent of total billed charges,,,481.95,90,,percent of total billed charges,,,439.11,82,,percent of total billed charges,,,481.95,90,,percent of total billed charges,,,455.18,85,,percent of total billed charges,,403.77,508.73,
ZIMMER SCREW SET HEX DRIVER 2MM,30186837,CDM,,,278,RC,inpatient,,567,567,,481.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,427.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,481.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,498.96,88,,percent of total billed charges,,,,,,,,,433.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,,,,,,,,,,,,,470.61,83,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,464.94,82,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,427.52,538.65,
ZIMMER STEM REV PSN 14X75MM,30186838,CDM,,,278,RC,inpatient,,15174.25,15174.25,,12882.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11441.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12898.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13353.34,88,,percent of total billed charges,,,,,,,,,11593.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13808.57,91,,percent of total billed charges,,,14415.54,95,,percent of total billed charges,,,12594.63,83,,percent of total billed charges,,,12594.63,83,,percent of total billed charges,,,,,,,,,,,,,,,12594.63,83,,percent of total billed charges,,,14415.54,95,,percent of total billed charges,,,13656.83,90,,percent of total billed charges,,,13656.83,90,,percent of total billed charges,,,12442.89,82,,percent of total billed charges,,,13656.83,90,,percent of total billed charges,,,12898.11,85,,percent of total billed charges,,11441.38,14415.54,
ZIMMER FEMUR CMT REV PSN SZ 9 RT,30186839,CDM,,,278,RC,inpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50633.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57080.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,50633.46,63795.47,
ZIMMER STEM OFFSET PSN REV 13 X135MM,30186840,CDM,,,278,RC,inpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18476.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20829.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,18476.77,23279.75,
ZIMMER TIBIA FIXED KEEL PSN SZ F,30186841,CDM,,,278,RC,inpatient,,24033.75,24033.75,,20404.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18121.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20428.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21149.7,88,,percent of total billed charges,,,,,,,,,18361.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21870.71,91,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,,,,,,,,,,,,,19948.01,83,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,19707.68,82,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,18121.45,22832.06,
ZIMMER TIBIA HALF BLOCK PSN SZ EF 5MM,30186842,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER TIBIA HALF BLOCK PSN SZ EF RM,30186843,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER FEMUR DISTAL AUG SZ 9 5MM,30186844,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER FEMUR DISTAL AUG SZ 95MM,30186845,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER CPS ASF PSN 6-9EF,30186846,CDM,,,278,RC,inpatient,,17135.63,17135.63,,14548.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12920.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14565.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15079.35,88,,percent of total billed charges,,,,,,,,,13091.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15593.42,91,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14222.57,83,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14051.22,82,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,12920.27,16278.85,
ARTHREX TENODESIS GRAFT SIZING KIT,30186847,CDM,,,270,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
SPINECRAFT SCREW 5.5 X 50MM,30186848,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT SCREW SET,30186849,CDM,,,278,RC,inpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,527.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,595,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,527.8,665,
SPINECRAFT ROD REVISION 6.0 T RIGHT,30186850,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
SPINECRAFT ROD REVISION 6.0 T LEFT,30186851,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
SPINECRAFT CROSS CONNECTOR 31-39MM,30186852,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
ZIMMER TROCAR DRILL PIN HEADLESS 75MM,30186853,CDM,,,278,RC,inpatient,,2111.85,2111.85,,1792.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1592.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1795.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1858.43,88,,percent of total billed charges,,,,,,,,,1613.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1921.78,91,,percent of total billed charges,,,2006.26,95,,percent of total billed charges,,,1752.84,83,,percent of total billed charges,,,1752.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1752.84,83,,percent of total billed charges,,,2006.26,95,,percent of total billed charges,,,1900.67,90,,percent of total billed charges,,,1900.67,90,,percent of total billed charges,,,1731.72,82,,percent of total billed charges,,,1900.67,90,,percent of total billed charges,,,1795.07,85,,percent of total billed charges,,1592.33,2006.26,
ZIMMER TIBIAL AUGMENT RL 5MM,30186854,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER TIBIAL AUGMENT RM 5MM,30186855,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER STEM REVISION PSN 16 X 135MM,30186856,CDM,,,278,RC,inpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18476.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20829.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,18476.77,23279.75,
ZIMMER FEMORAL AUGMENT POSTERIOR 15MM,30186857,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER FEMORAL CENTRAL CONE X-LARGE,30186858,CDM,,,278,RC,inpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36420.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41057.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,36420.56,45887.97,
ZIMMER FEMUR DISTAL AUG 10MM,30186859,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER INSERT POLY CCK 10MM,30186860,CDM,,,278,RC,inpatient,,23562.5,23562.5,,20004.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17766.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20028.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20735,88,,percent of total billed charges,,,,,,,,,18001.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21441.88,91,,percent of total billed charges,,,22384.38,95,,percent of total billed charges,,,19556.88,83,,percent of total billed charges,,,19556.88,83,,percent of total billed charges,,,,,,,,,,,,,,,19556.88,83,,percent of total billed charges,,,22384.38,95,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,19321.25,82,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,20028.13,85,,percent of total billed charges,,17766.13,22384.38,
ZIMMER FEMUR REV PSN SZ 9 R,30186861,CDM,,,278,RC,inpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50633.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57080.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,50633.46,63795.47,
ZIMMER STEM REVISION PSN 18 X 135MM,30186862,CDM,,,278,RC,inpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18476.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20829.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,18476.77,23279.75,
DEPUY CUP PRESSFIT BI-MENTUM 53,30186863,CDM,,,278,RC,inpatient,,25026.11,25026.11,,21247.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18869.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21272.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22022.98,88,,percent of total billed charges,,,,,,,,,19119.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22773.76,91,,percent of total billed charges,,,23774.8,95,,percent of total billed charges,,,20771.67,83,,percent of total billed charges,,,20771.67,83,,percent of total billed charges,,,,,,,,,,,,,,,20771.67,83,,percent of total billed charges,,,23774.8,95,,percent of total billed charges,,,22523.5,90,,percent of total billed charges,,,22523.5,90,,percent of total billed charges,,,20521.41,82,,percent of total billed charges,,,22523.5,90,,percent of total billed charges,,,21272.19,85,,percent of total billed charges,,18869.69,23774.8,
DEPUY LINER PE BI-MENTUM 28/53,30186864,CDM,,,278,RC,inpatient,,15818.92,15818.92,,13430.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11927.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13446.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13920.65,88,,percent of total billed charges,,,,,,,,,12085.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14395.22,91,,percent of total billed charges,,,15027.97,95,,percent of total billed charges,,,13129.7,83,,percent of total billed charges,,,13129.7,83,,percent of total billed charges,,,,,,,,,,,,,,,13129.7,83,,percent of total billed charges,,,15027.97,95,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,12971.51,82,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,13446.08,85,,percent of total billed charges,,11927.47,15027.97,
S&N GRAFIX 5X5 CM,30186865,CDM,,,278,RC,inpatient,,18525,18525,,15727.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13967.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15746.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16302,88,,percent of total billed charges,,,,,,,,,14153.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16857.75,91,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,,,,,,,,,,,,,15375.75,83,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15190.5,82,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15746.25,85,,percent of total billed charges,,13967.85,17598.75,
DEPUY STEM SUMMIT HIP SZ 4 HI,30186866,CDM,,,278,RC,inpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19184.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21627.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,19184.82,24171.86,
ARTHREX TIGER LOOP,30186867,CDM,,,278,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
DEPUY CAP COP POROUS,30186868,CDM,,,278,RC,inpatient,,48750,48750,,41388.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36757.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41437.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42900,88,,percent of total billed charges,,,,,,,,,37245,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,44362.5,91,,percent of total billed charges,,,46312.5,95,,percent of total billed charges,,,40462.5,83,,percent of total billed charges,,,40462.5,83,,percent of total billed charges,,,,,,,,,,,,,,,40462.5,83,,percent of total billed charges,,,46312.5,95,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,39975,82,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,41437.5,85,,percent of total billed charges,,36757.5,46312.5,
BREAST IMPLANT MEMORYGEL XTRA 490CC,30186869,CDM,,,278,RC,inpatient,,7982,7982,,6776.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6018.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6784.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7024.16,88,,percent of total billed charges,,,,,,,,,6098.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7263.62,91,,percent of total billed charges,,,7582.9,95,,percent of total billed charges,,,6625.06,83,,percent of total billed charges,,,6625.06,83,,percent of total billed charges,,,,,,,,,,,,,,,6625.06,83,,percent of total billed charges,,,7582.9,95,,percent of total billed charges,,,7183.8,90,,percent of total billed charges,,,7183.8,90,,percent of total billed charges,,,6545.24,82,,percent of total billed charges,,,7183.8,90,,percent of total billed charges,,,6784.7,85,,percent of total billed charges,,6018.43,7582.9,
SYNTHES SCREW CORTEX 4.5X38MM,30186870,CDM,,,278,RC,inpatient,,277.28,277.28,,235.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,235.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.01,88,,percent of total billed charges,,,,,,,,,211.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.32,91,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,,,,,,,,,,,,,230.14,83,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,227.37,82,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,209.07,263.42,
NEVRO TRIAL LEAD KIT 50CM,30186871,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
NEVRO NEEDLE EPIDURAL CURVED 4,30186872,CDM,,,270,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
ZIMMER LINER NEUTRAL E 32MM,30186874,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SYNTHES SCREW TFNA 90MM,30186875,CDM,,,278,RC,inpatient,,6487.46,6487.46,,5507.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4891.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5514.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5708.96,88,,percent of total billed charges,,,,,,,,,4956.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5903.59,91,,percent of total billed charges,,,6163.09,95,,percent of total billed charges,,,5384.59,83,,percent of total billed charges,,,5384.59,83,,percent of total billed charges,,,,,,,,,,,,,,,5384.59,83,,percent of total billed charges,,,6163.09,95,,percent of total billed charges,,,5838.71,90,,percent of total billed charges,,,5838.71,90,,percent of total billed charges,,,5319.72,82,,percent of total billed charges,,,5838.71,90,,percent of total billed charges,,,5514.34,85,,percent of total billed charges,,4891.54,6163.09,
DEPUY INSERT AOX RP POLY SZ 4 15MM,30186876,CDM,,,278,RC,inpatient,,17068.29,17068.29,,14490.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12869.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14508.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15020.1,88,,percent of total billed charges,,,,,,,,,13040.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15532.14,91,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,,,,,,,,,,,,,14166.68,83,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,13996,82,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,12869.49,16214.88,
DEPUY STEM CORAIL REVISION SZ12 HIGH OFF,30186877,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
SYNTHES PLATE T 12-HOLE LCP 141MM,30186878,CDM,,,278,RC,inpatient,,1815.32,1815.32,,1541.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1368.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1543.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1597.48,88,,percent of total billed charges,,,,,,,,,1386.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1651.94,91,,percent of total billed charges,,,1724.55,95,,percent of total billed charges,,,1506.72,83,,percent of total billed charges,,,1506.72,83,,percent of total billed charges,,,,,,,,,,,,,,,1506.72,83,,percent of total billed charges,,,1724.55,95,,percent of total billed charges,,,1633.79,90,,percent of total billed charges,,,1633.79,90,,percent of total billed charges,,,1488.56,82,,percent of total billed charges,,,1633.79,90,,percent of total billed charges,,,1543.02,85,,percent of total billed charges,,1368.75,1724.55,
SYNTHES TFNA 11MM X 440MM 130DEG LT,30186879,CDM,,,278,RC,inpatient,,21784.17,21784.17,,18494.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16425.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18516.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19170.07,88,,percent of total billed charges,,,,,,,,,16643.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19823.59,91,,percent of total billed charges,,,20694.96,95,,percent of total billed charges,,,18080.86,83,,percent of total billed charges,,,18080.86,83,,percent of total billed charges,,,,,,,,,,,,,,,18080.86,83,,percent of total billed charges,,,20694.96,95,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,17863.02,82,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,18516.54,85,,percent of total billed charges,,16425.26,20694.96,
SYNTHES SCREW LOCKING 5.0 X 52MM,30186880,CDM,,,278,RC,inpatient,,2185.24,2185.24,,1855.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1647.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1857.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1923.01,88,,percent of total billed charges,,,,,,,,,1669.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1988.57,91,,percent of total billed charges,,,2075.98,95,,percent of total billed charges,,,1813.75,83,,percent of total billed charges,,,1813.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1813.75,83,,percent of total billed charges,,,2075.98,95,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1791.9,82,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1857.45,85,,percent of total billed charges,,1647.67,2075.98,
ZIMMER LINER NEUTRAL G7 40MM,30186881,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
DEPUY STEM CORAIL HO SZ 13,30186882,CDM,,,278,RC,inpatient,,31229.32,31229.32,,26513.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23546.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26544.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27481.8,88,,percent of total billed charges,,,,,,,,,23859.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28418.68,91,,percent of total billed charges,,,29667.85,95,,percent of total billed charges,,,25920.34,83,,percent of total billed charges,,,25920.34,83,,percent of total billed charges,,,,,,,,,,,,,,,25920.34,83,,percent of total billed charges,,,29667.85,95,,percent of total billed charges,,,28106.39,90,,percent of total billed charges,,,28106.39,90,,percent of total billed charges,,,25608.04,82,,percent of total billed charges,,,28106.39,90,,percent of total billed charges,,,26544.92,85,,percent of total billed charges,,23546.91,29667.85,
S&N GRAFIX PRIME 3X4 CM,30186883,CDM,,,278,RC,inpatient,,8336.25,8336.25,,7077.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6285.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7085.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7335.9,88,,percent of total billed charges,,,,,,,,,6368.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7585.99,91,,percent of total billed charges,,,7919.44,95,,percent of total billed charges,,,6919.09,83,,percent of total billed charges,,,6919.09,83,,percent of total billed charges,,,,,,,,,,,,,,,6919.09,83,,percent of total billed charges,,,7919.44,95,,percent of total billed charges,,,7502.63,90,,percent of total billed charges,,,7502.63,90,,percent of total billed charges,,,6835.73,82,,percent of total billed charges,,,7502.63,90,,percent of total billed charges,,,7085.81,85,,percent of total billed charges,,6285.53,7919.44,
BARD POWERPORT MRI IMPLANTABLE PORT 8FR,30186884,CDM,,,278,RC,inpatient,,4815.72,4815.72,,4088.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3631.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4093.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4237.83,88,,percent of total billed charges,,,,,,,,,3679.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4382.31,91,,percent of total billed charges,,,4574.93,95,,percent of total billed charges,,,3997.05,83,,percent of total billed charges,,,3997.05,83,,percent of total billed charges,,,,,,,,,,,,,,,3997.05,83,,percent of total billed charges,,,4574.93,95,,percent of total billed charges,,,4334.15,90,,percent of total billed charges,,,4334.15,90,,percent of total billed charges,,,3948.89,82,,percent of total billed charges,,,4334.15,90,,percent of total billed charges,,,4093.36,85,,percent of total billed charges,,3631.05,4574.93,
FEMORAL SPACER MOLD 44A/P X 67M/L,30186885,CDM,,,278,RC,inpatient,,12967.5,12967.5,,11009.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9777.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11022.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11411.4,88,,percent of total billed charges,,,,,,,,,9907.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11800.43,91,,percent of total billed charges,,,12319.13,95,,percent of total billed charges,,,10763.03,83,,percent of total billed charges,,,10763.03,83,,percent of total billed charges,,,,,,,,,,,,,,,10763.03,83,,percent of total billed charges,,,12319.13,95,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,10633.35,82,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,11022.38,85,,percent of total billed charges,,9777.5,12319.13,
TIBIAL SPACER MOLD 45A/P X 70M/L,30186886,CDM,,,278,RC,inpatient,,12187.5,12187.5,,10347.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9189.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10359.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10725,88,,percent of total billed charges,,,,,,,,,9311.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11090.63,91,,percent of total billed charges,,,11578.13,95,,percent of total billed charges,,,10115.63,83,,percent of total billed charges,,,10115.63,83,,percent of total billed charges,,,,,,,,,,,,,,,10115.63,83,,percent of total billed charges,,,11578.13,95,,percent of total billed charges,,,10968.75,90,,percent of total billed charges,,,10968.75,90,,percent of total billed charges,,,9993.75,82,,percent of total billed charges,,,10968.75,90,,percent of total billed charges,,,10359.38,85,,percent of total billed charges,,9189.38,11578.13,
DEPUY GLENOSPHERE 38MM +4,30186887,CDM,,,278,RC,inpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14941.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16844.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,14941.68,18825.72,
ARTHREX SUTURE FIBERTAPE CERCUAGE,30186888,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
ARTHREX SUTURE FIBERLINIK,30186889,CDM,,,278,RC,inpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,448.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,505.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,448.63,565.25,
SYNTHES SCREW CORTEX TI 2.4 X 18,30186890,CDM,,,278,RC,inpatient,,643.51,643.51,,546.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,485.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,546.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,566.29,88,,percent of total billed charges,,,,,,,,,491.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,585.59,91,,percent of total billed charges,,,611.33,95,,percent of total billed charges,,,534.11,83,,percent of total billed charges,,,534.11,83,,percent of total billed charges,,,,,,,,,,,,,,,534.11,83,,percent of total billed charges,,,611.33,95,,percent of total billed charges,,,579.16,90,,percent of total billed charges,,,579.16,90,,percent of total billed charges,,,527.68,82,,percent of total billed charges,,,579.16,90,,percent of total billed charges,,,546.98,85,,percent of total billed charges,,485.21,611.33,
OSTEO STEM MEDIUM LONG,30186891,CDM,,,278,RC,inpatient,,21125,21125,,17935.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15928.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17956.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18590,88,,percent of total billed charges,,,,,,,,,16139.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19223.75,91,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,,,,,,,,,,,,,17533.75,83,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17322.5,82,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17956.25,85,,percent of total billed charges,,15928.25,20068.75,
OSTEO HEAD LARGE,30186892,CDM,,,278,RC,inpatient,,21125,21125,,17935.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15928.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17956.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18590,88,,percent of total billed charges,,,,,,,,,16139.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19223.75,91,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,,,,,,,,,,,,,17533.75,83,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17322.5,82,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17956.25,85,,percent of total billed charges,,15928.25,20068.75,
ZIMMER TIBIA PSN CEMENTED SZ F LEFT,30186893,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER INSERT ASF MC 11MM LEFT,30186894,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
DEPUY STEM CORAIL HIGH COL SZ 16,30186895,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
SYNTHES SCREW CORTEX 2.4 X 26MM,30186896,CDM,,,278,RC,inpatient,,827.05,827.05,,702.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,623.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,702.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,727.8,88,,percent of total billed charges,,,,,,,,,631.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,752.62,91,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,,,,,,,,,,,,,686.45,83,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,678.18,82,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,623.6,785.7,
DEPUY ATTUNE CRS FEMOR RIGHT SZ 4,30186897,CDM,,,278,RC,inpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39636.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44683.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,39636.69,49940.13,
DEPUY ATTUNE DISTAL AUGMENT SZ 4 4MM,30186898,CDM,,,278,RC,inpatient,,9677.92,9677.92,,8216.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7297.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8226.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8516.57,88,,percent of total billed charges,,,,,,,,,7393.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8806.91,91,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,,,,,,,,,,,,,8032.67,83,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,7935.89,82,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,7297.15,9194.02,
DEPUY ATTUNE POSTERIOR AUGMENT SZ 4 4MM,30186899,CDM,,,278,RC,inpatient,,9677.92,9677.92,,8216.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7297.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8226.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8516.57,88,,percent of total billed charges,,,,,,,,,7393.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8806.91,91,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,,,,,,,,,,,,,8032.67,83,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,7935.89,82,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,7297.15,9194.02,
DEPUY STEM 18 X 60MM,30186900,CDM,,,278,RC,inpatient,,13175.11,13175.11,,11185.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9934.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11198.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11594.1,88,,percent of total billed charges,,,,,,,,,10065.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11989.35,91,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,,,,,,,,,,,,,10935.34,83,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,10803.59,82,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,9934.03,12516.35,
DEPUY ATTUNE INSERT CRS SZ 4 14MM,30186901,CDM,,,278,RC,inpatient,,23578.82,23578.82,,20018.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17778.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20042,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20749.36,88,,percent of total billed charges,,,,,,,,,18014.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21456.73,91,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,,,,,,,,,,,,,19570.42,83,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,19334.63,82,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,20042,85,,percent of total billed charges,,17778.43,22399.88,
DEPUY REVISION TIBIA SZ 3,30186902,CDM,,,278,RC,inpatient,,39503.36,39503.36,,33538.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29785.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33577.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34762.96,88,,percent of total billed charges,,,,,,,,,30180.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35948.06,91,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32787.79,83,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,32392.76,82,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,29785.53,37528.19,
DEPUY TIBIA AUGMENT RL 10,30186903,CDM,,,278,RC,inpatient,,10997.61,10997.61,,9336.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8292.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9347.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9677.9,88,,percent of total billed charges,,,,,,,,,8402.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10007.83,91,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,,,,,,,,,,,,,9128.02,83,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9018.04,82,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,8292.2,10447.73,
DEPUY TIBIA AUGMENT RM 10,30186904,CDM,,,278,RC,inpatient,,10997.61,10997.61,,9336.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8292.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9347.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9677.9,88,,percent of total billed charges,,,,,,,,,8402.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10007.83,91,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,,,,,,,,,,,,,9128.02,83,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9018.04,82,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,8292.2,10447.73,
SPINECRAFT SCREW REDUCTION 7.0 X 45MM,30186905,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
STRYKER TUBING CROSSFLOW INFLOW,30186906,CDM,,,270,RC,inpatient,,496.83,496.83,,421.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,374.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,422.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,437.21,88,,percent of total billed charges,,,,,,,,,379.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,452.12,91,,percent of total billed charges,,,471.99,95,,percent of total billed charges,,,412.37,83,,percent of total billed charges,,,412.37,83,,percent of total billed charges,,,,,,,,,,,,,,,412.37,83,,percent of total billed charges,,,471.99,95,,percent of total billed charges,,,447.15,90,,percent of total billed charges,,,447.15,90,,percent of total billed charges,,,407.4,82,,percent of total billed charges,,,447.15,90,,percent of total billed charges,,,422.31,85,,percent of total billed charges,,374.61,471.99,
STRYKER USAGE HIP CHECK & HIP CHECK ROLL,30186907,CDM,,,270,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER TUBING CROSSFLOW OUTFLOW,30186908,CDM,,,270,RC,inpatient,,459.06,459.06,,389.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,346.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,390.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,403.97,88,,percent of total billed charges,,,,,,,,,350.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,417.74,91,,percent of total billed charges,,,436.11,95,,percent of total billed charges,,,381.02,83,,percent of total billed charges,,,381.02,83,,percent of total billed charges,,,,,,,,,,,,,,,381.02,83,,percent of total billed charges,,,436.11,95,,percent of total billed charges,,,413.15,90,,percent of total billed charges,,,413.15,90,,percent of total billed charges,,,376.43,82,,percent of total billed charges,,,413.15,90,,percent of total billed charges,,,390.2,85,,percent of total billed charges,,346.13,436.11,
STRYKER ANCHOR OMEGA 4.75 SINGLE,30186909,CDM,,,270,RC,inpatient,,3087.5,3087.5,,2621.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2327.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2624.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2717,88,,percent of total billed charges,,,,,,,,,2358.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2809.63,91,,percent of total billed charges,,,2933.13,95,,percent of total billed charges,,,2562.63,83,,percent of total billed charges,,,2562.63,83,,percent of total billed charges,,,,,,,,,,,,,,,2562.63,83,,percent of total billed charges,,,2933.13,95,,percent of total billed charges,,,2778.75,90,,percent of total billed charges,,,2778.75,90,,percent of total billed charges,,,2531.75,82,,percent of total billed charges,,,2778.75,90,,percent of total billed charges,,,2624.38,85,,percent of total billed charges,,2327.98,2933.13,
PHENOL SAFETY APPLICATOR KIT,30186910,CDM,,,270,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
DEPUY GLENOSPHERE ECCENTRIC 38MM +2,30186913,CDM,,,278,RC,inpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14941.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16844.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,14941.68,18825.72,
DEPUY GUIDE PIN,30186914,CDM,,,278,RC,inpatient,,949,949,,805.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,715.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,806.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,835.12,88,,percent of total billed charges,,,,,,,,,725.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,863.59,91,,percent of total billed charges,,,901.55,95,,percent of total billed charges,,,787.67,83,,percent of total billed charges,,,787.67,83,,percent of total billed charges,,,,,,,,,,,,,,,787.67,83,,percent of total billed charges,,,901.55,95,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,778.18,82,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,806.65,85,,percent of total billed charges,,715.55,901.55,
S&N GRAFIX PRIME 16MM DISK,30186915,CDM,,,278,RC,inpatient,,3056.63,3056.63,,2595.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2304.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2598.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2689.83,88,,percent of total billed charges,,,,,,,,,2335.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2781.53,91,,percent of total billed charges,,,2903.8,95,,percent of total billed charges,,,2537,83,,percent of total billed charges,,,2537,83,,percent of total billed charges,,,,,,,,,,,,,,,2537,83,,percent of total billed charges,,,2903.8,95,,percent of total billed charges,,,2750.97,90,,percent of total billed charges,,,2750.97,90,,percent of total billed charges,,,2506.44,82,,percent of total billed charges,,,2750.97,90,,percent of total billed charges,,,2598.14,85,,percent of total billed charges,,2304.7,2903.8,
SYNTHES PROTECTIVE CAP FOR 8.0MM CARBON,30186916,CDM,,,270,RC,inpatient,,52.11,52.11,,44.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.86,88,,percent of total billed charges,,,,,,,,,39.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47.42,91,,percent of total billed charges,,,49.5,95,,percent of total billed charges,,,43.25,83,,percent of total billed charges,,,43.25,83,,percent of total billed charges,,,,,,,,,,,,,,,43.25,83,,percent of total billed charges,,,49.5,95,,percent of total billed charges,,,46.9,90,,percent of total billed charges,,,46.9,90,,percent of total billed charges,,,42.73,82,,percent of total billed charges,,,46.9,90,,percent of total billed charges,,,44.29,85,,percent of total billed charges,,39.29,49.5,
ZIMMER HEAD FEMORAL 28MM +7 6 DEG,30186917,CDM,,,278,RC,inpatient,,10595,10595,,8995.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7988.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9005.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9323.6,88,,percent of total billed charges,,,,,,,,,8094.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9641.45,91,,percent of total billed charges,,,10065.25,95,,percent of total billed charges,,,8793.85,83,,percent of total billed charges,,,8793.85,83,,percent of total billed charges,,,,,,,,,,,,,,,8793.85,83,,percent of total billed charges,,,10065.25,95,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,8687.9,82,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,9005.75,85,,percent of total billed charges,,7988.63,10065.25,
SPINECRAFT SCREW 7.0 X 35MM,30186918,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ZIMMER INSERT PSN 13MM RIGHT,30186919,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
PATIENT TRIAL KIT 62,30186920,CDM,,,270,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
S&N GRAFIX PL PRIME 16MM DISC,30186922,CDM,,,278,RC,inpatient,,3056.63,3056.63,,2595.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2304.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2598.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2689.83,88,,percent of total billed charges,,,,,,,,,2335.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2781.53,91,,percent of total billed charges,,,2903.8,95,,percent of total billed charges,,,2537,83,,percent of total billed charges,,,2537,83,,percent of total billed charges,,,,,,,,,,,,,,,2537,83,,percent of total billed charges,,,2903.8,95,,percent of total billed charges,,,2750.97,90,,percent of total billed charges,,,2750.97,90,,percent of total billed charges,,,2506.44,82,,percent of total billed charges,,,2750.97,90,,percent of total billed charges,,,2598.14,85,,percent of total billed charges,,2304.7,2903.8,
DEPUY STEM STD CEMENTED SUMMIT SZ 2,30186923,CDM,,,278,RC,inpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19184.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21627.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,19184.82,24171.86,
DEPUY CEMENTRALIZERR 8.5,30186924,CDM,,,278,RC,inpatient,,919.36,919.36,,780.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,693.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,781.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,809.04,88,,percent of total billed charges,,,,,,,,,702.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,836.62,91,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,,,,,,,,,,,,,763.07,83,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,753.88,82,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,781.46,85,,percent of total billed charges,,693.2,873.39,
STRYKER SUCTION PROBE 90-S CRUISE,30186925,CDM,,,270,RC,inpatient,,942.5,942.5,,800.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,710.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,801.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,829.4,88,,percent of total billed charges,,,,,,,,,720.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,857.68,91,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,,,,,,,,,,,,,782.28,83,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,772.85,82,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,801.13,85,,percent of total billed charges,,710.65,895.38,
ZIMMER FEMUR PSN CR SZ 9 RIGHT,30186926,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER SCREW HEX HEADED 3.5 X 48MM,30186927,CDM,,,278,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
ZIMMER STEM EXTENSION OFFSET 15X145MM,30186928,CDM,,,278,RC,inpatient,,7276.62,7276.62,,6177.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5486.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6185.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6403.43,88,,percent of total billed charges,,,,,,,,,5559.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6621.72,91,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,,,,,,,,,,,,,6039.59,83,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,5966.83,82,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,5486.57,6912.79,
ZIMMER STEM EXTENSION STRAIGHT 14X145MM,30186929,CDM,,,278,RC,inpatient,,7276.62,7276.62,,6177.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5486.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6185.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6403.43,88,,percent of total billed charges,,,,,,,,,5559.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6621.72,91,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,,,,,,,,,,,,,6039.59,83,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,5966.83,82,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,5486.57,6912.79,
ZIMMER TIBIA HINGE PLATE SZ 3,30186930,CDM,,,278,RC,inpatient,,31427.57,31427.57,,26682.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23696.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26713.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27656.26,88,,percent of total billed charges,,,,,,,,,24010.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28599.09,91,,percent of total billed charges,,,29856.19,95,,percent of total billed charges,,,26084.88,83,,percent of total billed charges,,,26084.88,83,,percent of total billed charges,,,,,,,,,,,,,,,26084.88,83,,percent of total billed charges,,,29856.19,95,,percent of total billed charges,,,28284.81,90,,percent of total billed charges,,,28284.81,90,,percent of total billed charges,,,25770.61,82,,percent of total billed charges,,,28284.81,90,,percent of total billed charges,,,26713.43,85,,percent of total billed charges,,23696.39,29856.19,
ZIMMER FEMORAL HINGE ROTATING SZ D RIGHT,30186931,CDM,,,278,RC,inpatient,,57459.03,57459.03,,48782.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43324.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48840.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50563.95,88,,percent of total billed charges,,,,,,,,,43898.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52287.72,91,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,,,,,,,,,,,,,47690.99,83,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,47116.4,82,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,48840.18,85,,percent of total billed charges,,43324.11,54586.08,
ZIMMER AUGMENT BLOCK SZ D 5MM,30186932,CDM,,,278,RC,inpatient,,6483.75,6483.75,,5504.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4888.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5511.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5705.7,88,,percent of total billed charges,,,,,,,,,4953.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5900.21,91,,percent of total billed charges,,,6159.56,95,,percent of total billed charges,,,5381.51,83,,percent of total billed charges,,,5381.51,83,,percent of total billed charges,,,,,,,,,,,,,,,5381.51,83,,percent of total billed charges,,,6159.56,95,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5316.68,82,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5511.19,85,,percent of total billed charges,,4888.75,6159.56,
ZIMMER TIBIA AUGMENT BLOCK SZ 4 5MM,30186933,CDM,,,278,RC,inpatient,,6483.75,6483.75,,5504.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4888.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5511.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5705.7,88,,percent of total billed charges,,,,,,,,,4953.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5900.21,91,,percent of total billed charges,,,6159.56,95,,percent of total billed charges,,,5381.51,83,,percent of total billed charges,,,5381.51,83,,percent of total billed charges,,,,,,,,,,,,,,,5381.51,83,,percent of total billed charges,,,6159.56,95,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5316.68,82,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5511.19,85,,percent of total billed charges,,4888.75,6159.56,
ZIMMER HINGE POST INSERT SZ D 12MM,30186934,CDM,,,278,RC,inpatient,,12617.41,12617.41,,10712.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9513.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10724.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11103.32,88,,percent of total billed charges,,,,,,,,,9639.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11481.84,91,,percent of total billed charges,,,11986.54,95,,percent of total billed charges,,,10472.45,83,,percent of total billed charges,,,10472.45,83,,percent of total billed charges,,,,,,,,,,,,,,,10472.45,83,,percent of total billed charges,,,11986.54,95,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,10346.28,82,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,10724.8,85,,percent of total billed charges,,9513.53,11986.54,
DEPUY PE CUP 42 +9MM,30186935,CDM,,,278,RC,inpatient,,10688.08,10688.08,,9074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8058.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9084.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9405.51,88,,percent of total billed charges,,,,,,,,,8165.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9726.15,91,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,,,,,,,,,,,,,8871.11,83,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,8764.23,82,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,8058.81,10153.68,
SYNTHES SCREW CANCEL F-THD 4.0X40MM,30186936,CDM,,,278,RC,inpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,178.47,224.87,
SYNTHES SCREW CANCEL P-THD 4.0X40MM,30186937,CDM,,,278,RC,inpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,178.47,224.87,
DEPUY SURESPACE FEMORAL 53MM A/P,30186938,CDM,,,278,RC,inpatient,,15906.93,15906.93,,13504.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11993.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13520.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13998.1,88,,percent of total billed charges,,,,,,,,,12152.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14475.31,91,,percent of total billed charges,,,15111.58,95,,percent of total billed charges,,,13202.75,83,,percent of total billed charges,,,13202.75,83,,percent of total billed charges,,,,,,,,,,,,,,,13202.75,83,,percent of total billed charges,,,15111.58,95,,percent of total billed charges,,,14316.24,90,,percent of total billed charges,,,14316.24,90,,percent of total billed charges,,,13043.68,82,,percent of total billed charges,,,14316.24,90,,percent of total billed charges,,,13520.89,85,,percent of total billed charges,,11993.83,15111.58,
DEPUY SURESPACE TIBIA 52MM A/P,30186939,CDM,,,278,RC,inpatient,,13016.77,13016.77,,11051.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9814.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11064.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11454.76,88,,percent of total billed charges,,,,,,,,,9944.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11845.26,91,,percent of total billed charges,,,12365.93,95,,percent of total billed charges,,,10803.92,83,,percent of total billed charges,,,10803.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10803.92,83,,percent of total billed charges,,,12365.93,95,,percent of total billed charges,,,11715.09,90,,percent of total billed charges,,,11715.09,90,,percent of total billed charges,,,10673.75,82,,percent of total billed charges,,,11715.09,90,,percent of total billed charges,,,11064.25,85,,percent of total billed charges,,9814.64,12365.93,
SYNTHES PLATE 5 HOLE RIGHT HUMERUS 3.5MM,30186943,CDM,,,278,RC,inpatient,,17314.77,17314.77,,14700.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13055.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14717.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15237,88,,percent of total billed charges,,,,,,,,,13228.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15756.44,91,,percent of total billed charges,,,16449.03,95,,percent of total billed charges,,,14371.26,83,,percent of total billed charges,,,14371.26,83,,percent of total billed charges,,,,,,,,,,,,,,,14371.26,83,,percent of total billed charges,,,16449.03,95,,percent of total billed charges,,,15583.29,90,,percent of total billed charges,,,15583.29,90,,percent of total billed charges,,,14198.11,82,,percent of total billed charges,,,15583.29,90,,percent of total billed charges,,,14717.55,85,,percent of total billed charges,,13055.34,16449.03,
ZIMMER BLADE PATELLA REAMER SZ 38,30186944,CDM,,,270,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
ZIMMER FEMUR POROUS NARROW CR SZ 8,30186945,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER PATELLA VE SZ 35MM,30186946,CDM,,,278,RC,inpatient,,3575,3575,,3035.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2695.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3038.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3146,88,,percent of total billed charges,,,,,,,,,2731.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3253.25,91,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2967.25,83,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,2931.5,82,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,2695.55,3396.25,
DEPUY STEM REVISION CORAIL HO SZ 15,30186947,CDM,,,278,RC,inpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50336.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56745.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,50336.9,63421.82,
SYNTHES PLATE HUMERUS PROX. LCP 3.5 2H,30186949,CDM,,,278,RC,inpatient,,18035.75,18035.75,,15312.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13598.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15330.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15871.46,88,,percent of total billed charges,,,,,,,,,13779.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16412.53,91,,percent of total billed charges,,,17133.96,95,,percent of total billed charges,,,14969.67,83,,percent of total billed charges,,,14969.67,83,,percent of total billed charges,,,,,,,,,,,,,,,14969.67,83,,percent of total billed charges,,,17133.96,95,,percent of total billed charges,,,16232.18,90,,percent of total billed charges,,,16232.18,90,,percent of total billed charges,,,14789.32,82,,percent of total billed charges,,,16232.18,90,,percent of total billed charges,,,15330.39,85,,percent of total billed charges,,13598.96,17133.96,
MITEK DRILL BIT GRYPHON,30186950,CDM,,,270,RC,inpatient,,2132,2132,,1810.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1607.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1812.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1876.16,88,,percent of total billed charges,,,,,,,,,1628.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1940.12,91,,percent of total billed charges,,,2025.4,95,,percent of total billed charges,,,1769.56,83,,percent of total billed charges,,,1769.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1769.56,83,,percent of total billed charges,,,2025.4,95,,percent of total billed charges,,,1918.8,90,,percent of total billed charges,,,1918.8,90,,percent of total billed charges,,,1748.24,82,,percent of total billed charges,,,1918.8,90,,percent of total billed charges,,,1812.2,85,,percent of total billed charges,,1607.53,2025.4,
MITEK ANCHOR GRYPHON,30186951,CDM,,,270,RC,inpatient,,4153.5,4153.5,,3526.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3131.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3530.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3655.08,88,,percent of total billed charges,,,,,,,,,3173.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3779.69,91,,percent of total billed charges,,,3945.83,95,,percent of total billed charges,,,3447.41,83,,percent of total billed charges,,,3447.41,83,,percent of total billed charges,,,,,,,,,,,,,,,3447.41,83,,percent of total billed charges,,,3945.83,95,,percent of total billed charges,,,3738.15,90,,percent of total billed charges,,,3738.15,90,,percent of total billed charges,,,3405.87,82,,percent of total billed charges,,,3738.15,90,,percent of total billed charges,,,3530.48,85,,percent of total billed charges,,3131.74,3945.83,
SUTURE SHUTTLE 25DEG L,30186952,CDM,,,270,RC,inpatient,,1989,1989,,1688.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1499.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1690.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1750.32,88,,percent of total billed charges,,,,,,,,,1519.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1809.99,91,,percent of total billed charges,,,1889.55,95,,percent of total billed charges,,,1650.87,83,,percent of total billed charges,,,1650.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1650.87,83,,percent of total billed charges,,,1889.55,95,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1630.98,82,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1690.65,85,,percent of total billed charges,,1499.71,1889.55,
SUTURE SHUTTLE 90DEG,30186953,CDM,,,270,RC,inpatient,,1989,1989,,1688.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1499.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1690.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1750.32,88,,percent of total billed charges,,,,,,,,,1519.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1809.99,91,,percent of total billed charges,,,1889.55,95,,percent of total billed charges,,,1650.87,83,,percent of total billed charges,,,1650.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1650.87,83,,percent of total billed charges,,,1889.55,95,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1630.98,82,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1690.65,85,,percent of total billed charges,,1499.71,1889.55,
DEPUY STEM CORAIL HIGH COL SZ 13,30186954,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY VELYS NAVIGATION FEE,30186955,CDM,,,270,RC,inpatient,,3867.5,3867.5,,3283.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2916.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3287.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3403.4,88,,percent of total billed charges,,,,,,,,,2954.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3519.43,91,,percent of total billed charges,,,3674.13,95,,percent of total billed charges,,,3210.03,83,,percent of total billed charges,,,3210.03,83,,percent of total billed charges,,,,,,,,,,,,,,,3210.03,83,,percent of total billed charges,,,3674.13,95,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3171.35,82,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3287.38,85,,percent of total billed charges,,2916.1,3674.13,
SYNTHES PLATE BASE PHALANGEAL 2H 1.5MM,30186956,CDM,,,278,RC,inpatient,,5005.72,5005.72,,4249.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3774.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4254.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4405.03,88,,percent of total billed charges,,,,,,,,,3824.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4555.21,91,,percent of total billed charges,,,4755.43,95,,percent of total billed charges,,,4154.75,83,,percent of total billed charges,,,4154.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4154.75,83,,percent of total billed charges,,,4755.43,95,,percent of total billed charges,,,4505.15,90,,percent of total billed charges,,,4505.15,90,,percent of total billed charges,,,4104.69,82,,percent of total billed charges,,,4505.15,90,,percent of total billed charges,,,4254.86,85,,percent of total billed charges,,3774.31,4755.43,
SYNTHES SCREW CORTEX 1.5 11MM,30186957,CDM,,,278,RC,inpatient,,504.98,504.98,,428.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,380.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,429.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,444.38,88,,percent of total billed charges,,,,,,,,,385.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,459.53,91,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,,,,,,,,,,,,,419.13,83,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,414.08,82,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,380.75,479.73,
SYNTHES SCREW CORTEX 1.5 14MM,30186958,CDM,,,278,RC,inpatient,,504.98,504.98,,428.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,380.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,429.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,444.38,88,,percent of total billed charges,,,,,,,,,385.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,459.53,91,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,,,,,,,,,,,,,419.13,83,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,414.08,82,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,380.75,479.73,
SYNTHES SCREW CORTEX 1.5 16MM,30186959,CDM,,,278,RC,inpatient,,504.98,504.98,,428.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,380.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,429.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,444.38,88,,percent of total billed charges,,,,,,,,,385.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,459.53,91,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,,,,,,,,,,,,,419.13,83,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,414.08,82,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,380.75,479.73,
FREELINK REMOTE KIT,30186960,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
BOSTON CLIK ANCHOR,30186961,CDM,,,278,RC,inpatient,,2193.75,2193.75,,1862.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1654.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1864.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1930.5,88,,percent of total billed charges,,,,,,,,,1676.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1996.31,91,,percent of total billed charges,,,2084.06,95,,percent of total billed charges,,,1820.81,83,,percent of total billed charges,,,1820.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1820.81,83,,percent of total billed charges,,,2084.06,95,,percent of total billed charges,,,1974.38,90,,percent of total billed charges,,,1974.38,90,,percent of total billed charges,,,1798.88,82,,percent of total billed charges,,,1974.38,90,,percent of total billed charges,,,1864.69,85,,percent of total billed charges,,1654.09,2084.06,
ZIMMER FEMUR TIV STD RIGHT SZ 8,30186962,CDM,,,278,RC,inpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14703,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16575,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,14703,18525,
ZIMMER TIBIA CEMENTED RIGHT SZ E,30186963,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER INSERT PSN RIGHT MC SZ 10,30186964,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
SYNTHES SCREW CANCEL F-THD 4.0X45MM,30186965,CDM,,,278,RC,inpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,178.47,224.87,
ZIMMER FEMUR PSN CR SZ 10 LEFT,30186966,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
ARTHREX FIBERLOOP 2-0,30186967,CDM,,,278,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
ULRICH SCREWS RESCUE 4.5 X 16MM,30186968,CDM,,,278,RC,inpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1592.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1795.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,1592.83,2006.88,
ULRICH CAGE PEEK 8MM,30186969,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
ULRICH SCREW DRIVER UNION 2.5 HEX,30186970,CDM,,,270,RC,inpatient,,3640,3640,,3090.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2744.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3094,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3203.2,88,,percent of total billed charges,,,,,,,,,2780.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3312.4,91,,percent of total billed charges,,,3458,95,,percent of total billed charges,,,3021.2,83,,percent of total billed charges,,,3021.2,83,,percent of total billed charges,,,,,,,,,,,,,,,3021.2,83,,percent of total billed charges,,,3458,95,,percent of total billed charges,,,3276,90,,percent of total billed charges,,,3276,90,,percent of total billed charges,,,2984.8,82,,percent of total billed charges,,,3276,90,,percent of total billed charges,,,3094,85,,percent of total billed charges,,2744.56,3458,
ZIMMER FEMUR PSN CR CMT SZ 7 LEFT,30186971,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
ZIMMER FEMUR POROUS NARROW CCR SZ 8 RIGH,30186972,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
ZIMMER PATELLA POLY VE 38MM,30186973,CDM,,,270,RC,inpatient,,3575,3575,,3035.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2695.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3038.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3146,88,,percent of total billed charges,,,,,,,,,2731.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3253.25,91,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2967.25,83,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,2931.5,82,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,2695.55,3396.25,
ZIMMER ART SURF POLY VE 12MM 8-11EF,30186974,CDM,,,270,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ABBOTT PRODIGY MRI IPG,30186975,CDM,,,278,RC,inpatient,,126750,126750,,107610.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95569.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107737.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,111540,88,,percent of total billed charges,,,,,,,,,96837,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,115342.5,91,,percent of total billed charges,,,120412.5,95,,percent of total billed charges,,,105202.5,83,,percent of total billed charges,,,105202.5,83,,percent of total billed charges,,,,,,,,,,,,,,,105202.5,83,,percent of total billed charges,,,120412.5,95,,percent of total billed charges,,,114075,90,,percent of total billed charges,,,114075,90,,percent of total billed charges,,,103935,82,,percent of total billed charges,,,114075,90,,percent of total billed charges,,,107737.5,85,,percent of total billed charges,,95569.5,120412.5,
URETHRAL DILATOR SET S-CURVE,30186982,CDM,,,270,RC,inpatient,,1239.23,1239.23,,1052.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,934.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1053.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1090.52,88,,percent of total billed charges,,,,,,,,,946.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1127.7,91,,percent of total billed charges,,,1177.27,95,,percent of total billed charges,,,1028.56,83,,percent of total billed charges,,,1028.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1028.56,83,,percent of total billed charges,,,1177.27,95,,percent of total billed charges,,,1115.31,90,,percent of total billed charges,,,1115.31,90,,percent of total billed charges,,,1016.17,82,,percent of total billed charges,,,1115.31,90,,percent of total billed charges,,,1053.35,85,,percent of total billed charges,,934.38,1177.27,
WIREGUIDE BENTSON FIXED CORE 0.035 X 145,30186983,CDM,,,270,RC,inpatient,,182.32,182.32,,154.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,154.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,160.44,88,,percent of total billed charges,,,,,,,,,139.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,165.91,91,,percent of total billed charges,,,173.2,95,,percent of total billed charges,,,151.33,83,,percent of total billed charges,,,151.33,83,,percent of total billed charges,,,,,,,,,,,,,,,151.33,83,,percent of total billed charges,,,173.2,95,,percent of total billed charges,,,164.09,90,,percent of total billed charges,,,164.09,90,,percent of total billed charges,,,149.5,82,,percent of total billed charges,,,164.09,90,,percent of total billed charges,,,154.97,85,,percent of total billed charges,,137.47,173.2,
WIREGUIDE BIREWIRE NITINEL CORE .025 X 1,30186984,CDM,,,270,RC,inpatient,,352.73,352.73,,299.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,265.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,299.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,310.4,88,,percent of total billed charges,,,,,,,,,269.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,320.98,91,,percent of total billed charges,,,335.09,95,,percent of total billed charges,,,292.77,83,,percent of total billed charges,,,292.77,83,,percent of total billed charges,,,,,,,,,,,,,,,292.77,83,,percent of total billed charges,,,335.09,95,,percent of total billed charges,,,317.46,90,,percent of total billed charges,,,317.46,90,,percent of total billed charges,,,289.24,82,,percent of total billed charges,,,317.46,90,,percent of total billed charges,,,299.82,85,,percent of total billed charges,,265.96,335.09,
GUIDEWIRE 3CM STRAIGHT PTFE .035 X 150CM,30186985,CDM,,,270,RC,inpatient,,316.16,316.16,,268.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,238.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,268.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,278.22,88,,percent of total billed charges,,,,,,,,,241.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,287.71,91,,percent of total billed charges,,,300.35,95,,percent of total billed charges,,,262.41,83,,percent of total billed charges,,,262.41,83,,percent of total billed charges,,,,,,,,,,,,,,,262.41,83,,percent of total billed charges,,,300.35,95,,percent of total billed charges,,,284.54,90,,percent of total billed charges,,,284.54,90,,percent of total billed charges,,,259.25,82,,percent of total billed charges,,,284.54,90,,percent of total billed charges,,,268.74,85,,percent of total billed charges,,238.38,300.35,
GUIDEWIRE 3CM ANGLED PTFE .035 X 150CM,30186986,CDM,,,270,RC,inpatient,,318.56,318.56,,270.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,240.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,270.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,280.33,88,,percent of total billed charges,,,,,,,,,243.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,289.89,91,,percent of total billed charges,,,302.63,95,,percent of total billed charges,,,264.4,83,,percent of total billed charges,,,264.4,83,,percent of total billed charges,,,,,,,,,,,,,,,264.4,83,,percent of total billed charges,,,302.63,95,,percent of total billed charges,,,286.7,90,,percent of total billed charges,,,286.7,90,,percent of total billed charges,,,261.22,82,,percent of total billed charges,,,286.7,90,,percent of total billed charges,,,270.78,85,,percent of total billed charges,,240.19,302.63,
SAPS SINGLE ACTION PUMP SYSTEM,30186987,CDM,,,270,RC,inpatient,,534.87,534.87,,454.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,403.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,454.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,470.69,88,,percent of total billed charges,,,,,,,,,408.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,486.73,91,,percent of total billed charges,,,508.13,95,,percent of total billed charges,,,443.94,83,,percent of total billed charges,,,443.94,83,,percent of total billed charges,,,,,,,,,,,,,,,443.94,83,,percent of total billed charges,,,508.13,95,,percent of total billed charges,,,481.38,90,,percent of total billed charges,,,481.38,90,,percent of total billed charges,,,438.59,82,,percent of total billed charges,,,481.38,90,,percent of total billed charges,,,454.64,85,,percent of total billed charges,,403.29,508.13,
CAPIOSLIM,30186988,CDM,,,270,RC,inpatient,,3346.2,3346.2,,2840.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2523.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2844.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2944.66,88,,percent of total billed charges,,,,,,,,,2556.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3045.04,91,,percent of total billed charges,,,3178.89,95,,percent of total billed charges,,,2777.35,83,,percent of total billed charges,,,2777.35,83,,percent of total billed charges,,,,,,,,,,,,,,,2777.35,83,,percent of total billed charges,,,3178.89,95,,percent of total billed charges,,,3011.58,90,,percent of total billed charges,,,3011.58,90,,percent of total billed charges,,,2743.88,82,,percent of total billed charges,,,3011.58,90,,percent of total billed charges,,,2844.27,85,,percent of total billed charges,,2523.03,3178.89,
MONODEK PDO TC & T 26MM 1/2 CIRCLE,30186989,CDM,,,270,RC,inpatient,,311.85,311.85,,264.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,235.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,265.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,274.43,88,,percent of total billed charges,,,,,,,,,238.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,283.78,91,,percent of total billed charges,,,296.26,95,,percent of total billed charges,,,258.84,83,,percent of total billed charges,,,258.84,83,,percent of total billed charges,,,,,,,,,,,,,,,258.84,83,,percent of total billed charges,,,296.26,95,,percent of total billed charges,,,280.67,90,,percent of total billed charges,,,280.67,90,,percent of total billed charges,,,255.72,82,,percent of total billed charges,,,280.67,90,,percent of total billed charges,,,265.07,85,,percent of total billed charges,,235.13,296.26,
STENT TRIA SOFT 6F X 24CM,30186990,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
STENT TRIA SOFT 6F X 22CM,30186991,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
STENT TRIA SOFT 6F X 28CM,30186992,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
STENT TRIA SOFT 7F X 26CM,30186993,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
STENT TRIA SOFT 6F X 26CM,30186994,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
ZIMMER LINER NUETRAL 32MM E1,30186995,CDM,,,278,RC,inpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17447.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19669,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,17447.56,21983,
ZIMMER SHELL OSSEOTI G7 46MM B 3 HOLE,30186996,CDM,,,278,RC,inpatient,,37505,37505,,31841.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28278.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31879.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33004.4,88,,percent of total billed charges,,,,,,,,,28653.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34129.55,91,,percent of total billed charges,,,35629.75,95,,percent of total billed charges,,,31129.15,83,,percent of total billed charges,,,31129.15,83,,percent of total billed charges,,,,,,,,,,,,,,,31129.15,83,,percent of total billed charges,,,35629.75,95,,percent of total billed charges,,,33754.5,90,,percent of total billed charges,,,33754.5,90,,percent of total billed charges,,,30754.1,82,,percent of total billed charges,,,33754.5,90,,percent of total billed charges,,,31879.25,85,,percent of total billed charges,,28278.77,35629.75,
ULRICH CAGE PEEK 6MM 13 X 15 6DEG,30186997,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
ULRICH PLATE 3 LEVEL 48MM,30186998,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
ARTHREX PLATE 2-HOLE,30186999,CDM,,,278,RC,inpatient,,5525,5525,,4690.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4165.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4696.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4862,88,,percent of total billed charges,,,,,,,,,4221.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5027.75,91,,percent of total billed charges,,,5248.75,95,,percent of total billed charges,,,4585.75,83,,percent of total billed charges,,,4585.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4585.75,83,,percent of total billed charges,,,5248.75,95,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4530.5,82,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4696.25,85,,percent of total billed charges,,4165.85,5248.75,
ARTHREX TIGHT ROPE XP IMPLANT SYNDESMOSI,30187000,CDM,,,278,RC,inpatient,,9717.5,9717.5,,8250.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7327,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8259.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8551.4,88,,percent of total billed charges,,,,,,,,,7424.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8842.93,91,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,,,,,,,,,,,,,8065.53,83,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,7968.35,82,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8259.88,85,,percent of total billed charges,,7327,9231.63,
ZIMMER FEMUR PSN CR SZ 7 RIGHT,30187001,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
ZIMMER INSERT PSN RIGHT MC 10MM 6-7EF,30187002,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ZIMMER STEM STRAIGHT EXT 16MM X 145MM,30187003,CDM,,,278,RC,inpatient,,7276.62,7276.62,,6177.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5486.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6185.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6403.43,88,,percent of total billed charges,,,,,,,,,5559.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6621.72,91,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,,,,,,,,,,,,,6039.59,83,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,5966.83,82,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,5486.57,6912.79,
ZIMMER FEMORAL CENTRAL CONE SMALL,30187004,CDM,,,278,RC,inpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36420.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41057.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,36420.56,45887.97,
ZIMMER STEM TIBIAL PLATE SZ 4 ROTATING H,30187005,CDM,,,278,RC,inpatient,,28502.57,28502.57,,24198.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21490.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24227.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25082.26,88,,percent of total billed charges,,,,,,,,,21775.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25937.34,91,,percent of total billed charges,,,27077.44,95,,percent of total billed charges,,,23657.13,83,,percent of total billed charges,,,23657.13,83,,percent of total billed charges,,,,,,,,,,,,,,,23657.13,83,,percent of total billed charges,,,27077.44,95,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,23372.11,82,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,24227.18,85,,percent of total billed charges,,21490.94,27077.44,
ZIMMER AUGMENT BLOCK SZ E 10MM,30187006,CDM,,,278,RC,inpatient,,6483.75,6483.75,,5504.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4888.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5511.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5705.7,88,,percent of total billed charges,,,,,,,,,4953.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5900.21,91,,percent of total billed charges,,,6159.56,95,,percent of total billed charges,,,5381.51,83,,percent of total billed charges,,,5381.51,83,,percent of total billed charges,,,,,,,,,,,,,,,5381.51,83,,percent of total billed charges,,,6159.56,95,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5316.68,82,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5511.19,85,,percent of total billed charges,,4888.75,6159.56,
ZIMMER TIBIA AUGMENT BLOCK SZ E 10MM,30187007,CDM,,,278,RC,inpatient,,6483.75,6483.75,,5504.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4888.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5511.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5705.7,88,,percent of total billed charges,,,,,,,,,4953.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5900.21,91,,percent of total billed charges,,,6159.56,95,,percent of total billed charges,,,5381.51,83,,percent of total billed charges,,,5381.51,83,,percent of total billed charges,,,,,,,,,,,,,,,5381.51,83,,percent of total billed charges,,,6159.56,95,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5316.68,82,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5511.19,85,,percent of total billed charges,,4888.75,6159.56,
ZIMMER STEM STRAIGHT EXT 17MM X 145MM,30187008,CDM,,,278,RC,inpatient,,7276.62,7276.62,,6177.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5486.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6185.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6403.43,88,,percent of total billed charges,,,,,,,,,5559.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6621.72,91,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,,,,,,,,,,,,,6039.59,83,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,5966.83,82,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,5486.57,6912.79,
ZIMMER FEMORAL CENTRAL CONE LARGE,30187009,CDM,,,278,RC,inpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36420.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41057.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,36420.56,45887.97,
ZIMMER SURFACE ROTATING HING E 12MM,30187010,CDM,,,278,RC,inpatient,,12617.41,12617.41,,10712.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9513.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10724.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11103.32,88,,percent of total billed charges,,,,,,,,,9639.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11481.84,91,,percent of total billed charges,,,11986.54,95,,percent of total billed charges,,,10472.45,83,,percent of total billed charges,,,10472.45,83,,percent of total billed charges,,,,,,,,,,,,,,,10472.45,83,,percent of total billed charges,,,11986.54,95,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,10346.28,82,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,10724.8,85,,percent of total billed charges,,9513.53,11986.54,
ZIMMER FEMORAL ROTATING HINGE E-LT,30187011,CDM,,,278,RC,inpatient,,57459.03,57459.03,,48782.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43324.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48840.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50563.95,88,,percent of total billed charges,,,,,,,,,43898.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52287.72,91,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,,,,,,,,,,,,,47690.99,83,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,47116.4,82,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,48840.18,85,,percent of total billed charges,,43324.11,54586.08,
GYNECARE TVT EXACT,30187012,CDM,,,270,RC,inpatient,,9587.24,9587.24,,8139.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8436.77,88,,percent of total billed charges,,,,,,,,,7324.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.39,91,,percent of total billed charges,,,9107.88,95,,percent of total billed charges,,,7957.41,83,,percent of total billed charges,,,7957.41,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.41,83,,percent of total billed charges,,,9107.88,95,,percent of total billed charges,,,8628.52,90,,percent of total billed charges,,,8628.52,90,,percent of total billed charges,,,7861.54,82,,percent of total billed charges,,,8628.52,90,,percent of total billed charges,,,8149.15,85,,percent of total billed charges,,7228.78,9107.88,
SUSPENSORY BAUER & BLACK 0-16 LARGE,30187013,CDM,,,270,RC,inpatient,,131.92,131.92,,112,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,99.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,112.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,116.09,88,,percent of total billed charges,,,,,,,,,100.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,120.05,91,,percent of total billed charges,,,125.32,95,,percent of total billed charges,,,109.49,83,,percent of total billed charges,,,109.49,83,,percent of total billed charges,,,,,,,,,,,,,,,109.49,83,,percent of total billed charges,,,125.32,95,,percent of total billed charges,,,118.73,90,,percent of total billed charges,,,118.73,90,,percent of total billed charges,,,108.17,82,,percent of total billed charges,,,118.73,90,,percent of total billed charges,,,112.13,85,,percent of total billed charges,,99.47,125.32,
ZIMMER BEARING VIVACIT-E 28X44MM,30187014,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
ZIMMER BLADE PATELLA REAMER SZ 35,30187015,CDM,,,270,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
ZIMMER FEMUR PSN CR SZ 6 RIGHT,30187016,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
COOPER LONESTAR RETRACTOR RINGS,30187017,CDM,,,270,RC,inpatient,,584.85,584.85,,496.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,440.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,497.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,514.67,88,,percent of total billed charges,,,,,,,,,446.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,532.21,91,,percent of total billed charges,,,555.61,95,,percent of total billed charges,,,485.43,83,,percent of total billed charges,,,485.43,83,,percent of total billed charges,,,,,,,,,,,,,,,485.43,83,,percent of total billed charges,,,555.61,95,,percent of total billed charges,,,526.37,90,,percent of total billed charges,,,526.37,90,,percent of total billed charges,,,479.58,82,,percent of total billed charges,,,526.37,90,,percent of total billed charges,,,497.12,85,,percent of total billed charges,,440.98,555.61,
COOPER LONESTAR GYNE KIT W/8  HOOKS,30187018,CDM,,,270,RC,inpatient,,584.85,584.85,,496.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,440.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,497.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,514.67,88,,percent of total billed charges,,,,,,,,,446.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,532.21,91,,percent of total billed charges,,,555.61,95,,percent of total billed charges,,,485.43,83,,percent of total billed charges,,,485.43,83,,percent of total billed charges,,,,,,,,,,,,,,,485.43,83,,percent of total billed charges,,,555.61,95,,percent of total billed charges,,,526.37,90,,percent of total billed charges,,,526.37,90,,percent of total billed charges,,,479.58,82,,percent of total billed charges,,,526.37,90,,percent of total billed charges,,,497.12,85,,percent of total billed charges,,440.98,555.61,
COOPER LONESTAR SHARP STAY HOOKS 5MM,30187019,CDM,,,270,RC,inpatient,,478.38,478.38,,406.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,360.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,406.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,420.97,88,,percent of total billed charges,,,,,,,,,365.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,435.33,91,,percent of total billed charges,,,454.46,95,,percent of total billed charges,,,397.06,83,,percent of total billed charges,,,397.06,83,,percent of total billed charges,,,,,,,,,,,,,,,397.06,83,,percent of total billed charges,,,454.46,95,,percent of total billed charges,,,430.54,90,,percent of total billed charges,,,430.54,90,,percent of total billed charges,,,392.27,82,,percent of total billed charges,,,430.54,90,,percent of total billed charges,,,406.62,85,,percent of total billed charges,,360.7,454.46,
ZIMMER PATELLA CEMENTED 35MM,30187020,CDM,,,278,RC,inpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1715.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1933.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,1715.35,2161.25,
ZIMMER TIBIA CEMENTED LEFT SZ E,30187021,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER FEMUR PSN CR SZ 7 LEFT,30187022,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
SPINECRAFT POWER T HANDLE,30187023,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
SPINECRAFT ROD STRAIGHT 300MM,30187024,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
ZIMMER FEMUR POROUS CR SZ 9 RIGHT,30187025,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
ZIMMER TIBIA PSN  SZ F RIGHT,30187026,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
CAPIO SUTURE MONODEK 1 X 48IN,30187027,CDM,,,270,RC,inpatient,,364.86,364.86,,309.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,275.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,310.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,321.08,88,,percent of total billed charges,,,,,,,,,278.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,332.02,91,,percent of total billed charges,,,346.62,95,,percent of total billed charges,,,302.83,83,,percent of total billed charges,,,302.83,83,,percent of total billed charges,,,,,,,,,,,,,,,302.83,83,,percent of total billed charges,,,346.62,95,,percent of total billed charges,,,328.37,90,,percent of total billed charges,,,328.37,90,,percent of total billed charges,,,299.19,82,,percent of total billed charges,,,328.37,90,,percent of total billed charges,,,310.13,85,,percent of total billed charges,,275.1,346.62,
HEMORRHAGE OCCLUDER PIN W/APPLICATOR,30187028,CDM,,,270,RC,inpatient,,1105,1105,,938.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,833.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,939.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,972.4,88,,percent of total billed charges,,,,,,,,,844.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1005.55,91,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,,,,,,,,,,,,,917.15,83,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,906.1,82,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,833.17,1049.75,
STANDARD FIBERNET KIT,30187029,CDM,,,270,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER LINER NEUTRAL G7 36MM E,30187030,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ZIMMER TIBIA PSN CEMENTED SZ G 5 DEG RIG,30187031,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER FEMUR CEMENTED SZ 11 RIGHT,30187032,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
IR CAGE PEEK 6DEG 12X14X7,30187033,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
IR SCREW SELF DRILLING VARIABLE 14MM,30187034,CDM,,,278,RC,inpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1347.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1519.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,1347.78,1698.13,
IR PLATE CERVICAL 4 LEVEL 64MM,30187035,CDM,,,278,RC,inpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7351.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8287.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,7351.5,9262.5,
IR DRILL BIT 12MM,30187036,CDM,,,270,RC,inpatient,,2340,2340,,1986.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1764.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1989,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2059.2,88,,percent of total billed charges,,,,,,,,,1787.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2129.4,91,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1942.2,83,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1918.8,82,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1989,85,,percent of total billed charges,,1764.36,2223,
IR SCREW SELF DRILLING VARIABLE 16MM,30187037,CDM,,,278,RC,inpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1347.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1519.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,1347.78,1698.13,
SYNTHES PLATE 3 HOLE LEFT HUMERUS 3.5MM,30187038,CDM,,,278,RC,inpatient,,16634.87,16634.87,,14123,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12542.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14139.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14638.69,88,,percent of total billed charges,,,,,,,,,12709.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15137.73,91,,percent of total billed charges,,,15803.13,95,,percent of total billed charges,,,13806.94,83,,percent of total billed charges,,,13806.94,83,,percent of total billed charges,,,,,,,,,,,,,,,13806.94,83,,percent of total billed charges,,,15803.13,95,,percent of total billed charges,,,14971.38,90,,percent of total billed charges,,,14971.38,90,,percent of total billed charges,,,13640.59,82,,percent of total billed charges,,,14971.38,90,,percent of total billed charges,,,14139.64,85,,percent of total billed charges,,12542.69,15803.13,
IR CAGE PEEK 6DEG 12X14X6,30187039,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
IR CAGE PEEK 10DEG 12X14X8,30187040,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
IR CAGE PEEK 10DEG 12X14X7,30187041,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
IR PLATE CERVICAL 4 LEVEL 76MM,30187042,CDM,,,278,RC,inpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7351.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8287.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,7351.5,9262.5,
IR SCREW SELF DRILLING VARIABLE 4.0 X 18,30187043,CDM,,,278,RC,inpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1347.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1519.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,1347.78,1698.13,
KYPHON 20/2 BONE TAMP KIT,30187044,CDM,,,278,RC,inpatient,,24375,24375,,20694.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18378.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20718.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21450,88,,percent of total billed charges,,,,,,,,,18622.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22181.25,91,,percent of total billed charges,,,23156.25,95,,percent of total billed charges,,,20231.25,83,,percent of total billed charges,,,20231.25,83,,percent of total billed charges,,,,,,,,,,,,,,,20231.25,83,,percent of total billed charges,,,23156.25,95,,percent of total billed charges,,,21937.5,90,,percent of total billed charges,,,21937.5,90,,percent of total billed charges,,,19987.5,82,,percent of total billed charges,,,21937.5,90,,percent of total billed charges,,,20718.75,85,,percent of total billed charges,,18378.75,23156.25,
FIBRINET PLATELET SYSTEM,30187045,CDM,,,278,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
FIBRINET SYSTEM,30187046,CDM,,,278,RC,inpatient,,9717.5,9717.5,,8250.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7327,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8259.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8551.4,88,,percent of total billed charges,,,,,,,,,7424.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8842.93,91,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,,,,,,,,,,,,,8065.53,83,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,7968.35,82,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8259.88,85,,percent of total billed charges,,7327,9231.63,
ZIMMER LINER NEUTRAL F 40MM,30187047,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ZIMMER BEARING VIVACIT-E 28X42MM,30187048,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
TROCAR MAYO CATGUT 5D 1/2 CIRCL,30187049,CDM,,,270,RC,inpatient,,80.57,80.57,,68.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.9,88,,percent of total billed charges,,,,,,,,,61.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.32,91,,percent of total billed charges,,,76.54,95,,percent of total billed charges,,,66.87,83,,percent of total billed charges,,,66.87,83,,percent of total billed charges,,,,,,,,,,,,,,,66.87,83,,percent of total billed charges,,,76.54,95,,percent of total billed charges,,,72.51,90,,percent of total billed charges,,,72.51,90,,percent of total billed charges,,,66.07,82,,percent of total billed charges,,,72.51,90,,percent of total billed charges,,,68.48,85,,percent of total billed charges,,60.75,76.54,
IOVERA SMART TIP 190 W/NERVE STIM,30187050,CDM,,,270,RC,inpatient,,5196.75,5196.75,,4412.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3918.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4417.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4573.14,88,,percent of total billed charges,,,,,,,,,3970.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4729.04,91,,percent of total billed charges,,,4936.91,95,,percent of total billed charges,,,4313.3,83,,percent of total billed charges,,,4313.3,83,,percent of total billed charges,,,,,,,,,,,,,,,4313.3,83,,percent of total billed charges,,,4936.91,95,,percent of total billed charges,,,4677.08,90,,percent of total billed charges,,,4677.08,90,,percent of total billed charges,,,4261.34,82,,percent of total billed charges,,,4677.08,90,,percent of total billed charges,,,4417.24,85,,percent of total billed charges,,3918.35,4936.91,
OSTEO FEMORAL HEAD MEDIUM,30187052,CDM,,,278,RC,inpatient,,21125,21125,,17935.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15928.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17956.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18590,88,,percent of total billed charges,,,,,,,,,16139.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19223.75,91,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,,,,,,,,,,,,,17533.75,83,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17322.5,82,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17956.25,85,,percent of total billed charges,,15928.25,20068.75,
ALLODERM 4 X 12,30187053,CDM,,,278,RC,inpatient,,13734.5,13734.5,,11660.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10355.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11674.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12086.36,88,,percent of total billed charges,,,,,,,,,10493.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12498.4,91,,percent of total billed charges,,,13047.78,95,,percent of total billed charges,,,11399.64,83,,percent of total billed charges,,,11399.64,83,,percent of total billed charges,,,,,,,,,,,,,,,11399.64,83,,percent of total billed charges,,,13047.78,95,,percent of total billed charges,,,12361.05,90,,percent of total billed charges,,,12361.05,90,,percent of total billed charges,,,11262.29,82,,percent of total billed charges,,,12361.05,90,,percent of total billed charges,,,11674.33,85,,percent of total billed charges,,10355.81,13047.78,
ARTHREX SUTURE TIGERTAPE CERCLAGE,30187054,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
CATHETER OMNI FLUSH 5F .035 65CM,30187055,CDM,,,270,RC,inpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,197.93,249.38,
CATHETER OMNI FLUSH 5F .038 100CM,30187056,CDM,,,270,RC,inpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,197.93,249.38,
CATHETER KUMPE 5F .038 40CM,30187057,CDM,,,270,RC,inpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,186.62,235.13,
CATHETER COBRA C2 5F .035 65CM,30187058,CDM,,,270,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
CATHETER COBRA C2 5F .035 90CM,30187059,CDM,,,270,RC,inpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,186.62,235.13,
TERUMO GLIDEWIRE TORQUE DEVICE 0.010 - 0,30187060,CDM,,,270,RC,inpatient,,55.85,55.85,,47.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.15,88,,percent of total billed charges,,,,,,,,,42.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.82,91,,percent of total billed charges,,,53.06,95,,percent of total billed charges,,,46.36,83,,percent of total billed charges,,,46.36,83,,percent of total billed charges,,,,,,,,,,,,,,,46.36,83,,percent of total billed charges,,,53.06,95,,percent of total billed charges,,,50.27,90,,percent of total billed charges,,,50.27,90,,percent of total billed charges,,,45.8,82,,percent of total billed charges,,,50.27,90,,percent of total billed charges,,,47.47,85,,percent of total billed charges,,42.11,53.06,
TERUMO GLIDEWIRE STRAIGHT STANDARD 0.35,30187061,CDM,,,270,RC,inpatient,,476,476,,404.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,358.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,404.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,418.88,88,,percent of total billed charges,,,,,,,,,363.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,433.16,91,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,,,,,,,,,,,,,395.08,83,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,390.32,82,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,358.9,452.2,
TERUMO PROGREAT 2.4,30187062,CDM,,,270,RC,inpatient,,4355,4355,,3697.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3283.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3701.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3832.4,88,,percent of total billed charges,,,,,,,,,3327.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3963.05,91,,percent of total billed charges,,,4137.25,95,,percent of total billed charges,,,3614.65,83,,percent of total billed charges,,,3614.65,83,,percent of total billed charges,,,,,,,,,,,,,,,3614.65,83,,percent of total billed charges,,,4137.25,95,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3571.1,82,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3701.75,85,,percent of total billed charges,,3283.67,4137.25,
TERUMO PROGREAT 2.8,30187063,CDM,,,270,RC,inpatient,,4355,4355,,3697.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3283.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3701.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3832.4,88,,percent of total billed charges,,,,,,,,,3327.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3963.05,91,,percent of total billed charges,,,4137.25,95,,percent of total billed charges,,,3614.65,83,,percent of total billed charges,,,3614.65,83,,percent of total billed charges,,,,,,,,,,,,,,,3614.65,83,,percent of total billed charges,,,4137.25,95,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3571.1,82,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3701.75,85,,percent of total billed charges,,3283.67,4137.25,
COOK SHEALTH ANSEL 1 8FR 45CM,30187064,CDM,,,270,RC,inpatient,,454.23,454.23,,385.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,342.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,386.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,399.72,88,,percent of total billed charges,,,,,,,,,347.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,413.35,91,,percent of total billed charges,,,431.52,95,,percent of total billed charges,,,377.01,83,,percent of total billed charges,,,377.01,83,,percent of total billed charges,,,,,,,,,,,,,,,377.01,83,,percent of total billed charges,,,431.52,95,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,372.47,82,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,386.1,85,,percent of total billed charges,,342.49,431.52,
COOK SHEALTH ANSEL 1 7FR 45CM,30187065,CDM,,,270,RC,inpatient,,398.09,398.09,,337.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,300.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,338.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,350.32,88,,percent of total billed charges,,,,,,,,,304.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,362.26,91,,percent of total billed charges,,,378.19,95,,percent of total billed charges,,,330.41,83,,percent of total billed charges,,,330.41,83,,percent of total billed charges,,,,,,,,,,,,,,,330.41,83,,percent of total billed charges,,,378.19,95,,percent of total billed charges,,,358.28,90,,percent of total billed charges,,,358.28,90,,percent of total billed charges,,,326.43,82,,percent of total billed charges,,,358.28,90,,percent of total billed charges,,,338.38,85,,percent of total billed charges,,300.16,378.19,
CONTROL WIRE 8CM V18 300CM,30187066,CDM,,,270,RC,inpatient,,778.82,778.82,,661.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,587.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,662,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,685.36,88,,percent of total billed charges,,,,,,,,,595.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,708.73,91,,percent of total billed charges,,,739.88,95,,percent of total billed charges,,,646.42,83,,percent of total billed charges,,,646.42,83,,percent of total billed charges,,,,,,,,,,,,,,,646.42,83,,percent of total billed charges,,,739.88,95,,percent of total billed charges,,,700.94,90,,percent of total billed charges,,,700.94,90,,percent of total billed charges,,,638.63,82,,percent of total billed charges,,,700.94,90,,percent of total billed charges,,,662,85,,percent of total billed charges,,587.23,739.88,
MERIT CATHETER ONESTEP 5F 10CM,30187067,CDM,,,270,RC,inpatient,,148,148,,125.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,111.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,125.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,130.24,88,,percent of total billed charges,,,,,,,,,113.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,,,,,,,,,,,,,122.84,83,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,121.36,82,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,111.59,140.6,
MERIT CATHETER ONESTEP 5F 12CM,30187068,CDM,,,270,RC,inpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,226.2,285,
IR PLATE CERVICAL 1 LEVEL 12MM,30187070,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
ZIMMER FEMUR PERSONA RIGHT 12 STANDARD,30187073,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
ZIMMER TIBIA STEM PERSONA RIGHT H,30187074,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
SYNTHES SCREW CANCELLOUS 4X12MM,30187075,CDM,,,278,RC,inpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,178.47,224.87,
SYNTHES SCREW CANCELLOUS 4X14MM,30187076,CDM,,,278,RC,inpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,178.47,224.87,
SYNTHES SCREW CANCELLOUS 4X16MM,30187077,CDM,,,278,RC,inpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,178.47,224.87,
SYNTHES SCREW CANCELLOUS FT 4X10MM,30187078,CDM,,,278,RC,inpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,178.47,224.87,
SYNTHES SCREW CANCELLOUS FT 4X12MM,30187079,CDM,,,278,RC,inpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,178.47,224.87,
COOK FLEXOR ACCESS SHEATH 10.7FR X 55CM,30187080,CDM,,,270,RC,inpatient,,846.3,846.3,,718.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,638.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,719.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,744.74,88,,percent of total billed charges,,,,,,,,,646.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,770.13,91,,percent of total billed charges,,,803.99,95,,percent of total billed charges,,,702.43,83,,percent of total billed charges,,,702.43,83,,percent of total billed charges,,,,,,,,,,,,,,,702.43,83,,percent of total billed charges,,,803.99,95,,percent of total billed charges,,,761.67,90,,percent of total billed charges,,,761.67,90,,percent of total billed charges,,,693.97,82,,percent of total billed charges,,,761.67,90,,percent of total billed charges,,,719.36,85,,percent of total billed charges,,638.11,803.99,
COOK FLEXOR ACCESS SHEATH 12FR X 55CM,30187081,CDM,,,270,RC,inpatient,,846.3,846.3,,718.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,638.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,719.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,744.74,88,,percent of total billed charges,,,,,,,,,646.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,770.13,91,,percent of total billed charges,,,803.99,95,,percent of total billed charges,,,702.43,83,,percent of total billed charges,,,702.43,83,,percent of total billed charges,,,,,,,,,,,,,,,702.43,83,,percent of total billed charges,,,803.99,95,,percent of total billed charges,,,761.67,90,,percent of total billed charges,,,761.67,90,,percent of total billed charges,,,693.97,82,,percent of total billed charges,,,761.67,90,,percent of total billed charges,,,719.36,85,,percent of total billed charges,,638.11,803.99,
COOK FLEXOR YELLOW OPEN ENEDED 5FR X 70,30187082,CDM,,,270,RC,inpatient,,80.08,80.08,,67.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.47,88,,percent of total billed charges,,,,,,,,,61.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.87,91,,percent of total billed charges,,,76.08,95,,percent of total billed charges,,,66.47,83,,percent of total billed charges,,,66.47,83,,percent of total billed charges,,,,,,,,,,,,,,,66.47,83,,percent of total billed charges,,,76.08,95,,percent of total billed charges,,,72.07,90,,percent of total billed charges,,,72.07,90,,percent of total billed charges,,,65.67,82,,percent of total billed charges,,,72.07,90,,percent of total billed charges,,,68.07,85,,percent of total billed charges,,60.38,76.08,
GREENLIGHT LASER - MIDWEST THERAPY,30187083,CDM,,,270,RC,inpatient,,6337.5,6337.5,,5380.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4778.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5386.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5577,88,,percent of total billed charges,,,,,,,,,4841.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5767.13,91,,percent of total billed charges,,,6020.63,95,,percent of total billed charges,,,5260.13,83,,percent of total billed charges,,,5260.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5260.13,83,,percent of total billed charges,,,6020.63,95,,percent of total billed charges,,,5703.75,90,,percent of total billed charges,,,5703.75,90,,percent of total billed charges,,,5196.75,82,,percent of total billed charges,,,5703.75,90,,percent of total billed charges,,,5386.88,85,,percent of total billed charges,,4778.48,6020.63,
GREENLIGHT XPS MOXY FIBER - MIDWEST THER,30187084,CDM,,,270,RC,inpatient,,6142.5,6142.5,,5214.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4631.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5221.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5405.4,88,,percent of total billed charges,,,,,,,,,4692.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5589.68,91,,percent of total billed charges,,,5835.38,95,,percent of total billed charges,,,5098.28,83,,percent of total billed charges,,,5098.28,83,,percent of total billed charges,,,,,,,,,,,,,,,5098.28,83,,percent of total billed charges,,,5835.38,95,,percent of total billed charges,,,5528.25,90,,percent of total billed charges,,,5528.25,90,,percent of total billed charges,,,5036.85,82,,percent of total billed charges,,,5528.25,90,,percent of total billed charges,,,5221.13,85,,percent of total billed charges,,4631.45,5835.38,
DEPUY CEMENTRALIZER 10MM,30187085,CDM,,,270,RC,inpatient,,919.36,919.36,,780.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,693.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,781.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,809.04,88,,percent of total billed charges,,,,,,,,,702.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,836.62,91,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,,,,,,,,,,,,,763.07,83,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,753.88,82,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,781.46,85,,percent of total billed charges,,693.2,873.39,
DEPUY STEM CORAIL HIGH COL SZ 15,30187086,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY INSERT CR RP SZ 10 7MM,30187087,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
LABORIE NEEDLE INJECTION 35CM,30187088,CDM,,,270,RC,inpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,314.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,354.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,314.04,395.68,
LABORIE NEEDLE INJECTION 70CM,30187089,CDM,,,270,RC,inpatient,,518,518,,439.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,390.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,440.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,455.84,88,,percent of total billed charges,,,,,,,,,395.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,471.38,91,,percent of total billed charges,,,492.1,95,,percent of total billed charges,,,429.94,83,,percent of total billed charges,,,429.94,83,,percent of total billed charges,,,,,,,,,,,,,,,429.94,83,,percent of total billed charges,,,492.1,95,,percent of total billed charges,,,466.2,90,,percent of total billed charges,,,466.2,90,,percent of total billed charges,,,424.76,82,,percent of total billed charges,,,466.2,90,,percent of total billed charges,,,440.3,85,,percent of total billed charges,,390.57,492.1,
S&N TIBIAL CONE SHORT 20 ID,30187090,CDM,,,278,RC,inpatient,,38616.5,38616.5,,32785.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29116.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32824.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33982.52,88,,percent of total billed charges,,,,,,,,,29503.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35141.02,91,,percent of total billed charges,,,36685.68,95,,percent of total billed charges,,,32051.7,83,,percent of total billed charges,,,32051.7,83,,percent of total billed charges,,,,,,,,,,,,,,,32051.7,83,,percent of total billed charges,,,36685.68,95,,percent of total billed charges,,,34754.85,90,,percent of total billed charges,,,34754.85,90,,percent of total billed charges,,,31665.53,82,,percent of total billed charges,,,34754.85,90,,percent of total billed charges,,,32824.03,85,,percent of total billed charges,,29116.84,36685.68,
S&N WEDGE DISTAL/POST L SZ 4 15D X 5P,30187091,CDM,,,278,RC,inpatient,,19088.03,19088.03,,16205.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14392.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16224.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16797.47,88,,percent of total billed charges,,,,,,,,,14583.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17370.11,91,,percent of total billed charges,,,18133.63,95,,percent of total billed charges,,,15843.06,83,,percent of total billed charges,,,15843.06,83,,percent of total billed charges,,,,,,,,,,,,,,,15843.06,83,,percent of total billed charges,,,18133.63,95,,percent of total billed charges,,,17179.23,90,,percent of total billed charges,,,17179.23,90,,percent of total billed charges,,,15652.18,82,,percent of total billed charges,,,17179.23,90,,percent of total billed charges,,,16224.83,85,,percent of total billed charges,,14392.37,18133.63,
S&N WEDGES DISTAL 5MM SZ 4,30187092,CDM,,,278,RC,inpatient,,13043.03,13043.03,,11073.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9834.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11086.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11477.87,88,,percent of total billed charges,,,,,,,,,9964.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11869.16,91,,percent of total billed charges,,,12390.88,95,,percent of total billed charges,,,10825.71,83,,percent of total billed charges,,,10825.71,83,,percent of total billed charges,,,,,,,,,,,,,,,10825.71,83,,percent of total billed charges,,,12390.88,95,,percent of total billed charges,,,11738.73,90,,percent of total billed charges,,,11738.73,90,,percent of total billed charges,,,10695.28,82,,percent of total billed charges,,,11738.73,90,,percent of total billed charges,,,11086.58,85,,percent of total billed charges,,9834.44,12390.88,
S&N COUPLER OFFSET 4MM,30187093,CDM,,,278,RC,inpatient,,13168.48,13168.48,,11180.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9929.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11193.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11588.26,88,,percent of total billed charges,,,,,,,,,10060.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11983.32,91,,percent of total billed charges,,,12510.06,95,,percent of total billed charges,,,10929.84,83,,percent of total billed charges,,,10929.84,83,,percent of total billed charges,,,,,,,,,,,,,,,10929.84,83,,percent of total billed charges,,,12510.06,95,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,10798.15,82,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,11193.21,85,,percent of total billed charges,,9929.03,12510.06,
S&N FEMUR LEGION OX CONSTRAINED SZ 4 LT,30187094,CDM,,,278,RC,inpatient,,69403.95,69403.95,,58923.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52330.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58993.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,61075.48,88,,percent of total billed charges,,,,,,,,,53024.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,63157.59,91,,percent of total billed charges,,,65933.75,95,,percent of total billed charges,,,57605.28,83,,percent of total billed charges,,,57605.28,83,,percent of total billed charges,,,,,,,,,,,,,,,57605.28,83,,percent of total billed charges,,,65933.75,95,,percent of total billed charges,,,62463.56,90,,percent of total billed charges,,,62463.56,90,,percent of total billed charges,,,56911.24,82,,percent of total billed charges,,,62463.56,90,,percent of total billed charges,,,58993.36,85,,percent of total billed charges,,52330.58,65933.75,
S&N STEM PRESSFIT 16 X 120MM,30187095,CDM,,,278,RC,inpatient,,12842.44,12842.44,,10903.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9683.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10916.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11301.35,88,,percent of total billed charges,,,,,,,,,9811.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11686.62,91,,percent of total billed charges,,,12200.32,95,,percent of total billed charges,,,10659.23,83,,percent of total billed charges,,,10659.23,83,,percent of total billed charges,,,,,,,,,,,,,,,10659.23,83,,percent of total billed charges,,,12200.32,95,,percent of total billed charges,,,11558.2,90,,percent of total billed charges,,,11558.2,90,,percent of total billed charges,,,10530.8,82,,percent of total billed charges,,,11558.2,90,,percent of total billed charges,,,10916.07,85,,percent of total billed charges,,9683.2,12200.32,
S&N COUPLER OFFSET 2MM,30187096,CDM,,,278,RC,inpatient,,13168.48,13168.48,,11180.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9929.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11193.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11588.26,88,,percent of total billed charges,,,,,,,,,10060.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11983.32,91,,percent of total billed charges,,,12510.06,95,,percent of total billed charges,,,10929.84,83,,percent of total billed charges,,,10929.84,83,,percent of total billed charges,,,,,,,,,,,,,,,10929.84,83,,percent of total billed charges,,,12510.06,95,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,10798.15,82,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,11193.21,85,,percent of total billed charges,,9929.03,12510.06,
S&N WEDGE TIBIAL FINNED 10MM SZ4 LT,30187097,CDM,,,278,RC,inpatient,,17271.8,17271.8,,14663.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13022.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14681.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15199.18,88,,percent of total billed charges,,,,,,,,,13195.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15717.34,91,,percent of total billed charges,,,16408.21,95,,percent of total billed charges,,,14335.59,83,,percent of total billed charges,,,14335.59,83,,percent of total billed charges,,,,,,,,,,,,,,,14335.59,83,,percent of total billed charges,,,16408.21,95,,percent of total billed charges,,,15544.62,90,,percent of total billed charges,,,15544.62,90,,percent of total billed charges,,,14162.88,82,,percent of total billed charges,,,15544.62,90,,percent of total billed charges,,,14681.03,85,,percent of total billed charges,,13022.94,16408.21,
S&N STEM PRESSFIT 12 X 160MM,30187098,CDM,,,278,RC,inpatient,,13193.51,13193.51,,11201.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9947.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11214.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11610.29,88,,percent of total billed charges,,,,,,,,,10079.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12006.09,91,,percent of total billed charges,,,12533.83,95,,percent of total billed charges,,,10950.61,83,,percent of total billed charges,,,10950.61,83,,percent of total billed charges,,,,,,,,,,,,,,,10950.61,83,,percent of total billed charges,,,12533.83,95,,percent of total billed charges,,,11874.16,90,,percent of total billed charges,,,11874.16,90,,percent of total billed charges,,,10818.68,82,,percent of total billed charges,,,11874.16,90,,percent of total billed charges,,,11214.48,85,,percent of total billed charges,,9947.91,12533.83,
DEPUY-MITEK HEALIX PERMATAPE 5.5,30187100,CDM,,,278,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
DEPUY-MITEK HEALIX KNOTLESS 6.5,30187102,CDM,,,278,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
VASCULAR CLOSURE DEVICE 6F/7F,30187103,CDM,,,270,RC,inpatient,,1397.5,1397.5,,1186.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1053.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1187.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1229.8,88,,percent of total billed charges,,,,,,,,,1067.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1271.73,91,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1159.93,83,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1145.95,82,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,1053.72,1327.63,
ZIMMER PATELLA REAMER BLADE SZ 46,30187105,CDM,,,278,RC,inpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3675.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4143.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,3675.75,4631.25,
ZIMMER FEMUR CR LEFT SZ 11,30187106,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
PORT POWER INJECTABLE XCELA 8FR,30187107,CDM,,,278,RC,inpatient,,2502.5,2502.5,,2124.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1886.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2127.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2202.2,88,,percent of total billed charges,,,,,,,,,1911.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2277.28,91,,percent of total billed charges,,,2377.38,95,,percent of total billed charges,,,2077.08,83,,percent of total billed charges,,,2077.08,83,,percent of total billed charges,,,,,,,,,,,,,,,2077.08,83,,percent of total billed charges,,,2377.38,95,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2052.05,82,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2127.13,85,,percent of total billed charges,,1886.89,2377.38,
ZIMMER FEMUR PSN CR SZ 10 RIGHT,30187108,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
ZIMMER REAMER BLADE PATELLA SZ 46,30187109,CDM,,,278,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
UNIFUSE WITH COOPER WIRE 5FR 90CM,30187110,CDM,,,270,RC,inpatient,,1813.5,1813.5,,1539.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1367.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1541.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1595.88,88,,percent of total billed charges,,,,,,,,,1385.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1650.29,91,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.21,83,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1487.07,82,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1541.48,85,,percent of total billed charges,,1367.38,1722.83,
SYNTHES SCREW CORTEX S-T 4.5X16MM,30187111,CDM,,,278,RC,inpatient,,277.28,277.28,,235.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,235.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.01,88,,percent of total billed charges,,,,,,,,,211.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.32,91,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,,,,,,,,,,,,,230.14,83,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,227.37,82,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,209.07,263.42,
SYNTHES SCREW CORTEX S-T 4.5X40MM,30187112,CDM,,,278,RC,inpatient,,277.28,277.28,,235.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,235.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.01,88,,percent of total billed charges,,,,,,,,,211.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.32,91,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,,,,,,,,,,,,,230.14,83,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,227.37,82,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,209.07,263.42,
UNIFUSE WITH COOPER WIRE 5FR 135CM,30187113,CDM,,,270,RC,inpatient,,1813.5,1813.5,,1539.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1367.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1541.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1595.88,88,,percent of total billed charges,,,,,,,,,1385.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1650.29,91,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.21,83,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1487.07,82,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1541.48,85,,percent of total billed charges,,1367.38,1722.83,
SYNTHES PLATE HUMERUS PERIARTIC 6H 3.5MM,30187114,CDM,,,278,RC,inpatient,,19583.2,19583.2,,16626.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14765.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16645.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17233.22,88,,percent of total billed charges,,,,,,,,,14961.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17820.71,91,,percent of total billed charges,,,18604.04,95,,percent of total billed charges,,,16254.06,83,,percent of total billed charges,,,16254.06,83,,percent of total billed charges,,,,,,,,,,,,,,,16254.06,83,,percent of total billed charges,,,18604.04,95,,percent of total billed charges,,,17624.88,90,,percent of total billed charges,,,17624.88,90,,percent of total billed charges,,,16058.22,82,,percent of total billed charges,,,17624.88,90,,percent of total billed charges,,,16645.72,85,,percent of total billed charges,,14765.73,18604.04,
IR CAGE PEEK 6DEG 12X14X8,30187115,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
IR PLATE 3 LEVEL,30187116,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
SYNTHES SCREW LOCKING ST 5.0 X 18MM,30187117,CDM,,,278,RC,inpatient,,1453.66,1453.66,,1234.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1096.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1235.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1279.22,88,,percent of total billed charges,,,,,,,,,1110.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1322.83,91,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1206.54,83,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1192,82,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1235.61,85,,percent of total billed charges,,1096.06,1380.98,
SYNTHES SCREW LOCKING ST 5.0 X 22MM,30187118,CDM,,,278,RC,inpatient,,1453.66,1453.66,,1234.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1096.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1235.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1279.22,88,,percent of total billed charges,,,,,,,,,1110.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1322.83,91,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1206.54,83,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1192,82,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1235.61,85,,percent of total billed charges,,1096.06,1380.98,
CATHETER ONE-STEP SUPRAPUBIC,30187119,CDM,,,270,RC,inpatient,,1614.67,1614.67,,1370.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1217.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1372.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1420.91,88,,percent of total billed charges,,,,,,,,,1233.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1469.35,91,,percent of total billed charges,,,1533.94,95,,percent of total billed charges,,,1340.18,83,,percent of total billed charges,,,1340.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1340.18,83,,percent of total billed charges,,,1533.94,95,,percent of total billed charges,,,1453.2,90,,percent of total billed charges,,,1453.2,90,,percent of total billed charges,,,1324.03,82,,percent of total billed charges,,,1453.2,90,,percent of total billed charges,,,1372.47,85,,percent of total billed charges,,1217.46,1533.94,
ZIMMER INSERT POLY RIGHT MC SZ 11,30187120,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ZIMMER PATELLA VE SZ 32MM,30187121,CDM,,,278,RC,inpatient,,3575,3575,,3035.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2695.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3038.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3146,88,,percent of total billed charges,,,,,,,,,2731.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3253.25,91,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2967.25,83,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,2931.5,82,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,2695.55,3396.25,
ZIMMER BEARING MC 16MM,30187122,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
S&N FEMUR NARROW OX RT PS SZ 5,30187123,CDM,,,278,RC,inpatient,,26000,26000,,22074,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19604,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22100,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22880,88,,percent of total billed charges,,,,,,,,,19864,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23660,91,,percent of total billed charges,,,24700,95,,percent of total billed charges,,,21580,83,,percent of total billed charges,,,21580,83,,percent of total billed charges,,,,,,,,,,,,,,,21580,83,,percent of total billed charges,,,24700,95,,percent of total billed charges,,,23400,90,,percent of total billed charges,,,23400,90,,percent of total billed charges,,,21320,82,,percent of total billed charges,,,23400,90,,percent of total billed charges,,,22100,85,,percent of total billed charges,,19604,24700,
S&N PLATE TIBIA BASE GENISIS II SZ 4 RT,30187124,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
S&N PATELLA 32MM,30187125,CDM,,,278,RC,inpatient,,6584.24,6584.24,,5590.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4964.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5596.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5794.13,88,,percent of total billed charges,,,,,,,,,5030.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5991.66,91,,percent of total billed charges,,,6255.03,95,,percent of total billed charges,,,5464.92,83,,percent of total billed charges,,,5464.92,83,,percent of total billed charges,,,,,,,,,,,,,,,5464.92,83,,percent of total billed charges,,,6255.03,95,,percent of total billed charges,,,5925.82,90,,percent of total billed charges,,,5925.82,90,,percent of total billed charges,,,5399.08,82,,percent of total billed charges,,,5925.82,90,,percent of total billed charges,,,5596.6,85,,percent of total billed charges,,4964.52,6255.03,
S&N INSERT CONSTRAINED 9MM SZ 3/4,30187126,CDM,,,278,RC,inpatient,,22072.83,22072.83,,18739.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16642.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18761.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19424.09,88,,percent of total billed charges,,,,,,,,,16863.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20086.28,91,,percent of total billed charges,,,20969.19,95,,percent of total billed charges,,,18320.45,83,,percent of total billed charges,,,18320.45,83,,percent of total billed charges,,,,,,,,,,,,,,,18320.45,83,,percent of total billed charges,,,20969.19,95,,percent of total billed charges,,,19865.55,90,,percent of total billed charges,,,19865.55,90,,percent of total billed charges,,,18099.72,82,,percent of total billed charges,,,19865.55,90,,percent of total billed charges,,,18761.91,85,,percent of total billed charges,,16642.91,20969.19,
IR CAGE PEEK 6DEG 1MM,30187127,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
IR PLATE 3 LEVEL 51MM,30187128,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
NANOCROSS BALLOON 2.0 X 150 X 150,30187130,CDM,,,270,RC,inpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1458.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1643.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,1458.05,1837.06,
IMPACT ADMIRAL BALLOON 4X40,30187131,CDM,,,270,RC,inpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7302.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8232.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,7302.49,9200.75,
EVERCROSS BALLOON 4MM X 40MM,30187132,CDM,,,270,RC,inpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7302.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8232.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,7302.49,9200.75,
IVAS VERTEPORT CEMENT CANNULA 11G,30187133,CDM,,,270,RC,inpatient,,510.02,510.02,,433.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,384.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,433.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,448.82,88,,percent of total billed charges,,,,,,,,,389.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,464.12,91,,percent of total billed charges,,,484.52,95,,percent of total billed charges,,,423.32,83,,percent of total billed charges,,,423.32,83,,percent of total billed charges,,,,,,,,,,,,,,,423.32,83,,percent of total billed charges,,,484.52,95,,percent of total billed charges,,,459.02,90,,percent of total billed charges,,,459.02,90,,percent of total billed charges,,,418.22,82,,percent of total billed charges,,,459.02,90,,percent of total billed charges,,,433.52,85,,percent of total billed charges,,384.56,484.52,
DEPUY HEAD GLOBAL UNITE 40X15ECC,30187134,CDM,,,278,RC,inpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13297.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14990.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,13297.64,16754.32,
DEPUY CEMENT 2G,30187135,CDM,,,278,RC,inpatient,,2262,2262,,1920.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1705.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1922.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1990.56,88,,percent of total billed charges,,,,,,,,,1728.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2058.42,91,,percent of total billed charges,,,2148.9,95,,percent of total billed charges,,,1877.46,83,,percent of total billed charges,,,1877.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1877.46,83,,percent of total billed charges,,,2148.9,95,,percent of total billed charges,,,2035.8,90,,percent of total billed charges,,,2035.8,90,,percent of total billed charges,,,1854.84,82,,percent of total billed charges,,,2035.8,90,,percent of total billed charges,,,1922.7,85,,percent of total billed charges,,1705.55,2148.9,
STRYKER BLADE MAKO NARROW,30187136,CDM,,,270,RC,inpatient,,1982.5,1982.5,,1683.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1494.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1685.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1744.6,88,,percent of total billed charges,,,,,,,,,1514.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1804.08,91,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1645.48,83,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1625.65,82,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,1494.81,1883.38,
STRYKER BLADE MAKO STANDARD,30187137,CDM,,,270,RC,inpatient,,1982.5,1982.5,,1683.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1494.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1685.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1744.6,88,,percent of total billed charges,,,,,,,,,1514.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1804.08,91,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1645.48,83,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1625.65,82,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,1494.81,1883.38,
STRYKER BLADE AGGRESSIVE XL 4.0,30187138,CDM,,,270,RC,inpatient,,641.62,641.62,,544.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,483.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,545.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,564.63,88,,percent of total billed charges,,,,,,,,,490.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,583.87,91,,percent of total billed charges,,,609.54,95,,percent of total billed charges,,,532.54,83,,percent of total billed charges,,,532.54,83,,percent of total billed charges,,,,,,,,,,,,,,,532.54,83,,percent of total billed charges,,,609.54,95,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,526.13,82,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,545.38,85,,percent of total billed charges,,483.78,609.54,
SYNTHES GUIDEWIRE 1.4MM X 150MM TROCAR,30187139,CDM,,,278,RC,inpatient,,827.05,827.05,,702.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,623.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,702.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,727.8,88,,percent of total billed charges,,,,,,,,,631.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,752.62,91,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,,,,,,,,,,,,,686.45,83,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,678.18,82,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,623.6,785.7,
SYNTHES GUIDEWIRE 1.1MM X 150MM TROCAR,30187140,CDM,,,278,RC,inpatient,,714,714,,606.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,538.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,606.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,628.32,88,,percent of total billed charges,,,,,,,,,545.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,649.74,91,,percent of total billed charges,,,678.3,95,,percent of total billed charges,,,592.62,83,,percent of total billed charges,,,592.62,83,,percent of total billed charges,,,,,,,,,,,,,,,592.62,83,,percent of total billed charges,,,678.3,95,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,585.48,82,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,606.9,85,,percent of total billed charges,,538.36,678.3,
SYNTHES DRILL BIT CANN. QC 2.7 X 145MM,30187141,CDM,,,270,RC,inpatient,,4558.13,4558.13,,3869.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3436.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3874.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4011.15,88,,percent of total billed charges,,,,,,,,,3482.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4147.9,91,,percent of total billed charges,,,4330.22,95,,percent of total billed charges,,,3783.25,83,,percent of total billed charges,,,3783.25,83,,percent of total billed charges,,,,,,,,,,,,,,,3783.25,83,,percent of total billed charges,,,4330.22,95,,percent of total billed charges,,,4102.32,90,,percent of total billed charges,,,4102.32,90,,percent of total billed charges,,,3737.67,82,,percent of total billed charges,,,4102.32,90,,percent of total billed charges,,,3874.41,85,,percent of total billed charges,,3436.83,4330.22,
SYNTHES DRILL BIT CANN. QC 2.0 X 145MM,30187142,CDM,,,270,RC,inpatient,,4309.5,4309.5,,3658.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3249.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3663.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3792.36,88,,percent of total billed charges,,,,,,,,,3292.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3921.65,91,,percent of total billed charges,,,4094.03,95,,percent of total billed charges,,,3576.89,83,,percent of total billed charges,,,3576.89,83,,percent of total billed charges,,,,,,,,,,,,,,,3576.89,83,,percent of total billed charges,,,4094.03,95,,percent of total billed charges,,,3878.55,90,,percent of total billed charges,,,3878.55,90,,percent of total billed charges,,,3533.79,82,,percent of total billed charges,,,3878.55,90,,percent of total billed charges,,,3663.08,85,,percent of total billed charges,,3249.36,4094.03,
SYNTHES SCREW CANN COMPRESSION ST 4X40MM,30187143,CDM,,,278,RC,inpatient,,4033.25,4033.25,,3424.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3041.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3428.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3549.26,88,,percent of total billed charges,,,,,,,,,3081.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3670.26,91,,percent of total billed charges,,,3831.59,95,,percent of total billed charges,,,3347.6,83,,percent of total billed charges,,,3347.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3347.6,83,,percent of total billed charges,,,3831.59,95,,percent of total billed charges,,,3629.93,90,,percent of total billed charges,,,3629.93,90,,percent of total billed charges,,,3307.27,82,,percent of total billed charges,,,3629.93,90,,percent of total billed charges,,,3428.26,85,,percent of total billed charges,,3041.07,3831.59,
SYNTHES SCREW CANN COMPRESSION ST 3X20MM,30187144,CDM,,,278,RC,inpatient,,4033.25,4033.25,,3424.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3041.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3428.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3549.26,88,,percent of total billed charges,,,,,,,,,3081.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3670.26,91,,percent of total billed charges,,,3831.59,95,,percent of total billed charges,,,3347.6,83,,percent of total billed charges,,,3347.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3347.6,83,,percent of total billed charges,,,3831.59,95,,percent of total billed charges,,,3629.93,90,,percent of total billed charges,,,3629.93,90,,percent of total billed charges,,,3307.27,82,,percent of total billed charges,,,3629.93,90,,percent of total billed charges,,,3428.26,85,,percent of total billed charges,,3041.07,3831.59,
STAPLER CUTTER 100MM BLUE,30187145,CDM,,,270,RC,inpatient,,1368.64,1368.64,,1161.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1031.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1163.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1204.4,88,,percent of total billed charges,,,,,,,,,1045.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1245.46,91,,percent of total billed charges,,,1300.21,95,,percent of total billed charges,,,1135.97,83,,percent of total billed charges,,,1135.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1135.97,83,,percent of total billed charges,,,1300.21,95,,percent of total billed charges,,,1231.78,90,,percent of total billed charges,,,1231.78,90,,percent of total billed charges,,,1122.28,82,,percent of total billed charges,,,1231.78,90,,percent of total billed charges,,,1163.34,85,,percent of total billed charges,,1031.95,1300.21,
STRYKER DRAPE KIT RIO ONE PIECE W/POCKET,30187146,CDM,,,270,RC,inpatient,,351,351,,298,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,264.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,298.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,308.88,88,,percent of total billed charges,,,,,,,,,268.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,319.41,91,,percent of total billed charges,,,333.45,95,,percent of total billed charges,,,291.33,83,,percent of total billed charges,,,291.33,83,,percent of total billed charges,,,,,,,,,,,,,,,291.33,83,,percent of total billed charges,,,333.45,95,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,287.82,82,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,298.35,85,,percent of total billed charges,,264.65,333.45,
STRYKER KNEE TRACKING KIT VIZADISC,30187147,CDM,,,270,RC,inpatient,,1368.9,1368.9,,1162.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1032.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1163.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1204.63,88,,percent of total billed charges,,,,,,,,,1045.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1245.7,91,,percent of total billed charges,,,1300.46,95,,percent of total billed charges,,,1136.19,83,,percent of total billed charges,,,1136.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1136.19,83,,percent of total billed charges,,,1300.46,95,,percent of total billed charges,,,1232.01,90,,percent of total billed charges,,,1232.01,90,,percent of total billed charges,,,1122.5,82,,percent of total billed charges,,,1232.01,90,,percent of total billed charges,,,1163.57,85,,percent of total billed charges,,1032.15,1300.46,
STRYKER HIP TRACKING KIT VIZADISC,30187148,CDM,,,270,RC,inpatient,,1368.9,1368.9,,1162.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1032.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1163.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1204.63,88,,percent of total billed charges,,,,,,,,,1045.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1245.7,91,,percent of total billed charges,,,1300.46,95,,percent of total billed charges,,,1136.19,83,,percent of total billed charges,,,1136.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1136.19,83,,percent of total billed charges,,,1300.46,95,,percent of total billed charges,,,1232.01,90,,percent of total billed charges,,,1232.01,90,,percent of total billed charges,,,1122.5,82,,percent of total billed charges,,,1232.01,90,,percent of total billed charges,,,1163.57,85,,percent of total billed charges,,1032.15,1300.46,
STRYKER BONE PIN 3.2 X 110MM,30187149,CDM,,,278,RC,inpatient,,873.6,873.6,,741.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,658.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,742.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,768.77,88,,percent of total billed charges,,,,,,,,,667.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,794.98,91,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,,,,,,,,,,,,,725.09,83,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,716.35,82,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,742.56,85,,percent of total billed charges,,658.69,829.92,
STRYKER BONE PIN 3.2 X 140MM,30187150,CDM,,,278,RC,inpatient,,873.6,873.6,,741.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,658.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,742.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,768.77,88,,percent of total billed charges,,,,,,,,,667.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,794.98,91,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,,,,,,,,,,,,,725.09,83,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,716.35,82,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,742.56,85,,percent of total billed charges,,658.69,829.92,
STRYKER BONE PIN 4 X 110MM,30187151,CDM,,,278,RC,inpatient,,873.6,873.6,,741.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,658.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,742.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,768.77,88,,percent of total billed charges,,,,,,,,,667.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,794.98,91,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,,,,,,,,,,,,,725.09,83,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,716.35,82,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,742.56,85,,percent of total billed charges,,658.69,829.92,
STRYKER BONE PIN 4 X 140MM,30187152,CDM,,,278,RC,inpatient,,873.6,873.6,,741.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,658.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,742.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,768.77,88,,percent of total billed charges,,,,,,,,,667.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,794.98,91,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,,,,,,,,,,,,,725.09,83,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,716.35,82,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,742.56,85,,percent of total billed charges,,658.69,829.92,
STRYKER BONE PIN 4 X 170MM,30187153,CDM,,,278,RC,inpatient,,873.6,873.6,,741.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,658.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,742.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,768.77,88,,percent of total billed charges,,,,,,,,,667.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,794.98,91,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,,,,,,,,,,,,,725.09,83,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,716.35,82,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,742.56,85,,percent of total billed charges,,658.69,829.92,
STRYKER CHECKPOINT KIT FEMORAL/TIBIAL,30187154,CDM,,,270,RC,inpatient,,651,651,,552.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,490.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,553.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,572.88,88,,percent of total billed charges,,,,,,,,,497.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,592.41,91,,percent of total billed charges,,,618.45,95,,percent of total billed charges,,,540.33,83,,percent of total billed charges,,,540.33,83,,percent of total billed charges,,,,,,,,,,,,,,,540.33,83,,percent of total billed charges,,,618.45,95,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,533.82,82,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,553.35,85,,percent of total billed charges,,490.85,618.45,
STRYKER CHECKPOINT TIBIAL STERILE,30187155,CDM,,,270,RC,inpatient,,369,369,,313.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,313.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,324.72,88,,percent of total billed charges,,,,,,,,,281.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,335.79,91,,percent of total billed charges,,,350.55,95,,percent of total billed charges,,,306.27,83,,percent of total billed charges,,,306.27,83,,percent of total billed charges,,,,,,,,,,,,,,,306.27,83,,percent of total billed charges,,,350.55,95,,percent of total billed charges,,,332.1,90,,percent of total billed charges,,,332.1,90,,percent of total billed charges,,,302.58,82,,percent of total billed charges,,,332.1,90,,percent of total billed charges,,,313.65,85,,percent of total billed charges,,278.23,350.55,
STRYKER CHECKPOINT FEMORAL STERILE,30187156,CDM,,,270,RC,inpatient,,369,369,,313.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,313.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,324.72,88,,percent of total billed charges,,,,,,,,,281.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,335.79,91,,percent of total billed charges,,,350.55,95,,percent of total billed charges,,,306.27,83,,percent of total billed charges,,,306.27,83,,percent of total billed charges,,,,,,,,,,,,,,,306.27,83,,percent of total billed charges,,,350.55,95,,percent of total billed charges,,,332.1,90,,percent of total billed charges,,,332.1,90,,percent of total billed charges,,,302.58,82,,percent of total billed charges,,,332.1,90,,percent of total billed charges,,,313.65,85,,percent of total billed charges,,278.23,350.55,
STRYKER LEG POSITIONER KIT,30187157,CDM,,,270,RC,inpatient,,270,270,,229.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,203.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,229.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,237.6,88,,percent of total billed charges,,,,,,,,,206.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,245.7,91,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,,,,,,,,,,,,,224.1,83,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,243,90,,percent of total billed charges,,,243,90,,percent of total billed charges,,,221.4,82,,percent of total billed charges,,,243,90,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,203.58,256.5,
STRYKER RETRACTOR CORD SILICONE,30187158,CDM,,,270,RC,inpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,38.45,48.45,
STRYKER CHECKPOINT HEX 3.5MM IMPACTION,30187159,CDM,,,278,RC,inpatient,,756,756,,641.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,570.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,642.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,665.28,88,,percent of total billed charges,,,,,,,,,577.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,687.96,91,,percent of total billed charges,,,718.2,95,,percent of total billed charges,,,627.48,83,,percent of total billed charges,,,627.48,83,,percent of total billed charges,,,,,,,,,,,,,,,627.48,83,,percent of total billed charges,,,718.2,95,,percent of total billed charges,,,680.4,90,,percent of total billed charges,,,680.4,90,,percent of total billed charges,,,619.92,82,,percent of total billed charges,,,680.4,90,,percent of total billed charges,,,642.6,85,,percent of total billed charges,,570.02,718.2,
STRYKER MICS MALL BURR,30187160,CDM,,,278,RC,inpatient,,499.8,499.8,,424.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,376.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,424.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,439.82,88,,percent of total billed charges,,,,,,,,,381.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,454.82,91,,percent of total billed charges,,,474.81,95,,percent of total billed charges,,,414.83,83,,percent of total billed charges,,,414.83,83,,percent of total billed charges,,,,,,,,,,,,,,,414.83,83,,percent of total billed charges,,,474.81,95,,percent of total billed charges,,,449.82,90,,percent of total billed charges,,,449.82,90,,percent of total billed charges,,,409.84,82,,percent of total billed charges,,,449.82,90,,percent of total billed charges,,,424.83,85,,percent of total billed charges,,376.85,474.81,
STRYKER MICS IRRIGATION CLIP,30187161,CDM,,,278,RC,inpatient,,777,777,,659.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,585.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,660.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,683.76,88,,percent of total billed charges,,,,,,,,,593.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,707.07,91,,percent of total billed charges,,,738.15,95,,percent of total billed charges,,,644.91,83,,percent of total billed charges,,,644.91,83,,percent of total billed charges,,,,,,,,,,,,,,,644.91,83,,percent of total billed charges,,,738.15,95,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,637.14,82,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,660.45,85,,percent of total billed charges,,585.86,738.15,
STRYKER IRRIGATION TUBING,30187162,CDM,,,278,RC,inpatient,,777,777,,659.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,585.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,660.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,683.76,88,,percent of total billed charges,,,,,,,,,593.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,707.07,91,,percent of total billed charges,,,738.15,95,,percent of total billed charges,,,644.91,83,,percent of total billed charges,,,644.91,83,,percent of total billed charges,,,,,,,,,,,,,,,644.91,83,,percent of total billed charges,,,738.15,95,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,637.14,82,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,660.45,85,,percent of total billed charges,,585.86,738.15,
SPINECRAFT SCREW REDUCTION 6.5 X 50 POLY,30187163,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
DEPUY METAGLENE LONG PEG +10MM,30187164,CDM,,,278,RC,inpatient,,19707.03,19707.03,,16731.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14859.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16750.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17342.19,88,,percent of total billed charges,,,,,,,,,15056.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17933.4,91,,percent of total billed charges,,,18721.68,95,,percent of total billed charges,,,16356.83,83,,percent of total billed charges,,,16356.83,83,,percent of total billed charges,,,,,,,,,,,,,,,16356.83,83,,percent of total billed charges,,,18721.68,95,,percent of total billed charges,,,17736.33,90,,percent of total billed charges,,,17736.33,90,,percent of total billed charges,,,16159.76,82,,percent of total billed charges,,,17736.33,90,,percent of total billed charges,,,16750.98,85,,percent of total billed charges,,14859.1,18721.68,
DEPUY STEM STD UNITE SZ 12,30187165,CDM,,,278,RC,inpatient,,26023.86,26023.86,,22094.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19621.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22120.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22901,88,,percent of total billed charges,,,,,,,,,19882.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23681.71,91,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21599.8,83,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,21339.57,82,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,19621.99,24722.67,
DEPUY HEAD HUMERAL ECCENTRIC 44 X 18,30187166,CDM,,,278,RC,inpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13297.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14990.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,13297.64,16754.32,
STRYKER BLADE SAGITTAL DUAL CUTTING,30187167,CDM,,,270,RC,inpatient,,432.39,432.39,,367.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,326.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,367.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,380.5,88,,percent of total billed charges,,,,,,,,,330.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,393.47,91,,percent of total billed charges,,,410.77,95,,percent of total billed charges,,,358.88,83,,percent of total billed charges,,,358.88,83,,percent of total billed charges,,,,,,,,,,,,,,,358.88,83,,percent of total billed charges,,,410.77,95,,percent of total billed charges,,,389.15,90,,percent of total billed charges,,,389.15,90,,percent of total billed charges,,,354.56,82,,percent of total billed charges,,,389.15,90,,percent of total billed charges,,,367.53,85,,percent of total billed charges,,326.02,410.77,
STRYKER BLADE SAGITTAL PERFORMANCE,30187168,CDM,,,270,RC,inpatient,,432.39,432.39,,367.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,326.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,367.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,380.5,88,,percent of total billed charges,,,,,,,,,330.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,393.47,91,,percent of total billed charges,,,410.77,95,,percent of total billed charges,,,358.88,83,,percent of total billed charges,,,358.88,83,,percent of total billed charges,,,,,,,,,,,,,,,358.88,83,,percent of total billed charges,,,410.77,95,,percent of total billed charges,,,389.15,90,,percent of total billed charges,,,389.15,90,,percent of total billed charges,,,354.56,82,,percent of total billed charges,,,389.15,90,,percent of total billed charges,,,367.53,85,,percent of total billed charges,,326.02,410.77,
STRYKER BLADE SAGITTAL WIDE THICK,30187169,CDM,,,270,RC,inpatient,,292.73,292.73,,248.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,220.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,248.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,257.6,88,,percent of total billed charges,,,,,,,,,223.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,266.38,91,,percent of total billed charges,,,278.09,95,,percent of total billed charges,,,242.97,83,,percent of total billed charges,,,242.97,83,,percent of total billed charges,,,,,,,,,,,,,,,242.97,83,,percent of total billed charges,,,278.09,95,,percent of total billed charges,,,263.46,90,,percent of total billed charges,,,263.46,90,,percent of total billed charges,,,240.04,82,,percent of total billed charges,,,263.46,90,,percent of total billed charges,,,248.82,85,,percent of total billed charges,,220.72,278.09,
ZIMMER STEM SLOTTED POROUS 14X200,30187170,CDM,,,278,RC,inpatient,,44460,44460,,37746.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33522.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37791,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39124.8,88,,percent of total billed charges,,,,,,,,,33967.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40458.6,91,,percent of total billed charges,,,42237,95,,percent of total billed charges,,,36901.8,83,,percent of total billed charges,,,36901.8,83,,percent of total billed charges,,,,,,,,,,,,,,,36901.8,83,,percent of total billed charges,,,42237,95,,percent of total billed charges,,,40014,90,,percent of total billed charges,,,40014,90,,percent of total billed charges,,,36457.2,82,,percent of total billed charges,,,40014,90,,percent of total billed charges,,,37791,85,,percent of total billed charges,,33522.84,42237,
ZIMMER TAPER SLEEVE +0,30187171,CDM,,,270,RC,inpatient,,2860,2860,,2428.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2156.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2431,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2516.8,88,,percent of total billed charges,,,,,,,,,2185.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2602.6,91,,percent of total billed charges,,,2717,95,,percent of total billed charges,,,2373.8,83,,percent of total billed charges,,,2373.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2373.8,83,,percent of total billed charges,,,2717,95,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2345.2,82,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2431,85,,percent of total billed charges,,2156.44,2717,
ZIMMER BODY ARCOS SZ D STD 60MM,30187172,CDM,,,278,RC,inpatient,,81510,81510,,69201.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61458.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,69283.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71728.8,88,,percent of total billed charges,,,,,,,,,62273.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,74174.1,91,,percent of total billed charges,,,77434.5,95,,percent of total billed charges,,,67653.3,83,,percent of total billed charges,,,67653.3,83,,percent of total billed charges,,,,,,,,,,,,,,,67653.3,83,,percent of total billed charges,,,77434.5,95,,percent of total billed charges,,,73359,90,,percent of total billed charges,,,73359,90,,percent of total billed charges,,,66838.2,82,,percent of total billed charges,,,73359,90,,percent of total billed charges,,,69283.5,85,,percent of total billed charges,,61458.54,77434.5,
ZIMMER GUIDE WIRE BALL NOSE 100CM,30187173,CDM,,,270,RC,inpatient,,858,858,,728.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,646.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,729.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,755.04,88,,percent of total billed charges,,,,,,,,,655.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,780.78,91,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,,,,,,,,,,,,,712.14,83,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,703.56,82,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,646.93,815.1,
ZIMMER BEARING VIVACIT-E 28X38MM,30187174,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
IMPACT ADMIRAL BALLOON 6X40X130,30187176,CDM,,,270,RC,inpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7302.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8232.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,7302.49,9200.75,
MEDTRONIC SPIDER 6MM,30187177,CDM,,,270,RC,inpatient,,10090.08,10090.08,,8566.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7607.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8576.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8879.27,88,,percent of total billed charges,,,,,,,,,7708.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9181.97,91,,percent of total billed charges,,,9585.58,95,,percent of total billed charges,,,8374.77,83,,percent of total billed charges,,,8374.77,83,,percent of total billed charges,,,,,,,,,,,,,,,8374.77,83,,percent of total billed charges,,,9585.58,95,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,8273.87,82,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,8576.57,85,,percent of total billed charges,,7607.92,9585.58,
IR PLATE 2 LEVEL 28MM,30187178,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
IR PLATE 3 LEVEL 48MM,30187179,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
KURZ BLADES STERILE,30187180,CDM,,,270,RC,inpatient,,124.8,124.8,,105.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,94.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,106.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.82,88,,percent of total billed charges,,,,,,,,,95.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,113.57,91,,percent of total billed charges,,,118.56,95,,percent of total billed charges,,,103.58,83,,percent of total billed charges,,,103.58,83,,percent of total billed charges,,,,,,,,,,,,,,,103.58,83,,percent of total billed charges,,,118.56,95,,percent of total billed charges,,,112.32,90,,percent of total billed charges,,,112.32,90,,percent of total billed charges,,,102.34,82,,percent of total billed charges,,,112.32,90,,percent of total billed charges,,,106.08,85,,percent of total billed charges,,94.1,118.56,
TUBE VENT MICRON BOBBIN TITANIUM MINI,30187181,CDM,,,270,RC,inpatient,,285.83,285.83,,242.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,215.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,242.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,251.53,88,,percent of total billed charges,,,,,,,,,218.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,260.11,91,,percent of total billed charges,,,271.54,95,,percent of total billed charges,,,237.24,83,,percent of total billed charges,,,237.24,83,,percent of total billed charges,,,,,,,,,,,,,,,237.24,83,,percent of total billed charges,,,271.54,95,,percent of total billed charges,,,257.25,90,,percent of total billed charges,,,257.25,90,,percent of total billed charges,,,234.38,82,,percent of total billed charges,,,257.25,90,,percent of total billed charges,,,242.96,85,,percent of total billed charges,,215.52,271.54,
INTERSTIM PERC. EXTENSION KIT RE-CHARGEA,30187182,CDM,,,270,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
INTERSTIM EXTERNAL TEMP. STIMULATOR,30187183,CDM,,,270,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
INTERSTIM LEAD WIRE MRI RE-CHARGEABLE KI,30187184,CDM,,,270,RC,inpatient,,29601,29601,,25131.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22319.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25160.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26048.88,88,,percent of total billed charges,,,,,,,,,22615.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26936.91,91,,percent of total billed charges,,,28120.95,95,,percent of total billed charges,,,24568.83,83,,percent of total billed charges,,,24568.83,83,,percent of total billed charges,,,,,,,,,,,,,,,24568.83,83,,percent of total billed charges,,,28120.95,95,,percent of total billed charges,,,26640.9,90,,percent of total billed charges,,,26640.9,90,,percent of total billed charges,,,24272.82,82,,percent of total billed charges,,,26640.9,90,,percent of total billed charges,,,25160.85,85,,percent of total billed charges,,22319.15,28120.95,
UNIFUSE WITH COOPER WIRE 5FR 90CM X 15CM,30187185,CDM,,,270,RC,inpatient,,1813.5,1813.5,,1539.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1367.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1541.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1595.88,88,,percent of total billed charges,,,,,,,,,1385.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1650.29,91,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.21,83,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1487.07,82,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1541.48,85,,percent of total billed charges,,1367.38,1722.83,
SHEETING STERILE SILICONE 2X3,30187188,CDM,,,270,RC,inpatient,,823.97,823.97,,699.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.09,88,,percent of total billed charges,,,,,,,,,629.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,749.81,91,,percent of total billed charges,,,782.77,95,,percent of total billed charges,,,683.9,83,,percent of total billed charges,,,683.9,83,,percent of total billed charges,,,,,,,,,,,,,,,683.9,83,,percent of total billed charges,,,782.77,95,,percent of total billed charges,,,741.57,90,,percent of total billed charges,,,741.57,90,,percent of total billed charges,,,675.66,82,,percent of total billed charges,,,741.57,90,,percent of total billed charges,,,700.37,85,,percent of total billed charges,,621.27,782.77,
MEDTRONIC TUBING IRRIGATION DRILL ACCESS,30187191,CDM,,,270,RC,inpatient,,273.75,273.75,,232.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,206.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,232.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,240.9,88,,percent of total billed charges,,,,,,,,,209.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,249.11,91,,percent of total billed charges,,,260.06,95,,percent of total billed charges,,,227.21,83,,percent of total billed charges,,,227.21,83,,percent of total billed charges,,,,,,,,,,,,,,,227.21,83,,percent of total billed charges,,,260.06,95,,percent of total billed charges,,,246.38,90,,percent of total billed charges,,,246.38,90,,percent of total billed charges,,,224.48,82,,percent of total billed charges,,,246.38,90,,percent of total billed charges,,,232.69,85,,percent of total billed charges,,206.41,260.06,
MEDTRONIC NERVE STIMULATOR VARI-STEM III,30187192,CDM,,,270,RC,inpatient,,541.1,541.1,,459.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,407.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,459.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,476.17,88,,percent of total billed charges,,,,,,,,,413.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,492.4,91,,percent of total billed charges,,,514.05,95,,percent of total billed charges,,,449.11,83,,percent of total billed charges,,,449.11,83,,percent of total billed charges,,,,,,,,,,,,,,,449.11,83,,percent of total billed charges,,,514.05,95,,percent of total billed charges,,,486.99,90,,percent of total billed charges,,,486.99,90,,percent of total billed charges,,,443.7,82,,percent of total billed charges,,,486.99,90,,percent of total billed charges,,,459.94,85,,percent of total billed charges,,407.99,514.05,
DRESSING KIT GLASSCOCK ADULT,30187195,CDM,,,270,RC,inpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,93.5,117.8,
DRESSING KIT GLASSCOCK PEDS,30187196,CDM,,,270,RC,inpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,93.5,117.8,
FACE WRAP UNIVERSAL,30187197,CDM,,,270,RC,inpatient,,168.8,168.8,,143.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,127.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,143.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,148.54,88,,percent of total billed charges,,,,,,,,,128.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,153.61,91,,percent of total billed charges,,,160.36,95,,percent of total billed charges,,,140.1,83,,percent of total billed charges,,,140.1,83,,percent of total billed charges,,,,,,,,,,,,,,,140.1,83,,percent of total billed charges,,,160.36,95,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,138.42,82,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,143.48,85,,percent of total billed charges,,127.28,160.36,
CROUCH CORNEAL PROTECTOR,30187198,CDM,,,270,RC,inpatient,,169.36,169.36,,143.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,127.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,143.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,149.04,88,,percent of total billed charges,,,,,,,,,129.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,154.12,91,,percent of total billed charges,,,160.89,95,,percent of total billed charges,,,140.57,83,,percent of total billed charges,,,140.57,83,,percent of total billed charges,,,,,,,,,,,,,,,140.57,83,,percent of total billed charges,,,160.89,95,,percent of total billed charges,,,152.42,90,,percent of total billed charges,,,152.42,90,,percent of total billed charges,,,138.88,82,,percent of total billed charges,,,152.42,90,,percent of total billed charges,,,143.96,85,,percent of total billed charges,,127.7,160.89,
NEEDLE BEAVER BLADE W/ 3MM CUTTING,30187200,CDM,,,270,RC,inpatient,,126.37,126.37,,107.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,111.21,88,,percent of total billed charges,,,,,,,,,96.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,115,91,,percent of total billed charges,,,120.05,95,,percent of total billed charges,,,104.89,83,,percent of total billed charges,,,104.89,83,,percent of total billed charges,,,,,,,,,,,,,,,104.89,83,,percent of total billed charges,,,120.05,95,,percent of total billed charges,,,113.73,90,,percent of total billed charges,,,113.73,90,,percent of total billed charges,,,103.62,82,,percent of total billed charges,,,113.73,90,,percent of total billed charges,,,107.41,85,,percent of total billed charges,,95.28,120.05,
SPONGE NEURO STERILE 1/4 X 1/4  PATTIES,30187201,CDM,,,270,RC,inpatient,,126.88,126.88,,107.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,111.65,88,,percent of total billed charges,,,,,,,,,96.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,115.46,91,,percent of total billed charges,,,120.54,95,,percent of total billed charges,,,105.31,83,,percent of total billed charges,,,105.31,83,,percent of total billed charges,,,,,,,,,,,,,,,105.31,83,,percent of total billed charges,,,120.54,95,,percent of total billed charges,,,114.19,90,,percent of total billed charges,,,114.19,90,,percent of total billed charges,,,104.04,82,,percent of total billed charges,,,114.19,90,,percent of total billed charges,,,107.85,85,,percent of total billed charges,,95.67,120.54,
NONSTERILE RETRACTOR ADULT,30187203,CDM,,,270,RC,inpatient,,118.92,118.92,,100.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,89.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,101.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,104.65,88,,percent of total billed charges,,,,,,,,,90.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,108.22,91,,percent of total billed charges,,,112.97,95,,percent of total billed charges,,,98.7,83,,percent of total billed charges,,,98.7,83,,percent of total billed charges,,,,,,,,,,,,,,,98.7,83,,percent of total billed charges,,,112.97,95,,percent of total billed charges,,,107.03,90,,percent of total billed charges,,,107.03,90,,percent of total billed charges,,,97.51,82,,percent of total billed charges,,,107.03,90,,percent of total billed charges,,,101.08,85,,percent of total billed charges,,89.67,112.97,
MEDTRONIC NASAL SEPTAL BUTTON 2-PART,30187204,CDM,,,270,RC,inpatient,,1956.5,1956.5,,1661.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1475.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1663.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1721.72,88,,percent of total billed charges,,,,,,,,,1494.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1780.42,91,,percent of total billed charges,,,1858.68,95,,percent of total billed charges,,,1623.9,83,,percent of total billed charges,,,1623.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1623.9,83,,percent of total billed charges,,,1858.68,95,,percent of total billed charges,,,1760.85,90,,percent of total billed charges,,,1760.85,90,,percent of total billed charges,,,1604.33,82,,percent of total billed charges,,,1760.85,90,,percent of total billed charges,,,1663.03,85,,percent of total billed charges,,1475.2,1858.68,
ACCLARENT AERA EUSTACHIAN TUBE BALLOON D,30187206,CDM,,,270,RC,inpatient,,11758.5,11758.5,,9982.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8865.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9994.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10347.48,88,,percent of total billed charges,,,,,,,,,8983.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10700.24,91,,percent of total billed charges,,,11170.58,95,,percent of total billed charges,,,9759.56,83,,percent of total billed charges,,,9759.56,83,,percent of total billed charges,,,,,,,,,,,,,,,9759.56,83,,percent of total billed charges,,,11170.58,95,,percent of total billed charges,,,10582.65,90,,percent of total billed charges,,,10582.65,90,,percent of total billed charges,,,9641.97,82,,percent of total billed charges,,,10582.65,90,,percent of total billed charges,,,9994.73,85,,percent of total billed charges,,8865.91,11170.58,
RELIEVA SPINPLUS,30187207,CDM,,,270,RC,inpatient,,12675,12675,,10761.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9556.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10773.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11154,88,,percent of total billed charges,,,,,,,,,9683.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11534.25,91,,percent of total billed charges,,,12041.25,95,,percent of total billed charges,,,10520.25,83,,percent of total billed charges,,,10520.25,83,,percent of total billed charges,,,,,,,,,,,,,,,10520.25,83,,percent of total billed charges,,,12041.25,95,,percent of total billed charges,,,11407.5,90,,percent of total billed charges,,,11407.5,90,,percent of total billed charges,,,10393.5,82,,percent of total billed charges,,,11407.5,90,,percent of total billed charges,,,10773.75,85,,percent of total billed charges,,9556.95,12041.25,
ACCLARENT INFLATION DEVICE,30187208,CDM,,,270,RC,inpatient,,521.85,521.85,,443.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,393.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,443.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,459.23,88,,percent of total billed charges,,,,,,,,,398.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,474.88,91,,percent of total billed charges,,,495.76,95,,percent of total billed charges,,,433.14,83,,percent of total billed charges,,,433.14,83,,percent of total billed charges,,,,,,,,,,,,,,,433.14,83,,percent of total billed charges,,,495.76,95,,percent of total billed charges,,,469.67,90,,percent of total billed charges,,,469.67,90,,percent of total billed charges,,,427.92,82,,percent of total billed charges,,,469.67,90,,percent of total billed charges,,,443.57,85,,percent of total billed charges,,393.47,495.76,
LEVINE IRRIGATION SUCTION,30187209,CDM,,,270,RC,inpatient,,308.7,308.7,,262.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,232.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,262.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,271.66,88,,percent of total billed charges,,,,,,,,,235.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,280.92,91,,percent of total billed charges,,,293.27,95,,percent of total billed charges,,,256.22,83,,percent of total billed charges,,,256.22,83,,percent of total billed charges,,,,,,,,,,,,,,,256.22,83,,percent of total billed charges,,,293.27,95,,percent of total billed charges,,,277.83,90,,percent of total billed charges,,,277.83,90,,percent of total billed charges,,,253.13,82,,percent of total billed charges,,,277.83,90,,percent of total billed charges,,,262.4,85,,percent of total billed charges,,232.76,293.27,
VENT TUBE 1.14MM BOBBIN,30187210,CDM,,,270,RC,inpatient,,60.78,60.78,,51.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,45.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,51.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,53.49,88,,percent of total billed charges,,,,,,,,,46.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55.31,91,,percent of total billed charges,,,57.74,95,,percent of total billed charges,,,50.45,83,,percent of total billed charges,,,50.45,83,,percent of total billed charges,,,,,,,,,,,,,,,50.45,83,,percent of total billed charges,,,57.74,95,,percent of total billed charges,,,54.7,90,,percent of total billed charges,,,54.7,90,,percent of total billed charges,,,49.84,82,,percent of total billed charges,,,54.7,90,,percent of total billed charges,,,51.66,85,,percent of total billed charges,,45.83,57.74,
BURSHIELD DIAMOND 2.3MM X 95MM,30187211,CDM,,,270,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
BURSHIELD DIAMOND 2.3MM X 80MM ROUN,30187212,CDM,,,270,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
BURSHIELD DIAMOND 1.8MM X 95MM,30187213,CDM,,,270,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
NASAL PACKING 3.5CM MAROCEL KENNEDY,30187214,CDM,,,270,RC,inpatient,,297.75,297.75,,252.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,224.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,253.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,262.02,88,,percent of total billed charges,,,,,,,,,227.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,270.95,91,,percent of total billed charges,,,282.86,95,,percent of total billed charges,,,247.13,83,,percent of total billed charges,,,247.13,83,,percent of total billed charges,,,,,,,,,,,,,,,247.13,83,,percent of total billed charges,,,282.86,95,,percent of total billed charges,,,267.98,90,,percent of total billed charges,,,267.98,90,,percent of total billed charges,,,244.16,82,,percent of total billed charges,,,267.98,90,,percent of total billed charges,,,253.09,85,,percent of total billed charges,,224.5,282.86,
BLADE ROTATABLE TURBINATE INFERIOR 2MM M,30187215,CDM,,,270,RC,inpatient,,1939.6,1939.6,,1646.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1462.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1648.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1706.85,88,,percent of total billed charges,,,,,,,,,1481.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1765.04,91,,percent of total billed charges,,,1842.62,95,,percent of total billed charges,,,1609.87,83,,percent of total billed charges,,,1609.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1609.87,83,,percent of total billed charges,,,1842.62,95,,percent of total billed charges,,,1745.64,90,,percent of total billed charges,,,1745.64,90,,percent of total billed charges,,,1590.47,82,,percent of total billed charges,,,1745.64,90,,percent of total billed charges,,,1648.66,85,,percent of total billed charges,,1462.46,1842.62,
BUR DIAMOND 4.0MM LONG ROUND FINE,30187216,CDM,,,270,RC,inpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1372.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1547,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,1372.28,1729,
BUR ULTRA 5MM LONG,30187217,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
BUR ULTRA 4MM LONG,30187218,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
BUR ULTRA 3MM LONG,30187219,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
BUR DIAMOND 3MM LONG ROUND FINE,30187220,CDM,,,270,RC,inpatient,,1384.5,1384.5,,1175.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1043.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1176.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1218.36,88,,percent of total billed charges,,,,,,,,,1057.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1259.9,91,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1149.14,83,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1135.29,82,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1176.83,85,,percent of total billed charges,,1043.91,1315.28,
BUR DIAMOND 2MM LONG ROUND FINE,30187221,CDM,,,270,RC,inpatient,,1384.5,1384.5,,1175.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1043.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1176.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1218.36,88,,percent of total billed charges,,,,,,,,,1057.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1259.9,91,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1149.14,83,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1135.29,82,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1176.83,85,,percent of total billed charges,,1043.91,1315.28,
S&N ACL ELITE RENTAL,30187222,CDM,,,270,RC,inpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3675.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4143.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,3675.75,4631.25,
S&N ENDOBUTTON CL PAC,30187223,CDM,,,270,RC,inpatient,,2383.1,2383.1,,2023.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1796.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2025.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2097.13,88,,percent of total billed charges,,,,,,,,,1820.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2168.62,91,,percent of total billed charges,,,2263.95,95,,percent of total billed charges,,,1977.97,83,,percent of total billed charges,,,1977.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1977.97,83,,percent of total billed charges,,,2263.95,95,,percent of total billed charges,,,2144.79,90,,percent of total billed charges,,,2144.79,90,,percent of total billed charges,,,1954.14,82,,percent of total billed charges,,,2144.79,90,,percent of total billed charges,,,2025.64,85,,percent of total billed charges,,1796.86,2263.95,
ROD COBALT CHROME 450MM,30187224,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
SPINECRAFT CROSS CONNECTOR 39-50,30187225,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
SPINECRAFT CROSS CONNECTOR 50-75,30187226,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
SPINECRAFT SCREW SET,30187227,CDM,,,278,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
EXACTECH DRILL BIT KIT,30187228,CDM,,,270,RC,inpatient,,4732,4732,,4017.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3567.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4022.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4164.16,88,,percent of total billed charges,,,,,,,,,3615.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4306.12,91,,percent of total billed charges,,,4495.4,95,,percent of total billed charges,,,3927.56,83,,percent of total billed charges,,,3927.56,83,,percent of total billed charges,,,,,,,,,,,,,,,3927.56,83,,percent of total billed charges,,,4495.4,95,,percent of total billed charges,,,4258.8,90,,percent of total billed charges,,,4258.8,90,,percent of total billed charges,,,3880.24,82,,percent of total billed charges,,,4258.8,90,,percent of total billed charges,,,4022.2,85,,percent of total billed charges,,3567.93,4495.4,
EXACTECH SCREW KIT TORQUE DEFINING,30187229,CDM,,,270,RC,inpatient,,4335.5,4335.5,,3680.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3268.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3685.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3815.24,88,,percent of total billed charges,,,,,,,,,3312.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3945.31,91,,percent of total billed charges,,,4118.73,95,,percent of total billed charges,,,3598.47,83,,percent of total billed charges,,,3598.47,83,,percent of total billed charges,,,,,,,,,,,,,,,3598.47,83,,percent of total billed charges,,,4118.73,95,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3555.11,82,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3685.18,85,,percent of total billed charges,,3268.97,4118.73,
EXACTECH K-WIRE,30187230,CDM,,,278,RC,inpatient,,851.5,851.5,,722.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,642.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,723.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,749.32,88,,percent of total billed charges,,,,,,,,,650.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,774.87,91,,percent of total billed charges,,,808.93,95,,percent of total billed charges,,,706.75,83,,percent of total billed charges,,,706.75,83,,percent of total billed charges,,,,,,,,,,,,,,,706.75,83,,percent of total billed charges,,,808.93,95,,percent of total billed charges,,,766.35,90,,percent of total billed charges,,,766.35,90,,percent of total billed charges,,,698.23,82,,percent of total billed charges,,,766.35,90,,percent of total billed charges,,,723.78,85,,percent of total billed charges,,642.03,808.93,
EXACTECH PLATE BASE GLENOID STANDARD,30187231,CDM,,,278,RC,inpatient,,25707.5,25707.5,,21825.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19383.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21851.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22622.6,88,,percent of total billed charges,,,,,,,,,19640.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23393.83,91,,percent of total billed charges,,,24422.13,95,,percent of total billed charges,,,21337.23,83,,percent of total billed charges,,,21337.23,83,,percent of total billed charges,,,,,,,,,,,,,,,21337.23,83,,percent of total billed charges,,,24422.13,95,,percent of total billed charges,,,23136.75,90,,percent of total billed charges,,,23136.75,90,,percent of total billed charges,,,21080.15,82,,percent of total billed charges,,,23136.75,90,,percent of total billed charges,,,21851.38,85,,percent of total billed charges,,19383.46,24422.13,
EXACTECH SCREW LOCKING GLENOSPHERE,30187232,CDM,,,278,RC,inpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1514.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1707.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,1514.41,1908.08,
EXACTECH SCREW LOCKING YELLOW,30187233,CDM,,,278,RC,inpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1514.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1707.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,1514.41,1908.08,
EXACTECH SCREW LOCKING BLACK,30187234,CDM,,,278,RC,inpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1514.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1707.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,1514.41,1908.08,
EXACTECH SCREW LOCKING BLUE,30187235,CDM,,,278,RC,inpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1514.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1707.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,1514.41,1908.08,
EXACTECH STEM PRESERVE 7MM,30187236,CDM,,,278,RC,inpatient,,45461,45461,,38596.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34277.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38641.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40005.68,88,,percent of total billed charges,,,,,,,,,34732.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41369.51,91,,percent of total billed charges,,,43187.95,95,,percent of total billed charges,,,37732.63,83,,percent of total billed charges,,,37732.63,83,,percent of total billed charges,,,,,,,,,,,,,,,37732.63,83,,percent of total billed charges,,,43187.95,95,,percent of total billed charges,,,40914.9,90,,percent of total billed charges,,,40914.9,90,,percent of total billed charges,,,37278.02,82,,percent of total billed charges,,,40914.9,90,,percent of total billed charges,,,38641.85,85,,percent of total billed charges,,34277.59,43187.95,
EXACTECH ADAPTER TRAY +0MM,30187237,CDM,,,278,RC,inpatient,,30160,30160,,25605.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22740.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25636,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26540.8,88,,percent of total billed charges,,,,,,,,,23042.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27445.6,91,,percent of total billed charges,,,28652,95,,percent of total billed charges,,,25032.8,83,,percent of total billed charges,,,25032.8,83,,percent of total billed charges,,,,,,,,,,,,,,,25032.8,83,,percent of total billed charges,,,28652,95,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,24731.2,82,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,25636,85,,percent of total billed charges,,22740.64,28652,
EXACTECH GLENOSPHERE 42MM,30187238,CDM,,,278,RC,inpatient,,24102,24102,,20462.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18172.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20486.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21209.76,88,,percent of total billed charges,,,,,,,,,18413.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21932.82,91,,percent of total billed charges,,,22896.9,95,,percent of total billed charges,,,20004.66,83,,percent of total billed charges,,,20004.66,83,,percent of total billed charges,,,,,,,,,,,,,,,20004.66,83,,percent of total billed charges,,,22896.9,95,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,19763.64,82,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,20486.7,85,,percent of total billed charges,,18172.91,22896.9,
EXACTECH HUMERAL LINER 42MM +0,30187239,CDM,,,278,RC,inpatient,,13487.5,13487.5,,11450.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10169.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11464.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11869,88,,percent of total billed charges,,,,,,,,,10304.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12273.63,91,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,,,,,,,,,,,,,11194.63,83,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11059.75,82,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,10169.58,12813.13,
HOLMIUM LASER FEE - MIDWEST STONE,30187240,CDM,,,270,RC,inpatient,,5037.5,5037.5,,4276.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3798.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4281.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4433,88,,percent of total billed charges,,,,,,,,,3848.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4584.13,91,,percent of total billed charges,,,4785.63,95,,percent of total billed charges,,,4181.13,83,,percent of total billed charges,,,4181.13,83,,percent of total billed charges,,,,,,,,,,,,,,,4181.13,83,,percent of total billed charges,,,4785.63,95,,percent of total billed charges,,,4533.75,90,,percent of total billed charges,,,4533.75,90,,percent of total billed charges,,,4130.75,82,,percent of total billed charges,,,4533.75,90,,percent of total billed charges,,,4281.88,85,,percent of total billed charges,,3798.28,4785.63,
LITHOTRIPSY FEE - MIDWEST STONE,30187241,CDM,,,270,RC,inpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11762.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13260,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,11762.4,14820,
GLIDEWIRE ANGLED 260CM,30187242,CDM,,,270,RC,inpatient,,808.5,808.5,,686.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,609.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,687.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,711.48,88,,percent of total billed charges,,,,,,,,,617.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,735.74,91,,percent of total billed charges,,,768.08,95,,percent of total billed charges,,,671.06,83,,percent of total billed charges,,,671.06,83,,percent of total billed charges,,,,,,,,,,,,,,,671.06,83,,percent of total billed charges,,,768.08,95,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,662.97,82,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,687.23,85,,percent of total billed charges,,609.61,768.08,
BENTSON WIRE 180CM,30187243,CDM,,,270,RC,inpatient,,129.68,129.68,,110.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,97.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,110.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,114.12,88,,percent of total billed charges,,,,,,,,,99.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,118.01,91,,percent of total billed charges,,,123.2,95,,percent of total billed charges,,,107.63,83,,percent of total billed charges,,,107.63,83,,percent of total billed charges,,,,,,,,,,,,,,,107.63,83,,percent of total billed charges,,,123.2,95,,percent of total billed charges,,,116.71,90,,percent of total billed charges,,,116.71,90,,percent of total billed charges,,,106.34,82,,percent of total billed charges,,,116.71,90,,percent of total billed charges,,,110.23,85,,percent of total billed charges,,97.78,123.2,
IMPACT ADMIRAL BALLOON 5X40X130,30187244,CDM,,,270,RC,inpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7302.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8232.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,7302.49,9200.75,
IR PLATE 2 LEVEL 30MM,30187245,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
HANDSWITCH DISP. 8FR 3M,30187246,CDM,,,270,RC,inpatient,,168.56,168.56,,143.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,127.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,143.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,148.33,88,,percent of total billed charges,,,,,,,,,128.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,153.39,91,,percent of total billed charges,,,160.13,95,,percent of total billed charges,,,139.9,83,,percent of total billed charges,,,139.9,83,,percent of total billed charges,,,,,,,,,,,,,,,139.9,83,,percent of total billed charges,,,160.13,95,,percent of total billed charges,,,151.7,90,,percent of total billed charges,,,151.7,90,,percent of total billed charges,,,138.22,82,,percent of total billed charges,,,151.7,90,,percent of total billed charges,,,143.28,85,,percent of total billed charges,,127.09,160.13,
INTERSTIM WIRELESS STIMULATOR,30187247,CDM,,,278,RC,inpatient,,75920,75920,,64456.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,57243.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,64532,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66809.6,88,,percent of total billed charges,,,,,,,,,58002.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,69087.2,91,,percent of total billed charges,,,72124,95,,percent of total billed charges,,,63013.6,83,,percent of total billed charges,,,63013.6,83,,percent of total billed charges,,,,,,,,,,,,,,,63013.6,83,,percent of total billed charges,,,72124,95,,percent of total billed charges,,,68328,90,,percent of total billed charges,,,68328,90,,percent of total billed charges,,,62254.4,82,,percent of total billed charges,,,68328,90,,percent of total billed charges,,,64532,85,,percent of total billed charges,,57243.68,72124,
INTERSTIM PATIENT PROGRAMMER & COMMUNICA,30187248,CDM,,,270,RC,inpatient,,12675,12675,,10761.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9556.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10773.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11154,88,,percent of total billed charges,,,,,,,,,9683.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11534.25,91,,percent of total billed charges,,,12041.25,95,,percent of total billed charges,,,10520.25,83,,percent of total billed charges,,,10520.25,83,,percent of total billed charges,,,,,,,,,,,,,,,10520.25,83,,percent of total billed charges,,,12041.25,95,,percent of total billed charges,,,11407.5,90,,percent of total billed charges,,,11407.5,90,,percent of total billed charges,,,10393.5,82,,percent of total billed charges,,,11407.5,90,,percent of total billed charges,,,10773.75,85,,percent of total billed charges,,9556.95,12041.25,
INTERSTIM WIRELESS RE-CHARGER KIT,30187249,CDM,,,270,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
INTERSTIM WIRELESS RE-CHARGER BELT,30187250,CDM,,,270,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
INTERSTIM ANTIBIOTIC POUCH,30187251,CDM,,,270,RC,inpatient,,6467.5,6467.5,,5490.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4876.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5497.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5691.4,88,,percent of total billed charges,,,,,,,,,4941.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5885.43,91,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,,,,,,,,,,,,,5368.03,83,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5303.35,82,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,4876.5,6144.13,
SYNTHES PLATE 3 HOLE SHORT 54MM 2.4VA LC,30187252,CDM,,,278,RC,inpatient,,9419.41,9419.41,,7997.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7102.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8006.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8289.08,88,,percent of total billed charges,,,,,,,,,7196.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8571.66,91,,percent of total billed charges,,,8948.44,95,,percent of total billed charges,,,7818.11,83,,percent of total billed charges,,,7818.11,83,,percent of total billed charges,,,,,,,,,,,,,,,7818.11,83,,percent of total billed charges,,,8948.44,95,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,7723.92,82,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,8006.5,85,,percent of total billed charges,,7102.24,8948.44,
ZIMMER BLADE PATELLA REAMER SZ 35,30187254,CDM,,,278,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
SYNTHES SCREW LOCKING VA 2.4 X 16MM,30187255,CDM,,,278,RC,inpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1020.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1150.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,1020.93,1286.32,
PROTRACK FIXATION DEVICE 5MM,30187256,CDM,,,270,RC,inpatient,,4400.31,4400.31,,3735.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3317.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3740.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3872.27,88,,percent of total billed charges,,,,,,,,,3361.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4004.28,91,,percent of total billed charges,,,4180.29,95,,percent of total billed charges,,,3652.26,83,,percent of total billed charges,,,3652.26,83,,percent of total billed charges,,,,,,,,,,,,,,,3652.26,83,,percent of total billed charges,,,4180.29,95,,percent of total billed charges,,,3960.28,90,,percent of total billed charges,,,3960.28,90,,percent of total billed charges,,,3608.25,82,,percent of total billed charges,,,3960.28,90,,percent of total billed charges,,,3740.26,85,,percent of total billed charges,,3317.83,4180.29,
SECURESTRAP FIXATION DEVICE 5MM ABSORBAB,30187257,CDM,,,270,RC,inpatient,,4572.95,4572.95,,3882.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3448,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3887.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4024.2,88,,percent of total billed charges,,,,,,,,,3493.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4161.38,91,,percent of total billed charges,,,4344.3,95,,percent of total billed charges,,,3795.55,83,,percent of total billed charges,,,3795.55,83,,percent of total billed charges,,,,,,,,,,,,,,,3795.55,83,,percent of total billed charges,,,4344.3,95,,percent of total billed charges,,,4115.66,90,,percent of total billed charges,,,4115.66,90,,percent of total billed charges,,,3749.82,82,,percent of total billed charges,,,4115.66,90,,percent of total billed charges,,,3887.01,85,,percent of total billed charges,,3448,4344.3,
SECURESTRAP FIXATION DEVICE OPEN,30187258,CDM,,,270,RC,inpatient,,5103.87,5103.87,,4333.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3848.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4338.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4491.41,88,,percent of total billed charges,,,,,,,,,3899.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4644.52,91,,percent of total billed charges,,,4848.68,95,,percent of total billed charges,,,4236.21,83,,percent of total billed charges,,,4236.21,83,,percent of total billed charges,,,,,,,,,,,,,,,4236.21,83,,percent of total billed charges,,,4848.68,95,,percent of total billed charges,,,4593.48,90,,percent of total billed charges,,,4593.48,90,,percent of total billed charges,,,4185.17,82,,percent of total billed charges,,,4593.48,90,,percent of total billed charges,,,4338.29,85,,percent of total billed charges,,3848.32,4848.68,
MESH PROLENE W/KEYHOLD 2 X 12,30187259,CDM,,,278,RC,inpatient,,1082.38,1082.38,,918.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,816.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,920.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,952.49,88,,percent of total billed charges,,,,,,,,,826.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,984.97,91,,percent of total billed charges,,,1028.26,95,,percent of total billed charges,,,898.38,83,,percent of total billed charges,,,898.38,83,,percent of total billed charges,,,,,,,,,,,,,,,898.38,83,,percent of total billed charges,,,1028.26,95,,percent of total billed charges,,,974.14,90,,percent of total billed charges,,,974.14,90,,percent of total billed charges,,,887.55,82,,percent of total billed charges,,,974.14,90,,percent of total billed charges,,,920.02,85,,percent of total billed charges,,816.11,1028.26,
MESH ARTISYN Y-SHAPED,30187260,CDM,,,278,RC,inpatient,,6355.51,6355.51,,5395.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4792.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5402.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5592.85,88,,percent of total billed charges,,,,,,,,,4855.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5783.51,91,,percent of total billed charges,,,6037.73,95,,percent of total billed charges,,,5275.07,83,,percent of total billed charges,,,5275.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5275.07,83,,percent of total billed charges,,,6037.73,95,,percent of total billed charges,,,5719.96,90,,percent of total billed charges,,,5719.96,90,,percent of total billed charges,,,5211.52,82,,percent of total billed charges,,,5719.96,90,,percent of total billed charges,,,5402.18,85,,percent of total billed charges,,4792.05,6037.73,
DEPUY EPI IMPLANT SZ 1 LEFT,30187261,CDM,,,278,RC,inpatient,,40066,40066,,34016.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30209.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34056.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35258.08,88,,percent of total billed charges,,,,,,,,,30610.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36460.06,91,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,,,,,,,,,,,,,33254.78,83,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,32854.12,82,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,34056.1,85,,percent of total billed charges,,30209.76,38062.7,
DEPUY EPI IMPLANT SZ 1 RIGHT 145DEG,30187263,CDM,,,278,RC,inpatient,,40066,40066,,34016.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30209.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34056.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35258.08,88,,percent of total billed charges,,,,,,,,,30610.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36460.06,91,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,,,,,,,,,,,,,33254.78,83,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,32854.12,82,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,34056.1,85,,percent of total billed charges,,30209.76,38062.7,
STENT BILIARY EV3 PROTEGE GPS  SELF-EXPA,30187265,CDM,,,278,RC,inpatient,,8639.61,8639.61,,7335.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6514.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7343.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7602.86,88,,percent of total billed charges,,,,,,,,,6600.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7862.05,91,,percent of total billed charges,,,8207.63,95,,percent of total billed charges,,,7170.88,83,,percent of total billed charges,,,7170.88,83,,percent of total billed charges,,,,,,,,,,,,,,,7170.88,83,,percent of total billed charges,,,8207.63,95,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7084.48,82,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7343.67,85,,percent of total billed charges,,6514.27,8207.63,
STENT ABRE VENOUS SELF-EXPANDING SYSTEM,30187266,CDM,,,278,RC,inpatient,,13650,13650,,11588.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10292.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11602.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12012,88,,percent of total billed charges,,,,,,,,,10428.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12421.5,91,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,,,,,,,,,,,,,11329.5,83,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11193,82,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,10292.1,12967.5,
EVERCROSS BALLOON 9MM X 40MM X 80MM,30187267,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
AVAFLEX BALLOON KIT 11G 15MM,30187268,CDM,,,270,RC,inpatient,,16740.75,16740.75,,14212.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12622.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14229.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14731.86,88,,percent of total billed charges,,,,,,,,,12789.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15234.08,91,,percent of total billed charges,,,15903.71,95,,percent of total billed charges,,,13894.82,83,,percent of total billed charges,,,13894.82,83,,percent of total billed charges,,,,,,,,,,,,,,,13894.82,83,,percent of total billed charges,,,15903.71,95,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,13727.42,82,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,14229.64,85,,percent of total billed charges,,12622.53,15903.71,
ZIMMER FEMUR POROUS NARROW CCR SZ 8 LEFT,30187269,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
ZIMMER PATELLA CEMENTED 38MM,30187270,CDM,,,278,RC,inpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1715.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1933.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,1715.35,2161.25,
ZIMMER SCP KIT 11G X 120MM,30187271,CDM,,,270,RC,inpatient,,29835,29835,,25329.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22495.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25359.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26254.8,88,,percent of total billed charges,,,,,,,,,22793.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27149.85,91,,percent of total billed charges,,,28343.25,95,,percent of total billed charges,,,24763.05,83,,percent of total billed charges,,,24763.05,83,,percent of total billed charges,,,,,,,,,,,,,,,24763.05,83,,percent of total billed charges,,,28343.25,95,,percent of total billed charges,,,26851.5,90,,percent of total billed charges,,,26851.5,90,,percent of total billed charges,,,24464.7,82,,percent of total billed charges,,,26851.5,90,,percent of total billed charges,,,25359.75,85,,percent of total billed charges,,22495.59,28343.25,
SYNTHES GUIDE WIRE SPADE POINT 2.5 X 230,30187272,CDM,,,278,RC,inpatient,,536.55,536.55,,455.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,404.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,456.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,472.16,88,,percent of total billed charges,,,,,,,,,409.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,488.26,91,,percent of total billed charges,,,509.72,95,,percent of total billed charges,,,445.34,83,,percent of total billed charges,,,445.34,83,,percent of total billed charges,,,,,,,,,,,,,,,445.34,83,,percent of total billed charges,,,509.72,95,,percent of total billed charges,,,482.9,90,,percent of total billed charges,,,482.9,90,,percent of total billed charges,,,439.97,82,,percent of total billed charges,,,482.9,90,,percent of total billed charges,,,456.07,85,,percent of total billed charges,,404.56,509.72,
SYNTHES SCREW LAG DHS/DCS 12.7 X 95MM,30187273,CDM,,,278,RC,inpatient,,3974.1,3974.1,,3374.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2996.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3377.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3497.21,88,,percent of total billed charges,,,,,,,,,3036.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3616.43,91,,percent of total billed charges,,,3775.4,95,,percent of total billed charges,,,3298.5,83,,percent of total billed charges,,,3298.5,83,,percent of total billed charges,,,,,,,,,,,,,,,3298.5,83,,percent of total billed charges,,,3775.4,95,,percent of total billed charges,,,3576.69,90,,percent of total billed charges,,,3576.69,90,,percent of total billed charges,,,3258.76,82,,percent of total billed charges,,,3576.69,90,,percent of total billed charges,,,3377.99,85,,percent of total billed charges,,2996.47,3775.4,
SYNTHES PLATE STD CARREL 8 HOLE 135DEG,30187274,CDM,,,278,RC,inpatient,,8540.16,8540.16,,7250.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6439.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7259.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7515.34,88,,percent of total billed charges,,,,,,,,,6524.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7771.55,91,,percent of total billed charges,,,8113.15,95,,percent of total billed charges,,,7088.33,83,,percent of total billed charges,,,7088.33,83,,percent of total billed charges,,,,,,,,,,,,,,,7088.33,83,,percent of total billed charges,,,8113.15,95,,percent of total billed charges,,,7686.14,90,,percent of total billed charges,,,7686.14,90,,percent of total billed charges,,,7002.93,82,,percent of total billed charges,,,7686.14,90,,percent of total billed charges,,,7259.14,85,,percent of total billed charges,,6439.28,8113.15,
SYNTHES PIN POSITIONING CERCLAGE 4.5MM,30187275,CDM,,,278,RC,inpatient,,1846.39,1846.39,,1567.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1392.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1569.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1624.82,88,,percent of total billed charges,,,,,,,,,1410.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1680.21,91,,percent of total billed charges,,,1754.07,95,,percent of total billed charges,,,1532.5,83,,percent of total billed charges,,,1532.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1532.5,83,,percent of total billed charges,,,1754.07,95,,percent of total billed charges,,,1661.75,90,,percent of total billed charges,,,1661.75,90,,percent of total billed charges,,,1514.04,82,,percent of total billed charges,,,1661.75,90,,percent of total billed charges,,,1569.43,85,,percent of total billed charges,,1392.18,1754.07,
SYNTHES PLATE DISTAL RADIUS 2.4NN LCP,30187276,CDM,,,278,RC,inpatient,,4507.49,4507.49,,3826.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3398.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3831.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3966.59,88,,percent of total billed charges,,,,,,,,,3443.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4101.82,91,,percent of total billed charges,,,4282.12,95,,percent of total billed charges,,,3741.22,83,,percent of total billed charges,,,3741.22,83,,percent of total billed charges,,,,,,,,,,,,,,,3741.22,83,,percent of total billed charges,,,4282.12,95,,percent of total billed charges,,,4056.74,90,,percent of total billed charges,,,4056.74,90,,percent of total billed charges,,,3696.14,82,,percent of total billed charges,,,4056.74,90,,percent of total billed charges,,,3831.37,85,,percent of total billed charges,,3398.65,4282.12,
ZIMMER BEARING VIVACIT-E 28X40MM,30187277,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
DEPUY BODY GLBL UNITE ANT 142 SZ 12,30187278,CDM,,,278,RC,inpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9541.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10756.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,9541.61,12021.93,
DEPUY BODY GLBL UNITE ANT 135 SZ 12,30187279,CDM,,,278,RC,inpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9541.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10756.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,9541.61,12021.93,
DEPUY HEAD ECC GLOBAL UNITE 48X18,30187280,CDM,,,278,RC,inpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13297.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14990.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,13297.64,16754.32,
MINI STICK ENVI TRIAXIAL NON-VASCULAR IN,30187281,CDM,,,270,RC,inpatient,,894.4,894.4,,759.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,674.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,760.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,787.07,88,,percent of total billed charges,,,,,,,,,683.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,813.9,91,,percent of total billed charges,,,849.68,95,,percent of total billed charges,,,742.35,83,,percent of total billed charges,,,742.35,83,,percent of total billed charges,,,,,,,,,,,,,,,742.35,83,,percent of total billed charges,,,849.68,95,,percent of total billed charges,,,804.96,90,,percent of total billed charges,,,804.96,90,,percent of total billed charges,,,733.41,82,,percent of total billed charges,,,804.96,90,,percent of total billed charges,,,760.24,85,,percent of total billed charges,,674.38,849.68,
BIOMET NAIL HUMERAL VERSANAIL 8X240MM,30187282,CDM,,,278,RC,inpatient,,9613.5,9613.5,,8161.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7248.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8171.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8459.88,88,,percent of total billed charges,,,,,,,,,7344.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8748.29,91,,percent of total billed charges,,,9132.83,95,,percent of total billed charges,,,7979.21,83,,percent of total billed charges,,,7979.21,83,,percent of total billed charges,,,,,,,,,,,,,,,7979.21,83,,percent of total billed charges,,,9132.83,95,,percent of total billed charges,,,8652.15,90,,percent of total billed charges,,,8652.15,90,,percent of total billed charges,,,7883.07,82,,percent of total billed charges,,,8652.15,90,,percent of total billed charges,,,8171.48,85,,percent of total billed charges,,7248.58,9132.83,
ZIMMER FEMUR CEMENTED CR DZ 8 RIGHT,30187283,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
SYNTHES PLATE 3 HOLE LEFT 54MM 2.4VA LC,30187284,CDM,,,278,RC,inpatient,,9419.41,9419.41,,7997.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7102.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8006.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8289.08,88,,percent of total billed charges,,,,,,,,,7196.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8571.66,91,,percent of total billed charges,,,8948.44,95,,percent of total billed charges,,,7818.11,83,,percent of total billed charges,,,7818.11,83,,percent of total billed charges,,,,,,,,,,,,,,,7818.11,83,,percent of total billed charges,,,8948.44,95,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,7723.92,82,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,8006.5,85,,percent of total billed charges,,7102.24,8948.44,
SPINECRAFT ROD TITANIUM 6.0 X450,30187285,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
SPINECRAFT LATERAL CONNECTOR 25MM,30187286,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
NUVASIVE CERVICAL CAGE TI 6X15X12MM 7DEG,30187287,CDM,,,278,RC,inpatient,,52487.5,52487.5,,44561.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39575.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44614.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46189,88,,percent of total billed charges,,,,,,,,,40100.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47763.63,91,,percent of total billed charges,,,49863.13,95,,percent of total billed charges,,,43564.63,83,,percent of total billed charges,,,43564.63,83,,percent of total billed charges,,,,,,,,,,,,,,,43564.63,83,,percent of total billed charges,,,49863.13,95,,percent of total billed charges,,,47238.75,90,,percent of total billed charges,,,47238.75,90,,percent of total billed charges,,,43039.75,82,,percent of total billed charges,,,47238.75,90,,percent of total billed charges,,,44614.38,85,,percent of total billed charges,,39575.58,49863.13,
NUVASIVE PLATE HELIX  22MM,30187288,CDM,,,278,RC,inpatient,,10588.5,10588.5,,8989.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7983.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9000.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9317.88,88,,percent of total billed charges,,,,,,,,,8089.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9635.54,91,,percent of total billed charges,,,10059.08,95,,percent of total billed charges,,,8788.46,83,,percent of total billed charges,,,8788.46,83,,percent of total billed charges,,,,,,,,,,,,,,,8788.46,83,,percent of total billed charges,,,10059.08,95,,percent of total billed charges,,,9529.65,90,,percent of total billed charges,,,9529.65,90,,percent of total billed charges,,,8682.57,82,,percent of total billed charges,,,9529.65,90,,percent of total billed charges,,,9000.23,85,,percent of total billed charges,,7983.73,10059.08,
SPINECRAFT OPEN WASHER,30187289,CDM,,,278,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
DEPUY LINER PINNACLE DM 58/49,30187290,CDM,,,278,RC,inpatient,,20235.61,20235.61,,17180.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15257.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17200.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17807.34,88,,percent of total billed charges,,,,,,,,,15460.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18414.41,91,,percent of total billed charges,,,19223.83,95,,percent of total billed charges,,,16795.56,83,,percent of total billed charges,,,16795.56,83,,percent of total billed charges,,,,,,,,,,,,,,,16795.56,83,,percent of total billed charges,,,19223.83,95,,percent of total billed charges,,,18212.05,90,,percent of total billed charges,,,18212.05,90,,percent of total billed charges,,,16593.2,82,,percent of total billed charges,,,18212.05,90,,percent of total billed charges,,,17200.27,85,,percent of total billed charges,,15257.65,19223.83,
DEPUY FEMUR NEUTRAL STD LPS,30187291,CDM,,,278,RC,inpatient,,56410.06,56410.06,,47892.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42533.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47948.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49640.85,88,,percent of total billed charges,,,,,,,,,43097.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51333.15,91,,percent of total billed charges,,,53589.56,95,,percent of total billed charges,,,46820.35,83,,percent of total billed charges,,,46820.35,83,,percent of total billed charges,,,,,,,,,,,,,,,46820.35,83,,percent of total billed charges,,,53589.56,95,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,46256.25,82,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,47948.55,85,,percent of total billed charges,,42533.19,53589.56,
DEPUY SEGMENTAL COMPONENT 125MM,30187292,CDM,,,278,RC,inpatient,,18773.5,18773.5,,15938.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14155.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15957.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16520.68,88,,percent of total billed charges,,,,,,,,,14342.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17083.89,91,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,,,,,,,,,,,,,15582.01,83,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15394.27,82,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,14155.22,17834.83,
DEPUY STEM CEMENTED LPS 17X125MM,30187293,CDM,,,278,RC,inpatient,,42441.95,42441.95,,36033.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32001.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36075.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37348.92,88,,percent of total billed charges,,,,,,,,,32425.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38622.17,91,,percent of total billed charges,,,40319.85,95,,percent of total billed charges,,,35226.82,83,,percent of total billed charges,,,35226.82,83,,percent of total billed charges,,,,,,,,,,,,,,,35226.82,83,,percent of total billed charges,,,40319.85,95,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,34802.4,82,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,36075.66,85,,percent of total billed charges,,32001.23,40319.85,
DEPUY LINER PE MENTUM 28/49,30187294,CDM,,,278,RC,inpatient,,15818.92,15818.92,,13430.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11927.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13446.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13920.65,88,,percent of total billed charges,,,,,,,,,12085.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14395.22,91,,percent of total billed charges,,,15027.97,95,,percent of total billed charges,,,13129.7,83,,percent of total billed charges,,,13129.7,83,,percent of total billed charges,,,,,,,,,,,,,,,13129.7,83,,percent of total billed charges,,,15027.97,95,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,12971.51,82,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,13446.08,85,,percent of total billed charges,,11927.47,15027.97,
DEPUY SEGMENT COMPONENT LPS 65MM,30187295,CDM,,,278,RC,inpatient,,18773.5,18773.5,,15938.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14155.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15957.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16520.68,88,,percent of total billed charges,,,,,,,,,14342.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17083.89,91,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,,,,,,,,,,,,,15582.01,83,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15394.27,82,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,14155.22,17834.83,
DEPUY STEM CEMENTED LPS 13X125MM,30187296,CDM,,,278,RC,inpatient,,42441.95,42441.95,,36033.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32001.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36075.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37348.92,88,,percent of total billed charges,,,,,,,,,32425.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38622.17,91,,percent of total billed charges,,,40319.85,95,,percent of total billed charges,,,35226.82,83,,percent of total billed charges,,,35226.82,83,,percent of total billed charges,,,,,,,,,,,,,,,35226.82,83,,percent of total billed charges,,,40319.85,95,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,34802.4,82,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,36075.66,85,,percent of total billed charges,,32001.23,40319.85,
DEPUY ATTUNE INSERT REV. LPS XXSM 16MM,30187297,CDM,,,278,RC,inpatient,,39351.39,39351.39,,33409.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29670.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33448.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34629.22,88,,percent of total billed charges,,,,,,,,,30064.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35809.76,91,,percent of total billed charges,,,37383.82,95,,percent of total billed charges,,,32661.65,83,,percent of total billed charges,,,32661.65,83,,percent of total billed charges,,,,,,,,,,,,,,,32661.65,83,,percent of total billed charges,,,37383.82,95,,percent of total billed charges,,,35416.25,90,,percent of total billed charges,,,35416.25,90,,percent of total billed charges,,,32268.14,82,,percent of total billed charges,,,35416.25,90,,percent of total billed charges,,,33448.68,85,,percent of total billed charges,,29670.95,37383.82,
ZIMMER BEARING 1MM MC,30187298,CDM,,,270,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
SYNTHES SCREW CORTEX 1.5 X 12MM,30187299,CDM,,,278,RC,inpatient,,504.98,504.98,,428.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,380.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,429.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,444.38,88,,percent of total billed charges,,,,,,,,,385.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,459.53,91,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,,,,,,,,,,,,,419.13,83,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,414.08,82,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,380.75,479.73,
SYNTHES SCREW LOCKING 1.5 X 8MM,30187300,CDM,,,278,RC,inpatient,,1172.28,1172.28,,995.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,883.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,996.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1031.61,88,,percent of total billed charges,,,,,,,,,895.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1066.77,91,,percent of total billed charges,,,1113.67,95,,percent of total billed charges,,,972.99,83,,percent of total billed charges,,,972.99,83,,percent of total billed charges,,,,,,,,,,,,,,,972.99,83,,percent of total billed charges,,,1113.67,95,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,961.27,82,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,996.44,85,,percent of total billed charges,,883.9,1113.67,
DEPUY ATTUNE PATELLA MEDIAL 38MM,30187301,CDM,,,278,RC,inpatient,,9149.99,9149.99,,7768.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6899.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7777.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8051.99,88,,percent of total billed charges,,,,,,,,,6990.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8326.49,91,,percent of total billed charges,,,8692.49,95,,percent of total billed charges,,,7594.49,83,,percent of total billed charges,,,7594.49,83,,percent of total billed charges,,,,,,,,,,,,,,,7594.49,83,,percent of total billed charges,,,8692.49,95,,percent of total billed charges,,,8234.99,90,,percent of total billed charges,,,8234.99,90,,percent of total billed charges,,,7502.99,82,,percent of total billed charges,,,8234.99,90,,percent of total billed charges,,,7777.49,85,,percent of total billed charges,,6899.09,8692.49,
ZIMMER REAMER BLADE 51MM,30187302,CDM,,,278,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
DEPUY EPI 145 IMPLANT SZ 1,30187303,CDM,,,278,RC,inpatient,,40066,40066,,34016.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30209.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34056.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35258.08,88,,percent of total billed charges,,,,,,,,,30610.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36460.06,91,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,,,,,,,,,,,,,33254.78,83,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,32854.12,82,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,34056.1,85,,percent of total billed charges,,30209.76,38062.7,
DEPUY ATTUNE PRESSFIT STEM 22X110MM,30187304,CDM,,,278,RC,inpatient,,13175.11,13175.11,,11185.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9934.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11198.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11594.1,88,,percent of total billed charges,,,,,,,,,10065.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11989.35,91,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,,,,,,,,,,,,,10935.34,83,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,10803.59,82,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,9934.03,12516.35,
DEPUY REV. OFFSET ADAPTOR 2MM,30187305,CDM,,,278,RC,inpatient,,7038.46,7038.46,,5975.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5307,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5982.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6193.84,88,,percent of total billed charges,,,,,,,,,5377.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6405,91,,percent of total billed charges,,,6686.54,95,,percent of total billed charges,,,5841.92,83,,percent of total billed charges,,,5841.92,83,,percent of total billed charges,,,,,,,,,,,,,,,5841.92,83,,percent of total billed charges,,,6686.54,95,,percent of total billed charges,,,6334.61,90,,percent of total billed charges,,,6334.61,90,,percent of total billed charges,,,5771.54,82,,percent of total billed charges,,,6334.61,90,,percent of total billed charges,,,5982.69,85,,percent of total billed charges,,5307,6686.54,
DEPUY POST AUGMENT SZ 7 8MM,30187306,CDM,,,278,RC,inpatient,,9677.92,9677.92,,8216.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7297.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8226.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8516.57,88,,percent of total billed charges,,,,,,,,,7393.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8806.91,91,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,,,,,,,,,,,,,8032.67,83,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,7935.89,82,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,7297.15,9194.02,
DEPUY POST AUGMENT SZ 7 4MM,30187307,CDM,,,278,RC,inpatient,,9677.92,9677.92,,8216.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7297.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8226.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8516.57,88,,percent of total billed charges,,,,,,,,,7393.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8806.91,91,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,,,,,,,,,,,,,8032.67,83,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,7935.89,82,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,7297.15,9194.02,
DEPUY INSERT RP SZ 7 8MM,30187308,CDM,,,278,RC,inpatient,,23578.82,23578.82,,20018.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17778.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20042,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20749.36,88,,percent of total billed charges,,,,,,,,,18014.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21456.73,91,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,,,,,,,,,,,,,19570.42,83,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,19334.63,82,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,20042,85,,percent of total billed charges,,17778.43,22399.88,
SYNTHES PLATE NARROW LCP 12 HOLES 4.5MM,30187309,CDM,,,278,RC,inpatient,,6277.64,6277.64,,5329.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4733.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5335.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5524.32,88,,percent of total billed charges,,,,,,,,,4796.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5712.65,91,,percent of total billed charges,,,5963.76,95,,percent of total billed charges,,,5210.44,83,,percent of total billed charges,,,5210.44,83,,percent of total billed charges,,,,,,,,,,,,,,,5210.44,83,,percent of total billed charges,,,5963.76,95,,percent of total billed charges,,,5649.88,90,,percent of total billed charges,,,5649.88,90,,percent of total billed charges,,,5147.66,82,,percent of total billed charges,,,5649.88,90,,percent of total billed charges,,,5335.99,85,,percent of total billed charges,,4733.34,5963.76,
SYNTHES SCREW LOCKING 5.0X28MM,30187310,CDM,,,278,RC,inpatient,,1453.66,1453.66,,1234.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1096.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1235.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1279.22,88,,percent of total billed charges,,,,,,,,,1110.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1322.83,91,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1206.54,83,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1192,82,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1235.61,85,,percent of total billed charges,,1096.06,1380.98,
SYNTHES SCREW LOCKING 5.0X38MM,30187311,CDM,,,278,RC,inpatient,,1453.66,1453.66,,1234.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1096.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1235.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1279.22,88,,percent of total billed charges,,,,,,,,,1110.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1322.83,91,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1206.54,83,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1192,82,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1235.61,85,,percent of total billed charges,,1096.06,1380.98,
ZIMMER LINER G7 VE +5MM 40,30187312,CDM,,,278,RC,inpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7694.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8674.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,7694.57,9694.75,
SYNTHES SCREW LOCKING ST 2.4 X 12MM,30187313,CDM,,,278,RC,inpatient,,1166.43,1166.43,,990.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,879.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,991.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1026.46,88,,percent of total billed charges,,,,,,,,,891.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1061.45,91,,percent of total billed charges,,,1108.11,95,,percent of total billed charges,,,968.14,83,,percent of total billed charges,,,968.14,83,,percent of total billed charges,,,,,,,,,,,,,,,968.14,83,,percent of total billed charges,,,1108.11,95,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,956.47,82,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,991.47,85,,percent of total billed charges,,879.49,1108.11,
DEPUY STEM HUMERAL 10MM,30187314,CDM,,,278,RC,inpatient,,33123.22,33123.22,,28121.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24974.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28154.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29148.43,88,,percent of total billed charges,,,,,,,,,25306.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30142.13,91,,percent of total billed charges,,,31467.06,95,,percent of total billed charges,,,27492.27,83,,percent of total billed charges,,,27492.27,83,,percent of total billed charges,,,,,,,,,,,,,,,27492.27,83,,percent of total billed charges,,,31467.06,95,,percent of total billed charges,,,29810.9,90,,percent of total billed charges,,,29810.9,90,,percent of total billed charges,,,27161.04,82,,percent of total billed charges,,,29810.9,90,,percent of total billed charges,,,28154.74,85,,percent of total billed charges,,24974.91,31467.06,
SCISSOR LAPAROSCOPIC DISP. 5MM/35CM,30187315,CDM,,,270,RC,inpatient,,192,192,,163.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,163.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.96,88,,percent of total billed charges,,,,,,,,,146.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,,,,,,,,,,,,,159.36,83,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,157.44,82,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,144.77,182.4,
S&N GRAFIX PL PRIME 2X3CM,30187316,CDM,,,278,RC,inpatient,,6792.5,6792.5,,5766.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5121.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5773.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5977.4,88,,percent of total billed charges,,,,,,,,,5189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6181.18,91,,percent of total billed charges,,,6452.88,95,,percent of total billed charges,,,5637.78,83,,percent of total billed charges,,,5637.78,83,,percent of total billed charges,,,,,,,,,,,,,,,5637.78,83,,percent of total billed charges,,,6452.88,95,,percent of total billed charges,,,6113.25,90,,percent of total billed charges,,,6113.25,90,,percent of total billed charges,,,5569.85,82,,percent of total billed charges,,,6113.25,90,,percent of total billed charges,,,5773.63,85,,percent of total billed charges,,5121.55,6452.88,
ULRICH TAP NON-CANNULATED 5.5,30187317,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
ULRICH POLY 6.5 X 45MM,30187318,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH ROD 5.5 X 60MM,30187319,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ULRICH SCREW LOCKING SET,30187320,CDM,,,278,RC,inpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,527.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,595,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,527.8,665,
ULRICH POLY 6.5 X 40MM,30187321,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH ROD 5.5 X 70MM,30187322,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
MEDTRONIC HAWKONE,30187323,CDM,,,270,RC,inpatient,,24292.13,24292.13,,20624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18316.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20648.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21377.07,88,,percent of total billed charges,,,,,,,,,18559.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22105.84,91,,percent of total billed charges,,,23077.52,95,,percent of total billed charges,,,20162.47,83,,percent of total billed charges,,,20162.47,83,,percent of total billed charges,,,,,,,,,,,,,,,20162.47,83,,percent of total billed charges,,,23077.52,95,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,19919.55,82,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,20648.31,85,,percent of total billed charges,,18316.27,23077.52,
SYNTHES PLATE DISTAL RADIUS 6 HOLE RIGHT,30187324,CDM,,,278,RC,inpatient,,10357.23,10357.23,,8793.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7809.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8803.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9114.36,88,,percent of total billed charges,,,,,,,,,7912.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9425.08,91,,percent of total billed charges,,,9839.37,95,,percent of total billed charges,,,8596.5,83,,percent of total billed charges,,,8596.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8596.5,83,,percent of total billed charges,,,9839.37,95,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,8492.93,82,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,8803.65,85,,percent of total billed charges,,7809.35,9839.37,
SYNTHES SCREW LOCKING VA TI 2.4 X 16MM,30187325,CDM,,,278,RC,inpatient,,1494.68,1494.68,,1268.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1126.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1270.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1315.32,88,,percent of total billed charges,,,,,,,,,1141.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1360.16,91,,percent of total billed charges,,,1419.95,95,,percent of total billed charges,,,1240.58,83,,percent of total billed charges,,,1240.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1240.58,83,,percent of total billed charges,,,1419.95,95,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1225.64,82,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1270.48,85,,percent of total billed charges,,1126.99,1419.95,
SYNTHES SCREW CORTEX TI 2.4 X 12MM,30187326,CDM,,,278,RC,inpatient,,662.83,662.83,,562.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,499.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,563.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,583.29,88,,percent of total billed charges,,,,,,,,,506.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,603.18,91,,percent of total billed charges,,,629.69,95,,percent of total billed charges,,,550.15,83,,percent of total billed charges,,,550.15,83,,percent of total billed charges,,,,,,,,,,,,,,,550.15,83,,percent of total billed charges,,,629.69,95,,percent of total billed charges,,,596.55,90,,percent of total billed charges,,,596.55,90,,percent of total billed charges,,,543.52,82,,percent of total billed charges,,,596.55,90,,percent of total billed charges,,,563.41,85,,percent of total billed charges,,499.77,629.69,
SYNTHES SCREW CORTEX TI 2.4 X 22MM,30187327,CDM,,,278,RC,inpatient,,662.83,662.83,,562.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,499.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,563.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,583.29,88,,percent of total billed charges,,,,,,,,,506.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,603.18,91,,percent of total billed charges,,,629.69,95,,percent of total billed charges,,,550.15,83,,percent of total billed charges,,,550.15,83,,percent of total billed charges,,,,,,,,,,,,,,,550.15,83,,percent of total billed charges,,,629.69,95,,percent of total billed charges,,,596.55,90,,percent of total billed charges,,,596.55,90,,percent of total billed charges,,,543.52,82,,percent of total billed charges,,,596.55,90,,percent of total billed charges,,,563.41,85,,percent of total billed charges,,499.77,629.69,
ZIMMER PATELLA POLY VE 41MM,30187328,CDM,,,278,RC,inpatient,,3575,3575,,3035.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2695.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3038.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3146,88,,percent of total billed charges,,,,,,,,,2731.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3253.25,91,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2967.25,83,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,2931.5,82,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,2695.55,3396.25,
ARTHREX PASSPORT BUTTON CANNULA,30187329,CDM,,,278,RC,inpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
OPTION ELITE CAVA FILTER,30187330,CDM,,,270,RC,inpatient,,16575,16575,,14072.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12497.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14088.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14586,88,,percent of total billed charges,,,,,,,,,12663.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15083.25,91,,percent of total billed charges,,,15746.25,95,,percent of total billed charges,,,13757.25,83,,percent of total billed charges,,,13757.25,83,,percent of total billed charges,,,,,,,,,,,,,,,13757.25,83,,percent of total billed charges,,,15746.25,95,,percent of total billed charges,,,14917.5,90,,percent of total billed charges,,,14917.5,90,,percent of total billed charges,,,13591.5,82,,percent of total billed charges,,,14917.5,90,,percent of total billed charges,,,14088.75,85,,percent of total billed charges,,12497.55,15746.25,
DEPUY ATTUNE PATELLA MEDIAL 32MM,30187331,CDM,,,278,RC,inpatient,,9149.99,9149.99,,7768.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6899.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7777.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8051.99,88,,percent of total billed charges,,,,,,,,,6990.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8326.49,91,,percent of total billed charges,,,8692.49,95,,percent of total billed charges,,,7594.49,83,,percent of total billed charges,,,7594.49,83,,percent of total billed charges,,,,,,,,,,,,,,,7594.49,83,,percent of total billed charges,,,8692.49,95,,percent of total billed charges,,,8234.99,90,,percent of total billed charges,,,8234.99,90,,percent of total billed charges,,,7502.99,82,,percent of total billed charges,,,8234.99,90,,percent of total billed charges,,,7777.49,85,,percent of total billed charges,,6899.09,8692.49,
ZIMMER FEMUR POROUS SZ 11,30187332,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
VASCULAR CLOSURE DEVICE 5F FEMORAL,30187333,CDM,,,270,RC,inpatient,,1397.5,1397.5,,1186.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1053.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1187.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1229.8,88,,percent of total billed charges,,,,,,,,,1067.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1271.73,91,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1159.93,83,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1145.95,82,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,1053.72,1327.63,
ULRICH X-LINK XXXS,30187334,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
ULRICH X-LINK MEDIUM,30187335,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
ULRICH POLY 5.5 X 50MM,30187336,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH POLY 5.5 X 55MM,30187337,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH POLY 5.5 X 45MM,30187338,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH POLY 6.5 X 50MM,30187339,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH POLY 7.5 X 45MM,30187340,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH POLY 7.5 X 40MM,30187341,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH POLY 8.5 X 45MM,30187342,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH ILLIAC BOLT SCREW 8.0 X 80,30187343,CDM,,,278,RC,inpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7106.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8011.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,7106.45,8953.75,
ULRICH ROD COBALT CHROME 5.5,30187344,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
ULRICH TAP NON-CANNULATED 4.5,30187345,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
ZIMMER BEARING DUAL MOBILITY G,30187346,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
MEDTRONIC SPIDER 5MM,30187347,CDM,,,270,RC,inpatient,,10090.08,10090.08,,8566.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7607.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8576.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8879.27,88,,percent of total billed charges,,,,,,,,,7708.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9181.97,91,,percent of total billed charges,,,9585.58,95,,percent of total billed charges,,,8374.77,83,,percent of total billed charges,,,8374.77,83,,percent of total billed charges,,,,,,,,,,,,,,,8374.77,83,,percent of total billed charges,,,9585.58,95,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,8273.87,82,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,8576.57,85,,percent of total billed charges,,7607.92,9585.58,
IMPACT ADMIRAL BALLOON 4X60,30187348,CDM,,,270,RC,inpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7302.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8232.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,7302.49,9200.75,
ZIMMER TIBIA RIGHT 5DEG SZ D,30187349,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER BEARING MC 11MM,30187350,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ZIMMER LINER NEUTRAL G7 40MM H,30187351,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH ROD LORDOSED 100MM,30187352,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ULRICH POLY SCREW REDUCTION 6.5 X 55MM,30187353,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH ROD LORDOSED 5.5 X 80MM,30187354,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ULRICH ROD LORDOSED 5.5 X 110MM,30187355,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ULRICH X-LINK CONNECTOR SMALL,30187356,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
IR CAGE PEEK 6DEG 9MM,30187357,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
STEERING KIT ENHANCED W/STYLET CAP 50CM,30187358,CDM,,,270,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
STRYKER BURR ARTHROSCOPIC ROUND,30187359,CDM,,,270,RC,inpatient,,451.01,451.01,,382.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,340.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,383.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,396.89,88,,percent of total billed charges,,,,,,,,,344.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,410.42,91,,percent of total billed charges,,,428.46,95,,percent of total billed charges,,,374.34,83,,percent of total billed charges,,,374.34,83,,percent of total billed charges,,,,,,,,,,,,,,,374.34,83,,percent of total billed charges,,,428.46,95,,percent of total billed charges,,,405.91,90,,percent of total billed charges,,,405.91,90,,percent of total billed charges,,,369.83,82,,percent of total billed charges,,,405.91,90,,percent of total billed charges,,,383.36,85,,percent of total billed charges,,340.06,428.46,
MERETE SCREW INTERLOCKING 34MM,30187361,CDM,,,278,RC,inpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2129.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2400.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,2129.48,2683.04,
MERETE KNEE NAIL W/COLLAR 200 X 14MM,30187362,CDM,,,278,RC,inpatient,,17875,17875,,15175.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13477.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15193.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15730,88,,percent of total billed charges,,,,,,,,,13656.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16266.25,91,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14836.25,83,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,14657.5,82,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,13477.75,16981.25,
MEDTRONIC IRRIGATION TUBING,30187363,CDM,,,270,RC,inpatient,,819,819,,695.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,617.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,696.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,720.72,88,,percent of total billed charges,,,,,,,,,625.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,745.29,91,,percent of total billed charges,,,778.05,95,,percent of total billed charges,,,679.77,83,,percent of total billed charges,,,679.77,83,,percent of total billed charges,,,,,,,,,,,,,,,679.77,83,,percent of total billed charges,,,778.05,95,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,671.58,82,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,696.15,85,,percent of total billed charges,,617.53,778.05,
MEDTRONIC BURR 6MM,30187364,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
DEPUY CEMENT GENTAMICIN 40G,30187365,CDM,,,278,RC,inpatient,,1527.5,1527.5,,1296.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1151.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1298.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1344.2,88,,percent of total billed charges,,,,,,,,,1167.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1390.03,91,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1267.83,83,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1252.55,82,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,1151.74,1451.13,
S&N INSERT CONSTRAINED ARTICULAR SZ 7-8,30187366,CDM,,,278,RC,inpatient,,22072.83,22072.83,,18739.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16642.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18761.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19424.09,88,,percent of total billed charges,,,,,,,,,16863.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20086.28,91,,percent of total billed charges,,,20969.19,95,,percent of total billed charges,,,18320.45,83,,percent of total billed charges,,,18320.45,83,,percent of total billed charges,,,,,,,,,,,,,,,18320.45,83,,percent of total billed charges,,,20969.19,95,,percent of total billed charges,,,19865.55,90,,percent of total billed charges,,,19865.55,90,,percent of total billed charges,,,18099.72,82,,percent of total billed charges,,,19865.55,90,,percent of total billed charges,,,18761.91,85,,percent of total billed charges,,16642.91,20969.19,
BURSHIELD DIAMOND 1.0MM X 95MM,30187367,CDM,,,270,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
IR INTERBODY PEEK 7MM 6DEG 12X15,30187369,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
IR INTERBODY PEEK 8MM 10DEG 12X15,30187370,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
IR PLATE CERVICAL 14MM,30187371,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
AGILON SYNTHETIC PUTTY W/COLLOGEN 3CC,30187372,CDM,,,278,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
SYNTHES PLATE TIBIA VA PROX 8 HOLE RIGHT,30187373,CDM,,,278,RC,inpatient,,19694.55,19694.55,,16720.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14849.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16740.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17331.2,88,,percent of total billed charges,,,,,,,,,15046.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17922.04,91,,percent of total billed charges,,,18709.82,95,,percent of total billed charges,,,16346.48,83,,percent of total billed charges,,,16346.48,83,,percent of total billed charges,,,,,,,,,,,,,,,16346.48,83,,percent of total billed charges,,,18709.82,95,,percent of total billed charges,,,17725.1,90,,percent of total billed charges,,,17725.1,90,,percent of total billed charges,,,16149.53,82,,percent of total billed charges,,,17725.1,90,,percent of total billed charges,,,16740.37,85,,percent of total billed charges,,14849.69,18709.82,
SYNTHES SCREW LOCKING VA 3.5 X 28MM,30187374,CDM,,,278,RC,inpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1131.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1275.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,1131.4,1425.5,
ULRICH POLY 7.5 X 50MM,30187375,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH POLY 7.5 X 55MM,30187376,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH ROD LORDOSED 6.0 X 120,30187377,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ULRICH POLY 6.0 X 40MM,30187378,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH ROD 5.5 X 50MM,30187379,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ULRICH ROD 5.5 X 55MM,30187380,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ULRICH ROD 5.5 X 45MM,30187381,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ULRICH POLY 6.5 X 35MM,30187382,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
NUVASIVE PLATE ACP 1.9H 36MM 2-LEVEL,30187383,CDM,,,278,RC,inpatient,,15787.2,15787.2,,13403.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11903.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13419.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13892.74,88,,percent of total billed charges,,,,,,,,,12061.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14366.35,91,,percent of total billed charges,,,14997.84,95,,percent of total billed charges,,,13103.38,83,,percent of total billed charges,,,13103.38,83,,percent of total billed charges,,,,,,,,,,,,,,,13103.38,83,,percent of total billed charges,,,14997.84,95,,percent of total billed charges,,,14208.48,90,,percent of total billed charges,,,14208.48,90,,percent of total billed charges,,,12945.5,82,,percent of total billed charges,,,14208.48,90,,percent of total billed charges,,,13419.12,85,,percent of total billed charges,,11903.55,14997.84,
NUVASIVE SCREW ACP 3.5 X 15MM,30187384,CDM,,,278,RC,inpatient,,5026.45,5026.45,,4267.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3789.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4272.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4423.28,88,,percent of total billed charges,,,,,,,,,3840.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4574.07,91,,percent of total billed charges,,,4775.13,95,,percent of total billed charges,,,4171.95,83,,percent of total billed charges,,,4171.95,83,,percent of total billed charges,,,,,,,,,,,,,,,4171.95,83,,percent of total billed charges,,,4775.13,95,,percent of total billed charges,,,4523.81,90,,percent of total billed charges,,,4523.81,90,,percent of total billed charges,,,4121.69,82,,percent of total billed charges,,,4523.81,90,,percent of total billed charges,,,4272.48,85,,percent of total billed charges,,3789.94,4775.13,
NUVASIVE SCREW ACP 4.0 X 15MM,30187385,CDM,,,278,RC,inpatient,,5026.45,5026.45,,4267.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3789.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4272.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4423.28,88,,percent of total billed charges,,,,,,,,,3840.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4574.07,91,,percent of total billed charges,,,4775.13,95,,percent of total billed charges,,,4171.95,83,,percent of total billed charges,,,4171.95,83,,percent of total billed charges,,,,,,,,,,,,,,,4171.95,83,,percent of total billed charges,,,4775.13,95,,percent of total billed charges,,,4523.81,90,,percent of total billed charges,,,4523.81,90,,percent of total billed charges,,,4121.69,82,,percent of total billed charges,,,4523.81,90,,percent of total billed charges,,,4272.48,85,,percent of total billed charges,,3789.94,4775.13,
NUVASIVE DRILL ACP 11MM,30187386,CDM,,,270,RC,inpatient,,3575,3575,,3035.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2695.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3038.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3146,88,,percent of total billed charges,,,,,,,,,2731.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3253.25,91,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2967.25,83,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,2931.5,82,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,2695.55,3396.25,
SYNTHES SCREW LOCKING 4.0 X 36MM,30187387,CDM,,,278,RC,inpatient,,1740.83,1740.83,,1477.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1312.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1479.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1531.93,88,,percent of total billed charges,,,,,,,,,1329.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1584.16,91,,percent of total billed charges,,,1653.79,95,,percent of total billed charges,,,1444.89,83,,percent of total billed charges,,,1444.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.89,83,,percent of total billed charges,,,1653.79,95,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1427.48,82,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1479.71,85,,percent of total billed charges,,1312.59,1653.79,
ZIMMER BEARING 14MM MC,30187388,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ZIMMER BEARING 10MM MC,30187389,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ZIMMER FEMUR PSN CR SZ 9 LEFT,30187390,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
ZIMMER FEMUR PSN CR SZ 6 LEFT,30187391,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
ZIMMER TIBIA LEFT 5DEG SZ D,30187392,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER BEARING MC SZ 11,30187393,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ULRICH ROD LORDOSED 6.0 X 90,30187394,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ULRICH TAP NON-CANNULATED 6.5,30187395,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
IR PLATE 1 LEVEL 20MM,30187396,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
IR PEEK 10DEG 9MM,30187397,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
IR SCREW SELF DRILLING VARIABLE 4.5 X 16,30187398,CDM,,,278,RC,inpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1347.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1519.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,1347.78,1698.13,
EVERLIFT GI 59 10ML,30187399,CDM,,,270,RC,inpatient,,553,553,,469.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,416.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,470.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,486.64,88,,percent of total billed charges,,,,,,,,,422.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,503.23,91,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,,,,,,,,,,,,,458.99,83,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,453.46,82,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,416.96,525.35,
ULRICH ROD LORDOSED 6.0 X 70,30187402,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ULRICH SCREW REDUCTION 6.5 X 40,30187403,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
ULRICH SCREW REDUCTION 6.5 X 45,30187404,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
S&N REGENETEN IMPLANT MEDIUM,30187405,CDM,,,278,RC,inpatient,,32453.46,32453.46,,27552.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24469.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27585.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28559.04,88,,percent of total billed charges,,,,,,,,,24794.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29532.65,91,,percent of total billed charges,,,30830.79,95,,percent of total billed charges,,,26936.37,83,,percent of total billed charges,,,26936.37,83,,percent of total billed charges,,,,,,,,,,,,,,,26936.37,83,,percent of total billed charges,,,30830.79,95,,percent of total billed charges,,,29208.11,90,,percent of total billed charges,,,29208.11,90,,percent of total billed charges,,,26611.84,82,,percent of total billed charges,,,29208.11,90,,percent of total billed charges,,,27585.44,85,,percent of total billed charges,,24469.91,30830.79,
S&N BONE ANCHORS,30187406,CDM,,,278,RC,inpatient,,17037.54,17037.54,,14464.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12846.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14481.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14993.04,88,,percent of total billed charges,,,,,,,,,13016.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15504.16,91,,percent of total billed charges,,,16185.66,95,,percent of total billed charges,,,14141.16,83,,percent of total billed charges,,,14141.16,83,,percent of total billed charges,,,,,,,,,,,,,,,14141.16,83,,percent of total billed charges,,,16185.66,95,,percent of total billed charges,,,15333.79,90,,percent of total billed charges,,,15333.79,90,,percent of total billed charges,,,13970.78,82,,percent of total billed charges,,,15333.79,90,,percent of total billed charges,,,14481.91,85,,percent of total billed charges,,12846.31,16185.66,
S&N TENDON ANCHORS,30187407,CDM,,,278,RC,inpatient,,17037.54,17037.54,,14464.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12846.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14481.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14993.04,88,,percent of total billed charges,,,,,,,,,13016.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15504.16,91,,percent of total billed charges,,,16185.66,95,,percent of total billed charges,,,14141.16,83,,percent of total billed charges,,,14141.16,83,,percent of total billed charges,,,,,,,,,,,,,,,14141.16,83,,percent of total billed charges,,,16185.66,95,,percent of total billed charges,,,15333.79,90,,percent of total billed charges,,,15333.79,90,,percent of total billed charges,,,13970.78,82,,percent of total billed charges,,,15333.79,90,,percent of total billed charges,,,14481.91,85,,percent of total billed charges,,12846.31,16185.66,
FACE & NECK WRAP UNIVERSAL,30187408,CDM,,,270,RC,inpatient,,299.63,299.63,,254.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,225.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,254.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,263.67,88,,percent of total billed charges,,,,,,,,,228.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,272.66,91,,percent of total billed charges,,,284.65,95,,percent of total billed charges,,,248.69,83,,percent of total billed charges,,,248.69,83,,percent of total billed charges,,,,,,,,,,,,,,,248.69,83,,percent of total billed charges,,,284.65,95,,percent of total billed charges,,,269.67,90,,percent of total billed charges,,,269.67,90,,percent of total billed charges,,,245.7,82,,percent of total billed charges,,,269.67,90,,percent of total billed charges,,,254.69,85,,percent of total billed charges,,225.92,284.65,
SPLINT FINGER 4-PRONG LARGE,30187409,CDM,,,270,RC,inpatient,,6.3,6.3,,5.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.54,88,,percent of total billed charges,,,,,,,,,4.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.73,91,,percent of total billed charges,,,5.99,95,,percent of total billed charges,,,5.23,83,,percent of total billed charges,,,5.23,83,,percent of total billed charges,,,,,,,,,,,,,,,5.23,83,,percent of total billed charges,,,5.99,95,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.17,82,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.36,85,,percent of total billed charges,,4.75,5.99,
SPLINT FINGER 4-PRONG SMALL,30187410,CDM,,,270,RC,inpatient,,6.3,6.3,,5.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.54,88,,percent of total billed charges,,,,,,,,,4.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.73,91,,percent of total billed charges,,,5.99,95,,percent of total billed charges,,,5.23,83,,percent of total billed charges,,,5.23,83,,percent of total billed charges,,,,,,,,,,,,,,,5.23,83,,percent of total billed charges,,,5.99,95,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.17,82,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.36,85,,percent of total billed charges,,4.75,5.99,
S&N ENDOBUTTON 20MM,30187411,CDM,,,270,RC,inpatient,,2207.34,2207.34,,1874.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1664.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1876.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1942.46,88,,percent of total billed charges,,,,,,,,,1686.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2008.68,91,,percent of total billed charges,,,2096.97,95,,percent of total billed charges,,,1832.09,83,,percent of total billed charges,,,1832.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1832.09,83,,percent of total billed charges,,,2096.97,95,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1810.02,82,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1876.24,85,,percent of total billed charges,,1664.33,2096.97,
S&N TRAY RENTAL GRAFTMASTER,30187412,CDM,,,270,RC,inpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3675.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4143.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,3675.75,4631.25,
S&N SCREW INTERFERENCE 8X25,30187413,CDM,,,270,RC,inpatient,,4091.95,4091.95,,3474.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3085.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3478.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3600.92,88,,percent of total billed charges,,,,,,,,,3126.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3723.67,91,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3396.32,83,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3355.4,82,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,3085.33,3887.35,
ZIMMER COMP SIGNATURE GUIDES,30187414,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
ZIMMER STEM HUMERAL MINI 12MM,30187415,CDM,,,278,RC,inpatient,,46020,46020,,39070.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34699.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39117,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40497.6,88,,percent of total billed charges,,,,,,,,,35159.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41878.2,91,,percent of total billed charges,,,43719,95,,percent of total billed charges,,,38196.6,83,,percent of total billed charges,,,38196.6,83,,percent of total billed charges,,,,,,,,,,,,,,,38196.6,83,,percent of total billed charges,,,43719,95,,percent of total billed charges,,,41418,90,,percent of total billed charges,,,41418,90,,percent of total billed charges,,,37736.4,82,,percent of total billed charges,,,41418,90,,percent of total billed charges,,,39117,85,,percent of total billed charges,,34699.08,43719,
ZIMMER SCREW RVS 6.5 X 25MM,30187416,CDM,,,278,RC,inpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1372.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1547,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,1372.28,1729,
ZIMMER BEARING HUMERAL +3M 366MM,30187417,CDM,,,278,RC,inpatient,,17680,17680,,15010.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13330.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15028,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15558.4,88,,percent of total billed charges,,,,,,,,,13507.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16088.8,91,,percent of total billed charges,,,16796,95,,percent of total billed charges,,,14674.4,83,,percent of total billed charges,,,14674.4,83,,percent of total billed charges,,,,,,,,,,,,,,,14674.4,83,,percent of total billed charges,,,16796,95,,percent of total billed charges,,,15912,90,,percent of total billed charges,,,15912,90,,percent of total billed charges,,,14497.6,82,,percent of total billed charges,,,15912,90,,percent of total billed charges,,,15028,85,,percent of total billed charges,,13330.72,16796,
ZIMMER TRAY HUMERAL STD,30187418,CDM,,,278,RC,inpatient,,10725,10725,,9105.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8086.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9116.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9438,88,,percent of total billed charges,,,,,,,,,8193.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9759.75,91,,percent of total billed charges,,,10188.75,95,,percent of total billed charges,,,8901.75,83,,percent of total billed charges,,,8901.75,83,,percent of total billed charges,,,,,,,,,,,,,,,8901.75,83,,percent of total billed charges,,,10188.75,95,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,8794.5,82,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,9116.25,85,,percent of total billed charges,,8086.65,10188.75,
ZIMMER SCREW LOCKING 4.75 X 30MM,30187419,CDM,,,278,RC,inpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1372.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1547,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,1372.28,1729,
ZIMMER SCREW LOCKING 4.75 X 25MM,30187420,CDM,,,278,RC,inpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1372.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1547,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,1372.28,1729,
ZIMMER GLENOSPHERE STD 36MM,30187421,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
ZIMMER PATELLA VE SZ 29MM,30187422,CDM,,,278,RC,inpatient,,3575,3575,,3035.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2695.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3038.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3146,88,,percent of total billed charges,,,,,,,,,2731.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3253.25,91,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2967.25,83,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,2931.5,82,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,2695.55,3396.25,
ZIMMER TIBIA RIGHT C CEMENTED 5DEG,30187423,CDM,,,278,RC,inpatient,,7587.5,7587.5,,6441.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5720.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6449.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6677,88,,percent of total billed charges,,,,,,,,,5796.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6904.63,91,,percent of total billed charges,,,7208.13,95,,percent of total billed charges,,,6297.63,83,,percent of total billed charges,,,6297.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6297.63,83,,percent of total billed charges,,,7208.13,95,,percent of total billed charges,,,6828.75,90,,percent of total billed charges,,,6828.75,90,,percent of total billed charges,,,6221.75,82,,percent of total billed charges,,,6828.75,90,,percent of total billed charges,,,6449.38,85,,percent of total billed charges,,5720.98,7208.13,
ZIMMER FEMUR PSN CR CMT SZ 5 RIGHT,30187424,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
ZIMMER BEARING MC 10MM,30187425,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ARTHREX CARTIFORM DISC 20MM,30187426,CDM,,,278,RC,inpatient,,55250,55250,,46907.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41658.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46962.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48620,88,,percent of total billed charges,,,,,,,,,42211,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50277.5,91,,percent of total billed charges,,,52487.5,95,,percent of total billed charges,,,45857.5,83,,percent of total billed charges,,,45857.5,83,,percent of total billed charges,,,,,,,,,,,,,,,45857.5,83,,percent of total billed charges,,,52487.5,95,,percent of total billed charges,,,49725,90,,percent of total billed charges,,,49725,90,,percent of total billed charges,,,45305,82,,percent of total billed charges,,,49725,90,,percent of total billed charges,,,46962.5,85,,percent of total billed charges,,41658.5,52487.5,
ARTHREX BIOCARTILAGE 1CC,30187427,CDM,,,278,RC,inpatient,,6370,6370,,5408.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4802.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5414.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5605.6,88,,percent of total billed charges,,,,,,,,,4866.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5796.7,91,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5287.1,83,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5223.4,82,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5414.5,85,,percent of total billed charges,,4802.98,6051.5,
SYNTHES SCREW TFNA LAG 100MM,30187428,CDM,,,278,RC,inpatient,,8482.5,8482.5,,7201.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6395.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7210.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7464.6,88,,percent of total billed charges,,,,,,,,,6480.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7719.08,91,,percent of total billed charges,,,8058.38,95,,percent of total billed charges,,,7040.48,83,,percent of total billed charges,,,7040.48,83,,percent of total billed charges,,,,,,,,,,,,,,,7040.48,83,,percent of total billed charges,,,8058.38,95,,percent of total billed charges,,,7634.25,90,,percent of total billed charges,,,7634.25,90,,percent of total billed charges,,,6955.65,82,,percent of total billed charges,,,7634.25,90,,percent of total billed charges,,,7210.13,85,,percent of total billed charges,,6395.81,8058.38,
SYNTHES TFNA 12MM X 170MM 130DEG RT,30187429,CDM,,,278,RC,inpatient,,19032,19032,,16158.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14350.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16177.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16748.16,88,,percent of total billed charges,,,,,,,,,14540.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17319.12,91,,percent of total billed charges,,,18080.4,95,,percent of total billed charges,,,15796.56,83,,percent of total billed charges,,,15796.56,83,,percent of total billed charges,,,,,,,,,,,,,,,15796.56,83,,percent of total billed charges,,,18080.4,95,,percent of total billed charges,,,17128.8,90,,percent of total billed charges,,,17128.8,90,,percent of total billed charges,,,15606.24,82,,percent of total billed charges,,,17128.8,90,,percent of total billed charges,,,16177.2,85,,percent of total billed charges,,14350.13,18080.4,
S&N ANCHOR BIORAPTOR 2.3,30187431,CDM,,,270,RC,inpatient,,2031.58,2031.58,,1724.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1531.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1726.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1787.79,88,,percent of total billed charges,,,,,,,,,1552.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1848.74,91,,percent of total billed charges,,,1930,95,,percent of total billed charges,,,1686.21,83,,percent of total billed charges,,,1686.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1686.21,83,,percent of total billed charges,,,1930,95,,percent of total billed charges,,,1828.42,90,,percent of total billed charges,,,1828.42,90,,percent of total billed charges,,,1665.9,82,,percent of total billed charges,,,1828.42,90,,percent of total billed charges,,,1726.84,85,,percent of total billed charges,,1531.81,1930,
SYNTHES PLATE NARROW LCP 8H 4.5 X 152MM,30187432,CDM,,,278,RC,inpatient,,6058,6058,,5143.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4567.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5149.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5331.04,88,,percent of total billed charges,,,,,,,,,4628.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5512.78,91,,percent of total billed charges,,,5755.1,95,,percent of total billed charges,,,5028.14,83,,percent of total billed charges,,,5028.14,83,,percent of total billed charges,,,,,,,,,,,,,,,5028.14,83,,percent of total billed charges,,,5755.1,95,,percent of total billed charges,,,5452.2,90,,percent of total billed charges,,,5452.2,90,,percent of total billed charges,,,4967.56,82,,percent of total billed charges,,,5452.2,90,,percent of total billed charges,,,5149.3,85,,percent of total billed charges,,4567.73,5755.1,
SYNTHES PLATE PROX HUMERAL 6H 3.5 X 163M,30187433,CDM,,,278,RC,inpatient,,25421.5,25421.5,,21582.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19167.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21608.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22370.92,88,,percent of total billed charges,,,,,,,,,19422.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23133.57,91,,percent of total billed charges,,,24150.43,95,,percent of total billed charges,,,21099.85,83,,percent of total billed charges,,,21099.85,83,,percent of total billed charges,,,,,,,,,,,,,,,21099.85,83,,percent of total billed charges,,,24150.43,95,,percent of total billed charges,,,22879.35,90,,percent of total billed charges,,,22879.35,90,,percent of total billed charges,,,20845.63,82,,percent of total billed charges,,,22879.35,90,,percent of total billed charges,,,21608.28,85,,percent of total billed charges,,19167.81,24150.43,
SYNTHES SCREW CORTEX 4.5 X 28MM,30187434,CDM,,,278,RC,inpatient,,511,511,,433.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,385.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,434.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,449.68,88,,percent of total billed charges,,,,,,,,,390.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,465.01,91,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,,,,,,,,,,,,,424.13,83,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,419.02,82,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,385.29,485.45,
STRYKER FEMUR TRIATHLON CR LEFT,30187435,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER BASEPLATE TIBIAL,30187436,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER PATELLA TRIATHLON X3,30187437,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
STRYKER INSERT TRIATHLON CS SZ 3 12MM,30187438,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
SYNTHES SCREW CORTEX S-T 4.5X20MM,30187439,CDM,,,278,RC,inpatient,,511,511,,433.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,385.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,434.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,449.68,88,,percent of total billed charges,,,,,,,,,390.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,465.01,91,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,,,,,,,,,,,,,424.13,83,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,419.02,82,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,385.29,485.45,
AGILON SYNTHETIC PUTTY W/COLLOGEN 6CC,30187440,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
ULRICH BOLT ILLIAC 9.0 X 80,30187441,CDM,,,278,RC,inpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7106.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8011.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,7106.45,8953.75,
ULRICH ROD TITANIUM 6.0 X 500MM,30187442,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
ULRICH REVISION SET,30187443,CDM,,,278,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
IR DRILL 12MM,30187444,CDM,,,278,RC,inpatient,,2340,2340,,1986.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1764.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1989,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2059.2,88,,percent of total billed charges,,,,,,,,,1787.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2129.4,91,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1942.2,83,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1918.8,82,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1989,85,,percent of total billed charges,,1764.36,2223,
IR SCREW SELF DRILLING VARIABLE 4 X 12MM,30187445,CDM,,,278,RC,inpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1347.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1519.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,1347.78,1698.13,
DEPUY CAP ALTRX POROUS,30187446,CDM,,,278,RC,inpatient,,38252.5,38252.5,,32476.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28842.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32514.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33662.2,88,,percent of total billed charges,,,,,,,,,29224.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34809.78,91,,percent of total billed charges,,,36339.88,95,,percent of total billed charges,,,31749.58,83,,percent of total billed charges,,,31749.58,83,,percent of total billed charges,,,,,,,,,,,,,,,31749.58,83,,percent of total billed charges,,,36339.88,95,,percent of total billed charges,,,34427.25,90,,percent of total billed charges,,,34427.25,90,,percent of total billed charges,,,31367.05,82,,percent of total billed charges,,,34427.25,90,,percent of total billed charges,,,32514.63,85,,percent of total billed charges,,28842.39,36339.88,
LIGASURE EXACT DISSECTOR 20.6MM - 21CM,30187447,CDM,,,270,RC,inpatient,,5556.85,5556.85,,4717.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4189.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4723.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4890.03,88,,percent of total billed charges,,,,,,,,,4245.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5056.73,91,,percent of total billed charges,,,5279.01,95,,percent of total billed charges,,,4612.19,83,,percent of total billed charges,,,4612.19,83,,percent of total billed charges,,,,,,,,,,,,,,,4612.19,83,,percent of total billed charges,,,5279.01,95,,percent of total billed charges,,,5001.17,90,,percent of total billed charges,,,5001.17,90,,percent of total billed charges,,,4556.62,82,,percent of total billed charges,,,5001.17,90,,percent of total billed charges,,,4723.32,85,,percent of total billed charges,,4189.86,5279.01,
MERETE KNEE NAIL W/COLLAR 200 X 16MM,30187448,CDM,,,278,RC,inpatient,,17875,17875,,15175.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13477.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15193.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15730,88,,percent of total billed charges,,,,,,,,,13656.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16266.25,91,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14836.25,83,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,14657.5,82,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,13477.75,16981.25,
MERETE KNEE NAIL W/OUT COLLAR 200 X 18MM,30187449,CDM,,,278,RC,inpatient,,17875,17875,,15175.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13477.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15193.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15730,88,,percent of total billed charges,,,,,,,,,13656.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16266.25,91,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14836.25,83,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,14657.5,82,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,13477.75,16981.25,
MERETE SCREW INTERLOCKING 5.0 X 30MM,30187450,CDM,,,278,RC,inpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2129.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2400.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,2129.48,2683.04,
MERETE SCREW INTERLOCKING 5.0 X 32MM,30187451,CDM,,,278,RC,inpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2129.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2400.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,2129.48,2683.04,
S&N INSERT TIBIAL 8MM SZ 3-4,30187452,CDM,,,278,RC,inpatient,,6855.94,6855.94,,5820.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5169.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5827.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6033.23,88,,percent of total billed charges,,,,,,,,,5237.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6238.91,91,,percent of total billed charges,,,6513.14,95,,percent of total billed charges,,,5690.43,83,,percent of total billed charges,,,5690.43,83,,percent of total billed charges,,,,,,,,,,,,,,,5690.43,83,,percent of total billed charges,,,6513.14,95,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,5621.87,82,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,5827.55,85,,percent of total billed charges,,5169.38,6513.14,
S&N BASE TIBIAL RT MED 50MM SZ 4,30187453,CDM,,,278,RC,inpatient,,14631.63,14631.63,,12422.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11032.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12436.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12875.83,88,,percent of total billed charges,,,,,,,,,11178.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13314.78,91,,percent of total billed charges,,,13900.05,95,,percent of total billed charges,,,12144.25,83,,percent of total billed charges,,,12144.25,83,,percent of total billed charges,,,,,,,,,,,,,,,12144.25,83,,percent of total billed charges,,,13900.05,95,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,11997.94,82,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,12436.89,85,,percent of total billed charges,,11032.25,13900.05,
S&N FEMORAL COMPONENT RIGHT MED SZ 3,30187454,CDM,,,278,RC,inpatient,,27214.79,27214.79,,23105.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20519.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23132.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23949.02,88,,percent of total billed charges,,,,,,,,,20792.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24765.46,91,,percent of total billed charges,,,25854.05,95,,percent of total billed charges,,,22588.28,83,,percent of total billed charges,,,22588.28,83,,percent of total billed charges,,,,,,,,,,,,,,,22588.28,83,,percent of total billed charges,,,25854.05,95,,percent of total billed charges,,,24493.31,90,,percent of total billed charges,,,24493.31,90,,percent of total billed charges,,,22316.13,82,,percent of total billed charges,,,24493.31,90,,percent of total billed charges,,,23132.57,85,,percent of total billed charges,,20519.95,25854.05,
URETHRAL DILATOR TAPERED 6-10FR,30187455,CDM,,,270,RC,inpatient,,863.03,863.03,,732.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,650.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,733.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,759.47,88,,percent of total billed charges,,,,,,,,,659.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,785.36,91,,percent of total billed charges,,,819.88,95,,percent of total billed charges,,,716.31,83,,percent of total billed charges,,,716.31,83,,percent of total billed charges,,,,,,,,,,,,,,,716.31,83,,percent of total billed charges,,,819.88,95,,percent of total billed charges,,,776.73,90,,percent of total billed charges,,,776.73,90,,percent of total billed charges,,,707.68,82,,percent of total billed charges,,,776.73,90,,percent of total billed charges,,,733.58,85,,percent of total billed charges,,650.72,819.88,
ARTHREX DISP. KIT KNOTLESS SUTURETAK OPE,30187456,CDM,,,270,RC,inpatient,,1859,1859,,1578.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1401.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1580.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1635.92,88,,percent of total billed charges,,,,,,,,,1420.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1691.69,91,,percent of total billed charges,,,1766.05,95,,percent of total billed charges,,,1542.97,83,,percent of total billed charges,,,1542.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1542.97,83,,percent of total billed charges,,,1766.05,95,,percent of total billed charges,,,1673.1,90,,percent of total billed charges,,,1673.1,90,,percent of total billed charges,,,1524.38,82,,percent of total billed charges,,,1673.1,90,,percent of total billed charges,,,1580.15,85,,percent of total billed charges,,1401.69,1766.05,
ARTHREX SCORER CARTIFORM 20MM,30187457,CDM,,,270,RC,inpatient,,1859,1859,,1578.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1401.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1580.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1635.92,88,,percent of total billed charges,,,,,,,,,1420.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1691.69,91,,percent of total billed charges,,,1766.05,95,,percent of total billed charges,,,1542.97,83,,percent of total billed charges,,,1542.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1542.97,83,,percent of total billed charges,,,1766.05,95,,percent of total billed charges,,,1673.1,90,,percent of total billed charges,,,1673.1,90,,percent of total billed charges,,,1524.38,82,,percent of total billed charges,,,1673.1,90,,percent of total billed charges,,,1580.15,85,,percent of total billed charges,,1401.69,1766.05,
ARTHREX BC KNOTLESS SUTURETAK OPEN REPAI,30187458,CDM,,,270,RC,inpatient,,3952,3952,,3355.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2979.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3359.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3477.76,88,,percent of total billed charges,,,,,,,,,3019.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3596.32,91,,percent of total billed charges,,,3754.4,95,,percent of total billed charges,,,3280.16,83,,percent of total billed charges,,,3280.16,83,,percent of total billed charges,,,,,,,,,,,,,,,3280.16,83,,percent of total billed charges,,,3754.4,95,,percent of total billed charges,,,3556.8,90,,percent of total billed charges,,,3556.8,90,,percent of total billed charges,,,3240.64,82,,percent of total billed charges,,,3556.8,90,,percent of total billed charges,,,3359.2,85,,percent of total billed charges,,2979.81,3754.4,
ARTHREX MINI BC PUSHLOCK SUTURE ANCHOR,30187459,CDM,,,270,RC,inpatient,,3952,3952,,3355.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2979.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3359.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3477.76,88,,percent of total billed charges,,,,,,,,,3019.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3596.32,91,,percent of total billed charges,,,3754.4,95,,percent of total billed charges,,,3280.16,83,,percent of total billed charges,,,3280.16,83,,percent of total billed charges,,,,,,,,,,,,,,,3280.16,83,,percent of total billed charges,,,3754.4,95,,percent of total billed charges,,,3556.8,90,,percent of total billed charges,,,3556.8,90,,percent of total billed charges,,,3240.64,82,,percent of total billed charges,,,3556.8,90,,percent of total billed charges,,,3359.2,85,,percent of total billed charges,,2979.81,3754.4,
ZIMMER LINER G7 VIT E +5MM  SIZE D,30187460,CDM,,,278,RC,inpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7694.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8674.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,7694.57,9694.75,
DEPUY GLENOSPHERE 38 STD,30187461,CDM,,,278,RC,inpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14941.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16844.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,14941.68,18825.72,
ULRICH ROD LORDOSED 6.0 X 50MM,30187463,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ULRICH ROD LORDOSED 6.0 X 45MM,30187464,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ARTHREX ACP KIT SERIES I,30187465,CDM,,,270,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
ARTHREX THROMBINATOR SYSTEM,30187466,CDM,,,270,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
ARTHREX APPLICATOR ASSEMBLY 10CC 1:1,30187467,CDM,,,278,RC,inpatient,,553,553,,469.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,416.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,470.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,486.64,88,,percent of total billed charges,,,,,,,,,422.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,503.23,91,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,,,,,,,,,,,,,458.99,83,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,453.46,82,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,416.96,525.35,
ARTHREX BLENDING CONNECTOR W/MIXER,30187468,CDM,,,278,RC,inpatient,,322.5,322.5,,273.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,243.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,274.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.8,88,,percent of total billed charges,,,,,,,,,246.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,293.48,91,,percent of total billed charges,,,306.38,95,,percent of total billed charges,,,267.68,83,,percent of total billed charges,,,267.68,83,,percent of total billed charges,,,,,,,,,,,,,,,267.68,83,,percent of total billed charges,,,306.38,95,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,264.45,82,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,274.13,85,,percent of total billed charges,,243.17,306.38,
ZIMMER LINER NEUTRAL G7 36MM D,30187469,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
GORE VBX BALLOON EXPANDABLE 6X59,30187470,CDM,,,270,RC,inpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17516.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19746.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,17516.17,22069.45,
GORE VBX BALLOON EXPANDABLE 6X29,30187471,CDM,,,270,RC,inpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17516.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19746.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,17516.17,22069.45,
GORE VBX BALLOON EXPANDABLE 7X29,30187472,CDM,,,270,RC,inpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17516.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19746.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,17516.17,22069.45,
EVERCROSS BALLOON 5 X 100MM,30187473,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
EVERCROSS BALLOON 7 X 40MM,30187474,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
S&N FEMORAL COMPONENT 6N RIGHT,30187475,CDM,,,278,RC,inpatient,,32523.99,32523.99,,27612.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24523.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27645.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28621.11,88,,percent of total billed charges,,,,,,,,,24848.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29596.83,91,,percent of total billed charges,,,30897.79,95,,percent of total billed charges,,,26994.91,83,,percent of total billed charges,,,26994.91,83,,percent of total billed charges,,,,,,,,,,,,,,,26994.91,83,,percent of total billed charges,,,30897.79,95,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,26669.67,82,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,27645.39,85,,percent of total billed charges,,24523.09,30897.79,
S&N INSERT SZ 5-6 12MM,30187476,CDM,,,278,RC,inpatient,,16261.96,16261.96,,13806.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12261.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13822.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14310.52,88,,percent of total billed charges,,,,,,,,,12424.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14798.38,91,,percent of total billed charges,,,15448.86,95,,percent of total billed charges,,,13497.43,83,,percent of total billed charges,,,13497.43,83,,percent of total billed charges,,,,,,,,,,,,,,,13497.43,83,,percent of total billed charges,,,15448.86,95,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,13334.81,82,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,13822.67,85,,percent of total billed charges,,12261.52,15448.86,
AMPLATZ SUPER STIFF STRAIGHT 7 X 180CM,30187477,CDM,,,270,RC,inpatient,,322.5,322.5,,273.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,243.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,274.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.8,88,,percent of total billed charges,,,,,,,,,246.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,293.48,91,,percent of total billed charges,,,306.38,95,,percent of total billed charges,,,267.68,83,,percent of total billed charges,,,267.68,83,,percent of total billed charges,,,,,,,,,,,,,,,267.68,83,,percent of total billed charges,,,306.38,95,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,264.45,82,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,274.13,85,,percent of total billed charges,,243.17,306.38,
AMPLATZ SUPER STIFF STRAIGHT 7 X 260CM,30187478,CDM,,,270,RC,inpatient,,337.5,337.5,,286.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,254.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,286.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,297,88,,percent of total billed charges,,,,,,,,,257.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,307.13,91,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,,,,,,,,,,,,,280.13,83,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,276.75,82,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,254.48,320.63,
STRYKER TIBIAL BASEPLATE SZ 2,30187479,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER FEMUR TRIATHLON CR #2,30187480,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
ALLOSOURCE FEMORAL STRUT,30187481,CDM,,,278,RC,inpatient,,6357,6357,,5397.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4793.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5403.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5594.16,88,,percent of total billed charges,,,,,,,,,4856.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5784.87,91,,percent of total billed charges,,,6039.15,95,,percent of total billed charges,,,5276.31,83,,percent of total billed charges,,,5276.31,83,,percent of total billed charges,,,,,,,,,,,,,,,5276.31,83,,percent of total billed charges,,,6039.15,95,,percent of total billed charges,,,5721.3,90,,percent of total billed charges,,,5721.3,90,,percent of total billed charges,,,5212.74,82,,percent of total billed charges,,,5721.3,90,,percent of total billed charges,,,5403.45,85,,percent of total billed charges,,4793.18,6039.15,
ELECTRODE BIVAP BIPOLAR 22FR,30187482,CDM,,,270,RC,inpatient,,2361.15,2361.15,,2004.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1780.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2006.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2077.81,88,,percent of total billed charges,,,,,,,,,1803.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2148.65,91,,percent of total billed charges,,,2243.09,95,,percent of total billed charges,,,1959.75,83,,percent of total billed charges,,,1959.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1959.75,83,,percent of total billed charges,,,2243.09,95,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,1936.14,82,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,2006.98,85,,percent of total billed charges,,1780.31,2243.09,
ELECTRODE CUTTING BIPOLAR 26FR,30187483,CDM,,,270,RC,inpatient,,7083.44,7083.44,,6013.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5340.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6020.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6233.43,88,,percent of total billed charges,,,,,,,,,5411.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6445.93,91,,percent of total billed charges,,,6729.27,95,,percent of total billed charges,,,5879.26,83,,percent of total billed charges,,,5879.26,83,,percent of total billed charges,,,,,,,,,,,,,,,5879.26,83,,percent of total billed charges,,,6729.27,95,,percent of total billed charges,,,6375.1,90,,percent of total billed charges,,,6375.1,90,,percent of total billed charges,,,5808.42,82,,percent of total billed charges,,,6375.1,90,,percent of total billed charges,,,6020.92,85,,percent of total billed charges,,5340.91,6729.27,
IR PLATE 2 LEVEL 34MM,30187484,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
ULRICH ROD LORDOSED 6.0 X 100MM,30187485,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
IVAS ACCESST CANNULA 11G,30187486,CDM,,,270,RC,inpatient,,498.61,498.61,,423.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,375.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,423.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,438.78,88,,percent of total billed charges,,,,,,,,,380.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,453.74,91,,percent of total billed charges,,,473.68,95,,percent of total billed charges,,,413.85,83,,percent of total billed charges,,,413.85,83,,percent of total billed charges,,,,,,,,,,,,,,,413.85,83,,percent of total billed charges,,,473.68,95,,percent of total billed charges,,,448.75,90,,percent of total billed charges,,,448.75,90,,percent of total billed charges,,,408.86,82,,percent of total billed charges,,,448.75,90,,percent of total billed charges,,,423.82,85,,percent of total billed charges,,375.95,473.68,
ULRICH SCREW POLY 5.5 X 40MM,30187487,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH SCREW REDUCTION 5.5 X 40MM,30187488,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
ULRICH SCREW REDUCTION 5.5 X 45MM,30187489,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
ULRICH ROD LORDOSED 5.5 X 70MM,30187490,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ULRICH TAP NON-CANNULATED 4.0,30187491,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
CEMENT PUSHER 5.0MM,30187492,CDM,,,270,RC,inpatient,,495.95,495.95,,421.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,373.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,421.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,436.44,88,,percent of total billed charges,,,,,,,,,378.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,451.31,91,,percent of total billed charges,,,471.15,95,,percent of total billed charges,,,411.64,83,,percent of total billed charges,,,411.64,83,,percent of total billed charges,,,,,,,,,,,,,,,411.64,83,,percent of total billed charges,,,471.15,95,,percent of total billed charges,,,446.36,90,,percent of total billed charges,,,446.36,90,,percent of total billed charges,,,406.68,82,,percent of total billed charges,,,446.36,90,,percent of total billed charges,,,421.56,85,,percent of total billed charges,,373.95,471.15,
STRYKER CEMENT SIMPLEX P W/TOBRAMYCIN,30187493,CDM,,,278,RC,inpatient,,2782.33,2782.33,,2362.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2097.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2364.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2448.45,88,,percent of total billed charges,,,,,,,,,2125.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2531.92,91,,percent of total billed charges,,,2643.21,95,,percent of total billed charges,,,2309.33,83,,percent of total billed charges,,,2309.33,83,,percent of total billed charges,,,,,,,,,,,,,,,2309.33,83,,percent of total billed charges,,,2643.21,95,,percent of total billed charges,,,2504.1,90,,percent of total billed charges,,,2504.1,90,,percent of total billed charges,,,2281.51,82,,percent of total billed charges,,,2504.1,90,,percent of total billed charges,,,2364.98,85,,percent of total billed charges,,2097.88,2643.21,
COOK INTRODUCER 11F 60CM RADIOPAQUE BAND,30187494,CDM,,,270,RC,inpatient,,1982.5,1982.5,,1683.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1494.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1685.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1744.6,88,,percent of total billed charges,,,,,,,,,1514.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1804.08,91,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1645.48,83,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1625.65,82,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,1494.81,1883.38,
CATHETER SOFT-VU ANGIOGRAPHIC 4F 90CM .0,30187495,CDM,,,270,RC,inpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,186.62,235.13,
CATHETER SOFT-VU ANGIOGRAPHIC 5F 80CM .0,30187496,CDM,,,270,RC,inpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,186.62,235.13,
CATHETER SOS OMNI 5F 80CM .035,30187497,CDM,,,270,RC,inpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,186.62,235.13,
S&N HEAD FEMORAL OXI 32MM +0,30187498,CDM,,,278,RC,inpatient,,39292.5,39292.5,,33359.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29626.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33398.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34577.4,88,,percent of total billed charges,,,,,,,,,30019.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35756.18,91,,percent of total billed charges,,,37327.88,95,,percent of total billed charges,,,32612.78,83,,percent of total billed charges,,,32612.78,83,,percent of total billed charges,,,,,,,,,,,,,,,32612.78,83,,percent of total billed charges,,,37327.88,95,,percent of total billed charges,,,35363.25,90,,percent of total billed charges,,,35363.25,90,,percent of total billed charges,,,32219.85,82,,percent of total billed charges,,,35363.25,90,,percent of total billed charges,,,33398.63,85,,percent of total billed charges,,29626.55,37327.88,
TERUMO GLIDEWIRE STRAIGHT 260CM,30187499,CDM,,,270,RC,inpatient,,808.5,808.5,,686.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,609.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,687.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,711.48,88,,percent of total billed charges,,,,,,,,,617.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,735.74,91,,percent of total billed charges,,,768.08,95,,percent of total billed charges,,,671.06,83,,percent of total billed charges,,,671.06,83,,percent of total billed charges,,,,,,,,,,,,,,,671.06,83,,percent of total billed charges,,,768.08,95,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,662.97,82,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,687.23,85,,percent of total billed charges,,609.61,768.08,
TERUMO GLIDECATH ANGLED TAPER 5FR 100CM,30187500,CDM,,,270,RC,inpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,291.35,367.08,
CATHETER KUMPE  SOFT-VU 5F X 65CM NON BR,30187501,CDM,,,270,RC,inpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,186.62,235.13,
CATHETER KUMPE  SOFT-VU 5F X 100CM NONBR,30187502,CDM,,,270,RC,inpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,186.62,235.13,
GUIDEWIRE V-18 CONTROL WIRE 300CM,30187503,CDM,,,270,RC,inpatient,,778.82,778.82,,661.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,587.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,662,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,685.36,88,,percent of total billed charges,,,,,,,,,595.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,708.73,91,,percent of total billed charges,,,739.88,95,,percent of total billed charges,,,646.42,83,,percent of total billed charges,,,646.42,83,,percent of total billed charges,,,,,,,,,,,,,,,646.42,83,,percent of total billed charges,,,739.88,95,,percent of total billed charges,,,700.94,90,,percent of total billed charges,,,700.94,90,,percent of total billed charges,,,638.63,82,,percent of total billed charges,,,700.94,90,,percent of total billed charges,,,662,85,,percent of total billed charges,,587.23,739.88,
TERUMO GLIDECATH ANGLED TAPER 5FR 65CM,30187504,CDM,,,270,RC,inpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,291.35,367.08,
TERUMO GLIDECATH STRAIGHT 5F 100CM,30187505,CDM,,,270,RC,inpatient,,577.5,577.5,,490.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,435.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,490.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,508.2,88,,percent of total billed charges,,,,,,,,,441.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,525.53,91,,percent of total billed charges,,,548.63,95,,percent of total billed charges,,,479.33,83,,percent of total billed charges,,,479.33,83,,percent of total billed charges,,,,,,,,,,,,,,,479.33,83,,percent of total billed charges,,,548.63,95,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,473.55,82,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,490.88,85,,percent of total billed charges,,435.44,548.63,
TERUMO GLIDECATH SIMI 5F 100CM,30187506,CDM,,,270,RC,inpatient,,577.5,577.5,,490.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,435.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,490.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,508.2,88,,percent of total billed charges,,,,,,,,,441.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,525.53,91,,percent of total billed charges,,,548.63,95,,percent of total billed charges,,,479.33,83,,percent of total billed charges,,,479.33,83,,percent of total billed charges,,,,,,,,,,,,,,,479.33,83,,percent of total billed charges,,,548.63,95,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,473.55,82,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,490.88,85,,percent of total billed charges,,435.44,548.63,
TERUMO GLIDECATH SIM2 5F 100CM,30187507,CDM,,,270,RC,inpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,291.35,367.08,
TERUMO GLIDEWIRE ANGLED 0.035X180CM,30187508,CDM,,,270,RC,inpatient,,1501.5,1501.5,,1274.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1132.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1276.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1321.32,88,,percent of total billed charges,,,,,,,,,1147.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1366.37,91,,percent of total billed charges,,,1426.43,95,,percent of total billed charges,,,1246.25,83,,percent of total billed charges,,,1246.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1246.25,83,,percent of total billed charges,,,1426.43,95,,percent of total billed charges,,,1351.35,90,,percent of total billed charges,,,1351.35,90,,percent of total billed charges,,,1231.23,82,,percent of total billed charges,,,1351.35,90,,percent of total billed charges,,,1276.28,85,,percent of total billed charges,,1132.13,1426.43,
TERUMO GLIDEWIRE ANGLED 0.035X300XM,30187509,CDM,,,270,RC,inpatient,,1673.75,1673.75,,1421.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1262.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1422.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1472.9,88,,percent of total billed charges,,,,,,,,,1278.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1523.11,91,,percent of total billed charges,,,1590.06,95,,percent of total billed charges,,,1389.21,83,,percent of total billed charges,,,1389.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1389.21,83,,percent of total billed charges,,,1590.06,95,,percent of total billed charges,,,1506.38,90,,percent of total billed charges,,,1506.38,90,,percent of total billed charges,,,1372.48,82,,percent of total billed charges,,,1506.38,90,,percent of total billed charges,,,1422.69,85,,percent of total billed charges,,1262.01,1590.06,
ELECTRODE CUTTING BIPOLAR 24-26FR,30187510,CDM,,,270,RC,inpatient,,2361.15,2361.15,,2004.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1780.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2006.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2077.81,88,,percent of total billed charges,,,,,,,,,1803.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2148.65,91,,percent of total billed charges,,,2243.09,95,,percent of total billed charges,,,1959.75,83,,percent of total billed charges,,,1959.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1959.75,83,,percent of total billed charges,,,2243.09,95,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,1936.14,82,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,2006.98,85,,percent of total billed charges,,1780.31,2243.09,
ELECTRODE CUTTING BIPOLAR 22FR,30187511,CDM,,,270,RC,inpatient,,7083.44,7083.44,,6013.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5340.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6020.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6233.43,88,,percent of total billed charges,,,,,,,,,5411.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6445.93,91,,percent of total billed charges,,,6729.27,95,,percent of total billed charges,,,5879.26,83,,percent of total billed charges,,,5879.26,83,,percent of total billed charges,,,,,,,,,,,,,,,5879.26,83,,percent of total billed charges,,,6729.27,95,,percent of total billed charges,,,6375.1,90,,percent of total billed charges,,,6375.1,90,,percent of total billed charges,,,5808.42,82,,percent of total billed charges,,,6375.1,90,,percent of total billed charges,,,6020.92,85,,percent of total billed charges,,5340.91,6729.27,
ZIMMER BEARING 14MM MC ASF 8-11 E-F,30187512,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ULRICH BOLT ILLIAC 8.0 X 80MM,30187513,CDM,,,278,RC,inpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7106.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8011.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,7106.45,8953.75,
ZIMMER LINER G7 +5MM 36MM E,30187514,CDM,,,278,RC,inpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7694.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8674.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,7694.57,9694.75,
GORE VBX BALLOON EXPANDABLE ENDOPROSTHES,30187517,CDM,,,270,RC,inpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17516.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19746.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,17516.17,22069.45,
GORE VBX BALLOON EXPANDABLE ENDOPROSTHES,30187518,CDM,,,270,RC,inpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17516.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19746.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,17516.17,22069.45,
EVERCROSS BALLOON EV3,30187519,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
MEDTRONIC INPACK ADMIRAL 6MM X 60MM X 13,30187520,CDM,,,270,RC,inpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7302.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8232.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,7302.49,9200.75,
IR SCREW REDUCTION 6.5 X 50MM,30187521,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
DEPUY TIBIA BASE RP SZ 4,30187522,CDM,,,278,RC,inpatient,,39503.36,39503.36,,33538.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29785.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33577.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34762.96,88,,percent of total billed charges,,,,,,,,,30180.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35948.06,91,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32787.79,83,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,32392.76,82,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,29785.53,37528.19,
DEPUY TIBIA AUGMENT UNIV. 5MM,30187523,CDM,,,278,RC,inpatient,,10997.61,10997.61,,9336.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8292.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9347.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9677.9,88,,percent of total billed charges,,,,,,,,,8402.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10007.83,91,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,,,,,,,,,,,,,9128.02,83,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9018.04,82,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,8292.2,10447.73,
DEPUY ATTUNE STEM PRESSFIT 14 X 60,30187524,CDM,,,278,RC,inpatient,,13175.11,13175.11,,11185.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9934.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11198.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11594.1,88,,percent of total billed charges,,,,,,,,,10065.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11989.35,91,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,,,,,,,,,,,,,10935.34,83,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,10803.59,82,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,9934.03,12516.35,
DEPUY ATTUNE INSERT PS RP SZ5 12MM,30187525,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
S&N INSERTER TAPERED HOLD COVER,30187526,CDM,,,270,RC,inpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,296.1,373.07,
S&N FLEXIBLE DRILL 35MM,30187527,CDM,,,270,RC,inpatient,,2853.5,2853.5,,2422.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2151.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2425.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2511.08,88,,percent of total billed charges,,,,,,,,,2180.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2596.69,91,,percent of total billed charges,,,2710.83,95,,percent of total billed charges,,,2368.41,83,,percent of total billed charges,,,2368.41,83,,percent of total billed charges,,,,,,,,,,,,,,,2368.41,83,,percent of total billed charges,,,2710.83,95,,percent of total billed charges,,,2568.15,90,,percent of total billed charges,,,2568.15,90,,percent of total billed charges,,,2339.87,82,,percent of total billed charges,,,2568.15,90,,percent of total billed charges,,,2425.48,85,,percent of total billed charges,,2151.54,2710.83,
S&N SHELL 3 HOLE 56MM OD,30187528,CDM,,,278,RC,inpatient,,32402.5,32402.5,,27509.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24431.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27542.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28514.2,88,,percent of total billed charges,,,,,,,,,24755.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29486.28,91,,percent of total billed charges,,,30782.38,95,,percent of total billed charges,,,26894.08,83,,percent of total billed charges,,,26894.08,83,,percent of total billed charges,,,,,,,,,,,,,,,26894.08,83,,percent of total billed charges,,,30782.38,95,,percent of total billed charges,,,29162.25,90,,percent of total billed charges,,,29162.25,90,,percent of total billed charges,,,26570.05,82,,percent of total billed charges,,,29162.25,90,,percent of total billed charges,,,27542.13,85,,percent of total billed charges,,24431.49,30782.38,
S&N SCREW HOLE COVER,30187529,CDM,,,270,RC,inpatient,,763,763,,647.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,575.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,648.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,671.44,88,,percent of total billed charges,,,,,,,,,582.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,694.33,91,,percent of total billed charges,,,724.85,95,,percent of total billed charges,,,633.29,83,,percent of total billed charges,,,633.29,83,,percent of total billed charges,,,,,,,,,,,,,,,633.29,83,,percent of total billed charges,,,724.85,95,,percent of total billed charges,,,686.7,90,,percent of total billed charges,,,686.7,90,,percent of total billed charges,,,625.66,82,,percent of total billed charges,,,686.7,90,,percent of total billed charges,,,648.55,85,,percent of total billed charges,,575.3,724.85,
S&N SCREW HEAD CANCELLOUS 35MM,30187530,CDM,,,278,RC,inpatient,,2450.5,2450.5,,2080.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1847.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2082.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2156.44,88,,percent of total billed charges,,,,,,,,,1872.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2229.96,91,,percent of total billed charges,,,2327.98,95,,percent of total billed charges,,,2033.92,83,,percent of total billed charges,,,2033.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2033.92,83,,percent of total billed charges,,,2327.98,95,,percent of total billed charges,,,2205.45,90,,percent of total billed charges,,,2205.45,90,,percent of total billed charges,,,2009.41,82,,percent of total billed charges,,,2205.45,90,,percent of total billed charges,,,2082.93,85,,percent of total billed charges,,1847.68,2327.98,
S&N INSERT DUAL MOBILITY 28/44MM,30187531,CDM,,,278,RC,inpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7351.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8287.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,7351.5,9262.5,
S&N LINER DUAL MOBILITY 44/56MM,30187532,CDM,,,278,RC,inpatient,,13000,13000,,11037,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9802,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11050,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11440,88,,percent of total billed charges,,,,,,,,,9932,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11830,91,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,,,,,,,,,,,,,10790,83,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,10660,82,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11050,85,,percent of total billed charges,,9802,12350,
S&N HEAD FEMORAL 14/16 28MM +4,30187533,CDM,,,278,RC,inpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7351.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8287.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,7351.5,9262.5,
ULRICH ROD LORDOSED 6.0 X 110,30187534,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
S&N STEM PRESSFIT STRAIGHT 20 X 160MM,30187535,CDM,,,278,RC,inpatient,,13193.51,13193.51,,11201.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9947.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11214.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11610.29,88,,percent of total billed charges,,,,,,,,,10079.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12006.09,91,,percent of total billed charges,,,12533.83,95,,percent of total billed charges,,,10950.61,83,,percent of total billed charges,,,10950.61,83,,percent of total billed charges,,,,,,,,,,,,,,,10950.61,83,,percent of total billed charges,,,12533.83,95,,percent of total billed charges,,,11874.16,90,,percent of total billed charges,,,11874.16,90,,percent of total billed charges,,,10818.68,82,,percent of total billed charges,,,11874.16,90,,percent of total billed charges,,,11214.48,85,,percent of total billed charges,,9947.91,12533.83,
S&N INSERT ARTICULAR SZ 7-8 11MM,30187536,CDM,,,278,RC,inpatient,,22070.88,22070.88,,18738.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16641.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18760.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19422.37,88,,percent of total billed charges,,,,,,,,,16862.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20084.5,91,,percent of total billed charges,,,20967.34,95,,percent of total billed charges,,,18318.83,83,,percent of total billed charges,,,18318.83,83,,percent of total billed charges,,,,,,,,,,,,,,,18318.83,83,,percent of total billed charges,,,20967.34,95,,percent of total billed charges,,,19863.79,90,,percent of total billed charges,,,19863.79,90,,percent of total billed charges,,,18098.12,82,,percent of total billed charges,,,19863.79,90,,percent of total billed charges,,,18760.25,85,,percent of total billed charges,,16641.44,20967.34,
S&N SCREW-ON TIBIAL WEDGE 5MM,30187537,CDM,,,278,RC,inpatient,,14723.54,14723.54,,12500.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11101.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12515.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12956.72,88,,percent of total billed charges,,,,,,,,,11248.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13398.42,91,,percent of total billed charges,,,13987.36,95,,percent of total billed charges,,,12220.54,83,,percent of total billed charges,,,12220.54,83,,percent of total billed charges,,,,,,,,,,,,,,,12220.54,83,,percent of total billed charges,,,13987.36,95,,percent of total billed charges,,,13251.19,90,,percent of total billed charges,,,13251.19,90,,percent of total billed charges,,,12073.3,82,,percent of total billed charges,,,13251.19,90,,percent of total billed charges,,,12515.01,85,,percent of total billed charges,,11101.55,13987.36,
S&N STEM PRESSFIT STRAIGHT 18 X 120MM,30187538,CDM,,,278,RC,inpatient,,12842.44,12842.44,,10903.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9683.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10916.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11301.35,88,,percent of total billed charges,,,,,,,,,9811.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11686.62,91,,percent of total billed charges,,,12200.32,95,,percent of total billed charges,,,10659.23,83,,percent of total billed charges,,,10659.23,83,,percent of total billed charges,,,,,,,,,,,,,,,10659.23,83,,percent of total billed charges,,,12200.32,95,,percent of total billed charges,,,11558.2,90,,percent of total billed charges,,,11558.2,90,,percent of total billed charges,,,10530.8,82,,percent of total billed charges,,,11558.2,90,,percent of total billed charges,,,10916.07,85,,percent of total billed charges,,9683.2,12200.32,
S&N SCREW-ON FEMORAL L-WEDGE SZ 7,30187539,CDM,,,278,RC,inpatient,,19088.03,19088.03,,16205.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14392.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16224.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16797.47,88,,percent of total billed charges,,,,,,,,,14583.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17370.11,91,,percent of total billed charges,,,18133.63,95,,percent of total billed charges,,,15843.06,83,,percent of total billed charges,,,15843.06,83,,percent of total billed charges,,,,,,,,,,,,,,,15843.06,83,,percent of total billed charges,,,18133.63,95,,percent of total billed charges,,,17179.23,90,,percent of total billed charges,,,17179.23,90,,percent of total billed charges,,,15652.18,82,,percent of total billed charges,,,17179.23,90,,percent of total billed charges,,,16224.83,85,,percent of total billed charges,,14392.37,18133.63,
S&N FEMORAL COMPONENT LEFT SZ 7,30187540,CDM,,,278,RC,inpatient,,69403.95,69403.95,,58923.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52330.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58993.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,61075.48,88,,percent of total billed charges,,,,,,,,,53024.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,63157.59,91,,percent of total billed charges,,,65933.75,95,,percent of total billed charges,,,57605.28,83,,percent of total billed charges,,,57605.28,83,,percent of total billed charges,,,,,,,,,,,,,,,57605.28,83,,percent of total billed charges,,,65933.75,95,,percent of total billed charges,,,62463.56,90,,percent of total billed charges,,,62463.56,90,,percent of total billed charges,,,56911.24,82,,percent of total billed charges,,,62463.56,90,,percent of total billed charges,,,58993.36,85,,percent of total billed charges,,52330.58,65933.75,
S&N TIBIAL BASEPLATE LEFT SZ 7,30187541,CDM,,,278,RC,inpatient,,27741.48,27741.48,,23552.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20917.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23580.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24412.5,88,,percent of total billed charges,,,,,,,,,21194.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25244.75,91,,percent of total billed charges,,,26354.41,95,,percent of total billed charges,,,23025.43,83,,percent of total billed charges,,,23025.43,83,,percent of total billed charges,,,,,,,,,,,,,,,23025.43,83,,percent of total billed charges,,,26354.41,95,,percent of total billed charges,,,24967.33,90,,percent of total billed charges,,,24967.33,90,,percent of total billed charges,,,22748.01,82,,percent of total billed charges,,,24967.33,90,,percent of total billed charges,,,23580.26,85,,percent of total billed charges,,20917.08,26354.41,
S&N SCREW-ON TIBIAL WEDGE 5MM,30187542,CDM,,,278,RC,inpatient,,14723.54,14723.54,,12500.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11101.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12515.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12956.72,88,,percent of total billed charges,,,,,,,,,11248.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13398.42,91,,percent of total billed charges,,,13987.36,95,,percent of total billed charges,,,12220.54,83,,percent of total billed charges,,,12220.54,83,,percent of total billed charges,,,,,,,,,,,,,,,12220.54,83,,percent of total billed charges,,,13987.36,95,,percent of total billed charges,,,13251.19,90,,percent of total billed charges,,,13251.19,90,,percent of total billed charges,,,12073.3,82,,percent of total billed charges,,,13251.19,90,,percent of total billed charges,,,12515.01,85,,percent of total billed charges,,11101.55,13987.36,
STRYKER CUP TRIDENT II PSL,30187544,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
STRYKER LINER TRIDENT X3,30187545,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER STEM ACCOLADE II 4X132,30187546,CDM,,,278,RC,inpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11762.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13260,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,11762.4,14820,
STRYKER HEAD FEMORAL V40,30187547,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
STRYKER TIBIA BASEPLATE TRIATHLON,30187548,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER INSERT CS #2 9MM TRIATHLON,30187549,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
ZIMMER RECIP BLADE 10X70,30187550,CDM,,,278,RC,inpatient,,303.75,303.75,,257.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,229.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,258.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,267.3,88,,percent of total billed charges,,,,,,,,,232.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,276.41,91,,percent of total billed charges,,,288.56,95,,percent of total billed charges,,,252.11,83,,percent of total billed charges,,,252.11,83,,percent of total billed charges,,,,,,,,,,,,,,,252.11,83,,percent of total billed charges,,,288.56,95,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,249.08,82,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,258.19,85,,percent of total billed charges,,229.03,288.56,
ZIMMER SAGGITAL  BLADE 13X90,30187551,CDM,,,278,RC,inpatient,,303.75,303.75,,257.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,229.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,258.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,267.3,88,,percent of total billed charges,,,,,,,,,232.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,276.41,91,,percent of total billed charges,,,288.56,95,,percent of total billed charges,,,252.11,83,,percent of total billed charges,,,252.11,83,,percent of total billed charges,,,,,,,,,,,,,,,252.11,83,,percent of total billed charges,,,288.56,95,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,249.08,82,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,258.19,85,,percent of total billed charges,,229.03,288.56,
ZIMMER INSERTER FOR UNI ART SURFACE,30187552,CDM,,,278,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
ZIMMER SCREW MIS HEADED 33MM,30187553,CDM,,,278,RC,inpatient,,535.5,535.5,,454.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,403.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,455.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,471.24,88,,percent of total billed charges,,,,,,,,,409.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,487.31,91,,percent of total billed charges,,,508.73,95,,percent of total billed charges,,,444.47,83,,percent of total billed charges,,,444.47,83,,percent of total billed charges,,,,,,,,,,,,,,,444.47,83,,percent of total billed charges,,,508.73,95,,percent of total billed charges,,,481.95,90,,percent of total billed charges,,,481.95,90,,percent of total billed charges,,,439.11,82,,percent of total billed charges,,,481.95,90,,percent of total billed charges,,,455.18,85,,percent of total billed charges,,403.77,508.73,
ZIMMER FEMUR UNI RT SZ 2,30187554,CDM,,,278,RC,inpatient,,14332.5,14332.5,,12168.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10806.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12182.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12612.6,88,,percent of total billed charges,,,,,,,,,10950.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13042.58,91,,percent of total billed charges,,,13615.88,95,,percent of total billed charges,,,11895.98,83,,percent of total billed charges,,,11895.98,83,,percent of total billed charges,,,,,,,,,,,,,,,11895.98,83,,percent of total billed charges,,,13615.88,95,,percent of total billed charges,,,12899.25,90,,percent of total billed charges,,,12899.25,90,,percent of total billed charges,,,11752.65,82,,percent of total billed charges,,,12899.25,90,,percent of total billed charges,,,12182.63,85,,percent of total billed charges,,10806.71,13615.88,
ZIMMER TIBIA UNI RT SZ. D,30187555,CDM,,,278,RC,inpatient,,9555,9555,,8112.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7204.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8121.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8408.4,88,,percent of total billed charges,,,,,,,,,7300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8695.05,91,,percent of total billed charges,,,9077.25,95,,percent of total billed charges,,,7930.65,83,,percent of total billed charges,,,7930.65,83,,percent of total billed charges,,,,,,,,,,,,,,,7930.65,83,,percent of total billed charges,,,9077.25,95,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,7835.1,82,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,8121.75,85,,percent of total billed charges,,7204.47,9077.25,
ZIMMER ART SURFACE 9MM SZ. D,30187556,CDM,,,278,RC,inpatient,,8190,8190,,6953.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6175.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6961.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7207.2,88,,percent of total billed charges,,,,,,,,,6257.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7452.9,91,,percent of total billed charges,,,7780.5,95,,percent of total billed charges,,,6797.7,83,,percent of total billed charges,,,6797.7,83,,percent of total billed charges,,,,,,,,,,,,,,,6797.7,83,,percent of total billed charges,,,7780.5,95,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,6715.8,82,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,6961.5,85,,percent of total billed charges,,6175.26,7780.5,
ZIMMER TIBIA UNI LT SZ. D,30187557,CDM,,,278,RC,inpatient,,9555,9555,,8112.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7204.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8121.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8408.4,88,,percent of total billed charges,,,,,,,,,7300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8695.05,91,,percent of total billed charges,,,9077.25,95,,percent of total billed charges,,,7930.65,83,,percent of total billed charges,,,7930.65,83,,percent of total billed charges,,,,,,,,,,,,,,,7930.65,83,,percent of total billed charges,,,9077.25,95,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,7835.1,82,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,8121.75,85,,percent of total billed charges,,7204.47,9077.25,
ZIMMER FEMUR UNI LT SZ 2,30187558,CDM,,,278,RC,inpatient,,14332.5,14332.5,,12168.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10806.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12182.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12612.6,88,,percent of total billed charges,,,,,,,,,10950.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13042.58,91,,percent of total billed charges,,,13615.88,95,,percent of total billed charges,,,11895.98,83,,percent of total billed charges,,,11895.98,83,,percent of total billed charges,,,,,,,,,,,,,,,11895.98,83,,percent of total billed charges,,,13615.88,95,,percent of total billed charges,,,12899.25,90,,percent of total billed charges,,,12899.25,90,,percent of total billed charges,,,11752.65,82,,percent of total billed charges,,,12899.25,90,,percent of total billed charges,,,12182.63,85,,percent of total billed charges,,10806.71,13615.88,
ZIMMER ART SURFACE 9MM SZ. D LT,30187559,CDM,,,278,RC,inpatient,,8190,8190,,6953.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6175.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6961.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7207.2,88,,percent of total billed charges,,,,,,,,,6257.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7452.9,91,,percent of total billed charges,,,7780.5,95,,percent of total billed charges,,,6797.7,83,,percent of total billed charges,,,6797.7,83,,percent of total billed charges,,,,,,,,,,,,,,,6797.7,83,,percent of total billed charges,,,7780.5,95,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,6715.8,82,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,6961.5,85,,percent of total billed charges,,6175.26,7780.5,
AVAFLEX BALLOON KIT 11G X 20MM,30187560,CDM,,,270,RC,inpatient,,16740.75,16740.75,,14212.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12622.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14229.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14731.86,88,,percent of total billed charges,,,,,,,,,12789.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15234.08,91,,percent of total billed charges,,,15903.71,95,,percent of total billed charges,,,13894.82,83,,percent of total billed charges,,,13894.82,83,,percent of total billed charges,,,,,,,,,,,,,,,13894.82,83,,percent of total billed charges,,,15903.71,95,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,13727.42,82,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,14229.64,85,,percent of total billed charges,,12622.53,15903.71,
ULRICH ROD LORDOSED 6.0 X 60,30187561,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ZIMMER FEMUR SZ 6 LEFT CCR,30187562,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
ZIMMER BEARING MC 13MM 6-7E/F,30187563,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
DEPUY ATTUNE TIBIA AUGMENT LM/RL SZ 5/6,30187564,CDM,,,278,RC,inpatient,,10997.61,10997.61,,9336.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8292.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9347.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9677.9,88,,percent of total billed charges,,,,,,,,,8402.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10007.83,91,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,,,,,,,,,,,,,9128.02,83,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9018.04,82,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,8292.2,10447.73,
DEPUY ATTUNE TIBIA AUGMENT RM/LL SZ 5/6,30187565,CDM,,,278,RC,inpatient,,10997.61,10997.61,,9336.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8292.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9347.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9677.9,88,,percent of total billed charges,,,,,,,,,8402.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10007.83,91,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,,,,,,,,,,,,,9128.02,83,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9018.04,82,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,8292.2,10447.73,
ULRICH BOLT ILLIAC 8.0 X 70MM,30187566,CDM,,,278,RC,inpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7106.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8011.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,7106.45,8953.75,
ULRICH BOLT ILLIAC 8.0 X 90MM,30187567,CDM,,,278,RC,inpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7106.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8011.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,7106.45,8953.75,
ULRICH ROD LORDOSED 6.0 X 80,30187568,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ULRICH WASHER,30187569,CDM,,,278,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
STRYKER SPINEJACK CASE KIT 58MM,30187570,CDM,,,270,RC,inpatient,,27072.5,27072.5,,22984.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20412.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23011.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23823.8,88,,percent of total billed charges,,,,,,,,,20683.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24635.98,91,,percent of total billed charges,,,25718.88,95,,percent of total billed charges,,,22470.18,83,,percent of total billed charges,,,22470.18,83,,percent of total billed charges,,,,,,,,,,,,,,,22470.18,83,,percent of total billed charges,,,25718.88,95,,percent of total billed charges,,,24365.25,90,,percent of total billed charges,,,24365.25,90,,percent of total billed charges,,,22199.45,82,,percent of total billed charges,,,24365.25,90,,percent of total billed charges,,,23011.63,85,,percent of total billed charges,,20412.67,25718.88,
MERIT CATHETER ONESTEP 5F 15CM,30187571,CDM,,,270,RC,inpatient,,148,148,,125.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,111.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,125.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,130.24,88,,percent of total billed charges,,,,,,,,,113.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,,,,,,,,,,,,,122.84,83,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,121.36,82,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,111.59,140.6,
ZIMMER BEARING MC SZ 10,30187572,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
WRIGHT AM SURGICAL BLADE,30187573,CDM,,,270,RC,inpatient,,7488,7488,,6357.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5645.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6364.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6589.44,88,,percent of total billed charges,,,,,,,,,5720.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6814.08,91,,percent of total billed charges,,,7113.6,95,,percent of total billed charges,,,6215.04,83,,percent of total billed charges,,,6215.04,83,,percent of total billed charges,,,,,,,,,,,,,,,6215.04,83,,percent of total billed charges,,,7113.6,95,,percent of total billed charges,,,6739.2,90,,percent of total billed charges,,,6739.2,90,,percent of total billed charges,,,6140.16,82,,percent of total billed charges,,,6739.2,90,,percent of total billed charges,,,6364.8,85,,percent of total billed charges,,5645.95,7113.6,
DEPUY STEM CORAIL KLA SZ18,30187574,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
ALLERGAN INSPIRA BREAST IMPLANT 640CC,30187575,CDM,,,278,RC,inpatient,,6675.5,6675.5,,5667.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5033.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5674.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5874.44,88,,percent of total billed charges,,,,,,,,,5100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6074.71,91,,percent of total billed charges,,,6341.73,95,,percent of total billed charges,,,5540.67,83,,percent of total billed charges,,,5540.67,83,,percent of total billed charges,,,,,,,,,,,,,,,5540.67,83,,percent of total billed charges,,,6341.73,95,,percent of total billed charges,,,6007.95,90,,percent of total billed charges,,,6007.95,90,,percent of total billed charges,,,5473.91,82,,percent of total billed charges,,,6007.95,90,,percent of total billed charges,,,5674.18,85,,percent of total billed charges,,5033.33,6341.73,
STRYKER TRIATHLON INSERT TIBIAL SZ 3 CS,30187576,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER TRIATHLON FEMUR #4 RT,30187577,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER PATELLA TRIATHLON X3 S33MM,30187578,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
STRYKER TRIATHLON INSERT TIBIAL SZ 4 CS,30187579,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
ZIMMER FEMUR TITANIUM SZ 9 RIGHT,30187580,CDM,,,278,RC,inpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14703,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16575,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,14703,18525,
ZIMMER FEMUR CR SZ 10 LEFT,30187581,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
DEPUY STEM CORAIL HIGH COL SZ 14,30187582,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
ARTHREX PEEK SWIVELOCK C 4.75X19.1MM,30187583,CDM,,,270,RC,inpatient,,2437.5,2437.5,,2069.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1837.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2071.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2145,88,,percent of total billed charges,,,,,,,,,1862.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2218.13,91,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2023.13,83,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,1998.75,82,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,1837.88,2315.63,
ARTHREX SCORPION MULTIFIRE NEEDLE,30187584,CDM,,,270,RC,inpatient,,1105,1105,,938.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,833.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,939.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,972.4,88,,percent of total billed charges,,,,,,,,,844.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1005.55,91,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,,,,,,,,,,,,,917.15,83,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,906.1,82,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,833.17,1049.75,
ARTHREX PEEK SWIVELOCK 5.5,30187586,CDM,,,270,RC,inpatient,,2437.5,2437.5,,2069.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1837.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2071.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2145,88,,percent of total billed charges,,,,,,,,,1862.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2218.13,91,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2023.13,83,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,1998.75,82,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,1837.88,2315.63,
RELIEVA TRACT BALLOON,30187587,CDM,,,270,RC,inpatient,,4517.5,4517.5,,3835.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3406.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3839.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3975.4,88,,percent of total billed charges,,,,,,,,,3451.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4110.93,91,,percent of total billed charges,,,4291.63,95,,percent of total billed charges,,,3749.53,83,,percent of total billed charges,,,3749.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3749.53,83,,percent of total billed charges,,,4291.63,95,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,3704.35,82,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,3839.88,85,,percent of total billed charges,,3406.2,4291.63,
ZIMMER TIBIA REVISION SZ H,30187588,CDM,,,278,RC,inpatient,,24033.75,24033.75,,20404.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18121.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20428.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21149.7,88,,percent of total billed charges,,,,,,,,,18361.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21870.71,91,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,,,,,,,,,,,,,19948.01,83,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,19707.68,82,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,18121.45,22832.06,
ZIMMER AUGMENT TIBIAL 10MM,30187589,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER TIBIAL CONE XS,30187590,CDM,,,278,RC,inpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36420.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41057.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,36420.56,45887.97,
ZIMMER FEMUR REVISION 11R,30187591,CDM,,,278,RC,inpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50633.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57080.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,50633.46,63795.47,
ZIMMER AUGMENT POSTERIOR 10MM,30187592,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER AUGMENT DISTAL 10MM,30187593,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER AUGMENT DISTAL FEMORAL 15MM,30187594,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER STEM STRAIGHT 20 X135,30187595,CDM,,,278,RC,inpatient,,16258.13,16258.13,,13803.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12258.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13819.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14307.15,88,,percent of total billed charges,,,,,,,,,12421.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14794.9,91,,percent of total billed charges,,,15445.22,95,,percent of total billed charges,,,13494.25,83,,percent of total billed charges,,,13494.25,83,,percent of total billed charges,,,,,,,,,,,,,,,13494.25,83,,percent of total billed charges,,,15445.22,95,,percent of total billed charges,,,14632.32,90,,percent of total billed charges,,,14632.32,90,,percent of total billed charges,,,13331.67,82,,percent of total billed charges,,,14632.32,90,,percent of total billed charges,,,13819.41,85,,percent of total billed charges,,12258.63,15445.22,
ZIMMER FEMORAL CONE SM.,30187596,CDM,,,278,RC,inpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36420.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41057.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,36420.56,45887.97,
ZIMMER INSERT CPS 10MM,30187597,CDM,,,278,RC,inpatient,,17135.63,17135.63,,14548.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12920.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14565.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15079.35,88,,percent of total billed charges,,,,,,,,,13091.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15593.42,91,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14222.57,83,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14051.22,82,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,12920.27,16278.85,
SUCTION MALLEABLE 9FR,30187599,CDM,,,270,RC,inpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1519.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1712.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,1519.31,1914.25,
BLADE INF TURB 2.9MM,30187600,CDM,,,270,RC,inpatient,,2401.1,2401.1,,2038.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1810.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2040.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2112.97,88,,percent of total billed charges,,,,,,,,,1834.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2185,91,,percent of total billed charges,,,2281.05,95,,percent of total billed charges,,,1992.91,83,,percent of total billed charges,,,1992.91,83,,percent of total billed charges,,,,,,,,,,,,,,,1992.91,83,,percent of total billed charges,,,2281.05,95,,percent of total billed charges,,,2160.99,90,,percent of total billed charges,,,2160.99,90,,percent of total billed charges,,,1968.9,82,,percent of total billed charges,,,2160.99,90,,percent of total billed charges,,,2040.94,85,,percent of total billed charges,,1810.43,2281.05,
BUR SEPTO 12DEG. CURVED,30187601,CDM,,,270,RC,inpatient,,1733.36,1733.36,,1471.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1306.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1473.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1525.36,88,,percent of total billed charges,,,,,,,,,1324.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1577.36,91,,percent of total billed charges,,,1646.69,95,,percent of total billed charges,,,1438.69,83,,percent of total billed charges,,,1438.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1438.69,83,,percent of total billed charges,,,1646.69,95,,percent of total billed charges,,,1560.02,90,,percent of total billed charges,,,1560.02,90,,percent of total billed charges,,,1421.36,82,,percent of total billed charges,,,1560.02,90,,percent of total billed charges,,,1473.36,85,,percent of total billed charges,,1306.95,1646.69,
BLADE NAVIGATION TRICUT 13CM,30187602,CDM,,,270,RC,inpatient,,2502.5,2502.5,,2124.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1886.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2127.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2202.2,88,,percent of total billed charges,,,,,,,,,1911.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2277.28,91,,percent of total billed charges,,,2377.38,95,,percent of total billed charges,,,2077.08,83,,percent of total billed charges,,,2077.08,83,,percent of total billed charges,,,,,,,,,,,,,,,2077.08,83,,percent of total billed charges,,,2377.38,95,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2052.05,82,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2127.13,85,,percent of total billed charges,,1886.89,2377.38,
IR PLATE 2 LEVEL 30MM,30187603,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
ZIMMER STEM REVISION PSN 14 X 135MM,30187604,CDM,,,278,RC,inpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18476.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20829.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,18476.77,23279.75,
ZIMMER AUGMENT TIBIAL LATERAL 10MM,30187605,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER TIBIA REVISION SZ G RIGHT,30187606,CDM,,,278,RC,inpatient,,24033.75,24033.75,,20404.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18121.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20428.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21149.7,88,,percent of total billed charges,,,,,,,,,18361.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21870.71,91,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,,,,,,,,,,,,,19948.01,83,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,19707.68,82,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,18121.45,22832.06,
S&N SCREW BIOSURE 10X25,30187612,CDM,,,278,RC,inpatient,,4091.95,4091.95,,3474.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3085.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3478.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3600.92,88,,percent of total billed charges,,,,,,,,,3126.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3723.67,91,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3396.32,83,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3355.4,82,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,3085.33,3887.35,
STRYKER CUP TRIDENT II 54E,30187613,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
STRYKER INSERT TRIDENT 36MM ID,30187614,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER STEM ACCOLADE II SZ. 6,30187615,CDM,,,278,RC,inpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11762.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13260,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,11762.4,14820,
STRYKER HEAD DETAL CERAMIC 36MM,30187616,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
IR INTERBODY PEEK 8MM 6DEG,30187617,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
IR INTERBODY PEEK 6MM 6DEG,30187618,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
STRYKER SHAVER TOMCAT 4.0,30187619,CDM,,,270,RC,inpatient,,466.27,466.27,,395.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,351.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.32,88,,percent of total billed charges,,,,,,,,,356.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.31,91,,percent of total billed charges,,,442.96,95,,percent of total billed charges,,,387,83,,percent of total billed charges,,,387,83,,percent of total billed charges,,,,,,,,,,,,,,,387,83,,percent of total billed charges,,,442.96,95,,percent of total billed charges,,,419.64,90,,percent of total billed charges,,,419.64,90,,percent of total billed charges,,,382.34,82,,percent of total billed charges,,,419.64,90,,percent of total billed charges,,,396.33,85,,percent of total billed charges,,351.57,442.96,
ALAMO TIBIALIS TENDON FF 1.05 X 28.9CM,30187620,CDM,,,278,RC,inpatient,,11570,11570,,9822.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8723.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9834.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10181.6,88,,percent of total billed charges,,,,,,,,,8839.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10528.7,91,,percent of total billed charges,,,10991.5,95,,percent of total billed charges,,,9603.1,83,,percent of total billed charges,,,9603.1,83,,percent of total billed charges,,,,,,,,,,,,,,,9603.1,83,,percent of total billed charges,,,10991.5,95,,percent of total billed charges,,,10413,90,,percent of total billed charges,,,10413,90,,percent of total billed charges,,,9487.4,82,,percent of total billed charges,,,10413,90,,percent of total billed charges,,,9834.5,85,,percent of total billed charges,,8723.78,10991.5,
SYNTHES SCREW CORTEX S-T 4.5X18MM,30187621,CDM,,,278,RC,inpatient,,277.28,277.28,,235.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,235.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.01,88,,percent of total billed charges,,,,,,,,,211.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.32,91,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,,,,,,,,,,,,,230.14,83,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,227.37,82,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,209.07,263.42,
ULRICH ROD LORDOSED 6.0 X 40MM,30187622,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ZIMMER BEARING 10MM 8-11EF,30187623,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
DEPUY TRUMATCH BLOCK,30187625,CDM,,,278,RC,inpatient,,8833.5,8833.5,,7499.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6660.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7508.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7773.48,88,,percent of total billed charges,,,,,,,,,6748.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8038.49,91,,percent of total billed charges,,,8391.83,95,,percent of total billed charges,,,7331.81,83,,percent of total billed charges,,,7331.81,83,,percent of total billed charges,,,,,,,,,,,,,,,7331.81,83,,percent of total billed charges,,,8391.83,95,,percent of total billed charges,,,7950.15,90,,percent of total billed charges,,,7950.15,90,,percent of total billed charges,,,7243.47,82,,percent of total billed charges,,,7950.15,90,,percent of total billed charges,,,7508.48,85,,percent of total billed charges,,6660.46,8391.83,
ULRICH BOLT ILIAC 9.0 X 80MM,30187626,CDM,,,278,RC,inpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7106.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8011.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,7106.45,8953.75,
SCREW LATERAL MASS 24 X 4.0MM,30187627,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
ROD STRAIGHT 3.5 X 30MM,30187628,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
IR TAP 4.0,30187629,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
IR DRILL BIT 2.5,30187630,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
ARTHREX TRIMANO BEACH CHAIR KIT,30187631,CDM,,,270,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
STENT TRIA SOFT 7F X 24CM,30187632,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
GLIDEWIRE UROLOGIC ANGLED .89MM,30187633,CDM,,,270,RC,inpatient,,404.25,404.25,,343.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,304.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,343.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,355.74,88,,percent of total billed charges,,,,,,,,,308.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,367.87,91,,percent of total billed charges,,,384.04,95,,percent of total billed charges,,,335.53,83,,percent of total billed charges,,,335.53,83,,percent of total billed charges,,,,,,,,,,,,,,,335.53,83,,percent of total billed charges,,,384.04,95,,percent of total billed charges,,,363.83,90,,percent of total billed charges,,,363.83,90,,percent of total billed charges,,,331.49,82,,percent of total billed charges,,,363.83,90,,percent of total billed charges,,,343.61,85,,percent of total billed charges,,304.8,384.04,
STRYKER FEMUR TRIATHLON CR RT SZ 6,30187637,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER PATELLA TRIATHLON X3,30187638,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
STRYKER TIBIA BASEPLATE SZ 5,30187639,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER INSERT TRIATHLON CS #5 10MM,30187640,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
DEPUY CEMENTRALIZER 13.0,30187641,CDM,,,270,RC,inpatient,,919.36,919.36,,780.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,693.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,781.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,809.04,88,,percent of total billed charges,,,,,,,,,702.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,836.62,91,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,,,,,,,,,,,,,763.07,83,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,753.88,82,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,781.46,85,,percent of total billed charges,,693.2,873.39,
BOSTON TUNNEL WC TOOL,30187642,CDM,,,270,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
BOSTON OR CABLE 2X80,30187643,CDM,,,270,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
SYNTHES SCREW EXP 6.35  TI POLY 6X50MM,30187644,CDM,,,278,RC,inpatient,,14449.5,14449.5,,12267.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10894.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12282.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12715.56,88,,percent of total billed charges,,,,,,,,,11039.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13149.05,91,,percent of total billed charges,,,13727.03,95,,percent of total billed charges,,,11993.09,83,,percent of total billed charges,,,11993.09,83,,percent of total billed charges,,,,,,,,,,,,,,,11993.09,83,,percent of total billed charges,,,13727.03,95,,percent of total billed charges,,,13004.55,90,,percent of total billed charges,,,13004.55,90,,percent of total billed charges,,,11848.59,82,,percent of total billed charges,,,13004.55,90,,percent of total billed charges,,,12282.08,85,,percent of total billed charges,,10894.92,13727.03,
SYNTHES SCREW EXP 6.35  TI POLY 7X50MM,30187645,CDM,,,278,RC,inpatient,,14449.5,14449.5,,12267.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10894.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12282.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12715.56,88,,percent of total billed charges,,,,,,,,,11039.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13149.05,91,,percent of total billed charges,,,13727.03,95,,percent of total billed charges,,,11993.09,83,,percent of total billed charges,,,11993.09,83,,percent of total billed charges,,,,,,,,,,,,,,,11993.09,83,,percent of total billed charges,,,13727.03,95,,percent of total billed charges,,,13004.55,90,,percent of total billed charges,,,13004.55,90,,percent of total billed charges,,,11848.59,82,,percent of total billed charges,,,13004.55,90,,percent of total billed charges,,,12282.08,85,,percent of total billed charges,,10894.92,13727.03,
SYNTHES ROD PRE-LORD TI 45MM,30187646,CDM,,,278,RC,inpatient,,4660.53,4660.53,,3956.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3514.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3961.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4101.27,88,,percent of total billed charges,,,,,,,,,3560.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4241.08,91,,percent of total billed charges,,,4427.5,95,,percent of total billed charges,,,3868.24,83,,percent of total billed charges,,,3868.24,83,,percent of total billed charges,,,,,,,,,,,,,,,3868.24,83,,percent of total billed charges,,,4427.5,95,,percent of total billed charges,,,4194.48,90,,percent of total billed charges,,,4194.48,90,,percent of total billed charges,,,3821.63,82,,percent of total billed charges,,,4194.48,90,,percent of total billed charges,,,3961.45,85,,percent of total billed charges,,3514.04,4427.5,
SYNTHES SCREW SET EXP 635 TI SI,30187647,CDM,,,278,RC,inpatient,,2879.5,2879.5,,2444.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2171.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2447.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2533.96,88,,percent of total billed charges,,,,,,,,,2199.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2620.35,91,,percent of total billed charges,,,2735.53,95,,percent of total billed charges,,,2389.99,83,,percent of total billed charges,,,2389.99,83,,percent of total billed charges,,,,,,,,,,,,,,,2389.99,83,,percent of total billed charges,,,2735.53,95,,percent of total billed charges,,,2591.55,90,,percent of total billed charges,,,2591.55,90,,percent of total billed charges,,,2361.19,82,,percent of total billed charges,,,2591.55,90,,percent of total billed charges,,,2447.58,85,,percent of total billed charges,,2171.14,2735.53,
STRYKER PATELLA TRIATHLON SYMMETRIC X3,30187649,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
STRYKER TIBIA BASEPLATE CEMENTED,30187650,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER FEMUR CR TRIATHLON CEMENTED,30187651,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER INSERT CS #4 10MM,30187652,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER BASEPLATE TIBIAL SZ 3,30187653,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
STRYKER TRIATHLON FEMUR SZ 3 RT,30187654,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER INSERT TRIATHLON CS SZ 3 11MM,30187655,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER TRIATHLON FEMUR #4 LFT,30187656,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER INSERT TRIATHLON CS SZ 3 9MM,30187657,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
PATIENT TRIAL KIT 72,30187658,CDM,,,270,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
ZIMMER BEARING MC 11MM 6-7E/F,30187659,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ZIMMER FEMUR POROUS CR SZ 7 LFT,30187660,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER TIBIA POROUS SZ E LFT,30187661,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER FEMUR POROUS CR SZ 8 RT,30187662,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER TIBIA POROUS SZ E RT,30187663,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
STRYKER STEM ACCOLADE II SZ. 5,30187664,CDM,,,278,RC,inpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11762.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13260,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,11762.4,14820,
STRYKER HEAD UHR 48X28MM,30187665,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
STRYKER HEAD FEMORAL LFIT 28MM,30187666,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
LAPAROVUE VISIBILITY SYSTEM,30187667,CDM,,,270,RC,inpatient,,286.43,286.43,,243.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,215.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,243.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,252.06,88,,percent of total billed charges,,,,,,,,,218.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,260.65,91,,percent of total billed charges,,,272.11,95,,percent of total billed charges,,,237.74,83,,percent of total billed charges,,,237.74,83,,percent of total billed charges,,,,,,,,,,,,,,,237.74,83,,percent of total billed charges,,,272.11,95,,percent of total billed charges,,,257.79,90,,percent of total billed charges,,,257.79,90,,percent of total billed charges,,,234.87,82,,percent of total billed charges,,,257.79,90,,percent of total billed charges,,,243.47,85,,percent of total billed charges,,215.97,272.11,
ELECTRO LUBE ANTI-STICK SOLUTION,30187671,CDM,,,270,RC,inpatient,,223.88,223.88,,190.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,190.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,197.01,88,,percent of total billed charges,,,,,,,,,171.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.73,91,,percent of total billed charges,,,212.69,95,,percent of total billed charges,,,185.82,83,,percent of total billed charges,,,185.82,83,,percent of total billed charges,,,,,,,,,,,,,,,185.82,83,,percent of total billed charges,,,212.69,95,,percent of total billed charges,,,201.49,90,,percent of total billed charges,,,201.49,90,,percent of total billed charges,,,183.58,82,,percent of total billed charges,,,201.49,90,,percent of total billed charges,,,190.3,85,,percent of total billed charges,,168.81,212.69,
COOPER KOH-EFFICIENT 2.5CM,30187672,CDM,,,270,RC,inpatient,,912.74,912.74,,774.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,688.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,775.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,803.21,88,,percent of total billed charges,,,,,,,,,697.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,830.59,91,,percent of total billed charges,,,867.1,95,,percent of total billed charges,,,757.57,83,,percent of total billed charges,,,757.57,83,,percent of total billed charges,,,,,,,,,,,,,,,757.57,83,,percent of total billed charges,,,867.1,95,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,748.45,82,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,775.83,85,,percent of total billed charges,,688.21,867.1,
COOPER KOH-EFFICIENT 3.0CM,30187673,CDM,,,270,RC,inpatient,,912.74,912.74,,774.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,688.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,775.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,803.21,88,,percent of total billed charges,,,,,,,,,697.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,830.59,91,,percent of total billed charges,,,867.1,95,,percent of total billed charges,,,757.57,83,,percent of total billed charges,,,757.57,83,,percent of total billed charges,,,,,,,,,,,,,,,757.57,83,,percent of total billed charges,,,867.1,95,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,748.45,82,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,775.83,85,,percent of total billed charges,,688.21,867.1,
COOPER KOH-EFFICIENT 3.5CM,30187674,CDM,,,270,RC,inpatient,,912.74,912.74,,774.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,688.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,775.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,803.21,88,,percent of total billed charges,,,,,,,,,697.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,830.59,91,,percent of total billed charges,,,867.1,95,,percent of total billed charges,,,757.57,83,,percent of total billed charges,,,757.57,83,,percent of total billed charges,,,,,,,,,,,,,,,757.57,83,,percent of total billed charges,,,867.1,95,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,748.45,82,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,775.83,85,,percent of total billed charges,,688.21,867.1,
COOPER KOH-EFFICIENT 4.0CM,30187675,CDM,,,270,RC,inpatient,,1030.26,1030.26,,874.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,776.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,875.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,906.63,88,,percent of total billed charges,,,,,,,,,787.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,937.54,91,,percent of total billed charges,,,978.75,95,,percent of total billed charges,,,855.12,83,,percent of total billed charges,,,855.12,83,,percent of total billed charges,,,,,,,,,,,,,,,855.12,83,,percent of total billed charges,,,978.75,95,,percent of total billed charges,,,927.23,90,,percent of total billed charges,,,927.23,90,,percent of total billed charges,,,844.81,82,,percent of total billed charges,,,927.23,90,,percent of total billed charges,,,875.72,85,,percent of total billed charges,,776.82,978.75,
COOPER RUMI TIP YELLOW,30187676,CDM,,,270,RC,inpatient,,456.26,456.26,,387.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,344.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,387.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,401.51,88,,percent of total billed charges,,,,,,,,,348.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,415.2,91,,percent of total billed charges,,,433.45,95,,percent of total billed charges,,,378.7,83,,percent of total billed charges,,,378.7,83,,percent of total billed charges,,,,,,,,,,,,,,,378.7,83,,percent of total billed charges,,,433.45,95,,percent of total billed charges,,,410.63,90,,percent of total billed charges,,,410.63,90,,percent of total billed charges,,,374.13,82,,percent of total billed charges,,,410.63,90,,percent of total billed charges,,,387.82,85,,percent of total billed charges,,344.02,433.45,
COOPER RUMI TIP LAVENDER,30187677,CDM,,,270,RC,inpatient,,456.26,456.26,,387.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,344.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,387.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,401.51,88,,percent of total billed charges,,,,,,,,,348.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,415.2,91,,percent of total billed charges,,,433.45,95,,percent of total billed charges,,,378.7,83,,percent of total billed charges,,,378.7,83,,percent of total billed charges,,,,,,,,,,,,,,,378.7,83,,percent of total billed charges,,,433.45,95,,percent of total billed charges,,,410.63,90,,percent of total billed charges,,,410.63,90,,percent of total billed charges,,,374.13,82,,percent of total billed charges,,,410.63,90,,percent of total billed charges,,,387.82,85,,percent of total billed charges,,344.02,433.45,
COOPER RUMI TIP WHITE,30187678,CDM,,,270,RC,inpatient,,479.08,479.08,,406.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,361.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,407.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,421.59,88,,percent of total billed charges,,,,,,,,,366.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,435.96,91,,percent of total billed charges,,,455.13,95,,percent of total billed charges,,,397.64,83,,percent of total billed charges,,,397.64,83,,percent of total billed charges,,,,,,,,,,,,,,,397.64,83,,percent of total billed charges,,,455.13,95,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,392.85,82,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,407.22,85,,percent of total billed charges,,361.23,455.13,
COOPER RUMI TIP BLUE,30187679,CDM,,,270,RC,inpatient,,479.08,479.08,,406.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,361.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,407.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,421.59,88,,percent of total billed charges,,,,,,,,,366.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,435.96,91,,percent of total billed charges,,,455.13,95,,percent of total billed charges,,,397.64,83,,percent of total billed charges,,,397.64,83,,percent of total billed charges,,,,,,,,,,,,,,,397.64,83,,percent of total billed charges,,,455.13,95,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,392.85,82,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,407.22,85,,percent of total billed charges,,361.23,455.13,
COOPER RUMI TIP GREEN,30187680,CDM,,,270,RC,inpatient,,479.08,479.08,,406.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,361.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,407.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,421.59,88,,percent of total billed charges,,,,,,,,,366.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,435.96,91,,percent of total billed charges,,,455.13,95,,percent of total billed charges,,,397.64,83,,percent of total billed charges,,,397.64,83,,percent of total billed charges,,,,,,,,,,,,,,,397.64,83,,percent of total billed charges,,,455.13,95,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,392.85,82,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,407.22,85,,percent of total billed charges,,361.23,455.13,
COOPER RUMI TIP ORANGE,30187681,CDM,,,270,RC,inpatient,,479.08,479.08,,406.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,361.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,407.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,421.59,88,,percent of total billed charges,,,,,,,,,366.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,435.96,91,,percent of total billed charges,,,455.13,95,,percent of total billed charges,,,397.64,83,,percent of total billed charges,,,397.64,83,,percent of total billed charges,,,,,,,,,,,,,,,397.64,83,,percent of total billed charges,,,455.13,95,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,392.85,82,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,407.22,85,,percent of total billed charges,,361.23,455.13,
COOPER GYNECOLOGY KIT,30187682,CDM,,,270,RC,inpatient,,962.72,962.72,,817.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,725.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,818.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,847.19,88,,percent of total billed charges,,,,,,,,,735.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,876.08,91,,percent of total billed charges,,,914.58,95,,percent of total billed charges,,,799.06,83,,percent of total billed charges,,,799.06,83,,percent of total billed charges,,,,,,,,,,,,,,,799.06,83,,percent of total billed charges,,,914.58,95,,percent of total billed charges,,,866.45,90,,percent of total billed charges,,,866.45,90,,percent of total billed charges,,,789.43,82,,percent of total billed charges,,,866.45,90,,percent of total billed charges,,,818.31,85,,percent of total billed charges,,725.89,914.58,
INTUITIVE CANNULA SEAL 5-8MM,30187685,CDM,,,270,RC,inpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,108.58,136.8,
INTUITIVE OBTURATOR BLADELESS 8MM,30187686,CDM,,,270,RC,inpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,169.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,191.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,169.65,213.75,
INTUITIVE TIP COVER ACCESSORY,30187687,CDM,,,270,RC,inpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,120.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,120.64,152,
TRI-LUMEN TUBESET W/FILTER,30187688,CDM,,,270,RC,inpatient,,844.97,844.97,,717.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,637.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,718.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,743.57,88,,percent of total billed charges,,,,,,,,,645.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,768.92,91,,percent of total billed charges,,,802.72,95,,percent of total billed charges,,,701.33,83,,percent of total billed charges,,,701.33,83,,percent of total billed charges,,,,,,,,,,,,,,,701.33,83,,percent of total billed charges,,,802.72,95,,percent of total billed charges,,,760.47,90,,percent of total billed charges,,,760.47,90,,percent of total billed charges,,,692.88,82,,percent of total billed charges,,,760.47,90,,percent of total billed charges,,,718.22,85,,percent of total billed charges,,637.11,802.72,
TROCAR 8MM ACCESS PORT AIRSEAL,30187689,CDM,,,270,RC,inpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,633.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,714,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,633.36,798,
TROCAR 5MM ACCESS PORT AIRSEAL,30187690,CDM,,,270,RC,inpatient,,819,819,,695.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,617.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,696.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,720.72,88,,percent of total billed charges,,,,,,,,,625.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,745.29,91,,percent of total billed charges,,,778.05,95,,percent of total billed charges,,,679.77,83,,percent of total billed charges,,,679.77,83,,percent of total billed charges,,,,,,,,,,,,,,,679.77,83,,percent of total billed charges,,,778.05,95,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,671.58,82,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,696.15,85,,percent of total billed charges,,617.53,778.05,
ARTHREX DRILL 6MM CANNULATED,30187691,CDM,,,270,RC,inpatient,,1092,1092,,927.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,823.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,928.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,960.96,88,,percent of total billed charges,,,,,,,,,834.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,993.72,91,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,,,,,,,,,,,,,906.36,83,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,895.44,82,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,928.2,85,,percent of total billed charges,,823.37,1037.4,
ARTHREX PIN GLENOID 2.8MM NITINOL,30187692,CDM,,,278,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
ARTHREX STEM HUMERAL SZ 10,30187693,CDM,,,278,RC,inpatient,,16152.5,16152.5,,13713.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12178.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13729.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14214.2,88,,percent of total billed charges,,,,,,,,,12340.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14698.78,91,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,,,,,,,,,,,,,13406.58,83,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13245.05,82,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,12178.99,15344.88,
ARTHREX CUP SUTURE 36 +2 RIGHT,30187694,CDM,,,278,RC,inpatient,,11602.5,11602.5,,9850.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8748.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9862.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10210.2,88,,percent of total billed charges,,,,,,,,,8864.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10558.28,91,,percent of total billed charges,,,11022.38,95,,percent of total billed charges,,,9630.08,83,,percent of total billed charges,,,9630.08,83,,percent of total billed charges,,,,,,,,,,,,,,,9630.08,83,,percent of total billed charges,,,11022.38,95,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,9514.05,82,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,9862.13,85,,percent of total billed charges,,8748.29,11022.38,
ARTHREX INSERT HUMERAL S/36 +3,30187695,CDM,,,278,RC,inpatient,,6597.5,6597.5,,5601.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4974.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5607.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5805.8,88,,percent of total billed charges,,,,,,,,,5040.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6003.73,91,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,,,,,,,,,,,,,5475.93,83,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5409.95,82,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5607.88,85,,percent of total billed charges,,4974.52,6267.63,
ARTHREX SCREW NON-LOCKING 4.5 X 32MM,30187696,CDM,,,278,RC,inpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,633.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,714,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,633.36,798,
ARTHREX SCREW NON-LOCKING 4.5 X 36MM,30187697,CDM,,,278,RC,inpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,633.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,714,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,633.36,798,
ARTHREX GLENOSPHERE 36/24,30187698,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
ARTHREX BASEPLATE 24MM FULL AUGMENT +2,30187699,CDM,,,278,RC,inpatient,,20800,20800,,17659.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15683.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17680,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18304,88,,percent of total billed charges,,,,,,,,,15891.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18928,91,,percent of total billed charges,,,19760,95,,percent of total billed charges,,,17264,83,,percent of total billed charges,,,17264,83,,percent of total billed charges,,,,,,,,,,,,,,,17264,83,,percent of total billed charges,,,19760,95,,percent of total billed charges,,,18720,90,,percent of total billed charges,,,18720,90,,percent of total billed charges,,,17056,82,,percent of total billed charges,,,18720,90,,percent of total billed charges,,,17680,85,,percent of total billed charges,,15683.2,19760,
ARTHREX POST MODULAR 30MM,30187700,CDM,,,278,RC,inpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7106.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8011.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,7106.45,8953.75,
ARTHREX PIN SET GLENOID SYSTEM,30187701,CDM,,,278,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
ARTHREX DRILL BIT 3.0MM,30187702,CDM,,,270,RC,inpatient,,1241.5,1241.5,,1054.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,936.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1055.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1092.52,88,,percent of total billed charges,,,,,,,,,948.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1129.77,91,,percent of total billed charges,,,1179.43,95,,percent of total billed charges,,,1030.45,83,,percent of total billed charges,,,1030.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1030.45,83,,percent of total billed charges,,,1179.43,95,,percent of total billed charges,,,1117.35,90,,percent of total billed charges,,,1117.35,90,,percent of total billed charges,,,1018.03,82,,percent of total billed charges,,,1117.35,90,,percent of total billed charges,,,1055.28,85,,percent of total billed charges,,936.09,1179.43,
ARTHREX REAMER HEAD ANGLED S,30187703,CDM,,,278,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
ARTHREX STEM HUMERAL REVERS SZ 8,30187704,CDM,,,278,RC,inpatient,,16152.5,16152.5,,13713.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12178.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13729.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14214.2,88,,percent of total billed charges,,,,,,,,,12340.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14698.78,91,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,,,,,,,,,,,,,13406.58,83,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13245.05,82,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,12178.99,15344.88,
ARTHREX CUP SUTURE 36 NEUTRAL,30187705,CDM,,,278,RC,inpatient,,11602.5,11602.5,,9850.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8748.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9862.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10210.2,88,,percent of total billed charges,,,,,,,,,8864.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10558.28,91,,percent of total billed charges,,,11022.38,95,,percent of total billed charges,,,9630.08,83,,percent of total billed charges,,,9630.08,83,,percent of total billed charges,,,,,,,,,,,,,,,9630.08,83,,percent of total billed charges,,,11022.38,95,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,9514.05,82,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,9862.13,85,,percent of total billed charges,,8748.29,11022.38,
ARTHREX INSERT HUMERAL S/36 +6,30187706,CDM,,,278,RC,inpatient,,6597.5,6597.5,,5601.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4974.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5607.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5805.8,88,,percent of total billed charges,,,,,,,,,5040.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6003.73,91,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,,,,,,,,,,,,,5475.93,83,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5409.95,82,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5607.88,85,,percent of total billed charges,,4974.52,6267.63,
ARTHREX BASEPLATE 24MM MODULAR +2 LAT,30187707,CDM,,,278,RC,inpatient,,14300,14300,,12140.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10782.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12155,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12584,88,,percent of total billed charges,,,,,,,,,10925.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13013,91,,percent of total billed charges,,,13585,95,,percent of total billed charges,,,11869,83,,percent of total billed charges,,,11869,83,,percent of total billed charges,,,,,,,,,,,,,,,11869,83,,percent of total billed charges,,,13585,95,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,11726,82,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,12155,85,,percent of total billed charges,,10782.2,13585,
ARTHREX SCREW CENTRAL MODULAR 25MM,30187708,CDM,,,278,RC,inpatient,,6175,6175,,5242.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4655.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5248.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5434,88,,percent of total billed charges,,,,,,,,,4717.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5619.25,91,,percent of total billed charges,,,5866.25,95,,percent of total billed charges,,,5125.25,83,,percent of total billed charges,,,5125.25,83,,percent of total billed charges,,,,,,,,,,,,,,,5125.25,83,,percent of total billed charges,,,5866.25,95,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5063.5,82,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5248.75,85,,percent of total billed charges,,4655.95,5866.25,
ARTHREX SCREW LOCKING 5.5 X 28MM,30187709,CDM,,,278,RC,inpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,633.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,714,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,633.36,798,
ARTHREX GLENOSPHERE 36 +4 LAT/24,30187710,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
ARTHREX SCREW GLENOSPHERE,30187711,CDM,,,278,RC,inpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,633.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,714,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,633.36,798,
ARTHREX DRILL BIT 3.0MM MGS STERILE,30187712,CDM,,,270,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
ARTHREX GLENIOD CALIBRATOR 3D,30187713,CDM,,,270,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
SYNTHES PLATE HUMERUS PERIARTIC 3.5MM,30187715,CDM,,,278,RC,inpatient,,19583.2,19583.2,,16626.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14765.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16645.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17233.22,88,,percent of total billed charges,,,,,,,,,14961.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17820.71,91,,percent of total billed charges,,,18604.04,95,,percent of total billed charges,,,16254.06,83,,percent of total billed charges,,,16254.06,83,,percent of total billed charges,,,,,,,,,,,,,,,16254.06,83,,percent of total billed charges,,,18604.04,95,,percent of total billed charges,,,17624.88,90,,percent of total billed charges,,,17624.88,90,,percent of total billed charges,,,16058.22,82,,percent of total billed charges,,,17624.88,90,,percent of total billed charges,,,16645.72,85,,percent of total billed charges,,14765.73,18604.04,
SYNTHES CABLE 1.0 W/CRIMP 750MM,30187716,CDM,,,278,RC,inpatient,,4941.24,4941.24,,4195.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3725.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4200.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4348.29,88,,percent of total billed charges,,,,,,,,,3775.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4496.53,91,,percent of total billed charges,,,4694.18,95,,percent of total billed charges,,,4101.23,83,,percent of total billed charges,,,4101.23,83,,percent of total billed charges,,,,,,,,,,,,,,,4101.23,83,,percent of total billed charges,,,4694.18,95,,percent of total billed charges,,,4447.12,90,,percent of total billed charges,,,4447.12,90,,percent of total billed charges,,,4051.82,82,,percent of total billed charges,,,4447.12,90,,percent of total billed charges,,,4200.05,85,,percent of total billed charges,,3725.69,4694.18,
IR PLATE 12MM,30187717,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
STRYKER PULSE LAVAGE EXTENDED TIP,30187718,CDM,,,270,RC,inpatient,,100.4,100.4,,85.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88.35,88,,percent of total billed charges,,,,,,,,,76.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91.36,91,,percent of total billed charges,,,95.38,95,,percent of total billed charges,,,83.33,83,,percent of total billed charges,,,83.33,83,,percent of total billed charges,,,,,,,,,,,,,,,83.33,83,,percent of total billed charges,,,95.38,95,,percent of total billed charges,,,90.36,90,,percent of total billed charges,,,90.36,90,,percent of total billed charges,,,82.33,82,,percent of total billed charges,,,90.36,90,,percent of total billed charges,,,85.34,85,,percent of total billed charges,,75.7,95.38,
STRYKER HIP PRESSURIZER,30187719,CDM,,,270,RC,inpatient,,121.84,121.84,,103.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,103.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,107.22,88,,percent of total billed charges,,,,,,,,,93.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,110.87,91,,percent of total billed charges,,,115.75,95,,percent of total billed charges,,,101.13,83,,percent of total billed charges,,,101.13,83,,percent of total billed charges,,,,,,,,,,,,,,,101.13,83,,percent of total billed charges,,,115.75,95,,percent of total billed charges,,,109.66,90,,percent of total billed charges,,,109.66,90,,percent of total billed charges,,,99.91,82,,percent of total billed charges,,,109.66,90,,percent of total billed charges,,,103.56,85,,percent of total billed charges,,91.87,115.75,
ZIMMER FEMUR CR SZ 6 RIGHT,30187720,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
BOSTON CAPIO SUTURE TC NEEDLE 26MM,30187721,CDM,,,270,RC,inpatient,,364.88,364.88,,309.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,275.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,310.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,321.09,88,,percent of total billed charges,,,,,,,,,278.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,332.04,91,,percent of total billed charges,,,346.64,95,,percent of total billed charges,,,302.85,83,,percent of total billed charges,,,302.85,83,,percent of total billed charges,,,,,,,,,,,,,,,302.85,83,,percent of total billed charges,,,346.64,95,,percent of total billed charges,,,328.39,90,,percent of total billed charges,,,328.39,90,,percent of total billed charges,,,299.2,82,,percent of total billed charges,,,328.39,90,,percent of total billed charges,,,310.15,85,,percent of total billed charges,,275.12,346.64,
BOSTON CAPIO SUTURE MONODECK TC NEEDLE 2,30187722,CDM,,,270,RC,inpatient,,364.88,364.88,,309.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,275.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,310.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,321.09,88,,percent of total billed charges,,,,,,,,,278.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,332.04,91,,percent of total billed charges,,,346.64,95,,percent of total billed charges,,,302.85,83,,percent of total billed charges,,,302.85,83,,percent of total billed charges,,,,,,,,,,,,,,,302.85,83,,percent of total billed charges,,,346.64,95,,percent of total billed charges,,,328.39,90,,percent of total billed charges,,,328.39,90,,percent of total billed charges,,,299.2,82,,percent of total billed charges,,,328.39,90,,percent of total billed charges,,,310.15,85,,percent of total billed charges,,275.12,346.64,
S&N SCREW REGENESORB 9X25,30187723,CDM,,,270,RC,inpatient,,4091.95,4091.95,,3474.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3085.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3478.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3600.92,88,,percent of total billed charges,,,,,,,,,3126.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3723.67,91,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3396.32,83,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3355.4,82,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,3085.33,3887.35,
SYNTHES PLATE LCP CLAVICLE 2.7 VA RIGHT,30187724,CDM,,,278,RC,inpatient,,10635.63,10635.63,,9029.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8019.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9040.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9359.35,88,,percent of total billed charges,,,,,,,,,8125.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9678.42,91,,percent of total billed charges,,,10103.85,95,,percent of total billed charges,,,8827.57,83,,percent of total billed charges,,,8827.57,83,,percent of total billed charges,,,,,,,,,,,,,,,8827.57,83,,percent of total billed charges,,,10103.85,95,,percent of total billed charges,,,9572.07,90,,percent of total billed charges,,,9572.07,90,,percent of total billed charges,,,8721.22,82,,percent of total billed charges,,,9572.07,90,,percent of total billed charges,,,9040.29,85,,percent of total billed charges,,8019.27,10103.85,
AERIN RHINAER STYLUS,30187725,CDM,,,270,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
DEPUY ATTUNE FEMUR CRS 3MM LEFT,30187726,CDM,,,278,RC,inpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39636.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44683.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,39636.69,49940.13,
DEPUY ATTUNE INSERT PS FB SZ 3 7MM,30187727,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
STRYKER FEMUR CR TRIATHLON CEMENTED SZ 5,30187728,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER INSERT TRIATHLON CS #4 9MM,30187729,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER PATELLA TRIATHLON X3 32MM,30187730,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
SYNTHES TFNA HELICAL BLADE 75MM,30187731,CDM,,,278,RC,inpatient,,7033.78,7033.78,,5971.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5303.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5978.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6189.73,88,,percent of total billed charges,,,,,,,,,5373.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6400.74,91,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,,,,,,,,,,,,,5838.04,83,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5767.7,82,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5978.71,85,,percent of total billed charges,,5303.47,6682.09,
SYNTHES SCREW LOCKING 5.0MM X 26MM,30187732,CDM,,,278,RC,inpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1697.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1913.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,1697.12,2138.28,
STRYKER SHAVER CROSSBLADE SMOOTH 3.5MM,30187740,CDM,,,270,RC,inpatient,,640.01,640.01,,543.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,482.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,544.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,563.21,88,,percent of total billed charges,,,,,,,,,488.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,582.41,91,,percent of total billed charges,,,608.01,95,,percent of total billed charges,,,531.21,83,,percent of total billed charges,,,531.21,83,,percent of total billed charges,,,,,,,,,,,,,,,531.21,83,,percent of total billed charges,,,608.01,95,,percent of total billed charges,,,576.01,90,,percent of total billed charges,,,576.01,90,,percent of total billed charges,,,524.81,82,,percent of total billed charges,,,576.01,90,,percent of total billed charges,,,544.01,85,,percent of total billed charges,,482.57,608.01,
S&N FEMORAL COMPONENT SZ 2 RIGHT MED,30187741,CDM,,,278,RC,inpatient,,27182.29,27182.29,,23077.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20495.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23104.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23920.42,88,,percent of total billed charges,,,,,,,,,20767.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24735.88,91,,percent of total billed charges,,,25823.18,95,,percent of total billed charges,,,22561.3,83,,percent of total billed charges,,,22561.3,83,,percent of total billed charges,,,,,,,,,,,,,,,22561.3,83,,percent of total billed charges,,,25823.18,95,,percent of total billed charges,,,24464.06,90,,percent of total billed charges,,,24464.06,90,,percent of total billed charges,,,22289.48,82,,percent of total billed charges,,,24464.06,90,,percent of total billed charges,,,23104.95,85,,percent of total billed charges,,20495.45,25823.18,
S&N INSERT TIBIAL 8MM SZ 1-2,30187742,CDM,,,278,RC,inpatient,,6855.94,6855.94,,5820.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5169.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5827.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6033.23,88,,percent of total billed charges,,,,,,,,,5237.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6238.91,91,,percent of total billed charges,,,6513.14,95,,percent of total billed charges,,,5690.43,83,,percent of total billed charges,,,5690.43,83,,percent of total billed charges,,,,,,,,,,,,,,,5690.43,83,,percent of total billed charges,,,6513.14,95,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,5621.87,82,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,5827.55,85,,percent of total billed charges,,5169.38,6513.14,
S&N BASE TIBIAL SZ1 41MM,30187743,CDM,,,278,RC,inpatient,,14631.63,14631.63,,12422.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11032.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12436.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12875.83,88,,percent of total billed charges,,,,,,,,,11178.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13314.78,91,,percent of total billed charges,,,13900.05,95,,percent of total billed charges,,,12144.25,83,,percent of total billed charges,,,12144.25,83,,percent of total billed charges,,,,,,,,,,,,,,,12144.25,83,,percent of total billed charges,,,13900.05,95,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,11997.94,82,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,12436.89,85,,percent of total billed charges,,11032.25,13900.05,
SYNTHES PLATE TUBULAR 1/3 8 HOLE,30187744,CDM,,,278,RC,inpatient,,1987.05,1987.05,,1687.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1498.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1688.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1748.6,88,,percent of total billed charges,,,,,,,,,1518.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1808.22,91,,percent of total billed charges,,,1887.7,95,,percent of total billed charges,,,1649.25,83,,percent of total billed charges,,,1649.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1649.25,83,,percent of total billed charges,,,1887.7,95,,percent of total billed charges,,,1788.35,90,,percent of total billed charges,,,1788.35,90,,percent of total billed charges,,,1629.38,82,,percent of total billed charges,,,1788.35,90,,percent of total billed charges,,,1688.99,85,,percent of total billed charges,,1498.24,1887.7,
SYNTHES SCREW LOCKING TI 3.5X12MM,30187745,CDM,,,278,RC,inpatient,,1389.18,1389.18,,1179.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1047.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1180.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1222.48,88,,percent of total billed charges,,,,,,,,,1061.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1264.15,91,,percent of total billed charges,,,1319.72,95,,percent of total billed charges,,,1153.02,83,,percent of total billed charges,,,1153.02,83,,percent of total billed charges,,,,,,,,,,,,,,,1153.02,83,,percent of total billed charges,,,1319.72,95,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1139.13,82,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1180.8,85,,percent of total billed charges,,1047.44,1319.72,
SYNTHES SCREW LOCKING TI 3.5X14MM,30187746,CDM,,,278,RC,inpatient,,1389.18,1389.18,,1179.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1047.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1180.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1222.48,88,,percent of total billed charges,,,,,,,,,1061.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1264.15,91,,percent of total billed charges,,,1319.72,95,,percent of total billed charges,,,1153.02,83,,percent of total billed charges,,,1153.02,83,,percent of total billed charges,,,,,,,,,,,,,,,1153.02,83,,percent of total billed charges,,,1319.72,95,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1139.13,82,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1180.8,85,,percent of total billed charges,,1047.44,1319.72,
SYNTHES SCREW CORTEX ST 3.5X40MM,30187747,CDM,,,278,RC,inpatient,,311.1,311.1,,264.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,234.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,264.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,273.77,88,,percent of total billed charges,,,,,,,,,237.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,283.1,91,,percent of total billed charges,,,295.55,95,,percent of total billed charges,,,258.21,83,,percent of total billed charges,,,258.21,83,,percent of total billed charges,,,,,,,,,,,,,,,258.21,83,,percent of total billed charges,,,295.55,95,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,255.1,82,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,264.44,85,,percent of total billed charges,,234.57,295.55,
SYNTHES SCREW CANNULATED LT 4X54MM,30187748,CDM,,,278,RC,inpatient,,2268.37,2268.37,,1925.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1710.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1928.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1996.17,88,,percent of total billed charges,,,,,,,,,1733.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2064.22,91,,percent of total billed charges,,,2154.95,95,,percent of total billed charges,,,1882.75,83,,percent of total billed charges,,,1882.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1882.75,83,,percent of total billed charges,,,2154.95,95,,percent of total billed charges,,,2041.53,90,,percent of total billed charges,,,2041.53,90,,percent of total billed charges,,,1860.06,82,,percent of total billed charges,,,2041.53,90,,percent of total billed charges,,,1928.11,85,,percent of total billed charges,,1710.35,2154.95,
SYNTHES SCREW CANNULATED LT 4X58MM,30187749,CDM,,,278,RC,inpatient,,2268.37,2268.37,,1925.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1710.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1928.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1996.17,88,,percent of total billed charges,,,,,,,,,1733.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2064.22,91,,percent of total billed charges,,,2154.95,95,,percent of total billed charges,,,1882.75,83,,percent of total billed charges,,,1882.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1882.75,83,,percent of total billed charges,,,2154.95,95,,percent of total billed charges,,,2041.53,90,,percent of total billed charges,,,2041.53,90,,percent of total billed charges,,,1860.06,82,,percent of total billed charges,,,2041.53,90,,percent of total billed charges,,,1928.11,85,,percent of total billed charges,,1710.35,2154.95,
AIRSEAL OBTURATOR BLADELESS ACCESS PORT,30187753,CDM,,,270,RC,inpatient,,871.5,871.5,,739.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,657.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,740.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,766.92,88,,percent of total billed charges,,,,,,,,,665.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,793.07,91,,percent of total billed charges,,,827.93,95,,percent of total billed charges,,,723.35,83,,percent of total billed charges,,,723.35,83,,percent of total billed charges,,,,,,,,,,,,,,,723.35,83,,percent of total billed charges,,,827.93,95,,percent of total billed charges,,,784.35,90,,percent of total billed charges,,,784.35,90,,percent of total billed charges,,,714.63,82,,percent of total billed charges,,,784.35,90,,percent of total billed charges,,,740.78,85,,percent of total billed charges,,657.11,827.93,
TROCAR VERSAONE BLUNT W/THREADED ANCHOR,30187754,CDM,,,270,RC,inpatient,,1022.32,1022.32,,867.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,770.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,868.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,899.64,88,,percent of total billed charges,,,,,,,,,781.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,930.31,91,,percent of total billed charges,,,971.2,95,,percent of total billed charges,,,848.53,83,,percent of total billed charges,,,848.53,83,,percent of total billed charges,,,,,,,,,,,,,,,848.53,83,,percent of total billed charges,,,971.2,95,,percent of total billed charges,,,920.09,90,,percent of total billed charges,,,920.09,90,,percent of total billed charges,,,838.3,82,,percent of total billed charges,,,920.09,90,,percent of total billed charges,,,868.97,85,,percent of total billed charges,,770.83,971.2,
V-LOC WOUND CLOSURE 180 SZ 0 GS-21,30187755,CDM,,,270,RC,inpatient,,188.08,188.08,,159.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,159.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,165.51,88,,percent of total billed charges,,,,,,,,,143.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.15,91,,percent of total billed charges,,,178.68,95,,percent of total billed charges,,,156.11,83,,percent of total billed charges,,,156.11,83,,percent of total billed charges,,,,,,,,,,,,,,,156.11,83,,percent of total billed charges,,,178.68,95,,percent of total billed charges,,,169.27,90,,percent of total billed charges,,,169.27,90,,percent of total billed charges,,,154.23,82,,percent of total billed charges,,,169.27,90,,percent of total billed charges,,,159.87,85,,percent of total billed charges,,141.81,178.68,
ARTHREX REAMER LOW PROFILE,30187756,CDM,,,270,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
ARTHREX GLENOSPHERE 33/24,30187757,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
ARTHREX SCREW LOCKING 5.5 X 24MM,30187758,CDM,,,278,RC,inpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,633.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,714,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,633.36,798,
ARTHREX SUTURECUP REVERSE 36 +2 RIGHT,30187759,CDM,,,278,RC,inpatient,,11602.5,11602.5,,9850.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8748.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9862.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10210.2,88,,percent of total billed charges,,,,,,,,,8864.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10558.28,91,,percent of total billed charges,,,11022.38,95,,percent of total billed charges,,,9630.08,83,,percent of total billed charges,,,9630.08,83,,percent of total billed charges,,,,,,,,,,,,,,,9630.08,83,,percent of total billed charges,,,11022.38,95,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,9514.05,82,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,9862.13,85,,percent of total billed charges,,8748.29,11022.38,
ARTHREX STEM HUMERAL SZ 5 135DEG MODULAR,30187760,CDM,,,278,RC,inpatient,,16152.5,16152.5,,13713.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12178.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13729.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14214.2,88,,percent of total billed charges,,,,,,,,,12340.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14698.78,91,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,,,,,,,,,,,,,13406.58,83,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13245.05,82,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,12178.99,15344.88,
ARTHREX INSERT HUMERAL 36 +3/33,30187761,CDM,,,278,RC,inpatient,,6597.5,6597.5,,5601.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4974.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5607.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5805.8,88,,percent of total billed charges,,,,,,,,,5040.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6003.73,91,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,,,,,,,,,,,,,5475.93,83,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5409.95,82,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5607.88,85,,percent of total billed charges,,4974.52,6267.63,
ARTHREX SPACER REVERS 36 +6MM,30187762,CDM,,,278,RC,inpatient,,3185,3185,,2704.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2401.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2707.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2802.8,88,,percent of total billed charges,,,,,,,,,2433.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2898.35,91,,percent of total billed charges,,,3025.75,95,,percent of total billed charges,,,2643.55,83,,percent of total billed charges,,,2643.55,83,,percent of total billed charges,,,,,,,,,,,,,,,2643.55,83,,percent of total billed charges,,,3025.75,95,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2611.7,82,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2707.25,85,,percent of total billed charges,,2401.49,3025.75,
ARTHREX GLENOID TARGETER LEG SZ 10,30187763,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
ZIMMER PATELLA TM 10 X 29MM,30187764,CDM,,,278,RC,inpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3675.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4143.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,3675.75,4631.25,
ZIMMER FEMUR NARROW SZ 6 RIGHT,30187765,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ELECTRODE COAGULATION BIPOLAR 24-26FR,30187766,CDM,,,270,RC,inpatient,,2361.15,2361.15,,2004.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1780.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2006.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2077.81,88,,percent of total billed charges,,,,,,,,,1803.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2148.65,91,,percent of total billed charges,,,2243.09,95,,percent of total billed charges,,,1959.75,83,,percent of total billed charges,,,1959.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1959.75,83,,percent of total billed charges,,,2243.09,95,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,1936.14,82,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,2006.98,85,,percent of total billed charges,,1780.31,2243.09,
STRYKER CUP TRIDENT II PSL 58F,30187770,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
STRYKER INSERT TRIDENT 0 X3 36MM ID,30187771,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER STEM ACCOLADE II SZ 6 132DEG,30187772,CDM,,,278,RC,inpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11762.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13260,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,11762.4,14820,
STRYKER HEAD CERAMIC DELTA V-40 36/+5,30187773,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
SYNTHES SCREW CANNULATED 6.5 X 105,30187774,CDM,,,278,RC,inpatient,,2965.89,2965.89,,2518.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2236.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2521.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2609.98,88,,percent of total billed charges,,,,,,,,,2265.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2698.96,91,,percent of total billed charges,,,2817.6,95,,percent of total billed charges,,,2461.69,83,,percent of total billed charges,,,2461.69,83,,percent of total billed charges,,,,,,,,,,,,,,,2461.69,83,,percent of total billed charges,,,2817.6,95,,percent of total billed charges,,,2669.3,90,,percent of total billed charges,,,2669.3,90,,percent of total billed charges,,,2432.03,82,,percent of total billed charges,,,2669.3,90,,percent of total billed charges,,,2521.01,85,,percent of total billed charges,,2236.28,2817.6,
SYNTHES SCREW CORTEX 4.5 X 70MM,30187775,CDM,,,278,RC,inpatient,,277.28,277.28,,235.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,235.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.01,88,,percent of total billed charges,,,,,,,,,211.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.32,91,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,,,,,,,,,,,,,230.14,83,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,227.37,82,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,209.07,263.42,
DEPUY LINER PE MENTUM 28/47,30187776,CDM,,,278,RC,inpatient,,15818.92,15818.92,,13430.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11927.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13446.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13920.65,88,,percent of total billed charges,,,,,,,,,12085.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14395.22,91,,percent of total billed charges,,,15027.97,95,,percent of total billed charges,,,13129.7,83,,percent of total billed charges,,,13129.7,83,,percent of total billed charges,,,,,,,,,,,,,,,13129.7,83,,percent of total billed charges,,,15027.97,95,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,12971.51,82,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,13446.08,85,,percent of total billed charges,,11927.47,15027.97,
VIVAER ARC STYLUS,30187777,CDM,,,270,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
ADVANTAGE FIT SYSTEM,30187778,CDM,,,270,RC,inpatient,,10653.76,10653.76,,9045.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8032.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9055.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9375.31,88,,percent of total billed charges,,,,,,,,,8139.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9694.92,91,,percent of total billed charges,,,10121.07,95,,percent of total billed charges,,,8842.62,83,,percent of total billed charges,,,8842.62,83,,percent of total billed charges,,,,,,,,,,,,,,,8842.62,83,,percent of total billed charges,,,10121.07,95,,percent of total billed charges,,,9588.38,90,,percent of total billed charges,,,9588.38,90,,percent of total billed charges,,,8736.08,82,,percent of total billed charges,,,9588.38,90,,percent of total billed charges,,,9055.7,85,,percent of total billed charges,,8032.94,10121.07,
IR PLATE 3 LEVEL 51MM,30187779,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
STRYKER CUP TRIDENT II 50MM D,30187780,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
STRYKER STEM ACCOLADE II SZ 5 132DEG,30187781,CDM,,,278,RC,inpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11762.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13260,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,11762.4,14820,
STRYKER HEAD FEMORAL V40 36MM +5MM,30187782,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
ZIMMER BEARING DM 28X50MM,30187783,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
DEPUY STEM REVISION 16 HO,30187784,CDM,,,278,RC,inpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50336.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56745.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,50336.9,63421.82,
X-TACK ENDO HELIX 235CM,30187785,CDM,,,270,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
OVERSTITCH SUTURE CINCH LONG,30187786,CDM,,,270,RC,inpatient,,645.19,645.19,,547.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,486.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,548.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,567.77,88,,percent of total billed charges,,,,,,,,,492.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,587.12,91,,percent of total billed charges,,,612.93,95,,percent of total billed charges,,,535.51,83,,percent of total billed charges,,,535.51,83,,percent of total billed charges,,,,,,,,,,,,,,,535.51,83,,percent of total billed charges,,,612.93,95,,percent of total billed charges,,,580.67,90,,percent of total billed charges,,,580.67,90,,percent of total billed charges,,,529.06,82,,percent of total billed charges,,,580.67,90,,percent of total billed charges,,,548.41,85,,percent of total billed charges,,486.47,612.93,
ZIMMER FEMUR CEMENTED CR SZ8 LEFT,30187787,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
BOSTON LEAD KIT,30187788,CDM,,,270,RC,inpatient,,12350,12350,,10485.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9311.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10497.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10868,88,,percent of total billed charges,,,,,,,,,9435.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11238.5,91,,percent of total billed charges,,,11732.5,95,,percent of total billed charges,,,10250.5,83,,percent of total billed charges,,,10250.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10250.5,83,,percent of total billed charges,,,11732.5,95,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,10127,82,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,10497.5,85,,percent of total billed charges,,9311.9,11732.5,
DEPUY-MITEK ANCHOR PERMATAPE PEEK 5.5MM,30187789,CDM,,,278,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
S&N HEAD FEMORAL 36MM XL,30187790,CDM,,,278,RC,inpatient,,35977.5,35977.5,,30544.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27127.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30580.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31660.2,88,,percent of total billed charges,,,,,,,,,27486.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32739.53,91,,percent of total billed charges,,,34178.63,95,,percent of total billed charges,,,29861.33,83,,percent of total billed charges,,,29861.33,83,,percent of total billed charges,,,,,,,,,,,,,,,29861.33,83,,percent of total billed charges,,,34178.63,95,,percent of total billed charges,,,32379.75,90,,percent of total billed charges,,,32379.75,90,,percent of total billed charges,,,29501.55,82,,percent of total billed charges,,,32379.75,90,,percent of total billed charges,,,30580.88,85,,percent of total billed charges,,27127.04,34178.63,
STRYKER BASEPLATE TIBIAL SZ 6,30187791,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER INSERT TIBIAL SZ 6 10MM,30187792,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER PATELLA SZ S36MM,30187793,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
ENDOSCOPIC SCISSORS COLONIC LENGTH,30187794,CDM,,,270,RC,inpatient,,2155.83,2155.83,,1830.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1625.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1832.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1897.13,88,,percent of total billed charges,,,,,,,,,1647.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1961.81,91,,percent of total billed charges,,,2048.04,95,,percent of total billed charges,,,1789.34,83,,percent of total billed charges,,,1789.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1789.34,83,,percent of total billed charges,,,2048.04,95,,percent of total billed charges,,,1940.25,90,,percent of total billed charges,,,1940.25,90,,percent of total billed charges,,,1767.78,82,,percent of total billed charges,,,1940.25,90,,percent of total billed charges,,,1832.46,85,,percent of total billed charges,,1625.5,2048.04,
GORE VBX BALLOON EXPANDABLE 6X29,30187795,CDM,,,270,RC,inpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17516.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19746.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,17516.17,22069.45,
STRYKER INSERT TRIDENT 0 X3 36MM ID E,30187796,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
KYPHON TRAY FIRST FRACTURE,30187797,CDM,,,278,RC,inpatient,,25961,25961,,22040.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19574.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22066.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22845.68,88,,percent of total billed charges,,,,,,,,,19834.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23624.51,91,,percent of total billed charges,,,24662.95,95,,percent of total billed charges,,,21547.63,83,,percent of total billed charges,,,21547.63,83,,percent of total billed charges,,,,,,,,,,,,,,,21547.63,83,,percent of total billed charges,,,24662.95,95,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,21288.02,82,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,22066.85,85,,percent of total billed charges,,19574.59,24662.95,
STRYKER INSERT TRIATHLON CS SZ 3 10MM,30187798,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
G-TUBE STRAIGHT 16FR,30187800,CDM,,,270,RC,inpatient,,456.4,456.4,,387.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,344.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,387.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,401.63,88,,percent of total billed charges,,,,,,,,,348.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,415.32,91,,percent of total billed charges,,,433.58,95,,percent of total billed charges,,,378.81,83,,percent of total billed charges,,,378.81,83,,percent of total billed charges,,,,,,,,,,,,,,,378.81,83,,percent of total billed charges,,,433.58,95,,percent of total billed charges,,,410.76,90,,percent of total billed charges,,,410.76,90,,percent of total billed charges,,,374.25,82,,percent of total billed charges,,,410.76,90,,percent of total billed charges,,,387.94,85,,percent of total billed charges,,344.13,433.58,
GASTROSTOMY FEEDING TUBE INSERTION KIT 2,30187801,CDM,,,270,RC,inpatient,,1465.75,1465.75,,1244.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1105.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1245.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1289.86,88,,percent of total billed charges,,,,,,,,,1119.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1333.83,91,,percent of total billed charges,,,1392.46,95,,percent of total billed charges,,,1216.57,83,,percent of total billed charges,,,1216.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1216.57,83,,percent of total billed charges,,,1392.46,95,,percent of total billed charges,,,1319.18,90,,percent of total billed charges,,,1319.18,90,,percent of total billed charges,,,1201.92,82,,percent of total billed charges,,,1319.18,90,,percent of total billed charges,,,1245.89,85,,percent of total billed charges,,1105.18,1392.46,
LITHOVUE STANDARD DEFLECTION SCOPE,30187803,CDM,,,270,RC,inpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7351.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8287.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,7351.5,9262.5,
ZIMMER FEMUR NARROW SZ 5 LEFT,30187804,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER FEMUR NARROW SZ 5 RIGHT,30187805,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER TIBIA POROUS SZ D RIGHT,30187806,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER BEARING MC RIGH 10MM,30187807,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
IR PLATE 2 LEVEL 32MM,30187808,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
MENTOR MEMORYGEL BREAST IMPLANT 250CC,30187809,CDM,,,278,RC,inpatient,,6402.5,6402.5,,5435.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4827.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5442.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5634.2,88,,percent of total billed charges,,,,,,,,,4891.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5826.28,91,,percent of total billed charges,,,6082.38,95,,percent of total billed charges,,,5314.08,83,,percent of total billed charges,,,5314.08,83,,percent of total billed charges,,,,,,,,,,,,,,,5314.08,83,,percent of total billed charges,,,6082.38,95,,percent of total billed charges,,,5762.25,90,,percent of total billed charges,,,5762.25,90,,percent of total billed charges,,,5250.05,82,,percent of total billed charges,,,5762.25,90,,percent of total billed charges,,,5442.13,85,,percent of total billed charges,,4827.49,6082.38,
DEPUY SLEEVE POROUS 37MM,30187810,CDM,,,278,RC,inpatient,,29060.07,29060.07,,24672,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21911.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24701.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25572.86,88,,percent of total billed charges,,,,,,,,,22201.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26444.66,91,,percent of total billed charges,,,27607.07,95,,percent of total billed charges,,,24119.86,83,,percent of total billed charges,,,24119.86,83,,percent of total billed charges,,,,,,,,,,,,,,,24119.86,83,,percent of total billed charges,,,27607.07,95,,percent of total billed charges,,,26154.06,90,,percent of total billed charges,,,26154.06,90,,percent of total billed charges,,,23829.26,82,,percent of total billed charges,,,26154.06,90,,percent of total billed charges,,,24701.06,85,,percent of total billed charges,,21911.29,27607.07,
ULRICH X-LINK CONNECTOR X-SMALL,30187811,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
FALOPE-RING BAND APPLICATOR KIT,30187812,CDM,,,270,RC,inpatient,,2099.5,2099.5,,1782.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1583.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1784.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1847.56,88,,percent of total billed charges,,,,,,,,,1604.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1910.55,91,,percent of total billed charges,,,1994.53,95,,percent of total billed charges,,,1742.59,83,,percent of total billed charges,,,1742.59,83,,percent of total billed charges,,,,,,,,,,,,,,,1742.59,83,,percent of total billed charges,,,1994.53,95,,percent of total billed charges,,,1889.55,90,,percent of total billed charges,,,1889.55,90,,percent of total billed charges,,,1721.59,82,,percent of total billed charges,,,1889.55,90,,percent of total billed charges,,,1784.58,85,,percent of total billed charges,,1583.02,1994.53,
AERIN VIVAER,30187813,CDM,,,270,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
ARTHREX LASSO QUICKPASS 45DEG CURVED LEF,30187814,CDM,,,278,RC,inpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,784.16,988,
ARTHREX LASSO QUICKPASS 45DEG CURVE RIGH,30187815,CDM,,,278,RC,inpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,784.16,988,
ARTHREX FIBERTAK,30187816,CDM,,,270,RC,inpatient,,2730,2730,,2317.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2058.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2320.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2402.4,88,,percent of total billed charges,,,,,,,,,2085.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2484.3,91,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2265.9,83,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2238.6,82,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,2058.42,2593.5,
ARTHREX FIBERTAK STRAIGHT KIT,30187817,CDM,,,270,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
ARTHREX FIBERTAK CURVED KIT,30187818,CDM,,,270,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
ARTHREX SUTURE ANCHOR BC 2.9 X 12.5MM,30187819,CDM,,,278,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
ARTHREX KNIFE RETRACT. CANN. STRAIGHT,30187820,CDM,,,270,RC,inpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,980.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1105,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,980.2,1235,
ARTHREX SUTURE TAPE WH/BL 1.7MM,30187821,CDM,,,270,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
ARTHREX CANNULA CRYSTAL PARTIALLY THREAD,30187822,CDM,,,270,RC,inpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,150.8,190,
ARTHREX CANNULA TWIST-IN,30187823,CDM,,,270,RC,inpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,150.8,190,
ARTHREX TIGHTROPE II RT RECON,30187824,CDM,,,270,RC,inpatient,,3672.5,3672.5,,3117.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2769.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3121.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3231.8,88,,percent of total billed charges,,,,,,,,,2805.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3341.98,91,,percent of total billed charges,,,3488.88,95,,percent of total billed charges,,,3048.18,83,,percent of total billed charges,,,3048.18,83,,percent of total billed charges,,,,,,,,,,,,,,,3048.18,83,,percent of total billed charges,,,3488.88,95,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3011.45,82,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3121.63,85,,percent of total billed charges,,2769.07,3488.88,
ARTHREX TIGHTROPE II RT W/ DEPLOYING SUT,30187825,CDM,,,270,RC,inpatient,,3022.5,3022.5,,2566.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2278.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2569.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2659.8,88,,percent of total billed charges,,,,,,,,,2309.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2750.48,91,,percent of total billed charges,,,2871.38,95,,percent of total billed charges,,,2508.68,83,,percent of total billed charges,,,2508.68,83,,percent of total billed charges,,,,,,,,,,,,,,,2508.68,83,,percent of total billed charges,,,2871.38,95,,percent of total billed charges,,,2720.25,90,,percent of total billed charges,,,2720.25,90,,percent of total billed charges,,,2478.45,82,,percent of total billed charges,,,2720.25,90,,percent of total billed charges,,,2569.13,85,,percent of total billed charges,,2278.97,2871.38,
ARTHREX TIGHTROPE BUTTON EXTENDER,30187826,CDM,,,270,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
ARTHREX T-ROPE CLOSED DRL 4MM,30187827,CDM,,,270,RC,inpatient,,875,875,,742.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,659.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,743.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,770,88,,percent of total billed charges,,,,,,,,,668.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,796.25,91,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,,,,,,,,,,,,,726.25,83,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,717.5,82,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,659.75,831.25,
ARTHREX SCREW BIOCOMP 7X20 VENTED,30187828,CDM,,,270,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
ARTHREX SECONDARY FIXATION BIOSWVLK 4.75,30187829,CDM,,,270,RC,inpatient,,4712.5,4712.5,,4000.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3553.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4005.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4147,88,,percent of total billed charges,,,,,,,,,3600.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4288.38,91,,percent of total billed charges,,,4476.88,95,,percent of total billed charges,,,3911.38,83,,percent of total billed charges,,,3911.38,83,,percent of total billed charges,,,,,,,,,,,,,,,3911.38,83,,percent of total billed charges,,,4476.88,95,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,3864.25,82,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,4005.63,85,,percent of total billed charges,,3553.23,4476.88,
ARTHREX REEMER 7MM LP,30187830,CDM,,,270,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
ARTHREX REEMER 8MM LP,30187831,CDM,,,270,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
ARTHREX REAMER 9MM LP,30187832,CDM,,,270,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
ARTHREX ARTHROFLEX 40X70X2.0MM,30187833,CDM,,,270,RC,inpatient,,24713,24713,,20981.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18633.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21006.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21747.44,88,,percent of total billed charges,,,,,,,,,18880.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22488.83,91,,percent of total billed charges,,,23477.35,95,,percent of total billed charges,,,20511.79,83,,percent of total billed charges,,,20511.79,83,,percent of total billed charges,,,,,,,,,,,,,,,20511.79,83,,percent of total billed charges,,,23477.35,95,,percent of total billed charges,,,22241.7,90,,percent of total billed charges,,,22241.7,90,,percent of total billed charges,,,20264.66,82,,percent of total billed charges,,,22241.7,90,,percent of total billed charges,,,21006.05,85,,percent of total billed charges,,18633.6,23477.35,
ARTHREX T-ROPE K-LESS W/DRIVER,30187834,CDM,,,270,RC,inpatient,,9717.5,9717.5,,8250.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7327,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8259.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8551.4,88,,percent of total billed charges,,,,,,,,,7424.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8842.93,91,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,,,,,,,,,,,,,8065.53,83,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,7968.35,82,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8259.88,85,,percent of total billed charges,,7327,9231.63,
ARTHREX SWIVELOCK KNOTLESS 4.75MM BC,30187835,CDM,,,270,RC,inpatient,,2990,2990,,2538.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2254.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2541.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2631.2,88,,percent of total billed charges,,,,,,,,,2284.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2720.9,91,,percent of total billed charges,,,2840.5,95,,percent of total billed charges,,,2481.7,83,,percent of total billed charges,,,2481.7,83,,percent of total billed charges,,,,,,,,,,,,,,,2481.7,83,,percent of total billed charges,,,2840.5,95,,percent of total billed charges,,,2691,90,,percent of total billed charges,,,2691,90,,percent of total billed charges,,,2451.8,82,,percent of total billed charges,,,2691,90,,percent of total billed charges,,,2541.5,85,,percent of total billed charges,,2254.46,2840.5,
ARTHREX SWIVELOCK KNOTLESS 5.5MM BC,30187836,CDM,,,270,RC,inpatient,,2990,2990,,2538.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2254.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2541.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2631.2,88,,percent of total billed charges,,,,,,,,,2284.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2720.9,91,,percent of total billed charges,,,2840.5,95,,percent of total billed charges,,,2481.7,83,,percent of total billed charges,,,2481.7,83,,percent of total billed charges,,,,,,,,,,,,,,,2481.7,83,,percent of total billed charges,,,2840.5,95,,percent of total billed charges,,,2691,90,,percent of total billed charges,,,2691,90,,percent of total billed charges,,,2451.8,82,,percent of total billed charges,,,2691,90,,percent of total billed charges,,,2541.5,85,,percent of total billed charges,,2254.46,2840.5,
ARTHREX SPEEDBRIDGE IMPLANT SYSTEM,30187837,CDM,,,278,RC,inpatient,,13975,13975,,11864.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10537.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11878.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12298,88,,percent of total billed charges,,,,,,,,,10676.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12717.25,91,,percent of total billed charges,,,13276.25,95,,percent of total billed charges,,,11599.25,83,,percent of total billed charges,,,11599.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11599.25,83,,percent of total billed charges,,,13276.25,95,,percent of total billed charges,,,12577.5,90,,percent of total billed charges,,,12577.5,90,,percent of total billed charges,,,11459.5,82,,percent of total billed charges,,,12577.5,90,,percent of total billed charges,,,11878.75,85,,percent of total billed charges,,10537.15,13276.25,
ARTHREX FIBERSTITCH IMPLANT CURVED,30187838,CDM,,,278,RC,inpatient,,3217.5,3217.5,,2731.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2426,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2734.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2831.4,88,,percent of total billed charges,,,,,,,,,2458.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2927.93,91,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2670.53,83,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2638.35,82,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,2426,3056.63,
ARTHREX FIBERSTITCH IMPLANT 24 DEG CURVE,30187841,CDM,,,278,RC,inpatient,,3217.5,3217.5,,2731.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2426,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2734.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2831.4,88,,percent of total billed charges,,,,,,,,,2458.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2927.93,91,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2670.53,83,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2638.35,82,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,2426,3056.63,
ARTHREX FIBERSTITCH IMPLANT REVERSE CURV,30187842,CDM,,,278,RC,inpatient,,3217.5,3217.5,,2731.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2426,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2734.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2831.4,88,,percent of total billed charges,,,,,,,,,2458.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2927.93,91,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2670.53,83,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2638.35,82,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,2426,3056.63,
ARTHREX FIBERSTITCH IMPLANT STRAIGHT,30187843,CDM,,,278,RC,inpatient,,3217.5,3217.5,,2731.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2426,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2734.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2831.4,88,,percent of total billed charges,,,,,,,,,2458.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2927.93,91,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2670.53,83,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2638.35,82,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,2426,3056.63,
ARTHREX KNOT PUSHER/SUTURE CUTTER,30187844,CDM,,,270,RC,inpatient,,1430,1430,,1214.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1078.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1215.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1258.4,88,,percent of total billed charges,,,,,,,,,1092.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1301.3,91,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1186.9,83,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1172.6,82,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,1078.22,1358.5,
ARTHREX CANNULA TRIPLEDAM 7 X 7MM,30187845,CDM,,,278,RC,inpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
ELECTRODE COLLINS COAGULATING KNIFE,30187846,CDM,,,270,RC,inpatient,,2587.46,2587.46,,2196.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1950.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2199.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2276.96,88,,percent of total billed charges,,,,,,,,,1976.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2354.59,91,,percent of total billed charges,,,2458.09,95,,percent of total billed charges,,,2147.59,83,,percent of total billed charges,,,2147.59,83,,percent of total billed charges,,,,,,,,,,,,,,,2147.59,83,,percent of total billed charges,,,2458.09,95,,percent of total billed charges,,,2328.71,90,,percent of total billed charges,,,2328.71,90,,percent of total billed charges,,,2121.72,82,,percent of total billed charges,,,2328.71,90,,percent of total billed charges,,,2199.34,85,,percent of total billed charges,,1950.94,2458.09,
ULRICH SCREW POLY 7.5 X 55MM,30187847,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH SCREW REDUCTION 7.5 X 55MM,30187848,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
ULRICH ROD LORDOSED 6.0 X 110MM,30187849,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ULRICH SCREW POLY 7.5 X 50MM,30187850,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
STRYKER SCREW LP 6.5X25MM,30187851,CDM,,,278,RC,inpatient,,946.4,946.4,,803.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,713.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,804.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,832.83,88,,percent of total billed charges,,,,,,,,,723.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,861.22,91,,percent of total billed charges,,,899.08,95,,percent of total billed charges,,,785.51,83,,percent of total billed charges,,,785.51,83,,percent of total billed charges,,,,,,,,,,,,,,,785.51,83,,percent of total billed charges,,,899.08,95,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,776.05,82,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,804.44,85,,percent of total billed charges,,713.59,899.08,
STRYKER STEM #4 35MM,30187852,CDM,,,278,RC,inpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11762.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13260,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,11762.4,14820,
STRYKER HEAD DELTA V-40 36MM,30187853,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
ULRICH SCREW POLY 6.5 X 55,30187854,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH SCREW POLY 6.5 X 50,30187855,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
DEPUY GLENOSPHERE 42MM STD,30187857,CDM,,,278,RC,inpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14941.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16844.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,14941.68,18825.72,
ENDOSCOPIC MARKER 10ML TATTOO,30187858,CDM,,,270,RC,inpatient,,211.2,211.2,,179.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,179.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,185.86,88,,percent of total billed charges,,,,,,,,,161.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.19,91,,percent of total billed charges,,,200.64,95,,percent of total billed charges,,,175.3,83,,percent of total billed charges,,,175.3,83,,percent of total billed charges,,,,,,,,,,,,,,,175.3,83,,percent of total billed charges,,,200.64,95,,percent of total billed charges,,,190.08,90,,percent of total billed charges,,,190.08,90,,percent of total billed charges,,,173.18,82,,percent of total billed charges,,,190.08,90,,percent of total billed charges,,,179.52,85,,percent of total billed charges,,159.24,200.64,
ULRICH TAP NON-CANNULATED 5.5,30187859,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
SPINECRAFT ROD 6.0 X 300MM,30187860,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
ZIMMER BEARING HUMERAL 36MM STD,30187861,CDM,,,278,RC,inpatient,,10725,10725,,9105.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8086.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9116.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9438,88,,percent of total billed charges,,,,,,,,,8193.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9759.75,91,,percent of total billed charges,,,10188.75,95,,percent of total billed charges,,,8901.75,83,,percent of total billed charges,,,8901.75,83,,percent of total billed charges,,,,,,,,,,,,,,,8901.75,83,,percent of total billed charges,,,10188.75,95,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,8794.5,82,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,9116.25,85,,percent of total billed charges,,8086.65,10188.75,
ZIMMER ADAPTOR TAPER VERSA-DIAL 25MM,30187862,CDM,,,278,RC,inpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,980.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1105,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,980.2,1235,
ZIMMER LINER NEUTRAL SZ E 36MM +5,30187863,CDM,,,278,RC,inpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7694.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8674.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,7694.57,9694.75,
IR PLATE 2 LEVEL 30MM,30187864,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
IR PLATE 2 LEVEL 34MM,30187865,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
IR DRILL 12MM,30187866,CDM,,,278,RC,inpatient,,2340,2340,,1986.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1764.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1989,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2059.2,88,,percent of total billed charges,,,,,,,,,1787.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2129.4,91,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1942.2,83,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1918.8,82,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1989,85,,percent of total billed charges,,1764.36,2223,
DEPUY STEM CORAIL STD SZ 18,30187868,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
GORE VBX BALLOON EXPANDABLE ENDOPROSTHES,30187869,CDM,,,270,RC,inpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17516.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19746.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,17516.17,22069.45,
GORE VBX BALLOON EXPANDABLE ENDOPROSTHES,30187870,CDM,,,270,RC,inpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17516.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19746.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,17516.17,22069.45,
AMPLATZ GOOSE NECK MICROSNARE KIT,30187871,CDM,,,270,RC,inpatient,,4256.79,4256.79,,3614.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3209.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3618.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3745.98,88,,percent of total billed charges,,,,,,,,,3252.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3873.68,91,,percent of total billed charges,,,4043.95,95,,percent of total billed charges,,,3533.14,83,,percent of total billed charges,,,3533.14,83,,percent of total billed charges,,,,,,,,,,,,,,,3533.14,83,,percent of total billed charges,,,4043.95,95,,percent of total billed charges,,,3831.11,90,,percent of total billed charges,,,3831.11,90,,percent of total billed charges,,,3490.57,82,,percent of total billed charges,,,3831.11,90,,percent of total billed charges,,,3618.27,85,,percent of total billed charges,,3209.62,4043.95,
CAPSULAR TENSION RING 14C,30187873,CDM,,,278,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
ZIMMER TIBIA CENTRAL CONE LARGE,30187874,CDM,,,278,RC,inpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36420.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41057.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,36420.56,45887.97,
ZIMMER FEMORAL ROTATING HINGE F-RT,30187875,CDM,,,278,RC,inpatient,,57459.03,57459.03,,48782.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43324.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48840.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50563.95,88,,percent of total billed charges,,,,,,,,,43898.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52287.72,91,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,,,,,,,,,,,,,47690.99,83,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,47116.4,82,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,48840.18,85,,percent of total billed charges,,43324.11,54586.08,
ZIMMER STEM EXTENSION STRAIGHT 75MM,30187876,CDM,,,278,RC,inpatient,,7276.62,7276.62,,6177.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5486.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6185.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6403.43,88,,percent of total billed charges,,,,,,,,,5559.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6621.72,91,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,,,,,,,,,,,,,6039.59,83,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,5966.83,82,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,5486.57,6912.79,
ZIMMER FEMORAL CENTRAL CONE MEDIUM,30187877,CDM,,,278,RC,inpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36420.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41057.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,36420.56,45887.97,
ZIMMER AUGMENT BLOCK DISTAL ONLY 20MM,30187878,CDM,,,278,RC,inpatient,,7564.38,7564.38,,6422.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5703.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6429.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6656.65,88,,percent of total billed charges,,,,,,,,,5779.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6883.59,91,,percent of total billed charges,,,7186.16,95,,percent of total billed charges,,,6278.44,83,,percent of total billed charges,,,6278.44,83,,percent of total billed charges,,,,,,,,,,,,,,,6278.44,83,,percent of total billed charges,,,7186.16,95,,percent of total billed charges,,,6807.94,90,,percent of total billed charges,,,6807.94,90,,percent of total billed charges,,,6202.79,82,,percent of total billed charges,,,6807.94,90,,percent of total billed charges,,,6429.72,85,,percent of total billed charges,,5703.54,7186.16,
ZIMMER PLATE HINGE STEM TIBIAL SZ 5,30187879,CDM,,,278,RC,inpatient,,28502.57,28502.57,,24198.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21490.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24227.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25082.26,88,,percent of total billed charges,,,,,,,,,21775.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25937.34,91,,percent of total billed charges,,,27077.44,95,,percent of total billed charges,,,23657.13,83,,percent of total billed charges,,,23657.13,83,,percent of total billed charges,,,,,,,,,,,,,,,23657.13,83,,percent of total billed charges,,,27077.44,95,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,23372.11,82,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,24227.18,85,,percent of total billed charges,,21490.94,27077.44,
ZIMMER AUGMENT BLOCK HINGE FULL TIBIAL 1,30187880,CDM,,,278,RC,inpatient,,10304.84,10304.84,,8748.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7769.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8759.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9068.26,88,,percent of total billed charges,,,,,,,,,7872.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9377.4,91,,percent of total billed charges,,,9789.6,95,,percent of total billed charges,,,8553.02,83,,percent of total billed charges,,,8553.02,83,,percent of total billed charges,,,,,,,,,,,,,,,8553.02,83,,percent of total billed charges,,,9789.6,95,,percent of total billed charges,,,9274.36,90,,percent of total billed charges,,,9274.36,90,,percent of total billed charges,,,8449.97,82,,percent of total billed charges,,,9274.36,90,,percent of total billed charges,,,8759.11,85,,percent of total billed charges,,7769.85,9789.6,
ZIMMER HINGE ARTICULAR SURFACE 17MM SZ F,30187881,CDM,,,278,RC,inpatient,,12617.41,12617.41,,10712.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9513.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10724.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11103.32,88,,percent of total billed charges,,,,,,,,,9639.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11481.84,91,,percent of total billed charges,,,11986.54,95,,percent of total billed charges,,,10472.45,83,,percent of total billed charges,,,10472.45,83,,percent of total billed charges,,,,,,,,,,,,,,,10472.45,83,,percent of total billed charges,,,11986.54,95,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,10346.28,82,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,10724.8,85,,percent of total billed charges,,9513.53,11986.54,
DEPUY GLENOSPHERE 42MM +4MM,30187882,CDM,,,278,RC,inpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14941.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16844.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,14941.68,18825.72,
COOK STOPCOCK SANANTONIO,30187883,CDM,,,270,RC,inpatient,,82.71,82.71,,70.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,72.78,88,,percent of total billed charges,,,,,,,,,63.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.27,91,,percent of total billed charges,,,78.57,95,,percent of total billed charges,,,68.65,83,,percent of total billed charges,,,68.65,83,,percent of total billed charges,,,,,,,,,,,,,,,68.65,83,,percent of total billed charges,,,78.57,95,,percent of total billed charges,,,74.44,90,,percent of total billed charges,,,74.44,90,,percent of total billed charges,,,67.82,82,,percent of total billed charges,,,74.44,90,,percent of total billed charges,,,70.3,85,,percent of total billed charges,,62.36,78.57,
EVERCROSS BALLOON 4 X 60MM,30187885,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
KYPHON INTRODUCER NEEDLE BEVEL,30187886,CDM,,,278,RC,inpatient,,3003,3003,,2549.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2264.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2552.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2642.64,88,,percent of total billed charges,,,,,,,,,2294.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2732.73,91,,percent of total billed charges,,,2852.85,95,,percent of total billed charges,,,2492.49,83,,percent of total billed charges,,,2492.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2492.49,83,,percent of total billed charges,,,2852.85,95,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2462.46,82,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2552.55,85,,percent of total billed charges,,2264.26,2852.85,
KYPHON INTRODUCER NEEDLE DIAMOND,30187887,CDM,,,278,RC,inpatient,,3003,3003,,2549.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2264.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2552.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2642.64,88,,percent of total billed charges,,,,,,,,,2294.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2732.73,91,,percent of total billed charges,,,2852.85,95,,percent of total billed charges,,,2492.49,83,,percent of total billed charges,,,2492.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2492.49,83,,percent of total billed charges,,,2852.85,95,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2462.46,82,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2552.55,85,,percent of total billed charges,,2264.26,2852.85,
KYPHON 15/2 FRACTURE KIT,30187888,CDM,,,278,RC,inpatient,,25961,25961,,22040.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19574.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22066.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22845.68,88,,percent of total billed charges,,,,,,,,,19834.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23624.51,91,,percent of total billed charges,,,24662.95,95,,percent of total billed charges,,,21547.63,83,,percent of total billed charges,,,21547.63,83,,percent of total billed charges,,,,,,,,,,,,,,,21547.63,83,,percent of total billed charges,,,24662.95,95,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,21288.02,82,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,22066.85,85,,percent of total billed charges,,19574.59,24662.95,
ZIMMER FEMUR POROUS CR SZ 8 RIGHT,30187889,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER CPS LEFT 12MM,30187890,CDM,,,278,RC,inpatient,,17135.63,17135.63,,14548.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12920.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14565.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15079.35,88,,percent of total billed charges,,,,,,,,,13091.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15593.42,91,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14222.57,83,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14051.22,82,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,12920.27,16278.85,
ZIMMER AUGMENT DISTAL FEMUR 5MM,30187891,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER REVISION FEMUR CR STD SZ 5 LEFT,30187892,CDM,,,278,RC,inpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50633.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57080.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,50633.46,63795.47,
ZIMMER AUGMENT POST FEMUR 55MM,30187893,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER FEMUR CEMENTED REVISION SZ D LEFT,30187894,CDM,,,278,RC,inpatient,,24033.75,24033.75,,20404.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18121.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20428.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21149.7,88,,percent of total billed charges,,,,,,,,,18361.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21870.71,91,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,,,,,,,,,,,,,19948.01,83,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,19707.68,82,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,18121.45,22832.06,
ZIMMER AUGMENT TIBIAL 5MM,30187895,CDM,,,278,RC,inpatient,,10637.5,10637.5,,9031.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8020.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9041.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9361,88,,percent of total billed charges,,,,,,,,,8127.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9680.13,91,,percent of total billed charges,,,10105.63,95,,percent of total billed charges,,,8829.13,83,,percent of total billed charges,,,8829.13,83,,percent of total billed charges,,,,,,,,,,,,,,,8829.13,83,,percent of total billed charges,,,10105.63,95,,percent of total billed charges,,,9573.75,90,,percent of total billed charges,,,9573.75,90,,percent of total billed charges,,,8722.75,82,,percent of total billed charges,,,9573.75,90,,percent of total billed charges,,,9041.88,85,,percent of total billed charges,,8020.68,10105.63,
ZIMMER AUGMENT TIBIAL MEDIAL 5MM,30187896,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER STEM OFFSET 12 X 135MM,30187897,CDM,,,278,RC,inpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18476.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20829.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,18476.77,23279.75,
LIGASURE SMALL JAW OPEN SEALER/DIVIDER,30187898,CDM,,,270,RC,inpatient,,4459,4459,,3785.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3362.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3790.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3923.92,88,,percent of total billed charges,,,,,,,,,3406.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4057.69,91,,percent of total billed charges,,,4236.05,95,,percent of total billed charges,,,3700.97,83,,percent of total billed charges,,,3700.97,83,,percent of total billed charges,,,,,,,,,,,,,,,3700.97,83,,percent of total billed charges,,,4236.05,95,,percent of total billed charges,,,4013.1,90,,percent of total billed charges,,,4013.1,90,,percent of total billed charges,,,3656.38,82,,percent of total billed charges,,,4013.1,90,,percent of total billed charges,,,3790.15,85,,percent of total billed charges,,3362.09,4236.05,
EMG NEEDLE ELECTRODE PAIRED SUBDERMAL,30187899,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
SURECLIP 11MM HEMOSTATSIS CLIP,30187900,CDM,,,270,RC,inpatient,,611.65,611.65,,519.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,519.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.25,88,,percent of total billed charges,,,,,,,,,467.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.6,91,,percent of total billed charges,,,581.07,95,,percent of total billed charges,,,507.67,83,,percent of total billed charges,,,507.67,83,,percent of total billed charges,,,,,,,,,,,,,,,507.67,83,,percent of total billed charges,,,581.07,95,,percent of total billed charges,,,550.49,90,,percent of total billed charges,,,550.49,90,,percent of total billed charges,,,501.55,82,,percent of total billed charges,,,550.49,90,,percent of total billed charges,,,519.9,85,,percent of total billed charges,,461.18,581.07,
FORTEC HOLMIUM LASER HIGH WATTAGE,30187902,CDM,,,270,RC,inpatient,,3445,3445,,2924.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2597.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2928.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3031.6,88,,percent of total billed charges,,,,,,,,,2631.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3134.95,91,,percent of total billed charges,,,3272.75,95,,percent of total billed charges,,,2859.35,83,,percent of total billed charges,,,2859.35,83,,percent of total billed charges,,,,,,,,,,,,,,,2859.35,83,,percent of total billed charges,,,3272.75,95,,percent of total billed charges,,,3100.5,90,,percent of total billed charges,,,3100.5,90,,percent of total billed charges,,,2824.9,82,,percent of total billed charges,,,3100.5,90,,percent of total billed charges,,,2928.25,85,,percent of total billed charges,,2597.53,3272.75,
ULRICH SCREW POLY 6.5 X 45,30187903,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH SCREW POLY 6.5 X 40,30187904,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ZIMMER TIBIA REVISION SZ C RIGHT,30187905,CDM,,,278,RC,inpatient,,24033.75,24033.75,,20404.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18121.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20428.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21149.7,88,,percent of total billed charges,,,,,,,,,18361.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21870.71,91,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,,,,,,,,,,,,,19948.01,83,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,19707.68,82,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,18121.45,22832.06,
ZIMMER BLOCK LATERAL TIBIA 10MM,30187906,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER BLOCK MEDIAL TIBIA 10MM,30187907,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER DISTAL AUGMENT FEMUR SZ 5 10MM,30187908,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER FEMUR REVISION PSN SZ 5 RIGHT,30187909,CDM,,,278,RC,inpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50633.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57080.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,50633.46,63795.47,
ZIMMER INSERT CCK 12MM RIGHT,30187910,CDM,,,278,RC,inpatient,,23562.5,23562.5,,20004.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17766.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20028.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20735,88,,percent of total billed charges,,,,,,,,,18001.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21441.88,91,,percent of total billed charges,,,22384.38,95,,percent of total billed charges,,,19556.88,83,,percent of total billed charges,,,19556.88,83,,percent of total billed charges,,,,,,,,,,,,,,,19556.88,83,,percent of total billed charges,,,22384.38,95,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,19321.25,82,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,20028.13,85,,percent of total billed charges,,17766.13,22384.38,
ZIMMER FEMUR TIN SZ 7 LEFT,30187911,CDM,,,278,RC,inpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14703,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16575,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,14703,18525,
SYNTHES SCREW TFNA 105MM,30187912,CDM,,,278,RC,inpatient,,6682.07,6682.07,,5673.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5038.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5679.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5880.22,88,,percent of total billed charges,,,,,,,,,5105.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6080.68,91,,percent of total billed charges,,,6347.97,95,,percent of total billed charges,,,5546.12,83,,percent of total billed charges,,,5546.12,83,,percent of total billed charges,,,,,,,,,,,,,,,5546.12,83,,percent of total billed charges,,,6347.97,95,,percent of total billed charges,,,6013.86,90,,percent of total billed charges,,,6013.86,90,,percent of total billed charges,,,5479.3,82,,percent of total billed charges,,,6013.86,90,,percent of total billed charges,,,5679.76,85,,percent of total billed charges,,5038.28,6347.97,
SYNTHES SCREW METAPHYSEAL 2.7 X 10MM,30187913,CDM,,,278,RC,inpatient,,492.38,492.38,,418.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,371.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,418.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,433.29,88,,percent of total billed charges,,,,,,,,,376.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,448.07,91,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,,,,,,,,,,,,,408.68,83,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,403.75,82,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,371.25,467.76,
SYNTHES SCREW METAPHYSEAL 2.7 X 16MM,30187914,CDM,,,278,RC,inpatient,,492.38,492.38,,418.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,371.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,418.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,433.29,88,,percent of total billed charges,,,,,,,,,376.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,448.07,91,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,,,,,,,,,,,,,408.68,83,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,403.75,82,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,371.25,467.76,
SYNTHES SCREW METAPHYSEAL 2.7 X 18MM,30187915,CDM,,,278,RC,inpatient,,492.38,492.38,,418.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,371.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,418.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,433.29,88,,percent of total billed charges,,,,,,,,,376.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,448.07,91,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,,,,,,,,,,,,,408.68,83,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,403.75,82,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,371.25,467.76,
STRYKER STEM ACCOLADE II SZ 4 132DEG,30187916,CDM,,,278,RC,inpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11762.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13260,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,11762.4,14820,
STRYKER CUP TRIDENT II 52E,30187917,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
S&N SCREW INTERFERENCE 8X20,30187918,CDM,,,270,RC,inpatient,,4091.95,4091.95,,3474.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3085.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3478.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3600.92,88,,percent of total billed charges,,,,,,,,,3126.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3723.67,91,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3396.32,83,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3355.4,82,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,3085.33,3887.35,
ULRICH BOLT ILIAC 8.0 X 70MM,30187919,CDM,,,278,RC,inpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7106.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8011.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,7106.45,8953.75,
ULRICH TAP NON-CANNULATED 7.5,30187920,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
ULRICH SCREW REDUCTION 7.5 X 50MM,30187923,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
STRYKER TIBIA INSERT SZ 5 11MM,30187924,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
BLADDER EVACUATOR ELLIK,30187925,CDM,,,270,RC,inpatient,,81.35,81.35,,69.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,69.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.59,88,,percent of total billed charges,,,,,,,,,62.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,74.03,91,,percent of total billed charges,,,77.28,95,,percent of total billed charges,,,67.52,83,,percent of total billed charges,,,67.52,83,,percent of total billed charges,,,,,,,,,,,,,,,67.52,83,,percent of total billed charges,,,77.28,95,,percent of total billed charges,,,73.22,90,,percent of total billed charges,,,73.22,90,,percent of total billed charges,,,66.71,82,,percent of total billed charges,,,73.22,90,,percent of total billed charges,,,69.15,85,,percent of total billed charges,,61.34,77.28,
STRYKER FEMUR SZ 7 LEFT,30187926,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER INSERT TIBIA CS SZ 6,30187927,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STAPLER SEPTO,30187928,CDM,,,270,RC,inpatient,,1171.82,1171.82,,994.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,883.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,996.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1031.2,88,,percent of total billed charges,,,,,,,,,895.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1066.36,91,,percent of total billed charges,,,1113.23,95,,percent of total billed charges,,,972.61,83,,percent of total billed charges,,,972.61,83,,percent of total billed charges,,,,,,,,,,,,,,,972.61,83,,percent of total billed charges,,,1113.23,95,,percent of total billed charges,,,1054.64,90,,percent of total billed charges,,,1054.64,90,,percent of total billed charges,,,960.89,82,,percent of total billed charges,,,1054.64,90,,percent of total billed charges,,,996.05,85,,percent of total billed charges,,883.55,1113.23,
DEPUY POST AUGMENT SZ 6 8MM,30187931,CDM,,,278,RC,inpatient,,9677.92,9677.92,,8216.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7297.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8226.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8516.57,88,,percent of total billed charges,,,,,,,,,7393.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8806.91,91,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,,,,,,,,,,,,,8032.67,83,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,7935.89,82,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,7297.15,9194.02,
DEPUY ATTUNE SLEEVE FEMORAL 40MM,30187932,CDM,,,278,RC,inpatient,,25743.19,25743.19,,21855.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19410.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21881.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22654.01,88,,percent of total billed charges,,,,,,,,,19667.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23426.3,91,,percent of total billed charges,,,24456.03,95,,percent of total billed charges,,,21366.85,83,,percent of total billed charges,,,21366.85,83,,percent of total billed charges,,,,,,,,,,,,,,,21366.85,83,,percent of total billed charges,,,24456.03,95,,percent of total billed charges,,,23168.87,90,,percent of total billed charges,,,23168.87,90,,percent of total billed charges,,,21109.42,82,,percent of total billed charges,,,23168.87,90,,percent of total billed charges,,,21881.71,85,,percent of total billed charges,,19410.37,24456.03,
DEPUY ATTUNE INSERT CRS SZ 6 8MM,30187933,CDM,,,278,RC,inpatient,,23578.82,23578.82,,20018.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17778.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20042,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20749.36,88,,percent of total billed charges,,,,,,,,,18014.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21456.73,91,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,,,,,,,,,,,,,19570.42,83,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,19334.63,82,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,20042,85,,percent of total billed charges,,17778.43,22399.88,
ARTHREX INSERT HUMERAL 36 +6/33 COMBO,30187934,CDM,,,278,RC,inpatient,,6597.5,6597.5,,5601.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4974.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5607.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5805.8,88,,percent of total billed charges,,,,,,,,,5040.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6003.73,91,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,,,,,,,,,,,,,5475.93,83,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5409.95,82,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5607.88,85,,percent of total billed charges,,4974.52,6267.63,
ARTHREX GLENOSPHERE 33 +4 LAT/24,30187935,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
ARTHREX SCREW CENTRAL MODULAR 30MM,30187936,CDM,,,278,RC,inpatient,,6175,6175,,5242.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4655.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5248.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5434,88,,percent of total billed charges,,,,,,,,,4717.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5619.25,91,,percent of total billed charges,,,5866.25,95,,percent of total billed charges,,,5125.25,83,,percent of total billed charges,,,5125.25,83,,percent of total billed charges,,,,,,,,,,,,,,,5125.25,83,,percent of total billed charges,,,5866.25,95,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5063.5,82,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5248.75,85,,percent of total billed charges,,4655.95,5866.25,
BOSTON URETERAL ACCESS GUIDE 11/13 X 36M,30187937,CDM,,,270,RC,inpatient,,841.4,841.4,,714.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,634.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,715.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,740.43,88,,percent of total billed charges,,,,,,,,,642.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,765.67,91,,percent of total billed charges,,,799.33,95,,percent of total billed charges,,,698.36,83,,percent of total billed charges,,,698.36,83,,percent of total billed charges,,,,,,,,,,,,,,,698.36,83,,percent of total billed charges,,,799.33,95,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,689.95,82,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,715.19,85,,percent of total billed charges,,634.42,799.33,
S&N ENDOBUTTON 25MM,30187938,CDM,,,270,RC,inpatient,,2207.34,2207.34,,1874.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1664.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1876.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1942.46,88,,percent of total billed charges,,,,,,,,,1686.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2008.68,91,,percent of total billed charges,,,2096.97,95,,percent of total billed charges,,,1832.09,83,,percent of total billed charges,,,1832.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1832.09,83,,percent of total billed charges,,,2096.97,95,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1810.02,82,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1876.24,85,,percent of total billed charges,,1664.33,2096.97,
S&N SCREW BIO 9X25,30187939,CDM,,,270,RC,inpatient,,4091.95,4091.95,,3474.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3085.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3478.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3600.92,88,,percent of total billed charges,,,,,,,,,3126.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3723.67,91,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3396.32,83,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3355.4,82,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,3085.33,3887.35,
ZIMMER LINER G7 VIT E +5MM 40MM,30187940,CDM,,,278,RC,inpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7694.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8674.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,7694.57,9694.75,
ZIMMER STEM OFFSET REV 3MM 20X135MM,30187941,CDM,,,278,RC,inpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18476.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20829.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,18476.77,23279.75,
ZIMMER AUGMENT POSTERIOR FEMUR SZ11,30187942,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER BEARING CPS 10MM,30187943,CDM,,,278,RC,inpatient,,17135.63,17135.63,,14548.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12920.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14565.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15079.35,88,,percent of total billed charges,,,,,,,,,13091.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15593.42,91,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14222.57,83,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14051.22,82,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,12920.27,16278.85,
ZIMMER FEMUR REVISION PSN LEFT SZ 11,30187944,CDM,,,278,RC,inpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50633.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57080.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,50633.46,63795.47,
ZIMMER TIBIA BLOCK 5MM,30187945,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER TIBIA BLOCK 5MM LL,30187946,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER TIBIA REVISION LEFT SZ H-L,30187947,CDM,,,278,RC,inpatient,,24033.75,24033.75,,20404.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18121.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20428.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21149.7,88,,percent of total billed charges,,,,,,,,,18361.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21870.71,91,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,,,,,,,,,,,,,19948.01,83,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,19707.68,82,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,18121.45,22832.06,
SYNTHES TFNA 12MM X 125MM,30187948,CDM,,,278,RC,inpatient,,16019.38,16019.38,,13600.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12078.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13616.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14097.05,88,,percent of total billed charges,,,,,,,,,12238.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14577.64,91,,percent of total billed charges,,,15218.41,95,,percent of total billed charges,,,13296.09,83,,percent of total billed charges,,,13296.09,83,,percent of total billed charges,,,,,,,,,,,,,,,13296.09,83,,percent of total billed charges,,,15218.41,95,,percent of total billed charges,,,14417.44,90,,percent of total billed charges,,,14417.44,90,,percent of total billed charges,,,13135.89,82,,percent of total billed charges,,,14417.44,90,,percent of total billed charges,,,13616.47,85,,percent of total billed charges,,12078.61,15218.41,
STRYKER FEMUR TRIATHLON CR LEFT SZ 6,30187949,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER INSERT TIBIA CS SZ 6 12MM,30187950,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
SYNTHES PLATE LCP CLAVICLE 6 HOLE RIGHT,30187951,CDM,,,278,RC,inpatient,,10105.16,10105.16,,8579.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7619.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8589.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8892.54,88,,percent of total billed charges,,,,,,,,,7720.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9195.7,91,,percent of total billed charges,,,9599.9,95,,percent of total billed charges,,,8387.28,83,,percent of total billed charges,,,8387.28,83,,percent of total billed charges,,,,,,,,,,,,,,,8387.28,83,,percent of total billed charges,,,9599.9,95,,percent of total billed charges,,,9094.64,90,,percent of total billed charges,,,9094.64,90,,percent of total billed charges,,,8286.23,82,,percent of total billed charges,,,9094.64,90,,percent of total billed charges,,,8589.39,85,,percent of total billed charges,,7619.29,9599.9,
SYNTHES PLATE TIBIA 8 HOLE LEFT,30187952,CDM,,,278,RC,inpatient,,19694.55,19694.55,,16720.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14849.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16740.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17331.2,88,,percent of total billed charges,,,,,,,,,15046.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17922.04,91,,percent of total billed charges,,,18709.82,95,,percent of total billed charges,,,16346.48,83,,percent of total billed charges,,,16346.48,83,,percent of total billed charges,,,,,,,,,,,,,,,16346.48,83,,percent of total billed charges,,,18709.82,95,,percent of total billed charges,,,17725.1,90,,percent of total billed charges,,,17725.1,90,,percent of total billed charges,,,16149.53,82,,percent of total billed charges,,,17725.1,90,,percent of total billed charges,,,16740.37,85,,percent of total billed charges,,14849.69,18709.82,
SYNTHES SCREW LOCKING VA 3.5 X 85MM,30187953,CDM,,,278,RC,inpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1131.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1275.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,1131.4,1425.5,
SYNTHES SCREW LOCKING VA 3.5 X 90MM,30187954,CDM,,,278,RC,inpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1131.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1275.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,1131.4,1425.5,
ULRICH SCREW POLY 7.5 X 45MM,30187955,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SYNTHES NAIL TIBIA 10 X 390MM,30187956,CDM,,,278,RC,inpatient,,15439.13,15439.13,,13107.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11641.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13123.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13586.43,88,,percent of total billed charges,,,,,,,,,11795.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14049.61,91,,percent of total billed charges,,,14667.17,95,,percent of total billed charges,,,12814.48,83,,percent of total billed charges,,,12814.48,83,,percent of total billed charges,,,,,,,,,,,,,,,12814.48,83,,percent of total billed charges,,,14667.17,95,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,12660.09,82,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,13123.26,85,,percent of total billed charges,,11641.1,14667.17,
SYNTHES SCREW LOCKING 5.0 X 60MM,30187957,CDM,,,278,RC,inpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1697.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1913.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,1697.12,2138.28,
GORE VBX BALLOON EXPANDABLE 6X39,30187958,CDM,,,270,RC,inpatient,,24160.5,24160.5,,20512.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18217.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20536.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21261.24,88,,percent of total billed charges,,,,,,,,,18458.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21986.06,91,,percent of total billed charges,,,22952.48,95,,percent of total billed charges,,,20053.22,83,,percent of total billed charges,,,20053.22,83,,percent of total billed charges,,,,,,,,,,,,,,,20053.22,83,,percent of total billed charges,,,22952.48,95,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,19811.61,82,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,20536.43,85,,percent of total billed charges,,18217.02,22952.48,
EVERCROSS BALLOON 7 X 80MM,30187959,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
EVERCROSS BALLOON 4 X 200MM,30187960,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
INPACT ADMIRAL PTA BALLOON CATH 6X80X130,30187961,CDM,,,270,RC,inpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7302.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8232.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,7302.49,9200.75,
STRYKER SHELL CLUSTERHOLE 50D,30187962,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
DEPUY TRUMATCH BLOCK,30187963,CDM,,,278,RC,inpatient,,8833.5,8833.5,,7499.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6660.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7508.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7773.48,88,,percent of total billed charges,,,,,,,,,6748.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8038.49,91,,percent of total billed charges,,,8391.83,95,,percent of total billed charges,,,7331.81,83,,percent of total billed charges,,,7331.81,83,,percent of total billed charges,,,,,,,,,,,,,,,7331.81,83,,percent of total billed charges,,,8391.83,95,,percent of total billed charges,,,7950.15,90,,percent of total billed charges,,,7950.15,90,,percent of total billed charges,,,7243.47,82,,percent of total billed charges,,,7950.15,90,,percent of total billed charges,,,7508.48,85,,percent of total billed charges,,6660.46,8391.83,
STRYKER PATELLA SZ 33X9MM,30187964,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
S&N INSERT HIGH FLEX SZ 3-4 10MM,30187965,CDM,,,278,RC,inpatient,,13650,13650,,11588.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10292.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11602.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12012,88,,percent of total billed charges,,,,,,,,,10428.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12421.5,91,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,,,,,,,,,,,,,11329.5,83,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11193,82,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,10292.1,12967.5,
SYNTHES SCREW CANCEL F-THD 4.0X16MM,30187967,CDM,,,278,RC,inpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,178.47,224.87,
SYNTHES SCREW CANCEL F-THD 4.0X18MM,30187968,CDM,,,278,RC,inpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,178.47,224.87,
STRYKER CUP CLUSTERHOLE 54E,30187970,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
STRYKER FEMUR PRESSFIT SZ2 RIGHT,30187971,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
STRYKER INSERT PRESSFIT X3,30187972,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER TIBIA TRIATHLON TRITANIUM SZ 2,30187973,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER PATELLA METAL BACK SZ A32,30187974,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
S&N SCREW BIOSURE 10X25MM,30187975,CDM,,,270,RC,inpatient,,4091.95,4091.95,,3474.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3085.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3478.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3600.92,88,,percent of total billed charges,,,,,,,,,3126.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3723.67,91,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3396.32,83,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3355.4,82,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,3085.33,3887.35,
S&N GUIDE LGNP KIT LEFT F4/T3,30187976,CDM,,,278,RC,inpatient,,3412.5,3412.5,,2897.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2573.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2900.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3003,88,,percent of total billed charges,,,,,,,,,2607.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3105.38,91,,percent of total billed charges,,,3241.88,95,,percent of total billed charges,,,2832.38,83,,percent of total billed charges,,,2832.38,83,,percent of total billed charges,,,,,,,,,,,,,,,2832.38,83,,percent of total billed charges,,,3241.88,95,,percent of total billed charges,,,3071.25,90,,percent of total billed charges,,,3071.25,90,,percent of total billed charges,,,2798.25,82,,percent of total billed charges,,,3071.25,90,,percent of total billed charges,,,2900.63,85,,percent of total billed charges,,2573.03,3241.88,
S&N FEMUR SZ 4 LEFT,30187977,CDM,,,278,RC,inpatient,,26000,26000,,22074,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19604,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22100,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22880,88,,percent of total billed charges,,,,,,,,,19864,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23660,91,,percent of total billed charges,,,24700,95,,percent of total billed charges,,,21580,83,,percent of total billed charges,,,21580,83,,percent of total billed charges,,,,,,,,,,,,,,,21580,83,,percent of total billed charges,,,24700,95,,percent of total billed charges,,,23400,90,,percent of total billed charges,,,23400,90,,percent of total billed charges,,,21320,82,,percent of total billed charges,,,23400,90,,percent of total billed charges,,,22100,85,,percent of total billed charges,,19604,24700,
S&N TIBIAL BASEPLATE LEFT SZ 3,30187978,CDM,,,278,RC,inpatient,,8190,8190,,6953.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6175.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6961.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7207.2,88,,percent of total billed charges,,,,,,,,,6257.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7452.9,91,,percent of total billed charges,,,7780.5,95,,percent of total billed charges,,,6797.7,83,,percent of total billed charges,,,6797.7,83,,percent of total billed charges,,,,,,,,,,,,,,,6797.7,83,,percent of total billed charges,,,7780.5,95,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,6715.8,82,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,6961.5,85,,percent of total billed charges,,6175.26,7780.5,
S&N RESURFACING PATELLA 32MM,30187979,CDM,,,278,RC,inpatient,,5200,5200,,4414.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3920.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4420,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4576,88,,percent of total billed charges,,,,,,,,,3972.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4732,91,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,,,,,,,,,,,,,4316,83,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4264,82,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4420,85,,percent of total billed charges,,3920.8,4940,
ULRICH ROD LORDOSED 6.0X90MM,30187980,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
STRYKER INSERT TRIDENT X3 36MM,30187981,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER PATELLA X3 SZ 31MM,30187982,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
ZIMMER TIBIA CENTRAL CONE MEDIUM,30187983,CDM,,,278,RC,inpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36420.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41057.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,36420.56,45887.97,
STRYKER HUMERAL STEM 11 X 95MM,30187984,CDM,,,278,RC,inpatient,,38472.72,38472.72,,32663.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29008.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32701.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33855.99,88,,percent of total billed charges,,,,,,,,,29393.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35010.18,91,,percent of total billed charges,,,36549.08,95,,percent of total billed charges,,,31932.36,83,,percent of total billed charges,,,31932.36,83,,percent of total billed charges,,,,,,,,,,,,,,,31932.36,83,,percent of total billed charges,,,36549.08,95,,percent of total billed charges,,,34625.45,90,,percent of total billed charges,,,34625.45,90,,percent of total billed charges,,,31547.63,82,,percent of total billed charges,,,34625.45,90,,percent of total billed charges,,,32701.81,85,,percent of total billed charges,,29008.43,36549.08,
STRYKER HUMERAL CUP 32MM,30187985,CDM,,,278,RC,inpatient,,13000,13000,,11037,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9802,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11050,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11440,88,,percent of total billed charges,,,,,,,,,9932,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11830,91,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,,,,,,,,,,,,,10790,83,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,10660,82,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11050,85,,percent of total billed charges,,9802,12350,
STRYKER HUMERAL INSERT 32MM,30187986,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER BASEPLATE,30187987,CDM,,,278,RC,inpatient,,14300,14300,,12140.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10782.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12155,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12584,88,,percent of total billed charges,,,,,,,,,10925.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13013,91,,percent of total billed charges,,,13585,95,,percent of total billed charges,,,11869,83,,percent of total billed charges,,,11869,83,,percent of total billed charges,,,,,,,,,,,,,,,11869,83,,percent of total billed charges,,,13585,95,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,11726,82,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,12155,85,,percent of total billed charges,,10782.2,13585,
STRYKER SCREW PERIPHERAL 4.5 X 28MM,30187988,CDM,,,278,RC,inpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,980.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1105,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,980.2,1235,
STRYKER SCREW CENTER 6.5 X 32MM,30187989,CDM,,,278,RC,inpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,980.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1105,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,980.2,1235,
STRYKER GLENOSPHERE 32X2 CONCENTRIC,30187990,CDM,,,278,RC,inpatient,,13000,13000,,11037,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9802,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11050,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11440,88,,percent of total billed charges,,,,,,,,,9932,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11830,91,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,,,,,,,,,,,,,10790,83,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,10660,82,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11050,85,,percent of total billed charges,,9802,12350,
STRYKER DRILL BIT PERIPHERAL SCREW,30187991,CDM,,,278,RC,inpatient,,490,490,,416.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,369.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,416.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,431.2,88,,percent of total billed charges,,,,,,,,,374.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,445.9,91,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,,,,,,,,,,,,,406.7,83,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,401.8,82,,percent of total billed charges,,,441,90,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,369.46,465.5,
STRYKER NITINOL PILOT WIRE,30187992,CDM,,,278,RC,inpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,169.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,191.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,169.65,213.75,
ZIMMER FEMUR REVISION STANDARD 11R,30187993,CDM,,,278,RC,inpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50633.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57080.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,50633.46,63795.47,
S&N ENDO BUTTON 25CM CONT. LOOP,30187994,CDM,,,270,RC,inpatient,,2207.34,2207.34,,1874.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1664.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1876.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1942.46,88,,percent of total billed charges,,,,,,,,,1686.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2008.68,91,,percent of total billed charges,,,2096.97,95,,percent of total billed charges,,,1832.09,83,,percent of total billed charges,,,1832.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1832.09,83,,percent of total billed charges,,,2096.97,95,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1810.02,82,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1876.24,85,,percent of total billed charges,,1664.33,2096.97,
SPIRAL SNARE 20MM HOT,30187995,CDM,,,270,RC,inpatient,,54.47,54.47,,46.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47.93,88,,percent of total billed charges,,,,,,,,,41.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.57,91,,percent of total billed charges,,,51.75,95,,percent of total billed charges,,,45.21,83,,percent of total billed charges,,,45.21,83,,percent of total billed charges,,,,,,,,,,,,,,,45.21,83,,percent of total billed charges,,,51.75,95,,percent of total billed charges,,,49.02,90,,percent of total billed charges,,,49.02,90,,percent of total billed charges,,,44.67,82,,percent of total billed charges,,,49.02,90,,percent of total billed charges,,,46.3,85,,percent of total billed charges,,41.07,51.75,
NANOCROSS BALLOON 5.0 X 40,30187996,CDM,,,270,RC,inpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1458.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1643.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,1458.05,1837.06,
DEPUY EPI IMPLANT SZ 2 RIGHT 145DEG,30187997,CDM,,,278,RC,inpatient,,40066,40066,,34016.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30209.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34056.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35258.08,88,,percent of total billed charges,,,,,,,,,30610.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36460.06,91,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,,,,,,,,,,,,,33254.78,83,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,32854.12,82,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,34056.1,85,,percent of total billed charges,,30209.76,38062.7,
IMPACT ADMIRAL BALLOON 4X200X130,30187998,CDM,,,270,RC,inpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7302.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8232.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,7302.49,9200.75,
ZIMMER STEM REVISION PSN 15 X 135MM,30187999,CDM,,,278,RC,inpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18476.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20829.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,18476.77,23279.75,
ZIMMER FEMUR PSN SZ 11 LEFT,30188000,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
ZIMMER FEMORAL AUGMENT 10MM,30188001,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER FEMUR REVISION SZ 7 RIGHT,30188002,CDM,,,278,RC,inpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50633.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57080.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,50633.46,63795.47,
EVERCROSS BALLOON 6 X 40MM,30188004,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
ULRICH CONNECTOR LATERAL 15MM,30188005,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
ULRICH CONNECTOR LATERAL 30MM,30188006,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
INPACT ADMIRAL PTA BALLOON CATH 5X250X13,30188007,CDM,,,270,RC,inpatient,,21417.5,21417.5,,18183.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16148.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18204.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18847.4,88,,percent of total billed charges,,,,,,,,,16362.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19489.93,91,,percent of total billed charges,,,20346.63,95,,percent of total billed charges,,,17776.53,83,,percent of total billed charges,,,17776.53,83,,percent of total billed charges,,,,,,,,,,,,,,,17776.53,83,,percent of total billed charges,,,20346.63,95,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,17562.35,82,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,18204.88,85,,percent of total billed charges,,16148.8,20346.63,
INPACT ADMIRAL PTA BALLOON CATH 5X150X13,30188008,CDM,,,270,RC,inpatient,,11635,11635,,9878.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8772.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9889.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10238.8,88,,percent of total billed charges,,,,,,,,,8889.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10587.85,91,,percent of total billed charges,,,11053.25,95,,percent of total billed charges,,,9657.05,83,,percent of total billed charges,,,9657.05,83,,percent of total billed charges,,,,,,,,,,,,,,,9657.05,83,,percent of total billed charges,,,11053.25,95,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,9540.7,82,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,9889.75,85,,percent of total billed charges,,8772.79,11053.25,
EVERCROSS BALLOON 6X150MM,30188009,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
CATH DUAL LUMEN URETERAL 10FR,30188010,CDM,,,270,RC,inpatient,,473.27,473.27,,401.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,356.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,402.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,416.48,88,,percent of total billed charges,,,,,,,,,361.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,430.68,91,,percent of total billed charges,,,449.61,95,,percent of total billed charges,,,392.81,83,,percent of total billed charges,,,392.81,83,,percent of total billed charges,,,,,,,,,,,,,,,392.81,83,,percent of total billed charges,,,449.61,95,,percent of total billed charges,,,425.94,90,,percent of total billed charges,,,425.94,90,,percent of total billed charges,,,388.08,82,,percent of total billed charges,,,425.94,90,,percent of total billed charges,,,402.28,85,,percent of total billed charges,,356.85,449.61,
DEPUY SURESPACE TIBIA SPACER SML,30188013,CDM,,,278,RC,inpatient,,13016.77,13016.77,,11051.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9814.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11064.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11454.76,88,,percent of total billed charges,,,,,,,,,9944.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11845.26,91,,percent of total billed charges,,,12365.93,95,,percent of total billed charges,,,10803.92,83,,percent of total billed charges,,,10803.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10803.92,83,,percent of total billed charges,,,12365.93,95,,percent of total billed charges,,,11715.09,90,,percent of total billed charges,,,11715.09,90,,percent of total billed charges,,,10673.75,82,,percent of total billed charges,,,11715.09,90,,percent of total billed charges,,,11064.25,85,,percent of total billed charges,,9814.64,12365.93,
DEPUY SURESPACE FEMUR SPACER SML,30188014,CDM,,,278,RC,inpatient,,15906.93,15906.93,,13504.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11993.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13520.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13998.1,88,,percent of total billed charges,,,,,,,,,12152.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14475.31,91,,percent of total billed charges,,,15111.58,95,,percent of total billed charges,,,13202.75,83,,percent of total billed charges,,,13202.75,83,,percent of total billed charges,,,,,,,,,,,,,,,13202.75,83,,percent of total billed charges,,,15111.58,95,,percent of total billed charges,,,14316.24,90,,percent of total billed charges,,,14316.24,90,,percent of total billed charges,,,13043.68,82,,percent of total billed charges,,,14316.24,90,,percent of total billed charges,,,13520.89,85,,percent of total billed charges,,11993.83,15111.58,
COOK NEPHROSTOMY TUBE SET 10.0,30188015,CDM,,,270,RC,inpatient,,1112.28,1112.28,,944.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,838.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,945.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,978.81,88,,percent of total billed charges,,,,,,,,,849.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1012.17,91,,percent of total billed charges,,,1056.67,95,,percent of total billed charges,,,923.19,83,,percent of total billed charges,,,923.19,83,,percent of total billed charges,,,,,,,,,,,,,,,923.19,83,,percent of total billed charges,,,1056.67,95,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,912.07,82,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,945.44,85,,percent of total billed charges,,838.66,1056.67,
ULRICH TI ROD 6.0 X 500,30188016,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
ULRICH PARELLEL CONNECTOR REVISION,30188017,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
ULRICH SCREW POLY 8.5 X 55MM,30188018,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH SCREW POLY 8.5 X 50MM,30188019,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
GORE VBX BALLOON EXPANDABLE 6X19,30188020,CDM,,,270,RC,inpatient,,19974.5,19974.5,,16958.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15060.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16978.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17577.56,88,,percent of total billed charges,,,,,,,,,15260.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18176.8,91,,percent of total billed charges,,,18975.78,95,,percent of total billed charges,,,16578.84,83,,percent of total billed charges,,,16578.84,83,,percent of total billed charges,,,,,,,,,,,,,,,16578.84,83,,percent of total billed charges,,,18975.78,95,,percent of total billed charges,,,17977.05,90,,percent of total billed charges,,,17977.05,90,,percent of total billed charges,,,16379.09,82,,percent of total billed charges,,,17977.05,90,,percent of total billed charges,,,16978.33,85,,percent of total billed charges,,15060.77,18975.78,
GORE VBX BALLOON EXPANDABLE 5X19,30188021,CDM,,,270,RC,inpatient,,19974.5,19974.5,,16958.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15060.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16978.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17577.56,88,,percent of total billed charges,,,,,,,,,15260.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18176.8,91,,percent of total billed charges,,,18975.78,95,,percent of total billed charges,,,16578.84,83,,percent of total billed charges,,,16578.84,83,,percent of total billed charges,,,,,,,,,,,,,,,16578.84,83,,percent of total billed charges,,,18975.78,95,,percent of total billed charges,,,17977.05,90,,percent of total billed charges,,,17977.05,90,,percent of total billed charges,,,16379.09,82,,percent of total billed charges,,,17977.05,90,,percent of total billed charges,,,16978.33,85,,percent of total billed charges,,15060.77,18975.78,
EVERCROSS BALLOON 6 X 80MM,30188022,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
EVERCROSS BALLOON 10 X 40MM,30188023,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
IMPACT ADMIRAL BALLOON 5X80X130,30188024,CDM,,,270,RC,inpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7302.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8232.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,7302.49,9200.75,
SYNTHES PLATE VOLAR DIST. RAD. 2.4MM 6H,30188025,CDM,,,278,RC,inpatient,,10357.23,10357.23,,8793.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7809.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8803.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9114.36,88,,percent of total billed charges,,,,,,,,,7912.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9425.08,91,,percent of total billed charges,,,9839.37,95,,percent of total billed charges,,,8596.5,83,,percent of total billed charges,,,8596.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8596.5,83,,percent of total billed charges,,,9839.37,95,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,8492.93,82,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,8803.65,85,,percent of total billed charges,,7809.35,9839.37,
STRYKER SCREW PERIPHERAL 4.5 X32MM,30188026,CDM,,,278,RC,inpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,980.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1105,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,980.2,1235,
STRYKER STEM HUMERAL FRACTURE 11MM,30188027,CDM,,,278,RC,inpatient,,29281.01,29281.01,,24859.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22077.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24888.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25767.29,88,,percent of total billed charges,,,,,,,,,22370.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26645.72,91,,percent of total billed charges,,,27816.96,95,,percent of total billed charges,,,24303.24,83,,percent of total billed charges,,,24303.24,83,,percent of total billed charges,,,,,,,,,,,,,,,24303.24,83,,percent of total billed charges,,,27816.96,95,,percent of total billed charges,,,26352.91,90,,percent of total billed charges,,,26352.91,90,,percent of total billed charges,,,24010.43,82,,percent of total billed charges,,,26352.91,90,,percent of total billed charges,,,24888.86,85,,percent of total billed charges,,22077.88,27816.96,
FORTEC HOLMIUM FIBER 1000,30188028,CDM,,,270,RC,inpatient,,2307.5,2307.5,,1959.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1739.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1961.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2030.6,88,,percent of total billed charges,,,,,,,,,1762.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2099.83,91,,percent of total billed charges,,,2192.13,95,,percent of total billed charges,,,1915.23,83,,percent of total billed charges,,,1915.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1915.23,83,,percent of total billed charges,,,2192.13,95,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,1892.15,82,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,1961.38,85,,percent of total billed charges,,1739.86,2192.13,
ARTHREX SCREW INTERFERENCE 9X30MM,30188029,CDM,,,278,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
TRUSPAN  MENISCAL RPR. 12DEG NEEDLE,30188030,CDM,,,270,RC,inpatient,,5076.5,5076.5,,4309.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3827.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4315.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4467.32,88,,percent of total billed charges,,,,,,,,,3878.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4619.62,91,,percent of total billed charges,,,4822.68,95,,percent of total billed charges,,,4213.5,83,,percent of total billed charges,,,4213.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4213.5,83,,percent of total billed charges,,,4822.68,95,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4162.73,82,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4315.03,85,,percent of total billed charges,,3827.68,4822.68,
ECHO2 POSITIONING SYSTEM W/VENT 18X23CM,30188031,CDM,,,270,RC,inpatient,,10758.15,10758.15,,9133.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8111.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9144.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9467.17,88,,percent of total billed charges,,,,,,,,,8219.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9789.92,91,,percent of total billed charges,,,10220.24,95,,percent of total billed charges,,,8929.26,83,,percent of total billed charges,,,8929.26,83,,percent of total billed charges,,,,,,,,,,,,,,,8929.26,83,,percent of total billed charges,,,10220.24,95,,percent of total billed charges,,,9682.34,90,,percent of total billed charges,,,9682.34,90,,percent of total billed charges,,,8821.68,82,,percent of total billed charges,,,9682.34,90,,percent of total billed charges,,,9144.43,85,,percent of total billed charges,,8111.65,10220.24,
ECHO2 POSITIONING SYSTEM W/VENT 15X20CM,30188032,CDM,,,270,RC,inpatient,,5168.8,5168.8,,4388.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3897.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4393.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4548.54,88,,percent of total billed charges,,,,,,,,,3948.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4703.61,91,,percent of total billed charges,,,4910.36,95,,percent of total billed charges,,,4290.1,83,,percent of total billed charges,,,4290.1,83,,percent of total billed charges,,,,,,,,,,,,,,,4290.1,83,,percent of total billed charges,,,4910.36,95,,percent of total billed charges,,,4651.92,90,,percent of total billed charges,,,4651.92,90,,percent of total billed charges,,,4238.42,82,,percent of total billed charges,,,4651.92,90,,percent of total billed charges,,,4393.48,85,,percent of total billed charges,,3897.28,4910.36,
PERMAFIX FASTENERS 15,30188033,CDM,,,270,RC,inpatient,,14300,14300,,12140.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10782.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12155,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12584,88,,percent of total billed charges,,,,,,,,,10925.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13013,91,,percent of total billed charges,,,13585,95,,percent of total billed charges,,,11869,83,,percent of total billed charges,,,11869,83,,percent of total billed charges,,,,,,,,,,,,,,,11869,83,,percent of total billed charges,,,13585,95,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,11726,82,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,12155,85,,percent of total billed charges,,10782.2,13585,
IR PLATE 1 LEVEL 18MM,30188034,CDM,,,278,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
IR SCREW REVERSE 4.5X14,30188035,CDM,,,278,RC,inpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1347.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1519.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,1347.78,1698.13,
ZIMMER INSERT CPS 12MM,30188036,CDM,,,278,RC,inpatient,,17135.63,17135.63,,14548.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12920.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14565.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15079.35,88,,percent of total billed charges,,,,,,,,,13091.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15593.42,91,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14222.57,83,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14051.22,82,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,12920.27,16278.85,
ZIMMER STEM OFFSET 6MM 14X135,30188037,CDM,,,278,RC,inpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18476.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20829.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,18476.77,23279.75,
ZIMMER AUGMENT POST FEMUR SZ 5 10MM,30188038,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
COOK BILIARY DRAINAGE CATH 14FR,30188039,CDM,,,270,RC,inpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,545.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,614.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,545.11,686.81,
COOK MULTIPURPOSE DRAINAGE SET 14FR,30188040,CDM,,,270,RC,inpatient,,1393.15,1393.15,,1182.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1050.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1184.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1225.97,88,,percent of total billed charges,,,,,,,,,1064.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1267.77,91,,percent of total billed charges,,,1323.49,95,,percent of total billed charges,,,1156.31,83,,percent of total billed charges,,,1156.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1156.31,83,,percent of total billed charges,,,1323.49,95,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1142.38,82,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1184.18,85,,percent of total billed charges,,1050.44,1323.49,
AMPLATZ UTERAL STENT 8.5FR 24CM,30188042,CDM,,,270,RC,inpatient,,1073.22,1073.22,,911.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,809.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,912.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,944.43,88,,percent of total billed charges,,,,,,,,,819.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,976.63,91,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,,,,,,,,,,,,,890.77,83,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,880.04,82,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,809.21,1019.56,
EAR PACKING MEROCEL 12X15MM,30188043,CDM,,,270,RC,inpatient,,135.2,135.2,,114.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,101.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,114.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,118.98,88,,percent of total billed charges,,,,,,,,,103.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,123.03,91,,percent of total billed charges,,,128.44,95,,percent of total billed charges,,,112.22,83,,percent of total billed charges,,,112.22,83,,percent of total billed charges,,,,,,,,,,,,,,,112.22,83,,percent of total billed charges,,,128.44,95,,percent of total billed charges,,,121.68,90,,percent of total billed charges,,,121.68,90,,percent of total billed charges,,,110.86,82,,percent of total billed charges,,,121.68,90,,percent of total billed charges,,,114.92,85,,percent of total billed charges,,101.94,128.44,
SYNTHES SCREW LOCKING VA 2.4 X 18MM,30188044,CDM,,,278,RC,inpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1020.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1150.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,1020.93,1286.32,
STRYKER INSERT TRIATHLON CS #4 12MM,30188045,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
COOK CATH DRAINAGE LOCKING LOOP 16FR,30188046,CDM,,,270,RC,inpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,545.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,614.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,545.11,686.81,
COOK CATH DRAINAGE LOCKING LOOP 18FR,30188047,CDM,,,270,RC,inpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,545.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,614.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,545.11,686.81,
COOK DRAIN CATH MAC-LOC MULTIPURPOSE 8.5,30188048,CDM,,,270,RC,inpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,545.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,614.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,545.11,686.81,
COOK DRAIN CATH MAC-LOC MULTIPURPOSE 12F,30188049,CDM,,,270,RC,inpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,545.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,614.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,545.11,686.81,
COOK DRAIN CATH MAC-LOC MULTIPURPOSE 14F,30188050,CDM,,,270,RC,inpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,545.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,614.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,545.11,686.81,
STRYKER PATELLA X3 8MM,30188051,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
STRYKER INSERT TIBA SZ 5 CS,30188052,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
COOK NEPHROSTOMY TUBE SET 12.0,30188053,CDM,,,270,RC,inpatient,,1112.28,1112.28,,944.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,838.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,945.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,978.81,88,,percent of total billed charges,,,,,,,,,849.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1012.17,91,,percent of total billed charges,,,1056.67,95,,percent of total billed charges,,,923.19,83,,percent of total billed charges,,,923.19,83,,percent of total billed charges,,,,,,,,,,,,,,,923.19,83,,percent of total billed charges,,,1056.67,95,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,912.07,82,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,945.44,85,,percent of total billed charges,,838.66,1056.67,
COOK NEPHROSTOMY TUBE 10.0,30188054,CDM,,,270,RC,inpatient,,556.64,556.64,,472.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,419.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,473.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,489.84,88,,percent of total billed charges,,,,,,,,,425.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,506.54,91,,percent of total billed charges,,,528.81,95,,percent of total billed charges,,,462.01,83,,percent of total billed charges,,,462.01,83,,percent of total billed charges,,,,,,,,,,,,,,,462.01,83,,percent of total billed charges,,,528.81,95,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,456.44,82,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,473.14,85,,percent of total billed charges,,419.71,528.81,
COOK NEPHROSTOMY TUBE 12.0,30188055,CDM,,,270,RC,inpatient,,556.64,556.64,,472.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,419.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,473.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,489.84,88,,percent of total billed charges,,,,,,,,,425.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,506.54,91,,percent of total billed charges,,,528.81,95,,percent of total billed charges,,,462.01,83,,percent of total billed charges,,,462.01,83,,percent of total billed charges,,,,,,,,,,,,,,,462.01,83,,percent of total billed charges,,,528.81,95,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,456.44,82,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,473.14,85,,percent of total billed charges,,419.71,528.81,
COOK NEPHROSTOMY TUBE 14.0,30188056,CDM,,,270,RC,inpatient,,556.64,556.64,,472.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,419.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,473.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,489.84,88,,percent of total billed charges,,,,,,,,,425.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,506.54,91,,percent of total billed charges,,,528.81,95,,percent of total billed charges,,,462.01,83,,percent of total billed charges,,,462.01,83,,percent of total billed charges,,,,,,,,,,,,,,,462.01,83,,percent of total billed charges,,,528.81,95,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,456.44,82,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,473.14,85,,percent of total billed charges,,419.71,528.81,
COOK CONNECTING TUBE,30188057,CDM,,,270,RC,inpatient,,137.68,137.68,,116.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,103.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.16,88,,percent of total billed charges,,,,,,,,,105.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.29,91,,percent of total billed charges,,,130.8,95,,percent of total billed charges,,,114.27,83,,percent of total billed charges,,,114.27,83,,percent of total billed charges,,,,,,,,,,,,,,,114.27,83,,percent of total billed charges,,,130.8,95,,percent of total billed charges,,,123.91,90,,percent of total billed charges,,,123.91,90,,percent of total billed charges,,,112.9,82,,percent of total billed charges,,,123.91,90,,percent of total billed charges,,,117.03,85,,percent of total billed charges,,103.81,130.8,
AMPLATZ URETHERAL STENT 8.5FR 26CM,30188058,CDM,,,270,RC,inpatient,,1073.22,1073.22,,911.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,809.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,912.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,944.43,88,,percent of total billed charges,,,,,,,,,819.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,976.63,91,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,,,,,,,,,,,,,890.77,83,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,880.04,82,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,809.21,1019.56,
AMPLATZ URETHERAL STENT 8.5FR 28CM,30188059,CDM,,,270,RC,inpatient,,1073.22,1073.22,,911.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,809.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,912.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,944.43,88,,percent of total billed charges,,,,,,,,,819.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,976.63,91,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,,,,,,,,,,,,,890.77,83,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,880.04,82,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,809.21,1019.56,
AMPLATZ URETHERAL STENT 10.2FR 26CM,30188060,CDM,,,270,RC,inpatient,,1073.22,1073.22,,911.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,809.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,912.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,944.43,88,,percent of total billed charges,,,,,,,,,819.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,976.63,91,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,,,,,,,,,,,,,890.77,83,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,880.04,82,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,809.21,1019.56,
AMPLATZ URETHERAL STENT 10.2FR 28CM,30188061,CDM,,,270,RC,inpatient,,1073.22,1073.22,,911.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,809.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,912.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,944.43,88,,percent of total billed charges,,,,,,,,,819.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,976.63,91,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,,,,,,,,,,,,,890.77,83,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,880.04,82,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,809.21,1019.56,
CAPE NEPHROUNETEROSTONY STENT 10.2 X 28C,30188062,CDM,,,270,RC,inpatient,,898.24,898.24,,762.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,677.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,763.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,790.45,88,,percent of total billed charges,,,,,,,,,686.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,817.4,91,,percent of total billed charges,,,853.33,95,,percent of total billed charges,,,745.54,83,,percent of total billed charges,,,745.54,83,,percent of total billed charges,,,,,,,,,,,,,,,745.54,83,,percent of total billed charges,,,853.33,95,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,736.56,82,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,763.5,85,,percent of total billed charges,,677.27,853.33,
SYNTHES RT6 HEADHOLE 2 SHAFT HOLE,30188063,CDM,,,278,RC,inpatient,,9056,9056,,7688.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6828.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7697.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7969.28,88,,percent of total billed charges,,,,,,,,,6918.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8240.96,91,,percent of total billed charges,,,8603.2,95,,percent of total billed charges,,,7516.48,83,,percent of total billed charges,,,7516.48,83,,percent of total billed charges,,,,,,,,,,,,,,,7516.48,83,,percent of total billed charges,,,8603.2,95,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,7425.92,82,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,7697.6,85,,percent of total billed charges,,6828.22,8603.2,
SYNTHES LT6 HEADHOLE 2 SHAFT HOLE,30188064,CDM,,,278,RC,inpatient,,9056,9056,,7688.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6828.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7697.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7969.28,88,,percent of total billed charges,,,,,,,,,6918.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8240.96,91,,percent of total billed charges,,,8603.2,95,,percent of total billed charges,,,7516.48,83,,percent of total billed charges,,,7516.48,83,,percent of total billed charges,,,,,,,,,,,,,,,7516.48,83,,percent of total billed charges,,,8603.2,95,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,7425.92,82,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,7697.6,85,,percent of total billed charges,,6828.22,8603.2,
SYNTHES LT6 HEADHOLE 2 SHAFT HOLE,30188065,CDM,,,278,RC,inpatient,,9056,9056,,7688.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6828.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7697.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7969.28,88,,percent of total billed charges,,,,,,,,,6918.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8240.96,91,,percent of total billed charges,,,8603.2,95,,percent of total billed charges,,,7516.48,83,,percent of total billed charges,,,7516.48,83,,percent of total billed charges,,,,,,,,,,,,,,,7516.48,83,,percent of total billed charges,,,8603.2,95,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,7425.92,82,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,7697.6,85,,percent of total billed charges,,6828.22,8603.2,
SYNTHES 18 1.8 VA BUTTRESS,30188066,CDM,,,278,RC,inpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1020.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1150.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,1020.93,1286.32,
ZIMMER BEARING MC 12MM,30188067,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ZIMMER TIBIA SZ J LEFT,30188068,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER BEARING MC 12MM 6-7CD,30188069,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ARTHREX REAMER SMALL,30188070,CDM,,,270,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
ARTHREX STEM HUMERAL SZ 9,30188071,CDM,,,278,RC,inpatient,,16152.5,16152.5,,13713.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12178.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13729.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14214.2,88,,percent of total billed charges,,,,,,,,,12340.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14698.78,91,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,,,,,,,,,,,,,13406.58,83,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13245.05,82,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,12178.99,15344.88,
ARTHREX SCREW LOCKING 5.5 X 20MM,30188072,CDM,,,278,RC,inpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,633.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,714,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,633.36,798,
ARTHREX CUP REVERS 36 +2 LEFT,30188073,CDM,,,278,RC,inpatient,,11602.5,11602.5,,9850.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8748.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9862.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10210.2,88,,percent of total billed charges,,,,,,,,,8864.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10558.28,91,,percent of total billed charges,,,11022.38,95,,percent of total billed charges,,,9630.08,83,,percent of total billed charges,,,9630.08,83,,percent of total billed charges,,,,,,,,,,,,,,,9630.08,83,,percent of total billed charges,,,11022.38,95,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,9514.05,82,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,9862.13,85,,percent of total billed charges,,8748.29,11022.38,
ARTHREX GLENOID SYSTEM 30MM,30188074,CDM,,,278,RC,inpatient,,6175,6175,,5242.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4655.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5248.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5434,88,,percent of total billed charges,,,,,,,,,4717.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5619.25,91,,percent of total billed charges,,,5866.25,95,,percent of total billed charges,,,5125.25,83,,percent of total billed charges,,,5125.25,83,,percent of total billed charges,,,,,,,,,,,,,,,5125.25,83,,percent of total billed charges,,,5866.25,95,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5063.5,82,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5248.75,85,,percent of total billed charges,,4655.95,5866.25,
JAW BRA,30188076,CDM,,,270,RC,inpatient,,182,182,,154.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,154.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,160.16,88,,percent of total billed charges,,,,,,,,,139.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,149.24,82,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,137.23,172.9,
NEUROVISION STIMULATION PROBE HUMMINGBIR,30188077,CDM,,,270,RC,inpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,448.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,505.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,448.63,565.25,
S&N PATELLA 35MM,30188078,CDM,,,278,RC,inpatient,,5200,5200,,4414.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3920.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4420,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4576,88,,percent of total billed charges,,,,,,,,,3972.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4732,91,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,,,,,,,,,,,,,4316,83,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4264,82,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4420,85,,percent of total billed charges,,3920.8,4940,
STRYKER CUP CLUSTERHOLE 56MM F,30188079,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
STRYKER INSERT X3 36MM F,30188080,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER INSERT 36MM 0DEG,30188081,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER INSERT TRIATHLON CS SZ 2 12MM,30188082,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER PATELLA TRIATHLON X3,30188083,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
EVERCROSS BALLOON 5 X 200MM,30188084,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
INPACT ADMIRAL PTA BALLOON CATH 6X150X13,30188085,CDM,,,270,RC,inpatient,,11635,11635,,9878.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8772.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9889.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10238.8,88,,percent of total billed charges,,,,,,,,,8889.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10587.85,91,,percent of total billed charges,,,11053.25,95,,percent of total billed charges,,,9657.05,83,,percent of total billed charges,,,9657.05,83,,percent of total billed charges,,,,,,,,,,,,,,,9657.05,83,,percent of total billed charges,,,11053.25,95,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,9540.7,82,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,9889.75,85,,percent of total billed charges,,8772.79,11053.25,
VISIPRO STENT 6 X 27MM,30188086,CDM,,,270,RC,inpatient,,8008.98,8008.98,,6799.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6038.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6807.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7047.9,88,,percent of total billed charges,,,,,,,,,6118.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7288.17,91,,percent of total billed charges,,,7608.53,95,,percent of total billed charges,,,6647.45,83,,percent of total billed charges,,,6647.45,83,,percent of total billed charges,,,,,,,,,,,,,,,6647.45,83,,percent of total billed charges,,,7608.53,95,,percent of total billed charges,,,7208.08,90,,percent of total billed charges,,,7208.08,90,,percent of total billed charges,,,6567.36,82,,percent of total billed charges,,,7208.08,90,,percent of total billed charges,,,6807.63,85,,percent of total billed charges,,6038.77,7608.53,
STRYKER HEAD DELTA V-40 36MM -5MM,30188087,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
STRYKER SHELL CLUSTERHOLE 48MM D,30188088,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
STRYKER BASEPLATE 28 X 10.05MM,30188089,CDM,,,278,RC,inpatient,,14300,14300,,12140.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10782.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12155,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12584,88,,percent of total billed charges,,,,,,,,,10925.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13013,91,,percent of total billed charges,,,13585,95,,percent of total billed charges,,,11869,83,,percent of total billed charges,,,11869,83,,percent of total billed charges,,,,,,,,,,,,,,,11869,83,,percent of total billed charges,,,13585,95,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,11726,82,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,12155,85,,percent of total billed charges,,10782.2,13585,
STRYKER SCREW PERIPHERAL 4.5 X 24MM,30188090,CDM,,,278,RC,inpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,980.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1105,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,980.2,1235,
ARTHREX STEM HUMERAL SZ 6,30188091,CDM,,,278,RC,inpatient,,16152.5,16152.5,,13713.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12178.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13729.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14214.2,88,,percent of total billed charges,,,,,,,,,12340.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14698.78,91,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,,,,,,,,,,,,,13406.58,83,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13245.05,82,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,12178.99,15344.88,
ARTHREX GLENOID SYSTEM SHOULDER IMPLANT,30188092,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
ARTHREX BREAKAWAY PINS,30188093,CDM,,,270,RC,inpatient,,277.5,277.5,,235.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,235.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.2,88,,percent of total billed charges,,,,,,,,,212.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.53,91,,percent of total billed charges,,,263.63,95,,percent of total billed charges,,,230.33,83,,percent of total billed charges,,,230.33,83,,percent of total billed charges,,,,,,,,,,,,,,,230.33,83,,percent of total billed charges,,,263.63,95,,percent of total billed charges,,,249.75,90,,percent of total billed charges,,,249.75,90,,percent of total billed charges,,,227.55,82,,percent of total billed charges,,,249.75,90,,percent of total billed charges,,,235.88,85,,percent of total billed charges,,209.24,263.63,
ARTHREX ENTRY PIN 2.4MM,30188094,CDM,,,270,RC,inpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
S&N FEMORAL COMPONENT UNI LAT SZ 8 LEFT,30188095,CDM,,,278,RC,inpatient,,27227.79,27227.79,,23116.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20529.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23143.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23960.46,88,,percent of total billed charges,,,,,,,,,20802.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24777.29,91,,percent of total billed charges,,,25866.4,95,,percent of total billed charges,,,22599.07,83,,percent of total billed charges,,,22599.07,83,,percent of total billed charges,,,,,,,,,,,,,,,22599.07,83,,percent of total billed charges,,,25866.4,95,,percent of total billed charges,,,24505.01,90,,percent of total billed charges,,,24505.01,90,,percent of total billed charges,,,22326.79,82,,percent of total billed charges,,,24505.01,90,,percent of total billed charges,,,23143.62,85,,percent of total billed charges,,20529.75,25866.4,
S&N TIBIAL BASEPLATE UNI SZ 6 LEFT,30188096,CDM,,,278,RC,inpatient,,6855.94,6855.94,,5820.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5169.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5827.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6033.23,88,,percent of total billed charges,,,,,,,,,5237.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6238.91,91,,percent of total billed charges,,,6513.14,95,,percent of total billed charges,,,5690.43,83,,percent of total billed charges,,,5690.43,83,,percent of total billed charges,,,,,,,,,,,,,,,5690.43,83,,percent of total billed charges,,,6513.14,95,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,5621.87,82,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,5827.55,85,,percent of total billed charges,,5169.38,6513.14,
S&N TIBIAL INSERT UNI 12MM SZ 5-6,30188097,CDM,,,278,RC,inpatient,,14631.63,14631.63,,12422.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11032.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12436.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12875.83,88,,percent of total billed charges,,,,,,,,,11178.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13314.78,91,,percent of total billed charges,,,13900.05,95,,percent of total billed charges,,,12144.25,83,,percent of total billed charges,,,12144.25,83,,percent of total billed charges,,,,,,,,,,,,,,,12144.25,83,,percent of total billed charges,,,13900.05,95,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,11997.94,82,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,12436.89,85,,percent of total billed charges,,11032.25,13900.05,
AVAFLEX BALLOON KIT 10G X 20MM,30188098,CDM,,,270,RC,inpatient,,16740.75,16740.75,,14212.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12622.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14229.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14731.86,88,,percent of total billed charges,,,,,,,,,12789.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15234.08,91,,percent of total billed charges,,,15903.71,95,,percent of total billed charges,,,13894.82,83,,percent of total billed charges,,,13894.82,83,,percent of total billed charges,,,,,,,,,,,,,,,13894.82,83,,percent of total billed charges,,,15903.71,95,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,13727.42,82,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,14229.64,85,,percent of total billed charges,,12622.53,15903.71,
FORTEC HOLMIUM LASER HIGH WATTAGE,30188099,CDM,,,270,RC,inpatient,,1378,1378,,1169.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1039.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1171.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1212.64,88,,percent of total billed charges,,,,,,,,,1052.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1253.98,91,,percent of total billed charges,,,1309.1,95,,percent of total billed charges,,,1143.74,83,,percent of total billed charges,,,1143.74,83,,percent of total billed charges,,,,,,,,,,,,,,,1143.74,83,,percent of total billed charges,,,1309.1,95,,percent of total billed charges,,,1240.2,90,,percent of total billed charges,,,1240.2,90,,percent of total billed charges,,,1129.96,82,,percent of total billed charges,,,1240.2,90,,percent of total billed charges,,,1171.3,85,,percent of total billed charges,,1039.01,1309.1,
STRYKER FEMUR PRESSFIT SZ3 RIGHT,30188100,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
STRYKER FEMUR PRESSFIT SZ2 LEFT,30188101,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
STRYKER INSERT PS #2 10MM TRIATHLON,30188102,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER PATELLA METAL BACK SZ A29X9,30188103,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
SYNTHES PLATE LCP CLAVICLE 2.7 VA LEFT,30188104,CDM,,,278,RC,inpatient,,11851.13,11851.13,,10061.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8935.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10073.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10428.99,88,,percent of total billed charges,,,,,,,,,9054.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10784.53,91,,percent of total billed charges,,,11258.57,95,,percent of total billed charges,,,9836.44,83,,percent of total billed charges,,,9836.44,83,,percent of total billed charges,,,,,,,,,,,,,,,9836.44,83,,percent of total billed charges,,,11258.57,95,,percent of total billed charges,,,10666.02,90,,percent of total billed charges,,,10666.02,90,,percent of total billed charges,,,9717.93,82,,percent of total billed charges,,,10666.02,90,,percent of total billed charges,,,10073.46,85,,percent of total billed charges,,8935.75,11258.57,
SYNTHES SCREW METAPHYSEAL 2.7 X 20MM,30188105,CDM,,,278,RC,inpatient,,492.38,492.38,,418.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,371.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,418.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,433.29,88,,percent of total billed charges,,,,,,,,,376.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,448.07,91,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,,,,,,,,,,,,,408.68,83,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,403.75,82,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,371.25,467.76,
GORE VBX BALLOON EXPANDABLE 8X59,30188106,CDM,,,270,RC,inpatient,,24160.5,24160.5,,20512.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18217.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20536.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21261.24,88,,percent of total billed charges,,,,,,,,,18458.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21986.06,91,,percent of total billed charges,,,22952.48,95,,percent of total billed charges,,,20053.22,83,,percent of total billed charges,,,20053.22,83,,percent of total billed charges,,,,,,,,,,,,,,,20053.22,83,,percent of total billed charges,,,22952.48,95,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,19811.61,82,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,20536.43,85,,percent of total billed charges,,18217.02,22952.48,
GORE VBX BALLOON EXPANDABLE 8X39,30188107,CDM,,,270,RC,inpatient,,24160.5,24160.5,,20512.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18217.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20536.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21261.24,88,,percent of total billed charges,,,,,,,,,18458.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21986.06,91,,percent of total billed charges,,,22952.48,95,,percent of total billed charges,,,20053.22,83,,percent of total billed charges,,,20053.22,83,,percent of total billed charges,,,,,,,,,,,,,,,20053.22,83,,percent of total billed charges,,,22952.48,95,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,19811.61,82,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,20536.43,85,,percent of total billed charges,,18217.02,22952.48,
SYNTHES SCREW LAG 95MM,30188108,CDM,,,278,RC,inpatient,,6682.07,6682.07,,5673.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5038.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5679.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5880.22,88,,percent of total billed charges,,,,,,,,,5105.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6080.68,91,,percent of total billed charges,,,6347.97,95,,percent of total billed charges,,,5546.12,83,,percent of total billed charges,,,5546.12,83,,percent of total billed charges,,,,,,,,,,,,,,,5546.12,83,,percent of total billed charges,,,6347.97,95,,percent of total billed charges,,,6013.86,90,,percent of total billed charges,,,6013.86,90,,percent of total billed charges,,,5479.3,82,,percent of total billed charges,,,6013.86,90,,percent of total billed charges,,,5679.76,85,,percent of total billed charges,,5038.28,6347.97,
SYNTHES SCREW CANCELLOUS FT 4X14MM,30188109,CDM,,,278,RC,inpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,178.47,224.87,
DEPUY GLENOID M 26.5,30188110,CDM,,,278,RC,inpatient,,19821.75,19821.75,,16828.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14945.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16848.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17443.14,88,,percent of total billed charges,,,,,,,,,15143.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18037.79,91,,percent of total billed charges,,,18830.66,95,,percent of total billed charges,,,16452.05,83,,percent of total billed charges,,,16452.05,83,,percent of total billed charges,,,,,,,,,,,,,,,16452.05,83,,percent of total billed charges,,,18830.66,95,,percent of total billed charges,,,17839.58,90,,percent of total billed charges,,,17839.58,90,,percent of total billed charges,,,16253.84,82,,percent of total billed charges,,,17839.58,90,,percent of total billed charges,,,16848.49,85,,percent of total billed charges,,14945.6,18830.66,
ANATOMCOFFSET ADAPTER,30188111,CDM,,,278,RC,inpatient,,1738.75,1738.75,,1476.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1311.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1477.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1530.1,88,,percent of total billed charges,,,,,,,,,1328.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1582.26,91,,percent of total billed charges,,,1651.81,95,,percent of total billed charges,,,1443.16,83,,percent of total billed charges,,,1443.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1443.16,83,,percent of total billed charges,,,1651.81,95,,percent of total billed charges,,,1564.88,90,,percent of total billed charges,,,1564.88,90,,percent of total billed charges,,,1425.78,82,,percent of total billed charges,,,1564.88,90,,percent of total billed charges,,,1477.94,85,,percent of total billed charges,,1311.02,1651.81,
DEPUY SHORTSTEM S32,30188112,CDM,,,278,RC,inpatient,,36140,36140,,30682.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27249.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30719,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31803.2,88,,percent of total billed charges,,,,,,,,,27610.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32887.4,91,,percent of total billed charges,,,34333,95,,percent of total billed charges,,,29996.2,83,,percent of total billed charges,,,29996.2,83,,percent of total billed charges,,,,,,,,,,,,,,,29996.2,83,,percent of total billed charges,,,34333,95,,percent of total billed charges,,,32526,90,,percent of total billed charges,,,32526,90,,percent of total billed charges,,,29634.8,82,,percent of total billed charges,,,32526,90,,percent of total billed charges,,,30719,85,,percent of total billed charges,,27249.56,34333,
DEPUY HUM HEAD 42X16.5,30188113,CDM,,,278,RC,inpatient,,17630.93,17630.93,,14968.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13293.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14986.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15515.22,88,,percent of total billed charges,,,,,,,,,13470.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16044.15,91,,percent of total billed charges,,,16749.38,95,,percent of total billed charges,,,14633.67,83,,percent of total billed charges,,,14633.67,83,,percent of total billed charges,,,,,,,,,,,,,,,14633.67,83,,percent of total billed charges,,,16749.38,95,,percent of total billed charges,,,15867.84,90,,percent of total billed charges,,,15867.84,90,,percent of total billed charges,,,14457.36,82,,percent of total billed charges,,,15867.84,90,,percent of total billed charges,,,14986.29,85,,percent of total billed charges,,13293.72,16749.38,
DEPUY 3PKRESECTIONPIN,30188114,CDM,,,278,RC,inpatient,,1217.13,1217.13,,1033.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,917.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1034.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1071.07,88,,percent of total billed charges,,,,,,,,,929.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1107.59,91,,percent of total billed charges,,,1156.27,95,,percent of total billed charges,,,1010.22,83,,percent of total billed charges,,,1010.22,83,,percent of total billed charges,,,,,,,,,,,,,,,1010.22,83,,percent of total billed charges,,,1156.27,95,,percent of total billed charges,,,1095.42,90,,percent of total billed charges,,,1095.42,90,,percent of total billed charges,,,998.05,82,,percent of total billed charges,,,1095.42,90,,percent of total billed charges,,,1034.56,85,,percent of total billed charges,,917.72,1156.27,
DEPUY HUMERAL PIN3.5X130,30188115,CDM,,,278,RC,inpatient,,786.45,786.45,,667.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,592.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,668.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,692.08,88,,percent of total billed charges,,,,,,,,,600.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,715.67,91,,percent of total billed charges,,,747.13,95,,percent of total billed charges,,,652.75,83,,percent of total billed charges,,,652.75,83,,percent of total billed charges,,,,,,,,,,,,,,,652.75,83,,percent of total billed charges,,,747.13,95,,percent of total billed charges,,,707.81,90,,percent of total billed charges,,,707.81,90,,percent of total billed charges,,,644.89,82,,percent of total billed charges,,,707.81,90,,percent of total billed charges,,,668.48,85,,percent of total billed charges,,592.98,747.13,
DEPUY GLENOID PIN,30188116,CDM,,,278,RC,inpatient,,1043.25,1043.25,,885.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,786.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,886.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,918.06,88,,percent of total billed charges,,,,,,,,,797.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,949.36,91,,percent of total billed charges,,,991.09,95,,percent of total billed charges,,,865.9,83,,percent of total billed charges,,,865.9,83,,percent of total billed charges,,,,,,,,,,,,,,,865.9,83,,percent of total billed charges,,,991.09,95,,percent of total billed charges,,,938.93,90,,percent of total billed charges,,,938.93,90,,percent of total billed charges,,,855.47,82,,percent of total billed charges,,,938.93,90,,percent of total billed charges,,,886.76,85,,percent of total billed charges,,786.61,991.09,
DEPUY SIZER HANDLE,30188117,CDM,,,270,RC,inpatient,,539.28,539.28,,457.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,406.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,458.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,474.57,88,,percent of total billed charges,,,,,,,,,412.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,490.74,91,,percent of total billed charges,,,512.32,95,,percent of total billed charges,,,447.6,83,,percent of total billed charges,,,447.6,83,,percent of total billed charges,,,,,,,,,,,,,,,447.6,83,,percent of total billed charges,,,512.32,95,,percent of total billed charges,,,485.35,90,,percent of total billed charges,,,485.35,90,,percent of total billed charges,,,442.21,82,,percent of total billed charges,,,485.35,90,,percent of total billed charges,,,458.39,85,,percent of total billed charges,,406.62,512.32,
GORE VIABAHN 11MMx79MM 8FR135CM,30188118,CDM,,,270,RC,inpatient,,26507,26507,,22504.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19986.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22530.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23326.16,88,,percent of total billed charges,,,,,,,,,20251.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24121.37,91,,percent of total billed charges,,,25181.65,95,,percent of total billed charges,,,22000.81,83,,percent of total billed charges,,,22000.81,83,,percent of total billed charges,,,,,,,,,,,,,,,22000.81,83,,percent of total billed charges,,,25181.65,95,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,21735.74,82,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,22530.95,85,,percent of total billed charges,,19986.28,25181.65,
GORE VIABAHN HEPARIN 35 RO 13MMX10CM,30188119,CDM,,,270,RC,inpatient,,26006.5,26006.5,,22079.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19608.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22105.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22885.72,88,,percent of total billed charges,,,,,,,,,19868.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23665.92,91,,percent of total billed charges,,,24706.18,95,,percent of total billed charges,,,21585.4,83,,percent of total billed charges,,,21585.4,83,,percent of total billed charges,,,,,,,,,,,,,,,21585.4,83,,percent of total billed charges,,,24706.18,95,,percent of total billed charges,,,23405.85,90,,percent of total billed charges,,,23405.85,90,,percent of total billed charges,,,21325.33,82,,percent of total billed charges,,,23405.85,90,,percent of total billed charges,,,22105.53,85,,percent of total billed charges,,19608.9,24706.18,
DRAIN JACKSON HUBLESS SILICONE 15FR,30188120,CDM,,,270,RC,inpatient,,152.66,152.66,,129.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.34,88,,percent of total billed charges,,,,,,,,,116.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.92,91,,percent of total billed charges,,,145.03,95,,percent of total billed charges,,,126.71,83,,percent of total billed charges,,,126.71,83,,percent of total billed charges,,,,,,,,,,,,,,,126.71,83,,percent of total billed charges,,,145.03,95,,percent of total billed charges,,,137.39,90,,percent of total billed charges,,,137.39,90,,percent of total billed charges,,,125.18,82,,percent of total billed charges,,,137.39,90,,percent of total billed charges,,,129.76,85,,percent of total billed charges,,115.11,145.03,
URETERAL STENT TRIA FIRM 4.8Fx20CM,30188122,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
URETERAL STENT TRIA FIRM 4.8Fx22CM,30188123,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
URETERAL STENT TRIA FIRM 4.8Fx24CM,30188124,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
URETERAL STENT TRIA FIRM 4.8Fx26CM,30188125,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
URETERAL STENT TRIA FIRM 4.8Fx28CM,30188126,CDM,,,270,RC,inpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,975.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1099.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,975.3,1228.83,
NANOCROSS BALLOON 6X40,30188127,CDM,,,270,RC,inpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1458.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1643.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,1458.05,1837.06,
IMPACT ADMIRAL BALLOON 6X200X130,30188128,CDM,,,270,RC,inpatient,,19467.5,19467.5,,16527.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14678.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16547.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17131.4,88,,percent of total billed charges,,,,,,,,,14873.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17715.43,91,,percent of total billed charges,,,18494.13,95,,percent of total billed charges,,,16158.03,83,,percent of total billed charges,,,16158.03,83,,percent of total billed charges,,,,,,,,,,,,,,,16158.03,83,,percent of total billed charges,,,18494.13,95,,percent of total billed charges,,,17520.75,90,,percent of total billed charges,,,17520.75,90,,percent of total billed charges,,,15963.35,82,,percent of total billed charges,,,17520.75,90,,percent of total billed charges,,,16547.38,85,,percent of total billed charges,,14678.5,18494.13,
STRYKER,30188129,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
STRYKER MDM LINER,30188130,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER MDM LINER/INSERT,30188131,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER FEMORAL HEAD,30188132,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
ZIMMER SCREW HEX HEADED 3.5 X 27MM,30188133,CDM,,,278,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
ZIMMER ART SURFACE 12MM 3-5+ EF,30188134,CDM,,,278,RC,inpatient,,23562.5,23562.5,,20004.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17766.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20028.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20735,88,,percent of total billed charges,,,,,,,,,18001.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21441.88,91,,percent of total billed charges,,,22384.38,95,,percent of total billed charges,,,19556.88,83,,percent of total billed charges,,,19556.88,83,,percent of total billed charges,,,,,,,,,,,,,,,19556.88,83,,percent of total billed charges,,,22384.38,95,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,19321.25,82,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,20028.13,85,,percent of total billed charges,,17766.13,22384.38,
ZIMMER TIBIA FIXED KEEL PSN SZ E,30188135,CDM,,,278,RC,inpatient,,24033.75,24033.75,,20404.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18121.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20428.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21149.7,88,,percent of total billed charges,,,,,,,,,18361.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21870.71,91,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,,,,,,,,,,,,,19948.01,83,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,19707.68,82,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,18121.45,22832.06,
ZIMMER TIBIA HALF BLOCK PSN SZ EF 10MM,30188136,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER TIBIA HALF BLOCK PSN SZ EF LM 10M,30188137,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
ZIMMER STEM OFFSET 6MM 12X135MM,30188138,CDM,,,278,RC,inpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18476.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20829.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,18476.77,23279.75,
STRYKER SCREW LOCKING T2 F/T 5X40MM,30188139,CDM,,,278,RC,inpatient,,1774.37,1774.37,,1506.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1337.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1508.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1561.45,88,,percent of total billed charges,,,,,,,,,1355.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1614.68,91,,percent of total billed charges,,,1685.65,95,,percent of total billed charges,,,1472.73,83,,percent of total billed charges,,,1472.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1472.73,83,,percent of total billed charges,,,1685.65,95,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1454.98,82,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1508.21,85,,percent of total billed charges,,1337.87,1685.65,
STRYKER GUIDE WIRE TIP 3X1000,30188140,CDM,,,278,RC,inpatient,,1997,1997,,1695.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1505.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1697.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1757.36,88,,percent of total billed charges,,,,,,,,,1525.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1817.27,91,,percent of total billed charges,,,1897.15,95,,percent of total billed charges,,,1657.51,83,,percent of total billed charges,,,1657.51,83,,percent of total billed charges,,,,,,,,,,,,,,,1657.51,83,,percent of total billed charges,,,1897.15,95,,percent of total billed charges,,,1797.3,90,,percent of total billed charges,,,1797.3,90,,percent of total billed charges,,,1637.54,82,,percent of total billed charges,,,1797.3,90,,percent of total billed charges,,,1697.45,85,,percent of total billed charges,,1505.74,1897.15,
ZIMMER FEMUR LEFT CR SZ 12,30188141,CDM,,,278,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
ZIMMER INSERT MC 11MM,30188142,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
SCREW LATERAL MASS 12 X 3.5MM,30188145,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
SCREW SET,30188146,CDM,,,278,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
IR RODS 3.5 X 30MM LORDOSED,30188147,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
IR DRILL BIT 2.0,30188148,CDM,,,278,RC,inpatient,,2340,2340,,1986.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1764.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1989,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2059.2,88,,percent of total billed charges,,,,,,,,,1787.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2129.4,91,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1942.2,83,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1918.8,82,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1989,85,,percent of total billed charges,,1764.36,2223,
STRYKER SHELL CLUSTERHOLE 58F,30188149,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
STRYKER STEM ACCOLADE II SZ. 7,30188150,CDM,,,278,RC,inpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11762.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13260,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,11762.4,14820,
INPACT ADMIRAL PTA BALLOON CATH 5X120X13,30188151,CDM,,,270,RC,inpatient,,10660,10660,,9050.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8037.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9061,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9380.8,88,,percent of total billed charges,,,,,,,,,8144.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9700.6,91,,percent of total billed charges,,,10127,95,,percent of total billed charges,,,8847.8,83,,percent of total billed charges,,,8847.8,83,,percent of total billed charges,,,,,,,,,,,,,,,8847.8,83,,percent of total billed charges,,,10127,95,,percent of total billed charges,,,9594,90,,percent of total billed charges,,,9594,90,,percent of total billed charges,,,8741.2,82,,percent of total billed charges,,,9594,90,,percent of total billed charges,,,9061,85,,percent of total billed charges,,8037.64,10127,
ARTHREX STEM HUMERAL REVERS SZ 7,30188152,CDM,,,278,RC,inpatient,,16152.5,16152.5,,13713.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12178.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13729.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14214.2,88,,percent of total billed charges,,,,,,,,,12340.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14698.78,91,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,,,,,,,,,,,,,13406.58,83,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13245.05,82,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,12178.99,15344.88,
ULRICH SCREW POLY 5.5 X 45,30188153,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
DEPUY PIN HINGE LPS XX-XS,30188154,CDM,,,278,RC,inpatient,,4016.55,4016.55,,3410.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3028.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3414.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3534.56,88,,percent of total billed charges,,,,,,,,,3068.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3655.06,91,,percent of total billed charges,,,3815.72,95,,percent of total billed charges,,,3333.74,83,,percent of total billed charges,,,3333.74,83,,percent of total billed charges,,,,,,,,,,,,,,,3333.74,83,,percent of total billed charges,,,3815.72,95,,percent of total billed charges,,,3614.9,90,,percent of total billed charges,,,3614.9,90,,percent of total billed charges,,,3293.57,82,,percent of total billed charges,,,3614.9,90,,percent of total billed charges,,,3414.07,85,,percent of total billed charges,,3028.48,3815.72,
VENT TUBE 1.14MM BOBBIN W/FLANGE,30188155,CDM,,,270,RC,inpatient,,89.36,89.36,,75.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,75.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,78.64,88,,percent of total billed charges,,,,,,,,,68.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,81.32,91,,percent of total billed charges,,,84.89,95,,percent of total billed charges,,,74.17,83,,percent of total billed charges,,,74.17,83,,percent of total billed charges,,,,,,,,,,,,,,,74.17,83,,percent of total billed charges,,,84.89,95,,percent of total billed charges,,,80.42,90,,percent of total billed charges,,,80.42,90,,percent of total billed charges,,,73.28,82,,percent of total billed charges,,,80.42,90,,percent of total billed charges,,,75.96,85,,percent of total billed charges,,67.38,84.89,
STRYKER INSERT #4 11MM,30188156,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
ULRICH OFF SET CONNECTOR 30MM,30188157,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
ULRICH OFF SET CONNECTOR 15MM,30188158,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
ULRICH TAP  7.0,30188159,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
ULRICH BOLT PELVIC 8.0 X 90,30188160,CDM,,,278,RC,inpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7106.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8011.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,7106.45,8953.75,
ULRICH SCREW POLY 7.5 X 45,30188161,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH SCREW POLY 7.5 X 50,30188162,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
BLADE QUADCUT 3.4MM X 13CM,30188163,CDM,,,270,RC,inpatient,,2788.5,2788.5,,2367.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2102.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2370.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2453.88,88,,percent of total billed charges,,,,,,,,,2130.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2537.54,91,,percent of total billed charges,,,2649.08,95,,percent of total billed charges,,,2314.46,83,,percent of total billed charges,,,2314.46,83,,percent of total billed charges,,,,,,,,,,,,,,,2314.46,83,,percent of total billed charges,,,2649.08,95,,percent of total billed charges,,,2509.65,90,,percent of total billed charges,,,2509.65,90,,percent of total billed charges,,,2286.57,82,,percent of total billed charges,,,2509.65,90,,percent of total billed charges,,,2370.23,85,,percent of total billed charges,,2102.53,2649.08,
SYNTHES BONE HARVESTING KIT 520MM STERIL,30188164,CDM,,,278,RC,inpatient,,20163,20163,,17118.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15202.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17138.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17743.44,88,,percent of total billed charges,,,,,,,,,15404.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18348.33,91,,percent of total billed charges,,,19154.85,95,,percent of total billed charges,,,16735.29,83,,percent of total billed charges,,,16735.29,83,,percent of total billed charges,,,,,,,,,,,,,,,16735.29,83,,percent of total billed charges,,,19154.85,95,,percent of total billed charges,,,18146.7,90,,percent of total billed charges,,,18146.7,90,,percent of total billed charges,,,16533.66,82,,percent of total billed charges,,,18146.7,90,,percent of total billed charges,,,17138.55,85,,percent of total billed charges,,15202.9,19154.85,
SYNTHES REAMER HEAD 15.5MM,30188165,CDM,,,278,RC,inpatient,,4933.5,4933.5,,4188.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3719.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4193.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4341.48,88,,percent of total billed charges,,,,,,,,,3769.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4489.49,91,,percent of total billed charges,,,4686.83,95,,percent of total billed charges,,,4094.81,83,,percent of total billed charges,,,4094.81,83,,percent of total billed charges,,,,,,,,,,,,,,,4094.81,83,,percent of total billed charges,,,4686.83,95,,percent of total billed charges,,,4440.15,90,,percent of total billed charges,,,4440.15,90,,percent of total billed charges,,,4045.47,82,,percent of total billed charges,,,4440.15,90,,percent of total billed charges,,,4193.48,85,,percent of total billed charges,,3719.86,4686.83,
S&N INSERT HIGH FLEXION SZ7-8 9MM,30188166,CDM,,,278,RC,inpatient,,13000,13000,,11037,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9802,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11050,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11440,88,,percent of total billed charges,,,,,,,,,9932,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11830,91,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,,,,,,,,,,,,,10790,83,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,10660,82,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11050,85,,percent of total billed charges,,9802,12350,
BLADE QUADCUT 4.3MM X 13CM,30188167,CDM,,,270,RC,inpatient,,2788.5,2788.5,,2367.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2102.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2370.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2453.88,88,,percent of total billed charges,,,,,,,,,2130.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2537.54,91,,percent of total billed charges,,,2649.08,95,,percent of total billed charges,,,2314.46,83,,percent of total billed charges,,,2314.46,83,,percent of total billed charges,,,,,,,,,,,,,,,2314.46,83,,percent of total billed charges,,,2649.08,95,,percent of total billed charges,,,2509.65,90,,percent of total billed charges,,,2509.65,90,,percent of total billed charges,,,2286.57,82,,percent of total billed charges,,,2509.65,90,,percent of total billed charges,,,2370.23,85,,percent of total billed charges,,2102.53,2649.08,
MERZ PROLARYN GEL 1CC INJECTABLE IMPLANT,30188168,CDM,,,278,RC,inpatient,,4062.5,4062.5,,3449.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3063.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3453.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3575,88,,percent of total billed charges,,,,,,,,,3103.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3696.88,91,,percent of total billed charges,,,3859.38,95,,percent of total billed charges,,,3371.88,83,,percent of total billed charges,,,3371.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3371.88,83,,percent of total billed charges,,,3859.38,95,,percent of total billed charges,,,3656.25,90,,percent of total billed charges,,,3656.25,90,,percent of total billed charges,,,3331.25,82,,percent of total billed charges,,,3656.25,90,,percent of total billed charges,,,3453.13,85,,percent of total billed charges,,3063.13,3859.38,
ULRICH SCREW POLY 5.5 X 40,30188169,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH ROD LORDOSED 5.5 X 90MM,30188170,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
ATLIS SINGLE INCISION SLING SYSTEM,30188171,CDM,,,270,RC,inpatient,,14930.5,14930.5,,12675.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11257.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12690.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13138.84,88,,percent of total billed charges,,,,,,,,,11406.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13586.76,91,,percent of total billed charges,,,14183.98,95,,percent of total billed charges,,,12392.32,83,,percent of total billed charges,,,12392.32,83,,percent of total billed charges,,,,,,,,,,,,,,,12392.32,83,,percent of total billed charges,,,14183.98,95,,percent of total billed charges,,,13437.45,90,,percent of total billed charges,,,13437.45,90,,percent of total billed charges,,,12243.01,82,,percent of total billed charges,,,13437.45,90,,percent of total billed charges,,,12690.93,85,,percent of total billed charges,,11257.6,14183.98,
DEPUY HEAD ECCENTRIC 48X21,30188172,CDM,,,278,RC,inpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13297.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14990.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,13297.64,16754.32,
DEPUY BODY PROXIMAL 135 SZ12,30188173,CDM,,,278,RC,inpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9541.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10756.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,9541.61,12021.93,
DEPUY TRUMATCH SHLDER BLOCK 2.5,30188174,CDM,,,278,RC,inpatient,,16588,16588,,14083.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12507.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14099.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14597.44,88,,percent of total billed charges,,,,,,,,,12673.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15095.08,91,,percent of total billed charges,,,15758.6,95,,percent of total billed charges,,,13768.04,83,,percent of total billed charges,,,13768.04,83,,percent of total billed charges,,,,,,,,,,,,,,,13768.04,83,,percent of total billed charges,,,15758.6,95,,percent of total billed charges,,,14929.2,90,,percent of total billed charges,,,14929.2,90,,percent of total billed charges,,,13602.16,82,,percent of total billed charges,,,14929.2,90,,percent of total billed charges,,,14099.8,85,,percent of total billed charges,,12507.35,15758.6,
CENTINEL PRODISC IMPLANT LARGE 5MM,30188175,CDM,,,278,RC,inpatient,,48750,48750,,41388.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36757.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41437.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42900,88,,percent of total billed charges,,,,,,,,,37245,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,44362.5,91,,percent of total billed charges,,,46312.5,95,,percent of total billed charges,,,40462.5,83,,percent of total billed charges,,,40462.5,83,,percent of total billed charges,,,,,,,,,,,,,,,40462.5,83,,percent of total billed charges,,,46312.5,95,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,39975,82,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,41437.5,85,,percent of total billed charges,,36757.5,46312.5,
CENTINEL MILING BIT 2.0MM CYLINDRIC SHAF,30188176,CDM,,,278,RC,inpatient,,1996.8,1996.8,,1695.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1505.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1697.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1757.18,88,,percent of total billed charges,,,,,,,,,1525.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1817.09,91,,percent of total billed charges,,,1896.96,95,,percent of total billed charges,,,1657.34,83,,percent of total billed charges,,,1657.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1657.34,83,,percent of total billed charges,,,1896.96,95,,percent of total billed charges,,,1797.12,90,,percent of total billed charges,,,1797.12,90,,percent of total billed charges,,,1637.38,82,,percent of total billed charges,,,1797.12,90,,percent of total billed charges,,,1697.28,85,,percent of total billed charges,,1505.59,1896.96,
CENTINEL INSERTION TIP L/L DEEP 5MM,30188177,CDM,,,278,RC,inpatient,,2242.5,2242.5,,1903.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1690.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1906.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1973.4,88,,percent of total billed charges,,,,,,,,,1713.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2040.68,91,,percent of total billed charges,,,2130.38,95,,percent of total billed charges,,,1861.28,83,,percent of total billed charges,,,1861.28,83,,percent of total billed charges,,,,,,,,,,,,,,,1861.28,83,,percent of total billed charges,,,2130.38,95,,percent of total billed charges,,,2018.25,90,,percent of total billed charges,,,2018.25,90,,percent of total billed charges,,,1838.85,82,,percent of total billed charges,,,2018.25,90,,percent of total billed charges,,,1906.13,85,,percent of total billed charges,,1690.85,2130.38,
CENTINEL SCREW RETAINER 3.5X14MM,30188178,CDM,,,278,RC,inpatient,,1193.4,1193.4,,1013.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,899.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1014.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1050.19,88,,percent of total billed charges,,,,,,,,,911.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1085.99,91,,percent of total billed charges,,,1133.73,95,,percent of total billed charges,,,990.52,83,,percent of total billed charges,,,990.52,83,,percent of total billed charges,,,,,,,,,,,,,,,990.52,83,,percent of total billed charges,,,1133.73,95,,percent of total billed charges,,,1074.06,90,,percent of total billed charges,,,1074.06,90,,percent of total billed charges,,,978.59,82,,percent of total billed charges,,,1074.06,90,,percent of total billed charges,,,1014.39,85,,percent of total billed charges,,899.82,1133.73,
CENTINEL NUT RETAINER,30188179,CDM,,,278,RC,inpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,291.35,367.08,
HOLMIUM MASTERPULSE HF,30188180,CDM,,,270,RC,inpatient,,5310.5,5310.5,,4508.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4004.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4513.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4673.24,88,,percent of total billed charges,,,,,,,,,4057.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4832.56,91,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4407.72,83,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4354.61,82,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4513.93,85,,percent of total billed charges,,4004.12,5044.98,
ZIMMER BEARING MC 12MM 6-7C/D,30188181,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
CENTINEL PRODISC C IMPLANT LARGE-DEEP 6M,30188182,CDM,,,278,RC,inpatient,,48750,48750,,41388.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36757.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41437.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42900,88,,percent of total billed charges,,,,,,,,,37245,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,44362.5,91,,percent of total billed charges,,,46312.5,95,,percent of total billed charges,,,40462.5,83,,percent of total billed charges,,,40462.5,83,,percent of total billed charges,,,,,,,,,,,,,,,40462.5,83,,percent of total billed charges,,,46312.5,95,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,39975,82,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,41437.5,85,,percent of total billed charges,,36757.5,46312.5,
CENTINEL INSERTION TIP L/L DEEP 6MM,30188183,CDM,,,278,RC,inpatient,,2242.5,2242.5,,1903.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1690.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1906.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1973.4,88,,percent of total billed charges,,,,,,,,,1713.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2040.68,91,,percent of total billed charges,,,2130.38,95,,percent of total billed charges,,,1861.28,83,,percent of total billed charges,,,1861.28,83,,percent of total billed charges,,,,,,,,,,,,,,,1861.28,83,,percent of total billed charges,,,2130.38,95,,percent of total billed charges,,,2018.25,90,,percent of total billed charges,,,2018.25,90,,percent of total billed charges,,,1838.85,82,,percent of total billed charges,,,2018.25,90,,percent of total billed charges,,,1906.13,85,,percent of total billed charges,,1690.85,2130.38,
CENTINEL SCREW RETAINER 3.5X12MM,30188184,CDM,,,278,RC,inpatient,,1193.4,1193.4,,1013.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,899.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1014.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1050.19,88,,percent of total billed charges,,,,,,,,,911.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1085.99,91,,percent of total billed charges,,,1133.73,95,,percent of total billed charges,,,990.52,83,,percent of total billed charges,,,990.52,83,,percent of total billed charges,,,,,,,,,,,,,,,990.52,83,,percent of total billed charges,,,1133.73,95,,percent of total billed charges,,,1074.06,90,,percent of total billed charges,,,1074.06,90,,percent of total billed charges,,,978.59,82,,percent of total billed charges,,,1074.06,90,,percent of total billed charges,,,1014.39,85,,percent of total billed charges,,899.82,1133.73,
CENTINEL FIXATION PIN SHARP,30188185,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
CENTINEL FIXATION PIN BLUNT,30188186,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
CENTINEL PRODISC C IMPLANT LARGE 6MM,30188187,CDM,,,278,RC,inpatient,,48750,48750,,41388.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36757.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41437.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42900,88,,percent of total billed charges,,,,,,,,,37245,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,44362.5,91,,percent of total billed charges,,,46312.5,95,,percent of total billed charges,,,40462.5,83,,percent of total billed charges,,,40462.5,83,,percent of total billed charges,,,,,,,,,,,,,,,40462.5,83,,percent of total billed charges,,,46312.5,95,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,39975,82,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,41437.5,85,,percent of total billed charges,,36757.5,46312.5,
BLADE 4.0MM RAD 40 CURVED ROTATABLE BLAD,30188188,CDM,,,270,RC,inpatient,,2730,2730,,2317.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2058.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2320.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2402.4,88,,percent of total billed charges,,,,,,,,,2085.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2484.3,91,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2265.9,83,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2238.6,82,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,2058.42,2593.5,
MEDTRONIC MEDIUM BALL TIP 16.5CM,30188189,CDM,,,270,RC,inpatient,,2067,2067,,1754.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1558.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1756.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1818.96,88,,percent of total billed charges,,,,,,,,,1579.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1880.97,91,,percent of total billed charges,,,1963.65,95,,percent of total billed charges,,,1715.61,83,,percent of total billed charges,,,1715.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1715.61,83,,percent of total billed charges,,,1963.65,95,,percent of total billed charges,,,1860.3,90,,percent of total billed charges,,,1860.3,90,,percent of total billed charges,,,1694.94,82,,percent of total billed charges,,,1860.3,90,,percent of total billed charges,,,1756.95,85,,percent of total billed charges,,1558.52,1963.65,
ULRICH SCREW POLY 5.5 X 50,30188190,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
ULRICH ILLIAC BOLT SCREW 8.0 X 70,30188191,CDM,,,278,RC,inpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7106.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8011.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,7106.45,8953.75,
SYNTHES SCREW CORTEX ST 2.7 X 18,30188195,CDM,,,278,RC,inpatient,,454.51,454.51,,385.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,342.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,386.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,399.97,88,,percent of total billed charges,,,,,,,,,347.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,413.6,91,,percent of total billed charges,,,431.78,95,,percent of total billed charges,,,377.24,83,,percent of total billed charges,,,377.24,83,,percent of total billed charges,,,,,,,,,,,,,,,377.24,83,,percent of total billed charges,,,431.78,95,,percent of total billed charges,,,409.06,90,,percent of total billed charges,,,409.06,90,,percent of total billed charges,,,372.7,82,,percent of total billed charges,,,409.06,90,,percent of total billed charges,,,386.33,85,,percent of total billed charges,,342.7,431.78,
SYNTHES PLATE LAT DIST FIB 5 HOLE,30188196,CDM,,,278,RC,inpatient,,7362.03,7362.03,,6250.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5550.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6257.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6478.59,88,,percent of total billed charges,,,,,,,,,5624.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6699.45,91,,percent of total billed charges,,,6993.93,95,,percent of total billed charges,,,6110.48,83,,percent of total billed charges,,,6110.48,83,,percent of total billed charges,,,,,,,,,,,,,,,6110.48,83,,percent of total billed charges,,,6993.93,95,,percent of total billed charges,,,6625.83,90,,percent of total billed charges,,,6625.83,90,,percent of total billed charges,,,6036.86,82,,percent of total billed charges,,,6625.83,90,,percent of total billed charges,,,6257.73,85,,percent of total billed charges,,5550.97,6993.93,
SYNTHES SCREW LOCKING 2.7 X 14MM,30188197,CDM,,,278,RC,inpatient,,1301.24,1301.24,,1104.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,981.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1106.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1145.09,88,,percent of total billed charges,,,,,,,,,994.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1184.13,91,,percent of total billed charges,,,1236.18,95,,percent of total billed charges,,,1080.03,83,,percent of total billed charges,,,1080.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1080.03,83,,percent of total billed charges,,,1236.18,95,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1067.02,82,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1106.05,85,,percent of total billed charges,,981.13,1236.18,
IMPLANET JAZZ PF CONNECTOR 6MM,30188198,CDM,,,278,RC,inpatient,,15080,15080,,12802.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11370.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12818,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13270.4,88,,percent of total billed charges,,,,,,,,,11521.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13722.8,91,,percent of total billed charges,,,14326,95,,percent of total billed charges,,,12516.4,83,,percent of total billed charges,,,12516.4,83,,percent of total billed charges,,,,,,,,,,,,,,,12516.4,83,,percent of total billed charges,,,14326,95,,percent of total billed charges,,,13572,90,,percent of total billed charges,,,13572,90,,percent of total billed charges,,,12365.6,82,,percent of total billed charges,,,13572,90,,percent of total billed charges,,,12818,85,,percent of total billed charges,,11370.32,14326,
IMPLANET JAZZ PASSER BAND,30188199,CDM,,,278,RC,inpatient,,5720,5720,,4856.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4312.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4862,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5033.6,88,,percent of total billed charges,,,,,,,,,4370.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5205.2,91,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4747.6,83,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4690.4,82,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4862,85,,percent of total billed charges,,4312.88,5434,
STRYKER INSERT TRIATHLON CS SZ 2 11MM,30188200,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER FEMUR TRIATHLON PS RT SZ 7,30188201,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER INSERT TIBIAL SZ 6 9MM,30188202,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
ZIMMER TIBIA POROUS SZ D LEFT,30188203,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ZIMMER FEMUR CR SZ 6 LEFT,30188204,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
DEPUY INSERT RP SZ 4 7MM,30188205,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
STRYKER STEM HIP 132DEG #7 37X114MM,30188206,CDM,,,278,RC,inpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11762.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13260,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,11762.4,14820,
STRYKER CUP CLUSTERHOLE 46C,30188207,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
STRYKER LINER MDM 36MM C,30188208,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER LINER MDM 22.2MM 36C,30188209,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER STEM  ACCOLADE II 132 DEG SZ 3,30188210,CDM,,,278,RC,inpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11762.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13260,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,11762.4,14820,
STRYKER HEAD V40 COCR 22.2MM +3,30188211,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
STRYKER INSERT TRIDENT 36MM,30188212,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER STEM #2 127DEG,30188214,CDM,,,278,RC,inpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11762.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13260,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,11762.4,14820,
ZIMMER TIBIA RIGHT SZ F,30188215,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
STRYKER INSERT TRIATHLON CS SZ 2 10MM,30188217,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
DEPUY STEM SUMMIT 5 HI,30188218,CDM,,,278,RC,inpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19184.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21627.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,19184.82,24171.86,
ZIMMER DVR CROSSLOCK PLATE LEFT,30188219,CDM,,,278,RC,inpatient,,5323.5,5323.5,,4519.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4013.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4524.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4684.68,88,,percent of total billed charges,,,,,,,,,4067.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4844.39,91,,percent of total billed charges,,,5057.33,95,,percent of total billed charges,,,4418.51,83,,percent of total billed charges,,,4418.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4418.51,83,,percent of total billed charges,,,5057.33,95,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4365.27,82,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4524.98,85,,percent of total billed charges,,4013.92,5057.33,
ZIMMER K-WIRE SS 1.6X127MM,30188220,CDM,,,278,RC,inpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,186.62,235.13,
ZIMMER DRILL BIT 2.2MM,30188221,CDM,,,278,RC,inpatient,,651,651,,552.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,490.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,553.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,572.88,88,,percent of total billed charges,,,,,,,,,497.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,592.41,91,,percent of total billed charges,,,618.45,95,,percent of total billed charges,,,540.33,83,,percent of total billed charges,,,540.33,83,,percent of total billed charges,,,,,,,,,,,,,,,540.33,83,,percent of total billed charges,,,618.45,95,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,533.82,82,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,553.35,85,,percent of total billed charges,,490.85,618.45,
ZIMMER SCREW NON-LOCK 2.7X13MM,30188222,CDM,,,278,RC,inpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
ZIMMER SCREW NON-LOCK 2.7X16MM,30188223,CDM,,,278,RC,inpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
ZIMMER SCREW LOCKING  2.7X16MM,30188224,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ZIMMER SCREW LOCKING  2.7X18MM,30188225,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ZIMMER SCREW LOCKING  2.7X14MM,30188226,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ZIMMER SCREW CANCELLOUS 4X16MM,30188227,CDM,,,278,RC,inpatient,,424.55,424.55,,360.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,320.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,360.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,373.6,88,,percent of total billed charges,,,,,,,,,324.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,386.34,91,,percent of total billed charges,,,403.32,95,,percent of total billed charges,,,352.38,83,,percent of total billed charges,,,352.38,83,,percent of total billed charges,,,,,,,,,,,,,,,352.38,83,,percent of total billed charges,,,403.32,95,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,348.13,82,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,360.87,85,,percent of total billed charges,,320.11,403.32,
ZIMMER PLATE LOCKING FIBULA 8H 132MM,30188228,CDM,,,278,RC,inpatient,,4627.61,4627.61,,3928.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3489.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3933.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4072.3,88,,percent of total billed charges,,,,,,,,,3535.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4211.13,91,,percent of total billed charges,,,4396.23,95,,percent of total billed charges,,,3840.92,83,,percent of total billed charges,,,3840.92,83,,percent of total billed charges,,,,,,,,,,,,,,,3840.92,83,,percent of total billed charges,,,4396.23,95,,percent of total billed charges,,,4164.85,90,,percent of total billed charges,,,4164.85,90,,percent of total billed charges,,,3794.64,82,,percent of total billed charges,,,4164.85,90,,percent of total billed charges,,,3933.47,85,,percent of total billed charges,,3489.22,4396.23,
ZIMMER SCREW PERI 3.5X22 W/2.7MM HEAD,30188229,CDM,,,278,RC,inpatient,,257.1,257.1,,218.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,193.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,218.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,226.25,88,,percent of total billed charges,,,,,,,,,196.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,233.96,91,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,,,,,,,,,,,,,213.39,83,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,210.82,82,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,193.85,244.25,
ZIMMER SCREW PERI 3.5X14 W/2.7MM HEAD,30188230,CDM,,,278,RC,inpatient,,257.1,257.1,,218.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,193.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,218.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,226.25,88,,percent of total billed charges,,,,,,,,,196.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,233.96,91,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,,,,,,,,,,,,,213.39,83,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,210.82,82,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,193.85,244.25,
ZIMMER SCREW PERI 3.5X18 W/2.7MM HEAD,30188231,CDM,,,278,RC,inpatient,,257.1,257.1,,218.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,193.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,218.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,226.25,88,,percent of total billed charges,,,,,,,,,196.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,233.96,91,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,,,,,,,,,,,,,213.39,83,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,210.82,82,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,193.85,244.25,
ZIMMER SCREW PERI 3.5X16 W/2.7MM HEAD,30188232,CDM,,,278,RC,inpatient,,257.1,257.1,,218.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,193.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,218.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,226.25,88,,percent of total billed charges,,,,,,,,,196.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,233.96,91,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,,,,,,,,,,,,,213.39,83,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,210.82,82,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,193.85,244.25,
ZIMMER SCREW LOCKING 2.7X18MM,30188233,CDM,,,278,RC,inpatient,,715.26,715.26,,607.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,539.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,607.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,629.43,88,,percent of total billed charges,,,,,,,,,546.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,650.89,91,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,,,,,,,,,,,,,593.67,83,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,586.51,82,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,539.31,679.5,
ZIMMER DRILL STANDARD 2.0MM,30188234,CDM,,,278,RC,inpatient,,1285.44,1285.44,,1091.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,969.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1092.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1131.19,88,,percent of total billed charges,,,,,,,,,982.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1169.75,91,,percent of total billed charges,,,1221.17,95,,percent of total billed charges,,,1066.92,83,,percent of total billed charges,,,1066.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1066.92,83,,percent of total billed charges,,,1221.17,95,,percent of total billed charges,,,1156.9,90,,percent of total billed charges,,,1156.9,90,,percent of total billed charges,,,1054.06,82,,percent of total billed charges,,,1156.9,90,,percent of total billed charges,,,1092.62,85,,percent of total billed charges,,969.22,1221.17,
ZIMMER DRILL BIT QC 3.5X110MM,30188235,CDM,,,278,RC,inpatient,,484.54,484.54,,411.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,365.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,411.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,426.4,88,,percent of total billed charges,,,,,,,,,370.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,440.93,91,,percent of total billed charges,,,460.31,95,,percent of total billed charges,,,402.17,83,,percent of total billed charges,,,402.17,83,,percent of total billed charges,,,,,,,,,,,,,,,402.17,83,,percent of total billed charges,,,460.31,95,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,397.32,82,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,411.86,85,,percent of total billed charges,,365.34,460.31,
ZIMMER DRILL BIT QC 2.5X110MM,30188236,CDM,,,278,RC,inpatient,,484.54,484.54,,411.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,365.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,411.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,426.4,88,,percent of total billed charges,,,,,,,,,370.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,440.93,91,,percent of total billed charges,,,460.31,95,,percent of total billed charges,,,402.17,83,,percent of total billed charges,,,402.17,83,,percent of total billed charges,,,,,,,,,,,,,,,402.17,83,,percent of total billed charges,,,460.31,95,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,397.32,82,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,411.86,85,,percent of total billed charges,,365.34,460.31,
ZIMMER SCREW PERI 3.5X12MM W/2.7MM HEAD,30188237,CDM,,,278,RC,inpatient,,257.1,257.1,,218.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,193.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,218.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,226.25,88,,percent of total billed charges,,,,,,,,,196.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,233.96,91,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,,,,,,,,,,,,,213.39,83,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,210.82,82,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,193.85,244.25,
ZIMMER PLATE LOCKING FIBULA 8H 132MM RT,30188238,CDM,,,278,RC,inpatient,,4627.61,4627.61,,3928.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3489.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3933.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4072.3,88,,percent of total billed charges,,,,,,,,,3535.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4211.13,91,,percent of total billed charges,,,4396.23,95,,percent of total billed charges,,,3840.92,83,,percent of total billed charges,,,3840.92,83,,percent of total billed charges,,,,,,,,,,,,,,,3840.92,83,,percent of total billed charges,,,4396.23,95,,percent of total billed charges,,,4164.85,90,,percent of total billed charges,,,4164.85,90,,percent of total billed charges,,,3794.64,82,,percent of total billed charges,,,4164.85,90,,percent of total billed charges,,,3933.47,85,,percent of total billed charges,,3489.22,4396.23,
ZIMMER PLATE LOCKING FIBULA 10H 158MM RT,30188239,CDM,,,278,RC,inpatient,,4927.52,4927.52,,4183.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3715.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4188.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4336.22,88,,percent of total billed charges,,,,,,,,,3764.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4484.04,91,,percent of total billed charges,,,4681.14,95,,percent of total billed charges,,,4089.84,83,,percent of total billed charges,,,4089.84,83,,percent of total billed charges,,,,,,,,,,,,,,,4089.84,83,,percent of total billed charges,,,4681.14,95,,percent of total billed charges,,,4434.77,90,,percent of total billed charges,,,4434.77,90,,percent of total billed charges,,,4040.57,82,,percent of total billed charges,,,4434.77,90,,percent of total billed charges,,,4188.39,85,,percent of total billed charges,,3715.35,4681.14,
ZIMMER DRILL STANDARD 2.0MM,30188240,CDM,,,278,RC,inpatient,,1285.44,1285.44,,1091.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,969.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1092.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1131.19,88,,percent of total billed charges,,,,,,,,,982.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1169.75,91,,percent of total billed charges,,,1221.17,95,,percent of total billed charges,,,1066.92,83,,percent of total billed charges,,,1066.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1066.92,83,,percent of total billed charges,,,1221.17,95,,percent of total billed charges,,,1156.9,90,,percent of total billed charges,,,1156.9,90,,percent of total billed charges,,,1054.06,82,,percent of total billed charges,,,1156.9,90,,percent of total billed charges,,,1092.62,85,,percent of total billed charges,,969.22,1221.17,
ZIMMER SCREW LOCKING 2.7X14MM,30188241,CDM,,,278,RC,inpatient,,715.26,715.26,,607.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,539.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,607.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,629.43,88,,percent of total billed charges,,,,,,,,,546.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,650.89,91,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,,,,,,,,,,,,,593.67,83,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,586.51,82,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,539.31,679.5,
ZIMMER SCREW LOCKING 2.7X16MM,30188242,CDM,,,278,RC,inpatient,,715.26,715.26,,607.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,539.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,607.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,629.43,88,,percent of total billed charges,,,,,,,,,546.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,650.89,91,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,,,,,,,,,,,,,593.67,83,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,586.51,82,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,539.31,679.5,
ZIMMER DRILL BIT SS 2.9 KIT,30188243,CDM,,,278,RC,inpatient,,4823.33,4823.33,,4095.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3636.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4099.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4244.53,88,,percent of total billed charges,,,,,,,,,3685.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4389.23,91,,percent of total billed charges,,,4582.16,95,,percent of total billed charges,,,4003.36,83,,percent of total billed charges,,,4003.36,83,,percent of total billed charges,,,,,,,,,,,,,,,4003.36,83,,percent of total billed charges,,,4582.16,95,,percent of total billed charges,,,4341,90,,percent of total billed charges,,,4341,90,,percent of total billed charges,,,3955.13,82,,percent of total billed charges,,,4341,90,,percent of total billed charges,,,4099.83,85,,percent of total billed charges,,3636.79,4582.16,
ULRICH SCREW POLY 6.5 X 35MM,30188245,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SYNTHES NAIL TIBIA 9X285S,30188246,CDM,,,278,RC,inpatient,,15439.13,15439.13,,13107.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11641.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13123.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13586.43,88,,percent of total billed charges,,,,,,,,,11795.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14049.61,91,,percent of total billed charges,,,14667.17,95,,percent of total billed charges,,,12814.48,83,,percent of total billed charges,,,12814.48,83,,percent of total billed charges,,,,,,,,,,,,,,,12814.48,83,,percent of total billed charges,,,14667.17,95,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,12660.09,82,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,13123.26,85,,percent of total billed charges,,11641.1,14667.17,
SYNTHES SCREW LOCKING 4.0X30,30188247,CDM,,,278,RC,inpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1697.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1913.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,1697.12,2138.28,
SYNTHES SCREW LOCKING 4.0X32,30188248,CDM,,,278,RC,inpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1697.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1913.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,1697.12,2138.28,
SYNTHES END CAP 15MM,30188249,CDM,,,270,RC,inpatient,,2743.2,2743.2,,2328.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2068.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2331.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2414.02,88,,percent of total billed charges,,,,,,,,,2095.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2496.31,91,,percent of total billed charges,,,2606.04,95,,percent of total billed charges,,,2276.86,83,,percent of total billed charges,,,2276.86,83,,percent of total billed charges,,,,,,,,,,,,,,,2276.86,83,,percent of total billed charges,,,2606.04,95,,percent of total billed charges,,,2468.88,90,,percent of total billed charges,,,2468.88,90,,percent of total billed charges,,,2249.42,82,,percent of total billed charges,,,2468.88,90,,percent of total billed charges,,,2331.72,85,,percent of total billed charges,,2068.37,2606.04,
SYNTHES DRILL BIT 3.5MM,30188250,CDM,,,270,RC,inpatient,,1289.54,1289.54,,1094.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,972.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1096.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1134.8,88,,percent of total billed charges,,,,,,,,,985.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1173.48,91,,percent of total billed charges,,,1225.06,95,,percent of total billed charges,,,1070.32,83,,percent of total billed charges,,,1070.32,83,,percent of total billed charges,,,,,,,,,,,,,,,1070.32,83,,percent of total billed charges,,,1225.06,95,,percent of total billed charges,,,1160.59,90,,percent of total billed charges,,,1160.59,90,,percent of total billed charges,,,1057.42,82,,percent of total billed charges,,,1160.59,90,,percent of total billed charges,,,1096.11,85,,percent of total billed charges,,972.31,1225.06,
OLYMPUS ITIND SYSTEM IMPLANT & SNARE,30188251,CDM,,,278,RC,inpatient,,17647.5,17647.5,,14982.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13306.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15000.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15529.8,88,,percent of total billed charges,,,,,,,,,13482.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16059.23,91,,percent of total billed charges,,,16765.13,95,,percent of total billed charges,,,14647.43,83,,percent of total billed charges,,,14647.43,83,,percent of total billed charges,,,,,,,,,,,,,,,14647.43,83,,percent of total billed charges,,,16765.13,95,,percent of total billed charges,,,15882.75,90,,percent of total billed charges,,,15882.75,90,,percent of total billed charges,,,14470.95,82,,percent of total billed charges,,,15882.75,90,,percent of total billed charges,,,15000.38,85,,percent of total billed charges,,13306.22,16765.13,
ZIMMER PLATE DVR STANDARD LEFT,30188252,CDM,,,278,RC,inpatient,,5323.5,5323.5,,4519.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4013.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4524.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4684.68,88,,percent of total billed charges,,,,,,,,,4067.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4844.39,91,,percent of total billed charges,,,5057.33,95,,percent of total billed charges,,,4418.51,83,,percent of total billed charges,,,4418.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4418.51,83,,percent of total billed charges,,,5057.33,95,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4365.27,82,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4524.98,85,,percent of total billed charges,,4013.92,5057.33,
ZIMMER SCREW LOCKING  2.7X20MM,30188253,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ZIMMER SCREW LOCKING  2.7X22MM,30188254,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ZIMMER SCREW MD 2.7 X 18MM,30188255,CDM,,,278,RC,inpatient,,1033.5,1033.5,,877.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,779.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,878.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,909.48,88,,percent of total billed charges,,,,,,,,,789.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,940.49,91,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,,,,,,,,,,,,,857.81,83,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,847.47,82,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,779.26,981.83,
ZIMMER SCREW MD 2.7 X 26MM,30188256,CDM,,,278,RC,inpatient,,1033.5,1033.5,,877.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,779.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,878.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,909.48,88,,percent of total billed charges,,,,,,,,,789.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,940.49,91,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,,,,,,,,,,,,,857.81,83,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,847.47,82,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,779.26,981.83,
ZIMMER SCREW NON-LOCKING  2.7X22MM,30188257,CDM,,,278,RC,inpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
ZIMMER PLATE DVR WIDE LEFT,30188258,CDM,,,278,RC,inpatient,,5323.5,5323.5,,4519.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4013.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4524.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4684.68,88,,percent of total billed charges,,,,,,,,,4067.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4844.39,91,,percent of total billed charges,,,5057.33,95,,percent of total billed charges,,,4418.51,83,,percent of total billed charges,,,4418.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4418.51,83,,percent of total billed charges,,,5057.33,95,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4365.27,82,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4524.98,85,,percent of total billed charges,,4013.92,5057.33,
SYNTHES SCREW CANNULATED 4X40MM,30188259,CDM,,,278,RC,inpatient,,2063.23,2063.23,,1751.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1555.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1753.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1815.64,88,,percent of total billed charges,,,,,,,,,1576.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1877.54,91,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1712.48,83,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1691.85,82,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,1555.68,1960.07,
SYNTHES FIBULINK SYNDESMOSIS REPAIR KIT,30188260,CDM,,,278,RC,inpatient,,14144,14144,,12008.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10664.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12022.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12446.72,88,,percent of total billed charges,,,,,,,,,10806.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12871.04,91,,percent of total billed charges,,,13436.8,95,,percent of total billed charges,,,11739.52,83,,percent of total billed charges,,,11739.52,83,,percent of total billed charges,,,,,,,,,,,,,,,11739.52,83,,percent of total billed charges,,,13436.8,95,,percent of total billed charges,,,12729.6,90,,percent of total billed charges,,,12729.6,90,,percent of total billed charges,,,11598.08,82,,percent of total billed charges,,,12729.6,90,,percent of total billed charges,,,12022.4,85,,percent of total billed charges,,10664.58,13436.8,
STRYKER HEAD BIPOLAR UHR 26X47,30188261,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
STRYKER HEAD FEMORAL 26MM,30188262,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
STRYKER INSERT TRIATHLON CS SZ 2 13MM,30188263,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
ARTHREX TENODESIS IMPLANT SYSTEM 3.9BC,30188264,CDM,,,278,RC,inpatient,,5200,5200,,4414.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3920.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4420,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4576,88,,percent of total billed charges,,,,,,,,,3972.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4732,91,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,,,,,,,,,,,,,4316,83,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4264,82,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4420,85,,percent of total billed charges,,3920.8,4940,
STRYKER INSERT TRIATHLON #5 12MM,30188265,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER BLADE SHAVER AGRESSIVE MAX,30188266,CDM,,,270,RC,inpatient,,991.45,991.45,,841.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,747.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,842.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,872.48,88,,percent of total billed charges,,,,,,,,,757.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,902.22,91,,percent of total billed charges,,,941.88,95,,percent of total billed charges,,,822.9,83,,percent of total billed charges,,,822.9,83,,percent of total billed charges,,,,,,,,,,,,,,,822.9,83,,percent of total billed charges,,,941.88,95,,percent of total billed charges,,,892.31,90,,percent of total billed charges,,,892.31,90,,percent of total billed charges,,,812.99,82,,percent of total billed charges,,,892.31,90,,percent of total billed charges,,,842.73,85,,percent of total billed charges,,747.55,941.88,
EXTRACORPOREAL LITHOTRIPSY RIGHT - UNITE,30188267,CDM,,,270,RC,inpatient,,13650,13650,,11588.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10292.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11602.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12012,88,,percent of total billed charges,,,,,,,,,10428.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12421.5,91,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,,,,,,,,,,,,,11329.5,83,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11193,82,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,10292.1,12967.5,
GORE VBX BALLOON EXPANDABLE 8X39,30188268,CDM,,,270,RC,inpatient,,24160.5,24160.5,,20512.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18217.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20536.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21261.24,88,,percent of total billed charges,,,,,,,,,18458.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21986.06,91,,percent of total billed charges,,,22952.48,95,,percent of total billed charges,,,20053.22,83,,percent of total billed charges,,,20053.22,83,,percent of total billed charges,,,,,,,,,,,,,,,20053.22,83,,percent of total billed charges,,,22952.48,95,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,19811.61,82,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,20536.43,85,,percent of total billed charges,,18217.02,22952.48,
MTF PROFILE COSTAL CARTILAGE SHEET,30188269,CDM,,,278,RC,inpatient,,3042,3042,,2582.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2293.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2585.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2676.96,88,,percent of total billed charges,,,,,,,,,2324.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2768.22,91,,percent of total billed charges,,,2889.9,95,,percent of total billed charges,,,2524.86,83,,percent of total billed charges,,,2524.86,83,,percent of total billed charges,,,,,,,,,,,,,,,2524.86,83,,percent of total billed charges,,,2889.9,95,,percent of total billed charges,,,2737.8,90,,percent of total billed charges,,,2737.8,90,,percent of total billed charges,,,2494.44,82,,percent of total billed charges,,,2737.8,90,,percent of total billed charges,,,2585.7,85,,percent of total billed charges,,2293.67,2889.9,
ARTHREX TENODESIS IMPLANT SYSTEM 4.75,30188270,CDM,,,278,RC,inpatient,,5200,5200,,4414.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3920.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4420,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4576,88,,percent of total billed charges,,,,,,,,,3972.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4732,91,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,,,,,,,,,,,,,4316,83,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4264,82,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4420,85,,percent of total billed charges,,3920.8,4940,
STRYKER HEAD UHR 48X26MM,30188271,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
ARTHREX PASSPORT BUTTON CANNULA,30188272,CDM,,,278,RC,inpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
ARTHREX FIBERTAK DR SUTURE ANCHOR BLUE,30188273,CDM,,,278,RC,inpatient,,3055,3055,,2593.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2303.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2596.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2688.4,88,,percent of total billed charges,,,,,,,,,2334.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2780.05,91,,percent of total billed charges,,,2902.25,95,,percent of total billed charges,,,2535.65,83,,percent of total billed charges,,,2535.65,83,,percent of total billed charges,,,,,,,,,,,,,,,2535.65,83,,percent of total billed charges,,,2902.25,95,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2505.1,82,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2596.75,85,,percent of total billed charges,,2303.47,2902.25,
ARTHREX FIBERTAK DR SUTURE ANCHOR BLACK/,30188274,CDM,,,278,RC,inpatient,,3055,3055,,2593.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2303.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2596.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2688.4,88,,percent of total billed charges,,,,,,,,,2334.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2780.05,91,,percent of total billed charges,,,2902.25,95,,percent of total billed charges,,,2535.65,83,,percent of total billed charges,,,2535.65,83,,percent of total billed charges,,,,,,,,,,,,,,,2535.65,83,,percent of total billed charges,,,2902.25,95,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2505.1,82,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2596.75,85,,percent of total billed charges,,2303.47,2902.25,
ZIMMER TIBIAL CENTRAL CONE,30188278,CDM,,,278,RC,inpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36420.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41057.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,36420.56,45887.97,
ZIMMER SCREW CANCELLOUS 4X10MM,30188279,CDM,,,278,RC,inpatient,,424.55,424.55,,360.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,320.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,360.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,373.6,88,,percent of total billed charges,,,,,,,,,324.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,386.34,91,,percent of total billed charges,,,403.32,95,,percent of total billed charges,,,352.38,83,,percent of total billed charges,,,352.38,83,,percent of total billed charges,,,,,,,,,,,,,,,352.38,83,,percent of total billed charges,,,403.32,95,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,348.13,82,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,360.87,85,,percent of total billed charges,,320.11,403.32,
ZIMMER PLATE LOCKING FIBULA 6H 106MM RT,30188280,CDM,,,278,RC,inpatient,,4284.8,4284.8,,3637.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3230.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3642.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3770.62,88,,percent of total billed charges,,,,,,,,,3273.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3899.17,91,,percent of total billed charges,,,4070.56,95,,percent of total billed charges,,,3556.38,83,,percent of total billed charges,,,3556.38,83,,percent of total billed charges,,,,,,,,,,,,,,,3556.38,83,,percent of total billed charges,,,4070.56,95,,percent of total billed charges,,,3856.32,90,,percent of total billed charges,,,3856.32,90,,percent of total billed charges,,,3513.54,82,,percent of total billed charges,,,3856.32,90,,percent of total billed charges,,,3642.08,85,,percent of total billed charges,,3230.74,4070.56,
ZIMMER SCREW LOCKING 3.5X12MM,30188281,CDM,,,278,RC,inpatient,,669.13,669.13,,568.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,504.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,568.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,588.83,88,,percent of total billed charges,,,,,,,,,511.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,608.91,91,,percent of total billed charges,,,635.67,95,,percent of total billed charges,,,555.38,83,,percent of total billed charges,,,555.38,83,,percent of total billed charges,,,,,,,,,,,,,,,555.38,83,,percent of total billed charges,,,635.67,95,,percent of total billed charges,,,602.22,90,,percent of total billed charges,,,602.22,90,,percent of total billed charges,,,548.69,82,,percent of total billed charges,,,602.22,90,,percent of total billed charges,,,568.76,85,,percent of total billed charges,,504.52,635.67,
ZIMMER SCREW LOCKING 2.7X10MM,30188282,CDM,,,278,RC,inpatient,,715.26,715.26,,607.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,539.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,607.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,629.43,88,,percent of total billed charges,,,,,,,,,546.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,650.89,91,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,,,,,,,,,,,,,593.67,83,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,586.51,82,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,539.31,679.5,
ZIMMER SCREW LOCKING 2.7X12MM,30188283,CDM,,,278,RC,inpatient,,715.26,715.26,,607.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,539.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,607.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,629.43,88,,percent of total billed charges,,,,,,,,,546.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,650.89,91,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,,,,,,,,,,,,,593.67,83,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,586.51,82,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,539.31,679.5,
ARTHREX LABRAL TAPE WHITE/BLACK 1.5MM,30188284,CDM,,,270,RC,inpatient,,490,490,,416.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,369.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,416.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,431.2,88,,percent of total billed charges,,,,,,,,,374.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,445.9,91,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,,,,,,,,,,,,,406.7,83,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,401.8,82,,percent of total billed charges,,,441,90,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,369.46,465.5,
ARTHREX PASSPORT BUTTON CANNULA 40,30188285,CDM,,,278,RC,inpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
ARTHREX PASSPORT BUTTON CANNULA 50,30188286,CDM,,,278,RC,inpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
ARTHREX SUTURETAPE TIGERLINK 1.3MM WH/BL,30188287,CDM,,,270,RC,inpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,448.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,505.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,448.63,565.25,
ZIMMER ZIPTIGHT ANKLE SYN. SYSTEM,30188288,CDM,,,278,RC,inpatient,,4179.5,4179.5,,3548.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3151.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3552.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3677.96,88,,percent of total billed charges,,,,,,,,,3193.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3803.35,91,,percent of total billed charges,,,3970.53,95,,percent of total billed charges,,,3468.99,83,,percent of total billed charges,,,3468.99,83,,percent of total billed charges,,,,,,,,,,,,,,,3468.99,83,,percent of total billed charges,,,3970.53,95,,percent of total billed charges,,,3761.55,90,,percent of total billed charges,,,3761.55,90,,percent of total billed charges,,,3427.19,82,,percent of total billed charges,,,3761.55,90,,percent of total billed charges,,,3552.58,85,,percent of total billed charges,,3151.34,3970.53,
ULRICH SCREW REDUCTION 5.5 X 50MM,30188289,CDM,,,278,RC,inpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6616.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7458.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,6616.35,8336.25,
MERETE NAIL IKA WITHOUT COLLAR 200 X16,30188290,CDM,,,278,RC,inpatient,,17875,17875,,15175.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13477.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15193.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15730,88,,percent of total billed charges,,,,,,,,,13656.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16266.25,91,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14836.25,83,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,14657.5,82,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,13477.75,16981.25,
MERETE NAIL IKA WITHOUT COLLAR 200 X12,30188291,CDM,,,278,RC,inpatient,,17875,17875,,15175.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13477.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15193.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15730,88,,percent of total billed charges,,,,,,,,,13656.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16266.25,91,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14836.25,83,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,14657.5,82,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,13477.75,16981.25,
MERETE SCREW INTERLOCKING 28MM,30188292,CDM,,,278,RC,inpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2129.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2400.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,2129.48,2683.04,
MERETE SCREW INTERLOCKING 26MM,30188293,CDM,,,278,RC,inpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2129.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2400.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,2129.48,2683.04,
IR CAGE INTERBODY 6DEG 7X12X14,30188294,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
STRYKER SCREW LAG 10.5 X 80MM,30188296,CDM,,,278,RC,inpatient,,5200.33,5200.33,,4415.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3921.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4420.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4576.29,88,,percent of total billed charges,,,,,,,,,3973.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4732.3,91,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,,,,,,,,,,,,,4316.27,83,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4264.27,82,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4420.28,85,,percent of total billed charges,,3921.05,4940.31,
ULRICH ROD LORDOSED 5.5 X 120MM,30188297,CDM,,,278,RC,inpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
COOK DUAL LUMEN ACCESS CATH W/HYDROPHILI,30188298,CDM,,,270,RC,inpatient,,354.68,354.68,,301.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,267.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,301.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,312.12,88,,percent of total billed charges,,,,,,,,,270.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,322.76,91,,percent of total billed charges,,,336.95,95,,percent of total billed charges,,,294.38,83,,percent of total billed charges,,,294.38,83,,percent of total billed charges,,,,,,,,,,,,,,,294.38,83,,percent of total billed charges,,,336.95,95,,percent of total billed charges,,,319.21,90,,percent of total billed charges,,,319.21,90,,percent of total billed charges,,,290.84,82,,percent of total billed charges,,,319.21,90,,percent of total billed charges,,,301.48,85,,percent of total billed charges,,267.43,336.95,
COOK STENT BLACK SILICONE 22CM,30188299,CDM,,,270,RC,inpatient,,819.91,819.91,,696.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,618.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,696.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,721.52,88,,percent of total billed charges,,,,,,,,,626.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,746.12,91,,percent of total billed charges,,,778.91,95,,percent of total billed charges,,,680.53,83,,percent of total billed charges,,,680.53,83,,percent of total billed charges,,,,,,,,,,,,,,,680.53,83,,percent of total billed charges,,,778.91,95,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,672.33,82,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,696.92,85,,percent of total billed charges,,618.21,778.91,
COOK STENT BLACK SILICONE 24CM,30188300,CDM,,,270,RC,inpatient,,819.91,819.91,,696.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,618.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,696.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,721.52,88,,percent of total billed charges,,,,,,,,,626.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,746.12,91,,percent of total billed charges,,,778.91,95,,percent of total billed charges,,,680.53,83,,percent of total billed charges,,,680.53,83,,percent of total billed charges,,,,,,,,,,,,,,,680.53,83,,percent of total billed charges,,,778.91,95,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,672.33,82,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,696.92,85,,percent of total billed charges,,618.21,778.91,
COOK STENT BLACK SILICONE 26CM,30188301,CDM,,,270,RC,inpatient,,819.91,819.91,,696.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,618.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,696.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,721.52,88,,percent of total billed charges,,,,,,,,,626.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,746.12,91,,percent of total billed charges,,,778.91,95,,percent of total billed charges,,,680.53,83,,percent of total billed charges,,,680.53,83,,percent of total billed charges,,,,,,,,,,,,,,,680.53,83,,percent of total billed charges,,,778.91,95,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,672.33,82,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,696.92,85,,percent of total billed charges,,618.21,778.91,
COOK STENT BLACK SILICONE 28CM,30188302,CDM,,,270,RC,inpatient,,819.91,819.91,,696.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,618.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,696.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,721.52,88,,percent of total billed charges,,,,,,,,,626.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,746.12,91,,percent of total billed charges,,,778.91,95,,percent of total billed charges,,,680.53,83,,percent of total billed charges,,,680.53,83,,percent of total billed charges,,,,,,,,,,,,,,,680.53,83,,percent of total billed charges,,,778.91,95,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,672.33,82,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,696.92,85,,percent of total billed charges,,618.21,778.91,
JRF TENDON VERSAGRAFT 3.5,30188304,CDM,,,278,RC,inpatient,,8385,8385,,7118.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6322.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7127.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7378.8,88,,percent of total billed charges,,,,,,,,,6406.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7630.35,91,,percent of total billed charges,,,7965.75,95,,percent of total billed charges,,,6959.55,83,,percent of total billed charges,,,6959.55,83,,percent of total billed charges,,,,,,,,,,,,,,,6959.55,83,,percent of total billed charges,,,7965.75,95,,percent of total billed charges,,,7546.5,90,,percent of total billed charges,,,7546.5,90,,percent of total billed charges,,,6875.7,82,,percent of total billed charges,,,7546.5,90,,percent of total billed charges,,,7127.25,85,,percent of total billed charges,,6322.29,7965.75,
COOK INTRODUCER PEEL-AWAY 22FR,30188305,CDM,,,270,RC,inpatient,,373.2,373.2,,316.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,281.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,317.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,328.42,88,,percent of total billed charges,,,,,,,,,285.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,339.61,91,,percent of total billed charges,,,354.54,95,,percent of total billed charges,,,309.76,83,,percent of total billed charges,,,309.76,83,,percent of total billed charges,,,,,,,,,,,,,,,309.76,83,,percent of total billed charges,,,354.54,95,,percent of total billed charges,,,335.88,90,,percent of total billed charges,,,335.88,90,,percent of total billed charges,,,306.02,82,,percent of total billed charges,,,335.88,90,,percent of total billed charges,,,317.22,85,,percent of total billed charges,,281.39,354.54,
ARTHREX AC REPAIR LOW PROFILE,30188306,CDM,,,278,RC,inpatient,,11121.5,11121.5,,9442.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8385.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9453.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9786.92,88,,percent of total billed charges,,,,,,,,,8496.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10120.57,91,,percent of total billed charges,,,10565.43,95,,percent of total billed charges,,,9230.85,83,,percent of total billed charges,,,9230.85,83,,percent of total billed charges,,,,,,,,,,,,,,,9230.85,83,,percent of total billed charges,,,10565.43,95,,percent of total billed charges,,,10009.35,90,,percent of total billed charges,,,10009.35,90,,percent of total billed charges,,,9119.63,82,,percent of total billed charges,,,10009.35,90,,percent of total billed charges,,,9453.28,85,,percent of total billed charges,,8385.61,10565.43,
ARTHREX PASSPORT CANNULA 10X4,30188307,CDM,,,278,RC,inpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
ABBOTT PACEMAKER ASSURITY SR MRI SINGLE,30188308,CDM,,,278,RC,inpatient,,27950,27950,,23729.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21074.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23757.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24596,88,,percent of total billed charges,,,,,,,,,21353.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25434.5,91,,percent of total billed charges,,,26552.5,95,,percent of total billed charges,,,23198.5,83,,percent of total billed charges,,,23198.5,83,,percent of total billed charges,,,,,,,,,,,,,,,23198.5,83,,percent of total billed charges,,,26552.5,95,,percent of total billed charges,,,25155,90,,percent of total billed charges,,,25155,90,,percent of total billed charges,,,22919,82,,percent of total billed charges,,,25155,90,,percent of total billed charges,,,23757.5,85,,percent of total billed charges,,21074.3,26552.5,
ULRICH Z-ROD 300MM,30188309,CDM,,,278,RC,inpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3675.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4143.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,3675.75,4631.25,
TERUMO PROGREAT MICROCATHETER 2.8 X 110C,30188310,CDM,,,270,RC,inpatient,,3858.4,3858.4,,3275.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2909.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3279.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3395.39,88,,percent of total billed charges,,,,,,,,,2947.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3511.14,91,,percent of total billed charges,,,3665.48,95,,percent of total billed charges,,,3202.47,83,,percent of total billed charges,,,3202.47,83,,percent of total billed charges,,,,,,,,,,,,,,,3202.47,83,,percent of total billed charges,,,3665.48,95,,percent of total billed charges,,,3472.56,90,,percent of total billed charges,,,3472.56,90,,percent of total billed charges,,,3163.89,82,,percent of total billed charges,,,3472.56,90,,percent of total billed charges,,,3279.64,85,,percent of total billed charges,,2909.23,3665.48,
ZIMMER SCREW NON LOCKING 1.5X13MM,30188311,CDM,,,278,RC,inpatient,,574,574,,487.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,432.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,487.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,505.12,88,,percent of total billed charges,,,,,,,,,438.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,522.34,91,,percent of total billed charges,,,545.3,95,,percent of total billed charges,,,476.42,83,,percent of total billed charges,,,476.42,83,,percent of total billed charges,,,,,,,,,,,,,,,476.42,83,,percent of total billed charges,,,545.3,95,,percent of total billed charges,,,516.6,90,,percent of total billed charges,,,516.6,90,,percent of total billed charges,,,470.68,82,,percent of total billed charges,,,516.6,90,,percent of total billed charges,,,487.9,85,,percent of total billed charges,,432.8,545.3,
ZIMMER K-WIRE .35X6,30188312,CDM,,,278,RC,inpatient,,482.09,482.09,,409.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,363.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,409.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,424.24,88,,percent of total billed charges,,,,,,,,,368.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,438.7,91,,percent of total billed charges,,,457.99,95,,percent of total billed charges,,,400.13,83,,percent of total billed charges,,,400.13,83,,percent of total billed charges,,,,,,,,,,,,,,,400.13,83,,percent of total billed charges,,,457.99,95,,percent of total billed charges,,,433.88,90,,percent of total billed charges,,,433.88,90,,percent of total billed charges,,,395.31,82,,percent of total billed charges,,,433.88,90,,percent of total billed charges,,,409.78,85,,percent of total billed charges,,363.5,457.99,
ZIMMER DRILL BIT 1.1MM,30188313,CDM,,,278,RC,inpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,277.1,349.13,
ZIMMER SCREW NON-LOCK 2.7X14MM,30188314,CDM,,,278,RC,inpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
ZIMMER SCREW NON-LOCK 2.7X26MM,30188315,CDM,,,278,RC,inpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
ZIMMER SCREW LOCKING  MD 2.7X20MM,30188316,CDM,,,278,RC,inpatient,,1033.5,1033.5,,877.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,779.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,878.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,909.48,88,,percent of total billed charges,,,,,,,,,789.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,940.49,91,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,,,,,,,,,,,,,857.81,83,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,847.47,82,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,779.26,981.83,
ZIMMER SCREW LOCKING  MD 2.7X22MM,30188317,CDM,,,278,RC,inpatient,,1033.5,1033.5,,877.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,779.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,878.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,909.48,88,,percent of total billed charges,,,,,,,,,789.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,940.49,91,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,,,,,,,,,,,,,857.81,83,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,847.47,82,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,779.26,981.83,
ZIMMER SCREW LOCKING  2.7X13MM,30188318,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ZIMMER PLATE ULNA PROX 5H RIGHT,30188319,CDM,,,278,RC,inpatient,,4841.59,4841.59,,4110.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3650.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4115.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4260.6,88,,percent of total billed charges,,,,,,,,,3698.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4405.85,91,,percent of total billed charges,,,4599.51,95,,percent of total billed charges,,,4018.52,83,,percent of total billed charges,,,4018.52,83,,percent of total billed charges,,,,,,,,,,,,,,,4018.52,83,,percent of total billed charges,,,4599.51,95,,percent of total billed charges,,,4357.43,90,,percent of total billed charges,,,4357.43,90,,percent of total billed charges,,,3970.1,82,,percent of total billed charges,,,4357.43,90,,percent of total billed charges,,,4115.35,85,,percent of total billed charges,,3650.56,4599.51,
ZIMMER SCREW PERI 3.5X20 W/2.7MM HEAD,30188320,CDM,,,278,RC,inpatient,,257.1,257.1,,218.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,193.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,218.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,226.25,88,,percent of total billed charges,,,,,,,,,196.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,233.96,91,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,,,,,,,,,,,,,213.39,83,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,210.82,82,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,193.85,244.25,
ZIMMER SCREW CORTICAL ST 2.7X50MM,30188321,CDM,,,278,RC,inpatient,,168.8,168.8,,143.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,127.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,143.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,148.54,88,,percent of total billed charges,,,,,,,,,128.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,153.61,91,,percent of total billed charges,,,160.36,95,,percent of total billed charges,,,140.1,83,,percent of total billed charges,,,140.1,83,,percent of total billed charges,,,,,,,,,,,,,,,140.1,83,,percent of total billed charges,,,160.36,95,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,138.42,82,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,143.48,85,,percent of total billed charges,,127.28,160.36,
ZIMMER SCREW LOCKING 2.7X34MM,30188322,CDM,,,278,RC,inpatient,,715.26,715.26,,607.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,539.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,607.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,629.43,88,,percent of total billed charges,,,,,,,,,546.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,650.89,91,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,,,,,,,,,,,,,593.67,83,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,586.51,82,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,539.31,679.5,
ZIMMER SCREW LOCKING W/2.7MM HEAD 3.5X18,30188323,CDM,,,278,RC,inpatient,,669.13,669.13,,568.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,504.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,568.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,588.83,88,,percent of total billed charges,,,,,,,,,511.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,608.91,91,,percent of total billed charges,,,635.67,95,,percent of total billed charges,,,555.38,83,,percent of total billed charges,,,555.38,83,,percent of total billed charges,,,,,,,,,,,,,,,555.38,83,,percent of total billed charges,,,635.67,95,,percent of total billed charges,,,602.22,90,,percent of total billed charges,,,602.22,90,,percent of total billed charges,,,548.69,82,,percent of total billed charges,,,602.22,90,,percent of total billed charges,,,568.76,85,,percent of total billed charges,,504.52,635.67,
ZIMMER SCREW CORITCAL ST 2.7X20MM,30188324,CDM,,,278,RC,inpatient,,168.8,168.8,,143.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,127.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,143.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,148.54,88,,percent of total billed charges,,,,,,,,,128.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,153.61,91,,percent of total billed charges,,,160.36,95,,percent of total billed charges,,,140.1,83,,percent of total billed charges,,,140.1,83,,percent of total billed charges,,,,,,,,,,,,,,,140.1,83,,percent of total billed charges,,,160.36,95,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,138.42,82,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,143.48,85,,percent of total billed charges,,127.28,160.36,
ZIMMER DRILL BIT Q-C 2.0MM,30188325,CDM,,,278,RC,inpatient,,484.54,484.54,,411.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,365.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,411.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,426.4,88,,percent of total billed charges,,,,,,,,,370.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,440.93,91,,percent of total billed charges,,,460.31,95,,percent of total billed charges,,,402.17,83,,percent of total billed charges,,,402.17,83,,percent of total billed charges,,,,,,,,,,,,,,,402.17,83,,percent of total billed charges,,,460.31,95,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,397.32,82,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,411.86,85,,percent of total billed charges,,365.34,460.31,
STRYKER SCREW LAG 10.5X100,30188326,CDM,,,278,RC,inpatient,,5200.33,5200.33,,4415.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3921.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4420.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4576.29,88,,percent of total billed charges,,,,,,,,,3973.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4732.3,91,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,,,,,,,,,,,,,4316.27,83,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4264.27,82,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4420.28,85,,percent of total billed charges,,3921.05,4940.31,
STRYKER SCREW LOCKING FT 5X42MM,30188327,CDM,,,278,RC,inpatient,,1774.37,1774.37,,1506.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1337.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1508.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1561.45,88,,percent of total billed charges,,,,,,,,,1355.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1614.68,91,,percent of total billed charges,,,1685.65,95,,percent of total billed charges,,,1472.73,83,,percent of total billed charges,,,1472.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1472.73,83,,percent of total billed charges,,,1685.65,95,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1454.98,82,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1508.21,85,,percent of total billed charges,,1337.87,1685.65,
STRYKER GAMMA NAIL KIT 11X180MM X 130DEG,30188328,CDM,,,278,RC,inpatient,,13727.55,13727.55,,11654.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10350.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11668.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12080.24,88,,percent of total billed charges,,,,,,,,,10487.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12492.07,91,,percent of total billed charges,,,13041.17,95,,percent of total billed charges,,,11393.87,83,,percent of total billed charges,,,11393.87,83,,percent of total billed charges,,,,,,,,,,,,,,,11393.87,83,,percent of total billed charges,,,13041.17,95,,percent of total billed charges,,,12354.8,90,,percent of total billed charges,,,12354.8,90,,percent of total billed charges,,,11256.59,82,,percent of total billed charges,,,12354.8,90,,percent of total billed charges,,,11668.42,85,,percent of total billed charges,,10350.57,13041.17,
UROVAC BLADDER EVACUATOR,30188329,CDM,,,270,RC,inpatient,,190.96,190.96,,162.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,143.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.04,88,,percent of total billed charges,,,,,,,,,145.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,173.77,91,,percent of total billed charges,,,181.41,95,,percent of total billed charges,,,158.5,83,,percent of total billed charges,,,158.5,83,,percent of total billed charges,,,,,,,,,,,,,,,158.5,83,,percent of total billed charges,,,181.41,95,,percent of total billed charges,,,171.86,90,,percent of total billed charges,,,171.86,90,,percent of total billed charges,,,156.59,82,,percent of total billed charges,,,171.86,90,,percent of total billed charges,,,162.32,85,,percent of total billed charges,,143.98,181.41,
SCREW LATERAL MASS 28 x 3.5,30188330,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
SCREW LATERAL MASS 16 X 4.0MM,30188331,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
SCREW LATERAL MASS 5.5 X 30MM,30188332,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SCREW LATERAL MASS 14 X 4.0MM,30188333,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
ULRICH TRANSITION ROD SPECIALTY 3.5-5.5,30188334,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
BIOPSY FORCEP ALLIGATOR CUP SINGLE-USE,30188335,CDM,,,270,RC,inpatient,,208.28,208.28,,176.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,157.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,177.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.29,88,,percent of total billed charges,,,,,,,,,159.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,189.53,91,,percent of total billed charges,,,197.87,95,,percent of total billed charges,,,172.87,83,,percent of total billed charges,,,172.87,83,,percent of total billed charges,,,,,,,,,,,,,,,172.87,83,,percent of total billed charges,,,197.87,95,,percent of total billed charges,,,187.45,90,,percent of total billed charges,,,187.45,90,,percent of total billed charges,,,170.79,82,,percent of total billed charges,,,187.45,90,,percent of total billed charges,,,177.04,85,,percent of total billed charges,,157.04,197.87,
BRUSH CYTOLOGY 2.0 SINGLE-USE,30188336,CDM,,,270,RC,inpatient,,133.6,133.6,,113.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,100.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,113.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,117.57,88,,percent of total billed charges,,,,,,,,,102.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,121.58,91,,percent of total billed charges,,,126.92,95,,percent of total billed charges,,,110.89,83,,percent of total billed charges,,,110.89,83,,percent of total billed charges,,,,,,,,,,,,,,,110.89,83,,percent of total billed charges,,,126.92,95,,percent of total billed charges,,,120.24,90,,percent of total billed charges,,,120.24,90,,percent of total billed charges,,,109.55,82,,percent of total billed charges,,,120.24,90,,percent of total billed charges,,,113.56,85,,percent of total billed charges,,100.73,126.92,
OLYMPUS GUIDESHEATH 1.91MM,30188337,CDM,,,270,RC,inpatient,,1755,1755,,1490,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1323.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1491.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1544.4,88,,percent of total billed charges,,,,,,,,,1340.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1597.05,91,,percent of total billed charges,,,1667.25,95,,percent of total billed charges,,,1456.65,83,,percent of total billed charges,,,1456.65,83,,percent of total billed charges,,,,,,,,,,,,,,,1456.65,83,,percent of total billed charges,,,1667.25,95,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1439.1,82,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1491.75,85,,percent of total billed charges,,1323.27,1667.25,
OLYMPUS VIZISHOT 22G,30188338,CDM,,,270,RC,inpatient,,1547,1547,,1313.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1166.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1314.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1361.36,88,,percent of total billed charges,,,,,,,,,1181.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1407.77,91,,percent of total billed charges,,,1469.65,95,,percent of total billed charges,,,1284.01,83,,percent of total billed charges,,,1284.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1284.01,83,,percent of total billed charges,,,1469.65,95,,percent of total billed charges,,,1392.3,90,,percent of total billed charges,,,1392.3,90,,percent of total billed charges,,,1268.54,82,,percent of total billed charges,,,1392.3,90,,percent of total billed charges,,,1314.95,85,,percent of total billed charges,,1166.44,1469.65,
MERZ PROLARYN PLUS 1.0CC KIT,30188339,CDM,,,278,RC,inpatient,,4420,4420,,3752.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3332.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3757,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3889.6,88,,percent of total billed charges,,,,,,,,,3376.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4022.2,91,,percent of total billed charges,,,4199,95,,percent of total billed charges,,,3668.6,83,,percent of total billed charges,,,3668.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3668.6,83,,percent of total billed charges,,,4199,95,,percent of total billed charges,,,3978,90,,percent of total billed charges,,,3978,90,,percent of total billed charges,,,3624.4,82,,percent of total billed charges,,,3978,90,,percent of total billed charges,,,3757,85,,percent of total billed charges,,3332.68,4199,
FORTEC LASER FIBER DUST THULIUM,30188340,CDM,,,270,RC,inpatient,,5310.5,5310.5,,4508.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4004.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4513.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4673.24,88,,percent of total billed charges,,,,,,,,,4057.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4832.56,91,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4407.72,83,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4354.61,82,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4513.93,85,,percent of total billed charges,,4004.12,5044.98,
FORTEC FIBER THULIUM TFL 272,30188341,CDM,,,270,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
FORTEC FLEXIBLE UTERSCOPE 7FR,30188342,CDM,,,270,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
ZIMMER LINER NEUTRAL G7 40MM,30188343,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
STRYKER STEM #8 132DEG,30188344,CDM,,,278,RC,inpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11762.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13260,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,11762.4,14820,
STRYKER HEAD BIPOLAR 26MM,30188345,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
BARD ROTAREX 6F 135CM,30188346,CDM,,,270,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
STRYKER SCREW LOCKING 8 X 17.5MM,30188347,CDM,,,278,RC,inpatient,,1864.01,1864.01,,1582.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1405.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1584.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1640.33,88,,percent of total billed charges,,,,,,,,,1424.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1696.25,91,,percent of total billed charges,,,1770.81,95,,percent of total billed charges,,,1547.13,83,,percent of total billed charges,,,1547.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1547.13,83,,percent of total billed charges,,,1770.81,95,,percent of total billed charges,,,1677.61,90,,percent of total billed charges,,,1677.61,90,,percent of total billed charges,,,1528.49,82,,percent of total billed charges,,,1677.61,90,,percent of total billed charges,,,1584.41,85,,percent of total billed charges,,1405.46,1770.81,
ADMIRAL IN PACT 6X250X130,30188349,CDM,,,270,RC,inpatient,,21417.5,21417.5,,18183.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16148.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18204.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18847.4,88,,percent of total billed charges,,,,,,,,,16362.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19489.93,91,,percent of total billed charges,,,20346.63,95,,percent of total billed charges,,,17776.53,83,,percent of total billed charges,,,17776.53,83,,percent of total billed charges,,,,,,,,,,,,,,,17776.53,83,,percent of total billed charges,,,20346.63,95,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,17562.35,82,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,18204.88,85,,percent of total billed charges,,16148.8,20346.63,
DAT DUAL ACTION TISSUE CLIP 15MM,30188350,CDM,,,270,RC,inpatient,,2236,2236,,1898.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1685.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1900.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1967.68,88,,percent of total billed charges,,,,,,,,,1708.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2034.76,91,,percent of total billed charges,,,2124.2,95,,percent of total billed charges,,,1855.88,83,,percent of total billed charges,,,1855.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1855.88,83,,percent of total billed charges,,,2124.2,95,,percent of total billed charges,,,2012.4,90,,percent of total billed charges,,,2012.4,90,,percent of total billed charges,,,1833.52,82,,percent of total billed charges,,,2012.4,90,,percent of total billed charges,,,1900.6,85,,percent of total billed charges,,1685.94,2124.2,
CLIP WECK HEMOCLIP MD-LG,30188351,CDM,,,270,RC,inpatient,,221.79,221.79,,188.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,167.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,188.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,195.18,88,,percent of total billed charges,,,,,,,,,169.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,201.83,91,,percent of total billed charges,,,210.7,95,,percent of total billed charges,,,184.09,83,,percent of total billed charges,,,184.09,83,,percent of total billed charges,,,,,,,,,,,,,,,184.09,83,,percent of total billed charges,,,210.7,95,,percent of total billed charges,,,199.61,90,,percent of total billed charges,,,199.61,90,,percent of total billed charges,,,181.87,82,,percent of total billed charges,,,199.61,90,,percent of total billed charges,,,188.52,85,,percent of total billed charges,,167.23,210.7,
ZIMMER PLATE CLAVICLE NARROW 10H,30188352,CDM,,,278,RC,inpatient,,8794.5,8794.5,,7466.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6631.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7475.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7739.16,88,,percent of total billed charges,,,,,,,,,6719,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8003,91,,percent of total billed charges,,,8354.78,95,,percent of total billed charges,,,7299.44,83,,percent of total billed charges,,,7299.44,83,,percent of total billed charges,,,,,,,,,,,,,,,7299.44,83,,percent of total billed charges,,,8354.78,95,,percent of total billed charges,,,7915.05,90,,percent of total billed charges,,,7915.05,90,,percent of total billed charges,,,7211.49,82,,percent of total billed charges,,,7915.05,90,,percent of total billed charges,,,7475.33,85,,percent of total billed charges,,6631.05,8354.78,
ZIMMER DRILL BIT 2.2 X 135MM,30188353,CDM,,,278,RC,inpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,277.1,349.13,
ZIMMER DRILL STOP 2.2MM,30188354,CDM,,,278,RC,inpatient,,202.5,202.5,,171.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.2,88,,percent of total billed charges,,,,,,,,,154.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.28,91,,percent of total billed charges,,,192.38,95,,percent of total billed charges,,,168.08,83,,percent of total billed charges,,,168.08,83,,percent of total billed charges,,,,,,,,,,,,,,,168.08,83,,percent of total billed charges,,,192.38,95,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,166.05,82,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,172.13,85,,percent of total billed charges,,152.69,192.38,
ZIMMER SCREW MD 2.7 X 16MM,30188355,CDM,,,278,RC,inpatient,,1033.5,1033.5,,877.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,779.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,878.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,909.48,88,,percent of total billed charges,,,,,,,,,789.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,940.49,91,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,,,,,,,,,,,,,857.81,83,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,847.47,82,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,779.26,981.83,
ZIMMER SCREW MD 2.7 X 14MM,30188356,CDM,,,278,RC,inpatient,,1033.5,1033.5,,877.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,779.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,878.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,909.48,88,,percent of total billed charges,,,,,,,,,789.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,940.49,91,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,,,,,,,,,,,,,857.81,83,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,847.47,82,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,779.26,981.83,
TELEFLEX UROLIFT HANDLE,30188357,CDM,,,278,RC,inpatient,,6662.5,6662.5,,5656.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5023.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5663.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5863,88,,percent of total billed charges,,,,,,,,,5090.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6062.88,91,,percent of total billed charges,,,6329.38,95,,percent of total billed charges,,,5529.88,83,,percent of total billed charges,,,5529.88,83,,percent of total billed charges,,,,,,,,,,,,,,,5529.88,83,,percent of total billed charges,,,6329.38,95,,percent of total billed charges,,,5996.25,90,,percent of total billed charges,,,5996.25,90,,percent of total billed charges,,,5463.25,82,,percent of total billed charges,,,5996.25,90,,percent of total billed charges,,,5663.13,85,,percent of total billed charges,,5023.53,6329.38,
TELEFLEX UROLIFT IMPANT CARTRIDGE,30188358,CDM,,,278,RC,inpatient,,6662.5,6662.5,,5656.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5023.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5663.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5863,88,,percent of total billed charges,,,,,,,,,5090.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6062.88,91,,percent of total billed charges,,,6329.38,95,,percent of total billed charges,,,5529.88,83,,percent of total billed charges,,,5529.88,83,,percent of total billed charges,,,,,,,,,,,,,,,5529.88,83,,percent of total billed charges,,,6329.38,95,,percent of total billed charges,,,5996.25,90,,percent of total billed charges,,,5996.25,90,,percent of total billed charges,,,5463.25,82,,percent of total billed charges,,,5996.25,90,,percent of total billed charges,,,5663.13,85,,percent of total billed charges,,5023.53,6329.38,
V-LOC 90 VIOLET 3-0 6  V-20,30188359,CDM,,,270,RC,inpatient,,182.72,182.72,,155.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,155.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,160.79,88,,percent of total billed charges,,,,,,,,,139.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,166.28,91,,percent of total billed charges,,,173.58,95,,percent of total billed charges,,,151.66,83,,percent of total billed charges,,,151.66,83,,percent of total billed charges,,,,,,,,,,,,,,,151.66,83,,percent of total billed charges,,,173.58,95,,percent of total billed charges,,,164.45,90,,percent of total billed charges,,,164.45,90,,percent of total billed charges,,,149.83,82,,percent of total billed charges,,,164.45,90,,percent of total billed charges,,,155.31,85,,percent of total billed charges,,137.77,173.58,
TRUSPAN  MENISCAL RPR. 0DEG NEEDLE,30188360,CDM,,,270,RC,inpatient,,5076.5,5076.5,,4309.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3827.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4315.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4467.32,88,,percent of total billed charges,,,,,,,,,3878.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4619.62,91,,percent of total billed charges,,,4822.68,95,,percent of total billed charges,,,4213.5,83,,percent of total billed charges,,,4213.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4213.5,83,,percent of total billed charges,,,4822.68,95,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4162.73,82,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4315.03,85,,percent of total billed charges,,3827.68,4822.68,
TRUSPAN  MENISCAL RPR. 24DEG NEEDLE,30188361,CDM,,,270,RC,inpatient,,5076.5,5076.5,,4309.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3827.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4315.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4467.32,88,,percent of total billed charges,,,,,,,,,3878.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4619.62,91,,percent of total billed charges,,,4822.68,95,,percent of total billed charges,,,4213.5,83,,percent of total billed charges,,,4213.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4213.5,83,,percent of total billed charges,,,4822.68,95,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4162.73,82,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4315.03,85,,percent of total billed charges,,3827.68,4822.68,
STRYKER INSERT TRIATHLON CS #7 10MM,30188362,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER FEMUR CR BEADED #2,30188363,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
STRYKER PATELLA S31X9,30188364,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
BODY REST MOD PROX CONE 23MM +10,30188365,CDM,,,278,RC,inpatient,,27917.18,27917.18,,23701.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21049.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23729.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24567.12,88,,percent of total billed charges,,,,,,,,,21328.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25404.63,91,,percent of total billed charges,,,26521.32,95,,percent of total billed charges,,,23171.26,83,,percent of total billed charges,,,23171.26,83,,percent of total billed charges,,,,,,,,,,,,,,,23171.26,83,,percent of total billed charges,,,26521.32,95,,percent of total billed charges,,,25125.46,90,,percent of total billed charges,,,25125.46,90,,percent of total billed charges,,,22892.09,82,,percent of total billed charges,,,25125.46,90,,percent of total billed charges,,,23729.6,85,,percent of total billed charges,,21049.55,26521.32,
STRYKER STEM 155 X 16MM,30188366,CDM,,,278,RC,inpatient,,20002.13,20002.13,,16981.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15081.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17001.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17601.87,88,,percent of total billed charges,,,,,,,,,15281.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18201.94,91,,percent of total billed charges,,,19002.02,95,,percent of total billed charges,,,16601.77,83,,percent of total billed charges,,,16601.77,83,,percent of total billed charges,,,,,,,,,,,,,,,16601.77,83,,percent of total billed charges,,,19002.02,95,,percent of total billed charges,,,18001.92,90,,percent of total billed charges,,,18001.92,90,,percent of total billed charges,,,16401.75,82,,percent of total billed charges,,,18001.92,90,,percent of total billed charges,,,17001.81,85,,percent of total billed charges,,15081.61,19002.02,
STRYKER INSERT CS SZ 2 9MM,30188367,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER PLATE DECREASED 7 HOLE RIGHT,30188368,CDM,,,278,RC,inpatient,,10949.51,10949.51,,9296.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8255.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9307.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9635.57,88,,percent of total billed charges,,,,,,,,,8365.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9964.05,91,,percent of total billed charges,,,10402.03,95,,percent of total billed charges,,,9088.09,83,,percent of total billed charges,,,9088.09,83,,percent of total billed charges,,,,,,,,,,,,,,,9088.09,83,,percent of total billed charges,,,10402.03,95,,percent of total billed charges,,,9854.56,90,,percent of total billed charges,,,9854.56,90,,percent of total billed charges,,,8978.6,82,,percent of total billed charges,,,9854.56,90,,percent of total billed charges,,,9307.08,85,,percent of total billed charges,,8255.93,10402.03,
STRYKER SCREW LOCKING FT 3.5X14MM,30188369,CDM,,,278,RC,inpatient,,1918.22,1918.22,,1628.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1446.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1630.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1688.03,88,,percent of total billed charges,,,,,,,,,1465.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1745.58,91,,percent of total billed charges,,,1822.31,95,,percent of total billed charges,,,1592.12,83,,percent of total billed charges,,,1592.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1592.12,83,,percent of total billed charges,,,1822.31,95,,percent of total billed charges,,,1726.4,90,,percent of total billed charges,,,1726.4,90,,percent of total billed charges,,,1572.94,82,,percent of total billed charges,,,1726.4,90,,percent of total billed charges,,,1630.49,85,,percent of total billed charges,,1446.34,1822.31,
STRYKER SCREW LOCKING FT 3.5X16MM,30188370,CDM,,,278,RC,inpatient,,1918.22,1918.22,,1628.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1446.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1630.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1688.03,88,,percent of total billed charges,,,,,,,,,1465.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1745.58,91,,percent of total billed charges,,,1822.31,95,,percent of total billed charges,,,1592.12,83,,percent of total billed charges,,,1592.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1592.12,83,,percent of total billed charges,,,1822.31,95,,percent of total billed charges,,,1726.4,90,,percent of total billed charges,,,1726.4,90,,percent of total billed charges,,,1572.94,82,,percent of total billed charges,,,1726.4,90,,percent of total billed charges,,,1630.49,85,,percent of total billed charges,,1446.34,1822.31,
STRYKER SCREW BONE FT 3.5X14MM,30188371,CDM,,,278,RC,inpatient,,1043.32,1043.32,,885.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,786.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,886.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,918.12,88,,percent of total billed charges,,,,,,,,,797.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,949.42,91,,percent of total billed charges,,,991.15,95,,percent of total billed charges,,,865.96,83,,percent of total billed charges,,,865.96,83,,percent of total billed charges,,,,,,,,,,,,,,,865.96,83,,percent of total billed charges,,,991.15,95,,percent of total billed charges,,,938.99,90,,percent of total billed charges,,,938.99,90,,percent of total billed charges,,,855.52,82,,percent of total billed charges,,,938.99,90,,percent of total billed charges,,,886.82,85,,percent of total billed charges,,786.66,991.15,
STRYKER SCREW BONE FT 3.5X16MM,30188372,CDM,,,278,RC,inpatient,,1043.32,1043.32,,885.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,786.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,886.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,918.12,88,,percent of total billed charges,,,,,,,,,797.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,949.42,91,,percent of total billed charges,,,991.15,95,,percent of total billed charges,,,865.96,83,,percent of total billed charges,,,865.96,83,,percent of total billed charges,,,,,,,,,,,,,,,865.96,83,,percent of total billed charges,,,991.15,95,,percent of total billed charges,,,938.99,90,,percent of total billed charges,,,938.99,90,,percent of total billed charges,,,855.52,82,,percent of total billed charges,,,938.99,90,,percent of total billed charges,,,886.82,85,,percent of total billed charges,,786.66,991.15,
STRYKER DRILL BIT AO 2.6X135MM SCALED,30188373,CDM,,,278,RC,inpatient,,1571.57,1571.57,,1334.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1184.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1335.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1382.98,88,,percent of total billed charges,,,,,,,,,1200.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1430.13,91,,percent of total billed charges,,,1492.99,95,,percent of total billed charges,,,1304.4,83,,percent of total billed charges,,,1304.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1304.4,83,,percent of total billed charges,,,1492.99,95,,percent of total billed charges,,,1414.41,90,,percent of total billed charges,,,1414.41,90,,percent of total billed charges,,,1288.69,82,,percent of total billed charges,,,1414.41,90,,percent of total billed charges,,,1335.83,85,,percent of total billed charges,,1184.96,1492.99,
ZIMMER STEM STRAIGHT 11 X 145MM,30188374,CDM,,,278,RC,inpatient,,7276.62,7276.62,,6177.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5486.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6185.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6403.43,88,,percent of total billed charges,,,,,,,,,5559.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6621.72,91,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,,,,,,,,,,,,,6039.59,83,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,5966.83,82,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,5486.57,6912.79,
ZIMMER FEMUR ROTATING HINGE D LEFT,30188375,CDM,,,278,RC,inpatient,,57459.03,57459.03,,48782.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43324.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48840.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50563.95,88,,percent of total billed charges,,,,,,,,,43898.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52287.72,91,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,,,,,,,,,,,,,47690.99,83,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,47116.4,82,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,48840.18,85,,percent of total billed charges,,43324.11,54586.08,
ZIMMER TIBIAL PLATE NONMOD SZ 3,30188376,CDM,,,278,RC,inpatient,,28502.57,28502.57,,24198.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21490.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24227.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25082.26,88,,percent of total billed charges,,,,,,,,,21775.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25937.34,91,,percent of total billed charges,,,27077.44,95,,percent of total billed charges,,,23657.13,83,,percent of total billed charges,,,23657.13,83,,percent of total billed charges,,,,,,,,,,,,,,,23657.13,83,,percent of total billed charges,,,27077.44,95,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,23372.11,82,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,24227.18,85,,percent of total billed charges,,21490.94,27077.44,
DEPUY GLENOID REAMER HEAD,30188377,CDM,,,278,RC,inpatient,,9490,9490,,8057.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7155.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8066.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8351.2,88,,percent of total billed charges,,,,,,,,,7250.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8635.9,91,,percent of total billed charges,,,9015.5,95,,percent of total billed charges,,,7876.7,83,,percent of total billed charges,,,7876.7,83,,percent of total billed charges,,,,,,,,,,,,,,,7876.7,83,,percent of total billed charges,,,9015.5,95,,percent of total billed charges,,,8541,90,,percent of total billed charges,,,8541,90,,percent of total billed charges,,,7781.8,82,,percent of total billed charges,,,8541,90,,percent of total billed charges,,,8066.5,85,,percent of total billed charges,,7155.46,9015.5,
ZIMMER POLY CPS 10MM RIGHT,30188378,CDM,,,278,RC,inpatient,,17135.63,17135.63,,14548.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12920.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14565.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15079.35,88,,percent of total billed charges,,,,,,,,,13091.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15593.42,91,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14222.57,83,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14051.22,82,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,12920.27,16278.85,
DEPUY REAMER SHAFT TIP,30188379,CDM,,,278,RC,inpatient,,3360.5,3360.5,,2853.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2533.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2856.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2957.24,88,,percent of total billed charges,,,,,,,,,2567.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3058.06,91,,percent of total billed charges,,,3192.48,95,,percent of total billed charges,,,2789.22,83,,percent of total billed charges,,,2789.22,83,,percent of total billed charges,,,,,,,,,,,,,,,2789.22,83,,percent of total billed charges,,,3192.48,95,,percent of total billed charges,,,3024.45,90,,percent of total billed charges,,,3024.45,90,,percent of total billed charges,,,2755.61,82,,percent of total billed charges,,,3024.45,90,,percent of total billed charges,,,2856.43,85,,percent of total billed charges,,2533.82,3192.48,
ARTHREX IMPLANT DELIVERY SYSTEM LNT 4.75,30188380,CDM,,,278,RC,inpatient,,5590,5590,,4745.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4214.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4751.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4919.2,88,,percent of total billed charges,,,,,,,,,4270.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5086.9,91,,percent of total billed charges,,,5310.5,95,,percent of total billed charges,,,4639.7,83,,percent of total billed charges,,,4639.7,83,,percent of total billed charges,,,,,,,,,,,,,,,4639.7,83,,percent of total billed charges,,,5310.5,95,,percent of total billed charges,,,5031,90,,percent of total billed charges,,,5031,90,,percent of total billed charges,,,4583.8,82,,percent of total billed charges,,,5031,90,,percent of total billed charges,,,4751.5,85,,percent of total billed charges,,4214.86,5310.5,
SENSOR-URETERORENOCOPE 9FR DISP.,30188381,CDM,,,270,RC,inpatient,,8439.21,8439.21,,7164.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6363.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7173.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7426.5,88,,percent of total billed charges,,,,,,,,,6447.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7679.68,91,,percent of total billed charges,,,8017.25,95,,percent of total billed charges,,,7004.54,83,,percent of total billed charges,,,7004.54,83,,percent of total billed charges,,,,,,,,,,,,,,,7004.54,83,,percent of total billed charges,,,8017.25,95,,percent of total billed charges,,,7595.29,90,,percent of total billed charges,,,7595.29,90,,percent of total billed charges,,,6920.15,82,,percent of total billed charges,,,7595.29,90,,percent of total billed charges,,,7173.33,85,,percent of total billed charges,,6363.16,8017.25,
STRYKER FEMUR CR #4 LEFT,30188382,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
STRYKER TIBIA TRIATHLON TRITANIUM SZ 4,30188383,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER PATELLA METAL BACK SZ 36 X 10MM,30188384,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
STRYKER RESTRICTOR CEMENT MEDIUM,30188385,CDM,,,278,RC,inpatient,,1001,1001,,849.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,754.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,850.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,880.88,88,,percent of total billed charges,,,,,,,,,764.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,910.91,91,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,,,,,,,,,,,,,830.83,83,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,820.82,82,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,754.75,950.95,
STRYKER STEM CEMENTED SZ 7 132DEG,30188386,CDM,,,278,RC,inpatient,,11700,11700,,9933.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8821.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9945,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10296,88,,percent of total billed charges,,,,,,,,,8938.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10647,91,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,,,,,,,,,,,,,9711,83,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9594,82,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9945,85,,percent of total billed charges,,8821.8,11115,
STRYKER CEMENT SPACER 15MM,30188387,CDM,,,278,RC,inpatient,,1001,1001,,849.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,754.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,850.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,880.88,88,,percent of total billed charges,,,,,,,,,764.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,910.91,91,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,,,,,,,,,,,,,830.83,83,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,820.82,82,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,754.75,950.95,
STRYKER HEAD FEMORAL 26MM -3MM,30188388,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
ZIMMER SCREW NON-LOCK 2.7X18MM,30188389,CDM,,,278,RC,inpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
STRYKER STEM CEMENTED SZ 4 35X137MM,30188390,CDM,,,278,RC,inpatient,,11700,11700,,9933.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8821.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9945,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10296,88,,percent of total billed charges,,,,,,,,,8938.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10647,91,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,,,,,,,,,,,,,9711,83,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9594,82,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9945,85,,percent of total billed charges,,8821.8,11115,
STRYKER HEAD 44X26MM,30188391,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
STRYKER SPACER CEMENT 11MM,30188392,CDM,,,278,RC,inpatient,,1001,1001,,849.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,754.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,850.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,880.88,88,,percent of total billed charges,,,,,,,,,764.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,910.91,91,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,,,,,,,,,,,,,830.83,83,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,820.82,82,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,754.75,950.95,
ZIMMER FEMUR CEMENTLESS SZ 7 RIGHT,30188393,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER POLY RIGHT MC 12MM,30188394,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ZIMMER SHELL MULTIHOLE OSSEOTI G7 64MM I,30188395,CDM,,,278,RC,inpatient,,20962.5,20962.5,,17797.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15805.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17818.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18447,88,,percent of total billed charges,,,,,,,,,16015.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19075.88,91,,percent of total billed charges,,,19914.38,95,,percent of total billed charges,,,17398.88,83,,percent of total billed charges,,,17398.88,83,,percent of total billed charges,,,,,,,,,,,,,,,17398.88,83,,percent of total billed charges,,,19914.38,95,,percent of total billed charges,,,18866.25,90,,percent of total billed charges,,,18866.25,90,,percent of total billed charges,,,17189.25,82,,percent of total billed charges,,,18866.25,90,,percent of total billed charges,,,17818.13,85,,percent of total billed charges,,15805.73,19914.38,
STRYKER FEMUR TRIATHLON CR SZ 5 RT,30188396,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
STRYKER TIBIA TRIATHLON TRITANIUM SZ 5,30188397,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
S&N ENDO SCREW BIOSURE 6 X 20,30188398,CDM,,,278,RC,inpatient,,1771.51,1771.51,,1504.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1335.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1505.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1558.93,88,,percent of total billed charges,,,,,,,,,1353.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1612.07,91,,percent of total billed charges,,,1682.93,95,,percent of total billed charges,,,1470.35,83,,percent of total billed charges,,,1470.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1470.35,83,,percent of total billed charges,,,1682.93,95,,percent of total billed charges,,,1594.36,90,,percent of total billed charges,,,1594.36,90,,percent of total billed charges,,,1452.64,82,,percent of total billed charges,,,1594.36,90,,percent of total billed charges,,,1505.78,85,,percent of total billed charges,,1335.72,1682.93,
S&N HEALICOIL KNOTLESS 5.0,30188399,CDM,,,278,RC,inpatient,,7566,7566,,6423.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5704.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6431.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6658.08,88,,percent of total billed charges,,,,,,,,,5780.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6885.06,91,,percent of total billed charges,,,7187.7,95,,percent of total billed charges,,,6279.78,83,,percent of total billed charges,,,6279.78,83,,percent of total billed charges,,,,,,,,,,,,,,,6279.78,83,,percent of total billed charges,,,7187.7,95,,percent of total billed charges,,,6809.4,90,,percent of total billed charges,,,6809.4,90,,percent of total billed charges,,,6204.12,82,,percent of total billed charges,,,6809.4,90,,percent of total billed charges,,,6431.1,85,,percent of total billed charges,,5704.76,7187.7,
FORTEC FIBER HOLMIUM MP 200,30188400,CDM,,,270,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
ARTHREX GUIDE WIRE 1.6,30188401,CDM,,,278,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
ARTHREX REAMER MET,30188402,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
ARTHREX REAMER PHAL.,30188403,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
ARTHREX SCREW NL 3.0 X 16MM,30188404,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW NL 3.0 X 12MM,30188405,CDM,,,278,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ARTHREX SCREW VAL 3.0 X 20MM,30188406,CDM,,,278,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
ARTHREX SCREW VALL 3.0 X 16MM,30188407,CDM,,,278,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
ARTHREX COUNTERSINK,30188408,CDM,,,278,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
DEPUY SCREW CENTER METAGLENE 2MM,30188409,CDM,,,278,RC,inpatient,,32545.5,32545.5,,27631.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24539.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27663.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28640.04,88,,percent of total billed charges,,,,,,,,,24864.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29616.41,91,,percent of total billed charges,,,30918.23,95,,percent of total billed charges,,,27012.77,83,,percent of total billed charges,,,27012.77,83,,percent of total billed charges,,,,,,,,,,,,,,,27012.77,83,,percent of total billed charges,,,30918.23,95,,percent of total billed charges,,,29290.95,90,,percent of total billed charges,,,29290.95,90,,percent of total billed charges,,,26687.31,82,,percent of total billed charges,,,29290.95,90,,percent of total billed charges,,,27663.68,85,,percent of total billed charges,,24539.31,30918.23,
DEPUY SCREW CENTER METAGLENE 6C30MM,30188410,CDM,,,278,RC,inpatient,,5772,5772,,4900.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4352.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4906.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5079.36,88,,percent of total billed charges,,,,,,,,,4409.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5252.52,91,,percent of total billed charges,,,5483.4,95,,percent of total billed charges,,,4790.76,83,,percent of total billed charges,,,4790.76,83,,percent of total billed charges,,,,,,,,,,,,,,,4790.76,83,,percent of total billed charges,,,5483.4,95,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,4733.04,82,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,4906.2,85,,percent of total billed charges,,4352.09,5483.4,
DEPUY SCREW CENTER METAGLENE COLLET,30188411,CDM,,,278,RC,inpatient,,5687.5,5687.5,,4828.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4288.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4834.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5005,88,,percent of total billed charges,,,,,,,,,4345.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5175.63,91,,percent of total billed charges,,,5403.13,95,,percent of total billed charges,,,4720.63,83,,percent of total billed charges,,,4720.63,83,,percent of total billed charges,,,,,,,,,,,,,,,4720.63,83,,percent of total billed charges,,,5403.13,95,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,4663.75,82,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,4834.38,85,,percent of total billed charges,,4288.38,5403.13,
SHEATH CLEAR RENAL,30188413,CDM,,,270,RC,inpatient,,470.82,470.82,,399.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,355,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,400.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,414.32,88,,percent of total billed charges,,,,,,,,,359.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,428.45,91,,percent of total billed charges,,,447.28,95,,percent of total billed charges,,,390.78,83,,percent of total billed charges,,,390.78,83,,percent of total billed charges,,,,,,,,,,,,,,,390.78,83,,percent of total billed charges,,,447.28,95,,percent of total billed charges,,,423.74,90,,percent of total billed charges,,,423.74,90,,percent of total billed charges,,,386.07,82,,percent of total billed charges,,,423.74,90,,percent of total billed charges,,,400.2,85,,percent of total billed charges,,355,447.28,
CATHETER OCCLUDER BALLOON 26FR 65CM,30188414,CDM,,,270,RC,inpatient,,920.27,920.27,,781.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,693.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,782.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,809.84,88,,percent of total billed charges,,,,,,,,,703.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,837.45,91,,percent of total billed charges,,,874.26,95,,percent of total billed charges,,,763.82,83,,percent of total billed charges,,,763.82,83,,percent of total billed charges,,,,,,,,,,,,,,,763.82,83,,percent of total billed charges,,,874.26,95,,percent of total billed charges,,,828.24,90,,percent of total billed charges,,,828.24,90,,percent of total billed charges,,,754.62,82,,percent of total billed charges,,,828.24,90,,percent of total billed charges,,,782.23,85,,percent of total billed charges,,693.88,874.26,
STONE RETRIEVAL BASKET SEGURA HEMOSPHERE,30188415,CDM,,,270,RC,inpatient,,1178.78,1178.78,,1000.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,888.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1001.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1037.33,88,,percent of total billed charges,,,,,,,,,900.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1072.69,91,,percent of total billed charges,,,1119.84,95,,percent of total billed charges,,,978.39,83,,percent of total billed charges,,,978.39,83,,percent of total billed charges,,,,,,,,,,,,,,,978.39,83,,percent of total billed charges,,,1119.84,95,,percent of total billed charges,,,1060.9,90,,percent of total billed charges,,,1060.9,90,,percent of total billed charges,,,966.6,82,,percent of total billed charges,,,1060.9,90,,percent of total billed charges,,,1001.96,85,,percent of total billed charges,,888.8,1119.84,
ZIMMER SHELL LINER G7 40MM +5MM,30188416,CDM,,,278,RC,inpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7694.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8674.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,7694.57,9694.75,
ZIMMER SCREW FEMALE 2.5 X 25MM,30188417,CDM,,,278,RC,inpatient,,1072.5,1072.5,,910.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,808.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,911.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,943.8,88,,percent of total billed charges,,,,,,,,,819.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,975.98,91,,percent of total billed charges,,,1018.88,95,,percent of total billed charges,,,890.18,83,,percent of total billed charges,,,890.18,83,,percent of total billed charges,,,,,,,,,,,,,,,890.18,83,,percent of total billed charges,,,1018.88,95,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,879.45,82,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,911.63,85,,percent of total billed charges,,808.67,1018.88,
COOK CAPTURA 3-PRONG GRASPER,30188418,CDM,,,270,RC,inpatient,,1247.81,1247.81,,1059.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,940.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1060.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1098.07,88,,percent of total billed charges,,,,,,,,,953.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1135.51,91,,percent of total billed charges,,,1185.42,95,,percent of total billed charges,,,1035.68,83,,percent of total billed charges,,,1035.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1035.68,83,,percent of total billed charges,,,1185.42,95,,percent of total billed charges,,,1123.03,90,,percent of total billed charges,,,1123.03,90,,percent of total billed charges,,,1023.2,82,,percent of total billed charges,,,1123.03,90,,percent of total billed charges,,,1060.64,85,,percent of total billed charges,,940.85,1185.42,
BOSTON AMPLATZ DILATOR/SHEATH SET 8-30F,30188419,CDM,,,270,RC,inpatient,,1385.61,1385.61,,1176.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1044.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1177.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1219.34,88,,percent of total billed charges,,,,,,,,,1058.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1260.91,91,,percent of total billed charges,,,1316.33,95,,percent of total billed charges,,,1150.06,83,,percent of total billed charges,,,1150.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1150.06,83,,percent of total billed charges,,,1316.33,95,,percent of total billed charges,,,1247.05,90,,percent of total billed charges,,,1247.05,90,,percent of total billed charges,,,1136.2,82,,percent of total billed charges,,,1247.05,90,,percent of total billed charges,,,1177.77,85,,percent of total billed charges,,1044.75,1316.33,
BOSTON CATH MALICOT RE-ENTRY NEPHROSTOMY,30188420,CDM,,,270,RC,inpatient,,502.53,502.53,,426.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,378.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,427.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,442.23,88,,percent of total billed charges,,,,,,,,,383.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,457.3,91,,percent of total billed charges,,,477.4,95,,percent of total billed charges,,,417.1,83,,percent of total billed charges,,,417.1,83,,percent of total billed charges,,,,,,,,,,,,,,,417.1,83,,percent of total billed charges,,,477.4,95,,percent of total billed charges,,,452.28,90,,percent of total billed charges,,,452.28,90,,percent of total billed charges,,,412.07,82,,percent of total billed charges,,,452.28,90,,percent of total billed charges,,,427.15,85,,percent of total billed charges,,378.91,477.4,
BOSTON BALLOON CLEAR NEPHROMAX HIGH PRES,30188421,CDM,,,270,RC,inpatient,,1778.01,1778.01,,1509.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1340.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1511.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1564.65,88,,percent of total billed charges,,,,,,,,,1358.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1617.99,91,,percent of total billed charges,,,1689.11,95,,percent of total billed charges,,,1475.75,83,,percent of total billed charges,,,1475.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1475.75,83,,percent of total billed charges,,,1689.11,95,,percent of total billed charges,,,1600.21,90,,percent of total billed charges,,,1600.21,90,,percent of total billed charges,,,1457.97,82,,percent of total billed charges,,,1600.21,90,,percent of total billed charges,,,1511.31,85,,percent of total billed charges,,1340.62,1689.11,
BOSTON CATHETER BERN 65CM TORQUEABLE,30188422,CDM,,,270,RC,inpatient,,140.64,140.64,,119.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,106.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,119.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,123.76,88,,percent of total billed charges,,,,,,,,,107.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,127.98,91,,percent of total billed charges,,,133.61,95,,percent of total billed charges,,,116.73,83,,percent of total billed charges,,,116.73,83,,percent of total billed charges,,,,,,,,,,,,,,,116.73,83,,percent of total billed charges,,,133.61,95,,percent of total billed charges,,,126.58,90,,percent of total billed charges,,,126.58,90,,percent of total billed charges,,,115.32,82,,percent of total billed charges,,,126.58,90,,percent of total billed charges,,,119.54,85,,percent of total billed charges,,106.04,133.61,
BOSTON DILATOR/SHEATH SET 8-10F,30188423,CDM,,,270,RC,inpatient,,369.83,369.83,,313.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,314.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,325.45,88,,percent of total billed charges,,,,,,,,,282.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,336.55,91,,percent of total billed charges,,,351.34,95,,percent of total billed charges,,,306.96,83,,percent of total billed charges,,,306.96,83,,percent of total billed charges,,,,,,,,,,,,,,,306.96,83,,percent of total billed charges,,,351.34,95,,percent of total billed charges,,,332.85,90,,percent of total billed charges,,,332.85,90,,percent of total billed charges,,,303.26,82,,percent of total billed charges,,,332.85,90,,percent of total billed charges,,,314.36,85,,percent of total billed charges,,278.85,351.34,
ARTHREX ANCHOR DBLE LOADED W/TAPES 5.5,30188424,CDM,,,270,RC,inpatient,,2307.5,2307.5,,1959.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1739.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1961.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2030.6,88,,percent of total billed charges,,,,,,,,,1762.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2099.83,91,,percent of total billed charges,,,2192.13,95,,percent of total billed charges,,,1915.23,83,,percent of total billed charges,,,1915.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1915.23,83,,percent of total billed charges,,,2192.13,95,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,1892.15,82,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,1961.38,85,,percent of total billed charges,,1739.86,2192.13,
ARTHREX ANCHOR DBLE LOADED W/TAPES 4.75,30188425,CDM,,,270,RC,inpatient,,2307.5,2307.5,,1959.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1739.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1961.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2030.6,88,,percent of total billed charges,,,,,,,,,1762.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2099.83,91,,percent of total billed charges,,,2192.13,95,,percent of total billed charges,,,1915.23,83,,percent of total billed charges,,,1915.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1915.23,83,,percent of total billed charges,,,2192.13,95,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,1892.15,82,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,1961.38,85,,percent of total billed charges,,1739.86,2192.13,
ARTHREX ANCHOR BAILOUT,30188426,CDM,,,270,RC,inpatient,,2827.5,2827.5,,2400.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2131.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2403.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2488.2,88,,percent of total billed charges,,,,,,,,,2160.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2573.03,91,,percent of total billed charges,,,2686.13,95,,percent of total billed charges,,,2346.83,83,,percent of total billed charges,,,2346.83,83,,percent of total billed charges,,,,,,,,,,,,,,,2346.83,83,,percent of total billed charges,,,2686.13,95,,percent of total billed charges,,,2544.75,90,,percent of total billed charges,,,2544.75,90,,percent of total billed charges,,,2318.55,82,,percent of total billed charges,,,2544.75,90,,percent of total billed charges,,,2403.38,85,,percent of total billed charges,,2131.94,2686.13,
ARTHREX SUTURE ANCHOR SUTURETAK 2.4 X 12,30188427,CDM,,,270,RC,inpatient,,1982.5,1982.5,,1683.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1494.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1685.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1744.6,88,,percent of total billed charges,,,,,,,,,1514.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1804.08,91,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1645.48,83,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1625.65,82,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,1494.81,1883.38,
ARTHREX FIBERTAK SUTURE ANCHOR W1.3MM SU,30188428,CDM,,,270,RC,inpatient,,2405,2405,,2041.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1813.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2044.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2116.4,88,,percent of total billed charges,,,,,,,,,1837.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2188.55,91,,percent of total billed charges,,,2284.75,95,,percent of total billed charges,,,1996.15,83,,percent of total billed charges,,,1996.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1996.15,83,,percent of total billed charges,,,2284.75,95,,percent of total billed charges,,,2164.5,90,,percent of total billed charges,,,2164.5,90,,percent of total billed charges,,,1972.1,82,,percent of total billed charges,,,2164.5,90,,percent of total billed charges,,,2044.25,85,,percent of total billed charges,,1813.37,2284.75,
ARTHREX FIBERTAK DRILL STRAIGHT,30188429,CDM,,,270,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
ARTHREX SWIVELOCK BC 5.5X24.5MM,30188430,CDM,,,270,RC,inpatient,,2730,2730,,2317.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2058.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2320.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2402.4,88,,percent of total billed charges,,,,,,,,,2085.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2484.3,91,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2265.9,83,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2238.6,82,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,2058.42,2593.5,
ARTHREX BIO-SUTURE TAK KIT 2.4MM,30188431,CDM,,,270,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
STRYKER INSERT X3 36MM ID,30188432,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER CUP CLUSTERHOLE 60G,30188433,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
STRYKER STEM CEMENTED 132NK,30188434,CDM,,,278,RC,inpatient,,11700,11700,,9933.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8821.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9945,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10296,88,,percent of total billed charges,,,,,,,,,8938.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10647,91,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,,,,,,,,,,,,,9711,83,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9594,82,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9945,85,,percent of total billed charges,,8821.8,11115,
STRYKER HEAD COCR 26MM +4,30188435,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
STRYKER HEAD BIPOLAR 26MM X 50MM,30188436,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
STRYKER NAIL GAMMA 10X170MM 130DEG,30188437,CDM,,,278,RC,inpatient,,16162.58,16162.58,,13722.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12186.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13738.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14223.07,88,,percent of total billed charges,,,,,,,,,12348.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14707.95,91,,percent of total billed charges,,,15354.45,95,,percent of total billed charges,,,13414.94,83,,percent of total billed charges,,,13414.94,83,,percent of total billed charges,,,,,,,,,,,,,,,13414.94,83,,percent of total billed charges,,,15354.45,95,,percent of total billed charges,,,14546.32,90,,percent of total billed charges,,,14546.32,90,,percent of total billed charges,,,13253.32,82,,percent of total billed charges,,,14546.32,90,,percent of total billed charges,,,13738.19,85,,percent of total billed charges,,12186.59,15354.45,
STRYKER SCREW FT 5X30MM,30188438,CDM,,,278,RC,inpatient,,1774.37,1774.37,,1506.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1337.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1508.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1561.45,88,,percent of total billed charges,,,,,,,,,1355.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1614.68,91,,percent of total billed charges,,,1685.65,95,,percent of total billed charges,,,1472.73,83,,percent of total billed charges,,,1472.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1472.73,83,,percent of total billed charges,,,1685.65,95,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1454.98,82,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1508.21,85,,percent of total billed charges,,1337.87,1685.65,
ZIMMER PLATE TIBIAL SZ I ROTATING HINGE,30188439,CDM,,,278,RC,inpatient,,28502.57,28502.57,,24198.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21490.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24227.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25082.26,88,,percent of total billed charges,,,,,,,,,21775.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25937.34,91,,percent of total billed charges,,,27077.44,95,,percent of total billed charges,,,23657.13,83,,percent of total billed charges,,,23657.13,83,,percent of total billed charges,,,,,,,,,,,,,,,23657.13,83,,percent of total billed charges,,,27077.44,95,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,23372.11,82,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,24227.18,85,,percent of total billed charges,,21490.94,27077.44,
ZIMMER FEMUR ROTATING HINGE SZ C RIGHT,30188440,CDM,,,278,RC,inpatient,,57459.03,57459.03,,48782.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43324.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48840.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50563.95,88,,percent of total billed charges,,,,,,,,,43898.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52287.72,91,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,,,,,,,,,,,,,47690.99,83,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,47116.4,82,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,48840.18,85,,percent of total billed charges,,43324.11,54586.08,
ZIMMER SURFACE RHA SZ C 12MM,30188441,CDM,,,278,RC,inpatient,,12617.41,12617.41,,10712.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9513.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10724.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11103.32,88,,percent of total billed charges,,,,,,,,,9639.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11481.84,91,,percent of total billed charges,,,11986.54,95,,percent of total billed charges,,,10472.45,83,,percent of total billed charges,,,10472.45,83,,percent of total billed charges,,,,,,,,,,,,,,,10472.45,83,,percent of total billed charges,,,11986.54,95,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,10346.28,82,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,10724.8,85,,percent of total billed charges,,9513.53,11986.54,
ZIMMER SURFACE SEGMENTAL ART SZ C 12MM,30188442,CDM,,,278,RC,inpatient,,13434.33,13434.33,,11405.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10129.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11419.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11822.21,88,,percent of total billed charges,,,,,,,,,10263.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12225.24,91,,percent of total billed charges,,,12762.61,95,,percent of total billed charges,,,11150.49,83,,percent of total billed charges,,,11150.49,83,,percent of total billed charges,,,,,,,,,,,,,,,11150.49,83,,percent of total billed charges,,,12762.61,95,,percent of total billed charges,,,12090.9,90,,percent of total billed charges,,,12090.9,90,,percent of total billed charges,,,11016.15,82,,percent of total billed charges,,,12090.9,90,,percent of total billed charges,,,11419.18,85,,percent of total billed charges,,10129.48,12762.61,
ZIMMER FEMORAL BONE CEMENT PREP KIT,30188443,CDM,,,278,RC,inpatient,,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,627.33,790.4,
ZIMMER SCREWDRIVER 2MM HEX,30188444,CDM,,,278,RC,inpatient,,567,567,,481.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,427.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,481.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,498.96,88,,percent of total billed charges,,,,,,,,,433.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,,,,,,,,,,,,,470.61,83,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,464.94,82,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,427.52,538.65,
ARTHREX FIBERTAK RC SUTURE ANCHOR WHITE/,30188445,CDM,,,278,RC,inpatient,,3055,3055,,2593.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2303.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2596.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2688.4,88,,percent of total billed charges,,,,,,,,,2334.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2780.05,91,,percent of total billed charges,,,2902.25,95,,percent of total billed charges,,,2535.65,83,,percent of total billed charges,,,2535.65,83,,percent of total billed charges,,,,,,,,,,,,,,,2535.65,83,,percent of total billed charges,,,2902.25,95,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2505.1,82,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2596.75,85,,percent of total billed charges,,2303.47,2902.25,
ARTHREX DISPOSABLE INSTRUMENT KIT,30188446,CDM,,,270,RC,inpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1445.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1629.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,1445.8,1821.63,
ZIMMER DRILL CANNULATED 2.7MM,30188447,CDM,,,278,RC,inpatient,,3299.34,3299.34,,2801.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2487.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2804.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2903.42,88,,percent of total billed charges,,,,,,,,,2520.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3002.4,91,,percent of total billed charges,,,3134.37,95,,percent of total billed charges,,,2738.45,83,,percent of total billed charges,,,2738.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2738.45,83,,percent of total billed charges,,,3134.37,95,,percent of total billed charges,,,2969.41,90,,percent of total billed charges,,,2969.41,90,,percent of total billed charges,,,2705.46,82,,percent of total billed charges,,,2969.41,90,,percent of total billed charges,,,2804.44,85,,percent of total billed charges,,2487.7,3134.37,
ZIMMER SCREW CANNULATED 4.0 X48MM,30188448,CDM,,,278,RC,inpatient,,1164.8,1164.8,,988.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,878.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,990.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1025.02,88,,percent of total billed charges,,,,,,,,,889.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1059.97,91,,percent of total billed charges,,,1106.56,95,,percent of total billed charges,,,966.78,83,,percent of total billed charges,,,966.78,83,,percent of total billed charges,,,,,,,,,,,,,,,966.78,83,,percent of total billed charges,,,1106.56,95,,percent of total billed charges,,,1048.32,90,,percent of total billed charges,,,1048.32,90,,percent of total billed charges,,,955.14,82,,percent of total billed charges,,,1048.32,90,,percent of total billed charges,,,990.08,85,,percent of total billed charges,,878.26,1106.56,
ZIMMER PLATE LOCKING FIBULA 4H 80MM LT,30188449,CDM,,,278,RC,inpatient,,4006.34,4006.34,,3401.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3020.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3405.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3525.58,88,,percent of total billed charges,,,,,,,,,3060.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3645.77,91,,percent of total billed charges,,,3806.02,95,,percent of total billed charges,,,3325.26,83,,percent of total billed charges,,,3325.26,83,,percent of total billed charges,,,,,,,,,,,,,,,3325.26,83,,percent of total billed charges,,,3806.02,95,,percent of total billed charges,,,3605.71,90,,percent of total billed charges,,,3605.71,90,,percent of total billed charges,,,3285.2,82,,percent of total billed charges,,,3605.71,90,,percent of total billed charges,,,3405.39,85,,percent of total billed charges,,3020.78,3806.02,
ZIMMER WASHER,30188450,CDM,,,278,RC,inpatient,,276.9,276.9,,235.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,208.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,235.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,243.67,88,,percent of total billed charges,,,,,,,,,211.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,251.98,91,,percent of total billed charges,,,263.06,95,,percent of total billed charges,,,229.83,83,,percent of total billed charges,,,229.83,83,,percent of total billed charges,,,,,,,,,,,,,,,229.83,83,,percent of total billed charges,,,263.06,95,,percent of total billed charges,,,249.21,90,,percent of total billed charges,,,249.21,90,,percent of total billed charges,,,227.06,82,,percent of total billed charges,,,249.21,90,,percent of total billed charges,,,235.37,85,,percent of total billed charges,,208.78,263.06,
ZIMMER DRILL STANDARD 2.7MM,30188451,CDM,,,278,RC,inpatient,,853.72,853.72,,724.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,643.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,725.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,751.27,88,,percent of total billed charges,,,,,,,,,652.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,776.89,91,,percent of total billed charges,,,811.03,95,,percent of total billed charges,,,708.59,83,,percent of total billed charges,,,708.59,83,,percent of total billed charges,,,,,,,,,,,,,,,708.59,83,,percent of total billed charges,,,811.03,95,,percent of total billed charges,,,768.35,90,,percent of total billed charges,,,768.35,90,,percent of total billed charges,,,700.05,82,,percent of total billed charges,,,768.35,90,,percent of total billed charges,,,725.66,85,,percent of total billed charges,,643.7,811.03,
STRYKER CUP CLUSTERHOLE 52E,30188452,CDM,,,278,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
MEDTRONIC ELECTRODE 2-CHANNEL SUBDERMAL,30188453,CDM,,,270,RC,inpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,277.1,349.13,
COOK SEIDMAN ANTEGRADE STENT SET,30188454,CDM,,,270,RC,inpatient,,693.77,693.77,,589.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,523.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,589.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,610.52,88,,percent of total billed charges,,,,,,,,,530.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,631.33,91,,percent of total billed charges,,,659.08,95,,percent of total billed charges,,,575.83,83,,percent of total billed charges,,,575.83,83,,percent of total billed charges,,,,,,,,,,,,,,,575.83,83,,percent of total billed charges,,,659.08,95,,percent of total billed charges,,,624.39,90,,percent of total billed charges,,,624.39,90,,percent of total billed charges,,,568.89,82,,percent of total billed charges,,,624.39,90,,percent of total billed charges,,,589.7,85,,percent of total billed charges,,523.1,659.08,
ZIMMER TIBIA SZ E LEFT,30188456,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
STRYKER LINER CEMENTLESS E 42MM,30188457,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER BIOLOX FEMORAL HEAD 28MM,30188458,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
STRYKER INSERT RESTORATION ADM/MDM 28MM,30188459,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
ARTHREX FIBERTAK PERCUTANEOUS INSERTION,30188460,CDM,,,270,RC,inpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1102.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,1102.73,1389.38,
ARTHREX PASSPORT BUTTON CANNULA 12X5,30188461,CDM,,,278,RC,inpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,316.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,357,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,316.68,399,
ARTHREX TIGERLINK SUTURE 0.9MM,30188462,CDM,,,278,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
ARTHREX FIBERWIRE SUTURE 0,30188463,CDM,,,278,RC,inpatient,,168,168,,142.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,126.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,142.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,147.84,88,,percent of total billed charges,,,,,,,,,128.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,,,,,,,,,,,,,139.44,83,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,137.76,82,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,126.67,159.6,
ARTHREX GRAFT SPREADER,30188464,CDM,,,270,RC,inpatient,,2437.5,2437.5,,2069.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1837.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2071.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2145,88,,percent of total billed charges,,,,,,,,,1862.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2218.13,91,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2023.13,83,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,1998.75,82,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,1837.88,2315.63,
ARTHREX TISSUE TAK TENDON ANCHOR,30188465,CDM,,,278,RC,inpatient,,5687.5,5687.5,,4828.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4288.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4834.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5005,88,,percent of total billed charges,,,,,,,,,4345.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5175.63,91,,percent of total billed charges,,,5403.13,95,,percent of total billed charges,,,4720.63,83,,percent of total billed charges,,,4720.63,83,,percent of total billed charges,,,,,,,,,,,,,,,4720.63,83,,percent of total billed charges,,,5403.13,95,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,4663.75,82,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,4834.38,85,,percent of total billed charges,,4288.38,5403.13,
DEPUY OSTEOTOME FLAT SHORT,30188466,CDM,,,278,RC,inpatient,,3107,3107,,2637.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2342.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2640.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2734.16,88,,percent of total billed charges,,,,,,,,,2373.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2827.37,91,,percent of total billed charges,,,2951.65,95,,percent of total billed charges,,,2578.81,83,,percent of total billed charges,,,2578.81,83,,percent of total billed charges,,,,,,,,,,,,,,,2578.81,83,,percent of total billed charges,,,2951.65,95,,percent of total billed charges,,,2796.3,90,,percent of total billed charges,,,2796.3,90,,percent of total billed charges,,,2547.74,82,,percent of total billed charges,,,2796.3,90,,percent of total billed charges,,,2640.95,85,,percent of total billed charges,,2342.68,2951.65,
DEPUY OSTEOTOME FLAT MEDIUM,30188467,CDM,,,278,RC,inpatient,,3256.5,3256.5,,2764.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2455.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2768.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2865.72,88,,percent of total billed charges,,,,,,,,,2487.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2963.42,91,,percent of total billed charges,,,3093.68,95,,percent of total billed charges,,,2702.9,83,,percent of total billed charges,,,2702.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2702.9,83,,percent of total billed charges,,,3093.68,95,,percent of total billed charges,,,2930.85,90,,percent of total billed charges,,,2930.85,90,,percent of total billed charges,,,2670.33,82,,percent of total billed charges,,,2930.85,90,,percent of total billed charges,,,2768.03,85,,percent of total billed charges,,2455.4,3093.68,
ZIMMER LINER G7 36MM +5,30188468,CDM,,,278,RC,inpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7694.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8674.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,7694.57,9694.75,
SPINECRAFT SCREW 3.5 X 14MM,30188469,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
SPINECRAFT SET SCREW,30188470,CDM,,,278,RC,inpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,527.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,595,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,527.8,665,
SPINECRAFT DRILL 2.4,30188471,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
SPINECRAFT ROD LORDOSED 4.0 X 325,30188472,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
SPINECRAFT SCREW 5.0 X 30,30188473,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
ARTHREX DECELLULARIZED DERMIS,30188474,CDM,,,270,RC,inpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5881.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6630,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,5881.2,7410,
ZIMMER SCREW PEG 2.5 X 10MM,30188475,CDM,,,278,RC,inpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,464.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,523.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,464.46,585.2,
ZIMMER SCREW PEG 2.5 X 12MM,30188476,CDM,,,278,RC,inpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,464.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,523.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,464.46,585.2,
ZIMMER SCREW PEG 2.5 X 11MM,30188477,CDM,,,278,RC,inpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,464.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,523.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,464.46,585.2,
ZIMMER DRILL BIT 2.0 QC,30188478,CDM,,,278,RC,inpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,277.1,349.13,
ZIMMER DRILL BIT 2.5 QC,30188479,CDM,,,278,RC,inpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,277.1,349.13,
STRYKER SCREW LOCKING T2 F/T 5X37.5MM,30188480,CDM,,,278,RC,inpatient,,1774.37,1774.37,,1506.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1337.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1508.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1561.45,88,,percent of total billed charges,,,,,,,,,1355.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1614.68,91,,percent of total billed charges,,,1685.65,95,,percent of total billed charges,,,1472.73,83,,percent of total billed charges,,,1472.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1472.73,83,,percent of total billed charges,,,1685.65,95,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1454.98,82,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1508.21,85,,percent of total billed charges,,1337.87,1685.65,
SPINECRAFT SCREW 3.5 X 16MM,30188481,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
DERMIS ON DEMAND 15.0 X 4.5 X 3.0MM,30188482,CDM,,,278,RC,inpatient,,5817.5,5817.5,,4939.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4386.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4944.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5119.4,88,,percent of total billed charges,,,,,,,,,4444.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5293.93,91,,percent of total billed charges,,,5526.63,95,,percent of total billed charges,,,4828.53,83,,percent of total billed charges,,,4828.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4828.53,83,,percent of total billed charges,,,5526.63,95,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,4770.35,82,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,4944.88,85,,percent of total billed charges,,4386.4,5526.63,
TERUMO GLIDECATH STRAIGHT 4FR X 120CM,30188483,CDM,,,270,RC,inpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,291.35,367.08,
TERUMO GLIDECATH ANGLED 4FR X 120CM,30188484,CDM,,,270,RC,inpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,291.35,367.08,
TERUMO GLIDECATH STRAIGHT 4FR X 150CM,30188485,CDM,,,270,RC,inpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,291.35,367.08,
TERUMO GLIDECATH ANGLED 4FR X 150CM,30188486,CDM,,,270,RC,inpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,291.35,367.08,
TERUMO GLIDECATH STRAIGHT 5FXP X 150CM,30188487,CDM,,,270,RC,inpatient,,386.82,386.82,,328.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.4,88,,percent of total billed charges,,,,,,,,,295.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,352.01,91,,percent of total billed charges,,,367.48,95,,percent of total billed charges,,,321.06,83,,percent of total billed charges,,,321.06,83,,percent of total billed charges,,,,,,,,,,,,,,,321.06,83,,percent of total billed charges,,,367.48,95,,percent of total billed charges,,,348.14,90,,percent of total billed charges,,,348.14,90,,percent of total billed charges,,,317.19,82,,percent of total billed charges,,,348.14,90,,percent of total billed charges,,,328.8,85,,percent of total billed charges,,291.66,367.48,
ULRICH TAP  5.5,30188488,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
SPINECRAFT SCREW POLY 6.5 X 40MM,30188489,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
UNIFUSE WITH COOPER WIRE 5FR 90 X 40CM,30188490,CDM,,,270,RC,inpatient,,1995.5,1995.5,,1694.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1504.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1696.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1756.04,88,,percent of total billed charges,,,,,,,,,1524.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1815.91,91,,percent of total billed charges,,,1895.73,95,,percent of total billed charges,,,1656.27,83,,percent of total billed charges,,,1656.27,83,,percent of total billed charges,,,,,,,,,,,,,,,1656.27,83,,percent of total billed charges,,,1895.73,95,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1636.31,82,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1696.18,85,,percent of total billed charges,,1504.61,1895.73,
UNIFUSE WITH COOPER WIRE 5FR 135 X 30CM,30188491,CDM,,,270,RC,inpatient,,1995.5,1995.5,,1694.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1504.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1696.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1756.04,88,,percent of total billed charges,,,,,,,,,1524.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1815.91,91,,percent of total billed charges,,,1895.73,95,,percent of total billed charges,,,1656.27,83,,percent of total billed charges,,,1656.27,83,,percent of total billed charges,,,,,,,,,,,,,,,1656.27,83,,percent of total billed charges,,,1895.73,95,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1636.31,82,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1696.18,85,,percent of total billed charges,,1504.61,1895.73,
ZIMMER DVR ANATOMIC NARROW LEFT,30188492,CDM,,,278,RC,inpatient,,4751.5,4751.5,,4034.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3582.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4038.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4181.32,88,,percent of total billed charges,,,,,,,,,3630.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4323.87,91,,percent of total billed charges,,,4513.93,95,,percent of total billed charges,,,3943.75,83,,percent of total billed charges,,,3943.75,83,,percent of total billed charges,,,,,,,,,,,,,,,3943.75,83,,percent of total billed charges,,,4513.93,95,,percent of total billed charges,,,4276.35,90,,percent of total billed charges,,,4276.35,90,,percent of total billed charges,,,3896.23,82,,percent of total billed charges,,,4276.35,90,,percent of total billed charges,,,4038.78,85,,percent of total billed charges,,3582.63,4513.93,
ZIMMER DRILL BIT FAST 2.0MM,30188493,CDM,,,278,RC,inpatient,,693,693,,588.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,522.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,589.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,609.84,88,,percent of total billed charges,,,,,,,,,529.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,630.63,91,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,,,,,,,,,,,,,575.19,83,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,568.26,82,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,589.05,85,,percent of total billed charges,,522.52,658.35,
ZIMMER DRILL BIT DVR 2.5MM NS,30188494,CDM,,,278,RC,inpatient,,693,693,,588.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,522.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,589.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,609.84,88,,percent of total billed charges,,,,,,,,,529.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,630.63,91,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,,,,,,,,,,,,,575.19,83,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,568.26,82,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,589.05,85,,percent of total billed charges,,522.52,658.35,
ZIMMER SCREW CORTICAL 3.5X12MM,30188495,CDM,,,278,RC,inpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,464.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,523.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,464.46,585.2,
ZIMMER SCREW CORTICAL 3.5X14MM,30188496,CDM,,,278,RC,inpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,464.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,523.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,464.46,585.2,
ZIMMER PEG PARTIAL THREAD 2.5X18MM,30188497,CDM,,,278,RC,inpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,464.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,523.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,464.46,585.2,
ZIMMER PEG PARTIAL THREAD 2.5X20MM,30188498,CDM,,,278,RC,inpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,464.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,523.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,464.46,585.2,
ZIMMER PEG PARTIAL THREAD 2.5X22MM,30188499,CDM,,,278,RC,inpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,464.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,523.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,464.46,585.2,
BIOTRONIK PACEMAKER DUAL CHAMBER EDORA 8,30188500,CDM,,,278,RC,inpatient,,23725,23725,,20142.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17888.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20166.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20878,88,,percent of total billed charges,,,,,,,,,18125.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21589.75,91,,percent of total billed charges,,,22538.75,95,,percent of total billed charges,,,19691.75,83,,percent of total billed charges,,,19691.75,83,,percent of total billed charges,,,,,,,,,,,,,,,19691.75,83,,percent of total billed charges,,,22538.75,95,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,19454.5,82,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,20166.25,85,,percent of total billed charges,,17888.65,22538.75,
ZIMMER FEMUR NARROW SZ 6 LEFT,30188501,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER SCREW BONE 6.5X40 ST,30188502,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
MEDTRONIC BUR ROUND 4.5,30188503,CDM,,,270,RC,inpatient,,2517.65,2517.65,,2137.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1898.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2140,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2215.53,88,,percent of total billed charges,,,,,,,,,1923.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2291.06,91,,percent of total billed charges,,,2391.77,95,,percent of total billed charges,,,2089.65,83,,percent of total billed charges,,,2089.65,83,,percent of total billed charges,,,,,,,,,,,,,,,2089.65,83,,percent of total billed charges,,,2391.77,95,,percent of total billed charges,,,2265.89,90,,percent of total billed charges,,,2265.89,90,,percent of total billed charges,,,2064.47,82,,percent of total billed charges,,,2265.89,90,,percent of total billed charges,,,2140,85,,percent of total billed charges,,1898.31,2391.77,
MEDTRONIC BUR ROUND 3.2,30188504,CDM,,,270,RC,inpatient,,2465.65,2465.65,,2093.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1859.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2095.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2169.77,88,,percent of total billed charges,,,,,,,,,1883.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2243.74,91,,percent of total billed charges,,,2342.37,95,,percent of total billed charges,,,2046.49,83,,percent of total billed charges,,,2046.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2046.49,83,,percent of total billed charges,,,2342.37,95,,percent of total billed charges,,,2219.09,90,,percent of total billed charges,,,2219.09,90,,percent of total billed charges,,,2021.83,82,,percent of total billed charges,,,2219.09,90,,percent of total billed charges,,,2095.8,85,,percent of total billed charges,,1859.1,2342.37,
IR PLATE CERVICAL 4 LEVEL 72MM,30188505,CDM,,,278,RC,inpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7351.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8287.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,7351.5,9262.5,
SPINECRAFT SCREW POLY 6.5 X 50MM,30188506,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
SPINECRAFT ROD TITANIUM 5.5 X 300MM,30188507,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
ZIMMER SCREW CANCELLOUS 4X14MM,30188508,CDM,,,278,RC,inpatient,,424.55,424.55,,360.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,320.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,360.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,373.6,88,,percent of total billed charges,,,,,,,,,324.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,386.34,91,,percent of total billed charges,,,403.32,95,,percent of total billed charges,,,352.38,83,,percent of total billed charges,,,352.38,83,,percent of total billed charges,,,,,,,,,,,,,,,352.38,83,,percent of total billed charges,,,403.32,95,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,348.13,82,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,360.87,85,,percent of total billed charges,,320.11,403.32,
ZIMMER PLATE LOCKING FIBULA 4H 80MM RT,30188509,CDM,,,278,RC,inpatient,,4006.34,4006.34,,3401.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3020.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3405.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3525.58,88,,percent of total billed charges,,,,,,,,,3060.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3645.77,91,,percent of total billed charges,,,3806.02,95,,percent of total billed charges,,,3325.26,83,,percent of total billed charges,,,3325.26,83,,percent of total billed charges,,,,,,,,,,,,,,,3325.26,83,,percent of total billed charges,,,3806.02,95,,percent of total billed charges,,,3605.71,90,,percent of total billed charges,,,3605.71,90,,percent of total billed charges,,,3285.2,82,,percent of total billed charges,,,3605.71,90,,percent of total billed charges,,,3405.39,85,,percent of total billed charges,,3020.78,3806.02,
STRYKER BASEPLATE TIBIAL SZ 6,30188510,CDM,,,278,RC,inpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6861.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7735,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,6861.4,8645,
STRYKER FEMORAL COMPONENT SZ 6 LEFT,30188511,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER INSERT TIBIAL SZ 6 9MM,30188512,CDM,,,278,RC,inpatient,,15536.95,15536.95,,13190.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11714.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13206.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13672.52,88,,percent of total billed charges,,,,,,,,,11870.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14138.62,91,,percent of total billed charges,,,14760.1,95,,percent of total billed charges,,,12895.67,83,,percent of total billed charges,,,12895.67,83,,percent of total billed charges,,,,,,,,,,,,,,,12895.67,83,,percent of total billed charges,,,14760.1,95,,percent of total billed charges,,,13983.26,90,,percent of total billed charges,,,13983.26,90,,percent of total billed charges,,,12740.3,82,,percent of total billed charges,,,13983.26,90,,percent of total billed charges,,,13206.41,85,,percent of total billed charges,,11714.86,14760.1,
ULRICH END PLATE 10DEG 16X13,30188513,CDM,,,278,RC,inpatient,,45285.5,45285.5,,38447.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34145.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38492.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39851.24,88,,percent of total billed charges,,,,,,,,,34598.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41209.81,91,,percent of total billed charges,,,43021.23,95,,percent of total billed charges,,,37586.97,83,,percent of total billed charges,,,37586.97,83,,percent of total billed charges,,,,,,,,,,,,,,,37586.97,83,,percent of total billed charges,,,43021.23,95,,percent of total billed charges,,,40756.95,90,,percent of total billed charges,,,40756.95,90,,percent of total billed charges,,,37134.11,82,,percent of total billed charges,,,40756.95,90,,percent of total billed charges,,,38492.68,85,,percent of total billed charges,,34145.27,43021.23,
ULRICH CAGE CORPECTOMY 19-27MM,30188514,CDM,,,278,RC,inpatient,,145288,145288,,123349.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,109547.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,123494.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127853.44,88,,percent of total billed charges,,,,,,,,,111000.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132212.08,91,,percent of total billed charges,,,138023.6,95,,percent of total billed charges,,,120589.04,83,,percent of total billed charges,,,120589.04,83,,percent of total billed charges,,,,,,,,,,,,,,,120589.04,83,,percent of total billed charges,,,138023.6,95,,percent of total billed charges,,,130759.2,90,,percent of total billed charges,,,130759.2,90,,percent of total billed charges,,,119136.16,82,,percent of total billed charges,,,130759.2,90,,percent of total billed charges,,,123494.8,85,,percent of total billed charges,,109547.15,138023.6,
STRYKER INSERT MDM X3 36C,30188515,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER FEMUR TRIATHLON CR SZ 5 LEFT,30188516,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
STRYKER PATELLA S33MM,30188517,CDM,,,278,RC,inpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2940.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3315,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,2940.6,3705,
DEPUY ATTUNE INSERT PS RP SZ7 12MM,30188518,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY ATTUNE STEM PF 22X60MM,30188519,CDM,,,278,RC,inpatient,,13175.11,13175.11,,11185.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9934.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11198.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11594.1,88,,percent of total billed charges,,,,,,,,,10065.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11989.35,91,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,,,,,,,,,,,,,10935.34,83,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,10803.59,82,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,9934.03,12516.35,
STRYKER INSERT CS SZ 2 14MM,30188520,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
DEPUY METAGLENE CS 10MM,30188521,CDM,,,278,RC,inpatient,,25993.5,25993.5,,22068.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19599.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22094.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22874.28,88,,percent of total billed charges,,,,,,,,,19859.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23654.09,91,,percent of total billed charges,,,24693.83,95,,percent of total billed charges,,,21574.61,83,,percent of total billed charges,,,21574.61,83,,percent of total billed charges,,,,,,,,,,,,,,,21574.61,83,,percent of total billed charges,,,24693.83,95,,percent of total billed charges,,,23394.15,90,,percent of total billed charges,,,23394.15,90,,percent of total billed charges,,,21314.67,82,,percent of total billed charges,,,23394.15,90,,percent of total billed charges,,,22094.48,85,,percent of total billed charges,,19599.1,24693.83,
DEPUY SCREW METAGLENE 6X15MM,30188522,CDM,,,278,RC,inpatient,,5772,5772,,4900.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4352.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4906.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5079.36,88,,percent of total billed charges,,,,,,,,,4409.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5252.52,91,,percent of total billed charges,,,5483.4,95,,percent of total billed charges,,,4790.76,83,,percent of total billed charges,,,4790.76,83,,percent of total billed charges,,,,,,,,,,,,,,,4790.76,83,,percent of total billed charges,,,5483.4,95,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,4733.04,82,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,4906.2,85,,percent of total billed charges,,4352.09,5483.4,
DEPUY OSTEOTOME BLADE SHORT RADIAL,30188523,CDM,,,278,RC,inpatient,,3107,3107,,2637.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2342.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2640.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2734.16,88,,percent of total billed charges,,,,,,,,,2373.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2827.37,91,,percent of total billed charges,,,2951.65,95,,percent of total billed charges,,,2578.81,83,,percent of total billed charges,,,2578.81,83,,percent of total billed charges,,,,,,,,,,,,,,,2578.81,83,,percent of total billed charges,,,2951.65,95,,percent of total billed charges,,,2796.3,90,,percent of total billed charges,,,2796.3,90,,percent of total billed charges,,,2547.74,82,,percent of total billed charges,,,2796.3,90,,percent of total billed charges,,,2640.95,85,,percent of total billed charges,,2342.68,2951.65,
STRYKER INSERT MDM 42E,30188524,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER HEAD FEMORAL 28MM +4,30188525,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
ZIMMER FEMUR CR TM SZ 6 RIGHT,30188526,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
ZIMMER FEMUR CMT REV PSN SZ 9 LEFT,30188527,CDM,,,278,RC,inpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50633.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57080.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,50633.46,63795.47,
ZIMMER HEX DRIVER 2MM,30188528,CDM,,,278,RC,inpatient,,567,567,,481.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,427.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,481.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,498.96,88,,percent of total billed charges,,,,,,,,,433.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,,,,,,,,,,,,,470.61,83,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,464.94,82,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,427.52,538.65,
ZIMMER BEARING CPS 10MM LEFT,30188529,CDM,,,278,RC,inpatient,,17135.63,17135.63,,14548.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12920.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14565.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15079.35,88,,percent of total billed charges,,,,,,,,,13091.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15593.42,91,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14222.57,83,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14051.22,82,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,12920.27,16278.85,
ZIMMER LINER NEUTRAL FREEDOM CONT 36MM,30188530,CDM,,,278,RC,inpatient,,29655.6,29655.6,,25177.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22360.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25207.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26096.93,88,,percent of total billed charges,,,,,,,,,22656.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26986.6,91,,percent of total billed charges,,,28172.82,95,,percent of total billed charges,,,24614.15,83,,percent of total billed charges,,,24614.15,83,,percent of total billed charges,,,,,,,,,,,,,,,24614.15,83,,percent of total billed charges,,,28172.82,95,,percent of total billed charges,,,26690.04,90,,percent of total billed charges,,,26690.04,90,,percent of total billed charges,,,24317.59,82,,percent of total billed charges,,,26690.04,90,,percent of total billed charges,,,25207.26,85,,percent of total billed charges,,22360.32,28172.82,
ZIMMER HEAD FREEDOM CONT 36MM X +0,30188531,CDM,,,278,RC,inpatient,,12721.8,12721.8,,10800.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9592.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10813.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11195.18,88,,percent of total billed charges,,,,,,,,,9719.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11576.84,91,,percent of total billed charges,,,12085.71,95,,percent of total billed charges,,,10559.09,83,,percent of total billed charges,,,10559.09,83,,percent of total billed charges,,,,,,,,,,,,,,,10559.09,83,,percent of total billed charges,,,12085.71,95,,percent of total billed charges,,,11449.62,90,,percent of total billed charges,,,11449.62,90,,percent of total billed charges,,,10431.88,82,,percent of total billed charges,,,11449.62,90,,percent of total billed charges,,,10813.53,85,,percent of total billed charges,,9592.24,12085.71,
STRYKER RESTRICTOR CEMENT UNV. MEDIUM,30188532,CDM,,,278,RC,inpatient,,1001,1001,,849.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,754.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,850.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,880.88,88,,percent of total billed charges,,,,,,,,,764.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,910.91,91,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,,,,,,,,,,,,,830.83,83,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,820.82,82,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,754.75,950.95,
STRYKER SPACER DISTAL OSTEONICS UNV.,30188533,CDM,,,278,RC,inpatient,,1001,1001,,849.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,754.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,850.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,880.88,88,,percent of total billed charges,,,,,,,,,764.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,910.91,91,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,,,,,,,,,,,,,830.83,83,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,820.82,82,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,754.75,950.95,
STRYKER STEM ACCOLADE CS 127NK,30188534,CDM,,,278,RC,inpatient,,11700,11700,,9933.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8821.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9945,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10296,88,,percent of total billed charges,,,,,,,,,8938.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10647,91,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,,,,,,,,,,,,,9711,83,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9594,82,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9945,85,,percent of total billed charges,,8821.8,11115,
STRYKER BIPOLAR UHR 26X45MM,30188535,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
BOSTON GUIDEWIRE ZEBRA 3CM STRAIGHT,30188536,CDM,,,270,RC,inpatient,,384.16,384.16,,326.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,289.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,326.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,338.06,88,,percent of total billed charges,,,,,,,,,293.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,349.59,91,,percent of total billed charges,,,364.95,95,,percent of total billed charges,,,318.85,83,,percent of total billed charges,,,318.85,83,,percent of total billed charges,,,,,,,,,,,,,,,318.85,83,,percent of total billed charges,,,364.95,95,,percent of total billed charges,,,345.74,90,,percent of total billed charges,,,345.74,90,,percent of total billed charges,,,315.01,82,,percent of total billed charges,,,345.74,90,,percent of total billed charges,,,326.54,85,,percent of total billed charges,,289.66,364.95,
BOSTON GUIDEWIRE ZEBRA 3CM ANGLED,30188537,CDM,,,270,RC,inpatient,,384.16,384.16,,326.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,289.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,326.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,338.06,88,,percent of total billed charges,,,,,,,,,293.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,349.59,91,,percent of total billed charges,,,364.95,95,,percent of total billed charges,,,318.85,83,,percent of total billed charges,,,318.85,83,,percent of total billed charges,,,,,,,,,,,,,,,318.85,83,,percent of total billed charges,,,364.95,95,,percent of total billed charges,,,345.74,90,,percent of total billed charges,,,345.74,90,,percent of total billed charges,,,315.01,82,,percent of total billed charges,,,345.74,90,,percent of total billed charges,,,326.54,85,,percent of total billed charges,,289.66,364.95,
BOSTON BALLOON KIT NEPHROMAX 20CM X 30FR,30188538,CDM,,,270,RC,inpatient,,1695.79,1695.79,,1439.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1278.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1441.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1492.3,88,,percent of total billed charges,,,,,,,,,1295.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1543.17,91,,percent of total billed charges,,,1611,95,,percent of total billed charges,,,1407.51,83,,percent of total billed charges,,,1407.51,83,,percent of total billed charges,,,,,,,,,,,,,,,1407.51,83,,percent of total billed charges,,,1611,95,,percent of total billed charges,,,1526.21,90,,percent of total billed charges,,,1526.21,90,,percent of total billed charges,,,1390.55,82,,percent of total billed charges,,,1526.21,90,,percent of total billed charges,,,1441.42,85,,percent of total billed charges,,1278.63,1611,
BOSTON ZIPWIRE BENTSON .035X150 STIFF AN,30188539,CDM,,,270,RC,inpatient,,373.03,373.03,,316.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,281.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,317.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,328.27,88,,percent of total billed charges,,,,,,,,,284.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,339.46,91,,percent of total billed charges,,,354.38,95,,percent of total billed charges,,,309.61,83,,percent of total billed charges,,,309.61,83,,percent of total billed charges,,,,,,,,,,,,,,,309.61,83,,percent of total billed charges,,,354.38,95,,percent of total billed charges,,,335.73,90,,percent of total billed charges,,,335.73,90,,percent of total billed charges,,,305.88,82,,percent of total billed charges,,,335.73,90,,percent of total billed charges,,,317.08,85,,percent of total billed charges,,281.26,354.38,
BOSTON ZIPWIRE BENTSON .035X150 STD ANGL,30188540,CDM,,,270,RC,inpatient,,373.03,373.03,,316.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,281.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,317.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,328.27,88,,percent of total billed charges,,,,,,,,,284.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,339.46,91,,percent of total billed charges,,,354.38,95,,percent of total billed charges,,,309.61,83,,percent of total billed charges,,,309.61,83,,percent of total billed charges,,,,,,,,,,,,,,,309.61,83,,percent of total billed charges,,,354.38,95,,percent of total billed charges,,,335.73,90,,percent of total billed charges,,,335.73,90,,percent of total billed charges,,,305.88,82,,percent of total billed charges,,,335.73,90,,percent of total billed charges,,,317.08,85,,percent of total billed charges,,281.26,354.38,
BOSTON Y-ADAPTER GATEWAY ADVANTAGE,30188541,CDM,,,270,RC,inpatient,,126.64,126.64,,107.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,111.44,88,,percent of total billed charges,,,,,,,,,96.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,115.24,91,,percent of total billed charges,,,120.31,95,,percent of total billed charges,,,105.11,83,,percent of total billed charges,,,105.11,83,,percent of total billed charges,,,,,,,,,,,,,,,105.11,83,,percent of total billed charges,,,120.31,95,,percent of total billed charges,,,113.98,90,,percent of total billed charges,,,113.98,90,,percent of total billed charges,,,103.84,82,,percent of total billed charges,,,113.98,90,,percent of total billed charges,,,107.64,85,,percent of total billed charges,,95.49,120.31,
COOPER STAPLER SKIN INSORB,30188542,CDM,,,270,RC,inpatient,,433.58,433.58,,368.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,326.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,368.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,381.55,88,,percent of total billed charges,,,,,,,,,331.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,394.56,91,,percent of total billed charges,,,411.9,95,,percent of total billed charges,,,359.87,83,,percent of total billed charges,,,359.87,83,,percent of total billed charges,,,,,,,,,,,,,,,359.87,83,,percent of total billed charges,,,411.9,95,,percent of total billed charges,,,390.22,90,,percent of total billed charges,,,390.22,90,,percent of total billed charges,,,355.54,82,,percent of total billed charges,,,390.22,90,,percent of total billed charges,,,368.54,85,,percent of total billed charges,,326.92,411.9,
STRYKER SCREW LAG 10.5 X 110MM,30188543,CDM,,,278,RC,inpatient,,5200.33,5200.33,,4415.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3921.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4420.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4576.29,88,,percent of total billed charges,,,,,,,,,3973.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4732.3,91,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,,,,,,,,,,,,,4316.27,83,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4264.27,82,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4420.28,85,,percent of total billed charges,,3921.05,4940.31,
ZIMMER UC POLY PSN ASF 13MM,30188544,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
MENTOR MEMORYGEL BREAST IMPLANT 750CC,30188545,CDM,,,278,RC,inpatient,,6825,6825,,5794.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5146.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5801.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6006,88,,percent of total billed charges,,,,,,,,,5214.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6210.75,91,,percent of total billed charges,,,6483.75,95,,percent of total billed charges,,,5664.75,83,,percent of total billed charges,,,5664.75,83,,percent of total billed charges,,,,,,,,,,,,,,,5664.75,83,,percent of total billed charges,,,6483.75,95,,percent of total billed charges,,,6142.5,90,,percent of total billed charges,,,6142.5,90,,percent of total billed charges,,,5596.5,82,,percent of total billed charges,,,6142.5,90,,percent of total billed charges,,,5801.25,85,,percent of total billed charges,,5146.05,6483.75,
ULRICH BOLT ILLIAC 10.0 X 70MM,30188546,CDM,,,278,RC,inpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7106.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8011.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,7106.45,8953.75,
STRYKER INSERT CS SZ 2 10MM,30188547,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER FEMUR CR #4,30188548,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
STRYKER FEMUR TRIATHLON PS SZ4 LFT,30188549,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER INSERT TIBA SZ 4 TS,30188550,CDM,,,278,RC,inpatient,,15536.95,15536.95,,13190.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11714.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13206.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13672.52,88,,percent of total billed charges,,,,,,,,,11870.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14138.62,91,,percent of total billed charges,,,14760.1,95,,percent of total billed charges,,,12895.67,83,,percent of total billed charges,,,12895.67,83,,percent of total billed charges,,,,,,,,,,,,,,,12895.67,83,,percent of total billed charges,,,14760.1,95,,percent of total billed charges,,,13983.26,90,,percent of total billed charges,,,13983.26,90,,percent of total billed charges,,,12740.3,82,,percent of total billed charges,,,13983.26,90,,percent of total billed charges,,,13206.41,85,,percent of total billed charges,,11714.86,14760.1,
ZIMMER MC VE ASF 14MM RIGHT,30188551,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ZIMMER TIBIA PSN SZ J RIGHT,30188552,CDM,,,278,RC,inpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7228.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8149.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,7228.98,9108.13,
ARTHREX BONE GRAFT HARVESTER 8MM,30188553,CDM,,,278,RC,inpatient,,3672.5,3672.5,,3117.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2769.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3121.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3231.8,88,,percent of total billed charges,,,,,,,,,2805.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3341.98,91,,percent of total billed charges,,,3488.88,95,,percent of total billed charges,,,3048.18,83,,percent of total billed charges,,,3048.18,83,,percent of total billed charges,,,,,,,,,,,,,,,3048.18,83,,percent of total billed charges,,,3488.88,95,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3011.45,82,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3121.63,85,,percent of total billed charges,,2769.07,3488.88,
ARTHREX SCREW LP TI 4.5X32MM,30188554,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
ARTHREX SCREW LP TI 4.5X34MM,30188555,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
ARTHREX SCREW LP TI 4.5X36MM,30188556,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
ARTHREX SCREW LP TI 4.5X38MM,30188557,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
ARTHREX SCREW LP TI 4.5X48MM,30188558,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
ARTHREX SCREW LP TI 4.5X50MM,30188559,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
ARTHREX SCREW LP TI 4.5X60MM,30188560,CDM,,,278,RC,inpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,446.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,395.85,498.75,
ARTHREX G-WIRE W/TROCAR TIP .094X8,30188561,CDM,,,278,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
ARTHREX BB-TAK LARGE THREADED,30188562,CDM,,,278,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
ARTHREX DRILL BIT CALIBRATED 3.0MM LONG,30188563,CDM,,,278,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
ARTHREX DRILL BIT SOLID 5.5MM LONG,30188564,CDM,,,278,RC,inpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,735.15,926.25,
ARTHREX ANKLE FUSION PLATE ANTERIOR TT R,30188565,CDM,,,278,RC,inpatient,,13487.5,13487.5,,11450.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10169.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11464.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11869,88,,percent of total billed charges,,,,,,,,,10304.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12273.63,91,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,,,,,,,,,,,,,11194.63,83,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11059.75,82,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,10169.58,12813.13,
ARTHREX ALLOSYNC PURE 5CC,30188566,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
BOSTON URETERAL ACCESS SHEATH 11/13 X 46,30188567,CDM,,,270,RC,inpatient,,841.4,841.4,,714.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,634.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,715.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,740.43,88,,percent of total billed charges,,,,,,,,,642.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,765.67,91,,percent of total billed charges,,,799.33,95,,percent of total billed charges,,,698.36,83,,percent of total billed charges,,,698.36,83,,percent of total billed charges,,,,,,,,,,,,,,,698.36,83,,percent of total billed charges,,,799.33,95,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,689.95,82,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,715.19,85,,percent of total billed charges,,634.42,799.33,
BOSTON URETERAL ACCESS SHEATH 12/14 X 36,30188568,CDM,,,270,RC,inpatient,,841.4,841.4,,714.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,634.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,715.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,740.43,88,,percent of total billed charges,,,,,,,,,642.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,765.67,91,,percent of total billed charges,,,799.33,95,,percent of total billed charges,,,698.36,83,,percent of total billed charges,,,698.36,83,,percent of total billed charges,,,,,,,,,,,,,,,698.36,83,,percent of total billed charges,,,799.33,95,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,689.95,82,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,715.19,85,,percent of total billed charges,,634.42,799.33,
BOSTON URETERAL ACCESS SHEATH 12/14 X 46,30188569,CDM,,,270,RC,inpatient,,841.4,841.4,,714.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,634.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,715.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,740.43,88,,percent of total billed charges,,,,,,,,,642.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,765.67,91,,percent of total billed charges,,,799.33,95,,percent of total billed charges,,,698.36,83,,percent of total billed charges,,,698.36,83,,percent of total billed charges,,,,,,,,,,,,,,,698.36,83,,percent of total billed charges,,,799.33,95,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,689.95,82,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,715.19,85,,percent of total billed charges,,634.42,799.33,
STRYKER FEMUR CR #8 LFT,30188570,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER INSERT CS SZ 7 9MM,30188571,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
ZIMMER TIBIA RIGHT CR SZ F,30188572,CDM,,,278,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
SYNTHES GUIDEWIRE 1.6X150MM,30188573,CDM,,,278,RC,inpatient,,372.4,372.4,,316.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,280.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,316.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,327.71,88,,percent of total billed charges,,,,,,,,,284.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,338.88,91,,percent of total billed charges,,,353.78,95,,percent of total billed charges,,,309.09,83,,percent of total billed charges,,,309.09,83,,percent of total billed charges,,,,,,,,,,,,,,,309.09,83,,percent of total billed charges,,,353.78,95,,percent of total billed charges,,,335.16,90,,percent of total billed charges,,,335.16,90,,percent of total billed charges,,,305.37,82,,percent of total billed charges,,,335.16,90,,percent of total billed charges,,,316.54,85,,percent of total billed charges,,280.79,353.78,
BIOTRONIK PACEMAKER BIOMONITOR IIIM,30188574,CDM,,,278,RC,inpatient,,27300,27300,,23177.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20584.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23205,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24024,88,,percent of total billed charges,,,,,,,,,20857.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24843,91,,percent of total billed charges,,,25935,95,,percent of total billed charges,,,22659,83,,percent of total billed charges,,,22659,83,,percent of total billed charges,,,,,,,,,,,,,,,22659,83,,percent of total billed charges,,,25935,95,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,22386,82,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,23205,85,,percent of total billed charges,,20584.2,25935,
SURETRAC ELASTIC TRACTION SYSTEM 11MM,30188575,CDM,,,270,RC,inpatient,,1924,1924,,1633.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1450.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1635.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1693.12,88,,percent of total billed charges,,,,,,,,,1469.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1750.84,91,,percent of total billed charges,,,1827.8,95,,percent of total billed charges,,,1596.92,83,,percent of total billed charges,,,1596.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1596.92,83,,percent of total billed charges,,,1827.8,95,,percent of total billed charges,,,1731.6,90,,percent of total billed charges,,,1731.6,90,,percent of total billed charges,,,1577.68,82,,percent of total billed charges,,,1731.6,90,,percent of total billed charges,,,1635.4,85,,percent of total billed charges,,1450.7,1827.8,
ULTRASOUND GUIDED BIOPSY PROCEDURE FEE,30188576,CDM,,,270,RC,inpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6371.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7182.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,6371.3,8027.5,
STRYKER FEMUR TRIATHLON CR SZ 7 LEFT,30188577,CDM,,,278,RC,inpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11272.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12707.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,11272.3,14202.5,
STRYKER INSERT TIBIA CS SZ 6 11MM,30188578,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
STRYKER INSERT CS #4 10MM,30188579,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
ZIMMER DRILL BIT CALIB 2.7MM,30188580,CDM,,,278,RC,inpatient,,728,728,,618.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,548.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,618.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,640.64,88,,percent of total billed charges,,,,,,,,,556.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,662.48,91,,percent of total billed charges,,,691.6,95,,percent of total billed charges,,,604.24,83,,percent of total billed charges,,,604.24,83,,percent of total billed charges,,,,,,,,,,,,,,,604.24,83,,percent of total billed charges,,,691.6,95,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,596.96,82,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,618.8,85,,percent of total billed charges,,548.91,691.6,
ZIMMER K-WIRE S3 2.0 X 152MM,30188581,CDM,,,278,RC,inpatient,,285,285,,241.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,242.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,250.8,88,,percent of total billed charges,,,,,,,,,217.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,259.35,91,,percent of total billed charges,,,270.75,95,,percent of total billed charges,,,236.55,83,,percent of total billed charges,,,236.55,83,,percent of total billed charges,,,,,,,,,,,,,,,236.55,83,,percent of total billed charges,,,270.75,95,,percent of total billed charges,,,256.5,90,,percent of total billed charges,,,256.5,90,,percent of total billed charges,,,233.7,82,,percent of total billed charges,,,256.5,90,,percent of total billed charges,,,242.25,85,,percent of total billed charges,,214.89,270.75,
ZIMMER PLATE HUM LO 11 HOLE 190MM,30188582,CDM,,,278,RC,inpatient,,12584,12584,,10683.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9488.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10696.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11073.92,88,,percent of total billed charges,,,,,,,,,9614.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11451.44,91,,percent of total billed charges,,,11954.8,95,,percent of total billed charges,,,10444.72,83,,percent of total billed charges,,,10444.72,83,,percent of total billed charges,,,,,,,,,,,,,,,10444.72,83,,percent of total billed charges,,,11954.8,95,,percent of total billed charges,,,11325.6,90,,percent of total billed charges,,,11325.6,90,,percent of total billed charges,,,10318.88,82,,percent of total billed charges,,,11325.6,90,,percent of total billed charges,,,10696.4,85,,percent of total billed charges,,9488.34,11954.8,
ZIMMER SCREW CORTICAL ST 3.5X20MM,30188583,CDM,,,278,RC,inpatient,,195.2,195.2,,165.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,165.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,171.78,88,,percent of total billed charges,,,,,,,,,149.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,177.63,91,,percent of total billed charges,,,185.44,95,,percent of total billed charges,,,162.02,83,,percent of total billed charges,,,162.02,83,,percent of total billed charges,,,,,,,,,,,,,,,162.02,83,,percent of total billed charges,,,185.44,95,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,160.06,82,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,165.92,85,,percent of total billed charges,,147.18,185.44,
ZIMMER SCREW CORTICAL ST 3.5X18MM,30188584,CDM,,,278,RC,inpatient,,195.2,195.2,,165.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,165.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,171.78,88,,percent of total billed charges,,,,,,,,,149.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,177.63,91,,percent of total billed charges,,,185.44,95,,percent of total billed charges,,,162.02,83,,percent of total billed charges,,,162.02,83,,percent of total billed charges,,,,,,,,,,,,,,,162.02,83,,percent of total billed charges,,,185.44,95,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,160.06,82,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,165.92,85,,percent of total billed charges,,147.18,185.44,
ZIMMER SCREW CORTICAL T15 3.5X20MM,30188585,CDM,,,278,RC,inpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,316.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,357,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,316.68,399,
ZIMMER SCREW CORTICAL T15 3.5X22MM,30188586,CDM,,,278,RC,inpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,316.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,357,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,316.68,399,
ZIMMER SCREW CORTICAL T15 3.5X28MM,30188587,CDM,,,278,RC,inpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,316.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,357,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,316.68,399,
ZIMMER SCREW CORTICAL T15 3.5X26MM,30188588,CDM,,,278,RC,inpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,316.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,357,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,316.68,399,
ZIMMER SCREW LOCKING CANC 4.0 X 34MM,30188589,CDM,,,278,RC,inpatient,,858,858,,728.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,646.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,729.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,755.04,88,,percent of total billed charges,,,,,,,,,655.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,780.78,91,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,,,,,,,,,,,,,712.14,83,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,703.56,82,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,646.93,815.1,
ZIMMER SCREW LOCKING CANC 4.0 X 36MM,30188590,CDM,,,278,RC,inpatient,,858,858,,728.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,646.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,729.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,755.04,88,,percent of total billed charges,,,,,,,,,655.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,780.78,91,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,,,,,,,,,,,,,712.14,83,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,703.56,82,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,646.93,815.1,
ZIMMER SCREW LOCKING CANC 4.0 X 32MM,30188591,CDM,,,278,RC,inpatient,,858,858,,728.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,646.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,729.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,755.04,88,,percent of total billed charges,,,,,,,,,655.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,780.78,91,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,,,,,,,,,,,,,712.14,83,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,703.56,82,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,646.93,815.1,
ZIMMER SCREW LOCKING CANC 4.0 X 30MM,30188592,CDM,,,278,RC,inpatient,,858,858,,728.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,646.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,729.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,755.04,88,,percent of total billed charges,,,,,,,,,655.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,780.78,91,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,,,,,,,,,,,,,712.14,83,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,703.56,82,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,646.93,815.1,
ZIMMER SCREW LOCKING CANC 4.0 X 55MM,30188593,CDM,,,278,RC,inpatient,,858,858,,728.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,646.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,729.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,755.04,88,,percent of total billed charges,,,,,,,,,655.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,780.78,91,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,,,,,,,,,,,,,712.14,83,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,703.56,82,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,646.93,815.1,
ZIMMER SCREW LOCKING CANC 4.0 X 22MM,30188594,CDM,,,278,RC,inpatient,,858,858,,728.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,646.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,729.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,755.04,88,,percent of total billed charges,,,,,,,,,655.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,780.78,91,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,,,,,,,,,,,,,712.14,83,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,703.56,82,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,646.93,815.1,
ZIMMER SCREW TI MD 3.5 X 22MM,30188595,CDM,,,278,RC,inpatient,,1176.5,1176.5,,998.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,887.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1000.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1035.32,88,,percent of total billed charges,,,,,,,,,898.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1070.62,91,,percent of total billed charges,,,1117.68,95,,percent of total billed charges,,,976.5,83,,percent of total billed charges,,,976.5,83,,percent of total billed charges,,,,,,,,,,,,,,,976.5,83,,percent of total billed charges,,,1117.68,95,,percent of total billed charges,,,1058.85,90,,percent of total billed charges,,,1058.85,90,,percent of total billed charges,,,964.73,82,,percent of total billed charges,,,1058.85,90,,percent of total billed charges,,,1000.03,85,,percent of total billed charges,,887.08,1117.68,
STRYKER INSERT TIBA CS SZ 4 14MM,30188596,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
DEPUY STEM CORAIL HIGH COL SZ 11,30188597,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
SCREW LATERAL MASS 20 X 3.5MM,30188598,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
SCREW LATERAL MASS 25 X 5.0,30188599,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
ULRICH DRILL 2.4,30188600,CDM,,,278,RC,inpatient,,2340,2340,,1986.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1764.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1989,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2059.2,88,,percent of total billed charges,,,,,,,,,1787.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2129.4,91,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1942.2,83,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1918.8,82,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1989,85,,percent of total billed charges,,1764.36,2223,
SYNTHES DRILL BIT LARGE STEPPED QC 4.5/6,30188601,CDM,,,270,RC,inpatient,,5122.91,5122.91,,4349.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3862.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4354.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4508.16,88,,percent of total billed charges,,,,,,,,,3913.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4661.85,91,,percent of total billed charges,,,4866.76,95,,percent of total billed charges,,,4252.02,83,,percent of total billed charges,,,4252.02,83,,percent of total billed charges,,,,,,,,,,,,,,,4252.02,83,,percent of total billed charges,,,4866.76,95,,percent of total billed charges,,,4610.62,90,,percent of total billed charges,,,4610.62,90,,percent of total billed charges,,,4200.79,82,,percent of total billed charges,,,4610.62,90,,percent of total billed charges,,,4354.47,85,,percent of total billed charges,,3862.67,4866.76,
SYNTHES FRN CANN 380X10 RIGHT,30188602,CDM,,,278,RC,inpatient,,19234.74,19234.74,,16330.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14502.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16349.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16926.57,88,,percent of total billed charges,,,,,,,,,14695.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17503.61,91,,percent of total billed charges,,,18273,95,,percent of total billed charges,,,15964.83,83,,percent of total billed charges,,,15964.83,83,,percent of total billed charges,,,,,,,,,,,,,,,15964.83,83,,percent of total billed charges,,,18273,95,,percent of total billed charges,,,17311.27,90,,percent of total billed charges,,,17311.27,90,,percent of total billed charges,,,15772.49,82,,percent of total billed charges,,,17311.27,90,,percent of total billed charges,,,16349.53,85,,percent of total billed charges,,14502.99,18273,
SYNTHES SCREW TI RECON 6.5 X 85,30188603,CDM,,,278,RC,inpatient,,2321.15,2321.15,,1970.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1750.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1972.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2042.61,88,,percent of total billed charges,,,,,,,,,1773.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2112.25,91,,percent of total billed charges,,,2205.09,95,,percent of total billed charges,,,1926.55,83,,percent of total billed charges,,,1926.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1926.55,83,,percent of total billed charges,,,2205.09,95,,percent of total billed charges,,,2089.04,90,,percent of total billed charges,,,2089.04,90,,percent of total billed charges,,,1903.34,82,,percent of total billed charges,,,2089.04,90,,percent of total billed charges,,,1972.98,85,,percent of total billed charges,,1750.15,2205.09,
STRYKER SCREW LP 6.5X30MM,30188604,CDM,,,278,RC,inpatient,,946.4,946.4,,803.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,713.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,804.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,832.83,88,,percent of total billed charges,,,,,,,,,723.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,861.22,91,,percent of total billed charges,,,899.08,95,,percent of total billed charges,,,785.51,83,,percent of total billed charges,,,785.51,83,,percent of total billed charges,,,,,,,,,,,,,,,785.51,83,,percent of total billed charges,,,899.08,95,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,776.05,82,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,804.44,85,,percent of total billed charges,,713.59,899.08,
DEPUY-MITEK TENODESIS KIT,30188605,CDM,,,278,RC,inpatient,,5141.5,5141.5,,4365.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3876.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4370.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4524.52,88,,percent of total billed charges,,,,,,,,,3928.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4678.77,91,,percent of total billed charges,,,4884.43,95,,percent of total billed charges,,,4267.45,83,,percent of total billed charges,,,4267.45,83,,percent of total billed charges,,,,,,,,,,,,,,,4267.45,83,,percent of total billed charges,,,4884.43,95,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4216.03,82,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4370.28,85,,percent of total billed charges,,3876.69,4884.43,
DEPUY-MITEK QUICKANCHOR SUPER,30188606,CDM,,,278,RC,inpatient,,4589,4589,,3896.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3460.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3900.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4038.32,88,,percent of total billed charges,,,,,,,,,3506,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4175.99,91,,percent of total billed charges,,,4359.55,95,,percent of total billed charges,,,3808.87,83,,percent of total billed charges,,,3808.87,83,,percent of total billed charges,,,,,,,,,,,,,,,3808.87,83,,percent of total billed charges,,,4359.55,95,,percent of total billed charges,,,4130.1,90,,percent of total billed charges,,,4130.1,90,,percent of total billed charges,,,3762.98,82,,percent of total billed charges,,,4130.1,90,,percent of total billed charges,,,3900.65,85,,percent of total billed charges,,3460.11,4359.55,
STRYKER FEMUR CEMENTED #4 RIGHT,30188607,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
MEDTRONIC HAWKONE LARGE SHORT,30188608,CDM,,,270,RC,inpatient,,24292.13,24292.13,,20624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18316.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20648.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21377.07,88,,percent of total billed charges,,,,,,,,,18559.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22105.84,91,,percent of total billed charges,,,23077.52,95,,percent of total billed charges,,,20162.47,83,,percent of total billed charges,,,20162.47,83,,percent of total billed charges,,,,,,,,,,,,,,,20162.47,83,,percent of total billed charges,,,23077.52,95,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,19919.55,82,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,20648.31,85,,percent of total billed charges,,18316.27,23077.52,
MEDTRONIC VIANCE STANDARD EV3 150CM,30188609,CDM,,,270,RC,inpatient,,11319.82,11319.82,,9610.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8535.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9621.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9961.44,88,,percent of total billed charges,,,,,,,,,8648.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10301.04,91,,percent of total billed charges,,,10753.83,95,,percent of total billed charges,,,9395.45,83,,percent of total billed charges,,,9395.45,83,,percent of total billed charges,,,,,,,,,,,,,,,9395.45,83,,percent of total billed charges,,,10753.83,95,,percent of total billed charges,,,10187.84,90,,percent of total billed charges,,,10187.84,90,,percent of total billed charges,,,9282.25,82,,percent of total billed charges,,,10187.84,90,,percent of total billed charges,,,9621.85,85,,percent of total billed charges,,8535.14,10753.83,
ULRICH TAP  4.5,30188610,CDM,,,278,RC,inpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2205.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,2205.45,2778.75,
IMPACT ADMIRAL BALLOON 4X250X130,30188611,CDM,,,270,RC,inpatient,,21417.5,21417.5,,18183.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16148.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18204.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18847.4,88,,percent of total billed charges,,,,,,,,,16362.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19489.93,91,,percent of total billed charges,,,20346.63,95,,percent of total billed charges,,,17776.53,83,,percent of total billed charges,,,17776.53,83,,percent of total billed charges,,,,,,,,,,,,,,,17776.53,83,,percent of total billed charges,,,20346.63,95,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,17562.35,82,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,18204.88,85,,percent of total billed charges,,16148.8,20346.63,
STRYKER HEAD BIPOLAR 26MM X 53MM,30188612,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
STRYKER HEAD BIPOLAR 28MM,30188613,CDM,,,278,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
NEXTMED ESWL,30188614,CDM,,,270,RC,inpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12252.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13812.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,12252.5,15437.5,
SYNTHES PLATE DISTAL TIBIAL 3.5 X 10 HOL,30188615,CDM,,,270,RC,inpatient,,14120.28,14120.28,,11988.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10646.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12002.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12425.85,88,,percent of total billed charges,,,,,,,,,10787.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12849.45,91,,percent of total billed charges,,,13414.27,95,,percent of total billed charges,,,11719.83,83,,percent of total billed charges,,,11719.83,83,,percent of total billed charges,,,,,,,,,,,,,,,11719.83,83,,percent of total billed charges,,,13414.27,95,,percent of total billed charges,,,12708.25,90,,percent of total billed charges,,,12708.25,90,,percent of total billed charges,,,11578.63,82,,percent of total billed charges,,,12708.25,90,,percent of total billed charges,,,12002.24,85,,percent of total billed charges,,10646.69,13414.27,
FORTEC ULTRASOUND,30188616,CDM,,,270,RC,inpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4410.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4972.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,4410.9,5557.5,
FORTEC TRANSDUCER BK 9048,30188617,CDM,,,270,RC,inpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,980.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1105,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,980.2,1235,
FORTEC TRANSDUCER COVER,30188618,CDM,,,270,RC,inpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,150.8,190,
FORTEC PRECISION POINT,30188619,CDM,,,270,RC,inpatient,,1540.5,1540.5,,1307.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1161.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1309.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1355.64,88,,percent of total billed charges,,,,,,,,,1176.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.86,91,,percent of total billed charges,,,1463.48,95,,percent of total billed charges,,,1278.62,83,,percent of total billed charges,,,1278.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1278.62,83,,percent of total billed charges,,,1463.48,95,,percent of total billed charges,,,1386.45,90,,percent of total billed charges,,,1386.45,90,,percent of total billed charges,,,1263.21,82,,percent of total billed charges,,,1386.45,90,,percent of total billed charges,,,1309.43,85,,percent of total billed charges,,1161.54,1463.48,
FORTEC FIBER THULIUM TFL 365,30188620,CDM,,,270,RC,inpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1225.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1381.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,1225.25,1543.75,
AMPLATZ URETHERAL STENT 10.2FR 24CM,30188621,CDM,,,270,RC,inpatient,,1073.22,1073.22,,911.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,809.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,912.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,944.43,88,,percent of total billed charges,,,,,,,,,819.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,976.63,91,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,,,,,,,,,,,,,890.77,83,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,880.04,82,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,809.21,1019.56,
MEDTRONIC HAWKONE LARGE,30188622,CDM,,,270,RC,inpatient,,24292.13,24292.13,,20624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18316.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20648.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21377.07,88,,percent of total billed charges,,,,,,,,,18559.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22105.84,91,,percent of total billed charges,,,23077.52,95,,percent of total billed charges,,,20162.47,83,,percent of total billed charges,,,20162.47,83,,percent of total billed charges,,,,,,,,,,,,,,,20162.47,83,,percent of total billed charges,,,23077.52,95,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,19919.55,82,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,20648.31,85,,percent of total billed charges,,18316.27,23077.52,
ZIMMER POLY R MC VE 10MM 8-9/CD,30188623,CDM,,,278,RC,inpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6248.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7044.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,6248.78,7873.13,
ARTHREX SUTURE TAK PERC KIT 3.0MM,30188624,CDM,,,278,RC,inpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,955.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,955.7,1204.13,
ARTHREX SUTURE TAK DL W/SUTURE TAPE 3.0M,30188625,CDM,,,278,RC,inpatient,,2340,2340,,1986.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1764.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1989,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2059.2,88,,percent of total billed charges,,,,,,,,,1787.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2129.4,91,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1942.2,83,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1918.8,82,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1989,85,,percent of total billed charges,,1764.36,2223,
DEPUY HEAD HUMERAL SZ 48 +3,30188626,CDM,,,278,RC,inpatient,,16477.5,16477.5,,13989.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12424.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14005.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14500.2,88,,percent of total billed charges,,,,,,,,,12588.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14994.53,91,,percent of total billed charges,,,15653.63,95,,percent of total billed charges,,,13676.33,83,,percent of total billed charges,,,13676.33,83,,percent of total billed charges,,,,,,,,,,,,,,,13676.33,83,,percent of total billed charges,,,15653.63,95,,percent of total billed charges,,,14829.75,90,,percent of total billed charges,,,14829.75,90,,percent of total billed charges,,,13511.55,82,,percent of total billed charges,,,14829.75,90,,percent of total billed charges,,,14005.88,85,,percent of total billed charges,,12424.04,15653.63,
DEPUY PLATE ANCHOR SZ 48,30188627,CDM,,,278,RC,inpatient,,41340,41340,,35097.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31170.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35139,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36379.2,88,,percent of total billed charges,,,,,,,,,31583.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37619.4,91,,percent of total billed charges,,,39273,95,,percent of total billed charges,,,34312.2,83,,percent of total billed charges,,,34312.2,83,,percent of total billed charges,,,,,,,,,,,,,,,34312.2,83,,percent of total billed charges,,,39273,95,,percent of total billed charges,,,37206,90,,percent of total billed charges,,,37206,90,,percent of total billed charges,,,33898.8,82,,percent of total billed charges,,,37206,90,,percent of total billed charges,,,35139,85,,percent of total billed charges,,31170.36,39273,
DEPUY PLATE SZ 52,30188628,CDM,,,278,RC,inpatient,,41340,41340,,35097.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31170.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35139,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36379.2,88,,percent of total billed charges,,,,,,,,,31583.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37619.4,91,,percent of total billed charges,,,39273,95,,percent of total billed charges,,,34312.2,83,,percent of total billed charges,,,34312.2,83,,percent of total billed charges,,,,,,,,,,,,,,,34312.2,83,,percent of total billed charges,,,39273,95,,percent of total billed charges,,,37206,90,,percent of total billed charges,,,37206,90,,percent of total billed charges,,,33898.8,82,,percent of total billed charges,,,37206,90,,percent of total billed charges,,,35139,85,,percent of total billed charges,,31170.36,39273,
DEPUY HEAD HUMERAL SZ 52 +3,30188629,CDM,,,278,RC,inpatient,,16477.5,16477.5,,13989.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12424.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14005.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14500.2,88,,percent of total billed charges,,,,,,,,,12588.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14994.53,91,,percent of total billed charges,,,15653.63,95,,percent of total billed charges,,,13676.33,83,,percent of total billed charges,,,13676.33,83,,percent of total billed charges,,,,,,,,,,,,,,,13676.33,83,,percent of total billed charges,,,15653.63,95,,percent of total billed charges,,,14829.75,90,,percent of total billed charges,,,14829.75,90,,percent of total billed charges,,,13511.55,82,,percent of total billed charges,,,14829.75,90,,percent of total billed charges,,,14005.88,85,,percent of total billed charges,,12424.04,15653.63,
DEPUY METAGLENE SCREW CTR +4,30188630,CDM,,,278,RC,inpatient,,34170.5,34170.5,,29010.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25764.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29044.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30070.04,88,,percent of total billed charges,,,,,,,,,26106.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31095.16,91,,percent of total billed charges,,,32461.98,95,,percent of total billed charges,,,28361.52,83,,percent of total billed charges,,,28361.52,83,,percent of total billed charges,,,,,,,,,,,,,,,28361.52,83,,percent of total billed charges,,,32461.98,95,,percent of total billed charges,,,30753.45,90,,percent of total billed charges,,,30753.45,90,,percent of total billed charges,,,28019.81,82,,percent of total billed charges,,,30753.45,90,,percent of total billed charges,,,29044.93,85,,percent of total billed charges,,25764.56,32461.98,
CLIPS LIGATING TITANIUM LARGE ORANGE,30188631,CDM,,,270,RC,inpatient,,47.6,47.6,,40.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.89,88,,percent of total billed charges,,,,,,,,,36.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.32,91,,percent of total billed charges,,,45.22,95,,percent of total billed charges,,,39.51,83,,percent of total billed charges,,,39.51,83,,percent of total billed charges,,,,,,,,,,,,,,,39.51,83,,percent of total billed charges,,,45.22,95,,percent of total billed charges,,,42.84,90,,percent of total billed charges,,,42.84,90,,percent of total billed charges,,,39.03,82,,percent of total billed charges,,,42.84,90,,percent of total billed charges,,,40.46,85,,percent of total billed charges,,35.89,45.22,
FORTEC PROBE ULTRASOUND 8848,30188632,CDM,,,270,RC,inpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,980.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1105,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,980.2,1235,
STRYKER STEM ACCOLADE SZ 3 35X131MM,30188633,CDM,,,278,RC,inpatient,,11700,11700,,9933.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8821.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9945,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10296,88,,percent of total billed charges,,,,,,,,,8938.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10647,91,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,,,,,,,,,,,,,9711,83,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9594,82,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9945,85,,percent of total billed charges,,8821.8,11115,
STRYKER SPACER CEMENT 9MM,30188634,CDM,,,278,RC,inpatient,,1001,1001,,849.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,754.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,850.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,880.88,88,,percent of total billed charges,,,,,,,,,764.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,910.91,91,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,,,,,,,,,,,,,830.83,83,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,820.82,82,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,754.75,950.95,
AGILITI LASER PREMIUM STONE TREATEMENT,30188635,CDM,,,270,RC,inpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3675.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4143.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,3675.75,4631.25,
AGILITI FIBER QUANTA OF,30188636,CDM,,,270,RC,inpatient,,3185,3185,,2704.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2401.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2707.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2802.8,88,,percent of total billed charges,,,,,,,,,2433.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2898.35,91,,percent of total billed charges,,,3025.75,95,,percent of total billed charges,,,2643.55,83,,percent of total billed charges,,,2643.55,83,,percent of total billed charges,,,,,,,,,,,,,,,2643.55,83,,percent of total billed charges,,,3025.75,95,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2611.7,82,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2707.25,85,,percent of total billed charges,,2401.49,3025.75,
STRYKER TIBIA TRIATHLON TRITANIUM SZ 3,30188637,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER SCREW PERIPHERAL 4.5 X20MM,30188638,CDM,,,278,RC,inpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,980.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1105,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,980.2,1235,
STRYKER HUMERAL INSERT 32X4MM STD,30188639,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
STRYKER STEM PF HUMERAL 12X96MM,30188640,CDM,,,278,RC,inpatient,,38472.72,38472.72,,32663.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29008.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32701.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33855.99,88,,percent of total billed charges,,,,,,,,,29393.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35010.18,91,,percent of total billed charges,,,36549.08,95,,percent of total billed charges,,,31932.36,83,,percent of total billed charges,,,31932.36,83,,percent of total billed charges,,,,,,,,,,,,,,,31932.36,83,,percent of total billed charges,,,36549.08,95,,percent of total billed charges,,,34625.45,90,,percent of total billed charges,,,34625.45,90,,percent of total billed charges,,,31547.63,82,,percent of total billed charges,,,34625.45,90,,percent of total billed charges,,,32701.81,85,,percent of total billed charges,,29008.43,36549.08,
ZIMMER SCREW NON-LOCK 2.7X24MM,30188641,CDM,,,278,RC,inpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
TORNIER GUIDEWIRE .2 X 220MM,30188642,CDM,,,278,RC,inpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,857.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,966.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,857.68,1080.63,
TORNIER GLENOID GUIDE PSI,30188643,CDM,,,278,RC,inpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5636.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6353.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,5636.15,7101.25,
ULRICH HOOKS,30188644,CDM,,,278,RC,inpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,6126.25,7718.75,
STRYKER TIBIA TRIATHLON TRITANIUM SZ 4,30188645,CDM,,,278,RC,inpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7841.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8840,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,7841.6,9880,
FORTEC HOLMIUM FIBER 272 EXCALIBUR,30188646,CDM,,,270,RC,inpatient,,2372.5,2372.5,,2014.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1788.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2016.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2087.8,88,,percent of total billed charges,,,,,,,,,1812.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2158.98,91,,percent of total billed charges,,,2253.88,95,,percent of total billed charges,,,1969.18,83,,percent of total billed charges,,,1969.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1969.18,83,,percent of total billed charges,,,2253.88,95,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,1945.45,82,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,2016.63,85,,percent of total billed charges,,1788.87,2253.88,
ZIMMER FEMORAL AUGMENT 5MM,30188803,CDM,,,278,RC,inpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7817.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8812.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,7817.1,9849.13,
COOK NEPHROSTOMY TUBE SET 14.0,30188954,CDM,,,270,RC,inpatient,,1112.28,1112.28,,944.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,838.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,945.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,978.81,88,,percent of total billed charges,,,,,,,,,849.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1012.17,91,,percent of total billed charges,,,1056.67,95,,percent of total billed charges,,,923.19,83,,percent of total billed charges,,,923.19,83,,percent of total billed charges,,,,,,,,,,,,,,,923.19,83,,percent of total billed charges,,,1056.67,95,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,912.07,82,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,945.44,85,,percent of total billed charges,,838.66,1056.67,
DEPUY ATTUNE INSERT MS SZ5-6,30188955,CDM,,,278,RC,inpatient,,10005.39,10005.39,,8494.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7544.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8504.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8804.74,88,,percent of total billed charges,,,,,,,,,7644.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9104.9,91,,percent of total billed charges,,,9505.12,95,,percent of total billed charges,,,8304.47,83,,percent of total billed charges,,,8304.47,83,,percent of total billed charges,,,,,,,,,,,,,,,8304.47,83,,percent of total billed charges,,,9505.12,95,,percent of total billed charges,,,9004.85,90,,percent of total billed charges,,,9004.85,90,,percent of total billed charges,,,8204.42,82,,percent of total billed charges,,,9004.85,90,,percent of total billed charges,,,8504.58,85,,percent of total billed charges,,7544.06,9505.12,
DEPUY ATTUNE TIBIA BASE SZ 5,30188956,CDM,,,278,RC,inpatient,,12941.11,12941.11,,10987,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9757.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10999.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11388.18,88,,percent of total billed charges,,,,,,,,,9887.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11776.41,91,,percent of total billed charges,,,12294.05,95,,percent of total billed charges,,,10741.12,83,,percent of total billed charges,,,10741.12,83,,percent of total billed charges,,,,,,,,,,,,,,,10741.12,83,,percent of total billed charges,,,12294.05,95,,percent of total billed charges,,,11647,90,,percent of total billed charges,,,11647,90,,percent of total billed charges,,,10611.71,82,,percent of total billed charges,,,11647,90,,percent of total billed charges,,,10999.94,85,,percent of total billed charges,,9757.6,12294.05,
BAG URINARY DRAIN 4000ML,30190001,CDM,,,270,RC,inpatient,,37.71,37.71,,32.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33.18,88,,percent of total billed charges,,,,,,,,,28.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.32,91,,percent of total billed charges,,,35.82,95,,percent of total billed charges,,,31.3,83,,percent of total billed charges,,,31.3,83,,percent of total billed charges,,,,,,,,,,,,,,,31.3,83,,percent of total billed charges,,,35.82,95,,percent of total billed charges,,,33.94,90,,percent of total billed charges,,,33.94,90,,percent of total billed charges,,,30.92,82,,percent of total billed charges,,,33.94,90,,percent of total billed charges,,,32.05,85,,percent of total billed charges,,28.43,35.82,
RAPID RHINO EPISTAXIS ANTERIOR 4.5,30200009,CDM,,,270,RC,inpatient,,319.28,319.28,,271.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,240.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,271.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,280.97,88,,percent of total billed charges,,,,,,,,,243.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,290.54,91,,percent of total billed charges,,,303.32,95,,percent of total billed charges,,,265,83,,percent of total billed charges,,,265,83,,percent of total billed charges,,,,,,,,,,,,,,,265,83,,percent of total billed charges,,,303.32,95,,percent of total billed charges,,,287.35,90,,percent of total billed charges,,,287.35,90,,percent of total billed charges,,,261.81,82,,percent of total billed charges,,,287.35,90,,percent of total billed charges,,,271.39,85,,percent of total billed charges,,240.74,303.32,
RAPID RHINO EPISTAXIS ANTERIOR 5.5,30200010,CDM,,,270,RC,inpatient,,319.28,319.28,,271.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,240.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,271.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,280.97,88,,percent of total billed charges,,,,,,,,,243.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,290.54,91,,percent of total billed charges,,,303.32,95,,percent of total billed charges,,,265,83,,percent of total billed charges,,,265,83,,percent of total billed charges,,,,,,,,,,,,,,,265,83,,percent of total billed charges,,,303.32,95,,percent of total billed charges,,,287.35,90,,percent of total billed charges,,,287.35,90,,percent of total billed charges,,,261.81,82,,percent of total billed charges,,,287.35,90,,percent of total billed charges,,,271.39,85,,percent of total billed charges,,240.74,303.32,
*RAPID RHINO EPISTAXIS ANTERIOR W/,30200011,CDM,,,270,RC,inpatient,,204,204,,173.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,173.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,179.52,88,,percent of total billed charges,,,,,,,,,155.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,185.64,91,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,,,,,,,,,,,,,169.32,83,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,167.28,82,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,173.4,85,,percent of total billed charges,,153.82,193.8,
*RAPID RHINO 7.5 ANT/POST W/AIRWAY,30200012,CDM,,,270,RC,inpatient,,226.13,226.13,,191.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,170.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198.99,88,,percent of total billed charges,,,,,,,,,172.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,205.78,91,,percent of total billed charges,,,214.82,95,,percent of total billed charges,,,187.69,83,,percent of total billed charges,,,187.69,83,,percent of total billed charges,,,,,,,,,,,,,,,187.69,83,,percent of total billed charges,,,214.82,95,,percent of total billed charges,,,203.52,90,,percent of total billed charges,,,203.52,90,,percent of total billed charges,,,185.43,82,,percent of total billed charges,,,203.52,90,,percent of total billed charges,,,192.21,85,,percent of total billed charges,,170.5,214.82,
*RAPID RHINO PAC,30200013,CDM,,,270,RC,inpatient,,232.5,232.5,,197.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,175.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,197.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,204.6,88,,percent of total billed charges,,,,,,,,,177.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,211.58,91,,percent of total billed charges,,,220.88,95,,percent of total billed charges,,,192.98,83,,percent of total billed charges,,,192.98,83,,percent of total billed charges,,,,,,,,,,,,,,,192.98,83,,percent of total billed charges,,,220.88,95,,percent of total billed charges,,,209.25,90,,percent of total billed charges,,,209.25,90,,percent of total billed charges,,,190.65,82,,percent of total billed charges,,,209.25,90,,percent of total billed charges,,,197.63,85,,percent of total billed charges,,175.31,220.88,
*RAPID RHINO EPISTAXIS ANTERIOR,30200016,CDM,,,270,RC,inpatient,,271.5,271.5,,230.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,204.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,230.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,238.92,88,,percent of total billed charges,,,,,,,,,207.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,247.07,91,,percent of total billed charges,,,257.93,95,,percent of total billed charges,,,225.35,83,,percent of total billed charges,,,225.35,83,,percent of total billed charges,,,,,,,,,,,,,,,225.35,83,,percent of total billed charges,,,257.93,95,,percent of total billed charges,,,244.35,90,,percent of total billed charges,,,244.35,90,,percent of total billed charges,,,222.63,82,,percent of total billed charges,,,244.35,90,,percent of total billed charges,,,230.78,85,,percent of total billed charges,,204.71,257.93,
CO2 DETECTOR,30200020,CDM,,,270,RC,inpatient,,81.16,81.16,,68.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.42,88,,percent of total billed charges,,,,,,,,,62.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.86,91,,percent of total billed charges,,,77.1,95,,percent of total billed charges,,,67.36,83,,percent of total billed charges,,,67.36,83,,percent of total billed charges,,,,,,,,,,,,,,,67.36,83,,percent of total billed charges,,,77.1,95,,percent of total billed charges,,,73.04,90,,percent of total billed charges,,,73.04,90,,percent of total billed charges,,,66.55,82,,percent of total billed charges,,,73.04,90,,percent of total billed charges,,,68.99,85,,percent of total billed charges,,61.19,77.1,
C-COLLAR ADULT ADJUSTABLE,30200024,CDM,,,270,RC,inpatient,,49.13,49.13,,41.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,43.23,88,,percent of total billed charges,,,,,,,,,37.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,44.71,91,,percent of total billed charges,,,46.67,95,,percent of total billed charges,,,40.78,83,,percent of total billed charges,,,40.78,83,,percent of total billed charges,,,,,,,,,,,,,,,40.78,83,,percent of total billed charges,,,46.67,95,,percent of total billed charges,,,44.22,90,,percent of total billed charges,,,44.22,90,,percent of total billed charges,,,40.29,82,,percent of total billed charges,,,44.22,90,,percent of total billed charges,,,41.76,85,,percent of total billed charges,,37.04,46.67,
C-COLLAR PEDS ADJUSTABLE,30200025,CDM,,,270,RC,inpatient,,49.47,49.47,,42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,43.53,88,,percent of total billed charges,,,,,,,,,37.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.02,91,,percent of total billed charges,,,47,95,,percent of total billed charges,,,41.06,83,,percent of total billed charges,,,41.06,83,,percent of total billed charges,,,,,,,,,,,,,,,41.06,83,,percent of total billed charges,,,47,95,,percent of total billed charges,,,44.52,90,,percent of total billed charges,,,44.52,90,,percent of total billed charges,,,40.57,82,,percent of total billed charges,,,44.52,90,,percent of total billed charges,,,42.05,85,,percent of total billed charges,,37.3,47,
SPLINT FINGER METAL WHITE FOAM PAD,30200027,CDM,,,270,RC,inpatient,,26.96,26.96,,22.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23.72,88,,percent of total billed charges,,,,,,,,,20.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.53,91,,percent of total billed charges,,,25.61,95,,percent of total billed charges,,,22.38,83,,percent of total billed charges,,,22.38,83,,percent of total billed charges,,,,,,,,,,,,,,,22.38,83,,percent of total billed charges,,,25.61,95,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,22.11,82,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,22.92,85,,percent of total billed charges,,20.33,25.61,
PRESSURE INFUSION BAG 1000ML DISP.,30200030,CDM,,,270,RC,inpatient,,83.98,83.98,,71.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.9,88,,percent of total billed charges,,,,,,,,,64.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.42,91,,percent of total billed charges,,,79.78,95,,percent of total billed charges,,,69.7,83,,percent of total billed charges,,,69.7,83,,percent of total billed charges,,,,,,,,,,,,,,,69.7,83,,percent of total billed charges,,,79.78,95,,percent of total billed charges,,,75.58,90,,percent of total billed charges,,,75.58,90,,percent of total billed charges,,,68.86,82,,percent of total billed charges,,,75.58,90,,percent of total billed charges,,,71.38,85,,percent of total billed charges,,63.32,79.78,
TRACH 6.5 CUFFED,30200031,CDM,,,270,RC,inpatient,,12.38,12.38,,10.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.89,88,,percent of total billed charges,,,,,,,,,9.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.27,91,,percent of total billed charges,,,11.76,95,,percent of total billed charges,,,10.28,83,,percent of total billed charges,,,10.28,83,,percent of total billed charges,,,,,,,,,,,,,,,10.28,83,,percent of total billed charges,,,11.76,95,,percent of total billed charges,,,11.14,90,,percent of total billed charges,,,11.14,90,,percent of total billed charges,,,10.15,82,,percent of total billed charges,,,11.14,90,,percent of total billed charges,,,10.52,85,,percent of total billed charges,,9.33,11.76,
TRACH 8.5 CUFFED,30200033,CDM,,,270,RC,inpatient,,24.71,24.71,,20.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.74,88,,percent of total billed charges,,,,,,,,,18.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.49,91,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,,,,,,,,,,,,,20.51,83,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,20.26,82,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,21,85,,percent of total billed charges,,18.63,23.47,
SPLINT FINGER #3,30200034,CDM,,,270,RC,inpatient,,27,27,,22.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23.76,88,,percent of total billed charges,,,,,,,,,20.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,,,,,,,,,,,,,22.41,83,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.14,82,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,20.36,25.65,
TRACH 9.0 CUFFED,30200035,CDM,,,270,RC,inpatient,,24.75,24.75,,21.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.78,88,,percent of total billed charges,,,,,,,,,18.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.52,91,,percent of total billed charges,,,23.51,95,,percent of total billed charges,,,20.54,83,,percent of total billed charges,,,20.54,83,,percent of total billed charges,,,,,,,,,,,,,,,20.54,83,,percent of total billed charges,,,23.51,95,,percent of total billed charges,,,22.28,90,,percent of total billed charges,,,22.28,90,,percent of total billed charges,,,20.3,82,,percent of total billed charges,,,22.28,90,,percent of total billed charges,,,21.04,85,,percent of total billed charges,,18.66,23.51,
INFANT PROBE DISPOSABLE,30200039,CDM,,,270,RC,inpatient,,84.41,84.41,,71.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.28,88,,percent of total billed charges,,,,,,,,,64.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.81,91,,percent of total billed charges,,,80.19,95,,percent of total billed charges,,,70.06,83,,percent of total billed charges,,,70.06,83,,percent of total billed charges,,,,,,,,,,,,,,,70.06,83,,percent of total billed charges,,,80.19,95,,percent of total billed charges,,,75.97,90,,percent of total billed charges,,,75.97,90,,percent of total billed charges,,,69.22,82,,percent of total billed charges,,,75.97,90,,percent of total billed charges,,,71.75,85,,percent of total billed charges,,63.65,80.19,
PEDIATRIC PROBE DISPOSABLE,30200040,CDM,,,270,RC,inpatient,,91.22,91.22,,77.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.27,88,,percent of total billed charges,,,,,,,,,69.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,83.01,91,,percent of total billed charges,,,86.66,95,,percent of total billed charges,,,75.71,83,,percent of total billed charges,,,75.71,83,,percent of total billed charges,,,,,,,,,,,,,,,75.71,83,,percent of total billed charges,,,86.66,95,,percent of total billed charges,,,82.1,90,,percent of total billed charges,,,82.1,90,,percent of total billed charges,,,74.8,82,,percent of total billed charges,,,82.1,90,,percent of total billed charges,,,77.54,85,,percent of total billed charges,,68.78,86.66,
COTTON ROLL STERILE,30200041,CDM,,,270,RC,inpatient,,66.98,66.98,,56.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.94,88,,percent of total billed charges,,,,,,,,,51.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.95,91,,percent of total billed charges,,,63.63,95,,percent of total billed charges,,,55.59,83,,percent of total billed charges,,,55.59,83,,percent of total billed charges,,,,,,,,,,,,,,,55.59,83,,percent of total billed charges,,,63.63,95,,percent of total billed charges,,,60.28,90,,percent of total billed charges,,,60.28,90,,percent of total billed charges,,,54.92,82,,percent of total billed charges,,,60.28,90,,percent of total billed charges,,,56.93,85,,percent of total billed charges,,50.5,63.63,
SHOULDER IMMO WOMEN SMALL,30200042,CDM,,,270,RC,inpatient,,61.46,61.46,,52.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.08,88,,percent of total billed charges,,,,,,,,,46.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55.93,91,,percent of total billed charges,,,58.39,95,,percent of total billed charges,,,51.01,83,,percent of total billed charges,,,51.01,83,,percent of total billed charges,,,,,,,,,,,,,,,51.01,83,,percent of total billed charges,,,58.39,95,,percent of total billed charges,,,55.31,90,,percent of total billed charges,,,55.31,90,,percent of total billed charges,,,50.4,82,,percent of total billed charges,,,55.31,90,,percent of total billed charges,,,52.24,85,,percent of total billed charges,,46.34,58.39,
SHOULDER IMMO WOMEN MEDIUM,30200043,CDM,,,270,RC,inpatient,,58.14,58.14,,49.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.16,88,,percent of total billed charges,,,,,,,,,44.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52.91,91,,percent of total billed charges,,,55.23,95,,percent of total billed charges,,,48.26,83,,percent of total billed charges,,,48.26,83,,percent of total billed charges,,,,,,,,,,,,,,,48.26,83,,percent of total billed charges,,,55.23,95,,percent of total billed charges,,,52.33,90,,percent of total billed charges,,,52.33,90,,percent of total billed charges,,,47.67,82,,percent of total billed charges,,,52.33,90,,percent of total billed charges,,,49.42,85,,percent of total billed charges,,43.84,55.23,
SHOULDER IMMO WOMEN X-LGE,30200044,CDM,,,270,RC,inpatient,,61.46,61.46,,52.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.08,88,,percent of total billed charges,,,,,,,,,46.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55.93,91,,percent of total billed charges,,,58.39,95,,percent of total billed charges,,,51.01,83,,percent of total billed charges,,,51.01,83,,percent of total billed charges,,,,,,,,,,,,,,,51.01,83,,percent of total billed charges,,,58.39,95,,percent of total billed charges,,,55.31,90,,percent of total billed charges,,,55.31,90,,percent of total billed charges,,,50.4,82,,percent of total billed charges,,,55.31,90,,percent of total billed charges,,,52.24,85,,percent of total billed charges,,46.34,58.39,
RAPID RHINO EPISTAXIS ANTERIOR 7.5,30200051,CDM,,,270,RC,inpatient,,290.25,290.25,,246.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,218.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,246.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,255.42,88,,percent of total billed charges,,,,,,,,,221.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,264.13,91,,percent of total billed charges,,,275.74,95,,percent of total billed charges,,,240.91,83,,percent of total billed charges,,,240.91,83,,percent of total billed charges,,,,,,,,,,,,,,,240.91,83,,percent of total billed charges,,,275.74,95,,percent of total billed charges,,,261.23,90,,percent of total billed charges,,,261.23,90,,percent of total billed charges,,,238.01,82,,percent of total billed charges,,,261.23,90,,percent of total billed charges,,,246.71,85,,percent of total billed charges,,218.85,275.74,
NEEDLE EZ I/O BARIATRIC,30200052,CDM,,,270,RC,inpatient,,805,805,,683.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,606.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,684.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,708.4,88,,percent of total billed charges,,,,,,,,,615.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,732.55,91,,percent of total billed charges,,,764.75,95,,percent of total billed charges,,,668.15,83,,percent of total billed charges,,,668.15,83,,percent of total billed charges,,,,,,,,,,,,,,,668.15,83,,percent of total billed charges,,,764.75,95,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,660.1,82,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,684.25,85,,percent of total billed charges,,606.97,764.75,
SPLINT FINGER METAL WHITE FOAM PAD 1,30200057,CDM,,,270,RC,inpatient,,7.07,7.07,,6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6.22,88,,percent of total billed charges,,,,,,,,,5.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6.43,91,,percent of total billed charges,,,6.72,95,,percent of total billed charges,,,5.87,83,,percent of total billed charges,,,5.87,83,,percent of total billed charges,,,,,,,,,,,,,,,5.87,83,,percent of total billed charges,,,6.72,95,,percent of total billed charges,,,6.36,90,,percent of total billed charges,,,6.36,90,,percent of total billed charges,,,5.8,82,,percent of total billed charges,,,6.36,90,,percent of total billed charges,,,6.01,85,,percent of total billed charges,,5.33,6.72,
QUICK PRESSURE MONITOR SET,30200059,CDM,,,270,RC,inpatient,,810.83,810.83,,688.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,611.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,689.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,713.53,88,,percent of total billed charges,,,,,,,,,619.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,737.86,91,,percent of total billed charges,,,770.29,95,,percent of total billed charges,,,672.99,83,,percent of total billed charges,,,672.99,83,,percent of total billed charges,,,,,,,,,,,,,,,672.99,83,,percent of total billed charges,,,770.29,95,,percent of total billed charges,,,729.75,90,,percent of total billed charges,,,729.75,90,,percent of total billed charges,,,664.88,82,,percent of total billed charges,,,729.75,90,,percent of total billed charges,,,689.21,85,,percent of total billed charges,,611.37,770.29,
TRACH UNCUFFED SZ 4.0 MURPHY,30200060,CDM,,,270,RC,inpatient,,16.2,16.2,,13.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.26,88,,percent of total billed charges,,,,,,,,,12.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.74,91,,percent of total billed charges,,,15.39,95,,percent of total billed charges,,,13.45,83,,percent of total billed charges,,,13.45,83,,percent of total billed charges,,,,,,,,,,,,,,,13.45,83,,percent of total billed charges,,,15.39,95,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,13.28,82,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,13.77,85,,percent of total billed charges,,12.21,15.39,
C-COLLAR ADULT NO NECK,30200061,CDM,,,270,RC,inpatient,,54.32,54.32,,46.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47.8,88,,percent of total billed charges,,,,,,,,,41.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.43,91,,percent of total billed charges,,,51.6,95,,percent of total billed charges,,,45.09,83,,percent of total billed charges,,,45.09,83,,percent of total billed charges,,,,,,,,,,,,,,,45.09,83,,percent of total billed charges,,,51.6,95,,percent of total billed charges,,,48.89,90,,percent of total billed charges,,,48.89,90,,percent of total billed charges,,,44.54,82,,percent of total billed charges,,,48.89,90,,percent of total billed charges,,,46.17,85,,percent of total billed charges,,40.96,51.6,
EPISTAT NASAL CATHETER,30200062,CDM,,,270,RC,inpatient,,825.5,825.5,,700.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,622.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,701.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,726.44,88,,percent of total billed charges,,,,,,,,,630.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,751.21,91,,percent of total billed charges,,,784.23,95,,percent of total billed charges,,,685.17,83,,percent of total billed charges,,,685.17,83,,percent of total billed charges,,,,,,,,,,,,,,,685.17,83,,percent of total billed charges,,,784.23,95,,percent of total billed charges,,,742.95,90,,percent of total billed charges,,,742.95,90,,percent of total billed charges,,,676.91,82,,percent of total billed charges,,,742.95,90,,percent of total billed charges,,,701.68,85,,percent of total billed charges,,622.43,784.23,
EXTRACTOR FOREIGN BODY NASAL,30200063,CDM,,,270,RC,inpatient,,262.13,262.13,,222.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,222.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,230.67,88,,percent of total billed charges,,,,,,,,,200.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.54,91,,percent of total billed charges,,,249.02,95,,percent of total billed charges,,,217.57,83,,percent of total billed charges,,,217.57,83,,percent of total billed charges,,,,,,,,,,,,,,,217.57,83,,percent of total billed charges,,,249.02,95,,percent of total billed charges,,,235.92,90,,percent of total billed charges,,,235.92,90,,percent of total billed charges,,,214.95,82,,percent of total billed charges,,,235.92,90,,percent of total billed charges,,,222.81,85,,percent of total billed charges,,197.65,249.02,
NASAL INTRANASAL MUCOSAL ATOMIZATION DEV,30200064,CDM,,,270,RC,inpatient,,53.89,53.89,,45.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47.42,88,,percent of total billed charges,,,,,,,,,41.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.04,91,,percent of total billed charges,,,51.2,95,,percent of total billed charges,,,44.73,83,,percent of total billed charges,,,44.73,83,,percent of total billed charges,,,,,,,,,,,,,,,44.73,83,,percent of total billed charges,,,51.2,95,,percent of total billed charges,,,48.5,90,,percent of total billed charges,,,48.5,90,,percent of total billed charges,,,44.19,82,,percent of total billed charges,,,48.5,90,,percent of total billed charges,,,45.81,85,,percent of total billed charges,,40.63,51.2,
C-COLLAR BABY NO NECK,30200065,CDM,,,270,RC,inpatient,,76.5,76.5,,64.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,57.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.32,88,,percent of total billed charges,,,,,,,,,58.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,69.62,91,,percent of total billed charges,,,72.68,95,,percent of total billed charges,,,63.5,83,,percent of total billed charges,,,63.5,83,,percent of total billed charges,,,,,,,,,,,,,,,63.5,83,,percent of total billed charges,,,72.68,95,,percent of total billed charges,,,68.85,90,,percent of total billed charges,,,68.85,90,,percent of total billed charges,,,62.73,82,,percent of total billed charges,,,68.85,90,,percent of total billed charges,,,65.03,85,,percent of total billed charges,,57.68,72.68,
EZ-IO STABILIZER,30200066,CDM,,,270,RC,inpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,108.58,136.8,
AIRWAY NASO 12FR,30200067,CDM,,,270,RC,inpatient,,40.59,40.59,,34.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.72,88,,percent of total billed charges,,,,,,,,,31.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.94,91,,percent of total billed charges,,,38.56,95,,percent of total billed charges,,,33.69,83,,percent of total billed charges,,,33.69,83,,percent of total billed charges,,,,,,,,,,,,,,,33.69,83,,percent of total billed charges,,,38.56,95,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,33.28,82,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,34.5,85,,percent of total billed charges,,30.6,38.56,
AIRWAY NASO 14FR,30200068,CDM,,,270,RC,inpatient,,40.59,40.59,,34.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.72,88,,percent of total billed charges,,,,,,,,,31.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.94,91,,percent of total billed charges,,,38.56,95,,percent of total billed charges,,,33.69,83,,percent of total billed charges,,,33.69,83,,percent of total billed charges,,,,,,,,,,,,,,,33.69,83,,percent of total billed charges,,,38.56,95,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,33.28,82,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,34.5,85,,percent of total billed charges,,30.6,38.56,
AIRWAY NASO 18FR,30200069,CDM,,,270,RC,inpatient,,40.59,40.59,,34.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.72,88,,percent of total billed charges,,,,,,,,,31.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.94,91,,percent of total billed charges,,,38.56,95,,percent of total billed charges,,,33.69,83,,percent of total billed charges,,,33.69,83,,percent of total billed charges,,,,,,,,,,,,,,,33.69,83,,percent of total billed charges,,,38.56,95,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,33.28,82,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,34.5,85,,percent of total billed charges,,30.6,38.56,
TOURNI-COT SIZE XL,30200071,CDM,,,270,RC,inpatient,,24.75,24.75,,21.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.78,88,,percent of total billed charges,,,,,,,,,18.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.52,91,,percent of total billed charges,,,23.51,95,,percent of total billed charges,,,20.54,83,,percent of total billed charges,,,20.54,83,,percent of total billed charges,,,,,,,,,,,,,,,20.54,83,,percent of total billed charges,,,23.51,95,,percent of total billed charges,,,22.28,90,,percent of total billed charges,,,22.28,90,,percent of total billed charges,,,20.3,82,,percent of total billed charges,,,22.28,90,,percent of total billed charges,,,21.04,85,,percent of total billed charges,,18.66,23.51,
TOURNI-COT SIZE SMALL,30200072,CDM,,,270,RC,inpatient,,28.33,28.33,,24.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.93,88,,percent of total billed charges,,,,,,,,,21.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.78,91,,percent of total billed charges,,,26.91,95,,percent of total billed charges,,,23.51,83,,percent of total billed charges,,,23.51,83,,percent of total billed charges,,,,,,,,,,,,,,,23.51,83,,percent of total billed charges,,,26.91,95,,percent of total billed charges,,,25.5,90,,percent of total billed charges,,,25.5,90,,percent of total billed charges,,,23.23,82,,percent of total billed charges,,,25.5,90,,percent of total billed charges,,,24.08,85,,percent of total billed charges,,21.36,26.91,
POPE EAR WICK 24MM,30200073,CDM,,,270,RC,inpatient,,82.45,82.45,,70,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,72.56,88,,percent of total billed charges,,,,,,,,,62.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.03,91,,percent of total billed charges,,,78.33,95,,percent of total billed charges,,,68.43,83,,percent of total billed charges,,,68.43,83,,percent of total billed charges,,,,,,,,,,,,,,,68.43,83,,percent of total billed charges,,,78.33,95,,percent of total billed charges,,,74.21,90,,percent of total billed charges,,,74.21,90,,percent of total billed charges,,,67.61,82,,percent of total billed charges,,,74.21,90,,percent of total billed charges,,,70.08,85,,percent of total billed charges,,62.17,78.33,
EZ-IO NEEDLE & STABILIZER 25MM X15G,30200074,CDM,,,270,RC,inpatient,,887.9,887.9,,753.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,669.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,754.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,781.35,88,,percent of total billed charges,,,,,,,,,678.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,807.99,91,,percent of total billed charges,,,843.51,95,,percent of total billed charges,,,736.96,83,,percent of total billed charges,,,736.96,83,,percent of total billed charges,,,,,,,,,,,,,,,736.96,83,,percent of total billed charges,,,843.51,95,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,728.08,82,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,754.72,85,,percent of total billed charges,,669.48,843.51,
NEEDLE EZ I/O ADULT 15GA 25MM,30210047,CDM,,,270,RC,inpatient,,887.9,887.9,,753.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,669.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,754.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,781.35,88,,percent of total billed charges,,,,,,,,,678.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,807.99,91,,percent of total billed charges,,,843.51,95,,percent of total billed charges,,,736.96,83,,percent of total billed charges,,,736.96,83,,percent of total billed charges,,,,,,,,,,,,,,,736.96,83,,percent of total billed charges,,,843.51,95,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,728.08,82,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,754.72,85,,percent of total billed charges,,669.48,843.51,
NEEDLE EZ I/O PEDIATRIC,30210058,CDM,,,270,RC,inpatient,,887.9,887.9,,753.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,669.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,754.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,781.35,88,,percent of total billed charges,,,,,,,,,678.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,807.99,91,,percent of total billed charges,,,843.51,95,,percent of total billed charges,,,736.96,83,,percent of total billed charges,,,736.96,83,,percent of total billed charges,,,,,,,,,,,,,,,736.96,83,,percent of total billed charges,,,843.51,95,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,728.08,82,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,754.72,85,,percent of total billed charges,,669.48,843.51,
NEEDLE EZ I/O ADULT 15GA 45MM W/STABILIZ,30210059,CDM,,,270,RC,inpatient,,882.7,882.7,,749.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,665.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,750.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,776.78,88,,percent of total billed charges,,,,,,,,,674.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,803.26,91,,percent of total billed charges,,,838.57,95,,percent of total billed charges,,,732.64,83,,percent of total billed charges,,,732.64,83,,percent of total billed charges,,,,,,,,,,,,,,,732.64,83,,percent of total billed charges,,,838.57,95,,percent of total billed charges,,,794.43,90,,percent of total billed charges,,,794.43,90,,percent of total billed charges,,,723.81,82,,percent of total billed charges,,,794.43,90,,percent of total billed charges,,,750.3,85,,percent of total billed charges,,665.56,838.57,
TUBING MICROSTREAM INTUBATED CO2 FILTER,30230011,CDM,,,270,RC,inpatient,,122.16,122.16,,103.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,92.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,103.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,107.5,88,,percent of total billed charges,,,,,,,,,93.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.17,91,,percent of total billed charges,,,116.05,95,,percent of total billed charges,,,101.39,83,,percent of total billed charges,,,101.39,83,,percent of total billed charges,,,,,,,,,,,,,,,101.39,83,,percent of total billed charges,,,116.05,95,,percent of total billed charges,,,109.94,90,,percent of total billed charges,,,109.94,90,,percent of total billed charges,,,100.17,82,,percent of total billed charges,,,109.94,90,,percent of total billed charges,,,103.84,85,,percent of total billed charges,,92.11,116.05,
AMNISURE ROM KIT,30250289,CDM,,,270,RC,inpatient,,371,371,,314.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,279.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,315.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,326.48,88,,percent of total billed charges,,,,,,,,,283.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,337.61,91,,percent of total billed charges,,,352.45,95,,percent of total billed charges,,,307.93,83,,percent of total billed charges,,,307.93,83,,percent of total billed charges,,,,,,,,,,,,,,,307.93,83,,percent of total billed charges,,,352.45,95,,percent of total billed charges,,,333.9,90,,percent of total billed charges,,,333.9,90,,percent of total billed charges,,,304.22,82,,percent of total billed charges,,,333.9,90,,percent of total billed charges,,,315.35,85,,percent of total billed charges,,279.73,352.45,
CONTRAST ISOVUE-300 30ML,30260083,CDM,,,270,RC,inpatient,,43.77,43.77,,37.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.52,88,,percent of total billed charges,,,,,,,,,33.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,39.83,91,,percent of total billed charges,,,41.58,95,,percent of total billed charges,,,36.33,83,,percent of total billed charges,,,36.33,83,,percent of total billed charges,,,,,,,,,,,,,,,36.33,83,,percent of total billed charges,,,41.58,95,,percent of total billed charges,,,39.39,90,,percent of total billed charges,,,39.39,90,,percent of total billed charges,,,35.89,82,,percent of total billed charges,,,39.39,90,,percent of total billed charges,,,37.2,85,,percent of total billed charges,,33,41.58,
*SMART CT PICC BIOFLO 5FR DUAL LUMEN,30260092,CDM,,,270,RC,inpatient,,1510.6,1510.6,,1282.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1138.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1284.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1329.33,88,,percent of total billed charges,,,,,,,,,1154.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1374.65,91,,percent of total billed charges,,,1435.07,95,,percent of total billed charges,,,1253.8,83,,percent of total billed charges,,,1253.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1253.8,83,,percent of total billed charges,,,1435.07,95,,percent of total billed charges,,,1359.54,90,,percent of total billed charges,,,1359.54,90,,percent of total billed charges,,,1238.69,82,,percent of total billed charges,,,1359.54,90,,percent of total billed charges,,,1284.01,85,,percent of total billed charges,,1138.99,1435.07,
GLIDEWIRE ANGLED 150CM,30260093,CDM,,,270,RC,inpatient,,640.5,640.5,,543.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,482.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,544.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,563.64,88,,percent of total billed charges,,,,,,,,,489.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,582.86,91,,percent of total billed charges,,,608.48,95,,percent of total billed charges,,,531.62,83,,percent of total billed charges,,,531.62,83,,percent of total billed charges,,,,,,,,,,,,,,,531.62,83,,percent of total billed charges,,,608.48,95,,percent of total billed charges,,,576.45,90,,percent of total billed charges,,,576.45,90,,percent of total billed charges,,,525.21,82,,percent of total billed charges,,,576.45,90,,percent of total billed charges,,,544.43,85,,percent of total billed charges,,482.94,608.48,
TRAY EPIDURAL PERIFIX SINGLE DOSE,30260094,CDM,,,270,RC,inpatient,,123.98,123.98,,105.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.1,88,,percent of total billed charges,,,,,,,,,94.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.82,91,,percent of total billed charges,,,117.78,95,,percent of total billed charges,,,102.9,83,,percent of total billed charges,,,102.9,83,,percent of total billed charges,,,,,,,,,,,,,,,102.9,83,,percent of total billed charges,,,117.78,95,,percent of total billed charges,,,111.58,90,,percent of total billed charges,,,111.58,90,,percent of total billed charges,,,101.66,82,,percent of total billed charges,,,111.58,90,,percent of total billed charges,,,105.38,85,,percent of total billed charges,,93.48,117.78,
CATH DRAINAGE MULTIPURPOSE 12FR,30260095,CDM,,,270,RC,inpatient,,1393.15,1393.15,,1182.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1050.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1184.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1225.97,88,,percent of total billed charges,,,,,,,,,1064.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1267.77,91,,percent of total billed charges,,,1323.49,95,,percent of total billed charges,,,1156.31,83,,percent of total billed charges,,,1156.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1156.31,83,,percent of total billed charges,,,1323.49,95,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1142.38,82,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1184.18,85,,percent of total billed charges,,1050.44,1323.49,
*AVAMAX 13G NEEDLE PACK,30260099,CDM,,,270,RC,inpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,784.16,988,
COAXIAL BONE BIOPSY NEEDLE 11G X 12CM,30260100,CDM,,,270,RC,inpatient,,856.8,856.8,,727.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,646.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,728.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,753.98,88,,percent of total billed charges,,,,,,,,,654.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,779.69,91,,percent of total billed charges,,,813.96,95,,percent of total billed charges,,,711.14,83,,percent of total billed charges,,,711.14,83,,percent of total billed charges,,,,,,,,,,,,,,,711.14,83,,percent of total billed charges,,,813.96,95,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,702.58,82,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,728.28,85,,percent of total billed charges,,646.03,813.96,
COAXIAL BONE BIOPSY NEEDLE 13G X 12CM,30260104,CDM,,,270,RC,inpatient,,735,735,,624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,554.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,624.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,646.8,88,,percent of total billed charges,,,,,,,,,561.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,,,,,,,,,,,,,610.05,83,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,602.7,82,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,554.19,698.25,
CATHETER ANGIOGRAPHY PERIPHERAL 5FR 70CM,30260110,CDM,,,270,RC,inpatient,,147.68,147.68,,125.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,111.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,125.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.96,88,,percent of total billed charges,,,,,,,,,112.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,134.39,91,,percent of total billed charges,,,140.3,95,,percent of total billed charges,,,122.57,83,,percent of total billed charges,,,122.57,83,,percent of total billed charges,,,,,,,,,,,,,,,122.57,83,,percent of total billed charges,,,140.3,95,,percent of total billed charges,,,132.91,90,,percent of total billed charges,,,132.91,90,,percent of total billed charges,,,121.1,82,,percent of total billed charges,,,132.91,90,,percent of total billed charges,,,125.53,85,,percent of total billed charges,,111.35,140.3,
CATHETER ANGIOGRAPHY 5FR 90CML PIGTAIL,30260111,CDM,,,270,RC,inpatient,,147.68,147.68,,125.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,111.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,125.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.96,88,,percent of total billed charges,,,,,,,,,112.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,134.39,91,,percent of total billed charges,,,140.3,95,,percent of total billed charges,,,122.57,83,,percent of total billed charges,,,122.57,83,,percent of total billed charges,,,,,,,,,,,,,,,122.57,83,,percent of total billed charges,,,140.3,95,,percent of total billed charges,,,132.91,90,,percent of total billed charges,,,132.91,90,,percent of total billed charges,,,121.1,82,,percent of total billed charges,,,132.91,90,,percent of total billed charges,,,125.53,85,,percent of total billed charges,,111.35,140.3,
SET INTRODUCER CATHETER 5FR 13CML SHEATH,30260112,CDM,,,270,RC,inpatient,,274.58,274.58,,233.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,207.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,233.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,241.63,88,,percent of total billed charges,,,,,,,,,209.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,249.87,91,,percent of total billed charges,,,260.85,95,,percent of total billed charges,,,227.9,83,,percent of total billed charges,,,227.9,83,,percent of total billed charges,,,,,,,,,,,,,,,227.9,83,,percent of total billed charges,,,260.85,95,,percent of total billed charges,,,247.12,90,,percent of total billed charges,,,247.12,90,,percent of total billed charges,,,225.16,82,,percent of total billed charges,,,247.12,90,,percent of total billed charges,,,233.39,85,,percent of total billed charges,,207.03,260.85,
DILATOR INTERVENTIONAL CATH 6FR .038MM,30260113,CDM,,,270,RC,inpatient,,61.2,61.2,,51.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,53.86,88,,percent of total billed charges,,,,,,,,,46.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55.69,91,,percent of total billed charges,,,58.14,95,,percent of total billed charges,,,50.8,83,,percent of total billed charges,,,50.8,83,,percent of total billed charges,,,,,,,,,,,,,,,50.8,83,,percent of total billed charges,,,58.14,95,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,50.18,82,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,52.02,85,,percent of total billed charges,,46.14,58.14,
DILATOR INTERVENTIONAL CATH 8FR .035MM,30260114,CDM,,,270,RC,inpatient,,61.2,61.2,,51.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,53.86,88,,percent of total billed charges,,,,,,,,,46.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55.69,91,,percent of total billed charges,,,58.14,95,,percent of total billed charges,,,50.8,83,,percent of total billed charges,,,50.8,83,,percent of total billed charges,,,,,,,,,,,,,,,50.8,83,,percent of total billed charges,,,58.14,95,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,50.18,82,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,52.02,85,,percent of total billed charges,,46.14,58.14,
DILATOR INTERVENTIONAL CATH 10FR .038MM,30260115,CDM,,,270,RC,inpatient,,61.2,61.2,,51.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,53.86,88,,percent of total billed charges,,,,,,,,,46.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55.69,91,,percent of total billed charges,,,58.14,95,,percent of total billed charges,,,50.8,83,,percent of total billed charges,,,50.8,83,,percent of total billed charges,,,,,,,,,,,,,,,50.8,83,,percent of total billed charges,,,58.14,95,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,50.18,82,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,52.02,85,,percent of total billed charges,,46.14,58.14,
GUIDEWIRE VASCULAR FIXED CORE .035IN DIA,30260116,CDM,,,270,RC,inpatient,,119.28,119.28,,101.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,89.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,101.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,104.97,88,,percent of total billed charges,,,,,,,,,91.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,108.54,91,,percent of total billed charges,,,113.32,95,,percent of total billed charges,,,99,83,,percent of total billed charges,,,99,83,,percent of total billed charges,,,,,,,,,,,,,,,99,83,,percent of total billed charges,,,113.32,95,,percent of total billed charges,,,107.35,90,,percent of total billed charges,,,107.35,90,,percent of total billed charges,,,97.81,82,,percent of total billed charges,,,107.35,90,,percent of total billed charges,,,101.39,85,,percent of total billed charges,,89.94,113.32,
GUIDEWIRE VASCULAR FIXED CORE SS .035IN,30260117,CDM,,,270,RC,inpatient,,101.28,101.28,,85.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.13,88,,percent of total billed charges,,,,,,,,,77.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.16,91,,percent of total billed charges,,,96.22,95,,percent of total billed charges,,,84.06,83,,percent of total billed charges,,,84.06,83,,percent of total billed charges,,,,,,,,,,,,,,,84.06,83,,percent of total billed charges,,,96.22,95,,percent of total billed charges,,,91.15,90,,percent of total billed charges,,,91.15,90,,percent of total billed charges,,,83.05,82,,percent of total billed charges,,,91.15,90,,percent of total billed charges,,,86.09,85,,percent of total billed charges,,76.37,96.22,
GUIDEWIRE VASCULAR FIXED CORE .035IN DIA,30260118,CDM,,,270,RC,inpatient,,136.56,136.56,,115.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,102.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,116.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,120.17,88,,percent of total billed charges,,,,,,,,,104.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,124.27,91,,percent of total billed charges,,,129.73,95,,percent of total billed charges,,,113.34,83,,percent of total billed charges,,,113.34,83,,percent of total billed charges,,,,,,,,,,,,,,,113.34,83,,percent of total billed charges,,,129.73,95,,percent of total billed charges,,,122.9,90,,percent of total billed charges,,,122.9,90,,percent of total billed charges,,,111.98,82,,percent of total billed charges,,,122.9,90,,percent of total billed charges,,,116.08,85,,percent of total billed charges,,102.97,129.73,
DENALI JUGULAR FILTER,30260119,CDM,,,270,RC,inpatient,,10887.5,10887.5,,9243.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8209.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9254.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9581,88,,percent of total billed charges,,,,,,,,,8318.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9907.63,91,,percent of total billed charges,,,10343.13,95,,percent of total billed charges,,,9036.63,83,,percent of total billed charges,,,9036.63,83,,percent of total billed charges,,,,,,,,,,,,,,,9036.63,83,,percent of total billed charges,,,10343.13,95,,percent of total billed charges,,,9798.75,90,,percent of total billed charges,,,9798.75,90,,percent of total billed charges,,,8927.75,82,,percent of total billed charges,,,9798.75,90,,percent of total billed charges,,,9254.38,85,,percent of total billed charges,,8209.18,10343.13,
DENALI FEMORAL FILTER,30260120,CDM,,,270,RC,inpatient,,10042.5,10042.5,,8526.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7572.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8536.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8837.4,88,,percent of total billed charges,,,,,,,,,7672.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9138.68,91,,percent of total billed charges,,,9540.38,95,,percent of total billed charges,,,8335.28,83,,percent of total billed charges,,,8335.28,83,,percent of total billed charges,,,,,,,,,,,,,,,8335.28,83,,percent of total billed charges,,,9540.38,95,,percent of total billed charges,,,9038.25,90,,percent of total billed charges,,,9038.25,90,,percent of total billed charges,,,8234.85,82,,percent of total billed charges,,,9038.25,90,,percent of total billed charges,,,8536.13,85,,percent of total billed charges,,7572.05,9540.38,
MACROBORE EXT SET 30  W/OL NON-DEHP,30260122,CDM,,,270,RC,inpatient,,7.97,7.97,,6.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.01,88,,percent of total billed charges,,,,,,,,,6.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.25,91,,percent of total billed charges,,,7.57,95,,percent of total billed charges,,,6.62,83,,percent of total billed charges,,,6.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6.62,83,,percent of total billed charges,,,7.57,95,,percent of total billed charges,,,7.17,90,,percent of total billed charges,,,7.17,90,,percent of total billed charges,,,6.54,82,,percent of total billed charges,,,7.17,90,,percent of total billed charges,,,6.77,85,,percent of total billed charges,,6.01,7.57,
CENTEZE CENTESIS CATH 5FR 10CM 19GA 12CM,30260125,CDM,,,270,RC,inpatient,,128,128,,108.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,96.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,108.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,112.64,88,,percent of total billed charges,,,,,,,,,97.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,116.48,91,,percent of total billed charges,,,121.6,95,,percent of total billed charges,,,106.24,83,,percent of total billed charges,,,106.24,83,,percent of total billed charges,,,,,,,,,,,,,,,106.24,83,,percent of total billed charges,,,121.6,95,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,104.96,82,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,108.8,85,,percent of total billed charges,,96.51,121.6,
PICC BIOFLOW POWER INJECTABLE MST KIT W/,30260129,CDM,,,270,RC,inpatient,,1007.5,1007.5,,855.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,759.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,856.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,886.6,88,,percent of total billed charges,,,,,,,,,769.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,916.83,91,,percent of total billed charges,,,957.13,95,,percent of total billed charges,,,836.23,83,,percent of total billed charges,,,836.23,83,,percent of total billed charges,,,,,,,,,,,,,,,836.23,83,,percent of total billed charges,,,957.13,95,,percent of total billed charges,,,906.75,90,,percent of total billed charges,,,906.75,90,,percent of total billed charges,,,826.15,82,,percent of total billed charges,,,906.75,90,,percent of total billed charges,,,856.38,85,,percent of total billed charges,,759.66,957.13,
MEMBRANE KIT,30260131,CDM,,,270,RC,inpatient,,176.67,176.67,,149.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,133.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,150.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,155.47,88,,percent of total billed charges,,,,,,,,,134.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.77,91,,percent of total billed charges,,,167.84,95,,percent of total billed charges,,,146.64,83,,percent of total billed charges,,,146.64,83,,percent of total billed charges,,,,,,,,,,,,,,,146.64,83,,percent of total billed charges,,,167.84,95,,percent of total billed charges,,,159,90,,percent of total billed charges,,,159,90,,percent of total billed charges,,,144.87,82,,percent of total billed charges,,,159,90,,percent of total billed charges,,,150.17,85,,percent of total billed charges,,133.21,167.84,
DILATOR VASCULAR 8FR,30260142,CDM,,,270,RC,inpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,53.39,67.27,
VASCULAR FIXED CORE TSCF-35-145-3,30260143,CDM,,,270,RC,inpatient,,92.96,92.96,,78.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.8,88,,percent of total billed charges,,,,,,,,,71.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.59,91,,percent of total billed charges,,,88.31,95,,percent of total billed charges,,,77.16,83,,percent of total billed charges,,,77.16,83,,percent of total billed charges,,,,,,,,,,,,,,,77.16,83,,percent of total billed charges,,,88.31,95,,percent of total billed charges,,,83.66,90,,percent of total billed charges,,,83.66,90,,percent of total billed charges,,,76.23,82,,percent of total billed charges,,,83.66,90,,percent of total billed charges,,,79.02,85,,percent of total billed charges,,70.09,88.31,
NANOCROSS BALLOON 2.5 -2.0 X 210MM,30260144,CDM,,,270,RC,inpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1458.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1643.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,1458.05,1837.06,
NANOCROSS BALLOON 5.0 X 200MM,30260145,CDM,,,270,RC,inpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1458.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1643.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,1458.05,1837.06,
STENT PROTEGE 5 X 120MM,30260146,CDM,,,278,RC,inpatient,,10531.5,10531.5,,8941.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7940.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8951.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9267.72,88,,percent of total billed charges,,,,,,,,,8046.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9583.67,91,,percent of total billed charges,,,10004.93,95,,percent of total billed charges,,,8741.15,83,,percent of total billed charges,,,8741.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8741.15,83,,percent of total billed charges,,,10004.93,95,,percent of total billed charges,,,9478.35,90,,percent of total billed charges,,,9478.35,90,,percent of total billed charges,,,8635.83,82,,percent of total billed charges,,,9478.35,90,,percent of total billed charges,,,8951.78,85,,percent of total billed charges,,7940.75,10004.93,
EVERCROSS BALLOON 12MM X 40MM,30260147,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
EVERCROSS BALLOON 10MM X 40MM,30260148,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
TRAILBLAZER CATH 0.014 X 150CM,30260149,CDM,,,270,RC,inpatient,,1040.55,1040.55,,883.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.68,88,,percent of total billed charges,,,,,,,,,794.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.9,91,,percent of total billed charges,,,988.52,95,,percent of total billed charges,,,863.66,83,,percent of total billed charges,,,863.66,83,,percent of total billed charges,,,,,,,,,,,,,,,863.66,83,,percent of total billed charges,,,988.52,95,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,853.25,82,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,884.47,85,,percent of total billed charges,,784.57,988.52,
NANOCROSS BALLOON 2.0 -1.50 X 210MM,30260150,CDM,,,270,RC,inpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1458.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1643.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,1458.05,1837.06,
NANOCROSS BALLOON 5.0 X 100MM,30260151,CDM,,,270,RC,inpatient,,1740.38,1740.38,,1477.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1312.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1479.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1531.53,88,,percent of total billed charges,,,,,,,,,1329.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1583.75,91,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.52,83,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1427.11,82,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,1312.25,1653.36,
GUIDEWIRE FIXED CORE .035IN 145CM SAFET-,30260154,CDM,,,270,RC,inpatient,,90.64,90.64,,76.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.76,88,,percent of total billed charges,,,,,,,,,69.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.48,91,,percent of total billed charges,,,86.11,95,,percent of total billed charges,,,75.23,83,,percent of total billed charges,,,75.23,83,,percent of total billed charges,,,,,,,,,,,,,,,75.23,83,,percent of total billed charges,,,86.11,95,,percent of total billed charges,,,81.58,90,,percent of total billed charges,,,81.58,90,,percent of total billed charges,,,74.32,82,,percent of total billed charges,,,81.58,90,,percent of total billed charges,,,77.04,85,,percent of total billed charges,,68.34,86.11,
BARD PICC SOLO CATHETER KIT 5F,30260155,CDM,,,270,RC,inpatient,,839.8,839.8,,712.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,633.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,713.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,739.02,88,,percent of total billed charges,,,,,,,,,641.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,764.22,91,,percent of total billed charges,,,797.81,95,,percent of total billed charges,,,697.03,83,,percent of total billed charges,,,697.03,83,,percent of total billed charges,,,,,,,,,,,,,,,697.03,83,,percent of total billed charges,,,797.81,95,,percent of total billed charges,,,755.82,90,,percent of total billed charges,,,755.82,90,,percent of total billed charges,,,688.64,82,,percent of total billed charges,,,755.82,90,,percent of total billed charges,,,713.83,85,,percent of total billed charges,,633.21,797.81,
BARD PICC DUAL-LUMEN CATHETER KIT 5F,30260156,CDM,,,270,RC,inpatient,,865.15,865.15,,734.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,652.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,735.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,761.33,88,,percent of total billed charges,,,,,,,,,660.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,787.29,91,,percent of total billed charges,,,821.89,95,,percent of total billed charges,,,718.07,83,,percent of total billed charges,,,718.07,83,,percent of total billed charges,,,,,,,,,,,,,,,718.07,83,,percent of total billed charges,,,821.89,95,,percent of total billed charges,,,778.64,90,,percent of total billed charges,,,778.64,90,,percent of total billed charges,,,709.42,82,,percent of total billed charges,,,778.64,90,,percent of total billed charges,,,735.38,85,,percent of total billed charges,,652.32,821.89,
SHEATH FLEXOR ANSEL GUIDING 9F 45CM,30260160,CDM,,,270,RC,inpatient,,454.23,454.23,,385.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,342.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,386.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,399.72,88,,percent of total billed charges,,,,,,,,,347.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,413.35,91,,percent of total billed charges,,,431.52,95,,percent of total billed charges,,,377.01,83,,percent of total billed charges,,,377.01,83,,percent of total billed charges,,,,,,,,,,,,,,,377.01,83,,percent of total billed charges,,,431.52,95,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,372.47,82,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,386.1,85,,percent of total billed charges,,342.49,431.52,
TRAILBLAZER CATH 0.014 X 135CM,30260162,CDM,,,270,RC,inpatient,,1040.55,1040.55,,883.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.68,88,,percent of total billed charges,,,,,,,,,794.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.9,91,,percent of total billed charges,,,988.52,95,,percent of total billed charges,,,863.66,83,,percent of total billed charges,,,863.66,83,,percent of total billed charges,,,,,,,,,,,,,,,863.66,83,,percent of total billed charges,,,988.52,95,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,853.25,82,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,884.47,85,,percent of total billed charges,,784.57,988.52,
TRAILBLAZER CATH 0.014 X 90CM,30260163,CDM,,,270,RC,inpatient,,1040.55,1040.55,,883.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.68,88,,percent of total billed charges,,,,,,,,,794.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.9,91,,percent of total billed charges,,,988.52,95,,percent of total billed charges,,,863.66,83,,percent of total billed charges,,,863.66,83,,percent of total billed charges,,,,,,,,,,,,,,,863.66,83,,percent of total billed charges,,,988.52,95,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,853.25,82,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,884.47,85,,percent of total billed charges,,784.57,988.52,
TRAILBLAZER CATH 0.035 X 135CM,30260164,CDM,,,270,RC,inpatient,,1040.55,1040.55,,883.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.68,88,,percent of total billed charges,,,,,,,,,794.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.9,91,,percent of total billed charges,,,988.52,95,,percent of total billed charges,,,863.66,83,,percent of total billed charges,,,863.66,83,,percent of total billed charges,,,,,,,,,,,,,,,863.66,83,,percent of total billed charges,,,988.52,95,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,853.25,82,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,884.47,85,,percent of total billed charges,,784.57,988.52,
TRAILBLAZER CATH ANGLED 0.014 X 150CM,30260165,CDM,,,270,RC,inpatient,,1359.09,1359.09,,1153.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1024.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1155.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1196,88,,percent of total billed charges,,,,,,,,,1038.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1236.77,91,,percent of total billed charges,,,1291.14,95,,percent of total billed charges,,,1128.04,83,,percent of total billed charges,,,1128.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1128.04,83,,percent of total billed charges,,,1291.14,95,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1114.45,82,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1155.23,85,,percent of total billed charges,,1024.75,1291.14,
TRAILBLAZER CATH ANGLED 0.014 X 90CM,30260166,CDM,,,270,RC,inpatient,,1359.09,1359.09,,1153.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1024.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1155.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1196,88,,percent of total billed charges,,,,,,,,,1038.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1236.77,91,,percent of total billed charges,,,1291.14,95,,percent of total billed charges,,,1128.04,83,,percent of total billed charges,,,1128.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1128.04,83,,percent of total billed charges,,,1291.14,95,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1114.45,82,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1155.23,85,,percent of total billed charges,,1024.75,1291.14,
TRAILBLAZER CATH ANGLED 0.035 X 90CM,30260167,CDM,,,270,RC,inpatient,,1359.09,1359.09,,1153.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1024.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1155.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1196,88,,percent of total billed charges,,,,,,,,,1038.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1236.77,91,,percent of total billed charges,,,1291.14,95,,percent of total billed charges,,,1128.04,83,,percent of total billed charges,,,1128.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1128.04,83,,percent of total billed charges,,,1291.14,95,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1114.45,82,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1155.23,85,,percent of total billed charges,,1024.75,1291.14,
TRAILBLAZER CATH ANGLED 0.035 X 135CM,30260168,CDM,,,270,RC,inpatient,,1359.09,1359.09,,1153.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1024.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1155.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1196,88,,percent of total billed charges,,,,,,,,,1038.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1236.77,91,,percent of total billed charges,,,1291.14,95,,percent of total billed charges,,,1128.04,83,,percent of total billed charges,,,1128.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1128.04,83,,percent of total billed charges,,,1291.14,95,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1114.45,82,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1155.23,85,,percent of total billed charges,,1024.75,1291.14,
CHOCOLATE BALLOON PTA 5.0 X 40MM,30260169,CDM,,,270,RC,inpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3896.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4392.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,3896.3,4909.13,
NANOCROSS BALLOON 2.0 X 80MM,30260170,CDM,,,270,RC,inpatient,,1740.38,1740.38,,1477.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1312.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1479.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1531.53,88,,percent of total billed charges,,,,,,,,,1329.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1583.75,91,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.52,83,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1427.11,82,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,1312.25,1653.36,
NANOCROSS BALLOON 2.5 X 40MM,30260171,CDM,,,270,RC,inpatient,,1740.38,1740.38,,1477.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1312.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1479.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1531.53,88,,percent of total billed charges,,,,,,,,,1329.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1583.75,91,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.52,83,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1427.11,82,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,1312.25,1653.36,
MEDTRONIC SILVERHAWK,30260172,CDM,,,270,RC,inpatient,,19144.13,19144.13,,16253.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14434.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16272.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16846.83,88,,percent of total billed charges,,,,,,,,,14626.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17421.16,91,,percent of total billed charges,,,18186.92,95,,percent of total billed charges,,,15889.63,83,,percent of total billed charges,,,15889.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15889.63,83,,percent of total billed charges,,,18186.92,95,,percent of total billed charges,,,17229.72,90,,percent of total billed charges,,,17229.72,90,,percent of total billed charges,,,15698.19,82,,percent of total billed charges,,,17229.72,90,,percent of total billed charges,,,16272.51,85,,percent of total billed charges,,14434.67,18186.92,
MEDTRONIC VENASEAL CLOSURE SYSTEM,30260173,CDM,,,270,RC,inpatient,,14228.5,14228.5,,12080,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10728.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12094.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12521.08,88,,percent of total billed charges,,,,,,,,,10870.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12947.94,91,,percent of total billed charges,,,13517.08,95,,percent of total billed charges,,,11809.66,83,,percent of total billed charges,,,11809.66,83,,percent of total billed charges,,,,,,,,,,,,,,,11809.66,83,,percent of total billed charges,,,13517.08,95,,percent of total billed charges,,,12805.65,90,,percent of total billed charges,,,12805.65,90,,percent of total billed charges,,,11667.37,82,,percent of total billed charges,,,12805.65,90,,percent of total billed charges,,,12094.23,85,,percent of total billed charges,,10728.29,13517.08,
NANOCROSS BALLOON 5.0 X 80MM,30260174,CDM,,,270,RC,inpatient,,1740.38,1740.38,,1477.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1312.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1479.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1531.53,88,,percent of total billed charges,,,,,,,,,1329.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1583.75,91,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.52,83,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1427.11,82,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,1312.25,1653.36,
NANOCROSS BALLOON 4.0 X 40MM,30260175,CDM,,,270,RC,inpatient,,1740.38,1740.38,,1477.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1312.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1479.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1531.53,88,,percent of total billed charges,,,,,,,,,1329.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1583.75,91,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.52,83,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1427.11,82,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,1312.25,1653.36,
IMPACT ADMIRAL BALLOON 5X200X130CM,30260176,CDM,,,270,RC,inpatient,,14592.5,14592.5,,12389.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11002.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12403.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12841.4,88,,percent of total billed charges,,,,,,,,,11148.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13279.18,91,,percent of total billed charges,,,13862.88,95,,percent of total billed charges,,,12111.78,83,,percent of total billed charges,,,12111.78,83,,percent of total billed charges,,,,,,,,,,,,,,,12111.78,83,,percent of total billed charges,,,13862.88,95,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,11965.85,82,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,12403.63,85,,percent of total billed charges,,11002.75,13862.88,
EVERFLEX PROTEGE 6X150,30260177,CDM,,,270,RC,inpatient,,11162.13,11162.13,,9476.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8416.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9487.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9822.67,88,,percent of total billed charges,,,,,,,,,8527.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10157.54,91,,percent of total billed charges,,,10604.02,95,,percent of total billed charges,,,9264.57,83,,percent of total billed charges,,,9264.57,83,,percent of total billed charges,,,,,,,,,,,,,,,9264.57,83,,percent of total billed charges,,,10604.02,95,,percent of total billed charges,,,10045.92,90,,percent of total billed charges,,,10045.92,90,,percent of total billed charges,,,9152.95,82,,percent of total billed charges,,,10045.92,90,,percent of total billed charges,,,9487.81,85,,percent of total billed charges,,8416.25,10604.02,
EVERCROSS BALLOON 4 X 100MM,30260183,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
EVERCROSS BALLOON 4 X 40MM,30260184,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
EVERFLEX PROTEGE 6X200,30260185,CDM,,,270,RC,inpatient,,20621.58,20621.58,,17507.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15548.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17528.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18146.99,88,,percent of total billed charges,,,,,,,,,15754.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18765.64,91,,percent of total billed charges,,,19590.5,95,,percent of total billed charges,,,17115.91,83,,percent of total billed charges,,,17115.91,83,,percent of total billed charges,,,,,,,,,,,,,,,17115.91,83,,percent of total billed charges,,,19590.5,95,,percent of total billed charges,,,18559.42,90,,percent of total billed charges,,,18559.42,90,,percent of total billed charges,,,16909.7,82,,percent of total billed charges,,,18559.42,90,,percent of total billed charges,,,17528.34,85,,percent of total billed charges,,15548.67,19590.5,
EVERCROSS BALLOON 6 X 150MM,30260186,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
EVERFLEX PROTEGE 6X80,30260187,CDM,,,270,RC,inpatient,,8639.61,8639.61,,7335.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6514.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7343.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7602.86,88,,percent of total billed charges,,,,,,,,,6600.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7862.05,91,,percent of total billed charges,,,8207.63,95,,percent of total billed charges,,,7170.88,83,,percent of total billed charges,,,7170.88,83,,percent of total billed charges,,,,,,,,,,,,,,,7170.88,83,,percent of total billed charges,,,8207.63,95,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7084.48,82,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7343.67,85,,percent of total billed charges,,6514.27,8207.63,
CATH DRAINAGE 8.5FR (NC),30260188,CDM,,,270,RC,inpatient,,1393.15,1393.15,,1182.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1050.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1184.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1225.97,88,,percent of total billed charges,,,,,,,,,1064.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1267.77,91,,percent of total billed charges,,,1323.49,95,,percent of total billed charges,,,1156.31,83,,percent of total billed charges,,,1156.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1156.31,83,,percent of total billed charges,,,1323.49,95,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1142.38,82,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1184.18,85,,percent of total billed charges,,1050.44,1323.49,
DILATOR INTERVENTIONAL CATH 9FR 20CM,30260189,CDM,,,270,RC,inpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,53.39,67.27,
DILATOR INTERVENTIONAL CATH 6FR 20CM,30260190,CDM,,,270,RC,inpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,53.39,67.27,
DILATOR INTERVENTIONAL CATH 7FR 20CM,30260191,CDM,,,270,RC,inpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,53.39,67.27,
DILATOR INTERVENTIONAL CATH 11FR 20CM,30260192,CDM,,,270,RC,inpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,53.39,67.27,
DILATOR INTERVENTIONAL CATH 12FR 20CM,30260193,CDM,,,270,RC,inpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,53.39,67.27,
DILATOR INTERVENTIONAL CATH 14FR 20CM,30260194,CDM,,,270,RC,inpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,53.39,67.27,
DILATOR INTERVENTIONAL CATH 16FR 20CM,30260195,CDM,,,270,RC,inpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,53.39,67.27,
GLIDEWIRE ANGLED STIFF SHAFT 150CM,30260199,CDM,,,270,RC,inpatient,,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,269.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,303.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,269.18,339.15,
FEEDING DEVICE G-JET 18F X 30CM,30260200,CDM,,,270,RC,inpatient,,1943.5,1943.5,,1650.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1465.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1651.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1710.28,88,,percent of total billed charges,,,,,,,,,1484.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1768.59,91,,percent of total billed charges,,,1846.33,95,,percent of total billed charges,,,1613.11,83,,percent of total billed charges,,,1613.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1613.11,83,,percent of total billed charges,,,1846.33,95,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1593.67,82,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1651.98,85,,percent of total billed charges,,1465.4,1846.33,
LAPAROSCOPIC INTRODUCER KIT 22FR DILATOR,30260201,CDM,,,270,RC,inpatient,,1513.4,1513.4,,1284.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1141.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1286.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1331.79,88,,percent of total billed charges,,,,,,,,,1156.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1377.19,91,,percent of total billed charges,,,1437.73,95,,percent of total billed charges,,,1256.12,83,,percent of total billed charges,,,1256.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1256.12,83,,percent of total billed charges,,,1437.73,95,,percent of total billed charges,,,1362.06,90,,percent of total billed charges,,,1362.06,90,,percent of total billed charges,,,1240.99,82,,percent of total billed charges,,,1362.06,90,,percent of total billed charges,,,1286.39,85,,percent of total billed charges,,1141.1,1437.73,
PLEURX PLEURAL CATH & STARTER KIT,30260203,CDM,,,270,RC,inpatient,,11760.78,11760.78,,9984.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8867.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9996.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10349.49,88,,percent of total billed charges,,,,,,,,,8985.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10702.31,91,,percent of total billed charges,,,11172.74,95,,percent of total billed charges,,,9761.45,83,,percent of total billed charges,,,9761.45,83,,percent of total billed charges,,,,,,,,,,,,,,,9761.45,83,,percent of total billed charges,,,11172.74,95,,percent of total billed charges,,,10584.7,90,,percent of total billed charges,,,10584.7,90,,percent of total billed charges,,,9643.84,82,,percent of total billed charges,,,10584.7,90,,percent of total billed charges,,,9996.66,85,,percent of total billed charges,,8867.63,11172.74,
EVERCROSS BALLOON 8MM X 40MM,30260208,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
EVERCROSS BALLOON 10MM X 60MM,30260209,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
COOK DRAIN CATH MULTI-PURPOSE 10.2FR,30260210,CDM,,,270,RC,inpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,545.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,614.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,545.11,686.81,
CHOCOLATE BALLOON PTA 2.5 X 40MM,30260212,CDM,,,270,RC,inpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3896.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4392.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,3896.3,4909.13,
VISIPRO STENT 10 X 27MM,30260213,CDM,,,270,RC,inpatient,,8008.98,8008.98,,6799.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6038.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6807.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7047.9,88,,percent of total billed charges,,,,,,,,,6118.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7288.17,91,,percent of total billed charges,,,7608.53,95,,percent of total billed charges,,,6647.45,83,,percent of total billed charges,,,6647.45,83,,percent of total billed charges,,,,,,,,,,,,,,,6647.45,83,,percent of total billed charges,,,7608.53,95,,percent of total billed charges,,,7208.08,90,,percent of total billed charges,,,7208.08,90,,percent of total billed charges,,,6567.36,82,,percent of total billed charges,,,7208.08,90,,percent of total billed charges,,,6807.63,85,,percent of total billed charges,,6038.77,7608.53,
CHOCOLATE BALLOON PTA 3.0 X 120MM,30260214,CDM,,,270,RC,inpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3896.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4392.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,3896.3,4909.13,
CHOCOLATE BALLOON PTA 6.0 X 80MM,30260215,CDM,,,270,RC,inpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3896.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4392.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,3896.3,4909.13,
CHOCOLATE BALLOON PTA 3.0 X 40MM,30260216,CDM,,,270,RC,inpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3896.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4392.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,3896.3,4909.13,
CHOCOLATE BALLOON PTA 3.0 X 80MM,30260217,CDM,,,270,RC,inpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3896.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4392.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,3896.3,4909.13,
IMPACT ADMIRAL BALLOON 4X80X130CM,30260218,CDM,,,270,RC,inpatient,,14592.5,14592.5,,12389.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11002.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12403.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12841.4,88,,percent of total billed charges,,,,,,,,,11148.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13279.18,91,,percent of total billed charges,,,13862.88,95,,percent of total billed charges,,,12111.78,83,,percent of total billed charges,,,12111.78,83,,percent of total billed charges,,,,,,,,,,,,,,,12111.78,83,,percent of total billed charges,,,13862.88,95,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,11965.85,82,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,12403.63,85,,percent of total billed charges,,11002.75,13862.88,
CHOCOLATE BALLOON PTA 4.0 X 80MM,30260219,CDM,,,270,RC,inpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3896.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4392.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,3896.3,4909.13,
CHOCOLATE BALLOON PTA 4.0 X 120MM,30260220,CDM,,,270,RC,inpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3896.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4392.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,3896.3,4909.13,
CHOCOLATE BALLOON PTA 3.5 X 40MM,30260221,CDM,,,270,RC,inpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3896.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4392.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,3896.3,4909.13,
NANOCROSS BALLOON 3.0 X 80MM,30260222,CDM,,,270,RC,inpatient,,1740.38,1740.38,,1477.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1312.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1479.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1531.53,88,,percent of total billed charges,,,,,,,,,1329.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1583.75,91,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.52,83,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1427.11,82,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,1312.25,1653.36,
SPIDER DISTAL PROTECTION DEVICE 7.0MM,30260223,CDM,,,270,RC,inpatient,,10090.08,10090.08,,8566.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7607.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8576.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8879.27,88,,percent of total billed charges,,,,,,,,,7708.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9181.97,91,,percent of total billed charges,,,9585.58,95,,percent of total billed charges,,,8374.77,83,,percent of total billed charges,,,8374.77,83,,percent of total billed charges,,,,,,,,,,,,,,,8374.77,83,,percent of total billed charges,,,9585.58,95,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,8273.87,82,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,8576.57,85,,percent of total billed charges,,7607.92,9585.58,
CATH PHILIPS ASPIRATION 6F X 130CM STRAI,30260225,CDM,,,270,RC,inpatient,,10075,10075,,8553.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7596.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8563.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8866,88,,percent of total billed charges,,,,,,,,,7697.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9168.25,91,,percent of total billed charges,,,9571.25,95,,percent of total billed charges,,,8362.25,83,,percent of total billed charges,,,8362.25,83,,percent of total billed charges,,,,,,,,,,,,,,,8362.25,83,,percent of total billed charges,,,9571.25,95,,percent of total billed charges,,,9067.5,90,,percent of total billed charges,,,9067.5,90,,percent of total billed charges,,,8261.5,82,,percent of total billed charges,,,9067.5,90,,percent of total billed charges,,,8563.75,85,,percent of total billed charges,,7596.55,9571.25,
MEDTRONIC ABRE VENOUS STENT SYSTEM 16X12,30260226,CDM,,,270,RC,inpatient,,13650,13650,,11588.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10292.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11602.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12012,88,,percent of total billed charges,,,,,,,,,10428.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12421.5,91,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,,,,,,,,,,,,,11329.5,83,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11193,82,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,10292.1,12967.5,
EVERFLEX PROTEGE 8 X 40,30260227,CDM,,,270,RC,inpatient,,8639.61,8639.61,,7335.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6514.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7343.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7602.86,88,,percent of total billed charges,,,,,,,,,6600.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7862.05,91,,percent of total billed charges,,,8207.63,95,,percent of total billed charges,,,7170.88,83,,percent of total billed charges,,,7170.88,83,,percent of total billed charges,,,,,,,,,,,,,,,7170.88,83,,percent of total billed charges,,,8207.63,95,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7084.48,82,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7343.67,85,,percent of total billed charges,,6514.27,8207.63,
SHOCKWAVE CATH M5+ IVL 5.5X60X135,30260228,CDM,,,278,RC,inpatient,,22425,22425,,19038.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16908.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19061.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19734,88,,percent of total billed charges,,,,,,,,,17132.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20406.75,91,,percent of total billed charges,,,21303.75,95,,percent of total billed charges,,,18612.75,83,,percent of total billed charges,,,18612.75,83,,percent of total billed charges,,,,,,,,,,,,,,,18612.75,83,,percent of total billed charges,,,21303.75,95,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,18388.5,82,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,19061.25,85,,percent of total billed charges,,16908.45,21303.75,
NANOCROSS BALLOON 4.0 X 150MM,30260229,CDM,,,270,RC,inpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1458.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1643.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,1458.05,1837.06,
IMPACT ADMIRAL BALLOON 4X120X130,30260230,CDM,,,270,RC,inpatient,,19467.5,19467.5,,16527.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14678.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16547.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17131.4,88,,percent of total billed charges,,,,,,,,,14873.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17715.43,91,,percent of total billed charges,,,18494.13,95,,percent of total billed charges,,,16158.03,83,,percent of total billed charges,,,16158.03,83,,percent of total billed charges,,,,,,,,,,,,,,,16158.03,83,,percent of total billed charges,,,18494.13,95,,percent of total billed charges,,,17520.75,90,,percent of total billed charges,,,17520.75,90,,percent of total billed charges,,,15963.35,82,,percent of total billed charges,,,17520.75,90,,percent of total billed charges,,,16547.38,85,,percent of total billed charges,,14678.5,18494.13,
NANOCROSS BALLOON 2.5 X 150MM,30260231,CDM,,,270,RC,inpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1458.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1643.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,1458.05,1837.06,
NANOCROSS BALLOON 3.0-2.5 X 210MM,30260232,CDM,,,270,RC,inpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1458.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1643.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,1458.05,1837.06,
GLIDEWIRE STRAIGHT 150CM,30260233,CDM,,,270,RC,inpatient,,424.97,424.97,,360.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,320.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,361.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,373.97,88,,percent of total billed charges,,,,,,,,,324.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,386.72,91,,percent of total billed charges,,,403.72,95,,percent of total billed charges,,,352.73,83,,percent of total billed charges,,,352.73,83,,percent of total billed charges,,,,,,,,,,,,,,,352.73,83,,percent of total billed charges,,,403.72,95,,percent of total billed charges,,,382.47,90,,percent of total billed charges,,,382.47,90,,percent of total billed charges,,,348.48,82,,percent of total billed charges,,,382.47,90,,percent of total billed charges,,,361.22,85,,percent of total billed charges,,320.43,403.72,
UNIFUSE CATHETER  5F 135X50CM,30260234,CDM,,,270,RC,inpatient,,1995.5,1995.5,,1694.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1504.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1696.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1756.04,88,,percent of total billed charges,,,,,,,,,1524.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1815.91,91,,percent of total billed charges,,,1895.73,95,,percent of total billed charges,,,1656.27,83,,percent of total billed charges,,,1656.27,83,,percent of total billed charges,,,,,,,,,,,,,,,1656.27,83,,percent of total billed charges,,,1895.73,95,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1636.31,82,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1696.18,85,,percent of total billed charges,,1504.61,1895.73,
EVERCROSS BALLOON 4MM X 80MM,30260235,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
EVERCROSS BALLOON 6MM X 100MM,30260236,CDM,,,270,RC,inpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,621.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,700.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,621.8,783.44,
SHEATH INTRODUCER PINNACLE 4FR 10CM,30260237,CDM,,,270,RC,inpatient,,828.8,828.8,,703.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,624.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,704.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,729.34,88,,percent of total billed charges,,,,,,,,,633.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,754.21,91,,percent of total billed charges,,,787.36,95,,percent of total billed charges,,,687.9,83,,percent of total billed charges,,,687.9,83,,percent of total billed charges,,,,,,,,,,,,,,,687.9,83,,percent of total billed charges,,,787.36,95,,percent of total billed charges,,,745.92,90,,percent of total billed charges,,,745.92,90,,percent of total billed charges,,,679.62,82,,percent of total billed charges,,,745.92,90,,percent of total billed charges,,,704.48,85,,percent of total billed charges,,624.92,787.36,
BARD PTA CATH ATLAS 14MM X 4CM X 75CM,30260238,CDM,,,270,RC,inpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1715.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1933.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,1715.35,2161.25,
BARD PTA CATH ATLAS GOLD 14MM X 4CM  7F,30260239,CDM,,,270,RC,inpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1960.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2210,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,1960.4,2470,
BARD PTA CATH ATLAS 16MM X 40MM X 75CM,30260240,CDM,,,270,RC,inpatient,,2437.5,2437.5,,2069.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1837.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2071.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2145,88,,percent of total billed charges,,,,,,,,,1862.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2218.13,91,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2023.13,83,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,1998.75,82,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,1837.88,2315.63,
BARD PTA CATH ATLAS GOLD 16MM X 4CM  8F,30260241,CDM,,,270,RC,inpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2082.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2348.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,2082.93,2624.38,
BARD PTA CATH ATLAS 18MM X 40MM X 75CM,30260242,CDM,,,270,RC,inpatient,,2437.5,2437.5,,2069.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1837.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2071.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2145,88,,percent of total billed charges,,,,,,,,,1862.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2218.13,91,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2023.13,83,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,1998.75,82,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,1837.88,2315.63,
BARD PTA CATH ATLAS GOLD 18MM X 4CM  8F,30260243,CDM,,,270,RC,inpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2082.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2348.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,2082.93,2624.38,
BARD PTA CATH ATLAS 20MM X 40MM 9F,30260244,CDM,,,270,RC,inpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,2450.5,3087.5,
NANOCROSS BALLOON 6.0 X 200MM,30260245,CDM,,,270,RC,inpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1458.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1643.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,1458.05,1837.06,
NANOCROSS BALLOON 3.0 X 150MM,30260246,CDM,,,270,RC,inpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1458.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1643.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,1458.05,1837.06,
CHOCOLATE BALLOON PTA 5.0 X 120MM,30260247,CDM,,,270,RC,inpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3896.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4392.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,3896.3,4909.13,
SPIDER DISTAL PROTECTION DEVICE 3.0MM,30260249,CDM,,,270,RC,inpatient,,10090.08,10090.08,,8566.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7607.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8576.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8879.27,88,,percent of total billed charges,,,,,,,,,7708.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9181.97,91,,percent of total billed charges,,,9585.58,95,,percent of total billed charges,,,8374.77,83,,percent of total billed charges,,,8374.77,83,,percent of total billed charges,,,,,,,,,,,,,,,8374.77,83,,percent of total billed charges,,,9585.58,95,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,8273.87,82,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,8576.57,85,,percent of total billed charges,,7607.92,9585.58,
NANOCROSS BALLOON 3.5 X 150MM,30260250,CDM,,,270,RC,inpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1458.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1643.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,1458.05,1837.06,
SHOCKWAVE CATH M5+ IVL 7.0X60X135,30260251,CDM,,,278,RC,inpatient,,22425,22425,,19038.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16908.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19061.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19734,88,,percent of total billed charges,,,,,,,,,17132.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20406.75,91,,percent of total billed charges,,,21303.75,95,,percent of total billed charges,,,18612.75,83,,percent of total billed charges,,,18612.75,83,,percent of total billed charges,,,,,,,,,,,,,,,18612.75,83,,percent of total billed charges,,,21303.75,95,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,18388.5,82,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,19061.25,85,,percent of total billed charges,,16908.45,21303.75,
SHOCKWAVE CATH M5+ IVL 8.0X60X135,30260252,CDM,,,278,RC,inpatient,,22425,22425,,19038.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16908.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19061.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19734,88,,percent of total billed charges,,,,,,,,,17132.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20406.75,91,,percent of total billed charges,,,21303.75,95,,percent of total billed charges,,,18612.75,83,,percent of total billed charges,,,18612.75,83,,percent of total billed charges,,,,,,,,,,,,,,,18612.75,83,,percent of total billed charges,,,21303.75,95,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,18388.5,82,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,19061.25,85,,percent of total billed charges,,16908.45,21303.75,
APPLETON CAMBRIDGE RF SYSTEM RENTAL,30260253,CDM,,,270,RC,inpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3675.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4143.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,3675.75,4631.25,
APPLETON ELECTRODE COOLED ONE-PIECE SHAR,30260254,CDM,,,270,RC,inpatient,,8021,8021,,6809.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6047.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6817.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7058.48,88,,percent of total billed charges,,,,,,,,,6128.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7299.11,91,,percent of total billed charges,,,7619.95,95,,percent of total billed charges,,,6657.43,83,,percent of total billed charges,,,6657.43,83,,percent of total billed charges,,,,,,,,,,,,,,,6657.43,83,,percent of total billed charges,,,7619.95,95,,percent of total billed charges,,,7218.9,90,,percent of total billed charges,,,7218.9,90,,percent of total billed charges,,,6577.22,82,,percent of total billed charges,,,7218.9,90,,percent of total billed charges,,,6817.85,85,,percent of total billed charges,,6047.83,7619.95,
APPLETON TUBING SET COOLED ELECTRODES,30260255,CDM,,,270,RC,inpatient,,255,255,,216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,192.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,216.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,224.4,88,,percent of total billed charges,,,,,,,,,194.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,209.1,82,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,192.27,242.25,
APPLETON GROUND PAD,30260256,CDM,,,270,RC,inpatient,,217.5,217.5,,184.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,184.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,191.4,88,,percent of total billed charges,,,,,,,,,166.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,197.93,91,,percent of total billed charges,,,206.63,95,,percent of total billed charges,,,180.53,83,,percent of total billed charges,,,180.53,83,,percent of total billed charges,,,,,,,,,,,,,,,180.53,83,,percent of total billed charges,,,206.63,95,,percent of total billed charges,,,195.75,90,,percent of total billed charges,,,195.75,90,,percent of total billed charges,,,178.35,82,,percent of total billed charges,,,195.75,90,,percent of total billed charges,,,184.88,85,,percent of total billed charges,,164,206.63,
SHOCKWAVE CATH M5+ IVL 6.0MMX60MMX135CM,30260257,CDM,,,278,RC,inpatient,,22425,22425,,19038.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16908.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19061.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19734,88,,percent of total billed charges,,,,,,,,,17132.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20406.75,91,,percent of total billed charges,,,21303.75,95,,percent of total billed charges,,,18612.75,83,,percent of total billed charges,,,18612.75,83,,percent of total billed charges,,,,,,,,,,,,,,,18612.75,83,,percent of total billed charges,,,21303.75,95,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,18388.5,82,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,19061.25,85,,percent of total billed charges,,16908.45,21303.75,
BIOPSY SYSTEM ONCONTROL 102MM,30260258,CDM,,,270,RC,inpatient,,1142.9,1142.9,,970.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,861.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,971.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1005.75,88,,percent of total billed charges,,,,,,,,,873.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1040.04,91,,percent of total billed charges,,,1085.76,95,,percent of total billed charges,,,948.61,83,,percent of total billed charges,,,948.61,83,,percent of total billed charges,,,,,,,,,,,,,,,948.61,83,,percent of total billed charges,,,1085.76,95,,percent of total billed charges,,,1028.61,90,,percent of total billed charges,,,1028.61,90,,percent of total billed charges,,,937.18,82,,percent of total billed charges,,,1028.61,90,,percent of total billed charges,,,971.47,85,,percent of total billed charges,,861.75,1085.76,
CAPE NEPHROUNETEROSTONY STENT 10.2 X 26C,30260259,CDM,,,270,RC,inpatient,,898.24,898.24,,762.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,677.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,763.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,790.45,88,,percent of total billed charges,,,,,,,,,686.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,817.4,91,,percent of total billed charges,,,853.33,95,,percent of total billed charges,,,745.54,83,,percent of total billed charges,,,745.54,83,,percent of total billed charges,,,,,,,,,,,,,,,745.54,83,,percent of total billed charges,,,853.33,95,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,736.56,82,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,763.5,85,,percent of total billed charges,,677.27,853.33,
CAPE NEPHROUNETEROSTONY STENT 8.5 X 28CM,30260260,CDM,,,270,RC,inpatient,,898.24,898.24,,762.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,677.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,763.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,790.45,88,,percent of total billed charges,,,,,,,,,686.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,817.4,91,,percent of total billed charges,,,853.33,95,,percent of total billed charges,,,745.54,83,,percent of total billed charges,,,745.54,83,,percent of total billed charges,,,,,,,,,,,,,,,745.54,83,,percent of total billed charges,,,853.33,95,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,736.56,82,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,763.5,85,,percent of total billed charges,,677.27,853.33,
CAPE NEPHROUNETEROSTONY STENT 8.5 X 26CM,30260261,CDM,,,270,RC,inpatient,,898.24,898.24,,762.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,677.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,763.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,790.45,88,,percent of total billed charges,,,,,,,,,686.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,817.4,91,,percent of total billed charges,,,853.33,95,,percent of total billed charges,,,745.54,83,,percent of total billed charges,,,745.54,83,,percent of total billed charges,,,,,,,,,,,,,,,745.54,83,,percent of total billed charges,,,853.33,95,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,736.56,82,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,763.5,85,,percent of total billed charges,,677.27,853.33,
GALT STIFF MINI ACCESS 4F X 10CM,30260262,CDM,,,270,RC,inpatient,,301.73,301.73,,256.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,227.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,256.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,265.52,88,,percent of total billed charges,,,,,,,,,230.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,274.57,91,,percent of total billed charges,,,286.64,95,,percent of total billed charges,,,250.44,83,,percent of total billed charges,,,250.44,83,,percent of total billed charges,,,,,,,,,,,,,,,250.44,83,,percent of total billed charges,,,286.64,95,,percent of total billed charges,,,271.56,90,,percent of total billed charges,,,271.56,90,,percent of total billed charges,,,247.42,82,,percent of total billed charges,,,271.56,90,,percent of total billed charges,,,256.47,85,,percent of total billed charges,,227.5,286.64,
GLIDE SHEATH SLENDER 5FR RADIAL ACCESS,30260263,CDM,,,270,RC,inpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
GLIDE SHEATH SLENDER 6FR RADIAL ACCESS,30260264,CDM,,,270,RC,inpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
CATH FOGARTY EMBOLECTOMY 4FR X 80CM,30260265,CDM,,,270,RC,inpatient,,1132.63,1132.63,,961.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,854,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,962.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,996.71,88,,percent of total billed charges,,,,,,,,,865.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1030.69,91,,percent of total billed charges,,,1076,95,,percent of total billed charges,,,940.08,83,,percent of total billed charges,,,940.08,83,,percent of total billed charges,,,,,,,,,,,,,,,940.08,83,,percent of total billed charges,,,1076,95,,percent of total billed charges,,,1019.37,90,,percent of total billed charges,,,1019.37,90,,percent of total billed charges,,,928.76,82,,percent of total billed charges,,,1019.37,90,,percent of total billed charges,,,962.74,85,,percent of total billed charges,,854,1076,
CATH FOGARTY EMBOLECTOMY 5.5F X 80CM,30260266,CDM,,,270,RC,inpatient,,1472.97,1472.97,,1250.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1110.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1252.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1296.21,88,,percent of total billed charges,,,,,,,,,1125.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1340.4,91,,percent of total billed charges,,,1399.32,95,,percent of total billed charges,,,1222.57,83,,percent of total billed charges,,,1222.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1222.57,83,,percent of total billed charges,,,1399.32,95,,percent of total billed charges,,,1325.67,90,,percent of total billed charges,,,1325.67,90,,percent of total billed charges,,,1207.84,82,,percent of total billed charges,,,1325.67,90,,percent of total billed charges,,,1252.02,85,,percent of total billed charges,,1110.62,1399.32,
CATH FOGARTY EMBOLECTOMY 6F X 80CM,30260267,CDM,,,270,RC,inpatient,,1466.99,1466.99,,1245.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1106.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1246.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1290.95,88,,percent of total billed charges,,,,,,,,,1120.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1334.96,91,,percent of total billed charges,,,1393.64,95,,percent of total billed charges,,,1217.6,83,,percent of total billed charges,,,1217.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1217.6,83,,percent of total billed charges,,,1393.64,95,,percent of total billed charges,,,1320.29,90,,percent of total billed charges,,,1320.29,90,,percent of total billed charges,,,1202.93,82,,percent of total billed charges,,,1320.29,90,,percent of total billed charges,,,1246.94,85,,percent of total billed charges,,1106.11,1393.64,
CATH PHILIPS ASPIRATION QUICK CLEAR 8F,30260268,CDM,,,270,RC,inpatient,,18525,18525,,15727.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13967.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15746.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16302,88,,percent of total billed charges,,,,,,,,,14153.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16857.75,91,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,,,,,,,,,,,,,15375.75,83,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15190.5,82,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15746.25,85,,percent of total billed charges,,13967.85,17598.75,
INTRODUCER KIT - GASTROSTOMY FEEDING,30260269,CDM,,,270,RC,inpatient,,1748.5,1748.5,,1484.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1318.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1486.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1538.68,88,,percent of total billed charges,,,,,,,,,1335.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1591.14,91,,percent of total billed charges,,,1661.08,95,,percent of total billed charges,,,1451.26,83,,percent of total billed charges,,,1451.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1451.26,83,,percent of total billed charges,,,1661.08,95,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1433.77,82,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1486.23,85,,percent of total billed charges,,1318.37,1661.08,
MIC GASTROSTOMY FEEDING TUBE 18FR,30260270,CDM,,,270,RC,inpatient,,283.13,283.13,,240.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,213.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,240.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.15,88,,percent of total billed charges,,,,,,,,,216.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,257.65,91,,percent of total billed charges,,,268.97,95,,percent of total billed charges,,,235,83,,percent of total billed charges,,,235,83,,percent of total billed charges,,,,,,,,,,,,,,,235,83,,percent of total billed charges,,,268.97,95,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,232.17,82,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,240.66,85,,percent of total billed charges,,213.48,268.97,
MIC GASTROSTOMY FEEDING TUBE 20FR,30260271,CDM,,,270,RC,inpatient,,283.13,283.13,,240.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,213.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,240.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.15,88,,percent of total billed charges,,,,,,,,,216.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,257.65,91,,percent of total billed charges,,,268.97,95,,percent of total billed charges,,,235,83,,percent of total billed charges,,,235,83,,percent of total billed charges,,,,,,,,,,,,,,,235,83,,percent of total billed charges,,,268.97,95,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,232.17,82,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,240.66,85,,percent of total billed charges,,213.48,268.97,
MIC GASTROSTOMY FEEDING TUBE 22FR,30260272,CDM,,,270,RC,inpatient,,283.13,283.13,,240.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,213.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,240.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.15,88,,percent of total billed charges,,,,,,,,,216.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,257.65,91,,percent of total billed charges,,,268.97,95,,percent of total billed charges,,,235,83,,percent of total billed charges,,,235,83,,percent of total billed charges,,,,,,,,,,,,,,,235,83,,percent of total billed charges,,,268.97,95,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,232.17,82,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,240.66,85,,percent of total billed charges,,213.48,268.97,
MIC GASTRIC JEJUNAL FEEDING TUBE KIT 18F,30260273,CDM,,,270,RC,inpatient,,1497.54,1497.54,,1271.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1129.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1272.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1317.84,88,,percent of total billed charges,,,,,,,,,1144.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1362.76,91,,percent of total billed charges,,,1422.66,95,,percent of total billed charges,,,1242.96,83,,percent of total billed charges,,,1242.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1242.96,83,,percent of total billed charges,,,1422.66,95,,percent of total billed charges,,,1347.79,90,,percent of total billed charges,,,1347.79,90,,percent of total billed charges,,,1227.98,82,,percent of total billed charges,,,1347.79,90,,percent of total billed charges,,,1272.91,85,,percent of total billed charges,,1129.15,1422.66,
MIC GASTRIC JEJUNAL FEEDING TUBE KIT 22F,30260274,CDM,,,270,RC,inpatient,,1497.54,1497.54,,1271.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1129.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1272.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1317.84,88,,percent of total billed charges,,,,,,,,,1144.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1362.76,91,,percent of total billed charges,,,1422.66,95,,percent of total billed charges,,,1242.96,83,,percent of total billed charges,,,1242.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1242.96,83,,percent of total billed charges,,,1422.66,95,,percent of total billed charges,,,1347.79,90,,percent of total billed charges,,,1347.79,90,,percent of total billed charges,,,1227.98,82,,percent of total billed charges,,,1347.79,90,,percent of total billed charges,,,1272.91,85,,percent of total billed charges,,1129.15,1422.66,
COOK BILIARY DRAINAGE CATH 8.5F,30260275,CDM,,,270,RC,inpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,545.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,614.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,545.11,686.81,
COOK BILIARY DRAINAGE CATH 10.2F,30260276,CDM,,,270,RC,inpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,545.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,614.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,545.11,686.81,
COOK BILIARY DRAINAGE CATH 12F,30260277,CDM,,,270,RC,inpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,545.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,614.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,545.11,686.81,
COOK LIVER ACCESS & BIOPSY SET 18G,30260278,CDM,,,270,RC,inpatient,,3523,3523,,2991.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2656.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2994.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3100.24,88,,percent of total billed charges,,,,,,,,,2691.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3205.93,91,,percent of total billed charges,,,3346.85,95,,percent of total billed charges,,,2924.09,83,,percent of total billed charges,,,2924.09,83,,percent of total billed charges,,,,,,,,,,,,,,,2924.09,83,,percent of total billed charges,,,3346.85,95,,percent of total billed charges,,,3170.7,90,,percent of total billed charges,,,3170.7,90,,percent of total billed charges,,,2888.86,82,,percent of total billed charges,,,3170.7,90,,percent of total billed charges,,,2994.55,85,,percent of total billed charges,,2656.34,3346.85,
MERIT MICROSPHERE 1ML SYRINGE,30260279,CDM,,,270,RC,inpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1176.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1326,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,1176.24,1482,
MERIT MICROSPHERE 2ML SYRINGE,30260280,CDM,,,270,RC,inpatient,,1579.5,1579.5,,1341,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1190.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1342.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1389.96,88,,percent of total billed charges,,,,,,,,,1206.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1437.35,91,,percent of total billed charges,,,1500.53,95,,percent of total billed charges,,,1310.99,83,,percent of total billed charges,,,1310.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1310.99,83,,percent of total billed charges,,,1500.53,95,,percent of total billed charges,,,1421.55,90,,percent of total billed charges,,,1421.55,90,,percent of total billed charges,,,1295.19,82,,percent of total billed charges,,,1421.55,90,,percent of total billed charges,,,1342.58,85,,percent of total billed charges,,1190.94,1500.53,
MERIT MEDALLION SYRINGE 1ML,30260281,CDM,,,270,RC,inpatient,,17.55,17.55,,14.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.44,88,,percent of total billed charges,,,,,,,,,13.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.97,91,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14.57,83,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.39,82,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.92,85,,percent of total billed charges,,13.23,16.67,
MERIT MEDALLION SYRINGE 3ML,30260282,CDM,,,270,RC,inpatient,,17.55,17.55,,14.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.44,88,,percent of total billed charges,,,,,,,,,13.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.97,91,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14.57,83,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.39,82,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.92,85,,percent of total billed charges,,13.23,16.67,
MERIT MEDALLION SYRINGE 10ML,30260283,CDM,,,270,RC,inpatient,,17.55,17.55,,14.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.44,88,,percent of total billed charges,,,,,,,,,13.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.97,91,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14.57,83,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.39,82,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.92,85,,percent of total billed charges,,13.23,16.67,
URESIL ASPIRATION FLUSH ADAPTER,30260284,CDM,,,270,RC,inpatient,,188.1,188.1,,159.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,159.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,165.53,88,,percent of total billed charges,,,,,,,,,143.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.17,91,,percent of total billed charges,,,178.7,95,,percent of total billed charges,,,156.12,83,,percent of total billed charges,,,156.12,83,,percent of total billed charges,,,,,,,,,,,,,,,156.12,83,,percent of total billed charges,,,178.7,95,,percent of total billed charges,,,169.29,90,,percent of total billed charges,,,169.29,90,,percent of total billed charges,,,154.24,82,,percent of total billed charges,,,169.29,90,,percent of total billed charges,,,159.89,85,,percent of total billed charges,,141.83,178.7,
CATH IVUS VISION PV .014 RX DIGITAL,30260286,CDM,,,270,RC,inpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3675.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4143.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,3675.75,4631.25,
CATH IVUS VISION PV .035 RX DIGITAL,30260287,CDM,,,270,RC,inpatient,,6337.5,6337.5,,5380.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4778.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5386.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5577,88,,percent of total billed charges,,,,,,,,,4841.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5767.13,91,,percent of total billed charges,,,6020.63,95,,percent of total billed charges,,,5260.13,83,,percent of total billed charges,,,5260.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5260.13,83,,percent of total billed charges,,,6020.63,95,,percent of total billed charges,,,5703.75,90,,percent of total billed charges,,,5703.75,90,,percent of total billed charges,,,5196.75,82,,percent of total billed charges,,,5703.75,90,,percent of total billed charges,,,5386.88,85,,percent of total billed charges,,4778.48,6020.63,
NEEDLE BARD BIO 16 X 10,30270009,CDM,,,270,RC,inpatient,,328.73,328.73,,279.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,247.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,279.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,289.28,88,,percent of total billed charges,,,,,,,,,251.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,299.14,91,,percent of total billed charges,,,312.29,95,,percent of total billed charges,,,272.85,83,,percent of total billed charges,,,272.85,83,,percent of total billed charges,,,,,,,,,,,,,,,272.85,83,,percent of total billed charges,,,312.29,95,,percent of total billed charges,,,295.86,90,,percent of total billed charges,,,295.86,90,,percent of total billed charges,,,269.56,82,,percent of total billed charges,,,295.86,90,,percent of total billed charges,,,279.42,85,,percent of total billed charges,,247.86,312.29,
TRAY PARACENTESIS ABDOMINAL LARGE VOLUME,30270021,CDM,,,270,RC,inpatient,,466.67,466.67,,396.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,351.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.67,88,,percent of total billed charges,,,,,,,,,356.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.67,91,,percent of total billed charges,,,443.34,95,,percent of total billed charges,,,387.34,83,,percent of total billed charges,,,387.34,83,,percent of total billed charges,,,,,,,,,,,,,,,387.34,83,,percent of total billed charges,,,443.34,95,,percent of total billed charges,,,420,90,,percent of total billed charges,,,420,90,,percent of total billed charges,,,382.67,82,,percent of total billed charges,,,420,90,,percent of total billed charges,,,396.67,85,,percent of total billed charges,,351.87,443.34,
NEEDLE BIOPSY FRANSEEN LUNG 18 X 15,30290004,CDM,,,270,RC,inpatient,,194.48,194.48,,165.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,165.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,171.14,88,,percent of total billed charges,,,,,,,,,148.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.98,91,,percent of total billed charges,,,184.76,95,,percent of total billed charges,,,161.42,83,,percent of total billed charges,,,161.42,83,,percent of total billed charges,,,,,,,,,,,,,,,161.42,83,,percent of total billed charges,,,184.76,95,,percent of total billed charges,,,175.03,90,,percent of total billed charges,,,175.03,90,,percent of total billed charges,,,159.47,82,,percent of total billed charges,,,175.03,90,,percent of total billed charges,,,165.31,85,,percent of total billed charges,,146.64,184.76,
NEEDLE BIOPSY FRANSEEN LUNG 20 X 20,30290005,CDM,,,270,RC,inpatient,,194.48,194.48,,165.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,165.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,171.14,88,,percent of total billed charges,,,,,,,,,148.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.98,91,,percent of total billed charges,,,184.76,95,,percent of total billed charges,,,161.42,83,,percent of total billed charges,,,161.42,83,,percent of total billed charges,,,,,,,,,,,,,,,161.42,83,,percent of total billed charges,,,184.76,95,,percent of total billed charges,,,175.03,90,,percent of total billed charges,,,175.03,90,,percent of total billed charges,,,159.47,82,,percent of total billed charges,,,175.03,90,,percent of total billed charges,,,165.31,85,,percent of total billed charges,,146.64,184.76,
NEEDLE BIOPSY FRANSEEN LUNG 20 X 15,30290006,CDM,,,270,RC,inpatient,,218.55,218.55,,185.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,192.32,88,,percent of total billed charges,,,,,,,,,166.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,198.88,91,,percent of total billed charges,,,207.62,95,,percent of total billed charges,,,181.4,83,,percent of total billed charges,,,181.4,83,,percent of total billed charges,,,,,,,,,,,,,,,181.4,83,,percent of total billed charges,,,207.62,95,,percent of total billed charges,,,196.7,90,,percent of total billed charges,,,196.7,90,,percent of total billed charges,,,179.21,82,,percent of total billed charges,,,196.7,90,,percent of total billed charges,,,185.77,85,,percent of total billed charges,,164.79,207.62,
NEEDLE NERVE BLOCK 22GA X 2,30330004,CDM,,,270,RC,inpatient,,116.22,116.22,,98.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,87.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,98.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,102.27,88,,percent of total billed charges,,,,,,,,,88.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,105.76,91,,percent of total billed charges,,,110.41,95,,percent of total billed charges,,,96.46,83,,percent of total billed charges,,,96.46,83,,percent of total billed charges,,,,,,,,,,,,,,,96.46,83,,percent of total billed charges,,,110.41,95,,percent of total billed charges,,,104.6,90,,percent of total billed charges,,,104.6,90,,percent of total billed charges,,,95.3,82,,percent of total billed charges,,,104.6,90,,percent of total billed charges,,,98.79,85,,percent of total billed charges,,87.63,110.41,
NEEDLE SPINAL GERTIE MARX 25 X 124MM,30330005,CDM,,,270,RC,inpatient,,109.2,109.2,,92.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,92.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,96.1,88,,percent of total billed charges,,,,,,,,,83.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.37,91,,percent of total billed charges,,,103.74,95,,percent of total billed charges,,,90.64,83,,percent of total billed charges,,,90.64,83,,percent of total billed charges,,,,,,,,,,,,,,,90.64,83,,percent of total billed charges,,,103.74,95,,percent of total billed charges,,,98.28,90,,percent of total billed charges,,,98.28,90,,percent of total billed charges,,,89.54,82,,percent of total billed charges,,,98.28,90,,percent of total billed charges,,,92.82,85,,percent of total billed charges,,82.34,103.74,
RANGER STANDARD FLOW W/EXT SET,30330009,CDM,,,270,RC,inpatient,,83.22,83.22,,70.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.23,88,,percent of total billed charges,,,,,,,,,63.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.73,91,,percent of total billed charges,,,79.06,95,,percent of total billed charges,,,69.07,83,,percent of total billed charges,,,69.07,83,,percent of total billed charges,,,,,,,,,,,,,,,69.07,83,,percent of total billed charges,,,79.06,95,,percent of total billed charges,,,74.9,90,,percent of total billed charges,,,74.9,90,,percent of total billed charges,,,68.24,82,,percent of total billed charges,,,74.9,90,,percent of total billed charges,,,70.74,85,,percent of total billed charges,,62.75,79.06,
PRESSURE INFUSER BAG 1000ML,30330010,CDM,,,270,RC,inpatient,,123.76,123.76,,105.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,108.91,88,,percent of total billed charges,,,,,,,,,94.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.62,91,,percent of total billed charges,,,117.57,95,,percent of total billed charges,,,102.72,83,,percent of total billed charges,,,102.72,83,,percent of total billed charges,,,,,,,,,,,,,,,102.72,83,,percent of total billed charges,,,117.57,95,,percent of total billed charges,,,111.38,90,,percent of total billed charges,,,111.38,90,,percent of total billed charges,,,101.48,82,,percent of total billed charges,,,111.38,90,,percent of total billed charges,,,105.2,85,,percent of total billed charges,,93.32,117.57,
*C-FUSOR 1000ML UNIT,30330011,CDM,,,270,RC,inpatient,,521.43,521.43,,442.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,393.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,443.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,458.86,88,,percent of total billed charges,,,,,,,,,398.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,474.5,91,,percent of total billed charges,,,495.36,95,,percent of total billed charges,,,432.79,83,,percent of total billed charges,,,432.79,83,,percent of total billed charges,,,,,,,,,,,,,,,432.79,83,,percent of total billed charges,,,495.36,95,,percent of total billed charges,,,469.29,90,,percent of total billed charges,,,469.29,90,,percent of total billed charges,,,427.57,82,,percent of total billed charges,,,469.29,90,,percent of total billed charges,,,443.22,85,,percent of total billed charges,,393.16,495.36,
TRAY EPIDURAL ESPOCAN CSE,30330017,CDM,,,270,RC,inpatient,,342.73,342.73,,290.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,258.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,291.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,301.6,88,,percent of total billed charges,,,,,,,,,261.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,311.88,91,,percent of total billed charges,,,325.59,95,,percent of total billed charges,,,284.47,83,,percent of total billed charges,,,284.47,83,,percent of total billed charges,,,,,,,,,,,,,,,284.47,83,,percent of total billed charges,,,325.59,95,,percent of total billed charges,,,308.46,90,,percent of total billed charges,,,308.46,90,,percent of total billed charges,,,281.04,82,,percent of total billed charges,,,308.46,90,,percent of total billed charges,,,291.32,85,,percent of total billed charges,,258.42,325.59,
*AIRWAY KING LTD #4,30330023,CDM,,,270,RC,inpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,345.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,306.12,385.7,
SENSOR SKIN TEMPERATURE,30330024,CDM,,,270,RC,inpatient,,42.19,42.19,,35.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37.13,88,,percent of total billed charges,,,,,,,,,32.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38.39,91,,percent of total billed charges,,,40.08,95,,percent of total billed charges,,,35.02,83,,percent of total billed charges,,,35.02,83,,percent of total billed charges,,,,,,,,,,,,,,,35.02,83,,percent of total billed charges,,,40.08,95,,percent of total billed charges,,,37.97,90,,percent of total billed charges,,,37.97,90,,percent of total billed charges,,,34.6,82,,percent of total billed charges,,,37.97,90,,percent of total billed charges,,,35.86,85,,percent of total billed charges,,31.81,40.08,
*ESOPHAGEAL STETHOSCOPE W/TEMP SENSOR,30330025,CDM,,,270,RC,inpatient,,50.83,50.83,,43.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.73,88,,percent of total billed charges,,,,,,,,,38.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.26,91,,percent of total billed charges,,,48.29,95,,percent of total billed charges,,,42.19,83,,percent of total billed charges,,,42.19,83,,percent of total billed charges,,,,,,,,,,,,,,,42.19,83,,percent of total billed charges,,,48.29,95,,percent of total billed charges,,,45.75,90,,percent of total billed charges,,,45.75,90,,percent of total billed charges,,,41.68,82,,percent of total billed charges,,,45.75,90,,percent of total billed charges,,,43.21,85,,percent of total billed charges,,38.33,48.29,
DEPUY BODY GLBL UNITE 52X21,30330026,CDM,,,278,RC,inpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13297.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14990.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,13297.64,16754.32,
AIRWAY LMA UNIQUE SIZE 1.5,30330031,CDM,,,270,RC,inpatient,,114.48,114.48,,97.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,86.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,97.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,100.74,88,,percent of total billed charges,,,,,,,,,87.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,104.18,91,,percent of total billed charges,,,108.76,95,,percent of total billed charges,,,95.02,83,,percent of total billed charges,,,95.02,83,,percent of total billed charges,,,,,,,,,,,,,,,95.02,83,,percent of total billed charges,,,108.76,95,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,93.87,82,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,97.31,85,,percent of total billed charges,,86.32,108.76,
AIRWAY LMA UNIQUE SIZE 2,30330032,CDM,,,270,RC,inpatient,,114.48,114.48,,97.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,86.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,97.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,100.74,88,,percent of total billed charges,,,,,,,,,87.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,104.18,91,,percent of total billed charges,,,108.76,95,,percent of total billed charges,,,95.02,83,,percent of total billed charges,,,95.02,83,,percent of total billed charges,,,,,,,,,,,,,,,95.02,83,,percent of total billed charges,,,108.76,95,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,93.87,82,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,97.31,85,,percent of total billed charges,,86.32,108.76,
AIRWAY LMA UNIQUE SIZE 2.5,30330033,CDM,,,270,RC,inpatient,,78.99,78.99,,67.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.51,88,,percent of total billed charges,,,,,,,,,60.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.88,91,,percent of total billed charges,,,75.04,95,,percent of total billed charges,,,65.56,83,,percent of total billed charges,,,65.56,83,,percent of total billed charges,,,,,,,,,,,,,,,65.56,83,,percent of total billed charges,,,75.04,95,,percent of total billed charges,,,71.09,90,,percent of total billed charges,,,71.09,90,,percent of total billed charges,,,64.77,82,,percent of total billed charges,,,71.09,90,,percent of total billed charges,,,67.14,85,,percent of total billed charges,,59.56,75.04,
ESOPHOGEAL TAP PROBES 18FR,30330035,CDM,,,270,RC,inpatient,,46.22,46.22,,39.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.67,88,,percent of total billed charges,,,,,,,,,35.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.06,91,,percent of total billed charges,,,43.91,95,,percent of total billed charges,,,38.36,83,,percent of total billed charges,,,38.36,83,,percent of total billed charges,,,,,,,,,,,,,,,38.36,83,,percent of total billed charges,,,43.91,95,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,37.9,82,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,39.29,85,,percent of total billed charges,,34.85,43.91,
AIRWAY NASO PVC 32FR,30330037,CDM,,,270,RC,inpatient,,21.04,21.04,,17.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.52,88,,percent of total billed charges,,,,,,,,,16.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.15,91,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,,,,,,,,,,,,,17.46,83,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.25,82,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,15.86,19.99,
AIRWAY NASO PVC 34FR,30330038,CDM,,,270,RC,inpatient,,15.73,15.73,,13.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.84,88,,percent of total billed charges,,,,,,,,,12.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.31,91,,percent of total billed charges,,,14.94,95,,percent of total billed charges,,,13.06,83,,percent of total billed charges,,,13.06,83,,percent of total billed charges,,,,,,,,,,,,,,,13.06,83,,percent of total billed charges,,,14.94,95,,percent of total billed charges,,,14.16,90,,percent of total billed charges,,,14.16,90,,percent of total billed charges,,,12.9,82,,percent of total billed charges,,,14.16,90,,percent of total billed charges,,,13.37,85,,percent of total billed charges,,11.86,14.94,
AIRWAY NASO PVC 36FR,30330039,CDM,,,270,RC,inpatient,,15.93,15.93,,13.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.02,88,,percent of total billed charges,,,,,,,,,12.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.5,91,,percent of total billed charges,,,15.13,95,,percent of total billed charges,,,13.22,83,,percent of total billed charges,,,13.22,83,,percent of total billed charges,,,,,,,,,,,,,,,13.22,83,,percent of total billed charges,,,15.13,95,,percent of total billed charges,,,14.34,90,,percent of total billed charges,,,14.34,90,,percent of total billed charges,,,13.06,82,,percent of total billed charges,,,14.34,90,,percent of total billed charges,,,13.54,85,,percent of total billed charges,,12.01,15.13,
GLIDESCOPE COVER 3 STAT,30330041,CDM,,,270,RC,inpatient,,138.24,138.24,,117.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.65,88,,percent of total billed charges,,,,,,,,,105.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.8,91,,percent of total billed charges,,,131.33,95,,percent of total billed charges,,,114.74,83,,percent of total billed charges,,,114.74,83,,percent of total billed charges,,,,,,,,,,,,,,,114.74,83,,percent of total billed charges,,,131.33,95,,percent of total billed charges,,,124.42,90,,percent of total billed charges,,,124.42,90,,percent of total billed charges,,,113.36,82,,percent of total billed charges,,,124.42,90,,percent of total billed charges,,,117.5,85,,percent of total billed charges,,104.23,131.33,
INTRODUCER TRACH COUDE15FR 70CM,30330044,CDM,,,270,RC,inpatient,,47.57,47.57,,40.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.86,88,,percent of total billed charges,,,,,,,,,36.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.29,91,,percent of total billed charges,,,45.19,95,,percent of total billed charges,,,39.48,83,,percent of total billed charges,,,39.48,83,,percent of total billed charges,,,,,,,,,,,,,,,39.48,83,,percent of total billed charges,,,45.19,95,,percent of total billed charges,,,42.81,90,,percent of total billed charges,,,42.81,90,,percent of total billed charges,,,39.01,82,,percent of total billed charges,,,42.81,90,,percent of total billed charges,,,40.43,85,,percent of total billed charges,,35.87,45.19,
TRAY PENCAN LIDO ONLY,30330048,CDM,,,270,RC,inpatient,,140.21,140.21,,119.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,105.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,119.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,123.38,88,,percent of total billed charges,,,,,,,,,107.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,127.59,91,,percent of total billed charges,,,133.2,95,,percent of total billed charges,,,116.37,83,,percent of total billed charges,,,116.37,83,,percent of total billed charges,,,,,,,,,,,,,,,116.37,83,,percent of total billed charges,,,133.2,95,,percent of total billed charges,,,126.19,90,,percent of total billed charges,,,126.19,90,,percent of total billed charges,,,114.97,82,,percent of total billed charges,,,126.19,90,,percent of total billed charges,,,119.18,85,,percent of total billed charges,,105.72,133.2,
*NEEDLE SONOTAP 22G X 50MM,30330049,CDM,,,270,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
*NEEDLE STIMUPLEX ULTRA 22G X 2,30330052,CDM,,,270,RC,inpatient,,104.98,104.98,,89.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,89.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,92.38,88,,percent of total billed charges,,,,,,,,,80.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,95.53,91,,percent of total billed charges,,,99.73,95,,percent of total billed charges,,,87.13,83,,percent of total billed charges,,,87.13,83,,percent of total billed charges,,,,,,,,,,,,,,,87.13,83,,percent of total billed charges,,,99.73,95,,percent of total billed charges,,,94.48,90,,percent of total billed charges,,,94.48,90,,percent of total billed charges,,,86.08,82,,percent of total billed charges,,,94.48,90,,percent of total billed charges,,,89.23,85,,percent of total billed charges,,79.15,99.73,
AIRWAY LMA SUPREME SIZE 3,30330053,CDM,,,270,RC,inpatient,,193.13,193.13,,163.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,145.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,169.95,88,,percent of total billed charges,,,,,,,,,147.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,175.75,91,,percent of total billed charges,,,183.47,95,,percent of total billed charges,,,160.3,83,,percent of total billed charges,,,160.3,83,,percent of total billed charges,,,,,,,,,,,,,,,160.3,83,,percent of total billed charges,,,183.47,95,,percent of total billed charges,,,173.82,90,,percent of total billed charges,,,173.82,90,,percent of total billed charges,,,158.37,82,,percent of total billed charges,,,173.82,90,,percent of total billed charges,,,164.16,85,,percent of total billed charges,,145.62,183.47,
AIRWAY LMA SUPREME SIZE 4,30330054,CDM,,,270,RC,inpatient,,193.13,193.13,,163.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,145.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,169.95,88,,percent of total billed charges,,,,,,,,,147.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,175.75,91,,percent of total billed charges,,,183.47,95,,percent of total billed charges,,,160.3,83,,percent of total billed charges,,,160.3,83,,percent of total billed charges,,,,,,,,,,,,,,,160.3,83,,percent of total billed charges,,,183.47,95,,percent of total billed charges,,,173.82,90,,percent of total billed charges,,,173.82,90,,percent of total billed charges,,,158.37,82,,percent of total billed charges,,,173.82,90,,percent of total billed charges,,,164.16,85,,percent of total billed charges,,145.62,183.47,
AIRWAY LMA SUPREME SIZE 5,30330055,CDM,,,270,RC,inpatient,,193.6,193.6,,164.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,145.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.37,88,,percent of total billed charges,,,,,,,,,147.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.18,91,,percent of total billed charges,,,183.92,95,,percent of total billed charges,,,160.69,83,,percent of total billed charges,,,160.69,83,,percent of total billed charges,,,,,,,,,,,,,,,160.69,83,,percent of total billed charges,,,183.92,95,,percent of total billed charges,,,174.24,90,,percent of total billed charges,,,174.24,90,,percent of total billed charges,,,158.75,82,,percent of total billed charges,,,174.24,90,,percent of total billed charges,,,164.56,85,,percent of total billed charges,,145.97,183.92,
AIRWAY GUEDEL 70MM WHITE,30330056,CDM,,,270,RC,inpatient,,6.55,6.55,,5.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.76,88,,percent of total billed charges,,,,,,,,,5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.96,91,,percent of total billed charges,,,6.22,95,,percent of total billed charges,,,5.44,83,,percent of total billed charges,,,5.44,83,,percent of total billed charges,,,,,,,,,,,,,,,5.44,83,,percent of total billed charges,,,6.22,95,,percent of total billed charges,,,5.9,90,,percent of total billed charges,,,5.9,90,,percent of total billed charges,,,5.37,82,,percent of total billed charges,,,5.9,90,,percent of total billed charges,,,5.57,85,,percent of total billed charges,,4.94,6.22,
NEEDLE PENCIL PT 22GX5,30330058,CDM,,,270,RC,inpatient,,38.45,38.45,,32.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33.84,88,,percent of total billed charges,,,,,,,,,29.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.99,91,,percent of total billed charges,,,36.53,95,,percent of total billed charges,,,31.91,83,,percent of total billed charges,,,31.91,83,,percent of total billed charges,,,,,,,,,,,,,,,31.91,83,,percent of total billed charges,,,36.53,95,,percent of total billed charges,,,34.61,90,,percent of total billed charges,,,34.61,90,,percent of total billed charges,,,31.53,82,,percent of total billed charges,,,34.61,90,,percent of total billed charges,,,32.68,85,,percent of total billed charges,,28.99,36.53,
INTUBATION STYLET 10FR,30330059,CDM,,,270,RC,inpatient,,33.44,33.44,,28.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.43,88,,percent of total billed charges,,,,,,,,,25.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.43,91,,percent of total billed charges,,,31.77,95,,percent of total billed charges,,,27.76,83,,percent of total billed charges,,,27.76,83,,percent of total billed charges,,,,,,,,,,,,,,,27.76,83,,percent of total billed charges,,,31.77,95,,percent of total billed charges,,,30.1,90,,percent of total billed charges,,,30.1,90,,percent of total billed charges,,,27.42,82,,percent of total billed charges,,,30.1,90,,percent of total billed charges,,,28.42,85,,percent of total billed charges,,25.21,31.77,
DRYLINE WATER TRAP ADULT,30330066,CDM,,,270,RC,inpatient,,138.6,138.6,,117.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.97,88,,percent of total billed charges,,,,,,,,,105.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,126.13,91,,percent of total billed charges,,,131.67,95,,percent of total billed charges,,,115.04,83,,percent of total billed charges,,,115.04,83,,percent of total billed charges,,,,,,,,,,,,,,,115.04,83,,percent of total billed charges,,,131.67,95,,percent of total billed charges,,,124.74,90,,percent of total billed charges,,,124.74,90,,percent of total billed charges,,,113.65,82,,percent of total billed charges,,,124.74,90,,percent of total billed charges,,,117.81,85,,percent of total billed charges,,104.5,131.67,
BAT MASK ADULT LARGE,30330069,CDM,,,270,RC,inpatient,,50.49,50.49,,42.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.43,88,,percent of total billed charges,,,,,,,,,38.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.95,91,,percent of total billed charges,,,47.97,95,,percent of total billed charges,,,41.91,83,,percent of total billed charges,,,41.91,83,,percent of total billed charges,,,,,,,,,,,,,,,41.91,83,,percent of total billed charges,,,47.97,95,,percent of total billed charges,,,45.44,90,,percent of total billed charges,,,45.44,90,,percent of total billed charges,,,41.4,82,,percent of total billed charges,,,45.44,90,,percent of total billed charges,,,42.92,85,,percent of total billed charges,,38.07,47.97,
ARTERIAL CATHERIZATION SET 20G X 1 3/4,30330071,CDM,,,270,RC,inpatient,,75.31,75.31,,63.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,64.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66.27,88,,percent of total billed charges,,,,,,,,,57.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,68.53,91,,percent of total billed charges,,,71.54,95,,percent of total billed charges,,,62.51,83,,percent of total billed charges,,,62.51,83,,percent of total billed charges,,,,,,,,,,,,,,,62.51,83,,percent of total billed charges,,,71.54,95,,percent of total billed charges,,,67.78,90,,percent of total billed charges,,,67.78,90,,percent of total billed charges,,,61.75,82,,percent of total billed charges,,,67.78,90,,percent of total billed charges,,,64.01,85,,percent of total billed charges,,56.78,71.54,
NEEDLE SPINAL GERTIE MARX SET 17 X 125MM,30330074,CDM,,,270,RC,inpatient,,243.38,243.38,,206.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,183.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,206.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,214.17,88,,percent of total billed charges,,,,,,,,,185.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,221.48,91,,percent of total billed charges,,,231.21,95,,percent of total billed charges,,,202.01,83,,percent of total billed charges,,,202.01,83,,percent of total billed charges,,,,,,,,,,,,,,,202.01,83,,percent of total billed charges,,,231.21,95,,percent of total billed charges,,,219.04,90,,percent of total billed charges,,,219.04,90,,percent of total billed charges,,,199.57,82,,percent of total billed charges,,,219.04,90,,percent of total billed charges,,,206.87,85,,percent of total billed charges,,183.51,231.21,
AIRWAY ORAL AGT PREFORMED CUFFED 7.0,30330075,CDM,,,270,RC,inpatient,,44.96,44.96,,38.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.56,88,,percent of total billed charges,,,,,,,,,34.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.91,91,,percent of total billed charges,,,42.71,95,,percent of total billed charges,,,37.32,83,,percent of total billed charges,,,37.32,83,,percent of total billed charges,,,,,,,,,,,,,,,37.32,83,,percent of total billed charges,,,42.71,95,,percent of total billed charges,,,40.46,90,,percent of total billed charges,,,40.46,90,,percent of total billed charges,,,36.87,82,,percent of total billed charges,,,40.46,90,,percent of total billed charges,,,38.22,85,,percent of total billed charges,,33.9,42.71,
AIRWAY ORAL AGT PREFORMED CUFFED 8.0,30330076,CDM,,,270,RC,inpatient,,44.1,44.1,,37.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.81,88,,percent of total billed charges,,,,,,,,,33.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.13,91,,percent of total billed charges,,,41.9,95,,percent of total billed charges,,,36.6,83,,percent of total billed charges,,,36.6,83,,percent of total billed charges,,,,,,,,,,,,,,,36.6,83,,percent of total billed charges,,,41.9,95,,percent of total billed charges,,,39.69,90,,percent of total billed charges,,,39.69,90,,percent of total billed charges,,,36.16,82,,percent of total billed charges,,,39.69,90,,percent of total billed charges,,,37.49,85,,percent of total billed charges,,33.25,41.9,
TRACH TUBE UNCUFFED 4MM,30330077,CDM,,,270,RC,inpatient,,14.11,14.11,,11.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.42,88,,percent of total billed charges,,,,,,,,,10.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.84,91,,percent of total billed charges,,,13.4,95,,percent of total billed charges,,,11.71,83,,percent of total billed charges,,,11.71,83,,percent of total billed charges,,,,,,,,,,,,,,,11.71,83,,percent of total billed charges,,,13.4,95,,percent of total billed charges,,,12.7,90,,percent of total billed charges,,,12.7,90,,percent of total billed charges,,,11.57,82,,percent of total billed charges,,,12.7,90,,percent of total billed charges,,,11.99,85,,percent of total billed charges,,10.64,13.4,
NEEDLE NERVE BLOCK 21GA X 4,30330078,CDM,,,270,RC,inpatient,,112.37,112.37,,95.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,95.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.89,88,,percent of total billed charges,,,,,,,,,85.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,102.26,91,,percent of total billed charges,,,106.75,95,,percent of total billed charges,,,93.27,83,,percent of total billed charges,,,93.27,83,,percent of total billed charges,,,,,,,,,,,,,,,93.27,83,,percent of total billed charges,,,106.75,95,,percent of total billed charges,,,101.13,90,,percent of total billed charges,,,101.13,90,,percent of total billed charges,,,92.14,82,,percent of total billed charges,,,101.13,90,,percent of total billed charges,,,95.51,85,,percent of total billed charges,,84.73,106.75,
NEEDLE SONOBLOCK 22G X 2  FACET TIP,30330079,CDM,,,270,RC,inpatient,,122,122,,103.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,103.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,107.36,88,,percent of total billed charges,,,,,,,,,93.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,100.04,82,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,91.99,115.9,
NEEDLE SONOBLOCK 21G X 4  FACET TIP,30330080,CDM,,,270,RC,inpatient,,134,134,,113.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,101.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,113.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,117.92,88,,percent of total billed charges,,,,,,,,,102.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,121.94,91,,percent of total billed charges,,,127.3,95,,percent of total billed charges,,,111.22,83,,percent of total billed charges,,,111.22,83,,percent of total billed charges,,,,,,,,,,,,,,,111.22,83,,percent of total billed charges,,,127.3,95,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,109.88,82,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,113.9,85,,percent of total billed charges,,101.04,127.3,
CATHETER RADIAL ARTERY KIT 20G X 1 3/4,30330084,CDM,,,270,RC,inpatient,,75.48,75.48,,64.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,64.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66.42,88,,percent of total billed charges,,,,,,,,,57.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,68.69,91,,percent of total billed charges,,,71.71,95,,percent of total billed charges,,,62.65,83,,percent of total billed charges,,,62.65,83,,percent of total billed charges,,,,,,,,,,,,,,,62.65,83,,percent of total billed charges,,,71.71,95,,percent of total billed charges,,,67.93,90,,percent of total billed charges,,,67.93,90,,percent of total billed charges,,,61.89,82,,percent of total billed charges,,,67.93,90,,percent of total billed charges,,,64.16,85,,percent of total billed charges,,56.91,71.71,
STRYKER TIBIAL BASEPLATE,30330103,CDM,,,278,RC,inpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5391.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6077.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,5391.1,6792.5,
STRYKER TIBIAL BEARING INSERT,30330104,CDM,,,278,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
CATH PHILIPS ASPIRATION 10FX85CM,30330106,CDM,,,270,RC,inpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17153.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19337.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,17153.5,21612.5,
QUICKTRACH 4.0MM,30330117,CDM,,,270,RC,inpatient,,981.24,981.24,,833.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,739.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,834.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,863.49,88,,percent of total billed charges,,,,,,,,,749.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,892.93,91,,percent of total billed charges,,,932.18,95,,percent of total billed charges,,,814.43,83,,percent of total billed charges,,,814.43,83,,percent of total billed charges,,,,,,,,,,,,,,,814.43,83,,percent of total billed charges,,,932.18,95,,percent of total billed charges,,,883.12,90,,percent of total billed charges,,,883.12,90,,percent of total billed charges,,,804.62,82,,percent of total billed charges,,,883.12,90,,percent of total billed charges,,,834.05,85,,percent of total billed charges,,739.85,932.18,
QUICKTRACH 2.0MM,30330118,CDM,,,270,RC,inpatient,,981.24,981.24,,833.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,739.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,834.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,863.49,88,,percent of total billed charges,,,,,,,,,749.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,892.93,91,,percent of total billed charges,,,932.18,95,,percent of total billed charges,,,814.43,83,,percent of total billed charges,,,814.43,83,,percent of total billed charges,,,,,,,,,,,,,,,814.43,83,,percent of total billed charges,,,932.18,95,,percent of total billed charges,,,883.12,90,,percent of total billed charges,,,883.12,90,,percent of total billed charges,,,804.62,82,,percent of total billed charges,,,883.12,90,,percent of total billed charges,,,834.05,85,,percent of total billed charges,,739.85,932.18,
SENSOR SPO2 RD ADULT,30330119,CDM,,,270,RC,inpatient,,112.32,112.32,,95.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,95.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.84,88,,percent of total billed charges,,,,,,,,,85.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,102.21,91,,percent of total billed charges,,,106.7,95,,percent of total billed charges,,,93.23,83,,percent of total billed charges,,,93.23,83,,percent of total billed charges,,,,,,,,,,,,,,,93.23,83,,percent of total billed charges,,,106.7,95,,percent of total billed charges,,,101.09,90,,percent of total billed charges,,,101.09,90,,percent of total billed charges,,,92.1,82,,percent of total billed charges,,,101.09,90,,percent of total billed charges,,,95.47,85,,percent of total billed charges,,84.69,106.7,
SENSOR SPO2 RD INFANT,30330120,CDM,,,270,RC,inpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,108.58,136.8,
LEG LYMPH BANDAGE KIT,30340013,CDM,,,270,RC,inpatient,,1088.73,1088.73,,924.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,820.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,925.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,958.08,88,,percent of total billed charges,,,,,,,,,831.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,990.74,91,,percent of total billed charges,,,1034.29,95,,percent of total billed charges,,,903.65,83,,percent of total billed charges,,,903.65,83,,percent of total billed charges,,,,,,,,,,,,,,,903.65,83,,percent of total billed charges,,,1034.29,95,,percent of total billed charges,,,979.86,90,,percent of total billed charges,,,979.86,90,,percent of total billed charges,,,892.76,82,,percent of total billed charges,,,979.86,90,,percent of total billed charges,,,925.42,85,,percent of total billed charges,,820.9,1034.29,
ROSIDAL K 10X5CM,30340014,CDM,,,270,RC,inpatient,,63.54,63.54,,53.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.92,88,,percent of total billed charges,,,,,,,,,48.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.82,91,,percent of total billed charges,,,60.36,95,,percent of total billed charges,,,52.74,83,,percent of total billed charges,,,52.74,83,,percent of total billed charges,,,,,,,,,,,,,,,52.74,83,,percent of total billed charges,,,60.36,95,,percent of total billed charges,,,57.19,90,,percent of total billed charges,,,57.19,90,,percent of total billed charges,,,52.1,82,,percent of total billed charges,,,57.19,90,,percent of total billed charges,,,54.01,85,,percent of total billed charges,,47.91,60.36,
ROSIDAL K 12X5CM,30340015,CDM,,,270,RC,inpatient,,77.99,77.99,,66.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.63,88,,percent of total billed charges,,,,,,,,,59.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.97,91,,percent of total billed charges,,,74.09,95,,percent of total billed charges,,,64.73,83,,percent of total billed charges,,,64.73,83,,percent of total billed charges,,,,,,,,,,,,,,,64.73,83,,percent of total billed charges,,,74.09,95,,percent of total billed charges,,,70.19,90,,percent of total billed charges,,,70.19,90,,percent of total billed charges,,,63.95,82,,percent of total billed charges,,,70.19,90,,percent of total billed charges,,,66.29,85,,percent of total billed charges,,58.8,74.09,
MOLLEAST WRAP 6X4CM,30340016,CDM,,,270,RC,inpatient,,3.83,3.83,,3.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3.37,88,,percent of total billed charges,,,,,,,,,2.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3.49,91,,percent of total billed charges,,,3.64,95,,percent of total billed charges,,,3.18,83,,percent of total billed charges,,,3.18,83,,percent of total billed charges,,,,,,,,,,,,,,,3.18,83,,percent of total billed charges,,,3.64,95,,percent of total billed charges,,,3.45,90,,percent of total billed charges,,,3.45,90,,percent of total billed charges,,,3.14,82,,percent of total billed charges,,,3.45,90,,percent of total billed charges,,,3.26,85,,percent of total billed charges,,2.89,3.64,
GRAY FOAM 1/2  3X6,30340017,CDM,,,270,RC,inpatient,,167.2,167.2,,141.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,126.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,142.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,147.14,88,,percent of total billed charges,,,,,,,,,127.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,152.15,91,,percent of total billed charges,,,158.84,95,,percent of total billed charges,,,138.78,83,,percent of total billed charges,,,138.78,83,,percent of total billed charges,,,,,,,,,,,,,,,138.78,83,,percent of total billed charges,,,158.84,95,,percent of total billed charges,,,150.48,90,,percent of total billed charges,,,150.48,90,,percent of total billed charges,,,137.1,82,,percent of total billed charges,,,150.48,90,,percent of total billed charges,,,142.12,85,,percent of total billed charges,,126.07,158.84,
GRAY FOAM 1  3X6,30340018,CDM,,,270,RC,inpatient,,271.38,271.38,,230.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,204.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,230.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,238.81,88,,percent of total billed charges,,,,,,,,,207.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,246.96,91,,percent of total billed charges,,,257.81,95,,percent of total billed charges,,,225.25,83,,percent of total billed charges,,,225.25,83,,percent of total billed charges,,,,,,,,,,,,,,,225.25,83,,percent of total billed charges,,,257.81,95,,percent of total billed charges,,,244.24,90,,percent of total billed charges,,,244.24,90,,percent of total billed charges,,,222.53,82,,percent of total billed charges,,,244.24,90,,percent of total billed charges,,,230.67,85,,percent of total billed charges,,204.62,257.81,
ROSIDAL K 6X5CM,30340020,CDM,,,270,RC,inpatient,,44.78,44.78,,38.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.41,88,,percent of total billed charges,,,,,,,,,34.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.75,91,,percent of total billed charges,,,42.54,95,,percent of total billed charges,,,37.17,83,,percent of total billed charges,,,37.17,83,,percent of total billed charges,,,,,,,,,,,,,,,37.17,83,,percent of total billed charges,,,42.54,95,,percent of total billed charges,,,40.3,90,,percent of total billed charges,,,40.3,90,,percent of total billed charges,,,36.72,82,,percent of total billed charges,,,40.3,90,,percent of total billed charges,,,38.06,85,,percent of total billed charges,,33.76,42.54,
ROSIDAL K 8X5CM,30340021,CDM,,,270,RC,inpatient,,56.31,56.31,,47.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.55,88,,percent of total billed charges,,,,,,,,,43.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.24,91,,percent of total billed charges,,,53.49,95,,percent of total billed charges,,,46.74,83,,percent of total billed charges,,,46.74,83,,percent of total billed charges,,,,,,,,,,,,,,,46.74,83,,percent of total billed charges,,,53.49,95,,percent of total billed charges,,,50.68,90,,percent of total billed charges,,,50.68,90,,percent of total billed charges,,,46.17,82,,percent of total billed charges,,,50.68,90,,percent of total billed charges,,,47.86,85,,percent of total billed charges,,42.46,53.49,
ISOBAND 15 X 5CM,30340022,CDM,,,270,RC,inpatient,,103.6,103.6,,87.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,78.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,88.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,91.17,88,,percent of total billed charges,,,,,,,,,79.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,94.28,91,,percent of total billed charges,,,98.42,95,,percent of total billed charges,,,85.99,83,,percent of total billed charges,,,85.99,83,,percent of total billed charges,,,,,,,,,,,,,,,85.99,83,,percent of total billed charges,,,98.42,95,,percent of total billed charges,,,93.24,90,,percent of total billed charges,,,93.24,90,,percent of total billed charges,,,84.95,82,,percent of total billed charges,,,93.24,90,,percent of total billed charges,,,88.06,85,,percent of total billed charges,,78.11,98.42,
TRANSELAST CLASSIC 6 X 4CM,30340023,CDM,,,270,RC,inpatient,,5.4,5.4,,4.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4.75,88,,percent of total billed charges,,,,,,,,,4.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4.91,91,,percent of total billed charges,,,5.13,95,,percent of total billed charges,,,4.48,83,,percent of total billed charges,,,4.48,83,,percent of total billed charges,,,,,,,,,,,,,,,4.48,83,,percent of total billed charges,,,5.13,95,,percent of total billed charges,,,4.86,90,,percent of total billed charges,,,4.86,90,,percent of total billed charges,,,4.43,82,,percent of total billed charges,,,4.86,90,,percent of total billed charges,,,4.59,85,,percent of total billed charges,,4.07,5.13,
ARTIFLEX 10 X 3CM,30340024,CDM,,,270,RC,inpatient,,29.25,29.25,,24.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.74,88,,percent of total billed charges,,,,,,,,,22.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.62,91,,percent of total billed charges,,,27.79,95,,percent of total billed charges,,,24.28,83,,percent of total billed charges,,,24.28,83,,percent of total billed charges,,,,,,,,,,,,,,,24.28,83,,percent of total billed charges,,,27.79,95,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,23.99,82,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,24.86,85,,percent of total billed charges,,22.05,27.79,
ARTIFLEX 15 X 3CM,30340025,CDM,,,270,RC,inpatient,,40.5,40.5,,34.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.64,88,,percent of total billed charges,,,,,,,,,30.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.86,91,,percent of total billed charges,,,38.48,95,,percent of total billed charges,,,33.62,83,,percent of total billed charges,,,33.62,83,,percent of total billed charges,,,,,,,,,,,,,,,33.62,83,,percent of total billed charges,,,38.48,95,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,33.21,82,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,34.43,85,,percent of total billed charges,,30.54,38.48,
*BRACE FOOTDROP 670 RIGHT LARGE,30340028,CDM,,,270,RC,inpatient,,428.05,428.05,,363.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,322.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,363.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,376.68,88,,percent of total billed charges,,,,,,,,,327.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,389.53,91,,percent of total billed charges,,,406.65,95,,percent of total billed charges,,,355.28,83,,percent of total billed charges,,,355.28,83,,percent of total billed charges,,,,,,,,,,,,,,,355.28,83,,percent of total billed charges,,,406.65,95,,percent of total billed charges,,,385.25,90,,percent of total billed charges,,,385.25,90,,percent of total billed charges,,,351,82,,percent of total billed charges,,,385.25,90,,percent of total billed charges,,,363.84,85,,percent of total billed charges,,322.75,406.65,
LUMBAR ROLL ORIGINAL MAKENZIE,30340029,CDM,,,270,RC,inpatient,,198.75,198.75,,168.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.9,88,,percent of total billed charges,,,,,,,,,151.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.86,91,,percent of total billed charges,,,188.81,95,,percent of total billed charges,,,164.96,83,,percent of total billed charges,,,164.96,83,,percent of total billed charges,,,,,,,,,,,,,,,164.96,83,,percent of total billed charges,,,188.81,95,,percent of total billed charges,,,178.88,90,,percent of total billed charges,,,178.88,90,,percent of total billed charges,,,162.98,82,,percent of total billed charges,,,178.88,90,,percent of total billed charges,,,168.94,85,,percent of total billed charges,,149.86,188.81,
STATLOCK PICC PLUS VAR. WINGED CATHETER,30450004,CDM,,,270,RC,inpatient,,69.85,69.85,,59.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,59.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,61.47,88,,percent of total billed charges,,,,,,,,,53.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,63.56,91,,percent of total billed charges,,,66.36,95,,percent of total billed charges,,,57.98,83,,percent of total billed charges,,,57.98,83,,percent of total billed charges,,,,,,,,,,,,,,,57.98,83,,percent of total billed charges,,,66.36,95,,percent of total billed charges,,,62.87,90,,percent of total billed charges,,,62.87,90,,percent of total billed charges,,,57.28,82,,percent of total billed charges,,,62.87,90,,percent of total billed charges,,,59.37,85,,percent of total billed charges,,52.67,66.36,
NEEDLE EMG CONCENTRIC 26G X 1.5 GREEN,30450011,CDM,,,270,RC,inpatient,,57.46,57.46,,48.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.56,88,,percent of total billed charges,,,,,,,,,43.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52.29,91,,percent of total billed charges,,,54.59,95,,percent of total billed charges,,,47.69,83,,percent of total billed charges,,,47.69,83,,percent of total billed charges,,,,,,,,,,,,,,,47.69,83,,percent of total billed charges,,,54.59,95,,percent of total billed charges,,,51.71,90,,percent of total billed charges,,,51.71,90,,percent of total billed charges,,,47.12,82,,percent of total billed charges,,,51.71,90,,percent of total billed charges,,,48.84,85,,percent of total billed charges,,43.32,54.59,
NEEDLE EMG CONCENTRIC 26G X 2.0 BLUE,30450012,CDM,,,270,RC,inpatient,,57.46,57.46,,48.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.56,88,,percent of total billed charges,,,,,,,,,43.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52.29,91,,percent of total billed charges,,,54.59,95,,percent of total billed charges,,,47.69,83,,percent of total billed charges,,,47.69,83,,percent of total billed charges,,,,,,,,,,,,,,,47.69,83,,percent of total billed charges,,,54.59,95,,percent of total billed charges,,,51.71,90,,percent of total billed charges,,,51.71,90,,percent of total billed charges,,,47.12,82,,percent of total billed charges,,,51.71,90,,percent of total billed charges,,,48.84,85,,percent of total billed charges,,43.32,54.59,
P.O.S. HIP ADJ BRACE 0-60,30480017,CDM,,,270,RC,inpatient,,6697.15,6697.15,,5685.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5049.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5692.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5893.49,88,,percent of total billed charges,,,,,,,,,5116.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6094.41,91,,percent of total billed charges,,,6362.29,95,,percent of total billed charges,,,5558.63,83,,percent of total billed charges,,,5558.63,83,,percent of total billed charges,,,,,,,,,,,,,,,5558.63,83,,percent of total billed charges,,,6362.29,95,,percent of total billed charges,,,6027.44,90,,percent of total billed charges,,,6027.44,90,,percent of total billed charges,,,5491.66,82,,percent of total billed charges,,,6027.44,90,,percent of total billed charges,,,5692.58,85,,percent of total billed charges,,5049.65,6362.29,
BOOT WALKING MEDIUM,30650009,CDM,,,270,RC,inpatient,,364,364,,309.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,274.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,309.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,320.32,88,,percent of total billed charges,,,,,,,,,278.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,331.24,91,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,,,,,,,,,,,,,302.12,83,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,298.48,82,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,309.4,85,,percent of total billed charges,,274.46,345.8,
DRESSING PROMOGRAN 4.34 SQ. IN,30810006,CDM,,,270,RC,inpatient,,63.16,63.16,,53.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,53.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.58,88,,percent of total billed charges,,,,,,,,,48.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.48,91,,percent of total billed charges,,,60,95,,percent of total billed charges,,,52.42,83,,percent of total billed charges,,,52.42,83,,percent of total billed charges,,,,,,,,,,,,,,,52.42,83,,percent of total billed charges,,,60,95,,percent of total billed charges,,,56.84,90,,percent of total billed charges,,,56.84,90,,percent of total billed charges,,,51.79,82,,percent of total billed charges,,,56.84,90,,percent of total billed charges,,,53.69,85,,percent of total billed charges,,47.62,60,
*DRESSING AQUACEL HYDROFIBER 6X6,30810010,CDM,,,270,RC,inpatient,,68.68,68.68,,58.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.44,88,,percent of total billed charges,,,,,,,,,52.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.5,91,,percent of total billed charges,,,65.25,95,,percent of total billed charges,,,57,83,,percent of total billed charges,,,57,83,,percent of total billed charges,,,,,,,,,,,,,,,57,83,,percent of total billed charges,,,65.25,95,,percent of total billed charges,,,61.81,90,,percent of total billed charges,,,61.81,90,,percent of total billed charges,,,56.32,82,,percent of total billed charges,,,61.81,90,,percent of total billed charges,,,58.38,85,,percent of total billed charges,,51.78,65.25,
*KCI GRANUFOAM SILVER LGE M8275099,30810012,CDM,,,270,RC,inpatient,,599.2,599.2,,508.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,451.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,509.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,527.3,88,,percent of total billed charges,,,,,,,,,457.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,545.27,91,,percent of total billed charges,,,569.24,95,,percent of total billed charges,,,497.34,83,,percent of total billed charges,,,497.34,83,,percent of total billed charges,,,,,,,,,,,,,,,497.34,83,,percent of total billed charges,,,569.24,95,,percent of total billed charges,,,539.28,90,,percent of total billed charges,,,539.28,90,,percent of total billed charges,,,491.34,82,,percent of total billed charges,,,539.28,90,,percent of total billed charges,,,509.32,85,,percent of total billed charges,,451.8,569.24,
*DRESSING APLIGRAF,30810013,CDM,Q4101,HCPCS,270,RC,inpatient,,11076,11076,,9403.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8351.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9414.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9746.88,88,,percent of total billed charges,,,,,,,,,8462.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10079.16,91,,percent of total billed charges,,,10522.2,95,,percent of total billed charges,,,9193.08,83,,percent of total billed charges,,,9193.08,83,,percent of total billed charges,,,,,,,,,,,,,,,9193.08,83,,percent of total billed charges,,,10522.2,95,,percent of total billed charges,,,9968.4,90,,percent of total billed charges,,,9968.4,90,,percent of total billed charges,,,9082.32,82,,percent of total billed charges,,,9968.4,90,,percent of total billed charges,,,9414.6,85,,percent of total billed charges,,8351.3,10522.2,
V.A.C. GRANUFOAM DRESSING LG,30810017,CDM,,,270,RC,inpatient,,394.32,394.32,,334.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,297.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,335.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,347,88,,percent of total billed charges,,,,,,,,,301.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,358.83,91,,percent of total billed charges,,,374.6,95,,percent of total billed charges,,,327.29,83,,percent of total billed charges,,,327.29,83,,percent of total billed charges,,,,,,,,,,,,,,,327.29,83,,percent of total billed charges,,,374.6,95,,percent of total billed charges,,,354.89,90,,percent of total billed charges,,,354.89,90,,percent of total billed charges,,,323.34,82,,percent of total billed charges,,,354.89,90,,percent of total billed charges,,,335.17,85,,percent of total billed charges,,297.32,374.6,
*PAD CADEXOMER IODINE GEL,30810018,CDM,,,270,RC,inpatient,,41.67,41.67,,35.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36.67,88,,percent of total billed charges,,,,,,,,,31.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37.92,91,,percent of total billed charges,,,39.59,95,,percent of total billed charges,,,34.59,83,,percent of total billed charges,,,34.59,83,,percent of total billed charges,,,,,,,,,,,,,,,34.59,83,,percent of total billed charges,,,39.59,95,,percent of total billed charges,,,37.5,90,,percent of total billed charges,,,37.5,90,,percent of total billed charges,,,34.17,82,,percent of total billed charges,,,37.5,90,,percent of total billed charges,,,35.42,85,,percent of total billed charges,,31.42,39.59,
*DRESSING AQUACEL AG HYDROGIBER RIBBON,30810019,CDM,,,270,RC,inpatient,,84.88,84.88,,72.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,72.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.69,88,,percent of total billed charges,,,,,,,,,64.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,77.24,91,,percent of total billed charges,,,80.64,95,,percent of total billed charges,,,70.45,83,,percent of total billed charges,,,70.45,83,,percent of total billed charges,,,,,,,,,,,,,,,70.45,83,,percent of total billed charges,,,80.64,95,,percent of total billed charges,,,76.39,90,,percent of total billed charges,,,76.39,90,,percent of total billed charges,,,69.6,82,,percent of total billed charges,,,76.39,90,,percent of total billed charges,,,72.15,85,,percent of total billed charges,,64,80.64,
*KCI VACUM DRAPE 30.5 X 26CM,30810020,CDM,,,270,RC,inpatient,,62.39,62.39,,52.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,53.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.9,88,,percent of total billed charges,,,,,,,,,47.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.77,91,,percent of total billed charges,,,59.27,95,,percent of total billed charges,,,51.78,83,,percent of total billed charges,,,51.78,83,,percent of total billed charges,,,,,,,,,,,,,,,51.78,83,,percent of total billed charges,,,59.27,95,,percent of total billed charges,,,56.15,90,,percent of total billed charges,,,56.15,90,,percent of total billed charges,,,51.16,82,,percent of total billed charges,,,56.15,90,,percent of total billed charges,,,53.03,85,,percent of total billed charges,,47.04,59.27,
*DRESSING AQUACEL-AG 3/4 x18,30810021,CDM,,,270,RC,inpatient,,92.08,92.08,,78.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,69.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,78.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.03,88,,percent of total billed charges,,,,,,,,,70.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,83.79,91,,percent of total billed charges,,,87.48,95,,percent of total billed charges,,,76.43,83,,percent of total billed charges,,,76.43,83,,percent of total billed charges,,,,,,,,,,,,,,,76.43,83,,percent of total billed charges,,,87.48,95,,percent of total billed charges,,,82.87,90,,percent of total billed charges,,,82.87,90,,percent of total billed charges,,,75.51,82,,percent of total billed charges,,,82.87,90,,percent of total billed charges,,,78.27,85,,percent of total billed charges,,69.43,87.48,
*DRESSING AQUACEL AG W/IONIC SILVER,30810022,CDM,,,270,RC,inpatient,,75.31,75.31,,63.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,64.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66.27,88,,percent of total billed charges,,,,,,,,,57.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,68.53,91,,percent of total billed charges,,,71.54,95,,percent of total billed charges,,,62.51,83,,percent of total billed charges,,,62.51,83,,percent of total billed charges,,,,,,,,,,,,,,,62.51,83,,percent of total billed charges,,,71.54,95,,percent of total billed charges,,,67.78,90,,percent of total billed charges,,,67.78,90,,percent of total billed charges,,,61.75,82,,percent of total billed charges,,,67.78,90,,percent of total billed charges,,,64.01,85,,percent of total billed charges,,56.78,71.54,
*KCI VERSAFOAM 10X15 M8275067,30810023,CDM,,,270,RC,inpatient,,407.89,407.89,,346.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,307.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,346.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,358.94,88,,percent of total billed charges,,,,,,,,,311.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,371.18,91,,percent of total billed charges,,,387.5,95,,percent of total billed charges,,,338.55,83,,percent of total billed charges,,,338.55,83,,percent of total billed charges,,,,,,,,,,,,,,,338.55,83,,percent of total billed charges,,,387.5,95,,percent of total billed charges,,,367.1,90,,percent of total billed charges,,,367.1,90,,percent of total billed charges,,,334.47,82,,percent of total billed charges,,,367.1,90,,percent of total billed charges,,,346.71,85,,percent of total billed charges,,307.55,387.5,
*DRESSING MAXORB EXTRA 4X4,30810024,CDM,,,270,RC,inpatient,,47.94,47.94,,40.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.19,88,,percent of total billed charges,,,,,,,,,36.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.63,91,,percent of total billed charges,,,45.54,95,,percent of total billed charges,,,39.79,83,,percent of total billed charges,,,39.79,83,,percent of total billed charges,,,,,,,,,,,,,,,39.79,83,,percent of total billed charges,,,45.54,95,,percent of total billed charges,,,43.15,90,,percent of total billed charges,,,43.15,90,,percent of total billed charges,,,39.31,82,,percent of total billed charges,,,43.15,90,,percent of total billed charges,,,40.75,85,,percent of total billed charges,,36.15,45.54,
DRESSING COMPRESSION 4-LAYER,30810026,CDM,,,270,RC,inpatient,,81.08,81.08,,68.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.35,88,,percent of total billed charges,,,,,,,,,61.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.78,91,,percent of total billed charges,,,77.03,95,,percent of total billed charges,,,67.3,83,,percent of total billed charges,,,67.3,83,,percent of total billed charges,,,,,,,,,,,,,,,67.3,83,,percent of total billed charges,,,77.03,95,,percent of total billed charges,,,72.97,90,,percent of total billed charges,,,72.97,90,,percent of total billed charges,,,66.49,82,,percent of total billed charges,,,72.97,90,,percent of total billed charges,,,68.92,85,,percent of total billed charges,,61.13,77.03,
 * HYDROGEL SKINTEGRITY 4OZ,30810027,CDM,,,270,RC,inpatient,,47.86,47.86,,40.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.12,88,,percent of total billed charges,,,,,,,,,36.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.55,91,,percent of total billed charges,,,45.47,95,,percent of total billed charges,,,39.72,83,,percent of total billed charges,,,39.72,83,,percent of total billed charges,,,,,,,,,,,,,,,39.72,83,,percent of total billed charges,,,45.47,95,,percent of total billed charges,,,43.07,90,,percent of total billed charges,,,43.07,90,,percent of total billed charges,,,39.25,82,,percent of total billed charges,,,43.07,90,,percent of total billed charges,,,40.68,85,,percent of total billed charges,,36.09,45.47,
*DRESSING AQUACEL HYDROFIBER 4 X 4,30810029,CDM,,,270,RC,inpatient,,28.53,28.53,,24.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.11,88,,percent of total billed charges,,,,,,,,,21.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.96,91,,percent of total billed charges,,,27.1,95,,percent of total billed charges,,,23.68,83,,percent of total billed charges,,,23.68,83,,percent of total billed charges,,,,,,,,,,,,,,,23.68,83,,percent of total billed charges,,,27.1,95,,percent of total billed charges,,,25.68,90,,percent of total billed charges,,,25.68,90,,percent of total billed charges,,,23.39,82,,percent of total billed charges,,,25.68,90,,percent of total billed charges,,,24.25,85,,percent of total billed charges,,21.51,27.1,
DRESSING PROMOGRAN PRISMA 4.34SQ IN,30810030,CDM,,,270,RC,inpatient,,75.99,75.99,,64.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,57.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,64.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66.87,88,,percent of total billed charges,,,,,,,,,58.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,69.15,91,,percent of total billed charges,,,72.19,95,,percent of total billed charges,,,63.07,83,,percent of total billed charges,,,63.07,83,,percent of total billed charges,,,,,,,,,,,,,,,63.07,83,,percent of total billed charges,,,72.19,95,,percent of total billed charges,,,68.39,90,,percent of total billed charges,,,68.39,90,,percent of total billed charges,,,62.31,82,,percent of total billed charges,,,68.39,90,,percent of total billed charges,,,64.59,85,,percent of total billed charges,,57.3,72.19,
*KCI GRANUFOAM BRIDGE M8275042,30810031,CDM,,,270,RC,inpatient,,375.34,375.34,,318.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,283.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,319.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330.3,88,,percent of total billed charges,,,,,,,,,286.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.56,91,,percent of total billed charges,,,356.57,95,,percent of total billed charges,,,311.53,83,,percent of total billed charges,,,311.53,83,,percent of total billed charges,,,,,,,,,,,,,,,311.53,83,,percent of total billed charges,,,356.57,95,,percent of total billed charges,,,337.81,90,,percent of total billed charges,,,337.81,90,,percent of total billed charges,,,307.78,82,,percent of total billed charges,,,337.81,90,,percent of total billed charges,,,319.04,85,,percent of total billed charges,,283.01,356.57,
*DRESSING IODOFLEX CADEXOMER IODINE GEL,30810032,CDM,,,270,RC,inpatient,,78.46,78.46,,66.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.04,88,,percent of total billed charges,,,,,,,,,59.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.4,91,,percent of total billed charges,,,74.54,95,,percent of total billed charges,,,65.12,83,,percent of total billed charges,,,65.12,83,,percent of total billed charges,,,,,,,,,,,,,,,65.12,83,,percent of total billed charges,,,74.54,95,,percent of total billed charges,,,70.61,90,,percent of total billed charges,,,70.61,90,,percent of total billed charges,,,64.34,82,,percent of total billed charges,,,70.61,90,,percent of total billed charges,,,66.69,85,,percent of total billed charges,,59.16,74.54,
*DRESSING STRATASORB 4 X 4,30810037,CDM,,,270,RC,inpatient,,9.03,9.03,,7.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.95,88,,percent of total billed charges,,,,,,,,,6.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8.22,91,,percent of total billed charges,,,8.58,95,,percent of total billed charges,,,7.49,83,,percent of total billed charges,,,7.49,83,,percent of total billed charges,,,,,,,,,,,,,,,7.49,83,,percent of total billed charges,,,8.58,95,,percent of total billed charges,,,8.13,90,,percent of total billed charges,,,8.13,90,,percent of total billed charges,,,7.4,82,,percent of total billed charges,,,8.13,90,,percent of total billed charges,,,7.68,85,,percent of total billed charges,,6.81,8.58,
DRESSING OPTIFOAM 4 X 4,30810038,CDM,,,270,RC,inpatient,,21.96,21.96,,18.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.32,88,,percent of total billed charges,,,,,,,,,16.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.98,91,,percent of total billed charges,,,20.86,95,,percent of total billed charges,,,18.23,83,,percent of total billed charges,,,18.23,83,,percent of total billed charges,,,,,,,,,,,,,,,18.23,83,,percent of total billed charges,,,20.86,95,,percent of total billed charges,,,19.76,90,,percent of total billed charges,,,19.76,90,,percent of total billed charges,,,18.01,82,,percent of total billed charges,,,19.76,90,,percent of total billed charges,,,18.67,85,,percent of total billed charges,,16.56,20.86,
GAUZE BORDER 4 X 4,30810039,CDM,,,270,RC,inpatient,,4.82,4.82,,4.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4.24,88,,percent of total billed charges,,,,,,,,,3.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4.39,91,,percent of total billed charges,,,4.58,95,,percent of total billed charges,,,4,83,,percent of total billed charges,,,4,83,,percent of total billed charges,,,,,,,,,,,,,,,4,83,,percent of total billed charges,,,4.58,95,,percent of total billed charges,,,4.34,90,,percent of total billed charges,,,4.34,90,,percent of total billed charges,,,3.95,82,,percent of total billed charges,,,4.34,90,,percent of total billed charges,,,4.1,85,,percent of total billed charges,,3.63,4.58,
GAUZE BORDER 6 X 6,30810040,CDM,,,270,RC,inpatient,,7.07,7.07,,6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6.22,88,,percent of total billed charges,,,,,,,,,5.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6.43,91,,percent of total billed charges,,,6.72,95,,percent of total billed charges,,,5.87,83,,percent of total billed charges,,,5.87,83,,percent of total billed charges,,,,,,,,,,,,,,,5.87,83,,percent of total billed charges,,,6.72,95,,percent of total billed charges,,,6.36,90,,percent of total billed charges,,,6.36,90,,percent of total billed charges,,,5.8,82,,percent of total billed charges,,,6.36,90,,percent of total billed charges,,,6.01,85,,percent of total billed charges,,5.33,6.72,
CASTING SYSTEM 3  NO BOOT,30810041,CDM,,,270,RC,inpatient,,856.46,856.46,,727.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,645.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,727.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,753.68,88,,percent of total billed charges,,,,,,,,,654.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,779.38,91,,percent of total billed charges,,,813.64,95,,percent of total billed charges,,,710.86,83,,percent of total billed charges,,,710.86,83,,percent of total billed charges,,,,,,,,,,,,,,,710.86,83,,percent of total billed charges,,,813.64,95,,percent of total billed charges,,,770.81,90,,percent of total billed charges,,,770.81,90,,percent of total billed charges,,,702.3,82,,percent of total billed charges,,,770.81,90,,percent of total billed charges,,,727.99,85,,percent of total billed charges,,645.77,813.64,
BOOT REGULAR TCC-EZ,30810044,CDM,,,270,RC,inpatient,,476,476,,404.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,358.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,404.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,418.88,88,,percent of total billed charges,,,,,,,,,363.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,433.16,91,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,,,,,,,,,,,,,395.08,83,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,390.32,82,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,358.9,452.2,
BOOT LARGE TCC-EZ,30810045,CDM,,,270,RC,inpatient,,578.13,578.13,,490.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,435.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,491.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,508.75,88,,percent of total billed charges,,,,,,,,,441.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,526.1,91,,percent of total billed charges,,,549.22,95,,percent of total billed charges,,,479.85,83,,percent of total billed charges,,,479.85,83,,percent of total billed charges,,,,,,,,,,,,,,,479.85,83,,percent of total billed charges,,,549.22,95,,percent of total billed charges,,,520.32,90,,percent of total billed charges,,,520.32,90,,percent of total billed charges,,,474.07,82,,percent of total billed charges,,,520.32,90,,percent of total billed charges,,,491.41,85,,percent of total billed charges,,435.91,549.22,
*DRESSING BIATIAN SILICONE FOAM 4 X 4,30810046,CDM,,,270,RC,inpatient,,26.28,26.28,,22.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23.13,88,,percent of total billed charges,,,,,,,,,20.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.91,91,,percent of total billed charges,,,24.97,95,,percent of total billed charges,,,21.81,83,,percent of total billed charges,,,21.81,83,,percent of total billed charges,,,,,,,,,,,,,,,21.81,83,,percent of total billed charges,,,24.97,95,,percent of total billed charges,,,23.65,90,,percent of total billed charges,,,23.65,90,,percent of total billed charges,,,21.55,82,,percent of total billed charges,,,23.65,90,,percent of total billed charges,,,22.34,85,,percent of total billed charges,,19.82,24.97,
INTERDRY SHEET 10X36,30810047,CDM,,,270,RC,inpatient,,293.01,293.01,,248.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,220.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,249.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,257.85,88,,percent of total billed charges,,,,,,,,,223.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,266.64,91,,percent of total billed charges,,,278.36,95,,percent of total billed charges,,,243.2,83,,percent of total billed charges,,,243.2,83,,percent of total billed charges,,,,,,,,,,,,,,,243.2,83,,percent of total billed charges,,,278.36,95,,percent of total billed charges,,,263.71,90,,percent of total billed charges,,,263.71,90,,percent of total billed charges,,,240.27,82,,percent of total billed charges,,,263.71,90,,percent of total billed charges,,,249.06,85,,percent of total billed charges,,220.93,278.36,
BRAVA PROTECTIVE SHEET 4 X 4,30810048,CDM,,,270,RC,inpatient,,11.64,11.64,,9.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.24,88,,percent of total billed charges,,,,,,,,,8.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.59,91,,percent of total billed charges,,,11.06,95,,percent of total billed charges,,,9.66,83,,percent of total billed charges,,,9.66,83,,percent of total billed charges,,,,,,,,,,,,,,,9.66,83,,percent of total billed charges,,,11.06,95,,percent of total billed charges,,,10.48,90,,percent of total billed charges,,,10.48,90,,percent of total billed charges,,,9.54,82,,percent of total billed charges,,,10.48,90,,percent of total billed charges,,,9.89,85,,percent of total billed charges,,8.78,11.06,
*DRESSING POLYMEM WOUND FILLER 3.0 X 3.0,30810050,CDM,,,270,RC,inpatient,,103.12,103.12,,87.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.75,88,,percent of total billed charges,,,,,,,,,78.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.84,91,,percent of total billed charges,,,97.96,95,,percent of total billed charges,,,85.59,83,,percent of total billed charges,,,85.59,83,,percent of total billed charges,,,,,,,,,,,,,,,85.59,83,,percent of total billed charges,,,97.96,95,,percent of total billed charges,,,92.81,90,,percent of total billed charges,,,92.81,90,,percent of total billed charges,,,84.56,82,,percent of total billed charges,,,92.81,90,,percent of total billed charges,,,87.65,85,,percent of total billed charges,,77.75,97.96,
*DRESSING POLYMEM SILVER ROPE 0.4 X 14,30810051,CDM,,,270,RC,inpatient,,215.03,215.03,,182.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,162.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,182.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,189.23,88,,percent of total billed charges,,,,,,,,,164.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,195.68,91,,percent of total billed charges,,,204.28,95,,percent of total billed charges,,,178.47,83,,percent of total billed charges,,,178.47,83,,percent of total billed charges,,,,,,,,,,,,,,,178.47,83,,percent of total billed charges,,,204.28,95,,percent of total billed charges,,,193.53,90,,percent of total billed charges,,,193.53,90,,percent of total billed charges,,,176.32,82,,percent of total billed charges,,,193.53,90,,percent of total billed charges,,,182.78,85,,percent of total billed charges,,162.13,204.28,
*DRESSING POLYMEM MAX 8 X 8,30810052,CDM,,,270,RC,inpatient,,298.5,298.5,,253.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,225.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,253.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,262.68,88,,percent of total billed charges,,,,,,,,,228.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,271.64,91,,percent of total billed charges,,,283.58,95,,percent of total billed charges,,,247.76,83,,percent of total billed charges,,,247.76,83,,percent of total billed charges,,,,,,,,,,,,,,,247.76,83,,percent of total billed charges,,,283.58,95,,percent of total billed charges,,,268.65,90,,percent of total billed charges,,,268.65,90,,percent of total billed charges,,,244.77,82,,percent of total billed charges,,,268.65,90,,percent of total billed charges,,,253.73,85,,percent of total billed charges,,225.07,283.58,
BRAVA PROTECTIVE SHEET 8 X 8,30810060,CDM,,,270,RC,inpatient,,68.34,68.34,,58.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.14,88,,percent of total billed charges,,,,,,,,,52.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.19,91,,percent of total billed charges,,,64.92,95,,percent of total billed charges,,,56.72,83,,percent of total billed charges,,,56.72,83,,percent of total billed charges,,,,,,,,,,,,,,,56.72,83,,percent of total billed charges,,,64.92,95,,percent of total billed charges,,,61.51,90,,percent of total billed charges,,,61.51,90,,percent of total billed charges,,,56.04,82,,percent of total billed charges,,,61.51,90,,percent of total billed charges,,,58.09,85,,percent of total billed charges,,51.53,64.92,
BOOT LARGE CHARCOT TCC-EZ,30810061,CDM,,,270,RC,inpatient,,651,651,,552.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,490.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,553.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,572.88,88,,percent of total billed charges,,,,,,,,,497.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,592.41,91,,percent of total billed charges,,,618.45,95,,percent of total billed charges,,,540.33,83,,percent of total billed charges,,,540.33,83,,percent of total billed charges,,,,,,,,,,,,,,,540.33,83,,percent of total billed charges,,,618.45,95,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,533.82,82,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,553.35,85,,percent of total billed charges,,490.85,618.45,
BOOT EXTRA LARGE TCC-EZ,30810065,CDM,,,270,RC,inpatient,,606.69,606.69,,515.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,457.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,515.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,533.89,88,,percent of total billed charges,,,,,,,,,463.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,552.09,91,,percent of total billed charges,,,576.36,95,,percent of total billed charges,,,503.55,83,,percent of total billed charges,,,503.55,83,,percent of total billed charges,,,,,,,,,,,,,,,503.55,83,,percent of total billed charges,,,576.36,95,,percent of total billed charges,,,546.02,90,,percent of total billed charges,,,546.02,90,,percent of total billed charges,,,497.49,82,,percent of total billed charges,,,546.02,90,,percent of total billed charges,,,515.69,85,,percent of total billed charges,,457.44,576.36,
ATRAC-TAIN CREAM 5 OZ COLOPLAST,30810066,CDM,,,270,RC,inpatient,,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,33.93,42.75,
CASTING SYSTEM 4 -NO BOOT,30810068,CDM,,,270,RC,inpatient,,831.6,831.6,,706.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,706.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,731.81,88,,percent of total billed charges,,,,,,,,,635.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,756.76,91,,percent of total billed charges,,,790.02,95,,percent of total billed charges,,,690.23,83,,percent of total billed charges,,,690.23,83,,percent of total billed charges,,,,,,,,,,,,,,,690.23,83,,percent of total billed charges,,,790.02,95,,percent of total billed charges,,,748.44,90,,percent of total billed charges,,,748.44,90,,percent of total billed charges,,,681.91,82,,percent of total billed charges,,,748.44,90,,percent of total billed charges,,,706.86,85,,percent of total billed charges,,627.03,790.02,
DRESSING OASIS WOUND MATRIX 3X3.5CM,30810069,CDM,,,270,RC,inpatient,,1023.75,1023.75,,869.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,771.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,870.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,900.9,88,,percent of total billed charges,,,,,,,,,782.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,931.61,91,,percent of total billed charges,,,972.56,95,,percent of total billed charges,,,849.71,83,,percent of total billed charges,,,849.71,83,,percent of total billed charges,,,,,,,,,,,,,,,849.71,83,,percent of total billed charges,,,972.56,95,,percent of total billed charges,,,921.38,90,,percent of total billed charges,,,921.38,90,,percent of total billed charges,,,839.48,82,,percent of total billed charges,,,921.38,90,,percent of total billed charges,,,870.19,85,,percent of total billed charges,,771.91,972.56,
DRESSING PREVENA 20CM PEEL & STICK,30810072,CDM,,,270,RC,inpatient,,1955.85,1955.85,,1660.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1474.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1662.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1721.15,88,,percent of total billed charges,,,,,,,,,1494.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1779.82,91,,percent of total billed charges,,,1858.06,95,,percent of total billed charges,,,1623.36,83,,percent of total billed charges,,,1623.36,83,,percent of total billed charges,,,,,,,,,,,,,,,1623.36,83,,percent of total billed charges,,,1858.06,95,,percent of total billed charges,,,1760.27,90,,percent of total billed charges,,,1760.27,90,,percent of total billed charges,,,1603.8,82,,percent of total billed charges,,,1760.27,90,,percent of total billed charges,,,1662.47,85,,percent of total billed charges,,1474.71,1858.06,
ALLEVYN LIFE DRESSING 5 1/16 3X3  PAD,30810075,CDM,,,270,RC,inpatient,,32.27,32.27,,27.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28.4,88,,percent of total billed charges,,,,,,,,,24.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29.37,91,,percent of total billed charges,,,30.66,95,,percent of total billed charges,,,26.78,83,,percent of total billed charges,,,26.78,83,,percent of total billed charges,,,,,,,,,,,,,,,26.78,83,,percent of total billed charges,,,30.66,95,,percent of total billed charges,,,29.04,90,,percent of total billed charges,,,29.04,90,,percent of total billed charges,,,26.46,82,,percent of total billed charges,,,29.04,90,,percent of total billed charges,,,27.43,85,,percent of total billed charges,,24.33,30.66,
ALLEVYN LIFE DRESSING 6 1/16 4X4  PAD,30810076,CDM,,,270,RC,inpatient,,44.31,44.31,,37.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.99,88,,percent of total billed charges,,,,,,,,,33.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.32,91,,percent of total billed charges,,,42.09,95,,percent of total billed charges,,,36.78,83,,percent of total billed charges,,,36.78,83,,percent of total billed charges,,,,,,,,,,,,,,,36.78,83,,percent of total billed charges,,,42.09,95,,percent of total billed charges,,,39.88,90,,percent of total billed charges,,,39.88,90,,percent of total billed charges,,,36.33,82,,percent of total billed charges,,,39.88,90,,percent of total billed charges,,,37.66,85,,percent of total billed charges,,33.41,42.09,
ANASEPT ANTIMICROBIAL SKIN & WOUND GEL,30810077,CDM,,,270,RC,inpatient,,288.71,288.71,,245.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.06,88,,percent of total billed charges,,,,,,,,,220.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.73,91,,percent of total billed charges,,,274.27,95,,percent of total billed charges,,,239.63,83,,percent of total billed charges,,,239.63,83,,percent of total billed charges,,,,,,,,,,,,,,,239.63,83,,percent of total billed charges,,,274.27,95,,percent of total billed charges,,,259.84,90,,percent of total billed charges,,,259.84,90,,percent of total billed charges,,,236.74,82,,percent of total billed charges,,,259.84,90,,percent of total billed charges,,,245.4,85,,percent of total billed charges,,217.69,274.27,
DRESSING ALLEVYN LIFE FOAM SACRUM SMALL,30810078,CDM,,,270,RC,inpatient,,59.39,59.39,,50.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.26,88,,percent of total billed charges,,,,,,,,,45.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,54.04,91,,percent of total billed charges,,,56.42,95,,percent of total billed charges,,,49.29,83,,percent of total billed charges,,,49.29,83,,percent of total billed charges,,,,,,,,,,,,,,,49.29,83,,percent of total billed charges,,,56.42,95,,percent of total billed charges,,,53.45,90,,percent of total billed charges,,,53.45,90,,percent of total billed charges,,,48.7,82,,percent of total billed charges,,,53.45,90,,percent of total billed charges,,,50.48,85,,percent of total billed charges,,44.78,56.42,
KCI PREVENA INCISION MANAGEMENT SYSTEM,30810079,CDM,,,270,RC,inpatient,,3217.5,3217.5,,2731.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2426,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2734.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2831.4,88,,percent of total billed charges,,,,,,,,,2458.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2927.93,91,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2670.53,83,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2638.35,82,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,2426,3056.63,
ULTRA MIST APPLICATOR,30810080,CDM,,,270,RC,inpatient,,378,378,,320.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,285.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,321.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,332.64,88,,percent of total billed charges,,,,,,,,,288.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,343.98,91,,percent of total billed charges,,,359.1,95,,percent of total billed charges,,,313.74,83,,percent of total billed charges,,,313.74,83,,percent of total billed charges,,,,,,,,,,,,,,,313.74,83,,percent of total billed charges,,,359.1,95,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,309.96,82,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,321.3,85,,percent of total billed charges,,285.01,359.1,
DRESSING PREVENA 13CM PEEL & PLACE,30810082,CDM,,,270,RC,inpatient,,1955.85,1955.85,,1660.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1474.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1662.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1721.15,88,,percent of total billed charges,,,,,,,,,1494.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1779.82,91,,percent of total billed charges,,,1858.06,95,,percent of total billed charges,,,1623.36,83,,percent of total billed charges,,,1623.36,83,,percent of total billed charges,,,,,,,,,,,,,,,1623.36,83,,percent of total billed charges,,,1858.06,95,,percent of total billed charges,,,1760.27,90,,percent of total billed charges,,,1760.27,90,,percent of total billed charges,,,1603.8,82,,percent of total billed charges,,,1760.27,90,,percent of total billed charges,,,1662.47,85,,percent of total billed charges,,1474.71,1858.06,
DRESSING PREVENA PLUS KIT,30810083,CDM,,,270,RC,inpatient,,2512.77,2512.77,,2133.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1894.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2135.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2211.24,88,,percent of total billed charges,,,,,,,,,1919.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2286.62,91,,percent of total billed charges,,,2387.13,95,,percent of total billed charges,,,2085.6,83,,percent of total billed charges,,,2085.6,83,,percent of total billed charges,,,,,,,,,,,,,,,2085.6,83,,percent of total billed charges,,,2387.13,95,,percent of total billed charges,,,2261.49,90,,percent of total billed charges,,,2261.49,90,,percent of total billed charges,,,2060.47,82,,percent of total billed charges,,,2261.49,90,,percent of total billed charges,,,2135.85,85,,percent of total billed charges,,1894.63,2387.13,
PREVENA PLUS SYSTEM KIT,30810084,CDM,,,270,RC,inpatient,,4225,4225,,3587.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3185.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3591.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3718,88,,percent of total billed charges,,,,,,,,,3227.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3844.75,91,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,,,,,,,,,,,,,3506.75,83,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3464.5,82,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,3185.65,4013.75,
*KCI HARVESTER 5CM X 5CM,30810085,CDM,,,270,RC,inpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1715.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1933.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,1715.35,2161.25,
*KCI HARVESTER EXTENSION STRAP,30810086,CDM,,,270,RC,inpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,197.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,197.93,249.38,
ACTICOAT FLEX 7 4 X5,30810088,CDM,,,270,RC,inpatient,,157.17,157.17,,133.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,118.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,133.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,138.31,88,,percent of total billed charges,,,,,,,,,120.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,143.02,91,,percent of total billed charges,,,149.31,95,,percent of total billed charges,,,130.45,83,,percent of total billed charges,,,130.45,83,,percent of total billed charges,,,,,,,,,,,,,,,130.45,83,,percent of total billed charges,,,149.31,95,,percent of total billed charges,,,141.45,90,,percent of total billed charges,,,141.45,90,,percent of total billed charges,,,128.88,82,,percent of total billed charges,,,141.45,90,,percent of total billed charges,,,133.59,85,,percent of total billed charges,,118.51,149.31,
DRESSING PICO 4  X 12,30810089,CDM,,,270,RC,inpatient,,1796.17,1796.17,,1524.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1354.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1526.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1580.63,88,,percent of total billed charges,,,,,,,,,1372.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1634.51,91,,percent of total billed charges,,,1706.36,95,,percent of total billed charges,,,1490.82,83,,percent of total billed charges,,,1490.82,83,,percent of total billed charges,,,,,,,,,,,,,,,1490.82,83,,percent of total billed charges,,,1706.36,95,,percent of total billed charges,,,1616.55,90,,percent of total billed charges,,,1616.55,90,,percent of total billed charges,,,1472.86,82,,percent of total billed charges,,,1616.55,90,,percent of total billed charges,,,1526.74,85,,percent of total billed charges,,1354.31,1706.36,
DRESSING PICO 6  X 8,30810090,CDM,,,270,RC,inpatient,,1894.64,1894.64,,1608.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1428.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1610.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1667.28,88,,percent of total billed charges,,,,,,,,,1447.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1724.12,91,,percent of total billed charges,,,1799.91,95,,percent of total billed charges,,,1572.55,83,,percent of total billed charges,,,1572.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1572.55,83,,percent of total billed charges,,,1799.91,95,,percent of total billed charges,,,1705.18,90,,percent of total billed charges,,,1705.18,90,,percent of total billed charges,,,1553.6,82,,percent of total billed charges,,,1705.18,90,,percent of total billed charges,,,1610.44,85,,percent of total billed charges,,1428.56,1799.91,
DRESSING PICO 8  X 8,30810091,CDM,,,270,RC,inpatient,,1697.63,1697.63,,1441.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1280.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1442.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1493.91,88,,percent of total billed charges,,,,,,,,,1296.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1544.84,91,,percent of total billed charges,,,1612.75,95,,percent of total billed charges,,,1409.03,83,,percent of total billed charges,,,1409.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1409.03,83,,percent of total billed charges,,,1612.75,95,,percent of total billed charges,,,1527.87,90,,percent of total billed charges,,,1527.87,90,,percent of total billed charges,,,1392.06,82,,percent of total billed charges,,,1527.87,90,,percent of total billed charges,,,1442.99,85,,percent of total billed charges,,1280.01,1612.75,
DRESSING ADAPTIC TOUCH 2X3,30810092,CDM,,,270,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DRESSING PICO 4  X 8,30810093,CDM,,,270,RC,inpatient,,1941.12,1941.12,,1648.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1463.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1649.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1708.19,88,,percent of total billed charges,,,,,,,,,1483.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1766.42,91,,percent of total billed charges,,,1844.06,95,,percent of total billed charges,,,1611.13,83,,percent of total billed charges,,,1611.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1611.13,83,,percent of total billed charges,,,1844.06,95,,percent of total billed charges,,,1747.01,90,,percent of total billed charges,,,1747.01,90,,percent of total billed charges,,,1591.72,82,,percent of total billed charges,,,1747.01,90,,percent of total billed charges,,,1649.95,85,,percent of total billed charges,,1463.6,1844.06,
RENASYS ADHESIVE GEL PATCH,30810094,CDM,,,270,RC,inpatient,,153.23,153.23,,130.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.84,88,,percent of total billed charges,,,,,,,,,117.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,139.44,91,,percent of total billed charges,,,145.57,95,,percent of total billed charges,,,127.18,83,,percent of total billed charges,,,127.18,83,,percent of total billed charges,,,,,,,,,,,,,,,127.18,83,,percent of total billed charges,,,145.57,95,,percent of total billed charges,,,137.91,90,,percent of total billed charges,,,137.91,90,,percent of total billed charges,,,125.65,82,,percent of total billed charges,,,137.91,90,,percent of total billed charges,,,130.25,85,,percent of total billed charges,,115.54,145.57,
DRESSING OASIS ULTRA TRI-LAYER 7 X 20CM,30810095,CDM,,,270,RC,inpatient,,11136.06,11136.06,,9454.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8396.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9465.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9799.73,88,,percent of total billed charges,,,,,,,,,8507.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10133.81,91,,percent of total billed charges,,,10579.26,95,,percent of total billed charges,,,9242.93,83,,percent of total billed charges,,,9242.93,83,,percent of total billed charges,,,,,,,,,,,,,,,9242.93,83,,percent of total billed charges,,,10579.26,95,,percent of total billed charges,,,10022.45,90,,percent of total billed charges,,,10022.45,90,,percent of total billed charges,,,9131.57,82,,percent of total billed charges,,,10022.45,90,,percent of total billed charges,,,9465.65,85,,percent of total billed charges,,8396.59,10579.26,
TRANSMETATURSAL AMPUTUTIM BOOT TCC-EZ,30810096,CDM,,,270,RC,inpatient,,630,630,,534.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,475.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,535.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,554.4,88,,percent of total billed charges,,,,,,,,,481.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,573.3,91,,percent of total billed charges,,,598.5,95,,percent of total billed charges,,,522.9,83,,percent of total billed charges,,,522.9,83,,percent of total billed charges,,,,,,,,,,,,,,,522.9,83,,percent of total billed charges,,,598.5,95,,percent of total billed charges,,,567,90,,percent of total billed charges,,,567,90,,percent of total billed charges,,,516.6,82,,percent of total billed charges,,,567,90,,percent of total billed charges,,,535.5,85,,percent of total billed charges,,475.02,598.5,
*KCI PREVENA CANISTER 45ML,30810097,CDM,,,270,RC,inpatient,,189.12,189.12,,160.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,142.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,160.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,166.43,88,,percent of total billed charges,,,,,,,,,144.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,172.1,91,,percent of total billed charges,,,179.66,95,,percent of total billed charges,,,156.97,83,,percent of total billed charges,,,156.97,83,,percent of total billed charges,,,,,,,,,,,,,,,156.97,83,,percent of total billed charges,,,179.66,95,,percent of total billed charges,,,170.21,90,,percent of total billed charges,,,170.21,90,,percent of total billed charges,,,155.08,82,,percent of total billed charges,,,170.21,90,,percent of total billed charges,,,160.75,85,,percent of total billed charges,,142.6,179.66,
DRESSING PICO 4  X 16,30810098,CDM,,,270,RC,inpatient,,1695.4,1695.4,,1439.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1278.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1441.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1491.95,88,,percent of total billed charges,,,,,,,,,1295.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1542.81,91,,percent of total billed charges,,,1610.63,95,,percent of total billed charges,,,1407.18,83,,percent of total billed charges,,,1407.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1407.18,83,,percent of total billed charges,,,1610.63,95,,percent of total billed charges,,,1525.86,90,,percent of total billed charges,,,1525.86,90,,percent of total billed charges,,,1390.23,82,,percent of total billed charges,,,1525.86,90,,percent of total billed charges,,,1441.09,85,,percent of total billed charges,,1278.33,1610.63,
STIMULEN POWDER 1 GR.,30810099,CDM,,,270,RC,inpatient,,87.72,87.72,,74.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.19,88,,percent of total billed charges,,,,,,,,,67.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,79.83,91,,percent of total billed charges,,,83.33,95,,percent of total billed charges,,,72.81,83,,percent of total billed charges,,,72.81,83,,percent of total billed charges,,,,,,,,,,,,,,,72.81,83,,percent of total billed charges,,,83.33,95,,percent of total billed charges,,,78.95,90,,percent of total billed charges,,,78.95,90,,percent of total billed charges,,,71.93,82,,percent of total billed charges,,,78.95,90,,percent of total billed charges,,,74.56,85,,percent of total billed charges,,66.14,83.33,
COBAN 2 LAYER SYSTEM COMPRESSION XL,30810100,CDM,,,270,RC,inpatient,,95.92,95.92,,81.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,72.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,81.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,84.41,88,,percent of total billed charges,,,,,,,,,73.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,87.29,91,,percent of total billed charges,,,91.12,95,,percent of total billed charges,,,79.61,83,,percent of total billed charges,,,79.61,83,,percent of total billed charges,,,,,,,,,,,,,,,79.61,83,,percent of total billed charges,,,91.12,95,,percent of total billed charges,,,86.33,90,,percent of total billed charges,,,86.33,90,,percent of total billed charges,,,78.65,82,,percent of total billed charges,,,86.33,90,,percent of total billed charges,,,81.53,85,,percent of total billed charges,,72.32,91.12,
PREVENA PLUS 125 THERAPY UNIT 14 DAY,30810101,CDM,,,270,RC,inpatient,,2940.8,2940.8,,2496.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2217.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2499.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2587.9,88,,percent of total billed charges,,,,,,,,,2246.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2676.13,91,,percent of total billed charges,,,2793.76,95,,percent of total billed charges,,,2440.86,83,,percent of total billed charges,,,2440.86,83,,percent of total billed charges,,,,,,,,,,,,,,,2440.86,83,,percent of total billed charges,,,2793.76,95,,percent of total billed charges,,,2646.72,90,,percent of total billed charges,,,2646.72,90,,percent of total billed charges,,,2411.46,82,,percent of total billed charges,,,2646.72,90,,percent of total billed charges,,,2499.68,85,,percent of total billed charges,,2217.36,2793.76,
DRESSING PICO 6  X 6,30810102,CDM,,,270,RC,inpatient,,1870.07,1870.07,,1587.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1410.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1589.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1645.66,88,,percent of total billed charges,,,,,,,,,1428.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1701.76,91,,percent of total billed charges,,,1776.57,95,,percent of total billed charges,,,1552.16,83,,percent of total billed charges,,,1552.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1552.16,83,,percent of total billed charges,,,1776.57,95,,percent of total billed charges,,,1683.06,90,,percent of total billed charges,,,1683.06,90,,percent of total billed charges,,,1533.46,82,,percent of total billed charges,,,1683.06,90,,percent of total billed charges,,,1589.56,85,,percent of total billed charges,,1410.03,1776.57,
KCI PREVENA CANISTER 150ML,30810103,CDM,,,270,RC,inpatient,,198.9,198.9,,168.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,169.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,175.03,88,,percent of total billed charges,,,,,,,,,151.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,181,91,,percent of total billed charges,,,188.96,95,,percent of total billed charges,,,165.09,83,,percent of total billed charges,,,165.09,83,,percent of total billed charges,,,,,,,,,,,,,,,165.09,83,,percent of total billed charges,,,188.96,95,,percent of total billed charges,,,179.01,90,,percent of total billed charges,,,179.01,90,,percent of total billed charges,,,163.1,82,,percent of total billed charges,,,179.01,90,,percent of total billed charges,,,169.07,85,,percent of total billed charges,,149.97,188.96,
DRESSING PICO MULTISITE 15 X 20CM,30810104,CDM,,,270,RC,inpatient,,1463.09,1463.09,,1242.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1103.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287.52,88,,percent of total billed charges,,,,,,,,,1117.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1331.41,91,,percent of total billed charges,,,1389.94,95,,percent of total billed charges,,,1214.36,83,,percent of total billed charges,,,1214.36,83,,percent of total billed charges,,,,,,,,,,,,,,,1214.36,83,,percent of total billed charges,,,1389.94,95,,percent of total billed charges,,,1316.78,90,,percent of total billed charges,,,1316.78,90,,percent of total billed charges,,,1199.73,82,,percent of total billed charges,,,1316.78,90,,percent of total billed charges,,,1243.63,85,,percent of total billed charges,,1103.17,1389.94,
DRESSING OASIS WOUND MATRIX 5X7CM,30810105,CDM,,,270,RC,inpatient,,2088.06,2088.06,,1772.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1574.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1774.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1837.49,88,,percent of total billed charges,,,,,,,,,1595.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1900.13,91,,percent of total billed charges,,,1983.66,95,,percent of total billed charges,,,1733.09,83,,percent of total billed charges,,,1733.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1733.09,83,,percent of total billed charges,,,1983.66,95,,percent of total billed charges,,,1879.25,90,,percent of total billed charges,,,1879.25,90,,percent of total billed charges,,,1712.21,82,,percent of total billed charges,,,1879.25,90,,percent of total billed charges,,,1774.85,85,,percent of total billed charges,,1574.4,1983.66,
DRESSING PICO 6  X 12,30810106,CDM,,,270,RC,inpatient,,1463.04,1463.04,,1242.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1103.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287.48,88,,percent of total billed charges,,,,,,,,,1117.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1331.37,91,,percent of total billed charges,,,1389.89,95,,percent of total billed charges,,,1214.32,83,,percent of total billed charges,,,1214.32,83,,percent of total billed charges,,,,,,,,,,,,,,,1214.32,83,,percent of total billed charges,,,1389.89,95,,percent of total billed charges,,,1316.74,90,,percent of total billed charges,,,1316.74,90,,percent of total billed charges,,,1199.69,82,,percent of total billed charges,,,1316.74,90,,percent of total billed charges,,,1243.58,85,,percent of total billed charges,,1103.13,1389.89,
PLUROGEL BURN & WOUND DRESSING 1.75OZ,30810108,CDM,,,270,RC,inpatient,,648.9,648.9,,550.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,489.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,551.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,571.03,88,,percent of total billed charges,,,,,,,,,495.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,590.5,91,,percent of total billed charges,,,616.46,95,,percent of total billed charges,,,538.59,83,,percent of total billed charges,,,538.59,83,,percent of total billed charges,,,,,,,,,,,,,,,538.59,83,,percent of total billed charges,,,616.46,95,,percent of total billed charges,,,584.01,90,,percent of total billed charges,,,584.01,90,,percent of total billed charges,,,532.1,82,,percent of total billed charges,,,584.01,90,,percent of total billed charges,,,551.57,85,,percent of total billed charges,,489.27,616.46,
DRESSING POLYMEM MAX 4.5X4.5,30810110,CDM,,,270,RC,inpatient,,42.75,42.75,,36.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37.62,88,,percent of total billed charges,,,,,,,,,32.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38.9,91,,percent of total billed charges,,,40.61,95,,percent of total billed charges,,,35.48,83,,percent of total billed charges,,,35.48,83,,percent of total billed charges,,,,,,,,,,,,,,,35.48,83,,percent of total billed charges,,,40.61,95,,percent of total billed charges,,,38.48,90,,percent of total billed charges,,,38.48,90,,percent of total billed charges,,,35.06,82,,percent of total billed charges,,,38.48,90,,percent of total billed charges,,,36.34,85,,percent of total billed charges,,32.23,40.61,
DRESSING POLYMEM MAX 8 X8,30810111,CDM,,,270,RC,inpatient,,109.7,109.7,,93.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,93.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,96.54,88,,percent of total billed charges,,,,,,,,,83.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.83,91,,percent of total billed charges,,,104.22,95,,percent of total billed charges,,,91.05,83,,percent of total billed charges,,,91.05,83,,percent of total billed charges,,,,,,,,,,,,,,,91.05,83,,percent of total billed charges,,,104.22,95,,percent of total billed charges,,,98.73,90,,percent of total billed charges,,,98.73,90,,percent of total billed charges,,,89.95,82,,percent of total billed charges,,,98.73,90,,percent of total billed charges,,,93.25,85,,percent of total billed charges,,82.71,104.22,
DRESSING POLYMEM WIC 3X3,30810112,CDM,,,270,RC,inpatient,,38.25,38.25,,32.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33.66,88,,percent of total billed charges,,,,,,,,,29.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.81,91,,percent of total billed charges,,,36.34,95,,percent of total billed charges,,,31.75,83,,percent of total billed charges,,,31.75,83,,percent of total billed charges,,,,,,,,,,,,,,,31.75,83,,percent of total billed charges,,,36.34,95,,percent of total billed charges,,,34.43,90,,percent of total billed charges,,,34.43,90,,percent of total billed charges,,,31.37,82,,percent of total billed charges,,,34.43,90,,percent of total billed charges,,,32.51,85,,percent of total billed charges,,28.84,36.34,
TRIAD HYDROPHILIC WOUND PASTE,30810113,CDM,,,270,RC,inpatient,,71.32,71.32,,60.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.76,88,,percent of total billed charges,,,,,,,,,54.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.9,91,,percent of total billed charges,,,67.75,95,,percent of total billed charges,,,59.2,83,,percent of total billed charges,,,59.2,83,,percent of total billed charges,,,,,,,,,,,,,,,59.2,83,,percent of total billed charges,,,67.75,95,,percent of total billed charges,,,64.19,90,,percent of total billed charges,,,64.19,90,,percent of total billed charges,,,58.48,82,,percent of total billed charges,,,64.19,90,,percent of total billed charges,,,60.62,85,,percent of total billed charges,,53.78,67.75,
DRESSING MEPITEL SAFETAC 8X12IN,30810115,CDM,,,270,RC,inpatient,,191.73,191.73,,162.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.72,88,,percent of total billed charges,,,,,,,,,146.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.47,91,,percent of total billed charges,,,182.14,95,,percent of total billed charges,,,159.14,83,,percent of total billed charges,,,159.14,83,,percent of total billed charges,,,,,,,,,,,,,,,159.14,83,,percent of total billed charges,,,182.14,95,,percent of total billed charges,,,172.56,90,,percent of total billed charges,,,172.56,90,,percent of total billed charges,,,157.22,82,,percent of total billed charges,,,172.56,90,,percent of total billed charges,,,162.97,85,,percent of total billed charges,,144.56,182.14,
DRESSING POLYMEM WIC SILVER ROPE 14,30810117,CDM,,,270,RC,inpatient,,113.84,113.84,,96.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,100.18,88,,percent of total billed charges,,,,,,,,,86.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,103.59,91,,percent of total billed charges,,,108.15,95,,percent of total billed charges,,,94.49,83,,percent of total billed charges,,,94.49,83,,percent of total billed charges,,,,,,,,,,,,,,,94.49,83,,percent of total billed charges,,,108.15,95,,percent of total billed charges,,,102.46,90,,percent of total billed charges,,,102.46,90,,percent of total billed charges,,,93.35,82,,percent of total billed charges,,,102.46,90,,percent of total billed charges,,,96.76,85,,percent of total billed charges,,85.84,108.15,
DRESSING POLYMEM #3 OVAL,30810118,CDM,,,270,RC,inpatient,,24.12,24.12,,20.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.23,88,,percent of total billed charges,,,,,,,,,18.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.95,91,,percent of total billed charges,,,22.91,95,,percent of total billed charges,,,20.02,83,,percent of total billed charges,,,20.02,83,,percent of total billed charges,,,,,,,,,,,,,,,20.02,83,,percent of total billed charges,,,22.91,95,,percent of total billed charges,,,21.71,90,,percent of total billed charges,,,21.71,90,,percent of total billed charges,,,19.78,82,,percent of total billed charges,,,21.71,90,,percent of total billed charges,,,20.5,85,,percent of total billed charges,,18.19,22.91,
DRESSING AQUACEL EXTRA 6X6,30810119,CDM,,,270,RC,inpatient,,58.02,58.02,,49.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.06,88,,percent of total billed charges,,,,,,,,,44.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52.8,91,,percent of total billed charges,,,55.12,95,,percent of total billed charges,,,48.16,83,,percent of total billed charges,,,48.16,83,,percent of total billed charges,,,,,,,,,,,,,,,48.16,83,,percent of total billed charges,,,55.12,95,,percent of total billed charges,,,52.22,90,,percent of total billed charges,,,52.22,90,,percent of total billed charges,,,47.58,82,,percent of total billed charges,,,52.22,90,,percent of total billed charges,,,49.32,85,,percent of total billed charges,,43.75,55.12,
DRESSING AQUACEL EXTRA 4X5,30810120,CDM,,,270,RC,inpatient,,28.44,28.44,,24.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.03,88,,percent of total billed charges,,,,,,,,,21.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.88,91,,percent of total billed charges,,,27.02,95,,percent of total billed charges,,,23.61,83,,percent of total billed charges,,,23.61,83,,percent of total billed charges,,,,,,,,,,,,,,,23.61,83,,percent of total billed charges,,,27.02,95,,percent of total billed charges,,,25.6,90,,percent of total billed charges,,,25.6,90,,percent of total billed charges,,,23.32,82,,percent of total billed charges,,,25.6,90,,percent of total billed charges,,,24.17,85,,percent of total billed charges,,21.44,27.02,
DRESSING AQUACEL AG 6X6,30810121,CDM,,,270,RC,inpatient,,159.09,159.09,,135.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,135.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,140,88,,percent of total billed charges,,,,,,,,,121.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,144.77,91,,percent of total billed charges,,,151.14,95,,percent of total billed charges,,,132.04,83,,percent of total billed charges,,,132.04,83,,percent of total billed charges,,,,,,,,,,,,,,,132.04,83,,percent of total billed charges,,,151.14,95,,percent of total billed charges,,,143.18,90,,percent of total billed charges,,,143.18,90,,percent of total billed charges,,,130.45,82,,percent of total billed charges,,,143.18,90,,percent of total billed charges,,,135.23,85,,percent of total billed charges,,119.95,151.14,
DRESSING AQUACEL AG 4X5,30810122,CDM,,,270,RC,inpatient,,75.12,75.12,,63.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,63.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66.11,88,,percent of total billed charges,,,,,,,,,57.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,68.36,91,,percent of total billed charges,,,71.36,95,,percent of total billed charges,,,62.35,83,,percent of total billed charges,,,62.35,83,,percent of total billed charges,,,,,,,,,,,,,,,62.35,83,,percent of total billed charges,,,71.36,95,,percent of total billed charges,,,67.61,90,,percent of total billed charges,,,67.61,90,,percent of total billed charges,,,61.6,82,,percent of total billed charges,,,67.61,90,,percent of total billed charges,,,63.85,85,,percent of total billed charges,,56.64,71.36,
DRESSING AQUACEL AG .75X18,30810123,CDM,,,270,RC,inpatient,,83.15,83.15,,70.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.17,88,,percent of total billed charges,,,,,,,,,63.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.67,91,,percent of total billed charges,,,78.99,95,,percent of total billed charges,,,69.01,83,,percent of total billed charges,,,69.01,83,,percent of total billed charges,,,,,,,,,,,,,,,69.01,83,,percent of total billed charges,,,78.99,95,,percent of total billed charges,,,74.84,90,,percent of total billed charges,,,74.84,90,,percent of total billed charges,,,68.18,82,,percent of total billed charges,,,74.84,90,,percent of total billed charges,,,70.68,85,,percent of total billed charges,,62.7,78.99,
DRESSING CONVAMAX 10X10CM SUPERABSORBER,30810124,CDM,,,270,RC,inpatient,,17.8,17.8,,15.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.66,88,,percent of total billed charges,,,,,,,,,13.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.2,91,,percent of total billed charges,,,16.91,95,,percent of total billed charges,,,14.77,83,,percent of total billed charges,,,14.77,83,,percent of total billed charges,,,,,,,,,,,,,,,14.77,83,,percent of total billed charges,,,16.91,95,,percent of total billed charges,,,16.02,90,,percent of total billed charges,,,16.02,90,,percent of total billed charges,,,14.6,82,,percent of total billed charges,,,16.02,90,,percent of total billed charges,,,15.13,85,,percent of total billed charges,,13.42,16.91,
COBAN 2 LAYER LITE COMPRESSION THERAPY,30813699,CDM,,,270,RC,inpatient,,83.25,83.25,,70.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.26,88,,percent of total billed charges,,,,,,,,,63.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.76,91,,percent of total billed charges,,,79.09,95,,percent of total billed charges,,,69.1,83,,percent of total billed charges,,,69.1,83,,percent of total billed charges,,,,,,,,,,,,,,,69.1,83,,percent of total billed charges,,,79.09,95,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,68.27,82,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,70.76,85,,percent of total billed charges,,62.77,79.09,
COBAN 2 LAYER SYSTEM COMPRESSION,30813700,CDM,,,270,RC,inpatient,,84.97,84.97,,72.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,72.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.77,88,,percent of total billed charges,,,,,,,,,64.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,77.32,91,,percent of total billed charges,,,80.72,95,,percent of total billed charges,,,70.53,83,,percent of total billed charges,,,70.53,83,,percent of total billed charges,,,,,,,,,,,,,,,70.53,83,,percent of total billed charges,,,80.72,95,,percent of total billed charges,,,76.47,90,,percent of total billed charges,,,76.47,90,,percent of total billed charges,,,69.68,82,,percent of total billed charges,,,76.47,90,,percent of total billed charges,,,72.22,85,,percent of total billed charges,,64.07,80.72,
* DIETARY CONSULTATION (V0406),5220032,CDM,99211,CPT,942,RC,inpatient,,91,91,,77.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.08,88,,percent of total billed charges,,,,,,,,,69.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,,,,,,,,,,,,,75.53,83,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,74.62,82,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,68.61,86.45,
O/P CONSULT DIABETIC NUTRITION 30 MIN,5220035,CDM,G0108,HCPCS,510,RC,inpatient,,182,182,,154.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,154.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,160.16,88,,percent of total billed charges,,,,,,,,,139.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,149.24,82,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,137.23,172.9,
MNT-RE-ASSESSMENT/INTERVENTION 15 MIN,5220040,CDM,97803,CPT,942,RC,inpatient,,95,95,,80.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,83.6,88,,percent of total billed charges,,,,,,,,,72.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,,,,,,,,,,,,,78.85,83,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,77.9,82,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,71.63,90.25,
MNT-INIT ASSESSMENT/INTERVENTION 15 MIN,5220045,CDM,97802,CPT,942,RC,inpatient,,255,255,,216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,192.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,216.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,224.4,88,,percent of total billed charges,,,,,,,,,194.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,209.1,82,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,192.27,242.25,
* DIETARY ASSESSMENT (V0306),52999995,CDM,,,942,RC,inpatient,,32,32,,27.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28.16,88,,percent of total billed charges,,,,,,,,,24.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,,,,,,,,,,,,,26.56,83,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,26.24,82,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,24.13,30.4,
STRESS TEST,12801639,CDM,93017,CPT,482,RC,inpatient,,1671,1671,,1418.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1259.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1420.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1470.48,88,,percent of total billed charges,,,,,,,,,1276.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1520.61,91,,percent of total billed charges,,,1587.45,95,,percent of total billed charges,,,1386.93,83,,percent of total billed charges,,,1386.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1386.93,83,,percent of total billed charges,,,1587.45,95,,percent of total billed charges,,,1503.9,90,,percent of total billed charges,,,1503.9,90,,percent of total billed charges,,,1370.22,82,,percent of total billed charges,,,1503.9,90,,percent of total billed charges,,,1420.35,85,,percent of total billed charges,,1259.93,1587.45,
X RHC ECG TRACING ONLY,14800001,CDM,93005,CPT,730,RC,inpatient,,140,140,,118.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,105.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,119,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,123.2,88,,percent of total billed charges,,,,,,,,,106.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,133,95,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,114.8,82,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,105.56,133,
EVENT MONITOR HOOK-UP,14800276,CDM,93270,CPT,731,RC,inpatient,,870,870,,738.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,655.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,739.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,765.6,88,,percent of total billed charges,,,,,,,,,664.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,791.7,91,,percent of total billed charges,,,826.5,95,,percent of total billed charges,,,722.1,83,,percent of total billed charges,,,722.1,83,,percent of total billed charges,,,,,,,,,,,,,,,722.1,83,,percent of total billed charges,,,826.5,95,,percent of total billed charges,,,783,90,,percent of total billed charges,,,783,90,,percent of total billed charges,,,713.4,82,,percent of total billed charges,,,783,90,,percent of total billed charges,,,739.5,85,,percent of total billed charges,,655.98,826.5,
PAXT EKG 12 LEADS WITH INTERP,14800300,CDM,93000,CPT,730,RC,inpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,198.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,198.3,249.85,
PAXT EKG TRACING,14800305,CDM,93005,CPT,730,RC,inpatient,,480,480,,407.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,361.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,408,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,422.4,88,,percent of total billed charges,,,,,,,,,366.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,436.8,91,,percent of total billed charges,,,456,95,,percent of total billed charges,,,398.4,83,,percent of total billed charges,,,398.4,83,,percent of total billed charges,,,,,,,,,,,,,,,398.4,83,,percent of total billed charges,,,456,95,,percent of total billed charges,,,432,90,,percent of total billed charges,,,432,90,,percent of total billed charges,,,393.6,82,,percent of total billed charges,,,432,90,,percent of total billed charges,,,408,85,,percent of total billed charges,,361.92,456,
ZIO XT PATCH PLACEMENT 48 HOURS-7 DAYS,14800400,CDM,93243,CPT,731,RC,inpatient,,677,677,,574.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,510.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,575.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,595.76,88,,percent of total billed charges,,,,,,,,,517.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,616.07,91,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,,,,,,,,,,,,,561.91,83,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,555.14,82,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,575.45,85,,percent of total billed charges,,510.46,643.15,
ZIO XT PATCH PLACEMENT 7 DAYS UP TO 15,14800403,CDM,93247,CPT,731,RC,inpatient,,677,677,,574.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,510.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,575.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,595.76,88,,percent of total billed charges,,,,,,,,,517.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,616.07,91,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,,,,,,,,,,,,,561.91,83,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,555.14,82,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,575.45,85,,percent of total billed charges,,510.46,643.15,
ZIO XT PATCH PLCMENT 48 HOURS-7 DAYS IN,14800405,CDM,93242,CPT,731,RC,inpatient,,677,677,,574.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,510.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,575.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,595.76,88,,percent of total billed charges,,,,,,,,,517.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,616.07,91,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,,,,,,,,,,,,,561.91,83,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,555.14,82,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,575.45,85,,percent of total billed charges,,510.46,643.15,
ZIO XT PATCH PLCMT 7 DAYS UP TO 15 IN,14800406,CDM,93246,CPT,731,RC,inpatient,,677,677,,574.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,510.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,575.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,595.76,88,,percent of total billed charges,,,,,,,,,517.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,616.07,91,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,,,,,,,,,,,,,561.91,83,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,555.14,82,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,575.45,85,,percent of total billed charges,,510.46,643.15,
EEG COMA OR SLEEP ONLY,14801590,CDM,95822,CPT,740,RC,inpatient,TC,1881,1881,,1596.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1418.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1598.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1655.28,88,,percent of total billed charges,,,,,,,,,1437.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1711.71,91,,percent of total billed charges,,,1786.95,95,,percent of total billed charges,,,1561.23,83,,percent of total billed charges,,,1561.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1561.23,83,,percent of total billed charges,,,1786.95,95,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1542.42,82,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1598.85,85,,percent of total billed charges,,1418.27,1786.95,
EEG AWAKE AND DROWSY,14801591,CDM,95816,CPT,740,RC,inpatient,,2259,2259,,1917.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1703.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1920.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1987.92,88,,percent of total billed charges,,,,,,,,,1725.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2055.69,91,,percent of total billed charges,,,2146.05,95,,percent of total billed charges,,,1874.97,83,,percent of total billed charges,,,1874.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1874.97,83,,percent of total billed charges,,,2146.05,95,,percent of total billed charges,,,2033.1,90,,percent of total billed charges,,,2033.1,90,,percent of total billed charges,,,1852.38,82,,percent of total billed charges,,,2033.1,90,,percent of total billed charges,,,1920.15,85,,percent of total billed charges,,1703.29,2146.05,
EEG EXTENDED MONITORING 61-119 MINUTES,14801593,CDM,95813,CPT,740,RC,inpatient,TC,2332,2332,,1979.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1758.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1982.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2052.16,88,,percent of total billed charges,,,,,,,,,1781.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2122.12,91,,percent of total billed charges,,,2215.4,95,,percent of total billed charges,,,1935.56,83,,percent of total billed charges,,,1935.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1935.56,83,,percent of total billed charges,,,2215.4,95,,percent of total billed charges,,,2098.8,90,,percent of total billed charges,,,2098.8,90,,percent of total billed charges,,,1912.24,82,,percent of total billed charges,,,2098.8,90,,percent of total billed charges,,,1982.2,85,,percent of total billed charges,,1758.33,2215.4,
EEG EXTENDED MONITORING 41-60 MINUTES,14801594,CDM,95812,CPT,740,RC,inpatient,TC,1881,1881,,1596.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1418.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1598.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1655.28,88,,percent of total billed charges,,,,,,,,,1437.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1711.71,91,,percent of total billed charges,,,1786.95,95,,percent of total billed charges,,,1561.23,83,,percent of total billed charges,,,1561.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1561.23,83,,percent of total billed charges,,,1786.95,95,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1542.42,82,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1598.85,85,,percent of total billed charges,,1418.27,1786.95,
ELECTROCARDIOGRAM COMPLETE,14801595,CDM,93000,CPT,730,RC,inpatient,,572,572,,485.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,431.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,486.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,503.36,88,,percent of total billed charges,,,,,,,,,437.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,520.52,91,,percent of total billed charges,,,543.4,95,,percent of total billed charges,,,474.76,83,,percent of total billed charges,,,474.76,83,,percent of total billed charges,,,,,,,,,,,,,,,474.76,83,,percent of total billed charges,,,543.4,95,,percent of total billed charges,,,514.8,90,,percent of total billed charges,,,514.8,90,,percent of total billed charges,,,469.04,82,,percent of total billed charges,,,514.8,90,,percent of total billed charges,,,486.2,85,,percent of total billed charges,,431.29,543.4,
EKG,14801597,CDM,93005,CPT,730,RC,inpatient,XP,495,495,,420.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,373.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,420.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,435.6,88,,percent of total billed charges,,,,,,,,,378.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,450.45,91,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,,,,,,,,,,,,,410.85,83,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,405.9,82,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,373.23,470.25,
CLINICS EKG,14801598,CDM,93000,CPT,730,RC,inpatient,,573,573,,486.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,432.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,487.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,504.24,88,,percent of total billed charges,,,,,,,,,437.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,521.43,91,,percent of total billed charges,,,544.35,95,,percent of total billed charges,,,475.59,83,,percent of total billed charges,,,475.59,83,,percent of total billed charges,,,,,,,,,,,,,,,475.59,83,,percent of total billed charges,,,544.35,95,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,469.86,82,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,487.05,85,,percent of total billed charges,,432.04,544.35,
EKG PAXTON MCR INITIAL PREVET EXAM,14801599,CDM,G0404,HCPCS,730,RC,inpatient,,573,573,,486.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,432.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,487.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,504.24,88,,percent of total billed charges,,,,,,,,,437.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,521.43,91,,percent of total billed charges,,,544.35,95,,percent of total billed charges,,,475.59,83,,percent of total billed charges,,,475.59,83,,percent of total billed charges,,,,,,,,,,,,,,,475.59,83,,percent of total billed charges,,,544.35,95,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,469.86,82,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,487.05,85,,percent of total billed charges,,432.04,544.35,
X RHC NDX HEART RATE VARIABILITY,14801600,CDM,95921,CPT,740,RC,inpatient,TC,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,89.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,79.17,99.75,
X RHC NDX HEART RATE VARIABILITY,14801601,CDM,95921,CPT,740,RC,inpatient,TC,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
RHYTHM STRIP,14801613,CDM,93041,CPT,730,RC,inpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,135.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,135.72,171,
HOLTER MONITOR SET UP AND RECORDING,14801622,CDM,93225,CPT,731,RC,inpatient,,870,870,,738.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,655.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,739.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,765.6,88,,percent of total billed charges,,,,,,,,,664.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,791.7,91,,percent of total billed charges,,,826.5,95,,percent of total billed charges,,,722.1,83,,percent of total billed charges,,,722.1,83,,percent of total billed charges,,,,,,,,,,,,,,,722.1,83,,percent of total billed charges,,,826.5,95,,percent of total billed charges,,,783,90,,percent of total billed charges,,,783,90,,percent of total billed charges,,,713.4,82,,percent of total billed charges,,,783,90,,percent of total billed charges,,,739.5,85,,percent of total billed charges,,655.98,826.5,
HOLTER MONITOR SCANNING,14801623,CDM,93226,CPT,731,RC,inpatient,,1031,1031,,875.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,777.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,876.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,907.28,88,,percent of total billed charges,,,,,,,,,787.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,938.21,91,,percent of total billed charges,,,979.45,95,,percent of total billed charges,,,855.73,83,,percent of total billed charges,,,855.73,83,,percent of total billed charges,,,,,,,,,,,,,,,855.73,83,,percent of total billed charges,,,979.45,95,,percent of total billed charges,,,927.9,90,,percent of total billed charges,,,927.9,90,,percent of total billed charges,,,845.42,82,,percent of total billed charges,,,927.9,90,,percent of total billed charges,,,876.35,85,,percent of total billed charges,,777.37,979.45,
*EKG- THOPIAH(V-8-17),14801625,CDM,93005,CPT,730,RC,inpatient,,495,495,,420.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,373.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,420.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,435.6,88,,percent of total billed charges,,,,,,,,,378.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,450.45,91,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,,,,,,,,,,,,,410.85,83,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,405.9,82,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,373.23,470.25,
*INTERPRETATION OF EKG THOPIAH(V-8-17),14801626,CDM,93010,CPT,730,RC,inpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,58.81,74.1,
TILT TABLE TEST,14900001,CDM,93660,CPT,480,RC,inpatient,TC,3552,3552,,3015.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2678.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3019.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3125.76,88,,percent of total billed charges,,,,,,,,,2713.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3232.32,91,,percent of total billed charges,,,3374.4,95,,percent of total billed charges,,,2948.16,83,,percent of total billed charges,,,2948.16,83,,percent of total billed charges,,,,,,,,,,,,,,,2948.16,83,,percent of total billed charges,,,3374.4,95,,percent of total billed charges,,,3196.8,90,,percent of total billed charges,,,3196.8,90,,percent of total billed charges,,,2912.64,82,,percent of total billed charges,,,3196.8,90,,percent of total billed charges,,,3019.2,85,,percent of total billed charges,,2678.21,3374.4,
PRO FEE TILT TABLE,14900002,CDM,93660,CPT,480,RC,inpatient,26,515,515,,437.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,388.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,437.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,453.2,88,,percent of total billed charges,,,,,,,,,393.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,468.65,91,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,,,,,,,,,,,,,427.45,83,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,422.3,82,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,388.31,489.25,
CLSED TREATMENT SHAFT FRACTURE EA,2050701,CDM,26725,CPT,450,RC,inpatient,,977,977,,829.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,736.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,830.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,859.76,88,,percent of total billed charges,,,,,,,,,746.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,889.07,91,,percent of total billed charges,,,928.15,95,,percent of total billed charges,,,810.91,83,,percent of total billed charges,,,810.91,83,,percent of total billed charges,,,,,,,,,,,,,,,810.91,83,,percent of total billed charges,,,928.15,95,,percent of total billed charges,,,879.3,90,,percent of total billed charges,,,879.3,90,,percent of total billed charges,,,801.14,82,,percent of total billed charges,,,879.3,90,,percent of total billed charges,,,830.45,85,,percent of total billed charges,,736.66,928.15,
FF MONITORING PRESSURE COMPART SYNDROME,18601170,CDM,20950,CPT,361,RC,inpatient,,874,874,,742.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,659,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,742.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,769.12,88,,percent of total billed charges,,,,,,,,,667.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,795.34,91,,percent of total billed charges,,,830.3,95,,percent of total billed charges,,,725.42,83,,percent of total billed charges,,,725.42,83,,percent of total billed charges,,,,,,,,,,,,,,,725.42,83,,percent of total billed charges,,,830.3,95,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,716.68,82,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,742.9,85,,percent of total billed charges,,659,830.3,
* GOWNS ER IV (V0306),20310037,CDM,,,270,RC,inpatient,,25,25,,21.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22,88,,percent of total billed charges,,,,,,,,,19.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.75,91,,percent of total billed charges,,,23.75,95,,percent of total billed charges,,,20.75,83,,percent of total billed charges,,,20.75,83,,percent of total billed charges,,,,,,,,,,,,,,,20.75,83,,percent of total billed charges,,,23.75,95,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,20.5,82,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,21.25,85,,percent of total billed charges,,18.85,23.75,
PF CLOSED REDUCTION FINGER WO ANEST,20400112,CDM,26775,CPT,450,RC,inpatient,,484,484,,410.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,364.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,411.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,425.92,88,,percent of total billed charges,,,,,,,,,369.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,440.44,91,,percent of total billed charges,,,459.8,95,,percent of total billed charges,,,401.72,83,,percent of total billed charges,,,401.72,83,,percent of total billed charges,,,,,,,,,,,,,,,401.72,83,,percent of total billed charges,,,459.8,95,,percent of total billed charges,,,435.6,90,,percent of total billed charges,,,435.6,90,,percent of total billed charges,,,396.88,82,,percent of total billed charges,,,435.6,90,,percent of total billed charges,,,411.4,85,,percent of total billed charges,,364.94,459.8,
FF CLOSED TRTMT HIP DISLTN W ANESTHESIA,20500100,CDM,27252,CPT,450,RC,inpatient,,10960,10960,,9305.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8263.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9316,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9644.8,88,,percent of total billed charges,,,,,,,,,8373.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9973.6,91,,percent of total billed charges,,,10412,95,,percent of total billed charges,,,9096.8,83,,percent of total billed charges,,,9096.8,83,,percent of total billed charges,,,,,,,,,,,,,,,9096.8,83,,percent of total billed charges,,,10412,95,,percent of total billed charges,,,9864,90,,percent of total billed charges,,,9864,90,,percent of total billed charges,,,8987.2,82,,percent of total billed charges,,,9864,90,,percent of total billed charges,,,9316,85,,percent of total billed charges,,8263.84,10412,
FF CLOSED TRTMT HIP DISLTN W ANETH,20500101,CDM,27252,CPT,450,RC,inpatient,,10960,10960,,9305.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8263.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9316,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9644.8,88,,percent of total billed charges,,,,,,,,,8373.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9973.6,91,,percent of total billed charges,,,10412,95,,percent of total billed charges,,,9096.8,83,,percent of total billed charges,,,9096.8,83,,percent of total billed charges,,,,,,,,,,,,,,,9096.8,83,,percent of total billed charges,,,10412,95,,percent of total billed charges,,,9864,90,,percent of total billed charges,,,9864,90,,percent of total billed charges,,,8987.2,82,,percent of total billed charges,,,9864,90,,percent of total billed charges,,,9316,85,,percent of total billed charges,,8263.84,10412,
FF INJECTION INTO HEMORRHOID,20500102,CDM,46500,CPT,450,RC,inpatient,,5305,5305,,4503.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3999.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4509.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4668.4,88,,percent of total billed charges,,,,,,,,,4053.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4827.55,91,,percent of total billed charges,,,5039.75,95,,percent of total billed charges,,,4403.15,83,,percent of total billed charges,,,4403.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4403.15,83,,percent of total billed charges,,,5039.75,95,,percent of total billed charges,,,4774.5,90,,percent of total billed charges,,,4774.5,90,,percent of total billed charges,,,4350.1,82,,percent of total billed charges,,,4774.5,90,,percent of total billed charges,,,4509.25,85,,percent of total billed charges,,3999.97,5039.75,
FF WOUND DEBRIDE OF SOFT TISSUE EACH ADD,20500103,CDM,11045,CPT,450,RC,inpatient,,1514,1514,,1285.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1141.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1286.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1332.32,88,,percent of total billed charges,,,,,,,,,1156.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1377.74,91,,percent of total billed charges,,,1438.3,95,,percent of total billed charges,,,1256.62,83,,percent of total billed charges,,,1256.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1256.62,83,,percent of total billed charges,,,1438.3,95,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1241.48,82,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1286.9,85,,percent of total billed charges,,1141.56,1438.3,
FF CLOSED TREATMENT NURSEMAID ELBOW,20500104,CDM,24640,CPT,450,RC,inpatient,,1171,1171,,994.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,882.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,995.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1030.48,88,,percent of total billed charges,,,,,,,,,894.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1065.61,91,,percent of total billed charges,,,1112.45,95,,percent of total billed charges,,,971.93,83,,percent of total billed charges,,,971.93,83,,percent of total billed charges,,,,,,,,,,,,,,,971.93,83,,percent of total billed charges,,,1112.45,95,,percent of total billed charges,,,1053.9,90,,percent of total billed charges,,,1053.9,90,,percent of total billed charges,,,960.22,82,,percent of total billed charges,,,1053.9,90,,percent of total billed charges,,,995.35,85,,percent of total billed charges,,882.93,1112.45,
FF CLOSED REDUCTION CLAVICLE WO ANEST,20500105,CDM,23505,CPT,450,RC,inpatient,,1550,1550,,1315.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1168.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1317.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1364,88,,percent of total billed charges,,,,,,,,,1184.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1410.5,91,,percent of total billed charges,,,1472.5,95,,percent of total billed charges,,,1286.5,83,,percent of total billed charges,,,1286.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1286.5,83,,percent of total billed charges,,,1472.5,95,,percent of total billed charges,,,1395,90,,percent of total billed charges,,,1395,90,,percent of total billed charges,,,1271,82,,percent of total billed charges,,,1395,90,,percent of total billed charges,,,1317.5,85,,percent of total billed charges,,1168.7,1472.5,
FF APPLICATION OF LONG LEG CAST,20500106,CDM,29345,CPT,450,RC,inpatient,,1132,1132,,961.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,853.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,962.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,996.16,88,,percent of total billed charges,,,,,,,,,864.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1030.12,91,,percent of total billed charges,,,1075.4,95,,percent of total billed charges,,,939.56,83,,percent of total billed charges,,,939.56,83,,percent of total billed charges,,,,,,,,,,,,,,,939.56,83,,percent of total billed charges,,,1075.4,95,,percent of total billed charges,,,1018.8,90,,percent of total billed charges,,,1018.8,90,,percent of total billed charges,,,928.24,82,,percent of total billed charges,,,1018.8,90,,percent of total billed charges,,,962.2,85,,percent of total billed charges,,853.53,1075.4,
FF CLOSED REDUCTION FIBULA WO ANEST,20500107,CDM,27781,CPT,450,RC,inpatient,,5667,5667,,4811.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4272.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4816.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4986.96,88,,percent of total billed charges,,,,,,,,,4329.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5156.97,91,,percent of total billed charges,,,5383.65,95,,percent of total billed charges,,,4703.61,83,,percent of total billed charges,,,4703.61,83,,percent of total billed charges,,,,,,,,,,,,,,,4703.61,83,,percent of total billed charges,,,5383.65,95,,percent of total billed charges,,,5100.3,90,,percent of total billed charges,,,5100.3,90,,percent of total billed charges,,,4646.94,82,,percent of total billed charges,,,5100.3,90,,percent of total billed charges,,,4816.95,85,,percent of total billed charges,,4272.92,5383.65,
FF CLOSED REDUCTION TIBIA W/O ANESTHESIA,20500108,CDM,27532,CPT,450,RC,inpatient,,10001,10001,,8490.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7540.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8500.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8800.88,88,,percent of total billed charges,,,,,,,,,7640.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9100.91,91,,percent of total billed charges,,,9500.95,95,,percent of total billed charges,,,8300.83,83,,percent of total billed charges,,,8300.83,83,,percent of total billed charges,,,,,,,,,,,,,,,8300.83,83,,percent of total billed charges,,,9500.95,95,,percent of total billed charges,,,9000.9,90,,percent of total billed charges,,,9000.9,90,,percent of total billed charges,,,8200.82,82,,percent of total billed charges,,,9000.9,90,,percent of total billed charges,,,8500.85,85,,percent of total billed charges,,7540.75,9500.95,
FF OPEN TX INTERPHALANGEAL JOINT DISL,20500109,CDM,26765,CPT,450,RC,inpatient,,9315,9315,,7908.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7023.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7917.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8197.2,88,,percent of total billed charges,,,,,,,,,7116.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8476.65,91,,percent of total billed charges,,,8849.25,95,,percent of total billed charges,,,7731.45,83,,percent of total billed charges,,,7731.45,83,,percent of total billed charges,,,,,,,,,,,,,,,7731.45,83,,percent of total billed charges,,,8849.25,95,,percent of total billed charges,,,8383.5,90,,percent of total billed charges,,,8383.5,90,,percent of total billed charges,,,7638.3,82,,percent of total billed charges,,,8383.5,90,,percent of total billed charges,,,7917.75,85,,percent of total billed charges,,7023.51,8849.25,
FF CLOSED REDUCTION ANKLE WO ANEST,20500110,CDM,27818,CPT,450,RC,inpatient,,2167,2167,,1839.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1633.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1841.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1906.96,88,,percent of total billed charges,,,,,,,,,1655.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1971.97,91,,percent of total billed charges,,,2058.65,95,,percent of total billed charges,,,1798.61,83,,percent of total billed charges,,,1798.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1798.61,83,,percent of total billed charges,,,2058.65,95,,percent of total billed charges,,,1950.3,90,,percent of total billed charges,,,1950.3,90,,percent of total billed charges,,,1776.94,82,,percent of total billed charges,,,1950.3,90,,percent of total billed charges,,,1841.95,85,,percent of total billed charges,,1633.92,2058.65,
FF CLOSED RED POST HIP ARTH W ANETH,20500111,CDM,27266,CPT,450,RC,inpatient,,5769,5769,,4897.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4349.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4903.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5076.72,88,,percent of total billed charges,,,,,,,,,4407.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5249.79,91,,percent of total billed charges,,,5480.55,95,,percent of total billed charges,,,4788.27,83,,percent of total billed charges,,,4788.27,83,,percent of total billed charges,,,,,,,,,,,,,,,4788.27,83,,percent of total billed charges,,,5480.55,95,,percent of total billed charges,,,5192.1,90,,percent of total billed charges,,,5192.1,90,,percent of total billed charges,,,4730.58,82,,percent of total billed charges,,,5192.1,90,,percent of total billed charges,,,4903.65,85,,percent of total billed charges,,4349.83,5480.55,
FF DRAINAGE OF FINGER ABSCESS,20500112,CDM,26010,CPT,450,RC,inpatient,,1088,1088,,923.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,820.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,924.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,957.44,88,,percent of total billed charges,,,,,,,,,831.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,990.08,91,,percent of total billed charges,,,1033.6,95,,percent of total billed charges,,,903.04,83,,percent of total billed charges,,,903.04,83,,percent of total billed charges,,,,,,,,,,,,,,,903.04,83,,percent of total billed charges,,,1033.6,95,,percent of total billed charges,,,979.2,90,,percent of total billed charges,,,979.2,90,,percent of total billed charges,,,892.16,82,,percent of total billed charges,,,979.2,90,,percent of total billed charges,,,924.8,85,,percent of total billed charges,,820.35,1033.6,
FF I&D PERIANAL ABSCESS SUPERFICIAL,20500113,CDM,46050,CPT,450,RC,inpatient,,4499,4499,,3819.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3392.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3824.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3959.12,88,,percent of total billed charges,,,,,,,,,3437.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4094.09,91,,percent of total billed charges,,,4274.05,95,,percent of total billed charges,,,3734.17,83,,percent of total billed charges,,,3734.17,83,,percent of total billed charges,,,,,,,,,,,,,,,3734.17,83,,percent of total billed charges,,,4274.05,95,,percent of total billed charges,,,4049.1,90,,percent of total billed charges,,,4049.1,90,,percent of total billed charges,,,3689.18,82,,percent of total billed charges,,,4049.1,90,,percent of total billed charges,,,3824.15,85,,percent of total billed charges,,3392.25,4274.05,
FF DRAINAGE OF ABDOMEN ABSCESS,20500114,CDM,49020,CPT,450,RC,inpatient,,7671,7671,,6512.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5783.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6520.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6750.48,88,,percent of total billed charges,,,,,,,,,5860.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6980.61,91,,percent of total billed charges,,,7287.45,95,,percent of total billed charges,,,6366.93,83,,percent of total billed charges,,,6366.93,83,,percent of total billed charges,,,,,,,,,,,,,,,6366.93,83,,percent of total billed charges,,,7287.45,95,,percent of total billed charges,,,6903.9,90,,percent of total billed charges,,,6903.9,90,,percent of total billed charges,,,6290.22,82,,percent of total billed charges,,,6903.9,90,,percent of total billed charges,,,6520.35,85,,percent of total billed charges,,5783.93,7287.45,
FF CLSD TR FRACTURE RADIUS/ULNA,20500115,CDM,25600,CPT,450,RC,inpatient,,1138,1138,,966.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,858.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,967.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1001.44,88,,percent of total billed charges,,,,,,,,,869.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1035.58,91,,percent of total billed charges,,,1081.1,95,,percent of total billed charges,,,944.54,83,,percent of total billed charges,,,944.54,83,,percent of total billed charges,,,,,,,,,,,,,,,944.54,83,,percent of total billed charges,,,1081.1,95,,percent of total billed charges,,,1024.2,90,,percent of total billed charges,,,1024.2,90,,percent of total billed charges,,,933.16,82,,percent of total billed charges,,,1024.2,90,,percent of total billed charges,,,967.3,85,,percent of total billed charges,,858.05,1081.1,
FF ABN PARACENTESIS W/O IMAGING GUIDANCE,20500116,CDM,49082,CPT,450,RC,inpatient,,2725,2725,,2313.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2054.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2316.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2398,88,,percent of total billed charges,,,,,,,,,2081.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2479.75,91,,percent of total billed charges,,,2588.75,95,,percent of total billed charges,,,2261.75,83,,percent of total billed charges,,,2261.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2261.75,83,,percent of total billed charges,,,2588.75,95,,percent of total billed charges,,,2452.5,90,,percent of total billed charges,,,2452.5,90,,percent of total billed charges,,,2234.5,82,,percent of total billed charges,,,2452.5,90,,percent of total billed charges,,,2316.25,85,,percent of total billed charges,,2054.65,2588.75,
FF IRRIGATION CORPORA CAVERNOSA PRIAPISM,20500117,CDM,54220,CPT,450,RC,inpatient,,1307,1307,,1109.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,985.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1110.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1150.16,88,,percent of total billed charges,,,,,,,,,998.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1189.37,91,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1084.81,83,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1071.74,82,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1110.95,85,,percent of total billed charges,,985.48,1241.65,
FF REPAIR BLOOD VESSEL LESION,20500118,CDM,35226,CPT,450,RC,inpatient,,1563,1563,,1326.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1178.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1328.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1375.44,88,,percent of total billed charges,,,,,,,,,1194.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1422.33,91,,percent of total billed charges,,,1484.85,95,,percent of total billed charges,,,1297.29,83,,percent of total billed charges,,,1297.29,83,,percent of total billed charges,,,,,,,,,,,,,,,1297.29,83,,percent of total billed charges,,,1484.85,95,,percent of total billed charges,,,1406.7,90,,percent of total billed charges,,,1406.7,90,,percent of total billed charges,,,1281.66,82,,percent of total billed charges,,,1406.7,90,,percent of total billed charges,,,1328.55,85,,percent of total billed charges,,1178.5,1484.85,
FF REMOVAL OF FOREIGN BODY ANUS,20500119,CDM,46999,CPT,450,RC,inpatient,,2254,2254,,1913.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1699.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1915.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1983.52,88,,percent of total billed charges,,,,,,,,,1722.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2051.14,91,,percent of total billed charges,,,2141.3,95,,percent of total billed charges,,,1870.82,83,,percent of total billed charges,,,1870.82,83,,percent of total billed charges,,,,,,,,,,,,,,,1870.82,83,,percent of total billed charges,,,2141.3,95,,percent of total billed charges,,,2028.6,90,,percent of total billed charges,,,2028.6,90,,percent of total billed charges,,,1848.28,82,,percent of total billed charges,,,2028.6,90,,percent of total billed charges,,,1915.9,85,,percent of total billed charges,,1699.52,2141.3,
EXTENDED RECOVERY 1ST HOUR,20500200,CDM,,,710,RC,inpatient,,737,737,,625.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,555.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,626.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,648.56,88,,percent of total billed charges,,,,,,,,,563.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,670.67,91,,percent of total billed charges,,,700.15,95,,percent of total billed charges,,,611.71,83,,percent of total billed charges,,,611.71,83,,percent of total billed charges,,,,,,,,,,,,,,,611.71,83,,percent of total billed charges,,,700.15,95,,percent of total billed charges,,,663.3,90,,percent of total billed charges,,,663.3,90,,percent of total billed charges,,,604.34,82,,percent of total billed charges,,,663.3,90,,percent of total billed charges,,,626.45,85,,percent of total billed charges,,555.7,700.15,
EXTENDED RECOVERY EACH ADDTL HOUR,20500201,CDM,,,710,RC,inpatient,,458,458,,388.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,345.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,389.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,403.04,88,,percent of total billed charges,,,,,,,,,349.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,416.78,91,,percent of total billed charges,,,435.1,95,,percent of total billed charges,,,380.14,83,,percent of total billed charges,,,380.14,83,,percent of total billed charges,,,,,,,,,,,,,,,380.14,83,,percent of total billed charges,,,435.1,95,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,375.56,82,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,389.3,85,,percent of total billed charges,,345.33,435.1,
FF ADMINISTRATION PNU VACCINE,20500330,CDM,G0009,HCPCS,771,RC,inpatient,,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,130.44,164.35,
FF ADMINISTRATION FLU VACCINE,20500348,CDM,G0008,HCPCS,771,RC,inpatient,,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,130.44,164.35,
FF DRUG SCREENING COLLECTION,20500355,CDM,80306,CPT,300,RC,inpatient,,395,395,,335.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,297.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,335.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,347.6,88,,percent of total billed charges,,,,,,,,,301.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,359.45,91,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,,,,,,,,,,,,,327.85,83,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,323.9,82,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,297.83,375.25,
FF ER VISIT LEVEL 2,20500371,CDM,99282,CPT,450,RC,inpatient,,1538,1538,,1305.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1159.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1307.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1353.44,88,,percent of total billed charges,,,,,,,,,1175.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1399.58,91,,percent of total billed charges,,,1461.1,95,,percent of total billed charges,,,1276.54,83,,percent of total billed charges,,,1276.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1276.54,83,,percent of total billed charges,,,1461.1,95,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1261.16,82,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1307.3,85,,percent of total billed charges,,1159.65,1461.1,
FF INCISION DRAINEG BARTHO GLND ABCESS,20500380,CDM,56420,CPT,450,RC,inpatient,,984,984,,835.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,741.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,836.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,865.92,88,,percent of total billed charges,,,,,,,,,751.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,895.44,91,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,,,,,,,,,,,,,816.72,83,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,806.88,82,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,836.4,85,,percent of total billed charges,,741.94,934.8,
FF CAST REMOVAL,20500389,CDM,29700,CPT,450,RC,inpatient,,415,415,,352.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,312.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,352.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,365.2,88,,percent of total billed charges,,,,,,,,,317.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,377.65,91,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,,,,,,,,,,,,,344.45,83,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,340.3,82,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,312.91,394.25,
TREATMENT ROOM NEW PATIENT - ED,20500390,CDM,99202,CPT,761,RC,inpatient,,329,329,,279.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,248.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,279.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,289.52,88,,percent of total billed charges,,,,,,,,,251.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,299.39,91,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,,,,,,,,,,,,,273.07,83,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,269.78,82,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,248.07,312.55,
FF INSERT NON-INDWELLING BLADDER CATH,20500395,CDM,51701,CPT,450,RC,inpatient,,252,252,,213.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,214.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,221.76,88,,percent of total billed charges,,,,,,,,,192.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,229.32,91,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,,,,,,,,,,,,,209.16,83,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,206.64,82,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,190.01,239.4,
TREATMENT ROOM- ED,20500398,CDM,G0463,HCPCS,761,RC,inpatient,,641,641,,544.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,483.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,544.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,564.08,88,,percent of total billed charges,,,,,,,,,489.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,583.31,91,,percent of total billed charges,,,608.95,95,,percent of total billed charges,,,532.03,83,,percent of total billed charges,,,532.03,83,,percent of total billed charges,,,,,,,,,,,,,,,532.03,83,,percent of total billed charges,,,608.95,95,,percent of total billed charges,,,576.9,90,,percent of total billed charges,,,576.9,90,,percent of total billed charges,,,525.62,82,,percent of total billed charges,,,576.9,90,,percent of total billed charges,,,544.85,85,,percent of total billed charges,,483.31,608.95,
FF CLSD TR DISTAL RADIAL WITH MANIPULAT,20500400,CDM,25605,CPT,450,RC,inpatient,,2970,2970,,2521.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2239.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2524.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2613.6,88,,percent of total billed charges,,,,,,,,,2269.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2702.7,91,,percent of total billed charges,,,2821.5,95,,percent of total billed charges,,,2465.1,83,,percent of total billed charges,,,2465.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2465.1,83,,percent of total billed charges,,,2821.5,95,,percent of total billed charges,,,2673,90,,percent of total billed charges,,,2673,90,,percent of total billed charges,,,2435.4,82,,percent of total billed charges,,,2673,90,,percent of total billed charges,,,2524.5,85,,percent of total billed charges,,2239.38,2821.5,
FF ER VISIT LEVEL 5,20500413,CDM,99285,CPT,450,RC,inpatient,,5624,5624,,4774.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4240.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4780.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4949.12,88,,percent of total billed charges,,,,,,,,,4296.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5117.84,91,,percent of total billed charges,,,5342.8,95,,percent of total billed charges,,,4667.92,83,,percent of total billed charges,,,4667.92,83,,percent of total billed charges,,,,,,,,,,,,,,,4667.92,83,,percent of total billed charges,,,5342.8,95,,percent of total billed charges,,,5061.6,90,,percent of total billed charges,,,5061.6,90,,percent of total billed charges,,,4611.68,82,,percent of total billed charges,,,5061.6,90,,percent of total billed charges,,,4780.4,85,,percent of total billed charges,,4240.5,5342.8,
FF ER VISIT LEVEL 1,20500421,CDM,99281,CPT,450,RC,inpatient,,893,893,,758.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,673.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,759.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,785.84,88,,percent of total billed charges,,,,,,,,,682.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,812.63,91,,percent of total billed charges,,,848.35,95,,percent of total billed charges,,,741.19,83,,percent of total billed charges,,,741.19,83,,percent of total billed charges,,,,,,,,,,,,,,,741.19,83,,percent of total billed charges,,,848.35,95,,percent of total billed charges,,,803.7,90,,percent of total billed charges,,,803.7,90,,percent of total billed charges,,,732.26,82,,percent of total billed charges,,,803.7,90,,percent of total billed charges,,,759.05,85,,percent of total billed charges,,673.32,848.35,
FF ER VISIT LEVEL 3,20500454,CDM,99283,CPT,450,RC,inpatient,,2358,2358,,2001.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1777.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2004.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2075.04,88,,percent of total billed charges,,,,,,,,,1801.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2145.78,91,,percent of total billed charges,,,2240.1,95,,percent of total billed charges,,,1957.14,83,,percent of total billed charges,,,1957.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1957.14,83,,percent of total billed charges,,,2240.1,95,,percent of total billed charges,,,2122.2,90,,percent of total billed charges,,,2122.2,90,,percent of total billed charges,,,1933.56,82,,percent of total billed charges,,,2122.2,90,,percent of total billed charges,,,2004.3,85,,percent of total billed charges,,1777.93,2240.1,
FF ER VISIT LEVEL 4,20500462,CDM,99284,CPT,450,RC,inpatient,,3766,3766,,3197.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2839.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3201.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3314.08,88,,percent of total billed charges,,,,,,,,,2877.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3427.06,91,,percent of total billed charges,,,3577.7,95,,percent of total billed charges,,,3125.78,83,,percent of total billed charges,,,3125.78,83,,percent of total billed charges,,,,,,,,,,,,,,,3125.78,83,,percent of total billed charges,,,3577.7,95,,percent of total billed charges,,,3389.4,90,,percent of total billed charges,,,3389.4,90,,percent of total billed charges,,,3088.12,82,,percent of total billed charges,,,3389.4,90,,percent of total billed charges,,,3201.1,85,,percent of total billed charges,,2839.56,3577.7,
* FF CO2 MONITOR USAGE (V1104),20500488,CDM,,,270,RC,inpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.92,88,,percent of total billed charges,,,,,,,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,44.49,56.05,
FF MONITORING PRESSURE COMPART SYNDROME,20500490,CDM,20950,CPT,450,RC,inpatient,,1048,1048,,889.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,790.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,890.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,922.24,88,,percent of total billed charges,,,,,,,,,800.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,953.68,91,,percent of total billed charges,,,995.6,95,,percent of total billed charges,,,869.84,83,,percent of total billed charges,,,869.84,83,,percent of total billed charges,,,,,,,,,,,,,,,869.84,83,,percent of total billed charges,,,995.6,95,,percent of total billed charges,,,943.2,90,,percent of total billed charges,,,943.2,90,,percent of total billed charges,,,859.36,82,,percent of total billed charges,,,943.2,90,,percent of total billed charges,,,890.8,85,,percent of total billed charges,,790.19,995.6,
FF BONE MARROW NEEDLE BIOPSY,20500500,CDM,38221,CPT,450,RC,inpatient,,1960,1960,,1664.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1477.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1666,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1724.8,88,,percent of total billed charges,,,,,,,,,1497.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1783.6,91,,percent of total billed charges,,,1862,95,,percent of total billed charges,,,1626.8,83,,percent of total billed charges,,,1626.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1626.8,83,,percent of total billed charges,,,1862,95,,percent of total billed charges,,,1764,90,,percent of total billed charges,,,1764,90,,percent of total billed charges,,,1607.2,82,,percent of total billed charges,,,1764,90,,percent of total billed charges,,,1666,85,,percent of total billed charges,,1477.84,1862,
FF THORACENTESIS,20500511,CDM,32554,CPT,450,RC,inpatient,,2536,2536,,2153.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1912.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2155.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2231.68,88,,percent of total billed charges,,,,,,,,,1937.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2307.76,91,,percent of total billed charges,,,2409.2,95,,percent of total billed charges,,,2104.88,83,,percent of total billed charges,,,2104.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2104.88,83,,percent of total billed charges,,,2409.2,95,,percent of total billed charges,,,2282.4,90,,percent of total billed charges,,,2282.4,90,,percent of total billed charges,,,2079.52,82,,percent of total billed charges,,,2282.4,90,,percent of total billed charges,,,2155.6,85,,percent of total billed charges,,1912.14,2409.2,
FF BLOOD ADMINISTRATION SERVICE,20500530,CDM,36430,CPT,391,RC,inpatient,,1766,1766,,1499.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1331.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1501.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1554.08,88,,percent of total billed charges,,,,,,,,,1349.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1607.06,91,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.78,83,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1448.12,82,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,1331.56,1677.7,
FF BLOOD ADMIN UP TO 4 HOURS(V-11-20),20500531,CDM,36430,CPT,391,RC,inpatient,,2764,2764,,2346.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2084.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2349.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2432.32,88,,percent of total billed charges,,,,,,,,,2111.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2515.24,91,,percent of total billed charges,,,2625.8,95,,percent of total billed charges,,,2294.12,83,,percent of total billed charges,,,2294.12,83,,percent of total billed charges,,,,,,,,,,,,,,,2294.12,83,,percent of total billed charges,,,2625.8,95,,percent of total billed charges,,,2487.6,90,,percent of total billed charges,,,2487.6,90,,percent of total billed charges,,,2266.48,82,,percent of total billed charges,,,2487.6,90,,percent of total billed charges,,,2349.4,85,,percent of total billed charges,,2084.06,2625.8,
FF BLOOD ADMIN UP TO 6 HOURS(V-11-20),20500532,CDM,36430,CPT,391,RC,inpatient,,2179,2179,,1849.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1642.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1852.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1917.52,88,,percent of total billed charges,,,,,,,,,1664.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1982.89,91,,percent of total billed charges,,,2070.05,95,,percent of total billed charges,,,1808.57,83,,percent of total billed charges,,,1808.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1808.57,83,,percent of total billed charges,,,2070.05,95,,percent of total billed charges,,,1961.1,90,,percent of total billed charges,,,1961.1,90,,percent of total billed charges,,,1786.78,82,,percent of total billed charges,,,1961.1,90,,percent of total billed charges,,,1852.15,85,,percent of total billed charges,,1642.97,2070.05,
FF BLOOD ADMIN OVER 6 HOURS(V-11-20),20500533,CDM,36430,CPT,391,RC,inpatient,,3322,3322,,2820.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2504.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2823.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2923.36,88,,percent of total billed charges,,,,,,,,,2538.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3023.02,91,,percent of total billed charges,,,3155.9,95,,percent of total billed charges,,,2757.26,83,,percent of total billed charges,,,2757.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2757.26,83,,percent of total billed charges,,,3155.9,95,,percent of total billed charges,,,2989.8,90,,percent of total billed charges,,,2989.8,90,,percent of total billed charges,,,2724.04,82,,percent of total billed charges,,,2989.8,90,,percent of total billed charges,,,2823.7,85,,percent of total billed charges,,2504.79,3155.9,
FF URETHRA CATHETERIZATION,20500535,CDM,51702,CPT,450,RC,inpatient,,635,635,,539.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,478.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,539.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,558.8,88,,percent of total billed charges,,,,,,,,,485.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,577.85,91,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,,,,,,,,,,,,,527.05,83,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,520.7,82,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,539.75,85,,percent of total billed charges,,478.79,603.25,
FF GASTROSTOMY TUBE CHANGE,20500540,CDM,43762,CPT,450,RC,inpatient,,826,826,,701.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,622.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,702.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,726.88,88,,percent of total billed charges,,,,,,,,,631.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,751.66,91,,percent of total billed charges,,,784.7,95,,percent of total billed charges,,,685.58,83,,percent of total billed charges,,,685.58,83,,percent of total billed charges,,,,,,,,,,,,,,,685.58,83,,percent of total billed charges,,,784.7,95,,percent of total billed charges,,,743.4,90,,percent of total billed charges,,,743.4,90,,percent of total billed charges,,,677.32,82,,percent of total billed charges,,,743.4,90,,percent of total billed charges,,,702.1,85,,percent of total billed charges,,622.8,784.7,
"FF IV INFUSION, HYDRATION, UP TO 1 HOUR",20500560,CDM,96360,CPT,450,RC,inpatient,XU,1000,1000,,849,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,754,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,850,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,880,88,,percent of total billed charges,,,,,,,,,764,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,910,91,,percent of total billed charges,,,950,95,,percent of total billed charges,,,830,83,,percent of total billed charges,,,830,83,,percent of total billed charges,,,,,,,,,,,,,,,830,83,,percent of total billed charges,,,950,95,,percent of total billed charges,,,900,90,,percent of total billed charges,,,900,90,,percent of total billed charges,,,820,82,,percent of total billed charges,,,900,90,,percent of total billed charges,,,850,85,,percent of total billed charges,,754,950,
"FF IV INFUSION, HYDRATION, ADDT'L HOUR",20500561,CDM,96361,CPT,450,RC,inpatient,XU,302,302,,256.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,227.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,256.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,265.76,88,,percent of total billed charges,,,,,,,,,230.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,274.82,91,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,,,,,,,,,,,,,250.66,83,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,247.64,82,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,256.7,85,,percent of total billed charges,,227.71,286.9,
"FF IV INFUSION, THERAPEUTIC, UP TO 1 HR",20500562,CDM,96365,CPT,450,RC,inpatient,XU,1000,1000,,849,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,754,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,850,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,880,88,,percent of total billed charges,,,,,,,,,764,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,910,91,,percent of total billed charges,,,950,95,,percent of total billed charges,,,830,83,,percent of total billed charges,,,830,83,,percent of total billed charges,,,,,,,,,,,,,,,830,83,,percent of total billed charges,,,950,95,,percent of total billed charges,,,900,90,,percent of total billed charges,,,900,90,,percent of total billed charges,,,820,82,,percent of total billed charges,,,900,90,,percent of total billed charges,,,850,85,,percent of total billed charges,,754,950,
"FF IV INFUSION, THERAPEUTIC, ADDT'L HR",20500563,CDM,96366,CPT,450,RC,inpatient,XU,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
FF CONCURRENT ADDTL MEDICATED SOLUTION,20500564,CDM,96368,CPT,450,RC,inpatient,XU,653,653,,554.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,492.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,555.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,574.64,88,,percent of total billed charges,,,,,,,,,498.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,594.23,91,,percent of total billed charges,,,620.35,95,,percent of total billed charges,,,541.99,83,,percent of total billed charges,,,541.99,83,,percent of total billed charges,,,,,,,,,,,,,,,541.99,83,,percent of total billed charges,,,620.35,95,,percent of total billed charges,,,587.7,90,,percent of total billed charges,,,587.7,90,,percent of total billed charges,,,535.46,82,,percent of total billed charges,,,587.7,90,,percent of total billed charges,,,555.05,85,,percent of total billed charges,,492.36,620.35,
"FF IVP, SINGLE OR INITIAL",20500565,CDM,96374,CPT,450,RC,inpatient,XU,523,523,,444.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,394.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,444.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,460.24,88,,percent of total billed charges,,,,,,,,,399.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,475.93,91,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,,,,,,,,,,,,,434.09,83,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,428.86,82,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,444.55,85,,percent of total billed charges,,394.34,496.85,
"FF IVP, EA ADDTL NEW SUBSTANCE/DRUG",20500566,CDM,96375,CPT,450,RC,inpatient,XU,431,431,,365.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,324.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,366.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,379.28,88,,percent of total billed charges,,,,,,,,,329.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,392.21,91,,percent of total billed charges,,,409.45,95,,percent of total billed charges,,,357.73,83,,percent of total billed charges,,,357.73,83,,percent of total billed charges,,,,,,,,,,,,,,,357.73,83,,percent of total billed charges,,,409.45,95,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,353.42,82,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,366.35,85,,percent of total billed charges,,324.97,409.45,
FF IM/SQ INJECTION,20500567,CDM,96372,CPT,450,RC,inpatient,XU,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,376.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,424.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,376.25,474.05,
FF IVP SEQUENTIAL SAME SUBSTANCE,20500570,CDM,96376,CPT,450,RC,inpatient,XU,373,373,,316.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,281.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,317.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,328.24,88,,percent of total billed charges,,,,,,,,,284.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,339.43,91,,percent of total billed charges,,,354.35,95,,percent of total billed charges,,,309.59,83,,percent of total billed charges,,,309.59,83,,percent of total billed charges,,,,,,,,,,,,,,,309.59,83,,percent of total billed charges,,,354.35,95,,percent of total billed charges,,,335.7,90,,percent of total billed charges,,,335.7,90,,percent of total billed charges,,,305.86,82,,percent of total billed charges,,,335.7,90,,percent of total billed charges,,,317.05,85,,percent of total billed charges,,281.24,354.35,
FF IN DWELLING CATHETER FOLEY,20500705,CDM,51702,CPT,450,RC,inpatient,,490,490,,416.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,369.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,416.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,431.2,88,,percent of total billed charges,,,,,,,,,374.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,445.9,91,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,,,,,,,,,,,,,406.7,83,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,401.8,82,,percent of total billed charges,,,441,90,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,369.46,465.5,
FF CRITICAL CARE ADDITIONAL 30 MIN,20500708,CDM,99292,CPT,450,RC,inpatient,,1052,1052,,893.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,793.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,894.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,925.76,88,,percent of total billed charges,,,,,,,,,803.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,957.32,91,,percent of total billed charges,,,999.4,95,,percent of total billed charges,,,873.16,83,,percent of total billed charges,,,873.16,83,,percent of total billed charges,,,,,,,,,,,,,,,873.16,83,,percent of total billed charges,,,999.4,95,,percent of total billed charges,,,946.8,90,,percent of total billed charges,,,946.8,90,,percent of total billed charges,,,862.64,82,,percent of total billed charges,,,946.8,90,,percent of total billed charges,,,894.2,85,,percent of total billed charges,,793.21,999.4,
FF IMMUNIZATION ADMINISTRATION,20500720,CDM,90471,CPT,450,RC,inpatient,,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,376.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,424.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,376.25,474.05,
FF CLOSED TREATMNT OF FIBULA FRACTURE WO,20500780,CDM,27780,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
COMPLEX UROFLOWMETRY,20500785,CDM,51741,CPT,450,RC,inpatient,,1662,1662,,1411.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1253.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1412.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1462.56,88,,percent of total billed charges,,,,,,,,,1269.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1512.42,91,,percent of total billed charges,,,1578.9,95,,percent of total billed charges,,,1379.46,83,,percent of total billed charges,,,1379.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1379.46,83,,percent of total billed charges,,,1578.9,95,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1362.84,82,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1412.7,85,,percent of total billed charges,,1253.15,1578.9,
MEASUR POST VOID URINE ULTRASOUND,20500786,CDM,51798,CPT,450,RC,inpatient,,335,335,,284.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,252.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,284.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,294.8,88,,percent of total billed charges,,,,,,,,,255.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,304.85,91,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,,,,,,,,,,,,,278.05,83,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,274.7,82,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,252.59,318.25,
FF SUTURE REPAIR VAGINAL TEAR  NON OB,20500789,CDM,57200,CPT,450,RC,inpatient,,4941,4941,,4194.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3725.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4199.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4348.08,88,,percent of total billed charges,,,,,,,,,3774.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4496.31,91,,percent of total billed charges,,,4693.95,95,,percent of total billed charges,,,4101.03,83,,percent of total billed charges,,,4101.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4101.03,83,,percent of total billed charges,,,4693.95,95,,percent of total billed charges,,,4446.9,90,,percent of total billed charges,,,4446.9,90,,percent of total billed charges,,,4051.62,82,,percent of total billed charges,,,4446.9,90,,percent of total billed charges,,,4199.85,85,,percent of total billed charges,,3725.51,4693.95,
FF ASPIRATION OF BREAST,20500790,CDM,19000,CPT,450,RC,inpatient,,1157,1157,,982.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,872.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,983.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1018.16,88,,percent of total billed charges,,,,,,,,,883.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1052.87,91,,percent of total billed charges,,,1099.15,95,,percent of total billed charges,,,960.31,83,,percent of total billed charges,,,960.31,83,,percent of total billed charges,,,,,,,,,,,,,,,960.31,83,,percent of total billed charges,,,1099.15,95,,percent of total billed charges,,,1041.3,90,,percent of total billed charges,,,1041.3,90,,percent of total billed charges,,,948.74,82,,percent of total billed charges,,,1041.3,90,,percent of total billed charges,,,983.45,85,,percent of total billed charges,,872.38,1099.15,
FF ASP/INJ GANGLION CYST,20500791,CDM,20612,CPT,450,RC,inpatient,,1943,1943,,1649.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1465.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1651.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1709.84,88,,percent of total billed charges,,,,,,,,,1484.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1768.13,91,,percent of total billed charges,,,1845.85,95,,percent of total billed charges,,,1612.69,83,,percent of total billed charges,,,1612.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1612.69,83,,percent of total billed charges,,,1845.85,95,,percent of total billed charges,,,1748.7,90,,percent of total billed charges,,,1748.7,90,,percent of total billed charges,,,1593.26,82,,percent of total billed charges,,,1748.7,90,,percent of total billed charges,,,1651.55,85,,percent of total billed charges,,1465.02,1845.85,
FF EVACUATION OF SUBUNGUAL HEMATOMA,20500799,CDM,11740,CPT,450,RC,inpatient,,543,543,,461.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,409.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,461.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,477.84,88,,percent of total billed charges,,,,,,,,,414.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,494.13,91,,percent of total billed charges,,,515.85,95,,percent of total billed charges,,,450.69,83,,percent of total billed charges,,,450.69,83,,percent of total billed charges,,,,,,,,,,,,,,,450.69,83,,percent of total billed charges,,,515.85,95,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,445.26,82,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,461.55,85,,percent of total billed charges,,409.42,515.85,
FF ARTHRO/ASP/INJ MAJOR JT OR BURSA,20500800,CDM,20610,CPT,450,RC,inpatient,TC,2329,2329,,1977.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1756.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1979.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2049.52,88,,percent of total billed charges,,,,,,,,,1779.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2119.39,91,,percent of total billed charges,,,2212.55,95,,percent of total billed charges,,,1933.07,83,,percent of total billed charges,,,1933.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1933.07,83,,percent of total billed charges,,,2212.55,95,,percent of total billed charges,,,2096.1,90,,percent of total billed charges,,,2096.1,90,,percent of total billed charges,,,1909.78,82,,percent of total billed charges,,,2096.1,90,,percent of total billed charges,,,1979.65,85,,percent of total billed charges,,1756.07,2212.55,
FF ASPIRATION OF HEMATOMA,20500801,CDM,10160,CPT,450,RC,inpatient,,627,627,,532.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,472.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,532.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,551.76,88,,percent of total billed charges,,,,,,,,,479.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,570.57,91,,percent of total billed charges,,,595.65,95,,percent of total billed charges,,,520.41,83,,percent of total billed charges,,,520.41,83,,percent of total billed charges,,,,,,,,,,,,,,,520.41,83,,percent of total billed charges,,,595.65,95,,percent of total billed charges,,,564.3,90,,percent of total billed charges,,,564.3,90,,percent of total billed charges,,,514.14,82,,percent of total billed charges,,,564.3,90,,percent of total billed charges,,,532.95,85,,percent of total billed charges,,472.76,595.65,
FF BURN DRESSING DEBRIDEMENT SMALL,20500802,CDM,16020,CPT,450,RC,inpatient,,1139,1139,,967.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,858.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,968.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1002.32,88,,percent of total billed charges,,,,,,,,,870.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,,,,,,,,,,,,,945.37,83,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,933.98,82,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,858.81,1082.05,
FF BURN DRESSING LARGE,20500803,CDM,16030,CPT,450,RC,inpatient,,1366,1366,,1159.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1029.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1161.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1202.08,88,,percent of total billed charges,,,,,,,,,1043.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1243.06,91,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1133.78,83,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1120.12,82,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1161.1,85,,percent of total billed charges,,1029.96,1297.7,
FF BURN SIMPLE TREATMENT,20500804,CDM,16000,CPT,450,RC,inpatient,,761,761,,646.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,573.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,646.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,669.68,88,,percent of total billed charges,,,,,,,,,581.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,692.51,91,,percent of total billed charges,,,722.95,95,,percent of total billed charges,,,631.63,83,,percent of total billed charges,,,631.63,83,,percent of total billed charges,,,,,,,,,,,,,,,631.63,83,,percent of total billed charges,,,722.95,95,,percent of total billed charges,,,684.9,90,,percent of total billed charges,,,684.9,90,,percent of total billed charges,,,624.02,82,,percent of total billed charges,,,684.9,90,,percent of total billed charges,,,646.85,85,,percent of total billed charges,,573.79,722.95,
FF CAST REMOVAL LONG LEG ARM,20500805,CDM,29705,CPT,450,RC,inpatient,,415,415,,352.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,312.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,352.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,365.2,88,,percent of total billed charges,,,,,,,,,317.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,377.65,91,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,,,,,,,,,,,,,344.45,83,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,340.3,82,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,312.91,394.25,
FF CATHETERIZ URINARY COMPLEX,20500806,CDM,51703,CPT,450,RC,inpatient,,442,442,,375.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,333.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,375.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.96,88,,percent of total billed charges,,,,,,,,,337.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,402.22,91,,percent of total billed charges,,,419.9,95,,percent of total billed charges,,,366.86,83,,percent of total billed charges,,,366.86,83,,percent of total billed charges,,,,,,,,,,,,,,,366.86,83,,percent of total billed charges,,,419.9,95,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,362.44,82,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,375.7,85,,percent of total billed charges,,333.27,419.9,
FF CLOSED TRTMT HIP DISLTN WO ANESTHESIA,20500807,CDM,27250,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
FF CRITICAL CARE 30-74 MIN,20500808,CDM,99291,CPT,450,RC,inpatient,,6834,6834,,5802.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5152.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5808.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6013.92,88,,percent of total billed charges,,,,,,,,,5221.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6218.94,91,,percent of total billed charges,,,6492.3,95,,percent of total billed charges,,,5672.22,83,,percent of total billed charges,,,5672.22,83,,percent of total billed charges,,,,,,,,,,,,,,,5672.22,83,,percent of total billed charges,,,6492.3,95,,percent of total billed charges,,,6150.6,90,,percent of total billed charges,,,6150.6,90,,percent of total billed charges,,,5603.88,82,,percent of total billed charges,,,6150.6,90,,percent of total billed charges,,,5808.9,85,,percent of total billed charges,,5152.84,6492.3,
FF CV CATHETER PLACEMENT,20500809,CDM,36556,CPT,450,RC,inpatient,,2953,2953,,2507.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2226.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2510.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2598.64,88,,percent of total billed charges,,,,,,,,,2256.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2687.23,91,,percent of total billed charges,,,2805.35,95,,percent of total billed charges,,,2450.99,83,,percent of total billed charges,,,2450.99,83,,percent of total billed charges,,,,,,,,,,,,,,,2450.99,83,,percent of total billed charges,,,2805.35,95,,percent of total billed charges,,,2657.7,90,,percent of total billed charges,,,2657.7,90,,percent of total billed charges,,,2421.46,82,,percent of total billed charges,,,2657.7,90,,percent of total billed charges,,,2510.05,85,,percent of total billed charges,,2226.56,2805.35,
FF WOUND DEBRIDE OF SOFT TISSUE FIRST 20,20500810,CDM,11042,CPT,450,RC,inpatient,,3359,3359,,2851.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2532.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2855.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2955.92,88,,percent of total billed charges,,,,,,,,,2566.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3056.69,91,,percent of total billed charges,,,3191.05,95,,percent of total billed charges,,,2787.97,83,,percent of total billed charges,,,2787.97,83,,percent of total billed charges,,,,,,,,,,,,,,,2787.97,83,,percent of total billed charges,,,3191.05,95,,percent of total billed charges,,,3023.1,90,,percent of total billed charges,,,3023.1,90,,percent of total billed charges,,,2754.38,82,,percent of total billed charges,,,3023.1,90,,percent of total billed charges,,,2855.15,85,,percent of total billed charges,,2532.69,3191.05,
FF CLSED TRT ULNAR RADL SHFT W/O MANIP,20500811,CDM,25560,CPT,450,RC,inpatient,,984,984,,835.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,741.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,836.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,865.92,88,,percent of total billed charges,,,,,,,,,751.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,895.44,91,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,,,,,,,,,,,,,816.72,83,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,806.88,82,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,836.4,85,,percent of total billed charges,,741.94,934.8,
FF ENDOTRACHEAL INTUBATION,20500812,CDM,31500,CPT,450,RC,inpatient,,2052,2052,,1742.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1547.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1744.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1805.76,88,,percent of total billed charges,,,,,,,,,1567.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1867.32,91,,percent of total billed charges,,,1949.4,95,,percent of total billed charges,,,1703.16,83,,percent of total billed charges,,,1703.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1703.16,83,,percent of total billed charges,,,1949.4,95,,percent of total billed charges,,,1846.8,90,,percent of total billed charges,,,1846.8,90,,percent of total billed charges,,,1682.64,82,,percent of total billed charges,,,1846.8,90,,percent of total billed charges,,,1744.2,85,,percent of total billed charges,,1547.21,1949.4,
FF ER TRACH CRICOTHYROID,20500813,CDM,31605,CPT,450,RC,inpatient,,2903,2903,,2464.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2188.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2467.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2554.64,88,,percent of total billed charges,,,,,,,,,2217.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2641.73,91,,percent of total billed charges,,,2757.85,95,,percent of total billed charges,,,2409.49,83,,percent of total billed charges,,,2409.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2409.49,83,,percent of total billed charges,,,2757.85,95,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2380.46,82,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2467.55,85,,percent of total billed charges,,2188.86,2757.85,
FF ER TRACH TRANSTRACHEAL,20500814,CDM,31603,CPT,450,RC,inpatient,,2903,2903,,2464.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2188.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2467.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2554.64,88,,percent of total billed charges,,,,,,,,,2217.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2641.73,91,,percent of total billed charges,,,2757.85,95,,percent of total billed charges,,,2409.49,83,,percent of total billed charges,,,2409.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2409.49,83,,percent of total billed charges,,,2757.85,95,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2380.46,82,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2467.55,85,,percent of total billed charges,,2188.86,2757.85,
FF FC EAR NOSE LYR > 30 CM,20500815,CDM,12057,CPT,450,RC,inpatient,,1914,1914,,1624.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1443.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1626.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1684.32,88,,percent of total billed charges,,,,,,,,,1462.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1741.74,91,,percent of total billed charges,,,1818.3,95,,percent of total billed charges,,,1588.62,83,,percent of total billed charges,,,1588.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1588.62,83,,percent of total billed charges,,,1818.3,95,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1569.48,82,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1626.9,85,,percent of total billed charges,,1443.16,1818.3,
FF FC EAR NOSE LYR 0 TO 2.5 CM,20500816,CDM,12051,CPT,450,RC,inpatient,,1737,1737,,1474.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1309.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1476.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1528.56,88,,percent of total billed charges,,,,,,,,,1327.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1580.67,91,,percent of total billed charges,,,1650.15,95,,percent of total billed charges,,,1441.71,83,,percent of total billed charges,,,1441.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1441.71,83,,percent of total billed charges,,,1650.15,95,,percent of total billed charges,,,1563.3,90,,percent of total billed charges,,,1563.3,90,,percent of total billed charges,,,1424.34,82,,percent of total billed charges,,,1563.3,90,,percent of total billed charges,,,1476.45,85,,percent of total billed charges,,1309.7,1650.15,
FF FC EAR NOSE LYR 12.6 TO 20 CM,20500817,CDM,12055,CPT,450,RC,inpatient,,856,856,,726.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,645.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,727.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,753.28,88,,percent of total billed charges,,,,,,,,,653.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,778.96,91,,percent of total billed charges,,,813.2,95,,percent of total billed charges,,,710.48,83,,percent of total billed charges,,,710.48,83,,percent of total billed charges,,,,,,,,,,,,,,,710.48,83,,percent of total billed charges,,,813.2,95,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,701.92,82,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,727.6,85,,percent of total billed charges,,645.42,813.2,
FF FC EAR NOSE LYR 2.6 TO 5.0 CM,20500818,CDM,12052,CPT,450,RC,inpatient,,1398,1398,,1186.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1054.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1188.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1230.24,88,,percent of total billed charges,,,,,,,,,1068.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1272.18,91,,percent of total billed charges,,,1328.1,95,,percent of total billed charges,,,1160.34,83,,percent of total billed charges,,,1160.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1160.34,83,,percent of total billed charges,,,1328.1,95,,percent of total billed charges,,,1258.2,90,,percent of total billed charges,,,1258.2,90,,percent of total billed charges,,,1146.36,82,,percent of total billed charges,,,1258.2,90,,percent of total billed charges,,,1188.3,85,,percent of total billed charges,,1054.09,1328.1,
FF FC EAR NOSE LYR 20.1 TO 30 CM,20500819,CDM,12056,CPT,450,RC,inpatient,,922,922,,782.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,695.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,783.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,811.36,88,,percent of total billed charges,,,,,,,,,704.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,839.02,91,,percent of total billed charges,,,875.9,95,,percent of total billed charges,,,765.26,83,,percent of total billed charges,,,765.26,83,,percent of total billed charges,,,,,,,,,,,,,,,765.26,83,,percent of total billed charges,,,875.9,95,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,756.04,82,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,783.7,85,,percent of total billed charges,,695.19,875.9,
FF FC EAR NOSE LYR 5.1 TO 7.5 CM,20500820,CDM,12053,CPT,450,RC,inpatient,,1554,1554,,1319.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1171.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1320.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1367.52,88,,percent of total billed charges,,,,,,,,,1187.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1414.14,91,,percent of total billed charges,,,1476.3,95,,percent of total billed charges,,,1289.82,83,,percent of total billed charges,,,1289.82,83,,percent of total billed charges,,,,,,,,,,,,,,,1289.82,83,,percent of total billed charges,,,1476.3,95,,percent of total billed charges,,,1398.6,90,,percent of total billed charges,,,1398.6,90,,percent of total billed charges,,,1274.28,82,,percent of total billed charges,,,1398.6,90,,percent of total billed charges,,,1320.9,85,,percent of total billed charges,,1171.72,1476.3,
FF FC EAR NOSE LYR 7.6 TO 12.5 CM,20500821,CDM,12054,CPT,450,RC,inpatient,,1622,1622,,1377.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1222.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1378.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1427.36,88,,percent of total billed charges,,,,,,,,,1239.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1476.02,91,,percent of total billed charges,,,1540.9,95,,percent of total billed charges,,,1346.26,83,,percent of total billed charges,,,1346.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1346.26,83,,percent of total billed charges,,,1540.9,95,,percent of total billed charges,,,1459.8,90,,percent of total billed charges,,,1459.8,90,,percent of total billed charges,,,1330.04,82,,percent of total billed charges,,,1459.8,90,,percent of total billed charges,,,1378.7,85,,percent of total billed charges,,1222.99,1540.9,
FF FRACTURE DISTAL PHALANX,20500823,CDM,26720,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
FF FRACTURE MALLEOLUS LATERAL,20500824,CDM,27788,CPT,450,RC,inpatient,,1422,1422,,1207.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1072.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1208.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1251.36,88,,percent of total billed charges,,,,,,,,,1086.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1294.02,91,,percent of total billed charges,,,1350.9,95,,percent of total billed charges,,,1180.26,83,,percent of total billed charges,,,1180.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1180.26,83,,percent of total billed charges,,,1350.9,95,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1166.04,82,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1208.7,85,,percent of total billed charges,,1072.19,1350.9,
FF FRACTURE MALLEOLUS MEDIAL,20500825,CDM,27760,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
FF FRACTURE METATARSAL,20500826,CDM,28470,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
FF FRACTURE NR CARPAL,20500827,CDM,25630,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
FF FRACTURE NR CLAVICLE,20500828,CDM,23500,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
FF FRACTURE NR HUMERUS NECK,20500829,CDM,24500,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
FF FRACTURE NR METACARPAL,20500830,CDM,26600,CPT,450,RC,inpatient,,1707,1707,,1449.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1287.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1450.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1502.16,88,,percent of total billed charges,,,,,,,,,1304.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1553.37,91,,percent of total billed charges,,,1621.65,95,,percent of total billed charges,,,1416.81,83,,percent of total billed charges,,,1416.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1416.81,83,,percent of total billed charges,,,1621.65,95,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1399.74,82,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1450.95,85,,percent of total billed charges,,1287.08,1621.65,
FF CLOSED TX NOSE FX W/STABLJ,20500831,CDM,21320,CPT,450,RC,inpatient,,2903,2903,,2464.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2188.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2467.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2554.64,88,,percent of total billed charges,,,,,,,,,2217.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2641.73,91,,percent of total billed charges,,,2757.85,95,,percent of total billed charges,,,2409.49,83,,percent of total billed charges,,,2409.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2409.49,83,,percent of total billed charges,,,2757.85,95,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2380.46,82,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2467.55,85,,percent of total billed charges,,2188.86,2757.85,
FF FRACTURE NR RADIAL SHAFT,20500832,CDM,25500,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
FF FRACTURE NR ULNAR OLECRANON,20500833,CDM,24620,CPT,450,RC,inpatient,,4617,4617,,3919.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3481.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3924.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4062.96,88,,percent of total billed charges,,,,,,,,,3527.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4201.47,91,,percent of total billed charges,,,4386.15,95,,percent of total billed charges,,,3832.11,83,,percent of total billed charges,,,3832.11,83,,percent of total billed charges,,,,,,,,,,,,,,,3832.11,83,,percent of total billed charges,,,4386.15,95,,percent of total billed charges,,,4155.3,90,,percent of total billed charges,,,4155.3,90,,percent of total billed charges,,,3785.94,82,,percent of total billed charges,,,4155.3,90,,percent of total billed charges,,,3924.45,85,,percent of total billed charges,,3481.22,4386.15,
FF FRACTURE PROXIMAL PHALANX,20500834,CDM,26740,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
FF FRACTURE TARSAL,20500835,CDM,28450,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
FF FRACTURE TOE PHALANX,20500836,CDM,28515,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
FF HEMORRHAGE CERVICAL PACK,20500839,CDM,57180,CPT,450,RC,inpatient,,876,876,,743.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,660.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,744.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,770.88,88,,percent of total billed charges,,,,,,,,,669.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,797.16,91,,percent of total billed charges,,,832.2,95,,percent of total billed charges,,,727.08,83,,percent of total billed charges,,,727.08,83,,percent of total billed charges,,,,,,,,,,,,,,,727.08,83,,percent of total billed charges,,,832.2,95,,percent of total billed charges,,,788.4,90,,percent of total billed charges,,,788.4,90,,percent of total billed charges,,,718.32,82,,percent of total billed charges,,,788.4,90,,percent of total billed charges,,,744.6,85,,percent of total billed charges,,660.5,832.2,
FF BURN DRESSING DEBRIDEMENT MEDIUM,20500841,CDM,16025,CPT,450,RC,inpatient,,1139,1139,,967.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,858.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,968.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1002.32,88,,percent of total billed charges,,,,,,,,,870.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,,,,,,,,,,,,,945.37,83,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,933.98,82,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,858.81,1082.05,
FF I&D ABCESS MOUTH,20500842,CDM,40800,CPT,450,RC,inpatient,,768,768,,652.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,579.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,652.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,675.84,88,,percent of total billed charges,,,,,,,,,586.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,698.88,91,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,,,,,,,,,,,,,637.44,83,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,629.76,82,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,579.07,729.6,
FF I&D ABCESS PERITONSELLEN,20500843,CDM,42700,CPT,450,RC,inpatient,,768,768,,652.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,579.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,652.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,675.84,88,,percent of total billed charges,,,,,,,,,586.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,698.88,91,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,,,,,,,,,,,,,637.44,83,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,629.76,82,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,579.07,729.6,
FF I&D ABSCESS COMPLEX,20500844,CDM,10061,CPT,450,RC,inpatient,,1334,1334,,1132.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1005.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1133.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1173.92,88,,percent of total billed charges,,,,,,,,,1019.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1213.94,91,,percent of total billed charges,,,1267.3,95,,percent of total billed charges,,,1107.22,83,,percent of total billed charges,,,1107.22,83,,percent of total billed charges,,,,,,,,,,,,,,,1107.22,83,,percent of total billed charges,,,1267.3,95,,percent of total billed charges,,,1200.6,90,,percent of total billed charges,,,1200.6,90,,percent of total billed charges,,,1093.88,82,,percent of total billed charges,,,1200.6,90,,percent of total billed charges,,,1133.9,85,,percent of total billed charges,,1005.84,1267.3,
FF I&D BURSA (ANKLE),20500845,CDM,27604,CPT,450,RC,inpatient,,7256,7256,,6160.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5471.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6167.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6385.28,88,,percent of total billed charges,,,,,,,,,5543.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6602.96,91,,percent of total billed charges,,,6893.2,95,,percent of total billed charges,,,6022.48,83,,percent of total billed charges,,,6022.48,83,,percent of total billed charges,,,,,,,,,,,,,,,6022.48,83,,percent of total billed charges,,,6893.2,95,,percent of total billed charges,,,6530.4,90,,percent of total billed charges,,,6530.4,90,,percent of total billed charges,,,5949.92,82,,percent of total billed charges,,,6530.4,90,,percent of total billed charges,,,6167.6,85,,percent of total billed charges,,5471.02,6893.2,
FF I&D BURSA (ELBOW),20500846,CDM,23931,CPT,450,RC,inpatient,,5810,5810,,4932.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4380.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4938.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5112.8,88,,percent of total billed charges,,,,,,,,,4438.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5287.1,91,,percent of total billed charges,,,5519.5,95,,percent of total billed charges,,,4822.3,83,,percent of total billed charges,,,4822.3,83,,percent of total billed charges,,,,,,,,,,,,,,,4822.3,83,,percent of total billed charges,,,5519.5,95,,percent of total billed charges,,,5229,90,,percent of total billed charges,,,5229,90,,percent of total billed charges,,,4764.2,82,,percent of total billed charges,,,5229,90,,percent of total billed charges,,,4938.5,85,,percent of total billed charges,,4380.74,5519.5,
FF I&D BURSA (FOOT),20500847,CDM,28001,CPT,450,RC,inpatient,,4167,4167,,3537.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3141.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3541.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3666.96,88,,percent of total billed charges,,,,,,,,,3183.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3791.97,91,,percent of total billed charges,,,3958.65,95,,percent of total billed charges,,,3458.61,83,,percent of total billed charges,,,3458.61,83,,percent of total billed charges,,,,,,,,,,,,,,,3458.61,83,,percent of total billed charges,,,3958.65,95,,percent of total billed charges,,,3750.3,90,,percent of total billed charges,,,3750.3,90,,percent of total billed charges,,,3416.94,82,,percent of total billed charges,,,3750.3,90,,percent of total billed charges,,,3541.95,85,,percent of total billed charges,,3141.92,3958.65,
FF I&D BURSA (KNEE),20500848,CDM,27301,CPT,450,RC,inpatient,,5810,5810,,4932.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4380.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4938.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5112.8,88,,percent of total billed charges,,,,,,,,,4438.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5287.1,91,,percent of total billed charges,,,5519.5,95,,percent of total billed charges,,,4822.3,83,,percent of total billed charges,,,4822.3,83,,percent of total billed charges,,,,,,,,,,,,,,,4822.3,83,,percent of total billed charges,,,5519.5,95,,percent of total billed charges,,,5229,90,,percent of total billed charges,,,5229,90,,percent of total billed charges,,,4764.2,82,,percent of total billed charges,,,5229,90,,percent of total billed charges,,,4938.5,85,,percent of total billed charges,,4380.74,5519.5,
FF I&D PERIRECTAL ABSCESS,20500849,CDM,46040,CPT,450,RC,inpatient,,6439,6439,,5466.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4855.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5473.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5666.32,88,,percent of total billed charges,,,,,,,,,4919.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5859.49,91,,percent of total billed charges,,,6117.05,95,,percent of total billed charges,,,5344.37,83,,percent of total billed charges,,,5344.37,83,,percent of total billed charges,,,,,,,,,,,,,,,5344.37,83,,percent of total billed charges,,,6117.05,95,,percent of total billed charges,,,5795.1,90,,percent of total billed charges,,,5795.1,90,,percent of total billed charges,,,5279.98,82,,percent of total billed charges,,,5795.1,90,,percent of total billed charges,,,5473.15,85,,percent of total billed charges,,4855.01,6117.05,
FF I&D POLONIDAL CYST,20500850,CDM,10080,CPT,450,RC,inpatient,,569,569,,483.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,429.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,483.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,500.72,88,,percent of total billed charges,,,,,,,,,434.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,517.79,91,,percent of total billed charges,,,540.55,95,,percent of total billed charges,,,472.27,83,,percent of total billed charges,,,472.27,83,,percent of total billed charges,,,,,,,,,,,,,,,472.27,83,,percent of total billed charges,,,540.55,95,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,466.58,82,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,483.65,85,,percent of total billed charges,,429.03,540.55,
 FF INJ BURSA (INTERMEDIATE JNT),20500852,CDM,20605,CPT,450,RC,inpatient,,678,678,,575.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,511.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,576.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,596.64,88,,percent of total billed charges,,,,,,,,,517.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,616.98,91,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,,,,,,,,,,,,,562.74,83,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,555.96,82,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,576.3,85,,percent of total billed charges,,511.21,644.1,
FF INJECTION OF AA&/STRD PERIPHERAL NERV,20500853,CDM,64450,CPT,450,RC,inpatient,,1449,1449,,1230.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1092.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1231.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1275.12,88,,percent of total billed charges,,,,,,,,,1107.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1318.59,91,,percent of total billed charges,,,1376.55,95,,percent of total billed charges,,,1202.67,83,,percent of total billed charges,,,1202.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1202.67,83,,percent of total billed charges,,,1376.55,95,,percent of total billed charges,,,1304.1,90,,percent of total billed charges,,,1304.1,90,,percent of total billed charges,,,1188.18,82,,percent of total billed charges,,,1304.1,90,,percent of total billed charges,,,1231.65,85,,percent of total billed charges,,1092.55,1376.55,
FF INJECTION BURSA,20500854,CDM,20600,CPT,450,RC,inpatient,,678,678,,575.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,511.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,576.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,596.64,88,,percent of total billed charges,,,,,,,,,517.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,616.98,91,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,,,,,,,,,,,,,562.74,83,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,555.96,82,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,576.3,85,,percent of total billed charges,,511.21,644.1,
FF INJECTION OF SINGLE TENDON SHEATH,20500855,CDM,20550,CPT,450,RC,inpatient,,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,627.33,790.4,
FF IRRIGATION EAR ONE OR BOTH,20500856,CDM,69210,CPT,450,RC,inpatient,,529,529,,449.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,398.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,449.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,465.52,88,,percent of total billed charges,,,,,,,,,404.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,481.39,91,,percent of total billed charges,,,502.55,95,,percent of total billed charges,,,439.07,83,,percent of total billed charges,,,439.07,83,,percent of total billed charges,,,,,,,,,,,,,,,439.07,83,,percent of total billed charges,,,502.55,95,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,433.78,82,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,449.65,85,,percent of total billed charges,,398.87,502.55,
FF LUMBAR PUNCTURE DIAG,20500857,CDM,62270,CPT,450,RC,inpatient,,3102,3102,,2633.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2338.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2636.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2729.76,88,,percent of total billed charges,,,,,,,,,2369.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2822.82,91,,percent of total billed charges,,,2946.9,95,,percent of total billed charges,,,2574.66,83,,percent of total billed charges,,,2574.66,83,,percent of total billed charges,,,,,,,,,,,,,,,2574.66,83,,percent of total billed charges,,,2946.9,95,,percent of total billed charges,,,2791.8,90,,percent of total billed charges,,,2791.8,90,,percent of total billed charges,,,2543.64,82,,percent of total billed charges,,,2791.8,90,,percent of total billed charges,,,2636.7,85,,percent of total billed charges,,2338.91,2946.9,
FF INJ/ASP MD JNT ELBOW ANKLE,20500858,CDM,20605,CPT,450,RC,inpatient,,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,627.33,790.4,
FF INJ/ASP SM JNT FINGER TOE,20500859,CDM,20600,CPT,450,RC,inpatient,,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,627.33,790.4,
FF NASAL HEMORRHAGE,20500861,CDM,30905,CPT,450,RC,inpatient,,830,830,,704.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,625.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,705.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,730.4,88,,percent of total billed charges,,,,,,,,,634.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,755.3,91,,percent of total billed charges,,,788.5,95,,percent of total billed charges,,,688.9,83,,percent of total billed charges,,,688.9,83,,percent of total billed charges,,,,,,,,,,,,,,,688.9,83,,percent of total billed charges,,,788.5,95,,percent of total billed charges,,,747,90,,percent of total billed charges,,,747,90,,percent of total billed charges,,,680.6,82,,percent of total billed charges,,,747,90,,percent of total billed charges,,,705.5,85,,percent of total billed charges,,625.82,788.5,
FF NASAL HEMORRHAGE ANT COMPLEX,20500862,CDM,30903,CPT,450,RC,inpatient,,1357,1357,,1152.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1023.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1153.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1194.16,88,,percent of total billed charges,,,,,,,,,1036.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1234.87,91,,percent of total billed charges,,,1289.15,95,,percent of total billed charges,,,1126.31,83,,percent of total billed charges,,,1126.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1126.31,83,,percent of total billed charges,,,1289.15,95,,percent of total billed charges,,,1221.3,90,,percent of total billed charges,,,1221.3,90,,percent of total billed charges,,,1112.74,82,,percent of total billed charges,,,1221.3,90,,percent of total billed charges,,,1153.45,85,,percent of total billed charges,,1023.18,1289.15,
FF NASAL HEMORRHAGE ANT SIMPLE,20500863,CDM,30901,CPT,450,RC,inpatient,,995,995,,844.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,750.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,845.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,875.6,88,,percent of total billed charges,,,,,,,,,760.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,905.45,91,,percent of total billed charges,,,945.25,95,,percent of total billed charges,,,825.85,83,,percent of total billed charges,,,825.85,83,,percent of total billed charges,,,,,,,,,,,,,,,825.85,83,,percent of total billed charges,,,945.25,95,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,815.9,82,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,845.75,85,,percent of total billed charges,,750.23,945.25,
FF NK HD FT GEN LYR 12.6 TO 20 CM,20500867,CDM,12045,CPT,450,RC,inpatient,,786,786,,667.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,592.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,668.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,691.68,88,,percent of total billed charges,,,,,,,,,600.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,715.26,91,,percent of total billed charges,,,746.7,95,,percent of total billed charges,,,652.38,83,,percent of total billed charges,,,652.38,83,,percent of total billed charges,,,,,,,,,,,,,,,652.38,83,,percent of total billed charges,,,746.7,95,,percent of total billed charges,,,707.4,90,,percent of total billed charges,,,707.4,90,,percent of total billed charges,,,644.52,82,,percent of total billed charges,,,707.4,90,,percent of total billed charges,,,668.1,85,,percent of total billed charges,,592.64,746.7,
FF NK HD FT GEN LYR 20.1 TO 30 CM,20500868,CDM,12046,CPT,450,RC,inpatient,,856,856,,726.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,645.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,727.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,753.28,88,,percent of total billed charges,,,,,,,,,653.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,778.96,91,,percent of total billed charges,,,813.2,95,,percent of total billed charges,,,710.48,83,,percent of total billed charges,,,710.48,83,,percent of total billed charges,,,,,,,,,,,,,,,710.48,83,,percent of total billed charges,,,813.2,95,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,701.92,82,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,727.6,85,,percent of total billed charges,,645.42,813.2,
FF NK HD FT GEN LYR 7.6 TO 12.5 CM,20500869,CDM,12044,CPT,450,RC,inpatient,,714,714,,606.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,538.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,606.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,628.32,88,,percent of total billed charges,,,,,,,,,545.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,649.74,91,,percent of total billed charges,,,678.3,95,,percent of total billed charges,,,592.62,83,,percent of total billed charges,,,592.62,83,,percent of total billed charges,,,,,,,,,,,,,,,592.62,83,,percent of total billed charges,,,678.3,95,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,585.48,82,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,606.9,85,,percent of total billed charges,,538.36,678.3,
FF NK HND FT GEN LYR > 30 CM,20500870,CDM,12047,CPT,450,RC,inpatient,,1914,1914,,1624.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1443.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1626.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1684.32,88,,percent of total billed charges,,,,,,,,,1462.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1741.74,91,,percent of total billed charges,,,1818.3,95,,percent of total billed charges,,,1588.62,83,,percent of total billed charges,,,1588.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1588.62,83,,percent of total billed charges,,,1818.3,95,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1569.48,82,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1626.9,85,,percent of total billed charges,,1443.16,1818.3,
FF NK HND FT GEN LYR 0 TO 2.5 CM,20500871,CDM,12041,CPT,450,RC,inpatient,,580,580,,492.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,437.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,493,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,510.4,88,,percent of total billed charges,,,,,,,,,443.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,527.8,91,,percent of total billed charges,,,551,95,,percent of total billed charges,,,481.4,83,,percent of total billed charges,,,481.4,83,,percent of total billed charges,,,,,,,,,,,,,,,481.4,83,,percent of total billed charges,,,551,95,,percent of total billed charges,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,475.6,82,,percent of total billed charges,,,522,90,,percent of total billed charges,,,493,85,,percent of total billed charges,,437.32,551,
FF NK HND FT GEN LYR 2.6 TO 7.5 CM,20500872,CDM,12042,CPT,450,RC,inpatient,,1530,1530,,1298.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1153.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1300.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1346.4,88,,percent of total billed charges,,,,,,,,,1168.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1392.3,91,,percent of total billed charges,,,1453.5,95,,percent of total billed charges,,,1269.9,83,,percent of total billed charges,,,1269.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1269.9,83,,percent of total billed charges,,,1453.5,95,,percent of total billed charges,,,1377,90,,percent of total billed charges,,,1377,90,,percent of total billed charges,,,1254.6,82,,percent of total billed charges,,,1377,90,,percent of total billed charges,,,1300.5,85,,percent of total billed charges,,1153.62,1453.5,
FF PERITONEAL LAVAGE DIAG,20500873,CDM,49082,CPT,450,RC,inpatient,,1170,1170,,993.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,882.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,994.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1029.6,88,,percent of total billed charges,,,,,,,,,893.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1064.7,91,,percent of total billed charges,,,1111.5,95,,percent of total billed charges,,,971.1,83,,percent of total billed charges,,,971.1,83,,percent of total billed charges,,,,,,,,,,,,,,,971.1,83,,percent of total billed charges,,,1111.5,95,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,959.4,82,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,994.5,85,,percent of total billed charges,,882.18,1111.5,
FF REMOVAL OF FB EAR,20500874,CDM,69200,CPT,450,RC,inpatient,,635,635,,539.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,478.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,539.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,558.8,88,,percent of total billed charges,,,,,,,,,485.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,577.85,91,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,,,,,,,,,,,,,527.05,83,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,520.7,82,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,539.75,85,,percent of total billed charges,,478.79,603.25,
FF REMOVAL OF FB INTRANASAL,20500875,CDM,30300,CPT,450,RC,inpatient,,635,635,,539.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,478.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,539.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,558.8,88,,percent of total billed charges,,,,,,,,,485.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,577.85,91,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,,,,,,,,,,,,,527.05,83,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,520.7,82,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,539.75,85,,percent of total billed charges,,478.79,603.25,
FF REMOVAL OF FB PHARYNX,20500876,CDM,42809,CPT,450,RC,inpatient,,635,635,,539.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,478.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,539.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,558.8,88,,percent of total billed charges,,,,,,,,,485.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,577.85,91,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,,,,,,,,,,,,,527.05,83,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,520.7,82,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,539.75,85,,percent of total billed charges,,478.79,603.25,
FF REMOVAL OF FB/CONJUNCTIVA,20500879,CDM,65205,CPT,450,RC,inpatient,,945,945,,802.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,712.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,803.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,831.6,88,,percent of total billed charges,,,,,,,,,721.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,859.95,91,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,,,,,,,,,,,,,784.35,83,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,774.9,82,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,803.25,85,,percent of total billed charges,,712.53,897.75,
FF REMOVAL OF FB/CORNEA,20500880,CDM,65220,CPT,450,RC,inpatient,,945,945,,802.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,712.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,803.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,831.6,88,,percent of total billed charges,,,,,,,,,721.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,859.95,91,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,,,,,,,,,,,,,784.35,83,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,774.9,82,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,803.25,85,,percent of total billed charges,,712.53,897.75,
FF REMOVAL OF FB/EMBED/CONJ,20500881,CDM,65210,CPT,450,RC,inpatient,,467,467,,396.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,352.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.96,88,,percent of total billed charges,,,,,,,,,356.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.97,91,,percent of total billed charges,,,443.65,95,,percent of total billed charges,,,387.61,83,,percent of total billed charges,,,387.61,83,,percent of total billed charges,,,,,,,,,,,,,,,387.61,83,,percent of total billed charges,,,443.65,95,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,382.94,82,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,396.95,85,,percent of total billed charges,,352.12,443.65,
FF SCALP TRK EXT LYR 2.6 TO 7.5 CM,20500882,CDM,12032,CPT,450,RC,inpatient,,2514,2514,,2134.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1895.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2136.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2212.32,88,,percent of total billed charges,,,,,,,,,1920.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2287.74,91,,percent of total billed charges,,,2388.3,95,,percent of total billed charges,,,2086.62,83,,percent of total billed charges,,,2086.62,83,,percent of total billed charges,,,,,,,,,,,,,,,2086.62,83,,percent of total billed charges,,,2388.3,95,,percent of total billed charges,,,2262.6,90,,percent of total billed charges,,,2262.6,90,,percent of total billed charges,,,2061.48,82,,percent of total billed charges,,,2262.6,90,,percent of total billed charges,,,2136.9,85,,percent of total billed charges,,1895.56,2388.3,
FF SCALP TRK EXT LYR 0 TO 2.5 CM,20500883,CDM,12031,CPT,450,RC,inpatient,,1731,1731,,1469.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1305.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1471.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1523.28,88,,percent of total billed charges,,,,,,,,,1322.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1575.21,91,,percent of total billed charges,,,1644.45,95,,percent of total billed charges,,,1436.73,83,,percent of total billed charges,,,1436.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1436.73,83,,percent of total billed charges,,,1644.45,95,,percent of total billed charges,,,1557.9,90,,percent of total billed charges,,,1557.9,90,,percent of total billed charges,,,1419.42,82,,percent of total billed charges,,,1557.9,90,,percent of total billed charges,,,1471.35,85,,percent of total billed charges,,1305.17,1644.45,
FF SCALP TRK EXT LYR > 30 CM,20500884,CDM,12037,CPT,450,RC,inpatient,,1914,1914,,1624.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1443.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1626.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1684.32,88,,percent of total billed charges,,,,,,,,,1462.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1741.74,91,,percent of total billed charges,,,1818.3,95,,percent of total billed charges,,,1588.62,83,,percent of total billed charges,,,1588.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1588.62,83,,percent of total billed charges,,,1818.3,95,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1569.48,82,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1626.9,85,,percent of total billed charges,,1443.16,1818.3,
FF SCALP TRK EXT LYR 12.6 TO 20 CM,20500885,CDM,12035,CPT,450,RC,inpatient,,2144,2144,,1820.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1616.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1822.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1886.72,88,,percent of total billed charges,,,,,,,,,1638.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1951.04,91,,percent of total billed charges,,,2036.8,95,,percent of total billed charges,,,1779.52,83,,percent of total billed charges,,,1779.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1779.52,83,,percent of total billed charges,,,2036.8,95,,percent of total billed charges,,,1929.6,90,,percent of total billed charges,,,1929.6,90,,percent of total billed charges,,,1758.08,82,,percent of total billed charges,,,1929.6,90,,percent of total billed charges,,,1822.4,85,,percent of total billed charges,,1616.58,2036.8,
FF SCALP TRK EXT LYR 20.1 TO 30 CM,20500886,CDM,12036,CPT,450,RC,inpatient,,856,856,,726.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,645.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,727.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,753.28,88,,percent of total billed charges,,,,,,,,,653.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,778.96,91,,percent of total billed charges,,,813.2,95,,percent of total billed charges,,,710.48,83,,percent of total billed charges,,,710.48,83,,percent of total billed charges,,,,,,,,,,,,,,,710.48,83,,percent of total billed charges,,,813.2,95,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,701.92,82,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,727.6,85,,percent of total billed charges,,645.42,813.2,
FF SCALP TRK EXT LYR 7.6 TO 12.5 CM,20500887,CDM,12034,CPT,450,RC,inpatient,,2147,2147,,1822.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1618.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1824.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1889.36,88,,percent of total billed charges,,,,,,,,,1640.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1953.77,91,,percent of total billed charges,,,2039.65,95,,percent of total billed charges,,,1782.01,83,,percent of total billed charges,,,1782.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1782.01,83,,percent of total billed charges,,,2039.65,95,,percent of total billed charges,,,1932.3,90,,percent of total billed charges,,,1932.3,90,,percent of total billed charges,,,1760.54,82,,percent of total billed charges,,,1932.3,90,,percent of total billed charges,,,1824.95,85,,percent of total billed charges,,1618.84,2039.65,
FF SHLD RELOCAT W MANIPULATION WO ANTH,20500888,CDM,23650,CPT,450,RC,inpatient,,1707,1707,,1449.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1287.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1450.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1502.16,88,,percent of total billed charges,,,,,,,,,1304.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1553.37,91,,percent of total billed charges,,,1621.65,95,,percent of total billed charges,,,1416.81,83,,percent of total billed charges,,,1416.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1416.81,83,,percent of total billed charges,,,1621.65,95,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1399.74,82,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1450.95,85,,percent of total billed charges,,1287.08,1621.65,
FF SPLINT FINGER,20500889,CDM,29130,CPT,450,RC,inpatient,,575,575,,488.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,433.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,488.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,506,88,,percent of total billed charges,,,,,,,,,439.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,523.25,91,,percent of total billed charges,,,546.25,95,,percent of total billed charges,,,477.25,83,,percent of total billed charges,,,477.25,83,,percent of total billed charges,,,,,,,,,,,,,,,477.25,83,,percent of total billed charges,,,546.25,95,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,471.5,82,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,488.75,85,,percent of total billed charges,,433.55,546.25,
FF SPLINT LONG ARM,20500890,CDM,29105,CPT,450,RC,inpatient,,1208,1208,,1025.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,910.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1026.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1063.04,88,,percent of total billed charges,,,,,,,,,922.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1099.28,91,,percent of total billed charges,,,1147.6,95,,percent of total billed charges,,,1002.64,83,,percent of total billed charges,,,1002.64,83,,percent of total billed charges,,,,,,,,,,,,,,,1002.64,83,,percent of total billed charges,,,1147.6,95,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,990.56,82,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,1026.8,85,,percent of total billed charges,,910.83,1147.6,
FF SPLINT LONG LEG,20500891,CDM,29505,CPT,450,RC,inpatient,,1208,1208,,1025.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,910.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1026.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1063.04,88,,percent of total billed charges,,,,,,,,,922.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1099.28,91,,percent of total billed charges,,,1147.6,95,,percent of total billed charges,,,1002.64,83,,percent of total billed charges,,,1002.64,83,,percent of total billed charges,,,,,,,,,,,,,,,1002.64,83,,percent of total billed charges,,,1147.6,95,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,990.56,82,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,1026.8,85,,percent of total billed charges,,910.83,1147.6,
FF SPLINT SHORT LEG,20500892,CDM,29515,CPT,450,RC,inpatient,,1004,1004,,852.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,757.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,853.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,883.52,88,,percent of total billed charges,,,,,,,,,767.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,913.64,91,,percent of total billed charges,,,953.8,95,,percent of total billed charges,,,833.32,83,,percent of total billed charges,,,833.32,83,,percent of total billed charges,,,,,,,,,,,,,,,833.32,83,,percent of total billed charges,,,953.8,95,,percent of total billed charges,,,903.6,90,,percent of total billed charges,,,903.6,90,,percent of total billed charges,,,823.28,82,,percent of total billed charges,,,903.6,90,,percent of total billed charges,,,853.4,85,,percent of total billed charges,,757.02,953.8,
FF LAC REP S N T H F EX 0 TO 2.5 CM,20500893,CDM,12001,CPT,450,RC,inpatient,,1094,1094,,928.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,824.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,929.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,962.72,88,,percent of total billed charges,,,,,,,,,835.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,995.54,91,,percent of total billed charges,,,1039.3,95,,percent of total billed charges,,,908.02,83,,percent of total billed charges,,,908.02,83,,percent of total billed charges,,,,,,,,,,,,,,,908.02,83,,percent of total billed charges,,,1039.3,95,,percent of total billed charges,,,984.6,90,,percent of total billed charges,,,984.6,90,,percent of total billed charges,,,897.08,82,,percent of total billed charges,,,984.6,90,,percent of total billed charges,,,929.9,85,,percent of total billed charges,,824.88,1039.3,
FF LAC REP N T H F EX 2.6 TO 7.5 CM,20500894,CDM,12002,CPT,450,RC,inpatient,,1243,1243,,1055.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,937.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1056.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1093.84,88,,percent of total billed charges,,,,,,,,,949.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1131.13,91,,percent of total billed charges,,,1180.85,95,,percent of total billed charges,,,1031.69,83,,percent of total billed charges,,,1031.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1031.69,83,,percent of total billed charges,,,1180.85,95,,percent of total billed charges,,,1118.7,90,,percent of total billed charges,,,1118.7,90,,percent of total billed charges,,,1019.26,82,,percent of total billed charges,,,1118.7,90,,percent of total billed charges,,,1056.55,85,,percent of total billed charges,,937.22,1180.85,
FF LAC REPS N T H F EX 20.1 TO 30.0 CM,20500895,CDM,12006,CPT,450,RC,inpatient,,1932,1932,,1640.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1456.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1642.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1700.16,88,,percent of total billed charges,,,,,,,,,1476.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1758.12,91,,percent of total billed charges,,,1835.4,95,,percent of total billed charges,,,1603.56,83,,percent of total billed charges,,,1603.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1603.56,83,,percent of total billed charges,,,1835.4,95,,percent of total billed charges,,,1738.8,90,,percent of total billed charges,,,1738.8,90,,percent of total billed charges,,,1584.24,82,,percent of total billed charges,,,1738.8,90,,percent of total billed charges,,,1642.2,85,,percent of total billed charges,,1456.73,1835.4,
FF LAC REP S N T H F EX 7.6 TO 12.5 CM,20500896,CDM,12004,CPT,450,RC,inpatient,,1511,1511,,1282.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1139.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1284.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1329.68,88,,percent of total billed charges,,,,,,,,,1154.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1375.01,91,,percent of total billed charges,,,1435.45,95,,percent of total billed charges,,,1254.13,83,,percent of total billed charges,,,1254.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1254.13,83,,percent of total billed charges,,,1435.45,95,,percent of total billed charges,,,1359.9,90,,percent of total billed charges,,,1359.9,90,,percent of total billed charges,,,1239.02,82,,percent of total billed charges,,,1359.9,90,,percent of total billed charges,,,1284.35,85,,percent of total billed charges,,1139.29,1435.45,
FF LAC REPSCLP NK TRK EXT > 30 CM,20500897,CDM,12007,CPT,450,RC,inpatient,,2345,2345,,1990.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1768.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1993.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2063.6,88,,percent of total billed charges,,,,,,,,,1791.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2133.95,91,,percent of total billed charges,,,2227.75,95,,percent of total billed charges,,,1946.35,83,,percent of total billed charges,,,1946.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1946.35,83,,percent of total billed charges,,,2227.75,95,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,1922.9,82,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,1993.25,85,,percent of total billed charges,,1768.13,2227.75,
FF LAC REP SNTHF EX 12.6 TO 20.0 CM,20500898,CDM,12005,CPT,450,RC,inpatient,,1836,1836,,1558.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1384.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1560.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1615.68,88,,percent of total billed charges,,,,,,,,,1402.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1670.76,91,,percent of total billed charges,,,1744.2,95,,percent of total billed charges,,,1523.88,83,,percent of total billed charges,,,1523.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1523.88,83,,percent of total billed charges,,,1744.2,95,,percent of total billed charges,,,1652.4,90,,percent of total billed charges,,,1652.4,90,,percent of total billed charges,,,1505.52,82,,percent of total billed charges,,,1652.4,90,,percent of total billed charges,,,1560.6,85,,percent of total billed charges,,1384.34,1744.2,
FF LAC REP TRUNK COMPLEX 1.1 TO 2.5 CM,20500899,CDM,13100,CPT,450,RC,inpatient,,1914,1914,,1624.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1443.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1626.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1684.32,88,,percent of total billed charges,,,,,,,,,1462.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1741.74,91,,percent of total billed charges,,,1818.3,95,,percent of total billed charges,,,1588.62,83,,percent of total billed charges,,,1588.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1588.62,83,,percent of total billed charges,,,1818.3,95,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1569.48,82,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1626.9,85,,percent of total billed charges,,1443.16,1818.3,
FF LAC REP COMP -F N G H F 1.1 TO 2.5 CM,20500900,CDM,13131,CPT,450,RC,inpatient,,2196,2196,,1864.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1655.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1866.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1932.48,88,,percent of total billed charges,,,,,,,,,1677.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1998.36,91,,percent of total billed charges,,,2086.2,95,,percent of total billed charges,,,1822.68,83,,percent of total billed charges,,,1822.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1822.68,83,,percent of total billed charges,,,2086.2,95,,percent of total billed charges,,,1976.4,90,,percent of total billed charges,,,1976.4,90,,percent of total billed charges,,,1800.72,82,,percent of total billed charges,,,1976.4,90,,percent of total billed charges,,,1866.6,85,,percent of total billed charges,,1655.78,2086.2,
FF LAC REPR FACE 12.6 TO 20.0 CM,20500901,CDM,12016,CPT,450,RC,inpatient,,2001,2001,,1698.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1508.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1700.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1760.88,88,,percent of total billed charges,,,,,,,,,1528.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1820.91,91,,percent of total billed charges,,,1900.95,95,,percent of total billed charges,,,1660.83,83,,percent of total billed charges,,,1660.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1660.83,83,,percent of total billed charges,,,1900.95,95,,percent of total billed charges,,,1800.9,90,,percent of total billed charges,,,1800.9,90,,percent of total billed charges,,,1640.82,82,,percent of total billed charges,,,1800.9,90,,percent of total billed charges,,,1700.85,85,,percent of total billed charges,,1508.75,1900.95,
FF LAC REP FACE 2.6 TO 5.0 CM,20500902,CDM,12013,CPT,450,RC,inpatient,,1243,1243,,1055.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,937.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1056.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1093.84,88,,percent of total billed charges,,,,,,,,,949.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1131.13,91,,percent of total billed charges,,,1180.85,95,,percent of total billed charges,,,1031.69,83,,percent of total billed charges,,,1031.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1031.69,83,,percent of total billed charges,,,1180.85,95,,percent of total billed charges,,,1118.7,90,,percent of total billed charges,,,1118.7,90,,percent of total billed charges,,,1019.26,82,,percent of total billed charges,,,1118.7,90,,percent of total billed charges,,,1056.55,85,,percent of total billed charges,,937.22,1180.85,
FF LAC REPR FACE 20.1 TO 30.0 CM,20500903,CDM,12017,CPT,450,RC,inpatient,,922,922,,782.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,695.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,783.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,811.36,88,,percent of total billed charges,,,,,,,,,704.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,839.02,91,,percent of total billed charges,,,875.9,95,,percent of total billed charges,,,765.26,83,,percent of total billed charges,,,765.26,83,,percent of total billed charges,,,,,,,,,,,,,,,765.26,83,,percent of total billed charges,,,875.9,95,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,756.04,82,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,783.7,85,,percent of total billed charges,,695.19,875.9,
FF LAC REPR FACE 30.1 CM,20500904,CDM,12018,CPT,450,RC,inpatient,,995,995,,844.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,750.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,845.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,875.6,88,,percent of total billed charges,,,,,,,,,760.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,905.45,91,,percent of total billed charges,,,945.25,95,,percent of total billed charges,,,825.85,83,,percent of total billed charges,,,825.85,83,,percent of total billed charges,,,,,,,,,,,,,,,825.85,83,,percent of total billed charges,,,945.25,95,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,815.9,82,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,845.75,85,,percent of total billed charges,,750.23,945.25,
FF LAC REP FACE 5.1 TO 7.5 CM,20500905,CDM,12014,CPT,450,RC,inpatient,,1392,1392,,1181.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1049.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1183.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1224.96,88,,percent of total billed charges,,,,,,,,,1063.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1266.72,91,,percent of total billed charges,,,1322.4,95,,percent of total billed charges,,,1155.36,83,,percent of total billed charges,,,1155.36,83,,percent of total billed charges,,,,,,,,,,,,,,,1155.36,83,,percent of total billed charges,,,1322.4,95,,percent of total billed charges,,,1252.8,90,,percent of total billed charges,,,1252.8,90,,percent of total billed charges,,,1141.44,82,,percent of total billed charges,,,1252.8,90,,percent of total billed charges,,,1183.2,85,,percent of total billed charges,,1049.57,1322.4,
FF LAC REP FACE 7.6 TO 12.5 CM,20500906,CDM,12015,CPT,450,RC,inpatient,,1588,1588,,1348.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1197.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1349.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1397.44,88,,percent of total billed charges,,,,,,,,,1213.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1445.08,91,,percent of total billed charges,,,1508.6,95,,percent of total billed charges,,,1318.04,83,,percent of total billed charges,,,1318.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1318.04,83,,percent of total billed charges,,,1508.6,95,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1302.16,82,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1349.8,85,,percent of total billed charges,,1197.35,1508.6,
FF LAC REPR FACE 0 TO 2.5 CM,20500907,CDM,12011,CPT,450,RC,inpatient,,1094,1094,,928.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,824.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,929.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,962.72,88,,percent of total billed charges,,,,,,,,,835.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,995.54,91,,percent of total billed charges,,,1039.3,95,,percent of total billed charges,,,908.02,83,,percent of total billed charges,,,908.02,83,,percent of total billed charges,,,,,,,,,,,,,,,908.02,83,,percent of total billed charges,,,1039.3,95,,percent of total billed charges,,,984.6,90,,percent of total billed charges,,,984.6,90,,percent of total billed charges,,,897.08,82,,percent of total billed charges,,,984.6,90,,percent of total billed charges,,,929.9,85,,percent of total billed charges,,824.88,1039.3,
FF LAC REPAIR 2.5 CM MOUTH/TONGUE,20500908,CDM,41250,CPT,450,RC,inpatient,,768,768,,652.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,579.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,652.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,675.84,88,,percent of total billed charges,,,,,,,,,586.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,698.88,91,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,,,,,,,,,,,,,637.44,83,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,629.76,82,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,579.07,729.6,
FF TEMPOROMANDIBULAR DISLOCATION,20500909,CDM,21480,CPT,450,RC,inpatient,,768,768,,652.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,579.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,652.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,675.84,88,,percent of total billed charges,,,,,,,,,586.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,698.88,91,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,,,,,,,,,,,,,637.44,83,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,629.76,82,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,579.07,729.6,
FF PLACEMENT NEEDLE INTRAOSSEOUS,20500913,CDM,36680,CPT,450,RC,inpatient,,1310,1310,,1112.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,987.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1113.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1152.8,88,,percent of total billed charges,,,,,,,,,1000.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1192.1,91,,percent of total billed charges,,,1244.5,95,,percent of total billed charges,,,1087.3,83,,percent of total billed charges,,,1087.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1087.3,83,,percent of total billed charges,,,1244.5,95,,percent of total billed charges,,,1179,90,,percent of total billed charges,,,1179,90,,percent of total billed charges,,,1074.2,82,,percent of total billed charges,,,1179,90,,percent of total billed charges,,,1113.5,85,,percent of total billed charges,,987.74,1244.5,
FF GASTRO INTUB W/ASP,20500914,CDM,43753,CPT,450,RC,inpatient,,533,533,,452.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,401.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,453.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,469.04,88,,percent of total billed charges,,,,,,,,,407.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,485.03,91,,percent of total billed charges,,,506.35,95,,percent of total billed charges,,,442.39,83,,percent of total billed charges,,,442.39,83,,percent of total billed charges,,,,,,,,,,,,,,,442.39,83,,percent of total billed charges,,,506.35,95,,percent of total billed charges,,,479.7,90,,percent of total billed charges,,,479.7,90,,percent of total billed charges,,,437.06,82,,percent of total billed charges,,,479.7,90,,percent of total billed charges,,,453.05,85,,percent of total billed charges,,401.88,506.35,
FF I&D SKIN SIMPLE,20500915,CDM,10060,CPT,450,RC,inpatient,,1601,1601,,1359.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1207.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1360.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1408.88,88,,percent of total billed charges,,,,,,,,,1223.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1456.91,91,,percent of total billed charges,,,1520.95,95,,percent of total billed charges,,,1328.83,83,,percent of total billed charges,,,1328.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1328.83,83,,percent of total billed charges,,,1520.95,95,,percent of total billed charges,,,1440.9,90,,percent of total billed charges,,,1440.9,90,,percent of total billed charges,,,1312.82,82,,percent of total billed charges,,,1440.9,90,,percent of total billed charges,,,1360.85,85,,percent of total billed charges,,1207.15,1520.95,
FF CLOSED REDUCT OF TIBIA DISLO WO ANEST,20500916,CDM,27830,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
FF CLOSED REDUCT OF ELBOW DISLO WO ANEST,20500917,CDM,24600,CPT,450,RC,inpatient,,1422,1422,,1207.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1072.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1208.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1251.36,88,,percent of total billed charges,,,,,,,,,1086.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1294.02,91,,percent of total billed charges,,,1350.9,95,,percent of total billed charges,,,1180.26,83,,percent of total billed charges,,,1180.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1180.26,83,,percent of total billed charges,,,1350.9,95,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1166.04,82,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1208.7,85,,percent of total billed charges,,1072.19,1350.9,
FF CLOSED REDUCT OF ELBOW DISLO W/ ANEST,20500918,CDM,24605,CPT,450,RC,inpatient,,4961,4961,,4211.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3740.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4216.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4365.68,88,,percent of total billed charges,,,,,,,,,3790.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4514.51,91,,percent of total billed charges,,,4712.95,95,,percent of total billed charges,,,4117.63,83,,percent of total billed charges,,,4117.63,83,,percent of total billed charges,,,,,,,,,,,,,,,4117.63,83,,percent of total billed charges,,,4712.95,95,,percent of total billed charges,,,4464.9,90,,percent of total billed charges,,,4464.9,90,,percent of total billed charges,,,4068.02,82,,percent of total billed charges,,,4464.9,90,,percent of total billed charges,,,4216.85,85,,percent of total billed charges,,3740.59,4712.95,
FF SPLINT SHORT ARM,20500919,CDM,29125,CPT,450,RC,inpatient,,1208,1208,,1025.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,910.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1026.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1063.04,88,,percent of total billed charges,,,,,,,,,922.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1099.28,91,,percent of total billed charges,,,1147.6,95,,percent of total billed charges,,,1002.64,83,,percent of total billed charges,,,1002.64,83,,percent of total billed charges,,,,,,,,,,,,,,,1002.64,83,,percent of total billed charges,,,1147.6,95,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,990.56,82,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,1026.8,85,,percent of total billed charges,,910.83,1147.6,
FF CLOSED REDUCT THUMB DISLO WO ANEST,20500920,CDM,26641,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
FF CLD REDUCT METACARPOPHALANGEAL WO ANE,20500921,CDM,26700,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
FF CLOSED REDUCTION OF DISLOCATED TOE,20500922,CDM,28660,CPT,450,RC,inpatient,,1422,1422,,1207.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1072.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1208.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1251.36,88,,percent of total billed charges,,,,,,,,,1086.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1294.02,91,,percent of total billed charges,,,1350.9,95,,percent of total billed charges,,,1180.26,83,,percent of total billed charges,,,1180.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1180.26,83,,percent of total billed charges,,,1350.9,95,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1166.04,82,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1208.7,85,,percent of total billed charges,,1072.19,1350.9,
FF CLOSED TX RADIAL SHAFT FRACTURE,20500923,CDM,25505,CPT,450,RC,inpatient,,2751,2751,,2335.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2074.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2338.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2420.88,88,,percent of total billed charges,,,,,,,,,2101.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2503.41,91,,percent of total billed charges,,,2613.45,95,,percent of total billed charges,,,2283.33,83,,percent of total billed charges,,,2283.33,83,,percent of total billed charges,,,,,,,,,,,,,,,2283.33,83,,percent of total billed charges,,,2613.45,95,,percent of total billed charges,,,2475.9,90,,percent of total billed charges,,,2475.9,90,,percent of total billed charges,,,2255.82,82,,percent of total billed charges,,,2475.9,90,,percent of total billed charges,,,2338.35,85,,percent of total billed charges,,2074.25,2613.45,
FF REMOVL OF FORN BDY SUBCUT TISSUE SMPL,20500925,CDM,10120,CPT,450,RC,inpatient,,2043,2043,,1734.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1540.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1736.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1797.84,88,,percent of total billed charges,,,,,,,,,1560.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1859.13,91,,percent of total billed charges,,,1940.85,95,,percent of total billed charges,,,1695.69,83,,percent of total billed charges,,,1695.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1695.69,83,,percent of total billed charges,,,1940.85,95,,percent of total billed charges,,,1838.7,90,,percent of total billed charges,,,1838.7,90,,percent of total billed charges,,,1675.26,82,,percent of total billed charges,,,1838.7,90,,percent of total billed charges,,,1736.55,85,,percent of total billed charges,,1540.42,1940.85,
"FF REMOVAL OF EMBEDDED FB, EYELID",20500926,CDM,67938,CPT,450,RC,inpatient,,467,467,,396.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,352.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.96,88,,percent of total billed charges,,,,,,,,,356.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.97,91,,percent of total billed charges,,,443.65,95,,percent of total billed charges,,,387.61,83,,percent of total billed charges,,,387.61,83,,percent of total billed charges,,,,,,,,,,,,,,,387.61,83,,percent of total billed charges,,,443.65,95,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,382.94,82,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,396.95,85,,percent of total billed charges,,352.12,443.65,
"FF REPAIR, EXTENSOR TENDON, FINGER",20500927,CDM,26418,CPT,450,RC,inpatient,,5568,5568,,4727.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4198.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4732.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4899.84,88,,percent of total billed charges,,,,,,,,,4253.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5066.88,91,,percent of total billed charges,,,5289.6,95,,percent of total billed charges,,,4621.44,83,,percent of total billed charges,,,4621.44,83,,percent of total billed charges,,,,,,,,,,,,,,,4621.44,83,,percent of total billed charges,,,5289.6,95,,percent of total billed charges,,,5011.2,90,,percent of total billed charges,,,5011.2,90,,percent of total billed charges,,,4565.76,82,,percent of total billed charges,,,5011.2,90,,percent of total billed charges,,,4732.8,85,,percent of total billed charges,,4198.27,5289.6,
"FF UNLISTED PROCEDURE, HANDS OR FINGERS",20500928,CDM,26989,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
FF AVULSION OF NAIL PLATE,20500929,CDM,11730,CPT,450,RC,inpatient,,912,912,,774.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,687.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,775.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,802.56,88,,percent of total billed charges,,,,,,,,,696.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,829.92,91,,percent of total billed charges,,,866.4,95,,percent of total billed charges,,,756.96,83,,percent of total billed charges,,,756.96,83,,percent of total billed charges,,,,,,,,,,,,,,,756.96,83,,percent of total billed charges,,,866.4,95,,percent of total billed charges,,,820.8,90,,percent of total billed charges,,,820.8,90,,percent of total billed charges,,,747.84,82,,percent of total billed charges,,,820.8,90,,percent of total billed charges,,,775.2,85,,percent of total billed charges,,687.65,866.4,
FF SU-F N G H F COMP 2.6-7.5 CM,20500930,CDM,13132,CPT,450,RC,inpatient,,2414,2414,,2049.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1820.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2051.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2124.32,88,,percent of total billed charges,,,,,,,,,1844.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2196.74,91,,percent of total billed charges,,,2293.3,95,,percent of total billed charges,,,2003.62,83,,percent of total billed charges,,,2003.62,83,,percent of total billed charges,,,,,,,,,,,,,,,2003.62,83,,percent of total billed charges,,,2293.3,95,,percent of total billed charges,,,2172.6,90,,percent of total billed charges,,,2172.6,90,,percent of total billed charges,,,1979.48,82,,percent of total billed charges,,,2172.6,90,,percent of total billed charges,,,2051.9,85,,percent of total billed charges,,1820.16,2293.3,
FF REPAIR OF NAIL BED,20500931,CDM,11760,CPT,450,RC,inpatient,,1219,1219,,1034.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,919.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1036.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1072.72,88,,percent of total billed charges,,,,,,,,,931.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1109.29,91,,percent of total billed charges,,,1158.05,95,,percent of total billed charges,,,1011.77,83,,percent of total billed charges,,,1011.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1011.77,83,,percent of total billed charges,,,1158.05,95,,percent of total billed charges,,,1097.1,90,,percent of total billed charges,,,1097.1,90,,percent of total billed charges,,,999.58,82,,percent of total billed charges,,,1097.1,90,,percent of total billed charges,,,1036.15,85,,percent of total billed charges,,919.13,1158.05,
FF DRAINAGE OF HEMATOMA,20500933,CDM,10140,CPT,450,RC,inpatient,,4020,4020,,3412.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3031.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3417,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3537.6,88,,percent of total billed charges,,,,,,,,,3071.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3658.2,91,,percent of total billed charges,,,3819,95,,percent of total billed charges,,,3336.6,83,,percent of total billed charges,,,3336.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3336.6,83,,percent of total billed charges,,,3819,95,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3296.4,82,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3417,85,,percent of total billed charges,,3031.08,3819,
FF SU-S A L COMP 1.1-2.5 CM,20500935,CDM,13120,CPT,450,RC,inpatient,,1801,1801,,1529.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1357.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1530.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1584.88,88,,percent of total billed charges,,,,,,,,,1375.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1638.91,91,,percent of total billed charges,,,1710.95,95,,percent of total billed charges,,,1494.83,83,,percent of total billed charges,,,1494.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1494.83,83,,percent of total billed charges,,,1710.95,95,,percent of total billed charges,,,1620.9,90,,percent of total billed charges,,,1620.9,90,,percent of total billed charges,,,1476.82,82,,percent of total billed charges,,,1620.9,90,,percent of total billed charges,,,1530.85,85,,percent of total billed charges,,1357.95,1710.95,
FF SU-S A L COMP 2.6-7.5 CM,20500936,CDM,13121,CPT,450,RC,inpatient,,2279,2279,,1934.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1718.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1937.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2005.52,88,,percent of total billed charges,,,,,,,,,1741.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2073.89,91,,percent of total billed charges,,,2165.05,95,,percent of total billed charges,,,1891.57,83,,percent of total billed charges,,,1891.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1891.57,83,,percent of total billed charges,,,2165.05,95,,percent of total billed charges,,,2051.1,90,,percent of total billed charges,,,2051.1,90,,percent of total billed charges,,,1868.78,82,,percent of total billed charges,,,2051.1,90,,percent of total billed charges,,,1937.15,85,,percent of total billed charges,,1718.37,2165.05,
"FF EXPLORATION PENETRATING WOUND, NECK",20500937,CDM,20100,CPT,450,RC,inpatient,,5947,5947,,5049,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4484.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5054.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5233.36,88,,percent of total billed charges,,,,,,,,,4543.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5411.77,91,,percent of total billed charges,,,5649.65,95,,percent of total billed charges,,,4936.01,83,,percent of total billed charges,,,4936.01,83,,percent of total billed charges,,,,,,,,,,,,,,,4936.01,83,,percent of total billed charges,,,5649.65,95,,percent of total billed charges,,,5352.3,90,,percent of total billed charges,,,5352.3,90,,percent of total billed charges,,,4876.54,82,,percent of total billed charges,,,5352.3,90,,percent of total billed charges,,,5054.95,85,,percent of total billed charges,,4484.04,5649.65,
"FF EXPLOR PENETRATING WOUND, EXTREMITY",20500938,CDM,20103,CPT,450,RC,inpatient,,6322,6322,,5367.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4766.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5373.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5563.36,88,,percent of total billed charges,,,,,,,,,4830.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5753.02,91,,percent of total billed charges,,,6005.9,95,,percent of total billed charges,,,5247.26,83,,percent of total billed charges,,,5247.26,83,,percent of total billed charges,,,,,,,,,,,,,,,5247.26,83,,percent of total billed charges,,,6005.9,95,,percent of total billed charges,,,5689.8,90,,percent of total billed charges,,,5689.8,90,,percent of total billed charges,,,5184.04,82,,percent of total billed charges,,,5689.8,90,,percent of total billed charges,,,5373.7,85,,percent of total billed charges,,4766.79,6005.9,
FF TRIGGER POINT INJ 1 OR 2 MUSCLE GRP,20500939,CDM,20552,CPT,450,RC,inpatient,,1943,1943,,1649.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1465.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1651.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1709.84,88,,percent of total billed charges,,,,,,,,,1484.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1768.13,91,,percent of total billed charges,,,1845.85,95,,percent of total billed charges,,,1612.69,83,,percent of total billed charges,,,1612.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1612.69,83,,percent of total billed charges,,,1845.85,95,,percent of total billed charges,,,1748.7,90,,percent of total billed charges,,,1748.7,90,,percent of total billed charges,,,1593.26,82,,percent of total billed charges,,,1748.7,90,,percent of total billed charges,,,1651.55,85,,percent of total billed charges,,1465.02,1845.85,
FF TRIGGER PNT INJ 3 OR MORE MUSCLE GRP,20500940,CDM,20553,CPT,450,RC,inpatient,,936,936,,794.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,705.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,795.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,823.68,88,,percent of total billed charges,,,,,,,,,715.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,851.76,91,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,,,,,,,,,,,,,776.88,83,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,767.52,82,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,795.6,85,,percent of total billed charges,,705.74,889.2,
FF CLSD TX PROX HUMERAL FX W/MANIPULATIO,20500941,CDM,23605,CPT,450,RC,inpatient,,4766,4766,,4046.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3593.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4051.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4194.08,88,,percent of total billed charges,,,,,,,,,3641.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4337.06,91,,percent of total billed charges,,,4527.7,95,,percent of total billed charges,,,3955.78,83,,percent of total billed charges,,,3955.78,83,,percent of total billed charges,,,,,,,,,,,,,,,3955.78,83,,percent of total billed charges,,,4527.7,95,,percent of total billed charges,,,4289.4,90,,percent of total billed charges,,,4289.4,90,,percent of total billed charges,,,3908.12,82,,percent of total billed charges,,,4289.4,90,,percent of total billed charges,,,4051.1,85,,percent of total billed charges,,3593.56,4527.7,
FF RPR/ADV OF TENDON IN FINGER,20500942,CDM,26370,CPT,450,RC,inpatient,,8940,8940,,7590.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6740.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7599,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7867.2,88,,percent of total billed charges,,,,,,,,,6830.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8135.4,91,,percent of total billed charges,,,8493,95,,percent of total billed charges,,,7420.2,83,,percent of total billed charges,,,7420.2,83,,percent of total billed charges,,,,,,,,,,,,,,,7420.2,83,,percent of total billed charges,,,8493,95,,percent of total billed charges,,,8046,90,,percent of total billed charges,,,8046,90,,percent of total billed charges,,,7330.8,82,,percent of total billed charges,,,8046,90,,percent of total billed charges,,,7599,85,,percent of total billed charges,,6740.76,8493,
FF CLSD TX INTERPHALANGEAL JOINT DISL,20500943,CDM,26770,CPT,450,RC,inpatient,,1707,1707,,1449.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1287.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1450.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1502.16,88,,percent of total billed charges,,,,,,,,,1304.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1553.37,91,,percent of total billed charges,,,1621.65,95,,percent of total billed charges,,,1416.81,83,,percent of total billed charges,,,1416.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1416.81,83,,percent of total billed charges,,,1621.65,95,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1399.74,82,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1450.95,85,,percent of total billed charges,,1287.08,1621.65,
FF KNEE DISLOCATION W/O ANESTHESIA,20500944,CDM,27550,CPT,450,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
FF CLOSED REDUCTION PATELLA W/O ANESTH,20500945,CDM,27560,CPT,450,RC,inpatient,,1120,1120,,950.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,844.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,952,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,985.6,88,,percent of total billed charges,,,,,,,,,855.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1019.2,91,,percent of total billed charges,,,1064,95,,percent of total billed charges,,,929.6,83,,percent of total billed charges,,,929.6,83,,percent of total billed charges,,,,,,,,,,,,,,,929.6,83,,percent of total billed charges,,,1064,95,,percent of total billed charges,,,1008,90,,percent of total billed charges,,,1008,90,,percent of total billed charges,,,918.4,82,,percent of total billed charges,,,1008,90,,percent of total billed charges,,,952,85,,percent of total billed charges,,844.48,1064,
"FF REMOVAL OF FB, SUBQ, FOOT",20500946,CDM,28190,CPT,450,RC,inpatient,,1499,1499,,1272.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1130.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1274.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1319.12,88,,percent of total billed charges,,,,,,,,,1145.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1364.09,91,,percent of total billed charges,,,1424.05,95,,percent of total billed charges,,,1244.17,83,,percent of total billed charges,,,1244.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1244.17,83,,percent of total billed charges,,,1424.05,95,,percent of total billed charges,,,1349.1,90,,percent of total billed charges,,,1349.1,90,,percent of total billed charges,,,1229.18,82,,percent of total billed charges,,,1349.1,90,,percent of total billed charges,,,1274.15,85,,percent of total billed charges,,1130.25,1424.05,
FF ARTERIAL PUNCTURE DIAGNOSTIC,20500947,CDM,36600,CPT,450,RC,inpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,155.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,155.32,195.7,
FF INCISION OF THROMBOSED HEMORRHOID,20500948,CDM,46083,CPT,450,RC,inpatient,,1274,1274,,1081.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,960.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1082.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1121.12,88,,percent of total billed charges,,,,,,,,,973.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1159.34,91,,percent of total billed charges,,,1210.3,95,,percent of total billed charges,,,1057.42,83,,percent of total billed charges,,,1057.42,83,,percent of total billed charges,,,,,,,,,,,,,,,1057.42,83,,percent of total billed charges,,,1210.3,95,,percent of total billed charges,,,1146.6,90,,percent of total billed charges,,,1146.6,90,,percent of total billed charges,,,1044.68,82,,percent of total billed charges,,,1146.6,90,,percent of total billed charges,,,1082.9,85,,percent of total billed charges,,960.6,1210.3,
FF OB DELIVERY BY ED STAFF,20500949,CDM,59409,CPT,450,RC,inpatient,,7348,7348,,6238.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5540.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6245.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6466.24,88,,percent of total billed charges,,,,,,,,,5613.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6686.68,91,,percent of total billed charges,,,6980.6,95,,percent of total billed charges,,,6098.84,83,,percent of total billed charges,,,6098.84,83,,percent of total billed charges,,,,,,,,,,,,,,,6098.84,83,,percent of total billed charges,,,6980.6,95,,percent of total billed charges,,,6613.2,90,,percent of total billed charges,,,6613.2,90,,percent of total billed charges,,,6025.36,82,,percent of total billed charges,,,6613.2,90,,percent of total billed charges,,,6245.8,85,,percent of total billed charges,,5540.39,6980.6,
"FF BLEPHAROTOMY, ABSCESS DR, EYELID",20500950,CDM,67700,CPT,450,RC,inpatient,,953,953,,809.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,718.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,810.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,838.64,88,,percent of total billed charges,,,,,,,,,728.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,867.23,91,,percent of total billed charges,,,905.35,95,,percent of total billed charges,,,790.99,83,,percent of total billed charges,,,790.99,83,,percent of total billed charges,,,,,,,,,,,,,,,790.99,83,,percent of total billed charges,,,905.35,95,,percent of total billed charges,,,857.7,90,,percent of total billed charges,,,857.7,90,,percent of total billed charges,,,781.46,82,,percent of total billed charges,,,857.7,90,,percent of total billed charges,,,810.05,85,,percent of total billed charges,,718.56,905.35,
FF TEMPORARY EXTERNAL PACING,20500951,CDM,92953,CPT,450,RC,inpatient,,905,905,,768.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,682.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,769.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,796.4,88,,percent of total billed charges,,,,,,,,,691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,823.55,91,,percent of total billed charges,,,859.75,95,,percent of total billed charges,,,751.15,83,,percent of total billed charges,,,751.15,83,,percent of total billed charges,,,,,,,,,,,,,,,751.15,83,,percent of total billed charges,,,859.75,95,,percent of total billed charges,,,814.5,90,,percent of total billed charges,,,814.5,90,,percent of total billed charges,,,742.1,82,,percent of total billed charges,,,814.5,90,,percent of total billed charges,,,769.25,85,,percent of total billed charges,,682.37,859.75,
FF TUBE THORACOSTOMY,20500960,CDM,32551,CPT,450,RC,inpatient,,3503,3503,,2974.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2641.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2977.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3082.64,88,,percent of total billed charges,,,,,,,,,2676.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3187.73,91,,percent of total billed charges,,,3327.85,95,,percent of total billed charges,,,2907.49,83,,percent of total billed charges,,,2907.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2907.49,83,,percent of total billed charges,,,3327.85,95,,percent of total billed charges,,,3152.7,90,,percent of total billed charges,,,3152.7,90,,percent of total billed charges,,,2872.46,82,,percent of total billed charges,,,3152.7,90,,percent of total billed charges,,,2977.55,85,,percent of total billed charges,,2641.26,3327.85,
FF UNLISTED PROCEDURE RECTUM,20500961,CDM,45999,CPT,450,RC,inpatient,,4905,4905,,4164.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3698.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4169.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4316.4,88,,percent of total billed charges,,,,,,,,,3747.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4463.55,91,,percent of total billed charges,,,4659.75,95,,percent of total billed charges,,,4071.15,83,,percent of total billed charges,,,4071.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4071.15,83,,percent of total billed charges,,,4659.75,95,,percent of total billed charges,,,4414.5,90,,percent of total billed charges,,,4414.5,90,,percent of total billed charges,,,4022.1,82,,percent of total billed charges,,,4414.5,90,,percent of total billed charges,,,4169.25,85,,percent of total billed charges,,3698.37,4659.75,
FF CLOSED TREAT RADIAL ULNAR W MANIPULAT,20500962,CDM,25565,CPT,450,RC,inpatient,,2535,2535,,2152.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1911.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2154.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2230.8,88,,percent of total billed charges,,,,,,,,,1936.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2306.85,91,,percent of total billed charges,,,2408.25,95,,percent of total billed charges,,,2104.05,83,,percent of total billed charges,,,2104.05,83,,percent of total billed charges,,,,,,,,,,,,,,,2104.05,83,,percent of total billed charges,,,2408.25,95,,percent of total billed charges,,,2281.5,90,,percent of total billed charges,,,2281.5,90,,percent of total billed charges,,,2078.7,82,,percent of total billed charges,,,2281.5,90,,percent of total billed charges,,,2154.75,85,,percent of total billed charges,,1911.39,2408.25,
FF EXPLOR PENETRATING WOUND ABD/BACK,20500970,CDM,20102,CPT,450,RC,inpatient,,7487,7487,,6356.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5645.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6363.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6588.56,88,,percent of total billed charges,,,,,,,,,5720.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6813.17,91,,percent of total billed charges,,,7112.65,95,,percent of total billed charges,,,6214.21,83,,percent of total billed charges,,,6214.21,83,,percent of total billed charges,,,,,,,,,,,,,,,6214.21,83,,percent of total billed charges,,,7112.65,95,,percent of total billed charges,,,6738.3,90,,percent of total billed charges,,,6738.3,90,,percent of total billed charges,,,6139.34,82,,percent of total billed charges,,,6738.3,90,,percent of total billed charges,,,6363.95,85,,percent of total billed charges,,5645.2,7112.65,
FF CLD TREAT METACARP FRACT SG W/ MANIP,20500972,CDM,26605,CPT,450,RC,inpatient,,1686,1686,,1431.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1271.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1433.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1483.68,88,,percent of total billed charges,,,,,,,,,1288.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1534.26,91,,percent of total billed charges,,,1601.7,95,,percent of total billed charges,,,1399.38,83,,percent of total billed charges,,,1399.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1399.38,83,,percent of total billed charges,,,1601.7,95,,percent of total billed charges,,,1517.4,90,,percent of total billed charges,,,1517.4,90,,percent of total billed charges,,,1382.52,82,,percent of total billed charges,,,1517.4,90,,percent of total billed charges,,,1433.1,85,,percent of total billed charges,,1271.24,1601.7,
FF CLOSED SHLD RELOCAT W/SEDATIO,20500975,CDM,23655,CPT,450,RC,inpatient,,4297,4297,,3648.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3239.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3652.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3781.36,88,,percent of total billed charges,,,,,,,,,3282.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3910.27,91,,percent of total billed charges,,,4082.15,95,,percent of total billed charges,,,3566.51,83,,percent of total billed charges,,,3566.51,83,,percent of total billed charges,,,,,,,,,,,,,,,3566.51,83,,percent of total billed charges,,,4082.15,95,,percent of total billed charges,,,3867.3,90,,percent of total billed charges,,,3867.3,90,,percent of total billed charges,,,3523.54,82,,percent of total billed charges,,,3867.3,90,,percent of total billed charges,,,3652.45,85,,percent of total billed charges,,3239.94,4082.15,
FF I&D PERINEAL ABSCESS,20500976,CDM,56405,CPT,450,RC,inpatient,,3960,3960,,3362.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2985.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3366,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3484.8,88,,percent of total billed charges,,,,,,,,,3025.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3603.6,91,,percent of total billed charges,,,3762,95,,percent of total billed charges,,,3286.8,83,,percent of total billed charges,,,3286.8,83,,percent of total billed charges,,,,,,,,,,,,,,,3286.8,83,,percent of total billed charges,,,3762,95,,percent of total billed charges,,,3564,90,,percent of total billed charges,,,3564,90,,percent of total billed charges,,,3247.2,82,,percent of total billed charges,,,3564,90,,percent of total billed charges,,,3366,85,,percent of total billed charges,,2985.84,3762,
FF INJECTION BURSA INTERMEDIATE,20500978,CDM,20605,CPT,450,RC,inpatient,,710,710,,602.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,535.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,603.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,624.8,88,,percent of total billed charges,,,,,,,,,542.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,646.1,91,,percent of total billed charges,,,674.5,95,,percent of total billed charges,,,589.3,83,,percent of total billed charges,,,589.3,83,,percent of total billed charges,,,,,,,,,,,,,,,589.3,83,,percent of total billed charges,,,674.5,95,,percent of total billed charges,,,639,90,,percent of total billed charges,,,639,90,,percent of total billed charges,,,582.2,82,,percent of total billed charges,,,639,90,,percent of total billed charges,,,603.5,85,,percent of total billed charges,,535.34,674.5,
FF BURSA INTERMEDIATE,20500979,CDM,20605,CPT,450,RC,inpatient,,710,710,,602.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,535.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,603.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,624.8,88,,percent of total billed charges,,,,,,,,,542.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,646.1,91,,percent of total billed charges,,,674.5,95,,percent of total billed charges,,,589.3,83,,percent of total billed charges,,,589.3,83,,percent of total billed charges,,,,,,,,,,,,,,,589.3,83,,percent of total billed charges,,,674.5,95,,percent of total billed charges,,,639,90,,percent of total billed charges,,,639,90,,percent of total billed charges,,,582.2,82,,percent of total billed charges,,,639,90,,percent of total billed charges,,,603.5,85,,percent of total billed charges,,535.34,674.5,
FF BURSA INTERMEDIATE,20500980,CDM,20605,CPT,450,RC,inpatient,,710,710,,602.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,535.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,603.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,624.8,88,,percent of total billed charges,,,,,,,,,542.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,646.1,91,,percent of total billed charges,,,674.5,95,,percent of total billed charges,,,589.3,83,,percent of total billed charges,,,589.3,83,,percent of total billed charges,,,,,,,,,,,,,,,589.3,83,,percent of total billed charges,,,674.5,95,,percent of total billed charges,,,639,90,,percent of total billed charges,,,639,90,,percent of total billed charges,,,582.2,82,,percent of total billed charges,,,639,90,,percent of total billed charges,,,603.5,85,,percent of total billed charges,,535.34,674.5,
FF PUNCTURE ASPIRATION OF ABCESS CYST BU,20500985,CDM,10160,CPT,450,RC,inpatient,,597,597,,506.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,450.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,507.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,525.36,88,,percent of total billed charges,,,,,,,,,456.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,543.27,91,,percent of total billed charges,,,567.15,95,,percent of total billed charges,,,495.51,83,,percent of total billed charges,,,495.51,83,,percent of total billed charges,,,,,,,,,,,,,,,495.51,83,,percent of total billed charges,,,567.15,95,,percent of total billed charges,,,537.3,90,,percent of total billed charges,,,537.3,90,,percent of total billed charges,,,489.54,82,,percent of total billed charges,,,537.3,90,,percent of total billed charges,,,507.45,85,,percent of total billed charges,,450.14,567.15,
FF CLOSED TREAT ANKLE FX W ANESTHESIA,20500990,CDM,27810,CPT,450,RC,inpatient,,2853,2853,,2422.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2151.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2425.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2510.64,88,,percent of total billed charges,,,,,,,,,2179.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2596.23,91,,percent of total billed charges,,,2710.35,95,,percent of total billed charges,,,2367.99,83,,percent of total billed charges,,,2367.99,83,,percent of total billed charges,,,,,,,,,,,,,,,2367.99,83,,percent of total billed charges,,,2710.35,95,,percent of total billed charges,,,2567.7,90,,percent of total billed charges,,,2567.7,90,,percent of total billed charges,,,2339.46,82,,percent of total billed charges,,,2567.7,90,,percent of total billed charges,,,2425.05,85,,percent of total billed charges,,2151.16,2710.35,
FF CLOSED REDUCTION OF GREAT TOE,20501000,CDM,28495,CPT,450,RC,inpatient,,852,852,,723.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,642.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,724.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,749.76,88,,percent of total billed charges,,,,,,,,,650.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,775.32,91,,percent of total billed charges,,,809.4,95,,percent of total billed charges,,,707.16,83,,percent of total billed charges,,,707.16,83,,percent of total billed charges,,,,,,,,,,,,,,,707.16,83,,percent of total billed charges,,,809.4,95,,percent of total billed charges,,,766.8,90,,percent of total billed charges,,,766.8,90,,percent of total billed charges,,,698.64,82,,percent of total billed charges,,,766.8,90,,percent of total billed charges,,,724.2,85,,percent of total billed charges,,642.41,809.4,
FF TREATMENT ANKLE FRACTURE,20501001,CDM,28435,CPT,450,RC,inpatient,,3510,3510,,2979.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2646.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2983.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3088.8,88,,percent of total billed charges,,,,,,,,,2681.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3194.1,91,,percent of total billed charges,,,3334.5,95,,percent of total billed charges,,,2913.3,83,,percent of total billed charges,,,2913.3,83,,percent of total billed charges,,,,,,,,,,,,,,,2913.3,83,,percent of total billed charges,,,3334.5,95,,percent of total billed charges,,,3159,90,,percent of total billed charges,,,3159,90,,percent of total billed charges,,,2878.2,82,,percent of total billed charges,,,3159,90,,percent of total billed charges,,,2983.5,85,,percent of total billed charges,,2646.54,3334.5,
FF CLOSED TREAT FRACTURE ULNA,20501002,CDM,25535,CPT,450,RC,inpatient,,3704,3704,,3144.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2792.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3148.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3259.52,88,,percent of total billed charges,,,,,,,,,2829.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3370.64,91,,percent of total billed charges,,,3518.8,95,,percent of total billed charges,,,3074.32,83,,percent of total billed charges,,,3074.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3074.32,83,,percent of total billed charges,,,3518.8,95,,percent of total billed charges,,,3333.6,90,,percent of total billed charges,,,3333.6,90,,percent of total billed charges,,,3037.28,82,,percent of total billed charges,,,3333.6,90,,percent of total billed charges,,,3148.4,85,,percent of total billed charges,,2792.82,3518.8,
FF CLOSED REDUCTION FINGER WO ANEST,20501003,CDM,26775,CPT,450,RC,inpatient,,2422,2422,,2056.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1826.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2058.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2131.36,88,,percent of total billed charges,,,,,,,,,1850.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2204.02,91,,percent of total billed charges,,,2300.9,95,,percent of total billed charges,,,2010.26,83,,percent of total billed charges,,,2010.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2010.26,83,,percent of total billed charges,,,2300.9,95,,percent of total billed charges,,,2179.8,90,,percent of total billed charges,,,2179.8,90,,percent of total billed charges,,,1986.04,82,,percent of total billed charges,,,2179.8,90,,percent of total billed charges,,,2058.7,85,,percent of total billed charges,,1826.19,2300.9,
FF REMOVAL IMPACTED EAR WAX UNI,20501004,CDM,69209,CPT,450,RC,inpatient,,233,233,,197.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,175.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,198.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,205.04,88,,percent of total billed charges,,,,,,,,,178.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,212.03,91,,percent of total billed charges,,,221.35,95,,percent of total billed charges,,,193.39,83,,percent of total billed charges,,,193.39,83,,percent of total billed charges,,,,,,,,,,,,,,,193.39,83,,percent of total billed charges,,,221.35,95,,percent of total billed charges,,,209.7,90,,percent of total billed charges,,,209.7,90,,percent of total billed charges,,,191.06,82,,percent of total billed charges,,,209.7,90,,percent of total billed charges,,,198.05,85,,percent of total billed charges,,175.68,221.35,
FF TREAT FINGER FRACTURE EACH,20501005,CDM,26755,CPT,450,RC,inpatient,,1161,1161,,985.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,875.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,986.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1021.68,88,,percent of total billed charges,,,,,,,,,887,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1056.51,91,,percent of total billed charges,,,1102.95,95,,percent of total billed charges,,,963.63,83,,percent of total billed charges,,,963.63,83,,percent of total billed charges,,,,,,,,,,,,,,,963.63,83,,percent of total billed charges,,,1102.95,95,,percent of total billed charges,,,1044.9,90,,percent of total billed charges,,,1044.9,90,,percent of total billed charges,,,952.02,82,,percent of total billed charges,,,1044.9,90,,percent of total billed charges,,,986.85,85,,percent of total billed charges,,875.39,1102.95,
FF CLOSED REDUCT OF KNEE CAP DISL W/ANES,20501006,CDM,27562,CPT,450,RC,inpatient,,2209,2209,,1875.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1665.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1877.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1943.92,88,,percent of total billed charges,,,,,,,,,1687.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2010.19,91,,percent of total billed charges,,,2098.55,95,,percent of total billed charges,,,1833.47,83,,percent of total billed charges,,,1833.47,83,,percent of total billed charges,,,,,,,,,,,,,,,1833.47,83,,percent of total billed charges,,,2098.55,95,,percent of total billed charges,,,1988.1,90,,percent of total billed charges,,,1988.1,90,,percent of total billed charges,,,1811.38,82,,percent of total billed charges,,,1988.1,90,,percent of total billed charges,,,1877.65,85,,percent of total billed charges,,1665.59,2098.55,
FF TX SUPERFICIAL WOUND DEHISCENCE,20501007,CDM,12020,CPT,450,RC,inpatient,,5853,5853,,4969.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4413.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4975.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5150.64,88,,percent of total billed charges,,,,,,,,,4471.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5326.23,91,,percent of total billed charges,,,5560.35,95,,percent of total billed charges,,,4857.99,83,,percent of total billed charges,,,4857.99,83,,percent of total billed charges,,,,,,,,,,,,,,,4857.99,83,,percent of total billed charges,,,5560.35,95,,percent of total billed charges,,,5267.7,90,,percent of total billed charges,,,5267.7,90,,percent of total billed charges,,,4799.46,82,,percent of total billed charges,,,5267.7,90,,percent of total billed charges,,,4975.05,85,,percent of total billed charges,,4413.16,5560.35,
FF CLOSED TREATMENT KNEE DISLOCA W ANETH,20501008,CDM,27552,CPT,450,RC,inpatient,,7165,7165,,6083.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5402.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6090.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6305.2,88,,percent of total billed charges,,,,,,,,,5474.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6520.15,91,,percent of total billed charges,,,6806.75,95,,percent of total billed charges,,,5946.95,83,,percent of total billed charges,,,5946.95,83,,percent of total billed charges,,,,,,,,,,,,,,,5946.95,83,,percent of total billed charges,,,6806.75,95,,percent of total billed charges,,,6448.5,90,,percent of total billed charges,,,6448.5,90,,percent of total billed charges,,,5875.3,82,,percent of total billed charges,,,6448.5,90,,percent of total billed charges,,,6090.25,85,,percent of total billed charges,,5402.41,6806.75,
FF CLOSED TRTMT LOWER LEG FRACTURE W ANE,20501009,CDM,27825,CPT,450,RC,inpatient,,6022,6022,,5112.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4540.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5118.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5299.36,88,,percent of total billed charges,,,,,,,,,4600.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5480.02,91,,percent of total billed charges,,,5720.9,95,,percent of total billed charges,,,4998.26,83,,percent of total billed charges,,,4998.26,83,,percent of total billed charges,,,,,,,,,,,,,,,4998.26,83,,percent of total billed charges,,,5720.9,95,,percent of total billed charges,,,5419.8,90,,percent of total billed charges,,,5419.8,90,,percent of total billed charges,,,4938.04,82,,percent of total billed charges,,,5419.8,90,,percent of total billed charges,,,5118.7,85,,percent of total billed charges,,4540.59,5720.9,
FF CLSD TX HUMERAL FX W/MANIPULATIO,20501010,CDM,24505,CPT,450,RC,inpatient,,2357,2357,,2001.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1777.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2003.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2074.16,88,,percent of total billed charges,,,,,,,,,1800.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2144.87,91,,percent of total billed charges,,,2239.15,95,,percent of total billed charges,,,1956.31,83,,percent of total billed charges,,,1956.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1956.31,83,,percent of total billed charges,,,2239.15,95,,percent of total billed charges,,,2121.3,90,,percent of total billed charges,,,2121.3,90,,percent of total billed charges,,,1932.74,82,,percent of total billed charges,,,2121.3,90,,percent of total billed charges,,,2003.45,85,,percent of total billed charges,,1777.18,2239.15,
FF CLOSED TREATMENT OF TIBIA FRACTURE,20501011,CDM,27752,CPT,450,RC,inpatient,,4234,4234,,3594.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3192.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3598.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3725.92,88,,percent of total billed charges,,,,,,,,,3234.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3852.94,91,,percent of total billed charges,,,4022.3,95,,percent of total billed charges,,,3514.22,83,,percent of total billed charges,,,3514.22,83,,percent of total billed charges,,,,,,,,,,,,,,,3514.22,83,,percent of total billed charges,,,4022.3,95,,percent of total billed charges,,,3810.6,90,,percent of total billed charges,,,3810.6,90,,percent of total billed charges,,,3471.88,82,,percent of total billed charges,,,3810.6,90,,percent of total billed charges,,,3598.9,85,,percent of total billed charges,,3192.44,4022.3,
FF SPON CLOSED TRMT HIP DISLTN W ANES,20501012,CDM,27257,CPT,450,RC,inpatient,,3860,3860,,3277.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2910.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3281,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3396.8,88,,percent of total billed charges,,,,,,,,,2949.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3512.6,91,,percent of total billed charges,,,3667,95,,percent of total billed charges,,,3203.8,83,,percent of total billed charges,,,3203.8,83,,percent of total billed charges,,,,,,,,,,,,,,,3203.8,83,,percent of total billed charges,,,3667,95,,percent of total billed charges,,,3474,90,,percent of total billed charges,,,3474,90,,percent of total billed charges,,,3165.2,82,,percent of total billed charges,,,3474,90,,percent of total billed charges,,,3281,85,,percent of total billed charges,,2910.44,3667,
FF CLOSED RED POST HIP ARTH W/O ANETH,20501013,CDM,27265,CPT,450,RC,inpatient,,1514,1514,,1285.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1141.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1286.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1332.32,88,,percent of total billed charges,,,,,,,,,1156.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1377.74,91,,percent of total billed charges,,,1438.3,95,,percent of total billed charges,,,1256.62,83,,percent of total billed charges,,,1256.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1256.62,83,,percent of total billed charges,,,1438.3,95,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1241.48,82,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1286.9,85,,percent of total billed charges,,1141.56,1438.3,
FF EXC B9 LESION MRGN XCP SK TG 2.1-3.0,20501014,CDM,11403,CPT,450,RC,inpatient,,2901,2901,,2462.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2187.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2465.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2552.88,88,,percent of total billed charges,,,,,,,,,2216.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2639.91,91,,percent of total billed charges,,,2755.95,95,,percent of total billed charges,,,2407.83,83,,percent of total billed charges,,,2407.83,83,,percent of total billed charges,,,,,,,,,,,,,,,2407.83,83,,percent of total billed charges,,,2755.95,95,,percent of total billed charges,,,2610.9,90,,percent of total billed charges,,,2610.9,90,,percent of total billed charges,,,2378.82,82,,percent of total billed charges,,,2610.9,90,,percent of total billed charges,,,2465.85,85,,percent of total billed charges,,2187.35,2755.95,
FF EXC B9 LESION MRGN XCP SK TG 0.5 CM/<,20501015,CDM,11400,CPT,450,RC,inpatient,,1207,1207,,1024.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,910.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1025.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1062.16,88,,percent of total billed charges,,,,,,,,,922.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1098.37,91,,percent of total billed charges,,,1146.65,95,,percent of total billed charges,,,1001.81,83,,percent of total billed charges,,,1001.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1001.81,83,,percent of total billed charges,,,1146.65,95,,percent of total billed charges,,,1086.3,90,,percent of total billed charges,,,1086.3,90,,percent of total billed charges,,,989.74,82,,percent of total billed charges,,,1086.3,90,,percent of total billed charges,,,1025.95,85,,percent of total billed charges,,910.08,1146.65,
FF TELEHEALTH FACILITY FEE,20502000,CDM,Q3014,HCPCS,780,RC,inpatient,,58,58,,49.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.04,88,,percent of total billed charges,,25,,,,fee schedule,,,44.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,25,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52.78,91,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,,,,,,,,,,,,,48.14,83,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,47.56,82,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,25,55.1,
FF TELEHEALTH CONSULT UP TO 30 MINUTES,20502001,CDM,G0425,HCPCS,780,RC,inpatient,,350,350,,297.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,263.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,297.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,308,88,,percent of total billed charges,,,,,,,,,267.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,318.5,91,,percent of total billed charges,,,332.5,95,,percent of total billed charges,,,290.5,83,,percent of total billed charges,,,290.5,83,,percent of total billed charges,,,,,,,,,,,,,,,290.5,83,,percent of total billed charges,,,332.5,95,,percent of total billed charges,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,287,82,,percent of total billed charges,,,315,90,,percent of total billed charges,,,297.5,85,,percent of total billed charges,,263.9,332.5,
FF TELEHEALTH CONSULT UP TO 50 MINUTES,20502002,CDM,G0426,HCPCS,780,RC,inpatient,,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,349.86,440.8,
FF TELEHEALTH CONSULT UP TO 70 MINUTES,20502003,CDM,G0427,HCPCS,780,RC,inpatient,,601,601,,510.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,453.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,510.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,528.88,88,,percent of total billed charges,,,,,,,,,459.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,546.91,91,,percent of total billed charges,,,570.95,95,,percent of total billed charges,,,498.83,83,,percent of total billed charges,,,498.83,83,,percent of total billed charges,,,,,,,,,,,,,,,498.83,83,,percent of total billed charges,,,570.95,95,,percent of total billed charges,,,540.9,90,,percent of total billed charges,,,540.9,90,,percent of total billed charges,,,492.82,82,,percent of total billed charges,,,540.9,90,,percent of total billed charges,,,510.85,85,,percent of total billed charges,,453.15,570.95,
OP BLOOD ADMINISTRATION SERVICE,20600100,CDM,36430,CPT,391,RC,inpatient,,1766,1766,,1499.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1331.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1501.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1554.08,88,,percent of total billed charges,,,,,,,,,1349.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1607.06,91,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.78,83,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1448.12,82,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,1331.56,1677.7,
OP BLOOD ADMIN UP TO 4 HOURS(V-11-20),20600101,CDM,36430,CPT,391,RC,inpatient,,2764,2764,,2346.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2084.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2349.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2432.32,88,,percent of total billed charges,,,,,,,,,2111.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2515.24,91,,percent of total billed charges,,,2625.8,95,,percent of total billed charges,,,2294.12,83,,percent of total billed charges,,,2294.12,83,,percent of total billed charges,,,,,,,,,,,,,,,2294.12,83,,percent of total billed charges,,,2625.8,95,,percent of total billed charges,,,2487.6,90,,percent of total billed charges,,,2487.6,90,,percent of total billed charges,,,2266.48,82,,percent of total billed charges,,,2487.6,90,,percent of total billed charges,,,2349.4,85,,percent of total billed charges,,2084.06,2625.8,
OP BLOOD ADMIN UP TO 6 HOURS(V-11-20),20600102,CDM,36430,CPT,391,RC,inpatient,,3322,3322,,2820.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2504.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2823.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2923.36,88,,percent of total billed charges,,,,,,,,,2538.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3023.02,91,,percent of total billed charges,,,3155.9,95,,percent of total billed charges,,,2757.26,83,,percent of total billed charges,,,2757.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2757.26,83,,percent of total billed charges,,,3155.9,95,,percent of total billed charges,,,2989.8,90,,percent of total billed charges,,,2989.8,90,,percent of total billed charges,,,2724.04,82,,percent of total billed charges,,,2989.8,90,,percent of total billed charges,,,2823.7,85,,percent of total billed charges,,2504.79,3155.9,
OP BLOOD ADMIN OVER 6 HOURS(V-11-20),20600103,CDM,36430,CPT,391,RC,inpatient,,3770,3770,,3200.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2842.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3204.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3317.6,88,,percent of total billed charges,,,,,,,,,2880.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3430.7,91,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,,,,,,,,,,,,,3129.1,83,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3091.4,82,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3204.5,85,,percent of total billed charges,,2842.58,3581.5,
OP FOLEY INSERTION/CHANGE,20600130,CDM,51702,CPT,761,RC,inpatient,,433,433,,367.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,326.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,368.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,381.04,88,,percent of total billed charges,,,,,,,,,330.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,394.03,91,,percent of total billed charges,,,411.35,95,,percent of total billed charges,,,359.39,83,,percent of total billed charges,,,359.39,83,,percent of total billed charges,,,,,,,,,,,,,,,359.39,83,,percent of total billed charges,,,411.35,95,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,355.06,82,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,368.05,85,,percent of total billed charges,,326.48,411.35,
OP IM/SQ INJECTIONS,20600140,CDM,96372,CPT,761,RC,inpatient,XU,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,376.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,424.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,376.25,474.05,
"OP IV PUSH MEDICATION, INITIAL",20600150,CDM,96374,CPT,761,RC,inpatient,XU,523,523,,444.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,394.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,444.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,460.24,88,,percent of total billed charges,,,,,,,,,399.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,475.93,91,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,,,,,,,,,,,,,434.09,83,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,428.86,82,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,444.55,85,,percent of total billed charges,,394.34,496.85,
"OP IV PUSH MEDICATION, SEQUENTIAL",20600152,CDM,96375,CPT,761,RC,inpatient,XU,330,330,,280.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,248.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,280.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,290.4,88,,percent of total billed charges,,,,,,,,,252.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,300.3,91,,percent of total billed charges,,,313.5,95,,percent of total billed charges,,,273.9,83,,percent of total billed charges,,,273.9,83,,percent of total billed charges,,,,,,,,,,,,,,,273.9,83,,percent of total billed charges,,,313.5,95,,percent of total billed charges,,,297,90,,percent of total billed charges,,,297,90,,percent of total billed charges,,,270.6,82,,percent of total billed charges,,,297,90,,percent of total billed charges,,,280.5,85,,percent of total billed charges,,248.82,313.5,
"OP IV INFUSION, HYDRATION, UP TO 1 HOUR",20600160,CDM,96360,CPT,761,RC,inpatient,XU,1000,1000,,849,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,754,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,850,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,880,88,,percent of total billed charges,,,,,,,,,764,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,910,91,,percent of total billed charges,,,950,95,,percent of total billed charges,,,830,83,,percent of total billed charges,,,830,83,,percent of total billed charges,,,,,,,,,,,,,,,830,83,,percent of total billed charges,,,950,95,,percent of total billed charges,,,900,90,,percent of total billed charges,,,900,90,,percent of total billed charges,,,820,82,,percent of total billed charges,,,900,90,,percent of total billed charges,,,850,85,,percent of total billed charges,,754,950,
"OP IV INFUSION, HYDRATION, ADDT'L HOUR",20600161,CDM,96361,CPT,761,RC,inpatient,XU,302,302,,256.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,227.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,256.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,265.76,88,,percent of total billed charges,,,,,,,,,230.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,274.82,91,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,,,,,,,,,,,,,250.66,83,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,247.64,82,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,256.7,85,,percent of total billed charges,,227.71,286.9,
"OP IV INFUSION, THERAPEUTIC, UP TO 1 HR",20600162,CDM,96365,CPT,761,RC,inpatient,XU,1000,1000,,849,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,754,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,850,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,880,88,,percent of total billed charges,,,,,,,,,764,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,910,91,,percent of total billed charges,,,950,95,,percent of total billed charges,,,830,83,,percent of total billed charges,,,830,83,,percent of total billed charges,,,,,,,,,,,,,,,830,83,,percent of total billed charges,,,950,95,,percent of total billed charges,,,900,90,,percent of total billed charges,,,900,90,,percent of total billed charges,,,820,82,,percent of total billed charges,,,900,90,,percent of total billed charges,,,850,85,,percent of total billed charges,,754,950,
"OP IV INFUSION, THERAPEUTIC, ADDT'L HOUR",20600163,CDM,96366,CPT,761,RC,inpatient,XU,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
"OP IVP, SINGLE OR INITIAL",20600164,CDM,96374,CPT,761,RC,inpatient,XU,523,523,,444.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,394.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,444.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,460.24,88,,percent of total billed charges,,,,,,,,,399.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,475.93,91,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,,,,,,,,,,,,,434.09,83,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,428.86,82,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,444.55,85,,percent of total billed charges,,394.34,496.85,
OP IM/SQ ANTIBIOTIC INJECTION,20600165,CDM,96372,CPT,761,RC,inpatient,XU,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,376.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,424.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,376.25,474.05,
95886 NEEDLE EMG EA EXT W/PARASPINL AREA,14500000,CDM,95886,CPT,922,RC,inpatient,TC,947,947,,804,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,714.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,804.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,833.36,88,,percent of total billed charges,,,,,,,,,723.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,861.77,91,,percent of total billed charges,,,899.65,95,,percent of total billed charges,,,786.01,83,,percent of total billed charges,,,786.01,83,,percent of total billed charges,,,,,,,,,,,,,,,786.01,83,,percent of total billed charges,,,899.65,95,,percent of total billed charges,,,852.3,90,,percent of total billed charges,,,852.3,90,,percent of total billed charges,,,776.54,82,,percent of total billed charges,,,852.3,90,,percent of total billed charges,,,804.95,85,,percent of total billed charges,,714.04,899.65,
95885 NEEDLE EMG EA EXTY W/PARASPINL LIM,14500001,CDM,95885,CPT,922,RC,inpatient,TC,722,722,,612.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,544.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,613.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,635.36,88,,percent of total billed charges,,,,,,,,,551.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,657.02,91,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,,,,,,,,,,,,,599.26,83,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,592.04,82,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,613.7,85,,percent of total billed charges,,544.39,685.9,
95887 NEEDLE EMG NONEXT MSCLES W/NE COND,14500002,CDM,95887,CPT,922,RC,inpatient,TC,804,804,,682.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,606.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,683.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,707.52,88,,percent of total billed charges,,,,,,,,,614.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,731.64,91,,percent of total billed charges,,,763.8,95,,percent of total billed charges,,,667.32,83,,percent of total billed charges,,,667.32,83,,percent of total billed charges,,,,,,,,,,,,,,,667.32,83,,percent of total billed charges,,,763.8,95,,percent of total billed charges,,,723.6,90,,percent of total billed charges,,,723.6,90,,percent of total billed charges,,,659.28,82,,percent of total billed charges,,,723.6,90,,percent of total billed charges,,,683.4,85,,percent of total billed charges,,606.22,763.8,
95874 NEEDLE EMG GUID W/CHEMODENERVATION,14500003,CDM,95874,CPT,922,RC,inpatient,TC,548,548,,465.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,413.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,465.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,482.24,88,,percent of total billed charges,,,,,,,,,418.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,498.68,91,,percent of total billed charges,,,520.6,95,,percent of total billed charges,,,454.84,83,,percent of total billed charges,,,454.84,83,,percent of total billed charges,,,,,,,,,,,,,,,454.84,83,,percent of total billed charges,,,520.6,95,,percent of total billed charges,,,493.2,90,,percent of total billed charges,,,493.2,90,,percent of total billed charges,,,449.36,82,,percent of total billed charges,,,493.2,90,,percent of total billed charges,,,465.8,85,,percent of total billed charges,,413.19,520.6,
95868 NEEDLE ELECTROMYOGRAPHY CRAIN NRV,14500004,CDM,95868,CPT,922,RC,inpatient,TC,1495,1495,,1269.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1127.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1270.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1315.6,88,,percent of total billed charges,,,,,,,,,1142.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1360.45,91,,percent of total billed charges,,,1420.25,95,,percent of total billed charges,,,1240.85,83,,percent of total billed charges,,,1240.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1240.85,83,,percent of total billed charges,,,1420.25,95,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1225.9,82,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1270.75,85,,percent of total billed charges,,1127.23,1420.25,
95869 NEEDLE EMG THRC PARI MS EXC T1/T12,14500005,CDM,95869,CPT,922,RC,inpatient,TC,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,627.33,790.4,
95870 NEEDLE EMG LMTD STD MUSC 1 XTR/NON,14500006,CDM,95870,CPT,922,RC,inpatient,TC,784,784,,665.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,591.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,666.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,689.92,88,,percent of total billed charges,,,,,,,,,598.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,713.44,91,,percent of total billed charges,,,744.8,95,,percent of total billed charges,,,650.72,83,,percent of total billed charges,,,650.72,83,,percent of total billed charges,,,,,,,,,,,,,,,650.72,83,,percent of total billed charges,,,744.8,95,,percent of total billed charges,,,705.6,90,,percent of total billed charges,,,705.6,90,,percent of total billed charges,,,642.88,82,,percent of total billed charges,,,705.6,90,,percent of total billed charges,,,666.4,85,,percent of total billed charges,,591.14,744.8,
95867 NEEDLE ELECTRY CRAINIAL NRV MUS,14500007,CDM,95867,CPT,922,RC,inpatient,TC,1304,1304,,1107.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,983.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1108.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1147.52,88,,percent of total billed charges,,,,,,,,,996.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1186.64,91,,percent of total billed charges,,,1238.8,95,,percent of total billed charges,,,1082.32,83,,percent of total billed charges,,,1082.32,83,,percent of total billed charges,,,,,,,,,,,,,,,1082.32,83,,percent of total billed charges,,,1238.8,95,,percent of total billed charges,,,1173.6,90,,percent of total billed charges,,,1173.6,90,,percent of total billed charges,,,1069.28,82,,percent of total billed charges,,,1173.6,90,,percent of total billed charges,,,1108.4,85,,percent of total billed charges,,983.22,1238.8,
95861 NEEDLE EMG 2 XTR W/WO RELAD PARASL,14500008,CDM,95861,CPT,922,RC,inpatient,TC,1587,1587,,1347.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1196.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1348.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1396.56,88,,percent of total billed charges,,,,,,,,,1212.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1444.17,91,,percent of total billed charges,,,1507.65,95,,percent of total billed charges,,,1317.21,83,,percent of total billed charges,,,1317.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1317.21,83,,percent of total billed charges,,,1507.65,95,,percent of total billed charges,,,1428.3,90,,percent of total billed charges,,,1428.3,90,,percent of total billed charges,,,1301.34,82,,percent of total billed charges,,,1428.3,90,,percent of total billed charges,,,1348.95,85,,percent of total billed charges,,1196.6,1507.65,
95863 NEEDLE EMG 3 XTR W/WO RELATED PARL,14500009,CDM,95863,CPT,922,RC,inpatient,TC,1849,1849,,1569.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1394.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1571.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1627.12,88,,percent of total billed charges,,,,,,,,,1412.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1682.59,91,,percent of total billed charges,,,1756.55,95,,percent of total billed charges,,,1534.67,83,,percent of total billed charges,,,1534.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1534.67,83,,percent of total billed charges,,,1756.55,95,,percent of total billed charges,,,1664.1,90,,percent of total billed charges,,,1664.1,90,,percent of total billed charges,,,1516.18,82,,percent of total billed charges,,,1664.1,90,,percent of total billed charges,,,1571.65,85,,percent of total billed charges,,1394.15,1756.55,
95864 NEEDLE EMG 4 XTR W/WO RELATED PARL,14500010,CDM,95864,CPT,922,RC,inpatient,TC,2176,2176,,1847.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1640.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1849.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1914.88,88,,percent of total billed charges,,,,,,,,,1662.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1980.16,91,,percent of total billed charges,,,2067.2,95,,percent of total billed charges,,,1806.08,83,,percent of total billed charges,,,1806.08,83,,percent of total billed charges,,,,,,,,,,,,,,,1806.08,83,,percent of total billed charges,,,2067.2,95,,percent of total billed charges,,,1958.4,90,,percent of total billed charges,,,1958.4,90,,percent of total billed charges,,,1784.32,82,,percent of total billed charges,,,1958.4,90,,percent of total billed charges,,,1849.6,85,,percent of total billed charges,,1640.7,2067.2,
95860 NEEDLE EMG 1 XTR W/WO RELATED PARL,14500011,CDM,95860,CPT,922,RC,inpatient,TC,1052,1052,,893.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,793.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,894.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,925.76,88,,percent of total billed charges,,,,,,,,,803.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,957.32,91,,percent of total billed charges,,,999.4,95,,percent of total billed charges,,,873.16,83,,percent of total billed charges,,,873.16,83,,percent of total billed charges,,,,,,,,,,,,,,,873.16,83,,percent of total billed charges,,,999.4,95,,percent of total billed charges,,,946.8,90,,percent of total billed charges,,,946.8,90,,percent of total billed charges,,,862.64,82,,percent of total billed charges,,,946.8,90,,percent of total billed charges,,,894.2,85,,percent of total billed charges,,793.21,999.4,
95907 NERVE CONDUCTN STUDIES 1-2 STUDIES,14500012,CDM,95907,CPT,922,RC,inpatient,TC,1025,1025,,870.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,772.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,871.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,902,88,,percent of total billed charges,,,,,,,,,783.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,932.75,91,,percent of total billed charges,,,973.75,95,,percent of total billed charges,,,850.75,83,,percent of total billed charges,,,850.75,83,,percent of total billed charges,,,,,,,,,,,,,,,850.75,83,,percent of total billed charges,,,973.75,95,,percent of total billed charges,,,922.5,90,,percent of total billed charges,,,922.5,90,,percent of total billed charges,,,840.5,82,,percent of total billed charges,,,922.5,90,,percent of total billed charges,,,871.25,85,,percent of total billed charges,,772.85,973.75,
95908 NERVE CONDUCTN STUDIES 3-4 STUDIES,14500013,CDM,95908,CPT,922,RC,inpatient,TC,1643,1643,,1394.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1238.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1396.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1445.84,88,,percent of total billed charges,,,,,,,,,1255.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1495.13,91,,percent of total billed charges,,,1560.85,95,,percent of total billed charges,,,1363.69,83,,percent of total billed charges,,,1363.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1363.69,83,,percent of total billed charges,,,1560.85,95,,percent of total billed charges,,,1478.7,90,,percent of total billed charges,,,1478.7,90,,percent of total billed charges,,,1347.26,82,,percent of total billed charges,,,1478.7,90,,percent of total billed charges,,,1396.55,85,,percent of total billed charges,,1238.82,1560.85,
95909 NERVE CONDUCTN STUDIES 5-6 STUDIES,14500014,CDM,95909,CPT,922,RC,inpatient,TC,2514,2514,,2134.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1895.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2136.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2212.32,88,,percent of total billed charges,,,,,,,,,1920.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2287.74,91,,percent of total billed charges,,,2388.3,95,,percent of total billed charges,,,2086.62,83,,percent of total billed charges,,,2086.62,83,,percent of total billed charges,,,,,,,,,,,,,,,2086.62,83,,percent of total billed charges,,,2388.3,95,,percent of total billed charges,,,2262.6,90,,percent of total billed charges,,,2262.6,90,,percent of total billed charges,,,2061.48,82,,percent of total billed charges,,,2262.6,90,,percent of total billed charges,,,2136.9,85,,percent of total billed charges,,1895.56,2388.3,
95910 NERVE CONDUCTN STUDIES 7-8 STUDIES,14500015,CDM,95910,CPT,922,RC,inpatient,TC,3263,3263,,2770.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2460.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2773.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2871.44,88,,percent of total billed charges,,,,,,,,,2492.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2969.33,91,,percent of total billed charges,,,3099.85,95,,percent of total billed charges,,,2708.29,83,,percent of total billed charges,,,2708.29,83,,percent of total billed charges,,,,,,,,,,,,,,,2708.29,83,,percent of total billed charges,,,3099.85,95,,percent of total billed charges,,,2936.7,90,,percent of total billed charges,,,2936.7,90,,percent of total billed charges,,,2675.66,82,,percent of total billed charges,,,2936.7,90,,percent of total billed charges,,,2773.55,85,,percent of total billed charges,,2460.3,3099.85,
95911 NERVE CONDUCTN STUDIES 9-10 STUDIE,14500016,CDM,95911,CPT,922,RC,inpatient,TC,4202,4202,,3567.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3168.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3571.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3697.76,88,,percent of total billed charges,,,,,,,,,3210.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3823.82,91,,percent of total billed charges,,,3991.9,95,,percent of total billed charges,,,3487.66,83,,percent of total billed charges,,,3487.66,83,,percent of total billed charges,,,,,,,,,,,,,,,3487.66,83,,percent of total billed charges,,,3991.9,95,,percent of total billed charges,,,3781.8,90,,percent of total billed charges,,,3781.8,90,,percent of total billed charges,,,3445.64,82,,percent of total billed charges,,,3781.8,90,,percent of total billed charges,,,3571.7,85,,percent of total billed charges,,3168.31,3991.9,
95912 NERVE CONDUCTN STUDIES 11-12 STUDI,14500017,CDM,95912,CPT,922,RC,inpatient,TC,4613,4613,,3916.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3478.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3921.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4059.44,88,,percent of total billed charges,,,,,,,,,3524.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4197.83,91,,percent of total billed charges,,,4382.35,95,,percent of total billed charges,,,3828.79,83,,percent of total billed charges,,,3828.79,83,,percent of total billed charges,,,,,,,,,,,,,,,3828.79,83,,percent of total billed charges,,,4382.35,95,,percent of total billed charges,,,4151.7,90,,percent of total billed charges,,,4151.7,90,,percent of total billed charges,,,3782.66,82,,percent of total billed charges,,,4151.7,90,,percent of total billed charges,,,3921.05,85,,percent of total billed charges,,3478.2,4382.35,
95913 NERVE CONDUCTN STUDIES 13/> STUDIE,14500018,CDM,95913,CPT,922,RC,inpatient,TC,5980,5980,,5077.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4508.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5083,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5262.4,88,,percent of total billed charges,,,,,,,,,4568.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5441.8,91,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4963.4,83,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,4903.6,82,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5083,85,,percent of total billed charges,,4508.92,5681,
95937 NEUROMUSCULAR JUNCTION TEST,14500019,CDM,95937,CPT,922,RC,inpatient,TC,1019,1019,,865.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,768.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,866.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,896.72,88,,percent of total billed charges,,,,,,,,,778.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,927.29,91,,percent of total billed charges,,,968.05,95,,percent of total billed charges,,,845.77,83,,percent of total billed charges,,,845.77,83,,percent of total billed charges,,,,,,,,,,,,,,,845.77,83,,percent of total billed charges,,,968.05,95,,percent of total billed charges,,,917.1,90,,percent of total billed charges,,,917.1,90,,percent of total billed charges,,,835.58,82,,percent of total billed charges,,,917.1,90,,percent of total billed charges,,,866.15,85,,percent of total billed charges,,768.33,968.05,
64612 CHEMODN MUSC INNERVATED FACIAL NRV,14500020,CDM,64612,CPT,361,RC,inpatient,TC,1019,1019,,865.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,768.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,866.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,896.72,88,,percent of total billed charges,,,,,,,,,778.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,927.29,91,,percent of total billed charges,,,968.05,95,,percent of total billed charges,,,845.77,83,,percent of total billed charges,,,845.77,83,,percent of total billed charges,,,,,,,,,,,,,,,845.77,83,,percent of total billed charges,,,968.05,95,,percent of total billed charges,,,917.1,90,,percent of total billed charges,,,917.1,90,,percent of total billed charges,,,835.58,82,,percent of total billed charges,,,917.1,90,,percent of total billed charges,,,866.15,85,,percent of total billed charges,,768.33,968.05,
64615 CHEMODNRVTJ MUSC MIGRAINE,14500021,CDM,64615,CPT,361,RC,inpatient,TC,1365,1365,,1158.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1029.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1160.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1201.2,88,,percent of total billed charges,,,,,,,,,1042.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1242.15,91,,percent of total billed charges,,,1296.75,95,,percent of total billed charges,,,1132.95,83,,percent of total billed charges,,,1132.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1132.95,83,,percent of total billed charges,,,1296.75,95,,percent of total billed charges,,,1228.5,90,,percent of total billed charges,,,1228.5,90,,percent of total billed charges,,,1119.3,82,,percent of total billed charges,,,1228.5,90,,percent of total billed charges,,,1160.25,85,,percent of total billed charges,,1029.21,1296.75,
64616 CHEMODNRVTJ MUSC NECK DYSTON,14500022,CDM,64616,CPT,361,RC,inpatient,TC,1836,1836,,1558.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1384.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1560.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1615.68,88,,percent of total billed charges,,,,,,,,,1402.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1670.76,91,,percent of total billed charges,,,1744.2,95,,percent of total billed charges,,,1523.88,83,,percent of total billed charges,,,1523.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1523.88,83,,percent of total billed charges,,,1744.2,95,,percent of total billed charges,,,1652.4,90,,percent of total billed charges,,,1652.4,90,,percent of total billed charges,,,1505.52,82,,percent of total billed charges,,,1652.4,90,,percent of total billed charges,,,1560.6,85,,percent of total billed charges,,1384.34,1744.2,
HEMODYNAMIC PROFILE,1190134,CDM,,,480,RC,inpatient,,509,509,,432.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,383.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,432.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,447.92,88,,percent of total billed charges,,,,,,,,,388.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,463.19,91,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,,,,,,,,,,,,,422.47,83,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,417.38,82,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,383.79,483.55,
X INSERT TUNNELED CV CATH,26200041,CDM,36561,CPT,360,RC,inpatient,TC,10275,10275,,8723.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7747.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8733.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9042,88,,percent of total billed charges,,,,,,,,,7850.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9350.25,91,,percent of total billed charges,,,9761.25,95,,percent of total billed charges,,,8528.25,83,,percent of total billed charges,,,8528.25,83,,percent of total billed charges,,,,,,,,,,,,,,,8528.25,83,,percent of total billed charges,,,9761.25,95,,percent of total billed charges,,,9247.5,90,,percent of total billed charges,,,9247.5,90,,percent of total billed charges,,,8425.5,82,,percent of total billed charges,,,9247.5,90,,percent of total billed charges,,,8733.75,85,,percent of total billed charges,,7747.35,9761.25,
X IR PLMT BILIARY DRAINAGE CATH,26200042,CDM,47533,CPT,360,RC,inpatient,,10388,10388,,8819.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7832.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8829.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9141.44,88,,percent of total billed charges,,,,,,,,,7936.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9453.08,91,,percent of total billed charges,,,9868.6,95,,percent of total billed charges,,,8622.04,83,,percent of total billed charges,,,8622.04,83,,percent of total billed charges,,,,,,,,,,,,,,,8622.04,83,,percent of total billed charges,,,9868.6,95,,percent of total billed charges,,,9349.2,90,,percent of total billed charges,,,9349.2,90,,percent of total billed charges,,,8518.16,82,,percent of total billed charges,,,9349.2,90,,percent of total billed charges,,,8829.8,85,,percent of total billed charges,,7832.55,9868.6,
X IR EXCHANGE BILIARY DRAINAGE CATH,26200043,CDM,47536,CPT,360,RC,inpatient,,9064,9064,,7695.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6834.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7704.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7976.32,88,,percent of total billed charges,,,,,,,,,6924.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8248.24,91,,percent of total billed charges,,,8610.8,95,,percent of total billed charges,,,7523.12,83,,percent of total billed charges,,,7523.12,83,,percent of total billed charges,,,,,,,,,,,,,,,7523.12,83,,percent of total billed charges,,,8610.8,95,,percent of total billed charges,,,8157.6,90,,percent of total billed charges,,,8157.6,90,,percent of total billed charges,,,7432.48,82,,percent of total billed charges,,,8157.6,90,,percent of total billed charges,,,7704.4,85,,percent of total billed charges,,6834.26,8610.8,
X IR PLMT NEPHROSTOMY CATH,26200044,CDM,50432,CPT,360,RC,inpatient,,8823,8823,,7490.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6652.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7499.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7764.24,88,,percent of total billed charges,,,,,,,,,6740.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8028.93,91,,percent of total billed charges,,,8381.85,95,,percent of total billed charges,,,7323.09,83,,percent of total billed charges,,,7323.09,83,,percent of total billed charges,,,,,,,,,,,,,,,7323.09,83,,percent of total billed charges,,,8381.85,95,,percent of total billed charges,,,7940.7,90,,percent of total billed charges,,,7940.7,90,,percent of total billed charges,,,7234.86,82,,percent of total billed charges,,,7940.7,90,,percent of total billed charges,,,7499.55,85,,percent of total billed charges,,6652.54,8381.85,
X IR EXCHANGE NEPHROSTOMY CATH,26200045,CDM,50435,CPT,360,RC,inpatient,,6264,6264,,5318.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4723.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5324.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5512.32,88,,percent of total billed charges,,,,,,,,,4785.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5700.24,91,,percent of total billed charges,,,5950.8,95,,percent of total billed charges,,,5199.12,83,,percent of total billed charges,,,5199.12,83,,percent of total billed charges,,,,,,,,,,,,,,,5199.12,83,,percent of total billed charges,,,5950.8,95,,percent of total billed charges,,,5637.6,90,,percent of total billed charges,,,5637.6,90,,percent of total billed charges,,,5136.48,82,,percent of total billed charges,,,5637.6,90,,percent of total billed charges,,,5324.4,85,,percent of total billed charges,,4723.06,5950.8,
X IR SCLEROTHERAPY FLUID COLLECTION W/IM,26200046,CDM,49185,CPT,360,RC,inpatient,,4039,4039,,3429.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3045.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3433.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3554.32,88,,percent of total billed charges,,,,,,,,,3085.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3675.49,91,,percent of total billed charges,,,3837.05,95,,percent of total billed charges,,,3352.37,83,,percent of total billed charges,,,3352.37,83,,percent of total billed charges,,,,,,,,,,,,,,,3352.37,83,,percent of total billed charges,,,3837.05,95,,percent of total billed charges,,,3635.1,90,,percent of total billed charges,,,3635.1,90,,percent of total billed charges,,,3311.98,82,,percent of total billed charges,,,3635.1,90,,percent of total billed charges,,,3433.15,85,,percent of total billed charges,,3045.41,3837.05,
X IR ARTERIAL THROMBOLYSIS DAY 1,26200047,CDM,37211,CPT,360,RC,inpatient,,15326,15326,,13011.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11555.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13027.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13486.88,88,,percent of total billed charges,,,,,,,,,11709.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13946.66,91,,percent of total billed charges,,,14559.7,95,,percent of total billed charges,,,12720.58,83,,percent of total billed charges,,,12720.58,83,,percent of total billed charges,,,,,,,,,,,,,,,12720.58,83,,percent of total billed charges,,,14559.7,95,,percent of total billed charges,,,13793.4,90,,percent of total billed charges,,,13793.4,90,,percent of total billed charges,,,12567.32,82,,percent of total billed charges,,,13793.4,90,,percent of total billed charges,,,13027.1,85,,percent of total billed charges,,11555.8,14559.7,
X IR ARTERIAL THROMBOLYSIS DAY 2,26200048,CDM,37213,CPT,360,RC,inpatient,,11714,11714,,9945.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8832.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9956.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10308.32,88,,percent of total billed charges,,,,,,,,,8949.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10659.74,91,,percent of total billed charges,,,11128.3,95,,percent of total billed charges,,,9722.62,83,,percent of total billed charges,,,9722.62,83,,percent of total billed charges,,,,,,,,,,,,,,,9722.62,83,,percent of total billed charges,,,11128.3,95,,percent of total billed charges,,,10542.6,90,,percent of total billed charges,,,10542.6,90,,percent of total billed charges,,,9605.48,82,,percent of total billed charges,,,10542.6,90,,percent of total billed charges,,,9956.9,85,,percent of total billed charges,,8832.36,11128.3,
X IR ARTERIAL THROMBOLYSIS DAY 3/CATH RE,26200049,CDM,37214,CPT,360,RC,inpatient,,11714,11714,,9945.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8832.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9956.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10308.32,88,,percent of total billed charges,,,,,,,,,8949.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10659.74,91,,percent of total billed charges,,,11128.3,95,,percent of total billed charges,,,9722.62,83,,percent of total billed charges,,,9722.62,83,,percent of total billed charges,,,,,,,,,,,,,,,9722.62,83,,percent of total billed charges,,,11128.3,95,,percent of total billed charges,,,10542.6,90,,percent of total billed charges,,,10542.6,90,,percent of total billed charges,,,9605.48,82,,percent of total billed charges,,,10542.6,90,,percent of total billed charges,,,9956.9,85,,percent of total billed charges,,8832.36,11128.3,
X IR ANTEGRADE NEPHROSTOGRAM/URTEROGRAM,26200050,CDM,50431,CPT,360,RC,inpatient,,3675,3675,,3120.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2770.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3123.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3234,88,,percent of total billed charges,,,,,,,,,2807.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3344.25,91,,percent of total billed charges,,,3491.25,95,,percent of total billed charges,,,3050.25,83,,percent of total billed charges,,,3050.25,83,,percent of total billed charges,,,,,,,,,,,,,,,3050.25,83,,percent of total billed charges,,,3491.25,95,,percent of total billed charges,,,3307.5,90,,percent of total billed charges,,,3307.5,90,,percent of total billed charges,,,3013.5,82,,percent of total billed charges,,,3307.5,90,,percent of total billed charges,,,3123.75,85,,percent of total billed charges,,2770.95,3491.25,
X IR GASTRO/JEJUMOSTOMY TUBE PLACEMENT,26200051,CDM,49441,CPT,360,RC,inpatient,,6665,6665,,5658.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5025.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5665.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5865.2,88,,percent of total billed charges,,,,,,,,,5092.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6065.15,91,,percent of total billed charges,,,6331.75,95,,percent of total billed charges,,,5531.95,83,,percent of total billed charges,,,5531.95,83,,percent of total billed charges,,,,,,,,,,,,,,,5531.95,83,,percent of total billed charges,,,6331.75,95,,percent of total billed charges,,,5998.5,90,,percent of total billed charges,,,5998.5,90,,percent of total billed charges,,,5465.3,82,,percent of total billed charges,,,5998.5,90,,percent of total billed charges,,,5665.25,85,,percent of total billed charges,,5025.41,6331.75,
X IR GASTRO/JEJUMOSTOMY TUBE REPLACEMENT,26200052,CDM,49452,CPT,360,RC,inpatient,,3065,3065,,2602.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2311.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2605.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2697.2,88,,percent of total billed charges,,,,,,,,,2341.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2789.15,91,,percent of total billed charges,,,2911.75,95,,percent of total billed charges,,,2543.95,83,,percent of total billed charges,,,2543.95,83,,percent of total billed charges,,,,,,,,,,,,,,,2543.95,83,,percent of total billed charges,,,2911.75,95,,percent of total billed charges,,,2758.5,90,,percent of total billed charges,,,2758.5,90,,percent of total billed charges,,,2513.3,82,,percent of total billed charges,,,2758.5,90,,percent of total billed charges,,,2605.25,85,,percent of total billed charges,,2311.01,2911.75,
X IR FOREIGN BODY REMOVAL,26200053,CDM,20520,CPT,360,RC,inpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4901,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5525,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,4901,6175,
X IR NEPHROURETERAL STENT PLACEMENT,26200054,CDM,50433,CPT,360,RC,inpatient,TC,10115,10115,,8587.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7626.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8597.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8901.2,88,,percent of total billed charges,,,,,,,,,7727.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9204.65,91,,percent of total billed charges,,,9609.25,95,,percent of total billed charges,,,8395.45,83,,percent of total billed charges,,,8395.45,83,,percent of total billed charges,,,,,,,,,,,,,,,8395.45,83,,percent of total billed charges,,,9609.25,95,,percent of total billed charges,,,9103.5,90,,percent of total billed charges,,,9103.5,90,,percent of total billed charges,,,8294.3,82,,percent of total billed charges,,,9103.5,90,,percent of total billed charges,,,8597.75,85,,percent of total billed charges,,7626.71,9609.25,
X IR CHANGE OF PERC DRAIN CATH,26200055,CDM,75984,CPT,360,RC,inpatient,TC,3030,3030,,2572.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2284.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2575.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2666.4,88,,percent of total billed charges,,,,,,,,,2314.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2757.3,91,,percent of total billed charges,,,2878.5,95,,percent of total billed charges,,,2514.9,83,,percent of total billed charges,,,2514.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2514.9,83,,percent of total billed charges,,,2878.5,95,,percent of total billed charges,,,2727,90,,percent of total billed charges,,,2727,90,,percent of total billed charges,,,2484.6,82,,percent of total billed charges,,,2727,90,,percent of total billed charges,,,2575.5,85,,percent of total billed charges,,2284.62,2878.5,
X IR GUIDE PERC DRAIN W/CATH,26200056,CDM,75989,CPT,360,RC,inpatient,TC,3634,3634,,3085.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2740.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3088.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3197.92,88,,percent of total billed charges,,,,,,,,,2776.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3306.94,91,,percent of total billed charges,,,3452.3,95,,percent of total billed charges,,,3016.22,83,,percent of total billed charges,,,3016.22,83,,percent of total billed charges,,,,,,,,,,,,,,,3016.22,83,,percent of total billed charges,,,3452.3,95,,percent of total billed charges,,,3270.6,90,,percent of total billed charges,,,3270.6,90,,percent of total billed charges,,,2979.88,82,,percent of total billed charges,,,3270.6,90,,percent of total billed charges,,,3088.9,85,,percent of total billed charges,,2740.04,3452.3,
X IR GUIDED FLUID COLLECTION/DRAINAGE,26200057,CDM,10030,CPT,360,RC,inpatient,TC,4094,4094,,3475.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3086.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3479.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3602.72,88,,percent of total billed charges,,,,,,,,,3127.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3725.54,91,,percent of total billed charges,,,3889.3,95,,percent of total billed charges,,,3398.02,83,,percent of total billed charges,,,3398.02,83,,percent of total billed charges,,,,,,,,,,,,,,,3398.02,83,,percent of total billed charges,,,3889.3,95,,percent of total billed charges,,,3684.6,90,,percent of total billed charges,,,3684.6,90,,percent of total billed charges,,,3357.08,82,,percent of total billed charges,,,3684.6,90,,percent of total billed charges,,,3479.9,85,,percent of total billed charges,,3086.88,3889.3,
X IR ARTERIAL MECH THROMB PRIM,26200058,CDM,37184,CPT,360,RC,inpatient,TC,18625,18625,,15812.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14043.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15831.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16390,88,,percent of total billed charges,,,,,,,,,14229.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16948.75,91,,percent of total billed charges,,,17693.75,95,,percent of total billed charges,,,15458.75,83,,percent of total billed charges,,,15458.75,83,,percent of total billed charges,,,,,,,,,,,,,,,15458.75,83,,percent of total billed charges,,,17693.75,95,,percent of total billed charges,,,16762.5,90,,percent of total billed charges,,,16762.5,90,,percent of total billed charges,,,15272.5,82,,percent of total billed charges,,,16762.5,90,,percent of total billed charges,,,15831.25,85,,percent of total billed charges,,14043.25,17693.75,
X IR ARTERIAL MECH THROMB SEC,26200059,CDM,37185,CPT,360,RC,inpatient,TC,9347,9347,,7935.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7047.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7944.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8225.36,88,,percent of total billed charges,,,,,,,,,7141.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8505.77,91,,percent of total billed charges,,,8879.65,95,,percent of total billed charges,,,7758.01,83,,percent of total billed charges,,,7758.01,83,,percent of total billed charges,,,,,,,,,,,,,,,7758.01,83,,percent of total billed charges,,,8879.65,95,,percent of total billed charges,,,8412.3,90,,percent of total billed charges,,,8412.3,90,,percent of total billed charges,,,7664.54,82,,percent of total billed charges,,,8412.3,90,,percent of total billed charges,,,7944.95,85,,percent of total billed charges,,7047.64,8879.65,
X IR VENOUS MECH THROMB PRIM,26200060,CDM,37187,CPT,360,RC,inpatient,TC,15076,15076,,12799.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11367.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12814.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13266.88,88,,percent of total billed charges,,,,,,,,,11518.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13719.16,91,,percent of total billed charges,,,14322.2,95,,percent of total billed charges,,,12513.08,83,,percent of total billed charges,,,12513.08,83,,percent of total billed charges,,,,,,,,,,,,,,,12513.08,83,,percent of total billed charges,,,14322.2,95,,percent of total billed charges,,,13568.4,90,,percent of total billed charges,,,13568.4,90,,percent of total billed charges,,,12362.32,82,,percent of total billed charges,,,13568.4,90,,percent of total billed charges,,,12814.6,85,,percent of total billed charges,,11367.3,14322.2,
X IR VENOUS MECH THROMB SEC,26200061,CDM,37188,CPT,360,RC,inpatient,TC,9381,9381,,7964.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7073.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7973.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8255.28,88,,percent of total billed charges,,,,,,,,,7167.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8536.71,91,,percent of total billed charges,,,8911.95,95,,percent of total billed charges,,,7786.23,83,,percent of total billed charges,,,7786.23,83,,percent of total billed charges,,,,,,,,,,,,,,,7786.23,83,,percent of total billed charges,,,8911.95,95,,percent of total billed charges,,,8442.9,90,,percent of total billed charges,,,8442.9,90,,percent of total billed charges,,,7692.42,82,,percent of total billed charges,,,8442.9,90,,percent of total billed charges,,,7973.85,85,,percent of total billed charges,,7073.27,8911.95,
X IR GENICULAR NERVE BLOCK,26200062,CDM,64454,CPT,360,RC,inpatient,TC,4303,4303,,3653.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3244.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3657.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3786.64,88,,percent of total billed charges,,,,,,,,,3287.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3915.73,91,,percent of total billed charges,,,4087.85,95,,percent of total billed charges,,,3571.49,83,,percent of total billed charges,,,3571.49,83,,percent of total billed charges,,,,,,,,,,,,,,,3571.49,83,,percent of total billed charges,,,4087.85,95,,percent of total billed charges,,,3872.7,90,,percent of total billed charges,,,3872.7,90,,percent of total billed charges,,,3528.46,82,,percent of total billed charges,,,3872.7,90,,percent of total billed charges,,,3657.55,85,,percent of total billed charges,,3244.46,4087.85,
X IR PLACEMENT OF INTRAVASCULAR STENT,26200063,CDM,37238,CPT,360,RC,inpatient,TC,35329,35329,,29994.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26638.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30029.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31089.52,88,,percent of total billed charges,,,,,,,,,26991.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32149.39,91,,percent of total billed charges,,,33562.55,95,,percent of total billed charges,,,29323.07,83,,percent of total billed charges,,,29323.07,83,,percent of total billed charges,,,,,,,,,,,,,,,29323.07,83,,percent of total billed charges,,,33562.55,95,,percent of total billed charges,,,31796.1,90,,percent of total billed charges,,,31796.1,90,,percent of total billed charges,,,28969.78,82,,percent of total billed charges,,,31796.1,90,,percent of total billed charges,,,30029.65,85,,percent of total billed charges,,26638.07,33562.55,
X IR INTRO CATHETER SUP/INF VENA CAVA,26200064,CDM,36010,CPT,360,RC,inpatient,TC,5448,5448,,4625.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4107.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4630.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4794.24,88,,percent of total billed charges,,,,,,,,,4162.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4957.68,91,,percent of total billed charges,,,5175.6,95,,percent of total billed charges,,,4521.84,83,,percent of total billed charges,,,4521.84,83,,percent of total billed charges,,,,,,,,,,,,,,,4521.84,83,,percent of total billed charges,,,5175.6,95,,percent of total billed charges,,,4903.2,90,,percent of total billed charges,,,4903.2,90,,percent of total billed charges,,,4467.36,82,,percent of total billed charges,,,4903.2,90,,percent of total billed charges,,,4630.8,85,,percent of total billed charges,,4107.79,5175.6,
X VASCULAR EMBOLIZATION/OCCLUSION,26200065,CDM,37241,CPT,360,RC,inpatient,,33480,33480,,28424.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25243.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28458,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29462.4,88,,percent of total billed charges,,,,,,,,,25578.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30466.8,91,,percent of total billed charges,,,31806,95,,percent of total billed charges,,,27788.4,83,,percent of total billed charges,,,27788.4,83,,percent of total billed charges,,,,,,,,,,,,,,,27788.4,83,,percent of total billed charges,,,31806,95,,percent of total billed charges,,,30132,90,,percent of total billed charges,,,30132,90,,percent of total billed charges,,,27453.6,82,,percent of total billed charges,,,30132,90,,percent of total billed charges,,,28458,85,,percent of total billed charges,,25243.92,31806,
X IR ARTERIAL CATH PLACEMENT,26200066,CDM,36247,CPT,360,RC,inpatient,TC,9082,9082,,7710.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6847.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7719.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7992.16,88,,percent of total billed charges,,,,,,,,,6938.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8264.62,91,,percent of total billed charges,,,8627.9,95,,percent of total billed charges,,,7538.06,83,,percent of total billed charges,,,7538.06,83,,percent of total billed charges,,,,,,,,,,,,,,,7538.06,83,,percent of total billed charges,,,8627.9,95,,percent of total billed charges,,,8173.8,90,,percent of total billed charges,,,8173.8,90,,percent of total billed charges,,,7447.24,82,,percent of total billed charges,,,8173.8,90,,percent of total billed charges,,,7719.7,85,,percent of total billed charges,,6847.83,8627.9,
X IR ARTERIAL CATH PLACEMENT ADDITIONAL,26200067,CDM,36248,CPT,360,RC,inpatient,TC,5764,5764,,4893.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4346.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4899.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5072.32,88,,percent of total billed charges,,,,,,,,,4403.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5245.24,91,,percent of total billed charges,,,5475.8,95,,percent of total billed charges,,,4784.12,83,,percent of total billed charges,,,4784.12,83,,percent of total billed charges,,,,,,,,,,,,,,,4784.12,83,,percent of total billed charges,,,5475.8,95,,percent of total billed charges,,,5187.6,90,,percent of total billed charges,,,5187.6,90,,percent of total billed charges,,,4726.48,82,,percent of total billed charges,,,5187.6,90,,percent of total billed charges,,,4899.4,85,,percent of total billed charges,,4346.06,5475.8,
X REPAIR OF CENTRAL VENOUS CATH,26200068,CDM,,,360,RC,inpatient,,9185,9185,,7798.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6925.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7807.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8082.8,88,,percent of total billed charges,,,,,,,,,7017.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8358.35,91,,percent of total billed charges,,,8725.75,95,,percent of total billed charges,,,7623.55,83,,percent of total billed charges,,,7623.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7623.55,83,,percent of total billed charges,,,8725.75,95,,percent of total billed charges,,,8266.5,90,,percent of total billed charges,,,8266.5,90,,percent of total billed charges,,,7531.7,82,,percent of total billed charges,,,8266.5,90,,percent of total billed charges,,,7807.25,85,,percent of total billed charges,,6925.49,8725.75,
X IR REMOVAL OF NEPHROSTOMY CATH,26200069,CDM,50389,CPT,360,RC,inpatient,TC,4319,4319,,3666.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3256.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3671.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3800.72,88,,percent of total billed charges,,,,,,,,,3299.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3930.29,91,,percent of total billed charges,,,4103.05,95,,percent of total billed charges,,,3584.77,83,,percent of total billed charges,,,3584.77,83,,percent of total billed charges,,,,,,,,,,,,,,,3584.77,83,,percent of total billed charges,,,4103.05,95,,percent of total billed charges,,,3887.1,90,,percent of total billed charges,,,3887.1,90,,percent of total billed charges,,,3541.58,82,,percent of total billed charges,,,3887.1,90,,percent of total billed charges,,,3671.15,85,,percent of total billed charges,,3256.53,4103.05,
X IR RF ABLATION OF GENICULAR NERVES,26200070,CDM,64624,CPT,360,RC,inpatient,TC,8249,8249,,7003.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6219.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7011.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7259.12,88,,percent of total billed charges,,,,,,,,,6302.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7506.59,91,,percent of total billed charges,,,7836.55,95,,percent of total billed charges,,,6846.67,83,,percent of total billed charges,,,6846.67,83,,percent of total billed charges,,,,,,,,,,,,,,,6846.67,83,,percent of total billed charges,,,7836.55,95,,percent of total billed charges,,,7424.1,90,,percent of total billed charges,,,7424.1,90,,percent of total billed charges,,,6764.18,82,,percent of total billed charges,,,7424.1,90,,percent of total billed charges,,,7011.65,85,,percent of total billed charges,,6219.75,7836.55,
X IR INSERTION OF SUPRAPUBIC CATH,26200071,CDM,51102,CPT,360,RC,inpatient,TC,9836,9836,,8350.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7416.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8360.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8655.68,88,,percent of total billed charges,,,,,,,,,7514.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8950.76,91,,percent of total billed charges,,,9344.2,95,,percent of total billed charges,,,8163.88,83,,percent of total billed charges,,,8163.88,83,,percent of total billed charges,,,,,,,,,,,,,,,8163.88,83,,percent of total billed charges,,,9344.2,95,,percent of total billed charges,,,8852.4,90,,percent of total billed charges,,,8852.4,90,,percent of total billed charges,,,8065.52,82,,percent of total billed charges,,,8852.4,90,,percent of total billed charges,,,8360.6,85,,percent of total billed charges,,7416.34,9344.2,
X IR ANGIOGRAPHY PELVIC,26200072,CDM,75736,CPT,360,RC,inpatient,TC,9665,9665,,8205.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7287.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8215.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8505.2,88,,percent of total billed charges,,,,,,,,,7384.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8795.15,91,,percent of total billed charges,,,9181.75,95,,percent of total billed charges,,,8021.95,83,,percent of total billed charges,,,8021.95,83,,percent of total billed charges,,,,,,,,,,,,,,,8021.95,83,,percent of total billed charges,,,9181.75,95,,percent of total billed charges,,,8698.5,90,,percent of total billed charges,,,8698.5,90,,percent of total billed charges,,,7925.3,82,,percent of total billed charges,,,8698.5,90,,percent of total billed charges,,,8215.25,85,,percent of total billed charges,,7287.41,9181.75,
X IR SUPRAPUBIC CATH EXCHANGE,26200073,CDM,51705,CPT,360,RC,inpatient,TC,2929,2929,,2486.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2208.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2489.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2577.52,88,,percent of total billed charges,,,,,,,,,2237.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2665.39,91,,percent of total billed charges,,,2782.55,95,,percent of total billed charges,,,2431.07,83,,percent of total billed charges,,,2431.07,83,,percent of total billed charges,,,,,,,,,,,,,,,2431.07,83,,percent of total billed charges,,,2782.55,95,,percent of total billed charges,,,2636.1,90,,percent of total billed charges,,,2636.1,90,,percent of total billed charges,,,2401.78,82,,percent of total billed charges,,,2636.1,90,,percent of total billed charges,,,2489.65,85,,percent of total billed charges,,2208.47,2782.55,
X IR FEM/POPL REVASC W/STENT,26200074,CDM,37226,CPT,360,RC,inpatient,TC,42470,42470,,36057.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32022.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36099.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37373.6,88,,percent of total billed charges,,,,,,,,,32447.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38647.7,91,,percent of total billed charges,,,40346.5,95,,percent of total billed charges,,,35250.1,83,,percent of total billed charges,,,35250.1,83,,percent of total billed charges,,,,,,,,,,,,,,,35250.1,83,,percent of total billed charges,,,40346.5,95,,percent of total billed charges,,,38223,90,,percent of total billed charges,,,38223,90,,percent of total billed charges,,,34825.4,82,,percent of total billed charges,,,38223,90,,percent of total billed charges,,,36099.5,85,,percent of total billed charges,,32022.38,40346.5,
X IR REVASC W/ATHERECTOMY INCL ANGIOPLAS,26200075,CDM,37225,CPT,360,RC,inpatient,TC,42769,42769,,36310.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32247.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36353.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37636.72,88,,percent of total billed charges,,,,,,,,,32675.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38919.79,91,,percent of total billed charges,,,40630.55,95,,percent of total billed charges,,,35498.27,83,,percent of total billed charges,,,35498.27,83,,percent of total billed charges,,,,,,,,,,,,,,,35498.27,83,,percent of total billed charges,,,40630.55,95,,percent of total billed charges,,,38492.1,90,,percent of total billed charges,,,38492.1,90,,percent of total billed charges,,,35070.58,82,,percent of total billed charges,,,38492.1,90,,percent of total billed charges,,,36353.65,85,,percent of total billed charges,,32247.83,40630.55,
X IR GASTROSTOMY TUBE PLACEMENT,26200076,CDM,49440,CPT,360,RC,inpatient,TC,6214,6214,,5275.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4685.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5281.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5468.32,88,,percent of total billed charges,,,,,,,,,4747.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5654.74,91,,percent of total billed charges,,,5903.3,95,,percent of total billed charges,,,5157.62,83,,percent of total billed charges,,,5157.62,83,,percent of total billed charges,,,,,,,,,,,,,,,5157.62,83,,percent of total billed charges,,,5903.3,95,,percent of total billed charges,,,5592.6,90,,percent of total billed charges,,,5592.6,90,,percent of total billed charges,,,5095.48,82,,percent of total billed charges,,,5592.6,90,,percent of total billed charges,,,5281.9,85,,percent of total billed charges,,4685.36,5903.3,
X IR GASTROSTOMY TUBE REPLACEMENT,26200077,CDM,49450,CPT,360,RC,inpatient,TC,4018,4018,,3411.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3029.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3415.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3535.84,88,,percent of total billed charges,,,,,,,,,3069.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3656.38,91,,percent of total billed charges,,,3817.1,95,,percent of total billed charges,,,3334.94,83,,percent of total billed charges,,,3334.94,83,,percent of total billed charges,,,,,,,,,,,,,,,3334.94,83,,percent of total billed charges,,,3817.1,95,,percent of total billed charges,,,3616.2,90,,percent of total billed charges,,,3616.2,90,,percent of total billed charges,,,3294.76,82,,percent of total billed charges,,,3616.2,90,,percent of total billed charges,,,3415.3,85,,percent of total billed charges,,3029.57,3817.1,
X IR INSERTION OF CATH PLACEMENT,26200078,CDM,36245,CPT,360,RC,inpatient,TC,8265,8265,,7016.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6231.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7025.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7273.2,88,,percent of total billed charges,,,,,,,,,6314.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7521.15,91,,percent of total billed charges,,,7851.75,95,,percent of total billed charges,,,6859.95,83,,percent of total billed charges,,,6859.95,83,,percent of total billed charges,,,,,,,,,,,,,,,6859.95,83,,percent of total billed charges,,,7851.75,95,,percent of total billed charges,,,7438.5,90,,percent of total billed charges,,,7438.5,90,,percent of total billed charges,,,6777.3,82,,percent of total billed charges,,,7438.5,90,,percent of total billed charges,,,7025.25,85,,percent of total billed charges,,6231.81,7851.75,
X IR INJ OF SCLEROSANT SINGLE VEIN,26200079,CDM,36470,CPT,360,RC,inpatient,TC,3680,3680,,3124.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2774.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3128,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3238.4,88,,percent of total billed charges,,,,,,,,,2811.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3348.8,91,,percent of total billed charges,,,3496,95,,percent of total billed charges,,,3054.4,83,,percent of total billed charges,,,3054.4,83,,percent of total billed charges,,,,,,,,,,,,,,,3054.4,83,,percent of total billed charges,,,3496,95,,percent of total billed charges,,,3312,90,,percent of total billed charges,,,3312,90,,percent of total billed charges,,,3017.6,82,,percent of total billed charges,,,3312,90,,percent of total billed charges,,,3128,85,,percent of total billed charges,,2774.72,3496,
X IR INJ OF SCLEROSANT MULTIPLE VEIN,26200080,CDM,36471,CPT,360,RC,inpatient,TC,1835,1835,,1557.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1383.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1559.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1614.8,88,,percent of total billed charges,,,,,,,,,1401.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1669.85,91,,percent of total billed charges,,,1743.25,95,,percent of total billed charges,,,1523.05,83,,percent of total billed charges,,,1523.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1523.05,83,,percent of total billed charges,,,1743.25,95,,percent of total billed charges,,,1651.5,90,,percent of total billed charges,,,1651.5,90,,percent of total billed charges,,,1504.7,82,,percent of total billed charges,,,1651.5,90,,percent of total billed charges,,,1559.75,85,,percent of total billed charges,,1383.59,1743.25,
X IR VASCULAR EMBOLIZATION/OCCLUSION ART,26200081,CDM,37243,CPT,360,RC,inpatient,TC,33632,33632,,28553.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25358.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28587.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29596.16,88,,percent of total billed charges,,,,,,,,,25694.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30605.12,91,,percent of total billed charges,,,31950.4,95,,percent of total billed charges,,,27914.56,83,,percent of total billed charges,,,27914.56,83,,percent of total billed charges,,,,,,,,,,,,,,,27914.56,83,,percent of total billed charges,,,31950.4,95,,percent of total billed charges,,,30268.8,90,,percent of total billed charges,,,30268.8,90,,percent of total billed charges,,,27578.24,82,,percent of total billed charges,,,30268.8,90,,percent of total billed charges,,,28587.2,85,,percent of total billed charges,,25358.53,31950.4,
X IR TRANSCATHETER EMBOLIZATION,26200082,CDM,75894,CPT,360,RC,inpatient,TC,9745,9745,,8273.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7347.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8283.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8575.6,88,,percent of total billed charges,,,,,,,,,7445.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8867.95,91,,percent of total billed charges,,,9257.75,95,,percent of total billed charges,,,8088.35,83,,percent of total billed charges,,,8088.35,83,,percent of total billed charges,,,,,,,,,,,,,,,8088.35,83,,percent of total billed charges,,,9257.75,95,,percent of total billed charges,,,8770.5,90,,percent of total billed charges,,,8770.5,90,,percent of total billed charges,,,7990.9,82,,percent of total billed charges,,,8770.5,90,,percent of total billed charges,,,8283.25,85,,percent of total billed charges,,7347.73,9257.75,
X IR ANGIOGRAPHY THROUGH EXISTING CATH,26200083,CDM,75898,CPT,360,RC,inpatient,TC,4102,4102,,3482.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3092.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3486.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3609.76,88,,percent of total billed charges,,,,,,,,,3133.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3732.82,91,,percent of total billed charges,,,3896.9,95,,percent of total billed charges,,,3404.66,83,,percent of total billed charges,,,3404.66,83,,percent of total billed charges,,,,,,,,,,,,,,,3404.66,83,,percent of total billed charges,,,3896.9,95,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3363.64,82,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3486.7,85,,percent of total billed charges,,3092.91,3896.9,
X IR TRANSCATHETER BIOPSY,26200084,CDM,37200,CPT,360,RC,inpatient,TC,8126,8126,,6898.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6127,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6907.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150.88,88,,percent of total billed charges,,,,,,,,,6208.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7394.66,91,,percent of total billed charges,,,7719.7,95,,percent of total billed charges,,,6744.58,83,,percent of total billed charges,,,6744.58,83,,percent of total billed charges,,,,,,,,,,,,,,,6744.58,83,,percent of total billed charges,,,7719.7,95,,percent of total billed charges,,,7313.4,90,,percent of total billed charges,,,7313.4,90,,percent of total billed charges,,,6663.32,82,,percent of total billed charges,,,7313.4,90,,percent of total billed charges,,,6907.1,85,,percent of total billed charges,,6127,7719.7,
X IR LIVER NEEDLE BIOPSY,26200085,CDM,47000,CPT,360,RC,inpatient,TC,4409,4409,,3743.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3324.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3747.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3879.92,88,,percent of total billed charges,,,,,,,,,3368.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4012.19,91,,percent of total billed charges,,,4188.55,95,,percent of total billed charges,,,3659.47,83,,percent of total billed charges,,,3659.47,83,,percent of total billed charges,,,,,,,,,,,,,,,3659.47,83,,percent of total billed charges,,,4188.55,95,,percent of total billed charges,,,3968.1,90,,percent of total billed charges,,,3968.1,90,,percent of total billed charges,,,3615.38,82,,percent of total billed charges,,,3968.1,90,,percent of total billed charges,,,3747.65,85,,percent of total billed charges,,3324.39,4188.55,
.XXXXXIDH2,2520019,CDM,81121,CPT,300,RC,inpatient,,457,457,,387.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,344.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,388.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,402.16,88,,percent of total billed charges,,,,,,,,,349.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,415.87,91,,percent of total billed charges,,,434.15,95,,percent of total billed charges,,,379.31,83,,percent of total billed charges,,,379.31,83,,percent of total billed charges,,,,,,,,,,,,,,,379.31,83,,percent of total billed charges,,,434.15,95,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,374.74,82,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,388.45,85,,percent of total billed charges,,344.58,434.15,
URIC ACID SYNOVAL FLUID,2520245,CDM,84560,CPT,300,RC,inpatient,,119,119,,101.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,89.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,101.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,104.72,88,,percent of total billed charges,,,,,,,,,90.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,108.29,91,,percent of total billed charges,,,113.05,95,,percent of total billed charges,,,98.77,83,,percent of total billed charges,,,98.77,83,,percent of total billed charges,,,,,,,,,,,,,,,98.77,83,,percent of total billed charges,,,113.05,95,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,97.58,82,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,101.15,85,,percent of total billed charges,,89.73,113.05,
BONE MARROW ENGRAFTMENT,2520678,CDM,81267,CPT,300,RC,inpatient,,1307,1307,,1109.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,985.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1110.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1150.16,88,,percent of total billed charges,,,,,,,,,998.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1189.37,91,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1084.81,83,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1071.74,82,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1110.95,85,,percent of total billed charges,,985.48,1241.65,
DRUG SCREEN  GAH PRE-EMP(LABCORP),2522653,CDM,80307,CPT,300,RC,inpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,58.06,73.15,
* DEXTROMETER USAGE (V0904)(NC),23300475,CDM,,,270,RC,inpatient,,38,38,,32.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33.44,88,,percent of total billed charges,,,,,,,,,29.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.58,91,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,,,,,,,,,,,,,31.54,83,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,31.16,82,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,28.65,36.1,
X RHC SCREENING PAP SMEAR,25100000,CDM,Q0091,HCPCS,311,RC,inpatient,,140,140,,118.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,105.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,119,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,123.2,88,,percent of total billed charges,,,,,,,,,106.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,133,95,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,114.8,82,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,105.56,133,
X RHC VENIPUNCTURE BLOOD COLLECTION,25200001,CDM,36415,CPT,300,RC,inpatient,,39,39,,33.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34.32,88,,percent of total billed charges,,,,,,,,,29.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35.49,91,,percent of total billed charges,,,37.05,95,,percent of total billed charges,,,32.37,83,,percent of total billed charges,,,32.37,83,,percent of total billed charges,,,,,,,,,,,,,,,32.37,83,,percent of total billed charges,,,37.05,95,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,31.98,82,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,33.15,85,,percent of total billed charges,,29.41,37.05,
X RHC URINE DIPSTICK ONLY,25200002,CDM,81003,CPT,300,RC,inpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,38.45,48.45,
"X RHC OCCULT BLOOD SCREEN, FECES 1-3",25200003,CDM,82270,CPT,300,RC,inpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,18.1,22.8,
X RHC OCCULT BLOOD SCREEN FIT OFFICE,25200004,CDM,82272,CPT,300,RC,inpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,18.1,22.8,
X RHC GLUCOSE (PCX),25200005,CDM,82948,CPT,300,RC,inpatient,,33,33,,28.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.04,88,,percent of total billed charges,,,,,,,,,25.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.03,91,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,,,,,,,,,,,,,27.39,83,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,27.06,82,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,28.05,85,,percent of total billed charges,,24.88,31.35,
X RHC HEMOGLOBIN A1c,25200006,CDM,83036,CPT,300,RC,inpatient,,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,110.84,139.65,
X RHC PROTHROMBIN TIME,25200007,CDM,85610,CPT,300,RC,inpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,61.07,76.95,
"X RHC STREP SCREEN, RAPID",25200008,CDM,87880,CPT,300,RC,inpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,58.81,74.1,
X RHC MICROALBUMIN,25200009,CDM,82044,CPT,300,RC,inpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,65.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,65.6,82.65,
X RHC CAPILLARY PUNCTURE BLOOD COLLECT,25200010,CDM,36416,CPT,300,RC,inpatient,,44,44,,37.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.72,88,,percent of total billed charges,,,,,,,,,33.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,36.08,82,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,33.18,41.8,
ENTEROVIRUS RNA QL PCR,25200016,CDM,87498,CPT,300,RC,inpatient,,415,415,,352.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,312.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,352.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,365.2,88,,percent of total billed charges,,,,,,,,,317.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,377.65,91,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,,,,,,,,,,,,,344.45,83,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,340.3,82,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,312.91,394.25,
TROPONIN-I,25200017,CDM,84484,CPT,300,RC,inpatient,,379,379,,321.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,285.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,322.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,333.52,88,,percent of total billed charges,,,,,,,,,289.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,344.89,91,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,,,,,,,,,,,,,314.57,83,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,310.78,82,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,285.77,360.05,
ENDOMYSIAL ANTIBODY SCREEN,25200018,CDM,86255,CPT,300,RC,inpatient,,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,349.86,440.8,
MERCURY URINE,25200021,CDM,83825,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
ALBUMIN,25200022,CDM,82040,CPT,300,RC,inpatient,,99,99,,84.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,74.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,84.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,87.12,88,,percent of total billed charges,,,,,,,,,75.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,,,,,,,,,,,,,82.17,83,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,81.18,82,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,74.65,94.05,
C-PEPTIDE,25200023,CDM,84681,CPT,300,RC,inpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,283.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,319.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,283.5,357.2,
"HIV-1 RNA PCR, QN",25200024,CDM,87536,CPT,300,RC,inpatient,,677,677,,574.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,510.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,575.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,595.76,88,,percent of total billed charges,,,,,,,,,517.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,616.07,91,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,,,,,,,,,,,,,561.91,83,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,555.14,82,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,575.45,85,,percent of total billed charges,,510.46,643.15,
AMIODARONE,25200025,CDM,80151,CPT,300,RC,inpatient,,224,224,,190.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,190.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,197.12,88,,percent of total billed charges,,,,,,,,,171.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,183.68,82,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,168.9,212.8,
BETA 2 GLYCOPROTEIN 1 AB (IgG),25200026,CDM,86146,CPT,300,RC,inpatient,,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,110.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,98.02,123.5,
BETA 2 MICROGLOBULIN,25200027,CDM,82232,CPT,300,RC,inpatient,,291,291,,247.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,219.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,247.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,256.08,88,,percent of total billed charges,,,,,,,,,222.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,264.81,91,,percent of total billed charges,,,276.45,95,,percent of total billed charges,,,241.53,83,,percent of total billed charges,,,241.53,83,,percent of total billed charges,,,,,,,,,,,,,,,241.53,83,,percent of total billed charges,,,276.45,95,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,238.62,82,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,247.35,85,,percent of total billed charges,,219.41,276.45,
TESTOSTERONE FREE (INCLUDES TOTAL),25200028,CDM,84402,CPT,300,RC,inpatient,,460,460,,390.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,346.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,391,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,404.8,88,,percent of total billed charges,,,,,,,,,351.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,418.6,91,,percent of total billed charges,,,437,95,,percent of total billed charges,,,381.8,83,,percent of total billed charges,,,381.8,83,,percent of total billed charges,,,,,,,,,,,,,,,381.8,83,,percent of total billed charges,,,437,95,,percent of total billed charges,,,414,90,,percent of total billed charges,,,414,90,,percent of total billed charges,,,377.2,82,,percent of total billed charges,,,414,90,,percent of total billed charges,,,391,85,,percent of total billed charges,,346.84,437,
FETAL HEMOGLOGIN,25200029,CDM,83021,CPT,300,RC,inpatient,,82,82,,69.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,69.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,72.16,88,,percent of total billed charges,,,,,,,,,62.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,74.62,91,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,,,,,,,,,,,,,68.06,83,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,67.24,82,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,61.83,77.9,
ALKALINE PHOSPHATASE,25200030,CDM,84075,CPT,300,RC,inpatient,,116,116,,98.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,87.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,98.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,102.08,88,,percent of total billed charges,,,,,,,,,88.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,105.56,91,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,,,,,,,,,,,,,96.28,83,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,95.12,82,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,98.6,85,,percent of total billed charges,,87.46,110.2,
0SERTRALINE (ZOLOFT),25200031,CDM,80299,CPT,300,RC,inpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,226.2,285,
BB THAW FRESH FROZEN PLASMA,25200032,CDM,86927,CPT,300,RC,inpatient,,265,265,,224.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,199.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,225.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,233.2,88,,percent of total billed charges,,,,,,,,,202.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,241.15,91,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,,,,,,,,,,,,,219.95,83,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,217.3,82,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,199.81,251.75,
LEUKOCYTE ALKALINE PHOSPHATASE,25200033,CDM,85540,CPT,300,RC,inpatient,,161,161,,136.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,121.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,141.68,88,,percent of total billed charges,,,,,,,,,123,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,132.02,82,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,121.39,152.95,
FACTOR V (LEIDEN),25200034,CDM,81241,CPT,300,RC,inpatient,,731,731,,620.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,551.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,621.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,643.28,88,,percent of total billed charges,,,,,,,,,558.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,665.21,91,,percent of total billed charges,,,694.45,95,,percent of total billed charges,,,606.73,83,,percent of total billed charges,,,606.73,83,,percent of total billed charges,,,,,,,,,,,,,,,606.73,83,,percent of total billed charges,,,694.45,95,,percent of total billed charges,,,657.9,90,,percent of total billed charges,,,657.9,90,,percent of total billed charges,,,599.42,82,,percent of total billed charges,,,657.9,90,,percent of total billed charges,,,621.35,85,,percent of total billed charges,,551.17,694.45,
COPPER URINE (24-HOUR),25200035,CDM,82525,CPT,300,RC,inpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,155.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,155.32,195.7,
.DRUG SCREEN BLOOD,25200036,CDM,80307,CPT,300,RC,inpatient,,44,44,,37.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.72,88,,percent of total billed charges,,,,,,,,,33.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,36.08,82,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,33.18,41.8,
MUMPS ANTIBODY (IgG),25200037,CDM,86735,CPT,300,RC,inpatient,,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,110.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,98.02,123.5,
MUMPS ANTIBODY (IgM),25200038,CDM,86735,CPT,300,RC,inpatient,,164,164,,139.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,123.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,139.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,144.32,88,,percent of total billed charges,,,,,,,,,125.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,134.48,82,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,123.66,155.8,
GLOMERULAR BASEMENT MEMBRANE AB,25200039,CDM,83520,CPT,300,RC,inpatient,,565,565,,479.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,426.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,480.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,497.2,88,,percent of total billed charges,,,,,,,,,431.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,514.15,91,,percent of total billed charges,,,536.75,95,,percent of total billed charges,,,468.95,83,,percent of total billed charges,,,468.95,83,,percent of total billed charges,,,,,,,,,,,,,,,468.95,83,,percent of total billed charges,,,536.75,95,,percent of total billed charges,,,508.5,90,,percent of total billed charges,,,508.5,90,,percent of total billed charges,,,463.3,82,,percent of total billed charges,,,508.5,90,,percent of total billed charges,,,480.25,85,,percent of total billed charges,,426.01,536.75,
BK VIRUS DNA QN PCR,25200040,CDM,87799,CPT,300,RC,inpatient,,811,811,,688.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,611.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,689.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,713.68,88,,percent of total billed charges,,,,,,,,,619.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,738.01,91,,percent of total billed charges,,,770.45,95,,percent of total billed charges,,,673.13,83,,percent of total billed charges,,,673.13,83,,percent of total billed charges,,,,,,,,,,,,,,,673.13,83,,percent of total billed charges,,,770.45,95,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,665.02,82,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,689.35,85,,percent of total billed charges,,611.49,770.45,
.GTT - 2 HOUR,25200041,CDM,82951,CPT,300,RC,inpatient,,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,174.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,174.17,219.45,
.GTT - 4 HOUR,25200042,CDM,82951,CPT,300,RC,inpatient,,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,191.84,88,,percent of total billed charges,,,,,,,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,164.37,207.1,
.CBC W/MANUAL DIFF,25200043,CDM,85027,CPT,300,RC,inpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
GALACTOSE-1-PHOSPHATE LEVEL,25200044,CDM,82775,CPT,300,RC,inpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,157.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,177.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,157.59,198.55,
HERPES SIM 2 IGG AB,25200045,CDM,86696,CPT,300,RC,inpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,135.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,119.89,151.05,
FETAL FIBRONECTIN,25200046,CDM,82731,CPT,300,RC,inpatient,,713,713,,605.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,537.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,606.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,627.44,88,,percent of total billed charges,,,,,,,,,544.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,648.83,91,,percent of total billed charges,,,677.35,95,,percent of total billed charges,,,591.79,83,,percent of total billed charges,,,591.79,83,,percent of total billed charges,,,,,,,,,,,,,,,591.79,83,,percent of total billed charges,,,677.35,95,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,584.66,82,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,606.05,85,,percent of total billed charges,,537.6,677.35,
BNP,25200047,CDM,83880,CPT,300,RC,inpatient,,561,561,,476.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,422.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,476.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,493.68,88,,percent of total billed charges,,,,,,,,,428.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,510.51,91,,percent of total billed charges,,,532.95,95,,percent of total billed charges,,,465.63,83,,percent of total billed charges,,,465.63,83,,percent of total billed charges,,,,,,,,,,,,,,,465.63,83,,percent of total billed charges,,,532.95,95,,percent of total billed charges,,,504.9,90,,percent of total billed charges,,,504.9,90,,percent of total billed charges,,,460.02,82,,percent of total billed charges,,,504.9,90,,percent of total billed charges,,,476.85,85,,percent of total billed charges,,422.99,532.95,
AMYLASE SERUM,25200048,CDM,82150,CPT,300,RC,inpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,135.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,119.89,151.05,
TETRACYCLINE,25200050,CDM,80299,CPT,300,RC,inpatient,,358,358,,303.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,269.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,304.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,315.04,88,,percent of total billed charges,,,,,,,,,273.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,325.78,91,,percent of total billed charges,,,340.1,95,,percent of total billed charges,,,297.14,83,,percent of total billed charges,,,297.14,83,,percent of total billed charges,,,,,,,,,,,,,,,297.14,83,,percent of total billed charges,,,340.1,95,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,293.56,82,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,304.3,85,,percent of total billed charges,,269.93,340.1,
..HERPES SIM 1&2 IGM AB,25200051,CDM,86695,CPT,300,RC,inpatient,,175,175,,148.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,131.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,148.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154,88,,percent of total billed charges,,,,,,,,,133.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,,,,,,,,,,,,,145.25,83,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,143.5,82,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,131.95,166.25,
CYCLIC CITRULLINATED PEPTIDE  AB(IGG/IGA,25200052,CDM,86200,CPT,300,RC,inpatient,,381,381,,323.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,287.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,323.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,335.28,88,,percent of total billed charges,,,,,,,,,291.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,346.71,91,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,,,,,,,,,,,,,316.23,83,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,312.42,82,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,323.85,85,,percent of total billed charges,,287.27,361.95,
CYSTIC FIBROSIS CARRIER SCREEN,25200053,CDM,81220,CPT,300,RC,inpatient,,827,827,,702.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,623.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,702.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,727.76,88,,percent of total billed charges,,,,,,,,,631.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,752.57,91,,percent of total billed charges,,,785.65,95,,percent of total billed charges,,,686.41,83,,percent of total billed charges,,,686.41,83,,percent of total billed charges,,,,,,,,,,,,,,,686.41,83,,percent of total billed charges,,,785.65,95,,percent of total billed charges,,,744.3,90,,percent of total billed charges,,,744.3,90,,percent of total billed charges,,,678.14,82,,percent of total billed charges,,,744.3,90,,percent of total billed charges,,,702.95,85,,percent of total billed charges,,623.56,785.65,
CYTOCHROME P450 2D6 GENOTYPING,25200054,CDM,81226,CPT,300,RC,inpatient,,1572,1572,,1334.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1185.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1336.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1383.36,88,,percent of total billed charges,,,,,,,,,1201.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1430.52,91,,percent of total billed charges,,,1493.4,95,,percent of total billed charges,,,1304.76,83,,percent of total billed charges,,,1304.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1304.76,83,,percent of total billed charges,,,1493.4,95,,percent of total billed charges,,,1414.8,90,,percent of total billed charges,,,1414.8,90,,percent of total billed charges,,,1289.04,82,,percent of total billed charges,,,1414.8,90,,percent of total billed charges,,,1336.2,85,,percent of total billed charges,,1185.29,1493.4,
ANTIBIOTIC SENSITIVITY PANEL,25200055,CDM,87186,CPT,300,RC,inpatient,,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,114.61,144.4,
BETA 2 MICROGLOBULIN URINE,25200056,CDM,82232,CPT,300,RC,inpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,41.47,52.25,
ORGANISM I.D. AEROBIC,25200057,CDM,87077,CPT,300,RC,inpatient,,174,174,,147.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,131.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,153.12,88,,percent of total billed charges,,,,,,,,,132.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,158.34,91,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,,,,,,,,,,,,,144.42,83,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,142.68,82,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,131.2,165.3,
ORGANISM I.D. ANAEROBIC,25200058,CDM,87076,CPT,300,RC,inpatient,,127,127,,107.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,111.76,88,,percent of total billed charges,,,,,,,,,97.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,,,,,,,,,,,,,105.41,83,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,104.14,82,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,95.76,120.65,
TRYPSIN,25200059,CDM,83519,CPT,300,RC,inpatient,,149,149,,126.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,112.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,126.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,131.12,88,,percent of total billed charges,,,,,,,,,113.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,135.59,91,,percent of total billed charges,,,141.55,95,,percent of total billed charges,,,123.67,83,,percent of total billed charges,,,123.67,83,,percent of total billed charges,,,,,,,,,,,,,,,123.67,83,,percent of total billed charges,,,141.55,95,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,122.18,82,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,126.65,85,,percent of total billed charges,,112.35,141.55,
10-HYDROXYCARBEZEPINE,25200060,CDM,80183,CPT,300,RC,inpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,155.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,155.32,195.7,
DRUG SCREEN OPIATE SERUM,25200061,CDM,80361,CPT,300,RC,inpatient,,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,257.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,290.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,257.87,324.9,
.DRUG SCREEN OPIATE URINE,25200062,CDM,83925,CPT,300,RC,inpatient,,340,340,,288.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,256.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,289,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,299.2,88,,percent of total billed charges,,,,,,,,,259.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,309.4,91,,percent of total billed charges,,,323,95,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,,,,,,,,,,,,,282.2,83,,percent of total billed charges,,,323,95,,percent of total billed charges,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,278.8,82,,percent of total billed charges,,,306,90,,percent of total billed charges,,,289,85,,percent of total billed charges,,256.36,323,
BB ANTIBODY SCREEN,25200063,CDM,86850,CPT,300,RC,inpatient,,270,270,,229.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,203.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,229.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,237.6,88,,percent of total billed charges,,,,,,,,,206.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,245.7,91,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,,,,,,,,,,,,,224.1,83,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,243,90,,percent of total billed charges,,,243,90,,percent of total billed charges,,,221.4,82,,percent of total billed charges,,,243,90,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,203.58,256.5,
MYASTHENIA GRAVIS PANEL,25200064,CDM,83519,CPT,300,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
SULFONYLUREA SCREEN QT,25200066,CDM,80377,CPT,300,RC,inpatient,,498,498,,422.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,375.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,423.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,438.24,88,,percent of total billed charges,,,,,,,,,380.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,,,,,,,,,,,,,413.34,83,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,408.36,82,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,375.49,473.1,
SULFATIDE IGG,25200067,CDM,83520,CPT,300,RC,inpatient,,666,666,,565.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,502.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,566.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,586.08,88,,percent of total billed charges,,,,,,,,,508.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,606.06,91,,percent of total billed charges,,,632.7,95,,percent of total billed charges,,,552.78,83,,percent of total billed charges,,,552.78,83,,percent of total billed charges,,,,,,,,,,,,,,,552.78,83,,percent of total billed charges,,,632.7,95,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,546.12,82,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,566.1,85,,percent of total billed charges,,502.16,632.7,
MYELIN GLYCOPROTEIN ANTIBODY,25200068,CDM,84182,CPT,300,RC,inpatient,,480,480,,407.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,361.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,408,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,422.4,88,,percent of total billed charges,,,,,,,,,366.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,436.8,91,,percent of total billed charges,,,456,95,,percent of total billed charges,,,398.4,83,,percent of total billed charges,,,398.4,83,,percent of total billed charges,,,,,,,,,,,,,,,398.4,83,,percent of total billed charges,,,456,95,,percent of total billed charges,,,432,90,,percent of total billed charges,,,432,90,,percent of total billed charges,,,393.6,82,,percent of total billed charges,,,432,90,,percent of total billed charges,,,408,85,,percent of total billed charges,,361.92,456,
.GANGLIOSIDE ANTIBODIES (IGG & IGM),25200069,CDM,83516,CPT,300,RC,inpatient,,244,244,,207.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,183.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,207.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,214.72,88,,percent of total billed charges,,,,,,,,,186.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,222.04,91,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,,,,,,,,,,,,,202.52,83,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,200.08,82,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,183.98,231.8,
SULFOGLUCURONYL PARAGLOBOSIDE (SPGP),25200070,CDM,83520,CPT,300,RC,inpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,261.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,294.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,261.64,329.65,
ASO TITER,25200071,CDM,86060,CPT,300,RC,inpatient,,171,171,,145.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,128.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,145.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,150.48,88,,percent of total billed charges,,,,,,,,,130.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,,,,,,,,,,,,,141.93,83,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,140.22,82,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,128.93,162.45,
EBV VCA (IGG) ANTIBODY,25200072,CDM,86665,CPT,300,RC,inpatient,,328,328,,278.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,247.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,278.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,288.64,88,,percent of total billed charges,,,,,,,,,250.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,298.48,91,,percent of total billed charges,,,311.6,95,,percent of total billed charges,,,272.24,83,,percent of total billed charges,,,272.24,83,,percent of total billed charges,,,,,,,,,,,,,,,272.24,83,,percent of total billed charges,,,311.6,95,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,268.96,82,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,278.8,85,,percent of total billed charges,,247.31,311.6,
SULFATIDE IGM,25200073,CDM,83520,CPT,300,RC,inpatient,,666,666,,565.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,502.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,566.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,586.08,88,,percent of total billed charges,,,,,,,,,508.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,606.06,91,,percent of total billed charges,,,632.7,95,,percent of total billed charges,,,552.78,83,,percent of total billed charges,,,552.78,83,,percent of total billed charges,,,,,,,,,,,,,,,552.78,83,,percent of total billed charges,,,632.7,95,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,546.12,82,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,566.1,85,,percent of total billed charges,,502.16,632.7,
MYELIN BASIC PROTEIN,25200074,CDM,83873,CPT,300,RC,inpatient,,264,264,,224.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,199.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,224.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,232.32,88,,percent of total billed charges,,,,,,,,,201.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,240.24,91,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,,,,,,,,,,,,,219.12,83,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,216.48,82,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,199.06,250.8,
IGF-1,25200075,CDM,84305,CPT,300,RC,inpatient,,398,398,,337.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,300.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,338.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,350.24,88,,percent of total billed charges,,,,,,,,,304.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,362.18,91,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,,,,,,,,,,,,,330.34,83,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,326.36,82,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,338.3,85,,percent of total billed charges,,300.09,378.1,
..B CELLS TOTAL COUNT,25200076,CDM,86355,CPT,310,RC,inpatient,,681,681,,578.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,513.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,578.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,599.28,88,,percent of total billed charges,,,,,,,,,520.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,619.71,91,,percent of total billed charges,,,646.95,95,,percent of total billed charges,,,565.23,83,,percent of total billed charges,,,565.23,83,,percent of total billed charges,,,,,,,,,,,,,,,565.23,83,,percent of total billed charges,,,646.95,95,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,558.42,82,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,578.85,85,,percent of total billed charges,,513.47,646.95,
STRONGYLOIDES ANTIBODY,25200077,CDM,86682,CPT,300,RC,inpatient,,343,343,,291.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,258.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,291.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,301.84,88,,percent of total billed charges,,,,,,,,,262.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,312.13,91,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,,,,,,,,,,,,,284.69,83,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,281.26,82,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,291.55,85,,percent of total billed charges,,258.62,325.85,
.CARDIOLIPIN ANTIBODY (IGA),25200078,CDM,86147,CPT,300,RC,inpatient,,384,384,,326.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,289.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,326.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,337.92,88,,percent of total billed charges,,,,,,,,,293.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,349.44,91,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,,,,,,,,,,,,,318.72,83,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,314.88,82,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,326.4,85,,percent of total billed charges,,289.54,364.8,
.CARDIOLIPIN ANTIBODY (IgG),25200079,CDM,86147,CPT,300,RC,inpatient,,384,384,,326.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,289.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,326.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,337.92,88,,percent of total billed charges,,,,,,,,,293.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,349.44,91,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,,,,,,,,,,,,,318.72,83,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,314.88,82,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,326.4,85,,percent of total billed charges,,289.54,364.8,
.CARDIOLIPIN ANTIBODY (IgM),25200080,CDM,86147,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
.PHOSPHATIDYLSERINE AB IGM,25200081,CDM,86148,CPT,300,RC,inpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
.PHOSPHATIDYLSERINE AB IGA,25200082,CDM,86148,CPT,300,RC,inpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
.PHOSPHATIDYLSERINE AB IGG,25200083,CDM,86148,CPT,300,RC,inpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
.BETA-2 GLYCOPROTEIN IGA,25200084,CDM,86146,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
.BETA-2 GLYCOPROTEIN IGM,25200085,CDM,86146,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
.BETA-2 GLYCOPROTEIN IGG,25200086,CDM,86146,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
IGF BINDING PROTEIN,25200088,CDM,83519,CPT,300,RC,inpatient,,127,127,,107.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,111.76,88,,percent of total billed charges,,,,,,,,,97.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,,,,,,,,,,,,,105.41,83,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,104.14,82,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,95.76,120.65,
STREP A SCREEN (NAAT),25200089,CDM,87561,CPT,300,RC,inpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,261.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,294.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,261.64,329.65,
.STREP PNEUMO AB (14 SEROTYPES),25200090,CDM,86317,CPT,300,RC,inpatient,,34,34,,28.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.92,88,,percent of total billed charges,,,,,,,,,25.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,,,,,,,,,,,,,28.22,83,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,27.88,82,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,25.64,32.3,
.CARDIOLIPIN ANTIBODY (IgA),25200091,CDM,86147,CPT,300,RC,inpatient,,86,86,,73.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,75.68,88,,percent of total billed charges,,,,,,,,,65.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,78.26,91,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,,,,,,,,,,,,,71.38,83,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,70.52,82,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,64.84,81.7,
"DRUG OF ABUSE (10)SCREEN, SERUM",25200092,CDM,80307,CPT,300,RC,inpatient,,431,431,,365.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,324.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,366.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,379.28,88,,percent of total billed charges,,,,,,,,,329.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,392.21,91,,percent of total billed charges,,,409.45,95,,percent of total billed charges,,,357.73,83,,percent of total billed charges,,,357.73,83,,percent of total billed charges,,,,,,,,,,,,,,,357.73,83,,percent of total billed charges,,,409.45,95,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,353.42,82,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,366.35,85,,percent of total billed charges,,324.97,409.45,
#NAME?,25200093,CDM,87150,CPT,300,RC,inpatient,,589,589,,500.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,444.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,500.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,518.32,88,,percent of total billed charges,,,,,,,,,450,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,535.99,91,,percent of total billed charges,,,559.55,95,,percent of total billed charges,,,488.87,83,,percent of total billed charges,,,488.87,83,,percent of total billed charges,,,,,,,,,,,,,,,488.87,83,,percent of total billed charges,,,559.55,95,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,482.98,82,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,500.65,85,,percent of total billed charges,,444.11,559.55,
FACTOR V (LEIDEN)RFLX R2,25200094,CDM,81241,CPT,300,RC,inpatient,,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,454.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,512.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,454.66,572.85,
IGF-BP3,25200095,CDM,83519,CPT,300,RC,inpatient,,243,243,,206.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,183.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,206.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,213.84,88,,percent of total billed charges,,,,,,,,,185.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,221.13,91,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,,,,,,,,,,,,,201.69,83,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,199.26,82,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,206.55,85,,percent of total billed charges,,183.22,230.85,
EOSINOPHIL URINE,25200096,CDM,87205,CPT,300,RC,inpatient,,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,114.61,144.4,
BILIRUBIN DIRECT,25200097,CDM,82248,CPT,300,RC,inpatient,,100,100,,84.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88,88,,percent of total billed charges,,,,,,,,,76.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,83,83,,percent of total billed charges,,,,,,,,,,,,,,,83,83,,percent of total billed charges,,,95,95,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,82,82,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,75.4,95,
...ADALIMUMAB +AB,25200099,CDM,80299,CPT,300,RC,inpatient,,426,426,,361.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,321.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,362.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,374.88,88,,percent of total billed charges,,,,,,,,,325.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,387.66,91,,percent of total billed charges,,,404.7,95,,percent of total billed charges,,,353.58,83,,percent of total billed charges,,,353.58,83,,percent of total billed charges,,,,,,,,,,,,,,,353.58,83,,percent of total billed charges,,,404.7,95,,percent of total billed charges,,,383.4,90,,percent of total billed charges,,,383.4,90,,percent of total billed charges,,,349.32,82,,percent of total billed charges,,,383.4,90,,percent of total billed charges,,,362.1,85,,percent of total billed charges,,321.2,404.7,
CHEMILUMINESCENT ASSAY,25200100,CDM,82397,CPT,300,RC,inpatient,,315,315,,267.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,237.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,267.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,277.2,88,,percent of total billed charges,,,,,,,,,240.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,286.65,91,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,,,,,,,,,,,,,261.45,83,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,258.3,82,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,237.51,299.25,
BK VIRUS URINE,25200101,CDM,87799,CPT,300,RC,inpatient,,492,492,,417.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,370.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,418.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,432.96,88,,percent of total billed charges,,,,,,,,,375.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,447.72,91,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,,,,,,,,,,,,,408.36,83,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,403.44,82,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,370.97,467.4,
RAPAMUNE,25200102,CDM,80195,CPT,300,RC,inpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,61.07,76.95,
INTERLUKIN 6,25200103,CDM,83520,CPT,300,RC,inpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
CORTISOL SALIVARY,25200104,CDM,82533,CPT,300,RC,inpatient,,75,75,,63.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,63.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66,88,,percent of total billed charges,,,,,,,,,57.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,68.25,91,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,,,,,,,,,,,,,62.25,83,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,61.5,82,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,56.55,71.25,
BILIRUBIN TOTAL,25200105,CDM,82247,CPT,300,RC,inpatient,,101,101,,85.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88.88,88,,percent of total billed charges,,,,,,,,,77.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,82.82,82,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,76.15,95.95,
TROPONIN-T (SEND OUT),25200108,CDM,84484,CPT,300,RC,inpatient,,318,318,,269.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,239.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,270.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,279.84,88,,percent of total billed charges,,,,,,,,,242.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,289.38,91,,percent of total billed charges,,,302.1,95,,percent of total billed charges,,,263.94,83,,percent of total billed charges,,,263.94,83,,percent of total billed charges,,,,,,,,,,,,,,,263.94,83,,percent of total billed charges,,,302.1,95,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,260.76,82,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,270.3,85,,percent of total billed charges,,239.77,302.1,
PRO-BNP,25200109,CDM,83880,CPT,300,RC,inpatient,,510,510,,432.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,384.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,433.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,448.8,88,,percent of total billed charges,,,,,,,,,389.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,464.1,91,,percent of total billed charges,,,484.5,95,,percent of total billed charges,,,423.3,83,,percent of total billed charges,,,423.3,83,,percent of total billed charges,,,,,,,,,,,,,,,423.3,83,,percent of total billed charges,,,484.5,95,,percent of total billed charges,,,459,90,,percent of total billed charges,,,459,90,,percent of total billed charges,,,418.2,82,,percent of total billed charges,,,459,90,,percent of total billed charges,,,433.5,85,,percent of total billed charges,,384.54,484.5,
INTERLUKIN 2,25200110,CDM,83520,CPT,300,RC,inpatient,,267,267,,226.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,201.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,226.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,234.96,88,,percent of total billed charges,,,,,,,,,203.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,242.97,91,,percent of total billed charges,,,253.65,95,,percent of total billed charges,,,221.61,83,,percent of total billed charges,,,221.61,83,,percent of total billed charges,,,,,,,,,,,,,,,221.61,83,,percent of total billed charges,,,253.65,95,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,218.94,82,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,226.95,85,,percent of total billed charges,,201.32,253.65,
"DRUG SCREEN, CORD BLOOD",25200112,CDM,80307,CPT,300,RC,inpatient,,381,381,,323.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,287.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,323.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,335.28,88,,percent of total billed charges,,,,,,,,,291.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,346.71,91,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,,,,,,,,,,,,,316.23,83,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,312.42,82,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,323.85,85,,percent of total billed charges,,287.27,361.95,
BB BLOOD TYPING ABO,25200113,CDM,86900,CPT,300,RC,inpatient,,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,110.84,139.65,
GLIADIN ANTIBODY IGA,25200115,CDM,83516,CPT,300,RC,inpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,171.16,215.65,
GLIADIN ANTIBODY IGG,25200116,CDM,83516,CPT,300,RC,inpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,153.06,192.85,
GLUTEN SENSITIVITY SCREEN,25200117,CDM,83516,CPT,300,RC,inpatient,,536,536,,455.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,404.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,455.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,471.68,88,,percent of total billed charges,,,,,,,,,409.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,487.76,91,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,,,,,,,,,,,,,444.88,83,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,439.52,82,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,404.14,509.2,
.IDH1,25200118,CDM,81120,CPT,300,RC,inpatient,,475,475,,403.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,358.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,403.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,418,88,,percent of total billed charges,,,,,,,,,362.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,432.25,91,,percent of total billed charges,,,451.25,95,,percent of total billed charges,,,394.25,83,,percent of total billed charges,,,394.25,83,,percent of total billed charges,,,,,,,,,,,,,,,394.25,83,,percent of total billed charges,,,451.25,95,,percent of total billed charges,,,427.5,90,,percent of total billed charges,,,427.5,90,,percent of total billed charges,,,389.5,82,,percent of total billed charges,,,427.5,90,,percent of total billed charges,,,403.75,85,,percent of total billed charges,,358.15,451.25,
.IDH2,25200119,CDM,81121,CPT,300,RC,inpatient,,475,475,,403.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,358.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,403.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,418,88,,percent of total billed charges,,,,,,,,,362.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,432.25,91,,percent of total billed charges,,,451.25,95,,percent of total billed charges,,,394.25,83,,percent of total billed charges,,,394.25,83,,percent of total billed charges,,,,,,,,,,,,,,,394.25,83,,percent of total billed charges,,,451.25,95,,percent of total billed charges,,,427.5,90,,percent of total billed charges,,,427.5,90,,percent of total billed charges,,,389.5,82,,percent of total billed charges,,,427.5,90,,percent of total billed charges,,,403.75,85,,percent of total billed charges,,358.15,451.25,
AMINO ACID ANALYSIS (CSF),25200120,CDM,82139,CPT,300,RC,inpatient,,485,485,,411.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,365.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,412.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,426.8,88,,percent of total billed charges,,,,,,,,,370.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,441.35,91,,percent of total billed charges,,,460.75,95,,percent of total billed charges,,,402.55,83,,percent of total billed charges,,,402.55,83,,percent of total billed charges,,,,,,,,,,,,,,,402.55,83,,percent of total billed charges,,,460.75,95,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,397.7,82,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,412.25,85,,percent of total billed charges,,365.69,460.75,
.MICROALBUMIN URINE (24-HOUR),25200121,CDM,82043,CPT,300,RC,inpatient,,131,131,,111.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,111.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,115.28,88,,percent of total billed charges,,,,,,,,,100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,,,,,,,,,,,,,108.73,83,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,107.42,82,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,98.77,124.45,
MICROALBUMIN URINE (RANDOM),25200122,CDM,82043,CPT,300,RC,inpatient,,131,131,,111.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,111.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,115.28,88,,percent of total billed charges,,,,,,,,,100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,,,,,,,,,,,,,108.73,83,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,107.42,82,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,98.77,124.45,
.gASCA (IBD PROFILE),25200123,CDM,83516,CPT,300,RC,inpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,116.12,146.3,
.ACCA (IBD PROFILE),25200124,CDM,83516,CPT,300,RC,inpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,116.12,146.3,
.ALCA (IBD PROFILE),25200125,CDM,83516,CPT,300,RC,inpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,116.12,146.3,
.AMCA (IBD PROFILE),25200126,CDM,86255,CPT,300,RC,inpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,116.12,146.3,
.ATYPICAL PANCA (IBD PROFILE),25200127,CDM,86671,CPT,300,RC,inpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,116.12,146.3,
TESTOSTERONE FREE (NO TOTAL),25200129,CDM,84402,CPT,300,RC,inpatient,,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,277.47,349.6,
DRUG SCREEN BLOOD,25200131,CDM,80307,CPT,300,RC,inpatient,,44,44,,37.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.72,88,,percent of total billed charges,,,,,,,,,33.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,36.08,82,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,33.18,41.8,
GANGLIOSIDE ANTIBODIES (IGG & IGM),25200132,CDM,83516,CPT,300,RC,inpatient,,244,244,,207.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,183.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,207.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,214.72,88,,percent of total billed charges,,,,,,,,,186.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,222.04,91,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,,,,,,,,,,,,,202.52,83,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,200.08,82,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,183.98,231.8,
STREP PNEUMO AB (14 SEROTYPES),25200133,CDM,86317,CPT,300,RC,inpatient,,34,34,,28.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.92,88,,percent of total billed charges,,,,,,,,,25.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,,,,,,,,,,,,,28.22,83,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,27.88,82,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,25.64,32.3,
MICROALBUMIN URINE (24-HOUR),25200134,CDM,82043,CPT,300,RC,inpatient,TC,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,81.43,102.6,
CHLORIDE SERUM,25200135,CDM,82435,CPT,300,RC,inpatient,TC,86,86,,73.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,75.68,88,,percent of total billed charges,,,,,,,,,65.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,78.26,91,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,,,,,,,,,,,,,71.38,83,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,70.52,82,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,64.84,81.7,
HERPES SIM 1&2 PCR,25200137,CDM,87529,CPT,300,RC,inpatient,,524,524,,444.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,445.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,461.12,88,,percent of total billed charges,,,,,,,,,400.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,476.84,91,,percent of total billed charges,,,497.8,95,,percent of total billed charges,,,434.92,83,,percent of total billed charges,,,434.92,83,,percent of total billed charges,,,,,,,,,,,,,,,434.92,83,,percent of total billed charges,,,497.8,95,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,429.68,82,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,445.4,85,,percent of total billed charges,,395.1,497.8,
OLIGOCLONAL BANDS CSF & SERUM,25200138,CDM,83916,CPT,300,RC,inpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,179.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,159.09,200.45,
BB SERUM ALBUMIN 100 ML 25%,25200139,CDM,P9047,HCPCS,390,RC,inpatient,,755,755,,641,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,569.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,641.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,664.4,88,,percent of total billed charges,,,,,,,,,576.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,687.05,91,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,,,,,,,,,,,,,626.65,83,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,619.1,82,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,569.27,717.25,
"PHOSPHATIDYLSERINE (IGM,IGG,IGA)",25200140,CDM,86148,CPT,300,RC,inpatient,,282,282,,239.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,212.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,239.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,248.16,88,,percent of total billed charges,,,,,,,,,215.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,256.62,91,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,,,,,,,,,,,,,234.06,83,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,231.24,82,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,239.7,85,,percent of total billed charges,,212.63,267.9,
RICKETTSIA ANTIBODY PANEL,25200141,CDM,86757,CPT,300,RC,inpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,76.91,96.9,
EPIDERMAL ANTIBODY,25200142,CDM,86255,CPT,300,RC,inpatient,,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,376.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,424.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,376.25,474.05,
"CANDIDA ANTIBODIES(IGG,IGM,IGA)",25200143,CDM,86628,CPT,300,RC,inpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,41.47,52.25,
"EHELICHIA CHEFFENS (IGG,IGM)",25200144,CDM,86666,CPT,300,RC,inpatient,,224,224,,190.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,190.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,197.12,88,,percent of total billed charges,,,,,,,,,171.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,183.68,82,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,168.9,212.8,
EHELICHIA PCR,25200145,CDM,87798,CPT,300,RC,inpatient,,401,401,,340.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,302.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,340.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,352.88,88,,percent of total billed charges,,,,,,,,,306.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,364.91,91,,percent of total billed charges,,,380.95,95,,percent of total billed charges,,,332.83,83,,percent of total billed charges,,,332.83,83,,percent of total billed charges,,,,,,,,,,,,,,,332.83,83,,percent of total billed charges,,,380.95,95,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,328.82,82,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,340.85,85,,percent of total billed charges,,302.35,380.95,
HER 2 NEU BY FISH,25200146,CDM,88374,CPT,310,RC,inpatient,,515,515,,437.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,388.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,437.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,453.2,88,,percent of total billed charges,,,,,,,,,393.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,468.65,91,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,,,,,,,,,,,,,427.45,83,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,422.3,82,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,388.31,489.25,
BUN,25200147,CDM,84520,CPT,300,RC,inpatient,,97,97,,82.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,73.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,82.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,85.36,88,,percent of total billed charges,,,,,,,,,74.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,,,,,,,,,,,,,80.51,83,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,79.54,82,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,73.14,92.15,
HISTOPLASMA ANTIBODY COMP FIXATION,25200148,CDM,86698,CPT,300,RC,inpatient,,187,187,,158.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,158.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,164.56,88,,percent of total billed charges,,,,,,,,,142.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,153.34,82,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,141,177.65,
TRYPTASE,25200149,CDM,83520,CPT,300,RC,inpatient,,186,186,,157.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,140.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,158.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,163.68,88,,percent of total billed charges,,,,,,,,,142.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,169.26,91,,percent of total billed charges,,,176.7,95,,percent of total billed charges,,,154.38,83,,percent of total billed charges,,,154.38,83,,percent of total billed charges,,,,,,,,,,,,,,,154.38,83,,percent of total billed charges,,,176.7,95,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,152.52,82,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,158.1,85,,percent of total billed charges,,140.24,176.7,
"DRUG SCREEN, CORD TISSUE",25200150,CDM,80307,CPT,300,RC,inpatient,,504,504,,427.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,380.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,428.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,443.52,88,,percent of total billed charges,,,,,,,,,385.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,458.64,91,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,,,,,,,,,,,,,418.32,83,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,413.28,82,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,380.02,478.8,
.HSV 1 NAA (APTIMA),25200151,CDM,87529,CPT,300,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
.HSV 2 NAA (APTIMA),25200152,CDM,87529,CPT,300,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
CALCIUM  SERUM,25200154,CDM,82310,CPT,300,RC,inpatient,,151,151,,128.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,113.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,128.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,132.88,88,,percent of total billed charges,,,,,,,,,115.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,,,,,,,,,,,,,125.33,83,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,123.82,82,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,113.85,143.45,
..HERPES SIM 2 IGM AB(BILL ONLY),25200155,CDM,86696,CPT,300,RC,inpatient,,92,92,,78.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,69.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,78.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.96,88,,percent of total billed charges,,,,,,,,,70.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,,,,,,,,,,,,,76.36,83,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,75.44,82,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,69.37,87.4,
"DRUG OF ABUSE (10)SCREEN, WB",25200156,CDM,80307,CPT,300,RC,inpatient,,437,437,,371.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,329.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,371.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,384.56,88,,percent of total billed charges,,,,,,,,,333.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,397.67,91,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,,,,,,,,,,,,,362.71,83,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,358.34,82,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,329.5,415.15,
ALBUMIN (body fluid),25200157,CDM,82042,CPT,300,RC,inpatient,,7,7,,5.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6.16,88,,percent of total billed charges,,,,,,,,,5.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6.37,91,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,,,,,,,,,,,,,5.81,83,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.74,82,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,5.28,6.65,
RABIES NEUT AB,25200158,CDM,86382,CPT,300,RC,inpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,58.06,73.15,
EVEROLIMUS WHOLD BLOOD,25200159,CDM,80169,CPT,300,RC,inpatient,,363,363,,308.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,273.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,308.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,319.44,88,,percent of total billed charges,,,,,,,,,277.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,330.33,91,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,,,,,,,,,,,,,301.29,83,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,297.66,82,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,273.7,344.85,
BETA 2 TRANSFERIN,25200160,CDM,86335,CPT,300,RC,inpatient,,435,435,,369.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,327.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,369.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,382.8,88,,percent of total billed charges,,,,,,,,,332.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,395.85,91,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,,,,,,,,,,,,,361.05,83,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,356.7,82,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,327.99,413.25,
INFLIXIMAB  AB,25200161,CDM,80230,CPT,300,RC,inpatient,,279,279,,236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,210.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,237.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,245.52,88,,percent of total billed charges,,,,,,,,,213.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,253.89,91,,percent of total billed charges,,,265.05,95,,percent of total billed charges,,,231.57,83,,percent of total billed charges,,,231.57,83,,percent of total billed charges,,,,,,,,,,,,,,,231.57,83,,percent of total billed charges,,,265.05,95,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,228.78,82,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,237.15,85,,percent of total billed charges,,210.37,265.05,
TIBC,25200162,CDM,83550,CPT,300,RC,inpatient,,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,115.36,145.35,
BETA 2 GLYCOPROTEIN 1 AB (IgA),25200163,CDM,86146,CPT,300,RC,inpatient,,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,110.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,98.02,123.5,
BETA 2 GLYCOPROTEIN 1 AB (IgM),25200164,CDM,86146,CPT,300,RC,inpatient,,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,110.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,98.02,123.5,
.BULLOUS PEMPHIGOID 180 IGG,25200166,CDM,83516,CPT,300,RC,inpatient,,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
.BULLOUS PEMPHIGOID 230 IGG,25200167,CDM,83516,CPT,300,RC,inpatient,,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
BETA-D GLUCAN,25200168,CDM,87449,CPT,300,RC,inpatient,,541,541,,459.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,407.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,459.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,476.08,88,,percent of total billed charges,,,,,,,,,413.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,492.31,91,,percent of total billed charges,,,513.95,95,,percent of total billed charges,,,449.03,83,,percent of total billed charges,,,449.03,83,,percent of total billed charges,,,,,,,,,,,,,,,449.03,83,,percent of total billed charges,,,513.95,95,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,443.62,82,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,459.85,85,,percent of total billed charges,,407.91,513.95,
CULTURE SPUTUM,25200170,CDM,87070,CPT,300,RC,inpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,157.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,177.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,157.59,198.55,
PROBE STAIN ADDITIONAL,25200171,CDM,88377,CPT,310,RC,inpatient,,810,810,,687.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,610.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,688.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,712.8,88,,percent of total billed charges,,,,,,,,,618.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,737.1,91,,percent of total billed charges,,,769.5,95,,percent of total billed charges,,,672.3,83,,percent of total billed charges,,,672.3,83,,percent of total billed charges,,,,,,,,,,,,,,,672.3,83,,percent of total billed charges,,,769.5,95,,percent of total billed charges,,,729,90,,percent of total billed charges,,,729,90,,percent of total billed charges,,,664.2,82,,percent of total billed charges,,,729,90,,percent of total billed charges,,,688.5,85,,percent of total billed charges,,610.74,769.5,
MULTIPLEX STAIN,25200172,CDM,88374,CPT,310,RC,inpatient,,1260,1260,,1069.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,950.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1071,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1108.8,88,,percent of total billed charges,,,,,,,,,962.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1146.6,91,,percent of total billed charges,,,1197,95,,percent of total billed charges,,,1045.8,83,,percent of total billed charges,,,1045.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1045.8,83,,percent of total billed charges,,,1197,95,,percent of total billed charges,,,1134,90,,percent of total billed charges,,,1134,90,,percent of total billed charges,,,1033.2,82,,percent of total billed charges,,,1134,90,,percent of total billed charges,,,1071,85,,percent of total billed charges,,950.04,1197,
MORPHOMETRIC ANALYSIS 88367,25200173,CDM,88367,CPT,310,RC,inpatient,,504,504,,427.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,380.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,428.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,443.52,88,,percent of total billed charges,,,,,,,,,385.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,458.64,91,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,,,,,,,,,,,,,418.32,83,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,413.28,82,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,380.02,478.8,
TARGET GENOMIC SEQUENCE,25200174,CDM,81455,CPT,310,RC,inpatient,,1890,1890,,1604.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1425.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1606.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1663.2,88,,percent of total billed charges,,,,,,,,,1443.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1719.9,91,,percent of total billed charges,,,1795.5,95,,percent of total billed charges,,,1568.7,83,,percent of total billed charges,,,1568.7,83,,percent of total billed charges,,,,,,,,,,,,,,,1568.7,83,,percent of total billed charges,,,1795.5,95,,percent of total billed charges,,,1701,90,,percent of total billed charges,,,1701,90,,percent of total billed charges,,,1549.8,82,,percent of total billed charges,,,1701,90,,percent of total billed charges,,,1606.5,85,,percent of total billed charges,,1425.06,1795.5,
UIBC,25200175,CDM,83550,CPT,300,RC,inpatient,,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,115.36,145.35,
MYELOID-NGS,25200176,CDM,81450,CPT,300,RC,inpatient,,4410,4410,,3744.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3325.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3748.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3880.8,88,,percent of total billed charges,,,,,,,,,3369.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4013.1,91,,percent of total billed charges,,,4189.5,95,,percent of total billed charges,,,3660.3,83,,percent of total billed charges,,,3660.3,83,,percent of total billed charges,,,,,,,,,,,,,,,3660.3,83,,percent of total billed charges,,,4189.5,95,,percent of total billed charges,,,3969,90,,percent of total billed charges,,,3969,90,,percent of total billed charges,,,3616.2,82,,percent of total billed charges,,,3969,90,,percent of total billed charges,,,3748.5,85,,percent of total billed charges,,3325.14,4189.5,
DRAGU CBC W/AUTO DIFF,25200189,CDM,85025,CPT,300,RC,inpatient,,207,207,,175.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,156.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,182.16,88,,percent of total billed charges,,,,,,,,,158.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,188.37,91,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,,,,,,,,,,,,,171.81,83,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,169.74,82,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,175.95,85,,percent of total billed charges,,156.08,196.65,
CBC W/AUTO DIFF,25200190,CDM,85025,CPT,300,RC,inpatient,,207,207,,175.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,156.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,182.16,88,,percent of total billed charges,,,,,,,,,158.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,188.37,91,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,,,,,,,,,,,,,171.81,83,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,169.74,82,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,175.95,85,,percent of total billed charges,,156.08,196.65,
ANTI-SA AB IgG,25200194,CDM,83516,CPT,300,RC,inpatient,,381,381,,323.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,287.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,323.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,335.28,88,,percent of total billed charges,,,,,,,,,291.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,346.71,91,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,,,,,,,,,,,,,316.23,83,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,312.42,82,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,323.85,85,,percent of total billed charges,,287.27,361.95,
HCG QUANTITATIVE,25200196,CDM,84702,CPT,300,RC,inpatient,,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,200.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,226.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,200.56,252.7,
COMP METABOLIC PANEL,25200204,CDM,80053,CPT,300,RC,inpatient,,337,337,,286.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,254.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,286.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,296.56,88,,percent of total billed charges,,,,,,,,,257.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,306.67,91,,percent of total billed charges,,,320.15,95,,percent of total billed charges,,,279.71,83,,percent of total billed charges,,,279.71,83,,percent of total billed charges,,,,,,,,,,,,,,,279.71,83,,percent of total billed charges,,,320.15,95,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,276.34,82,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,286.45,85,,percent of total billed charges,,254.1,320.15,
.CHLORIDE SERUM,25200212,CDM,82435,CPT,300,RC,inpatient,,100,100,,84.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88,88,,percent of total billed charges,,,,,,,,,76.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,83,83,,percent of total billed charges,,,,,,,,,,,,,,,83,83,,percent of total billed charges,,,95,95,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,82,82,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,75.4,95,
14.3.3 PROTEIN ETA,25200214,CDM,83520,CPT,300,RC,inpatient,,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,174.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,174.17,219.45,
LDL CHOLESTEROL(MEASURED),25200215,CDM,83721,CPT,300,RC,inpatient,,197,197,,167.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.36,88,,percent of total billed charges,,,,,,,,,150.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.27,91,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,,,,,,,,,,,,,163.51,83,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,161.54,82,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,167.45,85,,percent of total billed charges,,148.54,187.15,
LDL-P,25200216,CDM,83704,CPT,300,RC,inpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,108.58,136.8,
CHOLESTEROL,25200220,CDM,82465,CPT,300,RC,inpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,76.91,96.9,
LDL CHOLESTEROL,25200221,CDM,83721,CPT,300,RC,inpatient,,171,171,,145.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,128.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,145.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,150.48,88,,percent of total billed charges,,,,,,,,,130.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,,,,,,,,,,,,,141.93,83,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,140.22,82,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,128.93,162.45,
.CHOLESTEROL FLUID,25200222,CDM,84311,CPT,300,RC,inpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,169.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,191.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,169.65,213.75,
MICROALBUMIN URINE(W/O CREAT),25200223,CDM,82043,CPT,300,RC,inpatient,,131,131,,111.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,111.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,115.28,88,,percent of total billed charges,,,,,,,,,100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,,,,,,,,,,,,,108.73,83,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,107.42,82,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,98.77,124.45,
CHOLESTEROL fluid,25200224,CDM,82465,CPT,300,RC,inpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,116.12,146.3,
NUCLEIC ACID REVERSE TRANSCRIPTION,25200226,CDM,83902,CPT,300,RC,inpatient,,340,340,,288.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,256.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,289,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,299.2,88,,percent of total billed charges,,,,,,,,,259.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,309.4,91,,percent of total billed charges,,,323,95,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,,,,,,,,,,,,,282.2,83,,percent of total billed charges,,,323,95,,percent of total billed charges,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,278.8,82,,percent of total billed charges,,,306,90,,percent of total billed charges,,,289,85,,percent of total billed charges,,256.36,323,
SPECIMEN COLLECTION & HANDLING CHARGE,25200238,CDM,36415,CPT,300,RC,inpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.92,88,,percent of total billed charges,,,,,,,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,44.49,56.05,
CRYOGLOBULIN,25200239,CDM,82595,CPT,300,RC,inpatient,,158,158,,134.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,134.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.04,88,,percent of total billed charges,,,,,,,,,120.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,143.78,91,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,,,,,,,,,,,,,131.14,83,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,129.56,82,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,119.13,150.1,
CARBON DIOXIDE,25200246,CDM,82374,CPT,300,RC,inpatient,,139,139,,118.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,118.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,122.32,88,,percent of total billed charges,,,,,,,,,106.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,126.49,91,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,,,,,,,,,,,,,115.37,83,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,113.98,82,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,118.15,85,,percent of total billed charges,,104.81,132.05,
BB CROSSMATCH ANTIGLOBULIN,25200250,CDM,86922,CPT,300,RC,inpatient,,385,385,,326.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,290.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,327.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,338.8,88,,percent of total billed charges,,,,,,,,,294.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,350.35,91,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,,,,,,,,,,,,,319.55,83,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,315.7,82,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,290.29,365.75,
BB CROSSMATCH IMMEDIATE SPIN,25200251,CDM,86920,CPT,300,RC,inpatient,,278,278,,236.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,236.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.64,88,,percent of total billed charges,,,,,,,,,212.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.98,91,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,,,,,,,,,,,,,230.74,83,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,227.96,82,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,209.61,264.1,
COLD HEMAGGLUTININS,25200253,CDM,86157,CPT,300,RC,inpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,116.12,146.3,
GENTAMICIN TROUGH,25200256,CDM,80170,CPT,300,RC,inpatient,,355,355,,301.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,267.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,301.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,312.4,88,,percent of total billed charges,,,,,,,,,271.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,323.05,91,,percent of total billed charges,,,337.25,95,,percent of total billed charges,,,294.65,83,,percent of total billed charges,,,294.65,83,,percent of total billed charges,,,,,,,,,,,,,,,294.65,83,,percent of total billed charges,,,337.25,95,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,291.1,82,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,301.75,85,,percent of total billed charges,,267.67,337.25,
VANCOMYCIN TROUGH,25200257,CDM,80202,CPT,300,RC,inpatient,,380,380,,322.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,286.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,323,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,334.4,88,,percent of total billed charges,,,,,,,,,290.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,345.8,91,,percent of total billed charges,,,361,95,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,,,,,,,,,,,,,315.4,83,,percent of total billed charges,,,361,95,,percent of total billed charges,,,342,90,,percent of total billed charges,,,342,90,,percent of total billed charges,,,311.6,82,,percent of total billed charges,,,342,90,,percent of total billed charges,,,323,85,,percent of total billed charges,,286.52,361,
BB COOMBS DIRECT,25200261,CDM,86880,CPT,300,RC,inpatient,,140,140,,118.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,105.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,119,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,123.2,88,,percent of total billed charges,,,,,,,,,106.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,133,95,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,114.8,82,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,105.56,133,
LABCORP DIRECT COOMBS,25200262,CDM,86880,CPT,300,RC,inpatient,,140,140,,118.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,105.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,119,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,123.2,88,,percent of total billed charges,,,,,,,,,106.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,133,95,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,114.8,82,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,105.56,133,
BB COOMBS INDIRECT,25200279,CDM,86885,CPT,300,RC,inpatient,,163,163,,138.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,122.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,138.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,143.44,88,,percent of total billed charges,,,,,,,,,124.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,,,,,,,,,,,,,135.29,83,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,133.66,82,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,122.9,154.85,
CHLORDIAZEPOXIDE,25200286,CDM,80346,CPT,300,RC,inpatient,,280,280,,237.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,211.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,238,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,246.4,88,,percent of total billed charges,,,,,,,,,213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,,,,,,,,,,,,,232.4,83,,percent of total billed charges,,,266,95,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,229.6,82,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,211.12,266,
LIDOCAINE,25200287,CDM,80176,CPT,300,RC,inpatient,,252,252,,213.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,214.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,221.76,88,,percent of total billed charges,,,,,,,,,192.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,229.32,91,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,,,,,,,,,,,,,209.16,83,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,206.64,82,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,190.01,239.4,
LISTERIA ANTIBODIES,25200288,CDM,86609,CPT,300,RC,inpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,58.06,73.15,
FUROSEMIDE,25200290,CDM,80375,CPT,300,RC,inpatient,,246,246,,208.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,185.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,209.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,216.48,88,,percent of total billed charges,,,,,,,,,187.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,223.86,91,,percent of total billed charges,,,233.7,95,,percent of total billed charges,,,204.18,83,,percent of total billed charges,,,204.18,83,,percent of total billed charges,,,,,,,,,,,,,,,204.18,83,,percent of total billed charges,,,233.7,95,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,201.72,82,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,209.1,85,,percent of total billed charges,,185.48,233.7,
PSA SCREEN,25200294,CDM,G0103,HCPCS,300,RC,inpatient,,295,295,,250.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,222.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,250.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,259.6,88,,percent of total billed charges,,17.6,,,,fee schedule,,,225.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,17.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,268.45,91,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,,,,,,,,,,,,,244.85,83,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,241.9,82,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,17.6,280.25,
PSA TOTAL,25200295,CDM,84153,CPT,300,RC,inpatient,,316,316,,268.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,238.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,268.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,278.08,88,,percent of total billed charges,,,,,,,,,241.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,287.56,91,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,,,,,,,,,,,,,262.28,83,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,259.12,82,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,238.26,300.2,
PROZAC (FLUOXETINE),25200296,CDM,80299,CPT,300,RC,inpatient,,316,316,,268.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,238.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,268.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,278.08,88,,percent of total billed charges,,,,,,,,,241.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,287.56,91,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,,,,,,,,,,,,,262.28,83,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,259.12,82,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,238.26,300.2,
FELBAMATE,25200298,CDM,80167,CPT,300,RC,inpatient,,171,171,,145.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,128.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,145.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,150.48,88,,percent of total billed charges,,,,,,,,,130.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,,,,,,,,,,,,,141.93,83,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,140.22,82,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,128.93,162.45,
PYRUVIC ACID,25200299,CDM,84210,CPT,300,RC,inpatient,,129,129,,109.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,97.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,109.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,113.52,88,,percent of total billed charges,,,,,,,,,98.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,105.78,82,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,97.27,122.55,
PSA FREE,25200301,CDM,84154,CPT,300,RC,inpatient,,378,378,,320.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,285.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,321.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,332.64,88,,percent of total billed charges,,,,,,,,,288.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,343.98,91,,percent of total billed charges,,,359.1,95,,percent of total billed charges,,,313.74,83,,percent of total billed charges,,,313.74,83,,percent of total billed charges,,,,,,,,,,,,,,,313.74,83,,percent of total billed charges,,,359.1,95,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,309.96,82,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,321.3,85,,percent of total billed charges,,285.01,359.1,
PSA ULTRASENSITIVE,25200302,CDM,84153,CPT,300,RC,inpatient,,275,275,,233.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,207.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,233.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,242,88,,percent of total billed charges,,,,,,,,,210.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,250.25,91,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,,,,,,,,,,,,,228.25,83,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,225.5,82,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,233.75,85,,percent of total billed charges,,207.35,261.25,
LIPID PANEL,25200303,CDM,80061,CPT,300,RC,inpatient,,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
FLT3,25200304,CDM,81245,CPT,300,RC,inpatient,,626,626,,531.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,472,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,532.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,550.88,88,,percent of total billed charges,,,,,,,,,478.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,569.66,91,,percent of total billed charges,,,594.7,95,,percent of total billed charges,,,519.58,83,,percent of total billed charges,,,519.58,83,,percent of total billed charges,,,,,,,,,,,,,,,519.58,83,,percent of total billed charges,,,594.7,95,,percent of total billed charges,,,563.4,90,,percent of total billed charges,,,563.4,90,,percent of total billed charges,,,513.32,82,,percent of total billed charges,,,563.4,90,,percent of total billed charges,,,532.1,85,,percent of total billed charges,,472,594.7,
CREATININE SERUM,25200311,CDM,82565,CPT,300,RC,inpatient,,118,118,,100.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,88.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,100.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,103.84,88,,percent of total billed charges,,,,,,,,,90.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,107.38,91,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,,,,,,,,,,,,,97.94,83,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,96.76,82,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,88.97,112.1,
GFR,25200312,CDM,82565,CPT,300,RC,inpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,92.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,82.19,103.55,
CREATININE CLEARANCE,25200329,CDM,82575,CPT,300,RC,inpatient,,222,222,,188.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,167.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,188.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,195.36,88,,percent of total billed charges,,,,,,,,,169.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,202.02,91,,percent of total billed charges,,,210.9,95,,percent of total billed charges,,,184.26,83,,percent of total billed charges,,,184.26,83,,percent of total billed charges,,,,,,,,,,,,,,,184.26,83,,percent of total billed charges,,,210.9,95,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,182.04,82,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,188.7,85,,percent of total billed charges,,167.39,210.9,
INVASIVE TROPHOBLAST ANTIGEN,25200339,CDM,82397,CPT,300,RC,inpatient,,567,567,,481.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,427.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,481.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,498.96,88,,percent of total billed charges,,,,,,,,,433.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,,,,,,,,,,,,,470.61,83,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,464.94,82,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,427.52,538.65,
MATERNAL SCREEN SPINA BIFIDA,25200340,CDM,82105,CPT,300,RC,inpatient,,30.5,30.5,,25.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.84,88,,percent of total billed charges,,,,,,,,,23.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27.76,91,,percent of total billed charges,,,28.98,95,,percent of total billed charges,,,25.32,83,,percent of total billed charges,,,25.32,83,,percent of total billed charges,,,,,,,,,,,,,,,25.32,83,,percent of total billed charges,,,28.98,95,,percent of total billed charges,,,27.45,90,,percent of total billed charges,,,27.45,90,,percent of total billed charges,,,25.01,82,,percent of total billed charges,,,27.45,90,,percent of total billed charges,,,25.93,85,,percent of total billed charges,,23,28.98,
GIARDIA ANTIBODY,25200344,CDM,86674,CPT,300,RC,inpatient,,196,196,,166.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,166.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,172.48,88,,percent of total billed charges,,,,,,,,,149.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,178.36,91,,percent of total billed charges,,,186.2,95,,percent of total billed charges,,,162.68,83,,percent of total billed charges,,,162.68,83,,percent of total billed charges,,,,,,,,,,,,,,,162.68,83,,percent of total billed charges,,,186.2,95,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,160.72,82,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,166.6,85,,percent of total billed charges,,147.78,186.2,
C-REACTIVE PROTEIN,25200345,CDM,86140,CPT,300,RC,inpatient,,135,135,,114.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,101.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,114.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,118.8,88,,percent of total billed charges,,,,,,,,,103.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,,,,,,,,,,,,,112.05,83,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,110.7,82,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,101.79,128.25,
GIARDIA ANTIGEN STOOL,25200346,CDM,87269,CPT,300,RC,inpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,135.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,135.72,171,
CORTISOL FREE URINE (24-HOUR),25200347,CDM,82530,CPT,300,RC,inpatient,,345,345,,292.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,260.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,293.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,303.6,88,,percent of total billed charges,,,,,,,,,263.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,313.95,91,,percent of total billed charges,,,327.75,95,,percent of total billed charges,,,286.35,83,,percent of total billed charges,,,286.35,83,,percent of total billed charges,,,,,,,,,,,,,,,286.35,83,,percent of total billed charges,,,327.75,95,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,282.9,82,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,293.25,85,,percent of total billed charges,,260.13,327.75,
CEFACLOR,25200348,CDM,86003,CPT,300,RC,inpatient,,91,91,,77.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.08,88,,percent of total billed charges,,,,,,,,,69.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,,,,,,,,,,,,,75.53,83,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,74.62,82,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,68.61,86.45,
"CORTISOL FREE, SERUM",25200350,CDM,82533,CPT,300,RC,inpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,261.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,294.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,261.64,329.65,
CULTURE URINE,25200352,CDM,87086,CPT,300,RC,inpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,179.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,159.09,200.45,
RITICULIN AB EVALUATION,25200353,CDM,86255,CPT,300,RC,inpatient,,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,280.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,316.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,280.49,353.4,
CELIAC  HLA DQ,25200357,CDM,81377,CPT,300,RC,inpatient,,790.75,790.75,,671.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,596.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,672.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,695.86,88,,percent of total billed charges,,,,,,,,,604.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,719.58,91,,percent of total billed charges,,,751.21,95,,percent of total billed charges,,,656.32,83,,percent of total billed charges,,,656.32,83,,percent of total billed charges,,,,,,,,,,,,,,,656.32,83,,percent of total billed charges,,,751.21,95,,percent of total billed charges,,,711.68,90,,percent of total billed charges,,,711.68,90,,percent of total billed charges,,,648.42,82,,percent of total billed charges,,,711.68,90,,percent of total billed charges,,,672.14,85,,percent of total billed charges,,596.23,751.21,
D-DIMER,25200360,CDM,85379,CPT,300,RC,inpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,179.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,159.09,200.45,
CULTURE GENITAL,25200377,CDM,87070,CPT,300,RC,inpatient,,253,253,,214.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,222.64,88,,percent of total billed charges,,,,,,,,,193.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,230.23,91,,percent of total billed charges,,,240.35,95,,percent of total billed charges,,,209.99,83,,percent of total billed charges,,,209.99,83,,percent of total billed charges,,,,,,,,,,,,,,,209.99,83,,percent of total billed charges,,,240.35,95,,percent of total billed charges,,,227.7,90,,percent of total billed charges,,,227.7,90,,percent of total billed charges,,,207.46,82,,percent of total billed charges,,,227.7,90,,percent of total billed charges,,,215.05,85,,percent of total billed charges,,190.76,240.35,
CULTURE AEROBIC,25200378,CDM,87070,CPT,300,RC,inpatient,TC,224,224,,190.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,190.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,197.12,88,,percent of total billed charges,,,,,,,,,171.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,183.68,82,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,168.9,212.8,
CULTURE MRSA SCREEN,25200381,CDM,87081,CPT,300,RC,inpatient,,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,114.61,144.4,
CULTURE VRE SCREEN,25200385,CDM,87081,CPT,300,RC,inpatient,,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,114.61,144.4,
PROGESTERONE,25200386,CDM,84144,CPT,300,RC,inpatient,,403,403,,342.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,303.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,342.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,354.64,88,,percent of total billed charges,,,,,,,,,307.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,366.73,91,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,,,,,,,,,,,,,334.49,83,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,330.46,82,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,342.55,85,,percent of total billed charges,,303.86,382.85,
17-OH PROGESTERONE/CREAT RATIO,25200387,CDM,82570,CPT,300,RC,inpatient,,403,403,,342.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,303.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,342.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,354.64,88,,percent of total billed charges,,,,,,,,,307.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,366.73,91,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,,,,,,,,,,,,,334.49,83,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,330.46,82,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,342.55,85,,percent of total billed charges,,303.86,382.85,
.CULTURE  AEROBIC (TISSUE),25200388,CDM,87070,CPT,300,RC,inpatient,,224,224,,190.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,190.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,197.12,88,,percent of total billed charges,,,,,,,,,171.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,183.68,82,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,168.9,212.8,
CULTURE AEROBIC(FLUID),25200389,CDM,87070,CPT,300,RC,inpatient,,249,249,,211.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,187.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,211.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,219.12,88,,percent of total billed charges,,,,,,,,,190.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,226.59,91,,percent of total billed charges,,,236.55,95,,percent of total billed charges,,,206.67,83,,percent of total billed charges,,,206.67,83,,percent of total billed charges,,,,,,,,,,,,,,,206.67,83,,percent of total billed charges,,,236.55,95,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,204.18,82,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,211.65,85,,percent of total billed charges,,187.75,236.55,
. MRSA NAA,25200390,CDM,87641,CPT,300,RC,inpatient,,183,183,,155.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,155.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,161.04,88,,percent of total billed charges,,,,,,,,,139.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,,,,,,,,,,,,,151.89,83,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,150.06,82,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,137.98,173.85,
".DIFFERENTIAL, MANUAL",25200394,CDM,85007,CPT,300,RC,inpatient,,86,86,,73.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,75.68,88,,percent of total billed charges,,,,,,,,,65.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,78.26,91,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,,,,,,,,,,,,,71.38,83,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,70.52,82,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,64.84,81.7,
DIGOXIN,25200402,CDM,80162,CPT,300,RC,inpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,226.2,285,
PHENYTOIN,25200410,CDM,80185,CPT,300,RC,inpatient,,277,277,,235.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,208.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,235.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,243.76,88,,percent of total billed charges,,,,,,,,,211.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.07,91,,percent of total billed charges,,,263.15,95,,percent of total billed charges,,,229.91,83,,percent of total billed charges,,,229.91,83,,percent of total billed charges,,,,,,,,,,,,,,,229.91,83,,percent of total billed charges,,,263.15,95,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,227.14,82,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,235.45,85,,percent of total billed charges,,208.86,263.15,
PHENYTOIN FREE,25200420,CDM,80186,CPT,300,RC,inpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,179.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,159.09,200.45,
PROTEIN TOTAL URINE (24-HOUR),25200428,CDM,84156,CPT,300,RC,inpatient,,182,182,,154.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,154.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,160.16,88,,percent of total billed charges,,,,,,,,,139.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,149.24,82,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,137.23,172.9,
ACTH,25200436,CDM,82024,CPT,300,RC,inpatient,,758,758,,643.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,571.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,644.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,667.04,88,,percent of total billed charges,,,,,,,,,579.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,689.78,91,,percent of total billed charges,,,720.1,95,,percent of total billed charges,,,629.14,83,,percent of total billed charges,,,629.14,83,,percent of total billed charges,,,,,,,,,,,,,,,629.14,83,,percent of total billed charges,,,720.1,95,,percent of total billed charges,,,682.2,90,,percent of total billed charges,,,682.2,90,,percent of total billed charges,,,621.56,82,,percent of total billed charges,,,682.2,90,,percent of total billed charges,,,644.3,85,,percent of total billed charges,,571.53,720.1,
VENIPUNCTURE BLOOD COLLECTION,25200444,CDM,36415,CPT,300,RC,inpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,41.47,52.25,
CAPILLARY PUNCTURE BLOOD COLLECTION,25200446,CDM,36416,CPT,300,RC,inpatient,,66,66,,56.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.08,88,,percent of total billed charges,,,,,,,,,50.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.06,91,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,,,,,,,,,,,,,54.78,83,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,54.12,82,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,49.76,62.7,
FIBRINOGEN,25200450,CDM,85385,CPT,300,RC,inpatient,,504,504,,427.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,380.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,428.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,443.52,88,,percent of total billed charges,,,,,,,,,385.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,458.64,91,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,,,,,,,,,,,,,418.32,83,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,413.28,82,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,380.02,478.8,
FIBRINOGEN (ACTIVITY),25200451,CDM,85384,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
.FUNGUS CULTURE WITH STAIN,25200452,CDM,87102,CPT,300,RC,inpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,223.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,252.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,223.94,282.15,
FUNGUS CULTURE WITH STAIN,25200453,CDM,87102,CPT,300,RC,inpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,223.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,252.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,223.94,282.15,
FUNGAL STAIN,25200454,CDM,87206,CPT,300,RC,inpatient,,29,29,,24.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.52,88,,percent of total billed charges,,,,,,,,,22.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.39,91,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,,,,,,,,,,,,,24.07,83,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,23.78,82,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,21.87,27.55,
DRAGU FIBRINOGEN (ANTIGEN),25200455,CDM,85385,CPT,300,RC,inpatient,,504,504,,427.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,380.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,428.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,443.52,88,,percent of total billed charges,,,,,,,,,385.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,458.64,91,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,,,,,,,,,,,,,418.32,83,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,413.28,82,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,380.02,478.8,
GENTAMICIN PEAK,25200469,CDM,80170,CPT,300,RC,inpatient,,355,355,,301.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,267.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,301.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,312.4,88,,percent of total billed charges,,,,,,,,,271.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,323.05,91,,percent of total billed charges,,,337.25,95,,percent of total billed charges,,,294.65,83,,percent of total billed charges,,,294.65,83,,percent of total billed charges,,,,,,,,,,,,,,,294.65,83,,percent of total billed charges,,,337.25,95,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,291.1,82,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,301.75,85,,percent of total billed charges,,267.67,337.25,
GENTAMICIN RANDOM,25200470,CDM,80170,CPT,300,RC,inpatient,,355,355,,301.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,267.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,301.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,312.4,88,,percent of total billed charges,,,,,,,,,271.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,323.05,91,,percent of total billed charges,,,337.25,95,,percent of total billed charges,,,294.65,83,,percent of total billed charges,,,294.65,83,,percent of total billed charges,,,,,,,,,,,,,,,294.65,83,,percent of total billed charges,,,337.25,95,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,291.1,82,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,301.75,85,,percent of total billed charges,,267.67,337.25,
GGT,25200477,CDM,82977,CPT,300,RC,inpatient,,196,196,,166.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,166.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,172.48,88,,percent of total billed charges,,,,,,,,,149.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,178.36,91,,percent of total billed charges,,,186.2,95,,percent of total billed charges,,,162.68,83,,percent of total billed charges,,,162.68,83,,percent of total billed charges,,,,,,,,,,,,,,,162.68,83,,percent of total billed charges,,,186.2,95,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,160.72,82,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,166.6,85,,percent of total billed charges,,147.78,186.2,
GEL SEPERATION,25200479,CDM,83894,CPT,300,RC,inpatient,,135,135,,114.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,101.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,114.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,118.8,88,,percent of total billed charges,,,,,,,,,103.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,,,,,,,,,,,,,112.05,83,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,110.7,82,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,101.79,128.25,
GLUCOSE SERUM,25200485,CDM,82947,CPT,300,RC,inpatient,,111,111,,94.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,83.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,97.68,88,,percent of total billed charges,,,,,,,,,84.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.01,91,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,,,,,,,,,,,,,92.13,83,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,91.02,82,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,94.35,85,,percent of total billed charges,,83.69,105.45,
GLUCOSE 1 HOUR PP,25200486,CDM,82950,CPT,300,RC,inpatient,,167,167,,141.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,146.96,88,,percent of total billed charges,,,,,,,,,127.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,,,,,,,,,,,,,138.61,83,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,136.94,82,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,125.92,158.65,
.GTT-ADDED SPECIMEN,25200487,CDM,82952,CPT,300,RC,inpatient,,72,72,,61.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,54.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,61.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,63.36,88,,percent of total billed charges,,,,,,,,,55.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,65.52,91,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,,,,,,,,,,,,,59.76,83,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,59.04,82,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,54.29,68.4,
"GLUCOSE, CSF/BODY FL",25200488,CDM,82945,CPT,300,RC,inpatient,,122,122,,103.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,103.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,107.36,88,,percent of total billed charges,,,,,,,,,93.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,100.04,82,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,91.99,115.9,
GLUCOSE (POC),25200490,CDM,82948,CPT,300,RC,inpatient,,33,33,,28.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.04,88,,percent of total billed charges,,,,,,,,,25.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.03,91,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,,,,,,,,,,,,,27.39,83,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,27.06,82,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,28.05,85,,percent of total billed charges,,24.88,31.35,
.GTT - 3 HOUR,25200493,CDM,82951,CPT,300,RC,inpatient,,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,174.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,174.17,219.45,
GRAM STAIN (BLOOD CULTURE),25200518,CDM,87205,CPT,300,RC,inpatient,TC,82,82,,69.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,69.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,72.16,88,,percent of total billed charges,,,,,,,,,62.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,74.62,91,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,,,,,,,,,,,,,68.06,83,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,67.24,82,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,61.83,77.9,
GRAM STAIN (NOT SPUTUM),25200519,CDM,87205,CPT,300,RC,inpatient,,98,98,,83.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,73.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,83.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,86.24,88,,percent of total billed charges,,,,,,,,,74.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,89.18,91,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,,,,,,,,,,,,,81.34,83,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,80.36,82,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,83.3,85,,percent of total billed charges,,73.89,93.1,
GRAM STAIN (SPUTUM),25200520,CDM,87205,CPT,300,RC,inpatient,,98,98,,83.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,73.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,83.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,86.24,88,,percent of total billed charges,,,,,,,,,74.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,89.18,91,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,,,,,,,,,,,,,81.34,83,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,80.36,82,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,83.3,85,,percent of total billed charges,,73.89,93.1,
....HERPES SIM1&2 IGM AB,25200525,CDM,86694,CPT,300,RC,inpatient,,32,32,,27.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28.16,88,,percent of total billed charges,,,,,,,,,24.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,,,,,,,,,,,,,26.56,83,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,26.24,82,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,24.13,30.4,
"HEPATITIS C, RNA, QN",25200526,CDM,87522,CPT,300,RC,inpatient,,1103,1103,,936.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,831.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,937.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,970.64,88,,percent of total billed charges,,,,,,,,,842.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1003.73,91,,percent of total billed charges,,,1047.85,95,,percent of total billed charges,,,915.49,83,,percent of total billed charges,,,915.49,83,,percent of total billed charges,,,,,,,,,,,,,,,915.49,83,,percent of total billed charges,,,1047.85,95,,percent of total billed charges,,,992.7,90,,percent of total billed charges,,,992.7,90,,percent of total billed charges,,,904.46,82,,percent of total billed charges,,,992.7,90,,percent of total billed charges,,,937.55,85,,percent of total billed charges,,831.66,1047.85,
HDL CHOLESTEROL,25200527,CDM,83718,CPT,300,RC,inpatient,,201,201,,170.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,151.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176.88,88,,percent of total billed charges,,,,,,,,,153.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182.91,91,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,,,,,,,,,,,,,166.83,83,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,164.82,82,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,151.55,190.95,
HERPES SIM VIRUS CULTURE,25200529,CDM,87255,CPT,300,RC,inpatient,,509,509,,432.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,383.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,432.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,447.92,88,,percent of total billed charges,,,,,,,,,388.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,463.19,91,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,,,,,,,,,,,,,422.47,83,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,417.38,82,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,383.79,483.55,
".HIV-1 RNA QL, PCR",25200530,CDM,87535,CPT,300,RC,inpatient,,762,762,,646.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,574.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,647.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,670.56,88,,percent of total billed charges,,,,,,,,,582.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,693.42,91,,percent of total billed charges,,,723.9,95,,percent of total billed charges,,,632.46,83,,percent of total billed charges,,,632.46,83,,percent of total billed charges,,,,,,,,,,,,,,,632.46,83,,percent of total billed charges,,,723.9,95,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,624.84,82,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,647.7,85,,percent of total billed charges,,574.55,723.9,
.HERPES SIMPLEX 1&2 PCR,25200531,CDM,87529,CPT,300,RC,inpatient,,524,524,,444.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,445.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,461.12,88,,percent of total billed charges,,,,,,,,,400.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,476.84,91,,percent of total billed charges,,,497.8,95,,percent of total billed charges,,,434.92,83,,percent of total billed charges,,,434.92,83,,percent of total billed charges,,,,,,,,,,,,,,,434.92,83,,percent of total billed charges,,,497.8,95,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,429.68,82,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,445.4,85,,percent of total billed charges,,395.1,497.8,
HIV AB REFLEX TO WESTERN BLOTT,25200532,CDM,86703,CPT,300,RC,inpatient,,418,418,,354.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,315.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,355.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,367.84,88,,percent of total billed charges,,,,,,,,,319.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,380.38,91,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,,,,,,,,,,,,,346.94,83,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,342.76,82,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,355.3,85,,percent of total billed charges,,315.17,397.1,
HIV GENOTYPE,25200533,CDM,87536,CPT,300,RC,inpatient,,658,658,,558.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,496.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,559.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,579.04,88,,percent of total billed charges,,,,,,,,,502.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,598.78,91,,percent of total billed charges,,,625.1,95,,percent of total billed charges,,,546.14,83,,percent of total billed charges,,,546.14,83,,percent of total billed charges,,,,,,,,,,,,,,,546.14,83,,percent of total billed charges,,,625.1,95,,percent of total billed charges,,,592.2,90,,percent of total billed charges,,,592.2,90,,percent of total billed charges,,,539.56,82,,percent of total billed charges,,,592.2,90,,percent of total billed charges,,,559.3,85,,percent of total billed charges,,496.13,625.1,
"HEPATITIS C, RNA, DIAGNOSIS",25200534,CDM,87522,CPT,300,RC,inpatient,,539,539,,457.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,406.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,458.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,474.32,88,,percent of total billed charges,,,,,,,,,411.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,490.49,91,,percent of total billed charges,,,512.05,95,,percent of total billed charges,,,447.37,83,,percent of total billed charges,,,447.37,83,,percent of total billed charges,,,,,,,,,,,,,,,447.37,83,,percent of total billed charges,,,512.05,95,,percent of total billed charges,,,485.1,90,,percent of total billed charges,,,485.1,90,,percent of total billed charges,,,441.98,82,,percent of total billed charges,,,485.1,90,,percent of total billed charges,,,458.15,85,,percent of total billed charges,,406.41,512.05,
HEMATOCRIT,25200535,CDM,85014,CPT,300,RC,inpatient,,70,70,,59.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,59.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,61.6,88,,percent of total billed charges,,,,,,,,,53.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,63.7,91,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,,,,,,,,,,,,,58.1,83,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,57.4,82,,percent of total billed charges,,,63,90,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,52.78,66.5,
.HIV-2,25200536,CDM,86702,CPT,300,RC,inpatient,,538,538,,456.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,405.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,457.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,473.44,88,,percent of total billed charges,,,,,,,,,411.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,489.58,91,,percent of total billed charges,,,511.1,95,,percent of total billed charges,,,446.54,83,,percent of total billed charges,,,446.54,83,,percent of total billed charges,,,,,,,,,,,,,,,446.54,83,,percent of total billed charges,,,511.1,95,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,441.16,82,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,457.3,85,,percent of total billed charges,,405.65,511.1,
.HIV-1 ANTIBODY CONFIRMATION,25200537,CDM,86689,CPT,300,RC,inpatient,,552,552,,468.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,416.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,469.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,485.76,88,,percent of total billed charges,,,,,,,,,421.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,502.32,91,,percent of total billed charges,,,524.4,95,,percent of total billed charges,,,458.16,83,,percent of total billed charges,,,458.16,83,,percent of total billed charges,,,,,,,,,,,,,,,458.16,83,,percent of total billed charges,,,524.4,95,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,452.64,82,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,469.2,85,,percent of total billed charges,,416.21,524.4,
.HIV P24 ANTIGEN,25200538,CDM,87390,CPT,300,RC,inpatient,,275,275,,233.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,207.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,233.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,242,88,,percent of total billed charges,,,,,,,,,210.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,250.25,91,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,,,,,,,,,,,,,228.25,83,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,225.5,82,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,233.75,85,,percent of total billed charges,,207.35,261.25,
HU AUTOANTIBODY,25200539,CDM,86255,CPT,300,RC,inpatient,,501,501,,425.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440.88,88,,percent of total billed charges,,,,,,,,,382.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,,,,,,,,,,,,,415.83,83,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,410.82,82,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,377.75,475.95,
"HEPATITIS C VIRAL LOAD, QN",25200540,CDM,87522,CPT,300,RC,inpatient,,1013,1013,,860.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,763.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,861.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,891.44,88,,percent of total billed charges,,,,,,,,,773.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,921.83,91,,percent of total billed charges,,,962.35,95,,percent of total billed charges,,,840.79,83,,percent of total billed charges,,,840.79,83,,percent of total billed charges,,,,,,,,,,,,,,,840.79,83,,percent of total billed charges,,,962.35,95,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,830.66,82,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,861.05,85,,percent of total billed charges,,763.8,962.35,
"HEPATITIS C RNA, GENOTYPE",25200541,CDM,87902,CPT,300,RC,inpatient,,3855,3855,,3272.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2906.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3276.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3392.4,88,,percent of total billed charges,,,,,,,,,2945.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3508.05,91,,percent of total billed charges,,,3662.25,95,,percent of total billed charges,,,3199.65,83,,percent of total billed charges,,,3199.65,83,,percent of total billed charges,,,,,,,,,,,,,,,3199.65,83,,percent of total billed charges,,,3662.25,95,,percent of total billed charges,,,3469.5,90,,percent of total billed charges,,,3469.5,90,,percent of total billed charges,,,3161.1,82,,percent of total billed charges,,,3469.5,90,,percent of total billed charges,,,3276.75,85,,percent of total billed charges,,2906.67,3662.25,
HEPATITIS A IGM ANTIBODY,25200542,CDM,86709,CPT,300,RC,inpatient,,261,261,,221.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,196.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,221.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,229.68,88,,percent of total billed charges,,,,,,,,,199.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.51,91,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,,,,,,,,,,,,,216.63,83,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,214.02,82,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,221.85,85,,percent of total billed charges,,196.79,247.95,
HEMOGLOBIN,25200543,CDM,85018,CPT,300,RC,inpatient,,71,71,,60.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.48,88,,percent of total billed charges,,,,,,,,,54.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,,,,,,,,,,,,,58.93,83,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,58.22,82,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,53.53,67.45,
INSULIN FREE (INCLUDES TOTAL),25200545,CDM,83527,CPT,300,RC,inpatient,,196,196,,166.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,166.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,172.48,88,,percent of total billed charges,,,,,,,,,149.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,178.36,91,,percent of total billed charges,,,186.2,95,,percent of total billed charges,,,162.68,83,,percent of total billed charges,,,162.68,83,,percent of total billed charges,,,,,,,,,,,,,,,162.68,83,,percent of total billed charges,,,186.2,95,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,160.72,82,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,166.6,85,,percent of total billed charges,,147.78,186.2,
INSULIN ANTIBODY,25200546,CDM,86337,CPT,300,RC,inpatient,,453,453,,384.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,341.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,385.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,398.64,88,,percent of total billed charges,,,,,,,,,346.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,412.23,91,,percent of total billed charges,,,430.35,95,,percent of total billed charges,,,375.99,83,,percent of total billed charges,,,375.99,83,,percent of total billed charges,,,,,,,,,,,,,,,375.99,83,,percent of total billed charges,,,430.35,95,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,371.46,82,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,385.05,85,,percent of total billed charges,,341.56,430.35,
ISLET CELL ANTIBODY,25200547,CDM,86341,CPT,300,RC,inpatient,,226,226,,191.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,170.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198.88,88,,percent of total billed charges,,,,,,,,,172.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,,,,,,,,,,,,,187.58,83,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,185.32,82,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,170.4,214.7,
"HYDROXYPROLINE TOTAL, URINE (24-HOUR)",25200548,CDM,83505,CPT,300,RC,inpatient,,520,520,,441.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,392.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,442,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,457.6,88,,percent of total billed charges,,,,,,,,,397.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,473.2,91,,percent of total billed charges,,,494,95,,percent of total billed charges,,,431.6,83,,percent of total billed charges,,,431.6,83,,percent of total billed charges,,,,,,,,,,,,,,,431.6,83,,percent of total billed charges,,,494,95,,percent of total billed charges,,,468,90,,percent of total billed charges,,,468,90,,percent of total billed charges,,,426.4,82,,percent of total billed charges,,,468,90,,percent of total billed charges,,,442,85,,percent of total billed charges,,392.08,494,
HUNTINGTON DISEASE ANALYSIS,25200549,CDM,81271,CPT,300,RC,inpatient,,511,511,,433.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,385.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,434.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,449.68,88,,percent of total billed charges,,,,,,,,,390.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,465.01,91,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,,,,,,,,,,,,,424.13,83,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,419.02,82,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,385.29,485.45,
CULTURE THROAT,25200550,CDM,87081,CPT,300,RC,inpatient,,171,171,,145.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,128.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,145.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,150.48,88,,percent of total billed charges,,,,,,,,,130.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,,,,,,,,,,,,,141.93,83,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,140.22,82,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,128.93,162.45,
X RHC HEMOGLOBIN,25200551,CDM,85018,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
HEPARIN INDUCED PLT AB,25200552,CDM,86022,CPT,300,RC,inpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,198.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,198.3,249.85,
CULTURE NEG STREP SCR CONFIRMATION,25200553,CDM,87081,CPT,300,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
"HEPATITIS C RNA, QT rfx geno",25200555,CDM,87522,CPT,300,RC,inpatient,,936,936,,794.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,705.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,795.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,823.68,88,,percent of total billed charges,,,,,,,,,715.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,851.76,91,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,,,,,,,,,,,,,776.88,83,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,767.52,82,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,795.6,85,,percent of total billed charges,,705.74,889.2,
.SEROTONIN RELEASE ASSAY,25200556,CDM,86022,CPT,300,RC,inpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,198.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,198.3,249.85,
HEPARIN ANTI XA (LMWH),25200557,CDM,85520,CPT,300,RC,inpatient,,282,282,,239.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,212.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,239.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,248.16,88,,percent of total billed charges,,,,,,,,,215.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,256.62,91,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,,,,,,,,,,,,,234.06,83,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,231.24,82,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,239.7,85,,percent of total billed charges,,212.63,267.9,
ISOHEMAGGLUTIN TITER,25200558,CDM,86940,CPT,300,RC,inpatient,,397,397,,337.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,299.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,337.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,349.36,88,,percent of total billed charges,,,,,,,,,303.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,361.27,91,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,,,,,,,,,,,,,329.51,83,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,325.54,82,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,337.45,85,,percent of total billed charges,,299.34,377.15,
"HEPATITIS C RNA, QUAL NAA",25200559,CDM,87521,CPT,300,RC,inpatient,,803,803,,681.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,605.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,682.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,706.64,88,,percent of total billed charges,,,,,,,,,613.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,730.73,91,,percent of total billed charges,,,762.85,95,,percent of total billed charges,,,666.49,83,,percent of total billed charges,,,666.49,83,,percent of total billed charges,,,,,,,,,,,,,,,666.49,83,,percent of total billed charges,,,762.85,95,,percent of total billed charges,,,722.7,90,,percent of total billed charges,,,722.7,90,,percent of total billed charges,,,658.46,82,,percent of total billed charges,,,722.7,90,,percent of total billed charges,,,682.55,85,,percent of total billed charges,,605.46,762.85,
GLUTAMIC ACID DECARBOXYLASE (CSF),25200560,CDM,86341,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
GLUTAMIC ACID (GAD65),25200561,CDM,86341,CPT,300,RC,inpatient,,568,568,,482.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,428.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,482.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,499.84,88,,percent of total billed charges,,,,,,,,,433.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,516.88,91,,percent of total billed charges,,,539.6,95,,percent of total billed charges,,,471.44,83,,percent of total billed charges,,,471.44,83,,percent of total billed charges,,,,,,,,,,,,,,,471.44,83,,percent of total billed charges,,,539.6,95,,percent of total billed charges,,,511.2,90,,percent of total billed charges,,,511.2,90,,percent of total billed charges,,,465.76,82,,percent of total billed charges,,,511.2,90,,percent of total billed charges,,,482.8,85,,percent of total billed charges,,428.27,539.6,
EBV CHRONIC/ACTIVE INFECTION,25200562,CDM,86663,CPT,300,RC,inpatient,,611,611,,518.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,460.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,519.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,537.68,88,,percent of total billed charges,,,,,,,,,466.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.01,91,,percent of total billed charges,,,580.45,95,,percent of total billed charges,,,507.13,83,,percent of total billed charges,,,507.13,83,,percent of total billed charges,,,,,,,,,,,,,,,507.13,83,,percent of total billed charges,,,580.45,95,,percent of total billed charges,,,549.9,90,,percent of total billed charges,,,549.9,90,,percent of total billed charges,,,501.02,82,,percent of total billed charges,,,549.9,90,,percent of total billed charges,,,519.35,85,,percent of total billed charges,,460.69,580.45,
HUMAN HERPES VIRUS 6 PCR,25200563,CDM,87532,CPT,300,RC,inpatient,,674,674,,572.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,508.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,572.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,593.12,88,,percent of total billed charges,,,,,,,,,514.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,613.34,91,,percent of total billed charges,,,640.3,95,,percent of total billed charges,,,559.42,83,,percent of total billed charges,,,559.42,83,,percent of total billed charges,,,,,,,,,,,,,,,559.42,83,,percent of total billed charges,,,640.3,95,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,552.68,82,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,572.9,85,,percent of total billed charges,,508.2,640.3,
HUMAN HERPES VIRUS 6 IGG AB,25200564,CDM,86790,CPT,300,RC,inpatient,,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,277.47,349.6,
ITRACONAZOLE,25200565,CDM,80189,CPT,300,RC,inpatient,,744,744,,631.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,560.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,632.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,654.72,88,,percent of total billed charges,,,,,,,,,568.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,677.04,91,,percent of total billed charges,,,706.8,95,,percent of total billed charges,,,617.52,83,,percent of total billed charges,,,617.52,83,,percent of total billed charges,,,,,,,,,,,,,,,617.52,83,,percent of total billed charges,,,706.8,95,,percent of total billed charges,,,669.6,90,,percent of total billed charges,,,669.6,90,,percent of total billed charges,,,610.08,82,,percent of total billed charges,,,669.6,90,,percent of total billed charges,,,632.4,85,,percent of total billed charges,,560.98,706.8,
HYPERTROPHIC CARDIOMYOPATHY(HCM),25200567,CDM,81405,CPT,300,RC,inpatient,,613,613,,520.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,462.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,521.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,539.44,88,,percent of total billed charges,,,,,,,,,468.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,557.83,91,,percent of total billed charges,,,582.35,95,,percent of total billed charges,,,508.79,83,,percent of total billed charges,,,508.79,83,,percent of total billed charges,,,,,,,,,,,,,,,508.79,83,,percent of total billed charges,,,582.35,95,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,502.66,82,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,521.05,85,,percent of total billed charges,,462.2,582.35,
KOH PREP,25200568,CDM,87220,CPT,300,RC,inpatient,,131,131,,111.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,111.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,115.28,88,,percent of total billed charges,,,,,,,,,100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,,,,,,,,,,,,,108.73,83,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,107.42,82,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,98.77,124.45,
WET PREP /w KOH,25200569,CDM,87210,CPT,300,RC,inpatient,,131,131,,111.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,111.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,115.28,88,,percent of total billed charges,,,,,,,,,100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,,,,,,,,,,,,,108.73,83,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,107.42,82,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,98.77,124.45,
BUPROPION,25200570,CDM,80299,CPT,300,RC,inpatient,,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,186.99,235.6,
VON WILLEBRAND FACTOR ANTIGEN,25200571,CDM,85245,CPT,300,RC,inpatient,,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,200.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,226.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,200.56,252.7,
VON WILLEBRAND FACTOR ACTIVITY,25200573,CDM,85246,CPT,300,RC,inpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,316.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,357,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,316.68,399,
EBV EA (EARLY ANTIGEN  AB),25200574,CDM,86663,CPT,300,RC,inpatient,,117,117,,99.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,88.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,99.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,102.96,88,,percent of total billed charges,,,,,,,,,89.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,106.47,91,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,,,,,,,,,,,,,97.11,83,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,95.94,82,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,99.45,85,,percent of total billed charges,,88.22,111.15,
ARIXTRA,25200575,CDM,85520,CPT,300,RC,inpatient,,308,308,,261.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,232.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,261.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,271.04,88,,percent of total billed charges,,,,,,,,,235.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,280.28,91,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,,,,,,,,,,,,,255.64,83,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,252.56,82,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,232.23,292.6,
..HEPATITIS C DRUG RESISTANCE,25200576,CDM,87900,CPT,300,RC,inpatient,,444,444,,376.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,334.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,377.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,390.72,88,,percent of total billed charges,,,,,,,,,339.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,404.04,91,,percent of total billed charges,,,421.8,95,,percent of total billed charges,,,368.52,83,,percent of total billed charges,,,368.52,83,,percent of total billed charges,,,,,,,,,,,,,,,368.52,83,,percent of total billed charges,,,421.8,95,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,364.08,82,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,377.4,85,,percent of total billed charges,,334.78,421.8,
..HEPATITIS C VIRUS,25200577,CDM,87902,CPT,300,RC,inpatient,,1329,1329,,1128.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1002.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1129.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1169.52,88,,percent of total billed charges,,,,,,,,,1015.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1209.39,91,,percent of total billed charges,,,1262.55,95,,percent of total billed charges,,,1103.07,83,,percent of total billed charges,,,1103.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1103.07,83,,percent of total billed charges,,,1262.55,95,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1089.78,82,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1129.65,85,,percent of total billed charges,,1002.07,1262.55,
"HEPATITIS C, RNA, NAA, QUAL",25200580,CDM,87521,CPT,300,RC,inpatient,,219,219,,185.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,165.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,186.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,192.72,88,,percent of total billed charges,,,,,,,,,167.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,199.29,91,,percent of total billed charges,,,208.05,95,,percent of total billed charges,,,181.77,83,,percent of total billed charges,,,181.77,83,,percent of total billed charges,,,,,,,,,,,,,,,181.77,83,,percent of total billed charges,,,208.05,95,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,179.58,82,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,186.15,85,,percent of total billed charges,,165.13,208.05,
IA2 AUTOANTIBODY,25200581,CDM,86337,CPT,300,RC,inpatient,,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,129.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,129.69,163.4,
HEPATITIS C GT1aNS5A,25200582,CDM,87522,CPT,300,RC,inpatient,,1013,1013,,860.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,763.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,861.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,891.44,88,,percent of total billed charges,,,,,,,,,773.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,921.83,91,,percent of total billed charges,,,962.35,95,,percent of total billed charges,,,840.79,83,,percent of total billed charges,,,840.79,83,,percent of total billed charges,,,,,,,,,,,,,,,840.79,83,,percent of total billed charges,,,962.35,95,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,830.66,82,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,861.05,85,,percent of total billed charges,,763.8,962.35,
FUNGAL EXAM THROAT,25200583,CDM,87210,CPT,300,RC,inpatient,,131,131,,111.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,111.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,115.28,88,,percent of total billed charges,,,,,,,,,100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,,,,,,,,,,,,,108.73,83,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,107.42,82,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,98.77,124.45,
LDH,25200584,CDM,83615,CPT,300,RC,inpatient,,165,165,,140.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,124.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,140.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,145.2,88,,percent of total billed charges,,,,,,,,,126.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,135.3,82,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,124.41,156.75,
HUMAN EPIDIDYMIS PROTEIN 4,25200585,CDM,86305,CPT,300,RC,inpatient,,648,648,,550.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,488.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,550.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,570.24,88,,percent of total billed charges,,,,,,,,,495.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,589.68,91,,percent of total billed charges,,,615.6,95,,percent of total billed charges,,,537.84,83,,percent of total billed charges,,,537.84,83,,percent of total billed charges,,,,,,,,,,,,,,,537.84,83,,percent of total billed charges,,,615.6,95,,percent of total billed charges,,,583.2,90,,percent of total billed charges,,,583.2,90,,percent of total billed charges,,,531.36,82,,percent of total billed charges,,,583.2,90,,percent of total billed charges,,,550.8,85,,percent of total billed charges,,488.59,615.6,
CULTURE STOOL,25200592,CDM,87045,CPT,300,RC,inpatient,,95,95,,80.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,83.6,88,,percent of total billed charges,,,,,,,,,72.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,,,,,,,,,,,,,78.85,83,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,77.9,82,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,71.63,90.25,
LABCORP GI,25200593,CDM,87507,CPT,300,RC,inpatient,,813,813,,690.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,613,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,691.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,715.44,88,,percent of total billed charges,,,,,,,,,621.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,739.83,91,,percent of total billed charges,,,772.35,95,,percent of total billed charges,,,674.79,83,,percent of total billed charges,,,674.79,83,,percent of total billed charges,,,,,,,,,,,,,,,674.79,83,,percent of total billed charges,,,772.35,95,,percent of total billed charges,,,731.7,90,,percent of total billed charges,,,731.7,90,,percent of total billed charges,,,666.66,82,,percent of total billed charges,,,731.7,90,,percent of total billed charges,,,691.05,85,,percent of total billed charges,,613,772.35,
LITHIUM,25200600,CDM,80178,CPT,300,RC,inpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,135.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,135.72,171,
"MYCOPLASMA PNEUMONIAE ANTIBODY, IGG",25200601,CDM,86738,CPT,300,RC,inpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,149.29,188.1,
"MYCOPLASMA PNEUMONIAE ANTIBODY, IGM",25200602,CDM,86738,CPT,300,RC,inpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,149.29,188.1,
MALARIA BLOOD PARASITES,25200603,CDM,87207,CPT,300,RC,inpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,92.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,82.19,103.55,
LEGIONELLA ANTIGEN URINE,25200604,CDM,87449,CPT,300,RC,inpatient,,291,291,,247.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,219.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,247.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,256.08,88,,percent of total billed charges,,,,,,,,,222.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,264.81,91,,percent of total billed charges,,,276.45,95,,percent of total billed charges,,,241.53,83,,percent of total billed charges,,,241.53,83,,percent of total billed charges,,,,,,,,,,,,,,,241.53,83,,percent of total billed charges,,,276.45,95,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,238.62,82,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,247.35,85,,percent of total billed charges,,219.41,276.45,
LIPOPROTEIN A,25200605,CDM,83695,CPT,300,RC,inpatient,,182,182,,154.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,154.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,160.16,88,,percent of total billed charges,,,,,,,,,139.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,149.24,82,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,137.23,172.9,
LEPTIN,25200606,CDM,82397,CPT,300,RC,inpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,179.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,159.09,200.45,
LP-PLA2,25200607,CDM,83698,CPT,300,RC,inpatient,,264,264,,224.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,199.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,224.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,232.32,88,,percent of total billed charges,,,,,,,,,201.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,240.24,91,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,,,,,,,,,,,,,219.12,83,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,216.48,82,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,199.06,250.8,
LIPOPROTEIN PHENOTYPING,25200608,CDM,83700,CPT,300,RC,inpatient,,278,278,,236.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,236.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.64,88,,percent of total billed charges,,,,,,,,,212.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.98,91,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,,,,,,,,,,,,,230.74,83,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,227.96,82,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,209.61,264.1,
HEMOSIDERIN QUAL UNINE,25200617,CDM,83070,CPT,300,RC,inpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,41.47,52.25,
HEPATIC FUNCTION PANEL,25200618,CDM,80076,CPT,300,RC,inpatient,,269,269,,228.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,202.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,228.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,236.72,88,,percent of total billed charges,,,,,,,,,205.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,244.79,91,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,,,,,,,,,,,,,223.27,83,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,220.58,82,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,202.83,255.55,
SS-A (RO) AB IGG,25200621,CDM,86235,CPT,300,RC,inpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,163.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,184.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,163.62,206.15,
SS-B (LA) AB IGG,25200622,CDM,86235,CPT,300,RC,inpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,163.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,184.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,163.62,206.15,
SCL-70 ANTIBODIES,25200623,CDM,86235,CPT,300,RC,inpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,163.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,184.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,163.62,206.15,
CYTOMEGALOVIRUS QT PCR,25200624,CDM,87497,CPT,300,RC,inpatient,,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,353.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,398.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,353.63,445.55,
MAGNESIUM,25200626,CDM,83735,CPT,300,RC,inpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,163.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,184.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,163.62,206.15,
CYTOMEGALOVIRUS DNA QT PCR,25200627,CDM,87497,CPT,300,RC,inpatient,,643,643,,545.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,484.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,546.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,565.84,88,,percent of total billed charges,,,,,,,,,491.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,585.13,91,,percent of total billed charges,,,610.85,95,,percent of total billed charges,,,533.69,83,,percent of total billed charges,,,533.69,83,,percent of total billed charges,,,,,,,,,,,,,,,533.69,83,,percent of total billed charges,,,610.85,95,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,527.26,82,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,546.55,85,,percent of total billed charges,,484.82,610.85,
MYCOPHENALATE / MYCOPHENOLIC ACID,25200628,CDM,80180,CPT,300,RC,inpatient,,290,290,,246.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,218.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,246.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,255.2,88,,percent of total billed charges,,,,,,,,,221.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,263.9,91,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,,,,,,,,,,,,,240.7,83,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,261,90,,percent of total billed charges,,,261,90,,percent of total billed charges,,,237.8,82,,percent of total billed charges,,,261,90,,percent of total billed charges,,,246.5,85,,percent of total billed charges,,218.66,275.5,
METANEPHRINES PLASMA FREE,25200629,CDM,83835,CPT,300,RC,inpatient,,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,454.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,512.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,454.66,572.85,
MYOCARDIAL ANTIBODY,25200630,CDM,86255,CPT,300,RC,inpatient,,275,275,,233.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,207.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,233.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,242,88,,percent of total billed charges,,,,,,,,,210.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,250.25,91,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,,,,,,,,,,,,,228.25,83,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,225.5,82,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,233.75,85,,percent of total billed charges,,207.35,261.25,
VASOACTIVE INTESTINAL POLYPEPTIDE (VIP),25200631,CDM,84586,CPT,300,RC,inpatient,,578,578,,490.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,435.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,491.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,508.64,88,,percent of total billed charges,,,,,,,,,441.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,525.98,91,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,,,,,,,,,,,,,479.74,83,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,473.96,82,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,491.3,85,,percent of total billed charges,,435.81,549.1,
AMNISURE (ROM) TEST,25200632,CDM,84112,CPT,300,RC,inpatient,,192,192,,163.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,163.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.96,88,,percent of total billed charges,,,,,,,,,146.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,,,,,,,,,,,,,159.36,83,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,157.44,82,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,144.77,182.4,
METHAMPHETAMINES D&L,25200633,CDM,80324,CPT,300,RC,inpatient,,204.75,204.75,,173.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,154.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,174.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,180.18,88,,percent of total billed charges,,,,,,,,,156.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,186.32,91,,percent of total billed charges,,,194.51,95,,percent of total billed charges,,,169.94,83,,percent of total billed charges,,,169.94,83,,percent of total billed charges,,,,,,,,,,,,,,,169.94,83,,percent of total billed charges,,,194.51,95,,percent of total billed charges,,,184.28,90,,percent of total billed charges,,,184.28,90,,percent of total billed charges,,,167.9,82,,percent of total billed charges,,,184.28,90,,percent of total billed charges,,,174.04,85,,percent of total billed charges,,154.38,194.51,
MONO TEST,25200634,CDM,86308,CPT,300,RC,inpatient,,133,133,,112.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,100.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,113.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,117.04,88,,percent of total billed charges,,,,,,,,,101.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,,,,,,,,,,,,,110.39,83,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,109.06,82,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,100.28,126.35,
THIORIDAZINE,25200635,CDM,G6057,HCPCS,300,RC,inpatient,,316,316,,268.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,238.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,268.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,278.08,88,,percent of total billed charges,,,,,,,,,241.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,287.56,91,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,,,,,,,,,,,,,262.28,83,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,259.12,82,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,238.26,300.2,
.SM ANTIBODIES(SMITH),25200636,CDM,86235,CPT,300,RC,inpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,163.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,184.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,163.62,206.15,
"CATECHOLAMINES, RANDOM URINE",25200637,CDM,82384,CPT,300,RC,inpatient,,485,485,,411.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,365.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,412.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,426.8,88,,percent of total billed charges,,,,,,,,,370.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,441.35,91,,percent of total billed charges,,,460.75,95,,percent of total billed charges,,,402.55,83,,percent of total billed charges,,,402.55,83,,percent of total billed charges,,,,,,,,,,,,,,,402.55,83,,percent of total billed charges,,,460.75,95,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,397.7,82,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,412.25,85,,percent of total billed charges,,365.69,460.75,
RIBOSOMAL P ANTIBODY,25200638,CDM,83516,CPT,300,RC,inpatient,,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,230.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,260.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,230.72,290.7,
CATECHOLAMINES PLASMA,25200639,CDM,82384,CPT,300,RC,inpatient,,366,366,,310.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,275.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,311.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,322.08,88,,percent of total billed charges,,,,,,,,,279.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,333.06,91,,percent of total billed charges,,,347.7,95,,percent of total billed charges,,,303.78,83,,percent of total billed charges,,,303.78,83,,percent of total billed charges,,,,,,,,,,,,,,,303.78,83,,percent of total billed charges,,,347.7,95,,percent of total billed charges,,,329.4,90,,percent of total billed charges,,,329.4,90,,percent of total billed charges,,,300.12,82,,percent of total billed charges,,,329.4,90,,percent of total billed charges,,,311.1,85,,percent of total billed charges,,275.96,347.7,
MERCURY BLOOD,25200640,CDM,83825,CPT,300,RC,inpatient,,315,315,,267.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,237.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,267.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,277.2,88,,percent of total billed charges,,,,,,,,,240.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,286.65,91,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,,,,,,,,,,,,,261.45,83,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,258.3,82,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,237.51,299.25,
STRIATED MUSCLE AB,25200641,CDM,86255,CPT,300,RC,inpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,62.58,78.85,
SCL-70 AB W/CONFIRM,25200642,CDM,86235,CPT,300,RC,inpatient,,341,341,,289.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,257.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,289.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,300.08,88,,percent of total billed charges,,,,,,,,,260.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,310.31,91,,percent of total billed charges,,,323.95,95,,percent of total billed charges,,,283.03,83,,percent of total billed charges,,,283.03,83,,percent of total billed charges,,,,,,,,,,,,,,,283.03,83,,percent of total billed charges,,,323.95,95,,percent of total billed charges,,,306.9,90,,percent of total billed charges,,,306.9,90,,percent of total billed charges,,,279.62,82,,percent of total billed charges,,,306.9,90,,percent of total billed charges,,,289.85,85,,percent of total billed charges,,257.11,323.95,
"OCCULT BLOOD, GASTRIC FLUID",25200643,CDM,82271,CPT,300,RC,inpatient,,63,63,,53.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,53.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.44,88,,percent of total billed charges,,,,,,,,,48.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,,,,,,,,,,,,,52.29,83,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,51.66,82,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,47.5,59.85,
.OCCULT BLOOD SCREEN FECES 1-3,25200644,CDM,82270,CPT,300,RC,inpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.92,88,,percent of total billed charges,,,,,,,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,44.49,56.05,
LYSOZYME SERUM,25200645,CDM,85549,CPT,300,RC,inpatient,,99,99,,84.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,74.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,84.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,87.12,88,,percent of total billed charges,,,,,,,,,75.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,,,,,,,,,,,,,82.17,83,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,81.18,82,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,74.65,94.05,
SMOOTH MUSCLE ANTIBODY (IgG),25200646,CDM,86255,CPT,300,RC,inpatient,,179,179,,151.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,134.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,152.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,157.52,88,,percent of total billed charges,,,,,,,,,136.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,146.78,82,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,134.97,170.05,
JCV AB RFX INHIBITION,25200647,CDM,86711,CPT,300,RC,inpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,62.58,78.85,
VASOACTIVE INTESTINAL POLYPEPTIDE,25200648,CDM,84586,CPT,300,RC,inpatient,,201,201,,170.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,151.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176.88,88,,percent of total billed charges,,,,,,,,,153.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182.91,91,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,,,,,,,,,,,,,166.83,83,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,164.82,82,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,151.55,190.95,
PANCREATIC POLYPEPTIDE,25200649,CDM,84586,CPT,300,RC,inpatient,,310,310,,263.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,233.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,263.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,272.8,88,,percent of total billed charges,,,,,,,,,236.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,282.1,91,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,,,,,,,,,,,,,257.3,83,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,279,90,,percent of total billed charges,,,279,90,,percent of total billed charges,,,254.2,82,,percent of total billed charges,,,279,90,,percent of total billed charges,,,263.5,85,,percent of total billed charges,,233.74,294.5,
THIOPURINE METABOLITES,25200650,CDM,80299,CPT,300,RC,inpatient,,768,768,,652.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,579.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,652.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,675.84,88,,percent of total billed charges,,,,,,,,,586.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,698.88,91,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,,,,,,,,,,,,,637.44,83,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,629.76,82,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,579.07,729.6,
THIOPURINE ACTIVITY,25200651,CDM,83789,CPT,300,RC,inpatient,,517,517,,438.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,389.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,439.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,454.96,88,,percent of total billed charges,,,,,,,,,394.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,470.47,91,,percent of total billed charges,,,491.15,95,,percent of total billed charges,,,429.11,83,,percent of total billed charges,,,429.11,83,,percent of total billed charges,,,,,,,,,,,,,,,429.11,83,,percent of total billed charges,,,491.15,95,,percent of total billed charges,,,465.3,90,,percent of total billed charges,,,465.3,90,,percent of total billed charges,,,423.94,82,,percent of total billed charges,,,465.3,90,,percent of total billed charges,,,439.45,85,,percent of total billed charges,,389.82,491.15,
JO-1 ANTIBODY,25200652,CDM,86235,CPT,300,RC,inpatient,,39,39,,33.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34.32,88,,percent of total billed charges,,,,,,,,,29.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35.49,91,,percent of total billed charges,,,37.05,95,,percent of total billed charges,,,32.37,83,,percent of total billed charges,,,32.37,83,,percent of total billed charges,,,,,,,,,,,,,,,32.37,83,,percent of total billed charges,,,37.05,95,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,31.98,82,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,33.15,85,,percent of total billed charges,,29.41,37.05,
THIOPURINE METHYLTRANSFERASE GENO,25200653,CDM,81335,CPT,300,RC,inpatient,,579,579,,491.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,436.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,492.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,509.52,88,,percent of total billed charges,,,,,,,,,442.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,526.89,91,,percent of total billed charges,,,550.05,95,,percent of total billed charges,,,480.57,83,,percent of total billed charges,,,480.57,83,,percent of total billed charges,,,,,,,,,,,,,,,480.57,83,,percent of total billed charges,,,550.05,95,,percent of total billed charges,,,521.1,90,,percent of total billed charges,,,521.1,90,,percent of total billed charges,,,474.78,82,,percent of total billed charges,,,521.1,90,,percent of total billed charges,,,492.15,85,,percent of total billed charges,,436.57,550.05,
OCCULT BLOOD SCREEN FECES FIT 1-3,25200655,CDM,82274,CPT,300,RC,inpatient,,92,92,,78.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,69.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,78.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.96,88,,percent of total billed charges,,,,,,,,,70.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,,,,,,,,,,,,,76.36,83,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,75.44,82,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,69.37,87.4,
"OCCULT BLOOD DIAGNOSTIC, FIT",25200656,CDM,82274,CPT,300,RC,inpatient,,321,321,,272.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,272.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,282.48,88,,percent of total billed charges,,,,,,,,,245.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,292.11,91,,percent of total billed charges,,,304.95,95,,percent of total billed charges,,,266.43,83,,percent of total billed charges,,,266.43,83,,percent of total billed charges,,,,,,,,,,,,,,,266.43,83,,percent of total billed charges,,,304.95,95,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,263.22,82,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,272.85,85,,percent of total billed charges,,242.03,304.95,
OX CARBAZEPINE,25200660,CDM,80183,CPT,300,RC,inpatient,,387,387,,328.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.56,88,,percent of total billed charges,,,,,,,,,295.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,352.17,91,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,,,,,,,,,,,,,321.21,83,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,317.34,82,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,328.95,85,,percent of total billed charges,,291.8,367.65,
.OLIGOCLONAL BANDS CSF & SERUM,25200661,CDM,83916,CPT,300,RC,inpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,179.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,159.09,200.45,
OXYCODONE URINE CONFIRM,25200663,CDM,80365,CPT,300,RC,inpatient,,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,130.44,164.35,
ANTI-RNA POLYMERASE III,25200667,CDM,86235,CPT,300,RC,inpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,163.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,184.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,163.62,206.15,
ANTI-HMGCR,25200668,CDM,83516,CPT,300,RC,inpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,163.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,184.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,163.62,206.15,
VMA URINE (24-HOUR),25200675,CDM,84585,CPT,300,RC,inpatient,,278,278,,236.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,236.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.64,88,,percent of total billed charges,,,,,,,,,212.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.98,91,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,,,,,,,,,,,,,230.74,83,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,227.96,82,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,209.61,264.1,
PH BODY FLUIDS,25200682,CDM,83986,CPT,300,RC,inpatient,,79,79,,67.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.52,88,,percent of total billed charges,,,,,,,,,60.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,,,,,,,,,,,,,65.57,83,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,64.78,82,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,59.57,75.05,
PHOSPHORUS SERUM,25200683,CDM,84100,CPT,300,RC,inpatient,,116,116,,98.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,87.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,98.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,102.08,88,,percent of total billed charges,,,,,,,,,88.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,105.56,91,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,,,,,,,,,,,,,96.28,83,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,95.12,82,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,98.6,85,,percent of total billed charges,,87.46,110.2,
PHOSPHORUS URINE,25200684,CDM,84105,CPT,300,RC,inpatient,,79,79,,67.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.52,88,,percent of total billed charges,,,,,,,,,60.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,,,,,,,,,,,,,65.57,83,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,64.78,82,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,59.57,75.05,
WBC FLUID,25200685,CDM,,,300,RC,inpatient,,6,6,,5.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.28,88,,percent of total billed charges,,,,,,,,,4.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4.98,83,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,4.92,82,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,4.52,5.7,
".PHOSPHATIDYLSERINE (IGM,IGG,IGA)",25200686,CDM,86148,CPT,300,RC,inpatient,,282,282,,239.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,212.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,239.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,248.16,88,,percent of total billed charges,,,,,,,,,215.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,256.62,91,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,,,,,,,,,,,,,234.06,83,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,231.24,82,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,239.7,85,,percent of total billed charges,,212.63,267.9,
PHOSPHOLIPIDS,25200687,CDM,84311,CPT,300,RC,inpatient,,192,192,,163.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,163.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.96,88,,percent of total billed charges,,,,,,,,,146.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,,,,,,,,,,,,,159.36,83,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,157.44,82,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,144.77,182.4,
PENICILLIN V IGE,25200688,CDM,86003,CPT,300,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
PENICILLIN G,25200689,CDM,86003,CPT,300,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
PH STOOL,25200690,CDM,83986,CPT,300,RC,inpatient,,63,63,,53.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,53.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.44,88,,percent of total billed charges,,,,,,,,,48.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,,,,,,,,,,,,,52.29,83,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,51.66,82,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,47.5,59.85,
PINWORM EXAM,25200691,CDM,87172,CPT,300,RC,inpatient,,99,99,,84.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,74.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,84.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,87.12,88,,percent of total billed charges,,,,,,,,,75.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,,,,,,,,,,,,,82.17,83,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,81.18,82,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,74.65,94.05,
ELECTROLYTES STOOL,25200692,CDM,84302,CPT,300,RC,inpatient,,117,117,,99.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,88.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,99.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,102.96,88,,percent of total billed charges,,,,,,,,,89.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,106.47,91,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,,,,,,,,,,,,,97.11,83,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,95.94,82,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,99.45,85,,percent of total billed charges,,88.22,111.15,
.POTASSIUM  STOOL,25200693,CDM,84999,CPT,300,RC,inpatient,,117,117,,99.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,88.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,99.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,102.96,88,,percent of total billed charges,,,,,,,,,89.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,106.47,91,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,,,,,,,,,,,,,97.11,83,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,95.94,82,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,99.45,85,,percent of total billed charges,,88.22,111.15,
.CHLORIDE STOOL,25200694,CDM,82438,CPT,300,RC,inpatient,,117,117,,99.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,88.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,99.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,102.96,88,,percent of total billed charges,,,,,,,,,89.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,106.47,91,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,,,,,,,,,,,,,97.11,83,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,95.94,82,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,99.45,85,,percent of total billed charges,,88.22,111.15,
PENICILLIN V COO2 IGE,25200695,CDM,86003,CPT,300,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
PLATELET COUNT,25200709,CDM,85049,CPT,300,RC,inpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,77.66,97.85,
PLASMA HEMOGLOBIN,25200710,CDM,83051,CPT,300,RC,inpatient,,99,99,,84.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,74.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,84.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,87.12,88,,percent of total billed charges,,,,,,,,,75.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,,,,,,,,,,,,,82.17,83,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,81.18,82,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,74.65,94.05,
PLATELET FUNCTION TEST,25200711,CDM,85576,CPT,300,RC,inpatient,,164,164,,139.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,123.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,139.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,144.32,88,,percent of total billed charges,,,,,,,,,125.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,134.48,82,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,123.66,155.8,
POTASSIUM SERUM,25200725,CDM,84132,CPT,300,RC,inpatient,,100,100,,84.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88,88,,percent of total billed charges,,,,,,,,,76.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,83,83,,percent of total billed charges,,,,,,,,,,,,,,,83,83,,percent of total billed charges,,,95,95,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,82,82,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,75.4,95,
.URINE DIPSTICK ONLY,25200730,CDM,81003,CPT,300,RC,inpatient,,95,95,,80.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,83.6,88,,percent of total billed charges,,,,,,,,,72.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,,,,,,,,,,,,,78.85,83,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,77.9,82,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,71.63,90.25,
"X RHC HCG, URINE PREGNANCY TEST",25200731,CDM,81025,CPT,300,RC,inpatient,,168,168,,142.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,126.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,142.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,147.84,88,,percent of total billed charges,,,,,,,,,128.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,,,,,,,,,,,,,139.44,83,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,137.76,82,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,126.67,159.6,
HCG URINE PREGNANCY TEST,25200733,CDM,81025,CPT,300,RC,inpatient,,190,190,,161.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,143.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,161.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,167.2,88,,percent of total billed charges,,,,,,,,,145.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,,,,,,,,,,,,,157.7,83,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,155.8,82,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,143.26,180.5,
PREGNENOLONE,25200735,CDM,84140,CPT,300,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
.PRENATAL PROFILE (QUEST),25200741,CDM,80055,CPT,300,RC,inpatient,,400,400,,339.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,301.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,340,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,352,88,,percent of total billed charges,,,,,,,,,305.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,364,91,,percent of total billed charges,,,380,95,,percent of total billed charges,,,332,83,,percent of total billed charges,,,332,83,,percent of total billed charges,,,,,,,,,,,,,,,332,83,,percent of total billed charges,,,380,95,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,328,82,,percent of total billed charges,,,360,90,,percent of total billed charges,,,340,85,,percent of total billed charges,,301.6,380,
.PRENATAL PROFILE,25200742,CDM,80055,CPT,300,RC,inpatient,,400,400,,339.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,301.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,340,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,352,88,,percent of total billed charges,,,,,,,,,305.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,364,91,,percent of total billed charges,,,380,95,,percent of total billed charges,,,332,83,,percent of total billed charges,,,332,83,,percent of total billed charges,,,,,,,,,,,,,,,332,83,,percent of total billed charges,,,380,95,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,328,82,,percent of total billed charges,,,360,90,,percent of total billed charges,,,340,85,,percent of total billed charges,,301.6,380,
PROTEIN TOTAL SERUM,25200758,CDM,84155,CPT,300,RC,inpatient,,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
PROTHROMBIN TIME w/INR,25200766,CDM,85610,CPT,300,RC,inpatient,,174,174,,147.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,131.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,153.12,88,,percent of total billed charges,,,,,,,,,132.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,158.34,91,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,,,,,,,,,,,,,144.42,83,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,142.68,82,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,131.2,165.3,
DRAGU PT w/INR,25200767,CDM,85610,CPT,300,RC,inpatient,,174,174,,147.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,131.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,153.12,88,,percent of total billed charges,,,,,,,,,132.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,158.34,91,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,,,,,,,,,,,,,144.42,83,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,142.68,82,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,131.2,165.3,
PARTIAL THROMBOPLASTIN TIME (PTT),25200774,CDM,85730,CPT,300,RC,inpatient,,187,187,,158.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,158.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,164.56,88,,percent of total billed charges,,,,,,,,,142.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,153.34,82,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,141,177.65,
TISSUE THROMBOPLASTIN INHIBITION,25200775,CDM,85705,CPT,300,RC,inpatient,,272,272,,230.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,205.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,231.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,239.36,88,,percent of total billed charges,,,,,,,,,207.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,247.52,91,,percent of total billed charges,,,258.4,95,,percent of total billed charges,,,225.76,83,,percent of total billed charges,,,225.76,83,,percent of total billed charges,,,,,,,,,,,,,,,225.76,83,,percent of total billed charges,,,258.4,95,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,223.04,82,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,231.2,85,,percent of total billed charges,,205.09,258.4,
REPTILASE,25200776,CDM,85635,CPT,300,RC,inpatient,,244,244,,207.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,183.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,207.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,214.72,88,,percent of total billed charges,,,,,,,,,186.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,222.04,91,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,,,,,,,,,,,,,202.52,83,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,200.08,82,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,183.98,231.8,
DRAGU PTT,25200777,CDM,85730,CPT,300,RC,inpatient,,187,187,,158.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,158.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,164.56,88,,percent of total billed charges,,,,,,,,,142.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,153.34,82,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,141,177.65,
QUINIDINE,25200782,CDM,80194,CPT,300,RC,inpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,198.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,198.3,249.85,
QUETIAPINE (SEROQUEL),25200783,CDM,80299,CPT,300,RC,inpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,347.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,391.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,347.59,437.95,
SERTRALINE & DESMETHYLSERTRALINE,25200784,CDM,80332,CPT,300,RC,inpatient,,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,191.84,88,,percent of total billed charges,,,,,,,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,164.37,207.1,
.....QUANTIFERON TB GOLD (LAB INCUBATED),25200785,CDM,86480,CPT,300,RC,inpatient,,424,424,,359.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,319.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,360.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,373.12,88,,percent of total billed charges,,,,,,,,,323.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,385.84,91,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,,,,,,,,,,,,,351.92,83,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,347.68,82,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,319.7,402.8,
..QUANTIFERON TB  +(LAB INCUBATED),25200786,CDM,86480,CPT,300,RC,inpatient,,424,424,,359.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,319.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,360.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,373.12,88,,percent of total billed charges,,,,,,,,,323.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,385.84,91,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,,,,,,,,,,,,,351.92,83,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,347.68,82,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,319.7,402.8,
QUANTIFERON TB GOLD +  (LABCORP INCUB),25200787,CDM,86480,CPT,300,RC,inpatient,,424,424,,359.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,319.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,360.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,373.12,88,,percent of total billed charges,,,,,,,,,323.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,385.84,91,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,,,,,,,,,,,,,351.92,83,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,347.68,82,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,319.7,402.8,
Q FEVER ANTIBODIES,25200788,CDM,86638,CPT,300,RC,inpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,198.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,198.3,249.85,
PNEUMOCYSTIS CARINNI STAIN,25200789,CDM,86638,CPT,300,RC,inpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,198.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,198.3,249.85,
RHEUMATOID FACTOR,25200790,CDM,86430,CPT,300,RC,inpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,89.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,79.17,99.75,
RHEUMATOID FACTOR (IGA),25200791,CDM,86431,CPT,300,RC,inpatient,,95,95,,80.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,83.6,88,,percent of total billed charges,,,,,,,,,72.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,,,,,,,,,,,,,78.85,83,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,77.9,82,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,71.63,90.25,
RHEUMATOID FACTOR (IGG),25200792,CDM,86431,CPT,300,RC,inpatient,,95,95,,80.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,83.6,88,,percent of total billed charges,,,,,,,,,72.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,,,,,,,,,,,,,78.85,83,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,77.9,82,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,71.63,90.25,
RHEUMATOID FACTOR  FLUID,25200795,CDM,86430,CPT,300,RC,inpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,81.43,102.6,
RED BLOOD CELL COUNT,25200808,CDM,85041,CPT,300,RC,inpatient,,54,54,,45.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47.52,88,,percent of total billed charges,,,,,,,,,41.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.14,91,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,,,,,,,,,,,,,44.82,83,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,44.28,82,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,40.72,51.3,
RESPIRATORY PANEL(BIOFIRE),25200809,CDM,0202U,CPT,300,RC,inpatient,,1085,1085,,921.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,818.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,922.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,954.8,88,,percent of total billed charges,,,,,,,,,828.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,987.35,91,,percent of total billed charges,,,1030.75,95,,percent of total billed charges,,,900.55,83,,percent of total billed charges,,,900.55,83,,percent of total billed charges,,,,,,,,,,,,,,,900.55,83,,percent of total billed charges,,,1030.75,95,,percent of total billed charges,,,976.5,90,,percent of total billed charges,,,976.5,90,,percent of total billed charges,,,889.7,82,,percent of total billed charges,,,976.5,90,,percent of total billed charges,,,922.25,85,,percent of total billed charges,,818.09,1030.75,
#NAME?,25200810,CDM,87798,CPT,300,RC,inpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,65.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,65.6,82.65,
#NAME?,25200811,CDM,87486,CPT,300,RC,inpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,65.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,65.6,82.65,
#NAME?,25200812,CDM,87581,CPT,300,RC,inpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,65.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,65.6,82.65,
TEACHER (BIOFIRE),25200813,CDM,0202U,CPT,300,RC,inpatient,,1589,1589,,1349.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1198.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1350.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1398.32,88,,percent of total billed charges,,,,,,,,,1214,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1445.99,91,,percent of total billed charges,,,1509.55,95,,percent of total billed charges,,,1318.87,83,,percent of total billed charges,,,1318.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1318.87,83,,percent of total billed charges,,,1509.55,95,,percent of total billed charges,,,1430.1,90,,percent of total billed charges,,,1430.1,90,,percent of total billed charges,,,1302.98,82,,percent of total billed charges,,,1430.1,90,,percent of total billed charges,,,1350.65,85,,percent of total billed charges,,1198.11,1509.55,
"COMPLEMENT, TOTAL (CH-50)",25200815,CDM,86162,CPT,300,RC,inpatient,,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,230.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,260.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,230.72,290.7,
COMPLEMENT (C1),25200816,CDM,86160,CPT,300,RC,inpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,345.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,306.12,385.7,
#NAME?,25200817,CDM,87798,CPT,300,RC,inpatient,,60,60,,50.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,45.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.8,88,,percent of total billed charges,,,,,,,,,45.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,,,,,,,,,,,,,49.8,83,,percent of total billed charges,,,57,95,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,49.2,82,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,45.24,57,
FECAL ELASTASE,25200820,CDM,82656,CPT,300,RC,inpatient,,511,511,,433.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,385.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,434.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,449.68,88,,percent of total billed charges,,,,,,,,,390.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,465.01,91,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,,,,,,,,,,,,,424.13,83,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,419.02,82,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,385.29,485.45,
FECAL CHYMOTRYPSIN,25200821,CDM,84490,CPT,300,RC,inpatient,,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,115.36,145.35,
FECAL FAT QUANT,25200824,CDM,82710,CPT,300,RC,inpatient,,244,244,,207.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,183.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,207.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,214.72,88,,percent of total billed charges,,,,,,,,,186.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,222.04,91,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,,,,,,,,,,,,,202.52,83,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,200.08,82,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,183.98,231.8,
FECAL FAT QUAL,25200825,CDM,82705,CPT,300,RC,inpatient,,244,244,,207.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,183.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,207.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,214.72,88,,percent of total billed charges,,,,,,,,,186.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,222.04,91,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,,,,,,,,,,,,,202.52,83,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,200.08,82,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,183.98,231.8,
RETICULOCYTE COUNT,25200832,CDM,85045,CPT,300,RC,inpatient,,128,128,,108.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,96.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,108.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,112.64,88,,percent of total billed charges,,,,,,,,,97.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,116.48,91,,percent of total billed charges,,,121.6,95,,percent of total billed charges,,,106.24,83,,percent of total billed charges,,,106.24,83,,percent of total billed charges,,,,,,,,,,,,,,,106.24,83,,percent of total billed charges,,,121.6,95,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,104.96,82,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,108.8,85,,percent of total billed charges,,96.51,121.6,
.RICKETTSIA ANTIBODY PANEL,25200833,CDM,86757,CPT,300,RC,inpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,76.91,96.9,
LIPASE,25200840,CDM,83690,CPT,300,RC,inpatient,,186,186,,157.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,140.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,158.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,163.68,88,,percent of total billed charges,,,,,,,,,142.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,169.26,91,,percent of total billed charges,,,176.7,95,,percent of total billed charges,,,154.38,83,,percent of total billed charges,,,154.38,83,,percent of total billed charges,,,,,,,,,,,,,,,154.38,83,,percent of total billed charges,,,176.7,95,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,152.52,82,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,158.1,85,,percent of total billed charges,,140.24,176.7,
RHOGAM (INJECTION ONLY),25200857,CDM,J2790,HCPCS,636,RC,inpatient,,795,795,,674.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,599.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,675.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,699.6,88,,percent of total billed charges,,80.41,,,,fee schedule,,,607.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,80.41,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,723.45,91,,percent of total billed charges,,,755.25,95,,percent of total billed charges,,,659.85,83,,percent of total billed charges,,,659.85,83,,percent of total billed charges,,,,,,,,,,,,,,,659.85,83,,percent of total billed charges,,,755.25,95,,percent of total billed charges,,,715.5,90,,percent of total billed charges,,,715.5,90,,percent of total billed charges,,,651.9,82,,percent of total billed charges,,,715.5,90,,percent of total billed charges,,,675.75,85,,percent of total billed charges,,80.41,755.25,
RPR REFLEX TO TREP. PALLIDUM,25200864,CDM,86592,CPT,300,RC,inpatient,,135,135,,114.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,101.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,114.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,118.8,88,,percent of total billed charges,,,,,,,,,103.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,,,,,,,,,,,,,112.05,83,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,110.7,82,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,101.79,128.25,
RPR,25200865,CDM,86592,CPT,300,RC,inpatient,,135,135,,114.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,101.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,114.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,118.8,88,,percent of total billed charges,,,,,,,,,103.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,,,,,,,,,,,,,112.05,83,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,110.7,82,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,101.79,128.25,
RISPERDAL,25200866,CDM,80299,CPT,300,RC,inpatient,,538,538,,456.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,405.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,457.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,473.44,88,,percent of total billed charges,,,,,,,,,411.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,489.58,91,,percent of total billed charges,,,511.1,95,,percent of total billed charges,,,446.54,83,,percent of total billed charges,,,446.54,83,,percent of total billed charges,,,,,,,,,,,,,,,446.54,83,,percent of total billed charges,,,511.1,95,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,441.16,82,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,457.3,85,,percent of total billed charges,,405.65,511.1,
TREPONEMA PALLIDUM AB,25200868,CDM,86780,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
TREPONEMA PALLIDUM CASCADE,25200869,CDM,86780,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
RUBELLA ANTIBODY (IgG),25200873,CDM,86762,CPT,300,RC,inpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,135.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,119.89,151.05,
REDUCING SUBSTANCES STOOL,25200874,CDM,84376,CPT,300,RC,inpatient,,82,82,,69.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,69.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,72.16,88,,percent of total billed charges,,,,,,,,,62.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,74.62,91,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,,,,,,,,,,,,,68.06,83,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,67.24,82,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,61.83,77.9,
MTHFR,25200875,CDM,81291,CPT,300,RC,inpatient,,632,632,,536.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,476.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,537.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,556.16,88,,percent of total billed charges,,,,,,,,,482.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,575.12,91,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,,,,,,,,,,,,,524.56,83,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,518.24,82,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,537.2,85,,percent of total billed charges,,476.53,600.4,
RUBELLA ANTIBODY IgM,25200876,CDM,86762,CPT,300,RC,inpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,135.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,119.89,151.05,
SED RATE,25200881,CDM,85652,CPT,300,RC,inpatient,,127,127,,107.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,111.76,88,,percent of total billed charges,,,,,,,,,97.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,,,,,,,,,,,,,105.41,83,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,104.14,82,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,95.76,120.65,
SCLERODERMA ANTIBODIES (SCL-70),25200882,CDM,86235,CPT,300,RC,inpatient,,319,319,,270.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,240.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,271.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,280.72,88,,percent of total billed charges,,,,,,,,,243.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,290.29,91,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,,,,,,,,,,,,,264.77,83,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,261.58,82,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,271.15,85,,percent of total billed charges,,240.53,303.05,
SCABIES ID,25200883,CDM,87169,CPT,300,RC,inpatient,,97,97,,82.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,73.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,82.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,85.36,88,,percent of total billed charges,,,,,,,,,74.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,,,,,,,,,,,,,80.51,83,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,79.54,82,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,73.14,92.15,
".CULTURE, CHLAMYDIA",25200899,CDM,87110,CPT,300,RC,inpatient,,301,301,,255.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264.88,88,,percent of total billed charges,,,,,,,,,229.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273.91,91,,percent of total billed charges,,,285.95,95,,percent of total billed charges,,,249.83,83,,percent of total billed charges,,,249.83,83,,percent of total billed charges,,,,,,,,,,,,,,,249.83,83,,percent of total billed charges,,,285.95,95,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,246.82,82,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,255.85,85,,percent of total billed charges,,226.95,285.95,
"..  CULTURE, CHLAMYDIA",25200900,CDM,87110,CPT,300,RC,inpatient,,311,311,,264.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,234.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,264.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,273.68,88,,percent of total billed charges,,,,,,,,,237.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,283.01,91,,percent of total billed charges,,,295.45,95,,percent of total billed charges,,,258.13,83,,percent of total billed charges,,,258.13,83,,percent of total billed charges,,,,,,,,,,,,,,,258.13,83,,percent of total billed charges,,,295.45,95,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,255.02,82,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,264.35,85,,percent of total billed charges,,234.49,295.45,
CULTURE CHLAMYDIA,25200901,CDM,87110,CPT,300,RC,inpatient,,311,311,,264.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,234.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,264.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,273.68,88,,percent of total billed charges,,,,,,,,,237.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,283.01,91,,percent of total billed charges,,,295.45,95,,percent of total billed charges,,,258.13,83,,percent of total billed charges,,,258.13,83,,percent of total billed charges,,,,,,,,,,,,,,,258.13,83,,percent of total billed charges,,,295.45,95,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,255.02,82,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,264.35,85,,percent of total billed charges,,234.49,295.45,
AST,25200907,CDM,84450,CPT,300,RC,inpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,120.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,120.64,152,
CALPROTECTIN STOOL,25200909,CDM,83993,CPT,300,RC,inpatient,,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,269.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,303.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,269.18,339.15,
CALRETICULIN (CLAR) MUTATION,25200910,CDM,81219,CPT,300,RC,inpatient,,732,732,,621.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,551.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,622.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,644.16,88,,percent of total billed charges,,,,,,,,,559.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,666.12,91,,percent of total billed charges,,,695.4,95,,percent of total billed charges,,,607.56,83,,percent of total billed charges,,,607.56,83,,percent of total billed charges,,,,,,,,,,,,,,,607.56,83,,percent of total billed charges,,,695.4,95,,percent of total billed charges,,,658.8,90,,percent of total billed charges,,,658.8,90,,percent of total billed charges,,,600.24,82,,percent of total billed charges,,,658.8,90,,percent of total billed charges,,,622.2,85,,percent of total billed charges,,551.93,695.4,
ALT,25200915,CDM,84460,CPT,300,RC,inpatient,,162,162,,137.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,122.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,137.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,142.56,88,,percent of total billed charges,,,,,,,,,123.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,,,,,,,,,,,,,134.46,83,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,132.84,82,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,122.15,153.9,
"CELL COUNT w/diff, CSF",25200923,CDM,89051,CPT,300,RC,inpatient,,148,148,,125.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,111.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,125.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,130.24,88,,percent of total billed charges,,,,,,,,,113.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,,,,,,,,,,,,,122.84,83,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,121.36,82,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,111.59,140.6,
SERZONE (NEFAZODONE),25200924,CDM,80299,CPT,300,RC,inpatient,,495,495,,420.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,373.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,420.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,435.6,88,,percent of total billed charges,,,,,,,,,378.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,450.45,91,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,,,,,,,,,,,,,410.85,83,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,405.9,82,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,373.23,470.25,
"SODIUM, SERUM",25200931,CDM,84295,CPT,300,RC,inpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,77.66,97.85,
SELENIUM,25200933,CDM,84255,CPT,300,RC,inpatient,,385,385,,326.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,290.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,327.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,338.8,88,,percent of total billed charges,,,,,,,,,294.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,350.35,91,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,,,,,,,,,,,,,319.55,83,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,315.7,82,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,290.29,365.75,
SELENIUM (URINE),25200934,CDM,84255,CPT,300,RC,inpatient,,385,385,,326.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,290.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,327.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,338.8,88,,percent of total billed charges,,,,,,,,,294.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,350.35,91,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,,,,,,,,,,,,,319.55,83,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,315.7,82,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,290.29,365.75,
SHELL VIAL DFA,25200935,CDM,87254,CPT,300,RC,inpatient,,99,99,,84.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,74.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,84.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,87.12,88,,percent of total billed charges,,,,,,,,,75.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,,,,,,,,,,,,,82.17,83,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,81.18,82,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,74.65,94.05,
SEX HORMONE BINDING GLOBULIN,25200940,CDM,84270,CPT,300,RC,inpatient,,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,332.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,294.81,371.45,
.FAI,25200942,CDM,84270,CPT,300,RC,inpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,171.16,215.65,
.FAI 2,25200943,CDM,84403,CPT,300,RC,inpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,171.16,215.65,
SOLUBLE TRANSFERRIN RECPTOR,25200950,CDM,84238,CPT,300,RC,inpatient,,578,578,,490.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,435.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,491.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,508.64,88,,percent of total billed charges,,,,,,,,,441.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,525.98,91,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,,,,,,,,,,,,,479.74,83,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,473.96,82,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,491.3,85,,percent of total billed charges,,435.81,549.1,
SOLUBLE LIVER AG,25200951,CDM,83516,CPT,300,RC,inpatient,,471,471,,399.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,355.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,400.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,414.48,88,,percent of total billed charges,,,,,,,,,359.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,428.61,91,,percent of total billed charges,,,447.45,95,,percent of total billed charges,,,390.93,83,,percent of total billed charges,,,390.93,83,,percent of total billed charges,,,,,,,,,,,,,,,390.93,83,,percent of total billed charges,,,447.45,95,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,386.22,82,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,400.35,85,,percent of total billed charges,,355.13,447.45,
"SPERM COUNT, POST VAS",25200956,CDM,89321,CPT,300,RC,inpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
T-3 REVERSE,25200963,CDM,84482,CPT,300,RC,inpatient,,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,230.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,260.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,230.72,290.7,
T-3 TOTAL,25200964,CDM,84480,CPT,300,RC,inpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,223.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,252.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,223.94,282.15,
"T-4, TOTAL",25200972,CDM,84436,CPT,300,RC,inpatient,,190,190,,161.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,143.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,161.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,167.2,88,,percent of total billed charges,,,,,,,,,145.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,,,,,,,,,,,,,157.7,83,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,155.8,82,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,143.26,180.5,
THEOPHYLLINE,25200980,CDM,80198,CPT,300,RC,inpatient,,254,254,,215.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,191.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,223.52,88,,percent of total billed charges,,,,,,,,,194.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,231.14,91,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,,,,,,,,,,,,,210.82,83,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,208.28,82,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,191.52,241.3,
CBC w/o DIFF,25200992,CDM,85027,CPT,300,RC,inpatient,,161,161,,136.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,121.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,141.68,88,,percent of total billed charges,,,,,,,,,123,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,132.02,82,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,121.39,152.95,
".PAP SMEAR, CONVENTIONAL (88147)",25200999,CDM,88147,CPT,311,RC,inpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,77.66,97.85,
HEPATITIS B CORE  TOTAL  AB,25201004,CDM,86704,CPT,300,RC,inpatient,,244,244,,207.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,183.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,207.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,214.72,88,,percent of total billed charges,,,,,,,,,186.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,222.04,91,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,,,,,,,,,,,,,202.52,83,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,200.08,82,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,183.98,231.8,
"COLLAGEN X-LINKED N-TELOPEPTIDE, URINE",25201005,CDM,82523,CPT,300,RC,inpatient,,339,339,,287.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,255.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,288.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,298.32,88,,percent of total billed charges,,,,,,,,,259,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,308.49,91,,percent of total billed charges,,,322.05,95,,percent of total billed charges,,,281.37,83,,percent of total billed charges,,,281.37,83,,percent of total billed charges,,,,,,,,,,,,,,,281.37,83,,percent of total billed charges,,,322.05,95,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,277.98,82,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,288.15,85,,percent of total billed charges,,255.61,322.05,
"HEPATITIS B VIRAL DNA, PCR",25201006,CDM,87517,CPT,300,RC,inpatient,,643,643,,545.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,484.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,546.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,565.84,88,,percent of total billed charges,,,,,,,,,491.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,585.13,91,,percent of total billed charges,,,610.85,95,,percent of total billed charges,,,533.69,83,,percent of total billed charges,,,533.69,83,,percent of total billed charges,,,,,,,,,,,,,,,533.69,83,,percent of total billed charges,,,610.85,95,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,527.26,82,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,546.55,85,,percent of total billed charges,,484.82,610.85,
"COLLAGEN X-LINKED N-TELOPEPTIDE, SERUM",25201007,CDM,82523,CPT,300,RC,inpatient,,288,288,,244.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,244.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,253.44,88,,percent of total billed charges,,,,,,,,,220.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.08,91,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,,,,,,,,,,,,,239.04,83,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,236.16,82,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,244.8,85,,percent of total billed charges,,217.15,273.6,
"HEPATITIS B CORE AB, IGM",25201010,CDM,86705,CPT,300,RC,inpatient,,101,101,,85.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88.88,88,,percent of total billed charges,,,,,,,,,77.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,82.82,82,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,76.15,95.95,
LC-1,25201011,CDM,86705,CPT,300,RC,inpatient,,317,317,,269.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,239.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,269.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,278.96,88,,percent of total billed charges,,,,,,,,,242.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,288.47,91,,percent of total billed charges,,,301.15,95,,percent of total billed charges,,,263.11,83,,percent of total billed charges,,,263.11,83,,percent of total billed charges,,,,,,,,,,,,,,,263.11,83,,percent of total billed charges,,,301.15,95,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,259.94,82,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,269.45,85,,percent of total billed charges,,239.02,301.15,
"HEPATITIS E  AB, IGM/IGG",25201012,CDM,86790,CPT,300,RC,inpatient,,490,490,,416.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,369.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,416.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,431.2,88,,percent of total billed charges,,,,,,,,,374.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,445.9,91,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,,,,,,,,,,,,,406.7,83,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,401.8,82,,percent of total billed charges,,,441,90,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,369.46,465.5,
VENLAFAXINE (EFIXER),25201013,CDM,80299,CPT,300,RC,inpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,464.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,523.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,464.46,585.2,
TRIGLYCERIDES,25201020,CDM,84478,CPT,300,RC,inpatient,,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,114.61,144.4,
TRIGLYCERIDES FLUID,25201021,CDM,84478,CPT,300,RC,inpatient,,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,110.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,98.02,123.5,
URIC ACID SERUM,25201038,CDM,84550,CPT,300,RC,inpatient,,119,119,,101.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,89.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,101.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,104.72,88,,percent of total billed charges,,,,,,,,,90.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,108.29,91,,percent of total billed charges,,,113.05,95,,percent of total billed charges,,,98.77,83,,percent of total billed charges,,,98.77,83,,percent of total billed charges,,,,,,,,,,,,,,,98.77,83,,percent of total billed charges,,,113.05,95,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,97.58,82,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,101.15,85,,percent of total billed charges,,89.73,113.05,
.SYNOVIAL ALPHA DEFENSINS,25201041,CDM,83516,CPT,300,RC,inpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,345.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,306.12,385.7,
.SYNOVIAL CRP,25201042,CDM,86140,CPT,300,RC,inpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
.SYNOVIAL HEMOGLOBIN,25201043,CDM,84311,CPT,300,RC,inpatient,,56,56,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.28,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,45.92,82,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,42.22,53.2,
URINALYSIS w/MICROSCOPIC,25201046,CDM,81001,CPT,300,RC,inpatient,,162,162,,137.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,122.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,137.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,142.56,88,,percent of total billed charges,,,,,,,,,123.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,,,,,,,,,,,,,134.46,83,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,132.84,82,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,122.15,153.9,
SYNOVIAL FLUID DIPSTICK,25201047,CDM,81003,CPT,300,RC,inpatient,,97,97,,82.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,73.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,82.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,85.36,88,,percent of total billed charges,,,,,,,,,74.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,,,,,,,,,,,,,80.51,83,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,79.54,82,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,73.14,92.15,
DIPSTICK UA MANUAL READ ONLY,25201048,CDM,81002,CPT,300,RC,inpatient,TC,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,37.7,47.5,
URINALYSIS W/O MICROSCOPIC,25201050,CDM,81003,CPT,300,RC,inpatient,,127,127,,107.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,111.76,88,,percent of total billed charges,,,,,,,,,97.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,,,,,,,,,,,,,105.41,83,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,104.14,82,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,95.76,120.65,
WHITE BLOOD CELL COUNT (WBC),25201053,CDM,85048,CPT,300,RC,inpatient,,65,65,,55.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.2,88,,percent of total billed charges,,,,,,,,,49.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.15,91,,percent of total billed charges,,,61.75,95,,percent of total billed charges,,,53.95,83,,percent of total billed charges,,,53.95,83,,percent of total billed charges,,,,,,,,,,,,,,,53.95,83,,percent of total billed charges,,,61.75,95,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,53.3,82,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,55.25,85,,percent of total billed charges,,49.01,61.75,
METANEPHRINES URINE RANDOM,25201060,CDM,83835,CPT,300,RC,inpatient,,541,541,,459.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,407.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,459.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,476.08,88,,percent of total billed charges,,,,,,,,,413.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,492.31,91,,percent of total billed charges,,,513.95,95,,percent of total billed charges,,,449.03,83,,percent of total billed charges,,,449.03,83,,percent of total billed charges,,,,,,,,,,,,,,,449.03,83,,percent of total billed charges,,,513.95,95,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,443.62,82,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,459.85,85,,percent of total billed charges,,407.91,513.95,
METANEPHRINES URINE (24-HOUR),25201061,CDM,83835,CPT,300,RC,inpatient,,379,379,,321.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,285.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,322.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,333.52,88,,percent of total billed charges,,,,,,,,,289.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,344.89,91,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,,,,,,,,,,,,,314.57,83,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,310.78,82,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,285.77,360.05,
IONIZED CALCIUM,25201079,CDM,82330,CPT,300,RC,inpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,155.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,155.32,195.7,
MDMA URINE CONFIRMATION,25201080,CDM,80307,CPT,300,RC,inpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,171.16,215.65,
MAGNESIUM RBC,25201085,CDM,83735,CPT,300,RC,inpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,77.66,97.85,
MANGANESE,25201086,CDM,83785,CPT,300,RC,inpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,171.16,215.65,
ESTROGEN,25201087,CDM,82672,CPT,300,RC,inpatient,,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,294.06,370.5,
ESTRADIOL (PEDIATRICS) ULT SENS,25201094,CDM,82670,CPT,300,RC,inpatient,,578,578,,490.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,435.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,491.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,508.64,88,,percent of total billed charges,,,,,,,,,441.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,525.98,91,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,,,,,,,,,,,,,479.74,83,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,473.96,82,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,491.3,85,,percent of total billed charges,,435.81,549.1,
ESTRADIOL,25201095,CDM,82670,CPT,300,RC,inpatient,,360,360,,305.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,271.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,306,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,316.8,88,,percent of total billed charges,,,,,,,,,275.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,327.6,91,,percent of total billed charges,,,342,95,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,,,,,,,,,,,,,298.8,83,,percent of total billed charges,,,342,95,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,295.2,82,,percent of total billed charges,,,324,90,,percent of total billed charges,,,306,85,,percent of total billed charges,,271.44,342,
LAMOTRIGINE,25201096,CDM,80175,CPT,300,RC,inpatient,,530,530,,449.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466.4,88,,percent of total billed charges,,,,,,,,,404.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,,,,,,,,,,,,,439.9,83,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,434.6,82,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,399.62,503.5,
BRIVARACETAM,25201097,CDM,80375,CPT,300,RC,inpatient,,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,179.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,202.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,179.45,226.1,
LACOSAMIDE (VIMPAT),25201098,CDM,80235,CPT,300,RC,inpatient,,243,243,,206.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,183.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,206.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,213.84,88,,percent of total billed charges,,,,,,,,,185.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,221.13,91,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,,,,,,,,,,,,,201.69,83,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,199.26,82,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,206.55,85,,percent of total billed charges,,183.22,230.85,
LACTOFERRIN FECAL QT,25201099,CDM,83631,CPT,300,RC,inpatient,,277,277,,235.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,208.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,235.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,243.76,88,,percent of total billed charges,,,,,,,,,211.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.07,91,,percent of total billed charges,,,263.15,95,,percent of total billed charges,,,229.91,83,,percent of total billed charges,,,229.91,83,,percent of total billed charges,,,,,,,,,,,,,,,229.91,83,,percent of total billed charges,,,263.15,95,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,227.14,82,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,235.45,85,,percent of total billed charges,,208.86,263.15,
DNASE-B ANTIBODY,25201100,CDM,86215,CPT,300,RC,inpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,149.29,188.1,
CATECHOLAMINES URINE (24-HOUR),25201103,CDM,82384,CPT,300,RC,inpatient,,458,458,,388.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,345.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,389.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,403.04,88,,percent of total billed charges,,,,,,,,,349.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,416.78,91,,percent of total billed charges,,,435.1,95,,percent of total billed charges,,,380.14,83,,percent of total billed charges,,,380.14,83,,percent of total billed charges,,,,,,,,,,,,,,,380.14,83,,percent of total billed charges,,,435.1,95,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,375.56,82,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,389.3,85,,percent of total billed charges,,345.33,435.1,
BLASTOMYCES ANTIBODY,25201110,CDM,86612,CPT,300,RC,inpatient,,63,63,,53.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,53.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.44,88,,percent of total billed charges,,,,,,,,,48.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,,,,,,,,,,,,,52.29,83,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,51.66,82,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,47.5,59.85,
BLASTOMYCES AG (URINE),25201111,CDM,86612,CPT,300,RC,inpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
ASPERGILLUS ANTIBODY,25201120,CDM,86606,CPT,300,RC,inpatient,,34,34,,28.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.92,88,,percent of total billed charges,,,,,,,,,25.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,,,,,,,,,,,,,28.22,83,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,27.88,82,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,25.64,32.3,
HYPERSENS PNEUMONITIS,25201122,CDM,86331,CPT,300,RC,inpatient,,140,140,,118.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,105.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,119,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,123.2,88,,percent of total billed charges,,,,,,,,,106.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,133,95,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,114.8,82,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,105.56,133,
ASPERGILLUS ANTIGEN,25201123,CDM,87305,CPT,300,RC,inpatient,,335,335,,284.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,252.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,284.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,294.8,88,,percent of total billed charges,,,,,,,,,255.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,304.85,91,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,,,,,,,,,,,,,278.05,83,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,274.7,82,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,252.59,318.25,
5-HIAA 24-HOUR URINE,25201129,CDM,83497,CPT,300,RC,inpatient,,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,203.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,180.21,227.05,
"5-HIAA, RANDOM URINE",25201130,CDM,83497,CPT,300,RC,inpatient,,265,265,,224.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,199.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,225.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,233.2,88,,percent of total billed charges,,,,,,,,,202.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,241.15,91,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,,,,,,,,,,,,,219.95,83,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,217.3,82,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,199.81,251.75,
PHOSPHOLIPASE A2 RECEPTOR IGG,25201132,CDM,83516,CPT,300,RC,inpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,226.2,285,
.EPIDERMAL ANTIBODY,25201136,CDM,86255,CPT,300,RC,inpatient,,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,376.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,424.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,376.25,474.05,
ERYTHROPOIETIN,25201137,CDM,82668,CPT,300,RC,inpatient,,436,436,,370.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,328.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,370.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,383.68,88,,percent of total billed charges,,,,,,,,,333.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,396.76,91,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,,,,,,,,,,,,,361.88,83,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,357.52,82,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,328.74,414.2,
BB PLATELET PHERESIS,25201145,CDM,P9035,HCPCS,390,RC,inpatient,,3193,3193,,2710.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2407.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2714.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2809.84,88,,percent of total billed charges,,,,,,,,,2439.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2905.63,91,,percent of total billed charges,,,3033.35,95,,percent of total billed charges,,,2650.19,83,,percent of total billed charges,,,2650.19,83,,percent of total billed charges,,,,,,,,,,,,,,,2650.19,83,,percent of total billed charges,,,3033.35,95,,percent of total billed charges,,,2873.7,90,,percent of total billed charges,,,2873.7,90,,percent of total billed charges,,,2618.26,82,,percent of total billed charges,,,2873.7,90,,percent of total billed charges,,,2714.05,85,,percent of total billed charges,,2407.52,3033.35,
"CHLAMYDIA, DNA (SWAB)",25201160,CDM,87491,CPT,300,RC,inpatient,,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,332.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,294.81,371.45,
".CANDIDA ANTIBODIES(IGG,IGM,IGA)",25201161,CDM,86628,CPT,300,RC,inpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,41.47,52.25,
CANDIDA  ANTIBODIES QUAL.,25201162,CDM,86628,CPT,300,RC,inpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,58.81,74.1,
TICLID LEVEL (TICLOPIDINE),25201179,CDM,80299,CPT,300,RC,inpatient,,508,508,,431.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,383.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,431.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,447.04,88,,percent of total billed charges,,,,,,,,,388.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,462.28,91,,percent of total billed charges,,,482.6,95,,percent of total billed charges,,,421.64,83,,percent of total billed charges,,,421.64,83,,percent of total billed charges,,,,,,,,,,,,,,,421.64,83,,percent of total billed charges,,,482.6,95,,percent of total billed charges,,,457.2,90,,percent of total billed charges,,,457.2,90,,percent of total billed charges,,,416.56,82,,percent of total billed charges,,,457.2,90,,percent of total billed charges,,,431.8,85,,percent of total billed charges,,383.03,482.6,
VANCOMYCIN RANDOM,25201201,CDM,80202,CPT,300,RC,inpatient,,380,380,,322.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,286.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,323,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,334.4,88,,percent of total billed charges,,,,,,,,,290.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,345.8,91,,percent of total billed charges,,,361,95,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,,,,,,,,,,,,,315.4,83,,percent of total billed charges,,,361,95,,percent of total billed charges,,,342,90,,percent of total billed charges,,,342,90,,percent of total billed charges,,,311.6,82,,percent of total billed charges,,,342,90,,percent of total billed charges,,,323,85,,percent of total billed charges,,286.52,361,
VANCOMYCIN PEAK,25201202,CDM,80202,CPT,300,RC,inpatient,,380,380,,322.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,286.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,323,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,334.4,88,,percent of total billed charges,,,,,,,,,290.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,345.8,91,,percent of total billed charges,,,361,95,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,,,,,,,,,,,,,315.4,83,,percent of total billed charges,,,361,95,,percent of total billed charges,,,342,90,,percent of total billed charges,,,342,90,,percent of total billed charges,,,311.6,82,,percent of total billed charges,,,342,90,,percent of total billed charges,,,323,85,,percent of total billed charges,,286.52,361,
LYME DISEASE AB/REFLEX,25201210,CDM,86618,CPT,300,RC,inpatient,,345,345,,292.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,260.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,293.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,303.6,88,,percent of total billed charges,,,,,,,,,263.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,313.95,91,,percent of total billed charges,,,327.75,95,,percent of total billed charges,,,286.35,83,,percent of total billed charges,,,286.35,83,,percent of total billed charges,,,,,,,,,,,,,,,286.35,83,,percent of total billed charges,,,327.75,95,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,282.9,82,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,293.25,85,,percent of total billed charges,,260.13,327.75,
LYME DISEASE DNA QUAL PCR,25201215,CDM,87801,CPT,300,RC,inpatient,,1053,1053,,894,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,793.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,895.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,926.64,88,,percent of total billed charges,,,,,,,,,804.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,958.23,91,,percent of total billed charges,,,1000.35,95,,percent of total billed charges,,,873.99,83,,percent of total billed charges,,,873.99,83,,percent of total billed charges,,,,,,,,,,,,,,,873.99,83,,percent of total billed charges,,,1000.35,95,,percent of total billed charges,,,947.7,90,,percent of total billed charges,,,947.7,90,,percent of total billed charges,,,863.46,82,,percent of total billed charges,,,947.7,90,,percent of total billed charges,,,895.05,85,,percent of total billed charges,,793.96,1000.35,
".EHELICHIA CHEFFENS (IGG,IGM)",25201220,CDM,86666,CPT,300,RC,inpatient,,224,224,,190.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,190.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,197.12,88,,percent of total billed charges,,,,,,,,,171.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,183.68,82,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,168.9,212.8,
.EHELICHIA PCR,25201221,CDM,87798,CPT,300,RC,inpatient,,401,401,,340.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,302.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,340.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,352.88,88,,percent of total billed charges,,,,,,,,,306.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,364.91,91,,percent of total billed charges,,,380.95,95,,percent of total billed charges,,,332.83,83,,percent of total billed charges,,,332.83,83,,percent of total billed charges,,,,,,,,,,,,,,,332.83,83,,percent of total billed charges,,,380.95,95,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,328.82,82,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,340.85,85,,percent of total billed charges,,302.35,380.95,
CALCIUM URINE (24-HOUR),25201236,CDM,82340,CPT,300,RC,inpatient,,158,158,,134.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,134.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.04,88,,percent of total billed charges,,,,,,,,,120.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,143.78,91,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,,,,,,,,,,,,,131.14,83,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,129.56,82,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,119.13,150.1,
CALCIUM URINE (RANDOM),25201237,CDM,82310,CPT,300,RC,inpatient,,158,158,,134.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,134.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.04,88,,percent of total billed charges,,,,,,,,,120.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,143.78,91,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,,,,,,,,,,,,,131.14,83,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,129.56,82,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,119.13,150.1,
URIC ACID URINE (24-HOUR),25201244,CDM,84560,CPT,300,RC,inpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,93.5,117.8,
UREA URINE (24-HOUR),25201245,CDM,84540,CPT,300,RC,inpatient,,113,113,,95.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,99.44,88,,percent of total billed charges,,,,,,,,,86.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,92.66,82,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,85.2,107.35,
URIC ACID URINE RANDOM,25201246,CDM,84560,CPT,300,RC,inpatient,,95,95,,80.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,83.6,88,,percent of total billed charges,,,,,,,,,72.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,,,,,,,,,,,,,78.85,83,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,77.9,82,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,71.63,90.25,
LEAD BLOOD(CAPILLARY SAMPLE),25201251,CDM,83655,CPT,300,RC,inpatient,,202,202,,171.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,171.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,177.76,88,,percent of total billed charges,,,,,,,,,154.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,183.82,91,,percent of total billed charges,,,191.9,95,,percent of total billed charges,,,167.66,83,,percent of total billed charges,,,167.66,83,,percent of total billed charges,,,,,,,,,,,,,,,167.66,83,,percent of total billed charges,,,191.9,95,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,165.64,82,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,171.7,85,,percent of total billed charges,,152.31,191.9,
LEAD URINE,25201252,CDM,83655,CPT,300,RC,inpatient,,155,155,,131.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,131.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,136.4,88,,percent of total billed charges,,,,,,,,,118.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,127.1,82,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,116.87,147.25,
LEAD BLOOD (WHOLE BLOOD),25201253,CDM,83655,CPT,300,RC,inpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
SILVER SERUM/PLASMA,25201254,CDM,83018,CPT,300,RC,inpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
ACETAMINOPHEN,25201269,CDM,80143,CPT,300,RC,inpatient,,383,383,,325.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,288.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,325.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,337.04,88,,percent of total billed charges,,,,,,,,,292.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,348.53,91,,percent of total billed charges,,,363.85,95,,percent of total billed charges,,,317.89,83,,percent of total billed charges,,,317.89,83,,percent of total billed charges,,,,,,,,,,,,,,,317.89,83,,percent of total billed charges,,,363.85,95,,percent of total billed charges,,,344.7,90,,percent of total billed charges,,,344.7,90,,percent of total billed charges,,,314.06,82,,percent of total billed charges,,,344.7,90,,percent of total billed charges,,,325.55,85,,percent of total billed charges,,288.78,363.85,
CA 125,25201277,CDM,86304,CPT,300,RC,inpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,283.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,319.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,283.5,357.2,
ALKALINE PHOSPHATASE ISOENZYMES,25201285,CDM,84080,CPT,300,RC,inpatient,,288,288,,244.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,244.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,253.44,88,,percent of total billed charges,,,,,,,,,220.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.08,91,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,,,,,,,,,,,,,239.04,83,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,236.16,82,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,244.8,85,,percent of total billed charges,,217.15,273.6,
ALKALINE PHOSPHATASE BONE SP,25201286,CDM,84075,CPT,300,RC,inpatient,,95,95,,80.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,83.6,88,,percent of total billed charges,,,,,,,,,72.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,,,,,,,,,,,,,78.85,83,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,77.9,82,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,71.63,90.25,
SURG  INSITU HYBRIDIZATION(INIT),25201290,CDM,88365,CPT,310,RC,inpatient,,161,161,,136.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,121.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,141.68,88,,percent of total billed charges,,,,,,,,,123,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,132.02,82,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,121.39,152.95,
SURG  INSITU HYBRIDIZATION(ADDITIONAL),25201291,CDM,88364,CPT,310,RC,inpatient,,161,161,,136.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,121.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,141.68,88,,percent of total billed charges,,,,,,,,,123,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,132.02,82,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,121.39,152.95,
PROBE STAIN (KAPA/LAMDA),25201292,CDM,88365,CPT,310,RC,inpatient,,316,316,,268.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,238.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,268.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,278.08,88,,percent of total billed charges,,,,,,,,,241.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,287.56,91,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,,,,,,,,,,,,,262.28,83,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,259.12,82,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,238.26,300.2,
ER/PR IMMUNOHISTOCHEM PARAFFIN,25201293,CDM,88360,CPT,310,RC,inpatient,,498,498,,422.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,375.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,423.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,438.24,88,,percent of total billed charges,,,,,,,,,380.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,,,,,,,,,,,,,413.34,83,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,408.36,82,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,375.49,473.1,
.HER 2 NEU BY FISH,25201294,CDM,88374,CPT,310,RC,inpatient,,515,515,,437.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,388.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,437.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,453.2,88,,percent of total billed charges,,,,,,,,,393.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,468.65,91,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,,,,,,,,,,,,,427.45,83,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,422.3,82,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,388.31,489.25,
SURG PATH-TISSUE INSITU HYBRIDIZATION,25201295,CDM,88275,CPT,310,RC,inpatient,,467,467,,396.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,352.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.96,88,,percent of total billed charges,,,,,,,,,356.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.97,91,,percent of total billed charges,,,443.65,95,,percent of total billed charges,,,387.61,83,,percent of total billed charges,,,387.61,83,,percent of total billed charges,,,,,,,,,,,,,,,387.61,83,,percent of total billed charges,,,443.65,95,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,382.94,82,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,396.95,85,,percent of total billed charges,,352.12,443.65,
MORPHOMETRIC ANALYSIS 88361,25201296,CDM,88361,CPT,310,RC,inpatient,,491,491,,416.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,370.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,417.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,432.08,88,,percent of total billed charges,,,,,,,,,375.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,446.81,91,,percent of total billed charges,,,466.45,95,,percent of total billed charges,,,407.53,83,,percent of total billed charges,,,407.53,83,,percent of total billed charges,,,,,,,,,,,,,,,407.53,83,,percent of total billed charges,,,466.45,95,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,402.62,82,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,417.35,85,,percent of total billed charges,,370.21,466.45,
PROBE STAIN,25201297,CDM,88364,CPT,310,RC,inpatient,,526,526,,446.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,396.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,447.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,462.88,88,,percent of total billed charges,,,,,,,,,401.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,478.66,91,,percent of total billed charges,,,499.7,95,,percent of total billed charges,,,436.58,83,,percent of total billed charges,,,436.58,83,,percent of total billed charges,,,,,,,,,,,,,,,436.58,83,,percent of total billed charges,,,499.7,95,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,431.32,82,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,447.1,85,,percent of total billed charges,,396.6,499.7,
MORPHOMETRIC STAIN,25201298,CDM,88377,CPT,310,RC,inpatient,,319,319,,270.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,240.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,271.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,280.72,88,,percent of total billed charges,,,,,,,,,243.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,290.29,91,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,,,,,,,,,,,,,264.77,83,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,261.58,82,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,271.15,85,,percent of total billed charges,,240.53,303.05,
"OXALATE, URINE (24-HOUR)",25201301,CDM,83945,CPT,300,RC,inpatient,,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
OSTEOCALCIN,25201302,CDM,83937,CPT,300,RC,inpatient,,498,498,,422.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,375.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,423.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,438.24,88,,percent of total billed charges,,,,,,,,,380.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,,,,,,,,,,,,,413.34,83,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,408.36,82,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,375.49,473.1,
OPIATES CONFIRMATION URINE,25201303,CDM,80361,CPT,300,RC,inpatient,,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,115.36,145.35,
AMPHETAMINES/METHAMPH URINE (CONFIRM),25201304,CDM,80324,CPT,300,RC,inpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,93.5,117.8,
TRICYCLIC ANTIDEPRESANT URINE (CONFIRM),25201305,CDM,80337,CPT,300,RC,inpatient,,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,130.44,164.35,
BENZODIAZEPINE URINE (CONFIRM),25201306,CDM,80346,CPT,300,RC,inpatient,,359,359,,304.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,270.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,305.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,315.92,88,,percent of total billed charges,,,,,,,,,274.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,,,,,,,,,,,,,297.97,83,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,294.38,82,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,270.69,341.05,
OLANZAPINE (ZYPREXA),25201307,CDM,80342,CPT,300,RC,inpatient,,431,431,,365.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,324.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,366.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,379.28,88,,percent of total billed charges,,,,,,,,,329.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,392.21,91,,percent of total billed charges,,,409.45,95,,percent of total billed charges,,,357.73,83,,percent of total billed charges,,,357.73,83,,percent of total billed charges,,,,,,,,,,,,,,,357.73,83,,percent of total billed charges,,,409.45,95,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,353.42,82,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,366.35,85,,percent of total billed charges,,324.97,409.45,
AMPHETAMINES/METHAMPH BLOOD (CONFIRM),25201308,CDM,80324,CPT,300,RC,inpatient,,329,329,,279.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,248.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,279.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,289.52,88,,percent of total billed charges,,,,,,,,,251.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,299.39,91,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,,,,,,,,,,,,,273.07,83,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,269.78,82,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,248.07,312.55,
ZINC TRANSPORTER 8 (ZNT8),25201309,CDM,86341,CPT,300,RC,inpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,283.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,319.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,283.5,357.2,
.ROMA (OVARIAN CANCER RISK),25201310,CDM,81500,CPT,300,RC,inpatient,,722,722,,612.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,544.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,613.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,635.36,88,,percent of total billed charges,,,,,,,,,551.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,657.02,91,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,,,,,,,,,,,,,599.26,83,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,592.04,82,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,613.7,85,,percent of total billed charges,,544.39,685.9,
FENTANYL CONFIRMATION URINE,25201311,CDM,80354,CPT,300,RC,inpatient,,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,115.36,145.35,
COCAINE CONFIRMATION URINE,25201312,CDM,80353,CPT,300,RC,inpatient,,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,115.36,145.35,
AMPHETAMINES SERUM,25201313,CDM,80324,CPT,300,RC,inpatient,,329,329,,279.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,248.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,279.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,289.52,88,,percent of total billed charges,,,,,,,,,251.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,299.39,91,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,,,,,,,,,,,,,273.07,83,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,269.78,82,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,248.07,312.55,
BENZENE PROFILE,25201314,CDM,84600,CPT,300,RC,inpatient,,260,260,,220.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,196.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,221,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,228.8,88,,percent of total billed charges,,,,,,,,,198.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,,,,,,,,,,,,,215.8,83,,percent of total billed charges,,,247,95,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,213.2,82,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,196.04,247,
METHYLPHENIDATE & METABOLITE,25201315,CDM,80360,CPT,300,RC,inpatient,,219,219,,185.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,165.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,186.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,192.72,88,,percent of total billed charges,,,,,,,,,167.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,199.29,91,,percent of total billed charges,,,208.05,95,,percent of total billed charges,,,181.77,83,,percent of total billed charges,,,181.77,83,,percent of total billed charges,,,,,,,,,,,,,,,181.77,83,,percent of total billed charges,,,208.05,95,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,179.58,82,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,186.15,85,,percent of total billed charges,,165.13,208.05,
METHYLHISTAMINE,25201316,CDM,82542,CPT,300,RC,inpatient,,471,471,,399.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,355.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,400.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,414.48,88,,percent of total billed charges,,,,,,,,,359.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,428.61,91,,percent of total billed charges,,,447.45,95,,percent of total billed charges,,,390.93,83,,percent of total billed charges,,,390.93,83,,percent of total billed charges,,,,,,,,,,,,,,,390.93,83,,percent of total billed charges,,,447.45,95,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,386.22,82,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,400.35,85,,percent of total billed charges,,355.13,447.45,
BENZODIAZEPINE & METABOLITE,25201317,CDM,80346,CPT,300,RC,inpatient,,417,417,,354.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,314.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,354.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,366.96,88,,percent of total billed charges,,,,,,,,,318.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,379.47,91,,percent of total billed charges,,,396.15,95,,percent of total billed charges,,,346.11,83,,percent of total billed charges,,,346.11,83,,percent of total billed charges,,,,,,,,,,,,,,,346.11,83,,percent of total billed charges,,,396.15,95,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,341.94,82,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,354.45,85,,percent of total billed charges,,314.42,396.15,
HEPATITIS B SURFACE AB  QUANT,25201318,CDM,86317,CPT,300,RC,inpatient,,210,210,,178.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,158.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,178.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,184.8,88,,percent of total billed charges,,,,,,,,,160.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,,,,,,,,,,,,,174.3,83,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,172.2,82,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,158.34,199.5,
HEPATITIS B SURFACE ANTIBODY,25201319,CDM,86706,CPT,300,RC,inpatient,,210,210,,178.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,158.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,178.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,184.8,88,,percent of total billed charges,,,,,,,,,160.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,,,,,,,,,,,,,174.3,83,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,172.2,82,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,158.34,199.5,
HEPATITIS B SCREEN (NON PREGNANT),25201320,CDM,G0499,HCPCS,300,RC,inpatient,,529,529,,449.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,398.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,449.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,465.52,88,,percent of total billed charges,,,,,,,,,404.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,481.39,91,,percent of total billed charges,,,502.55,95,,percent of total billed charges,,,439.07,83,,percent of total billed charges,,,439.07,83,,percent of total billed charges,,,,,,,,,,,,,,,439.07,83,,percent of total billed charges,,,502.55,95,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,433.78,82,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,449.65,85,,percent of total billed charges,,398.87,502.55,
BARBITURATE CONFIRMATION URINE,25201324,CDM,80345,CPT,300,RC,inpatient,,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,33.93,42.75,
PROSTATIC ACID PHOSPHATASE,25201327,CDM,84066,CPT,300,RC,inpatient,,166,166,,140.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,146.08,88,,percent of total billed charges,,,,,,,,,126.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,,,,,,,,,,,,,137.78,83,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,136.12,82,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,125.16,157.7,
LDH CSF,25201343,CDM,83615,CPT,300,RC,inpatient,,166,166,,140.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,146.08,88,,percent of total billed charges,,,,,,,,,126.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,,,,,,,,,,,,,137.78,83,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,136.12,82,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,125.16,157.7,
CITRIC ACID URINE (24-HOUR),25201351,CDM,82507,CPT,300,RC,inpatient,,280,280,,237.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,211.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,238,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,246.4,88,,percent of total billed charges,,,,,,,,,213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,,,,,,,,,,,,,232.4,83,,percent of total billed charges,,,266,95,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,229.6,82,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,211.12,266,
CITRIC ACID URINE (RANDOM),25201352,CDM,82507,CPT,300,RC,inpatient,,280,280,,237.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,211.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,238,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,246.4,88,,percent of total billed charges,,,,,,,,,213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,,,,,,,,,,,,,232.4,83,,percent of total billed charges,,,266,95,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,229.6,82,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,211.12,266,
HEPATITIS BE ANTIGEN,25201368,CDM,87350,CPT,300,RC,inpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,153.06,192.85,
HISTOPLASMA ANTIBODY TOTAL,25201383,CDM,86698,CPT,300,RC,inpatient,,189,189,,160.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,142.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,160.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,166.32,88,,percent of total billed charges,,,,,,,,,144.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,,,,,,,,,,,,,156.87,83,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,154.98,82,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,142.51,179.55,
.HISTOPLASMA ANTIBODY COMP FIXATION,25201384,CDM,86698,CPT,300,RC,inpatient,,187,187,,158.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,158.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,164.56,88,,percent of total billed charges,,,,,,,,,142.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,153.34,82,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,141,177.65,
HISTOPLASMA AG SERUM,25201385,CDM,87385,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
HISTOPLASMA AG URINE,25201386,CDM,87385,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
HISTOPLASMA AG AB (H & M),25201387,CDM,86698,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
IMIPRAMINE,25201392,CDM,G6030,HCPCS,300,RC,inpatient,,210,210,,178.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,158.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,178.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,184.8,88,,percent of total billed charges,,,,,,,,,160.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,,,,,,,,,,,,,174.3,83,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,172.2,82,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,158.34,199.5,
VECTRA,25201399,CDM,81490,CPT,300,RC,inpatient,,1869,1869,,1586.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1409.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1588.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1644.72,88,,percent of total billed charges,,,,,,,,,1427.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1700.79,91,,percent of total billed charges,,,1775.55,95,,percent of total billed charges,,,1551.27,83,,percent of total billed charges,,,1551.27,83,,percent of total billed charges,,,,,,,,,,,,,,,1551.27,83,,percent of total billed charges,,,1775.55,95,,percent of total billed charges,,,1682.1,90,,percent of total billed charges,,,1682.1,90,,percent of total billed charges,,,1532.58,82,,percent of total billed charges,,,1682.1,90,,percent of total billed charges,,,1588.65,85,,percent of total billed charges,,1409.23,1775.55,
VARICELLA-ZOSTER ANTIBODY (IgG),25201400,CDM,86787,CPT,300,RC,inpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,81.43,102.6,
"VARICELLA-ZOSTER ANTIBODY, IGM",25201401,CDM,86787,CPT,300,RC,inpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,92.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,82.19,103.55,
"ZIKA VIRUS, IGM",25201402,CDM,86790,CPT,300,RC,inpatient,,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,129.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,129.69,163.4,
"ZIKA VIRUS, COMP PROFILE",25201403,CDM,87798,CPT,300,RC,inpatient,,515,515,,437.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,388.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,437.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,453.2,88,,percent of total billed charges,,,,,,,,,393.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,468.65,91,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,,,,,,,,,,,,,427.45,83,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,422.3,82,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,388.31,489.25,
OSMOLALITY URINE,25201418,CDM,83935,CPT,300,RC,inpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,93.5,117.8,
OSMOLALITY STOOL,25201419,CDM,84999,CPT,300,RC,inpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,93.5,117.8,
SEROTONIN SERUM,25201426,CDM,84260,CPT,300,RC,inpatient,,319,319,,270.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,240.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,271.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,280.72,88,,percent of total billed charges,,,,,,,,,243.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,290.29,91,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,,,,,,,,,,,,,264.77,83,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,261.58,82,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,271.15,85,,percent of total billed charges,,240.53,303.05,
SEROTONIN WHOLE BLOOD,25201427,CDM,84260,CPT,300,RC,inpatient,,664,664,,563.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,500.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,564.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,584.32,88,,percent of total billed charges,,,,,,,,,507.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,604.24,91,,percent of total billed charges,,,630.8,95,,percent of total billed charges,,,551.12,83,,percent of total billed charges,,,551.12,83,,percent of total billed charges,,,,,,,,,,,,,,,551.12,83,,percent of total billed charges,,,630.8,95,,percent of total billed charges,,,597.6,90,,percent of total billed charges,,,597.6,90,,percent of total billed charges,,,544.48,82,,percent of total billed charges,,,597.6,90,,percent of total billed charges,,,564.4,85,,percent of total billed charges,,500.66,630.8,
ANTITHROMBIN III ANTIGEN,25201434,CDM,85300,CPT,300,RC,inpatient,,382,382,,324.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,288.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,324.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,336.16,88,,percent of total billed charges,,,,,,,,,291.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,347.62,91,,percent of total billed charges,,,362.9,95,,percent of total billed charges,,,317.06,83,,percent of total billed charges,,,317.06,83,,percent of total billed charges,,,,,,,,,,,,,,,317.06,83,,percent of total billed charges,,,362.9,95,,percent of total billed charges,,,343.8,90,,percent of total billed charges,,,343.8,90,,percent of total billed charges,,,313.24,82,,percent of total billed charges,,,343.8,90,,percent of total billed charges,,,324.7,85,,percent of total billed charges,,288.03,362.9,
ANTITHROMBIN III ACTIVITY,25201435,CDM,85300,CPT,300,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
ANTI-TH/TO AB (RDL),25201436,CDM,83516,CPT,300,RC,inpatient,,164,164,,139.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,123.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,139.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,144.32,88,,percent of total billed charges,,,,,,,,,125.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,134.48,82,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,123.66,155.8,
T-3 UPTAKE,25201442,CDM,84479,CPT,300,RC,inpatient,,171,171,,145.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,128.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,145.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,150.48,88,,percent of total billed charges,,,,,,,,,130.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,,,,,,,,,,,,,141.93,83,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,140.22,82,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,128.93,162.45,
THYROGLOBULIN+TGAB,25201458,CDM,86800,CPT,300,RC,inpatient,,175,175,,148.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,131.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,148.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154,88,,percent of total billed charges,,,,,,,,,133.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,,,,,,,,,,,,,145.25,83,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,143.5,82,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,131.95,166.25,
THYROGLOBULIN ANTIBODIES,25201459,CDM,86800,CPT,300,RC,inpatient,,260,260,,220.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,196.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,221,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,228.8,88,,percent of total billed charges,,,,,,,,,198.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,,,,,,,,,,,,,215.8,83,,percent of total billed charges,,,247,95,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,213.2,82,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,196.04,247,
.THYROGLOBULIN (TG RIA),25201461,CDM,84432,CPT,300,RC,inpatient,,260,260,,220.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,196.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,221,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,228.8,88,,percent of total billed charges,,,,,,,,,198.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,,,,,,,,,,,,,215.8,83,,percent of total billed charges,,,247,95,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,213.2,82,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,196.04,247,
THYROGLOBULIN AB IMA/MS,25201462,CDM,86800,CPT,300,RC,inpatient,,260,260,,220.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,196.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,221,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,228.8,88,,percent of total billed charges,,,,,,,,,198.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,,,,,,,,,,,,,215.8,83,,percent of total billed charges,,,247,95,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,213.2,82,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,196.04,247,
TOBRAMYCIN RANDOM,25201463,CDM,80200,CPT,300,RC,inpatient,,320,320,,271.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,241.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,272,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,281.6,88,,percent of total billed charges,,,,,,,,,244.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,291.2,91,,percent of total billed charges,,,304,95,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,,,,,,,,,,,,,265.6,83,,percent of total billed charges,,,304,95,,percent of total billed charges,,,288,90,,percent of total billed charges,,,288,90,,percent of total billed charges,,,262.4,82,,percent of total billed charges,,,288,90,,percent of total billed charges,,,272,85,,percent of total billed charges,,241.28,304,
TOBRAMYCIN PEAK,25201467,CDM,80200,CPT,300,RC,inpatient,,320,320,,271.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,241.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,272,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,281.6,88,,percent of total billed charges,,,,,,,,,244.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,291.2,91,,percent of total billed charges,,,304,95,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,,,,,,,,,,,,,265.6,83,,percent of total billed charges,,,304,95,,percent of total billed charges,,,288,90,,percent of total billed charges,,,288,90,,percent of total billed charges,,,262.4,82,,percent of total billed charges,,,288,90,,percent of total billed charges,,,272,85,,percent of total billed charges,,241.28,304,
INHIBIN-A,25201468,CDM,86336,CPT,300,RC,inpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,273.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,242.79,305.9,
TOBRAMYCIN TROUGH,25201469,CDM,80200,CPT,300,RC,inpatient,,320,320,,271.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,241.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,272,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,281.6,88,,percent of total billed charges,,,,,,,,,244.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,291.2,91,,percent of total billed charges,,,304,95,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,,,,,,,,,,,,,265.6,83,,percent of total billed charges,,,304,95,,percent of total billed charges,,,288,90,,percent of total billed charges,,,288,90,,percent of total billed charges,,,262.4,82,,percent of total billed charges,,,288,90,,percent of total billed charges,,,272,85,,percent of total billed charges,,241.28,304,
TOPIRAMATE,25201470,CDM,80201,CPT,300,RC,inpatient,,290,290,,246.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,218.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,246.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,255.2,88,,percent of total billed charges,,,,,,,,,221.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,263.9,91,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,,,,,,,,,,,,,240.7,83,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,261,90,,percent of total billed charges,,,261,90,,percent of total billed charges,,,237.8,82,,percent of total billed charges,,,261,90,,percent of total billed charges,,,246.5,85,,percent of total billed charges,,218.66,275.5,
INHIBIN-B,25201471,CDM,83520,CPT,300,RC,inpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,273.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,242.79,305.9,
TOXOPLASMA ANTIBODY (IgG),25201484,CDM,86777,CPT,300,RC,inpatient,,216,216,,183.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,162.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,183.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.08,88,,percent of total billed charges,,,,,,,,,165.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,177.12,82,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,162.86,205.2,
TOXOPLASMA ANTIBODY (IgM),25201485,CDM,86778,CPT,300,RC,inpatient,,216,216,,183.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,162.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,183.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.08,88,,percent of total billed charges,,,,,,,,,165.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,177.12,82,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,162.86,205.2,
.WEST NILE AB SERUM (IGM),25201490,CDM,86788,CPT,300,RC,inpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,93.5,117.8,
"WEST NILE AB CSF (IGG,IGM)",25201492,CDM,86789,CPT,300,RC,inpatient,,216,216,,183.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,162.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,183.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.08,88,,percent of total billed charges,,,,,,,,,165.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,177.12,82,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,162.86,205.2,
.WEST NILE AB CSF (IGM),25201493,CDM,86788,CPT,300,RC,inpatient,,252,252,,213.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,214.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,221.76,88,,percent of total billed charges,,,,,,,,,192.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,229.32,91,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,,,,,,,,,,,,,209.16,83,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,206.64,82,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,190.01,239.4,
SURG PATH-TISSUE IHC (ERA),25201501,CDM,88360,CPT,310,RC,inpatient,TC,470,470,,399.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,354.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,399.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,413.6,88,,percent of total billed charges,,,,,,,,,359.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,427.7,91,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,,,,,,,,,,,,,390.1,83,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,423,90,,percent of total billed charges,,,423,90,,percent of total billed charges,,,385.4,82,,percent of total billed charges,,,423,90,,percent of total billed charges,,,399.5,85,,percent of total billed charges,,354.38,446.5,
SPECIAL STAIN: HISTOLOGY,25201502,CDM,88314,CPT,300,RC,inpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
INTERNAL TUMOR  IHC,25201503,CDM,88360,CPT,300,RC,inpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,62.58,78.85,
CONCENTRATION TECHNIQUE,25201504,CDM,88108,CPT,300,RC,inpatient,,53,53,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46.64,88,,percent of total billed charges,,,,,,,,,40.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,,,,,,,,,,,,,43.99,83,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,43.46,82,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,39.96,50.35,
TISSUE (IGA)TRANSGLUTAMINASE AB,25201508,CDM,83516,CPT,300,RC,inpatient,,379,379,,321.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,285.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,322.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,333.52,88,,percent of total billed charges,,,,,,,,,289.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,344.89,91,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,,,,,,,,,,,,,314.57,83,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,310.78,82,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,285.77,360.05,
TRANSFERRIN,25201509,CDM,84466,CPT,300,RC,inpatient,,192,192,,163.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,163.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.96,88,,percent of total billed charges,,,,,,,,,146.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,,,,,,,,,,,,,159.36,83,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,157.44,82,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,144.77,182.4,
TISSUE GRINDING,25201510,CDM,87176,CPT,300,RC,inpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,65.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,65.6,82.65,
TISSUE(IGG) TRANSGLUTAMINASE AB,25201511,CDM,83516,CPT,300,RC,inpatient,,379,379,,321.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,285.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,322.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,333.52,88,,percent of total billed charges,,,,,,,,,289.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,344.89,91,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,,,,,,,,,,,,,314.57,83,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,310.78,82,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,285.77,360.05,
ALDOLASE,25201517,CDM,82085,CPT,300,RC,inpatient,,189,189,,160.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,142.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,160.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,166.32,88,,percent of total billed charges,,,,,,,,,144.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,,,,,,,,,,,,,156.87,83,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,154.98,82,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,142.51,179.55,
ADENOSINE DEAMINASE,25201520,CDM,84311,CPT,300,RC,inpatient,,620,620,,526.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,467.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,527,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,545.6,88,,percent of total billed charges,,,,,,,,,473.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,564.2,91,,percent of total billed charges,,,589,95,,percent of total billed charges,,,514.6,83,,percent of total billed charges,,,514.6,83,,percent of total billed charges,,,,,,,,,,,,,,,514.6,83,,percent of total billed charges,,,589,95,,percent of total billed charges,,,558,90,,percent of total billed charges,,,558,90,,percent of total billed charges,,,508.4,82,,percent of total billed charges,,,558,90,,percent of total billed charges,,,527,85,,percent of total billed charges,,467.48,589,
ANAPLASMA PHAGOCYTOPHILUM,25201521,CDM,87797,CPT,300,RC,inpatient,,315,315,,267.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,237.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,267.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,277.2,88,,percent of total billed charges,,,,,,,,,240.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,286.65,91,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,,,,,,,,,,,,,261.45,83,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,258.3,82,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,237.51,299.25,
ADENOVIRUS DNA (LAVAGE),25201522,CDM,87799,CPT,300,RC,inpatient,,564,564,,478.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,425.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,479.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,496.32,88,,percent of total billed charges,,,,,,,,,430.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,513.24,91,,percent of total billed charges,,,535.8,95,,percent of total billed charges,,,468.12,83,,percent of total billed charges,,,468.12,83,,percent of total billed charges,,,,,,,,,,,,,,,468.12,83,,percent of total billed charges,,,535.8,95,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,462.48,82,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,479.4,85,,percent of total billed charges,,425.26,535.8,
EHRLICHIA PROFILE,25201523,CDM,87798,CPT,300,RC,inpatient,,315,315,,267.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,237.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,267.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,277.2,88,,percent of total billed charges,,,,,,,,,240.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,286.65,91,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,,,,,,,,,,,,,261.45,83,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,258.3,82,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,237.51,299.25,
ALPHA-1-ANTITRYPSIN GENOTYPE,25201532,CDM,81332,CPT,300,RC,inpatient,,432,432,,366.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,325.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,367.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,380.16,88,,percent of total billed charges,,,,,,,,,330.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,393.12,91,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,,,,,,,,,,,,,358.56,83,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,354.24,82,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,325.73,410.4,
ALPHA-1-ANTITRYPSIN,25201533,CDM,82103,CPT,300,RC,inpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
ALPHA-1-ANTITRYPSIN PHENOTYPE,25201534,CDM,82104,CPT,300,RC,inpatient,,489,489,,415.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,368.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,415.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,430.32,88,,percent of total billed charges,,,,,,,,,373.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,444.99,91,,percent of total billed charges,,,464.55,95,,percent of total billed charges,,,405.87,83,,percent of total billed charges,,,405.87,83,,percent of total billed charges,,,,,,,,,,,,,,,405.87,83,,percent of total billed charges,,,464.55,95,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,400.98,82,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,415.65,85,,percent of total billed charges,,368.71,464.55,
ALPHA-1-ANTITRYPSIN (QUANT/MUTATION,25201535,CDM,82103,CPT,300,RC,inpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.92,88,,percent of total billed charges,,,,,,,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,44.49,56.05,
DRVVT,25201558,CDM,85613,CPT,300,RC,inpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,109.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,123.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,109.33,137.75,
DOXEPIN,25201559,CDM,80335,CPT,300,RC,inpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,109.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,123.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,109.33,137.75,
AMMONIA,25201574,CDM,82140,CPT,300,RC,inpatient,,308,308,,261.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,232.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,261.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,271.04,88,,percent of total billed charges,,,,,,,,,235.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,280.28,91,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,,,,,,,,,,,,,255.64,83,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,252.56,82,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,232.23,292.6,
AMOXAPINE,25201575,CDM,80299,CPT,300,RC,inpatient,,552,552,,468.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,416.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,469.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,485.76,88,,percent of total billed charges,,,,,,,,,421.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,502.32,91,,percent of total billed charges,,,524.4,95,,percent of total billed charges,,,458.16,83,,percent of total billed charges,,,458.16,83,,percent of total billed charges,,,,,,,,,,,,,,,458.16,83,,percent of total billed charges,,,524.4,95,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,452.64,82,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,469.2,85,,percent of total billed charges,,416.21,524.4,
PORPHOBILINOGEN URINE (24-HOUR),25201582,CDM,84110,CPT,300,RC,inpatient,,118,118,,100.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,88.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,100.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,103.84,88,,percent of total billed charges,,,,,,,,,90.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,107.38,91,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,,,,,,,,,,,,,97.94,83,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,96.76,82,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,88.97,112.1,
PLASMINOGEN ACTIVATOR INHIBITOR-1,25201585,CDM,85415,CPT,300,RC,inpatient,,501,501,,425.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440.88,88,,percent of total billed charges,,,,,,,,,382.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,,,,,,,,,,,,,415.83,83,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,410.82,82,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,377.75,475.95,
MITOCHONDRIAL ANTIBODY,25201590,CDM,86255,CPT,300,RC,inpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
THYROID PEROXIDASE ANTIBODIES,25201608,CDM,86376,CPT,300,RC,inpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,198.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,198.3,249.85,
THYROID STIMULATING IMMUNOGLOBIN,25201609,CDM,84445,CPT,300,RC,inpatient,,762,762,,646.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,574.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,647.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,670.56,88,,percent of total billed charges,,,,,,,,,582.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,693.42,91,,percent of total billed charges,,,723.9,95,,percent of total billed charges,,,632.46,83,,percent of total billed charges,,,632.46,83,,percent of total billed charges,,,,,,,,,,,,,,,632.46,83,,percent of total billed charges,,,723.9,95,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,624.84,82,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,647.7,85,,percent of total billed charges,,574.55,723.9,
THYROID CASCADE,25201610,CDM,84443,CPT,300,RC,inpatient,,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,186.99,235.6,
.METAL-LTT PANEL 2,25201611,CDM,86353,CPT,300,RC,inpatient,,112,112,,95.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,95.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.56,88,,percent of total billed charges,,,,,,,,,85.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.92,91,,percent of total billed charges,,,106.4,95,,percent of total billed charges,,,92.96,83,,percent of total billed charges,,,92.96,83,,percent of total billed charges,,,,,,,,,,,,,,,92.96,83,,percent of total billed charges,,,106.4,95,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,91.84,82,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,95.2,85,,percent of total billed charges,,84.45,106.4,
.METAL-LTT PANEL 2,25201612,CDM,86353,CPT,300,RC,inpatient,,112,112,,95.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,95.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.56,88,,percent of total billed charges,,,,,,,,,85.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.92,91,,percent of total billed charges,,,106.4,95,,percent of total billed charges,,,92.96,83,,percent of total billed charges,,,92.96,83,,percent of total billed charges,,,,,,,,,,,,,,,92.96,83,,percent of total billed charges,,,106.4,95,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,91.84,82,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,95.2,85,,percent of total billed charges,,84.45,106.4,
MICROSPORIDIA,25201613,CDM,87207,CPT,300,RC,inpatient,,129,129,,109.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,97.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,109.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,113.52,88,,percent of total billed charges,,,,,,,,,98.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,105.78,82,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,97.27,122.55,
IMMUNOGLOBULIN G,25201616,CDM,82784,CPT,300,RC,inpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,157.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,177.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,157.59,198.55,
.IGG-1 (PART OF PANEL),25201617,CDM,82787,CPT,300,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
.IGG-2 (PART OF PANEL),25201618,CDM,82787,CPT,300,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
.IGG-3 (PART OF PANEL),25201619,CDM,82787,CPT,300,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
.IGG-4 (PART OF PANEL),25201620,CDM,82787,CPT,300,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
LACTIC ACID,25201624,CDM,83605,CPT,300,RC,inpatient,,293,293,,248.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,220.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,249.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,257.84,88,,percent of total billed charges,,,,,,,,,223.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,266.63,91,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,,,,,,,,,,,,,243.19,83,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,240.26,82,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,249.05,85,,percent of total billed charges,,220.92,278.35,
"HEPATITIS A ANTIBODY, TOTAL(RFLX IGM)",25201639,CDM,86708,CPT,300,RC,inpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,223.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,252.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,223.94,282.15,
"HEPATITIS A ANTIBODY, TOTAL",25201640,CDM,86708,CPT,300,RC,inpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,223.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,252.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,223.94,282.15,
GLUCOSE-6-PHOSPHATE DEHYDROGENASE,25201657,CDM,82955,CPT,300,RC,inpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,135.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,135.72,171,
GLUTATHIONE,25201658,CDM,82978,CPT,300,RC,inpatient,,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,179.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,202.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,179.45,226.1,
GLUCAGON PLASMA,25201659,CDM,82943,CPT,300,RC,inpatient,,418,418,,354.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,315.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,355.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,367.84,88,,percent of total billed charges,,,,,,,,,319.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,380.38,91,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,,,,,,,,,,,,,346.94,83,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,342.76,82,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,355.3,85,,percent of total billed charges,,315.17,397.1,
GASTROINTESTINAL PANEL(BIOFIRE),25201660,CDM,87507,CPT,300,RC,inpatient,,827,827,,702.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,623.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,702.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,727.76,88,,percent of total billed charges,,,,,,,,,631.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,752.57,91,,percent of total billed charges,,,785.65,95,,percent of total billed charges,,,686.41,83,,percent of total billed charges,,,686.41,83,,percent of total billed charges,,,,,,,,,,,,,,,686.41,83,,percent of total billed charges,,,785.65,95,,percent of total billed charges,,,744.3,90,,percent of total billed charges,,,744.3,90,,percent of total billed charges,,,678.14,82,,percent of total billed charges,,,744.3,90,,percent of total billed charges,,,702.95,85,,percent of total billed charges,,623.56,785.65,
FORMALDEHYDE,25201661,CDM,86003,CPT,300,RC,inpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,135.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,135.72,171,
GASTRIN,25201665,CDM,82941,CPT,300,RC,inpatient,,224,224,,190.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,190.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,197.12,88,,percent of total billed charges,,,,,,,,,171.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,183.68,82,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,168.9,212.8,
FTA-ABS,25201681,CDM,86780,CPT,300,RC,inpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,155.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,155.32,195.7,
"ESTRIOL, SERUM",25201707,CDM,82677,CPT,300,RC,inpatient,,224,224,,190.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,190.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,197.12,88,,percent of total billed charges,,,,,,,,,171.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,183.68,82,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,168.9,212.8,
AMYLASE URINE (24-HOUR),25201715,CDM,82150,CPT,300,RC,inpatient,,166,166,,140.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,146.08,88,,percent of total billed charges,,,,,,,,,126.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,,,,,,,,,,,,,137.78,83,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,136.12,82,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,125.16,157.7,
AMYLASE FLUID,25201716,CDM,82150,CPT,300,RC,inpatient,,190,190,,161.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,143.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,161.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,167.2,88,,percent of total billed charges,,,,,,,,,145.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,,,,,,,,,,,,,157.7,83,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,155.8,82,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,143.26,180.5,
AMITRIPTYLINE,25201723,CDM,80335,CPT,300,RC,inpatient,,261,261,,221.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,196.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,221.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,229.68,88,,percent of total billed charges,,,,,,,,,199.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.51,91,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,,,,,,,,,,,,,216.63,83,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,214.02,82,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,221.85,85,,percent of total billed charges,,196.79,247.95,
ALUMUNUM,25201745,CDM,82108,CPT,300,RC,inpatient,,401,401,,340.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,302.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,340.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,352.88,88,,percent of total billed charges,,,,,,,,,306.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,364.91,91,,percent of total billed charges,,,380.95,95,,percent of total billed charges,,,332.83,83,,percent of total billed charges,,,332.83,83,,percent of total billed charges,,,,,,,,,,,,,,,332.83,83,,percent of total billed charges,,,380.95,95,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,328.82,82,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,340.85,85,,percent of total billed charges,,302.35,380.95,
AMIKACIN PEAK SERUM,25201749,CDM,80150,CPT,300,RC,inpatient,,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,186.99,235.6,
ADENOSINE DEAMINASE (FLUID),25201760,CDM,84311,CPT,300,RC,inpatient,,257,257,,218.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,193.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,218.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,226.16,88,,percent of total billed charges,,,,,,,,,196.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,233.87,91,,percent of total billed charges,,,244.15,95,,percent of total billed charges,,,213.31,83,,percent of total billed charges,,,213.31,83,,percent of total billed charges,,,,,,,,,,,,,,,213.31,83,,percent of total billed charges,,,244.15,95,,percent of total billed charges,,,231.3,90,,percent of total billed charges,,,231.3,90,,percent of total billed charges,,,210.74,82,,percent of total billed charges,,,231.3,90,,percent of total billed charges,,,218.45,85,,percent of total billed charges,,193.78,244.15,
ALDOSTERONE SERUM,25201764,CDM,82088,CPT,300,RC,inpatient,,613,613,,520.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,462.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,521.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,539.44,88,,percent of total billed charges,,,,,,,,,468.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,557.83,91,,percent of total billed charges,,,582.35,95,,percent of total billed charges,,,508.79,83,,percent of total billed charges,,,508.79,83,,percent of total billed charges,,,,,,,,,,,,,,,508.79,83,,percent of total billed charges,,,582.35,95,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,502.66,82,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,521.05,85,,percent of total billed charges,,462.2,582.35,
ALDOSTERONE URINE (24-HOUR),25201765,CDM,82088,CPT,300,RC,inpatient,,531,531,,450.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,400.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,451.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,467.28,88,,percent of total billed charges,,,,,,,,,405.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,483.21,91,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,,,,,,,,,,,,,440.73,83,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,435.42,82,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,400.37,504.45,
ADALIMUMAB & ANTIBODY,25201766,CDM,80299,CPT,300,RC,inpatient,,308,308,,261.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,232.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,261.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,271.04,88,,percent of total billed charges,,,,,,,,,235.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,280.28,91,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,,,,,,,,,,,,,255.64,83,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,252.56,82,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,232.23,292.6,
.ADALIMUMAB  ANTIBODY,25201767,CDM,82397,CPT,300,RC,inpatient,,308,308,,261.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,232.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,261.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,271.04,88,,percent of total billed charges,,,,,,,,,235.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,280.28,91,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,,,,,,,,,,,,,255.64,83,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,252.56,82,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,232.23,292.6,
SURG PATH LEVEL 4,25201772,CDM,88305,CPT,310,RC,inpatient,TC,613,613,,520.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,462.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,521.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,539.44,88,,percent of total billed charges,,,,,,,,,468.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,557.83,91,,percent of total billed charges,,,582.35,95,,percent of total billed charges,,,508.79,83,,percent of total billed charges,,,508.79,83,,percent of total billed charges,,,,,,,,,,,,,,,508.79,83,,percent of total billed charges,,,582.35,95,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,502.66,82,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,521.05,85,,percent of total billed charges,,462.2,582.35,
SURG PATH LEVEL 3,25201798,CDM,88304,CPT,310,RC,inpatient,TC,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,273.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,242.79,305.9,
.CYTOLOGY NON-GYN,25201806,CDM,88160,CPT,310,RC,inpatient,,400,400,,339.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,301.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,340,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,352,88,,percent of total billed charges,,,,,,,,,305.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,364,91,,percent of total billed charges,,,380,95,,percent of total billed charges,,,332,83,,percent of total billed charges,,,332,83,,percent of total billed charges,,,,,,,,,,,,,,,332,83,,percent of total billed charges,,,380,95,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,328,82,,percent of total billed charges,,,360,90,,percent of total billed charges,,,340,85,,percent of total billed charges,,301.6,380,
CYTOLOGY FINE NEEDLE ASPIRATION,25201807,CDM,88173,CPT,310,RC,inpatient,,498,498,,422.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,375.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,423.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,438.24,88,,percent of total billed charges,,,,,,,,,380.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,,,,,,,,,,,,,413.34,83,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,408.36,82,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,375.49,473.1,
CYTOSPIN FLOW,25201808,CDM,88108,CPT,310,RC,inpatient,,35,35,,29.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.8,88,,percent of total billed charges,,,,,,,,,26.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31.85,91,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,,,,,,,,,,,,,29.05,83,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,28.7,82,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,26.39,33.25,
CYTOLOGY BODY FLUID NON-GYN,25201809,CDM,88108,CPT,310,RC,inpatient,TC,255,255,,216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,192.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,216.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,224.4,88,,percent of total billed charges,,,,,,,,,194.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,209.1,82,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,192.27,242.25,
CYTOLOGY BREAST DISCHARGE,25201810,CDM,88161,CPT,310,RC,inpatient,,365,365,,309.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,275.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,310.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,321.2,88,,percent of total billed charges,,,,,,,,,278.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,332.15,91,,percent of total billed charges,,,346.75,95,,percent of total billed charges,,,302.95,83,,percent of total billed charges,,,302.95,83,,percent of total billed charges,,,,,,,,,,,,,,,302.95,83,,percent of total billed charges,,,346.75,95,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,299.3,82,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,310.25,85,,percent of total billed charges,,275.21,346.75,
CYTOLOGY MISC BODY FLUID,25201811,CDM,88112,CPT,310,RC,inpatient,TC,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,330.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,372.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,330.25,416.1,
SURG PATH LEVEL 1,25201814,CDM,88300,CPT,310,RC,inpatient,TC,113,113,,95.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,99.44,88,,percent of total billed charges,,,,,,,,,86.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,92.66,82,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,85.2,107.35,
CALCIUM SENSING RECEPTOR GENE,25201845,CDM,81405,CPT,300,RC,inpatient,,4169,4169,,3539.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3143.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3543.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3668.72,88,,percent of total billed charges,,,,,,,,,3185.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3793.79,91,,percent of total billed charges,,,3960.55,95,,percent of total billed charges,,,3460.27,83,,percent of total billed charges,,,3460.27,83,,percent of total billed charges,,,,,,,,,,,,,,,3460.27,83,,percent of total billed charges,,,3960.55,95,,percent of total billed charges,,,3752.1,90,,percent of total billed charges,,,3752.1,90,,percent of total billed charges,,,3418.58,82,,percent of total billed charges,,,3752.1,90,,percent of total billed charges,,,3543.65,85,,percent of total billed charges,,3143.43,3960.55,
PROCALCITONIN,25201847,CDM,84145,CPT,300,RC,inpatient,,418,418,,354.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,315.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,355.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,367.84,88,,percent of total billed charges,,,,,,,,,319.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,380.38,91,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,,,,,,,,,,,,,346.94,83,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,342.76,82,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,355.3,85,,percent of total billed charges,,315.17,397.1,
CALCITONIN,25201848,CDM,82308,CPT,300,RC,inpatient,,418,418,,354.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,315.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,355.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,367.84,88,,percent of total billed charges,,,,,,,,,319.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,380.38,91,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,,,,,,,,,,,,,346.94,83,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,342.76,82,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,355.3,85,,percent of total billed charges,,315.17,397.1,
"CADMIUM, BLOOD",25201849,CDM,82300,CPT,300,RC,inpatient,,280,280,,237.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,211.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,238,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,246.4,88,,percent of total billed charges,,,,,,,,,213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,,,,,,,,,,,,,232.4,83,,percent of total billed charges,,,266,95,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,229.6,82,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,211.12,266,
CADMIUM URINE,25201850,CDM,82300,CPT,300,RC,inpatient,,119,119,,101.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,89.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,101.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,104.72,88,,percent of total billed charges,,,,,,,,,90.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,108.29,91,,percent of total billed charges,,,113.05,95,,percent of total billed charges,,,98.77,83,,percent of total billed charges,,,98.77,83,,percent of total billed charges,,,,,,,,,,,,,,,98.77,83,,percent of total billed charges,,,113.05,95,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,97.58,82,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,101.15,85,,percent of total billed charges,,89.73,113.05,
CAROTENE,25201855,CDM,82380,CPT,300,RC,inpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,93.5,117.8,
CERULOPLASMIN,25201863,CDM,82390,CPT,300,RC,inpatient,,161,161,,136.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,121.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,141.68,88,,percent of total billed charges,,,,,,,,,123,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,132.02,82,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,121.39,152.95,
CD4 CELLS ABSOLUTE COUNT,25201864,CDM,86361,CPT,300,RC,inpatient,,681,681,,578.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,513.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,578.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,599.28,88,,percent of total billed charges,,,,,,,,,520.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,619.71,91,,percent of total billed charges,,,646.95,95,,percent of total billed charges,,,565.23,83,,percent of total billed charges,,,565.23,83,,percent of total billed charges,,,,,,,,,,,,,,,565.23,83,,percent of total billed charges,,,646.95,95,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,558.42,82,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,578.85,85,,percent of total billed charges,,513.47,646.95,
CD4/CD8 RATIO PROFILE,25201865,CDM,86360,CPT,300,RC,inpatient,,286,286,,242.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,215.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,243.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,251.68,88,,percent of total billed charges,,,,,,,,,218.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,260.26,91,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,,,,,,,,,,,,,237.38,83,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,234.52,82,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,215.64,271.7,
CARBON DISULFIDE,25201866,CDM,82374,CPT,300,RC,inpatient,,710,710,,602.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,535.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,603.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,624.8,88,,percent of total billed charges,,,,,,,,,542.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,646.1,91,,percent of total billed charges,,,674.5,95,,percent of total billed charges,,,589.3,83,,percent of total billed charges,,,589.3,83,,percent of total billed charges,,,,,,,,,,,,,,,589.3,83,,percent of total billed charges,,,674.5,95,,percent of total billed charges,,,639,90,,percent of total billed charges,,,639,90,,percent of total billed charges,,,582.2,82,,percent of total billed charges,,,639,90,,percent of total billed charges,,,603.5,85,,percent of total billed charges,,535.34,674.5,
CD33/CD66b CELLS,25201867,CDM,81268,CPT,300,RC,inpatient,,308,308,,261.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,232.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,261.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,271.04,88,,percent of total billed charges,,,,,,,,,235.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,280.28,91,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,,,,,,,,,,,,,255.64,83,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,252.56,82,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,232.23,292.6,
CARBOHYDRATE-DEFICIENT TRANSFERIN,25201868,CDM,82373,CPT,300,RC,inpatient,,273,273,,231.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,205.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,232.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,240.24,88,,percent of total billed charges,,,,,,,,,208.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,248.43,91,,percent of total billed charges,,,259.35,95,,percent of total billed charges,,,226.59,83,,percent of total billed charges,,,226.59,83,,percent of total billed charges,,,,,,,,,,,,,,,226.59,83,,percent of total billed charges,,,259.35,95,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,223.86,82,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,232.05,85,,percent of total billed charges,,205.84,259.35,
NEISSERIA GC DNA (SWAB),25201872,CDM,87591,CPT,300,RC,inpatient,,272,272,,230.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,205.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,231.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,239.36,88,,percent of total billed charges,,,,,,,,,207.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,247.52,91,,percent of total billed charges,,,258.4,95,,percent of total billed charges,,,225.76,83,,percent of total billed charges,,,225.76,83,,percent of total billed charges,,,,,,,,,,,,,,,225.76,83,,percent of total billed charges,,,258.4,95,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,223.04,82,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,231.2,85,,percent of total billed charges,,205.09,258.4,
"CHLAMYDIA, DNA (URINE)",25201873,CDM,87491,CPT,300,RC,inpatient,,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,332.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,294.81,371.45,
NEISSERIA GC DNA (URINE),25201874,CDM,87591,CPT,300,RC,inpatient,,272,272,,230.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,205.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,231.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,239.36,88,,percent of total billed charges,,,,,,,,,207.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,247.52,91,,percent of total billed charges,,,258.4,95,,percent of total billed charges,,,225.76,83,,percent of total billed charges,,,225.76,83,,percent of total billed charges,,,,,,,,,,,,,,,225.76,83,,percent of total billed charges,,,258.4,95,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,223.04,82,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,231.2,85,,percent of total billed charges,,205.09,258.4,
NEISSERIA GC ANTIBODIES (SERUM),25201875,CDM,86609,CPT,300,RC,inpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,34.68,43.7,
CYTOMEGALOVIRUS PCR (QUALITATIVE),25201885,CDM,87496,CPT,300,RC,inpatient,,385,385,,326.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,290.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,327.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,338.8,88,,percent of total billed charges,,,,,,,,,294.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,350.35,91,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,,,,,,,,,,,,,319.55,83,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,315.7,82,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,290.29,365.75,
CYTOMEGALOVIRUS PCR (LAVAGE),25201886,CDM,87497,CPT,300,RC,inpatient,,564,564,,478.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,425.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,479.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,496.32,88,,percent of total billed charges,,,,,,,,,430.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,513.24,91,,percent of total billed charges,,,535.8,95,,percent of total billed charges,,,468.12,83,,percent of total billed charges,,,468.12,83,,percent of total billed charges,,,,,,,,,,,,,,,468.12,83,,percent of total billed charges,,,535.8,95,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,462.48,82,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,479.4,85,,percent of total billed charges,,425.26,535.8,
CYTOMEGALOVIRUS AB(IGM),25201889,CDM,86645,CPT,300,RC,inpatient,,190,190,,161.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,143.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,161.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,167.2,88,,percent of total billed charges,,,,,,,,,145.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,,,,,,,,,,,,,157.7,83,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,155.8,82,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,143.26,180.5,
COMPLEMENT (C3),25201897,CDM,86160,CPT,300,RC,inpatient,,216,216,,183.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,162.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,183.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.08,88,,percent of total billed charges,,,,,,,,,165.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,177.12,82,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,162.86,205.2,
COMPLEMENT (C4),25201905,CDM,86160,CPT,300,RC,inpatient,,216,216,,183.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,162.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,183.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.08,88,,percent of total billed charges,,,,,,,,,165.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,177.12,82,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,162.86,205.2,
C4 BINDING PROTEIN,25201906,CDM,83520,CPT,300,RC,inpatient,,216,216,,183.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,162.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,183.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.08,88,,percent of total billed charges,,,,,,,,,165.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,177.12,82,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,162.86,205.2,
BONE DECALCIFICATION,25201914,CDM,88311,CPT,310,RC,inpatient,,166,166,,140.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,146.08,88,,percent of total billed charges,,,,,,,,,126.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,,,,,,,,,,,,,137.78,83,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,136.12,82,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,125.16,157.7,
BETA HYDROXYBUTYRATE,25201916,CDM,82010,CPT,300,RC,inpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,155.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,155.32,195.7,
ARSENIC,25201939,CDM,82175,CPT,300,RC,inpatient,,286,286,,242.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,215.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,243.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,251.68,88,,percent of total billed charges,,,,,,,,,218.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,260.26,91,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,,,,,,,,,,,,,237.38,83,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,234.52,82,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,215.64,271.7,
ARSENIC URINE,25201940,CDM,82175,CPT,300,RC,inpatient,,44,44,,37.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.72,88,,percent of total billed charges,,,,,,,,,33.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,36.08,82,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,33.18,41.8,
ARSENIC HAIR,25201941,CDM,82175,CPT,300,RC,inpatient,,585,585,,496.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,441.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,497.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,514.8,88,,percent of total billed charges,,,,,,,,,446.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,532.35,91,,percent of total billed charges,,,555.75,95,,percent of total billed charges,,,485.55,83,,percent of total billed charges,,,485.55,83,,percent of total billed charges,,,,,,,,,,,,,,,485.55,83,,percent of total billed charges,,,555.75,95,,percent of total billed charges,,,526.5,90,,percent of total billed charges,,,526.5,90,,percent of total billed charges,,,479.7,82,,percent of total billed charges,,,526.5,90,,percent of total billed charges,,,497.25,85,,percent of total billed charges,,441.09,555.75,
MERCURY HAIR,25201942,CDM,83825,CPT,300,RC,inpatient,,733,733,,622.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,552.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,623.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,645.04,88,,percent of total billed charges,,,,,,,,,560.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,667.03,91,,percent of total billed charges,,,696.35,95,,percent of total billed charges,,,608.39,83,,percent of total billed charges,,,608.39,83,,percent of total billed charges,,,,,,,,,,,,,,,608.39,83,,percent of total billed charges,,,696.35,95,,percent of total billed charges,,,659.7,90,,percent of total billed charges,,,659.7,90,,percent of total billed charges,,,601.06,82,,percent of total billed charges,,,659.7,90,,percent of total billed charges,,,623.05,85,,percent of total billed charges,,552.68,696.35,
VITAMIN C,25201947,CDM,82180,CPT,300,RC,inpatient,,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,200.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,226.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,200.56,252.7,
AZATHIOPRINE,25201950,CDM,80375,CPT,300,RC,inpatient,,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,129.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,129.69,163.4,
BUPRENORPHINE,25201952,CDM,80348,CPT,300,RC,inpatient,,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,129.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,129.69,163.4,
XANAX,25201953,CDM,80168,CPT,300,RC,inpatient,,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,129.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,129.69,163.4,
ETHOSUXIMIDE,25201954,CDM,80168,CPT,300,RC,inpatient,,166,166,,140.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,146.08,88,,percent of total billed charges,,,,,,,,,126.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,,,,,,,,,,,,,137.78,83,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,136.12,82,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,125.16,157.7,
ZONISAMIDE,25201955,CDM,80203,CPT,300,RC,inpatient,,207,207,,175.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,156.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,182.16,88,,percent of total billed charges,,,,,,,,,158.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,188.37,91,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,,,,,,,,,,,,,171.81,83,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,169.74,82,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,175.95,85,,percent of total billed charges,,156.08,196.65,
BUPRENORPHINE URINE CONFIRMATION,25201956,CDM,80348,CPT,300,RC,inpatient,,252,252,,213.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,214.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,221.76,88,,percent of total billed charges,,,,,,,,,192.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,229.32,91,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,,,,,,,,,,,,,209.16,83,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,206.64,82,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,190.01,239.4,
FENTANYL URINE,25201957,CDM,80307,CPT,300,RC,inpatient,,252,252,,213.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,214.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,221.76,88,,percent of total billed charges,,,,,,,,,192.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,229.32,91,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,,,,,,,,,,,,,209.16,83,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,206.64,82,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,190.01,239.4,
..BUPRENORPHINE CHARGE ONLY,25201958,CDM,G0480,HCPCS,300,RC,inpatient,,252,252,,213.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,214.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,221.76,88,,percent of total billed charges,,47.96,,,,fee schedule,,,192.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,47.96,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,229.32,91,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,,,,,,,,,,,,,209.16,83,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,206.64,82,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,47.96,239.4,
ZINC SERUM,25201962,CDM,84630,CPT,300,RC,inpatient,,204,204,,173.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,173.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,179.52,88,,percent of total billed charges,,,,,,,,,155.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,185.64,91,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,,,,,,,,,,,,,169.32,83,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,167.28,82,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,173.4,85,,percent of total billed charges,,153.82,193.8,
BB ADSORPTION OF SERUM EACH CELL,25201969,CDM,86978,CPT,300,RC,inpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,179.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,159.09,200.45,
BB ANTIBODY IDENTIFICATION,25201970,CDM,86870,CPT,300,RC,inpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,283.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,319.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,283.5,357.2,
BB ANTIGEN TESTING OF DONOR BLOOD,25201971,CDM,86902,CPT,300,RC,inpatient,,197,197,,167.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.36,88,,percent of total billed charges,,,,,,,,,150.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.27,91,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,,,,,,,,,,,,,163.51,83,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,161.54,82,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,167.45,85,,percent of total billed charges,,148.54,187.15,
BB AG SCREEN W/PT SERUM PER UNIT,25201972,CDM,86904,CPT,300,RC,inpatient,,197,197,,167.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.36,88,,percent of total billed charges,,,,,,,,,150.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.27,91,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,,,,,,,,,,,,,163.51,83,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,161.54,82,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,167.45,85,,percent of total billed charges,,148.54,187.15,
BB RBC AG NOT ABO OR D,25201973,CDM,86905,CPT,300,RC,inpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
BB RBC AG SCREEN SPECIFIC ORDER 1-10,25201974,CDM,86902,CPT,300,RC,inpatient,,197,197,,167.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.36,88,,percent of total billed charges,,,,,,,,,150.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.27,91,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,,,,,,,,,,,,,163.51,83,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,161.54,82,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,167.45,85,,percent of total billed charges,,148.54,187.15,
BB RH PHENOTYPING,25201975,CDM,86906,CPT,300,RC,inpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
BB RX RBC W/CHEMICALS,25201976,CDM,86970,CPT,300,RC,inpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
BB ANTIGEN TYPING K (KELL),25201977,CDM,86870,CPT,300,RC,inpatient,,166,166,,140.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,146.08,88,,percent of total billed charges,,,,,,,,,126.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,,,,,,,,,,,,,137.78,83,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,136.12,82,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,125.16,157.7,
BB ANTIGEN TYPING E (BIG E LITTLE E),25201978,CDM,,,300,RC,inpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,120.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,120.64,152,
.BB ANTIGEN TYPING E,25201979,CDM,86905,CPT,300,RC,inpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,120.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,120.64,152,
BORDETELLA PERTUSSIS CULTURE,25201992,CDM,87081,CPT,300,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
BORDETELLA PERTUSSIS PCR,25201993,CDM,87798,CPT,300,RC,inpatient,,874,874,,742.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,659,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,742.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,769.12,88,,percent of total billed charges,,,,,,,,,667.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,795.34,91,,percent of total billed charges,,,830.3,95,,percent of total billed charges,,,725.42,83,,percent of total billed charges,,,725.42,83,,percent of total billed charges,,,,,,,,,,,,,,,725.42,83,,percent of total billed charges,,,830.3,95,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,716.68,82,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,742.9,85,,percent of total billed charges,,659,830.3,
BORDETELLA PERTUSSIS ANTIBODIES,25201994,CDM,86615,CPT,300,RC,inpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,149.29,188.1,
"BRUCELLA ANTIBODIES (IgG, IgM)",25201996,CDM,86622,CPT,300,RC,inpatient,,97,97,,82.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,73.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,82.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,85.36,88,,percent of total billed charges,,,,,,,,,74.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,,,,,,,,,,,,,80.51,83,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,79.54,82,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,73.14,92.15,
CARBAMAZEPINE TOTAL,25202028,CDM,80156,CPT,300,RC,inpatient,,230,230,,195.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,173.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,195.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,202.4,88,,percent of total billed charges,,,,,,,,,175.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,209.3,91,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,,,,,,,,,,,,,190.9,83,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,188.6,82,,percent of total billed charges,,,207,90,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,173.42,218.5,
CARBAMAZEPINE FREE,25202029,CDM,80157,CPT,300,RC,inpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,153.06,192.85,
CLOSTRIDIUM DIFFICILE TOXINS A & B & AG,25202036,CDM,87324,CPT,300,RC,inpatient,,439,439,,372.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,331.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,373.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,386.32,88,,percent of total billed charges,,,,,,,,,335.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,399.49,91,,percent of total billed charges,,,417.05,95,,percent of total billed charges,,,364.37,83,,percent of total billed charges,,,364.37,83,,percent of total billed charges,,,,,,,,,,,,,,,364.37,83,,percent of total billed charges,,,417.05,95,,percent of total billed charges,,,395.1,90,,percent of total billed charges,,,395.1,90,,percent of total billed charges,,,359.98,82,,percent of total billed charges,,,395.1,90,,percent of total billed charges,,,373.15,85,,percent of total billed charges,,331.01,417.05,
.CULTURE CLOSTRIDIUM DIFFICILE,25202037,CDM,87081,CPT,300,RC,inpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
CLOSTRIDUM DIFFICILE PCR,25202038,CDM,87493,CPT,300,RC,inpatient,,537,537,,455.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,404.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,456.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,472.56,88,,percent of total billed charges,,,,,,,,,410.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,488.67,91,,percent of total billed charges,,,510.15,95,,percent of total billed charges,,,445.71,83,,percent of total billed charges,,,445.71,83,,percent of total billed charges,,,,,,,,,,,,,,,445.71,83,,percent of total billed charges,,,510.15,95,,percent of total billed charges,,,483.3,90,,percent of total billed charges,,,483.3,90,,percent of total billed charges,,,440.34,82,,percent of total billed charges,,,483.3,90,,percent of total billed charges,,,456.45,85,,percent of total billed charges,,404.9,510.15,
"COPPER, BLOOD",25202044,CDM,82525,CPT,300,RC,inpatient,,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,294.06,370.5,
NICKEL PLASMA,25202046,CDM,83885,CPT,300,RC,inpatient,,288,288,,244.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,244.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,253.44,88,,percent of total billed charges,,,,,,,,,220.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.08,91,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,,,,,,,,,,,,,239.04,83,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,236.16,82,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,244.8,85,,percent of total billed charges,,217.15,273.6,
CULTURE ANAEROBIC,25202051,CDM,87075,CPT,300,RC,inpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,155.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,155.32,195.7,
CULTURE GROUP B STREP,25202052,CDM,87081,CPT,300,RC,inpatient,,165,165,,140.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,124.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,140.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,145.2,88,,percent of total billed charges,,,,,,,,,126.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,135.3,82,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,124.41,156.75,
CULTURE FUNGUS (OTHER),25202069,CDM,87102,CPT,300,RC,inpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,223.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,252.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,223.94,282.15,
CULTURE FUNGUS (BLOOD),25202070,CDM,87101,CPT,300,RC,inpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,223.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,252.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,223.94,282.15,
"CULTURE FUNGUS (HAIR, SKIN, NAILS)",25202071,CDM,87101,CPT,300,RC,inpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,223.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,252.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,223.94,282.15,
CULT FUNGUS W/RAPID ID,25202072,CDM,87101,CPT,300,RC,inpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,157.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,177.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,157.59,198.55,
CYANIDE BLOOD,25202077,CDM,82600,CPT,300,RC,inpatient,,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
CYCLOSPORA SMEAR STOOL,25202080,CDM,87015,CPT,300,RC,inpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,109.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,123.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,109.33,137.75,
CYCLOSPORINE A,25202085,CDM,80158,CPT,300,RC,inpatient,,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
CYSTATIN C,25202086,CDM,82610,CPT,300,RC,inpatient,,482,482,,409.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,363.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,409.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,424.16,88,,percent of total billed charges,,,,,,,,,368.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,438.62,91,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,,,,,,,,,,,,,400.06,83,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,395.24,82,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,363.43,457.9,
DHEA-SULFATE,25202093,CDM,82627,CPT,300,RC,inpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,345.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,306.12,385.7,
DEXAMETHASONE SUPPRESSION,25202094,CDM,82533,CPT,300,RC,inpatient,,293,293,,248.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,220.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,249.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,257.84,88,,percent of total billed charges,,,,,,,,,223.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,266.63,91,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,,,,,,,,,,,,,243.19,83,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,240.26,82,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,249.05,85,,percent of total billed charges,,220.92,278.35,
AMINOLEVULINIC ACID,25202095,CDM,82135,CPT,300,RC,inpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,157.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,177.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,157.59,198.55,
DEXAMETHASONE,25202096,CDM,80375,CPT,300,RC,inpatient,,221,221,,187.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,166.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,187.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,194.48,88,,percent of total billed charges,,,,,,,,,168.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,201.11,91,,percent of total billed charges,,,209.95,95,,percent of total billed charges,,,183.43,83,,percent of total billed charges,,,183.43,83,,percent of total billed charges,,,,,,,,,,,,,,,183.43,83,,percent of total billed charges,,,209.95,95,,percent of total billed charges,,,198.9,90,,percent of total billed charges,,,198.9,90,,percent of total billed charges,,,181.22,82,,percent of total billed charges,,,198.9,90,,percent of total billed charges,,,187.85,85,,percent of total billed charges,,166.63,209.95,
DHEA,25202097,CDM,82627,CPT,300,RC,inpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,345.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,306.12,385.7,
CREATININE URINE,25202119,CDM,82570,CPT,300,RC,inpatient,,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,115.36,145.35,
COXSACKIE A ANTIBODIES,25202120,CDM,86658,CPT,300,RC,inpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,89.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,79.17,99.75,
COXSACKIE B ANTIBODIES,25202121,CDM,86658,CPT,300,RC,inpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,89.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,79.17,99.75,
MEASLES ANTIBODY (IgG),25202127,CDM,86765,CPT,300,RC,inpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,157.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,177.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,157.59,198.55,
MEASLES ANTIBODY (IgM),25202128,CDM,86765,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
PARVOVIRUS DNA PCR (HIGH RISK),25202130,CDM,87798,CPT,300,RC,inpatient,,711,711,,603.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,536.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,604.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,625.68,88,,percent of total billed charges,,,,,,,,,543.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,647.01,91,,percent of total billed charges,,,675.45,95,,percent of total billed charges,,,590.13,83,,percent of total billed charges,,,590.13,83,,percent of total billed charges,,,,,,,,,,,,,,,590.13,83,,percent of total billed charges,,,675.45,95,,percent of total billed charges,,,639.9,90,,percent of total billed charges,,,639.9,90,,percent of total billed charges,,,583.02,82,,percent of total billed charges,,,639.9,90,,percent of total billed charges,,,604.35,85,,percent of total billed charges,,536.09,675.45,
PARVOVIRUS B19 IgM ANTIBODY,25202133,CDM,86747,CPT,300,RC,inpatient,,226,226,,191.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,170.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198.88,88,,percent of total billed charges,,,,,,,,,172.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,,,,,,,,,,,,,187.58,83,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,185.32,82,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,170.4,214.7,
PARVOVIRUS B19  IgG ANTIBODY,25202134,CDM,86747,CPT,300,RC,inpatient,,226,226,,191.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,170.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198.88,88,,percent of total billed charges,,,,,,,,,172.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,,,,,,,,,,,,,187.58,83,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,185.32,82,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,170.4,214.7,
PARATHYROID HORMONE,25202135,CDM,83970,CPT,300,RC,inpatient,,741,741,,629.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,558.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,629.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,652.08,88,,percent of total billed charges,,,,,,,,,566.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,674.31,91,,percent of total billed charges,,,703.95,95,,percent of total billed charges,,,615.03,83,,percent of total billed charges,,,615.03,83,,percent of total billed charges,,,,,,,,,,,,,,,615.03,83,,percent of total billed charges,,,703.95,95,,percent of total billed charges,,,666.9,90,,percent of total billed charges,,,666.9,90,,percent of total billed charges,,,607.62,82,,percent of total billed charges,,,666.9,90,,percent of total billed charges,,,629.85,85,,percent of total billed charges,,558.71,703.95,
PTH RELATED PEPTIDE,25202136,CDM,83519,CPT,300,RC,inpatient,,113,113,,95.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,99.44,88,,percent of total billed charges,,,,,,,,,86.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,92.66,82,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,85.2,107.35,
GONADOTROPIN RELEASING HORMONE,25202137,CDM,83727,CPT,300,RC,inpatient,,529,529,,449.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,398.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,449.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,465.52,88,,percent of total billed charges,,,,,,,,,404.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,481.39,91,,percent of total billed charges,,,502.55,95,,percent of total billed charges,,,439.07,83,,percent of total billed charges,,,439.07,83,,percent of total billed charges,,,,,,,,,,,,,,,439.07,83,,percent of total billed charges,,,502.55,95,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,433.78,82,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,449.65,85,,percent of total billed charges,,398.87,502.55,
HISTAMINE DETERMINATION PLASMA,25202138,CDM,83088,CPT,300,RC,inpatient,,524,524,,444.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,395.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,445.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,461.12,88,,percent of total billed charges,,,,,,,,,400.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,476.84,91,,percent of total billed charges,,,497.8,95,,percent of total billed charges,,,434.92,83,,percent of total billed charges,,,434.92,83,,percent of total billed charges,,,,,,,,,,,,,,,434.92,83,,percent of total billed charges,,,497.8,95,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,429.68,82,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,445.4,85,,percent of total billed charges,,395.1,497.8,
HISTONE AB,25202139,CDM,86235,CPT,300,RC,inpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,34.68,43.7,
CK ISOENZYMES,25202143,CDM,82552,CPT,300,RC,inpatient,,344,344,,292.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,259.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,292.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,302.72,88,,percent of total billed charges,,,,,,,,,262.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,313.04,91,,percent of total billed charges,,,326.8,95,,percent of total billed charges,,,285.52,83,,percent of total billed charges,,,285.52,83,,percent of total billed charges,,,,,,,,,,,,,,,285.52,83,,percent of total billed charges,,,326.8,95,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,282.08,82,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,292.4,85,,percent of total billed charges,,259.38,326.8,
LDH ISOENZYMES,25202150,CDM,83625,CPT,300,RC,inpatient,,360,360,,305.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,271.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,306,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,316.8,88,,percent of total billed charges,,,,,,,,,275.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,327.6,91,,percent of total billed charges,,,342,95,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,,,,,,,,,,,,,298.8,83,,percent of total billed charges,,,342,95,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,295.2,82,,percent of total billed charges,,,324,90,,percent of total billed charges,,,306,85,,percent of total billed charges,,271.44,342,
CLORAZEPATE,25202168,CDM,80346,CPT,300,RC,inpatient,,280,280,,237.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,211.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,238,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,246.4,88,,percent of total billed charges,,,,,,,,,213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,,,,,,,,,,,,,232.4,83,,percent of total billed charges,,,266,95,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,229.6,82,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,211.12,266,
CLONAZEPAM,25202169,CDM,80346,CPT,300,RC,inpatient,,280,280,,237.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,211.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,238,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,246.4,88,,percent of total billed charges,,,,,,,,,213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,,,,,,,,,,,,,232.4,83,,percent of total billed charges,,,266,95,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,229.6,82,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,211.12,266,
THYROXINE BINDING GLOBULIN (TBG),25202176,CDM,84442,CPT,300,RC,inpatient,,290,290,,246.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,218.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,246.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,255.2,88,,percent of total billed charges,,,,,,,,,221.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,263.9,91,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,,,,,,,,,,,,,240.7,83,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,261,90,,percent of total billed charges,,,261,90,,percent of total billed charges,,,237.8,82,,percent of total billed charges,,,261,90,,percent of total billed charges,,,246.5,85,,percent of total billed charges,,218.66,275.5,
BONE MARROW PARTICLE SECTION,25202218,CDM,88305,CPT,310,RC,inpatient,,498,498,,422.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,375.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,423.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,438.24,88,,percent of total billed charges,,,,,,,,,380.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,,,,,,,,,,,,,413.34,83,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,408.36,82,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,375.49,473.1,
BONE MARROW IRON STAIN,25202226,CDM,88313,CPT,310,RC,inpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,132.7,167.2,
BONE MARROW INTERPRETATION,25202234,CDM,85097,CPT,310,RC,inpatient,,543,543,,461.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,409.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,461.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,477.84,88,,percent of total billed charges,,,,,,,,,414.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,494.13,91,,percent of total billed charges,,,515.85,95,,percent of total billed charges,,,450.69,83,,percent of total billed charges,,,450.69,83,,percent of total billed charges,,,,,,,,,,,,,,,450.69,83,,percent of total billed charges,,,515.85,95,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,445.26,82,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,461.55,85,,percent of total billed charges,,409.42,515.85,
PROTEIN ELECTRO CSF,25202242,CDM,84166,CPT,300,RC,inpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,171.16,215.65,
PROTEIN ELECTRO BODY FLUID,25202244,CDM,84166,CPT,300,RC,inpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,171.16,215.65,
BONE MARROW PERIPHERAL SMEAR,25202259,CDM,85060,CPT,300,RC,inpatient,,440,440,,373.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,331.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,374,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,387.2,88,,percent of total billed charges,,,,,,,,,336.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,400.4,91,,percent of total billed charges,,,418,95,,percent of total billed charges,,,365.2,83,,percent of total billed charges,,,365.2,83,,percent of total billed charges,,,,,,,,,,,,,,,365.2,83,,percent of total billed charges,,,418,95,,percent of total billed charges,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,360.8,82,,percent of total billed charges,,,396,90,,percent of total billed charges,,,374,85,,percent of total billed charges,,331.76,418,
BONE MARROW TREPHINE BIOPSY,25202260,CDM,88305,CPT,310,RC,inpatient,,498,498,,422.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,375.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,423.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,438.24,88,,percent of total billed charges,,,,,,,,,380.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,,,,,,,,,,,,,413.34,83,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,408.36,82,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,375.49,473.1,
BONE MARROW PROCESSING/STAINING,25202261,CDM,85999,CPT,310,RC,inpatient,,471,471,,399.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,355.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,400.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,414.48,88,,percent of total billed charges,,,,,,,,,359.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,428.61,91,,percent of total billed charges,,,447.45,95,,percent of total billed charges,,,390.93,83,,percent of total billed charges,,,390.93,83,,percent of total billed charges,,,,,,,,,,,,,,,390.93,83,,percent of total billed charges,,,447.45,95,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,386.22,82,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,400.35,85,,percent of total billed charges,,355.13,447.45,
ZINC PROTOPORPHYRIN FEP/ZPP,25202267,CDM,84202,CPT,300,RC,inpatient,,122,122,,103.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,103.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,107.36,88,,percent of total billed charges,,,,,,,,,93.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,100.04,82,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,91.99,115.9,
OSMITIC FRAGILITY,25202268,CDM,85555,CPT,300,RC,inpatient,,602,602,,511.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,453.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,511.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,529.76,88,,percent of total billed charges,,,,,,,,,459.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,547.82,91,,percent of total billed charges,,,571.9,95,,percent of total billed charges,,,499.66,83,,percent of total billed charges,,,499.66,83,,percent of total billed charges,,,,,,,,,,,,,,,499.66,83,,percent of total billed charges,,,571.9,95,,percent of total billed charges,,,541.8,90,,percent of total billed charges,,,541.8,90,,percent of total billed charges,,,493.64,82,,percent of total billed charges,,,541.8,90,,percent of total billed charges,,,511.7,85,,percent of total billed charges,,453.91,571.9,
HEXAGONAL PHOSPHOLIPID,25202270,CDM,85598,CPT,300,RC,inpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,116.12,146.3,
PLASMA FRACTION SUBSITUTION EACH,25202271,CDM,85732,CPT,300,RC,inpatient,,122,122,,103.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,103.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,107.36,88,,percent of total billed charges,,,,,,,,,93.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,100.04,82,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,91.99,115.9,
RENIN,25202275,CDM,84244,CPT,300,RC,inpatient,,433,433,,367.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,326.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,368.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,381.04,88,,percent of total billed charges,,,,,,,,,330.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,394.03,91,,percent of total billed charges,,,411.35,95,,percent of total billed charges,,,359.39,83,,percent of total billed charges,,,359.39,83,,percent of total billed charges,,,,,,,,,,,,,,,359.39,83,,percent of total billed charges,,,411.35,95,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,355.06,82,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,368.05,85,,percent of total billed charges,,326.48,411.35,
RENAL FUNCTION PANEL,25202276,CDM,80069,CPT,300,RC,inpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,198.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,198.3,249.85,
RAPAMUNE (RAPAMYCIN),25202277,CDM,80195,CPT,300,RC,inpatient,,501,501,,425.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440.88,88,,percent of total billed charges,,,,,,,,,382.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,,,,,,,,,,,,,415.83,83,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,410.82,82,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,377.75,475.95,
SALICYLATES,25202283,CDM,80179,CPT,300,RC,inpatient,,226,226,,191.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,170.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198.88,88,,percent of total billed charges,,,,,,,,,172.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,,,,,,,,,,,,,187.58,83,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,185.32,82,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,170.4,214.7,
SICKLE CELL SCREEN,25202291,CDM,85660,CPT,300,RC,inpatient,,91,91,,77.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.08,88,,percent of total billed charges,,,,,,,,,69.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,,,,,,,,,,,,,75.53,83,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,74.62,82,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,68.61,86.45,
JAK2 MUTATION PLASMA,25202301,CDM,81270,CPT,300,RC,inpatient,,1272,1272,,1079.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,959.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1081.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1119.36,88,,percent of total billed charges,,,,,,,,,971.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1157.52,91,,percent of total billed charges,,,1208.4,95,,percent of total billed charges,,,1055.76,83,,percent of total billed charges,,,1055.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1055.76,83,,percent of total billed charges,,,1208.4,95,,percent of total billed charges,,,1144.8,90,,percent of total billed charges,,,1144.8,90,,percent of total billed charges,,,1043.04,82,,percent of total billed charges,,,1144.8,90,,percent of total billed charges,,,1081.2,85,,percent of total billed charges,,959.09,1208.4,
JC VIRUS,25202302,CDM,87798,CPT,300,RC,inpatient,,599,599,,508.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,451.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,509.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,527.12,88,,percent of total billed charges,,,,,,,,,457.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,545.09,91,,percent of total billed charges,,,569.05,95,,percent of total billed charges,,,497.17,83,,percent of total billed charges,,,497.17,83,,percent of total billed charges,,,,,,,,,,,,,,,497.17,83,,percent of total billed charges,,,569.05,95,,percent of total billed charges,,,539.1,90,,percent of total billed charges,,,539.1,90,,percent of total billed charges,,,491.18,82,,percent of total billed charges,,,539.1,90,,percent of total billed charges,,,509.15,85,,percent of total billed charges,,451.65,569.05,
JAK2  v617f MUTATION /rflx exon 12-15,25202303,CDM,81270,CPT,300,RC,inpatient,,521,521,,442.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,392.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,442.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,458.48,88,,percent of total billed charges,,,,,,,,,398.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,474.11,91,,percent of total billed charges,,,494.95,95,,percent of total billed charges,,,432.43,83,,percent of total billed charges,,,432.43,83,,percent of total billed charges,,,,,,,,,,,,,,,432.43,83,,percent of total billed charges,,,494.95,95,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,427.22,82,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,442.85,85,,percent of total billed charges,,392.83,494.95,
..JAK2 EXON 12-15,25202304,CDM,81270,CPT,300,RC,inpatient,,546,546,,463.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,411.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,464.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,480.48,88,,percent of total billed charges,,,,,,,,,417.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,496.86,91,,percent of total billed charges,,,518.7,95,,percent of total billed charges,,,453.18,83,,percent of total billed charges,,,453.18,83,,percent of total billed charges,,,,,,,,,,,,,,,453.18,83,,percent of total billed charges,,,518.7,95,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,447.72,82,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,464.1,85,,percent of total billed charges,,411.68,518.7,
STOOL WBC STAIN,25202309,CDM,89055,CPT,300,RC,inpatient,,106,106,,89.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,90.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,93.28,88,,percent of total billed charges,,,,,,,,,80.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,,,,,,,,,,,,,87.98,83,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,86.92,82,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,79.92,100.7,
GROWTH HORMONE,25202317,CDM,83003,CPT,300,RC,inpatient,,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,280.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,316.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,280.49,353.4,
FRUCTOSAMINE,25202325,CDM,82985,CPT,300,RC,inpatient,,226,226,,191.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,170.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198.88,88,,percent of total billed charges,,,,,,,,,172.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,,,,,,,,,,,,,187.58,83,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,185.32,82,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,170.4,214.7,
..FRAGILE X,25202326,CDM,81243,CPT,300,RC,inpatient,,594,594,,504.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,447.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,504.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,522.72,88,,percent of total billed charges,,,,,,,,,453.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,540.54,91,,percent of total billed charges,,,564.3,95,,percent of total billed charges,,,493.02,83,,percent of total billed charges,,,493.02,83,,percent of total billed charges,,,,,,,,,,,,,,,493.02,83,,percent of total billed charges,,,564.3,95,,percent of total billed charges,,,534.6,90,,percent of total billed charges,,,534.6,90,,percent of total billed charges,,,487.08,82,,percent of total billed charges,,,534.6,90,,percent of total billed charges,,,504.9,85,,percent of total billed charges,,447.88,564.3,
INTRINSIC FACTOR ANTIBODY,25202332,CDM,86340,CPT,300,RC,inpatient,,226,226,,191.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,170.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198.88,88,,percent of total billed charges,,,,,,,,,172.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,,,,,,,,,,,,,187.58,83,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,185.32,82,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,170.4,214.7,
INSULIN TOTAL,25202333,CDM,83525,CPT,300,RC,inpatient,,295,295,,250.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,222.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,250.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,259.6,88,,percent of total billed charges,,,,,,,,,225.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,268.45,91,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,,,,,,,,,,,,,244.85,83,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,241.9,82,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,222.43,280.25,
INSULIN TOTAL (3 SPECIMENS),25202334,CDM,83525,CPT,300,RC,inpatient,,101,101,,85.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88.88,88,,percent of total billed charges,,,,,,,,,77.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,82.82,82,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,76.15,95.95,
PROINSULIN,25202335,CDM,84206,CPT,300,RC,inpatient,,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,269.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,303.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,269.18,339.15,
KETONE SERUM,25202341,CDM,82009,CPT,300,RC,inpatient,,149,149,,126.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,112.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,126.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,131.12,88,,percent of total billed charges,,,,,,,,,113.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,135.59,91,,percent of total billed charges,,,141.55,95,,percent of total billed charges,,,123.67,83,,percent of total billed charges,,,123.67,83,,percent of total billed charges,,,,,,,,,,,,,,,123.67,83,,percent of total billed charges,,,141.55,95,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,122.18,82,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,126.65,85,,percent of total billed charges,,112.35,141.55,
KEPPRA,25202342,CDM,80177,CPT,300,RC,inpatient,,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,269.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,303.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,269.18,339.15,
BB ANTIBODY ELUTION,25202375,CDM,86860,CPT,300,RC,inpatient,,179,179,,151.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,134.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,152.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,157.52,88,,percent of total billed charges,,,,,,,,,136.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,146.78,82,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,134.97,170.05,
T-4 FREE,25202382,CDM,84439,CPT,300,RC,inpatient,,255,255,,216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,192.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,216.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,224.4,88,,percent of total billed charges,,,,,,,,,194.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,209.1,82,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,192.27,242.25,
T-3 FREE,25202383,CDM,84481,CPT,300,RC,inpatient,,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
VASOPRESSIN,25202408,CDM,84588,CPT,300,RC,inpatient,,550,550,,466.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,414.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,467.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,484,88,,percent of total billed charges,,,,,,,,,420.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,500.5,91,,percent of total billed charges,,,522.5,95,,percent of total billed charges,,,456.5,83,,percent of total billed charges,,,456.5,83,,percent of total billed charges,,,,,,,,,,,,,,,456.5,83,,percent of total billed charges,,,522.5,95,,percent of total billed charges,,,495,90,,percent of total billed charges,,,495,90,,percent of total billed charges,,,451,82,,percent of total billed charges,,,495,90,,percent of total billed charges,,,467.5,85,,percent of total billed charges,,414.7,522.5,
APOLIPOPROTEIN A1,25202409,CDM,82172,CPT,300,RC,inpatient,,264,264,,224.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,199.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,224.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,232.32,88,,percent of total billed charges,,,,,,,,,201.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,240.24,91,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,,,,,,,,,,,,,219.12,83,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,216.48,82,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,199.06,250.8,
APOLIPOPROTEIN B,25202410,CDM,82172,CPT,300,RC,inpatient,,182,182,,154.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,154.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,160.16,88,,percent of total billed charges,,,,,,,,,139.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,149.24,82,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,137.23,172.9,
ACTIVATED PROTEIN C RESISTANCE,25202411,CDM,85307,CPT,300,RC,inpatient,,520,520,,441.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,392.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,442,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,457.6,88,,percent of total billed charges,,,,,,,,,397.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,473.2,91,,percent of total billed charges,,,494,95,,percent of total billed charges,,,431.6,83,,percent of total billed charges,,,431.6,83,,percent of total billed charges,,,,,,,,,,,,,,,431.6,83,,percent of total billed charges,,,494,95,,percent of total billed charges,,,468,90,,percent of total billed charges,,,468,90,,percent of total billed charges,,,426.4,82,,percent of total billed charges,,,468,90,,percent of total billed charges,,,442,85,,percent of total billed charges,,392.08,494,
CALIFORNIA ENCEPHALITIS,25202412,CDM,86651,CPT,300,RC,inpatient,,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,130.44,164.35,
EASTERN EQUINE ENCEPHALITIS,25202413,CDM,86652,CPT,300,RC,inpatient,,354,354,,300.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,266.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,300.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,311.52,88,,percent of total billed charges,,,,,,,,,270.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,322.14,91,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,,,,,,,,,,,,,293.82,83,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,290.28,82,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,300.9,85,,percent of total billed charges,,266.92,336.3,
WESTERN EQUINE ENCEPHALITIS,25202414,CDM,86654,CPT,300,RC,inpatient,,135,135,,114.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,101.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,114.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,118.8,88,,percent of total billed charges,,,,,,,,,103.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,,,,,,,,,,,,,112.05,83,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,110.7,82,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,101.79,128.25,
EASTERN EQUINE ENCEP (CSF),25202416,CDM,86652,CPT,300,RC,inpatient,,354,354,,300.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,266.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,300.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,311.52,88,,percent of total billed charges,,,,,,,,,270.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,322.14,91,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,,,,,,,,,,,,,293.82,83,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,290.28,82,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,300.9,85,,percent of total billed charges,,266.92,336.3,
APOE,25202417,CDM,81479,CPT,300,RC,inpatient,,718,718,,609.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,541.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,610.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,631.84,88,,percent of total billed charges,,,,,,,,,548.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,653.38,91,,percent of total billed charges,,,682.1,95,,percent of total billed charges,,,595.94,83,,percent of total billed charges,,,595.94,83,,percent of total billed charges,,,,,,,,,,,,,,,595.94,83,,percent of total billed charges,,,682.1,95,,percent of total billed charges,,,646.2,90,,percent of total billed charges,,,646.2,90,,percent of total billed charges,,,588.76,82,,percent of total billed charges,,,646.2,90,,percent of total billed charges,,,610.3,85,,percent of total billed charges,,541.37,682.1,
ANTI-MULLERIAN HORMONE,25202420,CDM,82397,CPT,300,RC,inpatient,,273,273,,231.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,205.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,232.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,240.24,88,,percent of total billed charges,,,,,,,,,208.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,248.43,91,,percent of total billed charges,,,259.35,95,,percent of total billed charges,,,226.59,83,,percent of total billed charges,,,226.59,83,,percent of total billed charges,,,,,,,,,,,,,,,226.59,83,,percent of total billed charges,,,259.35,95,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,223.86,82,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,232.05,85,,percent of total billed charges,,205.84,259.35,
ANTIPARIETAL CELL AB,25202421,CDM,83516,CPT,300,RC,inpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,18.1,22.8,
VORICONAZOLE,25202422,CDM,80285,CPT,300,RC,inpatient,,564,564,,478.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,425.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,479.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,496.32,88,,percent of total billed charges,,,,,,,,,430.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,513.24,91,,percent of total billed charges,,,535.8,95,,percent of total billed charges,,,468.12,83,,percent of total billed charges,,,468.12,83,,percent of total billed charges,,,,,,,,,,,,,,,468.12,83,,percent of total billed charges,,,535.8,95,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,462.48,82,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,479.4,85,,percent of total billed charges,,425.26,535.8,
ANTI-USTEKINUMAB AB,25202423,CDM,80299,CPT,300,RC,inpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,18.1,22.8,
DNA (SS) ANTIBODIES (IgG),25202430,CDM,86226,CPT,300,RC,inpatient,,72,72,,61.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,54.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,61.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,63.36,88,,percent of total billed charges,,,,,,,,,55.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,65.52,91,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,,,,,,,,,,,,,59.76,83,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,59.04,82,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,54.29,68.4,
DNA (DS) ANTIBODIES,25202432,CDM,86225,CPT,300,RC,inpatient,,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,186.99,235.6,
DNA (DS) AB CRITHIDIA LUCILIAE,25202433,CDM,86225,CPT,300,RC,inpatient,,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,186.99,235.6,
.DNA PROBE FISH,25202435,CDM,88271,CPT,300,RC,inpatient,,186,186,,157.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,140.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,158.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,163.68,88,,percent of total billed charges,,,,,,,,,142.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,169.26,91,,percent of total billed charges,,,176.7,95,,percent of total billed charges,,,154.38,83,,percent of total billed charges,,,154.38,83,,percent of total billed charges,,,,,,,,,,,,,,,154.38,83,,percent of total billed charges,,,176.7,95,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,152.52,82,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,158.1,85,,percent of total billed charges,,140.24,176.7,
.CELLULAR ENHANCEMENT,25202436,CDM,88112,CPT,300,RC,inpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,61.07,76.95,
.INTERPHASE HYBRIDIZATION 100-300 CELLS,25202440,CDM,88275,CPT,300,RC,inpatient,,413,413,,350.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,311.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,351.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,363.44,88,,percent of total billed charges,,,,,,,,,315.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,375.83,91,,percent of total billed charges,,,392.35,95,,percent of total billed charges,,,342.79,83,,percent of total billed charges,,,342.79,83,,percent of total billed charges,,,,,,,,,,,,,,,342.79,83,,percent of total billed charges,,,392.35,95,,percent of total billed charges,,,371.7,90,,percent of total billed charges,,,371.7,90,,percent of total billed charges,,,338.66,82,,percent of total billed charges,,,371.7,90,,percent of total billed charges,,,351.05,85,,percent of total billed charges,,311.4,392.35,
FISH BLADDER CANCER,25202446,CDM,88120,CPT,300,RC,inpatient,,1710,1710,,1451.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1289.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1453.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1504.8,88,,percent of total billed charges,,,,,,,,,1306.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1556.1,91,,percent of total billed charges,,,1624.5,95,,percent of total billed charges,,,1419.3,83,,percent of total billed charges,,,1419.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1419.3,83,,percent of total billed charges,,,1624.5,95,,percent of total billed charges,,,1539,90,,percent of total billed charges,,,1539,90,,percent of total billed charges,,,1402.2,82,,percent of total billed charges,,,1539,90,,percent of total billed charges,,,1453.5,85,,percent of total billed charges,,1289.34,1624.5,
FISH T315I BCR/ABL,25202447,CDM,81170,CPT,300,RC,inpatient,,988,988,,838.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,744.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,839.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,869.44,88,,percent of total billed charges,,,,,,,,,754.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,899.08,91,,percent of total billed charges,,,938.6,95,,percent of total billed charges,,,820.04,83,,percent of total billed charges,,,820.04,83,,percent of total billed charges,,,,,,,,,,,,,,,820.04,83,,percent of total billed charges,,,938.6,95,,percent of total billed charges,,,889.2,90,,percent of total billed charges,,,889.2,90,,percent of total billed charges,,,810.16,82,,percent of total billed charges,,,889.2,90,,percent of total billed charges,,,839.8,85,,percent of total billed charges,,744.95,938.6,
CONCENTRATION INFECT AGENT,25202450,CDM,87015,CPT,300,RC,inpatient,,168,168,,142.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,126.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,142.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,147.84,88,,percent of total billed charges,,,,,,,,,128.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,,,,,,,,,,,,,139.44,83,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,137.76,82,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,126.67,159.6,
COCCIDIOIDES ANTIBODY PANEL (ARUP),25202455,CDM,86635,CPT,300,RC,inpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,76.91,96.9,
...COCCIDIOIDES ANTIBODY,25202457,CDM,86635,CPT,300,RC,inpatient,,99,99,,84.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,74.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,84.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,87.12,88,,percent of total billed charges,,,,,,,,,75.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,,,,,,,,,,,,,82.17,83,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,81.18,82,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,74.65,94.05,
CRYPTOCOCCUS ANTIGEN (CSF),25202464,CDM,87899,CPT,300,RC,inpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
CRYPTOCOCCUS ANTIGEN (SERUM),25202465,CDM,87899,CPT,300,RC,inpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
CRYPTOCOCCUS ANTIBODIES,25202466,CDM,86641,CPT,300,RC,inpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
EBV VCA (IGM) ANTIBODY,25202499,CDM,86665,CPT,300,RC,inpatient,,328,328,,278.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,247.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,278.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,288.64,88,,percent of total billed charges,,,,,,,,,250.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,298.48,91,,percent of total billed charges,,,311.6,95,,percent of total billed charges,,,272.24,83,,percent of total billed charges,,,272.24,83,,percent of total billed charges,,,,,,,,,,,,,,,272.24,83,,percent of total billed charges,,,311.6,95,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,268.96,82,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,278.8,85,,percent of total billed charges,,247.31,311.6,
ALCOHOL BLOOD,25202507,CDM,82077,CPT,300,RC,inpatient,,324,324,,275.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,244.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,275.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,285.12,88,,percent of total billed charges,,,,,,,,,247.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,294.84,91,,percent of total billed charges,,,307.8,95,,percent of total billed charges,,,268.92,83,,percent of total billed charges,,,268.92,83,,percent of total billed charges,,,,,,,,,,,,,,,268.92,83,,percent of total billed charges,,,307.8,95,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,265.68,82,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,275.4,85,,percent of total billed charges,,244.3,307.8,
"ALCOHOL, ETHANOL, URINE",25202508,CDM,80307,CPT,300,RC,inpatient,,35,35,,29.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.8,88,,percent of total billed charges,,,,,,,,,26.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31.85,91,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,,,,,,,,,,,,,29.05,83,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,28.7,82,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,26.39,33.25,
ETHYL GLUCURONIDE (ETG),25202509,CDM,80307,CPT,300,RC,inpatient,,66,66,,56.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.08,88,,percent of total billed charges,,,,,,,,,50.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.06,91,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,,,,,,,,,,,,,54.78,83,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,54.12,82,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,49.76,62.7,
ETHYENE L GLYCOL (SERUM/PLASMA),25202510,CDM,82693,CPT,300,RC,inpatient,,38,38,,32.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33.44,88,,percent of total billed charges,,,,,,,,,29.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.58,91,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,,,,,,,,,,,,,31.54,83,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,31.16,82,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,28.65,36.1,
ANA W /9MARKERS,25202511,CDM,86225,CPT,300,RC,inpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
ANA REFLEX 9MARKERS,25202513,CDM,86038,CPT,300,RC,inpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
.ANA TITER & PATTERN,25202514,CDM,86039,CPT,300,RC,inpatient,,201,201,,170.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,151.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176.88,88,,percent of total billed charges,,,,,,,,,153.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182.91,91,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,,,,,,,,,,,,,166.83,83,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,164.82,82,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,151.55,190.95,
ANTINUCLEAR ANTIBODY SCREEN,25202515,CDM,86038,CPT,300,RC,inpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
CLOMIPRAMINE,25202516,CDM,80299,CPT,300,RC,inpatient,,443,443,,376.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,334.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,376.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,389.84,88,,percent of total billed charges,,,,,,,,,338.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,403.13,91,,percent of total billed charges,,,420.85,95,,percent of total billed charges,,,367.69,83,,percent of total billed charges,,,367.69,83,,percent of total billed charges,,,,,,,,,,,,,,,367.69,83,,percent of total billed charges,,,420.85,95,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,363.26,82,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,376.55,85,,percent of total billed charges,,334.02,420.85,
..ANTI,25202517,CDM,86038,CPT,300,RC,inpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
ANA REFLX DNA/RNP/SM/SSA&B,25202520,CDM,86038,CPT,300,RC,inpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
...ANA W/,25202521,CDM,86038,CPT,300,RC,inpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
CONNECTIVE TISSUE CASCADE,25202523,CDM,86038,CPT,300,RC,inpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
CENTROMERE AB,25202525,CDM,86256,CPT,300,RC,inpatient,,71,71,,60.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.48,88,,percent of total billed charges,,,,,,,,,54.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,,,,,,,,,,,,,58.93,83,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,58.22,82,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,53.53,67.45,
ANGIOTENSIN II,25202527,CDM,82163,CPT,300,RC,inpatient,,223,223,,189.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.24,88,,percent of total billed charges,,,,,,,,,170.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,202.93,91,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,,,,,,,,,,,,,185.09,83,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,182.86,82,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,168.14,211.85,
VITAMIN B12,25202531,CDM,82607,CPT,300,RC,inpatient,,292,292,,247.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,220.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,248.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,256.96,88,,percent of total billed charges,,,,,,,,,223.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,265.72,91,,percent of total billed charges,,,277.4,95,,percent of total billed charges,,,242.36,83,,percent of total billed charges,,,242.36,83,,percent of total billed charges,,,,,,,,,,,,,,,242.36,83,,percent of total billed charges,,,277.4,95,,percent of total billed charges,,,262.8,90,,percent of total billed charges,,,262.8,90,,percent of total billed charges,,,239.44,82,,percent of total billed charges,,,262.8,90,,percent of total billed charges,,,248.2,85,,percent of total billed charges,,220.17,277.4,
VITAMIN B12 BINDING CAPACITY,25202532,CDM,82608,CPT,300,RC,inpatient,,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,186.99,235.6,
CHOLINESTERASE SERUM,25202556,CDM,82480,CPT,300,RC,inpatient,,168,168,,142.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,126.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,142.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,147.84,88,,percent of total billed charges,,,,,,,,,128.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,,,,,,,,,,,,,139.44,83,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,137.76,82,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,126.67,159.6,
NMR LIPOPROFILE,25202560,CDM,83704,CPT,300,RC,inpatient,,329,329,,279.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,248.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,279.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,289.52,88,,percent of total billed charges,,,,,,,,,251.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,299.39,91,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,,,,,,,,,,,,,273.07,83,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,269.78,82,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,248.07,312.55,
CEA,25202564,CDM,82378,CPT,300,RC,inpatient,,395,395,,335.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,297.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,335.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,347.6,88,,percent of total billed charges,,,,,,,,,301.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,359.45,91,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,,,,,,,,,,,,,327.85,83,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,323.9,82,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,297.83,375.25,
CEA (BODY FLUID),25202565,CDM,82378,CPT,300,RC,inpatient,,34,34,,28.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.92,88,,percent of total billed charges,,,,,,,,,25.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,,,,,,,,,,,,,28.22,83,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,27.88,82,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,25.64,32.3,
CK TOTAL,25202572,CDM,82550,CPT,300,RC,inpatient,,155,155,,131.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,131.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,136.4,88,,percent of total billed charges,,,,,,,,,118.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,127.1,82,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,116.87,147.25,
CK-MB,25202580,CDM,82553,CPT,300,RC,inpatient,,264,264,,224.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,199.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,224.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,232.32,88,,percent of total billed charges,,,,,,,,,201.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,240.24,91,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,,,,,,,,,,,,,219.12,83,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,216.48,82,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,199.06,250.8,
CORTISOL STIMULATION,25202595,CDM,82533,CPT,300,RC,inpatient,,531,531,,450.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,400.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,451.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,467.28,88,,percent of total billed charges,,,,,,,,,405.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,483.21,91,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,,,,,,,,,,,,,440.73,83,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,435.42,82,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,400.37,504.45,
CORTISOL TOTAL SERUM,25202598,CDM,82533,CPT,300,RC,inpatient,,293,293,,248.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,220.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,249.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,257.84,88,,percent of total billed charges,,,,,,,,,223.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,266.63,91,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,,,,,,,,,,,,,243.19,83,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,240.26,82,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,249.05,85,,percent of total billed charges,,220.92,278.35,
CORTISOL TOTAL (A.M. & P.M.),25202599,CDM,82533,CPT,300,RC,inpatient,,293,293,,248.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,220.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,249.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,257.84,88,,percent of total billed charges,,,,,,,,,223.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,266.63,91,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,,,,,,,,,,,,,243.19,83,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,240.26,82,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,249.05,85,,percent of total billed charges,,220.92,278.35,
ANTI-68 KD ANTIBODIES WESTERN BLOT,25202600,CDM,84181,CPT,300,RC,inpatient,,370,370,,314.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,314.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,325.6,88,,percent of total billed charges,,,,,,,,,282.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,336.7,91,,percent of total billed charges,,,351.5,95,,percent of total billed charges,,,307.1,83,,percent of total billed charges,,,307.1,83,,percent of total billed charges,,,,,,,,,,,,,,,307.1,83,,percent of total billed charges,,,351.5,95,,percent of total billed charges,,,333,90,,percent of total billed charges,,,333,90,,percent of total billed charges,,,303.4,82,,percent of total billed charges,,,333,90,,percent of total billed charges,,,314.5,85,,percent of total billed charges,,278.98,351.5,
HLA-B27 ANTIGEN,25202606,CDM,81374,CPT,300,RC,inpatient,,504,504,,427.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,380.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,428.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,443.52,88,,percent of total billed charges,,,,,,,,,385.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,458.64,91,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,,,,,,,,,,,,,418.32,83,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,413.28,82,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,380.02,478.8,
HLA-B58,25202607,CDM,81381,CPT,300,RC,inpatient,,504,504,,427.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,380.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,428.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,443.52,88,,percent of total billed charges,,,,,,,,,385.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,458.64,91,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,,,,,,,,,,,,,418.32,83,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,413.28,82,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,380.02,478.8,
"HLA CLASS I A,B,C DNA TYPING",25202610,CDM,81372,CPT,300,RC,inpatient,,545,545,,462.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,410.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,463.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,479.6,88,,percent of total billed charges,,,,,,,,,416.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,495.95,91,,percent of total billed charges,,,517.75,95,,percent of total billed charges,,,452.35,83,,percent of total billed charges,,,452.35,83,,percent of total billed charges,,,,,,,,,,,,,,,452.35,83,,percent of total billed charges,,,517.75,95,,percent of total billed charges,,,490.5,90,,percent of total billed charges,,,490.5,90,,percent of total billed charges,,,446.9,82,,percent of total billed charges,,,490.5,90,,percent of total billed charges,,,463.25,85,,percent of total billed charges,,410.93,517.75,
"HLA DRB1,3,4,5, DQB1 (IR)",25202612,CDM,81375,CPT,300,RC,inpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
EBV NUCLEAR ANTIGEN ANTIBODY,25202614,CDM,86664,CPT,300,RC,inpatient,,275,275,,233.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,207.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,233.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,242,88,,percent of total billed charges,,,,,,,,,210.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,250.25,91,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,,,,,,,,,,,,,228.25,83,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,225.5,82,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,233.75,85,,percent of total billed charges,,207.35,261.25,
EPSTEIN BARR QT DNA PCR,25202615,CDM,87799,CPT,300,RC,inpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,580.58,731.5,
FERRITIN,25202622,CDM,82728,CPT,300,RC,inpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
FOLATE  SERUM,25202630,CDM,82746,CPT,300,RC,inpatient,,256,256,,217.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,193.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,217.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,225.28,88,,percent of total billed charges,,,,,,,,,195.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,232.96,91,,percent of total billed charges,,,243.2,95,,percent of total billed charges,,,212.48,83,,percent of total billed charges,,,212.48,83,,percent of total billed charges,,,,,,,,,,,,,,,212.48,83,,percent of total billed charges,,,243.2,95,,percent of total billed charges,,,230.4,90,,percent of total billed charges,,,230.4,90,,percent of total billed charges,,,209.92,82,,percent of total billed charges,,,230.4,90,,percent of total billed charges,,,217.6,85,,percent of total billed charges,,193.02,243.2,
FOLATE RBC,25202631,CDM,82747,CPT,300,RC,inpatient,,261,261,,221.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,196.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,221.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,229.68,88,,percent of total billed charges,,,,,,,,,199.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.51,91,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,,,,,,,,,,,,,216.63,83,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,214.02,82,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,221.85,85,,percent of total billed charges,,196.79,247.95,
CANNABINOID METABOLITE SYNTHETIC,25202645,CDM,80307,CPT,300,RC,inpatient,,310,310,,263.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,233.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,263.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,272.8,88,,percent of total billed charges,,,,,,,,,236.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,282.1,91,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,,,,,,,,,,,,,257.3,83,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,279,90,,percent of total billed charges,,,279,90,,percent of total billed charges,,,254.2,82,,percent of total billed charges,,,279,90,,percent of total billed charges,,,263.5,85,,percent of total billed charges,,233.74,294.5,
CANNABINOID MET SYNTHETIC BLOOD,25202646,CDM,80352,CPT,300,RC,inpatient,,261,261,,221.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,196.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,221.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,229.68,88,,percent of total billed charges,,,,,,,,,199.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.51,91,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,,,,,,,,,,,,,216.63,83,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,214.02,82,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,221.85,85,,percent of total billed charges,,196.79,247.95,
KLEIHAUER-BETKE,25202647,CDM,85460,CPT,300,RC,inpatient,,310,310,,263.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,233.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,263.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,272.8,88,,percent of total billed charges,,,,,,,,,236.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,282.1,91,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,,,,,,,,,,,,,257.3,83,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,279,90,,percent of total billed charges,,,279,90,,percent of total billed charges,,,254.2,82,,percent of total billed charges,,,279,90,,percent of total billed charges,,,263.5,85,,percent of total billed charges,,233.74,294.5,
DRUG SCREEN CLINICAL RAPID,25202648,CDM,80306,CPT,300,RC,inpatient,,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,203.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,180.21,227.05,
DRUG SCREEN MECONIUM,25202649,CDM,80307,CPT,300,RC,inpatient,,190,190,,161.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,143.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,161.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,167.2,88,,percent of total billed charges,,,,,,,,,145.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,,,,,,,,,,,,,157.7,83,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,155.8,82,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,143.26,180.5,
..DRUG SCREEN PRE-EMPLOYMENT,25202650,CDM,80307,CPT,300,RC,inpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,92.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,82.19,103.55,
DRUG SCREEN PRE-EMP(LABCORP),25202651,CDM,80307,CPT,300,RC,inpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,92.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,82.19,103.55,
DRUG OF ABUSE (10)SCRN(LABCORP),25202652,CDM,80307,CPT,300,RC,inpatient,,122,122,,103.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,103.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,107.36,88,,percent of total billed charges,,,,,,,,,93.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,100.04,82,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,91.99,115.9,
DRUG OF ABUSE (14)SCRN(LABCORP),25202653,CDM,80307,CPT,300,RC,inpatient,,122,122,,103.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,103.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,107.36,88,,percent of total billed charges,,,,,,,,,93.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,100.04,82,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,91.99,115.9,
..DRUG SCREEN POST ACCIDENT,25202660,CDM,80307,CPT,300,RC,inpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,92.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,82.19,103.55,
DISOPYRAMIDE,25202663,CDM,80299,CPT,300,RC,inpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,155.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,155.32,195.7,
.DIPHTHERIA ANTITOXOID AB,25202666,CDM,86648,CPT,300,RC,inpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,93.5,117.8,
.TETANUS  AB,25202667,CDM,86774,CPT,300,RC,inpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,93.5,117.8,
NUCLEIC ACID ISOLATION/EXTRACTION,25202669,CDM,83891,CPT,300,RC,inpatient,,189,189,,160.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,142.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,160.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,166.32,88,,percent of total billed charges,,,,,,,,,144.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,,,,,,,,,,,,,156.87,83,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,154.98,82,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,142.51,179.55,
NUCLEIC ACID AMPLIFICATION 1 SEQ,25202670,CDM,83898,CPT,300,RC,inpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.92,88,,percent of total billed charges,,,,,,,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,44.49,56.05,
NUCLEIC ACID AMPLIFICATION 1&2 SEQ,25202671,CDM,83900,CPT,300,RC,inpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,58.06,73.15,
NUCLEIC ACID AMPLIFICATION ADD SEQ,25202672,CDM,83901,CPT,300,RC,inpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,58.81,74.1,
NUCLEIC ACID MUTATION ID,25202673,CDM,83914,CPT,300,RC,inpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,89.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,79.17,99.75,
NUCLEIC ACID SEPERATION & ID,25202674,CDM,83909,CPT,300,RC,inpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,76.91,96.9,
NUCLEIC ACID INTERPRETATION,25202675,CDM,83912,CPT,300,RC,inpatient,,149,149,,126.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,112.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,126.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,131.12,88,,percent of total billed charges,,,,,,,,,113.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,135.59,91,,percent of total billed charges,,,141.55,95,,percent of total billed charges,,,123.67,83,,percent of total billed charges,,,123.67,83,,percent of total billed charges,,,,,,,,,,,,,,,123.67,83,,percent of total billed charges,,,141.55,95,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,122.18,82,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,126.65,85,,percent of total billed charges,,112.35,141.55,
"NUCLEIC ACID PROBE, each",25202676,CDM,83896,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
NUCLEIC ACID ENZYME DIGESTION,25202677,CDM,83892,CPT,300,RC,inpatient,,122,122,,103.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,103.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,107.36,88,,percent of total billed charges,,,,,,,,,93.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,100.04,82,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,91.99,115.9,
5-NUCLEOTIDASE,25202680,CDM,83915,CPT,300,RC,inpatient,,161,161,,136.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,121.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,141.68,88,,percent of total billed charges,,,,,,,,,123,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,132.02,82,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,121.39,152.95,
21 HYDROXYLASE,25202685,CDM,83519,CPT,300,RC,inpatient,,1588,1588,,1348.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1197.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1349.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1397.44,88,,percent of total billed charges,,,,,,,,,1213.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1445.08,91,,percent of total billed charges,,,1508.6,95,,percent of total billed charges,,,1318.04,83,,percent of total billed charges,,,1318.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1318.04,83,,percent of total billed charges,,,1508.6,95,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1302.16,82,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1349.8,85,,percent of total billed charges,,1197.35,1508.6,
IRON TOTAL,25202689,CDM,83540,CPT,300,RC,inpatient,,185,185,,157.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,139.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,157.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,162.8,88,,percent of total billed charges,,,,,,,,,141.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,168.35,91,,percent of total billed charges,,,175.75,95,,percent of total billed charges,,,153.55,83,,percent of total billed charges,,,153.55,83,,percent of total billed charges,,,,,,,,,,,,,,,153.55,83,,percent of total billed charges,,,175.75,95,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,151.7,82,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,157.25,85,,percent of total billed charges,,139.49,175.75,
OVA & PARASITES,25202705,CDM,87177,CPT,300,RC,inpatient,,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,110.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,98.02,123.5,
CRYPTOSPORIDIUM ANTIGEN STOOL,25202713,CDM,87272,CPT,300,RC,inpatient,,190,190,,161.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,143.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,161.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,167.2,88,,percent of total billed charges,,,,,,,,,145.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,,,,,,,,,,,,,157.7,83,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,155.8,82,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,143.26,180.5,
PROLACTIN,25202721,CDM,84146,CPT,300,RC,inpatient,,335,335,,284.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,252.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,284.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,294.8,88,,percent of total billed charges,,,,,,,,,255.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,304.85,91,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,,,,,,,,,,,,,278.05,83,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,274.7,82,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,252.59,318.25,
"PROLACTIN, FREE",25202722,CDM,84146,CPT,300,RC,inpatient,,129,129,,109.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,97.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,109.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,113.52,88,,percent of total billed charges,,,,,,,,,98.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,105.78,82,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,97.27,122.55,
ANDROSTENEDIONE,25202739,CDM,82157,CPT,300,RC,inpatient,,360,360,,305.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,271.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,306,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,316.8,88,,percent of total billed charges,,,,,,,,,275.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,327.6,91,,percent of total billed charges,,,342,95,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,,,,,,,,,,,,,298.8,83,,percent of total billed charges,,,342,95,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,295.2,82,,percent of total billed charges,,,324,90,,percent of total billed charges,,,306,85,,percent of total billed charges,,271.44,342,
FSH,25202747,CDM,83001,CPT,300,RC,inpatient,,377,377,,320.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,284.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,320.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,331.76,88,,percent of total billed charges,,,,,,,,,288.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,343.07,91,,percent of total billed charges,,,358.15,95,,percent of total billed charges,,,312.91,83,,percent of total billed charges,,,312.91,83,,percent of total billed charges,,,,,,,,,,,,,,,312.91,83,,percent of total billed charges,,,358.15,95,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,309.14,82,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,320.45,85,,percent of total billed charges,,284.26,358.15,
FSH (PEDIATRICS  ULT SENS),25202748,CDM,83001,CPT,300,RC,inpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,58.06,73.15,
VOLTAGE-GATED CA AB,25202760,CDM,86596,CPT,300,RC,inpatient,,208,208,,176.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,156.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,176.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.04,88,,percent of total billed charges,,,,,,,,,158.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,189.28,91,,percent of total billed charges,,,197.6,95,,percent of total billed charges,,,172.64,83,,percent of total billed charges,,,172.64,83,,percent of total billed charges,,,,,,,,,,,,,,,172.64,83,,percent of total billed charges,,,197.6,95,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,170.56,82,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,176.8,85,,percent of total billed charges,,156.83,197.6,
ACETYLCHOLINE RECEPTOR BIND AB,25202762,CDM,83519,CPT,300,RC,inpatient,,531,531,,450.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,400.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,451.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,467.28,88,,percent of total billed charges,,,,,,,,,405.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,483.21,91,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,,,,,,,,,,,,,440.73,83,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,435.42,82,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,400.37,504.45,
ACETYLCHOLINE RECEPTOR MOD AB,25202763,CDM,83519,CPT,300,RC,inpatient,,655,655,,556.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,493.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,556.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,576.4,88,,percent of total billed charges,,,,,,,,,500.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,596.05,91,,percent of total billed charges,,,622.25,95,,percent of total billed charges,,,543.65,83,,percent of total billed charges,,,543.65,83,,percent of total billed charges,,,,,,,,,,,,,,,543.65,83,,percent of total billed charges,,,622.25,95,,percent of total billed charges,,,589.5,90,,percent of total billed charges,,,589.5,90,,percent of total billed charges,,,537.1,82,,percent of total billed charges,,,589.5,90,,percent of total billed charges,,,556.75,85,,percent of total billed charges,,493.87,622.25,
ACETYLCHOLINE RECEPTOR BLOCK AB,25202764,CDM,83519,CPT,300,RC,inpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,481.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,543.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,481.81,607.05,
ACYLCARNITINE PLASMA,25202765,CDM,82017,CPT,300,RC,inpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,347.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,391.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,347.59,437.95,
TSH,25202770,CDM,84443,CPT,300,RC,inpatient,,321,321,,272.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,272.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,282.48,88,,percent of total billed charges,,,,,,,,,245.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,292.11,91,,percent of total billed charges,,,304.95,95,,percent of total billed charges,,,266.43,83,,percent of total billed charges,,,266.43,83,,percent of total billed charges,,,,,,,,,,,,,,,266.43,83,,percent of total billed charges,,,304.95,95,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,263.22,82,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,272.85,85,,percent of total billed charges,,242.03,304.95,
AMINO ACID ANALYSIS(URINE),25202772,CDM,82139,CPT,300,RC,inpatient,,858,858,,728.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,646.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,729.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,755.04,88,,percent of total billed charges,,,,,,,,,655.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,780.78,91,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,,,,,,,,,,,,,712.14,83,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,703.56,82,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,646.93,815.1,
AMINO ACID PLASMA,25202775,CDM,82139,CPT,300,RC,inpatient,,398,398,,337.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,300.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,338.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,350.24,88,,percent of total billed charges,,,,,,,,,304.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,362.18,91,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,,,,,,,,,,,,,330.34,83,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,326.36,82,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,338.3,85,,percent of total billed charges,,300.09,378.1,
CARNITINE,25202780,CDM,82379,CPT,300,RC,inpatient,,470,470,,399.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,354.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,399.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,413.6,88,,percent of total billed charges,,,,,,,,,359.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,427.7,91,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,,,,,,,,,,,,,390.1,83,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,423,90,,percent of total billed charges,,,423,90,,percent of total billed charges,,,385.4,82,,percent of total billed charges,,,423,90,,percent of total billed charges,,,399.5,85,,percent of total billed charges,,354.38,446.5,
ORGANIC ACID URINE QT,25202785,CDM,83918,CPT,300,RC,inpatient,,458,458,,388.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,345.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,389.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,403.04,88,,percent of total billed charges,,,,,,,,,349.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,416.78,91,,percent of total billed charges,,,435.1,95,,percent of total billed charges,,,380.14,83,,percent of total billed charges,,,380.14,83,,percent of total billed charges,,,,,,,,,,,,,,,380.14,83,,percent of total billed charges,,,435.1,95,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,375.56,82,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,389.3,85,,percent of total billed charges,,345.33,435.1,
BILE ACIDS FRACTIONATED,25202786,CDM,82239,CPT,300,RC,inpatient,,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,277.47,349.6,
BILE ACIDS TOTAL,25202787,CDM,82239,CPT,300,RC,inpatient,,26,26,,22.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.88,88,,percent of total billed charges,,,,,,,,,19.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.66,91,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,,,,,,,,,,,,,21.58,83,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,21.32,82,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,19.6,24.7,
TESTOSTERONE TOTAL (MALE),25202788,CDM,84403,CPT,300,RC,inpatient,,387,387,,328.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.56,88,,percent of total billed charges,,,,,,,,,295.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,352.17,91,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,,,,,,,,,,,,,321.21,83,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,317.34,82,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,328.95,85,,percent of total billed charges,,291.8,367.65,
TESTOSTERONE TOTAL (FEMALE/PED),25202789,CDM,84403,CPT,300,RC,inpatient,,387,387,,328.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.56,88,,percent of total billed charges,,,,,,,,,295.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,352.17,91,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,,,,,,,,,,,,,321.21,83,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,317.34,82,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,328.95,85,,percent of total billed charges,,291.8,367.65,
.TESTOSTERONE FREE (TOTAL NOT INC),25202791,CDM,84403,CPT,300,RC,inpatient,,42,42,,35.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36.96,88,,percent of total billed charges,,,,,,,,,32.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38.22,91,,percent of total billed charges,,,39.9,95,,percent of total billed charges,,,34.86,83,,percent of total billed charges,,,34.86,83,,percent of total billed charges,,,,,,,,,,,,,,,34.86,83,,percent of total billed charges,,,39.9,95,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,34.44,82,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,35.7,85,,percent of total billed charges,,31.67,39.9,
THIOCYANATE,25202796,CDM,84430,CPT,300,RC,inpatient,,339,339,,287.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,255.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,288.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,298.32,88,,percent of total billed charges,,,,,,,,,259,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,308.49,91,,percent of total billed charges,,,322.05,95,,percent of total billed charges,,,281.37,83,,percent of total billed charges,,,281.37,83,,percent of total billed charges,,,,,,,,,,,,,,,281.37,83,,percent of total billed charges,,,322.05,95,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,277.98,82,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,288.15,85,,percent of total billed charges,,255.61,322.05,
VALPROIC ACID,25202820,CDM,80164,CPT,300,RC,inpatient,,364,364,,309.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,274.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,309.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,320.32,88,,percent of total billed charges,,,,,,,,,278.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,331.24,91,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,,,,,,,,,,,,,302.12,83,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,298.48,82,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,309.4,85,,percent of total billed charges,,274.46,345.8,
"VALPROIC ACID, FREE",25202821,CDM,80165,CPT,300,RC,inpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,153.06,192.85,
VDRL CSF,25202838,CDM,86592,CPT,300,RC,inpatient,,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,99.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,112.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,99.53,125.4,
"VITAMIN D 1, 25-DIHYDROXY",25202846,CDM,82652,CPT,300,RC,inpatient,,668,668,,567.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,503.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,567.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,587.84,88,,percent of total billed charges,,,,,,,,,510.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,607.88,91,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,,,,,,,,,,,,,554.44,83,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,547.76,82,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,567.8,85,,percent of total billed charges,,503.67,634.6,
VITAMIN D 25-HYDROXY,25202853,CDM,82306,CPT,300,RC,inpatient,,443,443,,376.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,334.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,376.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,389.84,88,,percent of total billed charges,,,,,,,,,338.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,403.13,91,,percent of total billed charges,,,420.85,95,,percent of total billed charges,,,367.69,83,,percent of total billed charges,,,367.69,83,,percent of total billed charges,,,,,,,,,,,,,,,367.69,83,,percent of total billed charges,,,420.85,95,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,363.26,82,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,376.55,85,,percent of total billed charges,,334.02,420.85,
"CHLAMYDIA AB PANEL (IgG, IgM)",25202861,CDM,86631,CPT,300,RC,inpatient,,294,294,,249.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,221.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,249.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,258.72,88,,percent of total billed charges,,,,,,,,,224.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,267.54,91,,percent of total billed charges,,,279.3,95,,percent of total billed charges,,,244.02,83,,percent of total billed charges,,,244.02,83,,percent of total billed charges,,,,,,,,,,,,,,,244.02,83,,percent of total billed charges,,,279.3,95,,percent of total billed charges,,,264.6,90,,percent of total billed charges,,,264.6,90,,percent of total billed charges,,,241.08,82,,percent of total billed charges,,,264.6,90,,percent of total billed charges,,,249.9,85,,percent of total billed charges,,221.68,279.3,
"CHLAMYDIA AB PANEL (IGG,IGM,IGA)",25202862,CDM,86631,CPT,300,RC,inpatient,,230,230,,195.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,173.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,195.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,202.4,88,,percent of total billed charges,,,,,,,,,175.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,209.3,91,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,,,,,,,,,,,,,190.9,83,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,188.6,82,,percent of total billed charges,,,207,90,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,173.42,218.5,
X RHC INFLUENZA A,25202871,CDM,87804,CPT,300,RC,inpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,135.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,135.72,171,
INFLUENZA A (RAPID),25202879,CDM,87400,CPT,300,RC,inpatient,,216,216,,183.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,162.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,183.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.08,88,,percent of total billed charges,,,,,,,,,165.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,177.12,82,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,162.86,205.2,
INFLUENZA B (RAPID),25202880,CDM,87400,CPT,300,RC,inpatient,,244,244,,207.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,183.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,207.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,214.72,88,,percent of total billed charges,,,,,,,,,186.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,222.04,91,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,,,,,,,,,,,,,202.52,83,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,200.08,82,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,183.98,231.8,
RSV TEST,25202881,CDM,87420,CPT,300,RC,inpatient,,264,264,,224.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,199.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,224.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,232.32,88,,percent of total billed charges,,,,,,,,,201.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,240.24,91,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,,,,,,,,,,,,,219.12,83,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,216.48,82,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,199.06,250.8,
INFLUENZA A&B ANTIBODIES,25202882,CDM,86710,CPT,300,RC,inpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,153.06,192.85,
FACTOR V HR2 ALLELE DNA,25202883,CDM,81400,CPT,300,RC,inpatient,,904,904,,767.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,681.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,768.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,795.52,88,,percent of total billed charges,,,,,,,,,690.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,822.64,91,,percent of total billed charges,,,858.8,95,,percent of total billed charges,,,750.32,83,,percent of total billed charges,,,750.32,83,,percent of total billed charges,,,,,,,,,,,,,,,750.32,83,,percent of total billed charges,,,858.8,95,,percent of total billed charges,,,813.6,90,,percent of total billed charges,,,813.6,90,,percent of total billed charges,,,741.28,82,,percent of total billed charges,,,813.6,90,,percent of total billed charges,,,768.4,85,,percent of total billed charges,,681.62,858.8,
INFLUENZA H1N1,25202885,CDM,87798,CPT,300,RC,inpatient,,701,701,,595.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,528.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,595.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,616.88,88,,percent of total billed charges,,,,,,,,,535.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,637.91,91,,percent of total billed charges,,,665.95,95,,percent of total billed charges,,,581.83,83,,percent of total billed charges,,,581.83,83,,percent of total billed charges,,,,,,,,,,,,,,,581.83,83,,percent of total billed charges,,,665.95,95,,percent of total billed charges,,,630.9,90,,percent of total billed charges,,,630.9,90,,percent of total billed charges,,,574.82,82,,percent of total billed charges,,,630.9,90,,percent of total billed charges,,,595.85,85,,percent of total billed charges,,528.55,665.95,
2019 NOVEL CORONAVIRUS,25202886,CDM,87635,CPT,300,RC,inpatient,,254,254,,215.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,191.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,223.52,88,,percent of total billed charges,,,,,,,,,194.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,231.14,91,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,,,,,,,,,,,,,210.82,83,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,208.28,82,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,191.52,241.3,
MYOGLOBIN URINE,25202887,CDM,83874,CPT,300,RC,inpatient,,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,174.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,174.17,219.45,
MYOGLOBIN SERUM,25202888,CDM,83874,CPT,300,RC,inpatient,,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,217.91,274.55,
SARS CORONAVIRUS AB ( IgG) NUCLEOCAPSID,25202889,CDM,86769,CPT,300,RC,inpatient,,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
SARS CORONAVIRUS IGM,25202891,CDM,86769,CPT,300,RC,inpatient,,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
COVID (RAPID),25202892,CDM,87426,CPT,300,RC,inpatient,QW,254,254,,215.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,191.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,223.52,88,,percent of total billed charges,,,,,,,,,194.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,231.14,91,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,,,,,,,,,,,,,210.82,83,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,208.28,82,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,191.52,241.3,
SARS CORONAVIRUS AB ( IgA),25202895,CDM,86769,CPT,300,RC,inpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,61.07,76.95,
SARS CO2 SEMIQT TOTAL AB,25202900,CDM,86769,CPT,300,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
PROTEIN-S ANTIGEN,25202903,CDM,85305,CPT,300,RC,inpatient,,329,329,,279.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,248.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,279.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,289.52,88,,percent of total billed charges,,,,,,,,,251.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,299.39,91,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,,,,,,,,,,,,,273.07,83,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,269.78,82,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,248.07,312.55,
PROTEIN-S ACTIVITY (FUNCTIONAL),25202904,CDM,85306,CPT,300,RC,inpatient,,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
PROTEIN-S PANEL,25202905,CDM,85306,CPT,300,RC,inpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,149.29,188.1,
PROTEIN-S F VII AG RATIO,25202906,CDM,85305,CPT,300,RC,inpatient,,312,312,,264.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,235.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,265.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,274.56,88,,percent of total billed charges,,,,,,,,,238.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,283.92,91,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,,,,,,,,,,,,,258.96,83,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,255.84,82,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,265.2,85,,percent of total billed charges,,235.25,296.4,
PROTEIN-S F VII ANTIGEN,25202907,CDM,85302,CPT,300,RC,inpatient,,312,312,,264.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,235.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,265.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,274.56,88,,percent of total billed charges,,,,,,,,,238.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,283.92,91,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,,,,,,,,,,,,,258.96,83,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,255.84,82,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,265.2,85,,percent of total billed charges,,235.25,296.4,
"PROTEIN, TOTAL CSF/BODY FLUID",25202910,CDM,84157,CPT,300,RC,inpatient,,193,193,,163.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,145.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,169.84,88,,percent of total billed charges,,,,,,,,,147.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,175.63,91,,percent of total billed charges,,,183.35,95,,percent of total billed charges,,,160.19,83,,percent of total billed charges,,,160.19,83,,percent of total billed charges,,,,,,,,,,,,,,,160.19,83,,percent of total billed charges,,,183.35,95,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,158.26,82,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,164.05,85,,percent of total billed charges,,145.52,183.35,
PROTEIN-C ACTIVITY (FUNCTIONAL),25202911,CDM,85303,CPT,300,RC,inpatient,,393,393,,333.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,334.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.84,88,,percent of total billed charges,,,,,,,,,300.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.63,91,,percent of total billed charges,,,373.35,95,,percent of total billed charges,,,326.19,83,,percent of total billed charges,,,326.19,83,,percent of total billed charges,,,,,,,,,,,,,,,326.19,83,,percent of total billed charges,,,373.35,95,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,322.26,82,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,334.05,85,,percent of total billed charges,,296.32,373.35,
PROTEIN-C ACTIVITY & ANTIGEN,25202912,CDM,85302,CPT,300,RC,inpatient,,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,115.36,145.35,
PROTEIN-C ANTIGEN,25202914,CDM,85302,CPT,300,RC,inpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,153.06,192.85,
"PROTEIN TOTAL, URINE (RANDOM)W/ CREAT",25202915,CDM,84157,CPT,300,RC,inpatient,,193,193,,163.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,145.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,169.84,88,,percent of total billed charges,,,,,,,,,147.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,175.63,91,,percent of total billed charges,,,183.35,95,,percent of total billed charges,,,160.19,83,,percent of total billed charges,,,160.19,83,,percent of total billed charges,,,,,,,,,,,,,,,160.19,83,,percent of total billed charges,,,183.35,95,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,158.26,82,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,164.05,85,,percent of total billed charges,,145.52,183.35,
PHENOBARBITAL,25202929,CDM,80184,CPT,300,RC,inpatient,,317,317,,269.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,239.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,269.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,278.96,88,,percent of total billed charges,,,,,,,,,242.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,288.47,91,,percent of total billed charges,,,301.15,95,,percent of total billed charges,,,263.11,83,,percent of total billed charges,,,263.11,83,,percent of total billed charges,,,,,,,,,,,,,,,263.11,83,,percent of total billed charges,,,301.15,95,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,259.94,82,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,269.45,85,,percent of total billed charges,,239.02,301.15,
BACTERIAL ANTIGENS,25202945,CDM,86403,CPT,300,RC,inpatient,,27,27,,22.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23.76,88,,percent of total billed charges,,,,,,,,,20.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,,,,,,,,,,,,,22.41,83,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.14,82,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,20.36,25.65,
SURG PATH LEVEL 6,25202952,CDM,88309,CPT,310,RC,inpatient,TC,2054,2054,,1743.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1548.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1745.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1807.52,88,,percent of total billed charges,,,,,,,,,1569.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1869.14,91,,percent of total billed charges,,,1951.3,95,,percent of total billed charges,,,1704.82,83,,percent of total billed charges,,,1704.82,83,,percent of total billed charges,,,,,,,,,,,,,,,1704.82,83,,percent of total billed charges,,,1951.3,95,,percent of total billed charges,,,1848.6,90,,percent of total billed charges,,,1848.6,90,,percent of total billed charges,,,1684.28,82,,percent of total billed charges,,,1848.6,90,,percent of total billed charges,,,1745.9,85,,percent of total billed charges,,1548.72,1951.3,
SURG PATH LEVEL 5,25202960,CDM,88307,CPT,310,RC,inpatient,TC,792,792,,672.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,597.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,673.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,696.96,88,,percent of total billed charges,,,,,,,,,605.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,720.72,91,,percent of total billed charges,,,752.4,95,,percent of total billed charges,,,657.36,83,,percent of total billed charges,,,657.36,83,,percent of total billed charges,,,,,,,,,,,,,,,657.36,83,,percent of total billed charges,,,752.4,95,,percent of total billed charges,,,712.8,90,,percent of total billed charges,,,712.8,90,,percent of total billed charges,,,649.44,82,,percent of total billed charges,,,712.8,90,,percent of total billed charges,,,673.2,85,,percent of total billed charges,,597.17,752.4,
SURG PATH-FROZEN SECTION,25202978,CDM,88331,CPT,310,RC,inpatient,,435,435,,369.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,327.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,369.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,382.8,88,,percent of total billed charges,,,,,,,,,332.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,395.85,91,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,,,,,,,,,,,,,361.05,83,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,356.7,82,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,327.99,413.25,
SURG PATH LEVEL 2,25202986,CDM,88302,CPT,310,RC,inpatient,TC,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,230.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,260.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,230.72,290.7,
.PAP SMEAR SCREEN (G0143),25202990,CDM,G0143,HCPCS,311,RC,inpatient,,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,3.45,,,,fee schedule,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.45,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,3.45,287.85,
.PAP SMEAR (P3000),25202991,CDM,P3000,HCPCS,311,RC,inpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.92,88,,percent of total billed charges,,3.55,,,,fee schedule,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.55,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,3.55,56.05,
.PAP SMEAR SCREEN (G0145),25202992,CDM,G0145,HCPCS,311,RC,inpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110.88,88,,percent of total billed charges,,3.45,,,,fee schedule,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.45,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,3.45,119.7,
.PAP SMEAR THIN LAYER PREP (88143),25202993,CDM,88143,CPT,311,RC,inpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,155.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,155.32,195.7,
.PAP SMEAR CONVENTIONAL (88164),25202994,CDM,88164,CPT,311,RC,inpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,135.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,119.89,151.05,
.PAP SMEAR THIN LAYER PREP (88174),25202995,CDM,88174,CPT,311,RC,inpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,155.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,155.32,195.7,
.PAP SMEAR THIN LAYER PREP (88175),25202996,CDM,88175,CPT,311,RC,inpatient,,397,397,,337.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,299.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,337.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,349.36,88,,percent of total billed charges,,,,,,,,,303.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,361.27,91,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,,,,,,,,,,,,,329.51,83,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,325.54,82,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,337.45,85,,percent of total billed charges,,299.34,377.15,
.PAP SMEAR SCREEN (G0144),25202998,CDM,G0144,HCPCS,311,RC,inpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110.88,88,,percent of total billed charges,,3.45,,,,fee schedule,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.45,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,3.45,119.7,
.PAP SMEAR THIN LAYER PREP (88142),25202999,CDM,88142,CPT,311,RC,inpatient,,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
THYROTROPIN-BINDING INHIB IMMUNOGLOBULIN,25203001,CDM,83519,CPT,300,RC,inpatient,,316,316,,268.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,238.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,268.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,278.08,88,,percent of total billed charges,,,,,,,,,241.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,287.56,91,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,,,,,,,,,,,,,262.28,83,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,259.12,82,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,238.26,300.2,
T-CELL PROFILE ( HELPER/SUPPRESSOR),25203002,CDM,86359,CPT,310,RC,inpatient,,681,681,,578.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,513.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,578.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,599.28,88,,percent of total billed charges,,,,,,,,,520.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,619.71,91,,percent of total billed charges,,,646.95,95,,percent of total billed charges,,,565.23,83,,percent of total billed charges,,,565.23,83,,percent of total billed charges,,,,,,,,,,,,,,,565.23,83,,percent of total billed charges,,,646.95,95,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,558.42,82,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,578.85,85,,percent of total billed charges,,513.47,646.95,
V1212THYROTROPIN RELEASING HORMONE,25203003,CDM,83519,CPT,300,RC,inpatient,,641,641,,544.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,483.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,544.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,564.08,88,,percent of total billed charges,,,,,,,,,489.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,583.31,91,,percent of total billed charges,,,608.95,95,,percent of total billed charges,,,532.03,83,,percent of total billed charges,,,532.03,83,,percent of total billed charges,,,,,,,,,,,,,,,532.03,83,,percent of total billed charges,,,608.95,95,,percent of total billed charges,,,576.9,90,,percent of total billed charges,,,576.9,90,,percent of total billed charges,,,525.62,82,,percent of total billed charges,,,576.9,90,,percent of total billed charges,,,544.85,85,,percent of total billed charges,,483.31,608.95,
.PAP SMEAR CONVENTIONAL (88148),25203004,CDM,88148,CPT,311,RC,inpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,77.66,97.85,
.PAP SMEAR SCREEN (G0148),25203006,CDM,G0148,HCPCS,311,RC,inpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.92,88,,percent of total billed charges,,3.45,,,,fee schedule,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.45,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,3.45,56.05,
.PAP SMEAR PATH REVIEW(88141),25203008,CDM,88141,CPT,311,RC,inpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,62.58,78.85,
T-CELL RECEPTOR B-CHAIN,25203009,CDM,81340,CPT,310,RC,inpatient,,996,996,,845.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,750.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,846.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,876.48,88,,percent of total billed charges,,,,,,,,,760.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,906.36,91,,percent of total billed charges,,,946.2,95,,percent of total billed charges,,,826.68,83,,percent of total billed charges,,,826.68,83,,percent of total billed charges,,,,,,,,,,,,,,,826.68,83,,percent of total billed charges,,,946.2,95,,percent of total billed charges,,,896.4,90,,percent of total billed charges,,,896.4,90,,percent of total billed charges,,,816.72,82,,percent of total billed charges,,,896.4,90,,percent of total billed charges,,,846.6,85,,percent of total billed charges,,750.98,946.2,
T-CELL RECEPTOR Y-CHAIN,25203010,CDM,81342,CPT,310,RC,inpatient,,492,492,,417.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,370.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,418.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,432.96,88,,percent of total billed charges,,,,,,,,,375.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,447.72,91,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,,,,,,,,,,,,,408.36,83,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,403.44,82,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,370.97,467.4,
NEURON-SPECIFIC ENOLASE,25203011,CDM,86316,CPT,310,RC,inpatient,,79,79,,67.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.52,88,,percent of total billed charges,,,,,,,,,60.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,,,,,,,,,,,,,65.57,83,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,64.78,82,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,59.57,75.05,
PML-RARA TRANSCRIPT,25203012,CDM,81315,CPT,310,RC,inpatient,,809,809,,686.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,609.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,687.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,711.92,88,,percent of total billed charges,,,,,,,,,618.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,736.19,91,,percent of total billed charges,,,768.55,95,,percent of total billed charges,,,671.47,83,,percent of total billed charges,,,671.47,83,,percent of total billed charges,,,,,,,,,,,,,,,671.47,83,,percent of total billed charges,,,768.55,95,,percent of total billed charges,,,728.1,90,,percent of total billed charges,,,728.1,90,,percent of total billed charges,,,663.38,82,,percent of total billed charges,,,728.1,90,,percent of total billed charges,,,687.65,85,,percent of total billed charges,,609.99,768.55,
JAK2 MUTATION W/REFLEX CALR&12-15,25203013,CDM,81270,CPT,300,RC,inpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,316.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,357,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,316.68,399,
..JAK2 12-15MUTATION,25203014,CDM,81279,CPT,300,RC,inpatient,,945,945,,802.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,712.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,803.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,831.6,88,,percent of total billed charges,,,,,,,,,721.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,859.95,91,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,,,,,,,,,,,,,784.35,83,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,774.9,82,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,803.25,85,,percent of total billed charges,,712.53,897.75,
..CALRETICULIN MUTATION,25203015,CDM,81219,CPT,300,RC,inpatient,,945,945,,802.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,712.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,803.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,831.6,88,,percent of total billed charges,,,,,,,,,721.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,859.95,91,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,,,,,,,,,,,,,784.35,83,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,774.9,82,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,803.25,85,,percent of total billed charges,,712.53,897.75,
CULTURE BLOOD,25203034,CDM,87040,CPT,300,RC,inpatient,,299,299,,253.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,225.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,254.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,263.12,88,,percent of total billed charges,,,,,,,,,228.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,272.09,91,,percent of total billed charges,,,284.05,95,,percent of total billed charges,,,248.17,83,,percent of total billed charges,,,248.17,83,,percent of total billed charges,,,,,,,,,,,,,,,248.17,83,,percent of total billed charges,,,284.05,95,,percent of total billed charges,,,269.1,90,,percent of total billed charges,,,269.1,90,,percent of total billed charges,,,245.18,82,,percent of total billed charges,,,269.1,90,,percent of total billed charges,,,254.15,85,,percent of total billed charges,,225.45,284.05,
HEPATITIS B SURFACE ANTIGEN,25203042,CDM,87340,CPT,300,RC,inpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,150.8,190,
PREALBUMIN,25203059,CDM,84134,CPT,300,RC,inpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,198.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,198.3,249.85,
"H. PYLORI ANTIGEN, STOOL",25203070,CDM,87338,CPT,300,RC,inpatient,,453,453,,384.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,341.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,385.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,398.64,88,,percent of total billed charges,,,,,,,,,346.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,412.23,91,,percent of total billed charges,,,430.35,95,,percent of total billed charges,,,375.99,83,,percent of total billed charges,,,375.99,83,,percent of total billed charges,,,,,,,,,,,,,,,375.99,83,,percent of total billed charges,,,430.35,95,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,371.46,82,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,385.05,85,,percent of total billed charges,,341.56,430.35,
DISACCHARIDASES,25203071,CDM,82657,CPT,300,RC,inpatient,,562,562,,477.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,423.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,477.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,494.56,88,,percent of total billed charges,,,,,,,,,429.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,,,,,,,,,,,,,466.46,83,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,460.84,82,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,423.75,533.9,
IGE LATEX,25203074,CDM,86003,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
IMMUNOGLOBULIN E,25203075,CDM,82785,CPT,300,RC,inpatient,,246,246,,208.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,185.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,209.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,216.48,88,,percent of total billed charges,,,,,,,,,187.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,223.86,91,,percent of total billed charges,,,233.7,95,,percent of total billed charges,,,204.18,83,,percent of total billed charges,,,204.18,83,,percent of total billed charges,,,,,,,,,,,,,,,204.18,83,,percent of total billed charges,,,233.7,95,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,201.72,82,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,209.1,85,,percent of total billed charges,,185.48,233.7,
PROCAINAMIDE,25203083,CDM,80192,CPT,300,RC,inpatient,,330,330,,280.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,248.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,280.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,290.4,88,,percent of total billed charges,,,,,,,,,252.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,300.3,91,,percent of total billed charges,,,313.5,95,,percent of total billed charges,,,273.9,83,,percent of total billed charges,,,273.9,83,,percent of total billed charges,,,,,,,,,,,,,,,273.9,83,,percent of total billed charges,,,313.5,95,,percent of total billed charges,,,297,90,,percent of total billed charges,,,297,90,,percent of total billed charges,,,270.6,82,,percent of total billed charges,,,297,90,,percent of total billed charges,,,280.5,85,,percent of total billed charges,,248.82,313.5,
TACROLIMUS,25203084,CDM,80197,CPT,300,RC,inpatient,,398,398,,337.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,300.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,338.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,350.24,88,,percent of total billed charges,,,,,,,,,304.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,362.18,91,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,,,,,,,,,,,,,330.34,83,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,326.36,82,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,338.3,85,,percent of total billed charges,,300.09,378.1,
PROTRIPTYLINE,25203085,CDM,80299,CPT,300,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
TUMOR NECROSIS FACTOR ALPHA,25203086,CDM,83520,CPT,300,RC,inpatient,,398,398,,337.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,300.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,338.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,350.24,88,,percent of total billed charges,,,,,,,,,304.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,362.18,91,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,,,,,,,,,,,,,330.34,83,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,326.36,82,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,338.3,85,,percent of total billed charges,,300.09,378.1,
TITANIUM,25203088,CDM,83018,CPT,300,RC,inpatient,,397,397,,337.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,299.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,337.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,349.36,88,,percent of total billed charges,,,,,,,,,303.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,361.27,91,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,,,,,,,,,,,,,329.51,83,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,325.54,82,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,337.45,85,,percent of total billed charges,,299.34,377.15,
ALLERGEN EVALUATION EACH,25203091,CDM,86003,CPT,300,RC,inpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.92,88,,percent of total billed charges,,,,,,,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,63.34,79.8,
.ALLERGEN  MOLD,25203092,CDM,86003,CPT,300,RC,inpatient,,17,17,,14.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.96,88,,percent of total billed charges,,,,,,,,,12.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.47,91,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,,,,,,,,,,,,,14.11,83,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,13.94,82,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,14.45,85,,percent of total billed charges,,12.82,16.15,
ALLERGEN  MILK,25203093,CDM,86003,CPT,300,RC,inpatient,,54,54,,45.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47.52,88,,percent of total billed charges,,,,,,,,,41.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.14,91,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,,,,,,,,,,,,,44.82,83,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,44.28,82,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,40.72,51.3,
ALLERGEN  FRUIT,25203094,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  GRAPE,25203097,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  BLUEBERRY,25203098,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  BIRCH,25203099,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  HAZELNUT,25203101,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  WATERMELLON,25203102,CDM,86003,CPT,300,RC,inpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,58.81,74.1,
ALLERGEN  PUMPKIN,25203103,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  FOOD BERRIES,25203104,CDM,86003,CPT,300,RC,inpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,41.47,52.25,
ALLERGEN NUTS (7) PANEL,25203106,CDM,86003,CPT,300,RC,inpatient,,101,101,,85.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88.88,88,,percent of total billed charges,,,,,,,,,77.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,82.82,82,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,76.15,95.95,
ALLERGY SPICE (7) PANEL,25203107,CDM,86003,CPT,300,RC,inpatient,,91,91,,77.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.08,88,,percent of total billed charges,,,,,,,,,69.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,,,,,,,,,,,,,75.53,83,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,74.62,82,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,68.61,86.45,
HIV 1&2 (RAPID) ANTIBODY,25203108,CDM,86703,CPT,300,RC,inpatient,,237,237,,201.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.56,88,,percent of total billed charges,,,,,,,,,181.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.67,91,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,,,,,,,,,,,,,196.71,83,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,194.34,82,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,178.7,225.15,
HIV 1&2 ANTIBODY SCREEN,25203109,CDM,87389,CPT,300,RC,inpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
HIV 1/0/2 AB/AG W/p24 PANEL,25203111,CDM,87389,CPT,300,RC,inpatient,,278,278,,236.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,236.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.64,88,,percent of total billed charges,,,,,,,,,212.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.98,91,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,,,,,,,,,,,,,230.74,83,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,227.96,82,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,209.61,264.1,
ALLERGEN  GRAIN,25203112,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  CORN,25203113,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN FOOD BASIC,25203114,CDM,86003,CPT,300,RC,inpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,37.7,47.5,
...ALL,25203115,CDM,86003,CPT,300,RC,inpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,9.05,11.4,
...AL,25203116,CDM,86003,CPT,300,RC,inpatient,,53,53,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46.64,88,,percent of total billed charges,,,,,,,,,40.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,,,,,,,,,,,,,43.99,83,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,43.46,82,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,39.96,50.35,
17-HYDROXYCORTICOSTEROIDS 24-HR URINE,25203117,CDM,83491,CPT,300,RC,inpatient,,575,575,,488.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,433.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,488.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,506,88,,percent of total billed charges,,,,,,,,,439.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,523.25,91,,percent of total billed charges,,,546.25,95,,percent of total billed charges,,,477.25,83,,percent of total billed charges,,,477.25,83,,percent of total billed charges,,,,,,,,,,,,,,,477.25,83,,percent of total billed charges,,,546.25,95,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,471.5,82,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,488.75,85,,percent of total billed charges,,433.55,546.25,
...AL,25203118,CDM,86003,CPT,300,RC,inpatient,,7,7,,5.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6.16,88,,percent of total billed charges,,,,,,,,,5.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6.37,91,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,,,,,,,,,,,,,5.81,83,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.74,82,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,5.28,6.65,
ALLERGEN PROFILE PLUS PEDIATRIC,25203119,CDM,82785,CPT,300,RC,inpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.92,88,,percent of total billed charges,,,,,,,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,63.34,79.8,
ALLERGEN MEAT,25203120,CDM,86003,CPT,300,RC,inpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,37.7,47.5,
.ALLERGY FOOD CHICKEN,25203121,CDM,86003,CPT,300,RC,inpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,37.7,47.5,
.ALLERGY FOOD PORK,25203122,CDM,86003,CPT,300,RC,inpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,37.7,47.5,
ALLERGEN  HICKORY NUT,25203123,CDM,86003,CPT,300,RC,inpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,9.05,11.4,
"17-KETOSTEROIDS, 24-HOUR URINE",25203125,CDM,83586,CPT,300,RC,inpatient,,224,224,,190.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,190.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,197.12,88,,percent of total billed charges,,,,,,,,,171.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,183.68,82,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,168.9,212.8,
ALLERGEN  APRICOT,25203126,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  PISTACHIO,25203127,CDM,86003,CPT,300,RC,inpatient,,11,11,,9.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9.68,88,,percent of total billed charges,,,,,,,,,8.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,,,,,,,,,,,,,9.13,83,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.02,82,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,8.29,10.45,
..ALLERGEN  ARA H1,25203128,CDM,86008,CPT,300,RC,inpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,52.03,65.55,
..ALLERGEN  ARA H2,25203129,CDM,86008,CPT,300,RC,inpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,52.03,65.55,
..ALLERGEN  ARA H4,25203130,CDM,86008,CPT,300,RC,inpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,52.03,65.55,
..ALLERGEN  ARA H8,25203131,CDM,86008,CPT,300,RC,inpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,52.03,65.55,
..ALLERGEN  ARA H9,25203132,CDM,86008,CPT,300,RC,inpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,52.03,65.55,
LEGIONELLA ANTIBODIES,25203133,CDM,86713,CPT,300,RC,inpatient,,230,230,,195.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,173.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,195.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,202.4,88,,percent of total billed charges,,,,,,,,,175.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,209.3,91,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,,,,,,,,,,,,,190.9,83,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,188.6,82,,percent of total billed charges,,,207,90,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,173.42,218.5,
ALLERGEN  SCALLOP,25203136,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  SESAME SEED,25203137,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  SHRIMP,25203138,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  WALNUT,25203139,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
LIVER KIDNEY MICROSOMAL ANTIBODY,25203140,CDM,86376,CPT,300,RC,inpatient,,276,276,,234.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,208.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,234.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,242.88,88,,percent of total billed charges,,,,,,,,,210.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,251.16,91,,percent of total billed charges,,,262.2,95,,percent of total billed charges,,,229.08,83,,percent of total billed charges,,,229.08,83,,percent of total billed charges,,,,,,,,,,,,,,,229.08,83,,percent of total billed charges,,,262.2,95,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,226.32,82,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,234.6,85,,percent of total billed charges,,208.1,262.2,
ALLERGEN  CODFISH,25203141,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  CLAM,25203142,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
"HEPATITIS PANEL, ACUTE",25203143,CDM,80074,CPT,300,RC,inpatient,,713,713,,605.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,537.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,606.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,627.44,88,,percent of total billed charges,,,,,,,,,544.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,648.83,91,,percent of total billed charges,,,677.35,95,,percent of total billed charges,,,591.79,83,,percent of total billed charges,,,591.79,83,,percent of total billed charges,,,,,,,,,,,,,,,591.79,83,,percent of total billed charges,,,677.35,95,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,584.66,82,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,606.05,85,,percent of total billed charges,,537.6,677.35,
ALLERGEN  SWORDFISH,25203146,CDM,86003,CPT,300,RC,inpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,38.45,48.45,
ALLERGEN  CATFISH,25203147,CDM,86003,CPT,300,RC,inpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,38.45,48.45,
ALLERGEN  WHITEFISH,25203148,CDM,86003,CPT,300,RC,inpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,38.45,48.45,
LEM D-3,25203153,CDM,81479,CPT,300,RC,inpatient,,2100,2100,,1782.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1583.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1785,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1848,88,,percent of total billed charges,,,,,,,,,1604.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1911,91,,percent of total billed charges,,,1995,95,,percent of total billed charges,,,1743,83,,percent of total billed charges,,,1743,83,,percent of total billed charges,,,,,,,,,,,,,,,1743,83,,percent of total billed charges,,,1995,95,,percent of total billed charges,,,1890,90,,percent of total billed charges,,,1890,90,,percent of total billed charges,,,1722,82,,percent of total billed charges,,,1890,90,,percent of total billed charges,,,1785,85,,percent of total billed charges,,1583.4,1995,
BRBPS,25203154,CDM,87801,CPT,300,RC,inpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,633.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,714,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,633.36,798,
ALLERGEN  CHEESE,25203155,CDM,86003,CPT,300,RC,inpatient,,37,37,,31.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.56,88,,percent of total billed charges,,,,,,,,,28.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,30.34,82,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,27.9,35.15,
HIV 1&2 QUALITATIVE,25203156,CDM,87535,CPT,300,RC,inpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
SURG PATH-ELECTRON MICROSCOPY,25203158,CDM,88348,CPT,310,RC,inpatient,,4667,4667,,3962.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3518.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3966.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4106.96,88,,percent of total billed charges,,,,,,,,,3565.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4246.97,91,,percent of total billed charges,,,4433.65,95,,percent of total billed charges,,,3873.61,83,,percent of total billed charges,,,3873.61,83,,percent of total billed charges,,,,,,,,,,,,,,,3873.61,83,,percent of total billed charges,,,4433.65,95,,percent of total billed charges,,,4200.3,90,,percent of total billed charges,,,4200.3,90,,percent of total billed charges,,,3826.94,82,,percent of total billed charges,,,4200.3,90,,percent of total billed charges,,,3966.95,85,,percent of total billed charges,,3518.92,4433.65,
LH,25203166,CDM,83002,CPT,300,RC,inpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,283.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,319.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,283.5,357.2,
LH PEDIATRICS,25203167,CDM,83002,CPT,300,RC,inpatient,,29,29,,24.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.52,88,,percent of total billed charges,,,,,,,,,22.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.39,91,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,,,,,,,,,,,,,24.07,83,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,23.78,82,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,21.87,27.55,
CULTURE MYCOBACTERIA,25203182,CDM,87116,CPT,300,RC,inpatient,,201,201,,170.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,151.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,170.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,176.88,88,,percent of total billed charges,,,,,,,,,153.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,182.91,91,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,,,,,,,,,,,,,166.83,83,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,164.82,82,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,151.55,190.95,
SPECIAL STAIN: GROUP I,25203190,CDM,88312,CPT,310,RC,inpatient,,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,230.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,260.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,230.72,290.7,
PORPHYRINS PLASMA,25203207,CDM,82492,CPT,300,RC,inpatient,,617,617,,523.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,465.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,524.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.96,88,,percent of total billed charges,,,,,,,,,471.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,561.47,91,,percent of total billed charges,,,586.15,95,,percent of total billed charges,,,512.11,83,,percent of total billed charges,,,512.11,83,,percent of total billed charges,,,,,,,,,,,,,,,512.11,83,,percent of total billed charges,,,586.15,95,,percent of total billed charges,,,555.3,90,,percent of total billed charges,,,555.3,90,,percent of total billed charges,,,505.94,82,,percent of total billed charges,,,555.3,90,,percent of total billed charges,,,524.45,85,,percent of total billed charges,,465.22,586.15,
PORPHYRINS URINE (24-HOUR),25203208,CDM,84120,CPT,300,RC,inpatient,,252,252,,213.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,214.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,221.76,88,,percent of total billed charges,,,,,,,,,192.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,229.32,91,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,,,,,,,,,,,,,209.16,83,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,206.64,82,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,190.01,239.4,
PORPHOBILINOGEN URINE (RANDOM),25203209,CDM,84110,CPT,300,RC,inpatient,,23,23,,19.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.24,88,,percent of total billed charges,,,,,,,,,17.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.93,91,,percent of total billed charges,,,21.85,95,,percent of total billed charges,,,19.09,83,,percent of total billed charges,,,19.09,83,,percent of total billed charges,,,,,,,,,,,,,,,19.09,83,,percent of total billed charges,,,21.85,95,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,18.86,82,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,19.55,85,,percent of total billed charges,,17.34,21.85,
PROTEIN ELECTRO W/ INTERP (SERUM),25203215,CDM,84165,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
PROTEIN ELECTRO SERUM,25203216,CDM,84165,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
PROSTAGLANDIN F2A,25203218,CDM,84150,CPT,300,RC,inpatient,,434,434,,368.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,327.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,368.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,381.92,88,,percent of total billed charges,,,,,,,,,331.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,394.94,91,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,,,,,,,,,,,,,360.22,83,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,355.88,82,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,368.9,85,,percent of total billed charges,,327.24,412.3,
SPECIAL STAIN: GROUP II,25203224,CDM,88313,CPT,310,RC,inpatient,,315,315,,267.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,237.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,267.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,277.2,88,,percent of total billed charges,,,,,,,,,240.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,286.65,91,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,,,,,,,,,,,,,261.45,83,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,258.3,82,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,237.51,299.25,
PROTEIN ELECTROPH RFLEX IFE (RND URINE ),25203230,CDM,84166,CPT,300,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
PROTEIN ELECTRO 24 HOUR URINE,25203232,CDM,84166,CPT,300,RC,inpatient,,189,189,,160.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,142.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,160.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,166.32,88,,percent of total billed charges,,,,,,,,,144.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,,,,,,,,,,,,,156.87,83,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,154.98,82,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,142.51,179.55,
PROTEIN ELECTRO (URINE RANDOM),25203233,CDM,84166,CPT,300,RC,inpatient,,320,320,,271.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,241.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,272,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,281.6,88,,percent of total billed charges,,,,,,,,,244.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,291.2,91,,percent of total billed charges,,,304,95,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,,,,,,,,,,,,,265.6,83,,percent of total billed charges,,,304,95,,percent of total billed charges,,,288,90,,percent of total billed charges,,,288,90,,percent of total billed charges,,,262.4,82,,percent of total billed charges,,,288,90,,percent of total billed charges,,,272,85,,percent of total billed charges,,241.28,304,
CLONIDINE URINE,25203234,CDM,80375,CPT,300,RC,inpatient,,320.06,320.06,,271.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,241.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,272.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,281.65,88,,percent of total billed charges,,,,,,,,,244.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,291.25,91,,percent of total billed charges,,,304.06,95,,percent of total billed charges,,,265.65,83,,percent of total billed charges,,,265.65,83,,percent of total billed charges,,,,,,,,,,,,,,,265.65,83,,percent of total billed charges,,,304.06,95,,percent of total billed charges,,,288.05,90,,percent of total billed charges,,,288.05,90,,percent of total billed charges,,,262.45,82,,percent of total billed charges,,,288.05,90,,percent of total billed charges,,,272.05,85,,percent of total billed charges,,241.33,304.06,
ROCKY MT SPOTTED FEVER AB IGG,25203240,CDM,86757,CPT,300,RC,inpatient,,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,280.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,316.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,280.49,353.4,
ROMA (OVARIAN MALIGNANCY),25203241,CDM,81500,CPT,300,RC,inpatient,,909,909,,771.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,685.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,772.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,799.92,88,,percent of total billed charges,,,,,,,,,694.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,827.19,91,,percent of total billed charges,,,863.55,95,,percent of total billed charges,,,754.47,83,,percent of total billed charges,,,754.47,83,,percent of total billed charges,,,,,,,,,,,,,,,754.47,83,,percent of total billed charges,,,863.55,95,,percent of total billed charges,,,818.1,90,,percent of total billed charges,,,818.1,90,,percent of total billed charges,,,745.38,82,,percent of total billed charges,,,818.1,90,,percent of total billed charges,,,772.65,85,,percent of total billed charges,,685.39,863.55,
ROCKY MT SPOTTED FEVER AB IGM,25203242,CDM,86757,CPT,300,RC,inpatient,,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,280.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,316.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,280.49,353.4,
IMMUNOCYTOCHEMISTRY (INITIAL STAIN),25203257,CDM,88342,CPT,310,RC,inpatient,TC,498,498,,422.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,375.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,423.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,438.24,88,,percent of total billed charges,,,,,,,,,380.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,,,,,,,,,,,,,413.34,83,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,408.36,82,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,375.49,473.1,
IMMUNOCYTOCHEMISTRY (ADDITIONAL STAIN),25203258,CDM,88341,CPT,310,RC,inpatient,TC,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,110.84,139.65,
MULTIPLEX AB STAIN,25203259,CDM,88344,CPT,310,RC,inpatient,TC,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,110.84,139.65,
TOUCH PREP CYTO EXAM,25203260,CDM,88333,CPT,310,RC,inpatient,,850,850,,721.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,640.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,722.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,748,88,,percent of total billed charges,,,,,,,,,649.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,773.5,91,,percent of total billed charges,,,807.5,95,,percent of total billed charges,,,705.5,83,,percent of total billed charges,,,705.5,83,,percent of total billed charges,,,,,,,,,,,,,,,705.5,83,,percent of total billed charges,,,807.5,95,,percent of total billed charges,,,765,90,,percent of total billed charges,,,765,90,,percent of total billed charges,,,697,82,,percent of total billed charges,,,765,90,,percent of total billed charges,,,722.5,85,,percent of total billed charges,,640.9,807.5,
SURG PATH-IMMUNOFLUORESCENT STUDY,25203265,CDM,88346,CPT,310,RC,inpatient,,1557,1557,,1321.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1173.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1323.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1370.16,88,,percent of total billed charges,,,,,,,,,1189.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1416.87,91,,percent of total billed charges,,,1479.15,95,,percent of total billed charges,,,1292.31,83,,percent of total billed charges,,,1292.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1292.31,83,,percent of total billed charges,,,1479.15,95,,percent of total billed charges,,,1401.3,90,,percent of total billed charges,,,1401.3,90,,percent of total billed charges,,,1276.74,82,,percent of total billed charges,,,1401.3,90,,percent of total billed charges,,,1323.45,85,,percent of total billed charges,,1173.98,1479.15,
SURG PATH-CONSULT W/RECORDS,25203280,CDM,88325,CPT,310,RC,inpatient,,530,530,,449.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466.4,88,,percent of total billed charges,,,,,,,,,404.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,,,,,,,,,,,,,439.9,83,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,434.6,82,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,399.62,503.5,
SURG PATH-CONSULTATION,25203281,CDM,88323,CPT,310,RC,inpatient,,927,927,,787.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,698.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,787.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,815.76,88,,percent of total billed charges,,,,,,,,,708.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,843.57,91,,percent of total billed charges,,,880.65,95,,percent of total billed charges,,,769.41,83,,percent of total billed charges,,,769.41,83,,percent of total billed charges,,,,,,,,,,,,,,,769.41,83,,percent of total billed charges,,,880.65,95,,percent of total billed charges,,,834.3,90,,percent of total billed charges,,,834.3,90,,percent of total billed charges,,,760.14,82,,percent of total billed charges,,,834.3,90,,percent of total billed charges,,,787.95,85,,percent of total billed charges,,698.96,880.65,
NUCLEIC ACID MUTATION ID BY SEQUENCING,25203299,CDM,83904,CPT,300,RC,inpatient,,340,340,,288.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,256.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,289,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,299.2,88,,percent of total billed charges,,,,,,,,,259.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,309.4,91,,percent of total billed charges,,,323,95,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,,,,,,,,,,,,,282.2,83,,percent of total billed charges,,,323,95,,percent of total billed charges,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,278.8,82,,percent of total billed charges,,,306,90,,percent of total billed charges,,,289,85,,percent of total billed charges,,256.36,323,
NIACIN LEVEL,25203331,CDM,84591,CPT,300,RC,inpatient,,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,230.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,260.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,230.72,290.7,
...NICOTINE SCREEN,25203340,CDM,83887,CPT,300,RC,inpatient,,370,370,,314.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,314.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,325.6,88,,percent of total billed charges,,,,,,,,,282.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,336.7,91,,percent of total billed charges,,,351.5,95,,percent of total billed charges,,,307.1,83,,percent of total billed charges,,,307.1,83,,percent of total billed charges,,,,,,,,,,,,,,,307.1,83,,percent of total billed charges,,,351.5,95,,percent of total billed charges,,,333,90,,percent of total billed charges,,,333,90,,percent of total billed charges,,,303.4,82,,percent of total billed charges,,,333,90,,percent of total billed charges,,,314.5,85,,percent of total billed charges,,278.98,351.5,
DNA GENE MUTATION MYBPC3,25203354,CDM,81403,CPT,300,RC,inpatient,,491,491,,416.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,370.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,417.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,432.08,88,,percent of total billed charges,,,,,,,,,375.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,446.81,91,,percent of total billed charges,,,466.45,95,,percent of total billed charges,,,407.53,83,,percent of total billed charges,,,407.53,83,,percent of total billed charges,,,,,,,,,,,,,,,407.53,83,,percent of total billed charges,,,466.45,95,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,402.62,82,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,417.35,85,,percent of total billed charges,,370.21,466.45,
ANGELMAN PRADER-WILLI DNA,25203355,CDM,81331,CPT,300,RC,inpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,347.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,391.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,347.59,437.95,
SACCHAROMYCES CEREVISIAE AB IgA,25203358,CDM,86671,CPT,300,RC,inpatient,,302,302,,256.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,227.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,256.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,265.76,88,,percent of total billed charges,,,,,,,,,230.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,274.82,91,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,,,,,,,,,,,,,250.66,83,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,247.64,82,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,256.7,85,,percent of total billed charges,,227.71,286.9,
SACCHAROMYCES CEREVISIAE AB IgG,25203359,CDM,86671,CPT,300,RC,inpatient,,302,302,,256.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,227.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,256.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,265.76,88,,percent of total billed charges,,,,,,,,,230.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,274.82,91,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,,,,,,,,,,,,,250.66,83,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,247.64,82,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,256.7,85,,percent of total billed charges,,227.71,286.9,
WARFARIN SERUM,25203360,CDM,86021,CPT,300,RC,inpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,38.45,48.45,
..TRISOMY21/MONOSOMY X,25203361,CDM,81420,CPT,300,RC,inpatient,,984,984,,835.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,741.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,836.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,865.92,88,,percent of total billed charges,,,,,,,,,751.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,895.44,91,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,,,,,,,,,,,,,816.72,83,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,806.88,82,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,836.4,85,,percent of total billed charges,,741.94,934.8,
..FETAL CHROMOSOMAL MICRODELETION,25203362,CDM,81422,CPT,300,RC,inpatient,,984,984,,835.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,741.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,836.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,865.92,88,,percent of total billed charges,,,,,,,,,751.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,895.44,91,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,,,,,,,,,,,,,816.72,83,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,806.88,82,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,836.4,85,,percent of total billed charges,,741.94,934.8,
..MOLECULAR PATH UNLISTED,25203363,CDM,81479,CPT,300,RC,inpatient,,984,984,,835.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,741.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,836.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,865.92,88,,percent of total billed charges,,,,,,,,,751.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,895.44,91,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,,,,,,,,,,,,,816.72,83,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,806.88,82,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,836.4,85,,percent of total billed charges,,741.94,934.8,
HERPES SIM 1 IGG AB,25203364,CDM,86695,CPT,300,RC,inpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,135.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,119.89,151.05,
MATERNIT21 PLUS CORE W/ GENDER,25203366,CDM,81420,CPT,300,RC,inpatient,,1136,1136,,964.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,856.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,965.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,999.68,88,,percent of total billed charges,,,,,,,,,867.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1033.76,91,,percent of total billed charges,,,1079.2,95,,percent of total billed charges,,,942.88,83,,percent of total billed charges,,,942.88,83,,percent of total billed charges,,,,,,,,,,,,,,,942.88,83,,percent of total billed charges,,,1079.2,95,,percent of total billed charges,,,1022.4,90,,percent of total billed charges,,,1022.4,90,,percent of total billed charges,,,931.52,82,,percent of total billed charges,,,1022.4,90,,percent of total billed charges,,,965.6,85,,percent of total billed charges,,856.54,1079.2,
.HERPES SIM  2(LAVAGE),25203368,CDM,87530,CPT,300,RC,inpatient,,281,281,,238.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,211.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,238.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,247.28,88,,percent of total billed charges,,,,,,,,,214.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,255.71,91,,percent of total billed charges,,,266.95,95,,percent of total billed charges,,,233.23,83,,percent of total billed charges,,,233.23,83,,percent of total billed charges,,,,,,,,,,,,,,,233.23,83,,percent of total billed charges,,,266.95,95,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,230.42,82,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,238.85,85,,percent of total billed charges,,211.87,266.95,
.HERPES SIM 1 (LAVAGE),25203369,CDM,87530,CPT,300,RC,inpatient,,281,281,,238.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,211.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,238.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,247.28,88,,percent of total billed charges,,,,,,,,,214.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,255.71,91,,percent of total billed charges,,,266.95,95,,percent of total billed charges,,,233.23,83,,percent of total billed charges,,,233.23,83,,percent of total billed charges,,,,,,,,,,,,,,,233.23,83,,percent of total billed charges,,,266.95,95,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,230.42,82,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,238.85,85,,percent of total billed charges,,211.87,266.95,
FBN1 MARFAN SYNDROME,25203370,CDM,81408,CPT,300,RC,inpatient,,3400,3400,,2886.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2563.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2890,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2992,88,,percent of total billed charges,,,,,,,,,2597.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3094,91,,percent of total billed charges,,,3230,95,,percent of total billed charges,,,2822,83,,percent of total billed charges,,,2822,83,,percent of total billed charges,,,,,,,,,,,,,,,2822,83,,percent of total billed charges,,,3230,95,,percent of total billed charges,,,3060,90,,percent of total billed charges,,,3060,90,,percent of total billed charges,,,2788,82,,percent of total billed charges,,,3060,90,,percent of total billed charges,,,2890,85,,percent of total billed charges,,2563.6,3230,
H. PYLORI ANTIBODIES (IGA),25203371,CDM,86677,CPT,300,RC,inpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,163.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,184.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,163.62,206.15,
"H. PYLORI ANTIBODIES (IGA,IGM,IGG)",25203372,CDM,86677,CPT,300,RC,inpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,163.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,184.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,163.62,206.15,
H. PYLORI ANTIBODIES (IGM),25203373,CDM,86677,CPT,300,RC,inpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,163.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,184.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,163.62,206.15,
H. PYLORI BREATH TEST,25203374,CDM,83013,CPT,300,RC,inpatient,,713,713,,605.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,537.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,606.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,627.44,88,,percent of total billed charges,,,,,,,,,544.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,648.83,91,,percent of total billed charges,,,677.35,95,,percent of total billed charges,,,591.79,83,,percent of total billed charges,,,591.79,83,,percent of total billed charges,,,,,,,,,,,,,,,591.79,83,,percent of total billed charges,,,677.35,95,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,584.66,82,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,606.05,85,,percent of total billed charges,,537.6,677.35,
MATERNIT21 PLUS CORE NO GENDER,25203375,CDM,81420,CPT,300,RC,inpatient,,1136,1136,,964.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,856.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,965.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,999.68,88,,percent of total billed charges,,,,,,,,,867.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1033.76,91,,percent of total billed charges,,,1079.2,95,,percent of total billed charges,,,942.88,83,,percent of total billed charges,,,942.88,83,,percent of total billed charges,,,,,,,,,,,,,,,942.88,83,,percent of total billed charges,,,1079.2,95,,percent of total billed charges,,,1022.4,90,,percent of total billed charges,,,1022.4,90,,percent of total billed charges,,,931.52,82,,percent of total billed charges,,,1022.4,90,,percent of total billed charges,,,965.6,85,,percent of total billed charges,,856.54,1079.2,
SM and SM/RNP ANTIBODIES,25203380,CDM,86235,CPT,300,RC,inpatient,,319,319,,270.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,240.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,271.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,280.72,88,,percent of total billed charges,,,,,,,,,243.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,290.29,91,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,,,,,,,,,,,,,264.77,83,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,261.58,82,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,271.15,85,,percent of total billed charges,,240.53,303.05,
SMITH ANTIBODIES,25203381,CDM,86235,CPT,300,RC,inpatient,,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,114.61,144.4,
RNP AB & SMITH ANTIBODIES,25203382,CDM,86235,CPT,300,RC,inpatient,,37,37,,31.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.56,88,,percent of total billed charges,,,,,,,,,28.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,30.34,82,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,27.9,35.15,
MPO AB,25203384,CDM,83516,CPT,300,RC,inpatient,,37,37,,31.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.56,88,,percent of total billed charges,,,,,,,,,28.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,30.34,82,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,27.9,35.15,
PR3 AB,25203385,CDM,83516,CPT,300,RC,inpatient,,37,37,,31.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.56,88,,percent of total billed charges,,,,,,,,,28.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,30.34,82,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,27.9,35.15,
BASEMENT MEMBRANE AB,25203386,CDM,83516,CPT,300,RC,inpatient,,63,63,,53.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,53.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.44,88,,percent of total billed charges,,,,,,,,,48.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,,,,,,,,,,,,,52.29,83,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,51.66,82,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,47.5,59.85,
RNP AB,25203387,CDM,86235,CPT,300,RC,inpatient,,37,37,,31.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.56,88,,percent of total billed charges,,,,,,,,,28.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,30.34,82,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,27.9,35.15,
FACTOR X,25203398,CDM,85260,CPT,300,RC,inpatient,,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,217.91,274.55,
FACTOR VII,25203405,CDM,85230,CPT,300,RC,inpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,108.58,136.8,
FACTOR VIII,25203406,CDM,85240,CPT,300,RC,inpatient,,352,352,,298.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,265.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,299.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,309.76,88,,percent of total billed charges,,,,,,,,,268.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,,,,,,,,,,,,,292.16,83,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,288.64,82,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,265.41,334.4,
FACTOR II,25203407,CDM,85210,CPT,300,RC,inpatient,,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,217.91,274.55,
FACTOR IX,25203408,CDM,85250,CPT,300,RC,inpatient,,286,286,,242.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,215.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,243.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,251.68,88,,percent of total billed charges,,,,,,,,,218.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,260.26,91,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,,,,,,,,,,,,,237.38,83,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,234.52,82,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,215.64,271.7,
FACTOR XI,25203409,CDM,85270,CPT,300,RC,inpatient,,267,267,,226.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,201.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,226.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,234.96,88,,percent of total billed charges,,,,,,,,,203.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,242.97,91,,percent of total billed charges,,,253.65,95,,percent of total billed charges,,,221.61,83,,percent of total billed charges,,,221.61,83,,percent of total billed charges,,,,,,,,,,,,,,,221.61,83,,percent of total billed charges,,,253.65,95,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,218.94,82,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,226.95,85,,percent of total billed charges,,201.32,253.65,
FACTOR XII,25203410,CDM,85280,CPT,300,RC,inpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,76.91,96.9,
FACTOR II DNA ANALYSIS,25203411,CDM,81240,CPT,300,RC,inpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,153.06,192.85,
FACTOR V,25203414,CDM,85220,CPT,300,RC,inpatient,,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,217.91,274.55,
HYDROXYPROGESTERONE 17-ALPHA,25203422,CDM,83498,CPT,300,RC,inpatient,,407,407,,345.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,345.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,358.16,88,,percent of total billed charges,,,,,,,,,310.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,,,,,,,,,,,,,337.81,83,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,333.74,82,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,306.88,386.65,
17 HYDROXYPREGNENOLONE,25203423,CDM,84143,CPT,300,RC,inpatient,,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,179.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,202.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,179.45,226.1,
17 HYDROXYPROGESTERONE,25203424,CDM,83498,CPT,300,RC,inpatient,,407,407,,345.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,345.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,358.16,88,,percent of total billed charges,,,,,,,,,310.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,,,,,,,,,,,,,337.81,83,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,333.74,82,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,306.88,386.65,
17 HYDROXYPROGESTERONE URINE,25203425,CDM,83498,CPT,300,RC,inpatient,,530,530,,449.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466.4,88,,percent of total billed charges,,,,,,,,,404.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,,,,,,,,,,,,,439.9,83,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,434.6,82,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,399.62,503.5,
HEPATITIS C ANTIBODY,25203430,CDM,86803,CPT,300,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
HEPATITIS C  AB W/ REFLEX TO QNT,25203432,CDM,86803,CPT,300,RC,inpatient,,280,280,,237.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,211.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,238,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,246.4,88,,percent of total billed charges,,,,,,,,,213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,,,,,,,,,,,,,232.4,83,,percent of total billed charges,,,266,95,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,229.6,82,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,211.12,266,
HEPATITIS C AB HIGH RISK/OTHER,25203433,CDM,G0472,HCPCS,300,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,16.85,,,,fee schedule,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,16.85,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,16.85,245.1,
VITAMIN A,25203596,CDM,84590,CPT,300,RC,inpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,157.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,177.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,157.59,198.55,
VITAMIN K PLASMA,25203598,CDM,84597,CPT,300,RC,inpatient,,254,254,,215.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,191.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,223.52,88,,percent of total billed charges,,,,,,,,,194.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,231.14,91,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,,,,,,,,,,,,,210.82,83,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,208.28,82,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,191.52,241.3,
VITAMIN E (TOCOPHEROL),25203604,CDM,84446,CPT,300,RC,inpatient,,255,255,,216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,192.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,216.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,224.4,88,,percent of total billed charges,,,,,,,,,194.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,209.1,82,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,192.27,242.25,
IMMUNOFIXATION SERUM(INC SPE),25203611,CDM,86334,CPT,300,RC,inpatient,,403,403,,342.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,303.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,342.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,354.64,88,,percent of total billed charges,,,,,,,,,307.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,366.73,91,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,,,,,,,,,,,,,334.49,83,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,330.46,82,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,342.55,85,,percent of total billed charges,,303.86,382.85,
IFE AND PE CSF,25203612,CDM,86335,CPT,300,RC,inpatient,,358,358,,303.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,269.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,304.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,315.04,88,,percent of total billed charges,,,,,,,,,273.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,325.78,91,,percent of total billed charges,,,340.1,95,,percent of total billed charges,,,297.14,83,,percent of total billed charges,,,297.14,83,,percent of total billed charges,,,,,,,,,,,,,,,297.14,83,,percent of total billed charges,,,340.1,95,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,293.56,82,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,304.3,85,,percent of total billed charges,,269.93,340.1,
IMMUNOFIXATION URINE (RANDOM /24-HOUR),25203613,CDM,86335,CPT,300,RC,inpatient,,530,530,,449.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466.4,88,,percent of total billed charges,,,,,,,,,404.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,,,,,,,,,,,,,439.9,83,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,434.6,82,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,399.62,503.5,
FREE & LIGHT CHAINS URINE (RANDOM),25203614,CDM,86335,CPT,300,RC,inpatient,,530,530,,449.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466.4,88,,percent of total billed charges,,,,,,,,,404.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,,,,,,,,,,,,,439.9,83,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,434.6,82,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,399.62,503.5,
KAPPA/LAMBDA LIGHT CHAINS SERUM,25203615,CDM,83883,CPT,300,RC,inpatient,,437,437,,371.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,329.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,371.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,384.56,88,,percent of total billed charges,,,,,,,,,333.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,397.67,91,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,,,,,,,,,,,,,362.71,83,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,358.34,82,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,329.5,415.15,
..KAPPA/LAMBDA LIGHT CHAINS SERUM,25203616,CDM,83883,CPT,300,RC,inpatient,,437,437,,371.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,329.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,371.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,384.56,88,,percent of total billed charges,,,,,,,,,333.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,397.67,91,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,,,,,,,,,,,,,362.71,83,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,358.34,82,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,329.5,415.15,
C-R PROTEIN  (HS)(CARDIO),25203620,CDM,86141,CPT,300,RC,inpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,226.2,285,
IMMUNOGLOBULIN M,25203638,CDM,82784,CPT,300,RC,inpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,157.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,177.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,157.59,198.55,
IMMUNOGLOBULIN A,25203646,CDM,82784,CPT,300,RC,inpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,157.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,177.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,157.59,198.55,
IODINE URINE (RANDOM),25203647,CDM,83789,CPT,300,RC,inpatient,,183,183,,155.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,155.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,161.04,88,,percent of total billed charges,,,,,,,,,139.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,,,,,,,,,,,,,151.89,83,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,150.06,82,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,137.98,173.85,
IODINE 24 HR URINE,25203648,CDM,83789,CPT,300,RC,inpatient,,269,269,,228.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,202.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,228.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,236.72,88,,percent of total billed charges,,,,,,,,,205.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,244.79,91,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,,,,,,,,,,,,,223.27,83,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,220.58,82,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,202.83,255.55,
IODINE SERUM,25203649,CDM,83789,CPT,300,RC,inpatient,,114,114,,96.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,100.32,88,,percent of total billed charges,,,,,,,,,87.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,103.74,91,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,,,,,,,,,,,,,94.62,83,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,93.48,82,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,96.9,85,,percent of total billed charges,,85.96,108.3,
IMMUNOGLOBULIN D,25203650,CDM,82784,CPT,300,RC,inpatient,,166,166,,140.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,146.08,88,,percent of total billed charges,,,,,,,,,126.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,,,,,,,,,,,,,137.78,83,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,136.12,82,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,125.16,157.7,
ALPHA-FETOPROTEIN (TUMOR MARKER),25203652,CDM,82105,CPT,300,RC,inpatient,,313,313,,265.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,236,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,266.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,275.44,88,,percent of total billed charges,,,,,,,,,239.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,284.83,91,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,,,,,,,,,,,,,259.79,83,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,256.66,82,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,236,297.35,
ALPHA-FETOPROTEIN (PREGNANCY),25203653,CDM,82105,CPT,300,RC,inpatient,,313,313,,265.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,236,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,266.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,275.44,88,,percent of total billed charges,,,,,,,,,239.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,284.83,91,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,,,,,,,,,,,,,259.79,83,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,256.66,82,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,236,297.35,
ALPHA-FETOPROTEIN - L3,25203654,CDM,82107,CPT,300,RC,inpatient,,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,257.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,290.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,257.87,324.9,
HCG SERUM PREGNANCY TEST,25203661,CDM,84703,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
CARBOXYHEMOGLOBIN,25203679,CDM,82375,CPT,300,RC,inpatient,TC,282,282,,239.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,212.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,239.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,248.16,88,,percent of total billed charges,,,,,,,,,215.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,256.62,91,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,,,,,,,,,,,,,234.06,83,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,231.24,82,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,239.7,85,,percent of total billed charges,,212.63,267.9,
PROTHROMBIN GENE MUTATION,25203680,CDM,81240,CPT,300,RC,inpatient,,731,731,,620.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,551.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,621.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,643.28,88,,percent of total billed charges,,,,,,,,,558.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,665.21,91,,percent of total billed charges,,,694.45,95,,percent of total billed charges,,,606.73,83,,percent of total billed charges,,,606.73,83,,percent of total billed charges,,,,,,,,,,,,,,,606.73,83,,percent of total billed charges,,,694.45,95,,percent of total billed charges,,,657.9,90,,percent of total billed charges,,,657.9,90,,percent of total billed charges,,,599.42,82,,percent of total billed charges,,,657.9,90,,percent of total billed charges,,,621.35,85,,percent of total billed charges,,551.17,694.45,
HOMOCYSTEINE NUTRITIONAL,25203688,CDM,83090,CPT,300,RC,inpatient,,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,454.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,512.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,454.66,572.85,
METHYLMALONIC ACID,25203689,CDM,83921,CPT,300,RC,inpatient,,544,544,,461.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,410.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,462.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,478.72,88,,percent of total billed charges,,,,,,,,,415.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,495.04,91,,percent of total billed charges,,,516.8,95,,percent of total billed charges,,,451.52,83,,percent of total billed charges,,,451.52,83,,percent of total billed charges,,,,,,,,,,,,,,,451.52,83,,percent of total billed charges,,,516.8,95,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,446.08,82,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,462.4,85,,percent of total billed charges,,410.18,516.8,
MTHFR METYLENETETRAHYDROFOLATE,25203691,CDM,83891,CPT,300,RC,inpatient,,305,305,,258.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,229.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,259.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,268.4,88,,percent of total billed charges,,,,,,,,,233.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,277.55,91,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,,,,,,,,,,,,,253.15,83,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,250.1,82,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,229.97,289.75,
HOMOCYSTEINE CARDIOVASCULAR,25203692,CDM,83090,CPT,300,RC,inpatient,,360,360,,305.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,271.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,306,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,316.8,88,,percent of total billed charges,,,,,,,,,275.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,327.6,91,,percent of total billed charges,,,342,95,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,,,,,,,,,,,,,298.8,83,,percent of total billed charges,,,342,95,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,295.2,82,,percent of total billed charges,,,324,90,,percent of total billed charges,,,306,85,,percent of total billed charges,,271.44,342,
METHYLMALONIC ACID URINE,25203693,CDM,83921,CPT,300,RC,inpatient,,544,544,,461.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,410.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,462.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,478.72,88,,percent of total billed charges,,,,,,,,,415.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,495.04,91,,percent of total billed charges,,,516.8,95,,percent of total billed charges,,,451.52,83,,percent of total billed charges,,,451.52,83,,percent of total billed charges,,,,,,,,,,,,,,,451.52,83,,percent of total billed charges,,,516.8,95,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,446.08,82,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,462.4,85,,percent of total billed charges,,410.18,516.8,
ESTRONE,25203703,CDM,82679,CPT,300,RC,inpatient,,313,313,,265.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,236,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,266.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,275.44,88,,percent of total billed charges,,,,,,,,,239.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,284.83,91,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,,,,,,,,,,,,,259.79,83,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,256.66,82,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,236,297.35,
PRIMIDONE,25203711,CDM,80188,CPT,300,RC,inpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
GABAPENTIN PLASMA,25203737,CDM,80171,CPT,300,RC,inpatient,,509,509,,432.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,383.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,432.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,447.92,88,,percent of total billed charges,,,,,,,,,388.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,463.19,91,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,,,,,,,,,,,,,422.47,83,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,417.38,82,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,383.79,483.55,
NARCOLEPSY EVALUATION,25203738,CDM,80171,CPT,300,RC,inpatient,,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,203.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,180.21,227.05,
MYELODYSPLASTIC SYNDROME(FISH ),25203739,CDM,88120,CPT,300,RC,inpatient,,1400,1400,,1188.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1055.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1190,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1232,88,,percent of total billed charges,,,,,,,,,1069.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1274,91,,percent of total billed charges,,,1330,95,,percent of total billed charges,,,1162,83,,percent of total billed charges,,,1162,83,,percent of total billed charges,,,,,,,,,,,,,,,1162,83,,percent of total billed charges,,,1330,95,,percent of total billed charges,,,1260,90,,percent of total billed charges,,,1260,90,,percent of total billed charges,,,1148,82,,percent of total billed charges,,,1260,90,,percent of total billed charges,,,1190,85,,percent of total billed charges,,1055.6,1330,
NMO ANTIBODY (IgG),25203740,CDM,86255,CPT,300,RC,inpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,686.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,773.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,686.14,864.5,
NICOTINE  & METABOLITE(URINE),25203741,CDM,80323,CPT,300,RC,inpatient,,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,280.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,316.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,280.49,353.4,
NICOTINE &  METABOLITE (serum),25203742,CDM,80323,CPT,300,RC,inpatient,,351,351,,298,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,264.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,298.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,308.88,88,,percent of total billed charges,,,,,,,,,268.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,319.41,91,,percent of total billed charges,,,333.45,95,,percent of total billed charges,,,291.33,83,,percent of total billed charges,,,291.33,83,,percent of total billed charges,,,,,,,,,,,,,,,291.33,83,,percent of total billed charges,,,333.45,95,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,287.82,82,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,298.35,85,,percent of total billed charges,,264.65,333.45,
ELECTROLYTE PANEL,25203745,CDM,80051,CPT,300,RC,inpatient,,221,221,,187.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,166.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,187.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,194.48,88,,percent of total billed charges,,,,,,,,,168.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,201.11,91,,percent of total billed charges,,,209.95,95,,percent of total billed charges,,,183.43,83,,percent of total billed charges,,,183.43,83,,percent of total billed charges,,,,,,,,,,,,,,,183.43,83,,percent of total billed charges,,,209.95,95,,percent of total billed charges,,,198.9,90,,percent of total billed charges,,,198.9,90,,percent of total billed charges,,,181.22,82,,percent of total billed charges,,,198.9,90,,percent of total billed charges,,,187.85,85,,percent of total billed charges,,166.63,209.95,
VOLUME MEASUREMENT,25203752,CDM,81050,CPT,300,RC,inpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,41.47,52.25,
"CELL COUNT w/diff, BODY FLUID",25203760,CDM,89051,CPT,300,RC,inpatient,,148,148,,125.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,111.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,125.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,130.24,88,,percent of total billed charges,,,,,,,,,113.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,,,,,,,,,,,,,122.84,83,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,121.36,82,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,111.59,140.6,
HEPATITIS BE ANTIBODY,25203778,CDM,86707,CPT,300,RC,inpatient,,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,129.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,129.69,163.4,
ACID FAST STAIN,25203786,CDM,87206,CPT,300,RC,inpatient,,170,170,,144.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,128.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,144.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,149.6,88,,percent of total billed charges,,,,,,,,,129.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,154.7,91,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,,,,,,,,,,,,,141.1,83,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,139.4,82,,percent of total billed charges,,,153,90,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,128.18,161.5,
POTASSIUM URINE,25203794,CDM,84133,CPT,300,RC,inpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,120.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,120.64,152,
POTASSIUM URINE 24HR,25203795,CDM,84133,CPT,300,RC,inpatient,TC,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
"SODIUM, URINE",25203802,CDM,84300,CPT,300,RC,inpatient,,175,175,,148.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,131.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,148.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154,88,,percent of total billed charges,,,,,,,,,133.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,,,,,,,,,,,,,145.25,83,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,143.5,82,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,131.95,166.25,
"CHLORIDE, URINE",25203810,CDM,82436,CPT,300,RC,inpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,109.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,123.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,109.33,137.75,
"CHLORIDE, URINE (24HR)",25203811,CDM,82436,CPT,300,RC,inpatient,TC,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,110.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,98.02,123.5,
"VISCOSITY, SERUM",25203835,CDM,85810,CPT,300,RC,inpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,153.06,192.85,
CULTURE CSF,25203844,CDM,87070,CPT,300,RC,inpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,109.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,123.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,109.33,137.75,
"LDH, BODY FLUID",25203851,CDM,83615,CPT,300,RC,inpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
BB BLOOD TYPING RH,25203869,CDM,86901,CPT,300,RC,inpatient,,151,151,,128.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,113.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,128.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,132.88,88,,percent of total billed charges,,,,,,,,,115.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,,,,,,,,,,,,,125.33,83,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,123.82,82,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,113.85,143.45,
BASIC MET PANEL,25203885,CDM,80048,CPT,300,RC,inpatient,,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,217.91,274.55,
ISTAT CHEM PANEL,25203886,CDM,80047,CPT,300,RC,inpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,198.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,198.3,249.85,
BARTONELLA SPECIES ANTIBODY,25203893,CDM,86611,CPT,300,RC,inpatient,,60,60,,50.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,45.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.8,88,,percent of total billed charges,,,,,,,,,45.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,,,,,,,,,,,,,49.8,83,,percent of total billed charges,,,57,95,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,49.2,82,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,45.24,57,
BARTONELLA HENSELAE AB (IGG/IGM),25203894,CDM,86611,CPT,300,RC,inpatient,,183,183,,155.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,155.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,161.04,88,,percent of total billed charges,,,,,,,,,139.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,,,,,,,,,,,,,151.89,83,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,150.06,82,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,137.98,173.85,
BABESIA MICROTI AB (IGG/IGM),25203895,CDM,86753,CPT,300,RC,inpatient,,318,318,,269.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,239.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,270.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,279.84,88,,percent of total billed charges,,,,,,,,,242.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,289.38,91,,percent of total billed charges,,,302.1,95,,percent of total billed charges,,,263.94,83,,percent of total billed charges,,,263.94,83,,percent of total billed charges,,,,,,,,,,,,,,,263.94,83,,percent of total billed charges,,,302.1,95,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,260.76,82,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,270.3,85,,percent of total billed charges,,239.77,302.1,
BABESIA MICROTI  PCR,25203896,CDM,87798,CPT,300,RC,inpatient,,862,862,,731.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,649.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,732.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,758.56,88,,percent of total billed charges,,,,,,,,,658.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,784.42,91,,percent of total billed charges,,,818.9,95,,percent of total billed charges,,,715.46,83,,percent of total billed charges,,,715.46,83,,percent of total billed charges,,,,,,,,,,,,,,,715.46,83,,percent of total billed charges,,,818.9,95,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,706.84,82,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,732.7,85,,percent of total billed charges,,649.95,818.9,
CA 15-3,25203901,CDM,86300,CPT,300,RC,inpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,283.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,319.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,283.5,357.2,
CA 19-9,25203902,CDM,86301,CPT,300,RC,inpatient,,313,313,,265.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,236,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,266.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,275.44,88,,percent of total billed charges,,,,,,,,,239.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,284.83,91,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,,,,,,,,,,,,,259.79,83,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,256.66,82,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,236,297.35,
CA 27.29,25203903,CDM,86300,CPT,300,RC,inpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,283.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,319.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,283.5,357.2,
CULTURE STOOL CAMPYLOBACTER,25203904,CDM,87046,CPT,300,RC,inpatient,,143,143,,121.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,107.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,121.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,125.84,88,,percent of total billed charges,,,,,,,,,109.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,130.13,91,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,,,,,,,,,,,,,118.69,83,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,117.26,82,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,121.55,85,,percent of total billed charges,,107.82,135.85,
TRICHROME STAIN,25203907,CDM,87209,CPT,300,RC,inpatient,,268,268,,227.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,202.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,227.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,235.84,88,,percent of total billed charges,,,,,,,,,204.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,243.88,91,,percent of total billed charges,,,254.6,95,,percent of total billed charges,,,222.44,83,,percent of total billed charges,,,222.44,83,,percent of total billed charges,,,,,,,,,,,,,,,222.44,83,,percent of total billed charges,,,254.6,95,,percent of total billed charges,,,241.2,90,,percent of total billed charges,,,241.2,90,,percent of total billed charges,,,219.76,82,,percent of total billed charges,,,241.2,90,,percent of total billed charges,,,227.8,85,,percent of total billed charges,,202.07,254.6,
E COLI SHIGA TOXIN EIA,25203908,CDM,87427,CPT,300,RC,inpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,135.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,135.72,171,
CULTURE YERSINIA,25203910,CDM,87046,CPT,300,RC,inpatient,,165,165,,140.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,124.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,140.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,145.2,88,,percent of total billed charges,,,,,,,,,126.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,135.3,82,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,124.41,156.75,
CULTURE VIBRIO,25203915,CDM,87046,CPT,300,RC,inpatient,,168,168,,142.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,126.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,142.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,147.84,88,,percent of total billed charges,,,,,,,,,128.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,,,,,,,,,,,,,139.44,83,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,137.76,82,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,126.67,159.6,
HPV DNA HIGH RISK,25203920,CDM,87624,CPT,300,RC,inpatient,,590,590,,500.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,444.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,501.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,519.2,88,,percent of total billed charges,,,,,,,,,450.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,536.9,91,,percent of total billed charges,,,560.5,95,,percent of total billed charges,,,489.7,83,,percent of total billed charges,,,489.7,83,,percent of total billed charges,,,,,,,,,,,,,,,489.7,83,,percent of total billed charges,,,560.5,95,,percent of total billed charges,,,531,90,,percent of total billed charges,,,531,90,,percent of total billed charges,,,483.8,82,,percent of total billed charges,,,531,90,,percent of total billed charges,,,501.5,85,,percent of total billed charges,,444.86,560.5,
"HPV DNA genotypr 16,18/45",25203921,CDM,87625,CPT,300,RC,inpatient,,340,340,,288.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,256.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,289,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,299.2,88,,percent of total billed charges,,,,,,,,,259.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,309.4,91,,percent of total billed charges,,,323,95,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,,,,,,,,,,,,,282.2,83,,percent of total billed charges,,,323,95,,percent of total billed charges,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,278.8,82,,percent of total billed charges,,,306,90,,percent of total billed charges,,,289,85,,percent of total billed charges,,256.36,323,
"HPV DNA genotypr (APTIMA) 16,18/45",25203922,CDM,87624,CPT,300,RC,inpatient,,340,340,,288.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,256.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,289,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,299.2,88,,percent of total billed charges,,,,,,,,,259.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,309.4,91,,percent of total billed charges,,,323,95,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,,,,,,,,,,,,,282.2,83,,percent of total billed charges,,,323,95,,percent of total billed charges,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,278.8,82,,percent of total billed charges,,,306,90,,percent of total billed charges,,,289,85,,percent of total billed charges,,256.36,323,
.GTT - 5 HOUR,25203927,CDM,82951,CPT,300,RC,inpatient,,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,174.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,174.17,219.45,
PARIETAL CELL ANTIBODY,25203936,CDM,86255,CPT,300,RC,inpatient,,168,168,,142.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,126.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,142.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,147.84,88,,percent of total billed charges,,,,,,,,,128.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,,,,,,,,,,,,,139.44,83,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,137.76,82,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,126.67,159.6,
HEMOGLOBIN ELECTROPHORESIS W/REFLEX,25203943,CDM,83020,CPT,300,RC,inpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,116.12,146.3,
HEMOGLOBIN F,25203944,CDM,83021,CPT,300,RC,inpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,132.7,167.2,
ROTAVIRUS,25203950,CDM,87425,CPT,300,RC,inpatient,,254,254,,215.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,191.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,223.52,88,,percent of total billed charges,,,,,,,,,194.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,231.14,91,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,,,,,,,,,,,,,210.82,83,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,208.28,82,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,191.52,241.3,
ROHYPHNOL / FLUNITRAZEPAM,25203951,CDM,80346,CPT,300,RC,inpatient,,789,789,,669.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,594.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,670.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,694.32,88,,percent of total billed charges,,,,,,,,,602.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,717.99,91,,percent of total billed charges,,,749.55,95,,percent of total billed charges,,,654.87,83,,percent of total billed charges,,,654.87,83,,percent of total billed charges,,,,,,,,,,,,,,,654.87,83,,percent of total billed charges,,,749.55,95,,percent of total billed charges,,,710.1,90,,percent of total billed charges,,,710.1,90,,percent of total billed charges,,,646.98,82,,percent of total billed charges,,,710.1,90,,percent of total billed charges,,,670.65,85,,percent of total billed charges,,594.91,749.55,
ADENOVIRUS TYPE 40/41,25203952,CDM,87425,CPT,300,RC,inpatient,,64.84,64.84,,55.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.06,88,,percent of total billed charges,,,,,,,,,49.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59,91,,percent of total billed charges,,,61.6,95,,percent of total billed charges,,,53.82,83,,percent of total billed charges,,,53.82,83,,percent of total billed charges,,,,,,,,,,,,,,,53.82,83,,percent of total billed charges,,,61.6,95,,percent of total billed charges,,,58.36,90,,percent of total billed charges,,,58.36,90,,percent of total billed charges,,,53.17,82,,percent of total billed charges,,,58.36,90,,percent of total billed charges,,,55.11,85,,percent of total billed charges,,48.89,61.6,
..ROTAVIRUS CHARGE ONLY,25203954,CDM,87425,CPT,300,RC,inpatient,,47.93,47.93,,40.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.18,88,,percent of total billed charges,,,,,,,,,36.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.62,91,,percent of total billed charges,,,45.53,95,,percent of total billed charges,,,39.78,83,,percent of total billed charges,,,39.78,83,,percent of total billed charges,,,,,,,,,,,,,,,39.78,83,,percent of total billed charges,,,45.53,95,,percent of total billed charges,,,43.14,90,,percent of total billed charges,,,43.14,90,,percent of total billed charges,,,39.3,82,,percent of total billed charges,,,43.14,90,,percent of total billed charges,,,40.74,85,,percent of total billed charges,,36.14,45.53,
HEMOCHROMATOSIS DNA,25203955,CDM,81256,CPT,300,RC,inpatient,,755,755,,641,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,569.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,641.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,664.4,88,,percent of total billed charges,,,,,,,,,576.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,687.05,91,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,,,,,,,,,,,,,626.65,83,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,619.1,82,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,569.27,717.25,
RETICULIN AB IGA,25203960,CDM,86255,CPT,300,RC,inpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
..RETICULIN AB IGG,25203961,CDM,86255,CPT,300,RC,inpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
.RETICULIN AB IGA TITER,25203962,CDM,86255,CPT,300,RC,inpatient,,140,140,,118.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,105.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,119,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,123.2,88,,percent of total billed charges,,,,,,,,,106.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,133,95,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,114.8,82,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,105.56,133,
CYTOMEGALOVIRUS AB (IGG),25203968,CDM,86644,CPT,300,RC,inpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,135.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,119.89,151.05,
CLOTEST,25203976,CDM,87070,CPT,300,RC,inpatient,,255,255,,216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,192.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,216.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,224.4,88,,percent of total billed charges,,,,,,,,,194.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,209.1,82,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,192.27,242.25,
PTH ANTIBODY,25203980,CDM,83519,CPT,300,RC,inpatient,,387,387,,328.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.56,88,,percent of total billed charges,,,,,,,,,295.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,352.17,91,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,,,,,,,,,,,,,321.21,83,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,317.34,82,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,328.95,85,,percent of total billed charges,,291.8,367.65,
PTH RELATED PROTEIN,25203981,CDM,83519,CPT,300,RC,inpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,223.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,252.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,223.94,282.15,
PARASITE ID,25203982,CDM,87169,CPT,300,RC,inpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,34.68,43.7,
PCP URINE/W CONFIRM,25203983,CDM,80307,CPT,300,RC,inpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,52.03,65.55,
PAXIL,25203984,CDM,80332,CPT,300,RC,inpatient,,495,495,,420.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,373.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,420.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,435.6,88,,percent of total billed charges,,,,,,,,,378.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,450.45,91,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,,,,,,,,,,,,,410.85,83,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,405.9,82,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,373.23,470.25,
PARASITE ID (arthopod),25203985,CDM,87168,CPT,300,RC,inpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,34.68,43.7,
PORPHYRINS STOOL,25203992,CDM,84126,CPT,300,RC,inpatient,,902,902,,765.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,680.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,766.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,793.76,88,,percent of total billed charges,,,,,,,,,689.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,820.82,91,,percent of total billed charges,,,856.9,95,,percent of total billed charges,,,748.66,83,,percent of total billed charges,,,748.66,83,,percent of total billed charges,,,,,,,,,,,,,,,748.66,83,,percent of total billed charges,,,856.9,95,,percent of total billed charges,,,811.8,90,,percent of total billed charges,,,811.8,90,,percent of total billed charges,,,739.64,82,,percent of total billed charges,,,811.8,90,,percent of total billed charges,,,766.7,85,,percent of total billed charges,,680.11,856.9,
VITAMIN B-2,25204008,CDM,84252,CPT,300,RC,inpatient,,531,531,,450.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,400.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,451.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,467.28,88,,percent of total billed charges,,,,,,,,,405.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,483.21,91,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,,,,,,,,,,,,,440.73,83,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,435.42,82,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,400.37,504.45,
VITAMIN B-3,25204009,CDM,84591,CPT,300,RC,inpatient,,506,506,,429.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,381.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,430.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,445.28,88,,percent of total billed charges,,,,,,,,,386.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,460.46,91,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,,,,,,,,,,,,,419.98,83,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,414.92,82,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,430.1,85,,percent of total billed charges,,381.52,480.7,
VITAMIN B-6,25204016,CDM,84207,CPT,300,RC,inpatient,,507,507,,430.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,382.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,430.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,446.16,88,,percent of total billed charges,,,,,,,,,387.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,461.37,91,,percent of total billed charges,,,481.65,95,,percent of total billed charges,,,420.81,83,,percent of total billed charges,,,420.81,83,,percent of total billed charges,,,,,,,,,,,,,,,420.81,83,,percent of total billed charges,,,481.65,95,,percent of total billed charges,,,456.3,90,,percent of total billed charges,,,456.3,90,,percent of total billed charges,,,415.74,82,,percent of total billed charges,,,456.3,90,,percent of total billed charges,,,430.95,85,,percent of total billed charges,,382.28,481.65,
VITAMIN B-7,25204017,CDM,84591,CPT,300,RC,inpatient,,377,377,,320.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,284.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,320.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,331.76,88,,percent of total billed charges,,,,,,,,,288.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,343.07,91,,percent of total billed charges,,,358.15,95,,percent of total billed charges,,,312.91,83,,percent of total billed charges,,,312.91,83,,percent of total billed charges,,,,,,,,,,,,,,,312.91,83,,percent of total billed charges,,,358.15,95,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,309.14,82,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,320.45,85,,percent of total billed charges,,284.26,358.15,
PANCREATIC ELASTASE,25204020,CDM,82656,CPT,300,RC,inpatient,,687,687,,583.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,518,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,583.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,604.56,88,,percent of total billed charges,,,,,,,,,524.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,625.17,91,,percent of total billed charges,,,652.65,95,,percent of total billed charges,,,570.21,83,,percent of total billed charges,,,570.21,83,,percent of total billed charges,,,,,,,,,,,,,,,570.21,83,,percent of total billed charges,,,652.65,95,,percent of total billed charges,,,618.3,90,,percent of total billed charges,,,618.3,90,,percent of total billed charges,,,563.34,82,,percent of total billed charges,,,618.3,90,,percent of total billed charges,,,583.95,85,,percent of total billed charges,,518,652.65,
PANORAMA PRENATAL,25204021,CDM,81599,CPT,300,RC,inpatient,,2048,2048,,1738.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1544.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1740.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1802.24,88,,percent of total billed charges,,,,,,,,,1564.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1863.68,91,,percent of total billed charges,,,1945.6,95,,percent of total billed charges,,,1699.84,83,,percent of total billed charges,,,1699.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1699.84,83,,percent of total billed charges,,,1945.6,95,,percent of total billed charges,,,1843.2,90,,percent of total billed charges,,,1843.2,90,,percent of total billed charges,,,1679.36,82,,percent of total billed charges,,,1843.2,90,,percent of total billed charges,,,1740.8,85,,percent of total billed charges,,1544.19,1945.6,
FLOW CYTOMETRY EACH ADDED MARKER,25204024,CDM,88185,CPT,310,RC,inpatient,,278,278,,236.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,236.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.64,88,,percent of total billed charges,,,,,,,,,212.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.98,91,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,,,,,,,,,,,,,230.74,83,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,227.96,82,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,209.61,264.1,
FLOW CYTOMETRY 1ST MARKER,25204025,CDM,88184,CPT,310,RC,inpatient,,695,695,,590.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,524.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,590.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,611.6,88,,percent of total billed charges,,,,,,,,,530.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,632.45,91,,percent of total billed charges,,,660.25,95,,percent of total billed charges,,,576.85,83,,percent of total billed charges,,,576.85,83,,percent of total billed charges,,,,,,,,,,,,,,,576.85,83,,percent of total billed charges,,,660.25,95,,percent of total billed charges,,,625.5,90,,percent of total billed charges,,,625.5,90,,percent of total billed charges,,,569.9,82,,percent of total billed charges,,,625.5,90,,percent of total billed charges,,,590.75,85,,percent of total billed charges,,524.03,660.25,
FLOW CYTOMETRY INTERP 16 MARKERS,25204026,CDM,88189,CPT,310,RC,inpatient,,837,837,,710.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,631.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,711.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,736.56,88,,percent of total billed charges,,,,,,,,,639.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,761.67,91,,percent of total billed charges,,,795.15,95,,percent of total billed charges,,,694.71,83,,percent of total billed charges,,,694.71,83,,percent of total billed charges,,,,,,,,,,,,,,,694.71,83,,percent of total billed charges,,,795.15,95,,percent of total billed charges,,,753.3,90,,percent of total billed charges,,,753.3,90,,percent of total billed charges,,,686.34,82,,percent of total billed charges,,,753.3,90,,percent of total billed charges,,,711.45,85,,percent of total billed charges,,631.1,795.15,
FLOW CYTOMETRY PNH,25204028,CDM,88184,CPT,310,RC,inpatient,,312,312,,264.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,235.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,265.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,274.56,88,,percent of total billed charges,,,,,,,,,238.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,283.92,91,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,,,,,,,,,,,,,258.96,83,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,255.84,82,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,265.2,85,,percent of total billed charges,,235.25,296.4,
CHRONIC LYMPH LEUKEMIA FISH,25204029,CDM,,,310,RC,inpatient,,1500,1500,,1273.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1131,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1275,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1320,88,,percent of total billed charges,,,,,,,,,1146,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1365,91,,percent of total billed charges,,,1425,95,,percent of total billed charges,,,1245,83,,percent of total billed charges,,,1245,83,,percent of total billed charges,,,,,,,,,,,,,,,1245,83,,percent of total billed charges,,,1425,95,,percent of total billed charges,,,1350,90,,percent of total billed charges,,,1350,90,,percent of total billed charges,,,1230,82,,percent of total billed charges,,,1350,90,,percent of total billed charges,,,1275,85,,percent of total billed charges,,1131,1425,
STONE ANALYSIS,25204099,CDM,82365,CPT,300,RC,inpatient,,192,192,,163.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,163.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.96,88,,percent of total billed charges,,,,,,,,,146.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,,,,,,,,,,,,,159.36,83,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,157.44,82,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,144.77,182.4,
HAPTOGLOBIN,25204107,CDM,83010,CPT,300,RC,inpatient,,288,288,,244.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,244.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,253.44,88,,percent of total billed charges,,,,,,,,,220.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.08,91,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,,,,,,,,,,,,,239.04,83,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,236.16,82,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,244.8,85,,percent of total billed charges,,217.15,273.6,
HARMONY PRENATAL,25204108,CDM,81507,CPT,300,RC,inpatient,,1311,1311,,1113.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,988.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1114.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1153.68,88,,percent of total billed charges,,,,,,,,,1001.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1193.01,91,,percent of total billed charges,,,1245.45,95,,percent of total billed charges,,,1088.13,83,,percent of total billed charges,,,1088.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1088.13,83,,percent of total billed charges,,,1245.45,95,,percent of total billed charges,,,1179.9,90,,percent of total billed charges,,,1179.9,90,,percent of total billed charges,,,1075.02,82,,percent of total billed charges,,,1179.9,90,,percent of total billed charges,,,1114.35,85,,percent of total billed charges,,988.49,1245.45,
HEROIN SERUM,25204109,CDM,80356,CPT,310,RC,inpatient,,453,453,,384.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,341.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,385.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,398.64,88,,percent of total billed charges,,,,,,,,,346.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,412.23,91,,percent of total billed charges,,,430.35,95,,percent of total billed charges,,,375.99,83,,percent of total billed charges,,,375.99,83,,percent of total billed charges,,,,,,,,,,,,,,,375.99,83,,percent of total billed charges,,,430.35,95,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,371.46,82,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,385.05,85,,percent of total billed charges,,341.56,430.35,
FENTANYL & METABOLITE SERUM,25204110,CDM,80354,CPT,310,RC,inpatient,,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,174.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,174.17,219.45,
TRAMADOL SERUM,25204111,CDM,80373,CPT,310,RC,inpatient,,189,189,,160.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,142.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,160.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,166.32,88,,percent of total billed charges,,,,,,,,,144.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,,,,,,,,,,,,,156.87,83,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,154.98,82,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,142.51,179.55,
TRAMADOL URINE,25204112,CDM,80299,CPT,310,RC,inpatient,,189,189,,160.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,142.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,160.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,166.32,88,,percent of total billed charges,,,,,,,,,144.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,,,,,,,,,,,,,156.87,83,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,154.98,82,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,142.51,179.55,
VITAMIN B-1,25204115,CDM,84425,CPT,300,RC,inpatient,,384,384,,326.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,289.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,326.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,337.92,88,,percent of total billed charges,,,,,,,,,293.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,349.44,91,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,,,,,,,,,,,,,318.72,83,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,314.88,82,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,326.4,85,,percent of total billed charges,,289.54,364.8,
CRYSTALS SYNOVIAL FLUID,25204123,CDM,89060,CPT,300,RC,inpatient,,113,113,,95.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,99.44,88,,percent of total billed charges,,,,,,,,,86.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,92.66,82,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,85.2,107.35,
THROMBIN TIME,25204149,CDM,85670,CPT,300,RC,inpatient,,82,82,,69.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,69.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,72.16,88,,percent of total billed charges,,,,,,,,,62.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,74.62,91,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,,,,,,,,,,,,,68.06,83,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,67.24,82,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,61.83,77.9,
.PHOSPHO NEUTRALIZATION PLT,25204150,CDM,85597,CPT,300,RC,inpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,58.06,73.15,
.CHROMIUM,25204200,CDM,82495,CPT,310,RC,inpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,153.06,192.85,
CHROMIUM PLASMA,25204201,CDM,82495,CPT,310,RC,inpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,171.16,215.65,
ST. LOUIS ENCEPHALITIS(IgM),25204206,CDM,86653,CPT,300,RC,inpatient,,301,301,,255.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264.88,88,,percent of total billed charges,,,,,,,,,229.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273.91,91,,percent of total billed charges,,,285.95,95,,percent of total billed charges,,,249.83,83,,percent of total billed charges,,,249.83,83,,percent of total billed charges,,,,,,,,,,,,,,,249.83,83,,percent of total billed charges,,,285.95,95,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,246.82,82,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,255.85,85,,percent of total billed charges,,226.95,285.95,
ST. LOUIS ENCEPHALITIS(IgG),25204207,CDM,86653,CPT,300,RC,inpatient,,301,301,,255.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264.88,88,,percent of total billed charges,,,,,,,,,229.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273.91,91,,percent of total billed charges,,,285.95,95,,percent of total billed charges,,,249.83,83,,percent of total billed charges,,,249.83,83,,percent of total billed charges,,,,,,,,,,,,,,,249.83,83,,percent of total billed charges,,,285.95,95,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,246.82,82,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,255.85,85,,percent of total billed charges,,226.95,285.95,
COBALT PLASMA,25204210,CDM,83018,CPT,310,RC,inpatient,,397,397,,337.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,299.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,337.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,349.36,88,,percent of total billed charges,,,,,,,,,303.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,361.27,91,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,,,,,,,,,,,,,329.51,83,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,325.54,82,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,337.45,85,,percent of total billed charges,,299.34,377.15,
COBALT URINE,25204211,CDM,83018,CPT,300,RC,inpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110.88,88,,percent of total billed charges,,,,,,,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,95,119.7,
"THALLIUM, URINE",25204212,CDM,83018,CPT,300,RC,inpatient,,135,135,,114.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,101.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,114.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,118.8,88,,percent of total billed charges,,,,,,,,,103.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,,,,,,,,,,,,,112.05,83,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,110.7,82,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,101.79,128.25,
COENZYME Q10,25204213,CDM,82491,CPT,310,RC,inpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,153.06,192.85,
CULTURE VIRAL/TISSUE BX/FLUID,25204214,CDM,87252,CPT,300,RC,inpatient,,349,349,,296.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,263.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,296.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,307.12,88,,percent of total billed charges,,,,,,,,,266.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,317.59,91,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,,,,,,,,,,,,,289.67,83,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,286.18,82,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,263.15,331.55,
CULTURE VIRAL/HERPES/VARICELLA,25204215,CDM,87254,CPT,300,RC,inpatient,,293,293,,248.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,220.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,249.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,257.84,88,,percent of total billed charges,,,,,,,,,223.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,266.63,91,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,,,,,,,,,,,,,243.19,83,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,240.26,82,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,249.05,85,,percent of total billed charges,,220.92,278.35,
ADDITIONAL HIGH RESOLUTION STUDY,25204216,CDM,88289,CPT,300,RC,inpatient,,453,453,,384.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,341.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,385.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,398.64,88,,percent of total billed charges,,,,,,,,,346.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,412.23,91,,percent of total billed charges,,,430.35,95,,percent of total billed charges,,,375.99,83,,percent of total billed charges,,,375.99,83,,percent of total billed charges,,,,,,,,,,,,,,,375.99,83,,percent of total billed charges,,,430.35,95,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,371.46,82,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,385.05,85,,percent of total billed charges,,341.56,430.35,
CHROMOSOMAL MICRO ARRAY,25204219,CDM,81229,CPT,300,RC,inpatient,,2564,2564,,2176.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1933.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2179.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2256.32,88,,percent of total billed charges,,,,,,,,,1958.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2333.24,91,,percent of total billed charges,,,2435.8,95,,percent of total billed charges,,,2128.12,83,,percent of total billed charges,,,2128.12,83,,percent of total billed charges,,,,,,,,,,,,,,,2128.12,83,,percent of total billed charges,,,2435.8,95,,percent of total billed charges,,,2307.6,90,,percent of total billed charges,,,2307.6,90,,percent of total billed charges,,,2102.48,82,,percent of total billed charges,,,2307.6,90,,percent of total billed charges,,,2179.4,85,,percent of total billed charges,,1933.26,2435.8,
CHROMOGRANIN-A,25204220,CDM,86316,CPT,300,RC,inpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,283.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,319.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,283.5,357.2,
CHROMATIN AB,25204221,CDM,86235,CPT,300,RC,inpatient,,328,328,,278.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,247.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,278.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,288.64,88,,percent of total billed charges,,,,,,,,,250.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,298.48,91,,percent of total billed charges,,,311.6,95,,percent of total billed charges,,,272.24,83,,percent of total billed charges,,,272.24,83,,percent of total billed charges,,,,,,,,,,,,,,,272.24,83,,percent of total billed charges,,,311.6,95,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,268.96,82,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,278.8,85,,percent of total billed charges,,247.31,311.6,
COBALT BODY FLUID,25204222,CDM,83018,CPT,310,RC,inpatient,,397,397,,337.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,299.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,337.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,349.36,88,,percent of total billed charges,,,,,,,,,303.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,361.27,91,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,,,,,,,,,,,,,329.51,83,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,325.54,82,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,337.45,85,,percent of total billed charges,,299.34,377.15,
CHROMOSOME STUDIES BLOOD,25204223,CDM,88230,CPT,310,RC,inpatient,,4328,4328,,3674.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3263.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3678.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3808.64,88,,percent of total billed charges,,,,,,,,,3306.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3938.48,91,,percent of total billed charges,,,4111.6,95,,percent of total billed charges,,,3592.24,83,,percent of total billed charges,,,3592.24,83,,percent of total billed charges,,,,,,,,,,,,,,,3592.24,83,,percent of total billed charges,,,4111.6,95,,percent of total billed charges,,,3895.2,90,,percent of total billed charges,,,3895.2,90,,percent of total billed charges,,,3548.96,82,,percent of total billed charges,,,3895.2,90,,percent of total billed charges,,,3678.8,85,,percent of total billed charges,,3263.31,4111.6,
CHROMOSOME STUDIES TISSUE,25204224,CDM,88262,CPT,310,RC,inpatient,,1174,1174,,996.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,885.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,997.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1033.12,88,,percent of total billed charges,,,,,,,,,896.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1068.34,91,,percent of total billed charges,,,1115.3,95,,percent of total billed charges,,,974.42,83,,percent of total billed charges,,,974.42,83,,percent of total billed charges,,,,,,,,,,,,,,,974.42,83,,percent of total billed charges,,,1115.3,95,,percent of total billed charges,,,1056.6,90,,percent of total billed charges,,,1056.6,90,,percent of total billed charges,,,962.68,82,,percent of total billed charges,,,1056.6,90,,percent of total billed charges,,,997.9,85,,percent of total billed charges,,885.2,1115.3,
SURG PATH CHROMOSOME KARYOTYPE 25 CELLS,25204225,CDM,88264,CPT,310,RC,inpatient,,1839,1839,,1561.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1386.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1563.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1618.32,88,,percent of total billed charges,,,,,,,,,1405,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1673.49,91,,percent of total billed charges,,,1747.05,95,,percent of total billed charges,,,1526.37,83,,percent of total billed charges,,,1526.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1526.37,83,,percent of total billed charges,,,1747.05,95,,percent of total billed charges,,,1655.1,90,,percent of total billed charges,,,1655.1,90,,percent of total billed charges,,,1507.98,82,,percent of total billed charges,,,1655.1,90,,percent of total billed charges,,,1563.15,85,,percent of total billed charges,,1386.61,1747.05,
SURG PATH CHROMOSOME KARYOTYPE ADD CELLS,25204227,CDM,88280,CPT,310,RC,inpatient,,380,380,,322.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,286.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,323,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,334.4,88,,percent of total billed charges,,,,,,,,,290.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,345.8,91,,percent of total billed charges,,,361,95,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,,,,,,,,,,,,,315.4,83,,percent of total billed charges,,,361,95,,percent of total billed charges,,,342,90,,percent of total billed charges,,,342,90,,percent of total billed charges,,,311.6,82,,percent of total billed charges,,,342,90,,percent of total billed charges,,,323,85,,percent of total billed charges,,286.52,361,
CYTOGENITICS SOLID TUMOR,25204228,CDM,88239,CPT,310,RC,inpatient,,424,424,,359.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,319.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,360.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,373.12,88,,percent of total billed charges,,,,,,,,,323.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,385.84,91,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,,,,,,,,,,,,,351.92,83,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,347.68,82,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,319.7,402.8,
COUNT CELLS KARYOTYPES/BANDING,25204229,CDM,88262,CPT,300,RC,inpatient,,1360,1360,,1154.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1025.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1156,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1196.8,88,,percent of total billed charges,,,,,,,,,1039.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1237.6,91,,percent of total billed charges,,,1292,95,,percent of total billed charges,,,1128.8,83,,percent of total billed charges,,,1128.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1128.8,83,,percent of total billed charges,,,1292,95,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1115.2,82,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1156,85,,percent of total billed charges,,1025.44,1292,
TRAZODONE,25204230,CDM,80338,CPT,300,RC,inpatient,,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,186.99,235.6,
CHROMOSOME CORD/PLACENTA,25204231,CDM,81230,CPT,310,RC,inpatient,,1890,1890,,1604.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1425.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1606.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1663.2,88,,percent of total billed charges,,,,,,,,,1443.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1719.9,91,,percent of total billed charges,,,1795.5,95,,percent of total billed charges,,,1568.7,83,,percent of total billed charges,,,1568.7,83,,percent of total billed charges,,,,,,,,,,,,,,,1568.7,83,,percent of total billed charges,,,1795.5,95,,percent of total billed charges,,,1701,90,,percent of total billed charges,,,1701,90,,percent of total billed charges,,,1549.8,82,,percent of total billed charges,,,1701,90,,percent of total billed charges,,,1606.5,85,,percent of total billed charges,,1425.06,1795.5,
BONE MARROW CULTURE,25204232,CDM,88237,CPT,310,RC,inpatient,,1791,1791,,1520.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1350.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1522.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1576.08,88,,percent of total billed charges,,,,,,,,,1368.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1629.81,91,,percent of total billed charges,,,1701.45,95,,percent of total billed charges,,,1486.53,83,,percent of total billed charges,,,1486.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1486.53,83,,percent of total billed charges,,,1701.45,95,,percent of total billed charges,,,1611.9,90,,percent of total billed charges,,,1611.9,90,,percent of total billed charges,,,1468.62,82,,percent of total billed charges,,,1611.9,90,,percent of total billed charges,,,1522.35,85,,percent of total billed charges,,1350.41,1701.45,
TRICH VAG BY NAA,25204233,CDM,87661,CPT,300,RC,inpatient,,276,276,,234.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,208.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,234.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,242.88,88,,percent of total billed charges,,,,,,,,,210.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,251.16,91,,percent of total billed charges,,,262.2,95,,percent of total billed charges,,,229.08,83,,percent of total billed charges,,,229.08,83,,percent of total billed charges,,,,,,,,,,,,,,,229.08,83,,percent of total billed charges,,,262.2,95,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,226.32,82,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,234.6,85,,percent of total billed charges,,208.1,262.2,
DOWN SYNDROME CHROM MICRO ARRAY,25204235,CDM,81229,CPT,300,RC,inpatient,,3354,3354,,2847.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2528.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2850.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2951.52,88,,percent of total billed charges,,,,,,,,,2562.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3052.14,91,,percent of total billed charges,,,3186.3,95,,percent of total billed charges,,,2783.82,83,,percent of total billed charges,,,2783.82,83,,percent of total billed charges,,,,,,,,,,,,,,,2783.82,83,,percent of total billed charges,,,3186.3,95,,percent of total billed charges,,,3018.6,90,,percent of total billed charges,,,3018.6,90,,percent of total billed charges,,,2750.28,82,,percent of total billed charges,,,3018.6,90,,percent of total billed charges,,,2850.9,85,,percent of total billed charges,,2528.92,3186.3,
CULTURE VIRAL MUMPS,25204236,CDM,87254,CPT,300,RC,inpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,223.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,252.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,223.94,282.15,
CHROMIUM BODY FLUID,25204237,CDM,82495,CPT,310,RC,inpatient,,441,441,,374.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,332.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,374.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.08,88,,percent of total billed charges,,,,,,,,,336.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,401.31,91,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,,,,,,,,,,,,,366.03,83,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,361.62,82,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,374.85,85,,percent of total billed charges,,332.51,418.95,
FRAGILE X & SOUTHERN BLOT,25204238,CDM,81243,CPT,300,RC,inpatient,,634,634,,538.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,478.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,538.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,557.92,88,,percent of total billed charges,,,,,,,,,484.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,576.94,91,,percent of total billed charges,,,602.3,95,,percent of total billed charges,,,526.22,83,,percent of total billed charges,,,526.22,83,,percent of total billed charges,,,,,,,,,,,,,,,526.22,83,,percent of total billed charges,,,602.3,95,,percent of total billed charges,,,570.6,90,,percent of total billed charges,,,570.6,90,,percent of total billed charges,,,519.88,82,,percent of total billed charges,,,570.6,90,,percent of total billed charges,,,538.9,85,,percent of total billed charges,,478.04,602.3,
CHROMOSOME WB/ REFLEX Y DELETION,25204241,CDM,88230,CPT,310,RC,inpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,226.2,285,
PATH SMEAR REVIEW,25204491,CDM,85060,CPT,300,RC,inpatient,,440,440,,373.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,331.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,374,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,387.2,88,,percent of total billed charges,,,,,,,,,336.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,400.4,91,,percent of total billed charges,,,418,95,,percent of total billed charges,,,365.2,83,,percent of total billed charges,,,365.2,83,,percent of total billed charges,,,,,,,,,,,,,,,365.2,83,,percent of total billed charges,,,418,95,,percent of total billed charges,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,360.8,82,,percent of total billed charges,,,396,90,,percent of total billed charges,,,374,85,,percent of total billed charges,,331.76,418,
MYELOPEROXIDASE,25204500,CDM,83876,CPT,300,RC,inpatient,,265,265,,224.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,199.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,225.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,233.2,88,,percent of total billed charges,,,,,,,,,202.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,241.15,91,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,,,,,,,,,,,,,219.95,83,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,217.3,82,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,199.81,251.75,
OXLDL/ADIPONECTIN,25204501,CDM,83516,CPT,300,RC,inpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,171.16,215.65,
OMEGACHECK (OMEGA 3 & 6),25204502,CDM,82542,CPT,300,RC,inpatient,,111,111,,94.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,83.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,97.68,88,,percent of total billed charges,,,,,,,,,84.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.01,91,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,,,,,,,,,,,,,92.13,83,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,91.02,82,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,94.35,85,,percent of total billed charges,,83.69,105.45,
.NMR NO LIPIDS,25204503,CDM,83704,CPT,300,RC,inpatient,,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,217.91,274.55,
..F-2 ISOPROSTANE,25204505,CDM,83789,CPT,300,RC,inpatient,,517,517,,438.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,389.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,439.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,454.96,88,,percent of total billed charges,,,,,,,,,394.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,470.47,91,,percent of total billed charges,,,491.15,95,,percent of total billed charges,,,429.11,83,,percent of total billed charges,,,429.11,83,,percent of total billed charges,,,,,,,,,,,,,,,429.11,83,,percent of total billed charges,,,491.15,95,,percent of total billed charges,,,465.3,90,,percent of total billed charges,,,465.3,90,,percent of total billed charges,,,423.94,82,,percent of total billed charges,,,465.3,90,,percent of total billed charges,,,439.45,85,,percent of total billed charges,,389.82,491.15,
MYELOPROLIFERATIVE (MPN/CML) FISH,25204506,CDM,88271,CPT,300,RC,inpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
CANNABINOIDS SERUM W/CONFIRM,25210009,CDM,80307,CPT,310,RC,inpatient,,269,269,,228.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,202.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,228.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,236.72,88,,percent of total billed charges,,,,,,,,,205.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,244.79,91,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,,,,,,,,,,,,,223.27,83,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,220.58,82,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,202.83,255.55,
.PAP SMEAR (DR INTERP),25210016,CDM,,,310,RC,inpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,58.81,74.1,
THC CONFIRM URINE,25210018,CDM,82542,CPT,310,RC,inpatient,,269,269,,228.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,202.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,228.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,236.72,88,,percent of total billed charges,,,,,,,,,205.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,244.79,91,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,,,,,,,,,,,,,223.27,83,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,220.58,82,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,202.83,255.55,
.AMPLIFIED PROBE EACH ORGANISM,25210020,CDM,87798,CPT,300,RC,inpatient,,151,151,,128.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,113.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,128.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,132.88,88,,percent of total billed charges,,,,,,,,,115.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,,,,,,,,,,,,,125.33,83,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,123.82,82,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,113.85,143.45,
.CANDIDA  AMP  PROBE EACH ORGANISM,25210021,CDM,87481,CPT,300,RC,inpatient,,151,151,,128.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,113.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,128.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,132.88,88,,percent of total billed charges,,,,,,,,,115.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,,,,,,,,,,,,,125.33,83,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,123.82,82,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,113.85,143.45,
.TRICH VAG  AMP  PROBE EACH ORGANISM,25210022,CDM,87661,CPT,300,RC,inpatient,,151,151,,128.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,113.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,128.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,132.88,88,,percent of total billed charges,,,,,,,,,115.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,,,,,,,,,,,,,125.33,83,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,123.82,82,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,113.85,143.45,
METHADONE CONFIRM URINE,25210026,CDM,80358,CPT,310,RC,inpatient,,269,269,,228.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,202.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,228.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,236.72,88,,percent of total billed charges,,,,,,,,,205.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,244.79,91,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,,,,,,,,,,,,,223.27,83,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,220.58,82,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,202.83,255.55,
.LYME  ANTIBODY/RFX WESTERN BLOTT,25210029,CDM,86618,CPT,300,RC,inpatient,,27,27,,22.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23.76,88,,percent of total billed charges,,,,,,,,,20.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,,,,,,,,,,,,,22.41,83,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.14,82,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,20.36,25.65,
EHRLICHIA DETECTION PCR,25210030,CDM,87798,CPT,300,RC,inpatient,,247,247,,209.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,209.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,217.36,88,,percent of total billed charges,,,,,,,,,188.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,224.77,91,,percent of total billed charges,,,234.65,95,,percent of total billed charges,,,205.01,83,,percent of total billed charges,,,205.01,83,,percent of total billed charges,,,,,,,,,,,,,,,205.01,83,,percent of total billed charges,,,234.65,95,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,202.54,82,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,209.95,85,,percent of total billed charges,,186.24,234.65,
SCHISTOSOMAL  AB,25210031,CDM,86682,CPT,300,RC,inpatient,,337,337,,286.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,254.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,286.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,296.56,88,,percent of total billed charges,,,,,,,,,257.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,306.67,91,,percent of total billed charges,,,320.15,95,,percent of total billed charges,,,279.71,83,,percent of total billed charges,,,279.71,83,,percent of total billed charges,,,,,,,,,,,,,,,279.71,83,,percent of total billed charges,,,320.15,95,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,276.34,82,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,286.45,85,,percent of total billed charges,,254.1,320.15,
LYME  ANTIBODY/ CSF WESTERN BLOTT,25210033,CDM,86617,CPT,300,RC,inpatient,,516,516,,438.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,389.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,438.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,454.08,88,,percent of total billed charges,,,,,,,,,394.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,469.56,91,,percent of total billed charges,,,490.2,95,,percent of total billed charges,,,428.28,83,,percent of total billed charges,,,428.28,83,,percent of total billed charges,,,,,,,,,,,,,,,428.28,83,,percent of total billed charges,,,490.2,95,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,423.12,82,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,438.6,85,,percent of total billed charges,,389.06,490.2,
LYME  ANTIBODY/RFX,25210038,CDM,86618,CPT,300,RC,inpatient,,27,27,,22.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23.76,88,,percent of total billed charges,,,,,,,,,20.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,,,,,,,,,,,,,22.41,83,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.14,82,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,20.36,25.65,
ACETYLMORPHINE URINE,25210039,CDM,80356,CPT,310,RC,inpatient,,151,151,,128.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,113.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,128.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,132.88,88,,percent of total billed charges,,,,,,,,,115.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,,,,,,,,,,,,,125.33,83,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,123.82,82,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,113.85,143.45,
VAGINITIS PLUS CANDIDAX6,25210042,CDM,,,300,RC,inpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,226.2,285,
CREATININE 24-HOUR URINE,25210100,CDM,82570,CPT,300,RC,inpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,70.12,88.35,
MAGNESIUM URINE (24-HOUR),25210110,CDM,83735,CPT,300,RC,inpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,77.66,97.85,
PHOSPHORUS URINE (24-HOUR),25210120,CDM,84105,CPT,300,RC,inpatient,,28,28,,23.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.64,88,,percent of total billed charges,,,,,,,,,21.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,,,,,,,,,,,,,23.24,83,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,22.96,82,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,21.11,26.6,
SODIUM URINE (24-HOUR),25210130,CDM,84300,CPT,300,RC,inpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,90.48,114,
HERPES 6 (HHV-6),25210131,CDM,86790,CPT,300,RC,inpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,61.07,76.95,
HERPES 6 (HHV-6) QT,25210132,CDM,87533,CPT,300,RC,inpatient,,478,478,,405.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,360.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,406.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,420.64,88,,percent of total billed charges,,,,,,,,,365.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,434.98,91,,percent of total billed charges,,,454.1,95,,percent of total billed charges,,,396.74,83,,percent of total billed charges,,,396.74,83,,percent of total billed charges,,,,,,,,,,,,,,,396.74,83,,percent of total billed charges,,,454.1,95,,percent of total billed charges,,,430.2,90,,percent of total billed charges,,,430.2,90,,percent of total billed charges,,,391.96,82,,percent of total billed charges,,,430.2,90,,percent of total billed charges,,,406.3,85,,percent of total billed charges,,360.41,454.1,
HERPES 6 IGM (HHV-6),25210133,CDM,86790,CPT,300,RC,inpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,61.07,76.95,
DIHYDROTESTOSTERONE,25210140,CDM,82642,CPT,300,RC,inpatient,,101,101,,85.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88.88,88,,percent of total billed charges,,,,,,,,,77.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,82.82,82,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,76.15,95.95,
MLH1 MUTATION,25210150,CDM,81294,CPT,300,RC,inpatient,,2520,2520,,2139.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1900.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2142,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2217.6,88,,percent of total billed charges,,,,,,,,,1925.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2293.2,91,,percent of total billed charges,,,2394,95,,percent of total billed charges,,,2091.6,83,,percent of total billed charges,,,2091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,2091.6,83,,percent of total billed charges,,,2394,95,,percent of total billed charges,,,2268,90,,percent of total billed charges,,,2268,90,,percent of total billed charges,,,2066.4,82,,percent of total billed charges,,,2268,90,,percent of total billed charges,,,2142,85,,percent of total billed charges,,1900.08,2394,
MSH2 MUTATION,25210155,CDM,81295,CPT,300,RC,inpatient,,2520,2520,,2139.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1900.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2142,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2217.6,88,,percent of total billed charges,,,,,,,,,1925.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2293.2,91,,percent of total billed charges,,,2394,95,,percent of total billed charges,,,2091.6,83,,percent of total billed charges,,,2091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,2091.6,83,,percent of total billed charges,,,2394,95,,percent of total billed charges,,,2268,90,,percent of total billed charges,,,2268,90,,percent of total billed charges,,,2066.4,82,,percent of total billed charges,,,2268,90,,percent of total billed charges,,,2142,85,,percent of total billed charges,,1900.08,2394,
FAMILIAL ADENOMATOUS POLYPOSIS,25210160,CDM,81201,CPT,300,RC,inpatient,,2083,2083,,1768.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1570.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1770.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1833.04,88,,percent of total billed charges,,,,,,,,,1591.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1895.53,91,,percent of total billed charges,,,1978.85,95,,percent of total billed charges,,,1728.89,83,,percent of total billed charges,,,1728.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1728.89,83,,percent of total billed charges,,,1978.85,95,,percent of total billed charges,,,1874.7,90,,percent of total billed charges,,,1874.7,90,,percent of total billed charges,,,1708.06,82,,percent of total billed charges,,,1874.7,90,,percent of total billed charges,,,1770.55,85,,percent of total billed charges,,1570.58,1978.85,
MSH6 MUTATION,25210165,CDM,81298,CPT,300,RC,inpatient,,3111,3111,,2641.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2345.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2644.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2737.68,88,,percent of total billed charges,,,,,,,,,2376.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2831.01,91,,percent of total billed charges,,,2955.45,95,,percent of total billed charges,,,2582.13,83,,percent of total billed charges,,,2582.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2582.13,83,,percent of total billed charges,,,2955.45,95,,percent of total billed charges,,,2799.9,90,,percent of total billed charges,,,2799.9,90,,percent of total billed charges,,,2551.02,82,,percent of total billed charges,,,2799.9,90,,percent of total billed charges,,,2644.35,85,,percent of total billed charges,,2345.69,2955.45,
MUSK AB,25210167,CDM,83519,CPT,300,RC,inpatient,,2105,2105,,1787.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1587.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1789.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1852.4,88,,percent of total billed charges,,,,,,,,,1608.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1915.55,91,,percent of total billed charges,,,1999.75,95,,percent of total billed charges,,,1747.15,83,,percent of total billed charges,,,1747.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1747.15,83,,percent of total billed charges,,,1999.75,95,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1726.1,82,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1789.25,85,,percent of total billed charges,,1587.17,1999.75,
MPL MUTATION,25210168,CDM,81338,CPT,300,RC,inpatient,,882,882,,748.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,665.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,749.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,776.16,88,,percent of total billed charges,,,,,,,,,673.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,802.62,91,,percent of total billed charges,,,837.9,95,,percent of total billed charges,,,732.06,83,,percent of total billed charges,,,732.06,83,,percent of total billed charges,,,,,,,,,,,,,,,732.06,83,,percent of total billed charges,,,837.9,95,,percent of total billed charges,,,793.8,90,,percent of total billed charges,,,793.8,90,,percent of total billed charges,,,723.24,82,,percent of total billed charges,,,793.8,90,,percent of total billed charges,,,749.7,85,,percent of total billed charges,,665.03,837.9,
BRACASSURE COMP,25213000,CDM,81162,CPT,300,RC,inpatient,,3681,3681,,3125.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2775.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3128.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3239.28,88,,percent of total billed charges,,,,,,,,,2812.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3349.71,91,,percent of total billed charges,,,3496.95,95,,percent of total billed charges,,,3055.23,83,,percent of total billed charges,,,3055.23,83,,percent of total billed charges,,,,,,,,,,,,,,,3055.23,83,,percent of total billed charges,,,3496.95,95,,percent of total billed charges,,,3312.9,90,,percent of total billed charges,,,3312.9,90,,percent of total billed charges,,,3018.42,82,,percent of total billed charges,,,3312.9,90,,percent of total billed charges,,,3128.85,85,,percent of total billed charges,,2775.47,3496.95,
BRAF  GENE ANALYSIS,25213001,CDM,81210,CPT,310,RC,inpatient,,620,620,,526.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,467.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,527,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,545.6,88,,percent of total billed charges,,,,,,,,,473.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,564.2,91,,percent of total billed charges,,,589,95,,percent of total billed charges,,,514.6,83,,percent of total billed charges,,,514.6,83,,percent of total billed charges,,,,,,,,,,,,,,,514.6,83,,percent of total billed charges,,,589,95,,percent of total billed charges,,,558,90,,percent of total billed charges,,,558,90,,percent of total billed charges,,,508.4,82,,percent of total billed charges,,,558,90,,percent of total billed charges,,,527,85,,percent of total billed charges,,467.48,589,
. ONKOSIGHT  KIT GENE ANALYSIS,25213002,CDM,81402,CPT,310,RC,inpatient,,284,284,,241.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,214.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,241.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,249.92,88,,percent of total billed charges,,,,,,,,,216.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,258.44,91,,percent of total billed charges,,,269.8,95,,percent of total billed charges,,,235.72,83,,percent of total billed charges,,,235.72,83,,percent of total billed charges,,,,,,,,,,,,,,,235.72,83,,percent of total billed charges,,,269.8,95,,percent of total billed charges,,,255.6,90,,percent of total billed charges,,,255.6,90,,percent of total billed charges,,,232.88,82,,percent of total billed charges,,,255.6,90,,percent of total billed charges,,,241.4,85,,percent of total billed charges,,214.14,269.8,
.NRAS ONKOSIGHT MOLECULAR PATH5,25213003,CDM,81404,CPT,310,RC,inpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,273.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,242.79,305.9,
.MICRODISSECTION MANUAL,25213004,CDM,88381,CPT,310,RC,inpatient,,170,170,,144.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,128.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,144.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,149.6,88,,percent of total billed charges,,,,,,,,,129.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,154.7,91,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,,,,,,,,,,,,,141.1,83,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,139.4,82,,percent of total billed charges,,,153,90,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,128.18,161.5,
.MSI ANALYSIS,25213005,CDM,81301,CPT,310,RC,inpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,273.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,242.79,305.9,
BRACASSURE BRCA2,25213006,CDM,81217,CPT,300,RC,inpatient,,1314,1314,,1115.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,990.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1116.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1156.32,88,,percent of total billed charges,,,,,,,,,1003.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1195.74,91,,percent of total billed charges,,,1248.3,95,,percent of total billed charges,,,1090.62,83,,percent of total billed charges,,,1090.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1090.62,83,,percent of total billed charges,,,1248.3,95,,percent of total billed charges,,,1182.6,90,,percent of total billed charges,,,1182.6,90,,percent of total billed charges,,,1077.48,82,,percent of total billed charges,,,1182.6,90,,percent of total billed charges,,,1116.9,85,,percent of total billed charges,,990.76,1248.3,
.COMPLIANCE DRUG ANALYSIS,25213010,CDM,,,300,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
.HARMONY PRENATAL,25213020,CDM,,,300,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
.HARMONY W/XY,25213030,CDM,,,300,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
.HARMONY W/Y,25213040,CDM,,,300,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
.INHERITEST CARRIER,25213050,CDM,,,300,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
.INTEGRATED 1,25213060,CDM,,,300,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
.INTEGRATED 2,25213070,CDM,,,300,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
.SEQUENTIAL 1,25213090,CDM,,,300,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
.SEQUENTIAL 2,25213100,CDM,,,300,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
.INHERITEST SELECT CARRIER,25213110,CDM,,,300,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
.HLA CLASS 1 PLT AB,25213448,CDM,86022,CPT,300,RC,inpatient,,305,305,,258.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,229.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,259.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,268.4,88,,percent of total billed charges,,,,,,,,,233.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,277.55,91,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,,,,,,,,,,,,,253.15,83,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,250.1,82,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,229.97,289.75,
.IIb/IIIa  PLT AB,25213449,CDM,86022,CPT,300,RC,inpatient,,305,305,,258.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,229.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,259.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,268.4,88,,percent of total billed charges,,,,,,,,,233.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,277.55,91,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,,,,,,,,,,,,,253.15,83,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,250.1,82,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,229.97,289.75,
.Ib/IX  PLT AB,25213450,CDM,86022,CPT,300,RC,inpatient,,305,305,,258.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,229.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,259.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,268.4,88,,percent of total billed charges,,,,,,,,,233.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,277.55,91,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,,,,,,,,,,,,,253.15,83,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,250.1,82,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,229.97,289.75,
.Ib/IX  PLT AB,25213451,CDM,86022,CPT,300,RC,inpatient,,305,305,,258.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,229.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,259.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,268.4,88,,percent of total billed charges,,,,,,,,,233.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,277.55,91,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,,,,,,,,,,,,,253.15,83,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,250.1,82,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,229.97,289.75,
 .DELETE,25214008,CDM,80048,CPT,300,RC,inpatient,,106,106,,89.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,90.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,93.28,88,,percent of total billed charges,,,,,,,,,80.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,,,,,,,,,,,,,87.98,83,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,86.92,82,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,79.92,100.7,
RL CBC W/AUTO DIFF,25214009,CDM,85025,CPT,300,RC,inpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,70.12,88.35,
RL COMP METABOLIC PANEL,25214010,CDM,80053,CPT,300,RC,inpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,135.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,135.72,171,
RL CULTURE URINE,25214011,CDM,87086,CPT,300,RC,inpatient,,99,99,,84.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,74.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,84.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,87.12,88,,percent of total billed charges,,,,,,,,,75.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,,,,,,,,,,,,,82.17,83,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,81.18,82,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,74.65,94.05,
RL HEMOGLOBIN A1c,25214012,CDM,83036,CPT,300,RC,inpatient,,125,125,,106.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,94.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,106.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110,88,,percent of total billed charges,,,,,,,,,95.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,113.75,91,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,,,,,,,,,,,,,103.75,83,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,102.5,82,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,94.25,118.75,
.DELETE IRON TOTAL,25214013,CDM,83540,CPT,300,RC,inpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,58.06,73.15,
RL LIPID PANEL,25214014,CDM,80061,CPT,300,RC,inpatient,,158,158,,134.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,134.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.04,88,,percent of total billed charges,,,,,,,,,120.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,143.78,91,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,,,,,,,,,,,,,131.14,83,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,129.56,82,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,119.13,150.1,
.RL PARTIAL THROMBOPLASTIN TIME (PTT),25214015,CDM,85730,CPT,300,RC,inpatient,,163,163,,138.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,122.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,138.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,143.44,88,,percent of total billed charges,,,,,,,,,124.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,,,,,,,,,,,,,135.29,83,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,133.66,82,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,122.9,154.85,
RL PROTHROMBIN TIME w/INR,25214016,CDM,85610,CPT,300,RC,inpatient,,75,75,,63.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,63.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66,88,,percent of total billed charges,,,,,,,,,57.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,68.25,91,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,,,,,,,,,,,,,62.25,83,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,61.5,82,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,56.55,71.25,
RL TSH,25214017,CDM,84443,CPT,300,RC,inpatient,,165,165,,140.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,124.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,140.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,145.2,88,,percent of total billed charges,,,,,,,,,126.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,135.3,82,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,124.41,156.75,
RL CULTURE THROAT,25214018,CDM,87081,CPT,300,RC,inpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,58.06,73.15,
RL GGT,25214019,CDM,82977,CPT,300,RC,inpatient,,101,101,,85.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88.88,88,,percent of total billed charges,,,,,,,,,77.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,82.82,82,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,76.15,95.95,
RL BASIC MET PANEL,25214020,CDM,80048,CPT,300,RC,inpatient,,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,99.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,112.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,99.53,125.4,
ALLERGEN  CRAB,25214021,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  LOBSTER,25214022,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  CHOCOLATE,25214023,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN PTERONYSSINUS,25215000,CDM,86003,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
ALLERGEN D FARINAE,25215001,CDM,86003,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
ALLERGEN CAT DANDER,25215002,CDM,86003,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
ALLERGEN DOG DANDER,25215003,CDM,86003,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
ALLERGEN BLUEGRASS KENTUCKY,25215004,CDM,86003,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
ALLERGEN  ALTERARIA,25215005,CDM,86003,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
ALLERGEN OAK WHITE,25215006,CDM,86003,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
ALLERGEN ELM AMERICAN,25215007,CDM,86003,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
ALLERGEN RAGWEED,25215008,CDM,86003,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
ALLERGEN PLANTAIN,25215009,CDM,86003,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
ALLERGEN BERMUDA GRASS,25215010,CDM,86003,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
ALLERGEN HONEYBEE,25215011,CDM,86003,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
ALLERGEN WASP PAPER,25215012,CDM,86003,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
ALLERGEN TIMOTHY GRASS,25215013,CDM,86003,CPT,300,RC,inpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.92,88,,percent of total billed charges,,,,,,,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,63.34,79.8,
ALLERGEN RYE GRASS,25215014,CDM,86003,CPT,300,RC,inpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.92,88,,percent of total billed charges,,,,,,,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,63.34,79.8,
ALLERGEN MUCOR RACEMOSUS,25215015,CDM,86003,CPT,300,RC,inpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.92,88,,percent of total billed charges,,,,,,,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,63.34,79.8,
ALLERGEN JOHNSON GRASS,25215016,CDM,86003,CPT,300,RC,inpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.92,88,,percent of total billed charges,,,,,,,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,63.34,79.8,
ALLERGEN BAHIA GRASS,25215017,CDM,86003,CPT,300,RC,inpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.92,88,,percent of total billed charges,,,,,,,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,63.34,79.8,
ALLERGEN CLADOSPORIUM HERBARUM,25215018,CDM,86003,CPT,300,RC,inpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.92,88,,percent of total billed charges,,,,,,,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,63.34,79.8,
.CHLAMYDIA (LIQUID PAP),25220001,CDM,87491,CPT,300,RC,inpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,34.68,43.7,
.NEISSERIA (LIQUID PAP),25220002,CDM,87591,CPT,300,RC,inpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,34.68,43.7,
.TRICH (LIQUID PAP),25220003,CDM,87661,CPT,300,RC,inpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,34.68,43.7,
ALLERGEN  WHEAT,25220005,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  PINEAPPLE,25220006,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  ALMOND,25220007,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  TILAPIA,25220008,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  EGG WHITE,25220009,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  EGG YOLK,25220010,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  CASHEWS,25220011,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  PEANUT,25220012,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  ANIMAL,25220013,CDM,86005,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  EGG WHOLE,25220014,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  GOAT MILK,25220015,CDM,86003,CPT,300,RC,inpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,9.05,11.4,
ALLERGEN  SWISS CHEESE,25220016,CDM,86003,CPT,300,RC,inpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,9.05,11.4,
ALLERGEN  APPLE,25240000,CDM,86003,CPT,300,RC,inpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,9.05,11.4,
ALLERGEN  AVOCADO,25240001,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  BANANA,25240002,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  BARLEY,25240003,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  BRAZIL NUT,25240004,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  BROCCOLI,25240005,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  BRUSSEL SPROUTS,25240006,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  CABBAGE,25240007,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  CARROT,25240008,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  CAULIFLOWER,25240009,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  COCONUT,25240010,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  MILK,25240011,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  CUCUMBER,25240012,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  GARLIC,25240013,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  LEMON,25240014,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  MUSHROOM,25240015,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  MUSTARD,25240016,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  OAT,25240017,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  ORANGE,25240018,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  PEACH,25240019,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  PEAR,25240020,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  POTATOE WHITE,25240021,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  RICE,25240022,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  RYE,25240023,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  SOYBEAN,25240024,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  SPINACH,25240025,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  STRAWBERRY,25240026,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  TOMATO,25240027,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  WHITE BEAN,25240028,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  SOLE,25240029,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  GREEN PEA,25240030,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  CHICKEN,25240031,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  MELON,25240040,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN FOOD  VEGETABLE II,25240042,CDM,,,300,RC,inpatient,,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,277.47,349.6,
ALLERGEN  GREEN BEAN,25240043,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  ONION,25240044,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN GRAPEFRUIT,25240045,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  LIME,25240046,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  TANGERINE,25240047,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  TURKEY,25240048,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  ALFALFA,25240049,CDM,86003,CPT,300,RC,inpatient,,21,21,,17.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.48,88,,percent of total billed charges,,,,,,,,,16.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.22,82,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,15.83,19.95,
ALLERGEN  RABBIT,25240050,CDM,86003,CPT,300,RC,inpatient,,11,11,,9.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9.68,88,,percent of total billed charges,,,,,,,,,8.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,,,,,,,,,,,,,9.13,83,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.02,82,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,8.29,10.45,
ALLERGEN  MOUSE URINE,25240051,CDM,86003,CPT,300,RC,inpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,9.05,11.4,
ALLERGEN DUST MITE,25240052,CDM,86003,CPT,300,RC,inpatient,,7,7,,5.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6.16,88,,percent of total billed charges,,,,,,,,,5.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6.37,91,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,,,,,,,,,,,,,5.81,83,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.74,82,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,5.28,6.65,
ALLERGEN  SHEEP SORREL,25240054,CDM,86003,CPT,300,RC,inpatient,,7,7,,5.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6.16,88,,percent of total billed charges,,,,,,,,,5.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6.37,91,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,,,,,,,,,,,,,5.81,83,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.74,82,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,5.28,6.65,
ALLERGEN  NETTLE,25240055,CDM,86003,CPT,300,RC,inpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,9.05,11.4,
ALLERGEN  SILVER BIRCH,25240056,CDM,86003,CPT,300,RC,inpatient,,7,7,,5.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6.16,88,,percent of total billed charges,,,,,,,,,5.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6.37,91,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,,,,,,,,,,,,,5.81,83,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.74,82,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,5.28,6.65,
ALLERGEN PORK,25240057,CDM,86003,CPT,300,RC,inpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,9.05,11.4,
ALLERGEN MOSQUITO WHOLE BODY,25240058,CDM,86003,CPT,300,RC,inpatient,,47,47,,39.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.36,88,,percent of total billed charges,,,,,,,,,35.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,,,,,,,,,,,,,39.01,83,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,38.54,82,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,35.44,44.65,
.ALLERGEN PROFILE LATEX PLUS,25240060,CDM,86003,CPT,300,RC,inpatient,,47,47,,39.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.36,88,,percent of total billed charges,,,,,,,,,35.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,,,,,,,,,,,,,39.01,83,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,38.54,82,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,35.44,44.65,
ALLERGEN  MACADAMIA NUT,25240062,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  PECAN,25240063,CDM,86003,CPT,300,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
ALLERGEN  CELERY,25240065,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  LETTUCE,25240066,CDM,86003,CPT,300,RC,inpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,46.75,58.9,
ALLERGEN  EPICOCCUM PURPUR,25240067,CDM,86003,CPT,300,RC,inpatient,,21,21,,17.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.48,88,,percent of total billed charges,,,,,,,,,16.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.22,82,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,15.83,19.95,
ALLERGEN  RAT URINE,25240068,CDM,86003,CPT,300,RC,inpatient,,21,21,,17.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.48,88,,percent of total billed charges,,,,,,,,,16.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.22,82,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,15.83,19.95,
ALLERGEN  ORCHARD GRASS,25240069,CDM,86003,CPT,300,RC,inpatient,,21,21,,17.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.48,88,,percent of total billed charges,,,,,,,,,16.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.22,82,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,15.83,19.95,
PTT LA (SEND OUT),25250000,CDM,85730,CPT,300,RC,inpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,81.43,102.6,
C1 INHIBITOR FUNCTIONAL,25250002,CDM,86160,CPT,300,RC,inpatient,,72,72,,61.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,54.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,61.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,63.36,88,,percent of total billed charges,,,,,,,,,55.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,65.52,91,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,,,,,,,,,,,,,59.76,83,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,59.04,82,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,54.29,68.4,
C1 INHIBITOR PROTEIN TOTAL,25250004,CDM,86161,CPT,300,RC,inpatient,,44,44,,37.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.72,88,,percent of total billed charges,,,,,,,,,33.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,36.08,82,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,33.18,41.8,
VARICELLA-ZOSTER PCR,25250005,CDM,87798,CPT,300,RC,inpatient,,485,485,,411.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,365.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,412.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,426.8,88,,percent of total billed charges,,,,,,,,,370.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,441.35,91,,percent of total billed charges,,,460.75,95,,percent of total billed charges,,,402.55,83,,percent of total billed charges,,,402.55,83,,percent of total billed charges,,,,,,,,,,,,,,,402.55,83,,percent of total billed charges,,,460.75,95,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,397.7,82,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,412.25,85,,percent of total billed charges,,365.69,460.75,
.PATHOLOGIST CONSULATION,25250008,CDM,80503,CPT,300,RC,inpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,89.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,79.17,99.75,
FACTOR XIII,25250009,CDM,85291,CPT,300,RC,inpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,76.91,96.9,
.PATHOLOGIST CONSULATION (MODERATE,25250010,CDM,80504,CPT,300,RC,inpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,89.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,79.17,99.75,
.PATHOLOGIST CONSULATION(HIGH),25250011,CDM,80505,CPT,300,RC,inpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,89.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,79.17,99.75,
.PATHOLOGIST CONSULATION(PROLONG),25250012,CDM,80506,CPT,300,RC,inpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,89.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,79.17,99.75,
REFERED SLIDE CONSULT,25250015,CDM,88321,CPT,300,RC,inpatient,,316,316,,268.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,238.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,268.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,278.08,88,,percent of total billed charges,,,,,,,,,241.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,287.56,91,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,,,,,,,,,,,,,262.28,83,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,259.12,82,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,238.26,300.2,
MONKEYPOX DNA  PCR,25250017,CDM,87798,CPT,300,RC,inpatient,,158,158,,134.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,134.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.04,88,,percent of total billed charges,,,,,,,,,120.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,143.78,91,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,,,,,,,,,,,,,131.14,83,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,129.56,82,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,119.13,150.1,
POLIOVIRUS 1  ANTIBODY,25250020,CDM,86658,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
POLIOVIRUS 2  ANTIBODY,25250021,CDM,86382,CPT,300,RC,inpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,76.91,96.9,
POLIOVIRUS 3  ANTIBODY,25250022,CDM,86658,CPT,300,RC,inpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
FET,25250026,CDM,,,310,RC,inpatient,,672.48,672.48,,570.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,507.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,571.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,591.78,88,,percent of total billed charges,,,,,,,,,513.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,611.96,91,,percent of total billed charges,,,638.86,95,,percent of total billed charges,,,558.16,83,,percent of total billed charges,,,558.16,83,,percent of total billed charges,,,,,,,,,,,,,,,558.16,83,,percent of total billed charges,,,638.86,95,,percent of total billed charges,,,605.23,90,,percent of total billed charges,,,605.23,90,,percent of total billed charges,,,551.43,82,,percent of total billed charges,,,605.23,90,,percent of total billed charges,,,571.61,85,,percent of total billed charges,,507.05,638.86,
__2 HR GLUCOSE,25250032,CDM,82951,CPT,300,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
__3 HR GLUCOSE,25250033,CDM,82952,CPT,300,RC,inpatient,,85,85,,72.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,72.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.8,88,,percent of total billed charges,,,,,,,,,64.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,,,,,,,,,,,,,70.55,83,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,69.7,82,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,64.09,80.75,
__4 HR GLUCOSE,25250034,CDM,82952,CPT,300,RC,inpatient,,85,85,,72.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,72.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.8,88,,percent of total billed charges,,,,,,,,,64.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,,,,,,,,,,,,,70.55,83,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,69.7,82,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,64.09,80.75,
__5 HR GLUCOSE,25250035,CDM,82952,CPT,300,RC,inpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,65.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,65.6,82.65,
..ANALGESICS >6,25250040,CDM,80331,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..ANTIDEPRESSANTS >6,25250041,CDM,80334,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..ANTIDEPRESSANTS  >6,25250042,CDM,80337,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..ANTIDEPRESSANTS  NOS,25250043,CDM,80338,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..ANTIEPILEPTICS >7,25250044,CDM,80341,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..ANTIPSYCHOYICS >7,25250045,CDM,80344,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..BENZODIAZEPINES 1-12,25250046,CDM,80346,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..BUPRENOPHINE,25250047,CDM,80348,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..COCAINE,25250048,CDM,80353,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..FENTANYL,25250049,CDM,80354,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..GABAPENTIN,25250050,CDM,80355,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..KETAMINE,25250051,CDM,80357,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..METHADONE,25250052,CDM,80358,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..MDMA,25250053,CDM,80359,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..METHYPHENIDATE,25250054,CDM,80360,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..OPIATES,25250055,CDM,80361,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..OPIOIDS >5,25250056,CDM,80364,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..OXYCODONE,25250057,CDM,80365,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..PREGABALIN,25250058,CDM,80366,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..PROPOXYPHENE,25250059,CDM,80367,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..SEDATIVE HYPNOTICS,25250060,CDM,80368,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..SKELETAL RELAXANTS >3,25250061,CDM,80370,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..STIMULANTS SYNTHETIC,25250062,CDM,80371,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..TAPENTADOL,25250063,CDM,80372,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..TRAMADOL,25250064,CDM,80372,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..DRUGS NOS X7,25250065,CDM,80377,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..PHENCYCLIDINE,25250066,CDM,83992,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..DRUGS NOS,25250067,CDM,80307,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
..AMPHETAMINES 5 OR MORE,25250068,CDM,80326,CPT,300,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
ALLERGEN  HAMSTER EPITHELIUM,25250314,CDM,86003,CPT,300,RC,inpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,9.05,11.4,
ANA IFA W/ REFLEX,25252518,CDM,86038,CPT,300,RC,inpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
aPTT MIXING STUDIES,25252519,CDM,85730,CPT,300,RC,inpatient,,421,421,,357.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,317.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,357.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,370.48,88,,percent of total billed charges,,,,,,,,,321.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,383.11,91,,percent of total billed charges,,,399.95,95,,percent of total billed charges,,,349.43,83,,percent of total billed charges,,,349.43,83,,percent of total billed charges,,,,,,,,,,,,,,,349.43,83,,percent of total billed charges,,,399.95,95,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,345.22,82,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,357.85,85,,percent of total billed charges,,317.43,399.95,
aPT MIXING STUDIES,25252520,CDM,85610,CPT,300,RC,inpatient,,179,179,,151.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,134.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,152.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,157.52,88,,percent of total billed charges,,,,,,,,,136.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,146.78,82,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,134.97,170.05,
HEPARIN-DEP PLATELET AB,25252521,CDM,82542,CPT,300,RC,inpatient,,668,668,,567.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,503.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,567.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,587.84,88,,percent of total billed charges,,,,,,,,,510.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,607.88,91,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,,,,,,,,,,,,,554.44,83,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,547.76,82,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,567.8,85,,percent of total billed charges,,503.67,634.6,
IFE & PROTEIN ELECTROPHORESIS(24HR),25252522,CDM,84156,CPT,300,RC,inpatient,,79,79,,67.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.52,88,,percent of total billed charges,,,,,,,,,60.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,,,,,,,,,,,,,65.57,83,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,64.78,82,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,59.57,75.05,
SERIAL CBC W/AUTO DIFF,25260000,CDM,85025,CPT,300,RC,inpatient,,207,207,,175.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,156.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,182.16,88,,percent of total billed charges,,,,,,,,,158.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,188.37,91,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,,,,,,,,,,,,,171.81,83,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,169.74,82,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,175.95,85,,percent of total billed charges,,156.08,196.65,
SERIAL COMP METABOLIC PANEL,25260001,CDM,80053,CPT,300,RC,inpatient,,337,337,,286.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,254.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,286.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,296.56,88,,percent of total billed charges,,,,,,,,,257.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,306.67,91,,percent of total billed charges,,,320.15,95,,percent of total billed charges,,,279.71,83,,percent of total billed charges,,,279.71,83,,percent of total billed charges,,,,,,,,,,,,,,,279.71,83,,percent of total billed charges,,,320.15,95,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,276.34,82,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,286.45,85,,percent of total billed charges,,254.1,320.15,
SERIAL LDH,25260002,CDM,83615,CPT,300,RC,inpatient,,165,165,,140.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,124.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,140.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,145.2,88,,percent of total billed charges,,,,,,,,,126.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,135.3,82,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,124.41,156.75,
SERIAL TROPONIN-I,25260003,CDM,84484,CPT,300,RC,inpatient,,379,379,,321.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,285.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,322.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,333.52,88,,percent of total billed charges,,,,,,,,,289.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,344.89,91,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,,,,,,,,,,,,,314.57,83,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,310.78,82,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,285.77,360.05,
SERIAL PROTHROMBIN TIME w/INR,25260005,CDM,85610,CPT,300,RC,inpatient,,174,174,,147.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,131.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,153.12,88,,percent of total billed charges,,,,,,,,,132.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,158.34,91,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,,,,,,,,,,,,,144.42,83,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,142.68,82,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,131.2,165.3,
SERIAL PARTIAL THROMBOPLASTIN TIME (PTT),25260006,CDM,85730,CPT,300,RC,inpatient,,187,187,,158.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,158.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,164.56,88,,percent of total billed charges,,,,,,,,,142.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,153.34,82,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,141,177.65,
SERIAL D-DIMER,25260008,CDM,85379,CPT,300,RC,inpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,179.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,159.09,200.45,
SERIAL FIBRINOGEN (ANTIGEN),25260009,CDM,85385,CPT,300,RC,inpatient,,504,504,,427.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,380.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,428.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,443.52,88,,percent of total billed charges,,,,,,,,,385.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,458.64,91,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,,,,,,,,,,,,,418.32,83,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,413.28,82,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,380.02,478.8,
SERIAL FERRITIN,25260010,CDM,82728,CPT,300,RC,inpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
SERIAL ALT,25260011,CDM,84460,CPT,300,RC,inpatient,,162,162,,137.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,122.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,137.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,142.56,88,,percent of total billed charges,,,,,,,,,123.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,,,,,,,,,,,,,134.46,83,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,132.84,82,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,122.15,153.9,
SERIAL CK TOTAL,25260012,CDM,82550,CPT,300,RC,inpatient,,155,155,,131.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,131.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,136.4,88,,percent of total billed charges,,,,,,,,,118.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,127.1,82,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,116.87,147.25,
SERIAL C-REACTIVE PROTEIN,25260013,CDM,86140,CPT,300,RC,inpatient,,135,135,,114.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,101.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,114.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,118.8,88,,percent of total billed charges,,,,,,,,,103.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,,,,,,,,,,,,,112.05,83,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,110.7,82,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,101.79,128.25,
CYSTIC FIBROSIS GENE SEQ,25279400,CDM,81223,CPT,300,RC,inpatient,,1785,1785,,1515.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1345.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1517.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1570.8,88,,percent of total billed charges,,,,,,,,,1363.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1624.35,91,,percent of total billed charges,,,1695.75,95,,percent of total billed charges,,,1481.55,83,,percent of total billed charges,,,1481.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1481.55,83,,percent of total billed charges,,,1695.75,95,,percent of total billed charges,,,1606.5,90,,percent of total billed charges,,,1606.5,90,,percent of total billed charges,,,1463.7,82,,percent of total billed charges,,,1606.5,90,,percent of total billed charges,,,1517.25,85,,percent of total billed charges,,1345.89,1695.75,
PANCREATITIS 3 GENE PROFILE,25279401,CDM,81223,CPT,300,RC,inpatient,,1785,1785,,1515.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1345.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1517.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1570.8,88,,percent of total billed charges,,,,,,,,,1363.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1624.35,91,,percent of total billed charges,,,1695.75,95,,percent of total billed charges,,,1481.55,83,,percent of total billed charges,,,1481.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1481.55,83,,percent of total billed charges,,,1695.75,95,,percent of total billed charges,,,1606.5,90,,percent of total billed charges,,,1606.5,90,,percent of total billed charges,,,1463.7,82,,percent of total billed charges,,,1606.5,90,,percent of total billed charges,,,1517.25,85,,percent of total billed charges,,1345.89,1695.75,
.PL-7 AB,25300001,CDM,86235,CPT,300,RC,inpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,70.12,88.35,
.PL-12 AB,25300002,CDM,86235,CPT,300,RC,inpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,70.12,88.35,
.EJ AB,25300003,CDM,86235,CPT,300,RC,inpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,70.12,88.35,
.OJ AB,25300004,CDM,86235,CPT,300,RC,inpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,70.12,88.35,
.RO-52 AB,25300005,CDM,86235,CPT,300,RC,inpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,70.12,88.35,
.SCL-100 AB,25300006,CDM,86235,CPT,300,RC,inpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,70.12,88.35,
.KU AB,25300007,CDM,86235,CPT,300,RC,inpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,70.12,88.35,
.SIGNAL RECOG PARTICLE,25300008,CDM,86235,CPT,300,RC,inpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,70.12,88.35,
.MI-2 AB,25300009,CDM,86235,CPT,300,RC,inpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,70.12,88.35,
FL C-REACTIVE PROTEIN,25400000,CDM,86140,CPT,300,RC,inpatient,TC,67,67,,56.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.96,88,,percent of total billed charges,,,,,,,,,51.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,,,,,,,,,,,,,55.61,83,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,54.94,82,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,50.52,63.65,
FL MAGNESIUM,25400001,CDM,83735,CPT,300,RC,inpatient,TC,85,85,,72.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,72.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.8,88,,percent of total billed charges,,,,,,,,,64.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,,,,,,,,,,,,,70.55,83,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,69.7,82,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,64.09,80.75,
FL IRON TOTAL,25400002,CDM,83540,CPT,300,RC,inpatient,TC,76,76,,64.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,57.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,64.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66.88,88,,percent of total billed charges,,,,,,,,,58.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,,,,,,,,,,,,,63.08,83,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,62.32,82,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,57.3,72.2,
FL LDH,25400003,CDM,83615,CPT,300,RC,inpatient,TC,72,72,,61.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,54.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,61.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,63.36,88,,percent of total billed charges,,,,,,,,,55.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,65.52,91,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,,,,,,,,,,,,,59.76,83,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,59.04,82,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,54.29,68.4,
FL URIC ACID SERUM,25400004,CDM,84550,CPT,300,RC,inpatient,TC,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,36.19,45.6,
FL PHOSPHORUS SERUM,25400005,CDM,84100,CPT,300,RC,inpatient,TC,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,33.93,42.75,
FL VITAMIN B12,25400006,CDM,82607,CPT,300,RC,inpatient,TC,122,122,,103.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,103.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,107.36,88,,percent of total billed charges,,,,,,,,,93.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,100.04,82,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,91.99,115.9,
FL HOMOCYSTEINE CARDIOVASCULAR,25400007,CDM,83090,CPT,300,RC,inpatient,TC,182,182,,154.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,154.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,160.16,88,,percent of total billed charges,,,,,,,,,139.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,149.24,82,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,137.23,172.9,
FL APOLIPOPROTEIN B,25400008,CDM,82172,CPT,300,RC,inpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,81.43,102.6,
FL  LIPOPROTEIN A,25400009,CDM,83695,CPT,300,RC,inpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,81.43,102.6,
FL VITAMIN D 25-HYDROXY,25400010,CDM,82306,CPT,300,RC,inpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110.88,88,,percent of total billed charges,,,,,,,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,95,119.7,
FL DHEA-SULFATE,25400011,CDM,82627,CPT,300,RC,inpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,91.23,114.95,
COCCIDIOIDES IMMITIS,25502455,CDM,86635,CPT,300,RC,inpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,76.91,96.9,
BCR/ABL GENE REARRANGEMENT QT PCR,25799999,CDM,81206,CPT,300,RC,inpatient,,698,698,,592.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,526.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,593.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,614.24,88,,percent of total billed charges,,,,,,,,,533.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,635.18,91,,percent of total billed charges,,,663.1,95,,percent of total billed charges,,,579.34,83,,percent of total billed charges,,,579.34,83,,percent of total billed charges,,,,,,,,,,,,,,,579.34,83,,percent of total billed charges,,,663.1,95,,percent of total billed charges,,,628.2,90,,percent of total billed charges,,,628.2,90,,percent of total billed charges,,,572.36,82,,percent of total billed charges,,,628.2,90,,percent of total billed charges,,,593.3,85,,percent of total billed charges,,526.29,663.1,
.NUCLEIC ACID ISOLATION/EXTRACTION,25800000,CDM,83891,CPT,300,RC,inpatient,,189,189,,160.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,142.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,160.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,166.32,88,,percent of total billed charges,,,,,,,,,144.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,,,,,,,,,,,,,156.87,83,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,154.98,82,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,142.51,179.55,
".NUCLEIC ACID PROBE, each",25800001,CDM,83896,CPT,300,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
.NUCLEIC ACID AMPLIFICATION 1 SEQ,25800002,CDM,83898,CPT,300,RC,inpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,18.1,22.8,
.NUCLEIC ACID AMPLIFICATION 1&2 SEQ,25800003,CDM,83900,CPT,300,RC,inpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,58.06,73.15,
.NUCLEIC ACID AMPLIFICATION ADD SEQ,25800004,CDM,83901,CPT,300,RC,inpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,58.81,74.1,
.NUCLEIC ACID REVERSE TRANSCRIPTION,25800005,CDM,83902,CPT,300,RC,inpatient,,42,42,,35.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36.96,88,,percent of total billed charges,,,,,,,,,32.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38.22,91,,percent of total billed charges,,,39.9,95,,percent of total billed charges,,,34.86,83,,percent of total billed charges,,,34.86,83,,percent of total billed charges,,,,,,,,,,,,,,,34.86,83,,percent of total billed charges,,,39.9,95,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,34.44,82,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,35.7,85,,percent of total billed charges,,31.67,39.9,
.NUCLEIC ACID INTERPRETATION,25800006,CDM,83912,CPT,300,RC,inpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,37.7,47.5,
NOROVIRUS,25920592,CDM,87798,CPT,300,RC,inpatient,,246,246,,208.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,185.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,209.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,216.48,88,,percent of total billed charges,,,,,,,,,187.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,223.86,91,,percent of total billed charges,,,233.7,95,,percent of total billed charges,,,204.18,83,,percent of total billed charges,,,204.18,83,,percent of total billed charges,,,,,,,,,,,,,,,204.18,83,,percent of total billed charges,,,233.7,95,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,201.72,82,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,209.1,85,,percent of total billed charges,,185.48,233.7,
TH (DO NOT ORDER),25999964,CDM,,,300,RC,inpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
HEMOGLOBIN A1c,25999965,CDM,83036,CPT,300,RC,inpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
ANGIOTENSIN-1-CONVERTING ENZYME,25999966,CDM,82164,CPT,300,RC,inpatient,,223,223,,189.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.24,88,,percent of total billed charges,,,,,,,,,170.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,202.93,91,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,,,,,,,,,,,,,185.09,83,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,182.86,82,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,168.14,211.85,
9P21 GENOTYPE,25999973,CDM,81479,CPT,300,RC,inpatient,,764,764,,648.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,576.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,649.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,672.32,88,,percent of total billed charges,,,,,,,,,583.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,695.24,91,,percent of total billed charges,,,725.8,95,,percent of total billed charges,,,634.12,83,,percent of total billed charges,,,634.12,83,,percent of total billed charges,,,,,,,,,,,,,,,634.12,83,,percent of total billed charges,,,725.8,95,,percent of total billed charges,,,687.6,90,,percent of total billed charges,,,687.6,90,,percent of total billed charges,,,626.48,82,,percent of total billed charges,,,687.6,90,,percent of total billed charges,,,649.4,85,,percent of total billed charges,,576.06,725.8,
KIF6 GENOTYPE,25999974,CDM,81479,CPT,300,RC,inpatient,,495,495,,420.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,373.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,420.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,435.6,88,,percent of total billed charges,,,,,,,,,378.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,450.45,91,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,,,,,,,,,,,,,410.85,83,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,405.9,82,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,373.23,470.25,
ISTAT CHEM PANEL XRAY,26100005,CDM,82565,CPT,300,RC,inpatient,,97,97,,82.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,73.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,82.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,85.36,88,,percent of total billed charges,,,,,,,,,74.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,,,,,,,,,,,,,80.51,83,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,79.54,82,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,73.14,92.15,
ISTAT CREATININE XRAY,26100006,CDM,82565,CPT,300,RC,inpatient,,118,118,,100.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,88.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,100.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,103.84,88,,percent of total billed charges,,,,,,,,,90.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,107.38,91,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,,,,,,,,,,,,,97.94,83,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,96.76,82,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,88.97,112.1,
OT MOD 59 MANUAL THERAPY ANNEX,5900500,CDM,97140,CPT,430,RC,inpatient,GO,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
OT MOD 59 THERAPUTIC ACTIVITY ANNEX,5900501,CDM,97530,CPT,430,RC,inpatient,GO,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
OT MOD 59 THERAPUTIC EXER 15 MIN ANNEX,5900502,CDM,97110,CPT,430,RC,inpatient,GO,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
OT FUNCTIONAL THERAPEUTIC ACTIVITY ANNEX,5900606,CDM,97530,CPT,430,RC,inpatient,GO,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
OT SEF CARE/ MANG. TRNG. EA 15 MIN ANNEX,5900607,CDM,97535,CPT,430,RC,inpatient,GO,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,186.99,235.6,
OT COMM/W RE-INTEG. TRNG. EA 15MIN ANNEX,5900608,CDM,97537,CPT,430,RC,inpatient,GO,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,114.61,144.4,
OT W/C MGT/PROPULSON TMG 15 MIN ANNEX,5900620,CDM,97542,CPT,430,RC,inpatient,GO,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
OT DEV COG SK(ATTNPROB SOLV/EA15MN ANNEX,5900714,CDM,97129,CPT,430,RC,inpatient,GO,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
OT MANUAL THERAPY TQS EA 15 MIN ANNEX,5900720,CDM,97140,CPT,430,RC,inpatient,GO,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
OT THERA EX FOR STRENGTH EA 15 MIN ANNEX,5900738,CDM,97110,CPT,430,RC,inpatient,GO,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
"OT NEUR-MUSC RE-ED,BAL/PR/PST 15M ANNEX",5900739,CDM,97112,CPT,430,RC,inpatient,GO,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,179.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,202.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,179.45,226.1,
"OT ORT MGMT&TRNG, UE&LE, EA 15 MIN ANNEX",5900803,CDM,97760,CPT,430,RC,inpatient,GO,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
"OT ORO MGMT, UE&LE, EA 15 MIN MODF ANNEX",5900804,CDM,97760,CPT,430,RC,inpatient,GO,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
OT MOD 59 RE-EVALUATION ANNEX(V10-19),5900990,CDM,97004,CPT,430,RC,inpatient,GO,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,332.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,294.81,371.45,
OT RE-EVALUATION ANNEX(V10-19),5900993,CDM,97004,CPT,430,RC,inpatient,GO,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,332.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,294.81,371.45,
OT OCCUPATIONAL THER EVAL ANNEX(V10-19),5901041,CDM,97003,CPT,434,RC,inpatient,GO,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,520.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,461.45,581.4,
OT OCCPNAL THER EVAL W THCAP A(V10-19),5902000,CDM,97003,CPT,434,RC,inpatient,KX,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,520.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,461.45,581.4,
OT RE-EVALUATION W THCAP ANNEX(V10-19),5902001,CDM,97004,CPT,434,RC,inpatient,KX,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,332.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,294.81,371.45,
OT HOT/COLD PACK W THCAP ANNEX,5902002,CDM,97010,CPT,430,RC,inpatient,KX,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,110.84,139.65,
OT ELEL STIMTION UNATTDED W THCAP ANNEX,5902003,CDM,97014,CPT,430,RC,inpatient,KX,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,132.7,167.2,
OT VASOPNEUMATIC DEVICE W THCAP ANNEX,5902004,CDM,97016,CPT,430,RC,inpatient,KX,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,99.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,112.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,99.53,125.4,
OT PARAFFIN BATH I W THCAP ANNEX,5902005,CDM,97018,CPT,430,RC,inpatient,KX,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
OT WHIPOOL SUPERD/UNATTDED W THCAP ANNEX,5902006,CDM,97022,CPT,430,RC,inpatient,KX,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,200.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,226.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,200.56,252.7,
OT EL STIN ATTED EA 15 MIN W THCAP ANNEX,5902007,CDM,97032,CPT,430,RC,inpatient,KX,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,116.12,146.3,
OT IONTOPHORESIS 15 MIN W THCAP ANNEX,5902008,CDM,97033,CPT,430,RC,inpatient,KX,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,174.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,174.17,219.45,
OT ULTRSD/PHONOP EA 15 MIN W THCAP ANNEX,5902009,CDM,97035,CPT,430,RC,inpatient,KX,91,91,,77.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.08,88,,percent of total billed charges,,,,,,,,,69.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,,,,,,,,,,,,,75.53,83,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,74.62,82,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,68.61,86.45,
OT THRA EX FOR STRTH EA 15 W THCAP ANNEX,5902010,CDM,97110,CPT,430,RC,inpatient,KX,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
"OT NR-MSC RE-ED,BL/PT 15M W THCAP  ANNEX",5902011,CDM,97112,CPT,430,RC,inpatient,KX,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,179.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,202.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,179.45,226.1,
OT MANL THY TQS EA 15 MIN W THCAP ANNEX,5902012,CDM,97140,CPT,430,RC,inpatient,KX,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
OT FUNT THERTIC ACTIVITY W THCAP ANNEX,5902013,CDM,97530,CPT,430,RC,inpatient,KX,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
"OT DE CO SK(ATN,M S/EA15MN W THCAP ANNEX",5902014,CDM,97129,CPT,430,RC,inpatient,KX,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
"OT SY INTEGN TQS, EA 15 MS W THCAP ANNEX",5902015,CDM,97533,CPT,430,RC,inpatient,KX,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,129.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,129.69,163.4,
OT SEF CE/HE MA. TG. EA 15 W THCAP ANNEX,5902016,CDM,97535,CPT,430,RC,inpatient,KX,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,186.99,235.6,
OT CO/WO RE-ING. TRG. EA 15W THCAP ANNEX,5902017,CDM,97537,CPT,430,RC,inpatient,KX,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,114.61,144.4,
OT W/C MGT/PRN TMG 15 MIN W THCAP ANNEX,5902018,CDM,97542,CPT,430,RC,inpatient,KX,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
OT WORK HAR/COND INIT 2 HR W THCAP ANNEX,5902019,CDM,97545,CPT,430,RC,inpatient,KX,562,562,,477.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,423.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,477.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,494.56,88,,percent of total billed charges,,,,,,,,,429.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,,,,,,,,,,,,,466.46,83,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,460.84,82,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,423.75,533.9,
OT WORK HARDEG/CON ADD HR W THCAP ANNEX,5902020,CDM,97546,CPT,430,RC,inpatient,KX,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,217.91,274.55,
OT PY PEF TT/ME(FXN CAP)15 W THCAP ANNEX,5902021,CDM,97750,CPT,430,RC,inpatient,KX,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,203.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,180.21,227.05,
"OT O MGT&TG, UE&LE,EA 15  W THCAP ANNEX",5902022,CDM,97760,CPT,430,RC,inpatient,KX,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
OT CK O ORT/PR ES PT 15 MN W THCAP ANNEX,5902023,CDM,97763,CPT,430,RC,inpatient,KX,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,257.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,290.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,257.87,324.9,
OT ETL STIMN MEDICARE W THCAP ANNEX,5902024,CDM,G0283,HCPCS,430,RC,inpatient,KX,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,61.07,76.95,
OT THERA EX FOR STH EA 15 MIN ANNEX THER,5902034,CDM,97110,CPT,430,RC,inpatient,CO,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
OT FUNCTIONAL TH ACTIVITY ANNEX THERAPY,5902036,CDM,97530,CPT,430,RC,inpatient,CO,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
OT MAN THERAPY TQS EA 15 MIN ANNEX THERA,5902037,CDM,97140,CPT,430,RC,inpatient,CO,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
ANNEX FF ADMINISTRATION PNU VACCINE,32000001,CDM,G0009,HCPCS,771,RC,inpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,135.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,119.89,151.05,
ANNEX PNEUMOCOCC 23(PNEUMOVAX),32050001,CDM,90732,CPT,636,RC,inpatient,,1478,1478,,1254.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1114.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1256.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1300.64,88,,percent of total billed charges,,,,,,,,,1129.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1344.98,91,,percent of total billed charges,,,1404.1,95,,percent of total billed charges,,,1226.74,83,,percent of total billed charges,,,1226.74,83,,percent of total billed charges,,,,,,,,,,,,,,,1226.74,83,,percent of total billed charges,,,1404.1,95,,percent of total billed charges,,,1330.2,90,,percent of total billed charges,,,1330.2,90,,percent of total billed charges,,,1211.96,82,,percent of total billed charges,,,1330.2,90,,percent of total billed charges,,,1256.3,85,,percent of total billed charges,,1114.41,1404.1,
OT OCC THER EVAL LOW ANNEX,35200300,CDM,97165,CPT,434,RC,inpatient,GO,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,520.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,461.45,581.4,
OT OCCP THER EVAL LOW COMP W THCAP ANNEX,35200301,CDM,97165,CPT,434,RC,inpatient,KX,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,520.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,461.45,581.4,
OT OCC THER EVAL MOD ANNEX,35200305,CDM,97166,CPT,434,RC,inpatient,GO,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,520.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,461.45,581.4,
OT OCCP THER EVAL MOD COMP W THCAP ANNEX,35200306,CDM,97166,CPT,434,RC,inpatient,KX,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,520.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,461.45,581.4,
OT OCC THER EVAL HIGH COMPL  ANNEX,35200310,CDM,97167,CPT,434,RC,inpatient,GO,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,520.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,461.45,581.4,
OT OCC THER EVAL HIGH COMP W THCAP ANNEX,35200311,CDM,97167,CPT,434,RC,inpatient,KX,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,520.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,461.45,581.4,
OT MOD 59 RE-EVAL EST PLAN CARE ANNEX,35200315,CDM,97168,CPT,430,RC,inpatient,GO,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,332.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,294.81,371.45,
OT RE-EVAL EST PLAN CARE ANNEX,35200316,CDM,97168,CPT,430,RC,inpatient,GO,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,332.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,294.81,371.45,
OT RE-EVAL EST PLAN CARE W THCAP ANNEX,35200317,CDM,97168,CPT,434,RC,inpatient,KX,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,332.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,294.81,371.45,
ADMINISTRATION FLU VACCINE,890055,CDM,G0008,HCPCS,771,RC,inpatient,,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,110.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,98.02,123.5,
ADMINISTRATION PNEUMOCOCCAL VACCINE,890056,CDM,G0009,HCPCS,771,RC,inpatient,,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,110.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,98.02,123.5,
BEDSIDE PROCDURE-MS,890061,CDM,,,360,RC,inpatient,,1736,1736,,1473.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1308.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1475.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1527.68,88,,percent of total billed charges,,,,,,,,,1326.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1579.76,91,,percent of total billed charges,,,1649.2,95,,percent of total billed charges,,,1440.88,83,,percent of total billed charges,,,1440.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1440.88,83,,percent of total billed charges,,,1649.2,95,,percent of total billed charges,,,1562.4,90,,percent of total billed charges,,,1562.4,90,,percent of total billed charges,,,1423.52,82,,percent of total billed charges,,,1562.4,90,,percent of total billed charges,,,1475.6,85,,percent of total billed charges,,1308.94,1649.2,
NURSING CARE OBSERV FIRST HOUR,890068,CDM,G0378,HCPCS,762,RC,inpatient,,1135,1135,,963.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,855.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,964.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,998.8,88,,percent of total billed charges,,,,,,,,,867.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1032.85,91,,percent of total billed charges,,,1078.25,95,,percent of total billed charges,,,942.05,83,,percent of total billed charges,,,942.05,83,,percent of total billed charges,,,,,,,,,,,,,,,942.05,83,,percent of total billed charges,,,1078.25,95,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,930.7,82,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,964.75,85,,percent of total billed charges,,855.79,1078.25,
BLOOD ADMINISTRATION SERVICE,890070,CDM,36430,CPT,391,RC,inpatient,,1766,1766,,1499.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1331.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1501.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1554.08,88,,percent of total billed charges,,,,,,,,,1349.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1607.06,91,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.78,83,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1448.12,82,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,1331.56,1677.7,
BLOOD ADMIN UP TO 4 HOURS(V-11-20),890071,CDM,36430,CPT,391,RC,inpatient,,1372,1372,,1164.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1034.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1166.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1207.36,88,,percent of total billed charges,,,,,,,,,1048.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1248.52,91,,percent of total billed charges,,,1303.4,95,,percent of total billed charges,,,1138.76,83,,percent of total billed charges,,,1138.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.76,83,,percent of total billed charges,,,1303.4,95,,percent of total billed charges,,,1234.8,90,,percent of total billed charges,,,1234.8,90,,percent of total billed charges,,,1125.04,82,,percent of total billed charges,,,1234.8,90,,percent of total billed charges,,,1166.2,85,,percent of total billed charges,,1034.49,1303.4,
BLOOD ADMIN UP TO 6 HOURS(V-11-20),890072,CDM,36430,CPT,391,RC,inpatient,,1709,1709,,1450.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1288.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1452.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1503.92,88,,percent of total billed charges,,,,,,,,,1305.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1555.19,91,,percent of total billed charges,,,1623.55,95,,percent of total billed charges,,,1418.47,83,,percent of total billed charges,,,1418.47,83,,percent of total billed charges,,,,,,,,,,,,,,,1418.47,83,,percent of total billed charges,,,1623.55,95,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1401.38,82,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1452.65,85,,percent of total billed charges,,1288.59,1623.55,
BLOOD ADMIN OVER 6 HOURS(V-11-20),890073,CDM,36430,CPT,391,RC,inpatient,,2137,2137,,1814.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1611.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1816.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1880.56,88,,percent of total billed charges,,,,,,,,,1632.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1944.67,91,,percent of total billed charges,,,2030.15,95,,percent of total billed charges,,,1773.71,83,,percent of total billed charges,,,1773.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1773.71,83,,percent of total billed charges,,,2030.15,95,,percent of total billed charges,,,1923.3,90,,percent of total billed charges,,,1923.3,90,,percent of total billed charges,,,1752.34,82,,percent of total billed charges,,,1923.3,90,,percent of total billed charges,,,1816.45,85,,percent of total billed charges,,1611.3,2030.15,
NURSING CARE OBSERV ADDTL HOUR,890076,CDM,G0378,HCPCS,762,RC,inpatient,,178,178,,151.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,134.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,151.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,156.64,88,,percent of total billed charges,,,,,,,,,135.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,161.98,91,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,,,,,,,,,,,,,147.74,83,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,145.96,82,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,134.21,169.1,
TELEMETRY OBSERVATION FIRST HOUR,890077,CDM,G0378,HCPCS,762,RC,inpatient,,1553,1553,,1318.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1170.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1320.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1366.64,88,,percent of total billed charges,,,,,,,,,1186.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1413.23,91,,percent of total billed charges,,,1475.35,95,,percent of total billed charges,,,1288.99,83,,percent of total billed charges,,,1288.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1288.99,83,,percent of total billed charges,,,1475.35,95,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1273.46,82,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1320.05,85,,percent of total billed charges,,1170.96,1475.35,
TELEMETRY OBSERVATION ADDTL HOUR,890078,CDM,G0378,HCPCS,762,RC,inpatient,,184,184,,156.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,138.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,156.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,161.92,88,,percent of total billed charges,,,,,,,,,140.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,,,,,,,,,,,,,152.72,83,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,150.88,82,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,138.74,174.8,
EXTENDED RECOVERY 1ST HOUR,890080,CDM,,,710,RC,inpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,157.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,177.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,157.59,198.55,
EXTENDED RECOVERY EACH ADDTL HOUR,890082,CDM,,,710,RC,inpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,92.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,82.19,103.55,
"IV INFUSION, HYDRATION, UP TO 1 HOUR",890100,CDM,96360,CPT,260,RC,inpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,627.33,790.4,
"IV INFUSION, HYDRATION, ADDTL HOUR",890101,CDM,96361,CPT,260,RC,inpatient,XU,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
"IV INFUSION, THERAPEUTIC, UP TO 1 HOUR",890102,CDM,96365,CPT,260,RC,inpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,627.33,790.4,
"IV INFUSION, THERAPEUTIC, ADDTL HOUR",890103,CDM,96366,CPT,260,RC,inpatient,XU,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,189.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,213.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,189.25,238.45,
CONCURRENT ADDT'L MEDICATED SOLUTION,890104,CDM,96368,CPT,260,RC,inpatient,XU,522,522,,443.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,393.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,443.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,459.36,88,,percent of total billed charges,,,,,,,,,398.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,475.02,91,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,,,,,,,,,,,,,433.26,83,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,428.04,82,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,393.59,495.9,
IM/SQ INJECTION,890105,CDM,96372,CPT,260,RC,inpatient,XU,352,352,,298.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,265.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,299.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,309.76,88,,percent of total billed charges,,,,,,,,,268.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,,,,,,,,,,,,,292.16,83,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,288.64,82,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,265.41,334.4,
"IVP, SINGLE OR INITIAL",890106,CDM,96374,CPT,260,RC,inpatient,XU,436,436,,370.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,328.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,370.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,383.68,88,,percent of total billed charges,,,,,,,,,333.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,396.76,91,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,,,,,,,,,,,,,361.88,83,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,357.52,82,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,328.74,414.2,
"IVP, EACH ADDTL OF NEW SUBSTANCE/DRUG",890107,CDM,96375,CPT,260,RC,inpatient,XU,359,359,,304.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,270.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,305.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,315.92,88,,percent of total billed charges,,,,,,,,,274.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,,,,,,,,,,,,,297.97,83,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,294.38,82,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,270.69,341.05,
"IVP, EACH ADDTL SEQUENTIAL INTRA PUSH",890111,CDM,96376,CPT,260,RC,inpatient,XU,274,274,,232.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,206.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,232.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,241.12,88,,percent of total billed charges,,,,,,,,,209.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,249.34,91,,percent of total billed charges,,,260.3,95,,percent of total billed charges,,,227.42,83,,percent of total billed charges,,,227.42,83,,percent of total billed charges,,,,,,,,,,,,,,,227.42,83,,percent of total billed charges,,,260.3,95,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,224.68,82,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,232.9,85,,percent of total billed charges,,206.6,260.3,
COMPLEX UROFLOWMETRY,890115,CDM,51741,CPT,762,RC,inpatient,,1662,1662,,1411.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1253.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1412.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1462.56,88,,percent of total billed charges,,,,,,,,,1269.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1512.42,91,,percent of total billed charges,,,1578.9,95,,percent of total billed charges,,,1379.46,83,,percent of total billed charges,,,1379.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1379.46,83,,percent of total billed charges,,,1578.9,95,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1362.84,82,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1412.7,85,,percent of total billed charges,,1253.15,1578.9,
MINOR SURGERY CASE,891234,CDM,,,361,RC,inpatient,,16223,16223,,13773.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12232.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13789.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14276.24,88,,percent of total billed charges,,,,,,,,,12394.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14762.93,91,,percent of total billed charges,,,15411.85,95,,percent of total billed charges,,,13465.09,83,,percent of total billed charges,,,13465.09,83,,percent of total billed charges,,,,,,,,,,,,,,,13465.09,83,,percent of total billed charges,,,15411.85,95,,percent of total billed charges,,,14600.7,90,,percent of total billed charges,,,14600.7,90,,percent of total billed charges,,,13302.86,82,,percent of total billed charges,,,14600.7,90,,percent of total billed charges,,,13789.55,85,,percent of total billed charges,,12232.14,15411.85,
MINOR SURGERY WOUND CARE,891235,CDM,,,361,RC,inpatient,,2434,2434,,2066.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1835.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2068.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2141.92,88,,percent of total billed charges,,,,,,,,,1859.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2214.94,91,,percent of total billed charges,,,2312.3,95,,percent of total billed charges,,,2020.22,83,,percent of total billed charges,,,2020.22,83,,percent of total billed charges,,,,,,,,,,,,,,,2020.22,83,,percent of total billed charges,,,2312.3,95,,percent of total billed charges,,,2190.6,90,,percent of total billed charges,,,2190.6,90,,percent of total billed charges,,,1995.88,82,,percent of total billed charges,,,2190.6,90,,percent of total billed charges,,,2068.9,85,,percent of total billed charges,,1835.24,2312.3,
CARDIOVERSION EXTERNAL,899000,CDM,92960,CPT,761,RC,inpatient,,1444,1444,,1225.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1088.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1227.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1270.72,88,,percent of total billed charges,,,,,,,,,1103.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1314.04,91,,percent of total billed charges,,,1371.8,95,,percent of total billed charges,,,1198.52,83,,percent of total billed charges,,,1198.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1198.52,83,,percent of total billed charges,,,1371.8,95,,percent of total billed charges,,,1299.6,90,,percent of total billed charges,,,1299.6,90,,percent of total billed charges,,,1184.08,82,,percent of total billed charges,,,1299.6,90,,percent of total billed charges,,,1227.4,85,,percent of total billed charges,,1088.78,1371.8,
MM BRSTNDLLOC/PLC(SINGLE),30000996,CDM,19281,CPT,401,RC,inpatient,TC,929,929,,788.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,700.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,789.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,817.52,88,,percent of total billed charges,,,,,,,,,709.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,845.39,91,,percent of total billed charges,,,882.55,95,,percent of total billed charges,,,771.07,83,,percent of total billed charges,,,771.07,83,,percent of total billed charges,,,,,,,,,,,,,,,771.07,83,,percent of total billed charges,,,882.55,95,,percent of total billed charges,,,836.1,90,,percent of total billed charges,,,836.1,90,,percent of total billed charges,,,761.78,82,,percent of total billed charges,,,836.1,90,,percent of total billed charges,,,789.65,85,,percent of total billed charges,,700.47,882.55,
MM BRSTNDLLOC/PLC(2+),30000997,CDM,19282,CPT,401,RC,inpatient,TC,851,851,,722.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,641.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,723.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,748.88,88,,percent of total billed charges,,,,,,,,,650.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,774.41,91,,percent of total billed charges,,,808.45,95,,percent of total billed charges,,,706.33,83,,percent of total billed charges,,,706.33,83,,percent of total billed charges,,,,,,,,,,,,,,,706.33,83,,percent of total billed charges,,,808.45,95,,percent of total billed charges,,,765.9,90,,percent of total billed charges,,,765.9,90,,percent of total billed charges,,,697.82,82,,percent of total billed charges,,,765.9,90,,percent of total billed charges,,,723.35,85,,percent of total billed charges,,641.65,808.45,
MM BRST STRTCTC 1ST LESION,30000998,CDM,19081,CPT,401,RC,inpatient,TC,6087,6087,,5167.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4589.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5173.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5356.56,88,,percent of total billed charges,,,,,,,,,4650.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5539.17,91,,percent of total billed charges,,,5782.65,95,,percent of total billed charges,,,5052.21,83,,percent of total billed charges,,,5052.21,83,,percent of total billed charges,,,,,,,,,,,,,,,5052.21,83,,percent of total billed charges,,,5782.65,95,,percent of total billed charges,,,5478.3,90,,percent of total billed charges,,,5478.3,90,,percent of total billed charges,,,4991.34,82,,percent of total billed charges,,,5478.3,90,,percent of total billed charges,,,5173.95,85,,percent of total billed charges,,4589.6,5782.65,
MM BRST STRTCTC ADD LESION,30000999,CDM,19082,CPT,401,RC,inpatient,TC,4927,4927,,4183.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3714.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4187.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4335.76,88,,percent of total billed charges,,,,,,,,,3764.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4483.57,91,,percent of total billed charges,,,4680.65,95,,percent of total billed charges,,,4089.41,83,,percent of total billed charges,,,4089.41,83,,percent of total billed charges,,,,,,,,,,,,,,,4089.41,83,,percent of total billed charges,,,4680.65,95,,percent of total billed charges,,,4434.3,90,,percent of total billed charges,,,4434.3,90,,percent of total billed charges,,,4040.14,82,,percent of total billed charges,,,4434.3,90,,percent of total billed charges,,,4187.95,85,,percent of total billed charges,,3714.96,4680.65,
X SURGICAL SPECIMEN,30101162,CDM,76098,CPT,400,RC,inpatient,TC,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,697.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,786.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,697.45,878.75,
UL SURGICAL SPECIMEN,30101163,CDM,76098,CPT,400,RC,inpatient,TC,936,936,,794.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,705.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,795.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,823.68,88,,percent of total billed charges,,,,,,,,,715.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,851.76,91,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,,,,,,,,,,,,,776.88,83,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,767.52,82,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,795.6,85,,percent of total billed charges,,705.74,889.2,
MM SURGICAL SPECIMEN DIGITAL,30101164,CDM,76098,CPT,400,RC,inpatient,TC,608,608,,516.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,458.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,516.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,535.04,88,,percent of total billed charges,,,,,,,,,464.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,553.28,91,,percent of total billed charges,,,577.6,95,,percent of total billed charges,,,504.64,83,,percent of total billed charges,,,504.64,83,,percent of total billed charges,,,,,,,,,,,,,,,504.64,83,,percent of total billed charges,,,577.6,95,,percent of total billed charges,,,547.2,90,,percent of total billed charges,,,547.2,90,,percent of total billed charges,,,498.56,82,,percent of total billed charges,,,547.2,90,,percent of total billed charges,,,516.8,85,,percent of total billed charges,,458.43,577.6,
MM DUCTOGRAM SGL RT,30101165,CDM,77053,CPT,320,RC,inpatient,RT,2105,2105,,1787.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1587.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1789.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1852.4,88,,percent of total billed charges,,,,,,,,,1608.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1915.55,91,,percent of total billed charges,,,1999.75,95,,percent of total billed charges,,,1747.15,83,,percent of total billed charges,,,1747.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1747.15,83,,percent of total billed charges,,,1999.75,95,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1726.1,82,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1789.25,85,,percent of total billed charges,,1587.17,1999.75,
MM DUCTOGRAM SGL LT,30101166,CDM,77053,CPT,320,RC,inpatient,LT,2105,2105,,1787.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1587.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1789.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1852.4,88,,percent of total billed charges,,,,,,,,,1608.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1915.55,91,,percent of total billed charges,,,1999.75,95,,percent of total billed charges,,,1747.15,83,,percent of total billed charges,,,1747.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1747.15,83,,percent of total billed charges,,,1999.75,95,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1726.1,82,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1789.25,85,,percent of total billed charges,,1587.17,1999.75,
ASOCIATED DUCTOGRAM INJECTION PROCEDURE,30101167,CDM,19030,CPT,320,RC,inpatient,,959,959,,814.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,723.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,815.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,843.92,88,,percent of total billed charges,,,,,,,,,732.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,872.69,91,,percent of total billed charges,,,911.05,95,,percent of total billed charges,,,795.97,83,,percent of total billed charges,,,795.97,83,,percent of total billed charges,,,,,,,,,,,,,,,795.97,83,,percent of total billed charges,,,911.05,95,,percent of total billed charges,,,863.1,90,,percent of total billed charges,,,863.1,90,,percent of total billed charges,,,786.38,82,,percent of total billed charges,,,863.1,90,,percent of total billed charges,,,815.15,85,,percent of total billed charges,,723.09,911.05,
MM DUCTOGRAM 2+ RT,30101169,CDM,77054,CPT,320,RC,inpatient,RT,3010,3010,,2555.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2269.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2558.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2648.8,88,,percent of total billed charges,,,,,,,,,2299.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2739.1,91,,percent of total billed charges,,,2859.5,95,,percent of total billed charges,,,2498.3,83,,percent of total billed charges,,,2498.3,83,,percent of total billed charges,,,,,,,,,,,,,,,2498.3,83,,percent of total billed charges,,,2859.5,95,,percent of total billed charges,,,2709,90,,percent of total billed charges,,,2709,90,,percent of total billed charges,,,2468.2,82,,percent of total billed charges,,,2709,90,,percent of total billed charges,,,2558.5,85,,percent of total billed charges,,2269.54,2859.5,
* MA SCREEN BIL (V306),30101535,CDM,76092,CPT,403,RC,inpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,116.12,146.3,
* DNU MA BREAST NDL LOCAL & PLC (SINGLE),30101550,CDM,19290,CPT,769,RC,inpatient,TC,995,995,,844.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,750.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,845.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,875.6,88,,percent of total billed charges,,,,,,,,,760.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,905.45,91,,percent of total billed charges,,,945.25,95,,percent of total billed charges,,,825.85,83,,percent of total billed charges,,,825.85,83,,percent of total billed charges,,,,,,,,,,,,,,,825.85,83,,percent of total billed charges,,,945.25,95,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,815.9,82,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,845.75,85,,percent of total billed charges,,750.23,945.25,
*DNU MA BREAST NDL LOCAL & PLC (MULT 2+),30101568,CDM,19291,CPT,769,RC,inpatient,TC,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,129.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,129.69,163.4,
* DNU MA BREAST LOC GUIDE DIGITAL(V0107),30103994,CDM,76096,CPT,320,RC,inpatient,,865,865,,734.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,652.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,735.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,761.2,88,,percent of total billed charges,,,,,,,,,660.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,787.15,91,,percent of total billed charges,,,821.75,95,,percent of total billed charges,,,717.95,83,,percent of total billed charges,,,717.95,83,,percent of total billed charges,,,,,,,,,,,,,,,717.95,83,,percent of total billed charges,,,821.75,95,,percent of total billed charges,,,778.5,90,,percent of total billed charges,,,778.5,90,,percent of total billed charges,,,709.3,82,,percent of total billed charges,,,778.5,90,,percent of total billed charges,,,735.25,85,,percent of total billed charges,,652.21,821.75,
ASSOC 19281 BREAST LOCAL MAMMO SINGLE,30103995,CDM,19281,CPT,401,RC,inpatient,TC,1298,1298,,1102,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,978.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1103.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1142.24,88,,percent of total billed charges,,,,,,,,,991.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1181.18,91,,percent of total billed charges,,,1233.1,95,,percent of total billed charges,,,1077.34,83,,percent of total billed charges,,,1077.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1077.34,83,,percent of total billed charges,,,1233.1,95,,percent of total billed charges,,,1168.2,90,,percent of total billed charges,,,1168.2,90,,percent of total billed charges,,,1064.36,82,,percent of total billed charges,,,1168.2,90,,percent of total billed charges,,,1103.3,85,,percent of total billed charges,,978.69,1233.1,
ASSOC 19282 BREAST LOCAL MAMMO MULTI,30103996,CDM,19282,CPT,401,RC,inpatient,TC,1588,1588,,1348.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1197.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1349.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1397.44,88,,percent of total billed charges,,,,,,,,,1213.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1445.08,91,,percent of total billed charges,,,1508.6,95,,percent of total billed charges,,,1318.04,83,,percent of total billed charges,,,1318.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1318.04,83,,percent of total billed charges,,,1508.6,95,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1302.16,82,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1349.8,85,,percent of total billed charges,,1197.35,1508.6,
* MA DIAG BIL (V306),30104000,CDM,76091,CPT,401,RC,inpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,171.16,215.65,
* MA SCREEN RT (V306),30104018,CDM,76092,CPT,403,RC,inpatient,52,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,93.5,117.8,
* MA SCREEN LT (V306),30104019,CDM,76092,CPT,403,RC,inpatient,52,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,93.5,117.8,
* MA DIAG LT (V306),30104020,CDM,76090,CPT,401,RC,inpatient,,188,188,,159.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,159.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,165.44,88,,percent of total billed charges,,,,,,,,,143.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.08,91,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,,,,,,,,,,,,,156.04,83,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,154.16,82,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,141.75,178.6,
* MA DIAG RT (V306),30104021,CDM,76090,CPT,401,RC,inpatient,,188,188,,159.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,159.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,165.44,88,,percent of total billed charges,,,,,,,,,143.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.08,91,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,,,,,,,,,,,,,156.04,83,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,154.16,82,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,141.75,178.6,
MM DX MAMMO BIL INCL CAD,30104022,CDM,77066,CPT,401,RC,inpatient,TC,1463,1463,,1242.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1103.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1243.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1287.44,88,,percent of total billed charges,,,,,,,,,1117.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1331.33,91,,percent of total billed charges,,,1389.85,95,,percent of total billed charges,,,1214.29,83,,percent of total billed charges,,,1214.29,83,,percent of total billed charges,,,,,,,,,,,,,,,1214.29,83,,percent of total billed charges,,,1389.85,95,,percent of total billed charges,,,1316.7,90,,percent of total billed charges,,,1316.7,90,,percent of total billed charges,,,1199.66,82,,percent of total billed charges,,,1316.7,90,,percent of total billed charges,,,1243.55,85,,percent of total billed charges,,1103.1,1389.85,
MM DX MAMMO LEFT INCL CAD,30104023,CDM,77065,CPT,401,RC,inpatient,TC,1179,1179,,1000.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,888.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1002.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1037.52,88,,percent of total billed charges,,,,,,,,,900.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1072.89,91,,percent of total billed charges,,,1120.05,95,,percent of total billed charges,,,978.57,83,,percent of total billed charges,,,978.57,83,,percent of total billed charges,,,,,,,,,,,,,,,978.57,83,,percent of total billed charges,,,1120.05,95,,percent of total billed charges,,,1061.1,90,,percent of total billed charges,,,1061.1,90,,percent of total billed charges,,,966.78,82,,percent of total billed charges,,,1061.1,90,,percent of total billed charges,,,1002.15,85,,percent of total billed charges,,888.97,1120.05,
MM DX MAMMO RIGHT DIGITAL INCL CAD,30104024,CDM,77065,CPT,401,RC,inpatient,TC,1179,1179,,1000.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,888.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1002.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1037.52,88,,percent of total billed charges,,,,,,,,,900.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1072.89,91,,percent of total billed charges,,,1120.05,95,,percent of total billed charges,,,978.57,83,,percent of total billed charges,,,978.57,83,,percent of total billed charges,,,,,,,,,,,,,,,978.57,83,,percent of total billed charges,,,1120.05,95,,percent of total billed charges,,,1061.1,90,,percent of total billed charges,,,1061.1,90,,percent of total billed charges,,,966.78,82,,percent of total billed charges,,,1061.1,90,,percent of total billed charges,,,1002.15,85,,percent of total billed charges,,888.97,1120.05,
MM SCR MAMMO BIL INCL CAD,30104025,CDM,77067,CPT,403,RC,inpatient,TC,1251,1251,,1062.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,943.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1063.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1100.88,88,,percent of total billed charges,,,,,,,,,955.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1138.41,91,,percent of total billed charges,,,1188.45,95,,percent of total billed charges,,,1038.33,83,,percent of total billed charges,,,1038.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1038.33,83,,percent of total billed charges,,,1188.45,95,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1025.82,82,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1063.35,85,,percent of total billed charges,,943.25,1188.45,
MM SCR MAMMO LEFT INCL CAD,30104026,CDM,77067,CPT,403,RC,inpatient,TC,1251,1251,,1062.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,943.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1063.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1100.88,88,,percent of total billed charges,,,,,,,,,955.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1138.41,91,,percent of total billed charges,,,1188.45,95,,percent of total billed charges,,,1038.33,83,,percent of total billed charges,,,1038.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1038.33,83,,percent of total billed charges,,,1188.45,95,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1025.82,82,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1063.35,85,,percent of total billed charges,,943.25,1188.45,
MM SCR MAMMO RIGHT INCL CAD,30104027,CDM,77067,CPT,403,RC,inpatient,TC,1251,1251,,1062.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,943.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1063.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1100.88,88,,percent of total billed charges,,,,,,,,,955.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1138.41,91,,percent of total billed charges,,,1188.45,95,,percent of total billed charges,,,1038.33,83,,percent of total billed charges,,,1038.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1038.33,83,,percent of total billed charges,,,1188.45,95,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1025.82,82,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1063.35,85,,percent of total billed charges,,943.25,1188.45,
* MA SCREEN CAD ( V0107),30104028,CDM,77052,CPT,403,RC,inpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,65.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,65.6,82.65,
*   MA DIAG ICAD(V0107),30104029,CDM,77051,CPT,401,RC,inpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,65.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,65.6,82.65,
MM SCREEN ICAD(V 01-18),30104030,CDM,77067,CPT,403,RC,inpatient,TC,114,114,,96.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,100.32,88,,percent of total billed charges,,,,,,,,,87.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,103.74,91,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,,,,,,,,,,,,,94.62,83,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,93.48,82,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,96.9,85,,percent of total billed charges,,85.96,108.3,
MM DIAG ICAD(V 01-18),30104031,CDM,77065,CPT,401,RC,inpatient,TC,90,90,,76.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,76.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.2,88,,percent of total billed charges,,,,,,,,,68.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,73.8,82,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,67.86,85.5,
MM POST BX DIAG MAMMO LEFT,30104032,CDM,77065,CPT,401,RC,inpatient,LT,624,624,,529.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,470.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,530.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,549.12,88,,percent of total billed charges,,,,,,,,,476.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,567.84,91,,percent of total billed charges,,,592.8,95,,percent of total billed charges,,,517.92,83,,percent of total billed charges,,,517.92,83,,percent of total billed charges,,,,,,,,,,,,,,,517.92,83,,percent of total billed charges,,,592.8,95,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,511.68,82,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,530.4,85,,percent of total billed charges,,470.5,592.8,
MM POST BX DIAG MAMMO RIGHT,30104033,CDM,77065,CPT,401,RC,inpatient,RT,624,624,,529.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,470.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,530.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,549.12,88,,percent of total billed charges,,,,,,,,,476.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,567.84,91,,percent of total billed charges,,,592.8,95,,percent of total billed charges,,,517.92,83,,percent of total billed charges,,,517.92,83,,percent of total billed charges,,,,,,,,,,,,,,,517.92,83,,percent of total billed charges,,,592.8,95,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,511.68,82,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,530.4,85,,percent of total billed charges,,470.5,592.8,
DNU,3100058,CDM,73223,CPT,610,RC,inpatient,,4543,4543,,3857.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3425.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3861.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3997.84,88,,percent of total billed charges,,,,,,,,,3470.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4134.13,91,,percent of total billed charges,,,4315.85,95,,percent of total billed charges,,,3770.69,83,,percent of total billed charges,,,3770.69,83,,percent of total billed charges,,,,,,,,,,,,,,,3770.69,83,,percent of total billed charges,,,4315.85,95,,percent of total billed charges,,,4088.7,90,,percent of total billed charges,,,4088.7,90,,percent of total billed charges,,,3725.26,82,,percent of total billed charges,,,4088.7,90,,percent of total billed charges,,,3861.55,85,,percent of total billed charges,,3425.42,4315.85,
MR 3D RENDERING,31100000,CDM,76376,CPT,610,RC,inpatient,TC,1723,1723,,1462.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1299.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1464.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1516.24,88,,percent of total billed charges,,,,,,,,,1316.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1567.93,91,,percent of total billed charges,,,1636.85,95,,percent of total billed charges,,,1430.09,83,,percent of total billed charges,,,1430.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1430.09,83,,percent of total billed charges,,,1636.85,95,,percent of total billed charges,,,1550.7,90,,percent of total billed charges,,,1550.7,90,,percent of total billed charges,,,1412.86,82,,percent of total billed charges,,,1550.7,90,,percent of total billed charges,,,1464.55,85,,percent of total billed charges,,1299.14,1636.85,
MR NDL PLACE/BX OR ASP,31100003,CDM,77021,CPT,610,RC,inpatient,TC,3962,3962,,3363.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2987.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3367.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3486.56,88,,percent of total billed charges,,,,,,,,,3026.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3605.42,91,,percent of total billed charges,,,3763.9,95,,percent of total billed charges,,,3288.46,83,,percent of total billed charges,,,3288.46,83,,percent of total billed charges,,,,,,,,,,,,,,,3288.46,83,,percent of total billed charges,,,3763.9,95,,percent of total billed charges,,,3565.8,90,,percent of total billed charges,,,3565.8,90,,percent of total billed charges,,,3248.84,82,,percent of total billed charges,,,3565.8,90,,percent of total billed charges,,,3367.7,85,,percent of total billed charges,,2987.35,3763.9,
MRA HEAD W/O+REPROC,31100010,CDM,70544,CPT,611,RC,inpatient,TC,4911,4911,,4169.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3702.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4174.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4321.68,88,,percent of total billed charges,,,,,,,,,3752,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4469.01,91,,percent of total billed charges,,,4665.45,95,,percent of total billed charges,,,4076.13,83,,percent of total billed charges,,,4076.13,83,,percent of total billed charges,,,,,,,,,,,,,,,4076.13,83,,percent of total billed charges,,,4665.45,95,,percent of total billed charges,,,4419.9,90,,percent of total billed charges,,,4419.9,90,,percent of total billed charges,,,4027.02,82,,percent of total billed charges,,,4419.9,90,,percent of total billed charges,,,4174.35,85,,percent of total billed charges,,3702.89,4665.45,
MRA HEAD W + WO REPROC,31100011,CDM,70546,CPT,611,RC,inpatient,,5987,5987,,5082.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4514.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5088.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5268.56,88,,percent of total billed charges,,,,,,,,,4574.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5448.17,91,,percent of total billed charges,,,5687.65,95,,percent of total billed charges,,,4969.21,83,,percent of total billed charges,,,4969.21,83,,percent of total billed charges,,,,,,,,,,,,,,,4969.21,83,,percent of total billed charges,,,5687.65,95,,percent of total billed charges,,,5388.3,90,,percent of total billed charges,,,5388.3,90,,percent of total billed charges,,,4909.34,82,,percent of total billed charges,,,5388.3,90,,percent of total billed charges,,,5088.95,85,,percent of total billed charges,,4514.2,5687.65,
MRA NECK W +REPROC,31100015,CDM,70548,CPT,610,RC,inpatient,,5292,5292,,4492.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3990.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4498.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4656.96,88,,percent of total billed charges,,,,,,,,,4043.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4815.72,91,,percent of total billed charges,,,5027.4,95,,percent of total billed charges,,,4392.36,83,,percent of total billed charges,,,4392.36,83,,percent of total billed charges,,,,,,,,,,,,,,,4392.36,83,,percent of total billed charges,,,5027.4,95,,percent of total billed charges,,,4762.8,90,,percent of total billed charges,,,4762.8,90,,percent of total billed charges,,,4339.44,82,,percent of total billed charges,,,4762.8,90,,percent of total billed charges,,,4498.2,85,,percent of total billed charges,,3990.17,5027.4,
MRA NECK W/WO + REPROC,31100016,CDM,70549,CPT,610,RC,inpatient,,6502,6502,,5520.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4902.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5526.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5721.76,88,,percent of total billed charges,,,,,,,,,4967.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5916.82,91,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,,,,,,,,,,,,,5396.66,83,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5331.64,82,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,4902.51,6176.9,
MR BRAIN W/O,31100020,CDM,70551,CPT,611,RC,inpatient,TC,5262,5262,,4467.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3967.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4472.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4630.56,88,,percent of total billed charges,,,,,,,,,4020.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4788.42,91,,percent of total billed charges,,,4998.9,95,,percent of total billed charges,,,4367.46,83,,percent of total billed charges,,,4367.46,83,,percent of total billed charges,,,,,,,,,,,,,,,4367.46,83,,percent of total billed charges,,,4998.9,95,,percent of total billed charges,,,4735.8,90,,percent of total billed charges,,,4735.8,90,,percent of total billed charges,,,4314.84,82,,percent of total billed charges,,,4735.8,90,,percent of total billed charges,,,4472.7,85,,percent of total billed charges,,3967.55,4998.9,
MR NECK W/O,31100025,CDM,70540,CPT,610,RC,inpatient,TC,5048,5048,,4285.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3806.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4290.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4442.24,88,,percent of total billed charges,,,,,,,,,3856.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4593.68,91,,percent of total billed charges,,,4795.6,95,,percent of total billed charges,,,4189.84,83,,percent of total billed charges,,,4189.84,83,,percent of total billed charges,,,,,,,,,,,,,,,4189.84,83,,percent of total billed charges,,,4795.6,95,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4139.36,82,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4290.8,85,,percent of total billed charges,,3806.19,4795.6,
MR NECK W/,31100026,CDM,70542,CPT,610,RC,inpatient,,5671,5671,,4814.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4275.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4820.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4990.48,88,,percent of total billed charges,,,,,,,,,4332.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5160.61,91,,percent of total billed charges,,,5387.45,95,,percent of total billed charges,,,4706.93,83,,percent of total billed charges,,,4706.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4706.93,83,,percent of total billed charges,,,5387.45,95,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,4650.22,82,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,4820.35,85,,percent of total billed charges,,4275.93,5387.45,
MR NECK W/WO,31100027,CDM,70543,CPT,610,RC,inpatient,TC,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5807.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6546.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,5807.31,7316.9,
MR ORBIT W/,31100028,CDM,70542,CPT,610,RC,inpatient,,5190,5190,,4406.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3913.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4411.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4567.2,88,,percent of total billed charges,,,,,,,,,3965.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4722.9,91,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,,,,,,,,,,,,,4307.7,83,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4255.8,82,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4411.5,85,,percent of total billed charges,,3913.26,4930.5,
MR ORBIT W/WO,31100029,CDM,70543,CPT,610,RC,inpatient,TC,5952,5952,,5053.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4487.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5059.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5237.76,88,,percent of total billed charges,,,,,,,,,4547.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5416.32,91,,percent of total billed charges,,,5654.4,95,,percent of total billed charges,,,4940.16,83,,percent of total billed charges,,,4940.16,83,,percent of total billed charges,,,,,,,,,,,,,,,4940.16,83,,percent of total billed charges,,,5654.4,95,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,4880.64,82,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,5059.2,85,,percent of total billed charges,,4487.81,5654.4,
MR ORBIT W/O,31100030,CDM,70540,CPT,610,RC,inpatient,TC,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3420.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3855.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,3420.14,4309.2,
MR FACE W/O,31100035,CDM,70540,CPT,610,RC,inpatient,TC,5048,5048,,4285.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3806.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4290.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4442.24,88,,percent of total billed charges,,,,,,,,,3856.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4593.68,91,,percent of total billed charges,,,4795.6,95,,percent of total billed charges,,,4189.84,83,,percent of total billed charges,,,4189.84,83,,percent of total billed charges,,,,,,,,,,,,,,,4189.84,83,,percent of total billed charges,,,4795.6,95,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4139.36,82,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4290.8,85,,percent of total billed charges,,3806.19,4795.6,
MR FACE W/,31100036,CDM,70542,CPT,610,RC,inpatient,,5671,5671,,4814.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4275.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4820.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4990.48,88,,percent of total billed charges,,,,,,,,,4332.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5160.61,91,,percent of total billed charges,,,5387.45,95,,percent of total billed charges,,,4706.93,83,,percent of total billed charges,,,4706.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4706.93,83,,percent of total billed charges,,,5387.45,95,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,4650.22,82,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,4820.35,85,,percent of total billed charges,,4275.93,5387.45,
MR FACE W/WO,31100037,CDM,70543,CPT,610,RC,inpatient,TC,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5807.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6546.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,5807.31,7316.9,
MRA NECK WO + REPROC,31100040,CDM,70547,CPT,610,RC,inpatient,TC,4808,4808,,4081.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3625.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4086.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4231.04,88,,percent of total billed charges,,,,,,,,,3673.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4375.28,91,,percent of total billed charges,,,4567.6,95,,percent of total billed charges,,,3990.64,83,,percent of total billed charges,,,3990.64,83,,percent of total billed charges,,,,,,,,,,,,,,,3990.64,83,,percent of total billed charges,,,4567.6,95,,percent of total billed charges,,,4327.2,90,,percent of total billed charges,,,4327.2,90,,percent of total billed charges,,,3942.56,82,,percent of total billed charges,,,4327.2,90,,percent of total billed charges,,,4086.8,85,,percent of total billed charges,,3625.23,4567.6,
MRA HEAD W + REPROC,31100045,CDM,70545,CPT,611,RC,inpatient,,5443,5443,,4621.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4104.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4626.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4789.84,88,,percent of total billed charges,,,,,,,,,4158.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4953.13,91,,percent of total billed charges,,,5170.85,95,,percent of total billed charges,,,4517.69,83,,percent of total billed charges,,,4517.69,83,,percent of total billed charges,,,,,,,,,,,,,,,4517.69,83,,percent of total billed charges,,,5170.85,95,,percent of total billed charges,,,4898.7,90,,percent of total billed charges,,,4898.7,90,,percent of total billed charges,,,4463.26,82,,percent of total billed charges,,,4898.7,90,,percent of total billed charges,,,4626.55,85,,percent of total billed charges,,4104.02,5170.85,
MRV HEAD W + REPROC,31100046,CDM,70545,CPT,611,RC,inpatient,TC,5443,5443,,4621.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4104.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4626.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4789.84,88,,percent of total billed charges,,,,,,,,,4158.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4953.13,91,,percent of total billed charges,,,5170.85,95,,percent of total billed charges,,,4517.69,83,,percent of total billed charges,,,4517.69,83,,percent of total billed charges,,,,,,,,,,,,,,,4517.69,83,,percent of total billed charges,,,5170.85,95,,percent of total billed charges,,,4898.7,90,,percent of total billed charges,,,4898.7,90,,percent of total billed charges,,,4463.26,82,,percent of total billed charges,,,4898.7,90,,percent of total billed charges,,,4626.55,85,,percent of total billed charges,,4104.02,5170.85,
MRV HEAD W + WO REPROC,31100047,CDM,70546,CPT,611,RC,inpatient,TC,5987,5987,,5082.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4514.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5088.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5268.56,88,,percent of total billed charges,,,,,,,,,4574.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5448.17,91,,percent of total billed charges,,,5687.65,95,,percent of total billed charges,,,4969.21,83,,percent of total billed charges,,,4969.21,83,,percent of total billed charges,,,,,,,,,,,,,,,4969.21,83,,percent of total billed charges,,,5687.65,95,,percent of total billed charges,,,5388.3,90,,percent of total billed charges,,,5388.3,90,,percent of total billed charges,,,4909.34,82,,percent of total billed charges,,,5388.3,90,,percent of total billed charges,,,5088.95,85,,percent of total billed charges,,4514.2,5687.65,
MR BRAIN W/WO,31100050,CDM,70553,CPT,611,RC,inpatient,TC,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5807.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6546.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,5807.31,7316.9,
MR IAC AND BRAIN W/,31100051,CDM,70542,CPT,610,RC,inpatient,TC,5671,5671,,4814.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4275.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4820.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4990.48,88,,percent of total billed charges,,,,,,,,,4332.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5160.61,91,,percent of total billed charges,,,5387.45,95,,percent of total billed charges,,,4706.93,83,,percent of total billed charges,,,4706.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4706.93,83,,percent of total billed charges,,,5387.45,95,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,4650.22,82,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,4820.35,85,,percent of total billed charges,,4275.93,5387.45,
MR IAC AND BRAIN W/WO,31100052,CDM,70553,CPT,610,RC,inpatient,TC,8704,8704,,7389.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6562.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7398.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7659.52,88,,percent of total billed charges,,,,,,,,,6649.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7920.64,91,,percent of total billed charges,,,8268.8,95,,percent of total billed charges,,,7224.32,83,,percent of total billed charges,,,7224.32,83,,percent of total billed charges,,,,,,,,,,,,,,,7224.32,83,,percent of total billed charges,,,8268.8,95,,percent of total billed charges,,,7833.6,90,,percent of total billed charges,,,7833.6,90,,percent of total billed charges,,,7137.28,82,,percent of total billed charges,,,7833.6,90,,percent of total billed charges,,,7398.4,85,,percent of total billed charges,,6562.82,8268.8,
MR IAC AND BRAIN W/O,31100053,CDM,70540,CPT,610,RC,inpatient,TC,5048,5048,,4285.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3806.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4290.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4442.24,88,,percent of total billed charges,,,,,,,,,3856.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4593.68,91,,percent of total billed charges,,,4795.6,95,,percent of total billed charges,,,4189.84,83,,percent of total billed charges,,,4189.84,83,,percent of total billed charges,,,,,,,,,,,,,,,4189.84,83,,percent of total billed charges,,,4795.6,95,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4139.36,82,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4290.8,85,,percent of total billed charges,,3806.19,4795.6,
MR IAC W/WO,31100054,CDM,70543,CPT,610,RC,inpatient,TC,6043,6043,,5130.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4556.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5136.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5317.84,88,,percent of total billed charges,,,,,,,,,4616.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5499.13,91,,percent of total billed charges,,,5740.85,95,,percent of total billed charges,,,5015.69,83,,percent of total billed charges,,,5015.69,83,,percent of total billed charges,,,,,,,,,,,,,,,5015.69,83,,percent of total billed charges,,,5740.85,95,,percent of total billed charges,,,5438.7,90,,percent of total billed charges,,,5438.7,90,,percent of total billed charges,,,4955.26,82,,percent of total billed charges,,,5438.7,90,,percent of total billed charges,,,5136.55,85,,percent of total billed charges,,4556.42,5740.85,
MR CHEST W/O,31100055,CDM,71550,CPT,610,RC,inpatient,TC,5174,5174,,4392.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3901.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4397.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4553.12,88,,percent of total billed charges,,,,,,,,,3952.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4708.34,91,,percent of total billed charges,,,4915.3,95,,percent of total billed charges,,,4294.42,83,,percent of total billed charges,,,4294.42,83,,percent of total billed charges,,,,,,,,,,,,,,,4294.42,83,,percent of total billed charges,,,4915.3,95,,percent of total billed charges,,,4656.6,90,,percent of total billed charges,,,4656.6,90,,percent of total billed charges,,,4242.68,82,,percent of total billed charges,,,4656.6,90,,percent of total billed charges,,,4397.9,85,,percent of total billed charges,,3901.2,4915.3,
MR CHEST W/WO,31100056,CDM,71552,CPT,610,RC,inpatient,TC,5844,5844,,4961.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4406.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4967.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5142.72,88,,percent of total billed charges,,,,,,,,,4464.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5318.04,91,,percent of total billed charges,,,5551.8,95,,percent of total billed charges,,,4850.52,83,,percent of total billed charges,,,4850.52,83,,percent of total billed charges,,,,,,,,,,,,,,,4850.52,83,,percent of total billed charges,,,5551.8,95,,percent of total billed charges,,,5259.6,90,,percent of total billed charges,,,5259.6,90,,percent of total billed charges,,,4792.08,82,,percent of total billed charges,,,5259.6,90,,percent of total billed charges,,,4967.4,85,,percent of total billed charges,,4406.38,5551.8,
MR U EXT JOINT RIGHT W/WO (V 05-17),31100058,CDM,73223,CPT,610,RC,inpatient,RT,6144,6144,,5216.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4632.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5222.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5406.72,88,,percent of total billed charges,,,,,,,,,4694.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5591.04,91,,percent of total billed charges,,,5836.8,95,,percent of total billed charges,,,5099.52,83,,percent of total billed charges,,,5099.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5099.52,83,,percent of total billed charges,,,5836.8,95,,percent of total billed charges,,,5529.6,90,,percent of total billed charges,,,5529.6,90,,percent of total billed charges,,,5038.08,82,,percent of total billed charges,,,5529.6,90,,percent of total billed charges,,,5222.4,85,,percent of total billed charges,,4632.58,5836.8,
MR UP EXT JOINT RIGHT  W/O (V 05-17),31100059,CDM,73221,CPT,610,RC,inpatient,RT,5331,5331,,4526.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4019.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4531.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4691.28,88,,percent of total billed charges,,,,,,,,,4072.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4851.21,91,,percent of total billed charges,,,5064.45,95,,percent of total billed charges,,,4424.73,83,,percent of total billed charges,,,4424.73,83,,percent of total billed charges,,,,,,,,,,,,,,,4424.73,83,,percent of total billed charges,,,5064.45,95,,percent of total billed charges,,,4797.9,90,,percent of total billed charges,,,4797.9,90,,percent of total billed charges,,,4371.42,82,,percent of total billed charges,,,4797.9,90,,percent of total billed charges,,,4531.35,85,,percent of total billed charges,,4019.57,5064.45,
MR BRAIN W/,31100060,CDM,70552,CPT,611,RC,inpatient,TC,5903,5903,,5011.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4450.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5017.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5194.64,88,,percent of total billed charges,,,,,,,,,4509.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5371.73,91,,percent of total billed charges,,,5607.85,95,,percent of total billed charges,,,4899.49,83,,percent of total billed charges,,,4899.49,83,,percent of total billed charges,,,,,,,,,,,,,,,4899.49,83,,percent of total billed charges,,,5607.85,95,,percent of total billed charges,,,5312.7,90,,percent of total billed charges,,,5312.7,90,,percent of total billed charges,,,4840.46,82,,percent of total billed charges,,,5312.7,90,,percent of total billed charges,,,5017.55,85,,percent of total billed charges,,4450.86,5607.85,
* MRA CHEST W/WO & REPROCESSING (V306),31100066,CDM,C8911,HCPCS,610,RC,inpatient,,3224,3224,,2737.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2430.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2740.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2837.12,88,,percent of total billed charges,,,,,,,,,2463.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2675.92,83,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2643.68,82,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,2430.9,3062.8,
MR ABDOMEN W/O,31100075,CDM,74181,CPT,610,RC,inpatient,TC,5200,5200,,4414.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3920.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4420,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4576,88,,percent of total billed charges,,,,,,,,,3972.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4732,91,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,,,,,,,,,,,,,4316,83,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4264,82,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4420,85,,percent of total billed charges,,3920.8,4940,
MR ABDOMEN W/,31100076,CDM,74182,CPT,610,RC,inpatient,TC,5843,5843,,4960.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4405.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4966.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5141.84,88,,percent of total billed charges,,,,,,,,,4464.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5317.13,91,,percent of total billed charges,,,5550.85,95,,percent of total billed charges,,,4849.69,83,,percent of total billed charges,,,4849.69,83,,percent of total billed charges,,,,,,,,,,,,,,,4849.69,83,,percent of total billed charges,,,5550.85,95,,percent of total billed charges,,,5258.7,90,,percent of total billed charges,,,5258.7,90,,percent of total billed charges,,,4791.26,82,,percent of total billed charges,,,5258.7,90,,percent of total billed charges,,,4966.55,85,,percent of total billed charges,,4405.62,5550.85,
MR ABDOMEN W/WO,31100077,CDM,74183,CPT,610,RC,inpatient,TC,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5807.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6546.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,5807.31,7316.9,
MR MRCP,31100078,CDM,74181,CPT,610,RC,inpatient,TC,4941,4941,,4194.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3725.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4199.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4348.08,88,,percent of total billed charges,,,,,,,,,3774.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4496.31,91,,percent of total billed charges,,,4693.95,95,,percent of total billed charges,,,4101.03,83,,percent of total billed charges,,,4101.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4101.03,83,,percent of total billed charges,,,4693.95,95,,percent of total billed charges,,,4446.9,90,,percent of total billed charges,,,4446.9,90,,percent of total billed charges,,,4051.62,82,,percent of total billed charges,,,4446.9,90,,percent of total billed charges,,,4199.85,85,,percent of total billed charges,,3725.51,4693.95,
MRA LOWEXTBILW/ORW/O/REPR,31100079,CDM,73725,CPT,610,RC,inpatient,50,9072,9072,,7702.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6840.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7711.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7983.36,88,,percent of total billed charges,,,,,,,,,6931.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8255.52,91,,percent of total billed charges,,,8618.4,95,,percent of total billed charges,,,7529.76,83,,percent of total billed charges,,,7529.76,83,,percent of total billed charges,,,,,,,,,,,,,,,7529.76,83,,percent of total billed charges,,,8618.4,95,,percent of total billed charges,,,8164.8,90,,percent of total billed charges,,,8164.8,90,,percent of total billed charges,,,7439.04,82,,percent of total billed charges,,,8164.8,90,,percent of total billed charges,,,7711.2,85,,percent of total billed charges,,6840.29,8618.4,
MRA LOWEXTLT WORWO/REPROC,31100080,CDM,73725,CPT,610,RC,inpatient,LT,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3420.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3855.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,3420.14,4309.2,
MRA LOWEXTRT W/ORW/O/REPR,31100081,CDM,73725,CPT,610,RC,inpatient,RT,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3420.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3855.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,3420.14,4309.2,
MRA UPPER EXT W/WO CONTRAST,31100082,CDM,73225,CPT,610,RC,inpatient,TC,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3420.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3855.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,3420.14,4309.2,
MRA MRV ABD W/AND/OR W/OREPR,31100085,CDM,74185,CPT,610,RC,inpatient,TC,6250,6250,,5306.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4712.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5312.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5500,88,,percent of total billed charges,,,,,,,,,4775,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5687.5,91,,percent of total billed charges,,,5937.5,95,,percent of total billed charges,,,5187.5,83,,percent of total billed charges,,,5187.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5187.5,83,,percent of total billed charges,,,5937.5,95,,percent of total billed charges,,,5625,90,,percent of total billed charges,,,5625,90,,percent of total billed charges,,,5125,82,,percent of total billed charges,,,5625,90,,percent of total billed charges,,,5312.5,85,,percent of total billed charges,,4712.5,5937.5,
MRA ABD W/O & REPROC,31100090,CDM,74185,CPT,610,RC,inpatient,TC,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3420.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3855.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,3420.14,4309.2,
* DNU MR BONE MARROW(V0107),31100095,CDM,76400,CPT,610,RC,inpatient,,4675,4675,,3969.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3524.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3973.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4114,88,,percent of total billed charges,,,,,,,,,3571.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4254.25,91,,percent of total billed charges,,,4441.25,95,,percent of total billed charges,,,3880.25,83,,percent of total billed charges,,,3880.25,83,,percent of total billed charges,,,,,,,,,,,,,,,3880.25,83,,percent of total billed charges,,,4441.25,95,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,3833.5,82,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,3973.75,85,,percent of total billed charges,,3524.95,4441.25,
MR BONE MARROW,31100096,CDM,77084,CPT,610,RC,inpatient,TC,5190,5190,,4406.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3913.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4411.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4567.2,88,,percent of total billed charges,,,,,,,,,3965.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4722.9,91,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,,,,,,,,,,,,,4307.7,83,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4255.8,82,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4411.5,85,,percent of total billed charges,,3913.26,4930.5,
MR SHOULDER BILAT W/O,31100099,CDM,73221,CPT,610,RC,inpatient,50,10170,10170,,8634.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7668.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8644.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8949.6,88,,percent of total billed charges,,,,,,,,,7769.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9254.7,91,,percent of total billed charges,,,9661.5,95,,percent of total billed charges,,,8441.1,83,,percent of total billed charges,,,8441.1,83,,percent of total billed charges,,,,,,,,,,,,,,,8441.1,83,,percent of total billed charges,,,9661.5,95,,percent of total billed charges,,,9153,90,,percent of total billed charges,,,9153,90,,percent of total billed charges,,,8339.4,82,,percent of total billed charges,,,9153,90,,percent of total billed charges,,,8644.5,85,,percent of total billed charges,,7668.18,9661.5,
MRA LOW EXT LT W/ANDREPROC,31100105,CDM,73725,CPT,610,RC,inpatient,LT,5190,5190,,4406.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3913.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4411.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4567.2,88,,percent of total billed charges,,,,,,,,,3965.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4722.9,91,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,,,,,,,,,,,,,4307.7,83,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4255.8,82,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4411.5,85,,percent of total billed charges,,3913.26,4930.5,
MRA LOW EXT RTW/ANDREPROC,31100106,CDM,73725,CPT,610,RC,inpatient,RT,5190,5190,,4406.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3913.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4411.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4567.2,88,,percent of total billed charges,,,,,,,,,3965.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4722.9,91,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,,,,,,,,,,,,,4307.7,83,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4255.8,82,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4411.5,85,,percent of total billed charges,,3913.26,4930.5,
* MRA LOW EXT LT W/WO & REPROC (V306),31100107,CDM,C8914,HCPCS,610,RC,inpatient,,3224,3224,,2737.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2430.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2740.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2837.12,88,,percent of total billed charges,,,,,,,,,2463.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2675.92,83,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2643.68,82,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,2430.9,3062.8,
* MRA LOW EXTREM RT W/WO & REPROC (V306),31100108,CDM,C8914,HCPCS,610,RC,inpatient,,3224,3224,,2737.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2430.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2740.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2837.12,88,,percent of total billed charges,,,,,,,,,2463.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2675.92,83,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2643.68,82,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,2430.9,3062.8,
* DNU MR JT LOW LT WO (V606),31100110,CDM,73721,CPT,610,RC,inpatient,,2388,2388,,2027.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1800.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2029.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2101.44,88,,percent of total billed charges,,,,,,,,,1824.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2173.08,91,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1982.04,83,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,1958.16,82,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,1800.55,2268.6,
* DNU MR JT LOW RT WO (V606),31100111,CDM,73721,CPT,610,RC,inpatient,,2388,2388,,2027.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1800.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2029.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2101.44,88,,percent of total billed charges,,,,,,,,,1824.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2173.08,91,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1982.04,83,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,1958.16,82,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,1800.55,2268.6,
* MR JT LOW LT W (V606),31100112,CDM,73722,CPT,610,RC,inpatient,,2774,2774,,2355.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2091.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2357.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2441.12,88,,percent of total billed charges,,,,,,,,,2119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2524.34,91,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2302.42,83,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2274.68,82,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,2091.6,2635.3,
* MR JT LOW RT W (V06),31100113,CDM,73722,CPT,610,RC,inpatient,,2774,2774,,2355.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2091.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2357.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2441.12,88,,percent of total billed charges,,,,,,,,,2119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2524.34,91,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2302.42,83,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2274.68,82,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,2091.6,2635.3,
* DNU MR LOW EXT RT WO (V606),31100114,CDM,73718,CPT,610,RC,inpatient,,2388,2388,,2027.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1800.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2029.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2101.44,88,,percent of total billed charges,,,,,,,,,1824.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2173.08,91,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1982.04,83,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,1958.16,82,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,1800.55,2268.6,
* DNU MR LOW EXT LT WO (V606),31100115,CDM,73718,CPT,610,RC,inpatient,,2388,2388,,2027.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1800.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2029.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2101.44,88,,percent of total billed charges,,,,,,,,,1824.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2173.08,91,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1982.04,83,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,1958.16,82,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,1800.55,2268.6,
* MR LOW EXT LT W (V606),31100116,CDM,73719,CPT,610,RC,inpatient,,2774,2774,,2355.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2091.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2357.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2441.12,88,,percent of total billed charges,,,,,,,,,2119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2524.34,91,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2302.42,83,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2274.68,82,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,2091.6,2635.3,
* MR LOW EXT RT W (V606),31100117,CDM,73719,CPT,610,RC,inpatient,,2774,2774,,2355.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2091.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2357.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2441.12,88,,percent of total billed charges,,,,,,,,,2119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2524.34,91,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2302.42,83,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2274.68,82,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,2091.6,2635.3,
* DNU MR LOW EXT LT W/WO (V606),31100118,CDM,73720,CPT,610,RC,inpatient,,3224,3224,,2737.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2430.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2740.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2837.12,88,,percent of total billed charges,,,,,,,,,2463.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2675.92,83,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2643.68,82,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,2430.9,3062.8,
* DNU MR LOW EXT RT W/WO (V606),31100119,CDM,73720,CPT,610,RC,inpatient,,3224,3224,,2737.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2430.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2740.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2837.12,88,,percent of total billed charges,,,,,,,,,2463.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2675.92,83,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2643.68,82,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,2430.9,3062.8,
* MR UP EXT LT W (V606),31100122,CDM,73219,CPT,610,RC,inpatient,,2774,2774,,2355.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2091.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2357.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2441.12,88,,percent of total billed charges,,,,,,,,,2119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2524.34,91,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2302.42,83,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2274.68,82,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,2091.6,2635.3,
* MR UP EXT RT W (V606),31100123,CDM,73219,CPT,610,RC,inpatient,,2774,2774,,2355.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2091.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2357.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2441.12,88,,percent of total billed charges,,,,,,,,,2119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2524.34,91,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2302.42,83,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2274.68,82,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,2091.6,2635.3,
* DNU MR UP EXT LT W/WO (V606),31100124,CDM,73220,CPT,610,RC,inpatient,,3224,3224,,2737.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2430.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2740.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2837.12,88,,percent of total billed charges,,,,,,,,,2463.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2675.92,83,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2643.68,82,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,2430.9,3062.8,
* MR UP EXT LT WO (V606),31100125,CDM,73218,CPT,610,RC,inpatient,,2388,2388,,2027.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1800.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2029.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2101.44,88,,percent of total billed charges,,,,,,,,,1824.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2173.08,91,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1982.04,83,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,1958.16,82,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,1800.55,2268.6,
* DNU MR UP EXT RT W/WO (V606),31100126,CDM,73220,CPT,610,RC,inpatient,,3224,3224,,2737.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2430.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2740.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2837.12,88,,percent of total billed charges,,,,,,,,,2463.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2675.92,83,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2643.68,82,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,2430.9,3062.8,
* MR UP EXT RT WO (V606),31100127,CDM,73218,CPT,610,RC,inpatient,,2388,2388,,2027.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1800.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2029.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2101.44,88,,percent of total billed charges,,,,,,,,,1824.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2173.08,91,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1982.04,83,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,1958.16,82,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,1800.55,2268.6,
* DNU MR JT UP LT W (V806),31100134,CDM,73222,CPT,610,RC,inpatient,,4675,4675,,3969.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3524.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3973.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4114,88,,percent of total billed charges,,,,,,,,,3571.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4254.25,91,,percent of total billed charges,,,4441.25,95,,percent of total billed charges,,,3880.25,83,,percent of total billed charges,,,3880.25,83,,percent of total billed charges,,,,,,,,,,,,,,,3880.25,83,,percent of total billed charges,,,4441.25,95,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,3833.5,82,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,3973.75,85,,percent of total billed charges,,3524.95,4441.25,
* DNU MR JT UP LT WO (V806),31100135,CDM,73221,CPT,610,RC,inpatient,,4020,4020,,3412.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3031.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3417,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3537.6,88,,percent of total billed charges,,,,,,,,,3071.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3658.2,91,,percent of total billed charges,,,3819,95,,percent of total billed charges,,,3336.6,83,,percent of total billed charges,,,3336.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3336.6,83,,percent of total billed charges,,,3819,95,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3296.4,82,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3417,85,,percent of total billed charges,,3031.08,3819,
* DNU MR JT UP RT W (V806),31100136,CDM,73222,CPT,610,RC,inpatient,,4675,4675,,3969.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3524.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3973.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4114,88,,percent of total billed charges,,,,,,,,,3571.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4254.25,91,,percent of total billed charges,,,4441.25,95,,percent of total billed charges,,,3880.25,83,,percent of total billed charges,,,3880.25,83,,percent of total billed charges,,,,,,,,,,,,,,,3880.25,83,,percent of total billed charges,,,4441.25,95,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,3833.5,82,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,3973.75,85,,percent of total billed charges,,3524.95,4441.25,
* DNU MR JT UP LT W/WO (V806),31100137,CDM,73223,CPT,610,RC,inpatient,,5435,5435,,4614.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4097.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4619.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4782.8,88,,percent of total billed charges,,,,,,,,,4152.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4945.85,91,,percent of total billed charges,,,5163.25,95,,percent of total billed charges,,,4511.05,83,,percent of total billed charges,,,4511.05,83,,percent of total billed charges,,,,,,,,,,,,,,,4511.05,83,,percent of total billed charges,,,5163.25,95,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4456.7,82,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4619.75,85,,percent of total billed charges,,4097.99,5163.25,
* DNU MR JT UP RT W/WO,31100138,CDM,73223,CPT,610,RC,inpatient,,5435,5435,,4614.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4097.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4619.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4782.8,88,,percent of total billed charges,,,,,,,,,4152.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4945.85,91,,percent of total billed charges,,,5163.25,95,,percent of total billed charges,,,4511.05,83,,percent of total billed charges,,,4511.05,83,,percent of total billed charges,,,,,,,,,,,,,,,4511.05,83,,percent of total billed charges,,,5163.25,95,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4456.7,82,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4619.75,85,,percent of total billed charges,,4097.99,5163.25,
* DNU MR JT UP RT WO,31100139,CDM,73221,CPT,610,RC,inpatient,,4020,4020,,3412.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3031.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3417,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3537.6,88,,percent of total billed charges,,,,,,,,,3071.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3658.2,91,,percent of total billed charges,,,3819,95,,percent of total billed charges,,,3336.6,83,,percent of total billed charges,,,3336.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3336.6,83,,percent of total billed charges,,,3819,95,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3296.4,82,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3417,85,,percent of total billed charges,,3031.08,3819,
MRA PELV W/ ANDREPROC,31100140,CDM,72198,CPT,610,RC,inpatient,TC,5190,5190,,4406.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3913.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4411.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4567.2,88,,percent of total billed charges,,,,,,,,,3965.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4722.9,91,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,,,,,,,,,,,,,4307.7,83,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4255.8,82,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4411.5,85,,percent of total billed charges,,3913.26,4930.5,
MRA PELV W/O AND REPROC,31100145,CDM,72198,CPT,610,RC,inpatient,TC,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3420.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3855.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,3420.14,4309.2,
MRA PELV W/WO AND REPROC,31100146,CDM,72198,CPT,610,RC,inpatient,TC,5952,5952,,5053.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4487.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5059.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5237.76,88,,percent of total billed charges,,,,,,,,,4547.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5416.32,91,,percent of total billed charges,,,5654.4,95,,percent of total billed charges,,,4940.16,83,,percent of total billed charges,,,4940.16,83,,percent of total billed charges,,,,,,,,,,,,,,,4940.16,83,,percent of total billed charges,,,5654.4,95,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,4880.64,82,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,5059.2,85,,percent of total billed charges,,4487.81,5654.4,
MR PELVIS W/O,31100150,CDM,72195,CPT,610,RC,inpatient,TC,5077,5077,,4310.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3828.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4315.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4467.76,88,,percent of total billed charges,,,,,,,,,3878.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4620.07,91,,percent of total billed charges,,,4823.15,95,,percent of total billed charges,,,4213.91,83,,percent of total billed charges,,,4213.91,83,,percent of total billed charges,,,,,,,,,,,,,,,4213.91,83,,percent of total billed charges,,,4823.15,95,,percent of total billed charges,,,4569.3,90,,percent of total billed charges,,,4569.3,90,,percent of total billed charges,,,4163.14,82,,percent of total billed charges,,,4569.3,90,,percent of total billed charges,,,4315.45,85,,percent of total billed charges,,3828.06,4823.15,
MR PELVIS W/,31100151,CDM,72196,CPT,610,RC,inpatient,TC,5726,5726,,4861.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4317.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4867.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5038.88,88,,percent of total billed charges,,,,,,,,,4374.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5210.66,91,,percent of total billed charges,,,5439.7,95,,percent of total billed charges,,,4752.58,83,,percent of total billed charges,,,4752.58,83,,percent of total billed charges,,,,,,,,,,,,,,,4752.58,83,,percent of total billed charges,,,5439.7,95,,percent of total billed charges,,,5153.4,90,,percent of total billed charges,,,5153.4,90,,percent of total billed charges,,,4695.32,82,,percent of total billed charges,,,5153.4,90,,percent of total billed charges,,,4867.1,85,,percent of total billed charges,,4317.4,5439.7,
MR PELVIS W/WO,31100152,CDM,72197,CPT,610,RC,inpatient,TC,6864,6864,,5827.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5175.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5834.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6040.32,88,,percent of total billed charges,,,,,,,,,5244.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6246.24,91,,percent of total billed charges,,,6520.8,95,,percent of total billed charges,,,5697.12,83,,percent of total billed charges,,,5697.12,83,,percent of total billed charges,,,,,,,,,,,,,,,5697.12,83,,percent of total billed charges,,,6520.8,95,,percent of total billed charges,,,6177.6,90,,percent of total billed charges,,,6177.6,90,,percent of total billed charges,,,5628.48,82,,percent of total billed charges,,,6177.6,90,,percent of total billed charges,,,5834.4,85,,percent of total billed charges,,5175.46,6520.8,
MR C SPINE W/O,31100155,CDM,72141,CPT,612,RC,inpatient,TC,5602,5602,,4756.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4223.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4761.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4929.76,88,,percent of total billed charges,,,,,,,,,4279.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5097.82,91,,percent of total billed charges,,,5321.9,95,,percent of total billed charges,,,4649.66,83,,percent of total billed charges,,,4649.66,83,,percent of total billed charges,,,,,,,,,,,,,,,4649.66,83,,percent of total billed charges,,,5321.9,95,,percent of total billed charges,,,5041.8,90,,percent of total billed charges,,,5041.8,90,,percent of total billed charges,,,4593.64,82,,percent of total billed charges,,,5041.8,90,,percent of total billed charges,,,4761.7,85,,percent of total billed charges,,4223.91,5321.9,
MR C SPINE W/,31100160,CDM,72142,CPT,612,RC,inpatient,TC,5802,5802,,4925.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4374.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4931.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5105.76,88,,percent of total billed charges,,,,,,,,,4432.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5279.82,91,,percent of total billed charges,,,5511.9,95,,percent of total billed charges,,,4815.66,83,,percent of total billed charges,,,4815.66,83,,percent of total billed charges,,,,,,,,,,,,,,,4815.66,83,,percent of total billed charges,,,5511.9,95,,percent of total billed charges,,,5221.8,90,,percent of total billed charges,,,5221.8,90,,percent of total billed charges,,,4757.64,82,,percent of total billed charges,,,5221.8,90,,percent of total billed charges,,,4931.7,85,,percent of total billed charges,,4374.71,5511.9,
MR C SPINE W/WO,31100165,CDM,72156,CPT,612,RC,inpatient,TC,7434,7434,,6311.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5605.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6318.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6541.92,88,,percent of total billed charges,,,,,,,,,5679.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6764.94,91,,percent of total billed charges,,,7062.3,95,,percent of total billed charges,,,6170.22,83,,percent of total billed charges,,,6170.22,83,,percent of total billed charges,,,,,,,,,,,,,,,6170.22,83,,percent of total billed charges,,,7062.3,95,,percent of total billed charges,,,6690.6,90,,percent of total billed charges,,,6690.6,90,,percent of total billed charges,,,6095.88,82,,percent of total billed charges,,,6690.6,90,,percent of total billed charges,,,6318.9,85,,percent of total billed charges,,5605.24,7062.3,
MRA C SPINE WO + REPROC,31100175,CDM,72159,CPT,612,RC,inpatient,,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3420.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3855.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,3420.14,4309.2,
MR L SPINE W/,31100180,CDM,72149,CPT,612,RC,inpatient,TC,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4426.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4990.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,4426.73,5577.45,
MR L SPINE W/O,31100185,CDM,72148,CPT,612,RC,inpatient,TC,5602,5602,,4756.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4223.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4761.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4929.76,88,,percent of total billed charges,,,,,,,,,4279.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5097.82,91,,percent of total billed charges,,,5321.9,95,,percent of total billed charges,,,4649.66,83,,percent of total billed charges,,,4649.66,83,,percent of total billed charges,,,,,,,,,,,,,,,4649.66,83,,percent of total billed charges,,,5321.9,95,,percent of total billed charges,,,5041.8,90,,percent of total billed charges,,,5041.8,90,,percent of total billed charges,,,4593.64,82,,percent of total billed charges,,,5041.8,90,,percent of total billed charges,,,4761.7,85,,percent of total billed charges,,4223.91,5321.9,
MR L SPINE W/WO,31100190,CDM,72158,CPT,612,RC,inpatient,TC,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5807.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6546.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,5807.31,7316.9,
MRA L SPINE WO + REPROC,31100200,CDM,72159,CPT,612,RC,inpatient,,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3420.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3855.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,3420.14,4309.2,
MR T SPINE W/,31100205,CDM,72147,CPT,612,RC,inpatient,TC,5873,5873,,4986.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4428.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4992.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5168.24,88,,percent of total billed charges,,,,,,,,,4486.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5344.43,91,,percent of total billed charges,,,5579.35,95,,percent of total billed charges,,,4874.59,83,,percent of total billed charges,,,4874.59,83,,percent of total billed charges,,,,,,,,,,,,,,,4874.59,83,,percent of total billed charges,,,5579.35,95,,percent of total billed charges,,,5285.7,90,,percent of total billed charges,,,5285.7,90,,percent of total billed charges,,,4815.86,82,,percent of total billed charges,,,5285.7,90,,percent of total billed charges,,,4992.05,85,,percent of total billed charges,,4428.24,5579.35,
MR T SPINE W/O,31100210,CDM,72146,CPT,612,RC,inpatient,TC,5370,5370,,4559.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4048.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4564.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4725.6,88,,percent of total billed charges,,,,,,,,,4102.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4886.7,91,,percent of total billed charges,,,5101.5,95,,percent of total billed charges,,,4457.1,83,,percent of total billed charges,,,4457.1,83,,percent of total billed charges,,,,,,,,,,,,,,,4457.1,83,,percent of total billed charges,,,5101.5,95,,percent of total billed charges,,,4833,90,,percent of total billed charges,,,4833,90,,percent of total billed charges,,,4403.4,82,,percent of total billed charges,,,4833,90,,percent of total billed charges,,,4564.5,85,,percent of total billed charges,,4048.98,5101.5,
MR T SPINE W/WO,31100215,CDM,72157,CPT,612,RC,inpatient,TC,7294,7294,,6192.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5499.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6199.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6418.72,88,,percent of total billed charges,,,,,,,,,5572.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6637.54,91,,percent of total billed charges,,,6929.3,95,,percent of total billed charges,,,6054.02,83,,percent of total billed charges,,,6054.02,83,,percent of total billed charges,,,,,,,,,,,,,,,6054.02,83,,percent of total billed charges,,,6929.3,95,,percent of total billed charges,,,6564.6,90,,percent of total billed charges,,,6564.6,90,,percent of total billed charges,,,5981.08,82,,percent of total billed charges,,,6564.6,90,,percent of total billed charges,,,6199.9,85,,percent of total billed charges,,5499.68,6929.3,
* MRA THORACIC W/WO& REPROCESSING (V306),31100221,CDM,C8911,HCPCS,610,RC,inpatient,,3224,3224,,2737.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2430.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2740.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2837.12,88,,percent of total billed charges,,,,,,,,,2463.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2675.92,83,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2643.68,82,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,2430.9,3062.8,
MR TMJ,31100250,CDM,70336,CPT,610,RC,inpatient,,5069,5069,,4303.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3822.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4308.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4460.72,88,,percent of total billed charges,,,,,,,,,3872.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4612.79,91,,percent of total billed charges,,,4815.55,95,,percent of total billed charges,,,4207.27,83,,percent of total billed charges,,,4207.27,83,,percent of total billed charges,,,,,,,,,,,,,,,4207.27,83,,percent of total billed charges,,,4815.55,95,,percent of total billed charges,,,4562.1,90,,percent of total billed charges,,,4562.1,90,,percent of total billed charges,,,4156.58,82,,percent of total billed charges,,,4562.1,90,,percent of total billed charges,,,4308.65,85,,percent of total billed charges,,3822.03,4815.55,
* DNU MR BREAST RT W/WO(V0107),31100300,CDM,76093,CPT,610,RC,inpatient,,5435,5435,,4614.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4097.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4619.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4782.8,88,,percent of total billed charges,,,,,,,,,4152.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4945.85,91,,percent of total billed charges,,,5163.25,95,,percent of total billed charges,,,4511.05,83,,percent of total billed charges,,,4511.05,83,,percent of total billed charges,,,,,,,,,,,,,,,4511.05,83,,percent of total billed charges,,,5163.25,95,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4456.7,82,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4619.75,85,,percent of total billed charges,,4097.99,5163.25,
MR BREAST RT W/WO,31100302,CDM,77046,CPT,610,RC,inpatient,RT,5952,5952,,5053.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4487.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5059.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5237.76,88,,percent of total billed charges,,,,,,,,,4547.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5416.32,91,,percent of total billed charges,,,5654.4,95,,percent of total billed charges,,,4940.16,83,,percent of total billed charges,,,4940.16,83,,percent of total billed charges,,,,,,,,,,,,,,,4940.16,83,,percent of total billed charges,,,5654.4,95,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,4880.64,82,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,5059.2,85,,percent of total billed charges,,4487.81,5654.4,
* DNU MR BREAST LT W/WO(V0107),31100305,CDM,76093,CPT,610,RC,inpatient,,5435,5435,,4614.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4097.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4619.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4782.8,88,,percent of total billed charges,,,,,,,,,4152.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4945.85,91,,percent of total billed charges,,,5163.25,95,,percent of total billed charges,,,4511.05,83,,percent of total billed charges,,,4511.05,83,,percent of total billed charges,,,,,,,,,,,,,,,4511.05,83,,percent of total billed charges,,,5163.25,95,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4456.7,82,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4619.75,85,,percent of total billed charges,,4097.99,5163.25,
MR BREAST LT W/WO,31100307,CDM,77046,CPT,610,RC,inpatient,LT,5952,5952,,5053.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4487.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5059.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5237.76,88,,percent of total billed charges,,,,,,,,,4547.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5416.32,91,,percent of total billed charges,,,5654.4,95,,percent of total billed charges,,,4940.16,83,,percent of total billed charges,,,4940.16,83,,percent of total billed charges,,,,,,,,,,,,,,,4940.16,83,,percent of total billed charges,,,5654.4,95,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,4880.64,82,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,5059.2,85,,percent of total billed charges,,4487.81,5654.4,
MR BREAST BIL W/WO,31100309,CDM,77047,CPT,610,RC,inpatient,TC,11904,11904,,10106.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8975.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10118.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10475.52,88,,percent of total billed charges,,,,,,,,,9094.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10832.64,91,,percent of total billed charges,,,11308.8,95,,percent of total billed charges,,,9880.32,83,,percent of total billed charges,,,9880.32,83,,percent of total billed charges,,,,,,,,,,,,,,,9880.32,83,,percent of total billed charges,,,11308.8,95,,percent of total billed charges,,,10713.6,90,,percent of total billed charges,,,10713.6,90,,percent of total billed charges,,,9761.28,82,,percent of total billed charges,,,10713.6,90,,percent of total billed charges,,,10118.4,85,,percent of total billed charges,,8975.62,11308.8,
* DNU MR BREAST BIL W/WO(V0107),31100310,CDM,76094,CPT,610,RC,inpatient,,6901,6901,,5858.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5203.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5865.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6072.88,88,,percent of total billed charges,,,,,,,,,5272.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6279.91,91,,percent of total billed charges,,,6555.95,95,,percent of total billed charges,,,5727.83,83,,percent of total billed charges,,,5727.83,83,,percent of total billed charges,,,,,,,,,,,,,,,5727.83,83,,percent of total billed charges,,,6555.95,95,,percent of total billed charges,,,6210.9,90,,percent of total billed charges,,,6210.9,90,,percent of total billed charges,,,5658.82,82,,percent of total billed charges,,,6210.9,90,,percent of total billed charges,,,5865.85,85,,percent of total billed charges,,5203.35,6555.95,
* MR BREAST BIL W (V306),31100311,CDM,C8906,HCPCS,610,RC,inpatient,,3006,3006,,2552.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2266.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2555.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2645.28,88,,percent of total billed charges,,,,,,,,,2296.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2735.46,91,,percent of total billed charges,,,2855.7,95,,percent of total billed charges,,,2494.98,83,,percent of total billed charges,,,2494.98,83,,percent of total billed charges,,,,,,,,,,,,,,,2494.98,83,,percent of total billed charges,,,2855.7,95,,percent of total billed charges,,,2705.4,90,,percent of total billed charges,,,2705.4,90,,percent of total billed charges,,,2464.92,82,,percent of total billed charges,,,2705.4,90,,percent of total billed charges,,,2555.1,85,,percent of total billed charges,,2266.52,2855.7,
* MR BREAST LT W (V306),31100312,CDM,C8903,HCPCS,610,RC,inpatient,,2774,2774,,2355.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2091.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2357.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2441.12,88,,percent of total billed charges,,,,,,,,,2119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2524.34,91,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2302.42,83,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2274.68,82,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,2091.6,2635.3,
* MR BREAST RT W (V306),31100313,CDM,C8903,HCPCS,610,RC,inpatient,,2774,2774,,2355.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2091.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2357.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2441.12,88,,percent of total billed charges,,,,,,,,,2119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2524.34,91,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2302.42,83,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2274.68,82,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,2091.6,2635.3,
* MR BREAST LT WO (V306),31100314,CDM,C8904,HCPCS,610,RC,inpatient,,2388,2388,,2027.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1800.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2029.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2101.44,88,,percent of total billed charges,,,,,,,,,1824.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2173.08,91,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1982.04,83,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,1958.16,82,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,1800.55,2268.6,
* MR BREAST RT WO (V306),31100315,CDM,C8904,HCPCS,610,RC,inpatient,,2388,2388,,2027.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1800.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2029.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2101.44,88,,percent of total billed charges,,,,,,,,,1824.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2173.08,91,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1982.04,83,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,1958.16,82,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,1800.55,2268.6,
* MR BREAST BIL WO (V306),31100316,CDM,C8907,HCPCS,610,RC,inpatient,,2543,2543,,2159.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1917.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2161.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2237.84,88,,percent of total billed charges,,,,,,,,,1942.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2314.13,91,,percent of total billed charges,,,2415.85,95,,percent of total billed charges,,,2110.69,83,,percent of total billed charges,,,2110.69,83,,percent of total billed charges,,,,,,,,,,,,,,,2110.69,83,,percent of total billed charges,,,2415.85,95,,percent of total billed charges,,,2288.7,90,,percent of total billed charges,,,2288.7,90,,percent of total billed charges,,,2085.26,82,,percent of total billed charges,,,2288.7,90,,percent of total billed charges,,,2161.55,85,,percent of total billed charges,,1917.42,2415.85,
MR KNEE LT W,31101000,CDM,73722,CPT,610,RC,inpatient,,5471,5471,,4644.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4125.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4650.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4814.48,88,,percent of total billed charges,,,,,,,,,4179.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4978.61,91,,percent of total billed charges,,,5197.45,95,,percent of total billed charges,,,4540.93,83,,percent of total billed charges,,,4540.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4540.93,83,,percent of total billed charges,,,5197.45,95,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4486.22,82,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4650.35,85,,percent of total billed charges,,4125.13,5197.45,
MR KNEE LEFT W/WO,31101001,CDM,73723,CPT,610,RC,inpatient,LT,6683,6683,,5673.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5038.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5680.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5881.04,88,,percent of total billed charges,,,,,,,,,5105.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6081.53,91,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,,,,,,,,,,,,,5546.89,83,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5480.06,82,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,5038.98,6348.85,
MR KNEE LEFT W/O,31101002,CDM,73721,CPT,610,RC,inpatient,LT,5178,5178,,4396.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3904.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4401.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4556.64,88,,percent of total billed charges,,,,,,,,,3955.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4711.98,91,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,,,,,,,,,,,,,4297.74,83,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4245.96,82,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,3904.21,4919.1,
MR KNEE RT W,31101003,CDM,73722,CPT,610,RC,inpatient,,5471,5471,,4644.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4125.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4650.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4814.48,88,,percent of total billed charges,,,,,,,,,4179.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4978.61,91,,percent of total billed charges,,,5197.45,95,,percent of total billed charges,,,4540.93,83,,percent of total billed charges,,,4540.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4540.93,83,,percent of total billed charges,,,5197.45,95,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4486.22,82,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4650.35,85,,percent of total billed charges,,4125.13,5197.45,
MR KNEE RIGHT W/WO,31101004,CDM,73723,CPT,610,RC,inpatient,RT,6683,6683,,5673.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5038.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5680.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5881.04,88,,percent of total billed charges,,,,,,,,,5105.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6081.53,91,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,,,,,,,,,,,,,5546.89,83,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5480.06,82,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,5038.98,6348.85,
MR KNEE RIGHT W/O,31101005,CDM,73721,CPT,610,RC,inpatient,RT,5178,5178,,4396.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3904.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4401.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4556.64,88,,percent of total billed charges,,,,,,,,,3955.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4711.98,91,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,,,,,,,,,,,,,4297.74,83,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4245.96,82,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,3904.21,4919.1,
MR HIP LT W,31101006,CDM,73722,CPT,610,RC,inpatient,LT,6459,6459,,5483.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4870.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5490.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5683.92,88,,percent of total billed charges,,,,,,,,,4934.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5877.69,91,,percent of total billed charges,,,6136.05,95,,percent of total billed charges,,,5360.97,83,,percent of total billed charges,,,5360.97,83,,percent of total billed charges,,,,,,,,,,,,,,,5360.97,83,,percent of total billed charges,,,6136.05,95,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5296.38,82,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5490.15,85,,percent of total billed charges,,4870.09,6136.05,
MR HIP LEFT W/WO,31101007,CDM,73723,CPT,610,RC,inpatient,LT,6683,6683,,5673.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5038.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5680.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5881.04,88,,percent of total billed charges,,,,,,,,,5105.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6081.53,91,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,,,,,,,,,,,,,5546.89,83,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5480.06,82,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,5038.98,6348.85,
MR HIP LEFT W/O,31101008,CDM,73721,CPT,610,RC,inpatient,LT,5178,5178,,4396.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3904.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4401.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4556.64,88,,percent of total billed charges,,,,,,,,,3955.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4711.98,91,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,,,,,,,,,,,,,4297.74,83,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4245.96,82,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,3904.21,4919.1,
MR HIP RT W,31101009,CDM,73722,CPT,610,RC,inpatient,TC,6459,6459,,5483.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4870.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5490.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5683.92,88,,percent of total billed charges,,,,,,,,,4934.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5877.69,91,,percent of total billed charges,,,6136.05,95,,percent of total billed charges,,,5360.97,83,,percent of total billed charges,,,5360.97,83,,percent of total billed charges,,,,,,,,,,,,,,,5360.97,83,,percent of total billed charges,,,6136.05,95,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5296.38,82,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5490.15,85,,percent of total billed charges,,4870.09,6136.05,
MR HIP RIGHT W/WO,31101010,CDM,73723,CPT,610,RC,inpatient,RT,6683,6683,,5673.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5038.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5680.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5881.04,88,,percent of total billed charges,,,,,,,,,5105.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6081.53,91,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,,,,,,,,,,,,,5546.89,83,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5480.06,82,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,5038.98,6348.85,
MR HIP RIGHT W/O,31101011,CDM,73721,CPT,610,RC,inpatient,RT,5178,5178,,4396.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3904.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4401.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4556.64,88,,percent of total billed charges,,,,,,,,,3955.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4711.98,91,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,,,,,,,,,,,,,4297.74,83,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4245.96,82,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,3904.21,4919.1,
MR ANKLE LT W,31101012,CDM,73722,CPT,610,RC,inpatient,,5471,5471,,4644.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4125.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4650.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4814.48,88,,percent of total billed charges,,,,,,,,,4179.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4978.61,91,,percent of total billed charges,,,5197.45,95,,percent of total billed charges,,,4540.93,83,,percent of total billed charges,,,4540.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4540.93,83,,percent of total billed charges,,,5197.45,95,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4486.22,82,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4650.35,85,,percent of total billed charges,,4125.13,5197.45,
MR ANKLE LEFT W/WO,31101013,CDM,73723,CPT,610,RC,inpatient,LT,6683,6683,,5673.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5038.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5680.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5881.04,88,,percent of total billed charges,,,,,,,,,5105.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6081.53,91,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,,,,,,,,,,,,,5546.89,83,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5480.06,82,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,5038.98,6348.85,
MR ANKLE LEFT W/O,31101014,CDM,73721,CPT,610,RC,inpatient,LT,5178,5178,,4396.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3904.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4401.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4556.64,88,,percent of total billed charges,,,,,,,,,3955.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4711.98,91,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,,,,,,,,,,,,,4297.74,83,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4245.96,82,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,3904.21,4919.1,
MR ANKLE RT W,31101015,CDM,73722,CPT,610,RC,inpatient,,5471,5471,,4644.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4125.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4650.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4814.48,88,,percent of total billed charges,,,,,,,,,4179.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4978.61,91,,percent of total billed charges,,,5197.45,95,,percent of total billed charges,,,4540.93,83,,percent of total billed charges,,,4540.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4540.93,83,,percent of total billed charges,,,5197.45,95,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4486.22,82,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4650.35,85,,percent of total billed charges,,4125.13,5197.45,
MR ANKLE RIGHT W/WO,31101016,CDM,73723,CPT,610,RC,inpatient,RT,6683,6683,,5673.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5038.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5680.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5881.04,88,,percent of total billed charges,,,,,,,,,5105.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6081.53,91,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,,,,,,,,,,,,,5546.89,83,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5480.06,82,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,5038.98,6348.85,
MR ANKLE RIGHT W/O,31101017,CDM,73721,CPT,610,RC,inpatient,RT,5178,5178,,4396.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3904.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4401.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4556.64,88,,percent of total billed charges,,,,,,,,,3955.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4711.98,91,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,,,,,,,,,,,,,4297.74,83,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4245.96,82,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,3904.21,4919.1,
MR FEMUR LEFT W/,31101018,CDM,73719,CPT,610,RC,inpatient,LT,5797,5797,,4921.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4370.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4927.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5101.36,88,,percent of total billed charges,,,,,,,,,4428.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5275.27,91,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4811.51,83,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4753.54,82,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,4370.94,5507.15,
MR FEMUR LEFT W/WO,31101019,CDM,73720,CPT,610,RC,inpatient,LT,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5807.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6546.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,5807.31,7316.9,
MR FEMUR LEFT W/O,31101020,CDM,73718,CPT,610,RC,inpatient,LT,5066,5066,,4301.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3819.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4306.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4458.08,88,,percent of total billed charges,,,,,,,,,3870.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4610.06,91,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,,,,,,,,,,,,,4204.78,83,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4154.12,82,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,3819.76,4812.7,
MR FEMUR RIGHT W/,31101021,CDM,73719,CPT,610,RC,inpatient,RT,5797,5797,,4921.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4370.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4927.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5101.36,88,,percent of total billed charges,,,,,,,,,4428.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5275.27,91,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4811.51,83,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4753.54,82,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,4370.94,5507.15,
MR FEMUR RIGHT W/WO,31101022,CDM,73720,CPT,610,RC,inpatient,RT,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5807.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6546.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,5807.31,7316.9,
MR FEMUR RIGHT W/O,31101023,CDM,73718,CPT,610,RC,inpatient,RT,5066,5066,,4301.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3819.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4306.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4458.08,88,,percent of total billed charges,,,,,,,,,3870.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4610.06,91,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,,,,,,,,,,,,,4204.78,83,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4154.12,82,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,3819.76,4812.7,
MR LOW LEG LEFT W/,31101024,CDM,73719,CPT,610,RC,inpatient,LT,5797,5797,,4921.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4370.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4927.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5101.36,88,,percent of total billed charges,,,,,,,,,4428.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5275.27,91,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4811.51,83,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4753.54,82,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,4370.94,5507.15,
MR LOW LEG LEFT W/WO,31101025,CDM,73720,CPT,610,RC,inpatient,LT,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5807.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6546.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,5807.31,7316.9,
MR LOW LEG LEFT W/O,31101026,CDM,73718,CPT,610,RC,inpatient,LT,5066,5066,,4301.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3819.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4306.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4458.08,88,,percent of total billed charges,,,,,,,,,3870.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4610.06,91,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,,,,,,,,,,,,,4204.78,83,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4154.12,82,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,3819.76,4812.7,
MR LOW LEG RIGHT W/,31101027,CDM,73719,CPT,610,RC,inpatient,RT,5797,5797,,4921.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4370.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4927.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5101.36,88,,percent of total billed charges,,,,,,,,,4428.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5275.27,91,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4811.51,83,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4753.54,82,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,4370.94,5507.15,
MR LOW LEG RIGHT W/WO,31101028,CDM,73720,CPT,610,RC,inpatient,RT,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5807.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6546.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,5807.31,7316.9,
MR LOW LEG RIGHT W/O,31101029,CDM,73718,CPT,610,RC,inpatient,RT,5066,5066,,4301.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3819.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4306.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4458.08,88,,percent of total billed charges,,,,,,,,,3870.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4610.06,91,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,,,,,,,,,,,,,4204.78,83,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4154.12,82,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,3819.76,4812.7,
MR SHOULDER LEFT W/ (V 05-17),31101030,CDM,73222,CPT,610,RC,inpatient,LT,4675,4675,,3969.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3524.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3973.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4114,88,,percent of total billed charges,,,,,,,,,3571.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4254.25,91,,percent of total billed charges,,,4441.25,95,,percent of total billed charges,,,3880.25,83,,percent of total billed charges,,,3880.25,83,,percent of total billed charges,,,,,,,,,,,,,,,3880.25,83,,percent of total billed charges,,,4441.25,95,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,3833.5,82,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,3973.75,85,,percent of total billed charges,,3524.95,4441.25,
MR SHOULDER LEFT W/WO,31101031,CDM,73223,CPT,610,RC,inpatient,LT,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5807.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6546.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,5807.31,7316.9,
MR SHOULDER LEFT W/O,31101032,CDM,73221,CPT,610,RC,inpatient,LT,5084,5084,,4316.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3833.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4321.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4473.92,88,,percent of total billed charges,,,,,,,,,3884.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4626.44,91,,percent of total billed charges,,,4829.8,95,,percent of total billed charges,,,4219.72,83,,percent of total billed charges,,,4219.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4219.72,83,,percent of total billed charges,,,4829.8,95,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4168.88,82,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4321.4,85,,percent of total billed charges,,3833.34,4829.8,
MR SHOULDER RIGHT W/,31101033,CDM,73222,CPT,610,RC,inpatient,RT,6459,6459,,5483.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4870.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5490.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5683.92,88,,percent of total billed charges,,,,,,,,,4934.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5877.69,91,,percent of total billed charges,,,6136.05,95,,percent of total billed charges,,,5360.97,83,,percent of total billed charges,,,5360.97,83,,percent of total billed charges,,,,,,,,,,,,,,,5360.97,83,,percent of total billed charges,,,6136.05,95,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5296.38,82,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5490.15,85,,percent of total billed charges,,4870.09,6136.05,
MR SHOULDER RIGHT W/WO,31101034,CDM,73223,CPT,610,RC,inpatient,RT,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5807.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6546.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,5807.31,7316.9,
MR SHOULDER RIGHT W/O,31101035,CDM,73221,CPT,610,RC,inpatient,RT,5084,5084,,4316.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3833.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4321.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4473.92,88,,percent of total billed charges,,,,,,,,,3884.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4626.44,91,,percent of total billed charges,,,4829.8,95,,percent of total billed charges,,,4219.72,83,,percent of total billed charges,,,4219.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4219.72,83,,percent of total billed charges,,,4829.8,95,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4168.88,82,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4321.4,85,,percent of total billed charges,,3833.34,4829.8,
MR ELBOW LEFT W/,31101036,CDM,73222,CPT,610,RC,inpatient,LT,5523,5523,,4689.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4164.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4694.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4860.24,88,,percent of total billed charges,,,,,,,,,4219.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5025.93,91,,percent of total billed charges,,,5246.85,95,,percent of total billed charges,,,4584.09,83,,percent of total billed charges,,,4584.09,83,,percent of total billed charges,,,,,,,,,,,,,,,4584.09,83,,percent of total billed charges,,,5246.85,95,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4528.86,82,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4694.55,85,,percent of total billed charges,,4164.34,5246.85,
MR ELBOW LEFT W/WO,31101037,CDM,73223,CPT,610,RC,inpatient,LT,6613,6613,,5614.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4986.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5621.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5819.44,88,,percent of total billed charges,,,,,,,,,5052.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6017.83,91,,percent of total billed charges,,,6282.35,95,,percent of total billed charges,,,5488.79,83,,percent of total billed charges,,,5488.79,83,,percent of total billed charges,,,,,,,,,,,,,,,5488.79,83,,percent of total billed charges,,,6282.35,95,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5422.66,82,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5621.05,85,,percent of total billed charges,,4986.2,6282.35,
MR ELBOW LEFT W/O,31101038,CDM,73221,CPT,610,RC,inpatient,LT,5083,5083,,4315.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3832.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4320.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4473.04,88,,percent of total billed charges,,,,,,,,,3883.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4625.53,91,,percent of total billed charges,,,4828.85,95,,percent of total billed charges,,,4218.89,83,,percent of total billed charges,,,4218.89,83,,percent of total billed charges,,,,,,,,,,,,,,,4218.89,83,,percent of total billed charges,,,4828.85,95,,percent of total billed charges,,,4574.7,90,,percent of total billed charges,,,4574.7,90,,percent of total billed charges,,,4168.06,82,,percent of total billed charges,,,4574.7,90,,percent of total billed charges,,,4320.55,85,,percent of total billed charges,,3832.58,4828.85,
MR ELBOW RIGHT W/,31101039,CDM,73222,CPT,610,RC,inpatient,RT,5523,5523,,4689.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4164.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4694.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4860.24,88,,percent of total billed charges,,,,,,,,,4219.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5025.93,91,,percent of total billed charges,,,5246.85,95,,percent of total billed charges,,,4584.09,83,,percent of total billed charges,,,4584.09,83,,percent of total billed charges,,,,,,,,,,,,,,,4584.09,83,,percent of total billed charges,,,5246.85,95,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4528.86,82,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4694.55,85,,percent of total billed charges,,4164.34,5246.85,
MR ELBOW RIGHT W/O,31101040,CDM,73221,CPT,610,RC,inpatient,RT,5083,5083,,4315.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3832.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4320.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4473.04,88,,percent of total billed charges,,,,,,,,,3883.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4625.53,91,,percent of total billed charges,,,4828.85,95,,percent of total billed charges,,,4218.89,83,,percent of total billed charges,,,4218.89,83,,percent of total billed charges,,,,,,,,,,,,,,,4218.89,83,,percent of total billed charges,,,4828.85,95,,percent of total billed charges,,,4574.7,90,,percent of total billed charges,,,4574.7,90,,percent of total billed charges,,,4168.06,82,,percent of total billed charges,,,4574.7,90,,percent of total billed charges,,,4320.55,85,,percent of total billed charges,,3832.58,4828.85,
MR ELBOW RIGHT W/WO,31101041,CDM,73223,CPT,610,RC,inpatient,RT,6613,6613,,5614.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4986.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5621.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5819.44,88,,percent of total billed charges,,,,,,,,,5052.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6017.83,91,,percent of total billed charges,,,6282.35,95,,percent of total billed charges,,,5488.79,83,,percent of total billed charges,,,5488.79,83,,percent of total billed charges,,,,,,,,,,,,,,,5488.79,83,,percent of total billed charges,,,6282.35,95,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5422.66,82,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5621.05,85,,percent of total billed charges,,4986.2,6282.35,
MR WRIST LEFT W/,31101042,CDM,73222,CPT,610,RC,inpatient,LT,5523,5523,,4689.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4164.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4694.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4860.24,88,,percent of total billed charges,,,,,,,,,4219.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5025.93,91,,percent of total billed charges,,,5246.85,95,,percent of total billed charges,,,4584.09,83,,percent of total billed charges,,,4584.09,83,,percent of total billed charges,,,,,,,,,,,,,,,4584.09,83,,percent of total billed charges,,,5246.85,95,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4528.86,82,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4694.55,85,,percent of total billed charges,,4164.34,5246.85,
MR WRIST LEFT W/WO,31101043,CDM,73223,CPT,610,RC,inpatient,LT,6613,6613,,5614.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4986.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5621.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5819.44,88,,percent of total billed charges,,,,,,,,,5052.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6017.83,91,,percent of total billed charges,,,6282.35,95,,percent of total billed charges,,,5488.79,83,,percent of total billed charges,,,5488.79,83,,percent of total billed charges,,,,,,,,,,,,,,,5488.79,83,,percent of total billed charges,,,6282.35,95,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5422.66,82,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5621.05,85,,percent of total billed charges,,4986.2,6282.35,
MR WRIST LEFT W/O,31101044,CDM,73221,CPT,610,RC,inpatient,LT,5084,5084,,4316.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3833.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4321.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4473.92,88,,percent of total billed charges,,,,,,,,,3884.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4626.44,91,,percent of total billed charges,,,4829.8,95,,percent of total billed charges,,,4219.72,83,,percent of total billed charges,,,4219.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4219.72,83,,percent of total billed charges,,,4829.8,95,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4168.88,82,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4321.4,85,,percent of total billed charges,,3833.34,4829.8,
MR WRIST RIGHT W/,31101045,CDM,73222,CPT,610,RC,inpatient,RT,5523,5523,,4689.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4164.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4694.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4860.24,88,,percent of total billed charges,,,,,,,,,4219.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5025.93,91,,percent of total billed charges,,,5246.85,95,,percent of total billed charges,,,4584.09,83,,percent of total billed charges,,,4584.09,83,,percent of total billed charges,,,,,,,,,,,,,,,4584.09,83,,percent of total billed charges,,,5246.85,95,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4528.86,82,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4694.55,85,,percent of total billed charges,,4164.34,5246.85,
MR WRIST RIGHT W/WO,31101046,CDM,73223,CPT,610,RC,inpatient,RT,6613,6613,,5614.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4986.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5621.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5819.44,88,,percent of total billed charges,,,,,,,,,5052.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6017.83,91,,percent of total billed charges,,,6282.35,95,,percent of total billed charges,,,5488.79,83,,percent of total billed charges,,,5488.79,83,,percent of total billed charges,,,,,,,,,,,,,,,5488.79,83,,percent of total billed charges,,,6282.35,95,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5422.66,82,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5621.05,85,,percent of total billed charges,,4986.2,6282.35,
MR WRIST RIGHT W/O,31101047,CDM,73221,CPT,610,RC,inpatient,RT,5084,5084,,4316.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3833.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4321.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4473.92,88,,percent of total billed charges,,,,,,,,,3884.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4626.44,91,,percent of total billed charges,,,4829.8,95,,percent of total billed charges,,,4219.72,83,,percent of total billed charges,,,4219.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4219.72,83,,percent of total billed charges,,,4829.8,95,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4168.88,82,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4321.4,85,,percent of total billed charges,,3833.34,4829.8,
MR HUMERUS LT W,31101048,CDM,73219,CPT,610,RC,inpatient,,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4426.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4990.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,4426.73,5577.45,
MR HUMERUS LEFT W/WO,31101049,CDM,73220,CPT,610,RC,inpatient,LT,6502,6502,,5520.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4902.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5526.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5721.76,88,,percent of total billed charges,,,,,,,,,4967.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5916.82,91,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,,,,,,,,,,,,,5396.66,83,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5331.64,82,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,4902.51,6176.9,
MR HUMERUS LEFT W/O,31101050,CDM,73218,CPT,610,RC,inpatient,LT,4962,4962,,4212.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3741.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4217.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4366.56,88,,percent of total billed charges,,,,,,,,,3790.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4515.42,91,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,,,,,,,,,,,,,4118.46,83,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4068.84,82,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,3741.35,4713.9,
MR HUMERUS RT W,31101051,CDM,73219,CPT,610,RC,inpatient,,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4426.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4990.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,4426.73,5577.45,
MR HUMERUS RIGHT W/WO,31101052,CDM,73220,CPT,610,RC,inpatient,RT,6502,6502,,5520.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4902.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5526.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5721.76,88,,percent of total billed charges,,,,,,,,,4967.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5916.82,91,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,,,,,,,,,,,,,5396.66,83,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5331.64,82,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,4902.51,6176.9,
MR HUMERUS RIGHT W/O,31101053,CDM,73218,CPT,610,RC,inpatient,RT,4962,4962,,4212.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3741.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4217.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4366.56,88,,percent of total billed charges,,,,,,,,,3790.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4515.42,91,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,,,,,,,,,,,,,4118.46,83,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4068.84,82,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,3741.35,4713.9,
MR FOREARM LT W,31101054,CDM,73219,CPT,610,RC,inpatient,,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4426.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4990.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,4426.73,5577.45,
MR FOREARM LEFT W/WO,31101055,CDM,73220,CPT,610,RC,inpatient,LT,6502,6502,,5520.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4902.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5526.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5721.76,88,,percent of total billed charges,,,,,,,,,4967.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5916.82,91,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,,,,,,,,,,,,,5396.66,83,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5331.64,82,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,4902.51,6176.9,
MR FOREARM LEFT W/O,31101056,CDM,73218,CPT,610,RC,inpatient,LT,4962,4962,,4212.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3741.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4217.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4366.56,88,,percent of total billed charges,,,,,,,,,3790.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4515.42,91,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,,,,,,,,,,,,,4118.46,83,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4068.84,82,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,3741.35,4713.9,
MR FOREARM RT W,31101057,CDM,73219,CPT,610,RC,inpatient,,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4426.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4990.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,4426.73,5577.45,
MR FOREARM RIGHT W/WO,31101058,CDM,73220,CPT,610,RC,inpatient,RT,6502,6502,,5520.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4902.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5526.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5721.76,88,,percent of total billed charges,,,,,,,,,4967.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5916.82,91,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,,,,,,,,,,,,,5396.66,83,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5331.64,82,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,4902.51,6176.9,
MR FOREARM RIGHT W/O,31101059,CDM,73218,CPT,610,RC,inpatient,RT,4962,4962,,4212.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3741.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4217.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4366.56,88,,percent of total billed charges,,,,,,,,,3790.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4515.42,91,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,,,,,,,,,,,,,4118.46,83,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4068.84,82,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,3741.35,4713.9,
MR FOOT LEFT W/O,31101060,CDM,73718,CPT,610,RC,inpatient,LT,5066,5066,,4301.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3819.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4306.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4458.08,88,,percent of total billed charges,,,,,,,,,3870.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4610.06,91,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,,,,,,,,,,,,,4204.78,83,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4154.12,82,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,3819.76,4812.7,
MR FOOT RIGHT W/O,31101061,CDM,73718,CPT,610,RC,inpatient,RT,5066,5066,,4301.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3819.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4306.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4458.08,88,,percent of total billed charges,,,,,,,,,3870.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4610.06,91,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,,,,,,,,,,,,,4204.78,83,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4154.12,82,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,3819.76,4812.7,
MR FOOT LEFT W/WO,31101062,CDM,73720,CPT,610,RC,inpatient,LT,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5807.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6546.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,5807.31,7316.9,
MR FOOT LEFT W/,31101063,CDM,73719,CPT,610,RC,inpatient,LT,5797,5797,,4921.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4370.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4927.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5101.36,88,,percent of total billed charges,,,,,,,,,4428.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5275.27,91,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4811.51,83,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4753.54,82,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,4370.94,5507.15,
MR FOOT RIGHT W/,31101064,CDM,73719,CPT,610,RC,inpatient,RT,5797,5797,,4921.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4370.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4927.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5101.36,88,,percent of total billed charges,,,,,,,,,4428.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5275.27,91,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4811.51,83,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4753.54,82,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,4370.94,5507.15,
MR FOOT RIGHT W/WO,31101065,CDM,73720,CPT,610,RC,inpatient,RT,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5807.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6546.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,5807.31,7316.9,
MR HAND LEFT W/,31101066,CDM,73219,CPT,610,RC,inpatient,LT,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4426.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4990.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,4426.73,5577.45,
MR HAND LEFT W/WO,31101067,CDM,73220,CPT,610,RC,inpatient,LT,6502,6502,,5520.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4902.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5526.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5721.76,88,,percent of total billed charges,,,,,,,,,4967.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5916.82,91,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,,,,,,,,,,,,,5396.66,83,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5331.64,82,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,4902.51,6176.9,
MR HAND LEFT W/O,31101068,CDM,73218,CPT,610,RC,inpatient,LT,4962,4962,,4212.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3741.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4217.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4366.56,88,,percent of total billed charges,,,,,,,,,3790.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4515.42,91,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,,,,,,,,,,,,,4118.46,83,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4068.84,82,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,3741.35,4713.9,
MR HAND RIGHT W/,31101069,CDM,73219,CPT,610,RC,inpatient,RT,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4426.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4990.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,4426.73,5577.45,
MR HAND RIGHT W/WO,31101070,CDM,73220,CPT,610,RC,inpatient,RT,6502,6502,,5520.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4902.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5526.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5721.76,88,,percent of total billed charges,,,,,,,,,4967.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5916.82,91,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,,,,,,,,,,,,,5396.66,83,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5331.64,82,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,4902.51,6176.9,
MR HAND RIGHT W/O,31101071,CDM,73218,CPT,610,RC,inpatient,RT,4962,4962,,4212.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3741.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4217.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4366.56,88,,percent of total billed charges,,,,,,,,,3790.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4515.42,91,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,,,,,,,,,,,,,4118.46,83,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4068.84,82,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,3741.35,4713.9,
MR KNEE BILATERAL W/O,31101088,CDM,73721,CPT,610,RC,inpatient,50,9834,9834,,8349.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7414.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8358.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8653.92,88,,percent of total billed charges,,,,,,,,,7513.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8948.94,91,,percent of total billed charges,,,9342.3,95,,percent of total billed charges,,,8162.22,83,,percent of total billed charges,,,8162.22,83,,percent of total billed charges,,,,,,,,,,,,,,,8162.22,83,,percent of total billed charges,,,9342.3,95,,percent of total billed charges,,,8850.6,90,,percent of total billed charges,,,8850.6,90,,percent of total billed charges,,,8063.88,82,,percent of total billed charges,,,8850.6,90,,percent of total billed charges,,,8358.9,85,,percent of total billed charges,,7414.84,9342.3,
MR FOOT BILAT W/O,31101161,CDM,73718,CPT,610,RC,inpatient,50,10135,10135,,8604.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7641.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8614.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8918.8,88,,percent of total billed charges,,,,,,,,,7743.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9222.85,91,,percent of total billed charges,,,9628.25,95,,percent of total billed charges,,,8412.05,83,,percent of total billed charges,,,8412.05,83,,percent of total billed charges,,,,,,,,,,,,,,,8412.05,83,,percent of total billed charges,,,9628.25,95,,percent of total billed charges,,,9121.5,90,,percent of total billed charges,,,9121.5,90,,percent of total billed charges,,,8310.7,82,,percent of total billed charges,,,9121.5,90,,percent of total billed charges,,,8614.75,85,,percent of total billed charges,,7641.79,9628.25,
MR SHOULDER LEFT W/,31101899,CDM,73222,CPT,610,RC,inpatient,LT,6459,6459,,5483.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4870.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5490.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5683.92,88,,percent of total billed charges,,,,,,,,,4934.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5877.69,91,,percent of total billed charges,,,6136.05,95,,percent of total billed charges,,,5360.97,83,,percent of total billed charges,,,5360.97,83,,percent of total billed charges,,,,,,,,,,,,,,,5360.97,83,,percent of total billed charges,,,6136.05,95,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5296.38,82,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5490.15,85,,percent of total billed charges,,4870.09,6136.05,
MR HIP BILATERAL W/O,31101900,CDM,73721,CPT,610,RC,inpatient,50,10353,10353,,8789.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7806.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8800.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9110.64,88,,percent of total billed charges,,,,,,,,,7909.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9421.23,91,,percent of total billed charges,,,9835.35,95,,percent of total billed charges,,,8592.99,83,,percent of total billed charges,,,8592.99,83,,percent of total billed charges,,,,,,,,,,,,,,,8592.99,83,,percent of total billed charges,,,9835.35,95,,percent of total billed charges,,,9317.7,90,,percent of total billed charges,,,9317.7,90,,percent of total billed charges,,,8489.46,82,,percent of total billed charges,,,9317.7,90,,percent of total billed charges,,,8800.05,85,,percent of total billed charges,,7806.16,9835.35,
MR HIP BILATERAL W/WO,31101901,CDM,73723,CPT,610,RC,inpatient,50,13369,13369,,11350.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10080.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11363.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11764.72,88,,percent of total billed charges,,,,,,,,,10213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12165.79,91,,percent of total billed charges,,,12700.55,95,,percent of total billed charges,,,11096.27,83,,percent of total billed charges,,,11096.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11096.27,83,,percent of total billed charges,,,12700.55,95,,percent of total billed charges,,,12032.1,90,,percent of total billed charges,,,12032.1,90,,percent of total billed charges,,,10962.58,82,,percent of total billed charges,,,12032.1,90,,percent of total billed charges,,,11363.65,85,,percent of total billed charges,,10080.23,12700.55,
MR ORTHO PELVIS W/O (V 05-17),31101999,CDM,73721,CPT,610,RC,inpatient,50,8556,8556,,7264.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6451.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7272.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7529.28,88,,percent of total billed charges,,,,,,,,,6536.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7785.96,91,,percent of total billed charges,,,8128.2,95,,percent of total billed charges,,,7101.48,83,,percent of total billed charges,,,7101.48,83,,percent of total billed charges,,,,,,,,,,,,,,,7101.48,83,,percent of total billed charges,,,8128.2,95,,percent of total billed charges,,,7700.4,90,,percent of total billed charges,,,7700.4,90,,percent of total billed charges,,,7015.92,82,,percent of total billed charges,,,7700.4,90,,percent of total billed charges,,,7272.6,85,,percent of total billed charges,,6451.22,8128.2,
MRV HEAD W/O AND REPROC,31102009,CDM,70544,CPT,611,RC,inpatient,TC,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3420.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3855.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,3420.14,4309.2,
NM THYROID SCAN ONLY,28000001,CDM,78013,CPT,340,RC,inpatient,TC,1565,1565,,1328.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1180.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1330.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1377.2,88,,percent of total billed charges,,,,,,,,,1195.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1424.15,91,,percent of total billed charges,,,1486.75,95,,percent of total billed charges,,,1298.95,83,,percent of total billed charges,,,1298.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1298.95,83,,percent of total billed charges,,,1486.75,95,,percent of total billed charges,,,1408.5,90,,percent of total billed charges,,,1408.5,90,,percent of total billed charges,,,1283.3,82,,percent of total billed charges,,,1408.5,90,,percent of total billed charges,,,1330.25,85,,percent of total billed charges,,1180.01,1486.75,
NM HIDA,28101005,CDM,78226,CPT,340,RC,inpatient,TC,2834,2834,,2406.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2136.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2408.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2493.92,88,,percent of total billed charges,,,,,,,,,2165.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2578.94,91,,percent of total billed charges,,,2692.3,95,,percent of total billed charges,,,2352.22,83,,percent of total billed charges,,,2352.22,83,,percent of total billed charges,,,,,,,,,,,,,,,2352.22,83,,percent of total billed charges,,,2692.3,95,,percent of total billed charges,,,2550.6,90,,percent of total billed charges,,,2550.6,90,,percent of total billed charges,,,2323.88,82,,percent of total billed charges,,,2550.6,90,,percent of total billed charges,,,2408.9,85,,percent of total billed charges,,2136.84,2692.3,
NM BRAIN,28101014,CDM,78605,CPT,340,RC,inpatient,TC,1416,1416,,1202.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1067.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1203.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1246.08,88,,percent of total billed charges,,,,,,,,,1081.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1288.56,91,,percent of total billed charges,,,1345.2,95,,percent of total billed charges,,,1175.28,83,,percent of total billed charges,,,1175.28,83,,percent of total billed charges,,,,,,,,,,,,,,,1175.28,83,,percent of total billed charges,,,1345.2,95,,percent of total billed charges,,,1274.4,90,,percent of total billed charges,,,1274.4,90,,percent of total billed charges,,,1161.12,82,,percent of total billed charges,,,1274.4,90,,percent of total billed charges,,,1203.6,85,,percent of total billed charges,,1067.66,1345.2,
NM BRAIN W/FLOW STUDY,28101022,CDM,78606,CPT,340,RC,inpatient,TC,2364,2364,,2007.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1782.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2009.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2080.32,88,,percent of total billed charges,,,,,,,,,1806.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2151.24,91,,percent of total billed charges,,,2245.8,95,,percent of total billed charges,,,1962.12,83,,percent of total billed charges,,,1962.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1962.12,83,,percent of total billed charges,,,2245.8,95,,percent of total billed charges,,,2127.6,90,,percent of total billed charges,,,2127.6,90,,percent of total billed charges,,,1938.48,82,,percent of total billed charges,,,2127.6,90,,percent of total billed charges,,,2009.4,85,,percent of total billed charges,,1782.46,2245.8,
NM LIVERANDSPLEEN,28101030,CDM,78215,CPT,340,RC,inpatient,TC,2483,2483,,2108.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1872.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2110.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2185.04,88,,percent of total billed charges,,,,,,,,,1897.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2259.53,91,,percent of total billed charges,,,2358.85,95,,percent of total billed charges,,,2060.89,83,,percent of total billed charges,,,2060.89,83,,percent of total billed charges,,,,,,,,,,,,,,,2060.89,83,,percent of total billed charges,,,2358.85,95,,percent of total billed charges,,,2234.7,90,,percent of total billed charges,,,2234.7,90,,percent of total billed charges,,,2036.06,82,,percent of total billed charges,,,2234.7,90,,percent of total billed charges,,,2110.55,85,,percent of total billed charges,,1872.18,2358.85,
NM BREAST,28101038,CDM,78800,CPT,341,RC,inpatient,TC,1366,1366,,1159.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1029.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1161.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1202.08,88,,percent of total billed charges,,,,,,,,,1043.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1243.06,91,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1133.78,83,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1120.12,82,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1161.1,85,,percent of total billed charges,,1029.96,1297.7,
NM LUNG PERFUSION,28101055,CDM,78580,CPT,340,RC,inpatient,TC,1865,1865,,1583.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1406.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1585.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1641.2,88,,percent of total billed charges,,,,,,,,,1424.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1697.15,91,,percent of total billed charges,,,1771.75,95,,percent of total billed charges,,,1547.95,83,,percent of total billed charges,,,1547.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1547.95,83,,percent of total billed charges,,,1771.75,95,,percent of total billed charges,,,1678.5,90,,percent of total billed charges,,,1678.5,90,,percent of total billed charges,,,1529.3,82,,percent of total billed charges,,,1678.5,90,,percent of total billed charges,,,1585.25,85,,percent of total billed charges,,1406.21,1771.75,
NM LUNG VQ COMPLETE,28101060,CDM,78582,CPT,340,RC,inpatient,TC,2014,2014,,1709.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1518.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1711.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1772.32,88,,percent of total billed charges,,,,,,,,,1538.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1832.74,91,,percent of total billed charges,,,1913.3,95,,percent of total billed charges,,,1671.62,83,,percent of total billed charges,,,1671.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1671.62,83,,percent of total billed charges,,,1913.3,95,,percent of total billed charges,,,1812.6,90,,percent of total billed charges,,,1812.6,90,,percent of total billed charges,,,1651.48,82,,percent of total billed charges,,,1812.6,90,,percent of total billed charges,,,1711.9,85,,percent of total billed charges,,1518.56,1913.3,
NM LUNG VENTILATION,28101063,CDM,78597,CPT,340,RC,inpatient,TC,1865,1865,,1583.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1406.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1585.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1641.2,88,,percent of total billed charges,,,,,,,,,1424.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1697.15,91,,percent of total billed charges,,,1771.75,95,,percent of total billed charges,,,1547.95,83,,percent of total billed charges,,,1547.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1547.95,83,,percent of total billed charges,,,1771.75,95,,percent of total billed charges,,,1678.5,90,,percent of total billed charges,,,1678.5,90,,percent of total billed charges,,,1529.3,82,,percent of total billed charges,,,1678.5,90,,percent of total billed charges,,,1585.25,85,,percent of total billed charges,,1406.21,1771.75,
NM LUNG QUANTIFICATION,28101064,CDM,78598,CPT,340,RC,inpatient,TC,2365,2365,,2007.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1783.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2010.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2081.2,88,,percent of total billed charges,,,,,,,,,1806.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2152.15,91,,percent of total billed charges,,,2246.75,95,,percent of total billed charges,,,1962.95,83,,percent of total billed charges,,,1962.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1962.95,83,,percent of total billed charges,,,2246.75,95,,percent of total billed charges,,,2128.5,90,,percent of total billed charges,,,2128.5,90,,percent of total billed charges,,,1939.3,82,,percent of total billed charges,,,2128.5,90,,percent of total billed charges,,,2010.25,85,,percent of total billed charges,,1783.21,2246.75,
NM BONE SPECT,28101065,CDM,78803,CPT,340,RC,inpatient,TC,3218,3218,,2732.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2426.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2735.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2831.84,88,,percent of total billed charges,,,,,,,,,2458.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2928.38,91,,percent of total billed charges,,,3057.1,95,,percent of total billed charges,,,2670.94,83,,percent of total billed charges,,,2670.94,83,,percent of total billed charges,,,,,,,,,,,,,,,2670.94,83,,percent of total billed charges,,,3057.1,95,,percent of total billed charges,,,2896.2,90,,percent of total billed charges,,,2896.2,90,,percent of total billed charges,,,2638.76,82,,percent of total billed charges,,,2896.2,90,,percent of total billed charges,,,2735.3,85,,percent of total billed charges,,2426.37,3057.1,
NM LIVER SPECT,28101066,CDM,78803,CPT,340,RC,inpatient,TC,3047,3047,,2586.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2297.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2589.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2681.36,88,,percent of total billed charges,,,,,,,,,2327.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2772.77,91,,percent of total billed charges,,,2894.65,95,,percent of total billed charges,,,2529.01,83,,percent of total billed charges,,,2529.01,83,,percent of total billed charges,,,,,,,,,,,,,,,2529.01,83,,percent of total billed charges,,,2894.65,95,,percent of total billed charges,,,2742.3,90,,percent of total billed charges,,,2742.3,90,,percent of total billed charges,,,2498.54,82,,percent of total billed charges,,,2742.3,90,,percent of total billed charges,,,2589.95,85,,percent of total billed charges,,2297.44,2894.65,
NM BONE,28101089,CDM,78306,CPT,340,RC,inpatient,TC,3045,3045,,2585.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2295.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2588.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2679.6,88,,percent of total billed charges,,,,,,,,,2326.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2770.95,91,,percent of total billed charges,,,2892.75,95,,percent of total billed charges,,,2527.35,83,,percent of total billed charges,,,2527.35,83,,percent of total billed charges,,,,,,,,,,,,,,,2527.35,83,,percent of total billed charges,,,2892.75,95,,percent of total billed charges,,,2740.5,90,,percent of total billed charges,,,2740.5,90,,percent of total billed charges,,,2496.9,82,,percent of total billed charges,,,2740.5,90,,percent of total billed charges,,,2588.25,85,,percent of total billed charges,,2295.93,2892.75,
NM PARATHYROID,28101090,CDM,78070,CPT,340,RC,inpatient,TC,3680,3680,,3124.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2774.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3128,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3238.4,88,,percent of total billed charges,,,,,,,,,2811.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3348.8,91,,percent of total billed charges,,,3496,95,,percent of total billed charges,,,3054.4,83,,percent of total billed charges,,,3054.4,83,,percent of total billed charges,,,,,,,,,,,,,,,3054.4,83,,percent of total billed charges,,,3496,95,,percent of total billed charges,,,3312,90,,percent of total billed charges,,,3312,90,,percent of total billed charges,,,3017.6,82,,percent of total billed charges,,,3312,90,,percent of total billed charges,,,3128,85,,percent of total billed charges,,2774.72,3496,
NM INTEST/MECKELS,28101097,CDM,78290,CPT,340,RC,inpatient,TC,2365,2365,,2007.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1783.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2010.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2081.2,88,,percent of total billed charges,,,,,,,,,1806.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2152.15,91,,percent of total billed charges,,,2246.75,95,,percent of total billed charges,,,1962.95,83,,percent of total billed charges,,,1962.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1962.95,83,,percent of total billed charges,,,2246.75,95,,percent of total billed charges,,,2128.5,90,,percent of total billed charges,,,2128.5,90,,percent of total billed charges,,,1939.3,82,,percent of total billed charges,,,2128.5,90,,percent of total billed charges,,,2010.25,85,,percent of total billed charges,,1783.21,2246.75,
NM CISTERNOGRAM,28101100,CDM,78650,CPT,340,RC,inpatient,TC,2237,2237,,1899.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1686.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1901.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1968.56,88,,percent of total billed charges,,,,,,,,,1709.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2035.67,91,,percent of total billed charges,,,2125.15,95,,percent of total billed charges,,,1856.71,83,,percent of total billed charges,,,1856.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1856.71,83,,percent of total billed charges,,,2125.15,95,,percent of total billed charges,,,2013.3,90,,percent of total billed charges,,,2013.3,90,,percent of total billed charges,,,1834.34,82,,percent of total billed charges,,,2013.3,90,,percent of total billed charges,,,1901.45,85,,percent of total billed charges,,1686.7,2125.15,
NM CISTERNOGRAM FLUID SCAN,28101101,CDM,78630,CPT,340,RC,inpatient,TC,3336,3336,,2832.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2515.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2835.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2935.68,88,,percent of total billed charges,,,,,,,,,2548.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3035.76,91,,percent of total billed charges,,,3169.2,95,,percent of total billed charges,,,2768.88,83,,percent of total billed charges,,,2768.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2768.88,83,,percent of total billed charges,,,3169.2,95,,percent of total billed charges,,,3002.4,90,,percent of total billed charges,,,3002.4,90,,percent of total billed charges,,,2735.52,82,,percent of total billed charges,,,3002.4,90,,percent of total billed charges,,,2835.6,85,,percent of total billed charges,,2515.34,3169.2,
NM HIDA W/CCK CHALLENGE,28101105,CDM,78227,CPT,340,RC,inpatient,TC,3036,3036,,2577.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2289.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2580.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2671.68,88,,percent of total billed charges,,,,,,,,,2319.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2762.76,91,,percent of total billed charges,,,2884.2,95,,percent of total billed charges,,,2519.88,83,,percent of total billed charges,,,2519.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2519.88,83,,percent of total billed charges,,,2884.2,95,,percent of total billed charges,,,2732.4,90,,percent of total billed charges,,,2732.4,90,,percent of total billed charges,,,2489.52,82,,percent of total billed charges,,,2732.4,90,,percent of total billed charges,,,2580.6,85,,percent of total billed charges,,2289.14,2884.2,
NM RENOGRAMW/CAPOTEN/LASIX,28101113,CDM,78708,CPT,340,RC,inpatient,TC,2843,2843,,2413.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2143.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2416.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2501.84,88,,percent of total billed charges,,,,,,,,,2172.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2587.13,91,,percent of total billed charges,,,2700.85,95,,percent of total billed charges,,,2359.69,83,,percent of total billed charges,,,2359.69,83,,percent of total billed charges,,,,,,,,,,,,,,,2359.69,83,,percent of total billed charges,,,2700.85,95,,percent of total billed charges,,,2558.7,90,,percent of total billed charges,,,2558.7,90,,percent of total billed charges,,,2331.26,82,,percent of total billed charges,,,2558.7,90,,percent of total billed charges,,,2416.55,85,,percent of total billed charges,,2143.62,2700.85,
NM MYOCRDIOSNGL(RSTORSTRS),28101139,CDM,78451,CPT,340,RC,inpatient,TC,5111,5111,,4339.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3853.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4344.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4497.68,88,,percent of total billed charges,,,,,,,,,3904.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4651.01,91,,percent of total billed charges,,,4855.45,95,,percent of total billed charges,,,4242.13,83,,percent of total billed charges,,,4242.13,83,,percent of total billed charges,,,,,,,,,,,,,,,4242.13,83,,percent of total billed charges,,,4855.45,95,,percent of total billed charges,,,4599.9,90,,percent of total billed charges,,,4599.9,90,,percent of total billed charges,,,4191.02,82,,percent of total billed charges,,,4599.9,90,,percent of total billed charges,,,4344.35,85,,percent of total billed charges,,3853.69,4855.45,
NM MYOCRDIO STRS/RST,28101147,CDM,78452,CPT,340,RC,inpatient,TC,6939,6939,,5891.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5232.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5898.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6106.32,88,,percent of total billed charges,,,,,,,,,5301.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6314.49,91,,percent of total billed charges,,,6592.05,95,,percent of total billed charges,,,5759.37,83,,percent of total billed charges,,,5759.37,83,,percent of total billed charges,,,,,,,,,,,,,,,5759.37,83,,percent of total billed charges,,,6592.05,95,,percent of total billed charges,,,6245.1,90,,percent of total billed charges,,,6245.1,90,,percent of total billed charges,,,5689.98,82,,percent of total billed charges,,,6245.1,90,,percent of total billed charges,,,5898.15,85,,percent of total billed charges,,5232.01,6592.05,
NM CARDIAC EJECT(DONOTUSE),28101153,CDM,78480,CPT,340,RC,inpatient,,1201,1201,,1019.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,905.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1020.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1056.88,88,,percent of total billed charges,,,,,,,,,917.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1092.91,91,,percent of total billed charges,,,1140.95,95,,percent of total billed charges,,,996.83,83,,percent of total billed charges,,,996.83,83,,percent of total billed charges,,,,,,,,,,,,,,,996.83,83,,percent of total billed charges,,,1140.95,95,,percent of total billed charges,,,1080.9,90,,percent of total billed charges,,,1080.9,90,,percent of total billed charges,,,984.82,82,,percent of total billed charges,,,1080.9,90,,percent of total billed charges,,,1020.85,85,,percent of total billed charges,,905.55,1140.95,
NM CARDIAC WALL(DONOTUSE),28101155,CDM,78478,CPT,340,RC,inpatient,,1201,1201,,1019.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,905.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1020.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1056.88,88,,percent of total billed charges,,,,,,,,,917.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1092.91,91,,percent of total billed charges,,,1140.95,95,,percent of total billed charges,,,996.83,83,,percent of total billed charges,,,996.83,83,,percent of total billed charges,,,,,,,,,,,,,,,996.83,83,,percent of total billed charges,,,1140.95,95,,percent of total billed charges,,,1080.9,90,,percent of total billed charges,,,1080.9,90,,percent of total billed charges,,,984.82,82,,percent of total billed charges,,,1080.9,90,,percent of total billed charges,,,1020.85,85,,percent of total billed charges,,905.55,1140.95,
NM MYOCARDIAL PERFUSION PLANAR MULT STDY,28101156,CDM,78454,CPT,340,RC,inpatient,TC,5960,5960,,5060.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4493.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5066,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5244.8,88,,percent of total billed charges,,,,,,,,,4553.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5423.6,91,,percent of total billed charges,,,5662,95,,percent of total billed charges,,,4946.8,83,,percent of total billed charges,,,4946.8,83,,percent of total billed charges,,,,,,,,,,,,,,,4946.8,83,,percent of total billed charges,,,5662,95,,percent of total billed charges,,,5364,90,,percent of total billed charges,,,5364,90,,percent of total billed charges,,,4887.2,82,,percent of total billed charges,,,5364,90,,percent of total billed charges,,,5066,85,,percent of total billed charges,,4493.84,5662,
NM THYROID/UPTKANDSCAN,28101172,CDM,78014,CPT,340,RC,inpatient,TC,2486,2486,,2110.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1874.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2113.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2187.68,88,,percent of total billed charges,,,,,,,,,1899.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2262.26,91,,percent of total billed charges,,,2361.7,95,,percent of total billed charges,,,2063.38,83,,percent of total billed charges,,,2063.38,83,,percent of total billed charges,,,,,,,,,,,,,,,2063.38,83,,percent of total billed charges,,,2361.7,95,,percent of total billed charges,,,2237.4,90,,percent of total billed charges,,,2237.4,90,,percent of total billed charges,,,2038.52,82,,percent of total billed charges,,,2237.4,90,,percent of total billed charges,,,2113.1,85,,percent of total billed charges,,1874.44,2361.7,
NM THYROIDMETS/WHLBDY-I131,28101173,CDM,78018,CPT,340,RC,inpatient,TC,3168,3168,,2689.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2388.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2692.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2787.84,88,,percent of total billed charges,,,,,,,,,2420.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2882.88,91,,percent of total billed charges,,,3009.6,95,,percent of total billed charges,,,2629.44,83,,percent of total billed charges,,,2629.44,83,,percent of total billed charges,,,,,,,,,,,,,,,2629.44,83,,percent of total billed charges,,,3009.6,95,,percent of total billed charges,,,2851.2,90,,percent of total billed charges,,,2851.2,90,,percent of total billed charges,,,2597.76,82,,percent of total billed charges,,,2851.2,90,,percent of total billed charges,,,2692.8,85,,percent of total billed charges,,2388.67,3009.6,
NM TOMO SPECT INFARCT,28101194,CDM,0332T,CPT,340,RC,inpatient,TC,1744,1744,,1480.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1314.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1482.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1534.72,88,,percent of total billed charges,,,,,,,,,1332.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1587.04,91,,percent of total billed charges,,,1656.8,95,,percent of total billed charges,,,1447.52,83,,percent of total billed charges,,,1447.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1447.52,83,,percent of total billed charges,,,1656.8,95,,percent of total billed charges,,,1569.6,90,,percent of total billed charges,,,1569.6,90,,percent of total billed charges,,,1430.08,82,,percent of total billed charges,,,1569.6,90,,percent of total billed charges,,,1482.4,85,,percent of total billed charges,,1314.98,1656.8,
NM CARDIAC PLANAR,28101195,CDM,0331T,CPT,340,RC,inpatient,TC,2093,2093,,1776.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1578.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1779.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1841.84,88,,percent of total billed charges,,,,,,,,,1599.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1904.63,91,,percent of total billed charges,,,1988.35,95,,percent of total billed charges,,,1737.19,83,,percent of total billed charges,,,1737.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1737.19,83,,percent of total billed charges,,,1988.35,95,,percent of total billed charges,,,1883.7,90,,percent of total billed charges,,,1883.7,90,,percent of total billed charges,,,1716.26,82,,percent of total billed charges,,,1883.7,90,,percent of total billed charges,,,1779.05,85,,percent of total billed charges,,1578.12,1988.35,
NM ACUTE MI,28101196,CDM,78466,CPT,340,RC,inpatient,TC,2028,2028,,1721.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1529.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1723.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1784.64,88,,percent of total billed charges,,,,,,,,,1549.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1845.48,91,,percent of total billed charges,,,1926.6,95,,percent of total billed charges,,,1683.24,83,,percent of total billed charges,,,1683.24,83,,percent of total billed charges,,,,,,,,,,,,,,,1683.24,83,,percent of total billed charges,,,1926.6,95,,percent of total billed charges,,,1825.2,90,,percent of total billed charges,,,1825.2,90,,percent of total billed charges,,,1662.96,82,,percent of total billed charges,,,1825.2,90,,percent of total billed charges,,,1723.8,85,,percent of total billed charges,,1529.11,1926.6,
NM GALLIUM ABSCESS BODY,28101197,CDM,78300,CPT,340,RC,inpatient,TC,3948,3948,,3351.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2976.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3355.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3474.24,88,,percent of total billed charges,,,,,,,,,3016.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3592.68,91,,percent of total billed charges,,,3750.6,95,,percent of total billed charges,,,3276.84,83,,percent of total billed charges,,,3276.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3276.84,83,,percent of total billed charges,,,3750.6,95,,percent of total billed charges,,,3553.2,90,,percent of total billed charges,,,3553.2,90,,percent of total billed charges,,,3237.36,82,,percent of total billed charges,,,3553.2,90,,percent of total billed charges,,,3355.8,85,,percent of total billed charges,,2976.79,3750.6,
NM GALLIUM ABSCESS SPECT,28101198,CDM,78305,CPT,340,RC,inpatient,TC,3369,3369,,2860.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2540.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2863.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2964.72,88,,percent of total billed charges,,,,,,,,,2573.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3065.79,91,,percent of total billed charges,,,3200.55,95,,percent of total billed charges,,,2796.27,83,,percent of total billed charges,,,2796.27,83,,percent of total billed charges,,,,,,,,,,,,,,,2796.27,83,,percent of total billed charges,,,3200.55,95,,percent of total billed charges,,,3032.1,90,,percent of total billed charges,,,3032.1,90,,percent of total billed charges,,,2762.58,82,,percent of total billed charges,,,3032.1,90,,percent of total billed charges,,,2863.65,85,,percent of total billed charges,,2540.23,3200.55,
NM GALL TUMOR LOC BODY,28101200,CDM,78802,CPT,340,RC,inpatient,TC,3761,3761,,3193.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2835.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3196.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3309.68,88,,percent of total billed charges,,,,,,,,,2873.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3422.51,91,,percent of total billed charges,,,3572.95,95,,percent of total billed charges,,,3121.63,83,,percent of total billed charges,,,3121.63,83,,percent of total billed charges,,,,,,,,,,,,,,,3121.63,83,,percent of total billed charges,,,3572.95,95,,percent of total billed charges,,,3384.9,90,,percent of total billed charges,,,3384.9,90,,percent of total billed charges,,,3084.02,82,,percent of total billed charges,,,3384.9,90,,percent of total billed charges,,,3196.85,85,,percent of total billed charges,,2835.79,3572.95,
NM GALL TUMOR LOCATE LTD,28101201,CDM,78800,CPT,340,RC,inpatient,TC,1366,1366,,1159.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1029.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1161.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1202.08,88,,percent of total billed charges,,,,,,,,,1043.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1243.06,91,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1133.78,83,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1120.12,82,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1161.1,85,,percent of total billed charges,,1029.96,1297.7,
NM MYOCARDIAL PYP SCAN,28101202,CDM,78803,CPT,340,RC,inpatient,TC,4501,4501,,3821.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3393.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3825.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3960.88,88,,percent of total billed charges,,,,,,,,,3438.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4095.91,91,,percent of total billed charges,,,4275.95,95,,percent of total billed charges,,,3735.83,83,,percent of total billed charges,,,3735.83,83,,percent of total billed charges,,,,,,,,,,,,,,,3735.83,83,,percent of total billed charges,,,4275.95,95,,percent of total billed charges,,,4050.9,90,,percent of total billed charges,,,4050.9,90,,percent of total billed charges,,,3690.82,82,,percent of total billed charges,,,4050.9,90,,percent of total billed charges,,,3825.85,85,,percent of total billed charges,,3393.75,4275.95,
NM TESTICULAR,28101204,CDM,78761,CPT,340,RC,inpatient,TC,1705,1705,,1447.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1285.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1449.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1500.4,88,,percent of total billed charges,,,,,,,,,1302.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1551.55,91,,percent of total billed charges,,,1619.75,95,,percent of total billed charges,,,1415.15,83,,percent of total billed charges,,,1415.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1415.15,83,,percent of total billed charges,,,1619.75,95,,percent of total billed charges,,,1534.5,90,,percent of total billed charges,,,1534.5,90,,percent of total billed charges,,,1398.1,82,,percent of total billed charges,,,1534.5,90,,percent of total billed charges,,,1449.25,85,,percent of total billed charges,,1285.57,1619.75,
NM BONE 3 PHASE,28101253,CDM,78315,CPT,340,RC,inpatient,TC,3212,3212,,2726.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2421.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2730.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2826.56,88,,percent of total billed charges,,,,,,,,,2453.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2922.92,91,,percent of total billed charges,,,3051.4,95,,percent of total billed charges,,,2665.96,83,,percent of total billed charges,,,2665.96,83,,percent of total billed charges,,,,,,,,,,,,,,,2665.96,83,,percent of total billed charges,,,3051.4,95,,percent of total billed charges,,,2890.8,90,,percent of total billed charges,,,2890.8,90,,percent of total billed charges,,,2633.84,82,,percent of total billed charges,,,2890.8,90,,percent of total billed charges,,,2730.2,85,,percent of total billed charges,,2421.85,3051.4,
NM BONE LTD,28103028,CDM,78300,CPT,340,RC,inpatient,TC,1315,1315,,1116.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,991.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1117.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1157.2,88,,percent of total billed charges,,,,,,,,,1004.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1196.65,91,,percent of total billed charges,,,1249.25,95,,percent of total billed charges,,,1091.45,83,,percent of total billed charges,,,1091.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1091.45,83,,percent of total billed charges,,,1249.25,95,,percent of total billed charges,,,1183.5,90,,percent of total billed charges,,,1183.5,90,,percent of total billed charges,,,1078.3,82,,percent of total billed charges,,,1183.5,90,,percent of total billed charges,,,1117.75,85,,percent of total billed charges,,991.51,1249.25,
NM DOSE BONE/DOSE (<30 mCi),28103200,CDM,A9503,HCPCS,636,RC,inpatient,,351,351,,298,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,264.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,298.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,308.88,88,,percent of total billed charges,,,,,,,,,268.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,319.41,91,,percent of total billed charges,,,333.45,95,,percent of total billed charges,,,291.33,83,,percent of total billed charges,,,291.33,83,,percent of total billed charges,,,,,,,,,,,,,,,291.33,83,,percent of total billed charges,,,333.45,95,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,287.82,82,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,298.35,85,,percent of total billed charges,,264.65,333.45,
NM DOSE CCK,28103201,CDM,,,250,RC,inpatient,,223,223,,189.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.24,88,,percent of total billed charges,,,,,,,,,170.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,202.93,91,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,,,,,,,,,,,,,185.09,83,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,182.86,82,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,168.14,211.85,
* NM DOSE DTPA (PER mCi)(V1205),28103202,CDM,A9515,HCPCS,636,RC,inpatient,,30,30,,25.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.4,88,,percent of total billed charges,,,,,,,,,22.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,24.9,83,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,24.6,82,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,22.62,28.5,
NM DOSE CERETEC/DOSE (<25mCi),28103205,CDM,A9521,HCPCS,343,RC,inpatient,,12487,12487,,10601.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9415.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10613.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10988.56,88,,percent of total billed charges,,,,,,,,,9540.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11363.17,91,,percent of total billed charges,,,11862.65,95,,percent of total billed charges,,,10364.21,83,,percent of total billed charges,,,10364.21,83,,percent of total billed charges,,,,,,,,,,,,,,,10364.21,83,,percent of total billed charges,,,11862.65,95,,percent of total billed charges,,,11238.3,90,,percent of total billed charges,,,11238.3,90,,percent of total billed charges,,,10239.34,82,,percent of total billed charges,,,11238.3,90,,percent of total billed charges,,,10613.95,85,,percent of total billed charges,,9415.2,11862.65,
NM DOSE SESTAMIBI/DOSE (<40mCi),28103210,CDM,A9500,HCPCS,636,RC,inpatient,,983,983,,834.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,741.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,835.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,865.04,88,,percent of total billed charges,,,,,,,,,751.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,894.53,91,,percent of total billed charges,,,933.85,95,,percent of total billed charges,,,815.89,83,,percent of total billed charges,,,815.89,83,,percent of total billed charges,,,,,,,,,,,,,,,815.89,83,,percent of total billed charges,,,933.85,95,,percent of total billed charges,,,884.7,90,,percent of total billed charges,,,884.7,90,,percent of total billed charges,,,806.06,82,,percent of total billed charges,,,884.7,90,,percent of total billed charges,,,835.55,85,,percent of total billed charges,,741.18,933.85,
NM LYMPHOSCINTOGRAPHY (SENT NODE),28103211,CDM,78195,CPT,341,RC,inpatient,TC,2784,2784,,2363.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2099.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2366.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2449.92,88,,percent of total billed charges,,,,,,,,,2126.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2533.44,91,,percent of total billed charges,,,2644.8,95,,percent of total billed charges,,,2310.72,83,,percent of total billed charges,,,2310.72,83,,percent of total billed charges,,,,,,,,,,,,,,,2310.72,83,,percent of total billed charges,,,2644.8,95,,percent of total billed charges,,,2505.6,90,,percent of total billed charges,,,2505.6,90,,percent of total billed charges,,,2282.88,82,,percent of total billed charges,,,2505.6,90,,percent of total billed charges,,,2366.4,85,,percent of total billed charges,,2099.14,2644.8,
NM GATED HEART (MUGA),28103212,CDM,78472,CPT,341,RC,inpatient,TC,2933,2933,,2490.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2211.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2493.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2581.04,88,,percent of total billed charges,,,,,,,,,2240.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2669.03,91,,percent of total billed charges,,,2786.35,95,,percent of total billed charges,,,2434.39,83,,percent of total billed charges,,,2434.39,83,,percent of total billed charges,,,,,,,,,,,,,,,2434.39,83,,percent of total billed charges,,,2786.35,95,,percent of total billed charges,,,2639.7,90,,percent of total billed charges,,,2639.7,90,,percent of total billed charges,,,2405.06,82,,percent of total billed charges,,,2639.7,90,,percent of total billed charges,,,2493.05,85,,percent of total billed charges,,2211.48,2786.35,
NM DOSE DTPA/DOSE (<25mCi),28103213,CDM,A9539,HCPCS,636,RC,inpatient,,435,435,,369.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,327.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,369.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,382.8,88,,percent of total billed charges,,,,,,,,,332.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,395.85,91,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,,,,,,,,,,,,,361.05,83,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,356.7,82,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,327.99,413.25,
NM DOSE GALLIUM/mCi,28103214,CDM,A9556,HCPCS,343,RC,inpatient,,334,334,,283.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,251.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,283.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,293.92,88,,percent of total billed charges,,,,,,,,,255.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,303.94,91,,percent of total billed charges,,,317.3,95,,percent of total billed charges,,,277.22,83,,percent of total billed charges,,,277.22,83,,percent of total billed charges,,,,,,,,,,,,,,,277.22,83,,percent of total billed charges,,,317.3,95,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,273.88,82,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,283.9,85,,percent of total billed charges,,251.84,317.3,
NM DOSE CHOLETEC/DOSE (<15mCi),28103215,CDM,A9537,HCPCS,636,RC,inpatient,,384,384,,326.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,289.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,326.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,337.92,88,,percent of total billed charges,,,,,,,,,293.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,349.44,91,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,,,,,,,,,,,,,318.72,83,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,314.88,82,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,326.4,85,,percent of total billed charges,,289.54,364.8,
NM DOSE INDIUM/.5mCi,28103216,CDM,A9547,HCPCS,343,RC,inpatient,,9946,9946,,8444.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7499.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8454.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8752.48,88,,percent of total billed charges,,,,,,,,,7598.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9050.86,91,,percent of total billed charges,,,9448.7,95,,percent of total billed charges,,,8255.18,83,,percent of total billed charges,,,8255.18,83,,percent of total billed charges,,,,,,,,,,,,,,,8255.18,83,,percent of total billed charges,,,9448.7,95,,percent of total billed charges,,,8951.4,90,,percent of total billed charges,,,8951.4,90,,percent of total billed charges,,,8155.72,82,,percent of total billed charges,,,8951.4,90,,percent of total billed charges,,,8454.1,85,,percent of total billed charges,,7499.28,9448.7,
NM DOSE MAA/DOSE (<10 mCi),28103217,CDM,A9540,HCPCS,343,RC,inpatient,,282,282,,239.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,212.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,239.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,248.16,88,,percent of total billed charges,,,,,,,,,215.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,256.62,91,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,,,,,,,,,,,,,234.06,83,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,231.24,82,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,239.7,85,,percent of total billed charges,,212.63,267.9,
NM GI BLEED,28103218,CDM,78278,CPT,340,RC,inpatient,TC,2549,2549,,2164.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1921.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2166.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2243.12,88,,percent of total billed charges,,,,,,,,,1947.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2319.59,91,,percent of total billed charges,,,2421.55,95,,percent of total billed charges,,,2115.67,83,,percent of total billed charges,,,2115.67,83,,percent of total billed charges,,,,,,,,,,,,,,,2115.67,83,,percent of total billed charges,,,2421.55,95,,percent of total billed charges,,,2294.1,90,,percent of total billed charges,,,2294.1,90,,percent of total billed charges,,,2090.18,82,,percent of total billed charges,,,2294.1,90,,percent of total billed charges,,,2166.65,85,,percent of total billed charges,,1921.95,2421.55,
NM DOSE TECHNITIUM/mCi,28103219,CDM,A9512,HCPCS,343,RC,inpatient,,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,200.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,226.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,200.56,252.7,
NM DOSE TECHNETIUM TC-99 PYROPH (25mCi),28103220,CDM,A9538,HCPCS,636,RC,inpatient,,435,435,,369.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,327.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,369.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,382.8,88,,percent of total billed charges,,,,,,,,,332.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,395.85,91,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,,,,,,,,,,,,,361.05,83,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,356.7,82,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,327.99,413.25,
NM DOSE IODINE I123/100 uCi,28103221,CDM,A9516,HCPCS,636,RC,inpatient,,415,415,,352.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,312.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,352.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,365.2,88,,percent of total billed charges,,,,,,,,,317.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,377.65,91,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,,,,,,,,,,,,,344.45,83,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,340.3,82,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,312.91,394.25,
NM DOSE CARDIOLITE/DOSE (<40mCi),28103223,CDM,A9500,HCPCS,636,RC,inpatient,,1032,1032,,876.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,778.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,877.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,908.16,88,,percent of total billed charges,,,,,,,,,788.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,939.12,91,,percent of total billed charges,,,980.4,95,,percent of total billed charges,,,856.56,83,,percent of total billed charges,,,856.56,83,,percent of total billed charges,,,,,,,,,,,,,,,856.56,83,,percent of total billed charges,,,980.4,95,,percent of total billed charges,,,928.8,90,,percent of total billed charges,,,928.8,90,,percent of total billed charges,,,846.24,82,,percent of total billed charges,,,928.8,90,,percent of total billed charges,,,877.2,85,,percent of total billed charges,,778.13,980.4,
NM DOSE THALLIUM/mCi,28103224,CDM,A9505,HCPCS,636,RC,inpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,223.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,252.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,223.94,282.15,
NM DOSE IODINE I131/0.5 mCi,28103225,CDM,A9508,HCPCS,636,RC,inpatient,,1229,1229,,1043.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,926.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1044.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1081.52,88,,percent of total billed charges,,,,,,,,,938.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1118.39,91,,percent of total billed charges,,,1167.55,95,,percent of total billed charges,,,1020.07,83,,percent of total billed charges,,,1020.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1020.07,83,,percent of total billed charges,,,1167.55,95,,percent of total billed charges,,,1106.1,90,,percent of total billed charges,,,1106.1,90,,percent of total billed charges,,,1007.78,82,,percent of total billed charges,,,1106.1,90,,percent of total billed charges,,,1044.65,85,,percent of total billed charges,,926.67,1167.55,
NM RENAL W/FLOW,28103226,CDM,78707,CPT,340,RC,inpatient,TC,2821,2821,,2395.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2127.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2397.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2482.48,88,,percent of total billed charges,,,,,,,,,2155.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2567.11,91,,percent of total billed charges,,,2679.95,95,,percent of total billed charges,,,2341.43,83,,percent of total billed charges,,,2341.43,83,,percent of total billed charges,,,,,,,,,,,,,,,2341.43,83,,percent of total billed charges,,,2679.95,95,,percent of total billed charges,,,2538.9,90,,percent of total billed charges,,,2538.9,90,,percent of total billed charges,,,2313.22,82,,percent of total billed charges,,,2538.9,90,,percent of total billed charges,,,2397.85,85,,percent of total billed charges,,2127.03,2679.95,
NM DOSE MAG 3/DOSE (<15mCi),28103227,CDM,A9562,HCPCS,636,RC,inpatient,,1198,1198,,1017.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,903.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1018.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1054.24,88,,percent of total billed charges,,,,,,,,,915.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1090.18,91,,percent of total billed charges,,,1138.1,95,,percent of total billed charges,,,994.34,83,,percent of total billed charges,,,994.34,83,,percent of total billed charges,,,,,,,,,,,,,,,994.34,83,,percent of total billed charges,,,1138.1,95,,percent of total billed charges,,,1078.2,90,,percent of total billed charges,,,1078.2,90,,percent of total billed charges,,,982.36,82,,percent of total billed charges,,,1078.2,90,,percent of total billed charges,,,1018.3,85,,percent of total billed charges,,903.29,1138.1,
NM DOSE SULFUR COLLOID/DOSE (<20mCi),28103228,CDM,A9541,HCPCS,343,RC,inpatient,,623,623,,528.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,469.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,529.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,548.24,88,,percent of total billed charges,,,,,,,,,475.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,566.93,91,,percent of total billed charges,,,591.85,95,,percent of total billed charges,,,517.09,83,,percent of total billed charges,,,517.09,83,,percent of total billed charges,,,,,,,,,,,,,,,517.09,83,,percent of total billed charges,,,591.85,95,,percent of total billed charges,,,560.7,90,,percent of total billed charges,,,560.7,90,,percent of total billed charges,,,510.86,82,,percent of total billed charges,,,560.7,90,,percent of total billed charges,,,529.55,85,,percent of total billed charges,,469.74,591.85,
NM DOSE ULTRA TAG/DOSE (<30mCi),28103229,CDM,A9560,HCPCS,343,RC,inpatient,,769,769,,652.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,579.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,653.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,676.72,88,,percent of total billed charges,,,,,,,,,587.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,699.79,91,,percent of total billed charges,,,730.55,95,,percent of total billed charges,,,638.27,83,,percent of total billed charges,,,638.27,83,,percent of total billed charges,,,,,,,,,,,,,,,638.27,83,,percent of total billed charges,,,730.55,95,,percent of total billed charges,,,692.1,90,,percent of total billed charges,,,692.1,90,,percent of total billed charges,,,630.58,82,,percent of total billed charges,,,692.1,90,,percent of total billed charges,,,653.65,85,,percent of total billed charges,,579.83,730.55,
NM DOSE THALLIUM/mCi,28103230,CDM,A9505,HCPCS,636,RC,inpatient,,1487,1487,,1262.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1121.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1263.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1308.56,88,,percent of total billed charges,,,,,,,,,1136.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1353.17,91,,percent of total billed charges,,,1412.65,95,,percent of total billed charges,,,1234.21,83,,percent of total billed charges,,,1234.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1234.21,83,,percent of total billed charges,,,1412.65,95,,percent of total billed charges,,,1338.3,90,,percent of total billed charges,,,1338.3,90,,percent of total billed charges,,,1219.34,82,,percent of total billed charges,,,1338.3,90,,percent of total billed charges,,,1263.95,85,,percent of total billed charges,,1121.2,1412.65,
NM WHITE BLOOD CELL TAGGED,28103250,CDM,78300,CPT,340,RC,inpatient,TC,4849,4849,,4116.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3656.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4121.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4267.12,88,,percent of total billed charges,,,,,,,,,3704.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4412.59,91,,percent of total billed charges,,,4606.55,95,,percent of total billed charges,,,4024.67,83,,percent of total billed charges,,,4024.67,83,,percent of total billed charges,,,,,,,,,,,,,,,4024.67,83,,percent of total billed charges,,,4606.55,95,,percent of total billed charges,,,4364.1,90,,percent of total billed charges,,,4364.1,90,,percent of total billed charges,,,3976.18,82,,percent of total billed charges,,,4364.1,90,,percent of total billed charges,,,4121.65,85,,percent of total billed charges,,3656.15,4606.55,
NM GASTRIC EMPTYING,28103260,CDM,78264,CPT,340,RC,inpatient,TC,2756,2756,,2339.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2078.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2342.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2425.28,88,,percent of total billed charges,,,,,,,,,2105.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2507.96,91,,percent of total billed charges,,,2618.2,95,,percent of total billed charges,,,2287.48,83,,percent of total billed charges,,,2287.48,83,,percent of total billed charges,,,,,,,,,,,,,,,2287.48,83,,percent of total billed charges,,,2618.2,95,,percent of total billed charges,,,2480.4,90,,percent of total billed charges,,,2480.4,90,,percent of total billed charges,,,2259.92,82,,percent of total billed charges,,,2480.4,90,,percent of total billed charges,,,2342.6,85,,percent of total billed charges,,2078.02,2618.2,
NM DOSE IN-111 PENTETATE PER.5MC,28103290,CDM,A9548,HCPCS,343,RC,inpatient,,1851,1851,,1571.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1395.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1573.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1628.88,88,,percent of total billed charges,,,,,,,,,1414.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1684.41,91,,percent of total billed charges,,,1758.45,95,,percent of total billed charges,,,1536.33,83,,percent of total billed charges,,,1536.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1536.33,83,,percent of total billed charges,,,1758.45,95,,percent of total billed charges,,,1665.9,90,,percent of total billed charges,,,1665.9,90,,percent of total billed charges,,,1517.82,82,,percent of total billed charges,,,1665.9,90,,percent of total billed charges,,,1573.35,85,,percent of total billed charges,,1395.65,1758.45,
NM TUMOR LOCAL BODY2OR>DAY,28444220,CDM,78804,CPT,340,RC,inpatient,TC,3260,3260,,2767.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2458.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2771,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2868.8,88,,percent of total billed charges,,,,,,,,,2490.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2966.6,91,,percent of total billed charges,,,3097,95,,percent of total billed charges,,,2705.8,83,,percent of total billed charges,,,2705.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2705.8,83,,percent of total billed charges,,,3097,95,,percent of total billed charges,,,2934,90,,percent of total billed charges,,,2934,90,,percent of total billed charges,,,2673.2,82,,percent of total billed charges,,,2934,90,,percent of total billed charges,,,2771,85,,percent of total billed charges,,2458.04,3097,
NM OCTREOSCAN 2 OR>DAY,28544220,CDM,78804,CPT,340,RC,inpatient,TC,9219,9219,,7826.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6951.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7836.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8112.72,88,,percent of total billed charges,,,,,,,,,7043.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8389.29,91,,percent of total billed charges,,,8758.05,95,,percent of total billed charges,,,7651.77,83,,percent of total billed charges,,,7651.77,83,,percent of total billed charges,,,,,,,,,,,,,,,7651.77,83,,percent of total billed charges,,,8758.05,95,,percent of total billed charges,,,8297.1,90,,percent of total billed charges,,,8297.1,90,,percent of total billed charges,,,7559.58,82,,percent of total billed charges,,,8297.1,90,,percent of total billed charges,,,7836.15,85,,percent of total billed charges,,6951.13,8758.05,
BEDSIDE PROCDURE-OB,830082,CDM,,,360,RC,inpatient,,536,536,,455.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,404.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,455.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,471.68,88,,percent of total billed charges,,,,,,,,,409.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,487.76,91,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,,,,,,,,,,,,,444.88,83,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,439.52,82,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,404.14,509.2,
LABOR PER HOUR,831000,CDM,,,721,RC,inpatient,,788,788,,669.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,594.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,669.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,693.44,88,,percent of total billed charges,,,,,,,,,602.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,717.08,91,,percent of total billed charges,,,748.6,95,,percent of total billed charges,,,654.04,83,,percent of total billed charges,,,654.04,83,,percent of total billed charges,,,,,,,,,,,,,,,654.04,83,,percent of total billed charges,,,748.6,95,,percent of total billed charges,,,709.2,90,,percent of total billed charges,,,709.2,90,,percent of total billed charges,,,646.16,82,,percent of total billed charges,,,709.2,90,,percent of total billed charges,,,669.8,85,,percent of total billed charges,,594.15,748.6,
NURSING CARE OBSERVATION FIRST HOUR,832003,CDM,G0378,HCPCS,762,RC,inpatient,,1475,1475,,1252.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1112.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1253.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1298,88,,percent of total billed charges,,,,,,,,,1126.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1342.25,91,,percent of total billed charges,,,1401.25,95,,percent of total billed charges,,,1224.25,83,,percent of total billed charges,,,1224.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1224.25,83,,percent of total billed charges,,,1401.25,95,,percent of total billed charges,,,1327.5,90,,percent of total billed charges,,,1327.5,90,,percent of total billed charges,,,1209.5,82,,percent of total billed charges,,,1327.5,90,,percent of total billed charges,,,1253.75,85,,percent of total billed charges,,1112.15,1401.25,
NURSING CARE OBSERVATION EACH ADDTL,832011,CDM,G0378,HCPCS,762,RC,inpatient,,178,178,,151.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,134.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,151.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,156.64,88,,percent of total billed charges,,,,,,,,,135.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,161.98,91,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,,,,,,,,,,,,,147.74,83,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,145.96,82,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,134.21,169.1,
EXTENDED RECOVERY 1ST HOUR,832015,CDM,,,710,RC,inpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,157.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,177.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,157.59,198.55,
EXTENDED RECOVERY EACH ADDTL HOUR,832017,CDM,,,710,RC,inpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,92.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,82.19,103.55,
PKU,832030,CDM,84030,CPT,300,RC,inpatient,,295,295,,250.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,222.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,250.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,259.6,88,,percent of total billed charges,,,,,,,,,225.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,268.45,91,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,,,,,,,,,,,,,244.85,83,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,241.9,82,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,222.43,280.25,
"CIRCUMCISION, EXCEPT NEWBORN",832031,CDM,54150,CPT,360,RC,inpatient,,1021,1021,,866.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,769.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,867.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,898.48,88,,percent of total billed charges,,,,,,,,,780.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,929.11,91,,percent of total billed charges,,,969.95,95,,percent of total billed charges,,,847.43,83,,percent of total billed charges,,,847.43,83,,percent of total billed charges,,,,,,,,,,,,,,,847.43,83,,percent of total billed charges,,,969.95,95,,percent of total billed charges,,,918.9,90,,percent of total billed charges,,,918.9,90,,percent of total billed charges,,,837.22,82,,percent of total billed charges,,,918.9,90,,percent of total billed charges,,,867.85,85,,percent of total billed charges,,769.83,969.95,
"BILIRUBIN, TOTAL, TRANSCUTANEOUS",832032,CDM,88720,CPT,300,RC,inpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,81.43,102.6,
BLOOD ADMINISTRATION SERVICE,832035,CDM,36430,CPT,391,RC,inpatient,,1766,1766,,1499.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1331.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1501.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1554.08,88,,percent of total billed charges,,,,,,,,,1349.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1607.06,91,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.78,83,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1448.12,82,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,1331.56,1677.7,
BLOOD ADIN UP TO 4 HOURS(V-11-20),832036,CDM,36430,CPT,391,RC,inpatient,,1372,1372,,1164.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1034.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1166.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1207.36,88,,percent of total billed charges,,,,,,,,,1048.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1248.52,91,,percent of total billed charges,,,1303.4,95,,percent of total billed charges,,,1138.76,83,,percent of total billed charges,,,1138.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.76,83,,percent of total billed charges,,,1303.4,95,,percent of total billed charges,,,1234.8,90,,percent of total billed charges,,,1234.8,90,,percent of total billed charges,,,1125.04,82,,percent of total billed charges,,,1234.8,90,,percent of total billed charges,,,1166.2,85,,percent of total billed charges,,1034.49,1303.4,
BLOOD ADMIN UP TO 6 HOURS(V-11-20),832037,CDM,36430,CPT,391,RC,inpatient,,1709,1709,,1450.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1288.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1452.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1503.92,88,,percent of total billed charges,,,,,,,,,1305.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1555.19,91,,percent of total billed charges,,,1623.55,95,,percent of total billed charges,,,1418.47,83,,percent of total billed charges,,,1418.47,83,,percent of total billed charges,,,,,,,,,,,,,,,1418.47,83,,percent of total billed charges,,,1623.55,95,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1401.38,82,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1452.65,85,,percent of total billed charges,,1288.59,1623.55,
BLOOD ADMIN OVER 6 HOURS(V-11-20),832038,CDM,36430,CPT,391,RC,inpatient,,2137,2137,,1814.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1611.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1816.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1880.56,88,,percent of total billed charges,,,,,,,,,1632.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1944.67,91,,percent of total billed charges,,,2030.15,95,,percent of total billed charges,,,1773.71,83,,percent of total billed charges,,,1773.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1773.71,83,,percent of total billed charges,,,2030.15,95,,percent of total billed charges,,,1923.3,90,,percent of total billed charges,,,1923.3,90,,percent of total billed charges,,,1752.34,82,,percent of total billed charges,,,1923.3,90,,percent of total billed charges,,,1816.45,85,,percent of total billed charges,,1611.3,2030.15,
"SUBCUTANEOUS INF,INITIAL, UP TO 1 HOUR",832048,CDM,96369,CPT,260,RC,inpatient,,672,672,,570.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,506.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,571.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,591.36,88,,percent of total billed charges,,,,,,,,,513.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,611.52,91,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,,,,,,,,,,,,,557.76,83,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,551.04,82,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,571.2,85,,percent of total billed charges,,506.69,638.4,
"IV INFUSION, HYDRATION, UP TO 1 HOUR",832050,CDM,96360,CPT,260,RC,inpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,627.33,790.4,
"IV INFUSION, HYDRATION, EA ADDTL HOUR",832051,CDM,96361,CPT,260,RC,inpatient,XU,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,189.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,213.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,189.25,238.45,
"IV INFUSION, THERAPEUTIC, UP TO 1 HOUR",832052,CDM,96365,CPT,260,RC,inpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,627.33,790.4,
"IV INFUSION, THERAPEUTIC, EA ADDTL HOUR",832053,CDM,96366,CPT,260,RC,inpatient,XU,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,189.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,213.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,189.25,238.45,
CONCURRENT ADDTL MEDICATED SOLUTION,832054,CDM,96368,CPT,260,RC,inpatient,XU,522,522,,443.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,393.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,443.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,459.36,88,,percent of total billed charges,,,,,,,,,398.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,475.02,91,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,,,,,,,,,,,,,433.26,83,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,428.04,82,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,393.59,495.9,
IM/SQ INJECTION,832055,CDM,96372,CPT,260,RC,inpatient,XU,352,352,,298.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,265.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,299.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,309.76,88,,percent of total billed charges,,,,,,,,,268.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,,,,,,,,,,,,,292.16,83,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,288.64,82,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,265.41,334.4,
"IVP, SINGLE OR INITIAL",832056,CDM,96374,CPT,260,RC,inpatient,XU,436,436,,370.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,328.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,370.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,383.68,88,,percent of total billed charges,,,,,,,,,333.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,396.76,91,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,,,,,,,,,,,,,361.88,83,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,357.52,82,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,328.74,414.2,
"IVP, EA ADDTL OF NEW SUBSTANCE/DRUG",832057,CDM,96375,CPT,260,RC,inpatient,XU,359,359,,304.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,270.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,305.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,315.92,88,,percent of total billed charges,,,,,,,,,274.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,,,,,,,,,,,,,297.97,83,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,294.38,82,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,270.69,341.05,
IM INJECTION - ANTIBIOTIC,832058,CDM,96372,CPT,260,RC,inpatient,XU,319,319,,270.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,240.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,271.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,280.72,88,,percent of total billed charges,,,,,,,,,243.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,290.29,91,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,,,,,,,,,,,,,264.77,83,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,261.58,82,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,271.15,85,,percent of total billed charges,,240.53,303.05,
"IV INFUSION, ADDT'L SEQUENTIAL INF",832059,CDM,96367,CPT,260,RC,inpatient,,501,501,,425.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440.88,88,,percent of total billed charges,,,,,,,,,382.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,,,,,,,,,,,,,415.83,83,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,410.82,82,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,377.75,475.95,
"IVP, EA ADDTL SEQUENTIAL INTRA PUSH",832060,CDM,96376,CPT,260,RC,inpatient,XU,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
FETAL NON STRESS MONITORING,832100,CDM,59025,CPT,920,RC,inpatient,,759,759,,644.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,572.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,645.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,667.92,88,,percent of total billed charges,,,,,,,,,579.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,690.69,91,,percent of total billed charges,,,721.05,95,,percent of total billed charges,,,629.97,83,,percent of total billed charges,,,629.97,83,,percent of total billed charges,,,,,,,,,,,,,,,629.97,83,,percent of total billed charges,,,721.05,95,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,622.38,82,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,645.15,85,,percent of total billed charges,,572.29,721.05,
INSERT DRUG IMPLANT DEVICE,832200,CDM,11981,CPT,360,RC,inpatient,,3854,3854,,3272.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2905.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3275.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3391.52,88,,percent of total billed charges,,,,,,,,,2944.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3507.14,91,,percent of total billed charges,,,3661.3,95,,percent of total billed charges,,,3198.82,83,,percent of total billed charges,,,3198.82,83,,percent of total billed charges,,,,,,,,,,,,,,,3198.82,83,,percent of total billed charges,,,3661.3,95,,percent of total billed charges,,,3468.6,90,,percent of total billed charges,,,3468.6,90,,percent of total billed charges,,,3160.28,82,,percent of total billed charges,,,3468.6,90,,percent of total billed charges,,,3275.9,85,,percent of total billed charges,,2905.92,3661.3,
CODE BLUE NURSERY,932060,CDM,92950,CPT,480,RC,inpatient,,2261,2261,,1919.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1704.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1921.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1989.68,88,,percent of total billed charges,,,,,,,,,1727.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2057.51,91,,percent of total billed charges,,,2147.95,95,,percent of total billed charges,,,1876.63,83,,percent of total billed charges,,,1876.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1876.63,83,,percent of total billed charges,,,2147.95,95,,percent of total billed charges,,,2034.9,90,,percent of total billed charges,,,2034.9,90,,percent of total billed charges,,,1854.02,82,,percent of total billed charges,,,2034.9,90,,percent of total billed charges,,,1921.85,85,,percent of total billed charges,,1704.79,2147.95,
TYPMANOMETRY,932500,CDM,92551,CPT,471,RC,inpatient,,133,133,,112.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,100.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,113.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,117.04,88,,percent of total billed charges,,,,,,,,,101.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,,,,,,,,,,,,,110.39,83,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,109.06,82,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,100.28,126.35,
CIRCUMCISION,932508,CDM,54150,CPT,723,RC,inpatient,,912,912,,774.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,687.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,775.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,802.56,88,,percent of total billed charges,,,,,,,,,696.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,829.92,91,,percent of total billed charges,,,866.4,95,,percent of total billed charges,,,756.96,83,,percent of total billed charges,,,756.96,83,,percent of total billed charges,,,,,,,,,,,,,,,756.96,83,,percent of total billed charges,,,866.4,95,,percent of total billed charges,,,820.8,90,,percent of total billed charges,,,820.8,90,,percent of total billed charges,,,747.84,82,,percent of total billed charges,,,820.8,90,,percent of total billed charges,,,775.2,85,,percent of total billed charges,,687.65,866.4,
* DELIVERY CARE (V1004),1730015,CDM,,,722,RC,inpatient,,920,920,,781.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,693.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,782,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,809.6,88,,percent of total billed charges,,,,,,,,,702.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,837.2,91,,percent of total billed charges,,,874,95,,percent of total billed charges,,,763.6,83,,percent of total billed charges,,,763.6,83,,percent of total billed charges,,,,,,,,,,,,,,,763.6,83,,percent of total billed charges,,,874,95,,percent of total billed charges,,,828,90,,percent of total billed charges,,,828,90,,percent of total billed charges,,,754.4,82,,percent of total billed charges,,,828,90,,percent of total billed charges,,,782,85,,percent of total billed charges,,693.68,874,
FETAL MONITOR W INTERPRETATION,1731021,CDM,59050,CPT,920,RC,inpatient,,768,768,,652.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,579.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,652.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,675.84,88,,percent of total billed charges,,,,,,,,,586.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,698.88,91,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,,,,,,,,,,,,,637.44,83,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,629.76,82,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,579.07,729.6,
FETAL MONITOR INTERNAL,2331047,CDM,59050,CPT,920,RC,inpatient,,768,768,,652.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,579.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,652.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,675.84,88,,percent of total billed charges,,,,,,,,,586.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,698.88,91,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,,,,,,,,,,,,,637.44,83,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,629.76,82,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,579.07,729.6,
FETAL CONTRACT STRESS TEST,2332524,CDM,59020,CPT,920,RC,inpatient,,983,983,,834.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,741.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,835.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,865.04,88,,percent of total billed charges,,,,,,,,,751.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,894.53,91,,percent of total billed charges,,,933.85,95,,percent of total billed charges,,,815.89,83,,percent of total billed charges,,,815.89,83,,percent of total billed charges,,,,,,,,,,,,,,,815.89,83,,percent of total billed charges,,,933.85,95,,percent of total billed charges,,,884.7,90,,percent of total billed charges,,,884.7,90,,percent of total billed charges,,,806.06,82,,percent of total billed charges,,,884.7,90,,percent of total billed charges,,,835.55,85,,percent of total billed charges,,741.18,933.85,
* SCALP ELECTRODE (V0904),23301431,CDM,93012,CPT,732,RC,inpatient,,29,29,,24.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.52,88,,percent of total billed charges,,,,,,,,,22.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.39,91,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,,,,,,,,,,,,,24.07,83,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,23.78,82,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,21.87,27.55,
OT THERA EX FOR STRENGTH EA 15 MIN ANNEX,5902025,CDM,97110,CPT,430,RC,inpatient,KX,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
"OT NER-MC RE-ED,BAL/CRD/PRR/PT 15M ANNEX",5902026,CDM,97112,CPT,430,RC,inpatient,KX,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,179.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,202.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,179.45,226.1,
OT FUNCTIONAL THERAPEUTIC ACTIVITY ANNEX,5902027,CDM,97530,CPT,430,RC,inpatient,KX,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
"OT DEV CG SKL(AN,MEM,PB SOV/EA15MN ANNEX",5902028,CDM,97129,CPT,430,RC,inpatient,KX,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
OT SELF CE/HE MAN. TRNG. EA 15 MIN ANNEX,5902029,CDM,97535,CPT,430,RC,inpatient,KX,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,186.99,235.6,
OT COM/WK RE-INTEG. TRNG. EA 15MIN ANNEX,5902030,CDM,97537,CPT,430,RC,inpatient,KX,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,114.61,144.4,
OT W/C MGT/PROPULSON TMG 15 MIN ANNEX,5902031,CDM,97542,CPT,430,RC,inpatient,KX,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
"OT ORIC MGT&TRNG, UE&LE, EA 15 MIN ANNEX",5902032,CDM,97760,CPT,430,RC,inpatient,KX,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
"OT NER-MC RE-ED,BAL/CRD/PRR/PT 15M ANN T",5902035,CDM,97112,CPT,430,RC,inpatient,CO,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,179.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,202.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,179.45,226.1,
OT OCCUP THER EVAL LOW COMPLEX,35200302,CDM,97165,CPT,434,RC,inpatient,GO,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,520.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,461.45,581.4,
OT OCCU THER IPA EVAL LOW COMPLEX,35200303,CDM,97165,CPT,434,RC,inpatient,GO,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,115.36,145.35,
OT OCC THER EVAL LOW COMPLEX  W THCAP,35200304,CDM,97165,CPT,434,RC,inpatient,KX,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,520.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,461.45,581.4,
OT OCCUP THER EVAL MOD COMPLEX,35200307,CDM,97166,CPT,434,RC,inpatient,GO,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,520.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,461.45,581.4,
OT OCCU THER IPA EVAL MOD COMPLEX,35200308,CDM,97166,CPT,434,RC,inpatient,GO,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,115.36,145.35,
OT OCC THER EVAL MOD COMPLEX  W THCAP,35200309,CDM,97166,CPT,434,RC,inpatient,KX,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,520.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,461.45,581.4,
OT OCCUP THER EVAL HIGH COMPLEX,35200312,CDM,97167,CPT,434,RC,inpatient,GO,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,520.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,461.45,581.4,
OT OCCU THER IPA EVAL HIG COMPLEX,35200313,CDM,97167,CPT,434,RC,inpatient,GO,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,115.36,145.35,
OT OCC THER EVAL HIGH COMPLEX  W THCAP,35200314,CDM,97167,CPT,434,RC,inpatient,KX,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,520.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,461.45,581.4,
OT MOD 59 RE-EVAL EST PLAN CARE,35200318,CDM,97168,CPT,434,RC,inpatient,GO,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,332.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,294.81,371.45,
OT RE-EVALUATION EST PLAN CARE,35200319,CDM,97168,CPT,434,RC,inpatient,GO,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,332.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,294.81,371.45,
OT RE-EVAL EST PLAN CARE  W THCAP,35200320,CDM,97168,CPT,434,RC,inpatient,KX,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,332.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,294.81,371.45,
OT MOD 59 MANUAL THERAPY,35900500,CDM,97140,CPT,430,RC,inpatient,GO,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
OT MOD 59 THERAPUTIC ACTIVITY,35900501,CDM,97530,CPT,430,RC,inpatient,GO,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
OT MOD 59 THERAPUTIC EXERCISE 15 MIN,35900502,CDM,97110,CPT,430,RC,inpatient,GO,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
OT SUPPLY - DYNAMIC FINGER SPLINT,35900600,CDM,,,270,RC,inpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,273.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,242.79,305.9,
OT SUPPLY - LONG LEG SPLINT,35900601,CDM,,,270,RC,inpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,273.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,242.79,305.9,
OT FUNCTIONAL THERAPEUTIC ACTIVITY,35900606,CDM,97530,CPT,430,RC,inpatient,GO,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
OT SELF CARE/HOME MANG. TRNG. EA 15 MIN,35900607,CDM,97535,CPT,430,RC,inpatient,GO,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,186.99,235.6,
OT COMM/WORK RE-INTEG. TRNG. EA 15MIN,35900608,CDM,97537,CPT,430,RC,inpatient,GO,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,114.61,144.4,
OT SUPPLY - LONG ARM SPLINT,35900609,CDM,,,270,RC,inpatient,,480,480,,407.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,361.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,408,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,422.4,88,,percent of total billed charges,,,,,,,,,366.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,436.8,91,,percent of total billed charges,,,456,95,,percent of total billed charges,,,398.4,83,,percent of total billed charges,,,398.4,83,,percent of total billed charges,,,,,,,,,,,,,,,398.4,83,,percent of total billed charges,,,456,95,,percent of total billed charges,,,432,90,,percent of total billed charges,,,432,90,,percent of total billed charges,,,393.6,82,,percent of total billed charges,,,432,90,,percent of total billed charges,,,408,85,,percent of total billed charges,,361.92,456,
"OT SUPPLY - SHORT ARM SPLINT, STATIC",35900610,CDM,,,270,RC,inpatient,,354,354,,300.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,266.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,300.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,311.52,88,,percent of total billed charges,,,,,,,,,270.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,322.14,91,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,,,,,,,,,,,,,293.82,83,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,290.28,82,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,300.9,85,,percent of total billed charges,,266.92,336.3,
OT SUPPLY - DYNAMIC SHORT ARM SPLINT,35900611,CDM,,,270,RC,inpatient,,398,398,,337.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,300.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,338.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,350.24,88,,percent of total billed charges,,,,,,,,,304.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,362.18,91,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,,,,,,,,,,,,,330.34,83,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,326.36,82,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,338.3,85,,percent of total billed charges,,300.09,378.1,
OT SUPPLY - STATIC FINGER SPLINT,35900612,CDM,,,270,RC,inpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,273.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,242.79,305.9,
OT SHOULDER STRAPPING,35900615,CDM,29240,CPT,430,RC,inpatient,GO,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,191.84,88,,percent of total billed charges,,,,,,,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,164.37,207.1,
OT W/C MGT/PROPULSON TMG 15 MIN,35900620,CDM,97542,CPT,430,RC,inpatient,GO,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
OT WORK HARDENING/CONDITIONING INIT 2 HR,35900621,CDM,97545,CPT,430,RC,inpatient,GO,562,562,,477.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,423.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,477.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,494.56,88,,percent of total billed charges,,,,,,,,,429.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,,,,,,,,,,,,,466.46,83,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,460.84,82,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,423.75,533.9,
OT WORK HARDENING/CONDITIONING ADDTL HR,35900622,CDM,97546,CPT,430,RC,inpatient,GO,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,217.91,274.55,
OT CK OUT ORTHO/PROSTH USE EST PT 15 MIN,35900623,CDM,97763,CPT,430,RC,inpatient,GO,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,257.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,290.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,257.87,324.9,
OT PHY PERF TEST/MEASURE(FXNAL CAP)15MIN,35900624,CDM,97750,CPT,430,RC,inpatient,GO,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,203.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,180.21,227.05,
"OT SUPPLY - SHORT LEG SPLINT, CALF-FOOT",35900625,CDM,,,270,RC,inpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,273.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,242.79,305.9,
OT WHIRLPOOL SUPERVISED/UNATTENDED,35900650,CDM,97022,CPT,430,RC,inpatient,GO,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,200.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,226.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,200.56,252.7,
OT ULTRASOUND/PHONOP EA 15 MIN,35900670,CDM,97035,CPT,430,RC,inpatient,GO,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
OT PARAFFIN BATH I,35900688,CDM,97018,CPT,430,RC,inpatient,GO,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
OT VASOPNEUMATIC DEVICE,35900692,CDM,97016,CPT,430,RC,inpatient,GO,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,99.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,112.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,99.53,125.4,
"OT ELEC STIMULATION ATTENDED, EA 15 MIN",35900713,CDM,97032,CPT,430,RC,inpatient,GO,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,116.12,146.3,
"OT DEV COG SKL(ATTN,MEM,PROB SOLV/EA15MN",35900714,CDM,97129,CPT,430,RC,inpatient,GO,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
"OT SENSORY INTEGRATION TQS, EA 15 MINS",35900715,CDM,97533,CPT,430,RC,inpatient,GO,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,129.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,129.69,163.4,
OT GROUP,35900718,CDM,97150,CPT,430,RC,inpatient,GO,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,81.43,102.6,
OT MANUAL THERAPY TQS EA 15 MIN,35900720,CDM,97140,CPT,430,RC,inpatient,GO,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
OT UNLISTED MODALITY EA 15 MIN,35900722,CDM,97139,CPT,430,RC,inpatient,GO,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
OT THERA EX FOR STRENGTH EA 15 MIN,35900738,CDM,97110,CPT,430,RC,inpatient,GO,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
"OT NEUR-MUSC RE-ED,BAL/CRD/PRPR/PST 15M",35900739,CDM,97112,CPT,430,RC,inpatient,GO,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,179.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,202.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,179.45,226.1,
"OT THER EX EA 15 MIN, IPA PT U6",35900740,CDM,97110,CPT,430,RC,inpatient,GO,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
OT SELECTIVE DEBRIDEMENT >20 SQ CM,35900741,CDM,97598,CPT,430,RC,inpatient,GO,501,501,,425.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440.88,88,,percent of total billed charges,,,,,,,,,382.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,,,,,,,,,,,,,415.83,83,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,410.82,82,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,377.75,475.95,
OT SELECTIVE DEBRIDEMENT 20 SQCM OR LESS,35900742,CDM,97597,CPT,430,RC,inpatient,GO,400,400,,339.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,301.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,340,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,352,88,,percent of total billed charges,,,,,,,,,305.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,364,91,,percent of total billed charges,,,380,95,,percent of total billed charges,,,332,83,,percent of total billed charges,,,332,83,,percent of total billed charges,,,,,,,,,,,,,,,332,83,,percent of total billed charges,,,380,95,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,328,82,,percent of total billed charges,,,360,90,,percent of total billed charges,,,340,85,,percent of total billed charges,,301.6,380,
OT IONTOPHORESIS 15 MIN,35900746,CDM,97033,CPT,430,RC,inpatient,GO,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,174.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,174.17,219.45,
OT ELECTRICAL STIMULATION UNATTENDED,35900779,CDM,97014,CPT,430,RC,inpatient,GO,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,132.7,167.2,
OT ELECTRICAL STIMULATION MEDICARE,35900780,CDM,G0283,HCPCS,430,RC,inpatient,GO,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,110.84,139.65,
"OT ORTHOTIC MGMT&TRNG, UE&LE, EA 15 MIN",35900803,CDM,97760,CPT,430,RC,inpatient,GO,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
"OT ORTHO MGMTTRNG, UE&LE, EA 15 MIN MODF",35900804,CDM,97760,CPT,430,RC,inpatient,GO,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
OT THERAPUTTY,35900837,CDM,,,270,RC,inpatient,,30,30,,25.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.4,88,,percent of total billed charges,,,,,,,,,22.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,24.9,83,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,24.6,82,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,22.62,28.5,
*OT THERABAND PER YARD(V0708),35900845,CDM,,,270,RC,inpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,18.1,22.8,
OT MEPIFORM - PER SHEET,35900854,CDM,,,270,RC,inpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,81.43,102.6,
OT OVERDOOR PULLEYS,35900902,CDM,,,270,RC,inpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,52.03,65.55,
OT HAND HELPER,35900969,CDM,,,270,RC,inpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,58.06,73.15,
OT MOD 59 RE-EVALUATION(V10-19),35900990,CDM,97004,CPT,434,RC,inpatient,GO,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,332.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,294.81,371.45,
OT RE-EVALUATION(V10-19),35900993,CDM,97004,CPT,434,RC,inpatient,GO,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,332.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,294.81,371.45,
OT OCCUPATIONAL THER EVAL(V10-19),35901041,CDM,,,434,RC,inpatient,,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,520.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,461.45,581.4,
OT OCCU THER IPA EVAL 15 MIN(V10-19),35901042,CDM,97003,CPT,434,RC,inpatient,GO,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,115.36,145.35,
OT OCC SAFETY & HEALTH CONSULT 1HR,35901265,CDM,,,430,RC,inpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,273.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,242.79,305.9,
"OT ERGONOMIC ASSESSMENT & REPORT,EA HOUR",35901268,CDM,,,430,RC,inpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,273.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,242.79,305.9,
OT ELBOW WRIST STRAPPING W THCAP,35901305,CDM,29260,CPT,430,RC,inpatient,KX,410,410,,348.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,309.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,348.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,360.8,88,,percent of total billed charges,,,,,,,,,313.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,373.1,91,,percent of total billed charges,,,389.5,95,,percent of total billed charges,,,340.3,83,,percent of total billed charges,,,340.3,83,,percent of total billed charges,,,,,,,,,,,,,,,340.3,83,,percent of total billed charges,,,389.5,95,,percent of total billed charges,,,369,90,,percent of total billed charges,,,369,90,,percent of total billed charges,,,336.2,82,,percent of total billed charges,,,369,90,,percent of total billed charges,,,348.5,85,,percent of total billed charges,,309.14,389.5,
OT HAND FINGER STRAPPING W THCAP,35901306,CDM,29280,CPT,430,RC,inpatient,KX,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,277.47,349.6,
OT HIP STRAPPING W THCAP,35901307,CDM,29520,CPT,430,RC,inpatient,KX,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
OT KNEE STRAPPING W THCAP,35901308,CDM,29530,CPT,430,RC,inpatient,KX,432,432,,366.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,325.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,367.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,380.16,88,,percent of total billed charges,,,,,,,,,330.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,393.12,91,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,,,,,,,,,,,,,358.56,83,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,354.24,82,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,325.73,410.4,
OT ANKLE STRAPPING W THCAP,35901309,CDM,29540,CPT,430,RC,inpatient,KX,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,130.44,164.35,
OT SHOULDER STRAPPING W THCAP,35901310,CDM,29240,CPT,430,RC,inpatient,KX,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,191.84,88,,percent of total billed charges,,,,,,,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,164.37,207.1,
OT ELECTRICAL STIMTION UNATTDED W THCAP,35901314,CDM,97014,CPT,430,RC,inpatient,KX,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,132.7,167.2,
OT VASOPNEUMATIC DEVICE W THCAP,35901315,CDM,97016,CPT,430,RC,inpatient,KX,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,99.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,112.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,99.53,125.4,
OT PARAFFIN BATH I W THCAP,35901316,CDM,97018,CPT,430,RC,inpatient,KX,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
OT WHIRLPOOL SUPERD/UNATTDED W THCAP,35901317,CDM,97022,CPT,430,RC,inpatient,KX,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,200.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,226.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,200.56,252.7,
"OT ELE STIMN ATTENDED, EA 15 MIN W THCAP",35901318,CDM,97032,CPT,430,RC,inpatient,KX,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,116.12,146.3,
OT IONTOPHORESIS 15 MIN W THCAP,35901319,CDM,97033,CPT,430,RC,inpatient,KX,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,174.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,174.17,219.45,
OT ULTRASD/PHONOP EA 15 MIN W THCAP,35901320,CDM,97035,CPT,430,RC,inpatient,KX,91,91,,77.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.08,88,,percent of total billed charges,,,,,,,,,69.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,,,,,,,,,,,,,75.53,83,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,74.62,82,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,68.61,86.45,
OT THERA EX FOR STRTH EA 15 MIN W THCAP,35901321,CDM,97110,CPT,430,RC,inpatient,KX,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
"OT NER-MSC RE-ED,BL/CR/R/PT 15M W THCAP",35901322,CDM,97112,CPT,430,RC,inpatient,KX,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,179.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,202.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,179.45,226.1,
OT MANUAL THERAPY TQS EA 15 MIN W THCAP,35901323,CDM,97140,CPT,430,RC,inpatient,KX,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
OT FUNCTIONAL THERTIC ACTIVITY W THCAP,35901324,CDM,97530,CPT,430,RC,inpatient,KX,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
"OT DEV CO SK(ATN,MEM SOLV/EA15MN W THCAP",35901325,CDM,97129,CPT,430,RC,inpatient,KX,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
"OT SENSRY INTEGN TQS, EA 15 MINS W THCAP",35901326,CDM,97533,CPT,430,RC,inpatient,KX,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,129.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,129.69,163.4,
OT SEF CE/HOME MA. TG. EA 15 MIN W THCAP,35901327,CDM,97535,CPT,430,RC,inpatient,KX,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,186.99,235.6,
OT COM/WOK RE-ING. TRG. EA 15MIN W THCAP,35901328,CDM,97537,CPT,430,RC,inpatient,KX,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,114.61,144.4,
OT W/C MGT/PROPULSON TMG 15 MIN W THCAP,35901329,CDM,97542,CPT,430,RC,inpatient,KX,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
OT WORK HARING/CONDING INIT 2 HR W THCAP,35901330,CDM,97545,CPT,430,RC,inpatient,KX,562,562,,477.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,423.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,477.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,494.56,88,,percent of total billed charges,,,,,,,,,429.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,,,,,,,,,,,,,466.46,83,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,460.84,82,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,423.75,533.9,
OT WORK HARDEG/CONDNG ADDTL HR W THCAP,35901331,CDM,97546,CPT,430,RC,inpatient,KX,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,217.91,274.55,
OT PHY PEF TEST/ME(FXN CAP)15MIN W THCAP,35901332,CDM,97750,CPT,430,RC,inpatient,KX,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,203.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,180.21,227.05,
"OT ORTHO MGT&TG, UE&LE,EA 15 MIN W THCAP",35901333,CDM,97760,CPT,430,RC,inpatient,KX,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
OT CK O ORT/PRO USE ES PT 15 MIN W THCAP,35901334,CDM,97763,CPT,430,RC,inpatient,KX,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,257.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,290.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,257.87,324.9,
OT ELECTRICAL STIMN MEDICARE W THCAP,35901335,CDM,G0283,HCPCS,430,RC,inpatient,KX,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,61.07,76.95,
OT THERA EX FOR STRENGTH EA 15 MIN THERA,35901400,CDM,97110,CPT,430,RC,inpatient,CO,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
"OT NEUR-MUSC RE-ED,BAL/CRD/PRPR/PST 15M",35901401,CDM,97112,CPT,430,RC,inpatient,CO,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,179.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,202.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,179.45,226.1,
OT FUNCTIONAL THERAPEUTIC ACTIVITY THERA,35901402,CDM,97530,CPT,430,RC,inpatient,CO,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
OT MANUAL TH TQS EA 15 MIN THERAPY  ASSI,35901403,CDM,97140,CPT,430,RC,inpatient,CO,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
OT SELF CARE/HOME MANG. TRNG. EA 15 MIN,35901404,CDM,97535,CPT,430,RC,inpatient,CO,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,186.99,235.6,
OT ELBOW WRIST STRAPPING,35910000,CDM,29260,CPT,430,RC,inpatient,GO,410,410,,348.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,309.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,348.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,360.8,88,,percent of total billed charges,,,,,,,,,313.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,373.1,91,,percent of total billed charges,,,389.5,95,,percent of total billed charges,,,340.3,83,,percent of total billed charges,,,340.3,83,,percent of total billed charges,,,,,,,,,,,,,,,340.3,83,,percent of total billed charges,,,389.5,95,,percent of total billed charges,,,369,90,,percent of total billed charges,,,369,90,,percent of total billed charges,,,336.2,82,,percent of total billed charges,,,369,90,,percent of total billed charges,,,348.5,85,,percent of total billed charges,,309.14,389.5,
OT HAND FINGER STRAPPING,35910001,CDM,29280,CPT,430,RC,inpatient,GO,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,277.47,349.6,
OT HIP STRAPPING,35910002,CDM,29520,CPT,430,RC,inpatient,GO,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
OT KNEE STRAPPING,35910003,CDM,29530,CPT,430,RC,inpatient,GO,432,432,,366.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,325.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,367.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,380.16,88,,percent of total billed charges,,,,,,,,,330.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,393.12,91,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,,,,,,,,,,,,,358.56,83,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,354.24,82,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,325.73,410.4,
OT ANKLE STRAPPING,35910004,CDM,29540,CPT,430,RC,inpatient,GO,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,130.44,164.35,
OT SHOULDER STRAPPING,35910006,CDM,29240,CPT,430,RC,inpatient,GO,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,191.84,88,,percent of total billed charges,,,,,,,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,164.37,207.1,
OT UNLIST MODALITY SPEC TYPE&TIME CONSTA,35910007,CDM,97039,CPT,430,RC,inpatient,GO,167,167,,141.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,146.96,88,,percent of total billed charges,,,,,,,,,127.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,,,,,,,,,,,,,138.61,83,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,136.94,82,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,125.92,158.65,
OFFICE OUTPT EST 15 MIN,65000,CDM,99213,CPT,510,RC,inpatient,,90,90,,76.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,76.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.2,88,,percent of total billed charges,,,,,,,,,68.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,73.8,82,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,67.86,85.5,
ARTHROCENTESIS ASPIR/INJ MAJORJT/BUR,65001,CDM,20610,CPT,510,RC,inpatient,,58,58,,49.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.04,88,,percent of total billed charges,,,,,,,,,44.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52.78,91,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,,,,,,,,,,,,,48.14,83,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,47.56,82,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,43.73,55.1,
METHYLPREDNISOLONE 40 MG INJ,65002,CDM,J1030,HCPCS,636,RC,inpatient,,89,89,,75.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,75.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,78.32,88,,percent of total billed charges,,29.81,,,,fee schedule,,,68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,29.81,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.99,91,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,,,,,,,,,,,,,73.87,83,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,72.98,82,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,29.81,84.55,
SYNVISC INJ PER DOSE,65003,CDM,J7325,HCPCS,636,RC,inpatient,,3263,3263,,2770.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2460.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2773.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2871.44,88,,percent of total billed charges,,973.06,,,,fee schedule,,,2492.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,973.06,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2969.33,91,,percent of total billed charges,,,3099.85,95,,percent of total billed charges,,,2708.29,83,,percent of total billed charges,,,2708.29,83,,percent of total billed charges,,,,,,,,,,,,,,,2708.29,83,,percent of total billed charges,,,3099.85,95,,percent of total billed charges,,,2936.7,90,,percent of total billed charges,,,2936.7,90,,percent of total billed charges,,,2675.66,82,,percent of total billed charges,,,2936.7,90,,percent of total billed charges,,,2773.55,85,,percent of total billed charges,,973.06,3099.85,
OFFICE OUTPT EST 10 MIN,65004,CDM,99212,CPT,510,RC,inpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,62.58,78.85,
OFFICE OUTPT EST 25 MIN,65005,CDM,99214,CPT,510,RC,inpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,91.23,114.95,
APPLICATION OF LONG ARM CAST,65006,CDM,29065,CPT,510,RC,inpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,62.58,78.85,
OFFICE OUTPT NEW 30 MIN,65007,CDM,99203,CPT,510,RC,inpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,109.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,123.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,109.33,137.75,
EUFLEXXA INJ PER DOSE,65008,CDM,J7323,HCPCS,636,RC,inpatient,,861,861,,730.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,649.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,731.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,757.68,88,,percent of total billed charges,,261.77,,,,fee schedule,,,657.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,261.77,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,783.51,91,,percent of total billed charges,,,817.95,95,,percent of total billed charges,,,714.63,83,,percent of total billed charges,,,714.63,83,,percent of total billed charges,,,,,,,,,,,,,,,714.63,83,,percent of total billed charges,,,817.95,95,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,706.02,82,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,731.85,85,,percent of total billed charges,,261.77,817.95,
INJECTION THERAPEUTIC CARPAL TUNNEL,65009,CDM,20526,CPT,510,RC,inpatient,,71,71,,60.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.48,88,,percent of total billed charges,,,,,,,,,54.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,,,,,,,,,,,,,58.93,83,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,58.22,82,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,53.53,67.45,
OFFICE OUTPT EST 40-54 MIN,65010,CDM,99215,CPT,510,RC,inpatient,,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
OFFICE OUTPT NEW 45 MIN,65011,CDM,99204,CPT,510,RC,inpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,149.29,188.1,
ARTHROCENTESIS ASPIR/INJ INTERM JT/BUR,65012,CDM,20605,CPT,510,RC,inpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,34.68,43.7,
TRIAMCINOLONE ACETONIDE INJ 10MG,65013,CDM,J3301,HCPCS,636,RC,inpatient,,247,247,,209.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,209.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,217.36,88,,percent of total billed charges,,17.47,,,,fee schedule,,,188.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,17.47,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,224.77,91,,percent of total billed charges,,,234.65,95,,percent of total billed charges,,,205.01,83,,percent of total billed charges,,,205.01,83,,percent of total billed charges,,,,,,,,,,,,,,,205.01,83,,percent of total billed charges,,,234.65,95,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,202.54,82,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,209.95,85,,percent of total billed charges,,17.47,234.65,
ARTHROCENTESIS ASPIR/INJ SMALL JT/BUR,65014,CDM,20600,CPT,510,RC,inpatient,,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,33.93,42.75,
INJECTION 1 TENDON SHEATH/LIG FLUORO GU,65015,CDM,20550,CPT,510,RC,inpatient,,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,36.19,45.6,
APPLY FOREARM SPLINT,65016,CDM,29125,CPT,510,RC,inpatient,,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,36.19,45.6,
APPLY HAND/WRIST CAST,65017,CDM,29085,CPT,510,RC,inpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,61.07,76.95,
APPLY SHORT LEG CAST,65018,CDM,29405,CPT,510,RC,inpatient,,72,72,,61.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,54.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,61.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,63.36,88,,percent of total billed charges,,,,,,,,,55.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,65.52,91,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,,,,,,,,,,,,,59.76,83,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,59.04,82,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,54.29,68.4,
TREAT METACARPAL FRACTURE,65019,CDM,26605,CPT,510,RC,inpatient,,365,365,,309.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,275.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,310.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,321.2,88,,percent of total billed charges,,,,,,,,,278.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,332.15,91,,percent of total billed charges,,,346.75,95,,percent of total billed charges,,,302.95,83,,percent of total billed charges,,,302.95,83,,percent of total billed charges,,,,,,,,,,,,,,,302.95,83,,percent of total billed charges,,,346.75,95,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,299.3,82,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,310.25,85,,percent of total billed charges,,275.21,346.75,
TREATMENT OF ANKLE FRACTURE W/MANP,65020,CDM,27788,CPT,510,RC,inpatient,,477,477,,404.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,359.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,405.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,419.76,88,,percent of total billed charges,,,,,,,,,364.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,434.07,91,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,,,,,,,,,,,,,395.91,83,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,391.14,82,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,359.66,453.15,
TREAT METACARPAL FRACTURE WITHOUT MANIP,65021,CDM,26600,CPT,510,RC,inpatient,,348,348,,295.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,262.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,295.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,306.24,88,,percent of total billed charges,,,,,,,,,265.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,316.68,91,,percent of total billed charges,,,330.6,95,,percent of total billed charges,,,288.84,83,,percent of total billed charges,,,288.84,83,,percent of total billed charges,,,,,,,,,,,,,,,288.84,83,,percent of total billed charges,,,330.6,95,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,285.36,82,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,295.8,85,,percent of total billed charges,,262.39,330.6,
TREAT FRACTURE OF RADIUS,65022,CDM,25505,CPT,510,RC,inpatient,,568,568,,482.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,428.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,482.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,499.84,88,,percent of total billed charges,,,,,,,,,433.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,516.88,91,,percent of total billed charges,,,539.6,95,,percent of total billed charges,,,471.44,83,,percent of total billed charges,,,471.44,83,,percent of total billed charges,,,,,,,,,,,,,,,471.44,83,,percent of total billed charges,,,539.6,95,,percent of total billed charges,,,511.2,90,,percent of total billed charges,,,511.2,90,,percent of total billed charges,,,465.76,82,,percent of total billed charges,,,511.2,90,,percent of total billed charges,,,482.8,85,,percent of total billed charges,,428.27,539.6,
NEG PRESS WNDTX</=50 SQ CM,65023,CDM,97607,CPT,510,RC,inpatient,,29,29,,24.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.52,88,,percent of total billed charges,,,,,,,,,22.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.39,91,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,,,,,,,,,,,,,24.07,83,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,23.78,82,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,21.87,27.55,
INJECTION SINGLE TENDON ORIGIN/INSERTION,65024,CDM,20551,CPT,510,RC,inpatient,,49,49,,41.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,43.12,88,,percent of total billed charges,,,,,,,,,37.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,44.59,91,,percent of total billed charges,,,46.55,95,,percent of total billed charges,,,40.67,83,,percent of total billed charges,,,40.67,83,,percent of total billed charges,,,,,,,,,,,,,,,40.67,83,,percent of total billed charges,,,46.55,95,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,40.18,82,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,41.65,85,,percent of total billed charges,,36.95,46.55,
APPLICATION LOWER LEG SPLINT,65025,CDM,29515,CPT,510,RC,inpatient,,61,61,,51.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,45.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,51.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,53.68,88,,percent of total billed charges,,,,,,,,,46.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55.51,91,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,,,,,,,,,,,,,50.63,83,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,50.02,82,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,45.99,57.95,
APPLICATION OF FOREARM CAST,65026,CDM,29075,CPT,510,RC,inpatient,,76,76,,64.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,57.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,64.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66.88,88,,percent of total billed charges,,,,,,,,,58.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,,,,,,,,,,,,,63.08,83,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,62.32,82,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,57.3,72.2,
APPLICATION OF LONG LEG CAST WALKING,65027,CDM,29355,CPT,510,RC,inpatient,,133,133,,112.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,100.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,113.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,117.04,88,,percent of total billed charges,,,,,,,,,101.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,,,,,,,,,,,,,110.39,83,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,109.06,82,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,100.28,126.35,
GEL-ONE,65028,CDM,J7326,HCPCS,636,RC,inpatient,,3626,3626,,3078.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2734,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3082.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3190.88,88,,percent of total billed charges,,984.46,,,,fee schedule,,,2770.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,984.46,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3299.66,91,,percent of total billed charges,,,3444.7,95,,percent of total billed charges,,,3009.58,83,,percent of total billed charges,,,3009.58,83,,percent of total billed charges,,,,,,,,,,,,,,,3009.58,83,,percent of total billed charges,,,3444.7,95,,percent of total billed charges,,,3263.4,90,,percent of total billed charges,,,3263.4,90,,percent of total billed charges,,,2973.32,82,,percent of total billed charges,,,3263.4,90,,percent of total billed charges,,,3082.1,85,,percent of total billed charges,,984.46,3444.7,
APPLICATION OF LONG LEG CAST,65029,CDM,29345,CPT,510,RC,inpatient,,123,123,,104.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,92.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,104.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,108.24,88,,percent of total billed charges,,,,,,,,,93.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.93,91,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,,,,,,,,,,,,,102.09,83,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,100.86,82,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,104.55,85,,percent of total billed charges,,92.74,116.85,
OFFICE OUTPT NEW 15-29 MIN,65030,CDM,99202,CPT,510,RC,inpatient,,107,107,,90.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,80.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,90.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,94.16,88,,percent of total billed charges,,,,,,,,,81.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,97.37,91,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,,,,,,,,,,,,,88.81,83,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,87.74,82,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,90.95,85,,percent of total billed charges,,80.68,101.65,
APPLY LONG ARM SPLINT,65031,CDM,29105,CPT,510,RC,inpatient,,54,54,,45.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47.52,88,,percent of total billed charges,,,,,,,,,41.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.14,91,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,,,,,,,,,,,,,44.82,83,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,44.28,82,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,40.72,51.3,
TREAT FRACTURE RADIUS/ULNA,65032,CDM,25600,CPT,510,RC,inpatient,,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,332.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,294.81,371.45,
TREATMENT OF ANKLE FRACTURE,65034,CDM,28430,CPT,510,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
TREATMENT CLAVICLE FRACTURE,65035,CDM,23500,CPT,510,RC,inpatient,,278,278,,236.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,236.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,244.64,88,,percent of total billed charges,,,,,,,,,212.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.98,91,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,,,,,,,,,,,,,230.74,83,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,227.96,82,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,209.61,264.1,
METHYPREDNISOLONE 20 MG INJ,65036,CDM,J1020,HCPCS,636,RC,inpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.92,88,,percent of total billed charges,,11.93,,,,fee schedule,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11.93,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,11.93,79.8,
TREAT HUMERUS FRACTURE,65037,CDM,23600,CPT,510,RC,inpatient,,386,386,,327.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,339.68,88,,percent of total billed charges,,,,,,,,,294.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.26,91,,percent of total billed charges,,,366.7,95,,percent of total billed charges,,,320.38,83,,percent of total billed charges,,,320.38,83,,percent of total billed charges,,,,,,,,,,,,,,,320.38,83,,percent of total billed charges,,,366.7,95,,percent of total billed charges,,,347.4,90,,percent of total billed charges,,,347.4,90,,percent of total billed charges,,,316.52,82,,percent of total billed charges,,,347.4,90,,percent of total billed charges,,,328.1,85,,percent of total billed charges,,291.04,366.7,
TREAT HUMERUS FRACTURE W/O MANIP,65038,CDM,24500,CPT,510,RC,inpatient,,408,408,,346.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,307.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,346.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,359.04,88,,percent of total billed charges,,,,,,,,,311.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,371.28,91,,percent of total billed charges,,,387.6,95,,percent of total billed charges,,,338.64,83,,percent of total billed charges,,,338.64,83,,percent of total billed charges,,,,,,,,,,,,,,,338.64,83,,percent of total billed charges,,,387.6,95,,percent of total billed charges,,,367.2,90,,percent of total billed charges,,,367.2,90,,percent of total billed charges,,,334.56,82,,percent of total billed charges,,,367.2,90,,percent of total billed charges,,,346.8,85,,percent of total billed charges,,307.63,387.6,
INJECTION SINGLE/MLT TRIGGER POINT 1/2 M,65039,CDM,20552,CPT,510,RC,inpatient,,47,47,,39.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.36,88,,percent of total billed charges,,,,,,,,,35.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,,,,,,,,,,,,,39.01,83,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,38.54,82,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,35.44,44.65,
TREAT KNEE FRACTURE,65041,CDM,27530,CPT,510,RC,inpatient,,352,352,,298.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,265.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,299.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,309.76,88,,percent of total billed charges,,,,,,,,,268.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,,,,,,,,,,,,,292.16,83,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,288.64,82,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,265.41,334.4,
APPLICATION OF FINGER SPLINT,65042,CDM,29130,CPT,510,RC,inpatient,,36,36,,30.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31.68,88,,percent of total billed charges,,,,,,,,,27.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,,,,,,,,,,,,,29.88,83,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,29.52,82,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,27.14,34.2,
TREATMENT FRACTURE OF ULNA,65043,CDM,25530,CPT,510,RC,inpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,223.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,252.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,223.94,282.15,
APPLY LONG LEG SPLINT,65044,CDM,29505,CPT,510,RC,inpatient,,64,64,,54.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.32,88,,percent of total billed charges,,,,,,,,,48.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,,,,,,,,,,,,,53.12,83,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,52.48,82,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,48.26,60.8,
METHYLPREDNISOLONE 80 MG INJ,65045,CDM,J1040,HCPCS,636,RC,inpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,23.18,,,,fee schedule,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,23.18,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,23.18,167.2,
APPLY SHORT LEG CAST,65046,CDM,29425,CPT,510,RC,inpatient,,67,67,,56.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.96,88,,percent of total billed charges,,,,,,,,,51.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,,,,,,,,,,,,,55.61,83,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,54.94,82,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,50.52,63.65,
INJ DUPUYTRENCORD W/ENZYME,65047,CDM,20527,CPT,510,RC,inpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,61.07,76.95,
DRAIN/INJ JOINT/BURSA W/US,65048,CDM,20611,CPT,510,RC,inpatient,,75,75,,63.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,63.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66,88,,percent of total billed charges,,,,,,,,,57.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,68.25,91,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,,,,,,,,,,,,,62.25,83,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,61.5,82,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,56.55,71.25,
TREATMENT FRACTURE RADIUS/ULNA,65049,CDM,25560,CPT,510,RC,inpatient,,316,316,,268.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,238.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,268.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,278.08,88,,percent of total billed charges,,,,,,,,,241.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,287.56,91,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,,,,,,,,,,,,,262.28,83,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,259.12,82,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,238.26,300.2,
SIMPLE REPAIR SCALP/NECK/AX/TRUNK 2.5/<,65050,CDM,12001,CPT,510,RC,inpatient,,56,56,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.28,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,45.92,82,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,42.22,53.2,
DX BONE MARROW BIOPSIES,65051,CDM,38221,CPT,510,RC,inpatient,,85,85,,72.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,72.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.8,88,,percent of total billed charges,,,,,,,,,64.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,,,,,,,,,,,,,70.55,83,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,69.7,82,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,64.09,80.75,
"DRAINAGE OF SKIN ABSCESS, SINGLE OR SIMP",65052,CDM,10060,CPT,510,RC,inpatient,,125,125,,106.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,94.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,106.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110,88,,percent of total billed charges,,,,,,,,,95.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,113.75,91,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,,,,,,,,,,,,,103.75,83,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,102.5,82,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,94.25,118.75,
CLTX POST ANKLE FX,65053,CDM,27767,CPT,510,RC,inpatient,,412,412,,349.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,310.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,350.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,362.56,88,,percent of total billed charges,,,,,,,,,314.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,374.92,91,,percent of total billed charges,,,391.4,95,,percent of total billed charges,,,341.96,83,,percent of total billed charges,,,341.96,83,,percent of total billed charges,,,,,,,,,,,,,,,341.96,83,,percent of total billed charges,,,391.4,95,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,337.84,82,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,350.2,85,,percent of total billed charges,,310.65,391.4,
OFFICE OUTPT NEW/EST 40MIN,65054,CDM,99243,CPT,510,RC,inpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,70.12,88.35,
CASTING SUPPLIES,65055,CDM,Q4010,HCPCS,270,RC,inpatient,,73,73,,61.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,55.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,62.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,64.24,88,,percent of total billed charges,,,,,,,,,55.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,66.43,91,,percent of total billed charges,,,69.35,95,,percent of total billed charges,,,60.59,83,,percent of total billed charges,,,60.59,83,,percent of total billed charges,,,,,,,,,,,,,,,60.59,83,,percent of total billed charges,,,69.35,95,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,59.86,82,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,62.05,85,,percent of total billed charges,,55.04,69.35,
CASTING SUPPLIES,65056,CDM,Q4013,HCPCS,270,RC,inpatient,,79,79,,67.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.52,88,,percent of total billed charges,,,,,,,,,60.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,,,,,,,,,,,,,65.57,83,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,64.78,82,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,59.57,75.05,
CLTX THUMB DISLOCATION,65057,CDM,26641,CPT,510,RC,inpatient,,865,865,,734.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,652.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,735.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,761.2,88,,percent of total billed charges,,,,,,,,,660.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,787.15,91,,percent of total billed charges,,,821.75,95,,percent of total billed charges,,,717.95,83,,percent of total billed charges,,,717.95,83,,percent of total billed charges,,,,,,,,,,,,,,,717.95,83,,percent of total billed charges,,,821.75,95,,percent of total billed charges,,,778.5,90,,percent of total billed charges,,,778.5,90,,percent of total billed charges,,,709.3,82,,percent of total billed charges,,,778.5,90,,percent of total billed charges,,,735.25,85,,percent of total billed charges,,652.21,821.75,
CASTING SUPPLIES,65058,CDM,Q4018,HCPCS,270,RC,inpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,52.03,65.55,
TREATMENT SUPERFICIAL WOUND,65059,CDM,12020,CPT,510,RC,inpatient,,309,309,,262.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,232.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,262.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,271.92,88,,percent of total billed charges,,,,,,,,,236.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,281.19,91,,percent of total billed charges,,,293.55,95,,percent of total billed charges,,,256.47,83,,percent of total billed charges,,,256.47,83,,percent of total billed charges,,,,,,,,,,,,,,,256.47,83,,percent of total billed charges,,,293.55,95,,percent of total billed charges,,,278.1,90,,percent of total billed charges,,,278.1,90,,percent of total billed charges,,,253.38,82,,percent of total billed charges,,,278.1,90,,percent of total billed charges,,,262.65,85,,percent of total billed charges,,232.99,293.55,
CLOSED TREATMENT FINGER FRACTURE,65060,CDM,26725,CPT,510,RC,inpatient,,567,567,,481.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,427.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,481.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,498.96,88,,percent of total billed charges,,,,,,,,,433.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,,,,,,,,,,,,,470.61,83,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,464.94,82,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,427.52,538.65,
CLOSED TREATMENT TOE FRACTURE,65061,CDM,28510,CPT,510,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
DRAINAGE OF HEMATOMA SEROMA/FLUID COL,65062,CDM,10140,CPT,510,RC,inpatient,,226,226,,191.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,170.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198.88,88,,percent of total billed charges,,,,,,,,,172.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,,,,,,,,,,,,,187.58,83,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,185.32,82,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,170.4,214.7,
CASTING SUPPLIES,65063,CDM,Q4021,HCPCS,270,RC,inpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,37.7,47.5,
CLOSED TREATMENT GREATER ROCHANTERIC FX,65064,CDM,27246,CPT,510,RC,inpatient,,747,747,,634.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,563.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,634.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,657.36,88,,percent of total billed charges,,,,,,,,,570.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,679.77,91,,percent of total billed charges,,,709.65,95,,percent of total billed charges,,,620.01,83,,percent of total billed charges,,,620.01,83,,percent of total billed charges,,,,,,,,,,,,,,,620.01,83,,percent of total billed charges,,,709.65,95,,percent of total billed charges,,,672.3,90,,percent of total billed charges,,,672.3,90,,percent of total billed charges,,,612.54,82,,percent of total billed charges,,,672.3,90,,percent of total billed charges,,,634.95,85,,percent of total billed charges,,563.24,709.65,
CLOSED TREATMENT FINGER DISLOCATION,65065,CDM,26770,CPT,510,RC,inpatient,,155,155,,131.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,131.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,136.4,88,,percent of total billed charges,,,,,,,,,118.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,127.1,82,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,116.87,147.25,
CLOSED TREATMENT FINGER FRACTURE,65066,CDM,26720,CPT,510,RC,inpatient,,578,578,,490.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,435.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,491.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,508.64,88,,percent of total billed charges,,,,,,,,,441.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,525.98,91,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,,,,,,,,,,,,,479.74,83,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,473.96,82,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,491.3,85,,percent of total billed charges,,435.81,549.1,
CASTING SUPPLIES,65067,CDM,Q4006,HCPCS,270,RC,inpatient,,88,88,,74.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.44,88,,percent of total billed charges,,,,,,,,,67.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,,,,,,,,,,,,,73.04,83,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,72.16,82,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,66.35,83.6,
CLTX CARPAL SCAPHOID FX,65068,CDM,25622,CPT,510,RC,inpatient,,747,747,,634.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,563.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,634.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,657.36,88,,percent of total billed charges,,,,,,,,,570.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,679.77,91,,percent of total billed charges,,,709.65,95,,percent of total billed charges,,,620.01,83,,percent of total billed charges,,,620.01,83,,percent of total billed charges,,,,,,,,,,,,,,,620.01,83,,percent of total billed charges,,,709.65,95,,percent of total billed charges,,,672.3,90,,percent of total billed charges,,,672.3,90,,percent of total billed charges,,,612.54,82,,percent of total billed charges,,,672.3,90,,percent of total billed charges,,,634.95,85,,percent of total billed charges,,563.24,709.65,
INJ HYALURONAN/DERIVATIVE,65069,CDM,J7318,HCPCS,510,RC,inpatient,,2534,2534,,2151.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1910.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2153.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2229.92,88,,percent of total billed charges,,1111.92,,,,fee schedule,,,1935.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1111.92,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2305.94,91,,percent of total billed charges,,,2407.3,95,,percent of total billed charges,,,2103.22,83,,percent of total billed charges,,,2103.22,83,,percent of total billed charges,,,,,,,,,,,,,,,2103.22,83,,percent of total billed charges,,,2407.3,95,,percent of total billed charges,,,2280.6,90,,percent of total billed charges,,,2280.6,90,,percent of total billed charges,,,2077.88,82,,percent of total billed charges,,,2280.6,90,,percent of total billed charges,,,2153.9,85,,percent of total billed charges,,1111.92,2407.3,
CASTING SUPPLIES,65070,CDM,Q4014,HCPCS,270,RC,inpatient,,74,74,,62.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,55.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,62.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,65.12,88,,percent of total billed charges,,,,,,,,,56.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,,,,,,,,,,,,,61.42,83,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,60.68,82,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,55.8,70.3,
CLOSED TREATMENT PATELLAR FRACTURE,65071,CDM,27520,CPT,510,RC,inpatient,,191,191,,162.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.08,88,,percent of total billed charges,,,,,,,,,145.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,173.81,91,,percent of total billed charges,,,181.45,95,,percent of total billed charges,,,158.53,83,,percent of total billed charges,,,158.53,83,,percent of total billed charges,,,,,,,,,,,,,,,158.53,83,,percent of total billed charges,,,181.45,95,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,156.62,82,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,162.35,85,,percent of total billed charges,,144.01,181.45,
OFFICE OUTPT NEW 60 MIN,65072,CDM,99205,CPT,510,RC,inpatient,,237,237,,201.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.56,88,,percent of total billed charges,,,,,,,,,181.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.67,91,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,,,,,,,,,,,,,196.71,83,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,194.34,82,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,178.7,225.15,
CASTING SUPPLIES,65073,CDM,Q4038,HCPCS,270,RC,inpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,37.7,47.5,
CLOSED TREATMENT OF ANKLE FRACTURE,65074,CDM,27808,CPT,510,RC,inpatient,,920,920,,781.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,693.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,782,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,809.6,88,,percent of total billed charges,,,,,,,,,702.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,837.2,91,,percent of total billed charges,,,874,95,,percent of total billed charges,,,763.6,83,,percent of total billed charges,,,763.6,83,,percent of total billed charges,,,,,,,,,,,,,,,763.6,83,,percent of total billed charges,,,874,95,,percent of total billed charges,,,828,90,,percent of total billed charges,,,828,90,,percent of total billed charges,,,754.4,82,,percent of total billed charges,,,828,90,,percent of total billed charges,,,782,85,,percent of total billed charges,,693.68,874,
OFFICE OUTPT NEW 45 MIN,93000,CDM,99204,CPT,510,RC,inpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,149.29,188.1,
OFFICE OUTPT EST 25 MIN,93001,CDM,99214,CPT,510,RC,inpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,91.23,114.95,
OFFICE OUTPT NEW 30 MIN,93002,CDM,99203,CPT,510,RC,inpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,109.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,123.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,109.33,137.75,
"DRAINAGE OF SKIN ABSCESS, SINGLE/SIMPLE",93003,CDM,10060,CPT,510,RC,inpatient,,125,125,,106.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,94.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,106.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110,88,,percent of total billed charges,,,,,,,,,95.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,113.75,91,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,,,,,,,,,,,,,103.75,83,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,102.5,82,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,94.25,118.75,
OFFICE OUTPT EST 15 MIN,93004,CDM,99213,CPT,510,RC,inpatient,,90,90,,76.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,76.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.2,88,,percent of total billed charges,,,,,,,,,68.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,73.8,82,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,67.86,85.5,
OFFICE OUTPT EST 40-54 MIN,93005,CDM,99215,CPT,510,RC,inpatient,,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
TRIM NAIL(S),93006,CDM,11719,CPT,510,RC,inpatient,,9,9,,7.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.92,88,,percent of total billed charges,,,,,,,,,6.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.38,82,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,6.79,8.55,
EXC B9 LES MRGN XCP SK TG T/A/L 2.1-3.0,93007,CDM,11403,CPT,510,RC,inpatient,,179,179,,151.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,134.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,152.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,157.52,88,,percent of total billed charges,,,,,,,,,136.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,146.78,82,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,134.97,170.05,
DESTRUCTION PREMALIGNANT LESION 1ST,93008,CDM,17000,CPT,510,RC,inpatient,,64,64,,54.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.32,88,,percent of total billed charges,,,,,,,,,48.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,,,,,,,,,,,,,53.12,83,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,52.48,82,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,48.26,60.8,
BIOPSY OF VULVA/PERINEUM,93009,CDM,56605,CPT,510,RC,inpatient,,74,74,,62.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,55.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,62.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,65.12,88,,percent of total billed charges,,,,,,,,,56.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,,,,,,,,,,,,,61.42,83,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,60.68,82,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,55.8,70.3,
AVULSION NAIL PLATE PARTIAL/COMPLETE 1,93010,CDM,11730,CPT,510,RC,inpatient,,67,67,,56.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.96,88,,percent of total billed charges,,,,,,,,,51.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,,,,,,,,,,,,,55.61,83,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,54.94,82,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,50.52,63.65,
EXC TR-EXT B9+MARG 1.1-2 CM,93011,CDM,11402,CPT,510,RC,inpatient,,140,140,,118.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,105.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,119,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,123.2,88,,percent of total billed charges,,,,,,,,,106.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,133,95,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,114.8,82,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,105.56,133,
OFFICE OUTPT EST 10 MIN,93012,CDM,99212,CPT,510,RC,inpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,62.58,78.85,
EXC B9 LES MRGN XCP SK TG S/N/H 1.1-2.0,93013,CDM,11422,CPT,510,RC,inpatient,,164,164,,139.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,123.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,139.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,144.32,88,,percent of total billed charges,,,,,,,,,125.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,134.48,82,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,123.66,155.8,
EXC B9 LES MRGN XCP SK TG S/N/H 2.1-3 CM,93014,CDM,11423,CPT,510,RC,inpatient,,188,188,,159.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,159.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,165.44,88,,percent of total billed charges,,,,,,,,,143.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.08,91,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,,,,,,,,,,,,,156.04,83,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,154.16,82,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,141.75,178.6,
"EXCISION OF NAIL FOLD, TOE",93015,CDM,11765,CPT,510,RC,inpatient,,111,111,,94.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,83.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,97.68,88,,percent of total billed charges,,,,,,,,,84.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.01,91,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,,,,,,,,,,,,,92.13,83,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,91.02,82,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,94.35,85,,percent of total billed charges,,83.69,105.45,
EXC H-F-NK-SP B9+ MARG 3.1-4,93016,CDM,11424,CPT,510,RC,inpatient,,216,216,,183.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,162.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,183.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,190.08,88,,percent of total billed charges,,,,,,,,,165.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,177.12,82,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,162.86,205.2,
EXC B9 LES MRGN XCP SK TG T/A/L 0.6-1.0,93017,CDM,11401,CPT,510,RC,inpatient,,127,127,,107.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,111.76,88,,percent of total billed charges,,,,,,,,,97.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,,,,,,,,,,,,,105.41,83,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,104.14,82,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,95.76,120.65,
SIMPLE REPAIR SCALP/NECK/AX/TRUNK 2.5CM<,93018,CDM,12001,CPT,510,RC,inpatient,,56,56,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.28,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,45.92,82,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,42.22,53.2,
PROCTOSIGMOIDOSCOPY DX,93019,CDM,45300,CPT,510,RC,inpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,77.66,97.85,
EXC TR-EXT MAL+MARG >4CM,93020,CDM,11606,CPT,510,RC,inpatient,,412,412,,349.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,310.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,350.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,362.56,88,,percent of total billed charges,,,,,,,,,314.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,374.92,91,,percent of total billed charges,,,391.4,95,,percent of total billed charges,,,341.96,83,,percent of total billed charges,,,341.96,83,,percent of total billed charges,,,,,,,,,,,,,,,341.96,83,,percent of total billed charges,,,391.4,95,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,337.84,82,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,350.2,85,,percent of total billed charges,,310.65,391.4,
GI TRACT IMG INTRALUMINAL,93021,CDM,91110,CPT,510,RC,inpatient,,1030,1030,,874.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,776.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,875.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,906.4,88,,percent of total billed charges,,,,,,,,,786.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,937.3,91,,percent of total billed charges,,,978.5,95,,percent of total billed charges,,,854.9,83,,percent of total billed charges,,,854.9,83,,percent of total billed charges,,,,,,,,,,,,,,,854.9,83,,percent of total billed charges,,,978.5,95,,percent of total billed charges,,,927,90,,percent of total billed charges,,,927,90,,percent of total billed charges,,,844.6,82,,percent of total billed charges,,,927,90,,percent of total billed charges,,,875.5,85,,percent of total billed charges,,776.62,978.5,
SUPPLY MISC,99013,CDM,,,,,inpatient,,20,20,,16.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.6,88,,percent of total billed charges,,,,,,,,,15.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.2,91,,percent of total billed charges,,,19,95,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,,,,,,,,,,,,,16.6,83,,percent of total billed charges,,,19,95,,percent of total billed charges,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,16.4,82,,percent of total billed charges,,,18,90,,percent of total billed charges,,,17,85,,percent of total billed charges,,15.08,19,
OFFICE OUTPT EST 15MIN,105000,CDM,99213,CPT,510,RC,inpatient,,90,90,,76.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,76.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.2,88,,percent of total billed charges,,,,,,,,,68.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,73.8,82,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,67.86,85.5,
OFFICE OUTPT EST 25 MIN,105001,CDM,99214,CPT,510,RC,inpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,91.23,114.95,
OFFICE OUTPT NEW 45 MIN,105002,CDM,99204,CPT,510,RC,inpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,149.29,188.1,
OFFICE OUTPT EST 10 MIN,105003,CDM,99212,CPT,510,RC,inpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,62.58,78.85,
OFFICE OUTPT NEW 30 MIN,105004,CDM,99203,CPT,510,RC,inpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,109.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,123.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,109.33,137.75,
ECG ROUTINE ECG W/LEAST 12 LDS 1/R ONLY,105005,CDM,93010,CPT,510,RC,inpatient,,10,10,,8.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8.8,88,,percent of total billed charges,,,,,,,,,7.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9.1,91,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,,,,,,,,,,,,,8.3,83,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,9,90,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.2,82,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.5,85,,percent of total billed charges,,7.54,9.5,
CARDIOVASCULAR STRESS TEST,105006,CDM,93016,CPT,510,RC,inpatient,,27,27,,22.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23.76,88,,percent of total billed charges,,,,,,,,,20.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,,,,,,,,,,,,,22.41,83,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.14,82,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,20.36,25.65,
CARDIOVASCULAR STRESS TEST INTERPRET,105007,CDM,93018,CPT,510,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
OFFICE OUTPT EST,105008,CDM,99215,CPT,510,RC,inpatient,,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
OFFICE OUTPT NEW 60 MIN,105009,CDM,99205,CPT,510,RC,inpatient,,237,237,,201.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.56,88,,percent of total billed charges,,,,,,,,,181.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.67,91,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,,,,,,,,,,,,,196.71,83,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,194.34,82,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,178.7,225.15,
ELETROCARDIOGRAM TRACING,105010,CDM,93005,CPT,510,RC,inpatient,,123,123,,104.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,92.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,104.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,108.24,88,,percent of total billed charges,,,,,,,,,93.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.93,91,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,,,,,,,,,,,,,102.09,83,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,100.86,82,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,104.55,85,,percent of total billed charges,,92.74,116.85,
TTE W/DOPPLER COMPLETE,105011,CDM,93306,CPT,510,RC,inpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,77.66,97.85,
NJX SCLRSNT 1 INCMPTNT VEIN,105012,CDM,36470,CPT,510,RC,inpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,77.66,97.85,
NJX SCLRSNT MLT INCMPTNT VEIN,105013,CDM,36471,CPT,510,RC,inpatient,,129,129,,109.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,97.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,109.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,113.52,88,,percent of total billed charges,,,,,,,,,98.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,105.78,82,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,97.27,122.55,
OFFICE OUTPT VISIT NEW,105014,CDM,99202,CPT,510,RC,inpatient,,107,107,,90.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,80.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,90.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,94.16,88,,percent of total billed charges,,,,,,,,,81.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,97.37,91,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,,,,,,,,,,,,,88.81,83,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,87.74,82,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,90.95,85,,percent of total billed charges,,80.68,101.65,
CARDIOVASCULAR STRESS TEST,105015,CDM,93017,CPT,510,RC,inpatient,,115,115,,97.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,86.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,97.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,101.2,88,,percent of total billed charges,,,,,,,,,87.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,104.65,91,,percent of total billed charges,,,109.25,95,,percent of total billed charges,,,95.45,83,,percent of total billed charges,,,95.45,83,,percent of total billed charges,,,,,,,,,,,,,,,95.45,83,,percent of total billed charges,,,109.25,95,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,94.3,82,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,97.75,85,,percent of total billed charges,,86.71,109.25,
TTE W/DOPPLER COMPLETE,105016,CDM,93306,CPT,510,RC,inpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,77.66,97.85,
INSERT TEMP BLADDER CATH,141000,CDM,51702,CPT,510,RC,inpatient,,31,31,,26.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.28,88,,percent of total billed charges,,,,,,,,,23.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,,,,,,,,,,,,,25.73,83,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,25.42,82,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,23.37,29.45,
OFFICE OUTPT NEW 45 MIN,141001,CDM,99204,CPT,510,RC,inpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,149.29,188.1,
OFFICE OUTPT NEW 30 MIN,141002,CDM,99203,CPT,510,RC,inpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,109.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,123.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,109.33,137.75,
OFFICE OUTPT EST 25 MIN,141003,CDM,99214,CPT,510,RC,inpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,91.23,114.95,
"OFFICE/OUTPATIENT VISIT, NEW",141004,CDM,99202,CPT,510,RC,inpatient,,107,107,,90.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,80.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,90.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,94.16,88,,percent of total billed charges,,,,,,,,,81.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,97.37,91,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,,,,,,,,,,,,,88.81,83,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,87.74,82,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,90.95,85,,percent of total billed charges,,80.68,101.65,
OFFICE OUTPT EST 10 MIN,141005,CDM,99212,CPT,510,RC,inpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,62.58,78.85,
OFFICE OUTPT EST 15 MIN,141006,CDM,99213,CPT,510,RC,inpatient,,90,90,,76.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,76.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.2,88,,percent of total billed charges,,,,,,,,,68.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,73.8,82,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,67.86,85.5,
CYSTOSCOPY,141007,CDM,52000,CPT,510,RC,inpatient,,100,100,,84.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88,88,,percent of total billed charges,,,,,,,,,76.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,83,83,,percent of total billed charges,,,,,,,,,,,,,,,83,83,,percent of total billed charges,,,95,95,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,82,82,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,75.4,95,
BIOPSY OF PROSTATE,141008,CDM,55700,CPT,510,RC,inpatient,,162,162,,137.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,122.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,137.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,142.56,88,,percent of total billed charges,,,,,,,,,123.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,,,,,,,,,,,,,134.46,83,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,132.84,82,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,122.15,153.9,
GARAMYCIN GENTAMICIN INJ,141009,CDM,J1580,HCPCS,636,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,21.3,,,,fee schedule,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21.3,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,21.3,
VOIDING PRESSURE STUDIES/ANY TECH,141010,CDM,51728,CPT,510,RC,inpatient,,129,129,,109.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,97.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,109.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,113.52,88,,percent of total billed charges,,,,,,,,,98.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,105.78,82,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,97.27,122.55,
ANAL/URINARY MUSCLE STUDY,141011,CDM,51784,CPT,510,RC,inpatient,,66,66,,56.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.08,88,,percent of total billed charges,,,,,,,,,50.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.06,91,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,,,,,,,,,,,,,54.78,83,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,54.12,82,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,49.76,62.7,
INTRAABDOMINAL PRESSURE TEST,141012,CDM,51797,CPT,510,RC,inpatient,,49,49,,41.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,43.12,88,,percent of total billed charges,,,,,,,,,37.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,44.59,91,,percent of total billed charges,,,46.55,95,,percent of total billed charges,,,40.67,83,,percent of total billed charges,,,40.67,83,,percent of total billed charges,,,,,,,,,,,,,,,40.67,83,,percent of total billed charges,,,46.55,95,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,40.18,82,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,41.65,85,,percent of total billed charges,,36.95,46.55,
US URINE CAPACITY MEASURE,141013,CDM,51798,CPT,510,RC,inpatient,,26,26,,22.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.88,88,,percent of total billed charges,,,,,,,,,19.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.66,91,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,,,,,,,,,,,,,21.58,83,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,21.32,82,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,19.6,24.7,
INSERT BLADDER CATHETER,141014,CDM,51701,CPT,510,RC,inpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,108.58,136.8,
URINALYSIS DIPSTICK,141015,CDM,81003,CPT,300,RC,inpatient,,47,47,,39.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.36,88,,percent of total billed charges,,,,,,,,,35.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,,,,,,,,,,,,,39.01,83,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,38.54,82,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,35.44,44.65,
ELECTRO-UROFLOW FIRST,141016,CDM,51741,CPT,510,RC,inpatient,,136,136,,115.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,102.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,115.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,119.68,88,,percent of total billed charges,,,,,,,,,103.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,123.76,91,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,,,,,,,,,,,,,112.88,83,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,111.52,82,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,102.54,129.2,
COMPLEX CYSTOMETROGRAM,141017,CDM,51726,CPT,510,RC,inpatient,,515,515,,437.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,388.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,437.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,453.2,88,,percent of total billed charges,,,,,,,,,393.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,468.65,91,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,,,,,,,,,,,,,427.45,83,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,422.3,82,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,388.31,489.25,
CYSTOSCOPY CHEMODENERVATION,141018,CDM,52287,CPT,510,RC,inpatient,,610,610,,517.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,459.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,518.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,536.8,88,,percent of total billed charges,,,,,,,,,466.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,555.1,91,,percent of total billed charges,,,579.5,95,,percent of total billed charges,,,506.3,83,,percent of total billed charges,,,506.3,83,,percent of total billed charges,,,,,,,,,,,,,,,506.3,83,,percent of total billed charges,,,579.5,95,,percent of total billed charges,,,549,90,,percent of total billed charges,,,549,90,,percent of total billed charges,,,500.2,82,,percent of total billed charges,,,549,90,,percent of total billed charges,,,518.5,85,,percent of total billed charges,,459.94,579.5,
OFFICE OUTPT NEW 60 MIN,141019,CDM,99205,CPT,510,RC,inpatient,,237,237,,201.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.56,88,,percent of total billed charges,,,,,,,,,181.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.67,91,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,,,,,,,,,,,,,196.71,83,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,194.34,82,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,178.7,225.15,
INJECTION OF CORPORA CAVERNOSA,141020,CDM,54235,CPT,510,RC,inpatient,,148,148,,125.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,111.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,125.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,130.24,88,,percent of total billed charges,,,,,,,,,113.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,,,,,,,,,,,,,122.84,83,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,121.36,82,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,111.59,140.6,
US TRANSRECTAL,141021,CDM,76872,CPT,510,RC,inpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,155.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,155.32,195.7,
US GUIDANCE NEEDLE PLACEMENT,141022,CDM,76942,CPT,510,RC,inpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,155.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,155.32,195.7,
REMOVAL OF INDWELLING URETERAL STENT,141023,CDM,52310,CPT,510,RC,inpatient,,683,683,,579.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,514.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,580.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,601.04,88,,percent of total billed charges,,,,,,,,,521.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,621.53,91,,percent of total billed charges,,,648.85,95,,percent of total billed charges,,,566.89,83,,percent of total billed charges,,,566.89,83,,percent of total billed charges,,,,,,,,,,,,,,,566.89,83,,percent of total billed charges,,,648.85,95,,percent of total billed charges,,,614.7,90,,percent of total billed charges,,,614.7,90,,percent of total billed charges,,,560.06,82,,percent of total billed charges,,,614.7,90,,percent of total billed charges,,,580.55,85,,percent of total billed charges,,514.98,648.85,
FITTING/INSERTION OF PESSARY SUPPORT,141024,CDM,57160,CPT,510,RC,inpatient,,155,155,,131.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,131.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,136.4,88,,percent of total billed charges,,,,,,,,,118.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,127.1,82,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,116.87,147.25,
INJECTION ANESTHETIC AGENT/STEROID,141025,CDM,64450,CPT,510,RC,inpatient,,222,222,,188.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,167.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,188.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,195.36,88,,percent of total billed charges,,,,,,,,,169.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,202.02,91,,percent of total billed charges,,,210.9,95,,percent of total billed charges,,,184.26,83,,percent of total billed charges,,,184.26,83,,percent of total billed charges,,,,,,,,,,,,,,,184.26,83,,percent of total billed charges,,,210.9,95,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,182.04,82,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,188.7,85,,percent of total billed charges,,167.39,210.9,
NEUROELTRD STIM POST TIBIAL,141026,CDM,64566,CPT,510,RC,inpatient,,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,230.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,260.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,230.72,290.7,
ONABOTULINUMTOXINA INJ,141922,CDM,J0585,HCPCS,636,RC,inpatient,,16,16,,13.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.08,88,,percent of total billed charges,,2491.6,,,,fee schedule,,,12.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2491.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.56,91,,percent of total billed charges,,,15.2,95,,percent of total billed charges,,,13.28,83,,percent of total billed charges,,,13.28,83,,percent of total billed charges,,,,,,,,,,,,,,,13.28,83,,percent of total billed charges,,,15.2,95,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,13.12,82,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,13.6,85,,percent of total billed charges,,12.06,2491.6,
OFFICE OUTPT EST 15MIN,142000,CDM,99213,CPT,510,RC,inpatient,,90,90,,76.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,76.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.2,88,,percent of total billed charges,,,,,,,,,68.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,73.8,82,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,67.86,85.5,
OFFICE OUTPT NEW 45 MIN,142001,CDM,99204,CPT,510,RC,inpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,149.29,188.1,
EAR MICROSCOPY EXAMINATION,142002,CDM,92504,CPT,510,RC,inpatient,,11,11,,9.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9.68,88,,percent of total billed charges,,,,,,,,,8.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,,,,,,,,,,,,,9.13,83,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.02,82,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,8.29,10.45,
TYMPANOMETRY,142003,CDM,92567,CPT,510,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
"NASAL ENDOSCOPY, DX",142004,CDM,31231,CPT,510,RC,inpatient,,79,79,,67.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.52,88,,percent of total billed charges,,,,,,,,,60.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,,,,,,,,,,,,,65.57,83,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,64.78,82,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,59.57,75.05,
DIAGNOSTIC LARYNGOSCOPY,142005,CDM,31575,CPT,510,RC,inpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,61.07,76.95,
OFFICE OUTPT NEW 30 MIN,142006,CDM,99203,CPT,510,RC,inpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,109.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,123.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,109.33,137.75,
OFFICE OUTPT EST 25 MIN,142007,CDM,99214,CPT,510,RC,inpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,91.23,114.95,
CREATE EARDRUM OPENING,142008,CDM,69433,CPT,510,RC,inpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,135.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,119.89,151.05,
NASOPHARYNGOSCOPY,142009,CDM,92511,CPT,510,RC,inpatient,,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,33.93,42.75,
"OFFICE/OUTPATIENT VISIT, NEW",142010,CDM,99202,CPT,510,RC,inpatient,,107,107,,90.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,80.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,90.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,94.16,88,,percent of total billed charges,,,,,,,,,81.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,97.37,91,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,,,,,,,,,,,,,88.81,83,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,87.74,82,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,90.95,85,,percent of total billed charges,,80.68,101.65,
"EXCISION LESION, MOUTH ROOF",142011,CDM,42104,CPT,510,RC,inpatient,,164,164,,139.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,123.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,139.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,144.32,88,,percent of total billed charges,,,,,,,,,125.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,134.48,82,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,123.66,155.8,
OFFICE OUTPT EST 10 MIN,142012,CDM,99212,CPT,510,RC,inpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,62.58,78.85,
RMVL FB XTRNL AUD CANAL W/O ANES,142013,CDM,69200,CPT,510,RC,inpatient,,58,58,,49.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.04,88,,percent of total billed charges,,,,,,,,,44.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52.78,91,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,,,,,,,,,,,,,48.14,83,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,47.56,82,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,43.73,55.1,
CONTROL OF NOSEBLEED SIMPLE,142014,CDM,30901,CPT,510,RC,inpatient,,71,71,,60.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.48,88,,percent of total billed charges,,,,,,,,,54.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,,,,,,,,,,,,,58.93,83,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,58.22,82,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,53.53,67.45,
BIOPSY OF TONGUE,142015,CDM,41100,CPT,510,RC,inpatient,,131,131,,111.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,111.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,115.28,88,,percent of total billed charges,,,,,,,,,100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,,,,,,,,,,,,,108.73,83,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,107.42,82,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,98.77,124.45,
RMVL IMPACT CERUMEN BY INST SPX 1/2 EARS,142016,CDM,69210,CPT,510,RC,inpatient,,41,41,,34.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36.08,88,,percent of total billed charges,,,,,,,,,31.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,,,,,,,,,,,,,34.03,83,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,33.62,82,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,30.91,38.95,
CANALITH REPOSITIONING PROC,142017,CDM,95992,CPT,510,RC,inpatient,,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,33.93,42.75,
INTRANASAL BIOPSY,142018,CDM,30100,CPT,510,RC,inpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,61.07,76.95,
CLEAN OUT MASTOID CAVITY,142019,CDM,69220,CPT,510,RC,inpatient,,63,63,,53.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,53.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.44,88,,percent of total billed charges,,,,,,,,,48.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,,,,,,,,,,,,,52.29,83,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,51.66,82,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,47.5,59.85,
CONTROL OF NOSEBLEED COMPLEX,142020,CDM,30903,CPT,510,RC,inpatient,,98,98,,83.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,73.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,83.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,86.24,88,,percent of total billed charges,,,,,,,,,74.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,89.18,91,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,,,,,,,,,,,,,81.34,83,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,80.36,82,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,83.3,85,,percent of total billed charges,,73.89,93.1,
INJECTION TREATMENT OF NOSE,142021,CDM,30200,CPT,510,RC,inpatient,,71,71,,60.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.48,88,,percent of total billed charges,,,,,,,,,54.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,,,,,,,,,,,,,58.93,83,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,58.22,82,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,53.53,67.45,
BIOPSY OF LIP,142022,CDM,40490,CPT,510,RC,inpatient,,85,85,,72.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,72.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.8,88,,percent of total billed charges,,,,,,,,,64.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,,,,,,,,,,,,,70.55,83,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,69.7,82,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,64.09,80.75,
SHAVING SKIN LES 1 F/E/E/N/L/M DI 0.5 CM,142023,CDM,11310,CPT,510,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
REPAIR INTER F/E/E/N/L/M/MUC 2.5 CM<,142024,CDM,12051,CPT,510,RC,inpatient,,205,205,,174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,154.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,174.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,180.4,88,,percent of total billed charges,,,,,,,,,156.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,186.55,91,,percent of total billed charges,,,194.75,95,,percent of total billed charges,,,170.15,83,,percent of total billed charges,,,170.15,83,,percent of total billed charges,,,,,,,,,,,,,,,170.15,83,,percent of total billed charges,,,194.75,95,,percent of total billed charges,,,184.5,90,,percent of total billed charges,,,184.5,90,,percent of total billed charges,,,168.1,82,,percent of total billed charges,,,184.5,90,,percent of total billed charges,,,174.25,85,,percent of total billed charges,,154.57,194.75,
EXC B9 LES MARGN F/E/E/N/L/M 0.6-1.0 CM,142025,CDM,11441,CPT,510,RC,inpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,135.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,119.89,151.05,
BIOPSY OF MOUTH LESION,142026,CDM,40808,CPT,510,RC,inpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,89.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,79.17,99.75,
EXC FACE-MM MALIG+MARG 1.1-2,142027,CDM,11642,CPT,510,RC,inpatient,,220,220,,186.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,165.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,187,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,193.6,88,,percent of total billed charges,,,,,,,,,168.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,200.2,91,,percent of total billed charges,,,209,95,,percent of total billed charges,,,182.6,83,,percent of total billed charges,,,182.6,83,,percent of total billed charges,,,,,,,,,,,,,,,182.6,83,,percent of total billed charges,,,209,95,,percent of total billed charges,,,198,90,,percent of total billed charges,,,198,90,,percent of total billed charges,,,180.4,82,,percent of total billed charges,,,198,90,,percent of total billed charges,,,187,85,,percent of total billed charges,,165.88,209,
DRAINAGE OF TONSIL ABSCESS,142028,CDM,42700,CPT,510,RC,inpatient,,164,164,,139.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,123.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,139.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,144.32,88,,percent of total billed charges,,,,,,,,,125.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,134.48,82,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,123.66,155.8,
EXC B9 LES MARGN F/E/E/N/L/M 0.5CM/<,142029,CDM,11440,CPT,510,RC,inpatient,,125,125,,106.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,94.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,106.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110,88,,percent of total billed charges,,,,,,,,,95.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,113.75,91,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,,,,,,,,,,,,,103.75,83,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,102.5,82,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,94.25,118.75,
REPAIR COMPL F/C/C/M/N/AX/G 1.1- 2.5 CM,142030,CDM,13131,CPT,510,RC,inpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,223.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,252.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,223.94,282.15,
EXC B9 LES MARG XCP F/E/E/N/L/M 1.1-2.0C,142031,CDM,11442,CPT,510,RC,inpatient,,175,175,,148.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,131.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,148.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154,88,,percent of total billed charges,,,,,,,,,133.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,,,,,,,,,,,,,145.25,83,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,143.5,82,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,131.95,166.25,
REPAIR INTER F/E/E/N/L/M/MUC 2.6-5.0 CM,142032,CDM,12052,CPT,510,RC,inpatient,,243,243,,206.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,183.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,206.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,213.84,88,,percent of total billed charges,,,,,,,,,185.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,221.13,91,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,,,,,,,,,,,,,201.69,83,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,199.26,82,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,206.55,85,,percent of total billed charges,,183.22,230.85,
DESTRUCTION PREMALIGNANT LESION 2-14 EA,142033,CDM,17003,CPT,510,RC,inpatient,,2,2,,1.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1.76,88,,percent of total billed charges,,,,,,,,,1.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1.82,91,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,,,,,,,,,,,,,1.66,83,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.64,82,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.7,85,,percent of total billed charges,,1.51,1.9,
ESOPHAGOSCOPY FLEXIBLE,142034,CDM,43197,CPT,510,RC,inpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,77.66,97.85,
CLEAN OUT MASTOID CAVITY,142035,CDM,69222,CPT,510,RC,inpatient,,164,164,,139.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,123.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,139.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,144.32,88,,percent of total billed charges,,,,,,,,,125.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,134.48,82,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,123.66,155.8,
DRAINED TONGUE ABSCESS,142036,CDM,41000,CPT,510,RC,inpatient,,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,99.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,112.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,99.53,125.4,
ELECTRO-UROFLOWMETRY FIRST,142037,CDM,51741,CPT,510,RC,inpatient,,52,52,,44.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.76,88,,percent of total billed charges,,,,,,,,,39.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,42.64,82,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,39.21,49.4,
COMPREHENSIVE HEARING TEST,142038,CDM,92557,CPT,510,RC,inpatient,,52,52,,44.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.76,88,,percent of total billed charges,,,,,,,,,39.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,42.64,82,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,39.21,49.4,
EVOKED AUDITORY TST COMPLETE,142039,CDM,92588,CPT,510,RC,inpatient,,52,52,,44.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.76,88,,percent of total billed charges,,,,,,,,,39.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,42.64,82,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,39.21,49.4,
NASAL/SINUS ENDOSCOPY,142040,CDM,31237,CPT,510,RC,inpatient,,878,878,,745.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,662.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,746.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,772.64,88,,percent of total billed charges,,,,,,,,,670.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,798.98,91,,percent of total billed charges,,,834.1,95,,percent of total billed charges,,,728.74,83,,percent of total billed charges,,,728.74,83,,percent of total billed charges,,,,,,,,,,,,,,,728.74,83,,percent of total billed charges,,,834.1,95,,percent of total billed charges,,,790.2,90,,percent of total billed charges,,,790.2,90,,percent of total billed charges,,,719.96,82,,percent of total billed charges,,,790.2,90,,percent of total billed charges,,,746.3,85,,percent of total billed charges,,662.01,834.1,
LABYRINTHOTOMY TRANSCANAL,142041,CDM,69801,CPT,510,RC,inpatient,,1030,1030,,874.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,776.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,875.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,906.4,88,,percent of total billed charges,,,,,,,,,786.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,937.3,91,,percent of total billed charges,,,978.5,95,,percent of total billed charges,,,854.9,83,,percent of total billed charges,,,854.9,83,,percent of total billed charges,,,,,,,,,,,,,,,854.9,83,,percent of total billed charges,,,978.5,95,,percent of total billed charges,,,927,90,,percent of total billed charges,,,927,90,,percent of total billed charges,,,844.6,82,,percent of total billed charges,,,927,90,,percent of total billed charges,,,875.5,85,,percent of total billed charges,,776.62,978.5,
INCISION OF EARDRUM,142042,CDM,69420,CPT,510,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,194.53,245.1,
BIOPSY PALATE UVULA,142043,CDM,42100,CPT,510,RC,inpatient,,309,309,,262.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,232.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,262.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,271.92,88,,percent of total billed charges,,,,,,,,,236.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,281.19,91,,percent of total billed charges,,,293.55,95,,percent of total billed charges,,,256.47,83,,percent of total billed charges,,,256.47,83,,percent of total billed charges,,,,,,,,,,,,,,,256.47,83,,percent of total billed charges,,,293.55,95,,percent of total billed charges,,,278.1,90,,percent of total billed charges,,,278.1,90,,percent of total billed charges,,,253.38,82,,percent of total billed charges,,,278.1,90,,percent of total billed charges,,,262.65,85,,percent of total billed charges,,232.99,293.55,
NASAL/SINUS ENDOSCOPY W/CONTROL HEMORRHA,142044,CDM,31238,CPT,510,RC,inpatient,,515,515,,437.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,388.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,437.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,453.2,88,,percent of total billed charges,,,,,,,,,393.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,468.65,91,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,,,,,,,,,,,,,427.45,83,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,422.3,82,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,388.31,489.25,
NASAL/SINUS ENDOSCOPY,142045,CDM,31238,CPT,510,RC,inpatient,,528,528,,448.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,398.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,448.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,464.64,88,,percent of total billed charges,,,,,,,,,403.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,480.48,91,,percent of total billed charges,,,501.6,95,,percent of total billed charges,,,438.24,83,,percent of total billed charges,,,438.24,83,,percent of total billed charges,,,,,,,,,,,,,,,438.24,83,,percent of total billed charges,,,501.6,95,,percent of total billed charges,,,475.2,90,,percent of total billed charges,,,475.2,90,,percent of total billed charges,,,432.96,82,,percent of total billed charges,,,475.2,90,,percent of total billed charges,,,448.8,85,,percent of total billed charges,,398.11,501.6,
SHAVE SKIN LESION 0.6-1.0CM,142046,CDM,11311,CPT,510,RC,inpatient,,155,155,,131.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,131.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,136.4,88,,percent of total billed charges,,,,,,,,,118.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,127.1,82,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,116.87,147.25,
VISUALIZATION OF WINDPIPE,142047,CDM,31615,CPT,510,RC,inpatient,,487,487,,413.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,367.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,413.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,428.56,88,,percent of total billed charges,,,,,,,,,372.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,443.17,91,,percent of total billed charges,,,462.65,95,,percent of total billed charges,,,404.21,83,,percent of total billed charges,,,404.21,83,,percent of total billed charges,,,,,,,,,,,,,,,404.21,83,,percent of total billed charges,,,462.65,95,,percent of total billed charges,,,438.3,90,,percent of total billed charges,,,438.3,90,,percent of total billed charges,,,399.34,82,,percent of total billed charges,,,438.3,90,,percent of total billed charges,,,413.95,85,,percent of total billed charges,,367.2,462.65,
OFFICE OUTPT NEW 60 MIN,142048,CDM,99205,CPT,510,RC,inpatient,,237,237,,201.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.56,88,,percent of total billed charges,,,,,,,,,181.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.67,91,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,,,,,,,,,,,,,196.71,83,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,194.34,82,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,178.7,225.15,
THERAPEUTIC PROPH/DX INJECTION SUBQ/IM,144000,CDM,96372,CPT,510,RC,inpatient,XU,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,58.06,73.15,
THER PROPH/DX NJX EA SEQL IV PUSH SBST,144001,CDM,96375,CPT,510,RC,inpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,58.06,73.15,
OFFICE OUTPT NEW 30 MIN,144002,CDM,99203,CPT,510,RC,inpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,109.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,123.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,109.33,137.75,
OFFICE OUTPT NEW 45 MIN,144003,CDM,99204,CPT,510,RC,inpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,149.29,188.1,
OFFICE OUTPT NEW 60 MIN,144004,CDM,99205,CPT,510,RC,inpatient,,165,165,,140.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,124.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,140.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,145.2,88,,percent of total billed charges,,,,,,,,,126.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,135.3,82,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,124.41,156.75,
OFFICE OUTPT EST 10 MIN,144005,CDM,99212,CPT,510,RC,inpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,62.58,78.85,
OFFICE OUTPT EST 15 MIN,144006,CDM,99213,CPT,510,RC,inpatient,,90,90,,76.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,76.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.2,88,,percent of total billed charges,,,,,,,,,68.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,73.8,82,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,67.86,85.5,
OFFICE OUTPT EST 25 MIN,144007,CDM,99214,CPT,510,RC,inpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,91.23,114.95,
OFFICE OUTPT VISIT EST,144008,CDM,99215,CPT,510,RC,inpatient,,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
OFFICE CONSULT 60 MIN,144009,CDM,99244,CPT,510,RC,inpatient,,129,129,,109.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,97.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,109.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,113.52,88,,percent of total billed charges,,,,,,,,,98.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,105.78,82,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,97.27,122.55,
METHYLPREDNISOLONE INJECTION,144010,CDM,J2930,HCPCS,510,RC,inpatient,,177,177,,150.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,133.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,150.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,155.76,88,,percent of total billed charges,,172.26,,,,fee schedule,,,135.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,172.26,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,,,,,,,,,,,,,146.91,83,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,145.14,82,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,133.46,172.26,
PROLONGD SERV W/O CONTACT 1ST HOUR,145000,CDM,99358,CPT,510,RC,inpatient,,249,249,,211.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,187.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,211.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,219.12,88,,percent of total billed charges,,,,,,,,,190.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,226.59,91,,percent of total billed charges,,,236.55,95,,percent of total billed charges,,,206.67,83,,percent of total billed charges,,,206.67,83,,percent of total billed charges,,,,,,,,,,,,,,,206.67,83,,percent of total billed charges,,,236.55,95,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,204.18,82,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,211.65,85,,percent of total billed charges,,187.75,236.55,
OFFICE OUTPT NEW 30 MIN,145001,CDM,99203,CPT,510,RC,inpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,109.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,123.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,109.33,137.75,
OFFICE OUTPT EST 15MIN,145002,CDM,99213,CPT,510,RC,inpatient,,90,90,,76.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,76.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.2,88,,percent of total billed charges,,,,,,,,,68.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,73.8,82,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,67.86,85.5,
ARTHROCENTESIS ASPIR/INJ SMALL JT/BUR,146000,CDM,20600,CPT,510,RC,inpatient,,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,33.93,42.75,
ARTHROCENTESIS ASPIR/INJ INTERM JT/BUR,146001,CDM,20605,CPT,510,RC,inpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,34.68,43.7,
ARTHROCENTESIS ASPIR/INJ MAJORJT/BUR,146002,CDM,20610,CPT,510,RC,inpatient,,58,58,,49.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.04,88,,percent of total billed charges,,,,,,,,,44.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52.78,91,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,,,,,,,,,,,,,48.14,83,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,47.56,82,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,43.73,55.1,
DRAIN/INJ JOINT/BURSA W/US,146003,CDM,20611,CPT,510,RC,inpatient,,75,75,,63.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,63.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66,88,,percent of total billed charges,,,,,,,,,57.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,68.25,91,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,,,,,,,,,,,,,62.25,83,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,61.5,82,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,56.55,71.25,
ASPIRATION/INJECTION GANGLION CYST ANY L,146004,CDM,20612,CPT,510,RC,inpatient,,155,155,,131.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,131.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,136.4,88,,percent of total billed charges,,,,,,,,,118.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,127.1,82,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,116.87,147.25,
OFFICE OUTPT NEW 45 MIN,146005,CDM,99204,CPT,510,RC,inpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,149.29,188.1,
OFFICE OUTPT EST 25 MIN,146006,CDM,99214,CPT,510,RC,inpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,91.23,114.95,
OFFICE OUTPT NEW 60 MIN,146007,CDM,99205,CPT,510,RC,inpatient,,165,165,,140.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,124.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,140.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,145.2,88,,percent of total billed charges,,,,,,,,,126.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,135.3,82,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,124.41,156.75,
OFFICE OUTPT EST 25 MIN,151000,CDM,99214,CPT,510,RC,inpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,91.23,114.95,
OFFICE OUTPT NEW 45 MIN,151001,CDM,99204,CPT,510,RC,inpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,149.29,188.1,
OFFICE OUTPT NEW 60 MIN,151002,CDM,99205,CPT,510,RC,inpatient,,165,165,,140.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,124.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,140.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,145.2,88,,percent of total billed charges,,,,,,,,,126.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,135.3,82,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,124.41,156.75,
"IV CHEMO INFUSION UP TO 1 HR, SGL/INIT",4540121,CDM,96413,CPT,335,RC,inpatient,,1975,1975,,1676.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1489.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1678.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1738,88,,percent of total billed charges,,,,,,,,,1508.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1797.25,91,,percent of total billed charges,,,1876.25,95,,percent of total billed charges,,,1639.25,83,,percent of total billed charges,,,1639.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1639.25,83,,percent of total billed charges,,,1876.25,95,,percent of total billed charges,,,1777.5,90,,percent of total billed charges,,,1777.5,90,,percent of total billed charges,,,1619.5,82,,percent of total billed charges,,,1777.5,90,,percent of total billed charges,,,1678.75,85,,percent of total billed charges,,1489.15,1876.25,
"IV CHEMO INFUSION, EA ADDTL HR, TO 8 HR",4540122,CDM,96415,CPT,335,RC,inpatient,,335,335,,284.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,252.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,284.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,294.8,88,,percent of total billed charges,,,,,,,,,255.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,304.85,91,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,,,,,,,,,,,,,278.05,83,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,274.7,82,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,252.59,318.25,
CHEMO PROLONG INFUSE W/PUMP,4540125,CDM,96416,CPT,335,RC,inpatient,,1896,1896,,1609.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1429.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1611.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1668.48,88,,percent of total billed charges,,,,,,,,,1448.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1725.36,91,,percent of total billed charges,,,1801.2,95,,percent of total billed charges,,,1573.68,83,,percent of total billed charges,,,1573.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1573.68,83,,percent of total billed charges,,,1801.2,95,,percent of total billed charges,,,1706.4,90,,percent of total billed charges,,,1706.4,90,,percent of total billed charges,,,1554.72,82,,percent of total billed charges,,,1706.4,90,,percent of total billed charges,,,1611.6,85,,percent of total billed charges,,1429.58,1801.2,
"CHEMO ADMIN IV PUSH ONLY, SINGLE OR INIT",4540154,CDM,96409,CPT,335,RC,inpatient,,713,713,,605.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,537.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,606.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,627.44,88,,percent of total billed charges,,,,,,,,,544.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,648.83,91,,percent of total billed charges,,,677.35,95,,percent of total billed charges,,,591.79,83,,percent of total billed charges,,,591.79,83,,percent of total billed charges,,,,,,,,,,,,,,,591.79,83,,percent of total billed charges,,,677.35,95,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,584.66,82,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,606.05,85,,percent of total billed charges,,537.6,677.35,
"CHEMO - IV PUSH, EA ADDTL SUBSTANCE/DRUG",4540160,CDM,96411,CPT,335,RC,inpatient,,643,643,,545.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,484.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,546.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,565.84,88,,percent of total billed charges,,,,,,,,,491.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,585.13,91,,percent of total billed charges,,,610.85,95,,percent of total billed charges,,,533.69,83,,percent of total billed charges,,,533.69,83,,percent of total billed charges,,,,,,,,,,,,,,,533.69,83,,percent of total billed charges,,,610.85,95,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,527.26,82,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,546.55,85,,percent of total billed charges,,484.82,610.85,
"CHEMO - INFUSION OF DIF DRUG, UP TO 1 HR",4540165,CDM,96417,CPT,335,RC,inpatient,,536,536,,455.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,404.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,455.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,471.68,88,,percent of total billed charges,,,,,,,,,409.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,487.76,91,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,,,,,,,,,,,,,444.88,83,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,439.52,82,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,404.14,509.2,
"CHEMO - SQ,IM (NONHORMONAL,ANTINEOPLAST)",4540170,CDM,96401,CPT,331,RC,inpatient,,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,376.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,424.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,376.25,474.05,
"CHEMO - SQ,IM (HORMONAL,ANTINEOPLASTIC)",4540171,CDM,96402,CPT,331,RC,inpatient,,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,376.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,424.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,376.25,474.05,
CS WITH BIOPSY OF CERVIX ONLY,4540186,CDM,57455,CPT,510,RC,inpatient,,979,979,,831.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,738.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,832.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,861.52,88,,percent of total billed charges,,,,,,,,,747.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,890.89,91,,percent of total billed charges,,,930.05,95,,percent of total billed charges,,,812.57,83,,percent of total billed charges,,,812.57,83,,percent of total billed charges,,,,,,,,,,,,,,,812.57,83,,percent of total billed charges,,,930.05,95,,percent of total billed charges,,,881.1,90,,percent of total billed charges,,,881.1,90,,percent of total billed charges,,,802.78,82,,percent of total billed charges,,,881.1,90,,percent of total billed charges,,,832.15,85,,percent of total billed charges,,738.17,930.05,
CS WITH BIOPSY ENDO CURETTAGE ONLY,4540187,CDM,57456,CPT,510,RC,inpatient,,672,672,,570.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,506.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,571.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,591.36,88,,percent of total billed charges,,,,,,,,,513.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,611.52,91,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,,,,,,,,,,,,,557.76,83,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,551.04,82,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,571.2,85,,percent of total billed charges,,506.69,638.4,
CS WITH BIOPSY OF CERVIX & ENDO CURETTAG,4540188,CDM,57454,CPT,510,RC,inpatient,,1054,1054,,894.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,794.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,895.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,927.52,88,,percent of total billed charges,,,,,,,,,805.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,959.14,91,,percent of total billed charges,,,1001.3,95,,percent of total billed charges,,,874.82,83,,percent of total billed charges,,,874.82,83,,percent of total billed charges,,,,,,,,,,,,,,,874.82,83,,percent of total billed charges,,,1001.3,95,,percent of total billed charges,,,948.6,90,,percent of total billed charges,,,948.6,90,,percent of total billed charges,,,864.28,82,,percent of total billed charges,,,948.6,90,,percent of total billed charges,,,895.9,85,,percent of total billed charges,,794.72,1001.3,
LEEP,4540195,CDM,57460,CPT,510,RC,inpatient,,3962,3962,,3363.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2987.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3367.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3486.56,88,,percent of total billed charges,,,,,,,,,3026.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3605.42,91,,percent of total billed charges,,,3763.9,95,,percent of total billed charges,,,3288.46,83,,percent of total billed charges,,,3288.46,83,,percent of total billed charges,,,,,,,,,,,,,,,3288.46,83,,percent of total billed charges,,,3763.9,95,,percent of total billed charges,,,3565.8,90,,percent of total billed charges,,,3565.8,90,,percent of total billed charges,,,3248.84,82,,percent of total billed charges,,,3565.8,90,,percent of total billed charges,,,3367.7,85,,percent of total billed charges,,2987.35,3763.9,
COLPOSCOPY,4540196,CDM,57452,CPT,510,RC,inpatient,,890,890,,755.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,671.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,756.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,783.2,88,,percent of total billed charges,,,,,,,,,679.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,809.9,91,,percent of total billed charges,,,845.5,95,,percent of total billed charges,,,738.7,83,,percent of total billed charges,,,738.7,83,,percent of total billed charges,,,,,,,,,,,,,,,738.7,83,,percent of total billed charges,,,845.5,95,,percent of total billed charges,,,801,90,,percent of total billed charges,,,801,90,,percent of total billed charges,,,729.8,82,,percent of total billed charges,,,801,90,,percent of total billed charges,,,756.5,85,,percent of total billed charges,,671.06,845.5,
PHLEBOTOMY THERAPEUTIC SEPERATE PROCEDUR,4540199,CDM,99195,CPT,940,RC,inpatient,,336,336,,285.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,253.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,285.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,295.68,88,,percent of total billed charges,,,,,,,,,256.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,305.76,91,,percent of total billed charges,,,319.2,95,,percent of total billed charges,,,278.88,83,,percent of total billed charges,,,278.88,83,,percent of total billed charges,,,,,,,,,,,,,,,278.88,83,,percent of total billed charges,,,319.2,95,,percent of total billed charges,,,302.4,90,,percent of total billed charges,,,302.4,90,,percent of total billed charges,,,275.52,82,,percent of total billed charges,,,302.4,90,,percent of total billed charges,,,285.6,85,,percent of total billed charges,,253.34,319.2,
BLOOD ADMINISTRATION SERVICE,4540200,CDM,36430,CPT,391,RC,inpatient,,1766,1766,,1499.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1331.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1501.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1554.08,88,,percent of total billed charges,,,,,,,,,1349.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1607.06,91,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.78,83,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1448.12,82,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,1331.56,1677.7,
BLOOD ADMIN UP TO 4 HOURS(V11-20),4540201,CDM,36430,CPT,391,RC,inpatient,,2303,2303,,1955.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1736.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1957.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2026.64,88,,percent of total billed charges,,,,,,,,,1759.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2095.73,91,,percent of total billed charges,,,2187.85,95,,percent of total billed charges,,,1911.49,83,,percent of total billed charges,,,1911.49,83,,percent of total billed charges,,,,,,,,,,,,,,,1911.49,83,,percent of total billed charges,,,2187.85,95,,percent of total billed charges,,,2072.7,90,,percent of total billed charges,,,2072.7,90,,percent of total billed charges,,,1888.46,82,,percent of total billed charges,,,2072.7,90,,percent of total billed charges,,,1957.55,85,,percent of total billed charges,,1736.46,2187.85,
BLOOD ADMIN UP TO 6 HOURS(V-11-20),4540202,CDM,36430,CPT,391,RC,inpatient,,2769,2769,,2350.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2087.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2353.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2436.72,88,,percent of total billed charges,,,,,,,,,2115.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2519.79,91,,percent of total billed charges,,,2630.55,95,,percent of total billed charges,,,2298.27,83,,percent of total billed charges,,,2298.27,83,,percent of total billed charges,,,,,,,,,,,,,,,2298.27,83,,percent of total billed charges,,,2630.55,95,,percent of total billed charges,,,2492.1,90,,percent of total billed charges,,,2492.1,90,,percent of total billed charges,,,2270.58,82,,percent of total billed charges,,,2492.1,90,,percent of total billed charges,,,2353.65,85,,percent of total billed charges,,2087.83,2630.55,
BLOOD ADMIN OVER 6 HOURS(V-11-20),4540203,CDM,36430,CPT,391,RC,inpatient,,3080,3080,,2614.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2322.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2618,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2710.4,88,,percent of total billed charges,,,,,,,,,2353.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2802.8,91,,percent of total billed charges,,,2926,95,,percent of total billed charges,,,2556.4,83,,percent of total billed charges,,,2556.4,83,,percent of total billed charges,,,,,,,,,,,,,,,2556.4,83,,percent of total billed charges,,,2926,95,,percent of total billed charges,,,2772,90,,percent of total billed charges,,,2772,90,,percent of total billed charges,,,2525.6,82,,percent of total billed charges,,,2772,90,,percent of total billed charges,,,2618,85,,percent of total billed charges,,2322.32,2926,
COMPLEX UROFLOWMETRY,4540205,CDM,51741,CPT,510,RC,inpatient,,1662,1662,,1411.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1253.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1412.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1462.56,88,,percent of total billed charges,,,,,,,,,1269.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1512.42,91,,percent of total billed charges,,,1578.9,95,,percent of total billed charges,,,1379.46,83,,percent of total billed charges,,,1379.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1379.46,83,,percent of total billed charges,,,1578.9,95,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1362.84,82,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1412.7,85,,percent of total billed charges,,1253.15,1578.9,
MEASUR POST VOID URINE US PFA,4540206,CDM,51798,CPT,510,RC,inpatient,TC,335,335,,284.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,252.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,284.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,294.8,88,,percent of total billed charges,,,,,,,,,255.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,304.85,91,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,,,,,,,,,,,,,278.05,83,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,274.7,82,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,252.59,318.25,
BLOOD DRAW FROM IVAD,4540207,CDM,36591,CPT,510,RC,inpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,169.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,191.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,169.65,213.75,
"BLOOD DRAW FROM CVAD, PICC, PERIPH IV",4540208,CDM,36592,CPT,510,RC,inpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,155.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,175.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,155.32,195.7,
*DECLOTTING THROMB AGENT VASCULAR(V0108),4540210,CDM,36550,CPT,360,RC,inpatient,,340,340,,288.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,256.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,289,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,299.2,88,,percent of total billed charges,,,,,,,,,259.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,309.4,91,,percent of total billed charges,,,323,95,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,,,,,,,,,,,,,282.2,83,,percent of total billed charges,,,323,95,,percent of total billed charges,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,278.8,82,,percent of total billed charges,,,306,90,,percent of total billed charges,,,289,85,,percent of total billed charges,,256.36,323,
DECLOTTING THROMB AGENT VASCULAR,4540211,CDM,36593,CPT,510,RC,inpatient,,1013,1013,,860.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,763.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,861.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,891.44,88,,percent of total billed charges,,,,,,,,,773.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,921.83,91,,percent of total billed charges,,,962.35,95,,percent of total billed charges,,,840.79,83,,percent of total billed charges,,,840.79,83,,percent of total billed charges,,,,,,,,,,,,,,,840.79,83,,percent of total billed charges,,,962.35,95,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,830.66,82,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,861.05,85,,percent of total billed charges,,763.8,962.35,
IM/SQ INJECTION,4540215,CDM,96372,CPT,940,RC,inpatient,XU,416,416,,353.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,313.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,353.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,366.08,88,,percent of total billed charges,,,,,,,,,317.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,378.56,91,,percent of total billed charges,,,395.2,95,,percent of total billed charges,,,345.28,83,,percent of total billed charges,,,345.28,83,,percent of total billed charges,,,,,,,,,,,,,,,345.28,83,,percent of total billed charges,,,395.2,95,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,341.12,82,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,353.6,85,,percent of total billed charges,,313.66,395.2,
IV PUSH - SINGLE OR INITIAL,4540217,CDM,96374,CPT,510,RC,inpatient,XU,436,436,,370.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,328.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,370.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,383.68,88,,percent of total billed charges,,,,,,,,,333.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,396.76,91,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,,,,,,,,,,,,,361.88,83,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,357.52,82,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,328.74,414.2,
IV PUSH - EA ADDTL SEQUENTIAL IVP,4540218,CDM,96375,CPT,510,RC,inpatient,XU,359,359,,304.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,270.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,305.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,315.92,88,,percent of total billed charges,,,,,,,,,274.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,,,,,,,,,,,,,297.97,83,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,294.38,82,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,270.69,341.05,
"IV HYDRATION, INITIAL, FIRST HOUR",4540219,CDM,96360,CPT,510,RC,inpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,627.33,790.4,
"IV HYDRATION EACH HR, UP TO 8 HRS",4540220,CDM,96361,CPT,510,RC,inpatient,XU,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,189.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,213.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,189.25,238.45,
IV INFUSION UP TO 1 HR,4540222,CDM,96365,CPT,510,RC,inpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,627.33,790.4,
IV INFUSION ADD (2ND) HR OR 2ND SAME DAY,4540225,CDM,96366,CPT,510,RC,inpatient,XU,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,189.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,213.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,189.25,238.45,
IV INFUSION 3RD HOUR OR 3RD PER DAY,4540226,CDM,96366,CPT,510,RC,inpatient,XU,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
"IV INFUSION OF DIF DRUG, UP TO 1 HR",4540227,CDM,96367,CPT,510,RC,inpatient,,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,376.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,424.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,376.25,474.05,
IV INFUSION - CONCURRENT INFUSION,4540229,CDM,96368,CPT,510,RC,inpatient,XU,522,522,,443.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,393.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,443.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,459.36,88,,percent of total billed charges,,,,,,,,,398.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,475.02,91,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,,,,,,,,,,,,,433.26,83,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,428.04,82,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,393.59,495.9,
INJECTION EA ADDTL SEQ IVP OF SAME SUBST,4540233,CDM,96376,CPT,510,RC,inpatient,XU,310,310,,263.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,233.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,263.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,272.8,88,,percent of total billed charges,,,,,,,,,236.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,282.1,91,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,,,,,,,,,,,,,257.3,83,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,279,90,,percent of total billed charges,,,279,90,,percent of total billed charges,,,254.2,82,,percent of total billed charges,,,279,90,,percent of total billed charges,,,263.5,85,,percent of total billed charges,,233.74,294.5,
IRRIGATION OF IV AD FOR DRUG DELIVERY,4540240,CDM,96523,CPT,510,RC,inpatient,,536,536,,455.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,404.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,455.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,471.68,88,,percent of total billed charges,,,,,,,,,409.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,487.76,91,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,,,,,,,,,,,,,444.88,83,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,439.52,82,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,404.14,509.2,
BONE MARROW ASPIRATION & BIOPSY,4540301,CDM,G0364,HCPCS,510,RC,inpatient,,762,762,,646.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,574.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,647.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,670.56,88,,percent of total billed charges,,,,,,,,,582.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,693.42,91,,percent of total billed charges,,,723.9,95,,percent of total billed charges,,,632.46,83,,percent of total billed charges,,,632.46,83,,percent of total billed charges,,,,,,,,,,,,,,,632.46,83,,percent of total billed charges,,,723.9,95,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,624.84,82,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,647.7,85,,percent of total billed charges,,574.55,723.9,
BONE MARROW ASPIRATION,4540302,CDM,38221,CPT,510,RC,inpatient,,1523,1523,,1293.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1148.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1294.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1340.24,88,,percent of total billed charges,,,,,,,,,1163.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1385.93,91,,percent of total billed charges,,,1446.85,95,,percent of total billed charges,,,1264.09,83,,percent of total billed charges,,,1264.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1264.09,83,,percent of total billed charges,,,1446.85,95,,percent of total billed charges,,,1370.7,90,,percent of total billed charges,,,1370.7,90,,percent of total billed charges,,,1248.86,82,,percent of total billed charges,,,1370.7,90,,percent of total billed charges,,,1294.55,85,,percent of total billed charges,,1148.34,1446.85,
APPLICATION OF ON-BODY INJECTOR,4540303,CDM,96377,CPT,940,RC,inpatient,,512,512,,434.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,386.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,435.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,450.56,88,,percent of total billed charges,,,,,,,,,391.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,465.92,91,,percent of total billed charges,,,486.4,95,,percent of total billed charges,,,424.96,83,,percent of total billed charges,,,424.96,83,,percent of total billed charges,,,,,,,,,,,,,,,424.96,83,,percent of total billed charges,,,486.4,95,,percent of total billed charges,,,460.8,90,,percent of total billed charges,,,460.8,90,,percent of total billed charges,,,419.84,82,,percent of total billed charges,,,460.8,90,,percent of total billed charges,,,435.2,85,,percent of total billed charges,,386.05,486.4,
LUMBAR PUNCTURE,4540350,CDM,62270,CPT,510,RC,inpatient,,1500,1500,,1273.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1131,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1275,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1320,88,,percent of total billed charges,,,,,,,,,1146,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1365,91,,percent of total billed charges,,,1425,95,,percent of total billed charges,,,1245,83,,percent of total billed charges,,,1245,83,,percent of total billed charges,,,,,,,,,,,,,,,1245,83,,percent of total billed charges,,,1425,95,,percent of total billed charges,,,1350,90,,percent of total billed charges,,,1350,90,,percent of total billed charges,,,1230,82,,percent of total billed charges,,,1350,90,,percent of total billed charges,,,1275,85,,percent of total billed charges,,1131,1425,
DRUG SCREENING COLLECTION,4540355,CDM,,,300,RC,inpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,38.45,48.45,
BLADDER IRRIGATION SIMPLE LAVAGE,4540360,CDM,51700,CPT,510,RC,inpatient,,715,715,,607.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,539.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,607.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,629.2,88,,percent of total billed charges,,,,,,,,,546.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,650.65,91,,percent of total billed charges,,,679.25,95,,percent of total billed charges,,,593.45,83,,percent of total billed charges,,,593.45,83,,percent of total billed charges,,,,,,,,,,,,,,,593.45,83,,percent of total billed charges,,,679.25,95,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,586.3,82,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,607.75,85,,percent of total billed charges,,539.11,679.25,
INSERT NON INDWELLING BLAD CATH,4540361,CDM,51701,CPT,510,RC,inpatient,,359,359,,304.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,270.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,305.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,315.92,88,,percent of total billed charges,,,,,,,,,274.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,,,,,,,,,,,,,297.97,83,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,294.38,82,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,270.69,341.05,
INSERT TEMPORARY INDWEELING CATH,4540362,CDM,51702,CPT,510,RC,inpatient,,548,548,,465.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,413.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,465.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,482.24,88,,percent of total billed charges,,,,,,,,,418.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,498.68,91,,percent of total billed charges,,,520.6,95,,percent of total billed charges,,,454.84,83,,percent of total billed charges,,,454.84,83,,percent of total billed charges,,,,,,,,,,,,,,,454.84,83,,percent of total billed charges,,,520.6,95,,percent of total billed charges,,,493.2,90,,percent of total billed charges,,,493.2,90,,percent of total billed charges,,,449.36,82,,percent of total billed charges,,,493.2,90,,percent of total billed charges,,,465.8,85,,percent of total billed charges,,413.19,520.6,
OPC PREOP E/M EXAM,4540500,CDM,G0463,HCPCS,510,RC,inpatient,,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,257.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,290.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,257.87,324.9,
TREATMENT ROOM - OPC,4540601,CDM,G0463,HCPCS,510,RC,inpatient,,536,536,,455.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,404.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,455.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,471.68,88,,percent of total billed charges,,,,,,,,,409.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,487.76,91,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,,,,,,,,,,,,,444.88,83,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,439.52,82,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,404.14,509.2,
EXTERNAL ELECTROCARDIOGRAPHIC 7-15 DAYS,4540650,CDM,93248,CPT,510,RC,inpatient,,174,174,,147.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,131.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,153.12,88,,percent of total billed charges,,,,,,,,,132.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,158.34,91,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,,,,,,,,,,,,,144.42,83,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,142.68,82,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,131.2,165.3,
FF OPC MONITOR PRESSURE COMPART SYNDROME,4540700,CDM,20950,CPT,510,RC,inpatient,,874,874,,742.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,659,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,742.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,769.12,88,,percent of total billed charges,,,,,,,,,667.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,795.34,91,,percent of total billed charges,,,830.3,95,,percent of total billed charges,,,725.42,83,,percent of total billed charges,,,725.42,83,,percent of total billed charges,,,,,,,,,,,,,,,725.42,83,,percent of total billed charges,,,830.3,95,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,716.68,82,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,742.9,85,,percent of total billed charges,,659,830.3,
BLADDER INSTILLATION OF ANTICARCINOGENIC,4540900,CDM,51720,CPT,510,RC,inpatient,,2395,2395,,2033.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1805.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2035.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2107.6,88,,percent of total billed charges,,,,,,,,,1829.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2179.45,91,,percent of total billed charges,,,2275.25,95,,percent of total billed charges,,,1987.85,83,,percent of total billed charges,,,1987.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1987.85,83,,percent of total billed charges,,,2275.25,95,,percent of total billed charges,,,2155.5,90,,percent of total billed charges,,,2155.5,90,,percent of total billed charges,,,1963.9,82,,percent of total billed charges,,,2155.5,90,,percent of total billed charges,,,2035.75,85,,percent of total billed charges,,1805.83,2275.25,
CHANGE OF G-TUBE,4540905,CDM,43762,CPT,510,RC,inpatient,,1234,1234,,1047.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,930.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1048.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1085.92,88,,percent of total billed charges,,,,,,,,,942.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1122.94,91,,percent of total billed charges,,,1172.3,95,,percent of total billed charges,,,1024.22,83,,percent of total billed charges,,,1024.22,83,,percent of total billed charges,,,,,,,,,,,,,,,1024.22,83,,percent of total billed charges,,,1172.3,95,,percent of total billed charges,,,1110.6,90,,percent of total billed charges,,,1110.6,90,,percent of total billed charges,,,1011.88,82,,percent of total billed charges,,,1110.6,90,,percent of total billed charges,,,1048.9,85,,percent of total billed charges,,930.44,1172.3,
NERVE CONDUCTION EA NERVE W/O WAVE,4595900,CDM,95900,CPT,922,RC,inpatient,TC,385,385,,326.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,290.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,327.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,338.8,88,,percent of total billed charges,,,,,,,,,294.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,350.35,91,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,,,,,,,,,,,,,319.55,83,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,315.7,82,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,290.29,365.75,
NERVE CONDUCTION EA NERVE WITH WAVE,4595903,CDM,95903,CPT,922,RC,inpatient,TC,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,330.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,372.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,330.25,416.1,
NERVE CONDUCTION AMPL EA NERVE SENSORY,4595904,CDM,95904,CPT,922,RC,inpatient,TC,343,343,,291.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,258.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,291.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,301.84,88,,percent of total billed charges,,,,,,,,,262.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,312.13,91,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,,,,,,,,,,,,,284.69,83,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,281.26,82,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,291.55,85,,percent of total billed charges,,258.62,325.85,
H REFLEX STUDY GASTRO SOLEUS MUSCLE,4595934,CDM,95934,CPT,510,RC,inpatient,,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,330.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,372.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,330.25,416.1,
ER/OR OXYGEN (CHG. FOR O2),13800169,CDM,,,270,RC,inpatient,,183,183,,155.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,155.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,161.04,88,,percent of total billed charges,,,,,,,,,139.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,,,,,,,,,,,,,151.89,83,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,150.06,82,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,137.98,173.85,
OXYGEN PER HOUR,13800177,CDM,,,270,RC,inpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,81.43,102.6,
RECOVERY ROOM 1ST HR,19604009,CDM,,,710,RC,inpatient,,1987,1987,,1686.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1498.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1688.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1748.56,88,,percent of total billed charges,,,,,,,,,1518.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1808.17,91,,percent of total billed charges,,,1887.65,95,,percent of total billed charges,,,1649.21,83,,percent of total billed charges,,,1649.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1649.21,83,,percent of total billed charges,,,1887.65,95,,percent of total billed charges,,,1788.3,90,,percent of total billed charges,,,1788.3,90,,percent of total billed charges,,,1629.34,82,,percent of total billed charges,,,1788.3,90,,percent of total billed charges,,,1688.95,85,,percent of total billed charges,,1498.2,1887.65,
PACU RECOVERY ROOM 1ST HR,19604010,CDM,,,710,RC,inpatient,,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,130.44,164.35,
PACU ADDTL RECOVERY ROOM,19604011,CDM,,,710,RC,inpatient,,88,88,,74.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.44,88,,percent of total billed charges,,,,,,,,,67.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,,,,,,,,,,,,,73.04,83,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,72.16,82,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,66.35,83.6,
RECOVERY ROOM ADDT 15 MIN,19604025,CDM,,,710,RC,inpatient,,395,395,,335.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,297.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,335.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,347.6,88,,percent of total billed charges,,,,,,,,,301.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,359.45,91,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,,,,,,,,,,,,,327.85,83,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,323.9,82,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,297.83,375.25,
BONE MARROW BIOPSY,19604100,CDM,,,360,RC,inpatient,,2889,2889,,2452.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2178.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2455.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2542.32,88,,percent of total billed charges,,,,,,,,,2207.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2628.99,91,,percent of total billed charges,,,2744.55,95,,percent of total billed charges,,,2397.87,83,,percent of total billed charges,,,2397.87,83,,percent of total billed charges,,,,,,,,,,,,,,,2397.87,83,,percent of total billed charges,,,2744.55,95,,percent of total billed charges,,,2600.1,90,,percent of total billed charges,,,2600.1,90,,percent of total billed charges,,,2368.98,82,,percent of total billed charges,,,2600.1,90,,percent of total billed charges,,,2455.65,85,,percent of total billed charges,,2178.31,2744.55,
BONE MARROW ASPIRATION,19604110,CDM,38220,CPT,310,RC,inpatient,,4643,4643,,3941.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3500.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3946.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4085.84,88,,percent of total billed charges,,,,,,,,,3547.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4225.13,91,,percent of total billed charges,,,4410.85,95,,percent of total billed charges,,,3853.69,83,,percent of total billed charges,,,3853.69,83,,percent of total billed charges,,,,,,,,,,,,,,,3853.69,83,,percent of total billed charges,,,4410.85,95,,percent of total billed charges,,,4178.7,90,,percent of total billed charges,,,4178.7,90,,percent of total billed charges,,,3807.26,82,,percent of total billed charges,,,4178.7,90,,percent of total billed charges,,,3946.55,85,,percent of total billed charges,,3500.82,4410.85,
NM PET LTD OF CHEST HEAD/NECK,28101300,CDM,78811,CPT,340,RC,inpatient,TC,7195,7195,,6108.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5425.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6115.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6331.6,88,,percent of total billed charges,,,,,,,,,5496.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6547.45,91,,percent of total billed charges,,,6835.25,95,,percent of total billed charges,,,5971.85,83,,percent of total billed charges,,,5971.85,83,,percent of total billed charges,,,,,,,,,,,,,,,5971.85,83,,percent of total billed charges,,,6835.25,95,,percent of total billed charges,,,6475.5,90,,percent of total billed charges,,,6475.5,90,,percent of total billed charges,,,5899.9,82,,percent of total billed charges,,,6475.5,90,,percent of total billed charges,,,6115.75,85,,percent of total billed charges,,5425.03,6835.25,
NM PET SKULL BASE TO MID THIGH,28101301,CDM,78812,CPT,340,RC,inpatient,TC,8805,8805,,7475.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6638.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7484.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7748.4,88,,percent of total billed charges,,,,,,,,,6727.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8012.55,91,,percent of total billed charges,,,8364.75,95,,percent of total billed charges,,,7308.15,83,,percent of total billed charges,,,7308.15,83,,percent of total billed charges,,,,,,,,,,,,,,,7308.15,83,,percent of total billed charges,,,8364.75,95,,percent of total billed charges,,,7924.5,90,,percent of total billed charges,,,7924.5,90,,percent of total billed charges,,,7220.1,82,,percent of total billed charges,,,7924.5,90,,percent of total billed charges,,,7484.25,85,,percent of total billed charges,,6638.97,8364.75,
NM PET WHOLE BODY,28101302,CDM,78813,CPT,340,RC,inpatient,TC,8794,8794,,7466.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6630.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7474.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7738.72,88,,percent of total billed charges,,,,,,,,,6718.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8002.54,91,,percent of total billed charges,,,8354.3,95,,percent of total billed charges,,,7299.02,83,,percent of total billed charges,,,7299.02,83,,percent of total billed charges,,,,,,,,,,,,,,,7299.02,83,,percent of total billed charges,,,8354.3,95,,percent of total billed charges,,,7914.6,90,,percent of total billed charges,,,7914.6,90,,percent of total billed charges,,,7211.08,82,,percent of total billed charges,,,7914.6,90,,percent of total billed charges,,,7474.9,85,,percent of total billed charges,,6630.68,8354.3,
NM PET CT FOR ATT LTD,28101303,CDM,78814,CPT,340,RC,inpatient,TC,8482,8482,,7201.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6395.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7209.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7464.16,88,,percent of total billed charges,,,,,,,,,6480.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7718.62,91,,percent of total billed charges,,,8057.9,95,,percent of total billed charges,,,7040.06,83,,percent of total billed charges,,,7040.06,83,,percent of total billed charges,,,,,,,,,,,,,,,7040.06,83,,percent of total billed charges,,,8057.9,95,,percent of total billed charges,,,7633.8,90,,percent of total billed charges,,,7633.8,90,,percent of total billed charges,,,6955.24,82,,percent of total billed charges,,,7633.8,90,,percent of total billed charges,,,7209.7,85,,percent of total billed charges,,6395.43,8057.9,
NM PET CT ATT SKULL BASE MID TH,28101304,CDM,78815,CPT,340,RC,inpatient,TC,9386,9386,,7968.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7077.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7978.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8259.68,88,,percent of total billed charges,,,,,,,,,7170.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8541.26,91,,percent of total billed charges,,,8916.7,95,,percent of total billed charges,,,7790.38,83,,percent of total billed charges,,,7790.38,83,,percent of total billed charges,,,,,,,,,,,,,,,7790.38,83,,percent of total billed charges,,,8916.7,95,,percent of total billed charges,,,8447.4,90,,percent of total billed charges,,,8447.4,90,,percent of total billed charges,,,7696.52,82,,percent of total billed charges,,,8447.4,90,,percent of total billed charges,,,7978.1,85,,percent of total billed charges,,7077.04,8916.7,
NM PET CT ATT WHOLE BODY,28101305,CDM,78816,CPT,340,RC,inpatient,TC,9527,9527,,8088.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7183.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8097.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8383.76,88,,percent of total billed charges,,,,,,,,,7278.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8669.57,91,,percent of total billed charges,,,9050.65,95,,percent of total billed charges,,,7907.41,83,,percent of total billed charges,,,7907.41,83,,percent of total billed charges,,,,,,,,,,,,,,,7907.41,83,,percent of total billed charges,,,9050.65,95,,percent of total billed charges,,,8574.3,90,,percent of total billed charges,,,8574.3,90,,percent of total billed charges,,,7812.14,82,,percent of total billed charges,,,8574.3,90,,percent of total billed charges,,,8097.95,85,,percent of total billed charges,,7183.36,9050.65,
NM PET CT PROSTATE SKULL TO THIGH,28101500,CDM,78815,CPT,340,RC,inpatient,TC,9386,9386,,7968.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7077.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7978.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8259.68,88,,percent of total billed charges,,,,,,,,,7170.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8541.26,91,,percent of total billed charges,,,8916.7,95,,percent of total billed charges,,,7790.38,83,,percent of total billed charges,,,7790.38,83,,percent of total billed charges,,,,,,,,,,,,,,,7790.38,83,,percent of total billed charges,,,8916.7,95,,percent of total billed charges,,,8447.4,90,,percent of total billed charges,,,8447.4,90,,percent of total billed charges,,,7696.52,82,,percent of total billed charges,,,8447.4,90,,percent of total billed charges,,,7978.1,85,,percent of total billed charges,,7077.04,8916.7,
NM PET CT PROSTATE WHOLE BODY,28101501,CDM,78816,CPT,340,RC,inpatient,TC,9527,9527,,8088.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7183.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8097.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8383.76,88,,percent of total billed charges,,,,,,,,,7278.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8669.57,91,,percent of total billed charges,,,9050.65,95,,percent of total billed charges,,,7907.41,83,,percent of total billed charges,,,7907.41,83,,percent of total billed charges,,,,,,,,,,,,,,,7907.41,83,,percent of total billed charges,,,9050.65,95,,percent of total billed charges,,,8574.3,90,,percent of total billed charges,,,8574.3,90,,percent of total billed charges,,,7812.14,82,,percent of total billed charges,,,8574.3,90,,percent of total billed charges,,,8097.95,85,,percent of total billed charges,,7183.36,9050.65,
NM DOSE PET/DOSE (<45 mCi),28103291,CDM,A9552,HCPCS,636,RC,inpatient,,1793,1793,,1522.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1351.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1524.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1577.84,88,,percent of total billed charges,,,,,,,,,1369.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1631.63,91,,percent of total billed charges,,,1703.35,95,,percent of total billed charges,,,1488.19,83,,percent of total billed charges,,,1488.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1488.19,83,,percent of total billed charges,,,1703.35,95,,percent of total billed charges,,,1613.7,90,,percent of total billed charges,,,1613.7,90,,percent of total billed charges,,,1470.26,82,,percent of total billed charges,,,1613.7,90,,percent of total billed charges,,,1524.05,85,,percent of total billed charges,,1351.92,1703.35,
NM DOSE PIFLUFOLASTAT F-18 DIAGNOSTIC,28103292,CDM,A9595,HCPCS,636,RC,inpatient,,4928,4928,,4183.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3715.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4188.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4336.64,88,,percent of total billed charges,,,,,,,,,3764.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4484.48,91,,percent of total billed charges,,,4681.6,95,,percent of total billed charges,,,4090.24,83,,percent of total billed charges,,,4090.24,83,,percent of total billed charges,,,,,,,,,,,,,,,4090.24,83,,percent of total billed charges,,,4681.6,95,,percent of total billed charges,,,4435.2,90,,percent of total billed charges,,,4435.2,90,,percent of total billed charges,,,4040.96,82,,percent of total billed charges,,,4435.2,90,,percent of total billed charges,,,4188.8,85,,percent of total billed charges,,3715.71,4681.6,
AMERICAINE OTIC DROPS 15ML,3200847,CDM,,,250,RC,inpatient,,64,64,,54.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.32,88,,percent of total billed charges,,,,,,,,,48.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,,,,,,,,,,,,,53.12,83,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,52.48,82,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,48.26,60.8,
P-EPHED/FEXO(ALLEGRA D 12HR)TAB:120-60MG,32000007,CDM,,,250,RC,inpatient,,25.38,25.38,,21.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.33,88,,percent of total billed charges,,,,,,,,,19.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.1,91,,percent of total billed charges,,,24.11,95,,percent of total billed charges,,,21.07,83,,percent of total billed charges,,,21.07,83,,percent of total billed charges,,,,,,,,,,,,,,,21.07,83,,percent of total billed charges,,,24.11,95,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,20.81,82,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,21.57,85,,percent of total billed charges,,19.14,24.11,
METIPRANO(OPTIPRANOLOL)DROP:0.3% 10ML,32000008,CDM,,,250,RC,inpatient,,588.41,588.41,,499.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,443.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,500.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,517.8,88,,percent of total billed charges,,,,,,,,,449.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,535.45,91,,percent of total billed charges,,,558.99,95,,percent of total billed charges,,,488.38,83,,percent of total billed charges,,,488.38,83,,percent of total billed charges,,,,,,,,,,,,,,,488.38,83,,percent of total billed charges,,,558.99,95,,percent of total billed charges,,,529.57,90,,percent of total billed charges,,,529.57,90,,percent of total billed charges,,,482.5,82,,percent of total billed charges,,,529.57,90,,percent of total billed charges,,,500.15,85,,percent of total billed charges,,443.66,558.99,
OLANZAPINE (Zyprexia) TAB : 5MG,32000009,CDM,,,250,RC,inpatient,,203.8,203.8,,173.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,173.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,179.34,88,,percent of total billed charges,,,,,,,,,155.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,185.46,91,,percent of total billed charges,,,193.61,95,,percent of total billed charges,,,169.15,83,,percent of total billed charges,,,169.15,83,,percent of total billed charges,,,,,,,,,,,,,,,169.15,83,,percent of total billed charges,,,193.61,95,,percent of total billed charges,,,183.42,90,,percent of total billed charges,,,183.42,90,,percent of total billed charges,,,167.12,82,,percent of total billed charges,,,183.42,90,,percent of total billed charges,,,173.23,85,,percent of total billed charges,,153.67,193.61,
NATEGLINIDE (STARLIX) TAB : 60MG,32000010,CDM,,,250,RC,inpatient,,59.95,59.95,,50.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,45.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.76,88,,percent of total billed charges,,,,,,,,,45.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,54.55,91,,percent of total billed charges,,,56.95,95,,percent of total billed charges,,,49.76,83,,percent of total billed charges,,,49.76,83,,percent of total billed charges,,,,,,,,,,,,,,,49.76,83,,percent of total billed charges,,,56.95,95,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,49.16,82,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,50.96,85,,percent of total billed charges,,45.2,56.95,
ESOMEPRAZOLE (NEXIUM) CAP:40MG,32000012,CDM,,,250,RC,inpatient,,131.48,131.48,,111.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,99.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,111.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,115.7,88,,percent of total billed charges,,,,,,,,,100.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,119.65,91,,percent of total billed charges,,,124.91,95,,percent of total billed charges,,,109.13,83,,percent of total billed charges,,,109.13,83,,percent of total billed charges,,,,,,,,,,,,,,,109.13,83,,percent of total billed charges,,,124.91,95,,percent of total billed charges,,,118.33,90,,percent of total billed charges,,,118.33,90,,percent of total billed charges,,,107.81,82,,percent of total billed charges,,,118.33,90,,percent of total billed charges,,,111.76,85,,percent of total billed charges,,99.14,124.91,
ACARBOSE(PRECOSE)TAB:25MG,32000013,CDM,,,250,RC,inpatient,,13.48,13.48,,11.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.86,88,,percent of total billed charges,,,,,,,,,10.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.27,91,,percent of total billed charges,,,12.81,95,,percent of total billed charges,,,11.19,83,,percent of total billed charges,,,11.19,83,,percent of total billed charges,,,,,,,,,,,,,,,11.19,83,,percent of total billed charges,,,12.81,95,,percent of total billed charges,,,12.13,90,,percent of total billed charges,,,12.13,90,,percent of total billed charges,,,11.05,82,,percent of total billed charges,,,12.13,90,,percent of total billed charges,,,11.46,85,,percent of total billed charges,,10.16,12.81,
DEXTRAN 70/HYPROMELL (BION TEAR)DROP  EA,32000014,CDM,,,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
ABBOKINASE  **J3365**,32000017,CDM,J3365,HCPCS,636,RC,inpatient,,740,740,,628.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,557.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,629,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,651.2,88,,percent of total billed charges,,,,,,,,,565.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,673.4,91,,percent of total billed charges,,,703,95,,percent of total billed charges,,,614.2,83,,percent of total billed charges,,,614.2,83,,percent of total billed charges,,,,,,,,,,,,,,,614.2,83,,percent of total billed charges,,,703,95,,percent of total billed charges,,,666,90,,percent of total billed charges,,,666,90,,percent of total billed charges,,,606.8,82,,percent of total billed charges,,,666,90,,percent of total billed charges,,,629,85,,percent of total billed charges,,557.96,703,
LIDOCAINE 5% PATCH (LIDODERM),32000018,CDM,,,250,RC,inpatient,,118.75,118.75,,100.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,89.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,100.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,104.5,88,,percent of total billed charges,,,,,,,,,90.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,108.06,91,,percent of total billed charges,,,112.81,95,,percent of total billed charges,,,98.56,83,,percent of total billed charges,,,98.56,83,,percent of total billed charges,,,,,,,,,,,,,,,98.56,83,,percent of total billed charges,,,112.81,95,,percent of total billed charges,,,106.88,90,,percent of total billed charges,,,106.88,90,,percent of total billed charges,,,97.38,82,,percent of total billed charges,,,106.88,90,,percent of total billed charges,,,100.94,85,,percent of total billed charges,,89.54,112.81,
CHOLESTY/ASPART(QUESTRAN)POW(CAN-239.4G),32000019,CDM,,,250,RC,inpatient,,899.67,899.67,,763.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,678.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,764.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,791.71,88,,percent of total billed charges,,,,,,,,,687.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,818.7,91,,percent of total billed charges,,,854.69,95,,percent of total billed charges,,,746.73,83,,percent of total billed charges,,,746.73,83,,percent of total billed charges,,,,,,,,,,,,,,,746.73,83,,percent of total billed charges,,,854.69,95,,percent of total billed charges,,,809.7,90,,percent of total billed charges,,,809.7,90,,percent of total billed charges,,,737.73,82,,percent of total billed charges,,,809.7,90,,percent of total billed charges,,,764.72,85,,percent of total billed charges,,678.35,854.69,
ACYCLOVIR(ZOVIRAX):1000MG/20ML  (J/5MG),32000020,CDM,J0133,HCPCS,636,RC,inpatient,,84.31,84.31,,71.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.19,88,,percent of total billed charges,,31.5,,,,fee schedule,,,64.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,31.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.72,91,,percent of total billed charges,,,80.09,95,,percent of total billed charges,,,69.98,83,,percent of total billed charges,,,69.98,83,,percent of total billed charges,,,,,,,,,,,,,,,69.98,83,,percent of total billed charges,,,80.09,95,,percent of total billed charges,,,75.88,90,,percent of total billed charges,,,75.88,90,,percent of total billed charges,,,69.13,82,,percent of total billed charges,,,75.88,90,,percent of total billed charges,,,71.66,85,,percent of total billed charges,,31.5,80.09,
ZAFIRLUKAST(ACCOLATE)TAB:20MG,32000021,CDM,J8499,HCPCS,250,RC,inpatient,,37.42,37.42,,31.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.93,88,,percent of total billed charges,,,,,,,,,28.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.05,91,,percent of total billed charges,,,35.55,95,,percent of total billed charges,,,31.06,83,,percent of total billed charges,,,31.06,83,,percent of total billed charges,,,,,,,,,,,,,,,31.06,83,,percent of total billed charges,,,35.55,95,,percent of total billed charges,,,33.68,90,,percent of total billed charges,,,33.68,90,,percent of total billed charges,,,30.68,82,,percent of total billed charges,,,33.68,90,,percent of total billed charges,,,31.81,85,,percent of total billed charges,,28.21,35.55,
HYPROMELLOSE(GENTEAL) DROP :0.3% 15ML,32000023,CDM,,,250,RC,inpatient,,112.13,112.13,,95.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,95.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.67,88,,percent of total billed charges,,,,,,,,,85.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,102.04,91,,percent of total billed charges,,,106.52,95,,percent of total billed charges,,,93.07,83,,percent of total billed charges,,,93.07,83,,percent of total billed charges,,,,,,,,,,,,,,,93.07,83,,percent of total billed charges,,,106.52,95,,percent of total billed charges,,,100.92,90,,percent of total billed charges,,,100.92,90,,percent of total billed charges,,,91.95,82,,percent of total billed charges,,,100.92,90,,percent of total billed charges,,,95.31,85,,percent of total billed charges,,84.55,106.52,
METOPROLOL (TOPROL XL) TAB : 100MG,32000024,CDM,,,250,RC,inpatient,,29.98,29.98,,25.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.38,88,,percent of total billed charges,,,,,,,,,22.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27.28,91,,percent of total billed charges,,,28.48,95,,percent of total billed charges,,,24.88,83,,percent of total billed charges,,,24.88,83,,percent of total billed charges,,,,,,,,,,,,,,,24.88,83,,percent of total billed charges,,,28.48,95,,percent of total billed charges,,,26.98,90,,percent of total billed charges,,,26.98,90,,percent of total billed charges,,,24.58,82,,percent of total billed charges,,,26.98,90,,percent of total billed charges,,,25.48,85,,percent of total billed charges,,22.6,28.48,
AMIKACIN POWDER:5GM NOT STERILE,32000030,CDM,,,250,RC,inpatient,,588.72,588.72,,499.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,443.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,500.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,518.07,88,,percent of total billed charges,,,,,,,,,449.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,535.74,91,,percent of total billed charges,,,559.28,95,,percent of total billed charges,,,488.64,83,,percent of total billed charges,,,488.64,83,,percent of total billed charges,,,,,,,,,,,,,,,488.64,83,,percent of total billed charges,,,559.28,95,,percent of total billed charges,,,529.85,90,,percent of total billed charges,,,529.85,90,,percent of total billed charges,,,482.75,82,,percent of total billed charges,,,529.85,90,,percent of total billed charges,,,500.41,85,,percent of total billed charges,,443.89,559.28,
ONDANSETRON(ZOFRAN):4MG/2ML,32000031,CDM,J2405,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,1.38,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.38,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,1.38,60.99,
CLOTRI/BETA(LOTRISONE)CRM:15GM,32000032,CDM,J3490,HCPCS,250,RC,inpatient,,352.78,352.78,,299.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,266,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,299.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,310.45,88,,percent of total billed charges,,,,,,,,,269.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,321.03,91,,percent of total billed charges,,,335.14,95,,percent of total billed charges,,,292.81,83,,percent of total billed charges,,,292.81,83,,percent of total billed charges,,,,,,,,,,,,,,,292.81,83,,percent of total billed charges,,,335.14,95,,percent of total billed charges,,,317.5,90,,percent of total billed charges,,,317.5,90,,percent of total billed charges,,,289.28,82,,percent of total billed charges,,,317.5,90,,percent of total billed charges,,,299.86,85,,percent of total billed charges,,266,335.14,
PRAMIPEXOLE DI(MIRAPEX)TAB:0.25MG,32000033,CDM,,,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
RACEPINEPHRINE(S-2)VIAL 2.25%:UD-0.5ML*,32000034,CDM,J3490,HCPCS,250,RC,inpatient,,24.8,24.8,,21.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.82,88,,percent of total billed charges,,,,,,,,,18.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.57,91,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,,,,,,,,,,,,,20.58,83,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,20.34,82,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,18.7,23.56,
SODIUM HYPOCHLO(DAKINS)LIQ 0.5%:480ML,32000035,CDM,J3490,HCPCS,250,RC,inpatient,,193.02,193.02,,163.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,145.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,169.86,88,,percent of total billed charges,,,,,,,,,147.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,175.65,91,,percent of total billed charges,,,183.37,95,,percent of total billed charges,,,160.21,83,,percent of total billed charges,,,160.21,83,,percent of total billed charges,,,,,,,,,,,,,,,160.21,83,,percent of total billed charges,,,183.37,95,,percent of total billed charges,,,173.72,90,,percent of total billed charges,,,173.72,90,,percent of total billed charges,,,158.28,82,,percent of total billed charges,,,173.72,90,,percent of total billed charges,,,164.07,85,,percent of total billed charges,,145.54,183.37,
CAPTOPRIL(CAPOTEN)TAB:12.5MG,32000036,CDM,J8499,HCPCS,250,RC,inpatient,,19.77,19.77,,16.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.4,88,,percent of total billed charges,,,,,,,,,15.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.99,91,,percent of total billed charges,,,18.78,95,,percent of total billed charges,,,16.41,83,,percent of total billed charges,,,16.41,83,,percent of total billed charges,,,,,,,,,,,,,,,16.41,83,,percent of total billed charges,,,18.78,95,,percent of total billed charges,,,17.79,90,,percent of total billed charges,,,17.79,90,,percent of total billed charges,,,16.21,82,,percent of total billed charges,,,17.79,90,,percent of total billed charges,,,16.8,85,,percent of total billed charges,,14.91,18.78,
PIOGLITAZONE HCL (ACTOS) TAB : 30MG,32000037,CDM,,,250,RC,inpatient,,329.57,329.57,,279.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,248.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,280.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,290.02,88,,percent of total billed charges,,,,,,,,,251.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,299.91,91,,percent of total billed charges,,,313.09,95,,percent of total billed charges,,,273.54,83,,percent of total billed charges,,,273.54,83,,percent of total billed charges,,,,,,,,,,,,,,,273.54,83,,percent of total billed charges,,,313.09,95,,percent of total billed charges,,,296.61,90,,percent of total billed charges,,,296.61,90,,percent of total billed charges,,,270.25,82,,percent of total billed charges,,,296.61,90,,percent of total billed charges,,,280.13,85,,percent of total billed charges,,248.5,313.09,
MESALAMINE (CANASA) SUPP : 500MG,32000038,CDM,,,250,RC,inpatient,,72.16,72.16,,61.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,54.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,61.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,63.5,88,,percent of total billed charges,,,,,,,,,55.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,65.67,91,,percent of total billed charges,,,68.55,95,,percent of total billed charges,,,59.89,83,,percent of total billed charges,,,59.89,83,,percent of total billed charges,,,,,,,,,,,,,,,59.89,83,,percent of total billed charges,,,68.55,95,,percent of total billed charges,,,64.94,90,,percent of total billed charges,,,64.94,90,,percent of total billed charges,,,59.17,82,,percent of total billed charges,,,64.94,90,,percent of total billed charges,,,61.34,85,,percent of total billed charges,,54.41,68.55,
ACYCLOVIR(ZOVIRAX)ORAL:200MG/5ML (473ML),32000039,CDM,,,250,RC,inpatient,,2711.39,2711.39,,2301.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2044.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2304.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2386.02,88,,percent of total billed charges,,,,,,,,,2071.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2467.36,91,,percent of total billed charges,,,2575.82,95,,percent of total billed charges,,,2250.45,83,,percent of total billed charges,,,2250.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2250.45,83,,percent of total billed charges,,,2575.82,95,,percent of total billed charges,,,2440.25,90,,percent of total billed charges,,,2440.25,90,,percent of total billed charges,,,2223.34,82,,percent of total billed charges,,,2440.25,90,,percent of total billed charges,,,2304.68,85,,percent of total billed charges,,2044.39,2575.82,
RIVASTIGMINE (EXELON) CAP : 4.5MG,32000040,CDM,,,250,RC,inpatient,,78.98,78.98,,67.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.5,88,,percent of total billed charges,,,,,,,,,60.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.87,91,,percent of total billed charges,,,75.03,95,,percent of total billed charges,,,65.55,83,,percent of total billed charges,,,65.55,83,,percent of total billed charges,,,,,,,,,,,,,,,65.55,83,,percent of total billed charges,,,75.03,95,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,64.76,82,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,67.13,85,,percent of total billed charges,,59.55,75.03,
celeCOXIB(celeBREX)CAP:100MG,32000042,CDM,J8499,HCPCS,250,RC,inpatient,,14.05,14.05,,11.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.36,88,,percent of total billed charges,,,,,,,,,10.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.79,91,,percent of total billed charges,,,13.35,95,,percent of total billed charges,,,11.66,83,,percent of total billed charges,,,11.66,83,,percent of total billed charges,,,,,,,,,,,,,,,11.66,83,,percent of total billed charges,,,13.35,95,,percent of total billed charges,,,12.65,90,,percent of total billed charges,,,12.65,90,,percent of total billed charges,,,11.52,82,,percent of total billed charges,,,12.65,90,,percent of total billed charges,,,11.94,85,,percent of total billed charges,,10.59,13.35,
CITALOPRAM(celeXA)TAB :20MG,32000043,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ESTRADIOL(CLIMARA)PATCH:0.05MG/24HR,32000045,CDM,J3490,HCPCS,250,RC,inpatient,,242.66,242.66,,206.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,182.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,206.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,213.54,88,,percent of total billed charges,,,,,,,,,185.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,220.82,91,,percent of total billed charges,,,230.53,95,,percent of total billed charges,,,201.41,83,,percent of total billed charges,,,201.41,83,,percent of total billed charges,,,,,,,,,,,,,,,201.41,83,,percent of total billed charges,,,230.53,95,,percent of total billed charges,,,218.39,90,,percent of total billed charges,,,218.39,90,,percent of total billed charges,,,198.98,82,,percent of total billed charges,,,218.39,90,,percent of total billed charges,,,206.26,85,,percent of total billed charges,,182.97,230.53,
CEFDINIR(OMNICEF)CAP:300MG,32000047,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
NITROglycerin(NITRO-BID)OINT 2%:UD,32000048,CDM,J3490,HCPCS,250,RC,inpatient,,37.26,37.26,,31.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.79,88,,percent of total billed charges,,,,,,,,,28.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.91,91,,percent of total billed charges,,,35.4,95,,percent of total billed charges,,,30.93,83,,percent of total billed charges,,,30.93,83,,percent of total billed charges,,,,,,,,,,,,,,,30.93,83,,percent of total billed charges,,,35.4,95,,percent of total billed charges,,,33.53,90,,percent of total billed charges,,,33.53,90,,percent of total billed charges,,,30.55,82,,percent of total billed charges,,,33.53,90,,percent of total billed charges,,,31.67,85,,percent of total billed charges,,28.09,35.4,
GUAIFN/CODEINE(ROBITUSSIN AC) SYRP: 60ML,32000049,CDM,,,250,RC,inpatient,,7.5,7.5,,6.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6.6,88,,percent of total billed charges,,,,,,,,,5.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6.83,91,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,,,,,,,,,,,,,6.23,83,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.15,82,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,5.66,7.13,
GUAIFENE(ROBITUSSIN)SYRP: 100MG/5ML 90ML,32000050,CDM,,,250,RC,inpatient,,7.75,7.75,,6.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6.82,88,,percent of total billed charges,,,,,,,,,5.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.05,91,,percent of total billed charges,,,7.36,95,,percent of total billed charges,,,6.43,83,,percent of total billed charges,,,6.43,83,,percent of total billed charges,,,,,,,,,,,,,,,6.43,83,,percent of total billed charges,,,7.36,95,,percent of total billed charges,,,6.98,90,,percent of total billed charges,,,6.98,90,,percent of total billed charges,,,6.36,82,,percent of total billed charges,,,6.98,90,,percent of total billed charges,,,6.59,85,,percent of total billed charges,,5.84,7.36,
LACTULOSE (CONSTULOSE) SOL : 10G/15ML,32000051,CDM,,,250,RC,inpatient,,17.92,17.92,,15.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.77,88,,percent of total billed charges,,,,,,,,,13.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.31,91,,percent of total billed charges,,,17.02,95,,percent of total billed charges,,,14.87,83,,percent of total billed charges,,,14.87,83,,percent of total billed charges,,,,,,,,,,,,,,,14.87,83,,percent of total billed charges,,,17.02,95,,percent of total billed charges,,,16.13,90,,percent of total billed charges,,,16.13,90,,percent of total billed charges,,,14.69,82,,percent of total billed charges,,,16.13,90,,percent of total billed charges,,,15.23,85,,percent of total billed charges,,13.51,17.02,
PRALIDOXIME CHLORIDE(PROTOPAM)VIAL:1GM,32000052,CDM,J2730,HCPCS,636,RC,inpatient,,1246.69,1246.69,,1058.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,940,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1059.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1097.09,88,,percent of total billed charges,,165.77,,,,fee schedule,,,952.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,165.77,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1134.49,91,,percent of total billed charges,,,1184.36,95,,percent of total billed charges,,,1034.75,83,,percent of total billed charges,,,1034.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1034.75,83,,percent of total billed charges,,,1184.36,95,,percent of total billed charges,,,1122.02,90,,percent of total billed charges,,,1122.02,90,,percent of total billed charges,,,1022.29,82,,percent of total billed charges,,,1122.02,90,,percent of total billed charges,,,1059.69,85,,percent of total billed charges,,165.77,1184.36,
HYDROcod/APAP(LORCET):(2.5-167/5) 118ML,32000053,CDM,,,250,RC,inpatient,,103.25,103.25,,87.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.86,88,,percent of total billed charges,,,,,,,,,78.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.96,91,,percent of total billed charges,,,98.09,95,,percent of total billed charges,,,85.7,83,,percent of total billed charges,,,85.7,83,,percent of total billed charges,,,,,,,,,,,,,,,85.7,83,,percent of total billed charges,,,98.09,95,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,84.67,82,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,87.76,85,,percent of total billed charges,,77.85,98.09,
IV D51/2NS 1000ML/KCL30MEQ  (PREMIX),32000054,CDM,J3480,HCPCS,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,3.22,,,,fee schedule,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,3.22,181.67,
VALDECOXIB (BEXTRA) TAB : 10MG,32000055,CDM,,,250,RC,inpatient,,46.79,46.79,,39.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.18,88,,percent of total billed charges,,,,,,,,,35.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.58,91,,percent of total billed charges,,,44.45,95,,percent of total billed charges,,,38.84,83,,percent of total billed charges,,,38.84,83,,percent of total billed charges,,,,,,,,,,,,,,,38.84,83,,percent of total billed charges,,,44.45,95,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,38.37,82,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,39.77,85,,percent of total billed charges,,35.28,44.45,
WARFARIN(COUMADIN)TAB: 4MG,32000056,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CYANOCBLMN/FA/PYRX(FOLTEX)TAB:2-2.5-25MG,32000057,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FE FUM/VIT C/B12(FEOGEN FOR)CAP:460-60MG,32000058,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
VALPROATE(DEPAKENE)SYRP:250MG/5ML(480ML),32000059,CDM,J8499,HCPCS,250,RC,inpatient,,689.43,689.43,,585.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,519.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,586.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,606.7,88,,percent of total billed charges,,,,,,,,,526.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,627.38,91,,percent of total billed charges,,,654.96,95,,percent of total billed charges,,,572.23,83,,percent of total billed charges,,,572.23,83,,percent of total billed charges,,,,,,,,,,,,,,,572.23,83,,percent of total billed charges,,,654.96,95,,percent of total billed charges,,,620.49,90,,percent of total billed charges,,,620.49,90,,percent of total billed charges,,,565.33,82,,percent of total billed charges,,,620.49,90,,percent of total billed charges,,,586.02,85,,percent of total billed charges,,519.83,654.96,
HYDROCODONE/ACETA SOL :2.5-167/5ml 30ML,32000060,CDM,,,250,RC,inpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,18.1,22.8,
VERAPAMIL HCL (COVERA-HS) TAB : 180MG,32000061,CDM,,,250,RC,inpatient,,35.68,35.68,,30.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31.4,88,,percent of total billed charges,,,,,,,,,27.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.47,91,,percent of total billed charges,,,33.9,95,,percent of total billed charges,,,29.61,83,,percent of total billed charges,,,29.61,83,,percent of total billed charges,,,,,,,,,,,,,,,29.61,83,,percent of total billed charges,,,33.9,95,,percent of total billed charges,,,32.11,90,,percent of total billed charges,,,32.11,90,,percent of total billed charges,,,29.26,82,,percent of total billed charges,,,32.11,90,,percent of total billed charges,,,30.33,85,,percent of total billed charges,,26.9,33.9,
HYDROCODONE/ACETA SOL :2.5-167/5 60ML,32000062,CDM,,,250,RC,inpatient,,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,36.19,45.6,
ESCITALOPRAM(LEXAPRO)TAB:10MG,32000064,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DYPHYLLINE (DILOR) TAB : 200MG,32000065,CDM,,,250,RC,inpatient,,13.48,13.48,,11.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.86,88,,percent of total billed charges,,,,,,,,,10.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.27,91,,percent of total billed charges,,,12.81,95,,percent of total billed charges,,,11.19,83,,percent of total billed charges,,,11.19,83,,percent of total billed charges,,,,,,,,,,,,,,,11.19,83,,percent of total billed charges,,,12.81,95,,percent of total billed charges,,,12.13,90,,percent of total billed charges,,,12.13,90,,percent of total billed charges,,,11.05,82,,percent of total billed charges,,,12.13,90,,percent of total billed charges,,,11.46,85,,percent of total billed charges,,10.16,12.81,
VERAPAMIL HCL (COVERA-HS) TAB : 240MG,32000066,CDM,,,250,RC,inpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,9.8,12.35,
IV D5LR+KCL 20MEQ 1000ML    (ADMIX),32000067,CDM,,,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
CALCIUM CARBONATE/VIT D2 TAB : 500MG-125,32000068,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
AZITHROMYCIN(ZITHROMA)SUS 100MG/5ML 15ML,32000069,CDM,J8499,HCPCS,250,RC,inpatient,,175.98,175.98,,149.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.86,88,,percent of total billed charges,,,,,,,,,134.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.14,91,,percent of total billed charges,,,167.18,95,,percent of total billed charges,,,146.06,83,,percent of total billed charges,,,146.06,83,,percent of total billed charges,,,,,,,,,,,,,,,146.06,83,,percent of total billed charges,,,167.18,95,,percent of total billed charges,,,158.38,90,,percent of total billed charges,,,158.38,90,,percent of total billed charges,,,144.3,82,,percent of total billed charges,,,158.38,90,,percent of total billed charges,,,149.58,85,,percent of total billed charges,,132.69,167.18,
MORPHINE SULF CPJ SYR:4MG/ML,32000070,CDM,,,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,,,,,,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,50.92,64.15,
AMYLA/LIPAS/PROT(LIPRAM)CAP:33.2-10-38,32000071,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
buPROPion(Wellbutrin SR)TAB:100MG,32000072,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
TOLTERODINE(DETROL LA)CAP:2MG,32000073,CDM,J8499,HCPCS,250,RC,inpatient,,137.91,137.91,,117.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,103.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.36,88,,percent of total billed charges,,,,,,,,,105.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.5,91,,percent of total billed charges,,,131.01,95,,percent of total billed charges,,,114.47,83,,percent of total billed charges,,,114.47,83,,percent of total billed charges,,,,,,,,,,,,,,,114.47,83,,percent of total billed charges,,,131.01,95,,percent of total billed charges,,,124.12,90,,percent of total billed charges,,,124.12,90,,percent of total billed charges,,,113.09,82,,percent of total billed charges,,,124.12,90,,percent of total billed charges,,,117.22,85,,percent of total billed charges,,103.98,131.01,
WATER FOR INJECTION 10ML,32000074,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
METAXALONE (SKELAXIN) TAB : 400MG,32000075,CDM,,,250,RC,inpatient,,20.94,20.94,,17.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.43,88,,percent of total billed charges,,,,,,,,,16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.06,91,,percent of total billed charges,,,19.89,95,,percent of total billed charges,,,17.38,83,,percent of total billed charges,,,17.38,83,,percent of total billed charges,,,,,,,,,,,,,,,17.38,83,,percent of total billed charges,,,19.89,95,,percent of total billed charges,,,18.85,90,,percent of total billed charges,,,18.85,90,,percent of total billed charges,,,17.17,82,,percent of total billed charges,,,18.85,90,,percent of total billed charges,,,17.8,85,,percent of total billed charges,,15.79,19.89,
DICLOFENAC SODIUM TAB : 50MG,32000076,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CIPROFLOXACIN(CIPRO)SUS:250MG/5ML(100ML),32000077,CDM,J8499,HCPCS,250,RC,inpatient,,1267.93,1267.93,,1076.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,956.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1077.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1115.78,88,,percent of total billed charges,,,,,,,,,968.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1153.82,91,,percent of total billed charges,,,1204.53,95,,percent of total billed charges,,,1052.38,83,,percent of total billed charges,,,1052.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.38,83,,percent of total billed charges,,,1204.53,95,,percent of total billed charges,,,1141.14,90,,percent of total billed charges,,,1141.14,90,,percent of total billed charges,,,1039.7,82,,percent of total billed charges,,,1141.14,90,,percent of total billed charges,,,1077.74,85,,percent of total billed charges,,956.02,1204.53,
HEPAT A (HAVRIX)VL:1440 UNITS/ML,32000078,CDM,,,250,RC,inpatient,,792.69,792.69,,672.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,597.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,673.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,697.57,88,,percent of total billed charges,,,,,,,,,605.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,721.35,91,,percent of total billed charges,,,753.06,95,,percent of total billed charges,,,657.93,83,,percent of total billed charges,,,657.93,83,,percent of total billed charges,,,,,,,,,,,,,,,657.93,83,,percent of total billed charges,,,753.06,95,,percent of total billed charges,,,713.42,90,,percent of total billed charges,,,713.42,90,,percent of total billed charges,,,650.01,82,,percent of total billed charges,,,713.42,90,,percent of total billed charges,,,673.79,85,,percent of total billed charges,,597.69,753.06,
POLIOMYELITIS VAC KILLED(IPOL)VIAL:5ML,32000079,CDM,,,250,RC,inpatient,,2777.43,2777.43,,2358.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2094.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2360.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2444.14,88,,percent of total billed charges,,,,,,,,,2121.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2527.46,91,,percent of total billed charges,,,2638.56,95,,percent of total billed charges,,,2305.27,83,,percent of total billed charges,,,2305.27,83,,percent of total billed charges,,,,,,,,,,,,,,,2305.27,83,,percent of total billed charges,,,2638.56,95,,percent of total billed charges,,,2499.69,90,,percent of total billed charges,,,2499.69,90,,percent of total billed charges,,,2277.49,82,,percent of total billed charges,,,2499.69,90,,percent of total billed charges,,,2360.82,85,,percent of total billed charges,,2094.18,2638.56,
MENINGOC VAC A/C/Y W135 (MENOMUNE) VIAL,32000080,CDM,,,250,RC,inpatient,,1727.58,1727.58,,1466.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1302.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1468.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1520.27,88,,percent of total billed charges,,,,,,,,,1319.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1572.1,91,,percent of total billed charges,,,1641.2,95,,percent of total billed charges,,,1433.89,83,,percent of total billed charges,,,1433.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1433.89,83,,percent of total billed charges,,,1641.2,95,,percent of total billed charges,,,1554.82,90,,percent of total billed charges,,,1554.82,90,,percent of total billed charges,,,1416.62,82,,percent of total billed charges,,,1554.82,90,,percent of total billed charges,,,1468.44,85,,percent of total billed charges,,1302.6,1641.2,
PNEUMOCOC 13VAL(PREVNAR)SYR:0.5ML,32000082,CDM,90670,CPT,636,RC,inpatient,,3072.9,3072.9,,2608.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2316.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2611.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2704.15,88,,percent of total billed charges,,,,,,,,,2347.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2796.34,91,,percent of total billed charges,,,2919.26,95,,percent of total billed charges,,,2550.51,83,,percent of total billed charges,,,2550.51,83,,percent of total billed charges,,,,,,,,,,,,,,,2550.51,83,,percent of total billed charges,,,2919.26,95,,percent of total billed charges,,,2765.61,90,,percent of total billed charges,,,2765.61,90,,percent of total billed charges,,,2519.78,82,,percent of total billed charges,,,2765.61,90,,percent of total billed charges,,,2611.97,85,,percent of total billed charges,,2316.97,2919.26,
carBAMazepine(TEGretol XR)TAB:200MG,32000083,CDM,J8499,HCPCS,250,RC,inpatient,,47.22,47.22,,40.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.55,88,,percent of total billed charges,,,,,,,,,36.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.97,91,,percent of total billed charges,,,44.86,95,,percent of total billed charges,,,39.19,83,,percent of total billed charges,,,39.19,83,,percent of total billed charges,,,,,,,,,,,,,,,39.19,83,,percent of total billed charges,,,44.86,95,,percent of total billed charges,,,42.5,90,,percent of total billed charges,,,42.5,90,,percent of total billed charges,,,38.72,82,,percent of total billed charges,,,42.5,90,,percent of total billed charges,,,40.14,85,,percent of total billed charges,,35.6,44.86,
VALACYCLOVIR HCL (VALTREX) TAB : 500MG,32000084,CDM,J8499,HCPCS,250,RC,inpatient,,39.38,39.38,,33.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34.65,88,,percent of total billed charges,,,,,,,,,30.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35.84,91,,percent of total billed charges,,,37.41,95,,percent of total billed charges,,,32.69,83,,percent of total billed charges,,,32.69,83,,percent of total billed charges,,,,,,,,,,,,,,,32.69,83,,percent of total billed charges,,,37.41,95,,percent of total billed charges,,,35.44,90,,percent of total billed charges,,,35.44,90,,percent of total billed charges,,,32.29,82,,percent of total billed charges,,,35.44,90,,percent of total billed charges,,,33.47,85,,percent of total billed charges,,29.69,37.41,
TETANUS & DIPHT(DT)TOX VIAL:5ML,32000087,CDM,,,250,RC,inpatient,,175.09,175.09,,148.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,148.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.08,88,,percent of total billed charges,,,,,,,,,133.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,159.33,91,,percent of total billed charges,,,166.34,95,,percent of total billed charges,,,145.32,83,,percent of total billed charges,,,145.32,83,,percent of total billed charges,,,,,,,,,,,,,,,145.32,83,,percent of total billed charges,,,166.34,95,,percent of total billed charges,,,157.58,90,,percent of total billed charges,,,157.58,90,,percent of total billed charges,,,143.57,82,,percent of total billed charges,,,157.58,90,,percent of total billed charges,,,148.83,85,,percent of total billed charges,,132.02,166.34,
STARCH(ANUSOL)SUPP 51%:,32000088,CDM,,,250,RC,inpatient,,14.22,14.22,,12.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.51,88,,percent of total billed charges,,,,,,,,,10.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.94,91,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,,,,,,,,,,,,,11.8,83,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,11.66,82,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.09,85,,percent of total billed charges,,10.72,13.51,
LOVASTATIN(MEVACOR)TAB:10MG,32000089,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
HYDROCODONE/ACET SOL : 2.5-167/5ml 15ML,32000090,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
VALPROATE(DEPAKOTE)-VIAL:500MG/5ML,32000092,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
IRBESARTAN/HYDRO(AVALIDE)TAB:300-12.5MG,32000093,CDM,,,250,RC,inpatient,,51.39,51.39,,43.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.22,88,,percent of total billed charges,,,,,,,,,39.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.76,91,,percent of total billed charges,,,48.82,95,,percent of total billed charges,,,42.65,83,,percent of total billed charges,,,42.65,83,,percent of total billed charges,,,,,,,,,,,,,,,42.65,83,,percent of total billed charges,,,48.82,95,,percent of total billed charges,,,46.25,90,,percent of total billed charges,,,46.25,90,,percent of total billed charges,,,42.14,82,,percent of total billed charges,,,46.25,90,,percent of total billed charges,,,43.68,85,,percent of total billed charges,,38.75,48.82,
levETIRAcetam(KEPPRA)TAB:500MG,32000094,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
SODIUM CHLORIDE (MURO-128) DROP 2% 15ML,32000095,CDM,,,250,RC,inpatient,,252.81,252.81,,214.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,214.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,222.47,88,,percent of total billed charges,,,,,,,,,193.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,230.06,91,,percent of total billed charges,,,240.17,95,,percent of total billed charges,,,209.83,83,,percent of total billed charges,,,209.83,83,,percent of total billed charges,,,,,,,,,,,,,,,209.83,83,,percent of total billed charges,,,240.17,95,,percent of total billed charges,,,227.53,90,,percent of total billed charges,,,227.53,90,,percent of total billed charges,,,207.3,82,,percent of total billed charges,,,227.53,90,,percent of total billed charges,,,214.89,85,,percent of total billed charges,,190.62,240.17,
celeCOXIB(celeBREX)CAP:200MG,32000096,CDM,J8499,HCPCS,250,RC,inpatient,,19.44,19.44,,16.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.11,88,,percent of total billed charges,,,,,,,,,14.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.69,91,,percent of total billed charges,,,18.47,95,,percent of total billed charges,,,16.14,83,,percent of total billed charges,,,16.14,83,,percent of total billed charges,,,,,,,,,,,,,,,16.14,83,,percent of total billed charges,,,18.47,95,,percent of total billed charges,,,17.5,90,,percent of total billed charges,,,17.5,90,,percent of total billed charges,,,15.94,82,,percent of total billed charges,,,17.5,90,,percent of total billed charges,,,16.52,85,,percent of total billed charges,,14.66,18.47,
AZITHROMYCIN(ZITHROMA)SUS:200MG/5ML 30ML,32000097,CDM,,,250,RC,inpatient,,116.89,116.89,,99.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,88.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,99.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,102.86,88,,percent of total billed charges,,,,,,,,,89.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,106.37,91,,percent of total billed charges,,,111.05,95,,percent of total billed charges,,,97.02,83,,percent of total billed charges,,,97.02,83,,percent of total billed charges,,,,,,,,,,,,,,,97.02,83,,percent of total billed charges,,,111.05,95,,percent of total billed charges,,,105.2,90,,percent of total billed charges,,,105.2,90,,percent of total billed charges,,,95.85,82,,percent of total billed charges,,,105.2,90,,percent of total billed charges,,,99.36,85,,percent of total billed charges,,88.14,111.05,
CLOMIPRAMINE (ANAFRANIL) CAP : 25MG,32000098,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
metFORMIN(GLUCOPHAGE XR)TAB:500MG,32000103,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FOSINOPRIL(MONOPRIL)TAB:40MG,32000104,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
INDOCYANINE GREEN VIAL : 25MG,32000105,CDM,,,250,RC,inpatient,,1607.83,1607.83,,1365.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1212.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1366.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1414.89,88,,percent of total billed charges,,,,,,,,,1228.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1463.13,91,,percent of total billed charges,,,1527.44,95,,percent of total billed charges,,,1334.5,83,,percent of total billed charges,,,1334.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1334.5,83,,percent of total billed charges,,,1527.44,95,,percent of total billed charges,,,1447.05,90,,percent of total billed charges,,,1447.05,90,,percent of total billed charges,,,1318.42,82,,percent of total billed charges,,,1447.05,90,,percent of total billed charges,,,1366.66,85,,percent of total billed charges,,1212.3,1527.44,
AMPHOTRB(ABELCET):100MG/20ML  (J/10MG),32000107,CDM,J0287,HCPCS,636,RC,inpatient,,2610.72,2610.72,,2216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1968.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2219.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2297.43,88,,percent of total billed charges,,773.25,,,,fee schedule,,,1994.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,773.25,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2375.76,91,,percent of total billed charges,,,2480.18,95,,percent of total billed charges,,,2166.9,83,,percent of total billed charges,,,2166.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2166.9,83,,percent of total billed charges,,,2480.18,95,,percent of total billed charges,,,2349.65,90,,percent of total billed charges,,,2349.65,90,,percent of total billed charges,,,2140.79,82,,percent of total billed charges,,,2349.65,90,,percent of total billed charges,,,2219.11,85,,percent of total billed charges,,773.25,2480.18,
SALMETEROL (SEREVENT) DISC 50MCG 60'S,32000108,CDM,,,250,RC,inpatient,,144.33,144.33,,122.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127.01,88,,percent of total billed charges,,,,,,,,,110.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.34,91,,percent of total billed charges,,,137.11,95,,percent of total billed charges,,,119.79,83,,percent of total billed charges,,,119.79,83,,percent of total billed charges,,,,,,,,,,,,,,,119.79,83,,percent of total billed charges,,,137.11,95,,percent of total billed charges,,,129.9,90,,percent of total billed charges,,,129.9,90,,percent of total billed charges,,,118.35,82,,percent of total billed charges,,,129.9,90,,percent of total billed charges,,,122.68,85,,percent of total billed charges,,108.82,137.11,
MINERAL OIL (FLEET MINERAL OIL) 480ML,32000109,CDM,,,250,RC,inpatient,,48.69,48.69,,41.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.85,88,,percent of total billed charges,,,,,,,,,37.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,44.31,91,,percent of total billed charges,,,46.26,95,,percent of total billed charges,,,40.41,83,,percent of total billed charges,,,40.41,83,,percent of total billed charges,,,,,,,,,,,,,,,40.41,83,,percent of total billed charges,,,46.26,95,,percent of total billed charges,,,43.82,90,,percent of total billed charges,,,43.82,90,,percent of total billed charges,,,39.93,82,,percent of total billed charges,,,43.82,90,,percent of total billed charges,,,41.39,85,,percent of total billed charges,,36.71,46.26,
ALENDRONATE (FOSAMAX) TAB : 10MG,32000111,CDM,,,250,RC,inpatient,,46.31,46.31,,39.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.75,88,,percent of total billed charges,,,,,,,,,35.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.14,91,,percent of total billed charges,,,43.99,95,,percent of total billed charges,,,38.44,83,,percent of total billed charges,,,38.44,83,,percent of total billed charges,,,,,,,,,,,,,,,38.44,83,,percent of total billed charges,,,43.99,95,,percent of total billed charges,,,41.68,90,,percent of total billed charges,,,41.68,90,,percent of total billed charges,,,37.97,82,,percent of total billed charges,,,41.68,90,,percent of total billed charges,,,39.36,85,,percent of total billed charges,,34.92,43.99,
ALENDRONATE (FOSAMAX) TAB : 5MG,32000112,CDM,,,250,RC,inpatient,,46.31,46.31,,39.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.75,88,,percent of total billed charges,,,,,,,,,35.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.14,91,,percent of total billed charges,,,43.99,95,,percent of total billed charges,,,38.44,83,,percent of total billed charges,,,38.44,83,,percent of total billed charges,,,,,,,,,,,,,,,38.44,83,,percent of total billed charges,,,43.99,95,,percent of total billed charges,,,41.68,90,,percent of total billed charges,,,41.68,90,,percent of total billed charges,,,37.97,82,,percent of total billed charges,,,41.68,90,,percent of total billed charges,,,39.36,85,,percent of total billed charges,,34.92,43.99,
ENALAPRIL/HCTZ (VASERETIC) TAB:10-25MG,32000113,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
TESTOSTERONE CYPION VL:200MG/ML (J/200),32000114,CDM,J1080,HCPCS,636,RC,inpatient,,349.71,349.71,,296.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,263.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,297.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,307.74,88,,percent of total billed charges,,,,,,,,,267.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,318.24,91,,percent of total billed charges,,,332.22,95,,percent of total billed charges,,,290.26,83,,percent of total billed charges,,,290.26,83,,percent of total billed charges,,,,,,,,,,,,,,,290.26,83,,percent of total billed charges,,,332.22,95,,percent of total billed charges,,,314.74,90,,percent of total billed charges,,,314.74,90,,percent of total billed charges,,,286.76,82,,percent of total billed charges,,,314.74,90,,percent of total billed charges,,,297.25,85,,percent of total billed charges,,263.68,332.22,
BUPIVACAINE 0.5% PF INJ SOL 30ML,32000115,CDM,J3490,HCPCS,250,RC,inpatient,,131.86,131.86,,111.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,99.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,112.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,116.04,88,,percent of total billed charges,,,,,,,,,100.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,119.99,91,,percent of total billed charges,,,125.27,95,,percent of total billed charges,,,109.44,83,,percent of total billed charges,,,109.44,83,,percent of total billed charges,,,,,,,,,,,,,,,109.44,83,,percent of total billed charges,,,125.27,95,,percent of total billed charges,,,118.67,90,,percent of total billed charges,,,118.67,90,,percent of total billed charges,,,108.13,82,,percent of total billed charges,,,118.67,90,,percent of total billed charges,,,112.08,85,,percent of total billed charges,,99.42,125.27,
RISEDRONATE(ACTONEL)TAB:35MG,32000117,CDM,,,250,RC,inpatient,,459.31,459.31,,389.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,346.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,390.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,404.19,88,,percent of total billed charges,,,,,,,,,350.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,417.97,91,,percent of total billed charges,,,436.34,95,,percent of total billed charges,,,381.23,83,,percent of total billed charges,,,381.23,83,,percent of total billed charges,,,,,,,,,,,,,,,381.23,83,,percent of total billed charges,,,436.34,95,,percent of total billed charges,,,413.38,90,,percent of total billed charges,,,413.38,90,,percent of total billed charges,,,376.63,82,,percent of total billed charges,,,413.38,90,,percent of total billed charges,,,390.41,85,,percent of total billed charges,,346.32,436.34,
ERYTHROMYCIN BASE(E-MYCIN)TAB:500MG,32000118,CDM,,,250,RC,inpatient,,291.35,291.35,,247.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,219.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,247.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,256.39,88,,percent of total billed charges,,,,,,,,,222.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,265.13,91,,percent of total billed charges,,,276.78,95,,percent of total billed charges,,,241.82,83,,percent of total billed charges,,,241.82,83,,percent of total billed charges,,,,,,,,,,,,,,,241.82,83,,percent of total billed charges,,,276.78,95,,percent of total billed charges,,,262.22,90,,percent of total billed charges,,,262.22,90,,percent of total billed charges,,,238.91,82,,percent of total billed charges,,,262.22,90,,percent of total billed charges,,,247.65,85,,percent of total billed charges,,219.68,276.78,
COD/APAP/CAF/BU(FIORCET+C)CAP:30-325-50,32000120,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
metFORMIN(GLUCOPHAGE)TAB:850MG,32000121,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
POTCL/POT BICARB/CIT(KLYTE CL) TAB:25MEQ,32000122,CDM,,,250,RC,inpatient,,19.03,19.03,,16.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16.75,88,,percent of total billed charges,,,,,,,,,14.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.32,91,,percent of total billed charges,,,18.08,95,,percent of total billed charges,,,15.79,83,,percent of total billed charges,,,15.79,83,,percent of total billed charges,,,,,,,,,,,,,,,15.79,83,,percent of total billed charges,,,18.08,95,,percent of total billed charges,,,17.13,90,,percent of total billed charges,,,17.13,90,,percent of total billed charges,,,15.6,82,,percent of total billed charges,,,17.13,90,,percent of total billed charges,,,16.18,85,,percent of total billed charges,,14.35,18.08,
GATIFLOXACIN(ZYMAR)DROP 0.3%:5ML,32000123,CDM,,,250,RC,inpatient,,1024.26,1024.26,,869.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,772.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,870.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,901.35,88,,percent of total billed charges,,,,,,,,,782.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,932.08,91,,percent of total billed charges,,,973.05,95,,percent of total billed charges,,,850.14,83,,percent of total billed charges,,,850.14,83,,percent of total billed charges,,,,,,,,,,,,,,,850.14,83,,percent of total billed charges,,,973.05,95,,percent of total billed charges,,,921.83,90,,percent of total billed charges,,,921.83,90,,percent of total billed charges,,,839.89,82,,percent of total billed charges,,,921.83,90,,percent of total billed charges,,,870.62,85,,percent of total billed charges,,772.29,973.05,
OCTREOTIDE(SandoSTIN)VIAL:0.05MG/ML,32000124,CDM,J2354,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,22.34,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,22.34,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,22.34,60.99,
VERAPAMIL HCL (VERELAN PM) CAP : 240MG,32000125,CDM,,,250,RC,inpatient,,21.09,21.09,,17.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.56,88,,percent of total billed charges,,,,,,,,,16.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.19,91,,percent of total billed charges,,,20.04,95,,percent of total billed charges,,,17.5,83,,percent of total billed charges,,,17.5,83,,percent of total billed charges,,,,,,,,,,,,,,,17.5,83,,percent of total billed charges,,,20.04,95,,percent of total billed charges,,,18.98,90,,percent of total billed charges,,,18.98,90,,percent of total billed charges,,,17.29,82,,percent of total billed charges,,,18.98,90,,percent of total billed charges,,,17.93,85,,percent of total billed charges,,15.9,20.04,
guaiFENesin(MUCINEX)TAB:600MG,32000126,CDM,J8499,HCPCS,250,RC,inpatient,,15.2,15.2,,12.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.38,88,,percent of total billed charges,,,,,,,,,11.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.83,91,,percent of total billed charges,,,14.44,95,,percent of total billed charges,,,12.62,83,,percent of total billed charges,,,12.62,83,,percent of total billed charges,,,,,,,,,,,,,,,12.62,83,,percent of total billed charges,,,14.44,95,,percent of total billed charges,,,13.68,90,,percent of total billed charges,,,13.68,90,,percent of total billed charges,,,12.46,82,,percent of total billed charges,,,13.68,90,,percent of total billed charges,,,12.92,85,,percent of total billed charges,,11.46,14.44,
FLUCONAZOLE(DIFLUCAN)TAB:150MG,32000127,CDM,J8499,HCPCS,250,RC,inpatient,,23.69,23.69,,20.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.85,88,,percent of total billed charges,,,,,,,,,18.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.56,91,,percent of total billed charges,,,22.51,95,,percent of total billed charges,,,19.66,83,,percent of total billed charges,,,19.66,83,,percent of total billed charges,,,,,,,,,,,,,,,19.66,83,,percent of total billed charges,,,22.51,95,,percent of total billed charges,,,21.32,90,,percent of total billed charges,,,21.32,90,,percent of total billed charges,,,19.43,82,,percent of total billed charges,,,21.32,90,,percent of total billed charges,,,20.14,85,,percent of total billed charges,,17.86,22.51,
NIACINAMIDE TAB:500MG,32000128,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
EZETIMIBE(ZETIA)TAB:10MG,32000129,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FENOFIBRATE MICRONIZED (TRICOR)TAB:160MG,32000130,CDM,,,250,RC,inpatient,,46.95,46.95,,39.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.32,88,,percent of total billed charges,,,,,,,,,35.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.72,91,,percent of total billed charges,,,44.6,95,,percent of total billed charges,,,38.97,83,,percent of total billed charges,,,38.97,83,,percent of total billed charges,,,,,,,,,,,,,,,38.97,83,,percent of total billed charges,,,44.6,95,,percent of total billed charges,,,42.26,90,,percent of total billed charges,,,42.26,90,,percent of total billed charges,,,38.5,82,,percent of total billed charges,,,42.26,90,,percent of total billed charges,,,39.91,85,,percent of total billed charges,,35.4,44.6,
guaiFENesin(ORGANIDIN)TAB:200MG,32000131,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PARoxetine(PAXIL CR)TAB:37.5MG,32000132,CDM,,,250,RC,inpatient,,63.28,63.28,,53.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,53.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.69,88,,percent of total billed charges,,,,,,,,,48.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.58,91,,percent of total billed charges,,,60.12,95,,percent of total billed charges,,,52.52,83,,percent of total billed charges,,,52.52,83,,percent of total billed charges,,,,,,,,,,,,,,,52.52,83,,percent of total billed charges,,,60.12,95,,percent of total billed charges,,,56.95,90,,percent of total billed charges,,,56.95,90,,percent of total billed charges,,,51.89,82,,percent of total billed charges,,,56.95,90,,percent of total billed charges,,,53.79,85,,percent of total billed charges,,47.71,60.12,
PERINDOPRIL ERBUMINE(ACEON)TAB:8MG,32000133,CDM,,,250,RC,inpatient,,49.48,49.48,,42.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,43.54,88,,percent of total billed charges,,,,,,,,,37.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.03,91,,percent of total billed charges,,,47.01,95,,percent of total billed charges,,,41.07,83,,percent of total billed charges,,,41.07,83,,percent of total billed charges,,,,,,,,,,,,,,,41.07,83,,percent of total billed charges,,,47.01,95,,percent of total billed charges,,,44.53,90,,percent of total billed charges,,,44.53,90,,percent of total billed charges,,,40.57,82,,percent of total billed charges,,,44.53,90,,percent of total billed charges,,,42.06,85,,percent of total billed charges,,37.31,47.01,
ADENOCARD SYR : 3MG/ML *,32000134,CDM,,,250,RC,inpatient,,964.45,964.45,,818.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,727.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,819.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,848.72,88,,percent of total billed charges,,,,,,,,,736.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,877.65,91,,percent of total billed charges,,,916.23,95,,percent of total billed charges,,,800.49,83,,percent of total billed charges,,,800.49,83,,percent of total billed charges,,,,,,,,,,,,,,,800.49,83,,percent of total billed charges,,,916.23,95,,percent of total billed charges,,,868.01,90,,percent of total billed charges,,,868.01,90,,percent of total billed charges,,,790.85,82,,percent of total billed charges,,,868.01,90,,percent of total billed charges,,,819.78,85,,percent of total billed charges,,727.2,916.23,
EMOLLIENT (VANICREAM) CREAM,32000135,CDM,,,250,RC,inpatient,,67.56,67.56,,57.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.45,88,,percent of total billed charges,,,,,,,,,51.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.48,91,,percent of total billed charges,,,64.18,95,,percent of total billed charges,,,56.07,83,,percent of total billed charges,,,56.07,83,,percent of total billed charges,,,,,,,,,,,,,,,56.07,83,,percent of total billed charges,,,64.18,95,,percent of total billed charges,,,60.8,90,,percent of total billed charges,,,60.8,90,,percent of total billed charges,,,55.4,82,,percent of total billed charges,,,60.8,90,,percent of total billed charges,,,57.43,85,,percent of total billed charges,,50.94,64.18,
OCTREOTIDE(SandoSTIN LAR) KIT:30MG   J/1,32000136,CDM,J2353,HCPCS,636,RC,inpatient,,22063.9,22063.9,,18732.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16636.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18754.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19416.23,88,,percent of total billed charges,,8278.44,,,,fee schedule,,,16856.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8278.44,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20078.15,91,,percent of total billed charges,,,20960.71,95,,percent of total billed charges,,,18313.04,83,,percent of total billed charges,,,18313.04,83,,percent of total billed charges,,,,,,,,,,,,,,,18313.04,83,,percent of total billed charges,,,20960.71,95,,percent of total billed charges,,,19857.51,90,,percent of total billed charges,,,19857.51,90,,percent of total billed charges,,,18092.4,82,,percent of total billed charges,,,19857.51,90,,percent of total billed charges,,,18754.32,85,,percent of total billed charges,,8278.44,20960.71,
PARoxetine(PAXIL CR)TAB:12.5MG,32000137,CDM,,,250,RC,inpatient,,58.84,58.84,,49.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.78,88,,percent of total billed charges,,,,,,,,,44.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.54,91,,percent of total billed charges,,,55.9,95,,percent of total billed charges,,,48.84,83,,percent of total billed charges,,,48.84,83,,percent of total billed charges,,,,,,,,,,,,,,,48.84,83,,percent of total billed charges,,,55.9,95,,percent of total billed charges,,,52.96,90,,percent of total billed charges,,,52.96,90,,percent of total billed charges,,,48.25,82,,percent of total billed charges,,,52.96,90,,percent of total billed charges,,,50.01,85,,percent of total billed charges,,44.37,55.9,
CLOBETASOL(TEMOVATE)CREAM 0.05%:15GM,32000138,CDM,J3490,HCPCS,250,RC,inpatient,,54.25,54.25,,46.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47.74,88,,percent of total billed charges,,,,,,,,,41.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.37,91,,percent of total billed charges,,,51.54,95,,percent of total billed charges,,,45.03,83,,percent of total billed charges,,,45.03,83,,percent of total billed charges,,,,,,,,,,,,,,,45.03,83,,percent of total billed charges,,,51.54,95,,percent of total billed charges,,,48.83,90,,percent of total billed charges,,,48.83,90,,percent of total billed charges,,,44.49,82,,percent of total billed charges,,,48.83,90,,percent of total billed charges,,,46.11,85,,percent of total billed charges,,40.9,51.54,
FLUTICASON/SALMET(ADVAIR DISK):250-50MCG,32000139,CDM,,,250,RC,inpatient,,424,424,,359.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,319.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,360.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,373.12,88,,percent of total billed charges,,,,,,,,,323.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,385.84,91,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,,,,,,,,,,,,,351.92,83,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,347.68,82,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,319.7,402.8,
PALIVIZUMAB (SYNAGIS) VIAL : 50MG 1ML,32000140,CDM,,,250,RC,inpatient,,4962.74,4962.74,,4213.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3741.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4218.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4367.21,88,,percent of total billed charges,,,,,,,,,3791.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4516.09,91,,percent of total billed charges,,,4714.6,95,,percent of total billed charges,,,4119.07,83,,percent of total billed charges,,,4119.07,83,,percent of total billed charges,,,,,,,,,,,,,,,4119.07,83,,percent of total billed charges,,,4714.6,95,,percent of total billed charges,,,4466.47,90,,percent of total billed charges,,,4466.47,90,,percent of total billed charges,,,4069.45,82,,percent of total billed charges,,,4466.47,90,,percent of total billed charges,,,4218.33,85,,percent of total billed charges,,3741.91,4714.6,
PALIVIZUMAB (SYNAGIS) VIAL : 100MG 1ML,32000142,CDM,,,250,RC,inpatient,,5760.86,5760.86,,4890.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4343.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4896.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5069.56,88,,percent of total billed charges,,,,,,,,,4401.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5242.38,91,,percent of total billed charges,,,5472.82,95,,percent of total billed charges,,,4781.51,83,,percent of total billed charges,,,4781.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4781.51,83,,percent of total billed charges,,,5472.82,95,,percent of total billed charges,,,5184.77,90,,percent of total billed charges,,,5184.77,90,,percent of total billed charges,,,4723.91,82,,percent of total billed charges,,,5184.77,90,,percent of total billed charges,,,4896.73,85,,percent of total billed charges,,4343.69,5472.82,
INTERFE ALFA-2B(INTRON)MDV:6MMU/ML,32000143,CDM,J9214,HCPCS,636,RC,inpatient,,519.89,519.89,,441.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,392,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,441.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,457.5,88,,percent of total billed charges,,2443.05,,,,fee schedule,,,397.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2443.05,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,473.1,91,,percent of total billed charges,,,493.9,95,,percent of total billed charges,,,431.51,83,,percent of total billed charges,,,431.51,83,,percent of total billed charges,,,,,,,,,,,,,,,431.51,83,,percent of total billed charges,,,493.9,95,,percent of total billed charges,,,467.9,90,,percent of total billed charges,,,467.9,90,,percent of total billed charges,,,426.31,82,,percent of total billed charges,,,467.9,90,,percent of total billed charges,,,441.91,85,,percent of total billed charges,,392,2443.05,
CALCITONIN(MIACALCIN):400UNITS/2ML,32000144,CDM,J0630,HCPCS,250,RC,inpatient,,14488.42,14488.42,,12300.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10924.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12315.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12749.81,88,,percent of total billed charges,,3554.67,,,,fee schedule,,,11069.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3554.67,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13184.46,91,,percent of total billed charges,,,13764,95,,percent of total billed charges,,,12025.39,83,,percent of total billed charges,,,12025.39,83,,percent of total billed charges,,,,,,,,,,,,,,,12025.39,83,,percent of total billed charges,,,13764,95,,percent of total billed charges,,,13039.58,90,,percent of total billed charges,,,13039.58,90,,percent of total billed charges,,,11880.5,82,,percent of total billed charges,,,13039.58,90,,percent of total billed charges,,,12315.16,85,,percent of total billed charges,,3554.67,13764,
OXALIPLATIN(ELOXATIN):100MG  (J/0.5MG),32000145,CDM,J9263,HCPCS,636,RC,inpatient,,4073.58,4073.58,,3458.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3071.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3462.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3584.75,88,,percent of total billed charges,,38.5,,,,fee schedule,,,3112.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,38.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3706.96,91,,percent of total billed charges,,,3869.9,95,,percent of total billed charges,,,3381.07,83,,percent of total billed charges,,,3381.07,83,,percent of total billed charges,,,,,,,,,,,,,,,3381.07,83,,percent of total billed charges,,,3869.9,95,,percent of total billed charges,,,3666.22,90,,percent of total billed charges,,,3666.22,90,,percent of total billed charges,,,3340.34,82,,percent of total billed charges,,,3666.22,90,,percent of total billed charges,,,3462.54,85,,percent of total billed charges,,38.5,3869.9,
POTASSIUM CHL LIQ 40MEQ/30ML  UD,32000146,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
TESTOSTRN ENTH VIAL:1000MG/5ML,32000147,CDM,,,250,RC,inpatient,,1168.07,1168.07,,991.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,880.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,992.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1027.9,88,,percent of total billed charges,,,,,,,,,892.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1062.94,91,,percent of total billed charges,,,1109.67,95,,percent of total billed charges,,,969.5,83,,percent of total billed charges,,,969.5,83,,percent of total billed charges,,,,,,,,,,,,,,,969.5,83,,percent of total billed charges,,,1109.67,95,,percent of total billed charges,,,1051.26,90,,percent of total billed charges,,,1051.26,90,,percent of total billed charges,,,957.82,82,,percent of total billed charges,,,1051.26,90,,percent of total billed charges,,,992.86,85,,percent of total billed charges,,880.72,1109.67,
OXCARBAZEPINE (TRILEPTAL) TAB : 150MG,32000148,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
OXCARBAZEPINE (TRILEPTAL) TAB : 600MG,32000149,CDM,,,250,RC,inpatient,,75.81,75.81,,64.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,57.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,64.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66.71,88,,percent of total billed charges,,,,,,,,,57.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,68.99,91,,percent of total billed charges,,,72.02,95,,percent of total billed charges,,,62.92,83,,percent of total billed charges,,,62.92,83,,percent of total billed charges,,,,,,,,,,,,,,,62.92,83,,percent of total billed charges,,,72.02,95,,percent of total billed charges,,,68.23,90,,percent of total billed charges,,,68.23,90,,percent of total billed charges,,,62.16,82,,percent of total billed charges,,,68.23,90,,percent of total billed charges,,,64.44,85,,percent of total billed charges,,57.16,72.02,
IBUTILIDE(CORVERT):1MG/10ML,32000150,CDM,J1742,HCPCS,636,RC,inpatient,,882,882,,748.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,665.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,749.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,776.16,88,,percent of total billed charges,,492.2,,,,fee schedule,,,673.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,492.2,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,802.62,91,,percent of total billed charges,,,837.9,95,,percent of total billed charges,,,732.06,83,,percent of total billed charges,,,732.06,83,,percent of total billed charges,,,,,,,,,,,,,,,732.06,83,,percent of total billed charges,,,837.9,95,,percent of total billed charges,,,793.8,90,,percent of total billed charges,,,793.8,90,,percent of total billed charges,,,723.24,82,,percent of total billed charges,,,793.8,90,,percent of total billed charges,,,749.7,85,,percent of total billed charges,,492.2,837.9,
ISOSORBIDE MONONITRATE(IMDUR) TAB : 30MG,32000151,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
OSELTAM(TAMIFLU)SUSP:12MG/ML(75ML)SNS,32000152,CDM,,,250,RC,inpatient,,711.32,711.32,,603.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,536.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,604.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,625.96,88,,percent of total billed charges,,,,,,,,,543.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,647.3,91,,percent of total billed charges,,,675.75,95,,percent of total billed charges,,,590.4,83,,percent of total billed charges,,,590.4,83,,percent of total billed charges,,,,,,,,,,,,,,,590.4,83,,percent of total billed charges,,,675.75,95,,percent of total billed charges,,,640.19,90,,percent of total billed charges,,,640.19,90,,percent of total billed charges,,,583.28,82,,percent of total billed charges,,,640.19,90,,percent of total billed charges,,,604.62,85,,percent of total billed charges,,536.34,675.75,
OXALIPLATIN(ELOXATIN):50MG/10ML,32000153,CDM,J9263,HCPCS,636,RC,inpatient,,155.39,155.39,,131.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,117.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,132.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,136.74,88,,percent of total billed charges,,38.5,,,,fee schedule,,,118.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,38.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,141.4,91,,percent of total billed charges,,,147.62,95,,percent of total billed charges,,,128.97,83,,percent of total billed charges,,,128.97,83,,percent of total billed charges,,,,,,,,,,,,,,,128.97,83,,percent of total billed charges,,,147.62,95,,percent of total billed charges,,,139.85,90,,percent of total billed charges,,,139.85,90,,percent of total billed charges,,,127.42,82,,percent of total billed charges,,,139.85,90,,percent of total billed charges,,,132.08,85,,percent of total billed charges,,38.5,147.62,
PROPAFENONE(RYTHMOL)TAB:150MG,32000154,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
POTASSIUM CHLORIDE LIQ:20MEQ/15ML CUP PX,32000155,CDM,J8499,HCPCS,250,RC,inpatient,,113.56,113.56,,96.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,99.93,88,,percent of total billed charges,,,,,,,,,86.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,103.34,91,,percent of total billed charges,,,107.88,95,,percent of total billed charges,,,94.25,83,,percent of total billed charges,,,94.25,83,,percent of total billed charges,,,,,,,,,,,,,,,94.25,83,,percent of total billed charges,,,107.88,95,,percent of total billed charges,,,102.2,90,,percent of total billed charges,,,102.2,90,,percent of total billed charges,,,93.12,82,,percent of total billed charges,,,102.2,90,,percent of total billed charges,,,96.53,85,,percent of total billed charges,,85.62,107.88,
SUMAtriptan(IMITREX)TAB:25MG,32000156,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
prednisoLONE(PEDIAPRED):5MG/5ML(5ML),32000157,CDM,J7599,HCPCS,250,RC,inpatient,,53.27,53.27,,45.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46.88,88,,percent of total billed charges,,,,,,,,,40.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,48.48,91,,percent of total billed charges,,,50.61,95,,percent of total billed charges,,,44.21,83,,percent of total billed charges,,,44.21,83,,percent of total billed charges,,,,,,,,,,,,,,,44.21,83,,percent of total billed charges,,,50.61,95,,percent of total billed charges,,,47.94,90,,percent of total billed charges,,,47.94,90,,percent of total billed charges,,,43.68,82,,percent of total billed charges,,,47.94,90,,percent of total billed charges,,,45.28,85,,percent of total billed charges,,40.17,50.61,
PYRIDOSTIGMINE(REGONL)AMP:10MG/2ML,32000158,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
DACARBAZINE(DTIC)200MG VIAL,32000159,CDM,J9130,HCPCS,636,RC,inpatient,,176.2,176.2,,149.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,155.06,88,,percent of total billed charges,,40.8,,,,fee schedule,,,134.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,40.8,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.34,91,,percent of total billed charges,,,167.39,95,,percent of total billed charges,,,146.25,83,,percent of total billed charges,,,146.25,83,,percent of total billed charges,,,,,,,,,,,,,,,146.25,83,,percent of total billed charges,,,167.39,95,,percent of total billed charges,,,158.58,90,,percent of total billed charges,,,158.58,90,,percent of total billed charges,,,144.48,82,,percent of total billed charges,,,158.58,90,,percent of total billed charges,,,149.77,85,,percent of total billed charges,,40.8,167.39,
DACARBAZINE(DTIC)VIAL:100MG,32000160,CDM,J9130,HCPCS,636,RC,inpatient,,157.33,157.33,,133.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,118.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,133.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,138.45,88,,percent of total billed charges,,40.8,,,,fee schedule,,,120.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,40.8,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,143.17,91,,percent of total billed charges,,,149.46,95,,percent of total billed charges,,,130.58,83,,percent of total billed charges,,,130.58,83,,percent of total billed charges,,,,,,,,,,,,,,,130.58,83,,percent of total billed charges,,,149.46,95,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,129.01,82,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,133.73,85,,percent of total billed charges,,40.8,149.46,
FLURBIPROFEN(ANSAID)TAB:100MG,32000162,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
TRYPS/BAL/PERU/CST OIL(XENADRM)OINT:60GM,32000163,CDM,,,250,RC,inpatient,,729.4,729.4,,619.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,549.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,619.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,641.87,88,,percent of total billed charges,,,,,,,,,557.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,663.75,91,,percent of total billed charges,,,692.93,95,,percent of total billed charges,,,605.4,83,,percent of total billed charges,,,605.4,83,,percent of total billed charges,,,,,,,,,,,,,,,605.4,83,,percent of total billed charges,,,692.93,95,,percent of total billed charges,,,656.46,90,,percent of total billed charges,,,656.46,90,,percent of total billed charges,,,598.11,82,,percent of total billed charges,,,656.46,90,,percent of total billed charges,,,619.99,85,,percent of total billed charges,,549.97,692.93,
ORLISTAT (XENICAL) CAP : 120MG,32000164,CDM,,,250,RC,inpatient,,79.78,79.78,,67.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.21,88,,percent of total billed charges,,,,,,,,,60.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.6,91,,percent of total billed charges,,,75.79,95,,percent of total billed charges,,,66.22,83,,percent of total billed charges,,,66.22,83,,percent of total billed charges,,,,,,,,,,,,,,,66.22,83,,percent of total billed charges,,,75.79,95,,percent of total billed charges,,,71.8,90,,percent of total billed charges,,,71.8,90,,percent of total billed charges,,,65.42,82,,percent of total billed charges,,,71.8,90,,percent of total billed charges,,,67.81,85,,percent of total billed charges,,60.15,75.79,
MICONAZOLE NIT(DESENEX) AER : 2% 85GM,32000165,CDM,,,250,RC,inpatient,,67.72,67.72,,57.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.59,88,,percent of total billed charges,,,,,,,,,51.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.63,91,,percent of total billed charges,,,64.33,95,,percent of total billed charges,,,56.21,83,,percent of total billed charges,,,56.21,83,,percent of total billed charges,,,,,,,,,,,,,,,56.21,83,,percent of total billed charges,,,64.33,95,,percent of total billed charges,,,60.95,90,,percent of total billed charges,,,60.95,90,,percent of total billed charges,,,55.53,82,,percent of total billed charges,,,60.95,90,,percent of total billed charges,,,57.56,85,,percent of total billed charges,,51.06,64.33,
LEVOBUNOLOL (BETAGAN) DROP : 0.50%  10ML,32000166,CDM,,,250,RC,inpatient,,582.86,582.86,,494.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,439.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,495.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,512.92,88,,percent of total billed charges,,,,,,,,,445.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,530.4,91,,percent of total billed charges,,,553.72,95,,percent of total billed charges,,,483.77,83,,percent of total billed charges,,,483.77,83,,percent of total billed charges,,,,,,,,,,,,,,,483.77,83,,percent of total billed charges,,,553.72,95,,percent of total billed charges,,,524.57,90,,percent of total billed charges,,,524.57,90,,percent of total billed charges,,,477.95,82,,percent of total billed charges,,,524.57,90,,percent of total billed charges,,,495.43,85,,percent of total billed charges,,439.48,553.72,
BENAZEPR/HCT(LOTENSIN) HCT TAB:20-12.5MG,32000167,CDM,,,250,RC,inpatient,,14.91,14.91,,12.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.12,88,,percent of total billed charges,,,,,,,,,11.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.57,91,,percent of total billed charges,,,14.16,95,,percent of total billed charges,,,12.38,83,,percent of total billed charges,,,12.38,83,,percent of total billed charges,,,,,,,,,,,,,,,12.38,83,,percent of total billed charges,,,14.16,95,,percent of total billed charges,,,13.42,90,,percent of total billed charges,,,13.42,90,,percent of total billed charges,,,12.23,82,,percent of total billed charges,,,13.42,90,,percent of total billed charges,,,12.67,85,,percent of total billed charges,,11.24,14.16,
NAFTIFINE(NAFTIN)CREAM 1%:15GM,32000168,CDM,,,250,RC,inpatient,,593.96,593.96,,504.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,447.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,504.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,522.68,88,,percent of total billed charges,,,,,,,,,453.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,540.5,91,,percent of total billed charges,,,564.26,95,,percent of total billed charges,,,492.99,83,,percent of total billed charges,,,492.99,83,,percent of total billed charges,,,,,,,,,,,,,,,492.99,83,,percent of total billed charges,,,564.26,95,,percent of total billed charges,,,534.56,90,,percent of total billed charges,,,534.56,90,,percent of total billed charges,,,487.05,82,,percent of total billed charges,,,534.56,90,,percent of total billed charges,,,504.87,85,,percent of total billed charges,,447.85,564.26,
NAFTIFINE(NAFTIN)CREAM 1%:60GM,32000169,CDM,,,250,RC,inpatient,,1790.21,1790.21,,1519.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1349.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1521.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1575.38,88,,percent of total billed charges,,,,,,,,,1367.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1629.09,91,,percent of total billed charges,,,1700.7,95,,percent of total billed charges,,,1485.87,83,,percent of total billed charges,,,1485.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1485.87,83,,percent of total billed charges,,,1700.7,95,,percent of total billed charges,,,1611.19,90,,percent of total billed charges,,,1611.19,90,,percent of total billed charges,,,1467.97,82,,percent of total billed charges,,,1611.19,90,,percent of total billed charges,,,1521.68,85,,percent of total billed charges,,1349.82,1700.7,
BENAZEPRIL-HCTZ(LOTENSIN-HCT)TAB 20/25MG,32000170,CDM,,,250,RC,inpatient,,5,5,,4.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4.4,88,,percent of total billed charges,,,,,,,,,3.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4.55,91,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4.15,83,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.1,82,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,3.77,4.75,
ENOXAPARIN(LOVENOX):120MG/0.8ML,32000171,CDM,J1650,HCPCS,250,RC,inpatient,,174.18,174.18,,147.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,131.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,148.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,153.28,88,,percent of total billed charges,,15.16,,,,fee schedule,,,133.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.16,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,158.5,91,,percent of total billed charges,,,165.47,95,,percent of total billed charges,,,144.57,83,,percent of total billed charges,,,144.57,83,,percent of total billed charges,,,,,,,,,,,,,,,144.57,83,,percent of total billed charges,,,165.47,95,,percent of total billed charges,,,156.76,90,,percent of total billed charges,,,156.76,90,,percent of total billed charges,,,142.83,82,,percent of total billed charges,,,156.76,90,,percent of total billed charges,,,148.05,85,,percent of total billed charges,,15.16,165.47,
OMEPRAZOLE(priLOSEC)CAP:20MG,32000172,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
POLYETH GLYCL3350(MIRALAX)PAC:17GUD,32000173,CDM,J8499,HCPCS,250,RC,inpatient,,27.45,27.45,,23.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.16,88,,percent of total billed charges,,,,,,,,,20.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.98,91,,percent of total billed charges,,,26.08,95,,percent of total billed charges,,,22.78,83,,percent of total billed charges,,,22.78,83,,percent of total billed charges,,,,,,,,,,,,,,,22.78,83,,percent of total billed charges,,,26.08,95,,percent of total billed charges,,,24.71,90,,percent of total billed charges,,,24.71,90,,percent of total billed charges,,,22.51,82,,percent of total billed charges,,,24.71,90,,percent of total billed charges,,,23.33,85,,percent of total billed charges,,20.7,26.08,
LIDOCAINE(XYLOCAINE)JELLY 2%: 5ML,32000174,CDM,J3490,HCPCS,250,RC,inpatient,,116.83,116.83,,99.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,88.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,99.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,102.81,88,,percent of total billed charges,,,,,,,,,89.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,106.32,91,,percent of total billed charges,,,110.99,95,,percent of total billed charges,,,96.97,83,,percent of total billed charges,,,96.97,83,,percent of total billed charges,,,,,,,,,,,,,,,96.97,83,,percent of total billed charges,,,110.99,95,,percent of total billed charges,,,105.15,90,,percent of total billed charges,,,105.15,90,,percent of total billed charges,,,95.8,82,,percent of total billed charges,,,105.15,90,,percent of total billed charges,,,99.31,85,,percent of total billed charges,,88.09,110.99,
PRAMIPEXOLE DI-HCL (MIRAPEX) TAB : 1MG,32000175,CDM,,,250,RC,inpatient,,36.16,36.16,,30.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31.82,88,,percent of total billed charges,,,,,,,,,27.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.91,91,,percent of total billed charges,,,34.35,95,,percent of total billed charges,,,30.01,83,,percent of total billed charges,,,30.01,83,,percent of total billed charges,,,,,,,,,,,,,,,30.01,83,,percent of total billed charges,,,34.35,95,,percent of total billed charges,,,32.54,90,,percent of total billed charges,,,32.54,90,,percent of total billed charges,,,29.65,82,,percent of total billed charges,,,32.54,90,,percent of total billed charges,,,30.74,85,,percent of total billed charges,,27.26,34.35,
CHARCOAL/SORBTL(ACTIDOSE)ORAL:25G/120ML,32000176,CDM,J3490,HCPCS,250,RC,inpatient,,349.4,349.4,,296.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,263.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,296.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,307.47,88,,percent of total billed charges,,,,,,,,,266.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,317.95,91,,percent of total billed charges,,,331.93,95,,percent of total billed charges,,,290,83,,percent of total billed charges,,,290,83,,percent of total billed charges,,,,,,,,,,,,,,,290,83,,percent of total billed charges,,,331.93,95,,percent of total billed charges,,,314.46,90,,percent of total billed charges,,,314.46,90,,percent of total billed charges,,,286.51,82,,percent of total billed charges,,,314.46,90,,percent of total billed charges,,,296.99,85,,percent of total billed charges,,263.45,331.93,
DEXAMETHASONE(DECADRON): 4MG/ML 1ML,32000177,CDM,,,250,RC,inpatient,,85.33,85.33,,72.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,72.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,75.09,88,,percent of total billed charges,,,,,,,,,65.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,77.65,91,,percent of total billed charges,,,81.06,95,,percent of total billed charges,,,70.82,83,,percent of total billed charges,,,70.82,83,,percent of total billed charges,,,,,,,,,,,,,,,70.82,83,,percent of total billed charges,,,81.06,95,,percent of total billed charges,,,76.8,90,,percent of total billed charges,,,76.8,90,,percent of total billed charges,,,69.97,82,,percent of total billed charges,,,76.8,90,,percent of total billed charges,,,72.53,85,,percent of total billed charges,,64.34,81.06,
MULTIVITS STRESS FORMULA (STRESS600)TAB,32000178,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PODOFILOX SOL : 0.50% 3.5ML,32000179,CDM,,,250,RC,inpatient,,552.72,552.72,,469.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,416.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,469.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,486.39,88,,percent of total billed charges,,,,,,,,,422.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,502.98,91,,percent of total billed charges,,,525.08,95,,percent of total billed charges,,,458.76,83,,percent of total billed charges,,,458.76,83,,percent of total billed charges,,,,,,,,,,,,,,,458.76,83,,percent of total billed charges,,,525.08,95,,percent of total billed charges,,,497.45,90,,percent of total billed charges,,,497.45,90,,percent of total billed charges,,,453.23,82,,percent of total billed charges,,,497.45,90,,percent of total billed charges,,,469.81,85,,percent of total billed charges,,416.75,525.08,
metoPROLOL SUCC(TOPROL XL)TAB:25MG,32000180,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DICLOFENAC (VOLTARAN) TAB : 50MG,32000182,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ESTRADIOL(CLIMARA)PATCH:0.1MG/24HR,32000184,CDM,,,250,RC,inpatient,,309.11,309.11,,262.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,233.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,262.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,272.02,88,,percent of total billed charges,,,,,,,,,236.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,281.29,91,,percent of total billed charges,,,293.65,95,,percent of total billed charges,,,256.56,83,,percent of total billed charges,,,256.56,83,,percent of total billed charges,,,,,,,,,,,,,,,256.56,83,,percent of total billed charges,,,293.65,95,,percent of total billed charges,,,278.2,90,,percent of total billed charges,,,278.2,90,,percent of total billed charges,,,253.47,82,,percent of total billed charges,,,278.2,90,,percent of total billed charges,,,262.74,85,,percent of total billed charges,,233.07,293.65,
IBUPROFEN(MOTRIN)ORAL 100MG/5ML 480ML,32000185,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
IBUPROFEN(MOTRIN)ORAL:100MG/5ML (120ML),32000186,CDM,J8499,HCPCS,250,RC,inpatient,UD,45.43,45.43,,38.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.98,88,,percent of total billed charges,,,,,,,,,34.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.34,91,,percent of total billed charges,,,43.16,95,,percent of total billed charges,,,37.71,83,,percent of total billed charges,,,37.71,83,,percent of total billed charges,,,,,,,,,,,,,,,37.71,83,,percent of total billed charges,,,43.16,95,,percent of total billed charges,,,40.89,90,,percent of total billed charges,,,40.89,90,,percent of total billed charges,,,37.25,82,,percent of total billed charges,,,40.89,90,,percent of total billed charges,,,38.62,85,,percent of total billed charges,,34.25,43.16,
CEFDINIR (OMNICEF) SUS : 125MG/5ML 60ml,32000187,CDM,,,250,RC,inpatient,,725.36,725.36,,615.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,546.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,616.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,638.32,88,,percent of total billed charges,,,,,,,,,554.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,660.08,91,,percent of total billed charges,,,689.09,95,,percent of total billed charges,,,602.05,83,,percent of total billed charges,,,602.05,83,,percent of total billed charges,,,,,,,,,,,,,,,602.05,83,,percent of total billed charges,,,689.09,95,,percent of total billed charges,,,652.82,90,,percent of total billed charges,,,652.82,90,,percent of total billed charges,,,594.8,82,,percent of total billed charges,,,652.82,90,,percent of total billed charges,,,616.56,85,,percent of total billed charges,,546.92,689.09,
CEFDINIR(OMNICEF)SUS:125MG/5ML(100ML),32000188,CDM,J8499,HCPCS,250,RC,inpatient,,843.55,843.55,,716.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,636.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,717.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,742.32,88,,percent of total billed charges,,,,,,,,,644.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,767.63,91,,percent of total billed charges,,,801.37,95,,percent of total billed charges,,,700.15,83,,percent of total billed charges,,,700.15,83,,percent of total billed charges,,,,,,,,,,,,,,,700.15,83,,percent of total billed charges,,,801.37,95,,percent of total billed charges,,,759.2,90,,percent of total billed charges,,,759.2,90,,percent of total billed charges,,,691.71,82,,percent of total billed charges,,,759.2,90,,percent of total billed charges,,,717.02,85,,percent of total billed charges,,636.04,801.37,
CICLOPIROX(LOPROX)CREAM 0.77%:15GM,32000189,CDM,,,250,RC,inpatient,,129.5,129.5,,109.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,97.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,110.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,113.96,88,,percent of total billed charges,,,,,,,,,98.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,117.85,91,,percent of total billed charges,,,123.03,95,,percent of total billed charges,,,107.49,83,,percent of total billed charges,,,107.49,83,,percent of total billed charges,,,,,,,,,,,,,,,107.49,83,,percent of total billed charges,,,123.03,95,,percent of total billed charges,,,116.55,90,,percent of total billed charges,,,116.55,90,,percent of total billed charges,,,106.19,82,,percent of total billed charges,,,116.55,90,,percent of total billed charges,,,110.08,85,,percent of total billed charges,,97.64,123.03,
BACTERIOSTATIC NS VIAL:0.9% 30ML,32000190,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
MORPHINE SULF VIAL:10MG/ML,32000191,CDM,,,250,RC,inpatient,,106.58,106.58,,90.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,80.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,90.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,93.79,88,,percent of total billed charges,,,,,,,,,81.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,96.99,91,,percent of total billed charges,,,101.25,95,,percent of total billed charges,,,88.46,83,,percent of total billed charges,,,88.46,83,,percent of total billed charges,,,,,,,,,,,,,,,88.46,83,,percent of total billed charges,,,101.25,95,,percent of total billed charges,,,95.92,90,,percent of total billed charges,,,95.92,90,,percent of total billed charges,,,87.4,82,,percent of total billed charges,,,95.92,90,,percent of total billed charges,,,90.59,85,,percent of total billed charges,,80.36,101.25,
FORMOTEROL (FORADIL) CAP : 12MCG  60'S,32000192,CDM,,,250,RC,inpatient,,847.12,847.12,,719.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,638.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,720.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,745.47,88,,percent of total billed charges,,,,,,,,,647.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,770.88,91,,percent of total billed charges,,,804.76,95,,percent of total billed charges,,,703.11,83,,percent of total billed charges,,,703.11,83,,percent of total billed charges,,,,,,,,,,,,,,,703.11,83,,percent of total billed charges,,,804.76,95,,percent of total billed charges,,,762.41,90,,percent of total billed charges,,,762.41,90,,percent of total billed charges,,,694.64,82,,percent of total billed charges,,,762.41,90,,percent of total billed charges,,,720.05,85,,percent of total billed charges,,638.73,804.76,
CIPROF/DXMTH(CIPRODEX)DRP:0.3-0.1% 7.5ML,32000193,CDM,J3490,HCPCS,250,RC,inpatient,UD,1942.45,1942.45,,1649.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1464.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1651.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1709.36,88,,percent of total billed charges,,,,,,,,,1484.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1767.63,91,,percent of total billed charges,,,1845.33,95,,percent of total billed charges,,,1612.23,83,,percent of total billed charges,,,1612.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1612.23,83,,percent of total billed charges,,,1845.33,95,,percent of total billed charges,,,1748.21,90,,percent of total billed charges,,,1748.21,90,,percent of total billed charges,,,1592.81,82,,percent of total billed charges,,,1748.21,90,,percent of total billed charges,,,1651.08,85,,percent of total billed charges,,1464.61,1845.33,
MEMANTINE(NAMENDA)TAB:5 MG,32000194,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
MONSEL'S SOLUTION BOTTLE:8ML UD,32000195,CDM,J3490,HCPCS,250,RC,inpatient,,272.71,272.71,,231.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,205.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,231.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,239.98,88,,percent of total billed charges,,,,,,,,,208.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,248.17,91,,percent of total billed charges,,,259.07,95,,percent of total billed charges,,,226.35,83,,percent of total billed charges,,,226.35,83,,percent of total billed charges,,,,,,,,,,,,,,,226.35,83,,percent of total billed charges,,,259.07,95,,percent of total billed charges,,,245.44,90,,percent of total billed charges,,,245.44,90,,percent of total billed charges,,,223.62,82,,percent of total billed charges,,,245.44,90,,percent of total billed charges,,,231.8,85,,percent of total billed charges,,205.62,259.07,
MORPHINE SULF VIAL:25MG/ML (20ML),32000196,CDM,,,250,RC,inpatient,,73.27,73.27,,62.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,55.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,62.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,64.48,88,,percent of total billed charges,,,,,,,,,55.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,66.68,91,,percent of total billed charges,,,69.61,95,,percent of total billed charges,,,60.81,83,,percent of total billed charges,,,60.81,83,,percent of total billed charges,,,,,,,,,,,,,,,60.81,83,,percent of total billed charges,,,69.61,95,,percent of total billed charges,,,65.94,90,,percent of total billed charges,,,65.94,90,,percent of total billed charges,,,60.08,82,,percent of total billed charges,,,65.94,90,,percent of total billed charges,,,62.28,85,,percent of total billed charges,,55.25,69.61,
HYDROcod/APAP(NORCO)TAB 10/325MG:,32000197,CDM,,,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
CLOTRIMAZOLE(GYNE-LOTRIMIN 3)TAB:200MG,32000198,CDM,,,250,RC,inpatient,,41.55,41.55,,35.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36.56,88,,percent of total billed charges,,,,,,,,,31.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37.81,91,,percent of total billed charges,,,39.47,95,,percent of total billed charges,,,34.49,83,,percent of total billed charges,,,34.49,83,,percent of total billed charges,,,,,,,,,,,,,,,34.49,83,,percent of total billed charges,,,39.47,95,,percent of total billed charges,,,37.4,90,,percent of total billed charges,,,37.4,90,,percent of total billed charges,,,34.07,82,,percent of total billed charges,,,37.4,90,,percent of total billed charges,,,35.32,85,,percent of total billed charges,,31.33,39.47,
TRAMADOL/ACETAMN(ULTRACET)TAB:37.5-325MG,32000199,CDM,,,250,RC,inpatient,,24.9,24.9,,21.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.91,88,,percent of total billed charges,,,,,,,,,19.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.66,91,,percent of total billed charges,,,23.66,95,,percent of total billed charges,,,20.67,83,,percent of total billed charges,,,20.67,83,,percent of total billed charges,,,,,,,,,,,,,,,20.67,83,,percent of total billed charges,,,23.66,95,,percent of total billed charges,,,22.41,90,,percent of total billed charges,,,22.41,90,,percent of total billed charges,,,20.42,82,,percent of total billed charges,,,22.41,90,,percent of total billed charges,,,21.17,85,,percent of total billed charges,,18.77,23.66,
teraZOSIN (HYTRIN) CAPS :10MG,32000200,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
NAPROXEN (NAPROSYN) TAB : 375MG,32000201,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
LIDOCAINE(LMX 4)CREAM 4%:30GM,32000202,CDM,J3490,HCPCS,250,RC,inpatient,,532.9,532.9,,452.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,401.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,452.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,468.95,88,,percent of total billed charges,,,,,,,,,407.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,484.94,91,,percent of total billed charges,,,506.26,95,,percent of total billed charges,,,442.31,83,,percent of total billed charges,,,442.31,83,,percent of total billed charges,,,,,,,,,,,,,,,442.31,83,,percent of total billed charges,,,506.26,95,,percent of total billed charges,,,479.61,90,,percent of total billed charges,,,479.61,90,,percent of total billed charges,,,436.98,82,,percent of total billed charges,,,479.61,90,,percent of total billed charges,,,452.97,85,,percent of total billed charges,,401.81,506.26,
HC/PRAMOX(PRAMOSONE)OINT1%-1%:28.4GM,32000203,CDM,,,250,RC,inpatient,,2075.54,2075.54,,1762.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1564.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1764.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1826.48,88,,percent of total billed charges,,,,,,,,,1585.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1888.74,91,,percent of total billed charges,,,1971.76,95,,percent of total billed charges,,,1722.7,83,,percent of total billed charges,,,1722.7,83,,percent of total billed charges,,,,,,,,,,,,,,,1722.7,83,,percent of total billed charges,,,1971.76,95,,percent of total billed charges,,,1867.99,90,,percent of total billed charges,,,1867.99,90,,percent of total billed charges,,,1701.94,82,,percent of total billed charges,,,1867.99,90,,percent of total billed charges,,,1764.21,85,,percent of total billed charges,,1564.96,1971.76,
ONDANSETRON HCL (ZOFRAN) TAB : 24MG,32000204,CDM,,,250,RC,inpatient,,1343.46,1343.46,,1140.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1012.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1141.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1182.24,88,,percent of total billed charges,,,,,,,,,1026.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1222.55,91,,percent of total billed charges,,,1276.29,95,,percent of total billed charges,,,1115.07,83,,percent of total billed charges,,,1115.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1115.07,83,,percent of total billed charges,,,1276.29,95,,percent of total billed charges,,,1209.11,90,,percent of total billed charges,,,1209.11,90,,percent of total billed charges,,,1101.64,82,,percent of total billed charges,,,1209.11,90,,percent of total billed charges,,,1141.94,85,,percent of total billed charges,,1012.97,1276.29,
ONDANSETRON(ZOFRAN)TAB:4MG,32000205,CDM,,,250,RC,inpatient,,17.45,17.45,,14.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.36,88,,percent of total billed charges,,,,,,,,,13.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.88,91,,percent of total billed charges,,,16.58,95,,percent of total billed charges,,,14.48,83,,percent of total billed charges,,,14.48,83,,percent of total billed charges,,,,,,,,,,,,,,,14.48,83,,percent of total billed charges,,,16.58,95,,percent of total billed charges,,,15.71,90,,percent of total billed charges,,,15.71,90,,percent of total billed charges,,,14.31,82,,percent of total billed charges,,,15.71,90,,percent of total billed charges,,,14.83,85,,percent of total billed charges,,13.16,16.58,
MOMETASONE(ELOCON)CREAM 0.1%:15GM,32000207,CDM,,,250,RC,inpatient,,789.04,789.04,,669.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,594.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,670.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,694.36,88,,percent of total billed charges,,,,,,,,,602.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,718.03,91,,percent of total billed charges,,,749.59,95,,percent of total billed charges,,,654.9,83,,percent of total billed charges,,,654.9,83,,percent of total billed charges,,,,,,,,,,,,,,,654.9,83,,percent of total billed charges,,,749.59,95,,percent of total billed charges,,,710.14,90,,percent of total billed charges,,,710.14,90,,percent of total billed charges,,,647.01,82,,percent of total billed charges,,,710.14,90,,percent of total billed charges,,,670.68,85,,percent of total billed charges,,594.94,749.59,
MEMANTINE HCL (NAMENDA) TAB : 10MG,32000208,CDM,,,250,RC,inpatient,,123.39,123.39,,104.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,104.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,108.58,88,,percent of total billed charges,,,,,,,,,94.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.28,91,,percent of total billed charges,,,117.22,95,,percent of total billed charges,,,102.41,83,,percent of total billed charges,,,102.41,83,,percent of total billed charges,,,,,,,,,,,,,,,102.41,83,,percent of total billed charges,,,117.22,95,,percent of total billed charges,,,111.05,90,,percent of total billed charges,,,111.05,90,,percent of total billed charges,,,101.18,82,,percent of total billed charges,,,111.05,90,,percent of total billed charges,,,104.88,85,,percent of total billed charges,,93.04,117.22,
VALDECOXIB (BEXTRA) TAB : 20MG,32000209,CDM,,,250,RC,inpatient,,46.79,46.79,,39.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.18,88,,percent of total billed charges,,,,,,,,,35.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.58,91,,percent of total billed charges,,,44.45,95,,percent of total billed charges,,,38.84,83,,percent of total billed charges,,,38.84,83,,percent of total billed charges,,,,,,,,,,,,,,,38.84,83,,percent of total billed charges,,,44.45,95,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,38.37,82,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,39.77,85,,percent of total billed charges,,35.28,44.45,
BALSALAZIDE DISODIUM (COLAZAL) CAP:750MG,32000210,CDM,,,250,RC,inpatient,,92.78,92.78,,78.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,69.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,78.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.65,88,,percent of total billed charges,,,,,,,,,70.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.43,91,,percent of total billed charges,,,88.14,95,,percent of total billed charges,,,77.01,83,,percent of total billed charges,,,77.01,83,,percent of total billed charges,,,,,,,,,,,,,,,77.01,83,,percent of total billed charges,,,88.14,95,,percent of total billed charges,,,83.5,90,,percent of total billed charges,,,83.5,90,,percent of total billed charges,,,76.08,82,,percent of total billed charges,,,83.5,90,,percent of total billed charges,,,78.86,85,,percent of total billed charges,,69.96,88.14,
MORPHINE(ASTRAMORPH)INJ:10MG/10ML,32000212,CDM,J2274,HCPCS,250,RC,inpatient,,114.05,114.05,,96.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,100.36,88,,percent of total billed charges,,11.83,,,,fee schedule,,,87.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11.83,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,103.79,91,,percent of total billed charges,,,108.35,95,,percent of total billed charges,,,94.66,83,,percent of total billed charges,,,94.66,83,,percent of total billed charges,,,,,,,,,,,,,,,94.66,83,,percent of total billed charges,,,108.35,95,,percent of total billed charges,,,102.65,90,,percent of total billed charges,,,102.65,90,,percent of total billed charges,,,93.52,82,,percent of total billed charges,,,102.65,90,,percent of total billed charges,,,96.94,85,,percent of total billed charges,,11.83,108.35,
FENOFIBRATE MICRONIZED (TRICOR) TAB:54MG,32000214,CDM,,,250,RC,inpatient,,15.7,15.7,,13.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.82,88,,percent of total billed charges,,,,,,,,,11.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.29,91,,percent of total billed charges,,,14.92,95,,percent of total billed charges,,,13.03,83,,percent of total billed charges,,,13.03,83,,percent of total billed charges,,,,,,,,,,,,,,,13.03,83,,percent of total billed charges,,,14.92,95,,percent of total billed charges,,,14.13,90,,percent of total billed charges,,,14.13,90,,percent of total billed charges,,,12.87,82,,percent of total billed charges,,,14.13,90,,percent of total billed charges,,,13.35,85,,percent of total billed charges,,11.84,14.92,
LEVOTHYROXINE SOD (LEVOTHROID)TAB:175MCG,32000215,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PARoxetine(PAXIL)TAB:10MG,32000216,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
AMINOPHYLLINE 200MG TABS,32000217,CDM,,,250,RC,inpatient,,1.1,1.1,,0.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,0.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,0.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,0.97,88,,percent of total billed charges,,,,,,,,,0.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1,91,,percent of total billed charges,,,1.05,95,,percent of total billed charges,,,0.91,83,,percent of total billed charges,,,0.91,83,,percent of total billed charges,,,,,,,,,,,,,,,0.91,83,,percent of total billed charges,,,1.05,95,,percent of total billed charges,,,0.99,90,,percent of total billed charges,,,0.99,90,,percent of total billed charges,,,0.9,82,,percent of total billed charges,,,0.99,90,,percent of total billed charges,,,0.94,85,,percent of total billed charges,,0.83,1.05,
HEXACHLOROPH(PHISOHEX) LIQ 3%:473ML,32000218,CDM,,,250,RC,inpatient,,720.38,720.38,,611.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,543.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,612.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,633.93,88,,percent of total billed charges,,,,,,,,,550.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,655.55,91,,percent of total billed charges,,,684.36,95,,percent of total billed charges,,,597.92,83,,percent of total billed charges,,,597.92,83,,percent of total billed charges,,,,,,,,,,,,,,,597.92,83,,percent of total billed charges,,,684.36,95,,percent of total billed charges,,,648.34,90,,percent of total billed charges,,,648.34,90,,percent of total billed charges,,,590.71,82,,percent of total billed charges,,,648.34,90,,percent of total billed charges,,,612.32,85,,percent of total billed charges,,543.17,684.36,
DIVALPROEX (DEPAKOTE DR) TAB : 500MG,32000219,CDM,,,250,RC,inpatient,,69.78,69.78,,59.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,59.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,61.41,88,,percent of total billed charges,,,,,,,,,53.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,63.5,91,,percent of total billed charges,,,66.29,95,,percent of total billed charges,,,57.92,83,,percent of total billed charges,,,57.92,83,,percent of total billed charges,,,,,,,,,,,,,,,57.92,83,,percent of total billed charges,,,66.29,95,,percent of total billed charges,,,62.8,90,,percent of total billed charges,,,62.8,90,,percent of total billed charges,,,57.22,82,,percent of total billed charges,,,62.8,90,,percent of total billed charges,,,59.31,85,,percent of total billed charges,,52.61,66.29,
CALCIUM ACETATE (PHOSLO) TAB : 667MG,32000220,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PERGOLIDE (PERMAX) TAB : 0.25MG,32000221,CDM,,,250,RC,inpatient,,23.31,23.31,,19.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.51,88,,percent of total billed charges,,,,,,,,,17.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.21,91,,percent of total billed charges,,,22.14,95,,percent of total billed charges,,,19.35,83,,percent of total billed charges,,,19.35,83,,percent of total billed charges,,,,,,,,,,,,,,,19.35,83,,percent of total billed charges,,,22.14,95,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,19.11,82,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,19.81,85,,percent of total billed charges,,17.58,22.14,
CLORAZEPATE (TRANXENE) TAB : 7.5MG,32000222,CDM,,,250,RC,inpatient,,21.73,21.73,,18.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.12,88,,percent of total billed charges,,,,,,,,,16.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.77,91,,percent of total billed charges,,,20.64,95,,percent of total billed charges,,,18.04,83,,percent of total billed charges,,,18.04,83,,percent of total billed charges,,,,,,,,,,,,,,,18.04,83,,percent of total billed charges,,,20.64,95,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,17.82,82,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,18.47,85,,percent of total billed charges,,16.38,20.64,
OXYBUTYNIN (DITROPAN XL) TAB : 10MG,32000223,CDM,,,250,RC,inpatient,,57.25,57.25,,48.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.38,88,,percent of total billed charges,,,,,,,,,43.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52.1,91,,percent of total billed charges,,,54.39,95,,percent of total billed charges,,,47.52,83,,percent of total billed charges,,,47.52,83,,percent of total billed charges,,,,,,,,,,,,,,,47.52,83,,percent of total billed charges,,,54.39,95,,percent of total billed charges,,,51.53,90,,percent of total billed charges,,,51.53,90,,percent of total billed charges,,,46.95,82,,percent of total billed charges,,,51.53,90,,percent of total billed charges,,,48.66,85,,percent of total billed charges,,43.17,54.39,
TRAVOPROST(TRAVATAN)DROP:2.5ML,32000224,CDM,J3490,HCPCS,250,RC,inpatient,,1903.64,1903.64,,1616.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1435.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1618.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1675.2,88,,percent of total billed charges,,,,,,,,,1454.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1732.31,91,,percent of total billed charges,,,1808.46,95,,percent of total billed charges,,,1580.02,83,,percent of total billed charges,,,1580.02,83,,percent of total billed charges,,,,,,,,,,,,,,,1580.02,83,,percent of total billed charges,,,1808.46,95,,percent of total billed charges,,,1713.28,90,,percent of total billed charges,,,1713.28,90,,percent of total billed charges,,,1560.98,82,,percent of total billed charges,,,1713.28,90,,percent of total billed charges,,,1618.09,85,,percent of total billed charges,,1435.34,1808.46,
PRIMIDONE(MYSOLINE)TAB:50MG,32000225,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
BISMUT SUBS(PEPTOBISMOL)262MG/15ML:118ML,32000226,CDM,J8499,HCPCS,250,RC,inpatient,,44.77,44.77,,38.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.4,88,,percent of total billed charges,,,,,,,,,34.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.74,91,,percent of total billed charges,,,42.53,95,,percent of total billed charges,,,37.16,83,,percent of total billed charges,,,37.16,83,,percent of total billed charges,,,,,,,,,,,,,,,37.16,83,,percent of total billed charges,,,42.53,95,,percent of total billed charges,,,40.29,90,,percent of total billed charges,,,40.29,90,,percent of total billed charges,,,36.71,82,,percent of total billed charges,,,40.29,90,,percent of total billed charges,,,38.05,85,,percent of total billed charges,,33.76,42.53,
MODAFINIL (PROVIGIL) TAB : 100MG,32000228,CDM,,,250,RC,inpatient,,407.13,407.13,,345.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,346.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,358.27,88,,percent of total billed charges,,,,,,,,,311.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,370.49,91,,percent of total billed charges,,,386.77,95,,percent of total billed charges,,,337.92,83,,percent of total billed charges,,,337.92,83,,percent of total billed charges,,,,,,,,,,,,,,,337.92,83,,percent of total billed charges,,,386.77,95,,percent of total billed charges,,,366.42,90,,percent of total billed charges,,,366.42,90,,percent of total billed charges,,,333.85,82,,percent of total billed charges,,,366.42,90,,percent of total billed charges,,,346.06,85,,percent of total billed charges,,306.98,386.77,
SERTRALINE HCL (ZOLOFT) TAB : 25MG,32000229,CDM,,,250,RC,inpatient,,40.13,40.13,,34.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.31,88,,percent of total billed charges,,,,,,,,,30.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.52,91,,percent of total billed charges,,,38.12,95,,percent of total billed charges,,,33.31,83,,percent of total billed charges,,,33.31,83,,percent of total billed charges,,,,,,,,,,,,,,,33.31,83,,percent of total billed charges,,,38.12,95,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,32.91,82,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,34.11,85,,percent of total billed charges,,30.26,38.12,
CAL 600MG/VIT D 200MG TAB,32000230,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
URSODIOL (ACTIGALL) CAP : 300MG,32000232,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
RIVASTIGMINE (EXELON) CAP : 3MG,32000233,CDM,,,250,RC,inpatient,,78.98,78.98,,67.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.5,88,,percent of total billed charges,,,,,,,,,60.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.87,91,,percent of total billed charges,,,75.03,95,,percent of total billed charges,,,65.55,83,,percent of total billed charges,,,65.55,83,,percent of total billed charges,,,,,,,,,,,,,,,65.55,83,,percent of total billed charges,,,75.03,95,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,64.76,82,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,67.13,85,,percent of total billed charges,,59.55,75.03,
MELOXICAM(MOBIC)TAB:7.5MG,32000234,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
TIOTROPIUM(SPIRIVA)CAP:18MCG (5'S),32000235,CDM,J3490,HCPCS,250,RC,inpatient,,715.8,715.8,,607.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,539.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,608.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,629.9,88,,percent of total billed charges,,,,,,,,,546.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,651.38,91,,percent of total billed charges,,,680.01,95,,percent of total billed charges,,,594.11,83,,percent of total billed charges,,,594.11,83,,percent of total billed charges,,,,,,,,,,,,,,,594.11,83,,percent of total billed charges,,,680.01,95,,percent of total billed charges,,,644.22,90,,percent of total billed charges,,,644.22,90,,percent of total billed charges,,,586.96,82,,percent of total billed charges,,,644.22,90,,percent of total billed charges,,,608.43,85,,percent of total billed charges,,539.71,680.01,
ACARBOSE (PRECOSE) TAB : 50MG,32000236,CDM,,,250,RC,inpatient,,14.43,14.43,,12.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.7,88,,percent of total billed charges,,,,,,,,,11.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.13,91,,percent of total billed charges,,,13.71,95,,percent of total billed charges,,,11.98,83,,percent of total billed charges,,,11.98,83,,percent of total billed charges,,,,,,,,,,,,,,,11.98,83,,percent of total billed charges,,,13.71,95,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,11.83,82,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,12.27,85,,percent of total billed charges,,10.88,13.71,
ROPINIROLE HCL (REQUIP) TAB : 0.5MG,32000237,CDM,,,250,RC,inpatient,,93.57,93.57,,79.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,82.34,88,,percent of total billed charges,,,,,,,,,71.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,85.15,91,,percent of total billed charges,,,88.89,95,,percent of total billed charges,,,77.66,83,,percent of total billed charges,,,77.66,83,,percent of total billed charges,,,,,,,,,,,,,,,77.66,83,,percent of total billed charges,,,88.89,95,,percent of total billed charges,,,84.21,90,,percent of total billed charges,,,84.21,90,,percent of total billed charges,,,76.73,82,,percent of total billed charges,,,84.21,90,,percent of total billed charges,,,79.53,85,,percent of total billed charges,,70.55,88.89,
ROPINIROLE HCL (REQUIP) TAB : 2MG,32000238,CDM,,,250,RC,inpatient,,93.57,93.57,,79.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,82.34,88,,percent of total billed charges,,,,,,,,,71.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,85.15,91,,percent of total billed charges,,,88.89,95,,percent of total billed charges,,,77.66,83,,percent of total billed charges,,,77.66,83,,percent of total billed charges,,,,,,,,,,,,,,,77.66,83,,percent of total billed charges,,,88.89,95,,percent of total billed charges,,,84.21,90,,percent of total billed charges,,,84.21,90,,percent of total billed charges,,,76.73,82,,percent of total billed charges,,,84.21,90,,percent of total billed charges,,,79.53,85,,percent of total billed charges,,70.55,88.89,
BIMATOPROST(LUMIGAN)DROP 0.03%:2.5ML,32000239,CDM,,,250,RC,inpatient,,1368.6,1368.6,,1161.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1031.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1163.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1204.37,88,,percent of total billed charges,,,,,,,,,1045.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1245.43,91,,percent of total billed charges,,,1300.17,95,,percent of total billed charges,,,1135.94,83,,percent of total billed charges,,,1135.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1135.94,83,,percent of total billed charges,,,1300.17,95,,percent of total billed charges,,,1231.74,90,,percent of total billed charges,,,1231.74,90,,percent of total billed charges,,,1122.25,82,,percent of total billed charges,,,1231.74,90,,percent of total billed charges,,,1163.31,85,,percent of total billed charges,,1031.92,1300.17,
ROSUVASTATIN(CRESTOR)TAB:10MG,32000240,CDM,,,250,RC,inpatient,,17.97,17.97,,15.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.81,88,,percent of total billed charges,,,,,,,,,13.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.35,91,,percent of total billed charges,,,17.07,95,,percent of total billed charges,,,14.92,83,,percent of total billed charges,,,14.92,83,,percent of total billed charges,,,,,,,,,,,,,,,14.92,83,,percent of total billed charges,,,17.07,95,,percent of total billed charges,,,16.17,90,,percent of total billed charges,,,16.17,90,,percent of total billed charges,,,14.74,82,,percent of total billed charges,,,16.17,90,,percent of total billed charges,,,15.27,85,,percent of total billed charges,,13.55,17.07,
PRIMIDONE (MYSOLINE) TAB : 250MG,32000241,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ROPINIROLE HCL (REQUIP) TAB : 3MG,32000242,CDM,,,250,RC,inpatient,,97.06,97.06,,82.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,73.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,82.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,85.41,88,,percent of total billed charges,,,,,,,,,74.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,88.32,91,,percent of total billed charges,,,92.21,95,,percent of total billed charges,,,80.56,83,,percent of total billed charges,,,80.56,83,,percent of total billed charges,,,,,,,,,,,,,,,80.56,83,,percent of total billed charges,,,92.21,95,,percent of total billed charges,,,87.35,90,,percent of total billed charges,,,87.35,90,,percent of total billed charges,,,79.59,82,,percent of total billed charges,,,87.35,90,,percent of total billed charges,,,82.5,85,,percent of total billed charges,,73.18,92.21,
ZIDOVUDINE(RETROVIR)SYRP:10MG/ML (30ML),32000243,CDM,,,250,RC,inpatient,,98.49,98.49,,83.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,74.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,83.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,86.67,88,,percent of total billed charges,,,,,,,,,75.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,89.63,91,,percent of total billed charges,,,93.57,95,,percent of total billed charges,,,81.75,83,,percent of total billed charges,,,81.75,83,,percent of total billed charges,,,,,,,,,,,,,,,81.75,83,,percent of total billed charges,,,93.57,95,,percent of total billed charges,,,88.64,90,,percent of total billed charges,,,88.64,90,,percent of total billed charges,,,80.76,82,,percent of total billed charges,,,88.64,90,,percent of total billed charges,,,83.72,85,,percent of total billed charges,,74.26,93.57,
ZIDOVUDINE(RETROVIR IV)VIAL:200MG/20ML,32000244,CDM,J3485,HCPCS,250,RC,inpatient,,475.17,475.17,,403.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,358.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,403.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,418.15,88,,percent of total billed charges,,30.22,,,,fee schedule,,,363.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,30.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,432.4,91,,percent of total billed charges,,,451.41,95,,percent of total billed charges,,,394.39,83,,percent of total billed charges,,,394.39,83,,percent of total billed charges,,,,,,,,,,,,,,,394.39,83,,percent of total billed charges,,,451.41,95,,percent of total billed charges,,,427.65,90,,percent of total billed charges,,,427.65,90,,percent of total billed charges,,,389.64,82,,percent of total billed charges,,,427.65,90,,percent of total billed charges,,,403.89,85,,percent of total billed charges,,30.22,451.41,
oxyCODONE/ACETAMN(PERCOCET) 5MG-325MG:,32000245,CDM,,,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
DINOPROSTONE(PROSTIN E2)SUPP:20MG,32000246,CDM,,,250,RC,inpatient,,10485.76,10485.76,,8902.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7906.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8912.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9227.47,88,,percent of total billed charges,,,,,,,,,8011.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9542.04,91,,percent of total billed charges,,,9961.47,95,,percent of total billed charges,,,8703.18,83,,percent of total billed charges,,,8703.18,83,,percent of total billed charges,,,,,,,,,,,,,,,8703.18,83,,percent of total billed charges,,,9961.47,95,,percent of total billed charges,,,9437.18,90,,percent of total billed charges,,,9437.18,90,,percent of total billed charges,,,8598.32,82,,percent of total billed charges,,,9437.18,90,,percent of total billed charges,,,8912.9,85,,percent of total billed charges,,7906.26,9961.47,
VITAMIN B COMP W-C TAB,32000248,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
LANSOPRAZOLE (PREVACID) SOLU-TAB : 30MG,32000249,CDM,,,250,RC,inpatient,,59.95,59.95,,50.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,45.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.76,88,,percent of total billed charges,,,,,,,,,45.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,54.55,91,,percent of total billed charges,,,56.95,95,,percent of total billed charges,,,49.76,83,,percent of total billed charges,,,49.76,83,,percent of total billed charges,,,,,,,,,,,,,,,49.76,83,,percent of total billed charges,,,56.95,95,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,49.16,82,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,50.96,85,,percent of total billed charges,,45.2,56.95,
OLMESARTAN(BENICAR)TAB:40MG,32000250,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
RISPERIDONE (RISPERDAL) TAB : 1MG,32000251,CDM,,,250,RC,inpatient,,81.52,81.52,,69.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,69.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.74,88,,percent of total billed charges,,,,,,,,,62.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,74.18,91,,percent of total billed charges,,,77.44,95,,percent of total billed charges,,,67.66,83,,percent of total billed charges,,,67.66,83,,percent of total billed charges,,,,,,,,,,,,,,,67.66,83,,percent of total billed charges,,,77.44,95,,percent of total billed charges,,,73.37,90,,percent of total billed charges,,,73.37,90,,percent of total billed charges,,,66.85,82,,percent of total billed charges,,,73.37,90,,percent of total billed charges,,,69.29,85,,percent of total billed charges,,61.47,77.44,
SODIUM CHLORIDE FOR INHAL VL0.9%:5ML(RT),32000252,CDM,,,250,RC,inpatient,,7.5,7.5,,6.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6.6,88,,percent of total billed charges,,,,,,,,,5.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6.83,91,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,,,,,,,,,,,,,6.23,83,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.15,82,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,5.66,7.13,
LOVASTATIN (MEVACOR) TAB : 40MG,32000253,CDM,,,250,RC,inpatient,,19.51,19.51,,16.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.17,88,,percent of total billed charges,,,,,,,,,14.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.75,91,,percent of total billed charges,,,18.53,95,,percent of total billed charges,,,16.19,83,,percent of total billed charges,,,16.19,83,,percent of total billed charges,,,,,,,,,,,,,,,16.19,83,,percent of total billed charges,,,18.53,95,,percent of total billed charges,,,17.56,90,,percent of total billed charges,,,17.56,90,,percent of total billed charges,,,16,82,,percent of total billed charges,,,17.56,90,,percent of total billed charges,,,16.58,85,,percent of total billed charges,,14.71,18.53,
TOPIRAMATE(TOPAMAX)TAB:25MG,32000254,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DICLOFENAC (VOLTARAN) TAB : 100MG,32000257,CDM,,,250,RC,inpatient,,37.43,37.43,,31.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.94,88,,percent of total billed charges,,,,,,,,,28.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.06,91,,percent of total billed charges,,,35.56,95,,percent of total billed charges,,,31.07,83,,percent of total billed charges,,,31.07,83,,percent of total billed charges,,,,,,,,,,,,,,,31.07,83,,percent of total billed charges,,,35.56,95,,percent of total billed charges,,,33.69,90,,percent of total billed charges,,,33.69,90,,percent of total billed charges,,,30.69,82,,percent of total billed charges,,,33.69,90,,percent of total billed charges,,,31.82,85,,percent of total billed charges,,28.22,35.56,
METHYLCELLULOSE(CITRUCEL)PAC U/D:,32000258,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
HYDROcod/APAP (NORCO)TAB 7.5-325MG:,32000259,CDM,,,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
RIVASTIGMINE (EXELON) CAP : 6MG,32000260,CDM,,,250,RC,inpatient,,78.98,78.98,,67.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.5,88,,percent of total billed charges,,,,,,,,,60.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.87,91,,percent of total billed charges,,,75.03,95,,percent of total billed charges,,,65.55,83,,percent of total billed charges,,,65.55,83,,percent of total billed charges,,,,,,,,,,,,,,,65.55,83,,percent of total billed charges,,,75.03,95,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,64.76,82,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,67.13,85,,percent of total billed charges,,59.55,75.03,
ALENDRONATE (FOSAMAX) SOL:70MG/75ML,32000262,CDM,,,250,RC,inpatient,,393.33,393.33,,333.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,296.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,334.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,346.13,88,,percent of total billed charges,,,,,,,,,300.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,357.93,91,,percent of total billed charges,,,373.66,95,,percent of total billed charges,,,326.46,83,,percent of total billed charges,,,326.46,83,,percent of total billed charges,,,,,,,,,,,,,,,326.46,83,,percent of total billed charges,,,373.66,95,,percent of total billed charges,,,354,90,,percent of total billed charges,,,354,90,,percent of total billed charges,,,322.53,82,,percent of total billed charges,,,354,90,,percent of total billed charges,,,334.33,85,,percent of total billed charges,,296.57,373.66,
TROSPIUM(SANCTURA)TAB:20MG,32000263,CDM,,,250,RC,inpatient,,40.6,40.6,,34.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.73,88,,percent of total billed charges,,,,,,,,,31.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.95,91,,percent of total billed charges,,,38.57,95,,percent of total billed charges,,,33.7,83,,percent of total billed charges,,,33.7,83,,percent of total billed charges,,,,,,,,,,,,,,,33.7,83,,percent of total billed charges,,,38.57,95,,percent of total billed charges,,,36.54,90,,percent of total billed charges,,,36.54,90,,percent of total billed charges,,,33.29,82,,percent of total billed charges,,,36.54,90,,percent of total billed charges,,,34.51,85,,percent of total billed charges,,30.61,38.57,
ACYCLOVIR(ZOVIRAX):500MG/10ML,32000264,CDM,J0133,HCPCS,636,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,31.5,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,31.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,31.5,60.99,
OXICONAZOLE (OXISTAT) CREAM : 1%  30 GM,32000265,CDM,,,250,RC,inpatient,,725.36,725.36,,615.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,546.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,616.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,638.32,88,,percent of total billed charges,,,,,,,,,554.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,660.08,91,,percent of total billed charges,,,689.09,95,,percent of total billed charges,,,602.05,83,,percent of total billed charges,,,602.05,83,,percent of total billed charges,,,,,,,,,,,,,,,602.05,83,,percent of total billed charges,,,689.09,95,,percent of total billed charges,,,652.82,90,,percent of total billed charges,,,652.82,90,,percent of total billed charges,,,594.8,82,,percent of total billed charges,,,652.82,90,,percent of total billed charges,,,616.56,85,,percent of total billed charges,,546.92,689.09,
FLUTICA/SALMET(ADVAIR DISK):500-50MCG,32000267,CDM,J7699,HCPCS,250,RC,inpatient,,567.49,567.49,,481.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,427.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,482.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,499.39,88,,percent of total billed charges,,,,,,,,,433.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,516.42,91,,percent of total billed charges,,,539.12,95,,percent of total billed charges,,,471.02,83,,percent of total billed charges,,,471.02,83,,percent of total billed charges,,,,,,,,,,,,,,,471.02,83,,percent of total billed charges,,,539.12,95,,percent of total billed charges,,,510.74,90,,percent of total billed charges,,,510.74,90,,percent of total billed charges,,,465.34,82,,percent of total billed charges,,,510.74,90,,percent of total billed charges,,,482.37,85,,percent of total billed charges,,427.89,539.12,
tiZANidine(ZANAFLEX)TAB:2MG,32000268,CDM,,,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
IV LR 1000ML+PITOCIN:20UNITS (COMPD),32000269,CDM,,,258,RC,inpatient,,261.16,261.16,,221.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,196.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,221.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,229.82,88,,percent of total billed charges,,,,,,,,,199.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.66,91,,percent of total billed charges,,,248.1,95,,percent of total billed charges,,,216.76,83,,percent of total billed charges,,,216.76,83,,percent of total billed charges,,,,,,,,,,,,,,,216.76,83,,percent of total billed charges,,,248.1,95,,percent of total billed charges,,,235.04,90,,percent of total billed charges,,,235.04,90,,percent of total billed charges,,,214.15,82,,percent of total billed charges,,,235.04,90,,percent of total billed charges,,,221.99,85,,percent of total billed charges,,196.91,248.1,
EUCERIN (HYDROCERIN) CREAM:120ML,32000270,CDM,J3490,HCPCS,250,RC,inpatient,,49.35,49.35,,41.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,43.43,88,,percent of total billed charges,,,,,,,,,37.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,44.91,91,,percent of total billed charges,,,46.88,95,,percent of total billed charges,,,40.96,83,,percent of total billed charges,,,40.96,83,,percent of total billed charges,,,,,,,,,,,,,,,40.96,83,,percent of total billed charges,,,46.88,95,,percent of total billed charges,,,44.42,90,,percent of total billed charges,,,44.42,90,,percent of total billed charges,,,40.47,82,,percent of total billed charges,,,44.42,90,,percent of total billed charges,,,41.95,85,,percent of total billed charges,,37.21,46.88,
HYDROcod/APAP(NORCO)TAB 5-325MG:,32000271,CDM,,,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
ALTEPLACE(CATHFLO)VIAL:2MG,32000272,CDM,J2997,HCPCS,636,RC,inpatient,,2300.48,2300.48,,1953.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1734.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1955.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2024.42,88,,percent of total billed charges,,176.06,,,,fee schedule,,,1757.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,176.06,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2093.44,91,,percent of total billed charges,,,2185.46,95,,percent of total billed charges,,,1909.4,83,,percent of total billed charges,,,1909.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1909.4,83,,percent of total billed charges,,,2185.46,95,,percent of total billed charges,,,2070.43,90,,percent of total billed charges,,,2070.43,90,,percent of total billed charges,,,1886.39,82,,percent of total billed charges,,,2070.43,90,,percent of total billed charges,,,1955.41,85,,percent of total billed charges,,176.06,2185.46,
metoPROLOL TART(LOPRESSOR)TAB:25MG,32000273,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ATORVASTATIN CALCIUM(LIPITOR) TAB 80 MG:,32000274,CDM,,,250,RC,inpatient,,273.9,273.9,,232.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,206.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,232.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,241.03,88,,percent of total billed charges,,,,,,,,,209.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,249.25,91,,percent of total billed charges,,,260.21,95,,percent of total billed charges,,,227.34,83,,percent of total billed charges,,,227.34,83,,percent of total billed charges,,,,,,,,,,,,,,,227.34,83,,percent of total billed charges,,,260.21,95,,percent of total billed charges,,,246.51,90,,percent of total billed charges,,,246.51,90,,percent of total billed charges,,,224.6,82,,percent of total billed charges,,,246.51,90,,percent of total billed charges,,,232.82,85,,percent of total billed charges,,206.52,260.21,
ZALEPLON (SONATA) CAP : 10MG,32000275,CDM,,,250,RC,inpatient,,179.22,179.22,,152.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,135.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,152.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,157.71,88,,percent of total billed charges,,,,,,,,,136.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,163.09,91,,percent of total billed charges,,,170.26,95,,percent of total billed charges,,,148.75,83,,percent of total billed charges,,,148.75,83,,percent of total billed charges,,,,,,,,,,,,,,,148.75,83,,percent of total billed charges,,,170.26,95,,percent of total billed charges,,,161.3,90,,percent of total billed charges,,,161.3,90,,percent of total billed charges,,,146.96,82,,percent of total billed charges,,,161.3,90,,percent of total billed charges,,,152.34,85,,percent of total billed charges,,135.13,170.26,
PILOCARPINE HCL TAB : 5MG,32000277,CDM,,,250,RC,inpatient,,20.3,20.3,,17.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.86,88,,percent of total billed charges,,,,,,,,,15.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.47,91,,percent of total billed charges,,,19.29,95,,percent of total billed charges,,,16.85,83,,percent of total billed charges,,,16.85,83,,percent of total billed charges,,,,,,,,,,,,,,,16.85,83,,percent of total billed charges,,,19.29,95,,percent of total billed charges,,,18.27,90,,percent of total billed charges,,,18.27,90,,percent of total billed charges,,,16.65,82,,percent of total billed charges,,,18.27,90,,percent of total billed charges,,,17.26,85,,percent of total billed charges,,15.31,19.29,
DULoxetine(CYMBALTA)CAP:30MG,32000278,CDM,J8499,HCPCS,250,RC,inpatient,,17.65,17.65,,14.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.53,88,,percent of total billed charges,,,,,,,,,13.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.06,91,,percent of total billed charges,,,16.77,95,,percent of total billed charges,,,14.65,83,,percent of total billed charges,,,14.65,83,,percent of total billed charges,,,,,,,,,,,,,,,14.65,83,,percent of total billed charges,,,16.77,95,,percent of total billed charges,,,15.89,90,,percent of total billed charges,,,15.89,90,,percent of total billed charges,,,14.47,82,,percent of total billed charges,,,15.89,90,,percent of total billed charges,,,15,85,,percent of total billed charges,,13.31,16.77,
DULoxetine(CYMBALTA)CAP:20MG,32000279,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ZOLEDRONIC(ZOMETA)VIAL: 4MG/5ML,32000280,CDM,J3489,HCPCS,636,RC,inpatient,,135.3,135.3,,114.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,102.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,115.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,119.06,88,,percent of total billed charges,,41.84,,,,fee schedule,,,103.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,41.84,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,123.12,91,,percent of total billed charges,,,128.54,95,,percent of total billed charges,,,112.3,83,,percent of total billed charges,,,112.3,83,,percent of total billed charges,,,,,,,,,,,,,,,112.3,83,,percent of total billed charges,,,128.54,95,,percent of total billed charges,,,121.77,90,,percent of total billed charges,,,121.77,90,,percent of total billed charges,,,110.95,82,,percent of total billed charges,,,121.77,90,,percent of total billed charges,,,115.01,85,,percent of total billed charges,,41.84,128.54,
DICLOFENAC(VOLTARAN) DR TAB:75MG,32000281,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LEVOBUNOLOL (BETAGAN) DROP : 0.5%   5 ML,32000282,CDM,,,250,RC,inpatient,,31.24,31.24,,26.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.49,88,,percent of total billed charges,,,,,,,,,23.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.43,91,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,,,,,,,,,,,,,25.93,83,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,25.62,82,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,26.55,85,,percent of total billed charges,,23.55,29.68,
FLUTICASONE(FLOVENT HFA)AER:110MCG  12GM,32000283,CDM,,,250,RC,inpatient,,435,435,,369.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,327.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,369.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,382.8,88,,percent of total billed charges,,,,,,,,,332.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,395.85,91,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,,,,,,,,,,,,,361.05,83,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,356.7,82,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,327.99,413.25,
CYANOCOBALAMIN(VITAMIN B-12)TAB:100MCG,32000284,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LOVASTATIN(ALTOPREV)TAB:40MG,32000285,CDM,,,250,RC,inpatient,,425.52,425.52,,361.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,320.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,361.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,374.46,88,,percent of total billed charges,,,,,,,,,325.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,387.22,91,,percent of total billed charges,,,404.24,95,,percent of total billed charges,,,353.18,83,,percent of total billed charges,,,353.18,83,,percent of total billed charges,,,,,,,,,,,,,,,353.18,83,,percent of total billed charges,,,404.24,95,,percent of total billed charges,,,382.97,90,,percent of total billed charges,,,382.97,90,,percent of total billed charges,,,348.93,82,,percent of total billed charges,,,382.97,90,,percent of total billed charges,,,361.69,85,,percent of total billed charges,,320.84,404.24,
AZITHROMYCIN(ZITHROMA)SUS:200MG/5ML 22.5,32000286,CDM,,,250,RC,inpatient,,435.67,435.67,,369.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,328.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,370.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,383.39,88,,percent of total billed charges,,,,,,,,,332.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,396.46,91,,percent of total billed charges,,,413.89,95,,percent of total billed charges,,,361.61,83,,percent of total billed charges,,,361.61,83,,percent of total billed charges,,,,,,,,,,,,,,,361.61,83,,percent of total billed charges,,,413.89,95,,percent of total billed charges,,,392.1,90,,percent of total billed charges,,,392.1,90,,percent of total billed charges,,,357.25,82,,percent of total billed charges,,,392.1,90,,percent of total billed charges,,,370.32,85,,percent of total billed charges,,328.5,413.89,
MENING VAC W135(MENACTRA)VIAL:4MCG/0.5ML,32000287,CDM,,,250,RC,inpatient,,1891.28,1891.28,,1605.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1426.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1607.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1664.33,88,,percent of total billed charges,,,,,,,,,1444.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1721.06,91,,percent of total billed charges,,,1796.72,95,,percent of total billed charges,,,1569.76,83,,percent of total billed charges,,,1569.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1569.76,83,,percent of total billed charges,,,1796.72,95,,percent of total billed charges,,,1702.15,90,,percent of total billed charges,,,1702.15,90,,percent of total billed charges,,,1550.85,82,,percent of total billed charges,,,1702.15,90,,percent of total billed charges,,,1607.59,85,,percent of total billed charges,,1426.03,1796.72,
CAFFEINE(NO DOZ)TAB:200MG,32000288,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
HYDROcod/APAP(NORCO)TAB:5MG-325MG (1x10),32000290,CDM,,,250,RC,inpatient,,67.72,67.72,,57.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.59,88,,percent of total billed charges,,,,,,,,,51.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.63,91,,percent of total billed charges,,,64.33,95,,percent of total billed charges,,,56.21,83,,percent of total billed charges,,,56.21,83,,percent of total billed charges,,,,,,,,,,,,,,,56.21,83,,percent of total billed charges,,,64.33,95,,percent of total billed charges,,,60.95,90,,percent of total billed charges,,,60.95,90,,percent of total billed charges,,,55.53,82,,percent of total billed charges,,,60.95,90,,percent of total billed charges,,,57.56,85,,percent of total billed charges,,51.06,64.33,
LEVALBUTEROL HCL (XOPENEX)SOL:1.25MG/3ML,32000292,CDM,,,250,RC,inpatient,,130.84,130.84,,111.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,98.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,111.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,115.14,88,,percent of total billed charges,,,,,,,,,99.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,119.06,91,,percent of total billed charges,,,124.3,95,,percent of total billed charges,,,108.6,83,,percent of total billed charges,,,108.6,83,,percent of total billed charges,,,,,,,,,,,,,,,108.6,83,,percent of total billed charges,,,124.3,95,,percent of total billed charges,,,117.76,90,,percent of total billed charges,,,117.76,90,,percent of total billed charges,,,107.29,82,,percent of total billed charges,,,117.76,90,,percent of total billed charges,,,111.21,85,,percent of total billed charges,,98.65,124.3,
BUTORPHANOL(STADOL) VIAL : 2MG/ML   2ML,32000293,CDM,,,250,RC,inpatient,,109.91,109.91,,93.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,93.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,96.72,88,,percent of total billed charges,,,,,,,,,83.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,100.02,91,,percent of total billed charges,,,104.41,95,,percent of total billed charges,,,91.23,83,,percent of total billed charges,,,91.23,83,,percent of total billed charges,,,,,,,,,,,,,,,91.23,83,,percent of total billed charges,,,104.41,95,,percent of total billed charges,,,98.92,90,,percent of total billed charges,,,98.92,90,,percent of total billed charges,,,90.13,82,,percent of total billed charges,,,98.92,90,,percent of total billed charges,,,93.42,85,,percent of total billed charges,,82.87,104.41,
DEMECLOCYCLINE(DECL0MYCIN)TAB:150MG,32000294,CDM,,,250,RC,inpatient,,67.25,67.25,,57.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.18,88,,percent of total billed charges,,,,,,,,,51.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.2,91,,percent of total billed charges,,,63.89,95,,percent of total billed charges,,,55.82,83,,percent of total billed charges,,,55.82,83,,percent of total billed charges,,,,,,,,,,,,,,,55.82,83,,percent of total billed charges,,,63.89,95,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,55.15,82,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,57.16,85,,percent of total billed charges,,50.71,63.89,
BENZALKONIUM CH (MYCOCIDE NS) LIQ  30ML,32000295,CDM,,,250,RC,inpatient,,157.33,157.33,,133.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,118.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,133.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,138.45,88,,percent of total billed charges,,,,,,,,,120.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,143.17,91,,percent of total billed charges,,,149.46,95,,percent of total billed charges,,,130.58,83,,percent of total billed charges,,,130.58,83,,percent of total billed charges,,,,,,,,,,,,,,,130.58,83,,percent of total billed charges,,,149.46,95,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,129.01,82,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,133.73,85,,percent of total billed charges,,118.63,149.46,
CETIRIZINE(ZyrTEC)TAB:10MG,32000296,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
TIMOLOL SOL-GEL(TIMOPTIC XE):0.50% 2.5ML,32000297,CDM,,,250,RC,inpatient,,341.31,341.31,,289.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,257.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,290.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,300.35,88,,percent of total billed charges,,,,,,,,,260.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,310.59,91,,percent of total billed charges,,,324.24,95,,percent of total billed charges,,,283.29,83,,percent of total billed charges,,,283.29,83,,percent of total billed charges,,,,,,,,,,,,,,,283.29,83,,percent of total billed charges,,,324.24,95,,percent of total billed charges,,,307.18,90,,percent of total billed charges,,,307.18,90,,percent of total billed charges,,,279.87,82,,percent of total billed charges,,,307.18,90,,percent of total billed charges,,,290.11,85,,percent of total billed charges,,257.35,324.24,
NALOXONE(NARCAN)SYR:2MG/2ML,32000298,CDM,J2310,HCPCS,250,RC,inpatient,,502.29,502.29,,426.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,378.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,426.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,442.02,88,,percent of total billed charges,,19.95,,,,fee schedule,,,383.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.95,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,457.08,91,,percent of total billed charges,,,477.18,95,,percent of total billed charges,,,416.9,83,,percent of total billed charges,,,416.9,83,,percent of total billed charges,,,,,,,,,,,,,,,416.9,83,,percent of total billed charges,,,477.18,95,,percent of total billed charges,,,452.06,90,,percent of total billed charges,,,452.06,90,,percent of total billed charges,,,411.88,82,,percent of total billed charges,,,452.06,90,,percent of total billed charges,,,426.95,85,,percent of total billed charges,,19.95,477.18,
PANTOPRAZOLE(PROTONIX)VIAL:40MG,32000299,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
MORPHINE SULF CPJ SYR:2MG/ML,32000300,CDM,,,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,,,,,,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,50.92,64.15,
NALOXONE(NARCAN)AMP:0.4MG/ML,32000301,CDM,J2310,HCPCS,250,RC,inpatient,,74.35,74.35,,63.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,63.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,65.43,88,,percent of total billed charges,,19.95,,,,fee schedule,,,56.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.95,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,67.66,91,,percent of total billed charges,,,70.63,95,,percent of total billed charges,,,61.71,83,,percent of total billed charges,,,61.71,83,,percent of total billed charges,,,,,,,,,,,,,,,61.71,83,,percent of total billed charges,,,70.63,95,,percent of total billed charges,,,66.92,90,,percent of total billed charges,,,66.92,90,,percent of total billed charges,,,60.97,82,,percent of total billed charges,,,66.92,90,,percent of total billed charges,,,63.2,85,,percent of total billed charges,,19.95,70.63,
IBUPROFEN ORAL UD:100MG/5ML,32000302,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ACETAMINOPHEN ELIX : 130MG/5ML  (12.5ML),32000303,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
APAP/CODEINE ELIX 300MG-30MG/12.5ML UD,32000304,CDM,J8499,HCPCS,250,RC,inpatient,,41.18,41.18,,34.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36.24,88,,percent of total billed charges,,,,,,,,,31.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37.47,91,,percent of total billed charges,,,39.12,95,,percent of total billed charges,,,34.18,83,,percent of total billed charges,,,34.18,83,,percent of total billed charges,,,,,,,,,,,,,,,34.18,83,,percent of total billed charges,,,39.12,95,,percent of total billed charges,,,37.06,90,,percent of total billed charges,,,37.06,90,,percent of total billed charges,,,33.77,82,,percent of total billed charges,,,37.06,90,,percent of total billed charges,,,35,85,,percent of total billed charges,,31.05,39.12,
DOLASETRON MESYLATE (ANZEMET)TAB : 100MG,32000305,CDM,,,250,RC,inpatient,,1347.76,1347.76,,1144.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1016.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1145.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1186.03,88,,percent of total billed charges,,,,,,,,,1029.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1226.46,91,,percent of total billed charges,,,1280.37,95,,percent of total billed charges,,,1118.64,83,,percent of total billed charges,,,1118.64,83,,percent of total billed charges,,,,,,,,,,,,,,,1118.64,83,,percent of total billed charges,,,1280.37,95,,percent of total billed charges,,,1212.98,90,,percent of total billed charges,,,1212.98,90,,percent of total billed charges,,,1105.16,82,,percent of total billed charges,,,1212.98,90,,percent of total billed charges,,,1145.6,85,,percent of total billed charges,,1016.21,1280.37,
PHENYTOIN(DILANTIN)VIAL:100MG/2ML,32000306,CDM,J1165,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,15.86,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.86,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.86,59.21,
BECLOMETH DIPROP(QVAR) AER:40MCG(8.7GM),32000308,CDM,,,250,RC,inpatient,,2234.13,2234.13,,1896.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1684.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1899.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1966.03,88,,percent of total billed charges,,,,,,,,,1706.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2033.06,91,,percent of total billed charges,,,2122.42,95,,percent of total billed charges,,,1854.33,83,,percent of total billed charges,,,1854.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1854.33,83,,percent of total billed charges,,,2122.42,95,,percent of total billed charges,,,2010.72,90,,percent of total billed charges,,,2010.72,90,,percent of total billed charges,,,1831.99,82,,percent of total billed charges,,,2010.72,90,,percent of total billed charges,,,1899.01,85,,percent of total billed charges,,1684.53,2122.42,
LIOTHYRONINE SODIUM(CYTOMEL) TAB : 25MCG,32000309,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
IRINOTECAN(CAMPTOSAR)VIAL:100MG/5ML,32000310,CDM,J9206,HCPCS,636,RC,inpatient,,332.58,332.58,,282.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,250.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,282.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,292.67,88,,percent of total billed charges,,114.58,,,,fee schedule,,,254.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,114.58,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,302.65,91,,percent of total billed charges,,,315.95,95,,percent of total billed charges,,,276.04,83,,percent of total billed charges,,,276.04,83,,percent of total billed charges,,,,,,,,,,,,,,,276.04,83,,percent of total billed charges,,,315.95,95,,percent of total billed charges,,,299.32,90,,percent of total billed charges,,,299.32,90,,percent of total billed charges,,,272.72,82,,percent of total billed charges,,,299.32,90,,percent of total billed charges,,,282.69,85,,percent of total billed charges,,114.58,315.95,
PHENYTOIN(DILANTIN)VIAL:250MG/5ML,32000311,CDM,J1165,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,15.86,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.86,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,15.86,60.99,
BISOPROLOL(ZEBETA)TAB:5MG,32000313,CDM,,,250,RC,inpatient,,15.07,15.07,,12.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.26,88,,percent of total billed charges,,,,,,,,,11.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.71,91,,percent of total billed charges,,,14.32,95,,percent of total billed charges,,,12.51,83,,percent of total billed charges,,,12.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12.51,83,,percent of total billed charges,,,14.32,95,,percent of total billed charges,,,13.56,90,,percent of total billed charges,,,13.56,90,,percent of total billed charges,,,12.36,82,,percent of total billed charges,,,13.56,90,,percent of total billed charges,,,12.81,85,,percent of total billed charges,,11.36,14.32,
DANAZOL (DANOCRINE) CAP : 200MG,32000314,CDM,,,250,RC,inpatient,,63.6,63.6,,54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.97,88,,percent of total billed charges,,,,,,,,,48.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.88,91,,percent of total billed charges,,,60.42,95,,percent of total billed charges,,,52.79,83,,percent of total billed charges,,,52.79,83,,percent of total billed charges,,,,,,,,,,,,,,,52.79,83,,percent of total billed charges,,,60.42,95,,percent of total billed charges,,,57.24,90,,percent of total billed charges,,,57.24,90,,percent of total billed charges,,,52.15,82,,percent of total billed charges,,,57.24,90,,percent of total billed charges,,,54.06,85,,percent of total billed charges,,47.95,60.42,
MIGLITOL (GLYSET) TAB : 50MG,32000315,CDM,,,250,RC,inpatient,,50.28,50.28,,42.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.25,88,,percent of total billed charges,,,,,,,,,38.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.75,91,,percent of total billed charges,,,47.77,95,,percent of total billed charges,,,41.73,83,,percent of total billed charges,,,41.73,83,,percent of total billed charges,,,,,,,,,,,,,,,41.73,83,,percent of total billed charges,,,47.77,95,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,41.23,82,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,42.74,85,,percent of total billed charges,,37.91,47.77,
NALBUPHINE(NUBAIN)AMP:20MG/ML,32000316,CDM,J2300,HCPCS,250,RC,inpatient,,98.17,98.17,,83.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,74.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,83.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,86.39,88,,percent of total billed charges,,6.28,,,,fee schedule,,,75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6.28,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,89.33,91,,percent of total billed charges,,,93.26,95,,percent of total billed charges,,,81.48,83,,percent of total billed charges,,,81.48,83,,percent of total billed charges,,,,,,,,,,,,,,,81.48,83,,percent of total billed charges,,,93.26,95,,percent of total billed charges,,,88.35,90,,percent of total billed charges,,,88.35,90,,percent of total billed charges,,,80.5,82,,percent of total billed charges,,,88.35,90,,percent of total billed charges,,,83.44,85,,percent of total billed charges,,6.28,93.26,
BACITRACIN/POLYM B(POLYSPORIN)OINT:30GM,32000317,CDM,J3490,HCPCS,250,RC,inpatient,,119.12,119.12,,101.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,89.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,101.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,104.83,88,,percent of total billed charges,,,,,,,,,91.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,108.4,91,,percent of total billed charges,,,113.16,95,,percent of total billed charges,,,98.87,83,,percent of total billed charges,,,98.87,83,,percent of total billed charges,,,,,,,,,,,,,,,98.87,83,,percent of total billed charges,,,113.16,95,,percent of total billed charges,,,107.21,90,,percent of total billed charges,,,107.21,90,,percent of total billed charges,,,97.68,82,,percent of total billed charges,,,107.21,90,,percent of total billed charges,,,101.25,85,,percent of total billed charges,,89.82,113.16,
ENOXAPARIN(LOVENOX): 60MG/0.6ML,32000318,CDM,J1650,HCPCS,250,RC,inpatient,,92.48,92.48,,78.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,69.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,78.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.38,88,,percent of total billed charges,,15.16,,,,fee schedule,,,70.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.16,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.16,91,,percent of total billed charges,,,87.86,95,,percent of total billed charges,,,76.76,83,,percent of total billed charges,,,76.76,83,,percent of total billed charges,,,,,,,,,,,,,,,76.76,83,,percent of total billed charges,,,87.86,95,,percent of total billed charges,,,83.23,90,,percent of total billed charges,,,83.23,90,,percent of total billed charges,,,75.83,82,,percent of total billed charges,,,83.23,90,,percent of total billed charges,,,78.61,85,,percent of total billed charges,,15.16,87.86,
DIPHENHYDRAM(BENADRYL)VIAL:50MG/ML(10ML),32000319,CDM,,,250,RC,inpatient,,191.59,191.59,,162.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.6,88,,percent of total billed charges,,,,,,,,,146.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.35,91,,percent of total billed charges,,,182.01,95,,percent of total billed charges,,,159.02,83,,percent of total billed charges,,,159.02,83,,percent of total billed charges,,,,,,,,,,,,,,,159.02,83,,percent of total billed charges,,,182.01,95,,percent of total billed charges,,,172.43,90,,percent of total billed charges,,,172.43,90,,percent of total billed charges,,,157.1,82,,percent of total billed charges,,,172.43,90,,percent of total billed charges,,,162.85,85,,percent of total billed charges,,144.46,182.01,
DICYCLOMINE(BENTYL)CAP:10MG,32000323,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ENOXAPARIN(LOVENOX): 80MG/0.8ML,32000326,CDM,J1650,HCPCS,250,RC,inpatient,,123.37,123.37,,104.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,104.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,108.57,88,,percent of total billed charges,,15.16,,,,fee schedule,,,94.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.16,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.27,91,,percent of total billed charges,,,117.2,95,,percent of total billed charges,,,102.4,83,,percent of total billed charges,,,102.4,83,,percent of total billed charges,,,,,,,,,,,,,,,102.4,83,,percent of total billed charges,,,117.2,95,,percent of total billed charges,,,111.03,90,,percent of total billed charges,,,111.03,90,,percent of total billed charges,,,101.16,82,,percent of total billed charges,,,111.03,90,,percent of total billed charges,,,104.86,85,,percent of total billed charges,,15.16,117.2,
ENOXAPARIN(LOVENOX):100MG/ML,32000327,CDM,J1650,HCPCS,250,RC,inpatient,,154.09,154.09,,130.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.6,88,,percent of total billed charges,,15.16,,,,fee schedule,,,117.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.16,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.22,91,,percent of total billed charges,,,146.39,95,,percent of total billed charges,,,127.89,83,,percent of total billed charges,,,127.89,83,,percent of total billed charges,,,,,,,,,,,,,,,127.89,83,,percent of total billed charges,,,146.39,95,,percent of total billed charges,,,138.68,90,,percent of total billed charges,,,138.68,90,,percent of total billed charges,,,126.35,82,,percent of total billed charges,,,138.68,90,,percent of total billed charges,,,130.98,85,,percent of total billed charges,,15.16,146.39,
METHYLPHENIDATE(RITALIN SR)TAB : 20MG,32000328,CDM,,,250,RC,inpatient,,30.13,30.13,,25.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.51,88,,percent of total billed charges,,,,,,,,,23.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27.42,91,,percent of total billed charges,,,28.62,95,,percent of total billed charges,,,25.01,83,,percent of total billed charges,,,25.01,83,,percent of total billed charges,,,,,,,,,,,,,,,25.01,83,,percent of total billed charges,,,28.62,95,,percent of total billed charges,,,27.12,90,,percent of total billed charges,,,27.12,90,,percent of total billed charges,,,24.71,82,,percent of total billed charges,,,27.12,90,,percent of total billed charges,,,25.61,85,,percent of total billed charges,,22.72,28.62,
ALENDRONATE(FOSAMAX)TAB:70MG,32000329,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CONTAINER EMPTY BOTTLE :500ML,32000330,CDM,J3490,HCPCS,250,RC,inpatient,,195.4,195.4,,165.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,166.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,171.95,88,,percent of total billed charges,,,,,,,,,149.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,177.81,91,,percent of total billed charges,,,185.63,95,,percent of total billed charges,,,162.18,83,,percent of total billed charges,,,162.18,83,,percent of total billed charges,,,,,,,,,,,,,,,162.18,83,,percent of total billed charges,,,185.63,95,,percent of total billed charges,,,175.86,90,,percent of total billed charges,,,175.86,90,,percent of total billed charges,,,160.23,82,,percent of total billed charges,,,175.86,90,,percent of total billed charges,,,166.09,85,,percent of total billed charges,,147.33,185.63,
RIVASTIGMINE(EXELON)CAP:1.5MG,32000331,CDM,J8499,HCPCS,250,RC,inpatient,,43.46,43.46,,36.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.24,88,,percent of total billed charges,,,,,,,,,33.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,39.55,91,,percent of total billed charges,,,41.29,95,,percent of total billed charges,,,36.07,83,,percent of total billed charges,,,36.07,83,,percent of total billed charges,,,,,,,,,,,,,,,36.07,83,,percent of total billed charges,,,41.29,95,,percent of total billed charges,,,39.11,90,,percent of total billed charges,,,39.11,90,,percent of total billed charges,,,35.64,82,,percent of total billed charges,,,39.11,90,,percent of total billed charges,,,36.94,85,,percent of total billed charges,,32.77,41.29,
VENLAFAXINE(EFFEXOR XR)CAP:37.5MG,32000332,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
risperiDONE(risperDAL)TAB:0.25MG,32000333,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
HC PRAMOXINE(PROCTOFOAM) FOAM 1%:10GM,32000334,CDM,J3490,HCPCS,250,RC,inpatient,,2248.31,2248.31,,1908.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1695.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1911.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1978.51,88,,percent of total billed charges,,,,,,,,,1717.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2045.96,91,,percent of total billed charges,,,2135.89,95,,percent of total billed charges,,,1866.1,83,,percent of total billed charges,,,1866.1,83,,percent of total billed charges,,,,,,,,,,,,,,,1866.1,83,,percent of total billed charges,,,2135.89,95,,percent of total billed charges,,,2023.48,90,,percent of total billed charges,,,2023.48,90,,percent of total billed charges,,,1843.61,82,,percent of total billed charges,,,2023.48,90,,percent of total billed charges,,,1911.06,85,,percent of total billed charges,,1695.23,2135.89,
PHENYL(PHNERGANVC)SYR:5-6.25MG/5ML(60ML),32000337,CDM,,,250,RC,inpatient,,58.68,58.68,,49.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.64,88,,percent of total billed charges,,,,,,,,,44.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.4,91,,percent of total billed charges,,,55.75,95,,percent of total billed charges,,,48.7,83,,percent of total billed charges,,,48.7,83,,percent of total billed charges,,,,,,,,,,,,,,,48.7,83,,percent of total billed charges,,,55.75,95,,percent of total billed charges,,,52.81,90,,percent of total billed charges,,,52.81,90,,percent of total billed charges,,,48.12,82,,percent of total billed charges,,,52.81,90,,percent of total billed charges,,,49.88,85,,percent of total billed charges,,44.24,55.75,
ZINC (DERMAGRAN MOISTURIZR) SPR 118ML,32000339,CDM,,,250,RC,inpatient,,113.56,113.56,,96.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,99.93,88,,percent of total billed charges,,,,,,,,,86.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,103.34,91,,percent of total billed charges,,,107.88,95,,percent of total billed charges,,,94.25,83,,percent of total billed charges,,,94.25,83,,percent of total billed charges,,,,,,,,,,,,,,,94.25,83,,percent of total billed charges,,,107.88,95,,percent of total billed charges,,,102.2,90,,percent of total billed charges,,,102.2,90,,percent of total billed charges,,,93.12,82,,percent of total billed charges,,,102.2,90,,percent of total billed charges,,,96.53,85,,percent of total billed charges,,85.62,107.88,
glipiZIDE(GLUCOTROL XL)TAB:2.5 MG,32000340,CDM,J8499,HCPCS,250,RC,inpatient,,17.81,17.81,,15.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.67,88,,percent of total billed charges,,,,,,,,,13.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.21,91,,percent of total billed charges,,,16.92,95,,percent of total billed charges,,,14.78,83,,percent of total billed charges,,,14.78,83,,percent of total billed charges,,,,,,,,,,,,,,,14.78,83,,percent of total billed charges,,,16.92,95,,percent of total billed charges,,,16.03,90,,percent of total billed charges,,,16.03,90,,percent of total billed charges,,,14.6,82,,percent of total billed charges,,,16.03,90,,percent of total billed charges,,,15.14,85,,percent of total billed charges,,13.43,16.92,
ceFAClor(CECLOR)CAP:250MG (1X6),32000341,CDM,,,250,RC,inpatient,,165.9,165.9,,140.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,145.99,88,,percent of total billed charges,,,,,,,,,126.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,150.97,91,,percent of total billed charges,,,157.61,95,,percent of total billed charges,,,137.7,83,,percent of total billed charges,,,137.7,83,,percent of total billed charges,,,,,,,,,,,,,,,137.7,83,,percent of total billed charges,,,157.61,95,,percent of total billed charges,,,149.31,90,,percent of total billed charges,,,149.31,90,,percent of total billed charges,,,136.04,82,,percent of total billed charges,,,149.31,90,,percent of total billed charges,,,141.02,85,,percent of total billed charges,,125.09,157.61,
BENAZEPRIL (LOTENSIN) TAB : 40MG,32000342,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ALBUT/IPRAT(DUONEB)SOL:2.5-0.5 (3ML),32000343,CDM,J7620,HCPCS,250,RC,inpatient,,24.8,24.8,,21.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.82,88,,percent of total billed charges,,0.13,,,,fee schedule,,,18.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.13,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.57,91,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,,,,,,,,,,,,,20.58,83,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,20.34,82,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,0.13,23.56,
CANDESARTAN (ATACAND) TAB : 4MG,32000344,CDM,,,250,RC,inpatient,,59.16,59.16,,50.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.06,88,,percent of total billed charges,,,,,,,,,45.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.84,91,,percent of total billed charges,,,56.2,95,,percent of total billed charges,,,49.1,83,,percent of total billed charges,,,49.1,83,,percent of total billed charges,,,,,,,,,,,,,,,49.1,83,,percent of total billed charges,,,56.2,95,,percent of total billed charges,,,53.24,90,,percent of total billed charges,,,53.24,90,,percent of total billed charges,,,48.51,82,,percent of total billed charges,,,53.24,90,,percent of total billed charges,,,50.29,85,,percent of total billed charges,,44.61,56.2,
FEXOFENADINE HCL (ALLEGRA) TAB : 180MG,32000345,CDM,,,250,RC,inpatient,,16.97,16.97,,14.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.93,88,,percent of total billed charges,,,,,,,,,12.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.44,91,,percent of total billed charges,,,16.12,95,,percent of total billed charges,,,14.09,83,,percent of total billed charges,,,14.09,83,,percent of total billed charges,,,,,,,,,,,,,,,14.09,83,,percent of total billed charges,,,16.12,95,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,13.92,82,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,14.42,85,,percent of total billed charges,,12.8,16.12,
nitroPRUSSID(nitroPRESS)VIAL:25MG/ML 2ML,32000346,CDM,,,250,RC,inpatient,,127.36,127.36,,108.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,96.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,108.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,112.08,88,,percent of total billed charges,,,,,,,,,97.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,115.9,91,,percent of total billed charges,,,120.99,95,,percent of total billed charges,,,105.71,83,,percent of total billed charges,,,105.71,83,,percent of total billed charges,,,,,,,,,,,,,,,105.71,83,,percent of total billed charges,,,120.99,95,,percent of total billed charges,,,114.62,90,,percent of total billed charges,,,114.62,90,,percent of total billed charges,,,104.44,82,,percent of total billed charges,,,114.62,90,,percent of total billed charges,,,108.26,85,,percent of total billed charges,,96.03,120.99,
PRAMIPEXOLE DI-HCL (MIRAPEX) TAB:0.125MG,32000347,CDM,,,250,RC,inpatient,,24.74,24.74,,21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.77,88,,percent of total billed charges,,,,,,,,,18.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.51,91,,percent of total billed charges,,,23.5,95,,percent of total billed charges,,,20.53,83,,percent of total billed charges,,,20.53,83,,percent of total billed charges,,,,,,,,,,,,,,,20.53,83,,percent of total billed charges,,,23.5,95,,percent of total billed charges,,,22.27,90,,percent of total billed charges,,,22.27,90,,percent of total billed charges,,,20.29,82,,percent of total billed charges,,,22.27,90,,percent of total billed charges,,,21.03,85,,percent of total billed charges,,18.65,23.5,
PAPAI/UREA(ACCUZYME)OINT:30GM,32000350,CDM,,,250,RC,inpatient,,680.24,680.24,,577.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,512.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,578.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,598.61,88,,percent of total billed charges,,,,,,,,,519.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,619.02,91,,percent of total billed charges,,,646.23,95,,percent of total billed charges,,,564.6,83,,percent of total billed charges,,,564.6,83,,percent of total billed charges,,,,,,,,,,,,,,,564.6,83,,percent of total billed charges,,,646.23,95,,percent of total billed charges,,,612.22,90,,percent of total billed charges,,,612.22,90,,percent of total billed charges,,,557.8,82,,percent of total billed charges,,,612.22,90,,percent of total billed charges,,,578.2,85,,percent of total billed charges,,512.9,646.23,
"LIDOCAINE W/EPI 1:100,000 VIAL 1%:20ML",32000351,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
BUPIVACAINE(MARCAINE)VL 0.5%:10ML,32000352,CDM,J3490,HCPCS,250,RC,inpatient,,95.43,95.43,,81.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,81.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,83.98,88,,percent of total billed charges,,,,,,,,,72.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,86.84,91,,percent of total billed charges,,,90.66,95,,percent of total billed charges,,,79.21,83,,percent of total billed charges,,,79.21,83,,percent of total billed charges,,,,,,,,,,,,,,,79.21,83,,percent of total billed charges,,,90.66,95,,percent of total billed charges,,,85.89,90,,percent of total billed charges,,,85.89,90,,percent of total billed charges,,,78.25,82,,percent of total billed charges,,,85.89,90,,percent of total billed charges,,,81.12,85,,percent of total billed charges,,71.95,90.66,
INSUL GLA(LANTUS)VL:100UNITS/ML(10ML),32000353,CDM,J1815,HCPCS,250,RC,inpatient,,1459.32,1459.32,,1238.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1100.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1240.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1284.2,88,,percent of total billed charges,,,,,,,,,1114.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1327.98,91,,percent of total billed charges,,,1386.35,95,,percent of total billed charges,,,1211.24,83,,percent of total billed charges,,,1211.24,83,,percent of total billed charges,,,,,,,,,,,,,,,1211.24,83,,percent of total billed charges,,,1386.35,95,,percent of total billed charges,,,1313.39,90,,percent of total billed charges,,,1313.39,90,,percent of total billed charges,,,1196.64,82,,percent of total billed charges,,,1313.39,90,,percent of total billed charges,,,1240.42,85,,percent of total billed charges,,1100.33,1386.35,
inFLIXimab(REMICADE)VIAL 100MG,32000354,CDM,J1745,HCPCS,636,RC,inpatient,,5432.49,5432.49,,4612.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4096.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4617.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4780.59,88,,percent of total billed charges,,4377.75,,,,fee schedule,,,4150.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,4377.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4943.57,91,,percent of total billed charges,,,5160.87,95,,percent of total billed charges,,,4508.97,83,,percent of total billed charges,,,4508.97,83,,percent of total billed charges,,,,,,,,,,,,,,,4508.97,83,,percent of total billed charges,,,5160.87,95,,percent of total billed charges,,,4889.24,90,,percent of total billed charges,,,4889.24,90,,percent of total billed charges,,,4454.64,82,,percent of total billed charges,,,4889.24,90,,percent of total billed charges,,,4617.62,85,,percent of total billed charges,,4096.1,5160.87,
"LIDOCAINE W/EPI 1:100,000 VIAL 2%:20ML",32000356,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
ZIPRASIDONE (GEODON) CAP : 20 MG,32000357,CDM,,,250,RC,inpatient,,350.51,350.51,,297.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,264.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,297.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,308.45,88,,percent of total billed charges,,,,,,,,,267.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,318.96,91,,percent of total billed charges,,,332.98,95,,percent of total billed charges,,,290.92,83,,percent of total billed charges,,,290.92,83,,percent of total billed charges,,,,,,,,,,,,,,,290.92,83,,percent of total billed charges,,,332.98,95,,percent of total billed charges,,,315.46,90,,percent of total billed charges,,,315.46,90,,percent of total billed charges,,,287.42,82,,percent of total billed charges,,,315.46,90,,percent of total billed charges,,,297.93,85,,percent of total billed charges,,264.28,332.98,
HYDROCORTISONE (PROCTOZONE) CREAM:2.50%,32000358,CDM,,,250,RC,inpatient,,331,331,,281.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,249.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,281.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,291.28,88,,percent of total billed charges,,,,,,,,,252.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,301.21,91,,percent of total billed charges,,,314.45,95,,percent of total billed charges,,,274.73,83,,percent of total billed charges,,,274.73,83,,percent of total billed charges,,,,,,,,,,,,,,,274.73,83,,percent of total billed charges,,,314.45,95,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,271.42,82,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,281.35,85,,percent of total billed charges,,249.57,314.45,
INSUL LISP(HumaLOG MIX)75-25UNT/ML:10ML,32000359,CDM,,,250,RC,inpatient,,392.25,392.25,,333.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,295.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,333.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,345.18,88,,percent of total billed charges,,,,,,,,,299.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,356.95,91,,percent of total billed charges,,,372.64,95,,percent of total billed charges,,,325.57,83,,percent of total billed charges,,,325.57,83,,percent of total billed charges,,,,,,,,,,,,,,,325.57,83,,percent of total billed charges,,,372.64,95,,percent of total billed charges,,,353.03,90,,percent of total billed charges,,,353.03,90,,percent of total billed charges,,,321.65,82,,percent of total billed charges,,,353.03,90,,percent of total billed charges,,,333.41,85,,percent of total billed charges,,295.76,372.64,
QUEtiapine(SEROquel)TAB:100MG,32000360,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
teraZOSIN(HYTRIN)CAP:5MG,32000361,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
OLOPATADINE(PATANOL)DROP 0.1%:5ML,32000362,CDM,,,250,RC,inpatient,,2233.62,2233.62,,1896.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1684.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1898.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1965.59,88,,percent of total billed charges,,,,,,,,,1706.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2032.59,91,,percent of total billed charges,,,2121.94,95,,percent of total billed charges,,,1853.9,83,,percent of total billed charges,,,1853.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1853.9,83,,percent of total billed charges,,,2121.94,95,,percent of total billed charges,,,2010.26,90,,percent of total billed charges,,,2010.26,90,,percent of total billed charges,,,1831.57,82,,percent of total billed charges,,,2010.26,90,,percent of total billed charges,,,1898.58,85,,percent of total billed charges,,1684.15,2121.94,
MIRTAZAPINE(REMERON)SOL-TAB:30MG,32000364,CDM,,,250,RC,inpatient,,72.96,72.96,,61.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,55.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,62.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,64.2,88,,percent of total billed charges,,,,,,,,,55.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,66.39,91,,percent of total billed charges,,,69.31,95,,percent of total billed charges,,,60.56,83,,percent of total billed charges,,,60.56,83,,percent of total billed charges,,,,,,,,,,,,,,,60.56,83,,percent of total billed charges,,,69.31,95,,percent of total billed charges,,,65.66,90,,percent of total billed charges,,,65.66,90,,percent of total billed charges,,,59.83,82,,percent of total billed charges,,,65.66,90,,percent of total billed charges,,,62.02,85,,percent of total billed charges,,55.01,69.31,
BRINZOLAMIDE(AZOPT)DROP 1%:5ML,32000365,CDM,,,250,RC,inpatient,,558.75,558.75,,474.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,421.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,474.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,491.7,88,,percent of total billed charges,,,,,,,,,426.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,508.46,91,,percent of total billed charges,,,530.81,95,,percent of total billed charges,,,463.76,83,,percent of total billed charges,,,463.76,83,,percent of total billed charges,,,,,,,,,,,,,,,463.76,83,,percent of total billed charges,,,530.81,95,,percent of total billed charges,,,502.88,90,,percent of total billed charges,,,502.88,90,,percent of total billed charges,,,458.18,82,,percent of total billed charges,,,502.88,90,,percent of total billed charges,,,474.94,85,,percent of total billed charges,,421.3,530.81,
FLUTICA/SALMET(ADVAIR DISK):250-50MCG,32000367,CDM,J7699,HCPCS,250,RC,inpatient,,1666.47,1666.47,,1414.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1256.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1416.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1466.49,88,,percent of total billed charges,,,,,,,,,1273.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1516.49,91,,percent of total billed charges,,,1583.15,95,,percent of total billed charges,,,1383.17,83,,percent of total billed charges,,,1383.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1383.17,83,,percent of total billed charges,,,1583.15,95,,percent of total billed charges,,,1499.82,90,,percent of total billed charges,,,1499.82,90,,percent of total billed charges,,,1366.51,82,,percent of total billed charges,,,1499.82,90,,percent of total billed charges,,,1416.5,85,,percent of total billed charges,,1256.52,1583.15,
MAALOX QUICK DISSOLVE TAB:600MG,32000368,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
BUDESONIDE(PULMICORT) UD:0.5MG/2ML (NEB),32000369,CDM,,,250,RC,inpatient,,56.78,56.78,,48.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.97,88,,percent of total billed charges,,,,,,,,,43.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.67,91,,percent of total billed charges,,,53.94,95,,percent of total billed charges,,,47.13,83,,percent of total billed charges,,,47.13,83,,percent of total billed charges,,,,,,,,,,,,,,,47.13,83,,percent of total billed charges,,,53.94,95,,percent of total billed charges,,,51.1,90,,percent of total billed charges,,,51.1,90,,percent of total billed charges,,,46.56,82,,percent of total billed charges,,,51.1,90,,percent of total billed charges,,,48.26,85,,percent of total billed charges,,42.81,53.94,
CISplatin MDV :50MG/50ML   (J/10MG),32000370,CDM,J9060,HCPCS,636,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,47.9,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,47.9,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,47.9,60.99,
MANNITOL VIAL 25%:50 ML,32000371,CDM,J2150,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,34.78,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,34.78,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,34.78,59.21,
IPRATR(ATROVENT)NASAL SPR:21MCG  14GM,32000373,CDM,,,250,RC,inpatient,,1936.84,1936.84,,1644.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1460.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1646.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1704.42,88,,percent of total billed charges,,,,,,,,,1479.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1762.52,91,,percent of total billed charges,,,1840,95,,percent of total billed charges,,,1607.58,83,,percent of total billed charges,,,1607.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1607.58,83,,percent of total billed charges,,,1840,95,,percent of total billed charges,,,1743.16,90,,percent of total billed charges,,,1743.16,90,,percent of total billed charges,,,1588.21,82,,percent of total billed charges,,,1743.16,90,,percent of total billed charges,,,1646.31,85,,percent of total billed charges,,1460.38,1840,
BECLOMETH DIP (VANCERIL) AER:42MCG  17GM,32000374,CDM,,,250,RC,inpatient,,665.01,665.01,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.21,88,,percent of total billed charges,,,,,,,,,508.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.16,91,,percent of total billed charges,,,631.76,95,,percent of total billed charges,,,551.96,83,,percent of total billed charges,,,551.96,83,,percent of total billed charges,,,,,,,,,,,,,,,551.96,83,,percent of total billed charges,,,631.76,95,,percent of total billed charges,,,598.51,90,,percent of total billed charges,,,598.51,90,,percent of total billed charges,,,545.31,82,,percent of total billed charges,,,598.51,90,,percent of total billed charges,,,565.26,85,,percent of total billed charges,,501.42,631.76,
AMPHET ASP/D(ADEDERALL)TAB:10MG,32000375,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
LIDOCAINE HCL 1% VIAL:(10MG/ML) (20ML),32000376,CDM,J2001,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
FLUTICA/SALMET(ADVAIR DISK):100-50,32000377,CDM,,,250,RC,inpatient,,353.2,353.2,,299.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,266.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,300.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,310.82,88,,percent of total billed charges,,,,,,,,,269.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,321.41,91,,percent of total billed charges,,,335.54,95,,percent of total billed charges,,,293.16,83,,percent of total billed charges,,,293.16,83,,percent of total billed charges,,,,,,,,,,,,,,,293.16,83,,percent of total billed charges,,,335.54,95,,percent of total billed charges,,,317.88,90,,percent of total billed charges,,,317.88,90,,percent of total billed charges,,,289.62,82,,percent of total billed charges,,,317.88,90,,percent of total billed charges,,,300.22,85,,percent of total billed charges,,266.31,335.54,
GALANTAMINE(RAZADYNE)TAB:4MG,32000378,CDM,,,250,RC,inpatient,,88.82,88.82,,75.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,75.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,78.16,88,,percent of total billed charges,,,,,,,,,67.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.83,91,,percent of total billed charges,,,84.38,95,,percent of total billed charges,,,73.72,83,,percent of total billed charges,,,73.72,83,,percent of total billed charges,,,,,,,,,,,,,,,73.72,83,,percent of total billed charges,,,84.38,95,,percent of total billed charges,,,79.94,90,,percent of total billed charges,,,79.94,90,,percent of total billed charges,,,72.83,82,,percent of total billed charges,,,79.94,90,,percent of total billed charges,,,75.5,85,,percent of total billed charges,,66.97,84.38,
HYDROXYUREA (HYDREA) CAPS: 500MG,32000379,CDM,,,250,RC,inpatient,,22.68,22.68,,19.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.96,88,,percent of total billed charges,,,,,,,,,17.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.64,91,,percent of total billed charges,,,21.55,95,,percent of total billed charges,,,18.82,83,,percent of total billed charges,,,18.82,83,,percent of total billed charges,,,,,,,,,,,,,,,18.82,83,,percent of total billed charges,,,21.55,95,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,18.6,82,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,19.28,85,,percent of total billed charges,,17.1,21.55,
VALSRTN/HCTZ (DIOVAN) TAB : 80-12.5MG,32000380,CDM,,,250,RC,inpatient,,58.21,58.21,,49.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.22,88,,percent of total billed charges,,,,,,,,,44.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52.97,91,,percent of total billed charges,,,55.3,95,,percent of total billed charges,,,48.31,83,,percent of total billed charges,,,48.31,83,,percent of total billed charges,,,,,,,,,,,,,,,48.31,83,,percent of total billed charges,,,55.3,95,,percent of total billed charges,,,52.39,90,,percent of total billed charges,,,52.39,90,,percent of total billed charges,,,47.73,82,,percent of total billed charges,,,52.39,90,,percent of total billed charges,,,49.48,85,,percent of total billed charges,,43.89,55.3,
LIDOCAINE HCL 2% VIAL:(20MG/ML) (20ML),32000381,CDM,J2001,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
CLINDAMYCIN (CLEOCIN)CREAM : 2%    40GM,32000382,CDM,,,250,RC,inpatient,,2728.72,2728.72,,2316.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2057.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2319.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2401.27,88,,percent of total billed charges,,,,,,,,,2084.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2483.14,91,,percent of total billed charges,,,2592.28,95,,percent of total billed charges,,,2264.84,83,,percent of total billed charges,,,2264.84,83,,percent of total billed charges,,,,,,,,,,,,,,,2264.84,83,,percent of total billed charges,,,2592.28,95,,percent of total billed charges,,,2455.85,90,,percent of total billed charges,,,2455.85,90,,percent of total billed charges,,,2237.55,82,,percent of total billed charges,,,2455.85,90,,percent of total billed charges,,,2319.41,85,,percent of total billed charges,,2057.45,2592.28,
MAGNESI HYDR(M.O.M.)ORAL:400MG/5ML 480ML,32000383,CDM,,,250,RC,inpatient,,56.62,56.62,,48.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.83,88,,percent of total billed charges,,,,,,,,,43.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.52,91,,percent of total billed charges,,,53.79,95,,percent of total billed charges,,,46.99,83,,percent of total billed charges,,,46.99,83,,percent of total billed charges,,,,,,,,,,,,,,,46.99,83,,percent of total billed charges,,,53.79,95,,percent of total billed charges,,,50.96,90,,percent of total billed charges,,,50.96,90,,percent of total billed charges,,,46.43,82,,percent of total billed charges,,,50.96,90,,percent of total billed charges,,,48.13,85,,percent of total billed charges,,42.69,53.79,
GELATIN  ABSORBABL(GELFOAM)SPONGE:12-7MM,32000384,CDM,,,250,RC,inpatient,,49.75,49.75,,42.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,43.78,88,,percent of total billed charges,,,,,,,,,38.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.27,91,,percent of total billed charges,,,47.26,95,,percent of total billed charges,,,41.29,83,,percent of total billed charges,,,41.29,83,,percent of total billed charges,,,,,,,,,,,,,,,41.29,83,,percent of total billed charges,,,47.26,95,,percent of total billed charges,,,44.78,90,,percent of total billed charges,,,44.78,90,,percent of total billed charges,,,40.8,82,,percent of total billed charges,,,44.78,90,,percent of total billed charges,,,42.29,85,,percent of total billed charges,,37.51,47.26,
prednisoLONE(PRELONE)SYRP:15MG/5ML(30ML),32000385,CDM,J7599,HCPCS,250,RC,inpatient,,45.75,45.75,,38.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.26,88,,percent of total billed charges,,,,,,,,,34.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.63,91,,percent of total billed charges,,,43.46,95,,percent of total billed charges,,,37.97,83,,percent of total billed charges,,,37.97,83,,percent of total billed charges,,,,,,,,,,,,,,,37.97,83,,percent of total billed charges,,,43.46,95,,percent of total billed charges,,,41.18,90,,percent of total billed charges,,,41.18,90,,percent of total billed charges,,,37.52,82,,percent of total billed charges,,,41.18,90,,percent of total billed charges,,,38.89,85,,percent of total billed charges,,34.5,43.46,
LIDOCAINE VIAL1%--OB:(10MG/ML) TEAR 30ML,32000386,CDM,J2001,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
RACEPINEPHRINE HCL (S-2) VIAL : 2.25%,32000387,CDM,,,250,RC,inpatient,,27.28,27.28,,23.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.01,88,,percent of total billed charges,,,,,,,,,20.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.82,91,,percent of total billed charges,,,25.92,95,,percent of total billed charges,,,22.64,83,,percent of total billed charges,,,22.64,83,,percent of total billed charges,,,,,,,,,,,,,,,22.64,83,,percent of total billed charges,,,25.92,95,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,22.37,82,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,23.19,85,,percent of total billed charges,,20.57,25.92,
guaiFENesin(MUCINEX DM)TAB:600-30MG,32000389,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
VANCOMYCIN-VIAL:500MG,32000391,CDM,J3370,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,19.39,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.39,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,19.39,60.99,
COLLOIDAL OATMEAL (AVEENO BATH) PAC,32000392,CDM,,,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
THYMOL/MENTHOL (ABSORBINE JR) LIN 120ML,32000393,CDM,,,250,RC,inpatient,,82.47,82.47,,70.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,72.57,88,,percent of total billed charges,,,,,,,,,63.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.05,91,,percent of total billed charges,,,78.35,95,,percent of total billed charges,,,68.45,83,,percent of total billed charges,,,68.45,83,,percent of total billed charges,,,,,,,,,,,,,,,68.45,83,,percent of total billed charges,,,78.35,95,,percent of total billed charges,,,74.22,90,,percent of total billed charges,,,74.22,90,,percent of total billed charges,,,67.63,82,,percent of total billed charges,,,74.22,90,,percent of total billed charges,,,70.1,85,,percent of total billed charges,,62.18,78.35,
PRAMOX HCL/CAMPH/OATMEAL(AVEENO)LOT:120M,32000394,CDM,,,250,RC,inpatient,,66.29,66.29,,56.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.34,88,,percent of total billed charges,,,,,,,,,50.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.32,91,,percent of total billed charges,,,62.98,95,,percent of total billed charges,,,55.02,83,,percent of total billed charges,,,55.02,83,,percent of total billed charges,,,,,,,,,,,,,,,55.02,83,,percent of total billed charges,,,62.98,95,,percent of total billed charges,,,59.66,90,,percent of total billed charges,,,59.66,90,,percent of total billed charges,,,54.36,82,,percent of total billed charges,,,59.66,90,,percent of total billed charges,,,56.35,85,,percent of total billed charges,,49.98,62.98,
TEMAZEPAM (RESTORIL) CAP : 7.5MG,32000395,CDM,,,250,RC,inpatient,,41.71,41.71,,35.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36.7,88,,percent of total billed charges,,,,,,,,,31.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37.96,91,,percent of total billed charges,,,39.62,95,,percent of total billed charges,,,34.62,83,,percent of total billed charges,,,34.62,83,,percent of total billed charges,,,,,,,,,,,,,,,34.62,83,,percent of total billed charges,,,39.62,95,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,34.2,82,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,35.45,85,,percent of total billed charges,,31.45,39.62,
ACETAMINOPHEN(TYLENOL)EL:650MG/20ML *M&S,32000396,CDM,,,250,RC,inpatient,,22.2,22.2,,18.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.54,88,,percent of total billed charges,,,,,,,,,16.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.2,91,,percent of total billed charges,,,21.09,95,,percent of total billed charges,,,18.43,83,,percent of total billed charges,,,18.43,83,,percent of total billed charges,,,,,,,,,,,,,,,18.43,83,,percent of total billed charges,,,21.09,95,,percent of total billed charges,,,19.98,90,,percent of total billed charges,,,19.98,90,,percent of total billed charges,,,18.2,82,,percent of total billed charges,,,19.98,90,,percent of total billed charges,,,18.87,85,,percent of total billed charges,,16.74,21.09,
CARMUSTINE (BICNU) VIAL : 100MG,32000397,CDM,,,250,RC,inpatient,,2418.93,2418.93,,2053.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1823.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2056.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2128.66,88,,percent of total billed charges,,,,,,,,,1848.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2201.23,91,,percent of total billed charges,,,2297.98,95,,percent of total billed charges,,,2007.71,83,,percent of total billed charges,,,2007.71,83,,percent of total billed charges,,,,,,,,,,,,,,,2007.71,83,,percent of total billed charges,,,2297.98,95,,percent of total billed charges,,,2177.04,90,,percent of total billed charges,,,2177.04,90,,percent of total billed charges,,,1983.52,82,,percent of total billed charges,,,2177.04,90,,percent of total billed charges,,,2056.09,85,,percent of total billed charges,,1823.87,2297.98,
FLUTAMIDE(EULEXIN)CAP:125MG,32000398,CDM,,,250,RC,inpatient,,26.17,26.17,,22.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23.03,88,,percent of total billed charges,,,,,,,,,19.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.81,91,,percent of total billed charges,,,24.86,95,,percent of total billed charges,,,21.72,83,,percent of total billed charges,,,21.72,83,,percent of total billed charges,,,,,,,,,,,,,,,21.72,83,,percent of total billed charges,,,24.86,95,,percent of total billed charges,,,23.55,90,,percent of total billed charges,,,23.55,90,,percent of total billed charges,,,21.46,82,,percent of total billed charges,,,23.55,90,,percent of total billed charges,,,22.24,85,,percent of total billed charges,,19.73,24.86,
TOLTERODINE (DETROL LA) CAP : 4MG,32000399,CDM,,,250,RC,inpatient,,204.59,204.59,,173.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,154.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,173.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,180.04,88,,percent of total billed charges,,,,,,,,,156.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,186.18,91,,percent of total billed charges,,,194.36,95,,percent of total billed charges,,,169.81,83,,percent of total billed charges,,,169.81,83,,percent of total billed charges,,,,,,,,,,,,,,,169.81,83,,percent of total billed charges,,,194.36,95,,percent of total billed charges,,,184.13,90,,percent of total billed charges,,,184.13,90,,percent of total billed charges,,,167.76,82,,percent of total billed charges,,,184.13,90,,percent of total billed charges,,,173.9,85,,percent of total billed charges,,154.26,194.36,
RISPERIDONE (RISPERDAL) TAB : 0.5MG,32000400,CDM,,,250,RC,inpatient,,76.76,76.76,,65.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,57.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.55,88,,percent of total billed charges,,,,,,,,,58.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,69.85,91,,percent of total billed charges,,,72.92,95,,percent of total billed charges,,,63.71,83,,percent of total billed charges,,,63.71,83,,percent of total billed charges,,,,,,,,,,,,,,,63.71,83,,percent of total billed charges,,,72.92,95,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,62.94,82,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,65.25,85,,percent of total billed charges,,57.88,72.92,
FLUCONAZOLE SUS(DIFLUCAN):10MG/ML (35ML),32000401,CDM,,,250,RC,inpatient,,269.78,269.78,,229.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,203.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,229.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,237.41,88,,percent of total billed charges,,,,,,,,,206.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,245.5,91,,percent of total billed charges,,,256.29,95,,percent of total billed charges,,,223.92,83,,percent of total billed charges,,,223.92,83,,percent of total billed charges,,,,,,,,,,,,,,,223.92,83,,percent of total billed charges,,,256.29,95,,percent of total billed charges,,,242.8,90,,percent of total billed charges,,,242.8,90,,percent of total billed charges,,,221.22,82,,percent of total billed charges,,,242.8,90,,percent of total billed charges,,,229.31,85,,percent of total billed charges,,203.41,256.29,
TRANDOLAPRIL(MAVIK)TAB:1MG,32000402,CDM,,,250,RC,inpatient,,18.4,18.4,,15.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16.19,88,,percent of total billed charges,,,,,,,,,14.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.74,91,,percent of total billed charges,,,17.48,95,,percent of total billed charges,,,15.27,83,,percent of total billed charges,,,15.27,83,,percent of total billed charges,,,,,,,,,,,,,,,15.27,83,,percent of total billed charges,,,17.48,95,,percent of total billed charges,,,16.56,90,,percent of total billed charges,,,16.56,90,,percent of total billed charges,,,15.09,82,,percent of total billed charges,,,16.56,90,,percent of total billed charges,,,15.64,85,,percent of total billed charges,,13.87,17.48,
BRIMONIDINE TARTR DROP:0.15% 15ML,32000404,CDM,,,250,RC,inpatient,,199,199,,168.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,169.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,175.12,88,,percent of total billed charges,,,,,,,,,152.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,181.09,91,,percent of total billed charges,,,189.05,95,,percent of total billed charges,,,165.17,83,,percent of total billed charges,,,165.17,83,,percent of total billed charges,,,,,,,,,,,,,,,165.17,83,,percent of total billed charges,,,189.05,95,,percent of total billed charges,,,179.1,90,,percent of total billed charges,,,179.1,90,,percent of total billed charges,,,163.18,82,,percent of total billed charges,,,179.1,90,,percent of total billed charges,,,169.15,85,,percent of total billed charges,,150.05,189.05,
KETOROLAC(ACULAR)DROP 0.5%:5ML,32000405,CDM,,,250,RC,inpatient,,303.08,303.08,,257.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.71,88,,percent of total billed charges,,,,,,,,,231.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.8,91,,percent of total billed charges,,,287.93,95,,percent of total billed charges,,,251.56,83,,percent of total billed charges,,,251.56,83,,percent of total billed charges,,,,,,,,,,,,,,,251.56,83,,percent of total billed charges,,,287.93,95,,percent of total billed charges,,,272.77,90,,percent of total billed charges,,,272.77,90,,percent of total billed charges,,,248.53,82,,percent of total billed charges,,,272.77,90,,percent of total billed charges,,,257.62,85,,percent of total billed charges,,228.52,287.93,
TIMOLOL/DORZOL(COSOPT)DROP 0.5%-2%:10ML,32000406,CDM,,,250,RC,inpatient,,333.06,333.06,,282.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,251.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,283.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,293.09,88,,percent of total billed charges,,,,,,,,,254.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,303.08,91,,percent of total billed charges,,,316.41,95,,percent of total billed charges,,,276.44,83,,percent of total billed charges,,,276.44,83,,percent of total billed charges,,,,,,,,,,,,,,,276.44,83,,percent of total billed charges,,,316.41,95,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,273.11,82,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,283.1,85,,percent of total billed charges,,251.13,316.41,
FENOFIBRATE MICRONIZED (TRICOR) TAB:48MG,32000407,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
SALMETEROL(SEREVENT)DISC:50MCG (28'S),32000408,CDM,J3490,HCPCS,250,RC,inpatient,,1865.5,1865.5,,1583.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1406.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1585.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1641.64,88,,percent of total billed charges,,,,,,,,,1425.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1697.61,91,,percent of total billed charges,,,1772.23,95,,percent of total billed charges,,,1548.37,83,,percent of total billed charges,,,1548.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1548.37,83,,percent of total billed charges,,,1772.23,95,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1529.71,82,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1585.68,85,,percent of total billed charges,,1406.59,1772.23,
PIPERACIL/TAZO(ZOSYN)PIGGY:3.375G/50ML,32000409,CDM,,,250,RC,inpatient,,308.32,308.32,,261.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,232.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,262.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,271.32,88,,percent of total billed charges,,,,,,,,,235.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,280.57,91,,percent of total billed charges,,,292.9,95,,percent of total billed charges,,,255.91,83,,percent of total billed charges,,,255.91,83,,percent of total billed charges,,,,,,,,,,,,,,,255.91,83,,percent of total billed charges,,,292.9,95,,percent of total billed charges,,,277.49,90,,percent of total billed charges,,,277.49,90,,percent of total billed charges,,,252.82,82,,percent of total billed charges,,,277.49,90,,percent of total billed charges,,,262.07,85,,percent of total billed charges,,232.47,292.9,
ESZOPICLONE (LUNESTA) TAB : 2MG,32000410,CDM,,,250,RC,inpatient,,261.06,261.06,,221.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,196.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,221.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,229.73,88,,percent of total billed charges,,,,,,,,,199.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.56,91,,percent of total billed charges,,,248.01,95,,percent of total billed charges,,,216.68,83,,percent of total billed charges,,,216.68,83,,percent of total billed charges,,,,,,,,,,,,,,,216.68,83,,percent of total billed charges,,,248.01,95,,percent of total billed charges,,,234.95,90,,percent of total billed charges,,,234.95,90,,percent of total billed charges,,,214.07,82,,percent of total billed charges,,,234.95,90,,percent of total billed charges,,,221.9,85,,percent of total billed charges,,196.84,248.01,
NORMAL SALINE 0.9%-VIAL:50ML,32000451,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
ceFEPime(MAXIPIME)VIAL:2GM,32000452,CDM,J0692,HCPCS,250,RC,inpatient,,154.41,154.41,,131.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,131.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.88,88,,percent of total billed charges,,6.96,,,,fee schedule,,,117.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6.96,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.51,91,,percent of total billed charges,,,146.69,95,,percent of total billed charges,,,128.16,83,,percent of total billed charges,,,128.16,83,,percent of total billed charges,,,,,,,,,,,,,,,128.16,83,,percent of total billed charges,,,146.69,95,,percent of total billed charges,,,138.97,90,,percent of total billed charges,,,138.97,90,,percent of total billed charges,,,126.62,82,,percent of total billed charges,,,138.97,90,,percent of total billed charges,,,131.25,85,,percent of total billed charges,,6.96,146.69,
ceFEPime(MAXIPIME)VIAL:1GM,32000453,CDM,J0692,HCPCS,250,RC,inpatient,,91.01,91.01,,77.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.09,88,,percent of total billed charges,,6.96,,,,fee schedule,,,69.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6.96,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.82,91,,percent of total billed charges,,,86.46,95,,percent of total billed charges,,,75.54,83,,percent of total billed charges,,,75.54,83,,percent of total billed charges,,,,,,,,,,,,,,,75.54,83,,percent of total billed charges,,,86.46,95,,percent of total billed charges,,,81.91,90,,percent of total billed charges,,,81.91,90,,percent of total billed charges,,,74.63,82,,percent of total billed charges,,,81.91,90,,percent of total billed charges,,,77.36,85,,percent of total billed charges,,6.96,86.46,
ARIPiprazole(ABILIFY)TAB:5MG,32000454,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DIVaLproex(DEPAkote *er* )TAB:250MG,32000456,CDM,J8499,HCPCS,250,RC,inpatient,,20.26,20.26,,17.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.83,88,,percent of total billed charges,,,,,,,,,15.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.44,91,,percent of total billed charges,,,19.25,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.25,95,,percent of total billed charges,,,18.23,90,,percent of total billed charges,,,18.23,90,,percent of total billed charges,,,16.61,82,,percent of total billed charges,,,18.23,90,,percent of total billed charges,,,17.22,85,,percent of total billed charges,,15.28,19.25,
ZALEPLON (SONATA) CAP : 5MG,32000457,CDM,,,250,RC,inpatient,,50.12,50.12,,42.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.11,88,,percent of total billed charges,,,,,,,,,38.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.61,91,,percent of total billed charges,,,47.61,95,,percent of total billed charges,,,41.6,83,,percent of total billed charges,,,41.6,83,,percent of total billed charges,,,,,,,,,,,,,,,41.6,83,,percent of total billed charges,,,47.61,95,,percent of total billed charges,,,45.11,90,,percent of total billed charges,,,45.11,90,,percent of total billed charges,,,41.1,82,,percent of total billed charges,,,45.11,90,,percent of total billed charges,,,42.6,85,,percent of total billed charges,,37.79,47.61,
HYDROCHLOROTHIAZIDE(HCTZ) CAP:12.5MG,32000458,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CAMPATH SDPF: 30MG/ML  J/10MG,32000459,CDM,J9010,HCPCS,636,RC,inpatient,,4517.39,4517.39,,3835.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3406.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3839.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3975.3,88,,percent of total billed charges,,,,,,,,,3451.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4110.82,91,,percent of total billed charges,,,4291.52,95,,percent of total billed charges,,,3749.43,83,,percent of total billed charges,,,3749.43,83,,percent of total billed charges,,,,,,,,,,,,,,,3749.43,83,,percent of total billed charges,,,4291.52,95,,percent of total billed charges,,,4065.65,90,,percent of total billed charges,,,4065.65,90,,percent of total billed charges,,,3704.26,82,,percent of total billed charges,,,4065.65,90,,percent of total billed charges,,,3839.78,85,,percent of total billed charges,,3406.11,4291.52,
DORNASE(PULMOZYME):1MG/ML  U/D,32000460,CDM,,,250,RC,inpatient,,1621.8,1621.8,,1376.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1222.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1378.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1427.18,88,,percent of total billed charges,,,,,,,,,1239.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1475.84,91,,percent of total billed charges,,,1540.71,95,,percent of total billed charges,,,1346.09,83,,percent of total billed charges,,,1346.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1346.09,83,,percent of total billed charges,,,1540.71,95,,percent of total billed charges,,,1459.62,90,,percent of total billed charges,,,1459.62,90,,percent of total billed charges,,,1329.88,82,,percent of total billed charges,,,1459.62,90,,percent of total billed charges,,,1378.53,85,,percent of total billed charges,,1222.84,1540.71,
CARBAXEFED DM(RONDEC DM)DRPS:30ML,32000461,CDM,,,250,RC,inpatient,,99.76,99.76,,84.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,84.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,87.79,88,,percent of total billed charges,,,,,,,,,76.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,90.78,91,,percent of total billed charges,,,94.77,95,,percent of total billed charges,,,82.8,83,,percent of total billed charges,,,82.8,83,,percent of total billed charges,,,,,,,,,,,,,,,82.8,83,,percent of total billed charges,,,94.77,95,,percent of total billed charges,,,89.78,90,,percent of total billed charges,,,89.78,90,,percent of total billed charges,,,81.8,82,,percent of total billed charges,,,89.78,90,,percent of total billed charges,,,84.8,85,,percent of total billed charges,,75.22,94.77,
LEVONORGESTREL(PLAN B),32000462,CDM,J8499,HCPCS,250,RC,inpatient,,541.14,541.14,,459.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,408.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,459.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,476.2,88,,percent of total billed charges,,,,,,,,,413.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,492.44,91,,percent of total billed charges,,,514.08,95,,percent of total billed charges,,,449.15,83,,percent of total billed charges,,,449.15,83,,percent of total billed charges,,,,,,,,,,,,,,,449.15,83,,percent of total billed charges,,,514.08,95,,percent of total billed charges,,,487.03,90,,percent of total billed charges,,,487.03,90,,percent of total billed charges,,,443.73,82,,percent of total billed charges,,,487.03,90,,percent of total billed charges,,,459.97,85,,percent of total billed charges,,408.02,514.08,
CHOLESTYRAMINE (QUESTRAN LIGHT) U/D PKG,32000463,CDM,,,250,RC,inpatient,,23.31,23.31,,19.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.51,88,,percent of total billed charges,,,,,,,,,17.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.21,91,,percent of total billed charges,,,22.14,95,,percent of total billed charges,,,19.35,83,,percent of total billed charges,,,19.35,83,,percent of total billed charges,,,,,,,,,,,,,,,19.35,83,,percent of total billed charges,,,22.14,95,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,19.11,82,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,19.81,85,,percent of total billed charges,,17.58,22.14,
EXENATIDE (BYETTA)PPN 10MCG/0.04ML SYR,32000464,CDM,,,250,RC,inpatient,,1850.79,1850.79,,1571.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1395.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1573.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1628.7,88,,percent of total billed charges,,,,,,,,,1414,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1684.22,91,,percent of total billed charges,,,1758.25,95,,percent of total billed charges,,,1536.16,83,,percent of total billed charges,,,1536.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1536.16,83,,percent of total billed charges,,,1758.25,95,,percent of total billed charges,,,1665.71,90,,percent of total billed charges,,,1665.71,90,,percent of total billed charges,,,1517.65,82,,percent of total billed charges,,,1665.71,90,,percent of total billed charges,,,1573.17,85,,percent of total billed charges,,1395.5,1758.25,
BD ULTRA-FINE III SHORT PEN NEEDLES(BOX),32000465,CDM,,,250,RC,inpatient,,467.55,467.55,,396.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,352.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,397.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,411.44,88,,percent of total billed charges,,,,,,,,,357.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,425.47,91,,percent of total billed charges,,,444.17,95,,percent of total billed charges,,,388.07,83,,percent of total billed charges,,,388.07,83,,percent of total billed charges,,,,,,,,,,,,,,,388.07,83,,percent of total billed charges,,,444.17,95,,percent of total billed charges,,,420.8,90,,percent of total billed charges,,,420.8,90,,percent of total billed charges,,,383.39,82,,percent of total billed charges,,,420.8,90,,percent of total billed charges,,,397.42,85,,percent of total billed charges,,352.53,444.17,
MORPHINE SULF VIAL PCA:30MG/30ML,32000466,CDM,J2270,HCPCS,250,RC,inpatient,,136.93,136.93,,116.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,103.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,116.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,120.5,88,,percent of total billed charges,,5.94,,,,fee schedule,,,104.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.94,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,124.61,91,,percent of total billed charges,,,130.08,95,,percent of total billed charges,,,113.65,83,,percent of total billed charges,,,113.65,83,,percent of total billed charges,,,,,,,,,,,,,,,113.65,83,,percent of total billed charges,,,130.08,95,,percent of total billed charges,,,123.24,90,,percent of total billed charges,,,123.24,90,,percent of total billed charges,,,112.28,82,,percent of total billed charges,,,123.24,90,,percent of total billed charges,,,116.39,85,,percent of total billed charges,,5.94,130.08,
*DOCETAXEL (TaxoTERE) 20MG/0.5ML:(V1011),32000467,CDM,J9171,HCPCS,636,RC,inpatient,,3165.53,3165.53,,2687.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2386.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2690.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2785.67,88,,percent of total billed charges,,121.68,,,,fee schedule,,,2418.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2880.63,91,,percent of total billed charges,,,3007.25,95,,percent of total billed charges,,,2627.39,83,,percent of total billed charges,,,2627.39,83,,percent of total billed charges,,,,,,,,,,,,,,,2627.39,83,,percent of total billed charges,,,3007.25,95,,percent of total billed charges,,,2848.98,90,,percent of total billed charges,,,2848.98,90,,percent of total billed charges,,,2595.73,82,,percent of total billed charges,,,2848.98,90,,percent of total billed charges,,,2690.7,85,,percent of total billed charges,,121.68,3007.25,
CYCLOPHOSPHAMIDE(CYTOXAN)VIAL:500MG,32000468,CDM,J9070,HCPCS,636,RC,inpatient,,1503.02,1503.02,,1276.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1133.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1277.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1322.66,88,,percent of total billed charges,,1315.38,,,,fee schedule,,,1148.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1315.38,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1367.75,91,,percent of total billed charges,,,1427.87,95,,percent of total billed charges,,,1247.51,83,,percent of total billed charges,,,1247.51,83,,percent of total billed charges,,,,,,,,,,,,,,,1247.51,83,,percent of total billed charges,,,1427.87,95,,percent of total billed charges,,,1352.72,90,,percent of total billed charges,,,1352.72,90,,percent of total billed charges,,,1232.48,82,,percent of total billed charges,,,1352.72,90,,percent of total billed charges,,,1277.57,85,,percent of total billed charges,,1133.28,1427.87,
MORPHINE SULFATE,32000471,CDM,,,250,RC,inpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.78,88,,percent of total billed charges,,,,,,,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,49.51,62.38,
SOLIFENACIN(VESICARE)TAB:5MG,32000472,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
oxyCODONE(oxyCONTIN) ER TAB:10MG,32000473,CDM,,,250,RC,inpatient,,67.97,67.97,,57.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.81,88,,percent of total billed charges,,,,,,,,,51.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.85,91,,percent of total billed charges,,,64.57,95,,percent of total billed charges,,,56.42,83,,percent of total billed charges,,,56.42,83,,percent of total billed charges,,,,,,,,,,,,,,,56.42,83,,percent of total billed charges,,,64.57,95,,percent of total billed charges,,,61.17,90,,percent of total billed charges,,,61.17,90,,percent of total billed charges,,,55.74,82,,percent of total billed charges,,,61.17,90,,percent of total billed charges,,,57.77,85,,percent of total billed charges,,51.25,64.57,
CALFACTANT(INFASURF)SDV:210MG/6ML,32000474,CDM,,,250,RC,inpatient,,4458.9,4458.9,,3785.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3362.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3790.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3923.83,88,,percent of total billed charges,,,,,,,,,3406.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4057.6,91,,percent of total billed charges,,,4235.96,95,,percent of total billed charges,,,3700.89,83,,percent of total billed charges,,,3700.89,83,,percent of total billed charges,,,,,,,,,,,,,,,3700.89,83,,percent of total billed charges,,,4235.96,95,,percent of total billed charges,,,4013.01,90,,percent of total billed charges,,,4013.01,90,,percent of total billed charges,,,3656.3,82,,percent of total billed charges,,,4013.01,90,,percent of total billed charges,,,3790.07,85,,percent of total billed charges,,3362.01,4235.96,
lamoTRIgine(LaMICtal)TAB:100MG,32000475,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
MEPERIDINE (DEMEROL) PCA:300MG/30ML,32000476,CDM,,,250,RC,inpatient,,125.93,125.93,,106.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,94.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110.82,88,,percent of total billed charges,,,,,,,,,96.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,114.6,91,,percent of total billed charges,,,119.63,95,,percent of total billed charges,,,104.52,83,,percent of total billed charges,,,104.52,83,,percent of total billed charges,,,,,,,,,,,,,,,104.52,83,,percent of total billed charges,,,119.63,95,,percent of total billed charges,,,113.34,90,,percent of total billed charges,,,113.34,90,,percent of total billed charges,,,103.26,82,,percent of total billed charges,,,113.34,90,,percent of total billed charges,,,107.04,85,,percent of total billed charges,,94.95,119.63,
DUTASTERIDE(AVODART)GELCAP:0.5 MG,32000477,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ESZOPICLONE (LUNESTA) TAB : 1 MG,32000478,CDM,,,250,RC,inpatient,,771.11,771.11,,654.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,581.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,655.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,678.58,88,,percent of total billed charges,,,,,,,,,589.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,701.71,91,,percent of total billed charges,,,732.55,95,,percent of total billed charges,,,640.02,83,,percent of total billed charges,,,640.02,83,,percent of total billed charges,,,,,,,,,,,,,,,640.02,83,,percent of total billed charges,,,732.55,95,,percent of total billed charges,,,694,90,,percent of total billed charges,,,694,90,,percent of total billed charges,,,632.31,82,,percent of total billed charges,,,694,90,,percent of total billed charges,,,655.44,85,,percent of total billed charges,,581.42,732.55,
APAP/DICH/ISOMETH(MIDRIN)CAP:,32000479,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
EPOETIN(PROCRIT)MDV:20000UNITS/ML-J/1000,32000480,CDM,J0885,HCPCS,636,RC,inpatient,,243.96,243.96,,207.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,183.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,207.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,214.68,88,,percent of total billed charges,,669.6,,,,fee schedule,,,186.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,669.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,222,91,,percent of total billed charges,,,231.76,95,,percent of total billed charges,,,202.49,83,,percent of total billed charges,,,202.49,83,,percent of total billed charges,,,,,,,,,,,,,,,202.49,83,,percent of total billed charges,,,231.76,95,,percent of total billed charges,,,219.56,90,,percent of total billed charges,,,219.56,90,,percent of total billed charges,,,200.05,82,,percent of total billed charges,,,219.56,90,,percent of total billed charges,,,207.37,85,,percent of total billed charges,,183.95,669.6,
SODIUM CHLORIDE(AYR GEL NSL W/ALOE):,32000481,CDM,J3490,HCPCS,250,RC,inpatient,,48.2,48.2,,40.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.42,88,,percent of total billed charges,,,,,,,,,36.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.86,91,,percent of total billed charges,,,45.79,95,,percent of total billed charges,,,40.01,83,,percent of total billed charges,,,40.01,83,,percent of total billed charges,,,,,,,,,,,,,,,40.01,83,,percent of total billed charges,,,45.79,95,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,39.52,82,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,40.97,85,,percent of total billed charges,,36.34,45.79,
ETOMIDATE(AMIDATE)VIAL:20MG/10ML,32000482,CDM,J3490,HCPCS,250,RC,inpatient,,75.33,75.33,,63.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,64.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66.29,88,,percent of total billed charges,,,,,,,,,57.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,68.55,91,,percent of total billed charges,,,71.56,95,,percent of total billed charges,,,62.52,83,,percent of total billed charges,,,62.52,83,,percent of total billed charges,,,,,,,,,,,,,,,62.52,83,,percent of total billed charges,,,71.56,95,,percent of total billed charges,,,67.8,90,,percent of total billed charges,,,67.8,90,,percent of total billed charges,,,61.77,82,,percent of total billed charges,,,67.8,90,,percent of total billed charges,,,64.03,85,,percent of total billed charges,,56.8,71.56,
DARIFENACIN(ENABLEX ER)TAB:7.5MG,32000483,CDM,J8499,HCPCS,250,RC,inpatient,,35.84,35.84,,30.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31.54,88,,percent of total billed charges,,,,,,,,,27.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.61,91,,percent of total billed charges,,,34.05,95,,percent of total billed charges,,,29.75,83,,percent of total billed charges,,,29.75,83,,percent of total billed charges,,,,,,,,,,,,,,,29.75,83,,percent of total billed charges,,,34.05,95,,percent of total billed charges,,,32.26,90,,percent of total billed charges,,,32.26,90,,percent of total billed charges,,,29.39,82,,percent of total billed charges,,,32.26,90,,percent of total billed charges,,,30.46,85,,percent of total billed charges,,27.02,34.05,
ONDANSETRON(ZOFRAN)MDV:40MG/20ML(J/1MG),32000487,CDM,J2405,HCPCS,636,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,1.38,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.38,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,1.38,60.99,
riTUXimab(RITUXAN):100MG/10ML,32000489,CDM,J9312,HCPCS,636,RC,inpatient,,7438.21,7438.21,,6315.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5608.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6322.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6545.62,88,,percent of total billed charges,,10692.63,,,,fee schedule,,,5682.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,10692.63,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6768.77,91,,percent of total billed charges,,,7066.3,95,,percent of total billed charges,,,6173.71,83,,percent of total billed charges,,,6173.71,83,,percent of total billed charges,,,,,,,,,,,,,,,6173.71,83,,percent of total billed charges,,,7066.3,95,,percent of total billed charges,,,6694.39,90,,percent of total billed charges,,,6694.39,90,,percent of total billed charges,,,6099.33,82,,percent of total billed charges,,,6694.39,90,,percent of total billed charges,,,6322.48,85,,percent of total billed charges,,5608.41,10692.63,
NIACIN(NIASPAN)TAB:500MG,32000490,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
VANCOMYCIN-VIAL:1GM,32000491,CDM,J3370,HCPCS,250,RC,inpatient,,332.85,332.85,,282.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,250.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,282.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,292.91,88,,percent of total billed charges,,19.39,,,,fee schedule,,,254.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.39,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,302.89,91,,percent of total billed charges,,,316.21,95,,percent of total billed charges,,,276.27,83,,percent of total billed charges,,,276.27,83,,percent of total billed charges,,,,,,,,,,,,,,,276.27,83,,percent of total billed charges,,,316.21,95,,percent of total billed charges,,,299.57,90,,percent of total billed charges,,,299.57,90,,percent of total billed charges,,,272.94,82,,percent of total billed charges,,,299.57,90,,percent of total billed charges,,,282.92,85,,percent of total billed charges,,19.39,316.21,
EXENTIDE (BYETTA) SYRINGE 5MCG/0.02:,32000492,CDM,,,250,RC,inpatient,,3063.79,3063.79,,2601.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2310.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2604.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2696.14,88,,percent of total billed charges,,,,,,,,,2340.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2788.05,91,,percent of total billed charges,,,2910.6,95,,percent of total billed charges,,,2542.95,83,,percent of total billed charges,,,2542.95,83,,percent of total billed charges,,,,,,,,,,,,,,,2542.95,83,,percent of total billed charges,,,2910.6,95,,percent of total billed charges,,,2757.41,90,,percent of total billed charges,,,2757.41,90,,percent of total billed charges,,,2512.31,82,,percent of total billed charges,,,2757.41,90,,percent of total billed charges,,,2604.22,85,,percent of total billed charges,,2310.1,2910.6,
TERBINAFINE(LamISIL)TAB:250MG,32000494,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CROMOLYN(INTAL)MDI:8.1GM,32000495,CDM,,,250,RC,inpatient,,959.48,959.48,,814.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,723.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,815.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,844.34,88,,percent of total billed charges,,,,,,,,,733.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,873.13,91,,percent of total billed charges,,,911.51,95,,percent of total billed charges,,,796.37,83,,percent of total billed charges,,,796.37,83,,percent of total billed charges,,,,,,,,,,,,,,,796.37,83,,percent of total billed charges,,,911.51,95,,percent of total billed charges,,,863.53,90,,percent of total billed charges,,,863.53,90,,percent of total billed charges,,,786.77,82,,percent of total billed charges,,,863.53,90,,percent of total billed charges,,,815.56,85,,percent of total billed charges,,723.45,911.51,
IV DOPAmine/D5W 200MG 250ML  (PREMIX-PD),32000496,CDM,,,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
EPLERENONE(INSPRA)TAB:25 MG,32000498,CDM,,,250,RC,inpatient,,51.86,51.86,,44.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.64,88,,percent of total billed charges,,,,,,,,,39.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47.19,91,,percent of total billed charges,,,49.27,95,,percent of total billed charges,,,43.04,83,,percent of total billed charges,,,43.04,83,,percent of total billed charges,,,,,,,,,,,,,,,43.04,83,,percent of total billed charges,,,49.27,95,,percent of total billed charges,,,46.67,90,,percent of total billed charges,,,46.67,90,,percent of total billed charges,,,42.53,82,,percent of total billed charges,,,46.67,90,,percent of total billed charges,,,44.08,85,,percent of total billed charges,,39.1,49.27,
MIDODRINE TAB:5MG,32000499,CDM,,,250,RC,inpatient,,20.46,20.46,,17.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18,88,,percent of total billed charges,,,,,,,,,15.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.62,91,,percent of total billed charges,,,19.44,95,,percent of total billed charges,,,16.98,83,,percent of total billed charges,,,16.98,83,,percent of total billed charges,,,,,,,,,,,,,,,16.98,83,,percent of total billed charges,,,19.44,95,,percent of total billed charges,,,18.41,90,,percent of total billed charges,,,18.41,90,,percent of total billed charges,,,16.78,82,,percent of total billed charges,,,18.41,90,,percent of total billed charges,,,17.39,85,,percent of total billed charges,,15.43,19.44,
NICOTINE(NICORETTE)GUM:2MG,32000500,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ABATACEPT (ORENCIA) 250 MG VIAL,32000502,CDM,J0129,HCPCS,636,RC,inpatient,,6151.86,6151.86,,5222.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4638.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5229.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5413.64,88,,percent of total billed charges,,4324.6,,,,fee schedule,,,4700.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,4324.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5598.19,91,,percent of total billed charges,,,5844.27,95,,percent of total billed charges,,,5106.04,83,,percent of total billed charges,,,5106.04,83,,percent of total billed charges,,,,,,,,,,,,,,,5106.04,83,,percent of total billed charges,,,5844.27,95,,percent of total billed charges,,,5536.67,90,,percent of total billed charges,,,5536.67,90,,percent of total billed charges,,,5044.53,82,,percent of total billed charges,,,5536.67,90,,percent of total billed charges,,,5229.08,85,,percent of total billed charges,,4324.6,5844.27,
PEGFILGRASTIM(NEULASTA)SYR 6MG/0.6ML,32000503,CDM,J2506,HCPCS,636,RC,inpatient,,20954.21,20954.21,,17790.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15799.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17811.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18439.7,88,,percent of total billed charges,,1576.97,,,,fee schedule,,,16009.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1576.97,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19068.33,91,,percent of total billed charges,,,19906.5,95,,percent of total billed charges,,,17391.99,83,,percent of total billed charges,,,17391.99,83,,percent of total billed charges,,,,,,,,,,,,,,,17391.99,83,,percent of total billed charges,,,19906.5,95,,percent of total billed charges,,,18858.79,90,,percent of total billed charges,,,18858.79,90,,percent of total billed charges,,,17182.45,82,,percent of total billed charges,,,18858.79,90,,percent of total billed charges,,,17811.08,85,,percent of total billed charges,,1576.97,19906.5,
DICLOFEN/MISOPROS(ARTHROTEC)TAB:75MG,32000504,CDM,,,250,RC,inpatient,,59.16,59.16,,50.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.06,88,,percent of total billed charges,,,,,,,,,45.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.84,91,,percent of total billed charges,,,56.2,95,,percent of total billed charges,,,49.1,83,,percent of total billed charges,,,49.1,83,,percent of total billed charges,,,,,,,,,,,,,,,49.1,83,,percent of total billed charges,,,56.2,95,,percent of total billed charges,,,53.24,90,,percent of total billed charges,,,53.24,90,,percent of total billed charges,,,48.51,82,,percent of total billed charges,,,53.24,90,,percent of total billed charges,,,50.29,85,,percent of total billed charges,,44.61,56.2,
TOPIRAMATE(TOPAMAX)TAB:100MG,32000505,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
VORICONAZOLE (VFEND) TABS : 200 MG,32000506,CDM,,,250,RC,inpatient,,61.38,61.38,,52.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.01,88,,percent of total billed charges,,,,,,,,,46.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55.86,91,,percent of total billed charges,,,58.31,95,,percent of total billed charges,,,50.95,83,,percent of total billed charges,,,50.95,83,,percent of total billed charges,,,,,,,,,,,,,,,50.95,83,,percent of total billed charges,,,58.31,95,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,50.33,82,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,52.17,85,,percent of total billed charges,,46.28,58.31,
TEGASEROD (ZELNORM) TAB : 6 MG,32000507,CDM,,,250,RC,inpatient,,49.32,49.32,,41.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,43.4,88,,percent of total billed charges,,,,,,,,,37.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,44.88,91,,percent of total billed charges,,,46.85,95,,percent of total billed charges,,,40.94,83,,percent of total billed charges,,,40.94,83,,percent of total billed charges,,,,,,,,,,,,,,,40.94,83,,percent of total billed charges,,,46.85,95,,percent of total billed charges,,,44.39,90,,percent of total billed charges,,,44.39,90,,percent of total billed charges,,,40.44,82,,percent of total billed charges,,,44.39,90,,percent of total billed charges,,,41.92,85,,percent of total billed charges,,37.19,46.85,
CEFTAROLINE (TEFLARO)-VIAL:600MG  J/10MG,32000509,CDM,J0712,HCPCS,250,RC,inpatient,,2989.06,2989.06,,2537.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2253.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2540.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2630.37,88,,percent of total billed charges,,224.52,,,,fee schedule,,,2283.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,224.52,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2720.04,91,,percent of total billed charges,,,2839.61,95,,percent of total billed charges,,,2480.92,83,,percent of total billed charges,,,2480.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2480.92,83,,percent of total billed charges,,,2839.61,95,,percent of total billed charges,,,2690.15,90,,percent of total billed charges,,,2690.15,90,,percent of total billed charges,,,2451.03,82,,percent of total billed charges,,,2690.15,90,,percent of total billed charges,,,2540.7,85,,percent of total billed charges,,224.52,2839.61,
LUBIPROSTONE (AMITIZA) CAP 24 MCG :,32000510,CDM,,,250,RC,inpatient,,48.06,48.06,,40.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.29,88,,percent of total billed charges,,,,,,,,,36.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.73,91,,percent of total billed charges,,,45.66,95,,percent of total billed charges,,,39.89,83,,percent of total billed charges,,,39.89,83,,percent of total billed charges,,,,,,,,,,,,,,,39.89,83,,percent of total billed charges,,,45.66,95,,percent of total billed charges,,,43.25,90,,percent of total billed charges,,,43.25,90,,percent of total billed charges,,,39.41,82,,percent of total billed charges,,,43.25,90,,percent of total billed charges,,,40.85,85,,percent of total billed charges,,36.24,45.66,
CONTAINER EMPTY LIFECARE FLEX BAG:250ML,32000511,CDM,J3490,HCPCS,250,RC,inpatient,,46.79,46.79,,39.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.18,88,,percent of total billed charges,,,,,,,,,35.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.58,91,,percent of total billed charges,,,44.45,95,,percent of total billed charges,,,38.84,83,,percent of total billed charges,,,38.84,83,,percent of total billed charges,,,,,,,,,,,,,,,38.84,83,,percent of total billed charges,,,44.45,95,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,38.37,82,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,39.77,85,,percent of total billed charges,,35.28,44.45,
LEVOFLOX(LEVAQUIN)-IVPB:750MG/D5W150ML,32000512,CDM,J1956,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,3.21,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.21,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.21,187.11,
DIPT/TETANUS/PERT(ACELL)TET:0.5ML,32000513,CDM,,,250,RC,inpatient,,400.62,400.62,,340.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,302.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,340.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,352.55,88,,percent of total billed charges,,,,,,,,,306.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,364.56,91,,percent of total billed charges,,,380.59,95,,percent of total billed charges,,,332.51,83,,percent of total billed charges,,,332.51,83,,percent of total billed charges,,,,,,,,,,,,,,,332.51,83,,percent of total billed charges,,,380.59,95,,percent of total billed charges,,,360.56,90,,percent of total billed charges,,,360.56,90,,percent of total billed charges,,,328.51,82,,percent of total billed charges,,,360.56,90,,percent of total billed charges,,,340.53,85,,percent of total billed charges,,302.07,380.59,
GELATIN SPONGE (GELFOAM):SZ 100,32000514,CDM,J3490,HCPCS,250,RC,inpatient,,663.4,663.4,,563.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,500.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,563.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,583.79,88,,percent of total billed charges,,,,,,,,,506.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,603.69,91,,percent of total billed charges,,,630.23,95,,percent of total billed charges,,,550.62,83,,percent of total billed charges,,,550.62,83,,percent of total billed charges,,,,,,,,,,,,,,,550.62,83,,percent of total billed charges,,,630.23,95,,percent of total billed charges,,,597.06,90,,percent of total billed charges,,,597.06,90,,percent of total billed charges,,,543.99,82,,percent of total billed charges,,,597.06,90,,percent of total billed charges,,,563.89,85,,percent of total billed charges,,500.2,630.23,
TROLAMINE SALICYLATE(ASPERCREME) 10%:,32000515,CDM,,,250,RC,inpatient,,23.63,23.63,,20.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.79,88,,percent of total billed charges,,,,,,,,,18.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.5,91,,percent of total billed charges,,,22.45,95,,percent of total billed charges,,,19.61,83,,percent of total billed charges,,,19.61,83,,percent of total billed charges,,,,,,,,,,,,,,,19.61,83,,percent of total billed charges,,,22.45,95,,percent of total billed charges,,,21.27,90,,percent of total billed charges,,,21.27,90,,percent of total billed charges,,,19.38,82,,percent of total billed charges,,,21.27,90,,percent of total billed charges,,,20.09,85,,percent of total billed charges,,17.82,22.45,
METHOCARBAMOL(ROBAXIN)TABS:750MG,32000516,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FERROUS FUMARATE(FERRO-SEQUELS)CAPS:,32000517,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
FENOFIBRATE(TRICOR)TABS:145 MG,32000519,CDM,J8499,HCPCS,250,RC,inpatient,,45.1,45.1,,38.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.69,88,,percent of total billed charges,,,,,,,,,34.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.04,91,,percent of total billed charges,,,42.85,95,,percent of total billed charges,,,37.43,83,,percent of total billed charges,,,37.43,83,,percent of total billed charges,,,,,,,,,,,,,,,37.43,83,,percent of total billed charges,,,42.85,95,,percent of total billed charges,,,40.59,90,,percent of total billed charges,,,40.59,90,,percent of total billed charges,,,36.98,82,,percent of total billed charges,,,40.59,90,,percent of total billed charges,,,38.34,85,,percent of total billed charges,,34.01,42.85,
insul ASPART(novoLOG)VIAL 70/30:,32000520,CDM,J1815,HCPCS,250,RC,inpatient,,2311.91,2311.91,,1962.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1743.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1965.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2034.48,88,,percent of total billed charges,,,,,,,,,1766.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2103.84,91,,percent of total billed charges,,,2196.31,95,,percent of total billed charges,,,1918.89,83,,percent of total billed charges,,,1918.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1918.89,83,,percent of total billed charges,,,2196.31,95,,percent of total billed charges,,,2080.72,90,,percent of total billed charges,,,2080.72,90,,percent of total billed charges,,,1895.77,82,,percent of total billed charges,,,2080.72,90,,percent of total billed charges,,,1965.12,85,,percent of total billed charges,,1743.18,2196.31,
HEPATITIS B(NABI-HB)I.G. VIAL:5ML,32000521,CDM,90371,CPT,250,RC,inpatient,,5453.4,5453.4,,4629.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4111.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4635.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4798.99,88,,percent of total billed charges,,,,,,,,,4166.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4962.59,91,,percent of total billed charges,,,5180.73,95,,percent of total billed charges,,,4526.32,83,,percent of total billed charges,,,4526.32,83,,percent of total billed charges,,,,,,,,,,,,,,,4526.32,83,,percent of total billed charges,,,5180.73,95,,percent of total billed charges,,,4908.06,90,,percent of total billed charges,,,4908.06,90,,percent of total billed charges,,,4471.79,82,,percent of total billed charges,,,4908.06,90,,percent of total billed charges,,,4635.39,85,,percent of total billed charges,,4111.86,5180.73,
HEPATITIS B(NABI-NB)I.G. VIAL:1 ML,32000522,CDM,90371,CPT,250,RC,inpatient,,2286.41,2286.41,,1941.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1723.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1943.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2012.04,88,,percent of total billed charges,,,,,,,,,1746.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2080.63,91,,percent of total billed charges,,,2172.09,95,,percent of total billed charges,,,1897.72,83,,percent of total billed charges,,,1897.72,83,,percent of total billed charges,,,,,,,,,,,,,,,1897.72,83,,percent of total billed charges,,,2172.09,95,,percent of total billed charges,,,2057.77,90,,percent of total billed charges,,,2057.77,90,,percent of total billed charges,,,1874.86,82,,percent of total billed charges,,,2057.77,90,,percent of total billed charges,,,1943.45,85,,percent of total billed charges,,1723.95,2172.09,
SEVELAMER (RENAGEL) TABS 800 MG:,32000523,CDM,,,250,RC,inpatient,,123.87,123.87,,105.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.01,88,,percent of total billed charges,,,,,,,,,94.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.72,91,,percent of total billed charges,,,117.68,95,,percent of total billed charges,,,102.81,83,,percent of total billed charges,,,102.81,83,,percent of total billed charges,,,,,,,,,,,,,,,102.81,83,,percent of total billed charges,,,117.68,95,,percent of total billed charges,,,111.48,90,,percent of total billed charges,,,111.48,90,,percent of total billed charges,,,101.57,82,,percent of total billed charges,,,111.48,90,,percent of total billed charges,,,105.29,85,,percent of total billed charges,,93.4,117.68,
LIDOCAINE 4% PF INJ SOL AMP:5ML,32000524,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
ephinePHRINE PF(NO SULFITES) 1:1000:,32000525,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
SODIUM CHLORIDE FTV  LF SDPF 14.6%:20ML,32000526,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
ALFUZOSIN (UROXATRAL) ER TABS 10MG:,32000527,CDM,,,250,RC,inpatient,,205.23,205.23,,174.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,154.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,174.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,180.6,88,,percent of total billed charges,,,,,,,,,156.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,186.76,91,,percent of total billed charges,,,194.97,95,,percent of total billed charges,,,170.34,83,,percent of total billed charges,,,170.34,83,,percent of total billed charges,,,,,,,,,,,,,,,170.34,83,,percent of total billed charges,,,194.97,95,,percent of total billed charges,,,184.71,90,,percent of total billed charges,,,184.71,90,,percent of total billed charges,,,168.29,82,,percent of total billed charges,,,184.71,90,,percent of total billed charges,,,174.45,85,,percent of total billed charges,,154.74,194.97,
LEUPROLIDE(LUPRON)SYR30MG:PER7.5MG-MEN,32000528,CDM,J9217,HCPCS,636,RC,inpatient,,32653.22,32653.22,,27722.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24620.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27755.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28734.83,88,,percent of total billed charges,,998.81,,,,fee schedule,,,24947.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,998.81,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29714.43,91,,percent of total billed charges,,,31020.56,95,,percent of total billed charges,,,27102.17,83,,percent of total billed charges,,,27102.17,83,,percent of total billed charges,,,,,,,,,,,,,,,27102.17,83,,percent of total billed charges,,,31020.56,95,,percent of total billed charges,,,29387.9,90,,percent of total billed charges,,,29387.9,90,,percent of total billed charges,,,26775.64,82,,percent of total billed charges,,,29387.9,90,,percent of total billed charges,,,27755.24,85,,percent of total billed charges,,998.81,31020.56,
UREA (AQUAPHIL/CARBAMIDE) OINT 20%:,32000529,CDM,,,250,RC,inpatient,,89.93,89.93,,76.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,76.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.14,88,,percent of total billed charges,,,,,,,,,68.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,81.84,91,,percent of total billed charges,,,85.43,95,,percent of total billed charges,,,74.64,83,,percent of total billed charges,,,74.64,83,,percent of total billed charges,,,,,,,,,,,,,,,74.64,83,,percent of total billed charges,,,85.43,95,,percent of total billed charges,,,80.94,90,,percent of total billed charges,,,80.94,90,,percent of total billed charges,,,73.74,82,,percent of total billed charges,,,80.94,90,,percent of total billed charges,,,76.44,85,,percent of total billed charges,,67.81,85.43,
IRINOTECAN(CAMPTOSAR):40MG/2ML,32000530,CDM,J9206,HCPCS,636,RC,inpatient,,218.47,218.47,,185.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,192.25,88,,percent of total billed charges,,114.58,,,,fee schedule,,,166.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,114.58,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,198.81,91,,percent of total billed charges,,,207.55,95,,percent of total billed charges,,,181.33,83,,percent of total billed charges,,,181.33,83,,percent of total billed charges,,,,,,,,,,,,,,,181.33,83,,percent of total billed charges,,,207.55,95,,percent of total billed charges,,,196.62,90,,percent of total billed charges,,,196.62,90,,percent of total billed charges,,,179.15,82,,percent of total billed charges,,,196.62,90,,percent of total billed charges,,,185.7,85,,percent of total billed charges,,114.58,207.55,
AMPHOTER B LIP(AMBISOME):50MG   J/10MG,32000533,CDM,J0289,HCPCS,636,RC,inpatient,,2054.36,2054.36,,1744.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1548.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1746.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1807.84,88,,percent of total billed charges,,1942.8,,,,fee schedule,,,1569.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1942.8,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1869.47,91,,percent of total billed charges,,,1951.64,95,,percent of total billed charges,,,1705.12,83,,percent of total billed charges,,,1705.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1705.12,83,,percent of total billed charges,,,1951.64,95,,percent of total billed charges,,,1848.92,90,,percent of total billed charges,,,1848.92,90,,percent of total billed charges,,,1684.58,82,,percent of total billed charges,,,1848.92,90,,percent of total billed charges,,,1746.21,85,,percent of total billed charges,,1548.99,1951.64,
FORMOTEROL(FORADIL) 12 MCG:12'S,32000534,CDM,,,250,RC,inpatient,,847.12,847.12,,719.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,638.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,720.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,745.47,88,,percent of total billed charges,,,,,,,,,647.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,770.88,91,,percent of total billed charges,,,804.76,95,,percent of total billed charges,,,703.11,83,,percent of total billed charges,,,703.11,83,,percent of total billed charges,,,,,,,,,,,,,,,703.11,83,,percent of total billed charges,,,804.76,95,,percent of total billed charges,,,762.41,90,,percent of total billed charges,,,762.41,90,,percent of total billed charges,,,694.64,82,,percent of total billed charges,,,762.41,90,,percent of total billed charges,,,720.05,85,,percent of total billed charges,,638.73,804.76,
VINblastine(VELBAN)1MG/ML:J/1MG,32000535,CDM,J9360,HCPCS,636,RC,inpatient,,69.94,69.94,,59.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,59.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,61.55,88,,percent of total billed charges,,179.86,,,,fee schedule,,,53.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,179.86,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,63.65,91,,percent of total billed charges,,,66.44,95,,percent of total billed charges,,,58.05,83,,percent of total billed charges,,,58.05,83,,percent of total billed charges,,,,,,,,,,,,,,,58.05,83,,percent of total billed charges,,,66.44,95,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,57.35,82,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,59.45,85,,percent of total billed charges,,52.73,179.86,
QUINAPRIL(ACCUPRIL)TAB:10MG,32000536,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
METOPROTERENOL(ALUPENT)MDI:14GM,32000537,CDM,,,250,RC,inpatient,,624.88,624.88,,530.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,471.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,531.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,549.89,88,,percent of total billed charges,,,,,,,,,477.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,568.64,91,,percent of total billed charges,,,593.64,95,,percent of total billed charges,,,518.65,83,,percent of total billed charges,,,518.65,83,,percent of total billed charges,,,,,,,,,,,,,,,518.65,83,,percent of total billed charges,,,593.64,95,,percent of total billed charges,,,562.39,90,,percent of total billed charges,,,562.39,90,,percent of total billed charges,,,512.4,82,,percent of total billed charges,,,562.39,90,,percent of total billed charges,,,531.15,85,,percent of total billed charges,,471.16,593.64,
TRYPAN BLUE(VISION BLUE):0.5ML,32000538,CDM,,,250,RC,inpatient,,1014.33,1014.33,,861.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,764.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,862.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,892.61,88,,percent of total billed charges,,,,,,,,,774.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,923.04,91,,percent of total billed charges,,,963.61,95,,percent of total billed charges,,,841.89,83,,percent of total billed charges,,,841.89,83,,percent of total billed charges,,,,,,,,,,,,,,,841.89,83,,percent of total billed charges,,,963.61,95,,percent of total billed charges,,,912.9,90,,percent of total billed charges,,,912.9,90,,percent of total billed charges,,,831.75,82,,percent of total billed charges,,,912.9,90,,percent of total billed charges,,,862.18,85,,percent of total billed charges,,764.8,963.61,
IRON SUCROSE(VENOFER):100MG/5ML,32000539,CDM,J1756,HCPCS,636,RC,inpatient,,608.34,608.34,,516.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,458.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,517.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,535.34,88,,percent of total billed charges,,102,,,,fee schedule,,,464.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,102,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,553.59,91,,percent of total billed charges,,,577.92,95,,percent of total billed charges,,,504.92,83,,percent of total billed charges,,,504.92,83,,percent of total billed charges,,,,,,,,,,,,,,,504.92,83,,percent of total billed charges,,,577.92,95,,percent of total billed charges,,,547.51,90,,percent of total billed charges,,,547.51,90,,percent of total billed charges,,,498.84,82,,percent of total billed charges,,,547.51,90,,percent of total billed charges,,,517.09,85,,percent of total billed charges,,102,577.92,
INSUL ASPART(NovoLOG)100UNITS/ML:(10ML),32000540,CDM,J1815,HCPCS,250,RC,inpatient,,684.9,684.9,,581.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,516.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,582.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,602.71,88,,percent of total billed charges,,,,,,,,,523.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,623.26,91,,percent of total billed charges,,,650.66,95,,percent of total billed charges,,,568.47,83,,percent of total billed charges,,,568.47,83,,percent of total billed charges,,,,,,,,,,,,,,,568.47,83,,percent of total billed charges,,,650.66,95,,percent of total billed charges,,,616.41,90,,percent of total billed charges,,,616.41,90,,percent of total billed charges,,,561.62,82,,percent of total billed charges,,,616.41,90,,percent of total billed charges,,,582.17,85,,percent of total billed charges,,516.41,650.66,
QUINAPRIL HCL (ACCUPRIL) TAB : 20MG,32000541,CDM,,,250,RC,inpatient,,81.04,81.04,,68.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.32,88,,percent of total billed charges,,,,,,,,,61.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.75,91,,percent of total billed charges,,,76.99,95,,percent of total billed charges,,,67.26,83,,percent of total billed charges,,,67.26,83,,percent of total billed charges,,,,,,,,,,,,,,,67.26,83,,percent of total billed charges,,,76.99,95,,percent of total billed charges,,,72.94,90,,percent of total billed charges,,,72.94,90,,percent of total billed charges,,,66.45,82,,percent of total billed charges,,,72.94,90,,percent of total billed charges,,,68.88,85,,percent of total billed charges,,61.1,76.99,
ZANFEL CREAM:,32000542,CDM,J3490,HCPCS,250,RC,inpatient,,366.37,366.37,,311.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,276.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,311.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,322.41,88,,percent of total billed charges,,,,,,,,,279.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,333.4,91,,percent of total billed charges,,,348.05,95,,percent of total billed charges,,,304.09,83,,percent of total billed charges,,,304.09,83,,percent of total billed charges,,,,,,,,,,,,,,,304.09,83,,percent of total billed charges,,,348.05,95,,percent of total billed charges,,,329.73,90,,percent of total billed charges,,,329.73,90,,percent of total billed charges,,,300.42,82,,percent of total billed charges,,,329.73,90,,percent of total billed charges,,,311.41,85,,percent of total billed charges,,276.24,348.05,
NATEGLINIDE(STARLIX)TABS:120MG,32000543,CDM,J8499,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
ZOLMITRIPTAN (ZOMIG) ODT TABS 5 MG:,32000544,CDM,,,250,RC,inpatient,,440.75,440.75,,374.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,332.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,374.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,387.86,88,,percent of total billed charges,,,,,,,,,336.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,401.08,91,,percent of total billed charges,,,418.71,95,,percent of total billed charges,,,365.82,83,,percent of total billed charges,,,365.82,83,,percent of total billed charges,,,,,,,,,,,,,,,365.82,83,,percent of total billed charges,,,418.71,95,,percent of total billed charges,,,396.68,90,,percent of total billed charges,,,396.68,90,,percent of total billed charges,,,361.42,82,,percent of total billed charges,,,396.68,90,,percent of total billed charges,,,374.64,85,,percent of total billed charges,,332.33,418.71,
TRANDOLAPRIL(MAVIK) TABS 4MG:,32000545,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
QUINAPRIL HCL (ACCUPRIL) TAB : 5MG,32000546,CDM,,,250,RC,inpatient,,8.25,8.25,,7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.26,88,,percent of total billed charges,,,,,,,,,6.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.51,91,,percent of total billed charges,,,7.84,95,,percent of total billed charges,,,6.85,83,,percent of total billed charges,,,6.85,83,,percent of total billed charges,,,,,,,,,,,,,,,6.85,83,,percent of total billed charges,,,7.84,95,,percent of total billed charges,,,7.43,90,,percent of total billed charges,,,7.43,90,,percent of total billed charges,,,6.77,82,,percent of total billed charges,,,7.43,90,,percent of total billed charges,,,7.01,85,,percent of total billed charges,,6.22,7.84,
ACEBUTOLOL(SECTRAL)CAP:200MG,32000548,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
BEVACIZUMAB(AVASTIN):100MG/4ML,32000549,CDM,J9035,HCPCS,636,RC,inpatient,,6125.3,6125.3,,5200.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4618.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5206.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5390.26,88,,percent of total billed charges,,13247.18,,,,fee schedule,,,4679.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13247.18,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5574.02,91,,percent of total billed charges,,,5819.04,95,,percent of total billed charges,,,5084,83,,percent of total billed charges,,,5084,83,,percent of total billed charges,,,,,,,,,,,,,,,5084,83,,percent of total billed charges,,,5819.04,95,,percent of total billed charges,,,5512.77,90,,percent of total billed charges,,,5512.77,90,,percent of total billed charges,,,5022.75,82,,percent of total billed charges,,,5512.77,90,,percent of total billed charges,,,5206.51,85,,percent of total billed charges,,4618.48,13247.18,
FULVESTRANT(FASLODEX)SYN: 250MG/5ML,32000550,CDM,J9395,HCPCS,636,RC,inpatient,,1199.93,1199.93,,1018.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,904.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1019.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1055.94,88,,percent of total billed charges,,220.96,,,,fee schedule,,,916.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,220.96,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1091.94,91,,percent of total billed charges,,,1139.93,95,,percent of total billed charges,,,995.94,83,,percent of total billed charges,,,995.94,83,,percent of total billed charges,,,,,,,,,,,,,,,995.94,83,,percent of total billed charges,,,1139.93,95,,percent of total billed charges,,,1079.94,90,,percent of total billed charges,,,1079.94,90,,percent of total billed charges,,,983.94,82,,percent of total billed charges,,,1079.94,90,,percent of total billed charges,,,1019.94,85,,percent of total billed charges,,220.96,1139.93,
MORPHINE(DURAMORPH)AMP:10MG/10ML,32000552,CDM,J2274,HCPCS,250,RC,inpatient,,126.56,126.56,,107.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,111.37,88,,percent of total billed charges,,11.83,,,,fee schedule,,,96.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11.83,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,115.17,91,,percent of total billed charges,,,120.23,95,,percent of total billed charges,,,105.04,83,,percent of total billed charges,,,105.04,83,,percent of total billed charges,,,,,,,,,,,,,,,105.04,83,,percent of total billed charges,,,120.23,95,,percent of total billed charges,,,113.9,90,,percent of total billed charges,,,113.9,90,,percent of total billed charges,,,103.78,82,,percent of total billed charges,,,113.9,90,,percent of total billed charges,,,107.58,85,,percent of total billed charges,,11.83,120.23,
PAPAIN/UREA (ACCUZYME) OINT 10% (6GM):,32000553,CDM,,,250,RC,inpatient,,182.71,182.71,,155.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,155.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,160.78,88,,percent of total billed charges,,,,,,,,,139.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,166.27,91,,percent of total billed charges,,,173.57,95,,percent of total billed charges,,,151.65,83,,percent of total billed charges,,,151.65,83,,percent of total billed charges,,,,,,,,,,,,,,,151.65,83,,percent of total billed charges,,,173.57,95,,percent of total billed charges,,,164.44,90,,percent of total billed charges,,,164.44,90,,percent of total billed charges,,,149.82,82,,percent of total billed charges,,,164.44,90,,percent of total billed charges,,,155.3,85,,percent of total billed charges,,137.76,173.57,
carBAMazepine(CARBATROL)ER CAPS:100MG,32000554,CDM,,,250,RC,inpatient,,29.5,29.5,,25.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.96,88,,percent of total billed charges,,,,,,,,,22.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.85,91,,percent of total billed charges,,,28.03,95,,percent of total billed charges,,,24.49,83,,percent of total billed charges,,,24.49,83,,percent of total billed charges,,,,,,,,,,,,,,,24.49,83,,percent of total billed charges,,,28.03,95,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,24.19,82,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,25.08,85,,percent of total billed charges,,22.24,28.03,
TRIAMCINOLONE(KENALOG) 0.1% CRM:454GM,32000555,CDM,,,250,RC,inpatient,,171.29,171.29,,145.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,129.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,145.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,150.74,88,,percent of total billed charges,,,,,,,,,130.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,155.87,91,,percent of total billed charges,,,162.73,95,,percent of total billed charges,,,142.17,83,,percent of total billed charges,,,142.17,83,,percent of total billed charges,,,,,,,,,,,,,,,142.17,83,,percent of total billed charges,,,162.73,95,,percent of total billed charges,,,154.16,90,,percent of total billed charges,,,154.16,90,,percent of total billed charges,,,140.46,82,,percent of total billed charges,,,154.16,90,,percent of total billed charges,,,145.6,85,,percent of total billed charges,,129.15,162.73,
ACETAMINOPHEN ELIX : 160MG/5ML 480ML,32000557,CDM,,,250,RC,inpatient,,49.64,49.64,,42.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,43.68,88,,percent of total billed charges,,,,,,,,,37.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.17,91,,percent of total billed charges,,,47.16,95,,percent of total billed charges,,,41.2,83,,percent of total billed charges,,,41.2,83,,percent of total billed charges,,,,,,,,,,,,,,,41.2,83,,percent of total billed charges,,,47.16,95,,percent of total billed charges,,,44.68,90,,percent of total billed charges,,,44.68,90,,percent of total billed charges,,,40.7,82,,percent of total billed charges,,,44.68,90,,percent of total billed charges,,,42.19,85,,percent of total billed charges,,37.43,47.16,
PREGABALIN(LYRICA)CAPS:50MG,32000558,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
POTASSIUM CITRATE 10 MEQ TABS:,32000559,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
SILDENAFIL CITRATE  TABS 5 MG:,32000560,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ACETAMINOPHEN,32000561,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
LEUCOVORIN CALCIUM VIAL:200MG,32000562,CDM,J0640,HCPCS,636,RC,inpatient,,186.11,186.11,,158.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,140.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,158.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,163.78,88,,percent of total billed charges,,100.5,,,,fee schedule,,,142.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,100.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,169.36,91,,percent of total billed charges,,,176.8,95,,percent of total billed charges,,,154.47,83,,percent of total billed charges,,,154.47,83,,percent of total billed charges,,,,,,,,,,,,,,,154.47,83,,percent of total billed charges,,,176.8,95,,percent of total billed charges,,,167.5,90,,percent of total billed charges,,,167.5,90,,percent of total billed charges,,,152.61,82,,percent of total billed charges,,,167.5,90,,percent of total billed charges,,,158.19,85,,percent of total billed charges,,100.5,176.8,
PALONOSETRON(ALOXI)VL:0.25MG/5ML,32000563,CDM,J2469,HCPCS,636,RC,inpatient,,218.79,218.79,,185.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,192.54,88,,percent of total billed charges,,11.5,,,,fee schedule,,,167.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,199.1,91,,percent of total billed charges,,,207.85,95,,percent of total billed charges,,,181.6,83,,percent of total billed charges,,,181.6,83,,percent of total billed charges,,,,,,,,,,,,,,,181.6,83,,percent of total billed charges,,,207.85,95,,percent of total billed charges,,,196.91,90,,percent of total billed charges,,,196.91,90,,percent of total billed charges,,,179.41,82,,percent of total billed charges,,,196.91,90,,percent of total billed charges,,,185.97,85,,percent of total billed charges,,11.5,207.85,
PREGABALIN(LYRICA)CAPS:25MG,32000564,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
PCA EMPTY SYRINGE 30 ML:,32000565,CDM,,,250,RC,inpatient,,0.16,0.16,,0.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,0.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,0.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,0.14,88,,percent of total billed charges,,,,,,,,,0.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,0.15,91,,percent of total billed charges,,,0.15,95,,percent of total billed charges,,,0.13,83,,percent of total billed charges,,,0.13,83,,percent of total billed charges,,,,,,,,,,,,,,,0.13,83,,percent of total billed charges,,,0.15,95,,percent of total billed charges,,,0.14,90,,percent of total billed charges,,,0.14,90,,percent of total billed charges,,,0.13,82,,percent of total billed charges,,,0.14,90,,percent of total billed charges,,,0.14,85,,percent of total billed charges,,0.12,0.15,
ACET(TYLENOL) ORAL : 160MG/5ML 118ML,32000567,CDM,,,250,RC,inpatient,,38.06,38.06,,32.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33.49,88,,percent of total billed charges,,,,,,,,,29.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.63,91,,percent of total billed charges,,,36.16,95,,percent of total billed charges,,,31.59,83,,percent of total billed charges,,,31.59,83,,percent of total billed charges,,,,,,,,,,,,,,,31.59,83,,percent of total billed charges,,,36.16,95,,percent of total billed charges,,,34.25,90,,percent of total billed charges,,,34.25,90,,percent of total billed charges,,,31.21,82,,percent of total billed charges,,,34.25,90,,percent of total billed charges,,,32.35,85,,percent of total billed charges,,28.7,36.16,
ACETAMINOPHEN ELIX : 160MG/5ML 60ML,32000568,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ACETAMINOPHEN ELIX : 160MG/5ML 30ML,32000569,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ACETAMINOPHEN ELIX:480MG/15ML UD-ED,32000570,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ACETAMINOPHEN/COD(TYLENOL#3)TAB:30-300MG,32000571,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
ACETAMINOPHEN/DPHYDRM(MAPAP)TAB:500-25MG,32000572,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ACET/DIPHEN (TYLENOL PM) CAP: 500-25 MG,32000573,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
COD/APAP(TYLENOL+COD)TAB:30-300MG(1X10),32000574,CDM,J8499,HCPCS,250,RC,inpatient,,21.57,21.57,,18.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.98,88,,percent of total billed charges,,,,,,,,,16.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.63,91,,percent of total billed charges,,,20.49,95,,percent of total billed charges,,,17.9,83,,percent of total billed charges,,,17.9,83,,percent of total billed charges,,,,,,,,,,,,,,,17.9,83,,percent of total billed charges,,,20.49,95,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,17.69,82,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,18.33,85,,percent of total billed charges,,16.26,20.49,
ACETIC ACID/HYDROCORT(ACETASOL)DROP:2-1%,32000576,CDM,,,250,RC,inpatient,,2835.3,2835.3,,2407.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2137.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2410.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2495.06,88,,percent of total billed charges,,,,,,,,,2166.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2580.12,91,,percent of total billed charges,,,2693.54,95,,percent of total billed charges,,,2353.3,83,,percent of total billed charges,,,2353.3,83,,percent of total billed charges,,,,,,,,,,,,,,,2353.3,83,,percent of total billed charges,,,2693.54,95,,percent of total billed charges,,,2551.77,90,,percent of total billed charges,,,2551.77,90,,percent of total billed charges,,,2324.95,82,,percent of total billed charges,,,2551.77,90,,percent of total billed charges,,,2410.01,85,,percent of total billed charges,,2137.82,2693.54,
oxyCODONE IR TABS:5MG,32000578,CDM,,,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
INFLUENZA VACCINE 2008-2009 SYR 0.5ML:,32000579,CDM,90658,CPT,636,RC,inpatient,,226.32,226.32,,192.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,170.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,199.16,88,,percent of total billed charges,,,,,,,,,172.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,205.95,91,,percent of total billed charges,,,215,95,,percent of total billed charges,,,187.85,83,,percent of total billed charges,,,187.85,83,,percent of total billed charges,,,,,,,,,,,,,,,187.85,83,,percent of total billed charges,,,215,95,,percent of total billed charges,,,203.69,90,,percent of total billed charges,,,203.69,90,,percent of total billed charges,,,185.58,82,,percent of total billed charges,,,203.69,90,,percent of total billed charges,,,192.37,85,,percent of total billed charges,,170.65,215,
METAXALONE(SKELAXIN)TAB:800 MG,32000580,CDM,J8499,HCPCS,250,RC,inpatient,,170.18,170.18,,144.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,128.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,144.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,149.76,88,,percent of total billed charges,,,,,,,,,130.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,154.86,91,,percent of total billed charges,,,161.67,95,,percent of total billed charges,,,141.25,83,,percent of total billed charges,,,141.25,83,,percent of total billed charges,,,,,,,,,,,,,,,141.25,83,,percent of total billed charges,,,161.67,95,,percent of total billed charges,,,153.16,90,,percent of total billed charges,,,153.16,90,,percent of total billed charges,,,139.55,82,,percent of total billed charges,,,153.16,90,,percent of total billed charges,,,144.65,85,,percent of total billed charges,,128.32,161.67,
DEXTROMETHORPHAN(DELSYM):30MG/5ML U/D,32000582,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
HYDROmorphone (DILAUDID) 4MG TABS:,32000583,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
CLINDAMYCIN(CLEOCIN)LIQ 75MG/5ML: 100 ML,32000584,CDM,,,250,RC,inpatient,,510.37,510.37,,433.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,384.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,433.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,449.13,88,,percent of total billed charges,,,,,,,,,389.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,464.44,91,,percent of total billed charges,,,484.85,95,,percent of total billed charges,,,423.61,83,,percent of total billed charges,,,423.61,83,,percent of total billed charges,,,,,,,,,,,,,,,423.61,83,,percent of total billed charges,,,484.85,95,,percent of total billed charges,,,459.33,90,,percent of total billed charges,,,459.33,90,,percent of total billed charges,,,418.5,82,,percent of total billed charges,,,459.33,90,,percent of total billed charges,,,433.81,85,,percent of total billed charges,,384.82,484.85,
MORPHINE SULFATE TAB : 100MG (10X10MG),32000587,CDM,,,250,RC,inpatient,,30,30,,25.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.4,88,,percent of total billed charges,,,,,,,,,22.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,24.9,83,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,24.6,82,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,22.62,28.5,
TRASTUZUMAB(HERCEPTIN)MDV:440MG-J/10MG,32000588,CDM,J9355,HCPCS,636,RC,inpatient,,1464.42,1464.42,,1243.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1104.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1244.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1288.69,88,,percent of total billed charges,,8440.1,,,,fee schedule,,,1118.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8440.1,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1332.62,91,,percent of total billed charges,,,1391.2,95,,percent of total billed charges,,,1215.47,83,,percent of total billed charges,,,1215.47,83,,percent of total billed charges,,,,,,,,,,,,,,,1215.47,83,,percent of total billed charges,,,1391.2,95,,percent of total billed charges,,,1317.98,90,,percent of total billed charges,,,1317.98,90,,percent of total billed charges,,,1200.82,82,,percent of total billed charges,,,1317.98,90,,percent of total billed charges,,,1244.76,85,,percent of total billed charges,,1104.17,8440.1,
KETOCONAZOLE(NIZORAL)TABS 200MG:,32000590,CDM,J8499,HCPCS,250,RC,inpatient,,30.77,30.77,,26.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.08,88,,percent of total billed charges,,,,,,,,,23.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28,91,,percent of total billed charges,,,29.23,95,,percent of total billed charges,,,25.54,83,,percent of total billed charges,,,25.54,83,,percent of total billed charges,,,,,,,,,,,,,,,25.54,83,,percent of total billed charges,,,29.23,95,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,25.23,82,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,26.15,85,,percent of total billed charges,,23.2,29.23,
LIDOCAINE + EPI MPF 2%:20 ML-- ANES**,32000593,CDM,J3490,HCPCS,250,RC,inpatient,,64.71,64.71,,54.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.94,88,,percent of total billed charges,,,,,,,,,49.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.89,91,,percent of total billed charges,,,61.47,95,,percent of total billed charges,,,53.71,83,,percent of total billed charges,,,53.71,83,,percent of total billed charges,,,,,,,,,,,,,,,53.71,83,,percent of total billed charges,,,61.47,95,,percent of total billed charges,,,58.24,90,,percent of total billed charges,,,58.24,90,,percent of total billed charges,,,53.06,82,,percent of total billed charges,,,58.24,90,,percent of total billed charges,,,55,85,,percent of total billed charges,,48.79,61.47,
CALCITRIOL(ROCALTROL)CAPS:0.25MCG,32000594,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ALISKIREN (TEKTURNA)TABS 150 MG:,32000595,CDM,,,250,RC,inpatient,,91.67,91.67,,77.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,69.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.67,88,,percent of total billed charges,,,,,,,,,70.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,83.42,91,,percent of total billed charges,,,87.09,95,,percent of total billed charges,,,76.09,83,,percent of total billed charges,,,76.09,83,,percent of total billed charges,,,,,,,,,,,,,,,76.09,83,,percent of total billed charges,,,87.09,95,,percent of total billed charges,,,82.5,90,,percent of total billed charges,,,82.5,90,,percent of total billed charges,,,75.17,82,,percent of total billed charges,,,82.5,90,,percent of total billed charges,,,77.92,85,,percent of total billed charges,,69.12,87.09,
INSUL ASPART(NovoLOG FLEXPEN)300UNIT/3ML,32000597,CDM,J1815,HCPCS,250,RC,inpatient,,794.97,794.97,,674.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,599.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,675.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,699.57,88,,percent of total billed charges,,,,,,,,,607.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,723.42,91,,percent of total billed charges,,,755.22,95,,percent of total billed charges,,,659.83,83,,percent of total billed charges,,,659.83,83,,percent of total billed charges,,,,,,,,,,,,,,,659.83,83,,percent of total billed charges,,,755.22,95,,percent of total billed charges,,,715.47,90,,percent of total billed charges,,,715.47,90,,percent of total billed charges,,,651.88,82,,percent of total billed charges,,,715.47,90,,percent of total billed charges,,,675.72,85,,percent of total billed charges,,599.41,755.22,
MICONAZOLE(FUNGOID) TR 2% 30ML:,32000598,CDM,,,250,RC,inpatient,,288.33,288.33,,244.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,253.73,88,,percent of total billed charges,,,,,,,,,220.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.38,91,,percent of total billed charges,,,273.91,95,,percent of total billed charges,,,239.31,83,,percent of total billed charges,,,239.31,83,,percent of total billed charges,,,,,,,,,,,,,,,239.31,83,,percent of total billed charges,,,273.91,95,,percent of total billed charges,,,259.5,90,,percent of total billed charges,,,259.5,90,,percent of total billed charges,,,236.43,82,,percent of total billed charges,,,259.5,90,,percent of total billed charges,,,245.08,85,,percent of total billed charges,,217.4,273.91,
ALTEPLASE(ACTIVASE):100MG,32000602,CDM,J2997,HCPCS,636,RC,inpatient,,40957.96,40957.96,,34773.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30882.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34814.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36043,88,,percent of total billed charges,,176.06,,,,fee schedule,,,31291.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,176.06,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37271.74,91,,percent of total billed charges,,,38910.06,95,,percent of total billed charges,,,33995.11,83,,percent of total billed charges,,,33995.11,83,,percent of total billed charges,,,,,,,,,,,,,,,33995.11,83,,percent of total billed charges,,,38910.06,95,,percent of total billed charges,,,36862.16,90,,percent of total billed charges,,,36862.16,90,,percent of total billed charges,,,33585.53,82,,percent of total billed charges,,,36862.16,90,,percent of total billed charges,,,34814.27,85,,percent of total billed charges,,176.06,38910.06,
PIOGLITAZONE(ACTOS)TAB:15MG,32000603,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
RISEDRONATE(ACTONEL)TAB: 5MG,32000604,CDM,J8499,HCPCS,250,RC,inpatient,,40.44,40.44,,34.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.59,88,,percent of total billed charges,,,,,,,,,30.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.8,91,,percent of total billed charges,,,38.42,95,,percent of total billed charges,,,33.57,83,,percent of total billed charges,,,33.57,83,,percent of total billed charges,,,,,,,,,,,,,,,33.57,83,,percent of total billed charges,,,38.42,95,,percent of total billed charges,,,36.4,90,,percent of total billed charges,,,36.4,90,,percent of total billed charges,,,33.16,82,,percent of total billed charges,,,36.4,90,,percent of total billed charges,,,34.37,85,,percent of total billed charges,,30.49,38.42,
PEN G POTAS(PFIZERPEN)VIAL: 24 MIL UNITS,32000605,CDM,,,250,RC,inpatient,,611.4,611.4,,519.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,519.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.03,88,,percent of total billed charges,,,,,,,,,467.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.37,91,,percent of total billed charges,,,580.83,95,,percent of total billed charges,,,507.46,83,,percent of total billed charges,,,507.46,83,,percent of total billed charges,,,,,,,,,,,,,,,507.46,83,,percent of total billed charges,,,580.83,95,,percent of total billed charges,,,550.26,90,,percent of total billed charges,,,550.26,90,,percent of total billed charges,,,501.35,82,,percent of total billed charges,,,550.26,90,,percent of total billed charges,,,519.69,85,,percent of total billed charges,,461,580.83,
KETOROLAC TROMETHAMINE(ACULAR)DROP:0.50%,32000606,CDM,,,250,RC,inpatient,,2116.94,2116.94,,1797.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1596.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1799.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1862.91,88,,percent of total billed charges,,,,,,,,,1617.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1926.42,91,,percent of total billed charges,,,2011.09,95,,percent of total billed charges,,,1757.06,83,,percent of total billed charges,,,1757.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1757.06,83,,percent of total billed charges,,,2011.09,95,,percent of total billed charges,,,1905.25,90,,percent of total billed charges,,,1905.25,90,,percent of total billed charges,,,1735.89,82,,percent of total billed charges,,,1905.25,90,,percent of total billed charges,,,1799.4,85,,percent of total billed charges,,1596.17,2011.09,
PENICILLIN G POTAS VIAL:1 MIL UNITS,32000607,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
POLYETHYLENE GLYCOL(MIRALAX)PWD:119GM,32000609,CDM,J8499,HCPCS,250,RC,inpatient,,116.34,116.34,,98.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,87.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,98.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,102.38,88,,percent of total billed charges,,,,,,,,,88.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,105.87,91,,percent of total billed charges,,,110.52,95,,percent of total billed charges,,,96.56,83,,percent of total billed charges,,,96.56,83,,percent of total billed charges,,,,,,,,,,,,,,,96.56,83,,percent of total billed charges,,,110.52,95,,percent of total billed charges,,,104.71,90,,percent of total billed charges,,,104.71,90,,percent of total billed charges,,,95.4,82,,percent of total billed charges,,,104.71,90,,percent of total billed charges,,,98.89,85,,percent of total billed charges,,87.72,110.52,
RABIES VACCINE(RABAVERT):2.5UNITS,32000610,CDM,90675,CPT,250,RC,inpatient,,2955.83,2955.83,,2509.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2228.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2512.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2601.13,88,,percent of total billed charges,,,,,,,,,2258.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2689.81,91,,percent of total billed charges,,,2808.04,95,,percent of total billed charges,,,2453.34,83,,percent of total billed charges,,,2453.34,83,,percent of total billed charges,,,,,,,,,,,,,,,2453.34,83,,percent of total billed charges,,,2808.04,95,,percent of total billed charges,,,2660.25,90,,percent of total billed charges,,,2660.25,90,,percent of total billed charges,,,2423.78,82,,percent of total billed charges,,,2660.25,90,,percent of total billed charges,,,2512.46,85,,percent of total billed charges,,2228.7,2808.04,
NIFEdipine(PROCARDIA)CAP:10MG,32000611,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
RABIES I.G.(HyperRAB):300IntUnits/2ML,32000612,CDM,90375,CPT,250,RC,inpatient,,4943.85,4943.85,,4197.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3727.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4202.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4350.59,88,,percent of total billed charges,,,,,,,,,3777.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4498.9,91,,percent of total billed charges,,,4696.66,95,,percent of total billed charges,,,4103.4,83,,percent of total billed charges,,,4103.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4103.4,83,,percent of total billed charges,,,4696.66,95,,percent of total billed charges,,,4449.47,90,,percent of total billed charges,,,4449.47,90,,percent of total billed charges,,,4053.96,82,,percent of total billed charges,,,4449.47,90,,percent of total billed charges,,,4202.27,85,,percent of total billed charges,,3727.66,4696.66,
WARFARIN(COUMADIN)TAB: 6MG,32000613,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
guaiFENesin/COD (ROBITUSS AC)5ML UD PX,32000614,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
MIDAZOLAM(VERSED)VIAL:2MG/2ML,32000615,CDM,J2250,HCPCS,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,7.08,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.08,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,7.08,64.15,
METHYLENE BLUE 1% AMP:1ML,32000617,CDM,J3490,HCPCS,250,RC,inpatient,,298.01,298.01,,253.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,224.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,253.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,262.25,88,,percent of total billed charges,,,,,,,,,227.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,271.19,91,,percent of total billed charges,,,283.11,95,,percent of total billed charges,,,247.35,83,,percent of total billed charges,,,247.35,83,,percent of total billed charges,,,,,,,,,,,,,,,247.35,83,,percent of total billed charges,,,283.11,95,,percent of total billed charges,,,268.21,90,,percent of total billed charges,,,268.21,90,,percent of total billed charges,,,244.37,82,,percent of total billed charges,,,268.21,90,,percent of total billed charges,,,253.31,85,,percent of total billed charges,,224.7,283.11,
DEFEROXAMINE (DESFERAL) 2GM: PER 500MG,32000618,CDM,J0895,HCPCS,636,RC,inpatient,,1778.52,1778.52,,1509.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1341,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1511.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1565.1,88,,percent of total billed charges,,31.71,,,,fee schedule,,,1358.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,31.71,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1618.45,91,,percent of total billed charges,,,1689.59,95,,percent of total billed charges,,,1476.17,83,,percent of total billed charges,,,1476.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1476.17,83,,percent of total billed charges,,,1689.59,95,,percent of total billed charges,,,1600.67,90,,percent of total billed charges,,,1600.67,90,,percent of total billed charges,,,1458.39,82,,percent of total billed charges,,,1600.67,90,,percent of total billed charges,,,1511.74,85,,percent of total billed charges,,31.71,1689.59,
PROMETRIUM CAPS 100 MG,32000619,CDM,,,250,RC,inpatient,,55.99,55.99,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.27,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.95,91,,percent of total billed charges,,,53.19,95,,percent of total billed charges,,,46.47,83,,percent of total billed charges,,,46.47,83,,percent of total billed charges,,,,,,,,,,,,,,,46.47,83,,percent of total billed charges,,,53.19,95,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,45.91,82,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,47.59,85,,percent of total billed charges,,42.22,53.19,
risperiDONE(risperDAL)TAB:2MG,32000620,CDM,J8499,HCPCS,250,RC,inpatient,,20.19,20.19,,17.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.77,88,,percent of total billed charges,,,,,,,,,15.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.37,91,,percent of total billed charges,,,19.18,95,,percent of total billed charges,,,16.76,83,,percent of total billed charges,,,16.76,83,,percent of total billed charges,,,,,,,,,,,,,,,16.76,83,,percent of total billed charges,,,19.18,95,,percent of total billed charges,,,18.17,90,,percent of total billed charges,,,18.17,90,,percent of total billed charges,,,16.56,82,,percent of total billed charges,,,18.17,90,,percent of total billed charges,,,17.16,85,,percent of total billed charges,,15.22,19.18,
ADALAT CC,32000621,CDM,,,250,RC,inpatient,,21.73,21.73,,18.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.12,88,,percent of total billed charges,,,,,,,,,16.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.77,91,,percent of total billed charges,,,20.64,95,,percent of total billed charges,,,18.04,83,,percent of total billed charges,,,18.04,83,,percent of total billed charges,,,,,,,,,,,,,,,18.04,83,,percent of total billed charges,,,20.64,95,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,17.82,82,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,18.47,85,,percent of total billed charges,,16.38,20.64,
ZOLEDRONIC(RECLAST):5MG/100ML,32000622,CDM,J3489,HCPCS,636,RC,inpatient,,930.46,930.46,,789.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,701.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,790.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,818.8,88,,percent of total billed charges,,41.84,,,,fee schedule,,,710.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,41.84,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,846.72,91,,percent of total billed charges,,,883.94,95,,percent of total billed charges,,,772.28,83,,percent of total billed charges,,,772.28,83,,percent of total billed charges,,,,,,,,,,,,,,,772.28,83,,percent of total billed charges,,,883.94,95,,percent of total billed charges,,,837.41,90,,percent of total billed charges,,,837.41,90,,percent of total billed charges,,,762.98,82,,percent of total billed charges,,,837.41,90,,percent of total billed charges,,,790.89,85,,percent of total billed charges,,41.84,883.94,
BUPIVACAINE(SENSORCAINE-MPF)0.75%:30ML,32000624,CDM,,,250,RC,inpatient,,90.88,90.88,,77.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.97,88,,percent of total billed charges,,,,,,,,,69.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.7,91,,percent of total billed charges,,,86.34,95,,percent of total billed charges,,,75.43,83,,percent of total billed charges,,,75.43,83,,percent of total billed charges,,,,,,,,,,,,,,,75.43,83,,percent of total billed charges,,,86.34,95,,percent of total billed charges,,,81.79,90,,percent of total billed charges,,,81.79,90,,percent of total billed charges,,,74.52,82,,percent of total billed charges,,,81.79,90,,percent of total billed charges,,,77.25,85,,percent of total billed charges,,68.52,86.34,
DARBEPOETIN(ARANESP)SYR:200MCG/0.4ML,32000625,CDM,J0881,HCPCS,636,RC,inpatient,,7314.3,7314.3,,6209.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5514.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6217.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6436.58,88,,percent of total billed charges,,1579.5,,,,fee schedule,,,5588.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1579.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6656.01,91,,percent of total billed charges,,,6948.59,95,,percent of total billed charges,,,6070.87,83,,percent of total billed charges,,,6070.87,83,,percent of total billed charges,,,,,,,,,,,,,,,6070.87,83,,percent of total billed charges,,,6948.59,95,,percent of total billed charges,,,6582.87,90,,percent of total billed charges,,,6582.87,90,,percent of total billed charges,,,5997.73,82,,percent of total billed charges,,,6582.87,90,,percent of total billed charges,,,6217.16,85,,percent of total billed charges,,1579.5,6948.59,
HEParin LOCK CPJT:100UNITS/ML,32000627,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
ROPIVACAINE(NAROPIN)BTL 0.2%:200ML,32000628,CDM,J2795,HCPCS,250,RC,inpatient,,1163.81,1163.81,,988.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,877.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,989.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1024.15,88,,percent of total billed charges,,13.8,,,,fee schedule,,,889.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.8,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1059.07,91,,percent of total billed charges,,,1105.62,95,,percent of total billed charges,,,965.96,83,,percent of total billed charges,,,965.96,83,,percent of total billed charges,,,,,,,,,,,,,,,965.96,83,,percent of total billed charges,,,1105.62,95,,percent of total billed charges,,,1047.43,90,,percent of total billed charges,,,1047.43,90,,percent of total billed charges,,,954.32,82,,percent of total billed charges,,,1047.43,90,,percent of total billed charges,,,989.24,85,,percent of total billed charges,,13.8,1105.62,
HEP B IG (HYPERHEP B) SYR 0.5 ML:NEONATE,32000629,CDM,90371,CPT,250,RC,inpatient,,1089.58,1089.58,,925.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,821.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,926.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,958.83,88,,percent of total billed charges,,,,,,,,,832.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,991.52,91,,percent of total billed charges,,,1035.1,95,,percent of total billed charges,,,904.35,83,,percent of total billed charges,,,904.35,83,,percent of total billed charges,,,,,,,,,,,,,,,904.35,83,,percent of total billed charges,,,1035.1,95,,percent of total billed charges,,,980.62,90,,percent of total billed charges,,,980.62,90,,percent of total billed charges,,,893.46,82,,percent of total billed charges,,,980.62,90,,percent of total billed charges,,,926.14,85,,percent of total billed charges,,821.54,1035.1,
LINEZOLID(ZYVOX) TABS 600 MG:,32000630,CDM,,,250,RC,inpatient,,38.89,38.89,,33.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34.22,88,,percent of total billed charges,,,,,,,,,29.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35.39,91,,percent of total billed charges,,,36.95,95,,percent of total billed charges,,,32.28,83,,percent of total billed charges,,,32.28,83,,percent of total billed charges,,,,,,,,,,,,,,,32.28,83,,percent of total billed charges,,,36.95,95,,percent of total billed charges,,,35,90,,percent of total billed charges,,,35,90,,percent of total billed charges,,,31.89,82,,percent of total billed charges,,,35,90,,percent of total billed charges,,,33.06,85,,percent of total billed charges,,29.32,36.95,
FOMEPIZOLE (ANTIZOL):1.5GM/1.5ML -J/15MG,32000632,CDM,J1451,HCPCS,250,RC,inpatient,,6197.99,6197.99,,5262.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4673.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5268.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5454.23,88,,percent of total billed charges,,813.45,,,,fee schedule,,,4735.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,813.45,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5640.17,91,,percent of total billed charges,,,5888.09,95,,percent of total billed charges,,,5144.33,83,,percent of total billed charges,,,5144.33,83,,percent of total billed charges,,,,,,,,,,,,,,,5144.33,83,,percent of total billed charges,,,5888.09,95,,percent of total billed charges,,,5578.19,90,,percent of total billed charges,,,5578.19,90,,percent of total billed charges,,,5082.35,82,,percent of total billed charges,,,5578.19,90,,percent of total billed charges,,,5268.29,85,,percent of total billed charges,,813.45,5888.09,
oxyCODONE/ACETAMN(PERCOCET) 10/325MG:,32000633,CDM,,,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
HYDROmorphone (DILAUDID)TABS:2MG,32000634,CDM,,,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
HYDROmorphone (DILAUDID) SYR:2MG/ML,32000635,CDM,J1170,HCPCS,250,RC,inpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.78,88,,percent of total billed charges,,3.47,,,,fee schedule,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.47,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,3.47,62.38,
ADENOSINE(ADENOCARD)VL:6MG/2ML,32000636,CDM,J0153,HCPCS,636,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,52.44,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,52.44,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
ETODOLAC(LODINE)TAB:500MG,32000637,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
DARBEPOETIN(ARANESP):500MCG SYR  J/1MCG,32000638,CDM,J0881,HCPCS,636,RC,inpatient,,18285.75,18285.75,,15524.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13787.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15542.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16091.46,88,,percent of total billed charges,,1579.5,,,,fee schedule,,,13970.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1579.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16640.03,91,,percent of total billed charges,,,17371.46,95,,percent of total billed charges,,,15177.17,83,,percent of total billed charges,,,15177.17,83,,percent of total billed charges,,,,,,,,,,,,,,,15177.17,83,,percent of total billed charges,,,17371.46,95,,percent of total billed charges,,,16457.18,90,,percent of total billed charges,,,16457.18,90,,percent of total billed charges,,,14994.32,82,,percent of total billed charges,,,16457.18,90,,percent of total billed charges,,,15542.89,85,,percent of total billed charges,,1579.5,17371.46,
levETIRAcetam(KEPPRA)VIAL:500MG/5ML,32000639,CDM,J1953,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,15,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,15,60.99,
"POLYMYXIN B 500,000 UNITS/VIAL:",32000640,CDM,,,250,RC,inpatient,,187.31,187.31,,159.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,159.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,164.83,88,,percent of total billed charges,,,,,,,,,143.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,170.45,91,,percent of total billed charges,,,177.94,95,,percent of total billed charges,,,155.47,83,,percent of total billed charges,,,155.47,83,,percent of total billed charges,,,,,,,,,,,,,,,155.47,83,,percent of total billed charges,,,177.94,95,,percent of total billed charges,,,168.58,90,,percent of total billed charges,,,168.58,90,,percent of total billed charges,,,153.59,82,,percent of total billed charges,,,168.58,90,,percent of total billed charges,,,159.21,85,,percent of total billed charges,,141.23,177.94,
SPIRONOLACTONE(ALDACTONE)TAB:100MG,32000642,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
MITOMYCIN IV VIAL: 5 MG,32000643,CDM,J9280,HCPCS,636,RC,inpatient,,1869.38,1869.38,,1587.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1409.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1588.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1645.05,88,,percent of total billed charges,,542.94,,,,fee schedule,,,1428.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,542.94,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1701.14,91,,percent of total billed charges,,,1775.91,95,,percent of total billed charges,,,1551.59,83,,percent of total billed charges,,,1551.59,83,,percent of total billed charges,,,,,,,,,,,,,,,1551.59,83,,percent of total billed charges,,,1775.91,95,,percent of total billed charges,,,1682.44,90,,percent of total billed charges,,,1682.44,90,,percent of total billed charges,,,1532.89,82,,percent of total billed charges,,,1682.44,90,,percent of total billed charges,,,1588.97,85,,percent of total billed charges,,542.94,1775.91,
CASPOFUNGIN(CANCISAS)VL 50MG:J/5MG,32000644,CDM,J0637,HCPCS,636,RC,inpatient,,562.4,562.4,,477.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,424.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,478.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,494.91,88,,percent of total billed charges,,117.87,,,,fee schedule,,,429.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,117.87,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,511.78,91,,percent of total billed charges,,,534.28,95,,percent of total billed charges,,,466.79,83,,percent of total billed charges,,,466.79,83,,percent of total billed charges,,,,,,,,,,,,,,,466.79,83,,percent of total billed charges,,,534.28,95,,percent of total billed charges,,,506.16,90,,percent of total billed charges,,,506.16,90,,percent of total billed charges,,,461.17,82,,percent of total billed charges,,,506.16,90,,percent of total billed charges,,,478.04,85,,percent of total billed charges,,117.87,534.28,
ERTAPENEM(INVanz)VIAL:1GM,32000645,CDM,J1335,HCPCS,250,RC,inpatient,,583.83,583.83,,495.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,440.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,496.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,513.77,88,,percent of total billed charges,,30.48,,,,fee schedule,,,446.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,30.48,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,531.29,91,,percent of total billed charges,,,554.64,95,,percent of total billed charges,,,484.58,83,,percent of total billed charges,,,484.58,83,,percent of total billed charges,,,,,,,,,,,,,,,484.58,83,,percent of total billed charges,,,554.64,95,,percent of total billed charges,,,525.45,90,,percent of total billed charges,,,525.45,90,,percent of total billed charges,,,478.74,82,,percent of total billed charges,,,525.45,90,,percent of total billed charges,,,496.26,85,,percent of total billed charges,,30.48,554.64,
EPINEPHrine NASAL(ADREN SOL):30MG/30ML,32000646,CDM,,,250,RC,inpatient,,2897.53,2897.53,,2460,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2184.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2462.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2549.83,88,,percent of total billed charges,,,,,,,,,2213.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2636.75,91,,percent of total billed charges,,,2752.65,95,,percent of total billed charges,,,2404.95,83,,percent of total billed charges,,,2404.95,83,,percent of total billed charges,,,,,,,,,,,,,,,2404.95,83,,percent of total billed charges,,,2752.65,95,,percent of total billed charges,,,2607.78,90,,percent of total billed charges,,,2607.78,90,,percent of total billed charges,,,2375.97,82,,percent of total billed charges,,,2607.78,90,,percent of total billed charges,,,2462.9,85,,percent of total billed charges,,2184.74,2752.65,
DESOGESTREL-ETHINYL ESTRADIO(APRI) TABS:,32000647,CDM,,,250,RC,inpatient,,178.58,178.58,,151.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,134.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,151.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,157.15,88,,percent of total billed charges,,,,,,,,,136.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,162.51,91,,percent of total billed charges,,,169.65,95,,percent of total billed charges,,,148.22,83,,percent of total billed charges,,,148.22,83,,percent of total billed charges,,,,,,,,,,,,,,,148.22,83,,percent of total billed charges,,,169.65,95,,percent of total billed charges,,,160.72,90,,percent of total billed charges,,,160.72,90,,percent of total billed charges,,,146.44,82,,percent of total billed charges,,,160.72,90,,percent of total billed charges,,,151.79,85,,percent of total billed charges,,134.65,169.65,
MORPHINE SULF TAB IR:15MG,32000648,CDM,,,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
MORPHINE (ORAL)SOL UD:10MG/5ML,32000649,CDM,,,250,RC,inpatient,,20.1,20.1,,17.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.69,88,,percent of total billed charges,,,,,,,,,15.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.29,91,,percent of total billed charges,,,19.1,95,,percent of total billed charges,,,16.68,83,,percent of total billed charges,,,16.68,83,,percent of total billed charges,,,,,,,,,,,,,,,16.68,83,,percent of total billed charges,,,19.1,95,,percent of total billed charges,,,18.09,90,,percent of total billed charges,,,18.09,90,,percent of total billed charges,,,16.48,82,,percent of total billed charges,,,18.09,90,,percent of total billed charges,,,17.09,85,,percent of total billed charges,,15.16,19.1,
THROMBIN/GELATIN FOAM HEMOSTAT:,32000650,CDM,,,250,RC,inpatient,,755.6,755.6,,641.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,569.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,642.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,664.93,88,,percent of total billed charges,,,,,,,,,577.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,687.6,91,,percent of total billed charges,,,717.82,95,,percent of total billed charges,,,627.15,83,,percent of total billed charges,,,627.15,83,,percent of total billed charges,,,,,,,,,,,,,,,627.15,83,,percent of total billed charges,,,717.82,95,,percent of total billed charges,,,680.04,90,,percent of total billed charges,,,680.04,90,,percent of total billed charges,,,619.59,82,,percent of total billed charges,,,680.04,90,,percent of total billed charges,,,642.26,85,,percent of total billed charges,,569.72,717.82,
EPINEPHrine VIAL:30MG/30ML,32000651,CDM,J0171,HCPCS,250,RC,inpatient,,1953.99,1953.99,,1658.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1473.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1660.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1719.51,88,,percent of total billed charges,,7.28,,,,fee schedule,,,1492.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.28,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1778.13,91,,percent of total billed charges,,,1856.29,95,,percent of total billed charges,,,1621.81,83,,percent of total billed charges,,,1621.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1621.81,83,,percent of total billed charges,,,1856.29,95,,percent of total billed charges,,,1758.59,90,,percent of total billed charges,,,1758.59,90,,percent of total billed charges,,,1602.27,82,,percent of total billed charges,,,1758.59,90,,percent of total billed charges,,,1660.89,85,,percent of total billed charges,,7.28,1856.29,
LACTOBACILLUS RHAMNOSUS(CULTURELLE) CAP,32000652,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
BUDESONIDE (ENTOCORT) CAPS 3 MG:,32000653,CDM,,,250,RC,inpatient,,34.75,34.75,,29.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.58,88,,percent of total billed charges,,,,,,,,,26.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31.62,91,,percent of total billed charges,,,33.01,95,,percent of total billed charges,,,28.84,83,,percent of total billed charges,,,28.84,83,,percent of total billed charges,,,,,,,,,,,,,,,28.84,83,,percent of total billed charges,,,33.01,95,,percent of total billed charges,,,31.28,90,,percent of total billed charges,,,31.28,90,,percent of total billed charges,,,28.5,82,,percent of total billed charges,,,31.28,90,,percent of total billed charges,,,29.54,85,,percent of total billed charges,,26.2,33.01,
RABIES I.G.(HYPERRAB S/D)VIAL:10ML,32000654,CDM,90375,CPT,250,RC,inpatient,,15839.1,15839.1,,13447.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11942.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13463.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13938.41,88,,percent of total billed charges,,,,,,,,,12101.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14413.58,91,,percent of total billed charges,,,15047.15,95,,percent of total billed charges,,,13146.45,83,,percent of total billed charges,,,13146.45,83,,percent of total billed charges,,,,,,,,,,,,,,,13146.45,83,,percent of total billed charges,,,15047.15,95,,percent of total billed charges,,,14255.19,90,,percent of total billed charges,,,14255.19,90,,percent of total billed charges,,,12988.06,82,,percent of total billed charges,,,14255.19,90,,percent of total billed charges,,,13463.24,85,,percent of total billed charges,,11942.68,15047.15,
ALBUTEROL(VENTOLIN)HFA M.D.I.: (6.7GM),32000655,CDM,J7620,HCPCS,250,RC,inpatient,,389.87,389.87,,331,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,293.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.09,88,,percent of total billed charges,,0.13,,,,fee schedule,,,297.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.13,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.78,91,,percent of total billed charges,,,370.38,95,,percent of total billed charges,,,323.59,83,,percent of total billed charges,,,323.59,83,,percent of total billed charges,,,,,,,,,,,,,,,323.59,83,,percent of total billed charges,,,370.38,95,,percent of total billed charges,,,350.88,90,,percent of total billed charges,,,350.88,90,,percent of total billed charges,,,319.69,82,,percent of total billed charges,,,350.88,90,,percent of total billed charges,,,331.39,85,,percent of total billed charges,,0.13,370.38,
TEMSIROLIMUS(TORISEL)25MG/ML:J/1MG,32000657,CDM,J9330,HCPCS,636,RC,inpatient,,1003.83,1003.83,,852.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,756.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,853.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,883.37,88,,percent of total billed charges,,797,,,,fee schedule,,,766.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,797,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,913.49,91,,percent of total billed charges,,,953.64,95,,percent of total billed charges,,,833.18,83,,percent of total billed charges,,,833.18,83,,percent of total billed charges,,,,,,,,,,,,,,,833.18,83,,percent of total billed charges,,,953.64,95,,percent of total billed charges,,,903.45,90,,percent of total billed charges,,,903.45,90,,percent of total billed charges,,,823.14,82,,percent of total billed charges,,,903.45,90,,percent of total billed charges,,,853.26,85,,percent of total billed charges,,756.89,953.64,
FLUTICA/SALMET(ADVAIR DISK):100-50,32000658,CDM,J7699,HCPCS,250,RC,inpatient,,1341.1,1341.1,,1138.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1011.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1139.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1180.17,88,,percent of total billed charges,,,,,,,,,1024.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1220.4,91,,percent of total billed charges,,,1274.05,95,,percent of total billed charges,,,1113.11,83,,percent of total billed charges,,,1113.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1113.11,83,,percent of total billed charges,,,1274.05,95,,percent of total billed charges,,,1206.99,90,,percent of total billed charges,,,1206.99,90,,percent of total billed charges,,,1099.7,82,,percent of total billed charges,,,1206.99,90,,percent of total billed charges,,,1139.94,85,,percent of total billed charges,,1011.19,1274.05,
Warfarin(COUMadin)Tab:  0.5MG,32000659,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DOXORUBICIN(ADRIAMYCIN):10MG/5ML,32000661,CDM,J9000,HCPCS,636,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,43.69,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,43.69,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,43.69,59.21,
ALVIMOPAN(ENTEREG)CAP:12MG,32000663,CDM,J8499,HCPCS,250,RC,inpatient,,2642.47,2642.47,,2243.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1992.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2246.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2325.37,88,,percent of total billed charges,,,,,,,,,2018.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2404.65,91,,percent of total billed charges,,,2510.35,95,,percent of total billed charges,,,2193.25,83,,percent of total billed charges,,,2193.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2193.25,83,,percent of total billed charges,,,2510.35,95,,percent of total billed charges,,,2378.22,90,,percent of total billed charges,,,2378.22,90,,percent of total billed charges,,,2166.83,82,,percent of total billed charges,,,2378.22,90,,percent of total billed charges,,,2246.1,85,,percent of total billed charges,,1992.42,2510.35,
SPOT (DIAGNOSTIC AGENT),32000664,CDM,,,250,RC,inpatient,,341.51,341.51,,289.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,257.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,290.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,300.53,88,,percent of total billed charges,,,,,,,,,260.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,310.77,91,,percent of total billed charges,,,324.43,95,,percent of total billed charges,,,283.45,83,,percent of total billed charges,,,283.45,83,,percent of total billed charges,,,,,,,,,,,,,,,283.45,83,,percent of total billed charges,,,324.43,95,,percent of total billed charges,,,307.36,90,,percent of total billed charges,,,307.36,90,,percent of total billed charges,,,280.04,82,,percent of total billed charges,,,307.36,90,,percent of total billed charges,,,290.28,85,,percent of total billed charges,,257.5,324.43,
INTERFERON BETA 1A SYR:30MCG,32000665,CDM,,,250,RC,inpatient,,27504.22,27504.22,,23351.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20738.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23378.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24203.71,88,,percent of total billed charges,,,,,,,,,21013.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25028.84,91,,percent of total billed charges,,,26129.01,95,,percent of total billed charges,,,22828.5,83,,percent of total billed charges,,,22828.5,83,,percent of total billed charges,,,,,,,,,,,,,,,22828.5,83,,percent of total billed charges,,,26129.01,95,,percent of total billed charges,,,24753.8,90,,percent of total billed charges,,,24753.8,90,,percent of total billed charges,,,22553.46,82,,percent of total billed charges,,,24753.8,90,,percent of total billed charges,,,23378.59,85,,percent of total billed charges,,20738.18,26129.01,
PEMEtrexed(ALIMTA)VIAL:100MG,32000667,CDM,J9305,HCPCS,636,RC,inpatient,,5928.85,5928.85,,5033.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4470.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5039.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5217.39,88,,percent of total billed charges,,6016.12,,,,fee schedule,,,4529.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6016.12,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5395.25,91,,percent of total billed charges,,,5632.41,95,,percent of total billed charges,,,4920.95,83,,percent of total billed charges,,,4920.95,83,,percent of total billed charges,,,,,,,,,,,,,,,4920.95,83,,percent of total billed charges,,,5632.41,95,,percent of total billed charges,,,5335.97,90,,percent of total billed charges,,,5335.97,90,,percent of total billed charges,,,4861.66,82,,percent of total billed charges,,,5335.97,90,,percent of total billed charges,,,5039.52,85,,percent of total billed charges,,4470.35,6016.12,
PEMEtrexed (ALIMTA)VIAL:500MG,32000668,CDM,J9305,HCPCS,636,RC,inpatient,,15503.29,15503.29,,13162.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11689.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13177.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13642.9,88,,percent of total billed charges,,6016.12,,,,fee schedule,,,11844.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6016.12,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14107.99,91,,percent of total billed charges,,,14728.13,95,,percent of total billed charges,,,12867.73,83,,percent of total billed charges,,,12867.73,83,,percent of total billed charges,,,,,,,,,,,,,,,12867.73,83,,percent of total billed charges,,,14728.13,95,,percent of total billed charges,,,13952.96,90,,percent of total billed charges,,,13952.96,90,,percent of total billed charges,,,12712.7,82,,percent of total billed charges,,,13952.96,90,,percent of total billed charges,,,13177.8,85,,percent of total billed charges,,6016.12,14728.13,
CODEINE TAB:30 MG,32000669,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
CLOBETASOL (OLUX-E) FOAM 0.05% :,32000670,CDM,,,250,RC,inpatient,,3321.29,3321.29,,2819.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2504.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2823.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2922.74,88,,percent of total billed charges,,,,,,,,,2537.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3022.37,91,,percent of total billed charges,,,3155.23,95,,percent of total billed charges,,,2756.67,83,,percent of total billed charges,,,2756.67,83,,percent of total billed charges,,,,,,,,,,,,,,,2756.67,83,,percent of total billed charges,,,3155.23,95,,percent of total billed charges,,,2989.16,90,,percent of total billed charges,,,2989.16,90,,percent of total billed charges,,,2723.46,82,,percent of total billed charges,,,2989.16,90,,percent of total billed charges,,,2823.1,85,,percent of total billed charges,,2504.25,3155.23,
FLUOROURACIL(5-FU)VL:500MG/10ML,32000671,CDM,J9190,HCPCS,636,RC,inpatient,,273.37,273.37,,232.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,206.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,232.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,240.57,88,,percent of total billed charges,,47.2,,,,fee schedule,,,208.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,47.2,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,248.77,91,,percent of total billed charges,,,259.7,95,,percent of total billed charges,,,226.9,83,,percent of total billed charges,,,226.9,83,,percent of total billed charges,,,,,,,,,,,,,,,226.9,83,,percent of total billed charges,,,259.7,95,,percent of total billed charges,,,246.03,90,,percent of total billed charges,,,246.03,90,,percent of total billed charges,,,224.16,82,,percent of total billed charges,,,246.03,90,,percent of total billed charges,,,232.36,85,,percent of total billed charges,,47.2,259.7,
hepARIN LOCK FLUSH SYR 10UNITS/ML -(5ML),32000673,CDM,J1642,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
hepARIN LOCK FLUSH SYR 100UNITS/ML-(5ML),32000674,CDM,J1642,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
OSELTAMIVIR(TAMIFLU)CAP:75MG (#10),32000675,CDM,,,250,RC,inpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,152.71,192.4,
OSELTAM(TAMIFLU)SUSP:12MG/ML (SD) SNS,32000678,CDM,,,250,RC,inpatient,,142.26,142.26,,120.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,107.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,120.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,125.19,88,,percent of total billed charges,,,,,,,,,108.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,129.46,91,,percent of total billed charges,,,135.15,95,,percent of total billed charges,,,118.08,83,,percent of total billed charges,,,118.08,83,,percent of total billed charges,,,,,,,,,,,,,,,118.08,83,,percent of total billed charges,,,135.15,95,,percent of total billed charges,,,128.03,90,,percent of total billed charges,,,128.03,90,,percent of total billed charges,,,116.65,82,,percent of total billed charges,,,128.03,90,,percent of total billed charges,,,120.92,85,,percent of total billed charges,,107.26,135.15,
OSELTAMIVIR(TAMIFLU)CAP:30MG,32000679,CDM,J8499,HCPCS,250,RC,inpatient,,20.42,20.42,,17.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.97,88,,percent of total billed charges,,,,,,,,,15.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.58,91,,percent of total billed charges,,,19.4,95,,percent of total billed charges,,,16.95,83,,percent of total billed charges,,,16.95,83,,percent of total billed charges,,,,,,,,,,,,,,,16.95,83,,percent of total billed charges,,,19.4,95,,percent of total billed charges,,,18.38,90,,percent of total billed charges,,,18.38,90,,percent of total billed charges,,,16.74,82,,percent of total billed charges,,,18.38,90,,percent of total billed charges,,,17.36,85,,percent of total billed charges,,15.4,19.4,
PROPAFENONE(RYTHMOL)SR CAPS:225 MG,32000680,CDM,,,250,RC,inpatient,,89.29,89.29,,75.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,75.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,78.58,88,,percent of total billed charges,,,,,,,,,68.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,81.25,91,,percent of total billed charges,,,84.83,95,,percent of total billed charges,,,74.11,83,,percent of total billed charges,,,74.11,83,,percent of total billed charges,,,,,,,,,,,,,,,74.11,83,,percent of total billed charges,,,84.83,95,,percent of total billed charges,,,80.36,90,,percent of total billed charges,,,80.36,90,,percent of total billed charges,,,73.22,82,,percent of total billed charges,,,80.36,90,,percent of total billed charges,,,75.9,85,,percent of total billed charges,,67.32,84.83,
DIPHENHYDR(BENADRYL)EL:25MG/10ML,32000682,CDM,J8499,HCPCS,250,RC,inpatient,,26.14,26.14,,22.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23,88,,percent of total billed charges,,,,,,,,,19.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.79,91,,percent of total billed charges,,,24.83,95,,percent of total billed charges,,,21.7,83,,percent of total billed charges,,,21.7,83,,percent of total billed charges,,,,,,,,,,,,,,,21.7,83,,percent of total billed charges,,,24.83,95,,percent of total billed charges,,,23.53,90,,percent of total billed charges,,,23.53,90,,percent of total billed charges,,,21.43,82,,percent of total billed charges,,,23.53,90,,percent of total billed charges,,,22.22,85,,percent of total billed charges,,19.71,24.83,
DARBEPOTN(ARANESP)SY:300MCG/0.6ML J/1MCG,32000683,CDM,J0881,HCPCS,636,RC,inpatient,,10971.45,10971.45,,9314.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8272.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9325.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9654.88,88,,percent of total billed charges,,1579.5,,,,fee schedule,,,8382.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1579.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9984.02,91,,percent of total billed charges,,,10422.88,95,,percent of total billed charges,,,9106.3,83,,percent of total billed charges,,,9106.3,83,,percent of total billed charges,,,,,,,,,,,,,,,9106.3,83,,percent of total billed charges,,,10422.88,95,,percent of total billed charges,,,9874.31,90,,percent of total billed charges,,,9874.31,90,,percent of total billed charges,,,8996.59,82,,percent of total billed charges,,,9874.31,90,,percent of total billed charges,,,9325.73,85,,percent of total billed charges,,1579.5,10422.88,
ESMOLOL(BREVIBLOC)VL:100MG/10ML,32000684,CDM,J3490,HCPCS,250,RC,inpatient,,198.2,198.2,,168.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,149.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,168.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,174.42,88,,percent of total billed charges,,,,,,,,,151.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,180.36,91,,percent of total billed charges,,,188.29,95,,percent of total billed charges,,,164.51,83,,percent of total billed charges,,,164.51,83,,percent of total billed charges,,,,,,,,,,,,,,,164.51,83,,percent of total billed charges,,,188.29,95,,percent of total billed charges,,,178.38,90,,percent of total billed charges,,,178.38,90,,percent of total billed charges,,,162.52,82,,percent of total billed charges,,,178.38,90,,percent of total billed charges,,,168.47,85,,percent of total billed charges,,149.44,188.29,
IV DOPamine 400MG/D5W250ML   (PREMIX),32000685,CDM,J1265,HCPCS,250,RC,inpatient,,219.28,219.28,,186.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,165.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,186.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,192.97,88,,percent of total billed charges,,7.14,,,,fee schedule,,,167.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.14,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,199.54,91,,percent of total billed charges,,,208.32,95,,percent of total billed charges,,,182,83,,percent of total billed charges,,,182,83,,percent of total billed charges,,,,,,,,,,,,,,,182,83,,percent of total billed charges,,,208.32,95,,percent of total billed charges,,,197.35,90,,percent of total billed charges,,,197.35,90,,percent of total billed charges,,,179.81,82,,percent of total billed charges,,,197.35,90,,percent of total billed charges,,,186.39,85,,percent of total billed charges,,7.14,208.32,
GENTAMICIN-VIAL PEDS:20MG/2ML,32000687,CDM,J1580,HCPCS,250,RC,inpatient,,79.41,79.41,,67.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.88,88,,percent of total billed charges,,21.3,,,,fee schedule,,,60.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21.3,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.26,91,,percent of total billed charges,,,75.44,95,,percent of total billed charges,,,65.91,83,,percent of total billed charges,,,65.91,83,,percent of total billed charges,,,,,,,,,,,,,,,65.91,83,,percent of total billed charges,,,75.44,95,,percent of total billed charges,,,71.47,90,,percent of total billed charges,,,71.47,90,,percent of total billed charges,,,65.12,82,,percent of total billed charges,,,71.47,90,,percent of total billed charges,,,67.5,85,,percent of total billed charges,,21.3,75.44,
PHENOBARBITAL SODIUM VIAL:60MG/ML,32000688,CDM,,,250,RC,inpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.78,88,,percent of total billed charges,,,,,,,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,49.51,62.38,
DEXPANTHENOL VIAL 500MG/2ML:,32000690,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
FOSAPREPITANT (EMEND)115MG/10ML:,32000691,CDM,J1453,HCPCS,636,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,21,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,21,59.21,
PROPOFOL DRIP(DIPRIVAN)IVPB:1000MG/100ML,32000692,CDM,J2704,HCPCS,250,RC,inpatient,,506.87,506.87,,430.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,382.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,430.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,446.05,88,,percent of total billed charges,,14.4,,,,fee schedule,,,387.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.4,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,461.25,91,,percent of total billed charges,,,481.53,95,,percent of total billed charges,,,420.7,83,,percent of total billed charges,,,420.7,83,,percent of total billed charges,,,,,,,,,,,,,,,420.7,83,,percent of total billed charges,,,481.53,95,,percent of total billed charges,,,456.18,90,,percent of total billed charges,,,456.18,90,,percent of total billed charges,,,415.63,82,,percent of total billed charges,,,456.18,90,,percent of total billed charges,,,430.84,85,,percent of total billed charges,,14.4,481.53,
DICLOFENAC(VOLTAREN)TOPICAL GEL 1%:,32000693,CDM,J3490,HCPCS,250,RC,inpatient,,762.32,762.32,,647.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,574.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,647.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,670.84,88,,percent of total billed charges,,,,,,,,,582.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,693.71,91,,percent of total billed charges,,,724.2,95,,percent of total billed charges,,,632.73,83,,percent of total billed charges,,,632.73,83,,percent of total billed charges,,,,,,,,,,,,,,,632.73,83,,percent of total billed charges,,,724.2,95,,percent of total billed charges,,,686.09,90,,percent of total billed charges,,,686.09,90,,percent of total billed charges,,,625.1,82,,percent of total billed charges,,,686.09,90,,percent of total billed charges,,,647.97,85,,percent of total billed charges,,574.79,724.2,
BUPIVACAINE(MARCAINE)SPINAL:7.5MG/ML,32000694,CDM,J3490,HCPCS,250,RC,inpatient,,65.03,65.03,,55.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.23,88,,percent of total billed charges,,,,,,,,,49.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.18,91,,percent of total billed charges,,,61.78,95,,percent of total billed charges,,,53.97,83,,percent of total billed charges,,,53.97,83,,percent of total billed charges,,,,,,,,,,,,,,,53.97,83,,percent of total billed charges,,,61.78,95,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,53.32,82,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,55.28,85,,percent of total billed charges,,49.03,61.78,
fentaNYL PATCH(DURAGESIC): 12MCG/HR,32000695,CDM,,,250,RC,inpatient,,141.99,141.99,,120.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,107.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,120.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,124.95,88,,percent of total billed charges,,,,,,,,,108.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,129.21,91,,percent of total billed charges,,,134.89,95,,percent of total billed charges,,,117.85,83,,percent of total billed charges,,,117.85,83,,percent of total billed charges,,,,,,,,,,,,,,,117.85,83,,percent of total billed charges,,,134.89,95,,percent of total billed charges,,,127.79,90,,percent of total billed charges,,,127.79,90,,percent of total billed charges,,,116.43,82,,percent of total billed charges,,,127.79,90,,percent of total billed charges,,,120.69,85,,percent of total billed charges,,107.06,134.89,
ASPIRIN/DIPYRIDAMOLE(AGGRNX)CPM:25-200MG,32000697,CDM,J8499,HCPCS,250,RC,inpatient,,92.31,92.31,,78.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,69.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,78.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.23,88,,percent of total billed charges,,,,,,,,,70.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84,91,,percent of total billed charges,,,87.69,95,,percent of total billed charges,,,76.62,83,,percent of total billed charges,,,76.62,83,,percent of total billed charges,,,,,,,,,,,,,,,76.62,83,,percent of total billed charges,,,87.69,95,,percent of total billed charges,,,83.08,90,,percent of total billed charges,,,83.08,90,,percent of total billed charges,,,75.69,82,,percent of total billed charges,,,83.08,90,,percent of total billed charges,,,78.46,85,,percent of total billed charges,,69.6,87.69,
PENICILLIN G POTAS VIAL:5 MIL UNITS,32000698,CDM,J2540,HCPCS,250,RC,inpatient,,123.2,123.2,,104.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,92.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,104.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,108.42,88,,percent of total billed charges,,7.79,,,,fee schedule,,,94.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.79,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.11,91,,percent of total billed charges,,,117.04,95,,percent of total billed charges,,,102.26,83,,percent of total billed charges,,,102.26,83,,percent of total billed charges,,,,,,,,,,,,,,,102.26,83,,percent of total billed charges,,,117.04,95,,percent of total billed charges,,,110.88,90,,percent of total billed charges,,,110.88,90,,percent of total billed charges,,,101.02,82,,percent of total billed charges,,,110.88,90,,percent of total billed charges,,,104.72,85,,percent of total billed charges,,7.79,117.04,
CETUXIMAB(ERBITUX)200MG/100ML:J /10MG,32000699,CDM,J9055,HCPCS,636,RC,inpatient,,6552.68,6552.68,,5563.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4940.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5569.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5766.36,88,,percent of total billed charges,,10363.95,,,,fee schedule,,,5006.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,10363.95,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5962.94,91,,percent of total billed charges,,,6225.05,95,,percent of total billed charges,,,5438.72,83,,percent of total billed charges,,,5438.72,83,,percent of total billed charges,,,,,,,,,,,,,,,5438.72,83,,percent of total billed charges,,,6225.05,95,,percent of total billed charges,,,5897.41,90,,percent of total billed charges,,,5897.41,90,,percent of total billed charges,,,5373.2,82,,percent of total billed charges,,,5897.41,90,,percent of total billed charges,,,5569.78,85,,percent of total billed charges,,4940.72,10363.95,
CETUXIMA(ERBITUX)-IVPB:100MG/50ML,32000700,CDM,J9055,HCPCS,636,RC,inpatient,,5329.55,5329.55,,4524.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4018.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4530.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4690,88,,percent of total billed charges,,10363.95,,,,fee schedule,,,4071.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,10363.95,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4849.89,91,,percent of total billed charges,,,5063.07,95,,percent of total billed charges,,,4423.53,83,,percent of total billed charges,,,4423.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4423.53,83,,percent of total billed charges,,,5063.07,95,,percent of total billed charges,,,4796.6,90,,percent of total billed charges,,,4796.6,90,,percent of total billed charges,,,4370.23,82,,percent of total billed charges,,,4796.6,90,,percent of total billed charges,,,4530.12,85,,percent of total billed charges,,4018.48,10363.95,
FLUNISOLIDE(AEROBID)AER:250MCG,32000701,CDM,,,250,RC,inpatient,,379.75,379.75,,322.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,286.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,322.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,334.18,88,,percent of total billed charges,,,,,,,,,290.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,345.57,91,,percent of total billed charges,,,360.76,95,,percent of total billed charges,,,315.19,83,,percent of total billed charges,,,315.19,83,,percent of total billed charges,,,,,,,,,,,,,,,315.19,83,,percent of total billed charges,,,360.76,95,,percent of total billed charges,,,341.78,90,,percent of total billed charges,,,341.78,90,,percent of total billed charges,,,311.4,82,,percent of total billed charges,,,341.78,90,,percent of total billed charges,,,322.79,85,,percent of total billed charges,,286.33,360.76,
EMPTY EVACUATED CONTAINER:1000 ML,32000702,CDM,J3490,HCPCS,258,RC,inpatient,,400.82,400.82,,340.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,302.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,340.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,352.72,88,,percent of total billed charges,,,,,,,,,306.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,364.75,91,,percent of total billed charges,,,380.78,95,,percent of total billed charges,,,332.68,83,,percent of total billed charges,,,332.68,83,,percent of total billed charges,,,,,,,,,,,,,,,332.68,83,,percent of total billed charges,,,380.78,95,,percent of total billed charges,,,360.74,90,,percent of total billed charges,,,360.74,90,,percent of total billed charges,,,328.67,82,,percent of total billed charges,,,360.74,90,,percent of total billed charges,,,340.7,85,,percent of total billed charges,,302.22,380.78,
PACLITAXEL PROTIEN-BOUND(ABRAXANE):100MG,32000703,CDM,J9264,HCPCS,636,RC,inpatient,,6285.2,6285.2,,5336.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4739.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5342.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5530.98,88,,percent of total billed charges,,7314,,,,fee schedule,,,4801.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7314,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5719.53,91,,percent of total billed charges,,,5970.94,95,,percent of total billed charges,,,5216.72,83,,percent of total billed charges,,,5216.72,83,,percent of total billed charges,,,,,,,,,,,,,,,5216.72,83,,percent of total billed charges,,,5970.94,95,,percent of total billed charges,,,5656.68,90,,percent of total billed charges,,,5656.68,90,,percent of total billed charges,,,5153.86,82,,percent of total billed charges,,,5656.68,90,,percent of total billed charges,,,5342.42,85,,percent of total billed charges,,4739.04,7314,
CHOLECALCI(VITAMIN D)TAB:1000UNIT(25MCG),32000704,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
REGADENO(LEXISCAN):0.4MG/5ML,32000705,CDM,J2785,HCPCS,636,RC,inpatient,,1186.54,1186.54,,1007.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,894.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1008.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1044.16,88,,percent of total billed charges,,245.38,,,,fee schedule,,,906.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,245.38,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1079.75,91,,percent of total billed charges,,,1127.21,95,,percent of total billed charges,,,984.83,83,,percent of total billed charges,,,984.83,83,,percent of total billed charges,,,,,,,,,,,,,,,984.83,83,,percent of total billed charges,,,1127.21,95,,percent of total billed charges,,,1067.89,90,,percent of total billed charges,,,1067.89,90,,percent of total billed charges,,,972.96,82,,percent of total billed charges,,,1067.89,90,,percent of total billed charges,,,1008.56,85,,percent of total billed charges,,245.38,1127.21,
ALBUMIN (HUMAN) ALBUTEIN 100ML 25%,32000707,CDM,,,250,RC,inpatient,,236.5,236.5,,200.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.12,88,,percent of total billed charges,,,,,,,,,180.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.22,91,,percent of total billed charges,,,224.68,95,,percent of total billed charges,,,196.3,83,,percent of total billed charges,,,196.3,83,,percent of total billed charges,,,,,,,,,,,,,,,196.3,83,,percent of total billed charges,,,224.68,95,,percent of total billed charges,,,212.85,90,,percent of total billed charges,,,212.85,90,,percent of total billed charges,,,193.93,82,,percent of total billed charges,,,212.85,90,,percent of total billed charges,,,201.03,85,,percent of total billed charges,,178.32,224.68,
INFLUENZA VACCINE(2009-2010)SYR:0.5ML,32000709,CDM,90658,CPT,636,RC,inpatient,,165.9,165.9,,140.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,145.99,88,,percent of total billed charges,,,,,,,,,126.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,150.97,91,,percent of total billed charges,,,157.61,95,,percent of total billed charges,,,137.7,83,,percent of total billed charges,,,137.7,83,,percent of total billed charges,,,,,,,,,,,,,,,137.7,83,,percent of total billed charges,,,157.61,95,,percent of total billed charges,,,149.31,90,,percent of total billed charges,,,149.31,90,,percent of total billed charges,,,136.04,82,,percent of total billed charges,,,149.31,90,,percent of total billed charges,,,141.02,85,,percent of total billed charges,,125.09,157.61,
ALBUTEROL 0.5% 0.5ML,32000710,CDM,,,250,RC,inpatient,,24.11,24.11,,20.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.22,88,,percent of total billed charges,,,,,,,,,18.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.94,91,,percent of total billed charges,,,22.9,95,,percent of total billed charges,,,20.01,83,,percent of total billed charges,,,20.01,83,,percent of total billed charges,,,,,,,,,,,,,,,20.01,83,,percent of total billed charges,,,22.9,95,,percent of total billed charges,,,21.7,90,,percent of total billed charges,,,21.7,90,,percent of total billed charges,,,19.77,82,,percent of total billed charges,,,21.7,90,,percent of total billed charges,,,20.49,85,,percent of total billed charges,,18.18,22.9,
ALBUTEROL (VENTOLIN) TAB : 2MG,32000711,CDM,,,250,RC,inpatient,,2.5,2.5,,2.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.2,88,,percent of total billed charges,,,,,,,,,1.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.28,91,,percent of total billed charges,,,2.38,95,,percent of total billed charges,,,2.08,83,,percent of total billed charges,,,2.08,83,,percent of total billed charges,,,,,,,,,,,,,,,2.08,83,,percent of total billed charges,,,2.38,95,,percent of total billed charges,,,2.25,90,,percent of total billed charges,,,2.25,90,,percent of total billed charges,,,2.05,82,,percent of total billed charges,,,2.25,90,,percent of total billed charges,,,2.13,85,,percent of total billed charges,,1.89,2.38,
PROPARACAINE(ALCAINE)DROP 0.5%:15ML,32000713,CDM,J3490,HCPCS,250,RC,inpatient,,572.06,572.06,,485.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,431.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,486.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,503.41,88,,percent of total billed charges,,,,,,,,,437.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,520.57,91,,percent of total billed charges,,,543.46,95,,percent of total billed charges,,,474.81,83,,percent of total billed charges,,,474.81,83,,percent of total billed charges,,,,,,,,,,,,,,,474.81,83,,percent of total billed charges,,,543.46,95,,percent of total billed charges,,,514.85,90,,percent of total billed charges,,,514.85,90,,percent of total billed charges,,,469.09,82,,percent of total billed charges,,,514.85,90,,percent of total billed charges,,,486.25,85,,percent of total billed charges,,431.33,543.46,
ALBUTEROL SULFATE SOL:5MG/ML,32000714,CDM,,,250,RC,inpatient,,7.5,7.5,,6.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6.6,88,,percent of total billed charges,,,,,,,,,5.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6.83,91,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,,,,,,,,,,,,,6.23,83,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.15,82,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,5.66,7.13,
TIOTROPIUM BR (SPIRIVA) CAP : 18MCG 30'S,32000715,CDM,,,250,RC,inpatient,,779.04,779.04,,661.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,587.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,662.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,685.56,88,,percent of total billed charges,,,,,,,,,595.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,708.93,91,,percent of total billed charges,,,740.09,95,,percent of total billed charges,,,646.6,83,,percent of total billed charges,,,646.6,83,,percent of total billed charges,,,,,,,,,,,,,,,646.6,83,,percent of total billed charges,,,740.09,95,,percent of total billed charges,,,701.14,90,,percent of total billed charges,,,701.14,90,,percent of total billed charges,,,638.81,82,,percent of total billed charges,,,701.14,90,,percent of total billed charges,,,662.18,85,,percent of total billed charges,,587.4,740.09,
THYROTROPIN(THYROGEN):0.9MG/ML  J/0.9,32000717,CDM,J3240,HCPCS,636,RC,inpatient,,7025.8,7025.8,,5964.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5297.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5971.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6182.7,88,,percent of total billed charges,,1926.71,,,,fee schedule,,,5367.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1926.71,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6393.48,91,,percent of total billed charges,,,6674.51,95,,percent of total billed charges,,,5831.41,83,,percent of total billed charges,,,5831.41,83,,percent of total billed charges,,,,,,,,,,,,,,,5831.41,83,,percent of total billed charges,,,6674.51,95,,percent of total billed charges,,,6323.22,90,,percent of total billed charges,,,6323.22,90,,percent of total billed charges,,,5761.16,82,,percent of total billed charges,,,6323.22,90,,percent of total billed charges,,,5971.93,85,,percent of total billed charges,,1926.71,6674.51,
LIDOCAINE(LIDODERM)PATCH 5%,32000718,CDM,J3490,HCPCS,250,RC,inpatient,,27.94,27.94,,23.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.59,88,,percent of total billed charges,,,,,,,,,21.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.43,91,,percent of total billed charges,,,26.54,95,,percent of total billed charges,,,23.19,83,,percent of total billed charges,,,23.19,83,,percent of total billed charges,,,,,,,,,,,,,,,23.19,83,,percent of total billed charges,,,26.54,95,,percent of total billed charges,,,25.15,90,,percent of total billed charges,,,25.15,90,,percent of total billed charges,,,22.91,82,,percent of total billed charges,,,25.15,90,,percent of total billed charges,,,23.75,85,,percent of total billed charges,,21.07,26.54,
COLESTIPOL(COLESTID)TABS:1GM,32000719,CDM,,,250,RC,inpatient,,35.21,35.21,,29.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.98,88,,percent of total billed charges,,,,,,,,,26.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.04,91,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,,,,,,,,,,,,,29.22,83,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,28.87,82,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,29.93,85,,percent of total billed charges,,26.55,33.45,
AZITHROMYCIN(ZITHROMAX) 200MG/5ML-15ML,32000720,CDM,J8499,HCPCS,250,RC,inpatient,UD,121.73,121.73,,103.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,103.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,107.12,88,,percent of total billed charges,,,,,,,,,93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,110.77,91,,percent of total billed charges,,,115.64,95,,percent of total billed charges,,,101.04,83,,percent of total billed charges,,,101.04,83,,percent of total billed charges,,,,,,,,,,,,,,,101.04,83,,percent of total billed charges,,,115.64,95,,percent of total billed charges,,,109.56,90,,percent of total billed charges,,,109.56,90,,percent of total billed charges,,,99.82,82,,percent of total billed charges,,,109.56,90,,percent of total billed charges,,,103.47,85,,percent of total billed charges,,91.78,115.64,
NS(NORMAL SALINE)10ML PFS:,32000722,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
INFLUENZA A(H1N1)2009 SYR:(0.5 ML),32000723,CDM,90470,CPT,250,RC,inpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,613.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,691.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,613.19,772.59,
CIPROFLOX(CIPRO)-IVPB:400MG/200ML PREMIX,32000724,CDM,J0744,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,2.57,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.57,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,2.57,187.11,
THROMBIN-GEL 40:,32000725,CDM,J3490,HCPCS,250,RC,inpatient,,755.6,755.6,,641.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,569.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,642.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,664.93,88,,percent of total billed charges,,,,,,,,,577.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,687.6,91,,percent of total billed charges,,,717.82,95,,percent of total billed charges,,,627.15,83,,percent of total billed charges,,,627.15,83,,percent of total billed charges,,,,,,,,,,,,,,,627.15,83,,percent of total billed charges,,,717.82,95,,percent of total billed charges,,,680.04,90,,percent of total billed charges,,,680.04,90,,percent of total billed charges,,,619.59,82,,percent of total billed charges,,,680.04,90,,percent of total billed charges,,,642.26,85,,percent of total billed charges,,569.72,717.82,
ALFENTANIL(ALFENTA) AMP : 500MCG/ML 1 ML,32000731,CDM,,,250,RC,inpatient,,71.53,71.53,,60.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.95,88,,percent of total billed charges,,,,,,,,,54.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,65.09,91,,percent of total billed charges,,,67.95,95,,percent of total billed charges,,,59.37,83,,percent of total billed charges,,,59.37,83,,percent of total billed charges,,,,,,,,,,,,,,,59.37,83,,percent of total billed charges,,,67.95,95,,percent of total billed charges,,,64.38,90,,percent of total billed charges,,,64.38,90,,percent of total billed charges,,,58.65,82,,percent of total billed charges,,,64.38,90,,percent of total billed charges,,,60.8,85,,percent of total billed charges,,53.93,67.95,
CYCLOPENTOLATE(CYCLOGEL) 1%:15ML,32000732,CDM,,,250,RC,inpatient,,321.96,321.96,,273.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,273.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.32,88,,percent of total billed charges,,,,,,,,,245.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,292.98,91,,percent of total billed charges,,,305.86,95,,percent of total billed charges,,,267.23,83,,percent of total billed charges,,,267.23,83,,percent of total billed charges,,,,,,,,,,,,,,,267.23,83,,percent of total billed charges,,,305.86,95,,percent of total billed charges,,,289.76,90,,percent of total billed charges,,,289.76,90,,percent of total billed charges,,,264.01,82,,percent of total billed charges,,,289.76,90,,percent of total billed charges,,,273.67,85,,percent of total billed charges,,242.76,305.86,
ACETYLCYSTEINE(ACETADOTE):6000MG/30ML,32000733,CDM,J0132,HCPCS,250,RC,inpatient,,2653.06,2653.06,,2252.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2000.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2255.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2334.69,88,,percent of total billed charges,,140.2,,,,fee schedule,,,2026.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,140.2,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2414.28,91,,percent of total billed charges,,,2520.41,95,,percent of total billed charges,,,2202.04,83,,percent of total billed charges,,,2202.04,83,,percent of total billed charges,,,,,,,,,,,,,,,2202.04,83,,percent of total billed charges,,,2520.41,95,,percent of total billed charges,,,2387.75,90,,percent of total billed charges,,,2387.75,90,,percent of total billed charges,,,2175.51,82,,percent of total billed charges,,,2387.75,90,,percent of total billed charges,,,2255.1,85,,percent of total billed charges,,140.2,2520.41,
RANITIDINE(ZANTAC)-IVPB:50MG/NS50ML,32000734,CDM,,,258,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
MELPHALAN (ALKERAN) TAB : 2MG,32000736,CDM,,,250,RC,inpatient,,118.16,118.16,,100.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,89.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,100.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,103.98,88,,percent of total billed charges,,,,,,,,,90.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,107.53,91,,percent of total billed charges,,,112.25,95,,percent of total billed charges,,,98.07,83,,percent of total billed charges,,,98.07,83,,percent of total billed charges,,,,,,,,,,,,,,,98.07,83,,percent of total billed charges,,,112.25,95,,percent of total billed charges,,,106.34,90,,percent of total billed charges,,,106.34,90,,percent of total billed charges,,,96.89,82,,percent of total billed charges,,,106.34,90,,percent of total billed charges,,,100.44,85,,percent of total billed charges,,89.09,112.25,
GAMMAGLOB(GAMMAGARD)20GM/200ML:J 500MG,32000737,CDM,J1569,HCPCS,636,RC,inpatient,,1053.29,1053.29,,894.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,794.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,895.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,926.9,88,,percent of total billed charges,,11307.25,,,,fee schedule,,,804.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11307.25,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,958.49,91,,percent of total billed charges,,,1000.63,95,,percent of total billed charges,,,874.23,83,,percent of total billed charges,,,874.23,83,,percent of total billed charges,,,,,,,,,,,,,,,874.23,83,,percent of total billed charges,,,1000.63,95,,percent of total billed charges,,,947.96,90,,percent of total billed charges,,,947.96,90,,percent of total billed charges,,,863.7,82,,percent of total billed charges,,,947.96,90,,percent of total billed charges,,,895.3,85,,percent of total billed charges,,794.18,11307.25,
GAMMAGLOB(GAMMAGARD):20GM/200ML-J 500MG,32000738,CDM,J1569,HCPCS,636,RC,inpatient,,9433.46,9433.46,,8009.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7112.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8018.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8301.44,88,,percent of total billed charges,,11307.25,,,,fee schedule,,,7207.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11307.25,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8584.45,91,,percent of total billed charges,,,8961.79,95,,percent of total billed charges,,,7829.77,83,,percent of total billed charges,,,7829.77,83,,percent of total billed charges,,,,,,,,,,,,,,,7829.77,83,,percent of total billed charges,,,8961.79,95,,percent of total billed charges,,,8490.11,90,,percent of total billed charges,,,8490.11,90,,percent of total billed charges,,,7735.44,82,,percent of total billed charges,,,8490.11,90,,percent of total billed charges,,,8018.44,85,,percent of total billed charges,,7112.83,11307.25,
PAMIDRONATE(AREDIA) 30MG/10ML,32000739,CDM,J2430,HCPCS,636,RC,inpatient,,188.07,188.07,,159.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,159.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,165.5,88,,percent of total billed charges,,32.94,,,,fee schedule,,,143.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,32.94,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.14,91,,percent of total billed charges,,,178.67,95,,percent of total billed charges,,,156.1,83,,percent of total billed charges,,,156.1,83,,percent of total billed charges,,,,,,,,,,,,,,,156.1,83,,percent of total billed charges,,,178.67,95,,percent of total billed charges,,,169.26,90,,percent of total billed charges,,,169.26,90,,percent of total billed charges,,,154.22,82,,percent of total billed charges,,,169.26,90,,percent of total billed charges,,,159.86,85,,percent of total billed charges,,32.94,178.67,
BROMFENAC(XIBROM)0.09% OPTH SOLUTION,32000740,CDM,J3490,HCPCS,250,RC,inpatient,,2174.86,2174.86,,1846.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1639.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1848.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1913.88,88,,percent of total billed charges,,,,,,,,,1661.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1979.12,91,,percent of total billed charges,,,2066.12,95,,percent of total billed charges,,,1805.13,83,,percent of total billed charges,,,1805.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1805.13,83,,percent of total billed charges,,,2066.12,95,,percent of total billed charges,,,1957.37,90,,percent of total billed charges,,,1957.37,90,,percent of total billed charges,,,1783.39,82,,percent of total billed charges,,,1957.37,90,,percent of total billed charges,,,1848.63,85,,percent of total billed charges,,1639.84,2066.12,
ALLBEE W/C,32000741,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
BESIFLOXACIN(BESIVANCE)OPTH 0.6%:5ML,32000742,CDM,J3490,HCPCS,250,RC,inpatient,,2624.97,2624.97,,2228.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1979.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2231.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2309.97,88,,percent of total billed charges,,,,,,,,,2005.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2388.72,91,,percent of total billed charges,,,2493.72,95,,percent of total billed charges,,,2178.73,83,,percent of total billed charges,,,2178.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2178.73,83,,percent of total billed charges,,,2493.72,95,,percent of total billed charges,,,2362.47,90,,percent of total billed charges,,,2362.47,90,,percent of total billed charges,,,2152.48,82,,percent of total billed charges,,,2362.47,90,,percent of total billed charges,,,2231.22,85,,percent of total billed charges,,1979.23,2493.72,
PHYTONADIONE(VIT-K)NEONATAL SY:1MG/0.5ML,32000743,CDM,J3430,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,82.65,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,82.65,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,82.65,
DOCEtaxel(TaxoTERE)20MG/0.5ML:J/1MG,32000744,CDM,J9171,HCPCS,636,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,121.68,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,121.68,
D.P.T. (Tdap) (ADACEL) SYR 0.5ML,32000745,CDM,90715,CPT,250,RC,inpatient,,749.84,749.84,,636.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,565.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,637.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,659.86,88,,percent of total billed charges,,,,,,,,,572.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,682.35,91,,percent of total billed charges,,,712.35,95,,percent of total billed charges,,,622.37,83,,percent of total billed charges,,,622.37,83,,percent of total billed charges,,,,,,,,,,,,,,,622.37,83,,percent of total billed charges,,,712.35,95,,percent of total billed charges,,,674.86,90,,percent of total billed charges,,,674.86,90,,percent of total billed charges,,,614.87,82,,percent of total billed charges,,,674.86,90,,percent of total billed charges,,,637.36,85,,percent of total billed charges,,565.38,712.35,
FEXOFENADINE(ALLEGRA)TAB:60MG,32000746,CDM,,,250,RC,inpatient,,21.57,21.57,,18.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.98,88,,percent of total billed charges,,,,,,,,,16.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.63,91,,percent of total billed charges,,,20.49,95,,percent of total billed charges,,,17.9,83,,percent of total billed charges,,,17.9,83,,percent of total billed charges,,,,,,,,,,,,,,,17.9,83,,percent of total billed charges,,,20.49,95,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,17.69,82,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,18.33,85,,percent of total billed charges,,16.26,20.49,
FONDAPARINUX(ARIXTRA)2.5MG/0.5ML:J/0.5MG,32000747,CDM,J1652,HCPCS,636,RC,inpatient,,749.82,749.82,,636.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,565.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,637.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,659.84,88,,percent of total billed charges,,24.32,,,,fee schedule,,,572.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,24.32,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,682.34,91,,percent of total billed charges,,,712.33,95,,percent of total billed charges,,,622.35,83,,percent of total billed charges,,,622.35,83,,percent of total billed charges,,,,,,,,,,,,,,,622.35,83,,percent of total billed charges,,,712.33,95,,percent of total billed charges,,,674.84,90,,percent of total billed charges,,,674.84,90,,percent of total billed charges,,,614.85,82,,percent of total billed charges,,,674.84,90,,percent of total billed charges,,,637.35,85,,percent of total billed charges,,24.32,712.33,
NEBIVOLOL (BYSTOLIC) TABS 5MG:,32000748,CDM,,,250,RC,inpatient,,47.42,47.42,,40.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.73,88,,percent of total billed charges,,,,,,,,,36.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.15,91,,percent of total billed charges,,,45.05,95,,percent of total billed charges,,,39.36,83,,percent of total billed charges,,,39.36,83,,percent of total billed charges,,,,,,,,,,,,,,,39.36,83,,percent of total billed charges,,,45.05,95,,percent of total billed charges,,,42.68,90,,percent of total billed charges,,,42.68,90,,percent of total billed charges,,,38.88,82,,percent of total billed charges,,,42.68,90,,percent of total billed charges,,,40.31,85,,percent of total billed charges,,35.75,45.05,
METHYLNALTREXONE(RELISTOR):12MG/0.6ML,32000749,CDM,J2212,HCPCS,250,RC,inpatient,,2077.38,2077.38,,1763.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1566.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1765.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1828.09,88,,percent of total billed charges,,115.08,,,,fee schedule,,,1587.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,115.08,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1890.42,91,,percent of total billed charges,,,1973.51,95,,percent of total billed charges,,,1724.23,83,,percent of total billed charges,,,1724.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1724.23,83,,percent of total billed charges,,,1973.51,95,,percent of total billed charges,,,1869.64,90,,percent of total billed charges,,,1869.64,90,,percent of total billed charges,,,1703.45,82,,percent of total billed charges,,,1869.64,90,,percent of total billed charges,,,1765.77,85,,percent of total billed charges,,115.08,1973.51,
MOXIFLOXACIN (AVELOX) TAB 400MG:,32000750,CDM,,,250,RC,inpatient,,507.04,507.04,,430.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,382.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,430.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,446.2,88,,percent of total billed charges,,,,,,,,,387.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,461.41,91,,percent of total billed charges,,,481.69,95,,percent of total billed charges,,,420.84,83,,percent of total billed charges,,,420.84,83,,percent of total billed charges,,,,,,,,,,,,,,,420.84,83,,percent of total billed charges,,,481.69,95,,percent of total billed charges,,,456.34,90,,percent of total billed charges,,,456.34,90,,percent of total billed charges,,,415.77,82,,percent of total billed charges,,,456.34,90,,percent of total billed charges,,,430.98,85,,percent of total billed charges,,382.31,481.69,
ALLOPURINOL(ZYLOPRIM)TAB:100MG,32000751,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ALLOPURINOL (ZYLOPRIM) TAB : 300MG,32000752,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ESTRADIOL (VIVELLE-DOT) PAT : 0.1MG/24HR,32000753,CDM,,,250,RC,inpatient,,52.25,52.25,,44.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.98,88,,percent of total billed charges,,,,,,,,,39.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47.55,91,,percent of total billed charges,,,49.64,95,,percent of total billed charges,,,43.37,83,,percent of total billed charges,,,43.37,83,,percent of total billed charges,,,,,,,,,,,,,,,43.37,83,,percent of total billed charges,,,49.64,95,,percent of total billed charges,,,47.03,90,,percent of total billed charges,,,47.03,90,,percent of total billed charges,,,42.85,82,,percent of total billed charges,,,47.03,90,,percent of total billed charges,,,44.41,85,,percent of total billed charges,,39.4,49.64,
BRIMONIDINE(ALPHAGAN-P)DROP 0.2%:5ML,32000757,CDM,J3490,HCPCS,250,RC,inpatient,,78.92,78.92,,67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.45,88,,percent of total billed charges,,,,,,,,,60.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.82,91,,percent of total billed charges,,,74.97,95,,percent of total billed charges,,,65.5,83,,percent of total billed charges,,,65.5,83,,percent of total billed charges,,,,,,,,,,,,,,,65.5,83,,percent of total billed charges,,,74.97,95,,percent of total billed charges,,,71.03,90,,percent of total billed charges,,,71.03,90,,percent of total billed charges,,,64.71,82,,percent of total billed charges,,,71.03,90,,percent of total billed charges,,,67.08,85,,percent of total billed charges,,59.51,74.97,
ALPRAZolam(XANAX)TAB:0.25MG,32000761,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
ALPRAZolam(XANAX)TAB:0.5MG,32000766,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
RAMIPRIL(ALTACE)CAP:2.5MG,32000776,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
TOBRAMYCIN POWDER:1.2GM/50ML,32000780,CDM,J3260,HCPCS,250,RC,inpatient,,898.91,898.91,,763.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,677.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,764.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,791.04,88,,percent of total billed charges,,20.81,,,,fee schedule,,,686.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,20.81,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,818.01,91,,percent of total billed charges,,,853.96,95,,percent of total billed charges,,,746.1,83,,percent of total billed charges,,,746.1,83,,percent of total billed charges,,,,,,,,,,,,,,,746.1,83,,percent of total billed charges,,,853.96,95,,percent of total billed charges,,,809.02,90,,percent of total billed charges,,,809.02,90,,percent of total billed charges,,,737.11,82,,percent of total billed charges,,,809.02,90,,percent of total billed charges,,,764.07,85,,percent of total billed charges,,20.81,853.96,
RAMIPRIL (ALTACE) CAP : 5MG,32000781,CDM,,,250,RC,inpatient,,34.26,34.26,,29.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.15,88,,percent of total billed charges,,,,,,,,,26.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31.18,91,,percent of total billed charges,,,32.55,95,,percent of total billed charges,,,28.44,83,,percent of total billed charges,,,28.44,83,,percent of total billed charges,,,,,,,,,,,,,,,28.44,83,,percent of total billed charges,,,32.55,95,,percent of total billed charges,,,30.83,90,,percent of total billed charges,,,30.83,90,,percent of total billed charges,,,28.09,82,,percent of total billed charges,,,30.83,90,,percent of total billed charges,,,29.12,85,,percent of total billed charges,,25.83,32.55,
DAPTOmycin(CUBICIN):500MG--J/1MG,32000782,CDM,J0878,HCPCS,636,RC,inpatient,,388.73,388.73,,330.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,293.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,330.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,342.08,88,,percent of total billed charges,,33,,,,fee schedule,,,296.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,33,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,353.74,91,,percent of total billed charges,,,369.29,95,,percent of total billed charges,,,322.65,83,,percent of total billed charges,,,322.65,83,,percent of total billed charges,,,,,,,,,,,,,,,322.65,83,,percent of total billed charges,,,369.29,95,,percent of total billed charges,,,349.86,90,,percent of total billed charges,,,349.86,90,,percent of total billed charges,,,318.76,82,,percent of total billed charges,,,349.86,90,,percent of total billed charges,,,330.42,85,,percent of total billed charges,,33,369.29,
"THROMBIN,TOPICAL VIAL:20,000 UNITS",32000787,CDM,J3490,HCPCS,250,RC,inpatient,,2836.09,2836.09,,2407.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2138.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2410.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2495.76,88,,percent of total billed charges,,,,,,,,,2166.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2580.84,91,,percent of total billed charges,,,2694.29,95,,percent of total billed charges,,,2353.95,83,,percent of total billed charges,,,2353.95,83,,percent of total billed charges,,,,,,,,,,,,,,,2353.95,83,,percent of total billed charges,,,2694.29,95,,percent of total billed charges,,,2552.48,90,,percent of total billed charges,,,2552.48,90,,percent of total billed charges,,,2325.59,82,,percent of total billed charges,,,2552.48,90,,percent of total billed charges,,,2410.68,85,,percent of total billed charges,,2138.41,2694.29,
FERUMOXYTOL(FERAHEME):510MG/17ML,32000788,CDM,,,250,RC,inpatient,,6802.11,6802.11,,5774.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5128.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5781.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5985.86,88,,percent of total billed charges,,,,,,,,,5196.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6189.92,91,,percent of total billed charges,,,6462,95,,percent of total billed charges,,,5645.75,83,,percent of total billed charges,,,5645.75,83,,percent of total billed charges,,,,,,,,,,,,,,,5645.75,83,,percent of total billed charges,,,6462,95,,percent of total billed charges,,,6121.9,90,,percent of total billed charges,,,6121.9,90,,percent of total billed charges,,,5577.73,82,,percent of total billed charges,,,6121.9,90,,percent of total billed charges,,,5781.79,85,,percent of total billed charges,,5128.79,6462,
LINEZOLID(ZYVOX)-IVPB:600MG/300ML,32000789,CDM,J2020,HCPCS,250,RC,inpatient,,792.84,792.84,,673.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,597.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,673.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,697.7,88,,percent of total billed charges,,12.56,,,,fee schedule,,,605.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,12.56,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,721.48,91,,percent of total billed charges,,,753.2,95,,percent of total billed charges,,,658.06,83,,percent of total billed charges,,,658.06,83,,percent of total billed charges,,,,,,,,,,,,,,,658.06,83,,percent of total billed charges,,,753.2,95,,percent of total billed charges,,,713.56,90,,percent of total billed charges,,,713.56,90,,percent of total billed charges,,,650.13,82,,percent of total billed charges,,,713.56,90,,percent of total billed charges,,,673.91,85,,percent of total billed charges,,12.56,753.2,
HYDROmorphone (DILAUDID) SYR:1MG/ML,32000790,CDM,J1170,HCPCS,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,3.47,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.47,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,3.47,64.15,
INFLUENZA VACCINE(2010-2011)SYR:0.5ML,32000792,CDM,Q2034,HCPCS,636,RC,inpatient,,194.13,194.13,,164.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,165.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.83,88,,percent of total billed charges,,,,,,,,,148.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.66,91,,percent of total billed charges,,,184.42,95,,percent of total billed charges,,,161.13,83,,percent of total billed charges,,,161.13,83,,percent of total billed charges,,,,,,,,,,,,,,,161.13,83,,percent of total billed charges,,,184.42,95,,percent of total billed charges,,,174.72,90,,percent of total billed charges,,,174.72,90,,percent of total billed charges,,,159.19,82,,percent of total billed charges,,,174.72,90,,percent of total billed charges,,,165.01,85,,percent of total billed charges,,146.37,184.42,
FENOFIBRATE(TRICOR)CAP:200MG,32000793,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ERLOTINIB(TARCEVA)TAB:100MG,32000794,CDM,,,250,RC,inpatient,,1914.33,1914.33,,1625.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1443.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1627.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1684.61,88,,percent of total billed charges,,,,,,,,,1462.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1742.04,91,,percent of total billed charges,,,1818.61,95,,percent of total billed charges,,,1588.89,83,,percent of total billed charges,,,1588.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1588.89,83,,percent of total billed charges,,,1818.61,95,,percent of total billed charges,,,1722.9,90,,percent of total billed charges,,,1722.9,90,,percent of total billed charges,,,1569.75,82,,percent of total billed charges,,,1722.9,90,,percent of total billed charges,,,1627.18,85,,percent of total billed charges,,1443.4,1818.61,
ERLOTINIB(TARCEVA)TAB:150MG,32000795,CDM,,,250,RC,inpatient,,2165.26,2165.26,,1838.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1632.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1840.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1905.43,88,,percent of total billed charges,,,,,,,,,1654.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1970.39,91,,percent of total billed charges,,,2057,95,,percent of total billed charges,,,1797.17,83,,percent of total billed charges,,,1797.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1797.17,83,,percent of total billed charges,,,2057,95,,percent of total billed charges,,,1948.73,90,,percent of total billed charges,,,1948.73,90,,percent of total billed charges,,,1775.51,82,,percent of total billed charges,,,1948.73,90,,percent of total billed charges,,,1840.47,85,,percent of total billed charges,,1632.61,2057,
DENOSUMAB (PROLIA) 60 mg,32000797,CDM,J0897,HCPCS,636,RC,inpatient,,6874.88,6874.88,,5836.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5183.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5843.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6049.89,88,,percent of total billed charges,,2701.2,,,,fee schedule,,,5252.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2701.2,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6256.14,91,,percent of total billed charges,,,6531.14,95,,percent of total billed charges,,,5706.15,83,,percent of total billed charges,,,5706.15,83,,percent of total billed charges,,,,,,,,,,,,,,,5706.15,83,,percent of total billed charges,,,6531.14,95,,percent of total billed charges,,,6187.39,90,,percent of total billed charges,,,6187.39,90,,percent of total billed charges,,,5637.4,82,,percent of total billed charges,,,6187.39,90,,percent of total billed charges,,,5843.65,85,,percent of total billed charges,,2701.2,6531.14,
CABAZITAXEL(JEVTANA)60MG/1.5ML:J/1MG,32000798,CDM,J9043,HCPCS,636,RC,inpatient,,2851.97,2851.97,,2421.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2150.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2424.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2509.73,88,,percent of total billed charges,,11739.18,,,,fee schedule,,,2178.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11739.18,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2595.29,91,,percent of total billed charges,,,2709.37,95,,percent of total billed charges,,,2367.14,83,,percent of total billed charges,,,2367.14,83,,percent of total billed charges,,,,,,,,,,,,,,,2367.14,83,,percent of total billed charges,,,2709.37,95,,percent of total billed charges,,,2566.77,90,,percent of total billed charges,,,2566.77,90,,percent of total billed charges,,,2338.62,82,,percent of total billed charges,,,2566.77,90,,percent of total billed charges,,,2424.17,85,,percent of total billed charges,,2150.39,11739.18,
BOTOX THERAPEUTIC 100 UNITS: J/UNIT,32000799,CDM,J0585,HCPCS,636,RC,inpatient,,4780.69,4780.69,,4058.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3604.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4063.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4207.01,88,,percent of total billed charges,,2491.6,,,,fee schedule,,,3652.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2491.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4350.43,91,,percent of total billed charges,,,4541.66,95,,percent of total billed charges,,,3967.97,83,,percent of total billed charges,,,3967.97,83,,percent of total billed charges,,,,,,,,,,,,,,,3967.97,83,,percent of total billed charges,,,4541.66,95,,percent of total billed charges,,,4302.62,90,,percent of total billed charges,,,4302.62,90,,percent of total billed charges,,,3920.17,82,,percent of total billed charges,,,4302.62,90,,percent of total billed charges,,,4063.59,85,,percent of total billed charges,,2491.6,4541.66,
BCG LIVE (TICE) VIAL:50 MG,32000800,CDM,J9031,HCPCS,636,RC,inpatient,,2215.85,2215.85,,1881.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1670.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1883.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1949.95,88,,percent of total billed charges,,,,,,,,,1692.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2016.42,91,,percent of total billed charges,,,2105.06,95,,percent of total billed charges,,,1839.16,83,,percent of total billed charges,,,1839.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1839.16,83,,percent of total billed charges,,,2105.06,95,,percent of total billed charges,,,1994.27,90,,percent of total billed charges,,,1994.27,90,,percent of total billed charges,,,1817,82,,percent of total billed charges,,,1994.27,90,,percent of total billed charges,,,1883.47,85,,percent of total billed charges,,1670.75,2105.06,
HISTRELIN ACET(VANTAS)IMPLANT:50MG,32000802,CDM,J9225,HCPCS,636,RC,inpatient,,23028.98,23028.98,,19551.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17363.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19574.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20265.5,88,,percent of total billed charges,,5166.29,,,,fee schedule,,,17594.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5166.29,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20956.37,91,,percent of total billed charges,,,21877.53,95,,percent of total billed charges,,,19114.05,83,,percent of total billed charges,,,19114.05,83,,percent of total billed charges,,,,,,,,,,,,,,,19114.05,83,,percent of total billed charges,,,21877.53,95,,percent of total billed charges,,,20726.08,90,,percent of total billed charges,,,20726.08,90,,percent of total billed charges,,,18883.76,82,,percent of total billed charges,,,20726.08,90,,percent of total billed charges,,,19574.63,85,,percent of total billed charges,,5166.29,21877.53,
INTERFERON alpha2b:50MMU(Units)   J/1MMU,32000803,CDM,J9214,HCPCS,636,RC,inpatient,,399.67,399.67,,339.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,301.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,339.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,351.71,88,,percent of total billed charges,,2443.05,,,,fee schedule,,,305.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2443.05,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,363.7,91,,percent of total billed charges,,,379.69,95,,percent of total billed charges,,,331.73,83,,percent of total billed charges,,,331.73,83,,percent of total billed charges,,,,,,,,,,,,,,,331.73,83,,percent of total billed charges,,,379.69,95,,percent of total billed charges,,,359.7,90,,percent of total billed charges,,,359.7,90,,percent of total billed charges,,,327.73,82,,percent of total billed charges,,,359.7,90,,percent of total billed charges,,,339.72,85,,percent of total billed charges,,301.35,2443.05,
TIGECYCLINE(TIGACIL)VL:50MG          J/1,32000804,CDM,J3243,HCPCS,250,RC,inpatient,,2219.62,2219.62,,1884.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1673.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1886.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1953.27,88,,percent of total billed charges,,91.1,,,,fee schedule,,,1695.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,91.1,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2019.85,91,,percent of total billed charges,,,2108.64,95,,percent of total billed charges,,,1842.28,83,,percent of total billed charges,,,1842.28,83,,percent of total billed charges,,,,,,,,,,,,,,,1842.28,83,,percent of total billed charges,,,2108.64,95,,percent of total billed charges,,,1997.66,90,,percent of total billed charges,,,1997.66,90,,percent of total billed charges,,,1820.09,82,,percent of total billed charges,,,1997.66,90,,percent of total billed charges,,,1886.68,85,,percent of total billed charges,,91.1,2108.64,
BCG(THERACYCS) LIVE VIAL:81MG,32000805,CDM,J9031,HCPCS,636,RC,inpatient,,2408.31,2408.31,,2044.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1815.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2047.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2119.31,88,,percent of total billed charges,,,,,,,,,1839.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2191.56,91,,percent of total billed charges,,,2287.89,95,,percent of total billed charges,,,1998.9,83,,percent of total billed charges,,,1998.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1998.9,83,,percent of total billed charges,,,2287.89,95,,percent of total billed charges,,,2167.48,90,,percent of total billed charges,,,2167.48,90,,percent of total billed charges,,,1974.81,82,,percent of total billed charges,,,2167.48,90,,percent of total billed charges,,,2047.06,85,,percent of total billed charges,,1815.87,2287.89,
BELLADONNA ALK W/ PB(DONNATAL) ELIXR:5ML,32000807,CDM,,,250,RC,inpatient,,149.72,149.72,,127.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,112.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,127.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,131.75,88,,percent of total billed charges,,,,,,,,,114.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,136.25,91,,percent of total billed charges,,,142.23,95,,percent of total billed charges,,,124.27,83,,percent of total billed charges,,,124.27,83,,percent of total billed charges,,,,,,,,,,,,,,,124.27,83,,percent of total billed charges,,,142.23,95,,percent of total billed charges,,,134.75,90,,percent of total billed charges,,,134.75,90,,percent of total billed charges,,,122.77,82,,percent of total billed charges,,,134.75,90,,percent of total billed charges,,,127.26,85,,percent of total billed charges,,112.89,142.23,
PHENobarbital SODIUM VIAL:65MG/ML,32000808,CDM,J2560,HCPCS,250,RC,inpatient,,289.76,289.76,,246.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,218.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,246.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.99,88,,percent of total billed charges,,224.63,,,,fee schedule,,,221.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,224.63,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,263.68,91,,percent of total billed charges,,,275.27,95,,percent of total billed charges,,,240.5,83,,percent of total billed charges,,,240.5,83,,percent of total billed charges,,,,,,,,,,,,,,,240.5,83,,percent of total billed charges,,,275.27,95,,percent of total billed charges,,,260.78,90,,percent of total billed charges,,,260.78,90,,percent of total billed charges,,,237.6,82,,percent of total billed charges,,,260.78,90,,percent of total billed charges,,,246.3,85,,percent of total billed charges,,218.48,275.27,
TRANEXAMIC(CYKLOKAPRON)VIAL:1000MG/10ML,32000809,CDM,J3490,HCPCS,250,RC,inpatient,,64.22,64.22,,54.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.51,88,,percent of total billed charges,,,,,,,,,49.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.44,91,,percent of total billed charges,,,61.01,95,,percent of total billed charges,,,53.3,83,,percent of total billed charges,,,53.3,83,,percent of total billed charges,,,,,,,,,,,,,,,53.3,83,,percent of total billed charges,,,61.01,95,,percent of total billed charges,,,57.8,90,,percent of total billed charges,,,57.8,90,,percent of total billed charges,,,52.66,82,,percent of total billed charges,,,57.8,90,,percent of total billed charges,,,54.59,85,,percent of total billed charges,,48.42,61.01,
TESTOSTERONE(ANDROGEL) 1%:,32000810,CDM,,,250,RC,inpatient,,355.42,355.42,,301.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,267.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,302.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,312.77,88,,percent of total billed charges,,,,,,,,,271.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,323.43,91,,percent of total billed charges,,,337.65,95,,percent of total billed charges,,,295,83,,percent of total billed charges,,,295,83,,percent of total billed charges,,,,,,,,,,,,,,,295,83,,percent of total billed charges,,,337.65,95,,percent of total billed charges,,,319.88,90,,percent of total billed charges,,,319.88,90,,percent of total billed charges,,,291.44,82,,percent of total billed charges,,,319.88,90,,percent of total billed charges,,,302.11,85,,percent of total billed charges,,267.99,337.65,
POTASSIUM CHLORIDE VIAL:40MEQ/20ML,32000811,CDM,J3480,HCPCS,250,RC,inpatient,,77.12,77.12,,65.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.87,88,,percent of total billed charges,,3.22,,,,fee schedule,,,58.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.18,91,,percent of total billed charges,,,73.26,95,,percent of total billed charges,,,64.01,83,,percent of total billed charges,,,64.01,83,,percent of total billed charges,,,,,,,,,,,,,,,64.01,83,,percent of total billed charges,,,73.26,95,,percent of total billed charges,,,69.41,90,,percent of total billed charges,,,69.41,90,,percent of total billed charges,,,63.24,82,,percent of total billed charges,,,69.41,90,,percent of total billed charges,,,65.55,85,,percent of total billed charges,,3.22,73.26,
sitaGLIPtin(JANUVIA) TAB:100MG,32000812,CDM,,,250,RC,inpatient,,275.81,275.81,,234.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,207.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,234.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,242.71,88,,percent of total billed charges,,,,,,,,,210.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,250.99,91,,percent of total billed charges,,,262.02,95,,percent of total billed charges,,,228.92,83,,percent of total billed charges,,,228.92,83,,percent of total billed charges,,,,,,,,,,,,,,,228.92,83,,percent of total billed charges,,,262.02,95,,percent of total billed charges,,,248.23,90,,percent of total billed charges,,,248.23,90,,percent of total billed charges,,,226.16,82,,percent of total billed charges,,,248.23,90,,percent of total billed charges,,,234.44,85,,percent of total billed charges,,207.96,262.02,
OLOPATADINE(PATANASE):665MCG (30.5GM),32000813,CDM,,,250,RC,inpatient,,2225.21,2225.21,,1889.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1677.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1891.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1958.18,88,,percent of total billed charges,,,,,,,,,1700.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2024.94,91,,percent of total billed charges,,,2113.95,95,,percent of total billed charges,,,1846.92,83,,percent of total billed charges,,,1846.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1846.92,83,,percent of total billed charges,,,2113.95,95,,percent of total billed charges,,,2002.69,90,,percent of total billed charges,,,2002.69,90,,percent of total billed charges,,,1824.67,82,,percent of total billed charges,,,2002.69,90,,percent of total billed charges,,,1891.43,85,,percent of total billed charges,,1677.81,2113.95,
GLYCOPYRROL(ROBINUL)VIAL:0.2MG/1ML,32000814,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
IV DEXTRAN/D5W40(LMD 10%/5%DEXT) 500ML,32000815,CDM,,,250,RC,inpatient,,443.92,443.92,,376.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,334.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,377.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,390.65,88,,percent of total billed charges,,,,,,,,,339.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,403.97,91,,percent of total billed charges,,,421.72,95,,percent of total billed charges,,,368.45,83,,percent of total billed charges,,,368.45,83,,percent of total billed charges,,,,,,,,,,,,,,,368.45,83,,percent of total billed charges,,,421.72,95,,percent of total billed charges,,,399.53,90,,percent of total billed charges,,,399.53,90,,percent of total billed charges,,,364.01,82,,percent of total billed charges,,,399.53,90,,percent of total billed charges,,,377.33,85,,percent of total billed charges,,334.72,421.72,
hydrOXYzine(VISTARIL)VIAL(*IM*):50MG/ML,32000816,CDM,J3410,HCPCS,250,RC,inpatient,,293.3,293.3,,249.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,221.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,249.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,258.1,88,,percent of total billed charges,,45.34,,,,fee schedule,,,224.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,45.34,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,266.9,91,,percent of total billed charges,,,278.64,95,,percent of total billed charges,,,243.44,83,,percent of total billed charges,,,243.44,83,,percent of total billed charges,,,,,,,,,,,,,,,243.44,83,,percent of total billed charges,,,278.64,95,,percent of total billed charges,,,263.97,90,,percent of total billed charges,,,263.97,90,,percent of total billed charges,,,240.51,82,,percent of total billed charges,,,263.97,90,,percent of total billed charges,,,249.31,85,,percent of total billed charges,,45.34,278.64,
SUFentanil(SUFENTA) AMP:100MCG/2ML,32000817,CDM,,,250,RC,inpatient,,83.26,83.26,,70.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.27,88,,percent of total billed charges,,,,,,,,,63.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.77,91,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,,,,,,,,,,,,,69.11,83,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,68.27,82,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,70.77,85,,percent of total billed charges,,62.78,79.1,
ONDANSETRON(ZOFRAN)ODT TAB:4MG,32000818,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
VITAMIN B-COMPLEX 100 VIAL:30ML,32000819,CDM,J3490,HCPCS,250,RC,inpatient,,102.46,102.46,,86.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.16,88,,percent of total billed charges,,,,,,,,,78.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.24,91,,percent of total billed charges,,,97.34,95,,percent of total billed charges,,,85.04,83,,percent of total billed charges,,,85.04,83,,percent of total billed charges,,,,,,,,,,,,,,,85.04,83,,percent of total billed charges,,,97.34,95,,percent of total billed charges,,,92.21,90,,percent of total billed charges,,,92.21,90,,percent of total billed charges,,,84.02,82,,percent of total billed charges,,,92.21,90,,percent of total billed charges,,,87.09,85,,percent of total billed charges,,77.25,97.34,
SODIUM CHLORIDE 0.9% IRRIG (BAG) 1000ML:,32000820,CDM,,,258,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
AMANTADINE(SYMMETREL)SYRP:50MG/5ML(60ML),32000821,CDM,J8499,HCPCS,250,RC,inpatient,,13.96,13.96,,11.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.28,88,,percent of total billed charges,,,,,,,,,10.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.7,91,,percent of total billed charges,,,13.26,95,,percent of total billed charges,,,11.59,83,,percent of total billed charges,,,11.59,83,,percent of total billed charges,,,,,,,,,,,,,,,11.59,83,,percent of total billed charges,,,13.26,95,,percent of total billed charges,,,12.56,90,,percent of total billed charges,,,12.56,90,,percent of total billed charges,,,11.45,82,,percent of total billed charges,,,12.56,90,,percent of total billed charges,,,11.87,85,,percent of total billed charges,,10.53,13.26,
MEROPENEM(MERREM)VIAL:1000MG,32000822,CDM,J2185,HCPCS,250,RC,inpatient,,74.35,74.35,,63.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,63.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,65.43,88,,percent of total billed charges,,14.5,,,,fee schedule,,,56.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,67.66,91,,percent of total billed charges,,,70.63,95,,percent of total billed charges,,,61.71,83,,percent of total billed charges,,,61.71,83,,percent of total billed charges,,,,,,,,,,,,,,,61.71,83,,percent of total billed charges,,,70.63,95,,percent of total billed charges,,,66.92,90,,percent of total billed charges,,,66.92,90,,percent of total billed charges,,,60.97,82,,percent of total billed charges,,,66.92,90,,percent of total billed charges,,,63.2,85,,percent of total billed charges,,14.5,70.63,
BLEOMYCIN VIAL: 30 UNITS,32000823,CDM,J9040,HCPCS,636,RC,inpatient,,1033.4,1033.4,,877.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,779.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,878.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,909.39,88,,percent of total billed charges,,97.2,,,,fee schedule,,,789.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,97.2,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,940.39,91,,percent of total billed charges,,,981.73,95,,percent of total billed charges,,,857.72,83,,percent of total billed charges,,,857.72,83,,percent of total billed charges,,,,,,,,,,,,,,,857.72,83,,percent of total billed charges,,,981.73,95,,percent of total billed charges,,,930.06,90,,percent of total billed charges,,,930.06,90,,percent of total billed charges,,,847.39,82,,percent of total billed charges,,,930.06,90,,percent of total billed charges,,,878.39,85,,percent of total billed charges,,97.2,981.73,
CHLOROPROCAI(NESACAINE)VL:30MG/ML (20ML),32000824,CDM,,,250,RC,inpatient,,372.71,372.71,,316.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,281.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,316.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,327.98,88,,percent of total billed charges,,,,,,,,,284.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,339.17,91,,percent of total billed charges,,,354.07,95,,percent of total billed charges,,,309.35,83,,percent of total billed charges,,,309.35,83,,percent of total billed charges,,,,,,,,,,,,,,,309.35,83,,percent of total billed charges,,,354.07,95,,percent of total billed charges,,,335.44,90,,percent of total billed charges,,,335.44,90,,percent of total billed charges,,,305.62,82,,percent of total billed charges,,,335.44,90,,percent of total billed charges,,,316.8,85,,percent of total billed charges,,281.02,354.07,
NEBIVOLOL(BYSTOLIC)TAB:2.5MG,32000825,CDM,J8499,HCPCS,250,RC,inpatient,,93.46,93.46,,79.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,82.24,88,,percent of total billed charges,,,,,,,,,71.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,85.05,91,,percent of total billed charges,,,88.79,95,,percent of total billed charges,,,77.57,83,,percent of total billed charges,,,77.57,83,,percent of total billed charges,,,,,,,,,,,,,,,77.57,83,,percent of total billed charges,,,88.79,95,,percent of total billed charges,,,84.11,90,,percent of total billed charges,,,84.11,90,,percent of total billed charges,,,76.64,82,,percent of total billed charges,,,84.11,90,,percent of total billed charges,,,79.44,85,,percent of total billed charges,,70.47,88.79,
AMANTADINE(SYMETREL) SYRP:50MG/5ML 480ML,32000826,CDM,,,250,RC,inpatient,,109.43,109.43,,92.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,93.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,96.3,88,,percent of total billed charges,,,,,,,,,83.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.58,91,,percent of total billed charges,,,103.96,95,,percent of total billed charges,,,90.83,83,,percent of total billed charges,,,90.83,83,,percent of total billed charges,,,,,,,,,,,,,,,90.83,83,,percent of total billed charges,,,103.96,95,,percent of total billed charges,,,98.49,90,,percent of total billed charges,,,98.49,90,,percent of total billed charges,,,89.73,82,,percent of total billed charges,,,98.49,90,,percent of total billed charges,,,93.02,85,,percent of total billed charges,,82.51,103.96,
FOSAPREPITANT (EMEND)VIAL:150MG,32000827,CDM,J1453,HCPCS,636,RC,inpatient,,273.65,273.65,,232.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,206.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,232.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,240.81,88,,percent of total billed charges,,21,,,,fee schedule,,,209.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,249.02,91,,percent of total billed charges,,,259.97,95,,percent of total billed charges,,,227.13,83,,percent of total billed charges,,,227.13,83,,percent of total billed charges,,,,,,,,,,,,,,,227.13,83,,percent of total billed charges,,,259.97,95,,percent of total billed charges,,,246.29,90,,percent of total billed charges,,,246.29,90,,percent of total billed charges,,,224.39,82,,percent of total billed charges,,,246.29,90,,percent of total billed charges,,,232.6,85,,percent of total billed charges,,21,259.97,
SODIUM BICARB SYR 4.2%:5MEQ/10ML(INFANT),32000828,CDM,J3490,HCPCS,250,RC,inpatient,,188.73,188.73,,160.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,142.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,160.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,166.08,88,,percent of total billed charges,,,,,,,,,144.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.74,91,,percent of total billed charges,,,179.29,95,,percent of total billed charges,,,156.65,83,,percent of total billed charges,,,156.65,83,,percent of total billed charges,,,,,,,,,,,,,,,156.65,83,,percent of total billed charges,,,179.29,95,,percent of total billed charges,,,169.86,90,,percent of total billed charges,,,169.86,90,,percent of total billed charges,,,154.76,82,,percent of total billed charges,,,169.86,90,,percent of total billed charges,,,160.42,85,,percent of total billed charges,,142.3,179.29,
chlorproMAZINE(THORAZINE)AMP:50MG/2ML,32000829,CDM,J3230,HCPCS,250,RC,inpatient,,551.29,551.29,,468.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,415.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,468.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,485.14,88,,percent of total billed charges,,272.04,,,,fee schedule,,,421.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,272.04,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,501.67,91,,percent of total billed charges,,,523.73,95,,percent of total billed charges,,,457.57,83,,percent of total billed charges,,,457.57,83,,percent of total billed charges,,,,,,,,,,,,,,,457.57,83,,percent of total billed charges,,,523.73,95,,percent of total billed charges,,,496.16,90,,percent of total billed charges,,,496.16,90,,percent of total billed charges,,,452.06,82,,percent of total billed charges,,,496.16,90,,percent of total billed charges,,,468.6,85,,percent of total billed charges,,272.04,523.73,
DESVENLAFAXINE SUCC(PRISTIQ)TAB:50MG,32000830,CDM,,,250,RC,inpatient,,236,236,,200.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,177.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,200.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,207.68,88,,percent of total billed charges,,,,,,,,,180.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,214.76,91,,percent of total billed charges,,,224.2,95,,percent of total billed charges,,,195.88,83,,percent of total billed charges,,,195.88,83,,percent of total billed charges,,,,,,,,,,,,,,,195.88,83,,percent of total billed charges,,,224.2,95,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,193.52,82,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,200.6,85,,percent of total billed charges,,177.94,224.2,
AMANTADINE(SYMMETREL) SYRP:50MG/5ML 90ML,32000831,CDM,,,250,RC,inpatient,,20.78,20.78,,17.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.29,88,,percent of total billed charges,,,,,,,,,15.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.91,91,,percent of total billed charges,,,19.74,95,,percent of total billed charges,,,17.25,83,,percent of total billed charges,,,17.25,83,,percent of total billed charges,,,,,,,,,,,,,,,17.25,83,,percent of total billed charges,,,19.74,95,,percent of total billed charges,,,18.7,90,,percent of total billed charges,,,18.7,90,,percent of total billed charges,,,17.04,82,,percent of total billed charges,,,18.7,90,,percent of total billed charges,,,17.66,85,,percent of total billed charges,,15.67,19.74,
MAGIC MOUTH WASH 1(Lido Malx Bndrl):90ml,32000832,CDM,,,250,RC,inpatient,,108.17,108.17,,91.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.19,88,,percent of total billed charges,,,,,,,,,82.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.43,91,,percent of total billed charges,,,102.76,95,,percent of total billed charges,,,89.78,83,,percent of total billed charges,,,89.78,83,,percent of total billed charges,,,,,,,,,,,,,,,89.78,83,,percent of total billed charges,,,102.76,95,,percent of total billed charges,,,97.35,90,,percent of total billed charges,,,97.35,90,,percent of total billed charges,,,88.7,82,,percent of total billed charges,,,97.35,90,,percent of total billed charges,,,91.94,85,,percent of total billed charges,,81.56,102.76,
ARFORMOTEROL(BROVANA)INH:15MCG/2ML,32000833,CDM,,,250,RC,inpatient,,312.44,312.44,,265.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,235.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,265.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,274.95,88,,percent of total billed charges,,,,,,,,,238.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,284.32,91,,percent of total billed charges,,,296.82,95,,percent of total billed charges,,,259.33,83,,percent of total billed charges,,,259.33,83,,percent of total billed charges,,,,,,,,,,,,,,,259.33,83,,percent of total billed charges,,,296.82,95,,percent of total billed charges,,,281.2,90,,percent of total billed charges,,,281.2,90,,percent of total billed charges,,,256.2,82,,percent of total billed charges,,,281.2,90,,percent of total billed charges,,,265.57,85,,percent of total billed charges,,235.58,296.82,
RIFAMPIN VIAL:600MG,32000834,CDM,J3490,HCPCS,250,RC,inpatient,,1206.91,1206.91,,1024.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,910.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1025.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1062.08,88,,percent of total billed charges,,,,,,,,,922.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1098.29,91,,percent of total billed charges,,,1146.56,95,,percent of total billed charges,,,1001.74,83,,percent of total billed charges,,,1001.74,83,,percent of total billed charges,,,,,,,,,,,,,,,1001.74,83,,percent of total billed charges,,,1146.56,95,,percent of total billed charges,,,1086.22,90,,percent of total billed charges,,,1086.22,90,,percent of total billed charges,,,989.67,82,,percent of total billed charges,,,1086.22,90,,percent of total billed charges,,,1025.87,85,,percent of total billed charges,,910.01,1146.56,
DABIGATRAN(PRADAXA) CAPS:75MG,32000835,CDM,J8499,HCPCS,250,RC,inpatient,,120.92,120.92,,102.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,106.41,88,,percent of total billed charges,,,,,,,,,92.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,110.04,91,,percent of total billed charges,,,114.87,95,,percent of total billed charges,,,100.36,83,,percent of total billed charges,,,100.36,83,,percent of total billed charges,,,,,,,,,,,,,,,100.36,83,,percent of total billed charges,,,114.87,95,,percent of total billed charges,,,108.83,90,,percent of total billed charges,,,108.83,90,,percent of total billed charges,,,99.15,82,,percent of total billed charges,,,108.83,90,,percent of total billed charges,,,102.78,85,,percent of total billed charges,,91.17,114.87,
AMANTADINE(SYMMETREL)CAP:100MG,32000836,CDM,J8499,HCPCS,250,RC,inpatient,,14.71,14.71,,12.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.94,88,,percent of total billed charges,,,,,,,,,11.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.39,91,,percent of total billed charges,,,13.97,95,,percent of total billed charges,,,12.21,83,,percent of total billed charges,,,12.21,83,,percent of total billed charges,,,,,,,,,,,,,,,12.21,83,,percent of total billed charges,,,13.97,95,,percent of total billed charges,,,13.24,90,,percent of total billed charges,,,13.24,90,,percent of total billed charges,,,12.06,82,,percent of total billed charges,,,13.24,90,,percent of total billed charges,,,12.5,85,,percent of total billed charges,,11.09,13.97,
GLIMEPIRIDE (AMARYL) TAB : 2MG,32000837,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ACETAMINOPHEN-IVPB:1000MG/100ML,32000838,CDM,J0131,HCPCS,250,RC,inpatient,,168.96,168.96,,143.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,127.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,143.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,148.68,88,,percent of total billed charges,,5.83,,,,fee schedule,,,129.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.83,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,153.75,91,,percent of total billed charges,,,160.51,95,,percent of total billed charges,,,140.24,83,,percent of total billed charges,,,140.24,83,,percent of total billed charges,,,,,,,,,,,,,,,140.24,83,,percent of total billed charges,,,160.51,95,,percent of total billed charges,,,152.06,90,,percent of total billed charges,,,152.06,90,,percent of total billed charges,,,138.55,82,,percent of total billed charges,,,152.06,90,,percent of total billed charges,,,143.62,85,,percent of total billed charges,,5.83,160.51,
ZOLPIDEM(AMBIEN)TAB:5MG,32000841,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
ZOLPIDEM (AMBIEN) TAB : 10MG,32000842,CDM,,,250,RC,inpatient,,71.85,71.85,,61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,54.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,61.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,63.23,88,,percent of total billed charges,,,,,,,,,54.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,65.38,91,,percent of total billed charges,,,68.26,95,,percent of total billed charges,,,59.64,83,,percent of total billed charges,,,59.64,83,,percent of total billed charges,,,,,,,,,,,,,,,59.64,83,,percent of total billed charges,,,68.26,95,,percent of total billed charges,,,64.67,90,,percent of total billed charges,,,64.67,90,,percent of total billed charges,,,58.92,82,,percent of total billed charges,,,64.67,90,,percent of total billed charges,,,61.07,85,,percent of total billed charges,,54.17,68.26,
GLIMEPIRIDE(AMARYL)TAB:4MG,32000843,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
AMINOPHYLLINE VIAL:500MG/20ML,32000871,CDM,J0280,HCPCS,250,RC,inpatient,,128.78,128.78,,109.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,97.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,109.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,113.33,88,,percent of total billed charges,,34.11,,,,fee schedule,,,98.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,34.11,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,117.19,91,,percent of total billed charges,,,122.34,95,,percent of total billed charges,,,106.89,83,,percent of total billed charges,,,106.89,83,,percent of total billed charges,,,,,,,,,,,,,,,106.89,83,,percent of total billed charges,,,122.34,95,,percent of total billed charges,,,115.9,90,,percent of total billed charges,,,115.9,90,,percent of total billed charges,,,105.6,82,,percent of total billed charges,,,115.9,90,,percent of total billed charges,,,109.46,85,,percent of total billed charges,,34.11,122.34,
AMINOCAPROIC ACID(amicar)5000MG/20ML,32000876,CDM,J3490,HCPCS,250,RC,inpatient,,108.48,108.48,,92.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,92.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.46,88,,percent of total billed charges,,,,,,,,,82.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.72,91,,percent of total billed charges,,,103.06,95,,percent of total billed charges,,,90.04,83,,percent of total billed charges,,,90.04,83,,percent of total billed charges,,,,,,,,,,,,,,,90.04,83,,percent of total billed charges,,,103.06,95,,percent of total billed charges,,,97.63,90,,percent of total billed charges,,,97.63,90,,percent of total billed charges,,,88.95,82,,percent of total billed charges,,,97.63,90,,percent of total billed charges,,,92.21,85,,percent of total billed charges,,81.79,103.06,
AMITRIPTYLINE(ELAVIL)TAB:25MG,32000881,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
AMITRIPTYLINE(ELAVIL)TAB:10MG,32000886,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
AMITRIP HCL/CHLORDIAZEPOXDE TAB:12.5-5MG,32000911,CDM,,,250,RC,inpatient,,17.29,17.29,,14.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.22,88,,percent of total billed charges,,,,,,,,,13.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.73,91,,percent of total billed charges,,,16.43,95,,percent of total billed charges,,,14.35,83,,percent of total billed charges,,,14.35,83,,percent of total billed charges,,,,,,,,,,,,,,,14.35,83,,percent of total billed charges,,,16.43,95,,percent of total billed charges,,,15.56,90,,percent of total billed charges,,,15.56,90,,percent of total billed charges,,,14.18,82,,percent of total billed charges,,,15.56,90,,percent of total billed charges,,,14.7,85,,percent of total billed charges,,13.04,16.43,
AMMONIA(AMMONIA AROMATIC)AMP:,32000916,CDM,J3490,HCPCS,250,RC,inpatient,,54.58,54.58,,46.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.03,88,,percent of total billed charges,,,,,,,,,41.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.67,91,,percent of total billed charges,,,51.85,95,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,,,,,,,,,,,,,,45.3,83,,percent of total billed charges,,,51.85,95,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,44.76,82,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,46.39,85,,percent of total billed charges,,41.15,51.85,
AMOXAPINE (ASENDIN) TAB :  25MG,32000921,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
POTASSIUM CHLORIDE VIAL:20MEQ/10ML,32000926,CDM,J3480,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,3.22,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,3.22,60.99,
POTASS CHLOR -IVPB : 20MEQ/100 ML,32000927,CDM,J3480,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,3.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.22,187.11,
METHYL SALIC/MENTHL(ANALGESIC) OINT 30GM,32000936,CDM,,,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
PHYSOSTIGMINE(ANTILIRIUM)AMP:2MG/2ML,32000961,CDM,J3490,HCPCS,250,RC,inpatient,,1125.73,1125.73,,955.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,848.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,956.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,990.64,88,,percent of total billed charges,,,,,,,,,860.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1024.41,91,,percent of total billed charges,,,1069.44,95,,percent of total billed charges,,,934.36,83,,percent of total billed charges,,,934.36,83,,percent of total billed charges,,,,,,,,,,,,,,,934.36,83,,percent of total billed charges,,,1069.44,95,,percent of total billed charges,,,1013.16,90,,percent of total billed charges,,,1013.16,90,,percent of total billed charges,,,923.1,82,,percent of total billed charges,,,1013.16,90,,percent of total billed charges,,,956.87,85,,percent of total billed charges,,848.8,1069.44,
ANTIVENIN CROTALID(EQUINE)(POLYVALNT):,32000966,CDM,,,250,RC,inpatient,,4624.83,4624.83,,3926.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3487.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3931.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4069.85,88,,percent of total billed charges,,,,,,,,,3533.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4208.6,91,,percent of total billed charges,,,4393.59,95,,percent of total billed charges,,,3838.61,83,,percent of total billed charges,,,3838.61,83,,percent of total billed charges,,,,,,,,,,,,,,,3838.61,83,,percent of total billed charges,,,4393.59,95,,percent of total billed charges,,,4162.35,90,,percent of total billed charges,,,4162.35,90,,percent of total billed charges,,,3792.36,82,,percent of total billed charges,,,4162.35,90,,percent of total billed charges,,,3931.11,85,,percent of total billed charges,,3487.12,4393.59,
BDON ALK/PB(DONNATAL)EL :16.2MG/5ML 60ML,32000971,CDM,,,250,RC,inpatient,,1522.08,1522.08,,1292.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1147.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1293.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1339.43,88,,percent of total billed charges,,,,,,,,,1162.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1385.09,91,,percent of total billed charges,,,1445.98,95,,percent of total billed charges,,,1263.33,83,,percent of total billed charges,,,1263.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1263.33,83,,percent of total billed charges,,,1445.98,95,,percent of total billed charges,,,1369.87,90,,percent of total billed charges,,,1369.87,90,,percent of total billed charges,,,1248.11,82,,percent of total billed charges,,,1369.87,90,,percent of total billed charges,,,1293.77,85,,percent of total billed charges,,1147.65,1445.98,
BDON ALK/PB(DONNATAL) EL:16.2MG/5ML 90ML,32000976,CDM,,,250,RC,inpatient,,2283.05,2283.05,,1938.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1721.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1940.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2009.08,88,,percent of total billed charges,,,,,,,,,1744.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2077.58,91,,percent of total billed charges,,,2168.9,95,,percent of total billed charges,,,1894.93,83,,percent of total billed charges,,,1894.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1894.93,83,,percent of total billed charges,,,2168.9,95,,percent of total billed charges,,,2054.75,90,,percent of total billed charges,,,2054.75,90,,percent of total billed charges,,,1872.1,82,,percent of total billed charges,,,2054.75,90,,percent of total billed charges,,,1940.59,85,,percent of total billed charges,,1721.42,2168.9,
HYDROCORTISONE(ANUSOL-HC)CREAM 2.5%:30GM,32000986,CDM,,,250,RC,inpatient,,331,331,,281.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,249.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,281.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,291.28,88,,percent of total billed charges,,,,,,,,,252.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,301.21,91,,percent of total billed charges,,,314.45,95,,percent of total billed charges,,,274.73,83,,percent of total billed charges,,,274.73,83,,percent of total billed charges,,,,,,,,,,,,,,,274.73,83,,percent of total billed charges,,,314.45,95,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,271.42,82,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,281.35,85,,percent of total billed charges,,249.57,314.45,
HYDROCORTiSONE(ANUCORT HC)SUPP:25MG,32000992,CDM,J3490,HCPCS,250,RC,inpatient,,38.07,38.07,,32.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33.5,88,,percent of total billed charges,,,,,,,,,29.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.64,91,,percent of total billed charges,,,36.17,95,,percent of total billed charges,,,31.6,83,,percent of total billed charges,,,31.6,83,,percent of total billed charges,,,,,,,,,,,,,,,31.6,83,,percent of total billed charges,,,36.17,95,,percent of total billed charges,,,34.26,90,,percent of total billed charges,,,34.26,90,,percent of total billed charges,,,31.22,82,,percent of total billed charges,,,34.26,90,,percent of total billed charges,,,32.36,85,,percent of total billed charges,,28.7,36.17,
PRAM HCL/BALS/ZNOX/BENZL(ANUSOL)OINT 30G,32000996,CDM,,,250,RC,inpatient,,50.28,50.28,,42.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.25,88,,percent of total billed charges,,,,,,,,,38.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.75,91,,percent of total billed charges,,,47.77,95,,percent of total billed charges,,,41.73,83,,percent of total billed charges,,,41.73,83,,percent of total billed charges,,,,,,,,,,,,,,,41.73,83,,percent of total billed charges,,,47.77,95,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,41.23,82,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,42.74,85,,percent of total billed charges,,37.91,47.77,
PRAMOX/M.0./ZNX(ANUSOL)OINT:1%-12.5%30GM,32001001,CDM,,,250,RC,inpatient,,54.88,54.88,,46.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.29,88,,percent of total billed charges,,,,,,,,,41.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.94,91,,percent of total billed charges,,,52.14,95,,percent of total billed charges,,,45.55,83,,percent of total billed charges,,,45.55,83,,percent of total billed charges,,,,,,,,,,,,,,,45.55,83,,percent of total billed charges,,,52.14,95,,percent of total billed charges,,,49.39,90,,percent of total billed charges,,,49.39,90,,percent of total billed charges,,,45,82,,percent of total billed charges,,,49.39,90,,percent of total billed charges,,,46.65,85,,percent of total billed charges,,41.38,52.14,
DOLASETRON MESYLATE(ANZEMET)VIAL:20MG/ML,32001002,CDM,J1260,HCPCS,636,RC,inpatient,,312.76,312.76,,265.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,235.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,265.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,275.23,88,,percent of total billed charges,,,,,,,,,238.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,284.61,91,,percent of total billed charges,,,297.12,95,,percent of total billed charges,,,259.59,83,,percent of total billed charges,,,259.59,83,,percent of total billed charges,,,,,,,,,,,,,,,259.59,83,,percent of total billed charges,,,297.12,95,,percent of total billed charges,,,281.48,90,,percent of total billed charges,,,281.48,90,,percent of total billed charges,,,256.46,82,,percent of total billed charges,,,281.48,90,,percent of total billed charges,,,265.85,85,,percent of total billed charges,,235.82,297.12,
TUBERCULIN(TB)VIAL:5 T UNITS/0.1ML,32001006,CDM,J3490,HCPCS,250,RC,inpatient,,147.39,147.39,,125.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,111.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,125.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.7,88,,percent of total billed charges,,,,,,,,,112.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,134.12,91,,percent of total billed charges,,,140.02,95,,percent of total billed charges,,,122.33,83,,percent of total billed charges,,,122.33,83,,percent of total billed charges,,,,,,,,,,,,,,,122.33,83,,percent of total billed charges,,,140.02,95,,percent of total billed charges,,,132.65,90,,percent of total billed charges,,,132.65,90,,percent of total billed charges,,,120.86,82,,percent of total billed charges,,,132.65,90,,percent of total billed charges,,,125.28,85,,percent of total billed charges,,111.13,140.02,
TUBERCULIN(TB)VIAL:5 TEST UNITS/0.1ML,32001011,CDM,,,250,RC,inpatient,,141.25,141.25,,119.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,106.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,120.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,124.3,88,,percent of total billed charges,,,,,,,,,107.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,128.54,91,,percent of total billed charges,,,134.19,95,,percent of total billed charges,,,117.24,83,,percent of total billed charges,,,117.24,83,,percent of total billed charges,,,,,,,,,,,,,,,117.24,83,,percent of total billed charges,,,134.19,95,,percent of total billed charges,,,127.13,90,,percent of total billed charges,,,127.13,90,,percent of total billed charges,,,115.83,82,,percent of total billed charges,,,127.13,90,,percent of total billed charges,,,120.06,85,,percent of total billed charges,,106.5,134.19,
METARAMINOL (ARAMINE)VIAL:10MG/ML  10ML,32001026,CDM,,,250,RC,inpatient,,177.95,177.95,,151.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,134.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,151.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,156.6,88,,percent of total billed charges,,,,,,,,,135.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,161.93,91,,percent of total billed charges,,,169.05,95,,percent of total billed charges,,,147.7,83,,percent of total billed charges,,,147.7,83,,percent of total billed charges,,,,,,,,,,,,,,,147.7,83,,percent of total billed charges,,,169.05,95,,percent of total billed charges,,,160.16,90,,percent of total billed charges,,,160.16,90,,percent of total billed charges,,,145.92,82,,percent of total billed charges,,,160.16,90,,percent of total billed charges,,,151.26,85,,percent of total billed charges,,134.17,169.05,
PAMIDRONATE (AREDIA):90MG  (J PER 30MG),32001031,CDM,J2430,HCPCS,636,RC,inpatient,,527.34,527.34,,447.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,397.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,448.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,464.06,88,,percent of total billed charges,,32.94,,,,fee schedule,,,402.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,32.94,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,479.88,91,,percent of total billed charges,,,500.97,95,,percent of total billed charges,,,437.69,83,,percent of total billed charges,,,437.69,83,,percent of total billed charges,,,,,,,,,,,,,,,437.69,83,,percent of total billed charges,,,500.97,95,,percent of total billed charges,,,474.61,90,,percent of total billed charges,,,474.61,90,,percent of total billed charges,,,432.42,82,,percent of total billed charges,,,474.61,90,,percent of total billed charges,,,448.24,85,,percent of total billed charges,,32.94,500.97,
DONEPEZIL(ARICEPT)TAB:5MG,32001037,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DONEPEZIL (ARICEPT) TAB : 10MG,32001038,CDM,,,250,RC,inpatient,,255.66,255.66,,217.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,192.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,217.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,224.98,88,,percent of total billed charges,,,,,,,,,195.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,232.65,91,,percent of total billed charges,,,242.88,95,,percent of total billed charges,,,212.2,83,,percent of total billed charges,,,212.2,83,,percent of total billed charges,,,,,,,,,,,,,,,212.2,83,,percent of total billed charges,,,242.88,95,,percent of total billed charges,,,230.09,90,,percent of total billed charges,,,230.09,90,,percent of total billed charges,,,209.64,82,,percent of total billed charges,,,230.09,90,,percent of total billed charges,,,217.31,85,,percent of total billed charges,,192.77,242.88,
THYROID TAB : 30MG,32001051,CDM,,,250,RC,inpatient,,13.8,13.8,,11.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.14,88,,percent of total billed charges,,,,,,,,,10.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.56,91,,percent of total billed charges,,,13.11,95,,percent of total billed charges,,,11.45,83,,percent of total billed charges,,,11.45,83,,percent of total billed charges,,,,,,,,,,,,,,,11.45,83,,percent of total billed charges,,,13.11,95,,percent of total billed charges,,,12.42,90,,percent of total billed charges,,,12.42,90,,percent of total billed charges,,,11.32,82,,percent of total billed charges,,,12.42,90,,percent of total billed charges,,,11.73,85,,percent of total billed charges,,10.41,13.11,
THYROID TAB:60MG,32001061,CDM,J8499,HCPCS,250,RC,inpatient,,15.52,15.52,,13.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.66,88,,percent of total billed charges,,,,,,,,,11.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.12,91,,percent of total billed charges,,,14.74,95,,percent of total billed charges,,,12.88,83,,percent of total billed charges,,,12.88,83,,percent of total billed charges,,,,,,,,,,,,,,,12.88,83,,percent of total billed charges,,,14.74,95,,percent of total billed charges,,,13.97,90,,percent of total billed charges,,,13.97,90,,percent of total billed charges,,,12.73,82,,percent of total billed charges,,,13.97,90,,percent of total billed charges,,,13.19,85,,percent of total billed charges,,11.7,14.74,
ASCORBIC ACID(VITAMIN C)TAB:500MG,32001071,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
MESALAMINE(ASACOL)TAB:400MG,32001075,CDM,,,250,RC,inpatient,,35.05,35.05,,29.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.84,88,,percent of total billed charges,,,,,,,,,26.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31.9,91,,percent of total billed charges,,,33.3,95,,percent of total billed charges,,,29.09,83,,percent of total billed charges,,,29.09,83,,percent of total billed charges,,,,,,,,,,,,,,,29.09,83,,percent of total billed charges,,,33.3,95,,percent of total billed charges,,,31.55,90,,percent of total billed charges,,,31.55,90,,percent of total billed charges,,,28.74,82,,percent of total billed charges,,,31.55,90,,percent of total billed charges,,,29.79,85,,percent of total billed charges,,26.43,33.3,
ASA/CAL CRB/AL HYDRX(ASCRIPTIN)TAB:325MG,32001076,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ASPIRIN SUPP : 300MG,32001106,CDM,J3490,HCPCS,250,RC,inpatient,,21.24,21.24,,18.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.69,88,,percent of total billed charges,,,,,,,,,16.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.33,91,,percent of total billed charges,,,20.18,95,,percent of total billed charges,,,17.63,83,,percent of total billed charges,,,17.63,83,,percent of total billed charges,,,,,,,,,,,,,,,17.63,83,,percent of total billed charges,,,20.18,95,,percent of total billed charges,,,19.12,90,,percent of total billed charges,,,19.12,90,,percent of total billed charges,,,17.42,82,,percent of total billed charges,,,19.12,90,,percent of total billed charges,,,18.05,85,,percent of total billed charges,,16.01,20.18,
ASPIRIN SUPP:600MG,32001131,CDM,J3490,HCPCS,250,RC,inpatient,,21.25,21.25,,18.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.7,88,,percent of total billed charges,,,,,,,,,16.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.34,91,,percent of total billed charges,,,20.19,95,,percent of total billed charges,,,17.64,83,,percent of total billed charges,,,17.64,83,,percent of total billed charges,,,,,,,,,,,,,,,17.64,83,,percent of total billed charges,,,20.19,95,,percent of total billed charges,,,19.13,90,,percent of total billed charges,,,19.13,90,,percent of total billed charges,,,17.43,82,,percent of total billed charges,,,19.13,90,,percent of total billed charges,,,18.06,85,,percent of total billed charges,,16.02,20.19,
ASPIRIN,32001136,CDM,,,250,RC,inpatient,,22063.9,22063.9,,18732.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16636.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18754.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19416.23,88,,percent of total billed charges,,,,,,,,,16856.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20078.15,91,,percent of total billed charges,,,20960.71,95,,percent of total billed charges,,,18313.04,83,,percent of total billed charges,,,18313.04,83,,percent of total billed charges,,,,,,,,,,,,,,,18313.04,83,,percent of total billed charges,,,20960.71,95,,percent of total billed charges,,,19857.51,90,,percent of total billed charges,,,19857.51,90,,percent of total billed charges,,,18092.4,82,,percent of total billed charges,,,19857.51,90,,percent of total billed charges,,,18754.32,85,,percent of total billed charges,,16636.18,20960.71,
AZELASTINE(ASTELIN)SPR:137MCG (30ML),32001137,CDM,J3490,HCPCS,250,RC,inpatient,,199.2,199.2,,169.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,150.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,169.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,175.3,88,,percent of total billed charges,,,,,,,,,152.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,181.27,91,,percent of total billed charges,,,189.24,95,,percent of total billed charges,,,165.34,83,,percent of total billed charges,,,165.34,83,,percent of total billed charges,,,,,,,,,,,,,,,165.34,83,,percent of total billed charges,,,189.24,95,,percent of total billed charges,,,179.28,90,,percent of total billed charges,,,179.28,90,,percent of total billed charges,,,163.34,82,,percent of total billed charges,,,179.28,90,,percent of total billed charges,,,169.32,85,,percent of total billed charges,,150.2,189.24,
CANDESARTAN(ATACAND)TAB:16MG,32001138,CDM,J8499,HCPCS,250,RC,inpatient,,23.86,23.86,,20.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21,88,,percent of total billed charges,,,,,,,,,18.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.71,91,,percent of total billed charges,,,22.67,95,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,,,,,,,,,,,,,,19.8,83,,percent of total billed charges,,,22.67,95,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,19.57,82,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,20.28,85,,percent of total billed charges,,17.99,22.67,
ATENOLOL(TENORMIN)TAB:50MG,32001151,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ATENOLOL(TENORMIN)TAB:25MG,32001156,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LORazepam(ATIVAN)INJ:2MG/ML,32001161,CDM,J2060,HCPCS,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,1.91,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.91,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,1.91,64.15,
IPRATRO(ATROVENT)NASAL SPR:42MCG (15ML),32001162,CDM,,,250,RC,inpatient,,182,182,,154.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,154.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,160.16,88,,percent of total billed charges,,,,,,,,,139.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,149.24,82,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,137.23,172.9,
IPRATRO(ATROVENT)MDI AER:17MCG (12.9GM),32001166,CDM,J7644,HCPCS,250,RC,inpatient,,3469.91,3469.91,,2945.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2616.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2949.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3053.52,88,,percent of total billed charges,,0.21,,,,fee schedule,,,2651.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.21,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3157.62,91,,percent of total billed charges,,,3296.41,95,,percent of total billed charges,,,2880.03,83,,percent of total billed charges,,,2880.03,83,,percent of total billed charges,,,,,,,,,,,,,,,2880.03,83,,percent of total billed charges,,,3296.41,95,,percent of total billed charges,,,3122.92,90,,percent of total billed charges,,,3122.92,90,,percent of total billed charges,,,2845.33,82,,percent of total billed charges,,,3122.92,90,,percent of total billed charges,,,2949.42,85,,percent of total billed charges,,0.21,3296.41,
IPRATROPIUM(ATROVENT)SOL:0.5MG/2.5ML U/D,32001171,CDM,J7644,HCPCS,250,RC,inpatient,,24.8,24.8,,21.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.82,88,,percent of total billed charges,,0.21,,,,fee schedule,,,18.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.21,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.57,91,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,,,,,,,,,,,,,20.58,83,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,20.34,82,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,0.21,23.56,
ATROPINE AMP:0.4MG/0.5ML,32001181,CDM,J0461,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,42.6,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,42.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,42.6,59.21,
ATROPINE SYR:1MG/10ML,32001185,CDM,J0461,HCPCS,250,RC,inpatient,,160.95,160.95,,136.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,121.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,141.64,88,,percent of total billed charges,,42.6,,,,fee schedule,,,122.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,42.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,146.46,91,,percent of total billed charges,,,152.9,95,,percent of total billed charges,,,133.59,83,,percent of total billed charges,,,133.59,83,,percent of total billed charges,,,,,,,,,,,,,,,133.59,83,,percent of total billed charges,,,152.9,95,,percent of total billed charges,,,144.86,90,,percent of total billed charges,,,144.86,90,,percent of total billed charges,,,131.98,82,,percent of total billed charges,,,144.86,90,,percent of total billed charges,,,136.81,85,,percent of total billed charges,,42.6,152.9,
ATROPINE VIAL:0.4MG/ML (1ml),32001191,CDM,J0461,HCPCS,250,RC,inpatient,,66.83,66.83,,56.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.81,88,,percent of total billed charges,,42.6,,,,fee schedule,,,51.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,42.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.82,91,,percent of total billed charges,,,63.49,95,,percent of total billed charges,,,55.47,83,,percent of total billed charges,,,55.47,83,,percent of total billed charges,,,,,,,,,,,,,,,55.47,83,,percent of total billed charges,,,63.49,95,,percent of total billed charges,,,60.15,90,,percent of total billed charges,,,60.15,90,,percent of total billed charges,,,54.8,82,,percent of total billed charges,,,60.15,90,,percent of total billed charges,,,56.81,85,,percent of total billed charges,,42.6,63.49,
MEASLES VACCINE LIVE ATTENUATD VIAL:,32001196,CDM,90705,CPT,636,RC,inpatient,,265.02,265.02,,225,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,199.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,225.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,233.22,88,,percent of total billed charges,,,,,,,,,202.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,241.17,91,,percent of total billed charges,,,251.77,95,,percent of total billed charges,,,219.97,83,,percent of total billed charges,,,219.97,83,,percent of total billed charges,,,,,,,,,,,,,,,219.97,83,,percent of total billed charges,,,251.77,95,,percent of total billed charges,,,238.52,90,,percent of total billed charges,,,238.52,90,,percent of total billed charges,,,217.32,82,,percent of total billed charges,,,238.52,90,,percent of total billed charges,,,225.27,85,,percent of total billed charges,,199.83,251.77,
AMOX/CLAV(AUGMENTIN)TAB:250-125MG,32001201,CDM,,,250,RC,inpatient,,56.14,56.14,,47.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.4,88,,percent of total billed charges,,,,,,,,,42.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.09,91,,percent of total billed charges,,,53.33,95,,percent of total billed charges,,,46.6,83,,percent of total billed charges,,,46.6,83,,percent of total billed charges,,,,,,,,,,,,,,,46.6,83,,percent of total billed charges,,,53.33,95,,percent of total billed charges,,,50.53,90,,percent of total billed charges,,,50.53,90,,percent of total billed charges,,,46.03,82,,percent of total billed charges,,,50.53,90,,percent of total billed charges,,,47.72,85,,percent of total billed charges,,42.33,53.33,
AMOX/CLAV(AUGMENTIN)TAB 500-125MG,32001206,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
AMOX/CLAV(AUGMENTIN)TAB 500-125MG (1x6),32001207,CDM,,,250,RC,inpatient,,22.39,22.39,,19.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.7,88,,percent of total billed charges,,,,,,,,,17.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.37,91,,percent of total billed charges,,,21.27,95,,percent of total billed charges,,,18.58,83,,percent of total billed charges,,,18.58,83,,percent of total billed charges,,,,,,,,,,,,,,,18.58,83,,percent of total billed charges,,,21.27,95,,percent of total billed charges,,,20.15,90,,percent of total billed charges,,,20.15,90,,percent of total billed charges,,,18.36,82,,percent of total billed charges,,,20.15,90,,percent of total billed charges,,,19.03,85,,percent of total billed charges,,16.88,21.27,
AMOX/CLAV(AUGMENTIN)SUS 400-57/5 (100ML),32001210,CDM,J8499,HCPCS,250,RC,inpatient,,105.56,105.56,,89.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,89.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,92.89,88,,percent of total billed charges,,,,,,,,,80.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,96.06,91,,percent of total billed charges,,,100.28,95,,percent of total billed charges,,,87.61,83,,percent of total billed charges,,,87.61,83,,percent of total billed charges,,,,,,,,,,,,,,,87.61,83,,percent of total billed charges,,,100.28,95,,percent of total billed charges,,,95,90,,percent of total billed charges,,,95,90,,percent of total billed charges,,,86.56,82,,percent of total billed charges,,,95,90,,percent of total billed charges,,,89.73,85,,percent of total billed charges,,79.59,100.28,
AMOX/CLAV(AUGMENTN)SUS 250-62.5/5(75ML),32001211,CDM,J8499,HCPCS,250,RC,inpatient,,714.84,714.84,,606.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,538.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,607.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,629.06,88,,percent of total billed charges,,,,,,,,,546.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,650.5,91,,percent of total billed charges,,,679.1,95,,percent of total billed charges,,,593.32,83,,percent of total billed charges,,,593.32,83,,percent of total billed charges,,,,,,,,,,,,,,,593.32,83,,percent of total billed charges,,,679.1,95,,percent of total billed charges,,,643.36,90,,percent of total billed charges,,,643.36,90,,percent of total billed charges,,,586.17,82,,percent of total billed charges,,,643.36,90,,percent of total billed charges,,,607.61,85,,percent of total billed charges,,538.99,679.1,
AMOX/CLAV(AUGMENTIN)SUSP 125-31.25(75ML),32001216,CDM,J8499,HCPCS,250,RC,inpatient,,17.16,17.16,,14.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.1,88,,percent of total billed charges,,,,,,,,,13.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.62,91,,percent of total billed charges,,,16.3,95,,percent of total billed charges,,,14.24,83,,percent of total billed charges,,,14.24,83,,percent of total billed charges,,,,,,,,,,,,,,,14.24,83,,percent of total billed charges,,,16.3,95,,percent of total billed charges,,,15.44,90,,percent of total billed charges,,,15.44,90,,percent of total billed charges,,,14.07,82,,percent of total billed charges,,,15.44,90,,percent of total billed charges,,,14.59,85,,percent of total billed charges,,12.94,16.3,
AMOX/CLAV(AUGMENTIN)TAB 875-125MG,32001221,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
AMOX/CLAV(AUGMENTIN)TAB 875-125MG (1x6),32001222,CDM,J8499,HCPCS,250,RC,inpatient,,23.86,23.86,,20.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21,88,,percent of total billed charges,,,,,,,,,18.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.71,91,,percent of total billed charges,,,22.67,95,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,,,,,,,,,,,,,,19.8,83,,percent of total billed charges,,,22.67,95,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,19.57,82,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,20.28,85,,percent of total billed charges,,17.99,22.67,
ANTIPYRINE/BENZ/GLYC(AURALGAN) DROP:10ML,32001226,CDM,J3490,HCPCS,250,RC,inpatient,,164.87,164.87,,139.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,124.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,140.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,145.09,88,,percent of total billed charges,,,,,,,,,125.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,150.03,91,,percent of total billed charges,,,156.63,95,,percent of total billed charges,,,136.84,83,,percent of total billed charges,,,136.84,83,,percent of total billed charges,,,,,,,,,,,,,,,136.84,83,,percent of total billed charges,,,156.63,95,,percent of total billed charges,,,148.38,90,,percent of total billed charges,,,148.38,90,,percent of total billed charges,,,135.19,82,,percent of total billed charges,,,148.38,90,,percent of total billed charges,,,140.14,85,,percent of total billed charges,,124.31,156.63,
IRBESARTAN(avaPRO)TAB:150MG,32001227,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ROSIGLITAZONE(AVANdia)TAB:4MG,32001228,CDM,,,250,RC,inpatient,,65.03,65.03,,55.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.23,88,,percent of total billed charges,,,,,,,,,49.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.18,91,,percent of total billed charges,,,61.78,95,,percent of total billed charges,,,53.97,83,,percent of total billed charges,,,53.97,83,,percent of total billed charges,,,,,,,,,,,,,,,53.97,83,,percent of total billed charges,,,61.78,95,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,53.32,82,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,55.28,85,,percent of total billed charges,,49.03,61.78,
ROSIGLITAZONE MALEATE(AVAndia) TAB : 2MG,32001229,CDM,,,250,RC,inpatient,,43.77,43.77,,37.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.52,88,,percent of total billed charges,,,,,,,,,33.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,39.83,91,,percent of total billed charges,,,41.58,95,,percent of total billed charges,,,36.33,83,,percent of total billed charges,,,36.33,83,,percent of total billed charges,,,,,,,,,,,,,,,36.33,83,,percent of total billed charges,,,41.58,95,,percent of total billed charges,,,39.39,90,,percent of total billed charges,,,39.39,90,,percent of total billed charges,,,35.89,82,,percent of total billed charges,,,39.39,90,,percent of total billed charges,,,37.2,85,,percent of total billed charges,,33,41.58,
MICROFIB COLLAGEN(AVITENE)SHEET:70X35MM,32001241,CDM,,,250,RC,inpatient,,2681.28,2681.28,,2276.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2021.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2279.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2359.53,88,,percent of total billed charges,,,,,,,,,2048.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2439.96,91,,percent of total billed charges,,,2547.22,95,,percent of total billed charges,,,2225.46,83,,percent of total billed charges,,,2225.46,83,,percent of total billed charges,,,,,,,,,,,,,,,2225.46,83,,percent of total billed charges,,,2547.22,95,,percent of total billed charges,,,2413.15,90,,percent of total billed charges,,,2413.15,90,,percent of total billed charges,,,2198.65,82,,percent of total billed charges,,,2413.15,90,,percent of total billed charges,,,2279.09,85,,percent of total billed charges,,2021.69,2547.22,
NIZATIDINE (AXID) CAP : 150MG,32001246,CDM,,,250,RC,inpatient,,27.44,27.44,,23.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.15,88,,percent of total billed charges,,,,,,,,,20.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.97,91,,percent of total billed charges,,,26.07,95,,percent of total billed charges,,,22.78,83,,percent of total billed charges,,,22.78,83,,percent of total billed charges,,,,,,,,,,,,,,,22.78,83,,percent of total billed charges,,,26.07,95,,percent of total billed charges,,,24.7,90,,percent of total billed charges,,,24.7,90,,percent of total billed charges,,,22.5,82,,percent of total billed charges,,,24.7,90,,percent of total billed charges,,,23.32,85,,percent of total billed charges,,20.69,26.07,
AZTREONAM (AZACTAM) VIAL : 500MG,32001251,CDM,,,250,RC,inpatient,,211.26,211.26,,179.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,179.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,185.91,88,,percent of total billed charges,,,,,,,,,161.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.25,91,,percent of total billed charges,,,200.7,95,,percent of total billed charges,,,175.35,83,,percent of total billed charges,,,175.35,83,,percent of total billed charges,,,,,,,,,,,,,,,175.35,83,,percent of total billed charges,,,200.7,95,,percent of total billed charges,,,190.13,90,,percent of total billed charges,,,190.13,90,,percent of total billed charges,,,173.23,82,,percent of total billed charges,,,190.13,90,,percent of total billed charges,,,179.57,85,,percent of total billed charges,,159.29,200.7,
AZTREONAM (AZACTAM) VIAL : 2G,32001256,CDM,J3490,HCPCS,250,RC,inpatient,,821.96,821.96,,697.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,619.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,698.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,723.32,88,,percent of total billed charges,,,,,,,,,627.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,747.98,91,,percent of total billed charges,,,780.86,95,,percent of total billed charges,,,682.23,83,,percent of total billed charges,,,682.23,83,,percent of total billed charges,,,,,,,,,,,,,,,682.23,83,,percent of total billed charges,,,780.86,95,,percent of total billed charges,,,739.76,90,,percent of total billed charges,,,739.76,90,,percent of total billed charges,,,674.01,82,,percent of total billed charges,,,739.76,90,,percent of total billed charges,,,698.67,85,,percent of total billed charges,,619.76,780.86,
AZTREONAM(AZACTAM)VIAL:1GM,32001261,CDM,J3490,HCPCS,250,RC,inpatient,,485.13,485.13,,411.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,365.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,412.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,426.91,88,,percent of total billed charges,,,,,,,,,370.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,441.47,91,,percent of total billed charges,,,460.87,95,,percent of total billed charges,,,402.66,83,,percent of total billed charges,,,402.66,83,,percent of total billed charges,,,,,,,,,,,,,,,402.66,83,,percent of total billed charges,,,460.87,95,,percent of total billed charges,,,436.62,90,,percent of total billed charges,,,436.62,90,,percent of total billed charges,,,397.81,82,,percent of total billed charges,,,436.62,90,,percent of total billed charges,,,412.36,85,,percent of total billed charges,,365.79,460.87,
TRIAMCINOLONE(AZMACORT)AER:100MCG 20GM,32001266,CDM,,,250,RC,inpatient,,1928.24,1928.24,,1637.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1453.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1639,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1696.85,88,,percent of total billed charges,,,,,,,,,1473.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1754.7,91,,percent of total billed charges,,,1831.83,95,,percent of total billed charges,,,1600.44,83,,percent of total billed charges,,,1600.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1600.44,83,,percent of total billed charges,,,1831.83,95,,percent of total billed charges,,,1735.42,90,,percent of total billed charges,,,1735.42,90,,percent of total billed charges,,,1581.16,82,,percent of total billed charges,,,1735.42,90,,percent of total billed charges,,,1639,85,,percent of total billed charges,,1453.89,1831.83,
sulfaSALAzine(AZULFIDINE)TAB:500MG,32001271,CDM,J8499,HCPCS,250,RC,inpatient,,34.31,34.31,,29.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.19,88,,percent of total billed charges,,,,,,,,,26.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31.22,91,,percent of total billed charges,,,32.59,95,,percent of total billed charges,,,28.48,83,,percent of total billed charges,,,28.48,83,,percent of total billed charges,,,,,,,,,,,,,,,28.48,83,,percent of total billed charges,,,32.59,95,,percent of total billed charges,,,30.88,90,,percent of total billed charges,,,30.88,90,,percent of total billed charges,,,28.13,82,,percent of total billed charges,,,30.88,90,,percent of total billed charges,,,29.16,85,,percent of total billed charges,,25.87,32.59,
OPIUM/BELLA(B&O16-A)SUPP:30-16.2MG,32001276,CDM,,,250,RC,inpatient,,347.55,347.55,,295.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,262.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,295.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,305.84,88,,percent of total billed charges,,,,,,,,,265.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,316.27,91,,percent of total billed charges,,,330.17,95,,percent of total billed charges,,,288.47,83,,percent of total billed charges,,,288.47,83,,percent of total billed charges,,,,,,,,,,,,,,,288.47,83,,percent of total billed charges,,,330.17,95,,percent of total billed charges,,,312.8,90,,percent of total billed charges,,,312.8,90,,percent of total billed charges,,,284.99,82,,percent of total billed charges,,,312.8,90,,percent of total billed charges,,,295.42,85,,percent of total billed charges,,262.05,330.17,
BACITRACIN OPTH OINT:500UNIT/GM (3.5GM),32001291,CDM,J3490,HCPCS,250,RC,inpatient,,1391.34,1391.34,,1181.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1049.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1182.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1224.38,88,,percent of total billed charges,,,,,,,,,1062.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1266.12,91,,percent of total billed charges,,,1321.77,95,,percent of total billed charges,,,1154.81,83,,percent of total billed charges,,,1154.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1154.81,83,,percent of total billed charges,,,1321.77,95,,percent of total billed charges,,,1252.21,90,,percent of total billed charges,,,1252.21,90,,percent of total billed charges,,,1140.9,82,,percent of total billed charges,,,1252.21,90,,percent of total billed charges,,,1182.64,85,,percent of total billed charges,,1049.07,1321.77,
NEO/BACI/POLYM(TRPL ABX)OPHTH OINT:3.5GM,32001296,CDM,,,250,RC,inpatient,,55.99,55.99,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.27,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.95,91,,percent of total billed charges,,,53.19,95,,percent of total billed charges,,,46.47,83,,percent of total billed charges,,,46.47,83,,percent of total billed charges,,,,,,,,,,,,,,,46.47,83,,percent of total billed charges,,,53.19,95,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,45.91,82,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,47.59,85,,percent of total billed charges,,42.22,53.19,
BACITRACIN ZINC PAC:500UNIT/GM UD,32001301,CDM,J3490,HCPCS,250,RC,inpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,15.28,19.26,
BACITRACIN ZINC OINT:500:GM(30GM),32001306,CDM,J3490,HCPCS,250,RC,inpatient,,23.04,23.04,,19.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.28,88,,percent of total billed charges,,,,,,,,,17.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.97,91,,percent of total billed charges,,,21.89,95,,percent of total billed charges,,,19.12,83,,percent of total billed charges,,,19.12,83,,percent of total billed charges,,,,,,,,,,,,,,,19.12,83,,percent of total billed charges,,,21.89,95,,percent of total billed charges,,,20.74,90,,percent of total billed charges,,,20.74,90,,percent of total billed charges,,,18.89,82,,percent of total billed charges,,,20.74,90,,percent of total billed charges,,,19.58,85,,percent of total billed charges,,17.37,21.89,
NEO/BACI/POLYB(NEOSPORIN)ABX OINT:30GM,32001311,CDM,J3490,HCPCS,250,RC,inpatient,,36.44,36.44,,30.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.07,88,,percent of total billed charges,,,,,,,,,27.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.16,91,,percent of total billed charges,,,34.62,95,,percent of total billed charges,,,30.25,83,,percent of total billed charges,,,30.25,83,,percent of total billed charges,,,,,,,,,,,,,,,30.25,83,,percent of total billed charges,,,34.62,95,,percent of total billed charges,,,32.8,90,,percent of total billed charges,,,32.8,90,,percent of total billed charges,,,29.88,82,,percent of total billed charges,,,32.8,90,,percent of total billed charges,,,30.97,85,,percent of total billed charges,,27.48,34.62,
BACITRACIN VIAL:50000UNIT,32001316,CDM,J3490,HCPCS,250,RC,inpatient,,77.45,77.45,,65.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.16,88,,percent of total billed charges,,,,,,,,,59.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.48,91,,percent of total billed charges,,,73.58,95,,percent of total billed charges,,,64.28,83,,percent of total billed charges,,,64.28,83,,percent of total billed charges,,,,,,,,,,,,,,,64.28,83,,percent of total billed charges,,,73.58,95,,percent of total billed charges,,,69.71,90,,percent of total billed charges,,,69.71,90,,percent of total billed charges,,,63.51,82,,percent of total billed charges,,,69.71,90,,percent of total billed charges,,,65.83,85,,percent of total billed charges,,58.4,73.58,
BACLOFEN(LIORESAL)TAB:10MG,32001321,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
BACLOFEN (LIORESAL) TAB: 20MG,32001326,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
BAYCOL 0.3MG,32001327,CDM,,,250,RC,inpatient,,5.75,5.75,,4.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.06,88,,percent of total billed charges,,,,,,,,,4.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.23,91,,percent of total billed charges,,,5.46,95,,percent of total billed charges,,,4.77,83,,percent of total billed charges,,,4.77,83,,percent of total billed charges,,,,,,,,,,,,,,,4.77,83,,percent of total billed charges,,,5.46,95,,percent of total billed charges,,,5.18,90,,percent of total billed charges,,,5.18,90,,percent of total billed charges,,,4.72,82,,percent of total billed charges,,,5.18,90,,percent of total billed charges,,,4.89,85,,percent of total billed charges,,4.34,5.46,
MUPIROCIN(BACTROBAN)OINT 2%:22GM,32001331,CDM,J3490,HCPCS,250,RC,inpatient,,68.63,68.63,,58.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.39,88,,percent of total billed charges,,,,,,,,,52.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.45,91,,percent of total billed charges,,,65.2,95,,percent of total billed charges,,,56.96,83,,percent of total billed charges,,,56.96,83,,percent of total billed charges,,,,,,,,,,,,,,,56.96,83,,percent of total billed charges,,,65.2,95,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,56.28,82,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,58.34,85,,percent of total billed charges,,51.75,65.2,
MUPIROCIN(BACTROBANS)CREAM 2%:15GM,32001332,CDM,J3490,HCPCS,250,RC,inpatient,,2850.21,2850.21,,2419.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2149.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2422.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2508.18,88,,percent of total billed charges,,,,,,,,,2177.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2593.69,91,,percent of total billed charges,,,2707.7,95,,percent of total billed charges,,,2365.67,83,,percent of total billed charges,,,2365.67,83,,percent of total billed charges,,,,,,,,,,,,,,,2365.67,83,,percent of total billed charges,,,2707.7,95,,percent of total billed charges,,,2565.19,90,,percent of total billed charges,,,2565.19,90,,percent of total billed charges,,,2337.17,82,,percent of total billed charges,,,2565.19,90,,percent of total billed charges,,,2422.68,85,,percent of total billed charges,,2149.06,2707.7,
OXYQ/PETRO/WHT/LAN(BAGBALM)OINT 0.3%:,32001336,CDM,,,250,RC,inpatient,,18.25,18.25,,15.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16.06,88,,percent of total billed charges,,,,,,,,,13.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.61,91,,percent of total billed charges,,,17.34,95,,percent of total billed charges,,,15.15,83,,percent of total billed charges,,,15.15,83,,percent of total billed charges,,,,,,,,,,,,,,,15.15,83,,percent of total billed charges,,,17.34,95,,percent of total billed charges,,,16.43,90,,percent of total billed charges,,,16.43,90,,percent of total billed charges,,,14.97,82,,percent of total billed charges,,,16.43,90,,percent of total billed charges,,,15.51,85,,percent of total billed charges,,13.76,17.34,
DIMERCAPROL (BAL IN OIL) AMP : 100MG/ML,32001341,CDM,J0470,HCPCS,636,RC,inpatient,,1243.07,1243.07,,1055.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,937.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1056.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1093.9,88,,percent of total billed charges,,323.65,,,,fee schedule,,,949.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,323.65,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1131.19,91,,percent of total billed charges,,,1180.92,95,,percent of total billed charges,,,1031.75,83,,percent of total billed charges,,,1031.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1031.75,83,,percent of total billed charges,,,1180.92,95,,percent of total billed charges,,,1118.76,90,,percent of total billed charges,,,1118.76,90,,percent of total billed charges,,,1019.32,82,,percent of total billed charges,,,1118.76,90,,percent of total billed charges,,,1056.61,85,,percent of total billed charges,,323.65,1180.92,
BECLOMETHASONE DIPROP(VANCERIL)AER:42MCG,32001361,CDM,,,250,RC,inpatient,,665.01,665.01,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.21,88,,percent of total billed charges,,,,,,,,,508.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.16,91,,percent of total billed charges,,,631.76,95,,percent of total billed charges,,,551.96,83,,percent of total billed charges,,,551.96,83,,percent of total billed charges,,,,,,,,,,,,,,,551.96,83,,percent of total billed charges,,,631.76,95,,percent of total billed charges,,,598.51,90,,percent of total billed charges,,,598.51,90,,percent of total billed charges,,,545.31,82,,percent of total billed charges,,,598.51,90,,percent of total billed charges,,,565.26,85,,percent of total billed charges,,501.42,631.76,
BECLOMETHASONE(BECONASE) SPR:42MCG  25GM,32001376,CDM,,,250,RC,inpatient,,343.25,343.25,,291.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,258.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,291.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,302.06,88,,percent of total billed charges,,,,,,,,,262.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,312.36,91,,percent of total billed charges,,,326.09,95,,percent of total billed charges,,,284.9,83,,percent of total billed charges,,,284.9,83,,percent of total billed charges,,,,,,,,,,,,,,,284.9,83,,percent of total billed charges,,,326.09,95,,percent of total billed charges,,,308.93,90,,percent of total billed charges,,,308.93,90,,percent of total billed charges,,,281.47,82,,percent of total billed charges,,,308.93,90,,percent of total billed charges,,,291.76,85,,percent of total billed charges,,258.81,326.09,
DIPHENHYDRAM(BENADRYL)CREAM 1%:30GM,32001386,CDM,J3490,HCPCS,250,RC,inpatient,,40.6,40.6,,34.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.73,88,,percent of total billed charges,,,,,,,,,31.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.95,91,,percent of total billed charges,,,38.57,95,,percent of total billed charges,,,33.7,83,,percent of total billed charges,,,33.7,83,,percent of total billed charges,,,,,,,,,,,,,,,33.7,83,,percent of total billed charges,,,38.57,95,,percent of total billed charges,,,36.54,90,,percent of total billed charges,,,36.54,90,,percent of total billed charges,,,33.29,82,,percent of total billed charges,,,36.54,90,,percent of total billed charges,,,34.51,85,,percent of total billed charges,,30.61,38.57,
DICYCLOMINE(BENTYL)TAB:20MG,32001396,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
BENZTROPINE(COGENTIN)TAB:1MG,32001401,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
BENZONATATE(TESSALON)CAP:100MG,32001411,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
BETADINE 5%,32001415,CDM,,,250,RC,inpatient,,36,36,,30.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31.68,88,,percent of total billed charges,,,,,,,,,27.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,,,,,,,,,,,,,29.88,83,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,29.52,82,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,27.14,34.2,
POVIDONE-IODINE (BETADINE) OINT 10% 30GM,32001416,CDM,,,250,RC,inpatient,,24.27,24.27,,20.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.36,88,,percent of total billed charges,,,,,,,,,18.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.09,91,,percent of total billed charges,,,23.06,95,,percent of total billed charges,,,20.14,83,,percent of total billed charges,,,20.14,83,,percent of total billed charges,,,,,,,,,,,,,,,20.14,83,,percent of total billed charges,,,23.06,95,,percent of total billed charges,,,21.84,90,,percent of total billed charges,,,21.84,90,,percent of total billed charges,,,19.9,82,,percent of total billed charges,,,21.84,90,,percent of total billed charges,,,20.63,85,,percent of total billed charges,,18.3,23.06,
POVIDONE-IODINE (BETADINE) SWAB : 10%,32001421,CDM,,,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
BETAMETHASONE(VALISONE) OINT : 0.1% 45GM,32001426,CDM,,,250,RC,inpatient,,358.28,358.28,,304.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,270.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,304.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,315.29,88,,percent of total billed charges,,,,,,,,,273.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,326.03,91,,percent of total billed charges,,,340.37,95,,percent of total billed charges,,,297.37,83,,percent of total billed charges,,,297.37,83,,percent of total billed charges,,,,,,,,,,,,,,,297.37,83,,percent of total billed charges,,,340.37,95,,percent of total billed charges,,,322.45,90,,percent of total billed charges,,,322.45,90,,percent of total billed charges,,,293.79,82,,percent of total billed charges,,,322.45,90,,percent of total billed charges,,,304.54,85,,percent of total billed charges,,270.14,340.37,
BETAMETHASONE(VALISONE) CM : 0.1%  45GM,32001431,CDM,,,250,RC,inpatient,,394.6,394.6,,335.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,297.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,335.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,347.25,88,,percent of total billed charges,,,,,,,,,301.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,359.09,91,,percent of total billed charges,,,374.87,95,,percent of total billed charges,,,327.52,83,,percent of total billed charges,,,327.52,83,,percent of total billed charges,,,,,,,,,,,,,,,327.52,83,,percent of total billed charges,,,374.87,95,,percent of total billed charges,,,355.14,90,,percent of total billed charges,,,355.14,90,,percent of total billed charges,,,323.57,82,,percent of total billed charges,,,355.14,90,,percent of total billed charges,,,335.41,85,,percent of total billed charges,,297.53,374.87,
BETAMETHASONE(VALISONE) CM 0.1%:15GM,32001436,CDM,J3490,HCPCS,250,RC,inpatient,,221.88,221.88,,188.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,167.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,188.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,195.25,88,,percent of total billed charges,,,,,,,,,169.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,201.91,91,,percent of total billed charges,,,210.79,95,,percent of total billed charges,,,184.16,83,,percent of total billed charges,,,184.16,83,,percent of total billed charges,,,,,,,,,,,,,,,184.16,83,,percent of total billed charges,,,210.79,95,,percent of total billed charges,,,199.69,90,,percent of total billed charges,,,199.69,90,,percent of total billed charges,,,181.94,82,,percent of total billed charges,,,199.69,90,,percent of total billed charges,,,188.6,85,,percent of total billed charges,,167.3,210.79,
BETAMETHASONE(VALISONE) OINT:0.1% 15GM,32001441,CDM,,,250,RC,inpatient,,152.41,152.41,,129.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.12,88,,percent of total billed charges,,,,,,,,,116.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.69,91,,percent of total billed charges,,,144.79,95,,percent of total billed charges,,,126.5,83,,percent of total billed charges,,,126.5,83,,percent of total billed charges,,,,,,,,,,,,,,,126.5,83,,percent of total billed charges,,,144.79,95,,percent of total billed charges,,,137.17,90,,percent of total billed charges,,,137.17,90,,percent of total billed charges,,,124.98,82,,percent of total billed charges,,,137.17,90,,percent of total billed charges,,,129.55,85,,percent of total billed charges,,114.92,144.79,
BETAMETHASONE (VALISONE) LOT : 0.1% 60ML,32001446,CDM,,,250,RC,inpatient,,846.72,846.72,,718.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,638.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,719.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,745.11,88,,percent of total billed charges,,,,,,,,,646.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,770.52,91,,percent of total billed charges,,,804.38,95,,percent of total billed charges,,,702.78,83,,percent of total billed charges,,,702.78,83,,percent of total billed charges,,,,,,,,,,,,,,,702.78,83,,percent of total billed charges,,,804.38,95,,percent of total billed charges,,,762.05,90,,percent of total billed charges,,,762.05,90,,percent of total billed charges,,,694.31,82,,percent of total billed charges,,,762.05,90,,percent of total billed charges,,,719.71,85,,percent of total billed charges,,638.43,804.38,
SOTALOL(BETAPACE)TAB:80MG,32001451,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
POVIDONE-IODINE(BETADINE)SOL 5%:30ML,32001457,CDM,J3490,HCPCS,250,RC,inpatient,,232.35,232.35,,197.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,175.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,197.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,204.47,88,,percent of total billed charges,,,,,,,,,177.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,211.44,91,,percent of total billed charges,,,220.73,95,,percent of total billed charges,,,192.85,83,,percent of total billed charges,,,192.85,83,,percent of total billed charges,,,,,,,,,,,,,,,192.85,83,,percent of total billed charges,,,220.73,95,,percent of total billed charges,,,209.12,90,,percent of total billed charges,,,209.12,90,,percent of total billed charges,,,190.53,82,,percent of total billed charges,,,209.12,90,,percent of total billed charges,,,197.5,85,,percent of total billed charges,,175.19,220.73,
BETAMETHASONE DIPROPIONATE CR 0.05%:15GM,32001458,CDM,J3490,HCPCS,250,RC,inpatient,,380.32,380.32,,322.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,286.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,323.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,334.68,88,,percent of total billed charges,,,,,,,,,290.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,346.09,91,,percent of total billed charges,,,361.3,95,,percent of total billed charges,,,315.67,83,,percent of total billed charges,,,315.67,83,,percent of total billed charges,,,,,,,,,,,,,,,315.67,83,,percent of total billed charges,,,361.3,95,,percent of total billed charges,,,342.29,90,,percent of total billed charges,,,342.29,90,,percent of total billed charges,,,311.86,82,,percent of total billed charges,,,342.29,90,,percent of total billed charges,,,323.27,85,,percent of total billed charges,,286.76,361.3,
BETAMETHASONE DIPROP LOT: 0.05%   60ML,32001461,CDM,,,250,RC,inpatient,,473.1,473.1,,401.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,356.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,402.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,416.33,88,,percent of total billed charges,,,,,,,,,361.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,430.52,91,,percent of total billed charges,,,449.45,95,,percent of total billed charges,,,392.67,83,,percent of total billed charges,,,392.67,83,,percent of total billed charges,,,,,,,,,,,,,,,392.67,83,,percent of total billed charges,,,449.45,95,,percent of total billed charges,,,425.79,90,,percent of total billed charges,,,425.79,90,,percent of total billed charges,,,387.94,82,,percent of total billed charges,,,425.79,90,,percent of total billed charges,,,402.14,85,,percent of total billed charges,,356.72,449.45,
BETHANECHOL (URECHOLINE) TAB : 5MG,32001462,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
BETHANECHOL(URECHOLINE)TAB:10MG,32001466,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
BETHANECHOL(URECHOLINE)TAB:25MG,32001471,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
BETAXOLOL (BETOPTIC) DROP : 0.5%  10ML,32001476,CDM,,,250,RC,inpatient,,1337.68,1337.68,,1135.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1008.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1137.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1177.16,88,,percent of total billed charges,,,,,,,,,1021.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1217.29,91,,percent of total billed charges,,,1270.8,95,,percent of total billed charges,,,1110.27,83,,percent of total billed charges,,,1110.27,83,,percent of total billed charges,,,,,,,,,,,,,,,1110.27,83,,percent of total billed charges,,,1270.8,95,,percent of total billed charges,,,1203.91,90,,percent of total billed charges,,,1203.91,90,,percent of total billed charges,,,1096.9,82,,percent of total billed charges,,,1203.91,90,,percent of total billed charges,,,1137.03,85,,percent of total billed charges,,1008.61,1270.8,
BETAXOLOL(BETOPTIC S)DROP 0.25%:5ML,32001481,CDM,,,250,RC,inpatient,,679.44,679.44,,576.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,512.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,577.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,597.91,88,,percent of total billed charges,,,,,,,,,519.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,618.29,91,,percent of total billed charges,,,645.47,95,,percent of total billed charges,,,563.94,83,,percent of total billed charges,,,563.94,83,,percent of total billed charges,,,,,,,,,,,,,,,563.94,83,,percent of total billed charges,,,645.47,95,,percent of total billed charges,,,611.5,90,,percent of total billed charges,,,611.5,90,,percent of total billed charges,,,557.14,82,,percent of total billed charges,,,611.5,90,,percent of total billed charges,,,577.52,85,,percent of total billed charges,,512.3,645.47,
BIAXIN 125 MG/5ML 50ML,32001490,CDM,,,250,RC,inpatient,,59.5,59.5,,50.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.36,88,,percent of total billed charges,,,,,,,,,45.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,54.15,91,,percent of total billed charges,,,56.53,95,,percent of total billed charges,,,49.39,83,,percent of total billed charges,,,49.39,83,,percent of total billed charges,,,,,,,,,,,,,,,49.39,83,,percent of total billed charges,,,56.53,95,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,48.79,82,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,50.58,85,,percent of total billed charges,,44.86,56.53,
CLARITHROMY(BIAXIN) SUS: 125MG/5ML 100ML,32001491,CDM,,,250,RC,inpatient,,488.33,488.33,,414.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,368.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,415.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,429.73,88,,percent of total billed charges,,,,,,,,,373.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,444.38,91,,percent of total billed charges,,,463.91,95,,percent of total billed charges,,,405.31,83,,percent of total billed charges,,,405.31,83,,percent of total billed charges,,,,,,,,,,,,,,,405.31,83,,percent of total billed charges,,,463.91,95,,percent of total billed charges,,,439.5,90,,percent of total billed charges,,,439.5,90,,percent of total billed charges,,,400.43,82,,percent of total billed charges,,,439.5,90,,percent of total billed charges,,,415.08,85,,percent of total billed charges,,368.2,463.91,
CLARITHROMYCIN(BIAXIN)TAB:500MG,32001496,CDM,J8499,HCPCS,250,RC,inpatient,,36.76,36.76,,31.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.35,88,,percent of total billed charges,,,,,,,,,28.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.45,91,,percent of total billed charges,,,34.92,95,,percent of total billed charges,,,30.51,83,,percent of total billed charges,,,30.51,83,,percent of total billed charges,,,,,,,,,,,,,,,30.51,83,,percent of total billed charges,,,34.92,95,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,30.14,82,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,31.25,85,,percent of total billed charges,,27.72,34.92,
CLARITHROMYCIN(BIAXIN) TAB: 500MG (1X4),32001497,CDM,,,250,RC,inpatient,,142.9,142.9,,121.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,107.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,121.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,125.75,88,,percent of total billed charges,,,,,,,,,109.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,130.04,91,,percent of total billed charges,,,135.76,95,,percent of total billed charges,,,118.61,83,,percent of total billed charges,,,118.61,83,,percent of total billed charges,,,,,,,,,,,,,,,118.61,83,,percent of total billed charges,,,135.76,95,,percent of total billed charges,,,128.61,90,,percent of total billed charges,,,128.61,90,,percent of total billed charges,,,117.18,82,,percent of total billed charges,,,128.61,90,,percent of total billed charges,,,121.47,85,,percent of total billed charges,,107.75,135.76,
CLARITHROMY(BIAXIN) SUS :250MG/5ML 100ML,32001501,CDM,,,250,RC,inpatient,,788.66,788.66,,669.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,594.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,670.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,694.02,88,,percent of total billed charges,,,,,,,,,602.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,717.68,91,,percent of total billed charges,,,749.23,95,,percent of total billed charges,,,654.59,83,,percent of total billed charges,,,654.59,83,,percent of total billed charges,,,,,,,,,,,,,,,654.59,83,,percent of total billed charges,,,749.23,95,,percent of total billed charges,,,709.79,90,,percent of total billed charges,,,709.79,90,,percent of total billed charges,,,646.7,82,,percent of total billed charges,,,709.79,90,,percent of total billed charges,,,670.36,85,,percent of total billed charges,,594.65,749.23,
CLARITHROMYCIN (BIAXIN) TAB : 250MG,32001506,CDM,,,250,RC,inpatient,,98.01,98.01,,83.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,73.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,83.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,86.25,88,,percent of total billed charges,,,,,,,,,74.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,89.19,91,,percent of total billed charges,,,93.11,95,,percent of total billed charges,,,81.35,83,,percent of total billed charges,,,81.35,83,,percent of total billed charges,,,,,,,,,,,,,,,81.35,83,,percent of total billed charges,,,93.11,95,,percent of total billed charges,,,88.21,90,,percent of total billed charges,,,88.21,90,,percent of total billed charges,,,80.37,82,,percent of total billed charges,,,88.21,90,,percent of total billed charges,,,83.31,85,,percent of total billed charges,,73.9,93.11,
CITR ACID/NS CITRA(BICITRA):UD,32001512,CDM,J8499,HCPCS,250,RC,inpatient,,52.12,52.12,,44.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.87,88,,percent of total billed charges,,,,,,,,,39.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47.43,91,,percent of total billed charges,,,49.51,95,,percent of total billed charges,,,43.26,83,,percent of total billed charges,,,43.26,83,,percent of total billed charges,,,,,,,,,,,,,,,43.26,83,,percent of total billed charges,,,49.51,95,,percent of total billed charges,,,46.91,90,,percent of total billed charges,,,46.91,90,,percent of total billed charges,,,42.74,82,,percent of total billed charges,,,46.91,90,,percent of total billed charges,,,44.3,85,,percent of total billed charges,,39.3,49.51,
PEN GBENZ/PROC(BICILLN CR)SYR:1.2MMU/2ML,32001526,CDM,,,250,RC,inpatient,,1936.7,1936.7,,1644.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1460.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1646.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1704.3,88,,percent of total billed charges,,,,,,,,,1479.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1762.4,91,,percent of total billed charges,,,1839.87,95,,percent of total billed charges,,,1607.46,83,,percent of total billed charges,,,1607.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1607.46,83,,percent of total billed charges,,,1839.87,95,,percent of total billed charges,,,1743.03,90,,percent of total billed charges,,,1743.03,90,,percent of total billed charges,,,1588.09,82,,percent of total billed charges,,,1743.03,90,,percent of total billed charges,,,1646.2,85,,percent of total billed charges,,1460.27,1839.87,
PEN G BEN(BICILLIN LA)SYR:1.2MIL UNITS,32001531,CDM,J0570,HCPCS,250,RC,inpatient,,2981.27,2981.27,,2531.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2247.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2534.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2623.52,88,,percent of total billed charges,,,,,,,,,2277.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2712.96,91,,percent of total billed charges,,,2832.21,95,,percent of total billed charges,,,2474.45,83,,percent of total billed charges,,,2474.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2474.45,83,,percent of total billed charges,,,2832.21,95,,percent of total billed charges,,,2683.14,90,,percent of total billed charges,,,2683.14,90,,percent of total billed charges,,,2444.64,82,,percent of total billed charges,,,2683.14,90,,percent of total billed charges,,,2534.08,85,,percent of total billed charges,,2247.88,2832.21,
BISACODYL(DULCOLAX)TAB:5MG,32001541,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
BISACODYL(DULCOLAX)SUPP:10MG,32001546,CDM,J3490,HCPCS,250,RC,inpatient,,14.64,14.64,,12.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.88,88,,percent of total billed charges,,,,,,,,,11.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.32,91,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,,,,,,,,,,,,,12.15,83,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12,82,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,11.04,13.91,
BLEOMYCIN SULFATE VIAL : 15 UNIT   1ML,32001551,CDM,J9040,HCPCS,636,RC,inpatient,,334.49,334.49,,283.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,252.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,284.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,294.35,88,,percent of total billed charges,,97.2,,,,fee schedule,,,255.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,97.2,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,304.39,91,,percent of total billed charges,,,317.77,95,,percent of total billed charges,,,277.63,83,,percent of total billed charges,,,277.63,83,,percent of total billed charges,,,,,,,,,,,,,,,277.63,83,,percent of total billed charges,,,317.77,95,,percent of total billed charges,,,301.04,90,,percent of total billed charges,,,301.04,90,,percent of total billed charges,,,274.28,82,,percent of total billed charges,,,301.04,90,,percent of total billed charges,,,284.32,85,,percent of total billed charges,,97.2,317.77,
SULFACET/PRED(BLEPHAMIDE)OINT:10-0.2%3.5,32001556,CDM,,,250,RC,inpatient,,2003.1,2003.1,,1700.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1510.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1702.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1762.73,88,,percent of total billed charges,,,,,,,,,1530.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1822.82,91,,percent of total billed charges,,,1902.95,95,,percent of total billed charges,,,1662.57,83,,percent of total billed charges,,,1662.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1662.57,83,,percent of total billed charges,,,1902.95,95,,percent of total billed charges,,,1802.79,90,,percent of total billed charges,,,1802.79,90,,percent of total billed charges,,,1642.54,82,,percent of total billed charges,,,1802.79,90,,percent of total billed charges,,,1702.64,85,,percent of total billed charges,,1510.34,1902.95,
SULFACETAMIDE/PREDNS(BLEPHAMD)DROP:5ML,32001557,CDM,J3490,HCPCS,250,RC,inpatient,,2330.93,2330.93,,1978.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1757.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1981.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2051.22,88,,percent of total billed charges,,,,,,,,,1780.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2121.15,91,,percent of total billed charges,,,2214.38,95,,percent of total billed charges,,,1934.67,83,,percent of total billed charges,,,1934.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1934.67,83,,percent of total billed charges,,,2214.38,95,,percent of total billed charges,,,2097.84,90,,percent of total billed charges,,,2097.84,90,,percent of total billed charges,,,1911.36,82,,percent of total billed charges,,,2097.84,90,,percent of total billed charges,,,1981.29,85,,percent of total billed charges,,1757.52,2214.38,
SULFACETAMIDE(BLEPH 10)DROP 10%:15ML,32001566,CDM,J3490,HCPCS,250,RC,inpatient,,610.95,610.95,,518.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,460.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,519.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,537.64,88,,percent of total billed charges,,,,,,,,,466.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,555.96,91,,percent of total billed charges,,,580.4,95,,percent of total billed charges,,,507.09,83,,percent of total billed charges,,,507.09,83,,percent of total billed charges,,,,,,,,,,,,,,,507.09,83,,percent of total billed charges,,,580.4,95,,percent of total billed charges,,,549.86,90,,percent of total billed charges,,,549.86,90,,percent of total billed charges,,,500.98,82,,percent of total billed charges,,,549.86,90,,percent of total billed charges,,,519.31,85,,percent of total billed charges,,460.66,580.4,
DOMEBORO PKG,32001572,CDM,,,636,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
TERBUTALINE(BRETHINE)VIAL:1MG/ML,32001576,CDM,J3105,HCPCS,250,RC,inpatient,,300.17,300.17,,254.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264.15,88,,percent of total billed charges,,12.77,,,,fee schedule,,,229.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,12.77,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273.15,91,,percent of total billed charges,,,285.16,95,,percent of total billed charges,,,249.14,83,,percent of total billed charges,,,249.14,83,,percent of total billed charges,,,,,,,,,,,,,,,249.14,83,,percent of total billed charges,,,285.16,95,,percent of total billed charges,,,270.15,90,,percent of total billed charges,,,270.15,90,,percent of total billed charges,,,246.14,82,,percent of total billed charges,,,270.15,90,,percent of total billed charges,,,255.14,85,,percent of total billed charges,,12.77,285.16,
TERBUTALINE(BRETHINE)TAB:5MG,32001586,CDM,,,250,RC,inpatient,,84.06,84.06,,71.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.97,88,,percent of total billed charges,,,,,,,,,64.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.49,91,,percent of total billed charges,,,79.86,95,,percent of total billed charges,,,69.77,83,,percent of total billed charges,,,69.77,83,,percent of total billed charges,,,,,,,,,,,,,,,69.77,83,,percent of total billed charges,,,79.86,95,,percent of total billed charges,,,75.65,90,,percent of total billed charges,,,75.65,90,,percent of total billed charges,,,68.93,82,,percent of total billed charges,,,75.65,90,,percent of total billed charges,,,71.45,85,,percent of total billed charges,,63.38,79.86,
TERBUTALINE (BRETHINE) TAB : 2.5MG,32001591,CDM,J8499,HCPCS,250,RC,inpatient,,64.38,64.38,,54.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.65,88,,percent of total billed charges,,,,,,,,,49.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.59,91,,percent of total billed charges,,,61.16,95,,percent of total billed charges,,,53.44,83,,percent of total billed charges,,,53.44,83,,percent of total billed charges,,,,,,,,,,,,,,,53.44,83,,percent of total billed charges,,,61.16,95,,percent of total billed charges,,,57.94,90,,percent of total billed charges,,,57.94,90,,percent of total billed charges,,,52.79,82,,percent of total billed charges,,,57.94,90,,percent of total billed charges,,,54.72,85,,percent of total billed charges,,48.54,61.16,
BRETYLIUM TOSYLATE VIAL : 50MG/ML 10ML,32001596,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
GUAIFENESIN/COD (BRONTEX) TAB : 300-10MG,32001636,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
BALANCED SALT IRRIG SOL COMBS(BSS):15ML,32001651,CDM,J3490,HCPCS,250,RC,inpatient,,181.21,181.21,,153.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,154.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.46,88,,percent of total billed charges,,,,,,,,,138.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.9,91,,percent of total billed charges,,,172.15,95,,percent of total billed charges,,,150.4,83,,percent of total billed charges,,,150.4,83,,percent of total billed charges,,,,,,,,,,,,,,,150.4,83,,percent of total billed charges,,,172.15,95,,percent of total billed charges,,,163.09,90,,percent of total billed charges,,,163.09,90,,percent of total billed charges,,,148.59,82,,percent of total billed charges,,,163.09,90,,percent of total billed charges,,,154.03,85,,percent of total billed charges,,136.63,172.15,
BUMETANIDE (BUMEX) TAB : 0.5MG,32001661,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
BUMETANIDE(BUMEX)TAB:1MG,32001666,CDM,J8499,HCPCS,250,RC,inpatient,,15.69,15.69,,13.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.81,88,,percent of total billed charges,,,,,,,,,11.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.28,91,,percent of total billed charges,,,14.91,95,,percent of total billed charges,,,13.02,83,,percent of total billed charges,,,13.02,83,,percent of total billed charges,,,,,,,,,,,,,,,13.02,83,,percent of total billed charges,,,14.91,95,,percent of total billed charges,,,14.12,90,,percent of total billed charges,,,14.12,90,,percent of total billed charges,,,12.87,82,,percent of total billed charges,,,14.12,90,,percent of total billed charges,,,13.34,85,,percent of total billed charges,,11.83,14.91,
BUMETANIDE (BUMEX) TAB : 2MG,32001667,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
BUMETANIDE (BUMEX) VIAL : 0.25MG/ML  2ML,32001671,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
BUMETANIDE(BUMEX)VIAL:2.5MG/10ML,32001676,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
BUMETANIDE(BUMEX)VIAL:1MG/4ML,32001681,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
BUPRENEX,32001686,CDM,,,250,RC,inpatient,,245.04,245.04,,208.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,184.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,208.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,215.64,88,,percent of total billed charges,,,,,,,,,187.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,222.99,91,,percent of total billed charges,,,232.79,95,,percent of total billed charges,,,203.38,83,,percent of total billed charges,,,203.38,83,,percent of total billed charges,,,,,,,,,,,,,,,203.38,83,,percent of total billed charges,,,232.79,95,,percent of total billed charges,,,220.54,90,,percent of total billed charges,,,220.54,90,,percent of total billed charges,,,200.93,82,,percent of total billed charges,,,220.54,90,,percent of total billed charges,,,208.28,85,,percent of total billed charges,,184.76,232.79,
busPIRone(BUSPAR)TAB:5MG,32001691,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
BUSPIRONE (BUSPAR) TAB : 10MG,32001696,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CAFFEINE/SODIUM BENZOATE 0.5GM/2ML,32001702,CDM,,,250,RC,inpatient,,68,68,,57.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.84,88,,percent of total billed charges,,,,,,,,,51.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,,,,,,,,,,,,,56.44,83,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,55.76,82,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,51.27,64.6,
EDETATE CALC DISOD(EDTA)AMP:200MG/ML-5ML,32001706,CDM,J0600,HCPCS,636,RC,inpatient,,1091.87,1091.87,,927,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,823.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,928.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,960.85,88,,percent of total billed charges,,11417.19,,,,fee schedule,,,834.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11417.19,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,993.6,91,,percent of total billed charges,,,1037.28,95,,percent of total billed charges,,,906.25,83,,percent of total billed charges,,,906.25,83,,percent of total billed charges,,,,,,,,,,,,,,,906.25,83,,percent of total billed charges,,,1037.28,95,,percent of total billed charges,,,982.68,90,,percent of total billed charges,,,982.68,90,,percent of total billed charges,,,895.33,82,,percent of total billed charges,,,982.68,90,,percent of total billed charges,,,928.09,85,,percent of total billed charges,,823.27,11417.19,
ERGOTAMINE TART/CAF(MIGERGOT)SUP:2-100MG,32001711,CDM,,,250,RC,inpatient,,2180.24,2180.24,,1851.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1643.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1853.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1918.61,88,,percent of total billed charges,,,,,,,,,1665.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1984.02,91,,percent of total billed charges,,,2071.23,95,,percent of total billed charges,,,1809.6,83,,percent of total billed charges,,,1809.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1809.6,83,,percent of total billed charges,,,2071.23,95,,percent of total billed charges,,,1962.22,90,,percent of total billed charges,,,1962.22,90,,percent of total billed charges,,,1787.8,82,,percent of total billed charges,,,1962.22,90,,percent of total billed charges,,,1853.2,85,,percent of total billed charges,,1643.9,2071.23,
CALCIUM CARBONATE TAB:600MG  PX,32001712,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CALCIUM GLUCONATE VL:1GM/10ML(100MG/ML),32001716,CDM,J0610,HCPCS,250,RC,inpatient,,182.19,182.19,,154.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,137.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,154.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,160.33,88,,percent of total billed charges,,13.37,,,,fee schedule,,,139.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.37,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,165.79,91,,percent of total billed charges,,,173.08,95,,percent of total billed charges,,,151.22,83,,percent of total billed charges,,,151.22,83,,percent of total billed charges,,,,,,,,,,,,,,,151.22,83,,percent of total billed charges,,,173.08,95,,percent of total billed charges,,,163.97,90,,percent of total billed charges,,,163.97,90,,percent of total billed charges,,,149.4,82,,percent of total billed charges,,,163.97,90,,percent of total billed charges,,,154.86,85,,percent of total billed charges,,13.37,173.08,
PRAMOXINE/CALAM(CALADRYL)LOT:1-8% 180ML,32001726,CDM,,,250,RC,inpatient,,64.87,64.87,,55.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.09,88,,percent of total billed charges,,,,,,,,,49.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.03,91,,percent of total billed charges,,,61.63,95,,percent of total billed charges,,,53.84,83,,percent of total billed charges,,,53.84,83,,percent of total billed charges,,,,,,,,,,,,,,,53.84,83,,percent of total billed charges,,,61.63,95,,percent of total billed charges,,,58.38,90,,percent of total billed charges,,,58.38,90,,percent of total billed charges,,,53.19,82,,percent of total billed charges,,,58.38,90,,percent of total billed charges,,,55.14,85,,percent of total billed charges,,48.91,61.63,
VERAPAMIL(CALAN SR)TAB:180MG,32001731,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
VERAPAMIL (CALAN SR) TAB : 240 MG,32001736,CDM,,,250,RC,inpatient,,27.76,27.76,,23.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.43,88,,percent of total billed charges,,,,,,,,,21.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.26,91,,percent of total billed charges,,,26.37,95,,percent of total billed charges,,,23.04,83,,percent of total billed charges,,,23.04,83,,percent of total billed charges,,,,,,,,,,,,,,,23.04,83,,percent of total billed charges,,,26.37,95,,percent of total billed charges,,,24.98,90,,percent of total billed charges,,,24.98,90,,percent of total billed charges,,,22.76,82,,percent of total billed charges,,,24.98,90,,percent of total billed charges,,,23.6,85,,percent of total billed charges,,20.93,26.37,
CALAMINE LOT:180ML,32001741,CDM,J3490,HCPCS,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
CALCIUM /VIT D:600MG/400 I.U.,32001746,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CALCIUM CARB ORAL SUSP : 500MG/5ML 500ML,32001747,CDM,,,250,RC,inpatient,,139.09,139.09,,118.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,118.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,122.4,88,,percent of total billed charges,,,,,,,,,106.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,126.57,91,,percent of total billed charges,,,132.14,95,,percent of total billed charges,,,115.44,83,,percent of total billed charges,,,115.44,83,,percent of total billed charges,,,,,,,,,,,,,,,115.44,83,,percent of total billed charges,,,132.14,95,,percent of total billed charges,,,125.18,90,,percent of total billed charges,,,125.18,90,,percent of total billed charges,,,114.05,82,,percent of total billed charges,,,125.18,90,,percent of total billed charges,,,118.23,85,,percent of total billed charges,,104.87,132.14,
CALCIUM CHLOR SYR:10ML=1GM(100MG/ML),32001751,CDM,J3490,HCPCS,250,RC,inpatient,,161.93,161.93,,137.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,122.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,137.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,142.5,88,,percent of total billed charges,,,,,,,,,123.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,147.36,91,,percent of total billed charges,,,153.83,95,,percent of total billed charges,,,134.4,83,,percent of total billed charges,,,134.4,83,,percent of total billed charges,,,,,,,,,,,,,,,134.4,83,,percent of total billed charges,,,153.83,95,,percent of total billed charges,,,145.74,90,,percent of total billed charges,,,145.74,90,,percent of total billed charges,,,132.78,82,,percent of total billed charges,,,145.74,90,,percent of total billed charges,,,137.64,85,,percent of total billed charges,,122.1,153.83,
CAMPTOSAR 20MG,32001753,CDM,J9206,HCPCS,636,RC,inpatient,,149.5,149.5,,126.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,112.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,127.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,131.56,88,,percent of total billed charges,,114.58,,,,fee schedule,,,114.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,114.58,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,136.05,91,,percent of total billed charges,,,142.03,95,,percent of total billed charges,,,124.09,83,,percent of total billed charges,,,124.09,83,,percent of total billed charges,,,,,,,,,,,,,,,124.09,83,,percent of total billed charges,,,142.03,95,,percent of total billed charges,,,134.55,90,,percent of total billed charges,,,134.55,90,,percent of total billed charges,,,122.59,82,,percent of total billed charges,,,134.55,90,,percent of total billed charges,,,127.08,85,,percent of total billed charges,,112.72,142.03,
MOLD EXTRACTS (CANDIN) ALL,32001756,CDM,,,250,RC,inpatient,,1185.41,1185.41,,1006.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,893.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1007.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1043.16,88,,percent of total billed charges,,,,,,,,,905.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1078.72,91,,percent of total billed charges,,,1126.14,95,,percent of total billed charges,,,983.89,83,,percent of total billed charges,,,983.89,83,,percent of total billed charges,,,,,,,,,,,,,,,983.89,83,,percent of total billed charges,,,1126.14,95,,percent of total billed charges,,,1066.87,90,,percent of total billed charges,,,1066.87,90,,percent of total billed charges,,,972.04,82,,percent of total billed charges,,,1066.87,90,,percent of total billed charges,,,1007.6,85,,percent of total billed charges,,893.8,1126.14,
CAPTOPRIL (CAPOTEN) TAB : 25MG,32001771,CDM,,,250,RC,inpatient,,22.36,22.36,,18.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.68,88,,percent of total billed charges,,,,,,,,,17.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.35,91,,percent of total billed charges,,,21.24,95,,percent of total billed charges,,,18.56,83,,percent of total billed charges,,,18.56,83,,percent of total billed charges,,,,,,,,,,,,,,,18.56,83,,percent of total billed charges,,,21.24,95,,percent of total billed charges,,,20.12,90,,percent of total billed charges,,,20.12,90,,percent of total billed charges,,,18.34,82,,percent of total billed charges,,,20.12,90,,percent of total billed charges,,,19.01,85,,percent of total billed charges,,16.86,21.24,
CAPTOPRIL(CAPOTEN)TAB:50MG,32001776,CDM,J8499,HCPCS,250,RC,inpatient,,14.59,14.59,,12.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.84,88,,percent of total billed charges,,,,,,,,,11.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.28,91,,percent of total billed charges,,,13.86,95,,percent of total billed charges,,,12.11,83,,percent of total billed charges,,,12.11,83,,percent of total billed charges,,,,,,,,,,,,,,,12.11,83,,percent of total billed charges,,,13.86,95,,percent of total billed charges,,,13.13,90,,percent of total billed charges,,,13.13,90,,percent of total billed charges,,,11.96,82,,percent of total billed charges,,,13.13,90,,percent of total billed charges,,,12.4,85,,percent of total billed charges,,11,13.86,
CAPSAICIN (ZOSTRIX) CREAM :0.025% 60GM,32001786,CDM,J3490,HCPCS,250,RC,inpatient,,94.68,94.68,,80.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,83.32,88,,percent of total billed charges,,,,,,,,,72.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,86.16,91,,percent of total billed charges,,,89.95,95,,percent of total billed charges,,,78.58,83,,percent of total billed charges,,,78.58,83,,percent of total billed charges,,,,,,,,,,,,,,,78.58,83,,percent of total billed charges,,,89.95,95,,percent of total billed charges,,,85.21,90,,percent of total billed charges,,,85.21,90,,percent of total billed charges,,,77.64,82,,percent of total billed charges,,,85.21,90,,percent of total billed charges,,,80.48,85,,percent of total billed charges,,71.39,89.95,
CAPSAICIN(ZOSTRIX)CREAM 0.08%:60GM,32001787,CDM,,,250,RC,inpatient,,144.64,144.64,,122.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,109.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127.28,88,,percent of total billed charges,,,,,,,,,110.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,131.62,91,,percent of total billed charges,,,137.41,95,,percent of total billed charges,,,120.05,83,,percent of total billed charges,,,120.05,83,,percent of total billed charges,,,,,,,,,,,,,,,120.05,83,,percent of total billed charges,,,137.41,95,,percent of total billed charges,,,130.18,90,,percent of total billed charges,,,130.18,90,,percent of total billed charges,,,118.6,82,,percent of total billed charges,,,130.18,90,,percent of total billed charges,,,122.94,85,,percent of total billed charges,,109.06,137.41,
SUCRALFATE (CARAFATE)ORAL: 1G/10ML 90ML,32001791,CDM,,,250,RC,inpatient,,64.75,64.75,,54.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.98,88,,percent of total billed charges,,,,,,,,,49.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.92,91,,percent of total billed charges,,,61.51,95,,percent of total billed charges,,,53.74,83,,percent of total billed charges,,,53.74,83,,percent of total billed charges,,,,,,,,,,,,,,,53.74,83,,percent of total billed charges,,,61.51,95,,percent of total billed charges,,,58.28,90,,percent of total billed charges,,,58.28,90,,percent of total billed charges,,,53.1,82,,percent of total billed charges,,,58.28,90,,percent of total billed charges,,,55.04,85,,percent of total billed charges,,48.82,61.51,
SUCRALFATE(CARAFATE)TAB:1GM,32001796,CDM,J8499,HCPCS,250,RC,inpatient,,75.49,75.49,,64.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,64.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66.43,88,,percent of total billed charges,,,,,,,,,57.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,68.7,91,,percent of total billed charges,,,71.72,95,,percent of total billed charges,,,62.66,83,,percent of total billed charges,,,62.66,83,,percent of total billed charges,,,,,,,,,,,,,,,62.66,83,,percent of total billed charges,,,71.72,95,,percent of total billed charges,,,67.94,90,,percent of total billed charges,,,67.94,90,,percent of total billed charges,,,61.9,82,,percent of total billed charges,,,67.94,90,,percent of total billed charges,,,64.17,85,,percent of total billed charges,,56.92,71.72,
SUCRALFATE(CARAFATE):1GM/10ML (UD),32001799,CDM,J8499,HCPCS,250,RC,inpatient,,151.31,151.31,,128.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,128.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.15,88,,percent of total billed charges,,,,,,,,,115.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,137.69,91,,percent of total billed charges,,,143.74,95,,percent of total billed charges,,,125.59,83,,percent of total billed charges,,,125.59,83,,percent of total billed charges,,,,,,,,,,,,,,,125.59,83,,percent of total billed charges,,,143.74,95,,percent of total billed charges,,,136.18,90,,percent of total billed charges,,,136.18,90,,percent of total billed charges,,,124.07,82,,percent of total billed charges,,,136.18,90,,percent of total billed charges,,,128.61,85,,percent of total billed charges,,114.09,143.74,
SUCRALFATE (CARAFATE) ORAL:1G/10ML 414ML,32001801,CDM,,,250,RC,inpatient,,230.5,230.5,,195.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,173.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,195.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,202.84,88,,percent of total billed charges,,,,,,,,,176.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,209.76,91,,percent of total billed charges,,,218.98,95,,percent of total billed charges,,,191.32,83,,percent of total billed charges,,,191.32,83,,percent of total billed charges,,,,,,,,,,,,,,,191.32,83,,percent of total billed charges,,,218.98,95,,percent of total billed charges,,,207.45,90,,percent of total billed charges,,,207.45,90,,percent of total billed charges,,,189.01,82,,percent of total billed charges,,,207.45,90,,percent of total billed charges,,,195.93,85,,percent of total billed charges,,173.8,218.98,
SUCRALFATE (CARAFATE) ORAL:1G/10ML 60ML,32001811,CDM,,,250,RC,inpatient,,43.25,43.25,,36.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.06,88,,percent of total billed charges,,,,,,,,,33.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,39.36,91,,percent of total billed charges,,,41.09,95,,percent of total billed charges,,,35.9,83,,percent of total billed charges,,,35.9,83,,percent of total billed charges,,,,,,,,,,,,,,,35.9,83,,percent of total billed charges,,,41.09,95,,percent of total billed charges,,,38.93,90,,percent of total billed charges,,,38.93,90,,percent of total billed charges,,,35.47,82,,percent of total billed charges,,,38.93,90,,percent of total billed charges,,,36.76,85,,percent of total billed charges,,32.61,41.09,
CARBIDOPA/LEVODOPA TAB : 25MG-250MG,32001816,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
carBAMazepine(TEGretol)TAB:200MG,32001821,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CARB/LEVO(sineMET)TAB:25MG-100MG,32001826,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CARBIDOPA/LEVODOPA CR TAB : 25MG-100MG,32001827,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CARB/LEVO(sineMET)TAB:10MG-100MG,32001831,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
doxaZOSIN MESYLATE (CARDURA) TAB : 1MG,32001836,CDM,,,250,RC,inpatient,,42.5,42.5,,36.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37.4,88,,percent of total billed charges,,,,,,,,,32.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38.68,91,,percent of total billed charges,,,40.38,95,,percent of total billed charges,,,35.28,83,,percent of total billed charges,,,35.28,83,,percent of total billed charges,,,,,,,,,,,,,,,35.28,83,,percent of total billed charges,,,40.38,95,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,34.85,82,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,36.13,85,,percent of total billed charges,,32.05,40.38,
DILTIAZEM(CARDIZEM)VL:25MG/5ML,32001841,CDM,J3490,HCPCS,250,RC,inpatient,,65.03,65.03,,55.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.23,88,,percent of total billed charges,,,,,,,,,49.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.18,91,,percent of total billed charges,,,61.78,95,,percent of total billed charges,,,53.97,83,,percent of total billed charges,,,53.97,83,,percent of total billed charges,,,,,,,,,,,,,,,53.97,83,,percent of total billed charges,,,61.78,95,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,53.32,82,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,55.28,85,,percent of total billed charges,,49.03,61.78,
DILTIAZEM(CARDIZEM CD)CAP:120MG,32001851,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DILTIAZEM(CARDIZEM CD)CAP:180MG,32001856,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DILTIAZEM(CARDIZEM CD)CAP:240MG,32001861,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
NICARDIPINE (CARDENE) CAP : 20MG,32001871,CDM,,,250,RC,inpatient,,29.66,29.66,,25.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.1,88,,percent of total billed charges,,,,,,,,,22.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.99,91,,percent of total billed charges,,,28.18,95,,percent of total billed charges,,,24.62,83,,percent of total billed charges,,,24.62,83,,percent of total billed charges,,,,,,,,,,,,,,,24.62,83,,percent of total billed charges,,,28.18,95,,percent of total billed charges,,,26.69,90,,percent of total billed charges,,,26.69,90,,percent of total billed charges,,,24.32,82,,percent of total billed charges,,,26.69,90,,percent of total billed charges,,,25.21,85,,percent of total billed charges,,22.36,28.18,
NICARDIPINE (CARDENE) CAP : 30MG,32001876,CDM,,,250,RC,inpatient,,42.5,42.5,,36.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37.4,88,,percent of total billed charges,,,,,,,,,32.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38.68,91,,percent of total billed charges,,,40.38,95,,percent of total billed charges,,,35.28,83,,percent of total billed charges,,,35.28,83,,percent of total billed charges,,,,,,,,,,,,,,,35.28,83,,percent of total billed charges,,,40.38,95,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,34.85,82,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,36.13,85,,percent of total billed charges,,32.05,40.38,
DILTIAZEM(CARDIZEM)VL:50MG/10ML,32001881,CDM,J3490,HCPCS,250,RC,inpatient,,118.63,118.63,,100.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,89.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,100.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,104.39,88,,percent of total billed charges,,,,,,,,,90.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,107.95,91,,percent of total billed charges,,,112.7,95,,percent of total billed charges,,,98.46,83,,percent of total billed charges,,,98.46,83,,percent of total billed charges,,,,,,,,,,,,,,,98.46,83,,percent of total billed charges,,,112.7,95,,percent of total billed charges,,,106.77,90,,percent of total billed charges,,,106.77,90,,percent of total billed charges,,,97.28,82,,percent of total billed charges,,,106.77,90,,percent of total billed charges,,,100.84,85,,percent of total billed charges,,89.45,112.7,
doxaZOSIN(CARDURA)TAB:2MG,32001885,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DILTIAZEM HCL (CARDIZEM CD) CAP : 300MG,32001896,CDM,,,250,RC,inpatient,,45.36,45.36,,38.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.92,88,,percent of total billed charges,,,,,,,,,34.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.28,91,,percent of total billed charges,,,43.09,95,,percent of total billed charges,,,37.65,83,,percent of total billed charges,,,37.65,83,,percent of total billed charges,,,,,,,,,,,,,,,37.65,83,,percent of total billed charges,,,43.09,95,,percent of total billed charges,,,40.82,90,,percent of total billed charges,,,40.82,90,,percent of total billed charges,,,37.2,82,,percent of total billed charges,,,40.82,90,,percent of total billed charges,,,38.56,85,,percent of total billed charges,,34.2,43.09,
DILTIAZEM HCL SR CAP : 90MG,32001901,CDM,,,250,RC,inpatient,,51.07,51.07,,43.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.94,88,,percent of total billed charges,,,,,,,,,39.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.47,91,,percent of total billed charges,,,48.52,95,,percent of total billed charges,,,42.39,83,,percent of total billed charges,,,42.39,83,,percent of total billed charges,,,,,,,,,,,,,,,42.39,83,,percent of total billed charges,,,48.52,95,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,41.88,82,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,43.41,85,,percent of total billed charges,,38.51,48.52,
CARISOPRODOL(SOMA)TAB:350MG,32001906,CDM,J8499,HCPCS,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
CARISOPRODOL/ASPIRIN TAB : 200-325MG,32001911,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
BICALUTAMIDE(CASODEX)TAB:50MG,32001928,CDM,,,250,RC,inpatient,,274.7,274.7,,233.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,207.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,233.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,241.74,88,,percent of total billed charges,,,,,,,,,209.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,249.98,91,,percent of total billed charges,,,260.97,95,,percent of total billed charges,,,228,83,,percent of total billed charges,,,228,83,,percent of total billed charges,,,,,,,,,,,,,,,228,83,,percent of total billed charges,,,260.97,95,,percent of total billed charges,,,247.23,90,,percent of total billed charges,,,247.23,90,,percent of total billed charges,,,225.25,82,,percent of total billed charges,,,247.23,90,,percent of total billed charges,,,233.5,85,,percent of total billed charges,,207.12,260.97,
CASTOR OIL 180 ML,32001936,CDM,J3490,HCPCS,250,RC,inpatient,,30.93,30.93,,26.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.22,88,,percent of total billed charges,,,,,,,,,23.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.15,91,,percent of total billed charges,,,29.38,95,,percent of total billed charges,,,25.67,83,,percent of total billed charges,,,25.67,83,,percent of total billed charges,,,,,,,,,,,,,,,25.67,83,,percent of total billed charges,,,29.38,95,,percent of total billed charges,,,27.84,90,,percent of total billed charges,,,27.84,90,,percent of total billed charges,,,25.36,82,,percent of total billed charges,,,27.84,90,,percent of total billed charges,,,26.29,85,,percent of total billed charges,,23.32,29.38,
cloNIDine(CATAPRES-TTS 1)PAT:0.1MG/24HR,32001941,CDM,J3490,HCPCS,250,RC,inpatient,,161.28,161.28,,136.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,121.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,137.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,141.93,88,,percent of total billed charges,,,,,,,,,123.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,146.76,91,,percent of total billed charges,,,153.22,95,,percent of total billed charges,,,133.86,83,,percent of total billed charges,,,133.86,83,,percent of total billed charges,,,,,,,,,,,,,,,133.86,83,,percent of total billed charges,,,153.22,95,,percent of total billed charges,,,145.15,90,,percent of total billed charges,,,145.15,90,,percent of total billed charges,,,132.25,82,,percent of total billed charges,,,145.15,90,,percent of total billed charges,,,137.09,85,,percent of total billed charges,,121.61,153.22,
CLONIDINE (CATAPRES-TTS 2)PAT:0.2MG/24HR,32001946,CDM,,,250,RC,inpatient,,544.32,544.32,,462.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,410.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,462.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,479,88,,percent of total billed charges,,,,,,,,,415.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,495.33,91,,percent of total billed charges,,,517.1,95,,percent of total billed charges,,,451.79,83,,percent of total billed charges,,,451.79,83,,percent of total billed charges,,,,,,,,,,,,,,,451.79,83,,percent of total billed charges,,,517.1,95,,percent of total billed charges,,,489.89,90,,percent of total billed charges,,,489.89,90,,percent of total billed charges,,,446.34,82,,percent of total billed charges,,,489.89,90,,percent of total billed charges,,,462.67,85,,percent of total billed charges,,410.42,517.1,
CLONIDINE (CATAPRES-TTS 3)PAT:0.3MG/24HR,32001951,CDM,,,250,RC,inpatient,,2391.78,2391.78,,2030.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1803.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2033.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2104.77,88,,percent of total billed charges,,,,,,,,,1827.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2176.52,91,,percent of total billed charges,,,2272.19,95,,percent of total billed charges,,,1985.18,83,,percent of total billed charges,,,1985.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1985.18,83,,percent of total billed charges,,,2272.19,95,,percent of total billed charges,,,2152.6,90,,percent of total billed charges,,,2152.6,90,,percent of total billed charges,,,1961.26,82,,percent of total billed charges,,,2152.6,90,,percent of total billed charges,,,2033.01,85,,percent of total billed charges,,1803.4,2272.19,
DICLOFENAC POTASSIUM (CATAFLAM) TAB 50MG,32001961,CDM,,,250,RC,inpatient,,17.45,17.45,,14.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.36,88,,percent of total billed charges,,,,,,,,,13.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.88,91,,percent of total billed charges,,,16.58,95,,percent of total billed charges,,,14.48,83,,percent of total billed charges,,,14.48,83,,percent of total billed charges,,,,,,,,,,,,,,,14.48,83,,percent of total billed charges,,,16.58,95,,percent of total billed charges,,,15.71,90,,percent of total billed charges,,,15.71,90,,percent of total billed charges,,,14.31,82,,percent of total billed charges,,,15.71,90,,percent of total billed charges,,,14.83,85,,percent of total billed charges,,13.16,16.58,
ceFAClor(CECLOR)SUSP:125MG/5ML (75ML),32001976,CDM,,,250,RC,inpatient,,82.47,82.47,,70.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,72.57,88,,percent of total billed charges,,,,,,,,,63.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.05,91,,percent of total billed charges,,,78.35,95,,percent of total billed charges,,,68.45,83,,percent of total billed charges,,,68.45,83,,percent of total billed charges,,,,,,,,,,,,,,,68.45,83,,percent of total billed charges,,,78.35,95,,percent of total billed charges,,,74.22,90,,percent of total billed charges,,,74.22,90,,percent of total billed charges,,,67.63,82,,percent of total billed charges,,,74.22,90,,percent of total billed charges,,,70.1,85,,percent of total billed charges,,62.18,78.35,
ceFAClor(CECLOR)CAP:250MG,32001981,CDM,J8499,HCPCS,250,RC,inpatient,,27.6,27.6,,23.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.29,88,,percent of total billed charges,,,,,,,,,21.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.12,91,,percent of total billed charges,,,26.22,95,,percent of total billed charges,,,22.91,83,,percent of total billed charges,,,22.91,83,,percent of total billed charges,,,,,,,,,,,,,,,22.91,83,,percent of total billed charges,,,26.22,95,,percent of total billed charges,,,24.84,90,,percent of total billed charges,,,24.84,90,,percent of total billed charges,,,22.63,82,,percent of total billed charges,,,24.84,90,,percent of total billed charges,,,23.46,85,,percent of total billed charges,,20.81,26.22,
ceFAClor(CECLOR)SUSP:250MG/5ML (75ML),32001986,CDM,,,250,RC,inpatient,,170.65,170.65,,144.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,128.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,145.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,150.17,88,,percent of total billed charges,,,,,,,,,130.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,155.29,91,,percent of total billed charges,,,162.12,95,,percent of total billed charges,,,141.64,83,,percent of total billed charges,,,141.64,83,,percent of total billed charges,,,,,,,,,,,,,,,141.64,83,,percent of total billed charges,,,162.12,95,,percent of total billed charges,,,153.59,90,,percent of total billed charges,,,153.59,90,,percent of total billed charges,,,139.93,82,,percent of total billed charges,,,153.59,90,,percent of total billed charges,,,145.05,85,,percent of total billed charges,,128.67,162.12,
CEFADROXIL(DURICEF)CAP:500MG,32001987,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
cefUROXime(CEFTIN) SUS:125MG/5ML 100ML,32002006,CDM,,,250,RC,inpatient,,232.82,232.82,,197.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,175.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,197.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,204.88,88,,percent of total billed charges,,,,,,,,,177.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,211.87,91,,percent of total billed charges,,,221.18,95,,percent of total billed charges,,,193.24,83,,percent of total billed charges,,,193.24,83,,percent of total billed charges,,,,,,,,,,,,,,,193.24,83,,percent of total billed charges,,,221.18,95,,percent of total billed charges,,,209.54,90,,percent of total billed charges,,,209.54,90,,percent of total billed charges,,,190.91,82,,percent of total billed charges,,,209.54,90,,percent of total billed charges,,,197.9,85,,percent of total billed charges,,175.55,221.18,
cefUROXime(CEFTIN)TAB:250MG,32002011,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CEFPROZIL (CEFZIL) SUS : 125MG/5ML  50ML,32002016,CDM,,,250,RC,inpatient,,311.97,311.97,,264.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,235.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,265.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,274.53,88,,percent of total billed charges,,,,,,,,,238.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,283.89,91,,percent of total billed charges,,,296.37,95,,percent of total billed charges,,,258.94,83,,percent of total billed charges,,,258.94,83,,percent of total billed charges,,,,,,,,,,,,,,,258.94,83,,percent of total billed charges,,,296.37,95,,percent of total billed charges,,,280.77,90,,percent of total billed charges,,,280.77,90,,percent of total billed charges,,,255.82,82,,percent of total billed charges,,,280.77,90,,percent of total billed charges,,,265.17,85,,percent of total billed charges,,235.23,296.37,
CEFPROZIL(CEFZIL)TAB:250MG,32002021,CDM,J8499,HCPCS,250,RC,inpatient,,52.34,52.34,,44.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46.06,88,,percent of total billed charges,,,,,,,,,39.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47.63,91,,percent of total billed charges,,,49.72,95,,percent of total billed charges,,,43.44,83,,percent of total billed charges,,,43.44,83,,percent of total billed charges,,,,,,,,,,,,,,,43.44,83,,percent of total billed charges,,,49.72,95,,percent of total billed charges,,,47.11,90,,percent of total billed charges,,,47.11,90,,percent of total billed charges,,,42.92,82,,percent of total billed charges,,,47.11,90,,percent of total billed charges,,,44.49,85,,percent of total billed charges,,39.46,49.72,
CEFPROZIL (CEFZIL) TAB : 500MG,32002022,CDM,,,250,RC,inpatient,,132.11,132.11,,112.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,99.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,112.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,116.26,88,,percent of total billed charges,,,,,,,,,100.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,120.22,91,,percent of total billed charges,,,125.5,95,,percent of total billed charges,,,109.65,83,,percent of total billed charges,,,109.65,83,,percent of total billed charges,,,,,,,,,,,,,,,109.65,83,,percent of total billed charges,,,125.5,95,,percent of total billed charges,,,118.9,90,,percent of total billed charges,,,118.9,90,,percent of total billed charges,,,108.33,82,,percent of total billed charges,,,118.9,90,,percent of total billed charges,,,112.29,85,,percent of total billed charges,,99.61,125.5,
CEFPROZIL(CEFZIL)SUS:250MG/5ML (50ML),32002026,CDM,,,250,RC,inpatient,,393.96,393.96,,334.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,297.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,334.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,346.68,88,,percent of total billed charges,,,,,,,,,300.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,358.5,91,,percent of total billed charges,,,374.26,95,,percent of total billed charges,,,326.99,83,,percent of total billed charges,,,326.99,83,,percent of total billed charges,,,,,,,,,,,,,,,326.99,83,,percent of total billed charges,,,374.26,95,,percent of total billed charges,,,354.56,90,,percent of total billed charges,,,354.56,90,,percent of total billed charges,,,323.05,82,,percent of total billed charges,,,354.56,90,,percent of total billed charges,,,334.87,85,,percent of total billed charges,,297.05,374.26,
BETAMET/NAPH(CELESTONE)VIAL:6MG/ML (5ML),32002031,CDM,J0702,HCPCS,250,RC,inpatient,,591.51,591.51,,502.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,446,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,502.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,520.53,88,,percent of total billed charges,,34.08,,,,fee schedule,,,451.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,34.08,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,538.27,91,,percent of total billed charges,,,561.93,95,,percent of total billed charges,,,490.95,83,,percent of total billed charges,,,490.95,83,,percent of total billed charges,,,,,,,,,,,,,,,490.95,83,,percent of total billed charges,,,561.93,95,,percent of total billed charges,,,532.36,90,,percent of total billed charges,,,532.36,90,,percent of total billed charges,,,485.04,82,,percent of total billed charges,,,532.36,90,,percent of total billed charges,,,502.78,85,,percent of total billed charges,,34.08,561.93,
BETAMETHASO (CELESTONE)VIAL:6MG/ML 2.5ML,32002036,CDM,,,250,RC,inpatient,,567.15,567.15,,481.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,427.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,482.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,499.09,88,,percent of total billed charges,,,,,,,,,433.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,516.11,91,,percent of total billed charges,,,538.79,95,,percent of total billed charges,,,470.73,83,,percent of total billed charges,,,470.73,83,,percent of total billed charges,,,,,,,,,,,,,,,470.73,83,,percent of total billed charges,,,538.79,95,,percent of total billed charges,,,510.44,90,,percent of total billed charges,,,510.44,90,,percent of total billed charges,,,465.06,82,,percent of total billed charges,,,510.44,90,,percent of total billed charges,,,482.08,85,,percent of total billed charges,,427.63,538.79,
CARBOXYMETHYLCELL(CELLUVISC)DROP 1%:,32002037,CDM,,,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
METHSUXIMIDE (CELONTIN) CAP : 150MG,32002041,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
BENZOCAINE/MENTH(CHLORASEPTIC)LOZ:6/10MG,32002066,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
cePHALexin(KEFLEX)CAP:250MG,32002071,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
cephaLEXIN (KEFLEX) CAP : 250MG   1X8,32002072,CDM,,,250,RC,inpatient,,33.62,33.62,,28.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.59,88,,percent of total billed charges,,,,,,,,,25.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.59,91,,percent of total billed charges,,,31.94,95,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,,,,,,,,,,,,,,27.9,83,,percent of total billed charges,,,31.94,95,,percent of total billed charges,,,30.26,90,,percent of total billed charges,,,30.26,90,,percent of total billed charges,,,27.57,82,,percent of total billed charges,,,30.26,90,,percent of total billed charges,,,28.58,85,,percent of total billed charges,,25.35,31.94,
cePHALexin(KEFLEX):125MG/5ML (100ML),32002076,CDM,J8499,HCPCS,250,RC,inpatient,,407.36,407.36,,345.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,307.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,346.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,358.48,88,,percent of total billed charges,,,,,,,,,311.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,370.7,91,,percent of total billed charges,,,386.99,95,,percent of total billed charges,,,338.11,83,,percent of total billed charges,,,338.11,83,,percent of total billed charges,,,,,,,,,,,,,,,338.11,83,,percent of total billed charges,,,386.99,95,,percent of total billed charges,,,366.62,90,,percent of total billed charges,,,366.62,90,,percent of total billed charges,,,334.04,82,,percent of total billed charges,,,366.62,90,,percent of total billed charges,,,346.26,85,,percent of total billed charges,,307.15,386.99,
cePHALexin(KEFLEX)CAP:500MG,32002091,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
cephaLEXIN (KEFLEX) CAP : 500MG  1X8,32002092,CDM,,,250,RC,inpatient,,33.31,33.31,,28.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.31,88,,percent of total billed charges,,,,,,,,,25.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.31,91,,percent of total billed charges,,,31.64,95,,percent of total billed charges,,,27.65,83,,percent of total billed charges,,,27.65,83,,percent of total billed charges,,,,,,,,,,,,,,,27.65,83,,percent of total billed charges,,,31.64,95,,percent of total billed charges,,,29.98,90,,percent of total billed charges,,,29.98,90,,percent of total billed charges,,,27.31,82,,percent of total billed charges,,,29.98,90,,percent of total billed charges,,,28.31,85,,percent of total billed charges,,25.12,31.64,
cePHALexin(KEFLEX):250MG/5ML (100ML),32002106,CDM,J8499,HCPCS,250,RC,inpatient,,203.11,203.11,,172.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.74,88,,percent of total billed charges,,,,,,,,,155.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.83,91,,percent of total billed charges,,,192.95,95,,percent of total billed charges,,,168.58,83,,percent of total billed charges,,,168.58,83,,percent of total billed charges,,,,,,,,,,,,,,,168.58,83,,percent of total billed charges,,,192.95,95,,percent of total billed charges,,,182.8,90,,percent of total billed charges,,,182.8,90,,percent of total billed charges,,,166.55,82,,percent of total billed charges,,,182.8,90,,percent of total billed charges,,,172.64,85,,percent of total billed charges,,153.14,192.95,
TRIETHANOLAMINE (CERUMENEX)DROP:10% 6ML,32002111,CDM,,,250,RC,inpatient,,384.92,384.92,,326.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,290.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,327.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,338.73,88,,percent of total billed charges,,,,,,,,,294.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,350.28,91,,percent of total billed charges,,,365.67,95,,percent of total billed charges,,,319.48,83,,percent of total billed charges,,,319.48,83,,percent of total billed charges,,,,,,,,,,,,,,,319.48,83,,percent of total billed charges,,,365.67,95,,percent of total billed charges,,,346.43,90,,percent of total billed charges,,,346.43,90,,percent of total billed charges,,,315.63,82,,percent of total billed charges,,,346.43,90,,percent of total billed charges,,,327.18,85,,percent of total billed charges,,290.23,365.67,
DINOPROSTONE(CERVIDIL)SUPP:10MG,32002112,CDM,J3490,HCPCS,250,RC,inpatient,,3741.88,3741.88,,3176.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2821.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3180.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3292.85,88,,percent of total billed charges,,,,,,,,,2858.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3405.11,91,,percent of total billed charges,,,3554.79,95,,percent of total billed charges,,,3105.76,83,,percent of total billed charges,,,3105.76,83,,percent of total billed charges,,,,,,,,,,,,,,,3105.76,83,,percent of total billed charges,,,3554.79,95,,percent of total billed charges,,,3367.69,90,,percent of total billed charges,,,3367.69,90,,percent of total billed charges,,,3068.34,82,,percent of total billed charges,,,3367.69,90,,percent of total billed charges,,,3180.6,85,,percent of total billed charges,,2821.38,3554.79,
SULFAC/PREDN(CETAPRED)OINT:10-.25% 3.5GM,32002116,CDM,,,250,RC,inpatient,,390.47,390.47,,331.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.61,88,,percent of total billed charges,,,,,,,,,298.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.33,91,,percent of total billed charges,,,370.95,95,,percent of total billed charges,,,324.09,83,,percent of total billed charges,,,324.09,83,,percent of total billed charges,,,,,,,,,,,,,,,324.09,83,,percent of total billed charges,,,370.95,95,,percent of total billed charges,,,351.42,90,,percent of total billed charges,,,351.42,90,,percent of total billed charges,,,320.19,82,,percent of total billed charges,,,351.42,90,,percent of total billed charges,,,331.9,85,,percent of total billed charges,,294.41,370.95,
CETACAINE SPRAY FOR EGD ONLY,32002121,CDM,,,250,RC,inpatient,,20.33,20.33,,17.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.89,88,,percent of total billed charges,,,,,,,,,15.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.5,91,,percent of total billed charges,,,19.31,95,,percent of total billed charges,,,16.87,83,,percent of total billed charges,,,16.87,83,,percent of total billed charges,,,,,,,,,,,,,,,16.87,83,,percent of total billed charges,,,19.31,95,,percent of total billed charges,,,18.3,90,,percent of total billed charges,,,18.3,90,,percent of total billed charges,,,16.67,82,,percent of total billed charges,,,18.3,90,,percent of total billed charges,,,17.28,85,,percent of total billed charges,,15.33,19.31,
TETRA/BENZ/BUT(CETACAINE)SPR:56ML,32002126,CDM,,,250,RC,inpatient,,779.36,779.36,,661.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,587.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,662.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,685.84,88,,percent of total billed charges,,,,,,,,,595.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,709.22,91,,percent of total billed charges,,,740.39,95,,percent of total billed charges,,,646.87,83,,percent of total billed charges,,,646.87,83,,percent of total billed charges,,,,,,,,,,,,,,,646.87,83,,percent of total billed charges,,,740.39,95,,percent of total billed charges,,,701.42,90,,percent of total billed charges,,,701.42,90,,percent of total billed charges,,,639.08,82,,percent of total billed charges,,,701.42,90,,percent of total billed charges,,,662.46,85,,percent of total billed charges,,587.64,740.39,
TETRA/BENZ/BUT(CETACAINE)SPR:56GM,32002131,CDM,J3490,HCPCS,250,RC,inpatient,,78.43,78.43,,66.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.02,88,,percent of total billed charges,,,,,,,,,59.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.37,91,,percent of total billed charges,,,74.51,95,,percent of total billed charges,,,65.1,83,,percent of total billed charges,,,65.1,83,,percent of total billed charges,,,,,,,,,,,,,,,65.1,83,,percent of total billed charges,,,74.51,95,,percent of total billed charges,,,70.59,90,,percent of total billed charges,,,70.59,90,,percent of total billed charges,,,64.31,82,,percent of total billed charges,,,70.59,90,,percent of total billed charges,,,66.67,85,,percent of total billed charges,,59.14,74.51,
SULFACETAMIDE(BLEPH-10) OINT : 10% 3.5GM,32002136,CDM,,,250,RC,inpatient,,31.56,31.56,,26.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.77,88,,percent of total billed charges,,,,,,,,,24.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.72,91,,percent of total billed charges,,,29.98,95,,percent of total billed charges,,,26.19,83,,percent of total billed charges,,,26.19,83,,percent of total billed charges,,,,,,,,,,,,,,,26.19,83,,percent of total billed charges,,,29.98,95,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,25.88,82,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,26.83,85,,percent of total billed charges,,23.8,29.98,
PADIMATE O (CHAPSTICK) STICK,32002146,CDM,,,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
CHERRY FLAVOR SYRP   480 ML,32002156,CDM,,,250,RC,inpatient,,191.43,191.43,,162.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.46,88,,percent of total billed charges,,,,,,,,,146.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.2,91,,percent of total billed charges,,,181.86,95,,percent of total billed charges,,,158.89,83,,percent of total billed charges,,,158.89,83,,percent of total billed charges,,,,,,,,,,,,,,,158.89,83,,percent of total billed charges,,,181.86,95,,percent of total billed charges,,,172.29,90,,percent of total billed charges,,,172.29,90,,percent of total billed charges,,,156.97,82,,percent of total billed charges,,,172.29,90,,percent of total billed charges,,,162.72,85,,percent of total billed charges,,144.34,181.86,
CALCIUM CARB(TUMS)TAB:500 MG,32002171,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PERIOGARD ORAL SOLN. 480ML,32002177,CDM,,,250,RC,inpatient,,22.5,22.5,,19.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.8,88,,percent of total billed charges,,,,,,,,,17.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.48,91,,percent of total billed charges,,,21.38,95,,percent of total billed charges,,,18.68,83,,percent of total billed charges,,,18.68,83,,percent of total billed charges,,,,,,,,,,,,,,,18.68,83,,percent of total billed charges,,,21.38,95,,percent of total billed charges,,,20.25,90,,percent of total billed charges,,,20.25,90,,percent of total billed charges,,,18.45,82,,percent of total billed charges,,,20.25,90,,percent of total billed charges,,,19.13,85,,percent of total billed charges,,16.97,21.38,
CHLORDIAZEPOXIDE (LIBRIUM) CAP : 10MG,32002186,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
chlordiazePOXIDE(LIBRIUM)CAP:5MG,32002191,CDM,J8499,HCPCS,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
CHLORZOXAZONE(PARAFON FORTE) TAB : 500MG,32002196,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CHLORPROMAZINE (THORAZINE) TAB : 50MG,32002227,CDM,,,250,RC,inpatient,,107.69,107.69,,91.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,94.77,88,,percent of total billed charges,,,,,,,,,82.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98,91,,percent of total billed charges,,,102.31,95,,percent of total billed charges,,,89.38,83,,percent of total billed charges,,,89.38,83,,percent of total billed charges,,,,,,,,,,,,,,,89.38,83,,percent of total billed charges,,,102.31,95,,percent of total billed charges,,,96.92,90,,percent of total billed charges,,,96.92,90,,percent of total billed charges,,,88.31,82,,percent of total billed charges,,,96.92,90,,percent of total billed charges,,,91.54,85,,percent of total billed charges,,81.2,102.31,
CHLORPROPAMIDE (DIABINESE) : 100MG,32002236,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CHLORPROPAMIDE (DIABINESE) TAB : 250MG,32002246,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CHLORAL HYDRATE SYRP:500MG/5ML (5ML),32002251,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
PHENOL/NA (CHLORASEPTIC) SPRAY:180ML,32002261,CDM,J3490,HCPCS,250,RC,inpatient,,33.33,33.33,,28.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.33,88,,percent of total billed charges,,,,,,,,,25.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.33,91,,percent of total billed charges,,,31.66,95,,percent of total billed charges,,,27.66,83,,percent of total billed charges,,,27.66,83,,percent of total billed charges,,,,,,,,,,,,,,,27.66,83,,percent of total billed charges,,,31.66,95,,percent of total billed charges,,,30,90,,percent of total billed charges,,,30,90,,percent of total billed charges,,,27.33,82,,percent of total billed charges,,,30,90,,percent of total billed charges,,,28.33,85,,percent of total billed charges,,25.13,31.66,
chlorproMAZINE(THORAZINE)AMP:25MG/ML,32002271,CDM,J3230,HCPCS,250,RC,inpatient,,436.77,436.77,,370.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,329.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,371.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,384.36,88,,percent of total billed charges,,272.04,,,,fee schedule,,,333.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,272.04,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,397.46,91,,percent of total billed charges,,,414.93,95,,percent of total billed charges,,,362.52,83,,percent of total billed charges,,,362.52,83,,percent of total billed charges,,,,,,,,,,,,,,,362.52,83,,percent of total billed charges,,,414.93,95,,percent of total billed charges,,,393.09,90,,percent of total billed charges,,,393.09,90,,percent of total billed charges,,,358.15,82,,percent of total billed charges,,,393.09,90,,percent of total billed charges,,,371.25,85,,percent of total billed charges,,272.04,414.93,
PHENOL/NA(CHLORASEPTIC)LOZ:,32002276,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
chlordiazePOXIDE(LIBRIUM)CAP:25MG,32002281,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
CHLORPHENIRAMINE(CHLORTRIMETON)TAB:4MG,32002296,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PSEUDOEPHED/CHLOR(NOVOFED)CAP:120-8MG,32002302,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
chlorproMAZINE(THORAZINE)TAB:25MG,32002316,CDM,J8499,HCPCS,250,RC,inpatient,UD,44.88,44.88,,38.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.49,88,,percent of total billed charges,,,,,,,,,34.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.84,91,,percent of total billed charges,,,42.64,95,,percent of total billed charges,,,37.25,83,,percent of total billed charges,,,37.25,83,,percent of total billed charges,,,,,,,,,,,,,,,37.25,83,,percent of total billed charges,,,42.64,95,,percent of total billed charges,,,40.39,90,,percent of total billed charges,,,40.39,90,,percent of total billed charges,,,36.8,82,,percent of total billed charges,,,40.39,90,,percent of total billed charges,,,38.15,85,,percent of total billed charges,,33.84,42.64,
CHLORAL HYDRATE SYRP : 500MG/5ML,32002322,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
CHLORAL HYDRATE SYRP:500MG/5ML  (90ML),32002323,CDM,,,250,RC,inpatient,,21.73,21.73,,18.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.12,88,,percent of total billed charges,,,,,,,,,16.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.77,91,,percent of total billed charges,,,20.64,95,,percent of total billed charges,,,18.04,83,,percent of total billed charges,,,18.04,83,,percent of total billed charges,,,,,,,,,,,,,,,18.04,83,,percent of total billed charges,,,20.64,95,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,17.82,82,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,18.47,85,,percent of total billed charges,,16.38,20.64,
CHROMIUM PICOLINATE 200MCG,32002324,CDM,,,250,RC,inpatient,,0.5,0.5,,0.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,0.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,0.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,0.44,88,,percent of total billed charges,,,,,,,,,0.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,0.46,91,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,,,,,,,,,,,,,0.42,83,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.41,82,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.43,85,,percent of total billed charges,,0.38,0.48,
CIPROFLOXACIN(CILOXAN)DROP 0.3%:2.5ML,32002327,CDM,J3490,HCPCS,250,RC,inpatient,,98.53,98.53,,83.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,74.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,83.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,86.71,88,,percent of total billed charges,,,,,,,,,75.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,89.66,91,,percent of total billed charges,,,93.6,95,,percent of total billed charges,,,81.78,83,,percent of total billed charges,,,81.78,83,,percent of total billed charges,,,,,,,,,,,,,,,81.78,83,,percent of total billed charges,,,93.6,95,,percent of total billed charges,,,88.68,90,,percent of total billed charges,,,88.68,90,,percent of total billed charges,,,80.79,82,,percent of total billed charges,,,88.68,90,,percent of total billed charges,,,83.75,85,,percent of total billed charges,,74.29,93.6,
CIMETIDINE (TAGAMET) TAB : 300MG,32002331,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CIMETIDINE SOLUTION 300MG/5ML  60ML,32002337,CDM,,,250,RC,inpatient,,58.5,58.5,,49.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.48,88,,percent of total billed charges,,,,,,,,,44.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.24,91,,percent of total billed charges,,,55.58,95,,percent of total billed charges,,,48.56,83,,percent of total billed charges,,,48.56,83,,percent of total billed charges,,,,,,,,,,,,,,,48.56,83,,percent of total billed charges,,,55.58,95,,percent of total billed charges,,,52.65,90,,percent of total billed charges,,,52.65,90,,percent of total billed charges,,,47.97,82,,percent of total billed charges,,,52.65,90,,percent of total billed charges,,,49.73,85,,percent of total billed charges,,44.11,55.58,
CIMETIDINE(TAGAMET)TAB:400MG,32002341,CDM,J8499,HCPCS,250,RC,inpatient,,13.56,13.56,,11.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.93,88,,percent of total billed charges,,,,,,,,,10.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.34,91,,percent of total billed charges,,,12.88,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.88,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.12,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.53,85,,percent of total billed charges,,10.22,12.88,
CIPROFLOXACIN(CIPRO)/D5W PIG:400MG/0.2L,32002361,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
CIPROFLOXACIN (CIPRO) VL:400MG/40ML,32002366,CDM,J0744,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,2.57,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.57,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,2.57,59.21,
CIPROFLOXACIN (CIPRO)VIAL : 200MG/20ML,32002371,CDM,,,250,RC,inpatient,,66.61,66.61,,56.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.62,88,,percent of total billed charges,,,,,,,,,50.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.62,91,,percent of total billed charges,,,63.28,95,,percent of total billed charges,,,55.29,83,,percent of total billed charges,,,55.29,83,,percent of total billed charges,,,,,,,,,,,,,,,55.29,83,,percent of total billed charges,,,63.28,95,,percent of total billed charges,,,59.95,90,,percent of total billed charges,,,59.95,90,,percent of total billed charges,,,54.62,82,,percent of total billed charges,,,59.95,90,,percent of total billed charges,,,56.62,85,,percent of total billed charges,,50.22,63.28,
CIPROFLOXACIN(CIPRO)TAB:250MG,32002376,CDM,J8499,HCPCS,250,RC,inpatient,,61.6,61.6,,52.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.21,88,,percent of total billed charges,,,,,,,,,47.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.06,91,,percent of total billed charges,,,58.52,95,,percent of total billed charges,,,51.13,83,,percent of total billed charges,,,51.13,83,,percent of total billed charges,,,,,,,,,,,,,,,51.13,83,,percent of total billed charges,,,58.52,95,,percent of total billed charges,,,55.44,90,,percent of total billed charges,,,55.44,90,,percent of total billed charges,,,50.51,82,,percent of total billed charges,,,55.44,90,,percent of total billed charges,,,52.36,85,,percent of total billed charges,,46.45,58.52,
CIPROFLOXACIN (CIPRO) TAB: 250MG (1X4),32002377,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CIPROFLOXACIN (CIPRO) TAB : 500MG,32002381,CDM,,,250,RC,inpatient,,416.32,416.32,,353.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,313.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,353.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,366.36,88,,percent of total billed charges,,,,,,,,,318.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,378.85,91,,percent of total billed charges,,,395.5,95,,percent of total billed charges,,,345.55,83,,percent of total billed charges,,,345.55,83,,percent of total billed charges,,,,,,,,,,,,,,,345.55,83,,percent of total billed charges,,,395.5,95,,percent of total billed charges,,,374.69,90,,percent of total billed charges,,,374.69,90,,percent of total billed charges,,,341.38,82,,percent of total billed charges,,,374.69,90,,percent of total billed charges,,,353.87,85,,percent of total billed charges,,313.91,395.5,
CIPROFLOXACIN (CIPRO) TAB: 500 MG (1x4),32002382,CDM,,,250,RC,inpatient,,1411.2,1411.2,,1198.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1064.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1199.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1241.86,88,,percent of total billed charges,,,,,,,,,1078.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1284.19,91,,percent of total billed charges,,,1340.64,95,,percent of total billed charges,,,1171.3,83,,percent of total billed charges,,,1171.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1171.3,83,,percent of total billed charges,,,1340.64,95,,percent of total billed charges,,,1270.08,90,,percent of total billed charges,,,1270.08,90,,percent of total billed charges,,,1157.18,82,,percent of total billed charges,,,1270.08,90,,percent of total billed charges,,,1199.52,85,,percent of total billed charges,,1064.04,1340.64,
CIPROFLOXACIN (CIPRO) TAB : 750MG,32002386,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
METHYLCELLULOSE (CITRUCEL) POW   CAN,32002390,CDM,,,250,RC,inpatient,,97.7,97.7,,82.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,73.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,83.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,85.98,88,,percent of total billed charges,,,,,,,,,74.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,88.91,91,,percent of total billed charges,,,92.82,95,,percent of total billed charges,,,81.09,83,,percent of total billed charges,,,81.09,83,,percent of total billed charges,,,,,,,,,,,,,,,81.09,83,,percent of total billed charges,,,92.82,95,,percent of total billed charges,,,87.93,90,,percent of total billed charges,,,87.93,90,,percent of total billed charges,,,80.11,82,,percent of total billed charges,,,87.93,90,,percent of total billed charges,,,83.05,85,,percent of total billed charges,,73.67,92.82,
MAG CITRATE(CITROMA)SOL:300ML,32002391,CDM,J8499,HCPCS,250,RC,inpatient,,36.76,36.76,,31.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.35,88,,percent of total billed charges,,,,,,,,,28.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.45,91,,percent of total billed charges,,,34.92,95,,percent of total billed charges,,,30.51,83,,percent of total billed charges,,,30.51,83,,percent of total billed charges,,,,,,,,,,,,,,,30.51,83,,percent of total billed charges,,,34.92,95,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,30.14,82,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,31.25,85,,percent of total billed charges,,27.72,34.92,
CITRUCEL,32002396,CDM,,,250,RC,inpatient,,125.45,125.45,,106.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,94.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,106.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110.4,88,,percent of total billed charges,,,,,,,,,95.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,114.16,91,,percent of total billed charges,,,119.18,95,,percent of total billed charges,,,104.12,83,,percent of total billed charges,,,104.12,83,,percent of total billed charges,,,,,,,,,,,,,,,104.12,83,,percent of total billed charges,,,119.18,95,,percent of total billed charges,,,112.91,90,,percent of total billed charges,,,112.91,90,,percent of total billed charges,,,102.87,82,,percent of total billed charges,,,112.91,90,,percent of total billed charges,,,106.63,85,,percent of total billed charges,,94.59,119.18,
cefoTAXIME (CLAFORAN) VIAL : 500MG,32002401,CDM,J0698,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,5.72,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.72,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,5.72,59.21,
cefoTAXIME (CLAFORAN) VIAL : 2GM,32002406,CDM,,,250,RC,inpatient,,83.26,83.26,,70.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.27,88,,percent of total billed charges,,,,,,,,,63.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.77,91,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,,,,,,,,,,,,,69.11,83,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,68.27,82,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,70.77,85,,percent of total billed charges,,62.78,79.1,
ceFOTaxime(CLAFORAN)VIAL:1GM,32002411,CDM,J0698,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,5.72,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.72,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,5.72,59.21,
P-EPHED/LORA(CLARITIN D 12HR)TAB:,32002421,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
LORATADIN(CLARITIN)TAB:10MG,32002426,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CLEMASTINE (TAVIST-1) TAB : 1.34MG,32002431,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CLEMASTINE (TAVIST) TAB : 2.68MG,32002436,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CLINDAMYCIN(CLEOCIN)VIAL:300MG/2ML,32002441,CDM,,,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
CLINDAMYCIN(CLEOCIN)VIAL:600MG/4ML,32002446,CDM,,,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
CLIDINIUM/CHLORDIAZ(LIBRAX)CAP:2.5-5MG,32002456,CDM,J8499,HCPCS,250,RC,inpatient,,71.37,71.37,,60.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.81,88,,percent of total billed charges,,,,,,,,,54.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.95,91,,percent of total billed charges,,,67.8,95,,percent of total billed charges,,,59.24,83,,percent of total billed charges,,,59.24,83,,percent of total billed charges,,,,,,,,,,,,,,,59.24,83,,percent of total billed charges,,,67.8,95,,percent of total billed charges,,,64.23,90,,percent of total billed charges,,,64.23,90,,percent of total billed charges,,,58.52,82,,percent of total billed charges,,,64.23,90,,percent of total billed charges,,,60.66,85,,percent of total billed charges,,53.81,67.8,
CLINDAMYCIN(CLEOCIN)CAP:150MG,32002461,CDM,,,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
clonazePAM(KlonoPIN)TAB:0.5MG,32002466,CDM,,,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
CLOMIPRAMINE (ANAFRANIL) CAP : 50MG,32002467,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CLONIDINE (CATAPRES) TAB : 0.3MG,32002471,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
cloNIDine(CATAPRES)TAB:0.1MG,32002476,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CLORAZEPATE (TRANXENE) TAB : 3.75MG,32002481,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
CLOTRIMAZOLE(LOTRIMIN VAG) CRM : 1% 45GM,32002486,CDM,,,250,RC,inpatient,,39.33,39.33,,33.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34.61,88,,percent of total billed charges,,,,,,,,,30.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35.79,91,,percent of total billed charges,,,37.36,95,,percent of total billed charges,,,32.64,83,,percent of total billed charges,,,32.64,83,,percent of total billed charges,,,,,,,,,,,,,,,32.64,83,,percent of total billed charges,,,37.36,95,,percent of total billed charges,,,35.4,90,,percent of total billed charges,,,35.4,90,,percent of total billed charges,,,32.25,82,,percent of total billed charges,,,35.4,90,,percent of total billed charges,,,33.43,85,,percent of total billed charges,,29.65,37.36,
COCAINE HCL SOL 4%:4ML,32002496,CDM,,,250,RC,inpatient,,2934.5,2934.5,,2491.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2212.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2494.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2582.36,88,,percent of total billed charges,,,,,,,,,2241.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2670.4,91,,percent of total billed charges,,,2787.78,95,,percent of total billed charges,,,2435.64,83,,percent of total billed charges,,,2435.64,83,,percent of total billed charges,,,,,,,,,,,,,,,2435.64,83,,percent of total billed charges,,,2787.78,95,,percent of total billed charges,,,2641.05,90,,percent of total billed charges,,,2641.05,90,,percent of total billed charges,,,2406.29,82,,percent of total billed charges,,,2641.05,90,,percent of total billed charges,,,2494.33,85,,percent of total billed charges,,2212.61,2787.78,
CODEINE SULF TAB : 15MG,32002516,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
BENZTROPINE MESYLAT(COGENTIN)AMP:2MG/2ML,32002526,CDM,J0515,HCPCS,250,RC,inpatient,,747.8,747.8,,634.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,563.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,635.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,658.06,88,,percent of total billed charges,,87.59,,,,fee schedule,,,571.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,87.59,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,680.5,91,,percent of total billed charges,,,710.41,95,,percent of total billed charges,,,620.67,83,,percent of total billed charges,,,620.67,83,,percent of total billed charges,,,,,,,,,,,,,,,620.67,83,,percent of total billed charges,,,710.41,95,,percent of total billed charges,,,673.02,90,,percent of total billed charges,,,673.02,90,,percent of total billed charges,,,613.2,82,,percent of total billed charges,,,673.02,90,,percent of total billed charges,,,635.63,85,,percent of total billed charges,,87.59,710.41,
TACRINE HCL (COGNEX) CAP : 20MG,32002531,CDM,,,250,RC,inpatient,,17.6,17.6,,14.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.49,88,,percent of total billed charges,,,,,,,,,13.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.02,91,,percent of total billed charges,,,16.72,95,,percent of total billed charges,,,14.61,83,,percent of total billed charges,,,14.61,83,,percent of total billed charges,,,,,,,,,,,,,,,14.61,83,,percent of total billed charges,,,16.72,95,,percent of total billed charges,,,15.84,90,,percent of total billed charges,,,15.84,90,,percent of total billed charges,,,14.43,82,,percent of total billed charges,,,15.84,90,,percent of total billed charges,,,14.96,85,,percent of total billed charges,,13.27,16.72,
TACRINE HCL (COGNEX) CAP : 10MG,32002536,CDM,,,250,RC,inpatient,,38.86,38.86,,32.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34.2,88,,percent of total billed charges,,,,,,,,,29.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35.36,91,,percent of total billed charges,,,36.92,95,,percent of total billed charges,,,32.25,83,,percent of total billed charges,,,32.25,83,,percent of total billed charges,,,,,,,,,,,,,,,32.25,83,,percent of total billed charges,,,36.92,95,,percent of total billed charges,,,34.97,90,,percent of total billed charges,,,34.97,90,,percent of total billed charges,,,31.87,82,,percent of total billed charges,,,34.97,90,,percent of total billed charges,,,33.03,85,,percent of total billed charges,,29.3,36.92,
TACRINE HCL (COGNEX) CAP : 40MG,32002537,CDM,,,250,RC,inpatient,,38.86,38.86,,32.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34.2,88,,percent of total billed charges,,,,,,,,,29.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35.36,91,,percent of total billed charges,,,36.92,95,,percent of total billed charges,,,32.25,83,,percent of total billed charges,,,32.25,83,,percent of total billed charges,,,,,,,,,,,,,,,32.25,83,,percent of total billed charges,,,36.92,95,,percent of total billed charges,,,34.97,90,,percent of total billed charges,,,34.97,90,,percent of total billed charges,,,31.87,82,,percent of total billed charges,,,34.97,90,,percent of total billed charges,,,33.03,85,,percent of total billed charges,,29.3,36.92,
COLCHICINE TAB:0.6MG,32002541,CDM,J8499,HCPCS,250,RC,inpatient,,63.56,63.56,,53.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.93,88,,percent of total billed charges,,,,,,,,,48.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.84,91,,percent of total billed charges,,,60.38,95,,percent of total billed charges,,,52.75,83,,percent of total billed charges,,,52.75,83,,percent of total billed charges,,,,,,,,,,,,,,,52.75,83,,percent of total billed charges,,,60.38,95,,percent of total billed charges,,,57.2,90,,percent of total billed charges,,,57.2,90,,percent of total billed charges,,,52.12,82,,percent of total billed charges,,,57.2,90,,percent of total billed charges,,,54.03,85,,percent of total billed charges,,47.92,60.38,
ALBUTEROL/IPRA(COMBIVENT)AER/MDI:,32002545,CDM,,,250,RC,inpatient,,3052.63,3052.63,,2591.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2301.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2594.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2686.31,88,,percent of total billed charges,,,,,,,,,2332.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2777.89,91,,percent of total billed charges,,,2900,95,,percent of total billed charges,,,2533.68,83,,percent of total billed charges,,,2533.68,83,,percent of total billed charges,,,,,,,,,,,,,,,2533.68,83,,percent of total billed charges,,,2900,95,,percent of total billed charges,,,2747.37,90,,percent of total billed charges,,,2747.37,90,,percent of total billed charges,,,2503.16,82,,percent of total billed charges,,,2747.37,90,,percent of total billed charges,,,2594.74,85,,percent of total billed charges,,2301.68,2900,
PROCHLORPERAZINE(COMPAZINE)SUPP:2.5MG,32002546,CDM,,,250,RC,inpatient,,37.27,37.27,,31.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.8,88,,percent of total billed charges,,,,,,,,,28.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.92,91,,percent of total billed charges,,,35.41,95,,percent of total billed charges,,,30.93,83,,percent of total billed charges,,,30.93,83,,percent of total billed charges,,,,,,,,,,,,,,,30.93,83,,percent of total billed charges,,,35.41,95,,percent of total billed charges,,,33.54,90,,percent of total billed charges,,,33.54,90,,percent of total billed charges,,,30.56,82,,percent of total billed charges,,,33.54,90,,percent of total billed charges,,,31.68,85,,percent of total billed charges,,28.1,35.41,
PROCHLORPERZ(COMPAZINE)SYP:5MG/5ML 118ML,32002551,CDM,,,250,RC,inpatient,,339.72,339.72,,288.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,256.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,288.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,298.95,88,,percent of total billed charges,,,,,,,,,259.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,309.15,91,,percent of total billed charges,,,322.73,95,,percent of total billed charges,,,281.97,83,,percent of total billed charges,,,281.97,83,,percent of total billed charges,,,,,,,,,,,,,,,281.97,83,,percent of total billed charges,,,322.73,95,,percent of total billed charges,,,305.75,90,,percent of total billed charges,,,305.75,90,,percent of total billed charges,,,278.57,82,,percent of total billed charges,,,305.75,90,,percent of total billed charges,,,288.76,85,,percent of total billed charges,,256.15,322.73,
PROCHLORPERAZINE MALEATE(COMPAZ)SUPP:5MG,32002556,CDM,,,250,RC,inpatient,,41.39,41.39,,35.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36.42,88,,percent of total billed charges,,,,,,,,,31.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37.66,91,,percent of total billed charges,,,39.32,95,,percent of total billed charges,,,34.35,83,,percent of total billed charges,,,34.35,83,,percent of total billed charges,,,,,,,,,,,,,,,34.35,83,,percent of total billed charges,,,39.32,95,,percent of total billed charges,,,37.25,90,,percent of total billed charges,,,37.25,90,,percent of total billed charges,,,33.94,82,,percent of total billed charges,,,37.25,90,,percent of total billed charges,,,35.18,85,,percent of total billed charges,,31.21,39.32,
PROCHLORPER(COMPAZINE)  SYP:5MG/5ML 60ML,32002561,CDM,,,250,RC,inpatient,,172.72,172.72,,146.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,151.99,88,,percent of total billed charges,,,,,,,,,131.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.18,91,,percent of total billed charges,,,164.08,95,,percent of total billed charges,,,143.36,83,,percent of total billed charges,,,143.36,83,,percent of total billed charges,,,,,,,,,,,,,,,143.36,83,,percent of total billed charges,,,164.08,95,,percent of total billed charges,,,155.45,90,,percent of total billed charges,,,155.45,90,,percent of total billed charges,,,141.63,82,,percent of total billed charges,,,155.45,90,,percent of total billed charges,,,146.81,85,,percent of total billed charges,,130.23,164.08,
PROCHLORPERZN(COMPAZINE)SYP:5MG/5ML 90ML,32002566,CDM,,,250,RC,inpatient,,259.15,259.15,,220.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,195.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,220.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,228.05,88,,percent of total billed charges,,,,,,,,,197.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,235.83,91,,percent of total billed charges,,,246.19,95,,percent of total billed charges,,,215.09,83,,percent of total billed charges,,,215.09,83,,percent of total billed charges,,,,,,,,,,,,,,,215.09,83,,percent of total billed charges,,,246.19,95,,percent of total billed charges,,,233.24,90,,percent of total billed charges,,,233.24,90,,percent of total billed charges,,,212.5,82,,percent of total billed charges,,,233.24,90,,percent of total billed charges,,,220.28,85,,percent of total billed charges,,195.4,246.19,
PROCHLORPERAZINE(COMPAZINE)TAB:5MG,32002571,CDM,Q0164,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,0.52,,,,fee schedule,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.52,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,0.52,12.87,
ENTACAPONE(COMTAN)TAB:200MG,32002572,CDM,,,250,RC,inpatient,,128.47,128.47,,109.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,96.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,109.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,113.05,88,,percent of total billed charges,,,,,,,,,98.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,116.91,91,,percent of total billed charges,,,122.05,95,,percent of total billed charges,,,106.63,83,,percent of total billed charges,,,106.63,83,,percent of total billed charges,,,,,,,,,,,,,,,106.63,83,,percent of total billed charges,,,122.05,95,,percent of total billed charges,,,115.62,90,,percent of total billed charges,,,115.62,90,,percent of total billed charges,,,105.35,82,,percent of total billed charges,,,115.62,90,,percent of total billed charges,,,109.2,85,,percent of total billed charges,,96.87,122.05,
LACTULOSE (CONSTULOSE) SOL : 10G/15ML,32002576,CDM,,,250,RC,inpatient,,70.74,70.74,,60.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.25,88,,percent of total billed charges,,,,,,,,,54.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.37,91,,percent of total billed charges,,,67.2,95,,percent of total billed charges,,,58.71,83,,percent of total billed charges,,,58.71,83,,percent of total billed charges,,,,,,,,,,,,,,,58.71,83,,percent of total billed charges,,,67.2,95,,percent of total billed charges,,,63.67,90,,percent of total billed charges,,,63.67,90,,percent of total billed charges,,,58.01,82,,percent of total billed charges,,,63.67,90,,percent of total billed charges,,,60.13,85,,percent of total billed charges,,53.34,67.2,
LACTULOSE (CONSTULOSE) SOL : 10G/15ML,32002581,CDM,,,250,RC,inpatient,,26.8,26.8,,22.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23.58,88,,percent of total billed charges,,,,,,,,,20.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.39,91,,percent of total billed charges,,,25.46,95,,percent of total billed charges,,,22.24,83,,percent of total billed charges,,,22.24,83,,percent of total billed charges,,,,,,,,,,,,,,,22.24,83,,percent of total billed charges,,,25.46,95,,percent of total billed charges,,,24.12,90,,percent of total billed charges,,,24.12,90,,percent of total billed charges,,,21.98,82,,percent of total billed charges,,,24.12,90,,percent of total billed charges,,,22.78,85,,percent of total billed charges,,20.21,25.46,
LACTULOSE(CHRONULAC):20GM/30ML U/D,32002582,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
AMIODARONE(CORDARONE)TAB:200MG,32002601,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
AMIODARONE(CORDARONE)VIAL:150MG/3ML,32002602,CDM,J0282,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,7.62,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.62,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,7.62,60.99,
CARVEDILOL(COREG)TAB: 3.125MG,32002612,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CARVEDILOL(COREG)TAB:12.5MG,32002613,CDM,,,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CARVEDILOL (COREG) TAB : 6.25MG,32002614,CDM,,,250,RC,inpatient,,94.68,94.68,,80.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,83.32,88,,percent of total billed charges,,,,,,,,,72.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,86.16,91,,percent of total billed charges,,,89.95,95,,percent of total billed charges,,,78.58,83,,percent of total billed charges,,,78.58,83,,percent of total billed charges,,,,,,,,,,,,,,,78.58,83,,percent of total billed charges,,,89.95,95,,percent of total billed charges,,,85.21,90,,percent of total billed charges,,,85.21,90,,percent of total billed charges,,,77.64,82,,percent of total billed charges,,,85.21,90,,percent of total billed charges,,,80.48,85,,percent of total billed charges,,71.39,89.95,
CORTISONE ACETATE TAB:25MG,32002616,CDM,J8499,HCPCS,250,RC,inpatient,,41.55,41.55,,35.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36.56,88,,percent of total billed charges,,,,,,,,,31.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37.81,91,,percent of total billed charges,,,39.47,95,,percent of total billed charges,,,34.49,83,,percent of total billed charges,,,34.49,83,,percent of total billed charges,,,,,,,,,,,,,,,34.49,83,,percent of total billed charges,,,39.47,95,,percent of total billed charges,,,37.4,90,,percent of total billed charges,,,37.4,90,,percent of total billed charges,,,34.07,82,,percent of total billed charges,,,37.4,90,,percent of total billed charges,,,35.32,85,,percent of total billed charges,,31.33,39.47,
NEOMYCIN/POLYMIXIN/HYDROCORTISONE,32002622,CDM,,,250,RC,inpatient,,89,89,,75.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,75.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,78.32,88,,percent of total billed charges,,,,,,,,,68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.99,91,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,,,,,,,,,,,,,73.87,83,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,72.98,82,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,67.11,84.55,
COSYNTROPIN(CORTROSYN)VIAL:0.25MG,32002626,CDM,J0834,HCPCS,636,RC,inpatient,,375.41,375.41,,318.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,283.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,319.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330.36,88,,percent of total billed charges,,93.17,,,,fee schedule,,,286.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,93.17,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.62,91,,percent of total billed charges,,,356.64,95,,percent of total billed charges,,,311.59,83,,percent of total billed charges,,,311.59,83,,percent of total billed charges,,,,,,,,,,,,,,,311.59,83,,percent of total billed charges,,,356.64,95,,percent of total billed charges,,,337.87,90,,percent of total billed charges,,,337.87,90,,percent of total billed charges,,,307.84,82,,percent of total billed charges,,,337.87,90,,percent of total billed charges,,,319.1,85,,percent of total billed charges,,93.17,356.64,
MENTHOL(ROBITUSSIN)LOZ:10MG,32002627,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
WARFARIN(CoumADIN)TAB: 1MG,32002631,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
WARFARIN(COUMadin)TAB: 2MG,32002636,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
WARFARIN(COUMadin)TAB: 3MG,32002637,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
WARFARIN(COUMadin)TAB: 5MG,32002641,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
WARFARIN(CouMADIN)TAB:10MG,32002646,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
WARFARIN(couMADIN)TAB:   2.5MG,32002651,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
WARFARIN(couMADIN)TAB: 7.5MG,32002656,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LOSARTAN(COZAAR)TAB:25MG,32002661,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LOSARTAN POTASSIUM (COZAAR) TAB : 50MG,32002666,CDM,,,250,RC,inpatient,,40.13,40.13,,34.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.31,88,,percent of total billed charges,,,,,,,,,30.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.52,91,,percent of total billed charges,,,38.12,95,,percent of total billed charges,,,33.31,83,,percent of total billed charges,,,33.31,83,,percent of total billed charges,,,,,,,,,,,,,,,33.31,83,,percent of total billed charges,,,38.12,95,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,32.91,82,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,34.11,85,,percent of total billed charges,,30.26,38.12,
CROMOLYN (INTAL) DROP : 4% (EYES)  10ML,32002706,CDM,,,250,RC,inpatient,,54.56,54.56,,46.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.01,88,,percent of total billed charges,,,,,,,,,41.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.65,91,,percent of total billed charges,,,51.83,95,,percent of total billed charges,,,45.28,83,,percent of total billed charges,,,45.28,83,,percent of total billed charges,,,,,,,,,,,,,,,45.28,83,,percent of total billed charges,,,51.83,95,,percent of total billed charges,,,49.1,90,,percent of total billed charges,,,49.1,90,,percent of total billed charges,,,44.74,82,,percent of total billed charges,,,49.1,90,,percent of total billed charges,,,46.38,85,,percent of total billed charges,,41.14,51.83,
CROMOLYN NA (INTAL) AMP:20MG/2ML U/D,32002711,CDM,J7631,HCPCS,250,RC,inpatient,,90.56,90.56,,76.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,76.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.69,88,,percent of total billed charges,,1.49,,,,fee schedule,,,69.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.49,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.41,91,,percent of total billed charges,,,86.03,95,,percent of total billed charges,,,75.16,83,,percent of total billed charges,,,75.16,83,,percent of total billed charges,,,,,,,,,,,,,,,75.16,83,,percent of total billed charges,,,86.03,95,,percent of total billed charges,,,81.5,90,,percent of total billed charges,,,81.5,90,,percent of total billed charges,,,74.26,82,,percent of total billed charges,,,81.5,90,,percent of total billed charges,,,76.98,85,,percent of total billed charges,,1.49,86.03,
SODTHIO/SOD NIT/AMY NIT(CYANIDE ANTIDT):,32002726,CDM,,,250,RC,inpatient,,2826.54,2826.54,,2399.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2131.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2402.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2487.36,88,,percent of total billed charges,,,,,,,,,2159.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2572.15,91,,percent of total billed charges,,,2685.21,95,,percent of total billed charges,,,2346.03,83,,percent of total billed charges,,,2346.03,83,,percent of total billed charges,,,,,,,,,,,,,,,2346.03,83,,percent of total billed charges,,,2685.21,95,,percent of total billed charges,,,2543.89,90,,percent of total billed charges,,,2543.89,90,,percent of total billed charges,,,2317.76,82,,percent of total billed charges,,,2543.89,90,,percent of total billed charges,,,2402.56,85,,percent of total billed charges,,2131.21,2685.21,
CYANOCOBALAMINE (VITAMIN B12) VL:1000MCG,32002731,CDM,J3420,HCPCS,636,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,1.95,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.95,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,1.95,60.99,
CYCLOPENTOLATE(CYCLOGYL)DROP 1%:15ML,32002736,CDM,J3490,HCPCS,250,RC,inpatient,,68.2,68.2,,57.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.02,88,,percent of total billed charges,,,,,,,,,52.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.06,91,,percent of total billed charges,,,64.79,95,,percent of total billed charges,,,56.61,83,,percent of total billed charges,,,56.61,83,,percent of total billed charges,,,,,,,,,,,,,,,56.61,83,,percent of total billed charges,,,64.79,95,,percent of total billed charges,,,61.38,90,,percent of total billed charges,,,61.38,90,,percent of total billed charges,,,55.92,82,,percent of total billed charges,,,61.38,90,,percent of total billed charges,,,57.97,85,,percent of total billed charges,,51.42,64.79,
CYCLOPENTOLATE (CYCLOGYL) DROP:1%   5ML,32002741,CDM,,,250,RC,inpatient,,777.46,777.46,,660.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,586.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,660.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,684.16,88,,percent of total billed charges,,,,,,,,,593.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,707.49,91,,percent of total billed charges,,,738.59,95,,percent of total billed charges,,,645.29,83,,percent of total billed charges,,,645.29,83,,percent of total billed charges,,,,,,,,,,,,,,,645.29,83,,percent of total billed charges,,,738.59,95,,percent of total billed charges,,,699.71,90,,percent of total billed charges,,,699.71,90,,percent of total billed charges,,,637.52,82,,percent of total billed charges,,,699.71,90,,percent of total billed charges,,,660.84,85,,percent of total billed charges,,586.2,738.59,
CYCLOBENZAPRINE(FLEXERIL)TAB:10MG,32002746,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
medroxyPRO(PROVERA)TAB:2.5MG,32002747,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CYCLOBENZAPRINE(FLEXERIL) TAB:10MG (1x6),32002748,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PHENYL/CYCL(CYCLOMYDRYL)DROP 1%-0.2%:2ML,32002751,CDM,,,250,RC,inpatient,,479.61,479.61,,407.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,361.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,407.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,422.06,88,,percent of total billed charges,,,,,,,,,366.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,436.45,91,,percent of total billed charges,,,455.63,95,,percent of total billed charges,,,398.08,83,,percent of total billed charges,,,398.08,83,,percent of total billed charges,,,,,,,,,,,,,,,398.08,83,,percent of total billed charges,,,455.63,95,,percent of total billed charges,,,431.65,90,,percent of total billed charges,,,431.65,90,,percent of total billed charges,,,393.28,82,,percent of total billed charges,,,431.65,90,,percent of total billed charges,,,407.67,85,,percent of total billed charges,,361.63,455.63,
CYPROHEPTADINE(PERIACTIN)TAB:4MG,32002756,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CYCLOPHOSPHAMIDE (CYTOXAN) TAB : 50MG,32002761,CDM,,,250,RC,inpatient,,68.2,68.2,,57.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.02,88,,percent of total billed charges,,,,,,,,,52.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.06,91,,percent of total billed charges,,,64.79,95,,percent of total billed charges,,,56.61,83,,percent of total billed charges,,,56.61,83,,percent of total billed charges,,,,,,,,,,,,,,,56.61,83,,percent of total billed charges,,,64.79,95,,percent of total billed charges,,,61.38,90,,percent of total billed charges,,,61.38,90,,percent of total billed charges,,,55.92,82,,percent of total billed charges,,,61.38,90,,percent of total billed charges,,,57.97,85,,percent of total billed charges,,51.42,64.79,
MISOPROSTOL (CYTOTEC) TAB : 200MCG,32002766,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CYCLOPHOSPHAMIDE(CYTOXAN)VIAL:1GM,32002771,CDM,J9070,HCPCS,636,RC,inpatient,,3191.78,3191.78,,2709.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2406.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2713.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2808.77,88,,percent of total billed charges,,1315.38,,,,fee schedule,,,2438.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1315.38,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2904.52,91,,percent of total billed charges,,,3032.19,95,,percent of total billed charges,,,2649.18,83,,percent of total billed charges,,,2649.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2649.18,83,,percent of total billed charges,,,3032.19,95,,percent of total billed charges,,,2872.6,90,,percent of total billed charges,,,2872.6,90,,percent of total billed charges,,,2617.26,82,,percent of total billed charges,,,2872.6,90,,percent of total billed charges,,,2713.01,85,,percent of total billed charges,,1315.38,3032.19,
MISOPROSTOL(CYTOTEC)TAB:100MCG,32002776,CDM,J8499,HCPCS,250,RC,inpatient,,70.1,70.1,,59.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,59.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,61.69,88,,percent of total billed charges,,,,,,,,,53.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,63.79,91,,percent of total billed charges,,,66.6,95,,percent of total billed charges,,,58.18,83,,percent of total billed charges,,,58.18,83,,percent of total billed charges,,,,,,,,,,,,,,,58.18,83,,percent of total billed charges,,,66.6,95,,percent of total billed charges,,,63.09,90,,percent of total billed charges,,,63.09,90,,percent of total billed charges,,,57.48,82,,percent of total billed charges,,,63.09,90,,percent of total billed charges,,,59.59,85,,percent of total billed charges,,52.86,66.6,
MULTIVITAMINS LIQ  240 ML,32002778,CDM,,,250,RC,inpatient,,64.39,64.39,,54.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.66,88,,percent of total billed charges,,,,,,,,,49.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.59,91,,percent of total billed charges,,,61.17,95,,percent of total billed charges,,,53.44,83,,percent of total billed charges,,,53.44,83,,percent of total billed charges,,,,,,,,,,,,,,,53.44,83,,percent of total billed charges,,,61.17,95,,percent of total billed charges,,,57.95,90,,percent of total billed charges,,,57.95,90,,percent of total billed charges,,,52.8,82,,percent of total billed charges,,,57.95,90,,percent of total billed charges,,,54.73,85,,percent of total billed charges,,48.55,61.17,
DANTROLENE(DANTRIUM IV)VIAL:20MG,32002786,CDM,J3490,HCPCS,250,RC,inpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,613.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,691.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,613.19,772.59,
PROPOXY/APAP(DN-100)TAB:100-650MG(1x8),32002790,CDM,,,250,RC,inpatient,,23.47,23.47,,19.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.65,88,,percent of total billed charges,,,,,,,,,17.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.36,91,,percent of total billed charges,,,22.3,95,,percent of total billed charges,,,19.48,83,,percent of total billed charges,,,19.48,83,,percent of total billed charges,,,,,,,,,,,,,,,19.48,83,,percent of total billed charges,,,22.3,95,,percent of total billed charges,,,21.12,90,,percent of total billed charges,,,21.12,90,,percent of total billed charges,,,19.25,82,,percent of total billed charges,,,21.12,90,,percent of total billed charges,,,19.95,85,,percent of total billed charges,,17.7,22.3,
PROPOXY/APAP(DARVOCET N)TAB:100-650MG,32002792,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
PROPOXYPHENE(DARVON)CAP:65MG,32002796,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
PENCICLOVIR(DENAVIR)CREAM 1%:1.5GM,32002802,CDM,,,250,RC,inpatient,,1356.1,1356.1,,1151.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1022.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1152.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1193.37,88,,percent of total billed charges,,,,,,,,,1036.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1234.05,91,,percent of total billed charges,,,1288.3,95,,percent of total billed charges,,,1125.56,83,,percent of total billed charges,,,1125.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1125.56,83,,percent of total billed charges,,,1288.3,95,,percent of total billed charges,,,1220.49,90,,percent of total billed charges,,,1220.49,90,,percent of total billed charges,,,1112,82,,percent of total billed charges,,,1220.49,90,,percent of total billed charges,,,1152.69,85,,percent of total billed charges,,1022.5,1288.3,
SODIUM HYPOCHLOR DAKINS)LIQ:0.25%480ML,32002803,CDM,,,250,RC,inpatient,,157.33,157.33,,133.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,118.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,133.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,138.45,88,,percent of total billed charges,,,,,,,,,120.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,143.17,91,,percent of total billed charges,,,149.46,95,,percent of total billed charges,,,130.58,83,,percent of total billed charges,,,130.58,83,,percent of total billed charges,,,,,,,,,,,,,,,130.58,83,,percent of total billed charges,,,149.46,95,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,129.01,82,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,133.73,85,,percent of total billed charges,,118.63,149.46,
OXAPROZIN(DAYPRO)TAB:600MG,32002806,CDM,,,250,RC,inpatient,,47.58,47.58,,40.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.87,88,,percent of total billed charges,,,,,,,,,36.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.3,91,,percent of total billed charges,,,45.2,95,,percent of total billed charges,,,39.49,83,,percent of total billed charges,,,39.49,83,,percent of total billed charges,,,,,,,,,,,,,,,39.49,83,,percent of total billed charges,,,45.2,95,,percent of total billed charges,,,42.82,90,,percent of total billed charges,,,42.82,90,,percent of total billed charges,,,39.02,82,,percent of total billed charges,,,42.82,90,,percent of total billed charges,,,40.44,85,,percent of total billed charges,,35.88,45.2,
DESMOPRESSIN ACETATE(DDAVP)INJ:4MCG/ML,32002807,CDM,J2597,HCPCS,250,RC,inpatient,,503.6,503.6,,427.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,379.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,428.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,443.17,88,,percent of total billed charges,,30.44,,,,fee schedule,,,384.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,30.44,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,458.28,91,,percent of total billed charges,,,478.42,95,,percent of total billed charges,,,417.99,83,,percent of total billed charges,,,417.99,83,,percent of total billed charges,,,,,,,,,,,,,,,417.99,83,,percent of total billed charges,,,478.42,95,,percent of total billed charges,,,453.24,90,,percent of total billed charges,,,453.24,90,,percent of total billed charges,,,412.95,82,,percent of total billed charges,,,453.24,90,,percent of total billed charges,,,428.06,85,,percent of total billed charges,,30.44,478.42,
PSEUDOEPHED(SUDAFED)SYRP:30MG/5ML(118ML),32002831,CDM,J8499,HCPCS,250,RC,inpatient,,32.51,32.51,,27.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28.61,88,,percent of total billed charges,,,,,,,,,24.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29.58,91,,percent of total billed charges,,,30.88,95,,percent of total billed charges,,,26.98,83,,percent of total billed charges,,,26.98,83,,percent of total billed charges,,,,,,,,,,,,,,,26.98,83,,percent of total billed charges,,,30.88,95,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,26.66,82,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,27.63,85,,percent of total billed charges,,24.51,30.88,
DEMECLOCYCLIN (DECLOMYCIN)TAB:300MG,32002842,CDM,,,250,RC,inpatient,,191.11,191.11,,162.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.18,88,,percent of total billed charges,,,,,,,,,146.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,173.91,91,,percent of total billed charges,,,181.55,95,,percent of total billed charges,,,158.62,83,,percent of total billed charges,,,158.62,83,,percent of total billed charges,,,,,,,,,,,,,,,158.62,83,,percent of total billed charges,,,181.55,95,,percent of total billed charges,,,172,90,,percent of total billed charges,,,172,90,,percent of total billed charges,,,156.71,82,,percent of total billed charges,,,172,90,,percent of total billed charges,,,162.44,85,,percent of total billed charges,,144.1,181.55,
DEXTROM POLIS(DELSYM)SUS:30MG/5ML(120ML),32002861,CDM,,,250,RC,inpatient,,100.87,100.87,,85.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88.77,88,,percent of total billed charges,,,,,,,,,77.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91.79,91,,percent of total billed charges,,,95.83,95,,percent of total billed charges,,,83.72,83,,percent of total billed charges,,,83.72,83,,percent of total billed charges,,,,,,,,,,,,,,,83.72,83,,percent of total billed charges,,,95.83,95,,percent of total billed charges,,,90.78,90,,percent of total billed charges,,,90.78,90,,percent of total billed charges,,,82.71,82,,percent of total billed charges,,,90.78,90,,percent of total billed charges,,,85.74,85,,percent of total billed charges,,76.06,95.83,
TORSEMIDE (DEMEDEX) TAB : 20MG,32002862,CDM,,,250,RC,inpatient,,18.71,18.71,,15.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16.46,88,,percent of total billed charges,,,,,,,,,14.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.03,91,,percent of total billed charges,,,17.77,95,,percent of total billed charges,,,15.53,83,,percent of total billed charges,,,15.53,83,,percent of total billed charges,,,,,,,,,,,,,,,15.53,83,,percent of total billed charges,,,17.77,95,,percent of total billed charges,,,16.84,90,,percent of total billed charges,,,16.84,90,,percent of total billed charges,,,15.34,82,,percent of total billed charges,,,16.84,90,,percent of total billed charges,,,15.9,85,,percent of total billed charges,,14.11,17.77,
TORSEMIDE(DEMADEX)TAB:10MG,32002863,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DIVaLproex(DEPAkote DR)TAB:250MG,32002896,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DIVALPROEX (DEPAKOTE DR) TAB : 125MG,32002897,CDM,,,250,RC,inpatient,,15.86,15.86,,13.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.96,88,,percent of total billed charges,,,,,,,,,12.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.43,91,,percent of total billed charges,,,15.07,95,,percent of total billed charges,,,13.16,83,,percent of total billed charges,,,13.16,83,,percent of total billed charges,,,,,,,,,,,,,,,13.16,83,,percent of total billed charges,,,15.07,95,,percent of total billed charges,,,14.27,90,,percent of total billed charges,,,14.27,90,,percent of total billed charges,,,13.01,82,,percent of total billed charges,,,14.27,90,,percent of total billed charges,,,13.48,85,,percent of total billed charges,,11.96,15.07,
medroxyPRO(DEPOPROVERA)*IM*VIAL:150MG/ML,32002906,CDM,J1050,HCPCS,250,RC,inpatient,,352.62,352.62,,299.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,265.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,299.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,310.31,88,,percent of total billed charges,,165.1,,,,fee schedule,,,269.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,165.1,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,320.88,91,,percent of total billed charges,,,334.99,95,,percent of total billed charges,,,292.67,83,,percent of total billed charges,,,292.67,83,,percent of total billed charges,,,,,,,,,,,,,,,292.67,83,,percent of total billed charges,,,334.99,95,,percent of total billed charges,,,317.36,90,,percent of total billed charges,,,317.36,90,,percent of total billed charges,,,289.15,82,,percent of total billed charges,,,317.36,90,,percent of total billed charges,,,299.73,85,,percent of total billed charges,,165.1,334.99,
methylPRED(DEPO-MEDROL)*IM* VIAL:40MG/ML,32002911,CDM,J1030,HCPCS,250,RC,inpatient,,151.15,151.15,,128.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,113.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,128.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.01,88,,percent of total billed charges,,29.81,,,,fee schedule,,,115.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,29.81,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,137.55,91,,percent of total billed charges,,,143.59,95,,percent of total billed charges,,,125.45,83,,percent of total billed charges,,,125.45,83,,percent of total billed charges,,,,,,,,,,,,,,,125.45,83,,percent of total billed charges,,,143.59,95,,percent of total billed charges,,,136.04,90,,percent of total billed charges,,,136.04,90,,percent of total billed charges,,,123.94,82,,percent of total billed charges,,,136.04,90,,percent of total billed charges,,,128.48,85,,percent of total billed charges,,29.81,143.59,
BENZOCAI/LANOLIN(DERMOPLAST)AER20%:85G,32002916,CDM,J3490,HCPCS,250,RC,inpatient,,83.5,83.5,,70.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.48,88,,percent of total billed charges,,,,,,,,,63.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.99,91,,percent of total billed charges,,,79.33,95,,percent of total billed charges,,,69.31,83,,percent of total billed charges,,,69.31,83,,percent of total billed charges,,,,,,,,,,,,,,,69.31,83,,percent of total billed charges,,,79.33,95,,percent of total billed charges,,,75.15,90,,percent of total billed charges,,,75.15,90,,percent of total billed charges,,,68.47,82,,percent of total billed charges,,,75.15,90,,percent of total billed charges,,,70.98,85,,percent of total billed charges,,62.96,79.33,
DEFEROXAMINE MESYLT (DESFERAL)VIAL:500MG,32002921,CDM,J0895,HCPCS,636,RC,inpatient,,195.99,195.99,,166.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,166.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,172.47,88,,percent of total billed charges,,31.71,,,,fee schedule,,,149.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,31.71,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,178.35,91,,percent of total billed charges,,,186.19,95,,percent of total billed charges,,,162.67,83,,percent of total billed charges,,,162.67,83,,percent of total billed charges,,,,,,,,,,,,,,,162.67,83,,percent of total billed charges,,,186.19,95,,percent of total billed charges,,,176.39,90,,percent of total billed charges,,,176.39,90,,percent of total billed charges,,,160.71,82,,percent of total billed charges,,,176.39,90,,percent of total billed charges,,,166.59,85,,percent of total billed charges,,31.71,186.19,
DESIPRAMINE(NORPRAMINE)TAB:50MG,32002926,CDM,,,250,RC,inpatient,,45.68,45.68,,38.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.2,88,,percent of total billed charges,,,,,,,,,34.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.57,91,,percent of total billed charges,,,43.4,95,,percent of total billed charges,,,37.91,83,,percent of total billed charges,,,37.91,83,,percent of total billed charges,,,,,,,,,,,,,,,37.91,83,,percent of total billed charges,,,43.4,95,,percent of total billed charges,,,41.11,90,,percent of total billed charges,,,41.11,90,,percent of total billed charges,,,37.46,82,,percent of total billed charges,,,41.11,90,,percent of total billed charges,,,38.83,85,,percent of total billed charges,,34.44,43.4,
DESONIDE 0.05%,32002947,CDM,,,250,RC,inpatient,,37,37,,31.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.56,88,,percent of total billed charges,,,,,,,,,28.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,30.34,82,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,27.9,35.15,
DESMOPRESSIN ACETATE(DDAVP)SPR:0.1MG/ML,32002948,CDM,,,250,RC,inpatient,,2780.2,2780.2,,2360.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2096.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2363.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2446.58,88,,percent of total billed charges,,,,,,,,,2124.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2529.98,91,,percent of total billed charges,,,2641.19,95,,percent of total billed charges,,,2307.57,83,,percent of total billed charges,,,2307.57,83,,percent of total billed charges,,,,,,,,,,,,,,,2307.57,83,,percent of total billed charges,,,2641.19,95,,percent of total billed charges,,,2502.18,90,,percent of total billed charges,,,2502.18,90,,percent of total billed charges,,,2279.76,82,,percent of total billed charges,,,2502.18,90,,percent of total billed charges,,,2363.17,85,,percent of total billed charges,,2096.27,2641.19,
DESOXIMETASONE CREAM (TOPICORT) : 0.25%,32002956,CDM,,,250,RC,inpatient,,683.72,683.72,,580.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,515.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,581.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,601.67,88,,percent of total billed charges,,,,,,,,,522.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,622.19,91,,percent of total billed charges,,,649.53,95,,percent of total billed charges,,,567.49,83,,percent of total billed charges,,,567.49,83,,percent of total billed charges,,,,,,,,,,,,,,,567.49,83,,percent of total billed charges,,,649.53,95,,percent of total billed charges,,,615.35,90,,percent of total billed charges,,,615.35,90,,percent of total billed charges,,,560.65,82,,percent of total billed charges,,,615.35,90,,percent of total billed charges,,,581.16,85,,percent of total billed charges,,515.52,649.53,
TOLTERODINE TARTRATE (DETROL) TAB : 1MG,32002957,CDM,,,250,RC,inpatient,,100.55,100.55,,85.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88.48,88,,percent of total billed charges,,,,,,,,,76.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91.5,91,,percent of total billed charges,,,95.52,95,,percent of total billed charges,,,83.46,83,,percent of total billed charges,,,83.46,83,,percent of total billed charges,,,,,,,,,,,,,,,83.46,83,,percent of total billed charges,,,95.52,95,,percent of total billed charges,,,90.5,90,,percent of total billed charges,,,90.5,90,,percent of total billed charges,,,82.45,82,,percent of total billed charges,,,90.5,90,,percent of total billed charges,,,85.47,85,,percent of total billed charges,,75.81,95.52,
TOLTERODINE (DETROL) TAB : 2MG,32002958,CDM,,,250,RC,inpatient,,103.25,103.25,,87.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.86,88,,percent of total billed charges,,,,,,,,,78.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.96,91,,percent of total billed charges,,,98.09,95,,percent of total billed charges,,,85.7,83,,percent of total billed charges,,,85.7,83,,percent of total billed charges,,,,,,,,,,,,,,,85.7,83,,percent of total billed charges,,,98.09,95,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,84.67,82,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,87.76,85,,percent of total billed charges,,77.85,98.09,
DEXAMETHASONE(DECADRON)TAB:4MG,32002961,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DEXAMETHASONE TAB (DECADRON): 0.5MG,32002966,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
DEXAMETHASONE VIAL **PF**:10MG/ML,32002972,CDM,J1100,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,5,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,5,60.99,
DEXAMETHASONE(DECADRON)VIAL:4MG/ML  **,32002981,CDM,J1100,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,5,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,5,60.99,
DEXAMETHASONE (DECADRON) TAB : 0.75MG,32002986,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
DEXAMETHASONE (DECADRON) TAB : 2MG,32002993,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
DEXEDRINE 5MG TABLETS,32002997,CDM,,,250,RC,inpatient,,1,1,,0.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,0.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,0.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,0.88,88,,percent of total billed charges,,,,,,,,,0.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,0.91,91,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,,,,,,,,,,,,,0.83,83,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.82,82,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.85,85,,percent of total billed charges,,0.75,0.95,
DEXTROSE 50%-WATER SYR:50ML,32003001,CDM,J3490,HCPCS,250,RC,inpatient,,225.33,225.33,,191.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,169.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,191.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198.29,88,,percent of total billed charges,,,,,,,,,172.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,205.05,91,,percent of total billed charges,,,214.06,95,,percent of total billed charges,,,187.02,83,,percent of total billed charges,,,187.02,83,,percent of total billed charges,,,,,,,,,,,,,,,187.02,83,,percent of total billed charges,,,214.06,95,,percent of total billed charges,,,202.8,90,,percent of total billed charges,,,202.8,90,,percent of total billed charges,,,184.77,82,,percent of total billed charges,,,202.8,90,,percent of total billed charges,,,191.53,85,,percent of total billed charges,,169.9,214.06,
DIHYDROERGOTAMINE(DHE)AMP:1MG/ML,32003006,CDM,J1110,HCPCS,636,RC,inpatient,,939.04,939.04,,797.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,708.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,798.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,826.36,88,,percent of total billed charges,,174.3,,,,fee schedule,,,717.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,174.3,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,854.53,91,,percent of total billed charges,,,892.09,95,,percent of total billed charges,,,779.4,83,,percent of total billed charges,,,779.4,83,,percent of total billed charges,,,,,,,,,,,,,,,779.4,83,,percent of total billed charges,,,892.09,95,,percent of total billed charges,,,845.14,90,,percent of total billed charges,,,845.14,90,,percent of total billed charges,,,770.01,82,,percent of total billed charges,,,845.14,90,,percent of total billed charges,,,798.18,85,,percent of total billed charges,,174.3,892.09,
ACETAZOLAMIDE (DIAMOX) TAB : 250MG,32003021,CDM,J8499,HCPCS,250,RC,inpatient,,18.3,18.3,,15.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16.1,88,,percent of total billed charges,,,,,,,,,13.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.65,91,,percent of total billed charges,,,17.39,95,,percent of total billed charges,,,15.19,83,,percent of total billed charges,,,15.19,83,,percent of total billed charges,,,,,,,,,,,,,,,15.19,83,,percent of total billed charges,,,17.39,95,,percent of total billed charges,,,16.47,90,,percent of total billed charges,,,16.47,90,,percent of total billed charges,,,15.01,82,,percent of total billed charges,,,16.47,90,,percent of total billed charges,,,15.56,85,,percent of total billed charges,,13.8,17.39,
acetaZOLAMIDE(DIAMOX SEQUEL)ER CAP:500MG,32003022,CDM,J8499,HCPCS,250,RC,inpatient,,70.26,70.26,,59.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,59.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,61.83,88,,percent of total billed charges,,,,,,,,,53.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,63.94,91,,percent of total billed charges,,,66.75,95,,percent of total billed charges,,,58.32,83,,percent of total billed charges,,,58.32,83,,percent of total billed charges,,,,,,,,,,,,,,,58.32,83,,percent of total billed charges,,,66.75,95,,percent of total billed charges,,,63.23,90,,percent of total billed charges,,,63.23,90,,percent of total billed charges,,,57.61,82,,percent of total billed charges,,,63.23,90,,percent of total billed charges,,,59.72,85,,percent of total billed charges,,52.98,66.75,
acetaZOLAMIDE(DIAMOX)VIAL:500MG,32003026,CDM,J1120,HCPCS,250,RC,inpatient,,222.39,222.39,,188.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,167.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,195.7,88,,percent of total billed charges,,22.49,,,,fee schedule,,,169.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,22.49,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,202.37,91,,percent of total billed charges,,,211.27,95,,percent of total billed charges,,,184.58,83,,percent of total billed charges,,,184.58,83,,percent of total billed charges,,,,,,,,,,,,,,,184.58,83,,percent of total billed charges,,,211.27,95,,percent of total billed charges,,,200.15,90,,percent of total billed charges,,,200.15,90,,percent of total billed charges,,,182.36,82,,percent of total billed charges,,,200.15,90,,percent of total billed charges,,,189.03,85,,percent of total billed charges,,22.49,211.27,
COD LIVR/ZNOX(DIAPER RSH)OINT 40%:120GM,32003031,CDM,,,250,RC,inpatient,,31.56,31.56,,26.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.77,88,,percent of total billed charges,,,,,,,,,24.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.72,91,,percent of total billed charges,,,29.98,95,,percent of total billed charges,,,26.19,83,,percent of total billed charges,,,26.19,83,,percent of total billed charges,,,,,,,,,,,,,,,26.19,83,,percent of total billed charges,,,29.98,95,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,25.88,82,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,26.83,85,,percent of total billed charges,,23.8,29.98,
DIAZEPAM(VALIUM)SYR:10MG/2ML,32003036,CDM,J3360,HCPCS,250,RC,inpatient,,433.5,433.5,,368.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,326.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,368.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,381.48,88,,percent of total billed charges,,26.31,,,,fee schedule,,,331.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,26.31,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,394.49,91,,percent of total billed charges,,,411.83,95,,percent of total billed charges,,,359.81,83,,percent of total billed charges,,,359.81,83,,percent of total billed charges,,,,,,,,,,,,,,,359.81,83,,percent of total billed charges,,,411.83,95,,percent of total billed charges,,,390.15,90,,percent of total billed charges,,,390.15,90,,percent of total billed charges,,,355.47,82,,percent of total billed charges,,,390.15,90,,percent of total billed charges,,,368.48,85,,percent of total billed charges,,26.31,411.83,
DIAZEPAM(VALIUM)TAB:2MG,32003041,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
DIAZEPAM(VALIUM)TAB:5MG,32003046,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
DIBUCAINE (NUPERCAINAL) OINT : 1% 30 GM,32003056,CDM,,,250,RC,inpatient,,51.07,51.07,,43.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.94,88,,percent of total billed charges,,,,,,,,,39.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.47,91,,percent of total billed charges,,,48.52,95,,percent of total billed charges,,,42.39,83,,percent of total billed charges,,,42.39,83,,percent of total billed charges,,,,,,,,,,,,,,,42.39,83,,percent of total billed charges,,,48.52,95,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,41.88,82,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,43.41,85,,percent of total billed charges,,38.51,48.52,
DICLOXACILLIN(DYNAPEN)CAP:250MG,32003061,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
DICYCLOMINE(BENTYL)AMP:20MG/2ML,32003066,CDM,J0500,HCPCS,250,RC,inpatient,,622.23,622.23,,528.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,469.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,528.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,547.56,88,,percent of total billed charges,,25.64,,,,fee schedule,,,475.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,25.64,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,566.23,91,,percent of total billed charges,,,591.12,95,,percent of total billed charges,,,516.45,83,,percent of total billed charges,,,516.45,83,,percent of total billed charges,,,,,,,,,,,,,,,516.45,83,,percent of total billed charges,,,591.12,95,,percent of total billed charges,,,560.01,90,,percent of total billed charges,,,560.01,90,,percent of total billed charges,,,510.23,82,,percent of total billed charges,,,560.01,90,,percent of total billed charges,,,528.9,85,,percent of total billed charges,,25.64,591.12,
ETIDRONATE DISODIUM (DIDRONEL) TAB:200MG,32003071,CDM,,,250,RC,inpatient,,56.46,56.46,,47.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.68,88,,percent of total billed charges,,,,,,,,,43.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.38,91,,percent of total billed charges,,,53.64,95,,percent of total billed charges,,,46.86,83,,percent of total billed charges,,,46.86,83,,percent of total billed charges,,,,,,,,,,,,,,,46.86,83,,percent of total billed charges,,,53.64,95,,percent of total billed charges,,,50.81,90,,percent of total billed charges,,,50.81,90,,percent of total billed charges,,,46.3,82,,percent of total billed charges,,,50.81,90,,percent of total billed charges,,,47.99,85,,percent of total billed charges,,42.57,53.64,
DIETHYLSTILBESTROL (DES),32003076,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
FLUCONAZOLE(DIFLUCAN)TAB:100MG,32003081,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DIFLUNISAL(DOLOBID)TAB:500MG,32003086,CDM,J8499,HCPCS,250,RC,inpatient,,14.27,14.27,,12.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.56,88,,percent of total billed charges,,,,,,,,,10.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.99,91,,percent of total billed charges,,,13.56,95,,percent of total billed charges,,,11.84,83,,percent of total billed charges,,,11.84,83,,percent of total billed charges,,,,,,,,,,,,,,,11.84,83,,percent of total billed charges,,,13.56,95,,percent of total billed charges,,,12.84,90,,percent of total billed charges,,,12.84,90,,percent of total billed charges,,,11.7,82,,percent of total billed charges,,,12.84,90,,percent of total billed charges,,,12.13,85,,percent of total billed charges,,10.76,13.56,
DIGOXIN IMMUNE FAB(DIGIFAB)VIAL:40MG,32003091,CDM,J1162,HCPCS,636,RC,inpatient,,18397.26,18397.26,,15619.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13871.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15637.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16189.59,88,,percent of total billed charges,,85881.64,,,,fee schedule,,,14055.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,85881.64,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16741.51,91,,percent of total billed charges,,,17477.4,95,,percent of total billed charges,,,15269.73,83,,percent of total billed charges,,,15269.73,83,,percent of total billed charges,,,,,,,,,,,,,,,15269.73,83,,percent of total billed charges,,,17477.4,95,,percent of total billed charges,,,16557.53,90,,percent of total billed charges,,,16557.53,90,,percent of total billed charges,,,15085.75,82,,percent of total billed charges,,,16557.53,90,,percent of total billed charges,,,15637.67,85,,percent of total billed charges,,13871.53,85881.64,
DIGOXIN ELIX(LANOXIN):50MCG/ML (60ML),32003096,CDM,J8499,HCPCS,250,RC,inpatient,,1688.62,1688.62,,1433.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1273.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1435.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1485.99,88,,percent of total billed charges,,,,,,,,,1290.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1536.64,91,,percent of total billed charges,,,1604.19,95,,percent of total billed charges,,,1401.55,83,,percent of total billed charges,,,1401.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1401.55,83,,percent of total billed charges,,,1604.19,95,,percent of total billed charges,,,1519.76,90,,percent of total billed charges,,,1519.76,90,,percent of total billed charges,,,1384.67,82,,percent of total billed charges,,,1519.76,90,,percent of total billed charges,,,1435.33,85,,percent of total billed charges,,1273.22,1604.19,
guaiFENesin/PEPH(ROBTUSSN DAC)SYRP:120ML,32003101,CDM,,,250,RC,inpatient,,25.5,25.5,,21.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.44,88,,percent of total billed charges,,,,,,,,,19.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.21,91,,percent of total billed charges,,,24.23,95,,percent of total billed charges,,,21.17,83,,percent of total billed charges,,,21.17,83,,percent of total billed charges,,,,,,,,,,,,,,,21.17,83,,percent of total billed charges,,,24.23,95,,percent of total billed charges,,,22.95,90,,percent of total billed charges,,,22.95,90,,percent of total billed charges,,,20.91,82,,percent of total billed charges,,,22.95,90,,percent of total billed charges,,,21.68,85,,percent of total billed charges,,19.23,24.23,
GUAIFN/PEPH(ROBITUSSIN DAC) SYRP:  90ML,32003106,CDM,,,250,RC,inpatient,,666.12,666.12,,565.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,502.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,566.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,586.19,88,,percent of total billed charges,,,,,,,,,508.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,606.17,91,,percent of total billed charges,,,632.81,95,,percent of total billed charges,,,552.88,83,,percent of total billed charges,,,552.88,83,,percent of total billed charges,,,,,,,,,,,,,,,552.88,83,,percent of total billed charges,,,632.81,95,,percent of total billed charges,,,599.51,90,,percent of total billed charges,,,599.51,90,,percent of total billed charges,,,546.22,82,,percent of total billed charges,,,599.51,90,,percent of total billed charges,,,566.2,85,,percent of total billed charges,,502.25,632.81,
GUAIFN/PEPH(ROBITUSSIN DAC) SYRP:   60ML,32003111,CDM,,,250,RC,inpatient,,12.75,12.75,,10.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.22,88,,percent of total billed charges,,,,,,,,,9.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.6,91,,percent of total billed charges,,,12.11,95,,percent of total billed charges,,,10.58,83,,percent of total billed charges,,,10.58,83,,percent of total billed charges,,,,,,,,,,,,,,,10.58,83,,percent of total billed charges,,,12.11,95,,percent of total billed charges,,,11.48,90,,percent of total billed charges,,,11.48,90,,percent of total billed charges,,,10.46,82,,percent of total billed charges,,,11.48,90,,percent of total billed charges,,,10.84,85,,percent of total billed charges,,9.61,12.11,
PHENYTOIN(DILANTIN)ORAL : 125MG/5ML 60ML,32003116,CDM,,,250,RC,inpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,34.68,43.7,
PHENYTOIN(DILANTIN)ORAL:125MG/5ML(237ML),32003121,CDM,J8499,HCPCS,250,RC,inpatient,,454.23,454.23,,385.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,342.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,386.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,399.72,88,,percent of total billed charges,,,,,,,,,347.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,413.35,91,,percent of total billed charges,,,431.52,95,,percent of total billed charges,,,377.01,83,,percent of total billed charges,,,377.01,83,,percent of total billed charges,,,,,,,,,,,,,,,377.01,83,,percent of total billed charges,,,431.52,95,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,372.47,82,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,386.1,85,,percent of total billed charges,,342.49,431.52,
PHENYTOIN(DILANTIN) ER CAP:100MG,32003126,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
VALSARTN/HCTZ (DIOVAN)TAB: 160-12.5MG,32003152,CDM,,,250,RC,inpatient,,63.28,63.28,,53.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,53.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.69,88,,percent of total billed charges,,,,,,,,,48.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.58,91,,percent of total billed charges,,,60.12,95,,percent of total billed charges,,,52.52,83,,percent of total billed charges,,,52.52,83,,percent of total billed charges,,,,,,,,,,,,,,,52.52,83,,percent of total billed charges,,,60.12,95,,percent of total billed charges,,,56.95,90,,percent of total billed charges,,,56.95,90,,percent of total billed charges,,,51.89,82,,percent of total billed charges,,,56.95,90,,percent of total billed charges,,,53.79,85,,percent of total billed charges,,47.71,60.12,
PHENYTOIN(DILANTIN) IR CHEW TAB:50MG,32003156,CDM,J8499,HCPCS,250,RC,inpatient,,16.97,16.97,,14.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.93,88,,percent of total billed charges,,,,,,,,,12.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.44,91,,percent of total billed charges,,,16.12,95,,percent of total billed charges,,,14.09,83,,percent of total billed charges,,,14.09,83,,percent of total billed charges,,,,,,,,,,,,,,,14.09,83,,percent of total billed charges,,,16.12,95,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,13.92,82,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,14.42,85,,percent of total billed charges,,12.8,16.12,
DILTIAZEM HCL SR CAP : 60MG,32003166,CDM,,,250,RC,inpatient,,43.14,43.14,,36.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37.96,88,,percent of total billed charges,,,,,,,,,32.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,39.26,91,,percent of total billed charges,,,40.98,95,,percent of total billed charges,,,35.81,83,,percent of total billed charges,,,35.81,83,,percent of total billed charges,,,,,,,,,,,,,,,35.81,83,,percent of total billed charges,,,40.98,95,,percent of total billed charges,,,38.83,90,,percent of total billed charges,,,38.83,90,,percent of total billed charges,,,35.37,82,,percent of total billed charges,,,38.83,90,,percent of total billed charges,,,36.67,85,,percent of total billed charges,,32.53,40.98,
DILTIAZEM(CARDIZEM)TAB:30MG,32003171,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DILTIAZEM (CARDIZEM) TAB : 60MG,32003176,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PPA HCL/BROMPHENIR(DIMETAPP)ELIX:118ML,32003186,CDM,,,250,RC,inpatient,,14.27,14.27,,12.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.56,88,,percent of total billed charges,,,,,,,,,10.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.99,91,,percent of total billed charges,,,13.56,95,,percent of total billed charges,,,11.84,83,,percent of total billed charges,,,11.84,83,,percent of total billed charges,,,,,,,,,,,,,,,11.84,83,,percent of total billed charges,,,13.56,95,,percent of total billed charges,,,12.84,90,,percent of total billed charges,,,12.84,90,,percent of total billed charges,,,11.7,82,,percent of total billed charges,,,12.84,90,,percent of total billed charges,,,12.13,85,,percent of total billed charges,,10.76,13.56,
PPA HCL/BROMPHENIRAMIN(DIMETAPP)ELIX60ML,32003191,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PPA HCL/BROMPHENIRA(DIMETAPP) ELIX 90ML,32003196,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CASANTHRAN/DOCU(DIOCTO-C)SYRP:30-60MG/15,32003201,CDM,,,250,RC,inpatient,,53.29,53.29,,45.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46.9,88,,percent of total billed charges,,,,,,,,,40.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,48.49,91,,percent of total billed charges,,,50.63,95,,percent of total billed charges,,,44.23,83,,percent of total billed charges,,,44.23,83,,percent of total billed charges,,,,,,,,,,,,,,,44.23,83,,percent of total billed charges,,,50.63,95,,percent of total billed charges,,,47.96,90,,percent of total billed charges,,,47.96,90,,percent of total billed charges,,,43.7,82,,percent of total billed charges,,,47.96,90,,percent of total billed charges,,,45.3,85,,percent of total billed charges,,40.18,50.63,
CASANTHRAN/DOCU(DIOCTO-C)SYRP:30-60MG/15,32003206,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CASANTHRAN/DOCU(DIOCTO-C)SYRP:30-60MG/15,32003211,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
DOCUSATE (COLACE) SYRP : 60MG/15ML 480ML,32003216,CDM,,,250,RC,inpatient,,240.91,240.91,,204.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,181.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,212,88,,percent of total billed charges,,,,,,,,,184.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,219.23,91,,percent of total billed charges,,,228.86,95,,percent of total billed charges,,,199.96,83,,percent of total billed charges,,,199.96,83,,percent of total billed charges,,,,,,,,,,,,,,,199.96,83,,percent of total billed charges,,,228.86,95,,percent of total billed charges,,,216.82,90,,percent of total billed charges,,,216.82,90,,percent of total billed charges,,,197.55,82,,percent of total billed charges,,,216.82,90,,percent of total billed charges,,,204.77,85,,percent of total billed charges,,181.65,228.86,
DOCUSATE (COLACE) SYRP : 60MG/15ML 90ML,32003221,CDM,,,250,RC,inpatient,,45.84,45.84,,38.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.34,88,,percent of total billed charges,,,,,,,,,35.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.71,91,,percent of total billed charges,,,43.55,95,,percent of total billed charges,,,38.05,83,,percent of total billed charges,,,38.05,83,,percent of total billed charges,,,,,,,,,,,,,,,38.05,83,,percent of total billed charges,,,43.55,95,,percent of total billed charges,,,41.26,90,,percent of total billed charges,,,41.26,90,,percent of total billed charges,,,37.59,82,,percent of total billed charges,,,41.26,90,,percent of total billed charges,,,38.96,85,,percent of total billed charges,,34.56,43.55,
DOCUSATE(COLACE)SYRP:60MG/15ML (60ML),32003226,CDM,J8499,HCPCS,250,RC,inpatient,,31.54,31.54,,26.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.76,88,,percent of total billed charges,,,,,,,,,24.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.7,91,,percent of total billed charges,,,29.96,95,,percent of total billed charges,,,26.18,83,,percent of total billed charges,,,26.18,83,,percent of total billed charges,,,,,,,,,,,,,,,26.18,83,,percent of total billed charges,,,29.96,95,,percent of total billed charges,,,28.39,90,,percent of total billed charges,,,28.39,90,,percent of total billed charges,,,25.86,82,,percent of total billed charges,,,28.39,90,,percent of total billed charges,,,26.81,85,,percent of total billed charges,,23.78,29.96,
VALSARTAN(DIOVAN)TAB:80MG,32003227,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
diphenhydrAMINE(BENADRYL)CAP:25MG,32003231,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DIPHENHYD (BENADRYL) TAB: 25MG (1x10),32003232,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
OLSALAZINE SODIUM (DIPENTUM) CAP : 250MG,32003236,CDM,,,250,RC,inpatient,,29.18,29.18,,24.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.68,88,,percent of total billed charges,,,,,,,,,22.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.55,91,,percent of total billed charges,,,27.72,95,,percent of total billed charges,,,24.22,83,,percent of total billed charges,,,24.22,83,,percent of total billed charges,,,,,,,,,,,,,,,24.22,83,,percent of total billed charges,,,27.72,95,,percent of total billed charges,,,26.26,90,,percent of total billed charges,,,26.26,90,,percent of total billed charges,,,23.93,82,,percent of total billed charges,,,26.26,90,,percent of total billed charges,,,24.8,85,,percent of total billed charges,,22,27.72,
DIPHENOXY/ATROP(LOMOTIL)TAB:2.5-.025MG,32003241,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
DIPHENHYDRAMINE (BENADRYL) CAP : 50MG,32003251,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
TETANUS DIPHTHERA TOXOID PED SYR:5-10LFU,32003261,CDM,90723,CPT,636,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
TETANUS DIPHTH VIAL:6-2LFU MDV 0.5ML,32003262,CDM,,,250,RC,inpatient,,124.75,124.75,,105.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,94.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,106.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.78,88,,percent of total billed charges,,,,,,,,,95.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,113.52,91,,percent of total billed charges,,,118.51,95,,percent of total billed charges,,,103.54,83,,percent of total billed charges,,,103.54,83,,percent of total billed charges,,,,,,,,,,,,,,,103.54,83,,percent of total billed charges,,,118.51,95,,percent of total billed charges,,,112.28,90,,percent of total billed charges,,,112.28,90,,percent of total billed charges,,,102.3,82,,percent of total billed charges,,,112.28,90,,percent of total billed charges,,,106.04,85,,percent of total billed charges,,94.06,118.51,
DIPHENOX/ATR(LOMOTIL)LIQ:2.5MG/5ML(60ML),32003266,CDM,J8499,HCPCS,250,RC,inpatient,,846.59,846.59,,718.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,638.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,719.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,745,88,,percent of total billed charges,,,,,,,,,646.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,770.4,91,,percent of total billed charges,,,804.26,95,,percent of total billed charges,,,702.67,83,,percent of total billed charges,,,702.67,83,,percent of total billed charges,,,,,,,,,,,,,,,702.67,83,,percent of total billed charges,,,804.26,95,,percent of total billed charges,,,761.93,90,,percent of total billed charges,,,761.93,90,,percent of total billed charges,,,694.2,82,,percent of total billed charges,,,761.93,90,,percent of total billed charges,,,719.6,85,,percent of total billed charges,,638.33,804.26,
DIPHENHYDR(BENADRYL)VL PX:50MG/ML,32003271,CDM,J1200,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,2.34,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.34,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,2.34,60.99,
TETANUS DIPHTHERIA PED VIAL:,32003276,CDM,90702,CPT,250,RC,inpatient,,1411.2,1411.2,,1198.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1064.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1199.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1241.86,88,,percent of total billed charges,,,,,,,,,1078.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1284.19,91,,percent of total billed charges,,,1340.64,95,,percent of total billed charges,,,1171.3,83,,percent of total billed charges,,,1171.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1171.3,83,,percent of total billed charges,,,1340.64,95,,percent of total billed charges,,,1270.08,90,,percent of total billed charges,,,1270.08,90,,percent of total billed charges,,,1157.18,82,,percent of total billed charges,,,1270.08,90,,percent of total billed charges,,,1199.52,85,,percent of total billed charges,,1064.04,1340.64,
DIPHENHYD(BENADRYL)LIQ:12.5MG/5ML(120ML),32003281,CDM,,,250,RC,inpatient,,35.21,35.21,,29.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.98,88,,percent of total billed charges,,,,,,,,,26.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.04,91,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,,,,,,,,,,,,,29.22,83,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,28.87,82,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,29.93,85,,percent of total billed charges,,26.55,33.45,
DIPIVEFRIN (PROPINE) DROP : 0.1% 5 ML,32003286,CDM,,,250,RC,inpatient,,49.96,49.96,,42.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,43.96,88,,percent of total billed charges,,,,,,,,,38.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.46,91,,percent of total billed charges,,,47.46,95,,percent of total billed charges,,,41.47,83,,percent of total billed charges,,,41.47,83,,percent of total billed charges,,,,,,,,,,,,,,,41.47,83,,percent of total billed charges,,,47.46,95,,percent of total billed charges,,,44.96,90,,percent of total billed charges,,,44.96,90,,percent of total billed charges,,,40.97,82,,percent of total billed charges,,,44.96,90,,percent of total billed charges,,,42.47,85,,percent of total billed charges,,37.67,47.46,
PROPOFOL(DIPRIVAN)VL:200MG/20ML  BRAND,32003296,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
BETAMETHASONE DIPROP GEL 0.05%:15ML,32003301,CDM,J3490,HCPCS,250,RC,inpatient,,380.32,380.32,,322.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,286.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,323.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,334.68,88,,percent of total billed charges,,,,,,,,,290.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,346.09,91,,percent of total billed charges,,,361.3,95,,percent of total billed charges,,,315.67,83,,percent of total billed charges,,,315.67,83,,percent of total billed charges,,,,,,,,,,,,,,,315.67,83,,percent of total billed charges,,,361.3,95,,percent of total billed charges,,,342.29,90,,percent of total billed charges,,,342.29,90,,percent of total billed charges,,,311.86,82,,percent of total billed charges,,,342.29,90,,percent of total billed charges,,,323.27,85,,percent of total billed charges,,286.76,361.3,
DIPYRIDAMOLE(PERSANTINE)TAB:25MG,32003306,CDM,J8499,HCPCS,636,RC,inpatient,,24.67,24.67,,20.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.71,88,,percent of total billed charges,,,,,,,,,18.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.45,91,,percent of total billed charges,,,23.44,95,,percent of total billed charges,,,20.48,83,,percent of total billed charges,,,20.48,83,,percent of total billed charges,,,,,,,,,,,,,,,20.48,83,,percent of total billed charges,,,23.44,95,,percent of total billed charges,,,22.2,90,,percent of total billed charges,,,22.2,90,,percent of total billed charges,,,20.23,82,,percent of total billed charges,,,22.2,90,,percent of total billed charges,,,20.97,85,,percent of total billed charges,,18.6,23.44,
DIPYRIDAMOLE TAB (PERSANTINE) : 50MG,32003311,CDM,,,636,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
DIPYRIDAMOLE TAB (PERSANTINE) : 75MG,32003316,CDM,,,636,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
DISOPYRAMIDE PHOSP(NORPACE)CAP : 100MG,32003321,CDM,,,250,RC,inpatient,,33.15,33.15,,28.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.17,88,,percent of total billed charges,,,,,,,,,25.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.17,91,,percent of total billed charges,,,31.49,95,,percent of total billed charges,,,27.51,83,,percent of total billed charges,,,27.51,83,,percent of total billed charges,,,,,,,,,,,,,,,27.51,83,,percent of total billed charges,,,31.49,95,,percent of total billed charges,,,29.84,90,,percent of total billed charges,,,29.84,90,,percent of total billed charges,,,27.18,82,,percent of total billed charges,,,29.84,90,,percent of total billed charges,,,28.18,85,,percent of total billed charges,,25,31.49,
OXYBUTYNIN(DITROPAN XL)TAB:5MG,32003327,CDM,J8499,HCPCS,250,RC,inpatient,,37.42,37.42,,31.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.93,88,,percent of total billed charges,,,,,,,,,28.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.05,91,,percent of total billed charges,,,35.55,95,,percent of total billed charges,,,31.06,83,,percent of total billed charges,,,31.06,83,,percent of total billed charges,,,,,,,,,,,,,,,31.06,83,,percent of total billed charges,,,35.55,95,,percent of total billed charges,,,33.68,90,,percent of total billed charges,,,33.68,90,,percent of total billed charges,,,30.68,82,,percent of total billed charges,,,33.68,90,,percent of total billed charges,,,31.81,85,,percent of total billed charges,,28.21,35.55,
OXYBUTYNIN CHLORIDE (DITROPAN XL) :15MG,32003328,CDM,,,250,RC,inpatient,,58.68,58.68,,49.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.64,88,,percent of total billed charges,,,,,,,,,44.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.4,91,,percent of total billed charges,,,55.75,95,,percent of total billed charges,,,48.7,83,,percent of total billed charges,,,48.7,83,,percent of total billed charges,,,,,,,,,,,,,,,48.7,83,,percent of total billed charges,,,55.75,95,,percent of total billed charges,,,52.81,90,,percent of total billed charges,,,52.81,90,,percent of total billed charges,,,48.12,82,,percent of total billed charges,,,52.81,90,,percent of total billed charges,,,49.88,85,,percent of total billed charges,,44.24,55.75,
METOLAZONE(ZAROXOLYN)TAB:5MG,32003331,CDM,J8499,HCPCS,250,RC,inpatient,,43.95,43.95,,37.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.68,88,,percent of total billed charges,,,,,,,,,33.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,39.99,91,,percent of total billed charges,,,41.75,95,,percent of total billed charges,,,36.48,83,,percent of total billed charges,,,36.48,83,,percent of total billed charges,,,,,,,,,,,,,,,36.48,83,,percent of total billed charges,,,41.75,95,,percent of total billed charges,,,39.56,90,,percent of total billed charges,,,39.56,90,,percent of total billed charges,,,36.04,82,,percent of total billed charges,,,39.56,90,,percent of total billed charges,,,37.36,85,,percent of total billed charges,,33.14,41.75,
METOLAZONE (ZAROXOLYN) TAB : 2.5MG,32003336,CDM,,,250,RC,inpatient,,25.22,25.22,,21.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.19,88,,percent of total billed charges,,,,,,,,,19.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.95,91,,percent of total billed charges,,,23.96,95,,percent of total billed charges,,,20.93,83,,percent of total billed charges,,,20.93,83,,percent of total billed charges,,,,,,,,,,,,,,,20.93,83,,percent of total billed charges,,,23.96,95,,percent of total billed charges,,,22.7,90,,percent of total billed charges,,,22.7,90,,percent of total billed charges,,,20.68,82,,percent of total billed charges,,,22.7,90,,percent of total billed charges,,,21.44,85,,percent of total billed charges,,19.02,23.96,
DOBUTamine IV:250MG/20ML,32003351,CDM,J1250,HCPCS,250,RC,inpatient,,88.34,88.34,,75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,75.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.74,88,,percent of total billed charges,,13.07,,,,fee schedule,,,67.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.07,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.39,91,,percent of total billed charges,,,83.92,95,,percent of total billed charges,,,73.32,83,,percent of total billed charges,,,73.32,83,,percent of total billed charges,,,,,,,,,,,,,,,73.32,83,,percent of total billed charges,,,83.92,95,,percent of total billed charges,,,79.51,90,,percent of total billed charges,,,79.51,90,,percent of total billed charges,,,72.44,82,,percent of total billed charges,,,79.51,90,,percent of total billed charges,,,75.09,85,,percent of total billed charges,,13.07,83.92,
Docusate CALCIUM(SURFAK)CAP:240MG,32003356,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CASANTHRANOL/DOCUSATE SODM CAP:30-100MG,32003361,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
Docusate SODIUM(COLACE)CAP:100MG,32003366,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
BELLADONN ALKA/PB (DONNATAL) TAB: 16.2MG,32003381,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
DOPamine VIAL:200MG/5ML,32003406,CDM,J1265,HCPCS,636,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,7.14,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.14,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,7.14,59.21,
doXEPIN (sineQUAN) CAP : 50MG,32003416,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
DOXEpin(SINEquan)CAP:25MG,32003421,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
doXEPIN (sineQUAN) CAP : 10MG,32003426,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
DOXEPIN HCL CAP : 75MG,32003431,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
DOXYCYCLINE(VIBRAMYCIN)VIAL:100MG,32003441,CDM,J3490,HCPCS,250,RC,inpatient,,336.11,336.11,,285.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,253.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,285.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,295.78,88,,percent of total billed charges,,,,,,,,,256.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,305.86,91,,percent of total billed charges,,,319.3,95,,percent of total billed charges,,,278.97,83,,percent of total billed charges,,,278.97,83,,percent of total billed charges,,,,,,,,,,,,,,,278.97,83,,percent of total billed charges,,,319.3,95,,percent of total billed charges,,,302.5,90,,percent of total billed charges,,,302.5,90,,percent of total billed charges,,,275.61,82,,percent of total billed charges,,,302.5,90,,percent of total billed charges,,,285.69,85,,percent of total billed charges,,253.43,319.3,
DOXYCYCLINE(VBM)CAP:100MG,32003446,CDM,J8499,HCPCS,250,RC,inpatient,,20.92,20.92,,17.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.41,88,,percent of total billed charges,,,,,,,,,15.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.04,91,,percent of total billed charges,,,19.87,95,,percent of total billed charges,,,17.36,83,,percent of total billed charges,,,17.36,83,,percent of total billed charges,,,,,,,,,,,,,,,17.36,83,,percent of total billed charges,,,19.87,95,,percent of total billed charges,,,18.83,90,,percent of total billed charges,,,18.83,90,,percent of total billed charges,,,17.15,82,,percent of total billed charges,,,18.83,90,,percent of total billed charges,,,17.78,85,,percent of total billed charges,,15.77,19.87,
DOXYCYCLINE(VBM)TAB:100MG(1x4),32003447,CDM,,,250,RC,inpatient,,26.96,26.96,,22.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23.72,88,,percent of total billed charges,,,,,,,,,20.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.53,91,,percent of total billed charges,,,25.61,95,,percent of total billed charges,,,22.38,83,,percent of total billed charges,,,22.38,83,,percent of total billed charges,,,,,,,,,,,,,,,22.38,83,,percent of total billed charges,,,25.61,95,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,22.11,82,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,22.92,85,,percent of total billed charges,,20.33,25.61,
IV HETASTARCH/NS(hesPAN) 500ML,32003451,CDM,J3490,HCPCS,250,RC,inpatient,,232.82,232.82,,197.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,175.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,197.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,204.88,88,,percent of total billed charges,,,,,,,,,177.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,211.87,91,,percent of total billed charges,,,221.18,95,,percent of total billed charges,,,193.24,83,,percent of total billed charges,,,193.24,83,,percent of total billed charges,,,,,,,,,,,,,,,193.24,83,,percent of total billed charges,,,221.18,95,,percent of total billed charges,,,209.54,90,,percent of total billed charges,,,209.54,90,,percent of total billed charges,,,190.91,82,,percent of total billed charges,,,209.54,90,,percent of total billed charges,,,197.9,85,,percent of total billed charges,,175.55,221.18,
fentaNYL PATCH(DURAGESIC): 25MCG/HR,32003476,CDM,,,250,RC,inpatient,,54.74,54.74,,46.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.17,88,,percent of total billed charges,,,,,,,,,41.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.81,91,,percent of total billed charges,,,52,95,,percent of total billed charges,,,45.43,83,,percent of total billed charges,,,45.43,83,,percent of total billed charges,,,,,,,,,,,,,,,45.43,83,,percent of total billed charges,,,52,95,,percent of total billed charges,,,49.27,90,,percent of total billed charges,,,49.27,90,,percent of total billed charges,,,44.89,82,,percent of total billed charges,,,49.27,90,,percent of total billed charges,,,46.53,85,,percent of total billed charges,,41.27,52,
fentaNYL PATCH(DURAGESIC):100MCG/HR,32003481,CDM,,,250,RC,inpatient,,154.58,154.58,,131.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,131.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,136.03,88,,percent of total billed charges,,,,,,,,,118.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.67,91,,percent of total billed charges,,,146.85,95,,percent of total billed charges,,,128.3,83,,percent of total billed charges,,,128.3,83,,percent of total billed charges,,,,,,,,,,,,,,,128.3,83,,percent of total billed charges,,,146.85,95,,percent of total billed charges,,,139.12,90,,percent of total billed charges,,,139.12,90,,percent of total billed charges,,,126.76,82,,percent of total billed charges,,,139.12,90,,percent of total billed charges,,,131.39,85,,percent of total billed charges,,116.55,146.85,
fentaNYL PATCH(DURAGESIC):  50MCG/HR,32003486,CDM,,,250,RC,inpatient,,72.06,72.06,,61.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,54.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,61.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,63.41,88,,percent of total billed charges,,,,,,,,,55.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,65.57,91,,percent of total billed charges,,,68.46,95,,percent of total billed charges,,,59.81,83,,percent of total billed charges,,,59.81,83,,percent of total billed charges,,,,,,,,,,,,,,,59.81,83,,percent of total billed charges,,,68.46,95,,percent of total billed charges,,,64.85,90,,percent of total billed charges,,,64.85,90,,percent of total billed charges,,,59.09,82,,percent of total billed charges,,,64.85,90,,percent of total billed charges,,,61.25,85,,percent of total billed charges,,54.33,68.46,
GUAIFENE/P-EPHED(MUCINEX D)TB:1200-120MG,32003491,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
fentaNYL PATCH(DURAGESIC): 75MCG/HR,32003496,CDM,,,250,RC,inpatient,,111.6,111.6,,94.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.21,88,,percent of total billed charges,,,,,,,,,85.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.56,91,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,,,,,,,,,,,,,92.63,83,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,91.51,82,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,84.15,106.02,
CEFADROXIL(DURICEF)SUS:250MG/5ML(100ML),32003497,CDM,,,250,RC,inpatient,,489.12,489.12,,415.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,368.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,415.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,430.43,88,,percent of total billed charges,,,,,,,,,373.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,445.1,91,,percent of total billed charges,,,464.66,95,,percent of total billed charges,,,405.97,83,,percent of total billed charges,,,405.97,83,,percent of total billed charges,,,,,,,,,,,,,,,405.97,83,,percent of total billed charges,,,464.66,95,,percent of total billed charges,,,440.21,90,,percent of total billed charges,,,440.21,90,,percent of total billed charges,,,401.08,82,,percent of total billed charges,,,440.21,90,,percent of total billed charges,,,415.75,85,,percent of total billed charges,,368.8,464.66,
TRIAMTERENE/HCTZ(DYAZIDE)CAP:37.5-25MG,32003501,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DYNAPEN SUSPENSION 100 ML 62.5 ML\5ML,32003507,CDM,,,250,RC,inpatient,,32,32,,27.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28.16,88,,percent of total billed charges,,,,,,,,,24.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,,,,,,,,,,,,,26.56,83,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,26.24,82,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,24.13,30.4,
ISRADIPINE (DYNACIRC) CAP : 2.5MG,32003516,CDM,,,250,RC,inpatient,,20.3,20.3,,17.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.86,88,,percent of total billed charges,,,,,,,,,15.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.47,91,,percent of total billed charges,,,19.29,95,,percent of total billed charges,,,16.85,83,,percent of total billed charges,,,16.85,83,,percent of total billed charges,,,,,,,,,,,,,,,16.85,83,,percent of total billed charges,,,19.29,95,,percent of total billed charges,,,18.27,90,,percent of total billed charges,,,18.27,90,,percent of total billed charges,,,16.65,82,,percent of total billed charges,,,18.27,90,,percent of total billed charges,,,17.26,85,,percent of total billed charges,,15.31,19.29,
ISRADIPINE (DYNACIRC) CAP : 5MG,32003521,CDM,,,250,RC,inpatient,,29.66,29.66,,25.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.1,88,,percent of total billed charges,,,,,,,,,22.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.99,91,,percent of total billed charges,,,28.18,95,,percent of total billed charges,,,24.62,83,,percent of total billed charges,,,24.62,83,,percent of total billed charges,,,,,,,,,,,,,,,24.62,83,,percent of total billed charges,,,28.18,95,,percent of total billed charges,,,26.69,90,,percent of total billed charges,,,26.69,90,,percent of total billed charges,,,24.32,82,,percent of total billed charges,,,26.69,90,,percent of total billed charges,,,25.21,85,,percent of total billed charges,,22.36,28.18,
CARBAMIDE PEROX (DEBROX EAR)DROPS 6.50%:,32003531,CDM,J3490,HCPCS,250,RC,inpatient,,24.02,24.02,,20.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.14,88,,percent of total billed charges,,,,,,,,,18.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.86,91,,percent of total billed charges,,,22.82,95,,percent of total billed charges,,,19.94,83,,percent of total billed charges,,,19.94,83,,percent of total billed charges,,,,,,,,,,,,,,,19.94,83,,percent of total billed charges,,,22.82,95,,percent of total billed charges,,,21.62,90,,percent of total billed charges,,,21.62,90,,percent of total billed charges,,,19.7,82,,percent of total billed charges,,,21.62,90,,percent of total billed charges,,,20.42,85,,percent of total billed charges,,18.11,22.82,
PREDNISOLONE (PRED-FORTE) DROP : 1% 5ML,32003532,CDM,,,250,RC,inpatient,,66.75,66.75,,56.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.74,88,,percent of total billed charges,,,,,,,,,51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.74,91,,percent of total billed charges,,,63.41,95,,percent of total billed charges,,,55.4,83,,percent of total billed charges,,,55.4,83,,percent of total billed charges,,,,,,,,,,,,,,,55.4,83,,percent of total billed charges,,,63.41,95,,percent of total billed charges,,,60.08,90,,percent of total billed charges,,,60.08,90,,percent of total billed charges,,,54.74,82,,percent of total billed charges,,,60.08,90,,percent of total billed charges,,,56.74,85,,percent of total billed charges,,50.33,63.41,
prednisoLONE(PRED-FORTE)DROP 1%:5ML,32003536,CDM,J7599,HCPCS,250,RC,inpatient,,600.78,600.78,,510.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,452.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,510.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,528.69,88,,percent of total billed charges,,,,,,,,,459,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,546.71,91,,percent of total billed charges,,,570.74,95,,percent of total billed charges,,,498.65,83,,percent of total billed charges,,,498.65,83,,percent of total billed charges,,,,,,,,,,,,,,,498.65,83,,percent of total billed charges,,,570.74,95,,percent of total billed charges,,,540.7,90,,percent of total billed charges,,,540.7,90,,percent of total billed charges,,,492.64,82,,percent of total billed charges,,,540.7,90,,percent of total billed charges,,,510.66,85,,percent of total billed charges,,452.99,570.74,
ETHACRYNIC ACID(EDECRINTAB:25MG,32003541,CDM,,,250,RC,inpatient,,39.49,39.49,,33.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34.75,88,,percent of total billed charges,,,,,,,,,30.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35.94,91,,percent of total billed charges,,,37.52,95,,percent of total billed charges,,,32.78,83,,percent of total billed charges,,,32.78,83,,percent of total billed charges,,,,,,,,,,,,,,,32.78,83,,percent of total billed charges,,,37.52,95,,percent of total billed charges,,,35.54,90,,percent of total billed charges,,,35.54,90,,percent of total billed charges,,,32.38,82,,percent of total billed charges,,,35.54,90,,percent of total billed charges,,,33.57,85,,percent of total billed charges,,29.78,37.52,
ERYTHROMYCIN ETHYLSU (EES)ORAL:200MG/5ML,32003551,CDM,,,250,RC,inpatient,,66.77,66.77,,56.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.76,88,,percent of total billed charges,,,,,,,,,51.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.76,91,,percent of total billed charges,,,63.43,95,,percent of total billed charges,,,55.42,83,,percent of total billed charges,,,55.42,83,,percent of total billed charges,,,,,,,,,,,,,,,55.42,83,,percent of total billed charges,,,63.43,95,,percent of total billed charges,,,60.09,90,,percent of total billed charges,,,60.09,90,,percent of total billed charges,,,54.75,82,,percent of total billed charges,,,60.09,90,,percent of total billed charges,,,56.75,85,,percent of total billed charges,,50.34,63.43,
ERYTHROMYCIN ETHYLSU (EES)TAB : 400MG,32003556,CDM,,,250,RC,inpatient,,34.89,34.89,,29.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.7,88,,percent of total billed charges,,,,,,,,,26.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31.75,91,,percent of total billed charges,,,33.15,95,,percent of total billed charges,,,28.96,83,,percent of total billed charges,,,28.96,83,,percent of total billed charges,,,,,,,,,,,,,,,28.96,83,,percent of total billed charges,,,33.15,95,,percent of total billed charges,,,31.4,90,,percent of total billed charges,,,31.4,90,,percent of total billed charges,,,28.61,82,,percent of total billed charges,,,31.4,90,,percent of total billed charges,,,29.66,85,,percent of total billed charges,,26.31,33.15,
VENLAFAXINE(EFFEXOR)TAB:37.5MG,32003561,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
EFFEXOR XR 37.5MG,32003562,CDM,,,250,RC,inpatient,,7.5,7.5,,6.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6.6,88,,percent of total billed charges,,,,,,,,,5.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6.83,91,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,,,,,,,,,,,,,6.23,83,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.15,82,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,5.66,7.13,
VENLAFAXINE HCL (EFFEXOR XR) CAP : 75MG,32003563,CDM,,,250,RC,inpatient,,234.41,234.41,,199.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,176.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,199.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,206.28,88,,percent of total billed charges,,,,,,,,,179.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,213.31,91,,percent of total billed charges,,,222.69,95,,percent of total billed charges,,,194.56,83,,percent of total billed charges,,,194.56,83,,percent of total billed charges,,,,,,,,,,,,,,,194.56,83,,percent of total billed charges,,,222.69,95,,percent of total billed charges,,,210.97,90,,percent of total billed charges,,,210.97,90,,percent of total billed charges,,,192.22,82,,percent of total billed charges,,,210.97,90,,percent of total billed charges,,,199.25,85,,percent of total billed charges,,176.75,222.69,
VENLAFAXINE (EFFEXOR XR) CAP : 150MG,32003564,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DENTURE CLEANSER (EFFERDENT) TAB,32003566,CDM,,,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
POVIDONE-IODINE (BETADINE) PAC : 10% PKG,32003576,CDM,,,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
FLUOROURACIL(EFUDEX)CREAM 5%:40GM,32003581,CDM,,,250,RC,inpatient,,1308.79,1308.79,,1111.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,986.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1112.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1151.74,88,,percent of total billed charges,,,,,,,,,999.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1191,91,,percent of total billed charges,,,1243.35,95,,percent of total billed charges,,,1086.3,83,,percent of total billed charges,,,1086.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1086.3,83,,percent of total billed charges,,,1243.35,95,,percent of total billed charges,,,1177.91,90,,percent of total billed charges,,,1177.91,90,,percent of total billed charges,,,1073.21,82,,percent of total billed charges,,,1177.91,90,,percent of total billed charges,,,1112.47,85,,percent of total billed charges,,986.83,1243.35,
PERMETHRIN(ELIMITE)CREAM 5%:60GM,32003611,CDM,J3490,HCPCS,250,RC,inpatient,,367,367,,311.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,276.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,311.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,322.96,88,,percent of total billed charges,,,,,,,,,280.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,333.97,91,,percent of total billed charges,,,348.65,95,,percent of total billed charges,,,304.61,83,,percent of total billed charges,,,304.61,83,,percent of total billed charges,,,,,,,,,,,,,,,304.61,83,,percent of total billed charges,,,348.65,95,,percent of total billed charges,,,330.3,90,,percent of total billed charges,,,330.3,90,,percent of total billed charges,,,300.94,82,,percent of total billed charges,,,330.3,90,,percent of total billed charges,,,311.95,85,,percent of total billed charges,,276.72,348.65,
MOMETASONE (ELOCON) LOT : 0.1%   30ML,32003616,CDM,,,250,RC,inpatient,,838.25,838.25,,711.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,632.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,712.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,737.66,88,,percent of total billed charges,,,,,,,,,640.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,762.81,91,,percent of total billed charges,,,796.34,95,,percent of total billed charges,,,695.75,83,,percent of total billed charges,,,695.75,83,,percent of total billed charges,,,,,,,,,,,,,,,695.75,83,,percent of total billed charges,,,796.34,95,,percent of total billed charges,,,754.43,90,,percent of total billed charges,,,754.43,90,,percent of total billed charges,,,687.37,82,,percent of total billed charges,,,754.43,90,,percent of total billed charges,,,712.51,85,,percent of total billed charges,,632.04,796.34,
MOMETASONE (ELOCON) OINT : 0.1%  45GM,32003621,CDM,,,250,RC,inpatient,,1505.01,1505.01,,1277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1134.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1279.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1324.41,88,,percent of total billed charges,,,,,,,,,1149.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1369.56,91,,percent of total billed charges,,,1429.76,95,,percent of total billed charges,,,1249.16,83,,percent of total billed charges,,,1249.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1249.16,83,,percent of total billed charges,,,1429.76,95,,percent of total billed charges,,,1354.51,90,,percent of total billed charges,,,1354.51,90,,percent of total billed charges,,,1234.11,82,,percent of total billed charges,,,1354.51,90,,percent of total billed charges,,,1279.26,85,,percent of total billed charges,,1134.78,1429.76,
LIDOCAI/PRILOCA(EMLA)CR 2.5%-2.5%:5GM,32003622,CDM,J3490,HCPCS,250,RC,inpatient,,138.4,138.4,,117.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.79,88,,percent of total billed charges,,,,,,,,,105.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.94,91,,percent of total billed charges,,,131.48,95,,percent of total billed charges,,,114.87,83,,percent of total billed charges,,,114.87,83,,percent of total billed charges,,,,,,,,,,,,,,,114.87,83,,percent of total billed charges,,,131.48,95,,percent of total billed charges,,,124.56,90,,percent of total billed charges,,,124.56,90,,percent of total billed charges,,,113.49,82,,percent of total billed charges,,,124.56,90,,percent of total billed charges,,,117.64,85,,percent of total billed charges,,104.35,131.48,
PHOS AC DIL/DEXT/FRUCT(KALMZ) SOL  125ML,32003626,CDM,,,250,RC,inpatient,,41.71,41.71,,35.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36.7,88,,percent of total billed charges,,,,,,,,,31.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37.96,91,,percent of total billed charges,,,39.62,95,,percent of total billed charges,,,34.62,83,,percent of total billed charges,,,34.62,83,,percent of total billed charges,,,,,,,,,,,,,,,34.62,83,,percent of total billed charges,,,39.62,95,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,34.2,82,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,35.45,85,,percent of total billed charges,,31.45,39.62,
ENGERIX-B 20MCG (ADULT),32003632,CDM,,,250,RC,inpatient,,706.81,706.81,,600.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,532.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,600.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,621.99,88,,percent of total billed charges,,,,,,,,,540,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,643.2,91,,percent of total billed charges,,,671.47,95,,percent of total billed charges,,,586.65,83,,percent of total billed charges,,,586.65,83,,percent of total billed charges,,,,,,,,,,,,,,,586.65,83,,percent of total billed charges,,,671.47,95,,percent of total billed charges,,,636.13,90,,percent of total billed charges,,,636.13,90,,percent of total billed charges,,,579.58,82,,percent of total billed charges,,,636.13,90,,percent of total billed charges,,,600.79,85,,percent of total billed charges,,532.93,671.47,
EDROPHONIUM CHLORIDE (ENLON)VIAL:10MG/ML,32003656,CDM,,,250,RC,inpatient,,143.22,143.22,,121.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,107.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,121.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.03,88,,percent of total billed charges,,,,,,,,,109.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,130.33,91,,percent of total billed charges,,,136.06,95,,percent of total billed charges,,,118.87,83,,percent of total billed charges,,,118.87,83,,percent of total billed charges,,,,,,,,,,,,,,,118.87,83,,percent of total billed charges,,,136.06,95,,percent of total billed charges,,,128.9,90,,percent of total billed charges,,,128.9,90,,percent of total billed charges,,,117.44,82,,percent of total billed charges,,,128.9,90,,percent of total billed charges,,,121.74,85,,percent of total billed charges,,107.99,136.06,
ENLON PLUS 15ML,32003657,CDM,,,250,RC,inpatient,,56,56,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.28,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,45.92,82,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,42.22,53.2,
ePHEDrine SULFATE VIAL:50MG/ML **,32003666,CDM,J3490,HCPCS,250,RC,inpatient,,264.22,264.22,,224.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,199.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,224.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,232.51,88,,percent of total billed charges,,,,,,,,,201.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,240.44,91,,percent of total billed charges,,,251.01,95,,percent of total billed charges,,,219.3,83,,percent of total billed charges,,,219.3,83,,percent of total billed charges,,,,,,,,,,,,,,,219.3,83,,percent of total billed charges,,,251.01,95,,percent of total billed charges,,,237.8,90,,percent of total billed charges,,,237.8,90,,percent of total billed charges,,,216.66,82,,percent of total billed charges,,,237.8,90,,percent of total billed charges,,,224.59,85,,percent of total billed charges,,199.22,251.01,
EPINEPHRINE SYR (TUBEX) : 1MG/ML,32003671,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
EPINEPHrine AMP:1MG/ML,32003676,CDM,J0171,HCPCS,250,RC,inpatient,,168.96,168.96,,143.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,127.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,143.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,148.68,88,,percent of total billed charges,,7.28,,,,fee schedule,,,129.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.28,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,153.75,91,,percent of total billed charges,,,160.51,95,,percent of total billed charges,,,140.24,83,,percent of total billed charges,,,140.24,83,,percent of total billed charges,,,,,,,,,,,,,,,140.24,83,,percent of total billed charges,,,160.51,95,,percent of total billed charges,,,152.06,90,,percent of total billed charges,,,152.06,90,,percent of total billed charges,,,138.55,82,,percent of total billed charges,,,152.06,90,,percent of total billed charges,,,143.62,85,,percent of total billed charges,,7.28,160.51,
EPINEPHrine SYR:0.1MG/ML ** 10ML,32003681,CDM,J0171,HCPCS,250,RC,inpatient,,126.96,126.96,,107.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,111.72,88,,percent of total billed charges,,7.28,,,,fee schedule,,,97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.28,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,115.53,91,,percent of total billed charges,,,120.61,95,,percent of total billed charges,,,105.38,83,,percent of total billed charges,,,105.38,83,,percent of total billed charges,,,,,,,,,,,,,,,105.38,83,,percent of total billed charges,,,120.61,95,,percent of total billed charges,,,114.26,90,,percent of total billed charges,,,114.26,90,,percent of total billed charges,,,104.11,82,,percent of total billed charges,,,114.26,90,,percent of total billed charges,,,107.92,85,,percent of total billed charges,,7.28,120.61,
EPINEPHrine(EPIPEN)PEN:0.3MG/0.3ML,32003686,CDM,J0171,HCPCS,250,RC,inpatient,,2027.28,2027.28,,1721.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1528.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1723.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1784.01,88,,percent of total billed charges,,7.28,,,,fee schedule,,,1548.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.28,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1844.82,91,,percent of total billed charges,,,1925.92,95,,percent of total billed charges,,,1682.64,83,,percent of total billed charges,,,1682.64,83,,percent of total billed charges,,,,,,,,,,,,,,,1682.64,83,,percent of total billed charges,,,1925.92,95,,percent of total billed charges,,,1824.55,90,,percent of total billed charges,,,1824.55,90,,percent of total billed charges,,,1662.37,82,,percent of total billed charges,,,1824.55,90,,percent of total billed charges,,,1723.19,85,,percent of total billed charges,,7.28,1925.92,
EPINEPHrine(EPIPEN JR)PEN:0.15MG/0.3ML,32003687,CDM,J0171,HCPCS,250,RC,inpatient,,2007.91,2007.91,,1704.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1513.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1706.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1766.96,88,,percent of total billed charges,,7.28,,,,fee schedule,,,1534.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.28,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.2,91,,percent of total billed charges,,,1907.51,95,,percent of total billed charges,,,1666.57,83,,percent of total billed charges,,,1666.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1666.57,83,,percent of total billed charges,,,1907.51,95,,percent of total billed charges,,,1807.12,90,,percent of total billed charges,,,1807.12,90,,percent of total billed charges,,,1646.49,82,,percent of total billed charges,,,1807.12,90,,percent of total billed charges,,,1706.72,85,,percent of total billed charges,,7.28,1907.51,
MAG SULF-(EPSON SALT)GRAN:30GM,32003701,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
MAG SULF-(EPSON SALT)GRAN:90GM,32003706,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
MAG SULF-(EPSOM SALT)CRYSTALS:120GM,32003707,CDM,,,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
MAG SULF-(EPSOM SALT)GRAN:454GM,32003711,CDM,,,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
ERYTHROMYCIN LACTOBIONATE VIAL : 1G,32003736,CDM,,,250,RC,inpatient,,300.55,300.55,,255.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,255.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,264.48,88,,percent of total billed charges,,,,,,,,,229.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,273.5,91,,percent of total billed charges,,,285.52,95,,percent of total billed charges,,,249.46,83,,percent of total billed charges,,,249.46,83,,percent of total billed charges,,,,,,,,,,,,,,,249.46,83,,percent of total billed charges,,,285.52,95,,percent of total billed charges,,,270.5,90,,percent of total billed charges,,,270.5,90,,percent of total billed charges,,,246.45,82,,percent of total billed charges,,,270.5,90,,percent of total billed charges,,,255.47,85,,percent of total billed charges,,226.61,285.52,
ERYTHROMYCIN BASE/ETHOL(ERYDERM)SOL 2%:,32003737,CDM,,,250,RC,inpatient,,244.09,244.09,,207.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,184.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,207.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,214.8,88,,percent of total billed charges,,,,,,,,,186.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,222.12,91,,percent of total billed charges,,,231.89,95,,percent of total billed charges,,,202.59,83,,percent of total billed charges,,,202.59,83,,percent of total billed charges,,,,,,,,,,,,,,,202.59,83,,percent of total billed charges,,,231.89,95,,percent of total billed charges,,,219.68,90,,percent of total billed charges,,,219.68,90,,percent of total billed charges,,,200.15,82,,percent of total billed charges,,,219.68,90,,percent of total billed charges,,,207.48,85,,percent of total billed charges,,184.04,231.89,
ERYTHROMYCIN BASE OINT:5MG/G OPHTH **,32003741,CDM,J3490,HCPCS,250,RC,inpatient,,121.41,121.41,,103.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,103.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,106.84,88,,percent of total billed charges,,,,,,,,,92.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,110.48,91,,percent of total billed charges,,,115.34,95,,percent of total billed charges,,,100.77,83,,percent of total billed charges,,,100.77,83,,percent of total billed charges,,,,,,,,,,,,,,,100.77,83,,percent of total billed charges,,,115.34,95,,percent of total billed charges,,,109.27,90,,percent of total billed charges,,,109.27,90,,percent of total billed charges,,,99.56,82,,percent of total billed charges,,,109.27,90,,percent of total billed charges,,,103.2,85,,percent of total billed charges,,91.54,115.34,
ERYTHROMYCIN BASE (E-MYCIN) TAB : 250MG,32003746,CDM,,,250,RC,inpatient,,36.32,36.32,,30.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31.96,88,,percent of total billed charges,,,,,,,,,27.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.05,91,,percent of total billed charges,,,34.5,95,,percent of total billed charges,,,30.15,83,,percent of total billed charges,,,30.15,83,,percent of total billed charges,,,,,,,,,,,,,,,30.15,83,,percent of total billed charges,,,34.5,95,,percent of total billed charges,,,32.69,90,,percent of total billed charges,,,32.69,90,,percent of total billed charges,,,29.78,82,,percent of total billed charges,,,32.69,90,,percent of total billed charges,,,30.87,85,,percent of total billed charges,,27.39,34.5,
ERYTHROMYCIN STEARATE TAB:500MG,32003751,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ERYTHROMYCIN LACTOBIONAT VIAL:500MG,32003756,CDM,J1364,HCPCS,250,RC,inpatient,,1154.36,1154.36,,980.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,870.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,981.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1015.84,88,,percent of total billed charges,,165.79,,,,fee schedule,,,881.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,165.79,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1050.47,91,,percent of total billed charges,,,1096.64,95,,percent of total billed charges,,,958.12,83,,percent of total billed charges,,,958.12,83,,percent of total billed charges,,,,,,,,,,,,,,,958.12,83,,percent of total billed charges,,,1096.64,95,,percent of total billed charges,,,1038.92,90,,percent of total billed charges,,,1038.92,90,,percent of total billed charges,,,946.58,82,,percent of total billed charges,,,1038.92,90,,percent of total billed charges,,,981.21,85,,percent of total billed charges,,165.79,1096.64,
ESTRADIOL TAB : 2MG,32003761,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ESTRADIOL TAB : 0.5MG,32003762,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ESTRADIOL TAB : 1MG,32003763,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ESTRADERM 0.1 PATCH,32003767,CDM,,,250,RC,inpatient,,9.5,9.5,,8.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8.36,88,,percent of total billed charges,,,,,,,,,7.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8.65,91,,percent of total billed charges,,,9.03,95,,percent of total billed charges,,,7.89,83,,percent of total billed charges,,,7.89,83,,percent of total billed charges,,,,,,,,,,,,,,,7.89,83,,percent of total billed charges,,,9.03,95,,percent of total billed charges,,,8.55,90,,percent of total billed charges,,,8.55,90,,percent of total billed charges,,,7.79,82,,percent of total billed charges,,,8.55,90,,percent of total billed charges,,,8.08,85,,percent of total billed charges,,7.16,9.03,
ME-TEST/ESTROGEN (SYNTEST)TAB:2.5-1.25MG,32003768,CDM,,,250,RC,inpatient,,22.52,22.52,,19.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.82,88,,percent of total billed charges,,,,,,,,,17.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.49,91,,percent of total billed charges,,,21.39,95,,percent of total billed charges,,,18.69,83,,percent of total billed charges,,,18.69,83,,percent of total billed charges,,,,,,,,,,,,,,,18.69,83,,percent of total billed charges,,,21.39,95,,percent of total billed charges,,,20.27,90,,percent of total billed charges,,,20.27,90,,percent of total billed charges,,,18.47,82,,percent of total billed charges,,,20.27,90,,percent of total billed charges,,,19.14,85,,percent of total billed charges,,16.98,21.39,
MORICIZINE HCL (ETHMOZINE) TAB : 200MG,32003776,CDM,,,250,RC,inpatient,,17.76,17.76,,15.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.63,88,,percent of total billed charges,,,,,,,,,13.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.16,91,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,,,,,,,,,,,,,14.74,83,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,14.56,82,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.1,85,,percent of total billed charges,,13.39,16.87,
ETHYL CHLORIDE SPR,32003786,CDM,,,250,RC,inpatient,,503.4,503.4,,427.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,379.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,427.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,442.99,88,,percent of total billed charges,,,,,,,,,384.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,458.09,91,,percent of total billed charges,,,478.23,95,,percent of total billed charges,,,417.82,83,,percent of total billed charges,,,417.82,83,,percent of total billed charges,,,,,,,,,,,,,,,417.82,83,,percent of total billed charges,,,478.23,95,,percent of total billed charges,,,453.06,90,,percent of total billed charges,,,453.06,90,,percent of total billed charges,,,412.79,82,,percent of total billed charges,,,453.06,90,,percent of total billed charges,,,427.89,85,,percent of total billed charges,,379.56,478.23,
EUCERIN CREAM:120GM,32003796,CDM,,,250,RC,inpatient,,111.6,111.6,,94.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.21,88,,percent of total billed charges,,,,,,,,,85.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.56,91,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,,,,,,,,,,,,,92.63,83,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,91.51,82,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,84.15,106.02,
MIN OIL/PET WHT(EUCERIN) CREAM  454 GM,32003801,CDM,,,250,RC,inpatient,,178.58,178.58,,151.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,134.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,151.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,157.15,88,,percent of total billed charges,,,,,,,,,136.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,162.51,91,,percent of total billed charges,,,169.65,95,,percent of total billed charges,,,148.22,83,,percent of total billed charges,,,148.22,83,,percent of total billed charges,,,,,,,,,,,,,,,148.22,83,,percent of total billed charges,,,169.65,95,,percent of total billed charges,,,160.72,90,,percent of total billed charges,,,160.72,90,,percent of total billed charges,,,146.44,82,,percent of total billed charges,,,160.72,90,,percent of total billed charges,,,151.79,85,,percent of total billed charges,,134.65,169.65,
MO/UREA/PEG'S/H20(EUCERIN PLUS) 360ML,32003802,CDM,,,250,RC,inpatient,,126.4,126.4,,107.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,111.23,88,,percent of total billed charges,,,,,,,,,96.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,115.02,91,,percent of total billed charges,,,120.08,95,,percent of total billed charges,,,104.91,83,,percent of total billed charges,,,104.91,83,,percent of total billed charges,,,,,,,,,,,,,,,104.91,83,,percent of total billed charges,,,120.08,95,,percent of total billed charges,,,113.76,90,,percent of total billed charges,,,113.76,90,,percent of total billed charges,,,103.65,82,,percent of total billed charges,,,113.76,90,,percent of total billed charges,,,107.44,85,,percent of total billed charges,,95.31,120.08,
M.O./UREA/PEGS/H20(EUCERIN PLUS)CRM 120G,32003803,CDM,,,250,RC,inpatient,,87.39,87.39,,74.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,65.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,76.9,88,,percent of total billed charges,,,,,,,,,66.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,79.52,91,,percent of total billed charges,,,83.02,95,,percent of total billed charges,,,72.53,83,,percent of total billed charges,,,72.53,83,,percent of total billed charges,,,,,,,,,,,,,,,72.53,83,,percent of total billed charges,,,83.02,95,,percent of total billed charges,,,78.65,90,,percent of total billed charges,,,78.65,90,,percent of total billed charges,,,71.66,82,,percent of total billed charges,,,78.65,90,,percent of total billed charges,,,74.28,85,,percent of total billed charges,,65.89,83.02,
FLUTAMIDE (EULEXIN) CAP : 125MG,32003816,CDM,,,250,RC,inpatient,,36.32,36.32,,30.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31.96,88,,percent of total billed charges,,,,,,,,,27.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.05,91,,percent of total billed charges,,,34.5,95,,percent of total billed charges,,,30.15,83,,percent of total billed charges,,,30.15,83,,percent of total billed charges,,,,,,,,,,,,,,,30.15,83,,percent of total billed charges,,,34.5,95,,percent of total billed charges,,,32.69,90,,percent of total billed charges,,,32.69,90,,percent of total billed charges,,,29.78,82,,percent of total billed charges,,,32.69,90,,percent of total billed charges,,,30.87,85,,percent of total billed charges,,27.39,34.5,
CROTAMITON (EURAX) LOT : 10%       60ML,32003821,CDM,,,250,RC,inpatient,,231.4,231.4,,196.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,174.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.63,88,,percent of total billed charges,,,,,,,,,176.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,210.57,91,,percent of total billed charges,,,219.83,95,,percent of total billed charges,,,192.06,83,,percent of total billed charges,,,192.06,83,,percent of total billed charges,,,,,,,,,,,,,,,192.06,83,,percent of total billed charges,,,219.83,95,,percent of total billed charges,,,208.26,90,,percent of total billed charges,,,208.26,90,,percent of total billed charges,,,189.75,82,,percent of total billed charges,,,208.26,90,,percent of total billed charges,,,196.69,85,,percent of total billed charges,,174.48,219.83,
PHENOLPHTHALEIN (EVACUGEN) TAB : 97.2MG,32003826,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
RALOXIFENE(EVISTA)TAB:60MG,32003827,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
APAP/ASA/CAFFEINE TAB: 250/250/65MG,32003831,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PHENOLPHTHALEIN (EX-LAX) TAB : 90MG,32003836,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PURIFIED WATER (EYE-STREAM) IRRIG:30ML,32003871,CDM,J3490,HCPCS,250,RC,inpatient,,342.81,342.81,,291.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,258.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,291.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,301.67,88,,percent of total billed charges,,,,,,,,,261.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,311.96,91,,percent of total billed charges,,,325.67,95,,percent of total billed charges,,,284.53,83,,percent of total billed charges,,,284.53,83,,percent of total billed charges,,,,,,,,,,,,,,,284.53,83,,percent of total billed charges,,,325.67,95,,percent of total billed charges,,,308.53,90,,percent of total billed charges,,,308.53,90,,percent of total billed charges,,,281.1,82,,percent of total billed charges,,,308.53,90,,percent of total billed charges,,,291.39,85,,percent of total billed charges,,258.48,325.67,
FAMCICLOVIR(FAMVIR)TAB:500MG,32003881,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FAMCICLOVIR (FAMVIR) TAB 500 MG (1 x 4),32003882,CDM,,,250,RC,inpatient,,31.24,31.24,,26.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.49,88,,percent of total billed charges,,,,,,,,,23.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.43,91,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,,,,,,,,,,,,,25.93,83,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,25.62,82,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,26.55,85,,percent of total billed charges,,23.55,29.68,
FENOPROFEN CAL (NALFON)TAB : 600MG,32003891,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
FERRIC SUBSULFATE SOL 500ML,32003901,CDM,,,250,RC,inpatient,,226,226,,191.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,170.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198.88,88,,percent of total billed charges,,,,,,,,,172.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,,,,,,,,,,,,,187.58,83,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,185.32,82,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,170.4,214.7,
FERRIC SUBSULFATE SOL 60ML,32003906,CDM,,,250,RC,inpatient,,27.12,27.12,,23.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23.87,88,,percent of total billed charges,,,,,,,,,20.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.68,91,,percent of total billed charges,,,25.76,95,,percent of total billed charges,,,22.51,83,,percent of total billed charges,,,22.51,83,,percent of total billed charges,,,,,,,,,,,,,,,22.51,83,,percent of total billed charges,,,25.76,95,,percent of total billed charges,,,24.41,90,,percent of total billed charges,,,24.41,90,,percent of total billed charges,,,22.24,82,,percent of total billed charges,,,24.41,90,,percent of total billed charges,,,23.05,85,,percent of total billed charges,,20.45,25.76,
FERROUS SULFATE ELIX : 220MG/5ML 480ML,32003921,CDM,,,250,RC,inpatient,,57.25,57.25,,48.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.38,88,,percent of total billed charges,,,,,,,,,43.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52.1,91,,percent of total billed charges,,,54.39,95,,percent of total billed charges,,,47.52,83,,percent of total billed charges,,,47.52,83,,percent of total billed charges,,,,,,,,,,,,,,,47.52,83,,percent of total billed charges,,,54.39,95,,percent of total billed charges,,,51.53,90,,percent of total billed charges,,,51.53,90,,percent of total billed charges,,,46.95,82,,percent of total billed charges,,,51.53,90,,percent of total billed charges,,,48.66,85,,percent of total billed charges,,43.17,54.39,
FERROUS SULFATE ELIX:220MG/5ML (60ML),32003926,CDM,J8499,HCPCS,250,RC,inpatient,,14.54,14.54,,12.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.8,88,,percent of total billed charges,,,,,,,,,11.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.23,91,,percent of total billed charges,,,13.81,95,,percent of total billed charges,,,12.07,83,,percent of total billed charges,,,12.07,83,,percent of total billed charges,,,,,,,,,,,,,,,12.07,83,,percent of total billed charges,,,13.81,95,,percent of total billed charges,,,13.09,90,,percent of total billed charges,,,13.09,90,,percent of total billed charges,,,11.92,82,,percent of total billed charges,,,13.09,90,,percent of total billed charges,,,12.36,85,,percent of total billed charges,,10.96,13.81,
FERROUS SULFATE TAB:325(65)MG,32003931,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
IRON POLYSACCHRD CMPLX(FERREX)CAP:150MG,32003932,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FE PS CMPLX/CYA(FERREX FORTE)CAP:,32003933,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ACETAMINOPHEN(TYLENOL)SUPP:120MG,32003946,CDM,J3490,HCPCS,250,RC,inpatient,,14.64,14.64,,12.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.88,88,,percent of total billed charges,,,,,,,,,11.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.32,91,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,,,,,,,,,,,,,12.15,83,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12,82,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,11.04,13.91,
ACETAMINOPHEN(TYLENOL)SUPP:325MG,32003951,CDM,J3490,HCPCS,250,RC,inpatient,,14.64,14.64,,12.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.88,88,,percent of total billed charges,,,,,,,,,11.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.32,91,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,,,,,,,,,,,,,12.15,83,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12,82,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,11.04,13.91,
ACETAMINOPHEN(TYLENOL)SUPP:650MG,32003956,CDM,J3490,HCPCS,250,RC,inpatient,,14.64,14.64,,12.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.88,88,,percent of total billed charges,,,,,,,,,11.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.32,91,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,,,,,,,,,,,,,12.15,83,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12,82,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,11.04,13.91,
VAPONEFRIN,32003961,CDM,,,250,RC,inpatient,,9,9,,7.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.92,88,,percent of total billed charges,,,,,,,,,6.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.38,82,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,6.79,8.55,
CALC POLYCARBOPHIL(FIBERCON)TAB:625MG,32003966,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ASPIR/CAFF/BUTAL(FIORINAL) CAP:325-40-50,32003971,CDM,J8499,HCPCS,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
COD/ASA/CAF/BU(FIORINAL+C) CAP:30-325-50,32003976,CDM,,,250,RC,inpatient,,38.06,38.06,,32.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33.49,88,,percent of total billed charges,,,,,,,,,29.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.63,91,,percent of total billed charges,,,36.16,95,,percent of total billed charges,,,31.59,83,,percent of total billed charges,,,31.59,83,,percent of total billed charges,,,,,,,,,,,,,,,31.59,83,,percent of total billed charges,,,36.16,95,,percent of total billed charges,,,34.25,90,,percent of total billed charges,,,34.25,90,,percent of total billed charges,,,31.21,82,,percent of total billed charges,,,34.25,90,,percent of total billed charges,,,32.35,85,,percent of total billed charges,,28.7,36.16,
APAP/CAF/BUTALB(FIORICET)TAB:300-40-50MG,32003981,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
BISACODYL/NAPH MB-DB(FLEET PREP KIT #1),32003986,CDM,,,250,RC,inpatient,,72.64,72.64,,61.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,54.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,61.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,63.92,88,,percent of total billed charges,,,,,,,,,55.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,66.1,91,,percent of total billed charges,,,69.01,95,,percent of total billed charges,,,60.29,83,,percent of total billed charges,,,60.29,83,,percent of total billed charges,,,,,,,,,,,,,,,60.29,83,,percent of total billed charges,,,69.01,95,,percent of total billed charges,,,65.38,90,,percent of total billed charges,,,65.38,90,,percent of total billed charges,,,59.56,82,,percent of total billed charges,,,65.38,90,,percent of total billed charges,,,61.74,85,,percent of total billed charges,,54.77,69.01,
NA PHOS(FLEET ENEMA):133 ML**,32003991,CDM,J3490,HCPCS,250,RC,inpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,15.28,19.26,
MINERAL OIL(FLEET M.O. ENEMA):135ML,32003996,CDM,J3490,HCPCS,250,RC,inpatient,,30.07,30.07,,25.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.46,88,,percent of total billed charges,,,,,,,,,22.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27.36,91,,percent of total billed charges,,,28.57,95,,percent of total billed charges,,,24.96,83,,percent of total billed charges,,,24.96,83,,percent of total billed charges,,,,,,,,,,,,,,,24.96,83,,percent of total billed charges,,,28.57,95,,percent of total billed charges,,,27.06,90,,percent of total billed charges,,,27.06,90,,percent of total billed charges,,,24.66,82,,percent of total billed charges,,,27.06,90,,percent of total billed charges,,,25.56,85,,percent of total billed charges,,22.67,28.57,
TAMSULOSIN(FLOMAX)CAP:0.4MG,32003997,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FLUTICASONE(FLONASE)SPR:50MCG (16ML),32004000,CDM,J3490,HCPCS,250,RC,inpatient,,54.41,54.41,,46.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47.88,88,,percent of total billed charges,,,,,,,,,41.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.51,91,,percent of total billed charges,,,51.69,95,,percent of total billed charges,,,45.16,83,,percent of total billed charges,,,45.16,83,,percent of total billed charges,,,,,,,,,,,,,,,45.16,83,,percent of total billed charges,,,51.69,95,,percent of total billed charges,,,48.97,90,,percent of total billed charges,,,48.97,90,,percent of total billed charges,,,44.62,82,,percent of total billed charges,,,48.97,90,,percent of total billed charges,,,46.25,85,,percent of total billed charges,,41.03,51.69,
FLUDROCORTISONE(FLORINEF)TAB:0.1MG,32004001,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FLOIVENT 13G,32004007,CDM,,,250,RC,inpatient,,749.82,749.82,,636.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,565.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,637.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,659.84,88,,percent of total billed charges,,,,,,,,,572.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,682.34,91,,percent of total billed charges,,,712.33,95,,percent of total billed charges,,,622.35,83,,percent of total billed charges,,,622.35,83,,percent of total billed charges,,,,,,,,,,,,,,,622.35,83,,percent of total billed charges,,,712.33,95,,percent of total billed charges,,,674.84,90,,percent of total billed charges,,,674.84,90,,percent of total billed charges,,,614.85,82,,percent of total billed charges,,,674.84,90,,percent of total billed charges,,,637.35,85,,percent of total billed charges,,565.36,712.33,
FLUTICASONE(FLOVENT)MDI:220MCG,32004008,CDM,J7699,HCPCS,250,RC,inpatient,,3296.64,3296.64,,2798.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2485.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2802.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2901.04,88,,percent of total billed charges,,,,,,,,,2518.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2999.94,91,,percent of total billed charges,,,3131.81,95,,percent of total billed charges,,,2736.21,83,,percent of total billed charges,,,2736.21,83,,percent of total billed charges,,,,,,,,,,,,,,,2736.21,83,,percent of total billed charges,,,3131.81,95,,percent of total billed charges,,,2966.98,90,,percent of total billed charges,,,2966.98,90,,percent of total billed charges,,,2703.24,82,,percent of total billed charges,,,2966.98,90,,percent of total billed charges,,,2802.14,85,,percent of total billed charges,,2485.67,3131.81,
FLUTICASONE(FLOVENT)MDI:44MCG (7.9GM),32004009,CDM,,,250,RC,inpatient,,2802.37,2802.37,,2379.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2112.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2382.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2466.09,88,,percent of total billed charges,,,,,,,,,2141.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2550.16,91,,percent of total billed charges,,,2662.25,95,,percent of total billed charges,,,2325.97,83,,percent of total billed charges,,,2325.97,83,,percent of total billed charges,,,,,,,,,,,,,,,2325.97,83,,percent of total billed charges,,,2662.25,95,,percent of total billed charges,,,2522.13,90,,percent of total billed charges,,,2522.13,90,,percent of total billed charges,,,2297.94,82,,percent of total billed charges,,,2522.13,90,,percent of total billed charges,,,2382.01,85,,percent of total billed charges,,2112.99,2662.25,
FLOVENT 220MCG INAHALER (7.9G),32004010,CDM,,,250,RC,inpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,153.06,192.85,
FLUTICASONE(FLOVENT)MDI:110MCG (12G),32004012,CDM,J7699,HCPCS,250,RC,inpatient,,2122.36,2122.36,,1801.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1600.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1804.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1867.68,88,,percent of total billed charges,,,,,,,,,1621.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1931.35,91,,percent of total billed charges,,,2016.24,95,,percent of total billed charges,,,1761.56,83,,percent of total billed charges,,,1761.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1761.56,83,,percent of total billed charges,,,2016.24,95,,percent of total billed charges,,,1910.12,90,,percent of total billed charges,,,1910.12,90,,percent of total billed charges,,,1740.34,82,,percent of total billed charges,,,1910.12,90,,percent of total billed charges,,,1804.01,85,,percent of total billed charges,,1600.26,2016.24,
FLUSHIELD TUBEX,32004032,CDM,90657,CPT,636,RC,inpatient,,30,30,,25.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.4,88,,percent of total billed charges,,,,,,,,,22.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,24.9,83,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,24.6,82,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,22.62,28.5,
FLUDARABINE(FLUDARA)VIAL:50MG,32004036,CDM,J9185,HCPCS,636,RC,inpatient,,1333.52,1333.52,,1132.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1005.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1133.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1173.5,88,,percent of total billed charges,,184.43,,,,fee schedule,,,1018.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,184.43,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1213.5,91,,percent of total billed charges,,,1266.84,95,,percent of total billed charges,,,1106.82,83,,percent of total billed charges,,,1106.82,83,,percent of total billed charges,,,,,,,,,,,,,,,1106.82,83,,percent of total billed charges,,,1266.84,95,,percent of total billed charges,,,1200.17,90,,percent of total billed charges,,,1200.17,90,,percent of total billed charges,,,1093.49,82,,percent of total billed charges,,,1200.17,90,,percent of total billed charges,,,1133.49,85,,percent of total billed charges,,184.43,1266.84,
FLUORESCEIN(FLUOR-I)STRIP:9MG,32004051,CDM,J3490,HCPCS,250,RC,inpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,15.28,19.26,
HALOTHANE (FLUOTHANE) LIQ    5ML,32004061,CDM,,,250,RC,inpatient,,370.81,370.81,,314.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,279.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,315.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,326.31,88,,percent of total billed charges,,,,,,,,,283.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,337.44,91,,percent of total billed charges,,,352.27,95,,percent of total billed charges,,,307.77,83,,percent of total billed charges,,,307.77,83,,percent of total billed charges,,,,,,,,,,,,,,,307.77,83,,percent of total billed charges,,,352.27,95,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,304.06,82,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,315.19,85,,percent of total billed charges,,279.59,352.27,
HALOTHANE (FLUOTHANE) LIQ  20 ML,32004066,CDM,,,250,RC,inpatient,,370.81,370.81,,314.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,279.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,315.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,326.31,88,,percent of total billed charges,,,,,,,,,283.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,337.44,91,,percent of total billed charges,,,352.27,95,,percent of total billed charges,,,307.77,83,,percent of total billed charges,,,307.77,83,,percent of total billed charges,,,,,,,,,,,,,,,307.77,83,,percent of total billed charges,,,352.27,95,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,304.06,82,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,315.19,85,,percent of total billed charges,,279.59,352.27,
FLURAZEPAM HCL CAP(DALMANE) : 15MG,32004081,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
FLURBIPROFEN(OCUFEN)EYE DROP 0.03%:2.5ML,32004091,CDM,J3490,HCPCS,250,RC,inpatient,,583.17,583.17,,495.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,439.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,495.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,513.19,88,,percent of total billed charges,,,,,,,,,445.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,530.68,91,,percent of total billed charges,,,554.01,95,,percent of total billed charges,,,484.03,83,,percent of total billed charges,,,484.03,83,,percent of total billed charges,,,,,,,,,,,,,,,484.03,83,,percent of total billed charges,,,554.01,95,,percent of total billed charges,,,524.85,90,,percent of total billed charges,,,524.85,90,,percent of total billed charges,,,478.2,82,,percent of total billed charges,,,524.85,90,,percent of total billed charges,,,495.69,85,,percent of total billed charges,,439.71,554.01,
FOLIC ACID TAB:1MG,32004111,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FOLIC ACID VIAL:5MG/ML  (10ML),32004116,CDM,J3490,HCPCS,250,RC,inpatient,,703.76,703.76,,597.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,530.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,598.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,619.31,88,,percent of total billed charges,,,,,,,,,537.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,640.42,91,,percent of total billed charges,,,668.57,95,,percent of total billed charges,,,584.12,83,,percent of total billed charges,,,584.12,83,,percent of total billed charges,,,,,,,,,,,,,,,584.12,83,,percent of total billed charges,,,668.57,95,,percent of total billed charges,,,633.38,90,,percent of total billed charges,,,633.38,90,,percent of total billed charges,,,577.08,82,,percent of total billed charges,,,633.38,90,,percent of total billed charges,,,598.2,85,,percent of total billed charges,,530.64,668.57,
ISOFLURANE (FORANE) LIQ   20 ML,32004126,CDM,,,250,RC,inpatient,,370.81,370.81,,314.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,279.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,315.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,326.31,88,,percent of total billed charges,,,,,,,,,283.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,337.44,91,,percent of total billed charges,,,352.27,95,,percent of total billed charges,,,307.77,83,,percent of total billed charges,,,307.77,83,,percent of total billed charges,,,,,,,,,,,,,,,307.77,83,,percent of total billed charges,,,352.27,95,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,304.06,82,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,315.19,85,,percent of total billed charges,,279.59,352.27,
CEFTAZIDIME (FORTAZ) VIAL:500MG,32004131,CDM,,,250,RC,inpatient,,98.65,98.65,,83.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,74.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,83.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,86.81,88,,percent of total billed charges,,,,,,,,,75.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,89.77,91,,percent of total billed charges,,,93.72,95,,percent of total billed charges,,,81.88,83,,percent of total billed charges,,,81.88,83,,percent of total billed charges,,,,,,,,,,,,,,,81.88,83,,percent of total billed charges,,,93.72,95,,percent of total billed charges,,,88.79,90,,percent of total billed charges,,,88.79,90,,percent of total billed charges,,,80.89,82,,percent of total billed charges,,,88.79,90,,percent of total billed charges,,,83.85,85,,percent of total billed charges,,74.38,93.72,
cefTAZIDIME (TAZICEF) VIAL: 1GM,32004136,CDM,J0713,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,7.75,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,7.75,59.21,
FRAGMIN 2500U SYRINGE,32004137,CDM,,,250,RC,inpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,38.45,48.45,
DALTEPARIN PORCNE(FRAGMIN)SYR:5000 U/0.2,32004138,CDM,,,250,RC,inpatient,,431.55,431.55,,366.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,325.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,366.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,379.76,88,,percent of total billed charges,,,,,,,,,329.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,392.71,91,,percent of total billed charges,,,409.97,95,,percent of total billed charges,,,358.19,83,,percent of total billed charges,,,358.19,83,,percent of total billed charges,,,,,,,,,,,,,,,358.19,83,,percent of total billed charges,,,409.97,95,,percent of total billed charges,,,388.4,90,,percent of total billed charges,,,388.4,90,,percent of total billed charges,,,353.87,82,,percent of total billed charges,,,388.4,90,,percent of total billed charges,,,366.82,85,,percent of total billed charges,,325.39,409.97,
FRAGMIN 10000U/ML (1ML),32004139,CDM,,,250,RC,inpatient,,162,162,,137.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,122.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,137.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,142.56,88,,percent of total billed charges,,,,,,,,,123.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,,,,,,,,,,,,,134.46,83,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,132.84,82,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,122.15,153.9,
FRAGMIN 9.5ML MD,32004142,CDM,,,250,RC,inpatient,,661.5,661.5,,561.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,498.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,562.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,582.12,88,,percent of total billed charges,,,,,,,,,505.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,601.97,91,,percent of total billed charges,,,628.43,95,,percent of total billed charges,,,549.05,83,,percent of total billed charges,,,549.05,83,,percent of total billed charges,,,,,,,,,,,,,,,549.05,83,,percent of total billed charges,,,628.43,95,,percent of total billed charges,,,595.35,90,,percent of total billed charges,,,595.35,90,,percent of total billed charges,,,542.43,82,,percent of total billed charges,,,595.35,90,,percent of total billed charges,,,562.28,85,,percent of total billed charges,,498.77,628.43,
GRISEOFULVIN ULTRAMICROSIZE TAB : 330MG,32004146,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
AMPHOTERICIN B(FUNGIZONE)VIAL:50MG,32004151,CDM,J0285,HCPCS,636,RC,inpatient,,727.66,727.66,,617.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,548.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,618.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,640.34,88,,percent of total billed charges,,118.01,,,,fee schedule,,,555.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,118.01,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,662.17,91,,percent of total billed charges,,,691.28,95,,percent of total billed charges,,,603.96,83,,percent of total billed charges,,,603.96,83,,percent of total billed charges,,,,,,,,,,,,,,,603.96,83,,percent of total billed charges,,,691.28,95,,percent of total billed charges,,,654.89,90,,percent of total billed charges,,,654.89,90,,percent of total billed charges,,,596.68,82,,percent of total billed charges,,,654.89,90,,percent of total billed charges,,,618.51,85,,percent of total billed charges,,118.01,691.28,
FUROSEMIDE(LASIX)TAB:20MG,32004166,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FUROSEMIDE(LASIX)TAB:40MG,32004171,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FUROSEMIDE(LASIX)TAB:80MG,32004176,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FUROSEMIDE(LASIX)VL: 20MG/2ML,32004181,CDM,J1940,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,3.16,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.16,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,3.16,60.99,
FUROSEMIDE(LASIX)VL: 40MG/4ML,32004186,CDM,J1940,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,3.16,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.16,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,3.16,60.99,
FUROSEMIDE(LASIX)VL:100MG/10ML,32004191,CDM,J1940,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,3.16,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.16,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,3.16,60.99,
FUROSEMIDE(LASIX)ORAL SOL:10MG/ML (60ML),32004196,CDM,,,250,RC,inpatient,,85.96,85.96,,72.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,75.64,88,,percent of total billed charges,,,,,,,,,65.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,78.22,91,,percent of total billed charges,,,81.66,95,,percent of total billed charges,,,71.35,83,,percent of total billed charges,,,71.35,83,,percent of total billed charges,,,,,,,,,,,,,,,71.35,83,,percent of total billed charges,,,81.66,95,,percent of total billed charges,,,77.36,90,,percent of total billed charges,,,77.36,90,,percent of total billed charges,,,70.49,82,,percent of total billed charges,,,77.36,90,,percent of total billed charges,,,73.07,85,,percent of total billed charges,,64.81,81.66,
GELATIN  ABSORBABL(GELFOAM)SPONGE:12-7MM,32004206,CDM,J3490,HCPCS,250,RC,inpatient,,135.95,135.95,,115.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,102.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,115.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,119.64,88,,percent of total billed charges,,,,,,,,,103.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,123.71,91,,percent of total billed charges,,,129.15,95,,percent of total billed charges,,,112.84,83,,percent of total billed charges,,,112.84,83,,percent of total billed charges,,,,,,,,,,,,,,,112.84,83,,percent of total billed charges,,,129.15,95,,percent of total billed charges,,,122.36,90,,percent of total billed charges,,,122.36,90,,percent of total billed charges,,,111.48,82,,percent of total billed charges,,,122.36,90,,percent of total billed charges,,,115.56,85,,percent of total billed charges,,102.51,129.15,
GEMFIBROZIL(LOPID)TAB:600MG,32004211,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
GEMCITABINE(GEMZAR)VIAL:200MG,32004212,CDM,J9201,HCPCS,636,RC,inpatient,,155.39,155.39,,131.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,117.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,132.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,136.74,88,,percent of total billed charges,,55.14,,,,fee schedule,,,118.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,55.14,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,141.4,91,,percent of total billed charges,,,147.62,95,,percent of total billed charges,,,128.97,83,,percent of total billed charges,,,128.97,83,,percent of total billed charges,,,,,,,,,,,,,,,128.97,83,,percent of total billed charges,,,147.62,95,,percent of total billed charges,,,139.85,90,,percent of total billed charges,,,139.85,90,,percent of total billed charges,,,127.42,82,,percent of total billed charges,,,139.85,90,,percent of total billed charges,,,132.08,85,,percent of total billed charges,,55.14,147.62,
GEMZAR 1 GM  **J9201X5**,32004213,CDM,J9201,HCPCS,636,RC,inpatient,,493,493,,418.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,371.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,419.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,433.84,88,,percent of total billed charges,,55.14,,,,fee schedule,,,376.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,55.14,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,448.63,91,,percent of total billed charges,,,468.35,95,,percent of total billed charges,,,409.19,83,,percent of total billed charges,,,409.19,83,,percent of total billed charges,,,,,,,,,,,,,,,409.19,83,,percent of total billed charges,,,468.35,95,,percent of total billed charges,,,443.7,90,,percent of total billed charges,,,443.7,90,,percent of total billed charges,,,404.26,82,,percent of total billed charges,,,443.7,90,,percent of total billed charges,,,419.05,85,,percent of total billed charges,,55.14,468.35,
OXYMETAZOLINE(AFRIN)SPR 0.05%:15ML,32004216,CDM,J3490,HCPCS,250,RC,inpatient,,22.88,22.88,,19.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.13,88,,percent of total billed charges,,,,,,,,,17.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.82,91,,percent of total billed charges,,,21.74,95,,percent of total billed charges,,,18.99,83,,percent of total billed charges,,,18.99,83,,percent of total billed charges,,,,,,,,,,,,,,,18.99,83,,percent of total billed charges,,,21.74,95,,percent of total billed charges,,,20.59,90,,percent of total billed charges,,,20.59,90,,percent of total billed charges,,,18.76,82,,percent of total billed charges,,,20.59,90,,percent of total billed charges,,,19.45,85,,percent of total billed charges,,17.25,21.74,
MAGCAR/AL/ALG(GAVISCON)ORAL   360ML,32004221,CDM,,,250,RC,inpatient,,32.99,32.99,,28.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.03,88,,percent of total billed charges,,,,,,,,,25.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.02,91,,percent of total billed charges,,,31.34,95,,percent of total billed charges,,,27.38,83,,percent of total billed charges,,,27.38,83,,percent of total billed charges,,,,,,,,,,,,,,,27.38,83,,percent of total billed charges,,,31.34,95,,percent of total billed charges,,,29.69,90,,percent of total billed charges,,,29.69,90,,percent of total billed charges,,,27.05,82,,percent of total billed charges,,,29.69,90,,percent of total billed charges,,,28.04,85,,percent of total billed charges,,24.87,31.34,
ASPIRIN/ACET/CAFF(GENACED)TAB:250-250-65,32004226,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
SIMETHICONE(MYLICON)DROP:40MG/0.6ML 30ML,32004231,CDM,J8499,HCPCS,250,RC,inpatient,,29.74,29.74,,25.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.17,88,,percent of total billed charges,,,,,,,,,22.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27.06,91,,percent of total billed charges,,,28.25,95,,percent of total billed charges,,,24.68,83,,percent of total billed charges,,,24.68,83,,percent of total billed charges,,,,,,,,,,,,,,,24.68,83,,percent of total billed charges,,,28.25,95,,percent of total billed charges,,,26.77,90,,percent of total billed charges,,,26.77,90,,percent of total billed charges,,,24.39,82,,percent of total billed charges,,,26.77,90,,percent of total billed charges,,,25.28,85,,percent of total billed charges,,22.42,28.25,
TRISIL/ALH/NAHCO3(GAVISCON) TAB: 20-80MG,32004236,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
GENTAMICIN(GENTAMICIN)DROP 0.3%:5ML,32004246,CDM,J3490,HCPCS,250,RC,inpatient,,84.48,84.48,,71.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.34,88,,percent of total billed charges,,,,,,,,,64.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.88,91,,percent of total billed charges,,,80.26,95,,percent of total billed charges,,,70.12,83,,percent of total billed charges,,,70.12,83,,percent of total billed charges,,,,,,,,,,,,,,,70.12,83,,percent of total billed charges,,,80.26,95,,percent of total billed charges,,,76.03,90,,percent of total billed charges,,,76.03,90,,percent of total billed charges,,,69.27,82,,percent of total billed charges,,,76.03,90,,percent of total billed charges,,,71.81,85,,percent of total billed charges,,63.7,80.26,
GENOPTIC 1ML,32004247,CDM,,,250,RC,inpatient,,12.5,12.5,,10.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11,88,,percent of total billed charges,,,,,,,,,9.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.38,91,,percent of total billed charges,,,11.88,95,,percent of total billed charges,,,10.38,83,,percent of total billed charges,,,10.38,83,,percent of total billed charges,,,,,,,,,,,,,,,10.38,83,,percent of total billed charges,,,11.88,95,,percent of total billed charges,,,11.25,90,,percent of total billed charges,,,11.25,90,,percent of total billed charges,,,10.25,82,,percent of total billed charges,,,11.25,90,,percent of total billed charges,,,10.63,85,,percent of total billed charges,,9.43,11.88,
GENTAMICIN(GARAMYCIN)TOP CR 0.1%:15GM,32004251,CDM,J3490,HCPCS,250,RC,inpatient,,234.57,234.57,,199.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,176.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,199.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,206.42,88,,percent of total billed charges,,,,,,,,,179.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,213.46,91,,percent of total billed charges,,,222.84,95,,percent of total billed charges,,,194.69,83,,percent of total billed charges,,,194.69,83,,percent of total billed charges,,,,,,,,,,,,,,,194.69,83,,percent of total billed charges,,,222.84,95,,percent of total billed charges,,,211.11,90,,percent of total billed charges,,,211.11,90,,percent of total billed charges,,,192.35,82,,percent of total billed charges,,,211.11,90,,percent of total billed charges,,,199.38,85,,percent of total billed charges,,176.87,222.84,
GENTAMICIN(GARAMYCIN)TOP OINT 0.1%:30GM,32004256,CDM,J3490,HCPCS,250,RC,inpatient,,657.71,657.71,,558.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,495.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,559.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,578.78,88,,percent of total billed charges,,,,,,,,,502.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,598.52,91,,percent of total billed charges,,,624.82,95,,percent of total billed charges,,,545.9,83,,percent of total billed charges,,,545.9,83,,percent of total billed charges,,,,,,,,,,,,,,,545.9,83,,percent of total billed charges,,,624.82,95,,percent of total billed charges,,,591.94,90,,percent of total billed charges,,,591.94,90,,percent of total billed charges,,,539.32,82,,percent of total billed charges,,,591.94,90,,percent of total billed charges,,,559.05,85,,percent of total billed charges,,495.91,624.82,
GENTAMICIN(GENTAK)OPTH OINT 0.3%:3.5GM,32004271,CDM,J3490,HCPCS,250,RC,inpatient,,520.27,520.27,,441.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,392.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,442.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,457.84,88,,percent of total billed charges,,,,,,,,,397.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,473.45,91,,percent of total billed charges,,,494.26,95,,percent of total billed charges,,,431.82,83,,percent of total billed charges,,,431.82,83,,percent of total billed charges,,,,,,,,,,,,,,,431.82,83,,percent of total billed charges,,,494.26,95,,percent of total billed charges,,,468.24,90,,percent of total billed charges,,,468.24,90,,percent of total billed charges,,,426.62,82,,percent of total billed charges,,,468.24,90,,percent of total billed charges,,,442.23,85,,percent of total billed charges,,392.28,494.26,
GENTAMICIN-VIAL:80MG/2ML,32004276,CDM,J1580,HCPCS,250,RC,inpatient,,69.61,69.61,,59.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,59.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,61.26,88,,percent of total billed charges,,21.3,,,,fee schedule,,,53.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21.3,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,63.35,91,,percent of total billed charges,,,66.13,95,,percent of total billed charges,,,57.78,83,,percent of total billed charges,,,57.78,83,,percent of total billed charges,,,,,,,,,,,,,,,57.78,83,,percent of total billed charges,,,66.13,95,,percent of total billed charges,,,62.65,90,,percent of total billed charges,,,62.65,90,,percent of total billed charges,,,57.08,82,,percent of total billed charges,,,62.65,90,,percent of total billed charges,,,59.17,85,,percent of total billed charges,,21.3,66.13,
GENTAMICIN 40MG/ML 20ML,32004277,CDM,,,250,RC,inpatient,,40.5,40.5,,34.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.64,88,,percent of total billed charges,,,,,,,,,30.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.86,91,,percent of total billed charges,,,38.48,95,,percent of total billed charges,,,33.62,83,,percent of total billed charges,,,33.62,83,,percent of total billed charges,,,,,,,,,,,,,,,33.62,83,,percent of total billed charges,,,38.48,95,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,33.21,82,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,34.43,85,,percent of total billed charges,,30.54,38.48,
G I  COCKTAIL  30ML,32004296,CDM,,,250,RC,inpatient,,27.45,27.45,,23.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.16,88,,percent of total billed charges,,,,,,,,,20.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.98,91,,percent of total billed charges,,,26.08,95,,percent of total billed charges,,,22.78,83,,percent of total billed charges,,,22.78,83,,percent of total billed charges,,,,,,,,,,,,,,,22.78,83,,percent of total billed charges,,,26.08,95,,percent of total billed charges,,,24.71,90,,percent of total billed charges,,,24.71,90,,percent of total billed charges,,,22.51,82,,percent of total billed charges,,,24.71,90,,percent of total billed charges,,,23.33,85,,percent of total billed charges,,20.7,26.08,
GINSENG,32004297,CDM,,,250,RC,inpatient,,0.5,0.5,,0.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,0.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,0.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,0.44,88,,percent of total billed charges,,,,,,,,,0.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,0.46,91,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,,,,,,,,,,,,,0.42,83,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.41,82,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.43,85,,percent of total billed charges,,0.38,0.48,
glipiZIDE(GLUCOTROL)TAB:5MG,32004301,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
gliPIZIDE (GLUCOTROL) TAB : 10MG,32004306,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
GLUCAGON HUMAN RECOMBINANT KIT : 1MG,32004311,CDM,J1610,HCPCS,636,RC,inpatient,,1517.28,1517.28,,1288.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1144.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1289.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1335.21,88,,percent of total billed charges,,340.66,,,,fee schedule,,,1159.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,340.66,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1380.72,91,,percent of total billed charges,,,1441.42,95,,percent of total billed charges,,,1259.34,83,,percent of total billed charges,,,1259.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1259.34,83,,percent of total billed charges,,,1441.42,95,,percent of total billed charges,,,1365.55,90,,percent of total billed charges,,,1365.55,90,,percent of total billed charges,,,1244.17,82,,percent of total billed charges,,,1365.55,90,,percent of total billed charges,,,1289.69,85,,percent of total billed charges,,340.66,1441.42,
metFORMIN(GLUCOPHAGE)TAB:500MG,32004316,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
glipiZIDE(GLUCOTROL XL)TAB:5MG,32004321,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
glipiZIDE(GLUCOTROL XL)TAB:10MG,32004322,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
GLUCOSAMINE CHONDRTN,32004323,CDM,,,250,RC,inpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,2.26,2.85,
DEXTROSE(GLUCOSE)TAB:4GM,32004324,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
glyBURIDE (DIABETA) TAB : 1.25MG,32004326,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
glyBURIDE(DIABETA)TAB:2.5MG,32004331,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
glyBURIDE (DIABETA) TAB : 5MG,32004336,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
GLYCERIN(SANI-SUPP)SUPP:ADULT,32004341,CDM,J3490,HCPCS,250,RC,inpatient,,14.64,14.64,,12.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.88,88,,percent of total billed charges,,,,,,,,,11.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.32,91,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,,,,,,,,,,,,,12.15,83,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12,82,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,11.04,13.91,
GLYCERIN(SANI-SUPP)SUPP:PEDIATRIC,32004346,CDM,J3490,HCPCS,250,RC,inpatient,,14.64,14.64,,12.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.88,88,,percent of total billed charges,,,,,,,,,11.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.32,91,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,,,,,,,,,,,,,12.15,83,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12,82,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,11.04,13.91,
GLYCERIN + ROSEWATER,32004347,CDM,,,250,RC,inpatient,,11.5,11.5,,9.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.12,88,,percent of total billed charges,,,,,,,,,8.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.47,91,,percent of total billed charges,,,10.93,95,,percent of total billed charges,,,9.55,83,,percent of total billed charges,,,9.55,83,,percent of total billed charges,,,,,,,,,,,,,,,9.55,83,,percent of total billed charges,,,10.93,95,,percent of total billed charges,,,10.35,90,,percent of total billed charges,,,10.35,90,,percent of total billed charges,,,9.43,82,,percent of total billed charges,,,10.35,90,,percent of total billed charges,,,9.78,85,,percent of total billed charges,,8.67,10.93,
GLYCERIN LIQ 120 ML,32004351,CDM,,,250,RC,inpatient,,39.49,39.49,,33.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34.75,88,,percent of total billed charges,,,,,,,,,30.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35.94,91,,percent of total billed charges,,,37.52,95,,percent of total billed charges,,,32.78,83,,percent of total billed charges,,,32.78,83,,percent of total billed charges,,,,,,,,,,,,,,,32.78,83,,percent of total billed charges,,,37.52,95,,percent of total billed charges,,,35.54,90,,percent of total billed charges,,,35.54,90,,percent of total billed charges,,,32.38,82,,percent of total billed charges,,,35.54,90,,percent of total billed charges,,,33.57,85,,percent of total billed charges,,29.78,37.52,
GLYCERIN LIQ:480 ML,32004356,CDM,J3490,HCPCS,250,RC,inpatient,,327.67,327.67,,278.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,247.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,278.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,288.35,88,,percent of total billed charges,,,,,,,,,250.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,298.18,91,,percent of total billed charges,,,311.29,95,,percent of total billed charges,,,271.97,83,,percent of total billed charges,,,271.97,83,,percent of total billed charges,,,,,,,,,,,,,,,271.97,83,,percent of total billed charges,,,311.29,95,,percent of total billed charges,,,294.9,90,,percent of total billed charges,,,294.9,90,,percent of total billed charges,,,268.69,82,,percent of total billed charges,,,294.9,90,,percent of total billed charges,,,278.52,85,,percent of total billed charges,,247.06,311.29,
MIGLITOL (GLYSET) TAB : 25MG,32004357,CDM,,,250,RC,inpatient,,45.68,45.68,,38.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.2,88,,percent of total billed charges,,,,,,,,,34.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.57,91,,percent of total billed charges,,,43.4,95,,percent of total billed charges,,,37.91,83,,percent of total billed charges,,,37.91,83,,percent of total billed charges,,,,,,,,,,,,,,,37.91,83,,percent of total billed charges,,,43.4,95,,percent of total billed charges,,,41.11,90,,percent of total billed charges,,,41.11,90,,percent of total billed charges,,,37.46,82,,percent of total billed charges,,,41.11,90,,percent of total billed charges,,,38.83,85,,percent of total billed charges,,34.44,43.4,
glyBURIDE (GLYNASE) TAB : 6MG,32004361,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
glyBURIDE(GLYNASE)TAB:3MG,32004366,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
SODI/NAHC03/KCL/PEGS(GOLYTELY)SOL:4000ML,32004376,CDM,J8499,HCPCS,250,RC,inpatient,,160.3,160.3,,136.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,120.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,141.06,88,,percent of total billed charges,,,,,,,,,122.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,145.87,91,,percent of total billed charges,,,152.29,95,,percent of total billed charges,,,133.05,83,,percent of total billed charges,,,133.05,83,,percent of total billed charges,,,,,,,,,,,,,,,133.05,83,,percent of total billed charges,,,152.29,95,,percent of total billed charges,,,144.27,90,,percent of total billed charges,,,144.27,90,,percent of total billed charges,,,131.45,82,,percent of total billed charges,,,144.27,90,,percent of total billed charges,,,136.26,85,,percent of total billed charges,,120.87,152.29,
TRYPS/BAL/CAST OIL(GRANULAX) SPRAY 56.7G,32004386,CDM,,,250,RC,inpatient,,67,67,,56.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.96,88,,percent of total billed charges,,,,,,,,,51.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,,,,,,,,,,,,,55.61,83,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,54.94,82,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,50.52,63.65,
GRAPESEED EXTRACT,32004387,CDM,,,250,RC,inpatient,,1,1,,0.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,0.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,0.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,0.88,88,,percent of total billed charges,,,,,,,,,0.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,0.91,91,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,,,,,,,,,,,,,0.83,83,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.82,82,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.85,85,,percent of total billed charges,,0.75,0.95,
GUAIFENESIN (PHENYLFENESIN) TAB:400-75MG,32004396,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
EUCALYPTUS/MENTHOL(HALLS)LOZ:,32004397,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
guaiFENesin/COD(ROBITUSSIN AC)SYR:120ML,32004406,CDM,J8499,HCPCS,250,RC,inpatient,,94.94,94.94,,80.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,83.55,88,,percent of total billed charges,,,,,,,,,72.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,86.4,91,,percent of total billed charges,,,90.19,95,,percent of total billed charges,,,78.8,83,,percent of total billed charges,,,78.8,83,,percent of total billed charges,,,,,,,,,,,,,,,78.8,83,,percent of total billed charges,,,90.19,95,,percent of total billed charges,,,85.45,90,,percent of total billed charges,,,85.45,90,,percent of total billed charges,,,77.85,82,,percent of total billed charges,,,85.45,90,,percent of total billed charges,,,80.7,85,,percent of total billed charges,,71.58,90.19,
GUAIFN/CODEINE(ROBITUSSIN AC) SYRP :90ML,32004411,CDM,,,250,RC,inpatient,,11.25,11.25,,9.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9.9,88,,percent of total billed charges,,,,,,,,,8.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.24,91,,percent of total billed charges,,,10.69,95,,percent of total billed charges,,,9.34,83,,percent of total billed charges,,,9.34,83,,percent of total billed charges,,,,,,,,,,,,,,,9.34,83,,percent of total billed charges,,,10.69,95,,percent of total billed charges,,,10.13,90,,percent of total billed charges,,,10.13,90,,percent of total billed charges,,,9.23,82,,percent of total billed charges,,,10.13,90,,percent of total billed charges,,,9.56,85,,percent of total billed charges,,8.48,10.69,
HALOPERIDOL(HALDOL)VIAL:5MG/ML,32004421,CDM,J1630,HCPCS,636,RC,inpatient,,89.71,89.71,,76.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,76.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,78.94,88,,percent of total billed charges,,1.62,,,,fee schedule,,,68.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.62,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,81.64,91,,percent of total billed charges,,,85.22,95,,percent of total billed charges,,,74.46,83,,percent of total billed charges,,,74.46,83,,percent of total billed charges,,,,,,,,,,,,,,,74.46,83,,percent of total billed charges,,,85.22,95,,percent of total billed charges,,,80.74,90,,percent of total billed charges,,,80.74,90,,percent of total billed charges,,,73.56,82,,percent of total billed charges,,,80.74,90,,percent of total billed charges,,,76.25,85,,percent of total billed charges,,1.62,85.22,
HALCINONIDE (HALOG) CREAM : 0.1%  15GM,32004426,CDM,,,250,RC,inpatient,,332.9,332.9,,282.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,251.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,282.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,292.95,88,,percent of total billed charges,,,,,,,,,254.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,302.94,91,,percent of total billed charges,,,316.26,95,,percent of total billed charges,,,276.31,83,,percent of total billed charges,,,276.31,83,,percent of total billed charges,,,,,,,,,,,,,,,276.31,83,,percent of total billed charges,,,316.26,95,,percent of total billed charges,,,299.61,90,,percent of total billed charges,,,299.61,90,,percent of total billed charges,,,272.98,82,,percent of total billed charges,,,299.61,90,,percent of total billed charges,,,282.97,85,,percent of total billed charges,,251.01,316.26,
HALOPERIDOL(HALDOL)TAB:0.5MG,32004436,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
HALOPERIDOL LACTATE ORAL : 2MG/ML 120ML,32004446,CDM,,,250,RC,inpatient,,322.59,322.59,,273.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,243.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,274.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.88,88,,percent of total billed charges,,,,,,,,,246.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,293.56,91,,percent of total billed charges,,,306.46,95,,percent of total billed charges,,,267.75,83,,percent of total billed charges,,,267.75,83,,percent of total billed charges,,,,,,,,,,,,,,,267.75,83,,percent of total billed charges,,,306.46,95,,percent of total billed charges,,,290.33,90,,percent of total billed charges,,,290.33,90,,percent of total billed charges,,,264.52,82,,percent of total billed charges,,,290.33,90,,percent of total billed charges,,,274.2,85,,percent of total billed charges,,243.23,306.46,
HALOPERIDOL (HALDOL) TAB : 5MG,32004456,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CARBOPROST TROMET(HEMABATE)AMP:250MCG/ML,32004467,CDM,J3490,HCPCS,250,RC,inpatient,,2777.81,2777.81,,2358.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2094.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2361.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2444.47,88,,percent of total billed charges,,,,,,,,,2122.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2527.81,91,,percent of total billed charges,,,2638.92,95,,percent of total billed charges,,,2305.58,83,,percent of total billed charges,,,2305.58,83,,percent of total billed charges,,,,,,,,,,,,,,,2305.58,83,,percent of total billed charges,,,2638.92,95,,percent of total billed charges,,,2500.03,90,,percent of total billed charges,,,2500.03,90,,percent of total billed charges,,,2277.8,82,,percent of total billed charges,,,2500.03,90,,percent of total billed charges,,,2361.14,85,,percent of total billed charges,,2094.47,2638.92,
"HEParin VIAL:5,000UNITS/ML",32004471,CDM,J1644,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
HEParin VIAL: 10000 UNITS/ML   1ML,32004476,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
HEPARIN VIAL : 100 U/ML,32004481,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
HEParin LOCK 10ML:100UNITS/ML,32004486,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
INSUL REG(HumuLIN) 50-50UNIT/ML:10ML,32004505,CDM,,,250,RC,inpatient,,169,169,,143.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,127.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,143.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,148.72,88,,percent of total billed charges,,,,,,,,,129.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,153.79,91,,percent of total billed charges,,,160.55,95,,percent of total billed charges,,,140.27,83,,percent of total billed charges,,,140.27,83,,percent of total billed charges,,,,,,,,,,,,,,,140.27,83,,percent of total billed charges,,,160.55,95,,percent of total billed charges,,,152.1,90,,percent of total billed charges,,,152.1,90,,percent of total billed charges,,,138.58,82,,percent of total billed charges,,,152.1,90,,percent of total billed charges,,,143.65,85,,percent of total billed charges,,127.43,160.55,
insul NPH(novoLIN N):100UNIT/ML  (10ML),32004506,CDM,J1815,HCPCS,250,RC,inpatient,,252.94,252.94,,214.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,222.59,88,,percent of total billed charges,,,,,,,,,193.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,230.18,91,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,,,,,,,,,,,,,209.94,83,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,207.41,82,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,215,85,,percent of total billed charges,,190.72,240.29,
INSUL ZN(NOVOLIN L):100 UNITS/ML 10ML,32004511,CDM,,,250,RC,inpatient,,460.73,460.73,,391.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,347.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,391.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,405.44,88,,percent of total billed charges,,,,,,,,,352,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,419.26,91,,percent of total billed charges,,,437.69,95,,percent of total billed charges,,,382.41,83,,percent of total billed charges,,,382.41,83,,percent of total billed charges,,,,,,,,,,,,,,,382.41,83,,percent of total billed charges,,,437.69,95,,percent of total billed charges,,,414.66,90,,percent of total billed charges,,,414.66,90,,percent of total billed charges,,,377.8,82,,percent of total billed charges,,,414.66,90,,percent of total billed charges,,,391.62,85,,percent of total billed charges,,347.39,437.69,
insul REG(novoLIN R):100UNITS/ML (10ML),32004516,CDM,J1815,HCPCS,250,RC,inpatient,,252.94,252.94,,214.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,222.59,88,,percent of total billed charges,,,,,,,,,193.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,230.18,91,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,,,,,,,,,,,,,209.94,83,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,207.41,82,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,215,85,,percent of total billed charges,,190.72,240.29,
insul REG(novoLIN R):100UNITS/ML  (1ML),32004521,CDM,,,250,RC,inpatient,,223.15,223.15,,189.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.37,88,,percent of total billed charges,,,,,,,,,170.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.07,91,,percent of total billed charges,,,211.99,95,,percent of total billed charges,,,185.21,83,,percent of total billed charges,,,185.21,83,,percent of total billed charges,,,,,,,,,,,,,,,185.21,83,,percent of total billed charges,,,211.99,95,,percent of total billed charges,,,200.84,90,,percent of total billed charges,,,200.84,90,,percent of total billed charges,,,182.98,82,,percent of total billed charges,,,200.84,90,,percent of total billed charges,,,189.68,85,,percent of total billed charges,,168.26,211.99,
INSUL ZN EXT(HumuLINU):100UNIT/ML (10ML),32004526,CDM,,,250,RC,inpatient,,460.73,460.73,,391.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,347.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,391.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,405.44,88,,percent of total billed charges,,,,,,,,,352,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,419.26,91,,percent of total billed charges,,,437.69,95,,percent of total billed charges,,,382.41,83,,percent of total billed charges,,,382.41,83,,percent of total billed charges,,,,,,,,,,,,,,,382.41,83,,percent of total billed charges,,,437.69,95,,percent of total billed charges,,,414.66,90,,percent of total billed charges,,,414.66,90,,percent of total billed charges,,,377.8,82,,percent of total billed charges,,,414.66,90,,percent of total billed charges,,,391.62,85,,percent of total billed charges,,347.39,437.69,
insul ASPART(novoLOG)VL100UNIT/ML:10ML,32004527,CDM,,,250,RC,inpatient,,2290.88,2290.88,,1944.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1727.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1947.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2015.97,88,,percent of total billed charges,,,,,,,,,1750.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2084.7,91,,percent of total billed charges,,,2176.34,95,,percent of total billed charges,,,1901.43,83,,percent of total billed charges,,,1901.43,83,,percent of total billed charges,,,,,,,,,,,,,,,1901.43,83,,percent of total billed charges,,,2176.34,95,,percent of total billed charges,,,2061.79,90,,percent of total billed charges,,,2061.79,90,,percent of total billed charges,,,1878.52,82,,percent of total billed charges,,,2061.79,90,,percent of total billed charges,,,1947.25,85,,percent of total billed charges,,1727.32,2176.34,
insul NPH/R(novoLIN 70/30) VIAL:10ML,32004531,CDM,J1815,HCPCS,250,RC,inpatient,,251.31,251.31,,213.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,189.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,213.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,221.15,88,,percent of total billed charges,,,,,,,,,192,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,228.69,91,,percent of total billed charges,,,238.74,95,,percent of total billed charges,,,208.59,83,,percent of total billed charges,,,208.59,83,,percent of total billed charges,,,,,,,,,,,,,,,208.59,83,,percent of total billed charges,,,238.74,95,,percent of total billed charges,,,226.18,90,,percent of total billed charges,,,226.18,90,,percent of total billed charges,,,206.07,82,,percent of total billed charges,,,226.18,90,,percent of total billed charges,,,213.61,85,,percent of total billed charges,,189.49,238.74,
BENZOCAINE(HURRICAINE)SPR  20%:1ML,32004536,CDM,J3490,HCPCS,250,RC,inpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,15.28,19.26,
BENZOCAINE(HURRICAINE)SPR 20%:60ML,32004541,CDM,J3490,HCPCS,250,RC,inpatient,,533.83,533.83,,453.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,402.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,453.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,469.77,88,,percent of total billed charges,,,,,,,,,407.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,485.79,91,,percent of total billed charges,,,507.14,95,,percent of total billed charges,,,443.08,83,,percent of total billed charges,,,443.08,83,,percent of total billed charges,,,,,,,,,,,,,,,443.08,83,,percent of total billed charges,,,507.14,95,,percent of total billed charges,,,480.45,90,,percent of total billed charges,,,480.45,90,,percent of total billed charges,,,437.74,82,,percent of total billed charges,,,480.45,90,,percent of total billed charges,,,453.76,85,,percent of total billed charges,,402.51,507.14,
*TOPOTECAN(HYCAMTIN)VIAL:4MG(V1011),32004547,CDM,J9351,HCPCS,636,RC,inpatient,,5142.78,5142.78,,4366.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3877.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4371.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4525.65,88,,percent of total billed charges,,44.36,,,,fee schedule,,,3929.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,44.36,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4679.93,91,,percent of total billed charges,,,4885.64,95,,percent of total billed charges,,,4268.51,83,,percent of total billed charges,,,4268.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4268.51,83,,percent of total billed charges,,,4885.64,95,,percent of total billed charges,,,4628.5,90,,percent of total billed charges,,,4628.5,90,,percent of total billed charges,,,4217.08,82,,percent of total billed charges,,,4628.5,90,,percent of total billed charges,,,4371.36,85,,percent of total billed charges,,44.36,4885.64,
hydrALAZINE(APRESOLINE)VIAL:20MG/ML,32004556,CDM,J0360,HCPCS,250,RC,inpatient,,274.51,274.51,,233.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,206.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,233.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,241.57,88,,percent of total billed charges,,13.29,,,,fee schedule,,,209.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.29,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,249.8,91,,percent of total billed charges,,,260.78,95,,percent of total billed charges,,,227.84,83,,percent of total billed charges,,,227.84,83,,percent of total billed charges,,,,,,,,,,,,,,,227.84,83,,percent of total billed charges,,,260.78,95,,percent of total billed charges,,,247.06,90,,percent of total billed charges,,,247.06,90,,percent of total billed charges,,,225.1,82,,percent of total billed charges,,,247.06,90,,percent of total billed charges,,,233.33,85,,percent of total billed charges,,13.29,260.78,
HYDROXYCHLOROQUINE(PLAQUENIL)TAB:200MG,32004557,CDM,J8499,HCPCS,250,RC,inpatient,,16.83,16.83,,14.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.81,88,,percent of total billed charges,,,,,,,,,12.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.32,91,,percent of total billed charges,,,15.99,95,,percent of total billed charges,,,13.97,83,,percent of total billed charges,,,13.97,83,,percent of total billed charges,,,,,,,,,,,,,,,13.97,83,,percent of total billed charges,,,15.99,95,,percent of total billed charges,,,15.15,90,,percent of total billed charges,,,15.15,90,,percent of total billed charges,,,13.8,82,,percent of total billed charges,,,15.15,90,,percent of total billed charges,,,14.31,85,,percent of total billed charges,,12.69,15.99,
hydroxyZINE (ATARAX) TAB : 10MG,32004561,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
hydrOXYzine(ATARAX)TAB:25MG,32004566,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
HYDERGINE LC,32004571,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
HYDROCORTISONE CREAM 0.5%:30GM,32004576,CDM,J3490,HCPCS,250,RC,inpatient,,44.41,44.41,,37.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.08,88,,percent of total billed charges,,,,,,,,,33.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.41,91,,percent of total billed charges,,,42.19,95,,percent of total billed charges,,,36.86,83,,percent of total billed charges,,,36.86,83,,percent of total billed charges,,,,,,,,,,,,,,,36.86,83,,percent of total billed charges,,,42.19,95,,percent of total billed charges,,,39.97,90,,percent of total billed charges,,,39.97,90,,percent of total billed charges,,,36.42,82,,percent of total billed charges,,,39.97,90,,percent of total billed charges,,,37.75,85,,percent of total billed charges,,33.49,42.19,
HYDROCORTISONE ACETATE POW:10GM,32004581,CDM,,,250,RC,inpatient,,341.31,341.31,,289.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,257.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,290.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,300.35,88,,percent of total billed charges,,,,,,,,,260.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,310.59,91,,percent of total billed charges,,,324.24,95,,percent of total billed charges,,,283.29,83,,percent of total billed charges,,,283.29,83,,percent of total billed charges,,,,,,,,,,,,,,,283.29,83,,percent of total billed charges,,,324.24,95,,percent of total billed charges,,,307.18,90,,percent of total billed charges,,,307.18,90,,percent of total billed charges,,,279.87,82,,percent of total billed charges,,,307.18,90,,percent of total billed charges,,,290.11,85,,percent of total billed charges,,257.35,324.24,
HYDROCORTISONE OINT : 1%     28.35GM,32004586,CDM,,,250,RC,inpatient,,99.92,99.92,,84.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,84.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,87.93,88,,percent of total billed charges,,,,,,,,,76.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,90.93,91,,percent of total billed charges,,,94.92,95,,percent of total billed charges,,,82.93,83,,percent of total billed charges,,,82.93,83,,percent of total billed charges,,,,,,,,,,,,,,,82.93,83,,percent of total billed charges,,,94.92,95,,percent of total billed charges,,,89.93,90,,percent of total billed charges,,,89.93,90,,percent of total billed charges,,,81.93,82,,percent of total billed charges,,,89.93,90,,percent of total billed charges,,,84.93,85,,percent of total billed charges,,75.34,94.92,
hydrALAZINE(APRESOLINE)TAB:10MG,32004591,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
HYDROCORTISONE CREAM 1%:30GM,32004596,CDM,J3490,HCPCS,250,RC,inpatient,,25.16,25.16,,21.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.14,88,,percent of total billed charges,,,,,,,,,19.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.9,91,,percent of total billed charges,,,23.9,95,,percent of total billed charges,,,20.88,83,,percent of total billed charges,,,20.88,83,,percent of total billed charges,,,,,,,,,,,,,,,20.88,83,,percent of total billed charges,,,23.9,95,,percent of total billed charges,,,22.64,90,,percent of total billed charges,,,22.64,90,,percent of total billed charges,,,20.63,82,,percent of total billed charges,,,22.64,90,,percent of total billed charges,,,21.39,85,,percent of total billed charges,,18.97,23.9,
HYDROGEN PEROXIDE SOL 3%:480 ML,32004601,CDM,J3490,HCPCS,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
HYDROXY (ATARAX)SYRP : 10MG/5ML 480ML,32004606,CDM,,,250,RC,inpatient,,531.94,531.94,,451.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,401.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,452.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,468.11,88,,percent of total billed charges,,,,,,,,,406.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,484.07,91,,percent of total billed charges,,,505.34,95,,percent of total billed charges,,,441.51,83,,percent of total billed charges,,,441.51,83,,percent of total billed charges,,,,,,,,,,,,,,,441.51,83,,percent of total billed charges,,,505.34,95,,percent of total billed charges,,,478.75,90,,percent of total billed charges,,,478.75,90,,percent of total billed charges,,,436.19,82,,percent of total billed charges,,,478.75,90,,percent of total billed charges,,,452.15,85,,percent of total billed charges,,401.08,505.34,
HYDROXY (ATARAX) SYRP: 10MG/5ML  60ML,32004611,CDM,,,250,RC,inpatient,,67.56,67.56,,57.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.45,88,,percent of total billed charges,,,,,,,,,51.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.48,91,,percent of total billed charges,,,64.18,95,,percent of total billed charges,,,56.07,83,,percent of total billed charges,,,56.07,83,,percent of total billed charges,,,,,,,,,,,,,,,56.07,83,,percent of total billed charges,,,64.18,95,,percent of total billed charges,,,60.8,90,,percent of total billed charges,,,60.8,90,,percent of total billed charges,,,55.4,82,,percent of total billed charges,,,60.8,90,,percent of total billed charges,,,57.43,85,,percent of total billed charges,,50.94,64.18,
hydrALAZINE(APRESOLINE)TAB:25MG,32004621,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
HYDROGEN PEROXIDE SOL 3%:480ML,32004626,CDM,,,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
DIPHENHYDR(BENDRYL)EL:12.5MG/5ML(60ML)PX,32004636,CDM,,,250,RC,inpatient,,35.21,35.21,,29.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.98,88,,percent of total billed charges,,,,,,,,,26.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.04,91,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,,,,,,,,,,,,,29.22,83,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,28.87,82,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,29.93,85,,percent of total billed charges,,26.55,33.45,
HYDROCORTISONE(CORT-ENEMA):100MG/60ML,32004641,CDM,J3490,HCPCS,250,RC,inpatient,,99.76,99.76,,84.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,84.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,87.79,88,,percent of total billed charges,,,,,,,,,76.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,90.78,91,,percent of total billed charges,,,94.77,95,,percent of total billed charges,,,82.8,83,,percent of total billed charges,,,82.8,83,,percent of total billed charges,,,,,,,,,,,,,,,82.8,83,,percent of total billed charges,,,94.77,95,,percent of total billed charges,,,89.78,90,,percent of total billed charges,,,89.78,90,,percent of total billed charges,,,81.8,82,,percent of total billed charges,,,89.78,90,,percent of total billed charges,,,84.8,85,,percent of total billed charges,,75.22,94.77,
HYDROmorphone 2mg tabHCL,32004651,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
DIPHENHYDRA(BENADRYL)LIQ:12.5MG/5ML 90ML,32004656,CDM,,,250,RC,inpatient,,8.5,8.5,,7.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.48,88,,percent of total billed charges,,,,,,,,,6.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.74,91,,percent of total billed charges,,,8.08,95,,percent of total billed charges,,,7.06,83,,percent of total billed charges,,,7.06,83,,percent of total billed charges,,,,,,,,,,,,,,,7.06,83,,percent of total billed charges,,,8.08,95,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,6.97,82,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,7.23,85,,percent of total billed charges,,6.41,8.08,
NEO/HC/POLY SUSP(CORTISPORIN EAR):10ML,32004661,CDM,J3490,HCPCS,250,RC,inpatient,,785.42,785.42,,666.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,592.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,667.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,691.17,88,,percent of total billed charges,,,,,,,,,600.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,714.73,91,,percent of total billed charges,,,746.15,95,,percent of total billed charges,,,651.9,83,,percent of total billed charges,,,651.9,83,,percent of total billed charges,,,,,,,,,,,,,,,651.9,83,,percent of total billed charges,,,746.15,95,,percent of total billed charges,,,706.88,90,,percent of total billed charges,,,706.88,90,,percent of total billed charges,,,644.04,82,,percent of total billed charges,,,706.88,90,,percent of total billed charges,,,667.61,85,,percent of total billed charges,,592.21,746.15,
HYDROCORTISONE LOT:2.50% 59ML,32004666,CDM,,,250,RC,inpatient,,491.34,491.34,,417.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,370.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,417.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,432.38,88,,percent of total billed charges,,,,,,,,,375.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,447.12,91,,percent of total billed charges,,,466.77,95,,percent of total billed charges,,,407.81,83,,percent of total billed charges,,,407.81,83,,percent of total billed charges,,,,,,,,,,,,,,,407.81,83,,percent of total billed charges,,,466.77,95,,percent of total billed charges,,,442.21,90,,percent of total billed charges,,,442.21,90,,percent of total billed charges,,,402.9,82,,percent of total billed charges,,,442.21,90,,percent of total billed charges,,,417.64,85,,percent of total billed charges,,370.47,466.77,
HYDROCORTISONE CREAM  2.50%:30GM,32004671,CDM,J3490,HCPCS,250,RC,inpatient,,32.51,32.51,,27.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28.61,88,,percent of total billed charges,,,,,,,,,24.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29.58,91,,percent of total billed charges,,,30.88,95,,percent of total billed charges,,,26.98,83,,percent of total billed charges,,,26.98,83,,percent of total billed charges,,,,,,,,,,,,,,,26.98,83,,percent of total billed charges,,,30.88,95,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,26.66,82,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,27.63,85,,percent of total billed charges,,24.51,30.88,
DIPHENHYD(BENADRYL)LIQ:12.5MG/5ML(120ML),32004681,CDM,J8499,HCPCS,250,RC,inpatient,,35.21,35.21,,29.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.98,88,,percent of total billed charges,,,,,,,,,26.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.04,91,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,,,,,,,,,,,,,29.22,83,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,28.87,82,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,29.93,85,,percent of total billed charges,,26.55,33.45,
HYDROmorphone (Diluadid) 2mg/ml syringe,32004686,CDM,,,250,RC,inpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.78,88,,percent of total billed charges,,,,,,,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,49.51,62.38,
HYDROmorphone (DILAUDID) SYR : 4MG/ML,32004687,CDM,,,250,RC,inpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.78,88,,percent of total billed charges,,,,,,,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,49.51,62.38,
HYOSCYAMINE (LEVSIN)SUB-LING TAB:0.125MG,32004706,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
DIATRIZOATE MEGLUMINE (HYPAQUE)BTL : 60%,32004716,CDM,,,250,RC,inpatient,,338.29,338.29,,287.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,255.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,287.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,297.7,88,,percent of total billed charges,,,,,,,,,258.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,307.84,91,,percent of total billed charges,,,321.38,95,,percent of total billed charges,,,280.78,83,,percent of total billed charges,,,280.78,83,,percent of total billed charges,,,,,,,,,,,,,,,280.78,83,,percent of total billed charges,,,321.38,95,,percent of total billed charges,,,304.46,90,,percent of total billed charges,,,304.46,90,,percent of total billed charges,,,277.4,82,,percent of total billed charges,,,304.46,90,,percent of total billed charges,,,287.55,85,,percent of total billed charges,,255.07,321.38,
DIATRIZOATE MEGLUMINE(HYPAQUE-CY)BTL:30%,32004721,CDM,,,250,RC,inpatient,,317.2,317.2,,269.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,239.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,269.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,279.14,88,,percent of total billed charges,,,,,,,,,242.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,288.65,91,,percent of total billed charges,,,301.34,95,,percent of total billed charges,,,263.28,83,,percent of total billed charges,,,263.28,83,,percent of total billed charges,,,,,,,,,,,,,,,263.28,83,,percent of total billed charges,,,301.34,95,,percent of total billed charges,,,285.48,90,,percent of total billed charges,,,285.48,90,,percent of total billed charges,,,260.1,82,,percent of total billed charges,,,285.48,90,,percent of total billed charges,,,269.62,85,,percent of total billed charges,,239.17,301.34,
DIATRIZOATE MEGLUMINE(HYPAQUE)VIAL : 60%,32004726,CDM,,,250,RC,inpatient,,105.94,105.94,,89.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,90.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,93.23,88,,percent of total billed charges,,,,,,,,,80.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,96.41,91,,percent of total billed charges,,,100.64,95,,percent of total billed charges,,,87.93,83,,percent of total billed charges,,,87.93,83,,percent of total billed charges,,,,,,,,,,,,,,,87.93,83,,percent of total billed charges,,,100.64,95,,percent of total billed charges,,,95.35,90,,percent of total billed charges,,,95.35,90,,percent of total billed charges,,,86.87,82,,percent of total billed charges,,,95.35,90,,percent of total billed charges,,,90.05,85,,percent of total billed charges,,79.88,100.64,
DIAZOXIDE(HYPERSTAT IV)AMP:300MG/20ML,32004736,CDM,J1730,HCPCS,636,RC,inpatient,,1521.95,1521.95,,1292.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1147.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1293.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1339.32,88,,percent of total billed charges,,,,,,,,,1162.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1384.97,91,,percent of total billed charges,,,1445.85,95,,percent of total billed charges,,,1263.22,83,,percent of total billed charges,,,1263.22,83,,percent of total billed charges,,,,,,,,,,,,,,,1263.22,83,,percent of total billed charges,,,1445.85,95,,percent of total billed charges,,,1369.76,90,,percent of total billed charges,,,1369.76,90,,percent of total billed charges,,,1248,82,,percent of total billed charges,,,1369.76,90,,percent of total billed charges,,,1293.66,85,,percent of total billed charges,,1147.55,1445.85,
ELECTROLYTE(TPN)SOLUTION VIAL:20ML,32004743,CDM,J3490,HCPCS,250,RC,inpatient,,113.73,113.73,,96.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,100.08,88,,percent of total billed charges,,,,,,,,,86.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,103.49,91,,percent of total billed charges,,,108.04,95,,percent of total billed charges,,,94.4,83,,percent of total billed charges,,,94.4,83,,percent of total billed charges,,,,,,,,,,,,,,,94.4,83,,percent of total billed charges,,,108.04,95,,percent of total billed charges,,,102.36,90,,percent of total billed charges,,,102.36,90,,percent of total billed charges,,,93.26,82,,percent of total billed charges,,,102.36,90,,percent of total billed charges,,,96.67,85,,percent of total billed charges,,85.75,108.04,
HYDROCORTISONE LOT : 1%    118 ML,32004746,CDM,,,250,RC,inpatient,,109.59,109.59,,93.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,93.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,96.44,88,,percent of total billed charges,,,,,,,,,83.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.73,91,,percent of total billed charges,,,104.11,95,,percent of total billed charges,,,90.96,83,,percent of total billed charges,,,90.96,83,,percent of total billed charges,,,,,,,,,,,,,,,90.96,83,,percent of total billed charges,,,104.11,95,,percent of total billed charges,,,98.63,90,,percent of total billed charges,,,98.63,90,,percent of total billed charges,,,89.86,82,,percent of total billed charges,,,98.63,90,,percent of total billed charges,,,93.15,85,,percent of total billed charges,,82.63,104.11,
teraZOSIN (HYTRIN) CAP : 2MG,32004751,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
teraZOSIN(HYTRIN)CAP:1MG,32004756,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LOSARTAN/HYDCHLTHZD(HYZAAR)TAB:50-12.5MG,32004761,CDM,,,250,RC,inpatient,,44.41,44.41,,37.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.08,88,,percent of total billed charges,,,,,,,,,33.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.41,91,,percent of total billed charges,,,42.19,95,,percent of total billed charges,,,36.86,83,,percent of total billed charges,,,36.86,83,,percent of total billed charges,,,,,,,,,,,,,,,36.86,83,,percent of total billed charges,,,42.19,95,,percent of total billed charges,,,39.97,90,,percent of total billed charges,,,39.97,90,,percent of total billed charges,,,36.42,82,,percent of total billed charges,,,39.97,90,,percent of total billed charges,,,37.75,85,,percent of total billed charges,,33.49,42.19,
IBUPROFEN(MOTRIN IB)TAB:200MG,32004771,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ISOSORBIDE MONONITRATE(IMDUR)TAB:60MG,32004811,CDM,J8499,HCPCS,250,RC,inpatient,UD,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
IMIPRAMINE (TOFRANIL) TAB : 10MG,32004816,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
IMIPRAMINE (TOFRANIL) TAB : 25MG,32004821,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
SUMAtriptan(IMITREX)VIAL:6MG/0.5ML,32004826,CDM,J3030,HCPCS,250,RC,inpatient,,83.66,83.66,,71.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.62,88,,percent of total billed charges,,7.64,,,,fee schedule,,,63.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.64,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.13,91,,percent of total billed charges,,,79.48,95,,percent of total billed charges,,,69.44,83,,percent of total billed charges,,,69.44,83,,percent of total billed charges,,,,,,,,,,,,,,,69.44,83,,percent of total billed charges,,,79.48,95,,percent of total billed charges,,,75.29,90,,percent of total billed charges,,,75.29,90,,percent of total billed charges,,,68.6,82,,percent of total billed charges,,,75.29,90,,percent of total billed charges,,,71.11,85,,percent of total billed charges,,7.64,79.48,
azaTHIOprine(IMURAN)TAB:50MG,32004837,CDM,J7500,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
DROPERIDOL(INAPSINE):5MG/2ML,32004841,CDM,J1790,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,1.51,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.51,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,1.51,59.21,
PROPRANOLOL(INDERAL)AMP:1MG/ML,32004846,CDM,,,250,RC,inpatient,,99.92,99.92,,84.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,84.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,87.93,88,,percent of total billed charges,,,,,,,,,76.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,90.93,91,,percent of total billed charges,,,94.92,95,,percent of total billed charges,,,82.93,83,,percent of total billed charges,,,82.93,83,,percent of total billed charges,,,,,,,,,,,,,,,82.93,83,,percent of total billed charges,,,94.92,95,,percent of total billed charges,,,89.93,90,,percent of total billed charges,,,89.93,90,,percent of total billed charges,,,81.93,82,,percent of total billed charges,,,89.93,90,,percent of total billed charges,,,84.93,85,,percent of total billed charges,,75.34,94.92,
PROPRANOLOL (INDERAL LA) CAP : 160MG,32004851,CDM,,,250,RC,inpatient,,27.44,27.44,,23.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.15,88,,percent of total billed charges,,,,,,,,,20.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.97,91,,percent of total billed charges,,,26.07,95,,percent of total billed charges,,,22.78,83,,percent of total billed charges,,,22.78,83,,percent of total billed charges,,,,,,,,,,,,,,,22.78,83,,percent of total billed charges,,,26.07,95,,percent of total billed charges,,,24.7,90,,percent of total billed charges,,,24.7,90,,percent of total billed charges,,,22.5,82,,percent of total billed charges,,,24.7,90,,percent of total billed charges,,,23.32,85,,percent of total billed charges,,20.69,26.07,
PROPRANOLOL(INDERAL LA)CAP:80MG,32004856,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PROPRANOLOL HCL (INDERAL LA) CAP : 120MG,32004861,CDM,,,250,RC,inpatient,,74.38,74.38,,63.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,63.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,65.45,88,,percent of total billed charges,,,,,,,,,56.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,67.69,91,,percent of total billed charges,,,70.66,95,,percent of total billed charges,,,61.74,83,,percent of total billed charges,,,61.74,83,,percent of total billed charges,,,,,,,,,,,,,,,61.74,83,,percent of total billed charges,,,70.66,95,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,60.99,82,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,63.22,85,,percent of total billed charges,,56.08,70.66,
INDIGOTINDISLFNT(INDGO CARM) 0.8%:5ML,32004866,CDM,J3490,HCPCS,250,RC,inpatient,,2233.78,2233.78,,1896.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1684.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1898.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1965.73,88,,percent of total billed charges,,,,,,,,,1706.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2032.74,91,,percent of total billed charges,,,2122.09,95,,percent of total billed charges,,,1854.04,83,,percent of total billed charges,,,1854.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1854.04,83,,percent of total billed charges,,,2122.09,95,,percent of total billed charges,,,2010.4,90,,percent of total billed charges,,,2010.4,90,,percent of total billed charges,,,1831.7,82,,percent of total billed charges,,,2010.4,90,,percent of total billed charges,,,1898.71,85,,percent of total billed charges,,1684.27,2122.09,
INDOMETHACIN (INDOCIN) CAP : 50MG,32004871,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
INDOMETHACIN(INDOCIN)CAP:25MG,32004876,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
INDOMETHACIN (INDOCIN SR) CAP : 75MG,32004886,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
IRON DEXTRAN(INFED)100MG/2ML:Z-TRAC,32004896,CDM,J1750,HCPCS,636,RC,inpatient,,496.74,496.74,,421.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,374.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,422.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,437.13,88,,percent of total billed charges,,826.25,,,,fee schedule,,,379.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,826.25,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,452.03,91,,percent of total billed charges,,,471.9,95,,percent of total billed charges,,,412.29,83,,percent of total billed charges,,,412.29,83,,percent of total billed charges,,,,,,,,,,,,,,,412.29,83,,percent of total billed charges,,,471.9,95,,percent of total billed charges,,,447.07,90,,percent of total billed charges,,,447.07,90,,percent of total billed charges,,,407.33,82,,percent of total billed charges,,,447.07,90,,percent of total billed charges,,,422.23,85,,percent of total billed charges,,374.54,826.25,
INFLUENZA(FLUZONE):45MCG/0.5ML(S.D.)0607,32004897,CDM,90658,CPT,636,RC,inpatient,,186.51,186.51,,158.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,140.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,158.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,164.13,88,,percent of total billed charges,,,,,,,,,142.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,169.72,91,,percent of total billed charges,,,177.18,95,,percent of total billed charges,,,154.8,83,,percent of total billed charges,,,154.8,83,,percent of total billed charges,,,,,,,,,,,,,,,154.8,83,,percent of total billed charges,,,177.18,95,,percent of total billed charges,,,167.86,90,,percent of total billed charges,,,167.86,90,,percent of total billed charges,,,152.94,82,,percent of total billed charges,,,167.86,90,,percent of total billed charges,,,158.53,85,,percent of total billed charges,,140.63,177.18,
INFLUENZA VIRUS VACCINE VIAL 98/99,32004898,CDM,,,250,RC,inpatient,,111.5,111.5,,94.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.12,88,,percent of total billed charges,,,,,,,,,85.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.47,91,,percent of total billed charges,,,105.93,95,,percent of total billed charges,,,92.55,83,,percent of total billed charges,,,92.55,83,,percent of total billed charges,,,,,,,,,,,,,,,92.55,83,,percent of total billed charges,,,105.93,95,,percent of total billed charges,,,100.35,90,,percent of total billed charges,,,100.35,90,,percent of total billed charges,,,91.43,82,,percent of total billed charges,,,100.35,90,,percent of total billed charges,,,94.78,85,,percent of total billed charges,,84.07,105.93,
EPTIFIB(INTEGRILIN):20MG/10ML,32004952,CDM,J1327,HCPCS,636,RC,inpatient,,2116.8,2116.8,,1797.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1596.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1799.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1862.78,88,,percent of total billed charges,,198,,,,fee schedule,,,1617.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,198,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1926.29,91,,percent of total billed charges,,,2010.96,95,,percent of total billed charges,,,1756.94,83,,percent of total billed charges,,,1756.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1756.94,83,,percent of total billed charges,,,2010.96,95,,percent of total billed charges,,,1905.12,90,,percent of total billed charges,,,1905.12,90,,percent of total billed charges,,,1735.78,82,,percent of total billed charges,,,1905.12,90,,percent of total billed charges,,,1799.28,85,,percent of total billed charges,,198,2010.96,
EPTIFIB(INTEGRILIN):75MG/100ML,32004953,CDM,J1327,HCPCS,636,RC,inpatient,,4181.55,4181.55,,3550.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3152.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3554.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3679.76,88,,percent of total billed charges,,198,,,,fee schedule,,,3194.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,198,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3805.21,91,,percent of total billed charges,,,3972.47,95,,percent of total billed charges,,,3470.69,83,,percent of total billed charges,,,3470.69,83,,percent of total billed charges,,,,,,,,,,,,,,,3470.69,83,,percent of total billed charges,,,3972.47,95,,percent of total billed charges,,,3763.4,90,,percent of total billed charges,,,3763.4,90,,percent of total billed charges,,,3428.87,82,,percent of total billed charges,,,3763.4,90,,percent of total billed charges,,,3554.32,85,,percent of total billed charges,,198,3972.47,
CLIOQUINOL/HYDROCORT(VIOFORM) CRM : 3-1%,32004976,CDM,,,250,RC,inpatient,,205.7,205.7,,174.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,155.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,174.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,181.02,88,,percent of total billed charges,,,,,,,,,157.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,187.19,91,,percent of total billed charges,,,195.42,95,,percent of total billed charges,,,170.73,83,,percent of total billed charges,,,170.73,83,,percent of total billed charges,,,,,,,,,,,,,,,170.73,83,,percent of total billed charges,,,195.42,95,,percent of total billed charges,,,185.13,90,,percent of total billed charges,,,185.13,90,,percent of total billed charges,,,168.67,82,,percent of total billed charges,,,185.13,90,,percent of total billed charges,,,174.85,85,,percent of total billed charges,,155.1,195.42,
APRACLONIDINE(IOPIDINE)DROP 1%:0.2ML,32005012,CDM,,,250,RC,inpatient,,461.68,461.68,,391.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.28,88,,percent of total billed charges,,,,,,,,,352.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.13,91,,percent of total billed charges,,,438.6,95,,percent of total billed charges,,,383.19,83,,percent of total billed charges,,,383.19,83,,percent of total billed charges,,,,,,,,,,,,,,,383.19,83,,percent of total billed charges,,,438.6,95,,percent of total billed charges,,,415.51,90,,percent of total billed charges,,,415.51,90,,percent of total billed charges,,,378.58,82,,percent of total billed charges,,,415.51,90,,percent of total billed charges,,,392.43,85,,percent of total billed charges,,348.11,438.6,
IPECAC SYRP 30 ML,32005016,CDM,,,250,RC,inpatient,,72.48,72.48,,61.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,54.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,61.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,63.78,88,,percent of total billed charges,,,,,,,,,55.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,65.96,91,,percent of total billed charges,,,68.86,95,,percent of total billed charges,,,60.16,83,,percent of total billed charges,,,60.16,83,,percent of total billed charges,,,,,,,,,,,,,,,60.16,83,,percent of total billed charges,,,68.86,95,,percent of total billed charges,,,65.23,90,,percent of total billed charges,,,65.23,90,,percent of total billed charges,,,59.43,82,,percent of total billed charges,,,65.23,90,,percent of total billed charges,,,61.61,85,,percent of total billed charges,,54.65,68.86,
ISOSORBIDE (ISMO) TAB : 20MG,32005026,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ISOPROPYL ALCOHOL SOL 70%:480ML,32005041,CDM,J3490,HCPCS,250,RC,inpatient,,202.13,202.13,,171.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,171.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,177.87,88,,percent of total billed charges,,,,,,,,,154.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,183.94,91,,percent of total billed charges,,,192.02,95,,percent of total billed charges,,,167.77,83,,percent of total billed charges,,,167.77,83,,percent of total billed charges,,,,,,,,,,,,,,,167.77,83,,percent of total billed charges,,,192.02,95,,percent of total billed charges,,,181.92,90,,percent of total billed charges,,,181.92,90,,percent of total billed charges,,,165.75,82,,percent of total billed charges,,,181.92,90,,percent of total billed charges,,,171.81,85,,percent of total billed charges,,152.41,192.02,
ISOPROPYL ALCOHOL SOL : 70%    3840 ML,32005042,CDM,,,250,RC,inpatient,,417.59,417.59,,354.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,314.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,354.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,367.48,88,,percent of total billed charges,,,,,,,,,319.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,380.01,91,,percent of total billed charges,,,396.71,95,,percent of total billed charges,,,346.6,83,,percent of total billed charges,,,346.6,83,,percent of total billed charges,,,,,,,,,,,,,,,346.6,83,,percent of total billed charges,,,396.71,95,,percent of total billed charges,,,375.83,90,,percent of total billed charges,,,375.83,90,,percent of total billed charges,,,342.42,82,,percent of total billed charges,,,375.83,90,,percent of total billed charges,,,354.95,85,,percent of total billed charges,,314.86,396.71,
ATROPINE SULFATE DROP : 1% 5ML,32005046,CDM,,,250,RC,inpatient,,259.79,259.79,,220.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,195.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,220.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,228.62,88,,percent of total billed charges,,,,,,,,,198.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,236.41,91,,percent of total billed charges,,,246.8,95,,percent of total billed charges,,,215.63,83,,percent of total billed charges,,,215.63,83,,percent of total billed charges,,,,,,,,,,,,,,,215.63,83,,percent of total billed charges,,,246.8,95,,percent of total billed charges,,,233.81,90,,percent of total billed charges,,,233.81,90,,percent of total billed charges,,,213.03,82,,percent of total billed charges,,,233.81,90,,percent of total billed charges,,,220.82,85,,percent of total billed charges,,195.88,246.8,
PILOCARPINE HCL DROP : 0.50% 15ML,32005051,CDM,,,250,RC,inpatient,,51.54,51.54,,43.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.36,88,,percent of total billed charges,,,,,,,,,39.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.9,91,,percent of total billed charges,,,48.96,95,,percent of total billed charges,,,42.78,83,,percent of total billed charges,,,42.78,83,,percent of total billed charges,,,,,,,,,,,,,,,42.78,83,,percent of total billed charges,,,48.96,95,,percent of total billed charges,,,46.39,90,,percent of total billed charges,,,46.39,90,,percent of total billed charges,,,42.26,82,,percent of total billed charges,,,46.39,90,,percent of total billed charges,,,43.81,85,,percent of total billed charges,,38.86,48.96,
ISOPROTERENOL HCL AMP:0.2MG/ML (5ML),32005061,CDM,,,250,RC,inpatient,,73.59,73.59,,62.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,55.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,62.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,64.76,88,,percent of total billed charges,,,,,,,,,56.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,66.97,91,,percent of total billed charges,,,69.91,95,,percent of total billed charges,,,61.08,83,,percent of total billed charges,,,61.08,83,,percent of total billed charges,,,,,,,,,,,,,,,61.08,83,,percent of total billed charges,,,69.91,95,,percent of total billed charges,,,66.23,90,,percent of total billed charges,,,66.23,90,,percent of total billed charges,,,60.34,82,,percent of total billed charges,,,66.23,90,,percent of total billed charges,,,62.55,85,,percent of total billed charges,,55.49,69.91,
PILOCARPINE DROP 1%:15ML,32005066,CDM,,,250,RC,inpatient,,1112.7,1112.7,,944.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,838.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,945.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,979.18,88,,percent of total billed charges,,,,,,,,,850.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1012.56,91,,percent of total billed charges,,,1057.07,95,,percent of total billed charges,,,923.54,83,,percent of total billed charges,,,923.54,83,,percent of total billed charges,,,,,,,,,,,,,,,923.54,83,,percent of total billed charges,,,1057.07,95,,percent of total billed charges,,,1001.43,90,,percent of total billed charges,,,1001.43,90,,percent of total billed charges,,,912.41,82,,percent of total billed charges,,,1001.43,90,,percent of total billed charges,,,945.8,85,,percent of total billed charges,,838.98,1057.07,
PILOCARPINE DROP 1%:2ML,32005067,CDM,,,250,RC,inpatient,,79.93,79.93,,67.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.34,88,,percent of total billed charges,,,,,,,,,61.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.74,91,,percent of total billed charges,,,75.93,95,,percent of total billed charges,,,66.34,83,,percent of total billed charges,,,66.34,83,,percent of total billed charges,,,,,,,,,,,,,,,66.34,83,,percent of total billed charges,,,75.93,95,,percent of total billed charges,,,71.94,90,,percent of total billed charges,,,71.94,90,,percent of total billed charges,,,65.54,82,,percent of total billed charges,,,71.94,90,,percent of total billed charges,,,67.94,85,,percent of total billed charges,,60.27,75.93,
PILOCARPINE DROP 2%:15ML,32005071,CDM,J3490,HCPCS,250,RC,inpatient,,713.22,713.22,,605.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,537.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,606.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,627.63,88,,percent of total billed charges,,,,,,,,,544.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,649.03,91,,percent of total billed charges,,,677.56,95,,percent of total billed charges,,,591.97,83,,percent of total billed charges,,,591.97,83,,percent of total billed charges,,,,,,,,,,,,,,,591.97,83,,percent of total billed charges,,,677.56,95,,percent of total billed charges,,,641.9,90,,percent of total billed charges,,,641.9,90,,percent of total billed charges,,,584.84,82,,percent of total billed charges,,,641.9,90,,percent of total billed charges,,,606.24,85,,percent of total billed charges,,537.77,677.56,
PILOCARPINE DROP 4%:15ML,32005076,CDM,J3490,HCPCS,250,RC,inpatient,,1193.2,1193.2,,1013.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,899.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1014.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1050.02,88,,percent of total billed charges,,,,,,,,,911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1085.81,91,,percent of total billed charges,,,1133.54,95,,percent of total billed charges,,,990.36,83,,percent of total billed charges,,,990.36,83,,percent of total billed charges,,,,,,,,,,,,,,,990.36,83,,percent of total billed charges,,,1133.54,95,,percent of total billed charges,,,1073.88,90,,percent of total billed charges,,,1073.88,90,,percent of total billed charges,,,978.42,82,,percent of total billed charges,,,1073.88,90,,percent of total billed charges,,,1014.22,85,,percent of total billed charges,,899.67,1133.54,
HOMATROPINE HBR DROP 5%:5ML,32005077,CDM,J3490,HCPCS,250,RC,inpatient,,288.81,288.81,,245.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.15,88,,percent of total billed charges,,,,,,,,,220.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.82,91,,percent of total billed charges,,,274.37,95,,percent of total billed charges,,,239.71,83,,percent of total billed charges,,,239.71,83,,percent of total billed charges,,,,,,,,,,,,,,,239.71,83,,percent of total billed charges,,,274.37,95,,percent of total billed charges,,,259.93,90,,percent of total billed charges,,,259.93,90,,percent of total billed charges,,,236.82,82,,percent of total billed charges,,,259.93,90,,percent of total billed charges,,,245.49,85,,percent of total billed charges,,217.76,274.37,
SCOPOLAMINE (HYOSCINE) DROP: 0.25%   5ML,32005081,CDM,,,250,RC,inpatient,,579.52,579.52,,492.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,436.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,492.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,509.98,88,,percent of total billed charges,,,,,,,,,442.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,527.36,91,,percent of total billed charges,,,550.54,95,,percent of total billed charges,,,481,83,,percent of total billed charges,,,481,83,,percent of total billed charges,,,,,,,,,,,,,,,481,83,,percent of total billed charges,,,550.54,95,,percent of total billed charges,,,521.57,90,,percent of total billed charges,,,521.57,90,,percent of total billed charges,,,475.21,82,,percent of total billed charges,,,521.57,90,,percent of total billed charges,,,492.59,85,,percent of total billed charges,,436.96,550.54,
ISOSORBIDE DINITRATE (ISORDIL)TAB:10MG,32005086,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ISOSORBIDE (ISORDIL) TAB : 20MG,32005091,CDM,,,250,RC,inpatient,,15.86,15.86,,13.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.96,88,,percent of total billed charges,,,,,,,,,12.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.43,91,,percent of total billed charges,,,15.07,95,,percent of total billed charges,,,13.16,83,,percent of total billed charges,,,13.16,83,,percent of total billed charges,,,,,,,,,,,,,,,13.16,83,,percent of total billed charges,,,15.07,95,,percent of total billed charges,,,14.27,90,,percent of total billed charges,,,14.27,90,,percent of total billed charges,,,13.01,82,,percent of total billed charges,,,14.27,90,,percent of total billed charges,,,13.48,85,,percent of total billed charges,,11.96,15.07,
ISOXSUPRINE (VASODILAN) TAB : 10MG,32005096,CDM,,,250,RC,inpatient,,14.43,14.43,,12.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.7,88,,percent of total billed charges,,,,,,,,,11.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.13,91,,percent of total billed charges,,,13.71,95,,percent of total billed charges,,,11.98,83,,percent of total billed charges,,,11.98,83,,percent of total billed charges,,,,,,,,,,,,,,,11.98,83,,percent of total billed charges,,,13.71,95,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,11.83,82,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,12.27,85,,percent of total billed charges,,10.88,13.71,
ISOXSUPRINE(VASODILAN)TAB:20MG,32005101,CDM,,,250,RC,inpatient,,23.31,23.31,,19.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.51,88,,percent of total billed charges,,,,,,,,,17.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.21,91,,percent of total billed charges,,,22.14,95,,percent of total billed charges,,,19.35,83,,percent of total billed charges,,,19.35,83,,percent of total billed charges,,,,,,,,,,,,,,,19.35,83,,percent of total billed charges,,,22.14,95,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,19.11,82,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,19.81,85,,percent of total billed charges,,17.58,22.14,
ISOPROTERENOL HCL AMP:1MG/5ML,32005106,CDM,J3490,HCPCS,250,RC,inpatient,,684.63,684.63,,581.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,516.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,581.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,602.47,88,,percent of total billed charges,,,,,,,,,523.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,623.01,91,,percent of total billed charges,,,650.4,95,,percent of total billed charges,,,568.24,83,,percent of total billed charges,,,568.24,83,,percent of total billed charges,,,,,,,,,,,,,,,568.24,83,,percent of total billed charges,,,650.4,95,,percent of total billed charges,,,616.17,90,,percent of total billed charges,,,616.17,90,,percent of total billed charges,,,561.4,82,,percent of total billed charges,,,616.17,90,,percent of total billed charges,,,581.94,85,,percent of total billed charges,,516.21,650.4,
FLUCONAZOLE(DIFLUCAN)-IVPB:200MG/100ML,32005121,CDM,J1450,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,10.46,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,10.46,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,10.46,187.11,
POTASSIUM CHLORIDE(K-DUR)TAB:20MEQ,32005126,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
Potassium Chloride(K-DUR) ER TABS:10 meq,32005131,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
POTASSIUM BICARB/CIT (KLORCON) TAB:25MEQ,32005136,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
POTASSIUM CHLORIDE LIQ 20MEQ/15ML 500ML,32005151,CDM,,,250,RC,inpatient,,701.33,701.33,,595.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,528.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,596.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,617.17,88,,percent of total billed charges,,,,,,,,,535.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,638.21,91,,percent of total billed charges,,,666.26,95,,percent of total billed charges,,,582.1,83,,percent of total billed charges,,,582.1,83,,percent of total billed charges,,,,,,,,,,,,,,,582.1,83,,percent of total billed charges,,,666.26,95,,percent of total billed charges,,,631.2,90,,percent of total billed charges,,,631.2,90,,percent of total billed charges,,,575.09,82,,percent of total billed charges,,,631.2,90,,percent of total billed charges,,,596.13,85,,percent of total billed charges,,528.8,666.26,
POTASSIUM CHLORIDE LIQ:20MEQ/15ML 60ML,32005152,CDM,,,250,RC,inpatient,,88.97,88.97,,75.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,75.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,78.29,88,,percent of total billed charges,,,,,,,,,67.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.96,91,,percent of total billed charges,,,84.52,95,,percent of total billed charges,,,73.85,83,,percent of total billed charges,,,73.85,83,,percent of total billed charges,,,,,,,,,,,,,,,73.85,83,,percent of total billed charges,,,84.52,95,,percent of total billed charges,,,80.07,90,,percent of total billed charges,,,80.07,90,,percent of total billed charges,,,72.96,82,,percent of total billed charges,,,80.07,90,,percent of total billed charges,,,75.62,85,,percent of total billed charges,,67.08,84.52,
POTASSIUM CHLORIDE LIQ:20MEQ/15ML 90ML,32005153,CDM,,,250,RC,inpatient,,133.38,133.38,,113.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,100.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,113.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,117.37,88,,percent of total billed charges,,,,,,,,,101.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,121.38,91,,percent of total billed charges,,,126.71,95,,percent of total billed charges,,,110.71,83,,percent of total billed charges,,,110.71,83,,percent of total billed charges,,,,,,,,,,,,,,,110.71,83,,percent of total billed charges,,,126.71,95,,percent of total billed charges,,,120.04,90,,percent of total billed charges,,,120.04,90,,percent of total billed charges,,,109.37,82,,percent of total billed charges,,,120.04,90,,percent of total billed charges,,,113.37,85,,percent of total billed charges,,100.57,126.71,
ATTAPULGITE (KAOPEK)ORAL:600MG/15ML 60ML,32005156,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ATTAPULGITE (KAOPEK)ORAL:600MG/15ML 90ML,32005161,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ATTAPULGITE(KAOPEK)ORAL:600MG/15ML 240ML,32005166,CDM,,,250,RC,inpatient,,34.42,34.42,,29.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.29,88,,percent of total billed charges,,,,,,,,,26.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31.32,91,,percent of total billed charges,,,32.7,95,,percent of total billed charges,,,28.57,83,,percent of total billed charges,,,28.57,83,,percent of total billed charges,,,,,,,,,,,,,,,28.57,83,,percent of total billed charges,,,32.7,95,,percent of total billed charges,,,30.98,90,,percent of total billed charges,,,30.98,90,,percent of total billed charges,,,28.22,82,,percent of total billed charges,,,30.98,90,,percent of total billed charges,,,29.26,85,,percent of total billed charges,,25.95,32.7,
KETAMINE(KETALAR) VIAL:500MG/10ML,32005201,CDM,J3490,HCPCS,250,RC,inpatient,,90.24,90.24,,76.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,76.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.41,88,,percent of total billed charges,,,,,,,,,68.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.12,91,,percent of total billed charges,,,85.73,95,,percent of total billed charges,,,74.9,83,,percent of total billed charges,,,74.9,83,,percent of total billed charges,,,,,,,,,,,,,,,74.9,83,,percent of total billed charges,,,85.73,95,,percent of total billed charges,,,81.22,90,,percent of total billed charges,,,81.22,90,,percent of total billed charges,,,74,82,,percent of total billed charges,,,81.22,90,,percent of total billed charges,,,76.7,85,,percent of total billed charges,,68.04,85.73,
KETOPROFEN (ORUDIS) CAP : 50MG,32005206,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
KETOPROFEN (ORUDIS) CAP : 75MG,32005216,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
KETOROLAC(TORADOL)VL:60MG/2ML,32005217,CDM,J1885,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,2.54,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.54,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,2.54,60.99,
KETOROLAC(TORADOL)VL:30MG/ML,32005218,CDM,J1885,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,2.54,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.54,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,2.54,60.99,
SINCALIDE (KINEVAC) :__MCG/SW 5ML  (PD),32005221,CDM,J2805,HCPCS,250,RC,inpatient,,1726.68,1726.68,,1465.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1301.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1467.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1519.48,88,,percent of total billed charges,,,,,,,,,1319.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1571.28,91,,percent of total billed charges,,,1640.35,95,,percent of total billed charges,,,1433.14,83,,percent of total billed charges,,,1433.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1433.14,83,,percent of total billed charges,,,1640.35,95,,percent of total billed charges,,,1554.01,90,,percent of total billed charges,,,1554.01,90,,percent of total billed charges,,,1415.88,82,,percent of total billed charges,,,1554.01,90,,percent of total billed charges,,,1467.68,85,,percent of total billed charges,,1301.92,1640.35,
POTASSIUM PHOS MONO(K-PHOS)TAB:500MG,32005226,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
POTASSIUM BICARB/CIT/CA(K-LYTE)TAB:50MEQ,32005231,CDM,,,250,RC,inpatient,,35.68,35.68,,30.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31.4,88,,percent of total billed charges,,,,,,,,,27.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.47,91,,percent of total billed charges,,,33.9,95,,percent of total billed charges,,,29.61,83,,percent of total billed charges,,,29.61,83,,percent of total billed charges,,,,,,,,,,,,,,,29.61,83,,percent of total billed charges,,,33.9,95,,percent of total billed charges,,,32.11,90,,percent of total billed charges,,,32.11,90,,percent of total billed charges,,,29.26,82,,percent of total billed charges,,,32.11,90,,percent of total billed charges,,,30.33,85,,percent of total billed charges,,26.9,33.9,
AMMONIUM (LAC-HYDRIN) LOTION: 2%   225ML,32005237,CDM,,,250,RC,inpatient,,73.75,73.75,,62.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,55.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,62.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,64.9,88,,percent of total billed charges,,,,,,,,,56.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,67.11,91,,percent of total billed charges,,,70.06,95,,percent of total billed charges,,,61.21,83,,percent of total billed charges,,,61.21,83,,percent of total billed charges,,,,,,,,,,,,,,,61.21,83,,percent of total billed charges,,,70.06,95,,percent of total billed charges,,,66.38,90,,percent of total billed charges,,,66.38,90,,percent of total billed charges,,,60.48,82,,percent of total billed charges,,,66.38,90,,percent of total billed charges,,,62.69,85,,percent of total billed charges,,55.61,70.06,
LANOLIN/MO/PETRO WHT(LACRILUBE)OINT  7GM,32005241,CDM,,,250,RC,inpatient,,281.67,281.67,,239.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,212.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,239.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,247.87,88,,percent of total billed charges,,,,,,,,,215.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,256.32,91,,percent of total billed charges,,,267.59,95,,percent of total billed charges,,,233.79,83,,percent of total billed charges,,,233.79,83,,percent of total billed charges,,,,,,,,,,,,,,,233.79,83,,percent of total billed charges,,,267.59,95,,percent of total billed charges,,,253.5,90,,percent of total billed charges,,,253.5,90,,percent of total billed charges,,,230.97,82,,percent of total billed charges,,,253.5,90,,percent of total billed charges,,,239.42,85,,percent of total billed charges,,212.38,267.59,
LANOLIN/MIN OIL/PETRO WHT(LACRILUBE)PAC,32005246,CDM,,,250,RC,inpatient,,26.96,26.96,,22.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23.72,88,,percent of total billed charges,,,,,,,,,20.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.53,91,,percent of total billed charges,,,25.61,95,,percent of total billed charges,,,22.38,83,,percent of total billed charges,,,22.38,83,,percent of total billed charges,,,,,,,,,,,,,,,22.38,83,,percent of total billed charges,,,25.61,95,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,22.11,82,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,22.92,85,,percent of total billed charges,,20.33,25.61,
MILK DIGESTANT TABS,32005247,CDM,,,250,RC,inpatient,,32,32,,27.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28.16,88,,percent of total billed charges,,,,,,,,,24.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,,,,,,,,,,,,,26.56,83,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,26.24,82,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,24.13,30.4,
LACTOBACILLUS ACIDOPHILUS (LACTINEX)TAB,32005264,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ACIDOPHILUS/BULGARICUS(FLORANEX)TAB:,32005265,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
BCAINE/ALOE/BENZ(LANACANE)CM:6%-0.2%60GM,32005267,CDM,,,250,RC,inpatient,,78.51,78.51,,66.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.09,88,,percent of total billed charges,,,,,,,,,59.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.44,91,,percent of total billed charges,,,74.58,95,,percent of total billed charges,,,65.16,83,,percent of total billed charges,,,65.16,83,,percent of total billed charges,,,,,,,,,,,,,,,65.16,83,,percent of total billed charges,,,74.58,95,,percent of total billed charges,,,70.66,90,,percent of total billed charges,,,70.66,90,,percent of total billed charges,,,64.38,82,,percent of total billed charges,,,70.66,90,,percent of total billed charges,,,66.73,85,,percent of total billed charges,,59.2,74.58,
TERBINAFINE HCL(LAMISIL AT)CREAM:1% 2GM,32005268,CDM,,,250,RC,inpatient,,55.5,55.5,,47.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.84,88,,percent of total billed charges,,,,,,,,,42.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.51,91,,percent of total billed charges,,,52.73,95,,percent of total billed charges,,,46.07,83,,percent of total billed charges,,,46.07,83,,percent of total billed charges,,,,,,,,,,,,,,,46.07,83,,percent of total billed charges,,,52.73,95,,percent of total billed charges,,,49.95,90,,percent of total billed charges,,,49.95,90,,percent of total billed charges,,,45.51,82,,percent of total billed charges,,,49.95,90,,percent of total billed charges,,,47.18,85,,percent of total billed charges,,41.85,52.73,
TERBINAFINE(LamISIL AT)CREAM:24GM,32005269,CDM,J3490,HCPCS,250,RC,inpatient,,173.37,173.37,,147.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.57,88,,percent of total billed charges,,,,,,,,,132.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.77,91,,percent of total billed charges,,,164.7,95,,percent of total billed charges,,,143.9,83,,percent of total billed charges,,,143.9,83,,percent of total billed charges,,,,,,,,,,,,,,,143.9,83,,percent of total billed charges,,,164.7,95,,percent of total billed charges,,,156.03,90,,percent of total billed charges,,,156.03,90,,percent of total billed charges,,,142.16,82,,percent of total billed charges,,,156.03,90,,percent of total billed charges,,,147.36,85,,percent of total billed charges,,130.72,164.7,
TERBINAFINE HCL(LAMISIL AT)SPR:1%30GM,32005270,CDM,,,250,RC,inpatient,,113.08,113.08,,96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,99.51,88,,percent of total billed charges,,,,,,,,,86.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,102.9,91,,percent of total billed charges,,,107.43,95,,percent of total billed charges,,,93.86,83,,percent of total billed charges,,,93.86,83,,percent of total billed charges,,,,,,,,,,,,,,,93.86,83,,percent of total billed charges,,,107.43,95,,percent of total billed charges,,,101.77,90,,percent of total billed charges,,,101.77,90,,percent of total billed charges,,,92.73,82,,percent of total billed charges,,,101.77,90,,percent of total billed charges,,,96.12,85,,percent of total billed charges,,85.26,107.43,
DIGOXIN(LANOXIN)TAB:125MCG(0.125MG) YEL,32005281,CDM,J8499,HCPCS,250,RC,inpatient,,14.38,14.38,,12.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.65,88,,percent of total billed charges,,,,,,,,,10.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.09,91,,percent of total billed charges,,,13.66,95,,percent of total billed charges,,,11.94,83,,percent of total billed charges,,,11.94,83,,percent of total billed charges,,,,,,,,,,,,,,,11.94,83,,percent of total billed charges,,,13.66,95,,percent of total billed charges,,,12.94,90,,percent of total billed charges,,,12.94,90,,percent of total billed charges,,,11.79,82,,percent of total billed charges,,,12.94,90,,percent of total billed charges,,,12.22,85,,percent of total billed charges,,10.84,13.66,
LANOLIN OINT 1oz,32005286,CDM,J3490,HCPCS,250,RC,inpatient,,121.08,121.08,,102.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,106.55,88,,percent of total billed charges,,,,,,,,,92.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,110.18,91,,percent of total billed charges,,,115.03,95,,percent of total billed charges,,,100.5,83,,percent of total billed charges,,,100.5,83,,percent of total billed charges,,,,,,,,,,,,,,,100.5,83,,percent of total billed charges,,,115.03,95,,percent of total billed charges,,,108.97,90,,percent of total billed charges,,,108.97,90,,percent of total billed charges,,,99.29,82,,percent of total billed charges,,,108.97,90,,percent of total billed charges,,,102.92,85,,percent of total billed charges,,91.29,115.03,
DIGOXIN (LANOXIN) TAB : 250MCG,32005291,CDM,,,250,RC,inpatient,,15.23,15.23,,12.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.4,88,,percent of total billed charges,,,,,,,,,11.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.86,91,,percent of total billed charges,,,14.47,95,,percent of total billed charges,,,12.64,83,,percent of total billed charges,,,12.64,83,,percent of total billed charges,,,,,,,,,,,,,,,12.64,83,,percent of total billed charges,,,14.47,95,,percent of total billed charges,,,13.71,90,,percent of total billed charges,,,13.71,90,,percent of total billed charges,,,12.49,82,,percent of total billed charges,,,13.71,90,,percent of total billed charges,,,12.95,85,,percent of total billed charges,,11.48,14.47,
DIGOXIN(LANOXIN)AMP:500MCG/2ML,32005296,CDM,J1160,HCPCS,250,RC,inpatient,,115.2,115.2,,97.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,86.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,97.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,101.38,88,,percent of total billed charges,,41.16,,,,fee schedule,,,88.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,41.16,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,104.83,91,,percent of total billed charges,,,109.44,95,,percent of total billed charges,,,95.62,83,,percent of total billed charges,,,95.62,83,,percent of total billed charges,,,,,,,,,,,,,,,95.62,83,,percent of total billed charges,,,109.44,95,,percent of total billed charges,,,103.68,90,,percent of total billed charges,,,103.68,90,,percent of total billed charges,,,94.46,82,,percent of total billed charges,,,103.68,90,,percent of total billed charges,,,97.92,85,,percent of total billed charges,,41.16,109.44,
FLUVASTATIN SODIUM (LESCOL) CAP : 20MG,32005306,CDM,,,250,RC,inpatient,,85.01,85.01,,72.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,72.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.81,88,,percent of total billed charges,,,,,,,,,64.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,77.36,91,,percent of total billed charges,,,80.76,95,,percent of total billed charges,,,70.56,83,,percent of total billed charges,,,70.56,83,,percent of total billed charges,,,,,,,,,,,,,,,70.56,83,,percent of total billed charges,,,80.76,95,,percent of total billed charges,,,76.51,90,,percent of total billed charges,,,76.51,90,,percent of total billed charges,,,69.71,82,,percent of total billed charges,,,76.51,90,,percent of total billed charges,,,72.26,85,,percent of total billed charges,,64.1,80.76,
FLUVASTATIN SODIUM (LESCOL) CAP : 40MG,32005311,CDM,,,250,RC,inpatient,,84.85,84.85,,72.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,72.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.67,88,,percent of total billed charges,,,,,,,,,64.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,77.21,91,,percent of total billed charges,,,80.61,95,,percent of total billed charges,,,70.43,83,,percent of total billed charges,,,70.43,83,,percent of total billed charges,,,,,,,,,,,,,,,70.43,83,,percent of total billed charges,,,80.61,95,,percent of total billed charges,,,76.37,90,,percent of total billed charges,,,76.37,90,,percent of total billed charges,,,69.58,82,,percent of total billed charges,,,76.37,90,,percent of total billed charges,,,72.12,85,,percent of total billed charges,,63.98,80.61,
LEUCOVORIN 200MG,32005315,CDM,,,250,RC,inpatient,,234,234,,198.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,176.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,198.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,205.92,88,,percent of total billed charges,,,,,,,,,178.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,212.94,91,,percent of total billed charges,,,222.3,95,,percent of total billed charges,,,194.22,83,,percent of total billed charges,,,194.22,83,,percent of total billed charges,,,,,,,,,,,,,,,194.22,83,,percent of total billed charges,,,222.3,95,,percent of total billed charges,,,210.6,90,,percent of total billed charges,,,210.6,90,,percent of total billed charges,,,191.88,82,,percent of total billed charges,,,210.6,90,,percent of total billed charges,,,198.9,85,,percent of total billed charges,,176.44,222.3,
LEUCOVORIN CALCIUM VIAL:350MG,32005327,CDM,J0640,HCPCS,636,RC,inpatient,,267,267,,226.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,201.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,226.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,234.96,88,,percent of total billed charges,,100.5,,,,fee schedule,,,203.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,100.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,242.97,91,,percent of total billed charges,,,253.65,95,,percent of total billed charges,,,221.61,83,,percent of total billed charges,,,221.61,83,,percent of total billed charges,,,,,,,,,,,,,,,221.61,83,,percent of total billed charges,,,253.65,95,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,218.94,82,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,226.95,85,,percent of total billed charges,,100.5,253.65,
LEVOFLOXACIN (LEVAQUIN) TAB : 250MG 1X2,32005330,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
HYOSCYAMINE ER (LEVSINEX ER) TAB:0.375MG,32005332,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LEVOFLOXACIN(LEVAQUIN)TAB:250MG,32005333,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LEVOFLOXACIN(LEVAQUIN)TAB:500MG,32005334,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LEVOFLOX(LEVAQUIN)-IVPB:250MG/D5W50ML,32005335,CDM,J1956,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,3.21,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.21,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.21,187.11,
LEVOTHYROXINE (SYNTHROID)TAB: 125 MCG,32005336,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
LEVOFLOXA/DEX5%(LEVAQUIN)PIG:500MG/100ML,32005337,CDM,J1956,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,3.21,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.21,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.21,187.11,
LEVOBUNOLOL(BETAGAN)DROP 0.5%:5ML,32005339,CDM,J3490,HCPCS,250,RC,inpatient,,70.74,70.74,,60.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.25,88,,percent of total billed charges,,,,,,,,,54.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.37,91,,percent of total billed charges,,,67.2,95,,percent of total billed charges,,,58.71,83,,percent of total billed charges,,,58.71,83,,percent of total billed charges,,,,,,,,,,,,,,,58.71,83,,percent of total billed charges,,,67.2,95,,percent of total billed charges,,,63.67,90,,percent of total billed charges,,,63.67,90,,percent of total billed charges,,,58.01,82,,percent of total billed charges,,,63.67,90,,percent of total billed charges,,,60.13,85,,percent of total billed charges,,53.34,67.2,
LEVOFLOXACIN (LEVAQUIN) TAB :500MG (1X2),32005340,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
LEVOTHYROXINE(SYNTHROID)TAB:100MCG,32005346,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LEVOTHYROXINE (SYNTHROID)     TAB:150MCG,32005351,CDM,,,250,RC,inpatient,,22.68,22.68,,19.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.96,88,,percent of total billed charges,,,,,,,,,17.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.64,91,,percent of total billed charges,,,21.55,95,,percent of total billed charges,,,18.82,83,,percent of total billed charges,,,18.82,83,,percent of total billed charges,,,,,,,,,,,,,,,18.82,83,,percent of total billed charges,,,21.55,95,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,18.6,82,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,19.28,85,,percent of total billed charges,,17.1,21.55,
LEVOTHYROXINE(SYNTHROID)TAB:25MCG,32005356,CDM,,,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LEVOTHYROXINE(SYNTHROID)TAB:50MCG,32005361,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LEVOTHYROXINE(LEVOTHROID)TAB:88MCG,32005362,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LEVOTHYROXINE(LEVOTHROID)TAB:112 MCG,32005366,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LEVOTHYROXINE(SYNTHROID)TAB:75MCG,32005371,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LEVOXYL .075MG TAB,32005372,CDM,,,250,RC,inpatient,,1,1,,0.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,0.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,0.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,0.88,88,,percent of total billed charges,,,,,,,,,0.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,0.91,91,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,,,,,,,,,,,,,0.83,83,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.82,82,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.85,85,,percent of total billed charges,,0.75,0.95,
LEVOXYL .025MG TAB,32005373,CDM,,,250,RC,inpatient,,1,1,,0.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,0.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,0.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,0.88,88,,percent of total billed charges,,,,,,,,,0.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,0.91,91,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,,,,,,,,,,,,,0.83,83,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.82,82,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.85,85,,percent of total billed charges,,0.75,0.95,
LEVOTHYROXINE(SYNTHROID)INJ:200MCG,32005374,CDM,,,250,RC,inpatient,,706.72,706.72,,600.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,532.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,600.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,621.91,88,,percent of total billed charges,,,,,,,,,539.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,643.12,91,,percent of total billed charges,,,671.38,95,,percent of total billed charges,,,586.58,83,,percent of total billed charges,,,586.58,83,,percent of total billed charges,,,,,,,,,,,,,,,586.58,83,,percent of total billed charges,,,671.38,95,,percent of total billed charges,,,636.05,90,,percent of total billed charges,,,636.05,90,,percent of total billed charges,,,579.51,82,,percent of total billed charges,,,636.05,90,,percent of total billed charges,,,600.71,85,,percent of total billed charges,,532.87,671.38,
LEVOTHYROXINE (SYNTHROID)VIAL: 500 MCG,32005376,CDM,,,250,RC,inpatient,,333.06,333.06,,282.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,251.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,283.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,293.09,88,,percent of total billed charges,,,,,,,,,254.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,303.08,91,,percent of total billed charges,,,316.41,95,,percent of total billed charges,,,276.44,83,,percent of total billed charges,,,276.44,83,,percent of total billed charges,,,,,,,,,,,,,,,276.44,83,,percent of total billed charges,,,316.41,95,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,273.11,82,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,283.1,85,,percent of total billed charges,,251.13,316.41,
LIDOCAINE HCL AMP PF 1%:20MG/2ML,32005382,CDM,J2001,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
BUFFERED LIDOCAINE,32005383,CDM,,,250,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
LIDOCAINE OINT 5%:35.44GM,32005386,CDM,J3490,HCPCS,250,RC,inpatient,,346.24,346.24,,293.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,261.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,294.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,304.69,88,,percent of total billed charges,,,,,,,,,264.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,315.08,91,,percent of total billed charges,,,328.93,95,,percent of total billed charges,,,287.38,83,,percent of total billed charges,,,287.38,83,,percent of total billed charges,,,,,,,,,,,,,,,287.38,83,,percent of total billed charges,,,328.93,95,,percent of total billed charges,,,311.62,90,,percent of total billed charges,,,311.62,90,,percent of total billed charges,,,283.92,82,,percent of total billed charges,,,311.62,90,,percent of total billed charges,,,294.3,85,,percent of total billed charges,,261.06,328.93,
LIDOCAINE(UROJECT)JEL 2%:11ML,32005391,CDM,J2001,HCPCS,250,RC,inpatient,,80.23,80.23,,68.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.6,88,,percent of total billed charges,,0.75,,,,fee schedule,,,61.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.01,91,,percent of total billed charges,,,76.22,95,,percent of total billed charges,,,66.59,83,,percent of total billed charges,,,66.59,83,,percent of total billed charges,,,,,,,,,,,,,,,66.59,83,,percent of total billed charges,,,76.22,95,,percent of total billed charges,,,72.21,90,,percent of total billed charges,,,72.21,90,,percent of total billed charges,,,65.79,82,,percent of total billed charges,,,72.21,90,,percent of total billed charges,,,68.2,85,,percent of total billed charges,,0.75,76.22,
LIDOCAINE(XYLOCAINE)TOP SOL 4%:50ML,32005396,CDM,J3490,HCPCS,250,RC,inpatient,,651.97,651.97,,553.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,491.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,554.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,573.73,88,,percent of total billed charges,,,,,,,,,498.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,593.29,91,,percent of total billed charges,,,619.37,95,,percent of total billed charges,,,541.14,83,,percent of total billed charges,,,541.14,83,,percent of total billed charges,,,,,,,,,,,,,,,541.14,83,,percent of total billed charges,,,619.37,95,,percent of total billed charges,,,586.77,90,,percent of total billed charges,,,586.77,90,,percent of total billed charges,,,534.62,82,,percent of total billed charges,,,586.77,90,,percent of total billed charges,,,554.17,85,,percent of total billed charges,,491.59,619.37,
LIDOCAINE(XYLOCAIN SYR):100MG/5ML,32005401,CDM,J2001,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
LIDOCAINE VISCOUS(XYLOCAINE) 2%:15ML U/D,32005411,CDM,J8499,HCPCS,250,RC,inpatient,,64.38,64.38,,54.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.65,88,,percent of total billed charges,,,,,,,,,49.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.59,91,,percent of total billed charges,,,61.16,95,,percent of total billed charges,,,53.44,83,,percent of total billed charges,,,53.44,83,,percent of total billed charges,,,,,,,,,,,,,,,53.44,83,,percent of total billed charges,,,61.16,95,,percent of total billed charges,,,57.94,90,,percent of total billed charges,,,57.94,90,,percent of total billed charges,,,52.79,82,,percent of total billed charges,,,57.94,90,,percent of total billed charges,,,54.72,85,,percent of total billed charges,,48.54,61.16,
LIDOCAINE VISCOUS 2% SOL:100ML,32005412,CDM,J8499,HCPCS,250,RC,inpatient,,188.56,188.56,,160.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,142.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,160.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,165.93,88,,percent of total billed charges,,,,,,,,,144.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.59,91,,percent of total billed charges,,,179.13,95,,percent of total billed charges,,,156.5,83,,percent of total billed charges,,,156.5,83,,percent of total billed charges,,,,,,,,,,,,,,,156.5,83,,percent of total billed charges,,,179.13,95,,percent of total billed charges,,,169.7,90,,percent of total billed charges,,,169.7,90,,percent of total billed charges,,,154.62,82,,percent of total billed charges,,,169.7,90,,percent of total billed charges,,,160.28,85,,percent of total billed charges,,142.17,179.13,
IV NITROglycerin BTL 25MG/250ML (PREMIX),32005413,CDM,J3490,HCPCS,250,RC,inpatient,,316.67,316.67,,268.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,238.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,269.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,278.67,88,,percent of total billed charges,,,,,,,,,241.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,288.17,91,,percent of total billed charges,,,300.84,95,,percent of total billed charges,,,262.84,83,,percent of total billed charges,,,262.84,83,,percent of total billed charges,,,,,,,,,,,,,,,262.84,83,,percent of total billed charges,,,300.84,95,,percent of total billed charges,,,285,90,,percent of total billed charges,,,285,90,,percent of total billed charges,,,259.67,82,,percent of total billed charges,,,285,90,,percent of total billed charges,,,269.17,85,,percent of total billed charges,,238.77,300.84,
LINDANE LOT (KWELL) : 1%  60ML,32005426,CDM,,,250,RC,inpatient,,1470.34,1470.34,,1248.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1108.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1249.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1293.9,88,,percent of total billed charges,,,,,,,,,1123.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1338.01,91,,percent of total billed charges,,,1396.82,95,,percent of total billed charges,,,1220.38,83,,percent of total billed charges,,,1220.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1220.38,83,,percent of total billed charges,,,1396.82,95,,percent of total billed charges,,,1323.31,90,,percent of total billed charges,,,1323.31,90,,percent of total billed charges,,,1205.68,82,,percent of total billed charges,,,1323.31,90,,percent of total billed charges,,,1249.79,85,,percent of total billed charges,,1108.64,1396.82,
LINDANE SHAM (KWELL) 1%:60ML,32005431,CDM,,,250,RC,inpatient,,1498.83,1498.83,,1272.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1130.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1274.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1318.97,88,,percent of total billed charges,,,,,,,,,1145.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1363.94,91,,percent of total billed charges,,,1423.89,95,,percent of total billed charges,,,1244.03,83,,percent of total billed charges,,,1244.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1244.03,83,,percent of total billed charges,,,1423.89,95,,percent of total billed charges,,,1348.95,90,,percent of total billed charges,,,1348.95,90,,percent of total billed charges,,,1229.04,82,,percent of total billed charges,,,1348.95,90,,percent of total billed charges,,,1274.01,85,,percent of total billed charges,,1130.12,1423.89,
ATORVASTATIN(LIPITOR)TAB:10MG,32005432,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ATORVASTATIN (LIPITOR) TAB : 20MG,32005433,CDM,,,250,RC,inpatient,,287.7,287.7,,244.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,216.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,244.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,253.18,88,,percent of total billed charges,,,,,,,,,219.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,261.81,91,,percent of total billed charges,,,273.32,95,,percent of total billed charges,,,238.79,83,,percent of total billed charges,,,238.79,83,,percent of total billed charges,,,,,,,,,,,,,,,238.79,83,,percent of total billed charges,,,273.32,95,,percent of total billed charges,,,258.93,90,,percent of total billed charges,,,258.93,90,,percent of total billed charges,,,235.91,82,,percent of total billed charges,,,258.93,90,,percent of total billed charges,,,244.55,85,,percent of total billed charges,,216.93,273.32,
POLYVIN ALC (ARTIF TEARS)DROP 1.40%:15ML,32005436,CDM,J3490,HCPCS,250,RC,inpatient,,107.84,107.84,,91.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,94.9,88,,percent of total billed charges,,,,,,,,,82.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.13,91,,percent of total billed charges,,,102.45,95,,percent of total billed charges,,,89.51,83,,percent of total billed charges,,,89.51,83,,percent of total billed charges,,,,,,,,,,,,,,,89.51,83,,percent of total billed charges,,,102.45,95,,percent of total billed charges,,,97.06,90,,percent of total billed charges,,,97.06,90,,percent of total billed charges,,,88.43,82,,percent of total billed charges,,,97.06,90,,percent of total billed charges,,,91.66,85,,percent of total billed charges,,81.31,102.45,
ACTIVATED CHARCL(ACTIDOSE)ORAL:25G/120ML,32005441,CDM,J8499,HCPCS,250,RC,inpatient,,150,150,,127.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,113.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,127.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,132,88,,percent of total billed charges,,,,,,,,,114.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,,,,,,,,,,,,,124.5,83,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,123,82,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,113.1,142.5,
LIQUI-CHAR 50GM,32005442,CDM,,,250,RC,inpatient,,35,35,,29.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.8,88,,percent of total billed charges,,,,,,,,,26.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31.85,91,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,,,,,,,,,,,,,29.05,83,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,28.7,82,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,26.39,33.25,
LISTERINE 250ML,32005447,CDM,,,250,RC,inpatient,,10,10,,8.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8.8,88,,percent of total billed charges,,,,,,,,,7.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9.1,91,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,,,,,,,,,,,,,8.3,83,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,9,90,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.2,82,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.5,85,,percent of total billed charges,,7.54,9.5,
LITHIUM CARBONATE CAP:300MG,32005451,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LITHIUM CARBONATE CAP : 150MG,32005452,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
LITHIUM CARBONATE (LITHOBID)TAB:300MG,32005456,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ETODOLAC(LODINE)CAP:300MG,32005461,CDM,,,250,RC,inpatient,,13.64,13.64,,11.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12,88,,percent of total billed charges,,,,,,,,,10.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.41,91,,percent of total billed charges,,,12.96,95,,percent of total billed charges,,,11.32,83,,percent of total billed charges,,,11.32,83,,percent of total billed charges,,,,,,,,,,,,,,,11.32,83,,percent of total billed charges,,,12.96,95,,percent of total billed charges,,,12.28,90,,percent of total billed charges,,,12.28,90,,percent of total billed charges,,,11.18,82,,percent of total billed charges,,,12.28,90,,percent of total billed charges,,,11.59,85,,percent of total billed charges,,10.28,12.96,
ETODOLAC TAB (LODINE) : 400MG,32005471,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
LODINE XL 400MG,32005472,CDM,,,250,RC,inpatient,,4,4,,3.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3.52,88,,percent of total billed charges,,,,,,,,,3.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3.64,91,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3.32,83,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.28,82,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,3.02,3.8,
LONOX,32005475,CDM,,,250,RC,inpatient,,2,2,,1.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1.76,88,,percent of total billed charges,,,,,,,,,1.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1.82,91,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,,,,,,,,,,,,,1.66,83,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.64,82,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.7,85,,percent of total billed charges,,1.51,1.9,
LOPERAMIDE (IMODIUM) LIQ: 1MG/5ML 10 ML,32005481,CDM,,,250,RC,inpatient,,25.38,25.38,,21.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.33,88,,percent of total billed charges,,,,,,,,,19.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.1,91,,percent of total billed charges,,,24.11,95,,percent of total billed charges,,,21.07,83,,percent of total billed charges,,,21.07,83,,percent of total billed charges,,,,,,,,,,,,,,,21.07,83,,percent of total billed charges,,,24.11,95,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,20.81,82,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,21.57,85,,percent of total billed charges,,19.14,24.11,
LOPERAMIDE 1MG/5ML SOLUTION 120CC,32005482,CDM,,,250,RC,inpatient,,20.25,20.25,,17.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.82,88,,percent of total billed charges,,,,,,,,,15.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.43,91,,percent of total billed charges,,,19.24,95,,percent of total billed charges,,,16.81,83,,percent of total billed charges,,,16.81,83,,percent of total billed charges,,,,,,,,,,,,,,,16.81,83,,percent of total billed charges,,,19.24,95,,percent of total billed charges,,,18.23,90,,percent of total billed charges,,,18.23,90,,percent of total billed charges,,,16.61,82,,percent of total billed charges,,,18.23,90,,percent of total billed charges,,,17.21,85,,percent of total billed charges,,15.27,19.24,
LOPERAMIDE(IMODIUM)CAP:2MG,32005486,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LOPERAMIDE HCL (IMODIUM) 120ML,32005491,CDM,,,250,RC,inpatient,,28.5,28.5,,24.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.08,88,,percent of total billed charges,,,,,,,,,21.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.94,91,,percent of total billed charges,,,27.08,95,,percent of total billed charges,,,23.66,83,,percent of total billed charges,,,23.66,83,,percent of total billed charges,,,,,,,,,,,,,,,23.66,83,,percent of total billed charges,,,27.08,95,,percent of total billed charges,,,25.65,90,,percent of total billed charges,,,25.65,90,,percent of total billed charges,,,23.37,82,,percent of total billed charges,,,25.65,90,,percent of total billed charges,,,24.23,85,,percent of total billed charges,,21.49,27.08,
LOPERAMIDE(IMODIUM)LIQ:1MG/5ML(120ML),32005496,CDM,J8499,HCPCS,250,RC,inpatient,,28.5,28.5,,24.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.08,88,,percent of total billed charges,,,,,,,,,21.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.94,91,,percent of total billed charges,,,27.08,95,,percent of total billed charges,,,23.66,83,,percent of total billed charges,,,23.66,83,,percent of total billed charges,,,,,,,,,,,,,,,23.66,83,,percent of total billed charges,,,27.08,95,,percent of total billed charges,,,25.65,90,,percent of total billed charges,,,25.65,90,,percent of total billed charges,,,23.37,82,,percent of total billed charges,,,25.65,90,,percent of total billed charges,,,24.23,85,,percent of total billed charges,,21.49,27.08,
LORazepam(ATIVAN)TAB:0.5MG,32005511,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
LORAZEPAM (ATIVAN) TAB : 2MG,32005516,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
LORazepam(ATIVAN)TAB:1MG,32005526,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
HYDROCOD/ACET(VICOD ES)TAB :7.5-750MG,32005532,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
HYDROCOD/ACETA (LORCET) TAB:10-650MG,32005536,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
VICODIN TAB:5-500MG ***SUB TO NORCO,32005551,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
HYDROcod/APAP(VICODIN)TAB:5-500MG (1X10),32005552,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
BENAZEPRIL (LOTENSIN) TAB : 5MG,32005556,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
BENAZEPRIL(LOTENSIN)TAB:10MG,32005561,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
AMLODIPINE/BENZAPRIL(LOTREL) CAP:5-10MG,32005562,CDM,,,250,RC,inpatient,,40.13,40.13,,34.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.31,88,,percent of total billed charges,,,,,,,,,30.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.52,91,,percent of total billed charges,,,38.12,95,,percent of total billed charges,,,33.31,83,,percent of total billed charges,,,33.31,83,,percent of total billed charges,,,,,,,,,,,,,,,33.31,83,,percent of total billed charges,,,38.12,95,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,32.91,82,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,34.11,85,,percent of total billed charges,,30.26,38.12,
AMLODIPINE/BENAZEPRIL(LOTREL) CAP:5-20MG,32005563,CDM,,,250,RC,inpatient,,42.35,42.35,,35.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37.27,88,,percent of total billed charges,,,,,,,,,32.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38.54,91,,percent of total billed charges,,,40.23,95,,percent of total billed charges,,,35.15,83,,percent of total billed charges,,,35.15,83,,percent of total billed charges,,,,,,,,,,,,,,,35.15,83,,percent of total billed charges,,,40.23,95,,percent of total billed charges,,,38.12,90,,percent of total billed charges,,,38.12,90,,percent of total billed charges,,,34.73,82,,percent of total billed charges,,,38.12,90,,percent of total billed charges,,,36,85,,percent of total billed charges,,31.93,40.23,
LOTRISONE:15GM,32005566,CDM,,,250,RC,inpatient,,342.42,342.42,,290.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,258.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,291.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,301.33,88,,percent of total billed charges,,,,,,,,,261.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,311.6,91,,percent of total billed charges,,,325.3,95,,percent of total billed charges,,,284.21,83,,percent of total billed charges,,,284.21,83,,percent of total billed charges,,,,,,,,,,,,,,,284.21,83,,percent of total billed charges,,,325.3,95,,percent of total billed charges,,,308.18,90,,percent of total billed charges,,,308.18,90,,percent of total billed charges,,,280.78,82,,percent of total billed charges,,,308.18,90,,percent of total billed charges,,,291.06,85,,percent of total billed charges,,258.18,325.3,
LOTRISONE CREAM 45GM,32005567,CDM,,,250,RC,inpatient,,143,143,,121.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,107.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,121.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,125.84,88,,percent of total billed charges,,,,,,,,,109.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,130.13,91,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,,,,,,,,,,,,,118.69,83,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,117.26,82,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,121.55,85,,percent of total billed charges,,107.82,135.85,
ENOXAPARIN(LOVENOX): 30MG/0.3ML,32005571,CDM,J1650,HCPCS,250,RC,inpatient,,73.37,73.37,,62.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,55.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,62.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,64.57,88,,percent of total billed charges,,15.16,,,,fee schedule,,,56.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.16,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,66.77,91,,percent of total billed charges,,,69.7,95,,percent of total billed charges,,,60.9,83,,percent of total billed charges,,,60.9,83,,percent of total billed charges,,,,,,,,,,,,,,,60.9,83,,percent of total billed charges,,,69.7,95,,percent of total billed charges,,,66.03,90,,percent of total billed charges,,,66.03,90,,percent of total billed charges,,,60.16,82,,percent of total billed charges,,,66.03,90,,percent of total billed charges,,,62.36,85,,percent of total billed charges,,15.16,69.7,
LOVENOX 40MG/.4ML SYRINGES,32005572,CDM,,,250,RC,inpatient,,62.81,62.81,,53.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,53.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.27,88,,percent of total billed charges,,,,,,,,,47.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.16,91,,percent of total billed charges,,,59.67,95,,percent of total billed charges,,,52.13,83,,percent of total billed charges,,,52.13,83,,percent of total billed charges,,,,,,,,,,,,,,,52.13,83,,percent of total billed charges,,,59.67,95,,percent of total billed charges,,,56.53,90,,percent of total billed charges,,,56.53,90,,percent of total billed charges,,,51.5,82,,percent of total billed charges,,,56.53,90,,percent of total billed charges,,,53.39,85,,percent of total billed charges,,47.36,59.67,
ENOXAPARIN(LOVENOX): 40MG/0.4ML,32005573,CDM,J1650,HCPCS,636,RC,inpatient,,65.52,65.52,,55.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.66,88,,percent of total billed charges,,15.16,,,,fee schedule,,,50.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.16,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.62,91,,percent of total billed charges,,,62.24,95,,percent of total billed charges,,,54.38,83,,percent of total billed charges,,,54.38,83,,percent of total billed charges,,,,,,,,,,,,,,,54.38,83,,percent of total billed charges,,,62.24,95,,percent of total billed charges,,,58.97,90,,percent of total billed charges,,,58.97,90,,percent of total billed charges,,,53.73,82,,percent of total billed charges,,,58.97,90,,percent of total billed charges,,,55.69,85,,percent of total billed charges,,15.16,62.24,
INDAPAMIDE (LOZOL) TAB : 2.5MG,32005576,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
LEUPROLIDE ACETATE (LUPRON DEPOT) 7.5MG,32005587,CDM,J9217,HCPCS,636,RC,inpatient,,8125.74,8125.74,,6898.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150.65,88,,percent of total billed charges,,998.81,,,,fee schedule,,,6208.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,998.81,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7394.42,91,,percent of total billed charges,,,7719.45,95,,percent of total billed charges,,,6744.36,83,,percent of total billed charges,,,6744.36,83,,percent of total billed charges,,,,,,,,,,,,,,,6744.36,83,,percent of total billed charges,,,7719.45,95,,percent of total billed charges,,,7313.17,90,,percent of total billed charges,,,7313.17,90,,percent of total billed charges,,,6663.11,82,,percent of total billed charges,,,7313.17,90,,percent of total billed charges,,,6906.88,85,,percent of total billed charges,,998.81,7719.45,
*DEPO LUPRON 4 MONTH(V1014),32005592,CDM,J9217,HCPCS,636,RC,inpatient,,3144,3144,,2669.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2370.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2672.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2766.72,88,,percent of total billed charges,,998.81,,,,fee schedule,,,2402.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,998.81,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2861.04,91,,percent of total billed charges,,,2986.8,95,,percent of total billed charges,,,2609.52,83,,percent of total billed charges,,,2609.52,83,,percent of total billed charges,,,,,,,,,,,,,,,2609.52,83,,percent of total billed charges,,,2986.8,95,,percent of total billed charges,,,2829.6,90,,percent of total billed charges,,,2829.6,90,,percent of total billed charges,,,2578.08,82,,percent of total billed charges,,,2829.6,90,,percent of total billed charges,,,2672.4,85,,percent of total billed charges,,998.81,2986.8,
MAG+ALOH+SIMETH(MYLANTA):30ML,32005597,CDM,J8499,HCPCS,250,RC,inpatient,,54.58,54.58,,46.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.03,88,,percent of total billed charges,,,,,,,,,41.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.67,91,,percent of total billed charges,,,51.85,95,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,,,,,,,,,,,,,,45.3,83,,percent of total billed charges,,,51.85,95,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,44.76,82,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,46.39,85,,percent of total billed charges,,41.15,51.85,
MAG HYDRO(ALAMAG):200-225/5 (12OZ),32005601,CDM,,,250,RC,inpatient,,14.75,14.75,,12.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.98,88,,percent of total billed charges,,,,,,,,,11.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.42,91,,percent of total billed charges,,,14.01,95,,percent of total billed charges,,,12.24,83,,percent of total billed charges,,,12.24,83,,percent of total billed charges,,,,,,,,,,,,,,,12.24,83,,percent of total billed charges,,,14.01,95,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,12.1,82,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,12.54,85,,percent of total billed charges,,11.12,14.01,
MAG/AL/SIM(MAALOX+)ORAL:200-200-20 148ML,32005606,CDM,,,250,RC,inpatient,,32.35,32.35,,27.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28.47,88,,percent of total billed charges,,,,,,,,,24.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29.44,91,,percent of total billed charges,,,30.73,95,,percent of total billed charges,,,26.85,83,,percent of total billed charges,,,26.85,83,,percent of total billed charges,,,,,,,,,,,,,,,26.85,83,,percent of total billed charges,,,30.73,95,,percent of total billed charges,,,29.12,90,,percent of total billed charges,,,29.12,90,,percent of total billed charges,,,26.53,82,,percent of total billed charges,,,29.12,90,,percent of total billed charges,,,27.5,85,,percent of total billed charges,,24.39,30.73,
MAG/AL/SIM(MAALOX+)ORAL:200-225-25 148ML,32005611,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
MAALOX EXTRA STRENGTH PLUS 148CC,32005612,CDM,,,250,RC,inpatient,,3.25,3.25,,2.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.86,88,,percent of total billed charges,,,,,,,,,2.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.96,91,,percent of total billed charges,,,3.09,95,,percent of total billed charges,,,2.7,83,,percent of total billed charges,,,2.7,83,,percent of total billed charges,,,,,,,,,,,,,,,2.7,83,,percent of total billed charges,,,3.09,95,,percent of total billed charges,,,2.93,90,,percent of total billed charges,,,2.93,90,,percent of total billed charges,,,2.67,82,,percent of total billed charges,,,2.93,90,,percent of total billed charges,,,2.76,85,,percent of total billed charges,,2.45,3.09,
NITROFURANTOIN(MACROBID)CAP:100MG,32005616,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
MAG OXIDE TAB:400MG,32005621,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
MAGNESIUM SULF VIAL : 4MEQ/ML (1GM) 2ML,32005626,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
MAG SULF-VIAL:5GM/10ML,32005631,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
MAG SULF-VIAL:1GM/2ML,32005636,CDM,J3475,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,15.22,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,15.22,60.99,
METHENAMINE MANDELATE TAB : 1G,32005651,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
MAPROTILINE (LUDIOMIL) TAB : 25MG,32005661,CDM,,,250,RC,inpatient,,15.38,15.38,,13.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.53,88,,percent of total billed charges,,,,,,,,,11.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14,91,,percent of total billed charges,,,14.61,95,,percent of total billed charges,,,12.77,83,,percent of total billed charges,,,12.77,83,,percent of total billed charges,,,,,,,,,,,,,,,12.77,83,,percent of total billed charges,,,14.61,95,,percent of total billed charges,,,13.84,90,,percent of total billed charges,,,13.84,90,,percent of total billed charges,,,12.61,82,,percent of total billed charges,,,13.84,90,,percent of total billed charges,,,13.07,85,,percent of total billed charges,,11.6,14.61,
MAPROTILINE (LUDIOMIL) TAB : 50MG,32005666,CDM,,,250,RC,inpatient,,22.68,22.68,,19.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.96,88,,percent of total billed charges,,,,,,,,,17.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.64,91,,percent of total billed charges,,,21.55,95,,percent of total billed charges,,,18.82,83,,percent of total billed charges,,,18.82,83,,percent of total billed charges,,,,,,,,,,,,,,,18.82,83,,percent of total billed charges,,,21.55,95,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,18.6,82,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,19.28,85,,percent of total billed charges,,17.1,21.55,
MAPROTILINE (LUDIOMIL) TAB : 75MG,32005671,CDM,,,250,RC,inpatient,,31.24,31.24,,26.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.49,88,,percent of total billed charges,,,,,,,,,23.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.43,91,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,,,,,,,,,,,,,25.93,83,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,25.62,82,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,26.55,85,,percent of total billed charges,,23.55,29.68,
RIZATRIPTAN(MAXALT)TAB:10MG,32005682,CDM,J8499,HCPCS,250,RC,inpatient,,370.49,370.49,,314.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,279.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,314.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,326.03,88,,percent of total billed charges,,,,,,,,,283.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,337.15,91,,percent of total billed charges,,,351.97,95,,percent of total billed charges,,,307.51,83,,percent of total billed charges,,,307.51,83,,percent of total billed charges,,,,,,,,,,,,,,,307.51,83,,percent of total billed charges,,,351.97,95,,percent of total billed charges,,,333.44,90,,percent of total billed charges,,,333.44,90,,percent of total billed charges,,,303.8,82,,percent of total billed charges,,,333.44,90,,percent of total billed charges,,,314.92,85,,percent of total billed charges,,279.35,351.97,
NEO/POLY/DEX(MAXITROL)DROP 0.1%:5ML,32005686,CDM,J3490,HCPCS,250,RC,inpatient,,222.36,222.36,,188.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,167.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,195.68,88,,percent of total billed charges,,,,,,,,,169.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,202.35,91,,percent of total billed charges,,,211.24,95,,percent of total billed charges,,,184.56,83,,percent of total billed charges,,,184.56,83,,percent of total billed charges,,,,,,,,,,,,,,,184.56,83,,percent of total billed charges,,,211.24,95,,percent of total billed charges,,,200.12,90,,percent of total billed charges,,,200.12,90,,percent of total billed charges,,,182.34,82,,percent of total billed charges,,,200.12,90,,percent of total billed charges,,,189.01,85,,percent of total billed charges,,167.66,211.24,
DEXAMETHASONE(MAXIDEX)EYE DROP 0.1%:5ML,32005691,CDM,J3490,HCPCS,250,RC,inpatient,,706.21,706.21,,599.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,532.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,600.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,621.46,88,,percent of total billed charges,,,,,,,,,539.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,642.65,91,,percent of total billed charges,,,670.9,95,,percent of total billed charges,,,586.15,83,,percent of total billed charges,,,586.15,83,,percent of total billed charges,,,,,,,,,,,,,,,586.15,83,,percent of total billed charges,,,670.9,95,,percent of total billed charges,,,635.59,90,,percent of total billed charges,,,635.59,90,,percent of total billed charges,,,579.09,82,,percent of total billed charges,,,635.59,90,,percent of total billed charges,,,600.28,85,,percent of total billed charges,,532.48,670.9,
NEO/POLY/DEX OPHTH OINT:3.5GM,32005701,CDM,,,250,RC,inpatient,,299.75,299.75,,254.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,226.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,254.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,263.78,88,,percent of total billed charges,,,,,,,,,229.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,272.77,91,,percent of total billed charges,,,284.76,95,,percent of total billed charges,,,248.79,83,,percent of total billed charges,,,248.79,83,,percent of total billed charges,,,,,,,,,,,,,,,248.79,83,,percent of total billed charges,,,284.76,95,,percent of total billed charges,,,269.78,90,,percent of total billed charges,,,269.78,90,,percent of total billed charges,,,245.8,82,,percent of total billed charges,,,269.78,90,,percent of total billed charges,,,254.79,85,,percent of total billed charges,,226.01,284.76,
TRIAMTERENE/HCTZ(MAXZIDE) TAB : 37-26MG,32005706,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
FLUMAZENIL(ROMAZICON)VL:0.5MG/5ML,32005711,CDM,J3490,HCPCS,250,RC,inpatient,,111.44,111.44,,94.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.07,88,,percent of total billed charges,,,,,,,,,85.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.41,91,,percent of total billed charges,,,105.87,95,,percent of total billed charges,,,92.5,83,,percent of total billed charges,,,92.5,83,,percent of total billed charges,,,,,,,,,,,,,,,92.5,83,,percent of total billed charges,,,105.87,95,,percent of total billed charges,,,100.3,90,,percent of total billed charges,,,100.3,90,,percent of total billed charges,,,91.38,82,,percent of total billed charges,,,100.3,90,,percent of total billed charges,,,94.72,85,,percent of total billed charges,,84.03,105.87,
FREAMINE III KIT:8.50%,32005726,CDM,,,250,RC,inpatient,,252.75,252.75,,214.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,214.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,222.42,88,,percent of total billed charges,,,,,,,,,193.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,230,91,,percent of total billed charges,,,240.11,95,,percent of total billed charges,,,209.78,83,,percent of total billed charges,,,209.78,83,,percent of total billed charges,,,,,,,,,,,,,,,209.78,83,,percent of total billed charges,,,240.11,95,,percent of total billed charges,,,227.48,90,,percent of total billed charges,,,227.48,90,,percent of total billed charges,,,207.26,82,,percent of total billed charges,,,227.48,90,,percent of total billed charges,,,214.84,85,,percent of total billed charges,,190.57,240.11,
metroNID(FLAGYL)-IVPB:500MG/NS100ML,32005851,CDM,J3490,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
MECLIZINE (ANTIVERT) TAB : 12.5MG,32005921,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
MECLIZINE(ANTIVERT)TAB:25MG,32005926,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
MECLOFENAMATE (PONSTEL) CAP : 50MG,32005931,CDM,,,250,RC,inpatient,,55.51,55.51,,47.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.85,88,,percent of total billed charges,,,,,,,,,42.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.51,91,,percent of total billed charges,,,52.73,95,,percent of total billed charges,,,46.07,83,,percent of total billed charges,,,46.07,83,,percent of total billed charges,,,,,,,,,,,,,,,46.07,83,,percent of total billed charges,,,52.73,95,,percent of total billed charges,,,49.96,90,,percent of total billed charges,,,49.96,90,,percent of total billed charges,,,45.52,82,,percent of total billed charges,,,49.96,90,,percent of total billed charges,,,47.18,85,,percent of total billed charges,,41.85,52.73,
methylPRED(MEDROL)DOSEPAK:4MG (21TABS)ED,32005941,CDM,J8499,HCPCS,250,RC,inpatient,,81.86,81.86,,69.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,69.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,72.04,88,,percent of total billed charges,,,,,,,,,62.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,74.49,91,,percent of total billed charges,,,77.77,95,,percent of total billed charges,,,67.94,83,,percent of total billed charges,,,67.94,83,,percent of total billed charges,,,,,,,,,,,,,,,67.94,83,,percent of total billed charges,,,77.77,95,,percent of total billed charges,,,73.67,90,,percent of total billed charges,,,73.67,90,,percent of total billed charges,,,67.13,82,,percent of total billed charges,,,73.67,90,,percent of total billed charges,,,69.58,85,,percent of total billed charges,,61.72,77.77,
MEDROXYPROGESTERONE (PROVERA) TAB : 10MG,32005951,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ceFOXitin(MEFOXIN)-VIAL:1GM,32005961,CDM,J0694,HCPCS,250,RC,inpatient,,133.5,133.5,,113.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,100.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,113.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,117.48,88,,percent of total billed charges,,15.93,,,,fee schedule,,,101.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.93,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,121.49,91,,percent of total billed charges,,,126.83,95,,percent of total billed charges,,,110.81,83,,percent of total billed charges,,,110.81,83,,percent of total billed charges,,,,,,,,,,,,,,,110.81,83,,percent of total billed charges,,,126.83,95,,percent of total billed charges,,,120.15,90,,percent of total billed charges,,,120.15,90,,percent of total billed charges,,,109.47,82,,percent of total billed charges,,,120.15,90,,percent of total billed charges,,,113.48,85,,percent of total billed charges,,15.93,126.83,
ceFOXitin(MEFOXIN)-VIAL:2GM,32005966,CDM,J0694,HCPCS,250,RC,inpatient,,103.76,103.76,,88.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,78.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,88.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,91.31,88,,percent of total billed charges,,15.93,,,,fee schedule,,,79.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.93,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,94.42,91,,percent of total billed charges,,,98.57,95,,percent of total billed charges,,,86.12,83,,percent of total billed charges,,,86.12,83,,percent of total billed charges,,,,,,,,,,,,,,,86.12,83,,percent of total billed charges,,,98.57,95,,percent of total billed charges,,,93.38,90,,percent of total billed charges,,,93.38,90,,percent of total billed charges,,,85.08,82,,percent of total billed charges,,,93.38,90,,percent of total billed charges,,,88.2,85,,percent of total billed charges,,15.93,98.57,
MEGESTROL(MEGACE)TAB:40MG,32005971,CDM,J8999,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
MEGESTROL(MEGACE)ORAL:400MG/10ML (240ML),32005972,CDM,J8999,HCPCS,250,RC,inpatient,,499.59,499.59,,424.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,376.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,424.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,439.64,88,,percent of total billed charges,,,,,,,,,381.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,454.63,91,,percent of total billed charges,,,474.61,95,,percent of total billed charges,,,414.66,83,,percent of total billed charges,,,414.66,83,,percent of total billed charges,,,,,,,,,,,,,,,414.66,83,,percent of total billed charges,,,474.61,95,,percent of total billed charges,,,449.63,90,,percent of total billed charges,,,449.63,90,,percent of total billed charges,,,409.66,82,,percent of total billed charges,,,449.63,90,,percent of total billed charges,,,424.65,85,,percent of total billed charges,,376.69,474.61,
MENTHOLATUM OINT,32005987,CDM,,,250,RC,inpatient,,7.5,7.5,,6.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6.6,88,,percent of total billed charges,,,,,,,,,5.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6.83,91,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,,,,,,,,,,,,,6.23,83,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.15,82,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,5.66,7.13,
ESTROGENS ESTERIFIED (MENEST) TAB:1.25MG,32005988,CDM,,,250,RC,inpatient,,58.21,58.21,,49.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.22,88,,percent of total billed charges,,,,,,,,,44.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52.97,91,,percent of total billed charges,,,55.3,95,,percent of total billed charges,,,48.31,83,,percent of total billed charges,,,48.31,83,,percent of total billed charges,,,,,,,,,,,,,,,48.31,83,,percent of total billed charges,,,55.3,95,,percent of total billed charges,,,52.39,90,,percent of total billed charges,,,52.39,90,,percent of total billed charges,,,47.73,82,,percent of total billed charges,,,52.39,90,,percent of total billed charges,,,49.48,85,,percent of total billed charges,,43.89,55.3,
PHYTONADIONE(MEPHYTON)TAB:5MG,32005991,CDM,J8499,HCPCS,250,RC,inpatient,,657.19,657.19,,557.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,495.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,558.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,578.33,88,,percent of total billed charges,,,,,,,,,502.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,598.04,91,,percent of total billed charges,,,624.33,95,,percent of total billed charges,,,545.47,83,,percent of total billed charges,,,545.47,83,,percent of total billed charges,,,,,,,,,,,,,,,545.47,83,,percent of total billed charges,,,624.33,95,,percent of total billed charges,,,591.47,90,,percent of total billed charges,,,591.47,90,,percent of total billed charges,,,538.9,82,,percent of total billed charges,,,591.47,90,,percent of total billed charges,,,558.61,85,,percent of total billed charges,,495.52,624.33,
MEPERIDINE (DEMEROL) AMP:25MG/0.5ML,32005992,CDM,J2180,HCPCS,250,RC,inpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.78,88,,percent of total billed charges,,,,,,,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,49.51,62.38,
MEPERIDINE (DEMEROL) AMP:50MG/ML,32005993,CDM,J2180,HCPCS,250,RC,inpatient,,68.63,68.63,,58.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.39,88,,percent of total billed charges,,,,,,,,,52.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.45,91,,percent of total billed charges,,,65.2,95,,percent of total billed charges,,,56.96,83,,percent of total billed charges,,,56.96,83,,percent of total billed charges,,,,,,,,,,,,,,,56.96,83,,percent of total billed charges,,,65.2,95,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,56.28,82,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,58.34,85,,percent of total billed charges,,51.75,65.2,
MEPERIDINE (DEMEROL) SYR:50MG/ML,32005994,CDM,,,250,RC,inpatient,,102.93,102.93,,87.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.58,88,,percent of total billed charges,,,,,,,,,78.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.67,91,,percent of total billed charges,,,97.78,95,,percent of total billed charges,,,85.43,83,,percent of total billed charges,,,85.43,83,,percent of total billed charges,,,,,,,,,,,,,,,85.43,83,,percent of total billed charges,,,97.78,95,,percent of total billed charges,,,92.64,90,,percent of total billed charges,,,92.64,90,,percent of total billed charges,,,84.4,82,,percent of total billed charges,,,92.64,90,,percent of total billed charges,,,87.49,85,,percent of total billed charges,,77.61,97.78,
MEPERIDINE (DEMEROL) AMP:75MG/1.5ML,32005995,CDM,,,250,RC,inpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.78,88,,percent of total billed charges,,,,,,,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,49.51,62.38,
MEPERIDINE (DEMEROL) AMP:100MG/ML,32005998,CDM,J2180,HCPCS,250,RC,inpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.78,88,,percent of total billed charges,,,,,,,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,49.51,62.38,
MEPROBAMATE(EQUANIL)TAB:400MG,32006001,CDM,,,250,RC,inpatient,,24.42,24.42,,20.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.49,88,,percent of total billed charges,,,,,,,,,18.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.22,91,,percent of total billed charges,,,23.2,95,,percent of total billed charges,,,20.27,83,,percent of total billed charges,,,20.27,83,,percent of total billed charges,,,,,,,,,,,,,,,20.27,83,,percent of total billed charges,,,23.2,95,,percent of total billed charges,,,21.98,90,,percent of total billed charges,,,21.98,90,,percent of total billed charges,,,20.02,82,,percent of total billed charges,,,21.98,90,,percent of total billed charges,,,20.76,85,,percent of total billed charges,,18.41,23.2,
RUBELLA VACCINE(MERUVAX II)VIAL:0.5ML,32006016,CDM,90706,CPT,250,RC,inpatient,,306.42,306.42,,260.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,231.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,260.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,269.65,88,,percent of total billed charges,,,,,,,,,234.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,278.84,91,,percent of total billed charges,,,291.1,95,,percent of total billed charges,,,254.33,83,,percent of total billed charges,,,254.33,83,,percent of total billed charges,,,,,,,,,,,,,,,254.33,83,,percent of total billed charges,,,291.1,95,,percent of total billed charges,,,275.78,90,,percent of total billed charges,,,275.78,90,,percent of total billed charges,,,251.26,82,,percent of total billed charges,,,275.78,90,,percent of total billed charges,,,260.46,85,,percent of total billed charges,,231.04,291.1,
METAPROT(ALUPENT) SYRP: 10MG/5ML   60ML,32006021,CDM,,,250,RC,inpatient,,55.83,55.83,,47.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.13,88,,percent of total billed charges,,,,,,,,,42.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.81,91,,percent of total billed charges,,,53.04,95,,percent of total billed charges,,,46.34,83,,percent of total billed charges,,,46.34,83,,percent of total billed charges,,,,,,,,,,,,,,,46.34,83,,percent of total billed charges,,,53.04,95,,percent of total billed charges,,,50.25,90,,percent of total billed charges,,,50.25,90,,percent of total billed charges,,,45.78,82,,percent of total billed charges,,,50.25,90,,percent of total billed charges,,,47.46,85,,percent of total billed charges,,42.1,53.04,
METAPROTER (ALUPENT)SYRP:10MG/5ML   90ML,32006026,CDM,,,250,RC,inpatient,,83.74,83.74,,71.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.69,88,,percent of total billed charges,,,,,,,,,63.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.2,91,,percent of total billed charges,,,79.55,95,,percent of total billed charges,,,69.5,83,,percent of total billed charges,,,69.5,83,,percent of total billed charges,,,,,,,,,,,,,,,69.5,83,,percent of total billed charges,,,79.55,95,,percent of total billed charges,,,75.37,90,,percent of total billed charges,,,75.37,90,,percent of total billed charges,,,68.67,82,,percent of total billed charges,,,75.37,90,,percent of total billed charges,,,71.18,85,,percent of total billed charges,,63.14,79.55,
PSYLLIUM SEED(METAMUCIL)PAC U/D:,32006031,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
METAPROTEREN(ALUPENT)SYRP:10MG/5ML 480ML,32006041,CDM,,,250,RC,inpatient,,440.43,440.43,,373.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,332.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,374.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,387.58,88,,percent of total billed charges,,,,,,,,,336.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,400.79,91,,percent of total billed charges,,,418.41,95,,percent of total billed charges,,,365.56,83,,percent of total billed charges,,,365.56,83,,percent of total billed charges,,,,,,,,,,,,,,,365.56,83,,percent of total billed charges,,,418.41,95,,percent of total billed charges,,,396.39,90,,percent of total billed charges,,,396.39,90,,percent of total billed charges,,,361.15,82,,percent of total billed charges,,,396.39,90,,percent of total billed charges,,,374.37,85,,percent of total billed charges,,332.08,418.41,
METAPROTERENOL (ALUPENT) TAB : 10MG,32006046,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PSYLLIUM SEED/DEXTROSE(METAMUCIL)POW368,32006051,CDM,,,250,RC,inpatient,,113.4,113.4,,96.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,99.79,88,,percent of total billed charges,,,,,,,,,86.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,103.19,91,,percent of total billed charges,,,107.73,95,,percent of total billed charges,,,94.12,83,,percent of total billed charges,,,94.12,83,,percent of total billed charges,,,,,,,,,,,,,,,94.12,83,,percent of total billed charges,,,107.73,95,,percent of total billed charges,,,102.06,90,,percent of total billed charges,,,102.06,90,,percent of total billed charges,,,92.99,82,,percent of total billed charges,,,102.06,90,,percent of total billed charges,,,96.39,85,,percent of total billed charges,,85.5,107.73,
METHYLERGO(METHERGINE)AMP:0.2MG/ML,32006056,CDM,J2210,HCPCS,250,RC,inpatient,,328.76,328.76,,279.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,247.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,279.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,289.31,88,,percent of total billed charges,,20.4,,,,fee schedule,,,251.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,20.4,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,299.17,91,,percent of total billed charges,,,312.32,95,,percent of total billed charges,,,272.87,83,,percent of total billed charges,,,272.87,83,,percent of total billed charges,,,,,,,,,,,,,,,272.87,83,,percent of total billed charges,,,312.32,95,,percent of total billed charges,,,295.88,90,,percent of total billed charges,,,295.88,90,,percent of total billed charges,,,269.58,82,,percent of total billed charges,,,295.88,90,,percent of total billed charges,,,279.45,85,,percent of total billed charges,,20.4,312.32,
METHYLERGONOVIN(METHERGINE)TAB:0.2MG,32006061,CDM,J8499,HCPCS,250,RC,inpatient,,464.22,464.22,,394.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,350.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.51,88,,percent of total billed charges,,,,,,,,,354.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.44,91,,percent of total billed charges,,,441.01,95,,percent of total billed charges,,,385.3,83,,percent of total billed charges,,,385.3,83,,percent of total billed charges,,,,,,,,,,,,,,,385.3,83,,percent of total billed charges,,,441.01,95,,percent of total billed charges,,,417.8,90,,percent of total billed charges,,,417.8,90,,percent of total billed charges,,,380.66,82,,percent of total billed charges,,,417.8,90,,percent of total billed charges,,,394.59,85,,percent of total billed charges,,350.02,441.01,
METHYLENE BLUE VIAL 1%:10ML,32006066,CDM,,,250,RC,inpatient,,156.54,156.54,,132.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,118.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,133.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,137.76,88,,percent of total billed charges,,,,,,,,,119.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,142.45,91,,percent of total billed charges,,,148.71,95,,percent of total billed charges,,,129.93,83,,percent of total billed charges,,,129.93,83,,percent of total billed charges,,,,,,,,,,,,,,,129.93,83,,percent of total billed charges,,,148.71,95,,percent of total billed charges,,,140.89,90,,percent of total billed charges,,,140.89,90,,percent of total billed charges,,,128.36,82,,percent of total billed charges,,,140.89,90,,percent of total billed charges,,,133.06,85,,percent of total billed charges,,118.03,148.71,
METHOCARBAMOL (ROBAXIN) :500MG,32006076,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
METHOTREXATE SODIUM TAB : 2.5MG,32006081,CDM,J8610,HCPCS,250,RC,inpatient,,42.16,42.16,,35.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37.1,88,,percent of total billed charges,,4.84,,,,fee schedule,,,32.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,4.84,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38.37,91,,percent of total billed charges,,,40.05,95,,percent of total billed charges,,,34.99,83,,percent of total billed charges,,,34.99,83,,percent of total billed charges,,,,,,,,,,,,,,,34.99,83,,percent of total billed charges,,,40.05,95,,percent of total billed charges,,,37.94,90,,percent of total billed charges,,,37.94,90,,percent of total billed charges,,,34.57,82,,percent of total billed charges,,,37.94,90,,percent of total billed charges,,,35.84,85,,percent of total billed charges,,4.84,40.05,
METHOTREXATE:50MG/2ML  (J/5MG),32006091,CDM,J9250,HCPCS,636,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,6.29,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6.29,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,6.29,59.21,
METHYLDOPATE(ALDOMET):250MG/5ML  (J/5),32006106,CDM,J0210,HCPCS,636,RC,inpatient,,666.12,666.12,,565.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,502.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,566.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,586.19,88,,percent of total billed charges,,,,,,,,,508.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,606.17,91,,percent of total billed charges,,,632.81,95,,percent of total billed charges,,,552.88,83,,percent of total billed charges,,,552.88,83,,percent of total billed charges,,,,,,,,,,,,,,,552.88,83,,percent of total billed charges,,,632.81,95,,percent of total billed charges,,,599.51,90,,percent of total billed charges,,,599.51,90,,percent of total billed charges,,,546.22,82,,percent of total billed charges,,,599.51,90,,percent of total billed charges,,,566.2,85,,percent of total billed charges,,502.25,632.81,
METHYLDOPA (ALDOMET) TAB : 500MG,32006121,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
METHYLDOPA(ALDOMET)TAB:250MG,32006126,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
metoPROLOL(LOPRESSOR)VIAL:5MG/5ML,32006131,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
METOCLOP(REGLAN)-TAB:10MG,32006136,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
METOCLOP(REGLAN)-TAB:5MG,32006141,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
metoPROLOL TART(LOPRESSOR)TAB:50MG,32006146,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
METOCLOP(REGLAN) SOL : 5MG/5ML  500ML,32006151,CDM,,,250,RC,inpatient,,491.18,491.18,,417.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,370.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,417.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,432.24,88,,percent of total billed charges,,,,,,,,,375.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,446.97,91,,percent of total billed charges,,,466.62,95,,percent of total billed charges,,,407.68,83,,percent of total billed charges,,,407.68,83,,percent of total billed charges,,,,,,,,,,,,,,,407.68,83,,percent of total billed charges,,,466.62,95,,percent of total billed charges,,,442.06,90,,percent of total billed charges,,,442.06,90,,percent of total billed charges,,,402.77,82,,percent of total billed charges,,,442.06,90,,percent of total billed charges,,,417.5,85,,percent of total billed charges,,370.35,466.62,
METOCLOP(REGLAN)-SOL:5MG/5ML(60ML),32006156,CDM,J8499,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
METOCLOPRAMIDE(REGLAN) S0L: 5MG/5ML 90ML,32006161,CDM,,,250,RC,inpatient,,93.42,93.42,,79.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,70.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,79.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,82.21,88,,percent of total billed charges,,,,,,,,,71.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,85.01,91,,percent of total billed charges,,,88.75,95,,percent of total billed charges,,,77.54,83,,percent of total billed charges,,,77.54,83,,percent of total billed charges,,,,,,,,,,,,,,,77.54,83,,percent of total billed charges,,,88.75,95,,percent of total billed charges,,,84.08,90,,percent of total billed charges,,,84.08,90,,percent of total billed charges,,,76.6,82,,percent of total billed charges,,,84.08,90,,percent of total billed charges,,,79.41,85,,percent of total billed charges,,70.44,88.75,
METOCLOP(REGLAN)-VIAL:10MG/2ML,32006162,CDM,J2765,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,26.5,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,26.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,26.5,60.99,
metroNIDAZOLE(FLAGYL)TAB:250MG,32006166,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
metroNID(FLAGYL)TAB:500MG,32006171,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
metroNID(METROGEL)GEL(TOP)0.75%:28.4GM,32006176,CDM,,,250,RC,inpatient,,522.9,522.9,,443.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,394.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,444.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,460.15,88,,percent of total billed charges,,,,,,,,,399.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,475.84,91,,percent of total billed charges,,,496.76,95,,percent of total billed charges,,,434.01,83,,percent of total billed charges,,,434.01,83,,percent of total billed charges,,,,,,,,,,,,,,,434.01,83,,percent of total billed charges,,,496.76,95,,percent of total billed charges,,,470.61,90,,percent of total billed charges,,,470.61,90,,percent of total billed charges,,,428.78,82,,percent of total billed charges,,,470.61,90,,percent of total billed charges,,,444.47,85,,percent of total billed charges,,394.27,496.76,
metroNIDAZOLE VAG GEL 0.75%:70GM,32006177,CDM,J3490,HCPCS,250,RC,inpatient,,796.86,796.86,,676.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,600.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,677.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,701.24,88,,percent of total billed charges,,,,,,,,,608.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,725.14,91,,percent of total billed charges,,,757.02,95,,percent of total billed charges,,,661.39,83,,percent of total billed charges,,,661.39,83,,percent of total billed charges,,,,,,,,,,,,,,,661.39,83,,percent of total billed charges,,,757.02,95,,percent of total billed charges,,,717.17,90,,percent of total billed charges,,,717.17,90,,percent of total billed charges,,,653.43,82,,percent of total billed charges,,,717.17,90,,percent of total billed charges,,,677.33,85,,percent of total billed charges,,600.83,757.02,
metroNID(METROGEL)GEL 0.75%:45GM,32006178,CDM,,,250,RC,inpatient,,1928.77,1928.77,,1637.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1454.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1639.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1697.32,88,,percent of total billed charges,,,,,,,,,1473.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1755.18,91,,percent of total billed charges,,,1832.33,95,,percent of total billed charges,,,1600.88,83,,percent of total billed charges,,,1600.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1600.88,83,,percent of total billed charges,,,1832.33,95,,percent of total billed charges,,,1735.89,90,,percent of total billed charges,,,1735.89,90,,percent of total billed charges,,,1581.59,82,,percent of total billed charges,,,1735.89,90,,percent of total billed charges,,,1639.45,85,,percent of total billed charges,,1454.29,1832.33,
LOVASTATIN (MEVACOR) TAB : 20MG,32006181,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CALCITONIN(FORTICAL)NASAL:200UNITS,32006281,CDM,J3490,HCPCS,250,RC,inpatient,,255.07,255.07,,216.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,192.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,216.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,224.46,88,,percent of total billed charges,,,,,,,,,194.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,232.11,91,,percent of total billed charges,,,242.32,95,,percent of total billed charges,,,211.71,83,,percent of total billed charges,,,211.71,83,,percent of total billed charges,,,,,,,,,,,,,,,211.71,83,,percent of total billed charges,,,242.32,95,,percent of total billed charges,,,229.56,90,,percent of total billed charges,,,229.56,90,,percent of total billed charges,,,209.16,82,,percent of total billed charges,,,229.56,90,,percent of total billed charges,,,216.81,85,,percent of total billed charges,,192.32,242.32,
MICONAZOLE(MICATIN)CREAM 2%:30GM,32006286,CDM,,,250,RC,inpatient,,23.63,23.63,,20.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.79,88,,percent of total billed charges,,,,,,,,,18.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.5,91,,percent of total billed charges,,,22.45,95,,percent of total billed charges,,,19.61,83,,percent of total billed charges,,,19.61,83,,percent of total billed charges,,,,,,,,,,,,,,,19.61,83,,percent of total billed charges,,,22.45,95,,percent of total billed charges,,,21.27,90,,percent of total billed charges,,,21.27,90,,percent of total billed charges,,,19.38,82,,percent of total billed charges,,,21.27,90,,percent of total billed charges,,,20.09,85,,percent of total billed charges,,17.82,22.45,
MICONAZOLE (MICATIN) CREAM :2%   45GM,32006291,CDM,,,250,RC,inpatient,,133.22,133.22,,113.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,100.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,113.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,117.23,88,,percent of total billed charges,,,,,,,,,101.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,121.23,91,,percent of total billed charges,,,126.56,95,,percent of total billed charges,,,110.57,83,,percent of total billed charges,,,110.57,83,,percent of total billed charges,,,,,,,,,,,,,,,110.57,83,,percent of total billed charges,,,126.56,95,,percent of total billed charges,,,119.9,90,,percent of total billed charges,,,119.9,90,,percent of total billed charges,,,109.24,82,,percent of total billed charges,,,119.9,90,,percent of total billed charges,,,113.24,85,,percent of total billed charges,,100.45,126.56,
MIDAZOLAM(VERSED)VIAL:10MG/10ML,32006297,CDM,J2250,HCPCS,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,7.08,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.08,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,7.08,64.15,
POTASSIUM CHLORIDE(MICRO K)CAP ER:10MEQ,32006301,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LACTASE/RENNET(MILK DIGESTANT)TAB:25-2MG,32006312,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
MINERAL OIL:60ML,32006326,CDM,J3490,HCPCS,250,RC,inpatient,,30.77,30.77,,26.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.08,88,,percent of total billed charges,,,,,,,,,23.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28,91,,percent of total billed charges,,,29.23,95,,percent of total billed charges,,,25.54,83,,percent of total billed charges,,,25.54,83,,percent of total billed charges,,,,,,,,,,,,,,,25.54,83,,percent of total billed charges,,,29.23,95,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,25.23,82,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,26.15,85,,percent of total billed charges,,23.2,29.23,
MINERAL OIL(MURI-LUBE) VIAL STERILE 10ML,32006331,CDM,J3490,HCPCS,250,RC,inpatient,,253.6,253.6,,215.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,191.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,223.17,88,,percent of total billed charges,,,,,,,,,193.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,230.78,91,,percent of total billed charges,,,240.92,95,,percent of total billed charges,,,210.49,83,,percent of total billed charges,,,210.49,83,,percent of total billed charges,,,,,,,,,,,,,,,210.49,83,,percent of total billed charges,,,240.92,95,,percent of total billed charges,,,228.24,90,,percent of total billed charges,,,228.24,90,,percent of total billed charges,,,207.95,82,,percent of total billed charges,,,228.24,90,,percent of total billed charges,,,215.56,85,,percent of total billed charges,,191.21,240.92,
MINTRAN PATCH 0.1MG/HR,32006332,CDM,,,250,RC,inpatient,,5.5,5.5,,4.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4.84,88,,percent of total billed charges,,,,,,,,,4.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.01,91,,percent of total billed charges,,,5.23,95,,percent of total billed charges,,,4.57,83,,percent of total billed charges,,,4.57,83,,percent of total billed charges,,,,,,,,,,,,,,,4.57,83,,percent of total billed charges,,,5.23,95,,percent of total billed charges,,,4.95,90,,percent of total billed charges,,,4.95,90,,percent of total billed charges,,,4.51,82,,percent of total billed charges,,,4.95,90,,percent of total billed charges,,,4.68,85,,percent of total billed charges,,4.15,5.23,
MINOCYCLINE (MINOCIN) CAP : 100MG,32006336,CDM,J8499,HCPCS,250,RC,inpatient,,15.52,15.52,,13.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.66,88,,percent of total billed charges,,,,,,,,,11.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.12,91,,percent of total billed charges,,,14.74,95,,percent of total billed charges,,,12.88,83,,percent of total billed charges,,,12.88,83,,percent of total billed charges,,,,,,,,,,,,,,,12.88,83,,percent of total billed charges,,,14.74,95,,percent of total billed charges,,,13.97,90,,percent of total billed charges,,,13.97,90,,percent of total billed charges,,,12.73,82,,percent of total billed charges,,,13.97,90,,percent of total billed charges,,,13.19,85,,percent of total billed charges,,11.7,14.74,
MINOCYCLINE (MINOCIN) HCL CAP : 50MG,32006341,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ACETYLCHOLINE(MIOCHOL-E)KIT 1%:,32006351,CDM,J3490,HCPCS,250,RC,inpatient,,1638.79,1638.79,,1391.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1235.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1392.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1442.14,88,,percent of total billed charges,,,,,,,,,1252.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1491.3,91,,percent of total billed charges,,,1556.85,95,,percent of total billed charges,,,1360.2,83,,percent of total billed charges,,,1360.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1360.2,83,,percent of total billed charges,,,1556.85,95,,percent of total billed charges,,,1474.91,90,,percent of total billed charges,,,1474.91,90,,percent of total billed charges,,,1343.81,82,,percent of total billed charges,,,1474.91,90,,percent of total billed charges,,,1392.97,85,,percent of total billed charges,,1235.65,1556.85,
PRAMIPEXOLE DI-HCL (MIRAPEX) TAB : 0.5MG,32006352,CDM,,,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
MIVACURIUM (MIVACRON)VIAL:2MG/ML (10ML),32006411,CDM,,,250,RC,inpatient,,429.49,429.49,,364.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,323.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,365.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,377.95,88,,percent of total billed charges,,,,,,,,,328.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,390.84,91,,percent of total billed charges,,,408.02,95,,percent of total billed charges,,,356.48,83,,percent of total billed charges,,,356.48,83,,percent of total billed charges,,,,,,,,,,,,,,,356.48,83,,percent of total billed charges,,,408.02,95,,percent of total billed charges,,,386.54,90,,percent of total billed charges,,,386.54,90,,percent of total billed charges,,,352.18,82,,percent of total billed charges,,,386.54,90,,percent of total billed charges,,,365.07,85,,percent of total billed charges,,323.84,408.02,
MEASLES MUMPS&RUBELLA (MMR-II) VACCINE:,32006416,CDM,90707,CPT,250,RC,inpatient,,1250.17,1250.17,,1061.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,942.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1062.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1100.15,88,,percent of total billed charges,,,,,,,,,955.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1137.65,91,,percent of total billed charges,,,1187.66,95,,percent of total billed charges,,,1037.64,83,,percent of total billed charges,,,1037.64,83,,percent of total billed charges,,,,,,,,,,,,,,,1037.64,83,,percent of total billed charges,,,1187.66,95,,percent of total billed charges,,,1125.15,90,,percent of total billed charges,,,1125.15,90,,percent of total billed charges,,,1025.14,82,,percent of total billed charges,,,1125.15,90,,percent of total billed charges,,,1062.64,85,,percent of total billed charges,,942.63,1187.66,
PHILLIPS CHEWABLE TABS,32006425,CDM,,,250,RC,inpatient,,16,16,,13.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.08,88,,percent of total billed charges,,,,,,,,,12.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.56,91,,percent of total billed charges,,,15.2,95,,percent of total billed charges,,,13.28,83,,percent of total billed charges,,,13.28,83,,percent of total billed charges,,,,,,,,,,,,,,,13.28,83,,percent of total billed charges,,,15.2,95,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,13.12,82,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,13.6,85,,percent of total billed charges,,12.06,15.2,
MILK MAG(CONC)ORAL U/D:2400MG/10ML,32006426,CDM,J8499,HCPCS,250,RC,inpatient,,42.16,42.16,,35.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37.1,88,,percent of total billed charges,,,,,,,,,32.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38.37,91,,percent of total billed charges,,,40.05,95,,percent of total billed charges,,,34.99,83,,percent of total billed charges,,,34.99,83,,percent of total billed charges,,,,,,,,,,,,,,,34.99,83,,percent of total billed charges,,,40.05,95,,percent of total billed charges,,,37.94,90,,percent of total billed charges,,,37.94,90,,percent of total billed charges,,,34.57,82,,percent of total billed charges,,,37.94,90,,percent of total billed charges,,,35.84,85,,percent of total billed charges,,31.79,40.05,
CLOTRIMAZOLE(MYCELEX)TROCHE:10MG,32006427,CDM,J8499,HCPCS,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
MAGNE HYDRX(MLK MAG)ORAL:800MG/5ML 400ML,32006436,CDM,,,250,RC,inpatient,,120.54,120.54,,102.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,106.08,88,,percent of total billed charges,,,,,,,,,92.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.69,91,,percent of total billed charges,,,114.51,95,,percent of total billed charges,,,100.05,83,,percent of total billed charges,,,100.05,83,,percent of total billed charges,,,,,,,,,,,,,,,100.05,83,,percent of total billed charges,,,114.51,95,,percent of total billed charges,,,108.49,90,,percent of total billed charges,,,108.49,90,,percent of total billed charges,,,98.84,82,,percent of total billed charges,,,108.49,90,,percent of total billed charges,,,102.46,85,,percent of total billed charges,,90.89,114.51,
POLYETHYLENE GLYC(MIRALAX)POW:100% 255GM,32006442,CDM,,,250,RC,inpatient,,240.6,240.6,,204.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,181.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.73,88,,percent of total billed charges,,,,,,,,,183.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.95,91,,percent of total billed charges,,,228.57,95,,percent of total billed charges,,,199.7,83,,percent of total billed charges,,,199.7,83,,percent of total billed charges,,,,,,,,,,,,,,,199.7,83,,percent of total billed charges,,,228.57,95,,percent of total billed charges,,,216.54,90,,percent of total billed charges,,,216.54,90,,percent of total billed charges,,,197.29,82,,percent of total billed charges,,,216.54,90,,percent of total billed charges,,,204.51,85,,percent of total billed charges,,181.41,228.57,
MICONAZOLE(MONISTAT-3)CREAM 4%:25GM,32006447,CDM,,,250,RC,inpatient,,183.66,183.66,,155.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,138.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,156.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,161.62,88,,percent of total billed charges,,,,,,,,,140.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,167.13,91,,percent of total billed charges,,,174.48,95,,percent of total billed charges,,,152.44,83,,percent of total billed charges,,,152.44,83,,percent of total billed charges,,,,,,,,,,,,,,,152.44,83,,percent of total billed charges,,,174.48,95,,percent of total billed charges,,,165.29,90,,percent of total billed charges,,,165.29,90,,percent of total billed charges,,,150.6,82,,percent of total billed charges,,,165.29,90,,percent of total billed charges,,,156.11,85,,percent of total billed charges,,138.48,174.48,
MICONAZOLE(MONISTAT-3)VAG SUPP:3'S,32006448,CDM,,,250,RC,inpatient,,576.99,576.99,,489.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,435.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,490.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,507.75,88,,percent of total billed charges,,,,,,,,,440.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,525.06,91,,percent of total billed charges,,,548.14,95,,percent of total billed charges,,,478.9,83,,percent of total billed charges,,,478.9,83,,percent of total billed charges,,,,,,,,,,,,,,,478.9,83,,percent of total billed charges,,,548.14,95,,percent of total billed charges,,,519.29,90,,percent of total billed charges,,,519.29,90,,percent of total billed charges,,,473.13,82,,percent of total billed charges,,,519.29,90,,percent of total billed charges,,,490.44,85,,percent of total billed charges,,435.05,548.14,
FOSINOPRIL(MONOPRIL)TAB:10MG,32006451,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
FOSINOPRIL (MONOPRIL) TAB : 20MG,32006452,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
FOSFOMYCIN(MONUROL)PAC:3GM,32006453,CDM,J8499,HCPCS,250,RC,inpatient,,1306.5,1306.5,,1109.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,985.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1110.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1149.72,88,,percent of total billed charges,,,,,,,,,998.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1188.92,91,,percent of total billed charges,,,1241.18,95,,percent of total billed charges,,,1084.4,83,,percent of total billed charges,,,1084.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1084.4,83,,percent of total billed charges,,,1241.18,95,,percent of total billed charges,,,1175.85,90,,percent of total billed charges,,,1175.85,90,,percent of total billed charges,,,1071.33,82,,percent of total billed charges,,,1175.85,90,,percent of total billed charges,,,1110.53,85,,percent of total billed charges,,985.1,1241.18,
MORPHINE SULF(ORAL)SOL:20MG/5ML (60ML),32006466,CDM,,,250,RC,inpatient,,66.29,66.29,,56.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.34,88,,percent of total billed charges,,,,,,,,,50.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.32,91,,percent of total billed charges,,,62.98,95,,percent of total billed charges,,,55.02,83,,percent of total billed charges,,,55.02,83,,percent of total billed charges,,,,,,,,,,,,,,,55.02,83,,percent of total billed charges,,,62.98,95,,percent of total billed charges,,,59.66,90,,percent of total billed charges,,,59.66,90,,percent of total billed charges,,,54.36,82,,percent of total billed charges,,,59.66,90,,percent of total billed charges,,,56.35,85,,percent of total billed charges,,49.98,62.98,
MORPHINE SULF CPJ SYR:10MG/ML,32006471,CDM,J2270,HCPCS,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,5.94,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.94,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,5.94,64.15,
MORPHINE SULF VIAL:10MG/ML,32006476,CDM,,,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,,,,,,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,50.92,64.15,
MORPHINE SULFATE TAB : 10MG,32006481,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
MORPHINE SULF TAB IR:30MG,32006482,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
MORPHINE SULF(ORAMORPH)ER TAB:30MG,32006483,CDM,,,250,RC,inpatient,,21.25,21.25,,18.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.7,88,,percent of total billed charges,,,,,,,,,16.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.34,91,,percent of total billed charges,,,20.19,95,,percent of total billed charges,,,17.64,83,,percent of total billed charges,,,17.64,83,,percent of total billed charges,,,,,,,,,,,,,,,17.64,83,,percent of total billed charges,,,20.19,95,,percent of total billed charges,,,19.13,90,,percent of total billed charges,,,19.13,90,,percent of total billed charges,,,17.43,82,,percent of total billed charges,,,19.13,90,,percent of total billed charges,,,18.06,85,,percent of total billed charges,,16.02,20.19,
MORPHINE SULF(ORAMORPH)ER TAB:60MG,32006484,CDM,,,250,RC,inpatient,,61.06,61.06,,51.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,51.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,53.73,88,,percent of total billed charges,,,,,,,,,46.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55.56,91,,percent of total billed charges,,,58.01,95,,percent of total billed charges,,,50.68,83,,percent of total billed charges,,,50.68,83,,percent of total billed charges,,,,,,,,,,,,,,,50.68,83,,percent of total billed charges,,,58.01,95,,percent of total billed charges,,,54.95,90,,percent of total billed charges,,,54.95,90,,percent of total billed charges,,,50.07,82,,percent of total billed charges,,,54.95,90,,percent of total billed charges,,,51.9,85,,percent of total billed charges,,46.04,58.01,
IBUPROFEN (MOTRIN) TAB:800MG,32006496,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
IBUPROFEN(MOTRIN)ORAL : 100MG/5ML 5ML,32006501,CDM,,,250,RC,inpatient,,2.5,2.5,,2.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.2,88,,percent of total billed charges,,,,,,,,,1.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.28,91,,percent of total billed charges,,,2.38,95,,percent of total billed charges,,,2.08,83,,percent of total billed charges,,,2.08,83,,percent of total billed charges,,,,,,,,,,,,,,,2.08,83,,percent of total billed charges,,,2.38,95,,percent of total billed charges,,,2.25,90,,percent of total billed charges,,,2.25,90,,percent of total billed charges,,,2.05,82,,percent of total billed charges,,,2.25,90,,percent of total billed charges,,,2.13,85,,percent of total billed charges,,1.89,2.38,
MOTRIN SUSPENSION 473ML,32006502,CDM,,,250,RC,inpatient,,74,74,,62.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,55.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,62.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,65.12,88,,percent of total billed charges,,,,,,,,,56.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,,,,,,,,,,,,,61.42,83,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,60.68,82,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,55.8,70.3,
IBUPROFEN (MOTRIN) TAB:400MG,32006506,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
IBUPROFEN (MOTRIN) TAB : 400MG  1X8,32006507,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
IBUPROFEN (MOTRIN) TAB : 600MG  1X8,32006508,CDM,,,250,RC,inpatient,,23.31,23.31,,19.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.51,88,,percent of total billed charges,,,,,,,,,17.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.21,91,,percent of total billed charges,,,22.14,95,,percent of total billed charges,,,19.35,83,,percent of total billed charges,,,19.35,83,,percent of total billed charges,,,,,,,,,,,,,,,19.35,83,,percent of total billed charges,,,22.14,95,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,19.11,82,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,19.81,85,,percent of total billed charges,,17.58,22.14,
IBUPROFEN (MOTRIN) TAB : 800MG  1X8,32006509,CDM,,,250,RC,inpatient,,19.35,19.35,,16.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.03,88,,percent of total billed charges,,,,,,,,,14.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.61,91,,percent of total billed charges,,,18.38,95,,percent of total billed charges,,,16.06,83,,percent of total billed charges,,,16.06,83,,percent of total billed charges,,,,,,,,,,,,,,,16.06,83,,percent of total billed charges,,,18.38,95,,percent of total billed charges,,,17.42,90,,percent of total billed charges,,,17.42,90,,percent of total billed charges,,,15.87,82,,percent of total billed charges,,,17.42,90,,percent of total billed charges,,,16.45,85,,percent of total billed charges,,14.59,18.38,
IBUPROFEN (MOTRIN) TAB:600MG,32006511,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
MORPHINE SULF(ORAMORPH)ER TAB:15MG,32006521,CDM,,,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
ZN/CU/PHYD/MANG(MULTITRACE-4)VIAL:10ML,32006526,CDM,,,250,RC,inpatient,,410.14,410.14,,348.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,309.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,348.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,360.92,88,,percent of total billed charges,,,,,,,,,313.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,373.23,91,,percent of total billed charges,,,389.63,95,,percent of total billed charges,,,340.42,83,,percent of total billed charges,,,340.42,83,,percent of total billed charges,,,,,,,,,,,,,,,340.42,83,,percent of total billed charges,,,389.63,95,,percent of total billed charges,,,369.13,90,,percent of total billed charges,,,369.13,90,,percent of total billed charges,,,336.31,82,,percent of total billed charges,,,369.13,90,,percent of total billed charges,,,348.62,85,,percent of total billed charges,,309.25,389.63,
ACETYL(MUCOMYST)VIAL 20%:200MG/ML(30ML),32006531,CDM,J7608,HCPCS,250,RC,inpatient,,436.11,436.11,,370.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,328.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,370.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,383.78,88,,percent of total billed charges,,14.79,,,,fee schedule,,,333.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.79,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,396.86,91,,percent of total billed charges,,,414.3,95,,percent of total billed charges,,,361.97,83,,percent of total billed charges,,,361.97,83,,percent of total billed charges,,,,,,,,,,,,,,,361.97,83,,percent of total billed charges,,,414.3,95,,percent of total billed charges,,,392.5,90,,percent of total billed charges,,,392.5,90,,percent of total billed charges,,,357.61,82,,percent of total billed charges,,,392.5,90,,percent of total billed charges,,,370.69,85,,percent of total billed charges,,14.79,414.3,
ACETYL(MUCOMYST)VIAL 20%:200MG/ML(4ML),32006536,CDM,J7608,HCPCS,250,RC,inpatient,,86.77,86.77,,73.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,65.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,76.36,88,,percent of total billed charges,,14.79,,,,fee schedule,,,66.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.79,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,78.96,91,,percent of total billed charges,,,82.43,95,,percent of total billed charges,,,72.02,83,,percent of total billed charges,,,72.02,83,,percent of total billed charges,,,,,,,,,,,,,,,72.02,83,,percent of total billed charges,,,82.43,95,,percent of total billed charges,,,78.09,90,,percent of total billed charges,,,78.09,90,,percent of total billed charges,,,71.15,82,,percent of total billed charges,,,78.09,90,,percent of total billed charges,,,73.75,85,,percent of total billed charges,,14.79,82.43,
ACETYL(MUCOMYST)VIAL:100MG/ML 10% 4ML,32006541,CDM,,,250,RC,inpatient,,86.44,86.44,,73.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,65.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,76.07,88,,percent of total billed charges,,,,,,,,,66.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,78.66,91,,percent of total billed charges,,,82.12,95,,percent of total billed charges,,,71.75,83,,percent of total billed charges,,,71.75,83,,percent of total billed charges,,,,,,,,,,,,,,,71.75,83,,percent of total billed charges,,,82.12,95,,percent of total billed charges,,,77.8,90,,percent of total billed charges,,,77.8,90,,percent of total billed charges,,,70.88,82,,percent of total billed charges,,,77.8,90,,percent of total billed charges,,,73.47,85,,percent of total billed charges,,65.18,82.12,
MULTIDEX POWDER BOX (5X25GM PKTS),32006542,CDM,,,250,RC,inpatient,,75.5,75.5,,64.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,64.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66.44,88,,percent of total billed charges,,,,,,,,,57.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,68.71,91,,percent of total billed charges,,,71.73,95,,percent of total billed charges,,,62.67,83,,percent of total billed charges,,,62.67,83,,percent of total billed charges,,,,,,,,,,,,,,,62.67,83,,percent of total billed charges,,,71.73,95,,percent of total billed charges,,,67.95,90,,percent of total billed charges,,,67.95,90,,percent of total billed charges,,,61.91,82,,percent of total billed charges,,,67.95,90,,percent of total billed charges,,,64.18,85,,percent of total billed charges,,56.93,71.73,
ZINC SULF/CUSO4 P-HYD/MANG/CR VIAL : PED,32006546,CDM,,,250,RC,inpatient,,170.02,170.02,,144.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,128.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,144.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,149.62,88,,percent of total billed charges,,,,,,,,,129.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,154.72,91,,percent of total billed charges,,,161.52,95,,percent of total billed charges,,,141.12,83,,percent of total billed charges,,,141.12,83,,percent of total billed charges,,,,,,,,,,,,,,,141.12,83,,percent of total billed charges,,,161.52,95,,percent of total billed charges,,,153.02,90,,percent of total billed charges,,,153.02,90,,percent of total billed charges,,,139.42,82,,percent of total billed charges,,,153.02,90,,percent of total billed charges,,,144.52,85,,percent of total billed charges,,128.2,161.52,
MUMPS VACCINE LIVE VIAL,32006556,CDM,90704,CPT,636,RC,inpatient,,357.96,357.96,,303.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,269.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,304.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,315,88,,percent of total billed charges,,,,,,,,,273.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,325.74,91,,percent of total billed charges,,,340.06,95,,percent of total billed charges,,,297.11,83,,percent of total billed charges,,,297.11,83,,percent of total billed charges,,,,,,,,,,,,,,,297.11,83,,percent of total billed charges,,,340.06,95,,percent of total billed charges,,,322.16,90,,percent of total billed charges,,,322.16,90,,percent of total billed charges,,,293.53,82,,percent of total billed charges,,,322.16,90,,percent of total billed charges,,,304.27,85,,percent of total billed charges,,269.9,340.06,
MURINE TEARS 15ML,32006557,CDM,,,250,RC,inpatient,,15,15,,12.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.2,88,,percent of total billed charges,,,,,,,,,11.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.65,91,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,,,,,,,,,,,,,12.45,83,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.3,82,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,11.31,14.25,
VENLAFAXINE HCL (EFFEXOR) TAB : 100MG,32006565,CDM,,,250,RC,inpatient,,29.02,29.02,,24.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.54,88,,percent of total billed charges,,,,,,,,,22.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.41,91,,percent of total billed charges,,,27.57,95,,percent of total billed charges,,,24.09,83,,percent of total billed charges,,,24.09,83,,percent of total billed charges,,,,,,,,,,,,,,,24.09,83,,percent of total billed charges,,,27.57,95,,percent of total billed charges,,,26.12,90,,percent of total billed charges,,,26.12,90,,percent of total billed charges,,,23.8,82,,percent of total billed charges,,,26.12,90,,percent of total billed charges,,,24.67,85,,percent of total billed charges,,21.88,27.57,
MVI(ADULT) W/VIT K VIAL:10ML,32006566,CDM,J3490,HCPCS,250,RC,inpatient,,186.28,186.28,,158.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,140.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,158.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,163.93,88,,percent of total billed charges,,,,,,,,,142.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,169.51,91,,percent of total billed charges,,,176.97,95,,percent of total billed charges,,,154.61,83,,percent of total billed charges,,,154.61,83,,percent of total billed charges,,,,,,,,,,,,,,,154.61,83,,percent of total billed charges,,,176.97,95,,percent of total billed charges,,,167.65,90,,percent of total billed charges,,,167.65,90,,percent of total billed charges,,,152.75,82,,percent of total billed charges,,,167.65,90,,percent of total billed charges,,,158.34,85,,percent of total billed charges,,140.46,176.97,
CLOTRIMAZOLE (LOTRIMIN) SOL : 1%  10 ML,32006571,CDM,,,250,RC,inpatient,,601.09,601.09,,510.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,453.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,510.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,528.96,88,,percent of total billed charges,,,,,,,,,459.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,546.99,91,,percent of total billed charges,,,571.04,95,,percent of total billed charges,,,498.9,83,,percent of total billed charges,,,498.9,83,,percent of total billed charges,,,,,,,,,,,,,,,498.9,83,,percent of total billed charges,,,571.04,95,,percent of total billed charges,,,540.98,90,,percent of total billed charges,,,540.98,90,,percent of total billed charges,,,492.89,82,,percent of total billed charges,,,540.98,90,,percent of total billed charges,,,510.93,85,,percent of total billed charges,,453.22,571.04,
CLOTRIMAZOLE(LOTRIMIN)CREAM 1%:15 GM,32006576,CDM,J3490,HCPCS,250,RC,inpatient,,21.08,21.08,,17.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.55,88,,percent of total billed charges,,,,,,,,,16.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.18,91,,percent of total billed charges,,,20.03,95,,percent of total billed charges,,,17.5,83,,percent of total billed charges,,,17.5,83,,percent of total billed charges,,,,,,,,,,,,,,,17.5,83,,percent of total billed charges,,,20.03,95,,percent of total billed charges,,,18.97,90,,percent of total billed charges,,,18.97,90,,percent of total billed charges,,,17.29,82,,percent of total billed charges,,,18.97,90,,percent of total billed charges,,,17.92,85,,percent of total billed charges,,15.89,20.03,
NYSTATIN POWDER: 1500MU/15GM,32006581,CDM,J3490,HCPCS,250,RC,inpatient,,58.5,58.5,,49.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51.48,88,,percent of total billed charges,,,,,,,,,44.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53.24,91,,percent of total billed charges,,,55.58,95,,percent of total billed charges,,,48.56,83,,percent of total billed charges,,,48.56,83,,percent of total billed charges,,,,,,,,,,,,,,,48.56,83,,percent of total billed charges,,,55.58,95,,percent of total billed charges,,,52.65,90,,percent of total billed charges,,,52.65,90,,percent of total billed charges,,,47.97,82,,percent of total billed charges,,,52.65,90,,percent of total billed charges,,,49.73,85,,percent of total billed charges,,44.11,55.58,
TROPICAMIDE(MYDRIACYL)DROP 1%:2ML,32006582,CDM,J3490,HCPCS,250,RC,inpatient,,152.18,152.18,,129.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.92,88,,percent of total billed charges,,,,,,,,,116.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.48,91,,percent of total billed charges,,,144.57,95,,percent of total billed charges,,,126.31,83,,percent of total billed charges,,,126.31,83,,percent of total billed charges,,,,,,,,,,,,,,,126.31,83,,percent of total billed charges,,,144.57,95,,percent of total billed charges,,,136.96,90,,percent of total billed charges,,,136.96,90,,percent of total billed charges,,,124.79,82,,percent of total billed charges,,,136.96,90,,percent of total billed charges,,,129.35,85,,percent of total billed charges,,114.74,144.57,
PHENYLEPH(NEO-SYNPHR)DROP 2.5%(EYE):15ML,32006583,CDM,J3490,HCPCS,250,RC,inpatient,,1216.81,1216.81,,1033.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,917.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1034.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1070.79,88,,percent of total billed charges,,,,,,,,,929.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1107.3,91,,percent of total billed charges,,,1155.97,95,,percent of total billed charges,,,1009.95,83,,percent of total billed charges,,,1009.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1009.95,83,,percent of total billed charges,,,1155.97,95,,percent of total billed charges,,,1095.13,90,,percent of total billed charges,,,1095.13,90,,percent of total billed charges,,,997.78,82,,percent of total billed charges,,,1095.13,90,,percent of total billed charges,,,1034.29,85,,percent of total billed charges,,917.47,1155.97,
IOHEXOL (MYELO-KIT) KIT : 180MG/ML,32006586,CDM,,,250,RC,inpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,613.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,691.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,613.19,772.59,
TROLAMINE SALICYL(MYOFLEX) CREAM   90GM,32006621,CDM,,,250,RC,inpatient,,22.52,22.52,,19.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.82,88,,percent of total billed charges,,,,,,,,,17.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.49,91,,percent of total billed charges,,,21.39,95,,percent of total billed charges,,,18.69,83,,percent of total billed charges,,,18.69,83,,percent of total billed charges,,,,,,,,,,,,,,,18.69,83,,percent of total billed charges,,,21.39,95,,percent of total billed charges,,,20.27,90,,percent of total billed charges,,,20.27,90,,percent of total billed charges,,,18.47,82,,percent of total billed charges,,,20.27,90,,percent of total billed charges,,,19.14,85,,percent of total billed charges,,16.98,21.39,
NADOLOL(CORGARD)TAB:40MG,32006626,CDM,J8499,HCPCS,250,RC,inpatient,,54.74,54.74,,46.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.17,88,,percent of total billed charges,,,,,,,,,41.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.81,91,,percent of total billed charges,,,52,95,,percent of total billed charges,,,45.43,83,,percent of total billed charges,,,45.43,83,,percent of total billed charges,,,,,,,,,,,,,,,45.43,83,,percent of total billed charges,,,52,95,,percent of total billed charges,,,49.27,90,,percent of total billed charges,,,49.27,90,,percent of total billed charges,,,44.89,82,,percent of total billed charges,,,49.27,90,,percent of total billed charges,,,46.53,85,,percent of total billed charges,,41.27,52,
NAFCILLIN-VIAL:1GM,32006631,CDM,J3490,HCPCS,250,RC,inpatient,,84.69,84.69,,71.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.53,88,,percent of total billed charges,,,,,,,,,64.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,77.07,91,,percent of total billed charges,,,80.46,95,,percent of total billed charges,,,70.29,83,,percent of total billed charges,,,70.29,83,,percent of total billed charges,,,,,,,,,,,,,,,70.29,83,,percent of total billed charges,,,80.46,95,,percent of total billed charges,,,76.22,90,,percent of total billed charges,,,76.22,90,,percent of total billed charges,,,69.45,82,,percent of total billed charges,,,76.22,90,,percent of total billed charges,,,71.99,85,,percent of total billed charges,,63.86,80.46,
NAFCILLIN-VIAL:2GM,32006636,CDM,J3490,HCPCS,250,RC,inpatient,,604.74,604.74,,513.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,455.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,514.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,532.17,88,,percent of total billed charges,,,,,,,,,462.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,550.31,91,,percent of total billed charges,,,574.5,95,,percent of total billed charges,,,501.93,83,,percent of total billed charges,,,501.93,83,,percent of total billed charges,,,,,,,,,,,,,,,501.93,83,,percent of total billed charges,,,574.5,95,,percent of total billed charges,,,544.27,90,,percent of total billed charges,,,544.27,90,,percent of total billed charges,,,495.89,82,,percent of total billed charges,,,544.27,90,,percent of total billed charges,,,514.03,85,,percent of total billed charges,,455.97,574.5,
NALGEST (NALDECON),32006640,CDM,,,250,RC,inpatient,,0.5,0.5,,0.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,0.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,0.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,0.44,88,,percent of total billed charges,,,,,,,,,0.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,0.46,91,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,,,,,,,,,,,,,0.42,83,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.41,82,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.43,85,,percent of total billed charges,,0.38,0.48,
NAPHAZOLINE HCL (NAPHCON)DROP 0.01% 15ML,32006671,CDM,,,250,RC,inpatient,,312.28,312.28,,265.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,235.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,265.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,274.81,88,,percent of total billed charges,,,,,,,,,238.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,284.17,91,,percent of total billed charges,,,296.67,95,,percent of total billed charges,,,259.19,83,,percent of total billed charges,,,259.19,83,,percent of total billed charges,,,,,,,,,,,,,,,259.19,83,,percent of total billed charges,,,296.67,95,,percent of total billed charges,,,281.05,90,,percent of total billed charges,,,281.05,90,,percent of total billed charges,,,256.07,82,,percent of total billed charges,,,281.05,90,,percent of total billed charges,,,265.44,85,,percent of total billed charges,,235.46,296.67,
NAPH/PHE(VISINE-A)DROP:0.025-0.3%15ML,32006676,CDM,,,250,RC,inpatient,,68.83,68.83,,58.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.57,88,,percent of total billed charges,,,,,,,,,52.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.64,91,,percent of total billed charges,,,65.39,95,,percent of total billed charges,,,57.13,83,,percent of total billed charges,,,57.13,83,,percent of total billed charges,,,,,,,,,,,,,,,57.13,83,,percent of total billed charges,,,65.39,95,,percent of total billed charges,,,61.95,90,,percent of total billed charges,,,61.95,90,,percent of total billed charges,,,56.44,82,,percent of total billed charges,,,61.95,90,,percent of total billed charges,,,58.51,85,,percent of total billed charges,,51.9,65.39,
NAPROXEN (NAPROSYN) TAB : 250MG,32006681,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
NAPROXEN(NAPROSYN)TAB:500MG,32006687,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ROPIVACAINE(NAROPIN) 0.2%:100ML,32006695,CDM,J2795,HCPCS,250,RC,inpatient,,686.93,686.93,,583.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,517.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,583.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,604.5,88,,percent of total billed charges,,13.8,,,,fee schedule,,,524.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.8,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,625.11,91,,percent of total billed charges,,,652.58,95,,percent of total billed charges,,,570.15,83,,percent of total billed charges,,,570.15,83,,percent of total billed charges,,,,,,,,,,,,,,,570.15,83,,percent of total billed charges,,,652.58,95,,percent of total billed charges,,,618.24,90,,percent of total billed charges,,,618.24,90,,percent of total billed charges,,,563.28,82,,percent of total billed charges,,,618.24,90,,percent of total billed charges,,,583.89,85,,percent of total billed charges,,13.8,652.58,
NALOXONE(NARCAN)SYR:2MG/2ML,32006696,CDM,,,250,RC,inpatient,,481.51,481.51,,408.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,363.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,409.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,423.73,88,,percent of total billed charges,,,,,,,,,367.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,438.17,91,,percent of total billed charges,,,457.43,95,,percent of total billed charges,,,399.65,83,,percent of total billed charges,,,399.65,83,,percent of total billed charges,,,,,,,,,,,,,,,399.65,83,,percent of total billed charges,,,457.43,95,,percent of total billed charges,,,433.36,90,,percent of total billed charges,,,433.36,90,,percent of total billed charges,,,394.84,82,,percent of total billed charges,,,433.36,90,,percent of total billed charges,,,409.28,85,,percent of total billed charges,,363.06,457.43,
ROPIVACAINE 0.5%:150MG/30ML,32006697,CDM,J2795,HCPCS,250,RC,inpatient,,96.57,96.57,,81.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,72.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,82.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,84.98,88,,percent of total billed charges,,13.8,,,,fee schedule,,,73.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.8,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,87.88,91,,percent of total billed charges,,,91.74,95,,percent of total billed charges,,,80.15,83,,percent of total billed charges,,,80.15,83,,percent of total billed charges,,,,,,,,,,,,,,,80.15,83,,percent of total billed charges,,,91.74,95,,percent of total billed charges,,,86.91,90,,percent of total billed charges,,,86.91,90,,percent of total billed charges,,,79.19,82,,percent of total billed charges,,,86.91,90,,percent of total billed charges,,,82.08,85,,percent of total billed charges,,13.8,91.74,
FLUNISOLIDE(NASALIDE)0.025%:NASAL SPRY,32006701,CDM,,,250,RC,inpatient,,681.35,681.35,,578.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,513.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,579.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,599.59,88,,percent of total billed charges,,,,,,,,,520.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,620.03,91,,percent of total billed charges,,,647.28,95,,percent of total billed charges,,,565.52,83,,percent of total billed charges,,,565.52,83,,percent of total billed charges,,,,,,,,,,,,,,,565.52,83,,percent of total billed charges,,,647.28,95,,percent of total billed charges,,,613.22,90,,percent of total billed charges,,,613.22,90,,percent of total billed charges,,,558.71,82,,percent of total billed charges,,,613.22,90,,percent of total billed charges,,,579.15,85,,percent of total billed charges,,513.74,647.28,
TRIAMCINOLONE (NASACORT) AER: 55MCG 10GM,32006706,CDM,,,250,RC,inpatient,,675.63,675.63,,573.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,509.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,574.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,594.55,88,,percent of total billed charges,,,,,,,,,516.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,614.82,91,,percent of total billed charges,,,641.85,95,,percent of total billed charges,,,560.77,83,,percent of total billed charges,,,560.77,83,,percent of total billed charges,,,,,,,,,,,,,,,560.77,83,,percent of total billed charges,,,641.85,95,,percent of total billed charges,,,608.07,90,,percent of total billed charges,,,608.07,90,,percent of total billed charges,,,554.02,82,,percent of total billed charges,,,608.07,90,,percent of total billed charges,,,574.29,85,,percent of total billed charges,,509.43,641.85,
SODIUM CHLORIDE NASAL(OCEAN)SPR:45ML,32006716,CDM,J3490,HCPCS,250,RC,inpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,15.28,19.26,
VINORELBI(NAVELBINE)50MG/5ML:(J/10MG),32006722,CDM,J9390,HCPCS,636,RC,inpatient,,333.06,333.06,,282.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,251.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,283.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,293.09,88,,percent of total billed charges,,74.17,,,,fee schedule,,,254.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,74.17,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,303.08,91,,percent of total billed charges,,,316.41,95,,percent of total billed charges,,,276.44,83,,percent of total billed charges,,,276.44,83,,percent of total billed charges,,,,,,,,,,,,,,,276.44,83,,percent of total billed charges,,,316.41,95,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,273.11,82,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,283.1,85,,percent of total billed charges,,74.17,316.41,
PHENYLEPH(NEO-SYNEPHRINE)DROP 0.25%:15ML,32006746,CDM,,,250,RC,inpatient,,47.74,47.74,,40.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.01,88,,percent of total billed charges,,,,,,,,,36.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.44,91,,percent of total billed charges,,,45.35,95,,percent of total billed charges,,,39.62,83,,percent of total billed charges,,,39.62,83,,percent of total billed charges,,,,,,,,,,,,,,,39.62,83,,percent of total billed charges,,,45.35,95,,percent of total billed charges,,,42.97,90,,percent of total billed charges,,,42.97,90,,percent of total billed charges,,,39.15,82,,percent of total billed charges,,,42.97,90,,percent of total billed charges,,,40.58,85,,percent of total billed charges,,36,45.35,
PHENYLEPH(NEO-SYNEPHRINE)SPR 0.25%:15ML,32006747,CDM,,,250,RC,inpatient,,52.81,52.81,,44.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46.47,88,,percent of total billed charges,,,,,,,,,40.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,48.06,91,,percent of total billed charges,,,50.17,95,,percent of total billed charges,,,43.83,83,,percent of total billed charges,,,43.83,83,,percent of total billed charges,,,,,,,,,,,,,,,43.83,83,,percent of total billed charges,,,50.17,95,,percent of total billed charges,,,47.53,90,,percent of total billed charges,,,47.53,90,,percent of total billed charges,,,43.3,82,,percent of total billed charges,,,47.53,90,,percent of total billed charges,,,44.89,85,,percent of total billed charges,,39.82,50.17,
PHENYLEPH(NEO-SYNEPHRINE)SPR 1%:15ML,32006751,CDM,J3490,HCPCS,250,RC,inpatient,,66.67,66.67,,56.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.67,88,,percent of total billed charges,,,,,,,,,50.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.67,91,,percent of total billed charges,,,63.34,95,,percent of total billed charges,,,55.34,83,,percent of total billed charges,,,55.34,83,,percent of total billed charges,,,,,,,,,,,,,,,55.34,83,,percent of total billed charges,,,63.34,95,,percent of total billed charges,,,60,90,,percent of total billed charges,,,60,90,,percent of total billed charges,,,54.67,82,,percent of total billed charges,,,60,90,,percent of total billed charges,,,56.67,85,,percent of total billed charges,,50.27,63.34,
NEOMYCIN SULFATE TAB:500MG,32006771,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
NEOMYCIN/POLYMYXIN B\DEXAMETN 5ML SUS,32006772,CDM,,,250,RC,inpatient,,9.5,9.5,,8.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8.36,88,,percent of total billed charges,,,,,,,,,7.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8.65,91,,percent of total billed charges,,,9.03,95,,percent of total billed charges,,,7.89,83,,percent of total billed charges,,,7.89,83,,percent of total billed charges,,,,,,,,,,,,,,,7.89,83,,percent of total billed charges,,,9.03,95,,percent of total billed charges,,,8.55,90,,percent of total billed charges,,,8.55,90,,percent of total billed charges,,,7.79,82,,percent of total billed charges,,,8.55,90,,percent of total billed charges,,,8.08,85,,percent of total billed charges,,7.16,9.03,
NEOMY/POLYMYXB SOL(CORTISPORIN OTIC)10ML,32006776,CDM,,,250,RC,inpatient,,762.72,762.72,,647.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,575.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,648.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,671.19,88,,percent of total billed charges,,,,,,,,,582.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,694.08,91,,percent of total billed charges,,,724.58,95,,percent of total billed charges,,,633.06,83,,percent of total billed charges,,,633.06,83,,percent of total billed charges,,,,,,,,,,,,,,,633.06,83,,percent of total billed charges,,,724.58,95,,percent of total billed charges,,,686.45,90,,percent of total billed charges,,,686.45,90,,percent of total billed charges,,,625.43,82,,percent of total billed charges,,,686.45,90,,percent of total billed charges,,,648.31,85,,percent of total billed charges,,575.09,724.58,
NEO/BACI ZN(CORTISPORIN EYE)OINT:3.5GM,32006786,CDM,,,250,RC,inpatient,,69.94,69.94,,59.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,59.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,61.55,88,,percent of total billed charges,,,,,,,,,53.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,63.65,91,,percent of total billed charges,,,66.44,95,,percent of total billed charges,,,58.05,83,,percent of total billed charges,,,58.05,83,,percent of total billed charges,,,,,,,,,,,,,,,58.05,83,,percent of total billed charges,,,66.44,95,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,57.35,82,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,59.45,85,,percent of total billed charges,,52.73,66.44,
NEOSPORIN PLUS CREAM 15GM,32006797,CDM,,,250,RC,inpatient,,14,14,,11.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.32,88,,percent of total billed charges,,,,,,,,,10.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.74,91,,percent of total billed charges,,,13.3,95,,percent of total billed charges,,,11.62,83,,percent of total billed charges,,,11.62,83,,percent of total billed charges,,,,,,,,,,,,,,,11.62,83,,percent of total billed charges,,,13.3,95,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,11.48,82,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,11.9,85,,percent of total billed charges,,10.56,13.3,
CHLOROPROCAI(NESACAINE)VL:20MG/ML (20ML),32006798,CDM,J2400,HCPCS,250,RC,inpatient,,346.07,346.07,,293.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,260.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,294.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,304.54,88,,percent of total billed charges,,,,,,,,,264.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,314.92,91,,percent of total billed charges,,,328.77,95,,percent of total billed charges,,,287.24,83,,percent of total billed charges,,,287.24,83,,percent of total billed charges,,,,,,,,,,,,,,,287.24,83,,percent of total billed charges,,,328.77,95,,percent of total billed charges,,,311.46,90,,percent of total billed charges,,,311.46,90,,percent of total billed charges,,,283.78,82,,percent of total billed charges,,,311.46,90,,percent of total billed charges,,,294.16,85,,percent of total billed charges,,260.94,328.77,
NEOSYNEPHRINE OPTH DROPS 10% 5ML,32006802,CDM,,,250,RC,inpatient,,77.5,77.5,,65.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.2,88,,percent of total billed charges,,,,,,,,,59.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.53,91,,percent of total billed charges,,,73.63,95,,percent of total billed charges,,,64.33,83,,percent of total billed charges,,,64.33,83,,percent of total billed charges,,,,,,,,,,,,,,,64.33,83,,percent of total billed charges,,,73.63,95,,percent of total billed charges,,,69.75,90,,percent of total billed charges,,,69.75,90,,percent of total billed charges,,,63.55,82,,percent of total billed charges,,,69.75,90,,percent of total billed charges,,,65.88,85,,percent of total billed charges,,58.44,73.63,
NEOSTIGMINE VIAL:10MG/10ML,32006803,CDM,J2710,HCPCS,250,RC,inpatient,,69.28,69.28,,58.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.97,88,,percent of total billed charges,,2.49,,,,fee schedule,,,52.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.49,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,63.04,91,,percent of total billed charges,,,65.82,95,,percent of total billed charges,,,57.5,83,,percent of total billed charges,,,57.5,83,,percent of total billed charges,,,,,,,,,,,,,,,57.5,83,,percent of total billed charges,,,65.82,95,,percent of total billed charges,,,62.35,90,,percent of total billed charges,,,62.35,90,,percent of total billed charges,,,56.81,82,,percent of total billed charges,,,62.35,90,,percent of total billed charges,,,58.89,85,,percent of total billed charges,,2.49,65.82,
PHENYLEPH(NEO-SYNEPHRINE)DROP 1%:30ML,32006806,CDM,,,250,RC,inpatient,,32.04,32.04,,27.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28.2,88,,percent of total billed charges,,,,,,,,,24.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29.16,91,,percent of total billed charges,,,30.44,95,,percent of total billed charges,,,26.59,83,,percent of total billed charges,,,26.59,83,,percent of total billed charges,,,,,,,,,,,,,,,26.59,83,,percent of total billed charges,,,30.44,95,,percent of total billed charges,,,28.84,90,,percent of total billed charges,,,28.84,90,,percent of total billed charges,,,26.27,82,,percent of total billed charges,,,28.84,90,,percent of total billed charges,,,27.23,85,,percent of total billed charges,,24.16,30.44,
PHENYLEPH(NEO-SYNEPHRINE)SPR 0.5%:15ML,32006811,CDM,J3490,HCPCS,250,RC,inpatient,,59.48,59.48,,50.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.34,88,,percent of total billed charges,,,,,,,,,45.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,54.13,91,,percent of total billed charges,,,56.51,95,,percent of total billed charges,,,49.37,83,,percent of total billed charges,,,49.37,83,,percent of total billed charges,,,,,,,,,,,,,,,49.37,83,,percent of total billed charges,,,56.51,95,,percent of total billed charges,,,53.53,90,,percent of total billed charges,,,53.53,90,,percent of total billed charges,,,48.77,82,,percent of total billed charges,,,53.53,90,,percent of total billed charges,,,50.56,85,,percent of total billed charges,,44.85,56.51,
FILGRASTIM(NEUPOGEN):480MCG/1.6ML,32006816,CDM,J1442,HCPCS,636,RC,inpatient,,3853.25,3853.25,,3271.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2905.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3275.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3390.86,88,,percent of total billed charges,,947.52,,,,fee schedule,,,2943.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,947.52,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3506.46,91,,percent of total billed charges,,,3660.59,95,,percent of total billed charges,,,3198.2,83,,percent of total billed charges,,,3198.2,83,,percent of total billed charges,,,,,,,,,,,,,,,3198.2,83,,percent of total billed charges,,,3660.59,95,,percent of total billed charges,,,3467.93,90,,percent of total billed charges,,,3467.93,90,,percent of total billed charges,,,3159.67,82,,percent of total billed charges,,,3467.93,90,,percent of total billed charges,,,3275.26,85,,percent of total billed charges,,947.52,3660.59,
FILGRASTIM(NEUPOGEN)SYRINGE:300MCG/0.5ML,32006817,CDM,J1442,HCPCS,636,RC,inpatient,,2586.37,2586.37,,2195.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1950.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2198.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2276.01,88,,percent of total billed charges,,947.52,,,,fee schedule,,,1975.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,947.52,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2353.6,91,,percent of total billed charges,,,2457.05,95,,percent of total billed charges,,,2146.69,83,,percent of total billed charges,,,2146.69,83,,percent of total billed charges,,,,,,,,,,,,,,,2146.69,83,,percent of total billed charges,,,2457.05,95,,percent of total billed charges,,,2327.73,90,,percent of total billed charges,,,2327.73,90,,percent of total billed charges,,,2120.82,82,,percent of total billed charges,,,2327.73,90,,percent of total billed charges,,,2198.41,85,,percent of total billed charges,,947.52,2457.05,
GABAPENTIN(NEURONTIN)CAP:300MG,32006821,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
GABAPENTIN(NEURONTIN)CAP:100MG,32006822,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
GABAPENTIN (NEURONTIN) CAP : 400MG,32006823,CDM,,,250,RC,inpatient,,112.45,112.45,,95.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,95.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.96,88,,percent of total billed charges,,,,,,,,,85.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,102.33,91,,percent of total billed charges,,,106.83,95,,percent of total billed charges,,,93.33,83,,percent of total billed charges,,,93.33,83,,percent of total billed charges,,,,,,,,,,,,,,,93.33,83,,percent of total billed charges,,,106.83,95,,percent of total billed charges,,,101.21,90,,percent of total billed charges,,,101.21,90,,percent of total billed charges,,,92.21,82,,percent of total billed charges,,,101.21,90,,percent of total billed charges,,,95.58,85,,percent of total billed charges,,84.79,106.83,
SOD PHOS/K PHOS(NEUTRA PHOS K)PACKET,32006825,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
SODIUM BICARBANATE(NEUT)VIAL:5ML,32006826,CDM,J3490,HCPCS,250,RC,inpatient,,120.06,120.06,,101.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.65,88,,percent of total billed charges,,,,,,,,,91.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.25,91,,percent of total billed charges,,,114.06,95,,percent of total billed charges,,,99.65,83,,percent of total billed charges,,,99.65,83,,percent of total billed charges,,,,,,,,,,,,,,,99.65,83,,percent of total billed charges,,,114.06,95,,percent of total billed charges,,,108.05,90,,percent of total billed charges,,,108.05,90,,percent of total billed charges,,,98.45,82,,percent of total billed charges,,,108.05,90,,percent of total billed charges,,,102.05,85,,percent of total billed charges,,90.53,114.06,
NAPO4 MB-DB/K PH MBDB(NEUTRA PHOS)PKT:,32006827,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
NIACIN TAB : 50MG,32006831,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
NIACIN TAB : 100MG,32006836,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
NICOTINE PAT(NICODERM):7MG/24HR,32006850,CDM,J3490,HCPCS,250,RC,inpatient,,31.21,31.21,,26.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.46,88,,percent of total billed charges,,,,,,,,,23.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.4,91,,percent of total billed charges,,,29.65,95,,percent of total billed charges,,,25.9,83,,percent of total billed charges,,,25.9,83,,percent of total billed charges,,,,,,,,,,,,,,,25.9,83,,percent of total billed charges,,,29.65,95,,percent of total billed charges,,,28.09,90,,percent of total billed charges,,,28.09,90,,percent of total billed charges,,,25.59,82,,percent of total billed charges,,,28.09,90,,percent of total billed charges,,,26.53,85,,percent of total billed charges,,23.53,29.65,
NICOTINE PAT(NICODERM):14MG/24HR,32006851,CDM,J3490,HCPCS,250,RC,inpatient,,30.72,30.72,,26.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.03,88,,percent of total billed charges,,,,,,,,,23.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27.96,91,,percent of total billed charges,,,29.18,95,,percent of total billed charges,,,25.5,83,,percent of total billed charges,,,25.5,83,,percent of total billed charges,,,,,,,,,,,,,,,25.5,83,,percent of total billed charges,,,29.18,95,,percent of total billed charges,,,27.65,90,,percent of total billed charges,,,27.65,90,,percent of total billed charges,,,25.19,82,,percent of total billed charges,,,27.65,90,,percent of total billed charges,,,26.11,85,,percent of total billed charges,,23.16,29.18,
NICOTINE PAT(NICODERM):21MG/24HR,32006861,CDM,J3490,HCPCS,250,RC,inpatient,,26.31,26.31,,22.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23.15,88,,percent of total billed charges,,,,,,,,,20.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.94,91,,percent of total billed charges,,,24.99,95,,percent of total billed charges,,,21.84,83,,percent of total billed charges,,,21.84,83,,percent of total billed charges,,,,,,,,,,,,,,,21.84,83,,percent of total billed charges,,,24.99,95,,percent of total billed charges,,,23.68,90,,percent of total billed charges,,,23.68,90,,percent of total billed charges,,,21.57,82,,percent of total billed charges,,,23.68,90,,percent of total billed charges,,,22.36,85,,percent of total billed charges,,19.84,24.99,
nitroPRUSSID(nitroPRESS)VIAL:50MG/2ML,32006881,CDM,J3490,HCPCS,250,RC,inpatient,,254.55,254.55,,216.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,191.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,216.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,224,88,,percent of total billed charges,,,,,,,,,194.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,231.64,91,,percent of total billed charges,,,241.82,95,,percent of total billed charges,,,211.28,83,,percent of total billed charges,,,211.28,83,,percent of total billed charges,,,,,,,,,,,,,,,211.28,83,,percent of total billed charges,,,241.82,95,,percent of total billed charges,,,229.1,90,,percent of total billed charges,,,229.1,90,,percent of total billed charges,,,208.73,82,,percent of total billed charges,,,229.1,90,,percent of total billed charges,,,216.37,85,,percent of total billed charges,,191.93,241.82,
NITROglycerin PAT(NITRO-DUR):0.4MG/HR,32006887,CDM,J3490,HCPCS,250,RC,inpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,15.28,19.26,
NitroGLYCERIN (NITRO-DUR) PAT : 0.3MG/HR,32006897,CDM,,,250,RC,inpatient,,92.62,92.62,,78.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,69.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,78.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,81.51,88,,percent of total billed charges,,,,,,,,,70.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,84.28,91,,percent of total billed charges,,,87.99,95,,percent of total billed charges,,,76.87,83,,percent of total billed charges,,,76.87,83,,percent of total billed charges,,,,,,,,,,,,,,,76.87,83,,percent of total billed charges,,,87.99,95,,percent of total billed charges,,,83.36,90,,percent of total billed charges,,,83.36,90,,percent of total billed charges,,,75.95,82,,percent of total billed charges,,,83.36,90,,percent of total billed charges,,,78.73,85,,percent of total billed charges,,69.84,87.99,
NitroGLYCERIN (NITRO-DUR) PAT : 0.8MG/HR,32006901,CDM,,,250,RC,inpatient,,100.39,100.39,,85.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88.34,88,,percent of total billed charges,,,,,,,,,76.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91.35,91,,percent of total billed charges,,,95.37,95,,percent of total billed charges,,,83.32,83,,percent of total billed charges,,,83.32,83,,percent of total billed charges,,,,,,,,,,,,,,,83.32,83,,percent of total billed charges,,,95.37,95,,percent of total billed charges,,,90.35,90,,percent of total billed charges,,,90.35,90,,percent of total billed charges,,,82.32,82,,percent of total billed charges,,,90.35,90,,percent of total billed charges,,,85.33,85,,percent of total billed charges,,75.69,95.37,
NitroGLYCERIN (NITRO-BID)CAP : 6.5MG,32006906,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
NitroGLYCERIN PAT (NITRO-DUR) : 0.6MG/HR,32006912,CDM,,,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
NITROFURANTOIN MACRO(MACRODANTI)CAP:50MG,32006916,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
NITROglycerin PAT(NITRO-DUR):0.2MG/HR,32006922,CDM,J3490,HCPCS,250,RC,inpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,15.28,19.26,
NITROglycerin PAT(NITRO-DUR):0.1MG/HR,32006923,CDM,J3490,HCPCS,250,RC,inpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,15.28,19.26,
NitroGLYCERIN (NITRO-BID) OINT : 2% 30GM,32006926,CDM,,,250,RC,inpatient,,553.36,553.36,,469.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,417.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,470.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,486.96,88,,percent of total billed charges,,,,,,,,,422.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,503.56,91,,percent of total billed charges,,,525.69,95,,percent of total billed charges,,,459.29,83,,percent of total billed charges,,,459.29,83,,percent of total billed charges,,,,,,,,,,,,,,,459.29,83,,percent of total billed charges,,,525.69,95,,percent of total billed charges,,,498.02,90,,percent of total billed charges,,,498.02,90,,percent of total billed charges,,,453.76,82,,percent of total billed charges,,,498.02,90,,percent of total billed charges,,,470.36,85,,percent of total billed charges,,417.23,525.69,
NITROFURANTOIN (MACRODANTIN) CAP : 100MG,32006931,CDM,,,250,RC,inpatient,,15.38,15.38,,13.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.53,88,,percent of total billed charges,,,,,,,,,11.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14,91,,percent of total billed charges,,,14.61,95,,percent of total billed charges,,,12.77,83,,percent of total billed charges,,,12.77,83,,percent of total billed charges,,,,,,,,,,,,,,,12.77,83,,percent of total billed charges,,,14.61,95,,percent of total billed charges,,,13.84,90,,percent of total billed charges,,,13.84,90,,percent of total billed charges,,,12.61,82,,percent of total billed charges,,,13.84,90,,percent of total billed charges,,,13.07,85,,percent of total billed charges,,11.6,14.61,
NITROglycerin(NITROSTAT)TAB:0.4MG(25)PX,32006941,CDM,J8499,HCPCS,250,RC,inpatient,,429.91,429.91,,364.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,324.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,365.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,378.32,88,,percent of total billed charges,,,,,,,,,328.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,391.22,91,,percent of total billed charges,,,408.41,95,,percent of total billed charges,,,356.83,83,,percent of total billed charges,,,356.83,83,,percent of total billed charges,,,,,,,,,,,,,,,356.83,83,,percent of total billed charges,,,408.41,95,,percent of total billed charges,,,386.92,90,,percent of total billed charges,,,386.92,90,,percent of total billed charges,,,352.53,82,,percent of total billed charges,,,386.92,90,,percent of total billed charges,,,365.42,85,,percent of total billed charges,,324.15,408.41,
NITROglycerin VIAL:5MG/ML (10ML),32006946,CDM,J3490,HCPCS,250,RC,inpatient,,202.13,202.13,,171.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,171.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,177.87,88,,percent of total billed charges,,,,,,,,,154.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,183.94,91,,percent of total billed charges,,,192.02,95,,percent of total billed charges,,,167.77,83,,percent of total billed charges,,,167.77,83,,percent of total billed charges,,,,,,,,,,,,,,,167.77,83,,percent of total billed charges,,,192.02,95,,percent of total billed charges,,,181.92,90,,percent of total billed charges,,,181.92,90,,percent of total billed charges,,,165.75,82,,percent of total billed charges,,,181.92,90,,percent of total billed charges,,,171.81,85,,percent of total billed charges,,152.41,192.02,
NitroGLYCERIN (NITRO-BID) CAP : 2.5MG,32006951,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
NITROGLYCERIN TAB (SL): 0.3MG,32006956,CDM,,,250,RC,inpatient,,208.08,208.08,,176.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,156.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,176.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.11,88,,percent of total billed charges,,,,,,,,,158.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,189.35,91,,percent of total billed charges,,,197.68,95,,percent of total billed charges,,,172.71,83,,percent of total billed charges,,,172.71,83,,percent of total billed charges,,,,,,,,,,,,,,,172.71,83,,percent of total billed charges,,,197.68,95,,percent of total billed charges,,,187.27,90,,percent of total billed charges,,,187.27,90,,percent of total billed charges,,,170.63,82,,percent of total billed charges,,,187.27,90,,percent of total billed charges,,,176.87,85,,percent of total billed charges,,156.89,197.68,
NITROGLYCERIN 0.6MG 100'S,32006961,CDM,,,250,RC,inpatient,,208.08,208.08,,176.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,156.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,176.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.11,88,,percent of total billed charges,,,,,,,,,158.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,189.35,91,,percent of total billed charges,,,197.68,95,,percent of total billed charges,,,172.71,83,,percent of total billed charges,,,172.71,83,,percent of total billed charges,,,,,,,,,,,,,,,172.71,83,,percent of total billed charges,,,197.68,95,,percent of total billed charges,,,187.27,90,,percent of total billed charges,,,187.27,90,,percent of total billed charges,,,170.63,82,,percent of total billed charges,,,187.27,90,,percent of total billed charges,,,176.87,85,,percent of total billed charges,,156.89,197.68,
NitroGLYCERIN (NITROLINGUAL) AER : 0.4MG,32006962,CDM,,,250,RC,inpatient,,416.01,416.01,,353.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,313.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,353.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,366.09,88,,percent of total billed charges,,,,,,,,,317.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,378.57,91,,percent of total billed charges,,,395.21,95,,percent of total billed charges,,,345.29,83,,percent of total billed charges,,,345.29,83,,percent of total billed charges,,,,,,,,,,,,,,,345.29,83,,percent of total billed charges,,,395.21,95,,percent of total billed charges,,,374.41,90,,percent of total billed charges,,,374.41,90,,percent of total billed charges,,,341.13,82,,percent of total billed charges,,,374.41,90,,percent of total billed charges,,,353.61,85,,percent of total billed charges,,313.67,395.21,
KETOCONAZOLE(NIZORAL)CREAM 2%:15GM,32006966,CDM,J3490,HCPCS,250,RC,inpatient,,126.96,126.96,,107.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,107.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,111.72,88,,percent of total billed charges,,,,,,,,,97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,115.53,91,,percent of total billed charges,,,120.61,95,,percent of total billed charges,,,105.38,83,,percent of total billed charges,,,105.38,83,,percent of total billed charges,,,,,,,,,,,,,,,105.38,83,,percent of total billed charges,,,120.61,95,,percent of total billed charges,,,114.26,90,,percent of total billed charges,,,114.26,90,,percent of total billed charges,,,104.11,82,,percent of total billed charges,,,114.26,90,,percent of total billed charges,,,107.92,85,,percent of total billed charges,,95.73,120.61,
KETOCONAZOLE(NIZORAL)SHAMP 2%:120ML,32006971,CDM,,,250,RC,inpatient,,137.35,137.35,,116.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,103.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,116.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,120.87,88,,percent of total billed charges,,,,,,,,,104.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,124.99,91,,percent of total billed charges,,,130.48,95,,percent of total billed charges,,,114,83,,percent of total billed charges,,,114,83,,percent of total billed charges,,,,,,,,,,,,,,,114,83,,percent of total billed charges,,,130.48,95,,percent of total billed charges,,,123.62,90,,percent of total billed charges,,,123.62,90,,percent of total billed charges,,,112.63,82,,percent of total billed charges,,,123.62,90,,percent of total billed charges,,,116.75,85,,percent of total billed charges,,103.56,130.48,
TAMOXIFEN(NOLVADEX)TAB:10MG,32006976,CDM,,,250,RC,inpatient,,31.4,31.4,,26.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.63,88,,percent of total billed charges,,,,,,,,,23.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.57,91,,percent of total billed charges,,,29.83,95,,percent of total billed charges,,,26.06,83,,percent of total billed charges,,,26.06,83,,percent of total billed charges,,,,,,,,,,,,,,,26.06,83,,percent of total billed charges,,,29.83,95,,percent of total billed charges,,,28.26,90,,percent of total billed charges,,,28.26,90,,percent of total billed charges,,,25.75,82,,percent of total billed charges,,,28.26,90,,percent of total billed charges,,,26.69,85,,percent of total billed charges,,23.68,29.83,
VECURONIUM(NORCURON)VIAL:10MG,32006981,CDM,J3490,HCPCS,250,RC,inpatient,,108.82,108.82,,92.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,92.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.76,88,,percent of total billed charges,,,,,,,,,83.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.03,91,,percent of total billed charges,,,103.38,95,,percent of total billed charges,,,90.32,83,,percent of total billed charges,,,90.32,83,,percent of total billed charges,,,,,,,,,,,,,,,90.32,83,,percent of total billed charges,,,103.38,95,,percent of total billed charges,,,97.94,90,,percent of total billed charges,,,97.94,90,,percent of total billed charges,,,89.23,82,,percent of total billed charges,,,97.94,90,,percent of total billed charges,,,92.5,85,,percent of total billed charges,,82.05,103.38,
NOREPINEPHRIN(LEVOPHED)AMP:4MG/4ML,32006986,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
NORFLOXACIN (NOROXIN) TAB : 400MG,32006996,CDM,,,250,RC,inpatient,,67.25,67.25,,57.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.18,88,,percent of total billed charges,,,,,,,,,51.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.2,91,,percent of total billed charges,,,63.89,95,,percent of total billed charges,,,55.82,83,,percent of total billed charges,,,55.82,83,,percent of total billed charges,,,,,,,,,,,,,,,55.82,83,,percent of total billed charges,,,63.89,95,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,55.15,82,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,57.16,85,,percent of total billed charges,,50.71,63.89,
DISOPYRAMIDE(NORPACE)CAP:150MG,32007006,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
NORTRIPTYLINE(PAMELOR)CAP:10MG,32007011,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
NORTRIPTYLINE (PAMELOR) CAP : 25MG,32007016,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
NORTRIPTYLINE (PAMELOR) CAP : 50MG,32007021,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
amLODIPine(NORVASC)TAB:5MG,32007026,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
AMLODIPINE (NORVASC) TAB : 2.5MG,32007027,CDM,,,250,RC,inpatient,,119.74,119.74,,101.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,101.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.37,88,,percent of total billed charges,,,,,,,,,91.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,108.96,91,,percent of total billed charges,,,113.75,95,,percent of total billed charges,,,99.38,83,,percent of total billed charges,,,99.38,83,,percent of total billed charges,,,,,,,,,,,,,,,99.38,83,,percent of total billed charges,,,113.75,95,,percent of total billed charges,,,107.77,90,,percent of total billed charges,,,107.77,90,,percent of total billed charges,,,98.19,82,,percent of total billed charges,,,107.77,90,,percent of total billed charges,,,101.78,85,,percent of total billed charges,,90.28,113.75,
AMLODIPINE (NORVASC) TAB : 10MG,32007028,CDM,,,250,RC,inpatient,,164.15,164.15,,139.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,123.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,139.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,144.45,88,,percent of total billed charges,,,,,,,,,125.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,149.38,91,,percent of total billed charges,,,155.94,95,,percent of total billed charges,,,136.24,83,,percent of total billed charges,,,136.24,83,,percent of total billed charges,,,,,,,,,,,,,,,136.24,83,,percent of total billed charges,,,155.94,95,,percent of total billed charges,,,147.74,90,,percent of total billed charges,,,147.74,90,,percent of total billed charges,,,134.6,82,,percent of total billed charges,,,147.74,90,,percent of total billed charges,,,139.53,85,,percent of total billed charges,,123.77,155.94,
MITOX(NOVANTRONE):20MG/10ML (J/5MG),32007031,CDM,J9293,HCPCS,636,RC,inpatient,,2399.04,2399.04,,2036.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1808.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2039.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2111.16,88,,percent of total billed charges,,320.03,,,,fee schedule,,,1832.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,320.03,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2183.13,91,,percent of total billed charges,,,2279.09,95,,percent of total billed charges,,,1991.2,83,,percent of total billed charges,,,1991.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1991.2,83,,percent of total billed charges,,,2279.09,95,,percent of total billed charges,,,2159.14,90,,percent of total billed charges,,,2159.14,90,,percent of total billed charges,,,1967.21,82,,percent of total billed charges,,,2159.14,90,,percent of total billed charges,,,2039.18,85,,percent of total billed charges,,320.03,2279.09,
NALBUPHINE(NUBAIN)AMP:10MG/ML,32007032,CDM,J2300,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,6.28,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6.28,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,6.28,60.99,
NUBAIN 10MG/ML 1ML,32007033,CDM,,,250,RC,inpatient,,6,6,,5.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.28,88,,percent of total billed charges,,,,,,,,,4.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4.98,83,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,4.92,82,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,4.52,5.7,
MUMPS SKIN TEST ANTIGEN (MSTA) VIAL,32007036,CDM,,,250,RC,inpatient,,1608.1,1608.1,,1365.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1212.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1366.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1415.13,88,,percent of total billed charges,,,,,,,,,1228.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1463.37,91,,percent of total billed charges,,,1527.7,95,,percent of total billed charges,,,1334.72,83,,percent of total billed charges,,,1334.72,83,,percent of total billed charges,,,,,,,,,,,,,,,1334.72,83,,percent of total billed charges,,,1527.7,95,,percent of total billed charges,,,1447.29,90,,percent of total billed charges,,,1447.29,90,,percent of total billed charges,,,1318.64,82,,percent of total billed charges,,,1447.29,90,,percent of total billed charges,,,1366.89,85,,percent of total billed charges,,1212.51,1527.7,
NUBAIN 20MG/ML,32007040,CDM,,,250,RC,inpatient,,5,5,,4.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4.4,88,,percent of total billed charges,,,,,,,,,3.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4.55,91,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4.15,83,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.1,82,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,3.77,4.75,
NYSTATIN CREAM : 100000 U/G 15GM,32007046,CDM,,,250,RC,inpatient,,59.95,59.95,,50.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,45.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,50.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.76,88,,percent of total billed charges,,,,,,,,,45.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,54.55,91,,percent of total billed charges,,,56.95,95,,percent of total billed charges,,,49.76,83,,percent of total billed charges,,,49.76,83,,percent of total billed charges,,,,,,,,,,,,,,,49.76,83,,percent of total billed charges,,,56.95,95,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,49.16,82,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,50.96,85,,percent of total billed charges,,45.2,56.95,
NYSTATIN CREAM:30GM,32007061,CDM,J3490,HCPCS,250,RC,inpatient,,99.02,99.02,,84.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,74.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,84.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,87.14,88,,percent of total billed charges,,,,,,,,,75.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,90.11,91,,percent of total billed charges,,,94.07,95,,percent of total billed charges,,,82.19,83,,percent of total billed charges,,,82.19,83,,percent of total billed charges,,,,,,,,,,,,,,,82.19,83,,percent of total billed charges,,,94.07,95,,percent of total billed charges,,,89.12,90,,percent of total billed charges,,,89.12,90,,percent of total billed charges,,,81.2,82,,percent of total billed charges,,,89.12,90,,percent of total billed charges,,,84.17,85,,percent of total billed charges,,74.66,94.07,
NYSTATIN ORAL: 100MU/ML 60ML,32007071,CDM,J8499,HCPCS,250,RC,inpatient,,116.57,116.57,,98.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,87.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,99.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,102.58,88,,percent of total billed charges,,,,,,,,,89.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,106.08,91,,percent of total billed charges,,,110.74,95,,percent of total billed charges,,,96.75,83,,percent of total billed charges,,,96.75,83,,percent of total billed charges,,,,,,,,,,,,,,,96.75,83,,percent of total billed charges,,,110.74,95,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,95.59,82,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,99.08,85,,percent of total billed charges,,87.89,110.74,
NYSTATIN/TRIA(MYCOLOG)CREAM:30GM,32007076,CDM,,,250,RC,inpatient,,1350.72,1350.72,,1146.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1018.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1148.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1188.63,88,,percent of total billed charges,,,,,,,,,1031.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1229.16,91,,percent of total billed charges,,,1283.18,95,,percent of total billed charges,,,1121.1,83,,percent of total billed charges,,,1121.1,83,,percent of total billed charges,,,,,,,,,,,,,,,1121.1,83,,percent of total billed charges,,,1283.18,95,,percent of total billed charges,,,1215.65,90,,percent of total billed charges,,,1215.65,90,,percent of total billed charges,,,1107.59,82,,percent of total billed charges,,,1215.65,90,,percent of total billed charges,,,1148.11,85,,percent of total billed charges,,1018.44,1283.18,
NEO/POLY/GRAM(POLYMYCIN)DROP:10ML,32007081,CDM,,,250,RC,inpatient,,705.73,705.73,,599.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,532.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,599.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,621.04,88,,percent of total billed charges,,,,,,,,,539.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,642.21,91,,percent of total billed charges,,,670.44,95,,percent of total billed charges,,,585.76,83,,percent of total billed charges,,,585.76,83,,percent of total billed charges,,,,,,,,,,,,,,,585.76,83,,percent of total billed charges,,,670.44,95,,percent of total billed charges,,,635.16,90,,percent of total billed charges,,,635.16,90,,percent of total billed charges,,,578.7,82,,percent of total billed charges,,,635.16,90,,percent of total billed charges,,,599.87,85,,percent of total billed charges,,532.12,670.44,
OFLOXACIN (OCUFLOX) EYE DROP : 0.3% 10ML,32007083,CDM,,,250,RC,inpatient,,554.25,554.25,,470.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,417.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,471.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,487.74,88,,percent of total billed charges,,,,,,,,,423.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,504.37,91,,percent of total billed charges,,,526.54,95,,percent of total billed charges,,,460.03,83,,percent of total billed charges,,,460.03,83,,percent of total billed charges,,,,,,,,,,,,,,,460.03,83,,percent of total billed charges,,,526.54,95,,percent of total billed charges,,,498.83,90,,percent of total billed charges,,,498.83,90,,percent of total billed charges,,,454.49,82,,percent of total billed charges,,,498.83,90,,percent of total billed charges,,,471.11,85,,percent of total billed charges,,417.9,526.54,
BETA-CAROTENE(A) WC & E/MIN(OCUVITE)CAP:,32007086,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CLOVE OIL  3.7 ML,32007091,CDM,J3490,HCPCS,250,RC,inpatient,,80.57,80.57,,68.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.9,88,,percent of total billed charges,,,,,,,,,61.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.32,91,,percent of total billed charges,,,76.54,95,,percent of total billed charges,,,66.87,83,,percent of total billed charges,,,66.87,83,,percent of total billed charges,,,,,,,,,,,,,,,66.87,83,,percent of total billed charges,,,76.54,95,,percent of total billed charges,,,72.51,90,,percent of total billed charges,,,72.51,90,,percent of total billed charges,,,66.07,82,,percent of total billed charges,,,72.51,90,,percent of total billed charges,,,68.48,85,,percent of total billed charges,,60.75,76.54,
OLIVE OIL  30ML,32007096,CDM,,,250,RC,inpatient,,96.43,96.43,,81.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,72.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,81.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,84.86,88,,percent of total billed charges,,,,,,,,,73.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,87.75,91,,percent of total billed charges,,,91.61,95,,percent of total billed charges,,,80.04,83,,percent of total billed charges,,,80.04,83,,percent of total billed charges,,,,,,,,,,,,,,,80.04,83,,percent of total billed charges,,,91.61,95,,percent of total billed charges,,,86.79,90,,percent of total billed charges,,,86.79,90,,percent of total billed charges,,,79.07,82,,percent of total billed charges,,,86.79,90,,percent of total billed charges,,,81.97,85,,percent of total billed charges,,72.71,91.61,
IOHEXOL (OMNIPAQUE) BTL : 300MG/ML,32007101,CDM,,,250,RC,inpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,613.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,691.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,613.19,772.59,
OPIUM/BELLADONNA ALKALOID SUPP : 60-15MG,32007111,CDM,,,250,RC,inpatient,,38.38,38.38,,32.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33.77,88,,percent of total billed charges,,,,,,,,,29.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.93,91,,percent of total billed charges,,,36.46,95,,percent of total billed charges,,,31.86,83,,percent of total billed charges,,,31.86,83,,percent of total billed charges,,,,,,,,,,,,,,,31.86,83,,percent of total billed charges,,,36.46,95,,percent of total billed charges,,,34.54,90,,percent of total billed charges,,,34.54,90,,percent of total billed charges,,,31.47,82,,percent of total billed charges,,,34.54,90,,percent of total billed charges,,,32.62,85,,percent of total billed charges,,28.94,36.46,
IPODATE (ORAGRAFIN) CAP : 500MG    6'S,32007116,CDM,,,250,RC,inpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,152.71,192.4,
IPODATE SODIUM (ORAGRAFIN) CAP : 500MG,32007121,CDM,,,250,RC,inpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,152.71,192.4,
BENZOCAINE (ORAJEL) GEL : 10% 10ML,32007126,CDM,,,250,RC,inpatient,,57.89,57.89,,49.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,43.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.94,88,,percent of total billed charges,,,,,,,,,44.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,52.68,91,,percent of total billed charges,,,55,95,,percent of total billed charges,,,48.05,83,,percent of total billed charges,,,48.05,83,,percent of total billed charges,,,,,,,,,,,,,,,48.05,83,,percent of total billed charges,,,55,95,,percent of total billed charges,,,52.1,90,,percent of total billed charges,,,52.1,90,,percent of total billed charges,,,47.47,82,,percent of total billed charges,,,52.1,90,,percent of total billed charges,,,49.21,85,,percent of total billed charges,,43.65,55,
MORPHINE SULF(ORAMORPH)ER TAB:100MG,32007127,CDM,,,250,RC,inpatient,,61.22,61.22,,51.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,53.87,88,,percent of total billed charges,,,,,,,,,46.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55.71,91,,percent of total billed charges,,,58.16,95,,percent of total billed charges,,,50.81,83,,percent of total billed charges,,,50.81,83,,percent of total billed charges,,,,,,,,,,,,,,,50.81,83,,percent of total billed charges,,,58.16,95,,percent of total billed charges,,,55.1,90,,percent of total billed charges,,,55.1,90,,percent of total billed charges,,,50.2,82,,percent of total billed charges,,,55.1,90,,percent of total billed charges,,,52.04,85,,percent of total billed charges,,46.16,58.16,
HYDROCHLOROTHIAZIDE TAB:25MG,32007131,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
POLIOMYELITIS VACCINE(ORIMUNE DISPET)PIP,32007166,CDM,90712,CPT,636,RC,inpatient,,275.01,275.01,,233.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,207.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,233.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,242.01,88,,percent of total billed charges,,,,,,,,,210.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,250.26,91,,percent of total billed charges,,,261.26,95,,percent of total billed charges,,,228.26,83,,percent of total billed charges,,,228.26,83,,percent of total billed charges,,,,,,,,,,,,,,,228.26,83,,percent of total billed charges,,,261.26,95,,percent of total billed charges,,,247.51,90,,percent of total billed charges,,,247.51,90,,percent of total billed charges,,,225.51,82,,percent of total billed charges,,,247.51,90,,percent of total billed charges,,,233.76,85,,percent of total billed charges,,207.36,261.26,
DIENESTROL CREAM : 0.01% CREAM 78 GM,32007171,CDM,,,250,RC,inpatient,,406.17,406.17,,344.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,345.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,357.43,88,,percent of total billed charges,,,,,,,,,310.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,369.61,91,,percent of total billed charges,,,385.86,95,,percent of total billed charges,,,337.12,83,,percent of total billed charges,,,337.12,83,,percent of total billed charges,,,,,,,,,,,,,,,337.12,83,,percent of total billed charges,,,385.86,95,,percent of total billed charges,,,365.55,90,,percent of total billed charges,,,365.55,90,,percent of total billed charges,,,333.06,82,,percent of total billed charges,,,365.55,90,,percent of total billed charges,,,345.24,85,,percent of total billed charges,,306.25,385.86,
OTOGESIC (AMERICAINE),32007172,CDM,,,250,RC,inpatient,,20,20,,16.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.6,88,,percent of total billed charges,,,,,,,,,15.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.2,91,,percent of total billed charges,,,19,95,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,,,,,,,,,,,,,16.6,83,,percent of total billed charges,,,19,95,,percent of total billed charges,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,16.4,82,,percent of total billed charges,,,18,90,,percent of total billed charges,,,17,85,,percent of total billed charges,,15.08,19,
OXAZEPAM (SERAX) CAP : 15MG,32007186,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
OXAZEPAM (SERAX) CAP : 30MG,32007191,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
OXAZEPAM(SERAX)CAP:10MG,32007196,CDM,J8499,HCPCS,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
OXISTAT CREAM,32007197,CDM,,,250,RC,inpatient,,80.5,80.5,,68.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.84,88,,percent of total billed charges,,,,,,,,,61.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.26,91,,percent of total billed charges,,,76.48,95,,percent of total billed charges,,,66.82,83,,percent of total billed charges,,,66.82,83,,percent of total billed charges,,,,,,,,,,,,,,,66.82,83,,percent of total billed charges,,,76.48,95,,percent of total billed charges,,,72.45,90,,percent of total billed charges,,,72.45,90,,percent of total billed charges,,,66.01,82,,percent of total billed charges,,,72.45,90,,percent of total billed charges,,,68.43,85,,percent of total billed charges,,60.7,76.48,
OXISTAT 1% CM,32007198,CDM,,,250,RC,inpatient,,39,39,,33.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34.32,88,,percent of total billed charges,,,,,,,,,29.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35.49,91,,percent of total billed charges,,,37.05,95,,percent of total billed charges,,,32.37,83,,percent of total billed charges,,,32.37,83,,percent of total billed charges,,,,,,,,,,,,,,,32.37,83,,percent of total billed charges,,,37.05,95,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,31.98,82,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,33.15,85,,percent of total billed charges,,29.41,37.05,
OXYTOCIN(PITOCIN)VIAL:10UNIT/ML,32007199,CDM,J2590,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,2.57,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.57,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,2.57,60.99,
oxyCODONE (oxyCONTIN) ER TAB:20MG,32007200,CDM,,,250,RC,inpatient,,104.99,104.99,,89.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,89.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,92.39,88,,percent of total billed charges,,,,,,,,,80.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,95.54,91,,percent of total billed charges,,,99.74,95,,percent of total billed charges,,,87.14,83,,percent of total billed charges,,,87.14,83,,percent of total billed charges,,,,,,,,,,,,,,,87.14,83,,percent of total billed charges,,,99.74,95,,percent of total billed charges,,,94.49,90,,percent of total billed charges,,,94.49,90,,percent of total billed charges,,,86.09,82,,percent of total billed charges,,,94.49,90,,percent of total billed charges,,,89.24,85,,percent of total billed charges,,79.16,99.74,
OXYBUTYNIN(DITROPAN)TAB:5MG,32007201,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
OXYCODONE (OXYCONTIN CR) TAB : 80MG,32007202,CDM,,,250,RC,inpatient,,150.83,150.83,,128.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,113.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,128.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,132.73,88,,percent of total billed charges,,,,,,,,,115.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,137.26,91,,percent of total billed charges,,,143.29,95,,percent of total billed charges,,,125.19,83,,percent of total billed charges,,,125.19,83,,percent of total billed charges,,,,,,,,,,,,,,,125.19,83,,percent of total billed charges,,,143.29,95,,percent of total billed charges,,,135.75,90,,percent of total billed charges,,,135.75,90,,percent of total billed charges,,,123.68,82,,percent of total billed charges,,,135.75,90,,percent of total billed charges,,,128.21,85,,percent of total billed charges,,113.73,143.29,
OYSTER SHELL(OSCAL)TAB:1.25GM (500MG),32007207,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CALCIUM CARB(OSCAL+D) TAB : 250MG-125,32007211,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PANCREATIC ENZYME(PANCRELIPASE DR) CAPS:,32007216,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PANCURONIUM(PAVULON)VIAL:10MG/10ML,32007221,CDM,,,250,RC,inpatient,,90.72,90.72,,77.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.83,88,,percent of total billed charges,,,,,,,,,69.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.56,91,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,,,,,,,,,,,,,75.3,83,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,74.39,82,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,68.4,86.18,
PAPAVERINE (PAVABID) CAP : 150MG,32007226,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
CARBOplatin(PARAPLATIN)MDV:50MG/5ML J/50,32007241,CDM,J9045,HCPCS,636,RC,inpatient,,137.35,137.35,,116.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,103.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,116.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,120.87,88,,percent of total billed charges,,48.01,,,,fee schedule,,,104.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,48.01,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,124.99,91,,percent of total billed charges,,,130.48,95,,percent of total billed charges,,,114,83,,percent of total billed charges,,,114,83,,percent of total billed charges,,,,,,,,,,,,,,,114,83,,percent of total billed charges,,,130.48,95,,percent of total billed charges,,,123.62,90,,percent of total billed charges,,,123.62,90,,percent of total billed charges,,,112.63,82,,percent of total billed charges,,,123.62,90,,percent of total billed charges,,,116.75,85,,percent of total billed charges,,48.01,130.48,
PAROXETINE HCL (PAXIL) TAB : 20MG,32007261,CDM,,,250,RC,inpatient,,52.34,52.34,,44.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46.06,88,,percent of total billed charges,,,,,,,,,39.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47.63,91,,percent of total billed charges,,,49.72,95,,percent of total billed charges,,,43.44,83,,percent of total billed charges,,,43.44,83,,percent of total billed charges,,,,,,,,,,,,,,,43.44,83,,percent of total billed charges,,,49.72,95,,percent of total billed charges,,,47.11,90,,percent of total billed charges,,,47.11,90,,percent of total billed charges,,,42.92,82,,percent of total billed charges,,,47.11,90,,percent of total billed charges,,,44.49,85,,percent of total billed charges,,39.46,49.72,
ERYTHROMYCIN BASE(ERY-TAB)TAB:333MG,32007271,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PREDNISOLONE(PEDIAPRED)SOL 5MG/5ML 120ML,32007281,CDM,,,250,RC,inpatient,,1051.81,1051.81,,892.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,793.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,894.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,925.59,88,,percent of total billed charges,,,,,,,,,803.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,957.15,91,,percent of total billed charges,,,999.22,95,,percent of total billed charges,,,873,83,,percent of total billed charges,,,873,83,,percent of total billed charges,,,,,,,,,,,,,,,873,83,,percent of total billed charges,,,999.22,95,,percent of total billed charges,,,946.63,90,,percent of total billed charges,,,946.63,90,,percent of total billed charges,,,862.48,82,,percent of total billed charges,,,946.63,90,,percent of total billed charges,,,894.04,85,,percent of total billed charges,,793.06,999.22,
predNISOLONE (PEDIAPRED) 5MG/5ML 60ML,32007282,CDM,,,250,RC,inpatient,,620.6,620.6,,526.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,467.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,527.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,546.13,88,,percent of total billed charges,,,,,,,,,474.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,564.75,91,,percent of total billed charges,,,589.57,95,,percent of total billed charges,,,515.1,83,,percent of total billed charges,,,515.1,83,,percent of total billed charges,,,,,,,,,,,,,,,515.1,83,,percent of total billed charges,,,589.57,95,,percent of total billed charges,,,558.54,90,,percent of total billed charges,,,558.54,90,,percent of total billed charges,,,508.89,82,,percent of total billed charges,,,558.54,90,,percent of total billed charges,,,527.51,85,,percent of total billed charges,,467.93,589.57,
EES/SULF(PEDIAZOLE):200-600/5M  (100ML),32007286,CDM,,,250,RC,inpatient,,229.18,229.18,,194.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,172.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,194.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,201.68,88,,percent of total billed charges,,,,,,,,,175.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,208.55,91,,percent of total billed charges,,,217.72,95,,percent of total billed charges,,,190.22,83,,percent of total billed charges,,,190.22,83,,percent of total billed charges,,,,,,,,,,,,,,,190.22,83,,percent of total billed charges,,,217.72,95,,percent of total billed charges,,,206.26,90,,percent of total billed charges,,,206.26,90,,percent of total billed charges,,,187.93,82,,percent of total billed charges,,,206.26,90,,percent of total billed charges,,,194.8,85,,percent of total billed charges,,172.8,217.72,
PREDnisolone(PEDIAPRED) SOL 5MG/5ML 30ML,32007291,CDM,,,250,RC,inpatient,,310.22,310.22,,263.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,233.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,263.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,272.99,88,,percent of total billed charges,,,,,,,,,237.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,282.3,91,,percent of total billed charges,,,294.71,95,,percent of total billed charges,,,257.48,83,,percent of total billed charges,,,257.48,83,,percent of total billed charges,,,,,,,,,,,,,,,257.48,83,,percent of total billed charges,,,294.71,95,,percent of total billed charges,,,279.2,90,,percent of total billed charges,,,279.2,90,,percent of total billed charges,,,254.38,82,,percent of total billed charges,,,279.2,90,,percent of total billed charges,,,263.69,85,,percent of total billed charges,,233.91,294.71,
PEN G POTAS(PFIZERPEN) VIAL : 1 MIL UNIT,32007296,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
PEN G POTAS(PFIZERPEN) VIAL:  5 MIL UNIT,32007301,CDM,,,250,RC,inpatient,,118,118,,100.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,88.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,100.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,103.84,88,,percent of total billed charges,,,,,,,,,90.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,107.38,91,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,,,,,,,,,,,,,97.94,83,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,96.76,82,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,88.97,112.1,
PENICILLIN G POTAS VIAL: 5 MIL UNITS,32007302,CDM,,,250,RC,inpatient,,152.89,152.89,,129.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.54,88,,percent of total billed charges,,,,,,,,,116.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,139.13,91,,percent of total billed charges,,,145.25,95,,percent of total billed charges,,,126.9,83,,percent of total billed charges,,,126.9,83,,percent of total billed charges,,,,,,,,,,,,,,,126.9,83,,percent of total billed charges,,,145.25,95,,percent of total billed charges,,,137.6,90,,percent of total billed charges,,,137.6,90,,percent of total billed charges,,,125.37,82,,percent of total billed charges,,,137.6,90,,percent of total billed charges,,,129.96,85,,percent of total billed charges,,115.28,145.25,
PEN G POTAS(PFIZERPEN) VIAL : 10MIL UNIT,32007306,CDM,,,250,RC,inpatient,,84.53,84.53,,71.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.39,88,,percent of total billed charges,,,,,,,,,64.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.92,91,,percent of total billed charges,,,80.3,95,,percent of total billed charges,,,70.16,83,,percent of total billed charges,,,70.16,83,,percent of total billed charges,,,,,,,,,,,,,,,70.16,83,,percent of total billed charges,,,80.3,95,,percent of total billed charges,,,76.08,90,,percent of total billed charges,,,76.08,90,,percent of total billed charges,,,69.31,82,,percent of total billed charges,,,76.08,90,,percent of total billed charges,,,71.85,85,,percent of total billed charges,,63.74,80.3,
PENICILLIN V POTASSIUM TAB:500MG,32007311,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PENICILLIN V POTASSIUM TAB:250MG,32007316,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
MESALAMINE (PENTASA) CAP : 250MG,32007321,CDM,,,250,RC,inpatient,,9,9,,7.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.92,88,,percent of total billed charges,,,,,,,,,6.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.38,82,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,6.79,8.55,
FAMOTIDINE(PEPCID)TAB:20MG,32007331,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FAMOTIDINE(PEPCID)VIAL:20MG/2ML,32007332,CDM,J3490,HCPCS,636,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
OXYCOD/ASPIR(PERCODAN) TAB:4.88-325MG,32007336,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
PERGOLIDE (PERMAX) TAB : 0.05MG,32007346,CDM,,,250,RC,inpatient,,13.96,13.96,,11.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.28,88,,percent of total billed charges,,,,,,,,,10.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.7,91,,percent of total billed charges,,,13.26,95,,percent of total billed charges,,,11.59,83,,percent of total billed charges,,,11.59,83,,percent of total billed charges,,,,,,,,,,,,,,,11.59,83,,percent of total billed charges,,,13.26,95,,percent of total billed charges,,,12.56,90,,percent of total billed charges,,,12.56,90,,percent of total billed charges,,,11.45,82,,percent of total billed charges,,,12.56,90,,percent of total billed charges,,,11.87,85,,percent of total billed charges,,10.53,13.26,
PERPHENAZINE (TRILIFON) TAB : 2MG,32007351,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
DIPYRIDAMOLE (PERSANTINE):10mg/2ml,32007352,CDM,J1245,HCPCS,636,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,22.18,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,22.18,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,22.18,59.21,
PAPAIN/UREA/CHLRPH(PANAFL)OINT:30G,32007357,CDM,,,250,RC,inpatient,,986.5,986.5,,837.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,743.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,838.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,868.12,88,,percent of total billed charges,,,,,,,,,753.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,897.72,91,,percent of total billed charges,,,937.18,95,,percent of total billed charges,,,818.8,83,,percent of total billed charges,,,818.8,83,,percent of total billed charges,,,,,,,,,,,,,,,818.8,83,,percent of total billed charges,,,937.18,95,,percent of total billed charges,,,887.85,90,,percent of total billed charges,,,887.85,90,,percent of total billed charges,,,808.93,82,,percent of total billed charges,,,887.85,90,,percent of total billed charges,,,838.53,85,,percent of total billed charges,,743.82,937.18,
PETROLATUM WHITE(VASELINE)JEL:75GM,32007361,CDM,J3490,HCPCS,250,RC,inpatient,,26.64,26.64,,22.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23.44,88,,percent of total billed charges,,,,,,,,,20.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.24,91,,percent of total billed charges,,,25.31,95,,percent of total billed charges,,,22.11,83,,percent of total billed charges,,,22.11,83,,percent of total billed charges,,,,,,,,,,,,,,,22.11,83,,percent of total billed charges,,,25.31,95,,percent of total billed charges,,,23.98,90,,percent of total billed charges,,,23.98,90,,percent of total billed charges,,,21.84,82,,percent of total billed charges,,,23.98,90,,percent of total billed charges,,,22.64,85,,percent of total billed charges,,20.09,25.31,
PETROLATUM WHITE(VASELINE)JEL:U/D,32007366,CDM,,,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
PHENobarbital SODIUM VIAL:130MG/ML,32007381,CDM,,,250,RC,inpatient,,878.3,878.3,,745.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,662.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,746.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,772.9,88,,percent of total billed charges,,,,,,,,,671.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,799.25,91,,percent of total billed charges,,,834.39,95,,percent of total billed charges,,,728.99,83,,percent of total billed charges,,,728.99,83,,percent of total billed charges,,,,,,,,,,,,,,,728.99,83,,percent of total billed charges,,,834.39,95,,percent of total billed charges,,,790.47,90,,percent of total billed charges,,,790.47,90,,percent of total billed charges,,,720.21,82,,percent of total billed charges,,,790.47,90,,percent of total billed charges,,,746.56,85,,percent of total billed charges,,662.24,834.39,
PHENAZOPYRIDINE(PYRIDIUM)TAB:100MG,32007386,CDM,J8499,HCPCS,250,RC,inpatient,,13.89,13.89,,11.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.22,88,,percent of total billed charges,,,,,,,,,10.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.64,91,,percent of total billed charges,,,13.2,95,,percent of total billed charges,,,11.53,83,,percent of total billed charges,,,11.53,83,,percent of total billed charges,,,,,,,,,,,,,,,11.53,83,,percent of total billed charges,,,13.2,95,,percent of total billed charges,,,12.5,90,,percent of total billed charges,,,12.5,90,,percent of total billed charges,,,11.39,82,,percent of total billed charges,,,12.5,90,,percent of total billed charges,,,11.81,85,,percent of total billed charges,,10.47,13.2,
PHENYLEPH(NEO-SYNPHRINE)VIAL:10MG/ML,32007391,CDM,J2370,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
PHENYLEPH(NEO-SYNPHRN)DROP 10%(EYE):5ML,32007396,CDM,J3490,HCPCS,250,RC,inpatient,,648.2,648.2,,550.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,488.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,550.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,570.42,88,,percent of total billed charges,,,,,,,,,495.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,589.86,91,,percent of total billed charges,,,615.79,95,,percent of total billed charges,,,538.01,83,,percent of total billed charges,,,538.01,83,,percent of total billed charges,,,,,,,,,,,,,,,538.01,83,,percent of total billed charges,,,615.79,95,,percent of total billed charges,,,583.38,90,,percent of total billed charges,,,583.38,90,,percent of total billed charges,,,531.52,82,,percent of total billed charges,,,583.38,90,,percent of total billed charges,,,550.97,85,,percent of total billed charges,,488.74,615.79,
PHENOL LIQ  500ML,32007401,CDM,,,250,RC,inpatient,,710.57,710.57,,603.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,535.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,603.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,625.3,88,,percent of total billed charges,,,,,,,,,542.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,646.62,91,,percent of total billed charges,,,675.04,95,,percent of total billed charges,,,589.77,83,,percent of total billed charges,,,589.77,83,,percent of total billed charges,,,,,,,,,,,,,,,589.77,83,,percent of total billed charges,,,675.04,95,,percent of total billed charges,,,639.51,90,,percent of total billed charges,,,639.51,90,,percent of total billed charges,,,582.67,82,,percent of total billed charges,,,639.51,90,,percent of total billed charges,,,603.98,85,,percent of total billed charges,,535.77,675.04,
PROMETHAZINE(PHENERGAN)SUPP:12.5MG,32007406,CDM,J3490,HCPCS,250,RC,inpatient,,167.16,167.16,,141.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,126.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,142.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,147.1,88,,percent of total billed charges,,,,,,,,,127.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,152.12,91,,percent of total billed charges,,,158.8,95,,percent of total billed charges,,,138.74,83,,percent of total billed charges,,,138.74,83,,percent of total billed charges,,,,,,,,,,,,,,,138.74,83,,percent of total billed charges,,,158.8,95,,percent of total billed charges,,,150.44,90,,percent of total billed charges,,,150.44,90,,percent of total billed charges,,,137.07,82,,percent of total billed charges,,,150.44,90,,percent of total billed charges,,,142.09,85,,percent of total billed charges,,126.04,158.8,
PHENOL LIQ  500ML,32007411,CDM,,,250,RC,inpatient,,50.28,50.28,,42.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.25,88,,percent of total billed charges,,,,,,,,,38.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.75,91,,percent of total billed charges,,,47.77,95,,percent of total billed charges,,,41.73,83,,percent of total billed charges,,,41.73,83,,percent of total billed charges,,,,,,,,,,,,,,,41.73,83,,percent of total billed charges,,,47.77,95,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,41.23,82,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,42.74,85,,percent of total billed charges,,37.91,47.77,
PROMETHAZINE(PHENERGAN)SUPP:25MG,32007431,CDM,J3490,HCPCS,250,RC,inpatient,,54.09,54.09,,45.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47.6,88,,percent of total billed charges,,,,,,,,,41.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.22,91,,percent of total billed charges,,,51.39,95,,percent of total billed charges,,,44.89,83,,percent of total billed charges,,,44.89,83,,percent of total billed charges,,,,,,,,,,,,,,,44.89,83,,percent of total billed charges,,,51.39,95,,percent of total billed charges,,,48.68,90,,percent of total billed charges,,,48.68,90,,percent of total billed charges,,,44.35,82,,percent of total billed charges,,,48.68,90,,percent of total billed charges,,,45.98,85,,percent of total billed charges,,40.78,51.39,
PROMETHAZINE(PHENERGAN)TAB:25MG,32007432,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PROMETHAZINE(PHENERGAN)TAB:25MG (1x6),32007433,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PHENAZOPYRIDINE(PYRIDIUM) TAB : 200MG,32007436,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PHENAZOPYRIDI(PYRIDIUM) TAB :200MG (1X6),32007437,CDM,,,250,RC,inpatient,,16.49,16.49,,14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.51,88,,percent of total billed charges,,,,,,,,,12.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.01,91,,percent of total billed charges,,,15.67,95,,percent of total billed charges,,,13.69,83,,percent of total billed charges,,,13.69,83,,percent of total billed charges,,,,,,,,,,,,,,,13.69,83,,percent of total billed charges,,,15.67,95,,percent of total billed charges,,,14.84,90,,percent of total billed charges,,,14.84,90,,percent of total billed charges,,,13.52,82,,percent of total billed charges,,,14.84,90,,percent of total billed charges,,,14.02,85,,percent of total billed charges,,12.43,15.67,
PHISODERM LOTION 6 OZ,32007452,CDM,,,250,RC,inpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,9.05,11.4,
PHOSPHO SODA(FLEET-ORAL):45ML,32007456,CDM,,,250,RC,inpatient,,43.3,43.3,,36.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.1,88,,percent of total billed charges,,,,,,,,,33.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,39.4,91,,percent of total billed charges,,,41.14,95,,percent of total billed charges,,,35.94,83,,percent of total billed charges,,,35.94,83,,percent of total billed charges,,,,,,,,,,,,,,,35.94,83,,percent of total billed charges,,,41.14,95,,percent of total billed charges,,,38.97,90,,percent of total billed charges,,,38.97,90,,percent of total billed charges,,,35.51,82,,percent of total billed charges,,,38.97,90,,percent of total billed charges,,,36.81,85,,percent of total billed charges,,32.65,41.14,
PHENobarbital TAB:15MG,32007466,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
PHENobarbital ELIX UD: 20MG/5ML,32007471,CDM,J8499,HCPCS,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
PHENobarbital ELIX:20MG/5ML 60ML,32007476,CDM,J8499,HCPCS,250,RC,inpatient,,89.77,89.77,,76.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,76.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79,88,,percent of total billed charges,,,,,,,,,68.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,81.69,91,,percent of total billed charges,,,85.28,95,,percent of total billed charges,,,74.51,83,,percent of total billed charges,,,74.51,83,,percent of total billed charges,,,,,,,,,,,,,,,74.51,83,,percent of total billed charges,,,85.28,95,,percent of total billed charges,,,80.79,90,,percent of total billed charges,,,80.79,90,,percent of total billed charges,,,73.61,82,,percent of total billed charges,,,80.79,90,,percent of total billed charges,,,76.3,85,,percent of total billed charges,,67.69,85.28,
PHENobarbital ELIX:20MG/5ML 480ML,32007481,CDM,,,250,RC,inpatient,,134.65,134.65,,114.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,101.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,114.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,118.49,88,,percent of total billed charges,,,,,,,,,102.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,122.53,91,,percent of total billed charges,,,127.92,95,,percent of total billed charges,,,111.76,83,,percent of total billed charges,,,111.76,83,,percent of total billed charges,,,,,,,,,,,,,,,111.76,83,,percent of total billed charges,,,127.92,95,,percent of total billed charges,,,121.19,90,,percent of total billed charges,,,121.19,90,,percent of total billed charges,,,110.41,82,,percent of total billed charges,,,121.19,90,,percent of total billed charges,,,114.45,85,,percent of total billed charges,,101.53,127.92,
PHENOBARBITAL TAB : 60MG,32007486,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
PHENobarbital ELIX:20MG/5ML 480ML,32007491,CDM,,,250,RC,inpatient,,707.36,707.36,,600.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,533.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,601.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,622.48,88,,percent of total billed charges,,,,,,,,,540.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,643.7,91,,percent of total billed charges,,,671.99,95,,percent of total billed charges,,,587.11,83,,percent of total billed charges,,,587.11,83,,percent of total billed charges,,,,,,,,,,,,,,,587.11,83,,percent of total billed charges,,,671.99,95,,percent of total billed charges,,,636.62,90,,percent of total billed charges,,,636.62,90,,percent of total billed charges,,,580.04,82,,percent of total billed charges,,,636.62,90,,percent of total billed charges,,,601.26,85,,percent of total billed charges,,533.35,671.99,
PILOCARPINE DROP 2%:2ML,32007501,CDM,,,250,RC,inpatient,,79.93,79.93,,67.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.34,88,,percent of total billed charges,,,,,,,,,61.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.74,91,,percent of total billed charges,,,75.93,95,,percent of total billed charges,,,66.34,83,,percent of total billed charges,,,66.34,83,,percent of total billed charges,,,,,,,,,,,,,,,66.34,83,,percent of total billed charges,,,75.93,95,,percent of total billed charges,,,71.94,90,,percent of total billed charges,,,71.94,90,,percent of total billed charges,,,65.54,82,,percent of total billed charges,,,71.94,90,,percent of total billed charges,,,67.94,85,,percent of total billed charges,,60.27,75.93,
PILOCARPINE(PILOPINE HS)GEL 4%:4ML,32007506,CDM,,,250,RC,inpatient,,1287.69,1287.69,,1093.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,970.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1094.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1133.17,88,,percent of total billed charges,,,,,,,,,983.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1171.8,91,,percent of total billed charges,,,1223.31,95,,percent of total billed charges,,,1068.78,83,,percent of total billed charges,,,1068.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1068.78,83,,percent of total billed charges,,,1223.31,95,,percent of total billed charges,,,1158.92,90,,percent of total billed charges,,,1158.92,90,,percent of total billed charges,,,1055.91,82,,percent of total billed charges,,,1158.92,90,,percent of total billed charges,,,1094.54,85,,percent of total billed charges,,970.92,1223.31,
CILOSTAZOL(PLETAL)TAB:100MG,32007517,CDM,J8499,HCPCS,250,RC,inpatient,UD,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PIROXICAM (FELDENE) CAP : 20MG,32007536,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PIROXICAM(FELDENE)CAP:10MG,32007541,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PITRESSIN,32007551,CDM,,,250,RC,inpatient,,616.16,616.16,,523.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,464.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,523.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.22,88,,percent of total billed charges,,,,,,,,,470.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,560.71,91,,percent of total billed charges,,,585.35,95,,percent of total billed charges,,,511.41,83,,percent of total billed charges,,,511.41,83,,percent of total billed charges,,,,,,,,,,,,,,,511.41,83,,percent of total billed charges,,,585.35,95,,percent of total billed charges,,,554.54,90,,percent of total billed charges,,,554.54,90,,percent of total billed charges,,,505.25,82,,percent of total billed charges,,,554.54,90,,percent of total billed charges,,,523.74,85,,percent of total billed charges,,464.58,585.35,
CLOPIDOGREL(PLAVIX)TAB:75MG,32007572,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FELODIPINE(PLENDIL) E.R. TAB:2.5MG,32007576,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FELODIPINE (PLENDIL) TAB : 5MG,32007581,CDM,,,250,RC,inpatient,,22.84,22.84,,19.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.1,88,,percent of total billed charges,,,,,,,,,17.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.78,91,,percent of total billed charges,,,21.7,95,,percent of total billed charges,,,18.96,83,,percent of total billed charges,,,18.96,83,,percent of total billed charges,,,,,,,,,,,,,,,18.96,83,,percent of total billed charges,,,21.7,95,,percent of total billed charges,,,20.56,90,,percent of total billed charges,,,20.56,90,,percent of total billed charges,,,18.73,82,,percent of total billed charges,,,20.56,90,,percent of total billed charges,,,19.41,85,,percent of total billed charges,,17.22,21.7,
PNEUMOCOCCAL(PNEUMOVAX)VIAL:25MCG/0.5ML,32007586,CDM,90732,CPT,636,RC,inpatient,,1675.89,1675.89,,1422.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1263.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1424.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1474.78,88,,percent of total billed charges,,,,,,,,,1280.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1525.06,91,,percent of total billed charges,,,1592.1,95,,percent of total billed charges,,,1390.99,83,,percent of total billed charges,,,1390.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1390.99,83,,percent of total billed charges,,,1592.1,95,,percent of total billed charges,,,1508.3,90,,percent of total billed charges,,,1508.3,90,,percent of total billed charges,,,1374.23,82,,percent of total billed charges,,,1508.3,90,,percent of total billed charges,,,1424.51,85,,percent of total billed charges,,1263.62,1592.1,
POLIOMYELITIS VAC KILLED(IPOL)SYR 0.5ML,32007587,CDM,90713,CPT,636,RC,inpatient,,422.03,422.03,,358.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,318.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,358.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,371.39,88,,percent of total billed charges,,,,,,,,,322.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,384.05,91,,percent of total billed charges,,,400.93,95,,percent of total billed charges,,,350.28,83,,percent of total billed charges,,,350.28,83,,percent of total billed charges,,,,,,,,,,,,,,,350.28,83,,percent of total billed charges,,,400.93,95,,percent of total billed charges,,,379.83,90,,percent of total billed charges,,,379.83,90,,percent of total billed charges,,,346.06,82,,percent of total billed charges,,,379.83,90,,percent of total billed charges,,,358.73,85,,percent of total billed charges,,318.21,400.93,
PNEUMOCOCC 23(PNEUMOVAX)VIAL:25MCG/0.5ML,32007588,CDM,90732,CPT,636,RC,inpatient,,136.5,136.5,,115.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,102.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,116.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,120.12,88,,percent of total billed charges,,,,,,,,,104.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,124.22,91,,percent of total billed charges,,,129.68,95,,percent of total billed charges,,,113.3,83,,percent of total billed charges,,,113.3,83,,percent of total billed charges,,,,,,,,,,,,,,,113.3,83,,percent of total billed charges,,,129.68,95,,percent of total billed charges,,,122.85,90,,percent of total billed charges,,,122.85,90,,percent of total billed charges,,,111.93,82,,percent of total billed charges,,,122.85,90,,percent of total billed charges,,,116.03,85,,percent of total billed charges,,102.92,129.68,
POTASSIUM ACETATE VIAL:40MEQ/20ML,32007591,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
PODOPHYLLUM RESIN(PODOCON-25)LIQ 25% 15M,32007606,CDM,,,250,RC,inpatient,,1382.98,1382.98,,1174.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1042.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1175.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1217.02,88,,percent of total billed charges,,,,,,,,,1056.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1258.51,91,,percent of total billed charges,,,1313.83,95,,percent of total billed charges,,,1147.87,83,,percent of total billed charges,,,1147.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1147.87,83,,percent of total billed charges,,,1313.83,95,,percent of total billed charges,,,1244.68,90,,percent of total billed charges,,,1244.68,90,,percent of total billed charges,,,1134.04,82,,percent of total billed charges,,,1244.68,90,,percent of total billed charges,,,1175.53,85,,percent of total billed charges,,1042.77,1313.83,
MEPIVACAINE(POLOCAINE) 2% MPF:400MG/20ML,32007611,CDM,J0670,HCPCS,250,RC,inpatient,,125.49,125.49,,106.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,94.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,106.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110.43,88,,percent of total billed charges,,,,,,,,,95.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,114.2,91,,percent of total billed charges,,,119.22,95,,percent of total billed charges,,,104.16,83,,percent of total billed charges,,,104.16,83,,percent of total billed charges,,,,,,,,,,,,,,,104.16,83,,percent of total billed charges,,,119.22,95,,percent of total billed charges,,,112.94,90,,percent of total billed charges,,,112.94,90,,percent of total billed charges,,,102.9,82,,percent of total billed charges,,,112.94,90,,percent of total billed charges,,,106.67,85,,percent of total billed charges,,94.62,119.22,
BACITRACIN/POLYM B(POLYSPORIN)PWD:10GM,32007616,CDM,,,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
AMPicillin-VIAL:500MG,32007626,CDM,J0290,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,3.05,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.05,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,3.05,60.99,
AMPicillin-VIAL:250MG,32007631,CDM,J0290,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,3.05,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.05,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,3.05,60.99,
AMPicillin-VIAL:1GM,32007641,CDM,J0290,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,3.05,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.05,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,3.05,60.99,
AMPicillin-VIAL:2GM,32007646,CDM,J0290,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,3.05,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.05,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,3.05,59.21,
TETRACAINE HCL (PONTOCAINE) SOL:2% 30ML,32007656,CDM,,,250,RC,inpatient,,190.48,190.48,,161.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,143.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,161.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,167.62,88,,percent of total billed charges,,,,,,,,,145.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,173.34,91,,percent of total billed charges,,,180.96,95,,percent of total billed charges,,,158.1,83,,percent of total billed charges,,,158.1,83,,percent of total billed charges,,,,,,,,,,,,,,,158.1,83,,percent of total billed charges,,,180.96,95,,percent of total billed charges,,,171.43,90,,percent of total billed charges,,,171.43,90,,percent of total billed charges,,,156.19,82,,percent of total billed charges,,,171.43,90,,percent of total billed charges,,,161.91,85,,percent of total billed charges,,143.62,180.96,
POTASSIUM CHLORIDE (KLOR-CON 8) TAB:8MEQ,32007660,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
POTAS PHOS(KP04)VIAL:45MMOL/15ML,32007661,CDM,J3490,HCPCS,250,RC,inpatient,,615.21,615.21,,522.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,463.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,522.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,541.38,88,,percent of total billed charges,,,,,,,,,470.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,559.84,91,,percent of total billed charges,,,584.45,95,,percent of total billed charges,,,510.62,83,,percent of total billed charges,,,510.62,83,,percent of total billed charges,,,,,,,,,,,,,,,510.62,83,,percent of total billed charges,,,584.45,95,,percent of total billed charges,,,553.69,90,,percent of total billed charges,,,553.69,90,,percent of total billed charges,,,504.47,82,,percent of total billed charges,,,553.69,90,,percent of total billed charges,,,522.93,85,,percent of total billed charges,,463.87,584.45,
PROMETHAZINE(PHENERGAN)SUPP:50MG,32007666,CDM,J3490,HCPCS,250,RC,inpatient,,378.9,378.9,,321.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,285.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,322.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,333.43,88,,percent of total billed charges,,,,,,,,,289.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,344.8,91,,percent of total billed charges,,,359.96,95,,percent of total billed charges,,,314.49,83,,percent of total billed charges,,,314.49,83,,percent of total billed charges,,,,,,,,,,,,,,,314.49,83,,percent of total billed charges,,,359.96,95,,percent of total billed charges,,,341.01,90,,percent of total billed charges,,,341.01,90,,percent of total billed charges,,,310.7,82,,percent of total billed charges,,,341.01,90,,percent of total billed charges,,,322.07,85,,percent of total billed charges,,285.69,359.96,
REPAGLINIDE(PRANDIN)TAB:0.5MG,32007672,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PRAVASTATIN(PRAVACHOL)TAB:20MG,32007676,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PRAZOSIN (MINIPRES) CAP : 5MG,32007681,CDM,,,250,RC,inpatient,,47.58,47.58,,40.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.87,88,,percent of total billed charges,,,,,,,,,36.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.3,91,,percent of total billed charges,,,45.2,95,,percent of total billed charges,,,39.49,83,,percent of total billed charges,,,39.49,83,,percent of total billed charges,,,,,,,,,,,,,,,39.49,83,,percent of total billed charges,,,45.2,95,,percent of total billed charges,,,42.82,90,,percent of total billed charges,,,42.82,90,,percent of total billed charges,,,39.02,82,,percent of total billed charges,,,42.82,90,,percent of total billed charges,,,40.44,85,,percent of total billed charges,,35.88,45.2,
PRAZOSIN (MINIPRES) CAP : 2MG,32007686,CDM,,,250,RC,inpatient,,28.07,28.07,,23.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.7,88,,percent of total billed charges,,,,,,,,,21.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.54,91,,percent of total billed charges,,,26.67,95,,percent of total billed charges,,,23.3,83,,percent of total billed charges,,,23.3,83,,percent of total billed charges,,,,,,,,,,,,,,,23.3,83,,percent of total billed charges,,,26.67,95,,percent of total billed charges,,,25.26,90,,percent of total billed charges,,,25.26,90,,percent of total billed charges,,,23.02,82,,percent of total billed charges,,,25.26,90,,percent of total billed charges,,,23.86,85,,percent of total billed charges,,21.16,26.67,
PRAZOSIN(MINIPRES)CAP:1MG,32007691,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PRED FORTE 1% 5ML,32007692,CDM,,,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PREDNISOLONE ACITATE 1% SOLN 5ML,32007693,CDM,,,250,RC,inpatient,,45.5,45.5,,38.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.04,88,,percent of total billed charges,,,,,,,,,34.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.41,91,,percent of total billed charges,,,43.23,95,,percent of total billed charges,,,37.77,83,,percent of total billed charges,,,37.77,83,,percent of total billed charges,,,,,,,,,,,,,,,37.77,83,,percent of total billed charges,,,43.23,95,,percent of total billed charges,,,40.95,90,,percent of total billed charges,,,40.95,90,,percent of total billed charges,,,37.31,82,,percent of total billed charges,,,40.95,90,,percent of total billed charges,,,38.68,85,,percent of total billed charges,,34.31,43.23,
predNISONE ORAL (INTOSOL): 5MG/ML 30ML,32007701,CDM,,,250,RC,inpatient,,1742.76,1742.76,,1479.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1314.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1481.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1533.63,88,,percent of total billed charges,,,,,,,,,1331.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1585.91,91,,percent of total billed charges,,,1655.62,95,,percent of total billed charges,,,1446.49,83,,percent of total billed charges,,,1446.49,83,,percent of total billed charges,,,,,,,,,,,,,,,1446.49,83,,percent of total billed charges,,,1655.62,95,,percent of total billed charges,,,1568.48,90,,percent of total billed charges,,,1568.48,90,,percent of total billed charges,,,1429.06,82,,percent of total billed charges,,,1568.48,90,,percent of total billed charges,,,1481.35,85,,percent of total billed charges,,1314.04,1655.62,
predniSONE TAB: 5MG,32007706,CDM,J7599,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
predniSONE TAB: 2.5MG,32007707,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
predniSONE TAB:10MG,32007711,CDM,J7599,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
predniSONE TAB:20MG,32007716,CDM,J7599,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
predNISONE TAB : 20MG (1X4),32007717,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
predNISONE TAB : 50MG,32007721,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PRELONE 240ML,32007722,CDM,,,250,RC,inpatient,,215,215,,182.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,162.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,182.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,189.2,88,,percent of total billed charges,,,,,,,,,164.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,195.65,91,,percent of total billed charges,,,204.25,95,,percent of total billed charges,,,178.45,83,,percent of total billed charges,,,178.45,83,,percent of total billed charges,,,,,,,,,,,,,,,178.45,83,,percent of total billed charges,,,204.25,95,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,176.3,82,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,182.75,85,,percent of total billed charges,,162.11,204.25,
predniSONE TAB: 1MG,32007723,CDM,J7599,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
predNISOLONE(PRELONE)SYRP : 15MG/5ML 5ML,32007724,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
predNISOLONE(PRELONE) SYRP:15MG/5ML 60ML,32007725,CDM,,,250,RC,inpatient,,46.95,46.95,,39.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.32,88,,percent of total billed charges,,,,,,,,,35.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.72,91,,percent of total billed charges,,,44.6,95,,percent of total billed charges,,,38.97,83,,percent of total billed charges,,,38.97,83,,percent of total billed charges,,,,,,,,,,,,,,,38.97,83,,percent of total billed charges,,,44.6,95,,percent of total billed charges,,,42.26,90,,percent of total billed charges,,,42.26,90,,percent of total billed charges,,,38.5,82,,percent of total billed charges,,,42.26,90,,percent of total billed charges,,,39.91,85,,percent of total billed charges,,35.4,44.6,
ESTROGENS CONJUGATED(PREMARIN)VIAL:25MG,32007726,CDM,J1410,HCPCS,636,RC,inpatient,,2512.86,2512.86,,2133.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1894.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2135.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2211.32,88,,percent of total billed charges,,355.49,,,,fee schedule,,,1919.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,355.49,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2286.7,91,,percent of total billed charges,,,2387.22,95,,percent of total billed charges,,,2085.67,83,,percent of total billed charges,,,2085.67,83,,percent of total billed charges,,,,,,,,,,,,,,,2085.67,83,,percent of total billed charges,,,2387.22,95,,percent of total billed charges,,,2261.57,90,,percent of total billed charges,,,2261.57,90,,percent of total billed charges,,,2060.55,82,,percent of total billed charges,,,2261.57,90,,percent of total billed charges,,,2135.93,85,,percent of total billed charges,,355.49,2387.22,
ESTROGENS CONJUGATED (PREMARIN)TAB:0.3MG,32007731,CDM,,,250,RC,inpatient,,17.13,17.13,,14.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.07,88,,percent of total billed charges,,,,,,,,,13.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.59,91,,percent of total billed charges,,,16.27,95,,percent of total billed charges,,,14.22,83,,percent of total billed charges,,,14.22,83,,percent of total billed charges,,,,,,,,,,,,,,,14.22,83,,percent of total billed charges,,,16.27,95,,percent of total billed charges,,,15.42,90,,percent of total billed charges,,,15.42,90,,percent of total billed charges,,,14.05,82,,percent of total billed charges,,,15.42,90,,percent of total billed charges,,,14.56,85,,percent of total billed charges,,12.92,16.27,
ESTROGEN CONJ(PREMARIN)CR:0.625MG/GM,32007736,CDM,,,250,RC,inpatient,,2665.42,2665.42,,2262.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2009.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2265.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2345.57,88,,percent of total billed charges,,,,,,,,,2036.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2425.53,91,,percent of total billed charges,,,2532.15,95,,percent of total billed charges,,,2212.3,83,,percent of total billed charges,,,2212.3,83,,percent of total billed charges,,,,,,,,,,,,,,,2212.3,83,,percent of total billed charges,,,2532.15,95,,percent of total billed charges,,,2398.88,90,,percent of total billed charges,,,2398.88,90,,percent of total billed charges,,,2185.64,82,,percent of total billed charges,,,2398.88,90,,percent of total billed charges,,,2265.61,85,,percent of total billed charges,,2009.73,2532.15,
ESTROGEN/M-PROGEST(PREMPRO)TAB:0.625-2.5,32007742,CDM,,,250,RC,inpatient,,42.19,42.19,,35.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37.13,88,,percent of total billed charges,,,,,,,,,32.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38.39,91,,percent of total billed charges,,,40.08,95,,percent of total billed charges,,,35.02,83,,percent of total billed charges,,,35.02,83,,percent of total billed charges,,,,,,,,,,,,,,,35.02,83,,percent of total billed charges,,,40.08,95,,percent of total billed charges,,,37.97,90,,percent of total billed charges,,,37.97,90,,percent of total billed charges,,,34.6,82,,percent of total billed charges,,,37.97,90,,percent of total billed charges,,,35.86,85,,percent of total billed charges,,31.81,40.08,
ESTROGEN/M-PROGEST(PREMPRO)TAB:0.625-5MG,32007743,CDM,,,250,RC,inpatient,,32.51,32.51,,27.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28.61,88,,percent of total billed charges,,,,,,,,,24.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29.58,91,,percent of total billed charges,,,30.88,95,,percent of total billed charges,,,26.98,83,,percent of total billed charges,,,26.98,83,,percent of total billed charges,,,,,,,,,,,,,,,26.98,83,,percent of total billed charges,,,30.88,95,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,26.66,82,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,27.63,85,,percent of total billed charges,,24.51,30.88,
ESTROGENS CONJUGATD(PREMARIN)TAB:0.625MG,32007746,CDM,J8499,HCPCS,250,RC,inpatient,,103.25,103.25,,87.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.86,88,,percent of total billed charges,,,,,,,,,78.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.96,91,,percent of total billed charges,,,98.09,95,,percent of total billed charges,,,85.7,83,,percent of total billed charges,,,85.7,83,,percent of total billed charges,,,,,,,,,,,,,,,85.7,83,,percent of total billed charges,,,98.09,95,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,84.67,82,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,87.76,85,,percent of total billed charges,,77.85,98.09,
ESTROGENS CONJUGATED(PREMARIN)TAB:1.25MG,32007747,CDM,,,250,RC,inpatient,,17.76,17.76,,15.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.63,88,,percent of total billed charges,,,,,,,,,13.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.16,91,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,,,,,,,,,,,,,14.74,83,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,14.56,82,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.1,85,,percent of total billed charges,,13.39,16.87,
VIT/FE FUMAR/FA(PRENATAL 1+1)TAB:,32007751,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
SHARK LIVER OIL/MERC(PREP-H) SALTS SUPP,32007756,CDM,,,250,RC,inpatient,,14.22,14.22,,12.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.51,88,,percent of total billed charges,,,,,,,,,10.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.94,91,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,,,,,,,,,,,,,11.8,83,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,11.66,82,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.09,85,,percent of total billed charges,,10.72,13.51,
PHENYLEPH/SHK(FORMULATION R)OINT:30GM,32007761,CDM,J3490,HCPCS,250,RC,inpatient,,116.83,116.83,,99.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,88.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,99.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,102.81,88,,percent of total billed charges,,,,,,,,,89.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,106.32,91,,percent of total billed charges,,,110.99,95,,percent of total billed charges,,,96.97,83,,percent of total billed charges,,,96.97,83,,percent of total billed charges,,,,,,,,,,,,,,,96.97,83,,percent of total billed charges,,,110.99,95,,percent of total billed charges,,,105.15,90,,percent of total billed charges,,,105.15,90,,percent of total billed charges,,,95.8,82,,percent of total billed charges,,,105.15,90,,percent of total billed charges,,,99.31,85,,percent of total billed charges,,88.09,110.99,
DINOPROSTONE(PREPIDIL)GEL:0.5MG/3GM,32007766,CDM,,,250,RC,inpatient,,4354.38,4354.38,,3696.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3283.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3701.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3831.85,88,,percent of total billed charges,,,,,,,,,3326.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3962.49,91,,percent of total billed charges,,,4136.66,95,,percent of total billed charges,,,3614.14,83,,percent of total billed charges,,,3614.14,83,,percent of total billed charges,,,,,,,,,,,,,,,3614.14,83,,percent of total billed charges,,,4136.66,95,,percent of total billed charges,,,3918.94,90,,percent of total billed charges,,,3918.94,90,,percent of total billed charges,,,3570.59,82,,percent of total billed charges,,,3918.94,90,,percent of total billed charges,,,3701.22,85,,percent of total billed charges,,3283.2,4136.66,
LANSOPRAZOLE (PREVACID) CAP : 15MG,32007771,CDM,,,250,RC,inpatient,,83.26,83.26,,70.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.27,88,,percent of total billed charges,,,,,,,,,63.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.77,91,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,,,,,,,,,,,,,69.11,83,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,68.27,82,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,70.77,85,,percent of total billed charges,,62.78,79.1,
LANSOPRAZOLE (PREVACID) CAP : 30MG,32007772,CDM,,,250,RC,inpatient,,83.26,83.26,,70.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.27,88,,percent of total billed charges,,,,,,,,,63.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.77,91,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,,,,,,,,,,,,,69.11,83,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,68.27,82,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,70.77,85,,percent of total billed charges,,62.78,79.1,
OMEPRAZOLE(prilLOSEC)CAP:10MG,32007773,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
zz    OMEPRAZOLE (PRILOSEC) CAP : 20MG,32007776,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
OMEPRAZOLE (PRILOSEC) CAP : 40MG,32007777,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
OMEPRAZOLE (PRILOSEC) CAP : 20MG  (1x2),32007778,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
IMIPENEM/CILASTN SOD(PRIMAXIN)VIAL:500MG,32007786,CDM,J0743,HCPCS,250,RC,inpatient,,150.65,150.65,,127.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,113.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,128.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,132.57,88,,percent of total billed charges,,32.74,,,,fee schedule,,,115.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,32.74,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,137.09,91,,percent of total billed charges,,,143.12,95,,percent of total billed charges,,,125.04,83,,percent of total billed charges,,,125.04,83,,percent of total billed charges,,,,,,,,,,,,,,,125.04,83,,percent of total billed charges,,,143.12,95,,percent of total billed charges,,,135.59,90,,percent of total billed charges,,,135.59,90,,percent of total billed charges,,,123.53,82,,percent of total billed charges,,,135.59,90,,percent of total billed charges,,,128.05,85,,percent of total billed charges,,32.74,143.12,
PRIMAXIN 250 MG IV,32007787,CDM,,,250,RC,inpatient,,44.5,44.5,,37.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.16,88,,percent of total billed charges,,,,,,,,,34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.5,91,,percent of total billed charges,,,42.28,95,,percent of total billed charges,,,36.94,83,,percent of total billed charges,,,36.94,83,,percent of total billed charges,,,,,,,,,,,,,,,36.94,83,,percent of total billed charges,,,42.28,95,,percent of total billed charges,,,40.05,90,,percent of total billed charges,,,40.05,90,,percent of total billed charges,,,36.49,82,,percent of total billed charges,,,40.05,90,,percent of total billed charges,,,37.83,85,,percent of total billed charges,,33.55,42.28,
AMPicillin(PRNCIPEN)SUS:125MG/5ML(100ML),32007791,CDM,,,250,RC,inpatient,,53.61,53.61,,45.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47.18,88,,percent of total billed charges,,,,,,,,,40.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,48.79,91,,percent of total billed charges,,,50.93,95,,percent of total billed charges,,,44.5,83,,percent of total billed charges,,,44.5,83,,percent of total billed charges,,,,,,,,,,,,,,,44.5,83,,percent of total billed charges,,,50.93,95,,percent of total billed charges,,,48.25,90,,percent of total billed charges,,,48.25,90,,percent of total billed charges,,,43.96,82,,percent of total billed charges,,,48.25,90,,percent of total billed charges,,,45.57,85,,percent of total billed charges,,40.42,50.93,
LISINOPRIL(PRINIVIL)TAB:5MG,32007796,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
AMPicillin(PRNCIPEN)SUS:250MG/5ML(100ML),32007801,CDM,,,250,RC,inpatient,,179.85,179.85,,152.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,135.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,152.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,158.27,88,,percent of total billed charges,,,,,,,,,137.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,163.66,91,,percent of total billed charges,,,170.86,95,,percent of total billed charges,,,149.28,83,,percent of total billed charges,,,149.28,83,,percent of total billed charges,,,,,,,,,,,,,,,149.28,83,,percent of total billed charges,,,170.86,95,,percent of total billed charges,,,161.87,90,,percent of total billed charges,,,161.87,90,,percent of total billed charges,,,147.48,82,,percent of total billed charges,,,161.87,90,,percent of total billed charges,,,152.87,85,,percent of total billed charges,,135.61,170.86,
LISINOPRIL 10MG,32007806,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
AMPicillin(PRINCIPEN)CAP:250MG,32007811,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
AMPicillin (PRINCIPEN) CAP : 500MG,32007816,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
LISINOPRIL(PRINIVIL)TAB:20MG,32007821,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PROMETH(PHENERGAN)SYRP:6.25MG/5ML(120ML),32007826,CDM,J8499,HCPCS,250,RC,inpatient,,40.92,40.92,,34.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36.01,88,,percent of total billed charges,,,,,,,,,31.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37.24,91,,percent of total billed charges,,,38.87,95,,percent of total billed charges,,,33.96,83,,percent of total billed charges,,,33.96,83,,percent of total billed charges,,,,,,,,,,,,,,,33.96,83,,percent of total billed charges,,,38.87,95,,percent of total billed charges,,,36.83,90,,percent of total billed charges,,,36.83,90,,percent of total billed charges,,,33.55,82,,percent of total billed charges,,,36.83,90,,percent of total billed charges,,,34.78,85,,percent of total billed charges,,30.85,38.87,
PROMETH (PHENERGAN) SYRP:6.25MG/5ML 90ML,32007831,CDM,,,250,RC,inpatient,,31.24,31.24,,26.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.49,88,,percent of total billed charges,,,,,,,,,23.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.43,91,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,,,,,,,,,,,,,25.93,83,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,25.62,82,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,26.55,85,,percent of total billed charges,,23.55,29.68,
PROMETH(PHENERGAN) SYRP: 6.25MG/5ML 60ML,32007836,CDM,,,250,RC,inpatient,,20.78,20.78,,17.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.29,88,,percent of total billed charges,,,,,,,,,15.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.91,91,,percent of total billed charges,,,19.74,95,,percent of total billed charges,,,17.25,83,,percent of total billed charges,,,17.25,83,,percent of total billed charges,,,,,,,,,,,,,,,17.25,83,,percent of total billed charges,,,19.74,95,,percent of total billed charges,,,18.7,90,,percent of total billed charges,,,18.7,90,,percent of total billed charges,,,17.04,82,,percent of total billed charges,,,18.7,90,,percent of total billed charges,,,17.66,85,,percent of total billed charges,,15.67,19.74,
COD/PROMETH (PHENERGAN + COD) SYRP  90ML,32007846,CDM,,,250,RC,inpatient,,36.75,36.75,,31.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.34,88,,percent of total billed charges,,,,,,,,,28.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.44,91,,percent of total billed charges,,,34.91,95,,percent of total billed charges,,,30.5,83,,percent of total billed charges,,,30.5,83,,percent of total billed charges,,,,,,,,,,,,,,,30.5,83,,percent of total billed charges,,,34.91,95,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,30.14,82,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,31.24,85,,percent of total billed charges,,27.71,34.91,
COD/PROMETH (PHENERGAN + COD) SYRP 60ML,32007851,CDM,,,250,RC,inpatient,,24.5,24.5,,20.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.56,88,,percent of total billed charges,,,,,,,,,18.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.3,91,,percent of total billed charges,,,23.28,95,,percent of total billed charges,,,20.34,83,,percent of total billed charges,,,20.34,83,,percent of total billed charges,,,,,,,,,,,,,,,20.34,83,,percent of total billed charges,,,23.28,95,,percent of total billed charges,,,22.05,90,,percent of total billed charges,,,22.05,90,,percent of total billed charges,,,20.09,82,,percent of total billed charges,,,22.05,90,,percent of total billed charges,,,20.83,85,,percent of total billed charges,,18.47,23.28,
PROCAINAMIDE HCL VIAL : 500MG/ML 2ML,32007856,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
PROPRANOLOL(INDERAL)TAB:10MG,32007866,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PROBENECID(BENEMID)TAB:500MG,32007881,CDM,J8499,HCPCS,250,RC,inpatient,,48.69,48.69,,41.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.85,88,,percent of total billed charges,,,,,,,,,37.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,44.31,91,,percent of total billed charges,,,46.26,95,,percent of total billed charges,,,40.41,83,,percent of total billed charges,,,40.41,83,,percent of total billed charges,,,,,,,,,,,,,,,40.41,83,,percent of total billed charges,,,46.26,95,,percent of total billed charges,,,43.82,90,,percent of total billed charges,,,43.82,90,,percent of total billed charges,,,39.93,82,,percent of total billed charges,,,43.82,90,,percent of total billed charges,,,41.39,85,,percent of total billed charges,,36.71,46.26,
PROCHLORPERAZINE(COMPAZINE)SUPP:25MG,32007891,CDM,J3490,HCPCS,250,RC,inpatient,,99.51,99.51,,84.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,84.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,87.57,88,,percent of total billed charges,,,,,,,,,76.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,90.55,91,,percent of total billed charges,,,94.53,95,,percent of total billed charges,,,82.59,83,,percent of total billed charges,,,82.59,83,,percent of total billed charges,,,,,,,,,,,,,,,82.59,83,,percent of total billed charges,,,94.53,95,,percent of total billed charges,,,89.56,90,,percent of total billed charges,,,89.56,90,,percent of total billed charges,,,81.6,82,,percent of total billed charges,,,89.56,90,,percent of total billed charges,,,84.58,85,,percent of total billed charges,,75.03,94.53,
EPOETIN(PROCRIT):40000 UNITS/ML,32007895,CDM,J0885,HCPCS,636,RC,inpatient,,4501.61,4501.61,,3821.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3394.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3826.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3961.42,88,,percent of total billed charges,,669.6,,,,fee schedule,,,3439.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,669.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4096.47,91,,percent of total billed charges,,,4276.53,95,,percent of total billed charges,,,3736.34,83,,percent of total billed charges,,,3736.34,83,,percent of total billed charges,,,,,,,,,,,,,,,3736.34,83,,percent of total billed charges,,,4276.53,95,,percent of total billed charges,,,4051.45,90,,percent of total billed charges,,,4051.45,90,,percent of total billed charges,,,3691.32,82,,percent of total billed charges,,,4051.45,90,,percent of total billed charges,,,3826.37,85,,percent of total billed charges,,669.6,4276.53,
EPOETIN(PROCRIT): 4000 UNITS/ML,32007896,CDM,J0885,HCPCS,636,RC,inpatient,,1508.51,1508.51,,1280.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1137.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1282.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1327.49,88,,percent of total billed charges,,669.6,,,,fee schedule,,,1152.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,669.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1372.74,91,,percent of total billed charges,,,1433.08,95,,percent of total billed charges,,,1252.06,83,,percent of total billed charges,,,1252.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1252.06,83,,percent of total billed charges,,,1433.08,95,,percent of total billed charges,,,1357.66,90,,percent of total billed charges,,,1357.66,90,,percent of total billed charges,,,1236.98,82,,percent of total billed charges,,,1357.66,90,,percent of total billed charges,,,1282.23,85,,percent of total billed charges,,669.6,1433.08,
"PROCRIT VIALS 10,000 U/ML",32007897,CDM,,,250,RC,inpatient,,178,178,,151.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,134.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,151.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,156.64,88,,percent of total billed charges,,,,,,,,,135.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,161.98,91,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,,,,,,,,,,,,,147.74,83,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,145.96,82,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,134.21,169.1,
"PROCRIT 15,000U",32007898,CDM,,,250,RC,inpatient,,271.5,271.5,,230.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,204.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,230.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,238.92,88,,percent of total billed charges,,,,,,,,,207.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,247.07,91,,percent of total billed charges,,,257.93,95,,percent of total billed charges,,,225.35,83,,percent of total billed charges,,,225.35,83,,percent of total billed charges,,,,,,,,,,,,,,,225.35,83,,percent of total billed charges,,,257.93,95,,percent of total billed charges,,,244.35,90,,percent of total billed charges,,,244.35,90,,percent of total billed charges,,,222.63,82,,percent of total billed charges,,,244.35,90,,percent of total billed charges,,,230.78,85,,percent of total billed charges,,204.71,257.93,
PROCAINAMIDE (PROCAN SR) HCL TAB : 750MG,32007906,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PROCHLORPERAZINE(COMPAZINE)VIAL:10MG/2ML,32007916,CDM,J0780,HCPCS,250,RC,inpatient,,82.84,82.84,,70.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,72.9,88,,percent of total billed charges,,8.39,,,,fee schedule,,,63.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8.39,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.38,91,,percent of total billed charges,,,78.7,95,,percent of total billed charges,,,68.76,83,,percent of total billed charges,,,68.76,83,,percent of total billed charges,,,,,,,,,,,,,,,68.76,83,,percent of total billed charges,,,78.7,95,,percent of total billed charges,,,74.56,90,,percent of total billed charges,,,74.56,90,,percent of total billed charges,,,67.93,82,,percent of total billed charges,,,74.56,90,,percent of total billed charges,,,70.41,85,,percent of total billed charges,,8.39,78.7,
NIFEdipine(PROCARDIA XL)TAB:30MG,32007922,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
NIFEDIPINE TAB (PROCARDIA XL) : 90MG,32007926,CDM,,,250,RC,inpatient,,39.97,39.97,,33.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.17,88,,percent of total billed charges,,,,,,,,,30.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.37,91,,percent of total billed charges,,,37.97,95,,percent of total billed charges,,,33.18,83,,percent of total billed charges,,,33.18,83,,percent of total billed charges,,,,,,,,,,,,,,,33.18,83,,percent of total billed charges,,,37.97,95,,percent of total billed charges,,,35.97,90,,percent of total billed charges,,,35.97,90,,percent of total billed charges,,,32.78,82,,percent of total billed charges,,,35.97,90,,percent of total billed charges,,,33.97,85,,percent of total billed charges,,30.14,37.97,
NIFEDIPINE (PROCARDIA XL) TAB : 60MG,32007931,CDM,,,250,RC,inpatient,,61.38,61.38,,52.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.01,88,,percent of total billed charges,,,,,,,,,46.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55.86,91,,percent of total billed charges,,,58.31,95,,percent of total billed charges,,,50.95,83,,percent of total billed charges,,,50.95,83,,percent of total billed charges,,,,,,,,,,,,,,,50.95,83,,percent of total billed charges,,,58.31,95,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,50.33,82,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,52.17,85,,percent of total billed charges,,46.28,58.31,
PROCAINAMIDE VIAL:1000MG/10ML,32007936,CDM,,,250,RC,inpatient,,1225.06,1225.06,,1040.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,923.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1041.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1078.05,88,,percent of total billed charges,,,,,,,,,935.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1114.8,91,,percent of total billed charges,,,1163.81,95,,percent of total billed charges,,,1016.8,83,,percent of total billed charges,,,1016.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1016.8,83,,percent of total billed charges,,,1163.81,95,,percent of total billed charges,,,1102.55,90,,percent of total billed charges,,,1102.55,90,,percent of total billed charges,,,1004.55,82,,percent of total billed charges,,,1102.55,90,,percent of total billed charges,,,1041.3,85,,percent of total billed charges,,923.7,1163.81,
PROGESTERONE VIAL : 50MG/ML  10ML,32007951,CDM,,,250,RC,inpatient,,516.24,516.24,,438.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,389.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,438.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,454.29,88,,percent of total billed charges,,,,,,,,,394.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,469.78,91,,percent of total billed charges,,,490.43,95,,percent of total billed charges,,,428.48,83,,percent of total billed charges,,,428.48,83,,percent of total billed charges,,,,,,,,,,,,,,,428.48,83,,percent of total billed charges,,,490.43,95,,percent of total billed charges,,,464.62,90,,percent of total billed charges,,,464.62,90,,percent of total billed charges,,,423.32,82,,percent of total billed charges,,,464.62,90,,percent of total billed charges,,,438.8,85,,percent of total billed charges,,389.24,490.43,
COD/PROMETH(PHENERGAN/COD)SYRP:120ML,32007975,CDM,J8499,HCPCS,250,RC,inpatient,,44.25,44.25,,37.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.94,88,,percent of total billed charges,,,,,,,,,33.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.27,91,,percent of total billed charges,,,42.04,95,,percent of total billed charges,,,36.73,83,,percent of total billed charges,,,36.73,83,,percent of total billed charges,,,,,,,,,,,,,,,36.73,83,,percent of total billed charges,,,42.04,95,,percent of total billed charges,,,39.83,90,,percent of total billed charges,,,39.83,90,,percent of total billed charges,,,36.29,82,,percent of total billed charges,,,39.83,90,,percent of total billed charges,,,37.61,85,,percent of total billed charges,,33.36,42.04,
PHENYLEPHRINE(PHENERGAN VC)SYRP:(120ML),32007981,CDM,,,250,RC,inpatient,,82.15,82.15,,69.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,69.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,72.29,88,,percent of total billed charges,,,,,,,,,62.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,74.76,91,,percent of total billed charges,,,78.04,95,,percent of total billed charges,,,68.18,83,,percent of total billed charges,,,68.18,83,,percent of total billed charges,,,,,,,,,,,,,,,68.18,83,,percent of total billed charges,,,78.04,95,,percent of total billed charges,,,73.94,90,,percent of total billed charges,,,73.94,90,,percent of total billed charges,,,67.36,82,,percent of total billed charges,,,73.94,90,,percent of total billed charges,,,69.83,85,,percent of total billed charges,,61.94,78.04,
PROMETHAZINE(PHENERGAN)VIAL:25MG/ML,32007991,CDM,J2550,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,2.94,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.94,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,2.94,60.99,
PROMETHAZINE(PHENERGAN)VIAL :50MG/ML 1ML,32008001,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
PROPRANOLOL (INDERAL) TAB : 20MG,32008006,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PROPRANOLOL (INDERAL) TAB : 40MG,32008011,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PROPRANOLOL(INDERAL)VIAL:1MG/ML,32008016,CDM,J1800,HCPCS,250,RC,inpatient,,167.48,167.48,,142.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,126.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,142.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,147.38,88,,percent of total billed charges,,19.8,,,,fee schedule,,,127.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.8,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,152.41,91,,percent of total billed charges,,,159.11,95,,percent of total billed charges,,,139.01,83,,percent of total billed charges,,,139.01,83,,percent of total billed charges,,,,,,,,,,,,,,,139.01,83,,percent of total billed charges,,,159.11,95,,percent of total billed charges,,,150.73,90,,percent of total billed charges,,,150.73,90,,percent of total billed charges,,,137.33,82,,percent of total billed charges,,,150.73,90,,percent of total billed charges,,,142.36,85,,percent of total billed charges,,19.8,159.11,
PROPYLTHIOURACIL (PTU) TAB : 50MG,32008021,CDM,J8499,HCPCS,250,RC,inpatient,,35.78,35.78,,30.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31.49,88,,percent of total billed charges,,,,,,,,,27.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.56,91,,percent of total billed charges,,,33.99,95,,percent of total billed charges,,,29.7,83,,percent of total billed charges,,,29.7,83,,percent of total billed charges,,,,,,,,,,,,,,,29.7,83,,percent of total billed charges,,,33.99,95,,percent of total billed charges,,,32.2,90,,percent of total billed charges,,,32.2,90,,percent of total billed charges,,,29.34,82,,percent of total billed charges,,,32.2,90,,percent of total billed charges,,,30.41,85,,percent of total billed charges,,26.98,33.99,
PROPULSID 20 MG,32008027,CDM,,,250,RC,inpatient,,6.5,6.5,,5.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.72,88,,percent of total billed charges,,,,,,,,,4.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.92,91,,percent of total billed charges,,,6.18,95,,percent of total billed charges,,,5.4,83,,percent of total billed charges,,,5.4,83,,percent of total billed charges,,,,,,,,,,,,,,,5.4,83,,percent of total billed charges,,,6.18,95,,percent of total billed charges,,,5.85,90,,percent of total billed charges,,,5.85,90,,percent of total billed charges,,,5.33,82,,percent of total billed charges,,,5.85,90,,percent of total billed charges,,,5.53,85,,percent of total billed charges,,4.9,6.18,
PROPRANOLOL(INDERAL LA)CAP:60MG,32008041,CDM,J8499,HCPCS,250,RC,inpatient,,31.54,31.54,,26.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.76,88,,percent of total billed charges,,,,,,,,,24.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.7,91,,percent of total billed charges,,,29.96,95,,percent of total billed charges,,,26.18,83,,percent of total billed charges,,,26.18,83,,percent of total billed charges,,,,,,,,,,,,,,,26.18,83,,percent of total billed charges,,,29.96,95,,percent of total billed charges,,,28.39,90,,percent of total billed charges,,,28.39,90,,percent of total billed charges,,,25.86,82,,percent of total billed charges,,,28.39,90,,percent of total billed charges,,,26.81,85,,percent of total billed charges,,23.78,29.96,
PROSTIGMIN 1:2000,32008042,CDM,,,250,RC,inpatient,,223.47,223.47,,189.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.65,88,,percent of total billed charges,,,,,,,,,170.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.36,91,,percent of total billed charges,,,212.3,95,,percent of total billed charges,,,185.48,83,,percent of total billed charges,,,185.48,83,,percent of total billed charges,,,,,,,,,,,,,,,185.48,83,,percent of total billed charges,,,212.3,95,,percent of total billed charges,,,201.12,90,,percent of total billed charges,,,201.12,90,,percent of total billed charges,,,183.25,82,,percent of total billed charges,,,201.12,90,,percent of total billed charges,,,189.95,85,,percent of total billed charges,,168.5,212.3,
PROPOFOL(DIPRIVAN)VIAL:200MG/20ML*,32008043,CDM,J2704,HCPCS,250,RC,inpatient,,101.31,101.31,,86.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.15,88,,percent of total billed charges,,14.4,,,,fee schedule,,,77.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.4,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.19,91,,percent of total billed charges,,,96.24,95,,percent of total billed charges,,,84.09,83,,percent of total billed charges,,,84.09,83,,percent of total billed charges,,,,,,,,,,,,,,,84.09,83,,percent of total billed charges,,,96.24,95,,percent of total billed charges,,,91.18,90,,percent of total billed charges,,,91.18,90,,percent of total billed charges,,,83.07,82,,percent of total billed charges,,,91.18,90,,percent of total billed charges,,,86.11,85,,percent of total billed charges,,14.4,96.24,
ESTAZOLAM (PROSOM) TAB : 1MG,32008051,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
FINASTERIDE(PROSCAR)TAB:5MG,32008056,CDM,J8499,HCPCS,250,RC,inpatient,UD,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PROTAMINE SULF VIAL:250MG/25ML,32008066,CDM,J2720,HCPCS,250,RC,inpatient,,605.06,605.06,,513.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,456.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,514.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,532.45,88,,percent of total billed charges,,8.14,,,,fee schedule,,,462.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8.14,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,550.6,91,,percent of total billed charges,,,574.81,95,,percent of total billed charges,,,502.2,83,,percent of total billed charges,,,502.2,83,,percent of total billed charges,,,,,,,,,,,,,,,502.2,83,,percent of total billed charges,,,574.81,95,,percent of total billed charges,,,544.55,90,,percent of total billed charges,,,544.55,90,,percent of total billed charges,,,496.15,82,,percent of total billed charges,,,544.55,90,,percent of total billed charges,,,514.3,85,,percent of total billed charges,,8.14,574.81,
PANTOPRAZOLE (PROTONIX) 40MG   (1X2),32008069,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PANTOPRAZOLE (PROTONIX) TAB: 40MG,32008070,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FLUoxetine(PROzac)CAP:20MG,32008076,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FLUoxetine(PROzac)TAB:10MG,32008081,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PSEUDOEPHED(SUDAFED)TAB:30MG,32008086,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
BUDESONIDE(PULMICORT)AER:200MCG  MDI,32008087,CDM,,,250,RC,inpatient,,2081.86,2081.86,,1767.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1569.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1769.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1832.04,88,,percent of total billed charges,,,,,,,,,1590.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1894.49,91,,percent of total billed charges,,,1977.77,95,,percent of total billed charges,,,1727.94,83,,percent of total billed charges,,,1727.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1727.94,83,,percent of total billed charges,,,1977.77,95,,percent of total billed charges,,,1873.67,90,,percent of total billed charges,,,1873.67,90,,percent of total billed charges,,,1707.13,82,,percent of total billed charges,,,1873.67,90,,percent of total billed charges,,,1769.58,85,,percent of total billed charges,,1569.72,1977.77,
POLYVIN ALC(PURALUBE TEAR)DROP:1%   15ML,32008091,CDM,,,250,RC,inpatient,,31.56,31.56,,26.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.77,88,,percent of total billed charges,,,,,,,,,24.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.72,91,,percent of total billed charges,,,29.98,95,,percent of total billed charges,,,26.19,83,,percent of total billed charges,,,26.19,83,,percent of total billed charges,,,,,,,,,,,,,,,26.19,83,,percent of total billed charges,,,29.98,95,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,25.88,82,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,26.83,85,,percent of total billed charges,,23.8,29.98,
PYRIDOXINE(VIT-B6)VIAL:100MG/ML,32008096,CDM,J3415,HCPCS,250,RC,inpatient,,280.07,280.07,,237.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,211.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,238.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,246.46,88,,percent of total billed charges,,57.96,,,,fee schedule,,,213.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,57.96,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,254.86,91,,percent of total billed charges,,,266.07,95,,percent of total billed charges,,,232.46,83,,percent of total billed charges,,,232.46,83,,percent of total billed charges,,,,,,,,,,,,,,,232.46,83,,percent of total billed charges,,,266.07,95,,percent of total billed charges,,,252.06,90,,percent of total billed charges,,,252.06,90,,percent of total billed charges,,,229.66,82,,percent of total billed charges,,,252.06,90,,percent of total billed charges,,,238.06,85,,percent of total billed charges,,57.96,266.07,
SUCCINYLCHOL(QUELICIN)VIAL:200MG/10ML,32008101,CDM,J0330,HCPCS,250,RC,inpatient,,91.34,91.34,,77.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.38,88,,percent of total billed charges,,,,,,,,,69.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,83.12,91,,percent of total billed charges,,,86.77,95,,percent of total billed charges,,,75.81,83,,percent of total billed charges,,,75.81,83,,percent of total billed charges,,,,,,,,,,,,,,,75.81,83,,percent of total billed charges,,,86.77,95,,percent of total billed charges,,,82.21,90,,percent of total billed charges,,,82.21,90,,percent of total billed charges,,,74.9,82,,percent of total billed charges,,,82.21,90,,percent of total billed charges,,,77.64,85,,percent of total billed charges,,68.87,86.77,
QUESTRAN LIGHT,32008106,CDM,,,250,RC,inpatient,,135.5,135.5,,115.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,102.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,115.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,119.24,88,,percent of total billed charges,,,,,,,,,103.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,123.31,91,,percent of total billed charges,,,128.73,95,,percent of total billed charges,,,112.47,83,,percent of total billed charges,,,112.47,83,,percent of total billed charges,,,,,,,,,,,,,,,112.47,83,,percent of total billed charges,,,128.73,95,,percent of total billed charges,,,121.95,90,,percent of total billed charges,,,121.95,90,,percent of total billed charges,,,111.11,82,,percent of total billed charges,,,121.95,90,,percent of total billed charges,,,115.18,85,,percent of total billed charges,,102.17,128.73,
QUESTRAN LIGHT CAN 210GM,32008107,CDM,,,250,RC,inpatient,,135.5,135.5,,115.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,102.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,115.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,119.24,88,,percent of total billed charges,,,,,,,,,103.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,123.31,91,,percent of total billed charges,,,128.73,95,,percent of total billed charges,,,112.47,83,,percent of total billed charges,,,112.47,83,,percent of total billed charges,,,,,,,,,,,,,,,112.47,83,,percent of total billed charges,,,128.73,95,,percent of total billed charges,,,121.95,90,,percent of total billed charges,,,121.95,90,,percent of total billed charges,,,111.11,82,,percent of total billed charges,,,121.95,90,,percent of total billed charges,,,115.18,85,,percent of total billed charges,,102.17,128.73,
CHOLESTYRAMINE/SUCROSE(QUESTRAN)PAC:4GM,32008111,CDM,J8499,HCPCS,250,RC,inpatient,,21.09,21.09,,17.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.56,88,,percent of total billed charges,,,,,,,,,16.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.19,91,,percent of total billed charges,,,20.04,95,,percent of total billed charges,,,17.5,83,,percent of total billed charges,,,17.5,83,,percent of total billed charges,,,,,,,,,,,,,,,17.5,83,,percent of total billed charges,,,20.04,95,,percent of total billed charges,,,18.98,90,,percent of total billed charges,,,18.98,90,,percent of total billed charges,,,17.29,82,,percent of total billed charges,,,18.98,90,,percent of total billed charges,,,17.93,85,,percent of total billed charges,,15.9,20.04,
quiNIDINE GLUCONATE TAB:324MG,32008116,CDM,,,250,RC,inpatient,,120.69,120.69,,102.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,106.21,88,,percent of total billed charges,,,,,,,,,92.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.83,91,,percent of total billed charges,,,114.66,95,,percent of total billed charges,,,100.17,83,,percent of total billed charges,,,100.17,83,,percent of total billed charges,,,,,,,,,,,,,,,100.17,83,,percent of total billed charges,,,114.66,95,,percent of total billed charges,,,108.62,90,,percent of total billed charges,,,108.62,90,,percent of total billed charges,,,98.97,82,,percent of total billed charges,,,108.62,90,,percent of total billed charges,,,102.59,85,,percent of total billed charges,,91,114.66,
quiNINE SULFATE TAB : 260,32008121,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
quiNIDINE SULFATE TAB:200MG,32008126,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
quiNINE SULFATE CAP : 200MG,32008136,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
RAPLON 100MG,32008140,CDM,,,250,RC,inpatient,,60,60,,50.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,45.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,52.8,88,,percent of total billed charges,,,,,,,,,45.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,,,,,,,,,,,,,49.8,83,,percent of total billed charges,,,57,95,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,49.2,82,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,45.24,57,
quiNINE SULFATE CAP:325MG,32008141,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
R-TANNATE(RYNATAN)SUSO. 60ML,32008142,CDM,,,250,RC,inpatient,,6.5,6.5,,5.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.72,88,,percent of total billed charges,,,,,,,,,4.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5.92,91,,percent of total billed charges,,,6.18,95,,percent of total billed charges,,,5.4,83,,percent of total billed charges,,,5.4,83,,percent of total billed charges,,,,,,,,,,,,,,,5.4,83,,percent of total billed charges,,,6.18,95,,percent of total billed charges,,,5.85,90,,percent of total billed charges,,,5.85,90,,percent of total billed charges,,,5.33,82,,percent of total billed charges,,,5.85,90,,percent of total billed charges,,,5.53,85,,percent of total billed charges,,4.9,6.18,
RECOMBIVAX HB,32008146,CDM,90746,CPT,636,RC,inpatient,,722.11,722.11,,613.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,544.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,613.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,635.46,88,,percent of total billed charges,,,,,,,,,551.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,657.12,91,,percent of total billed charges,,,686,95,,percent of total billed charges,,,599.35,83,,percent of total billed charges,,,599.35,83,,percent of total billed charges,,,,,,,,,,,,,,,599.35,83,,percent of total billed charges,,,686,95,,percent of total billed charges,,,649.9,90,,percent of total billed charges,,,649.9,90,,percent of total billed charges,,,592.13,82,,percent of total billed charges,,,649.9,90,,percent of total billed charges,,,613.79,85,,percent of total billed charges,,544.47,686,
HEP B(ENGERIX)VIAL:10MCG/0.5ML 0.5ML ped,32008147,CDM,90744,CPT,636,RC,inpatient,,445.26,445.26,,378.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,335.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,378.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,391.83,88,,percent of total billed charges,,,,,,,,,340.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,405.19,91,,percent of total billed charges,,,423,95,,percent of total billed charges,,,369.57,83,,percent of total billed charges,,,369.57,83,,percent of total billed charges,,,,,,,,,,,,,,,369.57,83,,percent of total billed charges,,,423,95,,percent of total billed charges,,,400.73,90,,percent of total billed charges,,,400.73,90,,percent of total billed charges,,,365.11,82,,percent of total billed charges,,,400.73,90,,percent of total billed charges,,,378.47,85,,percent of total billed charges,,335.73,423,
REFRESH PLUS 0.5% DROPS 50X0.4ML,32008157,CDM,,,250,RC,inpatient,,42.5,42.5,,36.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36.13,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,37.4,88,,percent of total billed charges,,,,,,,,,32.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38.68,91,,percent of total billed charges,,,40.38,95,,percent of total billed charges,,,35.28,83,,percent of total billed charges,,,35.28,83,,percent of total billed charges,,,,,,,,,,,,,,,35.28,83,,percent of total billed charges,,,40.38,95,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,34.85,82,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,36.13,85,,percent of total billed charges,,32.05,40.38,
CARBOXY CELL(REFRESH TEARS)DROP 0.5%:,32008158,CDM,J3490,HCPCS,250,RC,inpatient,,107.84,107.84,,91.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,94.9,88,,percent of total billed charges,,,,,,,,,82.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.13,91,,percent of total billed charges,,,102.45,95,,percent of total billed charges,,,89.51,83,,percent of total billed charges,,,89.51,83,,percent of total billed charges,,,,,,,,,,,,,,,89.51,83,,percent of total billed charges,,,102.45,95,,percent of total billed charges,,,97.06,90,,percent of total billed charges,,,97.06,90,,percent of total billed charges,,,88.43,82,,percent of total billed charges,,,97.06,90,,percent of total billed charges,,,91.66,85,,percent of total billed charges,,81.31,102.45,
PETRO WHT/MIN OIL/SODCHL(REFRESH PM)OINT,32008159,CDM,,,250,RC,inpatient,,142.9,142.9,,121.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,107.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,121.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,125.75,88,,percent of total billed charges,,,,,,,,,109.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,130.04,91,,percent of total billed charges,,,135.76,95,,percent of total billed charges,,,118.61,83,,percent of total billed charges,,,118.61,83,,percent of total billed charges,,,,,,,,,,,,,,,118.61,83,,percent of total billed charges,,,135.76,95,,percent of total billed charges,,,128.61,90,,percent of total billed charges,,,128.61,90,,percent of total billed charges,,,117.18,82,,percent of total billed charges,,,128.61,90,,percent of total billed charges,,,121.47,85,,percent of total billed charges,,107.75,135.76,
PHENTOLAMINE(REGITINE)VIAL:5MG,32008161,CDM,J2760,HCPCS,250,RC,inpatient,,3014.52,3014.52,,2559.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2272.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2562.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2652.78,88,,percent of total billed charges,,826.95,,,,fee schedule,,,2303.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,826.95,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2743.21,91,,percent of total billed charges,,,2863.79,95,,percent of total billed charges,,,2502.05,83,,percent of total billed charges,,,2502.05,83,,percent of total billed charges,,,,,,,,,,,,,,,2502.05,83,,percent of total billed charges,,,2863.79,95,,percent of total billed charges,,,2713.07,90,,percent of total billed charges,,,2713.07,90,,percent of total billed charges,,,2471.91,82,,percent of total billed charges,,,2713.07,90,,percent of total billed charges,,,2562.34,85,,percent of total billed charges,,826.95,2863.79,
BECAPLERMIN(REGRANEX)GEL 0.01%:15GM,32008167,CDM,,,250,RC,inpatient,,6233.35,6233.35,,5292.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4699.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5298.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5485.35,88,,percent of total billed charges,,,,,,,,,4762.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5672.35,91,,percent of total billed charges,,,5921.68,95,,percent of total billed charges,,,5173.68,83,,percent of total billed charges,,,5173.68,83,,percent of total billed charges,,,,,,,,,,,,,,,5173.68,83,,percent of total billed charges,,,5921.68,95,,percent of total billed charges,,,5610.02,90,,percent of total billed charges,,,5610.02,90,,percent of total billed charges,,,5111.35,82,,percent of total billed charges,,,5610.02,90,,percent of total billed charges,,,5298.35,85,,percent of total billed charges,,4699.95,5921.68,
NABUMETONE(RELAFEN)TAB:500MG,32008171,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
MIRTAZAPINE (REMERON) TAB : 30MG,32008172,CDM,,,250,RC,inpatient,,91.67,91.67,,77.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,69.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.67,88,,percent of total billed charges,,,,,,,,,70.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,83.42,91,,percent of total billed charges,,,87.09,95,,percent of total billed charges,,,76.09,83,,percent of total billed charges,,,76.09,83,,percent of total billed charges,,,,,,,,,,,,,,,76.09,83,,percent of total billed charges,,,87.09,95,,percent of total billed charges,,,82.5,90,,percent of total billed charges,,,82.5,90,,percent of total billed charges,,,75.17,82,,percent of total billed charges,,,82.5,90,,percent of total billed charges,,,77.92,85,,percent of total billed charges,,69.12,87.09,
MIRTAZAPINE(REMERON)O.D.TAB:15MG,32008173,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
RELENZA,32008174,CDM,,,250,RC,inpatient,,133.25,133.25,,113.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,100.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,113.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,117.26,88,,percent of total billed charges,,,,,,,,,101.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,121.26,91,,percent of total billed charges,,,126.59,95,,percent of total billed charges,,,110.6,83,,percent of total billed charges,,,110.6,83,,percent of total billed charges,,,,,,,,,,,,,,,110.6,83,,percent of total billed charges,,,126.59,95,,percent of total billed charges,,,119.93,90,,percent of total billed charges,,,119.93,90,,percent of total billed charges,,,109.27,82,,percent of total billed charges,,,119.93,90,,percent of total billed charges,,,113.26,85,,percent of total billed charges,,100.47,126.59,
ZANAMIVIR(RELENZA)DISK:5MG,32008175,CDM,,,250,RC,inpatient,,370.81,370.81,,314.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,279.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,315.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,326.31,88,,percent of total billed charges,,,,,,,,,283.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,337.44,91,,percent of total billed charges,,,352.27,95,,percent of total billed charges,,,307.77,83,,percent of total billed charges,,,307.77,83,,percent of total billed charges,,,,,,,,,,,,,,,307.77,83,,percent of total billed charges,,,352.27,95,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,304.06,82,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,315.19,85,,percent of total billed charges,,279.59,352.27,
DIATRIZOATE MEGLUMINE(RENO-M-30)VIAL:30%,32008176,CDM,,,250,RC,inpatient,,222.67,222.67,,189.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,167.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,195.95,88,,percent of total billed charges,,,,,,,,,170.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,202.63,91,,percent of total billed charges,,,211.54,95,,percent of total billed charges,,,184.82,83,,percent of total billed charges,,,184.82,83,,percent of total billed charges,,,,,,,,,,,,,,,184.82,83,,percent of total billed charges,,,211.54,95,,percent of total billed charges,,,200.4,90,,percent of total billed charges,,,200.4,90,,percent of total billed charges,,,182.59,82,,percent of total billed charges,,,200.4,90,,percent of total billed charges,,,189.27,85,,percent of total billed charges,,167.89,211.54,
rOPINIRole HCL (REQUIP) TAB : 0.25MG,32008177,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
NABUMETONE (RELAFEN) TAB : 750MG,32008178,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
RETAVASE KIT,32008192,CDM,,,250,RC,inpatient,,3721.5,3721.5,,3159.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2806.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3163.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3274.92,88,,percent of total billed charges,,,,,,,,,2843.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3386.57,91,,percent of total billed charges,,,3535.43,95,,percent of total billed charges,,,3088.85,83,,percent of total billed charges,,,3088.85,83,,percent of total billed charges,,,,,,,,,,,,,,,3088.85,83,,percent of total billed charges,,,3535.43,95,,percent of total billed charges,,,3349.35,90,,percent of total billed charges,,,3349.35,90,,percent of total billed charges,,,3051.63,82,,percent of total billed charges,,,3349.35,90,,percent of total billed charges,,,3163.28,85,,percent of total billed charges,,2806.01,3535.43,
REZULIN 400MG TABLETS,32008197,CDM,,,250,RC,inpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,13.57,17.1,
PERMETHRIN(RID)SPR 0.5%:150ML,32008202,CDM,J3490,HCPCS,250,RC,inpatient,,71.05,71.05,,60.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.52,88,,percent of total billed charges,,,,,,,,,54.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.66,91,,percent of total billed charges,,,67.5,95,,percent of total billed charges,,,58.97,83,,percent of total billed charges,,,58.97,83,,percent of total billed charges,,,,,,,,,,,,,,,58.97,83,,percent of total billed charges,,,67.5,95,,percent of total billed charges,,,63.95,90,,percent of total billed charges,,,63.95,90,,percent of total billed charges,,,58.26,82,,percent of total billed charges,,,63.95,90,,percent of total billed charges,,,60.39,85,,percent of total billed charges,,53.57,67.5,
RIFAMPIN(RIFADIN)CAP:300MG,32008206,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DIMETHYL SULFOXIDE(RIMSO-50)SOL 50%:,32008216,CDM,,,250,RC,inpatient,,677.38,677.38,,575.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,510.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,575.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,596.09,88,,percent of total billed charges,,,,,,,,,517.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,616.42,91,,percent of total billed charges,,,643.51,95,,percent of total billed charges,,,562.23,83,,percent of total billed charges,,,562.23,83,,percent of total billed charges,,,,,,,,,,,,,,,562.23,83,,percent of total billed charges,,,643.51,95,,percent of total billed charges,,,609.64,90,,percent of total billed charges,,,609.64,90,,percent of total billed charges,,,555.45,82,,percent of total billed charges,,,609.64,90,,percent of total billed charges,,,575.77,85,,percent of total billed charges,,510.74,643.51,
METHYLPHENIDATE(RITALIN)TAB:5MG,32008271,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
METHYLPHENIDATE(RITALIN)TAB:10MG,32008272,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
GAVISCON:450MG/5ML (500ML),32008281,CDM,,,250,RC,inpatient,,127.2,127.2,,107.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,95.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,108.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,111.94,88,,percent of total billed charges,,,,,,,,,97.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,115.75,91,,percent of total billed charges,,,120.84,95,,percent of total billed charges,,,105.58,83,,percent of total billed charges,,,105.58,83,,percent of total billed charges,,,,,,,,,,,,,,,105.58,83,,percent of total billed charges,,,120.84,95,,percent of total billed charges,,,114.48,90,,percent of total billed charges,,,114.48,90,,percent of total billed charges,,,104.3,82,,percent of total billed charges,,,114.48,90,,percent of total billed charges,,,108.12,85,,percent of total billed charges,,95.91,120.84,
SODIUM POLYST SULF ORAL:15G/60ML (500ML),32008286,CDM,,,250,RC,inpatient,,661.52,661.52,,561.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,498.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,562.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,582.14,88,,percent of total billed charges,,,,,,,,,505.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,601.98,91,,percent of total billed charges,,,628.44,95,,percent of total billed charges,,,549.06,83,,percent of total billed charges,,,549.06,83,,percent of total billed charges,,,,,,,,,,,,,,,549.06,83,,percent of total billed charges,,,628.44,95,,percent of total billed charges,,,595.37,90,,percent of total billed charges,,,595.37,90,,percent of total billed charges,,,542.45,82,,percent of total billed charges,,,595.37,90,,percent of total billed charges,,,562.29,85,,percent of total billed charges,,498.79,628.44,
METHOCARB(ROBAXIN)VIAL:1000MG/10ML,32008291,CDM,,,250,RC,inpatient,,207.13,207.13,,175.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,156.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,176.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,182.27,88,,percent of total billed charges,,,,,,,,,158.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,188.49,91,,percent of total billed charges,,,196.77,95,,percent of total billed charges,,,171.92,83,,percent of total billed charges,,,171.92,83,,percent of total billed charges,,,,,,,,,,,,,,,171.92,83,,percent of total billed charges,,,196.77,95,,percent of total billed charges,,,186.42,90,,percent of total billed charges,,,186.42,90,,percent of total billed charges,,,169.85,82,,percent of total billed charges,,,186.42,90,,percent of total billed charges,,,176.06,85,,percent of total billed charges,,156.18,196.77,
guaiFENesin/D-METHORP(ROBAFEN-CF)SYR:4OZ,32008292,CDM,,,250,RC,inpatient,,24.58,24.58,,20.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.63,88,,percent of total billed charges,,,,,,,,,18.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.37,91,,percent of total billed charges,,,23.35,95,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,,,,,,,,,,,,,,20.4,83,,percent of total billed charges,,,23.35,95,,percent of total billed charges,,,22.12,90,,percent of total billed charges,,,22.12,90,,percent of total billed charges,,,20.16,82,,percent of total billed charges,,,22.12,90,,percent of total billed charges,,,20.89,85,,percent of total billed charges,,18.53,23.35,
GUAIFENE(ROBITUSSIN)SYRP :100MG/5ML 60ML,32008316,CDM,,,250,RC,inpatient,,5.25,5.25,,4.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4.62,88,,percent of total billed charges,,,,,,,,,4.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4.78,91,,percent of total billed charges,,,4.99,95,,percent of total billed charges,,,4.36,83,,percent of total billed charges,,,4.36,83,,percent of total billed charges,,,,,,,,,,,,,,,4.36,83,,percent of total billed charges,,,4.99,95,,percent of total billed charges,,,4.73,90,,percent of total billed charges,,,4.73,90,,percent of total billed charges,,,4.31,82,,percent of total billed charges,,,4.73,90,,percent of total billed charges,,,4.46,85,,percent of total billed charges,,3.96,4.99,
guaiFENesin(ROBTUS)SYRP:100MG/5ML(118ML),32008321,CDM,J8499,HCPCS,250,RC,inpatient,,30.39,30.39,,25.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.74,88,,percent of total billed charges,,,,,,,,,23.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27.65,91,,percent of total billed charges,,,28.87,95,,percent of total billed charges,,,25.22,83,,percent of total billed charges,,,25.22,83,,percent of total billed charges,,,,,,,,,,,,,,,25.22,83,,percent of total billed charges,,,28.87,95,,percent of total billed charges,,,27.35,90,,percent of total billed charges,,,27.35,90,,percent of total billed charges,,,24.92,82,,percent of total billed charges,,,27.35,90,,percent of total billed charges,,,25.83,85,,percent of total billed charges,,22.91,28.87,
GLYCOPYRROL(ROBINUL)VIAL:1MG/5ML,32008331,CDM,J3490,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
GUAIF/PEPH(ROBITUSN PE)SRP:100-30MG/5,32008336,CDM,,,250,RC,inpatient,,61.22,61.22,,51.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,53.87,88,,percent of total billed charges,,,,,,,,,46.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55.71,91,,percent of total billed charges,,,58.16,95,,percent of total billed charges,,,50.81,83,,percent of total billed charges,,,50.81,83,,percent of total billed charges,,,,,,,,,,,,,,,50.81,83,,percent of total billed charges,,,58.16,95,,percent of total billed charges,,,55.1,90,,percent of total billed charges,,,55.1,90,,percent of total billed charges,,,50.2,82,,percent of total billed charges,,,55.1,90,,percent of total billed charges,,,52.04,85,,percent of total billed charges,,46.16,58.16,
cefTRIAXone(ROCEPHIN)VIAL:1GM,32008346,CDM,J0696,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,8.06,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8.06,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,8.06,60.99,
guaiFENesin/DM(ROBITUSS DM)SYP:120ML,32008347,CDM,J8499,HCPCS,250,RC,inpatient,,30.07,30.07,,25.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.46,88,,percent of total billed charges,,,,,,,,,22.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27.36,91,,percent of total billed charges,,,28.57,95,,percent of total billed charges,,,24.96,83,,percent of total billed charges,,,24.96,83,,percent of total billed charges,,,,,,,,,,,,,,,24.96,83,,percent of total billed charges,,,28.57,95,,percent of total billed charges,,,27.06,90,,percent of total billed charges,,,27.06,90,,percent of total billed charges,,,24.66,82,,percent of total billed charges,,,27.06,90,,percent of total billed charges,,,25.56,85,,percent of total billed charges,,22.67,28.57,
cefTRIAXone(ROCEPHIN)VIAL:500MG,32008351,CDM,J0696,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,8.06,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8.06,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,8.06,60.99,
cefTRIAXone(ROCEPHIN)VIAL:250MG,32008356,CDM,J0696,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,8.06,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8.06,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,8.06,60.99,
MESALAMINE (ROWASA) ENEMA : 4G/60ML,32008371,CDM,,,250,RC,inpatient,,127.99,127.99,,108.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,96.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,108.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,112.63,88,,percent of total billed charges,,,,,,,,,97.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,116.47,91,,percent of total billed charges,,,121.59,95,,percent of total billed charges,,,106.23,83,,percent of total billed charges,,,106.23,83,,percent of total billed charges,,,,,,,,,,,,,,,106.23,83,,percent of total billed charges,,,121.59,95,,percent of total billed charges,,,115.19,90,,percent of total billed charges,,,115.19,90,,percent of total billed charges,,,104.95,82,,percent of total billed charges,,,115.19,90,,percent of total billed charges,,,108.79,85,,percent of total billed charges,,96.5,121.59,
MORPHINE SULF(ROXANOL)SOL : 20MG/ML 30ML,32008376,CDM,,,250,RC,inpatient,,257.41,257.41,,218.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,218.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,226.52,88,,percent of total billed charges,,,,,,,,,196.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.24,91,,percent of total billed charges,,,244.54,95,,percent of total billed charges,,,213.65,83,,percent of total billed charges,,,213.65,83,,percent of total billed charges,,,,,,,,,,,,,,,213.65,83,,percent of total billed charges,,,244.54,95,,percent of total billed charges,,,231.67,90,,percent of total billed charges,,,231.67,90,,percent of total billed charges,,,211.08,82,,percent of total billed charges,,,231.67,90,,percent of total billed charges,,,218.8,85,,percent of total billed charges,,194.09,244.54,
SODIUM POLYST SULF ORAL:15G/60ML (120ML),32008381,CDM,,,250,RC,inpatient,,158.76,158.76,,134.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,134.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.71,88,,percent of total billed charges,,,,,,,,,121.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,144.47,91,,percent of total billed charges,,,150.82,95,,percent of total billed charges,,,131.77,83,,percent of total billed charges,,,131.77,83,,percent of total billed charges,,,,,,,,,,,,,,,131.77,83,,percent of total billed charges,,,150.82,95,,percent of total billed charges,,,142.88,90,,percent of total billed charges,,,142.88,90,,percent of total billed charges,,,130.18,82,,percent of total billed charges,,,142.88,90,,percent of total billed charges,,,134.95,85,,percent of total billed charges,,119.71,150.82,
SODIUM POLYST SULF ORAL:15G/60ML (60ML),32008386,CDM,,,250,RC,inpatient,,143.69,143.69,,121.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,108.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,122.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,126.45,88,,percent of total billed charges,,,,,,,,,109.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,130.76,91,,percent of total billed charges,,,136.51,95,,percent of total billed charges,,,119.26,83,,percent of total billed charges,,,119.26,83,,percent of total billed charges,,,,,,,,,,,,,,,119.26,83,,percent of total billed charges,,,136.51,95,,percent of total billed charges,,,129.32,90,,percent of total billed charges,,,129.32,90,,percent of total billed charges,,,117.83,82,,percent of total billed charges,,,129.32,90,,percent of total billed charges,,,122.14,85,,percent of total billed charges,,108.34,136.51,
FE FUMRT/VIT C/B12(FEROCON)CAP:110-0.5MG,32008391,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
RACEPINEPHRINE HCL (S-2) VIAL 2.25% 15ML,32008396,CDM,,,250,RC,inpatient,,27.28,27.28,,23.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.01,88,,percent of total billed charges,,,,,,,,,20.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.82,91,,percent of total billed charges,,,25.92,95,,percent of total billed charges,,,22.64,83,,percent of total billed charges,,,22.64,83,,percent of total billed charges,,,,,,,,,,,,,,,22.64,83,,percent of total billed charges,,,25.92,95,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,22.37,82,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,23.19,85,,percent of total billed charges,,20.57,25.92,
LYTES/CARBOXYMETH(SALIVART)AER:75ML,32008397,CDM,,,250,RC,inpatient,,117.36,117.36,,99.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,88.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,99.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,103.28,88,,percent of total billed charges,,,,,,,,,89.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,106.8,91,,percent of total billed charges,,,111.49,95,,percent of total billed charges,,,97.41,83,,percent of total billed charges,,,97.41,83,,percent of total billed charges,,,,,,,,,,,,,,,97.41,83,,percent of total billed charges,,,111.49,95,,percent of total billed charges,,,105.62,90,,percent of total billed charges,,,105.62,90,,percent of total billed charges,,,96.24,82,,percent of total billed charges,,,105.62,90,,percent of total billed charges,,,99.76,85,,percent of total billed charges,,88.49,111.49,
LYTES/CARBOXYMETH(SALIVA SUBST)SOL 120ML,32008398,CDM,,,250,RC,inpatient,,25.75,25.75,,21.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.66,88,,percent of total billed charges,,,,,,,,,19.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.43,91,,percent of total billed charges,,,24.46,95,,percent of total billed charges,,,21.37,83,,percent of total billed charges,,,21.37,83,,percent of total billed charges,,,,,,,,,,,,,,,21.37,83,,percent of total billed charges,,,24.46,95,,percent of total billed charges,,,23.18,90,,percent of total billed charges,,,23.18,90,,percent of total billed charges,,,21.12,82,,percent of total billed charges,,,23.18,90,,percent of total billed charges,,,21.89,85,,percent of total billed charges,,19.42,24.46,
SALSALATE (DISALCID) TAB: 750MG,32008401,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
SALSALATE (DISALCID) TAB: 500MG,32008406,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
COLLAGENASE(SANTYL)OINT 250UNIT/GM:15GM,32008412,CDM,J3490,HCPCS,250,RC,inpatient,,1953.42,1953.42,,1658.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1472.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1660.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1719.01,88,,percent of total billed charges,,,,,,,,,1492.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1777.61,91,,percent of total billed charges,,,1855.75,95,,percent of total billed charges,,,1621.34,83,,percent of total billed charges,,,1621.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1621.34,83,,percent of total billed charges,,,1855.75,95,,percent of total billed charges,,,1758.08,90,,percent of total billed charges,,,1758.08,90,,percent of total billed charges,,,1601.8,82,,percent of total billed charges,,,1758.08,90,,percent of total billed charges,,,1660.41,85,,percent of total billed charges,,1472.88,1855.75,
SANDOSTATIN MDV,32008413,CDM,,,250,RC,inpatient,,188,188,,159.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,159.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,165.44,88,,percent of total billed charges,,,,,,,,,143.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,171.08,91,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,,,,,,,,,,,,,156.04,83,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,154.16,82,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,141.75,178.6,
SECOBARBITAL SODIUM 100MG,32008432,CDM,,,250,RC,inpatient,,2.75,2.75,,2.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.42,88,,percent of total billed charges,,,,,,,,,2.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.5,91,,percent of total billed charges,,,2.61,95,,percent of total billed charges,,,2.28,83,,percent of total billed charges,,,2.28,83,,percent of total billed charges,,,,,,,,,,,,,,,2.28,83,,percent of total billed charges,,,2.61,95,,percent of total billed charges,,,2.48,90,,percent of total billed charges,,,2.48,90,,percent of total billed charges,,,2.26,82,,percent of total billed charges,,,2.48,90,,percent of total billed charges,,,2.34,85,,percent of total billed charges,,2.07,2.61,
ACEBUTOLOL (SECTRAL) CAP : 400 MG,32008436,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
SELENIUM SULFIDE SHAMP 2.50%:118ML,32008446,CDM,J3490,HCPCS,250,RC,inpatient,,164.79,164.79,,139.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,124.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,140.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,145.02,88,,percent of total billed charges,,,,,,,,,125.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,149.96,91,,percent of total billed charges,,,156.55,95,,percent of total billed charges,,,136.78,83,,percent of total billed charges,,,136.78,83,,percent of total billed charges,,,,,,,,,,,,,,,136.78,83,,percent of total billed charges,,,156.55,95,,percent of total billed charges,,,148.31,90,,percent of total billed charges,,,148.31,90,,percent of total billed charges,,,135.13,82,,percent of total billed charges,,,148.31,90,,percent of total billed charges,,,140.07,85,,percent of total billed charges,,124.25,156.55,
SELEGILINE (ELDEPRYL) TAB : 5MG,32008451,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
SENNOSIDES(SENOKOT)TAB:8.6 MG,32008456,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
SENNOSIDES/DOCU(SENOKOT-S)TAB:8.6-50MG,32008461,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
BUPIVACAINE(SENSORCAINE)7.5% MPF:10ML,32008462,CDM,J3490,HCPCS,250,RC,inpatient,,96.43,96.43,,81.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,72.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,81.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,84.86,88,,percent of total billed charges,,,,,,,,,73.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,87.75,91,,percent of total billed charges,,,91.61,95,,percent of total billed charges,,,80.04,83,,percent of total billed charges,,,80.04,83,,percent of total billed charges,,,,,,,,,,,,,,,80.04,83,,percent of total billed charges,,,91.61,95,,percent of total billed charges,,,86.79,90,,percent of total billed charges,,,86.79,90,,percent of total billed charges,,,79.07,82,,percent of total billed charges,,,86.79,90,,percent of total billed charges,,,81.97,85,,percent of total billed charges,,72.71,91.61,
SENSORCAINE 0.5% MDV : 50 ML,32008466,CDM,,,250,RC,inpatient,,155.43,155.43,,131.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,117.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,132.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,136.78,88,,percent of total billed charges,,,,,,,,,118.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,141.44,91,,percent of total billed charges,,,147.66,95,,percent of total billed charges,,,129.01,83,,percent of total billed charges,,,129.01,83,,percent of total billed charges,,,,,,,,,,,,,,,129.01,83,,percent of total billed charges,,,147.66,95,,percent of total billed charges,,,139.89,90,,percent of total billed charges,,,139.89,90,,percent of total billed charges,,,127.45,82,,percent of total billed charges,,,139.89,90,,percent of total billed charges,,,132.12,85,,percent of total billed charges,,117.19,147.66,
BUPI/EPINE(SENSORCAINE)0.5%:30ML,32008471,CDM,,,250,RC,inpatient,,189.22,189.22,,160.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,142.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,160.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,166.51,88,,percent of total billed charges,,,,,,,,,144.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,172.19,91,,percent of total billed charges,,,179.76,95,,percent of total billed charges,,,157.05,83,,percent of total billed charges,,,157.05,83,,percent of total billed charges,,,,,,,,,,,,,,,157.05,83,,percent of total billed charges,,,179.76,95,,percent of total billed charges,,,170.3,90,,percent of total billed charges,,,170.3,90,,percent of total billed charges,,,155.16,82,,percent of total billed charges,,,170.3,90,,percent of total billed charges,,,160.84,85,,percent of total billed charges,,142.67,179.76,
BUPIVICAINE/EPI(MARCAINE)VL 0.25%:30ML*,32008476,CDM,J3490,HCPCS,250,RC,inpatient,,162.91,162.91,,138.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,122.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,138.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,143.36,88,,percent of total billed charges,,,,,,,,,124.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,148.25,91,,percent of total billed charges,,,154.76,95,,percent of total billed charges,,,135.22,83,,percent of total billed charges,,,135.22,83,,percent of total billed charges,,,,,,,,,,,,,,,135.22,83,,percent of total billed charges,,,154.76,95,,percent of total billed charges,,,146.62,90,,percent of total billed charges,,,146.62,90,,percent of total billed charges,,,133.59,82,,percent of total billed charges,,,146.62,90,,percent of total billed charges,,,138.47,85,,percent of total billed charges,,122.83,154.76,
bupivacaine 0.25% PF Inj Sol 30ML,32008481,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
SENSORCAINE .25% 1-5 ML,32008482,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
BUPIVICAINE(SENSORCAINE)VL 0.25%:30ML,32008483,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
MESORIDAZINE BESYLATE (SERENTIL)TAB:10MG,32008491,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
MESORIDAZINE BESYLATE (SERENTIL)TAB:25MG,32008496,CDM,,,250,RC,inpatient,,16.18,16.18,,13.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.24,88,,percent of total billed charges,,,,,,,,,12.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.72,91,,percent of total billed charges,,,15.37,95,,percent of total billed charges,,,13.43,83,,percent of total billed charges,,,13.43,83,,percent of total billed charges,,,,,,,,,,,,,,,13.43,83,,percent of total billed charges,,,15.37,95,,percent of total billed charges,,,14.56,90,,percent of total billed charges,,,14.56,90,,percent of total billed charges,,,13.27,82,,percent of total billed charges,,,14.56,90,,percent of total billed charges,,,13.75,85,,percent of total billed charges,,12.2,15.37,
MESORIDAZINE(SERENTIL)ORAL:25MG/ML 118ML,32008501,CDM,,,250,RC,inpatient,,883.28,883.28,,749.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,665.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,750.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,777.29,88,,percent of total billed charges,,,,,,,,,674.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,803.78,91,,percent of total billed charges,,,839.12,95,,percent of total billed charges,,,733.12,83,,percent of total billed charges,,,733.12,83,,percent of total billed charges,,,,,,,,,,,,,,,733.12,83,,percent of total billed charges,,,839.12,95,,percent of total billed charges,,,794.95,90,,percent of total billed charges,,,794.95,90,,percent of total billed charges,,,724.29,82,,percent of total billed charges,,,794.95,90,,percent of total billed charges,,,750.79,85,,percent of total billed charges,,665.99,839.12,
RESERPINE TAB:0.25MG,32008506,CDM,,,250,RC,inpatient,,20.14,20.14,,17.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.72,88,,percent of total billed charges,,,,,,,,,15.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.33,91,,percent of total billed charges,,,19.13,95,,percent of total billed charges,,,16.72,83,,percent of total billed charges,,,16.72,83,,percent of total billed charges,,,,,,,,,,,,,,,16.72,83,,percent of total billed charges,,,19.13,95,,percent of total billed charges,,,18.13,90,,percent of total billed charges,,,18.13,90,,percent of total billed charges,,,16.51,82,,percent of total billed charges,,,18.13,90,,percent of total billed charges,,,17.12,85,,percent of total billed charges,,15.19,19.13,
SEREVENT 13GM,32008512,CDM,,,250,RC,inpatient,,17,17,,14.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.96,88,,percent of total billed charges,,,,,,,,,12.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.47,91,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,,,,,,,,,,,,,14.11,83,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,13.94,82,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,14.45,85,,percent of total billed charges,,12.82,16.15,
QUEtiapine(SEROquel)TAB:25MG,32008522,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
SILVER NITRATE STICK (1),32008531,CDM,J3490,HCPCS,250,RC,inpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,15.28,19.26,
SIMETHICONE(MYLICON)TAB:80MG,32008536,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CARB/LEVO(sineMET CR)TAB:50MG-200MG,32008546,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
MONTELUKAST(SINGULAIR)TAB:10MG,32008552,CDM,J8499,HCPCS,250,RC,inpatient,,10,10,,8.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8.8,88,,percent of total billed charges,,,,,,,,,7.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9.1,91,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,,,,,,,,,,,,,8.3,83,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,9,90,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.2,82,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.5,85,,percent of total billed charges,,7.54,9.5,
FERROUS SULFATE(SLOW FE)TAB:160MG,32008556,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
SODIUM ACETATE VIAL:40MEQ/20ML,32008562,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
SODIUM BICARBONATE VIAL:50MEQ/50ML,32008566,CDM,J3490,HCPCS,250,RC,inpatient,UD,145.1,145.1,,123.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,109.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,123.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,127.69,88,,percent of total billed charges,,,,,,,,,110.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.04,91,,percent of total billed charges,,,137.85,95,,percent of total billed charges,,,120.43,83,,percent of total billed charges,,,120.43,83,,percent of total billed charges,,,,,,,,,,,,,,,120.43,83,,percent of total billed charges,,,137.85,95,,percent of total billed charges,,,130.59,90,,percent of total billed charges,,,130.59,90,,percent of total billed charges,,,118.98,82,,percent of total billed charges,,,130.59,90,,percent of total billed charges,,,123.34,85,,percent of total billed charges,,109.41,137.85,
NORMAL SALINE 0.9%-VIAL10ML,32008571,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
NORMAL SALINE 0.9% - VIAL: 20ML,32008576,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
SODIUM CHLORIDE FOR INHAL VL0.9%:3ML(RT),32008581,CDM,J3490,HCPCS,250,RC,inpatient,,24.8,24.8,,21.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.82,88,,percent of total billed charges,,,,,,,,,18.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.57,91,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,,,,,,,,,,,,,20.58,83,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,20.34,82,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,18.7,23.56,
SODIUM CHLORIDE FOR INHAL VL0.9%:5ML IRR,32008582,CDM,,,250,RC,inpatient,,7.5,7.5,,6.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6.6,88,,percent of total billed charges,,,,,,,,,5.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6.83,91,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,,,,,,,,,,,,,6.23,83,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.15,82,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,5.66,7.13,
SODIUM CHLORIDE VIAL : 4MEQ/ML 30ML,32008591,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
SODIUM BICARBONATE SYR:10MEQ/10ML(PEDS),32008596,CDM,J3490,HCPCS,250,RC,inpatient,,247.39,247.39,,210.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,217.7,88,,percent of total billed charges,,,,,,,,,189.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.12,91,,percent of total billed charges,,,235.02,95,,percent of total billed charges,,,205.33,83,,percent of total billed charges,,,205.33,83,,percent of total billed charges,,,,,,,,,,,,,,,205.33,83,,percent of total billed charges,,,235.02,95,,percent of total billed charges,,,222.65,90,,percent of total billed charges,,,222.65,90,,percent of total billed charges,,,202.86,82,,percent of total billed charges,,,222.65,90,,percent of total billed charges,,,210.28,85,,percent of total billed charges,,186.53,235.02,
SODIUM BICARBONATE SYR:50MEQ/50ML,32008606,CDM,J3490,HCPCS,250,RC,inpatient,,227.13,227.13,,192.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,199.87,88,,percent of total billed charges,,,,,,,,,173.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,206.69,91,,percent of total billed charges,,,215.77,95,,percent of total billed charges,,,188.52,83,,percent of total billed charges,,,188.52,83,,percent of total billed charges,,,,,,,,,,,,,,,188.52,83,,percent of total billed charges,,,215.77,95,,percent of total billed charges,,,204.42,90,,percent of total billed charges,,,204.42,90,,percent of total billed charges,,,186.25,82,,percent of total billed charges,,,204.42,90,,percent of total billed charges,,,193.06,85,,percent of total billed charges,,171.26,215.77,
CITRIC ACID/SODIUM CITRATE 334-500MG 480,32008607,CDM,,,250,RC,inpatient,,50.59,50.59,,42.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.52,88,,percent of total billed charges,,,,,,,,,38.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.04,91,,percent of total billed charges,,,48.06,95,,percent of total billed charges,,,41.99,83,,percent of total billed charges,,,41.99,83,,percent of total billed charges,,,,,,,,,,,,,,,41.99,83,,percent of total billed charges,,,48.06,95,,percent of total billed charges,,,45.53,90,,percent of total billed charges,,,45.53,90,,percent of total billed charges,,,41.48,82,,percent of total billed charges,,,45.53,90,,percent of total billed charges,,,43,85,,percent of total billed charges,,38.14,48.06,
ETHACRYNATE SOD(EDECRIN)VL:50MG,32008611,CDM,,,250,RC,inpatient,,23694.26,23694.26,,20116.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17865.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20140.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20850.95,88,,percent of total billed charges,,,,,,,,,18102.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21561.78,91,,percent of total billed charges,,,22509.55,95,,percent of total billed charges,,,19666.24,83,,percent of total billed charges,,,19666.24,83,,percent of total billed charges,,,,,,,,,,,,,,,19666.24,83,,percent of total billed charges,,,22509.55,95,,percent of total billed charges,,,21324.83,90,,percent of total billed charges,,,21324.83,90,,percent of total billed charges,,,19429.29,82,,percent of total billed charges,,,21324.83,90,,percent of total billed charges,,,20140.12,85,,percent of total billed charges,,17865.47,22509.55,
methylPRED(solu-MEDROL)VIAL:40MG/ML,32008612,CDM,J2920,HCPCS,250,RC,inpatient,,81.37,81.37,,69.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,61.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,69.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,71.61,88,,percent of total billed charges,,4.28,,,,fee schedule,,,62.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,4.28,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,74.05,91,,percent of total billed charges,,,77.3,95,,percent of total billed charges,,,67.54,83,,percent of total billed charges,,,67.54,83,,percent of total billed charges,,,,,,,,,,,,,,,67.54,83,,percent of total billed charges,,,77.3,95,,percent of total billed charges,,,73.23,90,,percent of total billed charges,,,73.23,90,,percent of total billed charges,,,66.72,82,,percent of total billed charges,,,73.23,90,,percent of total billed charges,,,69.16,85,,percent of total billed charges,,4.28,77.3,
methylPRED(solu-MEDROL)VIAL:125MG/2ML,32008613,CDM,J2930,HCPCS,250,RC,inpatient,,129.58,129.58,,110.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,97.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,110.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,114.03,88,,percent of total billed charges,,172.26,,,,fee schedule,,,99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,172.26,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,117.92,91,,percent of total billed charges,,,123.1,95,,percent of total billed charges,,,107.55,83,,percent of total billed charges,,,107.55,83,,percent of total billed charges,,,,,,,,,,,,,,,107.55,83,,percent of total billed charges,,,123.1,95,,percent of total billed charges,,,116.62,90,,percent of total billed charges,,,116.62,90,,percent of total billed charges,,,106.26,82,,percent of total billed charges,,,116.62,90,,percent of total billed charges,,,110.14,85,,percent of total billed charges,,97.7,172.26,
SOLU-MEDROL,32008616,CDM,,,250,RC,inpatient,,8.5,8.5,,7.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.48,88,,percent of total billed charges,,,,,,,,,6.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.74,91,,percent of total billed charges,,,8.08,95,,percent of total billed charges,,,7.06,83,,percent of total billed charges,,,7.06,83,,percent of total billed charges,,,,,,,,,,,,,,,7.06,83,,percent of total billed charges,,,8.08,95,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,6.97,82,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,7.23,85,,percent of total billed charges,,6.41,8.08,
METHYLPREDNISLNE (SOLU-MEDROL)VIAL:500MG,32008621,CDM,,,250,RC,inpatient,,404.27,404.27,,343.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,304.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,343.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,355.76,88,,percent of total billed charges,,,,,,,,,308.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,367.89,91,,percent of total billed charges,,,384.06,95,,percent of total billed charges,,,335.54,83,,percent of total billed charges,,,335.54,83,,percent of total billed charges,,,,,,,,,,,,,,,335.54,83,,percent of total billed charges,,,384.06,95,,percent of total billed charges,,,363.84,90,,percent of total billed charges,,,363.84,90,,percent of total billed charges,,,331.5,82,,percent of total billed charges,,,363.84,90,,percent of total billed charges,,,343.63,85,,percent of total billed charges,,304.82,384.06,
SOLU-MEDROL,32008626,CDM,,,250,RC,inpatient,,124.34,124.34,,105.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.42,88,,percent of total billed charges,,,,,,,,,95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,113.15,91,,percent of total billed charges,,,118.12,95,,percent of total billed charges,,,103.2,83,,percent of total billed charges,,,103.2,83,,percent of total billed charges,,,,,,,,,,,,,,,103.2,83,,percent of total billed charges,,,118.12,95,,percent of total billed charges,,,111.91,90,,percent of total billed charges,,,111.91,90,,percent of total billed charges,,,101.96,82,,percent of total billed charges,,,111.91,90,,percent of total billed charges,,,105.69,85,,percent of total billed charges,,93.75,118.12,
HYDROCORTISONE(SOLU-cortef)VL:250MG/2ML,32008631,CDM,J1720,HCPCS,250,RC,inpatient,,479.25,479.25,,406.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,361.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,407.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,421.74,88,,percent of total billed charges,,89.37,,,,fee schedule,,,366.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,89.37,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,436.12,91,,percent of total billed charges,,,455.29,95,,percent of total billed charges,,,397.78,83,,percent of total billed charges,,,397.78,83,,percent of total billed charges,,,,,,,,,,,,,,,397.78,83,,percent of total billed charges,,,455.29,95,,percent of total billed charges,,,431.33,90,,percent of total billed charges,,,431.33,90,,percent of total billed charges,,,392.99,82,,percent of total billed charges,,,431.33,90,,percent of total billed charges,,,407.36,85,,percent of total billed charges,,89.37,455.29,
HYDROCORT(solu-CORTEF) VIAL:500MG/4ML,32008636,CDM,,,250,RC,inpatient,,264.23,264.23,,224.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,199.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,224.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,232.52,88,,percent of total billed charges,,,,,,,,,201.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,240.45,91,,percent of total billed charges,,,251.02,95,,percent of total billed charges,,,219.31,83,,percent of total billed charges,,,219.31,83,,percent of total billed charges,,,,,,,,,,,,,,,219.31,83,,percent of total billed charges,,,251.02,95,,percent of total billed charges,,,237.81,90,,percent of total billed charges,,,237.81,90,,percent of total billed charges,,,216.67,82,,percent of total billed charges,,,237.81,90,,percent of total billed charges,,,224.6,85,,percent of total billed charges,,199.23,251.02,
methylPRED(solu-MEDROL)VIAL:1000MG/16ML,32008641,CDM,J2930,HCPCS,250,RC,inpatient,,395.26,395.26,,335.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,298.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,335.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,347.83,88,,percent of total billed charges,,172.26,,,,fee schedule,,,301.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,172.26,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,359.69,91,,percent of total billed charges,,,375.5,95,,percent of total billed charges,,,328.07,83,,percent of total billed charges,,,328.07,83,,percent of total billed charges,,,,,,,,,,,,,,,328.07,83,,percent of total billed charges,,,375.5,95,,percent of total billed charges,,,355.73,90,,percent of total billed charges,,,355.73,90,,percent of total billed charges,,,324.11,82,,percent of total billed charges,,,355.73,90,,percent of total billed charges,,,335.97,85,,percent of total billed charges,,172.26,375.5,
HYDROCORTISONE(SOLU-cortef)VL:100MG/2ML,32008646,CDM,J1720,HCPCS,250,RC,inpatient,,256.54,256.54,,217.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,193.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,218.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,225.76,88,,percent of total billed charges,,89.37,,,,fee schedule,,,196,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,89.37,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,233.45,91,,percent of total billed charges,,,243.71,95,,percent of total billed charges,,,212.93,83,,percent of total billed charges,,,212.93,83,,percent of total billed charges,,,,,,,,,,,,,,,212.93,83,,percent of total billed charges,,,243.71,95,,percent of total billed charges,,,230.89,90,,percent of total billed charges,,,230.89,90,,percent of total billed charges,,,210.36,82,,percent of total billed charges,,,230.89,90,,percent of total billed charges,,,218.06,85,,percent of total billed charges,,89.37,243.71,
SODIUM PHOS VIAL:45MMOL/15ML,32008651,CDM,J3490,HCPCS,250,RC,inpatient,,252.65,252.65,,214.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,214.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,222.33,88,,percent of total billed charges,,,,,,,,,193.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,229.91,91,,percent of total billed charges,,,240.02,95,,percent of total billed charges,,,209.7,83,,percent of total billed charges,,,209.7,83,,percent of total billed charges,,,,,,,,,,,,,,,209.7,83,,percent of total billed charges,,,240.02,95,,percent of total billed charges,,,227.39,90,,percent of total billed charges,,,227.39,90,,percent of total billed charges,,,207.17,82,,percent of total billed charges,,,227.39,90,,percent of total billed charges,,,214.75,85,,percent of total billed charges,,190.5,240.02,
ISOSORBIDE (ISORDIL) TAB : 30MG,32008656,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ISOSORBIDE (ISORDIL) TAB : 40MG,32008661,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
SORBITOL SOLUTION SOL 70%: 30ML,32008671,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
SORBITOL SOLUTION SOL : 70% 473ML,32008676,CDM,,,250,RC,inpatient,,55.99,55.99,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.27,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.95,91,,percent of total billed charges,,,53.19,95,,percent of total billed charges,,,46.47,83,,percent of total billed charges,,,46.47,83,,percent of total billed charges,,,,,,,,,,,,,,,46.47,83,,percent of total billed charges,,,53.19,95,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,45.91,82,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,47.59,85,,percent of total billed charges,,42.22,53.19,
SORBITOL SOLUTION SOL 70%: 50ML,32008686,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
SORBITOL SOLUTION SOL 70%:100ML,32008691,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
SORBITOL SOLUTION SOL 70%:480ML,32008696,CDM,J8499,HCPCS,250,RC,inpatient,,55.99,55.99,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.27,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.95,91,,percent of total billed charges,,,53.19,95,,percent of total billed charges,,,46.47,83,,percent of total billed charges,,,46.47,83,,percent of total billed charges,,,,,,,,,,,,,,,46.47,83,,percent of total billed charges,,,53.19,95,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,45.91,82,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,47.59,85,,percent of total billed charges,,42.22,53.19,
EDETATE DISODIUM(EDTA)AMP:200MG/ML,32008706,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
SPIRONOLACTONE(ALDACTONE)TAB: 25MG,32008731,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ITRACONAZOLE (SPORANOX) CAP : 100MG,32008732,CDM,,,250,RC,inpatient,,123.55,123.55,,104.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,108.72,88,,percent of total billed charges,,,,,,,,,94.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,112.43,91,,percent of total billed charges,,,117.37,95,,percent of total billed charges,,,102.55,83,,percent of total billed charges,,,102.55,83,,percent of total billed charges,,,,,,,,,,,,,,,102.55,83,,percent of total billed charges,,,117.37,95,,percent of total billed charges,,,111.2,90,,percent of total billed charges,,,111.2,90,,percent of total billed charges,,,101.31,82,,percent of total billed charges,,,111.2,90,,percent of total billed charges,,,105.02,85,,percent of total billed charges,,93.16,117.37,
SILVER SULFADIAZINE(SSD)CREAM 1%:400GM,32008740,CDM,J3490,HCPCS,250,RC,inpatient,,508.01,508.01,,431.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,383.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,431.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,447.05,88,,percent of total billed charges,,,,,,,,,388.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,462.29,91,,percent of total billed charges,,,482.61,95,,percent of total billed charges,,,421.65,83,,percent of total billed charges,,,421.65,83,,percent of total billed charges,,,,,,,,,,,,,,,421.65,83,,percent of total billed charges,,,482.61,95,,percent of total billed charges,,,457.21,90,,percent of total billed charges,,,457.21,90,,percent of total billed charges,,,416.57,82,,percent of total billed charges,,,457.21,90,,percent of total billed charges,,,431.81,85,,percent of total billed charges,,383.04,482.61,
POTASSIUM IODIDE(SSKI)SOL 1GM/ML:30ML,32008741,CDM,,,250,RC,inpatient,,64.25,64.25,,54.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.54,88,,percent of total billed charges,,,,,,,,,49.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.47,91,,percent of total billed charges,,,61.04,95,,percent of total billed charges,,,53.33,83,,percent of total billed charges,,,53.33,83,,percent of total billed charges,,,,,,,,,,,,,,,53.33,83,,percent of total billed charges,,,61.04,95,,percent of total billed charges,,,57.83,90,,percent of total billed charges,,,57.83,90,,percent of total billed charges,,,52.69,82,,percent of total billed charges,,,57.83,90,,percent of total billed charges,,,54.61,85,,percent of total billed charges,,48.44,61.04,
BUTORPHANOL(STADOL) :10MG/ML SPRAY 2.5ML,32008746,CDM,,,250,RC,inpatient,,66.14,66.14,,56.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.2,88,,percent of total billed charges,,,,,,,,,50.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.19,91,,percent of total billed charges,,,62.83,95,,percent of total billed charges,,,54.9,83,,percent of total billed charges,,,54.9,83,,percent of total billed charges,,,,,,,,,,,,,,,54.9,83,,percent of total billed charges,,,62.83,95,,percent of total billed charges,,,59.53,90,,percent of total billed charges,,,59.53,90,,percent of total billed charges,,,54.23,82,,percent of total billed charges,,,59.53,90,,percent of total billed charges,,,56.22,85,,percent of total billed charges,,49.87,62.83,
BUTORPHANOL(STADOL)VIAL:1MG/ML,32008751,CDM,J0595,HCPCS,250,RC,inpatient,,79.74,79.74,,67.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.17,88,,percent of total billed charges,,11.85,,,,fee schedule,,,60.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11.85,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.56,91,,percent of total billed charges,,,75.75,95,,percent of total billed charges,,,66.18,83,,percent of total billed charges,,,66.18,83,,percent of total billed charges,,,,,,,,,,,,,,,66.18,83,,percent of total billed charges,,,75.75,95,,percent of total billed charges,,,71.77,90,,percent of total billed charges,,,71.77,90,,percent of total billed charges,,,65.39,82,,percent of total billed charges,,,71.77,90,,percent of total billed charges,,,67.78,85,,percent of total billed charges,,11.85,75.75,
STERILE WATER FOR INJECTION VIAL: 10ML,32008756,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
STERILE WATER FOR INJECTION VIAL: 20ML,32008761,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
STREPTO (STREPTASE) 1.5MMU :(J PER 1MMU),32008781,CDM,J2995,HCPCS,636,RC,inpatient,,1156.11,1156.11,,981.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,871.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,982.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1017.38,88,,percent of total billed charges,,,,,,,,,883.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1052.06,91,,percent of total billed charges,,,1098.3,95,,percent of total billed charges,,,959.57,83,,percent of total billed charges,,,959.57,83,,percent of total billed charges,,,,,,,,,,,,,,,959.57,83,,percent of total billed charges,,,1098.3,95,,percent of total billed charges,,,1040.5,90,,percent of total billed charges,,,1040.5,90,,percent of total billed charges,,,948.01,82,,percent of total billed charges,,,1040.5,90,,percent of total billed charges,,,982.69,85,,percent of total billed charges,,871.71,1098.3,
POTASSIUM IODIDE/IODINE SOL 5% 473ML,32008786,CDM,,,250,RC,inpatient,,1008.54,1008.54,,856.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,760.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,857.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,887.52,88,,percent of total billed charges,,,,,,,,,770.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,917.77,91,,percent of total billed charges,,,958.11,95,,percent of total billed charges,,,837.09,83,,percent of total billed charges,,,837.09,83,,percent of total billed charges,,,,,,,,,,,,,,,837.09,83,,percent of total billed charges,,,958.11,95,,percent of total billed charges,,,907.69,90,,percent of total billed charges,,,907.69,90,,percent of total billed charges,,,827,82,,percent of total billed charges,,,907.69,90,,percent of total billed charges,,,857.26,85,,percent of total billed charges,,760.44,958.11,
POTASSIUM IODIDE/IODINE SOL 5%      60ML,32008791,CDM,,,250,RC,inpatient,,37.75,37.75,,32.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33.22,88,,percent of total billed charges,,,,,,,,,28.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.35,91,,percent of total billed charges,,,35.86,95,,percent of total billed charges,,,31.33,83,,percent of total billed charges,,,31.33,83,,percent of total billed charges,,,,,,,,,,,,,,,31.33,83,,percent of total billed charges,,,35.86,95,,percent of total billed charges,,,33.98,90,,percent of total billed charges,,,33.98,90,,percent of total billed charges,,,30.96,82,,percent of total billed charges,,,33.98,90,,percent of total billed charges,,,32.09,85,,percent of total billed charges,,28.46,35.86,
fentaNYL(SUBLIMAZE)PF INJ:100MCG/2ML,32008796,CDM,J3010,HCPCS,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,1.79,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.79,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,1.79,64.15,
HEXYLRESORCINOL (SUCRETS) LOZ,32008801,CDM,,,250,RC,inpatient,,33.62,33.62,,28.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.59,88,,percent of total billed charges,,,,,,,,,25.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.59,91,,percent of total billed charges,,,31.94,95,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,,,,,,,,,,,,,,27.9,83,,percent of total billed charges,,,31.94,95,,percent of total billed charges,,,30.26,90,,percent of total billed charges,,,30.26,90,,percent of total billed charges,,,27.57,82,,percent of total billed charges,,,30.26,90,,percent of total billed charges,,,28.58,85,,percent of total billed charges,,25.35,31.94,
SULF/TRIM(BACTRIM)SUS:200-40MG/5ML 100ML,32008806,CDM,J8499,HCPCS,250,RC,inpatient,UD,156.21,156.21,,132.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,117.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,132.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,137.46,88,,percent of total billed charges,,,,,,,,,119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,142.15,91,,percent of total billed charges,,,148.4,95,,percent of total billed charges,,,129.65,83,,percent of total billed charges,,,129.65,83,,percent of total billed charges,,,,,,,,,,,,,,,129.65,83,,percent of total billed charges,,,148.4,95,,percent of total billed charges,,,140.59,90,,percent of total billed charges,,,140.59,90,,percent of total billed charges,,,128.09,82,,percent of total billed charges,,,140.59,90,,percent of total billed charges,,,132.78,85,,percent of total billed charges,,117.78,148.4,
SULF/TRIM (BACTRIM)ORAL:200-40MG/5 480ML,32008811,CDM,,,250,RC,inpatient,,802.64,802.64,,681.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,605.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,682.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,706.32,88,,percent of total billed charges,,,,,,,,,613.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,730.4,91,,percent of total billed charges,,,762.51,95,,percent of total billed charges,,,666.19,83,,percent of total billed charges,,,666.19,83,,percent of total billed charges,,,,,,,,,,,,,,,666.19,83,,percent of total billed charges,,,762.51,95,,percent of total billed charges,,,722.38,90,,percent of total billed charges,,,722.38,90,,percent of total billed charges,,,658.16,82,,percent of total billed charges,,,722.38,90,,percent of total billed charges,,,682.24,85,,percent of total billed charges,,605.19,762.51,
NISOLDIPINE (SULAR) TAB : 10MG,32008821,CDM,,,250,RC,inpatient,,17.76,17.76,,15.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.63,88,,percent of total billed charges,,,,,,,,,13.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.16,91,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,,,,,,,,,,,,,14.74,83,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,14.56,82,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.1,85,,percent of total billed charges,,13.39,16.87,
NISOLDIPINE(SULAR)TAB:20MG,32008822,CDM,,,250,RC,inpatient,,17.76,17.76,,15.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.63,88,,percent of total billed charges,,,,,,,,,13.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.16,91,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,,,,,,,,,,,,,14.74,83,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,14.56,82,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.1,85,,percent of total billed charges,,13.39,16.87,
SULF/TRIM(BACTRIM)VIAL:800-160MG/10ML,32008826,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
SULF/TRIM TAB(BACTRIM PLAIN) : 400-80MG,32008836,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
SULF/TRIM(BACTRIM DS)TAB:800-160MG,32008841,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
SULF/TRIM(BACTRIM DS)TAB:800-160MG(1X6),32008842,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
SULINDAC TAB (CLINORIL): 150MG,32008856,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
SULINDAC TAB (CLINORIL) : 200MG,32008861,CDM,,,250,RC,inpatient,,16.81,16.81,,14.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.79,88,,percent of total billed charges,,,,,,,,,12.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.3,91,,percent of total billed charges,,,15.97,95,,percent of total billed charges,,,13.95,83,,percent of total billed charges,,,13.95,83,,percent of total billed charges,,,,,,,,,,,,,,,13.95,83,,percent of total billed charges,,,15.97,95,,percent of total billed charges,,,15.13,90,,percent of total billed charges,,,15.13,90,,percent of total billed charges,,,13.78,82,,percent of total billed charges,,,15.13,90,,percent of total billed charges,,,14.29,85,,percent of total billed charges,,12.67,15.97,
CIMETIDINE(TAGAMET)VIAL:150MG/ML,32008936,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
CIMETIDINE(TAGAMET) LIQ :300MG/5ML 237ML,32008941,CDM,,,250,RC,inpatient,,233.14,233.14,,197.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,175.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,198.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,205.16,88,,percent of total billed charges,,,,,,,,,178.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,212.16,91,,percent of total billed charges,,,221.48,95,,percent of total billed charges,,,193.51,83,,percent of total billed charges,,,193.51,83,,percent of total billed charges,,,,,,,,,,,,,,,193.51,83,,percent of total billed charges,,,221.48,95,,percent of total billed charges,,,209.83,90,,percent of total billed charges,,,209.83,90,,percent of total billed charges,,,191.17,82,,percent of total billed charges,,,209.83,90,,percent of total billed charges,,,198.17,85,,percent of total billed charges,,175.79,221.48,
CIMETIDINE (TAGAMET) VIAL : 150MG/ML 8ML,32008951,CDM,,,250,RC,inpatient,,66.61,66.61,,56.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.62,88,,percent of total billed charges,,,,,,,,,50.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.62,91,,percent of total billed charges,,,63.28,95,,percent of total billed charges,,,55.29,83,,percent of total billed charges,,,55.29,83,,percent of total billed charges,,,,,,,,,,,,,,,55.29,83,,percent of total billed charges,,,63.28,95,,percent of total billed charges,,,59.95,90,,percent of total billed charges,,,59.95,90,,percent of total billed charges,,,54.62,82,,percent of total billed charges,,,59.95,90,,percent of total billed charges,,,56.62,85,,percent of total billed charges,,50.22,63.28,
FLECAINIDE ACETATE (TAMBACOR)TAB : 100MG,32008971,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
*TAXOTERE 20MG  **J9170**(V1011),32008972,CDM,J9171,HCPCS,636,RC,inpatient,,428,428,,363.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,322.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,363.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,376.64,88,,percent of total billed charges,,121.68,,,,fee schedule,,,326.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,389.48,91,,percent of total billed charges,,,406.6,95,,percent of total billed charges,,,355.24,83,,percent of total billed charges,,,355.24,83,,percent of total billed charges,,,,,,,,,,,,,,,355.24,83,,percent of total billed charges,,,406.6,95,,percent of total billed charges,,,385.2,90,,percent of total billed charges,,,385.2,90,,percent of total billed charges,,,350.96,82,,percent of total billed charges,,,385.2,90,,percent of total billed charges,,,363.8,85,,percent of total billed charges,,121.68,406.6,
*DOCETAXEL (Taxotere) 80MG/2ML: (V1011),32008973,CDM,J9171,HCPCS,636,RC,inpatient,,3165.53,3165.53,,2687.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2386.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2690.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2785.67,88,,percent of total billed charges,,121.68,,,,fee schedule,,,2418.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2880.63,91,,percent of total billed charges,,,3007.25,95,,percent of total billed charges,,,2627.39,83,,percent of total billed charges,,,2627.39,83,,percent of total billed charges,,,,,,,,,,,,,,,2627.39,83,,percent of total billed charges,,,3007.25,95,,percent of total billed charges,,,2848.98,90,,percent of total billed charges,,,2848.98,90,,percent of total billed charges,,,2595.73,82,,percent of total billed charges,,,2848.98,90,,percent of total billed charges,,,2690.7,85,,percent of total billed charges,,121.68,3007.25,
PACLitaxel(TAXol)MDV:100MG/16.7ML J/1,32008974,CDM,J9267,HCPCS,636,RC,inpatient,,1.9,1.9,,1.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1.67,88,,percent of total billed charges,,61.04,,,,fee schedule,,,1.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,61.04,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1.73,91,,percent of total billed charges,,,1.81,95,,percent of total billed charges,,,1.58,83,,percent of total billed charges,,,1.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1.58,83,,percent of total billed charges,,,1.81,95,,percent of total billed charges,,,1.71,90,,percent of total billed charges,,,1.71,90,,percent of total billed charges,,,1.56,82,,percent of total billed charges,,,1.71,90,,percent of total billed charges,,,1.62,85,,percent of total billed charges,,1.43,61.04,
OSELTAMIVIR(TAMIFLU)CAP:75MG,32008975,CDM,J8499,HCPCS,250,RC,inpatient,,17.48,17.48,,14.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.38,88,,percent of total billed charges,,,,,,,,,13.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.91,91,,percent of total billed charges,,,16.61,95,,percent of total billed charges,,,14.51,83,,percent of total billed charges,,,14.51,83,,percent of total billed charges,,,,,,,,,,,,,,,14.51,83,,percent of total billed charges,,,16.61,95,,percent of total billed charges,,,15.73,90,,percent of total billed charges,,,15.73,90,,percent of total billed charges,,,14.33,82,,percent of total billed charges,,,15.73,90,,percent of total billed charges,,,14.86,85,,percent of total billed charges,,13.18,16.61,
METHIMAZOLE(TAPAZOLE)TAB:5MG,32008977,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
TRIMETHOBENZAMIDE (TIGAN) SUPP: 200MG-2%,32008996,CDM,,,250,RC,inpatient,,14.22,14.22,,12.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.51,88,,percent of total billed charges,,,,,,,,,10.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.94,91,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,,,,,,,,,,,,,11.8,83,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,11.66,82,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.09,85,,percent of total billed charges,,10.72,13.51,
TRIMETHOBENZAMIDE (TIGAN) SUPP: 100MG-2%,32009001,CDM,,,250,RC,inpatient,,14.22,14.22,,12.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.51,88,,percent of total billed charges,,,,,,,,,10.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.94,91,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,,,,,,,,,,,,,11.8,83,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,11.66,82,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.09,85,,percent of total billed charges,,10.72,13.51,
carBAMazepine(TEGretol)CHEW TAB:100MG,32009006,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
TELMISARTAN(MICARDIS)TAB:40MG,32009007,CDM,J8499,HCPCS,250,RC,inpatient,,23.86,23.86,,20.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21,88,,percent of total billed charges,,,,,,,,,18.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.71,91,,percent of total billed charges,,,22.67,95,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,,,,,,,,,,,,,,19.8,83,,percent of total billed charges,,,22.67,95,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,19.57,82,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,20.28,85,,percent of total billed charges,,17.99,22.67,
carBAMazepine(TEGretol):100MG/5ML(450ML),32009010,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
TEMAZEPAM(RESTORIL)CAP:15MG,32009016,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
ATENOLOL(TENORMIN IV)AMP:5MG/10ML,32009027,CDM,,,250,RC,inpatient,,62.25,62.25,,52.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.78,88,,percent of total billed charges,,,,,,,,,47.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.65,91,,percent of total billed charges,,,59.14,95,,percent of total billed charges,,,51.67,83,,percent of total billed charges,,,51.67,83,,percent of total billed charges,,,,,,,,,,,,,,,51.67,83,,percent of total billed charges,,,59.14,95,,percent of total billed charges,,,56.03,90,,percent of total billed charges,,,56.03,90,,percent of total billed charges,,,51.05,82,,percent of total billed charges,,,56.03,90,,percent of total billed charges,,,52.91,85,,percent of total billed charges,,46.94,59.14,
TERCONAZOLE (TERAZOL 7) CREAM:0.40% 45GM,32009036,CDM,,,250,RC,inpatient,,732.57,732.57,,621.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,552.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,622.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,644.66,88,,percent of total billed charges,,,,,,,,,559.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,666.64,91,,percent of total billed charges,,,695.94,95,,percent of total billed charges,,,608.03,83,,percent of total billed charges,,,608.03,83,,percent of total billed charges,,,,,,,,,,,,,,,608.03,83,,percent of total billed charges,,,695.94,95,,percent of total billed charges,,,659.31,90,,percent of total billed charges,,,659.31,90,,percent of total billed charges,,,600.71,82,,percent of total billed charges,,,659.31,90,,percent of total billed charges,,,622.68,85,,percent of total billed charges,,552.36,695.94,
TERCONAZOLE(TERAZOL 3)CREAM:20GM,32009041,CDM,,,250,RC,inpatient,,653.27,653.27,,554.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,492.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,555.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,574.88,88,,percent of total billed charges,,,,,,,,,499.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,594.48,91,,percent of total billed charges,,,620.61,95,,percent of total billed charges,,,542.21,83,,percent of total billed charges,,,542.21,83,,percent of total billed charges,,,,,,,,,,,,,,,542.21,83,,percent of total billed charges,,,620.61,95,,percent of total billed charges,,,587.94,90,,percent of total billed charges,,,587.94,90,,percent of total billed charges,,,535.68,82,,percent of total billed charges,,,587.94,90,,percent of total billed charges,,,555.28,85,,percent of total billed charges,,492.57,620.61,
TERCONAZOLE(TERAZOL 3)SUPP:80MG EA,32009046,CDM,,,250,RC,inpatient,,345.43,345.43,,293.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,260.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,293.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,303.98,88,,percent of total billed charges,,,,,,,,,263.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,314.34,91,,percent of total billed charges,,,328.16,95,,percent of total billed charges,,,286.71,83,,percent of total billed charges,,,286.71,83,,percent of total billed charges,,,,,,,,,,,,,,,286.71,83,,percent of total billed charges,,,328.16,95,,percent of total billed charges,,,310.89,90,,percent of total billed charges,,,310.89,90,,percent of total billed charges,,,283.25,82,,percent of total billed charges,,,310.89,90,,percent of total billed charges,,,293.62,85,,percent of total billed charges,,260.45,328.16,
TERCONAZOLE(TERAZOL)SUPP:80MG,32009051,CDM,J3490,HCPCS,250,RC,inpatient,,345.43,345.43,,293.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,260.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,293.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,303.98,88,,percent of total billed charges,,,,,,,,,263.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,314.34,91,,percent of total billed charges,,,328.16,95,,percent of total billed charges,,,286.71,83,,percent of total billed charges,,,286.71,83,,percent of total billed charges,,,,,,,,,,,,,,,286.71,83,,percent of total billed charges,,,328.16,95,,percent of total billed charges,,,310.89,90,,percent of total billed charges,,,310.89,90,,percent of total billed charges,,,283.25,82,,percent of total billed charges,,,310.89,90,,percent of total billed charges,,,293.62,85,,percent of total billed charges,,260.45,328.16,
TETAN&DIPH(TENIVAC)SYR:0.5ML  PYX,32009076,CDM,90714,CPT,636,RC,inpatient,,484.84,484.84,,411.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,365.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,412.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,426.66,88,,percent of total billed charges,,,,,,,,,370.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,441.2,91,,percent of total billed charges,,,460.6,95,,percent of total billed charges,,,402.42,83,,percent of total billed charges,,,402.42,83,,percent of total billed charges,,,,,,,,,,,,,,,402.42,83,,percent of total billed charges,,,460.6,95,,percent of total billed charges,,,436.36,90,,percent of total billed charges,,,436.36,90,,percent of total billed charges,,,397.57,82,,percent of total billed charges,,,436.36,90,,percent of total billed charges,,,412.11,85,,percent of total billed charges,,365.57,460.6,
TETRACYCLINE CAP:500MG,32009086,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
TETRACAINE DROP 0.5%:4ML,32009091,CDM,J3490,HCPCS,250,RC,inpatient,,196.9,196.9,,167.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.27,88,,percent of total billed charges,,,,,,,,,150.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.18,91,,percent of total billed charges,,,187.06,95,,percent of total billed charges,,,163.43,83,,percent of total billed charges,,,163.43,83,,percent of total billed charges,,,,,,,,,,,,,,,163.43,83,,percent of total billed charges,,,187.06,95,,percent of total billed charges,,,177.21,90,,percent of total billed charges,,,177.21,90,,percent of total billed charges,,,161.46,82,,percent of total billed charges,,,177.21,90,,percent of total billed charges,,,167.37,85,,percent of total billed charges,,148.46,187.06,
TETRACYCLINE HCL CAP : 250MG,32009096,CDM,,,250,RC,inpatient,,2.1,2.1,,1.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1.85,88,,percent of total billed charges,,,,,,,,,1.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1.91,91,,percent of total billed charges,,,2,95,,percent of total billed charges,,,1.74,83,,percent of total billed charges,,,1.74,83,,percent of total billed charges,,,,,,,,,,,,,,,1.74,83,,percent of total billed charges,,,2,95,,percent of total billed charges,,,1.89,90,,percent of total billed charges,,,1.89,90,,percent of total billed charges,,,1.72,82,,percent of total billed charges,,,1.89,90,,percent of total billed charges,,,1.79,85,,percent of total billed charges,,1.58,2,
THEOPHYLLINE(THEO-DUR)TAB:100MG,32009116,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
THEOPHYLLINE (THEO-DUR) TAB : 300MG,32009121,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
THEOPHYLLINE ANHYDROU SOL:80MG/15ML 30ML,32009126,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
THEOPHYLLINE (THEO-DUR) TAB : 200MG,32009136,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
THEOPHYLLINE ANHYDROU SOL:80MG/15ML 90ML,32009146,CDM,,,250,RC,inpatient,,13.8,13.8,,11.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.14,88,,percent of total billed charges,,,,,,,,,10.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.56,91,,percent of total billed charges,,,13.11,95,,percent of total billed charges,,,11.45,83,,percent of total billed charges,,,11.45,83,,percent of total billed charges,,,,,,,,,,,,,,,11.45,83,,percent of total billed charges,,,13.11,95,,percent of total billed charges,,,12.42,90,,percent of total billed charges,,,12.42,90,,percent of total billed charges,,,11.32,82,,percent of total billed charges,,,12.42,90,,percent of total billed charges,,,11.73,85,,percent of total billed charges,,10.41,13.11,
THEOPHYLLINE ANHYDR SOL:80MG/15ML 500ML,32009161,CDM,,,250,RC,inpatient,,76.76,76.76,,65.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,57.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.55,88,,percent of total billed charges,,,,,,,,,58.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,69.85,91,,percent of total billed charges,,,72.92,95,,percent of total billed charges,,,63.71,83,,percent of total billed charges,,,63.71,83,,percent of total billed charges,,,,,,,,,,,,,,,63.71,83,,percent of total billed charges,,,72.92,95,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,62.94,82,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,65.25,85,,percent of total billed charges,,57.88,72.92,
MULTIVITAMINS THERA TAB:,32009186,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
SODIUM CHLORIDE(SALT)TAB:1GM,32009196,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
THERAVITE (MULTIVITAMIN) 120ML,32009201,CDM,,,250,RC,inpatient,,53.77,53.77,,45.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47.32,88,,percent of total billed charges,,,,,,,,,41.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,48.93,91,,percent of total billed charges,,,51.08,95,,percent of total billed charges,,,44.63,83,,percent of total billed charges,,,44.63,83,,percent of total billed charges,,,,,,,,,,,,,,,44.63,83,,percent of total billed charges,,,51.08,95,,percent of total billed charges,,,48.39,90,,percent of total billed charges,,,48.39,90,,percent of total billed charges,,,44.09,82,,percent of total billed charges,,,48.39,90,,percent of total billed charges,,,45.7,85,,percent of total billed charges,,40.54,51.08,
SILVER SULFADIAZINE(SSD AF)CREAM 1%:50G,32009211,CDM,J3490,HCPCS,250,RC,inpatient,,114.05,114.05,,96.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,100.36,88,,percent of total billed charges,,,,,,,,,87.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,103.79,91,,percent of total billed charges,,,108.35,95,,percent of total billed charges,,,94.66,83,,percent of total billed charges,,,94.66,83,,percent of total billed charges,,,,,,,,,,,,,,,94.66,83,,percent of total billed charges,,,108.35,95,,percent of total billed charges,,,102.65,90,,percent of total billed charges,,,102.65,90,,percent of total billed charges,,,93.52,82,,percent of total billed charges,,,102.65,90,,percent of total billed charges,,,96.94,85,,percent of total billed charges,,85.99,108.35,
THIAMINE HCL VIAL:200MG/2ML,32009221,CDM,J3411,HCPCS,250,RC,inpatient,,80.56,80.56,,68.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.89,88,,percent of total billed charges,,2.88,,,,fee schedule,,,61.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.88,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.31,91,,percent of total billed charges,,,76.53,95,,percent of total billed charges,,,66.86,83,,percent of total billed charges,,,66.86,83,,percent of total billed charges,,,,,,,,,,,,,,,66.86,83,,percent of total billed charges,,,76.53,95,,percent of total billed charges,,,72.5,90,,percent of total billed charges,,,72.5,90,,percent of total billed charges,,,66.06,82,,percent of total billed charges,,,72.5,90,,percent of total billed charges,,,68.48,85,,percent of total billed charges,,2.88,76.53,
THIORIDAZINE (MELLARIL) TAB : 25MG,32009231,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
THIORIDAZINE (MELLARIL) TAB : 10MG,32009236,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
THIOTHIXENE 1 MG CAPS,32009247,CDM,,,250,RC,inpatient,,1,1,,0.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,0.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,0.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,0.88,88,,percent of total billed charges,,,,,,,,,0.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,0.91,91,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,,,,,,,,,,,,,0.83,83,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.82,82,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.85,85,,percent of total billed charges,,0.75,0.95,
THROMBIN VIAL 50000 UNIT:,32009257,CDM,,,250,RC,inpatient,,2217.01,2217.01,,1882.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1671.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1884.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1950.97,88,,percent of total billed charges,,,,,,,,,1693.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2017.48,91,,percent of total billed charges,,,2106.16,95,,percent of total billed charges,,,1840.12,83,,percent of total billed charges,,,1840.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1840.12,83,,percent of total billed charges,,,2106.16,95,,percent of total billed charges,,,1995.31,90,,percent of total billed charges,,,1995.31,90,,percent of total billed charges,,,1817.95,82,,percent of total billed charges,,,1995.31,90,,percent of total billed charges,,,1884.46,85,,percent of total billed charges,,1671.63,2106.16,
LIOTRIX (THYROLAR-1) TAB : 60MG,32009261,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
TICLOPIDINE (TICLID) TAB : 250MG,32009271,CDM,,,250,RC,inpatient,,21.57,21.57,,18.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.98,88,,percent of total billed charges,,,,,,,,,16.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.63,91,,percent of total billed charges,,,20.49,95,,percent of total billed charges,,,17.9,83,,percent of total billed charges,,,17.9,83,,percent of total billed charges,,,,,,,,,,,,,,,17.9,83,,percent of total billed charges,,,20.49,95,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,17.69,82,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,18.33,85,,percent of total billed charges,,16.26,20.49,
NEDOCROMIL(TILADE)AER:1.75MG  (16.2GM),32009276,CDM,,,250,RC,inpatient,,1213.5,1213.5,,1030.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,914.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1031.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1067.88,88,,percent of total billed charges,,,,,,,,,927.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1104.29,91,,percent of total billed charges,,,1152.83,95,,percent of total billed charges,,,1007.21,83,,percent of total billed charges,,,1007.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1007.21,83,,percent of total billed charges,,,1152.83,95,,percent of total billed charges,,,1092.15,90,,percent of total billed charges,,,1092.15,90,,percent of total billed charges,,,995.07,82,,percent of total billed charges,,,1092.15,90,,percent of total billed charges,,,1031.48,85,,percent of total billed charges,,914.98,1152.83,
TIMOLOL (BLOCADREN) TAB : 10MG,32009286,CDM,,,250,RC,inpatient,,22.68,22.68,,19.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.96,88,,percent of total billed charges,,,,,,,,,17.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.64,91,,percent of total billed charges,,,21.55,95,,percent of total billed charges,,,18.82,83,,percent of total billed charges,,,18.82,83,,percent of total billed charges,,,,,,,,,,,,,,,18.82,83,,percent of total billed charges,,,21.55,95,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,18.6,82,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,19.28,85,,percent of total billed charges,,17.1,21.55,
TIMOLOL(TIMOPTIC)DROP 0.25%:5ML,32009291,CDM,J3490,HCPCS,250,RC,inpatient,,50.43,50.43,,42.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.38,88,,percent of total billed charges,,,,,,,,,38.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.89,91,,percent of total billed charges,,,47.91,95,,percent of total billed charges,,,41.86,83,,percent of total billed charges,,,41.86,83,,percent of total billed charges,,,,,,,,,,,,,,,41.86,83,,percent of total billed charges,,,47.91,95,,percent of total billed charges,,,45.39,90,,percent of total billed charges,,,45.39,90,,percent of total billed charges,,,41.35,82,,percent of total billed charges,,,45.39,90,,percent of total billed charges,,,42.87,85,,percent of total billed charges,,38.02,47.91,
TIMOPTIC XE 0.25% 10ML,32009292,CDM,,,250,RC,inpatient,,37.5,37.5,,31.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33,88,,percent of total billed charges,,,,,,,,,28.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34.13,91,,percent of total billed charges,,,35.63,95,,percent of total billed charges,,,31.13,83,,percent of total billed charges,,,31.13,83,,percent of total billed charges,,,,,,,,,,,,,,,31.13,83,,percent of total billed charges,,,35.63,95,,percent of total billed charges,,,33.75,90,,percent of total billed charges,,,33.75,90,,percent of total billed charges,,,30.75,82,,percent of total billed charges,,,33.75,90,,percent of total billed charges,,,31.88,85,,percent of total billed charges,,28.28,35.63,
TIMOLOL(TIMOPTIC)DROP 0.5%:5ML,32009296,CDM,J3490,HCPCS,250,RC,inpatient,,165.52,165.52,,140.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,124.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,140.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,145.66,88,,percent of total billed charges,,,,,,,,,126.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,150.62,91,,percent of total billed charges,,,157.24,95,,percent of total billed charges,,,137.38,83,,percent of total billed charges,,,137.38,83,,percent of total billed charges,,,,,,,,,,,,,,,137.38,83,,percent of total billed charges,,,157.24,95,,percent of total billed charges,,,148.97,90,,percent of total billed charges,,,148.97,90,,percent of total billed charges,,,135.73,82,,percent of total billed charges,,,148.97,90,,percent of total billed charges,,,140.69,85,,percent of total billed charges,,124.8,157.24,
TINCTURE OF BENZOIN,32009302,CDM,,,250,RC,inpatient,,8.75,8.75,,7.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.7,88,,percent of total billed charges,,,,,,,,,6.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.96,91,,percent of total billed charges,,,8.31,95,,percent of total billed charges,,,7.26,83,,percent of total billed charges,,,7.26,83,,percent of total billed charges,,,,,,,,,,,,,,,7.26,83,,percent of total billed charges,,,8.31,95,,percent of total billed charges,,,7.88,90,,percent of total billed charges,,,7.88,90,,percent of total billed charges,,,7.18,82,,percent of total billed charges,,,7.88,90,,percent of total billed charges,,,7.44,85,,percent of total billed charges,,6.6,8.31,
TENECTEPLASE(TNKase)KIT:50MG,32009303,CDM,J3101,HCPCS,636,RC,inpatient,,29384.1,29384.1,,24947.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22155.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24976.49,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25858.01,88,,percent of total billed charges,,7193.6,,,,fee schedule,,,22449.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7193.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26739.53,91,,percent of total billed charges,,,27914.9,95,,percent of total billed charges,,,24388.8,83,,percent of total billed charges,,,24388.8,83,,percent of total billed charges,,,,,,,,,,,,,,,24388.8,83,,percent of total billed charges,,,27914.9,95,,percent of total billed charges,,,26445.69,90,,percent of total billed charges,,,26445.69,90,,percent of total billed charges,,,24094.96,82,,percent of total billed charges,,,26445.69,90,,percent of total billed charges,,,24976.49,85,,percent of total billed charges,,7193.6,27914.9,
TOBRAMYCIN-VIAL:80MG/2ML,32009306,CDM,J3260,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,20.81,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,20.81,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,20.81,60.99,
TOBRAMYCIN(TOBREX)OINT 0.3%:3.5GM,32009311,CDM,,,250,RC,inpatient,,3025.08,3025.08,,2568.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2280.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2571.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2662.07,88,,percent of total billed charges,,,,,,,,,2311.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2752.82,91,,percent of total billed charges,,,2873.83,95,,percent of total billed charges,,,2510.82,83,,percent of total billed charges,,,2510.82,83,,percent of total billed charges,,,,,,,,,,,,,,,2510.82,83,,percent of total billed charges,,,2873.83,95,,percent of total billed charges,,,2722.57,90,,percent of total billed charges,,,2722.57,90,,percent of total billed charges,,,2480.57,82,,percent of total billed charges,,,2722.57,90,,percent of total billed charges,,,2571.32,85,,percent of total billed charges,,2280.91,2873.83,
TOBRAMYCIN(TOBREX)DROP 0.3%:5ML,32009316,CDM,J3490,HCPCS,250,RC,inpatient,,123.04,123.04,,104.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,92.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,104.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,108.28,88,,percent of total billed charges,,,,,,,,,94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.97,91,,percent of total billed charges,,,116.89,95,,percent of total billed charges,,,102.12,83,,percent of total billed charges,,,102.12,83,,percent of total billed charges,,,,,,,,,,,,,,,102.12,83,,percent of total billed charges,,,116.89,95,,percent of total billed charges,,,110.74,90,,percent of total billed charges,,,110.74,90,,percent of total billed charges,,,100.89,82,,percent of total billed charges,,,110.74,90,,percent of total billed charges,,,104.58,85,,percent of total billed charges,,92.77,116.89,
TOBRA/DEX(TOBRADEX)DROP 0.3-0.1%:5ML,32009321,CDM,J3490,HCPCS,250,RC,inpatient,,1797.68,1797.68,,1526.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1355.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1528.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1581.96,88,,percent of total billed charges,,,,,,,,,1373.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1635.89,91,,percent of total billed charges,,,1707.8,95,,percent of total billed charges,,,1492.07,83,,percent of total billed charges,,,1492.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1492.07,83,,percent of total billed charges,,,1707.8,95,,percent of total billed charges,,,1617.91,90,,percent of total billed charges,,,1617.91,90,,percent of total billed charges,,,1474.1,82,,percent of total billed charges,,,1617.91,90,,percent of total billed charges,,,1528.03,85,,percent of total billed charges,,1355.45,1707.8,
TOBRA/DEX(TOBRADEX)OINT 0.3-0.1%:3.5GM,32009326,CDM,J3490,HCPCS,250,RC,inpatient,,3250.19,3250.19,,2759.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2450.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2762.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2860.17,88,,percent of total billed charges,,,,,,,,,2483.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2957.67,91,,percent of total billed charges,,,3087.68,95,,percent of total billed charges,,,2697.66,83,,percent of total billed charges,,,2697.66,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.66,83,,percent of total billed charges,,,3087.68,95,,percent of total billed charges,,,2925.17,90,,percent of total billed charges,,,2925.17,90,,percent of total billed charges,,,2665.16,82,,percent of total billed charges,,,2925.17,90,,percent of total billed charges,,,2762.66,85,,percent of total billed charges,,2450.64,3087.68,
TOLAZAMIDE (TOLINASE) TAB : 100MG,32009336,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
TOLAZAMIDE (TOLINASE) TAB : 250MG,32009341,CDM,,,250,RC,inpatient,,30.77,30.77,,26.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.08,88,,percent of total billed charges,,,,,,,,,23.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28,91,,percent of total billed charges,,,29.23,95,,percent of total billed charges,,,25.54,83,,percent of total billed charges,,,25.54,83,,percent of total billed charges,,,,,,,,,,,,,,,25.54,83,,percent of total billed charges,,,29.23,95,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,25.23,82,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,26.15,85,,percent of total billed charges,,23.2,29.23,
TOLBUTamide(ORINASE)TAB:500MG,32009346,CDM,,,250,RC,inpatient,,15.7,15.7,,13.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.82,88,,percent of total billed charges,,,,,,,,,11.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.29,91,,percent of total billed charges,,,14.92,95,,percent of total billed charges,,,13.03,83,,percent of total billed charges,,,13.03,83,,percent of total billed charges,,,,,,,,,,,,,,,13.03,83,,percent of total billed charges,,,14.92,95,,percent of total billed charges,,,14.13,90,,percent of total billed charges,,,14.13,90,,percent of total billed charges,,,12.87,82,,percent of total billed charges,,,14.13,90,,percent of total billed charges,,,13.35,85,,percent of total billed charges,,11.84,14.92,
DESOXIMETASONE OINT (TOPICORT) : 0.25%,32009371,CDM,,,250,RC,inpatient,,217.12,217.12,,184.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,163.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,184.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,191.07,88,,percent of total billed charges,,,,,,,,,165.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,197.58,91,,percent of total billed charges,,,206.26,95,,percent of total billed charges,,,180.21,83,,percent of total billed charges,,,180.21,83,,percent of total billed charges,,,,,,,,,,,,,,,180.21,83,,percent of total billed charges,,,206.26,95,,percent of total billed charges,,,195.41,90,,percent of total billed charges,,,195.41,90,,percent of total billed charges,,,178.04,82,,percent of total billed charges,,,195.41,90,,percent of total billed charges,,,184.55,85,,percent of total billed charges,,163.71,206.26,
DESOXIMETASONE GEL(TOPICORT)0.05%:,32009376,CDM,,,250,RC,inpatient,,781.74,781.74,,663.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,589.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,664.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,687.93,88,,percent of total billed charges,,,,,,,,,597.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,711.38,91,,percent of total billed charges,,,742.65,95,,percent of total billed charges,,,648.84,83,,percent of total billed charges,,,648.84,83,,percent of total billed charges,,,,,,,,,,,,,,,648.84,83,,percent of total billed charges,,,742.65,95,,percent of total billed charges,,,703.57,90,,percent of total billed charges,,,703.57,90,,percent of total billed charges,,,641.03,82,,percent of total billed charges,,,703.57,90,,percent of total billed charges,,,664.48,85,,percent of total billed charges,,589.43,742.65,
metoPROLOL SUCC(TOPROL XL)TAB:50MG,32009377,CDM,J8499,HCPCS,250,RC,inpatient,,15.36,15.36,,13.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.52,88,,percent of total billed charges,,,,,,,,,11.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.98,91,,percent of total billed charges,,,14.59,95,,percent of total billed charges,,,12.75,83,,percent of total billed charges,,,12.75,83,,percent of total billed charges,,,,,,,,,,,,,,,12.75,83,,percent of total billed charges,,,14.59,95,,percent of total billed charges,,,13.82,90,,percent of total billed charges,,,13.82,90,,percent of total billed charges,,,12.6,82,,percent of total billed charges,,,13.82,90,,percent of total billed charges,,,13.06,85,,percent of total billed charges,,11.58,14.59,
KETOROLAC(TORADOL)TAB:10MG,32009381,CDM,J8499,HCPCS,250,RC,inpatient,,14.54,14.54,,12.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.8,88,,percent of total billed charges,,,,,,,,,11.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.23,91,,percent of total billed charges,,,13.81,95,,percent of total billed charges,,,12.07,83,,percent of total billed charges,,,12.07,83,,percent of total billed charges,,,,,,,,,,,,,,,12.07,83,,percent of total billed charges,,,13.81,95,,percent of total billed charges,,,13.09,90,,percent of total billed charges,,,13.09,90,,percent of total billed charges,,,11.92,82,,percent of total billed charges,,,13.09,90,,percent of total billed charges,,,12.36,85,,percent of total billed charges,,10.96,13.81,
KETOROLAC (TORADOL) TAB: 10MG (1X10),32009382,CDM,,,250,RC,inpatient,,149.24,149.24,,126.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,112.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,126.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,131.33,88,,percent of total billed charges,,,,,,,,,114.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,135.81,91,,percent of total billed charges,,,141.78,95,,percent of total billed charges,,,123.87,83,,percent of total billed charges,,,123.87,83,,percent of total billed charges,,,,,,,,,,,,,,,123.87,83,,percent of total billed charges,,,141.78,95,,percent of total billed charges,,,134.32,90,,percent of total billed charges,,,134.32,90,,percent of total billed charges,,,122.38,82,,percent of total billed charges,,,134.32,90,,percent of total billed charges,,,126.85,85,,percent of total billed charges,,112.53,141.78,
KETOROLAC(TORADOL)VL:15MG/ML,32009386,CDM,J1885,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,2.54,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.54,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,2.54,60.99,
LABETALOL (TRANDATE) TAB : 200MG,32009421,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
LABETALOL(TRANDATE)TAB:100MG,32009426,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
SCOPOLAM(TRANSDERM SCOP)PAT 1MG/72HR:,32009431,CDM,J3490,HCPCS,250,RC,inpatient,,321.08,321.08,,272.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,272.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,282.55,88,,percent of total billed charges,,,,,,,,,245.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,292.18,91,,percent of total billed charges,,,305.03,95,,percent of total billed charges,,,266.5,83,,percent of total billed charges,,,266.5,83,,percent of total billed charges,,,,,,,,,,,,,,,266.5,83,,percent of total billed charges,,,305.03,95,,percent of total billed charges,,,288.97,90,,percent of total billed charges,,,288.97,90,,percent of total billed charges,,,263.29,82,,percent of total billed charges,,,288.97,90,,percent of total billed charges,,,272.92,85,,percent of total billed charges,,242.09,305.03,
LABETALOL(TRANDATE)VIAL:100MG/20ML,32009436,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
traZODone(DESERYL)TAB:50MG,32009441,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PENTOXIFYLLINE(TRENtal) ER TAB:400MG,32009446,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
TRIAMCINOLONE(KENALOG) 0.1% CRM:15GM,32009456,CDM,J3490,HCPCS,250,RC,inpatient,,29.74,29.74,,25.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.17,88,,percent of total billed charges,,,,,,,,,22.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27.06,91,,percent of total billed charges,,,28.25,95,,percent of total billed charges,,,24.68,83,,percent of total billed charges,,,24.68,83,,percent of total billed charges,,,,,,,,,,,,,,,24.68,83,,percent of total billed charges,,,28.25,95,,percent of total billed charges,,,26.77,90,,percent of total billed charges,,,26.77,90,,percent of total billed charges,,,24.39,82,,percent of total billed charges,,,26.77,90,,percent of total billed charges,,,25.28,85,,percent of total billed charges,,22.42,28.25,
TRIAMCINOLONE 0.1% CREAM,32009457,CDM,,,250,RC,inpatient,,74.38,74.38,,63.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,63.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,65.45,88,,percent of total billed charges,,,,,,,,,56.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,67.69,91,,percent of total billed charges,,,70.66,95,,percent of total billed charges,,,61.74,83,,percent of total billed charges,,,61.74,83,,percent of total billed charges,,,,,,,,,,,,,,,61.74,83,,percent of total billed charges,,,70.66,95,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,60.99,82,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,63.22,85,,percent of total billed charges,,56.08,70.66,
TRIAMCINOLONE(KENALOG)PASTE 0.1%:5GM,32009461,CDM,J3490,HCPCS,250,RC,inpatient,,489.28,489.28,,415.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,368.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,415.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,430.57,88,,percent of total billed charges,,,,,,,,,373.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,445.24,91,,percent of total billed charges,,,464.82,95,,percent of total billed charges,,,406.1,83,,percent of total billed charges,,,406.1,83,,percent of total billed charges,,,,,,,,,,,,,,,406.1,83,,percent of total billed charges,,,464.82,95,,percent of total billed charges,,,440.35,90,,percent of total billed charges,,,440.35,90,,percent of total billed charges,,,401.21,82,,percent of total billed charges,,,440.35,90,,percent of total billed charges,,,415.89,85,,percent of total billed charges,,368.92,464.82,
TRIAMCINOLONE(KENALOG) VIAL:40MG/ML,32009481,CDM,J3301,HCPCS,250,RC,inpatient,,158.17,158.17,,134.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,134.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.19,88,,percent of total billed charges,,17.47,,,,fee schedule,,,120.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,17.47,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,143.93,91,,percent of total billed charges,,,150.26,95,,percent of total billed charges,,,131.28,83,,percent of total billed charges,,,131.28,83,,percent of total billed charges,,,,,,,,,,,,,,,131.28,83,,percent of total billed charges,,,150.26,95,,percent of total billed charges,,,142.35,90,,percent of total billed charges,,,142.35,90,,percent of total billed charges,,,129.7,82,,percent of total billed charges,,,142.35,90,,percent of total billed charges,,,134.44,85,,percent of total billed charges,,17.47,150.26,
TRIAMCINOLONE(KENALOG)VIAL:50MG/5ML,32009482,CDM,J3301,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,17.47,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,17.47,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,17.47,59.21,
TRIAMTERENE/HCTZ(MAXZIDE) TAB : 75-50MG,32009486,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
TRIAMTERENE/HCTZ(DYAZIDE)CAP:50MG-25MG,32009487,CDM,,,250,RC,inpatient,,27.6,27.6,,23.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.29,88,,percent of total billed charges,,,,,,,,,21.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.12,91,,percent of total billed charges,,,26.22,95,,percent of total billed charges,,,22.91,83,,percent of total billed charges,,,22.91,83,,percent of total billed charges,,,,,,,,,,,,,,,22.91,83,,percent of total billed charges,,,26.22,95,,percent of total billed charges,,,24.84,90,,percent of total billed charges,,,24.84,90,,percent of total billed charges,,,22.63,82,,percent of total billed charges,,,24.84,90,,percent of total billed charges,,,23.46,85,,percent of total billed charges,,20.81,26.22,
TRIAZOLAM TAB : 0.25MG,32009491,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
TRIFLURIDINE (VIROPTIC) DROP : 1% 7.5ML,32009522,CDM,,,250,RC,inpatient,,2141.13,2141.13,,1817.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1614.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1819.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1884.19,88,,percent of total billed charges,,,,,,,,,1635.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1948.43,91,,percent of total billed charges,,,2034.07,95,,percent of total billed charges,,,1777.14,83,,percent of total billed charges,,,1777.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1777.14,83,,percent of total billed charges,,,2034.07,95,,percent of total billed charges,,,1927.02,90,,percent of total billed charges,,,1927.02,90,,percent of total billed charges,,,1755.73,82,,percent of total billed charges,,,1927.02,90,,percent of total billed charges,,,1819.96,85,,percent of total billed charges,,1614.41,2034.07,
TRIHEXYPHENIDYL(ARTANE)TAB:2MG,32009526,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
TRIMETHOBENZAMIDE (TIGAN)    CAP : 250MG,32009531,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
AMOXicillin(AMOXIL)DROP:50MG/ML (15ML),32009536,CDM,J8499,HCPCS,250,RC,inpatient,,21.89,21.89,,18.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.26,88,,percent of total billed charges,,,,,,,,,16.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.92,91,,percent of total billed charges,,,20.8,95,,percent of total billed charges,,,18.17,83,,percent of total billed charges,,,18.17,83,,percent of total billed charges,,,,,,,,,,,,,,,18.17,83,,percent of total billed charges,,,20.8,95,,percent of total billed charges,,,19.7,90,,percent of total billed charges,,,19.7,90,,percent of total billed charges,,,17.95,82,,percent of total billed charges,,,19.7,90,,percent of total billed charges,,,18.61,85,,percent of total billed charges,,16.51,20.8,
AMOXicillin(AMOXIL)CAP:500MG,32009541,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
AMOXicillin(AMOXIL)CAP: 500MG (1X6),32009542,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
AMOXicillin(AMOXIL)SUS 125MG/5ML(100ML),32009546,CDM,J8499,HCPCS,250,RC,inpatient,,22.88,22.88,,19.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.13,88,,percent of total billed charges,,,,,,,,,17.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.82,91,,percent of total billed charges,,,21.74,95,,percent of total billed charges,,,18.99,83,,percent of total billed charges,,,18.99,83,,percent of total billed charges,,,,,,,,,,,,,,,18.99,83,,percent of total billed charges,,,21.74,95,,percent of total billed charges,,,20.59,90,,percent of total billed charges,,,20.59,90,,percent of total billed charges,,,18.76,82,,percent of total billed charges,,,20.59,90,,percent of total billed charges,,,19.45,85,,percent of total billed charges,,17.25,21.74,
AMOXicillin(AMOXIL)SUS 250MG/5ML(100ML),32009551,CDM,J8499,HCPCS,250,RC,inpatient,,29.25,29.25,,24.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.74,88,,percent of total billed charges,,,,,,,,,22.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.62,91,,percent of total billed charges,,,27.79,95,,percent of total billed charges,,,24.28,83,,percent of total billed charges,,,24.28,83,,percent of total billed charges,,,,,,,,,,,,,,,24.28,83,,percent of total billed charges,,,27.79,95,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,23.99,82,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,24.86,85,,percent of total billed charges,,22.05,27.79,
AMOXicillin(AMOXIL)CAP:250MG,32009556,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
AMOXicllin CAP:250MG (1X6),32009557,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
TRIMETHOBENZ(TIGAN) VIAL: 100MG/ML 20ML,32009561,CDM,,,250,RC,inpatient,,35,35,,29.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.8,88,,percent of total billed charges,,,,,,,,,26.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31.85,91,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,,,,,,,,,,,,,29.05,83,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,28.7,82,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,26.39,33.25,
TRIMETHOPRIM (TRIMPEX) TAB : 100MG,32009566,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
PSEUDOPHD SULF/AZAT(TRINALIN)TAB:120-1MG,32009567,CDM,,,250,RC,inpatient,,19.19,19.19,,16.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16.89,88,,percent of total billed charges,,,,,,,,,14.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.46,91,,percent of total billed charges,,,18.23,95,,percent of total billed charges,,,15.93,83,,percent of total billed charges,,,15.93,83,,percent of total billed charges,,,,,,,,,,,,,,,15.93,83,,percent of total billed charges,,,18.23,95,,percent of total billed charges,,,17.27,90,,percent of total billed charges,,,17.27,90,,percent of total billed charges,,,15.74,82,,percent of total billed charges,,,17.27,90,,percent of total billed charges,,,16.31,85,,percent of total billed charges,,14.47,18.23,
NEO/BACI/POLYB(NEOSPORIN)ABX OINT:PKT,32009586,CDM,J3490,HCPCS,250,RC,inpatient,UD,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,15.28,19.26,
TROVAN 100MG TABS,32009617,CDM,,,250,RC,inpatient,,23.5,23.5,,19.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.68,88,,percent of total billed charges,,,,,,,,,17.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.39,91,,percent of total billed charges,,,22.33,95,,percent of total billed charges,,,19.51,83,,percent of total billed charges,,,19.51,83,,percent of total billed charges,,,,,,,,,,,,,,,19.51,83,,percent of total billed charges,,,22.33,95,,percent of total billed charges,,,21.15,90,,percent of total billed charges,,,21.15,90,,percent of total billed charges,,,19.27,82,,percent of total billed charges,,,21.15,90,,percent of total billed charges,,,19.98,85,,percent of total billed charges,,17.72,22.33,
DORZOLAMIDE(TRUSOPT)DROP 2%:10ML,32009621,CDM,J3490,HCPCS,250,RC,inpatient,,466.92,466.92,,396.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,352.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.89,88,,percent of total billed charges,,,,,,,,,356.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.9,91,,percent of total billed charges,,,443.57,95,,percent of total billed charges,,,387.54,83,,percent of total billed charges,,,387.54,83,,percent of total billed charges,,,,,,,,,,,,,,,387.54,83,,percent of total billed charges,,,443.57,95,,percent of total billed charges,,,420.23,90,,percent of total billed charges,,,420.23,90,,percent of total billed charges,,,382.87,82,,percent of total billed charges,,,420.23,90,,percent of total billed charges,,,396.88,85,,percent of total billed charges,,352.06,443.57,
TUBOCURARINE(QUELICIN) VIAL: 3MG/ML 10ML,32009636,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
GLYCERIN/WITCH(TUCKS)HAZEL LEAF PAD'S:,32009641,CDM,J3490,HCPCS,250,RC,inpatient,,49.51,49.51,,42.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,37.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,42.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,43.57,88,,percent of total billed charges,,,,,,,,,37.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,45.05,91,,percent of total billed charges,,,47.03,95,,percent of total billed charges,,,41.09,83,,percent of total billed charges,,,41.09,83,,percent of total billed charges,,,,,,,,,,,,,,,41.09,83,,percent of total billed charges,,,47.03,95,,percent of total billed charges,,,44.56,90,,percent of total billed charges,,,44.56,90,,percent of total billed charges,,,40.6,82,,percent of total billed charges,,,44.56,90,,percent of total billed charges,,,42.08,85,,percent of total billed charges,,37.33,47.03,
ALLANTOIN/ONION/PEGS/WATER(MEDERMA)GEL:,32009642,CDM,,,250,RC,inpatient,,241.71,241.71,,205.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,182.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,205.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,212.7,88,,percent of total billed charges,,,,,,,,,184.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,219.96,91,,percent of total billed charges,,,229.62,95,,percent of total billed charges,,,200.62,83,,percent of total billed charges,,,200.62,83,,percent of total billed charges,,,,,,,,,,,,,,,200.62,83,,percent of total billed charges,,,229.62,95,,percent of total billed charges,,,217.54,90,,percent of total billed charges,,,217.54,90,,percent of total billed charges,,,198.2,82,,percent of total billed charges,,,217.54,90,,percent of total billed charges,,,205.45,85,,percent of total billed charges,,182.25,229.62,
HYDROCODONE/PHENYL (TUSSIONEX) ORAL 90ML,32009666,CDM,,,250,RC,inpatient,,124.66,124.66,,105.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,93.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,105.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,109.7,88,,percent of total billed charges,,,,,,,,,95.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,113.44,91,,percent of total billed charges,,,118.43,95,,percent of total billed charges,,,103.47,83,,percent of total billed charges,,,103.47,83,,percent of total billed charges,,,,,,,,,,,,,,,103.47,83,,percent of total billed charges,,,118.43,95,,percent of total billed charges,,,112.19,90,,percent of total billed charges,,,112.19,90,,percent of total billed charges,,,102.22,82,,percent of total billed charges,,,112.19,90,,percent of total billed charges,,,105.96,85,,percent of total billed charges,,93.99,118.43,
HYDROcod/PHENYL(TUSSIONEX)ORAL:5ML,32009671,CDM,,,250,RC,inpatient,,40.13,40.13,,34.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.31,88,,percent of total billed charges,,,,,,,,,30.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.52,91,,percent of total billed charges,,,38.12,95,,percent of total billed charges,,,33.31,83,,percent of total billed charges,,,33.31,83,,percent of total billed charges,,,,,,,,,,,,,,,33.31,83,,percent of total billed charges,,,38.12,95,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,32.91,82,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,34.11,85,,percent of total billed charges,,30.26,38.12,
HYDROCODONE/PHENYL (TUSSIONEX) ORAL 60ML,32009676,CDM,,,250,RC,inpatient,,83.11,83.11,,70.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.14,88,,percent of total billed charges,,,,,,,,,63.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.63,91,,percent of total billed charges,,,78.95,95,,percent of total billed charges,,,68.98,83,,percent of total billed charges,,,68.98,83,,percent of total billed charges,,,,,,,,,,,,,,,68.98,83,,percent of total billed charges,,,78.95,95,,percent of total billed charges,,,74.8,90,,percent of total billed charges,,,74.8,90,,percent of total billed charges,,,68.15,82,,percent of total billed charges,,,74.8,90,,percent of total billed charges,,,70.64,85,,percent of total billed charges,,62.66,78.95,
ACETAMINOPHEN (TYLENOL) TAB : 325MG #50,32009747,CDM,,,250,RC,inpatient,,33.31,33.31,,28.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.31,88,,percent of total billed charges,,,,,,,,,25.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.31,91,,percent of total billed charges,,,31.64,95,,percent of total billed charges,,,27.65,83,,percent of total billed charges,,,27.65,83,,percent of total billed charges,,,,,,,,,,,,,,,27.65,83,,percent of total billed charges,,,31.64,95,,percent of total billed charges,,,29.98,90,,percent of total billed charges,,,29.98,90,,percent of total billed charges,,,27.31,82,,percent of total billed charges,,,29.98,90,,percent of total billed charges,,,28.31,85,,percent of total billed charges,,25.12,31.64,
ACETAMINOPHEN(TYLENOL)TAB:80MG,32009751,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
COD/APAP(TYLENOL+COD):12-120MG/5 (60ML),32009756,CDM,J8499,HCPCS,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
COD/APAP(TYLENOL/COD): 12-120MG/5 90ML,32009761,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
TYLENOL ES 500MG GELCAPS,32009772,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
OXYCODONE/ACETAMIN (TYLOX) CAP : 5-500MG,32009781,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
ACETAMINOPHEN(TYLENOL)DRP:100MG/ML(15ML),32009786,CDM,J8499,HCPCS,250,RC,inpatient,,35.21,35.21,,29.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.98,88,,percent of total billed charges,,,,,,,,,26.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.04,91,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,,,,,,,,,,,,,29.22,83,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,28.87,82,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,29.93,85,,percent of total billed charges,,26.55,33.45,
traMADol(ULTRAM)TAB:50MG,32009791,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
AMPicil/SULB(UNASYN):1.5GM,32009796,CDM,J0295,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,5.26,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.26,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,5.26,60.99,
MOEXIPRIL HCL (UNIVASC) TAB : 7.5MG,32009797,CDM,,,250,RC,inpatient,,43.3,43.3,,36.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,32.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,36.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.1,88,,percent of total billed charges,,,,,,,,,33.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,39.4,91,,percent of total billed charges,,,41.14,95,,percent of total billed charges,,,35.94,83,,percent of total billed charges,,,35.94,83,,percent of total billed charges,,,,,,,,,,,,,,,35.94,83,,percent of total billed charges,,,41.14,95,,percent of total billed charges,,,38.97,90,,percent of total billed charges,,,38.97,90,,percent of total billed charges,,,35.51,82,,percent of total billed charges,,,38.97,90,,percent of total billed charges,,,36.81,85,,percent of total billed charges,,32.65,41.14,
MOEXIPRIL HCL (UNIVASC) TAB : 15MG,32009798,CDM,,,250,RC,inpatient,,45.36,45.36,,38.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39.92,88,,percent of total billed charges,,,,,,,,,34.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.28,91,,percent of total billed charges,,,43.09,95,,percent of total billed charges,,,37.65,83,,percent of total billed charges,,,37.65,83,,percent of total billed charges,,,,,,,,,,,,,,,37.65,83,,percent of total billed charges,,,43.09,95,,percent of total billed charges,,,40.82,90,,percent of total billed charges,,,40.82,90,,percent of total billed charges,,,37.2,82,,percent of total billed charges,,,40.82,90,,percent of total billed charges,,,38.56,85,,percent of total billed charges,,34.2,43.09,
AMPicil/SULB(UNASYN):3GM,32009801,CDM,J0295,HCPCS,250,RC,inpatient,,140.2,140.2,,119.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,105.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,119.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,123.38,88,,percent of total billed charges,,5.26,,,,fee schedule,,,107.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.26,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,127.58,91,,percent of total billed charges,,,133.19,95,,percent of total billed charges,,,116.37,83,,percent of total billed charges,,,116.37,83,,percent of total billed charges,,,,,,,,,,,,,,,116.37,83,,percent of total billed charges,,,133.19,95,,percent of total billed charges,,,126.18,90,,percent of total billed charges,,,126.18,90,,percent of total billed charges,,,114.96,82,,percent of total billed charges,,,126.18,90,,percent of total billed charges,,,119.17,85,,percent of total billed charges,,5.26,133.19,
flavoxATE(URISPAS)TAB:100MG,32009816,CDM,,,250,RC,inpatient,,18.4,18.4,,15.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.64,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16.19,88,,percent of total billed charges,,,,,,,,,14.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.74,91,,percent of total billed charges,,,17.48,95,,percent of total billed charges,,,15.27,83,,percent of total billed charges,,,15.27,83,,percent of total billed charges,,,,,,,,,,,,,,,15.27,83,,percent of total billed charges,,,17.48,95,,percent of total billed charges,,,16.56,90,,percent of total billed charges,,,16.56,90,,percent of total billed charges,,,15.09,82,,percent of total billed charges,,,16.56,90,,percent of total billed charges,,,15.64,85,,percent of total billed charges,,13.87,17.48,
VANCOMYCIN-VIAL:500 MG **OPTH USE,32009818,CDM,J3370,HCPCS,250,RC,inpatient,,40.25,40.25,,34.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.42,88,,percent of total billed charges,,19.39,,,,fee schedule,,,30.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.39,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.63,91,,percent of total billed charges,,,38.24,95,,percent of total billed charges,,,33.41,83,,percent of total billed charges,,,33.41,83,,percent of total billed charges,,,,,,,,,,,,,,,33.41,83,,percent of total billed charges,,,38.24,95,,percent of total billed charges,,,36.23,90,,percent of total billed charges,,,36.23,90,,percent of total billed charges,,,33.01,82,,percent of total billed charges,,,36.23,90,,percent of total billed charges,,,34.21,85,,percent of total billed charges,,19.39,38.24,
VALPROATE(DEPAKENE)SYRP:250MG/5ML (90ML),32009819,CDM,J8499,HCPCS,250,RC,inpatient,,1346.28,1346.28,,1142.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1015.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1144.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1184.73,88,,percent of total billed charges,,,,,,,,,1028.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1225.11,91,,percent of total billed charges,,,1278.97,95,,percent of total billed charges,,,1117.41,83,,percent of total billed charges,,,1117.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1117.41,83,,percent of total billed charges,,,1278.97,95,,percent of total billed charges,,,1211.65,90,,percent of total billed charges,,,1211.65,90,,percent of total billed charges,,,1103.95,82,,percent of total billed charges,,,1211.65,90,,percent of total billed charges,,,1144.34,85,,percent of total billed charges,,1015.1,1278.97,
VANCOMYCIN HCL VIAL : 500MG,32009821,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
VANCOMYCIN HCL (VANCOCIN) CAP 125MG,32009827,CDM,J8499,HCPCS,250,RC,inpatient,,18.79,18.79,,15.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16.54,88,,percent of total billed charges,,,,,,,,,14.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.1,91,,percent of total billed charges,,,17.85,95,,percent of total billed charges,,,15.6,83,,percent of total billed charges,,,15.6,83,,percent of total billed charges,,,,,,,,,,,,,,,15.6,83,,percent of total billed charges,,,17.85,95,,percent of total billed charges,,,16.91,90,,percent of total billed charges,,,16.91,90,,percent of total billed charges,,,15.41,82,,percent of total billed charges,,,16.91,90,,percent of total billed charges,,,15.97,85,,percent of total billed charges,,14.17,17.85,
CEFPODOXIME(VANTIN) SUSP :50MG/5ML 100ML,32009841,CDM,,,250,RC,inpatient,,763.39,763.39,,648.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,575.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,648.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,671.78,88,,percent of total billed charges,,,,,,,,,583.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,694.68,91,,percent of total billed charges,,,725.22,95,,percent of total billed charges,,,633.61,83,,percent of total billed charges,,,633.61,83,,percent of total billed charges,,,,,,,,,,,,,,,633.61,83,,percent of total billed charges,,,725.22,95,,percent of total billed charges,,,687.05,90,,percent of total billed charges,,,687.05,90,,percent of total billed charges,,,625.98,82,,percent of total billed charges,,,687.05,90,,percent of total billed charges,,,648.88,85,,percent of total billed charges,,575.6,725.22,
VANTIN ORAL SUSP 50MG/5ML 50ML,32009842,CDM,,,250,RC,inpatient,,61.5,61.5,,52.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.12,88,,percent of total billed charges,,,,,,,,,46.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55.97,91,,percent of total billed charges,,,58.43,95,,percent of total billed charges,,,51.05,83,,percent of total billed charges,,,51.05,83,,percent of total billed charges,,,,,,,,,,,,,,,51.05,83,,percent of total billed charges,,,58.43,95,,percent of total billed charges,,,55.35,90,,percent of total billed charges,,,55.35,90,,percent of total billed charges,,,50.43,82,,percent of total billed charges,,,55.35,90,,percent of total billed charges,,,52.28,85,,percent of total billed charges,,46.37,58.43,
CEFPODOXIME(VANTIN)TAB:200MG,32009846,CDM,,,250,RC,inpatient,,134.18,134.18,,113.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,101.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,114.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,118.08,88,,percent of total billed charges,,,,,,,,,102.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,122.1,91,,percent of total billed charges,,,127.47,95,,percent of total billed charges,,,111.37,83,,percent of total billed charges,,,111.37,83,,percent of total billed charges,,,,,,,,,,,,,,,111.37,83,,percent of total billed charges,,,127.47,95,,percent of total billed charges,,,120.76,90,,percent of total billed charges,,,120.76,90,,percent of total billed charges,,,110.03,82,,percent of total billed charges,,,120.76,90,,percent of total billed charges,,,114.05,85,,percent of total billed charges,,101.17,127.47,
VARICELLA LOSTER(V-ZIG),32009852,CDM,90396,CPT,636,RC,inpatient,,157,157,,133.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,118.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,133.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,138.16,88,,percent of total billed charges,,,,,,,,,119.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,142.87,91,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,,,,,,,,,,,,,130.31,83,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,128.74,82,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,133.45,85,,percent of total billed charges,,118.38,149.15,
VARICELLA(VARIVAX)VIRUS VACC VIAL 1ML,32009853,CDM,,,250,RC,inpatient,,1910.63,1910.63,,1622.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1440.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1624.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1681.35,88,,percent of total billed charges,,,,,,,,,1459.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1738.67,91,,percent of total billed charges,,,1815.1,95,,percent of total billed charges,,,1585.82,83,,percent of total billed charges,,,1585.82,83,,percent of total billed charges,,,,,,,,,,,,,,,1585.82,83,,percent of total billed charges,,,1815.1,95,,percent of total billed charges,,,1719.57,90,,percent of total billed charges,,,1719.57,90,,percent of total billed charges,,,1566.72,82,,percent of total billed charges,,,1719.57,90,,percent of total billed charges,,,1624.04,85,,percent of total billed charges,,1440.62,1815.1,
VAQTA ADULT 50U SDV,32009854,CDM,,,250,RC,inpatient,,193,193,,163.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,145.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,169.84,88,,percent of total billed charges,,,,,,,,,147.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,175.63,91,,percent of total billed charges,,,183.35,95,,percent of total billed charges,,,160.19,83,,percent of total billed charges,,,160.19,83,,percent of total billed charges,,,,,,,,,,,,,,,160.19,83,,percent of total billed charges,,,183.35,95,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,158.26,82,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,164.05,85,,percent of total billed charges,,145.52,183.35,
VASOPRESSIN(PITRESSIN)VL:20UNIT/ML,32009855,CDM,,,250,RC,inpatient,,616.16,616.16,,523.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,464.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,523.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.22,88,,percent of total billed charges,,,,,,,,,470.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,560.71,91,,percent of total billed charges,,,585.35,95,,percent of total billed charges,,,511.41,83,,percent of total billed charges,,,511.41,83,,percent of total billed charges,,,,,,,,,,,,,,,511.41,83,,percent of total billed charges,,,585.35,95,,percent of total billed charges,,,554.54,90,,percent of total billed charges,,,554.54,90,,percent of total billed charges,,,505.25,82,,percent of total billed charges,,,554.54,90,,percent of total billed charges,,,523.74,85,,percent of total billed charges,,464.58,585.35,
ENALAPRIL(VASOTEC)TAB:10MG,32009856,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ENALAPRIL (VASOTEC) TAB : 20MG,32009861,CDM,,,250,RC,inpatient,,15.23,15.23,,12.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.4,88,,percent of total billed charges,,,,,,,,,11.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.86,91,,percent of total billed charges,,,14.47,95,,percent of total billed charges,,,12.64,83,,percent of total billed charges,,,12.64,83,,percent of total billed charges,,,,,,,,,,,,,,,12.64,83,,percent of total billed charges,,,14.47,95,,percent of total billed charges,,,13.71,90,,percent of total billed charges,,,13.71,90,,percent of total billed charges,,,12.49,82,,percent of total billed charges,,,13.71,90,,percent of total billed charges,,,12.95,85,,percent of total billed charges,,11.48,14.47,
ENALAPRIL(VASOTEC)TAB:5MG,32009871,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ENALAPRIL(VASOTEC)TAB:2.5MG,32009876,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ENALAPRILAT(VASOTEC)VIAL:1.25MG/ML,32009886,CDM,J3490,HCPCS,250,RC,inpatient,,95.26,95.26,,80.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,83.83,88,,percent of total billed charges,,,,,,,,,72.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,86.69,91,,percent of total billed charges,,,90.5,95,,percent of total billed charges,,,79.07,83,,percent of total billed charges,,,79.07,83,,percent of total billed charges,,,,,,,,,,,,,,,79.07,83,,percent of total billed charges,,,90.5,95,,percent of total billed charges,,,85.73,90,,percent of total billed charges,,,85.73,90,,percent of total billed charges,,,78.11,82,,percent of total billed charges,,,85.73,90,,percent of total billed charges,,,80.97,85,,percent of total billed charges,,71.83,90.5,
PENNICILLIN V POT SUSP:125MG/5ML(100ML),32009891,CDM,J8499,HCPCS,250,RC,inpatient,,98.69,98.69,,83.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,74.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,83.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,86.85,88,,percent of total billed charges,,,,,,,,,75.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,89.81,91,,percent of total billed charges,,,93.76,95,,percent of total billed charges,,,81.91,83,,percent of total billed charges,,,81.91,83,,percent of total billed charges,,,,,,,,,,,,,,,81.91,83,,percent of total billed charges,,,93.76,95,,percent of total billed charges,,,88.82,90,,percent of total billed charges,,,88.82,90,,percent of total billed charges,,,80.93,82,,percent of total billed charges,,,88.82,90,,percent of total billed charges,,,83.89,85,,percent of total billed charges,,74.41,93.76,
ALBUTEROL MDI: 90MCG/ACT  6.7GM,32009916,CDM,J7620,HCPCS,250,RC,inpatient,,292.65,292.65,,248.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,220.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,248.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,257.53,88,,percent of total billed charges,,0.13,,,,fee schedule,,,223.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.13,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,266.31,91,,percent of total billed charges,,,278.02,95,,percent of total billed charges,,,242.9,83,,percent of total billed charges,,,242.9,83,,percent of total billed charges,,,,,,,,,,,,,,,242.9,83,,percent of total billed charges,,,278.02,95,,percent of total billed charges,,,263.39,90,,percent of total billed charges,,,263.39,90,,percent of total billed charges,,,239.97,82,,percent of total billed charges,,,263.39,90,,percent of total billed charges,,,248.75,85,,percent of total billed charges,,0.13,278.02,
ALBUTEROL SULFATE SYRP : 2MG/5ML  473ML,32009921,CDM,,,250,RC,inpatient,,361.13,361.13,,306.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,272.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,306.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,317.79,88,,percent of total billed charges,,,,,,,,,275.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,328.63,91,,percent of total billed charges,,,343.07,95,,percent of total billed charges,,,299.74,83,,percent of total billed charges,,,299.74,83,,percent of total billed charges,,,,,,,,,,,,,,,299.74,83,,percent of total billed charges,,,343.07,95,,percent of total billed charges,,,325.02,90,,percent of total billed charges,,,325.02,90,,percent of total billed charges,,,296.13,82,,percent of total billed charges,,,325.02,90,,percent of total billed charges,,,306.96,85,,percent of total billed charges,,272.29,343.07,
ALBUTEROL SULFATE SYRP : 2MG/5ML  90 ML,32009926,CDM,,,250,RC,inpatient,,68.67,68.67,,58.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.43,88,,percent of total billed charges,,,,,,,,,52.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.49,91,,percent of total billed charges,,,65.24,95,,percent of total billed charges,,,57,83,,percent of total billed charges,,,57,83,,percent of total billed charges,,,,,,,,,,,,,,,57,83,,percent of total billed charges,,,65.24,95,,percent of total billed charges,,,61.8,90,,percent of total billed charges,,,61.8,90,,percent of total billed charges,,,56.31,82,,percent of total billed charges,,,61.8,90,,percent of total billed charges,,,58.37,85,,percent of total billed charges,,51.78,65.24,
ALBUTEROL SULFATE SYRP:2MG/5ML (60ML),32009931,CDM,J8499,HCPCS,250,RC,inpatient,,45.84,45.84,,38.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,40.34,88,,percent of total billed charges,,,,,,,,,35.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41.71,91,,percent of total billed charges,,,43.55,95,,percent of total billed charges,,,38.05,83,,percent of total billed charges,,,38.05,83,,percent of total billed charges,,,,,,,,,,,,,,,38.05,83,,percent of total billed charges,,,43.55,95,,percent of total billed charges,,,41.26,90,,percent of total billed charges,,,41.26,90,,percent of total billed charges,,,37.59,82,,percent of total billed charges,,,41.26,90,,percent of total billed charges,,,38.96,85,,percent of total billed charges,,34.56,43.55,
ALBUTEROL AER : 90MCG   17GM M.D.I,32009936,CDM,,,250,RC,inpatient,,362.56,362.56,,307.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,273.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,308.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,319.05,88,,percent of total billed charges,,,,,,,,,277,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,329.93,91,,percent of total billed charges,,,344.43,95,,percent of total billed charges,,,300.92,83,,percent of total billed charges,,,300.92,83,,percent of total billed charges,,,,,,,,,,,,,,,300.92,83,,percent of total billed charges,,,344.43,95,,percent of total billed charges,,,326.3,90,,percent of total billed charges,,,326.3,90,,percent of total billed charges,,,297.3,82,,percent of total billed charges,,,326.3,90,,percent of total billed charges,,,308.18,85,,percent of total billed charges,,273.37,344.43,
ALBUTEROL (BULK) ***J7625***,32009939,CDM,,,636,RC,inpatient,,817.69,817.69,,694.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,616.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,695.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,719.57,88,,percent of total billed charges,,,,,,,,,624.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,744.1,91,,percent of total billed charges,,,776.81,95,,percent of total billed charges,,,678.68,83,,percent of total billed charges,,,678.68,83,,percent of total billed charges,,,,,,,,,,,,,,,678.68,83,,percent of total billed charges,,,776.81,95,,percent of total billed charges,,,735.92,90,,percent of total billed charges,,,735.92,90,,percent of total billed charges,,,670.51,82,,percent of total billed charges,,,735.92,90,,percent of total billed charges,,,695.04,85,,percent of total billed charges,,616.54,776.81,
ALBUTEROL SOL:0.83MG/ML  PYX UD,32009940,CDM,J7609,HCPCS,250,RC,inpatient,,24.8,24.8,,21.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.82,88,,percent of total billed charges,,,,,,,,,18.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.57,91,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,,,,,,,,,,,,,20.58,83,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,20.34,82,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,18.7,23.56,
ALBUTEROL SULFATE SOL:5MG/ML (20ML),32009941,CDM,J7611,HCPCS,250,RC,inpatient,,801.31,801.31,,680.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,604.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,681.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,705.15,88,,percent of total billed charges,,1.33,,,,fee schedule,,,612.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.33,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,729.19,91,,percent of total billed charges,,,761.24,95,,percent of total billed charges,,,665.09,83,,percent of total billed charges,,,665.09,83,,percent of total billed charges,,,,,,,,,,,,,,,665.09,83,,percent of total billed charges,,,761.24,95,,percent of total billed charges,,,721.18,90,,percent of total billed charges,,,721.18,90,,percent of total billed charges,,,657.07,82,,percent of total billed charges,,,721.18,90,,percent of total billed charges,,,681.11,85,,percent of total billed charges,,1.33,761.24,
VENTOLIN (ALBUTEROL),32009946,CDM,,,636,RC,inpatient,,10.5,10.5,,8.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9.24,88,,percent of total billed charges,,,,,,,,,8.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9.56,91,,percent of total billed charges,,,9.98,95,,percent of total billed charges,,,8.72,83,,percent of total billed charges,,,8.72,83,,percent of total billed charges,,,,,,,,,,,,,,,8.72,83,,percent of total billed charges,,,9.98,95,,percent of total billed charges,,,9.45,90,,percent of total billed charges,,,9.45,90,,percent of total billed charges,,,8.61,82,,percent of total billed charges,,,9.45,90,,percent of total billed charges,,,8.93,85,,percent of total billed charges,,7.92,9.98,
ETOPOSIDE(TOPOSAR)MDV:100MG/5ML(J/10MG),32009956,CDM,J9181,HCPCS,250,RC,inpatient,,19.03,19.03,,16.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16.75,88,,percent of total billed charges,,21.03,,,,fee schedule,,,14.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21.03,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.32,91,,percent of total billed charges,,,18.08,95,,percent of total billed charges,,,15.79,83,,percent of total billed charges,,,15.79,83,,percent of total billed charges,,,,,,,,,,,,,,,15.79,83,,percent of total billed charges,,,18.08,95,,percent of total billed charges,,,17.13,90,,percent of total billed charges,,,17.13,90,,percent of total billed charges,,,15.6,82,,percent of total billed charges,,,17.13,90,,percent of total billed charges,,,16.18,85,,percent of total billed charges,,14.35,21.03,
VERAPAMIL(CALAN)VIAL:5MG/2ML,32009961,CDM,J3490,HCPCS,250,RC,inpatient,,100.33,100.33,,85.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88.29,88,,percent of total billed charges,,,,,,,,,76.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91.3,91,,percent of total billed charges,,,95.31,95,,percent of total billed charges,,,83.27,83,,percent of total billed charges,,,83.27,83,,percent of total billed charges,,,,,,,,,,,,,,,83.27,83,,percent of total billed charges,,,95.31,95,,percent of total billed charges,,,90.3,90,,percent of total billed charges,,,90.3,90,,percent of total billed charges,,,82.27,82,,percent of total billed charges,,,90.3,90,,percent of total billed charges,,,85.28,85,,percent of total billed charges,,75.65,95.31,
VERAPAMIL(CALAN)VIAL:10MG/4ML,32009966,CDM,J3490,HCPCS,250,RC,inpatient,,533.05,533.05,,452.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,401.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,453.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,469.08,88,,percent of total billed charges,,,,,,,,,407.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,485.08,91,,percent of total billed charges,,,506.4,95,,percent of total billed charges,,,442.43,83,,percent of total billed charges,,,442.43,83,,percent of total billed charges,,,,,,,,,,,,,,,442.43,83,,percent of total billed charges,,,506.4,95,,percent of total billed charges,,,479.75,90,,percent of total billed charges,,,479.75,90,,percent of total billed charges,,,437.1,82,,percent of total billed charges,,,479.75,90,,percent of total billed charges,,,453.09,85,,percent of total billed charges,,401.92,506.4,
VERAPAMIL(CALAN SR)TAB:120MG,32009970,CDM,J8499,HCPCS,250,RC,inpatient,,19.93,19.93,,16.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.54,88,,percent of total billed charges,,,,,,,,,15.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18.14,91,,percent of total billed charges,,,18.93,95,,percent of total billed charges,,,16.54,83,,percent of total billed charges,,,16.54,83,,percent of total billed charges,,,,,,,,,,,,,,,16.54,83,,percent of total billed charges,,,18.93,95,,percent of total billed charges,,,17.94,90,,percent of total billed charges,,,17.94,90,,percent of total billed charges,,,16.34,82,,percent of total billed charges,,,17.94,90,,percent of total billed charges,,,16.94,85,,percent of total billed charges,,15.03,18.93,
VERAPAMIL (CALAN) TAB : 120MG,32009971,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
VERAPAMIL(CALAN)TAB:80MG,32009976,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
VERAPAMIL HCL CAP : 240MG,32009986,CDM,,,250,RC,inpatient,,14.43,14.43,,12.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.7,88,,percent of total billed charges,,,,,,,,,11.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.13,91,,percent of total billed charges,,,13.71,95,,percent of total billed charges,,,11.98,83,,percent of total billed charges,,,11.98,83,,percent of total billed charges,,,,,,,,,,,,,,,11.98,83,,percent of total billed charges,,,13.71,95,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,11.83,82,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,12.27,85,,percent of total billed charges,,10.88,13.71,
MEBENDAZOLE (VERMOX) TAB : 100MG,32009991,CDM,,,250,RC,inpatient,,75.02,75.02,,63.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,63.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66.02,88,,percent of total billed charges,,,,,,,,,57.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,68.27,91,,percent of total billed charges,,,71.27,95,,percent of total billed charges,,,62.27,83,,percent of total billed charges,,,62.27,83,,percent of total billed charges,,,,,,,,,,,,,,,62.27,83,,percent of total billed charges,,,71.27,95,,percent of total billed charges,,,67.52,90,,percent of total billed charges,,,67.52,90,,percent of total billed charges,,,61.52,82,,percent of total billed charges,,,67.52,90,,percent of total billed charges,,,63.77,85,,percent of total billed charges,,56.57,71.27,
MIDAZOLAM(VERSED)VIAL:10MG/2ML,32009996,CDM,J2250,HCPCS,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,7.08,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.08,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,7.08,64.15,
ESTRADIOL(ESTRACE)VAG CR:0.1MG/GM,32010008,CDM,J3490,HCPCS,250,RC,inpatient,,407.83,407.83,,346.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,307.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,346.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,358.89,88,,percent of total billed charges,,,,,,,,,311.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,371.13,91,,percent of total billed charges,,,387.44,95,,percent of total billed charges,,,338.5,83,,percent of total billed charges,,,338.5,83,,percent of total billed charges,,,,,,,,,,,,,,,338.5,83,,percent of total billed charges,,,387.44,95,,percent of total billed charges,,,367.05,90,,percent of total billed charges,,,367.05,90,,percent of total billed charges,,,334.42,82,,percent of total billed charges,,,367.05,90,,percent of total billed charges,,,346.66,85,,percent of total billed charges,,307.5,387.44,
DILTIAZEM(CARDIZEM)VL:125MG/25ML,32010010,CDM,J3490,HCPCS,250,RC,inpatient,,173.37,173.37,,147.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.57,88,,percent of total billed charges,,,,,,,,,132.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.77,91,,percent of total billed charges,,,164.7,95,,percent of total billed charges,,,143.9,83,,percent of total billed charges,,,143.9,83,,percent of total billed charges,,,,,,,,,,,,,,,143.9,83,,percent of total billed charges,,,164.7,95,,percent of total billed charges,,,156.03,90,,percent of total billed charges,,,156.03,90,,percent of total billed charges,,,142.16,82,,percent of total billed charges,,,156.03,90,,percent of total billed charges,,,147.36,85,,percent of total billed charges,,130.72,164.7,
rOPINIRole HCL (REQUIP) TAB : 1 MG,32010013,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
RISPERIDONE(RISPERDAL CONSTA) VL:25MG,32010014,CDM,,,636,RC,inpatient,,4095.98,4095.98,,3477.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3088.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3481.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3604.46,88,,percent of total billed charges,,,,,,,,,3129.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3727.34,91,,percent of total billed charges,,,3891.18,95,,percent of total billed charges,,,3399.66,83,,percent of total billed charges,,,3399.66,83,,percent of total billed charges,,,,,,,,,,,,,,,3399.66,83,,percent of total billed charges,,,3891.18,95,,percent of total billed charges,,,3686.38,90,,percent of total billed charges,,,3686.38,90,,percent of total billed charges,,,3358.7,82,,percent of total billed charges,,,3686.38,90,,percent of total billed charges,,,3481.58,85,,percent of total billed charges,,3088.37,3891.18,
EUCALYPT/MEN/CAMP/TURP(VICK VAPORUB)OINT,32010016,CDM,,,250,RC,inpatient,,63.6,63.6,,54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.97,88,,percent of total billed charges,,,,,,,,,48.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.88,91,,percent of total billed charges,,,60.42,95,,percent of total billed charges,,,52.79,83,,percent of total billed charges,,,52.79,83,,percent of total billed charges,,,,,,,,,,,,,,,52.79,83,,percent of total billed charges,,,60.42,95,,percent of total billed charges,,,57.24,90,,percent of total billed charges,,,57.24,90,,percent of total billed charges,,,52.15,82,,percent of total billed charges,,,57.24,90,,percent of total billed charges,,,54.06,85,,percent of total billed charges,,47.95,60.42,
VICKS 44 COUGH RELIEF 4OZ,32010017,CDM,,,250,RC,inpatient,,12.75,12.75,,10.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.22,88,,percent of total billed charges,,,,,,,,,9.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.6,91,,percent of total billed charges,,,12.11,95,,percent of total billed charges,,,10.58,83,,percent of total billed charges,,,10.58,83,,percent of total billed charges,,,,,,,,,,,,,,,10.58,83,,percent of total billed charges,,,12.11,95,,percent of total billed charges,,,11.48,90,,percent of total billed charges,,,11.48,90,,percent of total billed charges,,,10.46,82,,percent of total billed charges,,,11.48,90,,percent of total billed charges,,,10.84,85,,percent of total billed charges,,9.61,12.11,
MAG SULF-IVPB 4GM/SW100ML(PRE-MIX),32010024,CDM,J3475,HCPCS,258,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,15.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,15.22,187.11,
MISOPROSTOL(CYTOTEC)TAB:25 MCG,32010025,CDM,J8499,HCPCS,250,RC,inpatient,,17.48,17.48,,14.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.38,88,,percent of total billed charges,,,,,,,,,13.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.91,91,,percent of total billed charges,,,16.61,95,,percent of total billed charges,,,14.51,83,,percent of total billed charges,,,14.51,83,,percent of total billed charges,,,,,,,,,,,,,,,14.51,83,,percent of total billed charges,,,16.61,95,,percent of total billed charges,,,15.73,90,,percent of total billed charges,,,15.73,90,,percent of total billed charges,,,14.33,82,,percent of total billed charges,,,15.73,90,,percent of total billed charges,,,14.86,85,,percent of total billed charges,,13.18,16.61,
FUROSEMIDE IV DRIP:100MG/NS50ML,32010033,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
MULTIVITAMINS LIQ 240 ML,32010036,CDM,,,250,RC,inpatient,,67.5,67.5,,57.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.4,88,,percent of total billed charges,,,,,,,,,51.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.43,91,,percent of total billed charges,,,64.13,95,,percent of total billed charges,,,56.03,83,,percent of total billed charges,,,56.03,83,,percent of total billed charges,,,,,,,,,,,,,,,56.03,83,,percent of total billed charges,,,64.13,95,,percent of total billed charges,,,60.75,90,,percent of total billed charges,,,60.75,90,,percent of total billed charges,,,55.35,82,,percent of total billed charges,,,60.75,90,,percent of total billed charges,,,57.38,85,,percent of total billed charges,,50.9,64.13,
NYSTATIN ORAL UD:500MU/5ML,32010037,CDM,J8499,HCPCS,250,RC,inpatient,,16.5,16.5,,14.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.52,88,,percent of total billed charges,,,,,,,,,12.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.02,91,,percent of total billed charges,,,15.68,95,,percent of total billed charges,,,13.7,83,,percent of total billed charges,,,13.7,83,,percent of total billed charges,,,,,,,,,,,,,,,13.7,83,,percent of total billed charges,,,15.68,95,,percent of total billed charges,,,14.85,90,,percent of total billed charges,,,14.85,90,,percent of total billed charges,,,13.53,82,,percent of total billed charges,,,14.85,90,,percent of total billed charges,,,14.03,85,,percent of total billed charges,,12.44,15.68,
SUFentanil(SUFENTA) FTV:50MCG/1ML,32010038,CDM,,,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,,,,,,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,50.92,64.15,
vinCRISTine SULFATE VIAL:1MG/ML,32010041,CDM,J9370,HCPCS,636,RC,inpatient,,90.2,90.2,,76.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,68.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,76.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,79.38,88,,percent of total billed charges,,19.52,,,,fee schedule,,,68.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.52,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,82.08,91,,percent of total billed charges,,,85.69,95,,percent of total billed charges,,,74.87,83,,percent of total billed charges,,,74.87,83,,percent of total billed charges,,,,,,,,,,,,,,,74.87,83,,percent of total billed charges,,,85.69,95,,percent of total billed charges,,,81.18,90,,percent of total billed charges,,,81.18,90,,percent of total billed charges,,,73.96,82,,percent of total billed charges,,,81.18,90,,percent of total billed charges,,,76.67,85,,percent of total billed charges,,19.52,85.69,
sitaGLIPtin(JANUVIA) TAB:50MG,32010042,CDM,J8499,HCPCS,250,RC,inpatient,,293.63,293.63,,249.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,221.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,249.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,258.39,88,,percent of total billed charges,,,,,,,,,224.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,267.2,91,,percent of total billed charges,,,278.95,95,,percent of total billed charges,,,243.71,83,,percent of total billed charges,,,243.71,83,,percent of total billed charges,,,,,,,,,,,,,,,243.71,83,,percent of total billed charges,,,278.95,95,,percent of total billed charges,,,264.27,90,,percent of total billed charges,,,264.27,90,,percent of total billed charges,,,240.78,82,,percent of total billed charges,,,264.27,90,,percent of total billed charges,,,249.59,85,,percent of total billed charges,,221.4,278.95,
INFLUENZA VACCINE(2011-2012)SYR:0.5ML,32010044,CDM,90656,CPT,636,RC,inpatient,,205.7,205.7,,174.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,155.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,174.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,181.02,88,,percent of total billed charges,,,,,,,,,157.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,187.19,91,,percent of total billed charges,,,195.42,95,,percent of total billed charges,,,170.73,83,,percent of total billed charges,,,170.73,83,,percent of total billed charges,,,,,,,,,,,,,,,170.73,83,,percent of total billed charges,,,195.42,95,,percent of total billed charges,,,185.13,90,,percent of total billed charges,,,185.13,90,,percent of total billed charges,,,168.67,82,,percent of total billed charges,,,185.13,90,,percent of total billed charges,,,174.85,85,,percent of total billed charges,,155.1,195.42,
ROFECOXIB (VIOXX) TAB : 25MG,32010047,CDM,,,250,RC,inpatient,,42.03,42.03,,35.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36.99,88,,percent of total billed charges,,,,,,,,,32.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38.25,91,,percent of total billed charges,,,39.93,95,,percent of total billed charges,,,34.88,83,,percent of total billed charges,,,34.88,83,,percent of total billed charges,,,,,,,,,,,,,,,34.88,83,,percent of total billed charges,,,39.93,95,,percent of total billed charges,,,37.83,90,,percent of total billed charges,,,37.83,90,,percent of total billed charges,,,34.46,82,,percent of total billed charges,,,37.83,90,,percent of total billed charges,,,35.73,85,,percent of total billed charges,,31.69,39.93,
ROFECOXIB (VIOXX) TAB : 12.5MG,32010048,CDM,,,250,RC,inpatient,,42.03,42.03,,35.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36.99,88,,percent of total billed charges,,,,,,,,,32.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38.25,91,,percent of total billed charges,,,39.93,95,,percent of total billed charges,,,34.88,83,,percent of total billed charges,,,34.88,83,,percent of total billed charges,,,,,,,,,,,,,,,34.88,83,,percent of total billed charges,,,39.93,95,,percent of total billed charges,,,37.83,90,,percent of total billed charges,,,37.83,90,,percent of total billed charges,,,34.46,82,,percent of total billed charges,,,37.83,90,,percent of total billed charges,,,35.73,85,,percent of total billed charges,,31.69,39.93,
ROFECOXIB (VIOXX) TAB : 25MG,32010049,CDM,,,250,RC,inpatient,,84.22,84.22,,71.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,63.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,71.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,74.11,88,,percent of total billed charges,,,,,,,,,64.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,76.64,91,,percent of total billed charges,,,80.01,95,,percent of total billed charges,,,69.9,83,,percent of total billed charges,,,69.9,83,,percent of total billed charges,,,,,,,,,,,,,,,69.9,83,,percent of total billed charges,,,80.01,95,,percent of total billed charges,,,75.8,90,,percent of total billed charges,,,75.8,90,,percent of total billed charges,,,69.06,82,,percent of total billed charges,,,75.8,90,,percent of total billed charges,,,71.59,85,,percent of total billed charges,,63.5,80.01,
RIVAROXABAN(XARELTO) TABS:10MG,32010050,CDM,J8499,HCPCS,250,RC,inpatient,,218.3,218.3,,185.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,192.1,88,,percent of total billed charges,,,,,,,,,166.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,198.65,91,,percent of total billed charges,,,207.39,95,,percent of total billed charges,,,181.19,83,,percent of total billed charges,,,181.19,83,,percent of total billed charges,,,,,,,,,,,,,,,181.19,83,,percent of total billed charges,,,207.39,95,,percent of total billed charges,,,196.47,90,,percent of total billed charges,,,196.47,90,,percent of total billed charges,,,179.01,82,,percent of total billed charges,,,196.47,90,,percent of total billed charges,,,185.56,85,,percent of total billed charges,,164.6,207.39,
VIDARABINE (VIRA-A) OINT : 3% 3.5GM,32010051,CDM,,,250,RC,inpatient,,360.34,360.34,,305.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,271.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,306.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,317.1,88,,percent of total billed charges,,,,,,,,,275.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,327.91,91,,percent of total billed charges,,,342.32,95,,percent of total billed charges,,,299.08,83,,percent of total billed charges,,,299.08,83,,percent of total billed charges,,,,,,,,,,,,,,,299.08,83,,percent of total billed charges,,,342.32,95,,percent of total billed charges,,,324.31,90,,percent of total billed charges,,,324.31,90,,percent of total billed charges,,,295.48,82,,percent of total billed charges,,,324.31,90,,percent of total billed charges,,,306.29,85,,percent of total billed charges,,271.7,342.32,
LIDOCAINE HCL 2% VIAL:(20MG/ML) (5ML),32010052,CDM,J2001,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
fentaNYL(SUBLIMAZE)PF INJ:250MCG/5ML,32010053,CDM,J3010,HCPCS,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,1.79,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.79,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,1.79,64.15,
methylPRED(DEPO-MEDROL)*IM* VIAL:80MG/ML,32010054,CDM,J1040,HCPCS,250,RC,inpatient,,280.07,280.07,,237.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,211.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,238.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,246.46,88,,percent of total billed charges,,23.18,,,,fee schedule,,,213.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,23.18,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,254.86,91,,percent of total billed charges,,,266.07,95,,percent of total billed charges,,,232.46,83,,percent of total billed charges,,,232.46,83,,percent of total billed charges,,,,,,,,,,,,,,,232.46,83,,percent of total billed charges,,,266.07,95,,percent of total billed charges,,,252.06,90,,percent of total billed charges,,,252.06,90,,percent of total billed charges,,,229.66,82,,percent of total billed charges,,,252.06,90,,percent of total billed charges,,,238.06,85,,percent of total billed charges,,23.18,266.07,
CHONDRO SU/HYALUR(VISCOAT)SYR:40-30MG/ML,32010056,CDM,,,250,RC,inpatient,,303.08,303.08,,257.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.71,88,,percent of total billed charges,,,,,,,,,231.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.8,91,,percent of total billed charges,,,287.93,95,,percent of total billed charges,,,251.56,83,,percent of total billed charges,,,251.56,83,,percent of total billed charges,,,,,,,,,,,,,,,251.56,83,,percent of total billed charges,,,287.93,95,,percent of total billed charges,,,272.77,90,,percent of total billed charges,,,272.77,90,,percent of total billed charges,,,248.53,82,,percent of total billed charges,,,272.77,90,,percent of total billed charges,,,257.62,85,,percent of total billed charges,,228.52,287.93,
DIAZEPAM(VALIUM)VIAL:50MG/10ML,32010057,CDM,J3360,HCPCS,250,RC,inpatient,,654.58,654.58,,555.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,493.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,556.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,576.03,88,,percent of total billed charges,,26.31,,,,fee schedule,,,500.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,26.31,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,595.67,91,,percent of total billed charges,,,621.85,95,,percent of total billed charges,,,543.3,83,,percent of total billed charges,,,543.3,83,,percent of total billed charges,,,,,,,,,,,,,,,543.3,83,,percent of total billed charges,,,621.85,95,,percent of total billed charges,,,589.12,90,,percent of total billed charges,,,589.12,90,,percent of total billed charges,,,536.76,82,,percent of total billed charges,,,589.12,90,,percent of total billed charges,,,556.39,85,,percent of total billed charges,,26.31,621.85,
FACTOR VIII (HUMATE-P):1 UNIT       J/1,32010060,CDM,J7187,HCPCS,636,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,12958.7,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,12958.7,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,12958.7,
MORPHINE SULF VIAL :50MG/ML  50ML,32010062,CDM,J2270,HCPCS,250,RC,inpatient,,450.27,450.27,,382.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,339.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,382.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,396.24,88,,percent of total billed charges,,5.94,,,,fee schedule,,,344.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.94,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,409.75,91,,percent of total billed charges,,,427.76,95,,percent of total billed charges,,,373.72,83,,percent of total billed charges,,,373.72,83,,percent of total billed charges,,,,,,,,,,,,,,,373.72,83,,percent of total billed charges,,,427.76,95,,percent of total billed charges,,,405.24,90,,percent of total billed charges,,,405.24,90,,percent of total billed charges,,,369.22,82,,percent of total billed charges,,,405.24,90,,percent of total billed charges,,,382.73,85,,percent of total billed charges,,5.94,427.76,
HYDROmorphone (DILAUDID) VIAL:2MG/ML,32010068,CDM,J1170,HCPCS,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,3.47,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.47,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,3.47,64.15,
ZOLEDRONIC(ZOMETA)BTL* 4MG/100ML:(J/1MG),32010070,CDM,J3489,HCPCS,636,RC,inpatient,,265.65,265.65,,225.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,200.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,225.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,233.77,88,,percent of total billed charges,,41.84,,,,fee schedule,,,202.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,41.84,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,241.74,91,,percent of total billed charges,,,252.37,95,,percent of total billed charges,,,220.49,83,,percent of total billed charges,,,220.49,83,,percent of total billed charges,,,,,,,,,,,,,,,220.49,83,,percent of total billed charges,,,252.37,95,,percent of total billed charges,,,239.09,90,,percent of total billed charges,,,239.09,90,,percent of total billed charges,,,217.83,82,,percent of total billed charges,,,239.09,90,,percent of total billed charges,,,225.8,85,,percent of total billed charges,,41.84,252.37,
methaDONE HCL TABS:10MG,32010072,CDM,,,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
THIAMINE(VITAMIN B-1)TAB:100MG,32010076,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PYRIDOXINE(VITAMIN B-6)TAB:50MG,32010077,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CYANOCOBALAMIN(VITAMIN B-12)TAB:500MCG,32010078,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
VITAMIN B12 500MCG TAB,32010079,CDM,,,250,RC,inpatient,,0.5,0.5,,0.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,0.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,0.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,0.44,88,,percent of total billed charges,,,,,,,,,0.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,0.46,91,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,,,,,,,,,,,,,0.42,83,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.41,82,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.43,85,,percent of total billed charges,,0.38,0.48,
VITAMIN E CAP : 200 UNIT,32010081,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
LEVOTHYROXINE(SYNTHROID)*INJ*:100MCG,32010082,CDM,J3490,HCPCS,250,RC,inpatient,,1147.34,1147.34,,974.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,865.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,975.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1009.66,88,,percent of total billed charges,,,,,,,,,876.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1044.08,91,,percent of total billed charges,,,1089.97,95,,percent of total billed charges,,,952.29,83,,percent of total billed charges,,,952.29,83,,percent of total billed charges,,,,,,,,,,,,,,,952.29,83,,percent of total billed charges,,,1089.97,95,,percent of total billed charges,,,1032.61,90,,percent of total billed charges,,,1032.61,90,,percent of total billed charges,,,940.82,82,,percent of total billed charges,,,1032.61,90,,percent of total billed charges,,,975.24,85,,percent of total billed charges,,865.09,1089.97,
VITAMIN E CAP : 1000 UNIT,32010087,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
VITAMIN E CAP:400 UNIT,32010088,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
VITAMINS A AND D OINT 60GM,32010091,CDM,,,250,RC,inpatient,,35.84,35.84,,30.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31.54,88,,percent of total billed charges,,,,,,,,,27.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.61,91,,percent of total billed charges,,,34.05,95,,percent of total billed charges,,,29.75,83,,percent of total billed charges,,,29.75,83,,percent of total billed charges,,,,,,,,,,,,,,,29.75,83,,percent of total billed charges,,,34.05,95,,percent of total billed charges,,,32.26,90,,percent of total billed charges,,,32.26,90,,percent of total billed charges,,,29.39,82,,percent of total billed charges,,,32.26,90,,percent of total billed charges,,,30.46,85,,percent of total billed charges,,27.02,34.05,
VITAMINS A & D OINT:U/D,32010092,CDM,J3490,HCPCS,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
VITAMIN A & D OINTMENT - BOX OF PACKETS,32010093,CDM,,,250,RC,inpatient,,29.5,29.5,,25.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.96,88,,percent of total billed charges,,,,,,,,,22.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.85,91,,percent of total billed charges,,,28.03,95,,percent of total billed charges,,,24.49,83,,percent of total billed charges,,,24.49,83,,percent of total billed charges,,,,,,,,,,,,,,,24.49,83,,percent of total billed charges,,,28.03,95,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,24.19,82,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,25.08,85,,percent of total billed charges,,22.24,28.03,
VITAMIN A & D OINTMENT PACKET,32010094,CDM,,,250,RC,inpatient,,0.5,0.5,,0.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,0.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,0.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,0.44,88,,percent of total billed charges,,,,,,,,,0.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,0.46,91,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,,,,,,,,,,,,,0.42,83,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.41,82,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.43,85,,percent of total billed charges,,0.38,0.48,
"VITAMIN D 50,000 units",32010101,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
CHOLECALCIFEROL(VITAMIN D)TAB:400UNITS,32010102,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ONDANSETRON(ZOFRAN):4MG/2ML  SYR  J/1MG,32010103,CDM,J2405,HCPCS,636,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,1.38,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.38,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,1.38,59.21,
VITAMIN E CREAM 60GM,32010106,CDM,,,250,RC,inpatient,,31.24,31.24,,26.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.49,88,,percent of total billed charges,,,,,,,,,23.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.43,91,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,,,,,,,,,,,,,25.93,83,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,25.62,82,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,26.55,85,,percent of total billed charges,,23.55,29.68,
PRASUGREL(EFFIENT)TAB:10MG,32010109,CDM,,,250,RC,inpatient,,106.26,106.26,,90.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,80.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,90.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,93.51,88,,percent of total billed charges,,,,,,,,,81.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,96.7,91,,percent of total billed charges,,,100.95,95,,percent of total billed charges,,,88.2,83,,percent of total billed charges,,,88.2,83,,percent of total billed charges,,,,,,,,,,,,,,,88.2,83,,percent of total billed charges,,,100.95,95,,percent of total billed charges,,,95.63,90,,percent of total billed charges,,,95.63,90,,percent of total billed charges,,,87.13,82,,percent of total billed charges,,,95.63,90,,percent of total billed charges,,,90.32,85,,percent of total billed charges,,80.12,100.95,
PRASUGREL(EFFIENT)TAB:5MG,32010110,CDM,,,250,RC,inpatient,,106.26,106.26,,90.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,80.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,90.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,93.51,88,,percent of total billed charges,,,,,,,,,81.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,96.7,91,,percent of total billed charges,,,100.95,95,,percent of total billed charges,,,88.2,83,,percent of total billed charges,,,88.2,83,,percent of total billed charges,,,,,,,,,,,,,,,88.2,83,,percent of total billed charges,,,100.95,95,,percent of total billed charges,,,95.63,90,,percent of total billed charges,,,95.63,90,,percent of total billed charges,,,87.13,82,,percent of total billed charges,,,95.63,90,,percent of total billed charges,,,90.32,85,,percent of total billed charges,,80.12,100.95,
PHYTONADIONE(VIT-K)NEONATL AMP:1MG/0.5ML,32010111,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
POTASSIUM IODIDE(LUGOL'S)SOL 5%:14ML,32010113,CDM,J3490,HCPCS,250,RC,inpatient,,544.95,544.95,,462.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,410.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,463.21,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,479.56,88,,percent of total billed charges,,,,,,,,,416.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,495.9,91,,percent of total billed charges,,,517.7,95,,percent of total billed charges,,,452.31,83,,percent of total billed charges,,,452.31,83,,percent of total billed charges,,,,,,,,,,,,,,,452.31,83,,percent of total billed charges,,,517.7,95,,percent of total billed charges,,,490.46,90,,percent of total billed charges,,,490.46,90,,percent of total billed charges,,,446.86,82,,percent of total billed charges,,,490.46,90,,percent of total billed charges,,,463.21,85,,percent of total billed charges,,410.89,517.7,
PHYTONADIONE(VIT-K ADULT)AMP:10MG/ML,32010116,CDM,J3430,HCPCS,250,RC,inpatient,,764.71,764.71,,649.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,576.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,650,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,672.94,88,,percent of total billed charges,,82.65,,,,fee schedule,,,584.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,82.65,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,695.89,91,,percent of total billed charges,,,726.47,95,,percent of total billed charges,,,634.71,83,,percent of total billed charges,,,634.71,83,,percent of total billed charges,,,,,,,,,,,,,,,634.71,83,,percent of total billed charges,,,726.47,95,,percent of total billed charges,,,688.24,90,,percent of total billed charges,,,688.24,90,,percent of total billed charges,,,627.06,82,,percent of total billed charges,,,688.24,90,,percent of total billed charges,,,650,85,,percent of total billed charges,,82.65,726.47,
ZN/CU/CR/MN/SE(MULTITRACE-5)VIAL:10ML,32010119,CDM,J3490,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
HALOPERIDOL DECANOATE(HALDOL)AMP:50MG/ML,32010120,CDM,J1631,HCPCS,636,RC,inpatient,,282.78,282.78,,240.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,213.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,240.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,248.85,88,,percent of total billed charges,,46.67,,,,fee schedule,,,216.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,46.67,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,257.33,91,,percent of total billed charges,,,268.64,95,,percent of total billed charges,,,234.71,83,,percent of total billed charges,,,234.71,83,,percent of total billed charges,,,,,,,,,,,,,,,234.71,83,,percent of total billed charges,,,268.64,95,,percent of total billed charges,,,254.5,90,,percent of total billed charges,,,254.5,90,,percent of total billed charges,,,231.88,82,,percent of total billed charges,,,254.5,90,,percent of total billed charges,,,240.36,85,,percent of total billed charges,,46.67,268.64,
PIPERONLY BUTOXID/PYRETHRM EXT(RID):60ML,32010123,CDM,,,250,RC,inpatient,,70.1,70.1,,59.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,59.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,61.69,88,,percent of total billed charges,,,,,,,,,53.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,63.79,91,,percent of total billed charges,,,66.6,95,,percent of total billed charges,,,58.18,83,,percent of total billed charges,,,58.18,83,,percent of total billed charges,,,,,,,,,,,,,,,58.18,83,,percent of total billed charges,,,66.6,95,,percent of total billed charges,,,63.09,90,,percent of total billed charges,,,63.09,90,,percent of total billed charges,,,57.48,82,,percent of total billed charges,,,63.09,90,,percent of total billed charges,,,59.59,85,,percent of total billed charges,,52.86,66.6,
MALATHION 0.5% LOTN (OVIDE):59ML,32010127,CDM,J3490,HCPCS,250,RC,inpatient,,2118.01,2118.01,,1798.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1596.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1800.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1863.85,88,,percent of total billed charges,,,,,,,,,1618.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1927.39,91,,percent of total billed charges,,,2012.11,95,,percent of total billed charges,,,1757.95,83,,percent of total billed charges,,,1757.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1757.95,83,,percent of total billed charges,,,2012.11,95,,percent of total billed charges,,,1906.21,90,,percent of total billed charges,,,1906.21,90,,percent of total billed charges,,,1736.77,82,,percent of total billed charges,,,1906.21,90,,percent of total billed charges,,,1800.31,85,,percent of total billed charges,,1596.98,2012.11,
3% SODIUM CHLORID INHALATION SOL:4ML(RT),32010128,CDM,,,250,RC,inpatient,,24.8,24.8,,21.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.82,88,,percent of total billed charges,,,,,,,,,18.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.57,91,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,,,,,,,,,,,,,20.58,83,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,20.34,82,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,18.7,23.56,
DICLOFENAC (VOLTARAN) TAB : 25MG,32010136,CDM,,,250,RC,inpatient,,17.76,17.76,,15.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.63,88,,percent of total billed charges,,,,,,,,,13.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16.16,91,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,,,,,,,,,,,,,14.74,83,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,14.56,82,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.1,85,,percent of total billed charges,,13.39,16.87,
STERILE WATER FOR INJECTION VIAL:100ML,32010146,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
buPROPion(Wellbutrin SR)TAB:150MG,32010165,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
BUPROPION (WELLBUTRIN) TAB : 100MG,32010166,CDM,,,250,RC,inpatient,,27.28,27.28,,23.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.01,88,,percent of total billed charges,,,,,,,,,20.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24.82,91,,percent of total billed charges,,,25.92,95,,percent of total billed charges,,,22.64,83,,percent of total billed charges,,,22.64,83,,percent of total billed charges,,,,,,,,,,,,,,,22.64,83,,percent of total billed charges,,,25.92,95,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,22.37,82,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,23.19,85,,percent of total billed charges,,20.57,25.92,
BUPROPION (WELLBUTRIN) TAB : 75MG,32010171,CDM,,,250,RC,inpatient,,16.97,16.97,,14.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.93,88,,percent of total billed charges,,,,,,,,,12.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.44,91,,percent of total billed charges,,,16.12,95,,percent of total billed charges,,,14.09,83,,percent of total billed charges,,,14.09,83,,percent of total billed charges,,,,,,,,,,,,,,,14.09,83,,percent of total billed charges,,,16.12,95,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,13.92,82,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,14.42,85,,percent of total billed charges,,12.8,16.12,
BUDESON/FORMOT(SYMBICORT) 160/4.5  6GM:,32010193,CDM,J3490,HCPCS,250,RC,inpatient,,2533,2533,,2150.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1909.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2153.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2229.04,88,,percent of total billed charges,,,,,,,,,1935.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2305.03,91,,percent of total billed charges,,,2406.35,95,,percent of total billed charges,,,2102.39,83,,percent of total billed charges,,,2102.39,83,,percent of total billed charges,,,,,,,,,,,,,,,2102.39,83,,percent of total billed charges,,,2406.35,95,,percent of total billed charges,,,2279.7,90,,percent of total billed charges,,,2279.7,90,,percent of total billed charges,,,2077.06,82,,percent of total billed charges,,,2279.7,90,,percent of total billed charges,,,2153.05,85,,percent of total billed charges,,1909.88,2406.35,
BUDESONID/FORMTERL(SYMBICORT) 10.2GM:,32010194,CDM,,,250,RC,inpatient,,2856.56,2856.56,,2425.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2153.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2428.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2513.77,88,,percent of total billed charges,,,,,,,,,2182.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2599.47,91,,percent of total billed charges,,,2713.73,95,,percent of total billed charges,,,2370.94,83,,percent of total billed charges,,,2370.94,83,,percent of total billed charges,,,,,,,,,,,,,,,2370.94,83,,percent of total billed charges,,,2713.73,95,,percent of total billed charges,,,2570.9,90,,percent of total billed charges,,,2570.9,90,,percent of total billed charges,,,2342.38,82,,percent of total billed charges,,,2570.9,90,,percent of total billed charges,,,2428.08,85,,percent of total billed charges,,2153.85,2713.73,
PEN G PROC(WYCILLIN)SYR: 1.2MIL UNIT 2ML,32010196,CDM,,,250,RC,inpatient,,819.03,819.03,,695.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,617.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,696.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,720.75,88,,percent of total billed charges,,,,,,,,,625.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,745.32,91,,percent of total billed charges,,,778.08,95,,percent of total billed charges,,,679.79,83,,percent of total billed charges,,,679.79,83,,percent of total billed charges,,,,,,,,,,,,,,,679.79,83,,percent of total billed charges,,,778.08,95,,percent of total billed charges,,,737.13,90,,percent of total billed charges,,,737.13,90,,percent of total billed charges,,,671.6,82,,percent of total billed charges,,,737.13,90,,percent of total billed charges,,,696.18,85,,percent of total billed charges,,617.55,778.08,
"PENICILL G PROCAINE SYR:600,000 Unit 1ML",32010201,CDM,,,250,RC,inpatient,,174.62,174.62,,148.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,131.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,148.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,153.67,88,,percent of total billed charges,,,,,,,,,133.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,158.9,91,,percent of total billed charges,,,165.89,95,,percent of total billed charges,,,144.93,83,,percent of total billed charges,,,144.93,83,,percent of total billed charges,,,,,,,,,,,,,,,144.93,83,,percent of total billed charges,,,165.89,95,,percent of total billed charges,,,157.16,90,,percent of total billed charges,,,157.16,90,,percent of total billed charges,,,143.19,82,,percent of total billed charges,,,157.16,90,,percent of total billed charges,,,148.43,85,,percent of total billed charges,,131.66,165.89,
HYALURONIDASE(HYLENEX)VIAL:150U/ML,32010211,CDM,J3473,HCPCS,636,RC,inpatient,,798.71,798.71,,678.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,602.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,678.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,702.86,88,,percent of total billed charges,,108,,,,fee schedule,,,610.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,108,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,726.83,91,,percent of total billed charges,,,758.77,95,,percent of total billed charges,,,662.93,83,,percent of total billed charges,,,662.93,83,,percent of total billed charges,,,,,,,,,,,,,,,662.93,83,,percent of total billed charges,,,758.77,95,,percent of total billed charges,,,718.84,90,,percent of total billed charges,,,718.84,90,,percent of total billed charges,,,654.94,82,,percent of total billed charges,,,718.84,90,,percent of total billed charges,,,678.9,85,,percent of total billed charges,,108,758.77,
LATANOPROST(XALATAN)DROP 0.005%:2.5ML,32010212,CDM,J3490,HCPCS,250,RC,inpatient,,95.43,95.43,,81.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,81.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,83.98,88,,percent of total billed charges,,,,,,,,,72.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,86.84,91,,percent of total billed charges,,,90.66,95,,percent of total billed charges,,,79.21,83,,percent of total billed charges,,,79.21,83,,percent of total billed charges,,,,,,,,,,,,,,,79.21,83,,percent of total billed charges,,,90.66,95,,percent of total billed charges,,,85.89,90,,percent of total billed charges,,,85.89,90,,percent of total billed charges,,,78.25,82,,percent of total billed charges,,,85.89,90,,percent of total billed charges,,,81.12,85,,percent of total billed charges,,71.95,90.66,
LIDOCAINE(XYLOCAINE)JEL 2%:30GM,32010216,CDM,J3490,HCPCS,250,RC,inpatient,,1468.59,1468.59,,1246.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1107.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1248.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1292.36,88,,percent of total billed charges,,,,,,,,,1122,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1336.42,91,,percent of total billed charges,,,1395.16,95,,percent of total billed charges,,,1218.93,83,,percent of total billed charges,,,1218.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1218.93,83,,percent of total billed charges,,,1395.16,95,,percent of total billed charges,,,1321.73,90,,percent of total billed charges,,,1321.73,90,,percent of total billed charges,,,1204.24,82,,percent of total billed charges,,,1321.73,90,,percent of total billed charges,,,1248.3,85,,percent of total billed charges,,1107.32,1395.16,
ATROPINE VIAL:0.4MG/ML (20 ML MDV),32010219,CDM,J0461,HCPCS,250,RC,inpatient,,154.74,154.74,,131.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,131.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,136.17,88,,percent of total billed charges,,42.6,,,,fee schedule,,,118.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,42.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.81,91,,percent of total billed charges,,,147,95,,percent of total billed charges,,,128.43,83,,percent of total billed charges,,,128.43,83,,percent of total billed charges,,,,,,,,,,,,,,,128.43,83,,percent of total billed charges,,,147,95,,percent of total billed charges,,,139.27,90,,percent of total billed charges,,,139.27,90,,percent of total billed charges,,,126.89,82,,percent of total billed charges,,,139.27,90,,percent of total billed charges,,,131.53,85,,percent of total billed charges,,42.6,147,
LIDOCAINE(XYLOCAINE)AMP 1.5%:15MG/ML20ML,32010221,CDM,J2001,HCPCS,250,RC,inpatient,,155.27,155.27,,131.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,117.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,131.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,136.64,88,,percent of total billed charges,,0.75,,,,fee schedule,,,118.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,141.3,91,,percent of total billed charges,,,147.51,95,,percent of total billed charges,,,128.87,83,,percent of total billed charges,,,128.87,83,,percent of total billed charges,,,,,,,,,,,,,,,128.87,83,,percent of total billed charges,,,147.51,95,,percent of total billed charges,,,139.74,90,,percent of total billed charges,,,139.74,90,,percent of total billed charges,,,127.32,82,,percent of total billed charges,,,139.74,90,,percent of total billed charges,,,131.98,85,,percent of total billed charges,,0.75,147.51,
XYLOCAINE 1% 30ML,32010222,CDM,,,250,RC,inpatient,,32,32,,27.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28.16,88,,percent of total billed charges,,,,,,,,,24.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,,,,,,,,,,,,,26.56,83,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,26.24,82,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,24.13,30.4,
LIDOCAINE(XYLOCAINE)VIAL 0.5%:50ML,32010226,CDM,J3490,HCPCS,250,RC,inpatient,,212.75,212.75,,180.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,160.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,187.22,88,,percent of total billed charges,,,,,,,,,162.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,193.6,91,,percent of total billed charges,,,202.11,95,,percent of total billed charges,,,176.58,83,,percent of total billed charges,,,176.58,83,,percent of total billed charges,,,,,,,,,,,,,,,176.58,83,,percent of total billed charges,,,202.11,95,,percent of total billed charges,,,191.48,90,,percent of total billed charges,,,191.48,90,,percent of total billed charges,,,174.46,82,,percent of total billed charges,,,191.48,90,,percent of total billed charges,,,180.84,85,,percent of total billed charges,,160.41,202.11,
LIDOCAINE HCL (XYLOCAINE) JEL : 2% 7.5GM,32010231,CDM,,,250,RC,inpatient,,433.3,433.3,,367.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,326.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,368.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,381.3,88,,percent of total billed charges,,,,,,,,,331.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,394.3,91,,percent of total billed charges,,,411.64,95,,percent of total billed charges,,,359.64,83,,percent of total billed charges,,,359.64,83,,percent of total billed charges,,,,,,,,,,,,,,,359.64,83,,percent of total billed charges,,,411.64,95,,percent of total billed charges,,,389.97,90,,percent of total billed charges,,,389.97,90,,percent of total billed charges,,,355.31,82,,percent of total billed charges,,,389.97,90,,percent of total billed charges,,,368.31,85,,percent of total billed charges,,326.71,411.64,
LIDOCAIN 5% W/DEXTROSE 7.5% 2ML F/SPINAL,32010236,CDM,,,250,RC,inpatient,,152.73,152.73,,129.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,115.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,134.4,88,,percent of total billed charges,,,,,,,,,116.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.98,91,,percent of total billed charges,,,145.09,95,,percent of total billed charges,,,126.77,83,,percent of total billed charges,,,126.77,83,,percent of total billed charges,,,,,,,,,,,,,,,126.77,83,,percent of total billed charges,,,145.09,95,,percent of total billed charges,,,137.46,90,,percent of total billed charges,,,137.46,90,,percent of total billed charges,,,125.24,82,,percent of total billed charges,,,137.46,90,,percent of total billed charges,,,129.82,85,,percent of total billed charges,,115.16,145.09,
SODIUM BICARBONATE TAB (10 GR):650 MG,32010253,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
RANITIDINE HCL TAB : 150MG,32010256,CDM,,,250,RC,inpatient,,8.5,8.5,,7.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.48,88,,percent of total billed charges,,,,,,,,,6.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.74,91,,percent of total billed charges,,,8.08,95,,percent of total billed charges,,,7.06,83,,percent of total billed charges,,,7.06,83,,percent of total billed charges,,,,,,,,,,,,,,,7.06,83,,percent of total billed charges,,,8.08,95,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,6.97,82,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,7.23,85,,percent of total billed charges,,6.41,8.08,
RANITIDINE(ZANTAC)VIAL:50MG/2ML,32010261,CDM,,,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
RANITIDINE (ZANTAC) SYRP 15MG/ML  480ML,32010266,CDM,,,250,RC,inpatient,,2634.32,2634.32,,2236.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1986.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2239.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2318.2,88,,percent of total billed charges,,,,,,,,,2012.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2397.23,91,,percent of total billed charges,,,2502.6,95,,percent of total billed charges,,,2186.49,83,,percent of total billed charges,,,2186.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2186.49,83,,percent of total billed charges,,,2502.6,95,,percent of total billed charges,,,2370.89,90,,percent of total billed charges,,,2370.89,90,,percent of total billed charges,,,2160.14,82,,percent of total billed charges,,,2370.89,90,,percent of total billed charges,,,2239.17,85,,percent of total billed charges,,1986.28,2502.6,
RANITIDINE (ZANTAC) TAB : 75MG,32010267,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
RANITIDINE(ZANTAC)TAB:150MG,32010271,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
RANITIDINE(ZANTAC)TAB:150MG(1x4),32010272,CDM,,,250,RC,inpatient,,23.95,23.95,,20.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.08,88,,percent of total billed charges,,,,,,,,,18.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.79,91,,percent of total billed charges,,,22.75,95,,percent of total billed charges,,,19.88,83,,percent of total billed charges,,,19.88,83,,percent of total billed charges,,,,,,,,,,,,,,,19.88,83,,percent of total billed charges,,,22.75,95,,percent of total billed charges,,,21.56,90,,percent of total billed charges,,,21.56,90,,percent of total billed charges,,,19.64,82,,percent of total billed charges,,,21.56,90,,percent of total billed charges,,,20.36,85,,percent of total billed charges,,18.06,22.75,
RANITIDINE (ZANTAC) SYRP : 15MG/ML  60ML,32010276,CDM,,,250,RC,inpatient,,713.38,713.38,,605.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,537.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,606.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,627.77,88,,percent of total billed charges,,,,,,,,,545.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,649.18,91,,percent of total billed charges,,,677.71,95,,percent of total billed charges,,,592.11,83,,percent of total billed charges,,,592.11,83,,percent of total billed charges,,,,,,,,,,,,,,,592.11,83,,percent of total billed charges,,,677.71,95,,percent of total billed charges,,,642.04,90,,percent of total billed charges,,,642.04,90,,percent of total billed charges,,,584.97,82,,percent of total billed charges,,,642.04,90,,percent of total billed charges,,,606.37,85,,percent of total billed charges,,537.89,677.71,
RANITIDINE (ZANTAC) SYRP: 15MG/ML  90ML,32010281,CDM,,,250,RC,inpatient,,906.93,906.93,,769.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,683.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,770.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,798.1,88,,percent of total billed charges,,,,,,,,,692.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,825.31,91,,percent of total billed charges,,,861.58,95,,percent of total billed charges,,,752.75,83,,percent of total billed charges,,,752.75,83,,percent of total billed charges,,,,,,,,,,,,,,,752.75,83,,percent of total billed charges,,,861.58,95,,percent of total billed charges,,,816.24,90,,percent of total billed charges,,,816.24,90,,percent of total billed charges,,,743.68,82,,percent of total billed charges,,,816.24,90,,percent of total billed charges,,,770.89,85,,percent of total billed charges,,683.83,861.58,
OMALIZUMAB(XOLAIR) VL:150MG,32010284,CDM,J2357,HCPCS,636,RC,inpatient,,5492.07,5492.07,,4662.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4141.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4668.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4833.02,88,,percent of total billed charges,,2898.9,,,,fee schedule,,,4195.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2898.9,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4997.78,91,,percent of total billed charges,,,5217.47,95,,percent of total billed charges,,,4558.42,83,,percent of total billed charges,,,4558.42,83,,percent of total billed charges,,,,,,,,,,,,,,,4558.42,83,,percent of total billed charges,,,5217.47,95,,percent of total billed charges,,,4942.86,90,,percent of total billed charges,,,4942.86,90,,percent of total billed charges,,,4503.5,82,,percent of total billed charges,,,4942.86,90,,percent of total billed charges,,,4668.26,85,,percent of total billed charges,,2898.9,5217.47,
METOLAZONE (ZAROXOLYN) TAB : 10MG,32010296,CDM,,,250,RC,inpatient,,34.26,34.26,,29.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.15,88,,percent of total billed charges,,,,,,,,,26.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31.18,91,,percent of total billed charges,,,32.55,95,,percent of total billed charges,,,28.44,83,,percent of total billed charges,,,28.44,83,,percent of total billed charges,,,,,,,,,,,,,,,28.44,83,,percent of total billed charges,,,32.55,95,,percent of total billed charges,,,30.83,90,,percent of total billed charges,,,30.83,90,,percent of total billed charges,,,28.09,82,,percent of total billed charges,,,30.83,90,,percent of total billed charges,,,29.12,85,,percent of total billed charges,,25.83,32.55,
ROCURONIUM(ZEMURON)VIAL:50MG/5ML,32010297,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
BISOPROL/HYDROCHLOR(ZIAC)TAB:10-6.25MG,32010301,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
INFLUENZA VACCINE(2012-2013)SYR:0.5ML,32010305,CDM,90656,CPT,636,RC,inpatient,,195.4,195.4,,165.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,166.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,171.95,88,,percent of total billed charges,,,,,,,,,149.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,177.81,91,,percent of total billed charges,,,185.63,95,,percent of total billed charges,,,162.18,83,,percent of total billed charges,,,162.18,83,,percent of total billed charges,,,,,,,,,,,,,,,162.18,83,,percent of total billed charges,,,185.63,95,,percent of total billed charges,,,175.86,90,,percent of total billed charges,,,175.86,90,,percent of total billed charges,,,160.23,82,,percent of total billed charges,,,175.86,90,,percent of total billed charges,,,166.09,85,,percent of total billed charges,,147.33,185.63,
BISOPROL/HYDROCHLOR(ZIAC) TAB:2.5-6.25MG,32010306,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
BISOPROL/HYDROCHLORO (ZIAC) TAB:5-6.25MG,32010311,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
cefUROXime(ZINACEF)VIAL:750MG,32010316,CDM,J0697,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,8.74,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8.74,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,8.74,59.21,
IBUP/HYDROCOD(VICOPROFEN)TAB:200-7.5MG,32010317,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
IBU/HYDCOD(VICOPROF)TAB:200-7.5MG(1X10),32010318,CDM,,,250,RC,inpatient,,48.85,48.85,,41.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.99,88,,percent of total billed charges,,,,,,,,,37.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,44.45,91,,percent of total billed charges,,,46.41,95,,percent of total billed charges,,,40.55,83,,percent of total billed charges,,,40.55,83,,percent of total billed charges,,,,,,,,,,,,,,,40.55,83,,percent of total billed charges,,,46.41,95,,percent of total billed charges,,,43.97,90,,percent of total billed charges,,,43.97,90,,percent of total billed charges,,,40.06,82,,percent of total billed charges,,,43.97,90,,percent of total billed charges,,,41.52,85,,percent of total billed charges,,36.83,46.41,
ceFUROXIME VIAL: 1.5GM,32010321,CDM,J0697,HCPCS,250,RC,inpatient,,88.4,88.4,,75.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,75.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.79,88,,percent of total billed charges,,8.74,,,,fee schedule,,,67.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8.74,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.44,91,,percent of total billed charges,,,83.98,95,,percent of total billed charges,,,73.37,83,,percent of total billed charges,,,73.37,83,,percent of total billed charges,,,,,,,,,,,,,,,73.37,83,,percent of total billed charges,,,83.98,95,,percent of total billed charges,,,79.56,90,,percent of total billed charges,,,79.56,90,,percent of total billed charges,,,72.49,82,,percent of total billed charges,,,79.56,90,,percent of total billed charges,,,75.14,85,,percent of total billed charges,,8.74,83.98,
CALCIUM CITRATE /VIT D:315MG/250 I.U.,32010325,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ZINC SULFATE CAP : 220MG,32010331,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ZINC SULFATE CAP:220MG,32010332,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ZINC OXIDE OINT 20%:30GM,32010336,CDM,J3490,HCPCS,250,RC,inpatient,,36.11,36.11,,30.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31.78,88,,percent of total billed charges,,,,,,,,,27.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.86,91,,percent of total billed charges,,,34.3,95,,percent of total billed charges,,,29.97,83,,percent of total billed charges,,,29.97,83,,percent of total billed charges,,,,,,,,,,,,,,,29.97,83,,percent of total billed charges,,,34.3,95,,percent of total billed charges,,,32.5,90,,percent of total billed charges,,,32.5,90,,percent of total billed charges,,,29.61,82,,percent of total billed charges,,,32.5,90,,percent of total billed charges,,,30.69,85,,percent of total billed charges,,27.23,34.3,
NAPROXEN(NAPROSYN EC)TAB:500MG,32010339,CDM,J8499,HCPCS,250,RC,inpatient,,14.75,14.75,,12.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.98,88,,percent of total billed charges,,,,,,,,,11.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.42,91,,percent of total billed charges,,,14.01,95,,percent of total billed charges,,,12.24,83,,percent of total billed charges,,,12.24,83,,percent of total billed charges,,,,,,,,,,,,,,,12.24,83,,percent of total billed charges,,,14.01,95,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,12.1,82,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,12.54,85,,percent of total billed charges,,11.12,14.01,
ZINC OXIDE OINT : 20% 454GM,32010341,CDM,,,250,RC,inpatient,,94.84,94.84,,80.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,83.46,88,,percent of total billed charges,,,,,,,,,72.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,86.3,91,,percent of total billed charges,,,90.1,95,,percent of total billed charges,,,78.72,83,,percent of total billed charges,,,78.72,83,,percent of total billed charges,,,,,,,,,,,,,,,78.72,83,,percent of total billed charges,,,90.1,95,,percent of total billed charges,,,85.36,90,,percent of total billed charges,,,85.36,90,,percent of total billed charges,,,77.77,82,,percent of total billed charges,,,85.36,90,,percent of total billed charges,,,80.61,85,,percent of total billed charges,,71.51,90.1,
AZITHROMYCIN(ZITHROMAX)TAB:250MG,32010346,CDM,J8499,HCPCS,250,RC,inpatient,,16.83,16.83,,14.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.81,88,,percent of total billed charges,,,,,,,,,12.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.32,91,,percent of total billed charges,,,15.99,95,,percent of total billed charges,,,13.97,83,,percent of total billed charges,,,13.97,83,,percent of total billed charges,,,,,,,,,,,,,,,13.97,83,,percent of total billed charges,,,15.99,95,,percent of total billed charges,,,15.15,90,,percent of total billed charges,,,15.15,90,,percent of total billed charges,,,13.8,82,,percent of total billed charges,,,15.15,90,,percent of total billed charges,,,14.31,85,,percent of total billed charges,,12.69,15.99,
AZITHROMYCIN (ZITHROMAX) VIAL : 500MG,32010347,CDM,J0456,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,3.12,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.12,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,3.12,60.99,
AZITHROMYCIN(ZITHROMAX)TAB:250MG (1X4),32010348,CDM,J8499,HCPCS,250,RC,inpatient,,40.76,40.76,,34.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.87,88,,percent of total billed charges,,,,,,,,,31.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37.09,91,,percent of total billed charges,,,38.72,95,,percent of total billed charges,,,33.83,83,,percent of total billed charges,,,33.83,83,,percent of total billed charges,,,,,,,,,,,,,,,33.83,83,,percent of total billed charges,,,38.72,95,,percent of total billed charges,,,36.68,90,,percent of total billed charges,,,36.68,90,,percent of total billed charges,,,33.42,82,,percent of total billed charges,,,36.68,90,,percent of total billed charges,,,34.65,85,,percent of total billed charges,,30.73,38.72,
SIMVASTATIN(ZOCOR)TAB:10MG,32010351,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
SIMVASTATIN (ZOCOR) TAB : 20MG,32010352,CDM,,,250,RC,inpatient,,72.8,72.8,,61.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,54.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,61.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,64.06,88,,percent of total billed charges,,,,,,,,,55.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,66.25,91,,percent of total billed charges,,,69.16,95,,percent of total billed charges,,,60.42,83,,percent of total billed charges,,,60.42,83,,percent of total billed charges,,,,,,,,,,,,,,,60.42,83,,percent of total billed charges,,,69.16,95,,percent of total billed charges,,,65.52,90,,percent of total billed charges,,,65.52,90,,percent of total billed charges,,,59.7,82,,percent of total billed charges,,,65.52,90,,percent of total billed charges,,,61.88,85,,percent of total billed charges,,54.89,69.16,
SIMVASTATIN(ZOCOR)TAB:40MG,32010353,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ONDANSETRON HCL (ZOFRAN) TAB : 8MG,32010356,CDM,,,250,RC,inpatient,,614.26,614.26,,521.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,463.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,522.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,540.55,88,,percent of total billed charges,,,,,,,,,469.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,558.98,91,,percent of total billed charges,,,583.55,95,,percent of total billed charges,,,509.84,83,,percent of total billed charges,,,509.84,83,,percent of total billed charges,,,,,,,,,,,,,,,509.84,83,,percent of total billed charges,,,583.55,95,,percent of total billed charges,,,552.83,90,,percent of total billed charges,,,552.83,90,,percent of total billed charges,,,503.69,82,,percent of total billed charges,,,552.83,90,,percent of total billed charges,,,522.12,85,,percent of total billed charges,,463.15,583.55,
ACYCLOVIR(ZOVIRAX)OINT 5%:5GM,32010360,CDM,,,250,RC,inpatient,,2822.4,2822.4,,2396.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2128.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2399.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2483.71,88,,percent of total billed charges,,,,,,,,,2156.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2568.38,91,,percent of total billed charges,,,2681.28,95,,percent of total billed charges,,,2342.59,83,,percent of total billed charges,,,2342.59,83,,percent of total billed charges,,,,,,,,,,,,,,,2342.59,83,,percent of total billed charges,,,2681.28,95,,percent of total billed charges,,,2540.16,90,,percent of total billed charges,,,2540.16,90,,percent of total billed charges,,,2314.37,82,,percent of total billed charges,,,2540.16,90,,percent of total billed charges,,,2399.04,85,,percent of total billed charges,,2128.09,2681.28,
L-LYSINE TAB:500MG,32010363,CDM,,,250,RC,inpatient,,9,9,,7.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.92,88,,percent of total billed charges,,,,,,,,,6.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.38,82,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,6.79,8.55,
PENCICLOVIR(DENAVIR)CREAM 1%:5GM,32010364,CDM,,,250,RC,inpatient,,3292.9,3292.9,,2795.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2482.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2798.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2897.75,88,,percent of total billed charges,,,,,,,,,2515.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2996.54,91,,percent of total billed charges,,,3128.26,95,,percent of total billed charges,,,2733.11,83,,percent of total billed charges,,,2733.11,83,,percent of total billed charges,,,,,,,,,,,,,,,2733.11,83,,percent of total billed charges,,,3128.26,95,,percent of total billed charges,,,2963.61,90,,percent of total billed charges,,,2963.61,90,,percent of total billed charges,,,2700.18,82,,percent of total billed charges,,,2963.61,90,,percent of total billed charges,,,2798.97,85,,percent of total billed charges,,2482.85,3128.26,
ZOFRAN 32MG (16ML),32010377,CDM,,,250,RC,inpatient,,294.5,294.5,,250.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,222.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,250.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,259.16,88,,percent of total billed charges,,,,,,,,,225,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,268,91,,percent of total billed charges,,,279.78,95,,percent of total billed charges,,,244.44,83,,percent of total billed charges,,,244.44,83,,percent of total billed charges,,,,,,,,,,,,,,,244.44,83,,percent of total billed charges,,,279.78,95,,percent of total billed charges,,,265.05,90,,percent of total billed charges,,,265.05,90,,percent of total billed charges,,,241.49,82,,percent of total billed charges,,,265.05,90,,percent of total billed charges,,,250.33,85,,percent of total billed charges,,222.05,279.78,
MICONAZOLE NITRATE(BAZA)CM 2%:142GM,32010385,CDM,,,250,RC,inpatient,,168.27,168.27,,142.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,126.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,143.03,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,148.08,88,,percent of total billed charges,,,,,,,,,128.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,153.13,91,,percent of total billed charges,,,159.86,95,,percent of total billed charges,,,139.66,83,,percent of total billed charges,,,139.66,83,,percent of total billed charges,,,,,,,,,,,,,,,139.66,83,,percent of total billed charges,,,159.86,95,,percent of total billed charges,,,151.44,90,,percent of total billed charges,,,151.44,90,,percent of total billed charges,,,137.98,82,,percent of total billed charges,,,151.44,90,,percent of total billed charges,,,143.03,85,,percent of total billed charges,,126.88,159.86,
GOSERELIN ACETATE (ZOLADEX) IMP : 3.6MG,32010386,CDM,J9202,HCPCS,636,RC,inpatient,,4650.03,4650.03,,3947.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3506.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3952.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4092.03,88,,percent of total billed charges,,1718.15,,,,fee schedule,,,3552.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1718.15,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4231.53,91,,percent of total billed charges,,,4417.53,95,,percent of total billed charges,,,3859.52,83,,percent of total billed charges,,,3859.52,83,,percent of total billed charges,,,,,,,,,,,,,,,3859.52,83,,percent of total billed charges,,,4417.53,95,,percent of total billed charges,,,4185.03,90,,percent of total billed charges,,,4185.03,90,,percent of total billed charges,,,3813.02,82,,percent of total billed charges,,,4185.03,90,,percent of total billed charges,,,3952.53,85,,percent of total billed charges,,1718.15,4417.53,
PIPERACILLIN/TAZO(ZOSYN)VIAL:2.25GM,32010392,CDM,J2543,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,5.92,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.92,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,5.92,60.99,
PIPERACILLIN/TAZO(ZOSYN)VIAL:4.5GM,32010393,CDM,J2543,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,5.92,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.92,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,5.92,60.99,
PIPERACILLIN/TAZO(ZOSYN)VIAL:3.375GM,32010394,CDM,J2543,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,5.92,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.92,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,5.92,60.99,
ceFAZolin(ANCEF)VL:1GM,32010401,CDM,J0690,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,2.88,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.88,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,2.88,60.99,
SERTRALINE(ZOLOFT)TAB: 50MG,32010406,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
SERTRALINE(ZOLOFT)TAB:100MG,32010407,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
TRANEXAMIC ACID- IRR:2000 MG/NS100ML,32010408,CDM,,,258,RC,inpatient,,369.38,369.38,,313.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,313.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,325.05,88,,percent of total billed charges,,,,,,,,,282.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,336.14,91,,percent of total billed charges,,,350.91,95,,percent of total billed charges,,,306.59,83,,percent of total billed charges,,,306.59,83,,percent of total billed charges,,,,,,,,,,,,,,,306.59,83,,percent of total billed charges,,,350.91,95,,percent of total billed charges,,,332.44,90,,percent of total billed charges,,,332.44,90,,percent of total billed charges,,,302.89,82,,percent of total billed charges,,,332.44,90,,percent of total billed charges,,,313.97,85,,percent of total billed charges,,278.51,350.91,
ACYCLOVIR(ZOVIRAX)CAP:200MG,32010411,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ZOVIRAX 1G VLS (500MG DOSE),32010417,CDM,,,250,RC,inpatient,,923.87,923.87,,784.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,696.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,785.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,813.01,88,,percent of total billed charges,,,,,,,,,705.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,840.72,91,,percent of total billed charges,,,877.68,95,,percent of total billed charges,,,766.81,83,,percent of total billed charges,,,766.81,83,,percent of total billed charges,,,,,,,,,,,,,,,766.81,83,,percent of total billed charges,,,877.68,95,,percent of total billed charges,,,831.48,90,,percent of total billed charges,,,831.48,90,,percent of total billed charges,,,757.57,82,,percent of total billed charges,,,831.48,90,,percent of total billed charges,,,785.29,85,,percent of total billed charges,,696.6,877.68,
ACYCLOVIR(ZOVIRAX)OINT 5%:15GM,32010421,CDM,J3490,HCPCS,250,RC,inpatient,,1032.46,1032.46,,876.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,778.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,877.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,908.56,88,,percent of total billed charges,,,,,,,,,788.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,939.54,91,,percent of total billed charges,,,980.84,95,,percent of total billed charges,,,856.94,83,,percent of total billed charges,,,856.94,83,,percent of total billed charges,,,,,,,,,,,,,,,856.94,83,,percent of total billed charges,,,980.84,95,,percent of total billed charges,,,929.21,90,,percent of total billed charges,,,929.21,90,,percent of total billed charges,,,846.62,82,,percent of total billed charges,,,929.21,90,,percent of total billed charges,,,877.59,85,,percent of total billed charges,,778.47,980.84,
ACYCLOVIR(ZOVIRAX) OINT : 5%   2 GM,32010422,CDM,,,250,RC,inpatient,,353.2,353.2,,299.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,266.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,300.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,310.82,88,,percent of total billed charges,,,,,,,,,269.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,321.41,91,,percent of total billed charges,,,335.54,95,,percent of total billed charges,,,293.16,83,,percent of total billed charges,,,293.16,83,,percent of total billed charges,,,,,,,,,,,,,,,293.16,83,,percent of total billed charges,,,335.54,95,,percent of total billed charges,,,317.88,90,,percent of total billed charges,,,317.88,90,,percent of total billed charges,,,289.62,82,,percent of total billed charges,,,317.88,90,,percent of total billed charges,,,300.22,85,,percent of total billed charges,,266.31,335.54,
ACYCLOVIR (ZOVIRAX) TAB : 800MG,32010426,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
ZYPREXX 5MG TAB,32010427,CDM,,,250,RC,inpatient,,21,21,,17.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.48,88,,percent of total billed charges,,,,,,,,,16.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.22,82,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,15.83,19.95,
OLANZapine (Zyprexa) TAB : 10MG,32010428,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
OLANZapine(ZyPREXA)TAB:2.5MG,32010429,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
BUPIVACAINE LIPOSOME(Exparel)VL1.3%:20ML,32010484,CDM,C9290,HCPCS,250,RC,inpatient,,2806.84,2806.84,,2383.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2116.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2385.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2470.02,88,,percent of total billed charges,,,,,,,,,2144.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2554.22,91,,percent of total billed charges,,,2666.5,95,,percent of total billed charges,,,2329.68,83,,percent of total billed charges,,,2329.68,83,,percent of total billed charges,,,,,,,,,,,,,,,2329.68,83,,percent of total billed charges,,,2666.5,95,,percent of total billed charges,,,2526.16,90,,percent of total billed charges,,,2526.16,90,,percent of total billed charges,,,2301.61,82,,percent of total billed charges,,,2526.16,90,,percent of total billed charges,,,2385.81,85,,percent of total billed charges,,2116.36,2666.5,
GLYCERIN(PEDIA LAX) SUPP:PEDIATRIC,32010506,CDM,,,250,RC,inpatient,,14.22,14.22,,12.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.51,88,,percent of total billed charges,,,,,,,,,10.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.94,91,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,,,,,,,,,,,,,11.8,83,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,11.66,82,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.09,85,,percent of total billed charges,,10.72,13.51,
LEUPROLIDE(LUPRON DEPO)(3MONTHS) 22.5MG,32010523,CDM,J9217,HCPCS,636,RC,inpatient,,24301.94,24301.94,,20632.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18323.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20656.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21385.71,88,,percent of total billed charges,,998.81,,,,fee schedule,,,18566.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,998.81,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22114.77,91,,percent of total billed charges,,,23086.84,95,,percent of total billed charges,,,20170.61,83,,percent of total billed charges,,,20170.61,83,,percent of total billed charges,,,,,,,,,,,,,,,20170.61,83,,percent of total billed charges,,,23086.84,95,,percent of total billed charges,,,21871.75,90,,percent of total billed charges,,,21871.75,90,,percent of total billed charges,,,19927.59,82,,percent of total billed charges,,,21871.75,90,,percent of total billed charges,,,20656.65,85,,percent of total billed charges,,998.81,23086.84,
AZACITIDINE (VIDAZA) VIAL:100MG,32010527,CDM,J9025,HCPCS,636,RC,inpatient,,510.46,510.46,,433.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,384.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,433.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,449.2,88,,percent of total billed charges,,100.6,,,,fee schedule,,,389.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,100.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,464.52,91,,percent of total billed charges,,,484.94,95,,percent of total billed charges,,,423.68,83,,percent of total billed charges,,,423.68,83,,percent of total billed charges,,,,,,,,,,,,,,,423.68,83,,percent of total billed charges,,,484.94,95,,percent of total billed charges,,,459.41,90,,percent of total billed charges,,,459.41,90,,percent of total billed charges,,,418.58,82,,percent of total billed charges,,,459.41,90,,percent of total billed charges,,,433.89,85,,percent of total billed charges,,100.6,484.94,
CHLORHEXIDINE (PERIDEX ORAL) LIQD:473ML,32010567,CDM,J8499,HCPCS,250,RC,inpatient,,33.99,33.99,,28.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.91,88,,percent of total billed charges,,,,,,,,,25.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.93,91,,percent of total billed charges,,,32.29,95,,percent of total billed charges,,,28.21,83,,percent of total billed charges,,,28.21,83,,percent of total billed charges,,,,,,,,,,,,,,,28.21,83,,percent of total billed charges,,,32.29,95,,percent of total billed charges,,,30.59,90,,percent of total billed charges,,,30.59,90,,percent of total billed charges,,,27.87,82,,percent of total billed charges,,,30.59,90,,percent of total billed charges,,,28.89,85,,percent of total billed charges,,25.63,32.29,
IV DOBUTamine 250MG/D5W250ML   (PREMIX),32010680,CDM,J1250,HCPCS,250,RC,inpatient,,341.02,341.02,,289.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,257.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,289.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,300.1,88,,percent of total billed charges,,13.07,,,,fee schedule,,,260.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.07,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,310.33,91,,percent of total billed charges,,,323.97,95,,percent of total billed charges,,,283.05,83,,percent of total billed charges,,,283.05,83,,percent of total billed charges,,,,,,,,,,,,,,,283.05,83,,percent of total billed charges,,,323.97,95,,percent of total billed charges,,,306.92,90,,percent of total billed charges,,,306.92,90,,percent of total billed charges,,,279.64,82,,percent of total billed charges,,,306.92,90,,percent of total billed charges,,,289.87,85,,percent of total billed charges,,13.07,323.97,
BUDESON/FORMOT(SYMBICORT) 80/4.5  6.9GM:,32010688,CDM,J3490,HCPCS,250,RC,inpatient,,2533.14,2533.14,,2150.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1909.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2153.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2229.16,88,,percent of total billed charges,,,,,,,,,1935.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2305.16,91,,percent of total billed charges,,,2406.48,95,,percent of total billed charges,,,2102.51,83,,percent of total billed charges,,,2102.51,83,,percent of total billed charges,,,,,,,,,,,,,,,2102.51,83,,percent of total billed charges,,,2406.48,95,,percent of total billed charges,,,2279.83,90,,percent of total billed charges,,,2279.83,90,,percent of total billed charges,,,2077.17,82,,percent of total billed charges,,,2279.83,90,,percent of total billed charges,,,2153.17,85,,percent of total billed charges,,1909.99,2406.48,
AMYL NITRITE(AROMATIC)AMP:,32010708,CDM,J3490,HCPCS,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
BORTEZOMIB (VELCADE) VIAL:3.5MG,32010725,CDM,J9044,HCPCS,636,RC,inpatient,,7616.7,7616.7,,6466.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5742.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6474.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6702.7,88,,percent of total billed charges,,,,,,,,,5819.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6931.2,91,,percent of total billed charges,,,7235.87,95,,percent of total billed charges,,,6321.86,83,,percent of total billed charges,,,6321.86,83,,percent of total billed charges,,,,,,,,,,,,,,,6321.86,83,,percent of total billed charges,,,7235.87,95,,percent of total billed charges,,,6855.03,90,,percent of total billed charges,,,6855.03,90,,percent of total billed charges,,,6245.69,82,,percent of total billed charges,,,6855.03,90,,percent of total billed charges,,,6474.2,85,,percent of total billed charges,,5742.99,7235.87,
SCLEROSOL(STERILE TALC POWDER)4GM,32010792,CDM,,,250,RC,inpatient,,1721.66,1721.66,,1461.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1298.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1463.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1515.06,88,,percent of total billed charges,,,,,,,,,1315.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1566.71,91,,percent of total billed charges,,,1635.58,95,,percent of total billed charges,,,1428.98,83,,percent of total billed charges,,,1428.98,83,,percent of total billed charges,,,,,,,,,,,,,,,1428.98,83,,percent of total billed charges,,,1635.58,95,,percent of total billed charges,,,1549.49,90,,percent of total billed charges,,,1549.49,90,,percent of total billed charges,,,1411.76,82,,percent of total billed charges,,,1549.49,90,,percent of total billed charges,,,1463.41,85,,percent of total billed charges,,1298.13,1635.58,
ROFLUMILAST(DALIRESP)TAB:500MCG,32010822,CDM,J8499,HCPCS,250,RC,inpatient,,157.17,157.17,,133.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,118.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,133.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,138.31,88,,percent of total billed charges,,,,,,,,,120.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,143.02,91,,percent of total billed charges,,,149.31,95,,percent of total billed charges,,,130.45,83,,percent of total billed charges,,,130.45,83,,percent of total billed charges,,,,,,,,,,,,,,,130.45,83,,percent of total billed charges,,,149.31,95,,percent of total billed charges,,,141.45,90,,percent of total billed charges,,,141.45,90,,percent of total billed charges,,,128.88,82,,percent of total billed charges,,,141.45,90,,percent of total billed charges,,,133.59,85,,percent of total billed charges,,118.51,149.31,
INFLUENZA VACCINE(2013-2014)SYR:0.5ML,32010830,CDM,90656,CPT,636,RC,inpatient,,195.55,195.55,,166.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,147.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,166.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,172.08,88,,percent of total billed charges,,,,,,,,,149.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,177.95,91,,percent of total billed charges,,,185.77,95,,percent of total billed charges,,,162.31,83,,percent of total billed charges,,,162.31,83,,percent of total billed charges,,,,,,,,,,,,,,,162.31,83,,percent of total billed charges,,,185.77,95,,percent of total billed charges,,,176,90,,percent of total billed charges,,,176,90,,percent of total billed charges,,,160.35,82,,percent of total billed charges,,,176,90,,percent of total billed charges,,,166.22,85,,percent of total billed charges,,147.44,185.77,
ANASTROZOLE(ARIMIDEX)TAB:1MG,32010853,CDM,J8999,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
HIGH DOSE FLU VACCIN(2013-2014)SYR:0.5ML,32010865,CDM,90656,CPT,636,RC,inpatient,,454.39,454.39,,385.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,342.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,386.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,399.86,88,,percent of total billed charges,,,,,,,,,347.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,413.49,91,,percent of total billed charges,,,431.67,95,,percent of total billed charges,,,377.14,83,,percent of total billed charges,,,377.14,83,,percent of total billed charges,,,,,,,,,,,,,,,377.14,83,,percent of total billed charges,,,431.67,95,,percent of total billed charges,,,408.95,90,,percent of total billed charges,,,408.95,90,,percent of total billed charges,,,372.6,82,,percent of total billed charges,,,408.95,90,,percent of total billed charges,,,386.23,85,,percent of total billed charges,,342.61,431.67,
IMMUNE GLOBULIN(FLEBOGAMA)SDV:20GM/200ML,32010920,CDM,J1572,HCPCS,636,RC,inpatient,,9438.66,9438.66,,8013.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7116.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8022.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8306.02,88,,percent of total billed charges,,5980.5,,,,fee schedule,,,7211.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5980.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8589.18,91,,percent of total billed charges,,,8966.73,95,,percent of total billed charges,,,7834.09,83,,percent of total billed charges,,,7834.09,83,,percent of total billed charges,,,,,,,,,,,,,,,7834.09,83,,percent of total billed charges,,,8966.73,95,,percent of total billed charges,,,8494.79,90,,percent of total billed charges,,,8494.79,90,,percent of total billed charges,,,7739.7,82,,percent of total billed charges,,,8494.79,90,,percent of total billed charges,,,8022.86,85,,percent of total billed charges,,5980.5,8966.73,
ATORVASTATIN(LIPITOR)TAB:40MG,32010935,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
cePHALexin(KEFLEX)CAP:500MG (1x6),32010936,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LABETALOL(TRANDATE)TAB:100MG (1x6),32010937,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
NIFEdipine(PROCARDIA)CAP:10MG (1x6),32010938,CDM,J8499,HCPCS,250,RC,inpatient,,37.27,37.27,,31.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.8,88,,percent of total billed charges,,,,,,,,,28.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.92,91,,percent of total billed charges,,,35.41,95,,percent of total billed charges,,,30.93,83,,percent of total billed charges,,,30.93,83,,percent of total billed charges,,,,,,,,,,,,,,,30.93,83,,percent of total billed charges,,,35.41,95,,percent of total billed charges,,,33.54,90,,percent of total billed charges,,,33.54,90,,percent of total billed charges,,,30.56,82,,percent of total billed charges,,,33.54,90,,percent of total billed charges,,,31.68,85,,percent of total billed charges,,28.1,35.41,
TRANEXAMIC ACID:1000 MG/NS100ML,32010951,CDM,,,258,RC,inpatient,,64.22,64.22,,54.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.51,88,,percent of total billed charges,,,,,,,,,49.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.44,91,,percent of total billed charges,,,61.01,95,,percent of total billed charges,,,53.3,83,,percent of total billed charges,,,53.3,83,,percent of total billed charges,,,,,,,,,,,,,,,53.3,83,,percent of total billed charges,,,61.01,95,,percent of total billed charges,,,57.8,90,,percent of total billed charges,,,57.8,90,,percent of total billed charges,,,52.66,82,,percent of total billed charges,,,57.8,90,,percent of total billed charges,,,54.59,85,,percent of total billed charges,,48.42,61.01,
GABAPENTIN(NEURONTIN)TAB:600MG,32010960,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
MICAFUNGIN SODIUM VL:100 MG,32010973,CDM,J2248,HCPCS,250,RC,inpatient,,1029.64,1029.64,,874.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,776.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,875.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,906.08,88,,percent of total billed charges,,118.05,,,,fee schedule,,,786.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,118.05,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,936.97,91,,percent of total billed charges,,,978.16,95,,percent of total billed charges,,,854.6,83,,percent of total billed charges,,,854.6,83,,percent of total billed charges,,,,,,,,,,,,,,,854.6,83,,percent of total billed charges,,,978.16,95,,percent of total billed charges,,,926.68,90,,percent of total billed charges,,,926.68,90,,percent of total billed charges,,,844.3,82,,percent of total billed charges,,,926.68,90,,percent of total billed charges,,,875.19,85,,percent of total billed charges,,118.05,978.16,
COMBIVENT RESPIMAT,32010991,CDM,J3490,HCPCS,250,RC,inpatient,,3057.39,3057.39,,2595.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2305.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2598.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2690.5,88,,percent of total billed charges,,,,,,,,,2335.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2782.22,91,,percent of total billed charges,,,2904.52,95,,percent of total billed charges,,,2537.63,83,,percent of total billed charges,,,2537.63,83,,percent of total billed charges,,,,,,,,,,,,,,,2537.63,83,,percent of total billed charges,,,2904.52,95,,percent of total billed charges,,,2751.65,90,,percent of total billed charges,,,2751.65,90,,percent of total billed charges,,,2507.06,82,,percent of total billed charges,,,2751.65,90,,percent of total billed charges,,,2598.78,85,,percent of total billed charges,,2305.27,2904.52,
ZOMETA PREMIX-IVPB:4MG/100ML,32010995,CDM,J3489,HCPCS,636,RC,inpatient,,273.7,273.7,,232.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,206.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,232.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,240.86,88,,percent of total billed charges,,41.84,,,,fee schedule,,,209.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,41.84,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,249.07,91,,percent of total billed charges,,,260.02,95,,percent of total billed charges,,,227.17,83,,percent of total billed charges,,,227.17,83,,percent of total billed charges,,,,,,,,,,,,,,,227.17,83,,percent of total billed charges,,,260.02,95,,percent of total billed charges,,,246.33,90,,percent of total billed charges,,,246.33,90,,percent of total billed charges,,,224.43,82,,percent of total billed charges,,,246.33,90,,percent of total billed charges,,,232.65,85,,percent of total billed charges,,41.84,260.02,
buPROPion XL(Wellbutrin XL)TAB:150MG,32011036,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
NEXTERONE(AMIODARONE)150MG/100ML(PREMIX),32011044,CDM,J0282,HCPCS,250,RC,inpatient,,586.28,586.28,,497.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,442.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,498.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,515.93,88,,percent of total billed charges,,7.62,,,,fee schedule,,,447.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.62,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,533.51,91,,percent of total billed charges,,,556.97,95,,percent of total billed charges,,,486.61,83,,percent of total billed charges,,,486.61,83,,percent of total billed charges,,,,,,,,,,,,,,,486.61,83,,percent of total billed charges,,,556.97,95,,percent of total billed charges,,,527.65,90,,percent of total billed charges,,,527.65,90,,percent of total billed charges,,,480.75,82,,percent of total billed charges,,,527.65,90,,percent of total billed charges,,,498.34,85,,percent of total billed charges,,7.62,556.97,
NEXTERONE(AMIODARONE)360MG/200ML(PREMIX),32011045,CDM,J0282,HCPCS,250,RC,inpatient,,779.74,779.74,,662,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,587.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,662.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,686.17,88,,percent of total billed charges,,7.62,,,,fee schedule,,,595.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.62,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,709.56,91,,percent of total billed charges,,,740.75,95,,percent of total billed charges,,,647.18,83,,percent of total billed charges,,,647.18,83,,percent of total billed charges,,,,,,,,,,,,,,,647.18,83,,percent of total billed charges,,,740.75,95,,percent of total billed charges,,,701.77,90,,percent of total billed charges,,,701.77,90,,percent of total billed charges,,,639.39,82,,percent of total billed charges,,,701.77,90,,percent of total billed charges,,,662.78,85,,percent of total billed charges,,7.62,740.75,
MAGNESIUM SULFATE-IVPB:2GM/50ML (PREMIX),32011049,CDM,J3475,HCPCS,258,RC,inpatient,,253.92,253.92,,215.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,191.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,223.45,88,,percent of total billed charges,,15.22,,,,fee schedule,,,193.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,231.07,91,,percent of total billed charges,,,241.22,95,,percent of total billed charges,,,210.75,83,,percent of total billed charges,,,210.75,83,,percent of total billed charges,,,,,,,,,,,,,,,210.75,83,,percent of total billed charges,,,241.22,95,,percent of total billed charges,,,228.53,90,,percent of total billed charges,,,228.53,90,,percent of total billed charges,,,208.21,82,,percent of total billed charges,,,228.53,90,,percent of total billed charges,,,215.83,85,,percent of total billed charges,,15.22,241.22,
HYDROXYPROPL METHYL(GONAK)DROP 2.5% 15ML,32011072,CDM,,,250,RC,inpatient,,322.43,322.43,,273.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,243.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,274.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,283.74,88,,percent of total billed charges,,,,,,,,,246.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,293.41,91,,percent of total billed charges,,,306.31,95,,percent of total billed charges,,,267.62,83,,percent of total billed charges,,,267.62,83,,percent of total billed charges,,,,,,,,,,,,,,,267.62,83,,percent of total billed charges,,,306.31,95,,percent of total billed charges,,,290.19,90,,percent of total billed charges,,,290.19,90,,percent of total billed charges,,,264.39,82,,percent of total billed charges,,,290.19,90,,percent of total billed charges,,,274.07,85,,percent of total billed charges,,243.11,306.31,
IV LR 250ML,32011088,CDM,,,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
ORPHENADRINE(NORFLEX)VL:60MG/2ML,32011090,CDM,J2360,HCPCS,250,RC,inpatient,,260.79,260.79,,221.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,196.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,221.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,229.5,88,,percent of total billed charges,,4.07,,,,fee schedule,,,199.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,4.07,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,237.32,91,,percent of total billed charges,,,247.75,95,,percent of total billed charges,,,216.46,83,,percent of total billed charges,,,216.46,83,,percent of total billed charges,,,,,,,,,,,,,,,216.46,83,,percent of total billed charges,,,247.75,95,,percent of total billed charges,,,234.71,90,,percent of total billed charges,,,234.71,90,,percent of total billed charges,,,213.85,82,,percent of total billed charges,,,234.71,90,,percent of total billed charges,,,221.67,85,,percent of total billed charges,,4.07,247.75,
FAMOTIDINE(PEPCID)IVPB:20MG/NS50ML,32011106,CDM,J3490,HCPCS,258,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
AMINOPHYLLINE VIAL:250MG/10ML,32011136,CDM,J0280,HCPCS,250,RC,inpatient,,208.24,208.24,,176.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,157.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,177,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.25,88,,percent of total billed charges,,34.11,,,,fee schedule,,,159.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,34.11,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,189.5,91,,percent of total billed charges,,,197.83,95,,percent of total billed charges,,,172.84,83,,percent of total billed charges,,,172.84,83,,percent of total billed charges,,,,,,,,,,,,,,,172.84,83,,percent of total billed charges,,,197.83,95,,percent of total billed charges,,,187.42,90,,percent of total billed charges,,,187.42,90,,percent of total billed charges,,,170.76,82,,percent of total billed charges,,,187.42,90,,percent of total billed charges,,,177,85,,percent of total billed charges,,34.11,197.83,
IV DEXTROSE 10%-WATER SOL 500ML,32011267,CDM,J3490,HCPCS,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
SODIUM THIOSULFATE VIAL: 12.5GM/50ML,32011269,CDM,,,250,RC,inpatient,,1255.97,1255.97,,1066.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,947,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1067.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1105.25,88,,percent of total billed charges,,,,,,,,,959.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1142.93,91,,percent of total billed charges,,,1193.17,95,,percent of total billed charges,,,1042.46,83,,percent of total billed charges,,,1042.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1042.46,83,,percent of total billed charges,,,1193.17,95,,percent of total billed charges,,,1130.37,90,,percent of total billed charges,,,1130.37,90,,percent of total billed charges,,,1029.9,82,,percent of total billed charges,,,1130.37,90,,percent of total billed charges,,,1067.57,85,,percent of total billed charges,,947,1193.17,
MEROPENEM(MERREM)VIAL IV:500MG,32011279,CDM,J2185,HCPCS,250,RC,inpatient,,96.59,96.59,,82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,72.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,82.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,85,88,,percent of total billed charges,,14.5,,,,fee schedule,,,73.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,87.9,91,,percent of total billed charges,,,91.76,95,,percent of total billed charges,,,80.17,83,,percent of total billed charges,,,80.17,83,,percent of total billed charges,,,,,,,,,,,,,,,80.17,83,,percent of total billed charges,,,91.76,95,,percent of total billed charges,,,86.93,90,,percent of total billed charges,,,86.93,90,,percent of total billed charges,,,79.2,82,,percent of total billed charges,,,86.93,90,,percent of total billed charges,,,82.1,85,,percent of total billed charges,,14.5,91.76,
DECITABINE VIAL: 50MG,32011327,CDM,J0894,HCPCS,636,RC,inpatient,,6132.7,6132.7,,5206.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4624.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5212.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5396.78,88,,percent of total billed charges,,70.75,,,,fee schedule,,,4685.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,70.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5580.76,91,,percent of total billed charges,,,5826.07,95,,percent of total billed charges,,,5090.14,83,,percent of total billed charges,,,5090.14,83,,percent of total billed charges,,,,,,,,,,,,,,,5090.14,83,,percent of total billed charges,,,5826.07,95,,percent of total billed charges,,,5519.43,90,,percent of total billed charges,,,5519.43,90,,percent of total billed charges,,,5028.81,82,,percent of total billed charges,,,5519.43,90,,percent of total billed charges,,,5212.8,85,,percent of total billed charges,,70.75,5826.07,
CHLORTHALIDONE TAB:25MG,32011342,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ROPIVACAINE 0.2%:20ML,32011394,CDM,J2795,HCPCS,250,RC,inpatient,,163.4,163.4,,138.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,123.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,138.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,143.79,88,,percent of total billed charges,,13.8,,,,fee schedule,,,124.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.8,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,148.69,91,,percent of total billed charges,,,155.23,95,,percent of total billed charges,,,135.62,83,,percent of total billed charges,,,135.62,83,,percent of total billed charges,,,,,,,,,,,,,,,135.62,83,,percent of total billed charges,,,155.23,95,,percent of total billed charges,,,147.06,90,,percent of total billed charges,,,147.06,90,,percent of total billed charges,,,133.99,82,,percent of total billed charges,,,147.06,90,,percent of total billed charges,,,138.89,85,,percent of total billed charges,,13.8,155.23,
Dangles Cocktail W/O Ketorolac,32011422,CDM,,,258,RC,inpatient,,369.77,369.77,,313.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,278.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,314.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,325.4,88,,percent of total billed charges,,,,,,,,,282.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,336.49,91,,percent of total billed charges,,,351.28,95,,percent of total billed charges,,,306.91,83,,percent of total billed charges,,,306.91,83,,percent of total billed charges,,,,,,,,,,,,,,,306.91,83,,percent of total billed charges,,,351.28,95,,percent of total billed charges,,,332.79,90,,percent of total billed charges,,,332.79,90,,percent of total billed charges,,,303.21,82,,percent of total billed charges,,,332.79,90,,percent of total billed charges,,,314.3,85,,percent of total billed charges,,278.81,351.28,
CLINDAMYCIN(CLEOCIN)VIAL:900MG/6ML,32011435,CDM,,,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
ceFAZolin(ANCef):10gm bulk vial,32011444,CDM,J0690,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,2.88,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.88,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,2.88,59.21,
DOPamine VIAL:400MG/10ML,32011445,CDM,J1265,HCPCS,636,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,7.14,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.14,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,7.14,59.21,
DOPamine VIAL:400MG/5ML(2x conc),32011446,CDM,J1265,HCPCS,636,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,7.14,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.14,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,7.14,59.21,
ACTIVATED CHARCL(ADULT)ORAL:50G/240ML,32011447,CDM,,,250,RC,inpatient,,298.96,298.96,,253.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,225.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,254.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,263.08,88,,percent of total billed charges,,,,,,,,,228.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,272.05,91,,percent of total billed charges,,,284.01,95,,percent of total billed charges,,,248.14,83,,percent of total billed charges,,,248.14,83,,percent of total billed charges,,,,,,,,,,,,,,,248.14,83,,percent of total billed charges,,,284.01,95,,percent of total billed charges,,,269.06,90,,percent of total billed charges,,,269.06,90,,percent of total billed charges,,,245.15,82,,percent of total billed charges,,,269.06,90,,percent of total billed charges,,,254.12,85,,percent of total billed charges,,225.42,284.01,
SUFentanil(SUFENTA) FTV:100MCG/2ML,32011448,CDM,,,250,RC,inpatient,,83.26,83.26,,70.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,62.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,70.77,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,73.27,88,,percent of total billed charges,,,,,,,,,63.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,75.77,91,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,,,,,,,,,,,,,69.11,83,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,68.27,82,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,70.77,85,,percent of total billed charges,,62.78,79.1,
HYDROmorphone (DILAUDID) VIAL:40MG/20ML,32011450,CDM,J1170,HCPCS,250,RC,inpatient,,396.02,396.02,,336.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,298.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,336.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,348.5,88,,percent of total billed charges,,3.47,,,,fee schedule,,,302.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.47,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,360.38,91,,percent of total billed charges,,,376.22,95,,percent of total billed charges,,,328.7,83,,percent of total billed charges,,,328.7,83,,percent of total billed charges,,,,,,,,,,,,,,,328.7,83,,percent of total billed charges,,,376.22,95,,percent of total billed charges,,,356.42,90,,percent of total billed charges,,,356.42,90,,percent of total billed charges,,,324.74,82,,percent of total billed charges,,,356.42,90,,percent of total billed charges,,,336.62,85,,percent of total billed charges,,3.47,376.22,
LEUCOVORIN CALCIUM VIAL:50MG,32011474,CDM,J0640,HCPCS,636,RC,inpatient,,166.53,166.53,,141.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,146.55,88,,percent of total billed charges,,100.5,,,,fee schedule,,,127.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,100.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,151.54,91,,percent of total billed charges,,,158.2,95,,percent of total billed charges,,,138.22,83,,percent of total billed charges,,,138.22,83,,percent of total billed charges,,,,,,,,,,,,,,,138.22,83,,percent of total billed charges,,,158.2,95,,percent of total billed charges,,,149.88,90,,percent of total billed charges,,,149.88,90,,percent of total billed charges,,,136.55,82,,percent of total billed charges,,,149.88,90,,percent of total billed charges,,,141.55,85,,percent of total billed charges,,100.5,158.2,
LIDOCAINE HCL 1% VIAL:(10MG/ML) (10ML),32011475,CDM,J2001,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
TRIAMCINOLONE(KENALOG) 0.1% CRM:80GM,32011477,CDM,,,250,RC,inpatient,,116.57,116.57,,98.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,87.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,99.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,102.58,88,,percent of total billed charges,,,,,,,,,89.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,106.08,91,,percent of total billed charges,,,110.74,95,,percent of total billed charges,,,96.75,83,,percent of total billed charges,,,96.75,83,,percent of total billed charges,,,,,,,,,,,,,,,96.75,83,,percent of total billed charges,,,110.74,95,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,95.59,82,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,99.08,85,,percent of total billed charges,,87.89,110.74,
EUCERIN LOT:480 GM,32011479,CDM,,,250,RC,inpatient,,39.89,39.89,,33.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.1,88,,percent of total billed charges,,,,,,,,,30.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.3,91,,percent of total billed charges,,,37.9,95,,percent of total billed charges,,,33.11,83,,percent of total billed charges,,,33.11,83,,percent of total billed charges,,,,,,,,,,,,,,,33.11,83,,percent of total billed charges,,,37.9,95,,percent of total billed charges,,,35.9,90,,percent of total billed charges,,,35.9,90,,percent of total billed charges,,,32.71,82,,percent of total billed charges,,,35.9,90,,percent of total billed charges,,,33.91,85,,percent of total billed charges,,30.08,37.9,
MEPIVACAINE 1% PF VL: 10MG/ML (30ML),32011480,CDM,J0670,HCPCS,250,RC,inpatient,,111.65,111.65,,94.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.25,88,,percent of total billed charges,,,,,,,,,85.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.6,91,,percent of total billed charges,,,106.07,95,,percent of total billed charges,,,92.67,83,,percent of total billed charges,,,92.67,83,,percent of total billed charges,,,,,,,,,,,,,,,92.67,83,,percent of total billed charges,,,106.07,95,,percent of total billed charges,,,100.49,90,,percent of total billed charges,,,100.49,90,,percent of total billed charges,,,91.55,82,,percent of total billed charges,,,100.49,90,,percent of total billed charges,,,94.9,85,,percent of total billed charges,,84.18,106.07,
METHIMAZOLE(TAPAZOLE)TAB:10MG,32011481,CDM,J8499,HCPCS,250,RC,inpatient,,9,9,,7.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.92,88,,percent of total billed charges,,,,,,,,,6.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.38,82,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,6.79,8.55,
methylPRED(solu-MEDROL)VIAL:500MG,32011482,CDM,J2930,HCPCS,250,RC,inpatient,,223.44,223.44,,189.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.63,88,,percent of total billed charges,,172.26,,,,fee schedule,,,170.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,172.26,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,203.33,91,,percent of total billed charges,,,212.27,95,,percent of total billed charges,,,185.46,83,,percent of total billed charges,,,185.46,83,,percent of total billed charges,,,,,,,,,,,,,,,185.46,83,,percent of total billed charges,,,212.27,95,,percent of total billed charges,,,201.1,90,,percent of total billed charges,,,201.1,90,,percent of total billed charges,,,183.22,82,,percent of total billed charges,,,201.1,90,,percent of total billed charges,,,189.92,85,,percent of total billed charges,,168.47,212.27,
NAFCILLIN BULK VIAL: 10GM,32011483,CDM,J3490,HCPCS,250,RC,inpatient,,715.67,715.67,,607.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,539.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,608.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,629.79,88,,percent of total billed charges,,,,,,,,,546.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,651.26,91,,percent of total billed charges,,,679.89,95,,percent of total billed charges,,,594.01,83,,percent of total billed charges,,,594.01,83,,percent of total billed charges,,,,,,,,,,,,,,,594.01,83,,percent of total billed charges,,,679.89,95,,percent of total billed charges,,,644.1,90,,percent of total billed charges,,,644.1,90,,percent of total billed charges,,,586.85,82,,percent of total billed charges,,,644.1,90,,percent of total billed charges,,,608.32,85,,percent of total billed charges,,539.62,679.89,
RAMIPRIL(ALTACE)CAP:10MG,32011484,CDM,,,250,RC,inpatient,,17.16,17.16,,14.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15.1,88,,percent of total billed charges,,,,,,,,,13.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.62,91,,percent of total billed charges,,,16.3,95,,percent of total billed charges,,,14.24,83,,percent of total billed charges,,,14.24,83,,percent of total billed charges,,,,,,,,,,,,,,,14.24,83,,percent of total billed charges,,,16.3,95,,percent of total billed charges,,,15.44,90,,percent of total billed charges,,,15.44,90,,percent of total billed charges,,,14.07,82,,percent of total billed charges,,,15.44,90,,percent of total billed charges,,,14.59,85,,percent of total billed charges,,12.94,16.3,
OFLOXACIN (OCUFLOX)DROP OPTH : 0.3% 5ML,32011485,CDM,,,250,RC,inpatient,,164.71,164.71,,139.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,124.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,140,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,144.94,88,,percent of total billed charges,,,,,,,,,125.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,149.89,91,,percent of total billed charges,,,156.47,95,,percent of total billed charges,,,136.71,83,,percent of total billed charges,,,136.71,83,,percent of total billed charges,,,,,,,,,,,,,,,136.71,83,,percent of total billed charges,,,156.47,95,,percent of total billed charges,,,148.24,90,,percent of total billed charges,,,148.24,90,,percent of total billed charges,,,135.06,82,,percent of total billed charges,,,148.24,90,,percent of total billed charges,,,140,85,,percent of total billed charges,,124.19,156.47,
PHENYLEPH(NEO-SYNPHRINE)VIAL:50MG/5ML,32011488,CDM,,,250,RC,inpatient,,114,114,,96.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,100.32,88,,percent of total billed charges,,,,,,,,,87.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,103.74,91,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,,,,,,,,,,,,,94.62,83,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,93.48,82,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,96.9,85,,percent of total billed charges,,85.96,108.3,
PIPERONLY BUTOXI/PYRETHRM EXT(RID):118ML,32011489,CDM,J3490,HCPCS,250,RC,inpatient,,72.22,72.22,,61.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,54.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,61.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,63.55,88,,percent of total billed charges,,,,,,,,,55.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,65.72,91,,percent of total billed charges,,,68.61,95,,percent of total billed charges,,,59.94,83,,percent of total billed charges,,,59.94,83,,percent of total billed charges,,,,,,,,,,,,,,,59.94,83,,percent of total billed charges,,,68.61,95,,percent of total billed charges,,,65,90,,percent of total billed charges,,,65,90,,percent of total billed charges,,,59.22,82,,percent of total billed charges,,,65,90,,percent of total billed charges,,,61.39,85,,percent of total billed charges,,54.45,68.61,
SILVER SULFADIAZINE(SSD AF)CREAM 1%:25G,32011490,CDM,J3490,HCPCS,250,RC,inpatient,,61.38,61.38,,52.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.01,88,,percent of total billed charges,,,,,,,,,46.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55.86,91,,percent of total billed charges,,,58.31,95,,percent of total billed charges,,,50.95,83,,percent of total billed charges,,,50.95,83,,percent of total billed charges,,,,,,,,,,,,,,,50.95,83,,percent of total billed charges,,,58.31,95,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,50.33,82,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,52.17,85,,percent of total billed charges,,46.28,58.31,
GLYCERIN INFANT RECTAL ENEMA 4ML,32011491,CDM,J3490,HCPCS,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
HYDROCODONE/APAP SOL : 7.5-325MG/15ML UD,32011512,CDM,,,250,RC,inpatient,,75,75,,63.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,56.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,63.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,66,88,,percent of total billed charges,,,,,,,,,57.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,68.25,91,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,,,,,,,,,,,,,62.25,83,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,61.5,82,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,56.55,71.25,
HYDROcod/APAP(Norco):7.5-325/15ML 118ML,32011513,CDM,,,250,RC,inpatient,,111.5,111.5,,94.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.12,88,,percent of total billed charges,,,,,,,,,85.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.47,91,,percent of total billed charges,,,105.93,95,,percent of total billed charges,,,92.55,83,,percent of total billed charges,,,92.55,83,,percent of total billed charges,,,,,,,,,,,,,,,92.55,83,,percent of total billed charges,,,105.93,95,,percent of total billed charges,,,100.35,90,,percent of total billed charges,,,100.35,90,,percent of total billed charges,,,91.43,82,,percent of total billed charges,,,100.35,90,,percent of total billed charges,,,94.78,85,,percent of total billed charges,,84.07,105.93,
ETANERCEPT (ENBREL)SYR: 50 mg/0.98ML,32011514,CDM,J1438,HCPCS,250,RC,inpatient,,7049.88,7049.88,,5985.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5315.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5992.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6203.89,88,,percent of total billed charges,,,,,,,,,5386.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6415.39,91,,percent of total billed charges,,,6697.39,95,,percent of total billed charges,,,5851.4,83,,percent of total billed charges,,,5851.4,83,,percent of total billed charges,,,,,,,,,,,,,,,5851.4,83,,percent of total billed charges,,,6697.39,95,,percent of total billed charges,,,6344.89,90,,percent of total billed charges,,,6344.89,90,,percent of total billed charges,,,5780.9,82,,percent of total billed charges,,,6344.89,90,,percent of total billed charges,,,5992.4,85,,percent of total billed charges,,5315.61,6697.39,
PHENYTOIN ORAL SUSP U/D:100MG/4ML,32011590,CDM,J8499,HCPCS,250,RC,inpatient,,69.28,69.28,,58.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.97,88,,percent of total billed charges,,,,,,,,,52.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,63.04,91,,percent of total billed charges,,,65.82,95,,percent of total billed charges,,,57.5,83,,percent of total billed charges,,,57.5,83,,percent of total billed charges,,,,,,,,,,,,,,,57.5,83,,percent of total billed charges,,,65.82,95,,percent of total billed charges,,,62.35,90,,percent of total billed charges,,,62.35,90,,percent of total billed charges,,,56.81,82,,percent of total billed charges,,,62.35,90,,percent of total billed charges,,,58.89,85,,percent of total billed charges,,52.24,65.82,
VALPROIC ACID SYRUP U/D:250MG/5ML,32011630,CDM,J8499,HCPCS,250,RC,inpatient,,16.18,16.18,,13.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.24,88,,percent of total billed charges,,,,,,,,,12.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.72,91,,percent of total billed charges,,,15.37,95,,percent of total billed charges,,,13.43,83,,percent of total billed charges,,,13.43,83,,percent of total billed charges,,,,,,,,,,,,,,,13.43,83,,percent of total billed charges,,,15.37,95,,percent of total billed charges,,,14.56,90,,percent of total billed charges,,,14.56,90,,percent of total billed charges,,,13.27,82,,percent of total billed charges,,,14.56,90,,percent of total billed charges,,,13.75,85,,percent of total billed charges,,12.2,15.37,
GUAIFENESIN SYRUP UD:200MG/10ML,32011631,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
BUDESONIDE(PULMICORT):0.5MG/2MLNEB,32011638,CDM,J7626,HCPCS,250,RC,inpatient,,29.25,29.25,,24.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.74,88,,percent of total billed charges,,1.93,,,,fee schedule,,,22.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.93,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.62,91,,percent of total billed charges,,,27.79,95,,percent of total billed charges,,,24.28,83,,percent of total billed charges,,,24.28,83,,percent of total billed charges,,,,,,,,,,,,,,,24.28,83,,percent of total billed charges,,,27.79,95,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,23.99,82,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,24.86,85,,percent of total billed charges,,1.93,27.79,
PROPOFOL(DIPRIVAN)VIAL:500MG/50ML,32011682,CDM,J2704,HCPCS,250,RC,inpatient,,80.23,80.23,,68.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.6,88,,percent of total billed charges,,14.4,,,,fee schedule,,,61.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.4,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73.01,91,,percent of total billed charges,,,76.22,95,,percent of total billed charges,,,66.59,83,,percent of total billed charges,,,66.59,83,,percent of total billed charges,,,,,,,,,,,,,,,66.59,83,,percent of total billed charges,,,76.22,95,,percent of total billed charges,,,72.21,90,,percent of total billed charges,,,72.21,90,,percent of total billed charges,,,65.79,82,,percent of total billed charges,,,72.21,90,,percent of total billed charges,,,68.2,85,,percent of total billed charges,,14.4,76.22,
VANCOMYCIN-VIAL:10GM BULK,32011683,CDM,J3370,HCPCS,250,RC,inpatient,,3035.16,3035.16,,2576.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2288.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2579.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2670.94,88,,percent of total billed charges,,19.39,,,,fee schedule,,,2318.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.39,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2762,91,,percent of total billed charges,,,2883.4,95,,percent of total billed charges,,,2519.18,83,,percent of total billed charges,,,2519.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2519.18,83,,percent of total billed charges,,,2883.4,95,,percent of total billed charges,,,2731.64,90,,percent of total billed charges,,,2731.64,90,,percent of total billed charges,,,2488.83,82,,percent of total billed charges,,,2731.64,90,,percent of total billed charges,,,2579.89,85,,percent of total billed charges,,19.39,2883.4,
SILVER SULFADIAZINE(SSD AF)CREAM 1%:20G,32011684,CDM,J3490,HCPCS,250,RC,inpatient,,139.71,139.71,,118.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,105.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,118.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,122.94,88,,percent of total billed charges,,,,,,,,,106.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,127.14,91,,percent of total billed charges,,,132.72,95,,percent of total billed charges,,,115.96,83,,percent of total billed charges,,,115.96,83,,percent of total billed charges,,,,,,,,,,,,,,,115.96,83,,percent of total billed charges,,,132.72,95,,percent of total billed charges,,,125.74,90,,percent of total billed charges,,,125.74,90,,percent of total billed charges,,,114.56,82,,percent of total billed charges,,,125.74,90,,percent of total billed charges,,,118.75,85,,percent of total billed charges,,105.34,132.72,
DEXAMETHASONE VIAL **NON PF** :10MG/ML,32011685,CDM,J1100,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,5,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,5,60.99,
ZN/CU/PHYD/MANG/SE(MULTITRACE-5)VIAL:1ML,32011686,CDM,J3490,HCPCS,250,RC,inpatient,,218.63,218.63,,185.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.84,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,192.39,88,,percent of total billed charges,,,,,,,,,167.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,198.95,91,,percent of total billed charges,,,207.7,95,,percent of total billed charges,,,181.46,83,,percent of total billed charges,,,181.46,83,,percent of total billed charges,,,,,,,,,,,,,,,181.46,83,,percent of total billed charges,,,207.7,95,,percent of total billed charges,,,196.77,90,,percent of total billed charges,,,196.77,90,,percent of total billed charges,,,179.28,82,,percent of total billed charges,,,196.77,90,,percent of total billed charges,,,185.84,85,,percent of total billed charges,,164.85,207.7,
MINERAL OIL:473ML,32011688,CDM,J3490,HCPCS,250,RC,inpatient,UD,29.5,29.5,,25.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.96,88,,percent of total billed charges,,,,,,,,,22.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.85,91,,percent of total billed charges,,,28.03,95,,percent of total billed charges,,,24.49,83,,percent of total billed charges,,,24.49,83,,percent of total billed charges,,,,,,,,,,,,,,,24.49,83,,percent of total billed charges,,,28.03,95,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,24.19,82,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,25.08,85,,percent of total billed charges,,22.24,28.03,
VasoSTRICT(VASOPRESSIN)VL:20UNIT/ML,32011689,CDM,J8499,HCPCS,250,RC,inpatient,,3039.96,3039.96,,2580.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2292.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2583.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2675.16,88,,percent of total billed charges,,,,,,,,,2322.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2766.36,91,,percent of total billed charges,,,2887.96,95,,percent of total billed charges,,,2523.17,83,,percent of total billed charges,,,2523.17,83,,percent of total billed charges,,,,,,,,,,,,,,,2523.17,83,,percent of total billed charges,,,2887.96,95,,percent of total billed charges,,,2735.96,90,,percent of total billed charges,,,2735.96,90,,percent of total billed charges,,,2492.77,82,,percent of total billed charges,,,2735.96,90,,percent of total billed charges,,,2583.97,85,,percent of total billed charges,,2292.13,2887.96,
NIVOLUMAB(OPDIVO)100MG/10ML,32011701,CDM,J9299,HCPCS,636,RC,inpatient,,12389.31,12389.31,,10518.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9341.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10530.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10902.59,88,,percent of total billed charges,,14182.56,,,,fee schedule,,,9465.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14182.56,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11274.27,91,,percent of total billed charges,,,11769.84,95,,percent of total billed charges,,,10283.13,83,,percent of total billed charges,,,10283.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10283.13,83,,percent of total billed charges,,,11769.84,95,,percent of total billed charges,,,11150.38,90,,percent of total billed charges,,,11150.38,90,,percent of total billed charges,,,10159.23,82,,percent of total billed charges,,,11150.38,90,,percent of total billed charges,,,10530.91,85,,percent of total billed charges,,9341.54,14182.56,
CABERGOLINE TAB:0.5MG,32011716,CDM,,,250,RC,inpatient,,51.23,51.23,,43.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.08,88,,percent of total billed charges,,,,,,,,,39.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.62,91,,percent of total billed charges,,,48.67,95,,percent of total billed charges,,,42.52,83,,percent of total billed charges,,,42.52,83,,percent of total billed charges,,,,,,,,,,,,,,,42.52,83,,percent of total billed charges,,,48.67,95,,percent of total billed charges,,,46.11,90,,percent of total billed charges,,,46.11,90,,percent of total billed charges,,,42.01,82,,percent of total billed charges,,,46.11,90,,percent of total billed charges,,,43.55,85,,percent of total billed charges,,38.63,48.67,
DOCEtaxel(TaxoTERE)MDV 20MG/ML:J/1MG,32011718,CDM,J9171,HCPCS,636,RC,inpatient,,26.33,26.33,,22.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23.17,88,,percent of total billed charges,,121.68,,,,fee schedule,,,20.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.96,91,,percent of total billed charges,,,25.01,95,,percent of total billed charges,,,21.85,83,,percent of total billed charges,,,21.85,83,,percent of total billed charges,,,,,,,,,,,,,,,21.85,83,,percent of total billed charges,,,25.01,95,,percent of total billed charges,,,23.7,90,,percent of total billed charges,,,23.7,90,,percent of total billed charges,,,21.59,82,,percent of total billed charges,,,23.7,90,,percent of total billed charges,,,22.38,85,,percent of total billed charges,,19.85,121.68,
DENOSUMAB (XGEVA): 120 mg,32011728,CDM,J0897,HCPCS,636,RC,inpatient,,12645.94,12645.94,,10736.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9535.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10749.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11128.43,88,,percent of total billed charges,,2701.2,,,,fee schedule,,,9661.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2701.2,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11507.81,91,,percent of total billed charges,,,12013.64,95,,percent of total billed charges,,,10496.13,83,,percent of total billed charges,,,10496.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10496.13,83,,percent of total billed charges,,,12013.64,95,,percent of total billed charges,,,11381.35,90,,percent of total billed charges,,,11381.35,90,,percent of total billed charges,,,10369.67,82,,percent of total billed charges,,,11381.35,90,,percent of total billed charges,,,10749.05,85,,percent of total billed charges,,2701.2,12013.64,
APIXABAN(ELIQUIS) TABS:2.5MG,32011733,CDM,J8499,HCPCS,250,RC,inpatient,,111.77,111.77,,94.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.36,88,,percent of total billed charges,,,,,,,,,85.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.71,91,,percent of total billed charges,,,106.18,95,,percent of total billed charges,,,92.77,83,,percent of total billed charges,,,92.77,83,,percent of total billed charges,,,,,,,,,,,,,,,92.77,83,,percent of total billed charges,,,106.18,95,,percent of total billed charges,,,100.59,90,,percent of total billed charges,,,100.59,90,,percent of total billed charges,,,91.65,82,,percent of total billed charges,,,100.59,90,,percent of total billed charges,,,95,85,,percent of total billed charges,,84.27,106.18,
HIV PEP KIT(ZIDOV EMTRICIT RALTEG)30 DAY,32011746,CDM,,,250,RC,inpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,152.71,192.4,
HYDROGEN PEROXIDE SOL 3%:240 ML,32011769,CDM,J3490,HCPCS,250,RC,inpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,14.84,18.7,
D5 0.225 NS 500ML,32011804,CDM,J3490,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
GEODON(ZIPRASIDONE)VIAL:20MG/ML,32011813,CDM,J3486,HCPCS,250,RC,inpatient,,771.46,771.46,,654.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,581.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,655.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,678.88,88,,percent of total billed charges,,,,,,,,,589.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,702.03,91,,percent of total billed charges,,,732.89,95,,percent of total billed charges,,,640.31,83,,percent of total billed charges,,,640.31,83,,percent of total billed charges,,,,,,,,,,,,,,,640.31,83,,percent of total billed charges,,,732.89,95,,percent of total billed charges,,,694.31,90,,percent of total billed charges,,,694.31,90,,percent of total billed charges,,,632.6,82,,percent of total billed charges,,,694.31,90,,percent of total billed charges,,,655.74,85,,percent of total billed charges,,581.68,732.89,
OXCARBAZEPINE (TRILEPTAL) TAB : 300MG,32011814,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
OXALIPLATIN(ELOXATIN):100MG/20ML,32011844,CDM,J9263,HCPCS,636,RC,inpatient,,302.45,302.45,,256.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.16,88,,percent of total billed charges,,38.5,,,,fee schedule,,,231.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,38.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.23,91,,percent of total billed charges,,,287.33,95,,percent of total billed charges,,,251.03,83,,percent of total billed charges,,,251.03,83,,percent of total billed charges,,,,,,,,,,,,,,,251.03,83,,percent of total billed charges,,,287.33,95,,percent of total billed charges,,,272.21,90,,percent of total billed charges,,,272.21,90,,percent of total billed charges,,,248.01,82,,percent of total billed charges,,,272.21,90,,percent of total billed charges,,,257.08,85,,percent of total billed charges,,38.5,287.33,
LIDOCAINE HCL 2%PF VIAL:(10MG/ML) (10ML),32011845,CDM,J2001,HCPCS,250,RC,inpatient,,100.39,100.39,,85.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88.34,88,,percent of total billed charges,,0.75,,,,fee schedule,,,76.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91.35,91,,percent of total billed charges,,,95.37,95,,percent of total billed charges,,,83.32,83,,percent of total billed charges,,,83.32,83,,percent of total billed charges,,,,,,,,,,,,,,,83.32,83,,percent of total billed charges,,,95.37,95,,percent of total billed charges,,,90.35,90,,percent of total billed charges,,,90.35,90,,percent of total billed charges,,,82.32,82,,percent of total billed charges,,,90.35,90,,percent of total billed charges,,,85.33,85,,percent of total billed charges,,0.75,95.37,
GADOBENATE DIMEGLUMINE 529MG/ML:15ML,32011846,CDM,,,250,RC,inpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,613.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,691.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,613.19,772.59,
GADOBENATE DIMEGLUMINE 529MG/ML:5ML,32011847,CDM,,,250,RC,inpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,613.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,691.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,613.19,772.59,
IOPAMIDOL 76% SOL:125ML,32011851,CDM,Q9967,HCPCS,250,RC,inpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,613.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,691.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,613.19,772.59,
BARIUM SULFATE 0.1% SUS:125ML,32011852,CDM,,,250,RC,inpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,152.71,192.4,
BARIUM SULFATE 2.1% SUS:450ML,32011853,CDM,,,250,RC,inpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,152.71,192.4,
BARIUM SULFATE 40% POW: 48GM,32011854,CDM,,,250,RC,inpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,152.71,192.4,
BARIUM SULFATE 105% SUS,32011855,CDM,,,250,RC,inpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,152.71,192.4,
BARIUM SULFATE 24% SUS: 600 ML,32011856,CDM,,,250,RC,inpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,152.71,192.4,
BARIUM SULFATE 98% POW: 340 GM,32011857,CDM,,,250,RC,inpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,152.71,192.4,
BARIUM SULFATE 96% POW: 176 GM,32011858,CDM,,,250,RC,inpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,152.71,192.4,
CITRIC ACID/SIMETH/BICARB 4G U/D PKT,32011859,CDM,,,250,RC,inpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,152.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,152.71,192.4,
DOCEtaxel(TaxoTERE)SDV: 80MG/4ML,32011866,CDM,J9171,HCPCS,636,RC,inpatient,,523.04,523.04,,444.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,394.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,444.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,460.28,88,,percent of total billed charges,,121.68,,,,fee schedule,,,399.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,475.97,91,,percent of total billed charges,,,496.89,95,,percent of total billed charges,,,434.12,83,,percent of total billed charges,,,434.12,83,,percent of total billed charges,,,,,,,,,,,,,,,434.12,83,,percent of total billed charges,,,496.89,95,,percent of total billed charges,,,470.74,90,,percent of total billed charges,,,470.74,90,,percent of total billed charges,,,428.89,82,,percent of total billed charges,,,470.74,90,,percent of total billed charges,,,444.58,85,,percent of total billed charges,,121.68,496.89,
IV MANNITOL SOL 20%:250 ML,32011867,CDM,,,250,RC,inpatient,,175,175,,148.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,131.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,148.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154,88,,percent of total billed charges,,,,,,,,,133.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,,,,,,,,,,,,,145.25,83,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,143.5,82,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,131.95,166.25,
CYCLOPHOSPHAMIDE(CYTOXAN)VIAL:1GM,32011868,CDM,J9070,HCPCS,636,RC,inpatient,,549.38,549.38,,466.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,414.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,466.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,483.45,88,,percent of total billed charges,,1315.38,,,,fee schedule,,,419.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1315.38,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,499.94,91,,percent of total billed charges,,,521.91,95,,percent of total billed charges,,,455.99,83,,percent of total billed charges,,,455.99,83,,percent of total billed charges,,,,,,,,,,,,,,,455.99,83,,percent of total billed charges,,,521.91,95,,percent of total billed charges,,,494.44,90,,percent of total billed charges,,,494.44,90,,percent of total billed charges,,,450.49,82,,percent of total billed charges,,,494.44,90,,percent of total billed charges,,,466.97,85,,percent of total billed charges,,414.23,1315.38,
IOPAMIDOL 41% SOL:20ML,32011869,CDM,Q9966,HCPCS,250,RC,inpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,613.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,691.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,613.19,772.59,
ERIBULIN (HALAVEN) VIAL:1MG/2ML,32011870,CDM,J9179,HCPCS,636,RC,inpatient,,5896.8,5896.8,,5006.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4446.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5012.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5189.18,88,,percent of total billed charges,,3770.4,,,,fee schedule,,,4505.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3770.4,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5366.09,91,,percent of total billed charges,,,5601.96,95,,percent of total billed charges,,,4894.34,83,,percent of total billed charges,,,4894.34,83,,percent of total billed charges,,,,,,,,,,,,,,,4894.34,83,,percent of total billed charges,,,5601.96,95,,percent of total billed charges,,,5307.12,90,,percent of total billed charges,,,5307.12,90,,percent of total billed charges,,,4835.38,82,,percent of total billed charges,,,5307.12,90,,percent of total billed charges,,,5012.28,85,,percent of total billed charges,,3770.4,5601.96,
diatrizoate meglumine 30% SOL:300ML,32011871,CDM,Q9958,HCPCS,250,RC,inpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,613.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,691.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,613.19,772.59,
RIFAMPIN(RIFADIN)CAP:150MG,32011872,CDM,J8499,HCPCS,250,RC,inpatient,,23.2,23.2,,19.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.42,88,,percent of total billed charges,,,,,,,,,17.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.11,91,,percent of total billed charges,,,22.04,95,,percent of total billed charges,,,19.26,83,,percent of total billed charges,,,19.26,83,,percent of total billed charges,,,,,,,,,,,,,,,19.26,83,,percent of total billed charges,,,22.04,95,,percent of total billed charges,,,20.88,90,,percent of total billed charges,,,20.88,90,,percent of total billed charges,,,19.02,82,,percent of total billed charges,,,20.88,90,,percent of total billed charges,,,19.72,85,,percent of total billed charges,,17.49,22.04,
FLUOROURACIL(5-FU)VL:2500MG/50ML,32011873,CDM,J9190,HCPCS,636,RC,inpatient,,445.1,445.1,,377.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,335.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,378.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,391.69,88,,percent of total billed charges,,47.2,,,,fee schedule,,,340.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,47.2,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,405.04,91,,percent of total billed charges,,,422.85,95,,percent of total billed charges,,,369.43,83,,percent of total billed charges,,,369.43,83,,percent of total billed charges,,,,,,,,,,,,,,,369.43,83,,percent of total billed charges,,,422.85,95,,percent of total billed charges,,,400.59,90,,percent of total billed charges,,,400.59,90,,percent of total billed charges,,,364.98,82,,percent of total billed charges,,,400.59,90,,percent of total billed charges,,,378.34,85,,percent of total billed charges,,47.2,422.85,
LEUCOVORIN CALCIUM VIAL:100MG,32011874,CDM,J0640,HCPCS,636,RC,inpatient,,161.44,161.44,,137.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,121.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,137.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,142.07,88,,percent of total billed charges,,100.5,,,,fee schedule,,,123.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,100.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,146.91,91,,percent of total billed charges,,,153.37,95,,percent of total billed charges,,,134,83,,percent of total billed charges,,,134,83,,percent of total billed charges,,,,,,,,,,,,,,,134,83,,percent of total billed charges,,,153.37,95,,percent of total billed charges,,,145.3,90,,percent of total billed charges,,,145.3,90,,percent of total billed charges,,,132.38,82,,percent of total billed charges,,,145.3,90,,percent of total billed charges,,,137.22,85,,percent of total billed charges,,100.5,153.37,
HYDROmorphone (DILAUDID) SYR:0.5MG/0.5ML,32011875,CDM,J1170,HCPCS,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,3.47,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.47,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,3.47,64.15,
INFLUENZA VACCINE(2015-2016)SYR:0.5ML,32011876,CDM,90656,CPT,636,RC,inpatient,,256.46,256.46,,217.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,193.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,217.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,225.68,88,,percent of total billed charges,,,,,,,,,195.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,233.38,91,,percent of total billed charges,,,243.64,95,,percent of total billed charges,,,212.86,83,,percent of total billed charges,,,212.86,83,,percent of total billed charges,,,,,,,,,,,,,,,212.86,83,,percent of total billed charges,,,243.64,95,,percent of total billed charges,,,230.81,90,,percent of total billed charges,,,230.81,90,,percent of total billed charges,,,210.3,82,,percent of total billed charges,,,230.81,90,,percent of total billed charges,,,217.99,85,,percent of total billed charges,,193.37,243.64,
HIGH DOSE FLU VACCIN(2015-2016)SYR:0.5ML,32011877,CDM,90656,CPT,636,RC,inpatient,,520.05,520.05,,441.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,392.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,442.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,457.64,88,,percent of total billed charges,,,,,,,,,397.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,473.25,91,,percent of total billed charges,,,494.05,95,,percent of total billed charges,,,431.64,83,,percent of total billed charges,,,431.64,83,,percent of total billed charges,,,,,,,,,,,,,,,431.64,83,,percent of total billed charges,,,494.05,95,,percent of total billed charges,,,468.05,90,,percent of total billed charges,,,468.05,90,,percent of total billed charges,,,426.44,82,,percent of total billed charges,,,468.05,90,,percent of total billed charges,,,442.04,85,,percent of total billed charges,,392.12,494.05,
SODIUM POLYST SULF ORAL UD:15G/60ML,32011878,CDM,J8499,HCPCS,250,RC,inpatient,,321.08,321.08,,272.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,242.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,272.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,282.55,88,,percent of total billed charges,,,,,,,,,245.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,292.18,91,,percent of total billed charges,,,305.03,95,,percent of total billed charges,,,266.5,83,,percent of total billed charges,,,266.5,83,,percent of total billed charges,,,,,,,,,,,,,,,266.5,83,,percent of total billed charges,,,305.03,95,,percent of total billed charges,,,288.97,90,,percent of total billed charges,,,288.97,90,,percent of total billed charges,,,263.29,82,,percent of total billed charges,,,288.97,90,,percent of total billed charges,,,272.92,85,,percent of total billed charges,,242.09,305.03,
LEUPROLIDE (LUPRON DEPO): 30MG/4MONTH,32011880,CDM,J9217,HCPCS,636,RC,inpatient,,34516.04,34516.04,,29304.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26025.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29338.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30374.12,88,,percent of total billed charges,,998.81,,,,fee schedule,,,26370.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,998.81,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31409.6,91,,percent of total billed charges,,,32790.24,95,,percent of total billed charges,,,28648.31,83,,percent of total billed charges,,,28648.31,83,,percent of total billed charges,,,,,,,,,,,,,,,28648.31,83,,percent of total billed charges,,,32790.24,95,,percent of total billed charges,,,31064.44,90,,percent of total billed charges,,,31064.44,90,,percent of total billed charges,,,28303.15,82,,percent of total billed charges,,,31064.44,90,,percent of total billed charges,,,29338.63,85,,percent of total billed charges,,998.81,32790.24,
MORPHINE SULF(ORAL)SOL:10MG/5ML (100ML),32011881,CDM,,,250,RC,inpatient,,151.78,151.78,,128.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.57,88,,percent of total billed charges,,,,,,,,,115.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.12,91,,percent of total billed charges,,,144.19,95,,percent of total billed charges,,,125.98,83,,percent of total billed charges,,,125.98,83,,percent of total billed charges,,,,,,,,,,,,,,,125.98,83,,percent of total billed charges,,,144.19,95,,percent of total billed charges,,,136.6,90,,percent of total billed charges,,,136.6,90,,percent of total billed charges,,,124.46,82,,percent of total billed charges,,,136.6,90,,percent of total billed charges,,,129.01,85,,percent of total billed charges,,114.44,144.19,
KETAMINE(KETALAR) VIAL:1000MG/20ML,32011882,CDM,,,250,RC,inpatient,,320.53,320.53,,272.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,241.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,272.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,282.07,88,,percent of total billed charges,,,,,,,,,244.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,291.68,91,,percent of total billed charges,,,304.5,95,,percent of total billed charges,,,266.04,83,,percent of total billed charges,,,266.04,83,,percent of total billed charges,,,,,,,,,,,,,,,266.04,83,,percent of total billed charges,,,304.5,95,,percent of total billed charges,,,288.48,90,,percent of total billed charges,,,288.48,90,,percent of total billed charges,,,262.83,82,,percent of total billed charges,,,288.48,90,,percent of total billed charges,,,272.45,85,,percent of total billed charges,,241.68,304.5,
TRANEXEMIC ACID TAB:650MG,32011883,CDM,J8499,HCPCS,250,RC,inpatient,,31.21,31.21,,26.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27.46,88,,percent of total billed charges,,,,,,,,,23.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28.4,91,,percent of total billed charges,,,29.65,95,,percent of total billed charges,,,25.9,83,,percent of total billed charges,,,25.9,83,,percent of total billed charges,,,,,,,,,,,,,,,25.9,83,,percent of total billed charges,,,29.65,95,,percent of total billed charges,,,28.09,90,,percent of total billed charges,,,28.09,90,,percent of total billed charges,,,25.59,82,,percent of total billed charges,,,28.09,90,,percent of total billed charges,,,26.53,85,,percent of total billed charges,,23.53,29.65,
PROVOCHOLINE(METHACHOLINE): 100MG VIAL,32011884,CDM,J7674,HCPCS,250,RC,inpatient,,1133.5,1133.5,,962.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,854.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,963.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,997.48,88,,percent of total billed charges,,162.5,,,,fee schedule,,,865.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,162.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1031.49,91,,percent of total billed charges,,,1076.83,95,,percent of total billed charges,,,940.81,83,,percent of total billed charges,,,940.81,83,,percent of total billed charges,,,,,,,,,,,,,,,940.81,83,,percent of total billed charges,,,1076.83,95,,percent of total billed charges,,,1020.15,90,,percent of total billed charges,,,1020.15,90,,percent of total billed charges,,,929.47,82,,percent of total billed charges,,,1020.15,90,,percent of total billed charges,,,963.48,85,,percent of total billed charges,,162.5,1076.83,
epiRUBICIN(ELLENCE):50MG/25ML,32011885,CDM,,,636,RC,inpatient,,769.84,769.84,,653.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,580.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,654.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,677.46,88,,percent of total billed charges,,,,,,,,,588.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,700.55,91,,percent of total billed charges,,,731.35,95,,percent of total billed charges,,,638.97,83,,percent of total billed charges,,,638.97,83,,percent of total billed charges,,,,,,,,,,,,,,,638.97,83,,percent of total billed charges,,,731.35,95,,percent of total billed charges,,,692.86,90,,percent of total billed charges,,,692.86,90,,percent of total billed charges,,,631.27,82,,percent of total billed charges,,,692.86,90,,percent of total billed charges,,,654.36,85,,percent of total billed charges,,580.46,731.35,
ACETAMINOPHEN INFANT GTT:160MG/5ML 30ML,32011887,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DOCEtaxel(TaxoTERE)SDV: *20MG/2ML*,32011888,CDM,J9171,HCPCS,636,RC,inpatient,,974.94,974.94,,827.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,735.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,828.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,857.95,88,,percent of total billed charges,,121.68,,,,fee schedule,,,744.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,887.2,91,,percent of total billed charges,,,926.19,95,,percent of total billed charges,,,809.2,83,,percent of total billed charges,,,809.2,83,,percent of total billed charges,,,,,,,,,,,,,,,809.2,83,,percent of total billed charges,,,926.19,95,,percent of total billed charges,,,877.45,90,,percent of total billed charges,,,877.45,90,,percent of total billed charges,,,799.45,82,,percent of total billed charges,,,877.45,90,,percent of total billed charges,,,828.7,85,,percent of total billed charges,,121.68,926.19,
DOCEtaxel(TaxoTERE)MDV: 80MG/4ML (J/1),32011889,CDM,J9171,HCPCS,636,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,121.68,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,121.68,
GEMCITABINE(GEMZAR)VIAL:1GM,32011892,CDM,J9201,HCPCS,636,RC,inpatient,,777.13,777.13,,659.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,585.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,660.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,683.87,88,,percent of total billed charges,,55.14,,,,fee schedule,,,593.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,55.14,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,707.19,91,,percent of total billed charges,,,738.27,95,,percent of total billed charges,,,645.02,83,,percent of total billed charges,,,645.02,83,,percent of total billed charges,,,,,,,,,,,,,,,645.02,83,,percent of total billed charges,,,738.27,95,,percent of total billed charges,,,699.42,90,,percent of total billed charges,,,699.42,90,,percent of total billed charges,,,637.25,82,,percent of total billed charges,,,699.42,90,,percent of total billed charges,,,660.56,85,,percent of total billed charges,,55.14,738.27,
"THROMBIN,TOPICAL VIAL:5,000 UNITS",32011902,CDM,J3490,HCPCS,250,RC,inpatient,,719.13,719.13,,610.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,542.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,611.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,632.83,88,,percent of total billed charges,,,,,,,,,549.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,654.41,91,,percent of total billed charges,,,683.17,95,,percent of total billed charges,,,596.88,83,,percent of total billed charges,,,596.88,83,,percent of total billed charges,,,,,,,,,,,,,,,596.88,83,,percent of total billed charges,,,683.17,95,,percent of total billed charges,,,647.22,90,,percent of total billed charges,,,647.22,90,,percent of total billed charges,,,589.69,82,,percent of total billed charges,,,647.22,90,,percent of total billed charges,,,611.26,85,,percent of total billed charges,,542.22,683.17,
CARDENE IVPB:20MG/NS200ML(PREMIX),32011903,CDM,J3490,HCPCS,258,RC,inpatient,,1425.94,1425.94,,1210.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1075.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1212.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1254.83,88,,percent of total billed charges,,,,,,,,,1089.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1297.61,91,,percent of total billed charges,,,1354.64,95,,percent of total billed charges,,,1183.53,83,,percent of total billed charges,,,1183.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1183.53,83,,percent of total billed charges,,,1354.64,95,,percent of total billed charges,,,1283.35,90,,percent of total billed charges,,,1283.35,90,,percent of total billed charges,,,1169.27,82,,percent of total billed charges,,,1283.35,90,,percent of total billed charges,,,1212.05,85,,percent of total billed charges,,1075.16,1354.64,
TRAMADOL 50 MG TAB (1X8),32011906,CDM,J8499,HCPCS,250,RC,inpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,12.73,16.04,
ONDANSETRON 4 MG ODT TAB (1X6),32011907,CDM,J8499,HCPCS,250,RC,inpatient,,19.44,19.44,,16.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.11,88,,percent of total billed charges,,,,,,,,,14.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.69,91,,percent of total billed charges,,,18.47,95,,percent of total billed charges,,,16.14,83,,percent of total billed charges,,,16.14,83,,percent of total billed charges,,,,,,,,,,,,,,,16.14,83,,percent of total billed charges,,,18.47,95,,percent of total billed charges,,,17.5,90,,percent of total billed charges,,,17.5,90,,percent of total billed charges,,,15.94,82,,percent of total billed charges,,,17.5,90,,percent of total billed charges,,,16.52,85,,percent of total billed charges,,14.66,18.47,
ENTYVIO (VEDOLIZUMAB) VIAL 300MG,32011914,CDM,J3380,HCPCS,636,RC,inpatient,,31788.14,31788.14,,26988.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23968.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27019.92,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27973.56,88,,percent of total billed charges,,6689.1,,,,fee schedule,,,24286.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6689.1,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28927.21,91,,percent of total billed charges,,,30198.73,95,,percent of total billed charges,,,26384.16,83,,percent of total billed charges,,,26384.16,83,,percent of total billed charges,,,,,,,,,,,,,,,26384.16,83,,percent of total billed charges,,,30198.73,95,,percent of total billed charges,,,28609.33,90,,percent of total billed charges,,,28609.33,90,,percent of total billed charges,,,26066.27,82,,percent of total billed charges,,,28609.33,90,,percent of total billed charges,,,27019.92,85,,percent of total billed charges,,6689.1,30198.73,
IBANDRONATE (BONIVA) IV SYRINGE:3MG/3ML,32011997,CDM,J1740,HCPCS,636,RC,inpatient,,1764,1764,,1497.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1330.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1499.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1552.32,88,,percent of total billed charges,,77.54,,,,fee schedule,,,1347.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,77.54,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1605.24,91,,percent of total billed charges,,,1675.8,95,,percent of total billed charges,,,1464.12,83,,percent of total billed charges,,,1464.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1464.12,83,,percent of total billed charges,,,1675.8,95,,percent of total billed charges,,,1587.6,90,,percent of total billed charges,,,1587.6,90,,percent of total billed charges,,,1446.48,82,,percent of total billed charges,,,1587.6,90,,percent of total billed charges,,,1499.4,85,,percent of total billed charges,,77.54,1675.8,
MEGESTROL(MEGACE)ORAL UD:400MG/10ML,32012025,CDM,J8999,HCPCS,250,RC,inpatient,,36.11,36.11,,30.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31.78,88,,percent of total billed charges,,,,,,,,,27.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32.86,91,,percent of total billed charges,,,34.3,95,,percent of total billed charges,,,29.97,83,,percent of total billed charges,,,29.97,83,,percent of total billed charges,,,,,,,,,,,,,,,29.97,83,,percent of total billed charges,,,34.3,95,,percent of total billed charges,,,32.5,90,,percent of total billed charges,,,32.5,90,,percent of total billed charges,,,29.61,82,,percent of total billed charges,,,32.5,90,,percent of total billed charges,,,30.69,85,,percent of total billed charges,,27.23,34.3,
IV LR 1000ML+PITOCIN:20UNITS (QuVa 503B),32012205,CDM,,,258,RC,inpatient,,294.61,294.61,,250.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,222.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,250.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,259.26,88,,percent of total billed charges,,,,,,,,,225.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,268.1,91,,percent of total billed charges,,,279.88,95,,percent of total billed charges,,,244.53,83,,percent of total billed charges,,,244.53,83,,percent of total billed charges,,,,,,,,,,,,,,,244.53,83,,percent of total billed charges,,,279.88,95,,percent of total billed charges,,,265.15,90,,percent of total billed charges,,,265.15,90,,percent of total billed charges,,,241.58,82,,percent of total billed charges,,,265.15,90,,percent of total billed charges,,,250.42,85,,percent of total billed charges,,222.14,279.88,
USODEOXYCHOLIC ACID(URSODIOL)CAP:300MG,32012385,CDM,J8499,HCPCS,250,RC,inpatient,,29.98,29.98,,25.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26.38,88,,percent of total billed charges,,,,,,,,,22.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27.28,91,,percent of total billed charges,,,28.48,95,,percent of total billed charges,,,24.88,83,,percent of total billed charges,,,24.88,83,,percent of total billed charges,,,,,,,,,,,,,,,24.88,83,,percent of total billed charges,,,28.48,95,,percent of total billed charges,,,26.98,90,,percent of total billed charges,,,26.98,90,,percent of total billed charges,,,24.58,82,,percent of total billed charges,,,26.98,90,,percent of total billed charges,,,25.48,85,,percent of total billed charges,,22.6,28.48,
MELATONIN TAB: 3 MG,32012419,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DOCEtaxel(TaxoTERE)SDV: *20MG/ML*,32012439,CDM,J9171,HCPCS,636,RC,inpatient,,527.34,527.34,,447.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,397.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,448.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,464.06,88,,percent of total billed charges,,121.68,,,,fee schedule,,,402.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,479.88,91,,percent of total billed charges,,,500.97,95,,percent of total billed charges,,,437.69,83,,percent of total billed charges,,,437.69,83,,percent of total billed charges,,,,,,,,,,,,,,,437.69,83,,percent of total billed charges,,,500.97,95,,percent of total billed charges,,,474.61,90,,percent of total billed charges,,,474.61,90,,percent of total billed charges,,,432.42,82,,percent of total billed charges,,,474.61,90,,percent of total billed charges,,,448.24,85,,percent of total billed charges,,121.68,500.97,
INFLUENZA VAC QUAD(2016-2017)SYR:0.5ML,32012452,CDM,90686,CPT,636,RC,inpatient,,286.75,286.75,,243.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,216.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,243.74,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,252.34,88,,percent of total billed charges,,,,,,,,,219.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,260.94,91,,percent of total billed charges,,,272.41,95,,percent of total billed charges,,,238,83,,percent of total billed charges,,,238,83,,percent of total billed charges,,,,,,,,,,,,,,,238,83,,percent of total billed charges,,,272.41,95,,percent of total billed charges,,,258.08,90,,percent of total billed charges,,,258.08,90,,percent of total billed charges,,,235.14,82,,percent of total billed charges,,,258.08,90,,percent of total billed charges,,,243.74,85,,percent of total billed charges,,216.21,272.41,
HIGH DOSE INFLU VAC (2016-2017)SYR:0.5ML,32012453,CDM,90662,CPT,636,RC,inpatient,,613.62,613.62,,520.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,462.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,521.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,539.99,88,,percent of total billed charges,,,,,,,,,468.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,558.39,91,,percent of total billed charges,,,582.94,95,,percent of total billed charges,,,509.3,83,,percent of total billed charges,,,509.3,83,,percent of total billed charges,,,,,,,,,,,,,,,509.3,83,,percent of total billed charges,,,582.94,95,,percent of total billed charges,,,552.26,90,,percent of total billed charges,,,552.26,90,,percent of total billed charges,,,503.17,82,,percent of total billed charges,,,552.26,90,,percent of total billed charges,,,521.58,85,,percent of total billed charges,,462.67,582.94,
PAIN EASE TOP ANESTHETIC SPR:116ML,32012468,CDM,J3490,HCPCS,250,RC,inpatient,,477.86,477.86,,405.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,360.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,406.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,420.52,88,,percent of total billed charges,,,,,,,,,365.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,434.85,91,,percent of total billed charges,,,453.97,95,,percent of total billed charges,,,396.62,83,,percent of total billed charges,,,396.62,83,,percent of total billed charges,,,,,,,,,,,,,,,396.62,83,,percent of total billed charges,,,453.97,95,,percent of total billed charges,,,430.07,90,,percent of total billed charges,,,430.07,90,,percent of total billed charges,,,391.85,82,,percent of total billed charges,,,430.07,90,,percent of total billed charges,,,406.18,85,,percent of total billed charges,,360.31,453.97,
CABAZItaxel(JEVTANA)SDV:60MG/1.5ML,32012494,CDM,J9043,HCPCS,636,RC,inpatient,,65494.31,65494.31,,55604.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49382.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55670.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57634.99,88,,percent of total billed charges,,11739.18,,,,fee schedule,,,50037.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11739.18,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59599.82,91,,percent of total billed charges,,,62219.59,95,,percent of total billed charges,,,54360.28,83,,percent of total billed charges,,,54360.28,83,,percent of total billed charges,,,,,,,,,,,,,,,54360.28,83,,percent of total billed charges,,,62219.59,95,,percent of total billed charges,,,58944.88,90,,percent of total billed charges,,,58944.88,90,,percent of total billed charges,,,53705.33,82,,percent of total billed charges,,,58944.88,90,,percent of total billed charges,,,55670.16,85,,percent of total billed charges,,11739.18,62219.59,
DOXOrubicin(ADRIAMYCIN):50MG/25ML,32012504,CDM,J9000,HCPCS,636,RC,inpatient,,316.83,316.83,,268.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,238.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,269.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,278.81,88,,percent of total billed charges,,43.69,,,,fee schedule,,,242.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,43.69,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,288.32,91,,percent of total billed charges,,,300.99,95,,percent of total billed charges,,,262.97,83,,percent of total billed charges,,,262.97,83,,percent of total billed charges,,,,,,,,,,,,,,,262.97,83,,percent of total billed charges,,,300.99,95,,percent of total billed charges,,,285.15,90,,percent of total billed charges,,,285.15,90,,percent of total billed charges,,,259.8,82,,percent of total billed charges,,,285.15,90,,percent of total billed charges,,,269.31,85,,percent of total billed charges,,43.69,300.99,
DOXOrubicin(ADRIAMYCIN):20MG/10ML,32012505,CDM,J9000,HCPCS,636,RC,inpatient,,230.07,230.07,,195.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,173.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,195.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,202.46,88,,percent of total billed charges,,43.69,,,,fee schedule,,,175.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,43.69,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,209.36,91,,percent of total billed charges,,,218.57,95,,percent of total billed charges,,,190.96,83,,percent of total billed charges,,,190.96,83,,percent of total billed charges,,,,,,,,,,,,,,,190.96,83,,percent of total billed charges,,,218.57,95,,percent of total billed charges,,,207.06,90,,percent of total billed charges,,,207.06,90,,percent of total billed charges,,,188.66,82,,percent of total billed charges,,,207.06,90,,percent of total billed charges,,,195.56,85,,percent of total billed charges,,43.69,218.57,
DESMOPRESSIN(DDVAP)NASAL:10MCG/0.1ML,32012535,CDM,J3490,HCPCS,250,RC,inpatient,,2120.16,2120.16,,1800.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1598.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1802.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1865.74,88,,percent of total billed charges,,,,,,,,,1619.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1929.35,91,,percent of total billed charges,,,2014.15,95,,percent of total billed charges,,,1759.73,83,,percent of total billed charges,,,1759.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1759.73,83,,percent of total billed charges,,,2014.15,95,,percent of total billed charges,,,1908.14,90,,percent of total billed charges,,,1908.14,90,,percent of total billed charges,,,1738.53,82,,percent of total billed charges,,,1908.14,90,,percent of total billed charges,,,1802.14,85,,percent of total billed charges,,1598.6,2014.15,
STIMATE (DDVAP)HIGHCONC NASAL:1.5MG/1ML,32012540,CDM,J3490,HCPCS,250,RC,inpatient,,5730.02,5730.02,,4864.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4320.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4870.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5042.42,88,,percent of total billed charges,,,,,,,,,4377.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5214.32,91,,percent of total billed charges,,,5443.52,95,,percent of total billed charges,,,4755.92,83,,percent of total billed charges,,,4755.92,83,,percent of total billed charges,,,,,,,,,,,,,,,4755.92,83,,percent of total billed charges,,,5443.52,95,,percent of total billed charges,,,5157.02,90,,percent of total billed charges,,,5157.02,90,,percent of total billed charges,,,4698.62,82,,percent of total billed charges,,,5157.02,90,,percent of total billed charges,,,4870.52,85,,percent of total billed charges,,4320.44,5443.52,
FACTOR VIII (HUMATE-P): 2004 UNITS,32012541,CDM,J7187,HCPCS,636,RC,inpatient,,7575.12,7575.12,,6431.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5711.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6438.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6666.11,88,,percent of total billed charges,,12958.7,,,,fee schedule,,,5787.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,12958.7,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6893.36,91,,percent of total billed charges,,,7196.36,95,,percent of total billed charges,,,6287.35,83,,percent of total billed charges,,,6287.35,83,,percent of total billed charges,,,,,,,,,,,,,,,6287.35,83,,percent of total billed charges,,,7196.36,95,,percent of total billed charges,,,6817.61,90,,percent of total billed charges,,,6817.61,90,,percent of total billed charges,,,6211.6,82,,percent of total billed charges,,,6817.61,90,,percent of total billed charges,,,6438.85,85,,percent of total billed charges,,5711.64,12958.7,
LIDOCAINE 4%CREAM:5GM,32012542,CDM,J3490,HCPCS,250,RC,inpatient,,54.58,54.58,,46.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.03,88,,percent of total billed charges,,,,,,,,,41.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.67,91,,percent of total billed charges,,,51.85,95,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,,,,,,,,,,,,,,45.3,83,,percent of total billed charges,,,51.85,95,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,44.76,82,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,46.39,85,,percent of total billed charges,,41.15,51.85,
CARBOplatin MDV:150MG/15ML   J/50,32012605,CDM,J9045,HCPCS,636,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,48.01,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,48.01,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.01,60.99,
ORBACTIV(ORITAVANCIN) IV VIAL: 1200MG,32012618,CDM,J2407,HCPCS,250,RC,inpatient,,14233.5,14233.5,,12084.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10732.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12098.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12525.48,88,,percent of total billed charges,,3096.6,,,,fee schedule,,,10874.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3096.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12952.49,91,,percent of total billed charges,,,13521.83,95,,percent of total billed charges,,,11813.81,83,,percent of total billed charges,,,11813.81,83,,percent of total billed charges,,,,,,,,,,,,,,,11813.81,83,,percent of total billed charges,,,13521.83,95,,percent of total billed charges,,,12810.15,90,,percent of total billed charges,,,12810.15,90,,percent of total billed charges,,,11671.47,82,,percent of total billed charges,,,12810.15,90,,percent of total billed charges,,,12098.48,85,,percent of total billed charges,,3096.6,13521.83,
ADALIMUMAB (HUMIRA) SYRINGE 40MG/0.8ML,32012642,CDM,J0135,HCPCS,636,RC,inpatient,,14099.8,14099.8,,11970.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10631.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11984.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12407.82,88,,percent of total billed charges,,,,,,,,,10772.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12830.82,91,,percent of total billed charges,,,13394.81,95,,percent of total billed charges,,,11702.83,83,,percent of total billed charges,,,11702.83,83,,percent of total billed charges,,,,,,,,,,,,,,,11702.83,83,,percent of total billed charges,,,13394.81,95,,percent of total billed charges,,,12689.82,90,,percent of total billed charges,,,12689.82,90,,percent of total billed charges,,,11561.84,82,,percent of total billed charges,,,12689.82,90,,percent of total billed charges,,,11984.83,85,,percent of total billed charges,,10631.25,13394.81,
PROPRANOLOL(INDERAL)TAB:80MG,32012731,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
MIDAZOLAM(VERSED)VIAL:5MG/5ML,32012759,CDM,J2250,HCPCS,250,RC,inpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.78,88,,percent of total billed charges,,7.08,,,,fee schedule,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.08,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,7.08,62.38,
MIDAZOLAM(VERSED)SYRINGE:10MG/2ML,32012760,CDM,J2250,HCPCS,250,RC,inpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.78,88,,percent of total billed charges,,7.08,,,,fee schedule,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.08,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,7.08,62.38,
WATER FOR IRRIGATION STERILE SOL:1500ML,32012813,CDM,J3490,HCPCS,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
WATER FOR IRRIGATION STERILE SOL: 250ML,32012814,CDM,J3490,HCPCS,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
riTUXimab(RITUXAN)VIAL:500MG/50ML,32012919,CDM,J9312,HCPCS,636,RC,inpatient,,23305.95,23305.95,,19786.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17572.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19810.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20509.24,88,,percent of total billed charges,,10692.63,,,,fee schedule,,,17805.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,10692.63,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21208.41,91,,percent of total billed charges,,,22140.65,95,,percent of total billed charges,,,19343.94,83,,percent of total billed charges,,,19343.94,83,,percent of total billed charges,,,,,,,,,,,,,,,19343.94,83,,percent of total billed charges,,,22140.65,95,,percent of total billed charges,,,20975.36,90,,percent of total billed charges,,,20975.36,90,,percent of total billed charges,,,19110.88,82,,percent of total billed charges,,,20975.36,90,,percent of total billed charges,,,19810.06,85,,percent of total billed charges,,10692.63,22140.65,
vinCRISTine SULFATE VIAL:2MG/2ML,32012920,CDM,J9370,HCPCS,636,RC,inpatient,,166.99,166.99,,141.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,146.95,88,,percent of total billed charges,,19.52,,,,fee schedule,,,127.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.52,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,151.96,91,,percent of total billed charges,,,158.64,95,,percent of total billed charges,,,138.6,83,,percent of total billed charges,,,138.6,83,,percent of total billed charges,,,,,,,,,,,,,,,138.6,83,,percent of total billed charges,,,158.64,95,,percent of total billed charges,,,150.29,90,,percent of total billed charges,,,150.29,90,,percent of total billed charges,,,136.93,82,,percent of total billed charges,,,150.29,90,,percent of total billed charges,,,141.94,85,,percent of total billed charges,,19.52,158.64,
TUDORZA PRESSAIR AER:400/ACT,32012971,CDM,J3490,HCPCS,250,RC,inpatient,,1985.63,1985.63,,1685.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1497.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1687.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1747.35,88,,percent of total billed charges,,,,,,,,,1517.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1806.92,91,,percent of total billed charges,,,1886.35,95,,percent of total billed charges,,,1648.07,83,,percent of total billed charges,,,1648.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1648.07,83,,percent of total billed charges,,,1886.35,95,,percent of total billed charges,,,1787.07,90,,percent of total billed charges,,,1787.07,90,,percent of total billed charges,,,1628.22,82,,percent of total billed charges,,,1787.07,90,,percent of total billed charges,,,1687.79,85,,percent of total billed charges,,1497.17,1886.35,
IMMUNE GLOBULIN(FLEBOGAMMA)SDV:5GM/50ML,32013034,CDM,J1572,HCPCS,636,RC,inpatient,,3838.39,3838.39,,3258.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2894.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3262.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3377.78,88,,percent of total billed charges,,5980.5,,,,fee schedule,,,2932.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5980.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3492.93,91,,percent of total billed charges,,,3646.47,95,,percent of total billed charges,,,3185.86,83,,percent of total billed charges,,,3185.86,83,,percent of total billed charges,,,,,,,,,,,,,,,3185.86,83,,percent of total billed charges,,,3646.47,95,,percent of total billed charges,,,3454.55,90,,percent of total billed charges,,,3454.55,90,,percent of total billed charges,,,3147.48,82,,percent of total billed charges,,,3454.55,90,,percent of total billed charges,,,3262.63,85,,percent of total billed charges,,2894.15,5980.5,
MEROPENEM(MERREM)VIAL IV:1GM,32013096,CDM,J2185,HCPCS,250,RC,inpatient,,88.82,88.82,,75.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,75.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,78.16,88,,percent of total billed charges,,14.5,,,,fee schedule,,,67.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.83,91,,percent of total billed charges,,,84.38,95,,percent of total billed charges,,,73.72,83,,percent of total billed charges,,,73.72,83,,percent of total billed charges,,,,,,,,,,,,,,,73.72,83,,percent of total billed charges,,,84.38,95,,percent of total billed charges,,,79.94,90,,percent of total billed charges,,,79.94,90,,percent of total billed charges,,,72.83,82,,percent of total billed charges,,,79.94,90,,percent of total billed charges,,,75.5,85,,percent of total billed charges,,14.5,84.38,
PEGFILGRASTIM(NEULASTA) ONPRO 6MG/0.6ML,32013125,CDM,J2506,HCPCS,636,RC,inpatient,,19831.81,19831.81,,16837.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14953.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16857.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17451.99,88,,percent of total billed charges,,1576.97,,,,fee schedule,,,15151.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1576.97,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18046.95,91,,percent of total billed charges,,,18840.22,95,,percent of total billed charges,,,16460.4,83,,percent of total billed charges,,,16460.4,83,,percent of total billed charges,,,,,,,,,,,,,,,16460.4,83,,percent of total billed charges,,,18840.22,95,,percent of total billed charges,,,17848.63,90,,percent of total billed charges,,,17848.63,90,,percent of total billed charges,,,16262.08,82,,percent of total billed charges,,,17848.63,90,,percent of total billed charges,,,16857.04,85,,percent of total billed charges,,1576.97,18840.22,
MAG SULF 50% IM SYRINGE:5GM/10ML,32013196,CDM,J3475,HCPCS,250,RC,inpatient,,275.96,275.96,,234.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,208.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,234.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,242.84,88,,percent of total billed charges,,15.22,,,,fee schedule,,,210.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,251.12,91,,percent of total billed charges,,,262.16,95,,percent of total billed charges,,,229.05,83,,percent of total billed charges,,,229.05,83,,percent of total billed charges,,,,,,,,,,,,,,,229.05,83,,percent of total billed charges,,,262.16,95,,percent of total billed charges,,,248.36,90,,percent of total billed charges,,,248.36,90,,percent of total billed charges,,,226.29,82,,percent of total billed charges,,,248.36,90,,percent of total billed charges,,,234.57,85,,percent of total billed charges,,15.22,262.16,
OSELTAM(TAMIFLU)SUSP:6MG/ML (60ML),32013214,CDM,J8499,HCPCS,250,RC,inpatient,,477.78,477.78,,405.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,360.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,406.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,420.45,88,,percent of total billed charges,,,,,,,,,365.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,434.78,91,,percent of total billed charges,,,453.89,95,,percent of total billed charges,,,396.56,83,,percent of total billed charges,,,396.56,83,,percent of total billed charges,,,,,,,,,,,,,,,396.56,83,,percent of total billed charges,,,453.89,95,,percent of total billed charges,,,430,90,,percent of total billed charges,,,430,90,,percent of total billed charges,,,391.78,82,,percent of total billed charges,,,430,90,,percent of total billed charges,,,406.11,85,,percent of total billed charges,,360.25,453.89,
PROVAYBLUE (METHYLENE BLUE) 0.5%AMP:10ML,32013233,CDM,J3490,HCPCS,250,RC,inpatient,,1918.85,1918.85,,1629.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1446.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1631.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1688.59,88,,percent of total billed charges,,,,,,,,,1466,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1746.15,91,,percent of total billed charges,,,1822.91,95,,percent of total billed charges,,,1592.65,83,,percent of total billed charges,,,1592.65,83,,percent of total billed charges,,,,,,,,,,,,,,,1592.65,83,,percent of total billed charges,,,1822.91,95,,percent of total billed charges,,,1726.97,90,,percent of total billed charges,,,1726.97,90,,percent of total billed charges,,,1573.46,82,,percent of total billed charges,,,1726.97,90,,percent of total billed charges,,,1631.02,85,,percent of total billed charges,,1446.81,1822.91,
"LIDOCAINE W/EPI 1:100,000 VIAL 1%:30ML",32013245,CDM,J3490,HCPCS,250,RC,inpatient,,88.4,88.4,,75.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,75.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.79,88,,percent of total billed charges,,,,,,,,,67.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.44,91,,percent of total billed charges,,,83.98,95,,percent of total billed charges,,,73.37,83,,percent of total billed charges,,,73.37,83,,percent of total billed charges,,,,,,,,,,,,,,,73.37,83,,percent of total billed charges,,,83.98,95,,percent of total billed charges,,,79.56,90,,percent of total billed charges,,,79.56,90,,percent of total billed charges,,,72.49,82,,percent of total billed charges,,,79.56,90,,percent of total billed charges,,,75.14,85,,percent of total billed charges,,66.65,83.98,
PROMETHAZINE W/ CODEINE:6.5-10MG/5ML UD,32013283,CDM,Q0169,HCPCS,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,0.17,,,,fee schedule,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.17,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,0.17,15.57,
CYRAMZA (RAMUCIRUMAB) VIAL 500MG,32013312,CDM,J9308,HCPCS,636,RC,inpatient,,29679.62,29679.62,,25198,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,22378.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,25227.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,26118.07,88,,percent of total billed charges,,16405,,,,fee schedule,,,22675.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,16405,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,27008.45,91,,percent of total billed charges,,,28195.64,95,,percent of total billed charges,,,24634.08,83,,percent of total billed charges,,,24634.08,83,,percent of total billed charges,,,,,,,,,,,,,,,24634.08,83,,percent of total billed charges,,,28195.64,95,,percent of total billed charges,,,26711.66,90,,percent of total billed charges,,,26711.66,90,,percent of total billed charges,,,24337.29,82,,percent of total billed charges,,,26711.66,90,,percent of total billed charges,,,25227.68,85,,percent of total billed charges,,16405,28195.64,
KEYTRUDA (PEMBROLIZUMAB) VIAL: 100MG/4ML,32013340,CDM,J9271,HCPCS,636,RC,inpatient,,24745,24745,,21008.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18657.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21033.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21775.6,88,,percent of total billed charges,,21819.2,,,,fee schedule,,,18905.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21819.2,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22517.95,91,,percent of total billed charges,,,23507.75,95,,percent of total billed charges,,,20538.35,83,,percent of total billed charges,,,20538.35,83,,percent of total billed charges,,,,,,,,,,,,,,,20538.35,83,,percent of total billed charges,,,23507.75,95,,percent of total billed charges,,,22270.5,90,,percent of total billed charges,,,22270.5,90,,percent of total billed charges,,,20290.9,82,,percent of total billed charges,,,22270.5,90,,percent of total billed charges,,,21033.25,85,,percent of total billed charges,,18657.73,23507.75,
"LIDOCAINE W/EPI 1:200,000 VIAL 1%:30ML",32013395,CDM,J3490,HCPCS,250,RC,inpatient,,172.87,172.87,,146.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.13,88,,percent of total billed charges,,,,,,,,,132.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.31,91,,percent of total billed charges,,,164.23,95,,percent of total billed charges,,,143.48,83,,percent of total billed charges,,,143.48,83,,percent of total billed charges,,,,,,,,,,,,,,,143.48,83,,percent of total billed charges,,,164.23,95,,percent of total billed charges,,,155.58,90,,percent of total billed charges,,,155.58,90,,percent of total billed charges,,,141.75,82,,percent of total billed charges,,,155.58,90,,percent of total billed charges,,,146.94,85,,percent of total billed charges,,130.34,164.23,
SACCHAROMYCES BOULA(FLORASTOR) CAP 250MG,32013435,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
METOCLOP(REGLAN)-SOL UD:10MG/10ML,32013436,CDM,J8499,HCPCS,250,RC,inpatient,,40.52,40.52,,34.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.66,88,,percent of total billed charges,,,,,,,,,30.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.87,91,,percent of total billed charges,,,38.49,95,,percent of total billed charges,,,33.63,83,,percent of total billed charges,,,33.63,83,,percent of total billed charges,,,,,,,,,,,,,,,33.63,83,,percent of total billed charges,,,38.49,95,,percent of total billed charges,,,36.47,90,,percent of total billed charges,,,36.47,90,,percent of total billed charges,,,33.23,82,,percent of total billed charges,,,36.47,90,,percent of total billed charges,,,34.44,85,,percent of total billed charges,,30.55,38.49,
methylPRED(MEDROL) TAB: 4 MG,32013442,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ROCURONIUM(ZEMURON)VIAL:100MG/10ML,32013540,CDM,J3490,HCPCS,250,RC,inpatient,,116.57,116.57,,98.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,87.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,99.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,102.58,88,,percent of total billed charges,,,,,,,,,89.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,106.08,91,,percent of total billed charges,,,110.74,95,,percent of total billed charges,,,96.75,83,,percent of total billed charges,,,96.75,83,,percent of total billed charges,,,,,,,,,,,,,,,96.75,83,,percent of total billed charges,,,110.74,95,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,95.59,82,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,99.08,85,,percent of total billed charges,,87.89,110.74,
INDOCYANIN GREEN(PINPOINT) VIAL,32013541,CDM,,,250,RC,inpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,613.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,691.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,613.19,772.59,
ETOPOSIDE(TOPOSAR)MDV:500MG/25ML(J/10MG),32013551,CDM,J9181,HCPCS,250,RC,inpatient,,12.69,12.69,,10.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.17,88,,percent of total billed charges,,21.03,,,,fee schedule,,,9.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21.03,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.55,91,,percent of total billed charges,,,12.06,95,,percent of total billed charges,,,10.53,83,,percent of total billed charges,,,10.53,83,,percent of total billed charges,,,,,,,,,,,,,,,10.53,83,,percent of total billed charges,,,12.06,95,,percent of total billed charges,,,11.42,90,,percent of total billed charges,,,11.42,90,,percent of total billed charges,,,10.41,82,,percent of total billed charges,,,11.42,90,,percent of total billed charges,,,10.79,85,,percent of total billed charges,,9.57,21.03,
CISplatin MDV :100MG/100ML   (J/10MG),32013570,CDM,J9060,HCPCS,636,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,47.9,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,47.9,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,47.9,60.99,
FILGRASTIM(NEUPOGEN)SYRINGE:480MCG/0.8ML,32013626,CDM,J1442,HCPCS,636,RC,inpatient,,3169.63,3169.63,,2691.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2389.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2694.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2789.27,88,,percent of total billed charges,,947.52,,,,fee schedule,,,2421.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,947.52,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2884.36,91,,percent of total billed charges,,,3011.15,95,,percent of total billed charges,,,2630.79,83,,percent of total billed charges,,,2630.79,83,,percent of total billed charges,,,,,,,,,,,,,,,2630.79,83,,percent of total billed charges,,,3011.15,95,,percent of total billed charges,,,2852.67,90,,percent of total billed charges,,,2852.67,90,,percent of total billed charges,,,2599.1,82,,percent of total billed charges,,,2852.67,90,,percent of total billed charges,,,2694.19,85,,percent of total billed charges,,947.52,3011.15,
FLUOROURACIL(5-FU)VL:5000MG/100ML,32013721,CDM,J9190,HCPCS,636,RC,inpatient,,999.11,999.11,,848.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,753.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,849.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,879.22,88,,percent of total billed charges,,47.2,,,,fee schedule,,,763.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,47.2,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,909.19,91,,percent of total billed charges,,,949.15,95,,percent of total billed charges,,,829.26,83,,percent of total billed charges,,,829.26,83,,percent of total billed charges,,,,,,,,,,,,,,,829.26,83,,percent of total billed charges,,,949.15,95,,percent of total billed charges,,,899.2,90,,percent of total billed charges,,,899.2,90,,percent of total billed charges,,,819.27,82,,percent of total billed charges,,,899.2,90,,percent of total billed charges,,,849.24,85,,percent of total billed charges,,47.2,949.15,
VAGISIL CREAM 5-2%:28GM,32013808,CDM,J3490,HCPCS,250,RC,inpatient,UD,44.25,44.25,,37.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.94,88,,percent of total billed charges,,,,,,,,,33.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.27,91,,percent of total billed charges,,,42.04,95,,percent of total billed charges,,,36.73,83,,percent of total billed charges,,,36.73,83,,percent of total billed charges,,,,,,,,,,,,,,,36.73,83,,percent of total billed charges,,,42.04,95,,percent of total billed charges,,,39.83,90,,percent of total billed charges,,,39.83,90,,percent of total billed charges,,,36.29,82,,percent of total billed charges,,,39.83,90,,percent of total billed charges,,,37.61,85,,percent of total billed charges,,33.36,42.04,
HERCEPTIN (TRASTUZUMAB) VIAL 150MG,32013809,CDM,J9355,HCPCS,636,RC,inpatient,,7363.53,7363.53,,6251.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5552.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6259,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6479.91,88,,percent of total billed charges,,8440.1,,,,fee schedule,,,5625.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8440.1,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6700.81,91,,percent of total billed charges,,,6995.35,95,,percent of total billed charges,,,6111.73,83,,percent of total billed charges,,,6111.73,83,,percent of total billed charges,,,,,,,,,,,,,,,6111.73,83,,percent of total billed charges,,,6995.35,95,,percent of total billed charges,,,6627.18,90,,percent of total billed charges,,,6627.18,90,,percent of total billed charges,,,6038.09,82,,percent of total billed charges,,,6627.18,90,,percent of total billed charges,,,6259,85,,percent of total billed charges,,5552.1,8440.1,
SUGAMMADEX(BRIDION) IV VIAL:200MG/2ML,32013907,CDM,J3490,HCPCS,250,RC,inpatient,,1652.08,1652.08,,1402.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1245.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1404.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1453.83,88,,percent of total billed charges,,,,,,,,,1262.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1503.39,91,,percent of total billed charges,,,1569.48,95,,percent of total billed charges,,,1371.23,83,,percent of total billed charges,,,1371.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1371.23,83,,percent of total billed charges,,,1569.48,95,,percent of total billed charges,,,1486.87,90,,percent of total billed charges,,,1486.87,90,,percent of total billed charges,,,1354.71,82,,percent of total billed charges,,,1486.87,90,,percent of total billed charges,,,1404.27,85,,percent of total billed charges,,1245.67,1569.48,
LEUPROLIDE (LUPRON DEPO): 45MG/6MONTH,32013918,CDM,J9217,HCPCS,636,RC,inpatient,,51774.75,51774.75,,43956.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39038.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44008.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45561.78,88,,percent of total billed charges,,998.81,,,,fee schedule,,,39555.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,998.81,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47115.02,91,,percent of total billed charges,,,49186.01,95,,percent of total billed charges,,,42973.04,83,,percent of total billed charges,,,42973.04,83,,percent of total billed charges,,,,,,,,,,,,,,,42973.04,83,,percent of total billed charges,,,49186.01,95,,percent of total billed charges,,,46597.28,90,,percent of total billed charges,,,46597.28,90,,percent of total billed charges,,,42455.3,82,,percent of total billed charges,,,46597.28,90,,percent of total billed charges,,,44008.54,85,,percent of total billed charges,,998.81,49186.01,
POTAS PHOS(KP04)VIAL:15MMOL/5ML,32014021,CDM,J3490,HCPCS,250,RC,inpatient,,343.14,343.14,,291.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,258.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,291.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,301.96,88,,percent of total billed charges,,,,,,,,,262.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,312.26,91,,percent of total billed charges,,,325.98,95,,percent of total billed charges,,,284.81,83,,percent of total billed charges,,,284.81,83,,percent of total billed charges,,,,,,,,,,,,,,,284.81,83,,percent of total billed charges,,,325.98,95,,percent of total billed charges,,,308.83,90,,percent of total billed charges,,,308.83,90,,percent of total billed charges,,,281.37,82,,percent of total billed charges,,,308.83,90,,percent of total billed charges,,,291.67,85,,percent of total billed charges,,258.73,325.98,
FLUZONE QUAD(2017-2018)SYR:0.5ML,32014110,CDM,90686,CPT,636,RC,inpatient,,276.92,276.92,,235.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,208.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,235.38,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,243.69,88,,percent of total billed charges,,,,,,,,,211.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252,91,,percent of total billed charges,,,263.07,95,,percent of total billed charges,,,229.84,83,,percent of total billed charges,,,229.84,83,,percent of total billed charges,,,,,,,,,,,,,,,229.84,83,,percent of total billed charges,,,263.07,95,,percent of total billed charges,,,249.23,90,,percent of total billed charges,,,249.23,90,,percent of total billed charges,,,227.07,82,,percent of total billed charges,,,249.23,90,,percent of total billed charges,,,235.38,85,,percent of total billed charges,,208.8,263.07,
FLUZONE HIGH DOSE (2017-2018)SYR:0.5ML,32014111,CDM,90662,CPT,636,RC,inpatient,,683.41,683.41,,580.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,515.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,580.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,601.4,88,,percent of total billed charges,,,,,,,,,522.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,621.9,91,,percent of total billed charges,,,649.24,95,,percent of total billed charges,,,567.23,83,,percent of total billed charges,,,567.23,83,,percent of total billed charges,,,,,,,,,,,,,,,567.23,83,,percent of total billed charges,,,649.24,95,,percent of total billed charges,,,615.07,90,,percent of total billed charges,,,615.07,90,,percent of total billed charges,,,560.4,82,,percent of total billed charges,,,615.07,90,,percent of total billed charges,,,580.9,85,,percent of total billed charges,,515.29,649.24,
GEMCITABINE(GEMZAR)VIAL:2GM,32014124,CDM,J9201,HCPCS,636,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,55.14,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,55.14,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
bupivacaine 0.25% PF Inj Sol 10ML,32014223,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
STERILE WATER FOR INJECTION VIAL:50ML,32014355,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
IMMUNE GLOBULIN(GAMUNEX-C)SDV:20GM/200ML,32014379,CDM,J1561,HCPCS,636,RC,inpatient,,8863.47,8863.47,,7525.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6683.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7533.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7799.85,88,,percent of total billed charges,,11167,,,,fee schedule,,,6771.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11167,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8065.76,91,,percent of total billed charges,,,8420.3,95,,percent of total billed charges,,,7356.68,83,,percent of total billed charges,,,7356.68,83,,percent of total billed charges,,,,,,,,,,,,,,,7356.68,83,,percent of total billed charges,,,8420.3,95,,percent of total billed charges,,,7977.12,90,,percent of total billed charges,,,7977.12,90,,percent of total billed charges,,,7268.05,82,,percent of total billed charges,,,7977.12,90,,percent of total billed charges,,,7533.95,85,,percent of total billed charges,,6683.06,11167,
IMMUNE GLOBULIN(GAMUNEX-C)SDV:2.5GM/25ML,32014380,CDM,J1561,HCPCS,636,RC,inpatient,,3407.55,3407.55,,2893.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2569.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2896.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2998.64,88,,percent of total billed charges,,11167,,,,fee schedule,,,2603.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11167,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3100.87,91,,percent of total billed charges,,,3237.17,95,,percent of total billed charges,,,2828.27,83,,percent of total billed charges,,,2828.27,83,,percent of total billed charges,,,,,,,,,,,,,,,2828.27,83,,percent of total billed charges,,,3237.17,95,,percent of total billed charges,,,3066.8,90,,percent of total billed charges,,,3066.8,90,,percent of total billed charges,,,2794.19,82,,percent of total billed charges,,,3066.8,90,,percent of total billed charges,,,2896.42,85,,percent of total billed charges,,2569.29,11167,
TECENTRIQ (ATEZOLIZUMAB)VIAL:1200MG/20ML,32014432,CDM,J9022,HCPCS,636,RC,inpatient,,41960.56,41960.56,,35624.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31638.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35666.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36925.29,88,,percent of total billed charges,,13787.09,,,,fee schedule,,,32057.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13787.09,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38184.11,91,,percent of total billed charges,,,39862.53,95,,percent of total billed charges,,,34827.26,83,,percent of total billed charges,,,34827.26,83,,percent of total billed charges,,,,,,,,,,,,,,,34827.26,83,,percent of total billed charges,,,39862.53,95,,percent of total billed charges,,,37764.5,90,,percent of total billed charges,,,37764.5,90,,percent of total billed charges,,,34407.66,82,,percent of total billed charges,,,37764.5,90,,percent of total billed charges,,,35666.48,85,,percent of total billed charges,,13787.09,39862.53,
FERRIC CARBOX(INJECTAFER)VIAL:750MG/15ML,32014434,CDM,J1439,HCPCS,636,RC,inpatient,,7355.95,7355.95,,6245.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5546.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6252.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6473.24,88,,percent of total billed charges,,855.75,,,,fee schedule,,,5619.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,855.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6693.91,91,,percent of total billed charges,,,6988.15,95,,percent of total billed charges,,,6105.44,83,,percent of total billed charges,,,6105.44,83,,percent of total billed charges,,,,,,,,,,,,,,,6105.44,83,,percent of total billed charges,,,6988.15,95,,percent of total billed charges,,,6620.36,90,,percent of total billed charges,,,6620.36,90,,percent of total billed charges,,,6031.88,82,,percent of total billed charges,,,6620.36,90,,percent of total billed charges,,,6252.56,85,,percent of total billed charges,,855.75,6988.15,
ACETAMINOPHEN SUSP UD: 160MG/5ML,32014437,CDM,J8499,HCPCS,250,RC,inpatient,,13.89,13.89,,11.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.22,88,,percent of total billed charges,,,,,,,,,10.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.64,91,,percent of total billed charges,,,13.2,95,,percent of total billed charges,,,11.53,83,,percent of total billed charges,,,11.53,83,,percent of total billed charges,,,,,,,,,,,,,,,11.53,83,,percent of total billed charges,,,13.2,95,,percent of total billed charges,,,12.5,90,,percent of total billed charges,,,12.5,90,,percent of total billed charges,,,11.39,82,,percent of total billed charges,,,12.5,90,,percent of total billed charges,,,11.81,85,,percent of total billed charges,,10.47,13.2,
GRANISETRON (KYTRIL):1MG/ML,32014533,CDM,J1626,HCPCS,636,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,7.72,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.72,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,7.72,60.99,
CARBOplatin MDV:450MG/45ML   J/50,32014547,CDM,J9045,HCPCS,636,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,48.01,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,48.01,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.01,60.99,
DEMECLOCYCLINE TAB:150MG,32014736,CDM,J8499,HCPCS,250,RC,inpatient,,67.25,67.25,,57.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.18,88,,percent of total billed charges,,,,,,,,,51.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.2,91,,percent of total billed charges,,,63.89,95,,percent of total billed charges,,,55.82,83,,percent of total billed charges,,,55.82,83,,percent of total billed charges,,,,,,,,,,,,,,,55.82,83,,percent of total billed charges,,,63.89,95,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,55.15,82,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,57.16,85,,percent of total billed charges,,50.71,63.89,
PACLitaxel(TAXol)MDV:300MG/50ML (J/1mg),32014769,CDM,J9267,HCPCS,636,RC,inpatient,,2.01,2.01,,1.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1.77,88,,percent of total billed charges,,61.04,,,,fee schedule,,,1.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,61.04,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1.83,91,,percent of total billed charges,,,1.91,95,,percent of total billed charges,,,1.67,83,,percent of total billed charges,,,1.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1.67,83,,percent of total billed charges,,,1.91,95,,percent of total billed charges,,,1.81,90,,percent of total billed charges,,,1.81,90,,percent of total billed charges,,,1.65,82,,percent of total billed charges,,,1.81,90,,percent of total billed charges,,,1.71,85,,percent of total billed charges,,1.52,61.04,
WATER FOR IRRIGATION STERILE SOL:500ML,32014841,CDM,J3490,HCPCS,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
FLUOROURACIL(5-FU)VL:1000MG/20ML,32014874,CDM,J9190,HCPCS,636,RC,inpatient,,100.71,100.71,,85.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88.62,88,,percent of total billed charges,,47.2,,,,fee schedule,,,76.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,47.2,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91.65,91,,percent of total billed charges,,,95.67,95,,percent of total billed charges,,,83.59,83,,percent of total billed charges,,,83.59,83,,percent of total billed charges,,,,,,,,,,,,,,,83.59,83,,percent of total billed charges,,,95.67,95,,percent of total billed charges,,,90.64,90,,percent of total billed charges,,,90.64,90,,percent of total billed charges,,,82.58,82,,percent of total billed charges,,,90.64,90,,percent of total billed charges,,,85.6,85,,percent of total billed charges,,47.2,95.67,
PEN G POTAS(PFIZERPEN)VIAL: 20 MIL UNITS,32014903,CDM,J2540,HCPCS,250,RC,inpatient,,611.4,611.4,,519.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,461,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,519.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,538.03,88,,percent of total billed charges,,7.79,,,,fee schedule,,,467.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.79,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,556.37,91,,percent of total billed charges,,,580.83,95,,percent of total billed charges,,,507.46,83,,percent of total billed charges,,,507.46,83,,percent of total billed charges,,,,,,,,,,,,,,,507.46,83,,percent of total billed charges,,,580.83,95,,percent of total billed charges,,,550.26,90,,percent of total billed charges,,,550.26,90,,percent of total billed charges,,,501.35,82,,percent of total billed charges,,,550.26,90,,percent of total billed charges,,,519.69,85,,percent of total billed charges,,7.79,580.83,
ALFENTanil(ALFENTA)PF AMP:1000MCG/2ML,32014955,CDM,J3490,HCPCS,250,RC,inpatient,,120.1,120.1,,101.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,90.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,102.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,105.69,88,,percent of total billed charges,,,,,,,,,91.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,109.29,91,,percent of total billed charges,,,114.1,95,,percent of total billed charges,,,99.68,83,,percent of total billed charges,,,99.68,83,,percent of total billed charges,,,,,,,,,,,,,,,99.68,83,,percent of total billed charges,,,114.1,95,,percent of total billed charges,,,108.09,90,,percent of total billed charges,,,108.09,90,,percent of total billed charges,,,98.48,82,,percent of total billed charges,,,108.09,90,,percent of total billed charges,,,102.09,85,,percent of total billed charges,,90.56,114.1,
TROPICAMIDE(MYDRIACYL)DROP 1%:15ML,32014956,CDM,J3490,HCPCS,250,RC,inpatient,,95.95,95.95,,81.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,72.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,81.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,84.44,88,,percent of total billed charges,,,,,,,,,73.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,87.31,91,,percent of total billed charges,,,91.15,95,,percent of total billed charges,,,79.64,83,,percent of total billed charges,,,79.64,83,,percent of total billed charges,,,,,,,,,,,,,,,79.64,83,,percent of total billed charges,,,91.15,95,,percent of total billed charges,,,86.36,90,,percent of total billed charges,,,86.36,90,,percent of total billed charges,,,78.68,82,,percent of total billed charges,,,86.36,90,,percent of total billed charges,,,81.56,85,,percent of total billed charges,,72.35,91.15,
fentaNYL PHARMACY ADMIX SYR:100MCG/2ML,32014964,CDM,J3010,HCPCS,250,RC,inpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.78,88,,percent of total billed charges,,1.79,,,,fee schedule,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.79,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,1.79,62.38,
INSUL GLA(LANTUS) PEN:100UNITS/ML(3ML),32014965,CDM,J1815,HCPCS,250,RC,inpatient,,431.21,431.21,,366.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,325.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,366.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,379.46,88,,percent of total billed charges,,,,,,,,,329.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,392.4,91,,percent of total billed charges,,,409.65,95,,percent of total billed charges,,,357.9,83,,percent of total billed charges,,,357.9,83,,percent of total billed charges,,,,,,,,,,,,,,,357.9,83,,percent of total billed charges,,,409.65,95,,percent of total billed charges,,,388.09,90,,percent of total billed charges,,,388.09,90,,percent of total billed charges,,,353.59,82,,percent of total billed charges,,,388.09,90,,percent of total billed charges,,,366.53,85,,percent of total billed charges,,325.13,409.65,
ROPIVACAINE(NAROPIN)BAG 0.2%:200ML,32015031,CDM,J2795,HCPCS,250,RC,inpatient,,1122.56,1122.56,,953.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,846.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,954.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,987.85,88,,percent of total billed charges,,13.8,,,,fee schedule,,,857.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.8,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1021.53,91,,percent of total billed charges,,,1066.43,95,,percent of total billed charges,,,931.72,83,,percent of total billed charges,,,931.72,83,,percent of total billed charges,,,,,,,,,,,,,,,931.72,83,,percent of total billed charges,,,1066.43,95,,percent of total billed charges,,,1010.3,90,,percent of total billed charges,,,1010.3,90,,percent of total billed charges,,,920.5,82,,percent of total billed charges,,,1010.3,90,,percent of total billed charges,,,954.18,85,,percent of total billed charges,,13.8,1066.43,
TETRACAINE SPINAL  AMP 1%: 2ML,32015056,CDM,J3490,HCPCS,250,RC,inpatient,,1070.52,1070.52,,908.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,807.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,909.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,942.06,88,,percent of total billed charges,,,,,,,,,817.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,974.17,91,,percent of total billed charges,,,1016.99,95,,percent of total billed charges,,,888.53,83,,percent of total billed charges,,,888.53,83,,percent of total billed charges,,,,,,,,,,,,,,,888.53,83,,percent of total billed charges,,,1016.99,95,,percent of total billed charges,,,963.47,90,,percent of total billed charges,,,963.47,90,,percent of total billed charges,,,877.83,82,,percent of total billed charges,,,963.47,90,,percent of total billed charges,,,909.94,85,,percent of total billed charges,,807.17,1016.99,
ROPIVACAINE(NAROPIN)AMP 0.5%:100MG/20ML,32015057,CDM,J2795,HCPCS,250,RC,inpatient,,248.2,248.2,,210.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,187.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.42,88,,percent of total billed charges,,13.8,,,,fee schedule,,,189.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.8,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.86,91,,percent of total billed charges,,,235.79,95,,percent of total billed charges,,,206.01,83,,percent of total billed charges,,,206.01,83,,percent of total billed charges,,,,,,,,,,,,,,,206.01,83,,percent of total billed charges,,,235.79,95,,percent of total billed charges,,,223.38,90,,percent of total billed charges,,,223.38,90,,percent of total billed charges,,,203.52,82,,percent of total billed charges,,,223.38,90,,percent of total billed charges,,,210.97,85,,percent of total billed charges,,13.8,235.79,
MORPHINE SULF VIAL:4MG/ML,32015088,CDM,,,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,,,,,,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,50.92,64.15,
MORPHINE SULF(ROXANOL)PO SOL :30MG/1.5ML,32015106,CDM,,,250,RC,inpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,12.36,15.57,
DRONABINOL(MARINOL)CAP:5MG,32015107,CDM,Q0167,HCPCS,250,RC,inpatient,,129.42,129.42,,109.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,97.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,110.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,113.89,88,,percent of total billed charges,,,,,,,,,98.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,117.77,91,,percent of total billed charges,,,122.95,95,,percent of total billed charges,,,107.42,83,,percent of total billed charges,,,107.42,83,,percent of total billed charges,,,,,,,,,,,,,,,107.42,83,,percent of total billed charges,,,122.95,95,,percent of total billed charges,,,116.48,90,,percent of total billed charges,,,116.48,90,,percent of total billed charges,,,106.12,82,,percent of total billed charges,,,116.48,90,,percent of total billed charges,,,110.01,85,,percent of total billed charges,,97.58,122.95,
SORBITOL SOLUTION SOL 70% UD:30ML,32015204,CDM,J8499,HCPCS,250,RC,inpatient,,34.89,34.89,,29.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30.7,88,,percent of total billed charges,,,,,,,,,26.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31.75,91,,percent of total billed charges,,,33.15,95,,percent of total billed charges,,,28.96,83,,percent of total billed charges,,,28.96,83,,percent of total billed charges,,,,,,,,,,,,,,,28.96,83,,percent of total billed charges,,,33.15,95,,percent of total billed charges,,,31.4,90,,percent of total billed charges,,,31.4,90,,percent of total billed charges,,,28.61,82,,percent of total billed charges,,,31.4,90,,percent of total billed charges,,,29.66,85,,percent of total billed charges,,26.31,33.15,
GRANISETRON (KYTRIL)MDV:4MG/4ML,32015235,CDM,J1626,HCPCS,636,RC,inpatient,,106.42,106.42,,90.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,80.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,90.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,93.65,88,,percent of total billed charges,,7.72,,,,fee schedule,,,81.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.72,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,96.84,91,,percent of total billed charges,,,101.1,95,,percent of total billed charges,,,88.33,83,,percent of total billed charges,,,88.33,83,,percent of total billed charges,,,,,,,,,,,,,,,88.33,83,,percent of total billed charges,,,101.1,95,,percent of total billed charges,,,95.78,90,,percent of total billed charges,,,95.78,90,,percent of total billed charges,,,87.26,82,,percent of total billed charges,,,95.78,90,,percent of total billed charges,,,90.46,85,,percent of total billed charges,,7.72,101.1,
BEVACIZUMAB(AVASTIN):400MG/16ML,32015368,CDM,J9035,HCPCS,636,RC,inpatient,,15062.18,15062.18,,12787.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11356.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12802.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13254.72,88,,percent of total billed charges,,13247.18,,,,fee schedule,,,11507.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13247.18,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13706.58,91,,percent of total billed charges,,,14309.07,95,,percent of total billed charges,,,12501.61,83,,percent of total billed charges,,,12501.61,83,,percent of total billed charges,,,,,,,,,,,,,,,12501.61,83,,percent of total billed charges,,,14309.07,95,,percent of total billed charges,,,13555.96,90,,percent of total billed charges,,,13555.96,90,,percent of total billed charges,,,12350.99,82,,percent of total billed charges,,,13555.96,90,,percent of total billed charges,,,12802.85,85,,percent of total billed charges,,11356.88,14309.07,
LIDOCAINE W/EPI 1.5% TEST DOSE AMP: 5ML,32015369,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
IPILIMUMAB(YERVOY)IV: 50MG/10ML,32015374,CDM,J9228,HCPCS,636,RC,inpatient,,33895.84,33895.84,,28777.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25557.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28811.46,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29828.34,88,,percent of total billed charges,,57086.4,,,,fee schedule,,,25896.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,57086.4,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30845.21,91,,percent of total billed charges,,,32201.05,95,,percent of total billed charges,,,28133.55,83,,percent of total billed charges,,,28133.55,83,,percent of total billed charges,,,,,,,,,,,,,,,28133.55,83,,percent of total billed charges,,,32201.05,95,,percent of total billed charges,,,30506.26,90,,percent of total billed charges,,,30506.26,90,,percent of total billed charges,,,27794.59,82,,percent of total billed charges,,,30506.26,90,,percent of total billed charges,,,28811.46,85,,percent of total billed charges,,25557.46,57086.4,
APREPITANT(CINVANTI)VL:130MG/18ML,32015376,CDM,J0185,HCPCS,636,RC,inpatient,,2901.54,2901.54,,2463.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2187.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2466.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2553.36,88,,percent of total billed charges,,218.66,,,,fee schedule,,,2216.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,218.66,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2640.4,91,,percent of total billed charges,,,2756.46,95,,percent of total billed charges,,,2408.28,83,,percent of total billed charges,,,2408.28,83,,percent of total billed charges,,,,,,,,,,,,,,,2408.28,83,,percent of total billed charges,,,2756.46,95,,percent of total billed charges,,,2611.39,90,,percent of total billed charges,,,2611.39,90,,percent of total billed charges,,,2379.26,82,,percent of total billed charges,,,2611.39,90,,percent of total billed charges,,,2466.31,85,,percent of total billed charges,,218.66,2756.46,
DOXOrubicin LIPOSOMAL VIAL: 50MG/25ML,32015456,CDM,Q2050,HCPCS,636,RC,inpatient,,10356.44,10356.44,,8792.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7808.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8802.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9113.67,88,,percent of total billed charges,,1455.81,,,,fee schedule,,,7912.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1455.81,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9424.36,91,,percent of total billed charges,,,9838.62,95,,percent of total billed charges,,,8595.85,83,,percent of total billed charges,,,8595.85,83,,percent of total billed charges,,,,,,,,,,,,,,,8595.85,83,,percent of total billed charges,,,9838.62,95,,percent of total billed charges,,,9320.8,90,,percent of total billed charges,,,9320.8,90,,percent of total billed charges,,,8492.28,82,,percent of total billed charges,,,9320.8,90,,percent of total billed charges,,,8802.97,85,,percent of total billed charges,,1455.81,9838.62,
DOXOrubicin LIPOSOMAL VIAL: 20MG/10ML,32015457,CDM,Q2050,HCPCS,636,RC,inpatient,,6738.57,6738.57,,5721.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5080.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5727.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5929.94,88,,percent of total billed charges,,1455.81,,,,fee schedule,,,5148.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1455.81,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6132.1,91,,percent of total billed charges,,,6401.64,95,,percent of total billed charges,,,5593.01,83,,percent of total billed charges,,,5593.01,83,,percent of total billed charges,,,,,,,,,,,,,,,5593.01,83,,percent of total billed charges,,,6401.64,95,,percent of total billed charges,,,6064.71,90,,percent of total billed charges,,,6064.71,90,,percent of total billed charges,,,5525.63,82,,percent of total billed charges,,,6064.71,90,,percent of total billed charges,,,5727.78,85,,percent of total billed charges,,1455.81,6401.64,
HYDROmorphone (DILAUDID) VIAL:1MG/ML,32015489,CDM,J1170,HCPCS,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,3.47,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.47,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,3.47,64.15,
VALSARTAN(DIOVAN)TAB:160MG,32015493,CDM,,,250,RC,inpatient,,14.75,14.75,,12.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12.98,88,,percent of total billed charges,,,,,,,,,11.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.42,91,,percent of total billed charges,,,14.01,95,,percent of total billed charges,,,12.24,83,,percent of total billed charges,,,12.24,83,,percent of total billed charges,,,,,,,,,,,,,,,12.24,83,,percent of total billed charges,,,14.01,95,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,12.1,82,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,12.54,85,,percent of total billed charges,,11.12,14.01,
BECLOMETH DIPROP(QVAR) HFA:40MCG(10.6GM),32015537,CDM,J7622,HCPCS,250,RC,inpatient,,2858.79,2858.79,,2427.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2155.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2429.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2515.74,88,,percent of total billed charges,,,,,,,,,2184.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2601.5,91,,percent of total billed charges,,,2715.85,95,,percent of total billed charges,,,2372.8,83,,percent of total billed charges,,,2372.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2372.8,83,,percent of total billed charges,,,2715.85,95,,percent of total billed charges,,,2572.91,90,,percent of total billed charges,,,2572.91,90,,percent of total billed charges,,,2344.21,82,,percent of total billed charges,,,2572.91,90,,percent of total billed charges,,,2429.97,85,,percent of total billed charges,,2155.53,2715.85,
LIDOCAINE HCL 2% VIAL:(20MG/ML) (2ML),32015564,CDM,J2001,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
LIDOCAINE HCL 2% VIAL:(20MG/ML) (10ML),32015682,CDM,J2001,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
IRINOTECAN(CAMPTOSAR):300MG/15ML,32015730,CDM,J9206,HCPCS,636,RC,inpatient,,894.34,894.34,,759.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,674.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,760.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,787.02,88,,percent of total billed charges,,114.58,,,,fee schedule,,,683.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,114.58,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,813.85,91,,percent of total billed charges,,,849.62,95,,percent of total billed charges,,,742.3,83,,percent of total billed charges,,,742.3,83,,percent of total billed charges,,,,,,,,,,,,,,,742.3,83,,percent of total billed charges,,,849.62,95,,percent of total billed charges,,,804.91,90,,percent of total billed charges,,,804.91,90,,percent of total billed charges,,,733.36,82,,percent of total billed charges,,,804.91,90,,percent of total billed charges,,,760.19,85,,percent of total billed charges,,114.58,849.62,
OCTREOTIDE ACETATE (SANDOSTATIN): 30MG,32015753,CDM,J2353,HCPCS,636,RC,inpatient,,28008.9,28008.9,,23779.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21118.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23807.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24647.83,88,,percent of total billed charges,,8278.44,,,,fee schedule,,,21398.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8278.44,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25488.1,91,,percent of total billed charges,,,26608.46,95,,percent of total billed charges,,,23247.39,83,,percent of total billed charges,,,23247.39,83,,percent of total billed charges,,,,,,,,,,,,,,,23247.39,83,,percent of total billed charges,,,26608.46,95,,percent of total billed charges,,,25208.01,90,,percent of total billed charges,,,25208.01,90,,percent of total billed charges,,,22967.3,82,,percent of total billed charges,,,25208.01,90,,percent of total billed charges,,,23807.57,85,,percent of total billed charges,,8278.44,26608.46,
MORPHINE SULF VIAL:2MG/ML,32015790,CDM,,,250,RC,inpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,57.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,59.43,88,,percent of total billed charges,,,,,,,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,50.92,64.15,
SACUBITRIL/VALSARTA(ENTRESTO)TAB:24/26MG,32015810,CDM,J8499,HCPCS,250,RC,inpatient,,173.86,173.86,,147.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,131.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,153,88,,percent of total billed charges,,,,,,,,,132.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,158.21,91,,percent of total billed charges,,,165.17,95,,percent of total billed charges,,,144.3,83,,percent of total billed charges,,,144.3,83,,percent of total billed charges,,,,,,,,,,,,,,,144.3,83,,percent of total billed charges,,,165.17,95,,percent of total billed charges,,,156.47,90,,percent of total billed charges,,,156.47,90,,percent of total billed charges,,,142.57,82,,percent of total billed charges,,,156.47,90,,percent of total billed charges,,,147.78,85,,percent of total billed charges,,131.09,165.17,
SACUBITRIL/VALSARTA(ENTRESTO)TAB:49/51MG,32015811,CDM,J8499,HCPCS,250,RC,inpatient,,172.88,172.88,,146.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.13,88,,percent of total billed charges,,,,,,,,,132.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.32,91,,percent of total billed charges,,,164.24,95,,percent of total billed charges,,,143.49,83,,percent of total billed charges,,,143.49,83,,percent of total billed charges,,,,,,,,,,,,,,,143.49,83,,percent of total billed charges,,,164.24,95,,percent of total billed charges,,,155.59,90,,percent of total billed charges,,,155.59,90,,percent of total billed charges,,,141.76,82,,percent of total billed charges,,,155.59,90,,percent of total billed charges,,,146.95,85,,percent of total billed charges,,130.35,164.24,
SACUBITRIL/VALSART(ENTRESTO)TAB:97/103MG,32015812,CDM,J8499,HCPCS,250,RC,inpatient,,161.6,161.6,,137.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,121.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,137.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,142.21,88,,percent of total billed charges,,,,,,,,,123.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,147.06,91,,percent of total billed charges,,,153.52,95,,percent of total billed charges,,,134.13,83,,percent of total billed charges,,,134.13,83,,percent of total billed charges,,,,,,,,,,,,,,,134.13,83,,percent of total billed charges,,,153.52,95,,percent of total billed charges,,,145.44,90,,percent of total billed charges,,,145.44,90,,percent of total billed charges,,,132.51,82,,percent of total billed charges,,,145.44,90,,percent of total billed charges,,,137.36,85,,percent of total billed charges,,121.85,153.52,
FLUZONE HIGH DOSE (2018-2019)SYR:0.5ML,32015818,CDM,90662,CPT,636,RC,inpatient,,743.2,743.2,,630.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,560.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,631.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,654.02,88,,percent of total billed charges,,,,,,,,,567.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,676.31,91,,percent of total billed charges,,,706.04,95,,percent of total billed charges,,,616.86,83,,percent of total billed charges,,,616.86,83,,percent of total billed charges,,,,,,,,,,,,,,,616.86,83,,percent of total billed charges,,,706.04,95,,percent of total billed charges,,,668.88,90,,percent of total billed charges,,,668.88,90,,percent of total billed charges,,,609.42,82,,percent of total billed charges,,,668.88,90,,percent of total billed charges,,,631.72,85,,percent of total billed charges,,560.37,706.04,
FLUZONE QUAD(2018-2019)SYR:0.5ML,32015819,CDM,90686,CPT,636,RC,inpatient,,277.07,277.07,,235.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,208.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,235.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,243.82,88,,percent of total billed charges,,,,,,,,,211.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.13,91,,percent of total billed charges,,,263.22,95,,percent of total billed charges,,,229.97,83,,percent of total billed charges,,,229.97,83,,percent of total billed charges,,,,,,,,,,,,,,,229.97,83,,percent of total billed charges,,,263.22,95,,percent of total billed charges,,,249.36,90,,percent of total billed charges,,,249.36,90,,percent of total billed charges,,,227.2,82,,percent of total billed charges,,,249.36,90,,percent of total billed charges,,,235.51,85,,percent of total billed charges,,208.91,263.22,
LIDOCAINE 4% (LARYNG-O-JET) TOP SOL:4ML,32015827,CDM,J3490,HCPCS,250,RC,inpatient,,477.94,477.94,,405.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,360.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,406.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,420.59,88,,percent of total billed charges,,,,,,,,,365.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,434.93,91,,percent of total billed charges,,,454.04,95,,percent of total billed charges,,,396.69,83,,percent of total billed charges,,,396.69,83,,percent of total billed charges,,,,,,,,,,,,,,,396.69,83,,percent of total billed charges,,,454.04,95,,percent of total billed charges,,,430.15,90,,percent of total billed charges,,,430.15,90,,percent of total billed charges,,,391.91,82,,percent of total billed charges,,,430.15,90,,percent of total billed charges,,,406.25,85,,percent of total billed charges,,360.37,454.04,
RIFAXIMIN(XIFAXAN)TAB:550MG,32015863,CDM,J8499,HCPCS,250,RC,inpatient,,720.65,720.65,,611.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,543.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,612.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,634.17,88,,percent of total billed charges,,,,,,,,,550.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,655.79,91,,percent of total billed charges,,,684.62,95,,percent of total billed charges,,,598.14,83,,percent of total billed charges,,,598.14,83,,percent of total billed charges,,,,,,,,,,,,,,,598.14,83,,percent of total billed charges,,,684.62,95,,percent of total billed charges,,,648.59,90,,percent of total billed charges,,,648.59,90,,percent of total billed charges,,,590.93,82,,percent of total billed charges,,,648.59,90,,percent of total billed charges,,,612.55,85,,percent of total billed charges,,543.37,684.62,
DEXTROSE(GLUCOSE) 40% GEL:  15GM/30ML,32015924,CDM,J8499,HCPCS,250,RC,inpatient,,19.61,19.61,,16.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17.26,88,,percent of total billed charges,,,,,,,,,14.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17.85,91,,percent of total billed charges,,,18.63,95,,percent of total billed charges,,,16.28,83,,percent of total billed charges,,,16.28,83,,percent of total billed charges,,,,,,,,,,,,,,,16.28,83,,percent of total billed charges,,,18.63,95,,percent of total billed charges,,,17.65,90,,percent of total billed charges,,,17.65,90,,percent of total billed charges,,,16.08,82,,percent of total billed charges,,,17.65,90,,percent of total billed charges,,,16.67,85,,percent of total billed charges,,14.79,18.63,
FACTOR VIII (HUMATE-P): 2092 UNITS,32015994,CDM,J7187,HCPCS,636,RC,inpatient,,8896.23,8896.23,,7552.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6707.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7561.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7828.68,88,,percent of total billed charges,,12958.7,,,,fee schedule,,,6796.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,12958.7,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8095.57,91,,percent of total billed charges,,,8451.42,95,,percent of total billed charges,,,7383.87,83,,percent of total billed charges,,,7383.87,83,,percent of total billed charges,,,,,,,,,,,,,,,7383.87,83,,percent of total billed charges,,,8451.42,95,,percent of total billed charges,,,8006.61,90,,percent of total billed charges,,,8006.61,90,,percent of total billed charges,,,7294.91,82,,percent of total billed charges,,,8006.61,90,,percent of total billed charges,,,7561.8,85,,percent of total billed charges,,6707.76,12958.7,
FACTOR VIII (HUMATE-P): 461 UNITS,32015995,CDM,J7187,HCPCS,636,RC,inpatient,,6074.72,6074.72,,5157.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4580.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5163.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5345.75,88,,percent of total billed charges,,12958.7,,,,fee schedule,,,4641.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,12958.7,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5528,91,,percent of total billed charges,,,5770.98,95,,percent of total billed charges,,,5042.02,83,,percent of total billed charges,,,5042.02,83,,percent of total billed charges,,,,,,,,,,,,,,,5042.02,83,,percent of total billed charges,,,5770.98,95,,percent of total billed charges,,,5467.25,90,,percent of total billed charges,,,5467.25,90,,percent of total billed charges,,,4981.27,82,,percent of total billed charges,,,5467.25,90,,percent of total billed charges,,,5163.51,85,,percent of total billed charges,,4580.34,12958.7,
ELEVIEW SUBMUCOSAL INJ:  10ML,32016084,CDM,J3490,HCPCS,250,RC,inpatient,,1411.4,1411.4,,1198.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1064.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1199.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1242.03,88,,percent of total billed charges,,,,,,,,,1078.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1284.37,91,,percent of total billed charges,,,1340.83,95,,percent of total billed charges,,,1171.46,83,,percent of total billed charges,,,1171.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1171.46,83,,percent of total billed charges,,,1340.83,95,,percent of total billed charges,,,1270.26,90,,percent of total billed charges,,,1270.26,90,,percent of total billed charges,,,1157.35,82,,percent of total billed charges,,,1270.26,90,,percent of total billed charges,,,1199.69,85,,percent of total billed charges,,1064.2,1340.83,
BACTERIOSTATIC WATER FOR INJ VIAL: 30ML,32016222,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
GOLIMUMAB (SIMPONI) VIAL: 50MG/4ML,32016223,CDM,J1602,HCPCS,636,RC,inpatient,,8838.72,8838.72,,7504.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6664.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7512.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7778.07,88,,percent of total billed charges,,,,,,,,,6752.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8043.24,91,,percent of total billed charges,,,8396.78,95,,percent of total billed charges,,,7336.14,83,,percent of total billed charges,,,7336.14,83,,percent of total billed charges,,,,,,,,,,,,,,,7336.14,83,,percent of total billed charges,,,8396.78,95,,percent of total billed charges,,,7954.85,90,,percent of total billed charges,,,7954.85,90,,percent of total billed charges,,,7247.75,82,,percent of total billed charges,,,7954.85,90,,percent of total billed charges,,,7512.91,85,,percent of total billed charges,,6664.39,8396.78,
KADCYLA (ADO-TRASTUZUMAB) VIAL 160MG,32016258,CDM,J9354,HCPCS,636,RC,inpatient,,26563.36,26563.36,,22552.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20028.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22578.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23375.76,88,,percent of total billed charges,,14278,,,,fee schedule,,,20294.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14278,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24172.66,91,,percent of total billed charges,,,25235.19,95,,percent of total billed charges,,,22047.59,83,,percent of total billed charges,,,22047.59,83,,percent of total billed charges,,,,,,,,,,,,,,,22047.59,83,,percent of total billed charges,,,25235.19,95,,percent of total billed charges,,,23907.02,90,,percent of total billed charges,,,23907.02,90,,percent of total billed charges,,,21781.96,82,,percent of total billed charges,,,23907.02,90,,percent of total billed charges,,,22578.86,85,,percent of total billed charges,,14278,25235.19,
CARFLIZOMIB (KYPROLIS) VIAL 60MG,32016302,CDM,J9047,HCPCS,636,RC,inpatient,,10969.83,10969.83,,9313.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8271.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9324.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9653.45,88,,percent of total billed charges,,7044.32,,,,fee schedule,,,8380.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7044.32,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9982.55,91,,percent of total billed charges,,,10421.34,95,,percent of total billed charges,,,9104.96,83,,percent of total billed charges,,,9104.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9104.96,83,,percent of total billed charges,,,10421.34,95,,percent of total billed charges,,,9872.85,90,,percent of total billed charges,,,9872.85,90,,percent of total billed charges,,,8995.26,82,,percent of total billed charges,,,9872.85,90,,percent of total billed charges,,,9324.36,85,,percent of total billed charges,,7044.32,10421.34,
CARFLIZOMIB (KYPROLIS) VIAL 10MG,32016303,CDM,J9047,HCPCS,636,RC,inpatient,,2974.04,2974.04,,2524.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2242.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2527.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2617.16,88,,percent of total billed charges,,7044.32,,,,fee schedule,,,2272.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7044.32,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2706.38,91,,percent of total billed charges,,,2825.34,95,,percent of total billed charges,,,2468.45,83,,percent of total billed charges,,,2468.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2468.45,83,,percent of total billed charges,,,2825.34,95,,percent of total billed charges,,,2676.64,90,,percent of total billed charges,,,2676.64,90,,percent of total billed charges,,,2438.71,82,,percent of total billed charges,,,2676.64,90,,percent of total billed charges,,,2527.93,85,,percent of total billed charges,,2242.43,7044.32,
IMMUNE GLOBULIN(GAMUNEX-C)SDV:40GM/400ML,32016350,CDM,J1561,HCPCS,636,RC,inpatient,,18170.46,18170.46,,15426.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13700.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15444.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15990,88,,percent of total billed charges,,11167,,,,fee schedule,,,13882.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11167,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16535.12,91,,percent of total billed charges,,,17261.94,95,,percent of total billed charges,,,15081.48,83,,percent of total billed charges,,,15081.48,83,,percent of total billed charges,,,,,,,,,,,,,,,15081.48,83,,percent of total billed charges,,,17261.94,95,,percent of total billed charges,,,16353.41,90,,percent of total billed charges,,,16353.41,90,,percent of total billed charges,,,14899.78,82,,percent of total billed charges,,,16353.41,90,,percent of total billed charges,,,15444.89,85,,percent of total billed charges,,11167,17261.94,
EPINEPHrine VIAL:1MG/ML,32016434,CDM,J0171,HCPCS,250,RC,inpatient,,252.78,252.78,,214.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,214.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,222.45,88,,percent of total billed charges,,7.28,,,,fee schedule,,,193.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.28,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,230.03,91,,percent of total billed charges,,,240.14,95,,percent of total billed charges,,,209.81,83,,percent of total billed charges,,,209.81,83,,percent of total billed charges,,,,,,,,,,,,,,,209.81,83,,percent of total billed charges,,,240.14,95,,percent of total billed charges,,,227.5,90,,percent of total billed charges,,,227.5,90,,percent of total billed charges,,,207.28,82,,percent of total billed charges,,,227.5,90,,percent of total billed charges,,,214.86,85,,percent of total billed charges,,7.28,240.14,
IMMUNE GLOBULIN(GAMUNEX-C)SDV:5GM/50ML,32016457,CDM,J1561,HCPCS,636,RC,inpatient,,3805.74,3805.74,,3231.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2869.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3234.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3349.05,88,,percent of total billed charges,,11167,,,,fee schedule,,,2907.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11167,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3463.22,91,,percent of total billed charges,,,3615.45,95,,percent of total billed charges,,,3158.76,83,,percent of total billed charges,,,3158.76,83,,percent of total billed charges,,,,,,,,,,,,,,,3158.76,83,,percent of total billed charges,,,3615.45,95,,percent of total billed charges,,,3425.17,90,,percent of total billed charges,,,3425.17,90,,percent of total billed charges,,,3120.71,82,,percent of total billed charges,,,3425.17,90,,percent of total billed charges,,,3234.88,85,,percent of total billed charges,,2869.53,11167,
EPINEPHrine 0.3MG/NS30ML - JAGASIA LOCAL,32016516,CDM,,,258,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
BLEOMYCIN VIAL: 15 UNITS,32016553,CDM,J9040,HCPCS,636,RC,inpatient,,334.49,334.49,,283.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,252.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,284.32,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,294.35,88,,percent of total billed charges,,97.2,,,,fee schedule,,,255.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,97.2,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,304.39,91,,percent of total billed charges,,,317.77,95,,percent of total billed charges,,,277.63,83,,percent of total billed charges,,,277.63,83,,percent of total billed charges,,,,,,,,,,,,,,,277.63,83,,percent of total billed charges,,,317.77,95,,percent of total billed charges,,,301.04,90,,percent of total billed charges,,,301.04,90,,percent of total billed charges,,,274.28,82,,percent of total billed charges,,,301.04,90,,percent of total billed charges,,,284.32,85,,percent of total billed charges,,97.2,317.77,
KETAMINE(KETALAR) VIAL:200MG/20ML,32016586,CDM,J3490,HCPCS,250,RC,inpatient,,334.32,334.32,,283.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,252.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,284.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,294.2,88,,percent of total billed charges,,,,,,,,,255.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,304.23,91,,percent of total billed charges,,,317.6,95,,percent of total billed charges,,,277.49,83,,percent of total billed charges,,,277.49,83,,percent of total billed charges,,,,,,,,,,,,,,,277.49,83,,percent of total billed charges,,,317.6,95,,percent of total billed charges,,,300.89,90,,percent of total billed charges,,,300.89,90,,percent of total billed charges,,,274.14,82,,percent of total billed charges,,,300.89,90,,percent of total billed charges,,,284.17,85,,percent of total billed charges,,252.08,317.6,
DEFEROXAMINE (DESFERAL)VIAL 500MG,32016620,CDM,J0895,HCPCS,636,RC,inpatient,,551.61,551.61,,468.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,415.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,468.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,485.42,88,,percent of total billed charges,,31.71,,,,fee schedule,,,421.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,31.71,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,501.97,91,,percent of total billed charges,,,524.03,95,,percent of total billed charges,,,457.84,83,,percent of total billed charges,,,457.84,83,,percent of total billed charges,,,,,,,,,,,,,,,457.84,83,,percent of total billed charges,,,524.03,95,,percent of total billed charges,,,496.45,90,,percent of total billed charges,,,496.45,90,,percent of total billed charges,,,452.32,82,,percent of total billed charges,,,496.45,90,,percent of total billed charges,,,468.87,85,,percent of total billed charges,,31.71,524.03,
MISOPROSTOL(CYTOTEC)TAB:200MCG,32016625,CDM,J8499,HCPCS,250,RC,inpatient,,15.36,15.36,,13.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.52,88,,percent of total billed charges,,,,,,,,,11.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13.98,91,,percent of total billed charges,,,14.59,95,,percent of total billed charges,,,12.75,83,,percent of total billed charges,,,12.75,83,,percent of total billed charges,,,,,,,,,,,,,,,12.75,83,,percent of total billed charges,,,14.59,95,,percent of total billed charges,,,13.82,90,,percent of total billed charges,,,13.82,90,,percent of total billed charges,,,12.6,82,,percent of total billed charges,,,13.82,90,,percent of total billed charges,,,13.06,85,,percent of total billed charges,,11.58,14.59,
BUPRENORPHINE(BUPRENEX)AMP:0.3MG/ML,32016656,CDM,J0592,HCPCS,250,RC,inpatient,,252.45,252.45,,214.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,214.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,222.16,88,,percent of total billed charges,,,,,,,,,192.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,229.73,91,,percent of total billed charges,,,239.83,95,,percent of total billed charges,,,209.53,83,,percent of total billed charges,,,209.53,83,,percent of total billed charges,,,,,,,,,,,,,,,209.53,83,,percent of total billed charges,,,239.83,95,,percent of total billed charges,,,227.21,90,,percent of total billed charges,,,227.21,90,,percent of total billed charges,,,207.01,82,,percent of total billed charges,,,227.21,90,,percent of total billed charges,,,214.58,85,,percent of total billed charges,,190.35,239.83,
IMMUNE GLOBULIN(GAMUNEX-C)SDV:1GM/10ML,32016675,CDM,J1561,HCPCS,636,RC,inpatient,,1291.32,1291.32,,1096.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,973.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1097.62,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1136.36,88,,percent of total billed charges,,11167,,,,fee schedule,,,986.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11167,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1175.1,91,,percent of total billed charges,,,1226.75,95,,percent of total billed charges,,,1071.8,83,,percent of total billed charges,,,1071.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1071.8,83,,percent of total billed charges,,,1226.75,95,,percent of total billed charges,,,1162.19,90,,percent of total billed charges,,,1162.19,90,,percent of total billed charges,,,1058.88,82,,percent of total billed charges,,,1162.19,90,,percent of total billed charges,,,1097.62,85,,percent of total billed charges,,973.66,11167,
NIVOLUMAB(OPDIVO)40MG/4ML,32016677,CDM,J9299,HCPCS,636,RC,inpatient,,5030.06,5030.06,,4270.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3792.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4275.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4426.45,88,,percent of total billed charges,,14182.56,,,,fee schedule,,,3842.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14182.56,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4577.35,91,,percent of total billed charges,,,4778.56,95,,percent of total billed charges,,,4174.95,83,,percent of total billed charges,,,4174.95,83,,percent of total billed charges,,,,,,,,,,,,,,,4174.95,83,,percent of total billed charges,,,4778.56,95,,percent of total billed charges,,,4527.05,90,,percent of total billed charges,,,4527.05,90,,percent of total billed charges,,,4124.65,82,,percent of total billed charges,,,4527.05,90,,percent of total billed charges,,,4275.55,85,,percent of total billed charges,,3792.67,14182.56,
IMMUNE GLOBULIN(GAMUNEX-C)SDV:10GM/100ML,32016754,CDM,J1561,HCPCS,636,RC,inpatient,,4542.62,4542.62,,3856.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3425.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3861.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3997.51,88,,percent of total billed charges,,11167,,,,fee schedule,,,3470.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11167,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4133.78,91,,percent of total billed charges,,,4315.49,95,,percent of total billed charges,,,3770.37,83,,percent of total billed charges,,,3770.37,83,,percent of total billed charges,,,,,,,,,,,,,,,3770.37,83,,percent of total billed charges,,,4315.49,95,,percent of total billed charges,,,4088.36,90,,percent of total billed charges,,,4088.36,90,,percent of total billed charges,,,3724.95,82,,percent of total billed charges,,,4088.36,90,,percent of total billed charges,,,3861.23,85,,percent of total billed charges,,3425.14,11167,
ERYTHROMYCIN BASE OPTH OINT:0.5% 3.5GM,32016768,CDM,J3490,HCPCS,250,RC,inpatient,,236.79,236.79,,201.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,178.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,201.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,208.38,88,,percent of total billed charges,,,,,,,,,180.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,215.48,91,,percent of total billed charges,,,224.95,95,,percent of total billed charges,,,196.54,83,,percent of total billed charges,,,196.54,83,,percent of total billed charges,,,,,,,,,,,,,,,196.54,83,,percent of total billed charges,,,224.95,95,,percent of total billed charges,,,213.11,90,,percent of total billed charges,,,213.11,90,,percent of total billed charges,,,194.17,82,,percent of total billed charges,,,213.11,90,,percent of total billed charges,,,201.27,85,,percent of total billed charges,,178.54,224.95,
RABIES I.G.(HyperRAB):300IntUnits/ML,32016858,CDM,90375,CPT,250,RC,inpatient,,5041.24,5041.24,,4280.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3801.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4285.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4436.29,88,,percent of total billed charges,,,,,,,,,3851.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4587.53,91,,percent of total billed charges,,,4789.18,95,,percent of total billed charges,,,4184.23,83,,percent of total billed charges,,,4184.23,83,,percent of total billed charges,,,,,,,,,,,,,,,4184.23,83,,percent of total billed charges,,,4789.18,95,,percent of total billed charges,,,4537.12,90,,percent of total billed charges,,,4537.12,90,,percent of total billed charges,,,4133.82,82,,percent of total billed charges,,,4537.12,90,,percent of total billed charges,,,4285.05,85,,percent of total billed charges,,3801.09,4789.18,
SODIUM PHOS VIAL:15MMOL/5ML,32016887,CDM,J3490,HCPCS,250,RC,inpatient,,276.96,276.96,,235.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,208.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,235.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,243.72,88,,percent of total billed charges,,,,,,,,,211.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.03,91,,percent of total billed charges,,,263.11,95,,percent of total billed charges,,,229.88,83,,percent of total billed charges,,,229.88,83,,percent of total billed charges,,,,,,,,,,,,,,,229.88,83,,percent of total billed charges,,,263.11,95,,percent of total billed charges,,,249.26,90,,percent of total billed charges,,,249.26,90,,percent of total billed charges,,,227.11,82,,percent of total billed charges,,,249.26,90,,percent of total billed charges,,,235.42,85,,percent of total billed charges,,208.83,263.11,
ANDEXANET ALFA(ANDEXXA)IV VIAL:200MG,32016924,CDM,J7169,HCPCS,636,RC,inpatient,,11753.46,11753.46,,9978.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8862.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9990.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10343.04,88,,percent of total billed charges,,21510,,,,fee schedule,,,8979.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21510,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10695.65,91,,percent of total billed charges,,,11165.79,95,,percent of total billed charges,,,9755.37,83,,percent of total billed charges,,,9755.37,83,,percent of total billed charges,,,,,,,,,,,,,,,9755.37,83,,percent of total billed charges,,,11165.79,95,,percent of total billed charges,,,10578.11,90,,percent of total billed charges,,,10578.11,90,,percent of total billed charges,,,9637.84,82,,percent of total billed charges,,,10578.11,90,,percent of total billed charges,,,9990.44,85,,percent of total billed charges,,8862.11,21510,
PROTAMINE SULF VIAL:50MG/5ML,32017038,CDM,J2720,HCPCS,250,RC,inpatient,,227.45,227.45,,193.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.16,88,,percent of total billed charges,,8.14,,,,fee schedule,,,173.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8.14,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,206.98,91,,percent of total billed charges,,,216.08,95,,percent of total billed charges,,,188.78,83,,percent of total billed charges,,,188.78,83,,percent of total billed charges,,,,,,,,,,,,,,,188.78,83,,percent of total billed charges,,,216.08,95,,percent of total billed charges,,,204.71,90,,percent of total billed charges,,,204.71,90,,percent of total billed charges,,,186.51,82,,percent of total billed charges,,,204.71,90,,percent of total billed charges,,,193.33,85,,percent of total billed charges,,8.14,216.08,
ROMOSOZUMAB SYR (EVENITY)210MG/2.34ML,32017148,CDM,J3111,HCPCS,636,RC,inpatient,,9960.84,9960.84,,8456.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7510.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8466.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8765.54,88,,percent of total billed charges,,2058,,,,fee schedule,,,7610.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2058,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9064.36,91,,percent of total billed charges,,,9462.8,95,,percent of total billed charges,,,8267.5,83,,percent of total billed charges,,,8267.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8267.5,83,,percent of total billed charges,,,9462.8,95,,percent of total billed charges,,,8964.76,90,,percent of total billed charges,,,8964.76,90,,percent of total billed charges,,,8167.89,82,,percent of total billed charges,,,8964.76,90,,percent of total billed charges,,,8466.71,85,,percent of total billed charges,,2058,9462.8,
INFLU VACC(FluBLOK) 2019-2020 SYR 0.5ML:,32017158,CDM,90682,CPT,636,RC,inpatient,,704.87,704.87,,598.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,531.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,599.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,620.29,88,,percent of total billed charges,,,,,,,,,538.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,641.43,91,,percent of total billed charges,,,669.63,95,,percent of total billed charges,,,585.04,83,,percent of total billed charges,,,585.04,83,,percent of total billed charges,,,,,,,,,,,,,,,585.04,83,,percent of total billed charges,,,669.63,95,,percent of total billed charges,,,634.38,90,,percent of total billed charges,,,634.38,90,,percent of total billed charges,,,577.99,82,,percent of total billed charges,,,634.38,90,,percent of total billed charges,,,599.14,85,,percent of total billed charges,,531.47,669.63,
BUPRENORPHINE/NALOXONE(SUBOXO)FILM:8-2MG,32017174,CDM,J0574,HCPCS,250,RC,inpatient,,51.31,51.31,,43.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,45.15,88,,percent of total billed charges,,,,,,,,,39.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.69,91,,percent of total billed charges,,,48.74,95,,percent of total billed charges,,,42.59,83,,percent of total billed charges,,,42.59,83,,percent of total billed charges,,,,,,,,,,,,,,,42.59,83,,percent of total billed charges,,,48.74,95,,percent of total billed charges,,,46.18,90,,percent of total billed charges,,,46.18,90,,percent of total billed charges,,,42.07,82,,percent of total billed charges,,,46.18,90,,percent of total billed charges,,,43.61,85,,percent of total billed charges,,38.69,48.74,
LEVONORGESTREL (MIRENA) IUD: 52MG,32017198,CDM,J7298,HCPCS,636,RC,inpatient,,4863.23,4863.23,,4128.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3666.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4133.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4279.64,88,,percent of total billed charges,,1053.23,,,,fee schedule,,,3715.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1053.23,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4425.54,91,,percent of total billed charges,,,4620.07,95,,percent of total billed charges,,,4036.48,83,,percent of total billed charges,,,4036.48,83,,percent of total billed charges,,,,,,,,,,,,,,,4036.48,83,,percent of total billed charges,,,4620.07,95,,percent of total billed charges,,,4376.91,90,,percent of total billed charges,,,4376.91,90,,percent of total billed charges,,,3987.85,82,,percent of total billed charges,,,4376.91,90,,percent of total billed charges,,,4133.75,85,,percent of total billed charges,,1053.23,4620.07,
PARAGARD COPPER IUD,32017199,CDM,J7300,HCPCS,636,RC,inpatient,,6687.07,6687.07,,5677.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5042.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5684.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5884.62,88,,percent of total billed charges,,979.9,,,,fee schedule,,,5108.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,979.9,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6085.23,91,,percent of total billed charges,,,6352.72,95,,percent of total billed charges,,,5550.27,83,,percent of total billed charges,,,5550.27,83,,percent of total billed charges,,,,,,,,,,,,,,,5550.27,83,,percent of total billed charges,,,6352.72,95,,percent of total billed charges,,,6018.36,90,,percent of total billed charges,,,6018.36,90,,percent of total billed charges,,,5483.4,82,,percent of total billed charges,,,6018.36,90,,percent of total billed charges,,,5684.01,85,,percent of total billed charges,,979.9,6352.72,
ETONOGESTREL (NEXPLANON) IMPLANT: 68 MG,32017200,CDM,J7307,HCPCS,636,RC,inpatient,,13148.98,13148.98,,11163.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9914.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11176.63,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11571.1,88,,percent of total billed charges,,1044.41,,,,fee schedule,,,10045.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1044.41,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11965.57,91,,percent of total billed charges,,,12491.53,95,,percent of total billed charges,,,10913.65,83,,percent of total billed charges,,,10913.65,83,,percent of total billed charges,,,,,,,,,,,,,,,10913.65,83,,percent of total billed charges,,,12491.53,95,,percent of total billed charges,,,11834.08,90,,percent of total billed charges,,,11834.08,90,,percent of total billed charges,,,10782.16,82,,percent of total billed charges,,,11834.08,90,,percent of total billed charges,,,11176.63,85,,percent of total billed charges,,1044.41,12491.53,
INFLU VACC(FLUZONE) 2019-2020 SYR 0.5ML:,32017251,CDM,90682,CPT,636,RC,inpatient,,314.54,314.54,,267.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,237.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,267.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,276.8,88,,percent of total billed charges,,,,,,,,,240.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,286.23,91,,percent of total billed charges,,,298.81,95,,percent of total billed charges,,,261.07,83,,percent of total billed charges,,,261.07,83,,percent of total billed charges,,,,,,,,,,,,,,,261.07,83,,percent of total billed charges,,,298.81,95,,percent of total billed charges,,,283.09,90,,percent of total billed charges,,,283.09,90,,percent of total billed charges,,,257.92,82,,percent of total billed charges,,,283.09,90,,percent of total billed charges,,,267.36,85,,percent of total billed charges,,237.16,298.81,
BUPRENORPHINE/NALOXONE(SUBOXO)FILM:4-1MG,32017265,CDM,J0574,HCPCS,250,RC,inpatient,,60.46,60.46,,51.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,45.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,51.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,53.2,88,,percent of total billed charges,,,,,,,,,46.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55.02,91,,percent of total billed charges,,,57.44,95,,percent of total billed charges,,,50.18,83,,percent of total billed charges,,,50.18,83,,percent of total billed charges,,,,,,,,,,,,,,,50.18,83,,percent of total billed charges,,,57.44,95,,percent of total billed charges,,,54.41,90,,percent of total billed charges,,,54.41,90,,percent of total billed charges,,,49.58,82,,percent of total billed charges,,,54.41,90,,percent of total billed charges,,,51.39,85,,percent of total billed charges,,45.59,57.44,
EPLERENONE(INSPRA)TAB: 25MG,32017266,CDM,J8499,HCPCS,250,RC,inpatient,,46.73,46.73,,39.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,35.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,39.72,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,41.12,88,,percent of total billed charges,,,,,,,,,35.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,42.52,91,,percent of total billed charges,,,44.39,95,,percent of total billed charges,,,38.79,83,,percent of total billed charges,,,38.79,83,,percent of total billed charges,,,,,,,,,,,,,,,38.79,83,,percent of total billed charges,,,44.39,95,,percent of total billed charges,,,42.06,90,,percent of total billed charges,,,42.06,90,,percent of total billed charges,,,38.32,82,,percent of total billed charges,,,42.06,90,,percent of total billed charges,,,39.72,85,,percent of total billed charges,,35.23,44.39,
RANOLAZINE(RANEXA) ER TAB:500MG,32017267,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
PEGFILGRASTIM-CBQV(UDENYCA)SYR 6MG/0.6ML,32017269,CDM,Q5111,HCPCS,636,RC,inpatient,,19194.26,19194.26,,16295.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14472.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16315.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16890.95,88,,percent of total billed charges,,1963.2,,,,fee schedule,,,14664.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1963.2,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17466.78,91,,percent of total billed charges,,,18234.55,95,,percent of total billed charges,,,15931.24,83,,percent of total billed charges,,,15931.24,83,,percent of total billed charges,,,,,,,,,,,,,,,15931.24,83,,percent of total billed charges,,,18234.55,95,,percent of total billed charges,,,17274.83,90,,percent of total billed charges,,,17274.83,90,,percent of total billed charges,,,15739.29,82,,percent of total billed charges,,,17274.83,90,,percent of total billed charges,,,16315.12,85,,percent of total billed charges,,1963.2,18234.55,
DEXRAZOXANE(ZINECARD) VIAL:250MG,32017291,CDM,J1190,HCPCS,636,RC,inpatient,,1763.87,1763.87,,1497.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1329.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1499.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1552.21,88,,percent of total billed charges,,940.21,,,,fee schedule,,,1347.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,940.21,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1605.12,91,,percent of total billed charges,,,1675.68,95,,percent of total billed charges,,,1464.01,83,,percent of total billed charges,,,1464.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1464.01,83,,percent of total billed charges,,,1675.68,95,,percent of total billed charges,,,1587.48,90,,percent of total billed charges,,,1587.48,90,,percent of total billed charges,,,1446.37,82,,percent of total billed charges,,,1587.48,90,,percent of total billed charges,,,1499.29,85,,percent of total billed charges,,940.21,1675.68,
DEXRAZOXANE(ZINECARD) VIAL:500MG,32017292,CDM,J1190,HCPCS,636,RC,inpatient,,2207.05,2207.05,,1873.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1664.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1875.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1942.2,88,,percent of total billed charges,,940.21,,,,fee schedule,,,1686.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,940.21,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2008.42,91,,percent of total billed charges,,,2096.7,95,,percent of total billed charges,,,1831.85,83,,percent of total billed charges,,,1831.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1831.85,83,,percent of total billed charges,,,2096.7,95,,percent of total billed charges,,,1986.35,90,,percent of total billed charges,,,1986.35,90,,percent of total billed charges,,,1809.78,82,,percent of total billed charges,,,1986.35,90,,percent of total billed charges,,,1875.99,85,,percent of total billed charges,,940.21,2096.7,
FLUZONE HIGH DOSE (2019-2020)SYR:0.5ML,32017314,CDM,90662,CPT,636,RC,inpatient,,704.87,704.87,,598.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,531.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,599.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,620.29,88,,percent of total billed charges,,,,,,,,,538.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,641.43,91,,percent of total billed charges,,,669.63,95,,percent of total billed charges,,,585.04,83,,percent of total billed charges,,,585.04,83,,percent of total billed charges,,,,,,,,,,,,,,,585.04,83,,percent of total billed charges,,,669.63,95,,percent of total billed charges,,,634.38,90,,percent of total billed charges,,,634.38,90,,percent of total billed charges,,,577.99,82,,percent of total billed charges,,,634.38,90,,percent of total billed charges,,,599.14,85,,percent of total billed charges,,531.47,669.63,
POLOCAINE(MEPIV) 1% MPF: 300MG/30ML,32017350,CDM,,,250,RC,inpatient,,127.78,127.78,,108.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,96.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,108.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,112.45,88,,percent of total billed charges,,,,,,,,,97.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,116.28,91,,percent of total billed charges,,,121.39,95,,percent of total billed charges,,,106.06,83,,percent of total billed charges,,,106.06,83,,percent of total billed charges,,,,,,,,,,,,,,,106.06,83,,percent of total billed charges,,,121.39,95,,percent of total billed charges,,,115,90,,percent of total billed charges,,,115,90,,percent of total billed charges,,,104.78,82,,percent of total billed charges,,,115,90,,percent of total billed charges,,,108.61,85,,percent of total billed charges,,96.35,121.39,
VANCOMYCIN INTRAOCULAR INJ 8MG/0.8ML,32017356,CDM,,,258,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
CYCLOPENTOLATE(CYCLOGYL)DROP 1%:2ML,32017358,CDM,J3490,HCPCS,250,RC,inpatient,,88.07,88.07,,74.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.5,88,,percent of total billed charges,,,,,,,,,67.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.14,91,,percent of total billed charges,,,83.67,95,,percent of total billed charges,,,73.1,83,,percent of total billed charges,,,73.1,83,,percent of total billed charges,,,,,,,,,,,,,,,73.1,83,,percent of total billed charges,,,83.67,95,,percent of total billed charges,,,79.26,90,,percent of total billed charges,,,79.26,90,,percent of total billed charges,,,72.22,82,,percent of total billed charges,,,79.26,90,,percent of total billed charges,,,74.86,85,,percent of total billed charges,,66.4,83.67,
PHENYLEPH(NEO-SYNPHR)DROP 2.5%(EYE):2ML,32017359,CDM,J3490,HCPCS,250,RC,inpatient,,498.32,498.32,,423.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,375.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,423.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,438.52,88,,percent of total billed charges,,,,,,,,,380.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,453.47,91,,percent of total billed charges,,,473.4,95,,percent of total billed charges,,,413.61,83,,percent of total billed charges,,,413.61,83,,percent of total billed charges,,,,,,,,,,,,,,,413.61,83,,percent of total billed charges,,,473.4,95,,percent of total billed charges,,,448.49,90,,percent of total billed charges,,,448.49,90,,percent of total billed charges,,,408.62,82,,percent of total billed charges,,,448.49,90,,percent of total billed charges,,,423.57,85,,percent of total billed charges,,375.73,473.4,
CLONIDINE(CATAPRES) TAB THP:0.1MG (1x6),32017362,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
LOPERAMIDE(IMODIUM) TAB THP:2MG (1x8),32017363,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
HydrOXYzine(Atarax) TAB THP:25MG (1x3),32017364,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
TRAZODONE(DESERYL)TAB THP:50MG (1x1),32017365,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
FACTOR VIII (HEMOFIL-M): 538 UNITS/10ML,32017673,CDM,J7190,HCPCS,636,RC,inpatient,,3918.61,3918.61,,3326.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2954.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3330.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3448.38,88,,percent of total billed charges,,7062.5,,,,fee schedule,,,2993.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7062.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3565.94,91,,percent of total billed charges,,,3722.68,95,,percent of total billed charges,,,3252.45,83,,percent of total billed charges,,,3252.45,83,,percent of total billed charges,,,,,,,,,,,,,,,3252.45,83,,percent of total billed charges,,,3722.68,95,,percent of total billed charges,,,3526.75,90,,percent of total billed charges,,,3526.75,90,,percent of total billed charges,,,3213.26,82,,percent of total billed charges,,,3526.75,90,,percent of total billed charges,,,3330.82,85,,percent of total billed charges,,2954.63,7062.5,
FACTOR VIII (HEMOFIL-M): 1830 UNITS/10ML,32017674,CDM,J7190,HCPCS,636,RC,inpatient,,7781.13,7781.13,,6606.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5866.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6613.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6847.39,88,,percent of total billed charges,,7062.5,,,,fee schedule,,,5944.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7062.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7080.83,91,,percent of total billed charges,,,7392.07,95,,percent of total billed charges,,,6458.34,83,,percent of total billed charges,,,6458.34,83,,percent of total billed charges,,,,,,,,,,,,,,,6458.34,83,,percent of total billed charges,,,7392.07,95,,percent of total billed charges,,,7003.02,90,,percent of total billed charges,,,7003.02,90,,percent of total billed charges,,,6380.53,82,,percent of total billed charges,,,7003.02,90,,percent of total billed charges,,,6613.96,85,,percent of total billed charges,,5866.97,7392.07,
FACTOR VIII (HEMOFIL-M): 1110 UNITS/10ML,32017675,CDM,J7190,HCPCS,636,RC,inpatient,,4825.17,4825.17,,4096.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3638.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4101.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4246.15,88,,percent of total billed charges,,7062.5,,,,fee schedule,,,3686.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7062.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4390.9,91,,percent of total billed charges,,,4583.91,95,,percent of total billed charges,,,4004.89,83,,percent of total billed charges,,,4004.89,83,,percent of total billed charges,,,,,,,,,,,,,,,4004.89,83,,percent of total billed charges,,,4583.91,95,,percent of total billed charges,,,4342.65,90,,percent of total billed charges,,,4342.65,90,,percent of total billed charges,,,3956.64,82,,percent of total billed charges,,,4342.65,90,,percent of total billed charges,,,4101.39,85,,percent of total billed charges,,3638.18,7062.5,
FACTOR VIII (HEMOFIL-M): 330 UNITS/10ML,32017676,CDM,J7190,HCPCS,636,RC,inpatient,,2179.66,2179.66,,1850.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1643.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1852.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1918.1,88,,percent of total billed charges,,7062.5,,,,fee schedule,,,1665.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7062.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1983.49,91,,percent of total billed charges,,,2070.68,95,,percent of total billed charges,,,1809.12,83,,percent of total billed charges,,,1809.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1809.12,83,,percent of total billed charges,,,2070.68,95,,percent of total billed charges,,,1961.69,90,,percent of total billed charges,,,1961.69,90,,percent of total billed charges,,,1787.32,82,,percent of total billed charges,,,1961.69,90,,percent of total billed charges,,,1852.71,85,,percent of total billed charges,,1643.46,7062.5,
FACTOR VIII (HEMOFIL-M): 1790 UNITS/10ML,32017718,CDM,J7190,HCPCS,636,RC,inpatient,,7955.01,7955.01,,6753.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5998.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6761.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7000.41,88,,percent of total billed charges,,7062.5,,,,fee schedule,,,6077.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7062.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7239.06,91,,percent of total billed charges,,,7557.26,95,,percent of total billed charges,,,6602.66,83,,percent of total billed charges,,,6602.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6602.66,83,,percent of total billed charges,,,7557.26,95,,percent of total billed charges,,,7159.51,90,,percent of total billed charges,,,7159.51,90,,percent of total billed charges,,,6523.11,82,,percent of total billed charges,,,7159.51,90,,percent of total billed charges,,,6761.76,85,,percent of total billed charges,,5998.08,7557.26,
FACTOR VIII (HEMOFIL-M): 1670 UNITS/10ML,32017725,CDM,J7190,HCPCS,636,RC,inpatient,,6896.52,6896.52,,5855.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5199.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5862.04,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6068.94,88,,percent of total billed charges,,7062.5,,,,fee schedule,,,5268.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7062.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6275.83,91,,percent of total billed charges,,,6551.69,95,,percent of total billed charges,,,5724.11,83,,percent of total billed charges,,,5724.11,83,,percent of total billed charges,,,,,,,,,,,,,,,5724.11,83,,percent of total billed charges,,,6551.69,95,,percent of total billed charges,,,6206.87,90,,percent of total billed charges,,,6206.87,90,,percent of total billed charges,,,5655.15,82,,percent of total billed charges,,,6206.87,90,,percent of total billed charges,,,5862.04,85,,percent of total billed charges,,5199.98,7062.5,
FACTOR VIII (HEMOFIL-M): 315 UNITS/10ML,32017726,CDM,J7190,HCPCS,636,RC,inpatient,,2403.6,2403.6,,2040.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1812.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2043.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2115.17,88,,percent of total billed charges,,7062.5,,,,fee schedule,,,1836.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7062.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2187.28,91,,percent of total billed charges,,,2283.42,95,,percent of total billed charges,,,1994.99,83,,percent of total billed charges,,,1994.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1994.99,83,,percent of total billed charges,,,2283.42,95,,percent of total billed charges,,,2163.24,90,,percent of total billed charges,,,2163.24,90,,percent of total billed charges,,,1970.95,82,,percent of total billed charges,,,2163.24,90,,percent of total billed charges,,,2043.06,85,,percent of total billed charges,,1812.31,7062.5,
METHOTREXATE VL:50MG/2ML,32017849,CDM,J9250,HCPCS,636,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,6.29,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6.29,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,6.29,59.21,
MEPERIDINE (DEMEROL) SYR:25MG/ML,32017851,CDM,,,250,RC,inpatient,,94.28,94.28,,80.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,82.97,88,,percent of total billed charges,,,,,,,,,72.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,85.79,91,,percent of total billed charges,,,89.57,95,,percent of total billed charges,,,78.25,83,,percent of total billed charges,,,78.25,83,,percent of total billed charges,,,,,,,,,,,,,,,78.25,83,,percent of total billed charges,,,89.57,95,,percent of total billed charges,,,84.85,90,,percent of total billed charges,,,84.85,90,,percent of total billed charges,,,77.31,82,,percent of total billed charges,,,84.85,90,,percent of total billed charges,,,80.14,85,,percent of total billed charges,,71.09,89.57,
REMDESIVIR (INVESTIGATIONAL)VIAL : 100MG,32017883,CDM,,,250,RC,inpatient,,4116.84,4116.84,,3495.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3104.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3499.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3622.82,88,,percent of total billed charges,,,,,,,,,3145.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3746.32,91,,percent of total billed charges,,,3911,95,,percent of total billed charges,,,3416.98,83,,percent of total billed charges,,,3416.98,83,,percent of total billed charges,,,,,,,,,,,,,,,3416.98,83,,percent of total billed charges,,,3911,95,,percent of total billed charges,,,3705.16,90,,percent of total billed charges,,,3705.16,90,,percent of total billed charges,,,3375.81,82,,percent of total billed charges,,,3705.16,90,,percent of total billed charges,,,3499.31,85,,percent of total billed charges,,3104.1,3911,
TOCILIZUMAB (ACTEMRA) VIAL: 400MG/20ML,32018020,CDM,J3262,HCPCS,636,RC,inpatient,,11429.01,11429.01,,9703.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8617.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9714.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10057.53,88,,percent of total billed charges,,4931.2,,,,fee schedule,,,8731.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,4931.2,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10400.4,91,,percent of total billed charges,,,10857.56,95,,percent of total billed charges,,,9486.08,83,,percent of total billed charges,,,9486.08,83,,percent of total billed charges,,,,,,,,,,,,,,,9486.08,83,,percent of total billed charges,,,10857.56,95,,percent of total billed charges,,,10286.11,90,,percent of total billed charges,,,10286.11,90,,percent of total billed charges,,,9371.79,82,,percent of total billed charges,,,10286.11,90,,percent of total billed charges,,,9714.66,85,,percent of total billed charges,,4931.2,10857.56,
carBAMazepine(TEGretol XR)TAB:100MG,32018098,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
COSYNTROPIN(CORTROSYN)VIAL:0.25MG,32018115,CDM,J0834,HCPCS,636,RC,inpatient,,350.73,350.73,,297.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,264.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,298.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,308.64,88,,percent of total billed charges,,93.17,,,,fee schedule,,,267.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,93.17,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,319.16,91,,percent of total billed charges,,,333.19,95,,percent of total billed charges,,,291.11,83,,percent of total billed charges,,,291.11,83,,percent of total billed charges,,,,,,,,,,,,,,,291.11,83,,percent of total billed charges,,,333.19,95,,percent of total billed charges,,,315.66,90,,percent of total billed charges,,,315.66,90,,percent of total billed charges,,,287.6,82,,percent of total billed charges,,,315.66,90,,percent of total billed charges,,,298.12,85,,percent of total billed charges,,93.17,333.19,
COSYNTROPIN(CORTROSYN) VIAL: 0.25MG,32018116,CDM,J0834,HCPCS,636,RC,inpatient,,386.77,386.77,,328.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.36,88,,percent of total billed charges,,93.17,,,,fee schedule,,,295.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,93.17,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,351.96,91,,percent of total billed charges,,,367.43,95,,percent of total billed charges,,,321.02,83,,percent of total billed charges,,,321.02,83,,percent of total billed charges,,,,,,,,,,,,,,,321.02,83,,percent of total billed charges,,,367.43,95,,percent of total billed charges,,,348.09,90,,percent of total billed charges,,,348.09,90,,percent of total billed charges,,,317.15,82,,percent of total billed charges,,,348.09,90,,percent of total billed charges,,,328.75,85,,percent of total billed charges,,93.17,367.43,
AMINO ACID 4.25%/DEXTROSE 10% 1000 ML,32018244,CDM,J3490,HCPCS,250,RC,inpatient,,601.64,601.64,,510.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,453.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,511.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,529.44,88,,percent of total billed charges,,,,,,,,,459.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,547.49,91,,percent of total billed charges,,,571.56,95,,percent of total billed charges,,,499.36,83,,percent of total billed charges,,,499.36,83,,percent of total billed charges,,,,,,,,,,,,,,,499.36,83,,percent of total billed charges,,,571.56,95,,percent of total billed charges,,,541.48,90,,percent of total billed charges,,,541.48,90,,percent of total billed charges,,,493.34,82,,percent of total billed charges,,,541.48,90,,percent of total billed charges,,,511.39,85,,percent of total billed charges,,453.64,571.56,
INFLU VACC(FLUZONE) 2020-2021 SYR 0.5ML:,32018285,CDM,90686,CPT,636,RC,inpatient,,297.88,297.88,,252.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,224.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,253.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,262.13,88,,percent of total billed charges,,,,,,,,,227.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,271.07,91,,percent of total billed charges,,,282.99,95,,percent of total billed charges,,,247.24,83,,percent of total billed charges,,,247.24,83,,percent of total billed charges,,,,,,,,,,,,,,,247.24,83,,percent of total billed charges,,,282.99,95,,percent of total billed charges,,,268.09,90,,percent of total billed charges,,,268.09,90,,percent of total billed charges,,,244.26,82,,percent of total billed charges,,,268.09,90,,percent of total billed charges,,,253.2,85,,percent of total billed charges,,224.6,282.99,
CASTOR OIL 59 ML,32018286,CDM,J3490,HCPCS,250,RC,inpatient,,56.46,56.46,,47.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49.68,88,,percent of total billed charges,,,,,,,,,43.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.38,91,,percent of total billed charges,,,53.64,95,,percent of total billed charges,,,46.86,83,,percent of total billed charges,,,46.86,83,,percent of total billed charges,,,,,,,,,,,,,,,46.86,83,,percent of total billed charges,,,53.64,95,,percent of total billed charges,,,50.81,90,,percent of total billed charges,,,50.81,90,,percent of total billed charges,,,46.3,82,,percent of total billed charges,,,50.81,90,,percent of total billed charges,,,47.99,85,,percent of total billed charges,,42.57,53.64,
SULF/TRIM(BACTRIM)SUS UD:800-160MG/20ML,32018332,CDM,J8499,HCPCS,250,RC,inpatient,UD,163.24,163.24,,138.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,123.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,138.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,143.65,88,,percent of total billed charges,,,,,,,,,124.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,148.55,91,,percent of total billed charges,,,155.08,95,,percent of total billed charges,,,135.49,83,,percent of total billed charges,,,135.49,83,,percent of total billed charges,,,,,,,,,,,,,,,135.49,83,,percent of total billed charges,,,155.08,95,,percent of total billed charges,,,146.92,90,,percent of total billed charges,,,146.92,90,,percent of total billed charges,,,133.86,82,,percent of total billed charges,,,146.92,90,,percent of total billed charges,,,138.75,85,,percent of total billed charges,,123.08,155.08,
INFLU VACC(FluBLOK) 2020-2021 SYR 0.5ML:,32018337,CDM,90686,CPT,636,RC,inpatient,,754.28,754.28,,640.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,568.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,641.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,663.77,88,,percent of total billed charges,,,,,,,,,576.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,686.39,91,,percent of total billed charges,,,716.57,95,,percent of total billed charges,,,626.05,83,,percent of total billed charges,,,626.05,83,,percent of total billed charges,,,,,,,,,,,,,,,626.05,83,,percent of total billed charges,,,716.57,95,,percent of total billed charges,,,678.85,90,,percent of total billed charges,,,678.85,90,,percent of total billed charges,,,618.51,82,,percent of total billed charges,,,678.85,90,,percent of total billed charges,,,641.14,85,,percent of total billed charges,,568.73,716.57,
TRIAMCINO(OROLONE) 0.1%DENTAL PASTE:5GM,32018339,CDM,J3490,HCPCS,250,RC,inpatient,,489.28,489.28,,415.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,368.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,415.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,430.57,88,,percent of total billed charges,,,,,,,,,373.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,445.24,91,,percent of total billed charges,,,464.82,95,,percent of total billed charges,,,406.1,83,,percent of total billed charges,,,406.1,83,,percent of total billed charges,,,,,,,,,,,,,,,406.1,83,,percent of total billed charges,,,464.82,95,,percent of total billed charges,,,440.35,90,,percent of total billed charges,,,440.35,90,,percent of total billed charges,,,401.21,82,,percent of total billed charges,,,440.35,90,,percent of total billed charges,,,415.89,85,,percent of total billed charges,,368.92,464.82,
CYCLOPENTOLATE(CYCLOGYL)DROP 2%:2ML,32018364,CDM,J3490,HCPCS,250,RC,inpatient,,600.78,600.78,,510.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,452.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,510.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,528.69,88,,percent of total billed charges,,,,,,,,,459,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,546.71,91,,percent of total billed charges,,,570.74,95,,percent of total billed charges,,,498.65,83,,percent of total billed charges,,,498.65,83,,percent of total billed charges,,,,,,,,,,,,,,,498.65,83,,percent of total billed charges,,,570.74,95,,percent of total billed charges,,,540.7,90,,percent of total billed charges,,,540.7,90,,percent of total billed charges,,,492.64,82,,percent of total billed charges,,,540.7,90,,percent of total billed charges,,,510.66,85,,percent of total billed charges,,452.99,570.74,
"HEParin25,000UNITS/0.45%NS500ML(PREMIX)",32018423,CDM,J1644,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
"LIDOCAINE W/EPI 1:200,000 VIAL 2%:20ML",32018448,CDM,J3490,HCPCS,250,RC,inpatient,,255.82,255.82,,217.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,192.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,217.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,225.12,88,,percent of total billed charges,,,,,,,,,195.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,232.8,91,,percent of total billed charges,,,243.03,95,,percent of total billed charges,,,212.33,83,,percent of total billed charges,,,212.33,83,,percent of total billed charges,,,,,,,,,,,,,,,212.33,83,,percent of total billed charges,,,243.03,95,,percent of total billed charges,,,230.24,90,,percent of total billed charges,,,230.24,90,,percent of total billed charges,,,209.77,82,,percent of total billed charges,,,230.24,90,,percent of total billed charges,,,217.45,85,,percent of total billed charges,,192.89,243.03,
LIDOCAINE HCL 2%PF VIAL:(20MG/ML) (5ML),32018471,CDM,J2001,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
ONABOTULINUMTOXINA(BOTOX-THER):100 UNITS,32018491,CDM,J0585,HCPCS,250,RC,inpatient,,5019.38,5019.38,,4261.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3784.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4266.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4417.05,88,,percent of total billed charges,,2491.6,,,,fee schedule,,,3834.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2491.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4567.64,91,,percent of total billed charges,,,4768.41,95,,percent of total billed charges,,,4166.09,83,,percent of total billed charges,,,4166.09,83,,percent of total billed charges,,,,,,,,,,,,,,,4166.09,83,,percent of total billed charges,,,4768.41,95,,percent of total billed charges,,,4517.44,90,,percent of total billed charges,,,4517.44,90,,percent of total billed charges,,,4115.89,82,,percent of total billed charges,,,4517.44,90,,percent of total billed charges,,,4266.47,85,,percent of total billed charges,,2491.6,4768.41,
METHOTREXATE VL:250MG/10ML,32018495,CDM,J9250,HCPCS,636,RC,inpatient,,106.7,106.7,,90.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,80.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,90.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,93.9,88,,percent of total billed charges,,6.29,,,,fee schedule,,,81.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6.29,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,97.1,91,,percent of total billed charges,,,101.37,95,,percent of total billed charges,,,88.56,83,,percent of total billed charges,,,88.56,83,,percent of total billed charges,,,,,,,,,,,,,,,88.56,83,,percent of total billed charges,,,101.37,95,,percent of total billed charges,,,96.03,90,,percent of total billed charges,,,96.03,90,,percent of total billed charges,,,87.49,82,,percent of total billed charges,,,96.03,90,,percent of total billed charges,,,90.7,85,,percent of total billed charges,,6.29,101.37,
PERJETA (PERTUZUMAB) VIAL: 420MG/14ML,32018569,CDM,J9306,HCPCS,636,RC,inpatient,,26129.97,26129.97,,22184.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19702,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22210.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22994.37,88,,percent of total billed charges,,12125.4,,,,fee schedule,,,19963.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,12125.4,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23778.27,91,,percent of total billed charges,,,24823.47,95,,percent of total billed charges,,,21687.88,83,,percent of total billed charges,,,21687.88,83,,percent of total billed charges,,,,,,,,,,,,,,,21687.88,83,,percent of total billed charges,,,24823.47,95,,percent of total billed charges,,,23516.97,90,,percent of total billed charges,,,23516.97,90,,percent of total billed charges,,,21426.58,82,,percent of total billed charges,,,23516.97,90,,percent of total billed charges,,,22210.47,85,,percent of total billed charges,,12125.4,24823.47,
DOCUSATE(COLACE)LIQUID UD:100MG/10ML,32018586,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
ENOXAPARIN(LOVENOX): 150MG/ML,32018626,CDM,J1650,HCPCS,250,RC,inpatient,,214.22,214.22,,181.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,182.09,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.51,88,,percent of total billed charges,,15.16,,,,fee schedule,,,163.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.16,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.94,91,,percent of total billed charges,,,203.51,95,,percent of total billed charges,,,177.8,83,,percent of total billed charges,,,177.8,83,,percent of total billed charges,,,,,,,,,,,,,,,177.8,83,,percent of total billed charges,,,203.51,95,,percent of total billed charges,,,192.8,90,,percent of total billed charges,,,192.8,90,,percent of total billed charges,,,175.66,82,,percent of total billed charges,,,192.8,90,,percent of total billed charges,,,182.09,85,,percent of total billed charges,,15.16,203.51,
MELOXICAM(ANJESO)VL:30MG/ML,32018628,CDM,J1738,HCPCS,250,RC,inpatient,,1366.01,1366.01,,1159.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1029.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1161.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1202.09,88,,percent of total billed charges,,89.86,,,,fee schedule,,,1043.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,89.86,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1243.07,91,,percent of total billed charges,,,1297.71,95,,percent of total billed charges,,,1133.79,83,,percent of total billed charges,,,1133.79,83,,percent of total billed charges,,,,,,,,,,,,,,,1133.79,83,,percent of total billed charges,,,1297.71,95,,percent of total billed charges,,,1229.41,90,,percent of total billed charges,,,1229.41,90,,percent of total billed charges,,,1120.13,82,,percent of total billed charges,,,1229.41,90,,percent of total billed charges,,,1161.11,85,,percent of total billed charges,,89.86,1297.71,
riTUXimab-ABBS(TRUXIMA)VIAL:500MG/50ML,32018685,CDM,Q5115,HCPCS,636,RC,inpatient,,19976.13,19976.13,,16959.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15062,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16979.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17578.99,88,,percent of total billed charges,,6680.52,,,,fee schedule,,,15261.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6680.52,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18178.28,91,,percent of total billed charges,,,18977.32,95,,percent of total billed charges,,,16580.19,83,,percent of total billed charges,,,16580.19,83,,percent of total billed charges,,,,,,,,,,,,,,,16580.19,83,,percent of total billed charges,,,18977.32,95,,percent of total billed charges,,,17978.52,90,,percent of total billed charges,,,17978.52,90,,percent of total billed charges,,,16380.43,82,,percent of total billed charges,,,17978.52,90,,percent of total billed charges,,,16979.71,85,,percent of total billed charges,,6680.52,18977.32,
ACETAMIN/CODEINE SOL: 300-30MG/12.5ML UD,32018920,CDM,,,250,RC,inpatient,,24.58,24.58,,20.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.89,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.63,88,,percent of total billed charges,,,,,,,,,18.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.37,91,,percent of total billed charges,,,23.35,95,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,,,,,,,,,,,,,,20.4,83,,percent of total billed charges,,,23.35,95,,percent of total billed charges,,,22.12,90,,percent of total billed charges,,,22.12,90,,percent of total billed charges,,,20.16,82,,percent of total billed charges,,,22.12,90,,percent of total billed charges,,,20.89,85,,percent of total billed charges,,18.53,23.35,
OXYCODONE ORAL SOL : 5MG/5ML UD,32018921,CDM,J8499,HCPCS,250,RC,inpatient,,65.03,65.03,,55.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.23,88,,percent of total billed charges,,,,,,,,,49.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.18,91,,percent of total billed charges,,,61.78,95,,percent of total billed charges,,,53.97,83,,percent of total billed charges,,,53.97,83,,percent of total billed charges,,,,,,,,,,,,,,,53.97,83,,percent of total billed charges,,,61.78,95,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,53.32,82,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,55.28,85,,percent of total billed charges,,49.03,61.78,
BUPIVACAINE/EPI(SENSORCAI)VL 0.25%:50ML,32018976,CDM,J3490,HCPCS,250,RC,inpatient,,150.67,150.67,,127.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,113.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,128.07,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,132.59,88,,percent of total billed charges,,,,,,,,,115.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,137.11,91,,percent of total billed charges,,,143.14,95,,percent of total billed charges,,,125.06,83,,percent of total billed charges,,,125.06,83,,percent of total billed charges,,,,,,,,,,,,,,,125.06,83,,percent of total billed charges,,,143.14,95,,percent of total billed charges,,,135.6,90,,percent of total billed charges,,,135.6,90,,percent of total billed charges,,,123.55,82,,percent of total billed charges,,,135.6,90,,percent of total billed charges,,,128.07,85,,percent of total billed charges,,113.61,143.14,
PROPRANOLOL(INDERAL)TAB:40MG,32019123,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DIBUCAINE TOPICAL OINT 1%: 28GM,32019139,CDM,J3490,HCPCS,250,RC,inpatient,,51.07,51.07,,43.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,38.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,43.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,44.94,88,,percent of total billed charges,,,,,,,,,39.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,46.47,91,,percent of total billed charges,,,48.52,95,,percent of total billed charges,,,42.39,83,,percent of total billed charges,,,42.39,83,,percent of total billed charges,,,,,,,,,,,,,,,42.39,83,,percent of total billed charges,,,48.52,95,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,41.88,82,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,43.41,85,,percent of total billed charges,,38.51,48.52,
MITOMYCIN IV VIAL: 40 MG,32019270,CDM,J9280,HCPCS,636,RC,inpatient,,2183.51,2183.51,,1853.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1646.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1855.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1921.49,88,,percent of total billed charges,,542.94,,,,fee schedule,,,1668.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,542.94,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1986.99,91,,percent of total billed charges,,,2074.33,95,,percent of total billed charges,,,1812.31,83,,percent of total billed charges,,,1812.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1812.31,83,,percent of total billed charges,,,2074.33,95,,percent of total billed charges,,,1965.16,90,,percent of total billed charges,,,1965.16,90,,percent of total billed charges,,,1790.48,82,,percent of total billed charges,,,1965.16,90,,percent of total billed charges,,,1855.98,85,,percent of total billed charges,,542.94,2074.33,
METHACHOLINE INHALATION KIT (NEPHRON),32019298,CDM,J7674,HCPCS,250,RC,inpatient,,1961.82,1961.82,,1665.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1479.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1667.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1726.4,88,,percent of total billed charges,,162.5,,,,fee schedule,,,1498.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,162.5,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1785.26,91,,percent of total billed charges,,,1863.73,95,,percent of total billed charges,,,1628.31,83,,percent of total billed charges,,,1628.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1628.31,83,,percent of total billed charges,,,1863.73,95,,percent of total billed charges,,,1765.64,90,,percent of total billed charges,,,1765.64,90,,percent of total billed charges,,,1608.69,82,,percent of total billed charges,,,1765.64,90,,percent of total billed charges,,,1667.55,85,,percent of total billed charges,,162.5,1863.73,
FORMOTEROL(PERFOROMIST):20MCG/2ML UD NEB,32019308,CDM,J7609,HCPCS,250,RC,inpatient,,79.41,79.41,,67.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.88,88,,percent of total billed charges,,,,,,,,,60.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.26,91,,percent of total billed charges,,,75.44,95,,percent of total billed charges,,,65.91,83,,percent of total billed charges,,,65.91,83,,percent of total billed charges,,,,,,,,,,,,,,,65.91,83,,percent of total billed charges,,,75.44,95,,percent of total billed charges,,,71.47,90,,percent of total billed charges,,,71.47,90,,percent of total billed charges,,,65.12,82,,percent of total billed charges,,,71.47,90,,percent of total billed charges,,,67.5,85,,percent of total billed charges,,59.88,75.44,
CYRAMZA (RAMUCIRUMAB) VIAL 100MG,32019352,CDM,J9308,HCPCS,636,RC,inpatient,,5819.54,5819.54,,4940.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4387.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4946.61,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5121.2,88,,percent of total billed charges,,16405,,,,fee schedule,,,4446.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,16405,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5295.78,91,,percent of total billed charges,,,5528.56,95,,percent of total billed charges,,,4830.22,83,,percent of total billed charges,,,4830.22,83,,percent of total billed charges,,,,,,,,,,,,,,,4830.22,83,,percent of total billed charges,,,5528.56,95,,percent of total billed charges,,,5237.59,90,,percent of total billed charges,,,5237.59,90,,percent of total billed charges,,,4772.02,82,,percent of total billed charges,,,5237.59,90,,percent of total billed charges,,,4946.61,85,,percent of total billed charges,,4387.93,16405,
KETAMINE(KETALAR) 503B SYR:50MG/5ML,32019360,CDM,J3490,HCPCS,250,RC,inpatient,,85.78,85.78,,72.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,72.91,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,75.49,88,,percent of total billed charges,,,,,,,,,65.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,78.06,91,,percent of total billed charges,,,81.49,95,,percent of total billed charges,,,71.2,83,,percent of total billed charges,,,71.2,83,,percent of total billed charges,,,,,,,,,,,,,,,71.2,83,,percent of total billed charges,,,81.49,95,,percent of total billed charges,,,77.2,90,,percent of total billed charges,,,77.2,90,,percent of total billed charges,,,70.34,82,,percent of total billed charges,,,77.2,90,,percent of total billed charges,,,72.91,85,,percent of total billed charges,,64.68,81.49,
KETAMINE(KETALAR) 503B VIAL:50MG/5ML,32019362,CDM,J3490,HCPCS,250,RC,inpatient,,68.63,68.63,,58.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.39,88,,percent of total billed charges,,,,,,,,,52.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.45,91,,percent of total billed charges,,,65.2,95,,percent of total billed charges,,,56.96,83,,percent of total billed charges,,,56.96,83,,percent of total billed charges,,,,,,,,,,,,,,,56.96,83,,percent of total billed charges,,,65.2,95,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,56.28,82,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,58.34,85,,percent of total billed charges,,51.75,65.2,
BUPIVACAINE/EPI(SENSORCAI)VL 0.5%:50ML,32019432,CDM,J3490,HCPCS,250,RC,inpatient,,301.47,301.47,,255.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,227.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,256.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,265.29,88,,percent of total billed charges,,,,,,,,,230.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,274.34,91,,percent of total billed charges,,,286.4,95,,percent of total billed charges,,,250.22,83,,percent of total billed charges,,,250.22,83,,percent of total billed charges,,,,,,,,,,,,,,,250.22,83,,percent of total billed charges,,,286.4,95,,percent of total billed charges,,,271.32,90,,percent of total billed charges,,,271.32,90,,percent of total billed charges,,,247.21,82,,percent of total billed charges,,,271.32,90,,percent of total billed charges,,,256.25,85,,percent of total billed charges,,227.31,286.4,
ASCLERA (POLIDOCANOL) 0.5% INJ:10MG/2ML,32019443,CDM,J3490,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
KANJINTI(TRASTUZUM-ANNS) MDV 420MG J/10,32019467,CDM,Q5117,HCPCS,636,RC,inpatient,,1297.36,1297.36,,1101.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,978.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1102.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1141.68,88,,percent of total billed charges,,3269.9,,,,fee schedule,,,991.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3269.9,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1180.6,91,,percent of total billed charges,,,1232.49,95,,percent of total billed charges,,,1076.81,83,,percent of total billed charges,,,1076.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1076.81,83,,percent of total billed charges,,,1232.49,95,,percent of total billed charges,,,1167.62,90,,percent of total billed charges,,,1167.62,90,,percent of total billed charges,,,1063.84,82,,percent of total billed charges,,,1167.62,90,,percent of total billed charges,,,1102.76,85,,percent of total billed charges,,978.21,3269.9,
TOCILIZUMAB (ACTEMRA) VIAL: 200MG/10ML,32019475,CDM,J3262,HCPCS,636,RC,inpatient,,5333.04,5333.04,,4527.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4021.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4533.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4693.08,88,,percent of total billed charges,,4931.2,,,,fee schedule,,,4074.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,4931.2,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4853.07,91,,percent of total billed charges,,,5066.39,95,,percent of total billed charges,,,4426.42,83,,percent of total billed charges,,,4426.42,83,,percent of total billed charges,,,,,,,,,,,,,,,4426.42,83,,percent of total billed charges,,,5066.39,95,,percent of total billed charges,,,4799.74,90,,percent of total billed charges,,,4799.74,90,,percent of total billed charges,,,4373.09,82,,percent of total billed charges,,,4799.74,90,,percent of total billed charges,,,4533.08,85,,percent of total billed charges,,4021.11,5066.39,
"LIDOCAINE W/EPI 1:100,000 VIAL 1%:50ML",32019483,CDM,J3490,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
BUPIVACAINE/EPI(SENSORCAI)VL 0.5%:10ML,32019486,CDM,J3490,HCPCS,250,RC,inpatient,,91.51,91.51,,77.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,77.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.53,88,,percent of total billed charges,,,,,,,,,69.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,83.27,91,,percent of total billed charges,,,86.93,95,,percent of total billed charges,,,75.95,83,,percent of total billed charges,,,75.95,83,,percent of total billed charges,,,,,,,,,,,,,,,75.95,83,,percent of total billed charges,,,86.93,95,,percent of total billed charges,,,82.36,90,,percent of total billed charges,,,82.36,90,,percent of total billed charges,,,75.04,82,,percent of total billed charges,,,82.36,90,,percent of total billed charges,,,77.78,85,,percent of total billed charges,,69,86.93,
dexmedeTOMidin(PRECEDEX)IV:1000MCG/250ML,32019575,CDM,J3490,HCPCS,250,RC,inpatient,,1237.16,1237.16,,1050.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,932.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1051.59,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1088.7,88,,percent of total billed charges,,,,,,,,,945.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1125.82,91,,percent of total billed charges,,,1175.3,95,,percent of total billed charges,,,1026.84,83,,percent of total billed charges,,,1026.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1026.84,83,,percent of total billed charges,,,1175.3,95,,percent of total billed charges,,,1113.44,90,,percent of total billed charges,,,1113.44,90,,percent of total billed charges,,,1014.47,82,,percent of total billed charges,,,1113.44,90,,percent of total billed charges,,,1051.59,85,,percent of total billed charges,,932.82,1175.3,
TEMAZEPAM(RESTORIL)CAP:7.5MG,32019588,CDM,J8499,HCPCS,250,RC,inpatient,,41.71,41.71,,35.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36.7,88,,percent of total billed charges,,,,,,,,,31.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37.96,91,,percent of total billed charges,,,39.62,95,,percent of total billed charges,,,34.62,83,,percent of total billed charges,,,34.62,83,,percent of total billed charges,,,,,,,,,,,,,,,34.62,83,,percent of total billed charges,,,39.62,95,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,34.2,82,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,35.45,85,,percent of total billed charges,,31.45,39.62,
CLINDAMYCIN-IVPB PREMIX:900MG/NS50ML,32019608,CDM,J3490,HCPCS,250,RC,inpatient,,220.43,220.43,,187.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,166.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,187.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,193.98,88,,percent of total billed charges,,,,,,,,,168.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,200.59,91,,percent of total billed charges,,,209.41,95,,percent of total billed charges,,,182.96,83,,percent of total billed charges,,,182.96,83,,percent of total billed charges,,,,,,,,,,,,,,,182.96,83,,percent of total billed charges,,,209.41,95,,percent of total billed charges,,,198.39,90,,percent of total billed charges,,,198.39,90,,percent of total billed charges,,,180.75,82,,percent of total billed charges,,,198.39,90,,percent of total billed charges,,,187.37,85,,percent of total billed charges,,166.2,209.41,
CLINDAMYCIN-IVPB PREMIX:600MG/NS50ML,32019609,CDM,J3490,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
CLINDAMYCIN-IVPB PREMIX:300MG/NS50ML,32019610,CDM,J3490,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
MEPIVACAINE 1% MDV: 10MG/ML (50ML),32019611,CDM,J0670,HCPCS,250,RC,inpatient,,102.03,102.03,,86.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.79,88,,percent of total billed charges,,,,,,,,,77.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.85,91,,percent of total billed charges,,,96.93,95,,percent of total billed charges,,,84.68,83,,percent of total billed charges,,,84.68,83,,percent of total billed charges,,,,,,,,,,,,,,,84.68,83,,percent of total billed charges,,,96.93,95,,percent of total billed charges,,,91.83,90,,percent of total billed charges,,,91.83,90,,percent of total billed charges,,,83.66,82,,percent of total billed charges,,,91.83,90,,percent of total billed charges,,,86.73,85,,percent of total billed charges,,76.93,96.93,
OPIUM TINCTURE ORAL: 10MG/ML 118ML,32019679,CDM,J8499,HCPCS,250,RC,inpatient,,2220.6,2220.6,,1885.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1674.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1887.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1954.13,88,,percent of total billed charges,,,,,,,,,1696.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2020.75,91,,percent of total billed charges,,,2109.57,95,,percent of total billed charges,,,1843.1,83,,percent of total billed charges,,,1843.1,83,,percent of total billed charges,,,,,,,,,,,,,,,1843.1,83,,percent of total billed charges,,,2109.57,95,,percent of total billed charges,,,1998.54,90,,percent of total billed charges,,,1998.54,90,,percent of total billed charges,,,1820.89,82,,percent of total billed charges,,,1998.54,90,,percent of total billed charges,,,1887.51,85,,percent of total billed charges,,1674.33,2109.57,
OPIUM TINCTURE ORAL: 6MG/0.6ML UD,32019681,CDM,J8499,HCPCS,250,RC,inpatient,,25.98,25.98,,22.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.86,88,,percent of total billed charges,,,,,,,,,19.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23.64,91,,percent of total billed charges,,,24.68,95,,percent of total billed charges,,,21.56,83,,percent of total billed charges,,,21.56,83,,percent of total billed charges,,,,,,,,,,,,,,,21.56,83,,percent of total billed charges,,,24.68,95,,percent of total billed charges,,,23.38,90,,percent of total billed charges,,,23.38,90,,percent of total billed charges,,,21.3,82,,percent of total billed charges,,,23.38,90,,percent of total billed charges,,,22.08,85,,percent of total billed charges,,19.59,24.68,
INFLU VACC(FLUZONE) 2021-2022 SYR 0.5ML:,32019707,CDM,90688,CPT,636,RC,inpatient,,304.09,304.09,,258.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,229.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,258.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,267.6,88,,percent of total billed charges,,,,,,,,,232.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,276.72,91,,percent of total billed charges,,,288.89,95,,percent of total billed charges,,,252.39,83,,percent of total billed charges,,,252.39,83,,percent of total billed charges,,,,,,,,,,,,,,,252.39,83,,percent of total billed charges,,,288.89,95,,percent of total billed charges,,,273.68,90,,percent of total billed charges,,,273.68,90,,percent of total billed charges,,,249.35,82,,percent of total billed charges,,,273.68,90,,percent of total billed charges,,,258.48,85,,percent of total billed charges,,229.28,288.89,
INFLU HD(FLUZONE HD)2021-2022 SYR 0.7ML:,32019708,CDM,90662,CPT,636,RC,inpatient,,822.1,822.1,,697.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,619.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,698.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,723.45,88,,percent of total billed charges,,,,,,,,,628.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,748.11,91,,percent of total billed charges,,,781,95,,percent of total billed charges,,,682.34,83,,percent of total billed charges,,,682.34,83,,percent of total billed charges,,,,,,,,,,,,,,,682.34,83,,percent of total billed charges,,,781,95,,percent of total billed charges,,,739.89,90,,percent of total billed charges,,,739.89,90,,percent of total billed charges,,,674.12,82,,percent of total billed charges,,,739.89,90,,percent of total billed charges,,,698.79,85,,percent of total billed charges,,619.86,781,
ZN/CU//MANG/SE(TRALEMENT)VIAL:1ML,32019748,CDM,J3490,HCPCS,250,RC,inpatient,,324.68,324.68,,275.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,244.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,275.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,285.72,88,,percent of total billed charges,,,,,,,,,248.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,295.46,91,,percent of total billed charges,,,308.45,95,,percent of total billed charges,,,269.48,83,,percent of total billed charges,,,269.48,83,,percent of total billed charges,,,,,,,,,,,,,,,269.48,83,,percent of total billed charges,,,308.45,95,,percent of total billed charges,,,292.21,90,,percent of total billed charges,,,292.21,90,,percent of total billed charges,,,266.24,82,,percent of total billed charges,,,292.21,90,,percent of total billed charges,,,275.98,85,,percent of total billed charges,,244.81,308.45,
CONG ESTROGEN(PREMARIN)VAG CR:0.625MG/GM,32019749,CDM,J3490,HCPCS,250,RC,inpatient,,3245.07,3245.07,,2755.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2446.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2758.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2855.66,88,,percent of total billed charges,,,,,,,,,2479.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2953.01,91,,percent of total billed charges,,,3082.82,95,,percent of total billed charges,,,2693.41,83,,percent of total billed charges,,,2693.41,83,,percent of total billed charges,,,,,,,,,,,,,,,2693.41,83,,percent of total billed charges,,,3082.82,95,,percent of total billed charges,,,2920.56,90,,percent of total billed charges,,,2920.56,90,,percent of total billed charges,,,2660.96,82,,percent of total billed charges,,,2920.56,90,,percent of total billed charges,,,2758.31,85,,percent of total billed charges,,2446.78,3082.82,
AMINO ACID 5%/DEXTROSE 20% 2000 ML,32019752,CDM,J3490,HCPCS,250,RC,inpatient,,1107.2,1107.2,,940.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,834.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,941.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,974.34,88,,percent of total billed charges,,,,,,,,,845.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1007.55,91,,percent of total billed charges,,,1051.84,95,,percent of total billed charges,,,918.98,83,,percent of total billed charges,,,918.98,83,,percent of total billed charges,,,,,,,,,,,,,,,918.98,83,,percent of total billed charges,,,1051.84,95,,percent of total billed charges,,,996.48,90,,percent of total billed charges,,,996.48,90,,percent of total billed charges,,,907.9,82,,percent of total billed charges,,,996.48,90,,percent of total billed charges,,,941.12,85,,percent of total billed charges,,834.83,1051.84,
AMINO ACID 5%/DEXTROSE 20% 1000 ML,32019753,CDM,J3490,HCPCS,250,RC,inpatient,,762.42,762.42,,647.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,574.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,648.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,670.93,88,,percent of total billed charges,,,,,,,,,582.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,693.8,91,,percent of total billed charges,,,724.3,95,,percent of total billed charges,,,632.81,83,,percent of total billed charges,,,632.81,83,,percent of total billed charges,,,,,,,,,,,,,,,632.81,83,,percent of total billed charges,,,724.3,95,,percent of total billed charges,,,686.18,90,,percent of total billed charges,,,686.18,90,,percent of total billed charges,,,625.18,82,,percent of total billed charges,,,686.18,90,,percent of total billed charges,,,648.06,85,,percent of total billed charges,,574.86,724.3,
INSUL LISPRO(humaLOG KWIKPEN)300UNIT/3ML,32019770,CDM,J1815,HCPCS,250,RC,inpatient,,326.31,326.31,,277.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,246.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,277.36,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,287.15,88,,percent of total billed charges,,,,,,,,,249.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,296.94,91,,percent of total billed charges,,,309.99,95,,percent of total billed charges,,,270.84,83,,percent of total billed charges,,,270.84,83,,percent of total billed charges,,,,,,,,,,,,,,,270.84,83,,percent of total billed charges,,,309.99,95,,percent of total billed charges,,,293.68,90,,percent of total billed charges,,,293.68,90,,percent of total billed charges,,,267.57,82,,percent of total billed charges,,,293.68,90,,percent of total billed charges,,,277.36,85,,percent of total billed charges,,246.04,309.99,
insul REG(humuLIN R):100UNITS/ML (10ML),32019771,CDM,J1815,HCPCS,250,RC,inpatient,,252.94,252.94,,214.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,222.59,88,,percent of total billed charges,,,,,,,,,193.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,230.18,91,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,,,,,,,,,,,,,209.94,83,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,207.41,82,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,215,85,,percent of total billed charges,,190.72,240.29,
insul NPH/R(humuLIN 70/30) VIAL:10ML,32019772,CDM,J1815,HCPCS,250,RC,inpatient,,243.93,243.93,,207.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,183.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,207.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,214.66,88,,percent of total billed charges,,,,,,,,,186.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,221.98,91,,percent of total billed charges,,,231.73,95,,percent of total billed charges,,,202.46,83,,percent of total billed charges,,,202.46,83,,percent of total billed charges,,,,,,,,,,,,,,,202.46,83,,percent of total billed charges,,,231.73,95,,percent of total billed charges,,,219.54,90,,percent of total billed charges,,,219.54,90,,percent of total billed charges,,,200.02,82,,percent of total billed charges,,,219.54,90,,percent of total billed charges,,,207.34,85,,percent of total billed charges,,183.92,231.73,
insul NPH(humuLIN N):100UNIT/ML  (10ML),32019773,CDM,J1815,HCPCS,250,RC,inpatient,,252.94,252.94,,214.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,222.59,88,,percent of total billed charges,,,,,,,,,193.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,230.18,91,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,,,,,,,,,,,,,209.94,83,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,207.41,82,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,215,85,,percent of total billed charges,,190.72,240.29,
insul LISPRO(humaLOG)VIAL 75/25 (10ML),32019774,CDM,J1815,HCPCS,250,RC,inpatient,,777.85,777.85,,660.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,586.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,661.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,684.51,88,,percent of total billed charges,,,,,,,,,594.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,707.84,91,,percent of total billed charges,,,738.96,95,,percent of total billed charges,,,645.62,83,,percent of total billed charges,,,645.62,83,,percent of total billed charges,,,,,,,,,,,,,,,645.62,83,,percent of total billed charges,,,738.96,95,,percent of total billed charges,,,700.07,90,,percent of total billed charges,,,700.07,90,,percent of total billed charges,,,637.84,82,,percent of total billed charges,,,700.07,90,,percent of total billed charges,,,661.17,85,,percent of total billed charges,,586.5,738.96,
PHENYLEPH(NEOSYNPHRIN)*503BVIAL:1MG/10ML,32019778,CDM,J2370,HCPCS,250,RC,inpatient,,89.38,89.38,,75.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,67.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,75.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,78.65,88,,percent of total billed charges,,,,,,,,,68.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,81.34,91,,percent of total billed charges,,,84.91,95,,percent of total billed charges,,,74.19,83,,percent of total billed charges,,,74.19,83,,percent of total billed charges,,,,,,,,,,,,,,,74.19,83,,percent of total billed charges,,,84.91,95,,percent of total billed charges,,,80.44,90,,percent of total billed charges,,,80.44,90,,percent of total billed charges,,,73.29,82,,percent of total billed charges,,,80.44,90,,percent of total billed charges,,,75.97,85,,percent of total billed charges,,67.39,84.91,
POLYETHYLENE GLYCOL(MIRALAX)PWD:238GM,32019822,CDM,J8499,HCPCS,250,RC,inpatient,,99.84,99.84,,84.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,84.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,87.86,88,,percent of total billed charges,,,,,,,,,76.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,90.85,91,,percent of total billed charges,,,94.85,95,,percent of total billed charges,,,82.87,83,,percent of total billed charges,,,82.87,83,,percent of total billed charges,,,,,,,,,,,,,,,82.87,83,,percent of total billed charges,,,94.85,95,,percent of total billed charges,,,89.86,90,,percent of total billed charges,,,89.86,90,,percent of total billed charges,,,81.87,82,,percent of total billed charges,,,89.86,90,,percent of total billed charges,,,84.86,85,,percent of total billed charges,,75.28,94.85,
DOXYLAMINE (UNISOM)TAB:25MG,32019824,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
DARATUMUMAB-HYA(DARZALEX)SDV:1800MG/15ML,32019878,CDM,J9144,HCPCS,636,RC,inpatient,,39332.56,39332.56,,33393.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29656.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33432.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34612.65,88,,percent of total billed charges,,8417.34,,,,fee schedule,,,30050.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8417.34,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35792.63,91,,percent of total billed charges,,,37365.93,95,,percent of total billed charges,,,32646.02,83,,percent of total billed charges,,,32646.02,83,,percent of total billed charges,,,,,,,,,,,,,,,32646.02,83,,percent of total billed charges,,,37365.93,95,,percent of total billed charges,,,35399.3,90,,percent of total billed charges,,,35399.3,90,,percent of total billed charges,,,32252.7,82,,percent of total billed charges,,,35399.3,90,,percent of total billed charges,,,33432.68,85,,percent of total billed charges,,8417.34,37365.93,
BUPIVACAINE LIPOSOME(Exparel)VL1.3%:10ML,32019923,CDM,C9290,HCPCS,250,RC,inpatient,,2751.95,2751.95,,2336.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2074.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2339.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2421.72,88,,percent of total billed charges,,,,,,,,,2102.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2504.27,91,,percent of total billed charges,,,2614.35,95,,percent of total billed charges,,,2284.12,83,,percent of total billed charges,,,2284.12,83,,percent of total billed charges,,,,,,,,,,,,,,,2284.12,83,,percent of total billed charges,,,2614.35,95,,percent of total billed charges,,,2476.76,90,,percent of total billed charges,,,2476.76,90,,percent of total billed charges,,,2256.6,82,,percent of total billed charges,,,2476.76,90,,percent of total billed charges,,,2339.16,85,,percent of total billed charges,,2074.97,2614.35,
BENDAMUSTINE(BENDEKA)MDV:100MG/4ML J/1,32019927,CDM,J9034,HCPCS,636,RC,inpatient,,418.14,418.14,,355,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,315.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,355.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,367.96,88,,percent of total billed charges,,6973.6,,,,fee schedule,,,319.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6973.6,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,380.51,91,,percent of total billed charges,,,397.23,95,,percent of total billed charges,,,347.06,83,,percent of total billed charges,,,347.06,83,,percent of total billed charges,,,,,,,,,,,,,,,347.06,83,,percent of total billed charges,,,397.23,95,,percent of total billed charges,,,376.33,90,,percent of total billed charges,,,376.33,90,,percent of total billed charges,,,342.87,82,,percent of total billed charges,,,376.33,90,,percent of total billed charges,,,355.42,85,,percent of total billed charges,,315.28,6973.6,
riTUXimab-ABBS(TRUXIMA)VIAL:100MG/10ML,32019929,CDM,Q5115,HCPCS,636,RC,inpatient,,4747.56,4747.56,,4030.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3579.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4035.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4177.85,88,,percent of total billed charges,,6680.52,,,,fee schedule,,,3627.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6680.52,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4320.28,91,,percent of total billed charges,,,4510.18,95,,percent of total billed charges,,,3940.47,83,,percent of total billed charges,,,3940.47,83,,percent of total billed charges,,,,,,,,,,,,,,,3940.47,83,,percent of total billed charges,,,4510.18,95,,percent of total billed charges,,,4272.8,90,,percent of total billed charges,,,4272.8,90,,percent of total billed charges,,,3893,82,,percent of total billed charges,,,4272.8,90,,percent of total billed charges,,,4035.43,85,,percent of total billed charges,,3579.66,6680.52,
dexmedeTOMidin(PRECEDEX)IV:200MCG/50ML,32019988,CDM,J3490,HCPCS,250,RC,inpatient,,204.41,204.41,,173.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,154.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,173.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,179.88,88,,percent of total billed charges,,,,,,,,,156.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,186.01,91,,percent of total billed charges,,,194.19,95,,percent of total billed charges,,,169.66,83,,percent of total billed charges,,,169.66,83,,percent of total billed charges,,,,,,,,,,,,,,,169.66,83,,percent of total billed charges,,,194.19,95,,percent of total billed charges,,,183.97,90,,percent of total billed charges,,,183.97,90,,percent of total billed charges,,,167.62,82,,percent of total billed charges,,,183.97,90,,percent of total billed charges,,,173.75,85,,percent of total billed charges,,154.13,194.19,
IV NS 0.9%  25ML,32020025,CDM,J7050,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
SODIUM ZIRCONIUM(LOKELMA)PAC:10G UD,32020065,CDM,J8499,HCPCS,250,RC,inpatient,,405,405,,343.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,305.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,344.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,356.4,88,,percent of total billed charges,,,,,,,,,309.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,368.55,91,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,,,,,,,,,,,,,336.15,83,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,332.1,82,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,305.37,384.75,
ETHYL ALCOHOL(ABLYSINOL) 99% AMP: 5ML,32020079,CDM,J2001,HCPCS,250,RC,inpatient,,6550.53,6550.53,,5561.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4939.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5567.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5764.47,88,,percent of total billed charges,,0.75,,,,fee schedule,,,5004.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5960.98,91,,percent of total billed charges,,,6223,95,,percent of total billed charges,,,5436.94,83,,percent of total billed charges,,,5436.94,83,,percent of total billed charges,,,,,,,,,,,,,,,5436.94,83,,percent of total billed charges,,,6223,95,,percent of total billed charges,,,5895.48,90,,percent of total billed charges,,,5895.48,90,,percent of total billed charges,,,5371.43,82,,percent of total billed charges,,,5895.48,90,,percent of total billed charges,,,5567.95,85,,percent of total billed charges,,0.75,6223,
INCLISIRAN (LEQVIO) SYR: 284MG/1.5ML,32020211,CDM,J1306,HCPCS,636,RC,inpatient,,15356.25,15356.25,,13037.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11578.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13052.81,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13513.5,88,,percent of total billed charges,,3423.05,,,,fee schedule,,,11732.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3423.05,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13974.19,91,,percent of total billed charges,,,14588.44,95,,percent of total billed charges,,,12745.69,83,,percent of total billed charges,,,12745.69,83,,percent of total billed charges,,,,,,,,,,,,,,,12745.69,83,,percent of total billed charges,,,14588.44,95,,percent of total billed charges,,,13820.63,90,,percent of total billed charges,,,13820.63,90,,percent of total billed charges,,,12592.13,82,,percent of total billed charges,,,13820.63,90,,percent of total billed charges,,,13052.81,85,,percent of total billed charges,,3423.05,14588.44,
AMISULPRIDE(BARHEMSYS)INJ:10MG/4ML,32020212,CDM,J3490,HCPCS,250,RC,inpatient,,1192.32,1192.32,,1012.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,899.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1013.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1049.24,88,,percent of total billed charges,,,,,,,,,910.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1085.01,91,,percent of total billed charges,,,1132.7,95,,percent of total billed charges,,,989.63,83,,percent of total billed charges,,,989.63,83,,percent of total billed charges,,,,,,,,,,,,,,,989.63,83,,percent of total billed charges,,,1132.7,95,,percent of total billed charges,,,1073.09,90,,percent of total billed charges,,,1073.09,90,,percent of total billed charges,,,977.7,82,,percent of total billed charges,,,1073.09,90,,percent of total billed charges,,,1013.47,85,,percent of total billed charges,,899.01,1132.7,
LANOLIN OINT 7GM,32020262,CDM,J3490,HCPCS,250,RC,inpatient,,39.22,39.22,,33.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,29.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,33.34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,34.51,88,,percent of total billed charges,,,,,,,,,29.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,35.69,91,,percent of total billed charges,,,37.26,95,,percent of total billed charges,,,32.55,83,,percent of total billed charges,,,32.55,83,,percent of total billed charges,,,,,,,,,,,,,,,32.55,83,,percent of total billed charges,,,37.26,95,,percent of total billed charges,,,35.3,90,,percent of total billed charges,,,35.3,90,,percent of total billed charges,,,32.16,82,,percent of total billed charges,,,35.3,90,,percent of total billed charges,,,33.34,85,,percent of total billed charges,,29.57,37.26,
risperiDONE(risperDAL)TAB:1MG,32020289,CDM,J8499,HCPCS,250,RC,inpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,10.22,12.87,
IMMUNE GLOBULIN(GAMMAGARD)SDV:30GM/300ML,32020299,CDM,J1569,HCPCS,636,RC,inpatient,,14150.24,14150.24,,12013.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10669.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12027.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12452.21,88,,percent of total billed charges,,11307.25,,,,fee schedule,,,10810.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11307.25,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12876.72,91,,percent of total billed charges,,,13442.73,95,,percent of total billed charges,,,11744.7,83,,percent of total billed charges,,,11744.7,83,,percent of total billed charges,,,,,,,,,,,,,,,11744.7,83,,percent of total billed charges,,,13442.73,95,,percent of total billed charges,,,12735.22,90,,percent of total billed charges,,,12735.22,90,,percent of total billed charges,,,11603.2,82,,percent of total billed charges,,,12735.22,90,,percent of total billed charges,,,12027.7,85,,percent of total billed charges,,10669.28,13442.73,
LABETALOL(TRANDATE)VIAL:200MG/40ML,32020300,CDM,J3490,HCPCS,250,RC,inpatient,,73.61,73.61,,62.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,55.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,62.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,64.78,88,,percent of total billed charges,,,,,,,,,56.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,66.99,91,,percent of total billed charges,,,69.93,95,,percent of total billed charges,,,61.1,83,,percent of total billed charges,,,61.1,83,,percent of total billed charges,,,,,,,,,,,,,,,61.1,83,,percent of total billed charges,,,69.93,95,,percent of total billed charges,,,66.25,90,,percent of total billed charges,,,66.25,90,,percent of total billed charges,,,60.36,82,,percent of total billed charges,,,66.25,90,,percent of total billed charges,,,62.57,85,,percent of total billed charges,,55.5,69.93,
guaiFENesin/DM(ROBITUSDM)200MG/20MG/10ML,32020330,CDM,J8499,HCPCS,250,RC,inpatient,,33.54,33.54,,28.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.51,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.52,88,,percent of total billed charges,,,,,,,,,25.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.52,91,,percent of total billed charges,,,31.86,95,,percent of total billed charges,,,27.84,83,,percent of total billed charges,,,27.84,83,,percent of total billed charges,,,,,,,,,,,,,,,27.84,83,,percent of total billed charges,,,31.86,95,,percent of total billed charges,,,30.19,90,,percent of total billed charges,,,30.19,90,,percent of total billed charges,,,27.5,82,,percent of total billed charges,,,30.19,90,,percent of total billed charges,,,28.51,85,,percent of total billed charges,,25.29,31.86,
DEXTROSE 50%-WATER SYR:50ML (ADMIXED),32020350,CDM,J3490,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
DEXTROSE 70% WATER,32020352,CDM,J3490,HCPCS,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
RIVAROXABAN(XARELTO) TABS:2.5MG,32020477,CDM,J8499,HCPCS,250,RC,inpatient,,109.15,109.15,,92.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,92.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,96.05,88,,percent of total billed charges,,,,,,,,,83.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.33,91,,percent of total billed charges,,,103.69,95,,percent of total billed charges,,,90.59,83,,percent of total billed charges,,,90.59,83,,percent of total billed charges,,,,,,,,,,,,,,,90.59,83,,percent of total billed charges,,,103.69,95,,percent of total billed charges,,,98.24,90,,percent of total billed charges,,,98.24,90,,percent of total billed charges,,,89.5,82,,percent of total billed charges,,,98.24,90,,percent of total billed charges,,,92.78,85,,percent of total billed charges,,82.3,103.69,
LIDOCAINE HCL 1% VIAL:(10MG/ML) (50ML),32020478,CDM,J2001,HCPCS,250,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,0.75,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,0.75,59.21,
SOTRADECOL 3% INJ:60MG/2ML,32020493,CDM,J3490,HCPCS,250,RC,inpatient,,1083.21,1083.21,,919.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,816.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,920.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,953.22,88,,percent of total billed charges,,,,,,,,,827.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,985.72,91,,percent of total billed charges,,,1029.05,95,,percent of total billed charges,,,899.06,83,,percent of total billed charges,,,899.06,83,,percent of total billed charges,,,,,,,,,,,,,,,899.06,83,,percent of total billed charges,,,1029.05,95,,percent of total billed charges,,,974.89,90,,percent of total billed charges,,,974.89,90,,percent of total billed charges,,,888.23,82,,percent of total billed charges,,,974.89,90,,percent of total billed charges,,,920.73,85,,percent of total billed charges,,816.74,1029.05,
LABETALOL(TRANDATE)SDV:20MG/4ML,32020512,CDM,J3490,HCPCS,250,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
LIPIODOL (ETHIODIZED OIL) INJ:4.8G/10ML,32020524,CDM,J3490,HCPCS,250,RC,inpatient,,6043.28,6043.28,,5130.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4556.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5136.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5318.09,88,,percent of total billed charges,,,,,,,,,4617.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5499.38,91,,percent of total billed charges,,,5741.12,95,,percent of total billed charges,,,5015.92,83,,percent of total billed charges,,,5015.92,83,,percent of total billed charges,,,,,,,,,,,,,,,5015.92,83,,percent of total billed charges,,,5741.12,95,,percent of total billed charges,,,5438.95,90,,percent of total billed charges,,,5438.95,90,,percent of total billed charges,,,4955.49,82,,percent of total billed charges,,,5438.95,90,,percent of total billed charges,,,5136.79,85,,percent of total billed charges,,4556.63,5741.12,
BEVACIZUMAB-AWWB(MVASI):400MG/16ML,32020635,CDM,Q5107,HCPCS,636,RC,inpatient,,12859.29,12859.29,,10917.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9695.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10930.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11316.18,88,,percent of total billed charges,,5758.9,,,,fee schedule,,,9824.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5758.9,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11701.95,91,,percent of total billed charges,,,12216.33,95,,percent of total billed charges,,,10673.21,83,,percent of total billed charges,,,10673.21,83,,percent of total billed charges,,,,,,,,,,,,,,,10673.21,83,,percent of total billed charges,,,12216.33,95,,percent of total billed charges,,,11573.36,90,,percent of total billed charges,,,11573.36,90,,percent of total billed charges,,,10544.62,82,,percent of total billed charges,,,11573.36,90,,percent of total billed charges,,,10930.4,85,,percent of total billed charges,,5758.9,12216.33,
LEUPROLIDE(LUPRON DEPO)(3MONTHS) 11.25MG,32020645,CDM,J1950,HCPCS,636,RC,inpatient,,21723.8,21723.8,,18443.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16379.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18465.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19116.94,88,,percent of total billed charges,,11820.38,,,,fee schedule,,,16596.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11820.38,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19768.66,91,,percent of total billed charges,,,20637.61,95,,percent of total billed charges,,,18030.75,83,,percent of total billed charges,,,18030.75,83,,percent of total billed charges,,,,,,,,,,,,,,,18030.75,83,,percent of total billed charges,,,20637.61,95,,percent of total billed charges,,,19551.42,90,,percent of total billed charges,,,19551.42,90,,percent of total billed charges,,,17813.52,82,,percent of total billed charges,,,19551.42,90,,percent of total billed charges,,,18465.23,85,,percent of total billed charges,,11820.38,20637.61,
LEUPROLIDE(LUPRON DEPO)(3MONTHS) 11.25MG,32020646,CDM,J1950,HCPCS,636,RC,inpatient,,21723.8,21723.8,,18443.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16379.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18465.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19116.94,88,,percent of total billed charges,,11820.38,,,,fee schedule,,,16596.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11820.38,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19768.66,91,,percent of total billed charges,,,20637.61,95,,percent of total billed charges,,,18030.75,83,,percent of total billed charges,,,18030.75,83,,percent of total billed charges,,,,,,,,,,,,,,,18030.75,83,,percent of total billed charges,,,20637.61,95,,percent of total billed charges,,,19551.42,90,,percent of total billed charges,,,19551.42,90,,percent of total billed charges,,,17813.52,82,,percent of total billed charges,,,19551.42,90,,percent of total billed charges,,,18465.23,85,,percent of total billed charges,,11820.38,20637.61,
INFLU VACC(FLUZONE) 2022-2023 SYR 0.5ML:,32020675,CDM,90686,CPT,636,RC,inpatient,,319.61,319.61,,271.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,240.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,271.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,281.26,88,,percent of total billed charges,,,,,,,,,244.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,290.85,91,,percent of total billed charges,,,303.63,95,,percent of total billed charges,,,265.28,83,,percent of total billed charges,,,265.28,83,,percent of total billed charges,,,,,,,,,,,,,,,265.28,83,,percent of total billed charges,,,303.63,95,,percent of total billed charges,,,287.65,90,,percent of total billed charges,,,287.65,90,,percent of total billed charges,,,262.08,82,,percent of total billed charges,,,287.65,90,,percent of total billed charges,,,271.67,85,,percent of total billed charges,,240.99,303.63,
CLINDAMYCIN-IVPB PREMIX:900MG/D5W50ML,32020676,CDM,J3490,HCPCS,250,RC,inpatient,,248.69,248.69,,211.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,187.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,211.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.85,88,,percent of total billed charges,,,,,,,,,190,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,226.31,91,,percent of total billed charges,,,236.26,95,,percent of total billed charges,,,206.41,83,,percent of total billed charges,,,206.41,83,,percent of total billed charges,,,,,,,,,,,,,,,206.41,83,,percent of total billed charges,,,236.26,95,,percent of total billed charges,,,223.82,90,,percent of total billed charges,,,223.82,90,,percent of total billed charges,,,203.93,82,,percent of total billed charges,,,223.82,90,,percent of total billed charges,,,211.39,85,,percent of total billed charges,,187.51,236.26,
NORTRIPTYLINE(PAMELOR)TAB:25MG,32020773,CDM,J8499,HCPCS,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
INFLU HD(FLUZONE HD)2022-2023 SYR 0.7ML:,32020818,CDM,90662,CPT,636,RC,inpatient,,833.73,833.73,,707.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,628.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,708.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,733.68,88,,percent of total billed charges,,,,,,,,,636.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,758.69,91,,percent of total billed charges,,,792.04,95,,percent of total billed charges,,,692,83,,percent of total billed charges,,,692,83,,percent of total billed charges,,,,,,,,,,,,,,,692,83,,percent of total billed charges,,,792.04,95,,percent of total billed charges,,,750.36,90,,percent of total billed charges,,,750.36,90,,percent of total billed charges,,,683.66,82,,percent of total billed charges,,,750.36,90,,percent of total billed charges,,,708.67,85,,percent of total billed charges,,628.63,792.04,
NIVOLUMAB(OPDIVO) 240MG/24ML,32020845,CDM,J9299,HCPCS,636,RC,inpatient,,33326.51,33326.51,,28294.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25128.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28327.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29327.33,88,,percent of total billed charges,,14182.56,,,,fee schedule,,,25461.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14182.56,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30327.12,91,,percent of total billed charges,,,31660.18,95,,percent of total billed charges,,,27661,83,,percent of total billed charges,,,27661,83,,percent of total billed charges,,,,,,,,,,,,,,,27661,83,,percent of total billed charges,,,31660.18,95,,percent of total billed charges,,,29993.86,90,,percent of total billed charges,,,29993.86,90,,percent of total billed charges,,,27327.74,82,,percent of total billed charges,,,29993.86,90,,percent of total billed charges,,,28327.53,85,,percent of total billed charges,,14182.56,31660.18,
KADCYLA (ADO-TRASTUZUMAB) VIAL 100MG,32020851,CDM,J9354,HCPCS,636,RC,inpatient,,16602.14,16602.14,,14095.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12518.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14111.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14609.88,88,,percent of total billed charges,,14278,,,,fee schedule,,,12684.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14278,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15107.95,91,,percent of total billed charges,,,15772.03,95,,percent of total billed charges,,,13779.78,83,,percent of total billed charges,,,13779.78,83,,percent of total billed charges,,,,,,,,,,,,,,,13779.78,83,,percent of total billed charges,,,15772.03,95,,percent of total billed charges,,,14941.93,90,,percent of total billed charges,,,14941.93,90,,percent of total billed charges,,,13613.75,82,,percent of total billed charges,,,14941.93,90,,percent of total billed charges,,,14111.82,85,,percent of total billed charges,,12518.01,15772.03,
dexmedeTOMidin(PRECEDEX)VIAL:200MCG/2ML,32020918,CDM,J3490,HCPCS,250,RC,inpatient,,122.55,122.55,,104.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,92.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,104.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,107.84,88,,percent of total billed charges,,,,,,,,,93.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,111.52,91,,percent of total billed charges,,,116.42,95,,percent of total billed charges,,,101.72,83,,percent of total billed charges,,,101.72,83,,percent of total billed charges,,,,,,,,,,,,,,,101.72,83,,percent of total billed charges,,,116.42,95,,percent of total billed charges,,,110.3,90,,percent of total billed charges,,,110.3,90,,percent of total billed charges,,,100.49,82,,percent of total billed charges,,,110.3,90,,percent of total billed charges,,,104.17,85,,percent of total billed charges,,92.4,116.42,
DOCEtaxel(TaxoTERE)MDV: 160MG/8ML (J/1),32020974,CDM,J9171,HCPCS,636,RC,inpatient,,15.44,15.44,,13.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13.12,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13.59,88,,percent of total billed charges,,121.68,,,,fee schedule,,,11.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14.05,91,,percent of total billed charges,,,14.67,95,,percent of total billed charges,,,12.82,83,,percent of total billed charges,,,12.82,83,,percent of total billed charges,,,,,,,,,,,,,,,12.82,83,,percent of total billed charges,,,14.67,95,,percent of total billed charges,,,13.9,90,,percent of total billed charges,,,13.9,90,,percent of total billed charges,,,12.66,82,,percent of total billed charges,,,13.9,90,,percent of total billed charges,,,13.12,85,,percent of total billed charges,,11.64,121.68,
inFLIXimab-DYYB(INFLECTRA PR)VIAL 100MG,32021017,CDM,Q5103,HCPCS,636,RC,inpatient,,4133.07,4133.07,,3508.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3116.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3513.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3637.1,88,,percent of total billed charges,,3868.13,,,,fee schedule,,,3157.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3868.13,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3761.09,91,,percent of total billed charges,,,3926.42,95,,percent of total billed charges,,,3430.45,83,,percent of total billed charges,,,3430.45,83,,percent of total billed charges,,,,,,,,,,,,,,,3430.45,83,,percent of total billed charges,,,3926.42,95,,percent of total billed charges,,,3719.76,90,,percent of total billed charges,,,3719.76,90,,percent of total billed charges,,,3389.12,82,,percent of total billed charges,,,3719.76,90,,percent of total billed charges,,,3513.11,85,,percent of total billed charges,,3116.33,3926.42,
VORICONAZOLE(VFEND)TAB:200MG,32021021,CDM,J8499,HCPCS,250,RC,inpatient,,22.29,22.29,,18.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.62,88,,percent of total billed charges,,,,,,,,,17.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.28,91,,percent of total billed charges,,,21.18,95,,percent of total billed charges,,,18.5,83,,percent of total billed charges,,,18.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18.5,83,,percent of total billed charges,,,21.18,95,,percent of total billed charges,,,20.06,90,,percent of total billed charges,,,20.06,90,,percent of total billed charges,,,18.28,82,,percent of total billed charges,,,20.06,90,,percent of total billed charges,,,18.95,85,,percent of total billed charges,,16.81,21.18,
PEGFILGRASTIM-JMDB(FULPHILA)SYR6MG/0.6ML,32021036,CDM,Q5108,HCPCS,636,RC,inpatient,,19431,19431,,16496.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14650.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16516.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17099.28,88,,percent of total billed charges,,1693.37,,,,fee schedule,,,14845.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1693.37,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17682.21,91,,percent of total billed charges,,,18459.45,95,,percent of total billed charges,,,16127.73,83,,percent of total billed charges,,,16127.73,83,,percent of total billed charges,,,,,,,,,,,,,,,16127.73,83,,percent of total billed charges,,,18459.45,95,,percent of total billed charges,,,17487.9,90,,percent of total billed charges,,,17487.9,90,,percent of total billed charges,,,15933.42,82,,percent of total billed charges,,,17487.9,90,,percent of total billed charges,,,16516.35,85,,percent of total billed charges,,1693.37,18459.45,
SACITUZUMAB GOV (TRODELVY) VIAL 180MG,32021068,CDM,J9317,HCPCS,636,RC,inpatient,,10547.24,10547.24,,8954.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7952.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8965.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9281.57,88,,percent of total billed charges,,16018,,,,fee schedule,,,8058.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,16018,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9597.99,91,,percent of total billed charges,,,10019.88,95,,percent of total billed charges,,,8754.21,83,,percent of total billed charges,,,8754.21,83,,percent of total billed charges,,,,,,,,,,,,,,,8754.21,83,,percent of total billed charges,,,10019.88,95,,percent of total billed charges,,,9492.52,90,,percent of total billed charges,,,9492.52,90,,percent of total billed charges,,,8648.74,82,,percent of total billed charges,,,9492.52,90,,percent of total billed charges,,,8965.15,85,,percent of total billed charges,,7952.62,16018,
riTUXimab-PVVR(RUXIENCE)VIAL:500MG/50ML,32021076,CDM,Q5119,HCPCS,636,RC,inpatient,,16934.4,16934.4,,14377.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12768.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14394.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14902.27,88,,percent of total billed charges,,3775.4,,,,fee schedule,,,12937.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3775.4,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15410.3,91,,percent of total billed charges,,,16087.68,95,,percent of total billed charges,,,14055.55,83,,percent of total billed charges,,,14055.55,83,,percent of total billed charges,,,,,,,,,,,,,,,14055.55,83,,percent of total billed charges,,,16087.68,95,,percent of total billed charges,,,15240.96,90,,percent of total billed charges,,,15240.96,90,,percent of total billed charges,,,13886.21,82,,percent of total billed charges,,,15240.96,90,,percent of total billed charges,,,14394.24,85,,percent of total billed charges,,3775.4,16087.68,
FILGRASTIM-SNDZ (ZARXIO)SYR:300MCG/0.5ML,32021093,CDM,Q5101,HCPCS,636,RC,inpatient,,2172.12,2172.12,,1844.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1637.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1846.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1911.47,88,,percent of total billed charges,,131.04,,,,fee schedule,,,1659.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,131.04,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1976.63,91,,percent of total billed charges,,,2063.51,95,,percent of total billed charges,,,1802.86,83,,percent of total billed charges,,,1802.86,83,,percent of total billed charges,,,,,,,,,,,,,,,1802.86,83,,percent of total billed charges,,,2063.51,95,,percent of total billed charges,,,1954.91,90,,percent of total billed charges,,,1954.91,90,,percent of total billed charges,,,1781.14,82,,percent of total billed charges,,,1954.91,90,,percent of total billed charges,,,1846.3,85,,percent of total billed charges,,131.04,2063.51,
ALPROSTADIL (EDEX) SYRINGE: 20MCG,32021193,CDM,J0270,HCPCS,636,RC,inpatient,,1552.1,1552.1,,1317.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1170.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1319.29,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1365.85,88,,percent of total billed charges,,,,,,,,,1185.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1412.41,91,,percent of total billed charges,,,1474.5,95,,percent of total billed charges,,,1288.24,83,,percent of total billed charges,,,1288.24,83,,percent of total billed charges,,,,,,,,,,,,,,,1288.24,83,,percent of total billed charges,,,1474.5,95,,percent of total billed charges,,,1396.89,90,,percent of total billed charges,,,1396.89,90,,percent of total billed charges,,,1272.72,82,,percent of total billed charges,,,1396.89,90,,percent of total billed charges,,,1319.29,85,,percent of total billed charges,,1170.28,1474.5,
INFLUENZA VIRUS VACCINE,32401018,CDM,90658,CPT,636,RC,inpatient,,21,21,,17.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.48,88,,percent of total billed charges,,,,,,,,,16.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.22,82,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,15.83,19.95,
DEXTROSE 70%-WATER SOL : 70%,32500071,CDM,,,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
HESPAN 6% IN NS 500 ML,32500136,CDM,,,250,RC,inpatient,,186.5,186.5,,158.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,140.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,158.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,164.12,88,,percent of total billed charges,,,,,,,,,142.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,169.72,91,,percent of total billed charges,,,177.18,95,,percent of total billed charges,,,154.8,83,,percent of total billed charges,,,154.8,83,,percent of total billed charges,,,,,,,,,,,,,,,154.8,83,,percent of total billed charges,,,177.18,95,,percent of total billed charges,,,167.85,90,,percent of total billed charges,,,167.85,90,,percent of total billed charges,,,152.93,82,,percent of total billed charges,,,167.85,90,,percent of total billed charges,,,158.53,85,,percent of total billed charges,,140.62,177.18,
TETANUS IMM GLOB(HYPERTET)SYR:250UNITS,32500146,CDM,J1670,HCPCS,636,RC,inpatient,,4013.84,4013.84,,3407.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3026.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3411.76,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3532.18,88,,percent of total billed charges,,537.77,,,,fee schedule,,,3066.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,537.77,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3652.59,91,,percent of total billed charges,,,3813.15,95,,percent of total billed charges,,,3331.49,83,,percent of total billed charges,,,3331.49,83,,percent of total billed charges,,,,,,,,,,,,,,,3331.49,83,,percent of total billed charges,,,3813.15,95,,percent of total billed charges,,,3612.46,90,,percent of total billed charges,,,3612.46,90,,percent of total billed charges,,,3291.35,82,,percent of total billed charges,,,3612.46,90,,percent of total billed charges,,,3411.76,85,,percent of total billed charges,,537.77,3813.15,
FAT EMULSIONS (INTRALIPID) : 20% 500 ML,32500171,CDM,,,250,RC,inpatient,,541.02,541.02,,459.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,407.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,459.87,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,476.1,88,,percent of total billed charges,,,,,,,,,413.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,492.33,91,,percent of total billed charges,,,513.97,95,,percent of total billed charges,,,449.05,83,,percent of total billed charges,,,449.05,83,,percent of total billed charges,,,,,,,,,,,,,,,449.05,83,,percent of total billed charges,,,513.97,95,,percent of total billed charges,,,486.92,90,,percent of total billed charges,,,486.92,90,,percent of total billed charges,,,443.64,82,,percent of total billed charges,,,486.92,90,,percent of total billed charges,,,459.87,85,,percent of total billed charges,,407.93,513.97,
CONTAINER EMPTY MCGAW MIXING BAG :2000ML,32500271,CDM,,,250,RC,inpatient,,134.33,134.33,,114.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,101.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,114.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,118.21,88,,percent of total billed charges,,,,,,,,,102.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,122.24,91,,percent of total billed charges,,,127.61,95,,percent of total billed charges,,,111.49,83,,percent of total billed charges,,,111.49,83,,percent of total billed charges,,,,,,,,,,,,,,,111.49,83,,percent of total billed charges,,,127.61,95,,percent of total billed charges,,,120.9,90,,percent of total billed charges,,,120.9,90,,percent of total billed charges,,,110.15,82,,percent of total billed charges,,,120.9,90,,percent of total billed charges,,,114.18,85,,percent of total billed charges,,101.28,127.61,
IV VENIPUNCTURE ST(BTRFLY 21X3/4IN 12IN),32500401,CDM,,,250,RC,inpatient,,8.25,8.25,,7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.26,88,,percent of total billed charges,,,,,,,,,6.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.51,91,,percent of total billed charges,,,7.84,95,,percent of total billed charges,,,6.85,83,,percent of total billed charges,,,6.85,83,,percent of total billed charges,,,,,,,,,,,,,,,6.85,83,,percent of total billed charges,,,7.84,95,,percent of total billed charges,,,7.43,90,,percent of total billed charges,,,7.43,90,,percent of total billed charges,,,6.77,82,,percent of total billed charges,,,7.43,90,,percent of total billed charges,,,7.01,85,,percent of total billed charges,,6.22,7.84,
IV VENIPUNCTURE (BTRFLY 25X3/4 12TBG),32500406,CDM,,,250,RC,inpatient,,9.2,9.2,,7.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.82,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8.1,88,,percent of total billed charges,,,,,,,,,7.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8.37,91,,percent of total billed charges,,,8.74,95,,percent of total billed charges,,,7.64,83,,percent of total billed charges,,,7.64,83,,percent of total billed charges,,,,,,,,,,,,,,,7.64,83,,percent of total billed charges,,,8.74,95,,percent of total billed charges,,,8.28,90,,percent of total billed charges,,,8.28,90,,percent of total billed charges,,,7.54,82,,percent of total billed charges,,,8.28,90,,percent of total billed charges,,,7.82,85,,percent of total billed charges,,6.94,8.74,
EXTENSION SET,32500411,CDM,,,250,RC,inpatient,,23.5,23.5,,19.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20.68,88,,percent of total billed charges,,,,,,,,,17.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.39,91,,percent of total billed charges,,,22.33,95,,percent of total billed charges,,,19.51,83,,percent of total billed charges,,,19.51,83,,percent of total billed charges,,,,,,,,,,,,,,,19.51,83,,percent of total billed charges,,,22.33,95,,percent of total billed charges,,,21.15,90,,percent of total billed charges,,,21.15,90,,percent of total billed charges,,,19.27,82,,percent of total billed charges,,,21.15,90,,percent of total billed charges,,,19.98,85,,percent of total billed charges,,17.72,22.33,
IV VENIPUNCTURE NEEDLE SET (BUTTERFLY),32500421,CDM,,,250,RC,inpatient,,8.88,8.88,,7.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.81,88,,percent of total billed charges,,,,,,,,,6.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8.08,91,,percent of total billed charges,,,8.44,95,,percent of total billed charges,,,7.37,83,,percent of total billed charges,,,7.37,83,,percent of total billed charges,,,,,,,,,,,,,,,7.37,83,,percent of total billed charges,,,8.44,95,,percent of total billed charges,,,7.99,90,,percent of total billed charges,,,7.99,90,,percent of total billed charges,,,7.28,82,,percent of total billed charges,,,7.99,90,,percent of total billed charges,,,7.55,85,,percent of total billed charges,,6.7,8.44,
IV VENIPUNCTURE NEEDLE SET (BUTTERFLY),32500426,CDM,,,250,RC,inpatient,,8.72,8.72,,7.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.67,88,,percent of total billed charges,,,,,,,,,6.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.94,91,,percent of total billed charges,,,8.28,95,,percent of total billed charges,,,7.24,83,,percent of total billed charges,,,7.24,83,,percent of total billed charges,,,,,,,,,,,,,,,7.24,83,,percent of total billed charges,,,8.28,95,,percent of total billed charges,,,7.85,90,,percent of total billed charges,,,7.85,90,,percent of total billed charges,,,7.15,82,,percent of total billed charges,,,7.85,90,,percent of total billed charges,,,7.41,85,,percent of total billed charges,,6.57,8.28,
IV ADMIN EXTENSION SET INFUS SET,32500431,CDM,,,250,RC,inpatient,,36.48,36.48,,30.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.1,88,,percent of total billed charges,,,,,,,,,27.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.2,91,,percent of total billed charges,,,34.66,95,,percent of total billed charges,,,30.28,83,,percent of total billed charges,,,30.28,83,,percent of total billed charges,,,,,,,,,,,,,,,30.28,83,,percent of total billed charges,,,34.66,95,,percent of total billed charges,,,32.83,90,,percent of total billed charges,,,32.83,90,,percent of total billed charges,,,29.91,82,,percent of total billed charges,,,32.83,90,,percent of total billed charges,,,31.01,85,,percent of total billed charges,,27.51,34.66,
IV VENIPUNCTURE NEEDLE SET (BUTTERFLY),32500461,CDM,,,250,RC,inpatient,,8.72,8.72,,7.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.41,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.67,88,,percent of total billed charges,,,,,,,,,6.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7.94,91,,percent of total billed charges,,,8.28,95,,percent of total billed charges,,,7.24,83,,percent of total billed charges,,,7.24,83,,percent of total billed charges,,,,,,,,,,,,,,,7.24,83,,percent of total billed charges,,,8.28,95,,percent of total billed charges,,,7.85,90,,percent of total billed charges,,,7.85,90,,percent of total billed charges,,,7.15,82,,percent of total billed charges,,,7.85,90,,percent of total billed charges,,,7.41,85,,percent of total billed charges,,6.57,8.28,
IV EQUIPMENT (PCA MINI BORE SET),32500481,CDM,,,250,RC,inpatient,,63.76,63.76,,54.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.11,88,,percent of total billed charges,,,,,,,,,48.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.02,91,,percent of total billed charges,,,60.57,95,,percent of total billed charges,,,52.92,83,,percent of total billed charges,,,52.92,83,,percent of total billed charges,,,,,,,,,,,,,,,52.92,83,,percent of total billed charges,,,60.57,95,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,52.28,82,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,54.2,85,,percent of total billed charges,,48.08,60.57,
SODIUM CHLORIDE IRRIG SOLN 0.9%:3000ML,32500516,CDM,,,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
FAT EMULSIONS (LIPOSYN II) EMU : 10%,32500526,CDM,,,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
AMINOSYN 3.5% IN DEXTROSE 5% 1000 ML,32500599,CDM,,,250,RC,inpatient,,298.33,298.33,,253.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,224.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,253.58,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,262.53,88,,percent of total billed charges,,,,,,,,,227.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,271.48,91,,percent of total billed charges,,,283.41,95,,percent of total billed charges,,,247.61,83,,percent of total billed charges,,,247.61,83,,percent of total billed charges,,,,,,,,,,,,,,,247.61,83,,percent of total billed charges,,,283.41,95,,percent of total billed charges,,,268.5,90,,percent of total billed charges,,,268.5,90,,percent of total billed charges,,,244.63,82,,percent of total billed charges,,,268.5,90,,percent of total billed charges,,,253.58,85,,percent of total billed charges,,224.94,283.41,
AMINOSYN 4.25%/DEXTROSE 25% 1000 ML,32500600,CDM,J3490,HCPCS,250,RC,inpatient,,529.09,529.09,,449.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,398.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,449.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,465.6,88,,percent of total billed charges,,,,,,,,,404.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,481.47,91,,percent of total billed charges,,,502.64,95,,percent of total billed charges,,,439.14,83,,percent of total billed charges,,,439.14,83,,percent of total billed charges,,,,,,,,,,,,,,,439.14,83,,percent of total billed charges,,,502.64,95,,percent of total billed charges,,,476.18,90,,percent of total billed charges,,,476.18,90,,percent of total billed charges,,,433.85,82,,percent of total billed charges,,,476.18,90,,percent of total billed charges,,,449.73,85,,percent of total billed charges,,398.93,502.64,
IV MAG SULF 40GM/SW1000ML(PREMIX),32505647,CDM,J3475,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,15.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,15.22,187.11,
MANNITOL SOL 20% 250 ML,32505716,CDM,J2150,HCPCS,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,34.78,,,,fee schedule,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,34.78,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,34.78,181.67,
IV MANNITOL SOL 20%:500 ML,32505731,CDM,J2150,HCPCS,250,RC,inpatient,,277.23,277.23,,235.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,209.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,235.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,243.96,88,,percent of total billed charges,,34.78,,,,fee schedule,,,211.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,34.78,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,252.28,91,,percent of total billed charges,,,263.37,95,,percent of total billed charges,,,230.1,83,,percent of total billed charges,,,230.1,83,,percent of total billed charges,,,,,,,,,,,,,,,230.1,83,,percent of total billed charges,,,263.37,95,,percent of total billed charges,,,249.51,90,,percent of total billed charges,,,249.51,90,,percent of total billed charges,,,227.33,82,,percent of total billed charges,,,249.51,90,,percent of total billed charges,,,235.65,85,,percent of total billed charges,,34.78,263.37,
DEXTROSE 20%-WATER SOL : 500ML,32505736,CDM,,,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
IV D 50% W (HAL) 500 ML,32505741,CDM,,,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
IV NS 3% (HYPERTONIC)500ML  (PREMIX),32505742,CDM,J7131,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,2.4,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.4,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,2.4,187.11,
IV NS1000ML/KCL20MEQ    (PREMIX),32505743,CDM,J3480,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,3.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.22,187.11,
IV D5W 100ML,32505771,CDM,J7060,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV NS 0.9% 50ML,32505776,CDM,J3490,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV NS 0.9%  100ML,32505781,CDM,J7050,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
FREAMINE III SOL:8.50% 500ML,32505786,CDM,,,250,RC,inpatient,,897.39,897.39,,761.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,676.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,762.78,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,789.7,88,,percent of total billed charges,,,,,,,,,685.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,816.62,91,,percent of total billed charges,,,852.52,95,,percent of total billed charges,,,744.83,83,,percent of total billed charges,,,744.83,83,,percent of total billed charges,,,,,,,,,,,,,,,744.83,83,,percent of total billed charges,,,852.52,95,,percent of total billed charges,,,807.65,90,,percent of total billed charges,,,807.65,90,,percent of total billed charges,,,735.86,82,,percent of total billed charges,,,807.65,90,,percent of total billed charges,,,762.78,85,,percent of total billed charges,,676.63,852.52,
ETHYL ALCOHOL/D5W (DEXTROSE) SOL:5%-5%,32505796,CDM,,,250,RC,inpatient,,348.44,348.44,,295.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,262.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,296.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,306.63,88,,percent of total billed charges,,,,,,,,,266.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,317.08,91,,percent of total billed charges,,,331.02,95,,percent of total billed charges,,,289.21,83,,percent of total billed charges,,,289.21,83,,percent of total billed charges,,,,,,,,,,,,,,,289.21,83,,percent of total billed charges,,,331.02,95,,percent of total billed charges,,,313.6,90,,percent of total billed charges,,,313.6,90,,percent of total billed charges,,,285.72,82,,percent of total billed charges,,,313.6,90,,percent of total billed charges,,,296.17,85,,percent of total billed charges,,262.72,331.02,
WATER FOR IRRIGATION STERILE SOL:1000ML,32505806,CDM,J3490,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
WATER FOR IRRIGATION STERILE SOL 2000ML,32505811,CDM,,,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
SODIUM CL IRRIG SOL 0.9% BOTTLE:1000ML,32505816,CDM,J3490,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
SODIUM CL IRRIG SOLN SOL : 0.90% 2000ML,32505821,CDM,,,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
SORBITOL SOLUTION SOL : 3.30% 2000ML,32505831,CDM,,,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
SORBITOL SOLUTION SOL : 3.30% 4000ML,32505836,CDM,,,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
ACETIC ACID SOL : 0.25%    1000 ML,32505841,CDM,,,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
BLOOD ADMINISTRATN SET (HORIZON PUMP),32505846,CDM,,,250,RC,inpatient,,101.19,101.19,,85.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.05,88,,percent of total billed charges,,,,,,,,,77.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.08,91,,percent of total billed charges,,,96.13,95,,percent of total billed charges,,,83.99,83,,percent of total billed charges,,,83.99,83,,percent of total billed charges,,,,,,,,,,,,,,,83.99,83,,percent of total billed charges,,,96.13,95,,percent of total billed charges,,,91.07,90,,percent of total billed charges,,,91.07,90,,percent of total billed charges,,,82.98,82,,percent of total billed charges,,,91.07,90,,percent of total billed charges,,,86.01,85,,percent of total billed charges,,76.3,96.13,
"IV HEParin 25,000UNITS/D5W500ML(PREMIX)",32505861,CDM,J1644,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV NS 0.9% 1000ML,32505876,CDM,J7050,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV EQUIPMENT (PLASTIC DUST CAP),32505881,CDM,,,250,RC,inpatient,,29,29,,24.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,25.52,88,,percent of total billed charges,,,,,,,,,22.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,26.39,91,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,,,,,,,,,,,,,24.07,83,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,23.78,82,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,21.87,27.55,
IV CATHETER PLUG,32505886,CDM,,,250,RC,inpatient,,10.5,10.5,,8.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9.24,88,,percent of total billed charges,,,,,,,,,8.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9.56,91,,percent of total billed charges,,,9.98,95,,percent of total billed charges,,,8.72,83,,percent of total billed charges,,,8.72,83,,percent of total billed charges,,,,,,,,,,,,,,,8.72,83,,percent of total billed charges,,,9.98,95,,percent of total billed charges,,,9.45,90,,percent of total billed charges,,,9.45,90,,percent of total billed charges,,,8.61,82,,percent of total billed charges,,,9.45,90,,percent of total billed charges,,,8.93,85,,percent of total billed charges,,7.92,9.98,
IV EQUIPMENT IV,32505891,CDM,,,250,RC,inpatient,,25.22,25.22,,21.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.44,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.19,88,,percent of total billed charges,,,,,,,,,19.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.95,91,,percent of total billed charges,,,23.96,95,,percent of total billed charges,,,20.93,83,,percent of total billed charges,,,20.93,83,,percent of total billed charges,,,,,,,,,,,,,,,20.93,83,,percent of total billed charges,,,23.96,95,,percent of total billed charges,,,22.7,90,,percent of total billed charges,,,22.7,90,,percent of total billed charges,,,20.68,82,,percent of total billed charges,,,22.7,90,,percent of total billed charges,,,21.44,85,,percent of total billed charges,,19.02,23.96,
CONTAINER EMPTY BOT : 2000ML,32505896,CDM,,,250,RC,inpatient,,134.33,134.33,,114.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,101.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,114.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,118.21,88,,percent of total billed charges,,,,,,,,,102.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,122.24,91,,percent of total billed charges,,,127.61,95,,percent of total billed charges,,,111.49,83,,percent of total billed charges,,,111.49,83,,percent of total billed charges,,,,,,,,,,,,,,,111.49,83,,percent of total billed charges,,,127.61,95,,percent of total billed charges,,,120.9,90,,percent of total billed charges,,,120.9,90,,percent of total billed charges,,,110.15,82,,percent of total billed charges,,,120.9,90,,percent of total billed charges,,,114.18,85,,percent of total billed charges,,101.28,127.61,
TRANSFER SETS (TRANSFER SET),32505901,CDM,,,250,RC,inpatient,,77.87,77.87,,66.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.53,88,,percent of total billed charges,,,,,,,,,59.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.86,91,,percent of total billed charges,,,73.98,95,,percent of total billed charges,,,64.63,83,,percent of total billed charges,,,64.63,83,,percent of total billed charges,,,,,,,,,,,,,,,64.63,83,,percent of total billed charges,,,73.98,95,,percent of total billed charges,,,70.08,90,,percent of total billed charges,,,70.08,90,,percent of total billed charges,,,63.85,82,,percent of total billed charges,,,70.08,90,,percent of total billed charges,,,66.19,85,,percent of total billed charges,,58.71,73.98,
IV ADMIN EXTENSION SET-FILTER INFUS SET,32505911,CDM,,,250,RC,inpatient,,125.77,125.77,,106.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,94.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,106.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,110.68,88,,percent of total billed charges,,,,,,,,,96.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,114.45,91,,percent of total billed charges,,,119.48,95,,percent of total billed charges,,,104.39,83,,percent of total billed charges,,,104.39,83,,percent of total billed charges,,,,,,,,,,,,,,,104.39,83,,percent of total billed charges,,,119.48,95,,percent of total billed charges,,,113.19,90,,percent of total billed charges,,,113.19,90,,percent of total billed charges,,,103.13,82,,percent of total billed charges,,,113.19,90,,percent of total billed charges,,,106.9,85,,percent of total billed charges,,94.83,119.48,
IV LIDOCAINE(XYLOCAINE) 2GM/D5W500ML:,32505916,CDM,J2001,HCPCS,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,0.75,,,,fee schedule,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,0.75,181.67,
IV D5W1000ML,32506196,CDM,J7070,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV D5W 500ML,32506201,CDM,J7060,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV D5W 250ML,32506206,CDM,J7060,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV DEXTROSE 10%-WATER SOL 1000ML,32506211,CDM,J3490,HCPCS,250,RC,inpatient,UD,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV DEXTROSE 10%-WATER SOL 250ML,32506212,CDM,J3490,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV D5NS 1000ML,32506216,CDM,J3490,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV D5NS 1000ML/KCL20MEQ  (PREMIX),32506217,CDM,J3480,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,3.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.22,187.11,
IV D51/2NS 1000ML,32506221,CDM,J3490,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV D51/4NS 250ML,32506227,CDM,J3490,HCPCS,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
IV D51/4NS1000ML,32506231,CDM,J3490,HCPCS,250,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
IV D51/4NS1000ML/KCL20MEQ  (PREMIX),32506232,CDM,J3480,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,3.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.22,187.11,
D5 1/4 NS 500ML,32506236,CDM,J3490,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV D51/2NS 1000ML/KCL20MEQ  (PREMIX),32506241,CDM,J3480,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,3.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.22,187.11,
IV D51/2NS 1000ML/KCL40MEQ  (PREMIX),32506242,CDM,J3480,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,3.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.22,187.11,
IV RINGERS LACTATE 1000ML,32506246,CDM,J7120,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV LR  500ML,32506251,CDM,J7120,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV D5LR 1000ML,32506256,CDM,J3490,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV NS 0.9%  500ML,32506261,CDM,J7050,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV NS 0.9%  250ML,32506266,CDM,J7050,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV 0.45% NS 1000ML,32506271,CDM,J3490,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,148.51,187.11,
IV 0.45% NS 1000ML/KCL20MEQ    (PREMIX),32506272,CDM,J3480,HCPCS,250,RC,inpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,148.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,167.42,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,173.32,88,,percent of total billed charges,,3.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.22,187.11,
PCA-HYDROmorphone :30MG/30ML,32599769,CDM,,,250,RC,inpatient,,306.05,306.05,,259.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,230.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,260.14,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,269.32,88,,percent of total billed charges,,,,,,,,,233.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,278.51,91,,percent of total billed charges,,,290.75,95,,percent of total billed charges,,,254.02,83,,percent of total billed charges,,,254.02,83,,percent of total billed charges,,,,,,,,,,,,,,,254.02,83,,percent of total billed charges,,,290.75,95,,percent of total billed charges,,,275.45,90,,percent of total billed charges,,,275.45,90,,percent of total billed charges,,,250.96,82,,percent of total billed charges,,,275.45,90,,percent of total billed charges,,,260.14,85,,percent of total billed charges,,230.76,290.75,
IV ISOPROTERENOL(ISUPREL):1MG/NS250ML,32599770,CDM,,,250,RC,inpatient,,684.63,684.63,,581.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,516.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,581.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,602.47,88,,percent of total billed charges,,,,,,,,,523.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,623.01,91,,percent of total billed charges,,,650.4,95,,percent of total billed charges,,,568.24,83,,percent of total billed charges,,,568.24,83,,percent of total billed charges,,,,,,,,,,,,,,,568.24,83,,percent of total billed charges,,,650.4,95,,percent of total billed charges,,,616.17,90,,percent of total billed charges,,,616.17,90,,percent of total billed charges,,,561.4,82,,percent of total billed charges,,,616.17,90,,percent of total billed charges,,,581.94,85,,percent of total billed charges,,516.21,650.4,
VANCOMYCIN-VIAL:2GM (FOR STERILE FIELD),32599773,CDM,,,250,RC,inpatient,,100.24,100.24,,85.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88.21,88,,percent of total billed charges,,,,,,,,,76.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91.22,91,,percent of total billed charges,,,95.23,95,,percent of total billed charges,,,83.2,83,,percent of total billed charges,,,83.2,83,,percent of total billed charges,,,,,,,,,,,,,,,83.2,83,,percent of total billed charges,,,95.23,95,,percent of total billed charges,,,90.22,90,,percent of total billed charges,,,90.22,90,,percent of total billed charges,,,82.2,82,,percent of total billed charges,,,90.22,90,,percent of total billed charges,,,85.2,85,,percent of total billed charges,,75.58,95.23,
MAG SULF-IVPB 4GM/NS250ML(PHARM MIX),32599776,CDM,,,258,RC,inpatient,,53.58,53.58,,45.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47.15,88,,percent of total billed charges,,,,,,,,,40.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,48.76,91,,percent of total billed charges,,,50.9,95,,percent of total billed charges,,,44.47,83,,percent of total billed charges,,,44.47,83,,percent of total billed charges,,,,,,,,,,,,,,,44.47,83,,percent of total billed charges,,,50.9,95,,percent of total billed charges,,,48.22,90,,percent of total billed charges,,,48.22,90,,percent of total billed charges,,,43.94,82,,percent of total billed charges,,,48.22,90,,percent of total billed charges,,,45.54,85,,percent of total billed charges,,40.4,50.9,
MAG SULF-IVPB 3GM/NS250ML(PHARM-MIX),32599777,CDM,,,258,RC,inpatient,,53.58,53.58,,45.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47.15,88,,percent of total billed charges,,,,,,,,,40.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,48.76,91,,percent of total billed charges,,,50.9,95,,percent of total billed charges,,,44.47,83,,percent of total billed charges,,,44.47,83,,percent of total billed charges,,,,,,,,,,,,,,,44.47,83,,percent of total billed charges,,,50.9,95,,percent of total billed charges,,,48.22,90,,percent of total billed charges,,,48.22,90,,percent of total billed charges,,,43.94,82,,percent of total billed charges,,,48.22,90,,percent of total billed charges,,,45.54,85,,percent of total billed charges,,40.4,50.9,
IV IRON SUCROSE(VENOFER):200MG/NS100ML,32599797,CDM,,,636,RC,inpatient,,583.33,583.33,,495.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,439.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,495.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,513.33,88,,percent of total billed charges,,,,,,,,,445.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,530.83,91,,percent of total billed charges,,,554.16,95,,percent of total billed charges,,,484.16,83,,percent of total billed charges,,,484.16,83,,percent of total billed charges,,,,,,,,,,,,,,,484.16,83,,percent of total billed charges,,,554.16,95,,percent of total billed charges,,,525,90,,percent of total billed charges,,,525,90,,percent of total billed charges,,,478.33,82,,percent of total billed charges,,,525,90,,percent of total billed charges,,,495.83,85,,percent of total billed charges,,439.83,554.16,
IV LR 1000ML+PITOCIN:10 UNITS (COMPD),32599815,CDM,,,258,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
levETIRAcetam(KEPPRA)-IVPB:500MG/NS100ML,32599828,CDM,,,250,RC,inpatient,,240.2,240.2,,203.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,181.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.38,88,,percent of total billed charges,,,,,,,,,183.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.58,91,,percent of total billed charges,,,228.19,95,,percent of total billed charges,,,199.37,83,,percent of total billed charges,,,199.37,83,,percent of total billed charges,,,,,,,,,,,,,,,199.37,83,,percent of total billed charges,,,228.19,95,,percent of total billed charges,,,216.18,90,,percent of total billed charges,,,216.18,90,,percent of total billed charges,,,196.96,82,,percent of total billed charges,,,216.18,90,,percent of total billed charges,,,204.17,85,,percent of total billed charges,,181.11,228.19,
IMIPENEM(PRIMAXIN)-IVPB:250MG/NS100ML,32599846,CDM,,,258,RC,inpatient,,310.19,310.19,,263.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,233.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,263.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,272.97,88,,percent of total billed charges,,,,,,,,,236.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,282.27,91,,percent of total billed charges,,,294.68,95,,percent of total billed charges,,,257.46,83,,percent of total billed charges,,,257.46,83,,percent of total billed charges,,,,,,,,,,,,,,,257.46,83,,percent of total billed charges,,,294.68,95,,percent of total billed charges,,,279.17,90,,percent of total billed charges,,,279.17,90,,percent of total billed charges,,,254.36,82,,percent of total billed charges,,,279.17,90,,percent of total billed charges,,,263.66,85,,percent of total billed charges,,233.88,294.68,
ON-Q-PUMP-400/ROPIVACAINE 0.2%:500ML,32599861,CDM,,,258,RC,inpatient,,1116.46,1116.46,,947.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,841.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,948.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,982.48,88,,percent of total billed charges,,,,,,,,,852.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1015.98,91,,percent of total billed charges,,,1060.64,95,,percent of total billed charges,,,926.66,83,,percent of total billed charges,,,926.66,83,,percent of total billed charges,,,,,,,,,,,,,,,926.66,83,,percent of total billed charges,,,1060.64,95,,percent of total billed charges,,,1004.81,90,,percent of total billed charges,,,1004.81,90,,percent of total billed charges,,,915.5,82,,percent of total billed charges,,,1004.81,90,,percent of total billed charges,,,948.99,85,,percent of total billed charges,,841.81,1060.64,
PENICILLIN- IVPB:24MIL UNITS/NS500ML,32599867,CDM,,,258,RC,inpatient,,139.75,139.75,,118.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,105.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,118.79,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,122.98,88,,percent of total billed charges,,,,,,,,,106.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,127.17,91,,percent of total billed charges,,,132.76,95,,percent of total billed charges,,,115.99,83,,percent of total billed charges,,,115.99,83,,percent of total billed charges,,,,,,,,,,,,,,,115.99,83,,percent of total billed charges,,,132.76,95,,percent of total billed charges,,,125.78,90,,percent of total billed charges,,,125.78,90,,percent of total billed charges,,,114.6,82,,percent of total billed charges,,,125.78,90,,percent of total billed charges,,,118.79,85,,percent of total billed charges,,105.37,132.76,
PCA-fentaNYL:10MCG/ML(30ML),32599870,CDM,,,250,RC,inpatient,,194.77,194.77,,165.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,165.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,171.4,88,,percent of total billed charges,,,,,,,,,148.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,177.24,91,,percent of total billed charges,,,185.03,95,,percent of total billed charges,,,161.66,83,,percent of total billed charges,,,161.66,83,,percent of total billed charges,,,,,,,,,,,,,,,161.66,83,,percent of total billed charges,,,185.03,95,,percent of total billed charges,,,175.29,90,,percent of total billed charges,,,175.29,90,,percent of total billed charges,,,159.71,82,,percent of total billed charges,,,175.29,90,,percent of total billed charges,,,165.55,85,,percent of total billed charges,,146.86,185.03,
vinBLASTine(VELBAN)10MG/10ML:J/1MG,32599871,CDM,J9360,HCPCS,636,RC,inpatient,,69.94,69.94,,59.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,59.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,61.55,88,,percent of total billed charges,,179.86,,,,fee schedule,,,53.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,179.86,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,63.65,91,,percent of total billed charges,,,66.44,95,,percent of total billed charges,,,58.05,83,,percent of total billed charges,,,58.05,83,,percent of total billed charges,,,,,,,,,,,,,,,58.05,83,,percent of total billed charges,,,66.44,95,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,57.35,82,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,59.45,85,,percent of total billed charges,,52.73,179.86,
LEUCOVORIN:600MG/NS250ML,32599874,CDM,,,636,RC,inpatient,,87.39,87.39,,74.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,65.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.28,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,76.9,88,,percent of total billed charges,,,,,,,,,66.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,79.52,91,,percent of total billed charges,,,83.02,95,,percent of total billed charges,,,72.53,83,,percent of total billed charges,,,72.53,83,,percent of total billed charges,,,,,,,,,,,,,,,72.53,83,,percent of total billed charges,,,83.02,95,,percent of total billed charges,,,78.65,90,,percent of total billed charges,,,78.65,90,,percent of total billed charges,,,71.66,82,,percent of total billed charges,,,78.65,90,,percent of total billed charges,,,74.28,85,,percent of total billed charges,,65.89,83.02,
DOXOrubicin(ADRIAMYCIN):10MG/5ML,32599894,CDM,J9000,HCPCS,636,RC,inpatient,,114.38,114.38,,97.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,86.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,97.22,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,100.65,88,,percent of total billed charges,,43.69,,,,fee schedule,,,87.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,43.69,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,104.09,91,,percent of total billed charges,,,108.66,95,,percent of total billed charges,,,94.94,83,,percent of total billed charges,,,94.94,83,,percent of total billed charges,,,,,,,,,,,,,,,94.94,83,,percent of total billed charges,,,108.66,95,,percent of total billed charges,,,102.94,90,,percent of total billed charges,,,102.94,90,,percent of total billed charges,,,93.79,82,,percent of total billed charges,,,102.94,90,,percent of total billed charges,,,97.22,85,,percent of total billed charges,,43.69,108.66,
FLUOROURACIL(5-FU):500MG/10ML,32599895,CDM,J9190,HCPCS,636,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,47.2,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,47.2,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
nitroGLYCERIN/D5W BTL : 25MG /250ML (PD),32599908,CDM,,,250,RC,inpatient,,88.5,88.5,,75.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,75.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.88,88,,percent of total billed charges,,,,,,,,,67.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.54,91,,percent of total billed charges,,,84.08,95,,percent of total billed charges,,,73.46,83,,percent of total billed charges,,,73.46,83,,percent of total billed charges,,,,,,,,,,,,,,,73.46,83,,percent of total billed charges,,,84.08,95,,percent of total billed charges,,,79.65,90,,percent of total billed charges,,,79.65,90,,percent of total billed charges,,,72.57,82,,percent of total billed charges,,,79.65,90,,percent of total billed charges,,,75.23,85,,percent of total billed charges,,66.73,84.08,
IV LIDOCAINE 2GM/D5W500ML,32599909,CDM,J2001,HCPCS,258,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,0.75,,,,fee schedule,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,0.75,181.67,
ROPIVACAI(NAROPIN)0.2%:100ML(EPIDURAL),32599915,CDM,,,250,RC,inpatient,,677.06,677.06,,574.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,510.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,575.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,595.81,88,,percent of total billed charges,,,,,,,,,517.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,616.12,91,,percent of total billed charges,,,643.21,95,,percent of total billed charges,,,561.96,83,,percent of total billed charges,,,561.96,83,,percent of total billed charges,,,,,,,,,,,,,,,561.96,83,,percent of total billed charges,,,643.21,95,,percent of total billed charges,,,609.35,90,,percent of total billed charges,,,609.35,90,,percent of total billed charges,,,555.19,82,,percent of total billed charges,,,609.35,90,,percent of total billed charges,,,575.5,85,,percent of total billed charges,,510.5,643.21,
POTASSIUM CHLORIDE-IVPB:20MEQ/100 ML*,32599916,CDM,J3480,HCPCS,250,RC,inpatient,,658.83,658.83,,559.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,496.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,560.01,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,579.77,88,,percent of total billed charges,,3.22,,,,fee schedule,,,503.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,599.54,91,,percent of total billed charges,,,625.89,95,,percent of total billed charges,,,546.83,83,,percent of total billed charges,,,546.83,83,,percent of total billed charges,,,,,,,,,,,,,,,546.83,83,,percent of total billed charges,,,625.89,95,,percent of total billed charges,,,592.95,90,,percent of total billed charges,,,592.95,90,,percent of total billed charges,,,540.24,82,,percent of total billed charges,,,592.95,90,,percent of total billed charges,,,560.01,85,,percent of total billed charges,,3.22,625.89,
TRIAMCIN(KENALOG)NEB TX:400MCG,32599920,CDM,,,250,RC,inpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,9.05,11.4,
MORPHINE SULF VIAL PCA:30MG/30ML,32599922,CDM,,,250,RC,inpatient,,77.25,77.25,,65.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,65.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,67.98,88,,percent of total billed charges,,,,,,,,,59.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.3,91,,percent of total billed charges,,,73.39,95,,percent of total billed charges,,,64.12,83,,percent of total billed charges,,,64.12,83,,percent of total billed charges,,,,,,,,,,,,,,,64.12,83,,percent of total billed charges,,,73.39,95,,percent of total billed charges,,,69.53,90,,percent of total billed charges,,,69.53,90,,percent of total billed charges,,,63.35,82,,percent of total billed charges,,,69.53,90,,percent of total billed charges,,,65.66,85,,percent of total billed charges,,58.25,73.39,
NitroGLY (NITRO-STAT)0.4MG 25'S  (PD),32599924,CDM,,,250,RC,inpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11.19,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,9.92,12.5,
IV D5.45NS/KCL 40MEQ 1000ML: (PREMIX),32599935,CDM,,,250,RC,inpatient,,100,100,,84.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,75.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,88,88,,percent of total billed charges,,,,,,,,,76.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,83,83,,percent of total billed charges,,,,,,,,,,,,,,,83,83,,percent of total billed charges,,,95,95,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,82,82,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,75.4,95,
IV NS1000ML+ POTASSIUM PHOS:45MM(PREMIX),32599949,CDM,,,258,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,144.19,181.67,
CLINDAMYCIN(CLEOCIN)-IVPB:900MG/NS100ML,32599986,CDM,,,258,RC,inpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54.57,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,48.41,60.99,
X RHC VNG BASIC VESTIBULAR EVALUATION,34010501,CDM,92540,CPT,471,RC,inpatient,TC,280,280,,237.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,211.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,238,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,246.4,88,,percent of total billed charges,,,,,,,,,213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,,,,,,,,,,,,,232.4,83,,percent of total billed charges,,,266,95,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,229.6,82,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,211.12,266,
X RHC VNG CALORIC VESTIBULAR,34010502,CDM,92543,CPT,471,RC,inpatient,TC,63,63,,53.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,53.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.44,88,,percent of total billed charges,,,,,,,,,48.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,,,,,,,,,,,,,52.29,83,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,51.66,82,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,47.5,59.85,
X RHC VNG SINUSOIDAL VERTICLE AXIS TEST,34010503,CDM,92546,CPT,471,RC,inpatient,TC,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,174.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,174.17,219.45,
VNG BASIC VESTIBULAR EVALUATION,34010540,CDM,92540,CPT,471,RC,inpatient,,809,809,,686.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,609.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,687.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,711.92,88,,percent of total billed charges,,,,,,,,,618.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,736.19,91,,percent of total billed charges,,,768.55,95,,percent of total billed charges,,,671.47,83,,percent of total billed charges,,,671.47,83,,percent of total billed charges,,,,,,,,,,,,,,,671.47,83,,percent of total billed charges,,,768.55,95,,percent of total billed charges,,,728.1,90,,percent of total billed charges,,,728.1,90,,percent of total billed charges,,,663.38,82,,percent of total billed charges,,,728.1,90,,percent of total billed charges,,,687.65,85,,percent of total billed charges,,609.99,768.55,
VNG CALORIC VESTIBULAR,34010543,CDM,92543,CPT,471,RC,inpatient,,354,354,,300.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,266.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,300.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,311.52,88,,percent of total billed charges,,,,,,,,,270.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,322.14,91,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,,,,,,,,,,,,,293.82,83,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,290.28,82,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,300.9,85,,percent of total billed charges,,266.92,336.3,
VNG SINUSOIDAL VERTICLE AXIS ROTATIONAL,34010546,CDM,92546,CPT,471,RC,inpatient,,607,607,,515.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,457.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,515.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,534.16,88,,percent of total billed charges,,,,,,,,,463.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,552.37,91,,percent of total billed charges,,,576.65,95,,percent of total billed charges,,,503.81,83,,percent of total billed charges,,,503.81,83,,percent of total billed charges,,,,,,,,,,,,,,,503.81,83,,percent of total billed charges,,,576.65,95,,percent of total billed charges,,,546.3,90,,percent of total billed charges,,,546.3,90,,percent of total billed charges,,,497.74,82,,percent of total billed charges,,,546.3,90,,percent of total billed charges,,,515.95,85,,percent of total billed charges,,457.68,576.65,
VNG MEDICARE CALORIC VESTIBULAR,34010743,CDM,92543,CPT,471,RC,inpatient,,482,482,,409.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,363.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,409.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,424.16,88,,percent of total billed charges,,,,,,,,,368.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,438.62,91,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,,,,,,,,,,,,,400.06,83,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,395.24,82,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,363.43,457.9,
VNG SPONTANEOUS NYSTAGMUS TEST W/RECORD,34109500,CDM,92541,CPT,471,RC,inpatient,,389,389,,330.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,293.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,330.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,342.32,88,,percent of total billed charges,,,,,,,,,297.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,353.99,91,,percent of total billed charges,,,369.55,95,,percent of total billed charges,,,322.87,83,,percent of total billed charges,,,322.87,83,,percent of total billed charges,,,,,,,,,,,,,,,322.87,83,,percent of total billed charges,,,369.55,95,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,318.98,82,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,330.65,85,,percent of total billed charges,,293.31,369.55,
VNG POSITORIAL NYSTAGMUS TEST,34109501,CDM,92542,CPT,471,RC,inpatient,,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,332.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,294.81,371.45,
VNG CALORIC VESTIBULAR,34109502,CDM,92543,CPT,471,RC,inpatient,,482,482,,409.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,363.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,409.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,424.16,88,,percent of total billed charges,,,,,,,,,368.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,438.62,91,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,,,,,,,,,,,,,400.06,83,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,395.24,82,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,363.43,457.9,
VNG OPTOKIN NYSTAGMUS BI DIRECT FOC PERI,34109503,CDM,92544,CPT,471,RC,inpatient,,352,352,,298.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,265.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,299.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,309.76,88,,percent of total billed charges,,,,,,,,,268.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,,,,,,,,,,,,,292.16,83,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,288.64,82,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,265.41,334.4,
VNG OSCILLATING TRACKING TEST W/RECODING,34109504,CDM,92545,CPT,471,RC,inpatient,,334,334,,283.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,251.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,283.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,293.92,88,,percent of total billed charges,,,,,,,,,255.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,303.94,91,,percent of total billed charges,,,317.3,95,,percent of total billed charges,,,277.22,83,,percent of total billed charges,,,277.22,83,,percent of total billed charges,,,,,,,,,,,,,,,277.22,83,,percent of total billed charges,,,317.3,95,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,273.88,82,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,283.9,85,,percent of total billed charges,,251.84,317.3,
VNG SINUSODIAL VERTICAL AXIS ROTATIONAL,34109505,CDM,92546,CPT,471,RC,inpatient,,607,607,,515.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,457.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,515.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,534.16,88,,percent of total billed charges,,,,,,,,,463.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,552.37,91,,percent of total billed charges,,,576.65,95,,percent of total billed charges,,,503.81,83,,percent of total billed charges,,,503.81,83,,percent of total billed charges,,,,,,,,,,,,,,,503.81,83,,percent of total billed charges,,,576.65,95,,percent of total billed charges,,,546.3,90,,percent of total billed charges,,,546.3,90,,percent of total billed charges,,,497.74,82,,percent of total billed charges,,,546.3,90,,percent of total billed charges,,,515.95,85,,percent of total billed charges,,457.68,576.65,
VNG MEDICARE CALORIC VESTIBULAR,34109507,CDM,92543,CPT,471,RC,inpatient,,482,482,,409.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,363.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,409.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,424.16,88,,percent of total billed charges,,,,,,,,,368.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,438.62,91,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,,,,,,,,,,,,,400.06,83,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,395.24,82,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,363.43,457.9,
PT KNEE STRAPPING,34900000,CDM,29530,CPT,420,RC,inpatient,GP,431,431,,365.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,324.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,366.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,379.28,88,,percent of total billed charges,,,,,,,,,329.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,392.21,91,,percent of total billed charges,,,409.45,95,,percent of total billed charges,,,357.73,83,,percent of total billed charges,,,357.73,83,,percent of total billed charges,,,,,,,,,,,,,,,357.73,83,,percent of total billed charges,,,409.45,95,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,353.42,82,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,366.35,85,,percent of total billed charges,,324.97,409.45,
PT HAND FINGER STRAPPING,34900001,CDM,29280,CPT,420,RC,inpatient,GP,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,277.47,349.6,
PT HIP STRAPPING,34900002,CDM,29520,CPT,420,RC,inpatient,GP,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
PT ELBOW WRIST STRAPPING,34900003,CDM,29260,CPT,420,RC,inpatient,GP,407,407,,345.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,345.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,358.16,88,,percent of total billed charges,,,,,,,,,310.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,,,,,,,,,,,,,337.81,83,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,333.74,82,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,306.88,386.65,
PT TOE STRAPPING,34900004,CDM,29550,CPT,420,RC,inpatient,GP,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,130.44,164.35,
PT ANKLESTRAPPING,34900005,CDM,29540,CPT,420,RC,inpatient,GP,405,405,,343.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,305.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,344.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,356.4,88,,percent of total billed charges,,,,,,,,,309.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,368.55,91,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,,,,,,,,,,,,,336.15,83,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,332.1,82,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,305.37,384.75,
PT SHOULDER STRAPPING,34900066,CDM,29240,CPT,420,RC,inpatient,GP,405,405,,343.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,305.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,344.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,356.4,88,,percent of total billed charges,,,,,,,,,309.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,368.55,91,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,,,,,,,,,,,,,336.15,83,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,332.1,82,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,305.37,384.75,
SM WORK HARDNG/CONDITIONING EA ADDTL HR,34900620,CDM,97546,CPT,951,RC,inpatient,,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,217.91,274.55,
PT WORK HARDNG/CONDITIONING EA ADDTL HR,34900622,CDM,97546,CPT,420,RC,inpatient,GP,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,217.91,274.55,
PT PHY PERFORM TEST/MEASURE EA 15 MIN,34900624,CDM,97750,CPT,420,RC,inpatient,GP,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,203.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,180.21,227.05,
PT BIOFEEDBACK TRAINING,34900650,CDM,90901,CPT,420,RC,inpatient,GP,235,235,,199.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,177.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,199.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,206.8,88,,percent of total billed charges,,,,,,,,,179.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,213.85,91,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,,,,,,,,,,,,,195.05,83,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,192.7,82,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,199.75,85,,percent of total billed charges,,177.19,223.25,
"PT BIOFEEDBACK, PERI/URO/RECTAL",34900655,CDM,90912,CPT,420,RC,inpatient,GP,230,230,,195.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,173.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,195.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,202.4,88,,percent of total billed charges,,,,,,,,,175.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,209.3,91,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,,,,,,,,,,,,,190.9,83,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,188.6,82,,percent of total billed charges,,,207,90,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,173.42,218.5,
PT MOD 59 RE-EVALUATION,34900700,CDM,97002,CPT,424,RC,inpatient,GP,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
PT RE-EVALUATION,34900705,CDM,97002,CPT,424,RC,inpatient,GP,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,294.06,370.5,
PT ELEC STIM (UNATTENDED),34900707,CDM,G0283,HCPCS,420,RC,inpatient,GP,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,132.7,167.2,
PT MEDICARE ELEC STIM (UNATTENDED),34900708,CDM,G0283,HCPCS,420,RC,inpatient,GP,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,110.84,139.65,
PT E-STIM: STAGE III-IV WOUND,34900710,CDM,G0281,HCPCS,420,RC,inpatient,GP,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
PT AQUATIC THERAPY EA 15 MINUTES,34900725,CDM,97113,CPT,420,RC,inpatient,GP,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,230.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,260.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,230.72,290.7,
X RHC MAGNATHERM,34901000,CDM,97024,CPT,420,RC,inpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,18.1,22.8,
PT MOD 59 MECHANICAL TRACTION,34901005,CDM,97012,CPT,420,RC,inpatient,59,179,179,,151.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,134.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,152.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,157.52,88,,percent of total billed charges,,,,,,,,,136.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,146.78,82,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,134.97,170.05,
PT MECHANICAL TRACTION,34901009,CDM,97012,CPT,420,RC,inpatient,GP,179,179,,151.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,134.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,152.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,157.52,88,,percent of total billed charges,,,,,,,,,136.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,146.78,82,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,134.97,170.05,
PT HOT/COLD PACK,34901010,CDM,97010,CPT,420,RC,inpatient,GP,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,110.84,139.65,
"PT ORTHOTICS MGMT&TRNG, UE&LE, EA 15 MIN",34901025,CDM,97760,CPT,420,RC,inpatient,GP,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
"PT PROSTHETIC TRNG, UE & LE, EA 15 MIN",34901026,CDM,97761,CPT,420,RC,inpatient,GP,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
PT FUNCTIONAL THERAPEUTIC ACTIVITY,34901027,CDM,97530,CPT,420,RC,inpatient,GP,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
"PT SENSORY INTEGRATION TQS, EA 15 MIN",34901030,CDM,97533,CPT,420,RC,inpatient,GP,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,129.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,129.69,163.4,
"PT W/C MGT/PROPULSION TRNG, EA 15 MIN",34901031,CDM,97542,CPT,420,RC,inpatient,GP,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
"PT CKOUT ORTH/PROSTH USE,EST PT EA 15MIN",34901032,CDM,97763,CPT,420,RC,inpatient,GP,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,257.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,290.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,257.87,324.9,
"PT HOME INST, SELF CARE, ADLS/EA 15 MINS",34901033,CDM,97535,CPT,420,RC,inpatient,GP,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,186.99,235.6,
SM WORK HARDENING/CONDITIONING INT 2 HRS,34901034,CDM,97545,CPT,951,RC,inpatient,,562,562,,477.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,423.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,477.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,494.56,88,,percent of total billed charges,,,,,,,,,429.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,,,,,,,,,,,,,466.46,83,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,460.84,82,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,423.75,533.9,
PT WORK HARDENING/CONDITIONING INT 2 HRS,34901035,CDM,97545,CPT,420,RC,inpatient,GP,562,562,,477.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,423.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,477.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,494.56,88,,percent of total billed charges,,,,,,,,,429.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,,,,,,,,,,,,,466.46,83,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,460.84,82,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,423.75,533.9,
PT NONSELECTIVE DEBRIDEMENT,34901037,CDM,97602,CPT,420,RC,inpatient,GP,360,360,,305.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,271.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,306,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,316.8,88,,percent of total billed charges,,,,,,,,,275.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,327.6,91,,percent of total billed charges,,,342,95,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,,,,,,,,,,,,,298.8,83,,percent of total billed charges,,,342,95,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,295.2,82,,percent of total billed charges,,,324,90,,percent of total billed charges,,,306,85,,percent of total billed charges,,271.44,342,
"PT SELECTIVE DEBRIDEMENT,20 SQ CM OR LES",34901040,CDM,97597,CPT,420,RC,inpatient,GP,400,400,,339.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,301.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,340,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,352,88,,percent of total billed charges,,,,,,,,,305.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,364,91,,percent of total billed charges,,,380,95,,percent of total billed charges,,,332,83,,percent of total billed charges,,,332,83,,percent of total billed charges,,,,,,,,,,,,,,,332,83,,percent of total billed charges,,,380,95,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,328,82,,percent of total billed charges,,,360,90,,percent of total billed charges,,,340,85,,percent of total billed charges,,301.6,380,
"PT SELECTIVE DEBRIDEMENT, >20 SQ CM",34901042,CDM,97598,CPT,420,RC,inpatient,GP,501,501,,425.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440.88,88,,percent of total billed charges,,,,,,,,,382.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,,,,,,,,,,,,,415.83,83,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,410.82,82,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,377.75,475.95,
PT PAXTON IPA THERP EXERCISE EA 15 MIN,34901089,CDM,97110,CPT,420,RC,inpatient,GP,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
PT THERAPEUTIC EXERCISE EA 15 MIN,34901090,CDM,97110,CPT,420,RC,inpatient,GP,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
"PT THER EX EA 15 MIN, IPA U6",34901091,CDM,97110,CPT,420,RC,inpatient,GP,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,146.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,164.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,146.28,184.3,
PT COMM/WORK RE-INTEG. TRNG. EA 15 MIN,34901092,CDM,97537,CPT,420,RC,inpatient,GP,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,114.61,144.4,
PT MEPIFORM - 1 SHEET,34901126,CDM,,,270,RC,inpatient,,113,113,,95.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,99.44,88,,percent of total billed charges,,,,,,,,,86.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,92.66,82,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,85.2,107.35,
PT MOD 59 THERAPEUTIC ACTIVITY,34901127,CDM,97530,CPT,420,RC,inpatient,GP,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
*PT THERABAND PER YARD(V0708),34901173,CDM,,,270,RC,inpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,20.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,18.1,22.8,
PT MOD 59 THERAPEUTIC EXERCISE,34901190,CDM,97110,CPT,420,RC,inpatient,GP,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
PT CONTRAST BATH EA 15 MIN,34901199,CDM,97034,CPT,420,RC,inpatient,GP,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
PT MOD-59 MANUAL THERAPY,34901230,CDM,97140,CPT,420,RC,inpatient,GP,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
PT MANUAL THERAPY TQS EA 15 MIN,34901231,CDM,97140,CPT,420,RC,inpatient,XU,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
PT GROUP,34901235,CDM,97150,CPT,420,RC,inpatient,GP,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,81.43,102.6,
PT HIP STRAPPING W THCAP,34901305,CDM,29520,CPT,420,RC,inpatient,KX,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
PT ELBOW WRIST STRAPPING W THCAP,34901306,CDM,29260,CPT,420,RC,inpatient,KX,339,339,,287.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,255.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,288.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,298.32,88,,percent of total billed charges,,,,,,,,,259,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,308.49,91,,percent of total billed charges,,,322.05,95,,percent of total billed charges,,,281.37,83,,percent of total billed charges,,,281.37,83,,percent of total billed charges,,,,,,,,,,,,,,,281.37,83,,percent of total billed charges,,,322.05,95,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,277.98,82,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,288.15,85,,percent of total billed charges,,255.61,322.05,
PT TOE STRAPPING W THCAP,34901307,CDM,29550,CPT,420,RC,inpatient,KX,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,130.44,164.35,
PT HAND FINGER STRAPPING W THCAP,34901308,CDM,29280,CPT,420,RC,inpatient,KX,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,277.47,349.6,
PT KNEE STRAPPING W THCAP,34901309,CDM,29530,CPT,420,RC,inpatient,KX,405,405,,343.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,305.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,344.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,356.4,88,,percent of total billed charges,,,,,,,,,309.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,368.55,91,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,,,,,,,,,,,,,336.15,83,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,332.1,82,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,305.37,384.75,
PT SHOULDER STRAPPING W THCAP,34901310,CDM,29240,CPT,420,RC,inpatient,KX,405,405,,343.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,305.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,344.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,356.4,88,,percent of total billed charges,,,,,,,,,309.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,368.55,91,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,,,,,,,,,,,,,336.15,83,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,332.1,82,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,305.37,384.75,
PT ANKLESTRAPPING W THCAP,34901311,CDM,29540,CPT,420,RC,inpatient,KX,405,405,,343.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,305.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,344.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,356.4,88,,percent of total billed charges,,,,,,,,,309.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,368.55,91,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,,,,,,,,,,,,,336.15,83,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,332.1,82,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,305.37,384.75,
PT BIOFEEDBACK TRAINING W THCAP,34901312,CDM,90901,CPT,420,RC,inpatient,KX,235,235,,199.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,177.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,199.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,206.8,88,,percent of total billed charges,,,,,,,,,179.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,213.85,91,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,,,,,,,,,,,,,195.05,83,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,192.7,82,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,199.75,85,,percent of total billed charges,,177.19,223.25,
"PT BIOFEEDBACK, PERI/URO/RECTAL W THCAP",34901313,CDM,90912,CPT,420,RC,inpatient,KX,230,230,,195.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,173.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,195.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,202.4,88,,percent of total billed charges,,,,,,,,,175.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,209.3,91,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,,,,,,,,,,,,,190.9,83,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,188.6,82,,percent of total billed charges,,,207,90,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,173.42,218.5,
PT RE-EVALUATION W THCAP,34901315,CDM,97002,CPT,424,RC,inpatient,KX,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
PT HOT/COLD PACK W THCAP,34901316,CDM,97010,CPT,420,RC,inpatient,KX,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,110.84,139.65,
PT MECHANICAL TRACTION W THCAP,34901317,CDM,97012,CPT,420,RC,inpatient,KX,179,179,,151.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,134.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,152.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,157.52,88,,percent of total billed charges,,,,,,,,,136.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,146.78,82,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,134.97,170.05,
PT ELEC STIM (UNATTENDED) W THCAP,34901318,CDM,97014,CPT,420,RC,inpatient,KX,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,132.7,167.2,
PT VASOPNEUMATIC DEVICE W THCAP,34901319,CDM,97016,CPT,420,RC,inpatient,KX,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,99.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,112.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,99.53,125.4,
PT PARAFFIN BATH I W THCAP,34901320,CDM,97018,CPT,420,RC,inpatient,KX,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
PT WHIRLPOOL SUPERVISED/UNATTED W THCAP,34901321,CDM,97022,CPT,420,RC,inpatient,KX,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,200.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,226.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,200.56,252.7,
"PT ELEICAL STIM ATTED, EA 15 MIN W THCAP",34901322,CDM,97032,CPT,420,RC,inpatient,KX,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,116.12,146.3,
PT IONTOPHORESIS EA 15 MIN W THCAP,34901323,CDM,97033,CPT,420,RC,inpatient,KX,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,174.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,174.17,219.45,
PT CONTRAST BATH EA 15 MIN W THCAP,34901324,CDM,97034,CPT,420,RC,inpatient,KX,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
PT ULTRASOUND/PHONOP EA 15 MIN W THCAP,34901325,CDM,97035,CPT,420,RC,inpatient,KX,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
PT THERAPEUTIC EXERISE EA 15 MIN W THCAP,34901326,CDM,97110,CPT,420,RC,inpatient,KX,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
PT NEUROMUSC RE-ED EA 15 MIN W THCAP,34901327,CDM,97112,CPT,420,RC,inpatient,KX,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,179.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,202.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,179.45,226.1,
PT AQUATIC THERAPY EA 15 MINUTES W THCAP,34901328,CDM,97113,CPT,420,RC,inpatient,KX,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,230.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,260.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,230.72,290.7,
PT GAIT TRAINING EA 15 MIN W THCAP,34901329,CDM,97116,CPT,420,RC,inpatient,KX,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,153.06,192.85,
PT MANUAL THERAPY TQS EA 15 MIN W THCAP,34901330,CDM,97140,CPT,420,RC,inpatient,KX,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
PT FUNCTIONAL THERAUTIC ACTIVITY W THCAP,34901331,CDM,97530,CPT,420,RC,inpatient,KX,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
"PT SENY INTEGTION TQS, EA 15 MIN W THCAP",34901332,CDM,97533,CPT,420,RC,inpatient,KX,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,129.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,146.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,129.69,163.4,
"PT HE INST, SELF CE, /EA 15 MINS W THCAP",34901333,CDM,97535,CPT,420,RC,inpatient,KX,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,186.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,210.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,186.99,235.6,
PT COM/WK RE-ING. TRG. EA 15 MIN W THCAP,34901334,CDM,97537,CPT,420,RC,inpatient,KX,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,129.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,114.61,144.4,
"PT W/C MGT/PRON TRNG, EA 15 MIN W THCAP",34901335,CDM,97542,CPT,420,RC,inpatient,KX,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,136.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,153.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,136.47,171.95,
PT WORK HARING/CONNING INT 2 HRS W THCAP,34901336,CDM,97545,CPT,420,RC,inpatient,KX,562,562,,477.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,423.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,477.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,494.56,88,,percent of total billed charges,,,,,,,,,429.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,,,,,,,,,,,,,466.46,83,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,460.84,82,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,423.75,533.9,
PT WORK HARDNG/CONING EA DTL HR W THCAP,34901337,CDM,97546,CPT,420,RC,inpatient,KX,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,217.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,245.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,217.91,274.55,
PT PHY PM TEST/MEARE EA 15 MIN W THCAP,34901338,CDM,97750,CPT,420,RC,inpatient,KX,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,203.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,180.21,227.05,
"PT ORTH MT&TRG, UE&LE, EA 15 MIN W THCAP",34901339,CDM,97760,CPT,420,RC,inpatient,KX,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
"PT PRIC TRNG, UE & LE, EA 15 MIN W THCAP",34901340,CDM,97761,CPT,420,RC,inpatient,KX,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
"PT COT OH/PRO USE,ET PT EA 15MIN W THCAP",34901341,CDM,97763,CPT,420,RC,inpatient,KX,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,257.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,290.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,257.87,324.9,
PT MEDIE ELEC STIM (UNATTENDED) W THCAP,34901342,CDM,G0283,HCPCS,420,RC,inpatient,KX,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,110.84,139.65,
PT NEUROMUSC RE-ED EA 15 MIN,34901390,CDM,97112,CPT,420,RC,inpatient,GP,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,179.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,202.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,179.45,226.1,
PT EVAL LOW COMPLEX W THCAP,34901400,CDM,97161,CPT,424,RC,inpatient,KX,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,294.06,370.5,
PT EVAL LOW COMPLEX,34901401,CDM,97161,CPT,424,RC,inpatient,GP,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,294.06,370.5,
PT IPA EVAL LOW COMPLEX,34901402,CDM,97161,CPT,424,RC,inpatient,GP,88,88,,74.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.44,88,,percent of total billed charges,,,,,,,,,67.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,,,,,,,,,,,,,73.04,83,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,72.16,82,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,66.35,83.6,
PT PAXTON IPA EVAL LOW COMPLEX,34901403,CDM,97161,CPT,420,RC,inpatient,GP,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,76.91,96.9,
PT EVAL MOD COMPLEX W THCAP,34901404,CDM,97162,CPT,424,RC,inpatient,KX,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,294.06,370.5,
PT EVAL MOD COMPLEX,34901405,CDM,97162,CPT,424,RC,inpatient,GP,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,294.06,370.5,
PT IPA EVAL MOD COMPLEX,34901406,CDM,97162,CPT,424,RC,inpatient,GP,88,88,,74.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.44,88,,percent of total billed charges,,,,,,,,,67.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,,,,,,,,,,,,,73.04,83,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,72.16,82,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,66.35,83.6,
PT PAXTON IPA EVAL MOD COMPLEX,34901407,CDM,97162,CPT,420,RC,inpatient,GP,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,76.91,96.9,
PT EVAL HIGH COMPLEX W THCAP,34901408,CDM,97163,CPT,424,RC,inpatient,KX,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,294.06,370.5,
PT EVAL HIGH COMPLEX,34901409,CDM,97163,CPT,424,RC,inpatient,GP,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,294.06,370.5,
PT IPA EVAL HIGH COMPLEX,34901410,CDM,97163,CPT,424,RC,inpatient,GP,88,88,,74.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,66.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,74.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,77.44,88,,percent of total billed charges,,,,,,,,,67.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,,,,,,,,,,,,,73.04,83,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,72.16,82,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,66.35,83.6,
PT PAXTON IPA EVAL HIGH COMPLEX,34901411,CDM,97163,CPT,420,RC,inpatient,GP,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,76.91,96.9,
PT MOD 59 RE-EVAL EST PLAN CARE,34901412,CDM,97164,CPT,424,RC,inpatient,GP,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
PT RE-EVALUATION EST PLAN CARE,34901413,CDM,97164,CPT,424,RC,inpatient,GP,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,294.06,370.5,
PT RE-EVAL EST PLAN CARE W THCAP,34901414,CDM,97164,CPT,424,RC,inpatient,KX,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
PT PARAFFIN BATH I,34901504,CDM,97018,CPT,420,RC,inpatient,GP,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
PT VASOPNEUMATIC DEVICE,34901510,CDM,97016,CPT,420,RC,inpatient,GP,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,99.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,112.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,99.53,125.4,
PT HEEL LIFT,34901615,CDM,,,270,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
PT OVERDOOR PULLEYS,34901645,CDM,,,270,RC,inpatient,,74,74,,62.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,55.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,62.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,65.12,88,,percent of total billed charges,,,,,,,,,56.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,,,,,,,,,,,,,61.42,83,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,60.68,82,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,55.8,70.3,
PT THERAPY BALL 45 CM,34901675,CDM,,,270,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
PT THERAPY BALL 55 CM,34901676,CDM,,,270,RC,inpatient,,74,74,,62.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,55.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,62.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,65.12,88,,percent of total billed charges,,,,,,,,,56.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,,,,,,,,,,,,,61.42,83,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,60.68,82,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,55.8,70.3,
PT THERAPY BALL 65 CM,34901677,CDM,,,270,RC,inpatient,,86,86,,73.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,73.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,75.68,88,,percent of total billed charges,,,,,,,,,65.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,78.26,91,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,,,,,,,,,,,,,71.38,83,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,70.52,82,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,64.84,81.7,
PT THERAPY BALL 75 CM,34901678,CDM,,,270,RC,inpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,77.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,87.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,77.66,97.85,
PT GAIT TRAINING EA 15 MIN THERAPY ASSIS,34901700,CDM,97116,CPT,420,RC,inpatient,CQ,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,153.06,192.85,
PT THERAPEUTIC EXERCISE EA 15 MIN THER A,34901701,CDM,97110,CPT,420,RC,inpatient,CQ,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
PT NEUROMUSC RE-ED EA 15 MIN THERAPY AS,34901702,CDM,97112,CPT,420,RC,inpatient,CQ,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,179.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,202.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,179.45,226.1,
PT FUNCTIONAL THERAPEUTIC ACTIVITY THER,34901703,CDM,97530,CPT,420,RC,inpatient,CQ,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
PT MANUAL THERAPY TQS EA 15 MIN THERAPY,34901704,CDM,97140,CPT,420,RC,inpatient,CQ,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
PT ULTRASOUND/PHONOP EA 15 MIN,34901801,CDM,97035,CPT,420,RC,inpatient,GP,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
PT WHIRLPOOL SUPERVISED/UNATTENDED,34902007,CDM,97022,CPT,420,RC,inpatient,GP,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,200.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,226.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,200.56,252.7,
APPLICATION MODALITY DIATHERMY,34902010,CDM,97024,CPT,420,RC,inpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,119.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,135.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,119.89,151.05,
PT UNLIST MODALITY SPEC TYPE&TIME CONSTA,34902020,CDM,97039,CPT,420,RC,inpatient,GP,167,167,,141.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,125.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,141.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,146.96,88,,percent of total billed charges,,,,,,,,,127.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,,,,,,,,,,,,,138.61,83,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,136.94,82,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,125.92,158.65,
PT UNLISTED MODALITY EA 15 MIN,34903104,CDM,97139,CPT,420,RC,inpatient,GP,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
PT GAIT TRAINING EA 15 MIN,34903302,CDM,97116,CPT,420,RC,inpatient,GP,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,153.06,192.85,
"PT ELECTRICAL STIM ATTENDED, EA 15 MIN",34905002,CDM,97032,CPT,420,RC,inpatient,GP,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,116.12,146.3,
PT STRAPPING - SHOULDER,34905111,CDM,29240,CPT,420,RC,inpatient,GP,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,191.84,88,,percent of total billed charges,,,,,,,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,164.37,207.1,
PT STRAPPING - ANKLE,34905116,CDM,29540,CPT,420,RC,inpatient,GP,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,130.44,164.35,
* TENS APPLICATION (V0904),34905118,CDM,64550,CPT,420,RC,inpatient,GP,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,58.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,66.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,58.81,74.1,
PT IONTOPHORESIS EA 15 MIN,34907204,CDM,97033,CPT,420,RC,inpatient,GP,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,174.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,174.17,219.45,
SM ATHLETIC TRAINING EVALUATION,34907500,CDM,97005,CPT,951,RC,inpatient,,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,353.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,398.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,353.63,445.55,
SM ATHLETIC TRAINING RE-EVALUATION,34907505,CDM,97006,CPT,951,RC,inpatient,,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,353.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,398.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,353.63,445.55,
SM AQUATIC THERAPY EA 15 MINUTES,34907510,CDM,97113,CPT,951,RC,inpatient,,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,230.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,260.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,230.72,290.7,
SM BIOFEEDBACK TRAINING,34907515,CDM,90901,CPT,951,RC,inpatient,,235,235,,199.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,177.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,199.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,206.8,88,,percent of total billed charges,,,,,,,,,179.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,213.85,91,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,,,,,,,,,,,,,195.05,83,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,192.7,82,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,199.75,85,,percent of total billed charges,,177.19,223.25,
SM CONTRAST BATH EA 15 MINUTES,34907520,CDM,97034,CPT,951,RC,inpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
SM ELECTICAL STIMULATION (UNATTENDED),34907525,CDM,97014,CPT,951,RC,inpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,132.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,149.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,132.7,167.2,
SM ELECTRICAL STIM ATTENDED EA 15 MIN,34907527,CDM,97032,CPT,951,RC,inpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,116.12,146.3,
SM FUNCTIONAL THERA ACT EA 15 MIN,34907530,CDM,97530,CPT,951,RC,inpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,188.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,212.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,188.5,237.5,
SM GAIT TRAINING EA 15 MINUTES,34907535,CDM,97116,CPT,951,RC,inpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,153.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,172.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,153.06,192.85,
SM GROUP,34907538,CDM,97150,CPT,951,RC,inpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,81.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,81.43,102.6,
SM IONTOPHORESIS EA 15 MINUTES,34907540,CDM,97033,CPT,951,RC,inpatient,,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,174.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,174.17,219.45,
SM MANUAL THER TQS EA 15 MINUTES,34907545,CDM,97140,CPT,951,RC,inpatient,,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
SM MECHANICAL TRACTION,34907550,CDM,97012,CPT,951,RC,inpatient,,179,179,,151.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,134.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,152.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,157.52,88,,percent of total billed charges,,,,,,,,,136.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,146.78,82,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,134.97,170.05,
SM NEUROMUSC RE-ED EA 15 MINUTES,34907555,CDM,97112,CPT,951,RC,inpatient,,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,179.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,202.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,179.45,226.1,
"SM ORTHOTIC MGT&TRNG, UE&LE, EA 15 MIN",34907560,CDM,97760,CPT,951,RC,inpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
"SM CKOUT FOR ORTHOTIC USE, EST PT, 15 MN",34907562,CDM,97763,CPT,951,RC,inpatient,,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,257.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,290.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,257.87,324.9,
SM PARAFFIN BATH I,34907565,CDM,97018,CPT,951,RC,inpatient,,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
SM VASOPNEUMATIC DEVICE,34907567,CDM,97016,CPT,951,RC,inpatient,,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,99.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,112.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,99.53,125.4,
SM PHY PERFORM TEST/MEAS EA 15 MIN,34907570,CDM,97750,CPT,951,RC,inpatient,,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,203.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,180.21,227.05,
PHYSICAL PERFORMANCE TEST 30 MIN FCE,34907575,CDM,97750,CPT,420,RC,inpatient,GP,344,344,,292.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,259.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,292.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,302.72,88,,percent of total billed charges,,,,,,,,,262.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,313.04,91,,percent of total billed charges,,,326.8,95,,percent of total billed charges,,,285.52,83,,percent of total billed charges,,,285.52,83,,percent of total billed charges,,,,,,,,,,,,,,,285.52,83,,percent of total billed charges,,,326.8,95,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,282.08,82,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,292.4,85,,percent of total billed charges,,259.38,326.8,
SM STRAPPING - SHOULDER,34907578,CDM,29240,CPT,951,RC,inpatient,,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,191.84,88,,percent of total billed charges,,,,,,,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,164.37,207.1,
SM STRAPPING - TOES,34907580,CDM,29550,CPT,951,RC,inpatient,,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,130.44,164.35,
SM THERAPEUTIC EXERCISE EA 15 MIN,34907595,CDM,97110,CPT,951,RC,inpatient,,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,193.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,171.91,216.6,
SM ULTRASOUND/PHONOP EA 15 MIN,34907600,CDM,97035,CPT,951,RC,inpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
SM UNLISTED MODALITY EA 15 MIN,34907605,CDM,97139,CPT,951,RC,inpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
SM WHIRLPOOL SUPERVISED/UNATTENDED,34907610,CDM,97022,CPT,951,RC,inpatient,,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,200.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,226.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,200.56,252.7,
SM ELBOW WRIST STRAPPING,34990000,CDM,29260,CPT,951,RC,inpatient,,410,410,,348.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,309.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,348.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,360.8,88,,percent of total billed charges,,,,,,,,,313.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,373.1,91,,percent of total billed charges,,,389.5,95,,percent of total billed charges,,,340.3,83,,percent of total billed charges,,,340.3,83,,percent of total billed charges,,,,,,,,,,,,,,,340.3,83,,percent of total billed charges,,,389.5,95,,percent of total billed charges,,,369,90,,percent of total billed charges,,,369,90,,percent of total billed charges,,,336.2,82,,percent of total billed charges,,,369,90,,percent of total billed charges,,,348.5,85,,percent of total billed charges,,309.14,389.5,
SM HAND FINGER STRAPPING,34990001,CDM,29280,CPT,951,RC,inpatient,,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,277.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,312.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,277.47,349.6,
SM HIP STRAPPING,34990002,CDM,29520,CPT,951,RC,inpatient,,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,228.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,257.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,228.46,287.85,
SM KNEE STRAPPING,34990003,CDM,29530,CPT,951,RC,inpatient,,432,432,,366.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,325.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,367.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,380.16,88,,percent of total billed charges,,,,,,,,,330.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,393.12,91,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,,,,,,,,,,,,,358.56,83,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,354.24,82,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,325.73,410.4,
SM ANKLESTRAPPING,34990004,CDM,29540,CPT,951,RC,inpatient,,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,130.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,147.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,130.44,164.35,
SM SHOULDER STRAPPING,34990006,CDM,29240,CPT,951,RC,inpatient,,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,191.84,88,,percent of total billed charges,,,,,,,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,164.37,207.1,
SM HOT/COLD PACK,34997650,CDM,97010,CPT,951,RC,inpatient,GP,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,110.84,139.65,
OT FINGER SPLINT,35200400,CDM,,,270,RC,inpatient,,44,44,,37.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,33.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,37.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,38.72,88,,percent of total billed charges,,,,,,,,,33.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,36.08,82,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,33.18,41.8,
OT HAND SPLINT,35200401,CDM,,,270,RC,inpatient,,79,79,,67.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,59.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,67.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,69.52,88,,percent of total billed charges,,,,,,,,,60.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,,,,,,,,,,,,,65.57,83,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,64.78,82,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,59.57,75.05,
OT WRIST SPLINT,35200402,CDM,,,270,RC,inpatient,,113,113,,95.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,99.44,88,,percent of total billed charges,,,,,,,,,86.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,92.66,82,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,85.2,107.35,
OT ELBOW SPLINT,35200403,CDM,,,270,RC,inpatient,,190,190,,161.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,143.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,161.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,167.2,88,,percent of total billed charges,,,,,,,,,145.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,,,,,,,,,,,,,157.7,83,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,155.8,82,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,143.26,180.5,
OT UE SPLINT,35200404,CDM,,,270,RC,inpatient,,350,350,,297.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,263.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,297.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,308,88,,percent of total billed charges,,,,,,,,,267.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,318.5,91,,percent of total billed charges,,,332.5,95,,percent of total billed charges,,,290.5,83,,percent of total billed charges,,,290.5,83,,percent of total billed charges,,,,,,,,,,,,,,,290.5,83,,percent of total billed charges,,,332.5,95,,percent of total billed charges,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,287,82,,percent of total billed charges,,,315,90,,percent of total billed charges,,,297.5,85,,percent of total billed charges,,263.9,332.5,
OT HOT/COLD PACK W THCAP,35901313,CDM,97010,CPT,430,RC,inpatient,KX,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,110.84,139.65,
OT AQUATIC THERAPY EA 15 MINUTES,35910008,CDM,97113,CPT,430,RC,inpatient,GO,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,230.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,260.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,230.72,290.7,
OT AQUATIC THERAPY EA 15 MINUTES W THCAP,35910009,CDM,97113,CPT,430,RC,inpatient,KX,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,230.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,260.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,230.72,290.7,
OT HOT/COLD PACK,35990750,CDM,97010,CPT,430,RC,inpatient,GO,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,110.84,139.65,
E-STIM,81000500,CDM,G0281,HCPCS,761,RC,inpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,110.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,124.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,110.08,138.7,
FOLLOW-UP ASSESSMENT 0-60 MIN LEVEL 1,13900001,CDM,G0463,HCPCS,510,RC,inpatient,PO,54,54,,45.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,40.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,45.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,47.52,88,,percent of total billed charges,,,,,,,,,41.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,49.14,91,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,,,,,,,,,,,,,44.82,83,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,44.28,82,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,40.72,51.3,
FOLLOW-UP ASSESSMENT 0-60 MIN LEVEL 2,13900002,CDM,G0463,HCPCS,510,RC,inpatient,PO,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
FOLLOW-UP ASSESSMENT 0-60 MIN LEVEL 3,13900003,CDM,G0463,HCPCS,510,RC,inpatient,PO,97,97,,82.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,73.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,82.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,85.36,88,,percent of total billed charges,,,,,,,,,74.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,,,,,,,,,,,,,80.51,83,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,79.54,82,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,73.14,92.15,
FOLLOW-UP ASSESSMENT 0-60 MIN LEVEL 4,13900004,CDM,G0463,HCPCS,510,RC,inpatient,PO,134,134,,113.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,101.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,113.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,117.92,88,,percent of total billed charges,,,,,,,,,102.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,121.94,91,,percent of total billed charges,,,127.3,95,,percent of total billed charges,,,111.22,83,,percent of total billed charges,,,111.22,83,,percent of total billed charges,,,,,,,,,,,,,,,111.22,83,,percent of total billed charges,,,127.3,95,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,109.88,82,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,113.9,85,,percent of total billed charges,,101.04,127.3,
FOLLOW-UP ASSESSMENT 0-60 MIN LEVEL 5,13900005,CDM,G0463,HCPCS,510,RC,inpatient,PO,161,161,,136.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,121.39,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,136.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,141.68,88,,percent of total billed charges,,,,,,,,,123,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,132.02,82,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,121.39,152.95,
EUFLEXXA INJ PER DOSE,13900050,CDM,J7323,HCPCS,636,RC,inpatient,,1791,1791,,1520.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1350.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1522.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1576.08,88,,percent of total billed charges,,261.77,,,,fee schedule,,,1368.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,261.77,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1629.81,91,,percent of total billed charges,,,1701.45,95,,percent of total billed charges,,,1486.53,83,,percent of total billed charges,,,1486.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1486.53,83,,percent of total billed charges,,,1701.45,95,,percent of total billed charges,,,1611.9,90,,percent of total billed charges,,,1611.9,90,,percent of total billed charges,,,1468.62,82,,percent of total billed charges,,,1611.9,90,,percent of total billed charges,,,1522.35,85,,percent of total billed charges,,261.77,1701.45,
SYNVISC OR SYNVISC-ONE INJ PER DOSE,13900051,CDM,J7325,HCPCS,636,RC,inpatient,,1696,1696,,1439.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1278.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1441.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1492.48,88,,percent of total billed charges,,973.06,,,,fee schedule,,,1295.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,973.06,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1543.36,91,,percent of total billed charges,,,1611.2,95,,percent of total billed charges,,,1407.68,83,,percent of total billed charges,,,1407.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1407.68,83,,percent of total billed charges,,,1611.2,95,,percent of total billed charges,,,1526.4,90,,percent of total billed charges,,,1526.4,90,,percent of total billed charges,,,1390.72,82,,percent of total billed charges,,,1526.4,90,,percent of total billed charges,,,1441.6,85,,percent of total billed charges,,973.06,1611.2,
METHYLPREDNISOLONE INJ PER DOSE,13900052,CDM,J1030,HCPCS,636,RC,inpatient,,92,92,,78.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,69.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,78.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,80.96,88,,percent of total billed charges,,29.81,,,,fee schedule,,,70.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,29.81,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,,,,,,,,,,,,,76.36,83,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,75.44,82,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,29.81,87.4,
TRIAMCINOLONE ACET INJ NOS,13900053,CDM,J3301,HCPCS,636,RC,inpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,194.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,219.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,227.04,88,,percent of total billed charges,,17.47,,,,fee schedule,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,17.47,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,17.47,245.1,
HYALURONAN GEL-ONE,13900054,CDM,J7326,HCPCS,636,RC,inpatient,,3771,3771,,3201.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2843.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3205.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3318.48,88,,percent of total billed charges,,984.46,,,,fee schedule,,,2881.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,984.46,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3431.61,91,,percent of total billed charges,,,3582.45,95,,percent of total billed charges,,,3129.93,83,,percent of total billed charges,,,3129.93,83,,percent of total billed charges,,,,,,,,,,,,,,,3129.93,83,,percent of total billed charges,,,3582.45,95,,percent of total billed charges,,,3393.9,90,,percent of total billed charges,,,3393.9,90,,percent of total billed charges,,,3092.22,82,,percent of total billed charges,,,3393.9,90,,percent of total billed charges,,,3205.35,85,,percent of total billed charges,,984.46,3582.45,
X DRAIN/INJ MINOR JT/BURSA LT,24200005,CDM,20605,CPT,360,RC,inpatient,LT,1974,1974,,1675.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1488.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1677.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1737.12,88,,percent of total billed charges,,,,,,,,,1508.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1796.34,91,,percent of total billed charges,,,1875.3,95,,percent of total billed charges,,,1638.42,83,,percent of total billed charges,,,1638.42,83,,percent of total billed charges,,,,,,,,,,,,,,,1638.42,83,,percent of total billed charges,,,1875.3,95,,percent of total billed charges,,,1776.6,90,,percent of total billed charges,,,1776.6,90,,percent of total billed charges,,,1618.68,82,,percent of total billed charges,,,1776.6,90,,percent of total billed charges,,,1677.9,85,,percent of total billed charges,,1488.4,1875.3,
X DRAIN/INJ MINOR JT/BURSA RT,24200006,CDM,20605,CPT,360,RC,inpatient,RT,1974,1974,,1675.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1488.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1677.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1737.12,88,,percent of total billed charges,,,,,,,,,1508.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1796.34,91,,percent of total billed charges,,,1875.3,95,,percent of total billed charges,,,1638.42,83,,percent of total billed charges,,,1638.42,83,,percent of total billed charges,,,,,,,,,,,,,,,1638.42,83,,percent of total billed charges,,,1875.3,95,,percent of total billed charges,,,1776.6,90,,percent of total billed charges,,,1776.6,90,,percent of total billed charges,,,1618.68,82,,percent of total billed charges,,,1776.6,90,,percent of total billed charges,,,1677.9,85,,percent of total billed charges,,1488.4,1875.3,
X DRAIN/INJ MINOR JT/BURSA BIL,24200007,CDM,20605,CPT,360,RC,inpatient,50,3947,3947,,3351,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2976.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3354.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3473.36,88,,percent of total billed charges,,,,,,,,,3015.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3591.77,91,,percent of total billed charges,,,3749.65,95,,percent of total billed charges,,,3276.01,83,,percent of total billed charges,,,3276.01,83,,percent of total billed charges,,,,,,,,,,,,,,,3276.01,83,,percent of total billed charges,,,3749.65,95,,percent of total billed charges,,,3552.3,90,,percent of total billed charges,,,3552.3,90,,percent of total billed charges,,,3236.54,82,,percent of total billed charges,,,3552.3,90,,percent of total billed charges,,,3354.95,85,,percent of total billed charges,,2976.04,3749.65,
X DRAIN/INJ MAJOR JT/BURSA LT,24200008,CDM,20610,CPT,320,RC,inpatient,LT,2349,2349,,1994.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1771.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1996.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2067.12,88,,percent of total billed charges,,,,,,,,,1794.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2137.59,91,,percent of total billed charges,,,2231.55,95,,percent of total billed charges,,,1949.67,83,,percent of total billed charges,,,1949.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1949.67,83,,percent of total billed charges,,,2231.55,95,,percent of total billed charges,,,2114.1,90,,percent of total billed charges,,,2114.1,90,,percent of total billed charges,,,1926.18,82,,percent of total billed charges,,,2114.1,90,,percent of total billed charges,,,1996.65,85,,percent of total billed charges,,1771.15,2231.55,
X DRAIN/INJ MAJOR JT/BURSA RT,24200009,CDM,20610,CPT,320,RC,inpatient,RT,2349,2349,,1994.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1771.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1996.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2067.12,88,,percent of total billed charges,,,,,,,,,1794.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2137.59,91,,percent of total billed charges,,,2231.55,95,,percent of total billed charges,,,1949.67,83,,percent of total billed charges,,,1949.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1949.67,83,,percent of total billed charges,,,2231.55,95,,percent of total billed charges,,,2114.1,90,,percent of total billed charges,,,2114.1,90,,percent of total billed charges,,,1926.18,82,,percent of total billed charges,,,2114.1,90,,percent of total billed charges,,,1996.65,85,,percent of total billed charges,,1771.15,2231.55,
X MANDIBLE 4V+,26100024,CDM,70110,CPT,320,RC,inpatient,TC,680,680,,577.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,512.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,578,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,598.4,88,,percent of total billed charges,,,,,,,,,519.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,618.8,91,,percent of total billed charges,,,646,95,,percent of total billed charges,,,564.4,83,,percent of total billed charges,,,564.4,83,,percent of total billed charges,,,,,,,,,,,,,,,564.4,83,,percent of total billed charges,,,646,95,,percent of total billed charges,,,612,90,,percent of total billed charges,,,612,90,,percent of total billed charges,,,557.6,82,,percent of total billed charges,,,612,90,,percent of total billed charges,,,578,85,,percent of total billed charges,,512.72,646,
X TMJ RT,26100030,CDM,70328,CPT,320,RC,inpatient,RT,363,363,,308.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,273.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,308.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,319.44,88,,percent of total billed charges,,,,,,,,,277.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,330.33,91,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,,,,,,,,,,,,,301.29,83,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,297.66,82,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,273.7,344.85,
X TMJ LT,26100031,CDM,70328,CPT,320,RC,inpatient,LT,363,363,,308.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,273.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,308.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,319.44,88,,percent of total billed charges,,,,,,,,,277.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,330.33,91,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,,,,,,,,,,,,,301.29,83,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,297.66,82,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,273.7,344.85,
X TMJ BILATERAL,26100032,CDM,70330,CPT,320,RC,inpatient,TC,729,729,,618.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,549.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,619.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,641.52,88,,percent of total billed charges,,,,,,,,,556.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,663.39,91,,percent of total billed charges,,,692.55,95,,percent of total billed charges,,,605.07,83,,percent of total billed charges,,,605.07,83,,percent of total billed charges,,,,,,,,,,,,,,,605.07,83,,percent of total billed charges,,,692.55,95,,percent of total billed charges,,,656.1,90,,percent of total billed charges,,,656.1,90,,percent of total billed charges,,,597.78,82,,percent of total billed charges,,,656.1,90,,percent of total billed charges,,,619.65,85,,percent of total billed charges,,549.67,692.55,
X SINUS 3V+,26100040,CDM,70220,CPT,320,RC,inpatient,TC,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,589.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,664.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,589.63,742.9,
X MASTOIDS 3V+,26100057,CDM,70130,CPT,320,RC,inpatient,TC,500,500,,424.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440,88,,percent of total billed charges,,,,,,,,,382,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,415,83,,percent of total billed charges,,,,,,,,,,,,,,,415,83,,percent of total billed charges,,,475,95,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,410,82,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,377,475,
X NASAL BONES 3V+,26100065,CDM,70160,CPT,320,RC,inpatient,TC,498,498,,422.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,375.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,423.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,438.24,88,,percent of total billed charges,,,,,,,,,380.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,,,,,,,,,,,,,413.34,83,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,408.36,82,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,375.49,473.1,
X FACIAL BONES 3V+,26100073,CDM,70150,CPT,320,RC,inpatient,TC,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,589.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,664.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,589.63,742.9,
X FACIAL BONES 1-2V,26100081,CDM,70140,CPT,320,RC,inpatient,,456,456,,387.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,343.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,387.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,401.28,88,,percent of total billed charges,,,,,,,,,348.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,414.96,91,,percent of total billed charges,,,433.2,95,,percent of total billed charges,,,378.48,83,,percent of total billed charges,,,378.48,83,,percent of total billed charges,,,,,,,,,,,,,,,378.48,83,,percent of total billed charges,,,433.2,95,,percent of total billed charges,,,410.4,90,,percent of total billed charges,,,410.4,90,,percent of total billed charges,,,373.92,82,,percent of total billed charges,,,410.4,90,,percent of total billed charges,,,387.6,85,,percent of total billed charges,,343.82,433.2,
X ORBITS 4V+,26100107,CDM,70200,CPT,320,RC,inpatient,TC,656,656,,556.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,494.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,557.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,577.28,88,,percent of total billed charges,,,,,,,,,501.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,596.96,91,,percent of total billed charges,,,623.2,95,,percent of total billed charges,,,544.48,83,,percent of total billed charges,,,544.48,83,,percent of total billed charges,,,,,,,,,,,,,,,544.48,83,,percent of total billed charges,,,623.2,95,,percent of total billed charges,,,590.4,90,,percent of total billed charges,,,590.4,90,,percent of total billed charges,,,537.92,82,,percent of total billed charges,,,590.4,90,,percent of total billed charges,,,557.6,85,,percent of total billed charges,,494.62,623.2,
X SKULL 4V+,26100115,CDM,70260,CPT,320,RC,inpatient,TC,811,811,,688.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,611.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,689.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,713.68,88,,percent of total billed charges,,,,,,,,,619.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,738.01,91,,percent of total billed charges,,,770.45,95,,percent of total billed charges,,,673.13,83,,percent of total billed charges,,,673.13,83,,percent of total billed charges,,,,,,,,,,,,,,,673.13,83,,percent of total billed charges,,,770.45,95,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,665.02,82,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,689.35,85,,percent of total billed charges,,611.49,770.45,
X SHOULDER RIGHT 2V+,26100123,CDM,73030,CPT,320,RC,inpatient,RT,530,530,,449.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466.4,88,,percent of total billed charges,,,,,,,,,404.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,,,,,,,,,,,,,439.9,83,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,434.6,82,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,399.62,503.5,
X SHOULDER LEFT 2V+,26100124,CDM,73030,CPT,320,RC,inpatient,LT,530,530,,449.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,399.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,450.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,466.4,88,,percent of total billed charges,,,,,,,,,404.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,,,,,,,,,,,,,439.9,83,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,434.6,82,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,399.62,503.5,
X ELBOW RIGHT 3V+,26100131,CDM,73080,CPT,320,RC,inpatient,RT,511,511,,433.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,385.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,434.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,449.68,88,,percent of total billed charges,,,,,,,,,390.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,465.01,91,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,,,,,,,,,,,,,424.13,83,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,419.02,82,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,385.29,485.45,
X ELBOW LEFT 3V+,26100132,CDM,73080,CPT,320,RC,inpatient,LT,511,511,,433.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,385.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,434.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,449.68,88,,percent of total billed charges,,,,,,,,,390.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,465.01,91,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,,,,,,,,,,,,,424.13,83,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,419.02,82,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,385.29,485.45,
X CLAVICLE RIGHT 2V+,26100149,CDM,73000,CPT,320,RC,inpatient,RT,437,437,,371.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,329.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,371.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,384.56,88,,percent of total billed charges,,,,,,,,,333.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,397.67,91,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,,,,,,,,,,,,,362.71,83,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,358.34,82,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,329.5,415.15,
X CLAVICLE LEFT 2V+,26100150,CDM,73000,CPT,320,RC,inpatient,LT,437,437,,371.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,329.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,371.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,384.56,88,,percent of total billed charges,,,,,,,,,333.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,397.67,91,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,,,,,,,,,,,,,362.71,83,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,358.34,82,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,329.5,415.15,
X HUMERUS RIGHT 2V+,26100156,CDM,73060,CPT,320,RC,inpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X HUMERUS LEFT 2V+,26100157,CDM,73060,CPT,320,RC,inpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X SCAPULA RIGHT 2V+,26100164,CDM,73010,CPT,320,RC,inpatient,RT,482,482,,409.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,363.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,409.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,424.16,88,,percent of total billed charges,,,,,,,,,368.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,438.62,91,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,,,,,,,,,,,,,400.06,83,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,395.24,82,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,363.43,457.9,
X FOREARM RIGHT 2V+,26100172,CDM,73090,CPT,320,RC,inpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X FOREARM LEFT 2V+,26100173,CDM,73090,CPT,320,RC,inpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X WRIST RIGHT 3V+,26100180,CDM,73110,CPT,320,RC,inpatient,RT,500,500,,424.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440,88,,percent of total billed charges,,,,,,,,,382,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,415,83,,percent of total billed charges,,,,,,,,,,,,,,,415,83,,percent of total billed charges,,,475,95,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,410,82,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,377,475,
X WRIST LEFT 3V+,26100181,CDM,73110,CPT,320,RC,inpatient,LT,500,500,,424.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440,88,,percent of total billed charges,,,,,,,,,382,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,415,83,,percent of total billed charges,,,,,,,,,,,,,,,415,83,,percent of total billed charges,,,475,95,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,410,82,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,377,475,
X HAND BIL 1V EA (DJD),26100197,CDM,73120,CPT,320,RC,inpatient,50,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X HAND RIGHT 3V+,26100198,CDM,73130,CPT,320,RC,inpatient,RT,506,506,,429.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,381.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,430.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,445.28,88,,percent of total billed charges,,,,,,,,,386.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,460.46,91,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,,,,,,,,,,,,,419.98,83,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,414.92,82,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,430.1,85,,percent of total billed charges,,381.52,480.7,
X HAND LEFT 3V+,26100199,CDM,73130,CPT,320,RC,inpatient,LT,506,506,,429.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,381.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,430.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,445.28,88,,percent of total billed charges,,,,,,,,,386.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,460.46,91,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,,,,,,,,,,,,,419.98,83,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,414.92,82,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,430.1,85,,percent of total billed charges,,381.52,480.7,
X FINGER (DO NOT USE),26100206,CDM,73140,CPT,320,RC,inpatient,RT,418,418,,354.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,315.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,355.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,367.84,88,,percent of total billed charges,,,,,,,,,319.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,380.38,91,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,,,,,,,,,,,,,346.94,83,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,342.76,82,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,355.3,85,,percent of total billed charges,,315.17,397.1,
X FINGER 2V+ 1OR>1DIGIT,26100207,CDM,73140,CPT,320,RC,inpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X AC JTS W/WO WTS,26100214,CDM,73050,CPT,320,RC,inpatient,,491,491,,416.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,370.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,417.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,432.08,88,,percent of total billed charges,,,,,,,,,375.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,446.81,91,,percent of total billed charges,,,466.45,95,,percent of total billed charges,,,407.53,83,,percent of total billed charges,,,407.53,83,,percent of total billed charges,,,,,,,,,,,,,,,407.53,83,,percent of total billed charges,,,466.45,95,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,402.62,82,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,417.35,85,,percent of total billed charges,,370.21,466.45,
X PELVIS 1-2V,26100222,CDM,72170,CPT,320,RC,inpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X FEMUR RIGHT 2V+,26100230,CDM,73552,CPT,320,RC,inpatient,TC,500,500,,424.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440,88,,percent of total billed charges,,,,,,,,,382,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,415,83,,percent of total billed charges,,,,,,,,,,,,,,,415,83,,percent of total billed charges,,,475,95,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,410,82,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,377,475,
X FEMUR LEFT 2V+,26100231,CDM,73552,CPT,320,RC,inpatient,TC,500,500,,424.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440,88,,percent of total billed charges,,,,,,,,,382,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,415,83,,percent of total billed charges,,,,,,,,,,,,,,,415,83,,percent of total billed charges,,,475,95,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,410,82,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,377,475,
X HIP RIGHT 2V+ W/PELVIS,26100248,CDM,73502,CPT,320,RC,inpatient,TC,946,946,,803.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,713.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,804.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,832.48,88,,percent of total billed charges,,,,,,,,,722.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,860.86,91,,percent of total billed charges,,,898.7,95,,percent of total billed charges,,,785.18,83,,percent of total billed charges,,,785.18,83,,percent of total billed charges,,,,,,,,,,,,,,,785.18,83,,percent of total billed charges,,,898.7,95,,percent of total billed charges,,,851.4,90,,percent of total billed charges,,,851.4,90,,percent of total billed charges,,,775.72,82,,percent of total billed charges,,,851.4,90,,percent of total billed charges,,,804.1,85,,percent of total billed charges,,713.28,898.7,
X HIP LEFT 2V+ W/PELVIS,26100249,CDM,73502,CPT,320,RC,inpatient,TC,946,946,,803.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,713.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,804.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,832.48,88,,percent of total billed charges,,,,,,,,,722.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,860.86,91,,percent of total billed charges,,,898.7,95,,percent of total billed charges,,,785.18,83,,percent of total billed charges,,,785.18,83,,percent of total billed charges,,,,,,,,,,,,,,,785.18,83,,percent of total billed charges,,,898.7,95,,percent of total billed charges,,,851.4,90,,percent of total billed charges,,,851.4,90,,percent of total billed charges,,,775.72,82,,percent of total billed charges,,,851.4,90,,percent of total billed charges,,,804.1,85,,percent of total billed charges,,713.28,898.7,
X KNEE RIGHT 1-2V,26100255,CDM,73560,CPT,320,RC,inpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X KNEE LEFT 1-2V,26100256,CDM,73560,CPT,320,RC,inpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X LOWER LEG RIGHT 2V+,26100263,CDM,73590,CPT,320,RC,inpatient,RT,470,470,,399.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,354.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,399.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,413.6,88,,percent of total billed charges,,,,,,,,,359.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,427.7,91,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,,,,,,,,,,,,,390.1,83,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,423,90,,percent of total billed charges,,,423,90,,percent of total billed charges,,,385.4,82,,percent of total billed charges,,,423,90,,percent of total billed charges,,,399.5,85,,percent of total billed charges,,354.38,446.5,
X LOWER LEG LEFT 2V+,26100264,CDM,73590,CPT,320,RC,inpatient,LT,470,470,,399.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,354.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,399.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,413.6,88,,percent of total billed charges,,,,,,,,,359.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,427.7,91,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,,,,,,,,,,,,,390.1,83,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,423,90,,percent of total billed charges,,,423,90,,percent of total billed charges,,,385.4,82,,percent of total billed charges,,,423,90,,percent of total billed charges,,,399.5,85,,percent of total billed charges,,354.38,446.5,
X ANKLE RIGHT 3V+,26100271,CDM,73610,CPT,320,RC,inpatient,RT,506,506,,429.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,381.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,430.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,445.28,88,,percent of total billed charges,,,,,,,,,386.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,460.46,91,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,,,,,,,,,,,,,419.98,83,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,414.92,82,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,430.1,85,,percent of total billed charges,,381.52,480.7,
X ANKLE LEFT 3V+,26100272,CDM,73610,CPT,320,RC,inpatient,LT,506,506,,429.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,381.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,430.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,445.28,88,,percent of total billed charges,,,,,,,,,386.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,460.46,91,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,,,,,,,,,,,,,419.98,83,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,414.92,82,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,430.1,85,,percent of total billed charges,,381.52,480.7,
X ANKLE BILATERAL 3V+,26100273,CDM,73610,CPT,320,RC,inpatient,50,1009,1009,,856.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,760.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,857.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,887.92,88,,percent of total billed charges,,,,,,,,,770.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,918.19,91,,percent of total billed charges,,,958.55,95,,percent of total billed charges,,,837.47,83,,percent of total billed charges,,,837.47,83,,percent of total billed charges,,,,,,,,,,,,,,,837.47,83,,percent of total billed charges,,,958.55,95,,percent of total billed charges,,,908.1,90,,percent of total billed charges,,,908.1,90,,percent of total billed charges,,,827.38,82,,percent of total billed charges,,,908.1,90,,percent of total billed charges,,,857.65,85,,percent of total billed charges,,760.79,958.55,
X ANKLE BILATERAL 2V,26100275,CDM,73600,CPT,320,RC,inpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,697.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,786.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,697.45,878.75,
X FOOT RIGHT 3V+,26100289,CDM,73630,CPT,320,RC,inpatient,RT,495,495,,420.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,373.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,420.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,435.6,88,,percent of total billed charges,,,,,,,,,378.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,450.45,91,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,,,,,,,,,,,,,410.85,83,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,405.9,82,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,373.23,470.25,
X FOOT LEFT 3V+,26100290,CDM,73630,CPT,320,RC,inpatient,LT,495,495,,420.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,373.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,420.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,435.6,88,,percent of total billed charges,,,,,,,,,378.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,450.45,91,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,,,,,,,,,,,,,410.85,83,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,405.9,82,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,373.23,470.25,
X TOES (DO NOT USE),26100297,CDM,73660,CPT,320,RC,inpatient,RT,389,389,,330.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,293.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,330.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,342.32,88,,percent of total billed charges,,,,,,,,,297.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,353.99,91,,percent of total billed charges,,,369.55,95,,percent of total billed charges,,,322.87,83,,percent of total billed charges,,,322.87,83,,percent of total billed charges,,,,,,,,,,,,,,,322.87,83,,percent of total billed charges,,,369.55,95,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,318.98,82,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,330.65,85,,percent of total billed charges,,293.31,369.55,
X CALCANEUS RIGHT 2V+,26100305,CDM,73650,CPT,320,RC,inpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X CALCANEUS LEFT 2V+,26100306,CDM,73650,CPT,320,RC,inpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X PELVIS W/HIP (CHILD),26100315,CDM,73501,CPT,320,RC,inpatient,,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,251.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,283.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,251.08,316.35,
X ABDOMEN 1V,26100321,CDM,74018,CPT,320,RC,inpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X ABDOMEN 2V+,26100339,CDM,74019,CPT,320,RC,inpatient,TC,569,569,,483.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,429.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,483.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,500.72,88,,percent of total billed charges,,,,,,,,,434.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,517.79,91,,percent of total billed charges,,,540.55,95,,percent of total billed charges,,,472.27,83,,percent of total billed charges,,,472.27,83,,percent of total billed charges,,,,,,,,,,,,,,,472.27,83,,percent of total billed charges,,,540.55,95,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,466.58,82,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,483.65,85,,percent of total billed charges,,429.03,540.55,
X SHOULDER ARTHRO RIGHT,26100347,CDM,73040,CPT,320,RC,inpatient,RT,1656,1656,,1405.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1248.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1407.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1457.28,88,,percent of total billed charges,,,,,,,,,1265.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1506.96,91,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1374.48,83,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1357.92,82,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1407.6,85,,percent of total billed charges,,1248.62,1573.2,
X SHOULDER ARTHRO LEFT,26100348,CDM,73040,CPT,320,RC,inpatient,LT,1656,1656,,1405.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1248.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1407.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1457.28,88,,percent of total billed charges,,,,,,,,,1265.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1506.96,91,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1374.48,83,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1357.92,82,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1407.6,85,,percent of total billed charges,,1248.62,1573.2,
X SHOULDER LEFT 1V,26100349,CDM,73020,CPT,320,RC,inpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X SHOULDER RIGHT 1V,26100350,CDM,73020,CPT,320,RC,inpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X FLUORO >1 HR (DNU 2/21/19),26100354,CDM,76001,CPT,320,RC,inpatient,TC,2216,2216,,1881.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1670.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1883.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1950.08,88,,percent of total billed charges,,,,,,,,,1693.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2016.56,91,,percent of total billed charges,,,2105.2,95,,percent of total billed charges,,,1839.28,83,,percent of total billed charges,,,1839.28,83,,percent of total billed charges,,,,,,,,,,,,,,,1839.28,83,,percent of total billed charges,,,2105.2,95,,percent of total billed charges,,,1994.4,90,,percent of total billed charges,,,1994.4,90,,percent of total billed charges,,,1817.12,82,,percent of total billed charges,,,1994.4,90,,percent of total billed charges,,,1883.6,85,,percent of total billed charges,,1670.86,2105.2,
X C SPINE 4 OR 5 VIEWS,26100362,CDM,72050,CPT,320,RC,inpatient,TC,862,862,,731.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,649.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,732.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,758.56,88,,percent of total billed charges,,,,,,,,,658.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,784.42,91,,percent of total billed charges,,,818.9,95,,percent of total billed charges,,,715.46,83,,percent of total billed charges,,,715.46,83,,percent of total billed charges,,,,,,,,,,,,,,,715.46,83,,percent of total billed charges,,,818.9,95,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,706.84,82,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,732.7,85,,percent of total billed charges,,649.95,818.9,
X C SPINE 6 OR MORE VIEWS,26100370,CDM,72052,CPT,320,RC,inpatient,TC,972,972,,825.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,732.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,826.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,855.36,88,,percent of total billed charges,,,,,,,,,742.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,884.52,91,,percent of total billed charges,,,923.4,95,,percent of total billed charges,,,806.76,83,,percent of total billed charges,,,806.76,83,,percent of total billed charges,,,,,,,,,,,,,,,806.76,83,,percent of total billed charges,,,923.4,95,,percent of total billed charges,,,874.8,90,,percent of total billed charges,,,874.8,90,,percent of total billed charges,,,797.04,82,,percent of total billed charges,,,874.8,90,,percent of total billed charges,,,826.2,85,,percent of total billed charges,,732.89,923.4,
X T SPINE 3V,26100388,CDM,72072,CPT,320,RC,inpatient,TC,666,666,,565.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,502.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,566.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,586.08,88,,percent of total billed charges,,,,,,,,,508.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,606.06,91,,percent of total billed charges,,,632.7,95,,percent of total billed charges,,,552.78,83,,percent of total billed charges,,,552.78,83,,percent of total billed charges,,,,,,,,,,,,,,,552.78,83,,percent of total billed charges,,,632.7,95,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,546.12,82,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,566.1,85,,percent of total billed charges,,502.16,632.7,
X THORACOLUMBAR 2V,26100389,CDM,72080,CPT,320,RC,inpatient,,543,543,,461.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,409.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,461.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,477.84,88,,percent of total billed charges,,,,,,,,,414.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,494.13,91,,percent of total billed charges,,,515.85,95,,percent of total billed charges,,,450.69,83,,percent of total billed charges,,,450.69,83,,percent of total billed charges,,,,,,,,,,,,,,,450.69,83,,percent of total billed charges,,,515.85,95,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,445.26,82,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,461.55,85,,percent of total billed charges,,409.42,515.85,
X L SPINE 2-3V,26100393,CDM,72100,CPT,320,RC,inpatient,TC,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,448.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,505.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,448.63,565.25,
X L SPINE 4-5V,26100396,CDM,72110,CPT,320,RC,inpatient,TC,922,922,,782.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,695.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,783.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,811.36,88,,percent of total billed charges,,,,,,,,,704.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,839.02,91,,percent of total billed charges,,,875.9,95,,percent of total billed charges,,,765.26,83,,percent of total billed charges,,,765.26,83,,percent of total billed charges,,,,,,,,,,,,,,,765.26,83,,percent of total billed charges,,,875.9,95,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,756.04,82,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,783.7,85,,percent of total billed charges,,695.19,875.9,
X ESI PAIN MGT C/T SPINE,26100400,CDM,62321,CPT,360,RC,inpatient,TC,4678,4678,,3971.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3527.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3976.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4116.64,88,,percent of total billed charges,,,,,,,,,3573.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4256.98,91,,percent of total billed charges,,,4444.1,95,,percent of total billed charges,,,3882.74,83,,percent of total billed charges,,,3882.74,83,,percent of total billed charges,,,,,,,,,,,,,,,3882.74,83,,percent of total billed charges,,,4444.1,95,,percent of total billed charges,,,4210.2,90,,percent of total billed charges,,,4210.2,90,,percent of total billed charges,,,3835.96,82,,percent of total billed charges,,,4210.2,90,,percent of total billed charges,,,3976.3,85,,percent of total billed charges,,3527.21,4444.1,
X ESI PAIN MGT L SPINE WO IMAGING,26100401,CDM,62322,CPT,320,RC,inpatient,TC,7269,7269,,6171.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5480.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6178.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6396.72,88,,percent of total billed charges,,,,,,,,,5553.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6614.79,91,,percent of total billed charges,,,6905.55,95,,percent of total billed charges,,,6033.27,83,,percent of total billed charges,,,6033.27,83,,percent of total billed charges,,,,,,,,,,,,,,,6033.27,83,,percent of total billed charges,,,6905.55,95,,percent of total billed charges,,,6542.1,90,,percent of total billed charges,,,6542.1,90,,percent of total billed charges,,,5960.58,82,,percent of total billed charges,,,6542.1,90,,percent of total billed charges,,,6178.65,85,,percent of total billed charges,,5480.83,6905.55,
X FACET INJ/NERVE BL L/S 1LVL,26100402,CDM,64493,CPT,320,RC,inpatient,TC,3571,3571,,3031.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2692.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3035.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3142.48,88,,percent of total billed charges,,,,,,,,,2728.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3249.61,91,,percent of total billed charges,,,3392.45,95,,percent of total billed charges,,,2963.93,83,,percent of total billed charges,,,2963.93,83,,percent of total billed charges,,,,,,,,,,,,,,,2963.93,83,,percent of total billed charges,,,3392.45,95,,percent of total billed charges,,,3213.9,90,,percent of total billed charges,,,3213.9,90,,percent of total billed charges,,,2928.22,82,,percent of total billed charges,,,3213.9,90,,percent of total billed charges,,,3035.35,85,,percent of total billed charges,,2692.53,3392.45,
X ESI PAIN MGT L SPINE W/IMAGING,26100403,CDM,62323,CPT,320,RC,inpatient,TC,8921,8921,,7573.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6726.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7582.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7850.48,88,,percent of total billed charges,,,,,,,,,6815.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8118.11,91,,percent of total billed charges,,,8474.95,95,,percent of total billed charges,,,7404.43,83,,percent of total billed charges,,,7404.43,83,,percent of total billed charges,,,,,,,,,,,,,,,7404.43,83,,percent of total billed charges,,,8474.95,95,,percent of total billed charges,,,8028.9,90,,percent of total billed charges,,,8028.9,90,,percent of total billed charges,,,7315.22,82,,percent of total billed charges,,,8028.9,90,,percent of total billed charges,,,7582.85,85,,percent of total billed charges,,6726.43,8474.95,
X SACRUM AND COCCYX 2V+,26100404,CDM,72220,CPT,320,RC,inpatient,TC,501,501,,425.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440.88,88,,percent of total billed charges,,,,,,,,,382.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,,,,,,,,,,,,,415.83,83,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,410.82,82,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,377.75,475.95,
X FACET INJ/NERVE BL L/S 2LVL,26100405,CDM,64494,CPT,320,RC,inpatient,TC,2121,2121,,1800.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1599.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1802.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1866.48,88,,percent of total billed charges,,,,,,,,,1620.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1930.11,91,,percent of total billed charges,,,2014.95,95,,percent of total billed charges,,,1760.43,83,,percent of total billed charges,,,1760.43,83,,percent of total billed charges,,,,,,,,,,,,,,,1760.43,83,,percent of total billed charges,,,2014.95,95,,percent of total billed charges,,,1908.9,90,,percent of total billed charges,,,1908.9,90,,percent of total billed charges,,,1739.22,82,,percent of total billed charges,,,1908.9,90,,percent of total billed charges,,,1802.85,85,,percent of total billed charges,,1599.23,2014.95,
X FACET INJ/NERVE BL L/S 3LVL,26100406,CDM,64495,CPT,320,RC,inpatient,TC,1956,1956,,1660.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1474.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1662.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1721.28,88,,percent of total billed charges,,,,,,,,,1494.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1779.96,91,,percent of total billed charges,,,1858.2,95,,percent of total billed charges,,,1623.48,83,,percent of total billed charges,,,1623.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1623.48,83,,percent of total billed charges,,,1858.2,95,,percent of total billed charges,,,1760.4,90,,percent of total billed charges,,,1760.4,90,,percent of total billed charges,,,1603.92,82,,percent of total billed charges,,,1760.4,90,,percent of total billed charges,,,1662.6,85,,percent of total billed charges,,1474.82,1858.2,
X INJ TRANSFORAMINAL EPIDURAL C/T SINGLE,26100407,CDM,64479,CPT,360,RC,inpatient,TC,3928,3928,,3334.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2961.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3338.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3456.64,88,,percent of total billed charges,,,,,,,,,3000.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3574.48,91,,percent of total billed charges,,,3731.6,95,,percent of total billed charges,,,3260.24,83,,percent of total billed charges,,,3260.24,83,,percent of total billed charges,,,,,,,,,,,,,,,3260.24,83,,percent of total billed charges,,,3731.6,95,,percent of total billed charges,,,3535.2,90,,percent of total billed charges,,,3535.2,90,,percent of total billed charges,,,3220.96,82,,percent of total billed charges,,,3535.2,90,,percent of total billed charges,,,3338.8,85,,percent of total billed charges,,2961.71,3731.6,
X INJ TRANSFORAMINAL EPIDURAL C/T EACH,26100408,CDM,64480,CPT,360,RC,inpatient,TC,2387,2387,,2026.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1799.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2028.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2100.56,88,,percent of total billed charges,,,,,,,,,1823.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2172.17,91,,percent of total billed charges,,,2267.65,95,,percent of total billed charges,,,1981.21,83,,percent of total billed charges,,,1981.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1981.21,83,,percent of total billed charges,,,2267.65,95,,percent of total billed charges,,,2148.3,90,,percent of total billed charges,,,2148.3,90,,percent of total billed charges,,,1957.34,82,,percent of total billed charges,,,2148.3,90,,percent of total billed charges,,,2028.95,85,,percent of total billed charges,,1799.8,2267.65,
X INTERCOSTAL NERVE BLOCK EACH ADD,26100409,CDM,64421,CPT,360,RC,inpatient,TC,3239,3239,,2749.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2442.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2753.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2850.32,88,,percent of total billed charges,,,,,,,,,2474.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2947.49,91,,percent of total billed charges,,,3077.05,95,,percent of total billed charges,,,2688.37,83,,percent of total billed charges,,,2688.37,83,,percent of total billed charges,,,,,,,,,,,,,,,2688.37,83,,percent of total billed charges,,,3077.05,95,,percent of total billed charges,,,2915.1,90,,percent of total billed charges,,,2915.1,90,,percent of total billed charges,,,2655.98,82,,percent of total billed charges,,,2915.1,90,,percent of total billed charges,,,2753.15,85,,percent of total billed charges,,2442.21,3077.05,
X INTERCOSTAL NERVE BLOCK INITIAL,26100410,CDM,64420,CPT,360,RC,inpatient,TC,2924,2924,,2482.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2204.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2485.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2573.12,88,,percent of total billed charges,,,,,,,,,2233.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2660.84,91,,percent of total billed charges,,,2777.8,95,,percent of total billed charges,,,2426.92,83,,percent of total billed charges,,,2426.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2426.92,83,,percent of total billed charges,,,2777.8,95,,percent of total billed charges,,,2631.6,90,,percent of total billed charges,,,2631.6,90,,percent of total billed charges,,,2397.68,82,,percent of total billed charges,,,2631.6,90,,percent of total billed charges,,,2485.4,85,,percent of total billed charges,,2204.7,2777.8,
X KNEE RIGHT 3V,26100412,CDM,73562,CPT,320,RC,inpatient,RT,549,549,,466.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,413.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,466.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,483.12,88,,percent of total billed charges,,,,,,,,,419.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,499.59,91,,percent of total billed charges,,,521.55,95,,percent of total billed charges,,,455.67,83,,percent of total billed charges,,,455.67,83,,percent of total billed charges,,,,,,,,,,,,,,,455.67,83,,percent of total billed charges,,,521.55,95,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,450.18,82,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,466.65,85,,percent of total billed charges,,413.95,521.55,
X KNEE LEFT 3V,26100413,CDM,73562,CPT,320,RC,inpatient,LT,549,549,,466.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,413.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,466.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,483.12,88,,percent of total billed charges,,,,,,,,,419.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,499.59,91,,percent of total billed charges,,,521.55,95,,percent of total billed charges,,,455.67,83,,percent of total billed charges,,,455.67,83,,percent of total billed charges,,,,,,,,,,,,,,,455.67,83,,percent of total billed charges,,,521.55,95,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,450.18,82,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,466.65,85,,percent of total billed charges,,413.95,521.55,
X FLUORO UP TO 1 HR,26100438,CDM,76000,CPT,320,RC,inpatient,TC,1650,1650,,1400.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1244.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1402.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1452,88,,percent of total billed charges,,,,,,,,,1260.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1501.5,91,,percent of total billed charges,,,1567.5,95,,percent of total billed charges,,,1369.5,83,,percent of total billed charges,,,1369.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1369.5,83,,percent of total billed charges,,,1567.5,95,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1353,82,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1402.5,85,,percent of total billed charges,,1244.1,1567.5,
X FLUORO GUIDE/CENT LINE,26100441,CDM,77001,CPT,320,RC,inpatient,TC,1650,1650,,1400.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1244.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1402.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1452,88,,percent of total billed charges,,,,,,,,,1260.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1501.5,91,,percent of total billed charges,,,1567.5,95,,percent of total billed charges,,,1369.5,83,,percent of total billed charges,,,1369.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1369.5,83,,percent of total billed charges,,,1567.5,95,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1353,82,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1402.5,85,,percent of total billed charges,,1244.1,1567.5,
X FLUORO GUIDE/EPIDURAL,26100442,CDM,77003,CPT,320,RC,inpatient,TC,1650,1650,,1400.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1244.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1402.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1452,88,,percent of total billed charges,,,,,,,,,1260.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1501.5,91,,percent of total billed charges,,,1567.5,95,,percent of total billed charges,,,1369.5,83,,percent of total billed charges,,,1369.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1369.5,83,,percent of total billed charges,,,1567.5,95,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1353,82,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1402.5,85,,percent of total billed charges,,1244.1,1567.5,
X FLUORO GUIDE/NDLPLCMNT,26100443,CDM,77002,CPT,320,RC,inpatient,TC,2319,2319,,1968.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1748.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1971.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2040.72,88,,percent of total billed charges,,,,,,,,,1771.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2110.29,91,,percent of total billed charges,,,2203.05,95,,percent of total billed charges,,,1924.77,83,,percent of total billed charges,,,1924.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1924.77,83,,percent of total billed charges,,,2203.05,95,,percent of total billed charges,,,2087.1,90,,percent of total billed charges,,,2087.1,90,,percent of total billed charges,,,1901.58,82,,percent of total billed charges,,,2087.1,90,,percent of total billed charges,,,1971.15,85,,percent of total billed charges,,1748.53,2203.05,
X JT SURVEY (1V+ JTS),26100455,CDM,77077,CPT,320,RC,inpatient,TC,403,403,,342.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,303.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,342.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,354.64,88,,percent of total billed charges,,,,,,,,,307.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,366.73,91,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,,,,,,,,,,,,,334.49,83,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,330.46,82,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,342.55,85,,percent of total billed charges,,303.86,382.85,
X L SPINE BENDING 2-3V,26100461,CDM,72120,CPT,320,RC,inpatient,TC,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,589.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,664.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,589.63,742.9,
X L SPINE W/BEND MIN 6 VIEWS,26100462,CDM,72114,CPT,320,RC,inpatient,TC,1031,1031,,875.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,777.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,876.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,907.28,88,,percent of total billed charges,,,,,,,,,787.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,938.21,91,,percent of total billed charges,,,979.45,95,,percent of total billed charges,,,855.73,83,,percent of total billed charges,,,855.73,83,,percent of total billed charges,,,,,,,,,,,,,,,855.73,83,,percent of total billed charges,,,979.45,95,,percent of total billed charges,,,927.9,90,,percent of total billed charges,,,927.9,90,,percent of total billed charges,,,845.42,82,,percent of total billed charges,,,927.9,90,,percent of total billed charges,,,876.35,85,,percent of total billed charges,,777.37,979.45,
X FLUORO GD/EPI BILATERAL,26100499,CDM,77003,CPT,320,RC,inpatient,50,3293,3293,,2795.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2482.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2799.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2897.84,88,,percent of total billed charges,,,,,,,,,2515.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2996.63,91,,percent of total billed charges,,,3128.35,95,,percent of total billed charges,,,2733.19,83,,percent of total billed charges,,,2733.19,83,,percent of total billed charges,,,,,,,,,,,,,,,2733.19,83,,percent of total billed charges,,,3128.35,95,,percent of total billed charges,,,2963.7,90,,percent of total billed charges,,,2963.7,90,,percent of total billed charges,,,2700.26,82,,percent of total billed charges,,,2963.7,90,,percent of total billed charges,,,2799.05,85,,percent of total billed charges,,2482.92,3128.35,
X SI JOINT <3V,26100502,CDM,72200,CPT,320,RC,inpatient,TC,400,400,,339.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,301.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,340,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,352,88,,percent of total billed charges,,,,,,,,,305.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,364,91,,percent of total billed charges,,,380,95,,percent of total billed charges,,,332,83,,percent of total billed charges,,,332,83,,percent of total billed charges,,,,,,,,,,,,,,,332,83,,percent of total billed charges,,,380,95,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,328,82,,percent of total billed charges,,,360,90,,percent of total billed charges,,,340,85,,percent of total billed charges,,301.6,380,
X SI JOINT 3V+,26100503,CDM,72202,CPT,320,RC,inpatient,TC,501,501,,425.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440.88,88,,percent of total billed charges,,,,,,,,,382.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,,,,,,,,,,,,,415.83,83,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,410.82,82,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,377.75,475.95,
X MYELOGRAM CERVICAL,26100549,CDM,62302,CPT,320,RC,inpatient,TC,5837,5837,,4955.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4401.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4961.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5136.56,88,,percent of total billed charges,,,,,,,,,4459.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5311.67,91,,percent of total billed charges,,,5545.15,95,,percent of total billed charges,,,4844.71,83,,percent of total billed charges,,,4844.71,83,,percent of total billed charges,,,,,,,,,,,,,,,4844.71,83,,percent of total billed charges,,,5545.15,95,,percent of total billed charges,,,5253.3,90,,percent of total billed charges,,,5253.3,90,,percent of total billed charges,,,4786.34,82,,percent of total billed charges,,,5253.3,90,,percent of total billed charges,,,4961.45,85,,percent of total billed charges,,4401.1,5545.15,
X PELVIS 3V+,26100560,CDM,72190,CPT,320,RC,inpatient,TC,605,605,,513.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,456.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,514.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,532.4,88,,percent of total billed charges,,,,,,,,,462.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,550.55,91,,percent of total billed charges,,,574.75,95,,percent of total billed charges,,,502.15,83,,percent of total billed charges,,,502.15,83,,percent of total billed charges,,,,,,,,,,,,,,,502.15,83,,percent of total billed charges,,,574.75,95,,percent of total billed charges,,,544.5,90,,percent of total billed charges,,,544.5,90,,percent of total billed charges,,,496.1,82,,percent of total billed charges,,,544.5,90,,percent of total billed charges,,,514.25,85,,percent of total billed charges,,456.17,574.75,
X BODYGRAM FB/CHILD,26100578,CDM,76010,CPT,320,RC,inpatient,TC,488,488,,414.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,367.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,414.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,429.44,88,,percent of total billed charges,,,,,,,,,372.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,444.08,91,,percent of total billed charges,,,463.6,95,,percent of total billed charges,,,405.04,83,,percent of total billed charges,,,405.04,83,,percent of total billed charges,,,,,,,,,,,,,,,405.04,83,,percent of total billed charges,,,463.6,95,,percent of total billed charges,,,439.2,90,,percent of total billed charges,,,439.2,90,,percent of total billed charges,,,400.16,82,,percent of total billed charges,,,439.2,90,,percent of total billed charges,,,414.8,85,,percent of total billed charges,,367.95,463.6,
X UP EXT INFANT RIGHT 2V,26100586,CDM,73092,CPT,320,RC,inpatient,RT,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
X UP EXT INFANT LEFT 2V,26100587,CDM,73092,CPT,320,RC,inpatient,LT,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,282.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,318.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,282.75,356.25,
X SPINE SURVEY (2V FULL SPINE),26100594,CDM,72082,CPT,320,RC,inpatient,,937,937,,795.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,706.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,796.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,824.56,88,,percent of total billed charges,,,,,,,,,715.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,852.67,91,,percent of total billed charges,,,890.15,95,,percent of total billed charges,,,777.71,83,,percent of total billed charges,,,777.71,83,,percent of total billed charges,,,,,,,,,,,,,,,777.71,83,,percent of total billed charges,,,890.15,95,,percent of total billed charges,,,843.3,90,,percent of total billed charges,,,843.3,90,,percent of total billed charges,,,768.34,82,,percent of total billed charges,,,843.3,90,,percent of total billed charges,,,796.45,85,,percent of total billed charges,,706.5,890.15,
X KNEE BILATERAL 3V,26100597,CDM,73562,CPT,320,RC,inpatient,50,1101,1101,,934.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,830.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,935.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,968.88,88,,percent of total billed charges,,,,,,,,,841.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1001.91,91,,percent of total billed charges,,,1045.95,95,,percent of total billed charges,,,913.83,83,,percent of total billed charges,,,913.83,83,,percent of total billed charges,,,,,,,,,,,,,,,913.83,83,,percent of total billed charges,,,1045.95,95,,percent of total billed charges,,,990.9,90,,percent of total billed charges,,,990.9,90,,percent of total billed charges,,,902.82,82,,percent of total billed charges,,,990.9,90,,percent of total billed charges,,,935.85,85,,percent of total billed charges,,830.15,1045.95,
X MYELOGRAM LUMBAR,26100602,CDM,62304,CPT,320,RC,inpatient,TC,5773,5773,,4901.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4352.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4907.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5080.24,88,,percent of total billed charges,,,,,,,,,4410.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5253.43,91,,percent of total billed charges,,,5484.35,95,,percent of total billed charges,,,4791.59,83,,percent of total billed charges,,,4791.59,83,,percent of total billed charges,,,,,,,,,,,,,,,4791.59,83,,percent of total billed charges,,,5484.35,95,,percent of total billed charges,,,5195.7,90,,percent of total billed charges,,,5195.7,90,,percent of total billed charges,,,4733.86,82,,percent of total billed charges,,,5195.7,90,,percent of total billed charges,,,4907.05,85,,percent of total billed charges,,4352.84,5484.35,
X CHEST 2V,26100628,CDM,71046,CPT,324,RC,inpatient,TC,470,470,,399.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,354.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,399.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,413.6,88,,percent of total billed charges,,,,,,,,,359.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,427.7,91,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,,,,,,,,,,,,,390.1,83,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,423,90,,percent of total billed charges,,,423,90,,percent of total billed charges,,,385.4,82,,percent of total billed charges,,,423,90,,percent of total billed charges,,,399.5,85,,percent of total billed charges,,354.38,446.5,
X CHEST PA OR LAT W/FLUORO,26100636,CDM,76000,CPT,324,RC,inpatient,TC,1095,1095,,929.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,825.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,930.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,963.6,88,,percent of total billed charges,,,,,,,,,836.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,996.45,91,,percent of total billed charges,,,1040.25,95,,percent of total billed charges,,,908.85,83,,percent of total billed charges,,,908.85,83,,percent of total billed charges,,,,,,,,,,,,,,,908.85,83,,percent of total billed charges,,,1040.25,95,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,897.9,82,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,930.75,85,,percent of total billed charges,,825.63,1040.25,
X BONE SURVEY COMPLETE,26100650,CDM,77075,CPT,320,RC,inpatient,TC,1359,1359,,1153.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1024.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1155.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1195.92,88,,percent of total billed charges,,,,,,,,,1038.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1236.69,91,,percent of total billed charges,,,1291.05,95,,percent of total billed charges,,,1127.97,83,,percent of total billed charges,,,1127.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1127.97,83,,percent of total billed charges,,,1291.05,95,,percent of total billed charges,,,1223.1,90,,percent of total billed charges,,,1223.1,90,,percent of total billed charges,,,1114.38,82,,percent of total billed charges,,,1223.1,90,,percent of total billed charges,,,1155.15,85,,percent of total billed charges,,1024.69,1291.05,
X MYELOGRAM THORACIC,26100677,CDM,62303,CPT,320,RC,inpatient,TC,5688,5688,,4829.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4288.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4834.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5005.44,88,,percent of total billed charges,,,,,,,,,4345.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5176.08,91,,percent of total billed charges,,,5403.6,95,,percent of total billed charges,,,4721.04,83,,percent of total billed charges,,,4721.04,83,,percent of total billed charges,,,,,,,,,,,,,,,4721.04,83,,percent of total billed charges,,,5403.6,95,,percent of total billed charges,,,5119.2,90,,percent of total billed charges,,,5119.2,90,,percent of total billed charges,,,4664.16,82,,percent of total billed charges,,,5119.2,90,,percent of total billed charges,,,4834.8,85,,percent of total billed charges,,4288.75,5403.6,
X RIBS RIGHT 2V,26100685,CDM,71100,CPT,320,RC,inpatient,RT,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,376.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,424.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,376.25,474.05,
X RIBS LEFT 2V,26100686,CDM,71100,CPT,320,RC,inpatient,LT,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,376.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,424.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,376.25,474.05,
X RIBS LEFT W/PA CXR 3V+,26100687,CDM,71101,CPT,320,RC,inpatient,LT,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,589.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,664.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,589.63,742.9,
X RIBS RIGHT W/PA CXR 3V+,26100688,CDM,71101,CPT,320,RC,inpatient,RT,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,589.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,664.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,589.63,742.9,
X RIBS BILATERAL W/PA CXR 4V+,26100689,CDM,71111,CPT,320,RC,inpatient,TC,936,936,,794.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,705.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,795.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,823.68,88,,percent of total billed charges,,,,,,,,,715.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,851.76,91,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,,,,,,,,,,,,,776.88,83,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,767.52,82,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,795.6,85,,percent of total billed charges,,705.74,889.2,
X RIBS BILATERAL 3V+,26100693,CDM,71110,CPT,320,RC,inpatient,TC,704,704,,597.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,530.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,598.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,619.52,88,,percent of total billed charges,,,,,,,,,537.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,640.64,91,,percent of total billed charges,,,668.8,95,,percent of total billed charges,,,584.32,83,,percent of total billed charges,,,584.32,83,,percent of total billed charges,,,,,,,,,,,,,,,584.32,83,,percent of total billed charges,,,668.8,95,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,577.28,82,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,598.4,85,,percent of total billed charges,,530.82,668.8,
X STERNUM 2V+,26100701,CDM,71120,CPT,320,RC,inpatient,TC,494,494,,419.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,372.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,419.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,434.72,88,,percent of total billed charges,,,,,,,,,377.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,449.54,91,,percent of total billed charges,,,469.3,95,,percent of total billed charges,,,410.02,83,,percent of total billed charges,,,410.02,83,,percent of total billed charges,,,,,,,,,,,,,,,410.02,83,,percent of total billed charges,,,469.3,95,,percent of total billed charges,,,444.6,90,,percent of total billed charges,,,444.6,90,,percent of total billed charges,,,405.08,82,,percent of total billed charges,,,444.6,90,,percent of total billed charges,,,419.9,85,,percent of total billed charges,,372.48,469.3,
X HIP ARTHROGRAM RIGHT,26100707,CDM,73525,CPT,320,RC,inpatient,RT,1656,1656,,1405.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1248.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1407.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1457.28,88,,percent of total billed charges,,,,,,,,,1265.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1506.96,91,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1374.48,83,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1357.92,82,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1407.6,85,,percent of total billed charges,,1248.62,1573.2,
X HIP ARTHROGRAM LEFT,26100708,CDM,73525,CPT,320,RC,inpatient,LT,1656,1656,,1405.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1248.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1407.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1457.28,88,,percent of total billed charges,,,,,,,,,1265.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1506.96,91,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1374.48,83,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1357.92,82,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1407.6,85,,percent of total billed charges,,1248.62,1573.2,
X HIPS BILAT W/ PELVIS,26100719,CDM,73521,CPT,320,RC,inpatient,TC,1693,1693,,1437.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1276.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1439.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1489.84,88,,percent of total billed charges,,,,,,,,,1293.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1540.63,91,,percent of total billed charges,,,1608.35,95,,percent of total billed charges,,,1405.19,83,,percent of total billed charges,,,1405.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1405.19,83,,percent of total billed charges,,,1608.35,95,,percent of total billed charges,,,1523.7,90,,percent of total billed charges,,,1523.7,90,,percent of total billed charges,,,1388.26,82,,percent of total billed charges,,,1523.7,90,,percent of total billed charges,,,1439.05,85,,percent of total billed charges,,1276.52,1608.35,
X SMALL BOWEL,26100735,CDM,74250,CPT,320,RC,inpatient,TC,1296,1296,,1100.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,977.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1101.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1140.48,88,,percent of total billed charges,,,,,,,,,990.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1179.36,91,,percent of total billed charges,,,1231.2,95,,percent of total billed charges,,,1075.68,83,,percent of total billed charges,,,1075.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1075.68,83,,percent of total billed charges,,,1231.2,95,,percent of total billed charges,,,1166.4,90,,percent of total billed charges,,,1166.4,90,,percent of total billed charges,,,1062.72,82,,percent of total billed charges,,,1166.4,90,,percent of total billed charges,,,1101.6,85,,percent of total billed charges,,977.18,1231.2,
X ESOPHAGUS,26100743,CDM,74220,CPT,320,RC,inpatient,TC,982,982,,833.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,740.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,834.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,864.16,88,,percent of total billed charges,,,,,,,,,750.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,893.62,91,,percent of total billed charges,,,932.9,95,,percent of total billed charges,,,815.06,83,,percent of total billed charges,,,815.06,83,,percent of total billed charges,,,,,,,,,,,,,,,815.06,83,,percent of total billed charges,,,932.9,95,,percent of total billed charges,,,883.8,90,,percent of total billed charges,,,883.8,90,,percent of total billed charges,,,805.24,82,,percent of total billed charges,,,883.8,90,,percent of total billed charges,,,834.7,85,,percent of total billed charges,,740.43,932.9,
X UGI W/O KUB,26100750,CDM,74240,CPT,320,RC,inpatient,TC,1185,1185,,1006.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,893.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1007.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1042.8,88,,percent of total billed charges,,,,,,,,,905.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1078.35,91,,percent of total billed charges,,,1125.75,95,,percent of total billed charges,,,983.55,83,,percent of total billed charges,,,983.55,83,,percent of total billed charges,,,,,,,,,,,,,,,983.55,83,,percent of total billed charges,,,1125.75,95,,percent of total billed charges,,,1066.5,90,,percent of total billed charges,,,1066.5,90,,percent of total billed charges,,,971.7,82,,percent of total billed charges,,,1066.5,90,,percent of total billed charges,,,1007.25,85,,percent of total billed charges,,893.49,1125.75,
X COLON,26100768,CDM,74270,CPT,320,RC,inpatient,TC,1578,1578,,1339.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1189.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1341.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1388.64,88,,percent of total billed charges,,,,,,,,,1205.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1435.98,91,,percent of total billed charges,,,1499.1,95,,percent of total billed charges,,,1309.74,83,,percent of total billed charges,,,1309.74,83,,percent of total billed charges,,,,,,,,,,,,,,,1309.74,83,,percent of total billed charges,,,1499.1,95,,percent of total billed charges,,,1420.2,90,,percent of total billed charges,,,1420.2,90,,percent of total billed charges,,,1293.96,82,,percent of total billed charges,,,1420.2,90,,percent of total billed charges,,,1341.3,85,,percent of total billed charges,,1189.81,1499.1,
SINOGRAFFIN LOW OSMOLAR CN 100-199 mg/ml,26100784,CDM,Q9965,HCPCS,636,RC,inpatient,,133,133,,112.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,100.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,113.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,117.04,88,,percent of total billed charges,,,,,,,,,101.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,,,,,,,,,,,,,110.39,83,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,109.06,82,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,100.28,126.35,
*SINOGRAFFIN <150MG/ML PER ML(V 0508),26100785,CDM,Q9965,HCPCS,636,RC,inpatient,,133,133,,112.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,100.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,113.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,117.04,88,,percent of total billed charges,,,,,,,,,101.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,,,,,,,,,,,,,110.39,83,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,109.06,82,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,100.28,126.35,
X HYSTROSALPING CATH,26100788,CDM,58340,CPT,360,RC,inpatient,,1107,1107,,939.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,834.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,940.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,974.16,88,,percent of total billed charges,,,,,,,,,845.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1007.37,91,,percent of total billed charges,,,1051.65,95,,percent of total billed charges,,,918.81,83,,percent of total billed charges,,,918.81,83,,percent of total billed charges,,,,,,,,,,,,,,,918.81,83,,percent of total billed charges,,,1051.65,95,,percent of total billed charges,,,996.3,90,,percent of total billed charges,,,996.3,90,,percent of total billed charges,,,907.74,82,,percent of total billed charges,,,996.3,90,,percent of total billed charges,,,940.95,85,,percent of total billed charges,,834.68,1051.65,
X HYSTEROSALPINGOGRAPHY,26100789,CDM,74740,CPT,320,RC,inpatient,TC,2734,2734,,2321.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2061.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2323.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2405.92,88,,percent of total billed charges,,,,,,,,,2088.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2487.94,91,,percent of total billed charges,,,2597.3,95,,percent of total billed charges,,,2269.22,83,,percent of total billed charges,,,2269.22,83,,percent of total billed charges,,,,,,,,,,,,,,,2269.22,83,,percent of total billed charges,,,2597.3,95,,percent of total billed charges,,,2460.6,90,,percent of total billed charges,,,2460.6,90,,percent of total billed charges,,,2241.88,82,,percent of total billed charges,,,2460.6,90,,percent of total billed charges,,,2323.9,85,,percent of total billed charges,,2061.44,2597.3,
X ORC (CHOLANGIOGRAMS),26100792,CDM,74300,CPT,320,RC,inpatient,TC,1329,1329,,1128.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1002.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1129.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1169.52,88,,percent of total billed charges,,,,,,,,,1015.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1209.39,91,,percent of total billed charges,,,1262.55,95,,percent of total billed charges,,,1103.07,83,,percent of total billed charges,,,1103.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1103.07,83,,percent of total billed charges,,,1262.55,95,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1089.78,82,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1129.65,85,,percent of total billed charges,,1002.07,1262.55,
X ORC (CHOLANG) ADDL SETS,26100795,CDM,74301,CPT,320,RC,inpatient,TC,546,546,,463.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,411.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,464.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,480.48,88,,percent of total billed charges,,,,,,,,,417.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,496.86,91,,percent of total billed charges,,,518.7,95,,percent of total billed charges,,,453.18,83,,percent of total billed charges,,,453.18,83,,percent of total billed charges,,,,,,,,,,,,,,,453.18,83,,percent of total billed charges,,,518.7,95,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,447.72,82,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,464.1,85,,percent of total billed charges,,411.68,518.7,
X T-TUBE CHOLE INJECTION,26100805,CDM,47531,CPT,361,RC,inpatient,,1431,1431,,1214.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1078.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1216.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1259.28,88,,percent of total billed charges,,,,,,,,,1093.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1302.21,91,,percent of total billed charges,,,1359.45,95,,percent of total billed charges,,,1187.73,83,,percent of total billed charges,,,1187.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1187.73,83,,percent of total billed charges,,,1359.45,95,,percent of total billed charges,,,1287.9,90,,percent of total billed charges,,,1287.9,90,,percent of total billed charges,,,1173.42,82,,percent of total billed charges,,,1287.9,90,,percent of total billed charges,,,1216.35,85,,percent of total billed charges,,1078.97,1359.45,
X COLON W/AIR,26100818,CDM,74280,CPT,320,RC,inpatient,,1744,1744,,1480.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1314.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1482.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1534.72,88,,percent of total billed charges,,,,,,,,,1332.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1587.04,91,,percent of total billed charges,,,1656.8,95,,percent of total billed charges,,,1447.52,83,,percent of total billed charges,,,1447.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1447.52,83,,percent of total billed charges,,,1656.8,95,,percent of total billed charges,,,1569.6,90,,percent of total billed charges,,,1569.6,90,,percent of total billed charges,,,1430.08,82,,percent of total billed charges,,,1569.6,90,,percent of total billed charges,,,1482.4,85,,percent of total billed charges,,1314.98,1656.8,
* DFU X IVP W/O TOMOGRAPHY,26100826,CDM,74400,CPT,320,RC,inpatient,TC,1226,1226,,1040.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,924.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1042.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1078.88,88,,percent of total billed charges,,,,,,,,,936.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1115.66,91,,percent of total billed charges,,,1164.7,95,,percent of total billed charges,,,1017.58,83,,percent of total billed charges,,,1017.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1017.58,83,,percent of total billed charges,,,1164.7,95,,percent of total billed charges,,,1103.4,90,,percent of total billed charges,,,1103.4,90,,percent of total billed charges,,,1005.32,82,,percent of total billed charges,,,1103.4,90,,percent of total billed charges,,,1042.1,85,,percent of total billed charges,,924.4,1164.7,
X SCAPULA LEFT 2V+,26100834,CDM,73010,CPT,320,RC,inpatient,LT,482,482,,409.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,363.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,409.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,424.16,88,,percent of total billed charges,,,,,,,,,368.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,438.62,91,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,,,,,,,,,,,,,400.06,83,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,395.24,82,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,363.43,457.9,
X RETRO PYELOGRAM,26100842,CDM,74400,CPT,320,RC,inpatient,TC,2246,2246,,1906.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1693.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1909.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1976.48,88,,percent of total billed charges,,,,,,,,,1715.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2043.86,91,,percent of total billed charges,,,2133.7,95,,percent of total billed charges,,,1864.18,83,,percent of total billed charges,,,1864.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1864.18,83,,percent of total billed charges,,,2133.7,95,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,1841.72,82,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,1909.1,85,,percent of total billed charges,,1693.48,2133.7,
X CYSTOGRAM,26100859,CDM,74430,CPT,320,RC,inpatient,TC,2246,2246,,1906.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1693.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1909.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1976.48,88,,percent of total billed charges,,,,,,,,,1715.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2043.86,91,,percent of total billed charges,,,2133.7,95,,percent of total billed charges,,,1864.18,83,,percent of total billed charges,,,1864.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1864.18,83,,percent of total billed charges,,,2133.7,95,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,1841.72,82,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,1909.1,85,,percent of total billed charges,,1693.48,2133.7,
X HIP LEFT 1V W/PELVIS,26100877,CDM,73501,CPT,320,RC,inpatient,TC,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,697.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,786.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,697.45,878.75,
X HIP RIGHT 1V W/PELVIS,26100878,CDM,73501,CPT,320,RC,inpatient,TC,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,697.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,786.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,697.45,878.75,
X SINUS-TRACT STUDY,26100883,CDM,76080,CPT,320,RC,inpatient,TC,1155,1155,,980.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,870.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,981.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1016.4,88,,percent of total billed charges,,,,,,,,,882.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1051.05,91,,percent of total billed charges,,,1097.25,95,,percent of total billed charges,,,958.65,83,,percent of total billed charges,,,958.65,83,,percent of total billed charges,,,,,,,,,,,,,,,958.65,83,,percent of total billed charges,,,1097.25,95,,percent of total billed charges,,,1039.5,90,,percent of total billed charges,,,1039.5,90,,percent of total billed charges,,,947.1,82,,percent of total billed charges,,,1039.5,90,,percent of total billed charges,,,981.75,85,,percent of total billed charges,,870.87,1097.25,
X TOES 2V+1OR>1DIGIT,26100917,CDM,73660,CPT,320,RC,inpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X VENOGRAPHY EXTREMITY UNILATERAL RS&I,26100925,CDM,75820,CPT,320,RC,inpatient,TC,2856,2856,,2424.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2153.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2427.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2513.28,88,,percent of total billed charges,,,,,,,,,2181.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2598.96,91,,percent of total billed charges,,,2713.2,95,,percent of total billed charges,,,2370.48,83,,percent of total billed charges,,,2370.48,83,,percent of total billed charges,,,,,,,,,,,,,,,2370.48,83,,percent of total billed charges,,,2713.2,95,,percent of total billed charges,,,2570.4,90,,percent of total billed charges,,,2570.4,90,,percent of total billed charges,,,2341.92,82,,percent of total billed charges,,,2570.4,90,,percent of total billed charges,,,2427.6,85,,percent of total billed charges,,2153.42,2713.2,
X VENOGRAPHY EXTREMITY BILATERAL RS&I,26100941,CDM,75822,CPT,320,RC,inpatient,TC,3486,3486,,2959.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2628.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2963.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3067.68,88,,percent of total billed charges,,,,,,,,,2663.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3172.26,91,,percent of total billed charges,,,3311.7,95,,percent of total billed charges,,,2893.38,83,,percent of total billed charges,,,2893.38,83,,percent of total billed charges,,,,,,,,,,,,,,,2893.38,83,,percent of total billed charges,,,3311.7,95,,percent of total billed charges,,,3137.4,90,,percent of total billed charges,,,3137.4,90,,percent of total billed charges,,,2858.52,82,,percent of total billed charges,,,3137.4,90,,percent of total billed charges,,,2963.1,85,,percent of total billed charges,,2628.44,3311.7,
X ARTERIOGRAM RT (UP OR LOW),26100945,CDM,75710,CPT,320,RC,inpatient,RT,7168,7168,,6085.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5404.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6092.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6307.84,88,,percent of total billed charges,,,,,,,,,5476.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6522.88,91,,percent of total billed charges,,,6809.6,95,,percent of total billed charges,,,5949.44,83,,percent of total billed charges,,,5949.44,83,,percent of total billed charges,,,,,,,,,,,,,,,5949.44,83,,percent of total billed charges,,,6809.6,95,,percent of total billed charges,,,6451.2,90,,percent of total billed charges,,,6451.2,90,,percent of total billed charges,,,5877.76,82,,percent of total billed charges,,,6451.2,90,,percent of total billed charges,,,6092.8,85,,percent of total billed charges,,5404.67,6809.6,
X ARTERIOGRAM LT (UP OR LOW),26100946,CDM,75710,CPT,320,RC,inpatient,LT,7168,7168,,6085.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5404.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6092.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6307.84,88,,percent of total billed charges,,,,,,,,,5476.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6522.88,91,,percent of total billed charges,,,6809.6,95,,percent of total billed charges,,,5949.44,83,,percent of total billed charges,,,5949.44,83,,percent of total billed charges,,,,,,,,,,,,,,,5949.44,83,,percent of total billed charges,,,6809.6,95,,percent of total billed charges,,,6451.2,90,,percent of total billed charges,,,6451.2,90,,percent of total billed charges,,,5877.76,82,,percent of total billed charges,,,6451.2,90,,percent of total billed charges,,,6092.8,85,,percent of total billed charges,,5404.67,6809.6,
X ARTERIOGRAM BIL (UP OR LOW),26100947,CDM,75716,CPT,320,RC,inpatient,TC,7892,7892,,6700.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5950.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6708.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6944.96,88,,percent of total billed charges,,,,,,,,,6029.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7181.72,91,,percent of total billed charges,,,7497.4,95,,percent of total billed charges,,,6550.36,83,,percent of total billed charges,,,6550.36,83,,percent of total billed charges,,,,,,,,,,,,,,,6550.36,83,,percent of total billed charges,,,7497.4,95,,percent of total billed charges,,,7102.8,90,,percent of total billed charges,,,7102.8,90,,percent of total billed charges,,,6471.44,82,,percent of total billed charges,,,7102.8,90,,percent of total billed charges,,,6708.2,85,,percent of total billed charges,,5950.57,7497.4,
X ARTERIOGRAM INJECT,26100948,CDM,36140,CPT,769,RC,inpatient,,4519,4519,,3836.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3407.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3841.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3976.72,88,,percent of total billed charges,,,,,,,,,3452.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4112.29,91,,percent of total billed charges,,,4293.05,95,,percent of total billed charges,,,3750.77,83,,percent of total billed charges,,,3750.77,83,,percent of total billed charges,,,,,,,,,,,,,,,3750.77,83,,percent of total billed charges,,,4293.05,95,,percent of total billed charges,,,4067.1,90,,percent of total billed charges,,,4067.1,90,,percent of total billed charges,,,3705.58,82,,percent of total billed charges,,,4067.1,90,,percent of total billed charges,,,3841.15,85,,percent of total billed charges,,3407.33,4293.05,
X LUMBAR PUNCTURE,26101006,CDM,62270,CPT,320,RC,inpatient,TC,3124,3124,,2652.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2355.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2655.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2749.12,88,,percent of total billed charges,,,,,,,,,2386.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2842.84,91,,percent of total billed charges,,,2967.8,95,,percent of total billed charges,,,2592.92,83,,percent of total billed charges,,,2592.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2592.92,83,,percent of total billed charges,,,2967.8,95,,percent of total billed charges,,,2811.6,90,,percent of total billed charges,,,2811.6,90,,percent of total billed charges,,,2561.68,82,,percent of total billed charges,,,2811.6,90,,percent of total billed charges,,,2655.4,85,,percent of total billed charges,,2355.5,2967.8,
X C SPINE 1V,26101261,CDM,72020,CPT,320,RC,inpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X MYELOGRAM INJECTION,26101279,CDM,62284,CPT,769,RC,inpatient,TC,2055,2055,,1744.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1549.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1746.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1808.4,88,,percent of total billed charges,,,,,,,,,1570.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1870.05,91,,percent of total billed charges,,,1952.25,95,,percent of total billed charges,,,1705.65,83,,percent of total billed charges,,,1705.65,83,,percent of total billed charges,,,,,,,,,,,,,,,1705.65,83,,percent of total billed charges,,,1952.25,95,,percent of total billed charges,,,1849.5,90,,percent of total billed charges,,,1849.5,90,,percent of total billed charges,,,1685.1,82,,percent of total billed charges,,,1849.5,90,,percent of total billed charges,,,1746.75,85,,percent of total billed charges,,1549.47,1952.25,
X SHOULDER ARTHRO/INJ,26101287,CDM,23350,CPT,361,RC,inpatient,TC,1420,1420,,1205.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1070.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1207,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1249.6,88,,percent of total billed charges,,,,,,,,,1084.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1292.2,91,,percent of total billed charges,,,1349,95,,percent of total billed charges,,,1178.6,83,,percent of total billed charges,,,1178.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1178.6,83,,percent of total billed charges,,,1349,95,,percent of total billed charges,,,1278,90,,percent of total billed charges,,,1278,90,,percent of total billed charges,,,1164.4,82,,percent of total billed charges,,,1278,90,,percent of total billed charges,,,1207,85,,percent of total billed charges,,1070.68,1349,
X L SPINE 1V,26101295,CDM,72020,CPT,320,RC,inpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X T SPINE 1V,26101303,CDM,72020,CPT,320,RC,inpatient,TC,395,395,,335.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,297.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,335.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,347.6,88,,percent of total billed charges,,,,,,,,,301.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,359.45,91,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,,,,,,,,,,,,,327.85,83,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,323.9,82,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,297.83,375.25,
X T SPINE 2V,26101305,CDM,72070,CPT,320,RC,inpatient,TC,519,519,,440.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,391.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,441.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,456.72,88,,percent of total billed charges,,,,,,,,,396.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,472.29,91,,percent of total billed charges,,,493.05,95,,percent of total billed charges,,,430.77,83,,percent of total billed charges,,,430.77,83,,percent of total billed charges,,,,,,,,,,,,,,,430.77,83,,percent of total billed charges,,,493.05,95,,percent of total billed charges,,,467.1,90,,percent of total billed charges,,,467.1,90,,percent of total billed charges,,,425.58,82,,percent of total billed charges,,,467.1,90,,percent of total billed charges,,,441.15,85,,percent of total billed charges,,391.33,493.05,
X T SPINE 4V+,26101306,CDM,72074,CPT,320,RC,inpatient,TC,688,688,,584.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,518.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,584.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,605.44,88,,percent of total billed charges,,,,,,,,,525.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,626.08,91,,percent of total billed charges,,,653.6,95,,percent of total billed charges,,,571.04,83,,percent of total billed charges,,,571.04,83,,percent of total billed charges,,,,,,,,,,,,,,,571.04,83,,percent of total billed charges,,,653.6,95,,percent of total billed charges,,,619.2,90,,percent of total billed charges,,,619.2,90,,percent of total billed charges,,,564.16,82,,percent of total billed charges,,,619.2,90,,percent of total billed charges,,,584.8,85,,percent of total billed charges,,518.75,653.6,
X CYSTOGRAPHY INJECT PFA,26101311,CDM,51600,CPT,769,RC,inpatient,TC,1582,1582,,1343.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1192.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1344.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1392.16,88,,percent of total billed charges,,,,,,,,,1208.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1439.62,91,,percent of total billed charges,,,1502.9,95,,percent of total billed charges,,,1313.06,83,,percent of total billed charges,,,1313.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1313.06,83,,percent of total billed charges,,,1502.9,95,,percent of total billed charges,,,1423.8,90,,percent of total billed charges,,,1423.8,90,,percent of total billed charges,,,1297.24,82,,percent of total billed charges,,,1423.8,90,,percent of total billed charges,,,1344.7,85,,percent of total billed charges,,1192.83,1502.9,
DX DXAVERFXASSESS(<2YRTRN),26101315,CDM,77086,CPT,320,RC,inpatient,TC,586,586,,497.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,441.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,498.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,515.68,88,,percent of total billed charges,,,,,,,,,447.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,533.26,91,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,,,,,,,,,,,,,486.38,83,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,480.52,82,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,498.1,85,,percent of total billed charges,,441.84,556.7,
DX DXA BONE DENS/WRIST,26101317,CDM,77081,CPT,320,RC,inpatient,TC,645,645,,547.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,486.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,548.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,567.6,88,,percent of total billed charges,,,,,,,,,492.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,586.95,91,,percent of total billed charges,,,612.75,95,,percent of total billed charges,,,535.35,83,,percent of total billed charges,,,535.35,83,,percent of total billed charges,,,,,,,,,,,,,,,535.35,83,,percent of total billed charges,,,612.75,95,,percent of total billed charges,,,580.5,90,,percent of total billed charges,,,580.5,90,,percent of total billed charges,,,528.9,82,,percent of total billed charges,,,580.5,90,,percent of total billed charges,,,548.25,85,,percent of total billed charges,,486.33,612.75,
DX DXA BONE DENS/HIP/SPINE,26101319,CDM,77080,CPT,320,RC,inpatient,TC,950,950,,806.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,716.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,807.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,836,88,,percent of total billed charges,,,,,,,,,725.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,864.5,91,,percent of total billed charges,,,902.5,95,,percent of total billed charges,,,788.5,83,,percent of total billed charges,,,788.5,83,,percent of total billed charges,,,,,,,,,,,,,,,788.5,83,,percent of total billed charges,,,902.5,95,,percent of total billed charges,,,855,90,,percent of total billed charges,,,855,90,,percent of total billed charges,,,779,82,,percent of total billed charges,,,855,90,,percent of total billed charges,,,807.5,85,,percent of total billed charges,,716.3,902.5,
X BAR SWAL W/ SPEECH,26101337,CDM,74230,CPT,320,RC,inpatient,TC,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,784.16,988,
X KNEE ARTHRO INJECT,26101543,CDM,27369,CPT,769,RC,inpatient,TC,957,957,,812.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,721.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,813.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,842.16,88,,percent of total billed charges,,,,,,,,,731.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,870.87,91,,percent of total billed charges,,,909.15,95,,percent of total billed charges,,,794.31,83,,percent of total billed charges,,,794.31,83,,percent of total billed charges,,,,,,,,,,,,,,,794.31,83,,percent of total billed charges,,,909.15,95,,percent of total billed charges,,,861.3,90,,percent of total billed charges,,,861.3,90,,percent of total billed charges,,,784.74,82,,percent of total billed charges,,,861.3,90,,percent of total billed charges,,,813.45,85,,percent of total billed charges,,721.58,909.15,
X VENOGRAM INJECT,26101576,CDM,36005,CPT,769,RC,inpatient,,2415,2415,,2050.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1820.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2052.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2125.2,88,,percent of total billed charges,,,,,,,,,1845.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2197.65,91,,percent of total billed charges,,,2294.25,95,,percent of total billed charges,,,2004.45,83,,percent of total billed charges,,,2004.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2004.45,83,,percent of total billed charges,,,2294.25,95,,percent of total billed charges,,,2173.5,90,,percent of total billed charges,,,2173.5,90,,percent of total billed charges,,,1980.3,82,,percent of total billed charges,,,2173.5,90,,percent of total billed charges,,,2052.75,85,,percent of total billed charges,,1820.91,2294.25,
X SINUS-TRACT INJECT,26101584,CDM,20501,CPT,769,RC,inpatient,,1101,1101,,934.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,830.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,935.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,968.88,88,,percent of total billed charges,,,,,,,,,841.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1001.91,91,,percent of total billed charges,,,1045.95,95,,percent of total billed charges,,,913.83,83,,percent of total billed charges,,,913.83,83,,percent of total billed charges,,,,,,,,,,,,,,,913.83,83,,percent of total billed charges,,,1045.95,95,,percent of total billed charges,,,990.9,90,,percent of total billed charges,,,990.9,90,,percent of total billed charges,,,902.82,82,,percent of total billed charges,,,990.9,90,,percent of total billed charges,,,935.85,85,,percent of total billed charges,,830.15,1045.95,
X ANKLE RIGHT 2V,26101592,CDM,73600,CPT,320,RC,inpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X ANKLE LEFT 2V,26101593,CDM,73600,CPT,320,RC,inpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X SKULL 1-3V,26101600,CDM,70250,CPT,320,RC,inpatient,TC,509,509,,432.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,383.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,432.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,447.92,88,,percent of total billed charges,,,,,,,,,388.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,463.19,91,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,,,,,,,,,,,,,422.47,83,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,417.38,82,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,383.79,483.55,
X ELBOW ARTHRO INJECT,26101614,CDM,24220,CPT,769,RC,inpatient,TC,873,873,,741.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,658.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,742.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,768.24,88,,percent of total billed charges,,,,,,,,,666.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,794.43,91,,percent of total billed charges,,,829.35,95,,percent of total billed charges,,,724.59,83,,percent of total billed charges,,,724.59,83,,percent of total billed charges,,,,,,,,,,,,,,,724.59,83,,percent of total billed charges,,,829.35,95,,percent of total billed charges,,,785.7,90,,percent of total billed charges,,,785.7,90,,percent of total billed charges,,,715.86,82,,percent of total billed charges,,,785.7,90,,percent of total billed charges,,,742.05,85,,percent of total billed charges,,658.24,829.35,
X ELBOW ARTHROGRAM LEFT,26101615,CDM,73085,CPT,320,RC,inpatient,LT,1360,1360,,1154.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1025.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1156,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1196.8,88,,percent of total billed charges,,,,,,,,,1039.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1237.6,91,,percent of total billed charges,,,1292,95,,percent of total billed charges,,,1128.8,83,,percent of total billed charges,,,1128.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1128.8,83,,percent of total billed charges,,,1292,95,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1115.2,82,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1156,85,,percent of total billed charges,,1025.44,1292,
X ELBOW ARTHROGRAM RIGHT,26101616,CDM,73085,CPT,320,RC,inpatient,RT,1360,1360,,1154.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1025.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1156,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1196.8,88,,percent of total billed charges,,,,,,,,,1039.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1237.6,91,,percent of total billed charges,,,1292,95,,percent of total billed charges,,,1128.8,83,,percent of total billed charges,,,1128.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1128.8,83,,percent of total billed charges,,,1292,95,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1115.2,82,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1156,85,,percent of total billed charges,,1025.44,1292,
X WRIST LEFT 2V,26101617,CDM,73100,CPT,320,RC,inpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X WRIST RIGHT 2V,26101618,CDM,73100,CPT,320,RC,inpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X WRIST ARTHRO INJECT,26101619,CDM,25246,CPT,769,RC,inpatient,TC,896,896,,760.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,675.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,761.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,788.48,88,,percent of total billed charges,,,,,,,,,684.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,815.36,91,,percent of total billed charges,,,851.2,95,,percent of total billed charges,,,743.68,83,,percent of total billed charges,,,743.68,83,,percent of total billed charges,,,,,,,,,,,,,,,743.68,83,,percent of total billed charges,,,851.2,95,,percent of total billed charges,,,806.4,90,,percent of total billed charges,,,806.4,90,,percent of total billed charges,,,734.72,82,,percent of total billed charges,,,806.4,90,,percent of total billed charges,,,761.6,85,,percent of total billed charges,,675.58,851.2,
X WRIST ARTHROGRAM RIGHT,26101620,CDM,73115,CPT,320,RC,inpatient,RT,1346,1346,,1142.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1014.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1144.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1184.48,88,,percent of total billed charges,,,,,,,,,1028.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1224.86,91,,percent of total billed charges,,,1278.7,95,,percent of total billed charges,,,1117.18,83,,percent of total billed charges,,,1117.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1117.18,83,,percent of total billed charges,,,1278.7,95,,percent of total billed charges,,,1211.4,90,,percent of total billed charges,,,1211.4,90,,percent of total billed charges,,,1103.72,82,,percent of total billed charges,,,1211.4,90,,percent of total billed charges,,,1144.1,85,,percent of total billed charges,,1014.88,1278.7,
X WRIST ARTHROGRAM LEFT,26101621,CDM,73115,CPT,320,RC,inpatient,LT,1346,1346,,1142.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1014.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1144.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1184.48,88,,percent of total billed charges,,,,,,,,,1028.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1224.86,91,,percent of total billed charges,,,1278.7,95,,percent of total billed charges,,,1117.18,83,,percent of total billed charges,,,1117.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1117.18,83,,percent of total billed charges,,,1278.7,95,,percent of total billed charges,,,1211.4,90,,percent of total billed charges,,,1211.4,90,,percent of total billed charges,,,1103.72,82,,percent of total billed charges,,,1211.4,90,,percent of total billed charges,,,1144.1,85,,percent of total billed charges,,1014.88,1278.7,
X C SPINE 2V OR 3V,26101627,CDM,72040,CPT,320,RC,inpatient,TC,549,549,,466.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,413.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,466.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,483.12,88,,percent of total billed charges,,,,,,,,,419.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,499.59,91,,percent of total billed charges,,,521.55,95,,percent of total billed charges,,,455.67,83,,percent of total billed charges,,,455.67,83,,percent of total billed charges,,,,,,,,,,,,,,,455.67,83,,percent of total billed charges,,,521.55,95,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,450.18,82,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,466.65,85,,percent of total billed charges,,413.95,521.55,
X FOOT RIGHT 2V,26101634,CDM,73620,CPT,320,RC,inpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X FOOT LEFT 2V,26101635,CDM,73620,CPT,320,RC,inpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X CHEST 4V,26101659,CDM,71048,CPT,324,RC,inpatient,TC,660,660,,560.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,497.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,561,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,580.8,88,,percent of total billed charges,,,,,,,,,504.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,600.6,91,,percent of total billed charges,,,627,95,,percent of total billed charges,,,547.8,83,,percent of total billed charges,,,547.8,83,,percent of total billed charges,,,,,,,,,,,,,,,547.8,83,,percent of total billed charges,,,627,95,,percent of total billed charges,,,594,90,,percent of total billed charges,,,594,90,,percent of total billed charges,,,541.2,82,,percent of total billed charges,,,594,90,,percent of total billed charges,,,561,85,,percent of total billed charges,,497.64,627,
X ELBOW RIGHT 2V,26101675,CDM,73070,CPT,320,RC,inpatient,RT,395,395,,335.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,297.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,335.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,347.6,88,,percent of total billed charges,,,,,,,,,301.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,359.45,91,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,,,,,,,,,,,,,327.85,83,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,323.9,82,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,297.83,375.25,
X ELBOW LEFT 2V,26101676,CDM,73070,CPT,320,RC,inpatient,LT,395,395,,335.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,297.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,335.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,347.6,88,,percent of total billed charges,,,,,,,,,301.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,359.45,91,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,,,,,,,,,,,,,327.85,83,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,323.9,82,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,297.83,375.25,
X HAND RIGHT 2V,26101683,CDM,73120,CPT,320,RC,inpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X HAND LEFT 2V,26101684,CDM,73120,CPT,320,RC,inpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X CHEST SPCL (DECUB) 1V+,26101691,CDM,71046,CPT,324,RC,inpatient,TC,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,294.06,370.5,
X SIJTARTHOSTEROIDINJRT,26101888,CDM,27096,CPT,320,RC,inpatient,RT,1757,1757,,1491.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1324.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1493.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1546.16,88,,percent of total billed charges,,,,,,,,,1342.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1598.87,91,,percent of total billed charges,,,1669.15,95,,percent of total billed charges,,,1458.31,83,,percent of total billed charges,,,1458.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1458.31,83,,percent of total billed charges,,,1669.15,95,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1440.74,82,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1493.45,85,,percent of total billed charges,,1324.78,1669.15,
X SI JTARTHOSTEROIDINJLT,26101889,CDM,27096,CPT,320,RC,inpatient,LT,1757,1757,,1491.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1324.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1493.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1546.16,88,,percent of total billed charges,,,,,,,,,1342.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1598.87,91,,percent of total billed charges,,,1669.15,95,,percent of total billed charges,,,1458.31,83,,percent of total billed charges,,,1458.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1458.31,83,,percent of total billed charges,,,1669.15,95,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1440.74,82,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1493.45,85,,percent of total billed charges,,1324.78,1669.15,
* DNU X SI ARTHRO/INJECTION,26101890,CDM,27096,CPT,361,RC,inpatient,,2070,2070,,1757.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1560.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1759.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1821.6,88,,percent of total billed charges,,,,,,,,,1581.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1883.7,91,,percent of total billed charges,,,1966.5,95,,percent of total billed charges,,,1718.1,83,,percent of total billed charges,,,1718.1,83,,percent of total billed charges,,,,,,,,,,,,,,,1718.1,83,,percent of total billed charges,,,1966.5,95,,percent of total billed charges,,,1863,90,,percent of total billed charges,,,1863,90,,percent of total billed charges,,,1697.4,82,,percent of total billed charges,,,1863,90,,percent of total billed charges,,,1759.5,85,,percent of total billed charges,,1560.78,1966.5,
X SI JTARTHOSTEROIDINJBIL,26101891,CDM,27096,CPT,320,RC,inpatient,50,3513,3513,,2982.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2648.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2986.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3091.44,88,,percent of total billed charges,,,,,,,,,2683.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3196.83,91,,percent of total billed charges,,,3337.35,95,,percent of total billed charges,,,2915.79,83,,percent of total billed charges,,,2915.79,83,,percent of total billed charges,,,,,,,,,,,,,,,2915.79,83,,percent of total billed charges,,,3337.35,95,,percent of total billed charges,,,3161.7,90,,percent of total billed charges,,,3161.7,90,,percent of total billed charges,,,2880.66,82,,percent of total billed charges,,,3161.7,90,,percent of total billed charges,,,2986.05,85,,percent of total billed charges,,2648.8,3337.35,
X LUMBARPUNCFORPATHANAL,26101892,CDM,62270,CPT,320,RC,inpatient,TC,1817,1817,,1542.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1370.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1544.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1598.96,88,,percent of total billed charges,,,,,,,,,1388.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1653.47,91,,percent of total billed charges,,,1726.15,95,,percent of total billed charges,,,1508.11,83,,percent of total billed charges,,,1508.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1508.11,83,,percent of total billed charges,,,1726.15,95,,percent of total billed charges,,,1635.3,90,,percent of total billed charges,,,1635.3,90,,percent of total billed charges,,,1489.94,82,,percent of total billed charges,,,1635.3,90,,percent of total billed charges,,,1544.45,85,,percent of total billed charges,,1370.02,1726.15,
X LOW EXT INFANT RIGHT 2V,26101980,CDM,73592,CPT,320,RC,inpatient,RT,427,427,,362.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,321.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,362.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,375.76,88,,percent of total billed charges,,,,,,,,,326.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,388.57,91,,percent of total billed charges,,,405.65,95,,percent of total billed charges,,,354.41,83,,percent of total billed charges,,,354.41,83,,percent of total billed charges,,,,,,,,,,,,,,,354.41,83,,percent of total billed charges,,,405.65,95,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,350.14,82,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,362.95,85,,percent of total billed charges,,321.96,405.65,
X LOW EXT INFANT LEFT 2V,26101981,CDM,73592,CPT,320,RC,inpatient,LT,427,427,,362.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,321.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,362.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,375.76,88,,percent of total billed charges,,,,,,,,,326.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,388.57,91,,percent of total billed charges,,,405.65,95,,percent of total billed charges,,,354.41,83,,percent of total billed charges,,,354.41,83,,percent of total billed charges,,,,,,,,,,,,,,,354.41,83,,percent of total billed charges,,,405.65,95,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,350.14,82,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,362.95,85,,percent of total billed charges,,321.96,405.65,
X HIP ARTHRO INJ,26101987,CDM,27093,CPT,361,RC,inpatient,TC,1656,1656,,1405.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1248.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1407.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1457.28,88,,percent of total billed charges,,,,,,,,,1265.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1506.96,91,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1374.48,83,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1357.92,82,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1407.6,85,,percent of total billed charges,,1248.62,1573.2,
X LOW EXT INFANT BIL 2V,26101989,CDM,73592,CPT,320,RC,inpatient,50,854,854,,725.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,643.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,725.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,751.52,88,,percent of total billed charges,,,,,,,,,652.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,777.14,91,,percent of total billed charges,,,811.3,95,,percent of total billed charges,,,708.82,83,,percent of total billed charges,,,708.82,83,,percent of total billed charges,,,,,,,,,,,,,,,708.82,83,,percent of total billed charges,,,811.3,95,,percent of total billed charges,,,768.6,90,,percent of total billed charges,,,768.6,90,,percent of total billed charges,,,700.28,82,,percent of total billed charges,,,768.6,90,,percent of total billed charges,,,725.9,85,,percent of total billed charges,,643.92,811.3,
X HIP ARTHRO INJ BIL,26101999,CDM,27093,CPT,361,RC,inpatient,50,3315,3315,,2814.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2499.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2817.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2917.2,88,,percent of total billed charges,,,,,,,,,2532.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3016.65,91,,percent of total billed charges,,,3149.25,95,,percent of total billed charges,,,2751.45,83,,percent of total billed charges,,,2751.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2751.45,83,,percent of total billed charges,,,3149.25,95,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2718.3,82,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2817.75,85,,percent of total billed charges,,2499.51,3149.25,
X MANDIBLE 1-3V,26102010,CDM,70100,CPT,320,RC,inpatient,TC,445,445,,377.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,335.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,378.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,391.6,88,,percent of total billed charges,,,,,,,,,339.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,404.95,91,,percent of total billed charges,,,422.75,95,,percent of total billed charges,,,369.35,83,,percent of total billed charges,,,369.35,83,,percent of total billed charges,,,,,,,,,,,,,,,369.35,83,,percent of total billed charges,,,422.75,95,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,364.9,82,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,378.25,85,,percent of total billed charges,,335.53,422.75,
X MASTOIDS 1-2V,26102015,CDM,70120,CPT,320,RC,inpatient,TC,441,441,,374.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,332.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,374.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.08,88,,percent of total billed charges,,,,,,,,,336.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,401.31,91,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,,,,,,,,,,,,,366.03,83,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,361.62,82,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,374.85,85,,percent of total billed charges,,332.51,418.95,
X SINUS 1-2V,26102244,CDM,70210,CPT,320,RC,inpatient,TC,379,379,,321.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,285.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,322.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,333.52,88,,percent of total billed charges,,,,,,,,,289.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,344.89,91,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,,,,,,,,,,,,,314.57,83,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,310.78,82,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,285.77,360.05,
X CLAVICLE BILATERAL,26102300,CDM,73000,CPT,320,RC,inpatient,50,875,875,,742.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,659.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,743.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,770,88,,percent of total billed charges,,,,,,,,,668.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,796.25,91,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,,,,,,,,,,,,,726.25,83,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,717.5,82,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,659.75,831.25,
X ELBOW BILATERAL 3V+,26102301,CDM,73080,CPT,320,RC,inpatient,50,1022,1022,,867.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,770.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,868.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,899.36,88,,percent of total billed charges,,,,,,,,,780.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,930.02,91,,percent of total billed charges,,,970.9,95,,percent of total billed charges,,,848.26,83,,percent of total billed charges,,,848.26,83,,percent of total billed charges,,,,,,,,,,,,,,,848.26,83,,percent of total billed charges,,,970.9,95,,percent of total billed charges,,,919.8,90,,percent of total billed charges,,,919.8,90,,percent of total billed charges,,,838.04,82,,percent of total billed charges,,,919.8,90,,percent of total billed charges,,,868.7,85,,percent of total billed charges,,770.59,970.9,
X FEMUR BILATERAL 2V,26102302,CDM,73552,CPT,320,RC,inpatient,TC,1002,1002,,850.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,755.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,851.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,881.76,88,,percent of total billed charges,,,,,,,,,765.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,911.82,91,,percent of total billed charges,,,951.9,95,,percent of total billed charges,,,831.66,83,,percent of total billed charges,,,831.66,83,,percent of total billed charges,,,,,,,,,,,,,,,831.66,83,,percent of total billed charges,,,951.9,95,,percent of total billed charges,,,901.8,90,,percent of total billed charges,,,901.8,90,,percent of total billed charges,,,821.64,82,,percent of total billed charges,,,901.8,90,,percent of total billed charges,,,851.7,85,,percent of total billed charges,,755.51,951.9,
X FINGER BIL (DO NOT USE),26102303,CDM,73140,CPT,320,RC,inpatient,50,22,22,,18.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19.36,88,,percent of total billed charges,,,,,,,,,16.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20.02,91,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,,,,,,,,,,,,,18.26,83,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.04,82,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,16.59,20.9,
X FOOT BILATERAL 3V+,26102304,CDM,73630,CPT,320,RC,inpatient,50,989,989,,839.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,745.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,840.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,870.32,88,,percent of total billed charges,,,,,,,,,755.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,899.99,91,,percent of total billed charges,,,939.55,95,,percent of total billed charges,,,820.87,83,,percent of total billed charges,,,820.87,83,,percent of total billed charges,,,,,,,,,,,,,,,820.87,83,,percent of total billed charges,,,939.55,95,,percent of total billed charges,,,890.1,90,,percent of total billed charges,,,890.1,90,,percent of total billed charges,,,810.98,82,,percent of total billed charges,,,890.1,90,,percent of total billed charges,,,840.65,85,,percent of total billed charges,,745.71,939.55,
X FOREARM BILATERAL,26102305,CDM,73090,CPT,320,RC,inpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,697.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,786.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,697.45,878.75,
X HAND BILATERAL 3V+,26102306,CDM,73130,CPT,320,RC,inpatient,50,1009,1009,,856.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,760.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,857.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,887.92,88,,percent of total billed charges,,,,,,,,,770.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,918.19,91,,percent of total billed charges,,,958.55,95,,percent of total billed charges,,,837.47,83,,percent of total billed charges,,,837.47,83,,percent of total billed charges,,,,,,,,,,,,,,,837.47,83,,percent of total billed charges,,,958.55,95,,percent of total billed charges,,,908.1,90,,percent of total billed charges,,,908.1,90,,percent of total billed charges,,,827.38,82,,percent of total billed charges,,,908.1,90,,percent of total billed charges,,,857.65,85,,percent of total billed charges,,760.79,958.55,
X HUMERUS BILATERAL 2V+,26102307,CDM,73060,CPT,320,RC,inpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,697.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,786.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,697.45,878.75,
X KNEE BILATERAL 1-2V,26102308,CDM,73560,CPT,320,RC,inpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,697.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,786.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,697.45,878.75,
X LOWER LEG BILATERAL 2V+,26102309,CDM,73590,CPT,320,RC,inpatient,50,941,941,,798.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,709.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,799.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,828.08,88,,percent of total billed charges,,,,,,,,,718.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,856.31,91,,percent of total billed charges,,,893.95,95,,percent of total billed charges,,,781.03,83,,percent of total billed charges,,,781.03,83,,percent of total billed charges,,,,,,,,,,,,,,,781.03,83,,percent of total billed charges,,,893.95,95,,percent of total billed charges,,,846.9,90,,percent of total billed charges,,,846.9,90,,percent of total billed charges,,,771.62,82,,percent of total billed charges,,,846.9,90,,percent of total billed charges,,,799.85,85,,percent of total billed charges,,709.51,893.95,
X CALCANEUS BILATERAL 2V+,26102310,CDM,73650,CPT,320,RC,inpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,697.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,786.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,697.45,878.75,
X SHOULDER BILATERAL 2V+,26102311,CDM,73030,CPT,320,RC,inpatient,50,1057,1057,,897.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,796.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,898.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,930.16,88,,percent of total billed charges,,,,,,,,,807.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,961.87,91,,percent of total billed charges,,,1004.15,95,,percent of total billed charges,,,877.31,83,,percent of total billed charges,,,877.31,83,,percent of total billed charges,,,,,,,,,,,,,,,877.31,83,,percent of total billed charges,,,1004.15,95,,percent of total billed charges,,,951.3,90,,percent of total billed charges,,,951.3,90,,percent of total billed charges,,,866.74,82,,percent of total billed charges,,,951.3,90,,percent of total billed charges,,,898.45,85,,percent of total billed charges,,796.98,1004.15,
X WRIST BILATERAL 3V+,26102313,CDM,73110,CPT,320,RC,inpatient,50,1002,1002,,850.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,755.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,851.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,881.76,88,,percent of total billed charges,,,,,,,,,765.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,911.82,91,,percent of total billed charges,,,951.9,95,,percent of total billed charges,,,831.66,83,,percent of total billed charges,,,831.66,83,,percent of total billed charges,,,,,,,,,,,,,,,831.66,83,,percent of total billed charges,,,951.9,95,,percent of total billed charges,,,901.8,90,,percent of total billed charges,,,901.8,90,,percent of total billed charges,,,821.64,82,,percent of total billed charges,,,901.8,90,,percent of total billed charges,,,851.7,85,,percent of total billed charges,,755.51,951.9,
X FOOT BILATERAL 2V,26102314,CDM,73620,CPT,320,RC,inpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,697.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,786.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,697.45,878.75,
X ELBOW BILATERAL 2V,26102315,CDM,73070,CPT,320,RC,inpatient,50,792,792,,672.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,597.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,673.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,696.96,88,,percent of total billed charges,,,,,,,,,605.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,720.72,91,,percent of total billed charges,,,752.4,95,,percent of total billed charges,,,657.36,83,,percent of total billed charges,,,657.36,83,,percent of total billed charges,,,,,,,,,,,,,,,657.36,83,,percent of total billed charges,,,752.4,95,,percent of total billed charges,,,712.8,90,,percent of total billed charges,,,712.8,90,,percent of total billed charges,,,649.44,82,,percent of total billed charges,,,712.8,90,,percent of total billed charges,,,673.2,85,,percent of total billed charges,,597.17,752.4,
X HAND BILATERAL 2V,26102316,CDM,73120,CPT,320,RC,inpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,697.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,786.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,697.45,878.75,
X WRIST BILATERAL 2V,26102317,CDM,73100,CPT,320,RC,inpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,697.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,786.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,697.45,878.75,
X KNEE BILATERAL 4V+,26102318,CDM,73564,CPT,320,RC,inpatient,50,1563,1563,,1326.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1178.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1328.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1375.44,88,,percent of total billed charges,,,,,,,,,1194.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1422.33,91,,percent of total billed charges,,,1484.85,95,,percent of total billed charges,,,1297.29,83,,percent of total billed charges,,,1297.29,83,,percent of total billed charges,,,,,,,,,,,,,,,1297.29,83,,percent of total billed charges,,,1484.85,95,,percent of total billed charges,,,1406.7,90,,percent of total billed charges,,,1406.7,90,,percent of total billed charges,,,1281.66,82,,percent of total billed charges,,,1406.7,90,,percent of total billed charges,,,1328.55,85,,percent of total billed charges,,1178.5,1484.85,
X SHOULDER BILATERAL 1V,26102319,CDM,73020,CPT,320,RC,inpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,697.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,786.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,697.45,878.75,
X KNEE RIGHT 4V+,26103036,CDM,73564,CPT,320,RC,inpatient,RT,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,589.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,664.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,589.63,742.9,
X KNEE LEFT 4V+,26103037,CDM,73564,CPT,320,RC,inpatient,LT,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,589.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,664.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,589.63,742.9,
X SCNOGRM(LEGLENGTH),26103180,CDM,77073,CPT,320,RC,inpatient,TC,1042,1042,,884.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,785.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,885.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,916.96,88,,percent of total billed charges,,,,,,,,,796.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,948.22,91,,percent of total billed charges,,,989.9,95,,percent of total billed charges,,,864.86,83,,percent of total billed charges,,,864.86,83,,percent of total billed charges,,,,,,,,,,,,,,,864.86,83,,percent of total billed charges,,,989.9,95,,percent of total billed charges,,,937.8,90,,percent of total billed charges,,,937.8,90,,percent of total billed charges,,,854.44,82,,percent of total billed charges,,,937.8,90,,percent of total billed charges,,,885.7,85,,percent of total billed charges,,785.67,989.9,
X UGI W/AIR W/O KUB,26103986,CDM,74246,CPT,320,RC,inpatient,TC,1303,1303,,1106.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,982.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1107.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1146.64,88,,percent of total billed charges,,,,,,,,,995.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1185.73,91,,percent of total billed charges,,,1237.85,95,,percent of total billed charges,,,1081.49,83,,percent of total billed charges,,,1081.49,83,,percent of total billed charges,,,,,,,,,,,,,,,1081.49,83,,percent of total billed charges,,,1237.85,95,,percent of total billed charges,,,1172.7,90,,percent of total billed charges,,,1172.7,90,,percent of total billed charges,,,1068.46,82,,percent of total billed charges,,,1172.7,90,,percent of total billed charges,,,1107.55,85,,percent of total billed charges,,982.46,1237.85,
X CHEST 1V,26104026,CDM,71045,CPT,324,RC,inpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X KNEE ARTHRO RIGHT,26104034,CDM,73580,CPT,320,RC,inpatient,RT,1538,1538,,1305.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1159.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1307.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1353.44,88,,percent of total billed charges,,,,,,,,,1175.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1399.58,91,,percent of total billed charges,,,1461.1,95,,percent of total billed charges,,,1276.54,83,,percent of total billed charges,,,1276.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1276.54,83,,percent of total billed charges,,,1461.1,95,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1261.16,82,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1307.3,85,,percent of total billed charges,,1159.65,1461.1,
X KNEE ARTHRO LEFT,26104035,CDM,73580,CPT,320,RC,inpatient,LT,1538,1538,,1305.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1159.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1307.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1353.44,88,,percent of total billed charges,,,,,,,,,1175.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1399.58,91,,percent of total billed charges,,,1461.1,95,,percent of total billed charges,,,1276.54,83,,percent of total billed charges,,,1276.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1276.54,83,,percent of total billed charges,,,1461.1,95,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1261.16,82,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1307.3,85,,percent of total billed charges,,1159.65,1461.1,
X CHEST W/AP LORDOTIC 3V,26104042,CDM,71047,CPT,324,RC,inpatient,TC,512,512,,434.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,386.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,435.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,450.56,88,,percent of total billed charges,,,,,,,,,391.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,465.92,91,,percent of total billed charges,,,486.4,95,,percent of total billed charges,,,424.96,83,,percent of total billed charges,,,424.96,83,,percent of total billed charges,,,,,,,,,,,,,,,424.96,83,,percent of total billed charges,,,486.4,95,,percent of total billed charges,,,460.8,90,,percent of total billed charges,,,460.8,90,,percent of total billed charges,,,419.84,82,,percent of total billed charges,,,460.8,90,,percent of total billed charges,,,435.2,85,,percent of total billed charges,,386.05,486.4,
X CHEST PA OR LAT W/OBLIQUES,26104059,CDM,71047,CPT,324,RC,inpatient,TC,585,585,,496.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,441.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,497.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,514.8,88,,percent of total billed charges,,,,,,,,,446.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,532.35,91,,percent of total billed charges,,,555.75,95,,percent of total billed charges,,,485.55,83,,percent of total billed charges,,,485.55,83,,percent of total billed charges,,,,,,,,,,,,,,,485.55,83,,percent of total billed charges,,,555.75,95,,percent of total billed charges,,,526.5,90,,percent of total billed charges,,,526.5,90,,percent of total billed charges,,,479.7,82,,percent of total billed charges,,,526.5,90,,percent of total billed charges,,,497.25,85,,percent of total billed charges,,441.09,555.75,
X SCOLIOSIS,26104067,CDM,72081,CPT,320,RC,inpatient,TC,474,474,,402.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,357.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,402.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,417.12,88,,percent of total billed charges,,,,,,,,,362.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,431.34,91,,percent of total billed charges,,,450.3,95,,percent of total billed charges,,,393.42,83,,percent of total billed charges,,,393.42,83,,percent of total billed charges,,,,,,,,,,,,,,,393.42,83,,percent of total billed charges,,,450.3,95,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,388.68,82,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,402.9,85,,percent of total billed charges,,357.4,450.3,
X NECK SOFT TISSUE 2V,26104075,CDM,70360,CPT,320,RC,inpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X CYSTOGRAM VOIDING (VCUG),26104083,CDM,74455,CPT,320,RC,inpatient,TC,2246,2246,,1906.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1693.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1909.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1976.48,88,,percent of total billed charges,,,,,,,,,1715.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2043.86,91,,percent of total billed charges,,,2133.7,95,,percent of total billed charges,,,1864.18,83,,percent of total billed charges,,,1864.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1864.18,83,,percent of total billed charges,,,2133.7,95,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,1841.72,82,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,1909.1,85,,percent of total billed charges,,1693.48,2133.7,
X UGI W/ AIR W/ SBFT,26104091,CDM,74246,CPT,320,RC,inpatient,TC,1935,1935,,1642.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1458.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1644.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1702.8,88,,percent of total billed charges,,,,,,,,,1478.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1760.85,91,,percent of total billed charges,,,1838.25,95,,percent of total billed charges,,,1606.05,83,,percent of total billed charges,,,1606.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1606.05,83,,percent of total billed charges,,,1838.25,95,,percent of total billed charges,,,1741.5,90,,percent of total billed charges,,,1741.5,90,,percent of total billed charges,,,1586.7,82,,percent of total billed charges,,,1741.5,90,,percent of total billed charges,,,1644.75,85,,percent of total billed charges,,1458.99,1838.25,
X UGI W/KUB,26104092,CDM,74240,CPT,320,RC,inpatient,TC,1466,1466,,1244.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1105.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1246.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1290.08,88,,percent of total billed charges,,,,,,,,,1120.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1334.06,91,,percent of total billed charges,,,1392.7,95,,percent of total billed charges,,,1216.78,83,,percent of total billed charges,,,1216.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1216.78,83,,percent of total billed charges,,,1392.7,95,,percent of total billed charges,,,1319.4,90,,percent of total billed charges,,,1319.4,90,,percent of total billed charges,,,1202.12,82,,percent of total billed charges,,,1319.4,90,,percent of total billed charges,,,1246.1,85,,percent of total billed charges,,1105.36,1392.7,
X UGI W/SBFT,26104093,CDM,74248,CPT,320,RC,inpatient,TC,1933,1933,,1641.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1457.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1643.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1701.04,88,,percent of total billed charges,,,,,,,,,1476.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1759.03,91,,percent of total billed charges,,,1836.35,95,,percent of total billed charges,,,1604.39,83,,percent of total billed charges,,,1604.39,83,,percent of total billed charges,,,,,,,,,,,,,,,1604.39,83,,percent of total billed charges,,,1836.35,95,,percent of total billed charges,,,1739.7,90,,percent of total billed charges,,,1739.7,90,,percent of total billed charges,,,1585.06,82,,percent of total billed charges,,,1739.7,90,,percent of total billed charges,,,1643.05,85,,percent of total billed charges,,1457.48,1836.35,
X UGI W/ AIR W/ KUB,26104094,CDM,74246,CPT,320,RC,inpatient,TC,1558,1558,,1322.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1174.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1324.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1371.04,88,,percent of total billed charges,,,,,,,,,1190.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1417.78,91,,percent of total billed charges,,,1480.1,95,,percent of total billed charges,,,1293.14,83,,percent of total billed charges,,,1293.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1293.14,83,,percent of total billed charges,,,1480.1,95,,percent of total billed charges,,,1402.2,90,,percent of total billed charges,,,1402.2,90,,percent of total billed charges,,,1277.56,82,,percent of total billed charges,,,1402.2,90,,percent of total billed charges,,,1324.3,85,,percent of total billed charges,,1174.73,1480.1,
X ABD OBSTR W/PA CHEST,26104109,CDM,74022,CPT,320,RC,inpatient,TC,785,785,,666.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,591.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,667.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,690.8,88,,percent of total billed charges,,,,,,,,,599.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,714.35,91,,percent of total billed charges,,,745.75,95,,percent of total billed charges,,,651.55,83,,percent of total billed charges,,,651.55,83,,percent of total billed charges,,,,,,,,,,,,,,,651.55,83,,percent of total billed charges,,,745.75,95,,percent of total billed charges,,,706.5,90,,percent of total billed charges,,,706.5,90,,percent of total billed charges,,,643.7,82,,percent of total billed charges,,,706.5,90,,percent of total billed charges,,,667.25,85,,percent of total billed charges,,591.89,745.75,
X SC JTS 3V+,26104133,CDM,71130,CPT,320,RC,inpatient,TC,445,445,,377.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,335.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,378.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,391.6,88,,percent of total billed charges,,,,,,,,,339.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,404.95,91,,percent of total billed charges,,,422.75,95,,percent of total billed charges,,,369.35,83,,percent of total billed charges,,,369.35,83,,percent of total billed charges,,,,,,,,,,,,,,,369.35,83,,percent of total billed charges,,,422.75,95,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,364.9,82,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,378.25,85,,percent of total billed charges,,335.53,422.75,
X BONE AGE STUDY,26104510,CDM,77072,CPT,320,RC,inpatient,TC,415,415,,352.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,312.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,352.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,365.2,88,,percent of total billed charges,,,,,,,,,317.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,377.65,91,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,,,,,,,,,,,,,344.45,83,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,340.3,82,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,312.91,394.25,
X KNEES AP WB BIL/1 FILM,26104521,CDM,73565,CPT,320,RC,inpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X STRESS (ANY JT),26104701,CDM,77071,CPT,320,RC,inpatient,TC,364,364,,309.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,274.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,309.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,320.32,88,,percent of total billed charges,,,,,,,,,278.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,331.24,91,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,,,,,,,,,,,,,302.12,83,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,298.48,82,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,309.4,85,,percent of total billed charges,,274.46,345.8,
X ORBIT (FB LOC),26104800,CDM,70030,CPT,320,RC,inpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X NAVICULAR RIGHT 2V,26158998,CDM,73100,CPT,320,RC,inpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X NAVICULAR LEFT 2V,26158999,CDM,73100,CPT,320,RC,inpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,348.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,392.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,348.35,438.9,
X PICC LINE WO IMAGING,26200000,CDM,36569,CPT,320,RC,inpatient,TC,9006,9006,,7646.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6790.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7655.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7925.28,88,,percent of total billed charges,,,,,,,,,6880.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8195.46,91,,percent of total billed charges,,,8555.7,95,,percent of total billed charges,,,7474.98,83,,percent of total billed charges,,,7474.98,83,,percent of total billed charges,,,,,,,,,,,,,,,7474.98,83,,percent of total billed charges,,,8555.7,95,,percent of total billed charges,,,8105.4,90,,percent of total billed charges,,,8105.4,90,,percent of total billed charges,,,7384.92,82,,percent of total billed charges,,,8105.4,90,,percent of total billed charges,,,7655.1,85,,percent of total billed charges,,6790.52,8555.7,
X EPIBLOODPATCHW/FLUORO,26200001,CDM,62273,CPT,320,RC,inpatient,TC,7778,7778,,6603.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5864.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6611.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6844.64,88,,percent of total billed charges,,,,,,,,,5942.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7077.98,91,,percent of total billed charges,,,7389.1,95,,percent of total billed charges,,,6455.74,83,,percent of total billed charges,,,6455.74,83,,percent of total billed charges,,,,,,,,,,,,,,,6455.74,83,,percent of total billed charges,,,7389.1,95,,percent of total billed charges,,,7000.2,90,,percent of total billed charges,,,7000.2,90,,percent of total billed charges,,,6377.96,82,,percent of total billed charges,,,7000.2,90,,percent of total billed charges,,,6611.3,85,,percent of total billed charges,,5864.61,7389.1,
X TRIGGERPTINJ1OR2MUSCLE,26200006,CDM,20552,CPT,320,RC,inpatient,,1732,1732,,1470.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1305.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1472.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1524.16,88,,percent of total billed charges,,,,,,,,,1323.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1576.12,91,,percent of total billed charges,,,1645.4,95,,percent of total billed charges,,,1437.56,83,,percent of total billed charges,,,1437.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1437.56,83,,percent of total billed charges,,,1645.4,95,,percent of total billed charges,,,1558.8,90,,percent of total billed charges,,,1558.8,90,,percent of total billed charges,,,1420.24,82,,percent of total billed charges,,,1558.8,90,,percent of total billed charges,,,1472.2,85,,percent of total billed charges,,1305.93,1645.4,
X DRAIN/INJ MAJOR JT/BURSA BIL,26200007,CDM,20610,CPT,320,RC,inpatient,50,5025,5025,,4266.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3788.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4271.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4422,88,,percent of total billed charges,,,,,,,,,3839.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4572.75,91,,percent of total billed charges,,,4773.75,95,,percent of total billed charges,,,4170.75,83,,percent of total billed charges,,,4170.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4170.75,83,,percent of total billed charges,,,4773.75,95,,percent of total billed charges,,,4522.5,90,,percent of total billed charges,,,4522.5,90,,percent of total billed charges,,,4120.5,82,,percent of total billed charges,,,4522.5,90,,percent of total billed charges,,,4271.25,85,,percent of total billed charges,,3788.85,4773.75,
X FACIAL NERVE BLOCK,26200008,CDM,64999,CPT,920,RC,inpatient,TC,2094,2094,,1777.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1578.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1779.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1842.72,88,,percent of total billed charges,,,,,,,,,1599.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1905.54,91,,percent of total billed charges,,,1989.3,95,,percent of total billed charges,,,1738.02,83,,percent of total billed charges,,,1738.02,83,,percent of total billed charges,,,,,,,,,,,,,,,1738.02,83,,percent of total billed charges,,,1989.3,95,,percent of total billed charges,,,1884.6,90,,percent of total billed charges,,,1884.6,90,,percent of total billed charges,,,1717.08,82,,percent of total billed charges,,,1884.6,90,,percent of total billed charges,,,1779.9,85,,percent of total billed charges,,1578.88,1989.3,
X lUMBAR DISCOGRAM,26200009,CDM,72295,CPT,320,RC,inpatient,TC,19639,19639,,16673.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14807.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16693.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17282.32,88,,percent of total billed charges,,,,,,,,,15004.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17871.49,91,,percent of total billed charges,,,18657.05,95,,percent of total billed charges,,,16300.37,83,,percent of total billed charges,,,16300.37,83,,percent of total billed charges,,,,,,,,,,,,,,,16300.37,83,,percent of total billed charges,,,18657.05,95,,percent of total billed charges,,,17675.1,90,,percent of total billed charges,,,17675.1,90,,percent of total billed charges,,,16103.98,82,,percent of total billed charges,,,17675.1,90,,percent of total billed charges,,,16693.15,85,,percent of total billed charges,,14807.81,18657.05,
X IVPW/OTOM(XPARTOFCTIVP),26200011,CDM,74410,CPT,320,RC,inpatient,TC,1428,1428,,1212.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1076.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1213.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1256.64,88,,percent of total billed charges,,,,,,,,,1090.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1299.48,91,,percent of total billed charges,,,1356.6,95,,percent of total billed charges,,,1185.24,83,,percent of total billed charges,,,1185.24,83,,percent of total billed charges,,,,,,,,,,,,,,,1185.24,83,,percent of total billed charges,,,1356.6,95,,percent of total billed charges,,,1285.2,90,,percent of total billed charges,,,1285.2,90,,percent of total billed charges,,,1170.96,82,,percent of total billed charges,,,1285.2,90,,percent of total billed charges,,,1213.8,85,,percent of total billed charges,,1076.71,1356.6,
X INSERTION OF CHEST TUBE LT,26200013,CDM,32551,CPT,920,RC,inpatient,LT,3003,3003,,2549.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2264.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2552.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2642.64,88,,percent of total billed charges,,,,,,,,,2294.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2732.73,91,,percent of total billed charges,,,2852.85,95,,percent of total billed charges,,,2492.49,83,,percent of total billed charges,,,2492.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2492.49,83,,percent of total billed charges,,,2852.85,95,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2462.46,82,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2552.55,85,,percent of total billed charges,,2264.26,2852.85,
X IVC FILTER,26200016,CDM,37191,CPT,360,RC,inpatient,,16826,16826,,14285.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12686.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14302.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14806.88,88,,percent of total billed charges,,,,,,,,,12855.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15311.66,91,,percent of total billed charges,,,15984.7,95,,percent of total billed charges,,,13965.58,83,,percent of total billed charges,,,13965.58,83,,percent of total billed charges,,,,,,,,,,,,,,,13965.58,83,,percent of total billed charges,,,15984.7,95,,percent of total billed charges,,,15143.4,90,,percent of total billed charges,,,15143.4,90,,percent of total billed charges,,,13797.32,82,,percent of total billed charges,,,15143.4,90,,percent of total billed charges,,,14302.1,85,,percent of total billed charges,,12686.8,15984.7,
X IVC FILTER REMOVAL,26200017,CDM,37193,CPT,360,RC,inpatient,,12717,12717,,10796.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9588.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10809.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11190.96,88,,percent of total billed charges,,,,,,,,,9715.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11572.47,91,,percent of total billed charges,,,12081.15,95,,percent of total billed charges,,,10555.11,83,,percent of total billed charges,,,10555.11,83,,percent of total billed charges,,,,,,,,,,,,,,,10555.11,83,,percent of total billed charges,,,12081.15,95,,percent of total billed charges,,,11445.3,90,,percent of total billed charges,,,11445.3,90,,percent of total billed charges,,,10427.94,82,,percent of total billed charges,,,11445.3,90,,percent of total billed charges,,,10809.45,85,,percent of total billed charges,,9588.62,12081.15,
X REMOVAL OF TUNNELED CT CATH,26200018,CDM,36590,CPT,360,RC,inpatient,TC,6236,6236,,5294.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4701.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5300.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5487.68,88,,percent of total billed charges,,,,,,,,,4764.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5674.76,91,,percent of total billed charges,,,5924.2,95,,percent of total billed charges,,,5175.88,83,,percent of total billed charges,,,5175.88,83,,percent of total billed charges,,,,,,,,,,,,,,,5175.88,83,,percent of total billed charges,,,5924.2,95,,percent of total billed charges,,,5612.4,90,,percent of total billed charges,,,5612.4,90,,percent of total billed charges,,,5113.52,82,,percent of total billed charges,,,5612.4,90,,percent of total billed charges,,,5300.6,85,,percent of total billed charges,,4701.94,5924.2,
UL DRAIN JOINT BURSA LT W/US,26200020,CDM,20611,CPT,320,RC,inpatient,LT,2513,2513,,2133.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1894.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2136.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2211.44,88,,percent of total billed charges,,,,,,,,,1919.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2286.83,91,,percent of total billed charges,,,2387.35,95,,percent of total billed charges,,,2085.79,83,,percent of total billed charges,,,2085.79,83,,percent of total billed charges,,,,,,,,,,,,,,,2085.79,83,,percent of total billed charges,,,2387.35,95,,percent of total billed charges,,,2261.7,90,,percent of total billed charges,,,2261.7,90,,percent of total billed charges,,,2060.66,82,,percent of total billed charges,,,2261.7,90,,percent of total billed charges,,,2136.05,85,,percent of total billed charges,,1894.8,2387.35,
UL DRAIN JOINT BURSA RT W/US,26200021,CDM,20611,CPT,320,RC,inpatient,RT,2513,2513,,2133.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1894.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2136.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2211.44,88,,percent of total billed charges,,,,,,,,,1919.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2286.83,91,,percent of total billed charges,,,2387.35,95,,percent of total billed charges,,,2085.79,83,,percent of total billed charges,,,2085.79,83,,percent of total billed charges,,,,,,,,,,,,,,,2085.79,83,,percent of total billed charges,,,2387.35,95,,percent of total billed charges,,,2261.7,90,,percent of total billed charges,,,2261.7,90,,percent of total billed charges,,,2060.66,82,,percent of total billed charges,,,2261.7,90,,percent of total billed charges,,,2136.05,85,,percent of total billed charges,,1894.8,2387.35,
UL DRAIN JOINT BURSABIL W/US,26200022,CDM,20611,CPT,320,RC,inpatient,50,5025,5025,,4266.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3788.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4271.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4422,88,,percent of total billed charges,,,,,,,,,3839.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4572.75,91,,percent of total billed charges,,,4773.75,95,,percent of total billed charges,,,4170.75,83,,percent of total billed charges,,,4170.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4170.75,83,,percent of total billed charges,,,4773.75,95,,percent of total billed charges,,,4522.5,90,,percent of total billed charges,,,4522.5,90,,percent of total billed charges,,,4120.5,82,,percent of total billed charges,,,4522.5,90,,percent of total billed charges,,,4271.25,85,,percent of total billed charges,,3788.85,4773.75,
X HIP JOINT BX BIL,26200023,CDM,27052,CPT,320,RC,inpatient,50,15657,15657,,13292.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11805.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13308.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13778.16,88,,percent of total billed charges,,,,,,,,,11961.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14247.87,91,,percent of total billed charges,,,14874.15,95,,percent of total billed charges,,,12995.31,83,,percent of total billed charges,,,12995.31,83,,percent of total billed charges,,,,,,,,,,,,,,,12995.31,83,,percent of total billed charges,,,14874.15,95,,percent of total billed charges,,,14091.3,90,,percent of total billed charges,,,14091.3,90,,percent of total billed charges,,,12838.74,82,,percent of total billed charges,,,14091.3,90,,percent of total billed charges,,,13308.45,85,,percent of total billed charges,,11805.38,14874.15,
X HIP JOINT BX LT,26200024,CDM,27052,CPT,320,RC,inpatient,LT,7829,7829,,6646.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5903.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6654.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6889.52,88,,percent of total billed charges,,,,,,,,,5981.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7124.39,91,,percent of total billed charges,,,7437.55,95,,percent of total billed charges,,,6498.07,83,,percent of total billed charges,,,6498.07,83,,percent of total billed charges,,,,,,,,,,,,,,,6498.07,83,,percent of total billed charges,,,7437.55,95,,percent of total billed charges,,,7046.1,90,,percent of total billed charges,,,7046.1,90,,percent of total billed charges,,,6419.78,82,,percent of total billed charges,,,7046.1,90,,percent of total billed charges,,,6654.65,85,,percent of total billed charges,,5903.07,7437.55,
X HIP JOINT BX RT,26200025,CDM,27052,CPT,320,RC,inpatient,RT,7829,7829,,6646.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5903.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6654.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6889.52,88,,percent of total billed charges,,,,,,,,,5981.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7124.39,91,,percent of total billed charges,,,7437.55,95,,percent of total billed charges,,,6498.07,83,,percent of total billed charges,,,6498.07,83,,percent of total billed charges,,,,,,,,,,,,,,,6498.07,83,,percent of total billed charges,,,7437.55,95,,percent of total billed charges,,,7046.1,90,,percent of total billed charges,,,7046.1,90,,percent of total billed charges,,,6419.78,82,,percent of total billed charges,,,7046.1,90,,percent of total billed charges,,,6654.65,85,,percent of total billed charges,,5903.07,7437.55,
X BONE BX DEEP,26200026,CDM,20225,CPT,320,RC,inpatient,TC,4515,4515,,3833.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3404.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3837.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3973.2,88,,percent of total billed charges,,,,,,,,,3449.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4108.65,91,,percent of total billed charges,,,4289.25,95,,percent of total billed charges,,,3747.45,83,,percent of total billed charges,,,3747.45,83,,percent of total billed charges,,,,,,,,,,,,,,,3747.45,83,,percent of total billed charges,,,4289.25,95,,percent of total billed charges,,,4063.5,90,,percent of total billed charges,,,4063.5,90,,percent of total billed charges,,,3702.3,82,,percent of total billed charges,,,4063.5,90,,percent of total billed charges,,,3837.75,85,,percent of total billed charges,,3404.31,4289.25,
X BONE BX SUPERFICIAL,26200027,CDM,20220,CPT,320,RC,inpatient,TC,3196,3196,,2713.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2409.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2716.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2812.48,88,,percent of total billed charges,,,,,,,,,2441.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2908.36,91,,percent of total billed charges,,,3036.2,95,,percent of total billed charges,,,2652.68,83,,percent of total billed charges,,,2652.68,83,,percent of total billed charges,,,,,,,,,,,,,,,2652.68,83,,percent of total billed charges,,,3036.2,95,,percent of total billed charges,,,2876.4,90,,percent of total billed charges,,,2876.4,90,,percent of total billed charges,,,2620.72,82,,percent of total billed charges,,,2876.4,90,,percent of total billed charges,,,2716.6,85,,percent of total billed charges,,2409.78,3036.2,
X GROSHONG CATHETER,26200029,CDM,36556,CPT,320,RC,inpatient,TC,9507,9507,,8071.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7168.28,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8080.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8366.16,88,,percent of total billed charges,,,,,,,,,7263.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8651.37,91,,percent of total billed charges,,,9031.65,95,,percent of total billed charges,,,7890.81,83,,percent of total billed charges,,,7890.81,83,,percent of total billed charges,,,,,,,,,,,,,,,7890.81,83,,percent of total billed charges,,,9031.65,95,,percent of total billed charges,,,8556.3,90,,percent of total billed charges,,,8556.3,90,,percent of total billed charges,,,7795.74,82,,percent of total billed charges,,,8556.3,90,,percent of total billed charges,,,8080.95,85,,percent of total billed charges,,7168.28,9031.65,
X GROSHONG REMOVAL CATHETER,26200030,CDM,36589,CPT,320,RC,inpatient,TC,7163,7163,,6081.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5400.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6088.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6303.44,88,,percent of total billed charges,,,,,,,,,5472.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6518.33,91,,percent of total billed charges,,,6804.85,95,,percent of total billed charges,,,5945.29,83,,percent of total billed charges,,,5945.29,83,,percent of total billed charges,,,,,,,,,,,,,,,5945.29,83,,percent of total billed charges,,,6804.85,95,,percent of total billed charges,,,6446.7,90,,percent of total billed charges,,,6446.7,90,,percent of total billed charges,,,5873.66,82,,percent of total billed charges,,,6446.7,90,,percent of total billed charges,,,6088.55,85,,percent of total billed charges,,5400.9,6804.85,
X IR AAA REPAIR,26200032,CDM,34701,CPT,360,RC,inpatient,,21149,21149,,17955.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15946.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17976.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18611.12,88,,percent of total billed charges,,,,,,,,,16157.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19245.59,91,,percent of total billed charges,,,20091.55,95,,percent of total billed charges,,,17553.67,83,,percent of total billed charges,,,17553.67,83,,percent of total billed charges,,,,,,,,,,,,,,,17553.67,83,,percent of total billed charges,,,20091.55,95,,percent of total billed charges,,,19034.1,90,,percent of total billed charges,,,19034.1,90,,percent of total billed charges,,,17342.18,82,,percent of total billed charges,,,19034.1,90,,percent of total billed charges,,,17976.65,85,,percent of total billed charges,,15946.35,20091.55,
X IR CATH ABD AO/RUN OFF,26200033,CDM,75630,CPT,320,RC,inpatient,,9621,9621,,8168.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7254.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8177.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8466.48,88,,percent of total billed charges,,,,,,,,,7350.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8755.11,91,,percent of total billed charges,,,9139.95,95,,percent of total billed charges,,,7985.43,83,,percent of total billed charges,,,7985.43,83,,percent of total billed charges,,,,,,,,,,,,,,,7985.43,83,,percent of total billed charges,,,9139.95,95,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,7889.22,82,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,8177.85,85,,percent of total billed charges,,7254.23,9139.95,
X IR ABDOMINAL AORTOGRAM,26200034,CDM,75625,CPT,360,RC,inpatient,,8186,8186,,6949.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6172.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6958.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7203.68,88,,percent of total billed charges,,,,,,,,,6254.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7449.26,91,,percent of total billed charges,,,7776.7,95,,percent of total billed charges,,,6794.38,83,,percent of total billed charges,,,6794.38,83,,percent of total billed charges,,,,,,,,,,,,,,,6794.38,83,,percent of total billed charges,,,7776.7,95,,percent of total billed charges,,,7367.4,90,,percent of total billed charges,,,7367.4,90,,percent of total billed charges,,,6712.52,82,,percent of total billed charges,,,7367.4,90,,percent of total billed charges,,,6958.1,85,,percent of total billed charges,,6172.24,7776.7,
X IR BIL KISSING STENTS,26200035,CDM,37221,CPT,360,RC,inpatient,,32736,32736,,27792.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24682.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,27825.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,28807.68,88,,percent of total billed charges,,,,,,,,,25010.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,29789.76,91,,percent of total billed charges,,,31099.2,95,,percent of total billed charges,,,27170.88,83,,percent of total billed charges,,,27170.88,83,,percent of total billed charges,,,,,,,,,,,,,,,27170.88,83,,percent of total billed charges,,,31099.2,95,,percent of total billed charges,,,29462.4,90,,percent of total billed charges,,,29462.4,90,,percent of total billed charges,,,26843.52,82,,percent of total billed charges,,,29462.4,90,,percent of total billed charges,,,27825.6,85,,percent of total billed charges,,24682.94,31099.2,
X PICC LINE W IMAGING,26200036,CDM,36573,CPT,320,RC,inpatient,TC,9511,9511,,8074.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7171.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8084.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8369.68,88,,percent of total billed charges,,,,,,,,,7266.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8655.01,91,,percent of total billed charges,,,9035.45,95,,percent of total billed charges,,,7894.13,83,,percent of total billed charges,,,7894.13,83,,percent of total billed charges,,,,,,,,,,,,,,,7894.13,83,,percent of total billed charges,,,9035.45,95,,percent of total billed charges,,,8559.9,90,,percent of total billed charges,,,8559.9,90,,percent of total billed charges,,,7799.02,82,,percent of total billed charges,,,8559.9,90,,percent of total billed charges,,,8084.35,85,,percent of total billed charges,,7171.29,9035.45,
X IR AAA REPAIR,26200037,CDM,34701,CPT,360,RC,inpatient,,20026,20026,,17002.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15099.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17022.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17622.88,88,,percent of total billed charges,,,,,,,,,15299.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18223.66,91,,percent of total billed charges,,,19024.7,95,,percent of total billed charges,,,16621.58,83,,percent of total billed charges,,,16621.58,83,,percent of total billed charges,,,,,,,,,,,,,,,16621.58,83,,percent of total billed charges,,,19024.7,95,,percent of total billed charges,,,18023.4,90,,percent of total billed charges,,,18023.4,90,,percent of total billed charges,,,16421.32,82,,percent of total billed charges,,,18023.4,90,,percent of total billed charges,,,17022.1,85,,percent of total billed charges,,15099.6,19024.7,
X BONE BIOPSY,26200038,CDM,20225,CPT,320,RC,inpatient,TC,4383,4383,,3721.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3304.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3725.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3857.04,88,,percent of total billed charges,,,,,,,,,3348.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3988.53,91,,percent of total billed charges,,,4163.85,95,,percent of total billed charges,,,3637.89,83,,percent of total billed charges,,,3637.89,83,,percent of total billed charges,,,,,,,,,,,,,,,3637.89,83,,percent of total billed charges,,,4163.85,95,,percent of total billed charges,,,3944.7,90,,percent of total billed charges,,,3944.7,90,,percent of total billed charges,,,3594.06,82,,percent of total billed charges,,,3944.7,90,,percent of total billed charges,,,3725.55,85,,percent of total billed charges,,3304.78,4163.85,
X INSERTION CHEST TUBE RIGHT,26200039,CDM,32551,CPT,920,RC,inpatient,RT,3003,3003,,2549.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2264.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2552.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2642.64,88,,percent of total billed charges,,,,,,,,,2294.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2732.73,91,,percent of total billed charges,,,2852.85,95,,percent of total billed charges,,,2492.49,83,,percent of total billed charges,,,2492.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2492.49,83,,percent of total billed charges,,,2852.85,95,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2462.46,82,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2552.55,85,,percent of total billed charges,,2264.26,2852.85,
X ARTHROCENTESISPHYSPRCDR,26200499,CDM,20605,CPT,320,RC,inpatient,,1285,1285,,1090.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,968.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1092.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1130.8,88,,percent of total billed charges,,,,,,,,,981.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1169.35,91,,percent of total billed charges,,,1220.75,95,,percent of total billed charges,,,1066.55,83,,percent of total billed charges,,,1066.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1066.55,83,,percent of total billed charges,,,1220.75,95,,percent of total billed charges,,,1156.5,90,,percent of total billed charges,,,1156.5,90,,percent of total billed charges,,,1053.7,82,,percent of total billed charges,,,1156.5,90,,percent of total billed charges,,,1092.25,85,,percent of total billed charges,,968.89,1220.75,
X HIP 1V BILATERAL W/PELV,26355587,CDM,73501,CPT,320,RC,inpatient,,1514,1514,,1285.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1141.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1286.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1332.32,88,,percent of total billed charges,,,,,,,,,1156.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1377.74,91,,percent of total billed charges,,,1438.3,95,,percent of total billed charges,,,1256.62,83,,percent of total billed charges,,,1256.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1256.62,83,,percent of total billed charges,,,1438.3,95,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1241.48,82,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1286.9,85,,percent of total billed charges,,1141.56,1438.3,
X INJ FORAMEN EPIDURAL L/S,26700119,CDM,64483,CPT,360,RC,inpatient,TC,3465,3465,,2941.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2612.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2945.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3049.2,88,,percent of total billed charges,,,,,,,,,2647.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3153.15,91,,percent of total billed charges,,,3291.75,95,,percent of total billed charges,,,2875.95,83,,percent of total billed charges,,,2875.95,83,,percent of total billed charges,,,,,,,,,,,,,,,2875.95,83,,percent of total billed charges,,,3291.75,95,,percent of total billed charges,,,3118.5,90,,percent of total billed charges,,,3118.5,90,,percent of total billed charges,,,2841.3,82,,percent of total billed charges,,,3118.5,90,,percent of total billed charges,,,2945.25,85,,percent of total billed charges,,2612.61,3291.75,
X INJ FORAMEN EPIDURAL L/S EACH ADDITION,26700300,CDM,64484,CPT,320,RC,inpatient,TC,2619,2619,,2223.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1974.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2226.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2304.72,88,,percent of total billed charges,,,,,,,,,2000.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2383.29,91,,percent of total billed charges,,,2488.05,95,,percent of total billed charges,,,2173.77,83,,percent of total billed charges,,,2173.77,83,,percent of total billed charges,,,,,,,,,,,,,,,2173.77,83,,percent of total billed charges,,,2488.05,95,,percent of total billed charges,,,2357.1,90,,percent of total billed charges,,,2357.1,90,,percent of total billed charges,,,2147.58,82,,percent of total billed charges,,,2357.1,90,,percent of total billed charges,,,2226.15,85,,percent of total billed charges,,1974.73,2488.05,
X CATH ABDAO/RUN OFF,27100900,CDM,75630,CPT,320,RC,inpatient,,8514,8514,,7228.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6419.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7236.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7492.32,88,,percent of total billed charges,,,,,,,,,6504.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7747.74,91,,percent of total billed charges,,,8088.3,95,,percent of total billed charges,,,7066.62,83,,percent of total billed charges,,,7066.62,83,,percent of total billed charges,,,,,,,,,,,,,,,7066.62,83,,percent of total billed charges,,,8088.3,95,,percent of total billed charges,,,7662.6,90,,percent of total billed charges,,,7662.6,90,,percent of total billed charges,,,6981.48,82,,percent of total billed charges,,,7662.6,90,,percent of total billed charges,,,7236.9,85,,percent of total billed charges,,6419.56,8088.3,
CTA CARDIAC W CONTRAST & SCORE,29100525,CDM,75572,CPT,320,RC,inpatient,TC,5229,5229,,4439.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3942.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4444.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4601.52,88,,percent of total billed charges,,,,,,,,,3994.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4758.39,91,,percent of total billed charges,,,4967.55,95,,percent of total billed charges,,,4340.07,83,,percent of total billed charges,,,4340.07,83,,percent of total billed charges,,,,,,,,,,,,,,,4340.07,83,,percent of total billed charges,,,4967.55,95,,percent of total billed charges,,,4706.1,90,,percent of total billed charges,,,4706.1,90,,percent of total billed charges,,,4287.78,82,,percent of total billed charges,,,4706.1,90,,percent of total billed charges,,,4444.65,85,,percent of total billed charges,,3942.67,4967.55,
*DNU GADOLINIUM PER ML (V0108),31100002,CDM,Q9952,HCPCS,270,RC,inpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,52.03,65.55,
GAD PER ML MR AGENT NDC: 00270-5164-14,31100012,CDM,A9579,HCPCS,636,RC,inpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,52.03,65.55,
SPINAL LUMBAR PUNCTURE,33762270,CDM,62270,CPT,370,RC,inpatient,,3124,3124,,2652.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2355.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2655.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2749.12,88,,percent of total billed charges,,,,,,,,,2386.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2842.84,91,,percent of total billed charges,,,2967.8,95,,percent of total billed charges,,,2592.92,83,,percent of total billed charges,,,2592.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2592.92,83,,percent of total billed charges,,,2967.8,95,,percent of total billed charges,,,2811.6,90,,percent of total billed charges,,,2811.6,90,,percent of total billed charges,,,2561.68,82,,percent of total billed charges,,,2811.6,90,,percent of total billed charges,,,2655.4,85,,percent of total billed charges,,2355.5,2967.8,
EEG AWAKE & ASLEEP,14801592,CDM,95819,CPT,740,RC,inpatient,,1881,1881,,1596.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1418.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1598.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1655.28,88,,percent of total billed charges,,,,,,,,,1437.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1711.71,91,,percent of total billed charges,,,1786.95,95,,percent of total billed charges,,,1561.23,83,,percent of total billed charges,,,1561.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1561.23,83,,percent of total billed charges,,,1786.95,95,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1542.42,82,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1598.85,85,,percent of total billed charges,,1418.27,1786.95,
"ST TX OF SPEECH,LNG,COMM &/OR AUDITORY",3643968,CDM,92507,CPT,440,RC,inpatient,GN,500,500,,424.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440,88,,percent of total billed charges,,,,,,,,,382,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,415,83,,percent of total billed charges,,,,,,,,,,,,,,,415,83,,percent of total billed charges,,,475,95,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,410,82,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,377,475,
IPA SPEECH THERAPY TREATMENT 15 MIN,3643969,CDM,92507,CPT,440,RC,inpatient,GN,500,500,,424.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,377,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,425,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,440,88,,percent of total billed charges,,,,,,,,,382,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,415,83,,percent of total billed charges,,,,,,,,,,,,,,,415,83,,percent of total billed charges,,,475,95,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,410,82,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,377,475,
IPA SPEECH THERAPY EVALUATION 15 MIN,3643980,CDM,92521,CPT,440,RC,inpatient,GN,363,363,,308.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,273.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,308.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,319.44,88,,percent of total billed charges,,,,,,,,,277.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,330.33,91,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,,,,,,,,,,,,,301.29,83,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,297.66,82,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,273.7,344.85,
"ST EVAL OF SPEECH,LNG,COMM &/OR AUDITORY",3643984,CDM,92521,CPT,444,RC,inpatient,GN,750,750,,636.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,565.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,637.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,660,88,,percent of total billed charges,,,,,,,,,573,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,682.5,91,,percent of total billed charges,,,712.5,95,,percent of total billed charges,,,622.5,83,,percent of total billed charges,,,622.5,83,,percent of total billed charges,,,,,,,,,,,,,,,622.5,83,,percent of total billed charges,,,712.5,95,,percent of total billed charges,,,675,90,,percent of total billed charges,,,675,90,,percent of total billed charges,,,615,82,,percent of total billed charges,,,675,90,,percent of total billed charges,,,637.5,85,,percent of total billed charges,,565.5,712.5,
"*ST EVAL IPA  SPCH,LNG,COMM,AUD IPA(V71)",3643985,CDM,92506,CPT,444,RC,inpatient,GN,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,283.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,319.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,283.5,357.2,
ST TREATMENT OF SWALLOWING DYSFUNCTION,3644736,CDM,92526,CPT,440,RC,inpatient,GN,452,452,,383.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,340.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,384.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,397.76,88,,percent of total billed charges,,,,,,,,,345.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,411.32,91,,percent of total billed charges,,,429.4,95,,percent of total billed charges,,,375.16,83,,percent of total billed charges,,,375.16,83,,percent of total billed charges,,,,,,,,,,,,,,,375.16,83,,percent of total billed charges,,,429.4,95,,percent of total billed charges,,,406.8,90,,percent of total billed charges,,,406.8,90,,percent of total billed charges,,,370.64,82,,percent of total billed charges,,,406.8,90,,percent of total billed charges,,,384.2,85,,percent of total billed charges,,340.81,429.4,
"ST ASSESS OF APAHASIA W/INTERP,EA HR",3644740,CDM,96105,CPT,440,RC,inpatient,GN,650,650,,551.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,490.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,552.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,572,88,,percent of total billed charges,,,,,,,,,496.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,591.5,91,,percent of total billed charges,,,617.5,95,,percent of total billed charges,,,539.5,83,,percent of total billed charges,,,539.5,83,,percent of total billed charges,,,,,,,,,,,,,,,539.5,83,,percent of total billed charges,,,617.5,95,,percent of total billed charges,,,585,90,,percent of total billed charges,,,585,90,,percent of total billed charges,,,533,82,,percent of total billed charges,,,585,90,,percent of total billed charges,,,552.5,85,,percent of total billed charges,,490.1,617.5,
"ST DEVELOPE TESTING W INTERP, EA HR",3644741,CDM,96111,CPT,440,RC,inpatient,GN,650,650,,551.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,490.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,552.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,572,88,,percent of total billed charges,,,,,,,,,496.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,591.5,91,,percent of total billed charges,,,617.5,95,,percent of total billed charges,,,539.5,83,,percent of total billed charges,,,539.5,83,,percent of total billed charges,,,,,,,,,,,,,,,539.5,83,,percent of total billed charges,,,617.5,95,,percent of total billed charges,,,585,90,,percent of total billed charges,,,585,90,,percent of total billed charges,,,533,82,,percent of total billed charges,,,585,90,,percent of total billed charges,,,552.5,85,,percent of total billed charges,,490.1,617.5,
"ST COGNITIVE SKILLS DEVELOPMNT,EA 15 MIN",3644747,CDM,97129,CPT,440,RC,inpatient,GN,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,99.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,112.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,99.53,125.4,
ST CLINICAL SWALLOW EVAL,3644748,CDM,92610,CPT,444,RC,inpatient,GN,648,648,,550.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,488.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,550.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,570.24,88,,percent of total billed charges,,,,,,,,,495.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,589.68,91,,percent of total billed charges,,,615.6,95,,percent of total billed charges,,,537.84,83,,percent of total billed charges,,,537.84,83,,percent of total billed charges,,,,,,,,,,,,,,,537.84,83,,percent of total billed charges,,,615.6,95,,percent of total billed charges,,,583.2,90,,percent of total billed charges,,,583.2,90,,percent of total billed charges,,,531.36,82,,percent of total billed charges,,,583.2,90,,percent of total billed charges,,,550.8,85,,percent of total billed charges,,488.59,615.6,
ST BARIUM SWALLOW EVALUATION,3644749,CDM,92611,CPT,444,RC,inpatient,GN,907,907,,770.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,683.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,770.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,798.16,88,,percent of total billed charges,,,,,,,,,692.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,825.37,91,,percent of total billed charges,,,861.65,95,,percent of total billed charges,,,752.81,83,,percent of total billed charges,,,752.81,83,,percent of total billed charges,,,,,,,,,,,,,,,752.81,83,,percent of total billed charges,,,861.65,95,,percent of total billed charges,,,816.3,90,,percent of total billed charges,,,816.3,90,,percent of total billed charges,,,743.74,82,,percent of total billed charges,,,816.3,90,,percent of total billed charges,,,770.95,85,,percent of total billed charges,,683.88,861.65,
ST EVAL OF SPEECH DEVICE (1 HOUR),3644750,CDM,92607,CPT,444,RC,inpatient,GN,650,650,,551.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,490.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,552.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,572,88,,percent of total billed charges,,,,,,,,,496.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,591.5,91,,percent of total billed charges,,,617.5,95,,percent of total billed charges,,,539.5,83,,percent of total billed charges,,,539.5,83,,percent of total billed charges,,,,,,,,,,,,,,,539.5,83,,percent of total billed charges,,,617.5,95,,percent of total billed charges,,,585,90,,percent of total billed charges,,,585,90,,percent of total billed charges,,,533,82,,percent of total billed charges,,,585,90,,percent of total billed charges,,,552.5,85,,percent of total billed charges,,490.1,617.5,
"ST EVAL OF SPEECH DEVICE,EA ADDTL 30 MIN",3644752,CDM,92608,CPT,444,RC,inpatient,GN,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
"*ST TX SP,LNG,COMM,AUDITO IPA U6(V0710)",3644755,CDM,92507,CPT,440,RC,inpatient,GN,343,343,,291.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,258.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,291.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,301.84,88,,percent of total billed charges,,,,,,,,,262.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,312.13,91,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,,,,,,,,,,,,,284.69,83,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,281.26,82,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,291.55,85,,percent of total billed charges,,258.62,325.85,
ST STANDARDIZD COGN PERF TEST PER HOUR,3644760,CDM,96125,CPT,444,RC,inpatient,GN,650,650,,551.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,490.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,552.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,572,88,,percent of total billed charges,,,,,,,,,496.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,591.5,91,,percent of total billed charges,,,617.5,95,,percent of total billed charges,,,539.5,83,,percent of total billed charges,,,539.5,83,,percent of total billed charges,,,,,,,,,,,,,,,539.5,83,,percent of total billed charges,,,617.5,95,,percent of total billed charges,,,585,90,,percent of total billed charges,,,585,90,,percent of total billed charges,,,533,82,,percent of total billed charges,,,585,90,,percent of total billed charges,,,552.5,85,,percent of total billed charges,,490.1,617.5,
IPA EVALUATION OF SPEECH,36000200,CDM,92521,CPT,440,RC,inpatient,GN,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,294.06,370.5,
IPA EVALUATION OF SPEECH SOUND PROD,36000201,CDM,92522,CPT,440,RC,inpatient,GN,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,294.06,370.5,
IPA EVALUATION OFSOUND PRODUCTION W LANG,36000202,CDM,92523,CPT,440,RC,inpatient,GN,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,294.06,370.5,
IPA BEHAVIORAL AND QUAL ANALYSIS OF V,36000203,CDM,92524,CPT,440,RC,inpatient,GN,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,294.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,331.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,294.06,370.5,
 SPEECH THERAPY EVALUATION 15 MIN,36092521,CDM,92521,CPT,440,RC,inpatient,GN,780,780,,662.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,588.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,663,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,686.4,88,,percent of total billed charges,,,,,,,,,595.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,,,,,,,,,,,,,647.4,83,,percent of total billed charges,,,741,95,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,639.6,82,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,588.12,741,
EVALUATION OF SPEECH SOUND PRODUCTION,36092522,CDM,92522,CPT,440,RC,inpatient,GN,780,780,,662.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,588.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,663,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,686.4,88,,percent of total billed charges,,,,,,,,,595.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,,,,,,,,,,,,,647.4,83,,percent of total billed charges,,,741,95,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,639.6,82,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,588.12,741,
EVALUATION OFSOUND PRODUCTION W LANGUAGE,36092523,CDM,92523,CPT,440,RC,inpatient,GN,780,780,,662.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,588.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,663,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,686.4,88,,percent of total billed charges,,,,,,,,,595.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,,,,,,,,,,,,,647.4,83,,percent of total billed charges,,,741,95,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,639.6,82,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,588.12,741,
BEHAVIORAL AND QUALITATIVE ANALYSIS OF V,36092524,CDM,92524,CPT,440,RC,inpatient,GN,780,780,,662.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,588.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,663,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,686.4,88,,percent of total billed charges,,,,,,,,,595.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,,,,,,,,,,,,,647.4,83,,percent of total billed charges,,,741,95,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,639.6,82,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,588.12,741,
"ST COGE SKILLS DEVT,EA 15 MIN W THCAP",36901300,CDM,97129,CPT,440,RC,inpatient,KX,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
"ST TX OF SPEECH,LNG,COMM &/OR AUDITORY",36901301,CDM,92507,CPT,440,RC,inpatient,KX,520,520,,441.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,392.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,442,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,457.6,88,,percent of total billed charges,,,,,,,,,397.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,473.2,91,,percent of total billed charges,,,494,95,,percent of total billed charges,,,431.6,83,,percent of total billed charges,,,431.6,83,,percent of total billed charges,,,,,,,,,,,,,,,431.6,83,,percent of total billed charges,,,494,95,,percent of total billed charges,,,468,90,,percent of total billed charges,,,468,90,,percent of total billed charges,,,426.4,82,,percent of total billed charges,,,468,90,,percent of total billed charges,,,442,85,,percent of total billed charges,,392.08,494,
 SPEECH THERAPY EVN 15 MIN W THCAP,36901302,CDM,92521,CPT,440,RC,inpatient,KX,780,780,,662.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,588.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,663,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,686.4,88,,percent of total billed charges,,,,,,,,,595.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,,,,,,,,,,,,,647.4,83,,percent of total billed charges,,,741,95,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,639.6,82,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,588.12,741,
EVALN OF SPEECH SOUND PRODN W THCAP,36901303,CDM,92522,CPT,440,RC,inpatient,KX,780,780,,662.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,588.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,663,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,686.4,88,,percent of total billed charges,,,,,,,,,595.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,,,,,,,,,,,,,647.4,83,,percent of total billed charges,,,741,95,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,639.6,82,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,588.12,741,
EVAON OFSOUND PRODN W LANGUAGE W THCAP,36901304,CDM,92523,CPT,440,RC,inpatient,KX,780,780,,662.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,588.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,663,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,686.4,88,,percent of total billed charges,,,,,,,,,595.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,,,,,,,,,,,,,647.4,83,,percent of total billed charges,,,741,95,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,639.6,82,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,588.12,741,
BEHL AND QUALITAE ANALYSIS OF V W THCAP,36901305,CDM,92524,CPT,440,RC,inpatient,KX,780,780,,662.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,588.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,663,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,686.4,88,,percent of total billed charges,,,,,,,,,595.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,,,,,,,,,,,,,647.4,83,,percent of total billed charges,,,741,95,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,639.6,82,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,588.12,741,
ST TREATMENT OF SW DYSN W THCAP,36901306,CDM,92526,CPT,440,RC,inpatient,KX,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,353.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,398.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,353.63,445.55,
ST EVAL OF SPEECH DEVIC (1 HOUR) W THCAP,36901308,CDM,92607,CPT,444,RC,inpatient,KX,676,676,,573.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,509.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,574.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,594.88,88,,percent of total billed charges,,,,,,,,,516.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,615.16,91,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,,,,,,,,,,,,,561.08,83,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,554.32,82,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,574.6,85,,percent of total billed charges,,509.7,642.2,
"ST EVAL OF SPCH ,EA ADDTL 30 MIN W THCAP",36901309,CDM,92608,CPT,444,RC,inpatient,KX,223,223,,189.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.24,88,,percent of total billed charges,,,,,,,,,170.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,202.93,91,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,,,,,,,,,,,,,185.09,83,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,182.86,82,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,168.14,211.85,
ST CLINICAL SWALLOW EVAL W THCAP,36901310,CDM,92610,CPT,444,RC,inpatient,KX,674,674,,572.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,508.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,572.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,593.12,88,,percent of total billed charges,,,,,,,,,514.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,613.34,91,,percent of total billed charges,,,640.3,95,,percent of total billed charges,,,559.42,83,,percent of total billed charges,,,559.42,83,,percent of total billed charges,,,,,,,,,,,,,,,559.42,83,,percent of total billed charges,,,640.3,95,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,552.68,82,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,572.9,85,,percent of total billed charges,,508.2,640.3,
ST BARIUM SWALLOW EVALUATION W THCAP,36901311,CDM,92611,CPT,444,RC,inpatient,KX,944,944,,801.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,711.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,802.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,830.72,88,,percent of total billed charges,,,,,,,,,721.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,859.04,91,,percent of total billed charges,,,896.8,95,,percent of total billed charges,,,783.52,83,,percent of total billed charges,,,783.52,83,,percent of total billed charges,,,,,,,,,,,,,,,783.52,83,,percent of total billed charges,,,896.8,95,,percent of total billed charges,,,849.6,90,,percent of total billed charges,,,849.6,90,,percent of total billed charges,,,774.08,82,,percent of total billed charges,,,849.6,90,,percent of total billed charges,,,802.4,85,,percent of total billed charges,,711.78,896.8,
"ST ASSESS OF APIA W/INTERP,EA HR W THCAP",36901312,CDM,96105,CPT,440,RC,inpatient,KX,676,676,,573.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,509.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,574.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,594.88,88,,percent of total billed charges,,,,,,,,,516.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,615.16,91,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,,,,,,,,,,,,,561.08,83,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,554.32,82,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,574.6,85,,percent of total billed charges,,509.7,642.2,
"ST DEVE TESTING W INTERP, EA HR W THCAP",36901313,CDM,96111,CPT,440,RC,inpatient,KX,676,676,,573.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,509.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,574.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,594.88,88,,percent of total billed charges,,,,,,,,,516.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,615.16,91,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,,,,,,,,,,,,,561.08,83,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,554.32,82,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,574.6,85,,percent of total billed charges,,509.7,642.2,
ST STAND COGN PERF TEST PER HOUR W THCAP,36901314,CDM,96125,CPT,444,RC,inpatient,KX,676,676,,573.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,509.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,574.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,594.88,88,,percent of total billed charges,,,,,,,,,516.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,615.16,91,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,,,,,,,,,,,,,561.08,83,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,554.32,82,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,574.6,85,,percent of total billed charges,,509.7,642.2,
ST ORAL SPEECH DEVICE EVAL,36901315,CDM,92597,CPT,440,RC,inpatient,GN,654,654,,555.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,493.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,555.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,575.52,88,,percent of total billed charges,,,,,,,,,499.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,595.14,91,,percent of total billed charges,,,621.3,95,,percent of total billed charges,,,542.82,83,,percent of total billed charges,,,542.82,83,,percent of total billed charges,,,,,,,,,,,,,,,542.82,83,,percent of total billed charges,,,621.3,95,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,536.28,82,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,555.9,85,,percent of total billed charges,,493.12,621.3,
ST ENDOSCOPY SWALLOW VID,36901316,CDM,92612,CPT,440,RC,inpatient,GN,841,841,,714.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,634.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,714.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,740.08,88,,percent of total billed charges,,,,,,,,,642.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,765.31,91,,percent of total billed charges,,,798.95,95,,percent of total billed charges,,,698.03,83,,percent of total billed charges,,,698.03,83,,percent of total billed charges,,,,,,,,,,,,,,,698.03,83,,percent of total billed charges,,,798.95,95,,percent of total billed charges,,,756.9,90,,percent of total billed charges,,,756.9,90,,percent of total billed charges,,,689.62,82,,percent of total billed charges,,,756.9,90,,percent of total billed charges,,,714.85,85,,percent of total billed charges,,634.11,798.95,
YAG LASER EYE PROCEDURE,18300279,CDM,,,360,RC,inpatient,,3874,3874,,3289.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2921,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3292.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3409.12,88,,percent of total billed charges,,,,,,,,,2959.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3525.34,91,,percent of total billed charges,,,3680.3,95,,percent of total billed charges,,,3215.42,83,,percent of total billed charges,,,3215.42,83,,percent of total billed charges,,,,,,,,,,,,,,,3215.42,83,,percent of total billed charges,,,3680.3,95,,percent of total billed charges,,,3486.6,90,,percent of total billed charges,,,3486.6,90,,percent of total billed charges,,,3176.68,82,,percent of total billed charges,,,3486.6,90,,percent of total billed charges,,,3292.9,85,,percent of total billed charges,,2921,3680.3,
FOREIGN BODY REMOVAL (ENDOSCOPIC) MAJOR,18307927,CDM,,,360,RC,inpatient,,1945,1945,,1651.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1466.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1653.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1711.6,88,,percent of total billed charges,,,,,,,,,1485.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1769.95,91,,percent of total billed charges,,,1847.75,95,,percent of total billed charges,,,1614.35,83,,percent of total billed charges,,,1614.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.35,83,,percent of total billed charges,,,1847.75,95,,percent of total billed charges,,,1750.5,90,,percent of total billed charges,,,1750.5,90,,percent of total billed charges,,,1594.9,82,,percent of total billed charges,,,1750.5,90,,percent of total billed charges,,,1653.25,85,,percent of total billed charges,,1466.53,1847.75,
* Z/OR (V0405),18307931,CDM,,,270,RC,inpatient,,314,314,,266.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,236.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,266.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,276.32,88,,percent of total billed charges,,,,,,,,,239.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,285.74,91,,percent of total billed charges,,,298.3,95,,percent of total billed charges,,,260.62,83,,percent of total billed charges,,,260.62,83,,percent of total billed charges,,,,,,,,,,,,,,,260.62,83,,percent of total billed charges,,,298.3,95,,percent of total billed charges,,,282.6,90,,percent of total billed charges,,,282.6,90,,percent of total billed charges,,,257.48,82,,percent of total billed charges,,,282.6,90,,percent of total billed charges,,,266.9,85,,percent of total billed charges,,236.76,298.3,
FOREIGN BODY REMOVAL (ENDOSCOPIC) MINOR,18307959,CDM,,,360,RC,inpatient,,614,614,,521.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,462.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,521.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,540.32,88,,percent of total billed charges,,,,,,,,,469.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,558.74,91,,percent of total billed charges,,,583.3,95,,percent of total billed charges,,,509.62,83,,percent of total billed charges,,,509.62,83,,percent of total billed charges,,,,,,,,,,,,,,,509.62,83,,percent of total billed charges,,,583.3,95,,percent of total billed charges,,,552.6,90,,percent of total billed charges,,,552.6,90,,percent of total billed charges,,,503.48,82,,percent of total billed charges,,,552.6,90,,percent of total billed charges,,,521.9,85,,percent of total billed charges,,462.96,583.3,
* ANESTHESIA CHG CPT 00120 1 HOUR(V0306),18400120,CDM,120,CPT,370,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
* ANESTHESIA CHG CPT 00140 1 HOUR(V0306),18400140,CDM,140,CPT,370,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
* ANESTHESIA CHG CPT 00142 1 HOUR(V0306),18400142,CDM,142,CPT,370,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
* ANESTHESIA CHG CPT 00300 1 HOUR(V0306),18400300,CDM,300,CPT,370,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
* ANESTHESIA CHG CPT 00320 1 HOUR(V0306),18400320,CDM,320,CPT,370,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
* ANESTHESIA CHG CPT 00400 1 HOUR(V0306),18400400,CDM,400,CPT,370,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
* ANESTHESIA CHG CPT 00750 1 HOUR(V0306),18400750,CDM,750,CPT,370,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
* ANESTHESIA CHG CPT 00790 1 HOUR(V0306),18400790,CDM,790,CPT,370,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
* ANESTHESIA CHG CPT 00830 1 HOUR(V0306),18400830,CDM,830,CPT,370,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
* ANESTHESIA CHG CPT 00840 1 HOUR(V0306),18400840,CDM,840,CPT,370,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
* ANESTHESIA CHG CPT 01480 1 HOUR(V0306),18401480,CDM,1480,CPT,370,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
* ANESTHESIA CHG CPT 01961 1 HOUR(V0306),18401961,CDM,1961,CPT,370,RC,inpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,501.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,565.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,501.41,631.75,
*ANESTHESIA EGD(V1007),18502000,CDM,,,370,RC,inpatient,,540,540,,458.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,407.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,459,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,475.2,88,,percent of total billed charges,,,,,,,,,412.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,491.4,91,,percent of total billed charges,,,513,95,,percent of total billed charges,,,448.2,83,,percent of total billed charges,,,448.2,83,,percent of total billed charges,,,,,,,,,,,,,,,448.2,83,,percent of total billed charges,,,513,95,,percent of total billed charges,,,486,90,,percent of total billed charges,,,486,90,,percent of total billed charges,,,442.8,82,,percent of total billed charges,,,486,90,,percent of total billed charges,,,459,85,,percent of total billed charges,,407.16,513,
*ANESTHESIA COLONOSCOPY(V1007),18502005,CDM,,,370,RC,inpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,2.26,2.85,
*ANESTHESIA EPIDURAL BLOOD PATCH(V1007),18502010,CDM,62273,CPT,360,RC,inpatient,,286,286,,242.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,215.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,243.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,251.68,88,,percent of total billed charges,,,,,,,,,218.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,260.26,91,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,,,,,,,,,,,,,237.38,83,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,234.52,82,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,215.64,271.7,
ANESTHESIA EPIDURAL STEROID INJ,18502015,CDM,,,370,RC,inpatient,,286,286,,242.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,215.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,243.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,251.68,88,,percent of total billed charges,,,,,,,,,218.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,260.26,91,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,,,,,,,,,,,,,237.38,83,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,234.52,82,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,215.64,271.7,
ANESTHESIA INTERCOSTAL NERVE,18502020,CDM,,,370,RC,inpatient,,286,286,,242.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,215.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,243.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,251.68,88,,percent of total billed charges,,,,,,,,,218.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,260.26,91,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,,,,,,,,,,,,,237.38,83,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,234.52,82,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,215.64,271.7,
ANESTHESIA LABOR EPIDURAL,18502025,CDM,,,370,RC,inpatient,,286,286,,242.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,215.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,243.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,251.68,88,,percent of total billed charges,,,,,,,,,218.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,260.26,91,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,,,,,,,,,,,,,237.38,83,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,234.52,82,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,215.64,271.7,
ANESTHESIA DX LUMBAR PUNCTURE,18502030,CDM,,,370,RC,inpatient,,286,286,,242.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,215.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,243.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,251.68,88,,percent of total billed charges,,,,,,,,,218.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,260.26,91,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,,,,,,,,,,,,,237.38,83,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,234.52,82,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,215.64,271.7,
*ANESTHESIA TECH FEE 1/2 HOUR(V1007),18502035,CDM,,,370,RC,inpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,2.26,2.85,
 *ANESTHESIA TECH FEE 1 HOUR(V 1007),18502040,CDM,,,370,RC,inpatient,,1143,1143,,970.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,861.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,971.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1005.84,88,,percent of total billed charges,,,,,,,,,873.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1040.13,91,,percent of total billed charges,,,1085.85,95,,percent of total billed charges,,,948.69,83,,percent of total billed charges,,,948.69,83,,percent of total billed charges,,,,,,,,,,,,,,,948.69,83,,percent of total billed charges,,,1085.85,95,,percent of total billed charges,,,1028.7,90,,percent of total billed charges,,,1028.7,90,,percent of total billed charges,,,937.26,82,,percent of total billed charges,,,1028.7,90,,percent of total billed charges,,,971.55,85,,percent of total billed charges,,861.82,1085.85,
DILATION OF ESOPHAGUS,18601120,CDM,,,360,RC,inpatient,,2336,2336,,1983.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1761.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1985.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2055.68,88,,percent of total billed charges,,,,,,,,,1784.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2125.76,91,,percent of total billed charges,,,2219.2,95,,percent of total billed charges,,,1938.88,83,,percent of total billed charges,,,1938.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1938.88,83,,percent of total billed charges,,,2219.2,95,,percent of total billed charges,,,2102.4,90,,percent of total billed charges,,,2102.4,90,,percent of total billed charges,,,1915.52,82,,percent of total billed charges,,,2102.4,90,,percent of total billed charges,,,1985.6,85,,percent of total billed charges,,1761.34,2219.2,
BRAVO GASTROESOPHAGEAL REFLUX TEST,18601121,CDM,91035,CPT,360,RC,inpatient,,3254,3254,,2762.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2453.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2765.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2863.52,88,,percent of total billed charges,,,,,,,,,2486.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2961.14,91,,percent of total billed charges,,,3091.3,95,,percent of total billed charges,,,2700.82,83,,percent of total billed charges,,,2700.82,83,,percent of total billed charges,,,,,,,,,,,,,,,2700.82,83,,percent of total billed charges,,,3091.3,95,,percent of total billed charges,,,2928.6,90,,percent of total billed charges,,,2928.6,90,,percent of total billed charges,,,2668.28,82,,percent of total billed charges,,,2928.6,90,,percent of total billed charges,,,2765.9,85,,percent of total billed charges,,2453.52,3091.3,
ENDOSCOPIC MUCOSAL RESECTION,18601122,CDM,,,360,RC,inpatient,,1329,1329,,1128.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1002.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1129.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1169.52,88,,percent of total billed charges,,,,,,,,,1015.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1209.39,91,,percent of total billed charges,,,1262.55,95,,percent of total billed charges,,,1103.07,83,,percent of total billed charges,,,1103.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1103.07,83,,percent of total billed charges,,,1262.55,95,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1089.78,82,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1129.65,85,,percent of total billed charges,,1002.07,1262.55,
PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE,18601123,CDM,43246,CPT,360,RC,inpatient,,3573,3573,,3033.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2694.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3037.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3144.24,88,,percent of total billed charges,,,,,,,,,2729.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3251.43,91,,percent of total billed charges,,,3394.35,95,,percent of total billed charges,,,2965.59,83,,percent of total billed charges,,,2965.59,83,,percent of total billed charges,,,,,,,,,,,,,,,2965.59,83,,percent of total billed charges,,,3394.35,95,,percent of total billed charges,,,3215.7,90,,percent of total billed charges,,,3215.7,90,,percent of total billed charges,,,2929.86,82,,percent of total billed charges,,,3215.7,90,,percent of total billed charges,,,3037.05,85,,percent of total billed charges,,2694.04,3394.35,
ESOPH BALLOON DISTENSION TEST,18601124,CDM,91040,CPT,750,RC,inpatient,,2675,2675,,2271.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2016.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2273.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2354,88,,percent of total billed charges,,,,,,,,,2043.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2434.25,91,,percent of total billed charges,,,2541.25,95,,percent of total billed charges,,,2220.25,83,,percent of total billed charges,,,2220.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2220.25,83,,percent of total billed charges,,,2541.25,95,,percent of total billed charges,,,2407.5,90,,percent of total billed charges,,,2407.5,90,,percent of total billed charges,,,2193.5,82,,percent of total billed charges,,,2407.5,90,,percent of total billed charges,,,2273.75,85,,percent of total billed charges,,2016.95,2541.25,
ENDOSCOPY SMALL INTESTINE,18601125,CDM,44360,CPT,360,RC,inpatient,,5413,5413,,4595.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4081.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4601.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4763.44,88,,percent of total billed charges,,,,,,,,,4135.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4925.83,91,,percent of total billed charges,,,5142.35,95,,percent of total billed charges,,,4492.79,83,,percent of total billed charges,,,4492.79,83,,percent of total billed charges,,,,,,,,,,,,,,,4492.79,83,,percent of total billed charges,,,5142.35,95,,percent of total billed charges,,,4871.7,90,,percent of total billed charges,,,4871.7,90,,percent of total billed charges,,,4438.66,82,,percent of total billed charges,,,4871.7,90,,percent of total billed charges,,,4601.05,85,,percent of total billed charges,,4081.4,5142.35,
SIGMOIDOSCOPY,18601144,CDM,,,360,RC,inpatient,,6153,6153,,5223.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4639.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5230.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5414.64,88,,percent of total billed charges,,,,,,,,,4700.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5599.23,91,,percent of total billed charges,,,5845.35,95,,percent of total billed charges,,,5106.99,83,,percent of total billed charges,,,5106.99,83,,percent of total billed charges,,,,,,,,,,,,,,,5106.99,83,,percent of total billed charges,,,5845.35,95,,percent of total billed charges,,,5537.7,90,,percent of total billed charges,,,5537.7,90,,percent of total billed charges,,,5045.46,82,,percent of total billed charges,,,5537.7,90,,percent of total billed charges,,,5230.05,85,,percent of total billed charges,,4639.36,5845.35,
* URETEROSCOPY (V1004),18601146,CDM,,,360,RC,inpatient,,973,973,,826.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,733.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,827.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,856.24,88,,percent of total billed charges,,,,,,,,,743.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,885.43,91,,percent of total billed charges,,,924.35,95,,percent of total billed charges,,,807.59,83,,percent of total billed charges,,,807.59,83,,percent of total billed charges,,,,,,,,,,,,,,,807.59,83,,percent of total billed charges,,,924.35,95,,percent of total billed charges,,,875.7,90,,percent of total billed charges,,,875.7,90,,percent of total billed charges,,,797.86,82,,percent of total billed charges,,,875.7,90,,percent of total billed charges,,,827.05,85,,percent of total billed charges,,733.64,924.35,
QUICK-LIFT SURGERY,18602050,CDM,,,360,RC,inpatient,,12746,12746,,10821.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9610.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10834.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11216.48,88,,percent of total billed charges,,,,,,,,,9737.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11598.86,91,,percent of total billed charges,,,12108.7,95,,percent of total billed charges,,,10579.18,83,,percent of total billed charges,,,10579.18,83,,percent of total billed charges,,,,,,,,,,,,,,,10579.18,83,,percent of total billed charges,,,12108.7,95,,percent of total billed charges,,,11471.4,90,,percent of total billed charges,,,11471.4,90,,percent of total billed charges,,,10451.72,82,,percent of total billed charges,,,11471.4,90,,percent of total billed charges,,,10834.1,85,,percent of total billed charges,,9610.48,12108.7,
COSMETIC NECK CONTOUR SURGERY,18602051,CDM,,,360,RC,inpatient,,3190,3190,,2708.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2405.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2711.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2807.2,88,,percent of total billed charges,,,,,,,,,2437.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2902.9,91,,percent of total billed charges,,,3030.5,95,,percent of total billed charges,,,2647.7,83,,percent of total billed charges,,,2647.7,83,,percent of total billed charges,,,,,,,,,,,,,,,2647.7,83,,percent of total billed charges,,,3030.5,95,,percent of total billed charges,,,2871,90,,percent of total billed charges,,,2871,90,,percent of total billed charges,,,2615.8,82,,percent of total billed charges,,,2871,90,,percent of total billed charges,,,2711.5,85,,percent of total billed charges,,2405.26,3030.5,
COSMETIC EYELIDS UPPER/LOW SURGERY,18602052,CDM,,,360,RC,inpatient,,8500,8500,,7216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6409,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7225,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7480,88,,percent of total billed charges,,,,,,,,,6494,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7735,91,,percent of total billed charges,,,8075,95,,percent of total billed charges,,,7055,83,,percent of total billed charges,,,7055,83,,percent of total billed charges,,,,,,,,,,,,,,,7055,83,,percent of total billed charges,,,8075,95,,percent of total billed charges,,,7650,90,,percent of total billed charges,,,7650,90,,percent of total billed charges,,,6970,82,,percent of total billed charges,,,7650,90,,percent of total billed charges,,,7225,85,,percent of total billed charges,,6409,8075,
COSMETIC FOREHEAD LIFT SURGERY,18602053,CDM,,,360,RC,inpatient,,7436,7436,,6313.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5606.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6320.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6543.68,88,,percent of total billed charges,,,,,,,,,5681.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6766.76,91,,percent of total billed charges,,,7064.2,95,,percent of total billed charges,,,6171.88,83,,percent of total billed charges,,,6171.88,83,,percent of total billed charges,,,,,,,,,,,,,,,6171.88,83,,percent of total billed charges,,,7064.2,95,,percent of total billed charges,,,6692.4,90,,percent of total billed charges,,,6692.4,90,,percent of total billed charges,,,6097.52,82,,percent of total billed charges,,,6692.4,90,,percent of total billed charges,,,6320.6,85,,percent of total billed charges,,5606.74,7064.2,
COSMETIC LIPO PER AREA SURGERY,18602054,CDM,,,360,RC,inpatient,,5951,5951,,5052.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4487.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5058.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5236.88,88,,percent of total billed charges,,,,,,,,,4546.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5415.41,91,,percent of total billed charges,,,5653.45,95,,percent of total billed charges,,,4939.33,83,,percent of total billed charges,,,4939.33,83,,percent of total billed charges,,,,,,,,,,,,,,,4939.33,83,,percent of total billed charges,,,5653.45,95,,percent of total billed charges,,,5355.9,90,,percent of total billed charges,,,5355.9,90,,percent of total billed charges,,,4879.82,82,,percent of total billed charges,,,5355.9,90,,percent of total billed charges,,,5058.35,85,,percent of total billed charges,,4487.05,5653.45,
COSMETIC COLLAGEN FILL SURGERY,18602055,CDM,,,360,RC,inpatient,,2132,2132,,1810.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1607.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1812.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1876.16,88,,percent of total billed charges,,,,,,,,,1628.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1940.12,91,,percent of total billed charges,,,2025.4,95,,percent of total billed charges,,,1769.56,83,,percent of total billed charges,,,1769.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1769.56,83,,percent of total billed charges,,,2025.4,95,,percent of total billed charges,,,1918.8,90,,percent of total billed charges,,,1918.8,90,,percent of total billed charges,,,1748.24,82,,percent of total billed charges,,,1918.8,90,,percent of total billed charges,,,1812.2,85,,percent of total billed charges,,1607.53,2025.4,
COSMETIC BROWLIFT SURGERY,18602056,CDM,,,360,RC,inpatient,,2550,2550,,2164.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1922.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2167.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2244,88,,percent of total billed charges,,,,,,,,,1948.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2320.5,91,,percent of total billed charges,,,2422.5,95,,percent of total billed charges,,,2116.5,83,,percent of total billed charges,,,2116.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2116.5,83,,percent of total billed charges,,,2422.5,95,,percent of total billed charges,,,2295,90,,percent of total billed charges,,,2295,90,,percent of total billed charges,,,2091,82,,percent of total billed charges,,,2295,90,,percent of total billed charges,,,2167.5,85,,percent of total billed charges,,1922.7,2422.5,
COSMETIC FACE/NECK/COUNT/LIPO,18602057,CDM,,,360,RC,inpatient,,16063,16063,,13637.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12111.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13653.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14135.44,88,,percent of total billed charges,,,,,,,,,12272.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14617.33,91,,percent of total billed charges,,,15259.85,95,,percent of total billed charges,,,13332.29,83,,percent of total billed charges,,,13332.29,83,,percent of total billed charges,,,,,,,,,,,,,,,13332.29,83,,percent of total billed charges,,,15259.85,95,,percent of total billed charges,,,14456.7,90,,percent of total billed charges,,,14456.7,90,,percent of total billed charges,,,13171.66,82,,percent of total billed charges,,,14456.7,90,,percent of total billed charges,,,13653.55,85,,percent of total billed charges,,12111.5,15259.85,
BRACHIAL PLEXUS CONT INFUS BY CATHETER,18602061,CDM,64416,CPT,360,RC,inpatient,,1139,1139,,967.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,858.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,968.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1002.32,88,,percent of total billed charges,,,,,,,,,870.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,,,,,,,,,,,,,945.37,83,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,933.98,82,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,858.81,1082.05,
INJECTION ANESTHETIC AGENT AXILLARY NERV,18602063,CDM,64417,CPT,360,RC,inpatient,,1139,1139,,967.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,858.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,968.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1002.32,88,,percent of total billed charges,,,,,,,,,870.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,,,,,,,,,,,,,945.37,83,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,933.98,82,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,858.81,1082.05,
SCIATIC NERVE CONT INFUS BY CATHETER,18602066,CDM,64446,CPT,360,RC,inpatient,,1139,1139,,967.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,858.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,968.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1002.32,88,,percent of total billed charges,,,,,,,,,870.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,,,,,,,,,,,,,945.37,83,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,933.98,82,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,858.81,1082.05,
FEMORAL NERVE CONT INFUS BY CATHETER,18602068,CDM,64448,CPT,360,RC,inpatient,,2276,2276,,1932.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1716.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1934.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2002.88,88,,percent of total billed charges,,,,,,,,,1738.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2071.16,91,,percent of total billed charges,,,2162.2,95,,percent of total billed charges,,,1889.08,83,,percent of total billed charges,,,1889.08,83,,percent of total billed charges,,,,,,,,,,,,,,,1889.08,83,,percent of total billed charges,,,2162.2,95,,percent of total billed charges,,,2048.4,90,,percent of total billed charges,,,2048.4,90,,percent of total billed charges,,,1866.32,82,,percent of total billed charges,,,2048.4,90,,percent of total billed charges,,,1934.6,85,,percent of total billed charges,,1716.1,2162.2,
LUMBAR PLEXUS POST APPR CONT INF CATHETR,18602069,CDM,64449,CPT,360,RC,inpatient,,1913,1913,,1624.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1442.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1626.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1683.44,88,,percent of total billed charges,,,,,,,,,1461.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1740.83,91,,percent of total billed charges,,,1817.35,95,,percent of total billed charges,,,1587.79,83,,percent of total billed charges,,,1587.79,83,,percent of total billed charges,,,,,,,,,,,,,,,1587.79,83,,percent of total billed charges,,,1817.35,95,,percent of total billed charges,,,1721.7,90,,percent of total billed charges,,,1721.7,90,,percent of total billed charges,,,1568.66,82,,percent of total billed charges,,,1721.7,90,,percent of total billed charges,,,1626.05,85,,percent of total billed charges,,1442.4,1817.35,
MINOR PROCEDURE UP TO 1/2 HOUR,18602070,CDM,,,360,RC,inpatient,,3608,3608,,3063.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2720.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3066.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3175.04,88,,percent of total billed charges,,,,,,,,,2756.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3283.28,91,,percent of total billed charges,,,3427.6,95,,percent of total billed charges,,,2994.64,83,,percent of total billed charges,,,2994.64,83,,percent of total billed charges,,,,,,,,,,,,,,,2994.64,83,,percent of total billed charges,,,3427.6,95,,percent of total billed charges,,,3247.2,90,,percent of total billed charges,,,3247.2,90,,percent of total billed charges,,,2958.56,82,,percent of total billed charges,,,3247.2,90,,percent of total billed charges,,,3066.8,85,,percent of total billed charges,,2720.43,3427.6,
MINOR PROCEDURE UP TO 1 HOUR,18602071,CDM,,,360,RC,inpatient,,4739,4739,,4023.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3573.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4028.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4170.32,88,,percent of total billed charges,,,,,,,,,3620.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4312.49,91,,percent of total billed charges,,,4502.05,95,,percent of total billed charges,,,3933.37,83,,percent of total billed charges,,,3933.37,83,,percent of total billed charges,,,,,,,,,,,,,,,3933.37,83,,percent of total billed charges,,,4502.05,95,,percent of total billed charges,,,4265.1,90,,percent of total billed charges,,,4265.1,90,,percent of total billed charges,,,3885.98,82,,percent of total billed charges,,,4265.1,90,,percent of total billed charges,,,4028.15,85,,percent of total billed charges,,3573.21,4502.05,
MINOR PROCEDURE UP TO 1 1/2 HOURS,18602072,CDM,,,360,RC,inpatient,,6020,6020,,5110.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4539.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5117,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5297.6,88,,percent of total billed charges,,,,,,,,,4599.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5478.2,91,,percent of total billed charges,,,5719,95,,percent of total billed charges,,,4996.6,83,,percent of total billed charges,,,4996.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4996.6,83,,percent of total billed charges,,,5719,95,,percent of total billed charges,,,5418,90,,percent of total billed charges,,,5418,90,,percent of total billed charges,,,4936.4,82,,percent of total billed charges,,,5418,90,,percent of total billed charges,,,5117,85,,percent of total billed charges,,4539.08,5719,
MINOR PROCEDURE UP TO 2 HOURS,18602073,CDM,,,360,RC,inpatient,,8054,8054,,6837.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6072.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6845.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7087.52,88,,percent of total billed charges,,,,,,,,,6153.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7329.14,91,,percent of total billed charges,,,7651.3,95,,percent of total billed charges,,,6684.82,83,,percent of total billed charges,,,6684.82,83,,percent of total billed charges,,,,,,,,,,,,,,,6684.82,83,,percent of total billed charges,,,7651.3,95,,percent of total billed charges,,,7248.6,90,,percent of total billed charges,,,7248.6,90,,percent of total billed charges,,,6604.28,82,,percent of total billed charges,,,7248.6,90,,percent of total billed charges,,,6845.9,85,,percent of total billed charges,,6072.72,7651.3,
MINOR COMPLICATED UP TO 1 HOUR,18602075,CDM,,,360,RC,inpatient,,5243,5243,,4451.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3953.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4456.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4613.84,88,,percent of total billed charges,,,,,,,,,4005.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4771.13,91,,percent of total billed charges,,,4980.85,95,,percent of total billed charges,,,4351.69,83,,percent of total billed charges,,,4351.69,83,,percent of total billed charges,,,,,,,,,,,,,,,4351.69,83,,percent of total billed charges,,,4980.85,95,,percent of total billed charges,,,4718.7,90,,percent of total billed charges,,,4718.7,90,,percent of total billed charges,,,4299.26,82,,percent of total billed charges,,,4718.7,90,,percent of total billed charges,,,4456.55,85,,percent of total billed charges,,3953.22,4980.85,
MINOR COMPLICATED UP TO 2 HOURS,18602076,CDM,,,360,RC,inpatient,,7179,7179,,6094.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5412.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6102.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6317.52,88,,percent of total billed charges,,,,,,,,,5484.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6532.89,91,,percent of total billed charges,,,6820.05,95,,percent of total billed charges,,,5958.57,83,,percent of total billed charges,,,5958.57,83,,percent of total billed charges,,,,,,,,,,,,,,,5958.57,83,,percent of total billed charges,,,6820.05,95,,percent of total billed charges,,,6461.1,90,,percent of total billed charges,,,6461.1,90,,percent of total billed charges,,,5886.78,82,,percent of total billed charges,,,6461.1,90,,percent of total billed charges,,,6102.15,85,,percent of total billed charges,,5412.97,6820.05,
MINOR COMPLICATED UP TO 3 HOURS,18602077,CDM,,,360,RC,inpatient,,11648,11648,,9889.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8782.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9900.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10250.24,88,,percent of total billed charges,,,,,,,,,8899.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10599.68,91,,percent of total billed charges,,,11065.6,95,,percent of total billed charges,,,9667.84,83,,percent of total billed charges,,,9667.84,83,,percent of total billed charges,,,,,,,,,,,,,,,9667.84,83,,percent of total billed charges,,,11065.6,95,,percent of total billed charges,,,10483.2,90,,percent of total billed charges,,,10483.2,90,,percent of total billed charges,,,9551.36,82,,percent of total billed charges,,,10483.2,90,,percent of total billed charges,,,9900.8,85,,percent of total billed charges,,8782.59,11065.6,
MAJOR PROCEDURE UP TO 1 HOUR,18602080,CDM,,,360,RC,inpatient,,9568,9568,,8123.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7214.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8132.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8419.84,88,,percent of total billed charges,,,,,,,,,7309.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8706.88,91,,percent of total billed charges,,,9089.6,95,,percent of total billed charges,,,7941.44,83,,percent of total billed charges,,,7941.44,83,,percent of total billed charges,,,,,,,,,,,,,,,7941.44,83,,percent of total billed charges,,,9089.6,95,,percent of total billed charges,,,8611.2,90,,percent of total billed charges,,,8611.2,90,,percent of total billed charges,,,7845.76,82,,percent of total billed charges,,,8611.2,90,,percent of total billed charges,,,8132.8,85,,percent of total billed charges,,7214.27,9089.6,
MAJOR PROCEDURE UP TO 2 HOURS,18602081,CDM,,,360,RC,inpatient,,13306,13306,,11296.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10032.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11310.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11709.28,88,,percent of total billed charges,,,,,,,,,10165.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12108.46,91,,percent of total billed charges,,,12640.7,95,,percent of total billed charges,,,11043.98,83,,percent of total billed charges,,,11043.98,83,,percent of total billed charges,,,,,,,,,,,,,,,11043.98,83,,percent of total billed charges,,,12640.7,95,,percent of total billed charges,,,11975.4,90,,percent of total billed charges,,,11975.4,90,,percent of total billed charges,,,10910.92,82,,percent of total billed charges,,,11975.4,90,,percent of total billed charges,,,11310.1,85,,percent of total billed charges,,10032.72,12640.7,
MAJOR PROCEDURE UP TO 3 HOURS,18602082,CDM,,,360,RC,inpatient,,18026,18026,,15304.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13591.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15322.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15862.88,88,,percent of total billed charges,,,,,,,,,13771.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16403.66,91,,percent of total billed charges,,,17124.7,95,,percent of total billed charges,,,14961.58,83,,percent of total billed charges,,,14961.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14961.58,83,,percent of total billed charges,,,17124.7,95,,percent of total billed charges,,,16223.4,90,,percent of total billed charges,,,16223.4,90,,percent of total billed charges,,,14781.32,82,,percent of total billed charges,,,16223.4,90,,percent of total billed charges,,,15322.1,85,,percent of total billed charges,,13591.6,17124.7,
MAJOR PROCEDURE UP TO 4 HOURS,18602083,CDM,,,360,RC,inpatient,,20352,20352,,17278.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15345.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17299.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17909.76,88,,percent of total billed charges,,,,,,,,,15548.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18520.32,91,,percent of total billed charges,,,19334.4,95,,percent of total billed charges,,,16892.16,83,,percent of total billed charges,,,16892.16,83,,percent of total billed charges,,,,,,,,,,,,,,,16892.16,83,,percent of total billed charges,,,19334.4,95,,percent of total billed charges,,,18316.8,90,,percent of total billed charges,,,18316.8,90,,percent of total billed charges,,,16688.64,82,,percent of total billed charges,,,18316.8,90,,percent of total billed charges,,,17299.2,85,,percent of total billed charges,,15345.41,19334.4,
MAJOR PROCEDURE OVER 4 HOURS,18602084,CDM,,,360,RC,inpatient,,22423,22423,,19037.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16906.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19059.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19732.24,88,,percent of total billed charges,,,,,,,,,17131.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20404.93,91,,percent of total billed charges,,,21301.85,95,,percent of total billed charges,,,18611.09,83,,percent of total billed charges,,,18611.09,83,,percent of total billed charges,,,,,,,,,,,,,,,18611.09,83,,percent of total billed charges,,,21301.85,95,,percent of total billed charges,,,20180.7,90,,percent of total billed charges,,,20180.7,90,,percent of total billed charges,,,18386.86,82,,percent of total billed charges,,,20180.7,90,,percent of total billed charges,,,19059.55,85,,percent of total billed charges,,16906.94,21301.85,
MAJOR COMPLICATED UP TO 1 HOUR,18602090,CDM,,,360,RC,inpatient,,15873,15873,,13476.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11968.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13492.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13968.24,88,,percent of total billed charges,,,,,,,,,12126.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14444.43,91,,percent of total billed charges,,,15079.35,95,,percent of total billed charges,,,13174.59,83,,percent of total billed charges,,,13174.59,83,,percent of total billed charges,,,,,,,,,,,,,,,13174.59,83,,percent of total billed charges,,,15079.35,95,,percent of total billed charges,,,14285.7,90,,percent of total billed charges,,,14285.7,90,,percent of total billed charges,,,13015.86,82,,percent of total billed charges,,,14285.7,90,,percent of total billed charges,,,13492.05,85,,percent of total billed charges,,11968.24,15079.35,
MAJOR COMPLICATED UP TO 2 HOURS,18602091,CDM,,,360,RC,inpatient,,26204,26204,,22247.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19757.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22273.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23059.52,88,,percent of total billed charges,,,,,,,,,20019.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23845.64,91,,percent of total billed charges,,,24893.8,95,,percent of total billed charges,,,21749.32,83,,percent of total billed charges,,,21749.32,83,,percent of total billed charges,,,,,,,,,,,,,,,21749.32,83,,percent of total billed charges,,,24893.8,95,,percent of total billed charges,,,23583.6,90,,percent of total billed charges,,,23583.6,90,,percent of total billed charges,,,21487.28,82,,percent of total billed charges,,,23583.6,90,,percent of total billed charges,,,22273.4,85,,percent of total billed charges,,19757.82,24893.8,
MAJOR COMPLICATED UP TO 3 HOURS,18602092,CDM,,,360,RC,inpatient,,33234,33234,,28215.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25058.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28248.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29245.92,88,,percent of total billed charges,,,,,,,,,25390.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30242.94,91,,percent of total billed charges,,,31572.3,95,,percent of total billed charges,,,27584.22,83,,percent of total billed charges,,,27584.22,83,,percent of total billed charges,,,,,,,,,,,,,,,27584.22,83,,percent of total billed charges,,,31572.3,95,,percent of total billed charges,,,29910.6,90,,percent of total billed charges,,,29910.6,90,,percent of total billed charges,,,27251.88,82,,percent of total billed charges,,,29910.6,90,,percent of total billed charges,,,28248.9,85,,percent of total billed charges,,25058.44,31572.3,
MAJOR COMPLICATED UP TO 4 HOURS,18602093,CDM,,,360,RC,inpatient,,40034,40034,,33988.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30185.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34028.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35229.92,88,,percent of total billed charges,,,,,,,,,30585.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36430.94,91,,percent of total billed charges,,,38032.3,95,,percent of total billed charges,,,33228.22,83,,percent of total billed charges,,,33228.22,83,,percent of total billed charges,,,,,,,,,,,,,,,33228.22,83,,percent of total billed charges,,,38032.3,95,,percent of total billed charges,,,36030.6,90,,percent of total billed charges,,,36030.6,90,,percent of total billed charges,,,32827.88,82,,percent of total billed charges,,,36030.6,90,,percent of total billed charges,,,34028.9,85,,percent of total billed charges,,30185.64,38032.3,
MAJOR COMPLICATED UP TO 5 HOURS,18602094,CDM,,,360,RC,inpatient,,41452,41452,,35192.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31254.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35234.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36477.76,88,,percent of total billed charges,,,,,,,,,31669.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37721.32,91,,percent of total billed charges,,,39379.4,95,,percent of total billed charges,,,34405.16,83,,percent of total billed charges,,,34405.16,83,,percent of total billed charges,,,,,,,,,,,,,,,34405.16,83,,percent of total billed charges,,,39379.4,95,,percent of total billed charges,,,37306.8,90,,percent of total billed charges,,,37306.8,90,,percent of total billed charges,,,33990.64,82,,percent of total billed charges,,,37306.8,90,,percent of total billed charges,,,35234.2,85,,percent of total billed charges,,31254.81,39379.4,
MAJOR COMPLICATED UP TO 6 HOURS,18602095,CDM,,,360,RC,inpatient,,58737,58737,,49867.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,44287.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,49926.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,51688.56,88,,percent of total billed charges,,,,,,,,,44875.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,53450.67,91,,percent of total billed charges,,,55800.15,95,,percent of total billed charges,,,48751.71,83,,percent of total billed charges,,,48751.71,83,,percent of total billed charges,,,,,,,,,,,,,,,48751.71,83,,percent of total billed charges,,,55800.15,95,,percent of total billed charges,,,52863.3,90,,percent of total billed charges,,,52863.3,90,,percent of total billed charges,,,48164.34,82,,percent of total billed charges,,,52863.3,90,,percent of total billed charges,,,49926.45,85,,percent of total billed charges,,44287.7,55800.15,
MAJOR COMPLICATED UP TO 7 HOURS,18602096,CDM,,,360,RC,inpatient,,61326,61326,,52065.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,46239.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52127.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,53966.88,88,,percent of total billed charges,,,,,,,,,46853.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55806.66,91,,percent of total billed charges,,,58259.7,95,,percent of total billed charges,,,50900.58,83,,percent of total billed charges,,,50900.58,83,,percent of total billed charges,,,,,,,,,,,,,,,50900.58,83,,percent of total billed charges,,,58259.7,95,,percent of total billed charges,,,55193.4,90,,percent of total billed charges,,,55193.4,90,,percent of total billed charges,,,50287.32,82,,percent of total billed charges,,,55193.4,90,,percent of total billed charges,,,52127.1,85,,percent of total billed charges,,46239.8,58259.7,
MAJOR COMPLICATED UP TO 8 HOURS,18602097,CDM,,,360,RC,inpatient,,63788,63788,,54156.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,48096.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54219.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,56133.44,88,,percent of total billed charges,,,,,,,,,48734.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,58047.08,91,,percent of total billed charges,,,60598.6,95,,percent of total billed charges,,,52944.04,83,,percent of total billed charges,,,52944.04,83,,percent of total billed charges,,,,,,,,,,,,,,,52944.04,83,,percent of total billed charges,,,60598.6,95,,percent of total billed charges,,,57409.2,90,,percent of total billed charges,,,57409.2,90,,percent of total billed charges,,,52306.16,82,,percent of total billed charges,,,57409.2,90,,percent of total billed charges,,,54219.8,85,,percent of total billed charges,,48096.15,60598.6,
MAJOR COMPLICATED OVER 8 HOURS,18602098,CDM,,,360,RC,inpatient,,68328,68328,,58010.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,51519.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58078.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60128.64,88,,percent of total billed charges,,,,,,,,,52202.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62178.48,91,,percent of total billed charges,,,64911.6,95,,percent of total billed charges,,,56712.24,83,,percent of total billed charges,,,56712.24,83,,percent of total billed charges,,,,,,,,,,,,,,,56712.24,83,,percent of total billed charges,,,64911.6,95,,percent of total billed charges,,,61495.2,90,,percent of total billed charges,,,61495.2,90,,percent of total billed charges,,,56028.96,82,,percent of total billed charges,,,61495.2,90,,percent of total billed charges,,,58078.8,85,,percent of total billed charges,,51519.31,64911.6,
MAJOR PROCEDURE UP TO 1 HOUR,18602110,CDM,,,360,RC,inpatient,,13964,13964,,11855.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10528.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,11869.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12288.32,88,,percent of total billed charges,,,,,,,,,10668.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12707.24,91,,percent of total billed charges,,,13265.8,95,,percent of total billed charges,,,11590.12,83,,percent of total billed charges,,,11590.12,83,,percent of total billed charges,,,,,,,,,,,,,,,11590.12,83,,percent of total billed charges,,,13265.8,95,,percent of total billed charges,,,12567.6,90,,percent of total billed charges,,,12567.6,90,,percent of total billed charges,,,11450.48,82,,percent of total billed charges,,,12567.6,90,,percent of total billed charges,,,11869.4,85,,percent of total billed charges,,10528.86,13265.8,
MAJOR PROCEDURE UP TO 2 HOURS,18602111,CDM,,,360,RC,inpatient,,17581,17581,,14926.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13256.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14943.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15471.28,88,,percent of total billed charges,,,,,,,,,13431.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15998.71,91,,percent of total billed charges,,,16701.95,95,,percent of total billed charges,,,14592.23,83,,percent of total billed charges,,,14592.23,83,,percent of total billed charges,,,,,,,,,,,,,,,14592.23,83,,percent of total billed charges,,,16701.95,95,,percent of total billed charges,,,15822.9,90,,percent of total billed charges,,,15822.9,90,,percent of total billed charges,,,14416.42,82,,percent of total billed charges,,,15822.9,90,,percent of total billed charges,,,14943.85,85,,percent of total billed charges,,13256.07,16701.95,
MAJOR PROCEDURE UP TO 3 HOURS,18602112,CDM,,,360,RC,inpatient,,22024,22024,,18698.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16606.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18720.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19381.12,88,,percent of total billed charges,,,,,,,,,16826.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20041.84,91,,percent of total billed charges,,,20922.8,95,,percent of total billed charges,,,18279.92,83,,percent of total billed charges,,,18279.92,83,,percent of total billed charges,,,,,,,,,,,,,,,18279.92,83,,percent of total billed charges,,,20922.8,95,,percent of total billed charges,,,19821.6,90,,percent of total billed charges,,,19821.6,90,,percent of total billed charges,,,18059.68,82,,percent of total billed charges,,,19821.6,90,,percent of total billed charges,,,18720.4,85,,percent of total billed charges,,16606.1,20922.8,
MAJOR PROCEDURE UP TO 4 HOURS,18602113,CDM,,,360,RC,inpatient,,23158,23158,,19661.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17461.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19684.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20379.04,88,,percent of total billed charges,,,,,,,,,17692.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,21073.78,91,,percent of total billed charges,,,22000.1,95,,percent of total billed charges,,,19221.14,83,,percent of total billed charges,,,19221.14,83,,percent of total billed charges,,,,,,,,,,,,,,,19221.14,83,,percent of total billed charges,,,22000.1,95,,percent of total billed charges,,,20842.2,90,,percent of total billed charges,,,20842.2,90,,percent of total billed charges,,,18989.56,82,,percent of total billed charges,,,20842.2,90,,percent of total billed charges,,,19684.3,85,,percent of total billed charges,,17461.13,22000.1,
MAJOR PROCEDURE OVER 4 HOURS,18602114,CDM,,,360,RC,inpatient,,26600,26600,,22583.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20056.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22610,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,23408,88,,percent of total billed charges,,,,,,,,,20322.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24206,91,,percent of total billed charges,,,25270,95,,percent of total billed charges,,,22078,83,,percent of total billed charges,,,22078,83,,percent of total billed charges,,,,,,,,,,,,,,,22078,83,,percent of total billed charges,,,25270,95,,percent of total billed charges,,,23940,90,,percent of total billed charges,,,23940,90,,percent of total billed charges,,,21812,82,,percent of total billed charges,,,23940,90,,percent of total billed charges,,,22610,85,,percent of total billed charges,,20056.4,25270,
MAJOR COMPLICATED UP TO 1 HOUR,18602120,CDM,,,360,RC,inpatient,,19684,19684,,16711.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14841.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16731.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17321.92,88,,percent of total billed charges,,,,,,,,,15038.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17912.44,91,,percent of total billed charges,,,18699.8,95,,percent of total billed charges,,,16337.72,83,,percent of total billed charges,,,16337.72,83,,percent of total billed charges,,,,,,,,,,,,,,,16337.72,83,,percent of total billed charges,,,18699.8,95,,percent of total billed charges,,,17715.6,90,,percent of total billed charges,,,17715.6,90,,percent of total billed charges,,,16140.88,82,,percent of total billed charges,,,17715.6,90,,percent of total billed charges,,,16731.4,85,,percent of total billed charges,,14841.74,18699.8,
MAJOR COMPLICATED UP TO 2 HOURS,18602121,CDM,,,360,RC,inpatient,,28155,28155,,23903.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21228.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23931.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24776.4,88,,percent of total billed charges,,,,,,,,,21510.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25621.05,91,,percent of total billed charges,,,26747.25,95,,percent of total billed charges,,,23368.65,83,,percent of total billed charges,,,23368.65,83,,percent of total billed charges,,,,,,,,,,,,,,,23368.65,83,,percent of total billed charges,,,26747.25,95,,percent of total billed charges,,,25339.5,90,,percent of total billed charges,,,25339.5,90,,percent of total billed charges,,,23087.1,82,,percent of total billed charges,,,25339.5,90,,percent of total billed charges,,,23931.75,85,,percent of total billed charges,,21228.87,26747.25,
MAJOR COMPLICATED UP TO 3 HOURS,18602122,CDM,,,360,RC,inpatient,,37165,37165,,31553.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28022.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31590.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32705.2,88,,percent of total billed charges,,,,,,,,,28394.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33820.15,91,,percent of total billed charges,,,35306.75,95,,percent of total billed charges,,,30846.95,83,,percent of total billed charges,,,30846.95,83,,percent of total billed charges,,,,,,,,,,,,,,,30846.95,83,,percent of total billed charges,,,35306.75,95,,percent of total billed charges,,,33448.5,90,,percent of total billed charges,,,33448.5,90,,percent of total billed charges,,,30475.3,82,,percent of total billed charges,,,33448.5,90,,percent of total billed charges,,,31590.25,85,,percent of total billed charges,,28022.41,35306.75,
MAJOR COMPLICATED UP TO 4 HOURS,18602123,CDM,,,360,RC,inpatient,,45353,45353,,38504.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,34196.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,38550.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,39910.64,88,,percent of total billed charges,,,,,,,,,34649.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,41271.23,91,,percent of total billed charges,,,43085.35,95,,percent of total billed charges,,,37642.99,83,,percent of total billed charges,,,37642.99,83,,percent of total billed charges,,,,,,,,,,,,,,,37642.99,83,,percent of total billed charges,,,43085.35,95,,percent of total billed charges,,,40817.7,90,,percent of total billed charges,,,40817.7,90,,percent of total billed charges,,,37189.46,82,,percent of total billed charges,,,40817.7,90,,percent of total billed charges,,,38550.05,85,,percent of total billed charges,,34196.16,43085.35,
MAJOR COMPLICATED UP TO 5 HOURS,18602124,CDM,,,360,RC,inpatient,,52431,52431,,44513.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,39532.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,44566.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,46139.28,88,,percent of total billed charges,,,,,,,,,40057.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,47712.21,91,,percent of total billed charges,,,49809.45,95,,percent of total billed charges,,,43517.73,83,,percent of total billed charges,,,43517.73,83,,percent of total billed charges,,,,,,,,,,,,,,,43517.73,83,,percent of total billed charges,,,49809.45,95,,percent of total billed charges,,,47187.9,90,,percent of total billed charges,,,47187.9,90,,percent of total billed charges,,,42993.42,82,,percent of total billed charges,,,47187.9,90,,percent of total billed charges,,,44566.35,85,,percent of total billed charges,,39532.97,49809.45,
MAJOR COMPLICATED UP TO 6 HOURS,18602125,CDM,,,360,RC,inpatient,,60660,60660,,51500.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,45737.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,51561,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,53380.8,88,,percent of total billed charges,,,,,,,,,46344.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,55200.6,91,,percent of total billed charges,,,57627,95,,percent of total billed charges,,,50347.8,83,,percent of total billed charges,,,50347.8,83,,percent of total billed charges,,,,,,,,,,,,,,,50347.8,83,,percent of total billed charges,,,57627,95,,percent of total billed charges,,,54594,90,,percent of total billed charges,,,54594,90,,percent of total billed charges,,,49741.2,82,,percent of total billed charges,,,54594,90,,percent of total billed charges,,,51561,85,,percent of total billed charges,,45737.64,57627,
MAJOR COMPLICATED UP TO 7 HOURS,18602126,CDM,,,360,RC,inpatient,,69030,69030,,58606.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,52048.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,58675.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,60746.4,88,,percent of total billed charges,,,,,,,,,52738.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,62817.3,91,,percent of total billed charges,,,65578.5,95,,percent of total billed charges,,,57294.9,83,,percent of total billed charges,,,57294.9,83,,percent of total billed charges,,,,,,,,,,,,,,,57294.9,83,,percent of total billed charges,,,65578.5,95,,percent of total billed charges,,,62127,90,,percent of total billed charges,,,62127,90,,percent of total billed charges,,,56604.6,82,,percent of total billed charges,,,62127,90,,percent of total billed charges,,,58675.5,85,,percent of total billed charges,,52048.62,65578.5,
MAJOR COMPLICATED UP TO 8 HOURS,18602127,CDM,,,360,RC,inpatient,,80561,80561,,68396.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60742.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68476.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70893.68,88,,percent of total billed charges,,,,,,,,,61548.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,73310.51,91,,percent of total billed charges,,,76532.95,95,,percent of total billed charges,,,66865.63,83,,percent of total billed charges,,,66865.63,83,,percent of total billed charges,,,,,,,,,,,,,,,66865.63,83,,percent of total billed charges,,,76532.95,95,,percent of total billed charges,,,72504.9,90,,percent of total billed charges,,,72504.9,90,,percent of total billed charges,,,66060.02,82,,percent of total billed charges,,,72504.9,90,,percent of total billed charges,,,68476.85,85,,percent of total billed charges,,60742.99,76532.95,
MAJOR COMPLICATED OVER 8 HOURS,18602128,CDM,,,360,RC,inpatient,,85528,85528,,72613.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,64488.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,72698.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,75264.64,88,,percent of total billed charges,,,,,,,,,65343.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,77830.48,91,,percent of total billed charges,,,81251.6,95,,percent of total billed charges,,,70988.24,83,,percent of total billed charges,,,70988.24,83,,percent of total billed charges,,,,,,,,,,,,,,,70988.24,83,,percent of total billed charges,,,81251.6,95,,percent of total billed charges,,,76975.2,90,,percent of total billed charges,,,76975.2,90,,percent of total billed charges,,,70132.96,82,,percent of total billed charges,,,76975.2,90,,percent of total billed charges,,,72698.8,85,,percent of total billed charges,,64488.11,81251.6,
MAJOR SURGERY EXTRACORPOREAL SHOCKWAVE,18602130,CDM,50590,CPT,360,RC,inpatient,,19964,19964,,16949.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15052.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16969.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17568.32,88,,percent of total billed charges,,,,,,,,,15252.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18167.24,91,,percent of total billed charges,,,18965.8,95,,percent of total billed charges,,,16570.12,83,,percent of total billed charges,,,16570.12,83,,percent of total billed charges,,,,,,,,,,,,,,,16570.12,83,,percent of total billed charges,,,18965.8,95,,percent of total billed charges,,,17967.6,90,,percent of total billed charges,,,17967.6,90,,percent of total billed charges,,,16370.48,82,,percent of total billed charges,,,17967.6,90,,percent of total billed charges,,,16969.4,85,,percent of total billed charges,,15052.86,18965.8,
MAJOR COMPLICATED III UP TO 1 HOUR,18602140,CDM,,,360,RC,inpatient,,25993,25993,,22068.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19598.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,22094.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22873.84,88,,percent of total billed charges,,,,,,,,,19858.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23653.63,91,,percent of total billed charges,,,24693.35,95,,percent of total billed charges,,,21574.19,83,,percent of total billed charges,,,21574.19,83,,percent of total billed charges,,,,,,,,,,,,,,,21574.19,83,,percent of total billed charges,,,24693.35,95,,percent of total billed charges,,,23393.7,90,,percent of total billed charges,,,23393.7,90,,percent of total billed charges,,,21314.26,82,,percent of total billed charges,,,23393.7,90,,percent of total billed charges,,,22094.05,85,,percent of total billed charges,,19598.72,24693.35,
MAJOR COMPLICATED III UP TO 2 HOURS,18602141,CDM,,,360,RC,inpatient,,34255,34255,,29082.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,25828.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29116.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,30144.4,88,,percent of total billed charges,,,,,,,,,26170.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,31172.05,91,,percent of total billed charges,,,32542.25,95,,percent of total billed charges,,,28431.65,83,,percent of total billed charges,,,28431.65,83,,percent of total billed charges,,,,,,,,,,,,,,,28431.65,83,,percent of total billed charges,,,32542.25,95,,percent of total billed charges,,,30829.5,90,,percent of total billed charges,,,30829.5,90,,percent of total billed charges,,,28089.1,82,,percent of total billed charges,,,30829.5,90,,percent of total billed charges,,,29116.75,85,,percent of total billed charges,,25828.27,32542.25,
MAJOR COMPLICATED III UP TO 3 HOURS,18602142,CDM,,,360,RC,inpatient,,41802,41802,,35489.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31518.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35531.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36785.76,88,,percent of total billed charges,,,,,,,,,31936.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,38039.82,91,,percent of total billed charges,,,39711.9,95,,percent of total billed charges,,,34695.66,83,,percent of total billed charges,,,34695.66,83,,percent of total billed charges,,,,,,,,,,,,,,,34695.66,83,,percent of total billed charges,,,39711.9,95,,percent of total billed charges,,,37621.8,90,,percent of total billed charges,,,37621.8,90,,percent of total billed charges,,,34277.64,82,,percent of total billed charges,,,37621.8,90,,percent of total billed charges,,,35531.7,85,,percent of total billed charges,,31518.71,39711.9,
MAJOR COMPLICATED III UP TO 4 HOURS,18602143,CDM,,,360,RC,inpatient,,48326,48326,,41028.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36437.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,41077.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42526.88,88,,percent of total billed charges,,,,,,,,,36921.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43976.66,91,,percent of total billed charges,,,45909.7,95,,percent of total billed charges,,,40110.58,83,,percent of total billed charges,,,40110.58,83,,percent of total billed charges,,,,,,,,,,,,,,,40110.58,83,,percent of total billed charges,,,45909.7,95,,percent of total billed charges,,,43493.4,90,,percent of total billed charges,,,43493.4,90,,percent of total billed charges,,,39627.32,82,,percent of total billed charges,,,43493.4,90,,percent of total billed charges,,,41077.1,85,,percent of total billed charges,,36437.8,45909.7,
MAJOR COMPLICATED III UP TO 5 HOURS,18602144,CDM,,,360,RC,inpatient,,55724,55724,,47309.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42015.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,47365.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,49037.12,88,,percent of total billed charges,,,,,,,,,42573.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50708.84,91,,percent of total billed charges,,,52937.8,95,,percent of total billed charges,,,46250.92,83,,percent of total billed charges,,,46250.92,83,,percent of total billed charges,,,,,,,,,,,,,,,46250.92,83,,percent of total billed charges,,,52937.8,95,,percent of total billed charges,,,50151.6,90,,percent of total billed charges,,,50151.6,90,,percent of total billed charges,,,45693.68,82,,percent of total billed charges,,,50151.6,90,,percent of total billed charges,,,47365.4,85,,percent of total billed charges,,42015.9,52937.8,
MAJOR COMPLICATED III UP TO 6 HOURS,18602145,CDM,,,360,RC,inpatient,,63624,63624,,54016.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47972.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,54080.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55989.12,88,,percent of total billed charges,,,,,,,,,48608.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57897.84,91,,percent of total billed charges,,,60442.8,95,,percent of total billed charges,,,52807.92,83,,percent of total billed charges,,,52807.92,83,,percent of total billed charges,,,,,,,,,,,,,,,52807.92,83,,percent of total billed charges,,,60442.8,95,,percent of total billed charges,,,57261.6,90,,percent of total billed charges,,,57261.6,90,,percent of total billed charges,,,52171.68,82,,percent of total billed charges,,,57261.6,90,,percent of total billed charges,,,54080.4,85,,percent of total billed charges,,47972.5,60442.8,
ESOPHAGOGASTROSCOPY EGD,18603035,CDM,,,360,RC,inpatient,,7683,7683,,6522.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5792.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6530.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6761.04,88,,percent of total billed charges,,,,,,,,,5869.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6991.53,91,,percent of total billed charges,,,7298.85,95,,percent of total billed charges,,,6376.89,83,,percent of total billed charges,,,6376.89,83,,percent of total billed charges,,,,,,,,,,,,,,,6376.89,83,,percent of total billed charges,,,7298.85,95,,percent of total billed charges,,,6914.7,90,,percent of total billed charges,,,6914.7,90,,percent of total billed charges,,,6300.06,82,,percent of total billed charges,,,6914.7,90,,percent of total billed charges,,,6530.55,85,,percent of total billed charges,,5792.98,7298.85,
ESOPHAGOGASTROSCOPY EGD WITH ENDOFLIP,18603036,CDM,,,360,RC,inpatient,,11022,11022,,9357.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,8310.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9368.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9699.36,88,,percent of total billed charges,,,,,,,,,8420.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10030.02,91,,percent of total billed charges,,,10470.9,95,,percent of total billed charges,,,9148.26,83,,percent of total billed charges,,,9148.26,83,,percent of total billed charges,,,,,,,,,,,,,,,9148.26,83,,percent of total billed charges,,,10470.9,95,,percent of total billed charges,,,9919.8,90,,percent of total billed charges,,,9919.8,90,,percent of total billed charges,,,9038.04,82,,percent of total billed charges,,,9919.8,90,,percent of total billed charges,,,9368.7,85,,percent of total billed charges,,8310.59,10470.9,
COMPLETE COLONOSCOPY,18603076,CDM,,,360,RC,inpatient,,7783,7783,,6607.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5868.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6615.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6849.04,88,,percent of total billed charges,,,,,,,,,5946.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7082.53,91,,percent of total billed charges,,,7393.85,95,,percent of total billed charges,,,6459.89,83,,percent of total billed charges,,,6459.89,83,,percent of total billed charges,,,,,,,,,,,,,,,6459.89,83,,percent of total billed charges,,,7393.85,95,,percent of total billed charges,,,7004.7,90,,percent of total billed charges,,,7004.7,90,,percent of total billed charges,,,6382.06,82,,percent of total billed charges,,,7004.7,90,,percent of total billed charges,,,6615.55,85,,percent of total billed charges,,5868.38,7393.85,
PROCTOSCOPY,18603077,CDM,,,360,RC,inpatient,,6236,6236,,5294.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4701.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5300.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5487.68,88,,percent of total billed charges,,,,,,,,,4764.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5674.76,91,,percent of total billed charges,,,5924.2,95,,percent of total billed charges,,,5175.88,83,,percent of total billed charges,,,5175.88,83,,percent of total billed charges,,,,,,,,,,,,,,,5175.88,83,,percent of total billed charges,,,5924.2,95,,percent of total billed charges,,,5612.4,90,,percent of total billed charges,,,5612.4,90,,percent of total billed charges,,,5113.52,82,,percent of total billed charges,,,5612.4,90,,percent of total billed charges,,,5300.6,85,,percent of total billed charges,,4701.94,5924.2,
 TRANSESOPHAGEAL ECHO,18603080,CDM,,,360,RC,inpatient,,7872,7872,,6683.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5935.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6691.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6927.36,88,,percent of total billed charges,,,,,,,,,6014.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7163.52,91,,percent of total billed charges,,,7478.4,95,,percent of total billed charges,,,6533.76,83,,percent of total billed charges,,,6533.76,83,,percent of total billed charges,,,,,,,,,,,,,,,6533.76,83,,percent of total billed charges,,,7478.4,95,,percent of total billed charges,,,7084.8,90,,percent of total billed charges,,,7084.8,90,,percent of total billed charges,,,6455.04,82,,percent of total billed charges,,,7084.8,90,,percent of total billed charges,,,6691.2,85,,percent of total billed charges,,5935.49,7478.4,
ENDOSCOPIC BIOPSY,18603084,CDM,,,360,RC,inpatient,,1432,1432,,1215.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1079.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1217.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1260.16,88,,percent of total billed charges,,,,,,,,,1094.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1303.12,91,,percent of total billed charges,,,1360.4,95,,percent of total billed charges,,,1188.56,83,,percent of total billed charges,,,1188.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1188.56,83,,percent of total billed charges,,,1360.4,95,,percent of total billed charges,,,1288.8,90,,percent of total billed charges,,,1288.8,90,,percent of total billed charges,,,1174.24,82,,percent of total billed charges,,,1288.8,90,,percent of total billed charges,,,1217.2,85,,percent of total billed charges,,1079.73,1360.4,
POLYPECTOMY,18603092,CDM,,,360,RC,inpatient,,1332,1332,,1130.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1004.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1132.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1172.16,88,,percent of total billed charges,,,,,,,,,1017.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1212.12,91,,percent of total billed charges,,,1265.4,95,,percent of total billed charges,,,1105.56,83,,percent of total billed charges,,,1105.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1105.56,83,,percent of total billed charges,,,1265.4,95,,percent of total billed charges,,,1198.8,90,,percent of total billed charges,,,1198.8,90,,percent of total billed charges,,,1092.24,82,,percent of total billed charges,,,1198.8,90,,percent of total billed charges,,,1132.2,85,,percent of total billed charges,,1004.33,1265.4,
X LUMBARKYPHOPLASTYINOR,26200002,CDM,22514,CPT,320,RC,inpatient,TC,15687,15687,,13318.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11828,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13333.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13804.56,88,,percent of total billed charges,,,,,,,,,11984.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14275.17,91,,percent of total billed charges,,,14902.65,95,,percent of total billed charges,,,13020.21,83,,percent of total billed charges,,,13020.21,83,,percent of total billed charges,,,,,,,,,,,,,,,13020.21,83,,percent of total billed charges,,,14902.65,95,,percent of total billed charges,,,14118.3,90,,percent of total billed charges,,,14118.3,90,,percent of total billed charges,,,12863.34,82,,percent of total billed charges,,,14118.3,90,,percent of total billed charges,,,13333.95,85,,percent of total billed charges,,11828,14902.65,
X LUMBARVRTEBROPLSTYINOR,26200003,CDM,22511,CPT,360,RC,inpatient,TC,17217,17217,,14617.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12981.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14634.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15150.96,88,,percent of total billed charges,,,,,,,,,13153.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15667.47,91,,percent of total billed charges,,,16356.15,95,,percent of total billed charges,,,14290.11,83,,percent of total billed charges,,,14290.11,83,,percent of total billed charges,,,,,,,,,,,,,,,14290.11,83,,percent of total billed charges,,,16356.15,95,,percent of total billed charges,,,15495.3,90,,percent of total billed charges,,,15495.3,90,,percent of total billed charges,,,14117.94,82,,percent of total billed charges,,,15495.3,90,,percent of total billed charges,,,14634.45,85,,percent of total billed charges,,12981.62,16356.15,
X TSPINEKYPHOPLASTYINOR,26200004,CDM,22513,CPT,360,RC,inpatient,TC,25378,25378,,21545.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,19135.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21571.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22332.64,88,,percent of total billed charges,,,,,,,,,19388.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,23093.98,91,,percent of total billed charges,,,24109.1,95,,percent of total billed charges,,,21063.74,83,,percent of total billed charges,,,21063.74,83,,percent of total billed charges,,,,,,,,,,,,,,,21063.74,83,,percent of total billed charges,,,24109.1,95,,percent of total billed charges,,,22840.2,90,,percent of total billed charges,,,22840.2,90,,percent of total billed charges,,,20809.96,82,,percent of total billed charges,,,22840.2,90,,percent of total billed charges,,,21571.3,85,,percent of total billed charges,,19135.01,24109.1,
X TSPINEVRTEBROPLSTYINOR,26200005,CDM,22510,CPT,360,RC,inpatient,TC,17504,17504,,14860.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13198.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14878.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15403.52,88,,percent of total billed charges,,,,,,,,,13373.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15928.64,91,,percent of total billed charges,,,16628.8,95,,percent of total billed charges,,,14528.32,83,,percent of total billed charges,,,14528.32,83,,percent of total billed charges,,,,,,,,,,,,,,,14528.32,83,,percent of total billed charges,,,16628.8,95,,percent of total billed charges,,,15753.6,90,,percent of total billed charges,,,15753.6,90,,percent of total billed charges,,,14353.28,82,,percent of total billed charges,,,15753.6,90,,percent of total billed charges,,,14878.4,85,,percent of total billed charges,,13198.02,16628.8,
X INJPROCED FORSPINALDISK,26200010,CDM,62290,CPT,360,RC,inpatient,,4833,4833,,4103.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3644.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4108.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4253.04,88,,percent of total billed charges,,,,,,,,,3692.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4398.03,91,,percent of total billed charges,,,4591.35,95,,percent of total billed charges,,,4011.39,83,,percent of total billed charges,,,4011.39,83,,percent of total billed charges,,,,,,,,,,,,,,,4011.39,83,,percent of total billed charges,,,4591.35,95,,percent of total billed charges,,,4349.7,90,,percent of total billed charges,,,4349.7,90,,percent of total billed charges,,,3963.06,82,,percent of total billed charges,,,4349.7,90,,percent of total billed charges,,,4108.05,85,,percent of total billed charges,,3644.08,4591.35,
X VERTBRPLSTYEAADDLVLTORL,26200015,CDM,22512,CPT,360,RC,inpatient,TC,10599,10599,,8998.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7991.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,9009.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9327.12,88,,percent of total billed charges,,,,,,,,,8097.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9645.09,91,,percent of total billed charges,,,10069.05,95,,percent of total billed charges,,,8797.17,83,,percent of total billed charges,,,8797.17,83,,percent of total billed charges,,,,,,,,,,,,,,,8797.17,83,,percent of total billed charges,,,10069.05,95,,percent of total billed charges,,,9539.1,90,,percent of total billed charges,,,9539.1,90,,percent of total billed charges,,,8691.18,82,,percent of total billed charges,,,9539.1,90,,percent of total billed charges,,,9009.15,85,,percent of total billed charges,,7991.65,10069.05,
X TSPINEKYPHOEAADDLVL,26200028,CDM,22515,CPT,360,RC,inpatient,TC,12204,12204,,10361.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9201.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10373.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10739.52,88,,percent of total billed charges,,,,,,,,,9323.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11105.64,91,,percent of total billed charges,,,11593.8,95,,percent of total billed charges,,,10129.32,83,,percent of total billed charges,,,10129.32,83,,percent of total billed charges,,,,,,,,,,,,,,,10129.32,83,,percent of total billed charges,,,11593.8,95,,percent of total billed charges,,,10983.6,90,,percent of total billed charges,,,10983.6,90,,percent of total billed charges,,,10007.28,82,,percent of total billed charges,,,10983.6,90,,percent of total billed charges,,,10373.4,85,,percent of total billed charges,,9201.82,11593.8,
X TSPINEVRTEBROBXINOR,26200031,CDM,20250,CPT,360,RC,inpatient,TC,10144,10144,,8612.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7648.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8622.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8926.72,88,,percent of total billed charges,,,,,,,,,7750.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9231.04,91,,percent of total billed charges,,,9636.8,95,,percent of total billed charges,,,8419.52,83,,percent of total billed charges,,,8419.52,83,,percent of total billed charges,,,,,,,,,,,,,,,8419.52,83,,percent of total billed charges,,,9636.8,95,,percent of total billed charges,,,9129.6,90,,percent of total billed charges,,,9129.6,90,,percent of total billed charges,,,8318.08,82,,percent of total billed charges,,,9129.6,90,,percent of total billed charges,,,8622.4,85,,percent of total billed charges,,7648.58,9636.8,
X LUMBARKYPHOPLASTYINOR(AUG),26200040,CDM,22514,CPT,360,RC,inpatient,TC,20879,20879,,17726.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15742.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17747.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18373.52,88,,percent of total billed charges,,,,,,,,,15951.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18999.89,91,,percent of total billed charges,,,19835.05,95,,percent of total billed charges,,,17329.57,83,,percent of total billed charges,,,17329.57,83,,percent of total billed charges,,,,,,,,,,,,,,,17329.57,83,,percent of total billed charges,,,19835.05,95,,percent of total billed charges,,,18791.1,90,,percent of total billed charges,,,18791.1,90,,percent of total billed charges,,,17120.78,82,,percent of total billed charges,,,18791.1,90,,percent of total billed charges,,,17747.15,85,,percent of total billed charges,,15742.77,19835.05,
X FACET INJ C/T SPINE LVL 1,26700116,CDM,64490,CPT,320,RC,inpatient,TC,3207,3207,,2722.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2418.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2725.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2822.16,88,,percent of total billed charges,,,,,,,,,2450.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2918.37,91,,percent of total billed charges,,,3046.65,95,,percent of total billed charges,,,2661.81,83,,percent of total billed charges,,,2661.81,83,,percent of total billed charges,,,,,,,,,,,,,,,2661.81,83,,percent of total billed charges,,,3046.65,95,,percent of total billed charges,,,2886.3,90,,percent of total billed charges,,,2886.3,90,,percent of total billed charges,,,2629.74,82,,percent of total billed charges,,,2886.3,90,,percent of total billed charges,,,2725.95,85,,percent of total billed charges,,2418.08,3046.65,
X FACET INJ C/T SPINE LVL 2,26700117,CDM,64491,CPT,320,RC,inpatient,TC,1632,1632,,1385.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1230.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1387.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1436.16,88,,percent of total billed charges,,,,,,,,,1246.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1485.12,91,,percent of total billed charges,,,1550.4,95,,percent of total billed charges,,,1354.56,83,,percent of total billed charges,,,1354.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1354.56,83,,percent of total billed charges,,,1550.4,95,,percent of total billed charges,,,1468.8,90,,percent of total billed charges,,,1468.8,90,,percent of total billed charges,,,1338.24,82,,percent of total billed charges,,,1468.8,90,,percent of total billed charges,,,1387.2,85,,percent of total billed charges,,1230.53,1550.4,
X FACET INJ C/T SPINE LVL 3,26700118,CDM,64492,CPT,320,RC,inpatient,TC,1540,1540,,1307.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1161.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1309,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1355.2,88,,percent of total billed charges,,,,,,,,,1176.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1401.4,91,,percent of total billed charges,,,1463,95,,percent of total billed charges,,,1278.2,83,,percent of total billed charges,,,1278.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1278.2,83,,percent of total billed charges,,,1463,95,,percent of total billed charges,,,1386,90,,percent of total billed charges,,,1386,90,,percent of total billed charges,,,1262.8,82,,percent of total billed charges,,,1386,90,,percent of total billed charges,,,1309,85,,percent of total billed charges,,1161.16,1463,
UL ECHO TEE TRANESOPHAGEAL,27200500,CDM,93312,CPT,480,RC,inpatient,TC,5600,5600,,4754.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4222.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4760,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4928,88,,percent of total billed charges,,,,,,,,,4278.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5096,91,,percent of total billed charges,,,5320,95,,percent of total billed charges,,,4648,83,,percent of total billed charges,,,4648,83,,percent of total billed charges,,,,,,,,,,,,,,,4648,83,,percent of total billed charges,,,5320,95,,percent of total billed charges,,,5040,90,,percent of total billed charges,,,5040,90,,percent of total billed charges,,,4592,82,,percent of total billed charges,,,5040,90,,percent of total billed charges,,,4760,85,,percent of total billed charges,,4222.4,5320,
INJ EPIDURAL CERV THORAC SINGLE,33762310,CDM,62320,CPT,360,RC,inpatient,,2455,2455,,2084.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1851.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2086.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2160.4,88,,percent of total billed charges,,,,,,,,,1875.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2234.05,91,,percent of total billed charges,,,2332.25,95,,percent of total billed charges,,,2037.65,83,,percent of total billed charges,,,2037.65,83,,percent of total billed charges,,,,,,,,,,,,,,,2037.65,83,,percent of total billed charges,,,2332.25,95,,percent of total billed charges,,,2209.5,90,,percent of total billed charges,,,2209.5,90,,percent of total billed charges,,,2013.1,82,,percent of total billed charges,,,2209.5,90,,percent of total billed charges,,,2086.75,85,,percent of total billed charges,,1851.07,2332.25,
INJ ANES ILIOINGUINAL ILIOHYPOGASTRIC NR,33764425,CDM,64425,CPT,360,RC,inpatient,,2267,2267,,1924.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1709.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1926.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1994.96,88,,percent of total billed charges,,,,,,,,,1731.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2062.97,91,,percent of total billed charges,,,2153.65,95,,percent of total billed charges,,,1881.61,83,,percent of total billed charges,,,1881.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1881.61,83,,percent of total billed charges,,,2153.65,95,,percent of total billed charges,,,2040.3,90,,percent of total billed charges,,,2040.3,90,,percent of total billed charges,,,1858.94,82,,percent of total billed charges,,,2040.3,90,,percent of total billed charges,,,1926.95,85,,percent of total billed charges,,1709.32,2153.65,
INJ FORAMEN EPIDURAL L/S,33764483,CDM,64483,CPT,360,RC,inpatient,,2455,2455,,2084.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1851.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2086.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2160.4,88,,percent of total billed charges,,,,,,,,,1875.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2234.05,91,,percent of total billed charges,,,2332.25,95,,percent of total billed charges,,,2037.65,83,,percent of total billed charges,,,2037.65,83,,percent of total billed charges,,,,,,,,,,,,,,,2037.65,83,,percent of total billed charges,,,2332.25,95,,percent of total billed charges,,,2209.5,90,,percent of total billed charges,,,2209.5,90,,percent of total billed charges,,,2013.1,82,,percent of total billed charges,,,2209.5,90,,percent of total billed charges,,,2086.75,85,,percent of total billed charges,,1851.07,2332.25,
TAP BLOCK BI INJECTION,33764488,CDM,64488,CPT,360,RC,inpatient,,3893,3893,,3305.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2935.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3309.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3425.84,88,,percent of total billed charges,,,,,,,,,2974.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3542.63,91,,percent of total billed charges,,,3698.35,95,,percent of total billed charges,,,3231.19,83,,percent of total billed charges,,,3231.19,83,,percent of total billed charges,,,,,,,,,,,,,,,3231.19,83,,percent of total billed charges,,,3698.35,95,,percent of total billed charges,,,3503.7,90,,percent of total billed charges,,,3503.7,90,,percent of total billed charges,,,3192.26,82,,percent of total billed charges,,,3503.7,90,,percent of total billed charges,,,3309.05,85,,percent of total billed charges,,2935.32,3698.35,
BLOOD ADMINISTRATION SERVICE,880071,CDM,36430,CPT,391,RC,inpatient,,1766,1766,,1499.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1331.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1501.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1554.08,88,,percent of total billed charges,,,,,,,,,1349.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1607.06,91,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.78,83,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1448.12,82,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,1331.56,1677.7,
BLOOD ADMINISTRATION UP TO 6 HOURS,880072,CDM,36430,CPT,391,RC,inpatient,,1709,1709,,1450.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1288.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1452.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1503.92,88,,percent of total billed charges,,,,,,,,,1305.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1555.19,91,,percent of total billed charges,,,1623.55,95,,percent of total billed charges,,,1418.47,83,,percent of total billed charges,,,1418.47,83,,percent of total billed charges,,,,,,,,,,,,,,,1418.47,83,,percent of total billed charges,,,1623.55,95,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1401.38,82,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1452.65,85,,percent of total billed charges,,1288.59,1623.55,
EXTENDED RECOVERY 1ST HOUR,880080,CDM,,,710,RC,inpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,157.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,177.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,157.59,198.55,
EXTENDED RECOVERY EACH ADDTL HOUR,880081,CDM,,,710,RC,inpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,92.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,82.19,103.55,
"IV INFUSION, HYDRATION, UP TO 1 HOUR",880100,CDM,96360,CPT,260,RC,inpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,627.33,790.4,
"IV INFUSION, HYDRATION, ADDTL HOUR",880101,CDM,96361,CPT,260,RC,inpatient,XU,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
"IV INFUSION, THERAPEUTIC, UP TO 1 HOUR",880102,CDM,96365,CPT,260,RC,inpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,627.33,790.4,
"IV INFUSION, THERAPEUTIC, ADDTL HOUR",880103,CDM,96366,CPT,260,RC,inpatient,XU,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,189.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,213.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,189.25,238.45,
CONCURRENT ADDT'L MEDICATED SOLUTION,880104,CDM,96368,CPT,260,RC,inpatient,XU,522,522,,443.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,393.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,443.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,459.36,88,,percent of total billed charges,,,,,,,,,398.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,475.02,91,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,,,,,,,,,,,,,433.26,83,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,428.04,82,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,393.59,495.9,
IM/SQ INJECTION,880105,CDM,96372,CPT,260,RC,inpatient,XU,352,352,,298.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,265.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,299.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,309.76,88,,percent of total billed charges,,,,,,,,,268.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,,,,,,,,,,,,,292.16,83,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,288.64,82,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,265.41,334.4,
"IVP, SINGLE OR INITIAL",880106,CDM,96374,CPT,260,RC,inpatient,XU,436,436,,370.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,328.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,370.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,383.68,88,,percent of total billed charges,,,,,,,,,333.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,396.76,91,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,,,,,,,,,,,,,361.88,83,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,357.52,82,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,328.74,414.2,
"IVP, EACH ADDTL OF NEW SUBSTANCE/DRUG",880107,CDM,96375,CPT,260,RC,inpatient,XU,359,359,,304.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,270.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,305.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,315.92,88,,percent of total billed charges,,,,,,,,,274.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,,,,,,,,,,,,,297.97,83,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,294.38,82,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,270.69,341.05,
"IVP, EACH ADDTL SEQUENTIAL INTRA PUSH",880108,CDM,96376,CPT,260,RC,inpatient,XU,274,274,,232.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,206.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,232.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,241.12,88,,percent of total billed charges,,,,,,,,,209.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,249.34,91,,percent of total billed charges,,,260.3,95,,percent of total billed charges,,,227.42,83,,percent of total billed charges,,,227.42,83,,percent of total billed charges,,,,,,,,,,,,,,,227.42,83,,percent of total billed charges,,,260.3,95,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,224.68,82,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,232.9,85,,percent of total billed charges,,206.6,260.3,
NURSING CARE OBSERV FIRST HOUR,880120,CDM,G0378,HCPCS,762,RC,inpatient,,1135,1135,,963.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,855.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,964.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,998.8,88,,percent of total billed charges,,,,,,,,,867.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1032.85,91,,percent of total billed charges,,,1078.25,95,,percent of total billed charges,,,942.05,83,,percent of total billed charges,,,942.05,83,,percent of total billed charges,,,,,,,,,,,,,,,942.05,83,,percent of total billed charges,,,1078.25,95,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,930.7,82,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,964.75,85,,percent of total billed charges,,855.79,1078.25,
NURSING CARE OBSERV ADDTL HOUR,880121,CDM,G0378,HCPCS,762,RC,inpatient,,187,187,,158.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,141,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,158.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,164.56,88,,percent of total billed charges,,,,,,,,,142.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,153.34,82,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,141,177.65,
TELEMETRY OBSERVATION FIRST HOUR,880122,CDM,G0378,HCPCS,762,RC,inpatient,,1553,1553,,1318.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1170.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1320.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1366.64,88,,percent of total billed charges,,,,,,,,,1186.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1413.23,91,,percent of total billed charges,,,1475.35,95,,percent of total billed charges,,,1288.99,83,,percent of total billed charges,,,1288.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1288.99,83,,percent of total billed charges,,,1475.35,95,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1273.46,82,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1320.05,85,,percent of total billed charges,,1170.96,1475.35,
TELEMETRY OBSERVATION ADDTL HOUR,880123,CDM,G0378,HCPCS,762,RC,inpatient,,184,184,,156.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,138.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,156.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,161.92,88,,percent of total billed charges,,,,,,,,,140.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,,,,,,,,,,,,,152.72,83,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,150.88,82,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,138.74,174.8,
UL 3D RENDERING,27100000,CDM,76376,CPT,402,RC,inpatient,TC,1413,1413,,1199.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1065.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1201.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1243.44,88,,percent of total billed charges,,,,,,,,,1079.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1285.83,91,,percent of total billed charges,,,1342.35,95,,percent of total billed charges,,,1172.79,83,,percent of total billed charges,,,1172.79,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.79,83,,percent of total billed charges,,,1342.35,95,,percent of total billed charges,,,1271.7,90,,percent of total billed charges,,,1271.7,90,,percent of total billed charges,,,1158.66,82,,percent of total billed charges,,,1271.7,90,,percent of total billed charges,,,1201.05,85,,percent of total billed charges,,1065.4,1342.35,
UL OB BIOPHYS WO NST,27100008,CDM,76819,CPT,402,RC,inpatient,TC,1358,1358,,1152.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1023.93,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1154.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1195.04,88,,percent of total billed charges,,,,,,,,,1037.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1235.78,91,,percent of total billed charges,,,1290.1,95,,percent of total billed charges,,,1127.14,83,,percent of total billed charges,,,1127.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1127.14,83,,percent of total billed charges,,,1290.1,95,,percent of total billed charges,,,1222.2,90,,percent of total billed charges,,,1222.2,90,,percent of total billed charges,,,1113.56,82,,percent of total billed charges,,,1222.2,90,,percent of total billed charges,,,1154.3,85,,percent of total billed charges,,1023.93,1290.1,
UL OB BIOPHYS W0/NST(EAADDL),27100009,CDM,76819,CPT,402,RC,inpatient,59,1041,1041,,883.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,784.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,884.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,916.08,88,,percent of total billed charges,,,,,,,,,795.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,947.31,91,,percent of total billed charges,,,988.95,95,,percent of total billed charges,,,864.03,83,,percent of total billed charges,,,864.03,83,,percent of total billed charges,,,,,,,,,,,,,,,864.03,83,,percent of total billed charges,,,988.95,95,,percent of total billed charges,,,936.9,90,,percent of total billed charges,,,936.9,90,,percent of total billed charges,,,853.62,82,,percent of total billed charges,,,936.9,90,,percent of total billed charges,,,884.85,85,,percent of total billed charges,,784.91,988.95,
UL OB BIOPHYS W NST,27100010,CDM,76818,CPT,402,RC,inpatient,TC,2244,2244,,1905.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1691.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1907.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1974.72,88,,percent of total billed charges,,,,,,,,,1714.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2042.04,91,,percent of total billed charges,,,2131.8,95,,percent of total billed charges,,,1862.52,83,,percent of total billed charges,,,1862.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1862.52,83,,percent of total billed charges,,,2131.8,95,,percent of total billed charges,,,2019.6,90,,percent of total billed charges,,,2019.6,90,,percent of total billed charges,,,1840.08,82,,percent of total billed charges,,,2019.6,90,,percent of total billed charges,,,1907.4,85,,percent of total billed charges,,1691.98,2131.8,
UL OB BIOPHYS W/NST(EAADDL),27100011,CDM,76818,CPT,402,RC,inpatient,59,1927,1927,,1636.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1452.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1637.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1695.76,88,,percent of total billed charges,,,,,,,,,1472.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1753.57,91,,percent of total billed charges,,,1830.65,95,,percent of total billed charges,,,1599.41,83,,percent of total billed charges,,,1599.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1599.41,83,,percent of total billed charges,,,1830.65,95,,percent of total billed charges,,,1734.3,90,,percent of total billed charges,,,1734.3,90,,percent of total billed charges,,,1580.14,82,,percent of total billed charges,,,1734.3,90,,percent of total billed charges,,,1637.95,85,,percent of total billed charges,,1452.96,1830.65,
UL UMBLICAL ARTERY DOPPLER,27100012,CDM,76820,CPT,402,RC,inpatient,TC,791,791,,671.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,596.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,672.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,696.08,88,,percent of total billed charges,,,,,,,,,604.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,719.81,91,,percent of total billed charges,,,751.45,95,,percent of total billed charges,,,656.53,83,,percent of total billed charges,,,656.53,83,,percent of total billed charges,,,,,,,,,,,,,,,656.53,83,,percent of total billed charges,,,751.45,95,,percent of total billed charges,,,711.9,90,,percent of total billed charges,,,711.9,90,,percent of total billed charges,,,648.62,82,,percent of total billed charges,,,711.9,90,,percent of total billed charges,,,672.35,85,,percent of total billed charges,,596.41,751.45,
UL AMNIOCENT GUIDE,27100016,CDM,76946,CPT,402,RC,inpatient,TC,1217,1217,,1033.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,917.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1034.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1070.96,88,,percent of total billed charges,,,,,,,,,929.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1107.47,91,,percent of total billed charges,,,1156.15,95,,percent of total billed charges,,,1010.11,83,,percent of total billed charges,,,1010.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1010.11,83,,percent of total billed charges,,,1156.15,95,,percent of total billed charges,,,1095.3,90,,percent of total billed charges,,,1095.3,90,,percent of total billed charges,,,997.94,82,,percent of total billed charges,,,1095.3,90,,percent of total billed charges,,,1034.45,85,,percent of total billed charges,,917.62,1156.15,
UL AV FISTULA DUPLEX,27100030,CDM,93990,CPT,402,RC,inpatient,TC,1172,1172,,995.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,883.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,996.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1031.36,88,,percent of total billed charges,,,,,,,,,895.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1066.52,91,,percent of total billed charges,,,1113.4,95,,percent of total billed charges,,,972.76,83,,percent of total billed charges,,,972.76,83,,percent of total billed charges,,,,,,,,,,,,,,,972.76,83,,percent of total billed charges,,,1113.4,95,,percent of total billed charges,,,1054.8,90,,percent of total billed charges,,,1054.8,90,,percent of total billed charges,,,961.04,82,,percent of total billed charges,,,1054.8,90,,percent of total billed charges,,,996.2,85,,percent of total billed charges,,883.69,1113.4,
UL ECHOCARDIO REAL TIME,27100099,CDM,93307,CPT,480,RC,inpatient,,1724,1724,,1463.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1299.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1465.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1517.12,88,,percent of total billed charges,,,,,,,,,1317.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1568.84,91,,percent of total billed charges,,,1637.8,95,,percent of total billed charges,,,1430.92,83,,percent of total billed charges,,,1430.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1430.92,83,,percent of total billed charges,,,1637.8,95,,percent of total billed charges,,,1551.6,90,,percent of total billed charges,,,1551.6,90,,percent of total billed charges,,,1413.68,82,,percent of total billed charges,,,1551.6,90,,percent of total billed charges,,,1465.4,85,,percent of total billed charges,,1299.9,1637.8,
UL ECHOCARDIO COLOR MAP,27100487,CDM,93325,CPT,480,RC,inpatient,,965,965,,819.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,727.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,820.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,849.2,88,,percent of total billed charges,,,,,,,,,737.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,878.15,91,,percent of total billed charges,,,916.75,95,,percent of total billed charges,,,800.95,83,,percent of total billed charges,,,800.95,83,,percent of total billed charges,,,,,,,,,,,,,,,800.95,83,,percent of total billed charges,,,916.75,95,,percent of total billed charges,,,868.5,90,,percent of total billed charges,,,868.5,90,,percent of total billed charges,,,791.3,82,,percent of total billed charges,,,868.5,90,,percent of total billed charges,,,820.25,85,,percent of total billed charges,,727.61,916.75,
UL ECHO/COMPLETE,27100488,CDM,93306,CPT,480,RC,inpatient,,4541,4541,,3855.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3423.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3859.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3996.08,88,,percent of total billed charges,,,,,,,,,3469.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4132.31,91,,percent of total billed charges,,,4313.95,95,,percent of total billed charges,,,3769.03,83,,percent of total billed charges,,,3769.03,83,,percent of total billed charges,,,,,,,,,,,,,,,3769.03,83,,percent of total billed charges,,,4313.95,95,,percent of total billed charges,,,4086.9,90,,percent of total billed charges,,,4086.9,90,,percent of total billed charges,,,3723.62,82,,percent of total billed charges,,,4086.9,90,,percent of total billed charges,,,3859.85,85,,percent of total billed charges,,3423.91,4313.95,
UL ECHO EXERCISE STRESS,27100489,CDM,93350,CPT,480,RC,inpatient,TC,3598,3598,,3054.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2712.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3058.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3166.24,88,,percent of total billed charges,,,,,,,,,2748.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3274.18,91,,percent of total billed charges,,,3418.1,95,,percent of total billed charges,,,2986.34,83,,percent of total billed charges,,,2986.34,83,,percent of total billed charges,,,,,,,,,,,,,,,2986.34,83,,percent of total billed charges,,,3418.1,95,,percent of total billed charges,,,3238.2,90,,percent of total billed charges,,,3238.2,90,,percent of total billed charges,,,2950.36,82,,percent of total billed charges,,,3238.2,90,,percent of total billed charges,,,3058.3,85,,percent of total billed charges,,2712.89,3418.1,
UL ECHO/LIMITED OR F/U,27100490,CDM,93308,CPT,480,RC,inpatient,,2113,2113,,1793.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1593.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1796.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1859.44,88,,percent of total billed charges,,,,,,,,,1614.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1922.83,91,,percent of total billed charges,,,2007.35,95,,percent of total billed charges,,,1753.79,83,,percent of total billed charges,,,1753.79,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.79,83,,percent of total billed charges,,,2007.35,95,,percent of total billed charges,,,1901.7,90,,percent of total billed charges,,,1901.7,90,,percent of total billed charges,,,1732.66,82,,percent of total billed charges,,,1901.7,90,,percent of total billed charges,,,1796.05,85,,percent of total billed charges,,1593.2,2007.35,
UL DOPPLER ECHO F/U OR LTD,27100491,CDM,93321,CPT,480,RC,inpatient,,2119,2119,,1799.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1597.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1801.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1864.72,88,,percent of total billed charges,,,,,,,,,1618.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1928.29,91,,percent of total billed charges,,,2013.05,95,,percent of total billed charges,,,1758.77,83,,percent of total billed charges,,,1758.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1758.77,83,,percent of total billed charges,,,2013.05,95,,percent of total billed charges,,,1907.1,90,,percent of total billed charges,,,1907.1,90,,percent of total billed charges,,,1737.58,82,,percent of total billed charges,,,1907.1,90,,percent of total billed charges,,,1801.15,85,,percent of total billed charges,,1597.73,2013.05,
UL ECHO DOBUTAMINE STRESS,27100493,CDM,93350,CPT,480,RC,inpatient,TC,3598,3598,,3054.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2712.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3058.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3166.24,88,,percent of total billed charges,,,,,,,,,2748.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3274.18,91,,percent of total billed charges,,,3418.1,95,,percent of total billed charges,,,2986.34,83,,percent of total billed charges,,,2986.34,83,,percent of total billed charges,,,,,,,,,,,,,,,2986.34,83,,percent of total billed charges,,,3418.1,95,,percent of total billed charges,,,3238.2,90,,percent of total billed charges,,,3238.2,90,,percent of total billed charges,,,2950.36,82,,percent of total billed charges,,,3238.2,90,,percent of total billed charges,,,3058.3,85,,percent of total billed charges,,2712.89,3418.1,
UL ECHO COMPLETE PEDIATRIC,27100498,CDM,93306,CPT,480,RC,inpatient,,4541,4541,,3855.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3423.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3859.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3996.08,88,,percent of total billed charges,,,,,,,,,3469.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4132.31,91,,percent of total billed charges,,,4313.95,95,,percent of total billed charges,,,3769.03,83,,percent of total billed charges,,,3769.03,83,,percent of total billed charges,,,,,,,,,,,,,,,3769.03,83,,percent of total billed charges,,,4313.95,95,,percent of total billed charges,,,4086.9,90,,percent of total billed charges,,,4086.9,90,,percent of total billed charges,,,3723.62,82,,percent of total billed charges,,,4086.9,90,,percent of total billed charges,,,3859.85,85,,percent of total billed charges,,3423.91,4313.95,
* DNU US ECHO TEE TRANSESOPHAGEAL,27100499,CDM,93312,CPT,480,RC,inpatient,,6023,6023,,5113.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4541.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5119.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5300.24,88,,percent of total billed charges,,,,,,,,,4601.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5480.93,91,,percent of total billed charges,,,5721.85,95,,percent of total billed charges,,,4999.09,83,,percent of total billed charges,,,4999.09,83,,percent of total billed charges,,,,,,,,,,,,,,,4999.09,83,,percent of total billed charges,,,5721.85,95,,percent of total billed charges,,,5420.7,90,,percent of total billed charges,,,5420.7,90,,percent of total billed charges,,,4938.86,82,,percent of total billed charges,,,5420.7,90,,percent of total billed charges,,,5119.55,85,,percent of total billed charges,,4541.34,5721.85,
UL ECHO CONTRAST/COMPLETE,27100500,CDM,C8929,HCPCS,480,RC,inpatient,,4773,4773,,4052.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3598.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4057.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4200.24,88,,percent of total billed charges,,,,,,,,,3646.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4343.43,91,,percent of total billed charges,,,4534.35,95,,percent of total billed charges,,,3961.59,83,,percent of total billed charges,,,3961.59,83,,percent of total billed charges,,,,,,,,,,,,,,,3961.59,83,,percent of total billed charges,,,4534.35,95,,percent of total billed charges,,,4295.7,90,,percent of total billed charges,,,4295.7,90,,percent of total billed charges,,,3913.86,82,,percent of total billed charges,,,4295.7,90,,percent of total billed charges,,,4057.05,85,,percent of total billed charges,,3598.84,4534.35,
UL ECHO CONTRAST/LIMITED OR F/U,27100501,CDM,C8929,HCPCS,480,RC,inpatient,,4773,4773,,4052.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3598.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4057.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4200.24,88,,percent of total billed charges,,,,,,,,,3646.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4343.43,91,,percent of total billed charges,,,4534.35,95,,percent of total billed charges,,,3961.59,83,,percent of total billed charges,,,3961.59,83,,percent of total billed charges,,,,,,,,,,,,,,,3961.59,83,,percent of total billed charges,,,4534.35,95,,percent of total billed charges,,,4295.7,90,,percent of total billed charges,,,4295.7,90,,percent of total billed charges,,,3913.86,82,,percent of total billed charges,,,4295.7,90,,percent of total billed charges,,,4057.05,85,,percent of total billed charges,,3598.84,4534.35,
UL TRANSVAGINAL (NOT OB),27100529,CDM,76830,CPT,402,RC,inpatient,TC,1526,1526,,1295.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1150.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1297.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1342.88,88,,percent of total billed charges,,,,,,,,,1165.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1388.66,91,,percent of total billed charges,,,1449.7,95,,percent of total billed charges,,,1266.58,83,,percent of total billed charges,,,1266.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1266.58,83,,percent of total billed charges,,,1449.7,95,,percent of total billed charges,,,1373.4,90,,percent of total billed charges,,,1373.4,90,,percent of total billed charges,,,1251.32,82,,percent of total billed charges,,,1373.4,90,,percent of total billed charges,,,1297.1,85,,percent of total billed charges,,1150.6,1449.7,
UL TRANSRECTAL (SURGERY),27100537,CDM,76872,CPT,402,RC,inpatient,TC,1231,1231,,1045.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,928.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1046.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1083.28,88,,percent of total billed charges,,,,,,,,,940.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1120.21,91,,percent of total billed charges,,,1169.45,95,,percent of total billed charges,,,1021.73,83,,percent of total billed charges,,,1021.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1021.73,83,,percent of total billed charges,,,1169.45,95,,percent of total billed charges,,,1107.9,90,,percent of total billed charges,,,1107.9,90,,percent of total billed charges,,,1009.42,82,,percent of total billed charges,,,1107.9,90,,percent of total billed charges,,,1046.35,85,,percent of total billed charges,,928.17,1169.45,
UL TRANSRECTAL (IN DEPT),27100538,CDM,76872,CPT,402,RC,inpatient,TC,1234,1234,,1047.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,930.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1048.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1085.92,88,,percent of total billed charges,,,,,,,,,942.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1122.94,91,,percent of total billed charges,,,1172.3,95,,percent of total billed charges,,,1024.22,83,,percent of total billed charges,,,1024.22,83,,percent of total billed charges,,,,,,,,,,,,,,,1024.22,83,,percent of total billed charges,,,1172.3,95,,percent of total billed charges,,,1110.6,90,,percent of total billed charges,,,1110.6,90,,percent of total billed charges,,,1011.88,82,,percent of total billed charges,,,1110.6,90,,percent of total billed charges,,,1048.9,85,,percent of total billed charges,,930.44,1172.3,
UL UP EXTVENDOPBILAT,27100545,CDM,93970,CPT,921,RC,inpatient,TC,3662,3662,,3109.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2761.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3112.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3222.56,88,,percent of total billed charges,,,,,,,,,2797.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3332.42,91,,percent of total billed charges,,,3478.9,95,,percent of total billed charges,,,3039.46,83,,percent of total billed charges,,,3039.46,83,,percent of total billed charges,,,,,,,,,,,,,,,3039.46,83,,percent of total billed charges,,,3478.9,95,,percent of total billed charges,,,3295.8,90,,percent of total billed charges,,,3295.8,90,,percent of total billed charges,,,3002.84,82,,percent of total billed charges,,,3295.8,90,,percent of total billed charges,,,3112.7,85,,percent of total billed charges,,2761.15,3478.9,
UL LOW EXTVENDOPBILAT,27100546,CDM,93970,CPT,921,RC,inpatient,TC,2591,2591,,2199.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1953.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2202.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2280.08,88,,percent of total billed charges,,,,,,,,,1979.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2357.81,91,,percent of total billed charges,,,2461.45,95,,percent of total billed charges,,,2150.53,83,,percent of total billed charges,,,2150.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2150.53,83,,percent of total billed charges,,,2461.45,95,,percent of total billed charges,,,2331.9,90,,percent of total billed charges,,,2331.9,90,,percent of total billed charges,,,2124.62,82,,percent of total billed charges,,,2331.9,90,,percent of total billed charges,,,2202.35,85,,percent of total billed charges,,1953.61,2461.45,
UL INF HIPS BIL W/DR,27100889,CDM,76885,CPT,402,RC,inpatient,TC,1005,1005,,853.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,757.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,854.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,884.4,88,,percent of total billed charges,,,,,,,,,767.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,914.55,91,,percent of total billed charges,,,954.75,95,,percent of total billed charges,,,834.15,83,,percent of total billed charges,,,834.15,83,,percent of total billed charges,,,,,,,,,,,,,,,834.15,83,,percent of total billed charges,,,954.75,95,,percent of total billed charges,,,904.5,90,,percent of total billed charges,,,904.5,90,,percent of total billed charges,,,824.1,82,,percent of total billed charges,,,904.5,90,,percent of total billed charges,,,854.25,85,,percent of total billed charges,,757.77,954.75,
UL INF HIPS NO DR,27100890,CDM,76886,CPT,402,RC,inpatient,TC,943,943,,800.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,711.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,801.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,829.84,88,,percent of total billed charges,,,,,,,,,720.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,858.13,91,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,,,,,,,,,,,,,782.69,83,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,773.26,82,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,801.55,85,,percent of total billed charges,,711.02,895.85,
UL UP EXT NON-VASC RIGHT COMPLETE,27100891,CDM,76881,CPT,402,RC,inpatient,RT,1505,1505,,1277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1134.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1279.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1324.4,88,,percent of total billed charges,,,,,,,,,1149.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1369.55,91,,percent of total billed charges,,,1429.75,95,,percent of total billed charges,,,1249.15,83,,percent of total billed charges,,,1249.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1249.15,83,,percent of total billed charges,,,1429.75,95,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1234.1,82,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1279.25,85,,percent of total billed charges,,1134.77,1429.75,
UL UP EXT NON-VASC LEFT COMPLETE,27100892,CDM,76881,CPT,402,RC,inpatient,LT,1505,1505,,1277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1134.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1279.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1324.4,88,,percent of total billed charges,,,,,,,,,1149.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1369.55,91,,percent of total billed charges,,,1429.75,95,,percent of total billed charges,,,1249.15,83,,percent of total billed charges,,,1249.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1249.15,83,,percent of total billed charges,,,1429.75,95,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1234.1,82,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1279.25,85,,percent of total billed charges,,1134.77,1429.75,
UL LOW EXT NON-VASC RIGHT COMPLETE,27100893,CDM,76881,CPT,402,RC,inpatient,RT,1195,1195,,1014.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,901.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1015.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1051.6,88,,percent of total billed charges,,,,,,,,,912.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1087.45,91,,percent of total billed charges,,,1135.25,95,,percent of total billed charges,,,991.85,83,,percent of total billed charges,,,991.85,83,,percent of total billed charges,,,,,,,,,,,,,,,991.85,83,,percent of total billed charges,,,1135.25,95,,percent of total billed charges,,,1075.5,90,,percent of total billed charges,,,1075.5,90,,percent of total billed charges,,,979.9,82,,percent of total billed charges,,,1075.5,90,,percent of total billed charges,,,1015.75,85,,percent of total billed charges,,901.03,1135.25,
UL LOW EXT NON-VASC LEFT COMPLETE,27100894,CDM,76881,CPT,402,RC,inpatient,LT,1195,1195,,1014.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,901.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1015.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1051.6,88,,percent of total billed charges,,,,,,,,,912.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1087.45,91,,percent of total billed charges,,,1135.25,95,,percent of total billed charges,,,991.85,83,,percent of total billed charges,,,991.85,83,,percent of total billed charges,,,,,,,,,,,,,,,991.85,83,,percent of total billed charges,,,1135.25,95,,percent of total billed charges,,,1075.5,90,,percent of total billed charges,,,1075.5,90,,percent of total billed charges,,,979.9,82,,percent of total billed charges,,,1075.5,90,,percent of total billed charges,,,1015.75,85,,percent of total billed charges,,901.03,1135.25,
UL EXT NON VASCULAR LIMITED RT LIMITED,27100895,CDM,76882,CPT,402,RC,inpatient,RT,1169,1169,,992.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,881.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,993.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1028.72,88,,percent of total billed charges,,,,,,,,,893.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1063.79,91,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,,,,,,,,,,,,,970.27,83,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,958.58,82,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,881.43,1110.55,
UL EXT NON VASCULAR LIMITED LEFT LIMITED,27100896,CDM,76882,CPT,402,RC,inpatient,LT,1169,1169,,992.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,881.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,993.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1028.72,88,,percent of total billed charges,,,,,,,,,893.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1063.79,91,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,,,,,,,,,,,,,970.27,83,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,958.58,82,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,881.43,1110.55,
UL JNT NON VASC RIGHT LIMITED,27100898,CDM,76882,CPT,402,RC,inpatient,RT,1169,1169,,992.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,881.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,993.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1028.72,88,,percent of total billed charges,,,,,,,,,893.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1063.79,91,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,,,,,,,,,,,,,970.27,83,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,958.58,82,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,881.43,1110.55,
UL JNT NON VASC LEFT LIMITED,27100899,CDM,76882,CPT,402,RC,inpatient,LT,1169,1169,,992.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,881.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,993.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1028.72,88,,percent of total billed charges,,,,,,,,,893.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1063.79,91,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,,,,,,,,,,,,,970.27,83,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,958.58,82,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,881.43,1110.55,
UL SOFT TISSUE LIMITED,27100901,CDM,76882,CPT,402,RC,inpatient,TC,1169,1169,,992.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,881.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,993.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1028.72,88,,percent of total billed charges,,,,,,,,,893.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1063.79,91,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,,,,,,,,,,,,,970.27,83,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,958.58,82,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,881.43,1110.55,
UL ST HEADAND/ORNECK,27101141,CDM,76536,CPT,402,RC,inpatient,TC,1607,1607,,1364.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1211.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1365.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1414.16,88,,percent of total billed charges,,,,,,,,,1227.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1462.37,91,,percent of total billed charges,,,1526.65,95,,percent of total billed charges,,,1333.81,83,,percent of total billed charges,,,1333.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1333.81,83,,percent of total billed charges,,,1526.65,95,,percent of total billed charges,,,1446.3,90,,percent of total billed charges,,,1446.3,90,,percent of total billed charges,,,1317.74,82,,percent of total billed charges,,,1446.3,90,,percent of total billed charges,,,1365.95,85,,percent of total billed charges,,1211.68,1526.65,
UL ABD LTD (SNGL ORGAN/QUAD),27101345,CDM,76705,CPT,402,RC,inpatient,TC,1617,1617,,1372.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1219.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1374.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1422.96,88,,percent of total billed charges,,,,,,,,,1235.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1471.47,91,,percent of total billed charges,,,1536.15,95,,percent of total billed charges,,,1342.11,83,,percent of total billed charges,,,1342.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1342.11,83,,percent of total billed charges,,,1536.15,95,,percent of total billed charges,,,1455.3,90,,percent of total billed charges,,,1455.3,90,,percent of total billed charges,,,1325.94,82,,percent of total billed charges,,,1455.3,90,,percent of total billed charges,,,1374.45,85,,percent of total billed charges,,1219.22,1536.15,
UL LIVER ELASTOGRAPHY,27101346,CDM,76981,CPT,402,RC,inpatient,TC,1051,1051,,892.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,792.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,893.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,924.88,88,,percent of total billed charges,,,,,,,,,802.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,956.41,91,,percent of total billed charges,,,998.45,95,,percent of total billed charges,,,872.33,83,,percent of total billed charges,,,872.33,83,,percent of total billed charges,,,,,,,,,,,,,,,872.33,83,,percent of total billed charges,,,998.45,95,,percent of total billed charges,,,945.9,90,,percent of total billed charges,,,945.9,90,,percent of total billed charges,,,861.82,82,,percent of total billed charges,,,945.9,90,,percent of total billed charges,,,893.35,85,,percent of total billed charges,,792.45,998.45,
BX THORACENTESIS,27101450,CDM,32555,CPT,361,RC,inpatient,,3058,3058,,2596.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2305.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2599.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2691.04,88,,percent of total billed charges,,,,,,,,,2336.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2782.78,91,,percent of total billed charges,,,2905.1,95,,percent of total billed charges,,,2538.14,83,,percent of total billed charges,,,2538.14,83,,percent of total billed charges,,,,,,,,,,,,,,,2538.14,83,,percent of total billed charges,,,2905.1,95,,percent of total billed charges,,,2752.2,90,,percent of total billed charges,,,2752.2,90,,percent of total billed charges,,,2507.56,82,,percent of total billed charges,,,2752.2,90,,percent of total billed charges,,,2599.3,85,,percent of total billed charges,,2305.73,2905.1,
UL BREAST CORE BX LT (EA),27101454,CDM,19083,CPT,402,RC,inpatient,LT,5772,5772,,4900.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4352.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4906.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5079.36,88,,percent of total billed charges,,,,,,,,,4409.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5252.52,91,,percent of total billed charges,,,5483.4,95,,percent of total billed charges,,,4790.76,83,,percent of total billed charges,,,4790.76,83,,percent of total billed charges,,,,,,,,,,,,,,,4790.76,83,,percent of total billed charges,,,5483.4,95,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,4733.04,82,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,4906.2,85,,percent of total billed charges,,4352.09,5483.4,
UL BREAST CORE BX RT (EA),27101455,CDM,19083,CPT,402,RC,inpatient,RT,5772,5772,,4900.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4352.09,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4906.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5079.36,88,,percent of total billed charges,,,,,,,,,4409.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5252.52,91,,percent of total billed charges,,,5483.4,95,,percent of total billed charges,,,4790.76,83,,percent of total billed charges,,,4790.76,83,,percent of total billed charges,,,,,,,,,,,,,,,4790.76,83,,percent of total billed charges,,,5483.4,95,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,4733.04,82,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,4906.2,85,,percent of total billed charges,,4352.09,5483.4,
UL PARACENTESIS W/ IMAGING,27101456,CDM,49083,CPT,361,RC,inpatient,TC,3538,3538,,3003.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2667.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3007.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3113.44,88,,percent of total billed charges,,,,,,,,,2703.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3219.58,91,,percent of total billed charges,,,3361.1,95,,percent of total billed charges,,,2936.54,83,,percent of total billed charges,,,2936.54,83,,percent of total billed charges,,,,,,,,,,,,,,,2936.54,83,,percent of total billed charges,,,3361.1,95,,percent of total billed charges,,,3184.2,90,,percent of total billed charges,,,3184.2,90,,percent of total billed charges,,,2901.16,82,,percent of total billed charges,,,3184.2,90,,percent of total billed charges,,,3007.3,85,,percent of total billed charges,,2667.65,3361.1,
ASSOCIATED 19000 BREAST ASPIRATION SINGL,27101457,CDM,19000,CPT,361,RC,inpatient,TC,1814,1814,,1540.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1367.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1541.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1596.32,88,,percent of total billed charges,,,,,,,,,1385.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1650.74,91,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.62,83,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1487.48,82,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,1367.76,1723.3,
ASSOCIATED 19001 BREAST ASPIRATION MULT,27101458,CDM,19001,CPT,361,RC,inpatient,TC,1968,1968,,1670.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1483.87,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1672.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1731.84,88,,percent of total billed charges,,,,,,,,,1503.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1790.88,91,,percent of total billed charges,,,1869.6,95,,percent of total billed charges,,,1633.44,83,,percent of total billed charges,,,1633.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1633.44,83,,percent of total billed charges,,,1869.6,95,,percent of total billed charges,,,1771.2,90,,percent of total billed charges,,,1771.2,90,,percent of total billed charges,,,1613.76,82,,percent of total billed charges,,,1771.2,90,,percent of total billed charges,,,1672.8,85,,percent of total billed charges,,1483.87,1869.6,
* DNU BX BREAST ASPIR ADDL LT,27101459,CDM,19001,CPT,361,RC,inpatient,TC,1814,1814,,1540.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1367.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1541.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1596.32,88,,percent of total billed charges,,,,,,,,,1385.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1650.74,91,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.62,83,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1487.48,82,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,1367.76,1723.3,
BX NEEDLE ASPIR/NON-SPEC,27101460,CDM,10005,CPT,361,RC,inpatient,TC,1814,1814,,1540.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1367.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1541.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1596.32,88,,percent of total billed charges,,,,,,,,,1385.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1650.74,91,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.62,83,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1487.48,82,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,1367.76,1723.3,
UL BREAST NEEDLE LOCALIZATION W/US LT,27101461,CDM,19285,CPT,402,RC,inpatient,LT,3976,3976,,3375.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2997.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3379.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3498.88,88,,percent of total billed charges,,,,,,,,,3037.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3618.16,91,,percent of total billed charges,,,3777.2,95,,percent of total billed charges,,,3300.08,83,,percent of total billed charges,,,3300.08,83,,percent of total billed charges,,,,,,,,,,,,,,,3300.08,83,,percent of total billed charges,,,3777.2,95,,percent of total billed charges,,,3578.4,90,,percent of total billed charges,,,3578.4,90,,percent of total billed charges,,,3260.32,82,,percent of total billed charges,,,3578.4,90,,percent of total billed charges,,,3379.6,85,,percent of total billed charges,,2997.9,3777.2,
UL BREAST NEEDLE LOCALIZATION W/US RT,27101462,CDM,19285,CPT,402,RC,inpatient,RT,3976,3976,,3375.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2997.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3379.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3498.88,88,,percent of total billed charges,,,,,,,,,3037.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3618.16,91,,percent of total billed charges,,,3777.2,95,,percent of total billed charges,,,3300.08,83,,percent of total billed charges,,,3300.08,83,,percent of total billed charges,,,,,,,,,,,,,,,3300.08,83,,percent of total billed charges,,,3777.2,95,,percent of total billed charges,,,3578.4,90,,percent of total billed charges,,,3578.4,90,,percent of total billed charges,,,3260.32,82,,percent of total billed charges,,,3578.4,90,,percent of total billed charges,,,3379.6,85,,percent of total billed charges,,2997.9,3777.2,
UL THYROID BX,27101463,CDM,60100,CPT,361,RC,inpatient,TC,2178,2178,,1849.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1642.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1851.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1916.64,88,,percent of total billed charges,,,,,,,,,1663.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1981.98,91,,percent of total billed charges,,,2069.1,95,,percent of total billed charges,,,1807.74,83,,percent of total billed charges,,,1807.74,83,,percent of total billed charges,,,,,,,,,,,,,,,1807.74,83,,percent of total billed charges,,,2069.1,95,,percent of total billed charges,,,1960.2,90,,percent of total billed charges,,,1960.2,90,,percent of total billed charges,,,1785.96,82,,percent of total billed charges,,,1960.2,90,,percent of total billed charges,,,1851.3,85,,percent of total billed charges,,1642.21,2069.1,
UL NECK/CHEST BX,27101464,CDM,21550,CPT,361,RC,inpatient,TC,6570,6570,,5577.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4953.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5584.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5781.6,88,,percent of total billed charges,,,,,,,,,5019.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5978.7,91,,percent of total billed charges,,,6241.5,95,,percent of total billed charges,,,5453.1,83,,percent of total billed charges,,,5453.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5453.1,83,,percent of total billed charges,,,6241.5,95,,percent of total billed charges,,,5913,90,,percent of total billed charges,,,5913,90,,percent of total billed charges,,,5387.4,82,,percent of total billed charges,,,5913,90,,percent of total billed charges,,,5584.5,85,,percent of total billed charges,,4953.78,6241.5,
UL THORACENTESIS W/IMG,27101465,CDM,32555,CPT,361,RC,inpatient,TC,3967,3967,,3367.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2991.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3371.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3490.96,88,,percent of total billed charges,,,,,,,,,3030.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3609.97,91,,percent of total billed charges,,,3768.65,95,,percent of total billed charges,,,3292.61,83,,percent of total billed charges,,,3292.61,83,,percent of total billed charges,,,,,,,,,,,,,,,3292.61,83,,percent of total billed charges,,,3768.65,95,,percent of total billed charges,,,3570.3,90,,percent of total billed charges,,,3570.3,90,,percent of total billed charges,,,3252.94,82,,percent of total billed charges,,,3570.3,90,,percent of total billed charges,,,3371.95,85,,percent of total billed charges,,2991.12,3768.65,
UL AMNIOCENTESIS,27101477,CDM,59000,CPT,769,RC,inpatient,,1480,1480,,1256.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1115.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1258,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1302.4,88,,percent of total billed charges,,,,,,,,,1130.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1346.8,91,,percent of total billed charges,,,1406,95,,percent of total billed charges,,,1228.4,83,,percent of total billed charges,,,1228.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1228.4,83,,percent of total billed charges,,,1406,95,,percent of total billed charges,,,1332,90,,percent of total billed charges,,,1332,90,,percent of total billed charges,,,1213.6,82,,percent of total billed charges,,,1332,90,,percent of total billed charges,,,1258,85,,percent of total billed charges,,1115.92,1406,
UL RETROPERIT/LTD,27101485,CDM,76775,CPT,402,RC,inpatient,TC,1477,1477,,1253.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1113.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1255.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1299.76,88,,percent of total billed charges,,,,,,,,,1128.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1344.07,91,,percent of total billed charges,,,1403.15,95,,percent of total billed charges,,,1225.91,83,,percent of total billed charges,,,1225.91,83,,percent of total billed charges,,,,,,,,,,,,,,,1225.91,83,,percent of total billed charges,,,1403.15,95,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1211.14,82,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1255.45,85,,percent of total billed charges,,1113.66,1403.15,
UL RETROPERIT/COMPL,27101493,CDM,76770,CPT,402,RC,inpatient,TC,1775,1775,,1506.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1338.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1508.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1562,88,,percent of total billed charges,,,,,,,,,1356.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1615.25,91,,percent of total billed charges,,,1686.25,95,,percent of total billed charges,,,1473.25,83,,percent of total billed charges,,,1473.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1473.25,83,,percent of total billed charges,,,1686.25,95,,percent of total billed charges,,,1597.5,90,,percent of total billed charges,,,1597.5,90,,percent of total billed charges,,,1455.5,82,,percent of total billed charges,,,1597.5,90,,percent of total billed charges,,,1508.75,85,,percent of total billed charges,,1338.35,1686.25,
UL OB LTD (1OR>1 FETUS),27101501,CDM,76815,CPT,402,RC,inpatient,TC,1175,1175,,997.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,885.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,998.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1034,88,,percent of total billed charges,,,,,,,,,897.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1069.25,91,,percent of total billed charges,,,1116.25,95,,percent of total billed charges,,,975.25,83,,percent of total billed charges,,,975.25,83,,percent of total billed charges,,,,,,,,,,,,,,,975.25,83,,percent of total billed charges,,,1116.25,95,,percent of total billed charges,,,1057.5,90,,percent of total billed charges,,,1057.5,90,,percent of total billed charges,,,963.5,82,,percent of total billed charges,,,1057.5,90,,percent of total billed charges,,,998.75,85,,percent of total billed charges,,885.95,1116.25,
UL BX BREAST W/DEVICE ADDL LESION US IMA,27101510,CDM,19084,CPT,402,RC,inpatient,TC,4873,4873,,4137.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3674.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4142.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4288.24,88,,percent of total billed charges,,,,,,,,,3722.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4434.43,91,,percent of total billed charges,,,4629.35,95,,percent of total billed charges,,,4044.59,83,,percent of total billed charges,,,4044.59,83,,percent of total billed charges,,,,,,,,,,,,,,,4044.59,83,,percent of total billed charges,,,4629.35,95,,percent of total billed charges,,,4385.7,90,,percent of total billed charges,,,4385.7,90,,percent of total billed charges,,,3995.86,82,,percent of total billed charges,,,4385.7,90,,percent of total billed charges,,,4142.05,85,,percent of total billed charges,,3674.24,4629.35,
UL GUIDED FLUID COLLECTION DRAINAGE,27101518,CDM,10030,CPT,402,RC,inpatient,TC,3821,3821,,3244.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2881.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3247.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3362.48,88,,percent of total billed charges,,,,,,,,,2919.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3477.11,91,,percent of total billed charges,,,3629.95,95,,percent of total billed charges,,,3171.43,83,,percent of total billed charges,,,3171.43,83,,percent of total billed charges,,,,,,,,,,,,,,,3171.43,83,,percent of total billed charges,,,3629.95,95,,percent of total billed charges,,,3438.9,90,,percent of total billed charges,,,3438.9,90,,percent of total billed charges,,,3133.22,82,,percent of total billed charges,,,3438.9,90,,percent of total billed charges,,,3247.85,85,,percent of total billed charges,,2881.03,3629.95,
UL OB (2-3 TRIM/EA ADDL),27101519,CDM,76810,CPT,402,RC,inpatient,TC,1551,1551,,1316.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1169.45,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1318.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1364.88,88,,percent of total billed charges,,,,,,,,,1184.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1411.41,91,,percent of total billed charges,,,1473.45,95,,percent of total billed charges,,,1287.33,83,,percent of total billed charges,,,1287.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1287.33,83,,percent of total billed charges,,,1473.45,95,,percent of total billed charges,,,1395.9,90,,percent of total billed charges,,,1395.9,90,,percent of total billed charges,,,1271.82,82,,percent of total billed charges,,,1395.9,90,,percent of total billed charges,,,1318.35,85,,percent of total billed charges,,1169.45,1473.45,
UL BREAST NDLLOCWIRE1SITE (V05-17),27101527,CDM,76942,CPT,402,RC,inpatient,TC,1866,1866,,1584.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1406.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1586.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1642.08,88,,percent of total billed charges,,,,,,,,,1425.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1698.06,91,,percent of total billed charges,,,1772.7,95,,percent of total billed charges,,,1548.78,83,,percent of total billed charges,,,1548.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1548.78,83,,percent of total billed charges,,,1772.7,95,,percent of total billed charges,,,1679.4,90,,percent of total billed charges,,,1679.4,90,,percent of total billed charges,,,1530.12,82,,percent of total billed charges,,,1679.4,90,,percent of total billed charges,,,1586.1,85,,percent of total billed charges,,1406.96,1772.7,
* DNU BX BREAST ASPIR ADDL RT,27101560,CDM,19001,CPT,361,RC,inpatient,,1814,1814,,1540.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1367.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1541.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1596.32,88,,percent of total billed charges,,,,,,,,,1385.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1650.74,91,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.62,83,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1487.48,82,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,1367.76,1723.3,
BX THYROID,27101561,CDM,60100,CPT,402,RC,inpatient,TC,1814,1814,,1540.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1367.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1541.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1596.32,88,,percent of total billed charges,,,,,,,,,1385.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1650.74,91,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.62,83,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1487.48,82,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,1367.76,1723.3,
UL FINE NEEDLE ASPIRATION,27101600,CDM,10005,CPT,402,RC,inpatient,TC,2131,2131,,1809.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1606.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1811.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1875.28,88,,percent of total billed charges,,,,,,,,,1628.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1939.21,91,,percent of total billed charges,,,2024.45,95,,percent of total billed charges,,,1768.73,83,,percent of total billed charges,,,1768.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1768.73,83,,percent of total billed charges,,,2024.45,95,,percent of total billed charges,,,1917.9,90,,percent of total billed charges,,,1917.9,90,,percent of total billed charges,,,1747.42,82,,percent of total billed charges,,,1917.9,90,,percent of total billed charges,,,1811.35,85,,percent of total billed charges,,1606.77,2024.45,
UL ECHOCARDIO DOPPLER,27101709,CDM,93320,CPT,480,RC,inpatient,,1332,1332,,1130.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1004.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1132.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1172.16,88,,percent of total billed charges,,,,,,,,,1017.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1212.12,91,,percent of total billed charges,,,1265.4,95,,percent of total billed charges,,,1105.56,83,,percent of total billed charges,,,1105.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1105.56,83,,percent of total billed charges,,,1265.4,95,,percent of total billed charges,,,1198.8,90,,percent of total billed charges,,,1198.8,90,,percent of total billed charges,,,1092.24,82,,percent of total billed charges,,,1198.8,90,,percent of total billed charges,,,1132.2,85,,percent of total billed charges,,1004.33,1265.4,
UL ARTERIAL STUDY TCPO2 1-2 LVL,27101714,CDM,93922,CPT,921,RC,inpatient,TC,1241,1241,,1053.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,935.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1054.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1092.08,88,,percent of total billed charges,,,,,,,,,948.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1129.31,91,,percent of total billed charges,,,1178.95,95,,percent of total billed charges,,,1030.03,83,,percent of total billed charges,,,1030.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1030.03,83,,percent of total billed charges,,,1178.95,95,,percent of total billed charges,,,1116.9,90,,percent of total billed charges,,,1116.9,90,,percent of total billed charges,,,1017.62,82,,percent of total billed charges,,,1116.9,90,,percent of total billed charges,,,1054.85,85,,percent of total billed charges,,935.71,1178.95,
UL LOW EXT ABI LMTD/UNI,27101715,CDM,93922,CPT,921,RC,inpatient,TC,1241,1241,,1053.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,935.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1054.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1092.08,88,,percent of total billed charges,,,,,,,,,948.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1129.31,91,,percent of total billed charges,,,1178.95,95,,percent of total billed charges,,,1030.03,83,,percent of total billed charges,,,1030.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1030.03,83,,percent of total billed charges,,,1178.95,95,,percent of total billed charges,,,1116.9,90,,percent of total billed charges,,,1116.9,90,,percent of total billed charges,,,1017.62,82,,percent of total billed charges,,,1116.9,90,,percent of total billed charges,,,1054.85,85,,percent of total billed charges,,935.71,1178.95,
UL LOW EXT ART DUPLEX BIL,27101716,CDM,93925,CPT,921,RC,inpatient,TC,3289,3289,,2792.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2479.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2795.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2894.32,88,,percent of total billed charges,,,,,,,,,2512.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2992.99,91,,percent of total billed charges,,,3124.55,95,,percent of total billed charges,,,2729.87,83,,percent of total billed charges,,,2729.87,83,,percent of total billed charges,,,,,,,,,,,,,,,2729.87,83,,percent of total billed charges,,,3124.55,95,,percent of total billed charges,,,2960.1,90,,percent of total billed charges,,,2960.1,90,,percent of total billed charges,,,2696.98,82,,percent of total billed charges,,,2960.1,90,,percent of total billed charges,,,2795.65,85,,percent of total billed charges,,2479.91,3124.55,
UL ARTERIAL STUDY TCPO2 3+ LVL,27101718,CDM,93923,CPT,921,RC,inpatient,TC,2645,2645,,2245.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1994.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2248.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2327.6,88,,percent of total billed charges,,,,,,,,,2020.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2406.95,91,,percent of total billed charges,,,2512.75,95,,percent of total billed charges,,,2195.35,83,,percent of total billed charges,,,2195.35,83,,percent of total billed charges,,,,,,,,,,,,,,,2195.35,83,,percent of total billed charges,,,2512.75,95,,percent of total billed charges,,,2380.5,90,,percent of total billed charges,,,2380.5,90,,percent of total billed charges,,,2168.9,82,,percent of total billed charges,,,2380.5,90,,percent of total billed charges,,,2248.25,85,,percent of total billed charges,,1994.33,2512.75,
UL LOW EXT ART DUPLEX RT,27101719,CDM,93926,CPT,921,RC,inpatient,RT,2669,2669,,2265.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2012.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2268.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2348.72,88,,percent of total billed charges,,,,,,,,,2039.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2428.79,91,,percent of total billed charges,,,2535.55,95,,percent of total billed charges,,,2215.27,83,,percent of total billed charges,,,2215.27,83,,percent of total billed charges,,,,,,,,,,,,,,,2215.27,83,,percent of total billed charges,,,2535.55,95,,percent of total billed charges,,,2402.1,90,,percent of total billed charges,,,2402.1,90,,percent of total billed charges,,,2188.58,82,,percent of total billed charges,,,2402.1,90,,percent of total billed charges,,,2268.65,85,,percent of total billed charges,,2012.43,2535.55,
UL UP EXT ARTDOPRESTONLY,27101720,CDM,93923,CPT,921,RC,inpatient,TC,2645,2645,,2245.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1994.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2248.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2327.6,88,,percent of total billed charges,,,,,,,,,2020.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2406.95,91,,percent of total billed charges,,,2512.75,95,,percent of total billed charges,,,2195.35,83,,percent of total billed charges,,,2195.35,83,,percent of total billed charges,,,,,,,,,,,,,,,2195.35,83,,percent of total billed charges,,,2512.75,95,,percent of total billed charges,,,2380.5,90,,percent of total billed charges,,,2380.5,90,,percent of total billed charges,,,2168.9,82,,percent of total billed charges,,,2380.5,90,,percent of total billed charges,,,2248.25,85,,percent of total billed charges,,1994.33,2512.75,
UL LOW EXT ABI REST MIN EXERCISE,27101721,CDM,93923,CPT,921,RC,inpatient,TC,2641,2641,,2242.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1991.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2244.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2324.08,88,,percent of total billed charges,,,,,,,,,2017.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2403.31,91,,percent of total billed charges,,,2508.95,95,,percent of total billed charges,,,2192.03,83,,percent of total billed charges,,,2192.03,83,,percent of total billed charges,,,,,,,,,,,,,,,2192.03,83,,percent of total billed charges,,,2508.95,95,,percent of total billed charges,,,2376.9,90,,percent of total billed charges,,,2376.9,90,,percent of total billed charges,,,2165.62,82,,percent of total billed charges,,,2376.9,90,,percent of total billed charges,,,2244.85,85,,percent of total billed charges,,1991.31,2508.95,
UL LOW EXT ABI REST/STRESS TREADMILL,27101722,CDM,93924,CPT,921,RC,inpatient,TC,3558,3558,,3020.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2682.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3024.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3131.04,88,,percent of total billed charges,,,,,,,,,2718.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3237.78,91,,percent of total billed charges,,,3380.1,95,,percent of total billed charges,,,2953.14,83,,percent of total billed charges,,,2953.14,83,,percent of total billed charges,,,,,,,,,,,,,,,2953.14,83,,percent of total billed charges,,,3380.1,95,,percent of total billed charges,,,3202.2,90,,percent of total billed charges,,,3202.2,90,,percent of total billed charges,,,2917.56,82,,percent of total billed charges,,,3202.2,90,,percent of total billed charges,,,3024.3,85,,percent of total billed charges,,2682.73,3380.1,
UL LOW EXT ART DUPLEX LEFT,27101723,CDM,93926,CPT,921,RC,inpatient,LT,2669,2669,,2265.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2012.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2268.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2348.72,88,,percent of total billed charges,,,,,,,,,2039.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2428.79,91,,percent of total billed charges,,,2535.55,95,,percent of total billed charges,,,2215.27,83,,percent of total billed charges,,,2215.27,83,,percent of total billed charges,,,,,,,,,,,,,,,2215.27,83,,percent of total billed charges,,,2535.55,95,,percent of total billed charges,,,2402.1,90,,percent of total billed charges,,,2402.1,90,,percent of total billed charges,,,2188.58,82,,percent of total billed charges,,,2402.1,90,,percent of total billed charges,,,2268.65,85,,percent of total billed charges,,2012.43,2535.55,
UL UP EXT ART DUPLEX BIL,27101724,CDM,93930,CPT,921,RC,inpatient,TC,5595,5595,,4750.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4218.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4755.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4923.6,88,,percent of total billed charges,,,,,,,,,4274.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5091.45,91,,percent of total billed charges,,,5315.25,95,,percent of total billed charges,,,4643.85,83,,percent of total billed charges,,,4643.85,83,,percent of total billed charges,,,,,,,,,,,,,,,4643.85,83,,percent of total billed charges,,,5315.25,95,,percent of total billed charges,,,5035.5,90,,percent of total billed charges,,,5035.5,90,,percent of total billed charges,,,4587.9,82,,percent of total billed charges,,,5035.5,90,,percent of total billed charges,,,4755.75,85,,percent of total billed charges,,4218.63,5315.25,
UL UP EXT ART DUPLEX RT,27101725,CDM,93931,CPT,921,RC,inpatient,RT,2798,2798,,2375.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2109.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2378.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2462.24,88,,percent of total billed charges,,,,,,,,,2137.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2546.18,91,,percent of total billed charges,,,2658.1,95,,percent of total billed charges,,,2322.34,83,,percent of total billed charges,,,2322.34,83,,percent of total billed charges,,,,,,,,,,,,,,,2322.34,83,,percent of total billed charges,,,2658.1,95,,percent of total billed charges,,,2518.2,90,,percent of total billed charges,,,2518.2,90,,percent of total billed charges,,,2294.36,82,,percent of total billed charges,,,2518.2,90,,percent of total billed charges,,,2378.3,85,,percent of total billed charges,,2109.69,2658.1,
UL UP EXT ART DUPLEX LT,27101726,CDM,93931,CPT,921,RC,inpatient,LT,2798,2798,,2375.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2109.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2378.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2462.24,88,,percent of total billed charges,,,,,,,,,2137.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2546.18,91,,percent of total billed charges,,,2658.1,95,,percent of total billed charges,,,2322.34,83,,percent of total billed charges,,,2322.34,83,,percent of total billed charges,,,,,,,,,,,,,,,2322.34,83,,percent of total billed charges,,,2658.1,95,,percent of total billed charges,,,2518.2,90,,percent of total billed charges,,,2518.2,90,,percent of total billed charges,,,2294.36,82,,percent of total billed charges,,,2518.2,90,,percent of total billed charges,,,2378.3,85,,percent of total billed charges,,2109.69,2658.1,
UL UP EXT VEN DOP RIGHT,27101733,CDM,93971,CPT,921,RC,inpatient,RT,1847,1847,,1568.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1392.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1569.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1625.36,88,,percent of total billed charges,,,,,,,,,1411.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1680.77,91,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1533.01,83,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1514.54,82,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,1392.64,1754.65,
UL UP EXT VEN DOP LEFT,27101734,CDM,93971,CPT,921,RC,inpatient,LT,1847,1847,,1568.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1392.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1569.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1625.36,88,,percent of total billed charges,,,,,,,,,1411.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1680.77,91,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1533.01,83,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1514.54,82,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,1392.64,1754.65,
UL LOW EXT VEN DOP RIGHT,27101735,CDM,93971,CPT,921,RC,inpatient,RT,1847,1847,,1568.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1392.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1569.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1625.36,88,,percent of total billed charges,,,,,,,,,1411.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1680.77,91,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1533.01,83,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1514.54,82,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,1392.64,1754.65,
UL LOW EXT VEN DOP LEFT,27101736,CDM,93971,CPT,921,RC,inpatient,LT,1847,1847,,1568.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1392.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1569.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1625.36,88,,percent of total billed charges,,,,,,,,,1411.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1680.77,91,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1533.01,83,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1514.54,82,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,1392.64,1754.65,
UL VEN REFLUX BILATERAL,27101750,CDM,93970,CPT,921,RC,inpatient,TC,3693,3693,,3135.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2784.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3139.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3249.84,88,,percent of total billed charges,,,,,,,,,2821.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3360.63,91,,percent of total billed charges,,,3508.35,95,,percent of total billed charges,,,3065.19,83,,percent of total billed charges,,,3065.19,83,,percent of total billed charges,,,,,,,,,,,,,,,3065.19,83,,percent of total billed charges,,,3508.35,95,,percent of total billed charges,,,3323.7,90,,percent of total billed charges,,,3323.7,90,,percent of total billed charges,,,3028.26,82,,percent of total billed charges,,,3323.7,90,,percent of total billed charges,,,3139.05,85,,percent of total billed charges,,2784.52,3508.35,
UL VEN REFLUX RIGHT,27101751,CDM,93971,CPT,921,RC,inpatient,RT,1847,1847,,1568.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1392.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1569.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1625.36,88,,percent of total billed charges,,,,,,,,,1411.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1680.77,91,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1533.01,83,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1514.54,82,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,1392.64,1754.65,
UL VEN REFLUX LEFT,27101752,CDM,93971,CPT,921,RC,inpatient,LT,1847,1847,,1568.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1392.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1569.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1625.36,88,,percent of total billed charges,,,,,,,,,1411.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1680.77,91,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1533.01,83,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1514.54,82,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,1392.64,1754.65,
UL CHEST (NON-CARDIAC),27101758,CDM,76604,CPT,402,RC,inpatient,TC,1296,1296,,1100.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,977.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1101.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1140.48,88,,percent of total billed charges,,,,,,,,,990.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1179.36,91,,percent of total billed charges,,,1231.2,95,,percent of total billed charges,,,1075.68,83,,percent of total billed charges,,,1075.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1075.68,83,,percent of total billed charges,,,1231.2,95,,percent of total billed charges,,,1166.4,90,,percent of total billed charges,,,1166.4,90,,percent of total billed charges,,,1062.72,82,,percent of total billed charges,,,1166.4,90,,percent of total billed charges,,,1101.6,85,,percent of total billed charges,,977.18,1231.2,
*DNU ASSOCIATED 19102 NEEDLE CORE OR BX,27102100,CDM,19102,CPT,361,RC,inpatient,TC,1814,1814,,1540.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1367.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1541.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1596.32,88,,percent of total billed charges,,,,,,,,,1385.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1650.74,91,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.62,83,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1487.48,82,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,1367.76,1723.3,
UL OB(2-3TRIM/1GESTATION),27103002,CDM,76805,CPT,402,RC,inpatient,TC,1759,1759,,1493.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1326.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1495.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1547.92,88,,percent of total billed charges,,,,,,,,,1343.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1600.69,91,,percent of total billed charges,,,1671.05,95,,percent of total billed charges,,,1459.97,83,,percent of total billed charges,,,1459.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1459.97,83,,percent of total billed charges,,,1671.05,95,,percent of total billed charges,,,1583.1,90,,percent of total billed charges,,,1583.1,90,,percent of total billed charges,,,1442.38,82,,percent of total billed charges,,,1583.1,90,,percent of total billed charges,,,1495.15,85,,percent of total billed charges,,1326.29,1671.05,
UL OB (1ST TRIM/1 GEST),27103003,CDM,76801,CPT,402,RC,inpatient,TC,1574,1574,,1336.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1186.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1337.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1385.12,88,,percent of total billed charges,,,,,,,,,1202.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1432.34,91,,percent of total billed charges,,,1495.3,95,,percent of total billed charges,,,1306.42,83,,percent of total billed charges,,,1306.42,83,,percent of total billed charges,,,,,,,,,,,,,,,1306.42,83,,percent of total billed charges,,,1495.3,95,,percent of total billed charges,,,1416.6,90,,percent of total billed charges,,,1416.6,90,,percent of total billed charges,,,1290.68,82,,percent of total billed charges,,,1416.6,90,,percent of total billed charges,,,1337.9,85,,percent of total billed charges,,1186.8,1495.3,
UL OB(1STTRIM/EAADDLGEST),27103005,CDM,76802,CPT,402,RC,inpatient,TC,1039,1039,,882.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,783.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,883.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,914.32,88,,percent of total billed charges,,,,,,,,,793.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,945.49,91,,percent of total billed charges,,,987.05,95,,percent of total billed charges,,,862.37,83,,percent of total billed charges,,,862.37,83,,percent of total billed charges,,,,,,,,,,,,,,,862.37,83,,percent of total billed charges,,,987.05,95,,percent of total billed charges,,,935.1,90,,percent of total billed charges,,,935.1,90,,percent of total billed charges,,,851.98,82,,percent of total billed charges,,,935.1,90,,percent of total billed charges,,,883.15,85,,percent of total billed charges,,783.41,987.05,
UL TRANSVAGINAL (OB),27103006,CDM,76817,CPT,402,RC,inpatient,TC,1383,1383,,1174.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1042.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1175.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1217.04,88,,percent of total billed charges,,,,,,,,,1056.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1258.53,91,,percent of total billed charges,,,1313.85,95,,percent of total billed charges,,,1147.89,83,,percent of total billed charges,,,1147.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1147.89,83,,percent of total billed charges,,,1313.85,95,,percent of total billed charges,,,1244.7,90,,percent of total billed charges,,,1244.7,90,,percent of total billed charges,,,1134.06,82,,percent of total billed charges,,,1244.7,90,,percent of total billed charges,,,1175.55,85,,percent of total billed charges,,1042.78,1313.85,
UL OB ADDITIONAL STUDY OF FETUS,27103007,CDM,76811,CPT,402,RC,inpatient,TC,1759,1759,,1493.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1326.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1495.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1547.92,88,,percent of total billed charges,,,,,,,,,1343.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1600.69,91,,percent of total billed charges,,,1671.05,95,,percent of total billed charges,,,1459.97,83,,percent of total billed charges,,,1459.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1459.97,83,,percent of total billed charges,,,1671.05,95,,percent of total billed charges,,,1583.1,90,,percent of total billed charges,,,1583.1,90,,percent of total billed charges,,,1442.38,82,,percent of total billed charges,,,1583.1,90,,percent of total billed charges,,,1495.15,85,,percent of total billed charges,,1326.29,1671.05,
UL OB FOLLOW UP,27103010,CDM,76816,CPT,402,RC,inpatient,TC,1169,1169,,992.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,881.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,993.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1028.72,88,,percent of total billed charges,,,,,,,,,893.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1063.79,91,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,,,,,,,,,,,,,970.27,83,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,958.58,82,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,881.43,1110.55,
UL OB F/U TWINS(2FETUS),27103011,CDM,76816,CPT,402,RC,inpatient,59,2135,2135,,1812.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1609.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1814.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1878.8,88,,percent of total billed charges,,,,,,,,,1631.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1942.85,91,,percent of total billed charges,,,2028.25,95,,percent of total billed charges,,,1772.05,83,,percent of total billed charges,,,1772.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1772.05,83,,percent of total billed charges,,,2028.25,95,,percent of total billed charges,,,1921.5,90,,percent of total billed charges,,,1921.5,90,,percent of total billed charges,,,1750.7,82,,percent of total billed charges,,,1921.5,90,,percent of total billed charges,,,1814.75,85,,percent of total billed charges,,1609.79,2028.25,
UL BLADDERONLY/PELVICLTD,27103043,CDM,76857,CPT,402,RC,inpatient,TC,1225,1225,,1040.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,923.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1041.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1078,88,,percent of total billed charges,,,,,,,,,935.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1114.75,91,,percent of total billed charges,,,1163.75,95,,percent of total billed charges,,,1016.75,83,,percent of total billed charges,,,1016.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1016.75,83,,percent of total billed charges,,,1163.75,95,,percent of total billed charges,,,1102.5,90,,percent of total billed charges,,,1102.5,90,,percent of total billed charges,,,1004.5,82,,percent of total billed charges,,,1102.5,90,,percent of total billed charges,,,1041.25,85,,percent of total billed charges,,923.65,1163.75,
UL PELVIC,27103044,CDM,76856,CPT,402,RC,inpatient,TC,1805,1805,,1532.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1360.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1534.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1588.4,88,,percent of total billed charges,,,,,,,,,1379.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1642.55,91,,percent of total billed charges,,,1714.75,95,,percent of total billed charges,,,1498.15,83,,percent of total billed charges,,,1498.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1498.15,83,,percent of total billed charges,,,1714.75,95,,percent of total billed charges,,,1624.5,90,,percent of total billed charges,,,1624.5,90,,percent of total billed charges,,,1480.1,82,,percent of total billed charges,,,1624.5,90,,percent of total billed charges,,,1534.25,85,,percent of total billed charges,,1360.97,1714.75,
UL INFANT SACRUM,27103045,CDM,76857,CPT,402,RC,inpatient,TC,1116,1116,,947.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,841.46,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,948.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,982.08,88,,percent of total billed charges,,,,,,,,,852.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1015.56,91,,percent of total billed charges,,,1060.2,95,,percent of total billed charges,,,926.28,83,,percent of total billed charges,,,926.28,83,,percent of total billed charges,,,,,,,,,,,,,,,926.28,83,,percent of total billed charges,,,1060.2,95,,percent of total billed charges,,,1004.4,90,,percent of total billed charges,,,1004.4,90,,percent of total billed charges,,,915.12,82,,percent of total billed charges,,,1004.4,90,,percent of total billed charges,,,948.6,85,,percent of total billed charges,,841.46,1060.2,
UL GALLBLADDER LTD,27103077,CDM,76705,CPT,402,RC,inpatient,TC,1617,1617,,1372.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1219.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1374.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1422.96,88,,percent of total billed charges,,,,,,,,,1235.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1471.47,91,,percent of total billed charges,,,1536.15,95,,percent of total billed charges,,,1342.11,83,,percent of total billed charges,,,1342.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1342.11,83,,percent of total billed charges,,,1536.15,95,,percent of total billed charges,,,1455.3,90,,percent of total billed charges,,,1455.3,90,,percent of total billed charges,,,1325.94,82,,percent of total billed charges,,,1455.3,90,,percent of total billed charges,,,1374.45,85,,percent of total billed charges,,1219.22,1536.15,
UL LIVER NEEDLE BIOPSY,27103078,CDM,47000,CPT,921,RC,inpatient,TC,4643,4643,,3941.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3500.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3946.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4085.84,88,,percent of total billed charges,,,,,,,,,3547.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4225.13,91,,percent of total billed charges,,,4410.85,95,,percent of total billed charges,,,3853.69,83,,percent of total billed charges,,,3853.69,83,,percent of total billed charges,,,,,,,,,,,,,,,3853.69,83,,percent of total billed charges,,,4410.85,95,,percent of total billed charges,,,4178.7,90,,percent of total billed charges,,,4178.7,90,,percent of total billed charges,,,3807.26,82,,percent of total billed charges,,,4178.7,90,,percent of total billed charges,,,3946.55,85,,percent of total billed charges,,3500.82,4410.85,
UL LIVER DUPLEX,27103080,CDM,93975,CPT,921,RC,inpatient,TC,2363,2363,,2006.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1781.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2008.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2079.44,88,,percent of total billed charges,,,,,,,,,1805.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2150.33,91,,percent of total billed charges,,,2244.85,95,,percent of total billed charges,,,1961.29,83,,percent of total billed charges,,,1961.29,83,,percent of total billed charges,,,,,,,,,,,,,,,1961.29,83,,percent of total billed charges,,,2244.85,95,,percent of total billed charges,,,2126.7,90,,percent of total billed charges,,,2126.7,90,,percent of total billed charges,,,1937.66,82,,percent of total billed charges,,,2126.7,90,,percent of total billed charges,,,2008.55,85,,percent of total billed charges,,1781.7,2244.85,
UL AORTA ONLY,27103085,CDM,76775,CPT,402,RC,inpatient,TC,1477,1477,,1253.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1113.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1255.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1299.76,88,,percent of total billed charges,,,,,,,,,1128.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1344.07,91,,percent of total billed charges,,,1403.15,95,,percent of total billed charges,,,1225.91,83,,percent of total billed charges,,,1225.91,83,,percent of total billed charges,,,,,,,,,,,,,,,1225.91,83,,percent of total billed charges,,,1403.15,95,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1211.14,82,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1255.45,85,,percent of total billed charges,,1113.66,1403.15,
UL ABDOMINAL AORTA SCREEN AAA,27103086,CDM,76706,CPT,402,RC,inpatient,TC,1477,1477,,1253.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1113.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1255.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1299.76,88,,percent of total billed charges,,,,,,,,,1128.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1344.07,91,,percent of total billed charges,,,1403.15,95,,percent of total billed charges,,,1225.91,83,,percent of total billed charges,,,1225.91,83,,percent of total billed charges,,,,,,,,,,,,,,,1225.91,83,,percent of total billed charges,,,1403.15,95,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1211.14,82,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1255.45,85,,percent of total billed charges,,1113.66,1403.15,
* DNU US UNLISTED PROCEDURE,27103089,CDM,76999,CPT,402,RC,inpatient,TC,913,913,,775.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,688.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,776.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,803.44,88,,percent of total billed charges,,,,,,,,,697.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,830.83,91,,percent of total billed charges,,,867.35,95,,percent of total billed charges,,,757.79,83,,percent of total billed charges,,,757.79,83,,percent of total billed charges,,,,,,,,,,,,,,,757.79,83,,percent of total billed charges,,,867.35,95,,percent of total billed charges,,,821.7,90,,percent of total billed charges,,,821.7,90,,percent of total billed charges,,,748.66,82,,percent of total billed charges,,,821.7,90,,percent of total billed charges,,,776.05,85,,percent of total billed charges,,688.4,867.35,
UL PROSTATE BIOPSY,27103090,CDM,55700,CPT,402,RC,inpatient,,7825,7825,,6643.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5900.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6651.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6886,88,,percent of total billed charges,,,,,,,,,5978.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7120.75,91,,percent of total billed charges,,,7433.75,95,,percent of total billed charges,,,6494.75,83,,percent of total billed charges,,,6494.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6494.75,83,,percent of total billed charges,,,7433.75,95,,percent of total billed charges,,,7042.5,90,,percent of total billed charges,,,7042.5,90,,percent of total billed charges,,,6416.5,82,,percent of total billed charges,,,7042.5,90,,percent of total billed charges,,,6651.25,85,,percent of total billed charges,,5900.05,7433.75,
UL SCLEROTHERAPY FLUID COLLECTION W/IMG,27103091,CDM,,,361,RC,inpatient,,4253,4253,,3610.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3206.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3615.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3742.64,88,,percent of total billed charges,,,,,,,,,3249.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3870.23,91,,percent of total billed charges,,,4040.35,95,,percent of total billed charges,,,3529.99,83,,percent of total billed charges,,,3529.99,83,,percent of total billed charges,,,,,,,,,,,,,,,3529.99,83,,percent of total billed charges,,,4040.35,95,,percent of total billed charges,,,3827.7,90,,percent of total billed charges,,,3827.7,90,,percent of total billed charges,,,3487.46,82,,percent of total billed charges,,,3827.7,90,,percent of total billed charges,,,3615.05,85,,percent of total billed charges,,3206.76,4040.35,
UL FOREIGN BODY REMOVAL,27103095,CDM,20520,CPT,361,RC,inpatient,,6845,6845,,5811.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5161.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5818.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6023.6,88,,percent of total billed charges,,,,,,,,,5229.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6228.95,91,,percent of total billed charges,,,6502.75,95,,percent of total billed charges,,,5681.35,83,,percent of total billed charges,,,5681.35,83,,percent of total billed charges,,,,,,,,,,,,,,,5681.35,83,,percent of total billed charges,,,6502.75,95,,percent of total billed charges,,,6160.5,90,,percent of total billed charges,,,6160.5,90,,percent of total billed charges,,,5612.9,82,,percent of total billed charges,,,6160.5,90,,percent of total billed charges,,,5818.25,85,,percent of total billed charges,,5161.13,6502.75,
UL ABD COMPLETE,27103127,CDM,76700,CPT,402,RC,inpatient,TC,2149,2149,,1824.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1620.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1826.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1891.12,88,,percent of total billed charges,,,,,,,,,1641.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1955.59,91,,percent of total billed charges,,,2041.55,95,,percent of total billed charges,,,1783.67,83,,percent of total billed charges,,,1783.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1783.67,83,,percent of total billed charges,,,2041.55,95,,percent of total billed charges,,,1934.1,90,,percent of total billed charges,,,1934.1,90,,percent of total billed charges,,,1762.18,82,,percent of total billed charges,,,1934.1,90,,percent of total billed charges,,,1826.65,85,,percent of total billed charges,,1620.35,2041.55,
UL RENAL ARTERY DOP,27103136,CDM,93976,CPT,921,RC,inpatient,TC,1582,1582,,1343.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1192.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1344.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1392.16,88,,percent of total billed charges,,,,,,,,,1208.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1439.62,91,,percent of total billed charges,,,1502.9,95,,percent of total billed charges,,,1313.06,83,,percent of total billed charges,,,1313.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1313.06,83,,percent of total billed charges,,,1502.9,95,,percent of total billed charges,,,1423.8,90,,percent of total billed charges,,,1423.8,90,,percent of total billed charges,,,1297.24,82,,percent of total billed charges,,,1423.8,90,,percent of total billed charges,,,1344.7,85,,percent of total billed charges,,1192.83,1502.9,
UL BREAST LIMITED RIGHT,27103330,CDM,76642,CPT,402,RC,inpatient,RT,1095,1095,,929.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,825.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,930.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,963.6,88,,percent of total billed charges,,,,,,,,,836.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,996.45,91,,percent of total billed charges,,,1040.25,95,,percent of total billed charges,,,908.85,83,,percent of total billed charges,,,908.85,83,,percent of total billed charges,,,,,,,,,,,,,,,908.85,83,,percent of total billed charges,,,1040.25,95,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,897.9,82,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,930.75,85,,percent of total billed charges,,825.63,1040.25,
UL BREAST LIMITED LEFT,27103331,CDM,76642,CPT,402,RC,inpatient,LT,1095,1095,,929.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,825.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,930.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,963.6,88,,percent of total billed charges,,,,,,,,,836.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,996.45,91,,percent of total billed charges,,,1040.25,95,,percent of total billed charges,,,908.85,83,,percent of total billed charges,,,908.85,83,,percent of total billed charges,,,,,,,,,,,,,,,908.85,83,,percent of total billed charges,,,1040.25,95,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,897.9,82,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,930.75,85,,percent of total billed charges,,825.63,1040.25,
UL BREAST LIMITED BILATERAL,27103332,CDM,76642,CPT,402,RC,inpatient,50,2188,2188,,1857.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1649.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1859.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1925.44,88,,percent of total billed charges,,,,,,,,,1671.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1991.08,91,,percent of total billed charges,,,2078.6,95,,percent of total billed charges,,,1816.04,83,,percent of total billed charges,,,1816.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1816.04,83,,percent of total billed charges,,,2078.6,95,,percent of total billed charges,,,1969.2,90,,percent of total billed charges,,,1969.2,90,,percent of total billed charges,,,1794.16,82,,percent of total billed charges,,,1969.2,90,,percent of total billed charges,,,1859.8,85,,percent of total billed charges,,1649.75,2078.6,
UL BREAST COMPLETE RIGHT,27103333,CDM,76641,CPT,402,RC,inpatient,RT,1367,1367,,1160.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1030.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1161.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1202.96,88,,percent of total billed charges,,,,,,,,,1044.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1243.97,91,,percent of total billed charges,,,1298.65,95,,percent of total billed charges,,,1134.61,83,,percent of total billed charges,,,1134.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1134.61,83,,percent of total billed charges,,,1298.65,95,,percent of total billed charges,,,1230.3,90,,percent of total billed charges,,,1230.3,90,,percent of total billed charges,,,1120.94,82,,percent of total billed charges,,,1230.3,90,,percent of total billed charges,,,1161.95,85,,percent of total billed charges,,1030.72,1298.65,
UL BREAST COMPLETE LEFT,27103334,CDM,76641,CPT,402,RC,inpatient,LT,1367,1367,,1160.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1030.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1161.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1202.96,88,,percent of total billed charges,,,,,,,,,1044.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1243.97,91,,percent of total billed charges,,,1298.65,95,,percent of total billed charges,,,1134.61,83,,percent of total billed charges,,,1134.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1134.61,83,,percent of total billed charges,,,1298.65,95,,percent of total billed charges,,,1230.3,90,,percent of total billed charges,,,1230.3,90,,percent of total billed charges,,,1120.94,82,,percent of total billed charges,,,1230.3,90,,percent of total billed charges,,,1161.95,85,,percent of total billed charges,,1030.72,1298.65,
UL BREAST COMPLETE BILATERAL,27103335,CDM,76641,CPT,402,RC,inpatient,50,2576,2576,,2187.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1942.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2189.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2266.88,88,,percent of total billed charges,,,,,,,,,1968.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2344.16,91,,percent of total billed charges,,,2447.2,95,,percent of total billed charges,,,2138.08,83,,percent of total billed charges,,,2138.08,83,,percent of total billed charges,,,,,,,,,,,,,,,2138.08,83,,percent of total billed charges,,,2447.2,95,,percent of total billed charges,,,2318.4,90,,percent of total billed charges,,,2318.4,90,,percent of total billed charges,,,2112.32,82,,percent of total billed charges,,,2318.4,90,,percent of total billed charges,,,2189.6,85,,percent of total billed charges,,1942.3,2447.2,
ASSOC 19285 BREAST LOCAL US SINGLE,27103995,CDM,19285,CPT,320,RC,inpatient,TC,1748,1748,,1484.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1317.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1485.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1538.24,88,,percent of total billed charges,,,,,,,,,1335.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1590.68,91,,percent of total billed charges,,,1660.6,95,,percent of total billed charges,,,1450.84,83,,percent of total billed charges,,,1450.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1450.84,83,,percent of total billed charges,,,1660.6,95,,percent of total billed charges,,,1573.2,90,,percent of total billed charges,,,1573.2,90,,percent of total billed charges,,,1433.36,82,,percent of total billed charges,,,1573.2,90,,percent of total billed charges,,,1485.8,85,,percent of total billed charges,,1317.99,1660.6,
ASSOC 19286 BREAST LOCAL US EACH ADD,27103996,CDM,19286,CPT,320,RC,inpatient,TC,1749,1749,,1484.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1318.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1486.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1539.12,88,,percent of total billed charges,,,,,,,,,1336.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1591.59,91,,percent of total billed charges,,,1661.55,95,,percent of total billed charges,,,1451.67,83,,percent of total billed charges,,,1451.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1451.67,83,,percent of total billed charges,,,1661.55,95,,percent of total billed charges,,,1574.1,90,,percent of total billed charges,,,1574.1,90,,percent of total billed charges,,,1434.18,82,,percent of total billed charges,,,1574.1,90,,percent of total billed charges,,,1486.65,85,,percent of total billed charges,,1318.75,1661.55,
UL THYROID(ST NECK),27104141,CDM,76536,CPT,402,RC,inpatient,TC,1607,1607,,1364.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1211.68,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1365.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1414.16,88,,percent of total billed charges,,,,,,,,,1227.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1462.37,91,,percent of total billed charges,,,1526.65,95,,percent of total billed charges,,,1333.81,83,,percent of total billed charges,,,1333.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1333.81,83,,percent of total billed charges,,,1526.65,95,,percent of total billed charges,,,1446.3,90,,percent of total billed charges,,,1446.3,90,,percent of total billed charges,,,1317.74,82,,percent of total billed charges,,,1446.3,90,,percent of total billed charges,,,1365.95,85,,percent of total billed charges,,1211.68,1526.65,
UL PANCREAS BX,27104150,CDM,48102,CPT,360,RC,inpatient,TC,4747,4747,,4030.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3579.24,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4034.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4177.36,88,,percent of total billed charges,,,,,,,,,3626.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4319.77,91,,percent of total billed charges,,,4509.65,95,,percent of total billed charges,,,3940.01,83,,percent of total billed charges,,,3940.01,83,,percent of total billed charges,,,,,,,,,,,,,,,3940.01,83,,percent of total billed charges,,,4509.65,95,,percent of total billed charges,,,4272.3,90,,percent of total billed charges,,,4272.3,90,,percent of total billed charges,,,3892.54,82,,percent of total billed charges,,,4272.3,90,,percent of total billed charges,,,4034.95,85,,percent of total billed charges,,3579.24,4509.65,
UL INSERTION OF SUPRAPUBIC CATH,27104151,CDM,51102,CPT,360,RC,inpatient,TC,9524,9524,,8085.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7181.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8095.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8381.12,88,,percent of total billed charges,,,,,,,,,7276.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8666.84,91,,percent of total billed charges,,,9047.8,95,,percent of total billed charges,,,7904.92,83,,percent of total billed charges,,,7904.92,83,,percent of total billed charges,,,,,,,,,,,,,,,7904.92,83,,percent of total billed charges,,,9047.8,95,,percent of total billed charges,,,8571.6,90,,percent of total billed charges,,,8571.6,90,,percent of total billed charges,,,7809.68,82,,percent of total billed charges,,,8571.6,90,,percent of total billed charges,,,8095.4,85,,percent of total billed charges,,7181.1,9047.8,
UL CAROTID ART,27104158,CDM,93880,CPT,921,RC,inpatient,TC,2509,2509,,2130.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1891.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2132.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2207.92,88,,percent of total billed charges,,,,,,,,,1916.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2283.19,91,,percent of total billed charges,,,2383.55,95,,percent of total billed charges,,,2082.47,83,,percent of total billed charges,,,2082.47,83,,percent of total billed charges,,,,,,,,,,,,,,,2082.47,83,,percent of total billed charges,,,2383.55,95,,percent of total billed charges,,,2258.1,90,,percent of total billed charges,,,2258.1,90,,percent of total billed charges,,,2057.38,82,,percent of total billed charges,,,2258.1,90,,percent of total billed charges,,,2132.65,85,,percent of total billed charges,,1891.79,2383.55,
UL NEONATAL BRAIN,27104182,CDM,76506,CPT,402,RC,inpatient,TC,1307,1307,,1109.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,985.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1110.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1150.16,88,,percent of total billed charges,,,,,,,,,998.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1189.37,91,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1084.81,83,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1071.74,82,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1110.95,85,,percent of total billed charges,,985.48,1241.65,
UL SCROTUM,27104513,CDM,76870,CPT,402,RC,inpatient,TC,1658,1658,,1407.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1250.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1409.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1459.04,88,,percent of total billed charges,,,,,,,,,1266.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1508.78,91,,percent of total billed charges,,,1575.1,95,,percent of total billed charges,,,1376.14,83,,percent of total billed charges,,,1376.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1376.14,83,,percent of total billed charges,,,1575.1,95,,percent of total billed charges,,,1492.2,90,,percent of total billed charges,,,1492.2,90,,percent of total billed charges,,,1359.56,82,,percent of total billed charges,,,1492.2,90,,percent of total billed charges,,,1409.3,85,,percent of total billed charges,,1250.13,1575.1,
UL SCLEROTHERAPY FLUID COLLECTION W/IMG,27193091,CDM,,,,,inpatient,,4253,4253,,3610.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3206.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3615.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3742.64,88,,percent of total billed charges,,,,,,,,,3249.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3870.23,91,,percent of total billed charges,,,4040.35,95,,percent of total billed charges,,,3529.99,83,,percent of total billed charges,,,3529.99,83,,percent of total billed charges,,,,,,,,,,,,,,,3529.99,83,,percent of total billed charges,,,4040.35,95,,percent of total billed charges,,,3827.7,90,,percent of total billed charges,,,3827.7,90,,percent of total billed charges,,,3487.46,82,,percent of total billed charges,,,3827.7,90,,percent of total billed charges,,,3615.05,85,,percent of total billed charges,,3206.76,4040.35,
UL DUPLEX AORTA-IVC-ILIAC,27200501,CDM,93978,CPT,921,RC,inpatient,TC,1915,1915,,1625.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1443.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1627.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1685.2,88,,percent of total billed charges,,,,,,,,,1463.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1742.65,91,,percent of total billed charges,,,1819.25,95,,percent of total billed charges,,,1589.45,83,,percent of total billed charges,,,1589.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1589.45,83,,percent of total billed charges,,,1819.25,95,,percent of total billed charges,,,1723.5,90,,percent of total billed charges,,,1723.5,90,,percent of total billed charges,,,1570.3,82,,percent of total billed charges,,,1723.5,90,,percent of total billed charges,,,1627.75,85,,percent of total billed charges,,1443.91,1819.25,
UL IR ENDOVENOUS ABLATION 1ST VEIN,27200502,CDM,36475,CPT,360,RC,inpatient,TC,12656,12656,,10744.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9542.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10757.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,11137.28,88,,percent of total billed charges,,,,,,,,,9669.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11516.96,91,,percent of total billed charges,,,12023.2,95,,percent of total billed charges,,,10504.48,83,,percent of total billed charges,,,10504.48,83,,percent of total billed charges,,,,,,,,,,,,,,,10504.48,83,,percent of total billed charges,,,12023.2,95,,percent of total billed charges,,,11390.4,90,,percent of total billed charges,,,11390.4,90,,percent of total billed charges,,,10377.92,82,,percent of total billed charges,,,11390.4,90,,percent of total billed charges,,,10757.6,85,,percent of total billed charges,,9542.62,12023.2,
UL IR ENDOVENOUS ABLATION VEIN ADD-ON,27200503,CDM,36476,CPT,360,RC,inpatient,TC,7660,7660,,6503.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5775.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6511,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6740.8,88,,percent of total billed charges,,,,,,,,,5852.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6970.6,91,,percent of total billed charges,,,7277,95,,percent of total billed charges,,,6357.8,83,,percent of total billed charges,,,6357.8,83,,percent of total billed charges,,,,,,,,,,,,,,,6357.8,83,,percent of total billed charges,,,7277,95,,percent of total billed charges,,,6894,90,,percent of total billed charges,,,6894,90,,percent of total billed charges,,,6281.2,82,,percent of total billed charges,,,6894,90,,percent of total billed charges,,,6511,85,,percent of total billed charges,,5775.64,7277,
UL IR VENASEAL ENDOVEN THER CHEM ADS 1ST,27200504,CDM,36482,CPT,360,RC,inpatient,,15687,15687,,13318.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11828,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13333.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13804.56,88,,percent of total billed charges,,,,,,,,,11984.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14275.17,91,,percent of total billed charges,,,14902.65,95,,percent of total billed charges,,,13020.21,83,,percent of total billed charges,,,13020.21,83,,percent of total billed charges,,,,,,,,,,,,,,,13020.21,83,,percent of total billed charges,,,14902.65,95,,percent of total billed charges,,,14118.3,90,,percent of total billed charges,,,14118.3,90,,percent of total billed charges,,,12863.34,82,,percent of total billed charges,,,14118.3,90,,percent of total billed charges,,,13333.95,85,,percent of total billed charges,,11828,14902.65,
UL IR VENASEAL ENDOVEN THER CHEM AD SBSQ,27200505,CDM,36483,CPT,360,RC,inpatient,,10175,10175,,8638.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7671.95,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8648.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8954,88,,percent of total billed charges,,,,,,,,,7773.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9259.25,91,,percent of total billed charges,,,9666.25,95,,percent of total billed charges,,,8445.25,83,,percent of total billed charges,,,8445.25,83,,percent of total billed charges,,,,,,,,,,,,,,,8445.25,83,,percent of total billed charges,,,9666.25,95,,percent of total billed charges,,,9157.5,90,,percent of total billed charges,,,9157.5,90,,percent of total billed charges,,,8343.5,82,,percent of total billed charges,,,9157.5,90,,percent of total billed charges,,,8648.75,85,,percent of total billed charges,,7671.95,9666.25,
UL DRAINAGE OF HEMATOMA/FLUID COLLECTION,27200506,CDM,10140,CPT,360,RC,inpatient,,8147,8147,,6916.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6142.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6924.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7169.36,88,,percent of total billed charges,,,,,,,,,6224.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7413.77,91,,percent of total billed charges,,,7739.65,95,,percent of total billed charges,,,6762.01,83,,percent of total billed charges,,,6762.01,83,,percent of total billed charges,,,,,,,,,,,,,,,6762.01,83,,percent of total billed charges,,,7739.65,95,,percent of total billed charges,,,7332.3,90,,percent of total billed charges,,,7332.3,90,,percent of total billed charges,,,6680.54,82,,percent of total billed charges,,,7332.3,90,,percent of total billed charges,,,6924.95,85,,percent of total billed charges,,6142.84,7739.65,
UL MICRO PHLEB 10-20-STABS,27200507,CDM,37765,CPT,360,RC,inpatient,TC,11975,11975,,10166.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9029.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10178.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10538,88,,percent of total billed charges,,,,,,,,,9148.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,10897.25,91,,percent of total billed charges,,,11376.25,95,,percent of total billed charges,,,9939.25,83,,percent of total billed charges,,,9939.25,83,,percent of total billed charges,,,,,,,,,,,,,,,9939.25,83,,percent of total billed charges,,,11376.25,95,,percent of total billed charges,,,10777.5,90,,percent of total billed charges,,,10777.5,90,,percent of total billed charges,,,9819.5,82,,percent of total billed charges,,,10777.5,90,,percent of total billed charges,,,10178.75,85,,percent of total billed charges,,9029.15,11376.25,
UL MICRO PHLEB 20 PLUS STABS,27200508,CDM,37766,CPT,360,RC,inpatient,TC,14376,14376,,12205.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10839.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12219.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12650.88,88,,percent of total billed charges,,,,,,,,,10983.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13082.16,91,,percent of total billed charges,,,13657.2,95,,percent of total billed charges,,,11932.08,83,,percent of total billed charges,,,11932.08,83,,percent of total billed charges,,,,,,,,,,,,,,,11932.08,83,,percent of total billed charges,,,13657.2,95,,percent of total billed charges,,,12938.4,90,,percent of total billed charges,,,12938.4,90,,percent of total billed charges,,,11788.32,82,,percent of total billed charges,,,12938.4,90,,percent of total billed charges,,,12219.6,85,,percent of total billed charges,,10839.5,13657.2,
UL INTRAVASCULAR ULTRASOUND INTIAL,27200509,CDM,37252,CPT,360,RC,inpatient,TC,10280,10280,,8727.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7751.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8738,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,9046.4,88,,percent of total billed charges,,,,,,,,,7853.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9354.8,91,,percent of total billed charges,,,9766,95,,percent of total billed charges,,,8532.4,83,,percent of total billed charges,,,8532.4,83,,percent of total billed charges,,,,,,,,,,,,,,,8532.4,83,,percent of total billed charges,,,9766,95,,percent of total billed charges,,,9252,90,,percent of total billed charges,,,9252,90,,percent of total billed charges,,,8429.6,82,,percent of total billed charges,,,9252,90,,percent of total billed charges,,,8738,85,,percent of total billed charges,,7751.12,9766,
UL INTRAVASCULAR ULTRASOUND ADDITIONAL,27200510,CDM,37253,CPT,360,RC,inpatient,TC,8562,8562,,7269.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6455.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7277.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7534.56,88,,percent of total billed charges,,,,,,,,,6541.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7791.42,91,,percent of total billed charges,,,8133.9,95,,percent of total billed charges,,,7106.46,83,,percent of total billed charges,,,7106.46,83,,percent of total billed charges,,,,,,,,,,,,,,,7106.46,83,,percent of total billed charges,,,8133.9,95,,percent of total billed charges,,,7705.8,90,,percent of total billed charges,,,7705.8,90,,percent of total billed charges,,,7020.84,82,,percent of total billed charges,,,7705.8,90,,percent of total billed charges,,,7277.7,85,,percent of total billed charges,,6455.75,8133.9,
UL VASCULAR EMBOLIZATION/OCCLUSION,27200511,CDM,37241,CPT,360,RC,inpatient,TC,37235,37235,,31612.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28075.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31649.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32766.8,88,,percent of total billed charges,,,,,,,,,28447.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33883.85,91,,percent of total billed charges,,,35373.25,95,,percent of total billed charges,,,30905.05,83,,percent of total billed charges,,,30905.05,83,,percent of total billed charges,,,,,,,,,,,,,,,30905.05,83,,percent of total billed charges,,,35373.25,95,,percent of total billed charges,,,33511.5,90,,percent of total billed charges,,,33511.5,90,,percent of total billed charges,,,30532.7,82,,percent of total billed charges,,,33511.5,90,,percent of total billed charges,,,31649.75,85,,percent of total billed charges,,28075.19,35373.25,
UL RADIOFREQUENCY ABLATION THYROID,27200512,CDM,0673T,CPT,360,RC,inpatient,,15054,15054,,12780.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11350.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12795.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13247.52,88,,percent of total billed charges,,,,,,,,,11501.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13699.14,91,,percent of total billed charges,,,14301.3,95,,percent of total billed charges,,,12494.82,83,,percent of total billed charges,,,12494.82,83,,percent of total billed charges,,,,,,,,,,,,,,,12494.82,83,,percent of total billed charges,,,14301.3,95,,percent of total billed charges,,,13548.6,90,,percent of total billed charges,,,13548.6,90,,percent of total billed charges,,,12344.28,82,,percent of total billed charges,,,13548.6,90,,percent of total billed charges,,,12795.9,85,,percent of total billed charges,,11350.72,14301.3,
UL UP EXT NONVASC BILAT COMPLETE,27235478,CDM,76881,CPT,402,RC,inpatient,50,2860,2860,,2428.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2156.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2431,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2516.8,88,,percent of total billed charges,,,,,,,,,2185.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2602.6,91,,percent of total billed charges,,,2717,95,,percent of total billed charges,,,2373.8,83,,percent of total billed charges,,,2373.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2373.8,83,,percent of total billed charges,,,2717,95,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2345.2,82,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2431,85,,percent of total billed charges,,2156.44,2717,
BX ABDOMEN,29100009,CDM,49180,CPT,361,RC,inpatient,,1595,1595,,1354.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1202.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1355.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1403.6,88,,percent of total billed charges,,,,,,,,,1218.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1451.45,91,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1323.85,83,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1307.9,82,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,1202.63,1515.25,
BX LIVER,29100010,CDM,47000,CPT,361,RC,inpatient,,1595,1595,,1354.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1202.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1355.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1403.6,88,,percent of total billed charges,,,,,,,,,1218.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1451.45,91,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1323.85,83,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1307.9,82,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,1202.63,1515.25,
BX LUNG PFA,29100011,CDM,32408,CPT,361,RC,inpatient,TC,1595,1595,,1354.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1202.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1355.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1403.6,88,,percent of total billed charges,,,,,,,,,1218.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1451.45,91,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1323.85,83,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1307.9,82,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,1202.63,1515.25,
BX ADRENAL,29100012,CDM,60540,CPT,361,RC,inpatient,,1595,1595,,1354.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1202.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1355.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1403.6,88,,percent of total billed charges,,,,,,,,,1218.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1451.45,91,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1323.85,83,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1307.9,82,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,1202.63,1515.25,
BX PLEURA,29100013,CDM,32400,CPT,361,RC,inpatient,,1595,1595,,1354.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1202.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1355.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1403.6,88,,percent of total billed charges,,,,,,,,,1218.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1451.45,91,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1323.85,83,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1307.9,82,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,1202.63,1515.25,
BX MUSCLE PFA,29100014,CDM,20206,CPT,361,RC,inpatient,TC,1595,1595,,1354.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1202.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1355.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1403.6,88,,percent of total billed charges,,,,,,,,,1218.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1451.45,91,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1323.85,83,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1307.9,82,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,1202.63,1515.25,
FOLLOW UP ASSESSMENT 0-60MIN,1000100,CDM,G0463,HCPCS,510,RC,inpatient,,387,387,,328.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,291.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,328.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,340.56,88,,percent of total billed charges,,,,,,,,,295.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,352.17,91,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,,,,,,,,,,,,,321.21,83,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,317.34,82,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,328.95,85,,percent of total billed charges,,291.8,367.65,
TELEPSY DIAGNOSTIC EVAL NO MED SERVICES,1000101,CDM,90791,CPT,900,RC,inpatient,GT,421,421,,357.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,317.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,357.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,370.48,88,,percent of total billed charges,,,,,,,,,321.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,383.11,91,,percent of total billed charges,,,399.95,95,,percent of total billed charges,,,349.43,83,,percent of total billed charges,,,349.43,83,,percent of total billed charges,,,,,,,,,,,,,,,349.43,83,,percent of total billed charges,,,399.95,95,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,345.22,82,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,357.85,85,,percent of total billed charges,,317.43,399.95,
TELEPSY DIAGNOSTIC EVAL WITH MED SERVICE,1000102,CDM,90792,CPT,900,RC,inpatient,GT,685,685,,581.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,516.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,582.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,602.8,88,,percent of total billed charges,,,,,,,,,523.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,623.35,91,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,,,,,,,,,,,,,568.55,83,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,561.7,82,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,582.25,85,,percent of total billed charges,,516.49,650.75,
TELEPSY INDIVIDUAL THERAPY 30 MIN,1000103,CDM,90832,CPT,914,RC,inpatient,GT,516,516,,438.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,389.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,438.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,454.08,88,,percent of total billed charges,,,,,,,,,394.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,469.56,91,,percent of total billed charges,,,490.2,95,,percent of total billed charges,,,428.28,83,,percent of total billed charges,,,428.28,83,,percent of total billed charges,,,,,,,,,,,,,,,428.28,83,,percent of total billed charges,,,490.2,95,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,423.12,82,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,438.6,85,,percent of total billed charges,,389.06,490.2,
TELEPSY INDIVIDUAL THERAPY 45 MIN,1000104,CDM,90834,CPT,914,RC,inpatient,GT,621,621,,527.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,468.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,527.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,546.48,88,,percent of total billed charges,,,,,,,,,474.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,565.11,91,,percent of total billed charges,,,589.95,95,,percent of total billed charges,,,515.43,83,,percent of total billed charges,,,515.43,83,,percent of total billed charges,,,,,,,,,,,,,,,515.43,83,,percent of total billed charges,,,589.95,95,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,509.22,82,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,527.85,85,,percent of total billed charges,,468.23,589.95,
TELEPSY INDIVIDUAL THERAPY 60 MIN,1000105,CDM,90837,CPT,914,RC,inpatient,GT,685,685,,581.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,516.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,582.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,602.8,88,,percent of total billed charges,,,,,,,,,523.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,623.35,91,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,,,,,,,,,,,,,568.55,83,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,561.7,82,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,582.25,85,,percent of total billed charges,,516.49,650.75,
TELEPSYCH,1000106,CDM,Q3014,HCPCS,914,RC,inpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,116.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,130.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,135.52,88,,percent of total billed charges,,25,,,,fee schedule,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,25,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,25,146.3,
DIAGNOSTIC EVALUATION NO MED SERVICES,1090791,CDM,90791,CPT,900,RC,inpatient,,421,421,,357.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,317.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,357.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,370.48,88,,percent of total billed charges,,,,,,,,,321.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,383.11,91,,percent of total billed charges,,,399.95,95,,percent of total billed charges,,,349.43,83,,percent of total billed charges,,,349.43,83,,percent of total billed charges,,,,,,,,,,,,,,,349.43,83,,percent of total billed charges,,,399.95,95,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,345.22,82,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,357.85,85,,percent of total billed charges,,317.43,399.95,
DIAGNOSTIC EVALUATION WITH MED SERVICES,1090792,CDM,90792,CPT,900,RC,inpatient,,685,685,,581.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,516.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,582.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,602.8,88,,percent of total billed charges,,,,,,,,,523.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,623.35,91,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,,,,,,,,,,,,,568.55,83,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,561.7,82,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,582.25,85,,percent of total billed charges,,516.49,650.75,
INITIAL EVALUATION ASSESSMENT,1090801,CDM,90791,CPT,900,RC,inpatient,,687,687,,583.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,518,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,583.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,604.56,88,,percent of total billed charges,,,,,,,,,524.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,625.17,91,,percent of total billed charges,,,652.65,95,,percent of total billed charges,,,570.21,83,,percent of total billed charges,,,570.21,83,,percent of total billed charges,,,,,,,,,,,,,,,570.21,83,,percent of total billed charges,,,652.65,95,,percent of total billed charges,,,618.3,90,,percent of total billed charges,,,618.3,90,,percent of total billed charges,,,563.34,82,,percent of total billed charges,,,618.3,90,,percent of total billed charges,,,583.95,85,,percent of total billed charges,,518,652.65,
INDIVIDUAL THERAPY 45 MIN,1090806,CDM,90834,CPT,914,RC,inpatient,,621,621,,527.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,468.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,527.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,546.48,88,,percent of total billed charges,,,,,,,,,474.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,565.11,91,,percent of total billed charges,,,589.95,95,,percent of total billed charges,,,515.43,83,,percent of total billed charges,,,515.43,83,,percent of total billed charges,,,,,,,,,,,,,,,515.43,83,,percent of total billed charges,,,589.95,95,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,509.22,82,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,527.85,85,,percent of total billed charges,,468.23,589.95,
INDIVIDUAL THERAPY 30 MIN,1090832,CDM,90832,CPT,914,RC,inpatient,,516,516,,438.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,389.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,438.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,454.08,88,,percent of total billed charges,,,,,,,,,394.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,469.56,91,,percent of total billed charges,,,490.2,95,,percent of total billed charges,,,428.28,83,,percent of total billed charges,,,428.28,83,,percent of total billed charges,,,,,,,,,,,,,,,428.28,83,,percent of total billed charges,,,490.2,95,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,423.12,82,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,438.6,85,,percent of total billed charges,,389.06,490.2,
INDIVIDUAL THERAPY 60 MIN,1090837,CDM,90837,CPT,914,RC,inpatient,,685,685,,581.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,516.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,582.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,602.8,88,,percent of total billed charges,,,,,,,,,523.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,623.35,91,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,,,,,,,,,,,,,568.55,83,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,561.7,82,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,582.25,85,,percent of total billed charges,,516.49,650.75,
PSYCHOTHERAPY FOR CRISIS 0-60 MIN,1090839,CDM,90839,CPT,914,RC,inpatient,,775,775,,657.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,584.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,658.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,682,88,,percent of total billed charges,,,,,,,,,592.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,705.25,91,,percent of total billed charges,,,736.25,95,,percent of total billed charges,,,643.25,83,,percent of total billed charges,,,643.25,83,,percent of total billed charges,,,,,,,,,,,,,,,643.25,83,,percent of total billed charges,,,736.25,95,,percent of total billed charges,,,697.5,90,,percent of total billed charges,,,697.5,90,,percent of total billed charges,,,635.5,82,,percent of total billed charges,,,697.5,90,,percent of total billed charges,,,658.75,85,,percent of total billed charges,,584.35,736.25,
PSYCHOTHERAPY FOR CRISIS EACH ADD 30MIN,1090840,CDM,90840,CPT,914,RC,inpatient,,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,174.17,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,196.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,174.17,219.45,
FAMILY THERAPY W/O PATIENT 1 HR,1090846,CDM,90846,CPT,916,RC,inpatient,,413,413,,350.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,311.4,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,351.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,363.44,88,,percent of total billed charges,,,,,,,,,315.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,375.83,91,,percent of total billed charges,,,392.35,95,,percent of total billed charges,,,342.79,83,,percent of total billed charges,,,342.79,83,,percent of total billed charges,,,,,,,,,,,,,,,342.79,83,,percent of total billed charges,,,392.35,95,,percent of total billed charges,,,371.7,90,,percent of total billed charges,,,371.7,90,,percent of total billed charges,,,338.66,82,,percent of total billed charges,,,371.7,90,,percent of total billed charges,,,351.05,85,,percent of total billed charges,,311.4,392.35,
FAMILY THERAPY WITH PATIENT 1 HR,1090847,CDM,90847,CPT,916,RC,inpatient,,685,685,,581.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,516.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,582.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,602.8,88,,percent of total billed charges,,,,,,,,,523.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,623.35,91,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,,,,,,,,,,,,,568.55,83,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,561.7,82,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,582.25,85,,percent of total billed charges,,516.49,650.75,
MULTI-FAMILY GROUP PSYCHOTHERAPY,1090849,CDM,90849,CPT,916,RC,inpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,169.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,191.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,169.65,213.75,
GROUP THERAPY,1090853,CDM,90853,CPT,915,RC,inpatient,,379,379,,321.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,285.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,322.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,333.52,88,,percent of total billed charges,,,,,,,,,289.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,344.89,91,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,,,,,,,,,,,,,314.57,83,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,310.78,82,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,285.77,360.05,
BEHAVIOR HEALTH FOLLOW UP ASSESSMENT,1090862,CDM,90863,CPT,900,RC,inpatient,,260,260,,220.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,196.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,221,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,228.8,88,,percent of total billed charges,,,,,,,,,198.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,,,,,,,,,,,,,215.8,83,,percent of total billed charges,,,247,95,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,213.2,82,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,196.04,247,
 FOLLOW UP ASSESSMENT,1090863,CDM,90863,CPT,900,RC,inpatient,,260,260,,220.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,196.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,221,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,228.8,88,,percent of total billed charges,,,,,,,,,198.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,,,,,,,,,,,,,215.8,83,,percent of total billed charges,,,247,95,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,213.2,82,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,196.04,247,
INTRA UTERINE PRESSURE GAUGE,6132599,CDM,,,290,RC,inpatient,,164,164,,139.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,123.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,139.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,144.32,88,,percent of total billed charges,,,,,,,,,125.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,134.48,82,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,123.66,155.8,
X RHC EMG-TC MOTOR NERVE CONDUCTION TEST,14800002,CDM,95903,CPT,922,RC,inpatient,TC,113,113,,95.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,85.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,96.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,99.44,88,,percent of total billed charges,,,,,,,,,86.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,92.66,82,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,85.2,107.35,
X RHC EMG-TC NERVE SENSORY,14800003,CDM,95904,CPT,922,RC,inpatient,TC,106,106,,89.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,79.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,90.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,93.28,88,,percent of total billed charges,,,,,,,,,80.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,,,,,,,,,,,,,87.98,83,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,86.92,82,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,79.92,100.7,
EXTENDED RECOVERY 1ST HOUR,15500000,CDM,,,710,RC,inpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,157.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,177.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,157.59,198.55,
EXTENDED RECOVERY EACH ADDTL HOUR,15500001,CDM,,,710,RC,inpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,82.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,92.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,82.19,103.55,
NURSING CARE OBSERV FIRST HOUR,15500002,CDM,G0378,HCPCS,762,RC,inpatient,,1135,1135,,963.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,855.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,964.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,998.8,88,,percent of total billed charges,,,,,,,,,867.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1032.85,91,,percent of total billed charges,,,1078.25,95,,percent of total billed charges,,,942.05,83,,percent of total billed charges,,,942.05,83,,percent of total billed charges,,,,,,,,,,,,,,,942.05,83,,percent of total billed charges,,,1078.25,95,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,930.7,82,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,964.75,85,,percent of total billed charges,,855.79,1078.25,
NURSING CARE OBSERV ADDTL HOUR,15500003,CDM,G0378,HCPCS,762,RC,inpatient,,37,37,,31.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,31.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,32.56,88,,percent of total billed charges,,,,,,,,,28.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,30.34,82,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,27.9,35.15,
TELEMETRY OBSERVATION FIRST HOUR,15500004,CDM,G0378,HCPCS,762,RC,inpatient,,1553,1553,,1318.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1170.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1320.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1366.64,88,,percent of total billed charges,,,,,,,,,1186.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1413.23,91,,percent of total billed charges,,,1475.35,95,,percent of total billed charges,,,1288.99,83,,percent of total billed charges,,,1288.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1288.99,83,,percent of total billed charges,,,1475.35,95,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1273.46,82,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1320.05,85,,percent of total billed charges,,1170.96,1475.35,
TELEMETRY OBSERVATION ADDTL HOUR,15500005,CDM,G0378,HCPCS,762,RC,inpatient,,95,95,,80.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,83.6,88,,percent of total billed charges,,,,,,,,,72.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,,,,,,,,,,,,,78.85,83,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,77.9,82,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,71.63,90.25,
"IV INFUSION, HYDRATION, UP TO 1 HOUR",15500006,CDM,96360,CPT,260,RC,inpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,627.33,790.4,
"IV INFUSION, HYDRATION, ADDTL HOUR",15500007,CDM,96361,CPT,260,RC,inpatient,XU,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,180.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,204,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,180.96,228,
"IV INFUSION, THERAPEUTIC, UP TO 1 HOUR",15500008,CDM,96365,CPT,260,RC,inpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,627.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,707.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,627.33,790.4,
"IV INFUSION, THERAPEUTIC, ADDTL HOUR",15500009,CDM,96366,CPT,260,RC,inpatient,XU,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,189.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,213.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,189.25,238.45,
CONCURRENT ADDT'L MEDICATED SOLUTION,15500010,CDM,96368,CPT,260,RC,inpatient,XU,522,522,,443.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,393.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,443.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,459.36,88,,percent of total billed charges,,,,,,,,,398.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,475.02,91,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,,,,,,,,,,,,,433.26,83,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,428.04,82,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,393.59,495.9,
IM/SQ INJECTION,15500011,CDM,96372,CPT,260,RC,inpatient,XU,352,352,,298.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,265.41,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,299.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,309.76,88,,percent of total billed charges,,,,,,,,,268.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,,,,,,,,,,,,,292.16,83,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,288.64,82,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,265.41,334.4,
"IVP, SINGLE OR INITIAL",15500012,CDM,96374,CPT,260,RC,inpatient,XU,436,436,,370.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,328.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,370.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,383.68,88,,percent of total billed charges,,,,,,,,,333.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,396.76,91,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,,,,,,,,,,,,,361.88,83,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,357.52,82,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,328.74,414.2,
"IVP, EACH ADDTL OF NEW SUBSTANCE/DRUG",15500013,CDM,96375,CPT,260,RC,inpatient,XU,359,359,,304.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,270.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,305.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,315.92,88,,percent of total billed charges,,,,,,,,,274.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,,,,,,,,,,,,,297.97,83,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,294.38,82,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,270.69,341.05,
"IVP, EACH ADDTL SEQUENTIAL INTRA PUSH",15500014,CDM,96376,CPT,260,RC,inpatient,XU,274,274,,232.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,206.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,232.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,241.12,88,,percent of total billed charges,,,,,,,,,209.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,249.34,91,,percent of total billed charges,,,260.3,95,,percent of total billed charges,,,227.42,83,,percent of total billed charges,,,227.42,83,,percent of total billed charges,,,,,,,,,,,,,,,227.42,83,,percent of total billed charges,,,260.3,95,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,224.68,82,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,232.9,85,,percent of total billed charges,,206.6,260.3,
BLOOD ADMINISTRATION SERVICE,15500015,CDM,36430,CPT,391,RC,inpatient,,1766,1766,,1499.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1331.56,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1501.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1554.08,88,,percent of total billed charges,,,,,,,,,1349.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1607.06,91,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.78,83,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1448.12,82,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,1331.56,1677.7,
PERIPHERAL VASCULAR REHAB,15802080,CDM,93668,CPT,480,RC,inpatient,,313,313,,265.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,236,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,266.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,275.44,88,,percent of total billed charges,,,,,,,,,239.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,284.83,91,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,,,,,,,,,,,,,259.79,83,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,256.66,82,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,236,297.35,
*ADHESIVE DRESSING 4 X 6 (4 X 3 PAD),23304026,CDM,,,270,RC,inpatient,,5,5,,4.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3.77,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4.4,88,,percent of total billed charges,,,,,,,,,3.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4.55,91,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4.15,83,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.1,82,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,3.77,4.75,
* SUTURE (DO NOT USE)(0605),23720151,CDM,,,270,RC,inpatient,,2,2,,1.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1.76,88,,percent of total billed charges,,,,,,,,,1.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1.82,91,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,,,,,,,,,,,,,1.66,83,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.64,82,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.7,85,,percent of total billed charges,,1.51,1.9,
BULLOUS PEMPHIGOID 180/ 230 IGG,25200165,CDM,,,300,RC,inpatient,,107.23,107.23,,91.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,80.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,91.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,94.36,88,,percent of total billed charges,,,,,,,,,81.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,97.58,91,,percent of total billed charges,,,101.87,95,,percent of total billed charges,,,89,83,,percent of total billed charges,,,89,83,,percent of total billed charges,,,,,,,,,,,,,,,89,83,,percent of total billed charges,,,101.87,95,,percent of total billed charges,,,96.51,90,,percent of total billed charges,,,96.51,90,,percent of total billed charges,,,87.93,82,,percent of total billed charges,,,96.51,90,,percent of total billed charges,,,91.15,85,,percent of total billed charges,,80.85,101.87,
COVID NAAT SURGICAL,25202884,CDM,87635,CPT,300,RC,inpatient,,254,254,,215.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,191.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,223.52,88,,percent of total billed charges,,,,,,,,,194.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,231.14,91,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,,,,,,,,,,,,,210.82,83,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,208.28,82,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,191.52,241.3,
STAPLER EEA INTRALUMINAL 33MM,30180011,CDM,,,270,RC,inpatient,,1821.37,1821.37,,1546.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1373.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1548.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1602.81,88,,percent of total billed charges,,,,,,,,,1391.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1657.45,91,,percent of total billed charges,,,1730.3,95,,percent of total billed charges,,,1511.74,83,,percent of total billed charges,,,1511.74,83,,percent of total billed charges,,,,,,,,,,,,,,,1511.74,83,,percent of total billed charges,,,1730.3,95,,percent of total billed charges,,,1639.23,90,,percent of total billed charges,,,1639.23,90,,percent of total billed charges,,,1493.52,82,,percent of total billed charges,,,1639.23,90,,percent of total billed charges,,,1548.16,85,,percent of total billed charges,,1373.31,1730.3,
COBLATOR WAND PROCISE EZ,30180319,CDM,,,270,RC,inpatient,,2007.85,2007.85,,1704.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1513.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1706.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1766.91,88,,percent of total billed charges,,,,,,,,,1534,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1827.14,91,,percent of total billed charges,,,1907.46,95,,percent of total billed charges,,,1666.52,83,,percent of total billed charges,,,1666.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1666.52,83,,percent of total billed charges,,,1907.46,95,,percent of total billed charges,,,1807.07,90,,percent of total billed charges,,,1807.07,90,,percent of total billed charges,,,1646.44,82,,percent of total billed charges,,,1807.07,90,,percent of total billed charges,,,1706.67,85,,percent of total billed charges,,1513.92,1907.46,
DEPUY INSERT SIGMA XLK 2.5 X 8,30180699,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY DELTA HEAD CER 12/14 32MM +1,30180906,CDM,,,278,RC,inpatient,,15642.97,15642.97,,13280.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11794.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,13296.52,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,13765.81,88,,percent of total billed charges,,,,,,,,,11951.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,14235.1,91,,percent of total billed charges,,,14860.82,95,,percent of total billed charges,,,12983.67,83,,percent of total billed charges,,,12983.67,83,,percent of total billed charges,,,,,,,,,,,,,,,12983.67,83,,percent of total billed charges,,,14860.82,95,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,12827.24,82,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,13296.52,85,,percent of total billed charges,,11794.8,14860.82,
DEPUY STEM TRI-LOCK STD OFFSET SZ1,30180907,CDM,,,278,RC,inpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30697.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34606.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,30697.71,38677.48,
DEPUY STEM TRI-LOCK HI OFFSET SZ8,30180925,CDM,,,278,RC,inpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30697.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34606.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,30697.71,38677.48,
DEPUY S-ROM SPEC-3 11/13 40MM,30180980,CDM,,,278,RC,inpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10650.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12006.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,10650.51,13419.08,
DEPUY FEMUR POROUS LT SZ2.5,30181006,CDM,,,278,RC,inpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27261.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30732.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,27261.42,34347.94,
DEPUY FEMUR POROUS C/R RT SZ2.5,30181007,CDM,,,278,RC,inpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27261.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30732.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,27261.42,34347.94,
DEPUY STEM TRI-LOCK HI OFFSET SZ6,30181015,CDM,,,278,RC,inpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30697.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34606.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,30697.71,38677.48,
DEPUY FEMUR POROUS LT SZ3,30181021,CDM,,,278,RC,inpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27261.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30732.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,27261.42,34347.94,
DEPUY FEMUR POROUS LT SZ5,30181023,CDM,,,278,RC,inpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,27261.42,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,30732.37,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,27261.42,34347.94,
DEPUY STEM TRI-LOCK HI OFFSET SZ4,30181099,CDM,,,278,RC,inpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30697.71,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34606.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,30697.71,38677.48,
DEPUY STEM SUMMIT STD SZ8,30181357,CDM,,,278,RC,inpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26584.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29969.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,26584.74,33495.37,
DEPUY STEM SUMMIT TAPER SZ9 HI OFF,30181420,CDM,,,278,RC,inpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26584.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29969.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,26584.74,33495.37,
DEPUY FEMORAL SIGMA UNI RM/LL SZ4,30181449,CDM,,,278,RC,inpatient,,20376.33,20376.33,,17299.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15363.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17319.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17931.17,88,,percent of total billed charges,,,,,,,,,15567.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18542.46,91,,percent of total billed charges,,,19357.51,95,,percent of total billed charges,,,16912.35,83,,percent of total billed charges,,,16912.35,83,,percent of total billed charges,,,,,,,,,,,,,,,16912.35,83,,percent of total billed charges,,,19357.51,95,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,16708.59,82,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,17319.88,85,,percent of total billed charges,,15363.75,19357.51,
DEPUY FIXED TIBIAL TRAY HP RM/LL SZ4,30181451,CDM,,,278,RC,inpatient,,12374.51,12374.51,,10505.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9330.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10518.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10889.57,88,,percent of total billed charges,,,,,,,,,9454.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11260.8,91,,percent of total billed charges,,,11755.78,95,,percent of total billed charges,,,10270.84,83,,percent of total billed charges,,,10270.84,83,,percent of total billed charges,,,,,,,,,,,,,,,10270.84,83,,percent of total billed charges,,,11755.78,95,,percent of total billed charges,,,11137.06,90,,percent of total billed charges,,,11137.06,90,,percent of total billed charges,,,10147.1,82,,percent of total billed charges,,,11137.06,90,,percent of total billed charges,,,10518.33,85,,percent of total billed charges,,9330.38,11755.78,
DEPUY INSERT SIGMA XLK 5 X 17,30181467,CDM,,,278,RC,inpatient,,14248.07,14248.07,,12096.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12110.86,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.3,88,,percent of total billed charges,,,,,,,,,10885.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12965.74,91,,percent of total billed charges,,,13535.67,95,,percent of total billed charges,,,11825.9,83,,percent of total billed charges,,,11825.9,83,,percent of total billed charges,,,,,,,,,,,,,,,11825.9,83,,percent of total billed charges,,,13535.67,95,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,11683.42,82,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,12110.86,85,,percent of total billed charges,,10743.04,13535.67,
DEPUY INSERT SIGMA XLK 4 X 20,30181660,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY INSERT SIGMA XLK 4 X 17.5,30181661,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY INSERT XLK 8MM SZ4,30181684,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY MBT KEEL TRAY SZ5,30181779,CDM,,,278,RC,inpatient,,22901.45,22901.45,,19443.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17267.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19466.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20153.28,88,,percent of total billed charges,,,,,,,,,17496.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20840.32,91,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19008.2,83,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,18779.19,82,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,19466.23,85,,percent of total billed charges,,17267.69,21756.38,
DEPUY FEMORAL SIGMA UNI RM/LL SZ5,30181805,CDM,,,278,RC,inpatient,,20376.33,20376.33,,17299.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15363.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17319.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17931.17,88,,percent of total billed charges,,,,,,,,,15567.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18542.46,91,,percent of total billed charges,,,19357.51,95,,percent of total billed charges,,,16912.35,83,,percent of total billed charges,,,16912.35,83,,percent of total billed charges,,,,,,,,,,,,,,,16912.35,83,,percent of total billed charges,,,19357.51,95,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,16708.59,82,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,17319.88,85,,percent of total billed charges,,15363.75,19357.51,
DEPUY MTB KEEL TRAY SZ4,30181823,CDM,,,270,RC,inpatient,,22901.45,22901.45,,19443.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17267.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19466.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20153.28,88,,percent of total billed charges,,,,,,,,,17496.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20840.32,91,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19008.2,83,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,18779.19,82,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,19466.23,85,,percent of total billed charges,,17267.69,21756.38,
DEPUY FEMORAL SIGMA UNI LM/RL SZ4,30181897,CDM,,,278,RC,inpatient,,20376.33,20376.33,,17299.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,15363.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,17319.88,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17931.17,88,,percent of total billed charges,,,,,,,,,15567.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,18542.46,91,,percent of total billed charges,,,19357.51,95,,percent of total billed charges,,,16912.35,83,,percent of total billed charges,,,16912.35,83,,percent of total billed charges,,,,,,,,,,,,,,,16912.35,83,,percent of total billed charges,,,19357.51,95,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,16708.59,82,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,17319.88,85,,percent of total billed charges,,15363.75,19357.51,
DEPUY TIBIAL TRAY FIXED BEARING SZ4,30181898,CDM,,,278,RC,inpatient,,12374.51,12374.51,,10505.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,9330.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,10518.33,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,10889.57,88,,percent of total billed charges,,,,,,,,,9454.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,11260.8,91,,percent of total billed charges,,,11755.78,95,,percent of total billed charges,,,10270.84,83,,percent of total billed charges,,,10270.84,83,,percent of total billed charges,,,,,,,,,,,,,,,10270.84,83,,percent of total billed charges,,,11755.78,95,,percent of total billed charges,,,11137.06,90,,percent of total billed charges,,,11137.06,90,,percent of total billed charges,,,10147.1,82,,percent of total billed charges,,,11137.06,90,,percent of total billed charges,,,10518.33,85,,percent of total billed charges,,9330.38,11755.78,
THERMOFLECT BOUFFANT CAP ADULT,30182026,CDM,,,270,RC,inpatient,,6.65,6.65,,5.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5.85,88,,percent of total billed charges,,,,,,,,,5.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6.05,91,,percent of total billed charges,,,6.32,95,,percent of total billed charges,,,5.52,83,,percent of total billed charges,,,5.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5.52,83,,percent of total billed charges,,,6.32,95,,percent of total billed charges,,,5.99,90,,percent of total billed charges,,,5.99,90,,percent of total billed charges,,,5.45,82,,percent of total billed charges,,,5.99,90,,percent of total billed charges,,,5.65,85,,percent of total billed charges,,5.01,6.32,
DEPUY TIBIAL TRAY RP SZ3,30182056,CDM,,,278,RC,inpatient,,22901.45,22901.45,,19443.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17267.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19466.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20153.28,88,,percent of total billed charges,,,,,,,,,17496.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20840.32,91,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19008.2,83,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,18779.19,82,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,19466.23,85,,percent of total billed charges,,17267.69,21756.38,
DEPUY INSERT XLK 10MM SZ4,30182327,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY INSERT SIGMA XLK 2 X 10,30182370,CDM,,,278,RC,inpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10743.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12111.24,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,10743.38,13536.09,
DEPUY INSERT TIBIAL AOX 10MM SZ3,30182610,CDM,,,278,RC,inpatient,,17068.29,17068.29,,14490.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12869.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14508.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15020.1,88,,percent of total billed charges,,,,,,,,,13040.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15532.14,91,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,,,,,,,,,,,,,14166.68,83,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,13996,82,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,12869.49,16214.88,
DEPUY-MITEK MICROFIX ANCHOR #3/0,30182731,CDM,,,278,RC,inpatient,,1678.5,1678.5,,1425.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1265.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1426.73,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1477.08,88,,percent of total billed charges,,,,,,,,,1282.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1527.44,91,,percent of total billed charges,,,1594.58,95,,percent of total billed charges,,,1393.16,83,,percent of total billed charges,,,1393.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1393.16,83,,percent of total billed charges,,,1594.58,95,,percent of total billed charges,,,1510.65,90,,percent of total billed charges,,,1510.65,90,,percent of total billed charges,,,1376.37,82,,percent of total billed charges,,,1510.65,90,,percent of total billed charges,,,1426.73,85,,percent of total billed charges,,1265.59,1594.58,
STENT URETERAL POLARIS,30182795,CDM,,,270,RC,inpatient,,904.8,904.8,,768.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,682.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,769.08,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,796.22,88,,percent of total billed charges,,,,,,,,,691.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,823.37,91,,percent of total billed charges,,,859.56,95,,percent of total billed charges,,,750.98,83,,percent of total billed charges,,,750.98,83,,percent of total billed charges,,,,,,,,,,,,,,,750.98,83,,percent of total billed charges,,,859.56,95,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,741.94,82,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,769.08,85,,percent of total billed charges,,682.22,859.56,
DEPUY MBT KEEL TRAY SZ2.0,30182953,CDM,,,278,RC,inpatient,,22901.45,22901.45,,19443.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17267.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19466.23,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,20153.28,88,,percent of total billed charges,,,,,,,,,17496.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20840.32,91,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19008.2,83,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,18779.19,82,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,19466.23,85,,percent of total billed charges,,17267.69,21756.38,
WRIGHT STEM PROFEMUR 5/8 SZ14,30183005,CDM,,,278,RC,inpatient,,18713.5,18713.5,,15887.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14109.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15906.48,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16467.88,88,,percent of total billed charges,,,,,,,,,14297.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17029.29,91,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,,,,,,,,,,,,,15532.21,83,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15345.07,82,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,14109.98,17777.83,
DEPUY TIBIAL TRAY FB SZ 6,30183207,CDM,,,278,RC,inpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14425.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16261.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,14425.07,18174.82,
DEPUY INSERT TIBIAL 4 X 5MM,30183318,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY ATTUNE TIBIA SZ 4,30183319,CDM,,,278,RC,inpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14425.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16261.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,14425.07,18174.82,
DEPUY TRAY TIBIAL CEMENTED SZ 7,30183328,CDM,,,278,RC,inpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14425.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16261.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,14425.07,18174.82,
DEPUY INSERT PS SZ 4 8MM,30183348,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY ATTUNE INSERT AOX SZ 7 8MM,30183418,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY TRAY TIBIAL SZ 8,30183460,CDM,,,278,RC,inpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14425.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16261.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,14425.07,18174.82,
DEPUY ATTUNE FEMUR SZ 3 LEFT,30183549,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY INSERT AOX 5MM SZ 3,30183550,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY ATTUNE TIBIA TRAY SZ 3,30183551,CDM,,,278,RC,inpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14425.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16261.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,14425.07,18174.82,
DEPUY ATTUNE FEMUR SZ 4N LT,30183567,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY FEMUR ATTUNE 4N RIGHT,30183577,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY ATTUNE INSERT AOX SZ 7 10MM,30183695,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY INSERT AOX 5MM SZ 3,30183723,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY ATTUNE FEMUR CR SZ 6 RT,30183734,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY ATTUNE FEMUR CR SZ 5 LT,30183747,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY FEMUR ATTUNE SZ 7 LT CR,30183838,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY INSERT AOX SZ 7 6MM,30183839,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY INSERT AOX SZ 4 6MM,30183841,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY FEMUR CR  SZ 4W RIGHT,30183847,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY ATTUNE FEMUR CR SZ 3 LT,30183867,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY ATTUNE TRAY FB SZ 10,30183880,CDM,,,278,RC,inpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14425.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16261.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,14425.07,18174.82,
DEPUY INSERT AOX SZ 7 7MM,30184046,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
MASK FACE LG ADULT INFL SZ 6,30184223,CDM,,,270,RC,inpatient,,21.23,21.23,,18.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18.68,88,,percent of total billed charges,,,,,,,,,16.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19.32,91,,percent of total billed charges,,,20.17,95,,percent of total billed charges,,,17.62,83,,percent of total billed charges,,,17.62,83,,percent of total billed charges,,,,,,,,,,,,,,,17.62,83,,percent of total billed charges,,,20.17,95,,percent of total billed charges,,,19.11,90,,percent of total billed charges,,,19.11,90,,percent of total billed charges,,,17.41,82,,percent of total billed charges,,,19.11,90,,percent of total billed charges,,,18.05,85,,percent of total billed charges,,16.01,20.17,
SPLINT FINGER STRIP PADDED 1/2X18,30184245,CDM,,,270,RC,inpatient,,8.79,8.79,,7.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7.47,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7.74,88,,percent of total billed charges,,,,,,,,,6.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8,91,,percent of total billed charges,,,8.35,95,,percent of total billed charges,,,7.3,83,,percent of total billed charges,,,7.3,83,,percent of total billed charges,,,,,,,,,,,,,,,7.3,83,,percent of total billed charges,,,8.35,95,,percent of total billed charges,,,7.91,90,,percent of total billed charges,,,7.91,90,,percent of total billed charges,,,7.21,82,,percent of total billed charges,,,7.91,90,,percent of total billed charges,,,7.47,85,,percent of total billed charges,,6.63,8.35,
DEPUY ATTUNE FEMUR SZ 3N LT CR,30184256,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY INSERT AOX SZ 3 5MM,30184257,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY FEMUR SZ 7 RT CR,30184262,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY INSERT SZ 7 5MM CR,30184263,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY STEM SUMMIT SZ 6 STD,30184374,CDM,,,278,RC,inpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,26584.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,29969.54,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,26584.74,33495.37,
DEPUY INSERT AOX 6MM SZ 4,30184430,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY ATTUNE RP SZ 4,30184431,CDM,,,278,RC,inpatient,,21286.98,21286.98,,18072.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16050.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18093.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18732.54,88,,percent of total billed charges,,,,,,,,,16263.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19371.15,91,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,,,,,,,,,,,,,17668.19,83,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,17455.32,82,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,16050.38,20222.63,
DEPUY TIBIA TRAY RP SZ 7,30184529,CDM,,,270,RC,inpatient,,21286.98,21286.98,,18072.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16050.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18093.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18732.54,88,,percent of total billed charges,,,,,,,,,16263.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19371.15,91,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,,,,,,,,,,,,,17668.19,83,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,17455.32,82,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,16050.38,20222.63,
DEPUY INSERT CR 6MM SZ 7,30184565,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY INSERT FB STAB 8MM,30184621,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY ATTUNE TIBIA MBT SZ 9,30184625,CDM,,,278,RC,inpatient,,21286.98,21286.98,,18072.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16050.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18093.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18732.54,88,,percent of total billed charges,,,,,,,,,16263.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19371.15,91,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,,,,,,,,,,,,,17668.19,83,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,17455.32,82,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,16050.38,20222.63,
DEPUY INSERT RP SZ 7 6MM,30184626,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY INSERT STAB FB 9 X 5MM,30184660,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY BIPOLAR CUP 54 OD,30184681,CDM,,,278,RC,inpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6126.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6906.31,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,6126.3,7718.82,
DEPUY INSERT AOX CR SZ 5 7MM,30184722,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY ATTUNE TIBIA TRAY SZ 8,30184728,CDM,,,278,RC,inpatient,,21286.98,21286.98,,18072.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16050.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18093.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18732.54,88,,percent of total billed charges,,,,,,,,,16263.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19371.15,91,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,,,,,,,,,,,,,17668.19,83,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,17455.32,82,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,16050.38,20222.63,
DEPUY FEMUR SZ 4 NARROW CR L,30184729,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY INSERT CR 7MM SZ 4,30184730,CDM,,,278,RC,inpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,10819.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12197.27,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,10819.7,13632.24,
DEPUY INSERT RP 8MM SZ 7,30184734,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY TIBIA TRAY RP SZ 6,30184735,CDM,,,270,RC,inpatient,,21286.98,21286.98,,18072.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16050.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18093.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18732.54,88,,percent of total billed charges,,,,,,,,,16263.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19371.15,91,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,,,,,,,,,,,,,17668.19,83,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,17455.32,82,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,16050.38,20222.63,
DEPUY INSERT RP SZ 5 5MM,30184831,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY ATTUNE RP TIBIAL TRAY SZ 3,30184832,CDM,,,278,RC,inpatient,,21286.98,21286.98,,18072.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16050.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18093.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18732.54,88,,percent of total billed charges,,,,,,,,,16263.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19371.15,91,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,,,,,,,,,,,,,17668.19,83,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,17455.32,82,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,16050.38,20222.63,
DEPUY ATTUNE PATELLA DOME SZ 29,30184869,CDM,,,278,RC,inpatient,,6897.67,6897.67,,5856.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5200.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5863.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6069.95,88,,percent of total billed charges,,,,,,,,,5269.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6276.88,91,,percent of total billed charges,,,6552.79,95,,percent of total billed charges,,,5725.07,83,,percent of total billed charges,,,5725.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5725.07,83,,percent of total billed charges,,,6552.79,95,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,5656.09,82,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,5863.02,85,,percent of total billed charges,,5200.84,6552.79,
DEPUY ATTUNE FEMUR SZ 3N LT PS,30184870,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY INSERT RP SZ 6 8MM,30184889,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY INSERT RP 10MM SZ 8,30185021,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY INSERT RP SZ 4 8MM,30185027,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
NEEDLE CARR-LOCKE INJECTION 25GA (NC),30185093,CDM,,,270,RC,inpatient,,441,441,,374.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,332.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,374.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.08,88,,percent of total billed charges,,,,,,,,,336.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,401.31,91,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,,,,,,,,,,,,,366.03,83,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,361.62,82,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,374.85,85,,percent of total billed charges,,332.51,418.95,
DEPUY INSERT AOX RP 5MM,30185147,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY FEMUR LEFT 10MM,30185224,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY TIBIA MBT 10MM,30185225,CDM,,,278,RC,inpatient,,21286.98,21286.98,,18072.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,16050.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,18093.93,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,18732.54,88,,percent of total billed charges,,,,,,,,,16263.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,19371.15,91,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,,,,,,,,,,,,,17668.19,83,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,17455.32,82,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,16050.38,20222.63,
DEPUY INSERT 5MM 10,30185226,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY PATELLA 41MM,30185232,CDM,,,278,RC,inpatient,,6897.67,6897.67,,5856.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5200.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5863.02,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6069.95,88,,percent of total billed charges,,,,,,,,,5269.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6276.88,91,,percent of total billed charges,,,6552.79,95,,percent of total billed charges,,,5725.07,83,,percent of total billed charges,,,5725.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5725.07,83,,percent of total billed charges,,,6552.79,95,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,5656.09,82,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,5863.02,85,,percent of total billed charges,,5200.84,6552.79,
DEPUY FEMUR ATTUNE PS SZ 4 LFT,30185295,CDM,,,278,RC,inpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21324.5,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,24039.56,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,21324.5,26867.74,
DEPUY TIBIAL TRAY FB SIZE 5,30185317,CDM,,,270,RC,inpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14425.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16261.68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,14425.07,18174.82,
DEPUY TRAY TIBIAL FB SZ 8,30185400,CDM,,,278,RC,inpatient,,19747.26,19747.26,,16765.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14889.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16785.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17377.59,88,,percent of total billed charges,,,,,,,,,15086.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17970.01,91,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,,,,,,,,,,,,,16390.23,83,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16192.75,82,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,14889.43,18759.9,
DEPUY TRAY TIBIAL FB SZ 5,30185401,CDM,,,278,RC,inpatient,,19747.26,19747.26,,16765.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14889.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16785.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17377.59,88,,percent of total billed charges,,,,,,,,,15086.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17970.01,91,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,,,,,,,,,,,,,16390.23,83,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16192.75,82,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,14889.43,18759.9,
DEPUY ATTUNE TIBIAL TRAY FB SZ 7,30185420,CDM,,,278,RC,inpatient,,19747.26,19747.26,,16765.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14889.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16785.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17377.59,88,,percent of total billed charges,,,,,,,,,15086.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17970.01,91,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,,,,,,,,,,,,,16390.23,83,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16192.75,82,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,14889.43,18759.9,
DEPUY TRAY TIBIAL FB SZ 3,30185536,CDM,,,278,RC,inpatient,,19747.26,19747.26,,16765.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14889.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16785.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17377.59,88,,percent of total billed charges,,,,,,,,,15086.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17970.01,91,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,,,,,,,,,,,,,16390.23,83,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16192.75,82,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,14889.43,18759.9,
DEPUY LINER ALTRX 40 X 58,30185681,CDM,,,278,RC,inpatient,,17691.38,17691.38,,15019.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13339.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,15037.67,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15568.41,88,,percent of total billed charges,,,,,,,,,13516.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16099.16,91,,percent of total billed charges,,,16806.81,95,,percent of total billed charges,,,14683.85,83,,percent of total billed charges,,,14683.85,83,,percent of total billed charges,,,,,,,,,,,,,,,14683.85,83,,percent of total billed charges,,,16806.81,95,,percent of total billed charges,,,15922.24,90,,percent of total billed charges,,,15922.24,90,,percent of total billed charges,,,14506.93,82,,percent of total billed charges,,,15922.24,90,,percent of total billed charges,,,15037.67,85,,percent of total billed charges,,13339.3,16806.81,
DEPUY FEMUR ATTUNE RT SZ 7,30186023,CDM,,,278,RC,inpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,23579.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,26581.83,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,23579.65,29709.1,
DEPUY TIBIA ATTUNE RP SZ 7,30186024,CDM,,,278,RC,inpatient,,22629.36,22629.36,,19212.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17062.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19234.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19913.84,88,,percent of total billed charges,,,,,,,,,17288.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20592.72,91,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,,,,,,,,,,,,,18782.37,83,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,18556.08,82,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,17062.54,21497.89,
DEPUY TIBIA ATTUNE RP SZ 5,30186039,CDM,,,278,RC,inpatient,,22629.36,22629.36,,19212.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17062.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19234.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19913.84,88,,percent of total billed charges,,,,,,,,,17288.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20592.72,91,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,,,,,,,,,,,,,18782.37,83,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,18556.08,82,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,17062.54,21497.89,
DEPUY INSERT ATTUNE TIBIAL SZ 5 6MM,30186040,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY CERAMIC HEAD 32MM +1MM TS,30186175,CDM,,,278,RC,inpatient,,14631.05,14631.05,,12421.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,11031.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,12436.39,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,12875.32,88,,percent of total billed charges,,,,,,,,,11178.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,13314.26,91,,percent of total billed charges,,,13899.5,95,,percent of total billed charges,,,12143.77,83,,percent of total billed charges,,,12143.77,83,,percent of total billed charges,,,,,,,,,,,,,,,12143.77,83,,percent of total billed charges,,,13899.5,95,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,11997.46,82,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,12436.39,85,,percent of total billed charges,,11031.81,13899.5,
DEPUY TIBIA ATTUNE RP SZ 4,30186189,CDM,,,278,RC,inpatient,,22629.36,22629.36,,19212.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17062.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19234.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19913.84,88,,percent of total billed charges,,,,,,,,,17288.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20592.72,91,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,,,,,,,,,,,,,18782.37,83,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,18556.08,82,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,17062.54,21497.89,
DEPUY INSERT RP SZ 5 10MM,30186190,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY STEM CORAIL HI OFFSET SZ10,30186246,CDM,,,278,RC,inpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,28974.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,32663.53,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,28974.47,36506.3,
DEPUY TIBIA  ATTUNE RP SZ 9,30186299,CDM,,,278,RC,inpatient,,19747.26,19747.26,,16765.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14889.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16785.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17377.59,88,,percent of total billed charges,,,,,,,,,15086.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17970.01,91,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,,,,,,,,,,,,,16390.23,83,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16192.75,82,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,14889.43,18759.9,
DEPUY TRAY TIBIAL FB SZ 4,30186392,CDM,,,278,RC,inpatient,,19747.26,19747.26,,16765.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,14889.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,16785.17,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,17377.59,88,,percent of total billed charges,,,,,,,,,15086.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,17970.01,91,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,,,,,,,,,,,,,16390.23,83,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16192.75,82,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,14889.43,18759.9,
DEPUY ATTUNE INSERT RP SZ 5 8MM,30186418,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY INSERT RP SZ 6 7MM,30186476,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY PRESSFIT TIBIA SZ. 5,30186506,CDM,,,278,RC,inpatient,,27458.8,27458.8,,23312.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20703.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23339.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24163.74,88,,percent of total billed charges,,,,,,,,,20978.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24987.51,91,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,,,,,,,,,,,,,22790.8,83,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,22516.22,82,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,20703.94,26085.86,
DEPUY PRESSFIT FEMUR LEFT 5N,30186507,CDM,,,278,RC,inpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30299.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34157.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,30299.65,38175.95,
DEPUY ATTUNE INSERT CR 6MM SZ 5,30186508,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY FEMUR CEMENTLESS CR RIGHT 5,30186539,CDM,,,278,RC,inpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30299.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34157.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,30299.65,38175.95,
DEPUY INSERT CR RP 5MM,30186540,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY PRESSFIT FEMUR PS 5N LEFT,30186598,CDM,,,278,RC,inpatient,,41399.35,41399.35,,35148.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31215.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35189.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36431.43,88,,percent of total billed charges,,,,,,,,,31629.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37673.41,91,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,,,,,,,,,,,,,34361.46,83,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,33947.47,82,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,35189.45,85,,percent of total billed charges,,31215.11,39329.38,
DEPUY PRESSFIT FEMUR CR 6N LEFT,30186599,CDM,,,278,RC,inpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30299.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34157.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,30299.65,38175.95,
DEPUY PRESSFIT TIBIA SZ. 6 RP,30186600,CDM,,,278,RC,inpatient,,27458.8,27458.8,,23312.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20703.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23339.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24163.74,88,,percent of total billed charges,,,,,,,,,20978.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24987.51,91,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,,,,,,,,,,,,,22790.8,83,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,22516.22,82,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,20703.94,26085.86,
DEPUY INSERT RP SZ 6 5MM,30186601,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY PRESSFIT FEMUR CEMTLESS SZ 6 LEFT,30186643,CDM,,,278,RC,inpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30299.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34157.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,30299.65,38175.95,
DEPUY INSERT RP 7MM SZ 7,30186652,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY TIBIA RP SZ 8,30186653,CDM,,,278,RC,inpatient,,22629.36,22629.36,,19212.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17062.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19234.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19913.84,88,,percent of total billed charges,,,,,,,,,17288.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20592.72,91,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,,,,,,,,,,,,,18782.37,83,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,18556.08,82,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,17062.54,21497.89,
DEPUY INSERT RP 8MM SZ 8,30186654,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY PRESSFIT FEMUR CR SZ 6 RIGHT,30186668,CDM,,,278,RC,inpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30299.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34157.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,30299.65,38175.95,
DEPUY INSERT 8MM,30186676,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY INSERT ATTUNE SZ 12,30186699,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY TIBIA  ATTUNE RP SZ 9,30186702,CDM,,,278,RC,inpatient,,22629.36,22629.36,,19212.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,17062.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,19234.96,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,19913.84,88,,percent of total billed charges,,,,,,,,,17288.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,20592.72,91,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,,,,,,,,,,,,,18782.37,83,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,18556.08,82,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,17062.54,21497.89,
DEPUY ATTUNE FEMUR PRESSFIT CR SZ 4 LEFT,30186729,CDM,,,278,RC,inpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30299.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34157.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,30299.65,38175.95,
DEPUY INSERT PRESSFIT 5MM,30186730,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY FEMUR PRESSFIT PS 7 RIGHT,30186779,CDM,,,278,RC,inpatient,,41399.35,41399.35,,35148.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31215.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35189.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36431.43,88,,percent of total billed charges,,,,,,,,,31629.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37673.41,91,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,,,,,,,,,,,,,34361.46,83,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,33947.47,82,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,35189.45,85,,percent of total billed charges,,31215.11,39329.38,
DEPUY TIBIA PRESSFIT PS 7,30186780,CDM,,,278,RC,inpatient,,27458.8,27458.8,,23312.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20703.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23339.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24163.74,88,,percent of total billed charges,,,,,,,,,20978.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24987.51,91,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,,,,,,,,,,,,,22790.8,83,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,22516.22,82,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,20703.94,26085.86,
DEPUY FEMUR POROUS CR SZ 6N RIGHT,30186911,CDM,,,278,RC,inpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30299.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34157.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,30299.65,38175.95,
DEPUY PRESSFIT INSERT 6MM RP,30186912,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY LINER ALTRX +4 40 X 62,30186921,CDM,,,278,RC,inpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,13270.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14960.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,13270.78,16720.48,
DEPUY PRESSFIT TIBIA SZ. 4,30187515,CDM,,,278,RC,inpatient,,27458.8,27458.8,,23312.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20703.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23339.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24163.74,88,,percent of total billed charges,,,,,,,,,20978.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24987.51,91,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,,,,,,,,,,,,,22790.8,83,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,22516.22,82,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,20703.94,26085.86,
DEPUY PRESSFIT FEMUR 6N LEFT,30187516,CDM,,,278,RC,inpatient,,41399.35,41399.35,,35148.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31215.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35189.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36431.43,88,,percent of total billed charges,,,,,,,,,31629.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37673.41,91,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,,,,,,,,,,,,,34361.46,83,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,33947.47,82,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,35189.45,85,,percent of total billed charges,,31215.11,39329.38,
DEPUY ATTUNE INSERT SZ 5 7MM,30187543,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY ATTUNE FEMUR SZ 6 NAR RT,30187624,CDM,,,278,RC,inpatient,,41399.35,41399.35,,35148.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31215.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35189.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36431.43,88,,percent of total billed charges,,,,,,,,,31629.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37673.41,91,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,,,,,,,,,,,,,34361.46,83,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,33947.47,82,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,35189.45,85,,percent of total billed charges,,31215.11,39329.38,
DEPUY ATTUNE FEMUR PRESSFIT RT SZ 9,30187767,CDM,,,278,RC,inpatient,,41399.35,41399.35,,35148.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,31215.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,35189.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,36431.43,88,,percent of total billed charges,,,,,,,,,31629.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,37673.41,91,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,,,,,,,,,,,,,34361.46,83,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,33947.47,82,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,35189.45,85,,percent of total billed charges,,31215.11,39329.38,
DEPUY ATTUNE INSERT PRESSFIT SZ 9 X 12MM,30187768,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
DEPUY ATTUNE FEMUR CR RT SZ 9,30188192,CDM,,,278,RC,inpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30299.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34157.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,30299.65,38175.95,
DEPUY ATTUNE TIBIA PRESSFIT RP SZ9,30188193,CDM,,,278,RC,inpatient,,27458.8,27458.8,,23312.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,20703.94,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23339.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24163.74,88,,percent of total billed charges,,,,,,,,,20978.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,24987.51,91,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,,,,,,,,,,,,,22790.8,83,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,22516.22,82,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,20703.94,26085.86,
DEPUY ATTUNE INSERT TIBIAL CR RP SZ 9 10,30188194,CDM,,,278,RC,inpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,12620.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,14227.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,12620.72,15901.43,
CATH DRAINAGE 10FR (NC),30260097,CDM,,,270,RC,inpatient,,1393.15,1393.15,,1182.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1050.44,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1184.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1225.97,88,,percent of total billed charges,,,,,,,,,1064.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1267.77,91,,percent of total billed charges,,,1323.49,95,,percent of total billed charges,,,1156.31,83,,percent of total billed charges,,,1156.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1156.31,83,,percent of total billed charges,,,1323.49,95,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1142.38,82,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1184.18,85,,percent of total billed charges,,1050.44,1323.49,
SENSOR ADHESIVE PED. PDTX LNCS (NC),30330046,CDM,,,270,RC,inpatient,,63.47,63.47,,53.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,53.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,55.85,88,,percent of total billed charges,,,,,,,,,48.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,57.76,91,,percent of total billed charges,,,60.3,95,,percent of total billed charges,,,52.68,83,,percent of total billed charges,,,52.68,83,,percent of total billed charges,,,,,,,,,,,,,,,52.68,83,,percent of total billed charges,,,60.3,95,,percent of total billed charges,,,57.12,90,,percent of total billed charges,,,57.12,90,,percent of total billed charges,,,52.05,82,,percent of total billed charges,,,57.12,90,,percent of total billed charges,,,53.95,85,,percent of total billed charges,,47.86,60.3,
ARM LYMPH BANDAGE KIT,30340012,CDM,,,270,RC,inpatient,,509.7,509.7,,432.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,384.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,433.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,448.54,88,,percent of total billed charges,,,,,,,,,389.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,463.83,91,,percent of total billed charges,,,484.22,95,,percent of total billed charges,,,423.05,83,,percent of total billed charges,,,423.05,83,,percent of total billed charges,,,,,,,,,,,,,,,423.05,83,,percent of total billed charges,,,484.22,95,,percent of total billed charges,,,458.73,90,,percent of total billed charges,,,458.73,90,,percent of total billed charges,,,417.95,82,,percent of total billed charges,,,458.73,90,,percent of total billed charges,,,433.25,85,,percent of total billed charges,,384.31,484.22,
DRESSING WOUND AQUACEL/AG 6X6,30810001,CDM,,,270,RC,inpatient,,151.4,151.4,,128.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,114.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,128.69,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,133.23,88,,percent of total billed charges,,,,,,,,,115.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,137.77,91,,percent of total billed charges,,,143.83,95,,percent of total billed charges,,,125.66,83,,percent of total billed charges,,,125.66,83,,percent of total billed charges,,,,,,,,,,,,,,,125.66,83,,percent of total billed charges,,,143.83,95,,percent of total billed charges,,,136.26,90,,percent of total billed charges,,,136.26,90,,percent of total billed charges,,,124.15,82,,percent of total billed charges,,,136.26,90,,percent of total billed charges,,,128.69,85,,percent of total billed charges,,114.16,143.83,
DRESSING FIBRACOL PLUS COLLAGEN-2,30810002,CDM,,,270,RC,inpatient,,65.81,65.81,,55.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,49.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,55.94,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,57.91,88,,percent of total billed charges,,,,,,,,,50.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,59.89,91,,percent of total billed charges,,,62.52,95,,percent of total billed charges,,,54.62,83,,percent of total billed charges,,,54.62,83,,percent of total billed charges,,,,,,,,,,,,,,,54.62,83,,percent of total billed charges,,,62.52,95,,percent of total billed charges,,,59.23,90,,percent of total billed charges,,,59.23,90,,percent of total billed charges,,,53.96,82,,percent of total billed charges,,,59.23,90,,percent of total billed charges,,,55.94,85,,percent of total billed charges,,49.62,62.52,
DRESSING DUO-DERM 6X6 THIN,30810003,CDM,,,270,RC,inpatient,,25.01,25.01,,21.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,18.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,21.26,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,22.01,88,,percent of total billed charges,,,,,,,,,19.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,22.76,91,,percent of total billed charges,,,23.76,95,,percent of total billed charges,,,20.76,83,,percent of total billed charges,,,20.76,83,,percent of total billed charges,,,,,,,,,,,,,,,20.76,83,,percent of total billed charges,,,23.76,95,,percent of total billed charges,,,22.51,90,,percent of total billed charges,,,22.51,90,,percent of total billed charges,,,20.51,82,,percent of total billed charges,,,22.51,90,,percent of total billed charges,,,21.26,85,,percent of total billed charges,,18.86,23.76,
DRESSING PROMOGRAN 19.1 SQ. IN,30810008,CDM,,,270,RC,inpatient,,155.48,155.48,,132,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,117.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,132.16,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,136.82,88,,percent of total billed charges,,,,,,,,,118.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,141.49,91,,percent of total billed charges,,,147.71,95,,percent of total billed charges,,,129.05,83,,percent of total billed charges,,,129.05,83,,percent of total billed charges,,,,,,,,,,,,,,,129.05,83,,percent of total billed charges,,,147.71,95,,percent of total billed charges,,,139.93,90,,percent of total billed charges,,,139.93,90,,percent of total billed charges,,,127.49,82,,percent of total billed charges,,,139.93,90,,percent of total billed charges,,,132.16,85,,percent of total billed charges,,117.23,147.71,
BETAMETHASONE DIPROP GLY OINT : 0.05%,32000227,CDM,,,,,inpatient,,111.75,111.75,,94.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,84.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,94.99,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,98.34,88,,percent of total billed charges,,,,,,,,,85.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,101.69,91,,percent of total billed charges,,,106.16,95,,percent of total billed charges,,,92.75,83,,percent of total billed charges,,,92.75,83,,percent of total billed charges,,,,,,,,,,,,,,,92.75,83,,percent of total billed charges,,,106.16,95,,percent of total billed charges,,,100.58,90,,percent of total billed charges,,,100.58,90,,percent of total billed charges,,,91.64,82,,percent of total billed charges,,,100.58,90,,percent of total billed charges,,,94.99,85,,percent of total billed charges,,84.26,106.16,
POLY B/TRIM(POLYTRIM)EYE DROP:10ML,32000484,CDM,J3490,HCPCS,250,RC,inpatient,,95.26,95.26,,80.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,71.83,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,80.97,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,83.83,88,,percent of total billed charges,,,,,,,,,72.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,86.69,91,,percent of total billed charges,,,90.5,95,,percent of total billed charges,,,79.07,83,,percent of total billed charges,,,79.07,83,,percent of total billed charges,,,,,,,,,,,,,,,79.07,83,,percent of total billed charges,,,90.5,95,,percent of total billed charges,,,85.73,90,,percent of total billed charges,,,85.73,90,,percent of total billed charges,,,78.11,82,,percent of total billed charges,,,85.73,90,,percent of total billed charges,,,80.97,85,,percent of total billed charges,,71.83,90.5,
IBANDRONATE (BONIVA)SYRINGE: 3MG/3ML,32000485,CDM,J1740,HCPCS,250,RC,inpatient,,1764,1764,,1497.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1330.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1499.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1552.32,88,,percent of total billed charges,,77.54,,,,fee schedule,,,1347.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,77.54,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1605.24,91,,percent of total billed charges,,,1675.8,95,,percent of total billed charges,,,1464.12,83,,percent of total billed charges,,,1464.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1464.12,83,,percent of total billed charges,,,1675.8,95,,percent of total billed charges,,,1587.6,90,,percent of total billed charges,,,1587.6,90,,percent of total billed charges,,,1446.48,82,,percent of total billed charges,,,1587.6,90,,percent of total billed charges,,,1499.4,85,,percent of total billed charges,,77.54,1675.8,
ALPROSTADIL(PROSTIN VR PED)AMP:500MCG/ML,32000493,CDM,J0270,HCPCS,250,RC,inpatient,,1730.8,1730.8,,1469.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1305.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1471.18,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1523.1,88,,percent of total billed charges,,,,,,,,,1322.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1575.03,91,,percent of total billed charges,,,1644.26,95,,percent of total billed charges,,,1436.56,83,,percent of total billed charges,,,1436.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1436.56,83,,percent of total billed charges,,,1644.26,95,,percent of total billed charges,,,1557.72,90,,percent of total billed charges,,,1557.72,90,,percent of total billed charges,,,1419.26,82,,percent of total billed charges,,,1557.72,90,,percent of total billed charges,,,1471.18,85,,percent of total billed charges,,1305.02,1644.26,
LAMIVUDINE/ZIDOVUD(COMBIVR)TAB:150-300MG,32004052,CDM,,,,,inpatient,,301.25,301.25,,255.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,227.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,256.06,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,265.1,88,,percent of total billed charges,,,,,,,,,230.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,274.14,91,,percent of total billed charges,,,286.19,95,,percent of total billed charges,,,250.04,83,,percent of total billed charges,,,250.04,83,,percent of total billed charges,,,,,,,,,,,,,,,250.04,83,,percent of total billed charges,,,286.19,95,,percent of total billed charges,,,271.13,90,,percent of total billed charges,,,271.13,90,,percent of total billed charges,,,247.03,82,,percent of total billed charges,,,271.13,90,,percent of total billed charges,,,256.06,85,,percent of total billed charges,,227.14,286.19,
RYAN ACETAMINOPHEN MAX,32014161,CDM,,,258,RC,inpatient,,10,10,,8.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8.8,88,,percent of total billed charges,,,,,,,,,7.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,9.1,91,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,,,,,,,,,,,,,8.3,83,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,9,90,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.2,82,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.5,85,,percent of total billed charges,,7.54,9.5,
NAFCILLIN-IVPB:1GM/NS50ML,32014505,CDM,,,258,RC,inpatient,,71.42,71.42,,60.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,53.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,60.71,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,62.85,88,,percent of total billed charges,,,,,,,,,54.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,64.99,91,,percent of total billed charges,,,67.85,95,,percent of total billed charges,,,59.28,83,,percent of total billed charges,,,59.28,83,,percent of total billed charges,,,,,,,,,,,,,,,59.28,83,,percent of total billed charges,,,67.85,95,,percent of total billed charges,,,64.28,90,,percent of total billed charges,,,64.28,90,,percent of total billed charges,,,58.56,82,,percent of total billed charges,,,64.28,90,,percent of total billed charges,,,60.71,85,,percent of total billed charges,,53.85,67.85,
AMPicillin-IVPB:1GM/NS50ML,32014511,CDM,,,258,RC,inpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,41.47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,46.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,41.47,52.25,
AMPicillin NEONATE:250MG/SW5ML,32016178,CDM,,,258,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
GENTAMICIN-IVPB:(PEDS) __MG/NS10ML,32017051,CDM,J1580,HCPCS,258,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,21.3,,,,fee schedule,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21.3,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,21.3,54.15,
GENTAMICIN-IVPB:(NN)11.25MG/NS2.5ML,32599788,CDM,,,258,RC,inpatient,,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,36.19,45.6,
GENTAMICIN-IVPB:(NN)10MG/NS2.5ML,32599789,CDM,,,258,RC,inpatient,,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,36.19,45.6,
GENTAMICIN-IVPB:(NN) 8.75MG/NS2.5ML,32599790,CDM,,,258,RC,inpatient,,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,36.19,45.6,
GENTAMICIN-IVPB:(NN) 7.5MG/NS2.5ML,32599791,CDM,,,258,RC,inpatient,,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,36.19,45.6,
GENTAMICIN-IVPB:(NN) 6.25MG/NS2.5ML,32599792,CDM,,,258,RC,inpatient,,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,36.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,40.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,36.19,45.6,
GENTAMICIN-IVPB:(NN) 5MG/NS2.5ML,32599793,CDM,J1580,HCPCS,258,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,21.3,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21.3,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,21.3,59.21,
ZITHROMAX-IVPB:250MG/NS250ML,32599801,CDM,,,258,RC,inpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,42.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,48.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,42.98,54.15,
KINEVAC-SYR:  5 MCG/ NS 5 ML     (PD),32599802,CDM,,,258,RC,inpatient,,1584.84,1584.84,,1345.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1194.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1347.11,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1394.66,88,,percent of total billed charges,,,,,,,,,1210.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1442.2,91,,percent of total billed charges,,,1505.6,95,,percent of total billed charges,,,1315.42,83,,percent of total billed charges,,,1315.42,83,,percent of total billed charges,,,,,,,,,,,,,,,1315.42,83,,percent of total billed charges,,,1505.6,95,,percent of total billed charges,,,1426.36,90,,percent of total billed charges,,,1426.36,90,,percent of total billed charges,,,1299.57,82,,percent of total billed charges,,,1426.36,90,,percent of total billed charges,,,1347.11,85,,percent of total billed charges,,1194.97,1505.6,
ceFOXitin(MEFOXIN)-IVPB:500MG/SW5ML,32599816,CDM,,,258,RC,inpatient,,66.88,66.88,,56.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,50.43,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,56.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,58.85,88,,percent of total billed charges,,,,,,,,,51.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,60.86,91,,percent of total billed charges,,,63.54,95,,percent of total billed charges,,,55.51,83,,percent of total billed charges,,,55.51,83,,percent of total billed charges,,,,,,,,,,,,,,,55.51,83,,percent of total billed charges,,,63.54,95,,percent of total billed charges,,,60.19,90,,percent of total billed charges,,,60.19,90,,percent of total billed charges,,,54.84,82,,percent of total billed charges,,,60.19,90,,percent of total billed charges,,,56.85,85,,percent of total billed charges,,50.43,63.54,
IMIPENEM(PRIMAXIN)-IVPB:1GM/NS250ML,32599847,CDM,,,258,RC,inpatient,,310.19,310.19,,263.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,233.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,263.66,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,272.97,88,,percent of total billed charges,,,,,,,,,236.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,282.27,91,,percent of total billed charges,,,294.68,95,,percent of total billed charges,,,257.46,83,,percent of total billed charges,,,257.46,83,,percent of total billed charges,,,,,,,,,,,,,,,257.46,83,,percent of total billed charges,,,294.68,95,,percent of total billed charges,,,279.17,90,,percent of total billed charges,,,279.17,90,,percent of total billed charges,,,254.36,82,,percent of total billed charges,,,279.17,90,,percent of total billed charges,,,263.66,85,,percent of total billed charges,,233.88,294.68,
IV LIPOSYN(INTRALIPIDS/FAT) 20% 500ML,32599929,CDM,J3490,HCPCS,250,RC,inpatient,,475.8,475.8,,403.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,358.75,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,404.43,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,418.7,88,,percent of total billed charges,,,,,,,,,363.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,432.98,91,,percent of total billed charges,,,452.01,95,,percent of total billed charges,,,394.91,83,,percent of total billed charges,,,394.91,83,,percent of total billed charges,,,,,,,,,,,,,,,394.91,83,,percent of total billed charges,,,452.01,95,,percent of total billed charges,,,428.22,90,,percent of total billed charges,,,428.22,90,,percent of total billed charges,,,390.16,82,,percent of total billed charges,,,428.22,90,,percent of total billed charges,,,404.43,85,,percent of total billed charges,,358.75,452.01,
INSULIN(HUMULIN R)-IVPB:100UNITS/NS100ML,32599933,CDM,,,258,RC,inpatient,,252.94,252.94,,214.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,190.72,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,215,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,222.59,88,,percent of total billed charges,,,,,,,,,193.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,230.18,91,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,,,,,,,,,,,,,209.94,83,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,207.41,82,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,215,85,,percent of total billed charges,,190.72,240.29,
LEVOFLOX(LEVAQUIN)-IVPB:500MG/D5W100ML,32599942,CDM,J1956,HCPCS,258,RC,inpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,144.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,162.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,168.28,88,,percent of total billed charges,,3.21,,,,fee schedule,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.21,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,3.21,181.67,
KCL-IVPB: 20MEQ/ SW 100 ML  (RIDER) (PD),32599944,CDM,,,258,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
TOBRAMYCIN-IVPB: 160MG/SW20ML,32599957,CDM,,,258,RC,inpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,47,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,52.98,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,47,59.21,
MULTIPLE SLEEP LATENCY TESTING MSLT,38000050,CDM,95805,CPT,740,RC,inpatient,TC,4706,4706,,3995.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3548.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4000.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4141.28,88,,percent of total billed charges,,,,,,,,,3595.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4282.46,91,,percent of total billed charges,,,4470.7,95,,percent of total billed charges,,,3905.98,83,,percent of total billed charges,,,3905.98,83,,percent of total billed charges,,,,,,,,,,,,,,,3905.98,83,,percent of total billed charges,,,4470.7,95,,percent of total billed charges,,,4235.4,90,,percent of total billed charges,,,4235.4,90,,percent of total billed charges,,,3858.92,82,,percent of total billed charges,,,4235.4,90,,percent of total billed charges,,,4000.1,85,,percent of total billed charges,,3548.32,4470.7,
SLEEP STUDY W/O CPAP,38000100,CDM,95810,CPT,920,RC,inpatient,,9008,9008,,7647.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,6792.03,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,7656.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,7927.04,88,,percent of total billed charges,,,,,,,,,6882.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8197.28,91,,percent of total billed charges,,,8557.6,95,,percent of total billed charges,,,7476.64,83,,percent of total billed charges,,,7476.64,83,,percent of total billed charges,,,,,,,,,,,,,,,7476.64,83,,percent of total billed charges,,,8557.6,95,,percent of total billed charges,,,8107.2,90,,percent of total billed charges,,,8107.2,90,,percent of total billed charges,,,7386.56,82,,percent of total billed charges,,,8107.2,90,,percent of total billed charges,,,7656.8,85,,percent of total billed charges,,6792.03,8557.6,
SLEEP STUDY WITH CPAP,38000150,CDM,95811,CPT,920,RC,inpatient,,9621,9621,,8168.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7254.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8177.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8466.48,88,,percent of total billed charges,,,,,,,,,7350.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8755.11,91,,percent of total billed charges,,,9139.95,95,,percent of total billed charges,,,7985.43,83,,percent of total billed charges,,,7985.43,83,,percent of total billed charges,,,,,,,,,,,,,,,7985.43,83,,percent of total billed charges,,,9139.95,95,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,7889.22,82,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,8177.85,85,,percent of total billed charges,,7254.23,9139.95,
SLEEP STUDY SPLIT/ CPAP,38000200,CDM,95811,CPT,740,RC,inpatient,,9621,9621,,8168.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,7254.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,8177.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,8466.48,88,,percent of total billed charges,,,,,,,,,7350.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,8755.11,91,,percent of total billed charges,,,9139.95,95,,percent of total billed charges,,,7985.43,83,,percent of total billed charges,,,7985.43,83,,percent of total billed charges,,,,,,,,,,,,,,,7985.43,83,,percent of total billed charges,,,9139.95,95,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,7889.22,82,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,8177.85,85,,percent of total billed charges,,7254.23,9139.95,
**OVERNIGHT PULSE OXIMETRY(V0710),38000250,CDM,94762,CPT,410,RC,inpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,198.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,223.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,198.3,249.85,
SLEEP STUDY UNATTENDED & RESPIRATORY EFF,38000275,CDM,95806,CPT,920,RC,inpatient,,1883,1883,,1598.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1419.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1600.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1657.04,88,,percent of total billed charges,,,,,,,,,1438.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1713.53,91,,percent of total billed charges,,,1788.85,95,,percent of total billed charges,,,1562.89,83,,percent of total billed charges,,,1562.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1562.89,83,,percent of total billed charges,,,1788.85,95,,percent of total billed charges,,,1694.7,90,,percent of total billed charges,,,1694.7,90,,percent of total billed charges,,,1544.06,82,,percent of total billed charges,,,1694.7,90,,percent of total billed charges,,,1600.55,85,,percent of total billed charges,,1419.78,1788.85,
WATCHPAT SLEEP STUDY,38000280,CDM,95800,CPT,920,RC,inpatient,,1783,1783,,1513.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1344.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1515.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1569.04,88,,percent of total billed charges,,,,,,,,,1362.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1622.53,91,,percent of total billed charges,,,1693.85,95,,percent of total billed charges,,,1479.89,83,,percent of total billed charges,,,1479.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1479.89,83,,percent of total billed charges,,,1693.85,95,,percent of total billed charges,,,1604.7,90,,percent of total billed charges,,,1604.7,90,,percent of total billed charges,,,1462.06,82,,percent of total billed charges,,,1604.7,90,,percent of total billed charges,,,1515.55,85,,percent of total billed charges,,1344.38,1693.85,
SLEEP STUDY SUSPENDED,38000300,CDM,95807,CPT,740,RC,inpatient,,3828,3828,,3249.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2886.31,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3253.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3368.64,88,,percent of total billed charges,,,,,,,,,2924.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3483.48,91,,percent of total billed charges,,,3636.6,95,,percent of total billed charges,,,3177.24,83,,percent of total billed charges,,,3177.24,83,,percent of total billed charges,,,,,,,,,,,,,,,3177.24,83,,percent of total billed charges,,,3636.6,95,,percent of total billed charges,,,3445.2,90,,percent of total billed charges,,,3445.2,90,,percent of total billed charges,,,3138.96,82,,percent of total billed charges,,,3445.2,90,,percent of total billed charges,,,3253.8,85,,percent of total billed charges,,2886.31,3636.6,
PAXTON EMG EACH NERVE W/O WAVE,40109000,CDM,95900,CPT,922,RC,inpatient,,118,118,,100.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,88.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,100.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,103.84,88,,percent of total billed charges,,,,,,,,,90.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,107.38,91,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,,,,,,,,,,,,,97.94,83,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,96.76,82,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,88.97,112.1,
PAXTON EMG EACH NERVE MOTOR W F STUDY,40109003,CDM,95903,CPT,922,RC,inpatient,,163,163,,138.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,122.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,138.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,143.44,88,,percent of total billed charges,,,,,,,,,124.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,,,,,,,,,,,,,135.29,83,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,133.66,82,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,122.9,154.85,
PAXTON EMG EACH NERVE SENSORY,40109004,CDM,95904,CPT,922,RC,inpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,76.91,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,86.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,76.91,96.9,
ABDOMINOPLASTY MINI S /SAL ABDOMEN,49000001,CDM,15877,CPT,360,RC,inpatient,,3897,3897,,3308.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2938.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3312.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3429.36,88,,percent of total billed charges,,,,,,,,,2977.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3546.27,91,,percent of total billed charges,,,3702.15,95,,percent of total billed charges,,,3234.51,83,,percent of total billed charges,,,3234.51,83,,percent of total billed charges,,,,,,,,,,,,,,,3234.51,83,,percent of total billed charges,,,3702.15,95,,percent of total billed charges,,,3507.3,90,,percent of total billed charges,,,3507.3,90,,percent of total billed charges,,,3195.54,82,,percent of total billed charges,,,3507.3,90,,percent of total billed charges,,,3312.45,85,,percent of total billed charges,,2938.34,3702.15,
ABDOMINOPLASTY TOTAL SAL ABDOMEN,49000002,CDM,15847,CPT,360,RC,inpatient,,5160,5160,,4380.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3890.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4386,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4540.8,88,,percent of total billed charges,,,,,,,,,3942.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4695.6,91,,percent of total billed charges,,,4902,95,,percent of total billed charges,,,4282.8,83,,percent of total billed charges,,,4282.8,83,,percent of total billed charges,,,,,,,,,,,,,,,4282.8,83,,percent of total billed charges,,,4902,95,,percent of total billed charges,,,4644,90,,percent of total billed charges,,,4644,90,,percent of total billed charges,,,4231.2,82,,percent of total billed charges,,,4644,90,,percent of total billed charges,,,4386,85,,percent of total billed charges,,3890.64,4902,
AUGMENTATION MAMMOPL BILAT IMPL ENDO,49000003,CDM,19325,CPT,360,RC,inpatient,,3764,3764,,3195.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2838.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3199.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3312.32,88,,percent of total billed charges,,,,,,,,,2875.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3425.24,91,,percent of total billed charges,,,3575.8,95,,percent of total billed charges,,,3124.12,83,,percent of total billed charges,,,3124.12,83,,percent of total billed charges,,,,,,,,,,,,,,,3124.12,83,,percent of total billed charges,,,3575.8,95,,percent of total billed charges,,,3387.6,90,,percent of total billed charges,,,3387.6,90,,percent of total billed charges,,,3086.48,82,,percent of total billed charges,,,3387.6,90,,percent of total billed charges,,,3199.4,85,,percent of total billed charges,,2838.06,3575.8,
AUGMENTATION MAMMOPL BILAT IMPL LOW,49000004,CDM,19325,CPT,360,RC,inpatient,,2997,2997,,2544.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2259.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2547.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2637.36,88,,percent of total billed charges,,,,,,,,,2289.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2727.27,91,,percent of total billed charges,,,2847.15,95,,percent of total billed charges,,,2487.51,83,,percent of total billed charges,,,2487.51,83,,percent of total billed charges,,,,,,,,,,,,,,,2487.51,83,,percent of total billed charges,,,2847.15,95,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2457.54,82,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2547.45,85,,percent of total billed charges,,2259.74,2847.15,
AUGMENTATION MAMMOPL BILAT IMPL MOD,49000005,CDM,19325,CPT,360,RC,inpatient,,2997,2997,,2544.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2259.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2547.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2637.36,88,,percent of total billed charges,,,,,,,,,2289.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2727.27,91,,percent of total billed charges,,,2847.15,95,,percent of total billed charges,,,2487.51,83,,percent of total billed charges,,,2487.51,83,,percent of total billed charges,,,,,,,,,,,,,,,2487.51,83,,percent of total billed charges,,,2847.15,95,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2457.54,82,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2547.45,85,,percent of total billed charges,,2259.74,2847.15,
AUGMENTATION MAMMOPL BILAT IMPL HIGH,49000006,CDM,19325,CPT,360,RC,inpatient,,2997,2997,,2544.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2259.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2547.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2637.36,88,,percent of total billed charges,,,,,,,,,2289.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2727.27,91,,percent of total billed charges,,,2847.15,95,,percent of total billed charges,,,2487.51,83,,percent of total billed charges,,,2487.51,83,,percent of total billed charges,,,,,,,,,,,,,,,2487.51,83,,percent of total billed charges,,,2847.15,95,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2457.54,82,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2547.45,85,,percent of total billed charges,,2259.74,2847.15,
AUGMENTATION MAMMOPL UNILATERAL IMPLANT,49000007,CDM,19325,CPT,360,RC,inpatient,,2224,2224,,1888.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1676.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1890.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1957.12,88,,percent of total billed charges,,,,,,,,,1699.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2023.84,91,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1845.92,83,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1823.68,82,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1890.4,85,,percent of total billed charges,,1676.9,2112.8,
AUGMENTATION MAMMOPL SILICONE UNILATERAL,49000008,CDM,19325,CPT,360,RC,inpatient,,2224,2224,,1888.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1676.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1890.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1957.12,88,,percent of total billed charges,,,,,,,,,1699.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2023.84,91,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1845.92,83,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1823.68,82,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1890.4,85,,percent of total billed charges,,1676.9,2112.8,
AUGMENTATION MAMMOPL SILICONE BILATERAL,49000009,CDM,19325,CPT,360,RC,inpatient,,3672,3672,,3117.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2768.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3121.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3231.36,88,,percent of total billed charges,,,,,,,,,2805.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3341.52,91,,percent of total billed charges,,,3488.4,95,,percent of total billed charges,,,3047.76,83,,percent of total billed charges,,,3047.76,83,,percent of total billed charges,,,,,,,,,,,,,,,3047.76,83,,percent of total billed charges,,,3488.4,95,,percent of total billed charges,,,3304.8,90,,percent of total billed charges,,,3304.8,90,,percent of total billed charges,,,3011.04,82,,percent of total billed charges,,,3304.8,90,,percent of total billed charges,,,3121.2,85,,percent of total billed charges,,2768.69,3488.4,
CAPSULECTOMY W/IMPLANT EXC UNIL SALINE,49000010,CDM,19371,CPT,360,RC,inpatient,,2770,2770,,2351.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2088.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2354.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2437.6,88,,percent of total billed charges,,,,,,,,,2116.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2520.7,91,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2299.1,83,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2271.4,82,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2354.5,85,,percent of total billed charges,,2088.58,2631.5,
CAPSULECTOMY W/IMPLANT EXC BILAT SALINE,49000011,CDM,19371,CPT,360,RC,inpatient,,3471,3471,,2946.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2617.13,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2950.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3054.48,88,,percent of total billed charges,,,,,,,,,2651.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3158.61,91,,percent of total billed charges,,,3297.45,95,,percent of total billed charges,,,2880.93,83,,percent of total billed charges,,,2880.93,83,,percent of total billed charges,,,,,,,,,,,,,,,2880.93,83,,percent of total billed charges,,,3297.45,95,,percent of total billed charges,,,3123.9,90,,percent of total billed charges,,,3123.9,90,,percent of total billed charges,,,2846.22,82,,percent of total billed charges,,,3123.9,90,,percent of total billed charges,,,2950.35,85,,percent of total billed charges,,2617.13,3297.45,
CAPSULECTOMY W/IMPLANT EXC UNI SILICONE,49000012,CDM,19371,CPT,360,RC,inpatient,,2770,2770,,2351.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2088.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2354.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2437.6,88,,percent of total billed charges,,,,,,,,,2116.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2520.7,91,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2299.1,83,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2271.4,82,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2354.5,85,,percent of total billed charges,,2088.58,2631.5,
CAPSULECTOMY W/IMPLANT EXC BILA SILICONE,49000013,CDM,19371,CPT,360,RC,inpatient,,5400,5400,,4584.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4071.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4590,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4752,88,,percent of total billed charges,,,,,,,,,4125.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4914,91,,percent of total billed charges,,,5130,95,,percent of total billed charges,,,4482,83,,percent of total billed charges,,,4482,83,,percent of total billed charges,,,,,,,,,,,,,,,4482,83,,percent of total billed charges,,,5130,95,,percent of total billed charges,,,4860,90,,percent of total billed charges,,,4860,90,,percent of total billed charges,,,4428,82,,percent of total billed charges,,,4860,90,,percent of total billed charges,,,4590,85,,percent of total billed charges,,4071.6,5130,
CAPSULOTOMY PERIPROSTHETIC UNILATERAL,49000014,CDM,19371,CPT,360,RC,inpatient,,2224,2224,,1888.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1676.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1890.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1957.12,88,,percent of total billed charges,,,,,,,,,1699.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2023.84,91,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1845.92,83,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1823.68,82,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1890.4,85,,percent of total billed charges,,1676.9,2112.8,
CAPSULOTOMY PERIPROSTHETIC BILATERAL,49000015,CDM,19371,CPT,360,RC,inpatient,,2770,2770,,2351.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2088.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2354.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2437.6,88,,percent of total billed charges,,,,,,,,,2116.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2520.7,91,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2299.1,83,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2271.4,82,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2354.5,85,,percent of total billed charges,,2088.58,2631.5,
CAPSULOTOMY OPEN PERIPROSTH UNILATERAL,49000016,CDM,19370,CPT,360,RC,inpatient,,2770,2770,,2351.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2088.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2354.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2437.6,88,,percent of total billed charges,,,,,,,,,2116.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2520.7,91,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2299.1,83,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2271.4,82,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2354.5,85,,percent of total billed charges,,2088.58,2631.5,
CAPSULOTOMY OPEN PERIPROSTH BILATERAL,49000017,CDM,19370,CPT,360,RC,inpatient,,2770,2770,,2351.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2088.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2354.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2437.6,88,,percent of total billed charges,,,,,,,,,2116.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2520.7,91,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2299.1,83,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2271.4,82,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2354.5,85,,percent of total billed charges,,2088.58,2631.5,
MASTECTOMY GYNECOMASTIA UNILATERAL,49000018,CDM,19300,CPT,360,RC,inpatient,,2472,2472,,2098.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1863.89,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2101.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2175.36,88,,percent of total billed charges,,,,,,,,,1888.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2249.52,91,,percent of total billed charges,,,2348.4,95,,percent of total billed charges,,,2051.76,83,,percent of total billed charges,,,2051.76,83,,percent of total billed charges,,,,,,,,,,,,,,,2051.76,83,,percent of total billed charges,,,2348.4,95,,percent of total billed charges,,,2224.8,90,,percent of total billed charges,,,2224.8,90,,percent of total billed charges,,,2027.04,82,,percent of total billed charges,,,2224.8,90,,percent of total billed charges,,,2101.2,85,,percent of total billed charges,,1863.89,2348.4,
MASTECTOMY GYNECOMASTIA BILATERAL,49000019,CDM,19300,CPT,360,RC,inpatient,,4018,4018,,3411.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3029.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3415.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3535.84,88,,percent of total billed charges,,,,,,,,,3069.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3656.38,91,,percent of total billed charges,,,3817.1,95,,percent of total billed charges,,,3334.94,83,,percent of total billed charges,,,3334.94,83,,percent of total billed charges,,,,,,,,,,,,,,,3334.94,83,,percent of total billed charges,,,3817.1,95,,percent of total billed charges,,,3616.2,90,,percent of total billed charges,,,3616.2,90,,percent of total billed charges,,,3294.76,82,,percent of total billed charges,,,3616.2,90,,percent of total billed charges,,,3415.3,85,,percent of total billed charges,,3029.57,3817.1,
MASTOPEXY AUGMENTATION MAMOPLASTY,49000020,CDM,19340,CPT,360,RC,inpatient,,4851,4851,,4118.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3657.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4123.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4268.88,88,,percent of total billed charges,,,,,,,,,3706.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4414.41,91,,percent of total billed charges,,,4608.45,95,,percent of total billed charges,,,4026.33,83,,percent of total billed charges,,,4026.33,83,,percent of total billed charges,,,,,,,,,,,,,,,4026.33,83,,percent of total billed charges,,,4608.45,95,,percent of total billed charges,,,4365.9,90,,percent of total billed charges,,,4365.9,90,,percent of total billed charges,,,3977.82,82,,percent of total billed charges,,,4365.9,90,,percent of total billed charges,,,4123.35,85,,percent of total billed charges,,3657.65,4608.45,
MASTOPEXY AUGMENTATION MAMO SILICONE,49000021,CDM,19340,CPT,360,RC,inpatient,,5346,5346,,4538.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4030.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4544.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4704.48,88,,percent of total billed charges,,,,,,,,,4084.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4864.86,91,,percent of total billed charges,,,5078.7,95,,percent of total billed charges,,,4437.18,83,,percent of total billed charges,,,4437.18,83,,percent of total billed charges,,,,,,,,,,,,,,,4437.18,83,,percent of total billed charges,,,5078.7,95,,percent of total billed charges,,,4811.4,90,,percent of total billed charges,,,4811.4,90,,percent of total billed charges,,,4383.72,82,,percent of total billed charges,,,4811.4,90,,percent of total billed charges,,,4544.1,85,,percent of total billed charges,,4030.88,5078.7,
MASTOPEXY UNILATERAL,49000022,CDM,19316,CPT,360,RC,inpatient,,3081,3081,,2615.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2323.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2618.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2711.28,88,,percent of total billed charges,,,,,,,,,2353.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2803.71,91,,percent of total billed charges,,,2926.95,95,,percent of total billed charges,,,2557.23,83,,percent of total billed charges,,,2557.23,83,,percent of total billed charges,,,,,,,,,,,,,,,2557.23,83,,percent of total billed charges,,,2926.95,95,,percent of total billed charges,,,2772.9,90,,percent of total billed charges,,,2772.9,90,,percent of total billed charges,,,2526.42,82,,percent of total billed charges,,,2772.9,90,,percent of total billed charges,,,2618.85,85,,percent of total billed charges,,2323.07,2926.95,
MASTOPEXY BIILATERAL,49000023,CDM,19316,CPT,360,RC,inpatient,,3720,3720,,3158.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2804.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3162,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3273.6,88,,percent of total billed charges,,,,,,,,,2842.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3385.2,91,,percent of total billed charges,,,3534,95,,percent of total billed charges,,,3087.6,83,,percent of total billed charges,,,3087.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3087.6,83,,percent of total billed charges,,,3534,95,,percent of total billed charges,,,3348,90,,percent of total billed charges,,,3348,90,,percent of total billed charges,,,3050.4,82,,percent of total billed charges,,,3348,90,,percent of total billed charges,,,3162,85,,percent of total billed charges,,2804.88,3534,
REDUCTION MAMMOPLASTY UNILATERAL,49000024,CDM,19318,CPT,360,RC,inpatient,,4593,4593,,3899.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3463.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3904.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4041.84,88,,percent of total billed charges,,,,,,,,,3509.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4179.63,91,,percent of total billed charges,,,4363.35,95,,percent of total billed charges,,,3812.19,83,,percent of total billed charges,,,3812.19,83,,percent of total billed charges,,,,,,,,,,,,,,,3812.19,83,,percent of total billed charges,,,4363.35,95,,percent of total billed charges,,,4133.7,90,,percent of total billed charges,,,4133.7,90,,percent of total billed charges,,,3766.26,82,,percent of total billed charges,,,4133.7,90,,percent of total billed charges,,,3904.05,85,,percent of total billed charges,,3463.12,4363.35,
REDUCTION MAMMOPLASTY BILATERAL,49000025,CDM,19318,CPT,360,RC,inpatient,,5068,5068,,4302.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3821.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4307.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4459.84,88,,percent of total billed charges,,,,,,,,,3871.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4611.88,91,,percent of total billed charges,,,4814.6,95,,percent of total billed charges,,,4206.44,83,,percent of total billed charges,,,4206.44,83,,percent of total billed charges,,,,,,,,,,,,,,,4206.44,83,,percent of total billed charges,,,4814.6,95,,percent of total billed charges,,,4561.2,90,,percent of total billed charges,,,4561.2,90,,percent of total billed charges,,,4155.76,82,,percent of total billed charges,,,4561.2,90,,percent of total billed charges,,,4307.8,85,,percent of total billed charges,,3821.27,4814.6,
BROWLIFT ENDO OR OPEN,49000026,CDM,67900,CPT,360,RC,inpatient,,2855,2855,,2423.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2152.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2426.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2512.4,88,,percent of total billed charges,,,,,,,,,2181.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2598.05,91,,percent of total billed charges,,,2712.25,95,,percent of total billed charges,,,2369.65,83,,percent of total billed charges,,,2369.65,83,,percent of total billed charges,,,,,,,,,,,,,,,2369.65,83,,percent of total billed charges,,,2712.25,95,,percent of total billed charges,,,2569.5,90,,percent of total billed charges,,,2569.5,90,,percent of total billed charges,,,2341.1,82,,percent of total billed charges,,,2569.5,90,,percent of total billed charges,,,2426.75,85,,percent of total billed charges,,2152.67,2712.25,
CHIN AUGMENTATION,49000027,CDM,21120,CPT,360,RC,inpatient,,3089,3089,,2622.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2329.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2625.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2718.32,88,,percent of total billed charges,,,,,,,,,2360,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2810.99,91,,percent of total billed charges,,,2934.55,95,,percent of total billed charges,,,2563.87,83,,percent of total billed charges,,,2563.87,83,,percent of total billed charges,,,,,,,,,,,,,,,2563.87,83,,percent of total billed charges,,,2934.55,95,,percent of total billed charges,,,2780.1,90,,percent of total billed charges,,,2780.1,90,,percent of total billed charges,,,2532.98,82,,percent of total billed charges,,,2780.1,90,,percent of total billed charges,,,2625.65,85,,percent of total billed charges,,2329.11,2934.55,
OTOPLASTY UNILATERAL,49000028,CDM,69300,CPT,360,RC,inpatient,,2293,2293,,1946.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1728.92,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1949.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2017.84,88,,percent of total billed charges,,,,,,,,,1751.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2086.63,91,,percent of total billed charges,,,2178.35,95,,percent of total billed charges,,,1903.19,83,,percent of total billed charges,,,1903.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1903.19,83,,percent of total billed charges,,,2178.35,95,,percent of total billed charges,,,2063.7,90,,percent of total billed charges,,,2063.7,90,,percent of total billed charges,,,1880.26,82,,percent of total billed charges,,,2063.7,90,,percent of total billed charges,,,1949.05,85,,percent of total billed charges,,1728.92,2178.35,
OTOPLASTY BILATERAL,49000029,CDM,69300,CPT,360,RC,inpatient,,3121,3121,,2649.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2353.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2652.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2746.48,88,,percent of total billed charges,,,,,,,,,2384.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2840.11,91,,percent of total billed charges,,,2964.95,95,,percent of total billed charges,,,2590.43,83,,percent of total billed charges,,,2590.43,83,,percent of total billed charges,,,,,,,,,,,,,,,2590.43,83,,percent of total billed charges,,,2964.95,95,,percent of total billed charges,,,2808.9,90,,percent of total billed charges,,,2808.9,90,,percent of total billed charges,,,2559.22,82,,percent of total billed charges,,,2808.9,90,,percent of total billed charges,,,2652.85,85,,percent of total billed charges,,2353.23,2964.95,
BLEPHAROPLASTY SKIN FAT BILAT LOWER COMP,49000030,CDM,15821,CPT,360,RC,inpatient,,2093,2093,,1776.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1578.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1779.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1841.84,88,,percent of total billed charges,,,,,,,,,1599.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1904.63,91,,percent of total billed charges,,,1988.35,95,,percent of total billed charges,,,1737.19,83,,percent of total billed charges,,,1737.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1737.19,83,,percent of total billed charges,,,1988.35,95,,percent of total billed charges,,,1883.7,90,,percent of total billed charges,,,1883.7,90,,percent of total billed charges,,,1716.26,82,,percent of total billed charges,,,1883.7,90,,percent of total billed charges,,,1779.05,85,,percent of total billed charges,,1578.12,1988.35,
BLEPHAROPLASTY SKIN BILAT UPPER,49000031,CDM,15822,CPT,360,RC,inpatient,,2583,2583,,2192.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1947.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2195.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2273.04,88,,percent of total billed charges,,,,,,,,,1973.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2350.53,91,,percent of total billed charges,,,2453.85,95,,percent of total billed charges,,,2143.89,83,,percent of total billed charges,,,2143.89,83,,percent of total billed charges,,,,,,,,,,,,,,,2143.89,83,,percent of total billed charges,,,2453.85,95,,percent of total billed charges,,,2324.7,90,,percent of total billed charges,,,2324.7,90,,percent of total billed charges,,,2118.06,82,,percent of total billed charges,,,2324.7,90,,percent of total billed charges,,,2195.55,85,,percent of total billed charges,,1947.58,2453.85,
BLEPHAROPLASTY BILATERAL UPPER/LOWER,49000032,CDM,15822,CPT,360,RC,inpatient,,3121,3121,,2649.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2353.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2652.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2746.48,88,,percent of total billed charges,,,,,,,,,2384.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2840.11,91,,percent of total billed charges,,,2964.95,95,,percent of total billed charges,,,2590.43,83,,percent of total billed charges,,,2590.43,83,,percent of total billed charges,,,,,,,,,,,,,,,2590.43,83,,percent of total billed charges,,,2964.95,95,,percent of total billed charges,,,2808.9,90,,percent of total billed charges,,,2808.9,90,,percent of total billed charges,,,2559.22,82,,percent of total billed charges,,,2808.9,90,,percent of total billed charges,,,2652.85,85,,percent of total billed charges,,2353.23,2964.95,
RHYTIDECTOMY CHEEK LIFT SMAS FLAP,49000033,CDM,15829,CPT,360,RC,inpatient,,5756,5756,,4886.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4340.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4892.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5065.28,88,,percent of total billed charges,,,,,,,,,4397.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5237.96,91,,percent of total billed charges,,,5468.2,95,,percent of total billed charges,,,4777.48,83,,percent of total billed charges,,,4777.48,83,,percent of total billed charges,,,,,,,,,,,,,,,4777.48,83,,percent of total billed charges,,,5468.2,95,,percent of total billed charges,,,5180.4,90,,percent of total billed charges,,,5180.4,90,,percent of total billed charges,,,4719.92,82,,percent of total billed charges,,,5180.4,90,,percent of total billed charges,,,4892.6,85,,percent of total billed charges,,4340.02,5468.2,
RHYTIDECTOMY CHEEK LIFT SMAS NECK LIFT,49000034,CDM,15828,CPT,360,RC,inpatient,,6476,6476,,5498.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4882.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5504.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5698.88,88,,percent of total billed charges,,,,,,,,,4947.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5893.16,91,,percent of total billed charges,,,6152.2,95,,percent of total billed charges,,,5375.08,83,,percent of total billed charges,,,5375.08,83,,percent of total billed charges,,,,,,,,,,,,,,,5375.08,83,,percent of total billed charges,,,6152.2,95,,percent of total billed charges,,,5828.4,90,,percent of total billed charges,,,5828.4,90,,percent of total billed charges,,,5310.32,82,,percent of total billed charges,,,5828.4,90,,percent of total billed charges,,,5504.6,85,,percent of total billed charges,,4882.9,6152.2,
RHYTIDECTOMY NECKLIFT W/PLATSYMAL TIGHT,49000035,CDM,15825,CPT,360,RC,inpatient,,3973,3973,,3373.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2995.64,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3377.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3496.24,88,,percent of total billed charges,,,,,,,,,3035.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3615.43,91,,percent of total billed charges,,,3774.35,95,,percent of total billed charges,,,3297.59,83,,percent of total billed charges,,,3297.59,83,,percent of total billed charges,,,,,,,,,,,,,,,3297.59,83,,percent of total billed charges,,,3774.35,95,,percent of total billed charges,,,3575.7,90,,percent of total billed charges,,,3575.7,90,,percent of total billed charges,,,3257.86,82,,percent of total billed charges,,,3575.7,90,,percent of total billed charges,,,3377.05,85,,percent of total billed charges,,2995.64,3774.35,
RHINOPLASTY COMP W/BONY PYRAMID FX,49000036,CDM,30410,CPT,360,RC,inpatient,,3609,3609,,3064.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2721.19,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3067.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3175.92,88,,percent of total billed charges,,,,,,,,,2757.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3284.19,91,,percent of total billed charges,,,3428.55,95,,percent of total billed charges,,,2995.47,83,,percent of total billed charges,,,2995.47,83,,percent of total billed charges,,,,,,,,,,,,,,,2995.47,83,,percent of total billed charges,,,3428.55,95,,percent of total billed charges,,,3248.1,90,,percent of total billed charges,,,3248.1,90,,percent of total billed charges,,,2959.38,82,,percent of total billed charges,,,3248.1,90,,percent of total billed charges,,,3067.65,85,,percent of total billed charges,,2721.19,3428.55,
BUTTOCK LIFT,49000037,CDM,15835,CPT,360,RC,inpatient,,4128,4128,,3504.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3112.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3508.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3632.64,88,,percent of total billed charges,,,,,,,,,3153.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3756.48,91,,percent of total billed charges,,,3921.6,95,,percent of total billed charges,,,3426.24,83,,percent of total billed charges,,,3426.24,83,,percent of total billed charges,,,,,,,,,,,,,,,3426.24,83,,percent of total billed charges,,,3921.6,95,,percent of total billed charges,,,3715.2,90,,percent of total billed charges,,,3715.2,90,,percent of total billed charges,,,3384.96,82,,percent of total billed charges,,,3715.2,90,,percent of total billed charges,,,3508.8,85,,percent of total billed charges,,3112.51,3921.6,
THIGH LIFT BILATERAL,49000038,CDM,15832,CPT,360,RC,inpatient,,4757,4757,,4038.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3586.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4043.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4186.16,88,,percent of total billed charges,,,,,,,,,3634.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4328.87,91,,percent of total billed charges,,,4519.15,95,,percent of total billed charges,,,3948.31,83,,percent of total billed charges,,,3948.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3948.31,83,,percent of total billed charges,,,4519.15,95,,percent of total billed charges,,,4281.3,90,,percent of total billed charges,,,4281.3,90,,percent of total billed charges,,,3900.74,82,,percent of total billed charges,,,4281.3,90,,percent of total billed charges,,,4043.45,85,,percent of total billed charges,,3586.78,4519.15,
THIGH LIFT UNILATERAL,49000039,CDM,15832,CPT,360,RC,inpatient,,3690,3690,,3132.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2782.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3136.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3247.2,88,,percent of total billed charges,,,,,,,,,2819.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3357.9,91,,percent of total billed charges,,,3505.5,95,,percent of total billed charges,,,3062.7,83,,percent of total billed charges,,,3062.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3062.7,83,,percent of total billed charges,,,3505.5,95,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3025.8,82,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3136.5,85,,percent of total billed charges,,2782.26,3505.5,
ARM LIFT BRACHIOPLASTY BILATERAL,49000040,CDM,15836,CPT,360,RC,inpatient,,3262,3262,,2769.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2459.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2772.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2870.56,88,,percent of total billed charges,,,,,,,,,2492.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2968.42,91,,percent of total billed charges,,,3098.9,95,,percent of total billed charges,,,2707.46,83,,percent of total billed charges,,,2707.46,83,,percent of total billed charges,,,,,,,,,,,,,,,2707.46,83,,percent of total billed charges,,,3098.9,95,,percent of total billed charges,,,2935.8,90,,percent of total billed charges,,,2935.8,90,,percent of total billed charges,,,2674.84,82,,percent of total billed charges,,,2935.8,90,,percent of total billed charges,,,2772.7,85,,percent of total billed charges,,2459.55,3098.9,
SUCTION ASSITED LIPECTOMY HEAD NECK,49000041,CDM,15876,CPT,360,RC,inpatient,,2224,2224,,1888.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1676.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1890.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1957.12,88,,percent of total billed charges,,,,,,,,,1699.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2023.84,91,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1845.92,83,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1823.68,82,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1890.4,85,,percent of total billed charges,,1676.9,2112.8,
SUCTION ASSITED LIPECTOMY TRUCK,49000042,CDM,15877,CPT,360,RC,inpatient,,2760,2760,,2343.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2081.04,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2346,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2428.8,88,,percent of total billed charges,,,,,,,,,2108.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2511.6,91,,percent of total billed charges,,,2622,95,,percent of total billed charges,,,2290.8,83,,percent of total billed charges,,,2290.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2290.8,83,,percent of total billed charges,,,2622,95,,percent of total billed charges,,,2484,90,,percent of total billed charges,,,2484,90,,percent of total billed charges,,,2263.2,82,,percent of total billed charges,,,2484,90,,percent of total billed charges,,,2346,85,,percent of total billed charges,,2081.04,2622,
SUCTION ASSITED LIPECTOMY UPPER EXTR,49000043,CDM,15878,CPT,360,RC,inpatient,,2224,2224,,1888.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1676.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1890.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1957.12,88,,percent of total billed charges,,,,,,,,,1699.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2023.84,91,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1845.92,83,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1823.68,82,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1890.4,85,,percent of total billed charges,,1676.9,2112.8,
SUCTION ASSITED LIPECTOMY LOWER EXTR,49000044,CDM,15879,CPT,360,RC,inpatient,,2400,2400,,2037.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1809.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2040,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2112,88,,percent of total billed charges,,,,,,,,,1833.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2184,91,,percent of total billed charges,,,2280,95,,percent of total billed charges,,,1992,83,,percent of total billed charges,,,1992,83,,percent of total billed charges,,,,,,,,,,,,,,,1992,83,,percent of total billed charges,,,2280,95,,percent of total billed charges,,,2160,90,,percent of total billed charges,,,2160,90,,percent of total billed charges,,,1968,82,,percent of total billed charges,,,2160,90,,percent of total billed charges,,,2040,85,,percent of total billed charges,,1809.6,2280,
FF ADMINISTRATION FLU VACCINE,50320000,CDM,G0008,HCPCS,771,RC,inpatient,,33,33,,28.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,24.88,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,28.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,29.04,88,,percent of total billed charges,,,,,,,,,25.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,30.03,91,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,,,,,,,,,,,,,27.39,83,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,27.06,82,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,28.05,85,,percent of total billed charges,,24.88,31.35,
<=MAINTENANCE WORK REQUEST=>,53230001,CDM,,,636,RC,inpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,2.26,2.85,
<=ELECTRICAL WORK REQUEST=>,53230002,CDM,,,636,RC,inpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,2.26,2.85,
<=PLUMBING WORK REQUEST=>,53230003,CDM,,,636,RC,inpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,2.26,2.85,
<=HVAC WORK REQUEST=>,53230004,CDM,,,636,RC,inpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,2.26,2.85,
<=PAINTING WORK REQUEST=>,53230005,CDM,,,636,RC,inpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,2.26,2.85,
MODERNA COVID-19 VACCINE ADMIN 1ST DOSE,58000001,CDM,0011A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
MODERNA COVID-19 VACCINE ADMIN 2ND DOSE,58000002,CDM,0012A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
PFIZER COVID-19 VACCINE ADMIN 1ST DOSE,58000003,CDM,0001A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
PFIZER COVID-19 VACCINE ADMIN 2ND DOSE,58000004,CDM,0002A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
MODERNA COVID-19 VACCINE ADMIN 3RD DOSE,58000005,CDM,0013A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
PFIZER COVID-19 VACCINE ADMIN 3RD DOSE,58000006,CDM,0003A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
PFIZER COVID-19 VACCINE ADMIN 1ST D/PEDS,58000007,CDM,0071A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
PFIZER COVID-19 VACCINE ADMIN 2ND D/PEDS,58000008,CDM,0072A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
PFIZER COVID-19 VACCINE ADMIN 4TH DOSE,58000009,CDM,0004A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
MODERNA COVID-19 VACCINE ADMIN 4TH DOSE,58000010,CDM,0064A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
PFIZER COVID-19 VACCINE ADMIN 3RD D/PEDS,58000011,CDM,0073A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
MODERNA COVID-19 VACCINE ADMIN 1ST D/PED,58000012,CDM,0104A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
MODERNA COVID-19 VACCINE BIVALENT 18+,58000013,CDM,0134A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
PFIZER COVID-19 VACCINE BIVALENT 12+,58000014,CDM,0124A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
PFIZER COVID-19 PED (6 MONTH-4 YEAR) 1ST,58000015,CDM,0081A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
PFIZER COVID-19 PED (6 MONTH-4 YEAR) 2ND,58000016,CDM,0082A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
PFIZER COVID-19 PED (6 MONTH-4 YEAR) 3RD,58000017,CDM,0083A,CPT,771,RC,inpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,60.32,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,68,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,60.32,76,
MASK FIT TEST,62000000,CDM,,,220,RC,inpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,30.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,34,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,30.16,38,
NEG PRESS WOUND TX </= 50 CM,4540501,CDM,97607,CPT,510,RC,inpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,347.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,391.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,347.59,437.95,
NEW E&M PATIENT LEVEL 1,8100100,CDM,G0463,HCPCS,510,RC,inpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,345.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,306.12,385.7,
NEW E&M PATIENT LEVEL 2,8100101,CDM,G0463,HCPCS,510,RC,inpatient,,492,492,,417.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,370.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,418.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,432.96,88,,percent of total billed charges,,,,,,,,,375.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,447.72,91,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,,,,,,,,,,,,,408.36,83,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,403.44,82,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,370.97,467.4,
NEW E&M PATIENT LEVEL 3,8100102,CDM,G0463,HCPCS,510,RC,inpatient,,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,454.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,512.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,454.66,572.85,
NEW E&M PATIENT LEVEL 4,8100103,CDM,G0463,HCPCS,510,RC,inpatient,,755,755,,641,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,569.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,641.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,664.4,88,,percent of total billed charges,,,,,,,,,576.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,687.05,91,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,,,,,,,,,,,,,626.65,83,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,619.1,82,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,569.27,717.25,
NEW E&M PATIENT LEVEL 5,8100104,CDM,G0463,HCPCS,510,RC,inpatient,,962,962,,816.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,725.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,817.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,846.56,88,,percent of total billed charges,,,,,,,,,734.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,875.42,91,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,,,,,,,,,,,,,798.46,83,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,788.84,82,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,817.7,85,,percent of total billed charges,,725.35,913.9,
ESTABLISHED E&M PATIENT LEVEL 1,8100120,CDM,G0463,HCPCS,510,RC,inpatient,,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,280.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,316.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,280.49,353.4,
ESTABLISHED E&M PATIENT LEVEL 2,8100121,CDM,G0463,HCPCS,510,RC,inpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,347.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,391.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,347.59,437.95,
ESTABLISHED E&M PATIENT LEVEL 3,8100122,CDM,G0463,HCPCS,510,RC,inpatient,,586,586,,497.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,441.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,498.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,515.68,88,,percent of total billed charges,,,,,,,,,447.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,533.26,91,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,,,,,,,,,,,,,486.38,83,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,480.52,82,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,498.1,85,,percent of total billed charges,,441.84,556.7,
ESTABLISHED E&M PATIENT LEVEL 4,8100123,CDM,G0463,HCPCS,510,RC,inpatient,,727,727,,617.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,548.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,617.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,639.76,88,,percent of total billed charges,,,,,,,,,555.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,661.57,91,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,,,,,,,,,,,,,603.41,83,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,596.14,82,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,617.95,85,,percent of total billed charges,,548.16,690.65,
ESTABLISHED E&M PATIENT LEVEL 5,8100124,CDM,G0463,HCPCS,510,RC,inpatient,,943,943,,800.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,711.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,801.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,829.84,88,,percent of total billed charges,,,,,,,,,720.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,858.13,91,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,,,,,,,,,,,,,782.69,83,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,773.26,82,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,801.55,85,,percent of total billed charges,,711.02,895.85,
INC/DRAIN ABSCESS - SIMPLE OR SIN W/MOD,8110060,CDM,10060,CPT,761,RC,inpatient,59,654,654,,555.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,493.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,555.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,575.52,88,,percent of total billed charges,,,,,,,,,499.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,595.14,91,,percent of total billed charges,,,621.3,95,,percent of total billed charges,,,542.82,83,,percent of total billed charges,,,542.82,83,,percent of total billed charges,,,,,,,,,,,,,,,542.82,83,,percent of total billed charges,,,621.3,95,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,536.28,82,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,555.9,85,,percent of total billed charges,,493.12,621.3,
INC/DRAIN ABS- COMPLICATED OR MULT W/MOD,8110061,CDM,10061,CPT,761,RC,inpatient,59,477,477,,404.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,359.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,405.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,419.76,88,,percent of total billed charges,,,,,,,,,364.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,434.07,91,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,,,,,,,,,,,,,395.91,83,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,391.14,82,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,359.66,453.15,
DEBRIDEMENT SKIN & SUBC TISSUE W/MOD,8111042,CDM,11042,CPT,761,RC,inpatient,59,1435,1435,,1218.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1081.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1219.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1262.8,88,,percent of total billed charges,,,,,,,,,1096.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1305.85,91,,percent of total billed charges,,,1363.25,95,,percent of total billed charges,,,1191.05,83,,percent of total billed charges,,,1191.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1191.05,83,,percent of total billed charges,,,1363.25,95,,percent of total billed charges,,,1291.5,90,,percent of total billed charges,,,1291.5,90,,percent of total billed charges,,,1176.7,82,,percent of total billed charges,,,1291.5,90,,percent of total billed charges,,,1219.75,85,,percent of total billed charges,,1081.99,1363.25,
DEBRIDE MUSC FAS<20 W/MOD,8111043,CDM,11043,CPT,761,RC,inpatient,59,1440,1440,,1222.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1085.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1224,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1267.2,88,,percent of total billed charges,,,,,,,,,1100.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1310.4,91,,percent of total billed charges,,,1368,95,,percent of total billed charges,,,1195.2,83,,percent of total billed charges,,,1195.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1195.2,83,,percent of total billed charges,,,1368,95,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1180.8,82,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1224,85,,percent of total billed charges,,1085.76,1368,
DEBRIDEMENT BONE < 20 W/MOD,8111044,CDM,11044,CPT,761,RC,inpatient,59,2623,2623,,2226.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1977.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2229.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2308.24,88,,percent of total billed charges,,,,,,,,,2003.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2386.93,91,,percent of total billed charges,,,2491.85,95,,percent of total billed charges,,,2177.09,83,,percent of total billed charges,,,2177.09,83,,percent of total billed charges,,,,,,,,,,,,,,,2177.09,83,,percent of total billed charges,,,2491.85,95,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2150.86,82,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2229.55,85,,percent of total billed charges,,1977.74,2491.85,
DEBRIDE SUBQ EA ADDTL 20 SQCM W/MOD,8111045,CDM,11045,CPT,761,RC,inpatient,59,1193,1193,,1012.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,899.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1014.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1049.84,88,,percent of total billed charges,,,,,,,,,911.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1085.63,91,,percent of total billed charges,,,1133.35,95,,percent of total billed charges,,,990.19,83,,percent of total billed charges,,,990.19,83,,percent of total billed charges,,,,,,,,,,,,,,,990.19,83,,percent of total billed charges,,,1133.35,95,,percent of total billed charges,,,1073.7,90,,percent of total billed charges,,,1073.7,90,,percent of total billed charges,,,978.26,82,,percent of total billed charges,,,1073.7,90,,percent of total billed charges,,,1014.05,85,,percent of total billed charges,,899.52,1133.35,
DEBRIDE MUSC FAS EA ADDTL <20 W/MOD,8111046,CDM,11046,CPT,761,RC,inpatient,59,1440,1440,,1222.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1085.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1224,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1267.2,88,,percent of total billed charges,,,,,,,,,1100.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1310.4,91,,percent of total billed charges,,,1368,95,,percent of total billed charges,,,1195.2,83,,percent of total billed charges,,,1195.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1195.2,83,,percent of total billed charges,,,1368,95,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1180.8,82,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1224,85,,percent of total billed charges,,1085.76,1368,
DEBRIDEMENT BONE EA ADDTL < 20 W/MOD,8111047,CDM,11047,CPT,761,RC,inpatient,59,2623,2623,,2226.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1977.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2229.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2308.24,88,,percent of total billed charges,,,,,,,,,2003.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2386.93,91,,percent of total billed charges,,,2491.85,95,,percent of total billed charges,,,2177.09,83,,percent of total billed charges,,,2177.09,83,,percent of total billed charges,,,,,,,,,,,,,,,2177.09,83,,percent of total billed charges,,,2491.85,95,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2150.86,82,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2229.55,85,,percent of total billed charges,,1977.74,2491.85,
PARE/CUT BENIGH HYPERKERA 2-4 LES W/MOD,8111056,CDM,11056,CPT,761,RC,inpatient,59,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,351.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,351.36,442.7,
PARE/CUT BENIGH HYPERKERA >4 LES W/MOD,8111057,CDM,11057,CPT,761,RC,inpatient,59,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,351.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,351.36,442.7,
BX SKIN/SQ TISSUE MUCOUS MEMB SNGL W/MOD,8111100,CDM,11102,CPT,761,RC,inpatient,59,668,668,,567.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,503.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,567.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,587.84,88,,percent of total billed charges,,,,,,,,,510.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,607.88,91,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,,,,,,,,,,,,,554.44,83,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,547.76,82,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,567.8,85,,percent of total billed charges,,503.67,634.6,
"BX SKIN, EA SEP/ADDT'L LESION W/MOD",8111101,CDM,11103,CPT,761,RC,inpatient,59,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,330.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,372.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,330.25,416.1,
FF EX BEN LESION MARGINS >4.0CM W MOD,8111406,CDM,11406,CPT,761,RC,inpatient,59,6271,6271,,5324.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4728.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5330.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5518.48,88,,percent of total billed charges,,,,,,,,,4791.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5706.61,91,,percent of total billed charges,,,5957.45,95,,percent of total billed charges,,,5204.93,83,,percent of total billed charges,,,5204.93,83,,percent of total billed charges,,,,,,,,,,,,,,,5204.93,83,,percent of total billed charges,,,5957.45,95,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5142.22,82,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5330.35,85,,percent of total billed charges,,4728.33,5957.45,
TRIM NAILS NONDYSTROPHIC W/MOD,8111719,CDM,11719,CPT,761,RC,inpatient,59,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
"DEBRID OF NAIL(S), ANY METH, 1-5 W/MOD",8111720,CDM,11720,CPT,761,RC,inpatient,59,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,251.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,283.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,251.08,316.35,
"DEBRID NAILS, ANY METH, 6 OR MORE W/MOD",8111721,CDM,11721,CPT,761,RC,inpatient,59,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,353.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,398.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,353.63,445.55,
"AVUL NAIL PLATE, PTL OR COMP, SNGL W/MOD",8111730,CDM,11730,CPT,761,RC,inpatient,59,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,330.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,372.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,330.25,416.1,
AVULSION EA ADDT'L NAIL PLATE W/MOD,8111732,CDM,11732,CPT,761,RC,inpatient,59,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,269.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,303.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,269.18,339.15,
"EXC NAIL & NA MATRIX, PTL OR COMP W/MOD",8111750,CDM,11750,CPT,761,RC,inpatient,59,1282,1282,,1088.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,966.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1089.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1128.16,88,,percent of total billed charges,,,,,,,,,979.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1166.62,91,,percent of total billed charges,,,1217.9,95,,percent of total billed charges,,,1064.06,83,,percent of total billed charges,,,1064.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1064.06,83,,percent of total billed charges,,,1217.9,95,,percent of total billed charges,,,1153.8,90,,percent of total billed charges,,,1153.8,90,,percent of total billed charges,,,1051.24,82,,percent of total billed charges,,,1153.8,90,,percent of total billed charges,,,1089.7,85,,percent of total billed charges,,966.63,1217.9,
FF AP SKIN SUB 1ST SQ CM TR AR LEG W/MOD,8115271,CDM,15271,CPT,761,RC,inpatient,59,2037,2037,,1729.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1535.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1731.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1792.56,88,,percent of total billed charges,,,,,,,,,1556.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1853.67,91,,percent of total billed charges,,,1935.15,95,,percent of total billed charges,,,1690.71,83,,percent of total billed charges,,,1690.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1690.71,83,,percent of total billed charges,,,1935.15,95,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1670.34,82,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1731.45,85,,percent of total billed charges,,1535.9,1935.15,
FF APL SKIN SUB ECH AD 25 SQ CM TR W/MOD,8115272,CDM,15272,CPT,761,RC,inpatient,59,223,223,,189.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.24,88,,percent of total billed charges,,,,,,,,,170.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,202.93,91,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,,,,,,,,,,,,,185.09,83,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,182.86,82,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,168.14,211.85,
FF APL SKIN SUB 1ST 100 SQ CM TK A W/MOD,8115273,CDM,15273,CPT,761,RC,inpatient,59,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4426.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4990.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,4426.73,5577.45,
FF APPL SKIN SUB ECH ADD 100 W/MOD,8115274,CDM,15274,CPT,761,RC,inpatient,59,442,442,,375.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,333.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,375.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.96,88,,percent of total billed charges,,,,,,,,,337.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,402.22,91,,percent of total billed charges,,,419.9,95,,percent of total billed charges,,,366.86,83,,percent of total billed charges,,,366.86,83,,percent of total billed charges,,,,,,,,,,,,,,,366.86,83,,percent of total billed charges,,,419.9,95,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,362.44,82,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,375.7,85,,percent of total billed charges,,333.27,419.9,
FF APL SKIN SUB 1ST SQ CM FAC SCA W/MOD,8115275,CDM,15275,CPT,761,RC,inpatient,59,2648,2648,,2248.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1996.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2250.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2330.24,88,,percent of total billed charges,,,,,,,,,2023.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2409.68,91,,percent of total billed charges,,,2515.6,95,,percent of total billed charges,,,2197.84,83,,percent of total billed charges,,,2197.84,83,,percent of total billed charges,,,,,,,,,,,,,,,2197.84,83,,percent of total billed charges,,,2515.6,95,,percent of total billed charges,,,2383.2,90,,percent of total billed charges,,,2383.2,90,,percent of total billed charges,,,2171.36,82,,percent of total billed charges,,,2383.2,90,,percent of total billed charges,,,2250.8,85,,percent of total billed charges,,1996.59,2515.6,
FF APL SKIN SUB ECH AD 25 SQ CM FA W/MOD,8115276,CDM,15276,CPT,761,RC,inpatient,59,622,622,,528.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,468.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,528.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,547.36,88,,percent of total billed charges,,,,,,,,,475.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,566.02,91,,percent of total billed charges,,,590.9,95,,percent of total billed charges,,,516.26,83,,percent of total billed charges,,,516.26,83,,percent of total billed charges,,,,,,,,,,,,,,,516.26,83,,percent of total billed charges,,,590.9,95,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,510.04,82,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,528.7,85,,percent of total billed charges,,468.99,590.9,
FF APL SKIN SUB 1ST 100 SQ CM FA W/MOD,8115277,CDM,15277,CPT,761,RC,inpatient,59,1941,1941,,1647.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1463.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1649.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1708.08,88,,percent of total billed charges,,,,,,,,,1482.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1766.31,91,,percent of total billed charges,,,1843.95,95,,percent of total billed charges,,,1611.03,83,,percent of total billed charges,,,1611.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1611.03,83,,percent of total billed charges,,,1843.95,95,,percent of total billed charges,,,1746.9,90,,percent of total billed charges,,,1746.9,90,,percent of total billed charges,,,1591.62,82,,percent of total billed charges,,,1746.9,90,,percent of total billed charges,,,1649.85,85,,percent of total billed charges,,1463.51,1843.95,
FF APPL SKIN SUB ECH ADD 100 FACE W/MOD,8115278,CDM,15278,CPT,761,RC,inpatient,59,557,557,,472.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,419.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,473.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,490.16,88,,percent of total billed charges,,,,,,,,,425.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,506.87,91,,percent of total billed charges,,,529.15,95,,percent of total billed charges,,,462.31,83,,percent of total billed charges,,,462.31,83,,percent of total billed charges,,,,,,,,,,,,,,,462.31,83,,percent of total billed charges,,,529.15,95,,percent of total billed charges,,,501.3,90,,percent of total billed charges,,,501.3,90,,percent of total billed charges,,,456.74,82,,percent of total billed charges,,,501.3,90,,percent of total billed charges,,,473.45,85,,percent of total billed charges,,419.98,529.15,
"DRESSINGS/DEBRIDEMENT BURNS, SMALL W/MOD",8116020,CDM,16020,CPT,761,RC,inpatient,59,432,432,,366.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,325.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,367.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,380.16,88,,percent of total billed charges,,,,,,,,,330.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,393.12,91,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,,,,,,,,,,,,,358.56,83,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,354.24,82,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,325.73,410.4,
"DRESSINGS/DEBRIDEMT BURNS, MEDIUM W/MOD",8116025,CDM,16025,CPT,761,RC,inpatient,59,477,477,,404.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,359.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,405.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,419.76,88,,percent of total billed charges,,,,,,,,,364.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,434.07,91,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,,,,,,,,,,,,,395.91,83,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,391.14,82,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,359.66,453.15,
"DRESSINGS/DEBRIDEMENT BURNS, LARGE W/MOD",8116030,CDM,16030,CPT,761,RC,inpatient,59,678,678,,575.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,511.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,576.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,596.64,88,,percent of total billed charges,,,,,,,,,517.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,616.98,91,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,,,,,,,,,,,,,562.74,83,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,555.96,82,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,576.3,85,,percent of total billed charges,,511.21,644.1,
CHEMICAL CAUTER GRANULATION TISSUE W/MOD,8117250,CDM,17250,CPT,761,RC,inpatient,59,617,617,,523.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,465.22,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,524.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,542.96,88,,percent of total billed charges,,,,,,,,,471.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,561.47,91,,percent of total billed charges,,,586.15,95,,percent of total billed charges,,,512.11,83,,percent of total billed charges,,,512.11,83,,percent of total billed charges,,,,,,,,,,,,,,,512.11,83,,percent of total billed charges,,,586.15,95,,percent of total billed charges,,,555.3,90,,percent of total billed charges,,,555.3,90,,percent of total billed charges,,,505.94,82,,percent of total billed charges,,,555.3,90,,percent of total billed charges,,,524.45,85,,percent of total billed charges,,465.22,586.15,
NEW E&M PATIENT LEVEL 1 W MOD,8130100,CDM,99202,CPT,761,RC,inpatient,25,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,345.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,306.12,385.7,
NEW OFFICE O/P SF 15-29 MIN W MOD,8130101,CDM,99202,CPT,761,RC,inpatient,25,492,492,,417.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,370.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,418.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,432.96,88,,percent of total billed charges,,,,,,,,,375.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,447.72,91,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,,,,,,,,,,,,,408.36,83,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,403.44,82,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,370.97,467.4,
NEW OFFICE O/P LOW 30-44 MIN W MOD,8130102,CDM,99203,CPT,761,RC,inpatient,25,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,454.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,512.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,454.66,572.85,
NEW OFFICE O/P NEW MOD 45-59 MIN W MOD,8130103,CDM,99204,CPT,761,RC,inpatient,25,755,755,,641,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,569.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,641.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,664.4,88,,percent of total billed charges,,,,,,,,,576.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,687.05,91,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,,,,,,,,,,,,,626.65,83,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,619.1,82,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,569.27,717.25,
NEW OFFICE O/P HI 60-74 MIN W MOD,8130104,CDM,99205,CPT,761,RC,inpatient,25,962,962,,816.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,725.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,817.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,846.56,88,,percent of total billed charges,,,,,,,,,734.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,875.42,91,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,,,,,,,,,,,,,798.46,83,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,788.84,82,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,817.7,85,,percent of total billed charges,,725.35,913.9,
DEBRIDE OPEN WND 20 SQCM W/MOD,8197597,CDM,97597,CPT,761,RC,inpatient,59,668,668,,567.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,503.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,567.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,587.84,88,,percent of total billed charges,,,,,,,,,510.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,607.88,91,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,,,,,,,,,,,,,554.44,83,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,547.76,82,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,567.8,85,,percent of total billed charges,,503.67,634.6,
DEBRIDE OPEN WND EA ADDT 20 SQCM W/MOD,8197598,CDM,97598,CPT,761,RC,inpatient,59,800,800,,679.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,603.2,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,680,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,704,88,,percent of total billed charges,,,,,,,,,611.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,728,91,,percent of total billed charges,,,760,95,,percent of total billed charges,,,664,83,,percent of total billed charges,,,664,83,,percent of total billed charges,,,,,,,,,,,,,,,664,83,,percent of total billed charges,,,760,95,,percent of total billed charges,,,720,90,,percent of total billed charges,,,720,90,,percent of total billed charges,,,656,82,,percent of total billed charges,,,720,90,,percent of total billed charges,,,680,85,,percent of total billed charges,,603.2,760,
NON-SELECTIVE DEBRIDEMENT W/MOD,8197602,CDM,97602,CPT,761,RC,inpatient,59,509,509,,432.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,383.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,432.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,447.92,88,,percent of total billed charges,,,,,,,,,388.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,463.19,91,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,,,,,,,,,,,,,422.47,83,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,417.38,82,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,383.79,483.55,
NEG PRES WD THER 50 SQ CM OR LESS W/MOD,8197605,CDM,97605,CPT,761,RC,inpatient,59,444,444,,376.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,334.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,377.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,390.72,88,,percent of total billed charges,,,,,,,,,339.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,404.04,91,,percent of total billed charges,,,421.8,95,,percent of total billed charges,,,368.52,83,,percent of total billed charges,,,368.52,83,,percent of total billed charges,,,,,,,,,,,,,,,368.52,83,,percent of total billed charges,,,421.8,95,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,364.08,82,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,377.4,85,,percent of total billed charges,,334.78,421.8,
NEG PRES WOUND THERAPY > 50 SQ CM W/MOD,8197606,CDM,97606,CPT,761,RC,inpatient,59,559,559,,474.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,421.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,475.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,491.92,88,,percent of total billed charges,,,,,,,,,427.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,508.69,91,,percent of total billed charges,,,531.05,95,,percent of total billed charges,,,463.97,83,,percent of total billed charges,,,463.97,83,,percent of total billed charges,,,,,,,,,,,,,,,463.97,83,,percent of total billed charges,,,531.05,95,,percent of total billed charges,,,503.1,90,,percent of total billed charges,,,503.1,90,,percent of total billed charges,,,458.38,82,,percent of total billed charges,,,503.1,90,,percent of total billed charges,,,475.15,85,,percent of total billed charges,,421.49,531.05,
OFFICE O/P EST MINIMAL W MOD PROB,8199211,CDM,99211,CPT,761,RC,inpatient,25,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,280.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,316.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,280.49,353.4,
EST OFFICE O/P SF 10-19 MIN W MOD,8199212,CDM,99212,CPT,761,RC,inpatient,25,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,347.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,391.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,347.59,437.95,
EST OFFICE O/P LOW 20-29 MIN W MOD,8199213,CDM,99213,CPT,761,RC,inpatient,25,586,586,,497.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,441.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,498.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,515.68,88,,percent of total billed charges,,,,,,,,,447.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,533.26,91,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,,,,,,,,,,,,,486.38,83,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,480.52,82,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,498.1,85,,percent of total billed charges,,441.84,556.7,
EST OFFICE O/P MOD 30-39 MIN W MOD,8199214,CDM,99214,CPT,761,RC,inpatient,25,727,727,,617.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,548.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,617.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,639.76,88,,percent of total billed charges,,,,,,,,,555.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,661.57,91,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,,,,,,,,,,,,,603.41,83,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,596.14,82,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,617.95,85,,percent of total billed charges,,548.16,690.65,
EST OFFICE O/P HI 40-54 MIN W MOD,8199215,CDM,99215,CPT,761,RC,inpatient,25,943,943,,800.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,711.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,801.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,829.84,88,,percent of total billed charges,,,,,,,,,720.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,858.13,91,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,,,,,,,,,,,,,782.69,83,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,773.26,82,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,801.55,85,,percent of total billed charges,,711.02,895.85,
NEW E&M PATIENT-LEVEL 1,81000100,CDM,99202,CPT,761,RC,inpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,345.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,306.12,385.7,
NEW OFFICE O/P SF 15-29 MIN,81000101,CDM,99202,CPT,761,RC,inpatient,,492,492,,417.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,370.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,418.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,432.96,88,,percent of total billed charges,,,,,,,,,375.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,447.72,91,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,,,,,,,,,,,,,408.36,83,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,403.44,82,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,370.97,467.4,
NEW OFFICE O/P NEW 30-44 MIN,81000102,CDM,99203,CPT,761,RC,inpatient,,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,454.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,512.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,454.66,572.85,
NEW OFFICE O/P NEW MOD 45-59 MIN,81000103,CDM,99204,CPT,761,RC,inpatient,,755,755,,641,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,569.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,641.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,664.4,88,,percent of total billed charges,,,,,,,,,576.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,687.05,91,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,,,,,,,,,,,,,626.65,83,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,619.1,82,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,569.27,717.25,
NEW OFFICE O/P HI 60-74 MIN,81000104,CDM,99205,CPT,761,RC,inpatient,,962,962,,816.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,725.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,817.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,846.56,88,,percent of total billed charges,,,,,,,,,734.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,875.42,91,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,,,,,,,,,,,,,798.46,83,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,788.84,82,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,817.7,85,,percent of total billed charges,,725.35,913.9,
DEBRIDE OPEN WND 20 SQCM,81000105,CDM,97597,CPT,761,RC,inpatient,,754,754,,640.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,568.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,640.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,663.52,88,,percent of total billed charges,,,,,,,,,576.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,686.14,91,,percent of total billed charges,,,716.3,95,,percent of total billed charges,,,625.82,83,,percent of total billed charges,,,625.82,83,,percent of total billed charges,,,,,,,,,,,,,,,625.82,83,,percent of total billed charges,,,716.3,95,,percent of total billed charges,,,678.6,90,,percent of total billed charges,,,678.6,90,,percent of total billed charges,,,618.28,82,,percent of total billed charges,,,678.6,90,,percent of total billed charges,,,640.9,85,,percent of total billed charges,,568.52,716.3,
DEBRIDE OPEN WND EA ADDT 20 SQCM,81000106,CDM,97598,CPT,761,RC,inpatient,,754,754,,640.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,568.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,640.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,663.52,88,,percent of total billed charges,,,,,,,,,576.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,686.14,91,,percent of total billed charges,,,716.3,95,,percent of total billed charges,,,625.82,83,,percent of total billed charges,,,625.82,83,,percent of total billed charges,,,,,,,,,,,,,,,625.82,83,,percent of total billed charges,,,716.3,95,,percent of total billed charges,,,678.6,90,,percent of total billed charges,,,678.6,90,,percent of total billed charges,,,618.28,82,,percent of total billed charges,,,678.6,90,,percent of total billed charges,,,640.9,85,,percent of total billed charges,,568.52,716.3,
FF APPL SKIN SUB 1ST SQ CM TRUNK ARM LEG,81000110,CDM,15271,CPT,761,RC,inpatient,,3452,3452,,2930.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2602.81,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2934.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3037.76,88,,percent of total billed charges,,,,,,,,,2637.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3141.32,91,,percent of total billed charges,,,3279.4,95,,percent of total billed charges,,,2865.16,83,,percent of total billed charges,,,2865.16,83,,percent of total billed charges,,,,,,,,,,,,,,,2865.16,83,,percent of total billed charges,,,3279.4,95,,percent of total billed charges,,,3106.8,90,,percent of total billed charges,,,3106.8,90,,percent of total billed charges,,,2830.64,82,,percent of total billed charges,,,3106.8,90,,percent of total billed charges,,,2934.2,85,,percent of total billed charges,,2602.81,3279.4,
FF APPL SKIN SUB ECH ADD 25 SQ CM TRUNK,81000111,CDM,15272,CPT,761,RC,inpatient,,223,223,,189.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,168.14,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,189.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,196.24,88,,percent of total billed charges,,,,,,,,,170.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,202.93,91,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,,,,,,,,,,,,,185.09,83,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,182.86,82,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,168.14,211.85,
FF APPL SKIN SUB 1ST 100 SQ CM TRUNK ARM,81000112,CDM,15273,CPT,761,RC,inpatient,,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4426.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4990.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,4426.73,5577.45,
FF APPL SKIN SUB ECH ADD 100,81000113,CDM,15274,CPT,761,RC,inpatient,,442,442,,375.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,333.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,375.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,388.96,88,,percent of total billed charges,,,,,,,,,337.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,402.22,91,,percent of total billed charges,,,419.9,95,,percent of total billed charges,,,366.86,83,,percent of total billed charges,,,366.86,83,,percent of total billed charges,,,,,,,,,,,,,,,366.86,83,,percent of total billed charges,,,419.9,95,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,362.44,82,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,375.7,85,,percent of total billed charges,,333.27,419.9,
FF APPL SKIN SUB 1ST SQ CM FACE SCALP,81000114,CDM,15275,CPT,761,RC,inpatient,,2643,2643,,2243.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1992.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2246.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2325.84,88,,percent of total billed charges,,,,,,,,,2019.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2405.13,91,,percent of total billed charges,,,2510.85,95,,percent of total billed charges,,,2193.69,83,,percent of total billed charges,,,2193.69,83,,percent of total billed charges,,,,,,,,,,,,,,,2193.69,83,,percent of total billed charges,,,2510.85,95,,percent of total billed charges,,,2378.7,90,,percent of total billed charges,,,2378.7,90,,percent of total billed charges,,,2167.26,82,,percent of total billed charges,,,2378.7,90,,percent of total billed charges,,,2246.55,85,,percent of total billed charges,,1992.82,2510.85,
FF APPL SKIN SUB ECH ADD 25 SQ CM FACE,81000115,CDM,15276,CPT,761,RC,inpatient,,622,622,,528.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,468.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,528.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,547.36,88,,percent of total billed charges,,,,,,,,,475.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,566.02,91,,percent of total billed charges,,,590.9,95,,percent of total billed charges,,,516.26,83,,percent of total billed charges,,,516.26,83,,percent of total billed charges,,,,,,,,,,,,,,,516.26,83,,percent of total billed charges,,,590.9,95,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,510.04,82,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,528.7,85,,percent of total billed charges,,468.99,590.9,
FF APPL SKIN SUB 1ST 100 SQ CM FACE,81000116,CDM,15277,CPT,761,RC,inpatient,,1941,1941,,1647.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1463.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1649.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1708.08,88,,percent of total billed charges,,,,,,,,,1482.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1766.31,91,,percent of total billed charges,,,1843.95,95,,percent of total billed charges,,,1611.03,83,,percent of total billed charges,,,1611.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1611.03,83,,percent of total billed charges,,,1843.95,95,,percent of total billed charges,,,1746.9,90,,percent of total billed charges,,,1746.9,90,,percent of total billed charges,,,1591.62,82,,percent of total billed charges,,,1746.9,90,,percent of total billed charges,,,1649.85,85,,percent of total billed charges,,1463.51,1843.95,
FF APPL SKIN SUB ECH ADD 100 FACE,81000117,CDM,15278,CPT,761,RC,inpatient,,557,557,,472.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,419.98,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,473.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,490.16,88,,percent of total billed charges,,,,,,,,,425.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,506.87,91,,percent of total billed charges,,,529.15,95,,percent of total billed charges,,,462.31,83,,percent of total billed charges,,,462.31,83,,percent of total billed charges,,,,,,,,,,,,,,,462.31,83,,percent of total billed charges,,,529.15,95,,percent of total billed charges,,,501.3,90,,percent of total billed charges,,,501.3,90,,percent of total billed charges,,,456.74,82,,percent of total billed charges,,,501.3,90,,percent of total billed charges,,,473.45,85,,percent of total billed charges,,419.98,529.15,
FF APPLICATION OF SKIN SUB UP 25 SQ CM,81000118,CDM,C5271,HCPCS,761,RC,inpatient,,2037,2037,,1729.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1535.9,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1731.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1792.56,88,,percent of total billed charges,,,,,,,,,1556.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1853.67,91,,percent of total billed charges,,,1935.15,95,,percent of total billed charges,,,1690.71,83,,percent of total billed charges,,,1690.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1690.71,83,,percent of total billed charges,,,1935.15,95,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1670.34,82,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1731.45,85,,percent of total billed charges,,1535.9,1935.15,
OFFICE O/P EST MINIMAL PROB,81000120,CDM,99211,CPT,761,RC,inpatient,,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,280.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,316.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,280.49,353.4,
EST OFFICE O/P SF 10-19 MIN,81000121,CDM,99212,CPT,761,RC,inpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,347.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,391.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,347.59,437.95,
EST OFFICE O/P LOW 20-29 MIN,81000122,CDM,99213,CPT,761,RC,inpatient,,586,586,,497.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,441.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,498.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,515.68,88,,percent of total billed charges,,,,,,,,,447.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,533.26,91,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,,,,,,,,,,,,,486.38,83,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,480.52,82,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,498.1,85,,percent of total billed charges,,441.84,556.7,
EST OFFICE O/P MOD 30-39 MIN,81000123,CDM,99214,CPT,761,RC,inpatient,,727,727,,617.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,548.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,617.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,639.76,88,,percent of total billed charges,,,,,,,,,555.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,661.57,91,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,,,,,,,,,,,,,603.41,83,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,596.14,82,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,617.95,85,,percent of total billed charges,,548.16,690.65,
EST OFFICE O/P HI 40-54 MIN,81000124,CDM,99215,CPT,761,RC,inpatient,,943,943,,800.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,711.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,801.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,829.84,88,,percent of total billed charges,,,,,,,,,720.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,858.13,91,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,,,,,,,,,,,,,782.69,83,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,773.26,82,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,801.55,85,,percent of total billed charges,,711.02,895.85,
SIMPLE SU 2.5 S N T EX,81000125,CDM,12001,CPT,761,RC,inpatient,,463,463,,393.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.1,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,393.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,407.44,88,,percent of total billed charges,,,,,,,,,353.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,421.33,91,,percent of total billed charges,,,439.85,95,,percent of total billed charges,,,384.29,83,,percent of total billed charges,,,384.29,83,,percent of total billed charges,,,,,,,,,,,,,,,384.29,83,,percent of total billed charges,,,439.85,95,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,379.66,82,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,393.55,85,,percent of total billed charges,,349.1,439.85,
NEW E&M PATIENT LEVEL 1 W MOD,81000126,CDM,G0463,HCPCS,510,RC,inpatient,25,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,306.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,345.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,306.12,385.7,
NEW E&M PATIENT LEVEL 2 W MOD,81000127,CDM,G0463,HCPCS,510,RC,inpatient,25,492,492,,417.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,370.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,418.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,432.96,88,,percent of total billed charges,,,,,,,,,375.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,447.72,91,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,,,,,,,,,,,,,408.36,83,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,403.44,82,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,370.97,467.4,
NEW E&M PATIENT LEVEL 3 W MOD,81000128,CDM,G0463,HCPCS,510,RC,inpatient,25,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,454.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,512.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,454.66,572.85,
NEW E&M PATIENT LEVEL 4 W MOD,81000129,CDM,G0463,HCPCS,510,RC,inpatient,25,755,755,,641,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,569.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,641.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,664.4,88,,percent of total billed charges,,,,,,,,,576.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,687.05,91,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,,,,,,,,,,,,,626.65,83,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,619.1,82,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,569.27,717.25,
NEW E&M PATIENT LEVEL 5 W MOD,81000130,CDM,G0463,HCPCS,510,RC,inpatient,25,962,962,,816.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,725.35,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,817.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,846.56,88,,percent of total billed charges,,,,,,,,,734.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,875.42,91,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,,,,,,,,,,,,,798.46,83,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,788.84,82,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,817.7,85,,percent of total billed charges,,725.35,913.9,
ESTABLISHED E&M PATIENT LEVEL 1 W MOD,81000131,CDM,G0463,HCPCS,510,RC,inpatient,25,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,280.49,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,316.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,280.49,353.4,
ESTABLISHED E&M PATIENT LEVEL 2 W MOD,81000132,CDM,G0463,HCPCS,510,RC,inpatient,25,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,347.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,391.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,347.59,437.95,
ESTABLISHED E&M PATIENT LEVEL 3 W MOD,81000133,CDM,G0463,HCPCS,510,RC,inpatient,25,586,586,,497.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,441.84,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,498.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,515.68,88,,percent of total billed charges,,,,,,,,,447.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,533.26,91,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,,,,,,,,,,,,,486.38,83,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,480.52,82,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,498.1,85,,percent of total billed charges,,441.84,556.7,
ESTABLISHED E&M PATIENT LEVEL 4 W MOD,81000134,CDM,G0463,HCPCS,510,RC,inpatient,25,727,727,,617.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,548.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,617.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,639.76,88,,percent of total billed charges,,,,,,,,,555.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,661.57,91,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,,,,,,,,,,,,,603.41,83,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,596.14,82,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,617.95,85,,percent of total billed charges,,548.16,690.65,
ESTABLISHED E&M PATIENT LEVEL 5 W MOD,81000135,CDM,G0463,HCPCS,510,RC,inpatient,25,943,943,,800.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,711.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,801.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,829.84,88,,percent of total billed charges,,,,,,,,,720.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,858.13,91,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,,,,,,,,,,,,,782.69,83,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,773.26,82,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,801.55,85,,percent of total billed charges,,711.02,895.85,
DEBRIDE EXT ECZEMATOUS SKIN(UP TO 10%),81000201,CDM,11000,CPT,761,RC,inpatient,,531,531,,450.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,400.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,451.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,467.28,88,,percent of total billed charges,,,,,,,,,405.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,483.21,91,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,,,,,,,,,,,,,440.73,83,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,435.42,82,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,400.37,504.45,
EACH ADDT'L 10% BODY SURFACE,81000202,CDM,11001,CPT,761,RC,inpatient,,416,416,,353.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,313.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,353.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,366.08,88,,percent of total billed charges,,,,,,,,,317.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,378.56,91,,percent of total billed charges,,,395.2,95,,percent of total billed charges,,,345.28,83,,percent of total billed charges,,,345.28,83,,percent of total billed charges,,,,,,,,,,,,,,,345.28,83,,percent of total billed charges,,,395.2,95,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,341.12,82,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,353.6,85,,percent of total billed charges,,313.66,395.2,
DEBRIDEMENT SKIN PARTIAL THICKNESS,81000203,CDM,11042,CPT,761,RC,inpatient,,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,454.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,512.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,454.66,572.85,
DEBRIDEMENT SKIN FULL THICKNESS,81000204,CDM,11043,CPT,761,RC,inpatient,,715,715,,607.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,539.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,607.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,629.2,88,,percent of total billed charges,,,,,,,,,546.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,650.65,91,,percent of total billed charges,,,679.25,95,,percent of total billed charges,,,593.45,83,,percent of total billed charges,,,593.45,83,,percent of total billed charges,,,,,,,,,,,,,,,593.45,83,,percent of total billed charges,,,679.25,95,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,586.3,82,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,607.75,85,,percent of total billed charges,,539.11,679.25,
DEBRIDEMENT SKIN & SUBCUTANEOUS TISSUE,81000205,CDM,11042,CPT,761,RC,inpatient,,1622,1622,,1377.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1222.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1378.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1427.36,88,,percent of total billed charges,,,,,,,,,1239.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1476.02,91,,percent of total billed charges,,,1540.9,95,,percent of total billed charges,,,1346.26,83,,percent of total billed charges,,,1346.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1346.26,83,,percent of total billed charges,,,1540.9,95,,percent of total billed charges,,,1459.8,90,,percent of total billed charges,,,1459.8,90,,percent of total billed charges,,,1330.04,82,,percent of total billed charges,,,1459.8,90,,percent of total billed charges,,,1378.7,85,,percent of total billed charges,,1222.99,1540.9,
DEBRIDE MUSC FAS<20,81000206,CDM,11043,CPT,761,RC,inpatient,,2071,2071,,1758.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1561.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1760.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1822.48,88,,percent of total billed charges,,,,,,,,,1582.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1884.61,91,,percent of total billed charges,,,1967.45,95,,percent of total billed charges,,,1718.93,83,,percent of total billed charges,,,1718.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1718.93,83,,percent of total billed charges,,,1967.45,95,,percent of total billed charges,,,1863.9,90,,percent of total billed charges,,,1863.9,90,,percent of total billed charges,,,1698.22,82,,percent of total billed charges,,,1863.9,90,,percent of total billed charges,,,1760.35,85,,percent of total billed charges,,1561.53,1967.45,
DEBRIDEMENT BONE < 20,81000207,CDM,11044,CPT,761,RC,inpatient,,2951,2951,,2505.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2225.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2508.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2596.88,88,,percent of total billed charges,,,,,,,,,2254.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2685.41,91,,percent of total billed charges,,,2803.45,95,,percent of total billed charges,,,2449.33,83,,percent of total billed charges,,,2449.33,83,,percent of total billed charges,,,,,,,,,,,,,,,2449.33,83,,percent of total billed charges,,,2803.45,95,,percent of total billed charges,,,2655.9,90,,percent of total billed charges,,,2655.9,90,,percent of total billed charges,,,2419.82,82,,percent of total billed charges,,,2655.9,90,,percent of total billed charges,,,2508.35,85,,percent of total billed charges,,2225.05,2803.45,
NON-SELECTIVE DEBRIDEMENT,81000208,CDM,97602,CPT,761,RC,inpatient,,756,756,,641.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,570.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,642.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,665.28,88,,percent of total billed charges,,,,,,,,,577.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,687.96,91,,percent of total billed charges,,,718.2,95,,percent of total billed charges,,,627.48,83,,percent of total billed charges,,,627.48,83,,percent of total billed charges,,,,,,,,,,,,,,,627.48,83,,percent of total billed charges,,,718.2,95,,percent of total billed charges,,,680.4,90,,percent of total billed charges,,,680.4,90,,percent of total billed charges,,,619.92,82,,percent of total billed charges,,,680.4,90,,percent of total billed charges,,,642.6,85,,percent of total billed charges,,570.02,718.2,
"SEL DEBRIDEMENT, 20 SQ CM OR LESS",81000210,CDM,97597,CPT,761,RC,inpatient,,255,255,,216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,192.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,216.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,224.4,88,,percent of total billed charges,,,,,,,,,194.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,209.1,82,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,192.27,242.25,
"SEL DEBRIDEMENT, GREATER THAN 20 SQ CM",81000211,CDM,97598,CPT,761,RC,inpatient,,381,381,,323.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,287.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,323.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,335.28,88,,percent of total billed charges,,,,,,,,,291.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,346.71,91,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,,,,,,,,,,,,,316.23,83,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,312.42,82,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,323.85,85,,percent of total billed charges,,287.27,361.95,
NEG PRESSURE WOUND THER 50 SQ CM OR LESS,81000212,CDM,97605,CPT,761,RC,inpatient,,444,444,,376.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,334.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,377.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,390.72,88,,percent of total billed charges,,,,,,,,,339.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,404.04,91,,percent of total billed charges,,,421.8,95,,percent of total billed charges,,,368.52,83,,percent of total billed charges,,,368.52,83,,percent of total billed charges,,,,,,,,,,,,,,,368.52,83,,percent of total billed charges,,,421.8,95,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,364.08,82,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,377.4,85,,percent of total billed charges,,334.78,421.8,
NEG PRESSURE WOUND THERAPY > 50 SQ CM,81000213,CDM,97606,CPT,761,RC,inpatient,,668,668,,567.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,503.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,567.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,587.84,88,,percent of total billed charges,,,,,,,,,510.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,607.88,91,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,,,,,,,,,,,,,554.44,83,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,547.76,82,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,567.8,85,,percent of total billed charges,,503.67,634.6,
NEG PRESS WOUND TX 50 SQ CM  REDUCED SER,81000214,CDM,97605,CPT,761,RC,inpatient,52,444,444,,376.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,334.78,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,377.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,390.72,88,,percent of total billed charges,,,,,,,,,339.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,404.04,91,,percent of total billed charges,,,421.8,95,,percent of total billed charges,,,368.52,83,,percent of total billed charges,,,368.52,83,,percent of total billed charges,,,,,,,,,,,,,,,368.52,83,,percent of total billed charges,,,421.8,95,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,364.08,82,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,377.4,85,,percent of total billed charges,,334.78,421.8,
DEBRIDE SUBQ EA ADDTL 20 SQCM,81000215,CDM,11045,CPT,761,RC,inpatient,,1307,1307,,1109.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,985.48,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1110.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1150.16,88,,percent of total billed charges,,,,,,,,,998.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1189.37,91,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1084.81,83,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1071.74,82,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1110.95,85,,percent of total billed charges,,985.48,1241.65,
DEBRIDE MUSC FAS EA ADDTL <20,81000216,CDM,11046,CPT,761,RC,inpatient,,1440,1440,,1222.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1085.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1224,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1267.2,88,,percent of total billed charges,,,,,,,,,1100.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1310.4,91,,percent of total billed charges,,,1368,95,,percent of total billed charges,,,1195.2,83,,percent of total billed charges,,,1195.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1195.2,83,,percent of total billed charges,,,1368,95,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1180.8,82,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1224,85,,percent of total billed charges,,1085.76,1368,
DEBRIDEMENT BONE EA ADDTL < 20,81000217,CDM,11047,CPT,761,RC,inpatient,,2623,2623,,2226.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1977.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2229.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2308.24,88,,percent of total billed charges,,,,,,,,,2003.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2386.93,91,,percent of total billed charges,,,2491.85,95,,percent of total billed charges,,,2177.09,83,,percent of total billed charges,,,2177.09,83,,percent of total billed charges,,,,,,,,,,,,,,,2177.09,83,,percent of total billed charges,,,2491.85,95,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2150.86,82,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2229.55,85,,percent of total billed charges,,1977.74,2491.85,
DERMAGRAFT 1 SQCM USED,81000218,CDM,Q4106,HCPCS,761,RC,inpatient,,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,189.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,213.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,189.25,238.45,
DERMAGRAFT 1 SQCM NOT USED,81000219,CDM,Q4106,HCPCS,761,RC,inpatient,JW,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,189.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,213.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,189.25,238.45,
PARE/CUT BENIGH HYPERKERATOTIC SGL LES,81000220,CDM,11055,CPT,761,RC,inpatient,,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,349.86,440.8,
PARE/CUT BENIGH HYPERKERATOTIC 2-4 LES,81000221,CDM,11056,CPT,761,RC,inpatient,,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,349.86,440.8,
PARE/CUT BENIGH HYPERKERATOTIC >4 LES,81000222,CDM,11057,CPT,761,RC,inpatient,,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,351.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,351.36,442.7,
REMOVAL SKIN TAGS 15 OR LESS,81000225,CDM,11200,CPT,761,RC,inpatient,,313,313,,265.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,236,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,266.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,275.44,88,,percent of total billed charges,,,,,,,,,239.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,284.83,91,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,,,,,,,,,,,,,259.79,83,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,256.66,82,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,236,297.35,
BX SKIN/SQ TISSUE MUCOUS MEMBRANE SNGL,81000240,CDM,11102,CPT,761,RC,inpatient,,581,581,,493.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,438.07,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,493.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,511.28,88,,percent of total billed charges,,,,,,,,,443.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,528.71,91,,percent of total billed charges,,,551.95,95,,percent of total billed charges,,,482.23,83,,percent of total billed charges,,,482.23,83,,percent of total billed charges,,,,,,,,,,,,,,,482.23,83,,percent of total billed charges,,,551.95,95,,percent of total billed charges,,,522.9,90,,percent of total billed charges,,,522.9,90,,percent of total billed charges,,,476.42,82,,percent of total billed charges,,,522.9,90,,percent of total billed charges,,,493.85,85,,percent of total billed charges,,438.07,551.95,
"BX SKIN, EA SEPARATE/ADDT'L LESION",81000241,CDM,11103,CPT,761,RC,inpatient,,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,330.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,372.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,330.25,416.1,
"BX BONE, TROCAR OR NEEDLE, SUPERFICIAL",81000242,CDM,20220,CPT,761,RC,inpatient,,1995,1995,,1693.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1504.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1695.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1755.6,88,,percent of total billed charges,,,,,,,,,1524.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1815.45,91,,percent of total billed charges,,,1895.25,95,,percent of total billed charges,,,1655.85,83,,percent of total billed charges,,,1655.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1655.85,83,,percent of total billed charges,,,1895.25,95,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1635.9,82,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1695.75,85,,percent of total billed charges,,1504.23,1895.25,
"BX BONE,OPEN;SUPERFICIAL",81000243,CDM,20240,CPT,761,RC,inpatient,,5618,5618,,4769.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4235.97,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4775.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4943.84,88,,percent of total billed charges,,,,,,,,,4292.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5112.38,91,,percent of total billed charges,,,5337.1,95,,percent of total billed charges,,,4662.94,83,,percent of total billed charges,,,4662.94,83,,percent of total billed charges,,,,,,,,,,,,,,,4662.94,83,,percent of total billed charges,,,5337.1,95,,percent of total billed charges,,,5056.2,90,,percent of total billed charges,,,5056.2,90,,percent of total billed charges,,,4606.76,82,,percent of total billed charges,,,5056.2,90,,percent of total billed charges,,,4775.3,85,,percent of total billed charges,,4235.97,5337.1,
TRIM NAILS NONDYSTROPHIC,81000250,CDM,11719,CPT,761,RC,inpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
INC/DRAIN ABSCESS - SIMPLE OR SINGLE,81000260,CDM,10060,CPT,761,RC,inpatient,,1335,1335,,1133.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1006.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1134.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1174.8,88,,percent of total billed charges,,,,,,,,,1019.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1214.85,91,,percent of total billed charges,,,1268.25,95,,percent of total billed charges,,,1108.05,83,,percent of total billed charges,,,1108.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1108.05,83,,percent of total billed charges,,,1268.25,95,,percent of total billed charges,,,1201.5,90,,percent of total billed charges,,,1201.5,90,,percent of total billed charges,,,1094.7,82,,percent of total billed charges,,,1201.5,90,,percent of total billed charges,,,1134.75,85,,percent of total billed charges,,1006.59,1268.25,
INC/DRAIN ABSCESS - COMPLICATED OR MULT,81000261,CDM,10061,CPT,761,RC,inpatient,,477,477,,404.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,359.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,405.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,419.76,88,,percent of total billed charges,,,,,,,,,364.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,434.07,91,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,,,,,,,,,,,,,395.91,83,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,391.14,82,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,359.66,453.15,
"INC/DRAIN HEMATOMA,SEROMA,FLUID COLLECT",81000262,CDM,10140,CPT,761,RC,inpatient,,2871,2871,,2437.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2164.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2440.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2526.48,88,,percent of total billed charges,,,,,,,,,2193.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2612.61,91,,percent of total billed charges,,,2727.45,95,,percent of total billed charges,,,2382.93,83,,percent of total billed charges,,,2382.93,83,,percent of total billed charges,,,,,,,,,,,,,,,2382.93,83,,percent of total billed charges,,,2727.45,95,,percent of total billed charges,,,2583.9,90,,percent of total billed charges,,,2583.9,90,,percent of total billed charges,,,2354.22,82,,percent of total billed charges,,,2583.9,90,,percent of total billed charges,,,2440.35,85,,percent of total billed charges,,2164.73,2727.45,
"PUNC ASP ABSCESS,HEMATOMA,BULLA OR CYST",81000263,CDM,10160,CPT,761,RC,inpatient,,457,457,,387.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,344.58,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,388.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,402.16,88,,percent of total billed charges,,,,,,,,,349.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,415.87,91,,percent of total billed charges,,,434.15,95,,percent of total billed charges,,,379.31,83,,percent of total billed charges,,,379.31,83,,percent of total billed charges,,,,,,,,,,,,,,,379.31,83,,percent of total billed charges,,,434.15,95,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,374.74,82,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,388.45,85,,percent of total billed charges,,344.58,434.15,
"INC/DRAIN, COMPLEX, POST-OP WOUND INF",81000264,CDM,10180,CPT,761,RC,inpatient,,7314,7314,,6209.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5514.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6216.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6436.32,88,,percent of total billed charges,,,,,,,,,5587.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6655.74,91,,percent of total billed charges,,,6948.3,95,,percent of total billed charges,,,6070.62,83,,percent of total billed charges,,,6070.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6070.62,83,,percent of total billed charges,,,6948.3,95,,percent of total billed charges,,,6582.6,90,,percent of total billed charges,,,6582.6,90,,percent of total billed charges,,,5997.48,82,,percent of total billed charges,,,6582.6,90,,percent of total billed charges,,,6216.9,85,,percent of total billed charges,,5514.76,6948.3,
TENOTOMY OPEN EXTENSOR FOOT/TOE TENDON,81000270,CDM,28234,CPT,761,RC,inpatient,,4390,4390,,3727.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3310.06,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3731.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3863.2,88,,percent of total billed charges,,,,,,,,,3353.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3994.9,91,,percent of total billed charges,,,4170.5,95,,percent of total billed charges,,,3643.7,83,,percent of total billed charges,,,3643.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3643.7,83,,percent of total billed charges,,,4170.5,95,,percent of total billed charges,,,3951,90,,percent of total billed charges,,,3951,90,,percent of total billed charges,,,3599.8,82,,percent of total billed charges,,,3951,90,,percent of total billed charges,,,3731.5,85,,percent of total billed charges,,3310.06,4170.5,
"DEBRIDEMENT OF NAIL(S), ANY METHOD, 1-5",81000280,CDM,11720,CPT,761,RC,inpatient,,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,251.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,283.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,251.08,316.35,
"DEBRIDEMENT NAILS, ANY METHOD, 6 OR MORE",81000281,CDM,11721,CPT,761,RC,inpatient,,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,353.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,398.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,353.63,445.55,
"AVULSION NAIL PLATE, PTL OR COMP, SNGL",81000282,CDM,11730,CPT,761,RC,inpatient,,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,330.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,372.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,330.25,416.1,
AVULSION EA ADDT'L NAIL PLATE,81000283,CDM,11732,CPT,761,RC,inpatient,,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,269.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,303.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,269.18,339.15,
"EXCISION NAIL & NAIL MATRIX, PTL OR COMP",81000284,CDM,11750,CPT,761,RC,inpatient,,1282,1282,,1088.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,966.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1089.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1128.16,88,,percent of total billed charges,,,,,,,,,979.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1166.62,91,,percent of total billed charges,,,1217.9,95,,percent of total billed charges,,,1064.06,83,,percent of total billed charges,,,1064.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1064.06,83,,percent of total billed charges,,,1217.9,95,,percent of total billed charges,,,1153.8,90,,percent of total billed charges,,,1153.8,90,,percent of total billed charges,,,1051.24,82,,percent of total billed charges,,,1153.8,90,,percent of total billed charges,,,1089.7,85,,percent of total billed charges,,966.63,1217.9,
"INIT PREP OF TAL SITE, FIRST 100 SQ CM",81000290,CDM,15002,CPT,761,RC,inpatient,,2999,2999,,2546.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2261.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2549.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2639.12,88,,percent of total billed charges,,,,,,,,,2291.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2729.09,91,,percent of total billed charges,,,2849.05,95,,percent of total billed charges,,,2489.17,83,,percent of total billed charges,,,2489.17,83,,percent of total billed charges,,,,,,,,,,,,,,,2489.17,83,,percent of total billed charges,,,2849.05,95,,percent of total billed charges,,,2699.1,90,,percent of total billed charges,,,2699.1,90,,percent of total billed charges,,,2459.18,82,,percent of total billed charges,,,2699.1,90,,percent of total billed charges,,,2549.15,85,,percent of total billed charges,,2261.25,2849.05,
"INIT PREP OF ENTF SITE, FIRST 100 SQ CM",81000291,CDM,15004,CPT,761,RC,inpatient,,2999,2999,,2546.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2261.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2549.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2639.12,88,,percent of total billed charges,,,,,,,,,2291.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2729.09,91,,percent of total billed charges,,,2849.05,95,,percent of total billed charges,,,2489.17,83,,percent of total billed charges,,,2489.17,83,,percent of total billed charges,,,,,,,,,,,,,,,2489.17,83,,percent of total billed charges,,,2849.05,95,,percent of total billed charges,,,2699.1,90,,percent of total billed charges,,,2699.1,90,,percent of total billed charges,,,2459.18,82,,percent of total billed charges,,,2699.1,90,,percent of total billed charges,,,2549.15,85,,percent of total billed charges,,2261.25,2849.05,
"SURG SITE PREP TAL, EA ADDT'L 100 SQ CM",81000292,CDM,15003,CPT,761,RC,inpatient,,2748,2748,,2333.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2071.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2335.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2418.24,88,,percent of total billed charges,,,,,,,,,2099.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2500.68,91,,percent of total billed charges,,,2610.6,95,,percent of total billed charges,,,2280.84,83,,percent of total billed charges,,,2280.84,83,,percent of total billed charges,,,,,,,,,,,,,,,2280.84,83,,percent of total billed charges,,,2610.6,95,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2253.36,82,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2335.8,85,,percent of total billed charges,,2071.99,2610.6,
"SURG SITE EMTF PREP, EA ADDT'L 100 SQ CM",81000293,CDM,15005,CPT,761,RC,inpatient,,2748,2748,,2333.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2071.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2335.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2418.24,88,,percent of total billed charges,,,,,,,,,2099.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2500.68,91,,percent of total billed charges,,,2610.6,95,,percent of total billed charges,,,2280.84,83,,percent of total billed charges,,,2280.84,83,,percent of total billed charges,,,,,,,,,,,,,,,2280.84,83,,percent of total billed charges,,,2610.6,95,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2253.36,82,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2335.8,85,,percent of total billed charges,,2071.99,2610.6,
"PINCH GRAFT, UP TO 2 CM DIAMETER",81000302,CDM,15050,CPT,761,RC,inpatient,,3125,3125,,2653.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2356.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2656.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2750,88,,percent of total billed charges,,,,,,,,,2387.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2843.75,91,,percent of total billed charges,,,2968.75,95,,percent of total billed charges,,,2593.75,83,,percent of total billed charges,,,2593.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2593.75,83,,percent of total billed charges,,,2968.75,95,,percent of total billed charges,,,2812.5,90,,percent of total billed charges,,,2812.5,90,,percent of total billed charges,,,2562.5,82,,percent of total billed charges,,,2812.5,90,,percent of total billed charges,,,2656.25,85,,percent of total billed charges,,2356.25,2968.75,
APL APLIGRAF SKIN SUBS/NEO 1ST 25 SQ CM,81000303,CDM,15271,CPT,761,RC,inpatient,,2011,2011,,1707.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1516.29,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1709.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1769.68,88,,percent of total billed charges,,,,,,,,,1536.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1830.01,91,,percent of total billed charges,,,1910.45,95,,percent of total billed charges,,,1669.13,83,,percent of total billed charges,,,1669.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1669.13,83,,percent of total billed charges,,,1910.45,95,,percent of total billed charges,,,1809.9,90,,percent of total billed charges,,,1809.9,90,,percent of total billed charges,,,1649.02,82,,percent of total billed charges,,,1809.9,90,,percent of total billed charges,,,1709.35,85,,percent of total billed charges,,1516.29,1910.45,
APL APLIG SKIN SUBS/NEODERM ADD 25 SQ CM,81000304,CDM,15271,CPT,761,RC,inpatient,,2010,2010,,1706.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1515.54,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1708.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1768.8,88,,percent of total billed charges,,,,,,,,,1535.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1829.1,91,,percent of total billed charges,,,1909.5,95,,percent of total billed charges,,,1668.3,83,,percent of total billed charges,,,1668.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1668.3,83,,percent of total billed charges,,,1909.5,95,,percent of total billed charges,,,1809,90,,percent of total billed charges,,,1809,90,,percent of total billed charges,,,1648.2,82,,percent of total billed charges,,,1809,90,,percent of total billed charges,,,1708.5,85,,percent of total billed charges,,1515.54,1909.5,
APPLY DERMAGRAFT 100,81000305,CDM,15727,CPT,761,RC,inpatient,,1366,1366,,1159.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1029.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1161.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1202.08,88,,percent of total billed charges,,,,,,,,,1043.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1243.06,91,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1133.78,83,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1120.12,82,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1161.1,85,,percent of total billed charges,,1029.96,1297.7,
APPL OASIS 1ST 100 SQCM,81000307,CDM,15271,CPT,761,RC,inpatient,,2184,2184,,1854.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1646.74,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1856.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1921.92,88,,percent of total billed charges,,,,,,,,,1668.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1987.44,91,,percent of total billed charges,,,2074.8,95,,percent of total billed charges,,,1812.72,83,,percent of total billed charges,,,1812.72,83,,percent of total billed charges,,,,,,,,,,,,,,,1812.72,83,,percent of total billed charges,,,2074.8,95,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1790.88,82,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1856.4,85,,percent of total billed charges,,1646.74,2074.8,
"APPL XENOGRAFT,SKIN; EA ADDT'L 100 SQ CM",81000308,CDM,15274,CPT,761,RC,inpatient,,1995,1995,,1693.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1504.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1695.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1755.6,88,,percent of total billed charges,,,,,,,,,1524.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1815.45,91,,percent of total billed charges,,,1895.25,95,,percent of total billed charges,,,1655.85,83,,percent of total billed charges,,,1655.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1655.85,83,,percent of total billed charges,,,1895.25,95,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1635.9,82,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1695.75,85,,percent of total billed charges,,1504.23,1895.25,
"DERMAL TISSUE, HUMAN ORIGIN PER44 SQ CM",81000310,CDM,Q4101,HCPCS,278,RC,inpatient,,6614,6614,,5615.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4986.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5621.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5820.32,88,,percent of total billed charges,,,,,,,,,5053.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6018.74,91,,percent of total billed charges,,,6283.3,95,,percent of total billed charges,,,5489.62,83,,percent of total billed charges,,,5489.62,83,,percent of total billed charges,,,,,,,,,,,,,,,5489.62,83,,percent of total billed charges,,,6283.3,95,,percent of total billed charges,,,5952.6,90,,percent of total billed charges,,,5952.6,90,,percent of total billed charges,,,5423.48,82,,percent of total billed charges,,,5952.6,90,,percent of total billed charges,,,5621.9,85,,percent of total billed charges,,4986.96,6283.3,
"DERMAL TISSUE, HUMAN ORIGIN PER SQ CM",81000312,CDM,Q4106,HCPCS,636,RC,inpatient,,4248,4248,,3606.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3202.99,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3610.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3738.24,88,,percent of total billed charges,,,,,,,,,3245.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3865.68,91,,percent of total billed charges,,,4035.6,95,,percent of total billed charges,,,3525.84,83,,percent of total billed charges,,,3525.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3525.84,83,,percent of total billed charges,,,4035.6,95,,percent of total billed charges,,,3823.2,90,,percent of total billed charges,,,3823.2,90,,percent of total billed charges,,,3483.36,82,,percent of total billed charges,,,3823.2,90,,percent of total billed charges,,,3610.8,85,,percent of total billed charges,,3202.99,4035.6,
HARVEST SKIN FOR TISSUE CULT AUTOGRAFT,81000314,CDM,15040,CPT,761,RC,inpatient,,2199,2199,,1866.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1658.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1869.15,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1935.12,88,,percent of total billed charges,,,,,,,,,1680.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2001.09,91,,percent of total billed charges,,,2089.05,95,,percent of total billed charges,,,1825.17,83,,percent of total billed charges,,,1825.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1825.17,83,,percent of total billed charges,,,2089.05,95,,percent of total billed charges,,,1979.1,90,,percent of total billed charges,,,1979.1,90,,percent of total billed charges,,,1803.18,82,,percent of total billed charges,,,1979.1,90,,percent of total billed charges,,,1869.15,85,,percent of total billed charges,,1658.05,2089.05,
APL OASIS EA ADDTL 100 SQCM,81000324,CDM,15274,CPT,761,RC,inpatient,,1995,1995,,1693.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1504.23,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1695.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1755.6,88,,percent of total billed charges,,,,,,,,,1524.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1815.45,91,,percent of total billed charges,,,1895.25,95,,percent of total billed charges,,,1655.85,83,,percent of total billed charges,,,1655.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1655.85,83,,percent of total billed charges,,,1895.25,95,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1635.9,82,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1695.75,85,,percent of total billed charges,,1504.23,1895.25,
APPLY DERMAGRAFT + 100 SQCM,81000325,CDM,15278,CPT,761,RC,inpatient,,1366,1366,,1159.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1029.96,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1161.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1202.08,88,,percent of total billed charges,,,,,,,,,1043.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1243.06,91,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1133.78,83,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1120.12,82,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1161.1,85,,percent of total billed charges,,1029.96,1297.7,
"DRESSINGS/DEBRIDEMENT BURNS, SMALL",81000350,CDM,16020,CPT,761,RC,inpatient,,432,432,,366.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,325.73,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,367.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,380.16,88,,percent of total billed charges,,,,,,,,,330.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,393.12,91,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,,,,,,,,,,,,,358.56,83,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,354.24,82,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,325.73,410.4,
"DRESSINGS/DEBRIDEMENT BURNS, MEDIUM",81000351,CDM,16025,CPT,761,RC,inpatient,,477,477,,404.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,359.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,405.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,419.76,88,,percent of total billed charges,,,,,,,,,364.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,434.07,91,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,,,,,,,,,,,,,395.91,83,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,391.14,82,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,359.66,453.15,
"DRESSINGS/DEBRIDEMENT BURNS, LARGE",81000352,CDM,16030,CPT,761,RC,inpatient,,678,678,,575.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,511.21,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,576.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,596.64,88,,percent of total billed charges,,,,,,,,,517.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,616.98,91,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,,,,,,,,,,,,,562.74,83,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,555.96,82,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,576.3,85,,percent of total billed charges,,511.21,644.1,
CHEMICAL CAUTER GRANULATION TISSUE,81000370,CDM,17250,CPT,761,RC,inpatient,,712,712,,604.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,536.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,605.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,626.56,88,,percent of total billed charges,,,,,,,,,543.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,647.92,91,,percent of total billed charges,,,676.4,95,,percent of total billed charges,,,590.96,83,,percent of total billed charges,,,590.96,83,,percent of total billed charges,,,,,,,,,,,,,,,590.96,83,,percent of total billed charges,,,676.4,95,,percent of total billed charges,,,640.8,90,,percent of total billed charges,,,640.8,90,,percent of total billed charges,,,583.84,82,,percent of total billed charges,,,640.8,90,,percent of total billed charges,,,605.2,85,,percent of total billed charges,,536.85,676.4,
"CHEMICAL CAUTERIZATION, 1ST LESION",81000371,CDM,17000,CPT,761,RC,inpatient,,255,255,,216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,192.27,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,216.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,224.4,88,,percent of total billed charges,,,,,,,,,194.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,209.1,82,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,192.27,242.25,
"CHEM CAUTERIZATION, 2ND THRU 14TH LESION",81000372,CDM,17003,CPT,761,RC,inpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,171.16,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,192.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,171.16,215.65,
PARE/CUT BENIGH HYPERKERATOTIC SGL LES,81000373,CDM,11055,CPT,761,RC,inpatient,Q7,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,349.86,440.8,
PARE/CUT BENIGH HYPERKERATOTIC SGL LES,81000374,CDM,11055,CPT,761,RC,inpatient,Q8,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,349.86,440.8,
PARE/CUT BENIGH HYPERKERATOTIC SGL LES,81000375,CDM,11055,CPT,761,RC,inpatient,Q9,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,349.86,440.8,
PARE/CUT BENIGH HYPERKERATOTIC SGL LES,81000376,CDM,11055,CPT,761,RC,inpatient,Q7,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,349.86,440.8,
PARE/CUT BENIGH HYPERKERATOTIC SGL LES,81000377,CDM,11055,CPT,761,RC,inpatient,Q8,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,349.86,440.8,
PARE/CUT BENIGH HYPERKERATOTIC SGL LES,81000378,CDM,11055,CPT,761,RC,inpatient,Q9,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,349.86,440.8,
PARE/CUT BENIGH HYPERKERATOTIC 2-4 LES,81000379,CDM,11056,CPT,761,RC,inpatient,Q7,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,349.86,440.8,
PARE/CUT BENIGH HYPERKERATOTIC 2-4 LES,81000380,CDM,11056,CPT,761,RC,inpatient,Q8,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,349.86,440.8,
PARE/CUT BENIGH HYPERKERATOTIC 2-4 LES,81000381,CDM,11056,CPT,761,RC,inpatient,Q9,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,349.86,440.8,
PARE/CUT BENIGH HYPERKERA 2-4 LES W/MOD,81000382,CDM,11056,CPT,761,RC,inpatient,Q7,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,351.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,351.36,442.7,
PARE/CUT BENIGH HYPERKERA 2-4 LES W/MOD,81000383,CDM,11056,CPT,761,RC,inpatient,Q8,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,351.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,351.36,442.7,
PARE/CUT BENIGH HYPERKERA 2-4 LES W/MOD,81000384,CDM,11056,CPT,761,RC,inpatient,Q9,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,351.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,351.36,442.7,
PARE/CUT BENIGH HYPERKERATOTIC >4 LES,81000385,CDM,11057,CPT,761,RC,inpatient,Q7,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,351.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,351.36,442.7,
PARE/CUT BENIGH HYPERKERATOTIC >4 LES,81000386,CDM,11057,CPT,761,RC,inpatient,Q8,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,351.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,351.36,442.7,
PARE/CUT BENIGH HYPERKERATOTIC >4 LES,81000387,CDM,11057,CPT,761,RC,inpatient,Q9,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,351.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,351.36,442.7,
PARE/CUT BENIGH HYPERKERA >4 LES W/MOD,81000388,CDM,11057,CPT,761,RC,inpatient,Q7,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,351.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,351.36,442.7,
PARE/CUT BENIGH HYPERKERA >4 LES W/MOD,81000389,CDM,11057,CPT,761,RC,inpatient,Q8,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,351.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,351.36,442.7,
PARE/CUT BENIGH HYPERKERA >4 LES W/MOD,81000390,CDM,11057,CPT,761,RC,inpatient,Q9,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,351.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,396.1,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,351.36,442.7,
TRIM NAILS NONDYSTROPHIC,81000391,CDM,11719,CPT,761,RC,inpatient,Q7,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
TRIM NAILS NONDYSTROPHIC,81000392,CDM,11719,CPT,761,RC,inpatient,Q8,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
TRIM NAILS NONDYSTROPHIC,81000393,CDM,11719,CPT,761,RC,inpatient,Q9,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
TRIM NAILS NONDYSTROPHIC W/MOD,81000394,CDM,11719,CPT,761,RC,inpatient,Q7,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
TRIM NAILS NONDYSTROPHIC W/MOD,81000395,CDM,11719,CPT,761,RC,inpatient,Q8,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
TRIM NAILS NONDYSTROPHIC W/MOD,81000396,CDM,11719,CPT,761,RC,inpatient,Q9,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,159.85,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,180.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,159.85,201.4,
"DEBRIDEMENT OF NAIL(S), ANY METHOD, 1-5",81000397,CDM,11720,CPT,761,RC,inpatient,Q7,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,251.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,283.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,251.08,316.35,
"DEBRIDEMENT OF NAIL(S), ANY METHOD, 1-5",81000398,CDM,11720,CPT,761,RC,inpatient,Q8,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,251.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,283.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,251.08,316.35,
"DEBRIDEMENT OF NAIL(S), ANY METHOD, 1-5",81000399,CDM,11720,CPT,761,RC,inpatient,Q9,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,251.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,283.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,251.08,316.35,
APPLICATION OF SHORT LEG CAST,81000400,CDM,29405,CPT,761,RC,inpatient,,1074,1074,,911.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,809.8,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,912.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,945.12,88,,percent of total billed charges,,,,,,,,,820.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,977.34,91,,percent of total billed charges,,,1020.3,95,,percent of total billed charges,,,891.42,83,,percent of total billed charges,,,891.42,83,,percent of total billed charges,,,,,,,,,,,,,,,891.42,83,,percent of total billed charges,,,1020.3,95,,percent of total billed charges,,,966.6,90,,percent of total billed charges,,,966.6,90,,percent of total billed charges,,,880.68,82,,percent of total billed charges,,,966.6,90,,percent of total billed charges,,,912.9,85,,percent of total billed charges,,809.8,1020.3,
APPL/REM  WRAP SINGLE,81000401,CDM,29580,CPT,761,RC,inpatient,,704,704,,597.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,530.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,598.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,619.52,88,,percent of total billed charges,,,,,,,,,537.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,640.64,91,,percent of total billed charges,,,668.8,95,,percent of total billed charges,,,584.32,83,,percent of total billed charges,,,584.32,83,,percent of total billed charges,,,,,,,,,,,,,,,584.32,83,,percent of total billed charges,,,668.8,95,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,577.28,82,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,598.4,85,,percent of total billed charges,,530.82,668.8,
APPL/REM WRAP BILAT,81000402,CDM,29580,CPT,761,RC,inpatient,50,855,855,,725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,644.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,726.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,752.4,88,,percent of total billed charges,,,,,,,,,653.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,778.05,91,,percent of total billed charges,,,812.25,95,,percent of total billed charges,,,709.65,83,,percent of total billed charges,,,709.65,83,,percent of total billed charges,,,,,,,,,,,,,,,709.65,83,,percent of total billed charges,,,812.25,95,,percent of total billed charges,,,769.5,90,,percent of total billed charges,,,769.5,90,,percent of total billed charges,,,701.1,82,,percent of total billed charges,,,769.5,90,,percent of total billed charges,,,726.75,85,,percent of total billed charges,,644.67,812.25,
"APPLY SHORT LEG CAST, WALKING",81000403,CDM,29425,CPT,761,RC,inpatient,,363,363,,308.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,273.7,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,308.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,319.44,88,,percent of total billed charges,,,,,,,,,277.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,330.33,91,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,,,,,,,,,,,,,301.29,83,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,297.66,82,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,273.7,344.85,
APPLY RIGID TOTAL CONTACT LEG CAST,81000404,CDM,29445,CPT,761,RC,inpatient,,1091,1091,,926.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,822.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,927.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,960.08,88,,percent of total billed charges,,,,,,,,,833.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,992.81,91,,percent of total billed charges,,,1036.45,95,,percent of total billed charges,,,905.53,83,,percent of total billed charges,,,905.53,83,,percent of total billed charges,,,,,,,,,,,,,,,905.53,83,,percent of total billed charges,,,1036.45,95,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,894.62,82,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,927.35,85,,percent of total billed charges,,822.61,1036.45,
M-L WRAP UNI,81000405,CDM,29581,CPT,761,RC,inpatient,,662,662,,562.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,499.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,562.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,582.56,88,,percent of total billed charges,,,,,,,,,505.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,602.42,91,,percent of total billed charges,,,628.9,95,,percent of total billed charges,,,549.46,83,,percent of total billed charges,,,549.46,83,,percent of total billed charges,,,,,,,,,,,,,,,549.46,83,,percent of total billed charges,,,628.9,95,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,542.84,82,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,562.7,85,,percent of total billed charges,,499.15,628.9,
M-L WRAP BIL,81000406,CDM,29581,CPT,761,RC,inpatient,50,1324,1324,,1124.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,998.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1125.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1165.12,88,,percent of total billed charges,,,,,,,,,1011.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1204.84,91,,percent of total billed charges,,,1257.8,95,,percent of total billed charges,,,1098.92,83,,percent of total billed charges,,,1098.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1098.92,83,,percent of total billed charges,,,1257.8,95,,percent of total billed charges,,,1191.6,90,,percent of total billed charges,,,1191.6,90,,percent of total billed charges,,,1085.68,82,,percent of total billed charges,,,1191.6,90,,percent of total billed charges,,,1125.4,85,,percent of total billed charges,,998.3,1257.8,
M-L WRAP UNI WITH MODIFIER,81000407,CDM,29581,CPT,761,RC,inpatient,59,662,662,,562.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,499.15,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,562.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,582.56,88,,percent of total billed charges,,,,,,,,,505.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,602.42,91,,percent of total billed charges,,,628.9,95,,percent of total billed charges,,,549.46,83,,percent of total billed charges,,,549.46,83,,percent of total billed charges,,,,,,,,,,,,,,,549.46,83,,percent of total billed charges,,,628.9,95,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,542.84,82,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,562.7,85,,percent of total billed charges,,499.15,628.9,
APPLY RIGID TL CONTACT LEG CAST WITH MOD,81000408,CDM,29445,CPT,761,RC,inpatient,59,1091,1091,,926.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,822.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,927.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,960.08,88,,percent of total billed charges,,,,,,,,,833.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,992.81,91,,percent of total billed charges,,,1036.45,95,,percent of total billed charges,,,905.53,83,,percent of total billed charges,,,905.53,83,,percent of total billed charges,,,,,,,,,,,,,,,905.53,83,,percent of total billed charges,,,1036.45,95,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,894.62,82,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,927.35,85,,percent of total billed charges,,822.61,1036.45,
APLIGRAF 1 SQCM USED,81000410,CDM,Q4101,HCPCS,278,RC,inpatient,,210,210,,178.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,158.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,178.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,184.8,88,,percent of total billed charges,,,,,,,,,160.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,,,,,,,,,,,,,174.3,83,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,172.2,82,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,158.34,199.5,
APLIGRAF 1 SQCM NOT USED,81000411,CDM,Q4101,HCPCS,278,RC,inpatient,JW,210,210,,178.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,158.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,178.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,184.8,88,,percent of total billed charges,,,,,,,,,160.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,,,,,,,,,,,,,174.3,83,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,172.2,82,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,158.34,199.5,
OASIS 1 SQCM USED,81000412,CDM,Q4102,HCPCS,278,RC,inpatient,,28,28,,23.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.64,88,,percent of total billed charges,,,,,,,,,21.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,,,,,,,,,,,,,23.24,83,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,22.96,82,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,21.11,26.6,
OASIS 1 SQCM  NOT USED,81000413,CDM,Q4102,HCPCS,278,RC,inpatient,JW,28,28,,23.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,21.11,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,23.8,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,24.64,88,,percent of total billed charges,,,,,,,,,21.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,,,,,,,,,,,,,23.24,83,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,22.96,82,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,21.11,26.6,
OASIS ULTRA TRI LAYER 1 SQCM USED,81000414,CDM,Q4124,HCPCS,272,RC,inpatient,JC,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,189.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,213.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,189.25,238.45,
APLI SKIN SUB PER SQ CM,81000415,CDM,Q4101,HCPCS,636,RC,inpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,169.65,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,191.25,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,169.65,213.75,
"IV INFUSION THERAPY, UP TO 1 HOUR",81000420,CDM,96365,CPT,761,RC,inpatient,XU,672,672,,570.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,506.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,571.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,591.36,88,,percent of total billed charges,,,,,,,,,513.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,611.52,91,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,,,,,,,,,,,,,557.76,83,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,551.04,82,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,571.2,85,,percent of total billed charges,,506.69,638.4,
"IV INFUSION THERAPY, ADDL HR, TO 8 HR",81000425,CDM,96366,CPT,761,RC,inpatient,XU,210,210,,178.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,158.34,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,178.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,184.8,88,,percent of total billed charges,,,,,,,,,160.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,,,,,,,,,,,,,174.3,83,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,172.2,82,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,158.34,199.5,
IM/SQ INJECTION,81000430,CDM,96372,CPT,761,RC,inpatient,XU,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,161.36,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,181.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,161.36,203.3,
IM INJECTION OF ANTIBIOTIC,81000431,CDM,96372,CPT,761,RC,inpatient,XU,290,290,,246.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,218.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,246.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,255.2,88,,percent of total billed charges,,,,,,,,,221.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,263.9,91,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,,,,,,,,,,,,,240.7,83,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,261,90,,percent of total billed charges,,,261,90,,percent of total billed charges,,,237.8,82,,percent of total billed charges,,,261,90,,percent of total billed charges,,,246.5,85,,percent of total billed charges,,218.66,275.5,
"SUBCUT INFU THERAPY,INITIAL UP TO 1 HOUR",81000432,CDM,96369,CPT,761,RC,inpatient,,672,672,,570.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,506.69,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,571.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,591.36,88,,percent of total billed charges,,,,,,,,,513.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,611.52,91,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,,,,,,,,,,,,,557.76,83,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,551.04,82,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,571.2,85,,percent of total billed charges,,506.69,638.4,
NON-INV STUDIES UPPER/LOWER EXTR SINGLE,81000450,CDM,93922,CPT,921,RC,inpatient,,878,878,,745.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,662.01,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,746.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,772.64,88,,percent of total billed charges,,,,,,,,,670.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,798.98,91,,percent of total billed charges,,,834.1,95,,percent of total billed charges,,,728.74,83,,percent of total billed charges,,,728.74,83,,percent of total billed charges,,,,,,,,,,,,,,,728.74,83,,percent of total billed charges,,,834.1,95,,percent of total billed charges,,,790.2,90,,percent of total billed charges,,,790.2,90,,percent of total billed charges,,,719.96,82,,percent of total billed charges,,,790.2,90,,percent of total billed charges,,,746.3,85,,percent of total billed charges,,662.01,834.1,
"NON-INV STUDIES UPPER/LOWER EXT, MULTIPL",81000451,CDM,93923,CPT,921,RC,inpatient,,1357,1357,,1152.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1023.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1153.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1194.16,88,,percent of total billed charges,,,,,,,,,1036.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1234.87,91,,percent of total billed charges,,,1289.15,95,,percent of total billed charges,,,1126.31,83,,percent of total billed charges,,,1126.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1126.31,83,,percent of total billed charges,,,1289.15,95,,percent of total billed charges,,,1221.3,90,,percent of total billed charges,,,1221.3,90,,percent of total billed charges,,,1112.74,82,,percent of total billed charges,,,1221.3,90,,percent of total billed charges,,,1153.45,85,,percent of total billed charges,,1023.18,1289.15,
NON-INV STUDIES UPPER/LOWER EXTR UNILATR,81000452,CDM,93922,CPT,921,RC,inpatient,52,815,815,,691.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,614.51,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,692.75,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,717.2,88,,percent of total billed charges,,,,,,,,,622.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,741.65,91,,percent of total billed charges,,,774.25,95,,percent of total billed charges,,,676.45,83,,percent of total billed charges,,,676.45,83,,percent of total billed charges,,,,,,,,,,,,,,,676.45,83,,percent of total billed charges,,,774.25,95,,percent of total billed charges,,,733.5,90,,percent of total billed charges,,,733.5,90,,percent of total billed charges,,,668.3,82,,percent of total billed charges,,,733.5,90,,percent of total billed charges,,,692.75,85,,percent of total billed charges,,614.51,774.25,
"NON-INV STUDIES UPPER/LOWER EXT,UNILATRL",81000453,CDM,93923,CPT,921,RC,inpatient,52,1253,1253,,1063.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,944.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1065.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1102.64,88,,percent of total billed charges,,,,,,,,,957.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1140.23,91,,percent of total billed charges,,,1190.35,95,,percent of total billed charges,,,1039.99,83,,percent of total billed charges,,,1039.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1039.99,83,,percent of total billed charges,,,1190.35,95,,percent of total billed charges,,,1127.7,90,,percent of total billed charges,,,1127.7,90,,percent of total billed charges,,,1027.46,82,,percent of total billed charges,,,1127.7,90,,percent of total billed charges,,,1065.05,85,,percent of total billed charges,,944.76,1190.35,
EPIDERMAL AUTOGRAFT ARMS FIRST 100 SQ CM,81000460,CDM,15110,CPT,761,RC,inpatient,,7652,7652,,6496.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,5769.61,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,6504.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,6733.76,88,,percent of total billed charges,,,,,,,,,5846.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,6963.32,91,,percent of total billed charges,,,7269.4,95,,percent of total billed charges,,,6351.16,83,,percent of total billed charges,,,6351.16,83,,percent of total billed charges,,,,,,,,,,,,,,,6351.16,83,,percent of total billed charges,,,7269.4,95,,percent of total billed charges,,,6886.8,90,,percent of total billed charges,,,6886.8,90,,percent of total billed charges,,,6274.64,82,,percent of total billed charges,,,6886.8,90,,percent of total billed charges,,,6504.2,85,,percent of total billed charges,,5769.61,7269.4,
EPIDRM A-GRFT-FACE/NCK/HF/G 100 SQ CM<,81000462,CDM,15115,CPT,761,RC,inpatient,,5630,5630,,4779.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4245.02,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4785.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,4954.4,88,,percent of total billed charges,,,,,,,,,4301.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5123.3,91,,percent of total billed charges,,,5348.5,95,,percent of total billed charges,,,4672.9,83,,percent of total billed charges,,,4672.9,83,,percent of total billed charges,,,,,,,,,,,,,,,4672.9,83,,percent of total billed charges,,,5348.5,95,,percent of total billed charges,,,5067,90,,percent of total billed charges,,,5067,90,,percent of total billed charges,,,4616.6,82,,percent of total billed charges,,,5067,90,,percent of total billed charges,,,4785.5,85,,percent of total billed charges,,4245.02,5348.5,
NEG PRESS WOUND TX </= 50 CM,81000464,CDM,97607,CPT,761,RC,inpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,347.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,391.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,347.59,437.95,
NEG PRESS WOUND TX >50 CM,81000465,CDM,97608,CPT,761,RC,inpatient,,632,632,,536.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,476.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,537.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,556.16,88,,percent of total billed charges,,,,,,,,,482.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,575.12,91,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,,,,,,,,,,,,,524.56,83,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,518.24,82,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,537.2,85,,percent of total billed charges,,476.53,600.4,
HYALOMATRIX 1 SQCM USED,81000470,CDM,Q4117,HCPCS,278,RC,inpatient,,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
HYALOMATRIX 1 SQCM  NOT USED,81000471,CDM,Q4117,HCPCS,278,RC,inpatient,JW,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,104.05,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,117.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,104.05,131.1,
GRAFIX STRAVIX PRIME 1 SQCM USED,81000480,CDM,Q4133,HCPCS,270,RC,inpatient,JC,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
GRAFIX STRAVIX PRIME 1 SQCM NOT USED,81000481,CDM,Q4133,HCPCS,278,RC,inpatient,JW,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1470.3,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1657.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,1470.3,1852.5,
FF EX BEN LESION MARGINS >4.0CM,81000501,CDM,11406,CPT,761,RC,inpatient,,6271,6271,,5324.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4728.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5330.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5518.48,88,,percent of total billed charges,,,,,,,,,4791.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5706.61,91,,percent of total billed charges,,,5957.45,95,,percent of total billed charges,,,5204.93,83,,percent of total billed charges,,,5204.93,83,,percent of total billed charges,,,,,,,,,,,,,,,5204.93,83,,percent of total billed charges,,,5957.45,95,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5142.22,82,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5330.35,85,,percent of total billed charges,,4728.33,5957.45,
"DEBRID OF NAIL(S), ANY METH, 1-5 W/MOD",81000502,CDM,11720,CPT,761,RC,inpatient,Q7,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,251.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,283.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,251.08,316.35,
"DEBRID OF NAIL(S), ANY METH, 1-5 W/MOD",81000503,CDM,11720,CPT,761,RC,inpatient,Q8,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,251.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,283.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,251.08,316.35,
"DEBRID OF NAIL(S), ANY METH, 1-5 W/MOD",81000504,CDM,11720,CPT,761,RC,inpatient,Q9,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,251.08,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,283.05,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,251.08,316.35,
"DEBRIDEMENT NAILS, ANY METHOD, 6 OR MORE",81000505,CDM,11721,CPT,761,RC,inpatient,Q7,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,353.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,398.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,353.63,445.55,
"DEBRIDEMENT NAILS, ANY METHOD, 6 OR MORE",81000506,CDM,11721,CPT,761,RC,inpatient,Q8,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,353.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,398.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,353.63,445.55,
"DEBRIDEMENT NAILS, ANY METHOD, 6 OR MORE",81000507,CDM,11721,CPT,761,RC,inpatient,Q9,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,353.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,398.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,353.63,445.55,
"DEBRID NAILS, ANY METH, 6 OR MORE W/MOD",81000508,CDM,11721,CPT,761,RC,inpatient,Q7,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,353.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,398.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,353.63,445.55,
"DEBRID NAILS, ANY METH, 6 OR MORE W/MOD",81000509,CDM,11721,CPT,761,RC,inpatient,Q8,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,353.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,398.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,353.63,445.55,
"DEBRID NAILS, ANY METH, 6 OR MORE W/MOD",81000510,CDM,11721,CPT,761,RC,inpatient,Q9,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,353.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,398.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,353.63,445.55,
"AVULSION NAIL PLATE, PTL OR COMP, SNGL",81000511,CDM,11730,CPT,761,RC,inpatient,Q7,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,330.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,372.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,330.25,416.1,
"AVULSION NAIL PLATE, PTL OR COMP, SNGL",81000512,CDM,11730,CPT,761,RC,inpatient,Q8,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,330.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,372.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,330.25,416.1,
"AVULSION NAIL PLATE, PTL OR COMP, SNGL",81000513,CDM,11730,CPT,761,RC,inpatient,Q9,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,330.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,372.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,330.25,416.1,
"AVUL NAIL PLATE, PTL OR COMP, SNGL W/MOD",81000514,CDM,11730,CPT,761,RC,inpatient,Q7,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,330.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,372.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,330.25,416.1,
"AVUL NAIL PLATE, PTL OR COMP, SNGL W/MOD",81000515,CDM,11730,CPT,761,RC,inpatient,Q8,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,330.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,372.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,330.25,416.1,
"AVUL NAIL PLATE, PTL OR COMP, SNGL W/MOD",81000516,CDM,11730,CPT,761,RC,inpatient,Q9,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,330.25,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,372.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,330.25,416.1,
AVULSION EA ADDT'L NAIL PLATE,81000517,CDM,11732,CPT,761,RC,inpatient,Q7,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,269.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,303.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,269.18,339.15,
AVULSION EA ADDT'L NAIL PLATE,81000518,CDM,11732,CPT,761,RC,inpatient,Q8,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,269.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,303.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,269.18,339.15,
AVULSION EA ADDT'L NAIL PLATE,81000519,CDM,11732,CPT,761,RC,inpatient,Q9,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,269.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,303.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,269.18,339.15,
AVULSION EA ADDT'L NAIL PLATE W/MOD,81000520,CDM,11732,CPT,761,RC,inpatient,Q7,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,269.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,303.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,269.18,339.15,
AVULSION EA ADDT'L NAIL PLATE W/MOD,81000521,CDM,11732,CPT,761,RC,inpatient,Q8,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,269.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,303.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,269.18,339.15,
AVULSION EA ADDT'L NAIL PLATE W/MOD,81000522,CDM,11732,CPT,761,RC,inpatient,Q9,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,269.18,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,303.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,269.18,339.15,
FF VISIT-NEW PATIENT,81000550,CDM,G0463,HCPCS,510,RC,inpatient,,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,454.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,512.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,454.66,572.85,
FF VISIT-NEW PATIENT W/MOD,81000551,CDM,G0463,HCPCS,510,RC,inpatient,25,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,454.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,512.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,454.66,572.85,
FF VISIT-ESTABLISHED PATIENT,81000552,CDM,G0463,HCPCS,510,RC,inpatient,,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,454.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,512.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,454.66,572.85,
FF VISIT-ESTABLISHED PATIENT WITH MOD,81000553,CDM,G0463,HCPCS,510,RC,inpatient,25,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,454.66,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,512.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,454.66,572.85,
 EXCISION BEN LESION MARGINS,81000554,CDM,11406,CPT,761,RC,inpatient,,6271,6271,,5324.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4728.33,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,5330.35,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5518.48,88,,percent of total billed charges,,,,,,,,,4791.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5706.61,91,,percent of total billed charges,,,5957.45,95,,percent of total billed charges,,,5204.93,83,,percent of total billed charges,,,5204.93,83,,percent of total billed charges,,,,,,,,,,,,,,,5204.93,83,,percent of total billed charges,,,5957.45,95,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5142.22,82,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5330.35,85,,percent of total billed charges,,4728.33,5957.45,
SCALP TRK EXT LYR 2.6 TO 7.5 CM,81000600,CDM,12032,CPT,761,RC,inpatient,,2096,2096,,1779.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,1580.38,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1781.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1844.48,88,,percent of total billed charges,,,,,,,,,1601.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1907.36,91,,percent of total billed charges,,,1991.2,95,,percent of total billed charges,,,1739.68,83,,percent of total billed charges,,,1739.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1739.68,83,,percent of total billed charges,,,1991.2,95,,percent of total billed charges,,,1886.4,90,,percent of total billed charges,,,1886.4,90,,percent of total billed charges,,,1718.72,82,,percent of total billed charges,,,1886.4,90,,percent of total billed charges,,,1781.6,85,,percent of total billed charges,,1580.38,1991.2,
EXC TR-EXT MAL MARG >4,81000601,CDM,11606,CPT,761,RC,inpatient,,5822,5822,,4942.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,4389.79,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,4948.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,5123.36,88,,percent of total billed charges,,,,,,,,,4448.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,5298.02,91,,percent of total billed charges,,,5530.9,95,,percent of total billed charges,,,4832.26,83,,percent of total billed charges,,,4832.26,83,,percent of total billed charges,,,,,,,,,,,,,,,4832.26,83,,percent of total billed charges,,,5530.9,95,,percent of total billed charges,,,5239.8,90,,percent of total billed charges,,,5239.8,90,,percent of total billed charges,,,4774.04,82,,percent of total billed charges,,,5239.8,90,,percent of total billed charges,,,4948.7,85,,percent of total billed charges,,4389.79,5530.9,
DESTRUCTION OF SKIN LESIONS,81000602,CDM,17106,CPT,761,RC,inpatient,,1316,1316,,1117.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,992.26,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,1118.6,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1158.08,88,,percent of total billed charges,,,,,,,,,1005.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1197.56,91,,percent of total billed charges,,,1250.2,95,,percent of total billed charges,,,1092.28,83,,percent of total billed charges,,,1092.28,83,,percent of total billed charges,,,,,,,,,,,,,,,1092.28,83,,percent of total billed charges,,,1250.2,95,,percent of total billed charges,,,1184.4,90,,percent of total billed charges,,,1184.4,90,,percent of total billed charges,,,1079.12,82,,percent of total billed charges,,,1184.4,90,,percent of total billed charges,,,1118.6,85,,percent of total billed charges,,992.26,1250.2,
DESTRUCTION OF MALIGNANT SKIN LESIONS,81000603,CDM,17262,CPT,761,RC,inpatient,,567,567,,481.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,427.52,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,481.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,498.96,88,,percent of total billed charges,,,,,,,,,433.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,,,,,,,,,,,,,470.61,83,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,464.94,82,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,427.52,538.65,
NEG PRESS WOUND TX </= 50 CM WITH MOD,81000604,CDM,97607,CPT,761,RC,inpatient,59,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,347.59,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,391.85,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,347.59,437.95,
NEG PRESS WOUND TX >50 CM WITH MOD,81000605,CDM,97608,CPT,761,RC,inpatient,59,632,632,,536.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,476.53,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,537.2,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,556.16,88,,percent of total billed charges,,,,,,,,,482.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,575.12,91,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,,,,,,,,,,,,,524.56,83,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,518.24,82,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,537.2,85,,percent of total billed charges,,476.53,600.4,
LOW FREQUENCY NON-CONTACT NON-THERMAL US,81000612,CDM,97610,CPT,761,RC,inpatient,,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,589.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,664.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,589.63,742.9,
LOW FREQ NON-CONCT NON-THERMAL US W MOD,81000613,CDM,97610,CPT,761,RC,inpatient,59,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,589.63,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,664.7,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,589.63,742.9,
TRIMMING OF DYSTROPHIC NAILS,81000614,CDM,G0127,HCPCS,761,RC,inpatient,,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,164.37,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,185.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,191.84,88,,percent of total billed charges,,14.35,,,,fee schedule,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.35,,,,fee schedule,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,14.35,207.1,
EPIFIX PER SQ CM,81000615,CDM,Q4186,HCPCS,636,RC,inpatient,,1154,1154,,979.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,870.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,980.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1015.52,88,,percent of total billed charges,,,,,,,,,881.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1050.14,91,,percent of total billed charges,,,1096.3,95,,percent of total billed charges,,,957.82,83,,percent of total billed charges,,,957.82,83,,percent of total billed charges,,,,,,,,,,,,,,,957.82,83,,percent of total billed charges,,,1096.3,95,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,946.28,82,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,980.9,85,,percent of total billed charges,,870.12,1096.3,
EPIFIX SQ CM NOT USED,81000616,CDM,Q4186,HCPCS,636,RC,inpatient,JW,1154,1154,,979.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,870.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,980.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1015.52,88,,percent of total billed charges,,,,,,,,,881.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1050.14,91,,percent of total billed charges,,,1096.3,95,,percent of total billed charges,,,957.82,83,,percent of total billed charges,,,957.82,83,,percent of total billed charges,,,,,,,,,,,,,,,957.82,83,,percent of total billed charges,,,1096.3,95,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,946.28,82,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,980.9,85,,percent of total billed charges,,870.12,1096.3,
EPIFIX SQ CM WITH MODIFIER,81000617,CDM,Q4186,HCPCS,636,RC,inpatient,JC,1154,1154,,979.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,870.12,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,980.9,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,1015.52,88,,percent of total billed charges,,,,,,,,,881.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,1050.14,91,,percent of total billed charges,,,1096.3,95,,percent of total billed charges,,,957.82,83,,percent of total billed charges,,,957.82,83,,percent of total billed charges,,,,,,,,,,,,,,,957.82,83,,percent of total billed charges,,,1096.3,95,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,946.28,82,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,980.9,85,,percent of total billed charges,,870.12,1096.3,
PUNCH BX SKIN SINGLE LESION,81000618,CDM,11104,CPT,761,RC,inpatient,,949,949,,805.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,715.55,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,806.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,835.12,88,,percent of total billed charges,,,,,,,,,725.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,863.59,91,,percent of total billed charges,,,901.55,95,,percent of total billed charges,,,787.67,83,,percent of total billed charges,,,787.67,83,,percent of total billed charges,,,,,,,,,,,,,,,787.67,83,,percent of total billed charges,,,901.55,95,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,778.18,82,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,806.65,85,,percent of total billed charges,,715.55,901.55,
PUNCH BX SKIN EA SEP/ADDITIONAL LESION,81000619,CDM,11105,CPT,761,RC,inpatient,,627,627,,532.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,472.76,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,532.95,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,551.76,88,,percent of total billed charges,,,,,,,,,479.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,570.57,91,,percent of total billed charges,,,595.65,95,,percent of total billed charges,,,520.41,83,,percent of total billed charges,,,520.41,83,,percent of total billed charges,,,,,,,,,,,,,,,520.41,83,,percent of total billed charges,,,595.65,95,,percent of total billed charges,,,564.3,90,,percent of total billed charges,,,564.3,90,,percent of total billed charges,,,514.14,82,,percent of total billed charges,,,564.3,90,,percent of total billed charges,,,532.95,85,,percent of total billed charges,,472.76,595.65,
TENOTOMY,81000620,CDM,28010,CPT,761,RC,inpatient,,4229,4229,,3590.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3188.67,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3594.65,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3721.52,88,,percent of total billed charges,,,,,,,,,3230.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3848.39,91,,percent of total billed charges,,,4017.55,95,,percent of total billed charges,,,3510.07,83,,percent of total billed charges,,,3510.07,83,,percent of total billed charges,,,,,,,,,,,,,,,3510.07,83,,percent of total billed charges,,,4017.55,95,,percent of total billed charges,,,3806.1,90,,percent of total billed charges,,,3806.1,90,,percent of total billed charges,,,3467.78,82,,percent of total billed charges,,,3806.1,90,,percent of total billed charges,,,3594.65,85,,percent of total billed charges,,3188.67,4017.55,
PARE/CUT BENIGH HYPERKERATOTIC W/MODIFIE,81001220,CDM,11055,CPT,761,RC,inpatient,59,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,349.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,394.4,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,349.86,440.8,
EXCISION BENIGN LESIONS 0.6 TO 1.0 CM,81011401,CDM,11401,CPT,761,RC,inpatient,,2717,2717,,2306.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2048.62,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2309.45,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2390.96,88,,percent of total billed charges,,,,,,,,,2075.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,2472.47,91,,percent of total billed charges,,,2581.15,95,,percent of total billed charges,,,2255.11,83,,percent of total billed charges,,,2255.11,83,,percent of total billed charges,,,,,,,,,,,,,,,2255.11,83,,percent of total billed charges,,,2581.15,95,,percent of total billed charges,,,2445.3,90,,percent of total billed charges,,,2445.3,90,,percent of total billed charges,,,2227.94,82,,percent of total billed charges,,,2445.3,90,,percent of total billed charges,,,2309.45,85,,percent of total billed charges,,2048.62,2581.15,
EXCISION BENIGN LESIONS 1.1 TO 2.0 CM,81011402,CDM,11402,CPT,761,RC,inpatient,,3330,3330,,2827.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,2510.82,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,2830.5,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,2930.4,88,,percent of total billed charges,,,,,,,,,2544.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,3030.3,91,,percent of total billed charges,,,3163.5,95,,percent of total billed charges,,,2763.9,83,,percent of total billed charges,,,2763.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2763.9,83,,percent of total billed charges,,,3163.5,95,,percent of total billed charges,,,2997,90,,percent of total billed charges,,,2997,90,,percent of total billed charges,,,2730.6,82,,percent of total billed charges,,,2997,90,,percent of total billed charges,,,2830.5,85,,percent of total billed charges,,2510.82,3163.5,
EXCISION BENIGN LESIONS INCLUD MARGINS,81011420,CDM,11420,CPT,761,RC,inpatient,,4403,4403,,3738.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,3319.86,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,3742.55,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,3874.64,88,,percent of total billed charges,,,,,,,,,3363.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,4006.73,91,,percent of total billed charges,,,4182.85,95,,percent of total billed charges,,,3654.49,83,,percent of total billed charges,,,3654.49,83,,percent of total billed charges,,,,,,,,,,,,,,,3654.49,83,,percent of total billed charges,,,4182.85,95,,percent of total billed charges,,,3962.7,90,,percent of total billed charges,,,3962.7,90,,percent of total billed charges,,,3610.46,82,,percent of total billed charges,,,3962.7,90,,percent of total billed charges,,,3742.55,85,,percent of total billed charges,,3319.86,4182.85,
ABRASION SINGLE LESION,81015786,CDM,15786,CPT,761,RC,inpatient,,400,400,,339.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,301.6,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,340,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,352,88,,percent of total billed charges,,,,,,,,,305.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,364,91,,percent of total billed charges,,,380,95,,percent of total billed charges,,,332,83,,percent of total billed charges,,,332,83,,percent of total billed charges,,,,,,,,,,,,,,,332,83,,percent of total billed charges,,,380,95,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,328,82,,percent of total billed charges,,,360,90,,percent of total billed charges,,,340,85,,percent of total billed charges,,301.6,380,
DESTRUCTION OF BENIGN LESIONS UP TO 14,81017110,CDM,17110,CPT,761,RC,inpatient,,518,518,,439.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,"If charges for a single uninterrupted inpatient stay are greater than $18,117, reimbursment will only be 85% of billed charges in lieu of per day payment rate",,390.57,75.4,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,440.3,82.8,,percent of total billed charges,Anesthesia - reimbursement is per 12 Minutes,,,,,,,,455.84,88,,percent of total billed charges,,,,,,,,,395.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,Inpatient services are reimbursed under a per diem method. Anesthesia - reimbursement is per 15 Minutes,,471.38,91,,percent of total billed charges,,,492.1,95,,percent of total billed charges,,,429.94,83,,percent of total billed charges,,,429.94,83,,percent of total billed charges,,,,,,,,,,,,,,,429.94,83,,percent of total billed charges,,,492.1,95,,percent of total billed charges,,,466.2,90,,percent of total billed charges,,,466.2,90,,percent of total billed charges,,,424.76,82,,percent of total billed charges,,,466.2,90,,percent of total billed charges,,,440.3,85,,percent of total billed charges,,390.57,492.1,
"Craniotomy, > 17, Except f or Trauma",1,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8330.99,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8330.99,,,,other,Services are paid on a DRG basis,8330.99,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8330.99,8330.99,
"Craniotomy for Trauma, >17",2,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9766.17,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9766.17,,,,other,Services are paid on a DRG basis,9766.17,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9766.17,9766.17,
"Craniotomy, 0-17",3,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4265.27,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4265.27,,,,other,Services are paid on a DRG basis,4265.27,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4265.27,4265.27,
Spinal Procedures,4,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7115.49,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7115.49,,,,other,Services are paid on a DRG basis,7115.49,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7115.49,7115.49,
Extracranial Vascular Procedures,5,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4640.05,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4640.05,,,,other,Services are paid on a DRG basis,4640.05,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4640.05,4640.05,
Carpal Tunnel Release,6,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1764.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1764.88,,,,other,Services are paid on a DRG basis,1764.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1764.88,1764.88,
Peripheral and Cranial Nerve and Other Nervous System Operating Room Proced,7,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4687.38,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4687.38,,,,other,Services are paid on a DRG basis,4687.38,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4687.38,4687.38,
Peripheral and Cranial Nerve and Other Nervous System Operating Room Proced,8,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2381.1,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2381.1,,,,other,Services are paid on a DRG basis,2381.1,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2381.1,2381.1,
Spinal Disorders and Injuries,9,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3349.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3349.41,,,,other,Services are paid on a DRG basis,3349.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3349.41,3349.41,
"Nervous System Neoplasms, W/ Complications",10,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2831.68,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2831.68,,,,other,Services are paid on a DRG basis,2831.68,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2831.68,2831.68,
"Nervous System Neoplasms, W/O Complications",11,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1983.29,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1983.29,,,,other,Services are paid on a DRG basis,1983.29,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1983.29,1983.29,
Degenerative Nervous System Disorders,12,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1988.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1988.41,,,,other,Services are paid on a DRG basis,1988.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1988.41,1988.41,
Multiple Sclerosis and Cerebellar Ataxia,13,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1908.15,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1908.15,,,,other,Services are paid on a DRG basis,1908.15,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1908.15,1908.15,
"Specific Cerebrovascular disorders, Except Transient Ischemic Attack",14,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3328.94,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3328.94,,,,other,Services are paid on a DRG basis,3328.94,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3328.94,3328.94,
Transient Ischemic Attack Occlusions and Precerebral,15,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1923.81,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1923.81,,,,other,Services are paid on a DRG basis,1923.81,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1923.81,1923.81,
"Nonspecific Cerebrovascular Disorders, Complications W/",16,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2819.53,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2819.53,,,,other,Services are paid on a DRG basis,2819.53,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2819.53,2819.53,
"Nonspecific Cerebrovascular Disorders, Complications W/O",17,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1749.53,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1749.53,,,,other,Services are paid on a DRG basis,1749.53,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1749.53,1749.53,
"Cranial and Peripheral Nerve Disorders, Complications W/",18,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2078.91,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2078.91,,,,other,Services are paid on a DRG basis,2078.91,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2078.91,2078.91,
"Cranial and Peripheral Nerve Disorders, Complications W/O",19,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1738.66,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1738.66,,,,other,Services are paid on a DRG basis,1738.66,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1738.66,1738.66,
"Nervous System Infection, Except Viral Meningitis",20,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4526.21,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4526.21,,,,other,Services are paid on a DRG basis,4526.21,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4526.21,4526.21,
Viral Meningitis,21,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2183.8,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2183.8,,,,other,Services are paid on a DRG basis,2183.8,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2183.8,2183.8,
Hypertensive Encephalopathy,22,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2276.85,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2276.85,,,,other,Services are paid on a DRG basis,2276.85,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2276.85,2276.85,
Nontraumatic Stupor and Coma,23,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1782.79,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1782.79,,,,other,Services are paid on a DRG basis,1782.79,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1782.79,1782.79,
"Seizure and Headache, > 17, W/ Complications",24,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2126.24,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2126.24,,,,other,Services are paid on a DRG basis,2126.24,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2126.24,2126.24,
"Seizure and Headache, and Comorbidit > 17, W/O Complications",25,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1343.73,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1343.73,,,,other,Services are paid on a DRG basis,1343.73,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1343.73,1343.73,
"Seizure and Headache, 0-17",26,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1433.91,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1433.91,,,,other,Services are paid on a DRG basis,1433.91,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1433.91,1433.91,
"Traumatic Stupor and Coma, More than One Hour",27,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2882.2,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2882.2,,,,other,Services are paid on a DRG basis,2882.2,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2882.2,2882.2,
"Traumatic Stupor
> 17, W/ Complica and Coma, less than One Hour, tions",28,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2094.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2094.58,,,,other,Services are paid on a DRG basis,2094.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2094.58,2094.58,
"Traumatic Stupor and Coma, less than One Hour,
> 17, W/O Complications",29,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1294.8,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1294.8,,,,other,Services are paid on a DRG basis,1294.8,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1294.8,1294.8,
"Traumatic Stupor One Hour, 0-17 and Coma, Comatose less than",30,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1026.5,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1026.5,,,,other,Services are paid on a DRG basis,1026.5,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1026.5,1026.5,
"Concussion, > 17, W/ Complications",31,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1168.17,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1168.17,,,,other,Services are paid on a DRG basis,1168.17,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1168.17,1168.17,
"Concussion, > 17, W/O Complications",32,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,928.97,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,928.97,,,,other,Services are paid on a DRG basis,928.97,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,928.97,928.97,
"Concussion, 0-17",33,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,623.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,623.26,,,,other,Services are paid on a DRG basis,623.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,623.26,623.26,
"Other Disorders of Nervous System, W/ Complications",34,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2396.77,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2396.77,,,,other,Services are paid on a DRG basis,2396.77,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2396.77,2396.77,
"Other Disorders of Nervous System, W/O Complications",35,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1166.57,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1166.57,,,,other,Services are paid on a DRG basis,1166.57,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1166.57,1166.57,
Retinal Procedures,36,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2001.2,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2001.2,,,,other,Services are paid on a DRG basis,2001.2,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2001.2,2001.2,
Orbital Procedures,37,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2425.55,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2425.55,,,,other,Services are paid on a DRG basis,2425.55,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2425.55,2425.55,
Primary Iris Procedures,38,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1115.08,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1115.08,,,,other,Services are paid on a DRG basis,1115.08,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1115.08,1115.08,
"Lens Procedures, W/ Or W/O Vitrectomy",39,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1407.36,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1407.36,,,,other,Services are paid on a DRG basis,1407.36,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1407.36,1407.36,
"Extraocular Procedures, Except Orbit, > 17",40,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1737.7,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1737.7,,,,other,Services are paid on a DRG basis,1737.7,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1737.7,1737.7,
"Extraocular Procedures, Except Orbit, 0-17",41,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1060.72,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1060.72,,,,other,Services are paid on a DRG basis,1060.72,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1060.72,1060.72,
"Intraocular Procedures, Except Retina, Iris and Lens",42,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2049.17,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2049.17,,,,other,Services are paid on a DRG basis,2049.17,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2049.17,2049.17,
Hyphema,43,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,946.56,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,946.56,,,,other,Services are paid on a DRG basis,946.56,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,946.56,946.56,
Acute Major Eye Infections,44,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1046.33,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1046.33,,,,other,Services are paid on a DRG basis,1046.33,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1046.33,1046.33,
Neurological Eye Disorders,45,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1729.39,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1729.39,,,,other,Services are paid on a DRG basis,1729.39,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1729.39,1729.39,
"Other Disorders of the Eye, > 17, W/ Complications",46,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1768.4,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1768.4,,,,other,Services are paid on a DRG basis,1768.4,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1768.4,1768.4,
"Other Disorders of the Eye, > 17, W/O Complications",47,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1145.46,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1145.46,,,,other,Services are paid on a DRG basis,1145.46,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1145.46,1145.46,
"Other Disorders of the Eye, 0-17",48,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1004.76,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1004.76,,,,other,Services are paid on a DRG basis,1004.76,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1004.76,1004.76,
Major Head and Neck Procedures,49,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4762.85,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4762.85,,,,other,Services are paid on a DRG basis,4762.85,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4762.85,4762.85,
Sialoadenectomy,50,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1933.09,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1933.09,,,,other,Services are paid on a DRG basis,1933.09,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1933.09,1933.09,
"Salivary Gland Procedures, Except Sialoadenectomy",51,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1903.99,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1903.99,,,,other,Services are paid on a DRG basis,1903.99,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1903.99,1903.99,
Cleft Lip and Palate Repair,52,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2382.06,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2382.06,,,,other,Services are paid on a DRG basis,2382.06,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2382.06,2382.06,
"Sinus and Mastoid Procedures, > 17",53,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2352.64,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2352.64,,,,other,Services are paid on a DRG basis,2352.64,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2352.64,2352.64,
"Sinus and Mastoid Procedures, 0-17",54,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1998,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1998,,,,other,Services are paid on a DRG basis,1998,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1998,1998,
"Miscellaneous Ear, Nose, Mouth and Throat Procedures",55,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1997.04,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1997.04,,,,other,Services are paid on a DRG basis,1997.04,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1997.04,1997.04,
Rhinoplasty,56,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2139.35,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2139.35,,,,other,Services are paid on a DRG basis,2139.35,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2139.35,2139.35,
"Tonsil and Adenoid Procedure, Except Tonsillectomy, or Adenoidectomy Age >1",57,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2582.57,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2582.57,,,,other,Services are paid on a DRG basis,2582.57,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2582.57,2582.57,
"Tonsil and Adenoid Procedure, Except Tonsillectomy, or Adenoidectomy Age 0-",58,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1138.11,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1138.11,,,,other,Services are paid on a DRG basis,1138.11,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1138.11,1138.11,
"Tonsillectomy or Adenoidectomy Only, > 17",59,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1281.37,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1281.37,,,,other,Services are paid on a DRG basis,1281.37,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1281.37,1281.37,
"Tonsillectomy or Adenoidectomy Only, 0-17",60,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,758.53,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,758.53,,,,other,Services are paid on a DRG basis,758.53,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,758.53,758.53,
"Myringotomy W/ Tube Insertion, > 17",61,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2789.47,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2789.47,,,,other,Services are paid on a DRG basis,2789.47,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2789.47,2789.47,
"Myringotomy W/ Tube Insertion, 0-17",62,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1102.29,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1102.29,,,,other,Services are paid on a DRG basis,1102.29,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1102.29,1102.29,
"Other Ear, Nose, Mouth and Throat Operating Room Procedures",63,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3166.17,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3166.17,,,,other,Services are paid on a DRG basis,3166.17,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3166.17,3166.17,
"Ear, Nose, Mouth and Throat Malignancy",64,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2988.69,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2988.69,,,,other,Services are paid on a DRG basis,2988.69,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2988.69,2988.69,
Dysequilibrium,65,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1363.87,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1363.87,,,,other,Services are paid on a DRG basis,1363.87,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1363.87,1363.87,
Epistaxis,66,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1458.85,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1458.85,,,,other,Services are paid on a DRG basis,1458.85,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1458.85,1458.85,
Epiglottitis,67,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2087.86,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2087.86,,,,other,Services are paid on a DRG basis,2087.86,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2087.86,2087.86,
"Otitis Media and Upper Respiratory Infection, > 17, W/ Complications",68,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1392.65,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1392.65,,,,other,Services are paid on a DRG basis,1392.65,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1392.65,1392.65,
"Otitis Media and Upper Respiratory Infection, > 17, W/O Complications",69,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,980.13,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,980.13,,,,other,Services are paid on a DRG basis,980.13,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,980.13,980.13,
"Otitis Media and Upper Respiratory Infection, 0-17",70,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1033.86,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1033.86,,,,other,Services are paid on a DRG basis,1033.86,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1033.86,1033.86,
Laryngotracheitis,71,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,983.65,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,983.65,,,,other,Services are paid on a DRG basis,983.65,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,983.65,983.65,
Nasal Trauma and Deformity,72,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1383.38,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1383.38,,,,other,Services are paid on a DRG basis,1383.38,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1383.38,1383.38,
"Other Ear, Nose, Mouth and Throat Diagnoses, > 17",73,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1603.07,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1603.07,,,,other,Services are paid on a DRG basis,1603.07,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1603.07,1603.07,
"Other Ear, Nose, Mouth and Throat Diagnoses, 0- 17",74,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1041.53,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1041.53,,,,other,Services are paid on a DRG basis,1041.53,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1041.53,1041.53,
Major Chest Procedures,75,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8849.99,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8849.99,,,,other,Services are paid on a DRG basis,8849.99,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8849.99,8849.99,
"Other Respiratory System Operating Room Procedures, W/ Complications",76,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6855.83,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6855.83,,,,other,Services are paid on a DRG basis,6855.83,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6855.83,6855.83,
"Other Respiratory System Operating Room Procedures, W/O Complications",77,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3440.55,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3440.55,,,,other,Services are paid on a DRG basis,3440.55,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3440.55,3440.55,
Pulmonary Embolism,78,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3601.72,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3601.72,,,,other,Services are paid on a DRG basis,3601.72,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3601.72,3601.72,
"Respiratory Infections and Inflammations, > 17 W/ Complications",79,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4777.56,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4777.56,,,,other,Services are paid on a DRG basis,4777.56,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4777.56,4777.56,
"Respiratory Infections and Inflammations, > 17 W/O Complications",80,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2621.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2621.58,,,,other,Services are paid on a DRG basis,2621.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2621.58,2621.58,
"Respiratory Infections and Inflammations, 0-17",81,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3498.11,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3498.11,,,,other,Services are paid on a DRG basis,3498.11,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3498.11,3498.11,
Respiratory Neoplasms,82,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3626.98,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3626.98,,,,other,Services are paid on a DRG basis,3626.98,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3626.98,3626.98,
"Major Chest Trauma, W/ Complications",83,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2388.14,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2388.14,,,,other,Services are paid on a DRG basis,2388.14,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2388.14,2388.14,
"Major Chest Trauma, W/O Complications",84,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1391.06,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1391.06,,,,other,Services are paid on a DRG basis,1391.06,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1391.06,1391.06,
"Pleural Effusion, W/ Complications",85,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2883.48,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2883.48,,,,other,Services are paid on a DRG basis,2883.48,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2883.48,2883.48,
"Pleural Effusion, W/O Complications",86,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1880.32,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1880.32,,,,other,Services are paid on a DRG basis,1880.32,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1880.32,1880.32,
Pulmonary Edema and Respiratory Failure,87,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3367.95,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3367.95,,,,other,Services are paid on a DRG basis,3367.95,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3367.95,3367.95,
Chronic Obstructive Pulmonary Disease,88,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2199.47,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2199.47,,,,other,Services are paid on a DRG basis,2199.47,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2199.47,2199.47,
"Simple Pneumonia and Pleurisy, > 17, W/ Complications",89,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2666.35,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2666.35,,,,other,Services are paid on a DRG basis,2666.35,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2666.35,2666.35,
"Simple Pneumonia and Pleurisy, > 17, W/O Complications",90,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1495.31,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1495.31,,,,other,Services are paid on a DRG basis,1495.31,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1495.31,1495.31,
"Simple Pneumonia and Pleurisy, 0-17",91,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1552.23,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1552.23,,,,other,Services are paid on a DRG basis,1552.23,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1552.23,1552.23,
"Interstitial Lung Disease, W/ Complications",92,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2628.62,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2628.62,,,,other,Services are paid on a DRG basis,2628.62,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2628.62,2628.62,
"Interstitial Lung Disease, W/O Complications",93,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1881.92,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1881.92,,,,other,Services are paid on a DRG basis,1881.92,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1881.92,1881.92,
"Pneumothorax, W/ Complications",94,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2874.53,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2874.53,,,,other,Services are paid on a DRG basis,2874.53,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2874.53,2874.53,
"Pneumothorax, W/O Complications",95,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1447.98,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1447.98,,,,other,Services are paid on a DRG basis,1447.98,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1447.98,1447.98,
"Bronchitis and Asthma, >17, W/ Complications",96,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1590.6,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1590.6,,,,other,Services are paid on a DRG basis,1590.6,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1590.6,1590.6,
"Bronchitis and Asthma, >17, W/O Complications",97,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1080.87,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1080.87,,,,other,Services are paid on a DRG basis,1080.87,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1080.87,1080.87,
"Bronchitis and Asthma, 0-17",98,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1250.67,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1250.67,,,,other,Services are paid on a DRG basis,1250.67,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1250.67,1250.67,
"Respiratory Signs and Symptoms, W/ Complications",99,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1648.8,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1648.8,,,,other,Services are paid on a DRG basis,1648.8,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1648.8,1648.8,
"Respiratory Signs and Symptoms, W/O Complications",100,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1345.01,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1345.01,,,,other,Services are paid on a DRG basis,1345.01,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1345.01,1345.01,
"Other Respiratory System Diagnoses, W/ Complications",101,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1973.38,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1973.38,,,,other,Services are paid on a DRG basis,1973.38,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1973.38,1973.38,
"Other Respiratory System Diagnoses, W/O Complications",102,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1090.14,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1090.14,,,,other,Services are paid on a DRG basis,1090.14,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1090.14,1090.14,
"Cardiac Valve Procedures, W/ Cardiac Catheterization",104,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22157.12,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22157.12,,,,other,Services are paid on a DRG basis,22157.12,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22157.12,22157.12,
"Cardiac Valve Procedures, W/O Cardiac Catheterization",105,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14739.76,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14739.76,,,,other,Services are paid on a DRG basis,14739.76,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14739.76,14739.76,
"Coronary Bypass, W/ Cardiac Catheterization",106,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15391.16,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15391.16,,,,other,Services are paid on a DRG basis,15391.16,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15391.16,15391.16,
"Coronary Bypass, W/O Cardiac Catheterization",107,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11435.44,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11435.44,,,,other,Services are paid on a DRG basis,11435.44,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11435.44,11435.44,
Other Cardiothoracic Procedures,108,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12680.68,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12680.68,,,,other,Services are paid on a DRG basis,12680.68,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12680.68,12680.68,
"Major Cardiovascular Procedures, W/ Complications",110,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11233.98,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11233.98,,,,other,Services are paid on a DRG basis,11233.98,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11233.98,11233.98,
"Major Cardiovascular Procedures, W/O Complications",111,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5522.97,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5522.97,,,,other,Services are paid on a DRG basis,5522.97,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5522.97,5522.97,
Percutaneous Cardiovascular Procedures,112,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5819.09,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5819.09,,,,other,Services are paid on a DRG basis,5819.09,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5819.09,5819.09,
"Amputation for Circulatory System Disorders, Except Upper Limb and Toe",113,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8582.98,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8582.98,,,,other,Services are paid on a DRG basis,8582.98,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8582.98,8582.98,
Upper Limb and Toe Amputation For Circulatory System Disorders,114,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4825.85,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4825.85,,,,other,Services are paid on a DRG basis,4825.85,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4825.85,4825.85,
"Permanent Cardiac Pacemaker Implant, W/ Acute Myocardial Infarction, Heart Failure",115,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10005.69,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10005.69,,,,other,Services are paid on a DRG basis,10005.69,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10005.69,10005.69,
"Permanent Cardiac Pacemaker Implant, W/O Acute Myocardial Infarction, Heart Failure",116,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8277.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8277.58,,,,other,Services are paid on a DRG basis,8277.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8277.58,8277.58,
"Cardiac Pacemaker Revision, Except Device Replacement",117,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3249.63,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3249.63,,,,other,Services are paid on a DRG basis,3249.63,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3249.63,3249.63,
Cardiac Pacemaker Device Replacement,118,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4338.5,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4338.5,,,,other,Services are paid on a DRG basis,4338.5,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4338.5,4338.5,
Vein Ligation and Stripping,119,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2308.51,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2308.51,,,,other,Services are paid on a DRG basis,2308.51,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2308.51,2308.51,
Other Circulatory System Operating Room Procedures,120,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6241.84,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6241.84,,,,other,Services are paid on a DRG basis,6241.84,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6241.84,6241.84,
"Circulatory Disorders, W/ Acute Myocardial Infarction And Cardiovascular Complications",121,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4142.47,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4142.47,,,,other,Services are paid on a DRG basis,4142.47,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4142.47,4142.47,
"Circulatory Disorders, W/ Acute Myocardial Infarction, W/O Cardiovascular Complications",122,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2887.32,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2887.32,,,,other,Services are paid on a DRG basis,2887.32,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2887.32,2887.32,
"Circulatory Disorders, W/ Acute Myocardial Infarction, Expired",123,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3703.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3703.41,,,,other,Services are paid on a DRG basis,3703.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3703.41,3703.41,
"Circulatory Disorders, Except Acute Myocardial Infarction, W/ Cardiac CATHW",124,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3943.56,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3943.56,,,,other,Services are paid on a DRG basis,3943.56,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3943.56,3943.56,
"Circulatory Disorders, Except Acute Myocardial Infarction, W/ Cardiac CATHW",125,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2647.16,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2647.16,,,,other,Services are paid on a DRG basis,2647.16,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2647.16,2647.16,
Acute and Subacute Endocarditis,126,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8564.43,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8564.43,,,,other,Services are paid on a DRG basis,8564.43,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8564.43,8564.43,
Heart Failure and Shock,127,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2591.52,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2591.52,,,,other,Services are paid on a DRG basis,2591.52,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2591.52,2591.52,
Deep Vein Thrombophlebitis,128,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1885.12,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1885.12,,,,other,Services are paid on a DRG basis,1885.12,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1885.12,1885.12,
"Cardiac Arrest, Unexplained",129,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3148.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3148.58,,,,other,Services are paid on a DRG basis,3148.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3148.58,3148.58,
"Peripheral Vascular Disorders, W/ Complications",130,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2555.07,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2555.07,,,,other,Services are paid on a DRG basis,2555.07,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2555.07,2555.07,
"Peripheral Vascular Disorders, W/O Complications",131,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1566.62,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1566.62,,,,other,Services are paid on a DRG basis,1566.62,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1566.62,1566.62,
"Atherosclerosis, W/ Complications",132,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2031.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2031.58,,,,other,Services are paid on a DRG basis,2031.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2031.58,2031.58,
"Atherosclerosis, W/O Complications",133,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1599.23,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1599.23,,,,other,Services are paid on a DRG basis,1599.23,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1599.23,1599.23,
Hypertension,134,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1604.03,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1604.03,,,,other,Services are paid on a DRG basis,1604.03,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1604.03,1604.03,
"Cardiac Congenital and Valvular Disorders, > 17, W/ Complications",135,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2093.3,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2093.3,,,,other,Services are paid on a DRG basis,2093.3,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2093.3,2093.3,
"Cardiac Congenital and Valvular Disorders, > 17, W/O Complications",136,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1344.37,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1344.37,,,,other,Services are paid on a DRG basis,1344.37,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1344.37,1344.37,
"Cardiac Congenital and Valvular Disorders, 0-17",137,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1443.18,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1443.18,,,,other,Services are paid on a DRG basis,1443.18,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1443.18,1443.18,
"Cardiac Arrhythmia and Conduction Disorders, W/ Complications",138,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1990.01,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1990.01,,,,other,Services are paid on a DRG basis,1990.01,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1990.01,1990.01,
"Cardiac Arrhythmia and Conduction Disorders, W/O Complications",139,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1375.07,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1375.07,,,,other,Services are paid on a DRG basis,1375.07,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1375.07,1375.07,
Angina Pectoris,140,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1687.81,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1687.81,,,,other,Services are paid on a DRG basis,1687.81,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1687.81,1687.81,
"Syncope and Collapse, W/ Complications",141,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1654.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1654.88,,,,other,Services are paid on a DRG basis,1654.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1654.88,1654.88,
"Syncope and Collapse, W/O Complications",142,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1241.72,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1241.72,,,,other,Services are paid on a DRG basis,1241.72,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1241.72,1241.72,
Chest Pain,143,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1439.34,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1439.34,,,,other,Services are paid on a DRG basis,1439.34,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1439.34,1439.34,
"Other Circulatory System Diagnoses, W/ Complications",144,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3076.63,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3076.63,,,,other,Services are paid on a DRG basis,3076.63,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3076.63,3076.63,
"Other Circulatory System Diagnoses, W/O Complications",145,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1775.12,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1775.12,,,,other,Services are paid on a DRG basis,1775.12,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1775.12,1775.12,
"Rectal Resection, W/ Complications",146,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7360.13,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7360.13,,,,other,Services are paid on a DRG basis,7360.13,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7360.13,7360.13,
"Rectal Resection, W/O Complications",147,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4307.16,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4307.16,,,,other,Services are paid on a DRG basis,4307.16,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4307.16,4307.16,
"Major Small and Large Bowel Procedures, W/ Complications",148,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8529.57,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8529.57,,,,other,Services are paid on a DRG basis,8529.57,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8529.57,8529.57,
"Major Small and Large Bowel Procedures, W/O Complications",149,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3301.76,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3301.76,,,,other,Services are paid on a DRG basis,3301.76,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3301.76,3301.76,
"Peritoneal Adhesiolysis, W/ Complications",150,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5849.79,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5849.79,,,,other,Services are paid on a DRG basis,5849.79,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5849.79,5849.79,
"Peritoneal Adhesiolysis, W/O Complications",151,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2810.89,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2810.89,,,,other,Services are paid on a DRG basis,2810.89,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2810.89,2810.89,
"Minor Small and Large Bowel Procedures, W/ Complications",152,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5323.11,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5323.11,,,,other,Services are paid on a DRG basis,5323.11,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5323.11,5323.11,
"Minor Small and Large Bowel Procedures, W/O Complications",153,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2794.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2794.26,,,,other,Services are paid on a DRG basis,2794.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2794.26,2794.26,
"Stomach, Esophageal and Duodenal Procedures, > 17, W/ Complications",154,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10835.21,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10835.21,,,,other,Services are paid on a DRG basis,10835.21,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10835.21,10835.21,
"Stomach, Esophageal and Duodenal Procedures, > 17, W/O Complications",155,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3964.99,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3964.99,,,,other,Services are paid on a DRG basis,3964.99,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3964.99,3964.99,
"Stomach, Esophageal and Duodenal Procedures, 0-17",156,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1823.4,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1823.4,,,,other,Services are paid on a DRG basis,1823.4,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1823.4,1823.4,
"Anal and Stomal Procedures, W/ Complications",157,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3004.04,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3004.04,,,,other,Services are paid on a DRG basis,3004.04,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3004.04,3004.04,
"Anal and Stomal Procedures, W/O Complications",158,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1779.59,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1779.59,,,,other,Services are paid on a DRG basis,1779.59,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1779.59,1779.59,
"Hernia Procedures, Except Inguinal and Femoral,> 17, W/ Complications",159,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3081.11,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3081.11,,,,other,Services are paid on a DRG basis,3081.11,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3081.11,3081.11,
"Hernia Procedures, Except Inguinal and Femoral,
>17, W/O Complications",160,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1976.9,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1976.9,,,,other,Services are paid on a DRG basis,1976.9,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1976.9,1976.9,
"Inguinal and Femoral Hernia Procedures, > 17, W/ Complications",161,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2678.18,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2678.18,,,,other,Services are paid on a DRG basis,2678.18,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2678.18,2678.18,
"Inguinal and Femoral Hernia Procedures, > 17, W/O Complications",162,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1515.13,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1515.13,,,,other,Services are paid on a DRG basis,1515.13,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1515.13,1515.13,
"Hernia Procedures, 0-17",163,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,831.12,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,831.12,,,,other,Services are paid on a DRG basis,831.12,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,831.12,831.12,
"Appendectomy, W/ Complicated Principal Diagnosis,W/ Complications",164,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5752.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5752.58,,,,other,Services are paid on a DRG basis,5752.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5752.58,5752.58,
"Appendectomy, W/ Complicated Principal Diagnosis, W/O Complications",165,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3041.78,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3041.78,,,,other,Services are paid on a DRG basis,3041.78,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3041.78,3041.78,
"Appendectomy, W/O Complicated Principal Diagnosis, W/ Complications",166,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2956.07,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2956.07,,,,other,Services are paid on a DRG basis,2956.07,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2956.07,2956.07,
"Appendectomy, W/O Complicated Principal Diagnosis, W/O Complications",167,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1839.07,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1839.07,,,,other,Services are paid on a DRG basis,1839.07,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1839.07,1839.07,
"Mouth Procedures, W/ Complications",168,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3583.81,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3583.81,,,,other,Services are paid on a DRG basis,3583.81,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3583.81,3583.81,
"Mouth Procedures, W/O Complications",169,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1712.12,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1712.12,,,,other,Services are paid on a DRG basis,1712.12,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1712.12,1712.12,
"Other Digestive System Operating Room Procedures, W/ Complications",170,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7664.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7664.88,,,,other,Services are paid on a DRG basis,7664.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7664.88,7664.88,
Other Digestive System O.R. Procedures W/O Complications,171,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2755.25,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2755.25,,,,other,Services are paid on a DRG basis,2755.25,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2755.25,2755.25,
"Digestive Malignancy, W/ Complications",172,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3728.03,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3728.03,,,,other,Services are paid on a DRG basis,3728.03,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3728.03,3728.03,
"Digestive Malignancy, W/O Complications",173,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1743.46,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1743.46,,,,other,Services are paid on a DRG basis,1743.46,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1743.46,1743.46,
"Gastrointestinal Hemorrhage, W/ Complications",174,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2431.95,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2431.95,,,,other,Services are paid on a DRG basis,2431.95,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2431.95,2431.95,
"Gastrointestinal Hemorrhage, W/O Complications",175,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1266.02,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1266.02,,,,other,Services are paid on a DRG basis,1266.02,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1266.02,1266.02,
Complicated Peptic Ulcer,176,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2522.13,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2522.13,,,,other,Services are paid on a DRG basis,2522.13,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2522.13,2522.13,
"Uncomplicated Peptic Ulcer, W/ Complications",177,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1895.67,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1895.67,,,,other,Services are paid on a DRG basis,1895.67,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1895.67,1895.67,
"Uncomplicated Peptic Ulcer, W/O Complications",178,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1518.97,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1518.97,,,,other,Services are paid on a DRG basis,1518.97,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1518.97,1518.97,
Inflammatory Bowel Disease,179,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2326.74,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2326.74,,,,other,Services are paid on a DRG basis,2326.74,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2326.74,2326.74,
"Gastrointestinal Obstruction, W/ Complications",180,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2299.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2299.88,,,,other,Services are paid on a DRG basis,2299.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2299.88,2299.88,
"Gastrointestinal Obstruction, W/O Complications",181,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1140.67,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1140.67,,,,other,Services are paid on a DRG basis,1140.67,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1140.67,1140.67,
"Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders, > 17 W/",182,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1691.97,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1691.97,,,,other,Services are paid on a DRG basis,1691.97,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1691.97,1691.97,
"Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders, > 17 W/",183,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1154.74,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1154.74,,,,other,Services are paid on a DRG basis,1154.74,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1154.74,1154.74,
"Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders, 0-17",184,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,953.59,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,953.59,,,,other,Services are paid on a DRG basis,953.59,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,953.59,953.59,
"Dental and Oral Disorders, Except Extractions and Restorations, > 17",185,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1580.69,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1580.69,,,,other,Services are paid on a DRG basis,1580.69,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1580.69,1580.69,
"Dental and Oral Disorders, Except Extractions and Restorations, 0-17",186,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1069.03,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1069.03,,,,other,Services are paid on a DRG basis,1069.03,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1069.03,1069.03,
Dental Extractions and Restorations,187,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1768.08,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1768.08,,,,other,Services are paid on a DRG basis,1768.08,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1768.08,1768.08,
"Other Digestive System Diagnoses, > 17, W/ Complications",188,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2666.35,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2666.35,,,,other,Services are paid on a DRG basis,2666.35,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2666.35,2666.35,
"Other Digestive System Diagnoses, > 17, W/O Complications",189,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1296.08,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1296.08,,,,other,Services are paid on a DRG basis,1296.08,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1296.08,1296.08,
"Other Digestive System Diagnoses, 0-17",190,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1050.49,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1050.49,,,,other,Services are paid on a DRG basis,1050.49,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1050.49,1050.49,
"Pancreas, Liver and Shunt Procedures, W/ Complications",191,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11304.97,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11304.97,,,,other,Services are paid on a DRG basis,11304.97,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11304.97,11304.97,
"Pancreas, Liver and Shunt Procedures, W/O Complications",192,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4973.9,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4973.9,,,,other,Services are paid on a DRG basis,4973.9,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4973.9,4973.9,
"Biliary Tract Procedures, W/ Complications, Except Only Cholecyst W/ Or W/O",193,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7749.94,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7749.94,,,,other,Services are paid on a DRG basis,7749.94,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7749.94,7749.94,
"Biliary Tract Procedures, W/O Complications, Except Only Cholecyst W/ Or W/O Complications",194,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4611.27,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4611.27,,,,other,Services are paid on a DRG basis,4611.27,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4611.27,4611.27,
"Total Cholecystectomy, W/ C.D.E., W/ Complications",195,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5925.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5925.58,,,,other,Services are paid on a DRG basis,5925.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5925.58,5925.58,
"Total Cholecystectomy, W/ C.D.E., W/O Complications",196,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4042.38,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4042.38,,,,other,Services are paid on a DRG basis,4042.38,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4042.38,4042.38,
"Total Cholecystectomy, W/O C.D.E., W/ Complications, Except by Scope",197,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5003.96,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5003.96,,,,other,Services are paid on a DRG basis,5003.96,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5003.96,5003.96,
"Total Cholecystectomy, W/O C.D.E., W/O Complications, Except by Scope",198,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2580.33,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2580.33,,,,other,Services are paid on a DRG basis,2580.33,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2580.33,2580.33,
Hepatobiliary Diagnostic Procedure for Malignancy,199,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6571.86,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6571.86,,,,other,Services are paid on a DRG basis,6571.86,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6571.86,6571.86,
Hepatobiliary Diagnostic Procedure for Non- Malignancy,200,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6890.68,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6890.68,,,,other,Services are paid on a DRG basis,6890.68,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6890.68,6890.68,
Other Hepatobiliary or Pancreas Operating Room Procedures,201,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8553.24,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8553.24,,,,other,Services are paid on a DRG basis,8553.24,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8553.24,8553.24,
Cirrhosis and Alcoholic Hepatitis,202,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3302.08,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3302.08,,,,other,Services are paid on a DRG basis,3302.08,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3302.08,3302.08,
Malignancy of Hepatobiliary System or Pancreas,203,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3174.49,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3174.49,,,,other,Services are paid on a DRG basis,3174.49,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3174.49,3174.49,
"Disorders of Pancreas, Except Malignancy",204,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2667.31,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2667.31,,,,other,Services are paid on a DRG basis,2667.31,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2667.31,2667.31,
"Disorders of Liver, Except Malignancy, Cirrhosis and Alcoholic Hepatitis, W",205,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3083.99,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3083.99,,,,other,Services are paid on a DRG basis,3083.99,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3083.99,3083.99,
"Disorders of Liver, Except Malignancy, Cirrhosis and Alcoholic Hepatitis, W",206,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1680.78,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1680.78,,,,other,Services are paid on a DRG basis,1680.78,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1680.78,1680.78,
"Disorders of the Biliary Tract, W/ Complications",207,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2287.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2287.41,,,,other,Services are paid on a DRG basis,2287.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2287.41,2287.41,
"Disorders of the Biliary Tract, W/O Complications",208,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1141.31,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1141.31,,,,other,Services are paid on a DRG basis,1141.31,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1141.31,1141.31,
Major Joint and Limb Reattachment Procedures- Lower Extremity,209,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6535.72,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6535.72,,,,other,Services are paid on a DRG basis,6535.72,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6535.72,6535.72,
"Hip and Femur Procedures, Except Major Joint, > 17, W/ Complications",210,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5586.61,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5586.61,,,,other,Services are paid on a DRG basis,5586.61,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5586.61,5586.61,
"Hip and Femur Procedures, Except Major Joint, > 17, W/O Complications",211,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3151.78,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3151.78,,,,other,Services are paid on a DRG basis,3151.78,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3151.78,3151.78,
"Hip and Femur Procedures, Except Major Joint, 0- 17",212,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3161.69,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3161.69,,,,other,Services are paid on a DRG basis,3161.69,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3161.69,3161.69,
Amputation for Musculoskeletal System and Connective Tissue Disorders,213,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6085.79,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6085.79,,,,other,Services are paid on a DRG basis,6085.79,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6085.79,6085.79,
"Back and Neck Procedures, W/ Complications",214,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5603.24,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5603.24,,,,other,Services are paid on a DRG basis,5603.24,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5603.24,5603.24,
"Back and Neck Procedures, W/O Complications",215,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2664.43,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2664.43,,,,other,Services are paid on a DRG basis,2664.43,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2664.43,2664.43,
Biopsies of Musculoskeletal System and Connective Tissue,216,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5828.36,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5828.36,,,,other,Services are paid on a DRG basis,5828.36,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5828.36,5828.36,
"Wound Debridement and Skin Graft, Except Hand, for Musculoskeletal & Conn. Tissue Disorders",217,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5039.14,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5039.14,,,,other,Services are paid on a DRG basis,5039.14,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5039.14,5039.14,
"Lower Extremity and Humerus Procedures, Except Hip, Foot and Femur, > 17, W",218,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3631.78,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3631.78,,,,other,Services are paid on a DRG basis,3631.78,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3631.78,3631.78,
"Lower Extremity and Humerus Procedures, Except Hip, Foot And Femur, > 17, W",219,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2259.91,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2259.91,,,,other,Services are paid on a DRG basis,2259.91,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2259.91,2259.91,
"Lower Extremity and Humerus Procedures, Except Hip, Foot And Femur, 0-17",220,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1264.42,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1264.42,,,,other,Services are paid on a DRG basis,1264.42,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1264.42,1264.42,
"Knee Procedures, W/ Complications",221,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4651.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4651.88,,,,other,Services are paid on a DRG basis,4651.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4651.88,4651.88,
"Knee Procedures, W/O Complications",222,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2351.36,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2351.36,,,,other,Services are paid on a DRG basis,2351.36,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2351.36,2351.36,
"Major Shoulder/Elbow Procedures, or Other Upper Extremity Procedures, W/ Co",223,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2726.79,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2726.79,,,,other,Services are paid on a DRG basis,2726.79,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2726.79,2726.79,
"Shoulder, Elbow or Forearm Procedures, Except Major Joint Procedures, W/O C",224,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1930.21,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1930.21,,,,other,Services are paid on a DRG basis,1930.21,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1930.21,1930.21,
Foot Procedures,225,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2127.52,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2127.52,,,,other,Services are paid on a DRG basis,2127.52,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2127.52,2127.52,
"Soft Tissue Procedures, W/ Complications",226,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2608.15,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2608.15,,,,other,Services are paid on a DRG basis,2608.15,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2608.15,2608.15,
"Soft Tissue Procedures, W/O Complications",227,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1786.31,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1786.31,,,,other,Services are paid on a DRG basis,1786.31,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1786.31,1786.31,
"Major Thumb or Joint Procedures, or Other Hand or Wrist Procedures, W/ Complications",228,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2595.68,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2595.68,,,,other,Services are paid on a DRG basis,2595.68,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2595.68,2595.68,
"Hand Or Wrist Procedures, Except Major Joint Procedures, W/O Complications",229,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1835.55,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1835.55,,,,other,Services are paid on a DRG basis,1835.55,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1835.55,1835.55,
Local Excision and Removal of Int Fix Devices Of Hip And Femur,230,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2764.52,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2764.52,,,,other,Services are paid on a DRG basis,2764.52,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2764.52,2764.52,
"Local Excision and Removal of Int Fix Devices, Except Hip And Femur",231,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3049.77,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3049.77,,,,other,Services are paid on a DRG basis,3049.77,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3049.77,3049.77,
Arthroscopy,232,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3218.62,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3218.62,,,,other,Services are paid on a DRG basis,3218.62,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3218.62,3218.62,
"Other Musculoskeletal System and Connect Tissue
O.R. Procedures, W/ Complications",233,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4372.39,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4372.39,,,,other,Services are paid on a DRG basis,4372.39,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4372.39,4372.39,
"Other Musculoskeletal System and Connect Tissue
O.R. Procedures, W/O Complications",234,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2198.19,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2198.19,,,,other,Services are paid on a DRG basis,2198.19,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2198.19,2198.19,
Fractures of Femur,235,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2714.64,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2714.64,,,,other,Services are paid on a DRG basis,2714.64,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2714.64,2714.64,
Fractures of Hip And Pelvis,236,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1770.64,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1770.64,,,,other,Services are paid on a DRG basis,1770.64,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1770.64,1770.64,
"Sprains, Strains, and Dislocations of Hip, Pelvis and Thigh",237,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1416,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1416,,,,other,Services are paid on a DRG basis,1416,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1416,1416,
Osteomyelitis,238,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3748.18,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3748.18,,,,other,Services are paid on a DRG basis,3748.18,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3748.18,3748.18,
Pathological Fractures And Musculoskeletal and Connective Tissue Malignancy,239,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2878.37,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2878.37,,,,other,Services are paid on a DRG basis,2878.37,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2878.37,2878.37,
"Connective Tissue Disorders, W/ Complications",240,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2844.79,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2844.79,,,,other,Services are paid on a DRG basis,2844.79,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2844.79,2844.79,
"Connective Tissue Disorders, W/O Complications",241,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1374.75,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1374.75,,,,other,Services are paid on a DRG basis,1374.75,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1374.75,1374.75,
Septic Arthritis,242,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2320.67,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2320.67,,,,other,Services are paid on a DRG basis,2320.67,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2320.67,2320.67,
Medical Back Problems,243,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1618.74,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1618.74,,,,other,Services are paid on a DRG basis,1618.74,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1618.74,1618.74,
"Bone Diseases and Specific Arthropathies, W/ Complications",244,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1836.51,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1836.51,,,,other,Services are paid on a DRG basis,1836.51,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1836.51,1836.51,
"Bone Diseases and Specific Arthropathies, W/O Complications",245,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1320.38,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1320.38,,,,other,Services are paid on a DRG basis,1320.38,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1320.38,1320.38,
Non-Specific Arthropathies,246,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1581.01,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1581.01,,,,other,Services are paid on a DRG basis,1581.01,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1581.01,1581.01,
Signs and Symptoms of Musculoskeletal System and Connective Tissues,247,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1166.89,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1166.89,,,,other,Services are paid on a DRG basis,1166.89,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1166.89,1166.89,
"Tendonitis, Myositis and Bursitis",248,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1396.17,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1396.17,,,,other,Services are paid on a DRG basis,1396.17,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1396.17,1396.17,
"Aftercare, Musculoskeletal System and Connective Tissues",249,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1752.73,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1752.73,,,,other,Services are paid on a DRG basis,1752.73,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1752.73,1752.73,
"Fx., Sprain, Strain and Dislocation of Forearm, Hand and Foot, > 17, W/ Com",250,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1699.01,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1699.01,,,,other,Services are paid on a DRG basis,1699.01,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1699.01,1699.01,
"Fx., Sprain, Strain and Dislocation of Forearm, Hand and Foot, > 17, W/O Co",251,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1130.11,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1130.11,,,,other,Services are paid on a DRG basis,1130.11,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1130.11,1130.11,
"Fx., Sprain, Strain and Dislocation of Forearm, Hand and Foot, 0-17",252,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,845.19,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,845.19,,,,other,Services are paid on a DRG basis,845.19,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,845.19,845.19,
"Fx., Sprain, Strain and Dislocation of Upper Arm and Lower Leg, Ex Foot, >1",253,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1569.49,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1569.49,,,,other,Services are paid on a DRG basis,1569.49,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1569.49,1569.49,
"Fx., Sprain, Strain and Dislocation of Upper Arm and Lower Leg, Ex Foot, >1",254,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,978.22,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,978.22,,,,other,Services are paid on a DRG basis,978.22,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,978.22,978.22,
"Fx., Sprain, Strain and Dislocation of Upper Arm and Lower Leg, Ex Foot, 0-",255,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,881.32,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,881.32,,,,other,Services are paid on a DRG basis,881.32,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,881.32,881.32,
Other Musculoskeletal System and Connective Tissue Diagnoses,256,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1257.39,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1257.39,,,,other,Services are paid on a DRG basis,1257.39,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1257.39,1257.39,
"Total Mastectomy for Malignancy, W/ Complications",257,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2813.77,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2813.77,,,,other,Services are paid on a DRG basis,2813.77,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2813.77,2813.77,
"Total Mastectomy for Malignancy, W/O Complications",258,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2162.37,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2162.37,,,,other,Services are paid on a DRG basis,2162.37,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2162.37,2162.37,
"Subtotal Mastectomy for Malignancy, W/ Complications",259,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2555.71,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2555.71,,,,other,Services are paid on a DRG basis,2555.71,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2555.71,2555.71,
"Subtotal Mastectomy for Malignancy, W/O Complications",260,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1583.25,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1583.25,,,,other,Services are paid on a DRG basis,1583.25,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1583.25,1583.25,
"Breast Procedures for Non-Malignancy, Except Biopsy and Local Excision",261,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2121.12,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2121.12,,,,other,Services are paid on a DRG basis,2121.12,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2121.12,2121.12,
Breast Biopsy and Local Excision for Non- Malignancy,262,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1807.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1807.41,,,,other,Services are paid on a DRG basis,1807.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1807.41,1807.41,
"Skin Graft or Debridement for Skin Ulcer or Cellulitis, W/ Complications",263,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5505.7,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5505.7,,,,other,Services are paid on a DRG basis,5505.7,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5505.7,5505.7,
"Skin Graft or Debridement for Skin Ulcer or Cellulitis, W/O Complications",264,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2561.14,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2561.14,,,,other,Services are paid on a DRG basis,2561.14,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2561.14,2561.14,
"Skin Graft or Debridement, Except for Skin Ulcer Or Cellulitis, W/ Complications",265,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3093.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3093.58,,,,other,Services are paid on a DRG basis,3093.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3093.58,3093.58,
"Skin Graft or Debridement, Except for Skin Ulcer or Cellulitis, W/O Complications",266,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1907.51,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1907.51,,,,other,Services are paid on a DRG basis,1907.51,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1907.51,1907.51,
Perianal and Pilonidal Procedures,267,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1893.75,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1893.75,,,,other,Services are paid on a DRG basis,1893.75,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1893.75,1893.75,
"Skin, Subcutaneous Tissue and Breast Plastic Procedures",268,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2559.22,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2559.22,,,,other,Services are paid on a DRG basis,2559.22,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2559.22,2559.22,
"Other Skin, Subcutaneous Tissue and Breast Procedures, W/ Complications",269,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3843.47,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3843.47,,,,other,Services are paid on a DRG basis,3843.47,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3843.47,3843.47,
"Other Skin, Subcutaneous Tissue and Breast Procedures, W/O Complications",270,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2281.97,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2281.97,,,,other,Services are paid on a DRG basis,2281.97,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2281.97,2281.97,
Skin Ulcers,271,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2493.35,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2493.35,,,,other,Services are paid on a DRG basis,2493.35,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2493.35,2493.35,
"Major Skin Disorders, W/Complications",272,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2448.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2448.26,,,,other,Services are paid on a DRG basis,2448.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2448.26,2448.26,
"Major Skin Disorders, W/O Complications",273,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1496.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1496.26,,,,other,Services are paid on a DRG basis,1496.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1496.26,1496.26,
"Malignant Breast Disorders, W/ Complications",274,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2902.99,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2902.99,,,,other,Services are paid on a DRG basis,2902.99,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2902.99,2902.99,
"Malignant Breast Disorders, W/O Complications",275,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1428.79,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1428.79,,,,other,Services are paid on a DRG basis,1428.79,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1428.79,1428.79,
Non-Malignant Breast Disorders,276,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1559.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1559.26,,,,other,Services are paid on a DRG basis,1559.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1559.26,1559.26,
"Cellulitis, > 17, W/ Complications",277,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2055.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2055.88,,,,other,Services are paid on a DRG basis,2055.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2055.88,2055.88,
"Cellulitis, > 17, W/O Complications",278,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1255.47,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1255.47,,,,other,Services are paid on a DRG basis,1255.47,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1255.47,1255.47,
"Cellulitis, 0-17",279,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1564.7,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1564.7,,,,other,Services are paid on a DRG basis,1564.7,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1564.7,1564.7,
"Trauma to the Skin, Subcutaneous Tissue and Breast, > 17, W/ Complications",280,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,936.64,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,936.64,,,,other,Services are paid on a DRG basis,936.64,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,936.64,936.64,
"Trauma to the Skin, Subcutaneous Tissue and Breast, > 17, W/O Complications",281,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,708.96,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,708.96,,,,other,Services are paid on a DRG basis,708.96,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,708.96,708.96,
"Trauma to the Skin, Subcutaneous Tissue and Breast, 0-17",282,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,767.48,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,767.48,,,,other,Services are paid on a DRG basis,767.48,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,767.48,767.48,
"Minor Skin Disorders, W/Complications",283,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1535.6,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1535.6,,,,other,Services are paid on a DRG basis,1535.6,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1535.6,1535.6,
"Minor Skin Disorders, W/O Complications",284,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,842.63,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,842.63,,,,other,Services are paid on a DRG basis,842.63,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,842.63,842.63,
"Amputation of Lower Limb for Endocrine, Nutritional and Metabolic Disorders",285,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7203.43,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7203.43,,,,other,Services are paid on a DRG basis,7203.43,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7203.43,7203.43,
Adrenal and Pituitary Procedures,286,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6464.09,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6464.09,,,,other,Services are paid on a DRG basis,6464.09,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6464.09,6464.09,
"Skin Grafts and Wound Debridement for Endocrine, Nutritional and Metab. Dis",287,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5086.15,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5086.15,,,,other,Services are paid on a DRG basis,5086.15,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5086.15,5086.15,
Operating Room Procedures for Obesity,288,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5207.35,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5207.35,,,,other,Services are paid on a DRG basis,5207.35,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5207.35,5207.35,
Parathyroid Procedures,289,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3020.67,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3020.67,,,,other,Services are paid on a DRG basis,3020.67,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3020.67,3020.67,
Thyroid Procedures,290,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2116.32,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2116.32,,,,other,Services are paid on a DRG basis,2116.32,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2116.32,2116.32,
Thyroglossal Procedures,291,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1420.48,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1420.48,,,,other,Services are paid on a DRG basis,1420.48,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1420.48,1420.48,
"Other Endocrine, Nutritional and Metabolic O.R. Procedures, W/ Complication",292,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7275.38,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7275.38,,,,other,Services are paid on a DRG basis,7275.38,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7275.38,7275.38,
"Other Endocrine, Nutritional and Metabolic O.R. Procedures, W/O Complications",293,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3230.77,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3230.77,,,,other,Services are paid on a DRG basis,3230.77,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3230.77,3230.77,
"Diabetes, Over 35 Years of Age",294,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1798.14,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1798.14,,,,other,Services are paid on a DRG basis,1798.14,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1798.14,1798.14,
"Diabetes, 35 Years of Age and Under",295,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1751.13,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1751.13,,,,other,Services are paid on a DRG basis,1751.13,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1751.13,1751.13,
"Nutritional and Misc. Metabolic Disorders, > 17, W/ Complications",296,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2082.43,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2082.43,,,,other,Services are paid on a DRG basis,2082.43,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2082.43,2082.43,
"Nutritional and Misc. Metabolic Disorders, > 17, W/O Complications",297,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1157.61,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1157.61,,,,other,Services are paid on a DRG basis,1157.61,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1157.61,1157.61,
"Nutritional and Miscellaneous Metabolic Disorders, 0-17",298,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1453.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1453.41,,,,other,Services are paid on a DRG basis,1453.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1453.41,1453.41,
Inborn Errors of Metabolism,299,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2050.13,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2050.13,,,,other,Services are paid on a DRG basis,2050.13,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2050.13,2050.13,
"Endocrine Disorders, W/ Complications",300,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2524.05,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2524.05,,,,other,Services are paid on a DRG basis,2524.05,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2524.05,2524.05,
"Endocrine Disorders, W/O Complications",301,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1445.74,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1445.74,,,,other,Services are paid on a DRG basis,1445.74,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1445.74,1445.74,
Kidney Transplant,302,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10473.53,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10473.53,,,,other,Services are paid on a DRG basis,10473.53,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10473.53,10473.53,
"Kidney, Ureter and Major Bladder Procedures for Neoplasm",303,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7129.56,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7129.56,,,,other,Services are paid on a DRG basis,7129.56,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7129.56,7129.56,
"Kidney, Ureter and Major Bladder Procedures for Non-Neoplasm, W/ Complications",304,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5744.9,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5744.9,,,,other,Services are paid on a DRG basis,5744.9,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5744.9,5744.9,
"Kidney, Ureter and Major Bladder Procedures for Non-Neoplasm, W/O Complications",305,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3094.22,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3094.22,,,,other,Services are paid on a DRG basis,3094.22,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3094.22,3094.22,
"Prostatectomy, W/ Complications",306,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3743.7,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3743.7,,,,other,Services are paid on a DRG basis,3743.7,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3743.7,3743.7,
"Prostatectomy, W/O Complications",307,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1842.91,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1842.91,,,,other,Services are paid on a DRG basis,1842.91,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1842.91,1842.91,
"Minor Bladder Procedures, W/ Complications",308,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5034.34,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5034.34,,,,other,Services are paid on a DRG basis,5034.34,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5034.34,5034.34,
"Minor Bladder Procedures, W/O Complications",309,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2731.27,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2731.27,,,,other,Services are paid on a DRG basis,2731.27,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2731.27,2731.27,
"Transurethral Procedures, W/ Complications",310,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2987.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2987.41,,,,other,Services are paid on a DRG basis,2987.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2987.41,2987.41,
"Transurethral Procedures, W/O Complications",311,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2027.74,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2027.74,,,,other,Services are paid on a DRG basis,2027.74,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2027.74,2027.74,
"Urethral Procedures, > 17, W/ Complications",312,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2354.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2354.88,,,,other,Services are paid on a DRG basis,2354.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2354.88,2354.88,
"Urethral Procedures, > 17, W/O Complications",313,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1329.34,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1329.34,,,,other,Services are paid on a DRG basis,1329.34,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1329.34,1329.34,
"Urethral Procedures, 0-17",314,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1253.87,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1253.87,,,,other,Services are paid on a DRG basis,1253.87,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1253.87,1253.87,
Other Kidney and Urinary Tract Operating Room Procedures,315,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6318.59,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6318.59,,,,other,Services are paid on a DRG basis,6318.59,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6318.59,6318.59,
Renal Failure,316,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3211.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3211.26,,,,other,Services are paid on a DRG basis,3211.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3211.26,3211.26,
Admit for Renal Dialysis,317,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1433.59,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1433.59,,,,other,Services are paid on a DRG basis,1433.59,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1433.59,1433.59,
"Kidney and Urinary Tract Neoplasms, W/ Complications",318,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3060.64,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3060.64,,,,other,Services are paid on a DRG basis,3060.64,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3060.64,3060.64,
"Kidney and Urinary Tract Neoplasms, W/O Complications",319,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1539.76,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1539.76,,,,other,Services are paid on a DRG basis,1539.76,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1539.76,1539.76,
"Kidney and Urinary Tract Infections, > 17, W/ Complications",320,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2185.4,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2185.4,,,,other,Services are paid on a DRG basis,2185.4,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2185.4,2185.4,
"Kidney and Urinary Tract Infections, > 17, W/O Complications",321,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1198.23,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1198.23,,,,other,Services are paid on a DRG basis,1198.23,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1198.23,1198.23,
"Kidney and Urinary Tract Infections, 0-17",322,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1248.11,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1248.11,,,,other,Services are paid on a DRG basis,1248.11,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1248.11,1248.11,
"Urinary Stones, W/ Complications or Extracorporeal Shock Wave Lithotripsy",323,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1941.08,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1941.08,,,,other,Services are paid on a DRG basis,1941.08,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1941.08,1941.08,
"Urinary Stones, W/O Complications",324,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1077.99,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1077.99,,,,other,Services are paid on a DRG basis,1077.99,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1077.99,1077.99,
"Kidney and Urinary Tract Signs and Symptoms, > 17, W/ Complications",325,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1664.47,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1664.47,,,,other,Services are paid on a DRG basis,1664.47,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1664.47,1664.47,
"Kidney and Urinary Tract Signs and Symptoms, > 17, W/O Complications",326,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1098.45,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1098.45,,,,other,Services are paid on a DRG basis,1098.45,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1098.45,1098.45,
"Kidney and Urinary Tract Signs And Symptoms, 0- 17",327,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1621.62,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1621.62,,,,other,Services are paid on a DRG basis,1621.62,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1621.62,1621.62,
"Urethral Stricture, > 17, W/ Complications",328,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1874.25,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1874.25,,,,other,Services are paid on a DRG basis,1874.25,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1874.25,1874.25,
"Urethral Stricture, > 17, W/O Complications",329,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1194.71,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1194.71,,,,other,Services are paid on a DRG basis,1194.71,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1194.71,1194.71,
"Urethral Stricture, 0-17",330,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,808.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,808.41,,,,other,Services are paid on a DRG basis,808.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,808.41,808.41,
"Other Kidney and Urinary Tract Diagnoses, > 17, W/ Complications",331,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2659.95,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2659.95,,,,other,Services are paid on a DRG basis,2659.95,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2659.95,2659.95,
"Other Kidney and Urinary Tract Diagnoses, > 17, W/O Complications",332,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1783.75,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1783.75,,,,other,Services are paid on a DRG basis,1783.75,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1783.75,1783.75,
"Other Kidney and Urinary Tract Diagnoses, 0-17",333,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2181.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2181.88,,,,other,Services are paid on a DRG basis,2181.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2181.88,2181.88,
"Major Male Pelvic Procedures, W/ Complications",334,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4781.08,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4781.08,,,,other,Services are paid on a DRG basis,4781.08,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4781.08,4781.08,
"Major Male Pelvic Procedures, W/O Complications",335,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3744.02,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3744.02,,,,other,Services are paid on a DRG basis,3744.02,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3744.02,3744.02,
"Transurethral Prostatectomy, W/ Complications",336,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2729.03,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2729.03,,,,other,Services are paid on a DRG basis,2729.03,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2729.03,2729.03,
"Transurethral Prostatectomy, W/O Complications",337,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1934.37,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1934.37,,,,other,Services are paid on a DRG basis,1934.37,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1934.37,1934.37,
"Testes Procedures, for Malignancy",338,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2711.44,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2711.44,,,,other,Services are paid on a DRG basis,2711.44,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2711.44,2711.44,
"Testes Procedures, Non-Malignancy, > 17",339,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2264.06,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2264.06,,,,other,Services are paid on a DRG basis,2264.06,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2264.06,2264.06,
"Testes Procedures, Non-Malignancy, 0-17",340,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,995.48,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,995.48,,,,other,Services are paid on a DRG basis,995.48,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,995.48,995.48,
Penis Procedures,341,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3131.32,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3131.32,,,,other,Services are paid on a DRG basis,3131.32,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3131.32,3131.32,
"Circumcision, > 17",342,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1862.42,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1862.42,,,,other,Services are paid on a DRG basis,1862.42,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1862.42,1862.42,
"Circumcision, 0-17",343,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1098.45,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1098.45,,,,other,Services are paid on a DRG basis,1098.45,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1098.45,1098.45,
Other Male Reproductive System Operating Room Procedures for Malignancy,344,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2767.72,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2767.72,,,,other,Services are paid on a DRG basis,2767.72,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2767.72,2767.72,
"Other Male Reproductive System Operating Room Procedures, Except for Malign",345,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2093.94,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2093.94,,,,other,Services are paid on a DRG basis,2093.94,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2093.94,2093.94,
"Malignancy, Male Reproductive System, W/ Complications",346,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2672.43,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2672.43,,,,other,Services are paid on a DRG basis,2672.43,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2672.43,2672.43,
"Malignancy, Male Reproductive System, W/O Complications",347,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1363.87,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1363.87,,,,other,Services are paid on a DRG basis,1363.87,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1363.87,1363.87,
"Benign Prostatic Hypertrophy, W/ Complications",348,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1872.01,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1872.01,,,,other,Services are paid on a DRG basis,1872.01,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1872.01,1872.01,
"Benign Prostatic Hypertrophy, W/O Complications",349,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1140.03,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1140.03,,,,other,Services are paid on a DRG basis,1140.03,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1140.03,1140.03,
Inflammation of the Male Reproductive System,350,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1427.83,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1427.83,,,,other,Services are paid on a DRG basis,1427.83,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1427.83,1427.83,
"Sterilization, Male",351,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,966.7,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,966.7,,,,other,Services are paid on a DRG basis,966.7,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,966.7,966.7,
Other Male Reproductive System Diagnoses,352,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1389.46,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1389.46,,,,other,Services are paid on a DRG basis,1389.46,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1389.46,1389.46,
"Pelvic Evisceration, Radical Hysterectomy and Radical Vulvectomy",353,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5055.77,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5055.77,,,,other,Services are paid on a DRG basis,5055.77,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5055.77,5055.77,
"Uterine, Adnexa Procedures for Non- Ovarian/Adnexal Malignancy, W/ Complications",354,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3535.84,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3535.84,,,,other,Services are paid on a DRG basis,3535.84,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3535.84,3535.84,
"Uterine, Adnexa Procedures for Non- Ovarian/Adnexal Malignancy, W/O Complications",355,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1770.96,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1770.96,,,,other,Services are paid on a DRG basis,1770.96,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1770.96,1770.96,
Female Reproductive System Reconstructive Procedures,356,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1869.45,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1869.45,,,,other,Services are paid on a DRG basis,1869.45,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1869.45,1869.45,
Uterine and Adnexa Procedures for Ovarian or Adnexal Malignancy,357,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5500.27,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5500.27,,,,other,Services are paid on a DRG basis,5500.27,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5500.27,5500.27,
"Uterine and Adnexa Procedures for Non- Malignancy, W/ Complications",358,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2741.5,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2741.5,,,,other,Services are paid on a DRG basis,2741.5,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2741.5,2741.5,
"Uterine and Adnexa Procedures for Non- Malignancy, W/O Complications",359,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1969.54,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1969.54,,,,other,Services are paid on a DRG basis,1969.54,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1969.54,1969.54,
"Vagina, Cervix and Vulva Procedures",360,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1953.87,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1953.87,,,,other,Services are paid on a DRG basis,1953.87,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1953.87,1953.87,
Laparoscopy and Incisional Tubal Interruption,361,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2579.69,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2579.69,,,,other,Services are paid on a DRG basis,2579.69,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2579.69,2579.69,
Endoscopic Tubal Interruption,362,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1444.78,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1444.78,,,,other,Services are paid on a DRG basis,1444.78,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1444.78,1444.78,
"Dilatation and Curettage, Conization and Radio- Implant, for Malignancy",363,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1930.21,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1930.21,,,,other,Services are paid on a DRG basis,1930.21,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1930.21,1930.21,
"Dilatation and Curettage, Conization, Except for Malignancy",364,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1603.39,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1603.39,,,,other,Services are paid on a DRG basis,1603.39,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1603.39,1603.39,
Other Female Reproductive System Operating Room Procedures,365,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3330.54,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3330.54,,,,other,Services are paid on a DRG basis,3330.54,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3330.54,3330.54,
"Malignancy, Female Reproductive System, W/ Complications",366,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2628.94,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2628.94,,,,other,Services are paid on a DRG basis,2628.94,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2628.94,2628.94,
"Malignancy, Female Reproductive System, W/O Complications",367,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1249.07,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1249.07,,,,other,Services are paid on a DRG basis,1249.07,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1249.07,1249.07,
"Infections, Female Reproductive System",368,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1399.05,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1399.05,,,,other,Services are paid on a DRG basis,1399.05,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1399.05,1399.05,
Menstrual and Other Female Reproductive System Disorders,369,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,929.29,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,929.29,,,,other,Services are paid on a DRG basis,929.29,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,929.29,929.29,
"Cesarean Section, W/ Complications",370,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2808.01,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2808.01,,,,other,Services are paid on a DRG basis,2808.01,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2808.01,2808.01,
"Cesarean Section, W/O Complications",371,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2332.82,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2332.82,,,,other,Services are paid on a DRG basis,2332.82,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2332.82,2332.82,
"Vaginal Delivery, W/ Complicating Diagnoses",372,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1777.67,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1777.67,,,,other,Services are paid on a DRG basis,1777.67,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1777.67,1777.67,
"Vaginal Delivery, W/O Complicating Diagnoses",373,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1459.81,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1459.81,,,,other,Services are paid on a DRG basis,1459.81,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1459.81,1459.81,
"Vaginal Delivery, W/ Sterilization or Dilatation and Curettage",374,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2093.3,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2093.3,,,,other,Services are paid on a DRG basis,2093.3,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2093.3,2093.3,
"Vaginal Delivery, W/ Operating Room Procedures, Except Sterilization or D&C",375,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1699.33,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1699.33,,,,other,Services are paid on a DRG basis,1699.33,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1699.33,1699.33,
"Postpartum and Post Abortion Diagnoses, W/O Operating Room Procedures",376,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,814.81,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,814.81,,,,other,Services are paid on a DRG basis,814.81,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,814.81,814.81,
"Postpartum and Post Abortion Diagnoses, W/ Operating Room Procedures",377,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1918.7,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1918.7,,,,other,Services are paid on a DRG basis,1918.7,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1918.7,1918.7,
Ectopic Pregnancy,378,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1963.47,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1963.47,,,,other,Services are paid on a DRG basis,1963.47,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1963.47,1963.47,
Threatened Abortion,379,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,722.39,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,722.39,,,,other,Services are paid on a DRG basis,722.39,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,722.39,722.39,
"Abortion, W/O Dilatation and Curettage",380,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,848.06,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,848.06,,,,other,Services are paid on a DRG basis,848.06,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,848.06,848.06,
"Abortion, W/ Dilatation and Curettage, Aspiration Curettage or Hysterotomy",381,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,865.01,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,865.01,,,,other,Services are paid on a DRG basis,865.01,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,865.01,865.01,
False Labor,382,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,437.14,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,437.14,,,,other,Services are paid on a DRG basis,437.14,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,437.14,437.14,
"Other Antepartum Diagnoses, W/ Medical Complications",383,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,828.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,828.88,,,,other,Services are paid on a DRG basis,828.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,828.88,828.88,
"Other Antepartum Diagnoses, W/O Medical Complications",384,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,639.57,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,639.57,,,,other,Services are paid on a DRG basis,639.57,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,639.57,639.57,
"Neonates, Died or Transferred to Another Acute Care Facility",385,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2336.97,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2336.97,,,,other,Services are paid on a DRG basis,2336.97,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2336.97,2336.97,
Extreme Immaturity or Respiratory Distress Syndrome,386,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14159.03,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14159.03,,,,other,Services are paid on a DRG basis,14159.03,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14159.03,14159.03,
"Prematurity, W/ Major Problems",387,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7702.93,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7702.93,,,,other,Services are paid on a DRG basis,7702.93,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7702.93,7702.93,
"Prematurity, W/O Major Problems",388,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2284.21,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2284.21,,,,other,Services are paid on a DRG basis,2284.21,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2284.21,2284.21,
"Full-Term Neonate, W/ Major Problems",389,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2071.23,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2071.23,,,,other,Services are paid on a DRG basis,2071.23,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2071.23,2071.23,
"Neonate, W/ Other Significant Problems",390,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,477.44,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,477.44,,,,other,Services are paid on a DRG basis,477.44,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,477.44,477.44,
"Splenectomy, > 17",392,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7724.04,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7724.04,,,,other,Services are paid on a DRG basis,7724.04,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7724.04,7724.04,
"Splenectomy, 0-17",393,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4410.13,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4410.13,,,,other,Services are paid on a DRG basis,4410.13,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4410.13,4410.13,
Other Operating Room Procedures of the Blood and Blood Forming Organs,394,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4331.14,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4331.14,,,,other,Services are paid on a DRG basis,4331.14,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4331.14,4331.14,
"Red Blood Cell Disorders, > 17",395,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2365.43,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2365.43,,,,other,Services are paid on a DRG basis,2365.43,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2365.43,2365.43,
"Red Blood Cell Disorders, 0-17",396,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1545.19,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1545.19,,,,other,Services are paid on a DRG basis,1545.19,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1545.19,1545.19,
Coagulation Disorders,397,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2503.9,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2503.9,,,,other,Services are paid on a DRG basis,2503.9,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2503.9,2503.9,
"Reticuloendothelial and Immunity Disorders, W/ Complications",398,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2738.94,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2738.94,,,,other,Services are paid on a DRG basis,2738.94,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2738.94,2738.94,
"Reticuloendothelial and Immunity Disorders, W/O Complications",399,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1478.04,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1478.04,,,,other,Services are paid on a DRG basis,1478.04,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1478.04,1478.04,
"Lymphoma and Leukemia, W/ Major Operating Room Procedure",400,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6772.36,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6772.36,,,,other,Services are paid on a DRG basis,6772.36,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6772.36,6772.36,
"Lymphoma and Non-Acute Leukemia, W/ Other
O.R. Procedures, W/ Complications",401,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7603.8,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7603.8,,,,other,Services are paid on a DRG basis,7603.8,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7603.8,7603.8,
"Lymphoma and Non-Acute Leukemia, W/ Other
O.R. Procedures, W/O Complication",402,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2564.98,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2564.98,,,,other,Services are paid on a DRG basis,2564.98,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2564.98,2564.98,
"Lymphoma and Non-Acute Leukemia, W/ Complications",403,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4657.32,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4657.32,,,,other,Services are paid on a DRG basis,4657.32,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4657.32,4657.32,
"Lymphoma and Non-Acute Leukemia, W/O Complications",404,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1994.17,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1994.17,,,,other,Services are paid on a DRG basis,1994.17,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1994.17,1994.17,
"Acute Leukemia, W/O Major Operating Room Procedure, 0-17",405,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2741.18,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2741.18,,,,other,Services are paid on a DRG basis,2741.18,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2741.18,2741.18,
"Myeloproliferative Disord or Poorly Diff Neoplasm, W/ Major O.R. Procedure,",406,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7573.42,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7573.42,,,,other,Services are paid on a DRG basis,7573.42,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7573.42,7573.42,
"Myeloproliferative Disord or Poorly Diff Neoplasm, W/ Major O.R. Procedure,",407,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3135.79,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3135.79,,,,other,Services are paid on a DRG basis,3135.79,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3135.79,3135.79,
"Myeloproliferative Disord or Poorly Diff Neoplasm, W/ Other O.R. Procedure",408,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4339.46,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4339.46,,,,other,Services are paid on a DRG basis,4339.46,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4339.46,4339.46,
Radiotherapy,409,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2169.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2169.41,,,,other,Services are paid on a DRG basis,2169.41,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2169.41,2169.41,
Chemotherapy W/O Acute Leukemia as Secondary Diagnosis,410,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2296.68,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2296.68,,,,other,Services are paid on a DRG basis,2296.68,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2296.68,2296.68,
"History of Malignancy, W/O Endoscopy",411,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1246.19,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1246.19,,,,other,Services are paid on a DRG basis,1246.19,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1246.19,1246.19,
"History of Malignancy, W/ Endoscopy",412,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1257.07,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1257.07,,,,other,Services are paid on a DRG basis,1257.07,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1257.07,1257.07,
"Other Myeloproliferative Disord or Poorly Diff Neoplasm Diagnosis, W/ Complications",413,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3896.56,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3896.56,,,,other,Services are paid on a DRG basis,3896.56,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3896.56,3896.56,
"Other Myeloproliferative Disord or Poorly Diff Neoplasm Diagnosis, W/O Complications",414,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1690.05,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1690.05,,,,other,Services are paid on a DRG basis,1690.05,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1690.05,1690.05,
Operating Room Procedure for Infectious and Parasitic Diseases,415,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8249.44,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8249.44,,,,other,Services are paid on a DRG basis,8249.44,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8249.44,8249.44,
"Septicemia, > 17",416,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4156.22,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4156.22,,,,other,Services are paid on a DRG basis,4156.22,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4156.22,4156.22,
"Septicemia, 0-17",417,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2899.15,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2899.15,,,,other,Services are paid on a DRG basis,2899.15,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2899.15,2899.15,
Postoperative and Post-Traumatic Infections,418,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1921.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1921.26,,,,other,Services are paid on a DRG basis,1921.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1921.26,1921.26,
"Fever of Unknown Origin,> 17, W/ Complications",419,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2189.23,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2189.23,,,,other,Services are paid on a DRG basis,2189.23,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2189.23,2189.23,
"Fever of Unknown Origin,> 17, W/O Complications",420,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1618.1,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1618.1,,,,other,Services are paid on a DRG basis,1618.1,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1618.1,1618.1,
"Viral Illness, > 17",421,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1529.84,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1529.84,,,,other,Services are paid on a DRG basis,1529.84,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1529.84,1529.84,
"Viral Illness and Fever of Unknown Origin, 0-17",422,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1199.51,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1199.51,,,,other,Services are paid on a DRG basis,1199.51,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1199.51,1199.51,
Other Infectious and Parasitic Diseases Diagnoses,423,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3293.45,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3293.45,,,,other,Services are paid on a DRG basis,3293.45,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3293.45,3293.45,
Operating Room Procedure w/ Principal Diagnoses of Mental Illness,424,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1424.31,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1424.31,,,,other,Services are paid on a DRG basis,1424.31,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1424.31,1424.31,
Acute Adjust React and Disturbances of Psychosocial Dysfunction,425,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,865.33,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,865.33,,,,other,Services are paid on a DRG basis,865.33,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,865.33,865.33,
Depressive Neuroses,426,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,541.07,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,541.07,,,,other,Services are paid on a DRG basis,541.07,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,541.07,541.07,
Neuroses Except Depressive,427,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,604.39,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,604.39,,,,other,Services are paid on a DRG basis,604.39,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,604.39,604.39,
Disorders of Personality and Impulse Control,428,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,477.44,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,477.44,,,,other,Services are paid on a DRG basis,477.44,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,477.44,477.44,
Organic Disturbances and Mental Retardation,429,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,848.06,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,848.06,,,,other,Services are paid on a DRG basis,848.06,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,848.06,848.06,
Psychoses,430,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,593.84,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,593.84,,,,other,Services are paid on a DRG basis,593.84,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,593.84,593.84,
Childhood Mental Disorders,431,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,574.97,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,574.97,,,,other,Services are paid on a DRG basis,574.97,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,574.97,574.97,
Other Mental Disorder Diagnoses,432,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2098.74,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2098.74,,,,other,Services are paid on a DRG basis,2098.74,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2098.74,2098.74,
"Alcohol/Drug Abuse or Dependence, Left Against Medical Advice",433,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,600.55,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,600.55,,,,other,Services are paid on a DRG basis,600.55,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,600.55,600.55,
"Alcohol/Drug Abuse or Dependence, Detox or Other Symptomatic Treatment, W/C",434,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1233.4,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1233.4,,,,other,Services are paid on a DRG basis,1233.4,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1233.4,1233.4,
"Alcohol/Drug Abuse or Dependence, Detox or Other Symptomatic Treatment, W/O",435,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,742.22,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,742.22,,,,other,Services are paid on a DRG basis,742.22,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,742.22,742.22,
"Alcohol/Drug Dependence, Combined Rehabilitation and Detox Therapy",437,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,742.22,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,742.22,,,,other,Services are paid on a DRG basis,742.22,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,742.22,742.22,
Skin Grafts for Injuries,439,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3701.81,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3701.81,,,,other,Services are paid on a DRG basis,3701.81,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3701.81,3701.81,
Wound Debridements for Injuries,440,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3409.53,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3409.53,,,,other,Services are paid on a DRG basis,3409.53,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3409.53,3409.53,
Hand Procedures for Injuries,441,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2230.17,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2230.17,,,,other,Services are paid on a DRG basis,2230.17,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2230.17,2230.17,
"Other Operating Room Procedures for Injuries, W/ Complications",442,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5606.12,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5606.12,,,,other,Services are paid on a DRG basis,5606.12,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5606.12,5606.12,
"Other Operating Room Procedures for Injuries, W/O Complications",443,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2276.54,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2276.54,,,,other,Services are paid on a DRG basis,2276.54,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2276.54,2276.54,
"Traumatic Injury, > 17, W/ Complications",444,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1164.33,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1164.33,,,,other,Services are paid on a DRG basis,1164.33,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1164.33,1164.33,
"Traumatic Injury, > 17, W/O Complications",445,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,875.25,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,875.25,,,,other,Services are paid on a DRG basis,875.25,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,875.25,875.25,
"Traumatic Injury, 0-17",446,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1043.13,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1043.13,,,,other,Services are paid on a DRG basis,1043.13,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1043.13,1043.13,
"Allergic Reactions, > 17",447,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1188.63,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1188.63,,,,other,Services are paid on a DRG basis,1188.63,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1188.63,1188.63,
"Allergic Reactions, 0-17",448,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,832.71,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,832.71,,,,other,Services are paid on a DRG basis,832.71,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,832.71,832.71,
"Poisoning and Toxic Effects Of Drugs, > 17, W/ Complications",449,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1427.19,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1427.19,,,,other,Services are paid on a DRG basis,1427.19,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1427.19,1427.19,
"Poisoning and Toxic Effects Of Drugs, > 17, W/O Complications",450,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,870.45,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,870.45,,,,other,Services are paid on a DRG basis,870.45,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,870.45,870.45,
"Poisoning and Toxic Effects Of Drugs, 0-17",451,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2468.09,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2468.09,,,,other,Services are paid on a DRG basis,2468.09,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2468.09,2468.09,
"Complications of Treatment, W/ Complications",452,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2149.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2149.26,,,,other,Services are paid on a DRG basis,2149.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2149.26,2149.26,
"Complications of Treatment, W/O Complications",453,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,932.81,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,932.81,,,,other,Services are paid on a DRG basis,932.81,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,932.81,932.81,
"Other Injury, Poisoning and Toxic Effects Diagnoses, W/ Complications",454,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1805.81,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1805.81,,,,other,Services are paid on a DRG basis,1805.81,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1805.81,1805.81,
"Other Injury, Poisoning and Toxic Effects Diagnoses, W/O Complications",455,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1163.69,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1163.69,,,,other,Services are paid on a DRG basis,1163.69,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1163.69,1163.69,
"Burns, Transferred to Another Acute Care Facility",456,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6047.74,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6047.74,,,,other,Services are paid on a DRG basis,6047.74,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6047.74,6047.74,
"Extensive Burns, W/O Operating Room Procedure",457,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4540.28,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4540.28,,,,other,Services are paid on a DRG basis,4540.28,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4540.28,4540.28,
"Non-Extensive Burns, W/ Skin Graft",458,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9979.15,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9979.15,,,,other,Services are paid on a DRG basis,9979.15,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9979.15,9979.15,
"Non-Extensive Burns, W/ Wound Debridement or Other O.R. Procedure",459,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4338.5,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4338.5,,,,other,Services are paid on a DRG basis,4338.5,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4338.5,4338.5,
"Non-Extensive Burns, W/O O.R. Procedure",460,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1843.87,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1843.87,,,,other,Services are paid on a DRG basis,1843.87,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1843.87,1843.87,
Operating Room Procedures W/ Diagnoses of Other Contact W/ Health Services,461,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3781.75,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3781.75,,,,other,Services are paid on a DRG basis,3781.75,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3781.75,3781.75,
"Signs and Symptoms, W/ Complications",463,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1641.45,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1641.45,,,,other,Services are paid on a DRG basis,1641.45,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1641.45,1641.45,
"Signs and Symptoms, W/O Complications",464,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1213.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1213.26,,,,other,Services are paid on a DRG basis,1213.26,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1213.26,1213.26,
"Aftercare, W/ History of Malignancy as Secondary Diagnosis",465,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1243,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1243,,,,other,Services are paid on a DRG basis,1243,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1243,1243,
"Aftercare, W/O History of Malignancy as Secondary Diagnosis",466,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1635.37,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1635.37,,,,other,Services are paid on a DRG basis,1635.37,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1635.37,1635.37,
Other Factors Influencing Health Status,467,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,876.84,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,876.84,,,,other,Services are paid on a DRG basis,876.84,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,876.84,876.84,
Extensive Operating Room Procedure Unrelated to Principal Diagnosis,468,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6987.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6987.58,,,,other,Services are paid on a DRG basis,6987.58,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6987.58,6987.58,
Bilateral or Multiple Major Joint Procedures of the Lower Extremity,471,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11884.74,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11884.74,,,,other,Services are paid on a DRG basis,11884.74,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11884.74,11884.74,
"Extensive Burns, W/ O.R. Procedure",472,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30874.09,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30874.09,,,,other,Services are paid on a DRG basis,30874.09,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30874.09,30874.09,
"Acute Leukemia, W/O Major O.R. Procedure, > 17",473,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11895.29,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11895.29,,,,other,Services are paid on a DRG basis,11895.29,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11895.29,11895.29,
"Respiratory System Diagnosis, W/ Ventilator Support",475,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8676.35,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8676.35,,,,other,Services are paid on a DRG basis,8676.35,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8676.35,8676.35,
Prostatic O.R. Procedure Unrelated to Principal Diagnosis,476,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6469.21,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6469.21,,,,other,Services are paid on a DRG basis,6469.21,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6469.21,6469.21,
Non-Extensive O.R. Procedure Unrelated to Principal Diagnosis,477,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4238.08,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4238.08,,,,other,Services are paid on a DRG basis,4238.08,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4238.08,4238.08,
"Other Vascular Procedures, W/ Complications",478,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6679.95,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6679.95,,,,other,Services are paid on a DRG basis,6679.95,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6679.95,6679.95,
"Other Vascular Procedures, W/O Complications",479,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4048.77,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4048.77,,,,other,Services are paid on a DRG basis,4048.77,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4048.77,4048.77,
"Tracheostomy, for Face, Mouth & Neck Diagnoses",482,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10069.33,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10069.33,,,,other,Services are paid on a DRG basis,10069.33,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10069.33,10069.33,
"Tracheostomy, Except for Face, Mouth, & Neck Diagnoses",483,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35664.12,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35664.12,,,,other,Services are paid on a DRG basis,35664.12,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,35664.12,35664.12,
Craniotomy for Multiple Significant Trauma,484,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14720.25,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14720.25,,,,other,Services are paid on a DRG basis,14720.25,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14720.25,14720.25,
"Limb Reattachment, Hip and Femur Procedures for Multiple Significant Trauma",485,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10245.53,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10245.53,,,,other,Services are paid on a DRG basis,10245.53,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10245.53,10245.53,
Other Operating Room Procedures for Multiple Significant Trauma,486,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13129.65,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13129.65,,,,other,Services are paid on a DRG basis,13129.65,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13129.65,13129.65,
Other Multiple Significant Trauma,487,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4525.25,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4525.25,,,,other,Services are paid on a DRG basis,4525.25,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4525.25,4525.25,
"HIV, W/ Extensive O.R. Procedure",488,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9622.59,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9622.59,,,,other,Services are paid on a DRG basis,9622.59,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9622.59,9622.59,
"HIV, W/ Major Related Condition",489,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4141.83,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4141.83,,,,other,Services are paid on a DRG basis,4141.83,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4141.83,4141.83,
"HIV, W/ or W/O Other Related Condition",490,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2495.59,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2495.59,,,,other,Services are paid on a DRG basis,2495.59,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2495.59,2495.59,
Major Joint & Limb Reattachment Procedures - Upper Extremity,491,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4674.27,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4674.27,,,,other,Services are paid on a DRG basis,4674.27,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4674.27,4674.27,
Chemotherapy W/ Acute Leukemia as Secondary Diagnosis,492,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5459.02,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5459.02,,,,other,Services are paid on a DRG basis,5459.02,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5459.02,5459.02,
Laparoscopic Cholecystectomy W/O C.D.E. W/ Complications,493,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4300.44,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4300.44,,,,other,Services are paid on a DRG basis,4300.44,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4300.44,4300.44,
Laparoscopic Cholecystectomy W/O C.D.E. W/O Complications,494,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2771.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2771.88,,,,other,Services are paid on a DRG basis,2771.88,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2771.88,2771.88,
"Neonates, Died or Transferred to Another Acute Care Facility (For Perinatal Level 3 Facilities)",985,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17673.45,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17673.45,,,,other,Services are paid on a DRG basis,17673.45,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17673.45,17673.45,
Extreme Immaturity or Respiratory Distress Syndrome (For Perinatal Level 3 Facilities),986,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32084.15,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32084.15,,,,other,Services are paid on a DRG basis,32084.15,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32084.15,32084.15,
"Prematurity, W/ Major Problems (For Perinatal Level Facilities)",987,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11482.77,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11482.77,,,,other,Services are paid on a DRG basis,11482.77,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11482.77,11482.77,
"Full-Term Neonate, W/ Major Problems (For Perinatal Level 3 Facilities)",989,DRG,,,,,inpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3439.27,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3439.27,,,,other,Services are paid on a DRG basis,3439.27,,,,other,Services are paid on a DRG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3439.27,3439.27,
ALS EMERGENCY TRANSPORT,2152019,CDM,A0427,HCPCS,540,RC,outpatient,,3213.64,3213.64,,2728.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,803.41,22,,percent of total billed charges,,193.45,,,,fee schedule,,,2892.28,90,,percent of total billed charges,,,2660.89,82.8,,percent of total billed charges,,,2731.59,85,,percent of total billed charges,,,,,,,,,2828,88,,percent of total billed charges,,193.45,,,,fee schedule,,,2455.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,193.45,,,,fee schedule,,,803.41,22,,percent of total billed charges,,,2924.41,91,,percent of total billed charges,,,3052.96,95,,percent of total billed charges,,,2667.32,83,,percent of total billed charges,,,2667.32,83,,percent of total billed charges,,,,,,,,,,,,,,,2667.32,83,,percent of total billed charges,,,3052.96,95,,percent of total billed charges,,,2892.28,90,,percent of total billed charges,,,2892.28,90,,percent of total billed charges,,,2635.18,82,,percent of total billed charges,,,2892.28,90,,percent of total billed charges,,,2731.59,85,,percent of total billed charges,,193.45,3052.96,
ALS EMERGENCY TRANSPORT LEVEL 2,2152020,CDM,A0433,HCPCS,540,RC,outpatient,,3260.19,3260.19,,2767.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,815.05,22,,percent of total billed charges,,193.45,,,,fee schedule,,,2934.17,90,,percent of total billed charges,,,2699.44,82.8,,percent of total billed charges,,,2771.16,85,,percent of total billed charges,,,,,,,,,2868.97,88,,percent of total billed charges,,193.45,,,,fee schedule,,,2490.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,193.45,,,,fee schedule,,,815.05,22,,percent of total billed charges,,,2966.77,91,,percent of total billed charges,,,3097.18,95,,percent of total billed charges,,,2705.96,83,,percent of total billed charges,,,2705.96,83,,percent of total billed charges,,,,,,,,,,,,,,,2705.96,83,,percent of total billed charges,,,3097.18,95,,percent of total billed charges,,,2934.17,90,,percent of total billed charges,,,2934.17,90,,percent of total billed charges,,,2673.36,82,,percent of total billed charges,,,2934.17,90,,percent of total billed charges,,,2771.16,85,,percent of total billed charges,,193.45,3097.18,
BLS NON EMERGENCY TRANSPORT,2152027,CDM,A0428,HCPCS,540,RC,outpatient,,2482.91,2482.91,,2107.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,620.73,22,,percent of total billed charges,,113.76,,,,fee schedule,,,2234.62,90,,percent of total billed charges,,,2055.85,82.8,,percent of total billed charges,,,2110.47,85,,percent of total billed charges,,,,,,,,,2184.96,88,,percent of total billed charges,,113.76,,,,fee schedule,,,1896.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,113.76,,,,fee schedule,,,620.73,22,,percent of total billed charges,,,2259.45,91,,percent of total billed charges,,,2358.76,95,,percent of total billed charges,,,2060.82,83,,percent of total billed charges,,,2060.82,83,,percent of total billed charges,,,,,,,,,,,,,,,2060.82,83,,percent of total billed charges,,,2358.76,95,,percent of total billed charges,,,2234.62,90,,percent of total billed charges,,,2234.62,90,,percent of total billed charges,,,2035.99,82,,percent of total billed charges,,,2234.62,90,,percent of total billed charges,,,2110.47,85,,percent of total billed charges,,113.76,2358.76,
BLS EMERGENCY TRANSPORT,2152030,CDM,A0429,HCPCS,540,RC,outpatient,,2583.7,2583.7,,2193.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,645.93,22,,percent of total billed charges,,113.76,,,,fee schedule,,,2325.33,90,,percent of total billed charges,,,2139.3,82.8,,percent of total billed charges,,,2196.15,85,,percent of total billed charges,,,,,,,,,2273.66,88,,percent of total billed charges,,113.76,,,,fee schedule,,,1973.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,113.76,,,,fee schedule,,,645.93,22,,percent of total billed charges,,,2351.17,91,,percent of total billed charges,,,2454.52,95,,percent of total billed charges,,,2144.47,83,,percent of total billed charges,,,2144.47,83,,percent of total billed charges,,,,,,,,,,,,,,,2144.47,83,,percent of total billed charges,,,2454.52,95,,percent of total billed charges,,,2325.33,90,,percent of total billed charges,,,2325.33,90,,percent of total billed charges,,,2118.63,82,,percent of total billed charges,,,2325.33,90,,percent of total billed charges,,,2196.15,85,,percent of total billed charges,,113.76,2454.52,
ALS EMERGENCY W/SPECIAL SERV,2154023,CDM,A0434,HCPCS,540,RC,outpatient,,3390.58,3390.58,,2878.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,847.65,22,,percent of total billed charges,,261.04,,,,fee schedule,,,3051.52,90,,percent of total billed charges,,,2807.4,82.8,,percent of total billed charges,,,2881.99,85,,percent of total billed charges,,,,,,,,,2983.71,88,,percent of total billed charges,,261.04,,,,fee schedule,,,2590.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,261.04,,,,fee schedule,,,847.65,22,,percent of total billed charges,,,3085.43,91,,percent of total billed charges,,,3221.05,95,,percent of total billed charges,,,2814.18,83,,percent of total billed charges,,,2814.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2814.18,83,,percent of total billed charges,,,3221.05,95,,percent of total billed charges,,,3051.52,90,,percent of total billed charges,,,3051.52,90,,percent of total billed charges,,,2780.28,82,,percent of total billed charges,,,3051.52,90,,percent of total billed charges,,,2881.99,85,,percent of total billed charges,,261.04,3221.05,
GROUND MILEAGE,2155012,CDM,A0425,HCPCS,540,RC,outpatient,,47.51,47.51,,40.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.88,22,,percent of total billed charges,,5.6,,,,fee schedule,,,42.76,90,,percent of total billed charges,,,39.34,82.8,,percent of total billed charges,,,40.38,85,,percent of total billed charges,,,,,,,,,41.81,88,,percent of total billed charges,,5.6,,,,fee schedule,,,36.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.6,,,,fee schedule,,,11.88,22,,percent of total billed charges,,,43.23,91,,percent of total billed charges,,,45.13,95,,percent of total billed charges,,,39.43,83,,percent of total billed charges,,,39.43,83,,percent of total billed charges,,,,,,,,,,,,,,,39.43,83,,percent of total billed charges,,,45.13,95,,percent of total billed charges,,,42.76,90,,percent of total billed charges,,,42.76,90,,percent of total billed charges,,,38.96,82,,percent of total billed charges,,,42.76,90,,percent of total billed charges,,,40.38,85,,percent of total billed charges,,5.6,45.13,
MED-SURG ROOM - LEVEL I,890040,CDM,,,111,RC,outpatient,,2800,2800,,2377.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,2464,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2377.2,2464,
MED-SURG ROOM - LEVEL II,890041,CDM,,,111,RC,outpatient,,3263,3263,,2770.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,2871.44,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2770.29,2871.44,
MED-SURG ROOM - LEVEL III,890042,CDM,,,111,RC,outpatient,,4272,4272,,3626.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,3759.36,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3626.93,3759.36,
MED-SURG ROOM - LEVEL IV,890043,CDM,,,111,RC,outpatient,,4680,4680,,3973.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,4118.4,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3973.32,4118.4,
LONG TERM CARE,890054,CDM,,,111,RC,outpatient,,295,295,,250.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,259.6,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,250.46,259.6,
TREATMENT ROOM - OB,830081,CDM,G0463,HCPCS,510,RC,outpatient,,536,536,,455.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,471.68,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,455.06,471.68,
OB ROOM - LEVEL I,830050,CDM,,,111,RC,outpatient,,2620,2620,,2224.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,2305.6,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2224.38,2305.6,
OB ROOM - LEVEL II,830051,CDM,,,111,RC,outpatient,,3028,3028,,2570.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,2664.64,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2570.77,2664.64,
OB ROOM - LEVEL III,830052,CDM,,,111,RC,outpatient,,3852,3852,,3270.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,3389.76,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3270.35,3389.76,
OB ROOM - LEVEL IV,830053,CDM,,,111,RC,outpatient,,4256,4256,,3613.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,3745.28,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3613.34,3745.28,
ORTHO ROOM - LEVEL I,880030,CDM,,,111,RC,outpatient,,2940,2940,,2496.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,2587.2,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2496.06,2587.2,
ORTHO ROOM - LEVEL II,880031,CDM,,,111,RC,outpatient,,3426,3426,,2908.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,3014.88,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2908.67,3014.88,
ORTHO ROOM - LEVEL III,880032,CDM,,,111,RC,outpatient,,4486,4486,,3808.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,3947.68,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3808.61,3947.68,
ORTHO ROOM - LEVEL IV,880033,CDM,,,111,RC,outpatient,,4914,4914,,4171.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,4324.32,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4171.99,4324.32,
SEMI-PRIVATE ROOM - LEVEL I,890050,CDM,,,120,RC,outpatient,,2035,2035,,1727.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,1790.8,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1727.72,1790.8,
SEMI-PRIVATE ROOM - LEVEL II,890051,CDM,,,120,RC,outpatient,,2364,2364,,2007.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,2080.32,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2007.04,2080.32,
SEMI-PRIVATE ROOM - LEVEL III,890052,CDM,,,120,RC,outpatient,,3035,3035,,2576.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,2670.8,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2576.72,2670.8,
SEMI-PRIVATE ROOM - LEVEL IV,890053,CDM,,,120,RC,outpatient,,3354,3354,,2847.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,2951.52,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2847.55,2951.52,
NEWBORN LEVEL I,831100,CDM,,,171,RC,outpatient,,1734,1734,,1472.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,1525.92,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1472.17,1525.92,
NEWBORN LEVEL II,831101,CDM,,,172,RC,outpatient,,2246,2246,,1906.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,1976.48,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1906.85,1976.48,
NEWBORN LEVEL III,831102,CDM,,,173,RC,outpatient,,2882,2882,,2446.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,2536.16,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2446.82,2536.16,
NEWBORN LEVEL IV,831103,CDM,,,174,RC,outpatient,,3391,3391,,2878.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,2984.08,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2878.96,2984.08,
DELIVERY LEVEL I,831051,CDM,,,722,RC,outpatient,,2502,2502,,2124.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,2201.76,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2124.2,2201.76,
DELIVERY LEVEL II,831052,CDM,,,722,RC,outpatient,,3708,3708,,3148.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,N/A,82.8,,percent of total billed charges,,,,,,,,,,,,,,,3263.04,88,,percent of total billed charges,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3148.09,3263.04,
EPIDURAL INJECTION,18601004,CDM,,,360,RC,outpatient,,9809,9809,,8327.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2452.25,22,,percent of total billed charges,,,,,,,,,8828.1,90,,percent of total billed charges,,,8121.85,82.8,,percent of total billed charges,,,8337.65,85,,percent of total billed charges,,,,,,,,,8631.92,88,,percent of total billed charges,,,,,,,,,7494.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2452.25,22,,percent of total billed charges,,,8926.19,91,,percent of total billed charges,,,9318.55,95,,percent of total billed charges,,,8141.47,83,,percent of total billed charges,,,8141.47,83,,percent of total billed charges,,,,,,,,,,,,,,,8141.47,83,,percent of total billed charges,,,9318.55,95,,percent of total billed charges,,,8828.1,90,,percent of total billed charges,,,8828.1,90,,percent of total billed charges,,,8043.38,82,,percent of total billed charges,,,8828.1,90,,percent of total billed charges,,,8337.65,85,,percent of total billed charges,,2452.25,9318.55,
INJN TRT OF NERVE CRYOANALGESIA LT KNEE,18601005,CDM,64640,CPT,360,RC,outpatient,LT,3932,3932,,3338.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,983,22,,percent of total billed charges,,,,,,,,,3538.8,90,,percent of total billed charges,,,3255.7,82.8,,percent of total billed charges,,,3342.2,85,,percent of total billed charges,,,,,,,,,3460.16,88,,percent of total billed charges,,,,,,,,,3004.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,983,22,,percent of total billed charges,,,3578.12,91,,percent of total billed charges,,,3735.4,95,,percent of total billed charges,,,3263.56,83,,percent of total billed charges,,,3263.56,83,,percent of total billed charges,,,,,,,,,,,,,,,3263.56,83,,percent of total billed charges,,,3735.4,95,,percent of total billed charges,,,3538.8,90,,percent of total billed charges,,,3538.8,90,,percent of total billed charges,,,3224.24,82,,percent of total billed charges,,,3538.8,90,,percent of total billed charges,,,3342.2,85,,percent of total billed charges,,983,3735.4,
INJN TRT OF NERVE CRYOANALGESIA RT KNEE,18601006,CDM,64640,CPT,360,RC,outpatient,RT,3932,3932,,3338.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,983,22,,percent of total billed charges,,,,,,,,,3538.8,90,,percent of total billed charges,,,3255.7,82.8,,percent of total billed charges,,,3342.2,85,,percent of total billed charges,,,,,,,,,3460.16,88,,percent of total billed charges,,,,,,,,,3004.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,983,22,,percent of total billed charges,,,3578.12,91,,percent of total billed charges,,,3735.4,95,,percent of total billed charges,,,3263.56,83,,percent of total billed charges,,,3263.56,83,,percent of total billed charges,,,,,,,,,,,,,,,3263.56,83,,percent of total billed charges,,,3735.4,95,,percent of total billed charges,,,3538.8,90,,percent of total billed charges,,,3538.8,90,,percent of total billed charges,,,3224.24,82,,percent of total billed charges,,,3538.8,90,,percent of total billed charges,,,3342.2,85,,percent of total billed charges,,983,3735.4,
ARTERIAL CATHERT PERCUTANEOUS,33036620,CDM,36620,CPT,360,RC,outpatient,,1682,1682,,1428.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,420.5,22,,percent of total billed charges,,,,,,,,,1513.8,90,,percent of total billed charges,,,1392.7,82.8,,percent of total billed charges,,,1429.7,85,,percent of total billed charges,,,,,,,,,1480.16,88,,percent of total billed charges,,,,,,,,,1285.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,420.5,22,,percent of total billed charges,,,1530.62,91,,percent of total billed charges,,,1597.9,95,,percent of total billed charges,,,1396.06,83,,percent of total billed charges,,,1396.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1396.06,83,,percent of total billed charges,,,1597.9,95,,percent of total billed charges,,,1513.8,90,,percent of total billed charges,,,1513.8,90,,percent of total billed charges,,,1379.24,82,,percent of total billed charges,,,1513.8,90,,percent of total billed charges,,,1429.7,85,,percent of total billed charges,,420.5,1597.9,
BRACHIAL PLEXUS CONT INFUS BY CATHETER,33602061,CDM,64416,CPT,360,RC,outpatient,,1139,1139,,967.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.75,22,,percent of total billed charges,,,,,,,,,1025.1,90,,percent of total billed charges,,,943.09,82.8,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,,,,,,,,1002.32,88,,percent of total billed charges,,,,,,,,,870.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.75,22,,percent of total billed charges,,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,,,,,,,,,,,,,945.37,83,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,933.98,82,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,284.75,1082.05,
NERVE BLOCK INJ PUDENDAL,33602064,CDM,64430,CPT,360,RC,outpatient,,2098,2098,,1781.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,524.5,22,,percent of total billed charges,,,,,,,,,1888.2,90,,percent of total billed charges,,,1737.14,82.8,,percent of total billed charges,,,1783.3,85,,percent of total billed charges,,,,,,,,,1846.24,88,,percent of total billed charges,,,,,,,,,1602.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,524.5,22,,percent of total billed charges,,,1909.18,91,,percent of total billed charges,,,1993.1,95,,percent of total billed charges,,,1741.34,83,,percent of total billed charges,,,1741.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1741.34,83,,percent of total billed charges,,,1993.1,95,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1720.36,82,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1783.3,85,,percent of total billed charges,,524.5,1993.1,
SCIATIC NERVE CONT INFUS BY CATHETER,33602066,CDM,64446,CPT,360,RC,outpatient,,1139,1139,,967.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.75,22,,percent of total billed charges,,,,,,,,,1025.1,90,,percent of total billed charges,,,943.09,82.8,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,,,,,,,,1002.32,88,,percent of total billed charges,,,,,,,,,870.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.75,22,,percent of total billed charges,,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,,,,,,,,,,,,,945.37,83,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,933.98,82,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,284.75,1082.05,
INJ ANESTHETIC AGENT FEMORAL NERVE,33602067,CDM,64447,CPT,360,RC,outpatient,,1818,1818,,1543.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,454.5,22,,percent of total billed charges,,,,,,,,,1636.2,90,,percent of total billed charges,,,1505.3,82.8,,percent of total billed charges,,,1545.3,85,,percent of total billed charges,,,,,,,,,1599.84,88,,percent of total billed charges,,,,,,,,,1388.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,454.5,22,,percent of total billed charges,,,1654.38,91,,percent of total billed charges,,,1727.1,95,,percent of total billed charges,,,1508.94,83,,percent of total billed charges,,,1508.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1508.94,83,,percent of total billed charges,,,1727.1,95,,percent of total billed charges,,,1636.2,90,,percent of total billed charges,,,1636.2,90,,percent of total billed charges,,,1490.76,82,,percent of total billed charges,,,1636.2,90,,percent of total billed charges,,,1545.3,85,,percent of total billed charges,,454.5,1727.1,
FEMORAL NERVE CONT INFUS BY CATHETER,33602068,CDM,64448,CPT,360,RC,outpatient,,8930,8930,,7581.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2232.5,22,,percent of total billed charges,,,,,,,,,8037,90,,percent of total billed charges,,,7394.04,82.8,,percent of total billed charges,,,7590.5,85,,percent of total billed charges,,,,,,,,,7858.4,88,,percent of total billed charges,,,,,,,,,6822.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2232.5,22,,percent of total billed charges,,,8126.3,91,,percent of total billed charges,,,8483.5,95,,percent of total billed charges,,,7411.9,83,,percent of total billed charges,,,7411.9,83,,percent of total billed charges,,,,,,,,,,,,,,,7411.9,83,,percent of total billed charges,,,8483.5,95,,percent of total billed charges,,,8037,90,,percent of total billed charges,,,8037,90,,percent of total billed charges,,,7322.6,82,,percent of total billed charges,,,8037,90,,percent of total billed charges,,,7590.5,85,,percent of total billed charges,,2232.5,8483.5,
LUMBAR PLEXUS POST APPR CONT INF CATHETR,33602069,CDM,64449,CPT,360,RC,outpatient,,1913,1913,,1624.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,478.25,22,,percent of total billed charges,,,,,,,,,1721.7,90,,percent of total billed charges,,,1583.96,82.8,,percent of total billed charges,,,1626.05,85,,percent of total billed charges,,,,,,,,,1683.44,88,,percent of total billed charges,,,,,,,,,1461.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,478.25,22,,percent of total billed charges,,,1740.83,91,,percent of total billed charges,,,1817.35,95,,percent of total billed charges,,,1587.79,83,,percent of total billed charges,,,1587.79,83,,percent of total billed charges,,,,,,,,,,,,,,,1587.79,83,,percent of total billed charges,,,1817.35,95,,percent of total billed charges,,,1721.7,90,,percent of total billed charges,,,1721.7,90,,percent of total billed charges,,,1568.66,82,,percent of total billed charges,,,1721.7,90,,percent of total billed charges,,,1626.05,85,,percent of total billed charges,,478.25,1817.35,
INSERT NON-TUNNEL CV CATH,33636556,CDM,36556,CPT,360,RC,outpatient,,3536,3536,,3002.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,884,22,,percent of total billed charges,,,,,,,,,3182.4,90,,percent of total billed charges,,,2927.81,82.8,,percent of total billed charges,,,3005.6,85,,percent of total billed charges,,,,,,,,,3111.68,88,,percent of total billed charges,,,,,,,,,2701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,884,22,,percent of total billed charges,,,3217.76,91,,percent of total billed charges,,,3359.2,95,,percent of total billed charges,,,2934.88,83,,percent of total billed charges,,,2934.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2934.88,83,,percent of total billed charges,,,3359.2,95,,percent of total billed charges,,,3182.4,90,,percent of total billed charges,,,3182.4,90,,percent of total billed charges,,,2899.52,82,,percent of total billed charges,,,3182.4,90,,percent of total billed charges,,,3005.6,85,,percent of total billed charges,,884,3359.2,
INJ ANESTHESIA INTERLAMINAR CRV/THRC,33662321,CDM,62321,CPT,360,RC,outpatient,,3822,3822,,3244.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,955.5,22,,percent of total billed charges,,,,,,,,,3439.8,90,,percent of total billed charges,,,3164.62,82.8,,percent of total billed charges,,,3248.7,85,,percent of total billed charges,,,,,,,,,3363.36,88,,percent of total billed charges,,,,,,,,,2920.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,955.5,22,,percent of total billed charges,,,3478.02,91,,percent of total billed charges,,,3630.9,95,,percent of total billed charges,,,3172.26,83,,percent of total billed charges,,,3172.26,83,,percent of total billed charges,,,,,,,,,,,,,,,3172.26,83,,percent of total billed charges,,,3630.9,95,,percent of total billed charges,,,3439.8,90,,percent of total billed charges,,,3439.8,90,,percent of total billed charges,,,3134.04,82,,percent of total billed charges,,,3439.8,90,,percent of total billed charges,,,3248.7,85,,percent of total billed charges,,955.5,3630.9,
INJ ANESTHESIA BRACHIAL PLEXUS SINGLE,33664415,CDM,64415,CPT,360,RC,outpatient,,2179,2179,,1849.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,544.75,22,,percent of total billed charges,,,,,,,,,1961.1,90,,percent of total billed charges,,,1804.21,82.8,,percent of total billed charges,,,1852.15,85,,percent of total billed charges,,,,,,,,,1917.52,88,,percent of total billed charges,,,,,,,,,1664.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,544.75,22,,percent of total billed charges,,,1982.89,91,,percent of total billed charges,,,2070.05,95,,percent of total billed charges,,,1808.57,83,,percent of total billed charges,,,1808.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1808.57,83,,percent of total billed charges,,,2070.05,95,,percent of total billed charges,,,1961.1,90,,percent of total billed charges,,,1961.1,90,,percent of total billed charges,,,1786.78,82,,percent of total billed charges,,,1961.1,90,,percent of total billed charges,,,1852.15,85,,percent of total billed charges,,544.75,2070.05,
INJECTION ANESTH SCIATIC SINGLE,33664445,CDM,64445,CPT,360,RC,outpatient,,2099,2099,,1782.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,524.75,22,,percent of total billed charges,,,,,,,,,1889.1,90,,percent of total billed charges,,,1737.97,82.8,,percent of total billed charges,,,1784.15,85,,percent of total billed charges,,,,,,,,,1847.12,88,,percent of total billed charges,,,,,,,,,1603.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,524.75,22,,percent of total billed charges,,,1910.09,91,,percent of total billed charges,,,1994.05,95,,percent of total billed charges,,,1742.17,83,,percent of total billed charges,,,1742.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1742.17,83,,percent of total billed charges,,,1994.05,95,,percent of total billed charges,,,1889.1,90,,percent of total billed charges,,,1889.1,90,,percent of total billed charges,,,1721.18,82,,percent of total billed charges,,,1889.1,90,,percent of total billed charges,,,1784.15,85,,percent of total billed charges,,524.75,1994.05,
INJECTION ANESTH FEMORAL SINGLE,33664447,CDM,64447,CPT,360,RC,outpatient,,1139,1139,,967.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.75,22,,percent of total billed charges,,,,,,,,,1025.1,90,,percent of total billed charges,,,943.09,82.8,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,,,,,,,,1002.32,88,,percent of total billed charges,,,,,,,,,870.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.75,22,,percent of total billed charges,,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,,,,,,,,,,,,,945.37,83,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,933.98,82,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,284.75,1082.05,
INJ ANESTH AGENT OTHER PERPHL BRANCH,33664450,CDM,64450,CPT,360,RC,outpatient,,3005,3005,,2551.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,751.25,22,,percent of total billed charges,,,,,,,,,2704.5,90,,percent of total billed charges,,,2488.14,82.8,,percent of total billed charges,,,2554.25,85,,percent of total billed charges,,,,,,,,,2644.4,88,,percent of total billed charges,,,,,,,,,2295.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,751.25,22,,percent of total billed charges,,,2734.55,91,,percent of total billed charges,,,2854.75,95,,percent of total billed charges,,,2494.15,83,,percent of total billed charges,,,2494.15,83,,percent of total billed charges,,,,,,,,,,,,,,,2494.15,83,,percent of total billed charges,,,2854.75,95,,percent of total billed charges,,,2704.5,90,,percent of total billed charges,,,2704.5,90,,percent of total billed charges,,,2464.1,82,,percent of total billed charges,,,2704.5,90,,percent of total billed charges,,,2554.25,85,,percent of total billed charges,,751.25,2854.75,
TAP BLOCK UNILATERAL BY INJECTION,33664486,CDM,64486,CPT,360,RC,outpatient,,3210,3210,,2725.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,802.5,22,,percent of total billed charges,,,,,,,,,2889,90,,percent of total billed charges,,,2657.88,82.8,,percent of total billed charges,,,2728.5,85,,percent of total billed charges,,,,,,,,,2824.8,88,,percent of total billed charges,,,,,,,,,2452.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,802.5,22,,percent of total billed charges,,,2921.1,91,,percent of total billed charges,,,3049.5,95,,percent of total billed charges,,,2664.3,83,,percent of total billed charges,,,2664.3,83,,percent of total billed charges,,,,,,,,,,,,,,,2664.3,83,,percent of total billed charges,,,3049.5,95,,percent of total billed charges,,,2889,90,,percent of total billed charges,,,2889,90,,percent of total billed charges,,,2632.2,82,,percent of total billed charges,,,2889,90,,percent of total billed charges,,,2728.5,85,,percent of total billed charges,,802.5,3049.5,
US VESSEL ACCESS REQ US,33676937,CDM,76937,CPT,370,RC,outpatient,,939,939,,797.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,234.75,22,,percent of total billed charges,,,,,,,,,845.1,90,,percent of total billed charges,,,777.49,82.8,,percent of total billed charges,,,798.15,85,,percent of total billed charges,,,,,,,,,826.32,88,,percent of total billed charges,,,,,,,,,717.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,234.75,22,,percent of total billed charges,,,854.49,91,,percent of total billed charges,,,892.05,95,,percent of total billed charges,,,779.37,83,,percent of total billed charges,,,779.37,83,,percent of total billed charges,,,,,,,,,,,,,,,779.37,83,,percent of total billed charges,,,892.05,95,,percent of total billed charges,,,845.1,90,,percent of total billed charges,,,845.1,90,,percent of total billed charges,,,769.98,82,,percent of total billed charges,,,845.1,90,,percent of total billed charges,,,798.15,85,,percent of total billed charges,,234.75,892.05,
UL NDL PLCMNT US GUIDANCE,33676942,CDM,76942,CPT,402,RC,outpatient,TC,1569,1569,,1332.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,392.25,22,,percent of total billed charges,,,,,,,,,1412.1,90,,percent of total billed charges,,,1299.13,82.8,,percent of total billed charges,,,1333.65,85,,percent of total billed charges,,,,,,,,,1380.72,88,,percent of total billed charges,,,,,,,,,1198.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,392.25,22,,percent of total billed charges,,,1427.79,91,,percent of total billed charges,,,1490.55,95,,percent of total billed charges,,,1302.27,83,,percent of total billed charges,,,1302.27,83,,percent of total billed charges,,,,,,,,,,,,,,,1302.27,83,,percent of total billed charges,,,1490.55,95,,percent of total billed charges,,,1412.1,90,,percent of total billed charges,,,1412.1,90,,percent of total billed charges,,,1286.58,82,,percent of total billed charges,,,1412.1,90,,percent of total billed charges,,,1333.65,85,,percent of total billed charges,,392.25,1490.55,
INJECTION ANESTHETIC AXILLARY NERVE,33700000,CDM,64417,CPT,360,RC,outpatient,,1749,1749,,1484.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,437.25,22,,percent of total billed charges,,,,,,,,,1574.1,90,,percent of total billed charges,,,1448.17,82.8,,percent of total billed charges,,,1486.65,85,,percent of total billed charges,,,,,,,,,1539.12,88,,percent of total billed charges,,,,,,,,,1336.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,437.25,22,,percent of total billed charges,,,1591.59,91,,percent of total billed charges,,,1661.55,95,,percent of total billed charges,,,1451.67,83,,percent of total billed charges,,,1451.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1451.67,83,,percent of total billed charges,,,1661.55,95,,percent of total billed charges,,,1574.1,90,,percent of total billed charges,,,1574.1,90,,percent of total billed charges,,,1434.18,82,,percent of total billed charges,,,1574.1,90,,percent of total billed charges,,,1486.65,85,,percent of total billed charges,,437.25,1661.55,
LABOR EPIDURAL/ITN,33700015,CDM,1967,CPT,964,RC,outpatient,QZ,2270,2270,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45,58,
"ARTERIAL CATHETERIZATION TRANSF, SAMPLE",33700020,CDM,36620,CPT,360,RC,outpatient,,530,530,,449.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.5,22,,percent of total billed charges,,,,,,,,,477,90,,percent of total billed charges,,,438.84,82.8,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,,,,,,,,466.4,88,,percent of total billed charges,,,,,,,,,404.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.5,22,,percent of total billed charges,,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,,,,,,,,,,,,,439.9,83,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,434.6,82,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,132.5,503.5,
ANESTHESIA CHG UNIT CPT 00100,33700100,CDM,100,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00102,33700102,CDM,102,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00103,33700103,CDM,103,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00104,33700104,CDM,104,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00120,33700120,CDM,120,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00124,33700124,CDM,124,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00126,33700126,CDM,126,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00140,33700140,CDM,140,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00142,33700142,CDM,142,CPT,964,RC,outpatient,QZ,384,384,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00144,33700144,CDM,144,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00145,33700145,CDM,145,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00160,33700160,CDM,160,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00162,33700162,CDM,162,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00164,33700164,CDM,164,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00170,33700170,CDM,170,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00172,33700172,CDM,172,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00174,33700174,CDM,174,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00176,33700176,CDM,176,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00190,33700190,CDM,190,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00192,33700192,CDM,192,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00210,33700210,CDM,210,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00212,33700212,CDM,212,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00214,33700214,CDM,214,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00215,33700215,CDM,215,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00216,33700216,CDM,216,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00218,33700218,CDM,218,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00220,33700220,CDM,220,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00222,33700222,CDM,222,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00300,33700300,CDM,300,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00320QZ,33700320,CDM,320,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00322,33700322,CDM,322,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00350,33700350,CDM,350,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00352,33700352,CDM,352,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00400,33700400,CDM,400,CPT,964,RC,outpatient,QZ,431,431,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00402,33700402,CDM,402,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00404,33700404,CDM,404,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00406,33700406,CDM,406,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00410,33700410,CDM,410,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00450,33700450,CDM,450,CPT,964,RC,outpatient,,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00452,33700452,CDM,452,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00454,33700454,CDM,454,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00470,33700470,CDM,470,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00472,33700472,CDM,472,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00474,33700474,CDM,474,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00500,33700500,CDM,500,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00520,33700520,CDM,520,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00522,33700522,CDM,522,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00524,33700524,CDM,524,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00528,33700528,CDM,528,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00530,33700530,CDM,530,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00532,33700532,CDM,532,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00537,33700537,CDM,537,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00540,33700540,CDM,540,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00542,33700542,CDM,542,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00546,33700546,CDM,546,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00548,33700548,CDM,548,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00600,33700600,CDM,600,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00604,33700604,CDM,604,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00620,33700620,CDM,620,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00622,33700622,CDM,622,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00630,33700630,CDM,630,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00632,33700632,CDM,632,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00634,33700634,CDM,634,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
DX LUMBAR PUNCTURE,33700635,CDM,635,CPT,964,RC,outpatient,QZ,636,636,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
"ANESTH, MANIPULATION CHG UNIT CPT 00640",33700640,CDM,640,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00670,33700670,CDM,670,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00700,33700700,CDM,700,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00702,33700702,CDM,702,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00730,33700730,CDM,730,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00740,33700740,CDM,731,CPT,964,RC,outpatient,QZ,466,466,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00750,33700750,CDM,750,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00752,33700752,CDM,752,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00754,33700754,CDM,754,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00756,33700756,CDM,756,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00770,33700770,CDM,770,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00790,33700790,CDM,790,CPT,964,RC,outpatient,QZ,498,498,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00792,33700792,CDM,792,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00794,33700794,CDM,794,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00800,33700800,CDM,800,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00802,33700802,CDM,802,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00810,33700810,CDM,811,CPT,964,RC,outpatient,QZ,498,498,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00820,33700820,CDM,820,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00830,33700830,CDM,830,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00832,33700832,CDM,832,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00840,33700840,CDM,840,CPT,964,RC,outpatient,QZ,459,459,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00842,33700842,CDM,842,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00844,33700844,CDM,844,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00846,33700846,CDM,846,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00848,33700848,CDM,848,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00851,33700851,CDM,851,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00860,33700860,CDM,860,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00862,33700862,CDM,862,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00864,33700864,CDM,864,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00866,33700866,CDM,866,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00870,33700870,CDM,870,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00872,33700872,CDM,872,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00873,33700873,CDM,873,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00880,33700880,CDM,880,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00882,33700882,CDM,882,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00902,33700902,CDM,902,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00904,33700904,CDM,904,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00906,33700906,CDM,906,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00908,33700908,CDM,908,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00910,33700910,CDM,910,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00912,33700912,CDM,912,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00914,33700914,CDM,914,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00916,33700916,CDM,916,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00918,33700918,CDM,918,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00920,33700920,CDM,920,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00921,33700921,CDM,921,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00922,33700922,CDM,922,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00924,33700924,CDM,924,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00926,33700926,CDM,926,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00928,33700928,CDM,928,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00930,33700930,CDM,930,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00932,33700932,CDM,932,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00934,33700934,CDM,934,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00936,33700936,CDM,936,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00938,33700938,CDM,938,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00940,33700940,CDM,940,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00942,33700942,CDM,942,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00944,33700944,CDM,944,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00948,33700948,CDM,948,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00950,33700950,CDM,950,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00952,33700952,CDM,952,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00100,33701100,CDM,100,CPT,964,RC,outpatient,,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01112,33701110,CDM,1112,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01120,33701120,CDM,1120,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01130,33701130,CDM,1130,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01140,33701140,CDM,1140,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01150,33701150,CDM,1150,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01160,33701160,CDM,1160,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01170,33701170,CDM,1170,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01180,33701180,CDM,1180,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01190,33701190,CDM,1190,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01200,33701200,CDM,1200,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01202,33701202,CDM,1202,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01210,33701210,CDM,1210,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01212,33701212,CDM,1212,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01214,33701214,CDM,1214,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01215,33701215,CDM,1215,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01220,33701220,CDM,1220,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01230,33701230,CDM,1230,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01232,33701232,CDM,1232,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01234,33701234,CDM,1234,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01250,33701250,CDM,1250,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01260,33701260,CDM,1260,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01270,33701270,CDM,1270,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01272,33701272,CDM,1272,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01274,33701274,CDM,1274,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01320,33701320,CDM,1320,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01340,33701340,CDM,1340,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01360,33701360,CDM,1360,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01380,33701380,CDM,1380,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01382,33701382,CDM,1382,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01390,33701390,CDM,1390,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01392,33701392,CDM,1392,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01400,33701400,CDM,1400,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01402,33701402,CDM,1402,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01404,33701404,CDM,1404,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01420,33701420,CDM,1420,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01430,33701430,CDM,1430,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01432,33701432,CDM,1432,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01440,33701440,CDM,1440,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01442,33701442,CDM,1442,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01444,33701444,CDM,1444,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01462,33701462,CDM,1462,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01464,33701464,CDM,1464,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01470,33701470,CDM,1470,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01472,33701472,CDM,1472,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01474,33701474,CDM,1474,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01480,33701480,CDM,1480,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01482,33701482,CDM,1482,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01484,33701484,CDM,1484,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01486,33701486,CDM,1486,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01490,33701490,CDM,1490,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01500,33701500,CDM,1500,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01502,33701502,CDM,1502,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01520,33701520,CDM,1520,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01522,33701522,CDM,1522,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01610,33701610,CDM,1610,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01620,33701620,CDM,1620,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01622,33701622,CDM,1622,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01630,33701630,CDM,1630,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01634,33701634,CDM,1634,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01636,33701636,CDM,1636,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01638,33701638,CDM,1638,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01650,33701650,CDM,1650,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01652,33701652,CDM,1652,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01654,33701654,CDM,1654,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01656,33701656,CDM,1656,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01670,33701670,CDM,1670,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01680,33701680,CDM,1680,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01682,33701682,CDM,1682,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01710,33701710,CDM,1710,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01712,33701712,CDM,1712,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01714,33701714,CDM,1714,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01716,33701716,CDM,1716,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01730,33701730,CDM,1730,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01732,33701732,CDM,1732,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01740,33701740,CDM,1740,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01742,33701742,CDM,1742,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01744,33701744,CDM,1744,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01756,33701756,CDM,1756,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01758,33701758,CDM,1758,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01760,33701760,CDM,1760,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01770,33701770,CDM,1770,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01772,33701772,CDM,1772,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01780,33701780,CDM,1780,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01782,33701782,CDM,1782,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01810,33701810,CDM,1810,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01820,33701820,CDM,1820,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01830,33701830,CDM,1830,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01832,33701832,CDM,1832,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01840,33701840,CDM,1840,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01842,33701842,CDM,1842,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01844,33701844,CDM,1844,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01850,33701850,CDM,1850,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01852,33701852,CDM,1852,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01860,33701860,CDM,1860,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01916,33701916,CDM,1916,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01920,33701920,CDM,1920,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01922,33701922,CDM,1922,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01924,33701924,CDM,1924,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01926,33701926,CDM,1926,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01930,33701930,CDM,1930,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01935 DIAGNOSTIC,33701935,CDM,1937,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01936 THERAPUTIC,33701936,CDM,1938,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT 01958,33701958,CDM,1958,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01961,33701961,CDM,1961,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01963,33701963,CDM,1963,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA MISSED OR INCOMPLETE AB,33701965,CDM,1965,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHARGE UNIT 01966,33701966,CDM,1966,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA LABOR EPIDURAL UNIT 01967,33701967,CDM,1967,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHARGE UNIT 01968,33701968,CDM,1968,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01990,33701990,CDM,1990,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA NERVE BLK OTHER THAN PRONE,33701991,CDM,1991,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA NERVE BLOCK PRONE,33701992,CDM,1992,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01992,33701994,CDM,1992,CPT,964,RC,outpatient,QZ,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHARGE UNIT 01996,33701996,CDM,1996,CPT,964,RC,outpatient,QZ,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
CATH UMBILICAL ARTERYNEWB DIAG THER,33736660,CDM,36660,CPT,361,RC,outpatient,,590,590,,500.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,147.5,22,,percent of total billed charges,,,,,,,,,531,90,,percent of total billed charges,,,488.52,82.8,,percent of total billed charges,,,501.5,85,,percent of total billed charges,,,,,,,,,519.2,88,,percent of total billed charges,,,,,,,,,450.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,147.5,22,,percent of total billed charges,,,536.9,91,,percent of total billed charges,,,560.5,95,,percent of total billed charges,,,489.7,83,,percent of total billed charges,,,489.7,83,,percent of total billed charges,,,,,,,,,,,,,,,489.7,83,,percent of total billed charges,,,560.5,95,,percent of total billed charges,,,531,90,,percent of total billed charges,,,531,90,,percent of total billed charges,,,483.8,82,,percent of total billed charges,,,531,90,,percent of total billed charges,,,501.5,85,,percent of total billed charges,,147.5,560.5,
EPIDURAL BLOOD PATCH,33762273,CDM,62273,CPT,360,RC,outpatient,,2398,2398,,2035.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,599.5,22,,percent of total billed charges,,,,,,,,,2158.2,90,,percent of total billed charges,,,1985.54,82.8,,percent of total billed charges,,,2038.3,85,,percent of total billed charges,,,,,,,,,2110.24,88,,percent of total billed charges,,,,,,,,,1832.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,599.5,22,,percent of total billed charges,,,2182.18,91,,percent of total billed charges,,,2278.1,95,,percent of total billed charges,,,1990.34,83,,percent of total billed charges,,,1990.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1990.34,83,,percent of total billed charges,,,2278.1,95,,percent of total billed charges,,,2158.2,90,,percent of total billed charges,,,2158.2,90,,percent of total billed charges,,,1966.36,82,,percent of total billed charges,,,2158.2,90,,percent of total billed charges,,,2038.3,85,,percent of total billed charges,,599.5,2278.1,
ESI LUMBAR EPIDURAL,33762311,CDM,62322,CPT,360,RC,outpatient,TC,7269,7269,,6171.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1817.25,22,,percent of total billed charges,,,,,,,,,6542.1,90,,percent of total billed charges,,,6018.73,82.8,,percent of total billed charges,,,6178.65,85,,percent of total billed charges,,,,,,,,,6396.72,88,,percent of total billed charges,,,,,,,,,5553.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1817.25,22,,percent of total billed charges,,,6614.79,91,,percent of total billed charges,,,6905.55,95,,percent of total billed charges,,,6033.27,83,,percent of total billed charges,,,6033.27,83,,percent of total billed charges,,,,,,,,,,,,,,,6033.27,83,,percent of total billed charges,,,6905.55,95,,percent of total billed charges,,,6542.1,90,,percent of total billed charges,,,6542.1,90,,percent of total billed charges,,,5960.58,82,,percent of total billed charges,,,6542.1,90,,percent of total billed charges,,,6178.65,85,,percent of total billed charges,,1817.25,6905.55,
LUMBAR SURGICAL EPIDURAL,33762319,CDM,62326,CPT,360,RC,outpatient,,5334,5334,,4528.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1333.5,22,,percent of total billed charges,,,,,,,,,4800.6,90,,percent of total billed charges,,,4416.55,82.8,,percent of total billed charges,,,4533.9,85,,percent of total billed charges,,,,,,,,,4693.92,88,,percent of total billed charges,,,,,,,,,4075.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1333.5,22,,percent of total billed charges,,,4853.94,91,,percent of total billed charges,,,5067.3,95,,percent of total billed charges,,,4427.22,83,,percent of total billed charges,,,4427.22,83,,percent of total billed charges,,,,,,,,,,,,,,,4427.22,83,,percent of total billed charges,,,5067.3,95,,percent of total billed charges,,,4800.6,90,,percent of total billed charges,,,4800.6,90,,percent of total billed charges,,,4373.88,82,,percent of total billed charges,,,4800.6,90,,percent of total billed charges,,,4533.9,85,,percent of total billed charges,,1333.5,5067.3,
INTERCOSTAL NERVE BLOCK,33764421,CDM,64421,CPT,360,RC,outpatient,,2924,2924,,2482.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731,22,,percent of total billed charges,,,,,,,,,2631.6,90,,percent of total billed charges,,,2421.07,82.8,,percent of total billed charges,,,2485.4,85,,percent of total billed charges,,,,,,,,,2573.12,88,,percent of total billed charges,,,,,,,,,2233.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731,22,,percent of total billed charges,,,2660.84,91,,percent of total billed charges,,,2777.8,95,,percent of total billed charges,,,2426.92,83,,percent of total billed charges,,,2426.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2426.92,83,,percent of total billed charges,,,2777.8,95,,percent of total billed charges,,,2631.6,90,,percent of total billed charges,,,2631.6,90,,percent of total billed charges,,,2397.68,82,,percent of total billed charges,,,2631.6,90,,percent of total billed charges,,,2485.4,85,,percent of total billed charges,,731,2777.8,
ANESTHESIA PREP SET UP,33771234,CDM,,,370,RC,outpatient,,523,523,,444.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.75,22,,percent of total billed charges,,,,,,,,,470.7,90,,percent of total billed charges,,,433.04,82.8,,percent of total billed charges,,,444.55,85,,percent of total billed charges,,,,,,,,,460.24,88,,percent of total billed charges,,,,,,,,,399.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.75,22,,percent of total billed charges,,,475.93,91,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,,,,,,,,,,,,,434.09,83,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,428.86,82,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,444.55,85,,percent of total billed charges,,130.75,496.85,
ANESTHESIA CHG UNIT CPT 93312,33793312,CDM,1922,CPT,964,RC,outpatient,QZ,466,466,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00103,33800103,CDM,103,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00126,33800126,CDM,126,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00142,33800142,CDM,142,CPT,963,RC,outpatient,AA,384,384,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00160,33800160,CDM,160,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00170,33800170,CDM,170,CPT,964,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00300,33800300,CDM,300,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00322,33800322,CDM,322,CPT,964,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00400,33800400,CDM,400,CPT,963,RC,outpatient,AA,431,431,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00402,33800402,CDM,402,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00404,33800404,CDM,404,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00410,33800410,CDM,410,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00450,33800450,CDM,450,CPT,964,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00520,33800520,CDM,520,CPT,964,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00524,33800524,CDM,524,CPT,964,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00530,33800530,CDM,530,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00532,33800532,CDM,532,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00600,33800600,CDM,600,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00620,33800620,CDM,620,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00630,33800630,CDM,630,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00670,33800670,CDM,670,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00702,33800702,CDM,702,CPT,964,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00740,33800740,CDM,731,CPT,963,RC,outpatient,AA,466,466,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00752,33800752,CDM,752,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00790,33800790,CDM,790,CPT,963,RC,outpatient,AA,416,416,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00800,33800800,CDM,800,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00810,33800810,CDM,811,CPT,963,RC,outpatient,AA,498,498,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00830,33800830,CDM,830,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00832,33800832,CDM,832,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00840,33800840,CDM,840,CPT,963,RC,outpatient,AA,459,459,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00851,33800851,CDM,851,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00860,33800860,CDM,860,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00873,33800873,CDM,873,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00902,33800902,CDM,902,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00910,33800910,CDM,910,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00912,33800912,CDM,912,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00914,33800914,CDM,914,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00918,33800918,CDM,918,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00920,33800920,CDM,920,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00942,33800942,CDM,942,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00944,33800944,CDM,944,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 00952,33800952,CDM,952,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01112,33801110,CDM,1112,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01200,33801200,CDM,1200,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01210,33801210,CDM,1210,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01214,33801214,CDM,1214,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01215,33801215,CDM,1215,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01232,33801232,CDM,1232,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01320,33801320,CDM,1320,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01360,33801360,CDM,1360,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01380,33801380,CDM,1380,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01382,33801382,CDM,1382,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01390,33801390,CDM,1390,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01392,33801392,CDM,1392,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01400,33801400,CDM,1400,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01402,33801402,CDM,1402,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01462,33801462,CDM,1462,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01470,33801470,CDM,1470,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01472,33801472,CDM,1472,CPT,964,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01480,33801480,CDM,1480,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01610,33801610,CDM,1610,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01620,33801620,CDM,1620,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01630,33801630,CDM,1630,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01638,33801638,CDM,1638,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01710,33801710,CDM,1710,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01730,33801730,CDM,1730,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01740,33801740,CDM,1740,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01770,33801770,CDM,1770,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01810,33801810,CDM,1810,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01820,33801820,CDM,1820,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01830,33801830,CDM,1830,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01916,33801916,CDM,1916,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01922,33801922,CDM,1922,CPT,964,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01924,33801924,CDM,1924,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01930,33801930,CDM,1930,CPT,964,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01935 DIAGNOSTIC,33801935,CDM,1937,CPT,964,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01936 THERAPUTIC,33801936,CDM,1938,CPT,964,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 01961,33801961,CDM,1961,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA MISSED OR INCOMPLETE AB,33801965,CDM,1965,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA LABOR EPIDURAL UNIT 01967,33801967,CDM,1967,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHARGE UNIT 01968,33801968,CDM,1968,CPT,963,RC,outpatient,AA,345,345,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA NERVE BLK OTHER THAN PRONE,33801991,CDM,1991,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA NERVE BLOCK PRONE,33801992,CDM,1992,CPT,963,RC,outpatient,AA,414,414,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
ANESTHESIA CHG UNIT CPT 93312,33893312,CDM,1922,CPT,963,RC,outpatient,AA,466,466,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.19,22,,percent of total billed charges,,,,,,,,,,,,,,,58,82.8,,percent of total billed charges,,,45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.19,58,
BB AUTOLOGOUS UNIT PROCESSING ONLY,25201822,CDM,86890,CPT,300,RC,outpatient,,569,569,,483.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,142.25,22,,percent of total billed charges,,,,,,,,,512.1,90,,percent of total billed charges,,,471.13,82.8,,percent of total billed charges,,,483.65,85,,percent of total billed charges,,,,,,,,,500.72,88,,percent of total billed charges,,,,,,,,,434.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,142.25,22,,percent of total billed charges,,,517.79,91,,percent of total billed charges,,,540.55,95,,percent of total billed charges,,,472.27,83,,percent of total billed charges,,,472.27,83,,percent of total billed charges,,,,,,,,,,,,,,,472.27,83,,percent of total billed charges,,,540.55,95,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,466.58,82,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,483.65,85,,percent of total billed charges,,142.25,540.55,
BB AUTOLOGOUS UNIT TRANSFUSED,25201823,CDM,P9016,HCPCS,300,RC,outpatient,,2098,2098,,1781.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,524.5,22,,percent of total billed charges,,,,,,,,,1888.2,90,,percent of total billed charges,,,1737.14,82.8,,percent of total billed charges,,,1783.3,85,,percent of total billed charges,,,,,,,,,1846.24,88,,percent of total billed charges,,,,,,,,,1602.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,524.5,22,,percent of total billed charges,,,1909.18,91,,percent of total billed charges,,,1993.1,95,,percent of total billed charges,,,1741.34,83,,percent of total billed charges,,,1741.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1741.34,83,,percent of total billed charges,,,1993.1,95,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1720.36,82,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1783.3,85,,percent of total billed charges,,524.5,1993.1,
BB FRESH FROZEN PLASMA,25202374,CDM,P9017,HCPCS,390,RC,outpatient,,393,393,,333.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.25,22,,percent of total billed charges,,,,,,,,,353.7,90,,percent of total billed charges,,,325.4,82.8,,percent of total billed charges,,,334.05,85,,percent of total billed charges,,,,,,,,,345.84,88,,percent of total billed charges,,,,,,,,,300.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.25,22,,percent of total billed charges,,,357.63,91,,percent of total billed charges,,,373.35,95,,percent of total billed charges,,,326.19,83,,percent of total billed charges,,,326.19,83,,percent of total billed charges,,,,,,,,,,,,,,,326.19,83,,percent of total billed charges,,,373.35,95,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,322.26,82,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,334.05,85,,percent of total billed charges,,98.25,373.35,
BB RED BLOOD CELLS EACH UNIT,25203018,CDM,P9016,HCPCS,390,RC,outpatient,,2098,2098,,1781.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,524.5,22,,percent of total billed charges,,,,,,,,,1888.2,90,,percent of total billed charges,,,1737.14,82.8,,percent of total billed charges,,,1783.3,85,,percent of total billed charges,,,,,,,,,1846.24,88,,percent of total billed charges,,,,,,,,,1602.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,524.5,22,,percent of total billed charges,,,1909.18,91,,percent of total billed charges,,,1993.1,95,,percent of total billed charges,,,1741.34,83,,percent of total billed charges,,,1741.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1741.34,83,,percent of total billed charges,,,1993.1,95,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1720.36,82,,percent of total billed charges,,,1888.2,90,,percent of total billed charges,,,1783.3,85,,percent of total billed charges,,524.5,1993.1,
BB CRYOPRECIPITATE,25203019,CDM,P9012,HCPCS,390,RC,outpatient,,148,148,,125.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37,22,,percent of total billed charges,,,,,,,,,133.2,90,,percent of total billed charges,,,122.54,82.8,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,,,,,,,,130.24,88,,percent of total billed charges,,,,,,,,,113.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37,22,,percent of total billed charges,,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,,,,,,,,,,,,,122.84,83,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,121.36,82,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,37,140.6,
"CARDIAC REHAB, PHASE II",15802090,CDM,93798,CPT,943,RC,outpatient,,596,596,,506,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149,22,,percent of total billed charges,,,,,,,,,536.4,90,,percent of total billed charges,,,493.49,82.8,,percent of total billed charges,,,506.6,85,,percent of total billed charges,,,,,,,,,524.48,88,,percent of total billed charges,,,,,,,,,455.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149,22,,percent of total billed charges,,,542.36,91,,percent of total billed charges,,,566.2,95,,percent of total billed charges,,,494.68,83,,percent of total billed charges,,,494.68,83,,percent of total billed charges,,,,,,,,,,,,,,,494.68,83,,percent of total billed charges,,,566.2,95,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,488.72,82,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,506.6,85,,percent of total billed charges,,149,566.2,
"CARDIAC REHAB, PHASE I(V-5-17)",15802091,CDM,93798,CPT,943,RC,outpatient,,264,264,,224.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66,22,,percent of total billed charges,,,,,,,,,237.6,90,,percent of total billed charges,,,218.59,82.8,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,,,,,,,,232.32,88,,percent of total billed charges,,,,,,,,,201.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66,22,,percent of total billed charges,,,240.24,91,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,,,,,,,,,,,,,219.12,83,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,216.48,82,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,66,250.8,
CARDIAC REHAB NON ECG MONITOR,15802092,CDM,93797,CPT,943,RC,outpatient,,596,596,,506,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149,22,,percent of total billed charges,,,,,,,,,536.4,90,,percent of total billed charges,,,493.49,82.8,,percent of total billed charges,,,506.6,85,,percent of total billed charges,,,,,,,,,524.48,88,,percent of total billed charges,,,,,,,,,455.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149,22,,percent of total billed charges,,,542.36,91,,percent of total billed charges,,,566.2,95,,percent of total billed charges,,,494.68,83,,percent of total billed charges,,,494.68,83,,percent of total billed charges,,,,,,,,,,,,,,,494.68,83,,percent of total billed charges,,,566.2,95,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,488.72,82,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,506.6,85,,percent of total billed charges,,149,566.2,
"CARDIAC REHAB, PHASE III",15802093,CDM,93798,CPT,943,RC,outpatient,,5,5,,4.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.25,22,,percent of total billed charges,,,,,,,,,4.5,90,,percent of total billed charges,,,4.14,82.8,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,,,,,,,,4.4,88,,percent of total billed charges,,,,,,,,,3.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.25,22,,percent of total billed charges,,,4.55,91,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4.15,83,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.1,82,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,1.25,4.75,
"CARDIAC REHAB, PHASE II WITH MODIFIER",15802094,CDM,93798,CPT,943,RC,outpatient,KX,596,596,,506,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149,22,,percent of total billed charges,,,,,,,,,536.4,90,,percent of total billed charges,,,493.49,82.8,,percent of total billed charges,,,506.6,85,,percent of total billed charges,,,,,,,,,524.48,88,,percent of total billed charges,,,,,,,,,455.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149,22,,percent of total billed charges,,,542.36,91,,percent of total billed charges,,,566.2,95,,percent of total billed charges,,,494.68,83,,percent of total billed charges,,,494.68,83,,percent of total billed charges,,,,,,,,,,,,,,,494.68,83,,percent of total billed charges,,,566.2,95,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,488.72,82,,percent of total billed charges,,,536.4,90,,percent of total billed charges,,,506.6,85,,percent of total billed charges,,149,566.2,
EDUCATION TRAINING PATIENT SELF MGT,15802095,CDM,98960,CPT,942,RC,outpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.5,22,,percent of total billed charges,,,,,,,,,45,90,,percent of total billed charges,,,41.4,82.8,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.5,22,,percent of total billed charges,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,12.5,47.5,
PULMONARY EXERCISE SESSION GROUP(V-5-17),16000065,CDM,G0239,HCPCS,410,RC,outpatient,,310,310,,263.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.5,22,,percent of total billed charges,,,,,,,,,279,90,,percent of total billed charges,,,256.68,82.8,,percent of total billed charges,,,263.5,85,,percent of total billed charges,,,,,,,,,272.8,88,,percent of total billed charges,,,,,,,,,236.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.5,22,,percent of total billed charges,,,282.1,91,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,,,,,,,,,,,,,257.3,83,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,279,90,,percent of total billed charges,,,279,90,,percent of total billed charges,,,254.2,82,,percent of total billed charges,,,279,90,,percent of total billed charges,,,263.5,85,,percent of total billed charges,,77.5,294.5,
PULMONARY REHAB PER HOUR PER SESSION,16000067,CDM,94625,CPT,948,RC,outpatient,,349,349,,296.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.25,22,,percent of total billed charges,,,,,,,,,314.1,90,,percent of total billed charges,,,288.97,82.8,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,,,,,,,,307.12,88,,percent of total billed charges,,,,,,,,,266.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.25,22,,percent of total billed charges,,,317.59,91,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,,,,,,,,,,,,,289.67,83,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,286.18,82,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,87.25,331.55,
PULMONARY REHAB PHASE III,16000068,CDM,94625,CPT,948,RC,outpatient,,5,5,,4.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.25,22,,percent of total billed charges,,,,,,,,,4.5,90,,percent of total billed charges,,,4.14,82.8,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,,,,,,,,4.4,88,,percent of total billed charges,,,,,,,,,3.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.25,22,,percent of total billed charges,,,4.55,91,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4.15,83,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.1,82,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,1.25,4.75,
*DO NOT USE PULM REHAB MULTIPLE PULSE OX,16000070,CDM,94761,CPT,410,RC,outpatient,,143,143,,121.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.75,22,,percent of total billed charges,,,,,,,,,128.7,90,,percent of total billed charges,,,118.4,82.8,,percent of total billed charges,,,121.55,85,,percent of total billed charges,,,,,,,,,125.84,88,,percent of total billed charges,,,,,,,,,109.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.75,22,,percent of total billed charges,,,130.13,91,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,,,,,,,,,,,,,118.69,83,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,117.26,82,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,121.55,85,,percent of total billed charges,,35.75,135.85,
PULMONARY REHAB PER HOUR PER SESSION MOD,16000071,CDM,94625,CPT,948,RC,outpatient,KX,349,349,,296.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.25,22,,percent of total billed charges,,,,,,,,,314.1,90,,percent of total billed charges,,,288.97,82.8,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,,,,,,,,307.12,88,,percent of total billed charges,,,,,,,,,266.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.25,22,,percent of total billed charges,,,317.59,91,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,,,,,,,,,,,,,289.67,83,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,286.18,82,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,87.25,331.55,
MINI HEART NEB FIRST HOUR,12800003,CDM,94644,CPT,410,RC,outpatient,,489,489,,415.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.25,22,,percent of total billed charges,,,,,,,,,440.1,90,,percent of total billed charges,,,404.89,82.8,,percent of total billed charges,,,415.65,85,,percent of total billed charges,,,,,,,,,430.32,88,,percent of total billed charges,,,,,,,,,373.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.25,22,,percent of total billed charges,,,444.99,91,,percent of total billed charges,,,464.55,95,,percent of total billed charges,,,405.87,83,,percent of total billed charges,,,405.87,83,,percent of total billed charges,,,,,,,,,,,,,,,405.87,83,,percent of total billed charges,,,464.55,95,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,400.98,82,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,415.65,85,,percent of total billed charges,,122.25,464.55,
HEART NEB 2 24 HOUR,12800005,CDM,94645,CPT,410,RC,outpatient,,689,689,,584.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,172.25,22,,percent of total billed charges,,,,,,,,,620.1,90,,percent of total billed charges,,,570.49,82.8,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,,,,,,,,606.32,88,,percent of total billed charges,,,,,,,,,526.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,172.25,22,,percent of total billed charges,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,,,,,,,,,,,,,571.87,83,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,564.98,82,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,172.25,654.55,
PULSE OXIMETRY CONTINUOUS,12800010,CDM,94762,CPT,410,RC,outpatient,,654,654,,555.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,163.5,22,,percent of total billed charges,,,,,,,,,588.6,90,,percent of total billed charges,,,541.51,82.8,,percent of total billed charges,,,555.9,85,,percent of total billed charges,,,,,,,,,575.52,88,,percent of total billed charges,,,,,,,,,499.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,163.5,22,,percent of total billed charges,,,595.14,91,,percent of total billed charges,,,621.3,95,,percent of total billed charges,,,542.82,83,,percent of total billed charges,,,542.82,83,,percent of total billed charges,,,,,,,,,,,,,,,542.82,83,,percent of total billed charges,,,621.3,95,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,536.28,82,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,555.9,85,,percent of total billed charges,,163.5,621.3,
VENT VISION INITIAL,12800014,CDM,94002,CPT,410,RC,outpatient,,2840,2840,,2411.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,710,22,,percent of total billed charges,,,,,,,,,2556,90,,percent of total billed charges,,,2351.52,82.8,,percent of total billed charges,,,2414,85,,percent of total billed charges,,,,,,,,,2499.2,88,,percent of total billed charges,,,,,,,,,2169.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,710,22,,percent of total billed charges,,,2584.4,91,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2357.2,83,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2328.8,82,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2414,85,,percent of total billed charges,,710,2698,
VENT VISION SUBSEQUENT,12800015,CDM,94003,CPT,410,RC,outpatient,,2499,2499,,2121.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,624.75,22,,percent of total billed charges,,,,,,,,,2249.1,90,,percent of total billed charges,,,2069.17,82.8,,percent of total billed charges,,,2124.15,85,,percent of total billed charges,,,,,,,,,2199.12,88,,percent of total billed charges,,,,,,,,,1909.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,624.75,22,,percent of total billed charges,,,2274.09,91,,percent of total billed charges,,,2374.05,95,,percent of total billed charges,,,2074.17,83,,percent of total billed charges,,,2074.17,83,,percent of total billed charges,,,,,,,,,,,,,,,2074.17,83,,percent of total billed charges,,,2374.05,95,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2049.18,82,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2124.15,85,,percent of total billed charges,,624.75,2374.05,
VPAP INITIAL,12800020,CDM,94002,CPT,410,RC,outpatient,,2840,2840,,2411.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,710,22,,percent of total billed charges,,,,,,,,,2556,90,,percent of total billed charges,,,2351.52,82.8,,percent of total billed charges,,,2414,85,,percent of total billed charges,,,,,,,,,2499.2,88,,percent of total billed charges,,,,,,,,,2169.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,710,22,,percent of total billed charges,,,2584.4,91,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2357.2,83,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2328.8,82,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2414,85,,percent of total billed charges,,710,2698,
VPAP SUBSEQUENT,12800021,CDM,94003,CPT,410,RC,outpatient,,2499,2499,,2121.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,624.75,22,,percent of total billed charges,,,,,,,,,2249.1,90,,percent of total billed charges,,,2069.17,82.8,,percent of total billed charges,,,2124.15,85,,percent of total billed charges,,,,,,,,,2199.12,88,,percent of total billed charges,,,,,,,,,1909.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,624.75,22,,percent of total billed charges,,,2274.09,91,,percent of total billed charges,,,2374.05,95,,percent of total billed charges,,,2074.17,83,,percent of total billed charges,,,2074.17,83,,percent of total billed charges,,,,,,,,,,,,,,,2074.17,83,,percent of total billed charges,,,2374.05,95,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2049.18,82,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2124.15,85,,percent of total billed charges,,624.75,2374.05,
CPT SUBSEQUENT,12800037,CDM,94668,CPT,410,RC,outpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.75,22,,percent of total billed charges,,,,,,,,,312.3,90,,percent of total billed charges,,,287.32,82.8,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.75,22,,percent of total billed charges,,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,86.75,329.65,
VENT ASTRAL INITIAL,12800046,CDM,94002,CPT,410,RC,outpatient,,2840,2840,,2411.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,710,22,,percent of total billed charges,,,,,,,,,2556,90,,percent of total billed charges,,,2351.52,82.8,,percent of total billed charges,,,2414,85,,percent of total billed charges,,,,,,,,,2499.2,88,,percent of total billed charges,,,,,,,,,2169.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,710,22,,percent of total billed charges,,,2584.4,91,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2357.2,83,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2328.8,82,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2414,85,,percent of total billed charges,,710,2698,
VPAP VENTILATOR SUBSEQUENT,12800050,CDM,94002,CPT,410,RC,outpatient,,2840,2840,,2411.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,710,22,,percent of total billed charges,,,,,,,,,2556,90,,percent of total billed charges,,,2351.52,82.8,,percent of total billed charges,,,2414,85,,percent of total billed charges,,,,,,,,,2499.2,88,,percent of total billed charges,,,,,,,,,2169.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,710,22,,percent of total billed charges,,,2584.4,91,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2357.2,83,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2328.8,82,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2414,85,,percent of total billed charges,,710,2698,
VENT CROSSVENT INITIAL,12800051,CDM,94002,CPT,410,RC,outpatient,,2679,2679,,2274.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,669.75,22,,percent of total billed charges,,,,,,,,,2411.1,90,,percent of total billed charges,,,2218.21,82.8,,percent of total billed charges,,,2277.15,85,,percent of total billed charges,,,,,,,,,2357.52,88,,percent of total billed charges,,,,,,,,,2046.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,669.75,22,,percent of total billed charges,,,2437.89,91,,percent of total billed charges,,,2545.05,95,,percent of total billed charges,,,2223.57,83,,percent of total billed charges,,,2223.57,83,,percent of total billed charges,,,,,,,,,,,,,,,2223.57,83,,percent of total billed charges,,,2545.05,95,,percent of total billed charges,,,2411.1,90,,percent of total billed charges,,,2411.1,90,,percent of total billed charges,,,2196.78,82,,percent of total billed charges,,,2411.1,90,,percent of total billed charges,,,2277.15,85,,percent of total billed charges,,669.75,2545.05,
VENT ASTRAL SUBSEQUENT,12800053,CDM,94003,CPT,410,RC,outpatient,,2499,2499,,2121.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,624.75,22,,percent of total billed charges,,,,,,,,,2249.1,90,,percent of total billed charges,,,2069.17,82.8,,percent of total billed charges,,,2124.15,85,,percent of total billed charges,,,,,,,,,2199.12,88,,percent of total billed charges,,,,,,,,,1909.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,624.75,22,,percent of total billed charges,,,2274.09,91,,percent of total billed charges,,,2374.05,95,,percent of total billed charges,,,2074.17,83,,percent of total billed charges,,,2074.17,83,,percent of total billed charges,,,,,,,,,,,,,,,2074.17,83,,percent of total billed charges,,,2374.05,95,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2049.18,82,,percent of total billed charges,,,2249.1,90,,percent of total billed charges,,,2124.15,85,,percent of total billed charges,,624.75,2374.05,
VENT CROSSVENT SUBSEQUENT,12800055,CDM,94003,CPT,410,RC,outpatient,,2840,2840,,2411.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,710,22,,percent of total billed charges,,,,,,,,,2556,90,,percent of total billed charges,,,2351.52,82.8,,percent of total billed charges,,,2414,85,,percent of total billed charges,,,,,,,,,2499.2,88,,percent of total billed charges,,,,,,,,,2169.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,710,22,,percent of total billed charges,,,2584.4,91,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,2357.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2357.2,83,,percent of total billed charges,,,2698,95,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2328.8,82,,percent of total billed charges,,,2556,90,,percent of total billed charges,,,2414,85,,percent of total billed charges,,710,2698,
CROUP TENT DAILY CHARGE,12800078,CDM,,,270,RC,outpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.75,22,,percent of total billed charges,,,,,,,,,2.7,90,,percent of total billed charges,,,2.48,82.8,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.75,22,,percent of total billed charges,,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,0.75,2.85,
CPAP PER 16 HOURS,12800095,CDM,94660,CPT,410,RC,outpatient,,544,544,,461.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,136,22,,percent of total billed charges,,,,,,,,,489.6,90,,percent of total billed charges,,,450.43,82.8,,percent of total billed charges,,,462.4,85,,percent of total billed charges,,,,,,,,,478.72,88,,percent of total billed charges,,,,,,,,,415.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,136,22,,percent of total billed charges,,,495.04,91,,percent of total billed charges,,,516.8,95,,percent of total billed charges,,,451.52,83,,percent of total billed charges,,,451.52,83,,percent of total billed charges,,,,,,,,,,,,,,,451.52,83,,percent of total billed charges,,,516.8,95,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,446.08,82,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,462.4,85,,percent of total billed charges,,136,516.8,
CPAP PER 24 HOURS,12800096,CDM,94660,CPT,410,RC,outpatient,,680,680,,577.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,170,22,,percent of total billed charges,,,,,,,,,612,90,,percent of total billed charges,,,563.04,82.8,,percent of total billed charges,,,578,85,,percent of total billed charges,,,,,,,,,598.4,88,,percent of total billed charges,,,,,,,,,519.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,170,22,,percent of total billed charges,,,618.8,91,,percent of total billed charges,,,646,95,,percent of total billed charges,,,564.4,83,,percent of total billed charges,,,564.4,83,,percent of total billed charges,,,,,,,,,,,,,,,564.4,83,,percent of total billed charges,,,646,95,,percent of total billed charges,,,612,90,,percent of total billed charges,,,612,90,,percent of total billed charges,,,557.6,82,,percent of total billed charges,,,612,90,,percent of total billed charges,,,578,85,,percent of total billed charges,,170,646,
CPAP PER 8 HOURS,12800102,CDM,94660,CPT,410,RC,outpatient,,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.5,22,,percent of total billed charges,,,,,,,,,394.2,90,,percent of total billed charges,,,362.66,82.8,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.5,22,,percent of total billed charges,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,109.5,416.1,
ACAPELLA SUBSEQUENT,12800105,CDM,94668,CPT,410,RC,outpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.75,22,,percent of total billed charges,,,,,,,,,312.3,90,,percent of total billed charges,,,287.32,82.8,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.75,22,,percent of total billed charges,,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,86.75,329.65,
IS SUBSEQUENT,12800115,CDM,,,410,RC,outpatient,,113,113,,95.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.25,22,,percent of total billed charges,,,,,,,,,101.7,90,,percent of total billed charges,,,93.56,82.8,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,,,,,,,,99.44,88,,percent of total billed charges,,,,,,,,,86.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.25,22,,percent of total billed charges,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,92.66,82,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,28.25,107.35,
EZ PAP TREATMENT,12800200,CDM,94640,CPT,410,RC,outpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,44,167.2,
NEBULIZER SUBSEQUENT,12800219,CDM,94640,CPT,410,RC,outpatient,76,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
NEBULIZER PRN,12800220,CDM,94640,CPT,410,RC,outpatient,,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
CPR UP TO 1 HOUR,12801001,CDM,92950,CPT,480,RC,outpatient,,1580,1580,,1341.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,395,22,,percent of total billed charges,,,,,,,,,1422,90,,percent of total billed charges,,,1308.24,82.8,,percent of total billed charges,,,1343,85,,percent of total billed charges,,,,,,,,,1390.4,88,,percent of total billed charges,,,,,,,,,1207.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,395,22,,percent of total billed charges,,,1437.8,91,,percent of total billed charges,,,1501,95,,percent of total billed charges,,,1311.4,83,,percent of total billed charges,,,1311.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1311.4,83,,percent of total billed charges,,,1501,95,,percent of total billed charges,,,1422,90,,percent of total billed charges,,,1422,90,,percent of total billed charges,,,1295.6,82,,percent of total billed charges,,,1422,90,,percent of total billed charges,,,1343,85,,percent of total billed charges,,395,1501,
CPR UP TO 2 HOURS,12801010,CDM,92950,CPT,480,RC,outpatient,,775,775,,657.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,193.75,22,,percent of total billed charges,,,,,,,,,697.5,90,,percent of total billed charges,,,641.7,82.8,,percent of total billed charges,,,658.75,85,,percent of total billed charges,,,,,,,,,682,88,,percent of total billed charges,,,,,,,,,592.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,193.75,22,,percent of total billed charges,,,705.25,91,,percent of total billed charges,,,736.25,95,,percent of total billed charges,,,643.25,83,,percent of total billed charges,,,643.25,83,,percent of total billed charges,,,,,,,,,,,,,,,643.25,83,,percent of total billed charges,,,736.25,95,,percent of total billed charges,,,697.5,90,,percent of total billed charges,,,697.5,90,,percent of total billed charges,,,635.5,82,,percent of total billed charges,,,697.5,90,,percent of total billed charges,,,658.75,85,,percent of total billed charges,,193.75,736.25,
CPR UP TO 3 HOURS,12801011,CDM,92950,CPT,480,RC,outpatient,,967,967,,820.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,241.75,22,,percent of total billed charges,,,,,,,,,870.3,90,,percent of total billed charges,,,800.68,82.8,,percent of total billed charges,,,821.95,85,,percent of total billed charges,,,,,,,,,850.96,88,,percent of total billed charges,,,,,,,,,738.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,241.75,22,,percent of total billed charges,,,879.97,91,,percent of total billed charges,,,918.65,95,,percent of total billed charges,,,802.61,83,,percent of total billed charges,,,802.61,83,,percent of total billed charges,,,,,,,,,,,,,,,802.61,83,,percent of total billed charges,,,918.65,95,,percent of total billed charges,,,870.3,90,,percent of total billed charges,,,870.3,90,,percent of total billed charges,,,792.94,82,,percent of total billed charges,,,870.3,90,,percent of total billed charges,,,821.95,85,,percent of total billed charges,,241.75,918.65,
SUCTIONING,12801019,CDM,31720,CPT,410,RC,outpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.75,22,,percent of total billed charges,,,,,,,,,236.7,90,,percent of total billed charges,,,217.76,82.8,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.75,22,,percent of total billed charges,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,65.75,249.85,
CROUP TENT SET UP,12801068,CDM,,,270,RC,outpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.75,22,,percent of total billed charges,,,,,,,,,2.7,90,,percent of total billed charges,,,2.48,82.8,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.75,22,,percent of total billed charges,,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,0.75,2.85,
INITIAL PERCUSSIVE NEBULIZER,12801070,CDM,94664,CPT,410,RC,outpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.75,22,,percent of total billed charges,,,,,,,,,312.3,90,,percent of total billed charges,,,287.32,82.8,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.75,22,,percent of total billed charges,,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,86.75,329.65,
SUBSEQUENT PERCUSSIVE NEBULIZER,12801071,CDM,94640,CPT,410,RC,outpatient,76,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
NEBULIZER INITIAL,12801092,CDM,94664,CPT,410,RC,outpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.75,22,,percent of total billed charges,,,,,,,,,312.3,90,,percent of total billed charges,,,287.32,82.8,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.75,22,,percent of total billed charges,,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,86.75,329.65,
EZ PAP INITIAL,12801093,CDM,94640,CPT,410,RC,outpatient,,295,295,,250.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.75,22,,percent of total billed charges,,,,,,,,,265.5,90,,percent of total billed charges,,,244.26,82.8,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,,,,,,,,259.6,88,,percent of total billed charges,,,,,,,,,225.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.75,22,,percent of total billed charges,,,268.45,91,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,,,,,,,,,,,,,244.85,83,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,241.9,82,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,73.75,280.25,
CPT INITIAL,12801126,CDM,94667,CPT,410,RC,outpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.75,22,,percent of total billed charges,,,,,,,,,312.3,90,,percent of total billed charges,,,287.32,82.8,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.75,22,,percent of total billed charges,,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,86.75,329.65,
TREATMENT ROOM,12801500,CDM,G0463,HCPCS,510,RC,outpatient,,155,155,,131.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.75,22,,percent of total billed charges,,,,,,,,,139.5,90,,percent of total billed charges,,,128.34,82.8,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,,,,,,,,136.4,88,,percent of total billed charges,,,,,,,,,118.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.75,22,,percent of total billed charges,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,127.1,82,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,38.75,147.25,
PULSE OX CHECK,12801506,CDM,94760,CPT,460,RC,outpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45,22,,percent of total billed charges,,,,,,,,,162,90,,percent of total billed charges,,,149.04,82.8,,percent of total billed charges,,,153,85,,percent of total billed charges,,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45,22,,percent of total billed charges,,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,45,171,
PULSE OX MULTIPLE FOR HOME O2 QUALIFY,12801507,CDM,94761,CPT,460,RC,outpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.75,22,,percent of total billed charges,,,,,,,,,189.9,90,,percent of total billed charges,,,174.71,82.8,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.75,22,,percent of total billed charges,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,52.75,200.45,
PFT-SCREENING,12801522,CDM,94010,CPT,460,RC,outpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.25,22,,percent of total billed charges,,,,,,,,,414.9,90,,percent of total billed charges,,,381.71,82.8,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.25,22,,percent of total billed charges,,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,115.25,437.95,
PFT-COMPLETE,12801530,CDM,94060,CPT,460,RC,outpatient,,992,992,,842.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,248,22,,percent of total billed charges,,,,,,,,,892.8,90,,percent of total billed charges,,,821.38,82.8,,percent of total billed charges,,,843.2,85,,percent of total billed charges,,,,,,,,,872.96,88,,percent of total billed charges,,,,,,,,,757.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,248,22,,percent of total billed charges,,,902.72,91,,percent of total billed charges,,,942.4,95,,percent of total billed charges,,,823.36,83,,percent of total billed charges,,,823.36,83,,percent of total billed charges,,,,,,,,,,,,,,,823.36,83,,percent of total billed charges,,,942.4,95,,percent of total billed charges,,,892.8,90,,percent of total billed charges,,,892.8,90,,percent of total billed charges,,,813.44,82,,percent of total billed charges,,,892.8,90,,percent of total billed charges,,,843.2,85,,percent of total billed charges,,248,942.4,
ABG(V-4-19),12801563,CDM,82803,CPT,300,RC,outpatient,,722,722,,612.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.5,22,,percent of total billed charges,,,,,,,,,649.8,90,,percent of total billed charges,,,597.82,82.8,,percent of total billed charges,,,613.7,85,,percent of total billed charges,,,,,,,,,635.36,88,,percent of total billed charges,,,,,,,,,551.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.5,22,,percent of total billed charges,,,657.02,91,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,,,,,,,,,,,,,599.26,83,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,592.04,82,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,613.7,85,,percent of total billed charges,,180.5,685.9,
ARTERIAL PUNCTURE,12801564,CDM,36600,CPT,361,RC,outpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
CORD VEIN GAS(V-12-20),12801565,CDM,82803,CPT,300,RC,outpatient,,349,349,,296.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.25,22,,percent of total billed charges,,,,,,,,,314.1,90,,percent of total billed charges,,,288.97,82.8,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,,,,,,,,307.12,88,,percent of total billed charges,,,,,,,,,266.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.25,22,,percent of total billed charges,,,317.59,91,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,,,,,,,,,,,,,289.67,83,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,286.18,82,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,87.25,331.55,
CORD ARTERY GAS(V-12-20),12801566,CDM,82803,CPT,300,RC,outpatient,,349,349,,296.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.25,22,,percent of total billed charges,,,,,,,,,314.1,90,,percent of total billed charges,,,288.97,82.8,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,,,,,,,,307.12,88,,percent of total billed charges,,,,,,,,,266.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.25,22,,percent of total billed charges,,,317.59,91,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,,,,,,,,,,,,,289.67,83,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,286.18,82,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,87.25,331.55,
ABG WITH LACTIC,12801567,CDM,83605,CPT,300,RC,outpatient,TC,978,978,,830.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,244.5,22,,percent of total billed charges,,,,,,,,,880.2,90,,percent of total billed charges,,,809.78,82.8,,percent of total billed charges,,,831.3,85,,percent of total billed charges,,,,,,,,,860.64,88,,percent of total billed charges,,,,,,,,,747.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,244.5,22,,percent of total billed charges,,,889.98,91,,percent of total billed charges,,,929.1,95,,percent of total billed charges,,,811.74,83,,percent of total billed charges,,,811.74,83,,percent of total billed charges,,,,,,,,,,,,,,,811.74,83,,percent of total billed charges,,,929.1,95,,percent of total billed charges,,,880.2,90,,percent of total billed charges,,,880.2,90,,percent of total billed charges,,,801.96,82,,percent of total billed charges,,,880.2,90,,percent of total billed charges,,,831.3,85,,percent of total billed charges,,244.5,929.1,
CAPILLARY BLOOD GAS,12801568,CDM,82803,CPT,300,RC,outpatient,,463,463,,393.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.75,22,,percent of total billed charges,,,,,,,,,416.7,90,,percent of total billed charges,,,383.36,82.8,,percent of total billed charges,,,393.55,85,,percent of total billed charges,,,,,,,,,407.44,88,,percent of total billed charges,,,,,,,,,353.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.75,22,,percent of total billed charges,,,421.33,91,,percent of total billed charges,,,439.85,95,,percent of total billed charges,,,384.29,83,,percent of total billed charges,,,384.29,83,,percent of total billed charges,,,,,,,,,,,,,,,384.29,83,,percent of total billed charges,,,439.85,95,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,379.66,82,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,393.55,85,,percent of total billed charges,,115.75,439.85,
CARBON MONOXIDE,12801576,CDM,82375,CPT,300,RC,outpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
ABG-ISTAT(V-6-20),12801580,CDM,82803,CPT,300,RC,outpatient,TC,722,722,,612.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.5,22,,percent of total billed charges,,,,,,,,,649.8,90,,percent of total billed charges,,,597.82,82.8,,percent of total billed charges,,,613.7,85,,percent of total billed charges,,,,,,,,,635.36,88,,percent of total billed charges,,,,,,,,,551.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.5,22,,percent of total billed charges,,,657.02,91,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,,,,,,,,,,,,,599.26,83,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,592.04,82,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,613.7,85,,percent of total billed charges,,180.5,685.9,
CORD VEIN GAS-ISTAT,12801581,CDM,82803,CPT,300,RC,outpatient,TC,349,349,,296.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.25,22,,percent of total billed charges,,,,,,,,,314.1,90,,percent of total billed charges,,,288.97,82.8,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,,,,,,,,307.12,88,,percent of total billed charges,,,,,,,,,266.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.25,22,,percent of total billed charges,,,317.59,91,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,,,,,,,,,,,,,289.67,83,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,286.18,82,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,87.25,331.55,
CORD ARTERY GAS-ISTAT,12801582,CDM,82803,CPT,300,RC,outpatient,TC,349,349,,296.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.25,22,,percent of total billed charges,,,,,,,,,314.1,90,,percent of total billed charges,,,288.97,82.8,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,,,,,,,,307.12,88,,percent of total billed charges,,,,,,,,,266.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.25,22,,percent of total billed charges,,,317.59,91,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,,,,,,,,,,,,,289.67,83,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,286.18,82,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,87.25,331.55,
ABG WITH LACTIC-ISTAT,12801583,CDM,83605,CPT,300,RC,outpatient,TC,978,978,,830.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,244.5,22,,percent of total billed charges,,,,,,,,,880.2,90,,percent of total billed charges,,,809.78,82.8,,percent of total billed charges,,,831.3,85,,percent of total billed charges,,,,,,,,,860.64,88,,percent of total billed charges,,,,,,,,,747.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,244.5,22,,percent of total billed charges,,,889.98,91,,percent of total billed charges,,,929.1,95,,percent of total billed charges,,,811.74,83,,percent of total billed charges,,,811.74,83,,percent of total billed charges,,,,,,,,,,,,,,,811.74,83,,percent of total billed charges,,,929.1,95,,percent of total billed charges,,,880.2,90,,percent of total billed charges,,,880.2,90,,percent of total billed charges,,,801.96,82,,percent of total billed charges,,,880.2,90,,percent of total billed charges,,,831.3,85,,percent of total billed charges,,244.5,929.1,
ACAPELLA INITIAL,12801600,CDM,94667,CPT,410,RC,outpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.75,22,,percent of total billed charges,,,,,,,,,312.3,90,,percent of total billed charges,,,287.32,82.8,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.75,22,,percent of total billed charges,,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,86.75,329.65,
PEAK FLOW CHECK,12801605,CDM,94010,CPT,460,RC,outpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.25,22,,percent of total billed charges,,,,,,,,,414.9,90,,percent of total billed charges,,,381.71,82.8,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.25,22,,percent of total billed charges,,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,115.25,437.95,
* AEROSOL MASK (V1004),12802009,CDM,,,270,RC,outpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.5,22,,percent of total billed charges,,,,,,,,,45,90,,percent of total billed charges,,,41.4,82.8,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.5,22,,percent of total billed charges,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,12.5,47.5,
MDI SUBSEQUENT,12802223,CDM,94640,CPT,410,RC,outpatient,76,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
MDI INITIAL,12802224,CDM,94664,CPT,410,RC,outpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.75,22,,percent of total billed charges,,,,,,,,,312.3,90,,percent of total billed charges,,,287.32,82.8,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.75,22,,percent of total billed charges,,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,86.75,329.65,
PH GAS ONLY,12802400,CDM,82800,CPT,410,RC,outpatient,,163,163,,138.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.75,22,,percent of total billed charges,,,,,,,,,146.7,90,,percent of total billed charges,,,134.96,82.8,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,,,,,,,,143.44,88,,percent of total billed charges,,,,,,,,,124.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.75,22,,percent of total billed charges,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,,,,,,,,,,,,,135.29,83,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,133.66,82,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,40.75,154.85,
NITROGEN WASHOUT,12803000,CDM,94727,CPT,460,RC,outpatient,,575,575,,488.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,143.75,22,,percent of total billed charges,,,,,,,,,517.5,90,,percent of total billed charges,,,476.1,82.8,,percent of total billed charges,,,488.75,85,,percent of total billed charges,,,,,,,,,506,88,,percent of total billed charges,,,,,,,,,439.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,143.75,22,,percent of total billed charges,,,523.25,91,,percent of total billed charges,,,546.25,95,,percent of total billed charges,,,477.25,83,,percent of total billed charges,,,477.25,83,,percent of total billed charges,,,,,,,,,,,,,,,477.25,83,,percent of total billed charges,,,546.25,95,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,471.5,82,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,488.75,85,,percent of total billed charges,,143.75,546.25,
DLCO,12803001,CDM,94729,CPT,460,RC,outpatient,,589,589,,500.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,147.25,22,,percent of total billed charges,,,,,,,,,530.1,90,,percent of total billed charges,,,487.69,82.8,,percent of total billed charges,,,500.65,85,,percent of total billed charges,,,,,,,,,518.32,88,,percent of total billed charges,,,,,,,,,450,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,147.25,22,,percent of total billed charges,,,535.99,91,,percent of total billed charges,,,559.55,95,,percent of total billed charges,,,488.87,83,,percent of total billed charges,,,488.87,83,,percent of total billed charges,,,,,,,,,,,,,,,488.87,83,,percent of total billed charges,,,559.55,95,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,482.98,82,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,500.65,85,,percent of total billed charges,,147.25,559.55,
VITAL CAPACITY TEST,12803002,CDM,94150,CPT,460,RC,outpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.75,22,,percent of total billed charges,,,,,,,,,236.7,90,,percent of total billed charges,,,217.76,82.8,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.75,22,,percent of total billed charges,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,65.75,249.85,
PFT WITH BODY BOX,12803003,CDM,94726,CPT,460,RC,outpatient,,1498,1498,,1271.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,374.5,22,,percent of total billed charges,,,,,,,,,1348.2,90,,percent of total billed charges,,,1240.34,82.8,,percent of total billed charges,,,1273.3,85,,percent of total billed charges,,,,,,,,,1318.24,88,,percent of total billed charges,,,,,,,,,1144.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,374.5,22,,percent of total billed charges,,,1363.18,91,,percent of total billed charges,,,1423.1,95,,percent of total billed charges,,,1243.34,83,,percent of total billed charges,,,1243.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1243.34,83,,percent of total billed charges,,,1423.1,95,,percent of total billed charges,,,1348.2,90,,percent of total billed charges,,,1348.2,90,,percent of total billed charges,,,1228.36,82,,percent of total billed charges,,,1348.2,90,,percent of total billed charges,,,1273.3,85,,percent of total billed charges,,374.5,1423.1,
METHACHOLINE CHALLENGE,12803004,CDM,94070,CPT,460,RC,outpatient,,1454,1454,,1234.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,363.5,22,,percent of total billed charges,,,,,,,,,1308.6,90,,percent of total billed charges,,,1203.91,82.8,,percent of total billed charges,,,1235.9,85,,percent of total billed charges,,,,,,,,,1279.52,88,,percent of total billed charges,,,,,,,,,1110.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,363.5,22,,percent of total billed charges,,,1323.14,91,,percent of total billed charges,,,1381.3,95,,percent of total billed charges,,,1206.82,83,,percent of total billed charges,,,1206.82,83,,percent of total billed charges,,,,,,,,,,,,,,,1206.82,83,,percent of total billed charges,,,1381.3,95,,percent of total billed charges,,,1308.6,90,,percent of total billed charges,,,1308.6,90,,percent of total billed charges,,,1192.28,82,,percent of total billed charges,,,1308.6,90,,percent of total billed charges,,,1235.9,85,,percent of total billed charges,,363.5,1381.3,
NEBULIZER WITH PEAK FLOW,12803005,CDM,94640,CPT,410,RC,outpatient,,541,541,,459.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,135.25,22,,percent of total billed charges,,,,,,,,,486.9,90,,percent of total billed charges,,,447.95,82.8,,percent of total billed charges,,,459.85,85,,percent of total billed charges,,,,,,,,,476.08,88,,percent of total billed charges,,,,,,,,,413.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,135.25,22,,percent of total billed charges,,,492.31,91,,percent of total billed charges,,,513.95,95,,percent of total billed charges,,,449.03,83,,percent of total billed charges,,,449.03,83,,percent of total billed charges,,,,,,,,,,,,,,,449.03,83,,percent of total billed charges,,,513.95,95,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,443.62,82,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,459.85,85,,percent of total billed charges,,135.25,513.95,
CT BONE MARROW ASPIRATION,29100080,CDM,38220,CPT,352,RC,outpatient,TC,4766,4766,,4046.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1191.5,22,,percent of total billed charges,,,,,,,,,4289.4,90,,percent of total billed charges,,,3946.25,82.8,,percent of total billed charges,,,4051.1,85,,percent of total billed charges,,,,,,,,,4194.08,88,,percent of total billed charges,,,,,,,,,3641.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1191.5,22,,percent of total billed charges,,,4337.06,91,,percent of total billed charges,,,4527.7,95,,percent of total billed charges,,,3955.78,83,,percent of total billed charges,,,3955.78,83,,percent of total billed charges,,,,,,,,,,,,,,,3955.78,83,,percent of total billed charges,,,4527.7,95,,percent of total billed charges,,,4289.4,90,,percent of total billed charges,,,4289.4,90,,percent of total billed charges,,,3908.12,82,,percent of total billed charges,,,4289.4,90,,percent of total billed charges,,,4051.1,85,,percent of total billed charges,,1191.5,4527.7,
CT BONE MARROW BIOPSY,29100081,CDM,38221,CPT,352,RC,outpatient,TC,3852,3852,,3270.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,963,22,,percent of total billed charges,,,,,,,,,3466.8,90,,percent of total billed charges,,,3189.46,82.8,,percent of total billed charges,,,3274.2,85,,percent of total billed charges,,,,,,,,,3389.76,88,,percent of total billed charges,,,,,,,,,2942.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,963,22,,percent of total billed charges,,,3505.32,91,,percent of total billed charges,,,3659.4,95,,percent of total billed charges,,,3197.16,83,,percent of total billed charges,,,3197.16,83,,percent of total billed charges,,,,,,,,,,,,,,,3197.16,83,,percent of total billed charges,,,3659.4,95,,percent of total billed charges,,,3466.8,90,,percent of total billed charges,,,3466.8,90,,percent of total billed charges,,,3158.64,82,,percent of total billed charges,,,3466.8,90,,percent of total billed charges,,,3274.2,85,,percent of total billed charges,,963,3659.4,
CT BONE MARROW ASPIRATION/BIOPSY,29100082,CDM,38222,CPT,352,RC,outpatient,TC,4939,4939,,4193.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1234.75,22,,percent of total billed charges,,,,,,,,,4445.1,90,,percent of total billed charges,,,4089.49,82.8,,percent of total billed charges,,,4198.15,85,,percent of total billed charges,,,,,,,,,4346.32,88,,percent of total billed charges,,,,,,,,,3773.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1234.75,22,,percent of total billed charges,,,4494.49,91,,percent of total billed charges,,,4692.05,95,,percent of total billed charges,,,4099.37,83,,percent of total billed charges,,,4099.37,83,,percent of total billed charges,,,,,,,,,,,,,,,4099.37,83,,percent of total billed charges,,,4692.05,95,,percent of total billed charges,,,4445.1,90,,percent of total billed charges,,,4445.1,90,,percent of total billed charges,,,4049.98,82,,percent of total billed charges,,,4445.1,90,,percent of total billed charges,,,4198.15,85,,percent of total billed charges,,1234.75,4692.05,
CT BONE MINERL DENSITY STUDY 1/> SITS AX,29100090,CDM,77078,CPT,352,RC,outpatient,TC,950,950,,806.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,237.5,22,,percent of total billed charges,,,,,,,,,855,90,,percent of total billed charges,,,786.6,82.8,,percent of total billed charges,,,807.5,85,,percent of total billed charges,,,,,,,,,836,88,,percent of total billed charges,,,,,,,,,725.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,237.5,22,,percent of total billed charges,,,864.5,91,,percent of total billed charges,,,902.5,95,,percent of total billed charges,,,788.5,83,,percent of total billed charges,,,788.5,83,,percent of total billed charges,,,,,,,,,,,,,,,788.5,83,,percent of total billed charges,,,902.5,95,,percent of total billed charges,,,855,90,,percent of total billed charges,,,855,90,,percent of total billed charges,,,779,82,,percent of total billed charges,,,855,90,,percent of total billed charges,,,807.5,85,,percent of total billed charges,,237.5,902.5,
CT BONE (DEEP) BIOPSY TROCAR/NEEDLE,29100100,CDM,20225,CPT,352,RC,outpatient,TC,4424,4424,,3755.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1106,22,,percent of total billed charges,,,,,,,,,3981.6,90,,percent of total billed charges,,,3663.07,82.8,,percent of total billed charges,,,3760.4,85,,percent of total billed charges,,,,,,,,,3893.12,88,,percent of total billed charges,,,,,,,,,3379.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1106,22,,percent of total billed charges,,,4025.84,91,,percent of total billed charges,,,4202.8,95,,percent of total billed charges,,,3671.92,83,,percent of total billed charges,,,3671.92,83,,percent of total billed charges,,,,,,,,,,,,,,,3671.92,83,,percent of total billed charges,,,4202.8,95,,percent of total billed charges,,,3981.6,90,,percent of total billed charges,,,3981.6,90,,percent of total billed charges,,,3627.68,82,,percent of total billed charges,,,3981.6,90,,percent of total billed charges,,,3760.4,85,,percent of total billed charges,,1106,4202.8,
CT BONE (SUPERFICI) BIOPSY TROCAR/NEEDLE,29100101,CDM,20220,CPT,352,RC,outpatient,TC,2947,2947,,2502,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,736.75,22,,percent of total billed charges,,,,,,,,,2652.3,90,,percent of total billed charges,,,2440.12,82.8,,percent of total billed charges,,,2504.95,85,,percent of total billed charges,,,,,,,,,2593.36,88,,percent of total billed charges,,,,,,,,,2251.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,736.75,22,,percent of total billed charges,,,2681.77,91,,percent of total billed charges,,,2799.65,95,,percent of total billed charges,,,2446.01,83,,percent of total billed charges,,,2446.01,83,,percent of total billed charges,,,,,,,,,,,,,,,2446.01,83,,percent of total billed charges,,,2799.65,95,,percent of total billed charges,,,2652.3,90,,percent of total billed charges,,,2652.3,90,,percent of total billed charges,,,2416.54,82,,percent of total billed charges,,,2652.3,90,,percent of total billed charges,,,2504.95,85,,percent of total billed charges,,736.75,2799.65,
CT LUNG PERCUT BX/MEDIASTINUM,29100102,CDM,32408,CPT,360,RC,outpatient,TC,3199,3199,,2715.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,799.75,22,,percent of total billed charges,,,,,,,,,2879.1,90,,percent of total billed charges,,,2648.77,82.8,,percent of total billed charges,,,2719.15,85,,percent of total billed charges,,,,,,,,,2815.12,88,,percent of total billed charges,,,,,,,,,2444.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,799.75,22,,percent of total billed charges,,,2911.09,91,,percent of total billed charges,,,3039.05,95,,percent of total billed charges,,,2655.17,83,,percent of total billed charges,,,2655.17,83,,percent of total billed charges,,,,,,,,,,,,,,,2655.17,83,,percent of total billed charges,,,3039.05,95,,percent of total billed charges,,,2879.1,90,,percent of total billed charges,,,2879.1,90,,percent of total billed charges,,,2623.18,82,,percent of total billed charges,,,2879.1,90,,percent of total billed charges,,,2719.15,85,,percent of total billed charges,,799.75,3039.05,
CT LIVER NEEDLE BIOPSY,29100103,CDM,47000,CPT,352,RC,outpatient,TC,3257,3257,,2765.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,814.25,22,,percent of total billed charges,,,,,,,,,2931.3,90,,percent of total billed charges,,,2696.8,82.8,,percent of total billed charges,,,2768.45,85,,percent of total billed charges,,,,,,,,,2866.16,88,,percent of total billed charges,,,,,,,,,2488.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,814.25,22,,percent of total billed charges,,,2963.87,91,,percent of total billed charges,,,3094.15,95,,percent of total billed charges,,,2703.31,83,,percent of total billed charges,,,2703.31,83,,percent of total billed charges,,,,,,,,,,,,,,,2703.31,83,,percent of total billed charges,,,3094.15,95,,percent of total billed charges,,,2931.3,90,,percent of total billed charges,,,2931.3,90,,percent of total billed charges,,,2670.74,82,,percent of total billed charges,,,2931.3,90,,percent of total billed charges,,,2768.45,85,,percent of total billed charges,,814.25,3094.15,
CT ABDOMINAL BIOPSY,29100104,CDM,49180,CPT,361,RC,outpatient,TC,3040,3040,,2580.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,760,22,,percent of total billed charges,,,,,,,,,2736,90,,percent of total billed charges,,,2517.12,82.8,,percent of total billed charges,,,2584,85,,percent of total billed charges,,,,,,,,,2675.2,88,,percent of total billed charges,,,,,,,,,2322.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,760,22,,percent of total billed charges,,,2766.4,91,,percent of total billed charges,,,2888,95,,percent of total billed charges,,,2523.2,83,,percent of total billed charges,,,2523.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2523.2,83,,percent of total billed charges,,,2888,95,,percent of total billed charges,,,2736,90,,percent of total billed charges,,,2736,90,,percent of total billed charges,,,2492.8,82,,percent of total billed charges,,,2736,90,,percent of total billed charges,,,2584,85,,percent of total billed charges,,760,2888,
CT RENAL BIOPSY PERQ,29100105,CDM,50200,CPT,352,RC,outpatient,TC,3440,3440,,2920.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,860,22,,percent of total billed charges,,,,,,,,,3096,90,,percent of total billed charges,,,2848.32,82.8,,percent of total billed charges,,,2924,85,,percent of total billed charges,,,,,,,,,3027.2,88,,percent of total billed charges,,,,,,,,,2628.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,860,22,,percent of total billed charges,,,3130.4,91,,percent of total billed charges,,,3268,95,,percent of total billed charges,,,2855.2,83,,percent of total billed charges,,,2855.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2855.2,83,,percent of total billed charges,,,3268,95,,percent of total billed charges,,,3096,90,,percent of total billed charges,,,3096,90,,percent of total billed charges,,,2820.8,82,,percent of total billed charges,,,3096,90,,percent of total billed charges,,,2924,85,,percent of total billed charges,,860,3268,
CT SOFT TISSUE (DEEP) BIOPSY,29100106,CDM,27041,CPT,352,RC,outpatient,TC,4531,4531,,3846.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1132.75,22,,percent of total billed charges,,,,,,,,,4077.9,90,,percent of total billed charges,,,3751.67,82.8,,percent of total billed charges,,,3851.35,85,,percent of total billed charges,,,,,,,,,3987.28,88,,percent of total billed charges,,,,,,,,,3461.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1132.75,22,,percent of total billed charges,,,4123.21,91,,percent of total billed charges,,,4304.45,95,,percent of total billed charges,,,3760.73,83,,percent of total billed charges,,,3760.73,83,,percent of total billed charges,,,,,,,,,,,,,,,3760.73,83,,percent of total billed charges,,,4304.45,95,,percent of total billed charges,,,4077.9,90,,percent of total billed charges,,,4077.9,90,,percent of total billed charges,,,3715.42,82,,percent of total billed charges,,,4077.9,90,,percent of total billed charges,,,3851.35,85,,percent of total billed charges,,1132.75,4304.45,
CT THORAX W/DYE,29100199,CDM,71260,CPT,352,RC,outpatient,TC,4379,4379,,3717.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1094.75,22,,percent of total billed charges,,,,,,,,,3941.1,90,,percent of total billed charges,,,3625.81,82.8,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,,,,,,,,3853.52,88,,percent of total billed charges,,,,,,,,,3345.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1094.75,22,,percent of total billed charges,,,3984.89,91,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,,,,,,,,,,,,,3634.57,83,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3590.78,82,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,1094.75,4160.05,
CT THORAX W/DYE PE,29100200,CDM,71260,CPT,352,RC,outpatient,TC,4379,4379,,3717.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1094.75,22,,percent of total billed charges,,,,,,,,,3941.1,90,,percent of total billed charges,,,3625.81,82.8,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,,,,,,,,3853.52,88,,percent of total billed charges,,,,,,,,,3345.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1094.75,22,,percent of total billed charges,,,3984.89,91,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,,,,,,,,,,,,,3634.57,83,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3590.78,82,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,1094.75,4160.05,
CT STONE (ABD/PELV W/O),29100201,CDM,74176,CPT,352,RC,outpatient,TC,6170,6170,,5238.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1542.5,22,,percent of total billed charges,,,,,,,,,5553,90,,percent of total billed charges,,,5108.76,82.8,,percent of total billed charges,,,5244.5,85,,percent of total billed charges,,,,,,,,,5429.6,88,,percent of total billed charges,,,,,,,,,4713.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1542.5,22,,percent of total billed charges,,,5614.7,91,,percent of total billed charges,,,5861.5,95,,percent of total billed charges,,,5121.1,83,,percent of total billed charges,,,5121.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5121.1,83,,percent of total billed charges,,,5861.5,95,,percent of total billed charges,,,5553,90,,percent of total billed charges,,,5553,90,,percent of total billed charges,,,5059.4,82,,percent of total billed charges,,,5553,90,,percent of total billed charges,,,5244.5,85,,percent of total billed charges,,1542.5,5861.5,
CT ABD/PELV W/WO,29100203,CDM,74178,CPT,352,RC,outpatient,TC,8550,8550,,7258.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2137.5,22,,percent of total billed charges,,,,,,,,,7695,90,,percent of total billed charges,,,7079.4,82.8,,percent of total billed charges,,,7267.5,85,,percent of total billed charges,,,,,,,,,7524,88,,percent of total billed charges,,,,,,,,,6532.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2137.5,22,,percent of total billed charges,,,7780.5,91,,percent of total billed charges,,,8122.5,95,,percent of total billed charges,,,7096.5,83,,percent of total billed charges,,,7096.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7096.5,83,,percent of total billed charges,,,8122.5,95,,percent of total billed charges,,,7695,90,,percent of total billed charges,,,7695,90,,percent of total billed charges,,,7011,82,,percent of total billed charges,,,7695,90,,percent of total billed charges,,,7267.5,85,,percent of total billed charges,,2137.5,8122.5,
CT ABD/PELV WITH,29100205,CDM,74177,CPT,352,RC,outpatient,TC,7335,7335,,6227.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1833.75,22,,percent of total billed charges,,,,,,,,,6601.5,90,,percent of total billed charges,,,6073.38,82.8,,percent of total billed charges,,,6234.75,85,,percent of total billed charges,,,,,,,,,6454.8,88,,percent of total billed charges,,,,,,,,,5603.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1833.75,22,,percent of total billed charges,,,6674.85,91,,percent of total billed charges,,,6968.25,95,,percent of total billed charges,,,6088.05,83,,percent of total billed charges,,,6088.05,83,,percent of total billed charges,,,,,,,,,,,,,,,6088.05,83,,percent of total billed charges,,,6968.25,95,,percent of total billed charges,,,6601.5,90,,percent of total billed charges,,,6601.5,90,,percent of total billed charges,,,6014.7,82,,percent of total billed charges,,,6601.5,90,,percent of total billed charges,,,6234.75,85,,percent of total billed charges,,1833.75,6968.25,
CT ABD/PELV W/O,29100206,CDM,74176,CPT,352,RC,outpatient,TC,6170,6170,,5238.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1542.5,22,,percent of total billed charges,,,,,,,,,5553,90,,percent of total billed charges,,,5108.76,82.8,,percent of total billed charges,,,5244.5,85,,percent of total billed charges,,,,,,,,,5429.6,88,,percent of total billed charges,,,,,,,,,4713.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1542.5,22,,percent of total billed charges,,,5614.7,91,,percent of total billed charges,,,5861.5,95,,percent of total billed charges,,,5121.1,83,,percent of total billed charges,,,5121.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5121.1,83,,percent of total billed charges,,,5861.5,95,,percent of total billed charges,,,5553,90,,percent of total billed charges,,,5553,90,,percent of total billed charges,,,5059.4,82,,percent of total billed charges,,,5553,90,,percent of total billed charges,,,5244.5,85,,percent of total billed charges,,1542.5,5861.5,
CT UROGRAM,29100207,CDM,74178,CPT,352,RC,outpatient,TC,8550,8550,,7258.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2137.5,22,,percent of total billed charges,,,,,,,,,7695,90,,percent of total billed charges,,,7079.4,82.8,,percent of total billed charges,,,7267.5,85,,percent of total billed charges,,,,,,,,,7524,88,,percent of total billed charges,,,,,,,,,6532.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2137.5,22,,percent of total billed charges,,,7780.5,91,,percent of total billed charges,,,8122.5,95,,percent of total billed charges,,,7096.5,83,,percent of total billed charges,,,7096.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7096.5,83,,percent of total billed charges,,,8122.5,95,,percent of total billed charges,,,7695,90,,percent of total billed charges,,,7695,90,,percent of total billed charges,,,7011,82,,percent of total billed charges,,,7695,90,,percent of total billed charges,,,7267.5,85,,percent of total billed charges,,2137.5,8122.5,
CT SELLA W/,29100300,CDM,70481,CPT,350,RC,outpatient,,3751,3751,,3184.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,937.75,22,,percent of total billed charges,,,,,,,,,3375.9,90,,percent of total billed charges,,,3105.83,82.8,,percent of total billed charges,,,3188.35,85,,percent of total billed charges,,,,,,,,,3300.88,88,,percent of total billed charges,,,,,,,,,2865.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,937.75,22,,percent of total billed charges,,,3413.41,91,,percent of total billed charges,,,3563.45,95,,percent of total billed charges,,,3113.33,83,,percent of total billed charges,,,3113.33,83,,percent of total billed charges,,,,,,,,,,,,,,,3113.33,83,,percent of total billed charges,,,3563.45,95,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3075.82,82,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3188.35,85,,percent of total billed charges,,937.75,3563.45,
CT SELLA W/WO,29100301,CDM,70482,CPT,350,RC,outpatient,,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1097.75,22,,percent of total billed charges,,,,,,,,,3951.9,90,,percent of total billed charges,,,3635.75,82.8,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1097.75,22,,percent of total billed charges,,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,1097.75,4171.45,
CT SELLA W/O,29100302,CDM,70480,CPT,350,RC,outpatient,TC,3397,3397,,2884.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,849.25,22,,percent of total billed charges,,,,,,,,,3057.3,90,,percent of total billed charges,,,2812.72,82.8,,percent of total billed charges,,,2887.45,85,,percent of total billed charges,,,,,,,,,2989.36,88,,percent of total billed charges,,,,,,,,,2595.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,849.25,22,,percent of total billed charges,,,3091.27,91,,percent of total billed charges,,,3227.15,95,,percent of total billed charges,,,2819.51,83,,percent of total billed charges,,,2819.51,83,,percent of total billed charges,,,,,,,,,,,,,,,2819.51,83,,percent of total billed charges,,,3227.15,95,,percent of total billed charges,,,3057.3,90,,percent of total billed charges,,,3057.3,90,,percent of total billed charges,,,2785.54,82,,percent of total billed charges,,,3057.3,90,,percent of total billed charges,,,2887.45,85,,percent of total billed charges,,849.25,3227.15,
CT C SPINE W/,29100479,CDM,72126,CPT,352,RC,outpatient,,4379,4379,,3717.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1094.75,22,,percent of total billed charges,,,,,,,,,3941.1,90,,percent of total billed charges,,,3625.81,82.8,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,,,,,,,,3853.52,88,,percent of total billed charges,,,,,,,,,3345.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1094.75,22,,percent of total billed charges,,,3984.89,91,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,,,,,,,,,,,,,3634.57,83,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3590.78,82,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,1094.75,4160.05,
CT LOW EXT W LT,29100495,CDM,73701,CPT,350,RC,outpatient,,3869,3869,,3284.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,967.25,22,,percent of total billed charges,,,,,,,,,3482.1,90,,percent of total billed charges,,,3203.53,82.8,,percent of total billed charges,,,3288.65,85,,percent of total billed charges,,,,,,,,,3404.72,88,,percent of total billed charges,,,,,,,,,2955.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,967.25,22,,percent of total billed charges,,,3520.79,91,,percent of total billed charges,,,3675.55,95,,percent of total billed charges,,,3211.27,83,,percent of total billed charges,,,3211.27,83,,percent of total billed charges,,,,,,,,,,,,,,,3211.27,83,,percent of total billed charges,,,3675.55,95,,percent of total billed charges,,,3482.1,90,,percent of total billed charges,,,3482.1,90,,percent of total billed charges,,,3172.58,82,,percent of total billed charges,,,3482.1,90,,percent of total billed charges,,,3288.65,85,,percent of total billed charges,,967.25,3675.55,
CT LOW EXT W RT,29100496,CDM,73701,CPT,350,RC,outpatient,,3869,3869,,3284.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,967.25,22,,percent of total billed charges,,,,,,,,,3482.1,90,,percent of total billed charges,,,3203.53,82.8,,percent of total billed charges,,,3288.65,85,,percent of total billed charges,,,,,,,,,3404.72,88,,percent of total billed charges,,,,,,,,,2955.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,967.25,22,,percent of total billed charges,,,3520.79,91,,percent of total billed charges,,,3675.55,95,,percent of total billed charges,,,3211.27,83,,percent of total billed charges,,,3211.27,83,,percent of total billed charges,,,,,,,,,,,,,,,3211.27,83,,percent of total billed charges,,,3675.55,95,,percent of total billed charges,,,3482.1,90,,percent of total billed charges,,,3482.1,90,,percent of total billed charges,,,3172.58,82,,percent of total billed charges,,,3482.1,90,,percent of total billed charges,,,3288.65,85,,percent of total billed charges,,967.25,3675.55,
CT LOW EXT W/WO LEFT,29100511,CDM,73702,CPT,350,RC,outpatient,LT,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1097.75,22,,percent of total billed charges,,,,,,,,,3951.9,90,,percent of total billed charges,,,3635.75,82.8,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1097.75,22,,percent of total billed charges,,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,1097.75,4171.45,
CT LOW EXT W/WO RIGHT,29100512,CDM,73702,CPT,350,RC,outpatient,RT,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1097.75,22,,percent of total billed charges,,,,,,,,,3951.9,90,,percent of total billed charges,,,3635.75,82.8,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1097.75,22,,percent of total billed charges,,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,1097.75,4171.45,
CTA LOW EXT RT W/WO/REPROC,29100513,CDM,73706,CPT,350,RC,outpatient,RT,5225,5225,,4436.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1306.25,22,,percent of total billed charges,,,,,,,,,4702.5,90,,percent of total billed charges,,,4326.3,82.8,,percent of total billed charges,,,4441.25,85,,percent of total billed charges,,,,,,,,,4598,88,,percent of total billed charges,,,,,,,,,3991.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1306.25,22,,percent of total billed charges,,,4754.75,91,,percent of total billed charges,,,4963.75,95,,percent of total billed charges,,,4336.75,83,,percent of total billed charges,,,4336.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4336.75,83,,percent of total billed charges,,,4963.75,95,,percent of total billed charges,,,4702.5,90,,percent of total billed charges,,,4702.5,90,,percent of total billed charges,,,4284.5,82,,percent of total billed charges,,,4702.5,90,,percent of total billed charges,,,4441.25,85,,percent of total billed charges,,1306.25,4963.75,
CTA LOW EXT LT W/WO/REPROC,29100514,CDM,73706,CPT,350,RC,outpatient,LT,5225,5225,,4436.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1306.25,22,,percent of total billed charges,,,,,,,,,4702.5,90,,percent of total billed charges,,,4326.3,82.8,,percent of total billed charges,,,4441.25,85,,percent of total billed charges,,,,,,,,,4598,88,,percent of total billed charges,,,,,,,,,3991.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1306.25,22,,percent of total billed charges,,,4754.75,91,,percent of total billed charges,,,4963.75,95,,percent of total billed charges,,,4336.75,83,,percent of total billed charges,,,4336.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4336.75,83,,percent of total billed charges,,,4963.75,95,,percent of total billed charges,,,4702.5,90,,percent of total billed charges,,,4702.5,90,,percent of total billed charges,,,4284.5,82,,percent of total billed charges,,,4702.5,90,,percent of total billed charges,,,4441.25,85,,percent of total billed charges,,1306.25,4963.75,
CTA LOW EXTBILATW/WO/REPRC,29100515,CDM,73706,CPT,350,RC,outpatient,50,10449,10449,,8871.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2612.25,22,,percent of total billed charges,,,,,,,,,9404.1,90,,percent of total billed charges,,,8651.77,82.8,,percent of total billed charges,,,8881.65,85,,percent of total billed charges,,,,,,,,,9195.12,88,,percent of total billed charges,,,,,,,,,7983.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2612.25,22,,percent of total billed charges,,,9508.59,91,,percent of total billed charges,,,9926.55,95,,percent of total billed charges,,,8672.67,83,,percent of total billed charges,,,8672.67,83,,percent of total billed charges,,,,,,,,,,,,,,,8672.67,83,,percent of total billed charges,,,9926.55,95,,percent of total billed charges,,,9404.1,90,,percent of total billed charges,,,9404.1,90,,percent of total billed charges,,,8568.18,82,,percent of total billed charges,,,9404.1,90,,percent of total billed charges,,,8881.65,85,,percent of total billed charges,,2612.25,9926.55,
CTA ABD (W OR W/O),29100516,CDM,74175,CPT,350,RC,outpatient,TC,6339,6339,,5381.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1584.75,22,,percent of total billed charges,,,,,,,,,5705.1,90,,percent of total billed charges,,,5248.69,82.8,,percent of total billed charges,,,5388.15,85,,percent of total billed charges,,,,,,,,,5578.32,88,,percent of total billed charges,,,,,,,,,4843,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1584.75,22,,percent of total billed charges,,,5768.49,91,,percent of total billed charges,,,6022.05,95,,percent of total billed charges,,,5261.37,83,,percent of total billed charges,,,5261.37,83,,percent of total billed charges,,,,,,,,,,,,,,,5261.37,83,,percent of total billed charges,,,6022.05,95,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5197.98,82,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5388.15,85,,percent of total billed charges,,1584.75,6022.05,
CTA CHEST W/WO/REPROC,29100517,CDM,71275,CPT,350,RC,outpatient,TC,6339,6339,,5381.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1584.75,22,,percent of total billed charges,,,,,,,,,5705.1,90,,percent of total billed charges,,,5248.69,82.8,,percent of total billed charges,,,5388.15,85,,percent of total billed charges,,,,,,,,,5578.32,88,,percent of total billed charges,,,,,,,,,4843,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1584.75,22,,percent of total billed charges,,,5768.49,91,,percent of total billed charges,,,6022.05,95,,percent of total billed charges,,,5261.37,83,,percent of total billed charges,,,5261.37,83,,percent of total billed charges,,,,,,,,,,,,,,,5261.37,83,,percent of total billed charges,,,6022.05,95,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5197.98,82,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5388.15,85,,percent of total billed charges,,1584.75,6022.05,
CTA RUNOFAORTA/LEGSW/WOREP,29100518,CDM,75635,CPT,350,RC,outpatient,TC,6339,6339,,5381.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1584.75,22,,percent of total billed charges,,,,,,,,,5705.1,90,,percent of total billed charges,,,5248.69,82.8,,percent of total billed charges,,,5388.15,85,,percent of total billed charges,,,,,,,,,5578.32,88,,percent of total billed charges,,,,,,,,,4843,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1584.75,22,,percent of total billed charges,,,5768.49,91,,percent of total billed charges,,,6022.05,95,,percent of total billed charges,,,5261.37,83,,percent of total billed charges,,,5261.37,83,,percent of total billed charges,,,,,,,,,,,,,,,5261.37,83,,percent of total billed charges,,,6022.05,95,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5197.98,82,,percent of total billed charges,,,5705.1,90,,percent of total billed charges,,,5388.15,85,,percent of total billed charges,,1584.75,6022.05,
CTA PELV W/WO/REPROC,29100519,CDM,72191,CPT,350,RC,outpatient,TC,6354,6354,,5394.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1588.5,22,,percent of total billed charges,,,,,,,,,5718.6,90,,percent of total billed charges,,,5261.11,82.8,,percent of total billed charges,,,5400.9,85,,percent of total billed charges,,,,,,,,,5591.52,88,,percent of total billed charges,,,,,,,,,4854.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1588.5,22,,percent of total billed charges,,,5782.14,91,,percent of total billed charges,,,6036.3,95,,percent of total billed charges,,,5273.82,83,,percent of total billed charges,,,5273.82,83,,percent of total billed charges,,,,,,,,,,,,,,,5273.82,83,,percent of total billed charges,,,6036.3,95,,percent of total billed charges,,,5718.6,90,,percent of total billed charges,,,5718.6,90,,percent of total billed charges,,,5210.28,82,,percent of total billed charges,,,5718.6,90,,percent of total billed charges,,,5400.9,85,,percent of total billed charges,,1588.5,6036.3,
CTA UP EXT BIL W/WO/REPROC,29100520,CDM,73206,CPT,350,RC,outpatient,TC,6354,6354,,5394.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1588.5,22,,percent of total billed charges,,,,,,,,,5718.6,90,,percent of total billed charges,,,5261.11,82.8,,percent of total billed charges,,,5400.9,85,,percent of total billed charges,,,,,,,,,5591.52,88,,percent of total billed charges,,,,,,,,,4854.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1588.5,22,,percent of total billed charges,,,5782.14,91,,percent of total billed charges,,,6036.3,95,,percent of total billed charges,,,5273.82,83,,percent of total billed charges,,,5273.82,83,,percent of total billed charges,,,,,,,,,,,,,,,5273.82,83,,percent of total billed charges,,,6036.3,95,,percent of total billed charges,,,5718.6,90,,percent of total billed charges,,,5718.6,90,,percent of total billed charges,,,5210.28,82,,percent of total billed charges,,,5718.6,90,,percent of total billed charges,,,5400.9,85,,percent of total billed charges,,1588.5,6036.3,
*DNU CTA NECK/CAROTID W/WO/REPROC PFA),29100522,CDM,70498,CPT,351,RC,outpatient,TC,3736,3736,,3171.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,934,22,,percent of total billed charges,,,,,,,,,3362.4,90,,percent of total billed charges,,,3093.41,82.8,,percent of total billed charges,,,3175.6,85,,percent of total billed charges,,,,,,,,,3287.68,88,,percent of total billed charges,,,,,,,,,2854.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,934,22,,percent of total billed charges,,,3399.76,91,,percent of total billed charges,,,3549.2,95,,percent of total billed charges,,,3100.88,83,,percent of total billed charges,,,3100.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3100.88,83,,percent of total billed charges,,,3549.2,95,,percent of total billed charges,,,3362.4,90,,percent of total billed charges,,,3362.4,90,,percent of total billed charges,,,3063.52,82,,percent of total billed charges,,,3362.4,90,,percent of total billed charges,,,3175.6,85,,percent of total billed charges,,934,3549.2,
CTA ABD&PELV W/O&W/DYE,29100523,CDM,74174,CPT,350,RC,outpatient,TC,7012,7012,,5953.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1753,22,,percent of total billed charges,,,,,,,,,6310.8,90,,percent of total billed charges,,,5805.94,82.8,,percent of total billed charges,,,5960.2,85,,percent of total billed charges,,,,,,,,,6170.56,88,,percent of total billed charges,,,,,,,,,5357.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1753,22,,percent of total billed charges,,,6380.92,91,,percent of total billed charges,,,6661.4,95,,percent of total billed charges,,,5819.96,83,,percent of total billed charges,,,5819.96,83,,percent of total billed charges,,,,,,,,,,,,,,,5819.96,83,,percent of total billed charges,,,6661.4,95,,percent of total billed charges,,,6310.8,90,,percent of total billed charges,,,6310.8,90,,percent of total billed charges,,,5749.84,82,,percent of total billed charges,,,6310.8,90,,percent of total billed charges,,,5960.2,85,,percent of total billed charges,,1753,6661.4,
CTA NECK/CAROTIDW/WO/REPRC,29100600,CDM,70498,CPT,351,RC,outpatient,TC,5789,5789,,4914.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1447.25,22,,percent of total billed charges,,,,,,,,,5210.1,90,,percent of total billed charges,,,4793.29,82.8,,percent of total billed charges,,,4920.65,85,,percent of total billed charges,,,,,,,,,5094.32,88,,percent of total billed charges,,,,,,,,,4422.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1447.25,22,,percent of total billed charges,,,5267.99,91,,percent of total billed charges,,,5499.55,95,,percent of total billed charges,,,4804.87,83,,percent of total billed charges,,,4804.87,83,,percent of total billed charges,,,,,,,,,,,,,,,4804.87,83,,percent of total billed charges,,,5499.55,95,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,4746.98,82,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,4920.65,85,,percent of total billed charges,,1447.25,5499.55,
CTA HEAD(COW)W/WO/REPROC,29100601,CDM,70496,CPT,351,RC,outpatient,TC,5789,5789,,4914.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1447.25,22,,percent of total billed charges,,,,,,,,,5210.1,90,,percent of total billed charges,,,4793.29,82.8,,percent of total billed charges,,,4920.65,85,,percent of total billed charges,,,,,,,,,5094.32,88,,percent of total billed charges,,,,,,,,,4422.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1447.25,22,,percent of total billed charges,,,5267.99,91,,percent of total billed charges,,,5499.55,95,,percent of total billed charges,,,4804.87,83,,percent of total billed charges,,,4804.87,83,,percent of total billed charges,,,,,,,,,,,,,,,4804.87,83,,percent of total billed charges,,,5499.55,95,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,4746.98,82,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,4920.65,85,,percent of total billed charges,,1447.25,5499.55,
CTA HEAD/NECK/CAROTID W W/O REPROCESSING,29100602,CDM,70498,CPT,351,RC,outpatient,TC,5789,5789,,4914.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1447.25,22,,percent of total billed charges,,,,,,,,,5210.1,90,,percent of total billed charges,,,4793.29,82.8,,percent of total billed charges,,,4920.65,85,,percent of total billed charges,,,,,,,,,5094.32,88,,percent of total billed charges,,,,,,,,,4422.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1447.25,22,,percent of total billed charges,,,5267.99,91,,percent of total billed charges,,,5499.55,95,,percent of total billed charges,,,4804.87,83,,percent of total billed charges,,,4804.87,83,,percent of total billed charges,,,,,,,,,,,,,,,4804.87,83,,percent of total billed charges,,,5499.55,95,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,4746.98,82,,percent of total billed charges,,,5210.1,90,,percent of total billed charges,,,4920.65,85,,percent of total billed charges,,1447.25,5499.55,
CT UP EXT LT W/WO,29100644,CDM,73202,CPT,350,RC,outpatient,,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1097.75,22,,percent of total billed charges,,,,,,,,,3951.9,90,,percent of total billed charges,,,3635.75,82.8,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1097.75,22,,percent of total billed charges,,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,1097.75,4171.45,
CT UP EXT RT W/WO,29100645,CDM,73202,CPT,350,RC,outpatient,,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1097.75,22,,percent of total billed charges,,,,,,,,,3951.9,90,,percent of total billed charges,,,3635.75,82.8,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1097.75,22,,percent of total billed charges,,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,1097.75,4171.45,
CT HEAD W/WO,29100909,CDM,70470,CPT,351,RC,outpatient,TC,4437,4437,,3767.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1109.25,22,,percent of total billed charges,,,,,,,,,3993.3,90,,percent of total billed charges,,,3673.84,82.8,,percent of total billed charges,,,3771.45,85,,percent of total billed charges,,,,,,,,,3904.56,88,,percent of total billed charges,,,,,,,,,3389.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1109.25,22,,percent of total billed charges,,,4037.67,91,,percent of total billed charges,,,4215.15,95,,percent of total billed charges,,,3682.71,83,,percent of total billed charges,,,3682.71,83,,percent of total billed charges,,,,,,,,,,,,,,,3682.71,83,,percent of total billed charges,,,4215.15,95,,percent of total billed charges,,,3993.3,90,,percent of total billed charges,,,3993.3,90,,percent of total billed charges,,,3638.34,82,,percent of total billed charges,,,3993.3,90,,percent of total billed charges,,,3771.45,85,,percent of total billed charges,,1109.25,4215.15,
CT C SPINE W/O,29100990,CDM,72125,CPT,352,RC,outpatient,TC,3830,3830,,3251.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,957.5,22,,percent of total billed charges,,,,,,,,,3447,90,,percent of total billed charges,,,3171.24,82.8,,percent of total billed charges,,,3255.5,85,,percent of total billed charges,,,,,,,,,3370.4,88,,percent of total billed charges,,,,,,,,,2926.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,957.5,22,,percent of total billed charges,,,3485.3,91,,percent of total billed charges,,,3638.5,95,,percent of total billed charges,,,3178.9,83,,percent of total billed charges,,,3178.9,83,,percent of total billed charges,,,,,,,,,,,,,,,3178.9,83,,percent of total billed charges,,,3638.5,95,,percent of total billed charges,,,3447,90,,percent of total billed charges,,,3447,90,,percent of total billed charges,,,3140.6,82,,percent of total billed charges,,,3447,90,,percent of total billed charges,,,3255.5,85,,percent of total billed charges,,957.5,3638.5,
CT FACIAL BONES W/O,29101121,CDM,70486,CPT,351,RC,outpatient,TC,3616,3616,,3069.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,904,22,,percent of total billed charges,,,,,,,,,3254.4,90,,percent of total billed charges,,,2994.05,82.8,,percent of total billed charges,,,3073.6,85,,percent of total billed charges,,,,,,,,,3182.08,88,,percent of total billed charges,,,,,,,,,2762.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,904,22,,percent of total billed charges,,,3290.56,91,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,,,,,,,,,,,,,3001.28,83,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,2965.12,82,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3073.6,85,,percent of total billed charges,,904,3435.2,
CT FACIAL BONES W/,29101122,CDM,70487,CPT,350,RC,outpatient,TC,3751,3751,,3184.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,937.75,22,,percent of total billed charges,,,,,,,,,3375.9,90,,percent of total billed charges,,,3105.83,82.8,,percent of total billed charges,,,3188.35,85,,percent of total billed charges,,,,,,,,,3300.88,88,,percent of total billed charges,,,,,,,,,2865.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,937.75,22,,percent of total billed charges,,,3413.41,91,,percent of total billed charges,,,3563.45,95,,percent of total billed charges,,,3113.33,83,,percent of total billed charges,,,3113.33,83,,percent of total billed charges,,,,,,,,,,,,,,,3113.33,83,,percent of total billed charges,,,3563.45,95,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3075.82,82,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3188.35,85,,percent of total billed charges,,937.75,3563.45,
CT FACIAL BONES W/WO,29101123,CDM,70488,CPT,350,RC,outpatient,,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1097.75,22,,percent of total billed charges,,,,,,,,,3951.9,90,,percent of total billed charges,,,3635.75,82.8,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1097.75,22,,percent of total billed charges,,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,1097.75,4171.45,
CT T SPINE W/O,29101220,CDM,72128,CPT,352,RC,outpatient,TC,3655,3655,,3103.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,913.75,22,,percent of total billed charges,,,,,,,,,3289.5,90,,percent of total billed charges,,,3026.34,82.8,,percent of total billed charges,,,3106.75,85,,percent of total billed charges,,,,,,,,,3216.4,88,,percent of total billed charges,,,,,,,,,2792.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,913.75,22,,percent of total billed charges,,,3326.05,91,,percent of total billed charges,,,3472.25,95,,percent of total billed charges,,,3033.65,83,,percent of total billed charges,,,3033.65,83,,percent of total billed charges,,,,,,,,,,,,,,,3033.65,83,,percent of total billed charges,,,3472.25,95,,percent of total billed charges,,,3289.5,90,,percent of total billed charges,,,3289.5,90,,percent of total billed charges,,,2997.1,82,,percent of total billed charges,,,3289.5,90,,percent of total billed charges,,,3106.75,85,,percent of total billed charges,,913.75,3472.25,
CT LTD OR FOLLOW-UP,29101386,CDM,76380,CPT,350,RC,outpatient,TC,2427,2427,,2060.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,606.75,22,,percent of total billed charges,,,,,,,,,2184.3,90,,percent of total billed charges,,,2009.56,82.8,,percent of total billed charges,,,2062.95,85,,percent of total billed charges,,,,,,,,,2135.76,88,,percent of total billed charges,,,,,,,,,1854.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,606.75,22,,percent of total billed charges,,,2208.57,91,,percent of total billed charges,,,2305.65,95,,percent of total billed charges,,,2014.41,83,,percent of total billed charges,,,2014.41,83,,percent of total billed charges,,,,,,,,,,,,,,,2014.41,83,,percent of total billed charges,,,2305.65,95,,percent of total billed charges,,,2184.3,90,,percent of total billed charges,,,2184.3,90,,percent of total billed charges,,,1990.14,82,,percent of total billed charges,,,2184.3,90,,percent of total billed charges,,,2062.95,85,,percent of total billed charges,,606.75,2305.65,
CT 3D RENDERING,29101395,CDM,76376,CPT,350,RC,outpatient,TC,1339,1339,,1136.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,334.75,22,,percent of total billed charges,,,,,,,,,1205.1,90,,percent of total billed charges,,,1108.69,82.8,,percent of total billed charges,,,1138.15,85,,percent of total billed charges,,,,,,,,,1178.32,88,,percent of total billed charges,,,,,,,,,1023,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,334.75,22,,percent of total billed charges,,,1218.49,91,,percent of total billed charges,,,1272.05,95,,percent of total billed charges,,,1111.37,83,,percent of total billed charges,,,1111.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1111.37,83,,percent of total billed charges,,,1272.05,95,,percent of total billed charges,,,1205.1,90,,percent of total billed charges,,,1205.1,90,,percent of total billed charges,,,1097.98,82,,percent of total billed charges,,,1205.1,90,,percent of total billed charges,,,1138.15,85,,percent of total billed charges,,334.75,1272.05,
CT IAC W/WO,29101428,CDM,70482,CPT,351,RC,outpatient,,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1097.75,22,,percent of total billed charges,,,,,,,,,3951.9,90,,percent of total billed charges,,,3635.75,82.8,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1097.75,22,,percent of total billed charges,,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,1097.75,4171.45,
CT IAC W/,29101436,CDM,70481,CPT,351,RC,outpatient,,3857,3857,,3274.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,964.25,22,,percent of total billed charges,,,,,,,,,3471.3,90,,percent of total billed charges,,,3193.6,82.8,,percent of total billed charges,,,3278.45,85,,percent of total billed charges,,,,,,,,,3394.16,88,,percent of total billed charges,,,,,,,,,2946.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,964.25,22,,percent of total billed charges,,,3509.87,91,,percent of total billed charges,,,3664.15,95,,percent of total billed charges,,,3201.31,83,,percent of total billed charges,,,3201.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3201.31,83,,percent of total billed charges,,,3664.15,95,,percent of total billed charges,,,3471.3,90,,percent of total billed charges,,,3471.3,90,,percent of total billed charges,,,3162.74,82,,percent of total billed charges,,,3471.3,90,,percent of total billed charges,,,3278.45,85,,percent of total billed charges,,964.25,3664.15,
CT TEMPORAL BONES W/,29101437,CDM,70481,CPT,351,RC,outpatient,,3751,3751,,3184.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,937.75,22,,percent of total billed charges,,,,,,,,,3375.9,90,,percent of total billed charges,,,3105.83,82.8,,percent of total billed charges,,,3188.35,85,,percent of total billed charges,,,,,,,,,3300.88,88,,percent of total billed charges,,,,,,,,,2865.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,937.75,22,,percent of total billed charges,,,3413.41,91,,percent of total billed charges,,,3563.45,95,,percent of total billed charges,,,3113.33,83,,percent of total billed charges,,,3113.33,83,,percent of total billed charges,,,,,,,,,,,,,,,3113.33,83,,percent of total billed charges,,,3563.45,95,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3075.82,82,,percent of total billed charges,,,3375.9,90,,percent of total billed charges,,,3188.35,85,,percent of total billed charges,,937.75,3563.45,
CT TEMPORAL BONES W/WO,29101438,CDM,70482,CPT,351,RC,outpatient,,4379,4379,,3717.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1094.75,22,,percent of total billed charges,,,,,,,,,3941.1,90,,percent of total billed charges,,,3625.81,82.8,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,,,,,,,,3853.52,88,,percent of total billed charges,,,,,,,,,3345.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1094.75,22,,percent of total billed charges,,,3984.89,91,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,,,,,,,,,,,,,3634.57,83,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3590.78,82,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,1094.75,4160.05,
CT TEMPORAL BONES W/O,29101439,CDM,70480,CPT,351,RC,outpatient,TC,3388,3388,,2876.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,847,22,,percent of total billed charges,,,,,,,,,3049.2,90,,percent of total billed charges,,,2805.26,82.8,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,,,,,,,,2981.44,88,,percent of total billed charges,,,,,,,,,2588.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,847,22,,percent of total billed charges,,,3083.08,91,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,,,,,,,,,,,,,2812.04,83,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2778.16,82,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,847,3218.6,
CT INJ TRANSFORAMINAL EPIDURAL C/T SINGL,29101950,CDM,64479,CPT,360,RC,outpatient,TC,3928,3928,,3334.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,982,22,,percent of total billed charges,,,,,,,,,3535.2,90,,percent of total billed charges,,,3252.38,82.8,,percent of total billed charges,,,3338.8,85,,percent of total billed charges,,,,,,,,,3456.64,88,,percent of total billed charges,,,,,,,,,3000.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,982,22,,percent of total billed charges,,,3574.48,91,,percent of total billed charges,,,3731.6,95,,percent of total billed charges,,,3260.24,83,,percent of total billed charges,,,3260.24,83,,percent of total billed charges,,,,,,,,,,,,,,,3260.24,83,,percent of total billed charges,,,3731.6,95,,percent of total billed charges,,,3535.2,90,,percent of total billed charges,,,3535.2,90,,percent of total billed charges,,,3220.96,82,,percent of total billed charges,,,3535.2,90,,percent of total billed charges,,,3338.8,85,,percent of total billed charges,,982,3731.6,
CT INJ TRANSFORAMINAL EPIDURAL C/T EACH,29101951,CDM,64480,CPT,360,RC,outpatient,TC,2387,2387,,2026.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,596.75,22,,percent of total billed charges,,,,,,,,,2148.3,90,,percent of total billed charges,,,1976.44,82.8,,percent of total billed charges,,,2028.95,85,,percent of total billed charges,,,,,,,,,2100.56,88,,percent of total billed charges,,,,,,,,,1823.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,596.75,22,,percent of total billed charges,,,2172.17,91,,percent of total billed charges,,,2267.65,95,,percent of total billed charges,,,1981.21,83,,percent of total billed charges,,,1981.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1981.21,83,,percent of total billed charges,,,2267.65,95,,percent of total billed charges,,,2148.3,90,,percent of total billed charges,,,2148.3,90,,percent of total billed charges,,,1957.34,82,,percent of total billed charges,,,2148.3,90,,percent of total billed charges,,,2028.95,85,,percent of total billed charges,,596.75,2267.65,
CT ASPIRATION & INJECTION KIDNEY CYST,29101980,CDM,50390,CPT,360,RC,outpatient,TC,3212,3212,,2726.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,803,22,,percent of total billed charges,,,,,,,,,2890.8,90,,percent of total billed charges,,,2659.54,82.8,,percent of total billed charges,,,2730.2,85,,percent of total billed charges,,,,,,,,,2826.56,88,,percent of total billed charges,,,,,,,,,2453.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,803,22,,percent of total billed charges,,,2922.92,91,,percent of total billed charges,,,3051.4,95,,percent of total billed charges,,,2665.96,83,,percent of total billed charges,,,2665.96,83,,percent of total billed charges,,,,,,,,,,,,,,,2665.96,83,,percent of total billed charges,,,3051.4,95,,percent of total billed charges,,,2890.8,90,,percent of total billed charges,,,2890.8,90,,percent of total billed charges,,,2633.84,82,,percent of total billed charges,,,2890.8,90,,percent of total billed charges,,,2730.2,85,,percent of total billed charges,,803,3051.4,
CT GUIDED ASPIRATION/INJ BONE CYST,29101981,CDM,20615,CPT,360,RC,outpatient,TC,4261,4261,,3617.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1065.25,22,,percent of total billed charges,,,,,,,,,3834.9,90,,percent of total billed charges,,,3528.11,82.8,,percent of total billed charges,,,3621.85,85,,percent of total billed charges,,,,,,,,,3749.68,88,,percent of total billed charges,,,,,,,,,3255.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1065.25,22,,percent of total billed charges,,,3877.51,91,,percent of total billed charges,,,4047.95,95,,percent of total billed charges,,,3536.63,83,,percent of total billed charges,,,3536.63,83,,percent of total billed charges,,,,,,,,,,,,,,,3536.63,83,,percent of total billed charges,,,4047.95,95,,percent of total billed charges,,,3834.9,90,,percent of total billed charges,,,3834.9,90,,percent of total billed charges,,,3494.02,82,,percent of total billed charges,,,3834.9,90,,percent of total billed charges,,,3621.85,85,,percent of total billed charges,,1065.25,4047.95,
CT FACET INJ C/T,29101982,CDM,64490,CPT,360,RC,outpatient,TC,3545,3545,,3009.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,886.25,22,,percent of total billed charges,,,,,,,,,3190.5,90,,percent of total billed charges,,,2935.26,82.8,,percent of total billed charges,,,3013.25,85,,percent of total billed charges,,,,,,,,,3119.6,88,,percent of total billed charges,,,,,,,,,2708.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,886.25,22,,percent of total billed charges,,,3225.95,91,,percent of total billed charges,,,3367.75,95,,percent of total billed charges,,,2942.35,83,,percent of total billed charges,,,2942.35,83,,percent of total billed charges,,,,,,,,,,,,,,,2942.35,83,,percent of total billed charges,,,3367.75,95,,percent of total billed charges,,,3190.5,90,,percent of total billed charges,,,3190.5,90,,percent of total billed charges,,,2906.9,82,,percent of total billed charges,,,3190.5,90,,percent of total billed charges,,,3013.25,85,,percent of total billed charges,,886.25,3367.75,
CT PUDENDAL NERVE BLOCK,29101983,CDM,64430,CPT,360,RC,outpatient,TC,4178,4178,,3547.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1044.5,22,,percent of total billed charges,,,,,,,,,3760.2,90,,percent of total billed charges,,,3459.38,82.8,,percent of total billed charges,,,3551.3,85,,percent of total billed charges,,,,,,,,,3676.64,88,,percent of total billed charges,,,,,,,,,3191.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1044.5,22,,percent of total billed charges,,,3801.98,91,,percent of total billed charges,,,3969.1,95,,percent of total billed charges,,,3467.74,83,,percent of total billed charges,,,3467.74,83,,percent of total billed charges,,,,,,,,,,,,,,,3467.74,83,,percent of total billed charges,,,3969.1,95,,percent of total billed charges,,,3760.2,90,,percent of total billed charges,,,3760.2,90,,percent of total billed charges,,,3425.96,82,,percent of total billed charges,,,3760.2,90,,percent of total billed charges,,,3551.3,85,,percent of total billed charges,,1044.5,3969.1,
CT OCCIPITAL NERVE INJECTION,29101984,CDM,64405,CPT,360,RC,outpatient,TC,2116,2116,,1796.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,529,22,,percent of total billed charges,,,,,,,,,1904.4,90,,percent of total billed charges,,,1752.05,82.8,,percent of total billed charges,,,1798.6,85,,percent of total billed charges,,,,,,,,,1862.08,88,,percent of total billed charges,,,,,,,,,1616.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,529,22,,percent of total billed charges,,,1925.56,91,,percent of total billed charges,,,2010.2,95,,percent of total billed charges,,,1756.28,83,,percent of total billed charges,,,1756.28,83,,percent of total billed charges,,,,,,,,,,,,,,,1756.28,83,,percent of total billed charges,,,2010.2,95,,percent of total billed charges,,,1904.4,90,,percent of total billed charges,,,1904.4,90,,percent of total billed charges,,,1735.12,82,,percent of total billed charges,,,1904.4,90,,percent of total billed charges,,,1798.6,85,,percent of total billed charges,,529,2010.2,
CT PARACERVICAL NERVE BLOCK,29101985,CDM,64435,CPT,360,RC,outpatient,TC,4249,4249,,3607.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1062.25,22,,percent of total billed charges,,,,,,,,,3824.1,90,,percent of total billed charges,,,3518.17,82.8,,percent of total billed charges,,,3611.65,85,,percent of total billed charges,,,,,,,,,3739.12,88,,percent of total billed charges,,,,,,,,,3246.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1062.25,22,,percent of total billed charges,,,3866.59,91,,percent of total billed charges,,,4036.55,95,,percent of total billed charges,,,3526.67,83,,percent of total billed charges,,,3526.67,83,,percent of total billed charges,,,,,,,,,,,,,,,3526.67,83,,percent of total billed charges,,,4036.55,95,,percent of total billed charges,,,3824.1,90,,percent of total billed charges,,,3824.1,90,,percent of total billed charges,,,3484.18,82,,percent of total billed charges,,,3824.1,90,,percent of total billed charges,,,3611.65,85,,percent of total billed charges,,1062.25,4036.55,
CT CRYO ABLATION RENAL TUMOR,29101990,CDM,50593,CPT,359,RC,outpatient,TC,17488,17488,,14847.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4372,22,,percent of total billed charges,,,,,,,,,15739.2,90,,percent of total billed charges,,,14480.06,82.8,,percent of total billed charges,,,14864.8,85,,percent of total billed charges,,,,,,,,,15389.44,88,,percent of total billed charges,,,,,,,,,13360.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4372,22,,percent of total billed charges,,,15914.08,91,,percent of total billed charges,,,16613.6,95,,percent of total billed charges,,,14515.04,83,,percent of total billed charges,,,14515.04,83,,percent of total billed charges,,,,,,,,,,,,,,,14515.04,83,,percent of total billed charges,,,16613.6,95,,percent of total billed charges,,,15739.2,90,,percent of total billed charges,,,15739.2,90,,percent of total billed charges,,,14340.16,82,,percent of total billed charges,,,15739.2,90,,percent of total billed charges,,,14864.8,85,,percent of total billed charges,,4372,16613.6,
CT CHANGE OF PERC DRAIN CATH,29101993,CDM,75984,CPT,359,RC,outpatient,TC,4405,4405,,3739.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1101.25,22,,percent of total billed charges,,,,,,,,,3964.5,90,,percent of total billed charges,,,3647.34,82.8,,percent of total billed charges,,,3744.25,85,,percent of total billed charges,,,,,,,,,3876.4,88,,percent of total billed charges,,,,,,,,,3365.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1101.25,22,,percent of total billed charges,,,4008.55,91,,percent of total billed charges,,,4184.75,95,,percent of total billed charges,,,3656.15,83,,percent of total billed charges,,,3656.15,83,,percent of total billed charges,,,,,,,,,,,,,,,3656.15,83,,percent of total billed charges,,,4184.75,95,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3612.1,82,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3744.25,85,,percent of total billed charges,,1101.25,4184.75,
CT ESI C/T SPINE,29101994,CDM,62321,CPT,360,RC,outpatient,TC,4678,4678,,3971.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1169.5,22,,percent of total billed charges,,,,,,,,,4210.2,90,,percent of total billed charges,,,3873.38,82.8,,percent of total billed charges,,,3976.3,85,,percent of total billed charges,,,,,,,,,4116.64,88,,percent of total billed charges,,,,,,,,,3573.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1169.5,22,,percent of total billed charges,,,4256.98,91,,percent of total billed charges,,,4444.1,95,,percent of total billed charges,,,3882.74,83,,percent of total billed charges,,,3882.74,83,,percent of total billed charges,,,,,,,,,,,,,,,3882.74,83,,percent of total billed charges,,,4444.1,95,,percent of total billed charges,,,4210.2,90,,percent of total billed charges,,,4210.2,90,,percent of total billed charges,,,3835.96,82,,percent of total billed charges,,,4210.2,90,,percent of total billed charges,,,3976.3,85,,percent of total billed charges,,1169.5,4444.1,
CT NEEDLE PLACEMENT CT GUIDANCE,29101995,CDM,77012,CPT,359,RC,outpatient,TC,4527,4527,,3843.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1131.75,22,,percent of total billed charges,,,,,,,,,4074.3,90,,percent of total billed charges,,,3748.36,82.8,,percent of total billed charges,,,3847.95,85,,percent of total billed charges,,,,,,,,,3983.76,88,,percent of total billed charges,,,,,,,,,3458.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1131.75,22,,percent of total billed charges,,,4119.57,91,,percent of total billed charges,,,4300.65,95,,percent of total billed charges,,,3757.41,83,,percent of total billed charges,,,3757.41,83,,percent of total billed charges,,,,,,,,,,,,,,,3757.41,83,,percent of total billed charges,,,4300.65,95,,percent of total billed charges,,,4074.3,90,,percent of total billed charges,,,4074.3,90,,percent of total billed charges,,,3712.14,82,,percent of total billed charges,,,4074.3,90,,percent of total billed charges,,,3847.95,85,,percent of total billed charges,,1131.75,4300.65,
CT GUIDE PERC DRAIN W/CATH,29101996,CDM,75989,CPT,359,RC,outpatient,TC,4405,4405,,3739.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1101.25,22,,percent of total billed charges,,,,,,,,,3964.5,90,,percent of total billed charges,,,3647.34,82.8,,percent of total billed charges,,,3744.25,85,,percent of total billed charges,,,,,,,,,3876.4,88,,percent of total billed charges,,,,,,,,,3365.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1101.25,22,,percent of total billed charges,,,4008.55,91,,percent of total billed charges,,,4184.75,95,,percent of total billed charges,,,3656.15,83,,percent of total billed charges,,,3656.15,83,,percent of total billed charges,,,,,,,,,,,,,,,3656.15,83,,percent of total billed charges,,,4184.75,95,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3612.1,82,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3744.25,85,,percent of total billed charges,,1101.25,4184.75,
* DNU CT GUIDE NEEDLE BX(V0107),29101998,CDM,76360,CPT,359,RC,outpatient,,4405,4405,,3739.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1101.25,22,,percent of total billed charges,,,,,,,,,3964.5,90,,percent of total billed charges,,,3647.34,82.8,,percent of total billed charges,,,3744.25,85,,percent of total billed charges,,,,,,,,,3876.4,88,,percent of total billed charges,,,,,,,,,3365.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1101.25,22,,percent of total billed charges,,,4008.55,91,,percent of total billed charges,,,4184.75,95,,percent of total billed charges,,,3656.15,83,,percent of total billed charges,,,3656.15,83,,percent of total billed charges,,,,,,,,,,,,,,,3656.15,83,,percent of total billed charges,,,4184.75,95,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3612.1,82,,percent of total billed charges,,,3964.5,90,,percent of total billed charges,,,3744.25,85,,percent of total billed charges,,1101.25,4184.75,
CT DRAINAGE OF OVARIAN CYST,29102000,CDM,49407,CPT,360,RC,outpatient,TC,6924,6924,,5878.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1731,22,,percent of total billed charges,,,,,,,,,6231.6,90,,percent of total billed charges,,,5733.07,82.8,,percent of total billed charges,,,5885.4,85,,percent of total billed charges,,,,,,,,,6093.12,88,,percent of total billed charges,,,,,,,,,5289.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1731,22,,percent of total billed charges,,,6300.84,91,,percent of total billed charges,,,6577.8,95,,percent of total billed charges,,,5746.92,83,,percent of total billed charges,,,5746.92,83,,percent of total billed charges,,,,,,,,,,,,,,,5746.92,83,,percent of total billed charges,,,6577.8,95,,percent of total billed charges,,,6231.6,90,,percent of total billed charges,,,6231.6,90,,percent of total billed charges,,,5677.68,82,,percent of total billed charges,,,6231.6,90,,percent of total billed charges,,,5885.4,85,,percent of total billed charges,,1731,6577.8,
CT HEAD W/O,29102004,CDM,70450,CPT,351,RC,outpatient,TC,3784,3784,,3212.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,946,22,,percent of total billed charges,,,,,,,,,3405.6,90,,percent of total billed charges,,,3133.15,82.8,,percent of total billed charges,,,3216.4,85,,percent of total billed charges,,,,,,,,,3329.92,88,,percent of total billed charges,,,,,,,,,2890.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,946,22,,percent of total billed charges,,,3443.44,91,,percent of total billed charges,,,3594.8,95,,percent of total billed charges,,,3140.72,83,,percent of total billed charges,,,3140.72,83,,percent of total billed charges,,,,,,,,,,,,,,,3140.72,83,,percent of total billed charges,,,3594.8,95,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3102.88,82,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3216.4,85,,percent of total billed charges,,946,3594.8,
CT HEAD W/,29102020,CDM,70460,CPT,351,RC,outpatient,TC,3908,3908,,3317.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,977,22,,percent of total billed charges,,,,,,,,,3517.2,90,,percent of total billed charges,,,3235.82,82.8,,percent of total billed charges,,,3321.8,85,,percent of total billed charges,,,,,,,,,3439.04,88,,percent of total billed charges,,,,,,,,,2985.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,977,22,,percent of total billed charges,,,3556.28,91,,percent of total billed charges,,,3712.6,95,,percent of total billed charges,,,3243.64,83,,percent of total billed charges,,,3243.64,83,,percent of total billed charges,,,,,,,,,,,,,,,3243.64,83,,percent of total billed charges,,,3712.6,95,,percent of total billed charges,,,3517.2,90,,percent of total billed charges,,,3517.2,90,,percent of total billed charges,,,3204.56,82,,percent of total billed charges,,,3517.2,90,,percent of total billed charges,,,3321.8,85,,percent of total billed charges,,977,3712.6,
CT ORBIT W/O,29102038,CDM,70480,CPT,351,RC,outpatient,TC,3358,3358,,2850.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,839.5,22,,percent of total billed charges,,,,,,,,,3022.2,90,,percent of total billed charges,,,2780.42,82.8,,percent of total billed charges,,,2854.3,85,,percent of total billed charges,,,,,,,,,2955.04,88,,percent of total billed charges,,,,,,,,,2565.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,839.5,22,,percent of total billed charges,,,3055.78,91,,percent of total billed charges,,,3190.1,95,,percent of total billed charges,,,2787.14,83,,percent of total billed charges,,,2787.14,83,,percent of total billed charges,,,,,,,,,,,,,,,2787.14,83,,percent of total billed charges,,,3190.1,95,,percent of total billed charges,,,3022.2,90,,percent of total billed charges,,,3022.2,90,,percent of total billed charges,,,2753.56,82,,percent of total billed charges,,,3022.2,90,,percent of total billed charges,,,2854.3,85,,percent of total billed charges,,839.5,3190.1,
CT ORBIT W/WO,29102046,CDM,70482,CPT,351,RC,outpatient,,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1097.75,22,,percent of total billed charges,,,,,,,,,3951.9,90,,percent of total billed charges,,,3635.75,82.8,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1097.75,22,,percent of total billed charges,,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,1097.75,4171.45,
CT ORBIT W/,29102053,CDM,70481,CPT,351,RC,outpatient,,3857,3857,,3274.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,964.25,22,,percent of total billed charges,,,,,,,,,3471.3,90,,percent of total billed charges,,,3193.6,82.8,,percent of total billed charges,,,3278.45,85,,percent of total billed charges,,,,,,,,,3394.16,88,,percent of total billed charges,,,,,,,,,2946.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,964.25,22,,percent of total billed charges,,,3509.87,91,,percent of total billed charges,,,3664.15,95,,percent of total billed charges,,,3201.31,83,,percent of total billed charges,,,3201.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3201.31,83,,percent of total billed charges,,,3664.15,95,,percent of total billed charges,,,3471.3,90,,percent of total billed charges,,,3471.3,90,,percent of total billed charges,,,3162.74,82,,percent of total billed charges,,,3471.3,90,,percent of total billed charges,,,3278.45,85,,percent of total billed charges,,964.25,3664.15,
CT NECK W/O (SOFT TISSUE),29102061,CDM,70490,CPT,351,RC,outpatient,TC,3388,3388,,2876.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,847,22,,percent of total billed charges,,,,,,,,,3049.2,90,,percent of total billed charges,,,2805.26,82.8,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,,,,,,,,2981.44,88,,percent of total billed charges,,,,,,,,,2588.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,847,22,,percent of total billed charges,,,3083.08,91,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,,,,,,,,,,,,,2812.04,83,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2778.16,82,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,847,3218.6,
CT NECK W/WO(SOFTTISSUE),29102079,CDM,70492,CPT,351,RC,outpatient,TC,4527,4527,,3843.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1131.75,22,,percent of total billed charges,,,,,,,,,4074.3,90,,percent of total billed charges,,,3748.36,82.8,,percent of total billed charges,,,3847.95,85,,percent of total billed charges,,,,,,,,,3983.76,88,,percent of total billed charges,,,,,,,,,3458.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1131.75,22,,percent of total billed charges,,,4119.57,91,,percent of total billed charges,,,4300.65,95,,percent of total billed charges,,,3757.41,83,,percent of total billed charges,,,3757.41,83,,percent of total billed charges,,,,,,,,,,,,,,,3757.41,83,,percent of total billed charges,,,4300.65,95,,percent of total billed charges,,,4074.3,90,,percent of total billed charges,,,4074.3,90,,percent of total billed charges,,,3712.14,82,,percent of total billed charges,,,4074.3,90,,percent of total billed charges,,,3847.95,85,,percent of total billed charges,,1131.75,4300.65,
CT NECK W/(SOFT TISSUE),29102087,CDM,70491,CPT,351,RC,outpatient,TC,3920,3920,,3328.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,980,22,,percent of total billed charges,,,,,,,,,3528,90,,percent of total billed charges,,,3245.76,82.8,,percent of total billed charges,,,3332,85,,percent of total billed charges,,,,,,,,,3449.6,88,,percent of total billed charges,,,,,,,,,2994.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,980,22,,percent of total billed charges,,,3567.2,91,,percent of total billed charges,,,3724,95,,percent of total billed charges,,,3253.6,83,,percent of total billed charges,,,3253.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3253.6,83,,percent of total billed charges,,,3724,95,,percent of total billed charges,,,3528,90,,percent of total billed charges,,,3528,90,,percent of total billed charges,,,3214.4,82,,percent of total billed charges,,,3528,90,,percent of total billed charges,,,3332,85,,percent of total billed charges,,980,3724,
CT THORAX W/O DYE,29102095,CDM,71250,CPT,352,RC,outpatient,TC,3616,3616,,3069.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,904,22,,percent of total billed charges,,,,,,,,,3254.4,90,,percent of total billed charges,,,2994.05,82.8,,percent of total billed charges,,,3073.6,85,,percent of total billed charges,,,,,,,,,3182.08,88,,percent of total billed charges,,,,,,,,,2762.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,904,22,,percent of total billed charges,,,3290.56,91,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,,,,,,,,,,,,,3001.28,83,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,2965.12,82,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3073.6,85,,percent of total billed charges,,904,3435.2,
CT LOW DOSE LUNG SCREENING,29102096,CDM,71271,CPT,352,RC,outpatient,TC,3616,3616,,3069.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,904,22,,percent of total billed charges,,,,,,,,,3254.4,90,,percent of total billed charges,,,2994.05,82.8,,percent of total billed charges,,,3073.6,85,,percent of total billed charges,,,,,,,,,3182.08,88,,percent of total billed charges,,,,,,,,,2762.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,904,22,,percent of total billed charges,,,3290.56,91,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,,,,,,,,,,,,,3001.28,83,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,2965.12,82,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3073.6,85,,percent of total billed charges,,904,3435.2,
CT THORAX W/O & W/DYE,29102103,CDM,71270,CPT,352,RC,outpatient,TC,4849,4849,,4116.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1212.25,22,,percent of total billed charges,,,,,,,,,4364.1,90,,percent of total billed charges,,,4014.97,82.8,,percent of total billed charges,,,4121.65,85,,percent of total billed charges,,,,,,,,,4267.12,88,,percent of total billed charges,,,,,,,,,3704.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1212.25,22,,percent of total billed charges,,,4412.59,91,,percent of total billed charges,,,4606.55,95,,percent of total billed charges,,,4024.67,83,,percent of total billed charges,,,4024.67,83,,percent of total billed charges,,,,,,,,,,,,,,,4024.67,83,,percent of total billed charges,,,4606.55,95,,percent of total billed charges,,,4364.1,90,,percent of total billed charges,,,4364.1,90,,percent of total billed charges,,,3976.18,82,,percent of total billed charges,,,4364.1,90,,percent of total billed charges,,,4121.65,85,,percent of total billed charges,,1212.25,4606.55,
CT THORAX W/DYE,29102111,CDM,71260,CPT,352,RC,outpatient,TC,4379,4379,,3717.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1094.75,22,,percent of total billed charges,,,,,,,,,3941.1,90,,percent of total billed charges,,,3625.81,82.8,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,,,,,,,,3853.52,88,,percent of total billed charges,,,,,,,,,3345.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1094.75,22,,percent of total billed charges,,,3984.89,91,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,,,,,,,,,,,,,3634.57,83,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3590.78,82,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,1094.75,4160.05,
CT PELVIS W/O,29102129,CDM,72192,CPT,352,RC,outpatient,TC,3784,3784,,3212.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,946,22,,percent of total billed charges,,,,,,,,,3405.6,90,,percent of total billed charges,,,3133.15,82.8,,percent of total billed charges,,,3216.4,85,,percent of total billed charges,,,,,,,,,3329.92,88,,percent of total billed charges,,,,,,,,,2890.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,946,22,,percent of total billed charges,,,3443.44,91,,percent of total billed charges,,,3594.8,95,,percent of total billed charges,,,3140.72,83,,percent of total billed charges,,,3140.72,83,,percent of total billed charges,,,,,,,,,,,,,,,3140.72,83,,percent of total billed charges,,,3594.8,95,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3102.88,82,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3216.4,85,,percent of total billed charges,,946,3594.8,
CT PELVIS W/WO,29102137,CDM,72194,CPT,352,RC,outpatient,TC,5573,5573,,4731.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1393.25,22,,percent of total billed charges,,,,,,,,,5015.7,90,,percent of total billed charges,,,4614.44,82.8,,percent of total billed charges,,,4737.05,85,,percent of total billed charges,,,,,,,,,4904.24,88,,percent of total billed charges,,,,,,,,,4257.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1393.25,22,,percent of total billed charges,,,5071.43,91,,percent of total billed charges,,,5294.35,95,,percent of total billed charges,,,4625.59,83,,percent of total billed charges,,,4625.59,83,,percent of total billed charges,,,,,,,,,,,,,,,4625.59,83,,percent of total billed charges,,,5294.35,95,,percent of total billed charges,,,5015.7,90,,percent of total billed charges,,,5015.7,90,,percent of total billed charges,,,4569.86,82,,percent of total billed charges,,,5015.7,90,,percent of total billed charges,,,4737.05,85,,percent of total billed charges,,1393.25,5294.35,
CT PELVIS W/,29102145,CDM,72193,CPT,352,RC,outpatient,TC,4379,4379,,3717.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1094.75,22,,percent of total billed charges,,,,,,,,,3941.1,90,,percent of total billed charges,,,3625.81,82.8,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,,,,,,,,3853.52,88,,percent of total billed charges,,,,,,,,,3345.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1094.75,22,,percent of total billed charges,,,3984.89,91,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,3634.57,83,,percent of total billed charges,,,,,,,,,,,,,,,3634.57,83,,percent of total billed charges,,,4160.05,95,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3590.78,82,,percent of total billed charges,,,3941.1,90,,percent of total billed charges,,,3722.15,85,,percent of total billed charges,,1094.75,4160.05,
CT ABDOMEN W/O,29102152,CDM,74150,CPT,352,RC,outpatient,TC,3784,3784,,3212.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,946,22,,percent of total billed charges,,,,,,,,,3405.6,90,,percent of total billed charges,,,3133.15,82.8,,percent of total billed charges,,,3216.4,85,,percent of total billed charges,,,,,,,,,3329.92,88,,percent of total billed charges,,,,,,,,,2890.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,946,22,,percent of total billed charges,,,3443.44,91,,percent of total billed charges,,,3594.8,95,,percent of total billed charges,,,3140.72,83,,percent of total billed charges,,,3140.72,83,,percent of total billed charges,,,,,,,,,,,,,,,3140.72,83,,percent of total billed charges,,,3594.8,95,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3102.88,82,,percent of total billed charges,,,3405.6,90,,percent of total billed charges,,,3216.4,85,,percent of total billed charges,,946,3594.8,
CT ABDOMEN W/WO,29102160,CDM,74170,CPT,352,RC,outpatient,TC,5093,5093,,4323.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1273.25,22,,percent of total billed charges,,,,,,,,,4583.7,90,,percent of total billed charges,,,4217,82.8,,percent of total billed charges,,,4329.05,85,,percent of total billed charges,,,,,,,,,4481.84,88,,percent of total billed charges,,,,,,,,,3891.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1273.25,22,,percent of total billed charges,,,4634.63,91,,percent of total billed charges,,,4838.35,95,,percent of total billed charges,,,4227.19,83,,percent of total billed charges,,,4227.19,83,,percent of total billed charges,,,,,,,,,,,,,,,4227.19,83,,percent of total billed charges,,,4838.35,95,,percent of total billed charges,,,4583.7,90,,percent of total billed charges,,,4583.7,90,,percent of total billed charges,,,4176.26,82,,percent of total billed charges,,,4583.7,90,,percent of total billed charges,,,4329.05,85,,percent of total billed charges,,1273.25,4838.35,
CT ABDOMEN W/,29102178,CDM,74160,CPT,352,RC,outpatient,TC,4404,4404,,3739,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1101,22,,percent of total billed charges,,,,,,,,,3963.6,90,,percent of total billed charges,,,3646.51,82.8,,percent of total billed charges,,,3743.4,85,,percent of total billed charges,,,,,,,,,3875.52,88,,percent of total billed charges,,,,,,,,,3364.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1101,22,,percent of total billed charges,,,4007.64,91,,percent of total billed charges,,,4183.8,95,,percent of total billed charges,,,3655.32,83,,percent of total billed charges,,,3655.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3655.32,83,,percent of total billed charges,,,4183.8,95,,percent of total billed charges,,,3963.6,90,,percent of total billed charges,,,3963.6,90,,percent of total billed charges,,,3611.28,82,,percent of total billed charges,,,3963.6,90,,percent of total billed charges,,,3743.4,85,,percent of total billed charges,,1101,4183.8,
CT L SPINE W/O,29102186,CDM,72131,CPT,352,RC,outpatient,TC,3830,3830,,3251.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,957.5,22,,percent of total billed charges,,,,,,,,,3447,90,,percent of total billed charges,,,3171.24,82.8,,percent of total billed charges,,,3255.5,85,,percent of total billed charges,,,,,,,,,3370.4,88,,percent of total billed charges,,,,,,,,,2926.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,957.5,22,,percent of total billed charges,,,3485.3,91,,percent of total billed charges,,,3638.5,95,,percent of total billed charges,,,3178.9,83,,percent of total billed charges,,,3178.9,83,,percent of total billed charges,,,,,,,,,,,,,,,3178.9,83,,percent of total billed charges,,,3638.5,95,,percent of total billed charges,,,3447,90,,percent of total billed charges,,,3447,90,,percent of total billed charges,,,3140.6,82,,percent of total billed charges,,,3447,90,,percent of total billed charges,,,3255.5,85,,percent of total billed charges,,957.5,3638.5,
CT L SPINE W/WO,29102194,CDM,72133,CPT,352,RC,outpatient,,4967,4967,,4216.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1241.75,22,,percent of total billed charges,,,,,,,,,4470.3,90,,percent of total billed charges,,,4112.68,82.8,,percent of total billed charges,,,4221.95,85,,percent of total billed charges,,,,,,,,,4370.96,88,,percent of total billed charges,,,,,,,,,3794.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1241.75,22,,percent of total billed charges,,,4519.97,91,,percent of total billed charges,,,4718.65,95,,percent of total billed charges,,,4122.61,83,,percent of total billed charges,,,4122.61,83,,percent of total billed charges,,,,,,,,,,,,,,,4122.61,83,,percent of total billed charges,,,4718.65,95,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4072.94,82,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4221.95,85,,percent of total billed charges,,1241.75,4718.65,
CT L SPINE W,29102202,CDM,72132,CPT,352,RC,outpatient,,4470,4470,,3795.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1117.5,22,,percent of total billed charges,,,,,,,,,4023,90,,percent of total billed charges,,,3701.16,82.8,,percent of total billed charges,,,3799.5,85,,percent of total billed charges,,,,,,,,,3933.6,88,,percent of total billed charges,,,,,,,,,3415.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1117.5,22,,percent of total billed charges,,,4067.7,91,,percent of total billed charges,,,4246.5,95,,percent of total billed charges,,,3710.1,83,,percent of total billed charges,,,3710.1,83,,percent of total billed charges,,,,,,,,,,,,,,,3710.1,83,,percent of total billed charges,,,4246.5,95,,percent of total billed charges,,,4023,90,,percent of total billed charges,,,4023,90,,percent of total billed charges,,,3665.4,82,,percent of total billed charges,,,4023,90,,percent of total billed charges,,,3799.5,85,,percent of total billed charges,,1117.5,4246.5,
CT IAC W/O,29102228,CDM,70480,CPT,351,RC,outpatient,TC,3405,3405,,2890.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,851.25,22,,percent of total billed charges,,,,,,,,,3064.5,90,,percent of total billed charges,,,2819.34,82.8,,percent of total billed charges,,,2894.25,85,,percent of total billed charges,,,,,,,,,2996.4,88,,percent of total billed charges,,,,,,,,,2601.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,851.25,22,,percent of total billed charges,,,3098.55,91,,percent of total billed charges,,,3234.75,95,,percent of total billed charges,,,2826.15,83,,percent of total billed charges,,,2826.15,83,,percent of total billed charges,,,,,,,,,,,,,,,2826.15,83,,percent of total billed charges,,,3234.75,95,,percent of total billed charges,,,3064.5,90,,percent of total billed charges,,,3064.5,90,,percent of total billed charges,,,2792.1,82,,percent of total billed charges,,,3064.5,90,,percent of total billed charges,,,2894.25,85,,percent of total billed charges,,851.25,3234.75,
CT C SPINE W/WO,29102251,CDM,72127,CPT,352,RC,outpatient,,4967,4967,,4216.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1241.75,22,,percent of total billed charges,,,,,,,,,4470.3,90,,percent of total billed charges,,,4112.68,82.8,,percent of total billed charges,,,4221.95,85,,percent of total billed charges,,,,,,,,,4370.96,88,,percent of total billed charges,,,,,,,,,3794.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1241.75,22,,percent of total billed charges,,,4519.97,91,,percent of total billed charges,,,4718.65,95,,percent of total billed charges,,,4122.61,83,,percent of total billed charges,,,4122.61,83,,percent of total billed charges,,,,,,,,,,,,,,,4122.61,83,,percent of total billed charges,,,4718.65,95,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4072.94,82,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4221.95,85,,percent of total billed charges,,1241.75,4718.65,
CT UP EXT LT W,29102269,CDM,73201,CPT,350,RC,outpatient,,4016,4016,,3409.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1004,22,,percent of total billed charges,,,,,,,,,3614.4,90,,percent of total billed charges,,,3325.25,82.8,,percent of total billed charges,,,3413.6,85,,percent of total billed charges,,,,,,,,,3534.08,88,,percent of total billed charges,,,,,,,,,3068.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1004,22,,percent of total billed charges,,,3654.56,91,,percent of total billed charges,,,3815.2,95,,percent of total billed charges,,,3333.28,83,,percent of total billed charges,,,3333.28,83,,percent of total billed charges,,,,,,,,,,,,,,,3333.28,83,,percent of total billed charges,,,3815.2,95,,percent of total billed charges,,,3614.4,90,,percent of total billed charges,,,3614.4,90,,percent of total billed charges,,,3293.12,82,,percent of total billed charges,,,3614.4,90,,percent of total billed charges,,,3413.6,85,,percent of total billed charges,,1004,3815.2,
CT UP EXT RT W,29102270,CDM,73201,CPT,350,RC,outpatient,TC,4016,4016,,3409.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1004,22,,percent of total billed charges,,,,,,,,,3614.4,90,,percent of total billed charges,,,3325.25,82.8,,percent of total billed charges,,,3413.6,85,,percent of total billed charges,,,,,,,,,3534.08,88,,percent of total billed charges,,,,,,,,,3068.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1004,22,,percent of total billed charges,,,3654.56,91,,percent of total billed charges,,,3815.2,95,,percent of total billed charges,,,3333.28,83,,percent of total billed charges,,,3333.28,83,,percent of total billed charges,,,,,,,,,,,,,,,3333.28,83,,percent of total billed charges,,,3815.2,95,,percent of total billed charges,,,3614.4,90,,percent of total billed charges,,,3614.4,90,,percent of total billed charges,,,3293.12,82,,percent of total billed charges,,,3614.4,90,,percent of total billed charges,,,3413.6,85,,percent of total billed charges,,1004,3815.2,
CT T SPINE W/WO,29102277,CDM,72130,CPT,352,RC,outpatient,,4967,4967,,4216.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1241.75,22,,percent of total billed charges,,,,,,,,,4470.3,90,,percent of total billed charges,,,4112.68,82.8,,percent of total billed charges,,,4221.95,85,,percent of total billed charges,,,,,,,,,4370.96,88,,percent of total billed charges,,,,,,,,,3794.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1241.75,22,,percent of total billed charges,,,4519.97,91,,percent of total billed charges,,,4718.65,95,,percent of total billed charges,,,4122.61,83,,percent of total billed charges,,,4122.61,83,,percent of total billed charges,,,,,,,,,,,,,,,4122.61,83,,percent of total billed charges,,,4718.65,95,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4072.94,82,,percent of total billed charges,,,4470.3,90,,percent of total billed charges,,,4221.95,85,,percent of total billed charges,,1241.75,4718.65,
CT UP EXT LEFT W/O,29102285,CDM,73200,CPT,350,RC,outpatient,LT,3388,3388,,2876.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,847,22,,percent of total billed charges,,,,,,,,,3049.2,90,,percent of total billed charges,,,2805.26,82.8,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,,,,,,,,2981.44,88,,percent of total billed charges,,,,,,,,,2588.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,847,22,,percent of total billed charges,,,3083.08,91,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,,,,,,,,,,,,,2812.04,83,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2778.16,82,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,847,3218.6,
CT UP EXT RIGHT W/O,29102286,CDM,73200,CPT,350,RC,outpatient,RT,3388,3388,,2876.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,847,22,,percent of total billed charges,,,,,,,,,3049.2,90,,percent of total billed charges,,,2805.26,82.8,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,,,,,,,,2981.44,88,,percent of total billed charges,,,,,,,,,2588.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,847,22,,percent of total billed charges,,,3083.08,91,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,,,,,,,,,,,,,2812.04,83,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2778.16,82,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,847,3218.6,
CT T SPINE W,29102293,CDM,72129,CPT,352,RC,outpatient,TC,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1097.75,22,,percent of total billed charges,,,,,,,,,3951.9,90,,percent of total billed charges,,,3635.75,82.8,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1097.75,22,,percent of total billed charges,,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,1097.75,4171.45,
CT SINUSES W/O,29102301,CDM,70486,CPT,351,RC,outpatient,TC,3616,3616,,3069.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,904,22,,percent of total billed charges,,,,,,,,,3254.4,90,,percent of total billed charges,,,2994.05,82.8,,percent of total billed charges,,,3073.6,85,,percent of total billed charges,,,,,,,,,3182.08,88,,percent of total billed charges,,,,,,,,,2762.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,904,22,,percent of total billed charges,,,3290.56,91,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,,,,,,,,,,,,,3001.28,83,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,2965.12,82,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3073.6,85,,percent of total billed charges,,904,3435.2,
CT SINUSES W/,29102302,CDM,70487,CPT,350,RC,outpatient,,3842,3842,,3261.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,960.5,22,,percent of total billed charges,,,,,,,,,3457.8,90,,percent of total billed charges,,,3181.18,82.8,,percent of total billed charges,,,3265.7,85,,percent of total billed charges,,,,,,,,,3380.96,88,,percent of total billed charges,,,,,,,,,2935.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,960.5,22,,percent of total billed charges,,,3496.22,91,,percent of total billed charges,,,3649.9,95,,percent of total billed charges,,,3188.86,83,,percent of total billed charges,,,3188.86,83,,percent of total billed charges,,,,,,,,,,,,,,,3188.86,83,,percent of total billed charges,,,3649.9,95,,percent of total billed charges,,,3457.8,90,,percent of total billed charges,,,3457.8,90,,percent of total billed charges,,,3150.44,82,,percent of total billed charges,,,3457.8,90,,percent of total billed charges,,,3265.7,85,,percent of total billed charges,,960.5,3649.9,
CT SINUSES W/WO,29102303,CDM,70488,CPT,350,RC,outpatient,TC,4391,4391,,3727.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1097.75,22,,percent of total billed charges,,,,,,,,,3951.9,90,,percent of total billed charges,,,3635.75,82.8,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,,,,,,,,3864.08,88,,percent of total billed charges,,,,,,,,,3354.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1097.75,22,,percent of total billed charges,,,3995.81,91,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,3644.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3644.53,83,,percent of total billed charges,,,4171.45,95,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3600.62,82,,percent of total billed charges,,,3951.9,90,,percent of total billed charges,,,3732.35,85,,percent of total billed charges,,1097.75,4171.45,
CT PARACENTESIS W/IMAGING,29102349,CDM,49083,CPT,360,RC,outpatient,TC,2973,2973,,2524.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,743.25,22,,percent of total billed charges,,,,,,,,,2675.7,90,,percent of total billed charges,,,2461.64,82.8,,percent of total billed charges,,,2527.05,85,,percent of total billed charges,,,,,,,,,2616.24,88,,percent of total billed charges,,,,,,,,,2271.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,743.25,22,,percent of total billed charges,,,2705.43,91,,percent of total billed charges,,,2824.35,95,,percent of total billed charges,,,2467.59,83,,percent of total billed charges,,,2467.59,83,,percent of total billed charges,,,,,,,,,,,,,,,2467.59,83,,percent of total billed charges,,,2824.35,95,,percent of total billed charges,,,2675.7,90,,percent of total billed charges,,,2675.7,90,,percent of total billed charges,,,2437.86,82,,percent of total billed charges,,,2675.7,90,,percent of total billed charges,,,2527.05,85,,percent of total billed charges,,743.25,2824.35,
CT PANCREAS BX,29102350,CDM,48102,CPT,360,RC,outpatient,TC,3989,3989,,3386.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,997.25,22,,percent of total billed charges,,,,,,,,,3590.1,90,,percent of total billed charges,,,3302.89,82.8,,percent of total billed charges,,,3390.65,85,,percent of total billed charges,,,,,,,,,3510.32,88,,percent of total billed charges,,,,,,,,,3047.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,997.25,22,,percent of total billed charges,,,3629.99,91,,percent of total billed charges,,,3789.55,95,,percent of total billed charges,,,3310.87,83,,percent of total billed charges,,,3310.87,83,,percent of total billed charges,,,,,,,,,,,,,,,3310.87,83,,percent of total billed charges,,,3789.55,95,,percent of total billed charges,,,3590.1,90,,percent of total billed charges,,,3590.1,90,,percent of total billed charges,,,3270.98,82,,percent of total billed charges,,,3590.1,90,,percent of total billed charges,,,3390.65,85,,percent of total billed charges,,997.25,3789.55,
CT LOW EXT LEFT W/O,29104166,CDM,73700,CPT,350,RC,outpatient,LT,3388,3388,,2876.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,847,22,,percent of total billed charges,,,,,,,,,3049.2,90,,percent of total billed charges,,,2805.26,82.8,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,,,,,,,,2981.44,88,,percent of total billed charges,,,,,,,,,2588.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,847,22,,percent of total billed charges,,,3083.08,91,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,,,,,,,,,,,,,2812.04,83,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2778.16,82,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,847,3218.6,
CT LOW EXT RIGHT W/O,29104167,CDM,73700,CPT,350,RC,outpatient,RT,3388,3388,,2876.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,847,22,,percent of total billed charges,,,,,,,,,3049.2,90,,percent of total billed charges,,,2805.26,82.8,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,,,,,,,,2981.44,88,,percent of total billed charges,,,,,,,,,2588.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,847,22,,percent of total billed charges,,,3083.08,91,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,2812.04,83,,percent of total billed charges,,,,,,,,,,,,,,,2812.04,83,,percent of total billed charges,,,3218.6,95,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2778.16,82,,percent of total billed charges,,,3049.2,90,,percent of total billed charges,,,2879.8,85,,percent of total billed charges,,847,3218.6,
CT GUIDED THORACENTESIS,29104170,CDM,,,352,RC,outpatient,,2965,2965,,2517.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,741.25,22,,percent of total billed charges,,,,,,,,,2668.5,90,,percent of total billed charges,,,2455.02,82.8,,percent of total billed charges,,,2520.25,85,,percent of total billed charges,,,,,,,,,2609.2,88,,percent of total billed charges,,,,,,,,,2265.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,741.25,22,,percent of total billed charges,,,2698.15,91,,percent of total billed charges,,,2816.75,95,,percent of total billed charges,,,2460.95,83,,percent of total billed charges,,,2460.95,83,,percent of total billed charges,,,,,,,,,,,,,,,2460.95,83,,percent of total billed charges,,,2816.75,95,,percent of total billed charges,,,2668.5,90,,percent of total billed charges,,,2668.5,90,,percent of total billed charges,,,2431.3,82,,percent of total billed charges,,,2668.5,90,,percent of total billed charges,,,2520.25,85,,percent of total billed charges,,741.25,2816.75,
CT SCLEROTHERAPY FLUID COLLECTION W/IMG,29104171,CDM,49185,CPT,360,RC,outpatient,,3574,3574,,3034.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,893.5,22,,percent of total billed charges,,,,,,,,,3216.6,90,,percent of total billed charges,,,2959.27,82.8,,percent of total billed charges,,,3037.9,85,,percent of total billed charges,,,,,,,,,3145.12,88,,percent of total billed charges,,,,,,,,,2730.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,893.5,22,,percent of total billed charges,,,3252.34,91,,percent of total billed charges,,,3395.3,95,,percent of total billed charges,,,2966.42,83,,percent of total billed charges,,,2966.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2966.42,83,,percent of total billed charges,,,3395.3,95,,percent of total billed charges,,,3216.6,90,,percent of total billed charges,,,3216.6,90,,percent of total billed charges,,,2930.68,82,,percent of total billed charges,,,3216.6,90,,percent of total billed charges,,,3037.9,85,,percent of total billed charges,,893.5,3395.3,
CT SI JTARTHOSTEROIDINJRT,29104180,CDM,27096,CPT,350,RC,outpatient,RT,1757,1757,,1491.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,439.25,22,,percent of total billed charges,,,,,,,,,1581.3,90,,percent of total billed charges,,,1454.8,82.8,,percent of total billed charges,,,1493.45,85,,percent of total billed charges,,,,,,,,,1546.16,88,,percent of total billed charges,,,,,,,,,1342.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,439.25,22,,percent of total billed charges,,,1598.87,91,,percent of total billed charges,,,1669.15,95,,percent of total billed charges,,,1458.31,83,,percent of total billed charges,,,1458.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1458.31,83,,percent of total billed charges,,,1669.15,95,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1440.74,82,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1493.45,85,,percent of total billed charges,,439.25,1669.15,
CT SI JTARTHOSTEROIDINJLT,29104181,CDM,27096,CPT,350,RC,outpatient,LT,1757,1757,,1491.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,439.25,22,,percent of total billed charges,,,,,,,,,1581.3,90,,percent of total billed charges,,,1454.8,82.8,,percent of total billed charges,,,1493.45,85,,percent of total billed charges,,,,,,,,,1546.16,88,,percent of total billed charges,,,,,,,,,1342.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,439.25,22,,percent of total billed charges,,,1598.87,91,,percent of total billed charges,,,1669.15,95,,percent of total billed charges,,,1458.31,83,,percent of total billed charges,,,1458.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1458.31,83,,percent of total billed charges,,,1669.15,95,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1440.74,82,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1493.45,85,,percent of total billed charges,,439.25,1669.15,
CT SI JTARTHOSTEROIDINJBIL,29104182,CDM,27096,CPT,350,RC,outpatient,50,3513,3513,,2982.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,878.25,22,,percent of total billed charges,,,,,,,,,3161.7,90,,percent of total billed charges,,,2908.76,82.8,,percent of total billed charges,,,2986.05,85,,percent of total billed charges,,,,,,,,,3091.44,88,,percent of total billed charges,,,,,,,,,2683.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,878.25,22,,percent of total billed charges,,,3196.83,91,,percent of total billed charges,,,3337.35,95,,percent of total billed charges,,,2915.79,83,,percent of total billed charges,,,2915.79,83,,percent of total billed charges,,,,,,,,,,,,,,,2915.79,83,,percent of total billed charges,,,3337.35,95,,percent of total billed charges,,,3161.7,90,,percent of total billed charges,,,3161.7,90,,percent of total billed charges,,,2880.66,82,,percent of total billed charges,,,3161.7,90,,percent of total billed charges,,,2986.05,85,,percent of total billed charges,,878.25,3337.35,
CT LOW EXT BILATERAL W/O,29104199,CDM,73700,CPT,350,RC,outpatient,50,6647,6647,,5643.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1661.75,22,,percent of total billed charges,,,,,,,,,5982.3,90,,percent of total billed charges,,,5503.72,82.8,,percent of total billed charges,,,5649.95,85,,percent of total billed charges,,,,,,,,,5849.36,88,,percent of total billed charges,,,,,,,,,5078.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1661.75,22,,percent of total billed charges,,,6048.77,91,,percent of total billed charges,,,6314.65,95,,percent of total billed charges,,,5517.01,83,,percent of total billed charges,,,5517.01,83,,percent of total billed charges,,,,,,,,,,,,,,,5517.01,83,,percent of total billed charges,,,6314.65,95,,percent of total billed charges,,,5982.3,90,,percent of total billed charges,,,5982.3,90,,percent of total billed charges,,,5450.54,82,,percent of total billed charges,,,5982.3,90,,percent of total billed charges,,,5649.95,85,,percent of total billed charges,,1661.75,6314.65,
CT INSERTION OF SUPRAPUBIC CATH,29104200,CDM,51102,CPT,360,RC,outpatient,TC,8003,8003,,6794.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2000.75,22,,percent of total billed charges,,,,,,,,,7202.7,90,,percent of total billed charges,,,6626.48,82.8,,percent of total billed charges,,,6802.55,85,,percent of total billed charges,,,,,,,,,7042.64,88,,percent of total billed charges,,,,,,,,,6114.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2000.75,22,,percent of total billed charges,,,7282.73,91,,percent of total billed charges,,,7602.85,95,,percent of total billed charges,,,6642.49,83,,percent of total billed charges,,,6642.49,83,,percent of total billed charges,,,,,,,,,,,,,,,6642.49,83,,percent of total billed charges,,,7602.85,95,,percent of total billed charges,,,7202.7,90,,percent of total billed charges,,,7202.7,90,,percent of total billed charges,,,6562.46,82,,percent of total billed charges,,,7202.7,90,,percent of total billed charges,,,6802.55,85,,percent of total billed charges,,2000.75,7602.85,
CT CARDIAC SCORING,29523668,CDM,75571,CPT,352,RC,outpatient,TC,101,101,,85.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.25,22,,percent of total billed charges,,,,,,,,,90.9,90,,percent of total billed charges,,,83.63,82.8,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,,,,,,,,88.88,88,,percent of total billed charges,,,,,,,,,77.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.25,22,,percent of total billed charges,,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,82.82,82,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,25.25,95.95,
PROCEDURE TRAY,932510,CDM,,,270,RC,outpatient,,118,118,,100.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.5,22,,percent of total billed charges,,,,,,,,,106.2,90,,percent of total billed charges,,,97.7,82.8,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,,,,,,,,103.84,88,,percent of total billed charges,,,,,,,,,90.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.5,22,,percent of total billed charges,,,107.38,91,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,,,,,,,,,,,,,97.94,83,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,96.76,82,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,29.5,112.1,
DELIVERY INSTRUMENTS,2332600,CDM,,,270,RC,outpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
PEEP VALVE,2382047,CDM,,,270,RC,outpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.75,22,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,42.23,82.8,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.75,22,,percent of total billed charges,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,12.75,48.45,
PUMP BREAST HAND HELD,8300001,CDM,,,270,RC,outpatient,,215,215,,182.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.75,22,,percent of total billed charges,,,,,,,,,193.5,90,,percent of total billed charges,,,178.02,82.8,,percent of total billed charges,,,182.75,85,,percent of total billed charges,,,,,,,,,189.2,88,,percent of total billed charges,,,,,,,,,164.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.75,22,,percent of total billed charges,,,195.65,91,,percent of total billed charges,,,204.25,95,,percent of total billed charges,,,178.45,83,,percent of total billed charges,,,178.45,83,,percent of total billed charges,,,,,,,,,,,,,,,178.45,83,,percent of total billed charges,,,204.25,95,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,176.3,82,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,182.75,85,,percent of total billed charges,,53.75,204.25,
CPAP MASK,12801191,CDM,,,270,RC,outpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.5,22,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,64.58,82.8,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.5,22,,percent of total billed charges,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,19.5,74.1,
MDI SPACER,12801670,CDM,,,270,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
DISPOSABLE OXYHOOD,12802210,CDM,,,270,RC,outpatient,,56,56,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14,22,,percent of total billed charges,,,,,,,,,50.4,90,,percent of total billed charges,,,46.37,82.8,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,,,,,,,,49.28,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14,22,,percent of total billed charges,,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,45.92,82,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,14,53.2,
POSTOP EYE KIT,18300271,CDM,,,270,RC,outpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.75,22,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,45.54,82.8,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.75,22,,percent of total billed charges,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,13.75,52.25,
S&N CONQUEST FX FEM COMP SZ13,18300285,CDM,,,278,RC,outpatient,,9315.28,9315.28,,7908.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2328.82,22,,percent of total billed charges,,,,,,,,,8383.75,90,,percent of total billed charges,,,7713.05,82.8,,percent of total billed charges,,,7917.99,85,,percent of total billed charges,,,,,,,,,8197.45,88,,percent of total billed charges,,,,,,,,,7116.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2328.82,22,,percent of total billed charges,,,8476.9,91,,percent of total billed charges,,,8849.52,95,,percent of total billed charges,,,7731.68,83,,percent of total billed charges,,,7731.68,83,,percent of total billed charges,,,,,,,,,,,,,,,7731.68,83,,percent of total billed charges,,,8849.52,95,,percent of total billed charges,,,8383.75,90,,percent of total billed charges,,,8383.75,90,,percent of total billed charges,,,7638.53,82,,percent of total billed charges,,,8383.75,90,,percent of total billed charges,,,7917.99,85,,percent of total billed charges,,2328.82,8849.52,
RETRACTOR C-SECTION LGE 9 x 14,18300287,CDM,,,270,RC,outpatient,,602,602,,511.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.5,22,,percent of total billed charges,,,,,,,,,541.8,90,,percent of total billed charges,,,498.46,82.8,,percent of total billed charges,,,511.7,85,,percent of total billed charges,,,,,,,,,529.76,88,,percent of total billed charges,,,,,,,,,459.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.5,22,,percent of total billed charges,,,547.82,91,,percent of total billed charges,,,571.9,95,,percent of total billed charges,,,499.66,83,,percent of total billed charges,,,499.66,83,,percent of total billed charges,,,,,,,,,,,,,,,499.66,83,,percent of total billed charges,,,571.9,95,,percent of total billed charges,,,541.8,90,,percent of total billed charges,,,541.8,90,,percent of total billed charges,,,493.64,82,,percent of total billed charges,,,541.8,90,,percent of total billed charges,,,511.7,85,,percent of total billed charges,,150.5,571.9,
RETRACTOR C-SECTION XLG 11 x 17,18300288,CDM,,,270,RC,outpatient,,623,623,,528.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,155.75,22,,percent of total billed charges,,,,,,,,,560.7,90,,percent of total billed charges,,,515.84,82.8,,percent of total billed charges,,,529.55,85,,percent of total billed charges,,,,,,,,,548.24,88,,percent of total billed charges,,,,,,,,,475.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,155.75,22,,percent of total billed charges,,,566.93,91,,percent of total billed charges,,,591.85,95,,percent of total billed charges,,,517.09,83,,percent of total billed charges,,,517.09,83,,percent of total billed charges,,,,,,,,,,,,,,,517.09,83,,percent of total billed charges,,,591.85,95,,percent of total billed charges,,,560.7,90,,percent of total billed charges,,,560.7,90,,percent of total billed charges,,,510.86,82,,percent of total billed charges,,,560.7,90,,percent of total billed charges,,,529.55,85,,percent of total billed charges,,155.75,591.85,
LEEP SQUARE ELECTRODE,18300289,CDM,,,270,RC,outpatient,,189.6,189.6,,160.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.4,22,,percent of total billed charges,,,,,,,,,170.64,90,,percent of total billed charges,,,156.99,82.8,,percent of total billed charges,,,161.16,85,,percent of total billed charges,,,,,,,,,166.85,88,,percent of total billed charges,,,,,,,,,144.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.4,22,,percent of total billed charges,,,172.54,91,,percent of total billed charges,,,180.12,95,,percent of total billed charges,,,157.37,83,,percent of total billed charges,,,157.37,83,,percent of total billed charges,,,,,,,,,,,,,,,157.37,83,,percent of total billed charges,,,180.12,95,,percent of total billed charges,,,170.64,90,,percent of total billed charges,,,170.64,90,,percent of total billed charges,,,155.47,82,,percent of total billed charges,,,170.64,90,,percent of total billed charges,,,161.16,85,,percent of total billed charges,,47.4,180.12,
LEEP BALL ELECTRODE,18300290,CDM,,,270,RC,outpatient,,189.68,189.68,,161.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.42,22,,percent of total billed charges,,,,,,,,,170.71,90,,percent of total billed charges,,,157.06,82.8,,percent of total billed charges,,,161.23,85,,percent of total billed charges,,,,,,,,,166.92,88,,percent of total billed charges,,,,,,,,,144.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.42,22,,percent of total billed charges,,,172.61,91,,percent of total billed charges,,,180.2,95,,percent of total billed charges,,,157.43,83,,percent of total billed charges,,,157.43,83,,percent of total billed charges,,,,,,,,,,,,,,,157.43,83,,percent of total billed charges,,,180.2,95,,percent of total billed charges,,,170.71,90,,percent of total billed charges,,,170.71,90,,percent of total billed charges,,,155.54,82,,percent of total billed charges,,,170.71,90,,percent of total billed charges,,,161.23,85,,percent of total billed charges,,47.42,180.2,
LEEP RADIUS ELECTRODE 20 X 10,18300291,CDM,,,270,RC,outpatient,,185.06,185.06,,157.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.27,22,,percent of total billed charges,,,,,,,,,166.55,90,,percent of total billed charges,,,153.23,82.8,,percent of total billed charges,,,157.3,85,,percent of total billed charges,,,,,,,,,162.85,88,,percent of total billed charges,,,,,,,,,141.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.27,22,,percent of total billed charges,,,168.4,91,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,,,,,,,,,,,,,153.6,83,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,151.75,82,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,157.3,85,,percent of total billed charges,,46.27,175.81,
NEEDLE BIOPSY TRU CUT 18G X 6,18300295,CDM,,,270,RC,outpatient,,124.08,124.08,,105.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.02,22,,percent of total billed charges,,,,,,,,,111.67,90,,percent of total billed charges,,,102.74,82.8,,percent of total billed charges,,,105.47,85,,percent of total billed charges,,,,,,,,,109.19,88,,percent of total billed charges,,,,,,,,,94.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.02,22,,percent of total billed charges,,,112.91,91,,percent of total billed charges,,,117.88,95,,percent of total billed charges,,,102.99,83,,percent of total billed charges,,,102.99,83,,percent of total billed charges,,,,,,,,,,,,,,,102.99,83,,percent of total billed charges,,,117.88,95,,percent of total billed charges,,,111.67,90,,percent of total billed charges,,,111.67,90,,percent of total billed charges,,,101.75,82,,percent of total billed charges,,,111.67,90,,percent of total billed charges,,,105.47,85,,percent of total billed charges,,31.02,117.88,
LEEP RADIUS ELECTRODE 2.0 X 0.8,18300296,CDM,,,270,RC,outpatient,,185.06,185.06,,157.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.27,22,,percent of total billed charges,,,,,,,,,166.55,90,,percent of total billed charges,,,153.23,82.8,,percent of total billed charges,,,157.3,85,,percent of total billed charges,,,,,,,,,162.85,88,,percent of total billed charges,,,,,,,,,141.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.27,22,,percent of total billed charges,,,168.4,91,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,,,,,,,,,,,,,153.6,83,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,151.75,82,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,157.3,85,,percent of total billed charges,,46.27,175.81,
LEEP RADIUS ELECTRODE 1.5 X .5CM,18300297,CDM,,,270,RC,outpatient,,185.06,185.06,,157.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.27,22,,percent of total billed charges,,,,,,,,,166.55,90,,percent of total billed charges,,,153.23,82.8,,percent of total billed charges,,,157.3,85,,percent of total billed charges,,,,,,,,,162.85,88,,percent of total billed charges,,,,,,,,,141.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.27,22,,percent of total billed charges,,,168.4,91,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,,,,,,,,,,,,,153.6,83,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,151.75,82,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,157.3,85,,percent of total billed charges,,46.27,175.81,
VIGILON WOUND DRESSING,18304053,CDM,,,270,RC,outpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.75,22,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,48.85,82.8,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,,,,,,,,51.92,88,,percent of total billed charges,,,,,,,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.75,22,,percent of total billed charges,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,14.75,56.05,
ENDO TROCAR GRIP       0,18307744,CDM,,,270,RC,outpatient,,30,30,,25.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.5,22,,percent of total billed charges,,,,,,,,,27,90,,percent of total billed charges,,,24.84,82.8,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,,,,,,,,26.4,88,,percent of total billed charges,,,,,,,,,22.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.5,22,,percent of total billed charges,,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,24.9,83,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,24.6,82,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,7.5,28.5,
Q HIP REFLECTION LINER (REG),18307928,CDM,,,270,RC,outpatient,,2209,2209,,1875.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,552.25,22,,percent of total billed charges,,,,,,,,,1988.1,90,,percent of total billed charges,,,1829.05,82.8,,percent of total billed charges,,,1877.65,85,,percent of total billed charges,,,,,,,,,1943.92,88,,percent of total billed charges,,,,,,,,,1687.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,552.25,22,,percent of total billed charges,,,2010.19,91,,percent of total billed charges,,,2098.55,95,,percent of total billed charges,,,1833.47,83,,percent of total billed charges,,,1833.47,83,,percent of total billed charges,,,,,,,,,,,,,,,1833.47,83,,percent of total billed charges,,,2098.55,95,,percent of total billed charges,,,1988.1,90,,percent of total billed charges,,,1988.1,90,,percent of total billed charges,,,1811.38,82,,percent of total billed charges,,,1988.1,90,,percent of total billed charges,,,1877.65,85,,percent of total billed charges,,552.25,2098.55,
Q HIP REFLECTION CUP,18307929,CDM,,,270,RC,outpatient,,5099,5099,,4329.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1274.75,22,,percent of total billed charges,,,,,,,,,4589.1,90,,percent of total billed charges,,,4221.97,82.8,,percent of total billed charges,,,4334.15,85,,percent of total billed charges,,,,,,,,,4487.12,88,,percent of total billed charges,,,,,,,,,3895.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1274.75,22,,percent of total billed charges,,,4640.09,91,,percent of total billed charges,,,4844.05,95,,percent of total billed charges,,,4232.17,83,,percent of total billed charges,,,4232.17,83,,percent of total billed charges,,,,,,,,,,,,,,,4232.17,83,,percent of total billed charges,,,4844.05,95,,percent of total billed charges,,,4589.1,90,,percent of total billed charges,,,4589.1,90,,percent of total billed charges,,,4181.18,82,,percent of total billed charges,,,4589.1,90,,percent of total billed charges,,,4334.15,85,,percent of total billed charges,,1274.75,4844.05,
Q UNIVERSAL BI-POLAR 45 MM OD,18307932,CDM,,,270,RC,outpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.75,22,,percent of total billed charges,,,,,,,,,236.7,90,,percent of total billed charges,,,217.76,82.8,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.75,22,,percent of total billed charges,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,65.75,249.85,
Q HIP BIPOLAR UNIV. SHELL,18307933,CDM,,,270,RC,outpatient,,4565,4565,,3875.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1141.25,22,,percent of total billed charges,,,,,,,,,4108.5,90,,percent of total billed charges,,,3779.82,82.8,,percent of total billed charges,,,3880.25,85,,percent of total billed charges,,,,,,,,,4017.2,88,,percent of total billed charges,,,,,,,,,3487.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1141.25,22,,percent of total billed charges,,,4154.15,91,,percent of total billed charges,,,4336.75,95,,percent of total billed charges,,,3788.95,83,,percent of total billed charges,,,3788.95,83,,percent of total billed charges,,,,,,,,,,,,,,,3788.95,83,,percent of total billed charges,,,4336.75,95,,percent of total billed charges,,,4108.5,90,,percent of total billed charges,,,4108.5,90,,percent of total billed charges,,,3743.3,82,,percent of total billed charges,,,4108.5,90,,percent of total billed charges,,,3880.25,85,,percent of total billed charges,,1141.25,4336.75,
SHELL,18307934,CDM,,,270,RC,outpatient,,1646,1646,,1397.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,411.5,22,,percent of total billed charges,,,,,,,,,1481.4,90,,percent of total billed charges,,,1362.89,82.8,,percent of total billed charges,,,1399.1,85,,percent of total billed charges,,,,,,,,,1448.48,88,,percent of total billed charges,,,,,,,,,1257.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,411.5,22,,percent of total billed charges,,,1497.86,91,,percent of total billed charges,,,1563.7,95,,percent of total billed charges,,,1366.18,83,,percent of total billed charges,,,1366.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1366.18,83,,percent of total billed charges,,,1563.7,95,,percent of total billed charges,,,1481.4,90,,percent of total billed charges,,,1481.4,90,,percent of total billed charges,,,1349.72,82,,percent of total billed charges,,,1481.4,90,,percent of total billed charges,,,1399.1,85,,percent of total billed charges,,411.5,1563.7,
Q HIP DISTAL CENTRALIZER,18307942,CDM,,,270,RC,outpatient,,555,555,,471.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,138.75,22,,percent of total billed charges,,,,,,,,,499.5,90,,percent of total billed charges,,,459.54,82.8,,percent of total billed charges,,,471.75,85,,percent of total billed charges,,,,,,,,,488.4,88,,percent of total billed charges,,,,,,,,,424.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,138.75,22,,percent of total billed charges,,,505.05,91,,percent of total billed charges,,,527.25,95,,percent of total billed charges,,,460.65,83,,percent of total billed charges,,,460.65,83,,percent of total billed charges,,,,,,,,,,,,,,,460.65,83,,percent of total billed charges,,,527.25,95,,percent of total billed charges,,,499.5,90,,percent of total billed charges,,,499.5,90,,percent of total billed charges,,,455.1,82,,percent of total billed charges,,,499.5,90,,percent of total billed charges,,,471.75,85,,percent of total billed charges,,138.75,527.25,
Q PREP IM TOTAL,18307975,CDM,,,270,RC,outpatient,,837,837,,710.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,209.25,22,,percent of total billed charges,,,,,,,,,753.3,90,,percent of total billed charges,,,693.04,82.8,,percent of total billed charges,,,711.45,85,,percent of total billed charges,,,,,,,,,736.56,88,,percent of total billed charges,,,,,,,,,639.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,209.25,22,,percent of total billed charges,,,761.67,91,,percent of total billed charges,,,795.15,95,,percent of total billed charges,,,694.71,83,,percent of total billed charges,,,694.71,83,,percent of total billed charges,,,,,,,,,,,,,,,694.71,83,,percent of total billed charges,,,795.15,95,,percent of total billed charges,,,753.3,90,,percent of total billed charges,,,753.3,90,,percent of total billed charges,,,686.34,82,,percent of total billed charges,,,753.3,90,,percent of total billed charges,,,711.45,85,,percent of total billed charges,,209.25,795.15,
MIXING BOWL,18307983,CDM,,,270,RC,outpatient,,298,298,,253,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.5,22,,percent of total billed charges,,,,,,,,,268.2,90,,percent of total billed charges,,,246.74,82.8,,percent of total billed charges,,,253.3,85,,percent of total billed charges,,,,,,,,,262.24,88,,percent of total billed charges,,,,,,,,,227.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.5,22,,percent of total billed charges,,,271.18,91,,percent of total billed charges,,,283.1,95,,percent of total billed charges,,,247.34,83,,percent of total billed charges,,,247.34,83,,percent of total billed charges,,,,,,,,,,,,,,,247.34,83,,percent of total billed charges,,,283.1,95,,percent of total billed charges,,,268.2,90,,percent of total billed charges,,,268.2,90,,percent of total billed charges,,,244.36,82,,percent of total billed charges,,,268.2,90,,percent of total billed charges,,,253.3,85,,percent of total billed charges,,74.5,283.1,
ARTHROTOME,18601088,CDM,,,360,RC,outpatient,,441,441,,374.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.25,22,,percent of total billed charges,,,,,,,,,396.9,90,,percent of total billed charges,,,365.15,82.8,,percent of total billed charges,,,374.85,85,,percent of total billed charges,,,,,,,,,388.08,88,,percent of total billed charges,,,,,,,,,336.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.25,22,,percent of total billed charges,,,401.31,91,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,,,,,,,,,,,,,366.03,83,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,361.62,82,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,374.85,85,,percent of total billed charges,,110.25,418.95,
LEEP ACCESSORY,18602005,CDM,,,360,RC,outpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.25,22,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,63.76,82.8,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.25,22,,percent of total billed charges,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,19.25,73.15,
HYPERTHERMIA BLANKET,19604033,CDM,,,270,RC,outpatient,,35,35,,29.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.75,22,,percent of total billed charges,,,,,,,,,31.5,90,,percent of total billed charges,,,28.98,82.8,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,,,,,,,,30.8,88,,percent of total billed charges,,,,,,,,,26.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.75,22,,percent of total billed charges,,,31.85,91,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,,,,,,,,,,,,,29.05,83,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,28.7,82,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,8.75,33.25,
NIPPLE SHIELD,23150017,CDM,,,270,RC,outpatient,,31.05,31.05,,26.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.76,22,,percent of total billed charges,,,,,,,,,27.95,90,,percent of total billed charges,,,25.71,82.8,,percent of total billed charges,,,26.39,85,,percent of total billed charges,,,,,,,,,27.32,88,,percent of total billed charges,,,,,,,,,23.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.76,22,,percent of total billed charges,,,28.26,91,,percent of total billed charges,,,29.5,95,,percent of total billed charges,,,25.77,83,,percent of total billed charges,,,25.77,83,,percent of total billed charges,,,,,,,,,,,,,,,25.77,83,,percent of total billed charges,,,29.5,95,,percent of total billed charges,,,27.95,90,,percent of total billed charges,,,27.95,90,,percent of total billed charges,,,25.46,82,,percent of total billed charges,,,27.95,90,,percent of total billed charges,,,26.39,85,,percent of total billed charges,,7.76,29.5,
*DUO DERM GRANULES,23300038,CDM,,,270,RC,outpatient,,34,34,,28.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.5,22,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,28.15,82.8,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,,,,,,,,29.92,88,,percent of total billed charges,,,,,,,,,25.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.5,22,,percent of total billed charges,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,,,,,,,,,,,,,28.22,83,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,27.88,82,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,8.5,32.3,
CAPNOGRAPHY MICROSTREAM TUBING H,23300093,CDM,,,270,RC,outpatient,,111.31,111.31,,94.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.83,22,,percent of total billed charges,,,,,,,,,100.18,90,,percent of total billed charges,,,92.16,82.8,,percent of total billed charges,,,94.61,85,,percent of total billed charges,,,,,,,,,97.95,88,,percent of total billed charges,,,,,,,,,85.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.83,22,,percent of total billed charges,,,101.29,91,,percent of total billed charges,,,105.74,95,,percent of total billed charges,,,92.39,83,,percent of total billed charges,,,92.39,83,,percent of total billed charges,,,,,,,,,,,,,,,92.39,83,,percent of total billed charges,,,105.74,95,,percent of total billed charges,,,100.18,90,,percent of total billed charges,,,100.18,90,,percent of total billed charges,,,91.27,82,,percent of total billed charges,,,100.18,90,,percent of total billed charges,,,94.61,85,,percent of total billed charges,,27.83,105.74,
RESQPOD CIRCULATORY ENHANCER,23300200,CDM,,,270,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
BARD UROLOGIST'S TRAY HEYMAN,23300315,CDM,,,270,RC,outpatient,,1498.19,1498.19,,1271.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,374.55,22,,percent of total billed charges,,,,,,,,,1348.37,90,,percent of total billed charges,,,1240.5,82.8,,percent of total billed charges,,,1273.46,85,,percent of total billed charges,,,,,,,,,1318.41,88,,percent of total billed charges,,,,,,,,,1144.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,374.55,22,,percent of total billed charges,,,1363.35,91,,percent of total billed charges,,,1423.28,95,,percent of total billed charges,,,1243.5,83,,percent of total billed charges,,,1243.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1243.5,83,,percent of total billed charges,,,1423.28,95,,percent of total billed charges,,,1348.37,90,,percent of total billed charges,,,1348.37,90,,percent of total billed charges,,,1228.52,82,,percent of total billed charges,,,1348.37,90,,percent of total billed charges,,,1273.46,85,,percent of total billed charges,,374.55,1423.28,
TRAY ARTHOGRAM,23300376,CDM,,,270,RC,outpatient,,75.17,75.17,,63.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.79,22,,percent of total billed charges,,,,,,,,,67.65,90,,percent of total billed charges,,,62.24,82.8,,percent of total billed charges,,,63.89,85,,percent of total billed charges,,,,,,,,,66.15,88,,percent of total billed charges,,,,,,,,,57.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.79,22,,percent of total billed charges,,,68.4,91,,percent of total billed charges,,,71.41,95,,percent of total billed charges,,,62.39,83,,percent of total billed charges,,,62.39,83,,percent of total billed charges,,,,,,,,,,,,,,,62.39,83,,percent of total billed charges,,,71.41,95,,percent of total billed charges,,,67.65,90,,percent of total billed charges,,,67.65,90,,percent of total billed charges,,,61.64,82,,percent of total billed charges,,,67.65,90,,percent of total billed charges,,,63.89,85,,percent of total billed charges,,18.79,71.41,
*BRIEFS PROTECTIVE LG,23300422,CDM,,,270,RC,outpatient,,6,6,,5.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.5,22,,percent of total billed charges,,,,,,,,,5.4,90,,percent of total billed charges,,,4.97,82.8,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,,,,,,,,5.28,88,,percent of total billed charges,,,,,,,,,4.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.5,22,,percent of total billed charges,,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4.98,83,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,4.92,82,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,1.5,5.7,
BRACE ANKLE REG UNIVERSAL,23300566,CDM,,,270,RC,outpatient,,81.18,81.18,,68.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.3,22,,percent of total billed charges,,,,,,,,,73.06,90,,percent of total billed charges,,,67.22,82.8,,percent of total billed charges,,,69,85,,percent of total billed charges,,,,,,,,,71.44,88,,percent of total billed charges,,,,,,,,,62.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.3,22,,percent of total billed charges,,,73.87,91,,percent of total billed charges,,,77.12,95,,percent of total billed charges,,,67.38,83,,percent of total billed charges,,,67.38,83,,percent of total billed charges,,,,,,,,,,,,,,,67.38,83,,percent of total billed charges,,,77.12,95,,percent of total billed charges,,,73.06,90,,percent of total billed charges,,,73.06,90,,percent of total billed charges,,,66.57,82,,percent of total billed charges,,,73.06,90,,percent of total billed charges,,,69,85,,percent of total billed charges,,20.3,77.12,
*RETROGRADE CAPS,23300574,CDM,,,270,RC,outpatient,,2,2,,1.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.5,22,,percent of total billed charges,,,,,,,,,1.8,90,,percent of total billed charges,,,1.66,82.8,,percent of total billed charges,,,1.7,85,,percent of total billed charges,,,,,,,,,1.76,88,,percent of total billed charges,,,,,,,,,1.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.5,22,,percent of total billed charges,,,1.82,91,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,,,,,,,,,,,,,1.66,83,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.64,82,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.7,85,,percent of total billed charges,,0.5,1.9,
AMS SPARC SLING SYSTEM,23300575,CDM,,,270,RC,outpatient,,4810,4810,,4083.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1202.5,22,,percent of total billed charges,,,,,,,,,4329,90,,percent of total billed charges,,,3982.68,82.8,,percent of total billed charges,,,4088.5,85,,percent of total billed charges,,,,,,,,,4232.8,88,,percent of total billed charges,,,,,,,,,3674.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1202.5,22,,percent of total billed charges,,,4377.1,91,,percent of total billed charges,,,4569.5,95,,percent of total billed charges,,,3992.3,83,,percent of total billed charges,,,3992.3,83,,percent of total billed charges,,,,,,,,,,,,,,,3992.3,83,,percent of total billed charges,,,4569.5,95,,percent of total billed charges,,,4329,90,,percent of total billed charges,,,4329,90,,percent of total billed charges,,,3944.2,82,,percent of total billed charges,,,4329,90,,percent of total billed charges,,,4088.5,85,,percent of total billed charges,,1202.5,4569.5,
AMS STRAIGHT-IN SYSTEM,23300576,CDM,,,270,RC,outpatient,,9717.5,9717.5,,8250.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2429.38,22,,percent of total billed charges,,,,,,,,,8745.75,90,,percent of total billed charges,,,8046.09,82.8,,percent of total billed charges,,,8259.88,85,,percent of total billed charges,,,,,,,,,8551.4,88,,percent of total billed charges,,,,,,,,,7424.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2429.38,22,,percent of total billed charges,,,8842.93,91,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,,,,,,,,,,,,,8065.53,83,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,7968.35,82,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8259.88,85,,percent of total billed charges,,2429.38,9231.63,
FEEDING TUBE KANGAROO,23300673,CDM,,,270,RC,outpatient,,40.39,40.39,,34.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.1,22,,percent of total billed charges,,,,,,,,,36.35,90,,percent of total billed charges,,,33.44,82.8,,percent of total billed charges,,,34.33,85,,percent of total billed charges,,,,,,,,,35.54,88,,percent of total billed charges,,,,,,,,,30.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.1,22,,percent of total billed charges,,,36.75,91,,percent of total billed charges,,,38.37,95,,percent of total billed charges,,,33.52,83,,percent of total billed charges,,,33.52,83,,percent of total billed charges,,,,,,,,,,,,,,,33.52,83,,percent of total billed charges,,,38.37,95,,percent of total billed charges,,,36.35,90,,percent of total billed charges,,,36.35,90,,percent of total billed charges,,,33.12,82,,percent of total billed charges,,,36.35,90,,percent of total billed charges,,,34.33,85,,percent of total billed charges,,10.1,38.37,
FEEDING TUBE 8 FR,23300674,CDM,,,270,RC,outpatient,,38.25,38.25,,32.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.56,22,,percent of total billed charges,,,,,,,,,34.43,90,,percent of total billed charges,,,31.67,82.8,,percent of total billed charges,,,32.51,85,,percent of total billed charges,,,,,,,,,33.66,88,,percent of total billed charges,,,,,,,,,29.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.56,22,,percent of total billed charges,,,34.81,91,,percent of total billed charges,,,36.34,95,,percent of total billed charges,,,31.75,83,,percent of total billed charges,,,31.75,83,,percent of total billed charges,,,,,,,,,,,,,,,31.75,83,,percent of total billed charges,,,36.34,95,,percent of total billed charges,,,34.43,90,,percent of total billed charges,,,34.43,90,,percent of total billed charges,,,31.37,82,,percent of total billed charges,,,34.43,90,,percent of total billed charges,,,32.51,85,,percent of total billed charges,,9.56,36.34,
FEEDING TUBE 5 FR,23300676,CDM,,,270,RC,outpatient,,8.01,8.01,,6.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2,22,,percent of total billed charges,,,,,,,,,7.21,90,,percent of total billed charges,,,6.63,82.8,,percent of total billed charges,,,6.81,85,,percent of total billed charges,,,,,,,,,7.05,88,,percent of total billed charges,,,,,,,,,6.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2,22,,percent of total billed charges,,,7.29,91,,percent of total billed charges,,,7.61,95,,percent of total billed charges,,,6.65,83,,percent of total billed charges,,,6.65,83,,percent of total billed charges,,,,,,,,,,,,,,,6.65,83,,percent of total billed charges,,,7.61,95,,percent of total billed charges,,,7.21,90,,percent of total billed charges,,,7.21,90,,percent of total billed charges,,,6.57,82,,percent of total billed charges,,,7.21,90,,percent of total billed charges,,,6.81,85,,percent of total billed charges,,2,7.61,
FEEDING TUBE KANGAROO 12FR X 43,23300680,CDM,,,270,RC,outpatient,,66.73,66.73,,56.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.68,22,,percent of total billed charges,,,,,,,,,60.06,90,,percent of total billed charges,,,55.25,82.8,,percent of total billed charges,,,56.72,85,,percent of total billed charges,,,,,,,,,58.72,88,,percent of total billed charges,,,,,,,,,50.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.68,22,,percent of total billed charges,,,60.72,91,,percent of total billed charges,,,63.39,95,,percent of total billed charges,,,55.39,83,,percent of total billed charges,,,55.39,83,,percent of total billed charges,,,,,,,,,,,,,,,55.39,83,,percent of total billed charges,,,63.39,95,,percent of total billed charges,,,60.06,90,,percent of total billed charges,,,60.06,90,,percent of total billed charges,,,54.72,82,,percent of total billed charges,,,60.06,90,,percent of total billed charges,,,56.72,85,,percent of total billed charges,,16.68,63.39,
FEEDING TUBE ATTACHMENT (FTAD),23300685,CDM,,,270,RC,outpatient,,24.93,24.93,,21.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.23,22,,percent of total billed charges,,,,,,,,,22.44,90,,percent of total billed charges,,,20.64,82.8,,percent of total billed charges,,,21.19,85,,percent of total billed charges,,,,,,,,,21.94,88,,percent of total billed charges,,,,,,,,,19.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.23,22,,percent of total billed charges,,,22.69,91,,percent of total billed charges,,,23.68,95,,percent of total billed charges,,,20.69,83,,percent of total billed charges,,,20.69,83,,percent of total billed charges,,,,,,,,,,,,,,,20.69,83,,percent of total billed charges,,,23.68,95,,percent of total billed charges,,,22.44,90,,percent of total billed charges,,,22.44,90,,percent of total billed charges,,,20.44,82,,percent of total billed charges,,,22.44,90,,percent of total billed charges,,,21.19,85,,percent of total billed charges,,6.23,23.68,
HEEL ELEVATOR UNIVERSAL,23300731,CDM,,,270,RC,outpatient,,218.23,218.23,,185.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.56,22,,percent of total billed charges,,,,,,,,,196.41,90,,percent of total billed charges,,,180.69,82.8,,percent of total billed charges,,,185.5,85,,percent of total billed charges,,,,,,,,,192.04,88,,percent of total billed charges,,,,,,,,,166.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.56,22,,percent of total billed charges,,,198.59,91,,percent of total billed charges,,,207.32,95,,percent of total billed charges,,,181.13,83,,percent of total billed charges,,,181.13,83,,percent of total billed charges,,,,,,,,,,,,,,,181.13,83,,percent of total billed charges,,,207.32,95,,percent of total billed charges,,,196.41,90,,percent of total billed charges,,,196.41,90,,percent of total billed charges,,,178.95,82,,percent of total billed charges,,,196.41,90,,percent of total billed charges,,,185.5,85,,percent of total billed charges,,54.56,207.32,
TRAY IRRIGATION,23300806,CDM,,,270,RC,outpatient,,14.58,14.58,,12.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.65,22,,percent of total billed charges,,,,,,,,,13.12,90,,percent of total billed charges,,,12.07,82.8,,percent of total billed charges,,,12.39,85,,percent of total billed charges,,,,,,,,,12.83,88,,percent of total billed charges,,,,,,,,,11.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.65,22,,percent of total billed charges,,,13.27,91,,percent of total billed charges,,,13.85,95,,percent of total billed charges,,,12.1,83,,percent of total billed charges,,,12.1,83,,percent of total billed charges,,,,,,,,,,,,,,,12.1,83,,percent of total billed charges,,,13.85,95,,percent of total billed charges,,,13.12,90,,percent of total billed charges,,,13.12,90,,percent of total billed charges,,,11.96,82,,percent of total billed charges,,,13.12,90,,percent of total billed charges,,,12.39,85,,percent of total billed charges,,3.65,13.85,
STOMA PASTE ADAPT 2OZ,23300822,CDM,,,270,RC,outpatient,,13.41,13.41,,11.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.35,22,,percent of total billed charges,,,,,,,,,12.07,90,,percent of total billed charges,,,11.1,82.8,,percent of total billed charges,,,11.4,85,,percent of total billed charges,,,,,,,,,11.8,88,,percent of total billed charges,,,,,,,,,10.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.35,22,,percent of total billed charges,,,12.2,91,,percent of total billed charges,,,12.74,95,,percent of total billed charges,,,11.13,83,,percent of total billed charges,,,11.13,83,,percent of total billed charges,,,,,,,,,,,,,,,11.13,83,,percent of total billed charges,,,12.74,95,,percent of total billed charges,,,12.07,90,,percent of total billed charges,,,12.07,90,,percent of total billed charges,,,11,82,,percent of total billed charges,,,12.07,90,,percent of total billed charges,,,11.4,85,,percent of total billed charges,,3.35,12.74,
*PAIN SOAKER,23300832,CDM,,,270,RC,outpatient,,1093,1093,,927.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,273.25,22,,percent of total billed charges,,,,,,,,,983.7,90,,percent of total billed charges,,,905,82.8,,percent of total billed charges,,,929.05,85,,percent of total billed charges,,,,,,,,,961.84,88,,percent of total billed charges,,,,,,,,,835.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,273.25,22,,percent of total billed charges,,,994.63,91,,percent of total billed charges,,,1038.35,95,,percent of total billed charges,,,907.19,83,,percent of total billed charges,,,907.19,83,,percent of total billed charges,,,,,,,,,,,,,,,907.19,83,,percent of total billed charges,,,1038.35,95,,percent of total billed charges,,,983.7,90,,percent of total billed charges,,,983.7,90,,percent of total billed charges,,,896.26,82,,percent of total billed charges,,,983.7,90,,percent of total billed charges,,,929.05,85,,percent of total billed charges,,273.25,1038.35,
NASO-GASTRIC TUBE HOLDER DALE,23301040,CDM,,,270,RC,outpatient,,32.67,32.67,,27.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.17,22,,percent of total billed charges,,,,,,,,,29.4,90,,percent of total billed charges,,,27.05,82.8,,percent of total billed charges,,,27.77,85,,percent of total billed charges,,,,,,,,,28.75,88,,percent of total billed charges,,,,,,,,,24.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.17,22,,percent of total billed charges,,,29.73,91,,percent of total billed charges,,,31.04,95,,percent of total billed charges,,,27.12,83,,percent of total billed charges,,,27.12,83,,percent of total billed charges,,,,,,,,,,,,,,,27.12,83,,percent of total billed charges,,,31.04,95,,percent of total billed charges,,,29.4,90,,percent of total billed charges,,,29.4,90,,percent of total billed charges,,,26.79,82,,percent of total billed charges,,,29.4,90,,percent of total billed charges,,,27.77,85,,percent of total billed charges,,8.17,31.04,
SLING ARM UNIVERSAL,23301177,CDM,,,270,RC,outpatient,,31.95,31.95,,27.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.99,22,,percent of total billed charges,,,,,,,,,28.76,90,,percent of total billed charges,,,26.45,82.8,,percent of total billed charges,,,27.16,85,,percent of total billed charges,,,,,,,,,28.12,88,,percent of total billed charges,,,,,,,,,24.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.99,22,,percent of total billed charges,,,29.07,91,,percent of total billed charges,,,30.35,95,,percent of total billed charges,,,26.52,83,,percent of total billed charges,,,26.52,83,,percent of total billed charges,,,,,,,,,,,,,,,26.52,83,,percent of total billed charges,,,30.35,95,,percent of total billed charges,,,28.76,90,,percent of total billed charges,,,28.76,90,,percent of total billed charges,,,26.2,82,,percent of total billed charges,,,28.76,90,,percent of total billed charges,,,27.16,85,,percent of total billed charges,,7.99,30.35,
SLING ARM PEDIATRIC,23301180,CDM,,,270,RC,outpatient,,36.63,36.63,,31.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.16,22,,percent of total billed charges,,,,,,,,,32.97,90,,percent of total billed charges,,,30.33,82.8,,percent of total billed charges,,,31.14,85,,percent of total billed charges,,,,,,,,,32.23,88,,percent of total billed charges,,,,,,,,,27.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.16,22,,percent of total billed charges,,,33.33,91,,percent of total billed charges,,,34.8,95,,percent of total billed charges,,,30.4,83,,percent of total billed charges,,,30.4,83,,percent of total billed charges,,,,,,,,,,,,,,,30.4,83,,percent of total billed charges,,,34.8,95,,percent of total billed charges,,,32.97,90,,percent of total billed charges,,,32.97,90,,percent of total billed charges,,,30.04,82,,percent of total billed charges,,,32.97,90,,percent of total billed charges,,,31.14,85,,percent of total billed charges,,9.16,34.8,
CLIPVAC TUBING DISP.,23301205,CDM,,,270,RC,outpatient,,74.38,74.38,,63.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.6,22,,percent of total billed charges,,,,,,,,,66.94,90,,percent of total billed charges,,,61.59,82.8,,percent of total billed charges,,,63.22,85,,percent of total billed charges,,,,,,,,,65.45,88,,percent of total billed charges,,,,,,,,,56.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.6,22,,percent of total billed charges,,,67.69,91,,percent of total billed charges,,,70.66,95,,percent of total billed charges,,,61.74,83,,percent of total billed charges,,,61.74,83,,percent of total billed charges,,,,,,,,,,,,,,,61.74,83,,percent of total billed charges,,,70.66,95,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,60.99,82,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,63.22,85,,percent of total billed charges,,18.6,70.66,
*TRAY SPINAL - LIDOCAINE,23301219,CDM,,,270,RC,outpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.75,22,,percent of total billed charges,,,,,,,,,78.3,90,,percent of total billed charges,,,72.04,82.8,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.75,22,,percent of total billed charges,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,21.75,82.65,
TRAY SPINAL - PENCAN,23301220,CDM,,,270,RC,outpatient,,174.61,174.61,,148.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.65,22,,percent of total billed charges,,,,,,,,,157.15,90,,percent of total billed charges,,,144.58,82.8,,percent of total billed charges,,,148.42,85,,percent of total billed charges,,,,,,,,,153.66,88,,percent of total billed charges,,,,,,,,,133.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.65,22,,percent of total billed charges,,,158.9,91,,percent of total billed charges,,,165.88,95,,percent of total billed charges,,,144.93,83,,percent of total billed charges,,,144.93,83,,percent of total billed charges,,,,,,,,,,,,,,,144.93,83,,percent of total billed charges,,,165.88,95,,percent of total billed charges,,,157.15,90,,percent of total billed charges,,,157.15,90,,percent of total billed charges,,,143.18,82,,percent of total billed charges,,,157.15,90,,percent of total billed charges,,,148.42,85,,percent of total billed charges,,43.65,165.88,
SPLINT WRIST COLLES ADULT LF,23301237,CDM,,,270,RC,outpatient,,38.7,38.7,,32.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.68,22,,percent of total billed charges,,,,,,,,,34.83,90,,percent of total billed charges,,,32.04,82.8,,percent of total billed charges,,,32.9,85,,percent of total billed charges,,,,,,,,,34.06,88,,percent of total billed charges,,,,,,,,,29.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.68,22,,percent of total billed charges,,,35.22,91,,percent of total billed charges,,,36.77,95,,percent of total billed charges,,,32.12,83,,percent of total billed charges,,,32.12,83,,percent of total billed charges,,,,,,,,,,,,,,,32.12,83,,percent of total billed charges,,,36.77,95,,percent of total billed charges,,,34.83,90,,percent of total billed charges,,,34.83,90,,percent of total billed charges,,,31.73,82,,percent of total billed charges,,,34.83,90,,percent of total billed charges,,,32.9,85,,percent of total billed charges,,9.68,36.77,
SPLINT WRIST COLLES ADULT RT,23301238,CDM,,,270,RC,outpatient,,38.7,38.7,,32.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.68,22,,percent of total billed charges,,,,,,,,,34.83,90,,percent of total billed charges,,,32.04,82.8,,percent of total billed charges,,,32.9,85,,percent of total billed charges,,,,,,,,,34.06,88,,percent of total billed charges,,,,,,,,,29.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.68,22,,percent of total billed charges,,,35.22,91,,percent of total billed charges,,,36.77,95,,percent of total billed charges,,,32.12,83,,percent of total billed charges,,,32.12,83,,percent of total billed charges,,,,,,,,,,,,,,,32.12,83,,percent of total billed charges,,,36.77,95,,percent of total billed charges,,,34.83,90,,percent of total billed charges,,,34.83,90,,percent of total billed charges,,,31.73,82,,percent of total billed charges,,,34.83,90,,percent of total billed charges,,,32.9,85,,percent of total billed charges,,9.68,36.77,
*SPLINT WRIST COLLES YOUTH R,23301239,CDM,,,270,RC,outpatient,,42,42,,35.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.5,22,,percent of total billed charges,,,,,,,,,37.8,90,,percent of total billed charges,,,34.78,82.8,,percent of total billed charges,,,35.7,85,,percent of total billed charges,,,,,,,,,36.96,88,,percent of total billed charges,,,,,,,,,32.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.5,22,,percent of total billed charges,,,38.22,91,,percent of total billed charges,,,39.9,95,,percent of total billed charges,,,34.86,83,,percent of total billed charges,,,34.86,83,,percent of total billed charges,,,,,,,,,,,,,,,34.86,83,,percent of total billed charges,,,39.9,95,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,34.44,82,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,35.7,85,,percent of total billed charges,,10.5,39.9,
ENDOSCOPIC CAPS,23301267,CDM,,,270,RC,outpatient,,51.43,51.43,,43.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.86,22,,percent of total billed charges,,,,,,,,,46.29,90,,percent of total billed charges,,,42.58,82.8,,percent of total billed charges,,,43.72,85,,percent of total billed charges,,,,,,,,,45.26,88,,percent of total billed charges,,,,,,,,,39.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.86,22,,percent of total billed charges,,,46.8,91,,percent of total billed charges,,,48.86,95,,percent of total billed charges,,,42.69,83,,percent of total billed charges,,,42.69,83,,percent of total billed charges,,,,,,,,,,,,,,,42.69,83,,percent of total billed charges,,,48.86,95,,percent of total billed charges,,,46.29,90,,percent of total billed charges,,,46.29,90,,percent of total billed charges,,,42.17,82,,percent of total billed charges,,,46.29,90,,percent of total billed charges,,,43.72,85,,percent of total billed charges,,12.86,48.86,
CAMERA COVER 9 X 96,23301268,CDM,,,270,RC,outpatient,,47.69,47.69,,40.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.92,22,,percent of total billed charges,,,,,,,,,42.92,90,,percent of total billed charges,,,39.49,82.8,,percent of total billed charges,,,40.54,85,,percent of total billed charges,,,,,,,,,41.97,88,,percent of total billed charges,,,,,,,,,36.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.92,22,,percent of total billed charges,,,43.4,91,,percent of total billed charges,,,45.31,95,,percent of total billed charges,,,39.58,83,,percent of total billed charges,,,39.58,83,,percent of total billed charges,,,,,,,,,,,,,,,39.58,83,,percent of total billed charges,,,45.31,95,,percent of total billed charges,,,42.92,90,,percent of total billed charges,,,42.92,90,,percent of total billed charges,,,39.11,82,,percent of total billed charges,,,42.92,90,,percent of total billed charges,,,40.54,85,,percent of total billed charges,,11.92,45.31,
CATH SUCTION INFANT 5/6FR,23301325,CDM,,,270,RC,outpatient,,2.27,2.27,,1.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.57,22,,percent of total billed charges,,,,,,,,,2.04,90,,percent of total billed charges,,,1.88,82.8,,percent of total billed charges,,,1.93,85,,percent of total billed charges,,,,,,,,,2,88,,percent of total billed charges,,,,,,,,,1.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.57,22,,percent of total billed charges,,,2.07,91,,percent of total billed charges,,,2.16,95,,percent of total billed charges,,,1.88,83,,percent of total billed charges,,,1.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1.88,83,,percent of total billed charges,,,2.16,95,,percent of total billed charges,,,2.04,90,,percent of total billed charges,,,2.04,90,,percent of total billed charges,,,1.86,82,,percent of total billed charges,,,2.04,90,,percent of total billed charges,,,1.93,85,,percent of total billed charges,,0.57,2.16,
* SUTURE K831H (V0605),23301384,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE 815H CHROMIC GUT 3 0 (V0205),23301391,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE 1744-41 (V0106),23301400,CDM,,,270,RC,outpatient,,20,20,,16.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5,22,,percent of total billed charges,,,,,,,,,18,90,,percent of total billed charges,,,16.56,82.8,,percent of total billed charges,,,17,85,,percent of total billed charges,,,,,,,,,17.6,88,,percent of total billed charges,,,,,,,,,15.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5,22,,percent of total billed charges,,,18.2,91,,percent of total billed charges,,,19,95,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,,,,,,,,,,,,,16.6,83,,percent of total billed charges,,,19,95,,percent of total billed charges,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,16.4,82,,percent of total billed charges,,,18,90,,percent of total billed charges,,,17,85,,percent of total billed charges,,5,19,
* SUTURE*1741-31 (V0205),23301401,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE 1665G (V0205),23301403,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE 8661G PROLENE 5 0 (V0205),23301405,CDM,,,270,RC,outpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
* SUTURE*1744-31 (V0605),23301413,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE VD-871 (V0205),23301414,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
GUIDEWIRE URO PTFE .038,23301424,CDM,,,270,RC,outpatient,,109.76,109.76,,93.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.44,22,,percent of total billed charges,,,,,,,,,98.78,90,,percent of total billed charges,,,90.88,82.8,,percent of total billed charges,,,93.3,85,,percent of total billed charges,,,,,,,,,96.59,88,,percent of total billed charges,,,,,,,,,83.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.44,22,,percent of total billed charges,,,99.88,91,,percent of total billed charges,,,104.27,95,,percent of total billed charges,,,91.1,83,,percent of total billed charges,,,91.1,83,,percent of total billed charges,,,,,,,,,,,,,,,91.1,83,,percent of total billed charges,,,104.27,95,,percent of total billed charges,,,98.78,90,,percent of total billed charges,,,98.78,90,,percent of total billed charges,,,90,82,,percent of total billed charges,,,98.78,90,,percent of total billed charges,,,93.3,85,,percent of total billed charges,,27.44,104.27,
"* VACUUM EXTRACTION, BODY (V0904)",23301429,CDM,93012,CPT,732,RC,outpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
* VACUUM ATTACHMENT (V0904),23301430,CDM,93012,CPT,732,RC,outpatient,,58,58,,49.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.5,22,,percent of total billed charges,,,,,,,,,52.2,90,,percent of total billed charges,,,48.02,82.8,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,,,,,,,,51.04,88,,percent of total billed charges,,,,,,,,,44.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.5,22,,percent of total billed charges,,,52.78,91,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,,,,,,,,,,,,,48.14,83,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,47.56,82,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,14.5,55.1,
TRAY TRACH CARE,23301499,CDM,,,270,RC,outpatient,,11.97,11.97,,10.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.99,22,,percent of total billed charges,,,,,,,,,10.77,90,,percent of total billed charges,,,9.91,82.8,,percent of total billed charges,,,10.17,85,,percent of total billed charges,,,,,,,,,10.53,88,,percent of total billed charges,,,,,,,,,9.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.99,22,,percent of total billed charges,,,10.89,91,,percent of total billed charges,,,11.37,95,,percent of total billed charges,,,9.94,83,,percent of total billed charges,,,9.94,83,,percent of total billed charges,,,,,,,,,,,,,,,9.94,83,,percent of total billed charges,,,11.37,95,,percent of total billed charges,,,10.77,90,,percent of total billed charges,,,10.77,90,,percent of total billed charges,,,9.82,82,,percent of total billed charges,,,10.77,90,,percent of total billed charges,,,10.17,85,,percent of total billed charges,,2.99,11.37,
* CENTRAL VENOUS PRESS MONITOR (V0605),23301600,CDM,,,270,RC,outpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.5,22,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,38.09,82.8,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.5,22,,percent of total billed charges,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,11.5,43.7,
FLOSEAL,23301649,CDM,,,270,RC,outpatient,,1192.75,1192.75,,1012.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,298.19,22,,percent of total billed charges,,,,,,,,,1073.48,90,,percent of total billed charges,,,987.6,82.8,,percent of total billed charges,,,1013.84,85,,percent of total billed charges,,,,,,,,,1049.62,88,,percent of total billed charges,,,,,,,,,911.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,298.19,22,,percent of total billed charges,,,1085.4,91,,percent of total billed charges,,,1133.11,95,,percent of total billed charges,,,989.98,83,,percent of total billed charges,,,989.98,83,,percent of total billed charges,,,,,,,,,,,,,,,989.98,83,,percent of total billed charges,,,1133.11,95,,percent of total billed charges,,,1073.48,90,,percent of total billed charges,,,1073.48,90,,percent of total billed charges,,,978.06,82,,percent of total billed charges,,,1073.48,90,,percent of total billed charges,,,1013.84,85,,percent of total billed charges,,298.19,1133.11,
*TUBE T 18FR,23301673,CDM,,,270,RC,outpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.25,22,,percent of total billed charges,,,,,,,,,62.1,90,,percent of total billed charges,,,57.13,82.8,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.25,22,,percent of total billed charges,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,17.25,65.55,
*TUBE T 24FR,23301676,CDM,,,270,RC,outpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.25,22,,percent of total billed charges,,,,,,,,,62.1,90,,percent of total billed charges,,,57.13,82.8,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.25,22,,percent of total billed charges,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,17.25,65.55,
*URETERAL CATHETER ADAPTORS,23301718,CDM,,,270,RC,outpatient,,5,5,,4.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.25,22,,percent of total billed charges,,,,,,,,,4.5,90,,percent of total billed charges,,,4.14,82.8,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,,,,,,,,4.4,88,,percent of total billed charges,,,,,,,,,3.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.25,22,,percent of total billed charges,,,4.55,91,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4.15,83,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.1,82,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,1.25,4.75,
*URETERAL CATHETER WHISTLE 4,23301719,CDM,,,270,RC,outpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.75,22,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,48.85,82.8,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,,,,,,,,51.92,88,,percent of total billed charges,,,,,,,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.75,22,,percent of total billed charges,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,14.75,56.05,
IV EXTENSION SET W/3-WAY STOPCOCK,23301741,CDM,,,270,RC,outpatient,,23.76,23.76,,20.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.94,22,,percent of total billed charges,,,,,,,,,21.38,90,,percent of total billed charges,,,19.67,82.8,,percent of total billed charges,,,20.2,85,,percent of total billed charges,,,,,,,,,20.91,88,,percent of total billed charges,,,,,,,,,18.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.94,22,,percent of total billed charges,,,21.62,91,,percent of total billed charges,,,22.57,95,,percent of total billed charges,,,19.72,83,,percent of total billed charges,,,19.72,83,,percent of total billed charges,,,,,,,,,,,,,,,19.72,83,,percent of total billed charges,,,22.57,95,,percent of total billed charges,,,21.38,90,,percent of total billed charges,,,21.38,90,,percent of total billed charges,,,19.48,82,,percent of total billed charges,,,21.38,90,,percent of total billed charges,,,20.2,85,,percent of total billed charges,,5.94,22.57,
* Z/OR (V0405),23301805,CDM,,,270,RC,outpatient,,5476,5476,,4649.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1369,22,,percent of total billed charges,,,,,,,,,4928.4,90,,percent of total billed charges,,,4534.13,82.8,,percent of total billed charges,,,4654.6,85,,percent of total billed charges,,,,,,,,,4818.88,88,,percent of total billed charges,,,,,,,,,4183.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1369,22,,percent of total billed charges,,,4983.16,91,,percent of total billed charges,,,5202.2,95,,percent of total billed charges,,,4545.08,83,,percent of total billed charges,,,4545.08,83,,percent of total billed charges,,,,,,,,,,,,,,,4545.08,83,,percent of total billed charges,,,5202.2,95,,percent of total billed charges,,,4928.4,90,,percent of total billed charges,,,4928.4,90,,percent of total billed charges,,,4490.32,82,,percent of total billed charges,,,4928.4,90,,percent of total billed charges,,,4654.6,85,,percent of total billed charges,,1369,5202.2,
* Z/OR (V0405),23301806,CDM,,,270,RC,outpatient,,1872,1872,,1589.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,468,22,,percent of total billed charges,,,,,,,,,1684.8,90,,percent of total billed charges,,,1550.02,82.8,,percent of total billed charges,,,1591.2,85,,percent of total billed charges,,,,,,,,,1647.36,88,,percent of total billed charges,,,,,,,,,1430.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,468,22,,percent of total billed charges,,,1703.52,91,,percent of total billed charges,,,1778.4,95,,percent of total billed charges,,,1553.76,83,,percent of total billed charges,,,1553.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1553.76,83,,percent of total billed charges,,,1778.4,95,,percent of total billed charges,,,1684.8,90,,percent of total billed charges,,,1684.8,90,,percent of total billed charges,,,1535.04,82,,percent of total billed charges,,,1684.8,90,,percent of total billed charges,,,1591.2,85,,percent of total billed charges,,468,1778.4,
* Z/OR (V0405),23301807,CDM,,,270,RC,outpatient,,1144,1144,,971.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,286,22,,percent of total billed charges,,,,,,,,,1029.6,90,,percent of total billed charges,,,947.23,82.8,,percent of total billed charges,,,972.4,85,,percent of total billed charges,,,,,,,,,1006.72,88,,percent of total billed charges,,,,,,,,,874.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,286,22,,percent of total billed charges,,,1041.04,91,,percent of total billed charges,,,1086.8,95,,percent of total billed charges,,,949.52,83,,percent of total billed charges,,,949.52,83,,percent of total billed charges,,,,,,,,,,,,,,,949.52,83,,percent of total billed charges,,,1086.8,95,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,938.08,82,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,972.4,85,,percent of total billed charges,,286,1086.8,
* Z/OR (V0405),23301808,CDM,,,270,RC,outpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.5,22,,percent of total billed charges,,,,,,,,,365.4,90,,percent of total billed charges,,,336.17,82.8,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.5,22,,percent of total billed charges,,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,101.5,385.7,
* Z/OR (V0405),23301836,CDM,,,270,RC,outpatient,,204,204,,173.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51,22,,percent of total billed charges,,,,,,,,,183.6,90,,percent of total billed charges,,,168.91,82.8,,percent of total billed charges,,,173.4,85,,percent of total billed charges,,,,,,,,,179.52,88,,percent of total billed charges,,,,,,,,,155.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51,22,,percent of total billed charges,,,185.64,91,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,,,,,,,,,,,,,169.32,83,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,167.28,82,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,173.4,85,,percent of total billed charges,,51,193.8,
* Z/OR (V0405),23301839,CDM,,,270,RC,outpatient,,705,705,,598.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,176.25,22,,percent of total billed charges,,,,,,,,,634.5,90,,percent of total billed charges,,,583.74,82.8,,percent of total billed charges,,,599.25,85,,percent of total billed charges,,,,,,,,,620.4,88,,percent of total billed charges,,,,,,,,,538.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,176.25,22,,percent of total billed charges,,,641.55,91,,percent of total billed charges,,,669.75,95,,percent of total billed charges,,,585.15,83,,percent of total billed charges,,,585.15,83,,percent of total billed charges,,,,,,,,,,,,,,,585.15,83,,percent of total billed charges,,,669.75,95,,percent of total billed charges,,,634.5,90,,percent of total billed charges,,,634.5,90,,percent of total billed charges,,,578.1,82,,percent of total billed charges,,,634.5,90,,percent of total billed charges,,,599.25,85,,percent of total billed charges,,176.25,669.75,
* Z/OR (V0405),23301840,CDM,,,270,RC,outpatient,,1430,1430,,1214.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,357.5,22,,percent of total billed charges,,,,,,,,,1287,90,,percent of total billed charges,,,1184.04,82.8,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,,,,,,,,1258.4,88,,percent of total billed charges,,,,,,,,,1092.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,357.5,22,,percent of total billed charges,,,1301.3,91,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1186.9,83,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1172.6,82,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,357.5,1358.5,
* Z/OR (V0405),23301841,CDM,,,270,RC,outpatient,,5605,5605,,4758.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1401.25,22,,percent of total billed charges,,,,,,,,,5044.5,90,,percent of total billed charges,,,4640.94,82.8,,percent of total billed charges,,,4764.25,85,,percent of total billed charges,,,,,,,,,4932.4,88,,percent of total billed charges,,,,,,,,,4282.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1401.25,22,,percent of total billed charges,,,5100.55,91,,percent of total billed charges,,,5324.75,95,,percent of total billed charges,,,4652.15,83,,percent of total billed charges,,,4652.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4652.15,83,,percent of total billed charges,,,5324.75,95,,percent of total billed charges,,,5044.5,90,,percent of total billed charges,,,5044.5,90,,percent of total billed charges,,,4596.1,82,,percent of total billed charges,,,5044.5,90,,percent of total billed charges,,,4764.25,85,,percent of total billed charges,,1401.25,5324.75,
* Z/OR (V0405),23301842,CDM,,,270,RC,outpatient,,749,749,,635.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,187.25,22,,percent of total billed charges,,,,,,,,,674.1,90,,percent of total billed charges,,,620.17,82.8,,percent of total billed charges,,,636.65,85,,percent of total billed charges,,,,,,,,,659.12,88,,percent of total billed charges,,,,,,,,,572.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,187.25,22,,percent of total billed charges,,,681.59,91,,percent of total billed charges,,,711.55,95,,percent of total billed charges,,,621.67,83,,percent of total billed charges,,,621.67,83,,percent of total billed charges,,,,,,,,,,,,,,,621.67,83,,percent of total billed charges,,,711.55,95,,percent of total billed charges,,,674.1,90,,percent of total billed charges,,,674.1,90,,percent of total billed charges,,,614.18,82,,percent of total billed charges,,,674.1,90,,percent of total billed charges,,,636.65,85,,percent of total billed charges,,187.25,711.55,
* Z/OR (V0405),23301843,CDM,,,270,RC,outpatient,,116,116,,98.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29,22,,percent of total billed charges,,,,,,,,,104.4,90,,percent of total billed charges,,,96.05,82.8,,percent of total billed charges,,,98.6,85,,percent of total billed charges,,,,,,,,,102.08,88,,percent of total billed charges,,,,,,,,,88.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29,22,,percent of total billed charges,,,105.56,91,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,,,,,,,,,,,,,96.28,83,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,95.12,82,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,98.6,85,,percent of total billed charges,,29,110.2,
* Z/OR (V0405),23301844,CDM,,,270,RC,outpatient,,1207,1207,,1024.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,301.75,22,,percent of total billed charges,,,,,,,,,1086.3,90,,percent of total billed charges,,,999.4,82.8,,percent of total billed charges,,,1025.95,85,,percent of total billed charges,,,,,,,,,1062.16,88,,percent of total billed charges,,,,,,,,,922.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,301.75,22,,percent of total billed charges,,,1098.37,91,,percent of total billed charges,,,1146.65,95,,percent of total billed charges,,,1001.81,83,,percent of total billed charges,,,1001.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1001.81,83,,percent of total billed charges,,,1146.65,95,,percent of total billed charges,,,1086.3,90,,percent of total billed charges,,,1086.3,90,,percent of total billed charges,,,989.74,82,,percent of total billed charges,,,1086.3,90,,percent of total billed charges,,,1025.95,85,,percent of total billed charges,,301.75,1146.65,
* Z/OR (V0405),23301845,CDM,,,270,RC,outpatient,,1001,1001,,849.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,250.25,22,,percent of total billed charges,,,,,,,,,900.9,90,,percent of total billed charges,,,828.83,82.8,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,,,,,,,,880.88,88,,percent of total billed charges,,,,,,,,,764.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,250.25,22,,percent of total billed charges,,,910.91,91,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,,,,,,,,,,,,,830.83,83,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,820.82,82,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,250.25,950.95,
*PENROSE TUBING 5/8,23301945,CDM,,,270,RC,outpatient,,17,17,,14.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.25,22,,percent of total billed charges,,,,,,,,,15.3,90,,percent of total billed charges,,,14.08,82.8,,percent of total billed charges,,,14.45,85,,percent of total billed charges,,,,,,,,,14.96,88,,percent of total billed charges,,,,,,,,,12.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.25,22,,percent of total billed charges,,,15.47,91,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,,,,,,,,,,,,,14.11,83,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,13.94,82,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,14.45,85,,percent of total billed charges,,4.25,16.15,
*PENROSE TUBING 1,23301946,CDM,,,270,RC,outpatient,,7,7,,5.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.75,22,,percent of total billed charges,,,,,,,,,6.3,90,,percent of total billed charges,,,5.8,82.8,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,,,,,,,,6.16,88,,percent of total billed charges,,,,,,,,,5.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.75,22,,percent of total billed charges,,,6.37,91,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,,,,,,,,,,,,,5.81,83,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.74,82,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,1.75,6.65,
DRAIN PENROSE TUBING 1/2,23301947,CDM,,,270,RC,outpatient,,9.27,9.27,,7.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.32,22,,percent of total billed charges,,,,,,,,,8.34,90,,percent of total billed charges,,,7.68,82.8,,percent of total billed charges,,,7.88,85,,percent of total billed charges,,,,,,,,,8.16,88,,percent of total billed charges,,,,,,,,,7.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.32,22,,percent of total billed charges,,,8.44,91,,percent of total billed charges,,,8.81,95,,percent of total billed charges,,,7.69,83,,percent of total billed charges,,,7.69,83,,percent of total billed charges,,,,,,,,,,,,,,,7.69,83,,percent of total billed charges,,,8.81,95,,percent of total billed charges,,,8.34,90,,percent of total billed charges,,,8.34,90,,percent of total billed charges,,,7.6,82,,percent of total billed charges,,,8.34,90,,percent of total billed charges,,,7.88,85,,percent of total billed charges,,2.32,8.81,
DRAIN PENROSE TUBING 1,23301949,CDM,,,270,RC,outpatient,,13.86,13.86,,11.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.47,22,,percent of total billed charges,,,,,,,,,12.47,90,,percent of total billed charges,,,11.48,82.8,,percent of total billed charges,,,11.78,85,,percent of total billed charges,,,,,,,,,12.2,88,,percent of total billed charges,,,,,,,,,10.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.47,22,,percent of total billed charges,,,12.61,91,,percent of total billed charges,,,13.17,95,,percent of total billed charges,,,11.5,83,,percent of total billed charges,,,11.5,83,,percent of total billed charges,,,,,,,,,,,,,,,11.5,83,,percent of total billed charges,,,13.17,95,,percent of total billed charges,,,12.47,90,,percent of total billed charges,,,12.47,90,,percent of total billed charges,,,11.37,82,,percent of total billed charges,,,12.47,90,,percent of total billed charges,,,11.78,85,,percent of total billed charges,,3.47,13.17,
*SARATOGA SUMP DRAIN 12FR 48,23301965,CDM,,,270,RC,outpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
*SARATOGA SUMP DRAIN 14FR 48,23301966,CDM,,,270,RC,outpatient,,171,171,,145.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.75,22,,percent of total billed charges,,,,,,,,,153.9,90,,percent of total billed charges,,,141.59,82.8,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,,,,,,,,150.48,88,,percent of total billed charges,,,,,,,,,130.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.75,22,,percent of total billed charges,,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,,,,,,,,,,,,,141.93,83,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,140.22,82,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,42.75,162.45,
*BILE BAG SMALL,23301994,CDM,,,270,RC,outpatient,,85,85,,72.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.25,22,,percent of total billed charges,,,,,,,,,76.5,90,,percent of total billed charges,,,70.38,82.8,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,,,,,,,,74.8,88,,percent of total billed charges,,,,,,,,,64.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.25,22,,percent of total billed charges,,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,,,,,,,,,,,,,70.55,83,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,69.7,82,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,21.25,80.75,
*TRACH 3.0 CUFFED,23302018,CDM,,,270,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
TRACH 4.0 CUFFED,23302020,CDM,,,270,RC,outpatient,,15.55,15.55,,13.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.89,22,,percent of total billed charges,,,,,,,,,14,90,,percent of total billed charges,,,12.88,82.8,,percent of total billed charges,,,13.22,85,,percent of total billed charges,,,,,,,,,13.68,88,,percent of total billed charges,,,,,,,,,11.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.89,22,,percent of total billed charges,,,14.15,91,,percent of total billed charges,,,14.77,95,,percent of total billed charges,,,12.91,83,,percent of total billed charges,,,12.91,83,,percent of total billed charges,,,,,,,,,,,,,,,12.91,83,,percent of total billed charges,,,14.77,95,,percent of total billed charges,,,14,90,,percent of total billed charges,,,14,90,,percent of total billed charges,,,12.75,82,,percent of total billed charges,,,14,90,,percent of total billed charges,,,13.22,85,,percent of total billed charges,,3.89,14.77,
TRACH 4.5 CUFFED,23302021,CDM,,,270,RC,outpatient,,16.79,16.79,,14.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.2,22,,percent of total billed charges,,,,,,,,,15.11,90,,percent of total billed charges,,,13.9,82.8,,percent of total billed charges,,,14.27,85,,percent of total billed charges,,,,,,,,,14.78,88,,percent of total billed charges,,,,,,,,,12.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.2,22,,percent of total billed charges,,,15.28,91,,percent of total billed charges,,,15.95,95,,percent of total billed charges,,,13.94,83,,percent of total billed charges,,,13.94,83,,percent of total billed charges,,,,,,,,,,,,,,,13.94,83,,percent of total billed charges,,,15.95,95,,percent of total billed charges,,,15.11,90,,percent of total billed charges,,,15.11,90,,percent of total billed charges,,,13.77,82,,percent of total billed charges,,,15.11,90,,percent of total billed charges,,,14.27,85,,percent of total billed charges,,4.2,15.95,
TRACH 5.0 UNCUFFED,23302022,CDM,,,270,RC,outpatient,,16.2,16.2,,13.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.05,22,,percent of total billed charges,,,,,,,,,14.58,90,,percent of total billed charges,,,13.41,82.8,,percent of total billed charges,,,13.77,85,,percent of total billed charges,,,,,,,,,14.26,88,,percent of total billed charges,,,,,,,,,12.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.05,22,,percent of total billed charges,,,14.74,91,,percent of total billed charges,,,15.39,95,,percent of total billed charges,,,13.45,83,,percent of total billed charges,,,13.45,83,,percent of total billed charges,,,,,,,,,,,,,,,13.45,83,,percent of total billed charges,,,15.39,95,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,13.28,82,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,13.77,85,,percent of total billed charges,,4.05,15.39,
TRACH 5.5 CUFFED,23302023,CDM,,,270,RC,outpatient,,24.71,24.71,,20.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.18,22,,percent of total billed charges,,,,,,,,,22.24,90,,percent of total billed charges,,,20.46,82.8,,percent of total billed charges,,,21,85,,percent of total billed charges,,,,,,,,,21.74,88,,percent of total billed charges,,,,,,,,,18.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.18,22,,percent of total billed charges,,,22.49,91,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,,,,,,,,,,,,,20.51,83,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,20.26,82,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,21,85,,percent of total billed charges,,6.18,23.47,
TRACH 6.0 CUFFED,23302024,CDM,,,270,RC,outpatient,,24.71,24.71,,20.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.18,22,,percent of total billed charges,,,,,,,,,22.24,90,,percent of total billed charges,,,20.46,82.8,,percent of total billed charges,,,21,85,,percent of total billed charges,,,,,,,,,21.74,88,,percent of total billed charges,,,,,,,,,18.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.18,22,,percent of total billed charges,,,22.49,91,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,,,,,,,,,,,,,20.51,83,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,20.26,82,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,21,85,,percent of total billed charges,,6.18,23.47,
TRACH 7.0 CUFFED,23302027,CDM,,,270,RC,outpatient,,24.71,24.71,,20.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.18,22,,percent of total billed charges,,,,,,,,,22.24,90,,percent of total billed charges,,,20.46,82.8,,percent of total billed charges,,,21,85,,percent of total billed charges,,,,,,,,,21.74,88,,percent of total billed charges,,,,,,,,,18.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.18,22,,percent of total billed charges,,,22.49,91,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,,,,,,,,,,,,,20.51,83,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,20.26,82,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,21,85,,percent of total billed charges,,6.18,23.47,
TRACH 7.5 CUFFED,23302028,CDM,,,270,RC,outpatient,,24.71,24.71,,20.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.18,22,,percent of total billed charges,,,,,,,,,22.24,90,,percent of total billed charges,,,20.46,82.8,,percent of total billed charges,,,21,85,,percent of total billed charges,,,,,,,,,21.74,88,,percent of total billed charges,,,,,,,,,18.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.18,22,,percent of total billed charges,,,22.49,91,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,,,,,,,,,,,,,20.51,83,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,20.26,82,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,21,85,,percent of total billed charges,,6.18,23.47,
TRACH 8.0 CUFFED,23302029,CDM,,,270,RC,outpatient,,24.71,24.71,,20.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.18,22,,percent of total billed charges,,,,,,,,,22.24,90,,percent of total billed charges,,,20.46,82.8,,percent of total billed charges,,,21,85,,percent of total billed charges,,,,,,,,,21.74,88,,percent of total billed charges,,,,,,,,,18.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.18,22,,percent of total billed charges,,,22.49,91,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,,,,,,,,,,,,,20.51,83,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,20.26,82,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,21,85,,percent of total billed charges,,6.18,23.47,
*TRACH 8.5 CUFFED,23302030,CDM,,,270,RC,outpatient,,15,15,,12.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.75,22,,percent of total billed charges,,,,,,,,,13.5,90,,percent of total billed charges,,,12.42,82.8,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,,,,,,,,13.2,88,,percent of total billed charges,,,,,,,,,11.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.75,22,,percent of total billed charges,,,13.65,91,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,,,,,,,,,,,,,12.45,83,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.3,82,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,3.75,14.25,
*TRACH 2.0  CUFFED,23302032,CDM,,,270,RC,outpatient,,8,8,,6.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2,22,,percent of total billed charges,,,,,,,,,7.2,90,,percent of total billed charges,,,6.62,82.8,,percent of total billed charges,,,6.8,85,,percent of total billed charges,,,,,,,,,7.04,88,,percent of total billed charges,,,,,,,,,6.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2,22,,percent of total billed charges,,,7.28,91,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,,,,,,,,,,,,,6.64,83,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.56,82,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.8,85,,percent of total billed charges,,2,7.6,
TRACH 3.0 UNCUFFED,23302035,CDM,,,270,RC,outpatient,,8.63,8.63,,7.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.16,22,,percent of total billed charges,,,,,,,,,7.77,90,,percent of total billed charges,,,7.15,82.8,,percent of total billed charges,,,7.34,85,,percent of total billed charges,,,,,,,,,7.59,88,,percent of total billed charges,,,,,,,,,6.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.16,22,,percent of total billed charges,,,7.85,91,,percent of total billed charges,,,8.2,95,,percent of total billed charges,,,7.16,83,,percent of total billed charges,,,7.16,83,,percent of total billed charges,,,,,,,,,,,,,,,7.16,83,,percent of total billed charges,,,8.2,95,,percent of total billed charges,,,7.77,90,,percent of total billed charges,,,7.77,90,,percent of total billed charges,,,7.08,82,,percent of total billed charges,,,7.77,90,,percent of total billed charges,,,7.34,85,,percent of total billed charges,,2.16,8.2,
TRACH 5.0 CUFFED,23302037,CDM,,,270,RC,outpatient,,24.71,24.71,,20.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.18,22,,percent of total billed charges,,,,,,,,,22.24,90,,percent of total billed charges,,,20.46,82.8,,percent of total billed charges,,,21,85,,percent of total billed charges,,,,,,,,,21.74,88,,percent of total billed charges,,,,,,,,,18.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.18,22,,percent of total billed charges,,,22.49,91,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,,,,,,,,,,,,,20.51,83,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,20.26,82,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,21,85,,percent of total billed charges,,6.18,23.47,
TRACH 2.5 UNCUFFED,23302040,CDM,,,270,RC,outpatient,,29.29,29.29,,24.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.32,22,,percent of total billed charges,,,,,,,,,26.36,90,,percent of total billed charges,,,24.25,82.8,,percent of total billed charges,,,24.9,85,,percent of total billed charges,,,,,,,,,25.78,88,,percent of total billed charges,,,,,,,,,22.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.32,22,,percent of total billed charges,,,26.65,91,,percent of total billed charges,,,27.83,95,,percent of total billed charges,,,24.31,83,,percent of total billed charges,,,24.31,83,,percent of total billed charges,,,,,,,,,,,,,,,24.31,83,,percent of total billed charges,,,27.83,95,,percent of total billed charges,,,26.36,90,,percent of total billed charges,,,26.36,90,,percent of total billed charges,,,24.02,82,,percent of total billed charges,,,26.36,90,,percent of total billed charges,,,24.9,85,,percent of total billed charges,,7.32,27.83,
TRACH 3.5 UNCUFFED,23302041,CDM,,,270,RC,outpatient,,9.99,9.99,,8.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.5,22,,percent of total billed charges,,,,,,,,,8.99,90,,percent of total billed charges,,,8.27,82.8,,percent of total billed charges,,,8.49,85,,percent of total billed charges,,,,,,,,,8.79,88,,percent of total billed charges,,,,,,,,,7.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.5,22,,percent of total billed charges,,,9.09,91,,percent of total billed charges,,,9.49,95,,percent of total billed charges,,,8.29,83,,percent of total billed charges,,,8.29,83,,percent of total billed charges,,,,,,,,,,,,,,,8.29,83,,percent of total billed charges,,,9.49,95,,percent of total billed charges,,,8.99,90,,percent of total billed charges,,,8.99,90,,percent of total billed charges,,,8.19,82,,percent of total billed charges,,,8.99,90,,percent of total billed charges,,,8.49,85,,percent of total billed charges,,2.5,9.49,
TRACH 4.5 UNCUFFED,23302043,CDM,,,270,RC,outpatient,,16.2,16.2,,13.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.05,22,,percent of total billed charges,,,,,,,,,14.58,90,,percent of total billed charges,,,13.41,82.8,,percent of total billed charges,,,13.77,85,,percent of total billed charges,,,,,,,,,14.26,88,,percent of total billed charges,,,,,,,,,12.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.05,22,,percent of total billed charges,,,14.74,91,,percent of total billed charges,,,15.39,95,,percent of total billed charges,,,13.45,83,,percent of total billed charges,,,13.45,83,,percent of total billed charges,,,,,,,,,,,,,,,13.45,83,,percent of total billed charges,,,15.39,95,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,13.28,82,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,13.77,85,,percent of total billed charges,,4.05,15.39,
*U CYSTOFLO URINE DRAIN BAG,23302059,CDM,,,270,RC,outpatient,,26,26,,22.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.5,22,,percent of total billed charges,,,,,,,,,23.4,90,,percent of total billed charges,,,21.53,82.8,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,,,,,,,,22.88,88,,percent of total billed charges,,,,,,,,,19.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.5,22,,percent of total billed charges,,,23.66,91,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,,,,,,,,,,,,,21.58,83,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,21.32,82,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,6.5,24.7,
URETERAL DILATATION SET,23302067,CDM,,,270,RC,outpatient,,1605,1605,,1362.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,401.25,22,,percent of total billed charges,,,,,,,,,1444.5,90,,percent of total billed charges,,,1328.94,82.8,,percent of total billed charges,,,1364.25,85,,percent of total billed charges,,,,,,,,,1412.4,88,,percent of total billed charges,,,,,,,,,1226.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,401.25,22,,percent of total billed charges,,,1460.55,91,,percent of total billed charges,,,1524.75,95,,percent of total billed charges,,,1332.15,83,,percent of total billed charges,,,1332.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1332.15,83,,percent of total billed charges,,,1524.75,95,,percent of total billed charges,,,1444.5,90,,percent of total billed charges,,,1444.5,90,,percent of total billed charges,,,1316.1,82,,percent of total billed charges,,,1444.5,90,,percent of total billed charges,,,1364.25,85,,percent of total billed charges,,401.25,1524.75,
URO DRAIN BAG (CASTLE),23302076,CDM,,,270,RC,outpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.25,22,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,63.76,82.8,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.25,22,,percent of total billed charges,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,19.25,73.15,
TAPE UMBILICAL 1/8 X 30,23302117,CDM,,,270,RC,outpatient,,12.98,12.98,,11.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.68,90,,percent of total billed charges,,,10.75,82.8,,percent of total billed charges,,,11.03,85,,percent of total billed charges,,,,,,,,,11.42,88,,percent of total billed charges,,,,,,,,,9.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.81,91,,percent of total billed charges,,,12.33,95,,percent of total billed charges,,,10.77,83,,percent of total billed charges,,,10.77,83,,percent of total billed charges,,,,,,,,,,,,,,,10.77,83,,percent of total billed charges,,,12.33,95,,percent of total billed charges,,,11.68,90,,percent of total billed charges,,,11.68,90,,percent of total billed charges,,,10.64,82,,percent of total billed charges,,,11.68,90,,percent of total billed charges,,,11.03,85,,percent of total billed charges,,3.25,12.33,
*TROCAR CATHETER 24FR 16,23302148,CDM,,,270,RC,outpatient,,136,136,,115.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34,22,,percent of total billed charges,,,,,,,,,122.4,90,,percent of total billed charges,,,112.61,82.8,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,,,,,,,,119.68,88,,percent of total billed charges,,,,,,,,,103.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34,22,,percent of total billed charges,,,123.76,91,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,,,,,,,,,,,,,112.88,83,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,111.52,82,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,34,129.2,
MESH PERFIX PLUG LARGE,23302380,CDM,,,270,RC,outpatient,,962,962,,816.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,240.5,22,,percent of total billed charges,,,,,,,,,865.8,90,,percent of total billed charges,,,796.54,82.8,,percent of total billed charges,,,817.7,85,,percent of total billed charges,,,,,,,,,846.56,88,,percent of total billed charges,,,,,,,,,734.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,240.5,22,,percent of total billed charges,,,875.42,91,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,,,,,,,,,,,,,798.46,83,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,788.84,82,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,817.7,85,,percent of total billed charges,,240.5,913.9,
MESH PERFIX PLUG SMALL,23302385,CDM,,,270,RC,outpatient,,932.75,932.75,,791.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,233.19,22,,percent of total billed charges,,,,,,,,,839.48,90,,percent of total billed charges,,,772.32,82.8,,percent of total billed charges,,,792.84,85,,percent of total billed charges,,,,,,,,,820.82,88,,percent of total billed charges,,,,,,,,,712.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,233.19,22,,percent of total billed charges,,,848.8,91,,percent of total billed charges,,,886.11,95,,percent of total billed charges,,,774.18,83,,percent of total billed charges,,,774.18,83,,percent of total billed charges,,,,,,,,,,,,,,,774.18,83,,percent of total billed charges,,,886.11,95,,percent of total billed charges,,,839.48,90,,percent of total billed charges,,,839.48,90,,percent of total billed charges,,,764.86,82,,percent of total billed charges,,,839.48,90,,percent of total billed charges,,,792.84,85,,percent of total billed charges,,233.19,886.11,
SPLINT NASAL DOYLE II,23302430,CDM,,,270,RC,outpatient,,532,532,,451.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,133,22,,percent of total billed charges,,,,,,,,,478.8,90,,percent of total billed charges,,,440.5,82.8,,percent of total billed charges,,,452.2,85,,percent of total billed charges,,,,,,,,,468.16,88,,percent of total billed charges,,,,,,,,,406.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,133,22,,percent of total billed charges,,,484.12,91,,percent of total billed charges,,,505.4,95,,percent of total billed charges,,,441.56,83,,percent of total billed charges,,,441.56,83,,percent of total billed charges,,,,,,,,,,,,,,,441.56,83,,percent of total billed charges,,,505.4,95,,percent of total billed charges,,,478.8,90,,percent of total billed charges,,,478.8,90,,percent of total billed charges,,,436.24,82,,percent of total billed charges,,,478.8,90,,percent of total billed charges,,,452.2,85,,percent of total billed charges,,133,505.4,
TOURNI-COT SIZE LARGE,23302450,CDM,,,270,RC,outpatient,,28.33,28.33,,24.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.08,22,,percent of total billed charges,,,,,,,,,25.5,90,,percent of total billed charges,,,23.46,82.8,,percent of total billed charges,,,24.08,85,,percent of total billed charges,,,,,,,,,24.93,88,,percent of total billed charges,,,,,,,,,21.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.08,22,,percent of total billed charges,,,25.78,91,,percent of total billed charges,,,26.91,95,,percent of total billed charges,,,23.51,83,,percent of total billed charges,,,23.51,83,,percent of total billed charges,,,,,,,,,,,,,,,23.51,83,,percent of total billed charges,,,26.91,95,,percent of total billed charges,,,25.5,90,,percent of total billed charges,,,25.5,90,,percent of total billed charges,,,23.23,82,,percent of total billed charges,,,25.5,90,,percent of total billed charges,,,24.08,85,,percent of total billed charges,,7.08,26.91,
*RUBBER BAND STERILE 3,23302497,CDM,,,270,RC,outpatient,,4,4,,3.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1,22,,percent of total billed charges,,,,,,,,,3.6,90,,percent of total billed charges,,,3.31,82.8,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,,,,,,,,3.52,88,,percent of total billed charges,,,,,,,,,3.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1,22,,percent of total billed charges,,,3.64,91,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3.32,83,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.28,82,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,1,3.8,
TRAY THORACENTESIS - ARROW,23302505,CDM,,,270,RC,outpatient,,667.88,667.88,,567.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.97,22,,percent of total billed charges,,,,,,,,,601.09,90,,percent of total billed charges,,,553,82.8,,percent of total billed charges,,,567.7,85,,percent of total billed charges,,,,,,,,,587.73,88,,percent of total billed charges,,,,,,,,,510.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.97,22,,percent of total billed charges,,,607.77,91,,percent of total billed charges,,,634.49,95,,percent of total billed charges,,,554.34,83,,percent of total billed charges,,,554.34,83,,percent of total billed charges,,,,,,,,,,,,,,,554.34,83,,percent of total billed charges,,,634.49,95,,percent of total billed charges,,,601.09,90,,percent of total billed charges,,,601.09,90,,percent of total billed charges,,,547.66,82,,percent of total billed charges,,,601.09,90,,percent of total billed charges,,,567.7,85,,percent of total billed charges,,166.97,634.49,
TUBE EAR REUTER BOBBIN BLUE 1.14MM,23302580,CDM,,,270,RC,outpatient,,195.2,195.2,,165.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.8,22,,percent of total billed charges,,,,,,,,,175.68,90,,percent of total billed charges,,,161.63,82.8,,percent of total billed charges,,,165.92,85,,percent of total billed charges,,,,,,,,,171.78,88,,percent of total billed charges,,,,,,,,,149.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.8,22,,percent of total billed charges,,,177.63,91,,percent of total billed charges,,,185.44,95,,percent of total billed charges,,,162.02,83,,percent of total billed charges,,,162.02,83,,percent of total billed charges,,,,,,,,,,,,,,,162.02,83,,percent of total billed charges,,,185.44,95,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,160.06,82,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,165.92,85,,percent of total billed charges,,48.8,185.44,
TUBE EAR GOODE-T 1.14MM X 6MM,23302596,CDM,,,270,RC,outpatient,,348,348,,295.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87,22,,percent of total billed charges,,,,,,,,,313.2,90,,percent of total billed charges,,,288.14,82.8,,percent of total billed charges,,,295.8,85,,percent of total billed charges,,,,,,,,,306.24,88,,percent of total billed charges,,,,,,,,,265.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87,22,,percent of total billed charges,,,316.68,91,,percent of total billed charges,,,330.6,95,,percent of total billed charges,,,288.84,83,,percent of total billed charges,,,288.84,83,,percent of total billed charges,,,,,,,,,,,,,,,288.84,83,,percent of total billed charges,,,330.6,95,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,285.36,82,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,295.8,85,,percent of total billed charges,,87,330.6,
TUBE EAR RICHARDS 1.32MM,23302598,CDM,,,270,RC,outpatient,,193.12,193.12,,163.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.28,22,,percent of total billed charges,,,,,,,,,173.81,90,,percent of total billed charges,,,159.9,82.8,,percent of total billed charges,,,164.15,85,,percent of total billed charges,,,,,,,,,169.95,88,,percent of total billed charges,,,,,,,,,147.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.28,22,,percent of total billed charges,,,175.74,91,,percent of total billed charges,,,183.46,95,,percent of total billed charges,,,160.29,83,,percent of total billed charges,,,160.29,83,,percent of total billed charges,,,,,,,,,,,,,,,160.29,83,,percent of total billed charges,,,183.46,95,,percent of total billed charges,,,173.81,90,,percent of total billed charges,,,173.81,90,,percent of total billed charges,,,158.36,82,,percent of total billed charges,,,173.81,90,,percent of total billed charges,,,164.15,85,,percent of total billed charges,,48.28,183.46,
TRACTION BOOT UNIVERSAL,23302729,CDM,,,270,RC,outpatient,,104.48,104.48,,88.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.12,22,,percent of total billed charges,,,,,,,,,94.03,90,,percent of total billed charges,,,86.51,82.8,,percent of total billed charges,,,88.81,85,,percent of total billed charges,,,,,,,,,91.94,88,,percent of total billed charges,,,,,,,,,79.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.12,22,,percent of total billed charges,,,95.08,91,,percent of total billed charges,,,99.26,95,,percent of total billed charges,,,86.72,83,,percent of total billed charges,,,86.72,83,,percent of total billed charges,,,,,,,,,,,,,,,86.72,83,,percent of total billed charges,,,99.26,95,,percent of total billed charges,,,94.03,90,,percent of total billed charges,,,94.03,90,,percent of total billed charges,,,85.67,82,,percent of total billed charges,,,94.03,90,,percent of total billed charges,,,88.81,85,,percent of total billed charges,,26.12,99.26,
ABDUCTION PILLOW  HIP UNIVERSAL,23302802,CDM,,,270,RC,outpatient,,129.84,129.84,,110.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.46,22,,percent of total billed charges,,,,,,,,,116.86,90,,percent of total billed charges,,,107.51,82.8,,percent of total billed charges,,,110.36,85,,percent of total billed charges,,,,,,,,,114.26,88,,percent of total billed charges,,,,,,,,,99.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.46,22,,percent of total billed charges,,,118.15,91,,percent of total billed charges,,,123.35,95,,percent of total billed charges,,,107.77,83,,percent of total billed charges,,,107.77,83,,percent of total billed charges,,,,,,,,,,,,,,,107.77,83,,percent of total billed charges,,,123.35,95,,percent of total billed charges,,,116.86,90,,percent of total billed charges,,,116.86,90,,percent of total billed charges,,,106.47,82,,percent of total billed charges,,,116.86,90,,percent of total billed charges,,,110.36,85,,percent of total billed charges,,32.46,123.35,
AIRWAY NASO PVC 26FR,23302835,CDM,,,270,RC,outpatient,,21.04,21.04,,17.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.26,22,,percent of total billed charges,,,,,,,,,18.94,90,,percent of total billed charges,,,17.42,82.8,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,,,,,,,,18.52,88,,percent of total billed charges,,,,,,,,,16.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.26,22,,percent of total billed charges,,,19.15,91,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,,,,,,,,,,,,,17.46,83,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.25,82,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,5.26,19.99,
AIRWAY NASO PVC 30FR,23302836,CDM,,,270,RC,outpatient,,24.68,24.68,,20.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.17,22,,percent of total billed charges,,,,,,,,,22.21,90,,percent of total billed charges,,,20.44,82.8,,percent of total billed charges,,,20.98,85,,percent of total billed charges,,,,,,,,,21.72,88,,percent of total billed charges,,,,,,,,,18.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.17,22,,percent of total billed charges,,,22.46,91,,percent of total billed charges,,,23.45,95,,percent of total billed charges,,,20.48,83,,percent of total billed charges,,,20.48,83,,percent of total billed charges,,,,,,,,,,,,,,,20.48,83,,percent of total billed charges,,,23.45,95,,percent of total billed charges,,,22.21,90,,percent of total billed charges,,,22.21,90,,percent of total billed charges,,,20.24,82,,percent of total billed charges,,,22.21,90,,percent of total billed charges,,,20.98,85,,percent of total billed charges,,6.17,23.45,
AIRWAY GUEDEL 50MM,23302838,CDM,,,270,RC,outpatient,,3.56,3.56,,3.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.89,22,,percent of total billed charges,,,,,,,,,3.2,90,,percent of total billed charges,,,2.95,82.8,,percent of total billed charges,,,3.03,85,,percent of total billed charges,,,,,,,,,3.13,88,,percent of total billed charges,,,,,,,,,2.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.89,22,,percent of total billed charges,,,3.24,91,,percent of total billed charges,,,3.38,95,,percent of total billed charges,,,2.95,83,,percent of total billed charges,,,2.95,83,,percent of total billed charges,,,,,,,,,,,,,,,2.95,83,,percent of total billed charges,,,3.38,95,,percent of total billed charges,,,3.2,90,,percent of total billed charges,,,3.2,90,,percent of total billed charges,,,2.92,82,,percent of total billed charges,,,3.2,90,,percent of total billed charges,,,3.03,85,,percent of total billed charges,,0.89,3.38,
AIRWAY NASO PVC 24FR,23302840,CDM,,,270,RC,outpatient,,21.04,21.04,,17.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.26,22,,percent of total billed charges,,,,,,,,,18.94,90,,percent of total billed charges,,,17.42,82.8,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,,,,,,,,18.52,88,,percent of total billed charges,,,,,,,,,16.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.26,22,,percent of total billed charges,,,19.15,91,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,,,,,,,,,,,,,17.46,83,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.25,82,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,5.26,19.99,
AIRWAY NASO PVC 28FR,23302841,CDM,,,270,RC,outpatient,,21.04,21.04,,17.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.26,22,,percent of total billed charges,,,,,,,,,18.94,90,,percent of total billed charges,,,17.42,82.8,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,,,,,,,,18.52,88,,percent of total billed charges,,,,,,,,,16.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.26,22,,percent of total billed charges,,,19.15,91,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,,,,,,,,,,,,,17.46,83,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.25,82,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,5.26,19.99,
AIRWAY NASO PVC 20FR,23302842,CDM,,,270,RC,outpatient,,21.04,21.04,,17.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.26,22,,percent of total billed charges,,,,,,,,,18.94,90,,percent of total billed charges,,,17.42,82.8,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,,,,,,,,18.52,88,,percent of total billed charges,,,,,,,,,16.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.26,22,,percent of total billed charges,,,19.15,91,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,,,,,,,,,,,,,17.46,83,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.25,82,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,5.26,19.99,
AIRWAY NASO PVC 22FR,23302843,CDM,,,270,RC,outpatient,,21.04,21.04,,17.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.26,22,,percent of total billed charges,,,,,,,,,18.94,90,,percent of total billed charges,,,17.42,82.8,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,,,,,,,,18.52,88,,percent of total billed charges,,,,,,,,,16.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.26,22,,percent of total billed charges,,,19.15,91,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,,,,,,,,,,,,,17.46,83,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.25,82,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,5.26,19.99,
PEAK FLOW METER W/ INSTRUCTIONS,23302901,CDM,,,270,RC,outpatient,,67.61,67.61,,57.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.9,22,,percent of total billed charges,,,,,,,,,60.85,90,,percent of total billed charges,,,55.98,82.8,,percent of total billed charges,,,57.47,85,,percent of total billed charges,,,,,,,,,59.5,88,,percent of total billed charges,,,,,,,,,51.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.9,22,,percent of total billed charges,,,61.53,91,,percent of total billed charges,,,64.23,95,,percent of total billed charges,,,56.12,83,,percent of total billed charges,,,56.12,83,,percent of total billed charges,,,,,,,,,,,,,,,56.12,83,,percent of total billed charges,,,64.23,95,,percent of total billed charges,,,60.85,90,,percent of total billed charges,,,60.85,90,,percent of total billed charges,,,55.44,82,,percent of total billed charges,,,60.85,90,,percent of total billed charges,,,57.47,85,,percent of total billed charges,,16.9,64.23,
CERVICAL COLLAR UNIVERSAL,23302920,CDM,,,270,RC,outpatient,,23.49,23.49,,19.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.87,22,,percent of total billed charges,,,,,,,,,21.14,90,,percent of total billed charges,,,19.45,82.8,,percent of total billed charges,,,19.97,85,,percent of total billed charges,,,,,,,,,20.67,88,,percent of total billed charges,,,,,,,,,17.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.87,22,,percent of total billed charges,,,21.38,91,,percent of total billed charges,,,22.32,95,,percent of total billed charges,,,19.5,83,,percent of total billed charges,,,19.5,83,,percent of total billed charges,,,,,,,,,,,,,,,19.5,83,,percent of total billed charges,,,22.32,95,,percent of total billed charges,,,21.14,90,,percent of total billed charges,,,21.14,90,,percent of total billed charges,,,19.26,82,,percent of total billed charges,,,21.14,90,,percent of total billed charges,,,19.97,85,,percent of total billed charges,,5.87,22.32,
PLEUREVAC DRAIN SET,23302927,CDM,,,270,RC,outpatient,,250.1,250.1,,212.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.53,22,,percent of total billed charges,,,,,,,,,225.09,90,,percent of total billed charges,,,207.08,82.8,,percent of total billed charges,,,212.59,85,,percent of total billed charges,,,,,,,,,220.09,88,,percent of total billed charges,,,,,,,,,191.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.53,22,,percent of total billed charges,,,227.59,91,,percent of total billed charges,,,237.6,95,,percent of total billed charges,,,207.58,83,,percent of total billed charges,,,207.58,83,,percent of total billed charges,,,,,,,,,,,,,,,207.58,83,,percent of total billed charges,,,237.6,95,,percent of total billed charges,,,225.09,90,,percent of total billed charges,,,225.09,90,,percent of total billed charges,,,205.08,82,,percent of total billed charges,,,225.09,90,,percent of total billed charges,,,212.59,85,,percent of total billed charges,,62.53,237.6,
*STOMA POWDER ADAPT 1OZ,23302968,CDM,,,270,RC,outpatient,,30,30,,25.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.5,22,,percent of total billed charges,,,,,,,,,27,90,,percent of total billed charges,,,24.84,82.8,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,,,,,,,,26.4,88,,percent of total billed charges,,,,,,,,,22.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.5,22,,percent of total billed charges,,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,24.9,83,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,24.6,82,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,7.5,28.5,
*SOCK AID,23303012,CDM,,,270,RC,outpatient,,52,52,,44.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13,22,,percent of total billed charges,,,,,,,,,46.8,90,,percent of total billed charges,,,43.06,82.8,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,,,,,,,,45.76,88,,percent of total billed charges,,,,,,,,,39.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13,22,,percent of total billed charges,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,42.64,82,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,13,49.4,
REACHER 26  LONG,23303014,CDM,,,270,RC,outpatient,,35.19,35.19,,29.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.8,22,,percent of total billed charges,,,,,,,,,31.67,90,,percent of total billed charges,,,29.14,82.8,,percent of total billed charges,,,29.91,85,,percent of total billed charges,,,,,,,,,30.97,88,,percent of total billed charges,,,,,,,,,26.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.8,22,,percent of total billed charges,,,32.02,91,,percent of total billed charges,,,33.43,95,,percent of total billed charges,,,29.21,83,,percent of total billed charges,,,29.21,83,,percent of total billed charges,,,,,,,,,,,,,,,29.21,83,,percent of total billed charges,,,33.43,95,,percent of total billed charges,,,31.67,90,,percent of total billed charges,,,31.67,90,,percent of total billed charges,,,28.86,82,,percent of total billed charges,,,31.67,90,,percent of total billed charges,,,29.91,85,,percent of total billed charges,,8.8,33.43,
*DIALYSIS TRAY,23303016,CDM,,,270,RC,outpatient,,114,114,,96.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.5,22,,percent of total billed charges,,,,,,,,,102.6,90,,percent of total billed charges,,,94.39,82.8,,percent of total billed charges,,,96.9,85,,percent of total billed charges,,,,,,,,,100.32,88,,percent of total billed charges,,,,,,,,,87.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.5,22,,percent of total billed charges,,,103.74,91,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,,,,,,,,,,,,,94.62,83,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,93.48,82,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,96.9,85,,percent of total billed charges,,28.5,108.3,
LEG LIFTER NAVY 42  REGULAR,23303018,CDM,,,270,RC,outpatient,,72.25,72.25,,61.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.06,22,,percent of total billed charges,,,,,,,,,65.03,90,,percent of total billed charges,,,59.82,82.8,,percent of total billed charges,,,61.41,85,,percent of total billed charges,,,,,,,,,63.58,88,,percent of total billed charges,,,,,,,,,55.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.06,22,,percent of total billed charges,,,65.75,91,,percent of total billed charges,,,68.64,95,,percent of total billed charges,,,59.97,83,,percent of total billed charges,,,59.97,83,,percent of total billed charges,,,,,,,,,,,,,,,59.97,83,,percent of total billed charges,,,68.64,95,,percent of total billed charges,,,65.03,90,,percent of total billed charges,,,65.03,90,,percent of total billed charges,,,59.25,82,,percent of total billed charges,,,65.03,90,,percent of total billed charges,,,61.41,85,,percent of total billed charges,,18.06,68.64,
*TOILET SEAT RAISED,23303024,CDM,,,270,RC,outpatient,,182,182,,154.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.5,22,,percent of total billed charges,,,,,,,,,163.8,90,,percent of total billed charges,,,150.7,82.8,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,,,,,,,,160.16,88,,percent of total billed charges,,,,,,,,,139.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.5,22,,percent of total billed charges,,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,149.24,82,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,45.5,172.9,
*COMBIDERM 6X10,23303119,CDM,,,270,RC,outpatient,,52,52,,44.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13,22,,percent of total billed charges,,,,,,,,,46.8,90,,percent of total billed charges,,,43.06,82.8,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,,,,,,,,45.76,88,,percent of total billed charges,,,,,,,,,39.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13,22,,percent of total billed charges,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,42.64,82,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,13,49.4,
*COMBIDERM 4X4 W/BORDER,23303120,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
*COMBIDERM 6X7,23303121,CDM,,,270,RC,outpatient,,38,38,,32.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.5,22,,percent of total billed charges,,,,,,,,,34.2,90,,percent of total billed charges,,,31.46,82.8,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,,,,,,,,33.44,88,,percent of total billed charges,,,,,,,,,29.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.5,22,,percent of total billed charges,,,34.58,91,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,,,,,,,,,,,,,31.54,83,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,31.16,82,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,9.5,36.1,
*COMBIDERM 5.25 X 5.25,23303122,CDM,,,270,RC,outpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.75,22,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,48.85,82.8,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,,,,,,,,51.92,88,,percent of total billed charges,,,,,,,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.75,22,,percent of total billed charges,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,14.75,56.05,
*COMBIDERM 5.25 X 5.25 W/BORDER,23303124,CDM,,,270,RC,outpatient,,31,31,,26.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.75,22,,percent of total billed charges,,,,,,,,,27.9,90,,percent of total billed charges,,,25.67,82.8,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,,,,,,,,27.28,88,,percent of total billed charges,,,,,,,,,23.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.75,22,,percent of total billed charges,,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,,,,,,,,,,,,,25.73,83,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,25.42,82,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,7.75,29.45,
KCI CANISTER M6275063,23303129,CDM,,,270,RC,outpatient,,318.68,318.68,,270.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.67,22,,percent of total billed charges,,,,,,,,,286.81,90,,percent of total billed charges,,,263.87,82.8,,percent of total billed charges,,,270.88,85,,percent of total billed charges,,,,,,,,,280.44,88,,percent of total billed charges,,,,,,,,,243.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.67,22,,percent of total billed charges,,,290,91,,percent of total billed charges,,,302.75,95,,percent of total billed charges,,,264.5,83,,percent of total billed charges,,,264.5,83,,percent of total billed charges,,,,,,,,,,,,,,,264.5,83,,percent of total billed charges,,,302.75,95,,percent of total billed charges,,,286.81,90,,percent of total billed charges,,,286.81,90,,percent of total billed charges,,,261.32,82,,percent of total billed charges,,,286.81,90,,percent of total billed charges,,,270.88,85,,percent of total billed charges,,79.67,302.75,
KCI GRANUFOAM SM M6275051,23303132,CDM,,,270,RC,outpatient,,300.08,300.08,,254.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.02,22,,percent of total billed charges,,,,,,,,,270.07,90,,percent of total billed charges,,,248.47,82.8,,percent of total billed charges,,,255.07,85,,percent of total billed charges,,,,,,,,,264.07,88,,percent of total billed charges,,,,,,,,,229.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.02,22,,percent of total billed charges,,,273.07,91,,percent of total billed charges,,,285.08,95,,percent of total billed charges,,,249.07,83,,percent of total billed charges,,,249.07,83,,percent of total billed charges,,,,,,,,,,,,,,,249.07,83,,percent of total billed charges,,,285.08,95,,percent of total billed charges,,,270.07,90,,percent of total billed charges,,,270.07,90,,percent of total billed charges,,,246.07,82,,percent of total billed charges,,,270.07,90,,percent of total billed charges,,,255.07,85,,percent of total billed charges,,75.02,285.08,
KCI VERSAFOAM WHITE SM M6275033,23303133,CDM,,,270,RC,outpatient,,83.02,83.02,,70.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.76,22,,percent of total billed charges,,,,,,,,,74.72,90,,percent of total billed charges,,,68.74,82.8,,percent of total billed charges,,,70.57,85,,percent of total billed charges,,,,,,,,,73.06,88,,percent of total billed charges,,,,,,,,,63.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.76,22,,percent of total billed charges,,,75.55,91,,percent of total billed charges,,,78.87,95,,percent of total billed charges,,,68.91,83,,percent of total billed charges,,,68.91,83,,percent of total billed charges,,,,,,,,,,,,,,,68.91,83,,percent of total billed charges,,,78.87,95,,percent of total billed charges,,,74.72,90,,percent of total billed charges,,,74.72,90,,percent of total billed charges,,,68.08,82,,percent of total billed charges,,,74.72,90,,percent of total billed charges,,,70.57,85,,percent of total billed charges,,20.76,78.87,
KCI GRANUFOAM LG M6275053,23303134,CDM,,,270,RC,outpatient,,425.53,425.53,,361.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,106.38,22,,percent of total billed charges,,,,,,,,,382.98,90,,percent of total billed charges,,,352.34,82.8,,percent of total billed charges,,,361.7,85,,percent of total billed charges,,,,,,,,,374.47,88,,percent of total billed charges,,,,,,,,,325.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,106.38,22,,percent of total billed charges,,,387.23,91,,percent of total billed charges,,,404.25,95,,percent of total billed charges,,,353.19,83,,percent of total billed charges,,,353.19,83,,percent of total billed charges,,,,,,,,,,,,,,,353.19,83,,percent of total billed charges,,,404.25,95,,percent of total billed charges,,,382.98,90,,percent of total billed charges,,,382.98,90,,percent of total billed charges,,,348.93,82,,percent of total billed charges,,,382.98,90,,percent of total billed charges,,,361.7,85,,percent of total billed charges,,106.38,404.25,
*KCI HEEL FOAM,23303135,CDM,,,270,RC,outpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94,22,,percent of total billed charges,,,,,,,,,338.4,90,,percent of total billed charges,,,311.33,82.8,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94,22,,percent of total billed charges,,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,94,357.2,
KCI GRANUFOAM MED M6275052,23303136,CDM,,,270,RC,outpatient,,352.8,352.8,,299.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.2,22,,percent of total billed charges,,,,,,,,,317.52,90,,percent of total billed charges,,,292.12,82.8,,percent of total billed charges,,,299.88,85,,percent of total billed charges,,,,,,,,,310.46,88,,percent of total billed charges,,,,,,,,,269.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.2,22,,percent of total billed charges,,,321.05,91,,percent of total billed charges,,,335.16,95,,percent of total billed charges,,,292.82,83,,percent of total billed charges,,,292.82,83,,percent of total billed charges,,,,,,,,,,,,,,,292.82,83,,percent of total billed charges,,,335.16,95,,percent of total billed charges,,,317.52,90,,percent of total billed charges,,,317.52,90,,percent of total billed charges,,,289.3,82,,percent of total billed charges,,,317.52,90,,percent of total billed charges,,,299.88,85,,percent of total billed charges,,88.2,335.16,
KCI GRANUFOAM SILVER MED M8275096,23303137,CDM,,,270,RC,outpatient,,477.44,477.44,,405.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.36,22,,percent of total billed charges,,,,,,,,,429.7,90,,percent of total billed charges,,,395.32,82.8,,percent of total billed charges,,,405.82,85,,percent of total billed charges,,,,,,,,,420.15,88,,percent of total billed charges,,,,,,,,,364.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.36,22,,percent of total billed charges,,,434.47,91,,percent of total billed charges,,,453.57,95,,percent of total billed charges,,,396.28,83,,percent of total billed charges,,,396.28,83,,percent of total billed charges,,,,,,,,,,,,,,,396.28,83,,percent of total billed charges,,,453.57,95,,percent of total billed charges,,,429.7,90,,percent of total billed charges,,,429.7,90,,percent of total billed charges,,,391.5,82,,percent of total billed charges,,,429.7,90,,percent of total billed charges,,,405.82,85,,percent of total billed charges,,119.36,453.57,
STAPLER SKIN PROXIMATE 35W,23303214,CDM,,,270,RC,outpatient,,53.41,53.41,,45.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.35,22,,percent of total billed charges,,,,,,,,,48.07,90,,percent of total billed charges,,,44.22,82.8,,percent of total billed charges,,,45.4,85,,percent of total billed charges,,,,,,,,,47,88,,percent of total billed charges,,,,,,,,,40.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.35,22,,percent of total billed charges,,,48.6,91,,percent of total billed charges,,,50.74,95,,percent of total billed charges,,,44.33,83,,percent of total billed charges,,,44.33,83,,percent of total billed charges,,,,,,,,,,,,,,,44.33,83,,percent of total billed charges,,,50.74,95,,percent of total billed charges,,,48.07,90,,percent of total billed charges,,,48.07,90,,percent of total billed charges,,,43.8,82,,percent of total billed charges,,,48.07,90,,percent of total billed charges,,,45.4,85,,percent of total billed charges,,13.35,50.74,
STAPLER REMOVER SKIN,23303222,CDM,,,270,RC,outpatient,,130.44,130.44,,110.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.61,22,,percent of total billed charges,,,,,,,,,117.4,90,,percent of total billed charges,,,108,82.8,,percent of total billed charges,,,110.87,85,,percent of total billed charges,,,,,,,,,114.79,88,,percent of total billed charges,,,,,,,,,99.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.61,22,,percent of total billed charges,,,118.7,91,,percent of total billed charges,,,123.92,95,,percent of total billed charges,,,108.27,83,,percent of total billed charges,,,108.27,83,,percent of total billed charges,,,,,,,,,,,,,,,108.27,83,,percent of total billed charges,,,123.92,95,,percent of total billed charges,,,117.4,90,,percent of total billed charges,,,117.4,90,,percent of total billed charges,,,106.96,82,,percent of total billed charges,,,117.4,90,,percent of total billed charges,,,110.87,85,,percent of total billed charges,,32.61,123.92,
* IV CATHETER JELCO 20 NO WINGS (V0904),23303236,CDM,,,270,RC,outpatient,,4,4,,3.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1,22,,percent of total billed charges,,,,,,,,,3.6,90,,percent of total billed charges,,,3.31,82.8,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,,,,,,,,3.52,88,,percent of total billed charges,,,,,,,,,3.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1,22,,percent of total billed charges,,,3.64,91,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3.32,83,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.28,82,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,1,3.8,
ENDO LOC ADULT,23303420,CDM,,,270,RC,outpatient,,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.25,22,,percent of total billed charges,,,,,,,,,40.5,90,,percent of total billed charges,,,37.26,82.8,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.25,22,,percent of total billed charges,,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,11.25,42.75,
ENDO LOC PED,23303421,CDM,,,270,RC,outpatient,,36,36,,30.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9,22,,percent of total billed charges,,,,,,,,,32.4,90,,percent of total billed charges,,,29.81,82.8,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,,,,,,,,31.68,88,,percent of total billed charges,,,,,,,,,27.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9,22,,percent of total billed charges,,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,,,,,,,,,,,,,29.88,83,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,29.52,82,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,9,34.2,
*EXTENSION TUBE 14' DISP,23303462,CDM,,,270,RC,outpatient,,6,6,,5.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.5,22,,percent of total billed charges,,,,,,,,,5.4,90,,percent of total billed charges,,,4.97,82.8,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,,,,,,,,5.28,88,,percent of total billed charges,,,,,,,,,4.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.5,22,,percent of total billed charges,,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4.98,83,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,4.92,82,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,1.5,5.7,
*EXTENSION TUBE 21' DISP,23303463,CDM,,,270,RC,outpatient,,6,6,,5.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.5,22,,percent of total billed charges,,,,,,,,,5.4,90,,percent of total billed charges,,,4.97,82.8,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,,,,,,,,5.28,88,,percent of total billed charges,,,,,,,,,4.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.5,22,,percent of total billed charges,,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4.98,83,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,4.92,82,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,1.5,5.7,
URINARY DRAINAGE BAG W METER,23303537,CDM,,,270,RC,outpatient,,51.34,51.34,,43.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.84,22,,percent of total billed charges,,,,,,,,,46.21,90,,percent of total billed charges,,,42.51,82.8,,percent of total billed charges,,,43.64,85,,percent of total billed charges,,,,,,,,,45.18,88,,percent of total billed charges,,,,,,,,,39.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.84,22,,percent of total billed charges,,,46.72,91,,percent of total billed charges,,,48.77,95,,percent of total billed charges,,,42.61,83,,percent of total billed charges,,,42.61,83,,percent of total billed charges,,,,,,,,,,,,,,,42.61,83,,percent of total billed charges,,,48.77,95,,percent of total billed charges,,,46.21,90,,percent of total billed charges,,,46.21,90,,percent of total billed charges,,,42.1,82,,percent of total billed charges,,,46.21,90,,percent of total billed charges,,,43.64,85,,percent of total billed charges,,12.84,48.77,
GUIDEWIRE COONS BENSON,23303554,CDM,,,270,RC,outpatient,,199.95,199.95,,169.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.99,22,,percent of total billed charges,,,,,,,,,179.96,90,,percent of total billed charges,,,165.56,82.8,,percent of total billed charges,,,169.96,85,,percent of total billed charges,,,,,,,,,175.96,88,,percent of total billed charges,,,,,,,,,152.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.99,22,,percent of total billed charges,,,181.95,91,,percent of total billed charges,,,189.95,95,,percent of total billed charges,,,165.96,83,,percent of total billed charges,,,165.96,83,,percent of total billed charges,,,,,,,,,,,,,,,165.96,83,,percent of total billed charges,,,189.95,95,,percent of total billed charges,,,179.96,90,,percent of total billed charges,,,179.96,90,,percent of total billed charges,,,163.96,82,,percent of total billed charges,,,179.96,90,,percent of total billed charges,,,169.96,85,,percent of total billed charges,,49.99,189.95,
GLIDEWIRE URO 150 X 3MM,23303555,CDM,,,270,RC,outpatient,,371.07,371.07,,315.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.77,22,,percent of total billed charges,,,,,,,,,333.96,90,,percent of total billed charges,,,307.25,82.8,,percent of total billed charges,,,315.41,85,,percent of total billed charges,,,,,,,,,326.54,88,,percent of total billed charges,,,,,,,,,283.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.77,22,,percent of total billed charges,,,337.67,91,,percent of total billed charges,,,352.52,95,,percent of total billed charges,,,307.99,83,,percent of total billed charges,,,307.99,83,,percent of total billed charges,,,,,,,,,,,,,,,307.99,83,,percent of total billed charges,,,352.52,95,,percent of total billed charges,,,333.96,90,,percent of total billed charges,,,333.96,90,,percent of total billed charges,,,304.28,82,,percent of total billed charges,,,333.96,90,,percent of total billed charges,,,315.41,85,,percent of total billed charges,,92.77,352.52,
AIRWAY I-GEL SUPRAGLOTTIC  #4,23303694,CDM,,,270,RC,outpatient,,76.87,76.87,,65.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.22,22,,percent of total billed charges,,,,,,,,,69.18,90,,percent of total billed charges,,,63.65,82.8,,percent of total billed charges,,,65.34,85,,percent of total billed charges,,,,,,,,,67.65,88,,percent of total billed charges,,,,,,,,,58.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.22,22,,percent of total billed charges,,,69.95,91,,percent of total billed charges,,,73.03,95,,percent of total billed charges,,,63.8,83,,percent of total billed charges,,,63.8,83,,percent of total billed charges,,,,,,,,,,,,,,,63.8,83,,percent of total billed charges,,,73.03,95,,percent of total billed charges,,,69.18,90,,percent of total billed charges,,,69.18,90,,percent of total billed charges,,,63.03,82,,percent of total billed charges,,,69.18,90,,percent of total billed charges,,,65.34,85,,percent of total billed charges,,19.22,73.03,
AIRWAY I-GEL SUPRAGLOTTIC #5,23303695,CDM,,,270,RC,outpatient,,76.87,76.87,,65.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.22,22,,percent of total billed charges,,,,,,,,,69.18,90,,percent of total billed charges,,,63.65,82.8,,percent of total billed charges,,,65.34,85,,percent of total billed charges,,,,,,,,,67.65,88,,percent of total billed charges,,,,,,,,,58.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.22,22,,percent of total billed charges,,,69.95,91,,percent of total billed charges,,,73.03,95,,percent of total billed charges,,,63.8,83,,percent of total billed charges,,,63.8,83,,percent of total billed charges,,,,,,,,,,,,,,,63.8,83,,percent of total billed charges,,,73.03,95,,percent of total billed charges,,,69.18,90,,percent of total billed charges,,,69.18,90,,percent of total billed charges,,,63.03,82,,percent of total billed charges,,,69.18,90,,percent of total billed charges,,,65.34,85,,percent of total billed charges,,19.22,73.03,
AIRWAY I-GEL SUPRAGLOTTIC  #3,23303696,CDM,,,270,RC,outpatient,,76.84,76.84,,65.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.21,22,,percent of total billed charges,,,,,,,,,69.16,90,,percent of total billed charges,,,63.62,82.8,,percent of total billed charges,,,65.31,85,,percent of total billed charges,,,,,,,,,67.62,88,,percent of total billed charges,,,,,,,,,58.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.21,22,,percent of total billed charges,,,69.92,91,,percent of total billed charges,,,73,95,,percent of total billed charges,,,63.78,83,,percent of total billed charges,,,63.78,83,,percent of total billed charges,,,,,,,,,,,,,,,63.78,83,,percent of total billed charges,,,73,95,,percent of total billed charges,,,69.16,90,,percent of total billed charges,,,69.16,90,,percent of total billed charges,,,63.01,82,,percent of total billed charges,,,69.16,90,,percent of total billed charges,,,65.31,85,,percent of total billed charges,,19.21,73,
TRAY BONE MARROW JAMSHIDE,23303842,CDM,,,270,RC,outpatient,,207.83,207.83,,176.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.96,22,,percent of total billed charges,,,,,,,,,187.05,90,,percent of total billed charges,,,172.08,82.8,,percent of total billed charges,,,176.66,85,,percent of total billed charges,,,,,,,,,182.89,88,,percent of total billed charges,,,,,,,,,158.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.96,22,,percent of total billed charges,,,189.13,91,,percent of total billed charges,,,197.44,95,,percent of total billed charges,,,172.5,83,,percent of total billed charges,,,172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,172.5,83,,percent of total billed charges,,,197.44,95,,percent of total billed charges,,,187.05,90,,percent of total billed charges,,,187.05,90,,percent of total billed charges,,,170.42,82,,percent of total billed charges,,,187.05,90,,percent of total billed charges,,,176.66,85,,percent of total billed charges,,51.96,197.44,
TRAY LUMBAR PUNCTURE,23303917,CDM,,,270,RC,outpatient,,189.53,189.53,,160.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.38,22,,percent of total billed charges,,,,,,,,,170.58,90,,percent of total billed charges,,,156.93,82.8,,percent of total billed charges,,,161.1,85,,percent of total billed charges,,,,,,,,,166.79,88,,percent of total billed charges,,,,,,,,,144.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.38,22,,percent of total billed charges,,,172.47,91,,percent of total billed charges,,,180.05,95,,percent of total billed charges,,,157.31,83,,percent of total billed charges,,,157.31,83,,percent of total billed charges,,,,,,,,,,,,,,,157.31,83,,percent of total billed charges,,,180.05,95,,percent of total billed charges,,,170.58,90,,percent of total billed charges,,,170.58,90,,percent of total billed charges,,,155.41,82,,percent of total billed charges,,,170.58,90,,percent of total billed charges,,,161.1,85,,percent of total billed charges,,47.38,180.05,
TRAY LUMBAR PUNCTURE - PEDS,23303925,CDM,,,270,RC,outpatient,,184.16,184.16,,156.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.04,22,,percent of total billed charges,,,,,,,,,165.74,90,,percent of total billed charges,,,152.48,82.8,,percent of total billed charges,,,156.54,85,,percent of total billed charges,,,,,,,,,162.06,88,,percent of total billed charges,,,,,,,,,140.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.04,22,,percent of total billed charges,,,167.59,91,,percent of total billed charges,,,174.95,95,,percent of total billed charges,,,152.85,83,,percent of total billed charges,,,152.85,83,,percent of total billed charges,,,,,,,,,,,,,,,152.85,83,,percent of total billed charges,,,174.95,95,,percent of total billed charges,,,165.74,90,,percent of total billed charges,,,165.74,90,,percent of total billed charges,,,151.01,82,,percent of total billed charges,,,165.74,90,,percent of total billed charges,,,156.54,85,,percent of total billed charges,,46.04,174.95,
TRAY PUDENDAL BLOCK,23303941,CDM,,,270,RC,outpatient,,57.15,57.15,,48.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.29,22,,percent of total billed charges,,,,,,,,,51.44,90,,percent of total billed charges,,,47.32,82.8,,percent of total billed charges,,,48.58,85,,percent of total billed charges,,,,,,,,,50.29,88,,percent of total billed charges,,,,,,,,,43.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.29,22,,percent of total billed charges,,,52.01,91,,percent of total billed charges,,,54.29,95,,percent of total billed charges,,,47.43,83,,percent of total billed charges,,,47.43,83,,percent of total billed charges,,,,,,,,,,,,,,,47.43,83,,percent of total billed charges,,,54.29,95,,percent of total billed charges,,,51.44,90,,percent of total billed charges,,,51.44,90,,percent of total billed charges,,,46.86,82,,percent of total billed charges,,,51.44,90,,percent of total billed charges,,,48.58,85,,percent of total billed charges,,14.29,54.29,
*THORACENTESIS PARACENTESIS TRAY(ARROW),23303959,CDM,,,270,RC,outpatient,,166,166,,140.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.5,22,,percent of total billed charges,,,,,,,,,149.4,90,,percent of total billed charges,,,137.45,82.8,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,,,,,,,,146.08,88,,percent of total billed charges,,,,,,,,,126.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.5,22,,percent of total billed charges,,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,,,,,,,,,,,,,137.78,83,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,136.12,82,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,41.5,157.7,
* TRACHEOSTOMY TUBE CUFF #6 (V0106),23303993,CDM,,,270,RC,outpatient,,235,235,,199.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,58.75,22,,percent of total billed charges,,,,,,,,,211.5,90,,percent of total billed charges,,,194.58,82.8,,percent of total billed charges,,,199.75,85,,percent of total billed charges,,,,,,,,,206.8,88,,percent of total billed charges,,,,,,,,,179.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,58.75,22,,percent of total billed charges,,,213.85,91,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,,,,,,,,,,,,,195.05,83,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,192.7,82,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,199.75,85,,percent of total billed charges,,58.75,223.25,
WARMING BLANKET FULL BODY,23304003,CDM,,,270,RC,outpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.5,22,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,64.58,82.8,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.5,22,,percent of total billed charges,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,19.5,74.1,
BLOOD TRANSFUSION FILTER,23304029,CDM,,,270,RC,outpatient,,49.05,49.05,,41.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.26,22,,percent of total billed charges,,,,,,,,,44.15,90,,percent of total billed charges,,,40.61,82.8,,percent of total billed charges,,,41.69,85,,percent of total billed charges,,,,,,,,,43.16,88,,percent of total billed charges,,,,,,,,,37.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.26,22,,percent of total billed charges,,,44.64,91,,percent of total billed charges,,,46.6,95,,percent of total billed charges,,,40.71,83,,percent of total billed charges,,,40.71,83,,percent of total billed charges,,,,,,,,,,,,,,,40.71,83,,percent of total billed charges,,,46.6,95,,percent of total billed charges,,,44.15,90,,percent of total billed charges,,,44.15,90,,percent of total billed charges,,,40.22,82,,percent of total billed charges,,,44.15,90,,percent of total billed charges,,,41.69,85,,percent of total billed charges,,12.26,46.6,
NEEDLE DRAIN CATH,23304080,CDM,,,270,RC,outpatient,,177,177,,150.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.25,22,,percent of total billed charges,,,,,,,,,159.3,90,,percent of total billed charges,,,146.56,82.8,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,,,,,,,,155.76,88,,percent of total billed charges,,,,,,,,,135.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.25,22,,percent of total billed charges,,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,,,,,,,,,,,,,146.91,83,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,145.14,82,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,44.25,168.15,
*BASIN SET LG,23304089,CDM,,,270,RC,outpatient,,22,22,,18.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.5,22,,percent of total billed charges,,,,,,,,,19.8,90,,percent of total billed charges,,,18.22,82.8,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,,,,,,,,19.36,88,,percent of total billed charges,,,,,,,,,16.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.5,22,,percent of total billed charges,,,20.02,91,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,,,,,,,,,,,,,18.26,83,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.04,82,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,5.5,20.9,
CONTAMINATION CONTROL DEVICE TRAY,23304090,CDM,,,270,RC,outpatient,,158.64,158.64,,134.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.66,22,,percent of total billed charges,,,,,,,,,142.78,90,,percent of total billed charges,,,131.35,82.8,,percent of total billed charges,,,134.84,85,,percent of total billed charges,,,,,,,,,139.6,88,,percent of total billed charges,,,,,,,,,121.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.66,22,,percent of total billed charges,,,144.36,91,,percent of total billed charges,,,150.71,95,,percent of total billed charges,,,131.67,83,,percent of total billed charges,,,131.67,83,,percent of total billed charges,,,,,,,,,,,,,,,131.67,83,,percent of total billed charges,,,150.71,95,,percent of total billed charges,,,142.78,90,,percent of total billed charges,,,142.78,90,,percent of total billed charges,,,130.08,82,,percent of total billed charges,,,142.78,90,,percent of total billed charges,,,134.84,85,,percent of total billed charges,,39.66,150.71,
LIGACLIP MEDIUM LS-200,23304105,CDM,,,270,RC,outpatient,,27.63,27.63,,23.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.91,22,,percent of total billed charges,,,,,,,,,24.87,90,,percent of total billed charges,,,22.88,82.8,,percent of total billed charges,,,23.49,85,,percent of total billed charges,,,,,,,,,24.31,88,,percent of total billed charges,,,,,,,,,21.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.91,22,,percent of total billed charges,,,25.14,91,,percent of total billed charges,,,26.25,95,,percent of total billed charges,,,22.93,83,,percent of total billed charges,,,22.93,83,,percent of total billed charges,,,,,,,,,,,,,,,22.93,83,,percent of total billed charges,,,26.25,95,,percent of total billed charges,,,24.87,90,,percent of total billed charges,,,24.87,90,,percent of total billed charges,,,22.66,82,,percent of total billed charges,,,24.87,90,,percent of total billed charges,,,23.49,85,,percent of total billed charges,,6.91,26.25,
LIGACLIP LARGE LS-400,23304113,CDM,,,270,RC,outpatient,,45.73,45.73,,38.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.43,22,,percent of total billed charges,,,,,,,,,41.16,90,,percent of total billed charges,,,37.86,82.8,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,,,,,,,,40.24,88,,percent of total billed charges,,,,,,,,,34.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.43,22,,percent of total billed charges,,,41.61,91,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,,,,,,,,,,,,,37.96,83,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,37.5,82,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,11.43,43.44,
STOMA POUCH W/CLAMP 2-1/4,23304226,CDM,,,270,RC,outpatient,,2.84,2.84,,2.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.71,22,,percent of total billed charges,,,,,,,,,2.56,90,,percent of total billed charges,,,2.35,82.8,,percent of total billed charges,,,2.41,85,,percent of total billed charges,,,,,,,,,2.5,88,,percent of total billed charges,,,,,,,,,2.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.71,22,,percent of total billed charges,,,2.58,91,,percent of total billed charges,,,2.7,95,,percent of total billed charges,,,2.36,83,,percent of total billed charges,,,2.36,83,,percent of total billed charges,,,,,,,,,,,,,,,2.36,83,,percent of total billed charges,,,2.7,95,,percent of total billed charges,,,2.56,90,,percent of total billed charges,,,2.56,90,,percent of total billed charges,,,2.33,82,,percent of total billed charges,,,2.56,90,,percent of total billed charges,,,2.41,85,,percent of total billed charges,,0.71,2.7,
STOMA POUCH 2-3/4 DISPOSABLE,23304227,CDM,,,270,RC,outpatient,,2.84,2.84,,2.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.71,22,,percent of total billed charges,,,,,,,,,2.56,90,,percent of total billed charges,,,2.35,82.8,,percent of total billed charges,,,2.41,85,,percent of total billed charges,,,,,,,,,2.5,88,,percent of total billed charges,,,,,,,,,2.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.71,22,,percent of total billed charges,,,2.58,91,,percent of total billed charges,,,2.7,95,,percent of total billed charges,,,2.36,83,,percent of total billed charges,,,2.36,83,,percent of total billed charges,,,,,,,,,,,,,,,2.36,83,,percent of total billed charges,,,2.7,95,,percent of total billed charges,,,2.56,90,,percent of total billed charges,,,2.56,90,,percent of total billed charges,,,2.33,82,,percent of total billed charges,,,2.56,90,,percent of total billed charges,,,2.41,85,,percent of total billed charges,,0.71,2.7,
*ELEC/SURG PENCIL W/SMOKE EVAC,23304255,CDM,,,270,RC,outpatient,,27,27,,22.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.75,22,,percent of total billed charges,,,,,,,,,24.3,90,,percent of total billed charges,,,22.36,82.8,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,,,,,,,,23.76,88,,percent of total billed charges,,,,,,,,,20.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.75,22,,percent of total billed charges,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,,,,,,,,,,,,,22.41,83,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.14,82,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,6.75,25.65,
ELEC/SURG GROUND PAD PEDIATRIC,23304256,CDM,,,270,RC,outpatient,,40.86,40.86,,34.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.22,22,,percent of total billed charges,,,,,,,,,36.77,90,,percent of total billed charges,,,33.83,82.8,,percent of total billed charges,,,34.73,85,,percent of total billed charges,,,,,,,,,35.96,88,,percent of total billed charges,,,,,,,,,31.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.22,22,,percent of total billed charges,,,37.18,91,,percent of total billed charges,,,38.82,95,,percent of total billed charges,,,33.91,83,,percent of total billed charges,,,33.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33.91,83,,percent of total billed charges,,,38.82,95,,percent of total billed charges,,,36.77,90,,percent of total billed charges,,,36.77,90,,percent of total billed charges,,,33.51,82,,percent of total billed charges,,,36.77,90,,percent of total billed charges,,,34.73,85,,percent of total billed charges,,10.22,38.82,
LIGACLIP SMALL LS-100,23304261,CDM,,,270,RC,outpatient,,23.58,23.58,,20.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.9,22,,percent of total billed charges,,,,,,,,,21.22,90,,percent of total billed charges,,,19.52,82.8,,percent of total billed charges,,,20.04,85,,percent of total billed charges,,,,,,,,,20.75,88,,percent of total billed charges,,,,,,,,,18.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.9,22,,percent of total billed charges,,,21.46,91,,percent of total billed charges,,,22.4,95,,percent of total billed charges,,,19.57,83,,percent of total billed charges,,,19.57,83,,percent of total billed charges,,,,,,,,,,,,,,,19.57,83,,percent of total billed charges,,,22.4,95,,percent of total billed charges,,,21.22,90,,percent of total billed charges,,,21.22,90,,percent of total billed charges,,,19.34,82,,percent of total billed charges,,,21.22,90,,percent of total billed charges,,,20.04,85,,percent of total billed charges,,5.9,22.4,
CATH COUDE 20F 30CC,23304387,CDM,,,270,RC,outpatient,,79.31,79.31,,67.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.83,22,,percent of total billed charges,,,,,,,,,71.38,90,,percent of total billed charges,,,65.67,82.8,,percent of total billed charges,,,67.41,85,,percent of total billed charges,,,,,,,,,69.79,88,,percent of total billed charges,,,,,,,,,60.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.83,22,,percent of total billed charges,,,72.17,91,,percent of total billed charges,,,75.34,95,,percent of total billed charges,,,65.83,83,,percent of total billed charges,,,65.83,83,,percent of total billed charges,,,,,,,,,,,,,,,65.83,83,,percent of total billed charges,,,75.34,95,,percent of total billed charges,,,71.38,90,,percent of total billed charges,,,71.38,90,,percent of total billed charges,,,65.03,82,,percent of total billed charges,,,71.38,90,,percent of total billed charges,,,67.41,85,,percent of total billed charges,,19.83,75.34,
KNEE IMMOBILIZER 18,23304427,CDM,,,270,RC,outpatient,,111.6,111.6,,94.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.9,22,,percent of total billed charges,,,,,,,,,100.44,90,,percent of total billed charges,,,92.4,82.8,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,,,,,,,,98.21,88,,percent of total billed charges,,,,,,,,,85.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.9,22,,percent of total billed charges,,,101.56,91,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,,,,,,,,,,,,,92.63,83,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,91.51,82,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,27.9,106.02,
KNEE IMMOBILIZER 22,23304428,CDM,,,270,RC,outpatient,,111.6,111.6,,94.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.9,22,,percent of total billed charges,,,,,,,,,100.44,90,,percent of total billed charges,,,92.4,82.8,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,,,,,,,,98.21,88,,percent of total billed charges,,,,,,,,,85.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.9,22,,percent of total billed charges,,,101.56,91,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,,,,,,,,,,,,,92.63,83,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,91.51,82,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,27.9,106.02,
KNEE IMMOBILIZER 24,23304429,CDM,,,270,RC,outpatient,,111.6,111.6,,94.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.9,22,,percent of total billed charges,,,,,,,,,100.44,90,,percent of total billed charges,,,92.4,82.8,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,,,,,,,,98.21,88,,percent of total billed charges,,,,,,,,,85.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.9,22,,percent of total billed charges,,,101.56,91,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,,,,,,,,,,,,,92.63,83,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,91.51,82,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,27.9,106.02,
MASK FACE ANES SMALL,23304436,CDM,,,270,RC,outpatient,,17.51,17.51,,14.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.38,22,,percent of total billed charges,,,,,,,,,15.76,90,,percent of total billed charges,,,14.5,82.8,,percent of total billed charges,,,14.88,85,,percent of total billed charges,,,,,,,,,15.41,88,,percent of total billed charges,,,,,,,,,13.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.38,22,,percent of total billed charges,,,15.93,91,,percent of total billed charges,,,16.63,95,,percent of total billed charges,,,14.53,83,,percent of total billed charges,,,14.53,83,,percent of total billed charges,,,,,,,,,,,,,,,14.53,83,,percent of total billed charges,,,16.63,95,,percent of total billed charges,,,15.76,90,,percent of total billed charges,,,15.76,90,,percent of total billed charges,,,14.36,82,,percent of total billed charges,,,15.76,90,,percent of total billed charges,,,14.88,85,,percent of total billed charges,,4.38,16.63,
KNEE IMMOBILIZER 14,23304437,CDM,,,270,RC,outpatient,,111.6,111.6,,94.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.9,22,,percent of total billed charges,,,,,,,,,100.44,90,,percent of total billed charges,,,92.4,82.8,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,,,,,,,,98.21,88,,percent of total billed charges,,,,,,,,,85.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.9,22,,percent of total billed charges,,,101.56,91,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,,,,,,,,,,,,,92.63,83,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,91.51,82,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,27.9,106.02,
KNEE IMMOBILIZER 20,23304439,CDM,,,270,RC,outpatient,,111.6,111.6,,94.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.9,22,,percent of total billed charges,,,,,,,,,100.44,90,,percent of total billed charges,,,92.4,82.8,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,,,,,,,,98.21,88,,percent of total billed charges,,,,,,,,,85.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.9,22,,percent of total billed charges,,,101.56,91,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,,,,,,,,,,,,,92.63,83,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,91.51,82,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,27.9,106.02,
KNEE IMMOBILIZER 16,23304440,CDM,,,270,RC,outpatient,,111.6,111.6,,94.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.9,22,,percent of total billed charges,,,,,,,,,100.44,90,,percent of total billed charges,,,92.4,82.8,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,,,,,,,,98.21,88,,percent of total billed charges,,,,,,,,,85.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.9,22,,percent of total billed charges,,,101.56,91,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,,,,,,,,,,,,,92.63,83,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,91.51,82,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,27.9,106.02,
*FACE MASK MEDIUM ANESTHESIA,23304446,CDM,,,270,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
*FACE MASK LARGE ANESTHESIA,23304447,CDM,,,270,RC,outpatient,,17,17,,14.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.25,22,,percent of total billed charges,,,,,,,,,15.3,90,,percent of total billed charges,,,14.08,82.8,,percent of total billed charges,,,14.45,85,,percent of total billed charges,,,,,,,,,14.96,88,,percent of total billed charges,,,,,,,,,12.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.25,22,,percent of total billed charges,,,15.47,91,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,,,,,,,,,,,,,14.11,83,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,13.94,82,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,14.45,85,,percent of total billed charges,,4.25,16.15,
MASK FACE ANES INFANT,23304448,CDM,,,270,RC,outpatient,,17.23,17.23,,14.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.31,22,,percent of total billed charges,,,,,,,,,15.51,90,,percent of total billed charges,,,14.27,82.8,,percent of total billed charges,,,14.65,85,,percent of total billed charges,,,,,,,,,15.16,88,,percent of total billed charges,,,,,,,,,13.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.31,22,,percent of total billed charges,,,15.68,91,,percent of total billed charges,,,16.37,95,,percent of total billed charges,,,14.3,83,,percent of total billed charges,,,14.3,83,,percent of total billed charges,,,,,,,,,,,,,,,14.3,83,,percent of total billed charges,,,16.37,95,,percent of total billed charges,,,15.51,90,,percent of total billed charges,,,15.51,90,,percent of total billed charges,,,14.13,82,,percent of total billed charges,,,15.51,90,,percent of total billed charges,,,14.65,85,,percent of total billed charges,,4.31,16.37,
MASK FACE ANES CHILD,23304449,CDM,,,270,RC,outpatient,,16.74,16.74,,14.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.19,22,,percent of total billed charges,,,,,,,,,15.07,90,,percent of total billed charges,,,13.86,82.8,,percent of total billed charges,,,14.23,85,,percent of total billed charges,,,,,,,,,14.73,88,,percent of total billed charges,,,,,,,,,12.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.19,22,,percent of total billed charges,,,15.23,91,,percent of total billed charges,,,15.9,95,,percent of total billed charges,,,13.89,83,,percent of total billed charges,,,13.89,83,,percent of total billed charges,,,,,,,,,,,,,,,13.89,83,,percent of total billed charges,,,15.9,95,,percent of total billed charges,,,15.07,90,,percent of total billed charges,,,15.07,90,,percent of total billed charges,,,13.73,82,,percent of total billed charges,,,15.07,90,,percent of total billed charges,,,14.23,85,,percent of total billed charges,,4.19,15.9,
SUPPORTER MALE ATHLETIC - LGE,23304535,CDM,,,270,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
SUPPORTER MALE ATHLETIC - XLG,23304536,CDM,,,270,RC,outpatient,,76.76,76.76,,65.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.19,22,,percent of total billed charges,,,,,,,,,69.08,90,,percent of total billed charges,,,63.56,82.8,,percent of total billed charges,,,65.25,85,,percent of total billed charges,,,,,,,,,67.55,88,,percent of total billed charges,,,,,,,,,58.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.19,22,,percent of total billed charges,,,69.85,91,,percent of total billed charges,,,72.92,95,,percent of total billed charges,,,63.71,83,,percent of total billed charges,,,63.71,83,,percent of total billed charges,,,,,,,,,,,,,,,63.71,83,,percent of total billed charges,,,72.92,95,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,62.94,82,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,65.25,85,,percent of total billed charges,,19.19,72.92,
LAP CHOLE ACCESSORY KIT,23304691,CDM,,,270,RC,outpatient,,1647.04,1647.04,,1398.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,411.76,22,,percent of total billed charges,,,,,,,,,1482.34,90,,percent of total billed charges,,,1363.75,82.8,,percent of total billed charges,,,1399.98,85,,percent of total billed charges,,,,,,,,,1449.4,88,,percent of total billed charges,,,,,,,,,1258.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,411.76,22,,percent of total billed charges,,,1498.81,91,,percent of total billed charges,,,1564.69,95,,percent of total billed charges,,,1367.04,83,,percent of total billed charges,,,1367.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1367.04,83,,percent of total billed charges,,,1564.69,95,,percent of total billed charges,,,1482.34,90,,percent of total billed charges,,,1482.34,90,,percent of total billed charges,,,1350.57,82,,percent of total billed charges,,,1482.34,90,,percent of total billed charges,,,1399.98,85,,percent of total billed charges,,411.76,1564.69,
NEEDLE VERES PNEUMO 120MM,23304692,CDM,,,270,RC,outpatient,,98.88,98.88,,83.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.72,22,,percent of total billed charges,,,,,,,,,88.99,90,,percent of total billed charges,,,81.87,82.8,,percent of total billed charges,,,84.05,85,,percent of total billed charges,,,,,,,,,87.01,88,,percent of total billed charges,,,,,,,,,75.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.72,22,,percent of total billed charges,,,89.98,91,,percent of total billed charges,,,93.94,95,,percent of total billed charges,,,82.07,83,,percent of total billed charges,,,82.07,83,,percent of total billed charges,,,,,,,,,,,,,,,82.07,83,,percent of total billed charges,,,93.94,95,,percent of total billed charges,,,88.99,90,,percent of total billed charges,,,88.99,90,,percent of total billed charges,,,81.08,82,,percent of total billed charges,,,88.99,90,,percent of total billed charges,,,84.05,85,,percent of total billed charges,,24.72,93.94,
LAPAROSCOPIC REDUCER CAP,23304693,CDM,,,270,RC,outpatient,,40.77,40.77,,34.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.19,22,,percent of total billed charges,,,,,,,,,36.69,90,,percent of total billed charges,,,33.76,82.8,,percent of total billed charges,,,34.65,85,,percent of total billed charges,,,,,,,,,35.88,88,,percent of total billed charges,,,,,,,,,31.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.19,22,,percent of total billed charges,,,37.1,91,,percent of total billed charges,,,38.73,95,,percent of total billed charges,,,33.84,83,,percent of total billed charges,,,33.84,83,,percent of total billed charges,,,,,,,,,,,,,,,33.84,83,,percent of total billed charges,,,38.73,95,,percent of total billed charges,,,36.69,90,,percent of total billed charges,,,36.69,90,,percent of total billed charges,,,33.43,82,,percent of total billed charges,,,36.69,90,,percent of total billed charges,,,34.65,85,,percent of total billed charges,,10.19,38.73,
*TUBING BLOOD WARMING,23304725,CDM,,,270,RC,outpatient,,22,22,,18.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.5,22,,percent of total billed charges,,,,,,,,,19.8,90,,percent of total billed charges,,,18.22,82.8,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,,,,,,,,19.36,88,,percent of total billed charges,,,,,,,,,16.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.5,22,,percent of total billed charges,,,20.02,91,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,,,,,,,,,,,,,18.26,83,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.04,82,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,5.5,20.9,
BALLOON URETERAL DILATATION,23304741,CDM,,,270,RC,outpatient,,1485.84,1485.84,,1261.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,371.46,22,,percent of total billed charges,,,,,,,,,1337.26,90,,percent of total billed charges,,,1230.28,82.8,,percent of total billed charges,,,1262.96,85,,percent of total billed charges,,,,,,,,,1307.54,88,,percent of total billed charges,,,,,,,,,1135.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,371.46,22,,percent of total billed charges,,,1352.11,91,,percent of total billed charges,,,1411.55,95,,percent of total billed charges,,,1233.25,83,,percent of total billed charges,,,1233.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1233.25,83,,percent of total billed charges,,,1411.55,95,,percent of total billed charges,,,1337.26,90,,percent of total billed charges,,,1337.26,90,,percent of total billed charges,,,1218.39,82,,percent of total billed charges,,,1337.26,90,,percent of total billed charges,,,1262.96,85,,percent of total billed charges,,371.46,1411.55,
SPLINT WRIST & FOREARM UNIV/LT,23304758,CDM,,,270,RC,outpatient,,65.2,65.2,,55.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.3,22,,percent of total billed charges,,,,,,,,,58.68,90,,percent of total billed charges,,,53.99,82.8,,percent of total billed charges,,,55.42,85,,percent of total billed charges,,,,,,,,,57.38,88,,percent of total billed charges,,,,,,,,,49.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.3,22,,percent of total billed charges,,,59.33,91,,percent of total billed charges,,,61.94,95,,percent of total billed charges,,,54.12,83,,percent of total billed charges,,,54.12,83,,percent of total billed charges,,,,,,,,,,,,,,,54.12,83,,percent of total billed charges,,,61.94,95,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,53.46,82,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,55.42,85,,percent of total billed charges,,16.3,61.94,
SPLINT WRIST & FOREARM UNIV/RT,23304761,CDM,,,270,RC,outpatient,,65.2,65.2,,55.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.3,22,,percent of total billed charges,,,,,,,,,58.68,90,,percent of total billed charges,,,53.99,82.8,,percent of total billed charges,,,55.42,85,,percent of total billed charges,,,,,,,,,57.38,88,,percent of total billed charges,,,,,,,,,49.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.3,22,,percent of total billed charges,,,59.33,91,,percent of total billed charges,,,61.94,95,,percent of total billed charges,,,54.12,83,,percent of total billed charges,,,54.12,83,,percent of total billed charges,,,,,,,,,,,,,,,54.12,83,,percent of total billed charges,,,61.94,95,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,53.46,82,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,55.42,85,,percent of total billed charges,,16.3,61.94,
SPLINT WRIST & FOREARM LF PED,23304765,CDM,,,270,RC,outpatient,,67.15,67.15,,57.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.79,22,,percent of total billed charges,,,,,,,,,60.44,90,,percent of total billed charges,,,55.6,82.8,,percent of total billed charges,,,57.08,85,,percent of total billed charges,,,,,,,,,59.09,88,,percent of total billed charges,,,,,,,,,51.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.79,22,,percent of total billed charges,,,61.11,91,,percent of total billed charges,,,63.79,95,,percent of total billed charges,,,55.73,83,,percent of total billed charges,,,55.73,83,,percent of total billed charges,,,,,,,,,,,,,,,55.73,83,,percent of total billed charges,,,63.79,95,,percent of total billed charges,,,60.44,90,,percent of total billed charges,,,60.44,90,,percent of total billed charges,,,55.06,82,,percent of total billed charges,,,60.44,90,,percent of total billed charges,,,57.08,85,,percent of total billed charges,,16.79,63.79,
* BREAST PUMP MEDELA (V1104),23304881,CDM,,,270,RC,outpatient,,66,66,,56.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.5,22,,percent of total billed charges,,,,,,,,,59.4,90,,percent of total billed charges,,,54.65,82.8,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,,,,,,,,58.08,88,,percent of total billed charges,,,,,,,,,50.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.5,22,,percent of total billed charges,,,60.06,91,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,,,,,,,,,,,,,54.78,83,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,54.12,82,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,16.5,62.7,
STAPLER SKIN PRECISE VISTA 15W,23304900,CDM,,,270,RC,outpatient,,69.96,69.96,,59.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.49,22,,percent of total billed charges,,,,,,,,,62.96,90,,percent of total billed charges,,,57.93,82.8,,percent of total billed charges,,,59.47,85,,percent of total billed charges,,,,,,,,,61.56,88,,percent of total billed charges,,,,,,,,,53.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.49,22,,percent of total billed charges,,,63.66,91,,percent of total billed charges,,,66.46,95,,percent of total billed charges,,,58.07,83,,percent of total billed charges,,,58.07,83,,percent of total billed charges,,,,,,,,,,,,,,,58.07,83,,percent of total billed charges,,,66.46,95,,percent of total billed charges,,,62.96,90,,percent of total billed charges,,,62.96,90,,percent of total billed charges,,,57.37,82,,percent of total billed charges,,,62.96,90,,percent of total billed charges,,,59.47,85,,percent of total billed charges,,17.49,66.46,
CHOLANGIOGRAM KIT 10FR,23304907,CDM,,,270,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
STAPLER SKIN 15R,23304915,CDM,,,270,RC,outpatient,,43.72,43.72,,37.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.93,22,,percent of total billed charges,,,,,,,,,39.35,90,,percent of total billed charges,,,36.2,82.8,,percent of total billed charges,,,37.16,85,,percent of total billed charges,,,,,,,,,38.47,88,,percent of total billed charges,,,,,,,,,33.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.93,22,,percent of total billed charges,,,39.79,91,,percent of total billed charges,,,41.53,95,,percent of total billed charges,,,36.29,83,,percent of total billed charges,,,36.29,83,,percent of total billed charges,,,,,,,,,,,,,,,36.29,83,,percent of total billed charges,,,41.53,95,,percent of total billed charges,,,39.35,90,,percent of total billed charges,,,39.35,90,,percent of total billed charges,,,35.85,82,,percent of total billed charges,,,39.35,90,,percent of total billed charges,,,37.16,85,,percent of total billed charges,,10.93,41.53,
STAPLER SKIN PRECISE VISTA 15R,23304916,CDM,,,270,RC,outpatient,,33.37,33.37,,28.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.34,22,,percent of total billed charges,,,,,,,,,30.03,90,,percent of total billed charges,,,27.63,82.8,,percent of total billed charges,,,28.36,85,,percent of total billed charges,,,,,,,,,29.37,88,,percent of total billed charges,,,,,,,,,25.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.34,22,,percent of total billed charges,,,30.37,91,,percent of total billed charges,,,31.7,95,,percent of total billed charges,,,27.7,83,,percent of total billed charges,,,27.7,83,,percent of total billed charges,,,,,,,,,,,,,,,27.7,83,,percent of total billed charges,,,31.7,95,,percent of total billed charges,,,30.03,90,,percent of total billed charges,,,30.03,90,,percent of total billed charges,,,27.36,82,,percent of total billed charges,,,30.03,90,,percent of total billed charges,,,28.36,85,,percent of total billed charges,,8.34,31.7,
ULTRASLING III BLACK MEDIUM,23305085,CDM,,,270,RC,outpatient,,373.95,373.95,,317.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.49,22,,percent of total billed charges,,,,,,,,,336.56,90,,percent of total billed charges,,,309.63,82.8,,percent of total billed charges,,,317.86,85,,percent of total billed charges,,,,,,,,,329.08,88,,percent of total billed charges,,,,,,,,,285.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.49,22,,percent of total billed charges,,,340.29,91,,percent of total billed charges,,,355.25,95,,percent of total billed charges,,,310.38,83,,percent of total billed charges,,,310.38,83,,percent of total billed charges,,,,,,,,,,,,,,,310.38,83,,percent of total billed charges,,,355.25,95,,percent of total billed charges,,,336.56,90,,percent of total billed charges,,,336.56,90,,percent of total billed charges,,,306.64,82,,percent of total billed charges,,,336.56,90,,percent of total billed charges,,,317.86,85,,percent of total billed charges,,93.49,355.25,
SPLINT WRIST RIGHT PEDIATRIC,23305090,CDM,,,270,RC,outpatient,,59.5,59.5,,50.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.88,22,,percent of total billed charges,,,,,,,,,53.55,90,,percent of total billed charges,,,49.27,82.8,,percent of total billed charges,,,50.58,85,,percent of total billed charges,,,,,,,,,52.36,88,,percent of total billed charges,,,,,,,,,45.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.88,22,,percent of total billed charges,,,54.15,91,,percent of total billed charges,,,56.53,95,,percent of total billed charges,,,49.39,83,,percent of total billed charges,,,49.39,83,,percent of total billed charges,,,,,,,,,,,,,,,49.39,83,,percent of total billed charges,,,56.53,95,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,48.79,82,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,50.58,85,,percent of total billed charges,,14.88,56.53,
*SPLINT WRIST RIGHT MEDIUM,23305091,CDM,,,270,RC,outpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.25,22,,percent of total billed charges,,,,,,,,,72.9,90,,percent of total billed charges,,,67.07,82.8,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.25,22,,percent of total billed charges,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,20.25,76.95,
SHOULDER IMMOBILIZER MEN XLG,23305293,CDM,,,270,RC,outpatient,,65.2,65.2,,55.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.3,22,,percent of total billed charges,,,,,,,,,58.68,90,,percent of total billed charges,,,53.99,82.8,,percent of total billed charges,,,55.42,85,,percent of total billed charges,,,,,,,,,57.38,88,,percent of total billed charges,,,,,,,,,49.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.3,22,,percent of total billed charges,,,59.33,91,,percent of total billed charges,,,61.94,95,,percent of total billed charges,,,54.12,83,,percent of total billed charges,,,54.12,83,,percent of total billed charges,,,,,,,,,,,,,,,54.12,83,,percent of total billed charges,,,61.94,95,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,53.46,82,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,55.42,85,,percent of total billed charges,,16.3,61.94,
SHOULDER IMMOBILIZER WOMEN LG,23305296,CDM,,,270,RC,outpatient,,64.43,64.43,,54.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.11,22,,percent of total billed charges,,,,,,,,,57.99,90,,percent of total billed charges,,,53.35,82.8,,percent of total billed charges,,,54.77,85,,percent of total billed charges,,,,,,,,,56.7,88,,percent of total billed charges,,,,,,,,,49.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.11,22,,percent of total billed charges,,,58.63,91,,percent of total billed charges,,,61.21,95,,percent of total billed charges,,,53.48,83,,percent of total billed charges,,,53.48,83,,percent of total billed charges,,,,,,,,,,,,,,,53.48,83,,percent of total billed charges,,,61.21,95,,percent of total billed charges,,,57.99,90,,percent of total billed charges,,,57.99,90,,percent of total billed charges,,,52.83,82,,percent of total billed charges,,,57.99,90,,percent of total billed charges,,,54.77,85,,percent of total billed charges,,16.11,61.21,
*SHOULDER IMMOBILIZER MEN SM,23305297,CDM,,,270,RC,outpatient,,101,101,,85.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.25,22,,percent of total billed charges,,,,,,,,,90.9,90,,percent of total billed charges,,,83.63,82.8,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,,,,,,,,88.88,88,,percent of total billed charges,,,,,,,,,77.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.25,22,,percent of total billed charges,,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,82.82,82,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,25.25,95.95,
*SHOULDER IMMOBILIZER MEN MED,23305298,CDM,,,270,RC,outpatient,,60,60,,50.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15,22,,percent of total billed charges,,,,,,,,,54,90,,percent of total billed charges,,,49.68,82.8,,percent of total billed charges,,,51,85,,percent of total billed charges,,,,,,,,,52.8,88,,percent of total billed charges,,,,,,,,,45.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15,22,,percent of total billed charges,,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,,,,,,,,,,,,,49.8,83,,percent of total billed charges,,,57,95,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,49.2,82,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,15,57,
SHOULDER IMMOBILIZER MEN LG,23305299,CDM,,,270,RC,outpatient,,65.2,65.2,,55.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.3,22,,percent of total billed charges,,,,,,,,,58.68,90,,percent of total billed charges,,,53.99,82.8,,percent of total billed charges,,,55.42,85,,percent of total billed charges,,,,,,,,,57.38,88,,percent of total billed charges,,,,,,,,,49.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.3,22,,percent of total billed charges,,,59.33,91,,percent of total billed charges,,,61.94,95,,percent of total billed charges,,,54.12,83,,percent of total billed charges,,,54.12,83,,percent of total billed charges,,,,,,,,,,,,,,,54.12,83,,percent of total billed charges,,,61.94,95,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,53.46,82,,percent of total billed charges,,,58.68,90,,percent of total billed charges,,,55.42,85,,percent of total billed charges,,16.3,61.94,
SHOULDER IMMOBILIZER UNIVERSAL,23305300,CDM,,,270,RC,outpatient,,56.44,56.44,,47.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.11,22,,percent of total billed charges,,,,,,,,,50.8,90,,percent of total billed charges,,,46.73,82.8,,percent of total billed charges,,,47.97,85,,percent of total billed charges,,,,,,,,,49.67,88,,percent of total billed charges,,,,,,,,,43.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.11,22,,percent of total billed charges,,,51.36,91,,percent of total billed charges,,,53.62,95,,percent of total billed charges,,,46.85,83,,percent of total billed charges,,,46.85,83,,percent of total billed charges,,,,,,,,,,,,,,,46.85,83,,percent of total billed charges,,,53.62,95,,percent of total billed charges,,,50.8,90,,percent of total billed charges,,,50.8,90,,percent of total billed charges,,,46.28,82,,percent of total billed charges,,,50.8,90,,percent of total billed charges,,,47.97,85,,percent of total billed charges,,14.11,53.62,
*FINGER SPLINT VELCRO PED,23305318,CDM,,,270,RC,outpatient,,47,47,,39.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.75,22,,percent of total billed charges,,,,,,,,,42.3,90,,percent of total billed charges,,,38.92,82.8,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,,,,,,,,41.36,88,,percent of total billed charges,,,,,,,,,35.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.75,22,,percent of total billed charges,,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,,,,,,,,,,,,,39.01,83,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,38.54,82,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,11.75,44.65,
*FINGER SPLINT VELCRO MED,23305319,CDM,,,270,RC,outpatient,,35,35,,29.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.75,22,,percent of total billed charges,,,,,,,,,31.5,90,,percent of total billed charges,,,28.98,82.8,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,,,,,,,,30.8,88,,percent of total billed charges,,,,,,,,,26.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.75,22,,percent of total billed charges,,,31.85,91,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,,,,,,,,,,,,,29.05,83,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,28.7,82,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,8.75,33.25,
FINGER/THUMB SPLINT LG/XLG RIGHT,23305320,CDM,,,270,RC,outpatient,,83.3,83.3,,70.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.83,22,,percent of total billed charges,,,,,,,,,74.97,90,,percent of total billed charges,,,68.97,82.8,,percent of total billed charges,,,70.81,85,,percent of total billed charges,,,,,,,,,73.3,88,,percent of total billed charges,,,,,,,,,63.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.83,22,,percent of total billed charges,,,75.8,91,,percent of total billed charges,,,79.14,95,,percent of total billed charges,,,69.14,83,,percent of total billed charges,,,69.14,83,,percent of total billed charges,,,,,,,,,,,,,,,69.14,83,,percent of total billed charges,,,79.14,95,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,68.31,82,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,70.81,85,,percent of total billed charges,,20.83,79.14,
FINGER/THUMB SPLINT SM/MD RIGHT,23305321,CDM,,,270,RC,outpatient,,83.3,83.3,,70.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.83,22,,percent of total billed charges,,,,,,,,,74.97,90,,percent of total billed charges,,,68.97,82.8,,percent of total billed charges,,,70.81,85,,percent of total billed charges,,,,,,,,,73.3,88,,percent of total billed charges,,,,,,,,,63.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.83,22,,percent of total billed charges,,,75.8,91,,percent of total billed charges,,,79.14,95,,percent of total billed charges,,,69.14,83,,percent of total billed charges,,,69.14,83,,percent of total billed charges,,,,,,,,,,,,,,,69.14,83,,percent of total billed charges,,,79.14,95,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,68.31,82,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,70.81,85,,percent of total billed charges,,20.83,79.14,
SPLINT FINGER PLASTIC,23305322,CDM,,,270,RC,outpatient,,17.55,17.55,,14.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.39,22,,percent of total billed charges,,,,,,,,,15.8,90,,percent of total billed charges,,,14.53,82.8,,percent of total billed charges,,,14.92,85,,percent of total billed charges,,,,,,,,,15.44,88,,percent of total billed charges,,,,,,,,,13.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.39,22,,percent of total billed charges,,,15.97,91,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14.57,83,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.39,82,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.92,85,,percent of total billed charges,,4.39,16.67,
FINGER/THUMB SPLINT LG/XLG LEFT,23305324,CDM,,,270,RC,outpatient,,83.3,83.3,,70.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.83,22,,percent of total billed charges,,,,,,,,,74.97,90,,percent of total billed charges,,,68.97,82.8,,percent of total billed charges,,,70.81,85,,percent of total billed charges,,,,,,,,,73.3,88,,percent of total billed charges,,,,,,,,,63.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.83,22,,percent of total billed charges,,,75.8,91,,percent of total billed charges,,,79.14,95,,percent of total billed charges,,,69.14,83,,percent of total billed charges,,,69.14,83,,percent of total billed charges,,,,,,,,,,,,,,,69.14,83,,percent of total billed charges,,,79.14,95,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,68.31,82,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,70.81,85,,percent of total billed charges,,20.83,79.14,
FINGER/THUMB SPLINT SM/MD LEFT,23305325,CDM,,,270,RC,outpatient,,83.3,83.3,,70.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.83,22,,percent of total billed charges,,,,,,,,,74.97,90,,percent of total billed charges,,,68.97,82.8,,percent of total billed charges,,,70.81,85,,percent of total billed charges,,,,,,,,,73.3,88,,percent of total billed charges,,,,,,,,,63.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.83,22,,percent of total billed charges,,,75.8,91,,percent of total billed charges,,,79.14,95,,percent of total billed charges,,,69.14,83,,percent of total billed charges,,,69.14,83,,percent of total billed charges,,,,,,,,,,,,,,,69.14,83,,percent of total billed charges,,,79.14,95,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,68.31,82,,percent of total billed charges,,,74.97,90,,percent of total billed charges,,,70.81,85,,percent of total billed charges,,20.83,79.14,
SPLINT CLAVICAL SM,23305342,CDM,,,270,RC,outpatient,,58.57,58.57,,49.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.64,22,,percent of total billed charges,,,,,,,,,52.71,90,,percent of total billed charges,,,48.5,82.8,,percent of total billed charges,,,49.78,85,,percent of total billed charges,,,,,,,,,51.54,88,,percent of total billed charges,,,,,,,,,44.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.64,22,,percent of total billed charges,,,53.3,91,,percent of total billed charges,,,55.64,95,,percent of total billed charges,,,48.61,83,,percent of total billed charges,,,48.61,83,,percent of total billed charges,,,,,,,,,,,,,,,48.61,83,,percent of total billed charges,,,55.64,95,,percent of total billed charges,,,52.71,90,,percent of total billed charges,,,52.71,90,,percent of total billed charges,,,48.03,82,,percent of total billed charges,,,52.71,90,,percent of total billed charges,,,49.78,85,,percent of total billed charges,,14.64,55.64,
SPLINT CLAVICLE LG,23305344,CDM,,,270,RC,outpatient,,42.84,42.84,,36.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.71,22,,percent of total billed charges,,,,,,,,,38.56,90,,percent of total billed charges,,,35.47,82.8,,percent of total billed charges,,,36.41,85,,percent of total billed charges,,,,,,,,,37.7,88,,percent of total billed charges,,,,,,,,,32.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.71,22,,percent of total billed charges,,,38.98,91,,percent of total billed charges,,,40.7,95,,percent of total billed charges,,,35.56,83,,percent of total billed charges,,,35.56,83,,percent of total billed charges,,,,,,,,,,,,,,,35.56,83,,percent of total billed charges,,,40.7,95,,percent of total billed charges,,,38.56,90,,percent of total billed charges,,,38.56,90,,percent of total billed charges,,,35.13,82,,percent of total billed charges,,,38.56,90,,percent of total billed charges,,,36.41,85,,percent of total billed charges,,10.71,40.7,
SPLINT CLAVICLE XLG,23305345,CDM,,,270,RC,outpatient,,44.28,44.28,,37.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.07,22,,percent of total billed charges,,,,,,,,,39.85,90,,percent of total billed charges,,,36.66,82.8,,percent of total billed charges,,,37.64,85,,percent of total billed charges,,,,,,,,,38.97,88,,percent of total billed charges,,,,,,,,,33.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.07,22,,percent of total billed charges,,,40.29,91,,percent of total billed charges,,,42.07,95,,percent of total billed charges,,,36.75,83,,percent of total billed charges,,,36.75,83,,percent of total billed charges,,,,,,,,,,,,,,,36.75,83,,percent of total billed charges,,,42.07,95,,percent of total billed charges,,,39.85,90,,percent of total billed charges,,,39.85,90,,percent of total billed charges,,,36.31,82,,percent of total billed charges,,,39.85,90,,percent of total billed charges,,,37.64,85,,percent of total billed charges,,11.07,42.07,
* SPLINT POSTERIOR TIBIA YOUTH (V0106),23305383,CDM,,,270,RC,outpatient,,183,183,,155.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.75,22,,percent of total billed charges,,,,,,,,,164.7,90,,percent of total billed charges,,,151.52,82.8,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,,,,,,,,161.04,88,,percent of total billed charges,,,,,,,,,139.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.75,22,,percent of total billed charges,,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,,,,,,,,,,,,,151.89,83,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,150.06,82,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,45.75,173.85,
*VISCERA RETAINER MEDIUM,23305482,CDM,,,270,RC,outpatient,,158,158,,134.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.5,22,,percent of total billed charges,,,,,,,,,142.2,90,,percent of total billed charges,,,130.82,82.8,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,,,,,,,,139.04,88,,percent of total billed charges,,,,,,,,,120.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.5,22,,percent of total billed charges,,,143.78,91,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,,,,,,,,,,,,,131.14,83,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,129.56,82,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,39.5,150.1,
BREATHING CIRCUIT W/FILTER,23305508,CDM,,,270,RC,outpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.7,22,,percent of total billed charges,,,,,,,,,63.73,90,,percent of total billed charges,,,58.63,82.8,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.7,22,,percent of total billed charges,,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,17.7,67.27,
BREATHING CIRCUIT PED.,23305509,CDM,,,270,RC,outpatient,,63.61,63.61,,54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.9,22,,percent of total billed charges,,,,,,,,,57.25,90,,percent of total billed charges,,,52.67,82.8,,percent of total billed charges,,,54.07,85,,percent of total billed charges,,,,,,,,,55.98,88,,percent of total billed charges,,,,,,,,,48.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.9,22,,percent of total billed charges,,,57.89,91,,percent of total billed charges,,,60.43,95,,percent of total billed charges,,,52.8,83,,percent of total billed charges,,,52.8,83,,percent of total billed charges,,,,,,,,,,,,,,,52.8,83,,percent of total billed charges,,,60.43,95,,percent of total billed charges,,,57.25,90,,percent of total billed charges,,,57.25,90,,percent of total billed charges,,,52.16,82,,percent of total billed charges,,,57.25,90,,percent of total billed charges,,,54.07,85,,percent of total billed charges,,15.9,60.43,
* LMA USE (V0904),23305510,CDM,,,270,RC,outpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325,22,,percent of total billed charges,,,,,,,,,1170,90,,percent of total billed charges,,,1076.4,82.8,,percent of total billed charges,,,1105,85,,percent of total billed charges,,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325,22,,percent of total billed charges,,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,325,1235,
*ELEC/SURG SHOULDER ARTHROSCOPY,23305567,CDM,,,270,RC,outpatient,,6,6,,5.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.5,22,,percent of total billed charges,,,,,,,,,5.4,90,,percent of total billed charges,,,4.97,82.8,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,,,,,,,,5.28,88,,percent of total billed charges,,,,,,,,,4.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.5,22,,percent of total billed charges,,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4.98,83,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,4.92,82,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,1.5,5.7,
CAST BUCKET,23305758,CDM,,,270,RC,outpatient,,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43,22,,percent of total billed charges,,,,,,,,,154.8,90,,percent of total billed charges,,,142.42,82.8,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43,22,,percent of total billed charges,,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,43,163.4,
SUCTION SIMPULSE IRRIGATION,23305797,CDM,,,270,RC,outpatient,,339.77,339.77,,288.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.94,22,,percent of total billed charges,,,,,,,,,305.79,90,,percent of total billed charges,,,281.33,82.8,,percent of total billed charges,,,288.8,85,,percent of total billed charges,,,,,,,,,299,88,,percent of total billed charges,,,,,,,,,259.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.94,22,,percent of total billed charges,,,309.19,91,,percent of total billed charges,,,322.78,95,,percent of total billed charges,,,282.01,83,,percent of total billed charges,,,282.01,83,,percent of total billed charges,,,,,,,,,,,,,,,282.01,83,,percent of total billed charges,,,322.78,95,,percent of total billed charges,,,305.79,90,,percent of total billed charges,,,305.79,90,,percent of total billed charges,,,278.61,82,,percent of total billed charges,,,305.79,90,,percent of total billed charges,,,288.8,85,,percent of total billed charges,,84.94,322.78,
*INFANT HEEL WARMER,23305804,CDM,,,270,RC,outpatient,,4,4,,3.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1,22,,percent of total billed charges,,,,,,,,,3.6,90,,percent of total billed charges,,,3.31,82.8,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,,,,,,,,3.52,88,,percent of total billed charges,,,,,,,,,3.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1,22,,percent of total billed charges,,,3.64,91,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3.32,83,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.28,82,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,1,3.8,
* PAD WHEELCHAIR AIR CUSHION (V1104),23305904,CDM,,,270,RC,outpatient,,143,143,,121.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.75,22,,percent of total billed charges,,,,,,,,,128.7,90,,percent of total billed charges,,,118.4,82.8,,percent of total billed charges,,,121.55,85,,percent of total billed charges,,,,,,,,,125.84,88,,percent of total billed charges,,,,,,,,,109.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.75,22,,percent of total billed charges,,,130.13,91,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,,,,,,,,,,,,,118.69,83,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,117.26,82,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,121.55,85,,percent of total billed charges,,35.75,135.85,
INTERCEED 4  X 3,23305952,CDM,,,270,RC,outpatient,,2409.63,2409.63,,2045.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,602.41,22,,percent of total billed charges,,,,,,,,,2168.67,90,,percent of total billed charges,,,1995.17,82.8,,percent of total billed charges,,,2048.19,85,,percent of total billed charges,,,,,,,,,2120.47,88,,percent of total billed charges,,,,,,,,,1840.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,602.41,22,,percent of total billed charges,,,2192.76,91,,percent of total billed charges,,,2289.15,95,,percent of total billed charges,,,1999.99,83,,percent of total billed charges,,,1999.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1999.99,83,,percent of total billed charges,,,2289.15,95,,percent of total billed charges,,,2168.67,90,,percent of total billed charges,,,2168.67,90,,percent of total billed charges,,,1975.9,82,,percent of total billed charges,,,2168.67,90,,percent of total billed charges,,,2048.19,85,,percent of total billed charges,,602.41,2289.15,
CATH GROSHONG 9.5F,23306019,CDM,,,270,RC,outpatient,,4872.08,4872.08,,4136.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1218.02,22,,percent of total billed charges,,,,,,,,,4384.87,90,,percent of total billed charges,,,4034.08,82.8,,percent of total billed charges,,,4141.27,85,,percent of total billed charges,,,,,,,,,4287.43,88,,percent of total billed charges,,,,,,,,,3722.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1218.02,22,,percent of total billed charges,,,4433.59,91,,percent of total billed charges,,,4628.48,95,,percent of total billed charges,,,4043.83,83,,percent of total billed charges,,,4043.83,83,,percent of total billed charges,,,,,,,,,,,,,,,4043.83,83,,percent of total billed charges,,,4628.48,95,,percent of total billed charges,,,4384.87,90,,percent of total billed charges,,,4384.87,90,,percent of total billed charges,,,3995.11,82,,percent of total billed charges,,,4384.87,90,,percent of total billed charges,,,4141.27,85,,percent of total billed charges,,1218.02,4628.48,
ABDOMINAL BINDER MED/LG 30  - 45,23306068,CDM,,,270,RC,outpatient,,74.55,74.55,,63.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.64,22,,percent of total billed charges,,,,,,,,,67.1,90,,percent of total billed charges,,,61.73,82.8,,percent of total billed charges,,,63.37,85,,percent of total billed charges,,,,,,,,,65.6,88,,percent of total billed charges,,,,,,,,,56.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.64,22,,percent of total billed charges,,,67.84,91,,percent of total billed charges,,,70.82,95,,percent of total billed charges,,,61.88,83,,percent of total billed charges,,,61.88,83,,percent of total billed charges,,,,,,,,,,,,,,,61.88,83,,percent of total billed charges,,,70.82,95,,percent of total billed charges,,,67.1,90,,percent of total billed charges,,,67.1,90,,percent of total billed charges,,,61.13,82,,percent of total billed charges,,,67.1,90,,percent of total billed charges,,,63.37,85,,percent of total billed charges,,18.64,70.82,
ABDOMINAL BINDER XLG 45  - 62,23306069,CDM,,,270,RC,outpatient,,75.23,75.23,,63.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.81,22,,percent of total billed charges,,,,,,,,,67.71,90,,percent of total billed charges,,,62.29,82.8,,percent of total billed charges,,,63.95,85,,percent of total billed charges,,,,,,,,,66.2,88,,percent of total billed charges,,,,,,,,,57.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.81,22,,percent of total billed charges,,,68.46,91,,percent of total billed charges,,,71.47,95,,percent of total billed charges,,,62.44,83,,percent of total billed charges,,,62.44,83,,percent of total billed charges,,,,,,,,,,,,,,,62.44,83,,percent of total billed charges,,,71.47,95,,percent of total billed charges,,,67.71,90,,percent of total billed charges,,,67.71,90,,percent of total billed charges,,,61.69,82,,percent of total billed charges,,,67.71,90,,percent of total billed charges,,,63.95,85,,percent of total billed charges,,18.81,71.47,
*BLADDER CARE W METER NO CATH,23306100,CDM,,,270,RC,outpatient,,52,52,,44.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13,22,,percent of total billed charges,,,,,,,,,46.8,90,,percent of total billed charges,,,43.06,82.8,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,,,,,,,,45.76,88,,percent of total billed charges,,,,,,,,,39.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13,22,,percent of total billed charges,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,42.64,82,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,13,49.4,
TRAY EPIDURAL W/17GA NEEDLE,23306192,CDM,,,270,RC,outpatient,,201.9,201.9,,171.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.48,22,,percent of total billed charges,,,,,,,,,181.71,90,,percent of total billed charges,,,167.17,82.8,,percent of total billed charges,,,171.62,85,,percent of total billed charges,,,,,,,,,177.67,88,,percent of total billed charges,,,,,,,,,154.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.48,22,,percent of total billed charges,,,183.73,91,,percent of total billed charges,,,191.81,95,,percent of total billed charges,,,167.58,83,,percent of total billed charges,,,167.58,83,,percent of total billed charges,,,,,,,,,,,,,,,167.58,83,,percent of total billed charges,,,191.81,95,,percent of total billed charges,,,181.71,90,,percent of total billed charges,,,181.71,90,,percent of total billed charges,,,165.56,82,,percent of total billed charges,,,181.71,90,,percent of total billed charges,,,171.62,85,,percent of total billed charges,,50.48,191.81,
MESH MERSILENE 12 X 12,23306218,CDM,,,270,RC,outpatient,,4987.39,4987.39,,4234.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1246.85,22,,percent of total billed charges,,,,,,,,,4488.65,90,,percent of total billed charges,,,4129.56,82.8,,percent of total billed charges,,,4239.28,85,,percent of total billed charges,,,,,,,,,4388.9,88,,percent of total billed charges,,,,,,,,,3810.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1246.85,22,,percent of total billed charges,,,4538.52,91,,percent of total billed charges,,,4738.02,95,,percent of total billed charges,,,4139.53,83,,percent of total billed charges,,,4139.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4139.53,83,,percent of total billed charges,,,4738.02,95,,percent of total billed charges,,,4488.65,90,,percent of total billed charges,,,4488.65,90,,percent of total billed charges,,,4089.66,82,,percent of total billed charges,,,4488.65,90,,percent of total billed charges,,,4239.28,85,,percent of total billed charges,,1246.85,4738.02,
*SUCTION MOUTH SWAB,23306225,CDM,,,270,RC,outpatient,,11,11,,9.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.75,22,,percent of total billed charges,,,,,,,,,9.9,90,,percent of total billed charges,,,9.11,82.8,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,,,,,,,,9.68,88,,percent of total billed charges,,,,,,,,,8.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.75,22,,percent of total billed charges,,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,,,,,,,,,,,,,9.13,83,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.02,82,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,2.75,10.45,
PEG TUBE KIT,23306308,CDM,,,270,RC,outpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,105,22,,percent of total billed charges,,,,,,,,,378,90,,percent of total billed charges,,,347.76,82.8,,percent of total billed charges,,,357,85,,percent of total billed charges,,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,105,22,,percent of total billed charges,,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,105,399,
TRAY CENTRAL VENOUS CATH 3-LUMEN,23306316,CDM,,,270,RC,outpatient,,874.93,874.93,,742.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.73,22,,percent of total billed charges,,,,,,,,,787.44,90,,percent of total billed charges,,,724.44,82.8,,percent of total billed charges,,,743.69,85,,percent of total billed charges,,,,,,,,,769.94,88,,percent of total billed charges,,,,,,,,,668.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.73,22,,percent of total billed charges,,,796.19,91,,percent of total billed charges,,,831.18,95,,percent of total billed charges,,,726.19,83,,percent of total billed charges,,,726.19,83,,percent of total billed charges,,,,,,,,,,,,,,,726.19,83,,percent of total billed charges,,,831.18,95,,percent of total billed charges,,,787.44,90,,percent of total billed charges,,,787.44,90,,percent of total billed charges,,,717.44,82,,percent of total billed charges,,,787.44,90,,percent of total billed charges,,,743.69,85,,percent of total billed charges,,218.73,831.18,
* ECG MONITOR (V0904),23306324,CDM,,,732,RC,outpatient,,70,70,,59.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.5,22,,percent of total billed charges,,,,,,,,,63,90,,percent of total billed charges,,,57.96,82.8,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,,,,,,,,61.6,88,,percent of total billed charges,,,,,,,,,53.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.5,22,,percent of total billed charges,,,63.7,91,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,,,,,,,,,,,,,58.1,83,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,57.4,82,,percent of total billed charges,,,63,90,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,17.5,66.5,
* STOMA O R SETS 70MM (V0605),23306365,CDM,,,270,RC,outpatient,,38,38,,32.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.5,22,,percent of total billed charges,,,,,,,,,34.2,90,,percent of total billed charges,,,31.46,82.8,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,,,,,,,,33.44,88,,percent of total billed charges,,,,,,,,,29.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.5,22,,percent of total billed charges,,,34.58,91,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,,,,,,,,,,,,,31.54,83,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,31.16,82,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,9.5,36.1,
* Z/OR (V0405),23306416,CDM,,,270,RC,outpatient,,10780,10780,,9152.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2695,22,,percent of total billed charges,,,,,,,,,9702,90,,percent of total billed charges,,,8925.84,82.8,,percent of total billed charges,,,9163,85,,percent of total billed charges,,,,,,,,,9486.4,88,,percent of total billed charges,,,,,,,,,8235.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2695,22,,percent of total billed charges,,,9809.8,91,,percent of total billed charges,,,10241,95,,percent of total billed charges,,,8947.4,83,,percent of total billed charges,,,8947.4,83,,percent of total billed charges,,,,,,,,,,,,,,,8947.4,83,,percent of total billed charges,,,10241,95,,percent of total billed charges,,,9702,90,,percent of total billed charges,,,9702,90,,percent of total billed charges,,,8839.6,82,,percent of total billed charges,,,9702,90,,percent of total billed charges,,,9163,85,,percent of total billed charges,,2695,10241,
* ILC LASER (V1004),23306417,CDM,,,360,RC,outpatient,,2111,2111,,1792.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,527.75,22,,percent of total billed charges,,,,,,,,,1899.9,90,,percent of total billed charges,,,1747.91,82.8,,percent of total billed charges,,,1794.35,85,,percent of total billed charges,,,,,,,,,1857.68,88,,percent of total billed charges,,,,,,,,,1612.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,527.75,22,,percent of total billed charges,,,1921.01,91,,percent of total billed charges,,,2005.45,95,,percent of total billed charges,,,1752.13,83,,percent of total billed charges,,,1752.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1752.13,83,,percent of total billed charges,,,2005.45,95,,percent of total billed charges,,,1899.9,90,,percent of total billed charges,,,1899.9,90,,percent of total billed charges,,,1731.02,82,,percent of total billed charges,,,1899.9,90,,percent of total billed charges,,,1794.35,85,,percent of total billed charges,,527.75,2005.45,
* PVP LASER FEE (V1004),23306419,CDM,,,360,RC,outpatient,,2413,2413,,2048.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,603.25,22,,percent of total billed charges,,,,,,,,,2171.7,90,,percent of total billed charges,,,1997.96,82.8,,percent of total billed charges,,,2051.05,85,,percent of total billed charges,,,,,,,,,2123.44,88,,percent of total billed charges,,,,,,,,,1843.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,603.25,22,,percent of total billed charges,,,2195.83,91,,percent of total billed charges,,,2292.35,95,,percent of total billed charges,,,2002.79,83,,percent of total billed charges,,,2002.79,83,,percent of total billed charges,,,,,,,,,,,,,,,2002.79,83,,percent of total billed charges,,,2292.35,95,,percent of total billed charges,,,2171.7,90,,percent of total billed charges,,,2171.7,90,,percent of total billed charges,,,1978.66,82,,percent of total billed charges,,,2171.7,90,,percent of total billed charges,,,2051.05,85,,percent of total billed charges,,603.25,2292.35,
* PVP FIBER FEE (V1004),23306420,CDM,,,360,RC,outpatient,,2111,2111,,1792.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,527.75,22,,percent of total billed charges,,,,,,,,,1899.9,90,,percent of total billed charges,,,1747.91,82.8,,percent of total billed charges,,,1794.35,85,,percent of total billed charges,,,,,,,,,1857.68,88,,percent of total billed charges,,,,,,,,,1612.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,527.75,22,,percent of total billed charges,,,1921.01,91,,percent of total billed charges,,,2005.45,95,,percent of total billed charges,,,1752.13,83,,percent of total billed charges,,,1752.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1752.13,83,,percent of total billed charges,,,2005.45,95,,percent of total billed charges,,,1899.9,90,,percent of total billed charges,,,1899.9,90,,percent of total billed charges,,,1731.02,82,,percent of total billed charges,,,1899.9,90,,percent of total billed charges,,,1794.35,85,,percent of total billed charges,,527.75,2005.45,
ELECTRODE DEFIB PEDS EDGE QUICK-COMBO,23306457,CDM,,,270,RC,outpatient,,215.18,215.18,,182.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.8,22,,percent of total billed charges,,,,,,,,,193.66,90,,percent of total billed charges,,,178.17,82.8,,percent of total billed charges,,,182.9,85,,percent of total billed charges,,,,,,,,,189.36,88,,percent of total billed charges,,,,,,,,,164.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.8,22,,percent of total billed charges,,,195.81,91,,percent of total billed charges,,,204.42,95,,percent of total billed charges,,,178.6,83,,percent of total billed charges,,,178.6,83,,percent of total billed charges,,,,,,,,,,,,,,,178.6,83,,percent of total billed charges,,,204.42,95,,percent of total billed charges,,,193.66,90,,percent of total billed charges,,,193.66,90,,percent of total billed charges,,,176.45,82,,percent of total billed charges,,,193.66,90,,percent of total billed charges,,,182.9,85,,percent of total billed charges,,53.8,204.42,
CAST SHOE DARCO WOMEN MEDIUM,23306481,CDM,,,270,RC,outpatient,,46.5,46.5,,39.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.63,22,,percent of total billed charges,,,,,,,,,41.85,90,,percent of total billed charges,,,38.5,82.8,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,,,,,,,,40.92,88,,percent of total billed charges,,,,,,,,,35.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.63,22,,percent of total billed charges,,,42.32,91,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,,,,,,,,,,,,,38.6,83,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,38.13,82,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,11.63,44.18,
CAST SHOE DARCO WOMEN LG,23306482,CDM,,,270,RC,outpatient,,46.5,46.5,,39.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.63,22,,percent of total billed charges,,,,,,,,,41.85,90,,percent of total billed charges,,,38.5,82.8,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,,,,,,,,40.92,88,,percent of total billed charges,,,,,,,,,35.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.63,22,,percent of total billed charges,,,42.32,91,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,,,,,,,,,,,,,38.6,83,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,38.13,82,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,11.63,44.18,
CAST SHOE DARCO MEN SMALL,23306483,CDM,,,270,RC,outpatient,,46.5,46.5,,39.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.63,22,,percent of total billed charges,,,,,,,,,41.85,90,,percent of total billed charges,,,38.5,82.8,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,,,,,,,,40.92,88,,percent of total billed charges,,,,,,,,,35.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.63,22,,percent of total billed charges,,,42.32,91,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,,,,,,,,,,,,,38.6,83,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,38.13,82,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,11.63,44.18,
CAST SHOE DARCO MEN MEDIUM,23306484,CDM,,,270,RC,outpatient,,46.5,46.5,,39.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.63,22,,percent of total billed charges,,,,,,,,,41.85,90,,percent of total billed charges,,,38.5,82.8,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,,,,,,,,40.92,88,,percent of total billed charges,,,,,,,,,35.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.63,22,,percent of total billed charges,,,42.32,91,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,,,,,,,,,,,,,38.6,83,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,38.13,82,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,11.63,44.18,
CAST SHOE DARCO MEN LG,23306485,CDM,,,270,RC,outpatient,,46.5,46.5,,39.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.63,22,,percent of total billed charges,,,,,,,,,41.85,90,,percent of total billed charges,,,38.5,82.8,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,,,,,,,,40.92,88,,percent of total billed charges,,,,,,,,,35.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.63,22,,percent of total billed charges,,,42.32,91,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,,,,,,,,,,,,,38.6,83,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,38.13,82,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,11.63,44.18,
CAST SHOE DARCO MEN XLG,23306486,CDM,,,270,RC,outpatient,,46.5,46.5,,39.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.63,22,,percent of total billed charges,,,,,,,,,41.85,90,,percent of total billed charges,,,38.5,82.8,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,,,,,,,,40.92,88,,percent of total billed charges,,,,,,,,,35.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.63,22,,percent of total billed charges,,,42.32,91,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,38.6,83,,percent of total billed charges,,,,,,,,,,,,,,,38.6,83,,percent of total billed charges,,,44.18,95,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,38.13,82,,percent of total billed charges,,,41.85,90,,percent of total billed charges,,,39.53,85,,percent of total billed charges,,11.63,44.18,
STOMA FLANGE HOL 14803,23306511,CDM,,,270,RC,outpatient,,8.51,8.51,,7.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.13,22,,percent of total billed charges,,,,,,,,,7.66,90,,percent of total billed charges,,,7.05,82.8,,percent of total billed charges,,,7.23,85,,percent of total billed charges,,,,,,,,,7.49,88,,percent of total billed charges,,,,,,,,,6.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.13,22,,percent of total billed charges,,,7.74,91,,percent of total billed charges,,,8.08,95,,percent of total billed charges,,,7.06,83,,percent of total billed charges,,,7.06,83,,percent of total billed charges,,,,,,,,,,,,,,,7.06,83,,percent of total billed charges,,,8.08,95,,percent of total billed charges,,,7.66,90,,percent of total billed charges,,,7.66,90,,percent of total billed charges,,,6.98,82,,percent of total billed charges,,,7.66,90,,percent of total billed charges,,,7.23,85,,percent of total billed charges,,2.13,8.08,
STOMA FLANGE FLAT 2-3/4,23306518,CDM,,,270,RC,outpatient,,4.5,4.5,,3.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.13,22,,percent of total billed charges,,,,,,,,,4.05,90,,percent of total billed charges,,,3.73,82.8,,percent of total billed charges,,,3.83,85,,percent of total billed charges,,,,,,,,,3.96,88,,percent of total billed charges,,,,,,,,,3.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.13,22,,percent of total billed charges,,,4.1,91,,percent of total billed charges,,,4.28,95,,percent of total billed charges,,,3.74,83,,percent of total billed charges,,,3.74,83,,percent of total billed charges,,,,,,,,,,,,,,,3.74,83,,percent of total billed charges,,,4.28,95,,percent of total billed charges,,,4.05,90,,percent of total billed charges,,,4.05,90,,percent of total billed charges,,,3.69,82,,percent of total billed charges,,,4.05,90,,percent of total billed charges,,,3.83,85,,percent of total billed charges,,1.13,4.28,
*STOMA POUCH W/CLAMP 1-3/4 (DISCONTINU,23306536,CDM,,,270,RC,outpatient,,8,8,,6.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2,22,,percent of total billed charges,,,,,,,,,7.2,90,,percent of total billed charges,,,6.62,82.8,,percent of total billed charges,,,6.8,85,,percent of total billed charges,,,,,,,,,7.04,88,,percent of total billed charges,,,,,,,,,6.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2,22,,percent of total billed charges,,,7.28,91,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,,,,,,,,,,,,,6.64,83,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.56,82,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.8,85,,percent of total billed charges,,2,7.6,
INTUBATION STYLET 14FR,23306605,CDM,,,270,RC,outpatient,,33.44,33.44,,28.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.36,22,,percent of total billed charges,,,,,,,,,30.1,90,,percent of total billed charges,,,27.69,82.8,,percent of total billed charges,,,28.42,85,,percent of total billed charges,,,,,,,,,29.43,88,,percent of total billed charges,,,,,,,,,25.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.36,22,,percent of total billed charges,,,30.43,91,,percent of total billed charges,,,31.77,95,,percent of total billed charges,,,27.76,83,,percent of total billed charges,,,27.76,83,,percent of total billed charges,,,,,,,,,,,,,,,27.76,83,,percent of total billed charges,,,31.77,95,,percent of total billed charges,,,30.1,90,,percent of total billed charges,,,30.1,90,,percent of total billed charges,,,27.42,82,,percent of total billed charges,,,30.1,90,,percent of total billed charges,,,28.42,85,,percent of total billed charges,,8.36,31.77,
* ADAPTIC DRESSING 3  X 8 (DUP) (V0605),23306627,CDM,,,270,RC,outpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.75,22,,percent of total billed charges,,,,,,,,,2.7,90,,percent of total billed charges,,,2.48,82.8,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.75,22,,percent of total billed charges,,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,0.75,2.85,
EYE IRRIGATION LENS MORGAN,23306712,CDM,,,270,RC,outpatient,,404.6,404.6,,343.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.15,22,,percent of total billed charges,,,,,,,,,364.14,90,,percent of total billed charges,,,335.01,82.8,,percent of total billed charges,,,343.91,85,,percent of total billed charges,,,,,,,,,356.05,88,,percent of total billed charges,,,,,,,,,309.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.15,22,,percent of total billed charges,,,368.19,91,,percent of total billed charges,,,384.37,95,,percent of total billed charges,,,335.82,83,,percent of total billed charges,,,335.82,83,,percent of total billed charges,,,,,,,,,,,,,,,335.82,83,,percent of total billed charges,,,384.37,95,,percent of total billed charges,,,364.14,90,,percent of total billed charges,,,364.14,90,,percent of total billed charges,,,331.77,82,,percent of total billed charges,,,364.14,90,,percent of total billed charges,,,343.91,85,,percent of total billed charges,,101.15,384.37,
*PROMOGRAM DRESSING,23306787,CDM,,,270,RC,outpatient,,60,60,,50.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15,22,,percent of total billed charges,,,,,,,,,54,90,,percent of total billed charges,,,49.68,82.8,,percent of total billed charges,,,51,85,,percent of total billed charges,,,,,,,,,52.8,88,,percent of total billed charges,,,,,,,,,45.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15,22,,percent of total billed charges,,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,,,,,,,,,,,,,49.8,83,,percent of total billed charges,,,57,95,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,49.2,82,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,15,57,
* EPI LOCK 4X4 (V0605),23306795,CDM,,,270,RC,outpatient,,139,139,,118.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.75,22,,percent of total billed charges,,,,,,,,,125.1,90,,percent of total billed charges,,,115.09,82.8,,percent of total billed charges,,,118.15,85,,percent of total billed charges,,,,,,,,,122.32,88,,percent of total billed charges,,,,,,,,,106.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.75,22,,percent of total billed charges,,,126.49,91,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,,,,,,,,,,,,,115.37,83,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,113.98,82,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,118.15,85,,percent of total billed charges,,34.75,132.05,
DRAIN JACKSON PRATT 10FR 7MM W/TROCAR,23306829,CDM,,,270,RC,outpatient,,82.88,82.88,,70.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.72,22,,percent of total billed charges,,,,,,,,,74.59,90,,percent of total billed charges,,,68.62,82.8,,percent of total billed charges,,,70.45,85,,percent of total billed charges,,,,,,,,,72.93,88,,percent of total billed charges,,,,,,,,,63.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.72,22,,percent of total billed charges,,,75.42,91,,percent of total billed charges,,,78.74,95,,percent of total billed charges,,,68.79,83,,percent of total billed charges,,,68.79,83,,percent of total billed charges,,,,,,,,,,,,,,,68.79,83,,percent of total billed charges,,,78.74,95,,percent of total billed charges,,,74.59,90,,percent of total billed charges,,,74.59,90,,percent of total billed charges,,,67.96,82,,percent of total billed charges,,,74.59,90,,percent of total billed charges,,,70.45,85,,percent of total billed charges,,20.72,78.74,
RESERVOIR WOUND DRAIN 400CC,23306850,CDM,,,270,RC,outpatient,,77.31,77.31,,65.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.33,22,,percent of total billed charges,,,,,,,,,69.58,90,,percent of total billed charges,,,64.01,82.8,,percent of total billed charges,,,65.71,85,,percent of total billed charges,,,,,,,,,68.03,88,,percent of total billed charges,,,,,,,,,59.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.33,22,,percent of total billed charges,,,70.35,91,,percent of total billed charges,,,73.44,95,,percent of total billed charges,,,64.17,83,,percent of total billed charges,,,64.17,83,,percent of total billed charges,,,,,,,,,,,,,,,64.17,83,,percent of total billed charges,,,73.44,95,,percent of total billed charges,,,69.58,90,,percent of total billed charges,,,69.58,90,,percent of total billed charges,,,63.39,82,,percent of total billed charges,,,69.58,90,,percent of total billed charges,,,65.71,85,,percent of total billed charges,,19.33,73.44,
DRAIN WOUND EVACUATOR 100CC,23306852,CDM,,,270,RC,outpatient,,67.12,67.12,,56.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.78,22,,percent of total billed charges,,,,,,,,,60.41,90,,percent of total billed charges,,,55.58,82.8,,percent of total billed charges,,,57.05,85,,percent of total billed charges,,,,,,,,,59.07,88,,percent of total billed charges,,,,,,,,,51.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.78,22,,percent of total billed charges,,,61.08,91,,percent of total billed charges,,,63.76,95,,percent of total billed charges,,,55.71,83,,percent of total billed charges,,,55.71,83,,percent of total billed charges,,,,,,,,,,,,,,,55.71,83,,percent of total billed charges,,,63.76,95,,percent of total billed charges,,,60.41,90,,percent of total billed charges,,,60.41,90,,percent of total billed charges,,,55.04,82,,percent of total billed charges,,,60.41,90,,percent of total billed charges,,,57.05,85,,percent of total billed charges,,16.78,63.76,
HOT PACK DISPOSABLE,23306886,CDM,,,270,RC,outpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.75,22,,percent of total billed charges,,,,,,,,,2.7,90,,percent of total billed charges,,,2.48,82.8,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.75,22,,percent of total billed charges,,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,0.75,2.85,
* BIOPSY NEEDLE PROSTATIC DISP (V0106),23306936,CDM,,,270,RC,outpatient,,177,177,,150.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.25,22,,percent of total billed charges,,,,,,,,,159.3,90,,percent of total billed charges,,,146.56,82.8,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,,,,,,,,155.76,88,,percent of total billed charges,,,,,,,,,135.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.25,22,,percent of total billed charges,,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,,,,,,,,,,,,,146.91,83,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,145.14,82,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,44.25,168.15,
DUOVISC 0.55 ML,23307015,CDM,,,270,RC,outpatient,,617.75,617.75,,524.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154.44,22,,percent of total billed charges,,,,,,,,,555.98,90,,percent of total billed charges,,,511.5,82.8,,percent of total billed charges,,,525.09,85,,percent of total billed charges,,,,,,,,,543.62,88,,percent of total billed charges,,,,,,,,,471.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154.44,22,,percent of total billed charges,,,562.15,91,,percent of total billed charges,,,586.86,95,,percent of total billed charges,,,512.73,83,,percent of total billed charges,,,512.73,83,,percent of total billed charges,,,,,,,,,,,,,,,512.73,83,,percent of total billed charges,,,586.86,95,,percent of total billed charges,,,555.98,90,,percent of total billed charges,,,555.98,90,,percent of total billed charges,,,506.56,82,,percent of total billed charges,,,555.98,90,,percent of total billed charges,,,525.09,85,,percent of total billed charges,,154.44,586.86,
EYE LENS IMPLANT (BAUSCH & LOMB),23307017,CDM,,,270,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
TRACH 5.5 UNCUFFED,23307023,CDM,,,270,RC,outpatient,,16.2,16.2,,13.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.05,22,,percent of total billed charges,,,,,,,,,14.58,90,,percent of total billed charges,,,13.41,82.8,,percent of total billed charges,,,13.77,85,,percent of total billed charges,,,,,,,,,14.26,88,,percent of total billed charges,,,,,,,,,12.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.05,22,,percent of total billed charges,,,14.74,91,,percent of total billed charges,,,15.39,95,,percent of total billed charges,,,13.45,83,,percent of total billed charges,,,13.45,83,,percent of total billed charges,,,,,,,,,,,,,,,13.45,83,,percent of total billed charges,,,15.39,95,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,13.28,82,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,13.77,85,,percent of total billed charges,,4.05,15.39,
* SUTURE CM830 (V0205),23307027,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
*PACK EYE - BAUSCH & LOMB,23307033,CDM,,,270,RC,outpatient,,34.74,34.74,,29.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.69,22,,percent of total billed charges,,,,,,,,,31.27,90,,percent of total billed charges,,,28.76,82.8,,percent of total billed charges,,,29.53,85,,percent of total billed charges,,,,,,,,,30.57,88,,percent of total billed charges,,,,,,,,,26.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.69,22,,percent of total billed charges,,,31.61,91,,percent of total billed charges,,,33,95,,percent of total billed charges,,,28.83,83,,percent of total billed charges,,,28.83,83,,percent of total billed charges,,,,,,,,,,,,,,,28.83,83,,percent of total billed charges,,,33,95,,percent of total billed charges,,,31.27,90,,percent of total billed charges,,,31.27,90,,percent of total billed charges,,,28.49,82,,percent of total billed charges,,,31.27,90,,percent of total billed charges,,,29.53,85,,percent of total billed charges,,8.69,33,
SYNTHES DRILL BIT 2.0MM 310.19,23307055,CDM,,,270,RC,outpatient,,803.25,803.25,,681.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,200.81,22,,percent of total billed charges,,,,,,,,,722.93,90,,percent of total billed charges,,,665.09,82.8,,percent of total billed charges,,,682.76,85,,percent of total billed charges,,,,,,,,,706.86,88,,percent of total billed charges,,,,,,,,,613.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,200.81,22,,percent of total billed charges,,,730.96,91,,percent of total billed charges,,,763.09,95,,percent of total billed charges,,,666.7,83,,percent of total billed charges,,,666.7,83,,percent of total billed charges,,,,,,,,,,,,,,,666.7,83,,percent of total billed charges,,,763.09,95,,percent of total billed charges,,,722.93,90,,percent of total billed charges,,,722.93,90,,percent of total billed charges,,,658.67,82,,percent of total billed charges,,,722.93,90,,percent of total billed charges,,,682.76,85,,percent of total billed charges,,200.81,763.09,
* SACRO BELT LARGE (V0106),23307066,CDM,,,270,RC,outpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.5,22,,percent of total billed charges,,,,,,,,,113.4,90,,percent of total billed charges,,,104.33,82.8,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,,,,,,,,110.88,88,,percent of total billed charges,,,,,,,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.5,22,,percent of total billed charges,,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,31.5,119.7,
SPLINT THUMB UNIV,23307082,CDM,,,270,RC,outpatient,,51.43,51.43,,43.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.86,22,,percent of total billed charges,,,,,,,,,46.29,90,,percent of total billed charges,,,42.58,82.8,,percent of total billed charges,,,43.72,85,,percent of total billed charges,,,,,,,,,45.26,88,,percent of total billed charges,,,,,,,,,39.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.86,22,,percent of total billed charges,,,46.8,91,,percent of total billed charges,,,48.86,95,,percent of total billed charges,,,42.69,83,,percent of total billed charges,,,42.69,83,,percent of total billed charges,,,,,,,,,,,,,,,42.69,83,,percent of total billed charges,,,48.86,95,,percent of total billed charges,,,46.29,90,,percent of total billed charges,,,46.29,90,,percent of total billed charges,,,42.17,82,,percent of total billed charges,,,46.29,90,,percent of total billed charges,,,43.72,85,,percent of total billed charges,,12.86,48.86,
*THUMB SPLINT LEFT,23307083,CDM,,,270,RC,outpatient,,171,171,,145.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.75,22,,percent of total billed charges,,,,,,,,,153.9,90,,percent of total billed charges,,,141.59,82.8,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,,,,,,,,150.48,88,,percent of total billed charges,,,,,,,,,130.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.75,22,,percent of total billed charges,,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,,,,,,,,,,,,,141.93,83,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,140.22,82,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,42.75,162.45,
*DRESSING DUODERM GEL,23307116,CDM,,,270,RC,outpatient,,24.57,24.57,,20.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.14,22,,percent of total billed charges,,,,,,,,,22.11,90,,percent of total billed charges,,,20.34,82.8,,percent of total billed charges,,,20.88,85,,percent of total billed charges,,,,,,,,,21.62,88,,percent of total billed charges,,,,,,,,,18.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.14,22,,percent of total billed charges,,,22.36,91,,percent of total billed charges,,,23.34,95,,percent of total billed charges,,,20.39,83,,percent of total billed charges,,,20.39,83,,percent of total billed charges,,,,,,,,,,,,,,,20.39,83,,percent of total billed charges,,,23.34,95,,percent of total billed charges,,,22.11,90,,percent of total billed charges,,,22.11,90,,percent of total billed charges,,,20.15,82,,percent of total billed charges,,,22.11,90,,percent of total billed charges,,,20.88,85,,percent of total billed charges,,6.14,23.34,
*DUODERM 4X4 W/BORDER/HYDRO,23307124,CDM,,,270,RC,outpatient,,26,26,,22.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.5,22,,percent of total billed charges,,,,,,,,,23.4,90,,percent of total billed charges,,,21.53,82.8,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,,,,,,,,22.88,88,,percent of total billed charges,,,,,,,,,19.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.5,22,,percent of total billed charges,,,23.66,91,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,,,,,,,,,,,,,21.58,83,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,21.32,82,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,6.5,24.7,
MERINA INTRAUTERINE SYSTEM (NC),23307200,CDM,,,270,RC,outpatient,,6820.06,6820.06,,5790.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1705.02,22,,percent of total billed charges,,,,,,,,,6138.05,90,,percent of total billed charges,,,5647.01,82.8,,percent of total billed charges,,,5797.05,85,,percent of total billed charges,,,,,,,,,6001.65,88,,percent of total billed charges,,,,,,,,,5210.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1705.02,22,,percent of total billed charges,,,6206.25,91,,percent of total billed charges,,,6479.06,95,,percent of total billed charges,,,5660.65,83,,percent of total billed charges,,,5660.65,83,,percent of total billed charges,,,,,,,,,,,,,,,5660.65,83,,percent of total billed charges,,,6479.06,95,,percent of total billed charges,,,6138.05,90,,percent of total billed charges,,,6138.05,90,,percent of total billed charges,,,5592.45,82,,percent of total billed charges,,,6138.05,90,,percent of total billed charges,,,5797.05,85,,percent of total billed charges,,1705.02,6479.06,
NEXPLANON (IUD),23307205,CDM,,,270,RC,outpatient,,2723.18,2723.18,,2311.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,680.8,22,,percent of total billed charges,,,,,,,,,2450.86,90,,percent of total billed charges,,,2254.79,82.8,,percent of total billed charges,,,2314.7,85,,percent of total billed charges,,,,,,,,,2396.4,88,,percent of total billed charges,,,,,,,,,2080.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,680.8,22,,percent of total billed charges,,,2478.09,91,,percent of total billed charges,,,2587.02,95,,percent of total billed charges,,,2260.24,83,,percent of total billed charges,,,2260.24,83,,percent of total billed charges,,,,,,,,,,,,,,,2260.24,83,,percent of total billed charges,,,2587.02,95,,percent of total billed charges,,,2450.86,90,,percent of total billed charges,,,2450.86,90,,percent of total billed charges,,,2233.01,82,,percent of total billed charges,,,2450.86,90,,percent of total billed charges,,,2314.7,85,,percent of total billed charges,,680.8,2587.02,
ENDO CLIP APPLIER,23307215,CDM,,,270,RC,outpatient,,2059.53,2059.53,,1748.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,514.88,22,,percent of total billed charges,,,,,,,,,1853.58,90,,percent of total billed charges,,,1705.29,82.8,,percent of total billed charges,,,1750.6,85,,percent of total billed charges,,,,,,,,,1812.39,88,,percent of total billed charges,,,,,,,,,1573.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,514.88,22,,percent of total billed charges,,,1874.17,91,,percent of total billed charges,,,1956.55,95,,percent of total billed charges,,,1709.41,83,,percent of total billed charges,,,1709.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1709.41,83,,percent of total billed charges,,,1956.55,95,,percent of total billed charges,,,1853.58,90,,percent of total billed charges,,,1853.58,90,,percent of total billed charges,,,1688.81,82,,percent of total billed charges,,,1853.58,90,,percent of total billed charges,,,1750.6,85,,percent of total billed charges,,514.88,1956.55,
TROCAR ENDO BLUNT 10/12MM,23307256,CDM,,,270,RC,outpatient,,195.04,195.04,,165.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.76,22,,percent of total billed charges,,,,,,,,,175.54,90,,percent of total billed charges,,,161.49,82.8,,percent of total billed charges,,,165.78,85,,percent of total billed charges,,,,,,,,,171.64,88,,percent of total billed charges,,,,,,,,,149.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.76,22,,percent of total billed charges,,,177.49,91,,percent of total billed charges,,,185.29,95,,percent of total billed charges,,,161.88,83,,percent of total billed charges,,,161.88,83,,percent of total billed charges,,,,,,,,,,,,,,,161.88,83,,percent of total billed charges,,,185.29,95,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,159.93,82,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,165.78,85,,percent of total billed charges,,48.76,185.29,
ENDO LOOP LIGATOR PDS,23307298,CDM,,,270,RC,outpatient,,287.97,287.97,,244.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.99,22,,percent of total billed charges,,,,,,,,,259.17,90,,percent of total billed charges,,,238.44,82.8,,percent of total billed charges,,,244.77,85,,percent of total billed charges,,,,,,,,,253.41,88,,percent of total billed charges,,,,,,,,,220.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.99,22,,percent of total billed charges,,,262.05,91,,percent of total billed charges,,,273.57,95,,percent of total billed charges,,,239.02,83,,percent of total billed charges,,,239.02,83,,percent of total billed charges,,,,,,,,,,,,,,,239.02,83,,percent of total billed charges,,,273.57,95,,percent of total billed charges,,,259.17,90,,percent of total billed charges,,,259.17,90,,percent of total billed charges,,,236.14,82,,percent of total billed charges,,,259.17,90,,percent of total billed charges,,,244.77,85,,percent of total billed charges,,71.99,273.57,
ENDO DISSECTORS ROUND PEANUTS,23307299,CDM,,,270,RC,outpatient,,117.73,117.73,,99.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.43,22,,percent of total billed charges,,,,,,,,,105.96,90,,percent of total billed charges,,,97.48,82.8,,percent of total billed charges,,,100.07,85,,percent of total billed charges,,,,,,,,,103.6,88,,percent of total billed charges,,,,,,,,,89.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.43,22,,percent of total billed charges,,,107.13,91,,percent of total billed charges,,,111.84,95,,percent of total billed charges,,,97.72,83,,percent of total billed charges,,,97.72,83,,percent of total billed charges,,,,,,,,,,,,,,,97.72,83,,percent of total billed charges,,,111.84,95,,percent of total billed charges,,,105.96,90,,percent of total billed charges,,,105.96,90,,percent of total billed charges,,,96.54,82,,percent of total billed charges,,,105.96,90,,percent of total billed charges,,,100.07,85,,percent of total billed charges,,29.43,111.84,
DRAIN WOUND 15 FR,23307306,CDM,,,270,RC,outpatient,,66.1,66.1,,56.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.53,22,,percent of total billed charges,,,,,,,,,59.49,90,,percent of total billed charges,,,54.73,82.8,,percent of total billed charges,,,56.19,85,,percent of total billed charges,,,,,,,,,58.17,88,,percent of total billed charges,,,,,,,,,50.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.53,22,,percent of total billed charges,,,60.15,91,,percent of total billed charges,,,62.8,95,,percent of total billed charges,,,54.86,83,,percent of total billed charges,,,54.86,83,,percent of total billed charges,,,,,,,,,,,,,,,54.86,83,,percent of total billed charges,,,62.8,95,,percent of total billed charges,,,59.49,90,,percent of total billed charges,,,59.49,90,,percent of total billed charges,,,54.2,82,,percent of total billed charges,,,59.49,90,,percent of total billed charges,,,56.19,85,,percent of total billed charges,,16.53,62.8,
PROCLUDE 6X6,23307330,CDM,,,270,RC,outpatient,,9,9,,7.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.25,22,,percent of total billed charges,,,,,,,,,8.1,90,,percent of total billed charges,,,7.45,82.8,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,,,,,,,,7.92,88,,percent of total billed charges,,,,,,,,,6.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.25,22,,percent of total billed charges,,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.38,82,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,2.25,8.55,
AIRWAY NASAL LATEX FREE 16FR,23307397,CDM,,,270,RC,outpatient,,91.04,91.04,,77.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.76,22,,percent of total billed charges,,,,,,,,,81.94,90,,percent of total billed charges,,,75.38,82.8,,percent of total billed charges,,,77.38,85,,percent of total billed charges,,,,,,,,,80.12,88,,percent of total billed charges,,,,,,,,,69.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.76,22,,percent of total billed charges,,,82.85,91,,percent of total billed charges,,,86.49,95,,percent of total billed charges,,,75.56,83,,percent of total billed charges,,,75.56,83,,percent of total billed charges,,,,,,,,,,,,,,,75.56,83,,percent of total billed charges,,,86.49,95,,percent of total billed charges,,,81.94,90,,percent of total billed charges,,,81.94,90,,percent of total billed charges,,,74.65,82,,percent of total billed charges,,,81.94,90,,percent of total billed charges,,,77.38,85,,percent of total billed charges,,22.76,86.49,
*PROFORE,23307440,CDM,,,270,RC,outpatient,,96,96,,81.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24,22,,percent of total billed charges,,,,,,,,,86.4,90,,percent of total billed charges,,,79.49,82.8,,percent of total billed charges,,,81.6,85,,percent of total billed charges,,,,,,,,,84.48,88,,percent of total billed charges,,,,,,,,,73.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24,22,,percent of total billed charges,,,87.36,91,,percent of total billed charges,,,91.2,95,,percent of total billed charges,,,79.68,83,,percent of total billed charges,,,79.68,83,,percent of total billed charges,,,,,,,,,,,,,,,79.68,83,,percent of total billed charges,,,91.2,95,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,78.72,82,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,81.6,85,,percent of total billed charges,,24,91.2,
STAPLER MULTI FIRE GIA,23307512,CDM,,,270,RC,outpatient,,1716.85,1716.85,,1457.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,429.21,22,,percent of total billed charges,,,,,,,,,1545.17,90,,percent of total billed charges,,,1421.55,82.8,,percent of total billed charges,,,1459.32,85,,percent of total billed charges,,,,,,,,,1510.83,88,,percent of total billed charges,,,,,,,,,1311.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,429.21,22,,percent of total billed charges,,,1562.33,91,,percent of total billed charges,,,1631.01,95,,percent of total billed charges,,,1424.99,83,,percent of total billed charges,,,1424.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1424.99,83,,percent of total billed charges,,,1631.01,95,,percent of total billed charges,,,1545.17,90,,percent of total billed charges,,,1545.17,90,,percent of total billed charges,,,1407.82,82,,percent of total billed charges,,,1545.17,90,,percent of total billed charges,,,1459.32,85,,percent of total billed charges,,429.21,1631.01,
*SPLINT MASON ALLEN SMALL,23307546,CDM,,,270,RC,outpatient,,88.32,88.32,,74.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.08,22,,percent of total billed charges,,,,,,,,,79.49,90,,percent of total billed charges,,,73.13,82.8,,percent of total billed charges,,,75.07,85,,percent of total billed charges,,,,,,,,,77.72,88,,percent of total billed charges,,,,,,,,,67.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.08,22,,percent of total billed charges,,,80.37,91,,percent of total billed charges,,,83.9,95,,percent of total billed charges,,,73.31,83,,percent of total billed charges,,,73.31,83,,percent of total billed charges,,,,,,,,,,,,,,,73.31,83,,percent of total billed charges,,,83.9,95,,percent of total billed charges,,,79.49,90,,percent of total billed charges,,,79.49,90,,percent of total billed charges,,,72.42,82,,percent of total billed charges,,,79.49,90,,percent of total billed charges,,,75.07,85,,percent of total billed charges,,22.08,83.9,
*SPLINT MASON ALLEN LG,23307547,CDM,,,270,RC,outpatient,,88.32,88.32,,74.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.08,22,,percent of total billed charges,,,,,,,,,79.49,90,,percent of total billed charges,,,73.13,82.8,,percent of total billed charges,,,75.07,85,,percent of total billed charges,,,,,,,,,77.72,88,,percent of total billed charges,,,,,,,,,67.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.08,22,,percent of total billed charges,,,80.37,91,,percent of total billed charges,,,83.9,95,,percent of total billed charges,,,73.31,83,,percent of total billed charges,,,73.31,83,,percent of total billed charges,,,,,,,,,,,,,,,73.31,83,,percent of total billed charges,,,83.9,95,,percent of total billed charges,,,79.49,90,,percent of total billed charges,,,79.49,90,,percent of total billed charges,,,72.42,82,,percent of total billed charges,,,79.49,90,,percent of total billed charges,,,75.07,85,,percent of total billed charges,,22.08,83.9,
ACMI FALOPE RINGS,23307553,CDM,,,270,RC,outpatient,,618.33,618.33,,524.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154.58,22,,percent of total billed charges,,,,,,,,,556.5,90,,percent of total billed charges,,,511.98,82.8,,percent of total billed charges,,,525.58,85,,percent of total billed charges,,,,,,,,,544.13,88,,percent of total billed charges,,,,,,,,,472.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154.58,22,,percent of total billed charges,,,562.68,91,,percent of total billed charges,,,587.41,95,,percent of total billed charges,,,513.21,83,,percent of total billed charges,,,513.21,83,,percent of total billed charges,,,,,,,,,,,,,,,513.21,83,,percent of total billed charges,,,587.41,95,,percent of total billed charges,,,556.5,90,,percent of total billed charges,,,556.5,90,,percent of total billed charges,,,507.03,82,,percent of total billed charges,,,556.5,90,,percent of total billed charges,,,525.58,85,,percent of total billed charges,,154.58,587.41,
*HYDROSORB 8X8,23307596,CDM,,,270,RC,outpatient,,64,64,,54.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16,22,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,52.99,82.8,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,,,,,,,,56.32,88,,percent of total billed charges,,,,,,,,,48.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16,22,,percent of total billed charges,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,,,,,,,,,,,,,53.12,83,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,52.48,82,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,16,60.8,
CO2 DETECTOR PEDIATRIC,23307654,CDM,,,270,RC,outpatient,,81.16,81.16,,68.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.29,22,,percent of total billed charges,,,,,,,,,73.04,90,,percent of total billed charges,,,67.2,82.8,,percent of total billed charges,,,68.99,85,,percent of total billed charges,,,,,,,,,71.42,88,,percent of total billed charges,,,,,,,,,62.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.29,22,,percent of total billed charges,,,73.86,91,,percent of total billed charges,,,77.1,95,,percent of total billed charges,,,67.36,83,,percent of total billed charges,,,67.36,83,,percent of total billed charges,,,,,,,,,,,,,,,67.36,83,,percent of total billed charges,,,77.1,95,,percent of total billed charges,,,73.04,90,,percent of total billed charges,,,73.04,90,,percent of total billed charges,,,66.55,82,,percent of total billed charges,,,73.04,90,,percent of total billed charges,,,68.99,85,,percent of total billed charges,,20.29,77.1,
TRAY PNEUMOTHORAX - ARROW,23307660,CDM,,,270,RC,outpatient,,1368.95,1368.95,,1162.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,342.24,22,,percent of total billed charges,,,,,,,,,1232.06,90,,percent of total billed charges,,,1133.49,82.8,,percent of total billed charges,,,1163.61,85,,percent of total billed charges,,,,,,,,,1204.68,88,,percent of total billed charges,,,,,,,,,1045.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,342.24,22,,percent of total billed charges,,,1245.74,91,,percent of total billed charges,,,1300.5,95,,percent of total billed charges,,,1136.23,83,,percent of total billed charges,,,1136.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1136.23,83,,percent of total billed charges,,,1300.5,95,,percent of total billed charges,,,1232.06,90,,percent of total billed charges,,,1232.06,90,,percent of total billed charges,,,1122.54,82,,percent of total billed charges,,,1232.06,90,,percent of total billed charges,,,1163.61,85,,percent of total billed charges,,342.24,1300.5,
LAPAFLATOR TUBING 201,23307678,CDM,,,270,RC,outpatient,,77.52,77.52,,65.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.38,22,,percent of total billed charges,,,,,,,,,69.77,90,,percent of total billed charges,,,64.19,82.8,,percent of total billed charges,,,65.89,85,,percent of total billed charges,,,,,,,,,68.22,88,,percent of total billed charges,,,,,,,,,59.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.38,22,,percent of total billed charges,,,70.54,91,,percent of total billed charges,,,73.64,95,,percent of total billed charges,,,64.34,83,,percent of total billed charges,,,64.34,83,,percent of total billed charges,,,,,,,,,,,,,,,64.34,83,,percent of total billed charges,,,73.64,95,,percent of total billed charges,,,69.77,90,,percent of total billed charges,,,69.77,90,,percent of total billed charges,,,63.57,82,,percent of total billed charges,,,69.77,90,,percent of total billed charges,,,65.89,85,,percent of total billed charges,,19.38,73.64,
ENDO RETRACTOR,23307777,CDM,,,270,RC,outpatient,,1745.45,1745.45,,1481.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,436.36,22,,percent of total billed charges,,,,,,,,,1570.91,90,,percent of total billed charges,,,1445.23,82.8,,percent of total billed charges,,,1483.63,85,,percent of total billed charges,,,,,,,,,1536,88,,percent of total billed charges,,,,,,,,,1333.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,436.36,22,,percent of total billed charges,,,1588.36,91,,percent of total billed charges,,,1658.18,95,,percent of total billed charges,,,1448.72,83,,percent of total billed charges,,,1448.72,83,,percent of total billed charges,,,,,,,,,,,,,,,1448.72,83,,percent of total billed charges,,,1658.18,95,,percent of total billed charges,,,1570.91,90,,percent of total billed charges,,,1570.91,90,,percent of total billed charges,,,1431.27,82,,percent of total billed charges,,,1570.91,90,,percent of total billed charges,,,1483.63,85,,percent of total billed charges,,436.36,1658.18,
GYRUS ENDO CUTTING FORECPS,23307778,CDM,,,270,RC,outpatient,,1813.5,1813.5,,1539.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,453.38,22,,percent of total billed charges,,,,,,,,,1632.15,90,,percent of total billed charges,,,1501.58,82.8,,percent of total billed charges,,,1541.48,85,,percent of total billed charges,,,,,,,,,1595.88,88,,percent of total billed charges,,,,,,,,,1385.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,453.38,22,,percent of total billed charges,,,1650.29,91,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.21,83,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1487.07,82,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1541.48,85,,percent of total billed charges,,453.38,1722.83,
FORCEPS MACRO,23307801,CDM,,,270,RC,outpatient,,494,494,,419.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.5,22,,percent of total billed charges,,,,,,,,,444.6,90,,percent of total billed charges,,,409.03,82.8,,percent of total billed charges,,,419.9,85,,percent of total billed charges,,,,,,,,,434.72,88,,percent of total billed charges,,,,,,,,,377.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.5,22,,percent of total billed charges,,,449.54,91,,percent of total billed charges,,,469.3,95,,percent of total billed charges,,,410.02,83,,percent of total billed charges,,,410.02,83,,percent of total billed charges,,,,,,,,,,,,,,,410.02,83,,percent of total billed charges,,,469.3,95,,percent of total billed charges,,,444.6,90,,percent of total billed charges,,,444.6,90,,percent of total billed charges,,,405.08,82,,percent of total billed charges,,,444.6,90,,percent of total billed charges,,,419.9,85,,percent of total billed charges,,123.5,469.3,
* Z/OR (V0405),23307872,CDM,,,270,RC,outpatient,,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43,22,,percent of total billed charges,,,,,,,,,154.8,90,,percent of total billed charges,,,142.42,82.8,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43,22,,percent of total billed charges,,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,43,163.4,
* Z/OR (V0405),23307875,CDM,,,270,RC,outpatient,,2060,2060,,1748.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,515,22,,percent of total billed charges,,,,,,,,,1854,90,,percent of total billed charges,,,1705.68,82.8,,percent of total billed charges,,,1751,85,,percent of total billed charges,,,,,,,,,1812.8,88,,percent of total billed charges,,,,,,,,,1573.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,515,22,,percent of total billed charges,,,1874.6,91,,percent of total billed charges,,,1957,95,,percent of total billed charges,,,1709.8,83,,percent of total billed charges,,,1709.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1709.8,83,,percent of total billed charges,,,1957,95,,percent of total billed charges,,,1854,90,,percent of total billed charges,,,1854,90,,percent of total billed charges,,,1689.2,82,,percent of total billed charges,,,1854,90,,percent of total billed charges,,,1751,85,,percent of total billed charges,,515,1957,
* Z/OR (V0405),23307878,CDM,,,270,RC,outpatient,,270,270,,229.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.5,22,,percent of total billed charges,,,,,,,,,243,90,,percent of total billed charges,,,223.56,82.8,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,,,,,,,,237.6,88,,percent of total billed charges,,,,,,,,,206.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.5,22,,percent of total billed charges,,,245.7,91,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,,,,,,,,,,,,,224.1,83,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,243,90,,percent of total billed charges,,,243,90,,percent of total billed charges,,,221.4,82,,percent of total billed charges,,,243,90,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,67.5,256.5,
* Z/OR (V0405),23307879,CDM,,,270,RC,outpatient,,374,374,,317.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.5,22,,percent of total billed charges,,,,,,,,,336.6,90,,percent of total billed charges,,,309.67,82.8,,percent of total billed charges,,,317.9,85,,percent of total billed charges,,,,,,,,,329.12,88,,percent of total billed charges,,,,,,,,,285.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.5,22,,percent of total billed charges,,,340.34,91,,percent of total billed charges,,,355.3,95,,percent of total billed charges,,,310.42,83,,percent of total billed charges,,,310.42,83,,percent of total billed charges,,,,,,,,,,,,,,,310.42,83,,percent of total billed charges,,,355.3,95,,percent of total billed charges,,,336.6,90,,percent of total billed charges,,,336.6,90,,percent of total billed charges,,,306.68,82,,percent of total billed charges,,,336.6,90,,percent of total billed charges,,,317.9,85,,percent of total billed charges,,93.5,355.3,
* Z/OR (V0405),23307880,CDM,,,270,RC,outpatient,,1170,1170,,993.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,292.5,22,,percent of total billed charges,,,,,,,,,1053,90,,percent of total billed charges,,,968.76,82.8,,percent of total billed charges,,,994.5,85,,percent of total billed charges,,,,,,,,,1029.6,88,,percent of total billed charges,,,,,,,,,893.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,292.5,22,,percent of total billed charges,,,1064.7,91,,percent of total billed charges,,,1111.5,95,,percent of total billed charges,,,971.1,83,,percent of total billed charges,,,971.1,83,,percent of total billed charges,,,,,,,,,,,,,,,971.1,83,,percent of total billed charges,,,1111.5,95,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,959.4,82,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,994.5,85,,percent of total billed charges,,292.5,1111.5,
* Z/OR (V0405),23307886,CDM,,,270,RC,outpatient,,5953,5953,,5054.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1488.25,22,,percent of total billed charges,,,,,,,,,5357.7,90,,percent of total billed charges,,,4929.08,82.8,,percent of total billed charges,,,5060.05,85,,percent of total billed charges,,,,,,,,,5238.64,88,,percent of total billed charges,,,,,,,,,4548.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1488.25,22,,percent of total billed charges,,,5417.23,91,,percent of total billed charges,,,5655.35,95,,percent of total billed charges,,,4940.99,83,,percent of total billed charges,,,4940.99,83,,percent of total billed charges,,,,,,,,,,,,,,,4940.99,83,,percent of total billed charges,,,5655.35,95,,percent of total billed charges,,,5357.7,90,,percent of total billed charges,,,5357.7,90,,percent of total billed charges,,,4881.46,82,,percent of total billed charges,,,5357.7,90,,percent of total billed charges,,,5060.05,85,,percent of total billed charges,,1488.25,5655.35,
* Z/OR (V0405),23307887,CDM,,,270,RC,outpatient,,3001,3001,,2547.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,750.25,22,,percent of total billed charges,,,,,,,,,2700.9,90,,percent of total billed charges,,,2484.83,82.8,,percent of total billed charges,,,2550.85,85,,percent of total billed charges,,,,,,,,,2640.88,88,,percent of total billed charges,,,,,,,,,2292.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,750.25,22,,percent of total billed charges,,,2730.91,91,,percent of total billed charges,,,2850.95,95,,percent of total billed charges,,,2490.83,83,,percent of total billed charges,,,2490.83,83,,percent of total billed charges,,,,,,,,,,,,,,,2490.83,83,,percent of total billed charges,,,2850.95,95,,percent of total billed charges,,,2700.9,90,,percent of total billed charges,,,2700.9,90,,percent of total billed charges,,,2460.82,82,,percent of total billed charges,,,2700.9,90,,percent of total billed charges,,,2550.85,85,,percent of total billed charges,,750.25,2850.95,
* STERI DRAPE #1060,23307918,CDM,,,270,RC,outpatient,,9,9,,7.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.25,22,,percent of total billed charges,,,,,,,,,8.1,90,,percent of total billed charges,,,7.45,82.8,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,,,,,,,,7.92,88,,percent of total billed charges,,,,,,,,,6.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.25,22,,percent of total billed charges,,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.38,82,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,2.25,8.55,
* Z/OR (V0405),23308075,CDM,,,270,RC,outpatient,,1825,1825,,1549.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,456.25,22,,percent of total billed charges,,,,,,,,,1642.5,90,,percent of total billed charges,,,1511.1,82.8,,percent of total billed charges,,,1551.25,85,,percent of total billed charges,,,,,,,,,1606,88,,percent of total billed charges,,,,,,,,,1394.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,456.25,22,,percent of total billed charges,,,1660.75,91,,percent of total billed charges,,,1733.75,95,,percent of total billed charges,,,1514.75,83,,percent of total billed charges,,,1514.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1514.75,83,,percent of total billed charges,,,1733.75,95,,percent of total billed charges,,,1642.5,90,,percent of total billed charges,,,1642.5,90,,percent of total billed charges,,,1496.5,82,,percent of total billed charges,,,1642.5,90,,percent of total billed charges,,,1551.25,85,,percent of total billed charges,,456.25,1733.75,
* SUTURE CP-412 (V0205),23308151,CDM,,,270,RC,outpatient,,308,308,,261.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77,22,,percent of total billed charges,,,,,,,,,277.2,90,,percent of total billed charges,,,255.02,82.8,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,,,,,,,,271.04,88,,percent of total billed charges,,,,,,,,,235.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77,22,,percent of total billed charges,,,280.28,91,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,,,,,,,,,,,,,255.64,83,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,252.56,82,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,77,292.6,
AIRWAY BERMAN 90MM,23308164,CDM,,,270,RC,outpatient,,6.3,6.3,,5.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.58,22,,percent of total billed charges,,,,,,,,,5.67,90,,percent of total billed charges,,,5.22,82.8,,percent of total billed charges,,,5.36,85,,percent of total billed charges,,,,,,,,,5.54,88,,percent of total billed charges,,,,,,,,,4.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.58,22,,percent of total billed charges,,,5.73,91,,percent of total billed charges,,,5.99,95,,percent of total billed charges,,,5.23,83,,percent of total billed charges,,,5.23,83,,percent of total billed charges,,,,,,,,,,,,,,,5.23,83,,percent of total billed charges,,,5.99,95,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.17,82,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.36,85,,percent of total billed charges,,1.58,5.99,
AIRWAY KING LTD #3(NON-STOCK),23308179,CDM,,,270,RC,outpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.5,22,,percent of total billed charges,,,,,,,,,365.4,90,,percent of total billed charges,,,336.17,82.8,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.5,22,,percent of total billed charges,,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,101.5,385.7,
AIRWAY KING LTD #5(NON-STOCK),23308181,CDM,,,270,RC,outpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.5,22,,percent of total billed charges,,,,,,,,,365.4,90,,percent of total billed charges,,,336.17,82.8,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.5,22,,percent of total billed charges,,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,101.5,385.7,
AIRWAY BERMAN 100MM,23308182,CDM,,,270,RC,outpatient,,4.02,4.02,,3.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.01,22,,percent of total billed charges,,,,,,,,,3.62,90,,percent of total billed charges,,,3.33,82.8,,percent of total billed charges,,,3.42,85,,percent of total billed charges,,,,,,,,,3.54,88,,percent of total billed charges,,,,,,,,,3.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.01,22,,percent of total billed charges,,,3.66,91,,percent of total billed charges,,,3.82,95,,percent of total billed charges,,,3.34,83,,percent of total billed charges,,,3.34,83,,percent of total billed charges,,,,,,,,,,,,,,,3.34,83,,percent of total billed charges,,,3.82,95,,percent of total billed charges,,,3.62,90,,percent of total billed charges,,,3.62,90,,percent of total billed charges,,,3.3,82,,percent of total billed charges,,,3.62,90,,percent of total billed charges,,,3.42,85,,percent of total billed charges,,1.01,3.82,
NG TUBE W/REFLUX 12F,23310052,CDM,,,270,RC,outpatient,,45.14,45.14,,38.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.29,22,,percent of total billed charges,,,,,,,,,40.63,90,,percent of total billed charges,,,37.38,82.8,,percent of total billed charges,,,38.37,85,,percent of total billed charges,,,,,,,,,39.72,88,,percent of total billed charges,,,,,,,,,34.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.29,22,,percent of total billed charges,,,41.08,91,,percent of total billed charges,,,42.88,95,,percent of total billed charges,,,37.47,83,,percent of total billed charges,,,37.47,83,,percent of total billed charges,,,,,,,,,,,,,,,37.47,83,,percent of total billed charges,,,42.88,95,,percent of total billed charges,,,40.63,90,,percent of total billed charges,,,40.63,90,,percent of total billed charges,,,37.01,82,,percent of total billed charges,,,40.63,90,,percent of total billed charges,,,38.37,85,,percent of total billed charges,,11.29,42.88,
NG TUBE W/REFLUX 14F,23310053,CDM,,,270,RC,outpatient,,43.65,43.65,,37.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.91,22,,percent of total billed charges,,,,,,,,,39.29,90,,percent of total billed charges,,,36.14,82.8,,percent of total billed charges,,,37.1,85,,percent of total billed charges,,,,,,,,,38.41,88,,percent of total billed charges,,,,,,,,,33.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.91,22,,percent of total billed charges,,,39.72,91,,percent of total billed charges,,,41.47,95,,percent of total billed charges,,,36.23,83,,percent of total billed charges,,,36.23,83,,percent of total billed charges,,,,,,,,,,,,,,,36.23,83,,percent of total billed charges,,,41.47,95,,percent of total billed charges,,,39.29,90,,percent of total billed charges,,,39.29,90,,percent of total billed charges,,,35.79,82,,percent of total billed charges,,,39.29,90,,percent of total billed charges,,,37.1,85,,percent of total billed charges,,10.91,41.47,
NG TUBE W/REFLUX 16F,23310054,CDM,,,270,RC,outpatient,,24.19,24.19,,20.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.05,22,,percent of total billed charges,,,,,,,,,21.77,90,,percent of total billed charges,,,20.03,82.8,,percent of total billed charges,,,20.56,85,,percent of total billed charges,,,,,,,,,21.29,88,,percent of total billed charges,,,,,,,,,18.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.05,22,,percent of total billed charges,,,22.01,91,,percent of total billed charges,,,22.98,95,,percent of total billed charges,,,20.08,83,,percent of total billed charges,,,20.08,83,,percent of total billed charges,,,,,,,,,,,,,,,20.08,83,,percent of total billed charges,,,22.98,95,,percent of total billed charges,,,21.77,90,,percent of total billed charges,,,21.77,90,,percent of total billed charges,,,19.84,82,,percent of total billed charges,,,21.77,90,,percent of total billed charges,,,20.56,85,,percent of total billed charges,,6.05,22.98,
NG TUBE W/REFLUX 18F,23310055,CDM,,,270,RC,outpatient,,28.75,28.75,,24.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.19,22,,percent of total billed charges,,,,,,,,,25.88,90,,percent of total billed charges,,,23.81,82.8,,percent of total billed charges,,,24.44,85,,percent of total billed charges,,,,,,,,,25.3,88,,percent of total billed charges,,,,,,,,,21.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.19,22,,percent of total billed charges,,,26.16,91,,percent of total billed charges,,,27.31,95,,percent of total billed charges,,,23.86,83,,percent of total billed charges,,,23.86,83,,percent of total billed charges,,,,,,,,,,,,,,,23.86,83,,percent of total billed charges,,,27.31,95,,percent of total billed charges,,,25.88,90,,percent of total billed charges,,,25.88,90,,percent of total billed charges,,,23.58,82,,percent of total billed charges,,,25.88,90,,percent of total billed charges,,,24.44,85,,percent of total billed charges,,7.19,27.31,
*TONSIL SPONGE 1 1/4,23660062,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
*TUBE GAUZE 1  X 50YDS,23660064,CDM,,,270,RC,outpatient,,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.75,22,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,121.72,82.8,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.75,22,,percent of total billed charges,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,36.75,139.65,
*TUBE GAUZE 5/8,23660065,CDM,,,270,RC,outpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.25,22,,percent of total billed charges,,,,,,,,,62.1,90,,percent of total billed charges,,,57.13,82.8,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.25,22,,percent of total billed charges,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,17.25,65.55,
TUBE GAUZE 7/8,23660091,CDM,,,270,RC,outpatient,,270,270,,229.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.5,22,,percent of total billed charges,,,,,,,,,243,90,,percent of total billed charges,,,223.56,82.8,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,,,,,,,,237.6,88,,percent of total billed charges,,,,,,,,,206.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.5,22,,percent of total billed charges,,,245.7,91,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,,,,,,,,,,,,,224.1,83,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,243,90,,percent of total billed charges,,,243,90,,percent of total billed charges,,,221.4,82,,percent of total billed charges,,,243,90,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,67.5,256.5,
*URETERAL CATH WHISTLE 6 FR,23670111,CDM,,,270,RC,outpatient,,22,22,,18.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.5,22,,percent of total billed charges,,,,,,,,,19.8,90,,percent of total billed charges,,,18.22,82.8,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,,,,,,,,19.36,88,,percent of total billed charges,,,,,,,,,16.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.5,22,,percent of total billed charges,,,20.02,91,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,,,,,,,,,,,,,18.26,83,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.04,82,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,5.5,20.9,
* SACRO BELT XSM (V0106),23700192,CDM,,,270,RC,outpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.5,22,,percent of total billed charges,,,,,,,,,113.4,90,,percent of total billed charges,,,104.33,82.8,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,,,,,,,,110.88,88,,percent of total billed charges,,,,,,,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.5,22,,percent of total billed charges,,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,31.5,119.7,
* SACRO BELT SMALL (V0106),23700193,CDM,,,270,RC,outpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.5,22,,percent of total billed charges,,,,,,,,,113.4,90,,percent of total billed charges,,,104.33,82.8,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,,,,,,,,110.88,88,,percent of total billed charges,,,,,,,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.5,22,,percent of total billed charges,,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,31.5,119.7,
* SACRO BELT MEDIUM (V0106),23700194,CDM,,,270,RC,outpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.5,22,,percent of total billed charges,,,,,,,,,113.4,90,,percent of total billed charges,,,104.33,82.8,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,,,,,,,,110.88,88,,percent of total billed charges,,,,,,,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.5,22,,percent of total billed charges,,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,31.5,119.7,
* SACRO BELT SMALL MED (V0106),23700195,CDM,,,270,RC,outpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.5,22,,percent of total billed charges,,,,,,,,,113.4,90,,percent of total billed charges,,,104.33,82.8,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,,,,,,,,110.88,88,,percent of total billed charges,,,,,,,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.5,22,,percent of total billed charges,,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,31.5,119.7,
* SACRO BELT XLARGE (V0106),23700196,CDM,,,270,RC,outpatient,,133,133,,112.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.25,22,,percent of total billed charges,,,,,,,,,119.7,90,,percent of total billed charges,,,110.12,82.8,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,,,,,,,,117.04,88,,percent of total billed charges,,,,,,,,,101.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.25,22,,percent of total billed charges,,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,,,,,,,,,,,,,110.39,83,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,109.06,82,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,33.25,126.35,
* SACRO BELT XXLG (V0106),23700199,CDM,,,270,RC,outpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36,22,,percent of total billed charges,,,,,,,,,129.6,90,,percent of total billed charges,,,119.23,82.8,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36,22,,percent of total billed charges,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,36,136.8,
* SUTURE 628H (V0205),23720001,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
SUTURE 1670H (V0605),23720007,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE J344H (V0205),23720009,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE 1673G (V0205),23720029,CDM,,,270,RC,outpatient,,86,86,,73.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.5,22,,percent of total billed charges,,,,,,,,,77.4,90,,percent of total billed charges,,,71.21,82.8,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,,,,,,,,75.68,88,,percent of total billed charges,,,,,,,,,65.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.5,22,,percent of total billed charges,,,78.26,91,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,,,,,,,,,,,,,71.38,83,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,70.52,82,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,21.5,81.7,
* SUTURE CL 922(V0205),23720034,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE 3027-79 (V0205),23720036,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE S102H (V0205),23720037,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE H822G (V0205),23720042,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
SUTURE 2-0 ETHILON FS 664G,23720044,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE GL 62 M (V0205),23720047,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE L113G (V0605),23720052,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE N862H (V0605),23720054,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE 583-41 (V0205),23720061,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE CG 813 (V0205),23720064,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE*636G (V0205),23720070,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE CL 831 (418H) (V0205),23720075,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE J214H (V0605),23720085,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE J493G (V0205),23720088,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE 9268-71 & CL-955 (V0205),23720103,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE 519H (V0205),23720110,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE B-518H (V0205),23720111,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE G202 (V0205),23720112,CDM,,,270,RC,outpatient,,245,245,,208.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.25,22,,percent of total billed charges,,,,,,,,,220.5,90,,percent of total billed charges,,,202.86,82.8,,percent of total billed charges,,,208.25,85,,percent of total billed charges,,,,,,,,,215.6,88,,percent of total billed charges,,,,,,,,,187.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.25,22,,percent of total billed charges,,,222.95,91,,percent of total billed charges,,,232.75,95,,percent of total billed charges,,,203.35,83,,percent of total billed charges,,,203.35,83,,percent of total billed charges,,,,,,,,,,,,,,,203.35,83,,percent of total billed charges,,,232.75,95,,percent of total billed charges,,,220.5,90,,percent of total billed charges,,,220.5,90,,percent of total billed charges,,,200.9,82,,percent of total billed charges,,,220.5,90,,percent of total billed charges,,,208.25,85,,percent of total billed charges,,61.25,232.75,
SUTURE SILK BLACK (V0205),23720114,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE GG 123 (V0205),23720117,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE J274H (V0205),23720127,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE J663H (V0205),23720129,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE J416H (V0205),23720141,CDM,,,270,RC,outpatient,,15,15,,12.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.75,22,,percent of total billed charges,,,,,,,,,13.5,90,,percent of total billed charges,,,12.42,82.8,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,,,,,,,,13.2,88,,percent of total billed charges,,,,,,,,,11.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.75,22,,percent of total billed charges,,,13.65,91,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,,,,,,,,,,,,,12.45,83,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.3,82,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,3.75,14.25,
* SUTURE GL 322 (V0205),23720144,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE J443H (V0605),23720147,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE 518-52 (V0205),23720149,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE N862H (V0205),23720152,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE 663H (V0205),23720153,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE J868H (V0205),23720157,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE J218H (V0605),23720159,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE J870H (V0205),23720165,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
* SUTURE X519H (V0605),23720166,CDM,,,270,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
NEEDLE SURGICAL ANCHOR 10D (NC),23730009,CDM,,,270,RC,outpatient,,169.2,169.2,,143.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.3,22,,percent of total billed charges,,,,,,,,,152.28,90,,percent of total billed charges,,,140.1,82.8,,percent of total billed charges,,,143.82,85,,percent of total billed charges,,,,,,,,,148.9,88,,percent of total billed charges,,,,,,,,,129.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.3,22,,percent of total billed charges,,,153.97,91,,percent of total billed charges,,,160.74,95,,percent of total billed charges,,,140.44,83,,percent of total billed charges,,,140.44,83,,percent of total billed charges,,,,,,,,,,,,,,,140.44,83,,percent of total billed charges,,,160.74,95,,percent of total billed charges,,,152.28,90,,percent of total billed charges,,,152.28,90,,percent of total billed charges,,,138.74,82,,percent of total billed charges,,,152.28,90,,percent of total billed charges,,,143.82,85,,percent of total billed charges,,42.3,160.74,
* THREE WAY STOPCOCK WO TUBE (V0605),23750024,CDM,,,270,RC,outpatient,,4,4,,3.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1,22,,percent of total billed charges,,,,,,,,,3.6,90,,percent of total billed charges,,,3.31,82.8,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,,,,,,,,3.52,88,,percent of total billed charges,,,,,,,,,3.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1,22,,percent of total billed charges,,,3.64,91,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3.32,83,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.28,82,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,1,3.8,
*STOMACH EVACUATOR EWALD TYPE,23770094,CDM,,,270,RC,outpatient,,187,187,,158.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.75,22,,percent of total billed charges,,,,,,,,,168.3,90,,percent of total billed charges,,,154.84,82.8,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,,,,,,,,164.56,88,,percent of total billed charges,,,,,,,,,142.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.75,22,,percent of total billed charges,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,153.34,82,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,46.75,177.65,
ELECTRODE DEFIB ADULT EDGE QUICK-COMBO,23780021,CDM,,,270,RC,outpatient,,200.4,200.4,,170.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.1,22,,percent of total billed charges,,,,,,,,,180.36,90,,percent of total billed charges,,,165.93,82.8,,percent of total billed charges,,,170.34,85,,percent of total billed charges,,,,,,,,,176.35,88,,percent of total billed charges,,,,,,,,,153.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.1,22,,percent of total billed charges,,,182.36,91,,percent of total billed charges,,,190.38,95,,percent of total billed charges,,,166.33,83,,percent of total billed charges,,,166.33,83,,percent of total billed charges,,,,,,,,,,,,,,,166.33,83,,percent of total billed charges,,,190.38,95,,percent of total billed charges,,,180.36,90,,percent of total billed charges,,,180.36,90,,percent of total billed charges,,,164.33,82,,percent of total billed charges,,,180.36,90,,percent of total billed charges,,,170.34,85,,percent of total billed charges,,50.1,190.38,
ELECTRODE DEFIB PAD ZOLL,23780030,CDM,,,270,RC,outpatient,,578.34,578.34,,491.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,144.59,22,,percent of total billed charges,,,,,,,,,520.51,90,,percent of total billed charges,,,478.87,82.8,,percent of total billed charges,,,491.59,85,,percent of total billed charges,,,,,,,,,508.94,88,,percent of total billed charges,,,,,,,,,441.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,144.59,22,,percent of total billed charges,,,526.29,91,,percent of total billed charges,,,549.42,95,,percent of total billed charges,,,480.02,83,,percent of total billed charges,,,480.02,83,,percent of total billed charges,,,,,,,,,,,,,,,480.02,83,,percent of total billed charges,,,549.42,95,,percent of total billed charges,,,520.51,90,,percent of total billed charges,,,520.51,90,,percent of total billed charges,,,474.24,82,,percent of total billed charges,,,520.51,90,,percent of total billed charges,,,491.59,85,,percent of total billed charges,,144.59,549.42,
*ELEC/SURG HOLSTER,23780037,CDM,,,270,RC,outpatient,,6,6,,5.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.5,22,,percent of total billed charges,,,,,,,,,5.4,90,,percent of total billed charges,,,4.97,82.8,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,,,,,,,,5.28,88,,percent of total billed charges,,,,,,,,,4.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.5,22,,percent of total billed charges,,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4.98,83,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,4.92,82,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,1.5,5.7,
AIRWAY BERMAN 80MM,23790100,CDM,,,270,RC,outpatient,,2.22,2.22,,1.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.56,22,,percent of total billed charges,,,,,,,,,2,90,,percent of total billed charges,,,1.84,82.8,,percent of total billed charges,,,1.89,85,,percent of total billed charges,,,,,,,,,1.95,88,,percent of total billed charges,,,,,,,,,1.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.56,22,,percent of total billed charges,,,2.02,91,,percent of total billed charges,,,2.11,95,,percent of total billed charges,,,1.84,83,,percent of total billed charges,,,1.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1.84,83,,percent of total billed charges,,,2.11,95,,percent of total billed charges,,,2,90,,percent of total billed charges,,,2,90,,percent of total billed charges,,,1.82,82,,percent of total billed charges,,,2,90,,percent of total billed charges,,,1.89,85,,percent of total billed charges,,0.56,2.11,
*AIRFLOW MATTRESS PLASTIC,23790101,CDM,,,270,RC,outpatient,,189,189,,160.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.25,22,,percent of total billed charges,,,,,,,,,170.1,90,,percent of total billed charges,,,156.49,82.8,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,,,,,,,,166.32,88,,percent of total billed charges,,,,,,,,,144.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.25,22,,percent of total billed charges,,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,,,,,,,,,,,,,156.87,83,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,154.98,82,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,47.25,179.55,
AIRWAY BERMAN 40MM,23790102,CDM,,,270,RC,outpatient,,5.49,5.49,,4.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.37,22,,percent of total billed charges,,,,,,,,,4.94,90,,percent of total billed charges,,,4.55,82.8,,percent of total billed charges,,,4.67,85,,percent of total billed charges,,,,,,,,,4.83,88,,percent of total billed charges,,,,,,,,,4.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.37,22,,percent of total billed charges,,,5,91,,percent of total billed charges,,,5.22,95,,percent of total billed charges,,,4.56,83,,percent of total billed charges,,,4.56,83,,percent of total billed charges,,,,,,,,,,,,,,,4.56,83,,percent of total billed charges,,,5.22,95,,percent of total billed charges,,,4.94,90,,percent of total billed charges,,,4.94,90,,percent of total billed charges,,,4.5,82,,percent of total billed charges,,,4.94,90,,percent of total billed charges,,,4.67,85,,percent of total billed charges,,1.37,5.22,
*U STONE RETRIVER 4 WIRE 8MM,23790186,CDM,,,270,RC,outpatient,,584,584,,495.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,146,22,,percent of total billed charges,,,,,,,,,525.6,90,,percent of total billed charges,,,483.55,82.8,,percent of total billed charges,,,496.4,85,,percent of total billed charges,,,,,,,,,513.92,88,,percent of total billed charges,,,,,,,,,446.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,146,22,,percent of total billed charges,,,531.44,91,,percent of total billed charges,,,554.8,95,,percent of total billed charges,,,484.72,83,,percent of total billed charges,,,484.72,83,,percent of total billed charges,,,,,,,,,,,,,,,484.72,83,,percent of total billed charges,,,554.8,95,,percent of total billed charges,,,525.6,90,,percent of total billed charges,,,525.6,90,,percent of total billed charges,,,478.88,82,,percent of total billed charges,,,525.6,90,,percent of total billed charges,,,496.4,85,,percent of total billed charges,,146,554.8,
*U STONE RETRIEVER 4 WIRE 11MM,23790187,CDM,,,270,RC,outpatient,,331,331,,281.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.75,22,,percent of total billed charges,,,,,,,,,297.9,90,,percent of total billed charges,,,274.07,82.8,,percent of total billed charges,,,281.35,85,,percent of total billed charges,,,,,,,,,291.28,88,,percent of total billed charges,,,,,,,,,252.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82.75,22,,percent of total billed charges,,,301.21,91,,percent of total billed charges,,,314.45,95,,percent of total billed charges,,,274.73,83,,percent of total billed charges,,,274.73,83,,percent of total billed charges,,,,,,,,,,,,,,,274.73,83,,percent of total billed charges,,,314.45,95,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,271.42,82,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,281.35,85,,percent of total billed charges,,82.75,314.45,
*U STONE RETRIEVER WIRE 8MM,23790188,CDM,,,270,RC,outpatient,,632,632,,536.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,158,22,,percent of total billed charges,,,,,,,,,568.8,90,,percent of total billed charges,,,523.3,82.8,,percent of total billed charges,,,537.2,85,,percent of total billed charges,,,,,,,,,556.16,88,,percent of total billed charges,,,,,,,,,482.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,158,22,,percent of total billed charges,,,575.12,91,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,,,,,,,,,,,,,524.56,83,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,518.24,82,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,537.2,85,,percent of total billed charges,,158,600.4,
*U STONE RETREIVER 6 WIRE 11MM,23790189,CDM,,,270,RC,outpatient,,344,344,,292.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86,22,,percent of total billed charges,,,,,,,,,309.6,90,,percent of total billed charges,,,284.83,82.8,,percent of total billed charges,,,292.4,85,,percent of total billed charges,,,,,,,,,302.72,88,,percent of total billed charges,,,,,,,,,262.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86,22,,percent of total billed charges,,,313.04,91,,percent of total billed charges,,,326.8,95,,percent of total billed charges,,,285.52,83,,percent of total billed charges,,,285.52,83,,percent of total billed charges,,,,,,,,,,,,,,,285.52,83,,percent of total billed charges,,,326.8,95,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,282.08,82,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,292.4,85,,percent of total billed charges,,86,326.8,
AIRWAY GUEDEL 60MM,23790203,CDM,,,270,RC,outpatient,,6.57,6.57,,5.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.64,22,,percent of total billed charges,,,,,,,,,5.91,90,,percent of total billed charges,,,5.44,82.8,,percent of total billed charges,,,5.58,85,,percent of total billed charges,,,,,,,,,5.78,88,,percent of total billed charges,,,,,,,,,5.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.64,22,,percent of total billed charges,,,5.98,91,,percent of total billed charges,,,6.24,95,,percent of total billed charges,,,5.45,83,,percent of total billed charges,,,5.45,83,,percent of total billed charges,,,,,,,,,,,,,,,5.45,83,,percent of total billed charges,,,6.24,95,,percent of total billed charges,,,5.91,90,,percent of total billed charges,,,5.91,90,,percent of total billed charges,,,5.39,82,,percent of total billed charges,,,5.91,90,,percent of total billed charges,,,5.58,85,,percent of total billed charges,,1.64,6.24,
BETADINE SURGICAL SCRUB 4 OZ,23790214,CDM,,,270,RC,outpatient,,10.71,10.71,,9.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.68,22,,percent of total billed charges,,,,,,,,,9.64,90,,percent of total billed charges,,,8.87,82.8,,percent of total billed charges,,,9.1,85,,percent of total billed charges,,,,,,,,,9.42,88,,percent of total billed charges,,,,,,,,,8.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.68,22,,percent of total billed charges,,,9.75,91,,percent of total billed charges,,,10.17,95,,percent of total billed charges,,,8.89,83,,percent of total billed charges,,,8.89,83,,percent of total billed charges,,,,,,,,,,,,,,,8.89,83,,percent of total billed charges,,,10.17,95,,percent of total billed charges,,,9.64,90,,percent of total billed charges,,,9.64,90,,percent of total billed charges,,,8.78,82,,percent of total billed charges,,,9.64,90,,percent of total billed charges,,,9.1,85,,percent of total billed charges,,2.68,10.17,
*INTUBATION STYLET 6FR,23790220,CDM,,,270,RC,outpatient,,33,33,,28.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.25,22,,percent of total billed charges,,,,,,,,,29.7,90,,percent of total billed charges,,,27.32,82.8,,percent of total billed charges,,,28.05,85,,percent of total billed charges,,,,,,,,,29.04,88,,percent of total billed charges,,,,,,,,,25.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.25,22,,percent of total billed charges,,,30.03,91,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,,,,,,,,,,,,,27.39,83,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,27.06,82,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,28.05,85,,percent of total billed charges,,8.25,31.35,
AIRWAY BERMAN 60MM,23790269,CDM,,,270,RC,outpatient,,5.15,5.15,,4.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.29,22,,percent of total billed charges,,,,,,,,,4.64,90,,percent of total billed charges,,,4.26,82.8,,percent of total billed charges,,,4.38,85,,percent of total billed charges,,,,,,,,,4.53,88,,percent of total billed charges,,,,,,,,,3.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.29,22,,percent of total billed charges,,,4.69,91,,percent of total billed charges,,,4.89,95,,percent of total billed charges,,,4.27,83,,percent of total billed charges,,,4.27,83,,percent of total billed charges,,,,,,,,,,,,,,,4.27,83,,percent of total billed charges,,,4.89,95,,percent of total billed charges,,,4.64,90,,percent of total billed charges,,,4.64,90,,percent of total billed charges,,,4.22,82,,percent of total billed charges,,,4.64,90,,percent of total billed charges,,,4.38,85,,percent of total billed charges,,1.29,4.89,
AIRWAY BERMAN 70MM,23790273,CDM,,,270,RC,outpatient,,2.7,2.7,,2.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.68,22,,percent of total billed charges,,,,,,,,,2.43,90,,percent of total billed charges,,,2.24,82.8,,percent of total billed charges,,,2.3,85,,percent of total billed charges,,,,,,,,,2.38,88,,percent of total billed charges,,,,,,,,,2.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.68,22,,percent of total billed charges,,,2.46,91,,percent of total billed charges,,,2.57,95,,percent of total billed charges,,,2.24,83,,percent of total billed charges,,,2.24,83,,percent of total billed charges,,,,,,,,,,,,,,,2.24,83,,percent of total billed charges,,,2.57,95,,percent of total billed charges,,,2.43,90,,percent of total billed charges,,,2.43,90,,percent of total billed charges,,,2.21,82,,percent of total billed charges,,,2.43,90,,percent of total billed charges,,,2.3,85,,percent of total billed charges,,0.68,2.57,
AIRWAY GUEDEL 110MM,23790274,CDM,,,270,RC,outpatient,,2.61,2.61,,2.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.65,22,,percent of total billed charges,,,,,,,,,2.35,90,,percent of total billed charges,,,2.16,82.8,,percent of total billed charges,,,2.22,85,,percent of total billed charges,,,,,,,,,2.3,88,,percent of total billed charges,,,,,,,,,1.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.65,22,,percent of total billed charges,,,2.38,91,,percent of total billed charges,,,2.48,95,,percent of total billed charges,,,2.17,83,,percent of total billed charges,,,2.17,83,,percent of total billed charges,,,,,,,,,,,,,,,2.17,83,,percent of total billed charges,,,2.48,95,,percent of total billed charges,,,2.35,90,,percent of total billed charges,,,2.35,90,,percent of total billed charges,,,2.14,82,,percent of total billed charges,,,2.35,90,,percent of total billed charges,,,2.22,85,,percent of total billed charges,,0.65,2.48,
AIRWAY GUEDEL 100MM,23790294,CDM,,,270,RC,outpatient,,14.16,14.16,,12.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.54,22,,percent of total billed charges,,,,,,,,,12.74,90,,percent of total billed charges,,,11.72,82.8,,percent of total billed charges,,,12.04,85,,percent of total billed charges,,,,,,,,,12.46,88,,percent of total billed charges,,,,,,,,,10.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.54,22,,percent of total billed charges,,,12.89,91,,percent of total billed charges,,,13.45,95,,percent of total billed charges,,,11.75,83,,percent of total billed charges,,,11.75,83,,percent of total billed charges,,,,,,,,,,,,,,,11.75,83,,percent of total billed charges,,,13.45,95,,percent of total billed charges,,,12.74,90,,percent of total billed charges,,,12.74,90,,percent of total billed charges,,,11.61,82,,percent of total billed charges,,,12.74,90,,percent of total billed charges,,,12.04,85,,percent of total billed charges,,3.54,13.45,
AIRWAY GUEDEL 80MM,23790295,CDM,,,270,RC,outpatient,,4.08,4.08,,3.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.02,22,,percent of total billed charges,,,,,,,,,3.67,90,,percent of total billed charges,,,3.38,82.8,,percent of total billed charges,,,3.47,85,,percent of total billed charges,,,,,,,,,3.59,88,,percent of total billed charges,,,,,,,,,3.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.02,22,,percent of total billed charges,,,3.71,91,,percent of total billed charges,,,3.88,95,,percent of total billed charges,,,3.39,83,,percent of total billed charges,,,3.39,83,,percent of total billed charges,,,,,,,,,,,,,,,3.39,83,,percent of total billed charges,,,3.88,95,,percent of total billed charges,,,3.67,90,,percent of total billed charges,,,3.67,90,,percent of total billed charges,,,3.35,82,,percent of total billed charges,,,3.67,90,,percent of total billed charges,,,3.47,85,,percent of total billed charges,,1.02,3.88,
AIRWAY GUEDEL 90MM,23790297,CDM,,,270,RC,outpatient,,9.1,9.1,,7.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.28,22,,percent of total billed charges,,,,,,,,,8.19,90,,percent of total billed charges,,,7.53,82.8,,percent of total billed charges,,,7.74,85,,percent of total billed charges,,,,,,,,,8.01,88,,percent of total billed charges,,,,,,,,,6.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.28,22,,percent of total billed charges,,,8.28,91,,percent of total billed charges,,,8.65,95,,percent of total billed charges,,,7.55,83,,percent of total billed charges,,,7.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7.55,83,,percent of total billed charges,,,8.65,95,,percent of total billed charges,,,8.19,90,,percent of total billed charges,,,8.19,90,,percent of total billed charges,,,7.46,82,,percent of total billed charges,,,8.19,90,,percent of total billed charges,,,7.74,85,,percent of total billed charges,,2.28,8.65,
BILI EYE PATCHES,23790298,CDM,,,270,RC,outpatient,,10.8,10.8,,9.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.7,22,,percent of total billed charges,,,,,,,,,9.72,90,,percent of total billed charges,,,8.94,82.8,,percent of total billed charges,,,9.18,85,,percent of total billed charges,,,,,,,,,9.5,88,,percent of total billed charges,,,,,,,,,8.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.7,22,,percent of total billed charges,,,9.83,91,,percent of total billed charges,,,10.26,95,,percent of total billed charges,,,8.96,83,,percent of total billed charges,,,8.96,83,,percent of total billed charges,,,,,,,,,,,,,,,8.96,83,,percent of total billed charges,,,10.26,95,,percent of total billed charges,,,9.72,90,,percent of total billed charges,,,9.72,90,,percent of total billed charges,,,8.86,82,,percent of total billed charges,,,9.72,90,,percent of total billed charges,,,9.18,85,,percent of total billed charges,,2.7,10.26,
"* GLUCOSE, MEDISCAN PAPER (V0106)",23790319,CDM,,,270,RC,outpatient,,15,15,,12.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.75,22,,percent of total billed charges,,,,,,,,,13.5,90,,percent of total billed charges,,,12.42,82.8,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,,,,,,,,13.2,88,,percent of total billed charges,,,,,,,,,11.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.75,22,,percent of total billed charges,,,13.65,91,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,,,,,,,,,,,,,12.45,83,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.3,82,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,3.75,14.25,
SCRUB KIT EXIDINE 4% CHG,23790365,CDM,,,270,RC,outpatient,,50.65,50.65,,43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.66,22,,percent of total billed charges,,,,,,,,,45.59,90,,percent of total billed charges,,,41.94,82.8,,percent of total billed charges,,,43.05,85,,percent of total billed charges,,,,,,,,,44.57,88,,percent of total billed charges,,,,,,,,,38.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.66,22,,percent of total billed charges,,,46.09,91,,percent of total billed charges,,,48.12,95,,percent of total billed charges,,,42.04,83,,percent of total billed charges,,,42.04,83,,percent of total billed charges,,,,,,,,,,,,,,,42.04,83,,percent of total billed charges,,,48.12,95,,percent of total billed charges,,,45.59,90,,percent of total billed charges,,,45.59,90,,percent of total billed charges,,,41.53,82,,percent of total billed charges,,,45.59,90,,percent of total billed charges,,,43.05,85,,percent of total billed charges,,12.66,48.12,
*TUBING CONNECTING 7',23790552,CDM,,,270,RC,outpatient,,8,8,,6.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2,22,,percent of total billed charges,,,,,,,,,7.2,90,,percent of total billed charges,,,6.62,82.8,,percent of total billed charges,,,6.8,85,,percent of total billed charges,,,,,,,,,7.04,88,,percent of total billed charges,,,,,,,,,6.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2,22,,percent of total billed charges,,,7.28,91,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,,,,,,,,,,,,,6.64,83,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.56,82,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.8,85,,percent of total billed charges,,2,7.6,
* LOOP OSTOMY SET 2 3/4 209 33 (V0605),23800066,CDM,,,270,RC,outpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.75,22,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,68.72,82.8,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.75,22,,percent of total billed charges,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,20.75,78.85,
*O2 MASK ADULT W/7' TUBING,23801192,CDM,,,270,RC,outpatient,,4,4,,3.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1,22,,percent of total billed charges,,,,,,,,,3.6,90,,percent of total billed charges,,,3.31,82.8,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,,,,,,,,3.52,88,,percent of total billed charges,,,,,,,,,3.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1,22,,percent of total billed charges,,,3.64,91,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3.32,83,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.28,82,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,1,3.8,
POCKET CHAMBER/METERED DOSE INHALER,23801670,CDM,,,270,RC,outpatient,,52.11,52.11,,44.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.03,22,,percent of total billed charges,,,,,,,,,46.9,90,,percent of total billed charges,,,43.15,82.8,,percent of total billed charges,,,44.29,85,,percent of total billed charges,,,,,,,,,45.86,88,,percent of total billed charges,,,,,,,,,39.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.03,22,,percent of total billed charges,,,47.42,91,,percent of total billed charges,,,49.5,95,,percent of total billed charges,,,43.25,83,,percent of total billed charges,,,43.25,83,,percent of total billed charges,,,,,,,,,,,,,,,43.25,83,,percent of total billed charges,,,49.5,95,,percent of total billed charges,,,46.9,90,,percent of total billed charges,,,46.9,90,,percent of total billed charges,,,42.73,82,,percent of total billed charges,,,46.9,90,,percent of total billed charges,,,44.29,85,,percent of total billed charges,,13.03,49.5,
*CPAP VALVE,23802027,CDM,,,270,RC,outpatient,,56,56,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14,22,,percent of total billed charges,,,,,,,,,50.4,90,,percent of total billed charges,,,46.37,82.8,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,,,,,,,,49.28,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14,22,,percent of total billed charges,,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,45.92,82,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,14,53.2,
*O2 CPAP 10CM,23802028,CDM,,,270,RC,outpatient,,60,60,,50.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15,22,,percent of total billed charges,,,,,,,,,54,90,,percent of total billed charges,,,49.68,82.8,,percent of total billed charges,,,51,85,,percent of total billed charges,,,,,,,,,52.8,88,,percent of total billed charges,,,,,,,,,45.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15,22,,percent of total billed charges,,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,,,,,,,,,,,,,49.8,83,,percent of total billed charges,,,57,95,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,49.2,82,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,15,57,
*FILTER,23802029,CDM,,,270,RC,outpatient,,56,56,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14,22,,percent of total billed charges,,,,,,,,,50.4,90,,percent of total billed charges,,,46.37,82.8,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,,,,,,,,49.28,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14,22,,percent of total billed charges,,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,45.92,82,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,14,53.2,
O2 CPAP ADJ. VALUE,23802030,CDM,,,270,RC,outpatient,,66,66,,56.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.5,22,,percent of total billed charges,,,,,,,,,59.4,90,,percent of total billed charges,,,54.65,82.8,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,,,,,,,,58.08,88,,percent of total billed charges,,,,,,,,,50.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.5,22,,percent of total billed charges,,,60.06,91,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,,,,,,,,,,,,,54.78,83,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,54.12,82,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,16.5,62.7,
CANOPY TENT,23802035,CDM,,,270,RC,outpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.25,22,,percent of total billed charges,,,,,,,,,98.1,90,,percent of total billed charges,,,90.25,82.8,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.25,22,,percent of total billed charges,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,27.25,103.55,
DISPOSABLE OXYHOOD,23802037,CDM,,,270,RC,outpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.5,22,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,64.58,82.8,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.5,22,,percent of total billed charges,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,19.5,74.1,
HAND HELD CIRCUIT,23802039,CDM,,,270,RC,outpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.5,22,,percent of total billed charges,,,,,,,,,91.8,90,,percent of total billed charges,,,84.46,82.8,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.5,22,,percent of total billed charges,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,25.5,96.9,
MINI HEART NEBULIZER CIRCUIT,23802040,CDM,,,270,RC,outpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.25,22,,percent of total billed charges,,,,,,,,,72.9,90,,percent of total billed charges,,,67.07,82.8,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.25,22,,percent of total billed charges,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,20.25,76.95,
IPPB CIRCUIT DISPOSABLE,23802042,CDM,,,270,RC,outpatient,,74,74,,62.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.5,22,,percent of total billed charges,,,,,,,,,66.6,90,,percent of total billed charges,,,61.27,82.8,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,,,,,,,,65.12,88,,percent of total billed charges,,,,,,,,,56.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.5,22,,percent of total billed charges,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,,,,,,,,,,,,,61.42,83,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,60.68,82,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,18.5,70.3,
IS DISPOSABLE,23802043,CDM,,,270,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
MASKS NON REBREATHER,23802044,CDM,,,270,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
MECHANICAL VENTILATOR CIRCUIT,23802046,CDM,,,270,RC,outpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36,22,,percent of total billed charges,,,,,,,,,129.6,90,,percent of total billed charges,,,119.23,82.8,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36,22,,percent of total billed charges,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,36,136.8,
*O2 MASK NON-REBREATHER,23802116,CDM,,,270,RC,outpatient,,8,8,,6.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2,22,,percent of total billed charges,,,,,,,,,7.2,90,,percent of total billed charges,,,6.62,82.8,,percent of total billed charges,,,6.8,85,,percent of total billed charges,,,,,,,,,7.04,88,,percent of total billed charges,,,,,,,,,6.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2,22,,percent of total billed charges,,,7.28,91,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,,,,,,,,,,,,,6.64,83,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.56,82,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.8,85,,percent of total billed charges,,2,7.6,
INTRAUTERINE PRESSURE CATHETER,23910257,CDM,59899,CPT,270,RC,outpatient,,474,474,,402.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,118.5,22,,percent of total billed charges,,,,,,,,,426.6,90,,percent of total billed charges,,,392.47,82.8,,percent of total billed charges,,,402.9,85,,percent of total billed charges,,,,,,,,,417.12,88,,percent of total billed charges,,,,,,,,,362.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,118.5,22,,percent of total billed charges,,,431.34,91,,percent of total billed charges,,,450.3,95,,percent of total billed charges,,,393.42,83,,percent of total billed charges,,,393.42,83,,percent of total billed charges,,,,,,,,,,,,,,,393.42,83,,percent of total billed charges,,,450.3,95,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,388.68,82,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,402.9,85,,percent of total billed charges,,118.5,450.3,
HYSTRO TRAY,26100786,CDM,,,270,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
H/S CATHETER SET,26100787,CDM,,,270,RC,outpatient,,19,19,,16.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.75,22,,percent of total billed charges,,,,,,,,,17.1,90,,percent of total billed charges,,,15.73,82.8,,percent of total billed charges,,,16.15,85,,percent of total billed charges,,,,,,,,,16.72,88,,percent of total billed charges,,,,,,,,,14.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.75,22,,percent of total billed charges,,,17.29,91,,percent of total billed charges,,,18.05,95,,percent of total billed charges,,,15.77,83,,percent of total billed charges,,,15.77,83,,percent of total billed charges,,,,,,,,,,,,,,,15.77,83,,percent of total billed charges,,,18.05,95,,percent of total billed charges,,,17.1,90,,percent of total billed charges,,,17.1,90,,percent of total billed charges,,,15.58,82,,percent of total billed charges,,,17.1,90,,percent of total billed charges,,,16.15,85,,percent of total billed charges,,4.75,18.05,
TRANSFER TUBING,26307769,CDM,,,270,RC,outpatient,,5,5,,4.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.25,22,,percent of total billed charges,,,,,,,,,4.5,90,,percent of total billed charges,,,4.14,82.8,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,,,,,,,,4.4,88,,percent of total billed charges,,,,,,,,,3.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.25,22,,percent of total billed charges,,,4.55,91,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4.15,83,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.1,82,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,1.25,4.75,
NEEDLE COAX BX,29101997,CDM,,,270,RC,outpatient,,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.25,22,,percent of total billed charges,,,,,,,,,260.1,90,,percent of total billed charges,,,239.29,82.8,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.25,22,,percent of total billed charges,,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,72.25,274.55,
NEEDLE CIBA,29101999,CDM,,,270,RC,outpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.25,22,,percent of total billed charges,,,,,,,,,130.5,90,,percent of total billed charges,,,120.06,82.8,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.25,22,,percent of total billed charges,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,36.25,137.75,
*BOOT SOF-CARE HEEL CARE,30040003,CDM,,,270,RC,outpatient,,148.4,148.4,,125.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.1,22,,percent of total billed charges,,,,,,,,,133.56,90,,percent of total billed charges,,,122.88,82.8,,percent of total billed charges,,,126.14,85,,percent of total billed charges,,,,,,,,,130.59,88,,percent of total billed charges,,,,,,,,,113.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.1,22,,percent of total billed charges,,,135.04,91,,percent of total billed charges,,,140.98,95,,percent of total billed charges,,,123.17,83,,percent of total billed charges,,,123.17,83,,percent of total billed charges,,,,,,,,,,,,,,,123.17,83,,percent of total billed charges,,,140.98,95,,percent of total billed charges,,,133.56,90,,percent of total billed charges,,,133.56,90,,percent of total billed charges,,,121.69,82,,percent of total billed charges,,,133.56,90,,percent of total billed charges,,,126.14,85,,percent of total billed charges,,37.1,140.98,
*BOOT SOF-CARE HEEL CARE SM. LONG,30040004,CDM,,,270,RC,outpatient,,160.72,160.72,,136.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.18,22,,percent of total billed charges,,,,,,,,,144.65,90,,percent of total billed charges,,,133.08,82.8,,percent of total billed charges,,,136.61,85,,percent of total billed charges,,,,,,,,,141.43,88,,percent of total billed charges,,,,,,,,,122.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.18,22,,percent of total billed charges,,,146.26,91,,percent of total billed charges,,,152.68,95,,percent of total billed charges,,,133.4,83,,percent of total billed charges,,,133.4,83,,percent of total billed charges,,,,,,,,,,,,,,,133.4,83,,percent of total billed charges,,,152.68,95,,percent of total billed charges,,,144.65,90,,percent of total billed charges,,,144.65,90,,percent of total billed charges,,,131.79,82,,percent of total billed charges,,,144.65,90,,percent of total billed charges,,,136.61,85,,percent of total billed charges,,40.18,152.68,
*BOOT SOF-CARE HEEL CARE LG. LONG,30040005,CDM,,,270,RC,outpatient,,160.8,160.8,,136.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.2,22,,percent of total billed charges,,,,,,,,,144.72,90,,percent of total billed charges,,,133.14,82.8,,percent of total billed charges,,,136.68,85,,percent of total billed charges,,,,,,,,,141.5,88,,percent of total billed charges,,,,,,,,,122.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.2,22,,percent of total billed charges,,,146.33,91,,percent of total billed charges,,,152.76,95,,percent of total billed charges,,,133.46,83,,percent of total billed charges,,,133.46,83,,percent of total billed charges,,,,,,,,,,,,,,,133.46,83,,percent of total billed charges,,,152.76,95,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,131.86,82,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,136.68,85,,percent of total billed charges,,40.2,152.76,
*BOOT SOF-CARE HEEL CARE MED. LONG,30040006,CDM,,,270,RC,outpatient,,160.8,160.8,,136.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.2,22,,percent of total billed charges,,,,,,,,,144.72,90,,percent of total billed charges,,,133.14,82.8,,percent of total billed charges,,,136.68,85,,percent of total billed charges,,,,,,,,,141.5,88,,percent of total billed charges,,,,,,,,,122.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.2,22,,percent of total billed charges,,,146.33,91,,percent of total billed charges,,,152.76,95,,percent of total billed charges,,,133.46,83,,percent of total billed charges,,,133.46,83,,percent of total billed charges,,,,,,,,,,,,,,,133.46,83,,percent of total billed charges,,,152.76,95,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,131.86,82,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,136.68,85,,percent of total billed charges,,40.2,152.76,
*DRESSING MAXORB AG EXTRA,30040007,CDM,,,270,RC,outpatient,,55.76,55.76,,47.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.94,22,,percent of total billed charges,,,,,,,,,50.18,90,,percent of total billed charges,,,46.17,82.8,,percent of total billed charges,,,47.4,85,,percent of total billed charges,,,,,,,,,49.07,88,,percent of total billed charges,,,,,,,,,42.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.94,22,,percent of total billed charges,,,50.74,91,,percent of total billed charges,,,52.97,95,,percent of total billed charges,,,46.28,83,,percent of total billed charges,,,46.28,83,,percent of total billed charges,,,,,,,,,,,,,,,46.28,83,,percent of total billed charges,,,52.97,95,,percent of total billed charges,,,50.18,90,,percent of total billed charges,,,50.18,90,,percent of total billed charges,,,45.72,82,,percent of total billed charges,,,50.18,90,,percent of total billed charges,,,47.4,85,,percent of total billed charges,,13.94,52.97,
"ADDITION TO LOWER EXTREMITY, TORSION CON",30040018,CDM,,,270,RC,outpatient,,940.42,940.42,,798.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.11,22,,percent of total billed charges,,,,,,,,,846.38,90,,percent of total billed charges,,,778.67,82.8,,percent of total billed charges,,,799.36,85,,percent of total billed charges,,,,,,,,,827.57,88,,percent of total billed charges,,,,,,,,,718.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.11,22,,percent of total billed charges,,,855.78,91,,percent of total billed charges,,,893.4,95,,percent of total billed charges,,,780.55,83,,percent of total billed charges,,,780.55,83,,percent of total billed charges,,,,,,,,,,,,,,,780.55,83,,percent of total billed charges,,,893.4,95,,percent of total billed charges,,,846.38,90,,percent of total billed charges,,,846.38,90,,percent of total billed charges,,,771.14,82,,percent of total billed charges,,,846.38,90,,percent of total billed charges,,,799.36,85,,percent of total billed charges,,235.11,893.4,
"*HIP KNEE ANKLE FOOT ORTHOSIS,TORSION",30040019,CDM,,,270,RC,outpatient,,3550.95,3550.95,,3014.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,887.74,22,,percent of total billed charges,,,,,,,,,3195.86,90,,percent of total billed charges,,,2940.19,82.8,,percent of total billed charges,,,3018.31,85,,percent of total billed charges,,,,,,,,,3124.84,88,,percent of total billed charges,,,,,,,,,2712.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,887.74,22,,percent of total billed charges,,,3231.36,91,,percent of total billed charges,,,3373.4,95,,percent of total billed charges,,,2947.29,83,,percent of total billed charges,,,2947.29,83,,percent of total billed charges,,,,,,,,,,,,,,,2947.29,83,,percent of total billed charges,,,3373.4,95,,percent of total billed charges,,,3195.86,90,,percent of total billed charges,,,3195.86,90,,percent of total billed charges,,,2911.78,82,,percent of total billed charges,,,3195.86,90,,percent of total billed charges,,,3018.31,85,,percent of total billed charges,,887.74,3373.4,
KCI GRANUFOAM DRSG BLACK MED,30040029,CDM,,,270,RC,outpatient,,311.08,311.08,,264.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.77,22,,percent of total billed charges,,,,,,,,,279.97,90,,percent of total billed charges,,,257.57,82.8,,percent of total billed charges,,,264.42,85,,percent of total billed charges,,,,,,,,,273.75,88,,percent of total billed charges,,,,,,,,,237.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.77,22,,percent of total billed charges,,,283.08,91,,percent of total billed charges,,,295.53,95,,percent of total billed charges,,,258.2,83,,percent of total billed charges,,,258.2,83,,percent of total billed charges,,,,,,,,,,,,,,,258.2,83,,percent of total billed charges,,,295.53,95,,percent of total billed charges,,,279.97,90,,percent of total billed charges,,,279.97,90,,percent of total billed charges,,,255.09,82,,percent of total billed charges,,,279.97,90,,percent of total billed charges,,,264.42,85,,percent of total billed charges,,77.77,295.53,
KCI GRANUFOAM DRSG BLACK SM,30040032,CDM,,,270,RC,outpatient,,278.06,278.06,,236.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.52,22,,percent of total billed charges,,,,,,,,,250.25,90,,percent of total billed charges,,,230.23,82.8,,percent of total billed charges,,,236.35,85,,percent of total billed charges,,,,,,,,,244.69,88,,percent of total billed charges,,,,,,,,,212.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.52,22,,percent of total billed charges,,,253.03,91,,percent of total billed charges,,,264.16,95,,percent of total billed charges,,,230.79,83,,percent of total billed charges,,,230.79,83,,percent of total billed charges,,,,,,,,,,,,,,,230.79,83,,percent of total billed charges,,,264.16,95,,percent of total billed charges,,,250.25,90,,percent of total billed charges,,,250.25,90,,percent of total billed charges,,,228.01,82,,percent of total billed charges,,,250.25,90,,percent of total billed charges,,,236.35,85,,percent of total billed charges,,69.52,264.16,
KCI CANISTERS NO GEL,30040033,CDM,,,270,RC,outpatient,,214.96,214.96,,182.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.74,22,,percent of total billed charges,,,,,,,,,193.46,90,,percent of total billed charges,,,177.99,82.8,,percent of total billed charges,,,182.72,85,,percent of total billed charges,,,,,,,,,189.16,88,,percent of total billed charges,,,,,,,,,164.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.74,22,,percent of total billed charges,,,195.61,91,,percent of total billed charges,,,204.21,95,,percent of total billed charges,,,178.42,83,,percent of total billed charges,,,178.42,83,,percent of total billed charges,,,,,,,,,,,,,,,178.42,83,,percent of total billed charges,,,204.21,95,,percent of total billed charges,,,193.46,90,,percent of total billed charges,,,193.46,90,,percent of total billed charges,,,176.27,82,,percent of total billed charges,,,193.46,90,,percent of total billed charges,,,182.72,85,,percent of total billed charges,,53.74,204.21,
FIBRACOL PLUS,30040034,CDM,,,270,RC,outpatient,,33.84,33.84,,28.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.46,22,,percent of total billed charges,,,,,,,,,30.46,90,,percent of total billed charges,,,28.02,82.8,,percent of total billed charges,,,28.76,85,,percent of total billed charges,,,,,,,,,29.78,88,,percent of total billed charges,,,,,,,,,25.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.46,22,,percent of total billed charges,,,30.79,91,,percent of total billed charges,,,32.15,95,,percent of total billed charges,,,28.09,83,,percent of total billed charges,,,28.09,83,,percent of total billed charges,,,,,,,,,,,,,,,28.09,83,,percent of total billed charges,,,32.15,95,,percent of total billed charges,,,30.46,90,,percent of total billed charges,,,30.46,90,,percent of total billed charges,,,27.75,82,,percent of total billed charges,,,30.46,90,,percent of total billed charges,,,28.76,85,,percent of total billed charges,,8.46,32.15,
WOUND V.A.C. DAILY RATE,30040035,CDM,,,270,RC,outpatient,,407.33,407.33,,345.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.83,22,,percent of total billed charges,,,,,,,,,366.6,90,,percent of total billed charges,,,337.27,82.8,,percent of total billed charges,,,346.23,85,,percent of total billed charges,,,,,,,,,358.45,88,,percent of total billed charges,,,,,,,,,311.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.83,22,,percent of total billed charges,,,370.67,91,,percent of total billed charges,,,386.96,95,,percent of total billed charges,,,338.08,83,,percent of total billed charges,,,338.08,83,,percent of total billed charges,,,,,,,,,,,,,,,338.08,83,,percent of total billed charges,,,386.96,95,,percent of total billed charges,,,366.6,90,,percent of total billed charges,,,366.6,90,,percent of total billed charges,,,334.01,82,,percent of total billed charges,,,366.6,90,,percent of total billed charges,,,346.23,85,,percent of total billed charges,,101.83,386.96,
FLEXI-SEAL FECAL MANAGEMENT KIT,30040044,CDM,,,270,RC,outpatient,,1219.53,1219.53,,1035.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,304.88,22,,percent of total billed charges,,,,,,,,,1097.58,90,,percent of total billed charges,,,1009.77,82.8,,percent of total billed charges,,,1036.6,85,,percent of total billed charges,,,,,,,,,1073.19,88,,percent of total billed charges,,,,,,,,,931.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,304.88,22,,percent of total billed charges,,,1109.77,91,,percent of total billed charges,,,1158.55,95,,percent of total billed charges,,,1012.21,83,,percent of total billed charges,,,1012.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1012.21,83,,percent of total billed charges,,,1158.55,95,,percent of total billed charges,,,1097.58,90,,percent of total billed charges,,,1097.58,90,,percent of total billed charges,,,1000.01,82,,percent of total billed charges,,,1097.58,90,,percent of total billed charges,,,1036.6,85,,percent of total billed charges,,304.88,1158.55,
*FEEDING SET KANGAROO EPUMP SPIKE SAFETY,30040046,CDM,,,270,RC,outpatient,,41.36,41.36,,35.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.34,22,,percent of total billed charges,,,,,,,,,37.22,90,,percent of total billed charges,,,34.25,82.8,,percent of total billed charges,,,35.16,85,,percent of total billed charges,,,,,,,,,36.4,88,,percent of total billed charges,,,,,,,,,31.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.34,22,,percent of total billed charges,,,37.64,91,,percent of total billed charges,,,39.29,95,,percent of total billed charges,,,34.33,83,,percent of total billed charges,,,34.33,83,,percent of total billed charges,,,,,,,,,,,,,,,34.33,83,,percent of total billed charges,,,39.29,95,,percent of total billed charges,,,37.22,90,,percent of total billed charges,,,37.22,90,,percent of total billed charges,,,33.92,82,,percent of total billed charges,,,37.22,90,,percent of total billed charges,,,35.16,85,,percent of total billed charges,,10.34,39.29,
CUSHION WAFFLE MATTRESS PAD,30040048,CDM,,,270,RC,outpatient,,300.11,300.11,,254.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.03,22,,percent of total billed charges,,,,,,,,,270.1,90,,percent of total billed charges,,,248.49,82.8,,percent of total billed charges,,,255.09,85,,percent of total billed charges,,,,,,,,,264.1,88,,percent of total billed charges,,,,,,,,,229.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.03,22,,percent of total billed charges,,,273.1,91,,percent of total billed charges,,,285.1,95,,percent of total billed charges,,,249.09,83,,percent of total billed charges,,,249.09,83,,percent of total billed charges,,,,,,,,,,,,,,,249.09,83,,percent of total billed charges,,,285.1,95,,percent of total billed charges,,,270.1,90,,percent of total billed charges,,,270.1,90,,percent of total billed charges,,,246.09,82,,percent of total billed charges,,,270.1,90,,percent of total billed charges,,,255.09,85,,percent of total billed charges,,75.03,285.1,
CUSHION WAFFLE 16X16X2,30040049,CDM,,,270,RC,outpatient,,141.11,141.11,,119.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.28,22,,percent of total billed charges,,,,,,,,,127,90,,percent of total billed charges,,,116.84,82.8,,percent of total billed charges,,,119.94,85,,percent of total billed charges,,,,,,,,,124.18,88,,percent of total billed charges,,,,,,,,,107.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.28,22,,percent of total billed charges,,,128.41,91,,percent of total billed charges,,,134.05,95,,percent of total billed charges,,,117.12,83,,percent of total billed charges,,,117.12,83,,percent of total billed charges,,,,,,,,,,,,,,,117.12,83,,percent of total billed charges,,,134.05,95,,percent of total billed charges,,,127,90,,percent of total billed charges,,,127,90,,percent of total billed charges,,,115.71,82,,percent of total billed charges,,,127,90,,percent of total billed charges,,,119.94,85,,percent of total billed charges,,35.28,134.05,
KCI SENSATRACK PAD,30040052,CDM,,,270,RC,outpatient,,148.72,148.72,,126.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.18,22,,percent of total billed charges,,,,,,,,,133.85,90,,percent of total billed charges,,,123.14,82.8,,percent of total billed charges,,,126.41,85,,percent of total billed charges,,,,,,,,,130.87,88,,percent of total billed charges,,,,,,,,,113.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.18,22,,percent of total billed charges,,,135.34,91,,percent of total billed charges,,,141.28,95,,percent of total billed charges,,,123.44,83,,percent of total billed charges,,,123.44,83,,percent of total billed charges,,,,,,,,,,,,,,,123.44,83,,percent of total billed charges,,,141.28,95,,percent of total billed charges,,,133.85,90,,percent of total billed charges,,,133.85,90,,percent of total billed charges,,,121.95,82,,percent of total billed charges,,,133.85,90,,percent of total billed charges,,,126.41,85,,percent of total billed charges,,37.18,141.28,
KCI GRANUFOAM DRSG BRIDGE XG,30040053,CDM,,,270,RC,outpatient,,401.87,401.87,,341.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100.47,22,,percent of total billed charges,,,,,,,,,361.68,90,,percent of total billed charges,,,332.75,82.8,,percent of total billed charges,,,341.59,85,,percent of total billed charges,,,,,,,,,353.65,88,,percent of total billed charges,,,,,,,,,307.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100.47,22,,percent of total billed charges,,,365.7,91,,percent of total billed charges,,,381.78,95,,percent of total billed charges,,,333.55,83,,percent of total billed charges,,,333.55,83,,percent of total billed charges,,,,,,,,,,,,,,,333.55,83,,percent of total billed charges,,,381.78,95,,percent of total billed charges,,,361.68,90,,percent of total billed charges,,,361.68,90,,percent of total billed charges,,,329.53,82,,percent of total billed charges,,,361.68,90,,percent of total billed charges,,,341.59,85,,percent of total billed charges,,100.47,381.78,
EAR SENSOR MASIMO LNCS E1,30040055,CDM,,,270,RC,outpatient,,187.87,187.87,,159.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.97,22,,percent of total billed charges,,,,,,,,,169.08,90,,percent of total billed charges,,,155.56,82.8,,percent of total billed charges,,,159.69,85,,percent of total billed charges,,,,,,,,,165.33,88,,percent of total billed charges,,,,,,,,,143.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.97,22,,percent of total billed charges,,,170.96,91,,percent of total billed charges,,,178.48,95,,percent of total billed charges,,,155.93,83,,percent of total billed charges,,,155.93,83,,percent of total billed charges,,,,,,,,,,,,,,,155.93,83,,percent of total billed charges,,,178.48,95,,percent of total billed charges,,,169.08,90,,percent of total billed charges,,,169.08,90,,percent of total billed charges,,,154.05,82,,percent of total billed charges,,,169.08,90,,percent of total billed charges,,,159.69,85,,percent of total billed charges,,46.97,178.48,
P.O.S. FOREARM CUFFS EXT FLEX,30048001,CDM,,,270,RC,outpatient,,4849.59,4849.59,,4117.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1212.4,22,,percent of total billed charges,,,,,,,,,4364.63,90,,percent of total billed charges,,,4015.46,82.8,,percent of total billed charges,,,4122.15,85,,percent of total billed charges,,,,,,,,,4267.64,88,,percent of total billed charges,,,,,,,,,3705.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1212.4,22,,percent of total billed charges,,,4413.13,91,,percent of total billed charges,,,4607.11,95,,percent of total billed charges,,,4025.16,83,,percent of total billed charges,,,4025.16,83,,percent of total billed charges,,,,,,,,,,,,,,,4025.16,83,,percent of total billed charges,,,4607.11,95,,percent of total billed charges,,,4364.63,90,,percent of total billed charges,,,4364.63,90,,percent of total billed charges,,,3976.66,82,,percent of total billed charges,,,4364.63,90,,percent of total billed charges,,,4122.15,85,,percent of total billed charges,,1212.4,4607.11,
P.O.S. UPP EXT FX ORTHOSIS HUMERAL,30048002,CDM,,,270,RC,outpatient,,2070.06,2070.06,,1757.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,517.52,22,,percent of total billed charges,,,,,,,,,1863.05,90,,percent of total billed charges,,,1714.01,82.8,,percent of total billed charges,,,1759.55,85,,percent of total billed charges,,,,,,,,,1821.65,88,,percent of total billed charges,,,,,,,,,1581.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,517.52,22,,percent of total billed charges,,,1883.75,91,,percent of total billed charges,,,1966.56,95,,percent of total billed charges,,,1718.15,83,,percent of total billed charges,,,1718.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1718.15,83,,percent of total billed charges,,,1966.56,95,,percent of total billed charges,,,1863.05,90,,percent of total billed charges,,,1863.05,90,,percent of total billed charges,,,1697.45,82,,percent of total billed charges,,,1863.05,90,,percent of total billed charges,,,1759.55,85,,percent of total billed charges,,517.52,1966.56,
P.O S. FORK STRAP BELOW KNEE,30048003,CDM,,,270,RC,outpatient,,450.73,450.73,,382.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,112.68,22,,percent of total billed charges,,,,,,,,,405.66,90,,percent of total billed charges,,,373.2,82.8,,percent of total billed charges,,,383.12,85,,percent of total billed charges,,,,,,,,,396.64,88,,percent of total billed charges,,,,,,,,,344.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,112.68,22,,percent of total billed charges,,,410.16,91,,percent of total billed charges,,,428.19,95,,percent of total billed charges,,,374.11,83,,percent of total billed charges,,,374.11,83,,percent of total billed charges,,,,,,,,,,,,,,,374.11,83,,percent of total billed charges,,,428.19,95,,percent of total billed charges,,,405.66,90,,percent of total billed charges,,,405.66,90,,percent of total billed charges,,,369.6,82,,percent of total billed charges,,,405.66,90,,percent of total billed charges,,,383.12,85,,percent of total billed charges,,112.68,428.19,
P.O.S. WAIST BELT WEBBING BELOW KNEE,30048004,CDM,,,270,RC,outpatient,,575.68,575.68,,488.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,143.92,22,,percent of total billed charges,,,,,,,,,518.11,90,,percent of total billed charges,,,476.66,82.8,,percent of total billed charges,,,489.33,85,,percent of total billed charges,,,,,,,,,506.6,88,,percent of total billed charges,,,,,,,,,439.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,143.92,22,,percent of total billed charges,,,523.87,91,,percent of total billed charges,,,546.9,95,,percent of total billed charges,,,477.81,83,,percent of total billed charges,,,477.81,83,,percent of total billed charges,,,,,,,,,,,,,,,477.81,83,,percent of total billed charges,,,546.9,95,,percent of total billed charges,,,518.11,90,,percent of total billed charges,,,518.11,90,,percent of total billed charges,,,472.06,82,,percent of total billed charges,,,518.11,90,,percent of total billed charges,,,489.33,85,,percent of total billed charges,,143.92,546.9,
P.O.S. FOREARM CUFFS FREE MOTION,30048005,CDM,,,270,RC,outpatient,,3656.06,3656.06,,3103.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,914.02,22,,percent of total billed charges,,,,,,,,,3290.45,90,,percent of total billed charges,,,3027.22,82.8,,percent of total billed charges,,,3107.65,85,,percent of total billed charges,,,,,,,,,3217.33,88,,percent of total billed charges,,,,,,,,,2793.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,914.02,22,,percent of total billed charges,,,3327.01,91,,percent of total billed charges,,,3473.26,95,,percent of total billed charges,,,3034.53,83,,percent of total billed charges,,,3034.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3034.53,83,,percent of total billed charges,,,3473.26,95,,percent of total billed charges,,,3290.45,90,,percent of total billed charges,,,3290.45,90,,percent of total billed charges,,,2997.97,82,,percent of total billed charges,,,3290.45,90,,percent of total billed charges,,,3107.65,85,,percent of total billed charges,,914.02,3473.26,
P.O.S. KAFO FEMORAL FX CAST RIGID,30048006,CDM,,,270,RC,outpatient,,7653.62,7653.62,,6497.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1913.41,22,,percent of total billed charges,,,,,,,,,6888.26,90,,percent of total billed charges,,,6337.2,82.8,,percent of total billed charges,,,6505.58,85,,percent of total billed charges,,,,,,,,,6735.19,88,,percent of total billed charges,,,,,,,,,5847.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1913.41,22,,percent of total billed charges,,,6964.79,91,,percent of total billed charges,,,7270.94,95,,percent of total billed charges,,,6352.5,83,,percent of total billed charges,,,6352.5,83,,percent of total billed charges,,,,,,,,,,,,,,,6352.5,83,,percent of total billed charges,,,7270.94,95,,percent of total billed charges,,,6888.26,90,,percent of total billed charges,,,6888.26,90,,percent of total billed charges,,,6275.97,82,,percent of total billed charges,,,6888.26,90,,percent of total billed charges,,,6505.58,85,,percent of total billed charges,,1913.41,7270.94,
P.O.S. ADJ MOTION KNEE JNT LERMAN,30048007,CDM,,,270,RC,outpatient,,1811.29,1811.29,,1537.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,452.82,22,,percent of total billed charges,,,,,,,,,1630.16,90,,percent of total billed charges,,,1499.75,82.8,,percent of total billed charges,,,1539.6,85,,percent of total billed charges,,,,,,,,,1593.94,88,,percent of total billed charges,,,,,,,,,1383.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,452.82,22,,percent of total billed charges,,,1648.27,91,,percent of total billed charges,,,1720.73,95,,percent of total billed charges,,,1503.37,83,,percent of total billed charges,,,1503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1503.37,83,,percent of total billed charges,,,1720.73,95,,percent of total billed charges,,,1630.16,90,,percent of total billed charges,,,1630.16,90,,percent of total billed charges,,,1485.26,82,,percent of total billed charges,,,1630.16,90,,percent of total billed charges,,,1539.6,85,,percent of total billed charges,,452.82,1720.73,
P.O.S. PELVIC BAND & BELT THIGH,30048008,CDM,,,270,RC,outpatient,,2023.32,2023.32,,1717.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,505.83,22,,percent of total billed charges,,,,,,,,,1820.99,90,,percent of total billed charges,,,1675.31,82.8,,percent of total billed charges,,,1719.82,85,,percent of total billed charges,,,,,,,,,1780.52,88,,percent of total billed charges,,,,,,,,,1545.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,505.83,22,,percent of total billed charges,,,1841.22,91,,percent of total billed charges,,,1922.15,95,,percent of total billed charges,,,1679.36,83,,percent of total billed charges,,,1679.36,83,,percent of total billed charges,,,,,,,,,,,,,,,1679.36,83,,percent of total billed charges,,,1922.15,95,,percent of total billed charges,,,1820.99,90,,percent of total billed charges,,,1820.99,90,,percent of total billed charges,,,1659.12,82,,percent of total billed charges,,,1820.99,90,,percent of total billed charges,,,1719.82,85,,percent of total billed charges,,505.83,1922.15,
P.O.S. PLAS SHOE INSESRT W/ANK JOINT,30048009,CDM,,,270,RC,outpatient,,866.46,866.46,,735.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,216.62,22,,percent of total billed charges,,,,,,,,,779.81,90,,percent of total billed charges,,,717.43,82.8,,percent of total billed charges,,,736.49,85,,percent of total billed charges,,,,,,,,,762.48,88,,percent of total billed charges,,,,,,,,,661.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,216.62,22,,percent of total billed charges,,,788.48,91,,percent of total billed charges,,,823.14,95,,percent of total billed charges,,,719.16,83,,percent of total billed charges,,,719.16,83,,percent of total billed charges,,,,,,,,,,,,,,,719.16,83,,percent of total billed charges,,,823.14,95,,percent of total billed charges,,,779.81,90,,percent of total billed charges,,,779.81,90,,percent of total billed charges,,,710.5,82,,percent of total billed charges,,,779.81,90,,percent of total billed charges,,,736.49,85,,percent of total billed charges,,216.62,823.14,
P.O.S. SURGICAL BOOT,30048011,CDM,,,270,RC,outpatient,,241.65,241.65,,205.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60.41,22,,percent of total billed charges,,,,,,,,,217.49,90,,percent of total billed charges,,,200.09,82.8,,percent of total billed charges,,,205.4,85,,percent of total billed charges,,,,,,,,,212.65,88,,percent of total billed charges,,,,,,,,,184.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60.41,22,,percent of total billed charges,,,219.9,91,,percent of total billed charges,,,229.57,95,,percent of total billed charges,,,200.57,83,,percent of total billed charges,,,200.57,83,,percent of total billed charges,,,,,,,,,,,,,,,200.57,83,,percent of total billed charges,,,229.57,95,,percent of total billed charges,,,217.49,90,,percent of total billed charges,,,217.49,90,,percent of total billed charges,,,198.15,82,,percent of total billed charges,,,217.49,90,,percent of total billed charges,,,205.4,85,,percent of total billed charges,,60.41,229.57,
P.O.S. KAFO FEM FX CAST MOLDED TO PT,30048012,CDM,,,270,RC,outpatient,,9427.02,9427.02,,8003.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2356.76,22,,percent of total billed charges,,,,,,,,,8484.32,90,,percent of total billed charges,,,7805.57,82.8,,percent of total billed charges,,,8012.97,85,,percent of total billed charges,,,,,,,,,8295.78,88,,percent of total billed charges,,,,,,,,,7202.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2356.76,22,,percent of total billed charges,,,8578.59,91,,percent of total billed charges,,,8955.67,95,,percent of total billed charges,,,7824.43,83,,percent of total billed charges,,,7824.43,83,,percent of total billed charges,,,,,,,,,,,,,,,7824.43,83,,percent of total billed charges,,,8955.67,95,,percent of total billed charges,,,8484.32,90,,percent of total billed charges,,,8484.32,90,,percent of total billed charges,,,7730.16,82,,percent of total billed charges,,,8484.32,90,,percent of total billed charges,,,8012.97,85,,percent of total billed charges,,2356.76,8955.67,
P.O.S. AFO POS SOLID ANK PLASTIC MO,30048013,CDM,,,270,RC,outpatient,,3732.04,3732.04,,3168.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,933.01,22,,percent of total billed charges,,,,,,,,,3358.84,90,,percent of total billed charges,,,3090.13,82.8,,percent of total billed charges,,,3172.23,85,,percent of total billed charges,,,,,,,,,3284.2,88,,percent of total billed charges,,,,,,,,,2851.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,933.01,22,,percent of total billed charges,,,3396.16,91,,percent of total billed charges,,,3545.44,95,,percent of total billed charges,,,3097.59,83,,percent of total billed charges,,,3097.59,83,,percent of total billed charges,,,,,,,,,,,,,,,3097.59,83,,percent of total billed charges,,,3545.44,95,,percent of total billed charges,,,3358.84,90,,percent of total billed charges,,,3358.84,90,,percent of total billed charges,,,3060.27,82,,percent of total billed charges,,,3358.84,90,,percent of total billed charges,,,3172.23,85,,percent of total billed charges,,933.01,3545.44,
P.O.S. PROSTHETIC TYPE SOCKET MOLD,30048014,CDM,,,270,RC,outpatient,,5016.25,5016.25,,4258.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1254.06,22,,percent of total billed charges,,,,,,,,,4514.63,90,,percent of total billed charges,,,4153.46,82.8,,percent of total billed charges,,,4263.81,85,,percent of total billed charges,,,,,,,,,4414.3,88,,percent of total billed charges,,,,,,,,,3832.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1254.06,22,,percent of total billed charges,,,4564.79,91,,percent of total billed charges,,,4765.44,95,,percent of total billed charges,,,4163.49,83,,percent of total billed charges,,,4163.49,83,,percent of total billed charges,,,,,,,,,,,,,,,4163.49,83,,percent of total billed charges,,,4765.44,95,,percent of total billed charges,,,4514.63,90,,percent of total billed charges,,,4514.63,90,,percent of total billed charges,,,4113.33,82,,percent of total billed charges,,,4514.63,90,,percent of total billed charges,,,4263.81,85,,percent of total billed charges,,1254.06,4765.44,
P.O.S. PADDING BELOW KNEE INTERFACE,30048015,CDM,,,270,RC,outpatient,,530.74,530.74,,450.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.69,22,,percent of total billed charges,,,,,,,,,477.67,90,,percent of total billed charges,,,439.45,82.8,,percent of total billed charges,,,451.13,85,,percent of total billed charges,,,,,,,,,467.05,88,,percent of total billed charges,,,,,,,,,405.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.69,22,,percent of total billed charges,,,482.97,91,,percent of total billed charges,,,504.2,95,,percent of total billed charges,,,440.51,83,,percent of total billed charges,,,440.51,83,,percent of total billed charges,,,,,,,,,,,,,,,440.51,83,,percent of total billed charges,,,504.2,95,,percent of total billed charges,,,477.67,90,,percent of total billed charges,,,477.67,90,,percent of total billed charges,,,435.21,82,,percent of total billed charges,,,477.67,90,,percent of total billed charges,,,451.13,85,,percent of total billed charges,,132.69,504.2,
P.O.S. TIBIAL LENGTH SOCK FX OR EQU,30048016,CDM,,,270,RC,outpatient,,559.3,559.3,,474.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,139.83,22,,percent of total billed charges,,,,,,,,,503.37,90,,percent of total billed charges,,,463.1,82.8,,percent of total billed charges,,,475.41,85,,percent of total billed charges,,,,,,,,,492.18,88,,percent of total billed charges,,,,,,,,,427.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,139.83,22,,percent of total billed charges,,,508.96,91,,percent of total billed charges,,,531.34,95,,percent of total billed charges,,,464.22,83,,percent of total billed charges,,,464.22,83,,percent of total billed charges,,,,,,,,,,,,,,,464.22,83,,percent of total billed charges,,,531.34,95,,percent of total billed charges,,,503.37,90,,percent of total billed charges,,,503.37,90,,percent of total billed charges,,,458.63,82,,percent of total billed charges,,,503.37,90,,percent of total billed charges,,,475.41,85,,percent of total billed charges,,139.83,531.34,
P.O.S. ORTHO DEVICE REPAIR,30048021,CDM,,,270,RC,outpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175,22,,percent of total billed charges,,,,,,,,,630,90,,percent of total billed charges,,,579.6,82.8,,percent of total billed charges,,,595,85,,percent of total billed charges,,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175,22,,percent of total billed charges,,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,175,665,
P.O.S. AFO MOLDED TO PATIENT PLASTI,30048022,CDM,,,270,RC,outpatient,,2863.19,2863.19,,2430.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,715.8,22,,percent of total billed charges,,,,,,,,,2576.87,90,,percent of total billed charges,,,2370.72,82.8,,percent of total billed charges,,,2433.71,85,,percent of total billed charges,,,,,,,,,2519.61,88,,percent of total billed charges,,,,,,,,,2187.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,715.8,22,,percent of total billed charges,,,2605.5,91,,percent of total billed charges,,,2720.03,95,,percent of total billed charges,,,2376.45,83,,percent of total billed charges,,,2376.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2376.45,83,,percent of total billed charges,,,2720.03,95,,percent of total billed charges,,,2576.87,90,,percent of total billed charges,,,2576.87,90,,percent of total billed charges,,,2347.82,82,,percent of total billed charges,,,2576.87,90,,percent of total billed charges,,,2433.71,85,,percent of total billed charges,,715.8,2720.03,
P.O.S. KO SINGLE UPRIGHT CUSTOM FIT,30048023,CDM,,,270,RC,outpatient,,5445.38,5445.38,,4623.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1361.35,22,,percent of total billed charges,,,,,,,,,4900.84,90,,percent of total billed charges,,,4508.77,82.8,,percent of total billed charges,,,4628.57,85,,percent of total billed charges,,,,,,,,,4791.93,88,,percent of total billed charges,,,,,,,,,4160.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1361.35,22,,percent of total billed charges,,,4955.3,91,,percent of total billed charges,,,5173.11,95,,percent of total billed charges,,,4519.67,83,,percent of total billed charges,,,4519.67,83,,percent of total billed charges,,,,,,,,,,,,,,,4519.67,83,,percent of total billed charges,,,5173.11,95,,percent of total billed charges,,,4900.84,90,,percent of total billed charges,,,4900.84,90,,percent of total billed charges,,,4465.21,82,,percent of total billed charges,,,4900.84,90,,percent of total billed charges,,,4628.57,85,,percent of total billed charges,,1361.35,5173.11,
P.O.S. AFO TIBIAL FRACTURE RIGID,30048024,CDM,,,270,RC,outpatient,,4677.53,4677.53,,3971.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1169.38,22,,percent of total billed charges,,,,,,,,,4209.78,90,,percent of total billed charges,,,3872.99,82.8,,percent of total billed charges,,,3975.9,85,,percent of total billed charges,,,,,,,,,4116.23,88,,percent of total billed charges,,,,,,,,,3573.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1169.38,22,,percent of total billed charges,,,4256.55,91,,percent of total billed charges,,,4443.65,95,,percent of total billed charges,,,3882.35,83,,percent of total billed charges,,,3882.35,83,,percent of total billed charges,,,,,,,,,,,,,,,3882.35,83,,percent of total billed charges,,,4443.65,95,,percent of total billed charges,,,4209.78,90,,percent of total billed charges,,,4209.78,90,,percent of total billed charges,,,3835.57,82,,percent of total billed charges,,,4209.78,90,,percent of total billed charges,,,3975.9,85,,percent of total billed charges,,1169.38,4443.65,
P.O.S. SOCK FRACTURE,30048025,CDM,,,270,RC,outpatient,,261.75,261.75,,222.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.44,22,,percent of total billed charges,,,,,,,,,235.58,90,,percent of total billed charges,,,216.73,82.8,,percent of total billed charges,,,222.49,85,,percent of total billed charges,,,,,,,,,230.34,88,,percent of total billed charges,,,,,,,,,199.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.44,22,,percent of total billed charges,,,238.19,91,,percent of total billed charges,,,248.66,95,,percent of total billed charges,,,217.25,83,,percent of total billed charges,,,217.25,83,,percent of total billed charges,,,,,,,,,,,,,,,217.25,83,,percent of total billed charges,,,248.66,95,,percent of total billed charges,,,235.58,90,,percent of total billed charges,,,235.58,90,,percent of total billed charges,,,214.64,82,,percent of total billed charges,,,235.58,90,,percent of total billed charges,,,222.49,85,,percent of total billed charges,,65.44,248.66,
OMNI KNEE ANKLE FOOT ORTHOSIS FULL PLAST,30048026,CDM,,,270,RC,outpatient,,14184.82,14184.82,,12042.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3546.21,22,,percent of total billed charges,,,,,,,,,12766.34,90,,percent of total billed charges,,,11745.03,82.8,,percent of total billed charges,,,12057.1,85,,percent of total billed charges,,,,,,,,,12482.64,88,,percent of total billed charges,,,,,,,,,10837.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3546.21,22,,percent of total billed charges,,,12908.19,91,,percent of total billed charges,,,13475.58,95,,percent of total billed charges,,,11773.4,83,,percent of total billed charges,,,11773.4,83,,percent of total billed charges,,,,,,,,,,,,,,,11773.4,83,,percent of total billed charges,,,13475.58,95,,percent of total billed charges,,,12766.34,90,,percent of total billed charges,,,12766.34,90,,percent of total billed charges,,,11631.55,82,,percent of total billed charges,,,12766.34,90,,percent of total billed charges,,,12057.1,85,,percent of total billed charges,,3546.21,13475.58,
OMNI ADDITION TO LOWER EXTREMITY STRAIGH,30048027,CDM,,,270,RC,outpatient,,1124.31,1124.31,,954.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,281.08,22,,percent of total billed charges,,,,,,,,,1011.88,90,,percent of total billed charges,,,930.93,82.8,,percent of total billed charges,,,955.66,85,,percent of total billed charges,,,,,,,,,989.39,88,,percent of total billed charges,,,,,,,,,858.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,281.08,22,,percent of total billed charges,,,1023.12,91,,percent of total billed charges,,,1068.09,95,,percent of total billed charges,,,933.18,83,,percent of total billed charges,,,933.18,83,,percent of total billed charges,,,,,,,,,,,,,,,933.18,83,,percent of total billed charges,,,1068.09,95,,percent of total billed charges,,,1011.88,90,,percent of total billed charges,,,1011.88,90,,percent of total billed charges,,,921.93,82,,percent of total billed charges,,,1011.88,90,,percent of total billed charges,,,955.66,85,,percent of total billed charges,,281.08,1068.09,
OMNI ADDITION TO KNEE LOCK W/INTEGRATED,30048028,CDM,,,270,RC,outpatient,,929.57,929.57,,789.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,232.39,22,,percent of total billed charges,,,,,,,,,836.61,90,,percent of total billed charges,,,769.68,82.8,,percent of total billed charges,,,790.13,85,,percent of total billed charges,,,,,,,,,818.02,88,,percent of total billed charges,,,,,,,,,710.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,232.39,22,,percent of total billed charges,,,845.91,91,,percent of total billed charges,,,883.09,95,,percent of total billed charges,,,771.54,83,,percent of total billed charges,,,771.54,83,,percent of total billed charges,,,,,,,,,,,,,,,771.54,83,,percent of total billed charges,,,883.09,95,,percent of total billed charges,,,836.61,90,,percent of total billed charges,,,836.61,90,,percent of total billed charges,,,762.25,82,,percent of total billed charges,,,836.61,90,,percent of total billed charges,,,790.13,85,,percent of total billed charges,,232.39,883.09,
P.O.S. KNEE JOINT DROP LOCK,30048031,CDM,,,270,RC,outpatient,,340.05,340.05,,288.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.01,22,,percent of total billed charges,,,,,,,,,306.05,90,,percent of total billed charges,,,281.56,82.8,,percent of total billed charges,,,289.04,85,,percent of total billed charges,,,,,,,,,299.24,88,,percent of total billed charges,,,,,,,,,259.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.01,22,,percent of total billed charges,,,309.45,91,,percent of total billed charges,,,323.05,95,,percent of total billed charges,,,282.24,83,,percent of total billed charges,,,282.24,83,,percent of total billed charges,,,,,,,,,,,,,,,282.24,83,,percent of total billed charges,,,323.05,95,,percent of total billed charges,,,306.05,90,,percent of total billed charges,,,306.05,90,,percent of total billed charges,,,278.84,82,,percent of total billed charges,,,306.05,90,,percent of total billed charges,,,289.04,85,,percent of total billed charges,,85.01,323.05,
P.O.S. KNEE DISCDIAL LOCK ADJ FLEX,30048032,CDM,,,270,RC,outpatient,,717.15,717.15,,608.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,179.29,22,,percent of total billed charges,,,,,,,,,645.44,90,,percent of total billed charges,,,593.8,82.8,,percent of total billed charges,,,609.58,85,,percent of total billed charges,,,,,,,,,631.09,88,,percent of total billed charges,,,,,,,,,547.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,179.29,22,,percent of total billed charges,,,652.61,91,,percent of total billed charges,,,681.29,95,,percent of total billed charges,,,595.23,83,,percent of total billed charges,,,595.23,83,,percent of total billed charges,,,,,,,,,,,,,,,595.23,83,,percent of total billed charges,,,681.29,95,,percent of total billed charges,,,645.44,90,,percent of total billed charges,,,645.44,90,,percent of total billed charges,,,588.06,82,,percent of total billed charges,,,645.44,90,,percent of total billed charges,,,609.58,85,,percent of total billed charges,,179.29,681.29,
OMNI PROSTHETIC SHRINKER ABOVE KNEE,30048034,CDM,,,270,RC,outpatient,,958.36,958.36,,813.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,239.59,22,,percent of total billed charges,,,,,,,,,862.52,90,,percent of total billed charges,,,793.52,82.8,,percent of total billed charges,,,814.61,85,,percent of total billed charges,,,,,,,,,843.36,88,,percent of total billed charges,,,,,,,,,732.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,239.59,22,,percent of total billed charges,,,872.11,91,,percent of total billed charges,,,910.44,95,,percent of total billed charges,,,795.44,83,,percent of total billed charges,,,795.44,83,,percent of total billed charges,,,,,,,,,,,,,,,795.44,83,,percent of total billed charges,,,910.44,95,,percent of total billed charges,,,862.52,90,,percent of total billed charges,,,862.52,90,,percent of total billed charges,,,785.86,82,,percent of total billed charges,,,862.52,90,,percent of total billed charges,,,814.61,85,,percent of total billed charges,,239.59,910.44,
KNEE ORTHOSIS ADJUSTABLE JOINTS,30048035,CDM,,,270,RC,outpatient,,4951.12,4951.12,,4203.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1237.78,22,,percent of total billed charges,,,,,,,,,4456.01,90,,percent of total billed charges,,,4099.53,82.8,,percent of total billed charges,,,4208.45,85,,percent of total billed charges,,,,,,,,,4356.99,88,,percent of total billed charges,,,,,,,,,3782.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1237.78,22,,percent of total billed charges,,,4505.52,91,,percent of total billed charges,,,4703.56,95,,percent of total billed charges,,,4109.43,83,,percent of total billed charges,,,4109.43,83,,percent of total billed charges,,,,,,,,,,,,,,,4109.43,83,,percent of total billed charges,,,4703.56,95,,percent of total billed charges,,,4456.01,90,,percent of total billed charges,,,4456.01,90,,percent of total billed charges,,,4059.92,82,,percent of total billed charges,,,4456.01,90,,percent of total billed charges,,,4208.45,85,,percent of total billed charges,,1237.78,4703.56,
OMNI TLSO BRACE,30048036,CDM,,,270,RC,outpatient,,7925.26,7925.26,,6728.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1981.32,22,,percent of total billed charges,,,,,,,,,7132.73,90,,percent of total billed charges,,,6562.12,82.8,,percent of total billed charges,,,6736.47,85,,percent of total billed charges,,,,,,,,,6974.23,88,,percent of total billed charges,,,,,,,,,6054.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1981.32,22,,percent of total billed charges,,,7211.99,91,,percent of total billed charges,,,7529,95,,percent of total billed charges,,,6577.97,83,,percent of total billed charges,,,6577.97,83,,percent of total billed charges,,,,,,,,,,,,,,,6577.97,83,,percent of total billed charges,,,7529,95,,percent of total billed charges,,,7132.73,90,,percent of total billed charges,,,7132.73,90,,percent of total billed charges,,,6498.71,82,,percent of total billed charges,,,7132.73,90,,percent of total billed charges,,,6736.47,85,,percent of total billed charges,,1981.32,7529,
OMNI HO POST-OP HIP ABDUCTION,30048037,CDM,,,270,RC,outpatient,,7466.68,7466.68,,6339.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1866.67,22,,percent of total billed charges,,,,,,,,,6720.01,90,,percent of total billed charges,,,6182.41,82.8,,percent of total billed charges,,,6346.68,85,,percent of total billed charges,,,,,,,,,6570.68,88,,percent of total billed charges,,,,,,,,,5704.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1866.67,22,,percent of total billed charges,,,6794.68,91,,percent of total billed charges,,,7093.35,95,,percent of total billed charges,,,6197.34,83,,percent of total billed charges,,,6197.34,83,,percent of total billed charges,,,,,,,,,,,,,,,6197.34,83,,percent of total billed charges,,,7093.35,95,,percent of total billed charges,,,6720.01,90,,percent of total billed charges,,,6720.01,90,,percent of total billed charges,,,6122.68,82,,percent of total billed charges,,,6720.01,90,,percent of total billed charges,,,6346.68,85,,percent of total billed charges,,1866.67,7093.35,
OMNI LOWER EXTREMITY ADDITION,30048038,CDM,,,270,RC,outpatient,,3109.21,3109.21,,2639.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,777.3,22,,percent of total billed charges,,,,,,,,,2798.29,90,,percent of total billed charges,,,2574.43,82.8,,percent of total billed charges,,,2642.83,85,,percent of total billed charges,,,,,,,,,2736.1,88,,percent of total billed charges,,,,,,,,,2375.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,777.3,22,,percent of total billed charges,,,2829.38,91,,percent of total billed charges,,,2953.75,95,,percent of total billed charges,,,2580.64,83,,percent of total billed charges,,,2580.64,83,,percent of total billed charges,,,,,,,,,,,,,,,2580.64,83,,percent of total billed charges,,,2953.75,95,,percent of total billed charges,,,2798.29,90,,percent of total billed charges,,,2798.29,90,,percent of total billed charges,,,2549.55,82,,percent of total billed charges,,,2798.29,90,,percent of total billed charges,,,2642.83,85,,percent of total billed charges,,777.3,2953.75,
TORSION CONTROL LOWER EXTREMITY ADDITION,30048039,CDM,,,270,RC,outpatient,,835.94,835.94,,709.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208.99,22,,percent of total billed charges,,,,,,,,,752.35,90,,percent of total billed charges,,,692.16,82.8,,percent of total billed charges,,,710.55,85,,percent of total billed charges,,,,,,,,,735.63,88,,percent of total billed charges,,,,,,,,,638.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208.99,22,,percent of total billed charges,,,760.71,91,,percent of total billed charges,,,794.14,95,,percent of total billed charges,,,693.83,83,,percent of total billed charges,,,693.83,83,,percent of total billed charges,,,,,,,,,,,,,,,693.83,83,,percent of total billed charges,,,794.14,95,,percent of total billed charges,,,752.35,90,,percent of total billed charges,,,752.35,90,,percent of total billed charges,,,685.47,82,,percent of total billed charges,,,752.35,90,,percent of total billed charges,,,710.55,85,,percent of total billed charges,,208.99,794.14,
OMNI HIP ABDUCTION BRACE LEFT,30048040,CDM,,,270,RC,outpatient,,11050,11050,,9381.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2762.5,22,,percent of total billed charges,,,,,,,,,9945,90,,percent of total billed charges,,,9149.4,82.8,,percent of total billed charges,,,9392.5,85,,percent of total billed charges,,,,,,,,,9724,88,,percent of total billed charges,,,,,,,,,8442.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2762.5,22,,percent of total billed charges,,,10055.5,91,,percent of total billed charges,,,10497.5,95,,percent of total billed charges,,,9171.5,83,,percent of total billed charges,,,9171.5,83,,percent of total billed charges,,,,,,,,,,,,,,,9171.5,83,,percent of total billed charges,,,10497.5,95,,percent of total billed charges,,,9945,90,,percent of total billed charges,,,9945,90,,percent of total billed charges,,,9061,82,,percent of total billed charges,,,9945,90,,percent of total billed charges,,,9392.5,85,,percent of total billed charges,,2762.5,10497.5,
*DRESSING POLYMEM OVAL #5,30050012,CDM,,,270,RC,outpatient,,28.44,28.44,,24.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.11,22,,percent of total billed charges,,,,,,,,,25.6,90,,percent of total billed charges,,,23.55,82.8,,percent of total billed charges,,,24.17,85,,percent of total billed charges,,,,,,,,,25.03,88,,percent of total billed charges,,,,,,,,,21.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.11,22,,percent of total billed charges,,,25.88,91,,percent of total billed charges,,,27.02,95,,percent of total billed charges,,,23.61,83,,percent of total billed charges,,,23.61,83,,percent of total billed charges,,,,,,,,,,,,,,,23.61,83,,percent of total billed charges,,,27.02,95,,percent of total billed charges,,,25.6,90,,percent of total billed charges,,,25.6,90,,percent of total billed charges,,,23.32,82,,percent of total billed charges,,,25.6,90,,percent of total billed charges,,,24.17,85,,percent of total billed charges,,7.11,27.02,
*DRESSING POLYMEM OVAL #3,30050013,CDM,,,270,RC,outpatient,,198.08,198.08,,168.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.52,22,,percent of total billed charges,,,,,,,,,178.27,90,,percent of total billed charges,,,164.01,82.8,,percent of total billed charges,,,168.37,85,,percent of total billed charges,,,,,,,,,174.31,88,,percent of total billed charges,,,,,,,,,151.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.52,22,,percent of total billed charges,,,180.25,91,,percent of total billed charges,,,188.18,95,,percent of total billed charges,,,164.41,83,,percent of total billed charges,,,164.41,83,,percent of total billed charges,,,,,,,,,,,,,,,164.41,83,,percent of total billed charges,,,188.18,95,,percent of total billed charges,,,178.27,90,,percent of total billed charges,,,178.27,90,,percent of total billed charges,,,162.43,82,,percent of total billed charges,,,178.27,90,,percent of total billed charges,,,168.37,85,,percent of total billed charges,,49.52,188.18,
PLEURX PERITONEAL KIT & CATHETER,30050027,CDM,,,270,RC,outpatient,,5512,5512,,4679.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1378,22,,percent of total billed charges,,,,,,,,,4960.8,90,,percent of total billed charges,,,4563.94,82.8,,percent of total billed charges,,,4685.2,85,,percent of total billed charges,,,,,,,,,4850.56,88,,percent of total billed charges,,,,,,,,,4211.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1378,22,,percent of total billed charges,,,5015.92,91,,percent of total billed charges,,,5236.4,95,,percent of total billed charges,,,4574.96,83,,percent of total billed charges,,,4574.96,83,,percent of total billed charges,,,,,,,,,,,,,,,4574.96,83,,percent of total billed charges,,,5236.4,95,,percent of total billed charges,,,4960.8,90,,percent of total billed charges,,,4960.8,90,,percent of total billed charges,,,4519.84,82,,percent of total billed charges,,,4960.8,90,,percent of total billed charges,,,4685.2,85,,percent of total billed charges,,1378,5236.4,
PLEURX  PERITONEAL CATHETER,30050028,CDM,,,270,RC,outpatient,,5484.38,5484.38,,4656.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1371.1,22,,percent of total billed charges,,,,,,,,,4935.94,90,,percent of total billed charges,,,4541.07,82.8,,percent of total billed charges,,,4661.72,85,,percent of total billed charges,,,,,,,,,4826.25,88,,percent of total billed charges,,,,,,,,,4190.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1371.1,22,,percent of total billed charges,,,4990.79,91,,percent of total billed charges,,,5210.16,95,,percent of total billed charges,,,4552.04,83,,percent of total billed charges,,,4552.04,83,,percent of total billed charges,,,,,,,,,,,,,,,4552.04,83,,percent of total billed charges,,,5210.16,95,,percent of total billed charges,,,4935.94,90,,percent of total billed charges,,,4935.94,90,,percent of total billed charges,,,4497.19,82,,percent of total billed charges,,,4935.94,90,,percent of total billed charges,,,4661.72,85,,percent of total billed charges,,1371.1,5210.16,
*SENSOR SPO2 NEONATAL,30080003,CDM,,,270,RC,outpatient,,142.8,142.8,,121.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.7,22,,percent of total billed charges,,,,,,,,,128.52,90,,percent of total billed charges,,,118.24,82.8,,percent of total billed charges,,,121.38,85,,percent of total billed charges,,,,,,,,,125.66,88,,percent of total billed charges,,,,,,,,,109.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.7,22,,percent of total billed charges,,,129.95,91,,percent of total billed charges,,,135.66,95,,percent of total billed charges,,,118.52,83,,percent of total billed charges,,,118.52,83,,percent of total billed charges,,,,,,,,,,,,,,,118.52,83,,percent of total billed charges,,,135.66,95,,percent of total billed charges,,,128.52,90,,percent of total billed charges,,,128.52,90,,percent of total billed charges,,,117.1,82,,percent of total billed charges,,,128.52,90,,percent of total billed charges,,,121.38,85,,percent of total billed charges,,35.7,135.66,
*OBSTETRICAL VACUUM DELIVERY KIT 60MM,30080026,CDM,,,270,RC,outpatient,,168,168,,142.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42,22,,percent of total billed charges,,,,,,,,,151.2,90,,percent of total billed charges,,,139.1,82.8,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,,,,,,,,147.84,88,,percent of total billed charges,,,,,,,,,128.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42,22,,percent of total billed charges,,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,,,,,,,,,,,,,139.44,83,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,137.76,82,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,42,159.6,
INTRAUTERINE PRESSURE MONITOR - INTRON,30080031,CDM,,,270,RC,outpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.25,22,,percent of total billed charges,,,,,,,,,202.5,90,,percent of total billed charges,,,186.3,82.8,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.25,22,,percent of total billed charges,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,56.25,213.75,
BREAST PUMP ACCESSORY KIT,30080039,CDM,,,270,RC,outpatient,,191.42,191.42,,162.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.86,22,,percent of total billed charges,,,,,,,,,172.28,90,,percent of total billed charges,,,158.5,82.8,,percent of total billed charges,,,162.71,85,,percent of total billed charges,,,,,,,,,168.45,88,,percent of total billed charges,,,,,,,,,146.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.86,22,,percent of total billed charges,,,174.19,91,,percent of total billed charges,,,181.85,95,,percent of total billed charges,,,158.88,83,,percent of total billed charges,,,158.88,83,,percent of total billed charges,,,,,,,,,,,,,,,158.88,83,,percent of total billed charges,,,181.85,95,,percent of total billed charges,,,172.28,90,,percent of total billed charges,,,172.28,90,,percent of total billed charges,,,156.96,82,,percent of total billed charges,,,172.28,90,,percent of total billed charges,,,162.71,85,,percent of total billed charges,,47.86,181.85,
NIPPLE SHIELD CONTACT 20MM,30080052,CDM,,,270,RC,outpatient,,36.63,36.63,,31.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.16,22,,percent of total billed charges,,,,,,,,,32.97,90,,percent of total billed charges,,,30.33,82.8,,percent of total billed charges,,,31.14,85,,percent of total billed charges,,,,,,,,,32.23,88,,percent of total billed charges,,,,,,,,,27.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.16,22,,percent of total billed charges,,,33.33,91,,percent of total billed charges,,,34.8,95,,percent of total billed charges,,,30.4,83,,percent of total billed charges,,,30.4,83,,percent of total billed charges,,,,,,,,,,,,,,,30.4,83,,percent of total billed charges,,,34.8,95,,percent of total billed charges,,,32.97,90,,percent of total billed charges,,,32.97,90,,percent of total billed charges,,,30.04,82,,percent of total billed charges,,,32.97,90,,percent of total billed charges,,,31.14,85,,percent of total billed charges,,9.16,34.8,
*ELECTRODE ECG SMART TRACE NEO/PED,30080056,CDM,,,270,RC,outpatient,,29.07,29.07,,24.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.27,22,,percent of total billed charges,,,,,,,,,26.16,90,,percent of total billed charges,,,24.07,82.8,,percent of total billed charges,,,24.71,85,,percent of total billed charges,,,,,,,,,25.58,88,,percent of total billed charges,,,,,,,,,22.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.27,22,,percent of total billed charges,,,26.45,91,,percent of total billed charges,,,27.62,95,,percent of total billed charges,,,24.13,83,,percent of total billed charges,,,24.13,83,,percent of total billed charges,,,,,,,,,,,,,,,24.13,83,,percent of total billed charges,,,27.62,95,,percent of total billed charges,,,26.16,90,,percent of total billed charges,,,26.16,90,,percent of total billed charges,,,23.84,82,,percent of total billed charges,,,26.16,90,,percent of total billed charges,,,24.71,85,,percent of total billed charges,,7.27,27.62,
MASK CPAP NEONATE 50MM DISPOSABLE,30080057,CDM,,,270,RC,outpatient,,52.19,52.19,,44.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.05,22,,percent of total billed charges,,,,,,,,,46.97,90,,percent of total billed charges,,,43.21,82.8,,percent of total billed charges,,,44.36,85,,percent of total billed charges,,,,,,,,,45.93,88,,percent of total billed charges,,,,,,,,,39.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.05,22,,percent of total billed charges,,,47.49,91,,percent of total billed charges,,,49.58,95,,percent of total billed charges,,,43.32,83,,percent of total billed charges,,,43.32,83,,percent of total billed charges,,,,,,,,,,,,,,,43.32,83,,percent of total billed charges,,,49.58,95,,percent of total billed charges,,,46.97,90,,percent of total billed charges,,,46.97,90,,percent of total billed charges,,,42.8,82,,percent of total billed charges,,,46.97,90,,percent of total billed charges,,,44.36,85,,percent of total billed charges,,13.05,49.58,
MASK CPAP NEONATE 60MM DISPOSABLE,30080058,CDM,,,270,RC,outpatient,,56.22,56.22,,47.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.06,22,,percent of total billed charges,,,,,,,,,50.6,90,,percent of total billed charges,,,46.55,82.8,,percent of total billed charges,,,47.79,85,,percent of total billed charges,,,,,,,,,49.47,88,,percent of total billed charges,,,,,,,,,42.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.06,22,,percent of total billed charges,,,51.16,91,,percent of total billed charges,,,53.41,95,,percent of total billed charges,,,46.66,83,,percent of total billed charges,,,46.66,83,,percent of total billed charges,,,,,,,,,,,,,,,46.66,83,,percent of total billed charges,,,53.41,95,,percent of total billed charges,,,50.6,90,,percent of total billed charges,,,50.6,90,,percent of total billed charges,,,46.1,82,,percent of total billed charges,,,50.6,90,,percent of total billed charges,,,47.79,85,,percent of total billed charges,,14.06,53.41,
KIT RESUS. T - PIECE CIRCUIT NEOPUFF,30080059,CDM,,,270,RC,outpatient,,55.25,55.25,,46.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.81,22,,percent of total billed charges,,,,,,,,,49.73,90,,percent of total billed charges,,,45.75,82.8,,percent of total billed charges,,,46.96,85,,percent of total billed charges,,,,,,,,,48.62,88,,percent of total billed charges,,,,,,,,,42.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.81,22,,percent of total billed charges,,,50.28,91,,percent of total billed charges,,,52.49,95,,percent of total billed charges,,,45.86,83,,percent of total billed charges,,,45.86,83,,percent of total billed charges,,,,,,,,,,,,,,,45.86,83,,percent of total billed charges,,,52.49,95,,percent of total billed charges,,,49.73,90,,percent of total billed charges,,,49.73,90,,percent of total billed charges,,,45.31,82,,percent of total billed charges,,,49.73,90,,percent of total billed charges,,,46.96,85,,percent of total billed charges,,13.81,52.49,
AIRWAY LMA UNIQUE SIZE 1,30080064,CDM,,,270,RC,outpatient,,114.48,114.48,,97.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.62,22,,percent of total billed charges,,,,,,,,,103.03,90,,percent of total billed charges,,,94.79,82.8,,percent of total billed charges,,,97.31,85,,percent of total billed charges,,,,,,,,,100.74,88,,percent of total billed charges,,,,,,,,,87.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.62,22,,percent of total billed charges,,,104.18,91,,percent of total billed charges,,,108.76,95,,percent of total billed charges,,,95.02,83,,percent of total billed charges,,,95.02,83,,percent of total billed charges,,,,,,,,,,,,,,,95.02,83,,percent of total billed charges,,,108.76,95,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,93.87,82,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,97.31,85,,percent of total billed charges,,28.62,108.76,
*BREAST PUMP MEDELA HARMONY MANUAL,30080065,CDM,,,270,RC,outpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
KIWI OMNICUP W/TRACTION FORCE INDICATOR,30080085,CDM,,,270,RC,outpatient,,256.8,256.8,,218.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.2,22,,percent of total billed charges,,,,,,,,,231.12,90,,percent of total billed charges,,,212.63,82.8,,percent of total billed charges,,,218.28,85,,percent of total billed charges,,,,,,,,,225.98,88,,percent of total billed charges,,,,,,,,,196.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.2,22,,percent of total billed charges,,,233.69,91,,percent of total billed charges,,,243.96,95,,percent of total billed charges,,,213.14,83,,percent of total billed charges,,,213.14,83,,percent of total billed charges,,,,,,,,,,,,,,,213.14,83,,percent of total billed charges,,,243.96,95,,percent of total billed charges,,,231.12,90,,percent of total billed charges,,,231.12,90,,percent of total billed charges,,,210.58,82,,percent of total billed charges,,,231.12,90,,percent of total billed charges,,,218.28,85,,percent of total billed charges,,64.2,243.96,
INTUBATION STYLET 2.5 - 4.5MM,30080086,CDM,,,270,RC,outpatient,,42.93,42.93,,36.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.73,22,,percent of total billed charges,,,,,,,,,38.64,90,,percent of total billed charges,,,35.55,82.8,,percent of total billed charges,,,36.49,85,,percent of total billed charges,,,,,,,,,37.78,88,,percent of total billed charges,,,,,,,,,32.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.73,22,,percent of total billed charges,,,39.07,91,,percent of total billed charges,,,40.78,95,,percent of total billed charges,,,35.63,83,,percent of total billed charges,,,35.63,83,,percent of total billed charges,,,,,,,,,,,,,,,35.63,83,,percent of total billed charges,,,40.78,95,,percent of total billed charges,,,38.64,90,,percent of total billed charges,,,38.64,90,,percent of total billed charges,,,35.2,82,,percent of total billed charges,,,38.64,90,,percent of total billed charges,,,36.49,85,,percent of total billed charges,,10.73,40.78,
QWIK CONNECT PLUS SPIRAL ELECTRODE,30080087,CDM,,,270,RC,outpatient,,31.1,31.1,,26.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.78,22,,percent of total billed charges,,,,,,,,,27.99,90,,percent of total billed charges,,,25.75,82.8,,percent of total billed charges,,,26.44,85,,percent of total billed charges,,,,,,,,,27.37,88,,percent of total billed charges,,,,,,,,,23.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.78,22,,percent of total billed charges,,,28.3,91,,percent of total billed charges,,,29.55,95,,percent of total billed charges,,,25.81,83,,percent of total billed charges,,,25.81,83,,percent of total billed charges,,,,,,,,,,,,,,,25.81,83,,percent of total billed charges,,,29.55,95,,percent of total billed charges,,,27.99,90,,percent of total billed charges,,,27.99,90,,percent of total billed charges,,,25.5,82,,percent of total billed charges,,,27.99,90,,percent of total billed charges,,,26.44,85,,percent of total billed charges,,7.78,29.55,
KOALA INTERUTERINE PRESSURE CATHETER,30080088,CDM,,,270,RC,outpatient,,299.55,299.55,,254.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.89,22,,percent of total billed charges,,,,,,,,,269.6,90,,percent of total billed charges,,,248.03,82.8,,percent of total billed charges,,,254.62,85,,percent of total billed charges,,,,,,,,,263.6,88,,percent of total billed charges,,,,,,,,,228.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.89,22,,percent of total billed charges,,,272.59,91,,percent of total billed charges,,,284.57,95,,percent of total billed charges,,,248.63,83,,percent of total billed charges,,,248.63,83,,percent of total billed charges,,,,,,,,,,,,,,,248.63,83,,percent of total billed charges,,,284.57,95,,percent of total billed charges,,,269.6,90,,percent of total billed charges,,,269.6,90,,percent of total billed charges,,,245.63,82,,percent of total billed charges,,,269.6,90,,percent of total billed charges,,,254.62,85,,percent of total billed charges,,74.89,284.57,
ELECTRODE ATTCHMENT,30080090,CDM,,,270,RC,outpatient,,3.33,3.33,,2.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.83,22,,percent of total billed charges,,,,,,,,,3,90,,percent of total billed charges,,,2.76,82.8,,percent of total billed charges,,,2.83,85,,percent of total billed charges,,,,,,,,,2.93,88,,percent of total billed charges,,,,,,,,,2.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.83,22,,percent of total billed charges,,,3.03,91,,percent of total billed charges,,,3.16,95,,percent of total billed charges,,,2.76,83,,percent of total billed charges,,,2.76,83,,percent of total billed charges,,,,,,,,,,,,,,,2.76,83,,percent of total billed charges,,,3.16,95,,percent of total billed charges,,,3,90,,percent of total billed charges,,,3,90,,percent of total billed charges,,,2.73,82,,percent of total billed charges,,,3,90,,percent of total billed charges,,,2.83,85,,percent of total billed charges,,0.83,3.16,
SMALL BORE EXTENSION SET,30080091,CDM,,,270,RC,outpatient,,17.73,17.73,,15.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.43,22,,percent of total billed charges,,,,,,,,,15.96,90,,percent of total billed charges,,,14.68,82.8,,percent of total billed charges,,,15.07,85,,percent of total billed charges,,,,,,,,,15.6,88,,percent of total billed charges,,,,,,,,,13.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.43,22,,percent of total billed charges,,,16.13,91,,percent of total billed charges,,,16.84,95,,percent of total billed charges,,,14.72,83,,percent of total billed charges,,,14.72,83,,percent of total billed charges,,,,,,,,,,,,,,,14.72,83,,percent of total billed charges,,,16.84,95,,percent of total billed charges,,,15.96,90,,percent of total billed charges,,,15.96,90,,percent of total billed charges,,,14.54,82,,percent of total billed charges,,,15.96,90,,percent of total billed charges,,,15.07,85,,percent of total billed charges,,4.43,16.84,
BALLOON TAMPANADE CATH POST PARTUM,30080096,CDM,,,270,RC,outpatient,,812,812,,689.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,203,22,,percent of total billed charges,,,,,,,,,730.8,90,,percent of total billed charges,,,672.34,82.8,,percent of total billed charges,,,690.2,85,,percent of total billed charges,,,,,,,,,714.56,88,,percent of total billed charges,,,,,,,,,620.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,203,22,,percent of total billed charges,,,738.92,91,,percent of total billed charges,,,771.4,95,,percent of total billed charges,,,673.96,83,,percent of total billed charges,,,673.96,83,,percent of total billed charges,,,,,,,,,,,,,,,673.96,83,,percent of total billed charges,,,771.4,95,,percent of total billed charges,,,730.8,90,,percent of total billed charges,,,730.8,90,,percent of total billed charges,,,665.84,82,,percent of total billed charges,,,730.8,90,,percent of total billed charges,,,690.2,85,,percent of total billed charges,,203,771.4,
NEOTECH MECONIUM ASPRIATOR,30080099,CDM,,,270,RC,outpatient,,33.41,33.41,,28.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.35,22,,percent of total billed charges,,,,,,,,,30.07,90,,percent of total billed charges,,,27.66,82.8,,percent of total billed charges,,,28.4,85,,percent of total billed charges,,,,,,,,,29.4,88,,percent of total billed charges,,,,,,,,,25.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.35,22,,percent of total billed charges,,,30.4,91,,percent of total billed charges,,,31.74,95,,percent of total billed charges,,,27.73,83,,percent of total billed charges,,,27.73,83,,percent of total billed charges,,,,,,,,,,,,,,,27.73,83,,percent of total billed charges,,,31.74,95,,percent of total billed charges,,,30.07,90,,percent of total billed charges,,,30.07,90,,percent of total billed charges,,,27.4,82,,percent of total billed charges,,,30.07,90,,percent of total billed charges,,,28.4,85,,percent of total billed charges,,8.35,31.74,
*SENSOR SPO2 INFANT,30080102,CDM,,,270,RC,outpatient,,92.43,92.43,,78.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.11,22,,percent of total billed charges,,,,,,,,,83.19,90,,percent of total billed charges,,,76.53,82.8,,percent of total billed charges,,,78.57,85,,percent of total billed charges,,,,,,,,,81.34,88,,percent of total billed charges,,,,,,,,,70.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.11,22,,percent of total billed charges,,,84.11,91,,percent of total billed charges,,,87.81,95,,percent of total billed charges,,,76.72,83,,percent of total billed charges,,,76.72,83,,percent of total billed charges,,,,,,,,,,,,,,,76.72,83,,percent of total billed charges,,,87.81,95,,percent of total billed charges,,,83.19,90,,percent of total billed charges,,,83.19,90,,percent of total billed charges,,,75.79,82,,percent of total billed charges,,,83.19,90,,percent of total billed charges,,,78.57,85,,percent of total billed charges,,23.11,87.81,
TENDERCARE HYDROGEL PADS,30080103,CDM,,,270,RC,outpatient,,10.35,10.35,,8.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.59,22,,percent of total billed charges,,,,,,,,,9.32,90,,percent of total billed charges,,,8.57,82.8,,percent of total billed charges,,,8.8,85,,percent of total billed charges,,,,,,,,,9.11,88,,percent of total billed charges,,,,,,,,,7.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.59,22,,percent of total billed charges,,,9.42,91,,percent of total billed charges,,,9.83,95,,percent of total billed charges,,,8.59,83,,percent of total billed charges,,,8.59,83,,percent of total billed charges,,,,,,,,,,,,,,,8.59,83,,percent of total billed charges,,,9.83,95,,percent of total billed charges,,,9.32,90,,percent of total billed charges,,,9.32,90,,percent of total billed charges,,,8.49,82,,percent of total billed charges,,,9.32,90,,percent of total billed charges,,,8.8,85,,percent of total billed charges,,2.59,9.83,
THERASHELLS BREAST SHELLS,30080104,CDM,,,270,RC,outpatient,,68.85,68.85,,58.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.21,22,,percent of total billed charges,,,,,,,,,61.97,90,,percent of total billed charges,,,57.01,82.8,,percent of total billed charges,,,58.52,85,,percent of total billed charges,,,,,,,,,60.59,88,,percent of total billed charges,,,,,,,,,52.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.21,22,,percent of total billed charges,,,62.65,91,,percent of total billed charges,,,65.41,95,,percent of total billed charges,,,57.15,83,,percent of total billed charges,,,57.15,83,,percent of total billed charges,,,,,,,,,,,,,,,57.15,83,,percent of total billed charges,,,65.41,95,,percent of total billed charges,,,61.97,90,,percent of total billed charges,,,61.97,90,,percent of total billed charges,,,56.46,82,,percent of total billed charges,,,61.97,90,,percent of total billed charges,,,58.52,85,,percent of total billed charges,,17.21,65.41,
FISHER&PAYKEL NEO WRAP,30080106,CDM,,,270,RC,outpatient,,23.13,23.13,,19.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.78,22,,percent of total billed charges,,,,,,,,,20.82,90,,percent of total billed charges,,,19.15,82.8,,percent of total billed charges,,,19.66,85,,percent of total billed charges,,,,,,,,,20.35,88,,percent of total billed charges,,,,,,,,,17.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.78,22,,percent of total billed charges,,,21.05,91,,percent of total billed charges,,,21.97,95,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19.2,83,,percent of total billed charges,,,21.97,95,,percent of total billed charges,,,20.82,90,,percent of total billed charges,,,20.82,90,,percent of total billed charges,,,18.97,82,,percent of total billed charges,,,20.82,90,,percent of total billed charges,,,19.66,85,,percent of total billed charges,,5.78,21.97,
COOK CERVICAL RIPENING BALLOON W/STYLET,30080115,CDM,,,270,RC,outpatient,,316.88,316.88,,269.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.22,22,,percent of total billed charges,,,,,,,,,285.19,90,,percent of total billed charges,,,262.38,82.8,,percent of total billed charges,,,269.35,85,,percent of total billed charges,,,,,,,,,278.85,88,,percent of total billed charges,,,,,,,,,242.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.22,22,,percent of total billed charges,,,288.36,91,,percent of total billed charges,,,301.04,95,,percent of total billed charges,,,263.01,83,,percent of total billed charges,,,263.01,83,,percent of total billed charges,,,,,,,,,,,,,,,263.01,83,,percent of total billed charges,,,301.04,95,,percent of total billed charges,,,285.19,90,,percent of total billed charges,,,285.19,90,,percent of total billed charges,,,259.84,82,,percent of total billed charges,,,285.19,90,,percent of total billed charges,,,269.35,85,,percent of total billed charges,,79.22,301.04,
CIRCUIT T-PIECE NEONATAL,30080119,CDM,,,270,RC,outpatient,,90.38,90.38,,76.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.6,22,,percent of total billed charges,,,,,,,,,81.34,90,,percent of total billed charges,,,74.83,82.8,,percent of total billed charges,,,76.82,85,,percent of total billed charges,,,,,,,,,79.53,88,,percent of total billed charges,,,,,,,,,69.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.6,22,,percent of total billed charges,,,82.25,91,,percent of total billed charges,,,85.86,95,,percent of total billed charges,,,75.02,83,,percent of total billed charges,,,75.02,83,,percent of total billed charges,,,,,,,,,,,,,,,75.02,83,,percent of total billed charges,,,85.86,95,,percent of total billed charges,,,81.34,90,,percent of total billed charges,,,81.34,90,,percent of total billed charges,,,74.11,82,,percent of total billed charges,,,81.34,90,,percent of total billed charges,,,76.82,85,,percent of total billed charges,,22.6,85.86,
TRANSWARMER TRANSPORT MATTRESS,30080122,CDM,,,270,RC,outpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.5,22,,percent of total billed charges,,,,,,,,,178.2,90,,percent of total billed charges,,,163.94,82.8,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.5,22,,percent of total billed charges,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,49.5,188.1,
BILIBAND EYE PROTECTION REG.,30080123,CDM,,,270,RC,outpatient,,31.43,31.43,,26.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.86,22,,percent of total billed charges,,,,,,,,,28.29,90,,percent of total billed charges,,,26.02,82.8,,percent of total billed charges,,,26.72,85,,percent of total billed charges,,,,,,,,,27.66,88,,percent of total billed charges,,,,,,,,,24.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.86,22,,percent of total billed charges,,,28.6,91,,percent of total billed charges,,,29.86,95,,percent of total billed charges,,,26.09,83,,percent of total billed charges,,,26.09,83,,percent of total billed charges,,,,,,,,,,,,,,,26.09,83,,percent of total billed charges,,,29.86,95,,percent of total billed charges,,,28.29,90,,percent of total billed charges,,,28.29,90,,percent of total billed charges,,,25.77,82,,percent of total billed charges,,,28.29,90,,percent of total billed charges,,,26.72,85,,percent of total billed charges,,7.86,29.86,
MITYSOFT BELL CUP VACUUM-ASSIST DELIVERY,30080124,CDM,,,270,RC,outpatient,,358.22,358.22,,304.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.56,22,,percent of total billed charges,,,,,,,,,322.4,90,,percent of total billed charges,,,296.61,82.8,,percent of total billed charges,,,304.49,85,,percent of total billed charges,,,,,,,,,315.23,88,,percent of total billed charges,,,,,,,,,273.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.56,22,,percent of total billed charges,,,325.98,91,,percent of total billed charges,,,340.31,95,,percent of total billed charges,,,297.32,83,,percent of total billed charges,,,297.32,83,,percent of total billed charges,,,,,,,,,,,,,,,297.32,83,,percent of total billed charges,,,340.31,95,,percent of total billed charges,,,322.4,90,,percent of total billed charges,,,322.4,90,,percent of total billed charges,,,293.74,82,,percent of total billed charges,,,322.4,90,,percent of total billed charges,,,304.49,85,,percent of total billed charges,,89.56,340.31,
TRAY UMBILICAL VENOUS CATHETER,30080126,CDM,,,270,RC,outpatient,,351.54,351.54,,298.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.89,22,,percent of total billed charges,,,,,,,,,316.39,90,,percent of total billed charges,,,291.08,82.8,,percent of total billed charges,,,298.81,85,,percent of total billed charges,,,,,,,,,309.36,88,,percent of total billed charges,,,,,,,,,268.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.89,22,,percent of total billed charges,,,319.9,91,,percent of total billed charges,,,333.96,95,,percent of total billed charges,,,291.78,83,,percent of total billed charges,,,291.78,83,,percent of total billed charges,,,,,,,,,,,,,,,291.78,83,,percent of total billed charges,,,333.96,95,,percent of total billed charges,,,316.39,90,,percent of total billed charges,,,316.39,90,,percent of total billed charges,,,288.26,82,,percent of total billed charges,,,316.39,90,,percent of total billed charges,,,298.81,85,,percent of total billed charges,,87.89,333.96,
SENSOR SPO2 INF-3,30080129,CDM,,,270,RC,outpatient,,163.3,163.3,,138.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.83,22,,percent of total billed charges,,,,,,,,,146.97,90,,percent of total billed charges,,,135.21,82.8,,percent of total billed charges,,,138.81,85,,percent of total billed charges,,,,,,,,,143.7,88,,percent of total billed charges,,,,,,,,,124.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.83,22,,percent of total billed charges,,,148.6,91,,percent of total billed charges,,,155.14,95,,percent of total billed charges,,,135.54,83,,percent of total billed charges,,,135.54,83,,percent of total billed charges,,,,,,,,,,,,,,,135.54,83,,percent of total billed charges,,,155.14,95,,percent of total billed charges,,,146.97,90,,percent of total billed charges,,,146.97,90,,percent of total billed charges,,,133.91,82,,percent of total billed charges,,,146.97,90,,percent of total billed charges,,,138.81,85,,percent of total billed charges,,40.83,155.14,
ELECTRODE ARRAY LABOR VIEW,30080130,CDM,,,270,RC,outpatient,,483,483,,410.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,120.75,22,,percent of total billed charges,,,,,,,,,434.7,90,,percent of total billed charges,,,399.92,82.8,,percent of total billed charges,,,410.55,85,,percent of total billed charges,,,,,,,,,425.04,88,,percent of total billed charges,,,,,,,,,369.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,120.75,22,,percent of total billed charges,,,439.53,91,,percent of total billed charges,,,458.85,95,,percent of total billed charges,,,400.89,83,,percent of total billed charges,,,400.89,83,,percent of total billed charges,,,,,,,,,,,,,,,400.89,83,,percent of total billed charges,,,458.85,95,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,396.06,82,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,410.55,85,,percent of total billed charges,,120.75,458.85,
INCENTIVE SPIROMETER,30120001,CDM,,,270,RC,outpatient,,23.2,23.2,,19.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.8,22,,percent of total billed charges,,,,,,,,,20.88,90,,percent of total billed charges,,,19.21,82.8,,percent of total billed charges,,,19.72,85,,percent of total billed charges,,,,,,,,,20.42,88,,percent of total billed charges,,,,,,,,,17.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.8,22,,percent of total billed charges,,,21.11,91,,percent of total billed charges,,,22.04,95,,percent of total billed charges,,,19.26,83,,percent of total billed charges,,,19.26,83,,percent of total billed charges,,,,,,,,,,,,,,,19.26,83,,percent of total billed charges,,,22.04,95,,percent of total billed charges,,,20.88,90,,percent of total billed charges,,,20.88,90,,percent of total billed charges,,,19.02,82,,percent of total billed charges,,,20.88,90,,percent of total billed charges,,,19.72,85,,percent of total billed charges,,5.8,22.04,
RESUSCITATOR W/ MANOMETER,30120007,CDM,,,270,RC,outpatient,,437.5,437.5,,371.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.38,22,,percent of total billed charges,,,,,,,,,393.75,90,,percent of total billed charges,,,362.25,82.8,,percent of total billed charges,,,371.88,85,,percent of total billed charges,,,,,,,,,385,88,,percent of total billed charges,,,,,,,,,334.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.38,22,,percent of total billed charges,,,398.13,91,,percent of total billed charges,,,415.63,95,,percent of total billed charges,,,363.13,83,,percent of total billed charges,,,363.13,83,,percent of total billed charges,,,,,,,,,,,,,,,363.13,83,,percent of total billed charges,,,415.63,95,,percent of total billed charges,,,393.75,90,,percent of total billed charges,,,393.75,90,,percent of total billed charges,,,358.75,82,,percent of total billed charges,,,393.75,90,,percent of total billed charges,,,371.88,85,,percent of total billed charges,,109.38,415.63,
ACAPELLA DM BLUE MOUTHPIECE,30120017,CDM,,,270,RC,outpatient,,322.5,322.5,,273.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.63,22,,percent of total billed charges,,,,,,,,,290.25,90,,percent of total billed charges,,,267.03,82.8,,percent of total billed charges,,,274.13,85,,percent of total billed charges,,,,,,,,,283.8,88,,percent of total billed charges,,,,,,,,,246.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.63,22,,percent of total billed charges,,,293.48,91,,percent of total billed charges,,,306.38,95,,percent of total billed charges,,,267.68,83,,percent of total billed charges,,,267.68,83,,percent of total billed charges,,,,,,,,,,,,,,,267.68,83,,percent of total billed charges,,,306.38,95,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,264.45,82,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,274.13,85,,percent of total billed charges,,80.63,306.38,
ACAPELLA DM GREEN MOUTHPIECE,30120018,CDM,,,270,RC,outpatient,,321.05,321.05,,272.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.26,22,,percent of total billed charges,,,,,,,,,288.95,90,,percent of total billed charges,,,265.83,82.8,,percent of total billed charges,,,272.89,85,,percent of total billed charges,,,,,,,,,282.52,88,,percent of total billed charges,,,,,,,,,245.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.26,22,,percent of total billed charges,,,292.16,91,,percent of total billed charges,,,305,95,,percent of total billed charges,,,266.47,83,,percent of total billed charges,,,266.47,83,,percent of total billed charges,,,,,,,,,,,,,,,266.47,83,,percent of total billed charges,,,305,95,,percent of total billed charges,,,288.95,90,,percent of total billed charges,,,288.95,90,,percent of total billed charges,,,263.26,82,,percent of total billed charges,,,288.95,90,,percent of total billed charges,,,272.89,85,,percent of total billed charges,,80.26,305,
HIGH FLO CAN,30120021,CDM,,,270,RC,outpatient,,26.1,26.1,,22.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.53,22,,percent of total billed charges,,,,,,,,,23.49,90,,percent of total billed charges,,,21.61,82.8,,percent of total billed charges,,,22.19,85,,percent of total billed charges,,,,,,,,,22.97,88,,percent of total billed charges,,,,,,,,,19.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.53,22,,percent of total billed charges,,,23.75,91,,percent of total billed charges,,,24.8,95,,percent of total billed charges,,,21.66,83,,percent of total billed charges,,,21.66,83,,percent of total billed charges,,,,,,,,,,,,,,,21.66,83,,percent of total billed charges,,,24.8,95,,percent of total billed charges,,,23.49,90,,percent of total billed charges,,,23.49,90,,percent of total billed charges,,,21.4,82,,percent of total billed charges,,,23.49,90,,percent of total billed charges,,,22.19,85,,percent of total billed charges,,6.53,24.8,
HIGH FLO HUM,30120022,CDM,,,270,RC,outpatient,,35.64,35.64,,30.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.91,22,,percent of total billed charges,,,,,,,,,32.08,90,,percent of total billed charges,,,29.51,82.8,,percent of total billed charges,,,30.29,85,,percent of total billed charges,,,,,,,,,31.36,88,,percent of total billed charges,,,,,,,,,27.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.91,22,,percent of total billed charges,,,32.43,91,,percent of total billed charges,,,33.86,95,,percent of total billed charges,,,29.58,83,,percent of total billed charges,,,29.58,83,,percent of total billed charges,,,,,,,,,,,,,,,29.58,83,,percent of total billed charges,,,33.86,95,,percent of total billed charges,,,32.08,90,,percent of total billed charges,,,32.08,90,,percent of total billed charges,,,29.22,82,,percent of total billed charges,,,32.08,90,,percent of total billed charges,,,30.29,85,,percent of total billed charges,,8.91,33.86,
AMBU BAG PEDIATRIC-PLUS,30120025,CDM,,,270,RC,outpatient,,191.7,191.7,,162.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.93,22,,percent of total billed charges,,,,,,,,,172.53,90,,percent of total billed charges,,,158.73,82.8,,percent of total billed charges,,,162.95,85,,percent of total billed charges,,,,,,,,,168.7,88,,percent of total billed charges,,,,,,,,,146.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.93,22,,percent of total billed charges,,,174.45,91,,percent of total billed charges,,,182.12,95,,percent of total billed charges,,,159.11,83,,percent of total billed charges,,,159.11,83,,percent of total billed charges,,,,,,,,,,,,,,,159.11,83,,percent of total billed charges,,,182.12,95,,percent of total billed charges,,,172.53,90,,percent of total billed charges,,,172.53,90,,percent of total billed charges,,,157.19,82,,percent of total billed charges,,,172.53,90,,percent of total billed charges,,,162.95,85,,percent of total billed charges,,47.93,182.12,
*MASK VENTURI DUAL DIAL ADULT,30120032,CDM,,,270,RC,outpatient,,10.17,10.17,,8.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.54,22,,percent of total billed charges,,,,,,,,,9.15,90,,percent of total billed charges,,,8.42,82.8,,percent of total billed charges,,,8.64,85,,percent of total billed charges,,,,,,,,,8.95,88,,percent of total billed charges,,,,,,,,,7.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.54,22,,percent of total billed charges,,,9.25,91,,percent of total billed charges,,,9.66,95,,percent of total billed charges,,,8.44,83,,percent of total billed charges,,,8.44,83,,percent of total billed charges,,,,,,,,,,,,,,,8.44,83,,percent of total billed charges,,,9.66,95,,percent of total billed charges,,,9.15,90,,percent of total billed charges,,,9.15,90,,percent of total billed charges,,,8.34,82,,percent of total billed charges,,,9.15,90,,percent of total billed charges,,,8.64,85,,percent of total billed charges,,2.54,9.66,
EZ PAP POSITIVE AIRWAY,30120033,CDM,,,270,RC,outpatient,,169.22,169.22,,143.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.31,22,,percent of total billed charges,,,,,,,,,152.3,90,,percent of total billed charges,,,140.11,82.8,,percent of total billed charges,,,143.84,85,,percent of total billed charges,,,,,,,,,148.91,88,,percent of total billed charges,,,,,,,,,129.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.31,22,,percent of total billed charges,,,153.99,91,,percent of total billed charges,,,160.76,95,,percent of total billed charges,,,140.45,83,,percent of total billed charges,,,140.45,83,,percent of total billed charges,,,,,,,,,,,,,,,140.45,83,,percent of total billed charges,,,160.76,95,,percent of total billed charges,,,152.3,90,,percent of total billed charges,,,152.3,90,,percent of total billed charges,,,138.76,82,,percent of total billed charges,,,152.3,90,,percent of total billed charges,,,143.84,85,,percent of total billed charges,,42.31,160.76,
HIGH-FLO SET,30120041,CDM,,,270,RC,outpatient,,25.38,25.38,,21.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.35,22,,percent of total billed charges,,,,,,,,,22.84,90,,percent of total billed charges,,,21.01,82.8,,percent of total billed charges,,,21.57,85,,percent of total billed charges,,,,,,,,,22.33,88,,percent of total billed charges,,,,,,,,,19.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.35,22,,percent of total billed charges,,,23.1,91,,percent of total billed charges,,,24.11,95,,percent of total billed charges,,,21.07,83,,percent of total billed charges,,,21.07,83,,percent of total billed charges,,,,,,,,,,,,,,,21.07,83,,percent of total billed charges,,,24.11,95,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,20.81,82,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,21.57,85,,percent of total billed charges,,6.35,24.11,
JET NEBULIZER 350ML,30120042,CDM,,,270,RC,outpatient,,14.31,14.31,,12.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.58,22,,percent of total billed charges,,,,,,,,,12.88,90,,percent of total billed charges,,,11.85,82.8,,percent of total billed charges,,,12.16,85,,percent of total billed charges,,,,,,,,,12.59,88,,percent of total billed charges,,,,,,,,,10.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.58,22,,percent of total billed charges,,,13.02,91,,percent of total billed charges,,,13.59,95,,percent of total billed charges,,,11.88,83,,percent of total billed charges,,,11.88,83,,percent of total billed charges,,,,,,,,,,,,,,,11.88,83,,percent of total billed charges,,,13.59,95,,percent of total billed charges,,,12.88,90,,percent of total billed charges,,,12.88,90,,percent of total billed charges,,,11.73,82,,percent of total billed charges,,,12.88,90,,percent of total billed charges,,,12.16,85,,percent of total billed charges,,3.58,13.59,
VENTILATORS DISPOSABLE,30120043,CDM,,,270,RC,outpatient,,575.75,575.75,,488.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,143.94,22,,percent of total billed charges,,,,,,,,,518.18,90,,percent of total billed charges,,,476.72,82.8,,percent of total billed charges,,,489.39,85,,percent of total billed charges,,,,,,,,,506.66,88,,percent of total billed charges,,,,,,,,,439.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,143.94,22,,percent of total billed charges,,,523.93,91,,percent of total billed charges,,,546.96,95,,percent of total billed charges,,,477.87,83,,percent of total billed charges,,,477.87,83,,percent of total billed charges,,,,,,,,,,,,,,,477.87,83,,percent of total billed charges,,,546.96,95,,percent of total billed charges,,,518.18,90,,percent of total billed charges,,,518.18,90,,percent of total billed charges,,,472.12,82,,percent of total billed charges,,,518.18,90,,percent of total billed charges,,,489.39,85,,percent of total billed charges,,143.94,546.96,
MASK VPAP SMALL,30120044,CDM,,,270,RC,outpatient,,207.53,207.53,,176.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.88,22,,percent of total billed charges,,,,,,,,,186.78,90,,percent of total billed charges,,,171.83,82.8,,percent of total billed charges,,,176.4,85,,percent of total billed charges,,,,,,,,,182.63,88,,percent of total billed charges,,,,,,,,,158.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.88,22,,percent of total billed charges,,,188.85,91,,percent of total billed charges,,,197.15,95,,percent of total billed charges,,,172.25,83,,percent of total billed charges,,,172.25,83,,percent of total billed charges,,,,,,,,,,,,,,,172.25,83,,percent of total billed charges,,,197.15,95,,percent of total billed charges,,,186.78,90,,percent of total billed charges,,,186.78,90,,percent of total billed charges,,,170.17,82,,percent of total billed charges,,,186.78,90,,percent of total billed charges,,,176.4,85,,percent of total billed charges,,51.88,197.15,
MASK VPAP MEDIUM,30120045,CDM,,,270,RC,outpatient,,214.65,214.65,,182.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.66,22,,percent of total billed charges,,,,,,,,,193.19,90,,percent of total billed charges,,,177.73,82.8,,percent of total billed charges,,,182.45,85,,percent of total billed charges,,,,,,,,,188.89,88,,percent of total billed charges,,,,,,,,,163.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.66,22,,percent of total billed charges,,,195.33,91,,percent of total billed charges,,,203.92,95,,percent of total billed charges,,,178.16,83,,percent of total billed charges,,,178.16,83,,percent of total billed charges,,,,,,,,,,,,,,,178.16,83,,percent of total billed charges,,,203.92,95,,percent of total billed charges,,,193.19,90,,percent of total billed charges,,,193.19,90,,percent of total billed charges,,,176.01,82,,percent of total billed charges,,,193.19,90,,percent of total billed charges,,,182.45,85,,percent of total billed charges,,53.66,203.92,
MASK VPAP LARGE,30120046,CDM,,,270,RC,outpatient,,214.65,214.65,,182.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.66,22,,percent of total billed charges,,,,,,,,,193.19,90,,percent of total billed charges,,,177.73,82.8,,percent of total billed charges,,,182.45,85,,percent of total billed charges,,,,,,,,,188.89,88,,percent of total billed charges,,,,,,,,,163.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.66,22,,percent of total billed charges,,,195.33,91,,percent of total billed charges,,,203.92,95,,percent of total billed charges,,,178.16,83,,percent of total billed charges,,,178.16,83,,percent of total billed charges,,,,,,,,,,,,,,,178.16,83,,percent of total billed charges,,,203.92,95,,percent of total billed charges,,,193.19,90,,percent of total billed charges,,,193.19,90,,percent of total billed charges,,,176.01,82,,percent of total billed charges,,,193.19,90,,percent of total billed charges,,,182.45,85,,percent of total billed charges,,53.66,203.92,
VPAP CIRCUIT,30120047,CDM,,,270,RC,outpatient,,63.75,63.75,,54.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.94,22,,percent of total billed charges,,,,,,,,,57.38,90,,percent of total billed charges,,,52.79,82.8,,percent of total billed charges,,,54.19,85,,percent of total billed charges,,,,,,,,,56.1,88,,percent of total billed charges,,,,,,,,,48.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.94,22,,percent of total billed charges,,,58.01,91,,percent of total billed charges,,,60.56,95,,percent of total billed charges,,,52.91,83,,percent of total billed charges,,,52.91,83,,percent of total billed charges,,,,,,,,,,,,,,,52.91,83,,percent of total billed charges,,,60.56,95,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,52.28,82,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,54.19,85,,percent of total billed charges,,15.94,60.56,
MASK FACE TENT DISP,30120049,CDM,,,270,RC,outpatient,,4.68,4.68,,3.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.17,22,,percent of total billed charges,,,,,,,,,4.21,90,,percent of total billed charges,,,3.88,82.8,,percent of total billed charges,,,3.98,85,,percent of total billed charges,,,,,,,,,4.12,88,,percent of total billed charges,,,,,,,,,3.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.17,22,,percent of total billed charges,,,4.26,91,,percent of total billed charges,,,4.45,95,,percent of total billed charges,,,3.88,83,,percent of total billed charges,,,3.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3.88,83,,percent of total billed charges,,,4.45,95,,percent of total billed charges,,,4.21,90,,percent of total billed charges,,,4.21,90,,percent of total billed charges,,,3.84,82,,percent of total billed charges,,,4.21,90,,percent of total billed charges,,,3.98,85,,percent of total billed charges,,1.17,4.45,
MASK AERO UNDER CHIN PEDIATRIC ELONG.,30120055,CDM,,,270,RC,outpatient,,4.23,4.23,,3.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.06,22,,percent of total billed charges,,,,,,,,,3.81,90,,percent of total billed charges,,,3.5,82.8,,percent of total billed charges,,,3.6,85,,percent of total billed charges,,,,,,,,,3.72,88,,percent of total billed charges,,,,,,,,,3.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.06,22,,percent of total billed charges,,,3.85,91,,percent of total billed charges,,,4.02,95,,percent of total billed charges,,,3.51,83,,percent of total billed charges,,,3.51,83,,percent of total billed charges,,,,,,,,,,,,,,,3.51,83,,percent of total billed charges,,,4.02,95,,percent of total billed charges,,,3.81,90,,percent of total billed charges,,,3.81,90,,percent of total billed charges,,,3.47,82,,percent of total billed charges,,,3.81,90,,percent of total billed charges,,,3.6,85,,percent of total billed charges,,1.06,4.02,
NASAL ASPIRATOR DEVICE,30120056,CDM,,,270,RC,outpatient,,17.19,17.19,,14.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.3,22,,percent of total billed charges,,,,,,,,,15.47,90,,percent of total billed charges,,,14.23,82.8,,percent of total billed charges,,,14.61,85,,percent of total billed charges,,,,,,,,,15.13,88,,percent of total billed charges,,,,,,,,,13.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.3,22,,percent of total billed charges,,,15.64,91,,percent of total billed charges,,,16.33,95,,percent of total billed charges,,,14.27,83,,percent of total billed charges,,,14.27,83,,percent of total billed charges,,,,,,,,,,,,,,,14.27,83,,percent of total billed charges,,,16.33,95,,percent of total billed charges,,,15.47,90,,percent of total billed charges,,,15.47,90,,percent of total billed charges,,,14.1,82,,percent of total billed charges,,,15.47,90,,percent of total billed charges,,,14.61,85,,percent of total billed charges,,4.3,16.33,
EZ PAP SYSTEM W/MEDIUM MASK,30120057,CDM,,,270,RC,outpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,44,167.2,
EZ PAP SYSTEM W/MOUTHPIECE,30120058,CDM,,,270,RC,outpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50,22,,percent of total billed charges,,,,,,,,,180,90,,percent of total billed charges,,,165.6,82.8,,percent of total billed charges,,,170,85,,percent of total billed charges,,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50,22,,percent of total billed charges,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,50,190,
HME FILTER W/GAS SAMPLING PORT,30120059,CDM,,,270,RC,outpatient,,17.1,17.1,,14.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.28,22,,percent of total billed charges,,,,,,,,,15.39,90,,percent of total billed charges,,,14.16,82.8,,percent of total billed charges,,,14.54,85,,percent of total billed charges,,,,,,,,,15.05,88,,percent of total billed charges,,,,,,,,,13.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.28,22,,percent of total billed charges,,,15.56,91,,percent of total billed charges,,,16.25,95,,percent of total billed charges,,,14.19,83,,percent of total billed charges,,,14.19,83,,percent of total billed charges,,,,,,,,,,,,,,,14.19,83,,percent of total billed charges,,,16.25,95,,percent of total billed charges,,,15.39,90,,percent of total billed charges,,,15.39,90,,percent of total billed charges,,,14.02,82,,percent of total billed charges,,,15.39,90,,percent of total billed charges,,,14.54,85,,percent of total billed charges,,4.28,16.25,
MASK NEBULIZER SYSTEM ADULT,30120060,CDM,,,270,RC,outpatient,,107.28,107.28,,91.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.82,22,,percent of total billed charges,,,,,,,,,96.55,90,,percent of total billed charges,,,88.83,82.8,,percent of total billed charges,,,91.19,85,,percent of total billed charges,,,,,,,,,94.41,88,,percent of total billed charges,,,,,,,,,81.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.82,22,,percent of total billed charges,,,97.62,91,,percent of total billed charges,,,101.92,95,,percent of total billed charges,,,89.04,83,,percent of total billed charges,,,89.04,83,,percent of total billed charges,,,,,,,,,,,,,,,89.04,83,,percent of total billed charges,,,101.92,95,,percent of total billed charges,,,96.55,90,,percent of total billed charges,,,96.55,90,,percent of total billed charges,,,87.97,82,,percent of total billed charges,,,96.55,90,,percent of total billed charges,,,91.19,85,,percent of total billed charges,,26.82,101.92,
*HEART NEB CIRCUIT,30120061,CDM,,,270,RC,outpatient,,53.72,53.72,,45.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.43,22,,percent of total billed charges,,,,,,,,,48.35,90,,percent of total billed charges,,,44.48,82.8,,percent of total billed charges,,,45.66,85,,percent of total billed charges,,,,,,,,,47.27,88,,percent of total billed charges,,,,,,,,,41.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.43,22,,percent of total billed charges,,,48.89,91,,percent of total billed charges,,,51.03,95,,percent of total billed charges,,,44.59,83,,percent of total billed charges,,,44.59,83,,percent of total billed charges,,,,,,,,,,,,,,,44.59,83,,percent of total billed charges,,,51.03,95,,percent of total billed charges,,,48.35,90,,percent of total billed charges,,,48.35,90,,percent of total billed charges,,,44.05,82,,percent of total billed charges,,,48.35,90,,percent of total billed charges,,,45.66,85,,percent of total billed charges,,13.43,51.03,
SENSOR FINGER NEONATE,30120062,CDM,,,270,RC,outpatient,,83.9,83.9,,71.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.98,22,,percent of total billed charges,,,,,,,,,75.51,90,,percent of total billed charges,,,69.47,82.8,,percent of total billed charges,,,71.32,85,,percent of total billed charges,,,,,,,,,73.83,88,,percent of total billed charges,,,,,,,,,64.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.98,22,,percent of total billed charges,,,76.35,91,,percent of total billed charges,,,79.71,95,,percent of total billed charges,,,69.64,83,,percent of total billed charges,,,69.64,83,,percent of total billed charges,,,,,,,,,,,,,,,69.64,83,,percent of total billed charges,,,79.71,95,,percent of total billed charges,,,75.51,90,,percent of total billed charges,,,75.51,90,,percent of total billed charges,,,68.8,82,,percent of total billed charges,,,75.51,90,,percent of total billed charges,,,71.32,85,,percent of total billed charges,,20.98,79.71,
MASK BIPAP/CPAP ADULT MED. FULL FACE,30120064,CDM,,,270,RC,outpatient,,197.63,197.63,,167.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.41,22,,percent of total billed charges,,,,,,,,,177.87,90,,percent of total billed charges,,,163.64,82.8,,percent of total billed charges,,,167.99,85,,percent of total billed charges,,,,,,,,,173.91,88,,percent of total billed charges,,,,,,,,,150.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.41,22,,percent of total billed charges,,,179.84,91,,percent of total billed charges,,,187.75,95,,percent of total billed charges,,,164.03,83,,percent of total billed charges,,,164.03,83,,percent of total billed charges,,,,,,,,,,,,,,,164.03,83,,percent of total billed charges,,,187.75,95,,percent of total billed charges,,,177.87,90,,percent of total billed charges,,,177.87,90,,percent of total billed charges,,,162.06,82,,percent of total billed charges,,,177.87,90,,percent of total billed charges,,,167.99,85,,percent of total billed charges,,49.41,187.75,
VENT CROSSVENT CIR,30120065,CDM,,,270,RC,outpatient,,79.48,79.48,,67.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.87,22,,percent of total billed charges,,,,,,,,,71.53,90,,percent of total billed charges,,,65.81,82.8,,percent of total billed charges,,,67.56,85,,percent of total billed charges,,,,,,,,,69.94,88,,percent of total billed charges,,,,,,,,,60.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.87,22,,percent of total billed charges,,,72.33,91,,percent of total billed charges,,,75.51,95,,percent of total billed charges,,,65.97,83,,percent of total billed charges,,,65.97,83,,percent of total billed charges,,,,,,,,,,,,,,,65.97,83,,percent of total billed charges,,,75.51,95,,percent of total billed charges,,,71.53,90,,percent of total billed charges,,,71.53,90,,percent of total billed charges,,,65.17,82,,percent of total billed charges,,,71.53,90,,percent of total billed charges,,,67.56,85,,percent of total billed charges,,19.87,75.51,
VENT VISION MASK S,30120068,CDM,,,270,RC,outpatient,,197.63,197.63,,167.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.41,22,,percent of total billed charges,,,,,,,,,177.87,90,,percent of total billed charges,,,163.64,82.8,,percent of total billed charges,,,167.99,85,,percent of total billed charges,,,,,,,,,173.91,88,,percent of total billed charges,,,,,,,,,150.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.41,22,,percent of total billed charges,,,179.84,91,,percent of total billed charges,,,187.75,95,,percent of total billed charges,,,164.03,83,,percent of total billed charges,,,164.03,83,,percent of total billed charges,,,,,,,,,,,,,,,164.03,83,,percent of total billed charges,,,187.75,95,,percent of total billed charges,,,177.87,90,,percent of total billed charges,,,177.87,90,,percent of total billed charges,,,162.06,82,,percent of total billed charges,,,177.87,90,,percent of total billed charges,,,167.99,85,,percent of total billed charges,,49.41,187.75,
VENT VISION MASK M,30120069,CDM,,,270,RC,outpatient,,197.7,197.7,,167.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.43,22,,percent of total billed charges,,,,,,,,,177.93,90,,percent of total billed charges,,,163.7,82.8,,percent of total billed charges,,,168.05,85,,percent of total billed charges,,,,,,,,,173.98,88,,percent of total billed charges,,,,,,,,,151.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.43,22,,percent of total billed charges,,,179.91,91,,percent of total billed charges,,,187.82,95,,percent of total billed charges,,,164.09,83,,percent of total billed charges,,,164.09,83,,percent of total billed charges,,,,,,,,,,,,,,,164.09,83,,percent of total billed charges,,,187.82,95,,percent of total billed charges,,,177.93,90,,percent of total billed charges,,,177.93,90,,percent of total billed charges,,,162.11,82,,percent of total billed charges,,,177.93,90,,percent of total billed charges,,,168.05,85,,percent of total billed charges,,49.43,187.82,
VENT VISION MASK L,30120070,CDM,,,270,RC,outpatient,,211.88,211.88,,179.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.97,22,,percent of total billed charges,,,,,,,,,190.69,90,,percent of total billed charges,,,175.44,82.8,,percent of total billed charges,,,180.1,85,,percent of total billed charges,,,,,,,,,186.45,88,,percent of total billed charges,,,,,,,,,161.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.97,22,,percent of total billed charges,,,192.81,91,,percent of total billed charges,,,201.29,95,,percent of total billed charges,,,175.86,83,,percent of total billed charges,,,175.86,83,,percent of total billed charges,,,,,,,,,,,,,,,175.86,83,,percent of total billed charges,,,201.29,95,,percent of total billed charges,,,190.69,90,,percent of total billed charges,,,190.69,90,,percent of total billed charges,,,173.74,82,,percent of total billed charges,,,190.69,90,,percent of total billed charges,,,180.1,85,,percent of total billed charges,,52.97,201.29,
VENT VISION CIRCUIT,30120071,CDM,,,270,RC,outpatient,,96.8,96.8,,82.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.2,22,,percent of total billed charges,,,,,,,,,87.12,90,,percent of total billed charges,,,80.15,82.8,,percent of total billed charges,,,82.28,85,,percent of total billed charges,,,,,,,,,85.18,88,,percent of total billed charges,,,,,,,,,73.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.2,22,,percent of total billed charges,,,88.09,91,,percent of total billed charges,,,91.96,95,,percent of total billed charges,,,80.34,83,,percent of total billed charges,,,80.34,83,,percent of total billed charges,,,,,,,,,,,,,,,80.34,83,,percent of total billed charges,,,91.96,95,,percent of total billed charges,,,87.12,90,,percent of total billed charges,,,87.12,90,,percent of total billed charges,,,79.38,82,,percent of total billed charges,,,87.12,90,,percent of total billed charges,,,82.28,85,,percent of total billed charges,,24.2,91.96,
MASK AERO CHAMBER SM,30120073,CDM,,,270,RC,outpatient,,107.68,107.68,,91.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.92,22,,percent of total billed charges,,,,,,,,,96.91,90,,percent of total billed charges,,,89.16,82.8,,percent of total billed charges,,,91.53,85,,percent of total billed charges,,,,,,,,,94.76,88,,percent of total billed charges,,,,,,,,,82.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.92,22,,percent of total billed charges,,,97.99,91,,percent of total billed charges,,,102.3,95,,percent of total billed charges,,,89.37,83,,percent of total billed charges,,,89.37,83,,percent of total billed charges,,,,,,,,,,,,,,,89.37,83,,percent of total billed charges,,,102.3,95,,percent of total billed charges,,,96.91,90,,percent of total billed charges,,,96.91,90,,percent of total billed charges,,,88.3,82,,percent of total billed charges,,,96.91,90,,percent of total billed charges,,,91.53,85,,percent of total billed charges,,26.92,102.3,
MASK AERO CHAMBER MED,30120074,CDM,,,270,RC,outpatient,,107.68,107.68,,91.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.92,22,,percent of total billed charges,,,,,,,,,96.91,90,,percent of total billed charges,,,89.16,82.8,,percent of total billed charges,,,91.53,85,,percent of total billed charges,,,,,,,,,94.76,88,,percent of total billed charges,,,,,,,,,82.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.92,22,,percent of total billed charges,,,97.99,91,,percent of total billed charges,,,102.3,95,,percent of total billed charges,,,89.37,83,,percent of total billed charges,,,89.37,83,,percent of total billed charges,,,,,,,,,,,,,,,89.37,83,,percent of total billed charges,,,102.3,95,,percent of total billed charges,,,96.91,90,,percent of total billed charges,,,96.91,90,,percent of total billed charges,,,88.3,82,,percent of total billed charges,,,96.91,90,,percent of total billed charges,,,91.53,85,,percent of total billed charges,,26.92,102.3,
MASK AERO CHAMBER LGE,30120075,CDM,,,270,RC,outpatient,,111.12,111.12,,94.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.78,22,,percent of total billed charges,,,,,,,,,100.01,90,,percent of total billed charges,,,92.01,82.8,,percent of total billed charges,,,94.45,85,,percent of total billed charges,,,,,,,,,97.79,88,,percent of total billed charges,,,,,,,,,84.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.78,22,,percent of total billed charges,,,101.12,91,,percent of total billed charges,,,105.56,95,,percent of total billed charges,,,92.23,83,,percent of total billed charges,,,92.23,83,,percent of total billed charges,,,,,,,,,,,,,,,92.23,83,,percent of total billed charges,,,105.56,95,,percent of total billed charges,,,100.01,90,,percent of total billed charges,,,100.01,90,,percent of total billed charges,,,91.12,82,,percent of total billed charges,,,100.01,90,,percent of total billed charges,,,94.45,85,,percent of total billed charges,,27.78,105.56,
MASK OXYMASK ADULT PLUS,30120078,CDM,,,270,RC,outpatient,,38.94,38.94,,33.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.74,22,,percent of total billed charges,,,,,,,,,35.05,90,,percent of total billed charges,,,32.24,82.8,,percent of total billed charges,,,33.1,85,,percent of total billed charges,,,,,,,,,34.27,88,,percent of total billed charges,,,,,,,,,29.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.74,22,,percent of total billed charges,,,35.44,91,,percent of total billed charges,,,36.99,95,,percent of total billed charges,,,32.32,83,,percent of total billed charges,,,32.32,83,,percent of total billed charges,,,,,,,,,,,,,,,32.32,83,,percent of total billed charges,,,36.99,95,,percent of total billed charges,,,35.05,90,,percent of total billed charges,,,35.05,90,,percent of total billed charges,,,31.93,82,,percent of total billed charges,,,35.05,90,,percent of total billed charges,,,33.1,85,,percent of total billed charges,,9.74,36.99,
TRACHE TEE OXYGENATOR,30120079,CDM,,,270,RC,outpatient,,5.9,5.9,,5.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.48,22,,percent of total billed charges,,,,,,,,,5.31,90,,percent of total billed charges,,,4.89,82.8,,percent of total billed charges,,,5.02,85,,percent of total billed charges,,,,,,,,,5.19,88,,percent of total billed charges,,,,,,,,,4.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.48,22,,percent of total billed charges,,,5.37,91,,percent of total billed charges,,,5.61,95,,percent of total billed charges,,,4.9,83,,percent of total billed charges,,,4.9,83,,percent of total billed charges,,,,,,,,,,,,,,,4.9,83,,percent of total billed charges,,,5.61,95,,percent of total billed charges,,,5.31,90,,percent of total billed charges,,,5.31,90,,percent of total billed charges,,,4.84,82,,percent of total billed charges,,,5.31,90,,percent of total billed charges,,,5.02,85,,percent of total billed charges,,1.48,5.61,
BREATHING CIRCUIT FOR IVENT 201,30120081,CDM,,,270,RC,outpatient,,109.51,109.51,,92.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.38,22,,percent of total billed charges,,,,,,,,,98.56,90,,percent of total billed charges,,,90.67,82.8,,percent of total billed charges,,,93.08,85,,percent of total billed charges,,,,,,,,,96.37,88,,percent of total billed charges,,,,,,,,,83.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.38,22,,percent of total billed charges,,,99.65,91,,percent of total billed charges,,,104.03,95,,percent of total billed charges,,,90.89,83,,percent of total billed charges,,,90.89,83,,percent of total billed charges,,,,,,,,,,,,,,,90.89,83,,percent of total billed charges,,,104.03,95,,percent of total billed charges,,,98.56,90,,percent of total billed charges,,,98.56,90,,percent of total billed charges,,,89.8,82,,percent of total billed charges,,,98.56,90,,percent of total billed charges,,,93.08,85,,percent of total billed charges,,27.38,104.03,
VENT VISION MASK LARGE,30120082,CDM,,,270,RC,outpatient,,54.78,54.78,,46.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.7,22,,percent of total billed charges,,,,,,,,,49.3,90,,percent of total billed charges,,,45.36,82.8,,percent of total billed charges,,,46.56,85,,percent of total billed charges,,,,,,,,,48.21,88,,percent of total billed charges,,,,,,,,,41.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.7,22,,percent of total billed charges,,,49.85,91,,percent of total billed charges,,,52.04,95,,percent of total billed charges,,,45.47,83,,percent of total billed charges,,,45.47,83,,percent of total billed charges,,,,,,,,,,,,,,,45.47,83,,percent of total billed charges,,,52.04,95,,percent of total billed charges,,,49.3,90,,percent of total billed charges,,,49.3,90,,percent of total billed charges,,,44.92,82,,percent of total billed charges,,,49.3,90,,percent of total billed charges,,,46.56,85,,percent of total billed charges,,13.7,52.04,
ABBOTT VASCULAR SUPERA 5.5X100X120,30143000,CDM,,,278,RC,outpatient,,18713.5,18713.5,,15887.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4678.38,22,,percent of total billed charges,,,,,,,,,16842.15,90,,percent of total billed charges,,,15494.78,82.8,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,,,,,,,,16467.88,88,,percent of total billed charges,,,,,,,,,14297.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4678.38,22,,percent of total billed charges,,,17029.29,91,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,,,,,,,,,,,,,15532.21,83,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15345.07,82,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,4678.38,17777.83,
ABBOTT VASCULAR SUPERA 6X100X120,30143001,CDM,,,278,RC,outpatient,,18713.5,18713.5,,15887.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4678.38,22,,percent of total billed charges,,,,,,,,,16842.15,90,,percent of total billed charges,,,15494.78,82.8,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,,,,,,,,16467.88,88,,percent of total billed charges,,,,,,,,,14297.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4678.38,22,,percent of total billed charges,,,17029.29,91,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,,,,,,,,,,,,,15532.21,83,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15345.07,82,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,4678.38,17777.83,
ABBOTT VASCULAR SUPERA 5.5X80X120,30143002,CDM,,,278,RC,outpatient,,18713.5,18713.5,,15887.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4678.38,22,,percent of total billed charges,,,,,,,,,16842.15,90,,percent of total billed charges,,,15494.78,82.8,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,,,,,,,,16467.88,88,,percent of total billed charges,,,,,,,,,14297.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4678.38,22,,percent of total billed charges,,,17029.29,91,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,,,,,,,,,,,,,15532.21,83,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15345.07,82,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,4678.38,17777.83,
ABBOTT VASCULAR SUPERA 5.0X100X120,30143003,CDM,,,278,RC,outpatient,,18713.5,18713.5,,15887.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4678.38,22,,percent of total billed charges,,,,,,,,,16842.15,90,,percent of total billed charges,,,15494.78,82.8,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,,,,,,,,16467.88,88,,percent of total billed charges,,,,,,,,,14297.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4678.38,22,,percent of total billed charges,,,17029.29,91,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,,,,,,,,,,,,,15532.21,83,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15345.07,82,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,4678.38,17777.83,
ABBOTT VASCULAR SUPERA 6X60X120,30143004,CDM,,,278,RC,outpatient,,18713.5,18713.5,,15887.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4678.38,22,,percent of total billed charges,,,,,,,,,16842.15,90,,percent of total billed charges,,,15494.78,82.8,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,,,,,,,,16467.88,88,,percent of total billed charges,,,,,,,,,14297.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4678.38,22,,percent of total billed charges,,,17029.29,91,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,,,,,,,,,,,,,15532.21,83,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15345.07,82,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,4678.38,17777.83,
ABBOTT VASCULAR SUPERA 5.0X80X120,30143005,CDM,,,278,RC,outpatient,,17274,17274,,14665.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4318.5,22,,percent of total billed charges,,,,,,,,,15546.6,90,,percent of total billed charges,,,14302.87,82.8,,percent of total billed charges,,,14682.9,85,,percent of total billed charges,,,,,,,,,15201.12,88,,percent of total billed charges,,,,,,,,,13197.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4318.5,22,,percent of total billed charges,,,15719.34,91,,percent of total billed charges,,,16410.3,95,,percent of total billed charges,,,14337.42,83,,percent of total billed charges,,,14337.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14337.42,83,,percent of total billed charges,,,16410.3,95,,percent of total billed charges,,,15546.6,90,,percent of total billed charges,,,15546.6,90,,percent of total billed charges,,,14164.68,82,,percent of total billed charges,,,15546.6,90,,percent of total billed charges,,,14682.9,85,,percent of total billed charges,,4318.5,16410.3,
ABBOTT VASCULAR SUPERA 6X40X120,30143006,CDM,,,278,RC,outpatient,,18713.5,18713.5,,15887.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4678.38,22,,percent of total billed charges,,,,,,,,,16842.15,90,,percent of total billed charges,,,15494.78,82.8,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,,,,,,,,16467.88,88,,percent of total billed charges,,,,,,,,,14297.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4678.38,22,,percent of total billed charges,,,17029.29,91,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,,,,,,,,,,,,,15532.21,83,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15345.07,82,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,4678.38,17777.83,
AMPLATZ SNARE GOOSENECK 6X102X120X15,30143007,CDM,,,270,RC,outpatient,,2017.99,2017.99,,1713.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,504.5,22,,percent of total billed charges,,,,,,,,,1816.19,90,,percent of total billed charges,,,1670.9,82.8,,percent of total billed charges,,,1715.29,85,,percent of total billed charges,,,,,,,,,1775.83,88,,percent of total billed charges,,,,,,,,,1541.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,504.5,22,,percent of total billed charges,,,1836.37,91,,percent of total billed charges,,,1917.09,95,,percent of total billed charges,,,1674.93,83,,percent of total billed charges,,,1674.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1674.93,83,,percent of total billed charges,,,1917.09,95,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1654.75,82,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1715.29,85,,percent of total billed charges,,504.5,1917.09,
AMPLATZ SNARE GOOSENECK 6X102X120X20,30143008,CDM,,,270,RC,outpatient,,2017.99,2017.99,,1713.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,504.5,22,,percent of total billed charges,,,,,,,,,1816.19,90,,percent of total billed charges,,,1670.9,82.8,,percent of total billed charges,,,1715.29,85,,percent of total billed charges,,,,,,,,,1775.83,88,,percent of total billed charges,,,,,,,,,1541.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,504.5,22,,percent of total billed charges,,,1836.37,91,,percent of total billed charges,,,1917.09,95,,percent of total billed charges,,,1674.93,83,,percent of total billed charges,,,1674.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1674.93,83,,percent of total billed charges,,,1917.09,95,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1654.75,82,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1715.29,85,,percent of total billed charges,,504.5,1917.09,
AMPLATZ SNARE GOOSENECK 6X102X120X25,30143009,CDM,,,270,RC,outpatient,,2017.99,2017.99,,1713.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,504.5,22,,percent of total billed charges,,,,,,,,,1816.19,90,,percent of total billed charges,,,1670.9,82.8,,percent of total billed charges,,,1715.29,85,,percent of total billed charges,,,,,,,,,1775.83,88,,percent of total billed charges,,,,,,,,,1541.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,504.5,22,,percent of total billed charges,,,1836.37,91,,percent of total billed charges,,,1917.09,95,,percent of total billed charges,,,1674.93,83,,percent of total billed charges,,,1674.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1674.93,83,,percent of total billed charges,,,1917.09,95,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1654.75,82,,percent of total billed charges,,,1816.19,90,,percent of total billed charges,,,1715.29,85,,percent of total billed charges,,504.5,1917.09,
VIABAHN 7F X 6MM X 10CM,30143010,CDM,,,270,RC,outpatient,,25499.5,25499.5,,21649.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6374.88,22,,percent of total billed charges,,,,,,,,,22949.55,90,,percent of total billed charges,,,21113.59,82.8,,percent of total billed charges,,,21674.58,85,,percent of total billed charges,,,,,,,,,22439.56,88,,percent of total billed charges,,,,,,,,,19481.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6374.88,22,,percent of total billed charges,,,23204.55,91,,percent of total billed charges,,,24224.53,95,,percent of total billed charges,,,21164.59,83,,percent of total billed charges,,,21164.59,83,,percent of total billed charges,,,,,,,,,,,,,,,21164.59,83,,percent of total billed charges,,,24224.53,95,,percent of total billed charges,,,22949.55,90,,percent of total billed charges,,,22949.55,90,,percent of total billed charges,,,20909.59,82,,percent of total billed charges,,,22949.55,90,,percent of total billed charges,,,21674.58,85,,percent of total billed charges,,6374.88,24224.53,
VIABAHN 8F X 8MM X 5CM,30143011,CDM,,,270,RC,outpatient,,23712,23712,,20131.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5928,22,,percent of total billed charges,,,,,,,,,21340.8,90,,percent of total billed charges,,,19633.54,82.8,,percent of total billed charges,,,20155.2,85,,percent of total billed charges,,,,,,,,,20866.56,88,,percent of total billed charges,,,,,,,,,18115.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5928,22,,percent of total billed charges,,,21577.92,91,,percent of total billed charges,,,22526.4,95,,percent of total billed charges,,,19680.96,83,,percent of total billed charges,,,19680.96,83,,percent of total billed charges,,,,,,,,,,,,,,,19680.96,83,,percent of total billed charges,,,22526.4,95,,percent of total billed charges,,,21340.8,90,,percent of total billed charges,,,21340.8,90,,percent of total billed charges,,,19443.84,82,,percent of total billed charges,,,21340.8,90,,percent of total billed charges,,,20155.2,85,,percent of total billed charges,,5928,22526.4,
VIABAHN 8F X 10MM X 5CM,30143012,CDM,,,270,RC,outpatient,,23712,23712,,20131.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5928,22,,percent of total billed charges,,,,,,,,,21340.8,90,,percent of total billed charges,,,19633.54,82.8,,percent of total billed charges,,,20155.2,85,,percent of total billed charges,,,,,,,,,20866.56,88,,percent of total billed charges,,,,,,,,,18115.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5928,22,,percent of total billed charges,,,21577.92,91,,percent of total billed charges,,,22526.4,95,,percent of total billed charges,,,19680.96,83,,percent of total billed charges,,,19680.96,83,,percent of total billed charges,,,,,,,,,,,,,,,19680.96,83,,percent of total billed charges,,,22526.4,95,,percent of total billed charges,,,21340.8,90,,percent of total billed charges,,,21340.8,90,,percent of total billed charges,,,19443.84,82,,percent of total billed charges,,,21340.8,90,,percent of total billed charges,,,20155.2,85,,percent of total billed charges,,5928,22526.4,
VIABAHN 8F X 11MM X 59MM,30143013,CDM,,,270,RC,outpatient,,26507,26507,,22504.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6626.75,22,,percent of total billed charges,,,,,,,,,23856.3,90,,percent of total billed charges,,,21947.8,82.8,,percent of total billed charges,,,22530.95,85,,percent of total billed charges,,,,,,,,,23326.16,88,,percent of total billed charges,,,,,,,,,20251.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6626.75,22,,percent of total billed charges,,,24121.37,91,,percent of total billed charges,,,25181.65,95,,percent of total billed charges,,,22000.81,83,,percent of total billed charges,,,22000.81,83,,percent of total billed charges,,,,,,,,,,,,,,,22000.81,83,,percent of total billed charges,,,25181.65,95,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,21735.74,82,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,22530.95,85,,percent of total billed charges,,6626.75,25181.65,
VIABAHN 8F X 11MM X 79MM,30143014,CDM,,,270,RC,outpatient,,26507,26507,,22504.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6626.75,22,,percent of total billed charges,,,,,,,,,23856.3,90,,percent of total billed charges,,,21947.8,82.8,,percent of total billed charges,,,22530.95,85,,percent of total billed charges,,,,,,,,,23326.16,88,,percent of total billed charges,,,,,,,,,20251.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6626.75,22,,percent of total billed charges,,,24121.37,91,,percent of total billed charges,,,25181.65,95,,percent of total billed charges,,,22000.81,83,,percent of total billed charges,,,22000.81,83,,percent of total billed charges,,,,,,,,,,,,,,,22000.81,83,,percent of total billed charges,,,25181.65,95,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,21735.74,82,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,22530.95,85,,percent of total billed charges,,6626.75,25181.65,
ROTH FOREIGN BODY NET 2.5MM,30180002,CDM,,,270,RC,outpatient,,605.93,605.93,,514.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,151.48,22,,percent of total billed charges,,,,,,,,,545.34,90,,percent of total billed charges,,,501.71,82.8,,percent of total billed charges,,,515.04,85,,percent of total billed charges,,,,,,,,,533.22,88,,percent of total billed charges,,,,,,,,,462.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,151.48,22,,percent of total billed charges,,,551.4,91,,percent of total billed charges,,,575.63,95,,percent of total billed charges,,,502.92,83,,percent of total billed charges,,,502.92,83,,percent of total billed charges,,,,,,,,,,,,,,,502.92,83,,percent of total billed charges,,,575.63,95,,percent of total billed charges,,,545.34,90,,percent of total billed charges,,,545.34,90,,percent of total billed charges,,,496.86,82,,percent of total billed charges,,,545.34,90,,percent of total billed charges,,,515.04,85,,percent of total billed charges,,151.48,575.63,
CLO TEST,30180003,CDM,,,270,RC,outpatient,,90.18,90.18,,76.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.55,22,,percent of total billed charges,,,,,,,,,81.16,90,,percent of total billed charges,,,74.67,82.8,,percent of total billed charges,,,76.65,85,,percent of total billed charges,,,,,,,,,79.36,88,,percent of total billed charges,,,,,,,,,68.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.55,22,,percent of total billed charges,,,82.06,91,,percent of total billed charges,,,85.67,95,,percent of total billed charges,,,74.85,83,,percent of total billed charges,,,74.85,83,,percent of total billed charges,,,,,,,,,,,,,,,74.85,83,,percent of total billed charges,,,85.67,95,,percent of total billed charges,,,81.16,90,,percent of total billed charges,,,81.16,90,,percent of total billed charges,,,73.95,82,,percent of total billed charges,,,81.16,90,,percent of total billed charges,,,76.65,85,,percent of total billed charges,,22.55,85.67,
LAP CHOLE KIT,30180004,CDM,,,270,RC,outpatient,,2280.01,2280.01,,1935.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,570,22,,percent of total billed charges,,,,,,,,,2052.01,90,,percent of total billed charges,,,1887.85,82.8,,percent of total billed charges,,,1938.01,85,,percent of total billed charges,,,,,,,,,2006.41,88,,percent of total billed charges,,,,,,,,,1741.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,570,22,,percent of total billed charges,,,2074.81,91,,percent of total billed charges,,,2166.01,95,,percent of total billed charges,,,1892.41,83,,percent of total billed charges,,,1892.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1892.41,83,,percent of total billed charges,,,2166.01,95,,percent of total billed charges,,,2052.01,90,,percent of total billed charges,,,2052.01,90,,percent of total billed charges,,,1869.61,82,,percent of total billed charges,,,2052.01,90,,percent of total billed charges,,,1938.01,85,,percent of total billed charges,,570,2166.01,
TROCAR ENDO DILATING TIP 7/8,30180007,CDM,,,270,RC,outpatient,,195.04,195.04,,165.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.76,22,,percent of total billed charges,,,,,,,,,175.54,90,,percent of total billed charges,,,161.49,82.8,,percent of total billed charges,,,165.78,85,,percent of total billed charges,,,,,,,,,171.64,88,,percent of total billed charges,,,,,,,,,149.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.76,22,,percent of total billed charges,,,177.49,91,,percent of total billed charges,,,185.29,95,,percent of total billed charges,,,161.88,83,,percent of total billed charges,,,161.88,83,,percent of total billed charges,,,,,,,,,,,,,,,161.88,83,,percent of total billed charges,,,185.29,95,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,159.93,82,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,165.78,85,,percent of total billed charges,,48.76,185.29,
LIGAMAX CLIP APPLIER 5MM,30180008,CDM,,,270,RC,outpatient,,943.06,943.06,,800.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.77,22,,percent of total billed charges,,,,,,,,,848.75,90,,percent of total billed charges,,,780.85,82.8,,percent of total billed charges,,,801.6,85,,percent of total billed charges,,,,,,,,,829.89,88,,percent of total billed charges,,,,,,,,,720.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.77,22,,percent of total billed charges,,,858.18,91,,percent of total billed charges,,,895.91,95,,percent of total billed charges,,,782.74,83,,percent of total billed charges,,,782.74,83,,percent of total billed charges,,,,,,,,,,,,,,,782.74,83,,percent of total billed charges,,,895.91,95,,percent of total billed charges,,,848.75,90,,percent of total billed charges,,,848.75,90,,percent of total billed charges,,,773.31,82,,percent of total billed charges,,,848.75,90,,percent of total billed charges,,,801.6,85,,percent of total billed charges,,235.77,895.91,
STAPLER EEA INTRALUMINAL 25MM,30180009,CDM,,,270,RC,outpatient,,2023.58,2023.58,,1718.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,505.9,22,,percent of total billed charges,,,,,,,,,1821.22,90,,percent of total billed charges,,,1675.52,82.8,,percent of total billed charges,,,1720.04,85,,percent of total billed charges,,,,,,,,,1780.75,88,,percent of total billed charges,,,,,,,,,1546.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,505.9,22,,percent of total billed charges,,,1841.46,91,,percent of total billed charges,,,1922.4,95,,percent of total billed charges,,,1679.57,83,,percent of total billed charges,,,1679.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1679.57,83,,percent of total billed charges,,,1922.4,95,,percent of total billed charges,,,1821.22,90,,percent of total billed charges,,,1821.22,90,,percent of total billed charges,,,1659.34,82,,percent of total billed charges,,,1821.22,90,,percent of total billed charges,,,1720.04,85,,percent of total billed charges,,505.9,1922.4,
STAPLER EEA INTRALUMINAL 29MM,30180010,CDM,,,270,RC,outpatient,,1805.83,1805.83,,1533.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,451.46,22,,percent of total billed charges,,,,,,,,,1625.25,90,,percent of total billed charges,,,1495.23,82.8,,percent of total billed charges,,,1534.96,85,,percent of total billed charges,,,,,,,,,1589.13,88,,percent of total billed charges,,,,,,,,,1379.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,451.46,22,,percent of total billed charges,,,1643.31,91,,percent of total billed charges,,,1715.54,95,,percent of total billed charges,,,1498.84,83,,percent of total billed charges,,,1498.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1498.84,83,,percent of total billed charges,,,1715.54,95,,percent of total billed charges,,,1625.25,90,,percent of total billed charges,,,1625.25,90,,percent of total billed charges,,,1480.78,82,,percent of total billed charges,,,1625.25,90,,percent of total billed charges,,,1534.96,85,,percent of total billed charges,,451.46,1715.54,
STAPLER TA CUTTER CURVED,30180012,CDM,,,270,RC,outpatient,,2924.03,2924.03,,2482.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.01,22,,percent of total billed charges,,,,,,,,,2631.63,90,,percent of total billed charges,,,2421.1,82.8,,percent of total billed charges,,,2485.43,85,,percent of total billed charges,,,,,,,,,2573.15,88,,percent of total billed charges,,,,,,,,,2233.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.01,22,,percent of total billed charges,,,2660.87,91,,percent of total billed charges,,,2777.83,95,,percent of total billed charges,,,2426.94,83,,percent of total billed charges,,,2426.94,83,,percent of total billed charges,,,,,,,,,,,,,,,2426.94,83,,percent of total billed charges,,,2777.83,95,,percent of total billed charges,,,2631.63,90,,percent of total billed charges,,,2631.63,90,,percent of total billed charges,,,2397.7,82,,percent of total billed charges,,,2631.63,90,,percent of total billed charges,,,2485.43,85,,percent of total billed charges,,731.01,2777.83,
STAPLER LIGACLIP ENDO ERCA M/L 10MM,30180013,CDM,,,270,RC,outpatient,,597.33,597.33,,507.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149.33,22,,percent of total billed charges,,,,,,,,,537.6,90,,percent of total billed charges,,,494.59,82.8,,percent of total billed charges,,,507.73,85,,percent of total billed charges,,,,,,,,,525.65,88,,percent of total billed charges,,,,,,,,,456.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149.33,22,,percent of total billed charges,,,543.57,91,,percent of total billed charges,,,567.46,95,,percent of total billed charges,,,495.78,83,,percent of total billed charges,,,495.78,83,,percent of total billed charges,,,,,,,,,,,,,,,495.78,83,,percent of total billed charges,,,567.46,95,,percent of total billed charges,,,537.6,90,,percent of total billed charges,,,537.6,90,,percent of total billed charges,,,489.81,82,,percent of total billed charges,,,537.6,90,,percent of total billed charges,,,507.73,85,,percent of total billed charges,,149.33,567.46,
NEEDLE VERES PNEUMO 150MM,30180014,CDM,,,270,RC,outpatient,,98.88,98.88,,83.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.72,22,,percent of total billed charges,,,,,,,,,88.99,90,,percent of total billed charges,,,81.87,82.8,,percent of total billed charges,,,84.05,85,,percent of total billed charges,,,,,,,,,87.01,88,,percent of total billed charges,,,,,,,,,75.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.72,22,,percent of total billed charges,,,89.98,91,,percent of total billed charges,,,93.94,95,,percent of total billed charges,,,82.07,83,,percent of total billed charges,,,82.07,83,,percent of total billed charges,,,,,,,,,,,,,,,82.07,83,,percent of total billed charges,,,93.94,95,,percent of total billed charges,,,88.99,90,,percent of total billed charges,,,88.99,90,,percent of total billed charges,,,81.08,82,,percent of total billed charges,,,88.99,90,,percent of total billed charges,,,84.05,85,,percent of total billed charges,,24.72,93.94,
STAPLER HEMORRHOID 33MM,30180015,CDM,,,270,RC,outpatient,,2583.95,2583.95,,2193.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,645.99,22,,percent of total billed charges,,,,,,,,,2325.56,90,,percent of total billed charges,,,2139.51,82.8,,percent of total billed charges,,,2196.36,85,,percent of total billed charges,,,,,,,,,2273.88,88,,percent of total billed charges,,,,,,,,,1974.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,645.99,22,,percent of total billed charges,,,2351.39,91,,percent of total billed charges,,,2454.75,95,,percent of total billed charges,,,2144.68,83,,percent of total billed charges,,,2144.68,83,,percent of total billed charges,,,,,,,,,,,,,,,2144.68,83,,percent of total billed charges,,,2454.75,95,,percent of total billed charges,,,2325.56,90,,percent of total billed charges,,,2325.56,90,,percent of total billed charges,,,2118.84,82,,percent of total billed charges,,,2325.56,90,,percent of total billed charges,,,2196.36,85,,percent of total billed charges,,645.99,2454.75,
STAPLER GIA RELOAD 55MM,30180016,CDM,,,270,RC,outpatient,,365.19,365.19,,310.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.3,22,,percent of total billed charges,,,,,,,,,328.67,90,,percent of total billed charges,,,302.38,82.8,,percent of total billed charges,,,310.41,85,,percent of total billed charges,,,,,,,,,321.37,88,,percent of total billed charges,,,,,,,,,279.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.3,22,,percent of total billed charges,,,332.32,91,,percent of total billed charges,,,346.93,95,,percent of total billed charges,,,303.11,83,,percent of total billed charges,,,303.11,83,,percent of total billed charges,,,,,,,,,,,,,,,303.11,83,,percent of total billed charges,,,346.93,95,,percent of total billed charges,,,328.67,90,,percent of total billed charges,,,328.67,90,,percent of total billed charges,,,299.46,82,,percent of total billed charges,,,328.67,90,,percent of total billed charges,,,310.41,85,,percent of total billed charges,,91.3,346.93,
STAPLER GIA RELOAD 75MM,30180017,CDM,,,270,RC,outpatient,,514.61,514.61,,436.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,128.65,22,,percent of total billed charges,,,,,,,,,463.15,90,,percent of total billed charges,,,426.1,82.8,,percent of total billed charges,,,437.42,85,,percent of total billed charges,,,,,,,,,452.86,88,,percent of total billed charges,,,,,,,,,393.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,128.65,22,,percent of total billed charges,,,468.3,91,,percent of total billed charges,,,488.88,95,,percent of total billed charges,,,427.13,83,,percent of total billed charges,,,427.13,83,,percent of total billed charges,,,,,,,,,,,,,,,427.13,83,,percent of total billed charges,,,488.88,95,,percent of total billed charges,,,463.15,90,,percent of total billed charges,,,463.15,90,,percent of total billed charges,,,421.98,82,,percent of total billed charges,,,463.15,90,,percent of total billed charges,,,437.42,85,,percent of total billed charges,,128.65,488.88,
STAPLER GIA CUTTER 75MM,30180019,CDM,,,270,RC,outpatient,,896.07,896.07,,760.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,224.02,22,,percent of total billed charges,,,,,,,,,806.46,90,,percent of total billed charges,,,741.95,82.8,,percent of total billed charges,,,761.66,85,,percent of total billed charges,,,,,,,,,788.54,88,,percent of total billed charges,,,,,,,,,684.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,224.02,22,,percent of total billed charges,,,815.42,91,,percent of total billed charges,,,851.27,95,,percent of total billed charges,,,743.74,83,,percent of total billed charges,,,743.74,83,,percent of total billed charges,,,,,,,,,,,,,,,743.74,83,,percent of total billed charges,,,851.27,95,,percent of total billed charges,,,806.46,90,,percent of total billed charges,,,806.46,90,,percent of total billed charges,,,734.78,82,,percent of total billed charges,,,806.46,90,,percent of total billed charges,,,761.66,85,,percent of total billed charges,,224.02,851.27,
STAPLER GIA ENDO RELOAD 45MM THIN,30180021,CDM,,,270,RC,outpatient,,884.59,884.59,,751.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,221.15,22,,percent of total billed charges,,,,,,,,,796.13,90,,percent of total billed charges,,,732.44,82.8,,percent of total billed charges,,,751.9,85,,percent of total billed charges,,,,,,,,,778.44,88,,percent of total billed charges,,,,,,,,,675.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,221.15,22,,percent of total billed charges,,,804.98,91,,percent of total billed charges,,,840.36,95,,percent of total billed charges,,,734.21,83,,percent of total billed charges,,,734.21,83,,percent of total billed charges,,,,,,,,,,,,,,,734.21,83,,percent of total billed charges,,,840.36,95,,percent of total billed charges,,,796.13,90,,percent of total billed charges,,,796.13,90,,percent of total billed charges,,,725.36,82,,percent of total billed charges,,,796.13,90,,percent of total billed charges,,,751.9,85,,percent of total billed charges,,221.15,840.36,
STAPLER TA PROX LIN 30MM,30180024,CDM,,,270,RC,outpatient,,635.9,635.9,,539.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,158.98,22,,percent of total billed charges,,,,,,,,,572.31,90,,percent of total billed charges,,,526.53,82.8,,percent of total billed charges,,,540.52,85,,percent of total billed charges,,,,,,,,,559.59,88,,percent of total billed charges,,,,,,,,,485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,158.98,22,,percent of total billed charges,,,578.67,91,,percent of total billed charges,,,604.11,95,,percent of total billed charges,,,527.8,83,,percent of total billed charges,,,527.8,83,,percent of total billed charges,,,,,,,,,,,,,,,527.8,83,,percent of total billed charges,,,604.11,95,,percent of total billed charges,,,572.31,90,,percent of total billed charges,,,572.31,90,,percent of total billed charges,,,521.44,82,,percent of total billed charges,,,572.31,90,,percent of total billed charges,,,540.52,85,,percent of total billed charges,,158.98,604.11,
STAPLER TA PROX LIN 60MM BLUE,30180025,CDM,,,270,RC,outpatient,,645.1,645.1,,547.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,161.28,22,,percent of total billed charges,,,,,,,,,580.59,90,,percent of total billed charges,,,534.14,82.8,,percent of total billed charges,,,548.34,85,,percent of total billed charges,,,,,,,,,567.69,88,,percent of total billed charges,,,,,,,,,492.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,161.28,22,,percent of total billed charges,,,587.04,91,,percent of total billed charges,,,612.85,95,,percent of total billed charges,,,535.43,83,,percent of total billed charges,,,535.43,83,,percent of total billed charges,,,,,,,,,,,,,,,535.43,83,,percent of total billed charges,,,612.85,95,,percent of total billed charges,,,580.59,90,,percent of total billed charges,,,580.59,90,,percent of total billed charges,,,528.98,82,,percent of total billed charges,,,580.59,90,,percent of total billed charges,,,548.34,85,,percent of total billed charges,,161.28,612.85,
STAPLER TA PROX LIN 60MM GREEN,30180026,CDM,,,270,RC,outpatient,,671.86,671.86,,570.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,167.97,22,,percent of total billed charges,,,,,,,,,604.67,90,,percent of total billed charges,,,556.3,82.8,,percent of total billed charges,,,571.08,85,,percent of total billed charges,,,,,,,,,591.24,88,,percent of total billed charges,,,,,,,,,513.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,167.97,22,,percent of total billed charges,,,611.39,91,,percent of total billed charges,,,638.27,95,,percent of total billed charges,,,557.64,83,,percent of total billed charges,,,557.64,83,,percent of total billed charges,,,,,,,,,,,,,,,557.64,83,,percent of total billed charges,,,638.27,95,,percent of total billed charges,,,604.67,90,,percent of total billed charges,,,604.67,90,,percent of total billed charges,,,550.93,82,,percent of total billed charges,,,604.67,90,,percent of total billed charges,,,571.08,85,,percent of total billed charges,,167.97,638.27,
DRAIN SATATOGA SUMP 28FR,30180029,CDM,,,270,RC,outpatient,,114.96,114.96,,97.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.74,22,,percent of total billed charges,,,,,,,,,103.46,90,,percent of total billed charges,,,95.19,82.8,,percent of total billed charges,,,97.72,85,,percent of total billed charges,,,,,,,,,101.16,88,,percent of total billed charges,,,,,,,,,87.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.74,22,,percent of total billed charges,,,104.61,91,,percent of total billed charges,,,109.21,95,,percent of total billed charges,,,95.42,83,,percent of total billed charges,,,95.42,83,,percent of total billed charges,,,,,,,,,,,,,,,95.42,83,,percent of total billed charges,,,109.21,95,,percent of total billed charges,,,103.46,90,,percent of total billed charges,,,103.46,90,,percent of total billed charges,,,94.27,82,,percent of total billed charges,,,103.46,90,,percent of total billed charges,,,97.72,85,,percent of total billed charges,,28.74,109.21,
STAPLER RELOADS FOR 60MM BLUE,30180030,CDM,,,270,RC,outpatient,,355.13,355.13,,301.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.78,22,,percent of total billed charges,,,,,,,,,319.62,90,,percent of total billed charges,,,294.05,82.8,,percent of total billed charges,,,301.86,85,,percent of total billed charges,,,,,,,,,312.51,88,,percent of total billed charges,,,,,,,,,271.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.78,22,,percent of total billed charges,,,323.17,91,,percent of total billed charges,,,337.37,95,,percent of total billed charges,,,294.76,83,,percent of total billed charges,,,294.76,83,,percent of total billed charges,,,,,,,,,,,,,,,294.76,83,,percent of total billed charges,,,337.37,95,,percent of total billed charges,,,319.62,90,,percent of total billed charges,,,319.62,90,,percent of total billed charges,,,291.21,82,,percent of total billed charges,,,319.62,90,,percent of total billed charges,,,301.86,85,,percent of total billed charges,,88.78,337.37,
STAPLER TA CUTTER 90MM,30180031,CDM,,,270,RC,outpatient,,731.45,731.45,,621,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,182.86,22,,percent of total billed charges,,,,,,,,,658.31,90,,percent of total billed charges,,,605.64,82.8,,percent of total billed charges,,,621.73,85,,percent of total billed charges,,,,,,,,,643.68,88,,percent of total billed charges,,,,,,,,,558.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,182.86,22,,percent of total billed charges,,,665.62,91,,percent of total billed charges,,,694.88,95,,percent of total billed charges,,,607.1,83,,percent of total billed charges,,,607.1,83,,percent of total billed charges,,,,,,,,,,,,,,,607.1,83,,percent of total billed charges,,,694.88,95,,percent of total billed charges,,,658.31,90,,percent of total billed charges,,,658.31,90,,percent of total billed charges,,,599.79,82,,percent of total billed charges,,,658.31,90,,percent of total billed charges,,,621.73,85,,percent of total billed charges,,182.86,694.88,
FLUID WARMER COVER OPEN TOP 44 X 44,30180036,CDM,,,270,RC,outpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.25,22,,percent of total billed charges,,,,,,,,,202.5,90,,percent of total billed charges,,,186.3,82.8,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.25,22,,percent of total billed charges,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,56.25,213.75,
ENDO POUCH RETRIEVER 10MM,30180039,CDM,,,270,RC,outpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75,22,,percent of total billed charges,,,,,,,,,270,90,,percent of total billed charges,,,248.4,82.8,,percent of total billed charges,,,255,85,,percent of total billed charges,,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75,22,,percent of total billed charges,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,75,285,
LAPAFLATOR TUBING HIGH FLOW,30180051,CDM,,,270,RC,outpatient,,63.75,63.75,,54.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.94,22,,percent of total billed charges,,,,,,,,,57.38,90,,percent of total billed charges,,,52.79,82.8,,percent of total billed charges,,,54.19,85,,percent of total billed charges,,,,,,,,,56.1,88,,percent of total billed charges,,,,,,,,,48.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.94,22,,percent of total billed charges,,,58.01,91,,percent of total billed charges,,,60.56,95,,percent of total billed charges,,,52.91,83,,percent of total billed charges,,,52.91,83,,percent of total billed charges,,,,,,,,,,,,,,,52.91,83,,percent of total billed charges,,,60.56,95,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,52.28,82,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,54.19,85,,percent of total billed charges,,15.94,60.56,
STRYKER SUCTION IRRIGATOR,30180056,CDM,,,270,RC,outpatient,,452.17,452.17,,383.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,113.04,22,,percent of total billed charges,,,,,,,,,406.95,90,,percent of total billed charges,,,374.4,82.8,,percent of total billed charges,,,384.34,85,,percent of total billed charges,,,,,,,,,397.91,88,,percent of total billed charges,,,,,,,,,345.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,113.04,22,,percent of total billed charges,,,411.47,91,,percent of total billed charges,,,429.56,95,,percent of total billed charges,,,375.3,83,,percent of total billed charges,,,375.3,83,,percent of total billed charges,,,,,,,,,,,,,,,375.3,83,,percent of total billed charges,,,429.56,95,,percent of total billed charges,,,406.95,90,,percent of total billed charges,,,406.95,90,,percent of total billed charges,,,370.78,82,,percent of total billed charges,,,406.95,90,,percent of total billed charges,,,384.34,85,,percent of total billed charges,,113.04,429.56,
LAPROSCOPIC MORCELLATOR,30180060,CDM,,,270,RC,outpatient,,3411.2,3411.2,,2896.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,852.8,22,,percent of total billed charges,,,,,,,,,3070.08,90,,percent of total billed charges,,,2824.47,82.8,,percent of total billed charges,,,2899.52,85,,percent of total billed charges,,,,,,,,,3001.86,88,,percent of total billed charges,,,,,,,,,2606.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,852.8,22,,percent of total billed charges,,,3104.19,91,,percent of total billed charges,,,3240.64,95,,percent of total billed charges,,,2831.3,83,,percent of total billed charges,,,2831.3,83,,percent of total billed charges,,,,,,,,,,,,,,,2831.3,83,,percent of total billed charges,,,3240.64,95,,percent of total billed charges,,,3070.08,90,,percent of total billed charges,,,3070.08,90,,percent of total billed charges,,,2797.18,82,,percent of total billed charges,,,3070.08,90,,percent of total billed charges,,,2899.52,85,,percent of total billed charges,,852.8,3240.64,
ELECTRODE TWIZZLE TIP,30180061,CDM,,,270,RC,outpatient,,2343.9,2343.9,,1989.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,585.98,22,,percent of total billed charges,,,,,,,,,2109.51,90,,percent of total billed charges,,,1940.75,82.8,,percent of total billed charges,,,1992.32,85,,percent of total billed charges,,,,,,,,,2062.63,88,,percent of total billed charges,,,,,,,,,1790.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,585.98,22,,percent of total billed charges,,,2132.95,91,,percent of total billed charges,,,2226.71,95,,percent of total billed charges,,,1945.44,83,,percent of total billed charges,,,1945.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1945.44,83,,percent of total billed charges,,,2226.71,95,,percent of total billed charges,,,2109.51,90,,percent of total billed charges,,,2109.51,90,,percent of total billed charges,,,1922,82,,percent of total billed charges,,,2109.51,90,,percent of total billed charges,,,1992.32,85,,percent of total billed charges,,585.98,2226.71,
ELECTRODE LOOP,30180062,CDM,,,270,RC,outpatient,,2145,2145,,1821.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,536.25,22,,percent of total billed charges,,,,,,,,,1930.5,90,,percent of total billed charges,,,1776.06,82.8,,percent of total billed charges,,,1823.25,85,,percent of total billed charges,,,,,,,,,1887.6,88,,percent of total billed charges,,,,,,,,,1638.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,536.25,22,,percent of total billed charges,,,1951.95,91,,percent of total billed charges,,,2037.75,95,,percent of total billed charges,,,1780.35,83,,percent of total billed charges,,,1780.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1780.35,83,,percent of total billed charges,,,2037.75,95,,percent of total billed charges,,,1930.5,90,,percent of total billed charges,,,1930.5,90,,percent of total billed charges,,,1758.9,82,,percent of total billed charges,,,1930.5,90,,percent of total billed charges,,,1823.25,85,,percent of total billed charges,,536.25,2037.75,
ELECTRODE 0-DEG VAPORIZING,30180063,CDM,,,270,RC,outpatient,,2607.35,2607.35,,2213.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,651.84,22,,percent of total billed charges,,,,,,,,,2346.62,90,,percent of total billed charges,,,2158.89,82.8,,percent of total billed charges,,,2216.25,85,,percent of total billed charges,,,,,,,,,2294.47,88,,percent of total billed charges,,,,,,,,,1992.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,651.84,22,,percent of total billed charges,,,2372.69,91,,percent of total billed charges,,,2476.98,95,,percent of total billed charges,,,2164.1,83,,percent of total billed charges,,,2164.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2164.1,83,,percent of total billed charges,,,2476.98,95,,percent of total billed charges,,,2346.62,90,,percent of total billed charges,,,2346.62,90,,percent of total billed charges,,,2138.03,82,,percent of total billed charges,,,2346.62,90,,percent of total billed charges,,,2216.25,85,,percent of total billed charges,,651.84,2476.98,
MESH PERFIX PLUG MEDIUM,30180070,CDM,,,270,RC,outpatient,,942.5,942.5,,800.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.63,22,,percent of total billed charges,,,,,,,,,848.25,90,,percent of total billed charges,,,780.39,82.8,,percent of total billed charges,,,801.13,85,,percent of total billed charges,,,,,,,,,829.4,88,,percent of total billed charges,,,,,,,,,720.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.63,22,,percent of total billed charges,,,857.68,91,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,,,,,,,,,,,,,782.28,83,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,772.85,82,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,801.13,85,,percent of total billed charges,,235.63,895.38,
S&N CONQUEST FX FEM COMP SZ16,30180074,CDM,,,278,RC,outpatient,,8788,8788,,7461.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2197,22,,percent of total billed charges,,,,,,,,,7909.2,90,,percent of total billed charges,,,7276.46,82.8,,percent of total billed charges,,,7469.8,85,,percent of total billed charges,,,,,,,,,7733.44,88,,percent of total billed charges,,,,,,,,,6714.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2197,22,,percent of total billed charges,,,7997.08,91,,percent of total billed charges,,,8348.6,95,,percent of total billed charges,,,7294.04,83,,percent of total billed charges,,,7294.04,83,,percent of total billed charges,,,,,,,,,,,,,,,7294.04,83,,percent of total billed charges,,,8348.6,95,,percent of total billed charges,,,7909.2,90,,percent of total billed charges,,,7909.2,90,,percent of total billed charges,,,7206.16,82,,percent of total billed charges,,,7909.2,90,,percent of total billed charges,,,7469.8,85,,percent of total billed charges,,2197,8348.6,
TROCAR ENDO BLADELESS 5MM,30180102,CDM,,,270,RC,outpatient,,195.04,195.04,,165.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.76,22,,percent of total billed charges,,,,,,,,,175.54,90,,percent of total billed charges,,,161.49,82.8,,percent of total billed charges,,,165.78,85,,percent of total billed charges,,,,,,,,,171.64,88,,percent of total billed charges,,,,,,,,,149.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.76,22,,percent of total billed charges,,,177.49,91,,percent of total billed charges,,,185.29,95,,percent of total billed charges,,,161.88,83,,percent of total billed charges,,,161.88,83,,percent of total billed charges,,,,,,,,,,,,,,,161.88,83,,percent of total billed charges,,,185.29,95,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,159.93,82,,percent of total billed charges,,,175.54,90,,percent of total billed charges,,,165.78,85,,percent of total billed charges,,48.76,185.29,
PROLIFT POSTERIOR,30180124,CDM,,,270,RC,outpatient,,9392.5,9392.5,,7974.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2348.13,22,,percent of total billed charges,,,,,,,,,8453.25,90,,percent of total billed charges,,,7776.99,82.8,,percent of total billed charges,,,7983.63,85,,percent of total billed charges,,,,,,,,,8265.4,88,,percent of total billed charges,,,,,,,,,7175.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2348.13,22,,percent of total billed charges,,,8547.18,91,,percent of total billed charges,,,8922.88,95,,percent of total billed charges,,,7795.78,83,,percent of total billed charges,,,7795.78,83,,percent of total billed charges,,,,,,,,,,,,,,,7795.78,83,,percent of total billed charges,,,8922.88,95,,percent of total billed charges,,,8453.25,90,,percent of total billed charges,,,8453.25,90,,percent of total billed charges,,,7701.85,82,,percent of total billed charges,,,8453.25,90,,percent of total billed charges,,,7983.63,85,,percent of total billed charges,,2348.13,8922.88,
PROLIFT TOTAL,30180125,CDM,,,270,RC,outpatient,,12512.5,12512.5,,10623.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3128.13,22,,percent of total billed charges,,,,,,,,,11261.25,90,,percent of total billed charges,,,10360.35,82.8,,percent of total billed charges,,,10635.63,85,,percent of total billed charges,,,,,,,,,11011,88,,percent of total billed charges,,,,,,,,,9559.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3128.13,22,,percent of total billed charges,,,11386.38,91,,percent of total billed charges,,,11886.88,95,,percent of total billed charges,,,10385.38,83,,percent of total billed charges,,,10385.38,83,,percent of total billed charges,,,,,,,,,,,,,,,10385.38,83,,percent of total billed charges,,,11886.88,95,,percent of total billed charges,,,11261.25,90,,percent of total billed charges,,,11261.25,90,,percent of total billed charges,,,10260.25,82,,percent of total billed charges,,,11261.25,90,,percent of total billed charges,,,10635.63,85,,percent of total billed charges,,3128.13,11886.88,
TVTO SYSTEM TENSION-FREE,30180131,CDM,,,270,RC,outpatient,,10865.6,10865.6,,9224.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2716.4,22,,percent of total billed charges,,,,,,,,,9779.04,90,,percent of total billed charges,,,8996.72,82.8,,percent of total billed charges,,,9235.76,85,,percent of total billed charges,,,,,,,,,9561.73,88,,percent of total billed charges,,,,,,,,,8301.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2716.4,22,,percent of total billed charges,,,9887.7,91,,percent of total billed charges,,,10322.32,95,,percent of total billed charges,,,9018.45,83,,percent of total billed charges,,,9018.45,83,,percent of total billed charges,,,,,,,,,,,,,,,9018.45,83,,percent of total billed charges,,,10322.32,95,,percent of total billed charges,,,9779.04,90,,percent of total billed charges,,,9779.04,90,,percent of total billed charges,,,8909.79,82,,percent of total billed charges,,,9779.04,90,,percent of total billed charges,,,9235.76,85,,percent of total billed charges,,2716.4,10322.32,
COBLATOR WAND,30180134,CDM,,,270,RC,outpatient,,2007.85,2007.85,,1704.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,501.96,22,,percent of total billed charges,,,,,,,,,1807.07,90,,percent of total billed charges,,,1662.5,82.8,,percent of total billed charges,,,1706.67,85,,percent of total billed charges,,,,,,,,,1766.91,88,,percent of total billed charges,,,,,,,,,1534,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,501.96,22,,percent of total billed charges,,,1827.14,91,,percent of total billed charges,,,1907.46,95,,percent of total billed charges,,,1666.52,83,,percent of total billed charges,,,1666.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1666.52,83,,percent of total billed charges,,,1907.46,95,,percent of total billed charges,,,1807.07,90,,percent of total billed charges,,,1807.07,90,,percent of total billed charges,,,1646.44,82,,percent of total billed charges,,,1807.07,90,,percent of total billed charges,,,1706.67,85,,percent of total billed charges,,501.96,1907.46,
LAPROSCOPIC CHOLANGIOGRAM CATHETER 19GA,30180143,CDM,,,270,RC,outpatient,,261.75,261.75,,222.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.44,22,,percent of total billed charges,,,,,,,,,235.58,90,,percent of total billed charges,,,216.73,82.8,,percent of total billed charges,,,222.49,85,,percent of total billed charges,,,,,,,,,230.34,88,,percent of total billed charges,,,,,,,,,199.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.44,22,,percent of total billed charges,,,238.19,91,,percent of total billed charges,,,248.66,95,,percent of total billed charges,,,217.25,83,,percent of total billed charges,,,217.25,83,,percent of total billed charges,,,,,,,,,,,,,,,217.25,83,,percent of total billed charges,,,248.66,95,,percent of total billed charges,,,235.58,90,,percent of total billed charges,,,235.58,90,,percent of total billed charges,,,214.64,82,,percent of total billed charges,,,235.58,90,,percent of total billed charges,,,222.49,85,,percent of total billed charges,,65.44,248.66,
PROLIFT ANTERIOR,30180144,CDM,,,270,RC,outpatient,,9912.5,9912.5,,8415.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2478.13,22,,percent of total billed charges,,,,,,,,,8921.25,90,,percent of total billed charges,,,8207.55,82.8,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,,,,,,,,8723,88,,percent of total billed charges,,,,,,,,,7573.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2478.13,22,,percent of total billed charges,,,9020.38,91,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,,,,,,,,,,,,,8227.38,83,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8128.25,82,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,2478.13,9416.88,
ESSURE BIRTH CONTROL SYSTEM,30180152,CDM,,,270,RC,outpatient,,6012.5,6012.5,,5104.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1503.13,22,,percent of total billed charges,,,,,,,,,5411.25,90,,percent of total billed charges,,,4978.35,82.8,,percent of total billed charges,,,5110.63,85,,percent of total billed charges,,,,,,,,,5291,88,,percent of total billed charges,,,,,,,,,4593.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1503.13,22,,percent of total billed charges,,,5471.38,91,,percent of total billed charges,,,5711.88,95,,percent of total billed charges,,,4990.38,83,,percent of total billed charges,,,4990.38,83,,percent of total billed charges,,,,,,,,,,,,,,,4990.38,83,,percent of total billed charges,,,5711.88,95,,percent of total billed charges,,,5411.25,90,,percent of total billed charges,,,5411.25,90,,percent of total billed charges,,,4930.25,82,,percent of total billed charges,,,5411.25,90,,percent of total billed charges,,,5110.63,85,,percent of total billed charges,,1503.13,5711.88,
CONTRAST OMNIPAQUE-300 10ML,30180154,CDM,,,270,RC,outpatient,,138.14,138.14,,117.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.54,22,,percent of total billed charges,,,,,,,,,124.33,90,,percent of total billed charges,,,114.38,82.8,,percent of total billed charges,,,117.42,85,,percent of total billed charges,,,,,,,,,121.56,88,,percent of total billed charges,,,,,,,,,105.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.54,22,,percent of total billed charges,,,125.71,91,,percent of total billed charges,,,131.23,95,,percent of total billed charges,,,114.66,83,,percent of total billed charges,,,114.66,83,,percent of total billed charges,,,,,,,,,,,,,,,114.66,83,,percent of total billed charges,,,131.23,95,,percent of total billed charges,,,124.33,90,,percent of total billed charges,,,124.33,90,,percent of total billed charges,,,113.27,82,,percent of total billed charges,,,124.33,90,,percent of total billed charges,,,117.42,85,,percent of total billed charges,,34.54,131.23,
VERICES INJECTOR NEEDLE ACU-JECT,30180155,CDM,,,270,RC,outpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75,22,,percent of total billed charges,,,,,,,,,270,90,,percent of total billed charges,,,248.4,82.8,,percent of total billed charges,,,255,85,,percent of total billed charges,,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75,22,,percent of total billed charges,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,75,285,
GYNECARE TVT SECURE SYSTEM,30180180,CDM,,,270,RC,outpatient,,6476.93,6476.93,,5498.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1619.23,22,,percent of total billed charges,,,,,,,,,5829.24,90,,percent of total billed charges,,,5362.9,82.8,,percent of total billed charges,,,5505.39,85,,percent of total billed charges,,,,,,,,,5699.7,88,,percent of total billed charges,,,,,,,,,4948.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1619.23,22,,percent of total billed charges,,,5894.01,91,,percent of total billed charges,,,6153.08,95,,percent of total billed charges,,,5375.85,83,,percent of total billed charges,,,5375.85,83,,percent of total billed charges,,,,,,,,,,,,,,,5375.85,83,,percent of total billed charges,,,6153.08,95,,percent of total billed charges,,,5829.24,90,,percent of total billed charges,,,5829.24,90,,percent of total billed charges,,,5311.08,82,,percent of total billed charges,,,5829.24,90,,percent of total billed charges,,,5505.39,85,,percent of total billed charges,,1619.23,6153.08,
NERVE BLOCK PAIN PACK,30180199,CDM,,,270,RC,outpatient,,148,148,,125.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37,22,,percent of total billed charges,,,,,,,,,133.2,90,,percent of total billed charges,,,122.54,82.8,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,,,,,,,,130.24,88,,percent of total billed charges,,,,,,,,,113.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37,22,,percent of total billed charges,,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,,,,,,,,,,,,,122.84,83,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,121.36,82,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,37,140.6,
TUBE EAR PAPARELLA 1 VENT,30180200,CDM,,,270,RC,outpatient,,176.8,176.8,,150.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.2,22,,percent of total billed charges,,,,,,,,,159.12,90,,percent of total billed charges,,,146.39,82.8,,percent of total billed charges,,,150.28,85,,percent of total billed charges,,,,,,,,,155.58,88,,percent of total billed charges,,,,,,,,,135.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.2,22,,percent of total billed charges,,,160.89,91,,percent of total billed charges,,,167.96,95,,percent of total billed charges,,,146.74,83,,percent of total billed charges,,,146.74,83,,percent of total billed charges,,,,,,,,,,,,,,,146.74,83,,percent of total billed charges,,,167.96,95,,percent of total billed charges,,,159.12,90,,percent of total billed charges,,,159.12,90,,percent of total billed charges,,,144.98,82,,percent of total billed charges,,,159.12,90,,percent of total billed charges,,,150.28,85,,percent of total billed charges,,44.2,167.96,
CONTRAST RENOGRAFIN-30 50ML,30180211,CDM,,,270,RC,outpatient,,28.26,28.26,,23.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.07,22,,percent of total billed charges,,,,,,,,,25.43,90,,percent of total billed charges,,,23.4,82.8,,percent of total billed charges,,,24.02,85,,percent of total billed charges,,,,,,,,,24.87,88,,percent of total billed charges,,,,,,,,,21.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.07,22,,percent of total billed charges,,,25.72,91,,percent of total billed charges,,,26.85,95,,percent of total billed charges,,,23.46,83,,percent of total billed charges,,,23.46,83,,percent of total billed charges,,,,,,,,,,,,,,,23.46,83,,percent of total billed charges,,,26.85,95,,percent of total billed charges,,,25.43,90,,percent of total billed charges,,,25.43,90,,percent of total billed charges,,,23.17,82,,percent of total billed charges,,,25.43,90,,percent of total billed charges,,,24.02,85,,percent of total billed charges,,7.07,26.85,
CARTER THOMASON CLOSURE SYSTEM,30180213,CDM,,,270,RC,outpatient,,808.5,808.5,,686.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,202.13,22,,percent of total billed charges,,,,,,,,,727.65,90,,percent of total billed charges,,,669.44,82.8,,percent of total billed charges,,,687.23,85,,percent of total billed charges,,,,,,,,,711.48,88,,percent of total billed charges,,,,,,,,,617.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,202.13,22,,percent of total billed charges,,,735.74,91,,percent of total billed charges,,,768.08,95,,percent of total billed charges,,,671.06,83,,percent of total billed charges,,,671.06,83,,percent of total billed charges,,,,,,,,,,,,,,,671.06,83,,percent of total billed charges,,,768.08,95,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,662.97,82,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,687.23,85,,percent of total billed charges,,202.13,768.08,
TRAY LAP CHOLE FLEX,30180214,CDM,,,270,RC,outpatient,,1747.22,1747.22,,1483.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,436.81,22,,percent of total billed charges,,,,,,,,,1572.5,90,,percent of total billed charges,,,1446.7,82.8,,percent of total billed charges,,,1485.14,85,,percent of total billed charges,,,,,,,,,1537.55,88,,percent of total billed charges,,,,,,,,,1334.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,436.81,22,,percent of total billed charges,,,1589.97,91,,percent of total billed charges,,,1659.86,95,,percent of total billed charges,,,1450.19,83,,percent of total billed charges,,,1450.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1450.19,83,,percent of total billed charges,,,1659.86,95,,percent of total billed charges,,,1572.5,90,,percent of total billed charges,,,1572.5,90,,percent of total billed charges,,,1432.72,82,,percent of total billed charges,,,1572.5,90,,percent of total billed charges,,,1485.14,85,,percent of total billed charges,,436.81,1659.86,
S&N COFIELD-2 ECCRNTRIC HEAD 24MM,30180228,CDM,,,278,RC,outpatient,,7635.42,7635.42,,6482.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1908.86,22,,percent of total billed charges,,,,,,,,,6871.88,90,,percent of total billed charges,,,6322.13,82.8,,percent of total billed charges,,,6490.11,85,,percent of total billed charges,,,,,,,,,6719.17,88,,percent of total billed charges,,,,,,,,,5833.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1908.86,22,,percent of total billed charges,,,6948.23,91,,percent of total billed charges,,,7253.65,95,,percent of total billed charges,,,6337.4,83,,percent of total billed charges,,,6337.4,83,,percent of total billed charges,,,,,,,,,,,,,,,6337.4,83,,percent of total billed charges,,,7253.65,95,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6261.04,82,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6490.11,85,,percent of total billed charges,,1908.86,7253.65,
MESH DAVOL FLAT 2 X 4,30180237,CDM,,,270,RC,outpatient,,342.53,342.53,,290.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.63,22,,percent of total billed charges,,,,,,,,,308.28,90,,percent of total billed charges,,,283.61,82.8,,percent of total billed charges,,,291.15,85,,percent of total billed charges,,,,,,,,,301.43,88,,percent of total billed charges,,,,,,,,,261.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.63,22,,percent of total billed charges,,,311.7,91,,percent of total billed charges,,,325.4,95,,percent of total billed charges,,,284.3,83,,percent of total billed charges,,,284.3,83,,percent of total billed charges,,,,,,,,,,,,,,,284.3,83,,percent of total billed charges,,,325.4,95,,percent of total billed charges,,,308.28,90,,percent of total billed charges,,,308.28,90,,percent of total billed charges,,,280.87,82,,percent of total billed charges,,,308.28,90,,percent of total billed charges,,,291.15,85,,percent of total billed charges,,85.63,325.4,
S&N COFIELD-2 ECCRNTRIC HEAD 46MM,30180243,CDM,,,278,RC,outpatient,,7635.42,7635.42,,6482.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1908.86,22,,percent of total billed charges,,,,,,,,,6871.88,90,,percent of total billed charges,,,6322.13,82.8,,percent of total billed charges,,,6490.11,85,,percent of total billed charges,,,,,,,,,6719.17,88,,percent of total billed charges,,,,,,,,,5833.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1908.86,22,,percent of total billed charges,,,6948.23,91,,percent of total billed charges,,,7253.65,95,,percent of total billed charges,,,6337.4,83,,percent of total billed charges,,,6337.4,83,,percent of total billed charges,,,,,,,,,,,,,,,6337.4,83,,percent of total billed charges,,,7253.65,95,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6261.04,82,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6490.11,85,,percent of total billed charges,,1908.86,7253.65,
STAPLER RELOADS FOR 60MM GREEN,30180249,CDM,,,270,RC,outpatient,,345.53,345.53,,293.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.38,22,,percent of total billed charges,,,,,,,,,310.98,90,,percent of total billed charges,,,286.1,82.8,,percent of total billed charges,,,293.7,85,,percent of total billed charges,,,,,,,,,304.07,88,,percent of total billed charges,,,,,,,,,263.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.38,22,,percent of total billed charges,,,314.43,91,,percent of total billed charges,,,328.25,95,,percent of total billed charges,,,286.79,83,,percent of total billed charges,,,286.79,83,,percent of total billed charges,,,,,,,,,,,,,,,286.79,83,,percent of total billed charges,,,328.25,95,,percent of total billed charges,,,310.98,90,,percent of total billed charges,,,310.98,90,,percent of total billed charges,,,283.33,82,,percent of total billed charges,,,310.98,90,,percent of total billed charges,,,293.7,85,,percent of total billed charges,,86.38,328.25,
CATHETER RACZ 24IN 610MM,30180250,CDM,,,270,RC,outpatient,,533.61,533.61,,453.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,133.4,22,,percent of total billed charges,,,,,,,,,480.25,90,,percent of total billed charges,,,441.83,82.8,,percent of total billed charges,,,453.57,85,,percent of total billed charges,,,,,,,,,469.58,88,,percent of total billed charges,,,,,,,,,407.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,133.4,22,,percent of total billed charges,,,485.59,91,,percent of total billed charges,,,506.93,95,,percent of total billed charges,,,442.9,83,,percent of total billed charges,,,442.9,83,,percent of total billed charges,,,,,,,,,,,,,,,442.9,83,,percent of total billed charges,,,506.93,95,,percent of total billed charges,,,480.25,90,,percent of total billed charges,,,480.25,90,,percent of total billed charges,,,437.56,82,,percent of total billed charges,,,480.25,90,,percent of total billed charges,,,453.57,85,,percent of total billed charges,,133.4,506.93,
GYRUS CUTTING FORCEP 33CM,30180251,CDM,,,270,RC,outpatient,,3146,3146,,2670.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,786.5,22,,percent of total billed charges,,,,,,,,,2831.4,90,,percent of total billed charges,,,2604.89,82.8,,percent of total billed charges,,,2674.1,85,,percent of total billed charges,,,,,,,,,2768.48,88,,percent of total billed charges,,,,,,,,,2403.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,786.5,22,,percent of total billed charges,,,2862.86,91,,percent of total billed charges,,,2988.7,95,,percent of total billed charges,,,2611.18,83,,percent of total billed charges,,,2611.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2611.18,83,,percent of total billed charges,,,2988.7,95,,percent of total billed charges,,,2831.4,90,,percent of total billed charges,,,2831.4,90,,percent of total billed charges,,,2579.72,82,,percent of total billed charges,,,2831.4,90,,percent of total billed charges,,,2674.1,85,,percent of total billed charges,,786.5,2988.7,
GYRUS PLASMA SEAL FORCEP 25CM,30180252,CDM,,,270,RC,outpatient,,1943.5,1943.5,,1650.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,485.88,22,,percent of total billed charges,,,,,,,,,1749.15,90,,percent of total billed charges,,,1609.22,82.8,,percent of total billed charges,,,1651.98,85,,percent of total billed charges,,,,,,,,,1710.28,88,,percent of total billed charges,,,,,,,,,1484.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,485.88,22,,percent of total billed charges,,,1768.59,91,,percent of total billed charges,,,1846.33,95,,percent of total billed charges,,,1613.11,83,,percent of total billed charges,,,1613.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1613.11,83,,percent of total billed charges,,,1846.33,95,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1593.67,82,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1651.98,85,,percent of total billed charges,,485.88,1846.33,
GYRUS PKS SEAL,30180257,CDM,,,270,RC,outpatient,,2822.3,2822.3,,2396.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,705.58,22,,percent of total billed charges,,,,,,,,,2540.07,90,,percent of total billed charges,,,2336.86,82.8,,percent of total billed charges,,,2398.96,85,,percent of total billed charges,,,,,,,,,2483.62,88,,percent of total billed charges,,,,,,,,,2156.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,705.58,22,,percent of total billed charges,,,2568.29,91,,percent of total billed charges,,,2681.19,95,,percent of total billed charges,,,2342.51,83,,percent of total billed charges,,,2342.51,83,,percent of total billed charges,,,,,,,,,,,,,,,2342.51,83,,percent of total billed charges,,,2681.19,95,,percent of total billed charges,,,2540.07,90,,percent of total billed charges,,,2540.07,90,,percent of total billed charges,,,2314.29,82,,percent of total billed charges,,,2540.07,90,,percent of total billed charges,,,2398.96,85,,percent of total billed charges,,705.58,2681.19,
DRAPE UROLOGICAL 23-1/2,30180294,CDM,,,270,RC,outpatient,,38.07,38.07,,32.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.52,22,,percent of total billed charges,,,,,,,,,34.26,90,,percent of total billed charges,,,31.52,82.8,,percent of total billed charges,,,32.36,85,,percent of total billed charges,,,,,,,,,33.5,88,,percent of total billed charges,,,,,,,,,29.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.52,22,,percent of total billed charges,,,34.64,91,,percent of total billed charges,,,36.17,95,,percent of total billed charges,,,31.6,83,,percent of total billed charges,,,31.6,83,,percent of total billed charges,,,,,,,,,,,,,,,31.6,83,,percent of total billed charges,,,36.17,95,,percent of total billed charges,,,34.26,90,,percent of total billed charges,,,34.26,90,,percent of total billed charges,,,31.22,82,,percent of total billed charges,,,34.26,90,,percent of total billed charges,,,32.36,85,,percent of total billed charges,,9.52,36.17,
S&N COFIELD-2 ECCRNTRIC HEAD 18MM,30180304,CDM,,,278,RC,outpatient,,7635.42,7635.42,,6482.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1908.86,22,,percent of total billed charges,,,,,,,,,6871.88,90,,percent of total billed charges,,,6322.13,82.8,,percent of total billed charges,,,6490.11,85,,percent of total billed charges,,,,,,,,,6719.17,88,,percent of total billed charges,,,,,,,,,5833.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1908.86,22,,percent of total billed charges,,,6948.23,91,,percent of total billed charges,,,7253.65,95,,percent of total billed charges,,,6337.4,83,,percent of total billed charges,,,6337.4,83,,percent of total billed charges,,,,,,,,,,,,,,,6337.4,83,,percent of total billed charges,,,7253.65,95,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6261.04,82,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6490.11,85,,percent of total billed charges,,1908.86,7253.65,
FILSHIE CLIP,30180307,CDM,,,270,RC,outpatient,,534.66,534.66,,453.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,133.67,22,,percent of total billed charges,,,,,,,,,481.19,90,,percent of total billed charges,,,442.7,82.8,,percent of total billed charges,,,454.46,85,,percent of total billed charges,,,,,,,,,470.5,88,,percent of total billed charges,,,,,,,,,408.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,133.67,22,,percent of total billed charges,,,486.54,91,,percent of total billed charges,,,507.93,95,,percent of total billed charges,,,443.77,83,,percent of total billed charges,,,443.77,83,,percent of total billed charges,,,,,,,,,,,,,,,443.77,83,,percent of total billed charges,,,507.93,95,,percent of total billed charges,,,481.19,90,,percent of total billed charges,,,481.19,90,,percent of total billed charges,,,438.42,82,,percent of total billed charges,,,481.19,90,,percent of total billed charges,,,454.46,85,,percent of total billed charges,,133.67,507.93,
TUBING ARTHROSCOPY IRRIGATION,30180314,CDM,,,270,RC,outpatient,,315,315,,267.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.75,22,,percent of total billed charges,,,,,,,,,283.5,90,,percent of total billed charges,,,260.82,82.8,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,,,,,,,,277.2,88,,percent of total billed charges,,,,,,,,,240.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.75,22,,percent of total billed charges,,,286.65,91,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,,,,,,,,,,,,,261.45,83,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,258.3,82,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,78.75,299.25,
SURGICEL 2 X 14,30180316,CDM,,,270,RC,outpatient,,1323.81,1323.81,,1123.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,330.95,22,,percent of total billed charges,,,,,,,,,1191.43,90,,percent of total billed charges,,,1096.11,82.8,,percent of total billed charges,,,1125.24,85,,percent of total billed charges,,,,,,,,,1164.95,88,,percent of total billed charges,,,,,,,,,1011.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,330.95,22,,percent of total billed charges,,,1204.67,91,,percent of total billed charges,,,1257.62,95,,percent of total billed charges,,,1098.76,83,,percent of total billed charges,,,1098.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1098.76,83,,percent of total billed charges,,,1257.62,95,,percent of total billed charges,,,1191.43,90,,percent of total billed charges,,,1191.43,90,,percent of total billed charges,,,1085.52,82,,percent of total billed charges,,,1191.43,90,,percent of total billed charges,,,1125.24,85,,percent of total billed charges,,330.95,1257.62,
LEEP PATIENT RETURN PAD,30180317,CDM,,,270,RC,outpatient,,71.3,71.3,,60.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.83,22,,percent of total billed charges,,,,,,,,,64.17,90,,percent of total billed charges,,,59.04,82.8,,percent of total billed charges,,,60.61,85,,percent of total billed charges,,,,,,,,,62.74,88,,percent of total billed charges,,,,,,,,,54.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.83,22,,percent of total billed charges,,,64.88,91,,percent of total billed charges,,,67.74,95,,percent of total billed charges,,,59.18,83,,percent of total billed charges,,,59.18,83,,percent of total billed charges,,,,,,,,,,,,,,,59.18,83,,percent of total billed charges,,,67.74,95,,percent of total billed charges,,,64.17,90,,percent of total billed charges,,,64.17,90,,percent of total billed charges,,,58.47,82,,percent of total billed charges,,,64.17,90,,percent of total billed charges,,,60.61,85,,percent of total billed charges,,17.83,67.74,
LEEP ELECTRODE HANDPIECE,30180318,CDM,,,270,RC,outpatient,,38.61,38.61,,32.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.65,22,,percent of total billed charges,,,,,,,,,34.75,90,,percent of total billed charges,,,31.97,82.8,,percent of total billed charges,,,32.82,85,,percent of total billed charges,,,,,,,,,33.98,88,,percent of total billed charges,,,,,,,,,29.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.65,22,,percent of total billed charges,,,35.14,91,,percent of total billed charges,,,36.68,95,,percent of total billed charges,,,32.05,83,,percent of total billed charges,,,32.05,83,,percent of total billed charges,,,,,,,,,,,,,,,32.05,83,,percent of total billed charges,,,36.68,95,,percent of total billed charges,,,34.75,90,,percent of total billed charges,,,34.75,90,,percent of total billed charges,,,31.66,82,,percent of total billed charges,,,34.75,90,,percent of total billed charges,,,32.82,85,,percent of total billed charges,,9.65,36.68,
S&N CONQUEST FX FEM COMP SZ15,30180325,CDM,,,278,RC,outpatient,,8788,8788,,7461.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2197,22,,percent of total billed charges,,,,,,,,,7909.2,90,,percent of total billed charges,,,7276.46,82.8,,percent of total billed charges,,,7469.8,85,,percent of total billed charges,,,,,,,,,7733.44,88,,percent of total billed charges,,,,,,,,,6714.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2197,22,,percent of total billed charges,,,7997.08,91,,percent of total billed charges,,,8348.6,95,,percent of total billed charges,,,7294.04,83,,percent of total billed charges,,,7294.04,83,,percent of total billed charges,,,,,,,,,,,,,,,7294.04,83,,percent of total billed charges,,,8348.6,95,,percent of total billed charges,,,7909.2,90,,percent of total billed charges,,,7909.2,90,,percent of total billed charges,,,7206.16,82,,percent of total billed charges,,,7909.2,90,,percent of total billed charges,,,7469.8,85,,percent of total billed charges,,2197,8348.6,
CONTRAST RENOGRAFIN-60 50ML,30180327,CDM,,,270,RC,outpatient,,24.03,24.03,,20.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.01,22,,percent of total billed charges,,,,,,,,,21.63,90,,percent of total billed charges,,,19.9,82.8,,percent of total billed charges,,,20.43,85,,percent of total billed charges,,,,,,,,,21.15,88,,percent of total billed charges,,,,,,,,,18.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.01,22,,percent of total billed charges,,,21.87,91,,percent of total billed charges,,,22.83,95,,percent of total billed charges,,,19.94,83,,percent of total billed charges,,,19.94,83,,percent of total billed charges,,,,,,,,,,,,,,,19.94,83,,percent of total billed charges,,,22.83,95,,percent of total billed charges,,,21.63,90,,percent of total billed charges,,,21.63,90,,percent of total billed charges,,,19.7,82,,percent of total billed charges,,,21.63,90,,percent of total billed charges,,,20.43,85,,percent of total billed charges,,6.01,22.83,
NOVASURE DISPOSABLE HANDPIECE,30180328,CDM,,,270,RC,outpatient,,6467.5,6467.5,,5490.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1616.88,22,,percent of total billed charges,,,,,,,,,5820.75,90,,percent of total billed charges,,,5355.09,82.8,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,,,,,,,,5691.4,88,,percent of total billed charges,,,,,,,,,4941.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1616.88,22,,percent of total billed charges,,,5885.43,91,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,,,,,,,,,,,,,5368.03,83,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5303.35,82,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,1616.88,6144.13,
LEEP REDI KIT,30180335,CDM,,,270,RC,outpatient,,253.05,253.05,,214.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.26,22,,percent of total billed charges,,,,,,,,,227.75,90,,percent of total billed charges,,,209.53,82.8,,percent of total billed charges,,,215.09,85,,percent of total billed charges,,,,,,,,,222.68,88,,percent of total billed charges,,,,,,,,,193.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.26,22,,percent of total billed charges,,,230.28,91,,percent of total billed charges,,,240.4,95,,percent of total billed charges,,,210.03,83,,percent of total billed charges,,,210.03,83,,percent of total billed charges,,,,,,,,,,,,,,,210.03,83,,percent of total billed charges,,,240.4,95,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,207.5,82,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,215.09,85,,percent of total billed charges,,63.26,240.4,
MESH DAVOL FLAT 10 X 14,30180344,CDM,,,270,RC,outpatient,,665.7,665.7,,565.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.43,22,,percent of total billed charges,,,,,,,,,599.13,90,,percent of total billed charges,,,551.2,82.8,,percent of total billed charges,,,565.85,85,,percent of total billed charges,,,,,,,,,585.82,88,,percent of total billed charges,,,,,,,,,508.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.43,22,,percent of total billed charges,,,605.79,91,,percent of total billed charges,,,632.42,95,,percent of total billed charges,,,552.53,83,,percent of total billed charges,,,552.53,83,,percent of total billed charges,,,,,,,,,,,,,,,552.53,83,,percent of total billed charges,,,632.42,95,,percent of total billed charges,,,599.13,90,,percent of total billed charges,,,599.13,90,,percent of total billed charges,,,545.87,82,,percent of total billed charges,,,599.13,90,,percent of total billed charges,,,565.85,85,,percent of total billed charges,,166.43,632.42,
NOVASURE DEVICE KIT,30180348,CDM,,,270,RC,outpatient,,7290.83,7290.83,,6189.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1822.71,22,,percent of total billed charges,,,,,,,,,6561.75,90,,percent of total billed charges,,,6036.81,82.8,,percent of total billed charges,,,6197.21,85,,percent of total billed charges,,,,,,,,,6415.93,88,,percent of total billed charges,,,,,,,,,5570.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1822.71,22,,percent of total billed charges,,,6634.66,91,,percent of total billed charges,,,6926.29,95,,percent of total billed charges,,,6051.39,83,,percent of total billed charges,,,6051.39,83,,percent of total billed charges,,,,,,,,,,,,,,,6051.39,83,,percent of total billed charges,,,6926.29,95,,percent of total billed charges,,,6561.75,90,,percent of total billed charges,,,6561.75,90,,percent of total billed charges,,,5978.48,82,,percent of total billed charges,,,6561.75,90,,percent of total billed charges,,,6197.21,85,,percent of total billed charges,,1822.71,6926.29,
S&N COFIELD-2 ECCRNTRIC HEAD 20MM,30180358,CDM,,,278,RC,outpatient,,7635.42,7635.42,,6482.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1908.86,22,,percent of total billed charges,,,,,,,,,6871.88,90,,percent of total billed charges,,,6322.13,82.8,,percent of total billed charges,,,6490.11,85,,percent of total billed charges,,,,,,,,,6719.17,88,,percent of total billed charges,,,,,,,,,5833.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1908.86,22,,percent of total billed charges,,,6948.23,91,,percent of total billed charges,,,7253.65,95,,percent of total billed charges,,,6337.4,83,,percent of total billed charges,,,6337.4,83,,percent of total billed charges,,,,,,,,,,,,,,,6337.4,83,,percent of total billed charges,,,7253.65,95,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6261.04,82,,percent of total billed charges,,,6871.88,90,,percent of total billed charges,,,6490.11,85,,percent of total billed charges,,1908.86,7253.65,
ZIMMER GIGLI SAW BLADE,30180362,CDM,,,270,RC,outpatient,,169.09,169.09,,143.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.27,22,,percent of total billed charges,,,,,,,,,152.18,90,,percent of total billed charges,,,140.01,82.8,,percent of total billed charges,,,143.73,85,,percent of total billed charges,,,,,,,,,148.8,88,,percent of total billed charges,,,,,,,,,129.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.27,22,,percent of total billed charges,,,153.87,91,,percent of total billed charges,,,160.64,95,,percent of total billed charges,,,140.34,83,,percent of total billed charges,,,140.34,83,,percent of total billed charges,,,,,,,,,,,,,,,140.34,83,,percent of total billed charges,,,160.64,95,,percent of total billed charges,,,152.18,90,,percent of total billed charges,,,152.18,90,,percent of total billed charges,,,138.65,82,,percent of total billed charges,,,152.18,90,,percent of total billed charges,,,143.73,85,,percent of total billed charges,,42.27,160.64,
SURECLIP 22MM HEMOSTATSIS CLIP,30180363,CDM,,,270,RC,outpatient,,978.15,978.15,,830.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,244.54,22,,percent of total billed charges,,,,,,,,,880.34,90,,percent of total billed charges,,,809.91,82.8,,percent of total billed charges,,,831.43,85,,percent of total billed charges,,,,,,,,,860.77,88,,percent of total billed charges,,,,,,,,,747.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,244.54,22,,percent of total billed charges,,,890.12,91,,percent of total billed charges,,,929.24,95,,percent of total billed charges,,,811.86,83,,percent of total billed charges,,,811.86,83,,percent of total billed charges,,,,,,,,,,,,,,,811.86,83,,percent of total billed charges,,,929.24,95,,percent of total billed charges,,,880.34,90,,percent of total billed charges,,,880.34,90,,percent of total billed charges,,,802.08,82,,percent of total billed charges,,,880.34,90,,percent of total billed charges,,,831.43,85,,percent of total billed charges,,244.54,929.24,
COBLATOR WAND FLEX ULTRA,30180367,CDM,,,270,RC,outpatient,,1430,1430,,1214.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,357.5,22,,percent of total billed charges,,,,,,,,,1287,90,,percent of total billed charges,,,1184.04,82.8,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,,,,,,,,1258.4,88,,percent of total billed charges,,,,,,,,,1092.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,357.5,22,,percent of total billed charges,,,1301.3,91,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1186.9,83,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1172.6,82,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,357.5,1358.5,
CATH THORACIC STRAIGHT 24F 8.0M,30180371,CDM,,,270,RC,outpatient,,45.73,45.73,,38.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.43,22,,percent of total billed charges,,,,,,,,,41.16,90,,percent of total billed charges,,,37.86,82.8,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,,,,,,,,40.24,88,,percent of total billed charges,,,,,,,,,34.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.43,22,,percent of total billed charges,,,41.61,91,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,,,,,,,,,,,,,37.96,83,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,37.5,82,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,11.43,43.44,
STRYKER SHAVER PLUS 5.0,30180373,CDM,,,270,RC,outpatient,,410.45,410.45,,348.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,102.61,22,,percent of total billed charges,,,,,,,,,369.41,90,,percent of total billed charges,,,339.85,82.8,,percent of total billed charges,,,348.88,85,,percent of total billed charges,,,,,,,,,361.2,88,,percent of total billed charges,,,,,,,,,313.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,102.61,22,,percent of total billed charges,,,373.51,91,,percent of total billed charges,,,389.93,95,,percent of total billed charges,,,340.67,83,,percent of total billed charges,,,340.67,83,,percent of total billed charges,,,,,,,,,,,,,,,340.67,83,,percent of total billed charges,,,389.93,95,,percent of total billed charges,,,369.41,90,,percent of total billed charges,,,369.41,90,,percent of total billed charges,,,336.57,82,,percent of total billed charges,,,369.41,90,,percent of total billed charges,,,348.88,85,,percent of total billed charges,,102.61,389.93,
CRYO SHOULDER CUFF,30180381,CDM,,,270,RC,outpatient,,329.78,329.78,,279.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.45,22,,percent of total billed charges,,,,,,,,,296.8,90,,percent of total billed charges,,,273.06,82.8,,percent of total billed charges,,,280.31,85,,percent of total billed charges,,,,,,,,,290.21,88,,percent of total billed charges,,,,,,,,,251.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82.45,22,,percent of total billed charges,,,300.1,91,,percent of total billed charges,,,313.29,95,,percent of total billed charges,,,273.72,83,,percent of total billed charges,,,273.72,83,,percent of total billed charges,,,,,,,,,,,,,,,273.72,83,,percent of total billed charges,,,313.29,95,,percent of total billed charges,,,296.8,90,,percent of total billed charges,,,296.8,90,,percent of total billed charges,,,270.42,82,,percent of total billed charges,,,296.8,90,,percent of total billed charges,,,280.31,85,,percent of total billed charges,,82.45,313.29,
SYNTHES SCREW CORTEX 3.5X14MM,30180382,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
SYNTHES SCREW CORTEX 3.5X16MM,30180383,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
SYNTHES SCREW CORTEX 3.5X18MM,30180384,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
SYNTHES SCREW CORTEX 3.5X22MM,30180385,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
*PAIN PUMP 250ML 5  CATH (DUPLICATE),30180392,CDM,,,270,RC,outpatient,,701,701,,595.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175.25,22,,percent of total billed charges,,,,,,,,,630.9,90,,percent of total billed charges,,,580.43,82.8,,percent of total billed charges,,,595.85,85,,percent of total billed charges,,,,,,,,,616.88,88,,percent of total billed charges,,,,,,,,,535.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175.25,22,,percent of total billed charges,,,637.91,91,,percent of total billed charges,,,665.95,95,,percent of total billed charges,,,581.83,83,,percent of total billed charges,,,581.83,83,,percent of total billed charges,,,,,,,,,,,,,,,581.83,83,,percent of total billed charges,,,665.95,95,,percent of total billed charges,,,630.9,90,,percent of total billed charges,,,630.9,90,,percent of total billed charges,,,574.82,82,,percent of total billed charges,,,630.9,90,,percent of total billed charges,,,595.85,85,,percent of total billed charges,,175.25,665.95,
STRYKER BLADE XL WIDE  34.5 X 12,30180393,CDM,,,270,RC,outpatient,,307.28,307.28,,260.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.82,22,,percent of total billed charges,,,,,,,,,276.55,90,,percent of total billed charges,,,254.43,82.8,,percent of total billed charges,,,261.19,85,,percent of total billed charges,,,,,,,,,270.41,88,,percent of total billed charges,,,,,,,,,234.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.82,22,,percent of total billed charges,,,279.62,91,,percent of total billed charges,,,291.92,95,,percent of total billed charges,,,255.04,83,,percent of total billed charges,,,255.04,83,,percent of total billed charges,,,,,,,,,,,,,,,255.04,83,,percent of total billed charges,,,291.92,95,,percent of total billed charges,,,276.55,90,,percent of total billed charges,,,276.55,90,,percent of total billed charges,,,251.97,82,,percent of total billed charges,,,276.55,90,,percent of total billed charges,,,261.19,85,,percent of total billed charges,,76.82,291.92,
CRYO ANKLE CUFF,30180394,CDM,,,270,RC,outpatient,,274.8,274.8,,233.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.7,22,,percent of total billed charges,,,,,,,,,247.32,90,,percent of total billed charges,,,227.53,82.8,,percent of total billed charges,,,233.58,85,,percent of total billed charges,,,,,,,,,241.82,88,,percent of total billed charges,,,,,,,,,209.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.7,22,,percent of total billed charges,,,250.07,91,,percent of total billed charges,,,261.06,95,,percent of total billed charges,,,228.08,83,,percent of total billed charges,,,228.08,83,,percent of total billed charges,,,,,,,,,,,,,,,228.08,83,,percent of total billed charges,,,261.06,95,,percent of total billed charges,,,247.32,90,,percent of total billed charges,,,247.32,90,,percent of total billed charges,,,225.34,82,,percent of total billed charges,,,247.32,90,,percent of total billed charges,,,233.58,85,,percent of total billed charges,,68.7,261.06,
CRYO KNEE CUFF S,30180395,CDM,,,270,RC,outpatient,,274.8,274.8,,233.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.7,22,,percent of total billed charges,,,,,,,,,247.32,90,,percent of total billed charges,,,227.53,82.8,,percent of total billed charges,,,233.58,85,,percent of total billed charges,,,,,,,,,241.82,88,,percent of total billed charges,,,,,,,,,209.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.7,22,,percent of total billed charges,,,250.07,91,,percent of total billed charges,,,261.06,95,,percent of total billed charges,,,228.08,83,,percent of total billed charges,,,228.08,83,,percent of total billed charges,,,,,,,,,,,,,,,228.08,83,,percent of total billed charges,,,261.06,95,,percent of total billed charges,,,247.32,90,,percent of total billed charges,,,247.32,90,,percent of total billed charges,,,225.34,82,,percent of total billed charges,,,247.32,90,,percent of total billed charges,,,233.58,85,,percent of total billed charges,,68.7,261.06,
CRYO KNEE CUFF M,30180396,CDM,,,270,RC,outpatient,,269.33,269.33,,228.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.33,22,,percent of total billed charges,,,,,,,,,242.4,90,,percent of total billed charges,,,223.01,82.8,,percent of total billed charges,,,228.93,85,,percent of total billed charges,,,,,,,,,237.01,88,,percent of total billed charges,,,,,,,,,205.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.33,22,,percent of total billed charges,,,245.09,91,,percent of total billed charges,,,255.86,95,,percent of total billed charges,,,223.54,83,,percent of total billed charges,,,223.54,83,,percent of total billed charges,,,,,,,,,,,,,,,223.54,83,,percent of total billed charges,,,255.86,95,,percent of total billed charges,,,242.4,90,,percent of total billed charges,,,242.4,90,,percent of total billed charges,,,220.85,82,,percent of total billed charges,,,242.4,90,,percent of total billed charges,,,228.93,85,,percent of total billed charges,,67.33,255.86,
CRYO KNEE CUFF L,30180397,CDM,,,270,RC,outpatient,,255.38,255.38,,216.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.85,22,,percent of total billed charges,,,,,,,,,229.84,90,,percent of total billed charges,,,211.45,82.8,,percent of total billed charges,,,217.07,85,,percent of total billed charges,,,,,,,,,224.73,88,,percent of total billed charges,,,,,,,,,195.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.85,22,,percent of total billed charges,,,232.4,91,,percent of total billed charges,,,242.61,95,,percent of total billed charges,,,211.97,83,,percent of total billed charges,,,211.97,83,,percent of total billed charges,,,,,,,,,,,,,,,211.97,83,,percent of total billed charges,,,242.61,95,,percent of total billed charges,,,229.84,90,,percent of total billed charges,,,229.84,90,,percent of total billed charges,,,209.41,82,,percent of total billed charges,,,229.84,90,,percent of total billed charges,,,217.07,85,,percent of total billed charges,,63.85,242.61,
CRYO SHOULDER CUFF W/ XL STRAP,30180399,CDM,,,270,RC,outpatient,,312.75,312.75,,265.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.19,22,,percent of total billed charges,,,,,,,,,281.48,90,,percent of total billed charges,,,258.96,82.8,,percent of total billed charges,,,265.84,85,,percent of total billed charges,,,,,,,,,275.22,88,,percent of total billed charges,,,,,,,,,238.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.19,22,,percent of total billed charges,,,284.6,91,,percent of total billed charges,,,297.11,95,,percent of total billed charges,,,259.58,83,,percent of total billed charges,,,259.58,83,,percent of total billed charges,,,,,,,,,,,,,,,259.58,83,,percent of total billed charges,,,297.11,95,,percent of total billed charges,,,281.48,90,,percent of total billed charges,,,281.48,90,,percent of total billed charges,,,256.46,82,,percent of total billed charges,,,281.48,90,,percent of total billed charges,,,265.84,85,,percent of total billed charges,,78.19,297.11,
CRYO CUFF IC COOLER,30180400,CDM,,,270,RC,outpatient,,383.6,383.6,,325.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,95.9,22,,percent of total billed charges,,,,,,,,,345.24,90,,percent of total billed charges,,,317.62,82.8,,percent of total billed charges,,,326.06,85,,percent of total billed charges,,,,,,,,,337.57,88,,percent of total billed charges,,,,,,,,,293.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,95.9,22,,percent of total billed charges,,,349.08,91,,percent of total billed charges,,,364.42,95,,percent of total billed charges,,,318.39,83,,percent of total billed charges,,,318.39,83,,percent of total billed charges,,,,,,,,,,,,,,,318.39,83,,percent of total billed charges,,,364.42,95,,percent of total billed charges,,,345.24,90,,percent of total billed charges,,,345.24,90,,percent of total billed charges,,,314.55,82,,percent of total billed charges,,,345.24,90,,percent of total billed charges,,,326.06,85,,percent of total billed charges,,95.9,364.42,
AV IMPULSE PAD REG,30180402,CDM,,,270,RC,outpatient,,408.77,408.77,,347.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,102.19,22,,percent of total billed charges,,,,,,,,,367.89,90,,percent of total billed charges,,,338.46,82.8,,percent of total billed charges,,,347.45,85,,percent of total billed charges,,,,,,,,,359.72,88,,percent of total billed charges,,,,,,,,,312.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,102.19,22,,percent of total billed charges,,,371.98,91,,percent of total billed charges,,,388.33,95,,percent of total billed charges,,,339.28,83,,percent of total billed charges,,,339.28,83,,percent of total billed charges,,,,,,,,,,,,,,,339.28,83,,percent of total billed charges,,,388.33,95,,percent of total billed charges,,,367.89,90,,percent of total billed charges,,,367.89,90,,percent of total billed charges,,,335.19,82,,percent of total billed charges,,,367.89,90,,percent of total billed charges,,,347.45,85,,percent of total billed charges,,102.19,388.33,
AV IMPULSE PAD LG,30180403,CDM,,,270,RC,outpatient,,408.77,408.77,,347.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,102.19,22,,percent of total billed charges,,,,,,,,,367.89,90,,percent of total billed charges,,,338.46,82.8,,percent of total billed charges,,,347.45,85,,percent of total billed charges,,,,,,,,,359.72,88,,percent of total billed charges,,,,,,,,,312.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,102.19,22,,percent of total billed charges,,,371.98,91,,percent of total billed charges,,,388.33,95,,percent of total billed charges,,,339.28,83,,percent of total billed charges,,,339.28,83,,percent of total billed charges,,,,,,,,,,,,,,,339.28,83,,percent of total billed charges,,,388.33,95,,percent of total billed charges,,,367.89,90,,percent of total billed charges,,,367.89,90,,percent of total billed charges,,,335.19,82,,percent of total billed charges,,,367.89,90,,percent of total billed charges,,,347.45,85,,percent of total billed charges,,102.19,388.33,
CPM UNIVERSAL PAD SET,30180404,CDM,,,270,RC,outpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36,22,,percent of total billed charges,,,,,,,,,129.6,90,,percent of total billed charges,,,119.23,82.8,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36,22,,percent of total billed charges,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,36,136.8,
ARTHROSCOPY TUBING,30180405,CDM,,,270,RC,outpatient,,463.7,463.7,,393.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.93,22,,percent of total billed charges,,,,,,,,,417.33,90,,percent of total billed charges,,,383.94,82.8,,percent of total billed charges,,,394.15,85,,percent of total billed charges,,,,,,,,,408.06,88,,percent of total billed charges,,,,,,,,,354.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.93,22,,percent of total billed charges,,,421.97,91,,percent of total billed charges,,,440.52,95,,percent of total billed charges,,,384.87,83,,percent of total billed charges,,,384.87,83,,percent of total billed charges,,,,,,,,,,,,,,,384.87,83,,percent of total billed charges,,,440.52,95,,percent of total billed charges,,,417.33,90,,percent of total billed charges,,,417.33,90,,percent of total billed charges,,,380.23,82,,percent of total billed charges,,,417.33,90,,percent of total billed charges,,,394.15,85,,percent of total billed charges,,115.93,440.52,
SHOULDER ABDUCTION SLING - MED,30180407,CDM,,,270,RC,outpatient,,36.99,36.99,,31.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.25,22,,percent of total billed charges,,,,,,,,,33.29,90,,percent of total billed charges,,,30.63,82.8,,percent of total billed charges,,,31.44,85,,percent of total billed charges,,,,,,,,,32.55,88,,percent of total billed charges,,,,,,,,,28.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.25,22,,percent of total billed charges,,,33.66,91,,percent of total billed charges,,,35.14,95,,percent of total billed charges,,,30.7,83,,percent of total billed charges,,,30.7,83,,percent of total billed charges,,,,,,,,,,,,,,,30.7,83,,percent of total billed charges,,,35.14,95,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,30.33,82,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,31.44,85,,percent of total billed charges,,9.25,35.14,
SHOULDER ABDUCTION SLING - LGE,30180408,CDM,,,270,RC,outpatient,,36.99,36.99,,31.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.25,22,,percent of total billed charges,,,,,,,,,33.29,90,,percent of total billed charges,,,30.63,82.8,,percent of total billed charges,,,31.44,85,,percent of total billed charges,,,,,,,,,32.55,88,,percent of total billed charges,,,,,,,,,28.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.25,22,,percent of total billed charges,,,33.66,91,,percent of total billed charges,,,35.14,95,,percent of total billed charges,,,30.7,83,,percent of total billed charges,,,30.7,83,,percent of total billed charges,,,,,,,,,,,,,,,30.7,83,,percent of total billed charges,,,35.14,95,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,30.33,82,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,31.44,85,,percent of total billed charges,,9.25,35.14,
STRYKER BUR 4.0 FLUTED,30180433,CDM,,,270,RC,outpatient,,492.49,492.49,,418.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.12,22,,percent of total billed charges,,,,,,,,,443.24,90,,percent of total billed charges,,,407.78,82.8,,percent of total billed charges,,,418.62,85,,percent of total billed charges,,,,,,,,,433.39,88,,percent of total billed charges,,,,,,,,,376.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.12,22,,percent of total billed charges,,,448.17,91,,percent of total billed charges,,,467.87,95,,percent of total billed charges,,,408.77,83,,percent of total billed charges,,,408.77,83,,percent of total billed charges,,,,,,,,,,,,,,,408.77,83,,percent of total billed charges,,,467.87,95,,percent of total billed charges,,,443.24,90,,percent of total billed charges,,,443.24,90,,percent of total billed charges,,,403.84,82,,percent of total billed charges,,,443.24,90,,percent of total billed charges,,,418.62,85,,percent of total billed charges,,123.12,467.87,
STRYKER BUR 5.0 FLUTED,30180434,CDM,,,270,RC,outpatient,,492.49,492.49,,418.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.12,22,,percent of total billed charges,,,,,,,,,443.24,90,,percent of total billed charges,,,407.78,82.8,,percent of total billed charges,,,418.62,85,,percent of total billed charges,,,,,,,,,433.39,88,,percent of total billed charges,,,,,,,,,376.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.12,22,,percent of total billed charges,,,448.17,91,,percent of total billed charges,,,467.87,95,,percent of total billed charges,,,408.77,83,,percent of total billed charges,,,408.77,83,,percent of total billed charges,,,,,,,,,,,,,,,408.77,83,,percent of total billed charges,,,467.87,95,,percent of total billed charges,,,443.24,90,,percent of total billed charges,,,443.24,90,,percent of total billed charges,,,403.84,82,,percent of total billed charges,,,443.24,90,,percent of total billed charges,,,418.62,85,,percent of total billed charges,,123.12,467.87,
S&N ENDO FAST KIT CURVED,30180440,CDM,,,270,RC,outpatient,,1956.5,1956.5,,1661.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,489.13,22,,percent of total billed charges,,,,,,,,,1760.85,90,,percent of total billed charges,,,1619.98,82.8,,percent of total billed charges,,,1663.03,85,,percent of total billed charges,,,,,,,,,1721.72,88,,percent of total billed charges,,,,,,,,,1494.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,489.13,22,,percent of total billed charges,,,1780.42,91,,percent of total billed charges,,,1858.68,95,,percent of total billed charges,,,1623.9,83,,percent of total billed charges,,,1623.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1623.9,83,,percent of total billed charges,,,1858.68,95,,percent of total billed charges,,,1760.85,90,,percent of total billed charges,,,1760.85,90,,percent of total billed charges,,,1604.33,82,,percent of total billed charges,,,1760.85,90,,percent of total billed charges,,,1663.03,85,,percent of total billed charges,,489.13,1858.68,
S&N ENDO SUTURE CUTTER,30180442,CDM,,,270,RC,outpatient,,913.9,913.9,,775.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,228.48,22,,percent of total billed charges,,,,,,,,,822.51,90,,percent of total billed charges,,,756.71,82.8,,percent of total billed charges,,,776.82,85,,percent of total billed charges,,,,,,,,,804.23,88,,percent of total billed charges,,,,,,,,,698.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,228.48,22,,percent of total billed charges,,,831.65,91,,percent of total billed charges,,,868.21,95,,percent of total billed charges,,,758.54,83,,percent of total billed charges,,,758.54,83,,percent of total billed charges,,,,,,,,,,,,,,,758.54,83,,percent of total billed charges,,,868.21,95,,percent of total billed charges,,,822.51,90,,percent of total billed charges,,,822.51,90,,percent of total billed charges,,,749.4,82,,percent of total billed charges,,,822.51,90,,percent of total billed charges,,,776.82,85,,percent of total billed charges,,228.48,868.21,
SYNTHES SCREW CORTEX 3.5X20MM,30180448,CDM,,,278,RC,outpatient,,267.75,267.75,,227.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.94,22,,percent of total billed charges,,,,,,,,,240.98,90,,percent of total billed charges,,,221.7,82.8,,percent of total billed charges,,,227.59,85,,percent of total billed charges,,,,,,,,,235.62,88,,percent of total billed charges,,,,,,,,,204.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.94,22,,percent of total billed charges,,,243.65,91,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,,,,,,,,,,,,,222.23,83,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,219.56,82,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,227.59,85,,percent of total billed charges,,66.94,254.36,
SYNTHES SCREW CANCEL F-THD 4.0X22MM,30180449,CDM,,,278,RC,outpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.78,22,,percent of total billed charges,,,,,,,,,200.82,90,,percent of total billed charges,,,184.75,82.8,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.78,22,,percent of total billed charges,,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,55.78,211.97,
DEPUY FRACTURE HEAD HIP BALL 53MM,30180462,CDM,,,278,RC,outpatient,,4693.78,4693.78,,3985.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1173.45,22,,percent of total billed charges,,,,,,,,,4224.4,90,,percent of total billed charges,,,3886.45,82.8,,percent of total billed charges,,,3989.71,85,,percent of total billed charges,,,,,,,,,4130.53,88,,percent of total billed charges,,,,,,,,,3586.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1173.45,22,,percent of total billed charges,,,4271.34,91,,percent of total billed charges,,,4459.09,95,,percent of total billed charges,,,3895.84,83,,percent of total billed charges,,,3895.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3895.84,83,,percent of total billed charges,,,4459.09,95,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,3848.9,82,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,3989.71,85,,percent of total billed charges,,1173.45,4459.09,
DEPUY SPACER 12/14 MMLGT +5,30180463,CDM,,,278,RC,outpatient,,1935.57,1935.57,,1643.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.89,22,,percent of total billed charges,,,,,,,,,1742.01,90,,percent of total billed charges,,,1602.65,82.8,,percent of total billed charges,,,1645.23,85,,percent of total billed charges,,,,,,,,,1703.3,88,,percent of total billed charges,,,,,,,,,1478.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.89,22,,percent of total billed charges,,,1761.37,91,,percent of total billed charges,,,1838.79,95,,percent of total billed charges,,,1606.52,83,,percent of total billed charges,,,1606.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1606.52,83,,percent of total billed charges,,,1838.79,95,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1587.17,82,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1645.23,85,,percent of total billed charges,,483.89,1838.79,
GYRUS PLASMA SPATULA,30180466,CDM,,,270,RC,outpatient,,2509,2509,,2130.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,627.25,22,,percent of total billed charges,,,,,,,,,2258.1,90,,percent of total billed charges,,,2077.45,82.8,,percent of total billed charges,,,2132.65,85,,percent of total billed charges,,,,,,,,,2207.92,88,,percent of total billed charges,,,,,,,,,1916.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,627.25,22,,percent of total billed charges,,,2283.19,91,,percent of total billed charges,,,2383.55,95,,percent of total billed charges,,,2082.47,83,,percent of total billed charges,,,2082.47,83,,percent of total billed charges,,,,,,,,,,,,,,,2082.47,83,,percent of total billed charges,,,2383.55,95,,percent of total billed charges,,,2258.1,90,,percent of total billed charges,,,2258.1,90,,percent of total billed charges,,,2057.38,82,,percent of total billed charges,,,2258.1,90,,percent of total billed charges,,,2132.65,85,,percent of total billed charges,,627.25,2383.55,
DEPUY STEM SUMMIT PRESSFIT SZ4,30180469,CDM,,,278,RC,outpatient,,11591.45,11591.45,,9841.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2897.86,22,,percent of total billed charges,,,,,,,,,10432.31,90,,percent of total billed charges,,,9597.72,82.8,,percent of total billed charges,,,9852.73,85,,percent of total billed charges,,,,,,,,,10200.48,88,,percent of total billed charges,,,,,,,,,8855.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2897.86,22,,percent of total billed charges,,,10548.22,91,,percent of total billed charges,,,11011.88,95,,percent of total billed charges,,,9620.9,83,,percent of total billed charges,,,9620.9,83,,percent of total billed charges,,,,,,,,,,,,,,,9620.9,83,,percent of total billed charges,,,11011.88,95,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,9504.99,82,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,9852.73,85,,percent of total billed charges,,2897.86,11011.88,
DEPUY BIPOLAR CUP 45MM,30180470,CDM,,,278,RC,outpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.27,22,,percent of total billed charges,,,,,,,,,7312.56,90,,percent of total billed charges,,,6727.56,82.8,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.27,22,,percent of total billed charges,,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,2031.27,7718.82,
DEPUY FEMORAL HEAD 28 +1.5,30180471,CDM,,,278,RC,outpatient,,7289.17,7289.17,,6188.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1822.29,22,,percent of total billed charges,,,,,,,,,6560.25,90,,percent of total billed charges,,,6035.43,82.8,,percent of total billed charges,,,6195.79,85,,percent of total billed charges,,,,,,,,,6414.47,88,,percent of total billed charges,,,,,,,,,5568.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1822.29,22,,percent of total billed charges,,,6633.14,91,,percent of total billed charges,,,6924.71,95,,percent of total billed charges,,,6050.01,83,,percent of total billed charges,,,6050.01,83,,percent of total billed charges,,,,,,,,,,,,,,,6050.01,83,,percent of total billed charges,,,6924.71,95,,percent of total billed charges,,,6560.25,90,,percent of total billed charges,,,6560.25,90,,percent of total billed charges,,,5977.12,82,,percent of total billed charges,,,6560.25,90,,percent of total billed charges,,,6195.79,85,,percent of total billed charges,,1822.29,6924.71,
SYNTHES SCREW LOCKING 3.5X18MM,30180476,CDM,,,278,RC,outpatient,,1217.84,1217.84,,1033.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,304.46,22,,percent of total billed charges,,,,,,,,,1096.06,90,,percent of total billed charges,,,1008.37,82.8,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,,,,,,,,1071.7,88,,percent of total billed charges,,,,,,,,,930.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,304.46,22,,percent of total billed charges,,,1108.23,91,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1010.81,83,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,998.63,82,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,304.46,1156.95,
SYNTHES SCREW LOCKING 3.5X20MM,30180477,CDM,,,278,RC,outpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,313.59,22,,percent of total billed charges,,,,,,,,,1128.93,90,,percent of total billed charges,,,1038.62,82.8,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,313.59,22,,percent of total billed charges,,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,313.59,1191.65,
SYNTHES SCREW LOCKING 3.5X30MM,30180478,CDM,,,278,RC,outpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,313.59,22,,percent of total billed charges,,,,,,,,,1128.93,90,,percent of total billed charges,,,1038.62,82.8,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,313.59,22,,percent of total billed charges,,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,313.59,1191.65,
SYNTHES PLATE LCP 8-HOLE 3.5MM,30180480,CDM,,,278,RC,outpatient,,3193.45,3193.45,,2711.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,798.36,22,,percent of total billed charges,,,,,,,,,2874.11,90,,percent of total billed charges,,,2644.18,82.8,,percent of total billed charges,,,2714.43,85,,percent of total billed charges,,,,,,,,,2810.24,88,,percent of total billed charges,,,,,,,,,2439.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,798.36,22,,percent of total billed charges,,,2906.04,91,,percent of total billed charges,,,3033.78,95,,percent of total billed charges,,,2650.56,83,,percent of total billed charges,,,2650.56,83,,percent of total billed charges,,,,,,,,,,,,,,,2650.56,83,,percent of total billed charges,,,3033.78,95,,percent of total billed charges,,,2874.11,90,,percent of total billed charges,,,2874.11,90,,percent of total billed charges,,,2618.63,82,,percent of total billed charges,,,2874.11,90,,percent of total billed charges,,,2714.43,85,,percent of total billed charges,,798.36,3033.78,
ARTHREX FIBERTAPE #2,30180501,CDM,,,270,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
SYNTHES SCREW CORTEX 3.5X12MM,30180503,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
SYNTHES SCREW CORTEX 3.5X30MM,30180504,CDM,,,278,RC,outpatient,,267.75,267.75,,227.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.94,22,,percent of total billed charges,,,,,,,,,240.98,90,,percent of total billed charges,,,221.7,82.8,,percent of total billed charges,,,227.59,85,,percent of total billed charges,,,,,,,,,235.62,88,,percent of total billed charges,,,,,,,,,204.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.94,22,,percent of total billed charges,,,243.65,91,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,,,,,,,,,,,,,222.23,83,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,219.56,82,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,227.59,85,,percent of total billed charges,,66.94,254.36,
MAGNUM WIRE WITH NEEDLE,30180509,CDM,,,270,RC,outpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.25,22,,percent of total billed charges,,,,,,,,,202.5,90,,percent of total billed charges,,,186.3,82.8,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.25,22,,percent of total billed charges,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,56.25,213.75,
S&N ENDO ARTHROPIERCE STR,30180511,CDM,,,278,RC,outpatient,,5569.2,5569.2,,4728.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1392.3,22,,percent of total billed charges,,,,,,,,,5012.28,90,,percent of total billed charges,,,4611.3,82.8,,percent of total billed charges,,,4733.82,85,,percent of total billed charges,,,,,,,,,4900.9,88,,percent of total billed charges,,,,,,,,,4254.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1392.3,22,,percent of total billed charges,,,5067.97,91,,percent of total billed charges,,,5290.74,95,,percent of total billed charges,,,4622.44,83,,percent of total billed charges,,,4622.44,83,,percent of total billed charges,,,,,,,,,,,,,,,4622.44,83,,percent of total billed charges,,,5290.74,95,,percent of total billed charges,,,5012.28,90,,percent of total billed charges,,,5012.28,90,,percent of total billed charges,,,4566.74,82,,percent of total billed charges,,,5012.28,90,,percent of total billed charges,,,4733.82,85,,percent of total billed charges,,1392.3,5290.74,
ARTHREX KNOT PUSHER CUTTER,30180518,CDM,,,270,RC,outpatient,,875,875,,742.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.75,22,,percent of total billed charges,,,,,,,,,787.5,90,,percent of total billed charges,,,724.5,82.8,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,,,,,,,,770,88,,percent of total billed charges,,,,,,,,,668.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.75,22,,percent of total billed charges,,,796.25,91,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,,,,,,,,,,,,,726.25,83,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,717.5,82,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,218.75,831.25,
ARTHREX MENISCUS CINCH,30180523,CDM,,,270,RC,outpatient,,1852.5,1852.5,,1572.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,463.13,22,,percent of total billed charges,,,,,,,,,1667.25,90,,percent of total billed charges,,,1533.87,82.8,,percent of total billed charges,,,1574.63,85,,percent of total billed charges,,,,,,,,,1630.2,88,,percent of total billed charges,,,,,,,,,1415.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,463.13,22,,percent of total billed charges,,,1685.78,91,,percent of total billed charges,,,1759.88,95,,percent of total billed charges,,,1537.58,83,,percent of total billed charges,,,1537.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1537.58,83,,percent of total billed charges,,,1759.88,95,,percent of total billed charges,,,1667.25,90,,percent of total billed charges,,,1667.25,90,,percent of total billed charges,,,1519.05,82,,percent of total billed charges,,,1667.25,90,,percent of total billed charges,,,1574.63,85,,percent of total billed charges,,463.13,1759.88,
ARTHREX SUTURE LASSO 30 STR,30180524,CDM,,,270,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
ARTHREX SUTURE LASSO 90 LEFT,30180526,CDM,,,270,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
ARTHREX SUTURE LASSO 90 RIGHT,30180527,CDM,,,270,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
ARTHREX SUTURE LASSO 25 LEFT,30180528,CDM,,,270,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
ARTHREX SUTURE LASSO 25 RIGHT,30180529,CDM,,,270,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
ARTHREX FIBERWIRE 2MM 18,30180531,CDM,,,270,RC,outpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,44,167.2,
SYNTHES SCREW CORTEX 3.5X38MM,30180533,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
DEPUY PINNACLE CUP 54MM,30180540,CDM,,,278,RC,outpatient,,14472.9,14472.9,,12287.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3618.23,22,,percent of total billed charges,,,,,,,,,13025.61,90,,percent of total billed charges,,,11983.56,82.8,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,,,,,,,,12736.15,88,,percent of total billed charges,,,,,,,,,11057.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3618.23,22,,percent of total billed charges,,,13170.34,91,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12012.51,83,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,11867.78,82,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,3618.23,13749.26,
DEPUY HOLE ELININATOR-PS,30180541,CDM,,,278,RC,outpatient,,1557.27,1557.27,,1322.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,389.32,22,,percent of total billed charges,,,,,,,,,1401.54,90,,percent of total billed charges,,,1289.42,82.8,,percent of total billed charges,,,1323.68,85,,percent of total billed charges,,,,,,,,,1370.4,88,,percent of total billed charges,,,,,,,,,1189.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,389.32,22,,percent of total billed charges,,,1417.12,91,,percent of total billed charges,,,1479.41,95,,percent of total billed charges,,,1292.53,83,,percent of total billed charges,,,1292.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1292.53,83,,percent of total billed charges,,,1479.41,95,,percent of total billed charges,,,1401.54,90,,percent of total billed charges,,,1401.54,90,,percent of total billed charges,,,1276.96,82,,percent of total billed charges,,,1401.54,90,,percent of total billed charges,,,1323.68,85,,percent of total billed charges,,389.32,1479.41,
DEPUY LINER ALTRX +4 NEUT 36 X 54,30180542,CDM,,,278,RC,outpatient,,14161.81,14161.81,,12023.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3540.45,22,,percent of total billed charges,,,,,,,,,12745.63,90,,percent of total billed charges,,,11725.98,82.8,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,,,,,,,,12462.39,88,,percent of total billed charges,,,,,,,,,10819.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3540.45,22,,percent of total billed charges,,,12887.25,91,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,,,,,,,,,,,,,11754.3,83,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,11612.68,82,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,3540.45,13453.72,
DEPUY FEMORAL HEAD 36MM +8.5,30180543,CDM,,,278,RC,outpatient,,15642.97,15642.97,,13280.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3910.74,22,,percent of total billed charges,,,,,,,,,14078.67,90,,percent of total billed charges,,,12952.38,82.8,,percent of total billed charges,,,13296.52,85,,percent of total billed charges,,,,,,,,,13765.81,88,,percent of total billed charges,,,,,,,,,11951.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3910.74,22,,percent of total billed charges,,,14235.1,91,,percent of total billed charges,,,14860.82,95,,percent of total billed charges,,,12983.67,83,,percent of total billed charges,,,12983.67,83,,percent of total billed charges,,,,,,,,,,,,,,,12983.67,83,,percent of total billed charges,,,14860.82,95,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,12827.24,82,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,13296.52,85,,percent of total billed charges,,3910.74,14860.82,
DEPUY STEM CORAIL STD SZ11,30180544,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY FEMUR POROUS LT SZ4,30180547,CDM,,,278,RC,outpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9038.93,22,,percent of total billed charges,,,,,,,,,32540.16,90,,percent of total billed charges,,,29936.94,82.8,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9038.93,22,,percent of total billed charges,,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,9038.93,34347.94,
DEPUY INSERT SIGMA XLK 4 X 8,30180548,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY FEMUR POROUS RT SZ4,30180550,CDM,,,278,RC,outpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9038.93,22,,percent of total billed charges,,,,,,,,,32540.16,90,,percent of total billed charges,,,29936.94,82.8,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9038.93,22,,percent of total billed charges,,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,9038.93,34347.94,
CRYO HAND/WRIST CUFF,30180552,CDM,,,270,RC,outpatient,,269.33,269.33,,228.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.33,22,,percent of total billed charges,,,,,,,,,242.4,90,,percent of total billed charges,,,223.01,82.8,,percent of total billed charges,,,228.93,85,,percent of total billed charges,,,,,,,,,237.01,88,,percent of total billed charges,,,,,,,,,205.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.33,22,,percent of total billed charges,,,245.09,91,,percent of total billed charges,,,255.86,95,,percent of total billed charges,,,223.54,83,,percent of total billed charges,,,223.54,83,,percent of total billed charges,,,,,,,,,,,,,,,223.54,83,,percent of total billed charges,,,255.86,95,,percent of total billed charges,,,242.4,90,,percent of total billed charges,,,242.4,90,,percent of total billed charges,,,220.85,82,,percent of total billed charges,,,242.4,90,,percent of total billed charges,,,228.93,85,,percent of total billed charges,,67.33,255.86,
ENCORE TIBIAL INSERT POLY,30180555,CDM,,,270,RC,outpatient,,7787,7787,,6611.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1946.75,22,,percent of total billed charges,,,,,,,,,7008.3,90,,percent of total billed charges,,,6447.64,82.8,,percent of total billed charges,,,6618.95,85,,percent of total billed charges,,,,,,,,,6852.56,88,,percent of total billed charges,,,,,,,,,5949.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1946.75,22,,percent of total billed charges,,,7086.17,91,,percent of total billed charges,,,7397.65,95,,percent of total billed charges,,,6463.21,83,,percent of total billed charges,,,6463.21,83,,percent of total billed charges,,,,,,,,,,,,,,,6463.21,83,,percent of total billed charges,,,7397.65,95,,percent of total billed charges,,,7008.3,90,,percent of total billed charges,,,7008.3,90,,percent of total billed charges,,,6385.34,82,,percent of total billed charges,,,7008.3,90,,percent of total billed charges,,,6618.95,85,,percent of total billed charges,,1946.75,7397.65,
ENCORE FEMUR RT SZ4,30180556,CDM,,,270,RC,outpatient,,16135.28,16135.28,,13698.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4033.82,22,,percent of total billed charges,,,,,,,,,14521.75,90,,percent of total billed charges,,,13360.01,82.8,,percent of total billed charges,,,13714.99,85,,percent of total billed charges,,,,,,,,,14199.05,88,,percent of total billed charges,,,,,,,,,12327.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4033.82,22,,percent of total billed charges,,,14683.1,91,,percent of total billed charges,,,15328.52,95,,percent of total billed charges,,,13392.28,83,,percent of total billed charges,,,13392.28,83,,percent of total billed charges,,,,,,,,,,,,,,,13392.28,83,,percent of total billed charges,,,15328.52,95,,percent of total billed charges,,,14521.75,90,,percent of total billed charges,,,14521.75,90,,percent of total billed charges,,,13230.93,82,,percent of total billed charges,,,14521.75,90,,percent of total billed charges,,,13714.99,85,,percent of total billed charges,,4033.82,15328.52,
ENCORE TIBIA RT SZ4,30180557,CDM,,,270,RC,outpatient,,10351.25,10351.25,,8788.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2587.81,22,,percent of total billed charges,,,,,,,,,9316.13,90,,percent of total billed charges,,,8570.84,82.8,,percent of total billed charges,,,8798.56,85,,percent of total billed charges,,,,,,,,,9109.1,88,,percent of total billed charges,,,,,,,,,7908.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2587.81,22,,percent of total billed charges,,,9419.64,91,,percent of total billed charges,,,9833.69,95,,percent of total billed charges,,,8591.54,83,,percent of total billed charges,,,8591.54,83,,percent of total billed charges,,,,,,,,,,,,,,,8591.54,83,,percent of total billed charges,,,9833.69,95,,percent of total billed charges,,,9316.13,90,,percent of total billed charges,,,9316.13,90,,percent of total billed charges,,,8488.03,82,,percent of total billed charges,,,9316.13,90,,percent of total billed charges,,,8798.56,85,,percent of total billed charges,,2587.81,9833.69,
ENCORE PATELLA 29MM,30180558,CDM,,,270,RC,outpatient,,4486.95,4486.95,,3809.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1121.74,22,,percent of total billed charges,,,,,,,,,4038.26,90,,percent of total billed charges,,,3715.19,82.8,,percent of total billed charges,,,3813.91,85,,percent of total billed charges,,,,,,,,,3948.52,88,,percent of total billed charges,,,,,,,,,3428.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1121.74,22,,percent of total billed charges,,,4083.12,91,,percent of total billed charges,,,4262.6,95,,percent of total billed charges,,,3724.17,83,,percent of total billed charges,,,3724.17,83,,percent of total billed charges,,,,,,,,,,,,,,,3724.17,83,,percent of total billed charges,,,4262.6,95,,percent of total billed charges,,,4038.26,90,,percent of total billed charges,,,4038.26,90,,percent of total billed charges,,,3679.3,82,,percent of total billed charges,,,4038.26,90,,percent of total billed charges,,,3813.91,85,,percent of total billed charges,,1121.74,4262.6,
ENCORE SAW BLADE,30180559,CDM,,,270,RC,outpatient,,751.45,751.45,,637.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,187.86,22,,percent of total billed charges,,,,,,,,,676.31,90,,percent of total billed charges,,,622.2,82.8,,percent of total billed charges,,,638.73,85,,percent of total billed charges,,,,,,,,,661.28,88,,percent of total billed charges,,,,,,,,,574.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,187.86,22,,percent of total billed charges,,,683.82,91,,percent of total billed charges,,,713.88,95,,percent of total billed charges,,,623.7,83,,percent of total billed charges,,,623.7,83,,percent of total billed charges,,,,,,,,,,,,,,,623.7,83,,percent of total billed charges,,,713.88,95,,percent of total billed charges,,,676.31,90,,percent of total billed charges,,,676.31,90,,percent of total billed charges,,,616.19,82,,percent of total billed charges,,,676.31,90,,percent of total billed charges,,,638.73,85,,percent of total billed charges,,187.86,713.88,
CONTRAST OMNIPAQUE-300 50ML,30180565,CDM,,,270,RC,outpatient,,349.28,349.28,,296.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.32,22,,percent of total billed charges,,,,,,,,,314.35,90,,percent of total billed charges,,,289.2,82.8,,percent of total billed charges,,,296.89,85,,percent of total billed charges,,,,,,,,,307.37,88,,percent of total billed charges,,,,,,,,,266.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.32,22,,percent of total billed charges,,,317.84,91,,percent of total billed charges,,,331.82,95,,percent of total billed charges,,,289.9,83,,percent of total billed charges,,,289.9,83,,percent of total billed charges,,,,,,,,,,,,,,,289.9,83,,percent of total billed charges,,,331.82,95,,percent of total billed charges,,,314.35,90,,percent of total billed charges,,,314.35,90,,percent of total billed charges,,,286.41,82,,percent of total billed charges,,,314.35,90,,percent of total billed charges,,,296.89,85,,percent of total billed charges,,87.32,331.82,
S&N ENDO FAST KIT STRAIGHT,30180566,CDM,,,270,RC,outpatient,,1392.5,1392.5,,1182.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,348.13,22,,percent of total billed charges,,,,,,,,,1253.25,90,,percent of total billed charges,,,1152.99,82.8,,percent of total billed charges,,,1183.63,85,,percent of total billed charges,,,,,,,,,1225.4,88,,percent of total billed charges,,,,,,,,,1063.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,348.13,22,,percent of total billed charges,,,1267.18,91,,percent of total billed charges,,,1322.88,95,,percent of total billed charges,,,1155.78,83,,percent of total billed charges,,,1155.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1155.78,83,,percent of total billed charges,,,1322.88,95,,percent of total billed charges,,,1253.25,90,,percent of total billed charges,,,1253.25,90,,percent of total billed charges,,,1141.85,82,,percent of total billed charges,,,1253.25,90,,percent of total billed charges,,,1183.63,85,,percent of total billed charges,,348.13,1322.88,
APERFIX FEMORAL IMPLANT 9 X 29,30180567,CDM,,,270,RC,outpatient,,4182.75,4182.75,,3551.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1045.69,22,,percent of total billed charges,,,,,,,,,3764.48,90,,percent of total billed charges,,,3463.32,82.8,,percent of total billed charges,,,3555.34,85,,percent of total billed charges,,,,,,,,,3680.82,88,,percent of total billed charges,,,,,,,,,3195.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1045.69,22,,percent of total billed charges,,,3806.3,91,,percent of total billed charges,,,3973.61,95,,percent of total billed charges,,,3471.68,83,,percent of total billed charges,,,3471.68,83,,percent of total billed charges,,,,,,,,,,,,,,,3471.68,83,,percent of total billed charges,,,3973.61,95,,percent of total billed charges,,,3764.48,90,,percent of total billed charges,,,3764.48,90,,percent of total billed charges,,,3429.86,82,,percent of total billed charges,,,3764.48,90,,percent of total billed charges,,,3555.34,85,,percent of total billed charges,,1045.69,3973.61,
APERFIX GUIDEWIRE 14,30180568,CDM,,,270,RC,outpatient,,787.5,787.5,,668.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,196.88,22,,percent of total billed charges,,,,,,,,,708.75,90,,percent of total billed charges,,,652.05,82.8,,percent of total billed charges,,,669.38,85,,percent of total billed charges,,,,,,,,,693,88,,percent of total billed charges,,,,,,,,,601.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,196.88,22,,percent of total billed charges,,,716.63,91,,percent of total billed charges,,,748.13,95,,percent of total billed charges,,,653.63,83,,percent of total billed charges,,,653.63,83,,percent of total billed charges,,,,,,,,,,,,,,,653.63,83,,percent of total billed charges,,,748.13,95,,percent of total billed charges,,,708.75,90,,percent of total billed charges,,,708.75,90,,percent of total billed charges,,,645.75,82,,percent of total billed charges,,,708.75,90,,percent of total billed charges,,,669.38,85,,percent of total billed charges,,196.88,748.13,
APERFIX TIBIAL IMPLANT 9 X 30,30180569,CDM,,,270,RC,outpatient,,2018.25,2018.25,,1713.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,504.56,22,,percent of total billed charges,,,,,,,,,1816.43,90,,percent of total billed charges,,,1671.11,82.8,,percent of total billed charges,,,1715.51,85,,percent of total billed charges,,,,,,,,,1776.06,88,,percent of total billed charges,,,,,,,,,1541.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,504.56,22,,percent of total billed charges,,,1836.61,91,,percent of total billed charges,,,1917.34,95,,percent of total billed charges,,,1675.15,83,,percent of total billed charges,,,1675.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1675.15,83,,percent of total billed charges,,,1917.34,95,,percent of total billed charges,,,1816.43,90,,percent of total billed charges,,,1816.43,90,,percent of total billed charges,,,1654.97,82,,percent of total billed charges,,,1816.43,90,,percent of total billed charges,,,1715.51,85,,percent of total billed charges,,504.56,1917.34,
DEPUY FEMUR CEMENTED RT SZ3,30180570,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
DEPUY INSERT SIGMA XLK 4 X 10,30180571,CDM,,,278,RC,outpatient,,12163.26,12163.26,,10326.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3040.82,22,,percent of total billed charges,,,,,,,,,10946.93,90,,percent of total billed charges,,,10071.18,82.8,,percent of total billed charges,,,10338.77,85,,percent of total billed charges,,,,,,,,,10703.67,88,,percent of total billed charges,,,,,,,,,9292.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3040.82,22,,percent of total billed charges,,,11068.57,91,,percent of total billed charges,,,11555.1,95,,percent of total billed charges,,,10095.51,83,,percent of total billed charges,,,10095.51,83,,percent of total billed charges,,,,,,,,,,,,,,,10095.51,83,,percent of total billed charges,,,11555.1,95,,percent of total billed charges,,,10946.93,90,,percent of total billed charges,,,10946.93,90,,percent of total billed charges,,,9973.87,82,,percent of total billed charges,,,10946.93,90,,percent of total billed charges,,,10338.77,85,,percent of total billed charges,,3040.82,11555.1,
DEPUY PATELLA 3-PEG 41MM,30180572,CDM,,,278,RC,outpatient,,5578.95,5578.95,,4736.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1394.74,22,,percent of total billed charges,,,,,,,,,5021.06,90,,percent of total billed charges,,,4619.37,82.8,,percent of total billed charges,,,4742.11,85,,percent of total billed charges,,,,,,,,,4909.48,88,,percent of total billed charges,,,,,,,,,4262.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1394.74,22,,percent of total billed charges,,,5076.84,91,,percent of total billed charges,,,5300,95,,percent of total billed charges,,,4630.53,83,,percent of total billed charges,,,4630.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4630.53,83,,percent of total billed charges,,,5300,95,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,4574.74,82,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,4742.11,85,,percent of total billed charges,,1394.74,5300,
DEPUY FEMUR CEMENTED RT SZ4,30180573,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
DEPUY PINNACLE CUP 50MM,30180579,CDM,,,278,RC,outpatient,,14472.9,14472.9,,12287.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3618.23,22,,percent of total billed charges,,,,,,,,,13025.61,90,,percent of total billed charges,,,11983.56,82.8,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,,,,,,,,12736.15,88,,percent of total billed charges,,,,,,,,,11057.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3618.23,22,,percent of total billed charges,,,13170.34,91,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12012.51,83,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,11867.78,82,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,3618.23,13749.26,
DEPUY LINER ALTRX +4 NUET 50 X 32,30180580,CDM,,,278,RC,outpatient,,11494.99,11494.99,,9759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2873.75,22,,percent of total billed charges,,,,,,,,,10345.49,90,,percent of total billed charges,,,9517.85,82.8,,percent of total billed charges,,,9770.74,85,,percent of total billed charges,,,,,,,,,10115.59,88,,percent of total billed charges,,,,,,,,,8782.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2873.75,22,,percent of total billed charges,,,10460.44,91,,percent of total billed charges,,,10920.24,95,,percent of total billed charges,,,9540.84,83,,percent of total billed charges,,,9540.84,83,,percent of total billed charges,,,,,,,,,,,,,,,9540.84,83,,percent of total billed charges,,,10920.24,95,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,9425.89,82,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,9770.74,85,,percent of total billed charges,,2873.75,10920.24,
DEPUY FEMORAL HEAD 32 +5,30180581,CDM,,,278,RC,outpatient,,5683.54,5683.54,,4825.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1420.89,22,,percent of total billed charges,,,,,,,,,5115.19,90,,percent of total billed charges,,,4705.97,82.8,,percent of total billed charges,,,4831.01,85,,percent of total billed charges,,,,,,,,,5001.52,88,,percent of total billed charges,,,,,,,,,4342.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1420.89,22,,percent of total billed charges,,,5172.02,91,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,,,,,,,,,,,,,4717.34,83,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4660.5,82,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4831.01,85,,percent of total billed charges,,1420.89,5399.36,
DEPUY STEM CORAIL STD SZ10,30180582,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY LINER ALTRX NEUT 36 X 62,30180584,CDM,,,278,RC,outpatient,,13197.15,13197.15,,11204.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3299.29,22,,percent of total billed charges,,,,,,,,,11877.44,90,,percent of total billed charges,,,10927.24,82.8,,percent of total billed charges,,,11217.58,85,,percent of total billed charges,,,,,,,,,11613.49,88,,percent of total billed charges,,,,,,,,,10082.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3299.29,22,,percent of total billed charges,,,12009.41,91,,percent of total billed charges,,,12537.29,95,,percent of total billed charges,,,10953.63,83,,percent of total billed charges,,,10953.63,83,,percent of total billed charges,,,,,,,,,,,,,,,10953.63,83,,percent of total billed charges,,,12537.29,95,,percent of total billed charges,,,11877.44,90,,percent of total billed charges,,,11877.44,90,,percent of total billed charges,,,10821.66,82,,percent of total billed charges,,,11877.44,90,,percent of total billed charges,,,11217.58,85,,percent of total billed charges,,3299.29,12537.29,
DEPUY BIOLOX HEAD 36MM +1.5,30180585,CDM,,,278,RC,outpatient,,15642.67,15642.67,,13280.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3910.67,22,,percent of total billed charges,,,,,,,,,14078.4,90,,percent of total billed charges,,,12952.13,82.8,,percent of total billed charges,,,13296.27,85,,percent of total billed charges,,,,,,,,,13765.55,88,,percent of total billed charges,,,,,,,,,11951,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3910.67,22,,percent of total billed charges,,,14234.83,91,,percent of total billed charges,,,14860.54,95,,percent of total billed charges,,,12983.42,83,,percent of total billed charges,,,12983.42,83,,percent of total billed charges,,,,,,,,,,,,,,,12983.42,83,,percent of total billed charges,,,14860.54,95,,percent of total billed charges,,,14078.4,90,,percent of total billed charges,,,14078.4,90,,percent of total billed charges,,,12826.99,82,,percent of total billed charges,,,14078.4,90,,percent of total billed charges,,,13296.27,85,,percent of total billed charges,,3910.67,14860.54,
DEPUY STEM CORAIL STD SZ15,30180586,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY PINNACLE CUP 60MM,30180587,CDM,,,278,RC,outpatient,,14472.9,14472.9,,12287.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3618.23,22,,percent of total billed charges,,,,,,,,,13025.61,90,,percent of total billed charges,,,11983.56,82.8,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,,,,,,,,12736.15,88,,percent of total billed charges,,,,,,,,,11057.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3618.23,22,,percent of total billed charges,,,13170.34,91,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12012.51,83,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,11867.78,82,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,3618.23,13749.26,
DEPUY LINER ALTRX NEUT 36 X 60,30180588,CDM,,,278,RC,outpatient,,12874.42,12874.42,,10930.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3218.61,22,,percent of total billed charges,,,,,,,,,11586.98,90,,percent of total billed charges,,,10660.02,82.8,,percent of total billed charges,,,10943.26,85,,percent of total billed charges,,,,,,,,,11329.49,88,,percent of total billed charges,,,,,,,,,9836.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3218.61,22,,percent of total billed charges,,,11715.72,91,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,,,,,,,,,,,,,10685.77,83,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10557.02,82,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10943.26,85,,percent of total billed charges,,3218.61,12230.7,
DEPUY PINNACLE CUP 56MM,30180589,CDM,,,278,RC,outpatient,,14472.9,14472.9,,12287.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3618.23,22,,percent of total billed charges,,,,,,,,,13025.61,90,,percent of total billed charges,,,11983.56,82.8,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,,,,,,,,12736.15,88,,percent of total billed charges,,,,,,,,,11057.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3618.23,22,,percent of total billed charges,,,13170.34,91,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12012.51,83,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,11867.78,82,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,3618.23,13749.26,
DEPUY LINER ALTRX NEUT 36 X 56,30180590,CDM,,,278,RC,outpatient,,12874.42,12874.42,,10930.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3218.61,22,,percent of total billed charges,,,,,,,,,11586.98,90,,percent of total billed charges,,,10660.02,82.8,,percent of total billed charges,,,10943.26,85,,percent of total billed charges,,,,,,,,,11329.49,88,,percent of total billed charges,,,,,,,,,9836.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3218.61,22,,percent of total billed charges,,,11715.72,91,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,,,,,,,,,,,,,10685.77,83,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10557.02,82,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10943.26,85,,percent of total billed charges,,3218.61,12230.7,
DEPUY FEMORAL HEAD 36MM +5,30180591,CDM,,,278,RC,outpatient,,8569.34,8569.34,,7275.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2142.34,22,,percent of total billed charges,,,,,,,,,7712.41,90,,percent of total billed charges,,,7095.41,82.8,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,,,,,,,,7541.02,88,,percent of total billed charges,,,,,,,,,6546.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2142.34,22,,percent of total billed charges,,,7798.1,91,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7112.55,83,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7026.86,82,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,2142.34,8140.87,
DEPUY STEM CORAIL STD SZ18,30180592,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY STEM CORAIL STD SZ13,30180593,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY FEMUR CEMENTED LT SZ3,30180600,CDM,,,278,RC,outpatient,,20746.18,20746.18,,17613.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5186.55,22,,percent of total billed charges,,,,,,,,,18671.56,90,,percent of total billed charges,,,17177.84,82.8,,percent of total billed charges,,,17634.25,85,,percent of total billed charges,,,,,,,,,18256.64,88,,percent of total billed charges,,,,,,,,,15850.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5186.55,22,,percent of total billed charges,,,18879.02,91,,percent of total billed charges,,,19708.87,95,,percent of total billed charges,,,17219.33,83,,percent of total billed charges,,,17219.33,83,,percent of total billed charges,,,,,,,,,,,,,,,17219.33,83,,percent of total billed charges,,,19708.87,95,,percent of total billed charges,,,18671.56,90,,percent of total billed charges,,,18671.56,90,,percent of total billed charges,,,17011.87,82,,percent of total billed charges,,,18671.56,90,,percent of total billed charges,,,17634.25,85,,percent of total billed charges,,5186.55,19708.87,
DEPUY INSERT SIGMA XLK 3 X 15,30180601,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY INSERT SIGMA XLK 3 X 8,30180602,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY PATELLA 3-PEG 35MM,30180603,CDM,,,278,RC,outpatient,,5578.95,5578.95,,4736.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1394.74,22,,percent of total billed charges,,,,,,,,,5021.06,90,,percent of total billed charges,,,4619.37,82.8,,percent of total billed charges,,,4742.11,85,,percent of total billed charges,,,,,,,,,4909.48,88,,percent of total billed charges,,,,,,,,,4262.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1394.74,22,,percent of total billed charges,,,5076.84,91,,percent of total billed charges,,,5300,95,,percent of total billed charges,,,4630.53,83,,percent of total billed charges,,,4630.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4630.53,83,,percent of total billed charges,,,5300,95,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,4574.74,82,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,4742.11,85,,percent of total billed charges,,1394.74,5300,
DEPUY TIBIAL TRAY SZ3,30180604,CDM,,,270,RC,outpatient,,17711.46,17711.46,,15037.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4427.87,22,,percent of total billed charges,,,,,,,,,15940.31,90,,percent of total billed charges,,,14665.09,82.8,,percent of total billed charges,,,15054.74,85,,percent of total billed charges,,,,,,,,,15586.08,88,,percent of total billed charges,,,,,,,,,13531.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4427.87,22,,percent of total billed charges,,,16117.43,91,,percent of total billed charges,,,16825.89,95,,percent of total billed charges,,,14700.51,83,,percent of total billed charges,,,14700.51,83,,percent of total billed charges,,,,,,,,,,,,,,,14700.51,83,,percent of total billed charges,,,16825.89,95,,percent of total billed charges,,,15940.31,90,,percent of total billed charges,,,15940.31,90,,percent of total billed charges,,,14523.4,82,,percent of total billed charges,,,15940.31,90,,percent of total billed charges,,,15054.74,85,,percent of total billed charges,,4427.87,16825.89,
RELIEVA SINUS GUIDE CATHETER 0 DEGREE,30180607,CDM,,,270,RC,outpatient,,2886,2886,,2450.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,721.5,22,,percent of total billed charges,,,,,,,,,2597.4,90,,percent of total billed charges,,,2389.61,82.8,,percent of total billed charges,,,2453.1,85,,percent of total billed charges,,,,,,,,,2539.68,88,,percent of total billed charges,,,,,,,,,2204.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,721.5,22,,percent of total billed charges,,,2626.26,91,,percent of total billed charges,,,2741.7,95,,percent of total billed charges,,,2395.38,83,,percent of total billed charges,,,2395.38,83,,percent of total billed charges,,,,,,,,,,,,,,,2395.38,83,,percent of total billed charges,,,2741.7,95,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2366.52,82,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2453.1,85,,percent of total billed charges,,721.5,2741.7,
RELIEVA SINUS BALLOON CATHETER 7X16,30180608,CDM,,,270,RC,outpatient,,6115.2,6115.2,,5191.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1528.8,22,,percent of total billed charges,,,,,,,,,5503.68,90,,percent of total billed charges,,,5063.39,82.8,,percent of total billed charges,,,5197.92,85,,percent of total billed charges,,,,,,,,,5381.38,88,,percent of total billed charges,,,,,,,,,4672.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1528.8,22,,percent of total billed charges,,,5564.83,91,,percent of total billed charges,,,5809.44,95,,percent of total billed charges,,,5075.62,83,,percent of total billed charges,,,5075.62,83,,percent of total billed charges,,,,,,,,,,,,,,,5075.62,83,,percent of total billed charges,,,5809.44,95,,percent of total billed charges,,,5503.68,90,,percent of total billed charges,,,5503.68,90,,percent of total billed charges,,,5014.46,82,,percent of total billed charges,,,5503.68,90,,percent of total billed charges,,,5197.92,85,,percent of total billed charges,,1528.8,5809.44,
RELIEVA SINUS GUIDE CATHETER M-110,30180610,CDM,,,270,RC,outpatient,,2886,2886,,2450.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,721.5,22,,percent of total billed charges,,,,,,,,,2597.4,90,,percent of total billed charges,,,2389.61,82.8,,percent of total billed charges,,,2453.1,85,,percent of total billed charges,,,,,,,,,2539.68,88,,percent of total billed charges,,,,,,,,,2204.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,721.5,22,,percent of total billed charges,,,2626.26,91,,percent of total billed charges,,,2741.7,95,,percent of total billed charges,,,2395.38,83,,percent of total billed charges,,,2395.38,83,,percent of total billed charges,,,,,,,,,,,,,,,2395.38,83,,percent of total billed charges,,,2741.7,95,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2366.52,82,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2453.1,85,,percent of total billed charges,,721.5,2741.7,
RELIEVA LUMA SENTRY ILLUMINATION SYSTEM,30180612,CDM,,,270,RC,outpatient,,3346.2,3346.2,,2840.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,836.55,22,,percent of total billed charges,,,,,,,,,3011.58,90,,percent of total billed charges,,,2770.65,82.8,,percent of total billed charges,,,2844.27,85,,percent of total billed charges,,,,,,,,,2944.66,88,,percent of total billed charges,,,,,,,,,2556.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,836.55,22,,percent of total billed charges,,,3045.04,91,,percent of total billed charges,,,3178.89,95,,percent of total billed charges,,,2777.35,83,,percent of total billed charges,,,2777.35,83,,percent of total billed charges,,,,,,,,,,,,,,,2777.35,83,,percent of total billed charges,,,3178.89,95,,percent of total billed charges,,,3011.58,90,,percent of total billed charges,,,3011.58,90,,percent of total billed charges,,,2743.88,82,,percent of total billed charges,,,3011.58,90,,percent of total billed charges,,,2844.27,85,,percent of total billed charges,,836.55,3178.89,
RELIEVA BALLOON INFLATION DEVICE,30180614,CDM,,,270,RC,outpatient,,521.85,521.85,,443.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.46,22,,percent of total billed charges,,,,,,,,,469.67,90,,percent of total billed charges,,,432.09,82.8,,percent of total billed charges,,,443.57,85,,percent of total billed charges,,,,,,,,,459.23,88,,percent of total billed charges,,,,,,,,,398.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.46,22,,percent of total billed charges,,,474.88,91,,percent of total billed charges,,,495.76,95,,percent of total billed charges,,,433.14,83,,percent of total billed charges,,,433.14,83,,percent of total billed charges,,,,,,,,,,,,,,,433.14,83,,percent of total billed charges,,,495.76,95,,percent of total billed charges,,,469.67,90,,percent of total billed charges,,,469.67,90,,percent of total billed charges,,,427.92,82,,percent of total billed charges,,,469.67,90,,percent of total billed charges,,,443.57,85,,percent of total billed charges,,130.46,495.76,
DEPUY CROSSLINK FIN GLENOID SZ52,30180616,CDM,,,278,RC,outpatient,,14866.35,14866.35,,12621.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3716.59,22,,percent of total billed charges,,,,,,,,,13379.72,90,,percent of total billed charges,,,12309.34,82.8,,percent of total billed charges,,,12636.4,85,,percent of total billed charges,,,,,,,,,13082.39,88,,percent of total billed charges,,,,,,,,,11357.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3716.59,22,,percent of total billed charges,,,13528.38,91,,percent of total billed charges,,,14123.03,95,,percent of total billed charges,,,12339.07,83,,percent of total billed charges,,,12339.07,83,,percent of total billed charges,,,,,,,,,,,,,,,12339.07,83,,percent of total billed charges,,,14123.03,95,,percent of total billed charges,,,13379.72,90,,percent of total billed charges,,,13379.72,90,,percent of total billed charges,,,12190.41,82,,percent of total billed charges,,,13379.72,90,,percent of total billed charges,,,12636.4,85,,percent of total billed charges,,3716.59,14123.03,
DEPUY STEM GLOBAL HUMERAL 52 X 18,30180617,CDM,,,278,RC,outpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4409.03,22,,percent of total billed charges,,,,,,,,,15872.52,90,,percent of total billed charges,,,14602.72,82.8,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4409.03,22,,percent of total billed charges,,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,4409.03,16754.32,
DEPUY STEM GLOBAL ADVANTAGE PC 12MM,30180618,CDM,,,278,RC,outpatient,,36482.49,36482.49,,30973.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9120.62,22,,percent of total billed charges,,,,,,,,,32834.24,90,,percent of total billed charges,,,30207.5,82.8,,percent of total billed charges,,,31010.12,85,,percent of total billed charges,,,,,,,,,32104.59,88,,percent of total billed charges,,,,,,,,,27872.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9120.62,22,,percent of total billed charges,,,33199.07,91,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,,,,,,,,,,,,,30280.47,83,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,29915.64,82,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,31010.12,85,,percent of total billed charges,,9120.62,34658.37,
DEPUY FEMUR POROUS C/R LT SZ3,30180619,CDM,,,278,RC,outpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9038.93,22,,percent of total billed charges,,,,,,,,,32540.16,90,,percent of total billed charges,,,29936.94,82.8,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9038.93,22,,percent of total billed charges,,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,9038.93,34347.94,
DEPUY INSERT SIGMA XLK 3 X 10,30180620,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY FLUTED FEMORAL STEM 5DEG 20X125M,30180621,CDM,,,278,RC,outpatient,,8217.3,8217.3,,6976.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2054.33,22,,percent of total billed charges,,,,,,,,,7395.57,90,,percent of total billed charges,,,6803.92,82.8,,percent of total billed charges,,,6984.71,85,,percent of total billed charges,,,,,,,,,7231.22,88,,percent of total billed charges,,,,,,,,,6278.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2054.33,22,,percent of total billed charges,,,7477.74,91,,percent of total billed charges,,,7806.44,95,,percent of total billed charges,,,6820.36,83,,percent of total billed charges,,,6820.36,83,,percent of total billed charges,,,,,,,,,,,,,,,6820.36,83,,percent of total billed charges,,,7806.44,95,,percent of total billed charges,,,7395.57,90,,percent of total billed charges,,,7395.57,90,,percent of total billed charges,,,6738.19,82,,percent of total billed charges,,,7395.57,90,,percent of total billed charges,,,6984.71,85,,percent of total billed charges,,2054.33,7806.44,
DEPUY FEMORAL STEM BOLT,30180622,CDM,,,278,RC,outpatient,,1474.2,1474.2,,1251.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,368.55,22,,percent of total billed charges,,,,,,,,,1326.78,90,,percent of total billed charges,,,1220.64,82.8,,percent of total billed charges,,,1253.07,85,,percent of total billed charges,,,,,,,,,1297.3,88,,percent of total billed charges,,,,,,,,,1126.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,368.55,22,,percent of total billed charges,,,1341.52,91,,percent of total billed charges,,,1400.49,95,,percent of total billed charges,,,1223.59,83,,percent of total billed charges,,,1223.59,83,,percent of total billed charges,,,,,,,,,,,,,,,1223.59,83,,percent of total billed charges,,,1400.49,95,,percent of total billed charges,,,1326.78,90,,percent of total billed charges,,,1326.78,90,,percent of total billed charges,,,1208.84,82,,percent of total billed charges,,,1326.78,90,,percent of total billed charges,,,1253.07,85,,percent of total billed charges,,368.55,1400.49,
DEPUY FEMUR TC3 LT SZ3,30180623,CDM,,,278,RC,outpatient,,36489.7,36489.7,,30979.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9122.43,22,,percent of total billed charges,,,,,,,,,32840.73,90,,percent of total billed charges,,,30213.47,82.8,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,,,,,,,,32110.94,88,,percent of total billed charges,,,,,,,,,27878.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9122.43,22,,percent of total billed charges,,,33205.63,91,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,,,,,,,,,,,,,30286.45,83,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,29921.55,82,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,9122.43,34665.22,
DEPUY DISTAL AUGMENT LT 4MM SZ3.0,30180624,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
DEPUY POSTERIOR AUGMENT 4MM SZ3.0,30180625,CDM,,,278,RC,outpatient,,6245.14,6245.14,,5302.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1561.29,22,,percent of total billed charges,,,,,,,,,5620.63,90,,percent of total billed charges,,,5170.98,82.8,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,,,,,,,,5495.72,88,,percent of total billed charges,,,,,,,,,4771.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1561.29,22,,percent of total billed charges,,,5683.08,91,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,,,,,,,,,,,,,5183.47,83,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5121.01,82,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,1561.29,5932.88,
DEPUY INSERT TC3 RP 15MM SZ3,30180626,CDM,,,278,RC,outpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5779.25,22,,percent of total billed charges,,,,,,,,,20805.29,90,,percent of total billed charges,,,19140.87,82.8,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5779.25,22,,percent of total billed charges,,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,5779.25,21961.14,
DEPUY MBT REVISION TIBIAL TRAY SZ5,30180627,CDM,,,278,RC,outpatient,,28838.62,28838.62,,24483.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7209.66,22,,percent of total billed charges,,,,,,,,,25954.76,90,,percent of total billed charges,,,23878.38,82.8,,percent of total billed charges,,,24512.83,85,,percent of total billed charges,,,,,,,,,25377.99,88,,percent of total billed charges,,,,,,,,,22032.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7209.66,22,,percent of total billed charges,,,26243.14,91,,percent of total billed charges,,,27396.69,95,,percent of total billed charges,,,23936.05,83,,percent of total billed charges,,,23936.05,83,,percent of total billed charges,,,,,,,,,,,,,,,23936.05,83,,percent of total billed charges,,,27396.69,95,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,23647.67,82,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,24512.83,85,,percent of total billed charges,,7209.66,27396.69,
DEPUY SLEEVE METAPHYSICAL 29MM,30180628,CDM,,,278,RC,outpatient,,12860.84,12860.84,,10918.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3215.21,22,,percent of total billed charges,,,,,,,,,11574.76,90,,percent of total billed charges,,,10648.78,82.8,,percent of total billed charges,,,10931.71,85,,percent of total billed charges,,,,,,,,,11317.54,88,,percent of total billed charges,,,,,,,,,9825.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3215.21,22,,percent of total billed charges,,,11703.36,91,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10674.5,83,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10545.89,82,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10931.71,85,,percent of total billed charges,,3215.21,12217.8,
DEPUY FLUTED TIBIAL ROD 14X75MM,30180629,CDM,,,278,RC,outpatient,,6279,6279,,5330.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1569.75,22,,percent of total billed charges,,,,,,,,,5651.1,90,,percent of total billed charges,,,5199.01,82.8,,percent of total billed charges,,,5337.15,85,,percent of total billed charges,,,,,,,,,5525.52,88,,percent of total billed charges,,,,,,,,,4797.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1569.75,22,,percent of total billed charges,,,5713.89,91,,percent of total billed charges,,,5965.05,95,,percent of total billed charges,,,5211.57,83,,percent of total billed charges,,,5211.57,83,,percent of total billed charges,,,,,,,,,,,,,,,5211.57,83,,percent of total billed charges,,,5965.05,95,,percent of total billed charges,,,5651.1,90,,percent of total billed charges,,,5651.1,90,,percent of total billed charges,,,5148.78,82,,percent of total billed charges,,,5651.1,90,,percent of total billed charges,,,5337.15,85,,percent of total billed charges,,1569.75,5965.05,
DEPUY BONE CEMENT W/ANTIBIOTIC 50-500,30180630,CDM,,,278,RC,outpatient,,1827.87,1827.87,,1551.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,456.97,22,,percent of total billed charges,,,,,,,,,1645.08,90,,percent of total billed charges,,,1513.48,82.8,,percent of total billed charges,,,1553.69,85,,percent of total billed charges,,,,,,,,,1608.53,88,,percent of total billed charges,,,,,,,,,1396.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,456.97,22,,percent of total billed charges,,,1663.36,91,,percent of total billed charges,,,1736.48,95,,percent of total billed charges,,,1517.13,83,,percent of total billed charges,,,1517.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1517.13,83,,percent of total billed charges,,,1736.48,95,,percent of total billed charges,,,1645.08,90,,percent of total billed charges,,,1645.08,90,,percent of total billed charges,,,1498.85,82,,percent of total billed charges,,,1645.08,90,,percent of total billed charges,,,1553.69,85,,percent of total billed charges,,456.97,1736.48,
DEPUY BLADE STABLECUT 13 X 90 (500),30180631,CDM,,,270,RC,outpatient,,594.58,594.58,,504.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,148.65,22,,percent of total billed charges,,,,,,,,,535.12,90,,percent of total billed charges,,,492.31,82.8,,percent of total billed charges,,,505.39,85,,percent of total billed charges,,,,,,,,,523.23,88,,percent of total billed charges,,,,,,,,,454.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,148.65,22,,percent of total billed charges,,,541.07,91,,percent of total billed charges,,,564.85,95,,percent of total billed charges,,,493.5,83,,percent of total billed charges,,,493.5,83,,percent of total billed charges,,,,,,,,,,,,,,,493.5,83,,percent of total billed charges,,,564.85,95,,percent of total billed charges,,,535.12,90,,percent of total billed charges,,,535.12,90,,percent of total billed charges,,,487.56,82,,percent of total billed charges,,,535.12,90,,percent of total billed charges,,,505.39,85,,percent of total billed charges,,148.65,564.85,
DEPUY FLEXABLE OSTEOTOME 10MM,30180633,CDM,,,278,RC,outpatient,,978.38,978.38,,830.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,244.6,22,,percent of total billed charges,,,,,,,,,880.54,90,,percent of total billed charges,,,810.1,82.8,,percent of total billed charges,,,831.62,85,,percent of total billed charges,,,,,,,,,860.97,88,,percent of total billed charges,,,,,,,,,747.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,244.6,22,,percent of total billed charges,,,890.33,91,,percent of total billed charges,,,929.46,95,,percent of total billed charges,,,812.06,83,,percent of total billed charges,,,812.06,83,,percent of total billed charges,,,,,,,,,,,,,,,812.06,83,,percent of total billed charges,,,929.46,95,,percent of total billed charges,,,880.54,90,,percent of total billed charges,,,880.54,90,,percent of total billed charges,,,802.27,82,,percent of total billed charges,,,880.54,90,,percent of total billed charges,,,831.62,85,,percent of total billed charges,,244.6,929.46,
SYNTHES DRILL BIT QUICK COUPLING 3.2MM,30180638,CDM,,,270,RC,outpatient,,782.74,782.74,,664.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195.69,22,,percent of total billed charges,,,,,,,,,704.47,90,,percent of total billed charges,,,648.11,82.8,,percent of total billed charges,,,665.33,85,,percent of total billed charges,,,,,,,,,688.81,88,,percent of total billed charges,,,,,,,,,598.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195.69,22,,percent of total billed charges,,,712.29,91,,percent of total billed charges,,,743.6,95,,percent of total billed charges,,,649.67,83,,percent of total billed charges,,,649.67,83,,percent of total billed charges,,,,,,,,,,,,,,,649.67,83,,percent of total billed charges,,,743.6,95,,percent of total billed charges,,,704.47,90,,percent of total billed charges,,,704.47,90,,percent of total billed charges,,,641.85,82,,percent of total billed charges,,,704.47,90,,percent of total billed charges,,,665.33,85,,percent of total billed charges,,195.69,743.6,
DEPUY PINNACLE CUP 52MM,30180665,CDM,,,278,RC,outpatient,,14472.9,14472.9,,12287.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3618.23,22,,percent of total billed charges,,,,,,,,,13025.61,90,,percent of total billed charges,,,11983.56,82.8,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,,,,,,,,12736.15,88,,percent of total billed charges,,,,,,,,,11057.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3618.23,22,,percent of total billed charges,,,13170.34,91,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12012.51,83,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,11867.78,82,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,3618.23,13749.26,
DEPUY LINER ALTRX +4 NEUT 36 X 52,30180666,CDM,,,278,RC,outpatient,,14161.81,14161.81,,12023.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3540.45,22,,percent of total billed charges,,,,,,,,,12745.63,90,,percent of total billed charges,,,11725.98,82.8,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,,,,,,,,12462.39,88,,percent of total billed charges,,,,,,,,,10819.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3540.45,22,,percent of total billed charges,,,12887.25,91,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,,,,,,,,,,,,,11754.3,83,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,11612.68,82,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,3540.45,13453.72,
DEPUY SECTOR II CUP 52MM,30180667,CDM,,,278,RC,outpatient,,14472.9,14472.9,,12287.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3618.23,22,,percent of total billed charges,,,,,,,,,13025.61,90,,percent of total billed charges,,,11983.56,82.8,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,,,,,,,,12736.15,88,,percent of total billed charges,,,,,,,,,11057.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3618.23,22,,percent of total billed charges,,,13170.34,91,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12012.51,83,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,11867.78,82,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,3618.23,13749.26,
DEPUY PINNACLE SCREW 6.5 X 40,30180668,CDM,,,278,RC,outpatient,,1244.95,1244.95,,1056.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,311.24,22,,percent of total billed charges,,,,,,,,,1120.46,90,,percent of total billed charges,,,1030.82,82.8,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,,,,,,,,1095.56,88,,percent of total billed charges,,,,,,,,,951.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,311.24,22,,percent of total billed charges,,,1132.9,91,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.31,83,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1020.86,82,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,311.24,1182.7,
DEPUY PINNACLE SCREW 6.5 X 15,30180669,CDM,,,278,RC,outpatient,,1244.95,1244.95,,1056.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,311.24,22,,percent of total billed charges,,,,,,,,,1120.46,90,,percent of total billed charges,,,1030.82,82.8,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,,,,,,,,1095.56,88,,percent of total billed charges,,,,,,,,,951.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,311.24,22,,percent of total billed charges,,,1132.9,91,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.31,83,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1020.86,82,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,311.24,1182.7,
DEPUY ARTICUL/EZE BALL 36MM +8.5,30180670,CDM,,,278,RC,outpatient,,8569.34,8569.34,,7275.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2142.34,22,,percent of total billed charges,,,,,,,,,7712.41,90,,percent of total billed charges,,,7095.41,82.8,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,,,,,,,,7541.02,88,,percent of total billed charges,,,,,,,,,6546.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2142.34,22,,percent of total billed charges,,,7798.1,91,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7112.55,83,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7026.86,82,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,2142.34,8140.87,
DEPUY FEMUR POROUS C/R LT SZ4,30180671,CDM,,,278,RC,outpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9038.93,22,,percent of total billed charges,,,,,,,,,32540.16,90,,percent of total billed charges,,,29936.94,82.8,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9038.93,22,,percent of total billed charges,,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,9038.93,34347.94,
DEPUY FEMUR POROUS C/R RT SZ4N,30180672,CDM,,,278,RC,outpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9038.93,22,,percent of total billed charges,,,,,,,,,32540.16,90,,percent of total billed charges,,,29936.94,82.8,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9038.93,22,,percent of total billed charges,,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,9038.93,34347.94,
DEPUY FEMUR CEMENTED LT SZ5,30180673,CDM,,,278,RC,outpatient,,20746.18,20746.18,,17613.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5186.55,22,,percent of total billed charges,,,,,,,,,18671.56,90,,percent of total billed charges,,,17177.84,82.8,,percent of total billed charges,,,17634.25,85,,percent of total billed charges,,,,,,,,,18256.64,88,,percent of total billed charges,,,,,,,,,15850.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5186.55,22,,percent of total billed charges,,,18879.02,91,,percent of total billed charges,,,19708.87,95,,percent of total billed charges,,,17219.33,83,,percent of total billed charges,,,17219.33,83,,percent of total billed charges,,,,,,,,,,,,,,,17219.33,83,,percent of total billed charges,,,19708.87,95,,percent of total billed charges,,,18671.56,90,,percent of total billed charges,,,18671.56,90,,percent of total billed charges,,,17011.87,82,,percent of total billed charges,,,18671.56,90,,percent of total billed charges,,,17634.25,85,,percent of total billed charges,,5186.55,19708.87,
DEPUY FEMUR CEMENTED RT SZ5,30180674,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
DEPUY PATELLA 3-PEG 32MM,30180675,CDM,,,278,RC,outpatient,,6022.25,6022.25,,5112.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1505.56,22,,percent of total billed charges,,,,,,,,,5420.03,90,,percent of total billed charges,,,4986.42,82.8,,percent of total billed charges,,,5118.91,85,,percent of total billed charges,,,,,,,,,5299.58,88,,percent of total billed charges,,,,,,,,,4601,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1505.56,22,,percent of total billed charges,,,5480.25,91,,percent of total billed charges,,,5721.14,95,,percent of total billed charges,,,4998.47,83,,percent of total billed charges,,,4998.47,83,,percent of total billed charges,,,,,,,,,,,,,,,4998.47,83,,percent of total billed charges,,,5721.14,95,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,4938.25,82,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,5118.91,85,,percent of total billed charges,,1505.56,5721.14,
DEPUY SELF CENT HIP 49X28 BRN,30180676,CDM,,,278,RC,outpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.27,22,,percent of total billed charges,,,,,,,,,7312.56,90,,percent of total billed charges,,,6727.56,82.8,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.27,22,,percent of total billed charges,,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,2031.27,7718.82,
DEPUY FEMORAL HEAD 28 +5,30180677,CDM,,,278,RC,outpatient,,6922.18,6922.18,,5876.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1730.55,22,,percent of total billed charges,,,,,,,,,6229.96,90,,percent of total billed charges,,,5731.57,82.8,,percent of total billed charges,,,5883.85,85,,percent of total billed charges,,,,,,,,,6091.52,88,,percent of total billed charges,,,,,,,,,5288.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1730.55,22,,percent of total billed charges,,,6299.18,91,,percent of total billed charges,,,6576.07,95,,percent of total billed charges,,,5745.41,83,,percent of total billed charges,,,5745.41,83,,percent of total billed charges,,,,,,,,,,,,,,,5745.41,83,,percent of total billed charges,,,6576.07,95,,percent of total billed charges,,,6229.96,90,,percent of total billed charges,,,6229.96,90,,percent of total billed charges,,,5676.19,82,,percent of total billed charges,,,6229.96,90,,percent of total billed charges,,,5883.85,85,,percent of total billed charges,,1730.55,6576.07,
S&N HEWSON SUTURE RETRIVER,30180679,CDM,,,270,RC,outpatient,,814.24,814.24,,691.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,203.56,22,,percent of total billed charges,,,,,,,,,732.82,90,,percent of total billed charges,,,674.19,82.8,,percent of total billed charges,,,692.1,85,,percent of total billed charges,,,,,,,,,716.53,88,,percent of total billed charges,,,,,,,,,622.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,203.56,22,,percent of total billed charges,,,740.96,91,,percent of total billed charges,,,773.53,95,,percent of total billed charges,,,675.82,83,,percent of total billed charges,,,675.82,83,,percent of total billed charges,,,,,,,,,,,,,,,675.82,83,,percent of total billed charges,,,773.53,95,,percent of total billed charges,,,732.82,90,,percent of total billed charges,,,732.82,90,,percent of total billed charges,,,667.68,82,,percent of total billed charges,,,732.82,90,,percent of total billed charges,,,692.1,85,,percent of total billed charges,,203.56,773.53,
SYNTHES PLATE LCP 6-HOLE 69MM,30180689,CDM,,,278,RC,outpatient,,1585.68,1585.68,,1346.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,396.42,22,,percent of total billed charges,,,,,,,,,1427.11,90,,percent of total billed charges,,,1312.94,82.8,,percent of total billed charges,,,1347.83,85,,percent of total billed charges,,,,,,,,,1395.4,88,,percent of total billed charges,,,,,,,,,1211.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,396.42,22,,percent of total billed charges,,,1442.97,91,,percent of total billed charges,,,1506.4,95,,percent of total billed charges,,,1316.11,83,,percent of total billed charges,,,1316.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1316.11,83,,percent of total billed charges,,,1506.4,95,,percent of total billed charges,,,1427.11,90,,percent of total billed charges,,,1427.11,90,,percent of total billed charges,,,1300.26,82,,percent of total billed charges,,,1427.11,90,,percent of total billed charges,,,1347.83,85,,percent of total billed charges,,396.42,1506.4,
SYNTHES DRILL BIT 3.5MM 110MM,30180690,CDM,,,270,RC,outpatient,,852.18,852.18,,723.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,213.05,22,,percent of total billed charges,,,,,,,,,766.96,90,,percent of total billed charges,,,705.61,82.8,,percent of total billed charges,,,724.35,85,,percent of total billed charges,,,,,,,,,749.92,88,,percent of total billed charges,,,,,,,,,651.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,213.05,22,,percent of total billed charges,,,775.48,91,,percent of total billed charges,,,809.57,95,,percent of total billed charges,,,707.31,83,,percent of total billed charges,,,707.31,83,,percent of total billed charges,,,,,,,,,,,,,,,707.31,83,,percent of total billed charges,,,809.57,95,,percent of total billed charges,,,766.96,90,,percent of total billed charges,,,766.96,90,,percent of total billed charges,,,698.79,82,,percent of total billed charges,,,766.96,90,,percent of total billed charges,,,724.35,85,,percent of total billed charges,,213.05,809.57,
DEPUY INSERT SIGMA XLK 2.5 X 15,30180691,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY TIBIAL TRAY SZ2.5,30180692,CDM,,,270,RC,outpatient,,18568.29,18568.29,,15764.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4642.07,22,,percent of total billed charges,,,,,,,,,16711.46,90,,percent of total billed charges,,,15374.54,82.8,,percent of total billed charges,,,15783.05,85,,percent of total billed charges,,,,,,,,,16340.1,88,,percent of total billed charges,,,,,,,,,14186.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4642.07,22,,percent of total billed charges,,,16897.14,91,,percent of total billed charges,,,17639.88,95,,percent of total billed charges,,,15411.68,83,,percent of total billed charges,,,15411.68,83,,percent of total billed charges,,,,,,,,,,,,,,,15411.68,83,,percent of total billed charges,,,17639.88,95,,percent of total billed charges,,,16711.46,90,,percent of total billed charges,,,16711.46,90,,percent of total billed charges,,,15226,82,,percent of total billed charges,,,16711.46,90,,percent of total billed charges,,,15783.05,85,,percent of total billed charges,,4642.07,17639.88,
DEPUY FEMORAL HEAD 36MM +1.5,30180693,CDM,,,278,RC,outpatient,,8569.34,8569.34,,7275.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2142.34,22,,percent of total billed charges,,,,,,,,,7712.41,90,,percent of total billed charges,,,7095.41,82.8,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,,,,,,,,7541.02,88,,percent of total billed charges,,,,,,,,,6546.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2142.34,22,,percent of total billed charges,,,7798.1,91,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7112.55,83,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7026.86,82,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,2142.34,8140.87,
DEPUY STEM CORAIL STD SZ14,30180694,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY FEMUR POROUS RT SZ1.5,30180695,CDM,,,278,RC,outpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9038.93,22,,percent of total billed charges,,,,,,,,,32540.16,90,,percent of total billed charges,,,29936.94,82.8,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9038.93,22,,percent of total billed charges,,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,9038.93,34347.94,
DEPUY INSERT SIGMA XLK 5 X 10,30180696,CDM,,,278,RC,outpatient,,12163.26,12163.26,,10326.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3040.82,22,,percent of total billed charges,,,,,,,,,10946.93,90,,percent of total billed charges,,,10071.18,82.8,,percent of total billed charges,,,10338.77,85,,percent of total billed charges,,,,,,,,,10703.67,88,,percent of total billed charges,,,,,,,,,9292.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3040.82,22,,percent of total billed charges,,,11068.57,91,,percent of total billed charges,,,11555.1,95,,percent of total billed charges,,,10095.51,83,,percent of total billed charges,,,10095.51,83,,percent of total billed charges,,,,,,,,,,,,,,,10095.51,83,,percent of total billed charges,,,11555.1,95,,percent of total billed charges,,,10946.93,90,,percent of total billed charges,,,10946.93,90,,percent of total billed charges,,,9973.87,82,,percent of total billed charges,,,10946.93,90,,percent of total billed charges,,,10338.77,85,,percent of total billed charges,,3040.82,11555.1,
DEPUY TIBIAL TRAY SZ5,30180697,CDM,,,270,RC,outpatient,,17711.46,17711.46,,15037.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4427.87,22,,percent of total billed charges,,,,,,,,,15940.31,90,,percent of total billed charges,,,14665.09,82.8,,percent of total billed charges,,,15054.74,85,,percent of total billed charges,,,,,,,,,15586.08,88,,percent of total billed charges,,,,,,,,,13531.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4427.87,22,,percent of total billed charges,,,16117.43,91,,percent of total billed charges,,,16825.89,95,,percent of total billed charges,,,14700.51,83,,percent of total billed charges,,,14700.51,83,,percent of total billed charges,,,,,,,,,,,,,,,14700.51,83,,percent of total billed charges,,,16825.89,95,,percent of total billed charges,,,15940.31,90,,percent of total billed charges,,,15940.31,90,,percent of total billed charges,,,14523.4,82,,percent of total billed charges,,,15940.31,90,,percent of total billed charges,,,15054.74,85,,percent of total billed charges,,4427.87,16825.89,
DEPUY PFC SIG CR FEM LT SZ4N,30180698,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
SYNTHES DRILL BIT 1.8MM 310.509,30180705,CDM,,,270,RC,outpatient,,1518.14,1518.14,,1288.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,379.54,22,,percent of total billed charges,,,,,,,,,1366.33,90,,percent of total billed charges,,,1257.02,82.8,,percent of total billed charges,,,1290.42,85,,percent of total billed charges,,,,,,,,,1335.96,88,,percent of total billed charges,,,,,,,,,1159.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,379.54,22,,percent of total billed charges,,,1381.51,91,,percent of total billed charges,,,1442.23,95,,percent of total billed charges,,,1260.06,83,,percent of total billed charges,,,1260.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1260.06,83,,percent of total billed charges,,,1442.23,95,,percent of total billed charges,,,1366.33,90,,percent of total billed charges,,,1366.33,90,,percent of total billed charges,,,1244.87,82,,percent of total billed charges,,,1366.33,90,,percent of total billed charges,,,1290.42,85,,percent of total billed charges,,379.54,1442.23,
SYNTHES SCREW CORTEX S-T 2.4X16MM,30180710,CDM,,,278,RC,outpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149.92,22,,percent of total billed charges,,,,,,,,,539.72,90,,percent of total billed charges,,,496.54,82.8,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149.92,22,,percent of total billed charges,,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,149.92,569.71,
SYNTHES SCREW CORTEX S-T 2.4X22MM,30180711,CDM,,,278,RC,outpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149.92,22,,percent of total billed charges,,,,,,,,,539.72,90,,percent of total billed charges,,,496.54,82.8,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149.92,22,,percent of total billed charges,,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,149.92,569.71,
DEPUY INSERT SIGMA XLK 2.5 X 12.5,30180718,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
PREP KIT BONE BIOPREP,30180724,CDM,,,270,RC,outpatient,,728.27,728.27,,618.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,182.07,22,,percent of total billed charges,,,,,,,,,655.44,90,,percent of total billed charges,,,603.01,82.8,,percent of total billed charges,,,619.03,85,,percent of total billed charges,,,,,,,,,640.88,88,,percent of total billed charges,,,,,,,,,556.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,182.07,22,,percent of total billed charges,,,662.73,91,,percent of total billed charges,,,691.86,95,,percent of total billed charges,,,604.46,83,,percent of total billed charges,,,604.46,83,,percent of total billed charges,,,,,,,,,,,,,,,604.46,83,,percent of total billed charges,,,691.86,95,,percent of total billed charges,,,655.44,90,,percent of total billed charges,,,655.44,90,,percent of total billed charges,,,597.18,82,,percent of total billed charges,,,655.44,90,,percent of total billed charges,,,619.03,85,,percent of total billed charges,,182.07,691.86,
DEPUY STEM GLOBAL FX PC 10MM,30180725,CDM,,,278,RC,outpatient,,38704.58,38704.58,,32860.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9676.15,22,,percent of total billed charges,,,,,,,,,34834.12,90,,percent of total billed charges,,,32047.39,82.8,,percent of total billed charges,,,32898.89,85,,percent of total billed charges,,,,,,,,,34060.03,88,,percent of total billed charges,,,,,,,,,29570.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9676.15,22,,percent of total billed charges,,,35221.17,91,,percent of total billed charges,,,36769.35,95,,percent of total billed charges,,,32124.8,83,,percent of total billed charges,,,32124.8,83,,percent of total billed charges,,,,,,,,,,,,,,,32124.8,83,,percent of total billed charges,,,36769.35,95,,percent of total billed charges,,,34834.12,90,,percent of total billed charges,,,34834.12,90,,percent of total billed charges,,,31737.76,82,,percent of total billed charges,,,34834.12,90,,percent of total billed charges,,,32898.89,85,,percent of total billed charges,,9676.15,36769.35,
DEPUY STEM GLOBAL HUMERAL 44 X 18,30180726,CDM,,,278,RC,outpatient,,15560.09,15560.09,,13210.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3890.02,22,,percent of total billed charges,,,,,,,,,14004.08,90,,percent of total billed charges,,,12883.75,82.8,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,,,,,,,,13692.88,88,,percent of total billed charges,,,,,,,,,11887.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3890.02,22,,percent of total billed charges,,,14159.68,91,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12914.87,83,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,12759.27,82,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,3890.02,14782.09,
DEPUY PFC SIG CR FEM RT SZ4N,30180732,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
DEPUY INSERT SIGMA XLK 3 X 12.5,30180733,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
EYE LENS IMPLANT (ALCON),30180734,CDM,,,278,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
CATH URETERAL ACCESS 6FR OPEN END,30180736,CDM,,,270,RC,outpatient,,81.84,81.84,,69.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.46,22,,percent of total billed charges,,,,,,,,,73.66,90,,percent of total billed charges,,,67.76,82.8,,percent of total billed charges,,,69.56,85,,percent of total billed charges,,,,,,,,,72.02,88,,percent of total billed charges,,,,,,,,,62.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.46,22,,percent of total billed charges,,,74.47,91,,percent of total billed charges,,,77.75,95,,percent of total billed charges,,,67.93,83,,percent of total billed charges,,,67.93,83,,percent of total billed charges,,,,,,,,,,,,,,,67.93,83,,percent of total billed charges,,,77.75,95,,percent of total billed charges,,,73.66,90,,percent of total billed charges,,,73.66,90,,percent of total billed charges,,,67.11,82,,percent of total billed charges,,,73.66,90,,percent of total billed charges,,,69.56,85,,percent of total billed charges,,20.46,77.75,
DEPUY STEM TRI-LOCK HI OFFSET SZ0,30180740,CDM,,,278,RC,outpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10178.29,22,,percent of total billed charges,,,,,,,,,36641.83,90,,percent of total billed charges,,,33710.48,82.8,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10178.29,22,,percent of total billed charges,,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,10178.29,38677.48,
DEPUY DURALOC CUP OPTION SZ54,30180742,CDM,,,278,RC,outpatient,,10985.85,10985.85,,9326.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2746.46,22,,percent of total billed charges,,,,,,,,,9887.27,90,,percent of total billed charges,,,9096.28,82.8,,percent of total billed charges,,,9337.97,85,,percent of total billed charges,,,,,,,,,9667.55,88,,percent of total billed charges,,,,,,,,,8393.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2746.46,22,,percent of total billed charges,,,9997.12,91,,percent of total billed charges,,,10436.56,95,,percent of total billed charges,,,9118.26,83,,percent of total billed charges,,,9118.26,83,,percent of total billed charges,,,,,,,,,,,,,,,9118.26,83,,percent of total billed charges,,,10436.56,95,,percent of total billed charges,,,9887.27,90,,percent of total billed charges,,,9887.27,90,,percent of total billed charges,,,9008.4,82,,percent of total billed charges,,,9887.27,90,,percent of total billed charges,,,9337.97,85,,percent of total billed charges,,2746.46,10436.56,
DEPUY ARTICUL/EZE BALL 32MM +5,30180743,CDM,,,278,RC,outpatient,,7271.29,7271.29,,6173.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1817.82,22,,percent of total billed charges,,,,,,,,,6544.16,90,,percent of total billed charges,,,6020.63,82.8,,percent of total billed charges,,,6180.6,85,,percent of total billed charges,,,,,,,,,6398.74,88,,percent of total billed charges,,,,,,,,,5555.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1817.82,22,,percent of total billed charges,,,6616.87,91,,percent of total billed charges,,,6907.73,95,,percent of total billed charges,,,6035.17,83,,percent of total billed charges,,,6035.17,83,,percent of total billed charges,,,,,,,,,,,,,,,6035.17,83,,percent of total billed charges,,,6907.73,95,,percent of total billed charges,,,6544.16,90,,percent of total billed charges,,,6544.16,90,,percent of total billed charges,,,5962.46,82,,percent of total billed charges,,,6544.16,90,,percent of total billed charges,,,6180.6,85,,percent of total billed charges,,1817.82,6907.73,
DEPUY STEM TRI-LOCK STD OFFSET SZ7,30180745,CDM,,,278,RC,outpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10178.29,22,,percent of total billed charges,,,,,,,,,36641.83,90,,percent of total billed charges,,,33710.48,82.8,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10178.29,22,,percent of total billed charges,,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,10178.29,38677.48,
DEPUY STEM TRI-LOCK STD OFFSET SZ6,30180746,CDM,,,278,RC,outpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10178.29,22,,percent of total billed charges,,,,,,,,,36641.83,90,,percent of total billed charges,,,33710.48,82.8,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10178.29,22,,percent of total billed charges,,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,10178.29,38677.48,
"DEPUY DURALOC INSERT 32/58,60",30180747,CDM,,,278,RC,outpatient,,8870.1,8870.1,,7530.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2217.53,22,,percent of total billed charges,,,,,,,,,7983.09,90,,percent of total billed charges,,,7344.44,82.8,,percent of total billed charges,,,7539.59,85,,percent of total billed charges,,,,,,,,,7805.69,88,,percent of total billed charges,,,,,,,,,6776.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2217.53,22,,percent of total billed charges,,,8071.79,91,,percent of total billed charges,,,8426.6,95,,percent of total billed charges,,,7362.18,83,,percent of total billed charges,,,7362.18,83,,percent of total billed charges,,,,,,,,,,,,,,,7362.18,83,,percent of total billed charges,,,8426.6,95,,percent of total billed charges,,,7983.09,90,,percent of total billed charges,,,7983.09,90,,percent of total billed charges,,,7273.48,82,,percent of total billed charges,,,7983.09,90,,percent of total billed charges,,,7539.59,85,,percent of total billed charges,,2217.53,8426.6,
DEPUY DURALOC CUP OPTION SZ58,30180748,CDM,,,278,RC,outpatient,,8277.04,8277.04,,7027.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2069.26,22,,percent of total billed charges,,,,,,,,,7449.34,90,,percent of total billed charges,,,6853.39,82.8,,percent of total billed charges,,,7035.48,85,,percent of total billed charges,,,,,,,,,7283.8,88,,percent of total billed charges,,,,,,,,,6323.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2069.26,22,,percent of total billed charges,,,7532.11,91,,percent of total billed charges,,,7863.19,95,,percent of total billed charges,,,6869.94,83,,percent of total billed charges,,,6869.94,83,,percent of total billed charges,,,,,,,,,,,,,,,6869.94,83,,percent of total billed charges,,,7863.19,95,,percent of total billed charges,,,7449.34,90,,percent of total billed charges,,,7449.34,90,,percent of total billed charges,,,6787.17,82,,percent of total billed charges,,,7449.34,90,,percent of total billed charges,,,7035.48,85,,percent of total billed charges,,2069.26,7863.19,
DEPUY ARTICUL/EZE BALL 32MM +1,30180749,CDM,,,278,RC,outpatient,,9650.62,9650.62,,8193.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2412.66,22,,percent of total billed charges,,,,,,,,,8685.56,90,,percent of total billed charges,,,7990.71,82.8,,percent of total billed charges,,,8203.03,85,,percent of total billed charges,,,,,,,,,8492.55,88,,percent of total billed charges,,,,,,,,,7373.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2412.66,22,,percent of total billed charges,,,8782.06,91,,percent of total billed charges,,,9168.09,95,,percent of total billed charges,,,8010.01,83,,percent of total billed charges,,,8010.01,83,,percent of total billed charges,,,,,,,,,,,,,,,8010.01,83,,percent of total billed charges,,,9168.09,95,,percent of total billed charges,,,8685.56,90,,percent of total billed charges,,,8685.56,90,,percent of total billed charges,,,7913.51,82,,percent of total billed charges,,,8685.56,90,,percent of total billed charges,,,8203.03,85,,percent of total billed charges,,2412.66,9168.09,
DEPUY STEM SUMMIT TAPER SZ6 HI OFF,30180752,CDM,,,278,RC,outpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8814.57,22,,percent of total billed charges,,,,,,,,,31732.45,90,,percent of total billed charges,,,29193.86,82.8,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8814.57,22,,percent of total billed charges,,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,8814.57,33495.37,
DEPUY SELF CENT HIP 48X28 BRN,30180756,CDM,,,278,RC,outpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.27,22,,percent of total billed charges,,,,,,,,,7312.56,90,,percent of total billed charges,,,6727.56,82.8,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.27,22,,percent of total billed charges,,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,2031.27,7718.82,
DEPUY FEMUR CEMENTED LT SZ4,30180757,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
DEPUY INSERT SIGMA XLK 4 X 12.5,30180758,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY INSERT SIGMA XLK 4 X 15,30180759,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
POLYSORB SOFT TISSUE ANCHOR 2MM,30180760,CDM,,,270,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
ARTELON CMC SPACER,30180761,CDM,,,270,RC,outpatient,,12148.5,12148.5,,10314.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3037.13,22,,percent of total billed charges,,,,,,,,,10933.65,90,,percent of total billed charges,,,10058.96,82.8,,percent of total billed charges,,,10326.23,85,,percent of total billed charges,,,,,,,,,10690.68,88,,percent of total billed charges,,,,,,,,,9281.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3037.13,22,,percent of total billed charges,,,11055.14,91,,percent of total billed charges,,,11541.08,95,,percent of total billed charges,,,10083.26,83,,percent of total billed charges,,,10083.26,83,,percent of total billed charges,,,,,,,,,,,,,,,10083.26,83,,percent of total billed charges,,,11541.08,95,,percent of total billed charges,,,10933.65,90,,percent of total billed charges,,,10933.65,90,,percent of total billed charges,,,9961.77,82,,percent of total billed charges,,,10933.65,90,,percent of total billed charges,,,10326.23,85,,percent of total billed charges,,3037.13,11541.08,
SYNTHES ROD REAMER 2.5MM,30180764,CDM,,,270,RC,outpatient,,1172.28,1172.28,,995.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,293.07,22,,percent of total billed charges,,,,,,,,,1055.05,90,,percent of total billed charges,,,970.65,82.8,,percent of total billed charges,,,996.44,85,,percent of total billed charges,,,,,,,,,1031.61,88,,percent of total billed charges,,,,,,,,,895.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,293.07,22,,percent of total billed charges,,,1066.77,91,,percent of total billed charges,,,1113.67,95,,percent of total billed charges,,,972.99,83,,percent of total billed charges,,,972.99,83,,percent of total billed charges,,,,,,,,,,,,,,,972.99,83,,percent of total billed charges,,,1113.67,95,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,961.27,82,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,996.44,85,,percent of total billed charges,,293.07,1113.67,
STENT URETERAL CONTOUR 6 X 22,30180773,CDM,,,270,RC,outpatient,,917.28,917.28,,778.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,229.32,22,,percent of total billed charges,,,,,,,,,825.55,90,,percent of total billed charges,,,759.51,82.8,,percent of total billed charges,,,779.69,85,,percent of total billed charges,,,,,,,,,807.21,88,,percent of total billed charges,,,,,,,,,700.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,229.32,22,,percent of total billed charges,,,834.72,91,,percent of total billed charges,,,871.42,95,,percent of total billed charges,,,761.34,83,,percent of total billed charges,,,761.34,83,,percent of total billed charges,,,,,,,,,,,,,,,761.34,83,,percent of total billed charges,,,871.42,95,,percent of total billed charges,,,825.55,90,,percent of total billed charges,,,825.55,90,,percent of total billed charges,,,752.17,82,,percent of total billed charges,,,825.55,90,,percent of total billed charges,,,779.69,85,,percent of total billed charges,,229.32,871.42,
SYNTHES SCREW STARDRIVE 4.0X34MM,30180783,CDM,,,278,RC,outpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,562.71,22,,percent of total billed charges,,,,,,,,,2025.74,90,,percent of total billed charges,,,1863.68,82.8,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,562.71,22,,percent of total billed charges,,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,562.71,2138.28,
SYNTHES GUIDEWIRE 3.2MM,30180784,CDM,,,278,RC,outpatient,,984.75,984.75,,836.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,246.19,22,,percent of total billed charges,,,,,,,,,886.28,90,,percent of total billed charges,,,815.37,82.8,,percent of total billed charges,,,837.04,85,,percent of total billed charges,,,,,,,,,866.58,88,,percent of total billed charges,,,,,,,,,752.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,246.19,22,,percent of total billed charges,,,896.12,91,,percent of total billed charges,,,935.51,95,,percent of total billed charges,,,817.34,83,,percent of total billed charges,,,817.34,83,,percent of total billed charges,,,,,,,,,,,,,,,817.34,83,,percent of total billed charges,,,935.51,95,,percent of total billed charges,,,886.28,90,,percent of total billed charges,,,886.28,90,,percent of total billed charges,,,807.5,82,,percent of total billed charges,,,886.28,90,,percent of total billed charges,,,837.04,85,,percent of total billed charges,,246.19,935.51,
SHOULDER ABDUCTION SLING - XLGE,30180790,CDM,,,270,RC,outpatient,,36.99,36.99,,31.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.25,22,,percent of total billed charges,,,,,,,,,33.29,90,,percent of total billed charges,,,30.63,82.8,,percent of total billed charges,,,31.44,85,,percent of total billed charges,,,,,,,,,32.55,88,,percent of total billed charges,,,,,,,,,28.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.25,22,,percent of total billed charges,,,33.66,91,,percent of total billed charges,,,35.14,95,,percent of total billed charges,,,30.7,83,,percent of total billed charges,,,30.7,83,,percent of total billed charges,,,,,,,,,,,,,,,30.7,83,,percent of total billed charges,,,35.14,95,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,30.33,82,,percent of total billed charges,,,33.29,90,,percent of total billed charges,,,31.44,85,,percent of total billed charges,,9.25,35.14,
ARTHREX CANNULA 7MM,30180792,CDM,,,270,RC,outpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50,22,,percent of total billed charges,,,,,,,,,180,90,,percent of total billed charges,,,165.6,82.8,,percent of total billed charges,,,170,85,,percent of total billed charges,,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50,22,,percent of total billed charges,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,50,190,
HAND TRAP,30180795,CDM,,,270,RC,outpatient,,213.75,213.75,,181.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.44,22,,percent of total billed charges,,,,,,,,,192.38,90,,percent of total billed charges,,,176.99,82.8,,percent of total billed charges,,,181.69,85,,percent of total billed charges,,,,,,,,,188.1,88,,percent of total billed charges,,,,,,,,,163.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.44,22,,percent of total billed charges,,,194.51,91,,percent of total billed charges,,,203.06,95,,percent of total billed charges,,,177.41,83,,percent of total billed charges,,,177.41,83,,percent of total billed charges,,,,,,,,,,,,,,,177.41,83,,percent of total billed charges,,,203.06,95,,percent of total billed charges,,,192.38,90,,percent of total billed charges,,,192.38,90,,percent of total billed charges,,,175.28,82,,percent of total billed charges,,,192.38,90,,percent of total billed charges,,,181.69,85,,percent of total billed charges,,53.44,203.06,
ARTHREX FIBERSTICK #2,30180801,CDM,,,270,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
ARTHREX CANNULA 8.25M,30180817,CDM,,,270,RC,outpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50,22,,percent of total billed charges,,,,,,,,,180,90,,percent of total billed charges,,,165.6,82.8,,percent of total billed charges,,,170,85,,percent of total billed charges,,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50,22,,percent of total billed charges,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,50,190,
NOVASURE ABLATION KIT,30180818,CDM,,,270,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
STRYKER DISP 18X4 QUICK TOURN CUFF,30180819,CDM,,,270,RC,outpatient,,181.24,181.24,,153.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.31,22,,percent of total billed charges,,,,,,,,,163.12,90,,percent of total billed charges,,,150.07,82.8,,percent of total billed charges,,,154.05,85,,percent of total billed charges,,,,,,,,,159.49,88,,percent of total billed charges,,,,,,,,,138.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.31,22,,percent of total billed charges,,,164.93,91,,percent of total billed charges,,,172.18,95,,percent of total billed charges,,,150.43,83,,percent of total billed charges,,,150.43,83,,percent of total billed charges,,,,,,,,,,,,,,,150.43,83,,percent of total billed charges,,,172.18,95,,percent of total billed charges,,,163.12,90,,percent of total billed charges,,,163.12,90,,percent of total billed charges,,,148.62,82,,percent of total billed charges,,,163.12,90,,percent of total billed charges,,,154.05,85,,percent of total billed charges,,45.31,172.18,
STRYKER DISP 12X2 QUICK TOURN CUFF,30180820,CDM,,,270,RC,outpatient,,122.24,122.24,,103.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.56,22,,percent of total billed charges,,,,,,,,,110.02,90,,percent of total billed charges,,,101.21,82.8,,percent of total billed charges,,,103.9,85,,percent of total billed charges,,,,,,,,,107.57,88,,percent of total billed charges,,,,,,,,,93.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.56,22,,percent of total billed charges,,,111.24,91,,percent of total billed charges,,,116.13,95,,percent of total billed charges,,,101.46,83,,percent of total billed charges,,,101.46,83,,percent of total billed charges,,,,,,,,,,,,,,,101.46,83,,percent of total billed charges,,,116.13,95,,percent of total billed charges,,,110.02,90,,percent of total billed charges,,,110.02,90,,percent of total billed charges,,,100.24,82,,percent of total billed charges,,,110.02,90,,percent of total billed charges,,,103.9,85,,percent of total billed charges,,30.56,116.13,
STRYKER DISP 34X4 QUICK TOURN CUFF,30180821,CDM,,,270,RC,outpatient,,221.56,221.56,,188.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.39,22,,percent of total billed charges,,,,,,,,,199.4,90,,percent of total billed charges,,,183.45,82.8,,percent of total billed charges,,,188.33,85,,percent of total billed charges,,,,,,,,,194.97,88,,percent of total billed charges,,,,,,,,,169.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.39,22,,percent of total billed charges,,,201.62,91,,percent of total billed charges,,,210.48,95,,percent of total billed charges,,,183.89,83,,percent of total billed charges,,,183.89,83,,percent of total billed charges,,,,,,,,,,,,,,,183.89,83,,percent of total billed charges,,,210.48,95,,percent of total billed charges,,,199.4,90,,percent of total billed charges,,,199.4,90,,percent of total billed charges,,,181.68,82,,percent of total billed charges,,,199.4,90,,percent of total billed charges,,,188.33,85,,percent of total billed charges,,55.39,210.48,
STRYKER DISP 44X4 QUICK TOURN CUFF,30180822,CDM,,,270,RC,outpatient,,241.96,241.96,,205.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60.49,22,,percent of total billed charges,,,,,,,,,217.76,90,,percent of total billed charges,,,200.34,82.8,,percent of total billed charges,,,205.67,85,,percent of total billed charges,,,,,,,,,212.92,88,,percent of total billed charges,,,,,,,,,184.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60.49,22,,percent of total billed charges,,,220.18,91,,percent of total billed charges,,,229.86,95,,percent of total billed charges,,,200.83,83,,percent of total billed charges,,,200.83,83,,percent of total billed charges,,,,,,,,,,,,,,,200.83,83,,percent of total billed charges,,,229.86,95,,percent of total billed charges,,,217.76,90,,percent of total billed charges,,,217.76,90,,percent of total billed charges,,,198.41,82,,percent of total billed charges,,,217.76,90,,percent of total billed charges,,,205.67,85,,percent of total billed charges,,60.49,229.86,
STRYKER DISP 24X4 QUICK TOURN CUFF,30180823,CDM,,,270,RC,outpatient,,190.76,190.76,,161.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.69,22,,percent of total billed charges,,,,,,,,,171.68,90,,percent of total billed charges,,,157.95,82.8,,percent of total billed charges,,,162.15,85,,percent of total billed charges,,,,,,,,,167.87,88,,percent of total billed charges,,,,,,,,,145.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.69,22,,percent of total billed charges,,,173.59,91,,percent of total billed charges,,,181.22,95,,percent of total billed charges,,,158.33,83,,percent of total billed charges,,,158.33,83,,percent of total billed charges,,,,,,,,,,,,,,,158.33,83,,percent of total billed charges,,,181.22,95,,percent of total billed charges,,,171.68,90,,percent of total billed charges,,,171.68,90,,percent of total billed charges,,,156.42,82,,percent of total billed charges,,,171.68,90,,percent of total billed charges,,,162.15,85,,percent of total billed charges,,47.69,181.22,
STRYKER DISP 30X4 QUICK TOURN CUFF,30180824,CDM,,,270,RC,outpatient,,206.16,206.16,,175.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.54,22,,percent of total billed charges,,,,,,,,,185.54,90,,percent of total billed charges,,,170.7,82.8,,percent of total billed charges,,,175.24,85,,percent of total billed charges,,,,,,,,,181.42,88,,percent of total billed charges,,,,,,,,,157.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.54,22,,percent of total billed charges,,,187.61,91,,percent of total billed charges,,,195.85,95,,percent of total billed charges,,,171.11,83,,percent of total billed charges,,,171.11,83,,percent of total billed charges,,,,,,,,,,,,,,,171.11,83,,percent of total billed charges,,,195.85,95,,percent of total billed charges,,,185.54,90,,percent of total billed charges,,,185.54,90,,percent of total billed charges,,,169.05,82,,percent of total billed charges,,,185.54,90,,percent of total billed charges,,,175.24,85,,percent of total billed charges,,51.54,195.85,
CARTILAGE BIOPSY TRANSPORT KIT,30180828,CDM,,,270,RC,outpatient,,3692,3692,,3134.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,923,22,,percent of total billed charges,,,,,,,,,3322.8,90,,percent of total billed charges,,,3056.98,82.8,,percent of total billed charges,,,3138.2,85,,percent of total billed charges,,,,,,,,,3248.96,88,,percent of total billed charges,,,,,,,,,2820.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,923,22,,percent of total billed charges,,,3359.72,91,,percent of total billed charges,,,3507.4,95,,percent of total billed charges,,,3064.36,83,,percent of total billed charges,,,3064.36,83,,percent of total billed charges,,,,,,,,,,,,,,,3064.36,83,,percent of total billed charges,,,3507.4,95,,percent of total billed charges,,,3322.8,90,,percent of total billed charges,,,3322.8,90,,percent of total billed charges,,,3027.44,82,,percent of total billed charges,,,3322.8,90,,percent of total billed charges,,,3138.2,85,,percent of total billed charges,,923,3507.4,
DEPUY STEM TRI-LOCK STD OFFSET SZ4,30180829,CDM,,,278,RC,outpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10178.29,22,,percent of total billed charges,,,,,,,,,36641.83,90,,percent of total billed charges,,,33710.48,82.8,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10178.29,22,,percent of total billed charges,,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,10178.29,38677.48,
DEPUY ARTICUL/EZE BALL 32MM +13,30180830,CDM,,,278,RC,outpatient,,5683.54,5683.54,,4825.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1420.89,22,,percent of total billed charges,,,,,,,,,5115.19,90,,percent of total billed charges,,,4705.97,82.8,,percent of total billed charges,,,4831.01,85,,percent of total billed charges,,,,,,,,,5001.52,88,,percent of total billed charges,,,,,,,,,4342.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1420.89,22,,percent of total billed charges,,,5172.02,91,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,,,,,,,,,,,,,4717.34,83,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4660.5,82,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4831.01,85,,percent of total billed charges,,1420.89,5399.36,
DEPUY PINNACLE CUP 64MM,30180831,CDM,,,278,RC,outpatient,,14472.9,14472.9,,12287.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3618.23,22,,percent of total billed charges,,,,,,,,,13025.61,90,,percent of total billed charges,,,11983.56,82.8,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,,,,,,,,12736.15,88,,percent of total billed charges,,,,,,,,,11057.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3618.23,22,,percent of total billed charges,,,13170.34,91,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12012.51,83,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,11867.78,82,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,3618.23,13749.26,
DEPUY LINER ALTRX NEUT 36 X 64,30180832,CDM,,,278,RC,outpatient,,13197.15,13197.15,,11204.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3299.29,22,,percent of total billed charges,,,,,,,,,11877.44,90,,percent of total billed charges,,,10927.24,82.8,,percent of total billed charges,,,11217.58,85,,percent of total billed charges,,,,,,,,,11613.49,88,,percent of total billed charges,,,,,,,,,10082.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3299.29,22,,percent of total billed charges,,,12009.41,91,,percent of total billed charges,,,12537.29,95,,percent of total billed charges,,,10953.63,83,,percent of total billed charges,,,10953.63,83,,percent of total billed charges,,,,,,,,,,,,,,,10953.63,83,,percent of total billed charges,,,12537.29,95,,percent of total billed charges,,,11877.44,90,,percent of total billed charges,,,11877.44,90,,percent of total billed charges,,,10821.66,82,,percent of total billed charges,,,11877.44,90,,percent of total billed charges,,,11217.58,85,,percent of total billed charges,,3299.29,12537.29,
DEPUY LINER ALTRX +4 NEUT 36 X 64,30180833,CDM,,,278,RC,outpatient,,14543.23,14543.23,,12347.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3635.81,22,,percent of total billed charges,,,,,,,,,13088.91,90,,percent of total billed charges,,,12041.79,82.8,,percent of total billed charges,,,12361.75,85,,percent of total billed charges,,,,,,,,,12798.04,88,,percent of total billed charges,,,,,,,,,11111.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3635.81,22,,percent of total billed charges,,,13234.34,91,,percent of total billed charges,,,13816.07,95,,percent of total billed charges,,,12070.88,83,,percent of total billed charges,,,12070.88,83,,percent of total billed charges,,,,,,,,,,,,,,,12070.88,83,,percent of total billed charges,,,13816.07,95,,percent of total billed charges,,,13088.91,90,,percent of total billed charges,,,13088.91,90,,percent of total billed charges,,,11925.45,82,,percent of total billed charges,,,13088.91,90,,percent of total billed charges,,,12361.75,85,,percent of total billed charges,,3635.81,13816.07,
DEPUY STEM CORAIL STD SZ12,30180834,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY LINER ALTRX +4 36 X 64,30180835,CDM,,,278,RC,outpatient,,14543.23,14543.23,,12347.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3635.81,22,,percent of total billed charges,,,,,,,,,13088.91,90,,percent of total billed charges,,,12041.79,82.8,,percent of total billed charges,,,12361.75,85,,percent of total billed charges,,,,,,,,,12798.04,88,,percent of total billed charges,,,,,,,,,11111.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3635.81,22,,percent of total billed charges,,,13234.34,91,,percent of total billed charges,,,13816.07,95,,percent of total billed charges,,,12070.88,83,,percent of total billed charges,,,12070.88,83,,percent of total billed charges,,,,,,,,,,,,,,,12070.88,83,,percent of total billed charges,,,13816.07,95,,percent of total billed charges,,,13088.91,90,,percent of total billed charges,,,13088.91,90,,percent of total billed charges,,,11925.45,82,,percent of total billed charges,,,13088.91,90,,percent of total billed charges,,,12361.75,85,,percent of total billed charges,,3635.81,13816.07,
SYNTHES DRILL BIT TAPERED 10X4MM,30180842,CDM,,,278,RC,outpatient,,1939.28,1939.28,,1646.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,484.82,22,,percent of total billed charges,,,,,,,,,1745.35,90,,percent of total billed charges,,,1605.72,82.8,,percent of total billed charges,,,1648.39,85,,percent of total billed charges,,,,,,,,,1706.57,88,,percent of total billed charges,,,,,,,,,1481.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,484.82,22,,percent of total billed charges,,,1764.74,91,,percent of total billed charges,,,1842.32,95,,percent of total billed charges,,,1609.6,83,,percent of total billed charges,,,1609.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1609.6,83,,percent of total billed charges,,,1842.32,95,,percent of total billed charges,,,1745.35,90,,percent of total billed charges,,,1745.35,90,,percent of total billed charges,,,1590.21,82,,percent of total billed charges,,,1745.35,90,,percent of total billed charges,,,1648.39,85,,percent of total billed charges,,484.82,1842.32,
DEPUY INSERT SIGMA XLK 5 X 15,30180843,CDM,,,278,RC,outpatient,,14248.07,14248.07,,12096.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.02,22,,percent of total billed charges,,,,,,,,,12823.26,90,,percent of total billed charges,,,11797.4,82.8,,percent of total billed charges,,,12110.86,85,,percent of total billed charges,,,,,,,,,12538.3,88,,percent of total billed charges,,,,,,,,,10885.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.02,22,,percent of total billed charges,,,12965.74,91,,percent of total billed charges,,,13535.67,95,,percent of total billed charges,,,11825.9,83,,percent of total billed charges,,,11825.9,83,,percent of total billed charges,,,,,,,,,,,,,,,11825.9,83,,percent of total billed charges,,,13535.67,95,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,11683.42,82,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,12110.86,85,,percent of total billed charges,,3562.02,13535.67,
SYNTHES SCREW LOCKING 3.5X16MM,30180847,CDM,,,278,RC,outpatient,,1217.84,1217.84,,1033.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,304.46,22,,percent of total billed charges,,,,,,,,,1096.06,90,,percent of total billed charges,,,1008.37,82.8,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,,,,,,,,1071.7,88,,percent of total billed charges,,,,,,,,,930.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,304.46,22,,percent of total billed charges,,,1108.23,91,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1010.81,83,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,998.63,82,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,304.46,1156.95,
SYNTHES DRILL BIT 2.0MM 310.21,30180849,CDM,,,270,RC,outpatient,,832.33,832.33,,706.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208.08,22,,percent of total billed charges,,,,,,,,,749.1,90,,percent of total billed charges,,,689.17,82.8,,percent of total billed charges,,,707.48,85,,percent of total billed charges,,,,,,,,,732.45,88,,percent of total billed charges,,,,,,,,,635.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208.08,22,,percent of total billed charges,,,757.42,91,,percent of total billed charges,,,790.71,95,,percent of total billed charges,,,690.83,83,,percent of total billed charges,,,690.83,83,,percent of total billed charges,,,,,,,,,,,,,,,690.83,83,,percent of total billed charges,,,790.71,95,,percent of total billed charges,,,749.1,90,,percent of total billed charges,,,749.1,90,,percent of total billed charges,,,682.51,82,,percent of total billed charges,,,749.1,90,,percent of total billed charges,,,707.48,85,,percent of total billed charges,,208.08,790.71,
SYNTHES PLATE LCP TUBULAR 5-HOLE,30180850,CDM,,,278,RC,outpatient,,1585.68,1585.68,,1346.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,396.42,22,,percent of total billed charges,,,,,,,,,1427.11,90,,percent of total billed charges,,,1312.94,82.8,,percent of total billed charges,,,1347.83,85,,percent of total billed charges,,,,,,,,,1395.4,88,,percent of total billed charges,,,,,,,,,1211.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,396.42,22,,percent of total billed charges,,,1442.97,91,,percent of total billed charges,,,1506.4,95,,percent of total billed charges,,,1316.11,83,,percent of total billed charges,,,1316.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1316.11,83,,percent of total billed charges,,,1506.4,95,,percent of total billed charges,,,1427.11,90,,percent of total billed charges,,,1427.11,90,,percent of total billed charges,,,1300.26,82,,percent of total billed charges,,,1427.11,90,,percent of total billed charges,,,1347.83,85,,percent of total billed charges,,396.42,1506.4,
SYNTHES K-WIRE 2.0MM,30180851,CDM,,,278,RC,outpatient,,105.4,105.4,,89.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.35,22,,percent of total billed charges,,,,,,,,,94.86,90,,percent of total billed charges,,,87.27,82.8,,percent of total billed charges,,,89.59,85,,percent of total billed charges,,,,,,,,,92.75,88,,percent of total billed charges,,,,,,,,,80.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.35,22,,percent of total billed charges,,,95.91,91,,percent of total billed charges,,,100.13,95,,percent of total billed charges,,,87.48,83,,percent of total billed charges,,,87.48,83,,percent of total billed charges,,,,,,,,,,,,,,,87.48,83,,percent of total billed charges,,,100.13,95,,percent of total billed charges,,,94.86,90,,percent of total billed charges,,,94.86,90,,percent of total billed charges,,,86.43,82,,percent of total billed charges,,,94.86,90,,percent of total billed charges,,,89.59,85,,percent of total billed charges,,26.35,100.13,
DEPUY ARTICUL/EZE BALL 32MM +17,30180856,CDM,,,278,RC,outpatient,,4752.22,4752.22,,4034.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1188.06,22,,percent of total billed charges,,,,,,,,,4277,90,,percent of total billed charges,,,3934.84,82.8,,percent of total billed charges,,,4039.39,85,,percent of total billed charges,,,,,,,,,4181.95,88,,percent of total billed charges,,,,,,,,,3630.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1188.06,22,,percent of total billed charges,,,4324.52,91,,percent of total billed charges,,,4514.61,95,,percent of total billed charges,,,3944.34,83,,percent of total billed charges,,,3944.34,83,,percent of total billed charges,,,,,,,,,,,,,,,3944.34,83,,percent of total billed charges,,,4514.61,95,,percent of total billed charges,,,4277,90,,percent of total billed charges,,,4277,90,,percent of total billed charges,,,3896.82,82,,percent of total billed charges,,,4277,90,,percent of total billed charges,,,4039.39,85,,percent of total billed charges,,1188.06,4514.61,
DEPUY STATURE AML 12MM X 6IN,30180857,CDM,,,278,RC,outpatient,,38122.11,38122.11,,32365.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9530.53,22,,percent of total billed charges,,,,,,,,,34309.9,90,,percent of total billed charges,,,31565.11,82.8,,percent of total billed charges,,,32403.79,85,,percent of total billed charges,,,,,,,,,33547.46,88,,percent of total billed charges,,,,,,,,,29125.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9530.53,22,,percent of total billed charges,,,34691.12,91,,percent of total billed charges,,,36216,95,,percent of total billed charges,,,31641.35,83,,percent of total billed charges,,,31641.35,83,,percent of total billed charges,,,,,,,,,,,,,,,31641.35,83,,percent of total billed charges,,,36216,95,,percent of total billed charges,,,34309.9,90,,percent of total billed charges,,,34309.9,90,,percent of total billed charges,,,31260.13,82,,percent of total billed charges,,,34309.9,90,,percent of total billed charges,,,32403.79,85,,percent of total billed charges,,9530.53,36216,
DEPUY HIP POROUS - CAPITATED (691),30180858,CDM,,,278,RC,outpatient,,30294.81,30294.81,,25720.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7573.7,22,,percent of total billed charges,,,,,,,,,27265.33,90,,percent of total billed charges,,,25084.1,82.8,,percent of total billed charges,,,25750.59,85,,percent of total billed charges,,,,,,,,,26659.43,88,,percent of total billed charges,,,,,,,,,23145.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7573.7,22,,percent of total billed charges,,,27568.28,91,,percent of total billed charges,,,28780.07,95,,percent of total billed charges,,,25144.69,83,,percent of total billed charges,,,25144.69,83,,percent of total billed charges,,,,,,,,,,,,,,,25144.69,83,,percent of total billed charges,,,28780.07,95,,percent of total billed charges,,,27265.33,90,,percent of total billed charges,,,27265.33,90,,percent of total billed charges,,,24841.74,82,,percent of total billed charges,,,27265.33,90,,percent of total billed charges,,,25750.59,85,,percent of total billed charges,,7573.7,28780.07,
DEPUY FEMORAL HEAD 36MM LGE METAL,30180859,CDM,,,278,RC,outpatient,,1729,1729,,1467.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,432.25,22,,percent of total billed charges,,,,,,,,,1556.1,90,,percent of total billed charges,,,1431.61,82.8,,percent of total billed charges,,,1469.65,85,,percent of total billed charges,,,,,,,,,1521.52,88,,percent of total billed charges,,,,,,,,,1320.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,432.25,22,,percent of total billed charges,,,1573.39,91,,percent of total billed charges,,,1642.55,95,,percent of total billed charges,,,1435.07,83,,percent of total billed charges,,,1435.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1435.07,83,,percent of total billed charges,,,1642.55,95,,percent of total billed charges,,,1556.1,90,,percent of total billed charges,,,1556.1,90,,percent of total billed charges,,,1417.78,82,,percent of total billed charges,,,1556.1,90,,percent of total billed charges,,,1469.65,85,,percent of total billed charges,,432.25,1642.55,
DEPUY LINER ALTRX X-LINK (669),30180860,CDM,,,278,RC,outpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,690.63,22,,percent of total billed charges,,,,,,,,,2486.25,90,,percent of total billed charges,,,2287.35,82.8,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,690.63,22,,percent of total billed charges,,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,690.63,2624.38,
SYNTHES CABLE W/CRIMP 1.7M TI,30180861,CDM,,,278,RC,outpatient,,4947.09,4947.09,,4200.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1236.77,22,,percent of total billed charges,,,,,,,,,4452.38,90,,percent of total billed charges,,,4096.19,82.8,,percent of total billed charges,,,4205.03,85,,percent of total billed charges,,,,,,,,,4353.44,88,,percent of total billed charges,,,,,,,,,3779.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1236.77,22,,percent of total billed charges,,,4501.85,91,,percent of total billed charges,,,4699.74,95,,percent of total billed charges,,,4106.08,83,,percent of total billed charges,,,4106.08,83,,percent of total billed charges,,,,,,,,,,,,,,,4106.08,83,,percent of total billed charges,,,4699.74,95,,percent of total billed charges,,,4452.38,90,,percent of total billed charges,,,4452.38,90,,percent of total billed charges,,,4056.61,82,,percent of total billed charges,,,4452.38,90,,percent of total billed charges,,,4205.03,85,,percent of total billed charges,,1236.77,4699.74,
SYNTHES GUIDEWIRE 722,30180886,CDM,,,278,RC,outpatient,,351.68,351.68,,298.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.92,22,,percent of total billed charges,,,,,,,,,316.51,90,,percent of total billed charges,,,291.19,82.8,,percent of total billed charges,,,298.93,85,,percent of total billed charges,,,,,,,,,309.48,88,,percent of total billed charges,,,,,,,,,268.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.92,22,,percent of total billed charges,,,320.03,91,,percent of total billed charges,,,334.1,95,,percent of total billed charges,,,291.89,83,,percent of total billed charges,,,291.89,83,,percent of total billed charges,,,,,,,,,,,,,,,291.89,83,,percent of total billed charges,,,334.1,95,,percent of total billed charges,,,316.51,90,,percent of total billed charges,,,316.51,90,,percent of total billed charges,,,288.38,82,,percent of total billed charges,,,316.51,90,,percent of total billed charges,,,298.93,85,,percent of total billed charges,,87.92,334.1,
SYNTHES DRILL BIT CANNULATED 2.7MM,30180887,CDM,,,278,RC,outpatient,,4519.19,4519.19,,3836.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1129.8,22,,percent of total billed charges,,,,,,,,,4067.27,90,,percent of total billed charges,,,3741.89,82.8,,percent of total billed charges,,,3841.31,85,,percent of total billed charges,,,,,,,,,3976.89,88,,percent of total billed charges,,,,,,,,,3452.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1129.8,22,,percent of total billed charges,,,4112.46,91,,percent of total billed charges,,,4293.23,95,,percent of total billed charges,,,3750.93,83,,percent of total billed charges,,,3750.93,83,,percent of total billed charges,,,,,,,,,,,,,,,3750.93,83,,percent of total billed charges,,,4293.23,95,,percent of total billed charges,,,4067.27,90,,percent of total billed charges,,,4067.27,90,,percent of total billed charges,,,3705.74,82,,percent of total billed charges,,,4067.27,90,,percent of total billed charges,,,3841.31,85,,percent of total billed charges,,1129.8,4293.23,
DEPUY INSERT SIGMA XLK 5 X 12.5,30180892,CDM,,,278,RC,outpatient,,14248.07,14248.07,,12096.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.02,22,,percent of total billed charges,,,,,,,,,12823.26,90,,percent of total billed charges,,,11797.4,82.8,,percent of total billed charges,,,12110.86,85,,percent of total billed charges,,,,,,,,,12538.3,88,,percent of total billed charges,,,,,,,,,10885.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.02,22,,percent of total billed charges,,,12965.74,91,,percent of total billed charges,,,13535.67,95,,percent of total billed charges,,,11825.9,83,,percent of total billed charges,,,11825.9,83,,percent of total billed charges,,,,,,,,,,,,,,,11825.9,83,,percent of total billed charges,,,13535.67,95,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,11683.42,82,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,12110.86,85,,percent of total billed charges,,3562.02,13535.67,
DEPUY KNEE POROUS - CAPITATED (704),30180893,CDM,,,278,RC,outpatient,,26914.88,26914.88,,22850.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6728.72,22,,percent of total billed charges,,,,,,,,,24223.39,90,,percent of total billed charges,,,22285.52,82.8,,percent of total billed charges,,,22877.65,85,,percent of total billed charges,,,,,,,,,23685.09,88,,percent of total billed charges,,,,,,,,,20562.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6728.72,22,,percent of total billed charges,,,24492.54,91,,percent of total billed charges,,,25569.14,95,,percent of total billed charges,,,22339.35,83,,percent of total billed charges,,,22339.35,83,,percent of total billed charges,,,,,,,,,,,,,,,22339.35,83,,percent of total billed charges,,,25569.14,95,,percent of total billed charges,,,24223.39,90,,percent of total billed charges,,,24223.39,90,,percent of total billed charges,,,22070.2,82,,percent of total billed charges,,,24223.39,90,,percent of total billed charges,,,22877.65,85,,percent of total billed charges,,6728.72,25569.14,
DEPUY LINER ALTRX X-LINK (712),30180894,CDM,,,278,RC,outpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,568.75,22,,percent of total billed charges,,,,,,,,,2047.5,90,,percent of total billed charges,,,1883.7,82.8,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,568.75,22,,percent of total billed charges,,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,568.75,2161.25,
DEPUY KNEE HYBRID - CAPITATED (703),30180895,CDM,,,278,RC,outpatient,,25239.57,25239.57,,21428.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6309.89,22,,percent of total billed charges,,,,,,,,,22715.61,90,,percent of total billed charges,,,20898.36,82.8,,percent of total billed charges,,,21453.63,85,,percent of total billed charges,,,,,,,,,22210.82,88,,percent of total billed charges,,,,,,,,,19283.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6309.89,22,,percent of total billed charges,,,22968.01,91,,percent of total billed charges,,,23977.59,95,,percent of total billed charges,,,20948.84,83,,percent of total billed charges,,,20948.84,83,,percent of total billed charges,,,,,,,,,,,,,,,20948.84,83,,percent of total billed charges,,,23977.59,95,,percent of total billed charges,,,22715.61,90,,percent of total billed charges,,,22715.61,90,,percent of total billed charges,,,20696.45,82,,percent of total billed charges,,,22715.61,90,,percent of total billed charges,,,21453.63,85,,percent of total billed charges,,6309.89,23977.59,
DEPUY UPCHARGE PORCOAT FEMUR(735),30180896,CDM,,,278,RC,outpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325,22,,percent of total billed charges,,,,,,,,,1170,90,,percent of total billed charges,,,1076.4,82.8,,percent of total billed charges,,,1105,85,,percent of total billed charges,,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325,22,,percent of total billed charges,,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,325,1235,
DEPUY UPCHARGE XLINK INSERT(736),30180897,CDM,,,278,RC,outpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,568.75,22,,percent of total billed charges,,,,,,,,,2047.5,90,,percent of total billed charges,,,1883.7,82.8,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,568.75,22,,percent of total billed charges,,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,568.75,2161.25,
SYNTHES SCREW CORTEX 4.5X30MM,30180898,CDM,,,278,RC,outpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.35,22,,percent of total billed charges,,,,,,,,,235.24,90,,percent of total billed charges,,,216.42,82.8,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.35,22,,percent of total billed charges,,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,65.35,248.31,
DEPUY UPCHARGE CERAMIC HEAD(695),30180908,CDM,,,278,RC,outpatient,,4225,4225,,3587.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1056.25,22,,percent of total billed charges,,,,,,,,,3802.5,90,,percent of total billed charges,,,3498.3,82.8,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,,,,,,,,3718,88,,percent of total billed charges,,,,,,,,,3227.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1056.25,22,,percent of total billed charges,,,3844.75,91,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,,,,,,,,,,,,,3506.75,83,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3464.5,82,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,1056.25,4013.75,
SYNTHES K-WIRE 1.25MM,30180910,CDM,,,278,RC,outpatient,,111.82,111.82,,94.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.96,22,,percent of total billed charges,,,,,,,,,100.64,90,,percent of total billed charges,,,92.59,82.8,,percent of total billed charges,,,95.05,85,,percent of total billed charges,,,,,,,,,98.4,88,,percent of total billed charges,,,,,,,,,85.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.96,22,,percent of total billed charges,,,101.76,91,,percent of total billed charges,,,106.23,95,,percent of total billed charges,,,92.81,83,,percent of total billed charges,,,92.81,83,,percent of total billed charges,,,,,,,,,,,,,,,92.81,83,,percent of total billed charges,,,106.23,95,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,91.69,82,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,95.05,85,,percent of total billed charges,,27.96,106.23,
SYNTHES SCREW STARDRIVE 3.5X10MM,30180914,CDM,,,278,RC,outpatient,,1217.84,1217.84,,1033.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,304.46,22,,percent of total billed charges,,,,,,,,,1096.06,90,,percent of total billed charges,,,1008.37,82.8,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,,,,,,,,1071.7,88,,percent of total billed charges,,,,,,,,,930.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,304.46,22,,percent of total billed charges,,,1108.23,91,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1010.81,83,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,998.63,82,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,304.46,1156.95,
SYNTHES SCREW STARDRIVE 3.5X12MM,30180915,CDM,,,278,RC,outpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,313.59,22,,percent of total billed charges,,,,,,,,,1128.93,90,,percent of total billed charges,,,1038.62,82.8,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,313.59,22,,percent of total billed charges,,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,313.59,1191.65,
ARTHREX SCREW ANCHOR 5.5 W/FIBERWIRE,30180919,CDM,,,270,RC,outpatient,,1657.5,1657.5,,1407.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,414.38,22,,percent of total billed charges,,,,,,,,,1491.75,90,,percent of total billed charges,,,1372.41,82.8,,percent of total billed charges,,,1408.88,85,,percent of total billed charges,,,,,,,,,1458.6,88,,percent of total billed charges,,,,,,,,,1266.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,414.38,22,,percent of total billed charges,,,1508.33,91,,percent of total billed charges,,,1574.63,95,,percent of total billed charges,,,1375.73,83,,percent of total billed charges,,,1375.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1375.73,83,,percent of total billed charges,,,1574.63,95,,percent of total billed charges,,,1491.75,90,,percent of total billed charges,,,1491.75,90,,percent of total billed charges,,,1359.15,82,,percent of total billed charges,,,1491.75,90,,percent of total billed charges,,,1408.88,85,,percent of total billed charges,,414.38,1574.63,
DEPUY PATELLA BLADE MED,30180920,CDM,,,278,RC,outpatient,,1748.5,1748.5,,1484.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,437.13,22,,percent of total billed charges,,,,,,,,,1573.65,90,,percent of total billed charges,,,1447.76,82.8,,percent of total billed charges,,,1486.23,85,,percent of total billed charges,,,,,,,,,1538.68,88,,percent of total billed charges,,,,,,,,,1335.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,437.13,22,,percent of total billed charges,,,1591.14,91,,percent of total billed charges,,,1661.08,95,,percent of total billed charges,,,1451.26,83,,percent of total billed charges,,,1451.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1451.26,83,,percent of total billed charges,,,1661.08,95,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1433.77,82,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1486.23,85,,percent of total billed charges,,437.13,1661.08,
DEPUY UPCHARGE PORCOAT FEMUR(711),30180921,CDM,,,278,RC,outpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325,22,,percent of total billed charges,,,,,,,,,1170,90,,percent of total billed charges,,,1076.4,82.8,,percent of total billed charges,,,1105,85,,percent of total billed charges,,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325,22,,percent of total billed charges,,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,325,1235,
DEPUY UPCHARGE CERAMIC LINER(696),30180922,CDM,,,278,RC,outpatient,,4225,4225,,3587.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1056.25,22,,percent of total billed charges,,,,,,,,,3802.5,90,,percent of total billed charges,,,3498.3,82.8,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,,,,,,,,3718,88,,percent of total billed charges,,,,,,,,,3227.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1056.25,22,,percent of total billed charges,,,3844.75,91,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,,,,,,,,,,,,,3506.75,83,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3464.5,82,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,1056.25,4013.75,
DEPUY PATELLA BLADE SM,30180923,CDM,,,278,RC,outpatient,,1878.5,1878.5,,1594.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,469.63,22,,percent of total billed charges,,,,,,,,,1690.65,90,,percent of total billed charges,,,1555.4,82.8,,percent of total billed charges,,,1596.73,85,,percent of total billed charges,,,,,,,,,1653.08,88,,percent of total billed charges,,,,,,,,,1435.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,469.63,22,,percent of total billed charges,,,1709.44,91,,percent of total billed charges,,,1784.58,95,,percent of total billed charges,,,1559.16,83,,percent of total billed charges,,,1559.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1559.16,83,,percent of total billed charges,,,1784.58,95,,percent of total billed charges,,,1690.65,90,,percent of total billed charges,,,1690.65,90,,percent of total billed charges,,,1540.37,82,,percent of total billed charges,,,1690.65,90,,percent of total billed charges,,,1596.73,85,,percent of total billed charges,,469.63,1784.58,
DEPUY KNEE CEMENTED - CAPITATED (702),30180924,CDM,,,278,RC,outpatient,,23564.26,23564.26,,20006.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5891.07,22,,percent of total billed charges,,,,,,,,,21207.83,90,,percent of total billed charges,,,19511.21,82.8,,percent of total billed charges,,,20029.62,85,,percent of total billed charges,,,,,,,,,20736.55,88,,percent of total billed charges,,,,,,,,,18003.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5891.07,22,,percent of total billed charges,,,21443.48,91,,percent of total billed charges,,,22386.05,95,,percent of total billed charges,,,19558.34,83,,percent of total billed charges,,,19558.34,83,,percent of total billed charges,,,,,,,,,,,,,,,19558.34,83,,percent of total billed charges,,,22386.05,95,,percent of total billed charges,,,21207.83,90,,percent of total billed charges,,,21207.83,90,,percent of total billed charges,,,19322.69,82,,percent of total billed charges,,,21207.83,90,,percent of total billed charges,,,20029.62,85,,percent of total billed charges,,5891.07,22386.05,
DEPUY PINNACLE CUP SECTOR II 60MM,30180926,CDM,,,278,RC,outpatient,,18892.32,18892.32,,16039.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4723.08,22,,percent of total billed charges,,,,,,,,,17003.09,90,,percent of total billed charges,,,15642.84,82.8,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,,,,,,,,16625.24,88,,percent of total billed charges,,,,,,,,,14433.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4723.08,22,,percent of total billed charges,,,17192.01,91,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15680.63,83,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,15491.7,82,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,4723.08,17947.7,
DEPUY PINNACLE CUP INSERT 40 X 60,30180927,CDM,,,278,RC,outpatient,,17516.2,17516.2,,14871.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4379.05,22,,percent of total billed charges,,,,,,,,,15764.58,90,,percent of total billed charges,,,14503.41,82.8,,percent of total billed charges,,,14888.77,85,,percent of total billed charges,,,,,,,,,15414.26,88,,percent of total billed charges,,,,,,,,,13382.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4379.05,22,,percent of total billed charges,,,15939.74,91,,percent of total billed charges,,,16640.39,95,,percent of total billed charges,,,14538.45,83,,percent of total billed charges,,,14538.45,83,,percent of total billed charges,,,,,,,,,,,,,,,14538.45,83,,percent of total billed charges,,,16640.39,95,,percent of total billed charges,,,15764.58,90,,percent of total billed charges,,,15764.58,90,,percent of total billed charges,,,14363.28,82,,percent of total billed charges,,,15764.58,90,,percent of total billed charges,,,14888.77,85,,percent of total billed charges,,4379.05,16640.39,
DEPUY FEMORAL HEAD 40MM +15.5,30180928,CDM,,,278,RC,outpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3531.34,22,,percent of total billed charges,,,,,,,,,12712.82,90,,percent of total billed charges,,,11695.79,82.8,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3531.34,22,,percent of total billed charges,,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,3531.34,13419.08,
DEPUY PINNACLE MAR +4 10D 32 X 54,30180930,CDM,,,278,RC,outpatient,,10342.15,10342.15,,8780.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2585.54,22,,percent of total billed charges,,,,,,,,,9307.94,90,,percent of total billed charges,,,8563.3,82.8,,percent of total billed charges,,,8790.83,85,,percent of total billed charges,,,,,,,,,9101.09,88,,percent of total billed charges,,,,,,,,,7901.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2585.54,22,,percent of total billed charges,,,9411.36,91,,percent of total billed charges,,,9825.04,95,,percent of total billed charges,,,8583.98,83,,percent of total billed charges,,,8583.98,83,,percent of total billed charges,,,,,,,,,,,,,,,8583.98,83,,percent of total billed charges,,,9825.04,95,,percent of total billed charges,,,9307.94,90,,percent of total billed charges,,,9307.94,90,,percent of total billed charges,,,8480.56,82,,percent of total billed charges,,,9307.94,90,,percent of total billed charges,,,8790.83,85,,percent of total billed charges,,2585.54,9825.04,
DEPUY PINNACLE MAR +4 10D 32 X 50,30180931,CDM,,,278,RC,outpatient,,10342.15,10342.15,,8780.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2585.54,22,,percent of total billed charges,,,,,,,,,9307.94,90,,percent of total billed charges,,,8563.3,82.8,,percent of total billed charges,,,8790.83,85,,percent of total billed charges,,,,,,,,,9101.09,88,,percent of total billed charges,,,,,,,,,7901.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2585.54,22,,percent of total billed charges,,,9411.36,91,,percent of total billed charges,,,9825.04,95,,percent of total billed charges,,,8583.98,83,,percent of total billed charges,,,8583.98,83,,percent of total billed charges,,,,,,,,,,,,,,,8583.98,83,,percent of total billed charges,,,9825.04,95,,percent of total billed charges,,,9307.94,90,,percent of total billed charges,,,9307.94,90,,percent of total billed charges,,,8480.56,82,,percent of total billed charges,,,9307.94,90,,percent of total billed charges,,,8790.83,85,,percent of total billed charges,,2585.54,9825.04,
GORTEX SOFT TISSUE PATCH 10CM X 15CM,30180934,CDM,,,270,RC,outpatient,,4381,4381,,3719.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1095.25,22,,percent of total billed charges,,,,,,,,,3942.9,90,,percent of total billed charges,,,3627.47,82.8,,percent of total billed charges,,,3723.85,85,,percent of total billed charges,,,,,,,,,3855.28,88,,percent of total billed charges,,,,,,,,,3347.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1095.25,22,,percent of total billed charges,,,3986.71,91,,percent of total billed charges,,,4161.95,95,,percent of total billed charges,,,3636.23,83,,percent of total billed charges,,,3636.23,83,,percent of total billed charges,,,,,,,,,,,,,,,3636.23,83,,percent of total billed charges,,,4161.95,95,,percent of total billed charges,,,3942.9,90,,percent of total billed charges,,,3942.9,90,,percent of total billed charges,,,3592.42,82,,percent of total billed charges,,,3942.9,90,,percent of total billed charges,,,3723.85,85,,percent of total billed charges,,1095.25,4161.95,
RAPID RHINO STAMMBERGER FOAM DRESSING,30180935,CDM,,,270,RC,outpatient,,483.07,483.07,,410.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,120.77,22,,percent of total billed charges,,,,,,,,,434.76,90,,percent of total billed charges,,,399.98,82.8,,percent of total billed charges,,,410.61,85,,percent of total billed charges,,,,,,,,,425.1,88,,percent of total billed charges,,,,,,,,,369.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,120.77,22,,percent of total billed charges,,,439.59,91,,percent of total billed charges,,,458.92,95,,percent of total billed charges,,,400.95,83,,percent of total billed charges,,,400.95,83,,percent of total billed charges,,,,,,,,,,,,,,,400.95,83,,percent of total billed charges,,,458.92,95,,percent of total billed charges,,,434.76,90,,percent of total billed charges,,,434.76,90,,percent of total billed charges,,,396.12,82,,percent of total billed charges,,,434.76,90,,percent of total billed charges,,,410.61,85,,percent of total billed charges,,120.77,458.92,
BARD AVAULTA SOLO ANTERIOR SYSTEM,30180937,CDM,,,270,RC,outpatient,,9262.5,9262.5,,7863.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2315.63,22,,percent of total billed charges,,,,,,,,,8336.25,90,,percent of total billed charges,,,7669.35,82.8,,percent of total billed charges,,,7873.13,85,,percent of total billed charges,,,,,,,,,8151,88,,percent of total billed charges,,,,,,,,,7076.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2315.63,22,,percent of total billed charges,,,8428.88,91,,percent of total billed charges,,,8799.38,95,,percent of total billed charges,,,7687.88,83,,percent of total billed charges,,,7687.88,83,,percent of total billed charges,,,,,,,,,,,,,,,7687.88,83,,percent of total billed charges,,,8799.38,95,,percent of total billed charges,,,8336.25,90,,percent of total billed charges,,,8336.25,90,,percent of total billed charges,,,7595.25,82,,percent of total billed charges,,,8336.25,90,,percent of total billed charges,,,7873.13,85,,percent of total billed charges,,2315.63,8799.38,
BARD AVAULTA SOLO POSTERIOR SYSTEM,30180938,CDM,,,270,RC,outpatient,,9262.5,9262.5,,7863.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2315.63,22,,percent of total billed charges,,,,,,,,,8336.25,90,,percent of total billed charges,,,7669.35,82.8,,percent of total billed charges,,,7873.13,85,,percent of total billed charges,,,,,,,,,8151,88,,percent of total billed charges,,,,,,,,,7076.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2315.63,22,,percent of total billed charges,,,8428.88,91,,percent of total billed charges,,,8799.38,95,,percent of total billed charges,,,7687.88,83,,percent of total billed charges,,,7687.88,83,,percent of total billed charges,,,,,,,,,,,,,,,7687.88,83,,percent of total billed charges,,,8799.38,95,,percent of total billed charges,,,8336.25,90,,percent of total billed charges,,,8336.25,90,,percent of total billed charges,,,7595.25,82,,percent of total billed charges,,,8336.25,90,,percent of total billed charges,,,7873.13,85,,percent of total billed charges,,2315.63,8799.38,
SYNTHES SCREW CORTEX 3.5X26MM,30180939,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
SYNTHES DRILL BIT 2.7MM,30180941,CDM,,,270,RC,outpatient,,1178.13,1178.13,,1000.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,294.53,22,,percent of total billed charges,,,,,,,,,1060.32,90,,percent of total billed charges,,,975.49,82.8,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,,,,,,,,1036.75,88,,percent of total billed charges,,,,,,,,,900.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,294.53,22,,percent of total billed charges,,,1072.1,91,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,,,,,,,,,,,,,977.85,83,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,966.07,82,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,294.53,1119.22,
STRYKER BLADE MICRO 18X.51X5.5MM,30180946,CDM,,,270,RC,outpatient,,307.28,307.28,,260.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.82,22,,percent of total billed charges,,,,,,,,,276.55,90,,percent of total billed charges,,,254.43,82.8,,percent of total billed charges,,,261.19,85,,percent of total billed charges,,,,,,,,,270.41,88,,percent of total billed charges,,,,,,,,,234.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.82,22,,percent of total billed charges,,,279.62,91,,percent of total billed charges,,,291.92,95,,percent of total billed charges,,,255.04,83,,percent of total billed charges,,,255.04,83,,percent of total billed charges,,,,,,,,,,,,,,,255.04,83,,percent of total billed charges,,,291.92,95,,percent of total billed charges,,,276.55,90,,percent of total billed charges,,,276.55,90,,percent of total billed charges,,,251.97,82,,percent of total billed charges,,,276.55,90,,percent of total billed charges,,,261.19,85,,percent of total billed charges,,76.82,291.92,
SYNTHES SCREW CORTEX 3.5X32MM,30180950,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
SYNTHES SCREW CORTEX 3.5X34MM,30180951,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
SYNTHES SCREW CORTEX 3.5X36MM,30180952,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
SYNTHES SCREW CORTEX 3.5X40MM,30180953,CDM,,,278,RC,outpatient,,267.75,267.75,,227.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.94,22,,percent of total billed charges,,,,,,,,,240.98,90,,percent of total billed charges,,,221.7,82.8,,percent of total billed charges,,,227.59,85,,percent of total billed charges,,,,,,,,,235.62,88,,percent of total billed charges,,,,,,,,,204.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.94,22,,percent of total billed charges,,,243.65,91,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,,,,,,,,,,,,,222.23,83,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,219.56,82,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,227.59,85,,percent of total billed charges,,66.94,254.36,
SYNTHES SCREW CANCEL F-THD 4.0X26MM,30180956,CDM,,,278,RC,outpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.18,22,,percent of total billed charges,,,,,,,,,213.03,90,,percent of total billed charges,,,195.99,82.8,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.18,22,,percent of total billed charges,,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,59.18,224.87,
SYNTHES PLATE TUBULAR 8-HOLE,30180964,CDM,,,278,RC,outpatient,,1811.23,1811.23,,1537.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,452.81,22,,percent of total billed charges,,,,,,,,,1630.11,90,,percent of total billed charges,,,1499.7,82.8,,percent of total billed charges,,,1539.55,85,,percent of total billed charges,,,,,,,,,1593.88,88,,percent of total billed charges,,,,,,,,,1383.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,452.81,22,,percent of total billed charges,,,1648.22,91,,percent of total billed charges,,,1720.67,95,,percent of total billed charges,,,1503.32,83,,percent of total billed charges,,,1503.32,83,,percent of total billed charges,,,,,,,,,,,,,,,1503.32,83,,percent of total billed charges,,,1720.67,95,,percent of total billed charges,,,1630.11,90,,percent of total billed charges,,,1630.11,90,,percent of total billed charges,,,1485.21,82,,percent of total billed charges,,,1630.11,90,,percent of total billed charges,,,1539.55,85,,percent of total billed charges,,452.81,1720.67,
DEPUY KNEE CEMENTED - CAPITATED (017),30180966,CDM,,,278,RC,outpatient,,25218.18,25218.18,,21410.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6304.55,22,,percent of total billed charges,,,,,,,,,22696.36,90,,percent of total billed charges,,,20880.65,82.8,,percent of total billed charges,,,21435.45,85,,percent of total billed charges,,,,,,,,,22192,88,,percent of total billed charges,,,,,,,,,19266.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6304.55,22,,percent of total billed charges,,,22948.54,91,,percent of total billed charges,,,23957.27,95,,percent of total billed charges,,,20931.09,83,,percent of total billed charges,,,20931.09,83,,percent of total billed charges,,,,,,,,,,,,,,,20931.09,83,,percent of total billed charges,,,23957.27,95,,percent of total billed charges,,,22696.36,90,,percent of total billed charges,,,22696.36,90,,percent of total billed charges,,,20678.91,82,,percent of total billed charges,,,22696.36,90,,percent of total billed charges,,,21435.45,85,,percent of total billed charges,,6304.55,23957.27,
DEPUY UPCHARGE XLINK POLY(027),30180967,CDM,,,278,RC,outpatient,,2434.71,2434.71,,2067.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,608.68,22,,percent of total billed charges,,,,,,,,,2191.24,90,,percent of total billed charges,,,2015.94,82.8,,percent of total billed charges,,,2069.5,85,,percent of total billed charges,,,,,,,,,2142.54,88,,percent of total billed charges,,,,,,,,,1860.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,608.68,22,,percent of total billed charges,,,2215.59,91,,percent of total billed charges,,,2312.97,95,,percent of total billed charges,,,2020.81,83,,percent of total billed charges,,,2020.81,83,,percent of total billed charges,,,,,,,,,,,,,,,2020.81,83,,percent of total billed charges,,,2312.97,95,,percent of total billed charges,,,2191.24,90,,percent of total billed charges,,,2191.24,90,,percent of total billed charges,,,1996.46,82,,percent of total billed charges,,,2191.24,90,,percent of total billed charges,,,2069.5,85,,percent of total billed charges,,608.68,2312.97,
AQUAMANTYS BIPOLAR SEALER 6.0,30180968,CDM,,,270,RC,outpatient,,4953,4953,,4205.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1238.25,22,,percent of total billed charges,,,,,,,,,4457.7,90,,percent of total billed charges,,,4101.08,82.8,,percent of total billed charges,,,4210.05,85,,percent of total billed charges,,,,,,,,,4358.64,88,,percent of total billed charges,,,,,,,,,3784.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1238.25,22,,percent of total billed charges,,,4507.23,91,,percent of total billed charges,,,4705.35,95,,percent of total billed charges,,,4110.99,83,,percent of total billed charges,,,4110.99,83,,percent of total billed charges,,,,,,,,,,,,,,,4110.99,83,,percent of total billed charges,,,4705.35,95,,percent of total billed charges,,,4457.7,90,,percent of total billed charges,,,4457.7,90,,percent of total billed charges,,,4061.46,82,,percent of total billed charges,,,4457.7,90,,percent of total billed charges,,,4210.05,85,,percent of total billed charges,,1238.25,4705.35,
AQUAMANTYS BIPOLAR SEALER 2.3,30180969,CDM,,,270,RC,outpatient,,3458,3458,,2935.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,864.5,22,,percent of total billed charges,,,,,,,,,3112.2,90,,percent of total billed charges,,,2863.22,82.8,,percent of total billed charges,,,2939.3,85,,percent of total billed charges,,,,,,,,,3043.04,88,,percent of total billed charges,,,,,,,,,2641.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,864.5,22,,percent of total billed charges,,,3146.78,91,,percent of total billed charges,,,3285.1,95,,percent of total billed charges,,,2870.14,83,,percent of total billed charges,,,2870.14,83,,percent of total billed charges,,,,,,,,,,,,,,,2870.14,83,,percent of total billed charges,,,3285.1,95,,percent of total billed charges,,,3112.2,90,,percent of total billed charges,,,3112.2,90,,percent of total billed charges,,,2835.56,82,,percent of total billed charges,,,3112.2,90,,percent of total billed charges,,,2939.3,85,,percent of total billed charges,,864.5,3285.1,
AQUAMANTYS BIPOLAR SEALER MALLEABLE,30180970,CDM,,,270,RC,outpatient,,3718,3718,,3156.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,929.5,22,,percent of total billed charges,,,,,,,,,3346.2,90,,percent of total billed charges,,,3078.5,82.8,,percent of total billed charges,,,3160.3,85,,percent of total billed charges,,,,,,,,,3271.84,88,,percent of total billed charges,,,,,,,,,2840.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,929.5,22,,percent of total billed charges,,,3383.38,91,,percent of total billed charges,,,3532.1,95,,percent of total billed charges,,,3085.94,83,,percent of total billed charges,,,3085.94,83,,percent of total billed charges,,,,,,,,,,,,,,,3085.94,83,,percent of total billed charges,,,3532.1,95,,percent of total billed charges,,,3346.2,90,,percent of total billed charges,,,3346.2,90,,percent of total billed charges,,,3048.76,82,,percent of total billed charges,,,3346.2,90,,percent of total billed charges,,,3160.3,85,,percent of total billed charges,,929.5,3532.1,
AQUAMANTYS EPIDURAL VEIN SEALER,30180971,CDM,,,270,RC,outpatient,,4143.75,4143.75,,3518.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1035.94,22,,percent of total billed charges,,,,,,,,,3729.38,90,,percent of total billed charges,,,3431.03,82.8,,percent of total billed charges,,,3522.19,85,,percent of total billed charges,,,,,,,,,3646.5,88,,percent of total billed charges,,,,,,,,,3165.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1035.94,22,,percent of total billed charges,,,3770.81,91,,percent of total billed charges,,,3936.56,95,,percent of total billed charges,,,3439.31,83,,percent of total billed charges,,,3439.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3439.31,83,,percent of total billed charges,,,3936.56,95,,percent of total billed charges,,,3729.38,90,,percent of total billed charges,,,3729.38,90,,percent of total billed charges,,,3397.88,82,,percent of total billed charges,,,3729.38,90,,percent of total billed charges,,,3522.19,85,,percent of total billed charges,,1035.94,3936.56,
SYNTHES SCREW CORTEX 4.5X40MM,30180972,CDM,,,278,RC,outpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.35,22,,percent of total billed charges,,,,,,,,,235.24,90,,percent of total billed charges,,,216.42,82.8,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.35,22,,percent of total billed charges,,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,65.35,248.31,
DEPUY PINNACLE SCREW 6.5 X 35,30180978,CDM,,,278,RC,outpatient,,1075.49,1075.49,,913.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,268.87,22,,percent of total billed charges,,,,,,,,,967.94,90,,percent of total billed charges,,,890.51,82.8,,percent of total billed charges,,,914.17,85,,percent of total billed charges,,,,,,,,,946.43,88,,percent of total billed charges,,,,,,,,,821.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,268.87,22,,percent of total billed charges,,,978.7,91,,percent of total billed charges,,,1021.72,95,,percent of total billed charges,,,892.66,83,,percent of total billed charges,,,892.66,83,,percent of total billed charges,,,,,,,,,,,,,,,892.66,83,,percent of total billed charges,,,1021.72,95,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,881.9,82,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,914.17,85,,percent of total billed charges,,268.87,1021.72,
DEPUY LERE BONE MILL RENTAL 5415-00,30180983,CDM,,,278,RC,outpatient,,4257.5,4257.5,,3614.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1064.38,22,,percent of total billed charges,,,,,,,,,3831.75,90,,percent of total billed charges,,,3525.21,82.8,,percent of total billed charges,,,3618.88,85,,percent of total billed charges,,,,,,,,,3746.6,88,,percent of total billed charges,,,,,,,,,3252.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1064.38,22,,percent of total billed charges,,,3874.33,91,,percent of total billed charges,,,4044.63,95,,percent of total billed charges,,,3533.73,83,,percent of total billed charges,,,3533.73,83,,percent of total billed charges,,,,,,,,,,,,,,,3533.73,83,,percent of total billed charges,,,4044.63,95,,percent of total billed charges,,,3831.75,90,,percent of total billed charges,,,3831.75,90,,percent of total billed charges,,,3491.15,82,,percent of total billed charges,,,3831.75,90,,percent of total billed charges,,,3618.88,85,,percent of total billed charges,,1064.38,4044.63,
DEPUY HEAD LARGE HIP (007),30180984,CDM,,,278,RC,outpatient,,43728.75,43728.75,,37125.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10932.19,22,,percent of total billed charges,,,,,,,,,39355.88,90,,percent of total billed charges,,,36207.41,82.8,,percent of total billed charges,,,37169.44,85,,percent of total billed charges,,,,,,,,,38481.3,88,,percent of total billed charges,,,,,,,,,33408.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10932.19,22,,percent of total billed charges,,,39793.16,91,,percent of total billed charges,,,41542.31,95,,percent of total billed charges,,,36294.86,83,,percent of total billed charges,,,36294.86,83,,percent of total billed charges,,,,,,,,,,,,,,,36294.86,83,,percent of total billed charges,,,41542.31,95,,percent of total billed charges,,,39355.88,90,,percent of total billed charges,,,39355.88,90,,percent of total billed charges,,,35857.58,82,,percent of total billed charges,,,39355.88,90,,percent of total billed charges,,,37169.44,85,,percent of total billed charges,,10932.19,41542.31,
VASCULAR LOOPS,30180993,CDM,,,270,RC,outpatient,,11.7,11.7,,9.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.93,22,,percent of total billed charges,,,,,,,,,10.53,90,,percent of total billed charges,,,9.69,82.8,,percent of total billed charges,,,9.95,85,,percent of total billed charges,,,,,,,,,10.3,88,,percent of total billed charges,,,,,,,,,8.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.93,22,,percent of total billed charges,,,10.65,91,,percent of total billed charges,,,11.12,95,,percent of total billed charges,,,9.71,83,,percent of total billed charges,,,9.71,83,,percent of total billed charges,,,,,,,,,,,,,,,9.71,83,,percent of total billed charges,,,11.12,95,,percent of total billed charges,,,10.53,90,,percent of total billed charges,,,10.53,90,,percent of total billed charges,,,9.59,82,,percent of total billed charges,,,10.53,90,,percent of total billed charges,,,9.95,85,,percent of total billed charges,,2.93,11.12,
SYNTHES K-WIRE 28MM,30180996,CDM,,,278,RC,outpatient,,504.98,504.98,,428.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126.25,22,,percent of total billed charges,,,,,,,,,454.48,90,,percent of total billed charges,,,418.12,82.8,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,,,,,,,,444.38,88,,percent of total billed charges,,,,,,,,,385.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126.25,22,,percent of total billed charges,,,459.53,91,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,,,,,,,,,,,,,419.13,83,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,414.08,82,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,126.25,479.73,
SYNTHES DRILL BIT CANNULATED 5.0MM,30181000,CDM,,,270,RC,outpatient,,4460.56,4460.56,,3787.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1115.14,22,,percent of total billed charges,,,,,,,,,4014.5,90,,percent of total billed charges,,,3693.34,82.8,,percent of total billed charges,,,3791.48,85,,percent of total billed charges,,,,,,,,,3925.29,88,,percent of total billed charges,,,,,,,,,3407.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1115.14,22,,percent of total billed charges,,,4059.11,91,,percent of total billed charges,,,4237.53,95,,percent of total billed charges,,,3702.26,83,,percent of total billed charges,,,3702.26,83,,percent of total billed charges,,,,,,,,,,,,,,,3702.26,83,,percent of total billed charges,,,4237.53,95,,percent of total billed charges,,,4014.5,90,,percent of total billed charges,,,4014.5,90,,percent of total billed charges,,,3657.66,82,,percent of total billed charges,,,4014.5,90,,percent of total billed charges,,,3791.48,85,,percent of total billed charges,,1115.14,4237.53,
DEPUY INSERT SIGMA XLK 2.5X10MM,30181003,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY FEMUR CEMENTED RT SZ2.5,30181004,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
DEPUY FEMUR CEMENTED LT SZ2.5,30181005,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
DEPUY KNEE POROUS - CAPITATED (019),30181008,CDM,,,278,RC,outpatient,,27856.92,27856.92,,23650.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6964.23,22,,percent of total billed charges,,,,,,,,,25071.23,90,,percent of total billed charges,,,23065.53,82.8,,percent of total billed charges,,,23678.38,85,,percent of total billed charges,,,,,,,,,24514.09,88,,percent of total billed charges,,,,,,,,,21282.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6964.23,22,,percent of total billed charges,,,25349.8,91,,percent of total billed charges,,,26464.07,95,,percent of total billed charges,,,23121.24,83,,percent of total billed charges,,,23121.24,83,,percent of total billed charges,,,,,,,,,,,,,,,23121.24,83,,percent of total billed charges,,,26464.07,95,,percent of total billed charges,,,25071.23,90,,percent of total billed charges,,,25071.23,90,,percent of total billed charges,,,22842.67,82,,percent of total billed charges,,,25071.23,90,,percent of total billed charges,,,23678.38,85,,percent of total billed charges,,6964.23,26464.07,
DEPUY UPCHARGE PORCOAT FEMUR(026),30181009,CDM,,,278,RC,outpatient,,1391.26,1391.26,,1181.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,347.82,22,,percent of total billed charges,,,,,,,,,1252.13,90,,percent of total billed charges,,,1151.96,82.8,,percent of total billed charges,,,1182.57,85,,percent of total billed charges,,,,,,,,,1224.31,88,,percent of total billed charges,,,,,,,,,1062.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,347.82,22,,percent of total billed charges,,,1266.05,91,,percent of total billed charges,,,1321.7,95,,percent of total billed charges,,,1154.75,83,,percent of total billed charges,,,1154.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1154.75,83,,percent of total billed charges,,,1321.7,95,,percent of total billed charges,,,1252.13,90,,percent of total billed charges,,,1252.13,90,,percent of total billed charges,,,1140.83,82,,percent of total billed charges,,,1252.13,90,,percent of total billed charges,,,1182.57,85,,percent of total billed charges,,347.82,1321.7,
NEEDLE SPINAL 18GA 6,30181010,CDM,,,270,RC,outpatient,,24.03,24.03,,20.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.01,22,,percent of total billed charges,,,,,,,,,21.63,90,,percent of total billed charges,,,19.9,82.8,,percent of total billed charges,,,20.43,85,,percent of total billed charges,,,,,,,,,21.15,88,,percent of total billed charges,,,,,,,,,18.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.01,22,,percent of total billed charges,,,21.87,91,,percent of total billed charges,,,22.83,95,,percent of total billed charges,,,19.94,83,,percent of total billed charges,,,19.94,83,,percent of total billed charges,,,,,,,,,,,,,,,19.94,83,,percent of total billed charges,,,22.83,95,,percent of total billed charges,,,21.63,90,,percent of total billed charges,,,21.63,90,,percent of total billed charges,,,19.7,82,,percent of total billed charges,,,21.63,90,,percent of total billed charges,,,20.43,85,,percent of total billed charges,,6.01,22.83,
DEPUY HIP POROUS - CAPITATED (006),30181016,CDM,,,278,RC,outpatient,,32421.22,32421.22,,27525.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8105.31,22,,percent of total billed charges,,,,,,,,,29179.1,90,,percent of total billed charges,,,26844.77,82.8,,percent of total billed charges,,,27558.04,85,,percent of total billed charges,,,,,,,,,28530.67,88,,percent of total billed charges,,,,,,,,,24769.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8105.31,22,,percent of total billed charges,,,29503.31,91,,percent of total billed charges,,,30800.16,95,,percent of total billed charges,,,26909.61,83,,percent of total billed charges,,,26909.61,83,,percent of total billed charges,,,,,,,,,,,,,,,26909.61,83,,percent of total billed charges,,,30800.16,95,,percent of total billed charges,,,29179.1,90,,percent of total billed charges,,,29179.1,90,,percent of total billed charges,,,26585.4,82,,percent of total billed charges,,,29179.1,90,,percent of total billed charges,,,27558.04,85,,percent of total billed charges,,8105.31,30800.16,
DEPUY UPCHARGE METAL HEAD (009),30181017,CDM,,,278,RC,outpatient,,1850.36,1850.36,,1570.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,462.59,22,,percent of total billed charges,,,,,,,,,1665.32,90,,percent of total billed charges,,,1532.1,82.8,,percent of total billed charges,,,1572.81,85,,percent of total billed charges,,,,,,,,,1628.32,88,,percent of total billed charges,,,,,,,,,1413.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,462.59,22,,percent of total billed charges,,,1683.83,91,,percent of total billed charges,,,1757.84,95,,percent of total billed charges,,,1535.8,83,,percent of total billed charges,,,1535.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1535.8,83,,percent of total billed charges,,,1757.84,95,,percent of total billed charges,,,1665.32,90,,percent of total billed charges,,,1665.32,90,,percent of total billed charges,,,1517.3,82,,percent of total billed charges,,,1665.32,90,,percent of total billed charges,,,1572.81,85,,percent of total billed charges,,462.59,1757.84,
DEPUY LINER ALTRX X-LINK (014),30181018,CDM,,,278,RC,outpatient,,2956.46,2956.46,,2510.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,739.12,22,,percent of total billed charges,,,,,,,,,2660.81,90,,percent of total billed charges,,,2447.95,82.8,,percent of total billed charges,,,2512.99,85,,percent of total billed charges,,,,,,,,,2601.68,88,,percent of total billed charges,,,,,,,,,2258.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,739.12,22,,percent of total billed charges,,,2690.38,91,,percent of total billed charges,,,2808.64,95,,percent of total billed charges,,,2453.86,83,,percent of total billed charges,,,2453.86,83,,percent of total billed charges,,,,,,,,,,,,,,,2453.86,83,,percent of total billed charges,,,2808.64,95,,percent of total billed charges,,,2660.81,90,,percent of total billed charges,,,2660.81,90,,percent of total billed charges,,,2424.3,82,,percent of total billed charges,,,2660.81,90,,percent of total billed charges,,,2512.99,85,,percent of total billed charges,,739.12,2808.64,
DEPUY INSERT SIGMA XLK 5 X 8,30181022,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY PATELLA BLADE LGE,30181024,CDM,,,278,RC,outpatient,,1748.5,1748.5,,1484.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,437.13,22,,percent of total billed charges,,,,,,,,,1573.65,90,,percent of total billed charges,,,1447.76,82.8,,percent of total billed charges,,,1486.23,85,,percent of total billed charges,,,,,,,,,1538.68,88,,percent of total billed charges,,,,,,,,,1335.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,437.13,22,,percent of total billed charges,,,1591.14,91,,percent of total billed charges,,,1661.08,95,,percent of total billed charges,,,1451.26,83,,percent of total billed charges,,,1451.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1451.26,83,,percent of total billed charges,,,1661.08,95,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1433.77,82,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1486.23,85,,percent of total billed charges,,437.13,1661.08,
SYNTHES SCREW CANNUL 4.0X48MM,30181031,CDM,,,278,RC,outpatient,,2003.17,2003.17,,1700.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,500.79,22,,percent of total billed charges,,,,,,,,,1802.85,90,,percent of total billed charges,,,1658.62,82.8,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,,,,,,,,1762.79,88,,percent of total billed charges,,,,,,,,,1530.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,500.79,22,,percent of total billed charges,,,1822.88,91,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1662.63,83,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1642.6,82,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,500.79,1903.01,
SYNTHES SCREW CANNUL 4.0X50MM,30181032,CDM,,,278,RC,outpatient,,2063.23,2063.23,,1751.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,515.81,22,,percent of total billed charges,,,,,,,,,1856.91,90,,percent of total billed charges,,,1708.35,82.8,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,,,,,,,,1815.64,88,,percent of total billed charges,,,,,,,,,1576.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,515.81,22,,percent of total billed charges,,,1877.54,91,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1712.48,83,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1691.85,82,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,515.81,1960.07,
SYNTHES WASHER 7.0MM,30181033,CDM,,,270,RC,outpatient,,290.85,290.85,,246.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.71,22,,percent of total billed charges,,,,,,,,,261.77,90,,percent of total billed charges,,,240.82,82.8,,percent of total billed charges,,,247.22,85,,percent of total billed charges,,,,,,,,,255.95,88,,percent of total billed charges,,,,,,,,,222.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.71,22,,percent of total billed charges,,,264.67,91,,percent of total billed charges,,,276.31,95,,percent of total billed charges,,,241.41,83,,percent of total billed charges,,,241.41,83,,percent of total billed charges,,,,,,,,,,,,,,,241.41,83,,percent of total billed charges,,,276.31,95,,percent of total billed charges,,,261.77,90,,percent of total billed charges,,,261.77,90,,percent of total billed charges,,,238.5,82,,percent of total billed charges,,,261.77,90,,percent of total billed charges,,,247.22,85,,percent of total billed charges,,72.71,276.31,
ZIMMER BLADE EXPLANT 58MM X 10,30181037,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
ZIMMER BLADE EXPLANT 58MM X 20,30181038,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
DEPUY PINNACLE CUP REVISION 62MM,30181039,CDM,,,278,RC,outpatient,,33437.04,33437.04,,28388.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8359.26,22,,percent of total billed charges,,,,,,,,,30093.34,90,,percent of total billed charges,,,27685.87,82.8,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,,,,,,,,29424.6,88,,percent of total billed charges,,,,,,,,,25545.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8359.26,22,,percent of total billed charges,,,30427.71,91,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,,,,,,,,,,,,,27752.74,83,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,27418.37,82,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,8359.26,31765.19,
DEPUY 5.0MM DIA TPRD HD PER SCRW 40,30181040,CDM,,,278,RC,outpatient,,930,930,,789.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,232.5,22,,percent of total billed charges,,,,,,,,,837,90,,percent of total billed charges,,,770.04,82.8,,percent of total billed charges,,,790.5,85,,percent of total billed charges,,,,,,,,,818.4,88,,percent of total billed charges,,,,,,,,,710.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,232.5,22,,percent of total billed charges,,,846.3,91,,percent of total billed charges,,,883.5,95,,percent of total billed charges,,,771.9,83,,percent of total billed charges,,,771.9,83,,percent of total billed charges,,,,,,,,,,,,,,,771.9,83,,percent of total billed charges,,,883.5,95,,percent of total billed charges,,,837,90,,percent of total billed charges,,,837,90,,percent of total billed charges,,,762.6,82,,percent of total billed charges,,,837,90,,percent of total billed charges,,,790.5,85,,percent of total billed charges,,232.5,883.5,
DEPUY SCREW TAPER 30 X 5.0,30181041,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
DEPUY PINNACLE SCREW 6.5 X 50,30181042,CDM,,,278,RC,outpatient,,1244.95,1244.95,,1056.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,311.24,22,,percent of total billed charges,,,,,,,,,1120.46,90,,percent of total billed charges,,,1030.82,82.8,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,,,,,,,,1095.56,88,,percent of total billed charges,,,,,,,,,951.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,311.24,22,,percent of total billed charges,,,1132.9,91,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.31,83,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1020.86,82,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,311.24,1182.7,
DEPUY LINER ALTRX +4 NEUT 36 X 56,30181043,CDM,,,278,RC,outpatient,,14161.81,14161.81,,12023.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3540.45,22,,percent of total billed charges,,,,,,,,,12745.63,90,,percent of total billed charges,,,11725.98,82.8,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,,,,,,,,12462.39,88,,percent of total billed charges,,,,,,,,,10819.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3540.45,22,,percent of total billed charges,,,12887.25,91,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,,,,,,,,,,,,,11754.3,83,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,11612.68,82,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,3540.45,13453.72,
DEPUY KNEE HYBRID - CAPITATED (018),30181044,CDM,,,278,RC,outpatient,,27011.14,27011.14,,22932.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6752.79,22,,percent of total billed charges,,,,,,,,,24310.03,90,,percent of total billed charges,,,22365.22,82.8,,percent of total billed charges,,,22959.47,85,,percent of total billed charges,,,,,,,,,23769.8,88,,percent of total billed charges,,,,,,,,,20636.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6752.79,22,,percent of total billed charges,,,24580.14,91,,percent of total billed charges,,,25660.58,95,,percent of total billed charges,,,22419.25,83,,percent of total billed charges,,,22419.25,83,,percent of total billed charges,,,,,,,,,,,,,,,22419.25,83,,percent of total billed charges,,,25660.58,95,,percent of total billed charges,,,24310.03,90,,percent of total billed charges,,,24310.03,90,,percent of total billed charges,,,22149.13,82,,percent of total billed charges,,,24310.03,90,,percent of total billed charges,,,22959.47,85,,percent of total billed charges,,6752.79,25660.58,
DEPUY PINNACLE CUP 58MM,30181052,CDM,,,278,RC,outpatient,,14472.9,14472.9,,12287.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3618.23,22,,percent of total billed charges,,,,,,,,,13025.61,90,,percent of total billed charges,,,11983.56,82.8,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,,,,,,,,12736.15,88,,percent of total billed charges,,,,,,,,,11057.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3618.23,22,,percent of total billed charges,,,13170.34,91,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,12012.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12012.51,83,,percent of total billed charges,,,13749.26,95,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,11867.78,82,,percent of total billed charges,,,13025.61,90,,percent of total billed charges,,,12301.97,85,,percent of total billed charges,,3618.23,13749.26,
DEPUY LINER ALTRX +4 NEUT 36 X 58,30181053,CDM,,,278,RC,outpatient,,14161.81,14161.81,,12023.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3540.45,22,,percent of total billed charges,,,,,,,,,12745.63,90,,percent of total billed charges,,,11725.98,82.8,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,,,,,,,,12462.39,88,,percent of total billed charges,,,,,,,,,10819.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3540.45,22,,percent of total billed charges,,,12887.25,91,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,,,,,,,,,,,,,11754.3,83,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,11612.68,82,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,3540.45,13453.72,
DEPUY FEMORAL HEAD 40MM +5,30181054,CDM,,,278,RC,outpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3531.34,22,,percent of total billed charges,,,,,,,,,12712.82,90,,percent of total billed charges,,,11695.79,82.8,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3531.34,22,,percent of total billed charges,,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,3531.34,13419.08,
DEPUY HEAD METAL LGE =/>40MM,30181055,CDM,,,278,RC,outpatient,,4032.6,4032.6,,3423.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1008.15,22,,percent of total billed charges,,,,,,,,,3629.34,90,,percent of total billed charges,,,3338.99,82.8,,percent of total billed charges,,,3427.71,85,,percent of total billed charges,,,,,,,,,3548.69,88,,percent of total billed charges,,,,,,,,,3080.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1008.15,22,,percent of total billed charges,,,3669.67,91,,percent of total billed charges,,,3830.97,95,,percent of total billed charges,,,3347.06,83,,percent of total billed charges,,,3347.06,83,,percent of total billed charges,,,,,,,,,,,,,,,3347.06,83,,percent of total billed charges,,,3830.97,95,,percent of total billed charges,,,3629.34,90,,percent of total billed charges,,,3629.34,90,,percent of total billed charges,,,3306.73,82,,percent of total billed charges,,,3629.34,90,,percent of total billed charges,,,3427.71,85,,percent of total billed charges,,1008.15,3830.97,
DEPUY LINER ALTRX +4 NEUT 36 X 60,30181056,CDM,,,278,RC,outpatient,,14161.81,14161.81,,12023.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3540.45,22,,percent of total billed charges,,,,,,,,,12745.63,90,,percent of total billed charges,,,11725.98,82.8,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,,,,,,,,12462.39,88,,percent of total billed charges,,,,,,,,,10819.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3540.45,22,,percent of total billed charges,,,12887.25,91,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,,,,,,,,,,,,,11754.3,83,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,11612.68,82,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,3540.45,13453.72,
DEPUY STEM SUMMIT TAPER SZ7 HI OFF,30181057,CDM,,,278,RC,outpatient,,35147,35147,,29839.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8786.75,22,,percent of total billed charges,,,,,,,,,31632.3,90,,percent of total billed charges,,,29101.72,82.8,,percent of total billed charges,,,29874.95,85,,percent of total billed charges,,,,,,,,,30929.36,88,,percent of total billed charges,,,,,,,,,26852.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8786.75,22,,percent of total billed charges,,,31983.77,91,,percent of total billed charges,,,33389.65,95,,percent of total billed charges,,,29172.01,83,,percent of total billed charges,,,29172.01,83,,percent of total billed charges,,,,,,,,,,,,,,,29172.01,83,,percent of total billed charges,,,33389.65,95,,percent of total billed charges,,,31632.3,90,,percent of total billed charges,,,31632.3,90,,percent of total billed charges,,,28820.54,82,,percent of total billed charges,,,31632.3,90,,percent of total billed charges,,,29874.95,85,,percent of total billed charges,,8786.75,33389.65,
MEDSOURCE RADIAL STEM 9.0X4.0MM,30181065,CDM,,,278,RC,outpatient,,10504,10504,,8917.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2626,22,,percent of total billed charges,,,,,,,,,9453.6,90,,percent of total billed charges,,,8697.31,82.8,,percent of total billed charges,,,8928.4,85,,percent of total billed charges,,,,,,,,,9243.52,88,,percent of total billed charges,,,,,,,,,8025.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2626,22,,percent of total billed charges,,,9558.64,91,,percent of total billed charges,,,9978.8,95,,percent of total billed charges,,,8718.32,83,,percent of total billed charges,,,8718.32,83,,percent of total billed charges,,,,,,,,,,,,,,,8718.32,83,,percent of total billed charges,,,9978.8,95,,percent of total billed charges,,,9453.6,90,,percent of total billed charges,,,9453.6,90,,percent of total billed charges,,,8613.28,82,,percent of total billed charges,,,9453.6,90,,percent of total billed charges,,,8928.4,85,,percent of total billed charges,,2626,9978.8,
MEDSOURCE RADIAL HEAD 24.0MM RIGHT,30181066,CDM,,,278,RC,outpatient,,16796,16796,,14259.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4199,22,,percent of total billed charges,,,,,,,,,15116.4,90,,percent of total billed charges,,,13907.09,82.8,,percent of total billed charges,,,14276.6,85,,percent of total billed charges,,,,,,,,,14780.48,88,,percent of total billed charges,,,,,,,,,12832.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4199,22,,percent of total billed charges,,,15284.36,91,,percent of total billed charges,,,15956.2,95,,percent of total billed charges,,,13940.68,83,,percent of total billed charges,,,13940.68,83,,percent of total billed charges,,,,,,,,,,,,,,,13940.68,83,,percent of total billed charges,,,15956.2,95,,percent of total billed charges,,,15116.4,90,,percent of total billed charges,,,15116.4,90,,percent of total billed charges,,,13772.72,82,,percent of total billed charges,,,15116.4,90,,percent of total billed charges,,,14276.6,85,,percent of total billed charges,,4199,15956.2,
SINGLE TITANIUM PORT SYSTEM,30181069,CDM,,,270,RC,outpatient,,2502.5,2502.5,,2124.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,625.63,22,,percent of total billed charges,,,,,,,,,2252.25,90,,percent of total billed charges,,,2072.07,82.8,,percent of total billed charges,,,2127.13,85,,percent of total billed charges,,,,,,,,,2202.2,88,,percent of total billed charges,,,,,,,,,1911.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,625.63,22,,percent of total billed charges,,,2277.28,91,,percent of total billed charges,,,2377.38,95,,percent of total billed charges,,,2077.08,83,,percent of total billed charges,,,2077.08,83,,percent of total billed charges,,,,,,,,,,,,,,,2077.08,83,,percent of total billed charges,,,2377.38,95,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2052.05,82,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2127.13,85,,percent of total billed charges,,625.63,2377.38,
ANTERIOR TIBIALIS TENDON,30181081,CDM,,,270,RC,outpatient,,5720,5720,,4856.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1430,22,,percent of total billed charges,,,,,,,,,5148,90,,percent of total billed charges,,,4736.16,82.8,,percent of total billed charges,,,4862,85,,percent of total billed charges,,,,,,,,,5033.6,88,,percent of total billed charges,,,,,,,,,4370.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1430,22,,percent of total billed charges,,,5205.2,91,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4747.6,83,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4690.4,82,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4862,85,,percent of total billed charges,,1430,5434,
DEPUY FEMUR CEMENTED LT SZ2,30181082,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
DEPUY INSERT SIGMA XLK 2 X 15,30181083,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY LINER ALTRX +4 NEUT 44 X 64,30181084,CDM,,,278,RC,outpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4400.13,22,,percent of total billed charges,,,,,,,,,15840.46,90,,percent of total billed charges,,,14573.22,82.8,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4400.13,22,,percent of total billed charges,,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,4400.13,16720.48,
DEPUY FEMORAL HEAD 44MM +8.5,30181086,CDM,,,278,RC,outpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3531.34,22,,percent of total billed charges,,,,,,,,,12712.82,90,,percent of total billed charges,,,11695.79,82.8,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3531.34,22,,percent of total billed charges,,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,3531.34,13419.08,
DEPUY STEM CORAIL HI OFFSET SZ18,30181087,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
S&N RESURFACING PATELLA 35MM,30181088,CDM,,,278,RC,outpatient,,6584.24,6584.24,,5590.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1646.06,22,,percent of total billed charges,,,,,,,,,5925.82,90,,percent of total billed charges,,,5451.75,82.8,,percent of total billed charges,,,5596.6,85,,percent of total billed charges,,,,,,,,,5794.13,88,,percent of total billed charges,,,,,,,,,5030.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1646.06,22,,percent of total billed charges,,,5991.66,91,,percent of total billed charges,,,6255.03,95,,percent of total billed charges,,,5464.92,83,,percent of total billed charges,,,5464.92,83,,percent of total billed charges,,,,,,,,,,,,,,,5464.92,83,,percent of total billed charges,,,6255.03,95,,percent of total billed charges,,,5925.82,90,,percent of total billed charges,,,5925.82,90,,percent of total billed charges,,,5399.08,82,,percent of total billed charges,,,5925.82,90,,percent of total billed charges,,,5596.6,85,,percent of total billed charges,,1646.06,6255.03,
SYNTHES SCREW CORTEX S-T 2.7X14MM,30181089,CDM,,,278,RC,outpatient,,410.27,410.27,,348.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,102.57,22,,percent of total billed charges,,,,,,,,,369.24,90,,percent of total billed charges,,,339.7,82.8,,percent of total billed charges,,,348.73,85,,percent of total billed charges,,,,,,,,,361.04,88,,percent of total billed charges,,,,,,,,,313.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,102.57,22,,percent of total billed charges,,,373.35,91,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,,,,,,,,,,,,,340.52,83,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,336.42,82,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,348.73,85,,percent of total billed charges,,102.57,389.76,
SYNTHES SCREW DISTAL RADIUS 2.4X22MM,30181092,CDM,,,278,RC,outpatient,,1276.28,1276.28,,1083.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,319.07,22,,percent of total billed charges,,,,,,,,,1148.65,90,,percent of total billed charges,,,1056.76,82.8,,percent of total billed charges,,,1084.84,85,,percent of total billed charges,,,,,,,,,1123.13,88,,percent of total billed charges,,,,,,,,,975.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,319.07,22,,percent of total billed charges,,,1161.41,91,,percent of total billed charges,,,1212.47,95,,percent of total billed charges,,,1059.31,83,,percent of total billed charges,,,1059.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1059.31,83,,percent of total billed charges,,,1212.47,95,,percent of total billed charges,,,1148.65,90,,percent of total billed charges,,,1148.65,90,,percent of total billed charges,,,1046.55,82,,percent of total billed charges,,,1148.65,90,,percent of total billed charges,,,1084.84,85,,percent of total billed charges,,319.07,1212.47,
SYNTHES SCREW DISTAL RADIUS 2.4X18MM,30181093,CDM,,,278,RC,outpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,338.51,22,,percent of total billed charges,,,,,,,,,1218.62,90,,percent of total billed charges,,,1121.13,82.8,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,338.51,22,,percent of total billed charges,,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,338.51,1286.32,
SYNTHES SCREW DISTAL RADIUS 2.4X16MM,30181094,CDM,,,278,RC,outpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,338.51,22,,percent of total billed charges,,,,,,,,,1218.62,90,,percent of total billed charges,,,1121.13,82.8,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,338.51,22,,percent of total billed charges,,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,338.51,1286.32,
SYNTHES SCREW DISTAL RADIUS 2.4X20MM,30181095,CDM,,,278,RC,outpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,338.51,22,,percent of total billed charges,,,,,,,,,1218.62,90,,percent of total billed charges,,,1121.13,82.8,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,338.51,22,,percent of total billed charges,,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,338.51,1286.32,
SYNTHES SCREW CORTEX S-T 2.4X20MM,30181096,CDM,,,278,RC,outpatient,,565.25,565.25,,479.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141.31,22,,percent of total billed charges,,,,,,,,,508.73,90,,percent of total billed charges,,,468.03,82.8,,percent of total billed charges,,,480.46,85,,percent of total billed charges,,,,,,,,,497.42,88,,percent of total billed charges,,,,,,,,,431.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141.31,22,,percent of total billed charges,,,514.38,91,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,,,,,,,,,,,,,469.16,83,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,463.51,82,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,480.46,85,,percent of total billed charges,,141.31,536.99,
DEPUY LINER ALTRX NEUT 36 X 58,30181101,CDM,,,278,RC,outpatient,,12874.42,12874.42,,10930.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3218.61,22,,percent of total billed charges,,,,,,,,,11586.98,90,,percent of total billed charges,,,10660.02,82.8,,percent of total billed charges,,,10943.26,85,,percent of total billed charges,,,,,,,,,11329.49,88,,percent of total billed charges,,,,,,,,,9836.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3218.61,22,,percent of total billed charges,,,11715.72,91,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,,,,,,,,,,,,,10685.77,83,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10557.02,82,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10943.26,85,,percent of total billed charges,,3218.61,12230.7,
DEPUY UPCHARGE CERAMIC HEAD(010),30181102,CDM,,,278,RC,outpatient,,4521.53,4521.53,,3838.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1130.38,22,,percent of total billed charges,,,,,,,,,4069.38,90,,percent of total billed charges,,,3743.83,82.8,,percent of total billed charges,,,3843.3,85,,percent of total billed charges,,,,,,,,,3978.95,88,,percent of total billed charges,,,,,,,,,3454.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1130.38,22,,percent of total billed charges,,,4114.59,91,,percent of total billed charges,,,4295.45,95,,percent of total billed charges,,,3752.87,83,,percent of total billed charges,,,3752.87,83,,percent of total billed charges,,,,,,,,,,,,,,,3752.87,83,,percent of total billed charges,,,4295.45,95,,percent of total billed charges,,,4069.38,90,,percent of total billed charges,,,4069.38,90,,percent of total billed charges,,,3707.65,82,,percent of total billed charges,,,4069.38,90,,percent of total billed charges,,,3843.3,85,,percent of total billed charges,,1130.38,4295.45,
SYNTHES SCREW CORTEX S-T 2.4X18MM,30181103,CDM,,,278,RC,outpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149.92,22,,percent of total billed charges,,,,,,,,,539.72,90,,percent of total billed charges,,,496.54,82.8,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149.92,22,,percent of total billed charges,,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,149.92,569.71,
STRYKER BONE CLEANING TIP,30181114,CDM,,,270,RC,outpatient,,96,96,,81.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24,22,,percent of total billed charges,,,,,,,,,86.4,90,,percent of total billed charges,,,79.49,82.8,,percent of total billed charges,,,81.6,85,,percent of total billed charges,,,,,,,,,84.48,88,,percent of total billed charges,,,,,,,,,73.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24,22,,percent of total billed charges,,,87.36,91,,percent of total billed charges,,,91.2,95,,percent of total billed charges,,,79.68,83,,percent of total billed charges,,,79.68,83,,percent of total billed charges,,,,,,,,,,,,,,,79.68,83,,percent of total billed charges,,,91.2,95,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,78.72,82,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,81.6,85,,percent of total billed charges,,24,91.2,
BIOMET BONE HEALING STIMULATOR,30181115,CDM,,,278,RC,outpatient,,40839.5,40839.5,,34672.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10209.88,22,,percent of total billed charges,,,,,,,,,36755.55,90,,percent of total billed charges,,,33815.11,82.8,,percent of total billed charges,,,34713.58,85,,percent of total billed charges,,,,,,,,,35938.76,88,,percent of total billed charges,,,,,,,,,31201.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10209.88,22,,percent of total billed charges,,,37163.95,91,,percent of total billed charges,,,38797.53,95,,percent of total billed charges,,,33896.79,83,,percent of total billed charges,,,33896.79,83,,percent of total billed charges,,,,,,,,,,,,,,,33896.79,83,,percent of total billed charges,,,38797.53,95,,percent of total billed charges,,,36755.55,90,,percent of total billed charges,,,36755.55,90,,percent of total billed charges,,,33488.39,82,,percent of total billed charges,,,36755.55,90,,percent of total billed charges,,,34713.58,85,,percent of total billed charges,,10209.88,38797.53,
DEPUY PINNACLE SCREW 6.5 X 55,30181135,CDM,,,278,RC,outpatient,,1244.95,1244.95,,1056.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,311.24,22,,percent of total billed charges,,,,,,,,,1120.46,90,,percent of total billed charges,,,1030.82,82.8,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,,,,,,,,1095.56,88,,percent of total billed charges,,,,,,,,,951.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,311.24,22,,percent of total billed charges,,,1132.9,91,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.31,83,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1020.86,82,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,311.24,1182.7,
DEPUY SELF CENT HIP 51X28 BRN,30181136,CDM,,,278,RC,outpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.27,22,,percent of total billed charges,,,,,,,,,7312.56,90,,percent of total billed charges,,,6727.56,82.8,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.27,22,,percent of total billed charges,,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,2031.27,7718.82,
DEPUY ARTICUL/EZE BALL 28MM +8.5,30181137,CDM,,,278,RC,outpatient,,7289.17,7289.17,,6188.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1822.29,22,,percent of total billed charges,,,,,,,,,6560.25,90,,percent of total billed charges,,,6035.43,82.8,,percent of total billed charges,,,6195.79,85,,percent of total billed charges,,,,,,,,,6414.47,88,,percent of total billed charges,,,,,,,,,5568.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1822.29,22,,percent of total billed charges,,,6633.14,91,,percent of total billed charges,,,6924.71,95,,percent of total billed charges,,,6050.01,83,,percent of total billed charges,,,6050.01,83,,percent of total billed charges,,,,,,,,,,,,,,,6050.01,83,,percent of total billed charges,,,6924.71,95,,percent of total billed charges,,,6560.25,90,,percent of total billed charges,,,6560.25,90,,percent of total billed charges,,,5977.12,82,,percent of total billed charges,,,6560.25,90,,percent of total billed charges,,,6195.79,85,,percent of total billed charges,,1822.29,6924.71,
DEPUY-MITEK MICROFIX ANCHOR #2/0,30181138,CDM,,,278,RC,outpatient,,4270.5,4270.5,,3625.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1067.63,22,,percent of total billed charges,,,,,,,,,3843.45,90,,percent of total billed charges,,,3535.97,82.8,,percent of total billed charges,,,3629.93,85,,percent of total billed charges,,,,,,,,,3758.04,88,,percent of total billed charges,,,,,,,,,3262.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1067.63,22,,percent of total billed charges,,,3886.16,91,,percent of total billed charges,,,4056.98,95,,percent of total billed charges,,,3544.52,83,,percent of total billed charges,,,3544.52,83,,percent of total billed charges,,,,,,,,,,,,,,,3544.52,83,,percent of total billed charges,,,4056.98,95,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3501.81,82,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3629.93,85,,percent of total billed charges,,1067.63,4056.98,
DEMINERALIZED BONE MATRIX 30ML,30181139,CDM,,,270,RC,outpatient,,4547.4,4547.4,,3860.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1136.85,22,,percent of total billed charges,,,,,,,,,4092.66,90,,percent of total billed charges,,,3765.25,82.8,,percent of total billed charges,,,3865.29,85,,percent of total billed charges,,,,,,,,,4001.71,88,,percent of total billed charges,,,,,,,,,3474.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1136.85,22,,percent of total billed charges,,,4138.13,91,,percent of total billed charges,,,4320.03,95,,percent of total billed charges,,,3774.34,83,,percent of total billed charges,,,3774.34,83,,percent of total billed charges,,,,,,,,,,,,,,,3774.34,83,,percent of total billed charges,,,4320.03,95,,percent of total billed charges,,,4092.66,90,,percent of total billed charges,,,4092.66,90,,percent of total billed charges,,,3728.87,82,,percent of total billed charges,,,4092.66,90,,percent of total billed charges,,,3865.29,85,,percent of total billed charges,,1136.85,4320.03,
DEPUY CROSSLINK ANC GLENOID SZ48,30181144,CDM,,,278,RC,outpatient,,17098.9,17098.9,,14516.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4274.73,22,,percent of total billed charges,,,,,,,,,15389.01,90,,percent of total billed charges,,,14157.89,82.8,,percent of total billed charges,,,14534.07,85,,percent of total billed charges,,,,,,,,,15047.03,88,,percent of total billed charges,,,,,,,,,13063.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4274.73,22,,percent of total billed charges,,,15560,91,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,,,,,,,,,,,,,14192.09,83,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14021.1,82,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14534.07,85,,percent of total billed charges,,4274.73,16243.96,
DEPUY STEM GLOBAL HUMERAL 48 X 21,30181145,CDM,,,278,RC,outpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4409.03,22,,percent of total billed charges,,,,,,,,,15872.52,90,,percent of total billed charges,,,14602.72,82.8,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4409.03,22,,percent of total billed charges,,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,4409.03,16754.32,
DEPUY GLOBAL ADVANTAGE PC STEM 14MM,30181146,CDM,,,278,RC,outpatient,,36482.49,36482.49,,30973.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9120.62,22,,percent of total billed charges,,,,,,,,,32834.24,90,,percent of total billed charges,,,30207.5,82.8,,percent of total billed charges,,,31010.12,85,,percent of total billed charges,,,,,,,,,32104.59,88,,percent of total billed charges,,,,,,,,,27872.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9120.62,22,,percent of total billed charges,,,33199.07,91,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,,,,,,,,,,,,,30280.47,83,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,29915.64,82,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,31010.12,85,,percent of total billed charges,,9120.62,34658.37,
DEPUY PINNACLE CUP REVISION 72MM,30181148,CDM,,,278,RC,outpatient,,33437.04,33437.04,,28388.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8359.26,22,,percent of total billed charges,,,,,,,,,30093.34,90,,percent of total billed charges,,,27685.87,82.8,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,,,,,,,,29424.6,88,,percent of total billed charges,,,,,,,,,25545.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8359.26,22,,percent of total billed charges,,,30427.71,91,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,,,,,,,,,,,,,27752.74,83,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,27418.37,82,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,8359.26,31765.19,
DEPUY PINNACLE SCREW 6.5 X 45,30181149,CDM,,,278,RC,outpatient,,1244.95,1244.95,,1056.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,311.24,22,,percent of total billed charges,,,,,,,,,1120.46,90,,percent of total billed charges,,,1030.82,82.8,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,,,,,,,,1095.56,88,,percent of total billed charges,,,,,,,,,951.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,311.24,22,,percent of total billed charges,,,1132.9,91,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.31,83,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1020.86,82,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,311.24,1182.7,
DEPUY PINNACLE SCREW 6.5 X 20,30181150,CDM,,,278,RC,outpatient,,1075.49,1075.49,,913.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,268.87,22,,percent of total billed charges,,,,,,,,,967.94,90,,percent of total billed charges,,,890.51,82.8,,percent of total billed charges,,,914.17,85,,percent of total billed charges,,,,,,,,,946.43,88,,percent of total billed charges,,,,,,,,,821.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,268.87,22,,percent of total billed charges,,,978.7,91,,percent of total billed charges,,,1021.72,95,,percent of total billed charges,,,892.66,83,,percent of total billed charges,,,892.66,83,,percent of total billed charges,,,,,,,,,,,,,,,892.66,83,,percent of total billed charges,,,1021.72,95,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,881.9,82,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,914.17,85,,percent of total billed charges,,268.87,1021.72,
DEPUY SCREW TAPER 45 X 5.0,30181151,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
DEPUY PINNACLE CUP INSERT 44 X 66,30181152,CDM,,,278,RC,outpatient,,18531.63,18531.63,,15733.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4632.91,22,,percent of total billed charges,,,,,,,,,16678.47,90,,percent of total billed charges,,,15344.19,82.8,,percent of total billed charges,,,15751.89,85,,percent of total billed charges,,,,,,,,,16307.83,88,,percent of total billed charges,,,,,,,,,14158.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4632.91,22,,percent of total billed charges,,,16863.78,91,,percent of total billed charges,,,17605.05,95,,percent of total billed charges,,,15381.25,83,,percent of total billed charges,,,15381.25,83,,percent of total billed charges,,,,,,,,,,,,,,,15381.25,83,,percent of total billed charges,,,17605.05,95,,percent of total billed charges,,,16678.47,90,,percent of total billed charges,,,16678.47,90,,percent of total billed charges,,,15195.94,82,,percent of total billed charges,,,16678.47,90,,percent of total billed charges,,,15751.89,85,,percent of total billed charges,,4632.91,17605.05,
DEPUY STEM TRI-LOCK HI OFFSET SZ3,30181157,CDM,,,278,RC,outpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10178.29,22,,percent of total billed charges,,,,,,,,,36641.83,90,,percent of total billed charges,,,33710.48,82.8,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10178.29,22,,percent of total billed charges,,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,10178.29,38677.48,
DEPUY STEM SUMMIT PRESSFIT SZ6,30181158,CDM,,,278,RC,outpatient,,11591.45,11591.45,,9841.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2897.86,22,,percent of total billed charges,,,,,,,,,10432.31,90,,percent of total billed charges,,,9597.72,82.8,,percent of total billed charges,,,9852.73,85,,percent of total billed charges,,,,,,,,,10200.48,88,,percent of total billed charges,,,,,,,,,8855.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2897.86,22,,percent of total billed charges,,,10548.22,91,,percent of total billed charges,,,11011.88,95,,percent of total billed charges,,,9620.9,83,,percent of total billed charges,,,9620.9,83,,percent of total billed charges,,,,,,,,,,,,,,,9620.9,83,,percent of total billed charges,,,11011.88,95,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,9504.99,82,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,9852.73,85,,percent of total billed charges,,2897.86,11011.88,
DEPUY ORTHOSORB RESORBABLE PIN,30181159,CDM,,,278,RC,outpatient,,3095.95,3095.95,,2628.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,773.99,22,,percent of total billed charges,,,,,,,,,2786.36,90,,percent of total billed charges,,,2563.45,82.8,,percent of total billed charges,,,2631.56,85,,percent of total billed charges,,,,,,,,,2724.44,88,,percent of total billed charges,,,,,,,,,2365.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,773.99,22,,percent of total billed charges,,,2817.31,91,,percent of total billed charges,,,2941.15,95,,percent of total billed charges,,,2569.64,83,,percent of total billed charges,,,2569.64,83,,percent of total billed charges,,,,,,,,,,,,,,,2569.64,83,,percent of total billed charges,,,2941.15,95,,percent of total billed charges,,,2786.36,90,,percent of total billed charges,,,2786.36,90,,percent of total billed charges,,,2538.68,82,,percent of total billed charges,,,2786.36,90,,percent of total billed charges,,,2631.56,85,,percent of total billed charges,,773.99,2941.15,
ELECTRODE CUTTING MONO 22-24FR,30181160,CDM,,,270,RC,outpatient,,658.35,658.35,,558.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,164.59,22,,percent of total billed charges,,,,,,,,,592.52,90,,percent of total billed charges,,,545.11,82.8,,percent of total billed charges,,,559.6,85,,percent of total billed charges,,,,,,,,,579.35,88,,percent of total billed charges,,,,,,,,,502.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,164.59,22,,percent of total billed charges,,,599.1,91,,percent of total billed charges,,,625.43,95,,percent of total billed charges,,,546.43,83,,percent of total billed charges,,,546.43,83,,percent of total billed charges,,,,,,,,,,,,,,,546.43,83,,percent of total billed charges,,,625.43,95,,percent of total billed charges,,,592.52,90,,percent of total billed charges,,,592.52,90,,percent of total billed charges,,,539.85,82,,percent of total billed charges,,,592.52,90,,percent of total billed charges,,,559.6,85,,percent of total billed charges,,164.59,625.43,
ELECTRODE CUTTING MONO 24FR,30181161,CDM,,,270,RC,outpatient,,648.45,648.45,,550.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,162.11,22,,percent of total billed charges,,,,,,,,,583.61,90,,percent of total billed charges,,,536.92,82.8,,percent of total billed charges,,,551.18,85,,percent of total billed charges,,,,,,,,,570.64,88,,percent of total billed charges,,,,,,,,,495.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,162.11,22,,percent of total billed charges,,,590.09,91,,percent of total billed charges,,,616.03,95,,percent of total billed charges,,,538.21,83,,percent of total billed charges,,,538.21,83,,percent of total billed charges,,,,,,,,,,,,,,,538.21,83,,percent of total billed charges,,,616.03,95,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,531.73,82,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,551.18,85,,percent of total billed charges,,162.11,616.03,
SYNTHES PLATE LCP RT 2.7MM,30181164,CDM,,,278,RC,outpatient,,6318.65,6318.65,,5364.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1579.66,22,,percent of total billed charges,,,,,,,,,5686.79,90,,percent of total billed charges,,,5231.84,82.8,,percent of total billed charges,,,5370.85,85,,percent of total billed charges,,,,,,,,,5560.41,88,,percent of total billed charges,,,,,,,,,4827.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1579.66,22,,percent of total billed charges,,,5749.97,91,,percent of total billed charges,,,6002.72,95,,percent of total billed charges,,,5244.48,83,,percent of total billed charges,,,5244.48,83,,percent of total billed charges,,,,,,,,,,,,,,,5244.48,83,,percent of total billed charges,,,6002.72,95,,percent of total billed charges,,,5686.79,90,,percent of total billed charges,,,5686.79,90,,percent of total billed charges,,,5181.29,82,,percent of total billed charges,,,5686.79,90,,percent of total billed charges,,,5370.85,85,,percent of total billed charges,,1579.66,6002.72,
GUIDEWIRE ENDOSCOPY .038IN,30181165,CDM,,,270,RC,outpatient,,109.76,109.76,,93.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.44,22,,percent of total billed charges,,,,,,,,,98.78,90,,percent of total billed charges,,,90.88,82.8,,percent of total billed charges,,,93.3,85,,percent of total billed charges,,,,,,,,,96.59,88,,percent of total billed charges,,,,,,,,,83.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.44,22,,percent of total billed charges,,,99.88,91,,percent of total billed charges,,,104.27,95,,percent of total billed charges,,,91.1,83,,percent of total billed charges,,,91.1,83,,percent of total billed charges,,,,,,,,,,,,,,,91.1,83,,percent of total billed charges,,,104.27,95,,percent of total billed charges,,,98.78,90,,percent of total billed charges,,,98.78,90,,percent of total billed charges,,,90,82,,percent of total billed charges,,,98.78,90,,percent of total billed charges,,,93.3,85,,percent of total billed charges,,27.44,104.27,
SYNTHES SCREW CORTEX S-T 2.7X18MM,30181178,CDM,,,278,RC,outpatient,,410.27,410.27,,348.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,102.57,22,,percent of total billed charges,,,,,,,,,369.24,90,,percent of total billed charges,,,339.7,82.8,,percent of total billed charges,,,348.73,85,,percent of total billed charges,,,,,,,,,361.04,88,,percent of total billed charges,,,,,,,,,313.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,102.57,22,,percent of total billed charges,,,373.35,91,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,,,,,,,,,,,,,340.52,83,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,336.42,82,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,348.73,85,,percent of total billed charges,,102.57,389.76,
SYNTHES PLATE DISTAL RADIUS 2.4MM,30181180,CDM,,,278,RC,outpatient,,8878.68,8878.68,,7538,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2219.67,22,,percent of total billed charges,,,,,,,,,7990.81,90,,percent of total billed charges,,,7351.55,82.8,,percent of total billed charges,,,7546.88,85,,percent of total billed charges,,,,,,,,,7813.24,88,,percent of total billed charges,,,,,,,,,6783.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2219.67,22,,percent of total billed charges,,,8079.6,91,,percent of total billed charges,,,8434.75,95,,percent of total billed charges,,,7369.3,83,,percent of total billed charges,,,7369.3,83,,percent of total billed charges,,,,,,,,,,,,,,,7369.3,83,,percent of total billed charges,,,8434.75,95,,percent of total billed charges,,,7990.81,90,,percent of total billed charges,,,7990.81,90,,percent of total billed charges,,,7280.52,82,,percent of total billed charges,,,7990.81,90,,percent of total billed charges,,,7546.88,85,,percent of total billed charges,,2219.67,8434.75,
DEPUY LINER ALTRX +4 40 X 60,30181181,CDM,,,278,RC,outpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4400.13,22,,percent of total billed charges,,,,,,,,,15840.46,90,,percent of total billed charges,,,14573.22,82.8,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4400.13,22,,percent of total billed charges,,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,4400.13,16720.48,
DEPUY LINER ALTRX +4 NEUT 40 X 60,30181182,CDM,,,278,RC,outpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4400.13,22,,percent of total billed charges,,,,,,,,,15840.46,90,,percent of total billed charges,,,14573.22,82.8,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4400.13,22,,percent of total billed charges,,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,4400.13,16720.48,
CAPIO SUTURE CAPTURE DEVICE,30181183,CDM,,,270,RC,outpatient,,2250.63,2250.63,,1910.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,562.66,22,,percent of total billed charges,,,,,,,,,2025.57,90,,percent of total billed charges,,,1863.52,82.8,,percent of total billed charges,,,1913.04,85,,percent of total billed charges,,,,,,,,,1980.55,88,,percent of total billed charges,,,,,,,,,1719.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,562.66,22,,percent of total billed charges,,,2048.07,91,,percent of total billed charges,,,2138.1,95,,percent of total billed charges,,,1868.02,83,,percent of total billed charges,,,1868.02,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.02,83,,percent of total billed charges,,,2138.1,95,,percent of total billed charges,,,2025.57,90,,percent of total billed charges,,,2025.57,90,,percent of total billed charges,,,1845.52,82,,percent of total billed charges,,,2025.57,90,,percent of total billed charges,,,1913.04,85,,percent of total billed charges,,562.66,2138.1,
CAPIO SUTURE BONDEK 3.5 X 90CM,30181184,CDM,,,270,RC,outpatient,,228.15,228.15,,193.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.04,22,,percent of total billed charges,,,,,,,,,205.34,90,,percent of total billed charges,,,188.91,82.8,,percent of total billed charges,,,193.93,85,,percent of total billed charges,,,,,,,,,200.77,88,,percent of total billed charges,,,,,,,,,174.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.04,22,,percent of total billed charges,,,207.62,91,,percent of total billed charges,,,216.74,95,,percent of total billed charges,,,189.36,83,,percent of total billed charges,,,189.36,83,,percent of total billed charges,,,,,,,,,,,,,,,189.36,83,,percent of total billed charges,,,216.74,95,,percent of total billed charges,,,205.34,90,,percent of total billed charges,,,205.34,90,,percent of total billed charges,,,187.08,82,,percent of total billed charges,,,205.34,90,,percent of total billed charges,,,193.93,85,,percent of total billed charges,,57.04,216.74,
CAPIO SUTURE BONDEK 3.5 X 122CM,30181185,CDM,,,270,RC,outpatient,,228.15,228.15,,193.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.04,22,,percent of total billed charges,,,,,,,,,205.34,90,,percent of total billed charges,,,188.91,82.8,,percent of total billed charges,,,193.93,85,,percent of total billed charges,,,,,,,,,200.77,88,,percent of total billed charges,,,,,,,,,174.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.04,22,,percent of total billed charges,,,207.62,91,,percent of total billed charges,,,216.74,95,,percent of total billed charges,,,189.36,83,,percent of total billed charges,,,189.36,83,,percent of total billed charges,,,,,,,,,,,,,,,189.36,83,,percent of total billed charges,,,216.74,95,,percent of total billed charges,,,205.34,90,,percent of total billed charges,,,205.34,90,,percent of total billed charges,,,187.08,82,,percent of total billed charges,,,205.34,90,,percent of total billed charges,,,193.93,85,,percent of total billed charges,,57.04,216.74,
RTI GRAFT MATRIX HD 4 X 5CM,30181186,CDM,,,270,RC,outpatient,,10335,10335,,8774.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2583.75,22,,percent of total billed charges,,,,,,,,,9301.5,90,,percent of total billed charges,,,8557.38,82.8,,percent of total billed charges,,,8784.75,85,,percent of total billed charges,,,,,,,,,9094.8,88,,percent of total billed charges,,,,,,,,,7895.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2583.75,22,,percent of total billed charges,,,9404.85,91,,percent of total billed charges,,,9818.25,95,,percent of total billed charges,,,8578.05,83,,percent of total billed charges,,,8578.05,83,,percent of total billed charges,,,,,,,,,,,,,,,8578.05,83,,percent of total billed charges,,,9818.25,95,,percent of total billed charges,,,9301.5,90,,percent of total billed charges,,,9301.5,90,,percent of total billed charges,,,8474.7,82,,percent of total billed charges,,,9301.5,90,,percent of total billed charges,,,8784.75,85,,percent of total billed charges,,2583.75,9818.25,
DEPUY TIBIAL TRAY SZ2,30181187,CDM,,,270,RC,outpatient,,18568.29,18568.29,,15764.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4642.07,22,,percent of total billed charges,,,,,,,,,16711.46,90,,percent of total billed charges,,,15374.54,82.8,,percent of total billed charges,,,15783.05,85,,percent of total billed charges,,,,,,,,,16340.1,88,,percent of total billed charges,,,,,,,,,14186.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4642.07,22,,percent of total billed charges,,,16897.14,91,,percent of total billed charges,,,17639.88,95,,percent of total billed charges,,,15411.68,83,,percent of total billed charges,,,15411.68,83,,percent of total billed charges,,,,,,,,,,,,,,,15411.68,83,,percent of total billed charges,,,17639.88,95,,percent of total billed charges,,,16711.46,90,,percent of total billed charges,,,16711.46,90,,percent of total billed charges,,,15226,82,,percent of total billed charges,,,16711.46,90,,percent of total billed charges,,,15783.05,85,,percent of total billed charges,,4642.07,17639.88,
DEPUY KNEE CEMENTED - CAPITATED (004),30181188,CDM,,,278,RC,outpatient,,20035.08,20035.08,,17009.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5008.77,22,,percent of total billed charges,,,,,,,,,18031.57,90,,percent of total billed charges,,,16589.05,82.8,,percent of total billed charges,,,17029.82,85,,percent of total billed charges,,,,,,,,,17630.87,88,,percent of total billed charges,,,,,,,,,15306.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5008.77,22,,percent of total billed charges,,,18231.92,91,,percent of total billed charges,,,19033.33,95,,percent of total billed charges,,,16629.12,83,,percent of total billed charges,,,16629.12,83,,percent of total billed charges,,,,,,,,,,,,,,,16629.12,83,,percent of total billed charges,,,19033.33,95,,percent of total billed charges,,,18031.57,90,,percent of total billed charges,,,18031.57,90,,percent of total billed charges,,,16428.77,82,,percent of total billed charges,,,18031.57,90,,percent of total billed charges,,,17029.82,85,,percent of total billed charges,,5008.77,19033.33,
RTI GRAFT MATRIX HD 8 X 5CM,30181190,CDM,,,270,RC,outpatient,,19981,19981,,16963.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4995.25,22,,percent of total billed charges,,,,,,,,,17982.9,90,,percent of total billed charges,,,16544.27,82.8,,percent of total billed charges,,,16983.85,85,,percent of total billed charges,,,,,,,,,17583.28,88,,percent of total billed charges,,,,,,,,,15265.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4995.25,22,,percent of total billed charges,,,18182.71,91,,percent of total billed charges,,,18981.95,95,,percent of total billed charges,,,16584.23,83,,percent of total billed charges,,,16584.23,83,,percent of total billed charges,,,,,,,,,,,,,,,16584.23,83,,percent of total billed charges,,,18981.95,95,,percent of total billed charges,,,17982.9,90,,percent of total billed charges,,,17982.9,90,,percent of total billed charges,,,16384.42,82,,percent of total billed charges,,,17982.9,90,,percent of total billed charges,,,16983.85,85,,percent of total billed charges,,4995.25,18981.95,
SYNTHES GUIDEWIRE 2.5MM,30181202,CDM,,,278,RC,outpatient,,131.24,131.24,,111.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.81,22,,percent of total billed charges,,,,,,,,,118.12,90,,percent of total billed charges,,,108.67,82.8,,percent of total billed charges,,,111.55,85,,percent of total billed charges,,,,,,,,,115.49,88,,percent of total billed charges,,,,,,,,,100.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.81,22,,percent of total billed charges,,,119.43,91,,percent of total billed charges,,,124.68,95,,percent of total billed charges,,,108.93,83,,percent of total billed charges,,,108.93,83,,percent of total billed charges,,,,,,,,,,,,,,,108.93,83,,percent of total billed charges,,,124.68,95,,percent of total billed charges,,,118.12,90,,percent of total billed charges,,,118.12,90,,percent of total billed charges,,,107.62,82,,percent of total billed charges,,,118.12,90,,percent of total billed charges,,,111.55,85,,percent of total billed charges,,32.81,124.68,
SYNTHES GUIDEWIRE 2.0MM,30181203,CDM,,,278,RC,outpatient,,245.78,245.78,,208.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.45,22,,percent of total billed charges,,,,,,,,,221.2,90,,percent of total billed charges,,,203.51,82.8,,percent of total billed charges,,,208.91,85,,percent of total billed charges,,,,,,,,,216.29,88,,percent of total billed charges,,,,,,,,,187.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.45,22,,percent of total billed charges,,,223.66,91,,percent of total billed charges,,,233.49,95,,percent of total billed charges,,,204,83,,percent of total billed charges,,,204,83,,percent of total billed charges,,,,,,,,,,,,,,,204,83,,percent of total billed charges,,,233.49,95,,percent of total billed charges,,,221.2,90,,percent of total billed charges,,,221.2,90,,percent of total billed charges,,,201.54,82,,percent of total billed charges,,,221.2,90,,percent of total billed charges,,,208.91,85,,percent of total billed charges,,61.45,233.49,
SYNTHES DRILL BIT 3.2MM,30181204,CDM,,,270,RC,outpatient,,2227.36,2227.36,,1891.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,556.84,22,,percent of total billed charges,,,,,,,,,2004.62,90,,percent of total billed charges,,,1844.25,82.8,,percent of total billed charges,,,1893.26,85,,percent of total billed charges,,,,,,,,,1960.08,88,,percent of total billed charges,,,,,,,,,1701.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,556.84,22,,percent of total billed charges,,,2026.9,91,,percent of total billed charges,,,2115.99,95,,percent of total billed charges,,,1848.71,83,,percent of total billed charges,,,1848.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1848.71,83,,percent of total billed charges,,,2115.99,95,,percent of total billed charges,,,2004.62,90,,percent of total billed charges,,,2004.62,90,,percent of total billed charges,,,1826.44,82,,percent of total billed charges,,,2004.62,90,,percent of total billed charges,,,1893.26,85,,percent of total billed charges,,556.84,2115.99,
SYNTHES DRILL BIT CALIBRATED 3.2MM,30181205,CDM,,,270,RC,outpatient,,2924.87,2924.87,,2483.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.22,22,,percent of total billed charges,,,,,,,,,2632.38,90,,percent of total billed charges,,,2421.79,82.8,,percent of total billed charges,,,2486.14,85,,percent of total billed charges,,,,,,,,,2573.89,88,,percent of total billed charges,,,,,,,,,2234.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.22,22,,percent of total billed charges,,,2661.63,91,,percent of total billed charges,,,2778.63,95,,percent of total billed charges,,,2427.64,83,,percent of total billed charges,,,2427.64,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.64,83,,percent of total billed charges,,,2778.63,95,,percent of total billed charges,,,2632.38,90,,percent of total billed charges,,,2632.38,90,,percent of total billed charges,,,2398.39,82,,percent of total billed charges,,,2632.38,90,,percent of total billed charges,,,2486.14,85,,percent of total billed charges,,731.22,2778.63,
SYNTHES CANNULA W/STOP 4.5MM,30181207,CDM,,,278,RC,outpatient,,3408.93,3408.93,,2894.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,852.23,22,,percent of total billed charges,,,,,,,,,3068.04,90,,percent of total billed charges,,,2822.59,82.8,,percent of total billed charges,,,2897.59,85,,percent of total billed charges,,,,,,,,,2999.86,88,,percent of total billed charges,,,,,,,,,2604.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,852.23,22,,percent of total billed charges,,,3102.13,91,,percent of total billed charges,,,3238.48,95,,percent of total billed charges,,,2829.41,83,,percent of total billed charges,,,2829.41,83,,percent of total billed charges,,,,,,,,,,,,,,,2829.41,83,,percent of total billed charges,,,3238.48,95,,percent of total billed charges,,,3068.04,90,,percent of total billed charges,,,3068.04,90,,percent of total billed charges,,,2795.32,82,,percent of total billed charges,,,3068.04,90,,percent of total billed charges,,,2897.59,85,,percent of total billed charges,,852.23,3238.48,
SYNTHES TIBIAL END CAP 0MM,30181208,CDM,,,278,RC,outpatient,,1795.63,1795.63,,1524.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,448.91,22,,percent of total billed charges,,,,,,,,,1616.07,90,,percent of total billed charges,,,1486.78,82.8,,percent of total billed charges,,,1526.29,85,,percent of total billed charges,,,,,,,,,1580.15,88,,percent of total billed charges,,,,,,,,,1371.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,448.91,22,,percent of total billed charges,,,1634.02,91,,percent of total billed charges,,,1705.85,95,,percent of total billed charges,,,1490.37,83,,percent of total billed charges,,,1490.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1490.37,83,,percent of total billed charges,,,1705.85,95,,percent of total billed charges,,,1616.07,90,,percent of total billed charges,,,1616.07,90,,percent of total billed charges,,,1472.42,82,,percent of total billed charges,,,1616.07,90,,percent of total billed charges,,,1526.29,85,,percent of total billed charges,,448.91,1705.85,
DEPUY LINER ALTRX +4 NEUT 40 X 58,30181209,CDM,,,278,RC,outpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4400.13,22,,percent of total billed charges,,,,,,,,,15840.46,90,,percent of total billed charges,,,14573.22,82.8,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4400.13,22,,percent of total billed charges,,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,4400.13,16720.48,
DEPUY FEMORAL HEAD 40MM +0.5,30181210,CDM,,,278,RC,outpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3531.34,22,,percent of total billed charges,,,,,,,,,12712.82,90,,percent of total billed charges,,,11695.79,82.8,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3531.34,22,,percent of total billed charges,,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,3531.34,13419.08,
DEPUY SUMMIT STD SZ7,30181211,CDM,,,278,RC,outpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8814.57,22,,percent of total billed charges,,,,,,,,,31732.45,90,,percent of total billed charges,,,29193.86,82.8,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8814.57,22,,percent of total billed charges,,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,8814.57,33495.37,
DEPUY STEM SUMMIT PRESSFIT SZ7,30181212,CDM,,,278,RC,outpatient,,11591.45,11591.45,,9841.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2897.86,22,,percent of total billed charges,,,,,,,,,10432.31,90,,percent of total billed charges,,,9597.72,82.8,,percent of total billed charges,,,9852.73,85,,percent of total billed charges,,,,,,,,,10200.48,88,,percent of total billed charges,,,,,,,,,8855.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2897.86,22,,percent of total billed charges,,,10548.22,91,,percent of total billed charges,,,11011.88,95,,percent of total billed charges,,,9620.9,83,,percent of total billed charges,,,9620.9,83,,percent of total billed charges,,,,,,,,,,,,,,,9620.9,83,,percent of total billed charges,,,11011.88,95,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,9504.99,82,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,9852.73,85,,percent of total billed charges,,2897.86,11011.88,
DEPUY STEM TRI-LOCK HI OFFSET SZ1,30181221,CDM,,,278,RC,outpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10178.29,22,,percent of total billed charges,,,,,,,,,36641.83,90,,percent of total billed charges,,,33710.48,82.8,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10178.29,22,,percent of total billed charges,,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,10178.29,38677.48,
DEPUY SELF CENT HIP 53X28 BRN,30181224,CDM,,,278,RC,outpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.27,22,,percent of total billed charges,,,,,,,,,7312.56,90,,percent of total billed charges,,,6727.56,82.8,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.27,22,,percent of total billed charges,,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,2031.27,7718.82,
RTI GRACILIUS TENDON,30181226,CDM,,,270,RC,outpatient,,8937.5,8937.5,,7587.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2234.38,22,,percent of total billed charges,,,,,,,,,8043.75,90,,percent of total billed charges,,,7400.25,82.8,,percent of total billed charges,,,7596.88,85,,percent of total billed charges,,,,,,,,,7865,88,,percent of total billed charges,,,,,,,,,6828.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2234.38,22,,percent of total billed charges,,,8133.13,91,,percent of total billed charges,,,8490.63,95,,percent of total billed charges,,,7418.13,83,,percent of total billed charges,,,7418.13,83,,percent of total billed charges,,,,,,,,,,,,,,,7418.13,83,,percent of total billed charges,,,8490.63,95,,percent of total billed charges,,,8043.75,90,,percent of total billed charges,,,8043.75,90,,percent of total billed charges,,,7328.75,82,,percent of total billed charges,,,8043.75,90,,percent of total billed charges,,,7596.88,85,,percent of total billed charges,,2234.38,8490.63,
SYNTHES DRILL BIT 2.8MM 165MM,30181228,CDM,,,270,RC,outpatient,,920.27,920.27,,781.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,230.07,22,,percent of total billed charges,,,,,,,,,828.24,90,,percent of total billed charges,,,761.98,82.8,,percent of total billed charges,,,782.23,85,,percent of total billed charges,,,,,,,,,809.84,88,,percent of total billed charges,,,,,,,,,703.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,230.07,22,,percent of total billed charges,,,837.45,91,,percent of total billed charges,,,874.26,95,,percent of total billed charges,,,763.82,83,,percent of total billed charges,,,763.82,83,,percent of total billed charges,,,,,,,,,,,,,,,763.82,83,,percent of total billed charges,,,874.26,95,,percent of total billed charges,,,828.24,90,,percent of total billed charges,,,828.24,90,,percent of total billed charges,,,754.62,82,,percent of total billed charges,,,828.24,90,,percent of total billed charges,,,782.23,85,,percent of total billed charges,,230.07,874.26,
SYNTHES PLATE TUBULAR 3-HOLE 90MM,30181230,CDM,,,278,RC,outpatient,,14477.84,14477.84,,12291.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3619.46,22,,percent of total billed charges,,,,,,,,,13030.06,90,,percent of total billed charges,,,11987.65,82.8,,percent of total billed charges,,,12306.16,85,,percent of total billed charges,,,,,,,,,12740.5,88,,percent of total billed charges,,,,,,,,,11061.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3619.46,22,,percent of total billed charges,,,13174.83,91,,percent of total billed charges,,,13753.95,95,,percent of total billed charges,,,12016.61,83,,percent of total billed charges,,,12016.61,83,,percent of total billed charges,,,,,,,,,,,,,,,12016.61,83,,percent of total billed charges,,,13753.95,95,,percent of total billed charges,,,13030.06,90,,percent of total billed charges,,,13030.06,90,,percent of total billed charges,,,11871.83,82,,percent of total billed charges,,,13030.06,90,,percent of total billed charges,,,12306.16,85,,percent of total billed charges,,3619.46,13753.95,
DEPUY FEMUR CEMENTED RT SZ2,30181239,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
SYNTHES SCREW HEX HEAD 5.0X36MM,30181240,CDM,,,278,RC,outpatient,,2160.28,2160.28,,1834.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,540.07,22,,percent of total billed charges,,,,,,,,,1944.25,90,,percent of total billed charges,,,1788.71,82.8,,percent of total billed charges,,,1836.24,85,,percent of total billed charges,,,,,,,,,1901.05,88,,percent of total billed charges,,,,,,,,,1650.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,540.07,22,,percent of total billed charges,,,1965.85,91,,percent of total billed charges,,,2052.27,95,,percent of total billed charges,,,1793.03,83,,percent of total billed charges,,,1793.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1793.03,83,,percent of total billed charges,,,2052.27,95,,percent of total billed charges,,,1944.25,90,,percent of total billed charges,,,1944.25,90,,percent of total billed charges,,,1771.43,82,,percent of total billed charges,,,1944.25,90,,percent of total billed charges,,,1836.24,85,,percent of total billed charges,,540.07,2052.27,
MEGADYNE E-Z CLEAN NEEDLE 2.75,30181243,CDM,,,270,RC,outpatient,,47.6,47.6,,40.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.9,22,,percent of total billed charges,,,,,,,,,42.84,90,,percent of total billed charges,,,39.41,82.8,,percent of total billed charges,,,40.46,85,,percent of total billed charges,,,,,,,,,41.89,88,,percent of total billed charges,,,,,,,,,36.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.9,22,,percent of total billed charges,,,43.32,91,,percent of total billed charges,,,45.22,95,,percent of total billed charges,,,39.51,83,,percent of total billed charges,,,39.51,83,,percent of total billed charges,,,,,,,,,,,,,,,39.51,83,,percent of total billed charges,,,45.22,95,,percent of total billed charges,,,42.84,90,,percent of total billed charges,,,42.84,90,,percent of total billed charges,,,39.03,82,,percent of total billed charges,,,42.84,90,,percent of total billed charges,,,40.46,85,,percent of total billed charges,,11.9,45.22,
AMS ELEVATE KIT ANTERIOR,30181244,CDM,,,278,RC,outpatient,,13056.55,13056.55,,11085.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3264.14,22,,percent of total billed charges,,,,,,,,,11750.9,90,,percent of total billed charges,,,10810.82,82.8,,percent of total billed charges,,,11098.07,85,,percent of total billed charges,,,,,,,,,11489.76,88,,percent of total billed charges,,,,,,,,,9975.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3264.14,22,,percent of total billed charges,,,11881.46,91,,percent of total billed charges,,,12403.72,95,,percent of total billed charges,,,10836.94,83,,percent of total billed charges,,,10836.94,83,,percent of total billed charges,,,,,,,,,,,,,,,10836.94,83,,percent of total billed charges,,,12403.72,95,,percent of total billed charges,,,11750.9,90,,percent of total billed charges,,,11750.9,90,,percent of total billed charges,,,10706.37,82,,percent of total billed charges,,,11750.9,90,,percent of total billed charges,,,11098.07,85,,percent of total billed charges,,3264.14,12403.72,
AMS ELEVATE KIT POSTERIOR,30181245,CDM,,,278,RC,outpatient,,10989.55,10989.55,,9330.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2747.39,22,,percent of total billed charges,,,,,,,,,9890.6,90,,percent of total billed charges,,,9099.35,82.8,,percent of total billed charges,,,9341.12,85,,percent of total billed charges,,,,,,,,,9670.8,88,,percent of total billed charges,,,,,,,,,8396.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2747.39,22,,percent of total billed charges,,,10000.49,91,,percent of total billed charges,,,10440.07,95,,percent of total billed charges,,,9121.33,83,,percent of total billed charges,,,9121.33,83,,percent of total billed charges,,,,,,,,,,,,,,,9121.33,83,,percent of total billed charges,,,10440.07,95,,percent of total billed charges,,,9890.6,90,,percent of total billed charges,,,9890.6,90,,percent of total billed charges,,,9011.43,82,,percent of total billed charges,,,9890.6,90,,percent of total billed charges,,,9341.12,85,,percent of total billed charges,,2747.39,10440.07,
MESH SOLYX SLING,30181247,CDM,,,270,RC,outpatient,,11752.65,11752.65,,9978,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2938.16,22,,percent of total billed charges,,,,,,,,,10577.39,90,,percent of total billed charges,,,9731.19,82.8,,percent of total billed charges,,,9989.75,85,,percent of total billed charges,,,,,,,,,10342.33,88,,percent of total billed charges,,,,,,,,,8979.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2938.16,22,,percent of total billed charges,,,10694.91,91,,percent of total billed charges,,,11165.02,95,,percent of total billed charges,,,9754.7,83,,percent of total billed charges,,,9754.7,83,,percent of total billed charges,,,,,,,,,,,,,,,9754.7,83,,percent of total billed charges,,,11165.02,95,,percent of total billed charges,,,10577.39,90,,percent of total billed charges,,,10577.39,90,,percent of total billed charges,,,9637.17,82,,percent of total billed charges,,,10577.39,90,,percent of total billed charges,,,9989.75,85,,percent of total billed charges,,2938.16,11165.02,
SYNTHES SCREW DISTAL RADIUS 2.4X28MM,30181251,CDM,,,278,RC,outpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,338.51,22,,percent of total billed charges,,,,,,,,,1218.62,90,,percent of total billed charges,,,1121.13,82.8,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,338.51,22,,percent of total billed charges,,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,338.51,1286.32,
JURGAN BALL - GR,30181253,CDM,,,270,RC,outpatient,,48.2,48.2,,40.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.05,22,,percent of total billed charges,,,,,,,,,43.38,90,,percent of total billed charges,,,39.91,82.8,,percent of total billed charges,,,40.97,85,,percent of total billed charges,,,,,,,,,42.42,88,,percent of total billed charges,,,,,,,,,36.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.05,22,,percent of total billed charges,,,43.86,91,,percent of total billed charges,,,45.79,95,,percent of total billed charges,,,40.01,83,,percent of total billed charges,,,40.01,83,,percent of total billed charges,,,,,,,,,,,,,,,40.01,83,,percent of total billed charges,,,45.79,95,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,39.52,82,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,40.97,85,,percent of total billed charges,,12.05,45.79,
JURGAN BALL - BL,30181254,CDM,,,270,RC,outpatient,,45.31,45.31,,38.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.33,22,,percent of total billed charges,,,,,,,,,40.78,90,,percent of total billed charges,,,37.52,82.8,,percent of total billed charges,,,38.51,85,,percent of total billed charges,,,,,,,,,39.87,88,,percent of total billed charges,,,,,,,,,34.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.33,22,,percent of total billed charges,,,41.23,91,,percent of total billed charges,,,43.04,95,,percent of total billed charges,,,37.61,83,,percent of total billed charges,,,37.61,83,,percent of total billed charges,,,,,,,,,,,,,,,37.61,83,,percent of total billed charges,,,43.04,95,,percent of total billed charges,,,40.78,90,,percent of total billed charges,,,40.78,90,,percent of total billed charges,,,37.15,82,,percent of total billed charges,,,40.78,90,,percent of total billed charges,,,38.51,85,,percent of total billed charges,,11.33,43.04,
JURGAN BALL - CR,30181255,CDM,,,270,RC,outpatient,,48.2,48.2,,40.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.05,22,,percent of total billed charges,,,,,,,,,43.38,90,,percent of total billed charges,,,39.91,82.8,,percent of total billed charges,,,40.97,85,,percent of total billed charges,,,,,,,,,42.42,88,,percent of total billed charges,,,,,,,,,36.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.05,22,,percent of total billed charges,,,43.86,91,,percent of total billed charges,,,45.79,95,,percent of total billed charges,,,40.01,83,,percent of total billed charges,,,40.01,83,,percent of total billed charges,,,,,,,,,,,,,,,40.01,83,,percent of total billed charges,,,45.79,95,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,39.52,82,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,40.97,85,,percent of total billed charges,,12.05,45.79,
JURGAN BALL - YL,30181256,CDM,,,270,RC,outpatient,,55.25,55.25,,46.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.81,22,,percent of total billed charges,,,,,,,,,49.73,90,,percent of total billed charges,,,45.75,82.8,,percent of total billed charges,,,46.96,85,,percent of total billed charges,,,,,,,,,48.62,88,,percent of total billed charges,,,,,,,,,42.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.81,22,,percent of total billed charges,,,50.28,91,,percent of total billed charges,,,52.49,95,,percent of total billed charges,,,45.86,83,,percent of total billed charges,,,45.86,83,,percent of total billed charges,,,,,,,,,,,,,,,45.86,83,,percent of total billed charges,,,52.49,95,,percent of total billed charges,,,49.73,90,,percent of total billed charges,,,49.73,90,,percent of total billed charges,,,45.31,82,,percent of total billed charges,,,49.73,90,,percent of total billed charges,,,46.96,85,,percent of total billed charges,,13.81,52.49,
SYNTHES DRILL BIT CANNULATED 3.2MM,30181263,CDM,,,270,RC,outpatient,,4176.9,4176.9,,3546.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1044.23,22,,percent of total billed charges,,,,,,,,,3759.21,90,,percent of total billed charges,,,3458.47,82.8,,percent of total billed charges,,,3550.37,85,,percent of total billed charges,,,,,,,,,3675.67,88,,percent of total billed charges,,,,,,,,,3191.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1044.23,22,,percent of total billed charges,,,3800.98,91,,percent of total billed charges,,,3968.06,95,,percent of total billed charges,,,3466.83,83,,percent of total billed charges,,,3466.83,83,,percent of total billed charges,,,,,,,,,,,,,,,3466.83,83,,percent of total billed charges,,,3968.06,95,,percent of total billed charges,,,3759.21,90,,percent of total billed charges,,,3759.21,90,,percent of total billed charges,,,3425.06,82,,percent of total billed charges,,,3759.21,90,,percent of total billed charges,,,3550.37,85,,percent of total billed charges,,1044.23,3968.06,
RTI SEMITENDINOSIS TENDON 200MM,30181265,CDM,,,278,RC,outpatient,,8612.5,8612.5,,7312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2153.13,22,,percent of total billed charges,,,,,,,,,7751.25,90,,percent of total billed charges,,,7131.15,82.8,,percent of total billed charges,,,7320.63,85,,percent of total billed charges,,,,,,,,,7579,88,,percent of total billed charges,,,,,,,,,6579.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2153.13,22,,percent of total billed charges,,,7837.38,91,,percent of total billed charges,,,8181.88,95,,percent of total billed charges,,,7148.38,83,,percent of total billed charges,,,7148.38,83,,percent of total billed charges,,,,,,,,,,,,,,,7148.38,83,,percent of total billed charges,,,8181.88,95,,percent of total billed charges,,,7751.25,90,,percent of total billed charges,,,7751.25,90,,percent of total billed charges,,,7062.25,82,,percent of total billed charges,,,7751.25,90,,percent of total billed charges,,,7320.63,85,,percent of total billed charges,,2153.13,8181.88,
CATH URETERAL OPEN END 5FR,30181273,CDM,,,270,RC,outpatient,,86.24,86.24,,73.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.56,22,,percent of total billed charges,,,,,,,,,77.62,90,,percent of total billed charges,,,71.41,82.8,,percent of total billed charges,,,73.3,85,,percent of total billed charges,,,,,,,,,75.89,88,,percent of total billed charges,,,,,,,,,65.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.56,22,,percent of total billed charges,,,78.48,91,,percent of total billed charges,,,81.93,95,,percent of total billed charges,,,71.58,83,,percent of total billed charges,,,71.58,83,,percent of total billed charges,,,,,,,,,,,,,,,71.58,83,,percent of total billed charges,,,81.93,95,,percent of total billed charges,,,77.62,90,,percent of total billed charges,,,77.62,90,,percent of total billed charges,,,70.72,82,,percent of total billed charges,,,77.62,90,,percent of total billed charges,,,73.3,85,,percent of total billed charges,,21.56,81.93,
DEPUY HEAD 40MM +8.5,30181278,CDM,,,278,RC,outpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3531.34,22,,percent of total billed charges,,,,,,,,,12712.82,90,,percent of total billed charges,,,11695.79,82.8,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3531.34,22,,percent of total billed charges,,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,3531.34,13419.08,
DEPUY STEM SUMMIT TAPER SZ5 HI OFF,30181279,CDM,,,278,RC,outpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8814.57,22,,percent of total billed charges,,,,,,,,,31732.45,90,,percent of total billed charges,,,29193.86,82.8,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8814.57,22,,percent of total billed charges,,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,8814.57,33495.37,
S&N ENDO NEEDLE XL,30181284,CDM,,,270,RC,outpatient,,556.5,556.5,,472.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,139.13,22,,percent of total billed charges,,,,,,,,,500.85,90,,percent of total billed charges,,,460.78,82.8,,percent of total billed charges,,,473.03,85,,percent of total billed charges,,,,,,,,,489.72,88,,percent of total billed charges,,,,,,,,,425.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,139.13,22,,percent of total billed charges,,,506.42,91,,percent of total billed charges,,,528.68,95,,percent of total billed charges,,,461.9,83,,percent of total billed charges,,,461.9,83,,percent of total billed charges,,,,,,,,,,,,,,,461.9,83,,percent of total billed charges,,,528.68,95,,percent of total billed charges,,,500.85,90,,percent of total billed charges,,,500.85,90,,percent of total billed charges,,,456.33,82,,percent of total billed charges,,,500.85,90,,percent of total billed charges,,,473.03,85,,percent of total billed charges,,139.13,528.68,
S&N ENDO ABLATOR,30181287,CDM,,,278,RC,outpatient,,3280.36,3280.36,,2785.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,820.09,22,,percent of total billed charges,,,,,,,,,2952.32,90,,percent of total billed charges,,,2716.14,82.8,,percent of total billed charges,,,2788.31,85,,percent of total billed charges,,,,,,,,,2886.72,88,,percent of total billed charges,,,,,,,,,2506.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,820.09,22,,percent of total billed charges,,,2985.13,91,,percent of total billed charges,,,3116.34,95,,percent of total billed charges,,,2722.7,83,,percent of total billed charges,,,2722.7,83,,percent of total billed charges,,,,,,,,,,,,,,,2722.7,83,,percent of total billed charges,,,3116.34,95,,percent of total billed charges,,,2952.32,90,,percent of total billed charges,,,2952.32,90,,percent of total billed charges,,,2689.9,82,,percent of total billed charges,,,2952.32,90,,percent of total billed charges,,,2788.31,85,,percent of total billed charges,,820.09,3116.34,
DEPUY PINNACLE 100 CUP W/CRIPTION 60MM,30181299,CDM,,,278,RC,outpatient,,20679.88,20679.88,,17557.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5169.97,22,,percent of total billed charges,,,,,,,,,18611.89,90,,percent of total billed charges,,,17122.94,82.8,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,,,,,,,,18198.29,88,,percent of total billed charges,,,,,,,,,15799.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5169.97,22,,percent of total billed charges,,,18818.69,91,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17164.3,83,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,16957.5,82,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,5169.97,19645.89,
DEPUY UPCHARGE GRIPTON CUP(016),30181300,CDM,,,278,RC,outpatient,,2608.65,2608.65,,2214.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,652.16,22,,percent of total billed charges,,,,,,,,,2347.79,90,,percent of total billed charges,,,2159.96,82.8,,percent of total billed charges,,,2217.35,85,,percent of total billed charges,,,,,,,,,2295.61,88,,percent of total billed charges,,,,,,,,,1993.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,652.16,22,,percent of total billed charges,,,2373.87,91,,percent of total billed charges,,,2478.22,95,,percent of total billed charges,,,2165.18,83,,percent of total billed charges,,,2165.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2165.18,83,,percent of total billed charges,,,2478.22,95,,percent of total billed charges,,,2347.79,90,,percent of total billed charges,,,2347.79,90,,percent of total billed charges,,,2139.09,82,,percent of total billed charges,,,2347.79,90,,percent of total billed charges,,,2217.35,85,,percent of total billed charges,,652.16,2478.22,
DEPUY STEM SUMMIT STD SZ4,30181307,CDM,,,278,RC,outpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8814.57,22,,percent of total billed charges,,,,,,,,,31732.45,90,,percent of total billed charges,,,29193.86,82.8,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8814.57,22,,percent of total billed charges,,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,8814.57,33495.37,
SYNTHES ROD REAMER 3MM 351.76S,30181309,CDM,,,278,RC,outpatient,,1674.08,1674.08,,1421.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,418.52,22,,percent of total billed charges,,,,,,,,,1506.67,90,,percent of total billed charges,,,1386.14,82.8,,percent of total billed charges,,,1422.97,85,,percent of total billed charges,,,,,,,,,1473.19,88,,percent of total billed charges,,,,,,,,,1279,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,418.52,22,,percent of total billed charges,,,1523.41,91,,percent of total billed charges,,,1590.38,95,,percent of total billed charges,,,1389.49,83,,percent of total billed charges,,,1389.49,83,,percent of total billed charges,,,,,,,,,,,,,,,1389.49,83,,percent of total billed charges,,,1590.38,95,,percent of total billed charges,,,1506.67,90,,percent of total billed charges,,,1506.67,90,,percent of total billed charges,,,1372.75,82,,percent of total billed charges,,,1506.67,90,,percent of total billed charges,,,1422.97,85,,percent of total billed charges,,418.52,1590.38,
DEPUY STEM GLOBAL FX PC 6MM,30181314,CDM,,,278,RC,outpatient,,38704.58,38704.58,,32860.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9676.15,22,,percent of total billed charges,,,,,,,,,34834.12,90,,percent of total billed charges,,,32047.39,82.8,,percent of total billed charges,,,32898.89,85,,percent of total billed charges,,,,,,,,,34060.03,88,,percent of total billed charges,,,,,,,,,29570.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9676.15,22,,percent of total billed charges,,,35221.17,91,,percent of total billed charges,,,36769.35,95,,percent of total billed charges,,,32124.8,83,,percent of total billed charges,,,32124.8,83,,percent of total billed charges,,,,,,,,,,,,,,,32124.8,83,,percent of total billed charges,,,36769.35,95,,percent of total billed charges,,,34834.12,90,,percent of total billed charges,,,34834.12,90,,percent of total billed charges,,,31737.76,82,,percent of total billed charges,,,34834.12,90,,percent of total billed charges,,,32898.89,85,,percent of total billed charges,,9676.15,36769.35,
GYRUS GAUZE SACK,30181315,CDM,,,270,RC,outpatient,,10.96,10.96,,9.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.74,22,,percent of total billed charges,,,,,,,,,9.86,90,,percent of total billed charges,,,9.07,82.8,,percent of total billed charges,,,9.32,85,,percent of total billed charges,,,,,,,,,9.64,88,,percent of total billed charges,,,,,,,,,8.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.74,22,,percent of total billed charges,,,9.97,91,,percent of total billed charges,,,10.41,95,,percent of total billed charges,,,9.1,83,,percent of total billed charges,,,9.1,83,,percent of total billed charges,,,,,,,,,,,,,,,9.1,83,,percent of total billed charges,,,10.41,95,,percent of total billed charges,,,9.86,90,,percent of total billed charges,,,9.86,90,,percent of total billed charges,,,8.99,82,,percent of total billed charges,,,9.86,90,,percent of total billed charges,,,9.32,85,,percent of total billed charges,,2.74,10.41,
SYNTHES SCREW LOCKING 2.7X16MM,30181316,CDM,,,278,RC,outpatient,,1178.13,1178.13,,1000.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,294.53,22,,percent of total billed charges,,,,,,,,,1060.32,90,,percent of total billed charges,,,975.49,82.8,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,,,,,,,,1036.75,88,,percent of total billed charges,,,,,,,,,900.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,294.53,22,,percent of total billed charges,,,1072.1,91,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,,,,,,,,,,,,,977.85,83,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,966.07,82,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,294.53,1119.22,
SYNTHES SCREW LOCKING 2.7X14MM,30181317,CDM,,,278,RC,outpatient,,1178.13,1178.13,,1000.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,294.53,22,,percent of total billed charges,,,,,,,,,1060.32,90,,percent of total billed charges,,,975.49,82.8,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,,,,,,,,1036.75,88,,percent of total billed charges,,,,,,,,,900.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,294.53,22,,percent of total billed charges,,,1072.1,91,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,,,,,,,,,,,,,977.85,83,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,966.07,82,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,294.53,1119.22,
SYNTHES DRILL BIT 2.0MM 323.062,30181319,CDM,,,270,RC,outpatient,,1518.14,1518.14,,1288.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,379.54,22,,percent of total billed charges,,,,,,,,,1366.33,90,,percent of total billed charges,,,1257.02,82.8,,percent of total billed charges,,,1290.42,85,,percent of total billed charges,,,,,,,,,1335.96,88,,percent of total billed charges,,,,,,,,,1159.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,379.54,22,,percent of total billed charges,,,1381.51,91,,percent of total billed charges,,,1442.23,95,,percent of total billed charges,,,1260.06,83,,percent of total billed charges,,,1260.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1260.06,83,,percent of total billed charges,,,1442.23,95,,percent of total billed charges,,,1366.33,90,,percent of total billed charges,,,1366.33,90,,percent of total billed charges,,,1244.87,82,,percent of total billed charges,,,1366.33,90,,percent of total billed charges,,,1290.42,85,,percent of total billed charges,,379.54,1442.23,
DEPUY SCREW TAPER HD 50 X 5.0,30181321,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
DEPUY SCREW TAPER 35 X 5.0,30181322,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
DEPUY LINER ALTRX +4 NEUT 40 X 56,30181323,CDM,,,278,RC,outpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4400.13,22,,percent of total billed charges,,,,,,,,,15840.46,90,,percent of total billed charges,,,14573.22,82.8,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4400.13,22,,percent of total billed charges,,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,4400.13,16720.48,
DEPUY FEMORAL HEAD 40MM +9,30181324,CDM,,,278,RC,outpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3531.34,22,,percent of total billed charges,,,,,,,,,12712.82,90,,percent of total billed charges,,,11695.79,82.8,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3531.34,22,,percent of total billed charges,,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,3531.34,13419.08,
DEPUY INSERT TIBIA TC3 12.5MM SZ2.5,30181326,CDM,,,278,RC,outpatient,,17187.04,17187.04,,14591.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4296.76,22,,percent of total billed charges,,,,,,,,,15468.34,90,,percent of total billed charges,,,14230.87,82.8,,percent of total billed charges,,,14608.98,85,,percent of total billed charges,,,,,,,,,15124.6,88,,percent of total billed charges,,,,,,,,,13130.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4296.76,22,,percent of total billed charges,,,15640.21,91,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,,,,,,,,,,,,,14265.24,83,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14093.37,82,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14608.98,85,,percent of total billed charges,,4296.76,16327.69,
DEPUY FEMUR TC3 RT SZ2,30181327,CDM,,,278,RC,outpatient,,48160.65,48160.65,,40888.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12040.16,22,,percent of total billed charges,,,,,,,,,43344.59,90,,percent of total billed charges,,,39877.02,82.8,,percent of total billed charges,,,40936.55,85,,percent of total billed charges,,,,,,,,,42381.37,88,,percent of total billed charges,,,,,,,,,36794.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12040.16,22,,percent of total billed charges,,,43826.19,91,,percent of total billed charges,,,45752.62,95,,percent of total billed charges,,,39973.34,83,,percent of total billed charges,,,39973.34,83,,percent of total billed charges,,,,,,,,,,,,,,,39973.34,83,,percent of total billed charges,,,45752.62,95,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,39491.73,82,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,40936.55,85,,percent of total billed charges,,12040.16,45752.62,
DEPUY DISTAL AUGMENT RT 4MM SZ2.0,30181328,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
DEPUY STEM GLOBAL HUMERAL 48 X 18,30181340,CDM,,,278,RC,outpatient,,15560.09,15560.09,,13210.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3890.02,22,,percent of total billed charges,,,,,,,,,14004.08,90,,percent of total billed charges,,,12883.75,82.8,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,,,,,,,,13692.88,88,,percent of total billed charges,,,,,,,,,11887.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3890.02,22,,percent of total billed charges,,,14159.68,91,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12914.87,83,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,12759.27,82,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,3890.02,14782.09,
DEPUY FIXATION PINS,30181341,CDM,,,278,RC,outpatient,,1898,1898,,1611.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,474.5,22,,percent of total billed charges,,,,,,,,,1708.2,90,,percent of total billed charges,,,1571.54,82.8,,percent of total billed charges,,,1613.3,85,,percent of total billed charges,,,,,,,,,1670.24,88,,percent of total billed charges,,,,,,,,,1450.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,474.5,22,,percent of total billed charges,,,1727.18,91,,percent of total billed charges,,,1803.1,95,,percent of total billed charges,,,1575.34,83,,percent of total billed charges,,,1575.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1575.34,83,,percent of total billed charges,,,1803.1,95,,percent of total billed charges,,,1708.2,90,,percent of total billed charges,,,1708.2,90,,percent of total billed charges,,,1556.36,82,,percent of total billed charges,,,1708.2,90,,percent of total billed charges,,,1613.3,85,,percent of total billed charges,,474.5,1803.1,
DEPUY CROSSLINK FIN GLENOID SZ40,30181344,CDM,,,278,RC,outpatient,,14866.35,14866.35,,12621.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3716.59,22,,percent of total billed charges,,,,,,,,,13379.72,90,,percent of total billed charges,,,12309.34,82.8,,percent of total billed charges,,,12636.4,85,,percent of total billed charges,,,,,,,,,13082.39,88,,percent of total billed charges,,,,,,,,,11357.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3716.59,22,,percent of total billed charges,,,13528.38,91,,percent of total billed charges,,,14123.03,95,,percent of total billed charges,,,12339.07,83,,percent of total billed charges,,,12339.07,83,,percent of total billed charges,,,,,,,,,,,,,,,12339.07,83,,percent of total billed charges,,,14123.03,95,,percent of total billed charges,,,13379.72,90,,percent of total billed charges,,,13379.72,90,,percent of total billed charges,,,12190.41,82,,percent of total billed charges,,,13379.72,90,,percent of total billed charges,,,12636.4,85,,percent of total billed charges,,3716.59,14123.03,
DEPUY STEM GLOBAL HUMERAL 40 X 21,30181345,CDM,,,278,RC,outpatient,,15560.09,15560.09,,13210.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3890.02,22,,percent of total billed charges,,,,,,,,,14004.08,90,,percent of total billed charges,,,12883.75,82.8,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,,,,,,,,13692.88,88,,percent of total billed charges,,,,,,,,,11887.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3890.02,22,,percent of total billed charges,,,14159.68,91,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12914.87,83,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,12759.27,82,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,3890.02,14782.09,
DEPUY STEM GLOBAL ADVANTAGE PC 10MM,30181346,CDM,,,278,RC,outpatient,,36482.49,36482.49,,30973.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9120.62,22,,percent of total billed charges,,,,,,,,,32834.24,90,,percent of total billed charges,,,30207.5,82.8,,percent of total billed charges,,,31010.12,85,,percent of total billed charges,,,,,,,,,32104.59,88,,percent of total billed charges,,,,,,,,,27872.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9120.62,22,,percent of total billed charges,,,33199.07,91,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,,,,,,,,,,,,,30280.47,83,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,29915.64,82,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,31010.12,85,,percent of total billed charges,,9120.62,34658.37,
DEPUY ANCHOR PEG DRILL BIT,30181347,CDM,,,278,RC,outpatient,,1384.5,1384.5,,1175.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,346.13,22,,percent of total billed charges,,,,,,,,,1246.05,90,,percent of total billed charges,,,1146.37,82.8,,percent of total billed charges,,,1176.83,85,,percent of total billed charges,,,,,,,,,1218.36,88,,percent of total billed charges,,,,,,,,,1057.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,346.13,22,,percent of total billed charges,,,1259.9,91,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1149.14,83,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1135.29,82,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1176.83,85,,percent of total billed charges,,346.13,1315.28,
DEPUY DRILL BIT KEELED GLENOID,30181348,CDM,,,278,RC,outpatient,,1092,1092,,927.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,273,22,,percent of total billed charges,,,,,,,,,982.8,90,,percent of total billed charges,,,904.18,82.8,,percent of total billed charges,,,928.2,85,,percent of total billed charges,,,,,,,,,960.96,88,,percent of total billed charges,,,,,,,,,834.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,273,22,,percent of total billed charges,,,993.72,91,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,,,,,,,,,,,,,906.36,83,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,895.44,82,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,928.2,85,,percent of total billed charges,,273,1037.4,
STRYKER BLADE SAGITAL SYSTEM 6,30181349,CDM,,,270,RC,outpatient,,469.21,469.21,,398.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.3,22,,percent of total billed charges,,,,,,,,,422.29,90,,percent of total billed charges,,,388.51,82.8,,percent of total billed charges,,,398.83,85,,percent of total billed charges,,,,,,,,,412.9,88,,percent of total billed charges,,,,,,,,,358.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.3,22,,percent of total billed charges,,,426.98,91,,percent of total billed charges,,,445.75,95,,percent of total billed charges,,,389.44,83,,percent of total billed charges,,,389.44,83,,percent of total billed charges,,,,,,,,,,,,,,,389.44,83,,percent of total billed charges,,,445.75,95,,percent of total billed charges,,,422.29,90,,percent of total billed charges,,,422.29,90,,percent of total billed charges,,,384.75,82,,percent of total billed charges,,,422.29,90,,percent of total billed charges,,,398.83,85,,percent of total billed charges,,117.3,445.75,
DEPUY FEMORAL HEAD 40MM +5.0,30181353,CDM,,,278,RC,outpatient,,15414.23,15414.23,,13086.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3853.56,22,,percent of total billed charges,,,,,,,,,13872.81,90,,percent of total billed charges,,,12762.98,82.8,,percent of total billed charges,,,13102.1,85,,percent of total billed charges,,,,,,,,,13564.52,88,,percent of total billed charges,,,,,,,,,11776.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3853.56,22,,percent of total billed charges,,,14026.95,91,,percent of total billed charges,,,14643.52,95,,percent of total billed charges,,,12793.81,83,,percent of total billed charges,,,12793.81,83,,percent of total billed charges,,,,,,,,,,,,,,,12793.81,83,,percent of total billed charges,,,14643.52,95,,percent of total billed charges,,,13872.81,90,,percent of total billed charges,,,13872.81,90,,percent of total billed charges,,,12639.67,82,,percent of total billed charges,,,13872.81,90,,percent of total billed charges,,,13102.1,85,,percent of total billed charges,,3853.56,14643.52,
DEPUY PINNACLE CUP 100 W/GRIPTION 62MM,30181354,CDM,,,278,RC,outpatient,,20679.88,20679.88,,17557.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5169.97,22,,percent of total billed charges,,,,,,,,,18611.89,90,,percent of total billed charges,,,17122.94,82.8,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,,,,,,,,18198.29,88,,percent of total billed charges,,,,,,,,,15799.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5169.97,22,,percent of total billed charges,,,18818.69,91,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17164.3,83,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,16957.5,82,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,5169.97,19645.89,
DEPUY LINER ALTRX +4 NEUT 44 X 62,30181355,CDM,,,278,RC,outpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4400.13,22,,percent of total billed charges,,,,,,,,,15840.46,90,,percent of total billed charges,,,14573.22,82.8,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4400.13,22,,percent of total billed charges,,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,4400.13,16720.48,
S&N PATELLAR COMPONENT 32MM,30181358,CDM,,,278,RC,outpatient,,4250.48,4250.48,,3608.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1062.62,22,,percent of total billed charges,,,,,,,,,3825.43,90,,percent of total billed charges,,,3519.4,82.8,,percent of total billed charges,,,3612.91,85,,percent of total billed charges,,,,,,,,,3740.42,88,,percent of total billed charges,,,,,,,,,3247.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1062.62,22,,percent of total billed charges,,,3867.94,91,,percent of total billed charges,,,4037.96,95,,percent of total billed charges,,,3527.9,83,,percent of total billed charges,,,3527.9,83,,percent of total billed charges,,,,,,,,,,,,,,,3527.9,83,,percent of total billed charges,,,4037.96,95,,percent of total billed charges,,,3825.43,90,,percent of total billed charges,,,3825.43,90,,percent of total billed charges,,,3485.39,82,,percent of total billed charges,,,3825.43,90,,percent of total billed charges,,,3612.91,85,,percent of total billed charges,,1062.62,4037.96,
DEPUY CERAMIC HEAD 36MM +5,30181360,CDM,,,278,RC,outpatient,,15642.97,15642.97,,13280.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3910.74,22,,percent of total billed charges,,,,,,,,,14078.67,90,,percent of total billed charges,,,12952.38,82.8,,percent of total billed charges,,,13296.52,85,,percent of total billed charges,,,,,,,,,13765.81,88,,percent of total billed charges,,,,,,,,,11951.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3910.74,22,,percent of total billed charges,,,14235.1,91,,percent of total billed charges,,,14860.82,95,,percent of total billed charges,,,12983.67,83,,percent of total billed charges,,,12983.67,83,,percent of total billed charges,,,,,,,,,,,,,,,12983.67,83,,percent of total billed charges,,,14860.82,95,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,12827.24,82,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,13296.52,85,,percent of total billed charges,,3910.74,14860.82,
DEPUY INSERT TC3 RP 10MM SZ3,30181362,CDM,,,278,RC,outpatient,,15465.58,15465.58,,13130.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3866.4,22,,percent of total billed charges,,,,,,,,,13919.02,90,,percent of total billed charges,,,12805.5,82.8,,percent of total billed charges,,,13145.74,85,,percent of total billed charges,,,,,,,,,13609.71,88,,percent of total billed charges,,,,,,,,,11815.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3866.4,22,,percent of total billed charges,,,14073.68,91,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,,,,,,,,,,,,,12836.43,83,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,12681.78,82,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13145.74,85,,percent of total billed charges,,3866.4,14692.3,
DEPUY MBT REVISION TIBIAL TRAY SZ4,30181363,CDM,,,278,RC,outpatient,,28838.62,28838.62,,24483.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7209.66,22,,percent of total billed charges,,,,,,,,,25954.76,90,,percent of total billed charges,,,23878.38,82.8,,percent of total billed charges,,,24512.83,85,,percent of total billed charges,,,,,,,,,25377.99,88,,percent of total billed charges,,,,,,,,,22032.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7209.66,22,,percent of total billed charges,,,26243.14,91,,percent of total billed charges,,,27396.69,95,,percent of total billed charges,,,23936.05,83,,percent of total billed charges,,,23936.05,83,,percent of total billed charges,,,,,,,,,,,,,,,23936.05,83,,percent of total billed charges,,,27396.69,95,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,23647.67,82,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,24512.83,85,,percent of total billed charges,,7209.66,27396.69,
MEDSOURCE RADIAL HEAD 28.0MM RIGHT,30181372,CDM,,,278,RC,outpatient,,17888,17888,,15186.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4472,22,,percent of total billed charges,,,,,,,,,16099.2,90,,percent of total billed charges,,,14811.26,82.8,,percent of total billed charges,,,15204.8,85,,percent of total billed charges,,,,,,,,,15741.44,88,,percent of total billed charges,,,,,,,,,13666.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4472,22,,percent of total billed charges,,,16278.08,91,,percent of total billed charges,,,16993.6,95,,percent of total billed charges,,,14847.04,83,,percent of total billed charges,,,14847.04,83,,percent of total billed charges,,,,,,,,,,,,,,,14847.04,83,,percent of total billed charges,,,16993.6,95,,percent of total billed charges,,,16099.2,90,,percent of total billed charges,,,16099.2,90,,percent of total billed charges,,,14668.16,82,,percent of total billed charges,,,16099.2,90,,percent of total billed charges,,,15204.8,85,,percent of total billed charges,,4472,16993.6,
RTI FEMORAL HEAD,30181377,CDM,,,278,RC,outpatient,,9646,9646,,8189.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2411.5,22,,percent of total billed charges,,,,,,,,,8681.4,90,,percent of total billed charges,,,7986.89,82.8,,percent of total billed charges,,,8199.1,85,,percent of total billed charges,,,,,,,,,8488.48,88,,percent of total billed charges,,,,,,,,,7369.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2411.5,22,,percent of total billed charges,,,8777.86,91,,percent of total billed charges,,,9163.7,95,,percent of total billed charges,,,8006.18,83,,percent of total billed charges,,,8006.18,83,,percent of total billed charges,,,,,,,,,,,,,,,8006.18,83,,percent of total billed charges,,,9163.7,95,,percent of total billed charges,,,8681.4,90,,percent of total billed charges,,,8681.4,90,,percent of total billed charges,,,7909.72,82,,percent of total billed charges,,,8681.4,90,,percent of total billed charges,,,8199.1,85,,percent of total billed charges,,2411.5,9163.7,
DEPUY FEMORAL HEAD 40MM +12,30181378,CDM,,,278,RC,outpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3531.34,22,,percent of total billed charges,,,,,,,,,12712.82,90,,percent of total billed charges,,,11695.79,82.8,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3531.34,22,,percent of total billed charges,,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,3531.34,13419.08,
DEPUY GUIDEWIRE BALL NOSE 3.0 X 100CM,30181379,CDM,,,278,RC,outpatient,,682.43,682.43,,579.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,170.61,22,,percent of total billed charges,,,,,,,,,614.19,90,,percent of total billed charges,,,565.05,82.8,,percent of total billed charges,,,580.07,85,,percent of total billed charges,,,,,,,,,600.54,88,,percent of total billed charges,,,,,,,,,521.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,170.61,22,,percent of total billed charges,,,621.01,91,,percent of total billed charges,,,648.31,95,,percent of total billed charges,,,566.42,83,,percent of total billed charges,,,566.42,83,,percent of total billed charges,,,,,,,,,,,,,,,566.42,83,,percent of total billed charges,,,648.31,95,,percent of total billed charges,,,614.19,90,,percent of total billed charges,,,614.19,90,,percent of total billed charges,,,559.59,82,,percent of total billed charges,,,614.19,90,,percent of total billed charges,,,580.07,85,,percent of total billed charges,,170.61,648.31,
DEPUY STEM GLOBAL HUMERAL 44 X 18 ECC,30181380,CDM,,,278,RC,outpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4409.03,22,,percent of total billed charges,,,,,,,,,15872.52,90,,percent of total billed charges,,,14602.72,82.8,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4409.03,22,,percent of total billed charges,,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,4409.03,16754.32,
DEPUY SMALL GOLD DRILL BIT,30181381,CDM,,,278,RC,outpatient,,1384.5,1384.5,,1175.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,346.13,22,,percent of total billed charges,,,,,,,,,1246.05,90,,percent of total billed charges,,,1146.37,82.8,,percent of total billed charges,,,1176.83,85,,percent of total billed charges,,,,,,,,,1218.36,88,,percent of total billed charges,,,,,,,,,1057.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,346.13,22,,percent of total billed charges,,,1259.9,91,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1149.14,83,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1135.29,82,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1176.83,85,,percent of total billed charges,,346.13,1315.28,
DEPUY DRILL BIT LGE ANCHOR,30181382,CDM,,,278,RC,outpatient,,1384.5,1384.5,,1175.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,346.13,22,,percent of total billed charges,,,,,,,,,1246.05,90,,percent of total billed charges,,,1146.37,82.8,,percent of total billed charges,,,1176.83,85,,percent of total billed charges,,,,,,,,,1218.36,88,,percent of total billed charges,,,,,,,,,1057.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,346.13,22,,percent of total billed charges,,,1259.9,91,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1149.14,83,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1135.29,82,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1176.83,85,,percent of total billed charges,,346.13,1315.28,
DEPUY PINNACLE CUP 100 W/GRIPTION 50MM,30181383,CDM,,,278,RC,outpatient,,21679.88,21679.88,,18406.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5419.97,22,,percent of total billed charges,,,,,,,,,19511.89,90,,percent of total billed charges,,,17950.94,82.8,,percent of total billed charges,,,18427.9,85,,percent of total billed charges,,,,,,,,,19078.29,88,,percent of total billed charges,,,,,,,,,16563.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5419.97,22,,percent of total billed charges,,,19728.69,91,,percent of total billed charges,,,20595.89,95,,percent of total billed charges,,,17994.3,83,,percent of total billed charges,,,17994.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17994.3,83,,percent of total billed charges,,,20595.89,95,,percent of total billed charges,,,19511.89,90,,percent of total billed charges,,,19511.89,90,,percent of total billed charges,,,17777.5,82,,percent of total billed charges,,,19511.89,90,,percent of total billed charges,,,18427.9,85,,percent of total billed charges,,5419.97,20595.89,
DEPUY LINER ALTRX X-LINK (008),30181385,CDM,,,278,RC,outpatient,,4372.88,4372.88,,3712.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1093.22,22,,percent of total billed charges,,,,,,,,,3935.59,90,,percent of total billed charges,,,3620.74,82.8,,percent of total billed charges,,,3716.95,85,,percent of total billed charges,,,,,,,,,3848.13,88,,percent of total billed charges,,,,,,,,,3340.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1093.22,22,,percent of total billed charges,,,3979.32,91,,percent of total billed charges,,,4154.24,95,,percent of total billed charges,,,3629.49,83,,percent of total billed charges,,,3629.49,83,,percent of total billed charges,,,,,,,,,,,,,,,3629.49,83,,percent of total billed charges,,,4154.24,95,,percent of total billed charges,,,3935.59,90,,percent of total billed charges,,,3935.59,90,,percent of total billed charges,,,3585.76,82,,percent of total billed charges,,,3935.59,90,,percent of total billed charges,,,3716.95,85,,percent of total billed charges,,1093.22,4154.24,
DEPUY FEMUR TC3 RT SZ5,30181386,CDM,,,278,RC,outpatient,,48160.65,48160.65,,40888.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12040.16,22,,percent of total billed charges,,,,,,,,,43344.59,90,,percent of total billed charges,,,39877.02,82.8,,percent of total billed charges,,,40936.55,85,,percent of total billed charges,,,,,,,,,42381.37,88,,percent of total billed charges,,,,,,,,,36794.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12040.16,22,,percent of total billed charges,,,43826.19,91,,percent of total billed charges,,,45752.62,95,,percent of total billed charges,,,39973.34,83,,percent of total billed charges,,,39973.34,83,,percent of total billed charges,,,,,,,,,,,,,,,39973.34,83,,percent of total billed charges,,,45752.62,95,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,39491.73,82,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,40936.55,85,,percent of total billed charges,,12040.16,45752.62,
DEPUY FEMORAL ADAPTER BOLT,30181387,CDM,,,278,RC,outpatient,,1765.6,1765.6,,1498.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,441.4,22,,percent of total billed charges,,,,,,,,,1589.04,90,,percent of total billed charges,,,1461.92,82.8,,percent of total billed charges,,,1500.76,85,,percent of total billed charges,,,,,,,,,1553.73,88,,percent of total billed charges,,,,,,,,,1348.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,441.4,22,,percent of total billed charges,,,1606.7,91,,percent of total billed charges,,,1677.32,95,,percent of total billed charges,,,1465.45,83,,percent of total billed charges,,,1465.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.45,83,,percent of total billed charges,,,1677.32,95,,percent of total billed charges,,,1589.04,90,,percent of total billed charges,,,1589.04,90,,percent of total billed charges,,,1447.79,82,,percent of total billed charges,,,1589.04,90,,percent of total billed charges,,,1500.76,85,,percent of total billed charges,,441.4,1677.32,
DEPUY FEMORAL ADAPTER 5DEG,30181388,CDM,,,278,RC,outpatient,,12849.85,12849.85,,10909.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3212.46,22,,percent of total billed charges,,,,,,,,,11564.87,90,,percent of total billed charges,,,10639.68,82.8,,percent of total billed charges,,,10922.37,85,,percent of total billed charges,,,,,,,,,11307.87,88,,percent of total billed charges,,,,,,,,,9817.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3212.46,22,,percent of total billed charges,,,11693.36,91,,percent of total billed charges,,,12207.36,95,,percent of total billed charges,,,10665.38,83,,percent of total billed charges,,,10665.38,83,,percent of total billed charges,,,,,,,,,,,,,,,10665.38,83,,percent of total billed charges,,,12207.36,95,,percent of total billed charges,,,11564.87,90,,percent of total billed charges,,,11564.87,90,,percent of total billed charges,,,10536.88,82,,percent of total billed charges,,,11564.87,90,,percent of total billed charges,,,10922.37,85,,percent of total billed charges,,3212.46,12207.36,
DEPUY CEMENTED STEM,30181389,CDM,,,278,RC,outpatient,,6179.68,6179.68,,5246.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1544.92,22,,percent of total billed charges,,,,,,,,,5561.71,90,,percent of total billed charges,,,5116.78,82.8,,percent of total billed charges,,,5252.73,85,,percent of total billed charges,,,,,,,,,5438.12,88,,percent of total billed charges,,,,,,,,,4721.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1544.92,22,,percent of total billed charges,,,5623.51,91,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5129.13,83,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5067.34,82,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5252.73,85,,percent of total billed charges,,1544.92,5870.7,
DEPUY INSERT TIBIA TC3 12.5MM SZ5,30181390,CDM,,,278,RC,outpatient,,17187.04,17187.04,,14591.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4296.76,22,,percent of total billed charges,,,,,,,,,15468.34,90,,percent of total billed charges,,,14230.87,82.8,,percent of total billed charges,,,14608.98,85,,percent of total billed charges,,,,,,,,,15124.6,88,,percent of total billed charges,,,,,,,,,13130.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4296.76,22,,percent of total billed charges,,,15640.21,91,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,,,,,,,,,,,,,14265.24,83,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14093.37,82,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14608.98,85,,percent of total billed charges,,4296.76,16327.69,
DEPUY SCREW CANNULATED 5.0X30MM,30181391,CDM,,,278,RC,outpatient,,838.11,838.11,,711.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,209.53,22,,percent of total billed charges,,,,,,,,,754.3,90,,percent of total billed charges,,,693.96,82.8,,percent of total billed charges,,,712.39,85,,percent of total billed charges,,,,,,,,,737.54,88,,percent of total billed charges,,,,,,,,,640.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,209.53,22,,percent of total billed charges,,,762.68,91,,percent of total billed charges,,,796.2,95,,percent of total billed charges,,,695.63,83,,percent of total billed charges,,,695.63,83,,percent of total billed charges,,,,,,,,,,,,,,,695.63,83,,percent of total billed charges,,,796.2,95,,percent of total billed charges,,,754.3,90,,percent of total billed charges,,,754.3,90,,percent of total billed charges,,,687.25,82,,percent of total billed charges,,,754.3,90,,percent of total billed charges,,,712.39,85,,percent of total billed charges,,209.53,796.2,
DEPUY SCREW CANNULATED 5.0X50MM,30181392,CDM,,,278,RC,outpatient,,838.11,838.11,,711.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,209.53,22,,percent of total billed charges,,,,,,,,,754.3,90,,percent of total billed charges,,,693.96,82.8,,percent of total billed charges,,,712.39,85,,percent of total billed charges,,,,,,,,,737.54,88,,percent of total billed charges,,,,,,,,,640.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,209.53,22,,percent of total billed charges,,,762.68,91,,percent of total billed charges,,,796.2,95,,percent of total billed charges,,,695.63,83,,percent of total billed charges,,,695.63,83,,percent of total billed charges,,,,,,,,,,,,,,,695.63,83,,percent of total billed charges,,,796.2,95,,percent of total billed charges,,,754.3,90,,percent of total billed charges,,,754.3,90,,percent of total billed charges,,,687.25,82,,percent of total billed charges,,,754.3,90,,percent of total billed charges,,,712.39,85,,percent of total billed charges,,209.53,796.2,
DEPUY SCREW CANNULATED 36 X 4.5,30181393,CDM,,,278,RC,outpatient,,710.99,710.99,,603.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,177.75,22,,percent of total billed charges,,,,,,,,,639.89,90,,percent of total billed charges,,,588.7,82.8,,percent of total billed charges,,,604.34,85,,percent of total billed charges,,,,,,,,,625.67,88,,percent of total billed charges,,,,,,,,,543.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,177.75,22,,percent of total billed charges,,,647,91,,percent of total billed charges,,,675.44,95,,percent of total billed charges,,,590.12,83,,percent of total billed charges,,,590.12,83,,percent of total billed charges,,,,,,,,,,,,,,,590.12,83,,percent of total billed charges,,,675.44,95,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,583.01,82,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,604.34,85,,percent of total billed charges,,177.75,675.44,
DEPUY SCREW CANNULATED 40 X 4.5,30181394,CDM,,,278,RC,outpatient,,710.99,710.99,,603.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,177.75,22,,percent of total billed charges,,,,,,,,,639.89,90,,percent of total billed charges,,,588.7,82.8,,percent of total billed charges,,,604.34,85,,percent of total billed charges,,,,,,,,,625.67,88,,percent of total billed charges,,,,,,,,,543.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,177.75,22,,percent of total billed charges,,,647,91,,percent of total billed charges,,,675.44,95,,percent of total billed charges,,,590.12,83,,percent of total billed charges,,,590.12,83,,percent of total billed charges,,,,,,,,,,,,,,,590.12,83,,percent of total billed charges,,,675.44,95,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,583.01,82,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,604.34,85,,percent of total billed charges,,177.75,675.44,
DEPUY SCREW CANNULATED 50 X 4.5,30181395,CDM,,,278,RC,outpatient,,710.99,710.99,,603.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,177.75,22,,percent of total billed charges,,,,,,,,,639.89,90,,percent of total billed charges,,,588.7,82.8,,percent of total billed charges,,,604.34,85,,percent of total billed charges,,,,,,,,,625.67,88,,percent of total billed charges,,,,,,,,,543.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,177.75,22,,percent of total billed charges,,,647,91,,percent of total billed charges,,,675.44,95,,percent of total billed charges,,,590.12,83,,percent of total billed charges,,,590.12,83,,percent of total billed charges,,,,,,,,,,,,,,,590.12,83,,percent of total billed charges,,,675.44,95,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,583.01,82,,percent of total billed charges,,,639.89,90,,percent of total billed charges,,,604.34,85,,percent of total billed charges,,177.75,675.44,
DEPUY PINNACLE CUP REVISION 60MM,30181396,CDM,,,278,RC,outpatient,,33437.04,33437.04,,28388.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8359.26,22,,percent of total billed charges,,,,,,,,,30093.34,90,,percent of total billed charges,,,27685.87,82.8,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,,,,,,,,29424.6,88,,percent of total billed charges,,,,,,,,,25545.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8359.26,22,,percent of total billed charges,,,30427.71,91,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,,,,,,,,,,,,,27752.74,83,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,27418.37,82,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,8359.26,31765.19,
DEPUY LINER ALTRX +4 35 X 45,30181397,CDM,,,278,RC,outpatient,,11806.99,11806.99,,10024.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2951.75,22,,percent of total billed charges,,,,,,,,,10626.29,90,,percent of total billed charges,,,9776.19,82.8,,percent of total billed charges,,,10035.94,85,,percent of total billed charges,,,,,,,,,10390.15,88,,percent of total billed charges,,,,,,,,,9020.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2951.75,22,,percent of total billed charges,,,10744.36,91,,percent of total billed charges,,,11216.64,95,,percent of total billed charges,,,9799.8,83,,percent of total billed charges,,,9799.8,83,,percent of total billed charges,,,,,,,,,,,,,,,9799.8,83,,percent of total billed charges,,,11216.64,95,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,9681.73,82,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,10035.94,85,,percent of total billed charges,,2951.75,11216.64,
DEPUY LERE BONE MILL RENTAL 2902-0213,30181398,CDM,,,278,RC,outpatient,,4296.5,4296.5,,3647.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1074.13,22,,percent of total billed charges,,,,,,,,,3866.85,90,,percent of total billed charges,,,3557.5,82.8,,percent of total billed charges,,,3652.03,85,,percent of total billed charges,,,,,,,,,3780.92,88,,percent of total billed charges,,,,,,,,,3282.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1074.13,22,,percent of total billed charges,,,3909.82,91,,percent of total billed charges,,,4081.68,95,,percent of total billed charges,,,3566.1,83,,percent of total billed charges,,,3566.1,83,,percent of total billed charges,,,,,,,,,,,,,,,3566.1,83,,percent of total billed charges,,,4081.68,95,,percent of total billed charges,,,3866.85,90,,percent of total billed charges,,,3866.85,90,,percent of total billed charges,,,3523.13,82,,percent of total billed charges,,,3866.85,90,,percent of total billed charges,,,3652.03,85,,percent of total billed charges,,1074.13,4081.68,
DEPUY PINNACLE CUP SECTOR II 48MM,30181401,CDM,,,278,RC,outpatient,,18892.32,18892.32,,16039.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4723.08,22,,percent of total billed charges,,,,,,,,,17003.09,90,,percent of total billed charges,,,15642.84,82.8,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,,,,,,,,16625.24,88,,percent of total billed charges,,,,,,,,,14433.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4723.08,22,,percent of total billed charges,,,17192.01,91,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15680.63,83,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,15491.7,82,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,4723.08,17947.7,
DEPUY LINER ALTRX +4 32 X 48,30181402,CDM,,,278,RC,outpatient,,11806.99,11806.99,,10024.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2951.75,22,,percent of total billed charges,,,,,,,,,10626.29,90,,percent of total billed charges,,,9776.19,82.8,,percent of total billed charges,,,10035.94,85,,percent of total billed charges,,,,,,,,,10390.15,88,,percent of total billed charges,,,,,,,,,9020.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2951.75,22,,percent of total billed charges,,,10744.36,91,,percent of total billed charges,,,11216.64,95,,percent of total billed charges,,,9799.8,83,,percent of total billed charges,,,9799.8,83,,percent of total billed charges,,,,,,,,,,,,,,,9799.8,83,,percent of total billed charges,,,11216.64,95,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,9681.73,82,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,10035.94,85,,percent of total billed charges,,2951.75,11216.64,
DEPUY STEM CORAIL HI OFFSET SZ12,30181405,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
GUIDEWIRE CORE COONS BENSON,30181406,CDM,,,270,RC,outpatient,,199.95,199.95,,169.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.99,22,,percent of total billed charges,,,,,,,,,179.96,90,,percent of total billed charges,,,165.56,82.8,,percent of total billed charges,,,169.96,85,,percent of total billed charges,,,,,,,,,175.96,88,,percent of total billed charges,,,,,,,,,152.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.99,22,,percent of total billed charges,,,181.95,91,,percent of total billed charges,,,189.95,95,,percent of total billed charges,,,165.96,83,,percent of total billed charges,,,165.96,83,,percent of total billed charges,,,,,,,,,,,,,,,165.96,83,,percent of total billed charges,,,189.95,95,,percent of total billed charges,,,179.96,90,,percent of total billed charges,,,179.96,90,,percent of total billed charges,,,163.96,82,,percent of total billed charges,,,179.96,90,,percent of total billed charges,,,169.96,85,,percent of total billed charges,,49.99,189.95,
STRYKER SAGITTAL BLADE 21X90X1.19MM,30181418,CDM,,,270,RC,outpatient,,478.73,478.73,,406.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.68,22,,percent of total billed charges,,,,,,,,,430.86,90,,percent of total billed charges,,,396.39,82.8,,percent of total billed charges,,,406.92,85,,percent of total billed charges,,,,,,,,,421.28,88,,percent of total billed charges,,,,,,,,,365.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.68,22,,percent of total billed charges,,,435.64,91,,percent of total billed charges,,,454.79,95,,percent of total billed charges,,,397.35,83,,percent of total billed charges,,,397.35,83,,percent of total billed charges,,,,,,,,,,,,,,,397.35,83,,percent of total billed charges,,,454.79,95,,percent of total billed charges,,,430.86,90,,percent of total billed charges,,,430.86,90,,percent of total billed charges,,,392.56,82,,percent of total billed charges,,,430.86,90,,percent of total billed charges,,,406.92,85,,percent of total billed charges,,119.68,454.79,
DEPUY PINNACLE CUP 100 W/GRIPTION 56MM,30181419,CDM,,,278,RC,outpatient,,20679.88,20679.88,,17557.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5169.97,22,,percent of total billed charges,,,,,,,,,18611.89,90,,percent of total billed charges,,,17122.94,82.8,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,,,,,,,,18198.29,88,,percent of total billed charges,,,,,,,,,15799.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5169.97,22,,percent of total billed charges,,,18818.69,91,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17164.3,83,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,16957.5,82,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,5169.97,19645.89,
SYNTHES SCREW LOCKING 2.7X10MM,30181421,CDM,,,278,RC,outpatient,,1110.53,1110.53,,942.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,277.63,22,,percent of total billed charges,,,,,,,,,999.48,90,,percent of total billed charges,,,919.52,82.8,,percent of total billed charges,,,943.95,85,,percent of total billed charges,,,,,,,,,977.27,88,,percent of total billed charges,,,,,,,,,848.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,277.63,22,,percent of total billed charges,,,1010.58,91,,percent of total billed charges,,,1055,95,,percent of total billed charges,,,921.74,83,,percent of total billed charges,,,921.74,83,,percent of total billed charges,,,,,,,,,,,,,,,921.74,83,,percent of total billed charges,,,1055,95,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,910.63,82,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,943.95,85,,percent of total billed charges,,277.63,1055,
SYNTHES SCREW LOCKING 2.7X12MM,30181422,CDM,,,278,RC,outpatient,,1178.13,1178.13,,1000.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,294.53,22,,percent of total billed charges,,,,,,,,,1060.32,90,,percent of total billed charges,,,975.49,82.8,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,,,,,,,,1036.75,88,,percent of total billed charges,,,,,,,,,900.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,294.53,22,,percent of total billed charges,,,1072.1,91,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,,,,,,,,,,,,,977.85,83,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,966.07,82,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,294.53,1119.22,
DEPUY PINNACLE CUP 100 W/GRIPTION 54MM,30181430,CDM,,,278,RC,outpatient,,20679.88,20679.88,,17557.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5169.97,22,,percent of total billed charges,,,,,,,,,18611.89,90,,percent of total billed charges,,,17122.94,82.8,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,,,,,,,,18198.29,88,,percent of total billed charges,,,,,,,,,15799.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5169.97,22,,percent of total billed charges,,,18818.69,91,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17164.3,83,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,16957.5,82,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,5169.97,19645.89,
DEPUY FEMORAL HEAD 36MM -2,30181431,CDM,,,278,RC,outpatient,,8569.34,8569.34,,7275.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2142.34,22,,percent of total billed charges,,,,,,,,,7712.41,90,,percent of total billed charges,,,7095.41,82.8,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,,,,,,,,7541.02,88,,percent of total billed charges,,,,,,,,,6546.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2142.34,22,,percent of total billed charges,,,7798.1,91,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7112.55,83,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7026.86,82,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,2142.34,8140.87,
DEPUY STEM BOWED SZ13.5 X 9,30181432,CDM,,,278,RC,outpatient,,67359.5,67359.5,,57188.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16839.88,22,,percent of total billed charges,,,,,,,,,60623.55,90,,percent of total billed charges,,,55773.67,82.8,,percent of total billed charges,,,57255.58,85,,percent of total billed charges,,,,,,,,,59276.36,88,,percent of total billed charges,,,,,,,,,51462.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16839.88,22,,percent of total billed charges,,,61297.15,91,,percent of total billed charges,,,63991.53,95,,percent of total billed charges,,,55908.39,83,,percent of total billed charges,,,55908.39,83,,percent of total billed charges,,,,,,,,,,,,,,,55908.39,83,,percent of total billed charges,,,63991.53,95,,percent of total billed charges,,,60623.55,90,,percent of total billed charges,,,60623.55,90,,percent of total billed charges,,,55234.79,82,,percent of total billed charges,,,60623.55,90,,percent of total billed charges,,,57255.58,85,,percent of total billed charges,,16839.88,63991.53,
RTI PERONEAL TENDON,30181433,CDM,,,270,RC,outpatient,,16536,16536,,14039.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4134,22,,percent of total billed charges,,,,,,,,,14882.4,90,,percent of total billed charges,,,13691.81,82.8,,percent of total billed charges,,,14055.6,85,,percent of total billed charges,,,,,,,,,14551.68,88,,percent of total billed charges,,,,,,,,,12633.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4134,22,,percent of total billed charges,,,15047.76,91,,percent of total billed charges,,,15709.2,95,,percent of total billed charges,,,13724.88,83,,percent of total billed charges,,,13724.88,83,,percent of total billed charges,,,,,,,,,,,,,,,13724.88,83,,percent of total billed charges,,,15709.2,95,,percent of total billed charges,,,14882.4,90,,percent of total billed charges,,,14882.4,90,,percent of total billed charges,,,13559.52,82,,percent of total billed charges,,,14882.4,90,,percent of total billed charges,,,14055.6,85,,percent of total billed charges,,4134,15709.2,
DEPUY STEM CORAIL HI OFFSET SZ15,30181438,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY STEM CALCAR SZ15.0 X 9,30181439,CDM,,,278,RC,outpatient,,41578.1,41578.1,,35299.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10394.53,22,,percent of total billed charges,,,,,,,,,37420.29,90,,percent of total billed charges,,,34426.67,82.8,,percent of total billed charges,,,35341.39,85,,percent of total billed charges,,,,,,,,,36588.73,88,,percent of total billed charges,,,,,,,,,31765.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10394.53,22,,percent of total billed charges,,,37836.07,91,,percent of total billed charges,,,39499.2,95,,percent of total billed charges,,,34509.82,83,,percent of total billed charges,,,34509.82,83,,percent of total billed charges,,,,,,,,,,,,,,,34509.82,83,,percent of total billed charges,,,39499.2,95,,percent of total billed charges,,,37420.29,90,,percent of total billed charges,,,37420.29,90,,percent of total billed charges,,,34094.04,82,,percent of total billed charges,,,37420.29,90,,percent of total billed charges,,,35341.39,85,,percent of total billed charges,,10394.53,39499.2,
DEPUY PINNACLE CUP SECTOR II 58MM,30181440,CDM,,,278,RC,outpatient,,18892.32,18892.32,,16039.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4723.08,22,,percent of total billed charges,,,,,,,,,17003.09,90,,percent of total billed charges,,,15642.84,82.8,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,,,,,,,,16625.24,88,,percent of total billed charges,,,,,,,,,14433.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4723.08,22,,percent of total billed charges,,,17192.01,91,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15680.63,83,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,15491.7,82,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,4723.08,17947.7,
DEPUY PINNACLE SCREW 6.5 X 30,30181441,CDM,,,278,RC,outpatient,,1075.49,1075.49,,913.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,268.87,22,,percent of total billed charges,,,,,,,,,967.94,90,,percent of total billed charges,,,890.51,82.8,,percent of total billed charges,,,914.17,85,,percent of total billed charges,,,,,,,,,946.43,88,,percent of total billed charges,,,,,,,,,821.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,268.87,22,,percent of total billed charges,,,978.7,91,,percent of total billed charges,,,1021.72,95,,percent of total billed charges,,,892.66,83,,percent of total billed charges,,,892.66,83,,percent of total billed charges,,,,,,,,,,,,,,,892.66,83,,percent of total billed charges,,,1021.72,95,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,881.9,82,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,914.17,85,,percent of total billed charges,,268.87,1021.72,
DEPUY PINNACLE CUP INSERT 40 X 58,30181442,CDM,,,278,RC,outpatient,,17516.2,17516.2,,14871.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4379.05,22,,percent of total billed charges,,,,,,,,,15764.58,90,,percent of total billed charges,,,14503.41,82.8,,percent of total billed charges,,,14888.77,85,,percent of total billed charges,,,,,,,,,15414.26,88,,percent of total billed charges,,,,,,,,,13382.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4379.05,22,,percent of total billed charges,,,15939.74,91,,percent of total billed charges,,,16640.39,95,,percent of total billed charges,,,14538.45,83,,percent of total billed charges,,,14538.45,83,,percent of total billed charges,,,,,,,,,,,,,,,14538.45,83,,percent of total billed charges,,,16640.39,95,,percent of total billed charges,,,15764.58,90,,percent of total billed charges,,,15764.58,90,,percent of total billed charges,,,14363.28,82,,percent of total billed charges,,,15764.58,90,,percent of total billed charges,,,14888.77,85,,percent of total billed charges,,4379.05,16640.39,
DEPUY FEMORAL HEAD 40MM +8.5,30181443,CDM,,,278,RC,outpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4782.85,22,,percent of total billed charges,,,,,,,,,17218.25,90,,percent of total billed charges,,,15840.79,82.8,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4782.85,22,,percent of total billed charges,,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,4782.85,18174.82,
RIGID URETERAL DILATION SYSTEM,30181444,CDM,,,270,RC,outpatient,,1111.44,1111.44,,943.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,277.86,22,,percent of total billed charges,,,,,,,,,1000.3,90,,percent of total billed charges,,,920.27,82.8,,percent of total billed charges,,,944.72,85,,percent of total billed charges,,,,,,,,,978.07,88,,percent of total billed charges,,,,,,,,,849.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,277.86,22,,percent of total billed charges,,,1011.41,91,,percent of total billed charges,,,1055.87,95,,percent of total billed charges,,,922.5,83,,percent of total billed charges,,,922.5,83,,percent of total billed charges,,,,,,,,,,,,,,,922.5,83,,percent of total billed charges,,,1055.87,95,,percent of total billed charges,,,1000.3,90,,percent of total billed charges,,,1000.3,90,,percent of total billed charges,,,911.38,82,,percent of total billed charges,,,1000.3,90,,percent of total billed charges,,,944.72,85,,percent of total billed charges,,277.86,1055.87,
BALLOON UROMAX ULTRA DILATATION,30181445,CDM,,,270,RC,outpatient,,2068.63,2068.63,,1756.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,517.16,22,,percent of total billed charges,,,,,,,,,1861.77,90,,percent of total billed charges,,,1712.83,82.8,,percent of total billed charges,,,1758.34,85,,percent of total billed charges,,,,,,,,,1820.39,88,,percent of total billed charges,,,,,,,,,1580.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,517.16,22,,percent of total billed charges,,,1882.45,91,,percent of total billed charges,,,1965.2,95,,percent of total billed charges,,,1716.96,83,,percent of total billed charges,,,1716.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1716.96,83,,percent of total billed charges,,,1965.2,95,,percent of total billed charges,,,1861.77,90,,percent of total billed charges,,,1861.77,90,,percent of total billed charges,,,1696.28,82,,percent of total billed charges,,,1861.77,90,,percent of total billed charges,,,1758.34,85,,percent of total billed charges,,517.16,1965.2,
DEPUY KNEE UNI-FIXED BEARING,30181447,CDM,,,278,RC,outpatient,,18806,18806,,15966.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4701.5,22,,percent of total billed charges,,,,,,,,,16925.4,90,,percent of total billed charges,,,15571.37,82.8,,percent of total billed charges,,,15985.1,85,,percent of total billed charges,,,,,,,,,16549.28,88,,percent of total billed charges,,,,,,,,,14367.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4701.5,22,,percent of total billed charges,,,17113.46,91,,percent of total billed charges,,,17865.7,95,,percent of total billed charges,,,15608.98,83,,percent of total billed charges,,,15608.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15608.98,83,,percent of total billed charges,,,17865.7,95,,percent of total billed charges,,,16925.4,90,,percent of total billed charges,,,16925.4,90,,percent of total billed charges,,,15420.92,82,,percent of total billed charges,,,16925.4,90,,percent of total billed charges,,,15985.1,85,,percent of total billed charges,,4701.5,17865.7,
DEPUY INSERT SIGMA HP UNIVERSAL,30181448,CDM,,,278,RC,outpatient,,3909.43,3909.43,,3319.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,977.36,22,,percent of total billed charges,,,,,,,,,3518.49,90,,percent of total billed charges,,,3237.01,82.8,,percent of total billed charges,,,3323.02,85,,percent of total billed charges,,,,,,,,,3440.3,88,,percent of total billed charges,,,,,,,,,2986.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,977.36,22,,percent of total billed charges,,,3557.58,91,,percent of total billed charges,,,3713.96,95,,percent of total billed charges,,,3244.83,83,,percent of total billed charges,,,3244.83,83,,percent of total billed charges,,,,,,,,,,,,,,,3244.83,83,,percent of total billed charges,,,3713.96,95,,percent of total billed charges,,,3518.49,90,,percent of total billed charges,,,3518.49,90,,percent of total billed charges,,,3205.73,82,,percent of total billed charges,,,3518.49,90,,percent of total billed charges,,,3323.02,85,,percent of total billed charges,,977.36,3713.96,
DEPUY SAWBLADE 13 X 70,30181452,CDM,,,278,RC,outpatient,,1074.06,1074.06,,911.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,268.52,22,,percent of total billed charges,,,,,,,,,966.65,90,,percent of total billed charges,,,889.32,82.8,,percent of total billed charges,,,912.95,85,,percent of total billed charges,,,,,,,,,945.17,88,,percent of total billed charges,,,,,,,,,820.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,268.52,22,,percent of total billed charges,,,977.39,91,,percent of total billed charges,,,1020.36,95,,percent of total billed charges,,,891.47,83,,percent of total billed charges,,,891.47,83,,percent of total billed charges,,,,,,,,,,,,,,,891.47,83,,percent of total billed charges,,,1020.36,95,,percent of total billed charges,,,966.65,90,,percent of total billed charges,,,966.65,90,,percent of total billed charges,,,880.73,82,,percent of total billed charges,,,966.65,90,,percent of total billed charges,,,912.95,85,,percent of total billed charges,,268.52,1020.36,
DEPUY STEM CORAIL KLA SZ12,30181454,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY STEM HUMERAL SZ10,30181455,CDM,,,278,RC,outpatient,,35653.09,35653.09,,30269.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8913.27,22,,percent of total billed charges,,,,,,,,,32087.78,90,,percent of total billed charges,,,29520.76,82.8,,percent of total billed charges,,,30305.13,85,,percent of total billed charges,,,,,,,,,31374.72,88,,percent of total billed charges,,,,,,,,,27238.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8913.27,22,,percent of total billed charges,,,32444.31,91,,percent of total billed charges,,,33870.44,95,,percent of total billed charges,,,29592.06,83,,percent of total billed charges,,,29592.06,83,,percent of total billed charges,,,,,,,,,,,,,,,29592.06,83,,percent of total billed charges,,,33870.44,95,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,29235.53,82,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,30305.13,85,,percent of total billed charges,,8913.27,33870.44,
DEPUY ECC GLENOSPHERE 38MM,30181456,CDM,,,278,RC,outpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4954.14,22,,percent of total billed charges,,,,,,,,,17834.9,90,,percent of total billed charges,,,16408.1,82.8,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4954.14,22,,percent of total billed charges,,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,4954.14,18825.72,
DEPUY SCREW NON LOCKING 18MM,30181457,CDM,,,278,RC,outpatient,,1330.16,1330.16,,1129.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,332.54,22,,percent of total billed charges,,,,,,,,,1197.14,90,,percent of total billed charges,,,1101.37,82.8,,percent of total billed charges,,,1130.64,85,,percent of total billed charges,,,,,,,,,1170.54,88,,percent of total billed charges,,,,,,,,,1016.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,332.54,22,,percent of total billed charges,,,1210.45,91,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1104.03,83,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1090.73,82,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1130.64,85,,percent of total billed charges,,332.54,1263.65,
DEPUY SCREW LOCKING 30MM,30181458,CDM,,,278,RC,outpatient,,2237.76,2237.76,,1899.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,559.44,22,,percent of total billed charges,,,,,,,,,2013.98,90,,percent of total billed charges,,,1852.87,82.8,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,,,,,,,,1969.23,88,,percent of total billed charges,,,,,,,,,1709.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,559.44,22,,percent of total billed charges,,,2036.36,91,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1857.34,83,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1834.96,82,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,559.44,2125.87,
DEPUY SCREW LOCKING 42MM,30181459,CDM,,,278,RC,outpatient,,2237.76,2237.76,,1899.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,559.44,22,,percent of total billed charges,,,,,,,,,2013.98,90,,percent of total billed charges,,,1852.87,82.8,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,,,,,,,,1969.23,88,,percent of total billed charges,,,,,,,,,1709.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,559.44,22,,percent of total billed charges,,,2036.36,91,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1857.34,83,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1834.96,82,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,559.44,2125.87,
DEPUY METAGLENE,30181460,CDM,,,278,RC,outpatient,,13765.7,13765.7,,11687.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3441.43,22,,percent of total billed charges,,,,,,,,,12389.13,90,,percent of total billed charges,,,11398,82.8,,percent of total billed charges,,,11700.85,85,,percent of total billed charges,,,,,,,,,12113.82,88,,percent of total billed charges,,,,,,,,,10516.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3441.43,22,,percent of total billed charges,,,12526.79,91,,percent of total billed charges,,,13077.42,95,,percent of total billed charges,,,11425.53,83,,percent of total billed charges,,,11425.53,83,,percent of total billed charges,,,,,,,,,,,,,,,11425.53,83,,percent of total billed charges,,,13077.42,95,,percent of total billed charges,,,12389.13,90,,percent of total billed charges,,,12389.13,90,,percent of total billed charges,,,11287.87,82,,percent of total billed charges,,,12389.13,90,,percent of total billed charges,,,11700.85,85,,percent of total billed charges,,3441.43,13077.42,
DEPUY HUMERAL CUP 38+6,30181461,CDM,,,278,RC,outpatient,,10688.08,10688.08,,9074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2672.02,22,,percent of total billed charges,,,,,,,,,9619.27,90,,percent of total billed charges,,,8849.73,82.8,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,,,,,,,,9405.51,88,,percent of total billed charges,,,,,,,,,8165.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2672.02,22,,percent of total billed charges,,,9726.15,91,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,,,,,,,,,,,,,8871.11,83,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,8764.23,82,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,2672.02,10153.68,
DEPUY GUIDE PIN 2.0MM,30181462,CDM,,,278,RC,outpatient,,1105,1105,,938.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,276.25,22,,percent of total billed charges,,,,,,,,,994.5,90,,percent of total billed charges,,,914.94,82.8,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,,,,,,,,972.4,88,,percent of total billed charges,,,,,,,,,844.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,276.25,22,,percent of total billed charges,,,1005.55,91,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,,,,,,,,,,,,,917.15,83,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,906.1,82,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,276.25,1049.75,
DEPUY GUIDE PIN GLENOSPHERE,30181463,CDM,,,278,RC,outpatient,,1105,1105,,938.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,276.25,22,,percent of total billed charges,,,,,,,,,994.5,90,,percent of total billed charges,,,914.94,82.8,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,,,,,,,,972.4,88,,percent of total billed charges,,,,,,,,,844.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,276.25,22,,percent of total billed charges,,,1005.55,91,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,,,,,,,,,,,,,917.15,83,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,906.1,82,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,276.25,1049.75,
DEPUY GUIDE PIN SCREW,30181464,CDM,,,278,RC,outpatient,,2021.5,2021.5,,1716.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,505.38,22,,percent of total billed charges,,,,,,,,,1819.35,90,,percent of total billed charges,,,1673.8,82.8,,percent of total billed charges,,,1718.28,85,,percent of total billed charges,,,,,,,,,1778.92,88,,percent of total billed charges,,,,,,,,,1544.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,505.38,22,,percent of total billed charges,,,1839.57,91,,percent of total billed charges,,,1920.43,95,,percent of total billed charges,,,1677.85,83,,percent of total billed charges,,,1677.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1677.85,83,,percent of total billed charges,,,1920.43,95,,percent of total billed charges,,,1819.35,90,,percent of total billed charges,,,1819.35,90,,percent of total billed charges,,,1657.63,82,,percent of total billed charges,,,1819.35,90,,percent of total billed charges,,,1718.28,85,,percent of total billed charges,,505.38,1920.43,
DEPUY DRILL BIT 2.0,30181465,CDM,,,278,RC,outpatient,,1833,1833,,1556.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,458.25,22,,percent of total billed charges,,,,,,,,,1649.7,90,,percent of total billed charges,,,1517.72,82.8,,percent of total billed charges,,,1558.05,85,,percent of total billed charges,,,,,,,,,1613.04,88,,percent of total billed charges,,,,,,,,,1400.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,458.25,22,,percent of total billed charges,,,1668.03,91,,percent of total billed charges,,,1741.35,95,,percent of total billed charges,,,1521.39,83,,percent of total billed charges,,,1521.39,83,,percent of total billed charges,,,,,,,,,,,,,,,1521.39,83,,percent of total billed charges,,,1741.35,95,,percent of total billed charges,,,1649.7,90,,percent of total billed charges,,,1649.7,90,,percent of total billed charges,,,1503.06,82,,percent of total billed charges,,,1649.7,90,,percent of total billed charges,,,1558.05,85,,percent of total billed charges,,458.25,1741.35,
DEPUY STEM GLOBAL HUMERAL 52 X 15,30181466,CDM,,,278,RC,outpatient,,15560.09,15560.09,,13210.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3890.02,22,,percent of total billed charges,,,,,,,,,14004.08,90,,percent of total billed charges,,,12883.75,82.8,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,,,,,,,,13692.88,88,,percent of total billed charges,,,,,,,,,11887.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3890.02,22,,percent of total billed charges,,,14159.68,91,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12914.87,83,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,12759.27,82,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,3890.02,14782.09,
SYNTHES SCREW CANNUL 4.0X30MM,30181470,CDM,,,278,RC,outpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,486.2,22,,percent of total billed charges,,,,,,,,,1750.32,90,,percent of total billed charges,,,1610.29,82.8,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,486.2,22,,percent of total billed charges,,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,486.2,1847.56,
SYNTHES SCREW CANNUL 4.0X32MM,30181471,CDM,,,278,RC,outpatient,,2003.17,2003.17,,1700.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,500.79,22,,percent of total billed charges,,,,,,,,,1802.85,90,,percent of total billed charges,,,1658.62,82.8,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,,,,,,,,1762.79,88,,percent of total billed charges,,,,,,,,,1530.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,500.79,22,,percent of total billed charges,,,1822.88,91,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1662.63,83,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1642.6,82,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,500.79,1903.01,
GYRUS MESH 2X3,30181472,CDM,,,270,RC,outpatient,,1946.75,1946.75,,1652.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,486.69,22,,percent of total billed charges,,,,,,,,,1752.08,90,,percent of total billed charges,,,1611.91,82.8,,percent of total billed charges,,,1654.74,85,,percent of total billed charges,,,,,,,,,1713.14,88,,percent of total billed charges,,,,,,,,,1487.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,486.69,22,,percent of total billed charges,,,1771.54,91,,percent of total billed charges,,,1849.41,95,,percent of total billed charges,,,1615.8,83,,percent of total billed charges,,,1615.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1615.8,83,,percent of total billed charges,,,1849.41,95,,percent of total billed charges,,,1752.08,90,,percent of total billed charges,,,1752.08,90,,percent of total billed charges,,,1596.34,82,,percent of total billed charges,,,1752.08,90,,percent of total billed charges,,,1654.74,85,,percent of total billed charges,,486.69,1849.41,
MESH HERNIA REBOUND 3.94  X 5.03,30181473,CDM,,,270,RC,outpatient,,4631.25,4631.25,,3931.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1157.81,22,,percent of total billed charges,,,,,,,,,4168.13,90,,percent of total billed charges,,,3834.68,82.8,,percent of total billed charges,,,3936.56,85,,percent of total billed charges,,,,,,,,,4075.5,88,,percent of total billed charges,,,,,,,,,3538.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1157.81,22,,percent of total billed charges,,,4214.44,91,,percent of total billed charges,,,4399.69,95,,percent of total billed charges,,,3843.94,83,,percent of total billed charges,,,3843.94,83,,percent of total billed charges,,,,,,,,,,,,,,,3843.94,83,,percent of total billed charges,,,4399.69,95,,percent of total billed charges,,,4168.13,90,,percent of total billed charges,,,4168.13,90,,percent of total billed charges,,,3797.63,82,,percent of total billed charges,,,4168.13,90,,percent of total billed charges,,,3936.56,85,,percent of total billed charges,,1157.81,4399.69,
DRAIN JACKSON PRATT FLAT 7MM,30181474,CDM,,,270,RC,outpatient,,55.85,55.85,,47.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.96,22,,percent of total billed charges,,,,,,,,,50.27,90,,percent of total billed charges,,,46.24,82.8,,percent of total billed charges,,,47.47,85,,percent of total billed charges,,,,,,,,,49.15,88,,percent of total billed charges,,,,,,,,,42.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.96,22,,percent of total billed charges,,,50.82,91,,percent of total billed charges,,,53.06,95,,percent of total billed charges,,,46.36,83,,percent of total billed charges,,,46.36,83,,percent of total billed charges,,,,,,,,,,,,,,,46.36,83,,percent of total billed charges,,,53.06,95,,percent of total billed charges,,,50.27,90,,percent of total billed charges,,,50.27,90,,percent of total billed charges,,,45.8,82,,percent of total billed charges,,,50.27,90,,percent of total billed charges,,,47.47,85,,percent of total billed charges,,13.96,53.06,
DRAIN JACKSON PRATT FLAT 10MM,30181475,CDM,,,270,RC,outpatient,,54.06,54.06,,45.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.52,22,,percent of total billed charges,,,,,,,,,48.65,90,,percent of total billed charges,,,44.76,82.8,,percent of total billed charges,,,45.95,85,,percent of total billed charges,,,,,,,,,47.57,88,,percent of total billed charges,,,,,,,,,41.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.52,22,,percent of total billed charges,,,49.19,91,,percent of total billed charges,,,51.36,95,,percent of total billed charges,,,44.87,83,,percent of total billed charges,,,44.87,83,,percent of total billed charges,,,,,,,,,,,,,,,44.87,83,,percent of total billed charges,,,51.36,95,,percent of total billed charges,,,48.65,90,,percent of total billed charges,,,48.65,90,,percent of total billed charges,,,44.33,82,,percent of total billed charges,,,48.65,90,,percent of total billed charges,,,45.95,85,,percent of total billed charges,,13.52,51.36,
SYNTHES SCREW LOCKING 2.7X18MM,30181477,CDM,,,278,RC,outpatient,,1178.13,1178.13,,1000.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,294.53,22,,percent of total billed charges,,,,,,,,,1060.32,90,,percent of total billed charges,,,975.49,82.8,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,,,,,,,,1036.75,88,,percent of total billed charges,,,,,,,,,900.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,294.53,22,,percent of total billed charges,,,1072.1,91,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,,,,,,,,,,,,,977.85,83,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,966.07,82,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,294.53,1119.22,
DEPUY FEMORAL HEAD 40MM -2,30181481,CDM,,,278,RC,outpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3531.34,22,,percent of total billed charges,,,,,,,,,12712.82,90,,percent of total billed charges,,,11695.79,82.8,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3531.34,22,,percent of total billed charges,,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,3531.34,13419.08,
DEPUY STEM BOWED SZ18.0 X 8,30181482,CDM,,,278,RC,outpatient,,67789.22,67789.22,,57553.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16947.31,22,,percent of total billed charges,,,,,,,,,61010.3,90,,percent of total billed charges,,,56129.47,82.8,,percent of total billed charges,,,57620.84,85,,percent of total billed charges,,,,,,,,,59654.51,88,,percent of total billed charges,,,,,,,,,51790.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16947.31,22,,percent of total billed charges,,,61688.19,91,,percent of total billed charges,,,64399.76,95,,percent of total billed charges,,,56265.05,83,,percent of total billed charges,,,56265.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56265.05,83,,percent of total billed charges,,,64399.76,95,,percent of total billed charges,,,61010.3,90,,percent of total billed charges,,,61010.3,90,,percent of total billed charges,,,55587.16,82,,percent of total billed charges,,,61010.3,90,,percent of total billed charges,,,57620.84,85,,percent of total billed charges,,16947.31,64399.76,
DEPUY MORELAND RENTAL 2902-04-000,30181483,CDM,,,278,RC,outpatient,,4550,4550,,3862.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1137.5,22,,percent of total billed charges,,,,,,,,,4095,90,,percent of total billed charges,,,3767.4,82.8,,percent of total billed charges,,,3867.5,85,,percent of total billed charges,,,,,,,,,4004,88,,percent of total billed charges,,,,,,,,,3476.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1137.5,22,,percent of total billed charges,,,4140.5,91,,percent of total billed charges,,,4322.5,95,,percent of total billed charges,,,3776.5,83,,percent of total billed charges,,,3776.5,83,,percent of total billed charges,,,,,,,,,,,,,,,3776.5,83,,percent of total billed charges,,,4322.5,95,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,3731,82,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,3867.5,85,,percent of total billed charges,,1137.5,4322.5,
DEPUY OSTEOTOME THIN 10MM X 3,30181484,CDM,,,270,RC,outpatient,,3672.5,3672.5,,3117.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,918.13,22,,percent of total billed charges,,,,,,,,,3305.25,90,,percent of total billed charges,,,3040.83,82.8,,percent of total billed charges,,,3121.63,85,,percent of total billed charges,,,,,,,,,3231.8,88,,percent of total billed charges,,,,,,,,,2805.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,918.13,22,,percent of total billed charges,,,3341.98,91,,percent of total billed charges,,,3488.88,95,,percent of total billed charges,,,3048.18,83,,percent of total billed charges,,,3048.18,83,,percent of total billed charges,,,,,,,,,,,,,,,3048.18,83,,percent of total billed charges,,,3488.88,95,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3011.45,82,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3121.63,85,,percent of total billed charges,,918.13,3488.88,
DEPUY OSTEOTOME THIN 10MM X 5,30181485,CDM,,,278,RC,outpatient,,3861,3861,,3277.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,965.25,22,,percent of total billed charges,,,,,,,,,3474.9,90,,percent of total billed charges,,,3196.91,82.8,,percent of total billed charges,,,3281.85,85,,percent of total billed charges,,,,,,,,,3397.68,88,,percent of total billed charges,,,,,,,,,2949.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,965.25,22,,percent of total billed charges,,,3513.51,91,,percent of total billed charges,,,3667.95,95,,percent of total billed charges,,,3204.63,83,,percent of total billed charges,,,3204.63,83,,percent of total billed charges,,,,,,,,,,,,,,,3204.63,83,,percent of total billed charges,,,3667.95,95,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3166.02,82,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3281.85,85,,percent of total billed charges,,965.25,3667.95,
TISSEEL FIBRIN SEALANT 4ML PRIMA,30181490,CDM,,,278,RC,outpatient,,1564.1,1564.1,,1327.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,391.03,22,,percent of total billed charges,,,,,,,,,1407.69,90,,percent of total billed charges,,,1295.07,82.8,,percent of total billed charges,,,1329.49,85,,percent of total billed charges,,,,,,,,,1376.41,88,,percent of total billed charges,,,,,,,,,1194.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,391.03,22,,percent of total billed charges,,,1423.33,91,,percent of total billed charges,,,1485.9,95,,percent of total billed charges,,,1298.2,83,,percent of total billed charges,,,1298.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1298.2,83,,percent of total billed charges,,,1485.9,95,,percent of total billed charges,,,1407.69,90,,percent of total billed charges,,,1407.69,90,,percent of total billed charges,,,1282.56,82,,percent of total billed charges,,,1407.69,90,,percent of total billed charges,,,1329.49,85,,percent of total billed charges,,391.03,1485.9,
ELASTIC STAY 5MM,30181498,CDM,,,270,RC,outpatient,,49.22,49.22,,41.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.31,22,,percent of total billed charges,,,,,,,,,44.3,90,,percent of total billed charges,,,40.75,82.8,,percent of total billed charges,,,41.84,85,,percent of total billed charges,,,,,,,,,43.31,88,,percent of total billed charges,,,,,,,,,37.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.31,22,,percent of total billed charges,,,44.79,91,,percent of total billed charges,,,46.76,95,,percent of total billed charges,,,40.85,83,,percent of total billed charges,,,40.85,83,,percent of total billed charges,,,,,,,,,,,,,,,40.85,83,,percent of total billed charges,,,46.76,95,,percent of total billed charges,,,44.3,90,,percent of total billed charges,,,44.3,90,,percent of total billed charges,,,40.36,82,,percent of total billed charges,,,44.3,90,,percent of total billed charges,,,41.84,85,,percent of total billed charges,,12.31,46.76,
STRYKER SHAVER AGGRESSIVE PLUS 4.0,30181504,CDM,,,270,RC,outpatient,,365.6,365.6,,310.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.4,22,,percent of total billed charges,,,,,,,,,329.04,90,,percent of total billed charges,,,302.72,82.8,,percent of total billed charges,,,310.76,85,,percent of total billed charges,,,,,,,,,321.73,88,,percent of total billed charges,,,,,,,,,279.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.4,22,,percent of total billed charges,,,332.7,91,,percent of total billed charges,,,347.32,95,,percent of total billed charges,,,303.45,83,,percent of total billed charges,,,303.45,83,,percent of total billed charges,,,,,,,,,,,,,,,303.45,83,,percent of total billed charges,,,347.32,95,,percent of total billed charges,,,329.04,90,,percent of total billed charges,,,329.04,90,,percent of total billed charges,,,299.79,82,,percent of total billed charges,,,329.04,90,,percent of total billed charges,,,310.76,85,,percent of total billed charges,,91.4,347.32,
DEPUY LINER ALTRX +4 NEUT 32 X 48,30181506,CDM,,,278,RC,outpatient,,11494.99,11494.99,,9759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2873.75,22,,percent of total billed charges,,,,,,,,,10345.49,90,,percent of total billed charges,,,9517.85,82.8,,percent of total billed charges,,,9770.74,85,,percent of total billed charges,,,,,,,,,10115.59,88,,percent of total billed charges,,,,,,,,,8782.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2873.75,22,,percent of total billed charges,,,10460.44,91,,percent of total billed charges,,,10920.24,95,,percent of total billed charges,,,9540.84,83,,percent of total billed charges,,,9540.84,83,,percent of total billed charges,,,,,,,,,,,,,,,9540.84,83,,percent of total billed charges,,,10920.24,95,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,9425.89,82,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,9770.74,85,,percent of total billed charges,,2873.75,10920.24,
DEPUY FEMORAL HEAD 32MM +1,30181507,CDM,,,278,RC,outpatient,,5683.54,5683.54,,4825.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1420.89,22,,percent of total billed charges,,,,,,,,,5115.19,90,,percent of total billed charges,,,4705.97,82.8,,percent of total billed charges,,,4831.01,85,,percent of total billed charges,,,,,,,,,5001.52,88,,percent of total billed charges,,,,,,,,,4342.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1420.89,22,,percent of total billed charges,,,5172.02,91,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,,,,,,,,,,,,,4717.34,83,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4660.5,82,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4831.01,85,,percent of total billed charges,,1420.89,5399.36,
DEPUY FEMUR TC3 RT SZ2.5,30181508,CDM,,,278,RC,outpatient,,36489.7,36489.7,,30979.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9122.43,22,,percent of total billed charges,,,,,,,,,32840.73,90,,percent of total billed charges,,,30213.47,82.8,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,,,,,,,,32110.94,88,,percent of total billed charges,,,,,,,,,27878.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9122.43,22,,percent of total billed charges,,,33205.63,91,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,,,,,,,,,,,,,30286.45,83,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,29921.55,82,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,9122.43,34665.22,
DEPUY POSTERIOR AUGMENT 4MM SZ2.5,30181509,CDM,,,278,RC,outpatient,,6245.14,6245.14,,5302.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1561.29,22,,percent of total billed charges,,,,,,,,,5620.63,90,,percent of total billed charges,,,5170.98,82.8,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,,,,,,,,5495.72,88,,percent of total billed charges,,,,,,,,,4771.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1561.29,22,,percent of total billed charges,,,5683.08,91,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,,,,,,,,,,,,,5183.47,83,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5121.01,82,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,1561.29,5932.88,
DEPUY DISTAL AUGMENT RT 12MM SZ2.5,30181510,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
DEPUY STEM CEMENTED 13 X 90,30181511,CDM,,,278,RC,outpatient,,8116.23,8116.23,,6890.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2029.06,22,,percent of total billed charges,,,,,,,,,7304.61,90,,percent of total billed charges,,,6720.24,82.8,,percent of total billed charges,,,6898.8,85,,percent of total billed charges,,,,,,,,,7142.28,88,,percent of total billed charges,,,,,,,,,6200.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2029.06,22,,percent of total billed charges,,,7385.77,91,,percent of total billed charges,,,7710.42,95,,percent of total billed charges,,,6736.47,83,,percent of total billed charges,,,6736.47,83,,percent of total billed charges,,,,,,,,,,,,,,,6736.47,83,,percent of total billed charges,,,7710.42,95,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,6655.31,82,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,6898.8,85,,percent of total billed charges,,2029.06,7710.42,
DEPUY INSERT TC3 RP 30MM SZ2.5,30181512,CDM,,,278,RC,outpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5779.25,22,,percent of total billed charges,,,,,,,,,20805.29,90,,percent of total billed charges,,,19140.87,82.8,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5779.25,22,,percent of total billed charges,,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,5779.25,21961.14,
DEPUY MBT REVISION TIBIAL TRAY SZ2.5,30181513,CDM,,,278,RC,outpatient,,28838.62,28838.62,,24483.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7209.66,22,,percent of total billed charges,,,,,,,,,25954.76,90,,percent of total billed charges,,,23878.38,82.8,,percent of total billed charges,,,24512.83,85,,percent of total billed charges,,,,,,,,,25377.99,88,,percent of total billed charges,,,,,,,,,22032.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7209.66,22,,percent of total billed charges,,,26243.14,91,,percent of total billed charges,,,27396.69,95,,percent of total billed charges,,,23936.05,83,,percent of total billed charges,,,23936.05,83,,percent of total billed charges,,,,,,,,,,,,,,,23936.05,83,,percent of total billed charges,,,27396.69,95,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,23647.67,82,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,24512.83,85,,percent of total billed charges,,7209.66,27396.69,
DEPUY MBT TRAY SLEEVE 37MM,30181514,CDM,,,278,RC,outpatient,,12860.84,12860.84,,10918.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3215.21,22,,percent of total billed charges,,,,,,,,,11574.76,90,,percent of total billed charges,,,10648.78,82.8,,percent of total billed charges,,,10931.71,85,,percent of total billed charges,,,,,,,,,11317.54,88,,percent of total billed charges,,,,,,,,,9825.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3215.21,22,,percent of total billed charges,,,11703.36,91,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10674.5,83,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10545.89,82,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10931.71,85,,percent of total billed charges,,3215.21,12217.8,
DEPUY OSTEOTOME FLEX 12MM X 3,30181515,CDM,,,278,RC,outpatient,,1352,1352,,1147.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,338,22,,percent of total billed charges,,,,,,,,,1216.8,90,,percent of total billed charges,,,1119.46,82.8,,percent of total billed charges,,,1149.2,85,,percent of total billed charges,,,,,,,,,1189.76,88,,percent of total billed charges,,,,,,,,,1032.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,338,22,,percent of total billed charges,,,1230.32,91,,percent of total billed charges,,,1284.4,95,,percent of total billed charges,,,1122.16,83,,percent of total billed charges,,,1122.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1122.16,83,,percent of total billed charges,,,1284.4,95,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1108.64,82,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1149.2,85,,percent of total billed charges,,338,1284.4,
DEPUY BONE CEMENT W/ANTIBIOTIC 35-500,30181516,CDM,,,270,RC,outpatient,,1527.5,1527.5,,1296.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,381.88,22,,percent of total billed charges,,,,,,,,,1374.75,90,,percent of total billed charges,,,1264.77,82.8,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,,,,,,,,1344.2,88,,percent of total billed charges,,,,,,,,,1167.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,381.88,22,,percent of total billed charges,,,1390.03,91,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1267.83,83,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1252.55,82,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,381.88,1451.13,
BIOGUIDE PATCH 40/50,30181518,CDM,,,270,RC,outpatient,,2687.1,2687.1,,2281.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,671.78,22,,percent of total billed charges,,,,,,,,,2418.39,90,,percent of total billed charges,,,2224.92,82.8,,percent of total billed charges,,,2284.04,85,,percent of total billed charges,,,,,,,,,2364.65,88,,percent of total billed charges,,,,,,,,,2052.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,671.78,22,,percent of total billed charges,,,2445.26,91,,percent of total billed charges,,,2552.75,95,,percent of total billed charges,,,2230.29,83,,percent of total billed charges,,,2230.29,83,,percent of total billed charges,,,,,,,,,,,,,,,2230.29,83,,percent of total billed charges,,,2552.75,95,,percent of total billed charges,,,2418.39,90,,percent of total billed charges,,,2418.39,90,,percent of total billed charges,,,2203.42,82,,percent of total billed charges,,,2418.39,90,,percent of total billed charges,,,2284.04,85,,percent of total billed charges,,671.78,2552.75,
DEPUY INSERT SIGMA XLK 3 X 17,30181519,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY STEM CORAIL HI OFFSET SZ13,30181522,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY PINNACLE CUP INSERT 44 X 62,30181523,CDM,,,278,RC,outpatient,,18531.63,18531.63,,15733.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4632.91,22,,percent of total billed charges,,,,,,,,,16678.47,90,,percent of total billed charges,,,15344.19,82.8,,percent of total billed charges,,,15751.89,85,,percent of total billed charges,,,,,,,,,16307.83,88,,percent of total billed charges,,,,,,,,,14158.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4632.91,22,,percent of total billed charges,,,16863.78,91,,percent of total billed charges,,,17605.05,95,,percent of total billed charges,,,15381.25,83,,percent of total billed charges,,,15381.25,83,,percent of total billed charges,,,,,,,,,,,,,,,15381.25,83,,percent of total billed charges,,,17605.05,95,,percent of total billed charges,,,16678.47,90,,percent of total billed charges,,,16678.47,90,,percent of total billed charges,,,15195.94,82,,percent of total billed charges,,,16678.47,90,,percent of total billed charges,,,15751.89,85,,percent of total billed charges,,4632.91,17605.05,
DEPUY CERAMIC HEAD 44MM +5,30181524,CDM,,,278,RC,outpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4782.85,22,,percent of total billed charges,,,,,,,,,17218.25,90,,percent of total billed charges,,,15840.79,82.8,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4782.85,22,,percent of total billed charges,,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,4782.85,18174.82,
DEPUY STEM SUMMIT BASIC SZ8,30181525,CDM,,,278,RC,outpatient,,11591.45,11591.45,,9841.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2897.86,22,,percent of total billed charges,,,,,,,,,10432.31,90,,percent of total billed charges,,,9597.72,82.8,,percent of total billed charges,,,9852.73,85,,percent of total billed charges,,,,,,,,,10200.48,88,,percent of total billed charges,,,,,,,,,8855.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2897.86,22,,percent of total billed charges,,,10548.22,91,,percent of total billed charges,,,11011.88,95,,percent of total billed charges,,,9620.9,83,,percent of total billed charges,,,9620.9,83,,percent of total billed charges,,,,,,,,,,,,,,,9620.9,83,,percent of total billed charges,,,11011.88,95,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,9504.99,82,,percent of total billed charges,,,10432.31,90,,percent of total billed charges,,,9852.73,85,,percent of total billed charges,,2897.86,11011.88,
DEPUY SCREW LOCKING 36MM,30181526,CDM,,,278,RC,outpatient,,2237.76,2237.76,,1899.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,559.44,22,,percent of total billed charges,,,,,,,,,2013.98,90,,percent of total billed charges,,,1852.87,82.8,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,,,,,,,,1969.23,88,,percent of total billed charges,,,,,,,,,1709.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,559.44,22,,percent of total billed charges,,,2036.36,91,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1857.34,83,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1834.96,82,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,559.44,2125.87,
DEPUY SCREW NON LOCKING 24MM,30181527,CDM,,,278,RC,outpatient,,1330.16,1330.16,,1129.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,332.54,22,,percent of total billed charges,,,,,,,,,1197.14,90,,percent of total billed charges,,,1101.37,82.8,,percent of total billed charges,,,1130.64,85,,percent of total billed charges,,,,,,,,,1170.54,88,,percent of total billed charges,,,,,,,,,1016.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,332.54,22,,percent of total billed charges,,,1210.45,91,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1104.03,83,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1090.73,82,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1130.64,85,,percent of total billed charges,,332.54,1263.65,
DEPUY HUMERAL CUP 38+3,30181528,CDM,,,278,RC,outpatient,,10688.08,10688.08,,9074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2672.02,22,,percent of total billed charges,,,,,,,,,9619.27,90,,percent of total billed charges,,,8849.73,82.8,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,,,,,,,,9405.51,88,,percent of total billed charges,,,,,,,,,8165.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2672.02,22,,percent of total billed charges,,,9726.15,91,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,,,,,,,,,,,,,8871.11,83,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,8764.23,82,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,2672.02,10153.68,
DEPUY CEMENTLESS EPIPHYSIS SZ1,30181529,CDM,,,278,RC,outpatient,,33055.36,33055.36,,28064,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8263.84,22,,percent of total billed charges,,,,,,,,,29749.82,90,,percent of total billed charges,,,27369.84,82.8,,percent of total billed charges,,,28097.06,85,,percent of total billed charges,,,,,,,,,29088.72,88,,percent of total billed charges,,,,,,,,,25254.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8263.84,22,,percent of total billed charges,,,30080.38,91,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,,,,,,,,,,,,,27435.95,83,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,27105.4,82,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,28097.06,85,,percent of total billed charges,,8263.84,31402.59,
DEPUY STEM HUMERAL SZ0,30181530,CDM,,,278,RC,outpatient,,17244.96,17244.96,,14640.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4311.24,22,,percent of total billed charges,,,,,,,,,15520.46,90,,percent of total billed charges,,,14278.83,82.8,,percent of total billed charges,,,14658.22,85,,percent of total billed charges,,,,,,,,,15175.56,88,,percent of total billed charges,,,,,,,,,13175.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4311.24,22,,percent of total billed charges,,,15692.91,91,,percent of total billed charges,,,16382.71,95,,percent of total billed charges,,,14313.32,83,,percent of total billed charges,,,14313.32,83,,percent of total billed charges,,,,,,,,,,,,,,,14313.32,83,,percent of total billed charges,,,16382.71,95,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,14140.87,82,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,14658.22,85,,percent of total billed charges,,4311.24,16382.71,
DEPUY BONE CEMENT W/ANTIBIOTIC 50-501,30181531,CDM,,,270,RC,outpatient,,1879.61,1879.61,,1595.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,469.9,22,,percent of total billed charges,,,,,,,,,1691.65,90,,percent of total billed charges,,,1556.32,82.8,,percent of total billed charges,,,1597.67,85,,percent of total billed charges,,,,,,,,,1654.06,88,,percent of total billed charges,,,,,,,,,1436.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,469.9,22,,percent of total billed charges,,,1710.45,91,,percent of total billed charges,,,1785.63,95,,percent of total billed charges,,,1560.08,83,,percent of total billed charges,,,1560.08,83,,percent of total billed charges,,,,,,,,,,,,,,,1560.08,83,,percent of total billed charges,,,1785.63,95,,percent of total billed charges,,,1691.65,90,,percent of total billed charges,,,1691.65,90,,percent of total billed charges,,,1541.28,82,,percent of total billed charges,,,1691.65,90,,percent of total billed charges,,,1597.67,85,,percent of total billed charges,,469.9,1785.63,
DEPUY DRILL BIT 2.5,30181532,CDM,,,278,RC,outpatient,,553,553,,469.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,138.25,22,,percent of total billed charges,,,,,,,,,497.7,90,,percent of total billed charges,,,457.88,82.8,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,,,,,,,,486.64,88,,percent of total billed charges,,,,,,,,,422.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,138.25,22,,percent of total billed charges,,,503.23,91,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,,,,,,,,,,,,,458.99,83,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,453.46,82,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,138.25,525.35,
DEPUY DRILL BIT 3.2,30181533,CDM,,,278,RC,outpatient,,335.18,335.18,,284.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.8,22,,percent of total billed charges,,,,,,,,,301.66,90,,percent of total billed charges,,,277.53,82.8,,percent of total billed charges,,,284.9,85,,percent of total billed charges,,,,,,,,,294.96,88,,percent of total billed charges,,,,,,,,,256.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.8,22,,percent of total billed charges,,,305.01,91,,percent of total billed charges,,,318.42,95,,percent of total billed charges,,,278.2,83,,percent of total billed charges,,,278.2,83,,percent of total billed charges,,,,,,,,,,,,,,,278.2,83,,percent of total billed charges,,,318.42,95,,percent of total billed charges,,,301.66,90,,percent of total billed charges,,,301.66,90,,percent of total billed charges,,,274.85,82,,percent of total billed charges,,,301.66,90,,percent of total billed charges,,,284.9,85,,percent of total billed charges,,83.8,318.42,
ENDO STITCH 10MM SUTURING DEVICE,30181534,CDM,,,270,RC,outpatient,,2733.51,2733.51,,2320.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,683.38,22,,percent of total billed charges,,,,,,,,,2460.16,90,,percent of total billed charges,,,2263.35,82.8,,percent of total billed charges,,,2323.48,85,,percent of total billed charges,,,,,,,,,2405.49,88,,percent of total billed charges,,,,,,,,,2088.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,683.38,22,,percent of total billed charges,,,2487.49,91,,percent of total billed charges,,,2596.83,95,,percent of total billed charges,,,2268.81,83,,percent of total billed charges,,,2268.81,83,,percent of total billed charges,,,,,,,,,,,,,,,2268.81,83,,percent of total billed charges,,,2596.83,95,,percent of total billed charges,,,2460.16,90,,percent of total billed charges,,,2460.16,90,,percent of total billed charges,,,2241.48,82,,percent of total billed charges,,,2460.16,90,,percent of total billed charges,,,2323.48,85,,percent of total billed charges,,683.38,2596.83,
S&N ENDO RAP PAC 1.5,30181539,CDM,,,278,RC,outpatient,,1687.14,1687.14,,1432.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,421.79,22,,percent of total billed charges,,,,,,,,,1518.43,90,,percent of total billed charges,,,1396.95,82.8,,percent of total billed charges,,,1434.07,85,,percent of total billed charges,,,,,,,,,1484.68,88,,percent of total billed charges,,,,,,,,,1288.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,421.79,22,,percent of total billed charges,,,1535.3,91,,percent of total billed charges,,,1602.78,95,,percent of total billed charges,,,1400.33,83,,percent of total billed charges,,,1400.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1400.33,83,,percent of total billed charges,,,1602.78,95,,percent of total billed charges,,,1518.43,90,,percent of total billed charges,,,1518.43,90,,percent of total billed charges,,,1383.45,82,,percent of total billed charges,,,1518.43,90,,percent of total billed charges,,,1434.07,85,,percent of total billed charges,,421.79,1602.78,
S&N ENDO PAC,30181540,CDM,,,270,RC,outpatient,,3416.47,3416.47,,2900.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,854.12,22,,percent of total billed charges,,,,,,,,,3074.82,90,,percent of total billed charges,,,2828.84,82.8,,percent of total billed charges,,,2904,85,,percent of total billed charges,,,,,,,,,3006.49,88,,percent of total billed charges,,,,,,,,,2610.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,854.12,22,,percent of total billed charges,,,3108.99,91,,percent of total billed charges,,,3245.65,95,,percent of total billed charges,,,2835.67,83,,percent of total billed charges,,,2835.67,83,,percent of total billed charges,,,,,,,,,,,,,,,2835.67,83,,percent of total billed charges,,,3245.65,95,,percent of total billed charges,,,3074.82,90,,percent of total billed charges,,,3074.82,90,,percent of total billed charges,,,2801.51,82,,percent of total billed charges,,,3074.82,90,,percent of total billed charges,,,2904,85,,percent of total billed charges,,854.12,3245.65,
S&N ENDO PROBE 30MM,30181543,CDM,,,270,RC,outpatient,,1475.5,1475.5,,1252.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,368.88,22,,percent of total billed charges,,,,,,,,,1327.95,90,,percent of total billed charges,,,1221.71,82.8,,percent of total billed charges,,,1254.18,85,,percent of total billed charges,,,,,,,,,1298.44,88,,percent of total billed charges,,,,,,,,,1127.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,368.88,22,,percent of total billed charges,,,1342.71,91,,percent of total billed charges,,,1401.73,95,,percent of total billed charges,,,1224.67,83,,percent of total billed charges,,,1224.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1224.67,83,,percent of total billed charges,,,1401.73,95,,percent of total billed charges,,,1327.95,90,,percent of total billed charges,,,1327.95,90,,percent of total billed charges,,,1209.91,82,,percent of total billed charges,,,1327.95,90,,percent of total billed charges,,,1254.18,85,,percent of total billed charges,,368.88,1401.73,
RETRACTOR ALEXIS WOUND MED 5 X 9,30181546,CDM,,,270,RC,outpatient,,364,364,,309.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91,22,,percent of total billed charges,,,,,,,,,327.6,90,,percent of total billed charges,,,301.39,82.8,,percent of total billed charges,,,309.4,85,,percent of total billed charges,,,,,,,,,320.32,88,,percent of total billed charges,,,,,,,,,278.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91,22,,percent of total billed charges,,,331.24,91,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,,,,,,,,,,,,,302.12,83,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,298.48,82,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,309.4,85,,percent of total billed charges,,91,345.8,
CLIP APPLIER SURGICLIP S-9.0IN,30181548,CDM,,,270,RC,outpatient,,1182.55,1182.55,,1003.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,295.64,22,,percent of total billed charges,,,,,,,,,1064.3,90,,percent of total billed charges,,,979.15,82.8,,percent of total billed charges,,,1005.17,85,,percent of total billed charges,,,,,,,,,1040.64,88,,percent of total billed charges,,,,,,,,,903.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,295.64,22,,percent of total billed charges,,,1076.12,91,,percent of total billed charges,,,1123.42,95,,percent of total billed charges,,,981.52,83,,percent of total billed charges,,,981.52,83,,percent of total billed charges,,,,,,,,,,,,,,,981.52,83,,percent of total billed charges,,,1123.42,95,,percent of total billed charges,,,1064.3,90,,percent of total billed charges,,,1064.3,90,,percent of total billed charges,,,969.69,82,,percent of total billed charges,,,1064.3,90,,percent of total billed charges,,,1005.17,85,,percent of total billed charges,,295.64,1123.42,
CLIP APPLIER SURGICLIP M-9.75IN,30181549,CDM,,,270,RC,outpatient,,1167.01,1167.01,,990.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,291.75,22,,percent of total billed charges,,,,,,,,,1050.31,90,,percent of total billed charges,,,966.28,82.8,,percent of total billed charges,,,991.96,85,,percent of total billed charges,,,,,,,,,1026.97,88,,percent of total billed charges,,,,,,,,,891.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,291.75,22,,percent of total billed charges,,,1061.98,91,,percent of total billed charges,,,1108.66,95,,percent of total billed charges,,,968.62,83,,percent of total billed charges,,,968.62,83,,percent of total billed charges,,,,,,,,,,,,,,,968.62,83,,percent of total billed charges,,,1108.66,95,,percent of total billed charges,,,1050.31,90,,percent of total billed charges,,,1050.31,90,,percent of total billed charges,,,956.95,82,,percent of total billed charges,,,1050.31,90,,percent of total billed charges,,,991.96,85,,percent of total billed charges,,291.75,1108.66,
MARGIN MAP W/5MM CHARM,30181550,CDM,,,270,RC,outpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36,22,,percent of total billed charges,,,,,,,,,129.6,90,,percent of total billed charges,,,119.23,82.8,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36,22,,percent of total billed charges,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,36,136.8,
RTI HEMI FEMORAL SHAFT 131MM-165MM,30181551,CDM,,,278,RC,outpatient,,7923.5,7923.5,,6727.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1980.88,22,,percent of total billed charges,,,,,,,,,7131.15,90,,percent of total billed charges,,,6560.66,82.8,,percent of total billed charges,,,6734.98,85,,percent of total billed charges,,,,,,,,,6972.68,88,,percent of total billed charges,,,,,,,,,6053.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1980.88,22,,percent of total billed charges,,,7210.39,91,,percent of total billed charges,,,7527.33,95,,percent of total billed charges,,,6576.51,83,,percent of total billed charges,,,6576.51,83,,percent of total billed charges,,,,,,,,,,,,,,,6576.51,83,,percent of total billed charges,,,7527.33,95,,percent of total billed charges,,,7131.15,90,,percent of total billed charges,,,7131.15,90,,percent of total billed charges,,,6497.27,82,,percent of total billed charges,,,7131.15,90,,percent of total billed charges,,,6734.98,85,,percent of total billed charges,,1980.88,7527.33,
DEPUY LINER ALTRX +4 40 X 56,30181552,CDM,,,278,RC,outpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4400.13,22,,percent of total billed charges,,,,,,,,,15840.46,90,,percent of total billed charges,,,14573.22,82.8,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4400.13,22,,percent of total billed charges,,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,4400.13,16720.48,
DEPUY CERAMIC HEAD 40MM +12,30181553,CDM,,,278,RC,outpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4782.85,22,,percent of total billed charges,,,,,,,,,17218.25,90,,percent of total billed charges,,,15840.79,82.8,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4782.85,22,,percent of total billed charges,,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,4782.85,18174.82,
DEPUY STEM BOWED SZ15.0 X 9,30181554,CDM,,,278,RC,outpatient,,41578.1,41578.1,,35299.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10394.53,22,,percent of total billed charges,,,,,,,,,37420.29,90,,percent of total billed charges,,,34426.67,82.8,,percent of total billed charges,,,35341.39,85,,percent of total billed charges,,,,,,,,,36588.73,88,,percent of total billed charges,,,,,,,,,31765.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10394.53,22,,percent of total billed charges,,,37836.07,91,,percent of total billed charges,,,39499.2,95,,percent of total billed charges,,,34509.82,83,,percent of total billed charges,,,34509.82,83,,percent of total billed charges,,,,,,,,,,,,,,,34509.82,83,,percent of total billed charges,,,39499.2,95,,percent of total billed charges,,,37420.29,90,,percent of total billed charges,,,37420.29,90,,percent of total billed charges,,,34094.04,82,,percent of total billed charges,,,37420.29,90,,percent of total billed charges,,,35341.39,85,,percent of total billed charges,,10394.53,39499.2,
DEPUY OSTEOTOME FLEX 8MM X 5,30181555,CDM,,,278,RC,outpatient,,3861,3861,,3277.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,965.25,22,,percent of total billed charges,,,,,,,,,3474.9,90,,percent of total billed charges,,,3196.91,82.8,,percent of total billed charges,,,3281.85,85,,percent of total billed charges,,,,,,,,,3397.68,88,,percent of total billed charges,,,,,,,,,2949.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,965.25,22,,percent of total billed charges,,,3513.51,91,,percent of total billed charges,,,3667.95,95,,percent of total billed charges,,,3204.63,83,,percent of total billed charges,,,3204.63,83,,percent of total billed charges,,,,,,,,,,,,,,,3204.63,83,,percent of total billed charges,,,3667.95,95,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3166.02,82,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3281.85,85,,percent of total billed charges,,965.25,3667.95,
DEPUY LERE BONE MILL RENTAL 290-202B,30181556,CDM,,,278,RC,outpatient,,4524,4524,,3840.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1131,22,,percent of total billed charges,,,,,,,,,4071.6,90,,percent of total billed charges,,,3745.87,82.8,,percent of total billed charges,,,3845.4,85,,percent of total billed charges,,,,,,,,,3981.12,88,,percent of total billed charges,,,,,,,,,3456.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1131,22,,percent of total billed charges,,,4116.84,91,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,,,,,,,,,,,,,3754.92,83,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3709.68,82,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3845.4,85,,percent of total billed charges,,1131,4297.8,
DEPUY MORELAND RENTAL 290-204B,30181557,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
ZIMMER BLADE EXPLANT 56MM X 20,30181558,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
ORTHADAPT BIOIMPLANT 3CM X 3CM,30181569,CDM,,,270,RC,outpatient,,14434.55,14434.55,,12254.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3608.64,22,,percent of total billed charges,,,,,,,,,12991.1,90,,percent of total billed charges,,,11951.81,82.8,,percent of total billed charges,,,12269.37,85,,percent of total billed charges,,,,,,,,,12702.4,88,,percent of total billed charges,,,,,,,,,11028,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3608.64,22,,percent of total billed charges,,,13135.44,91,,percent of total billed charges,,,13712.82,95,,percent of total billed charges,,,11980.68,83,,percent of total billed charges,,,11980.68,83,,percent of total billed charges,,,,,,,,,,,,,,,11980.68,83,,percent of total billed charges,,,13712.82,95,,percent of total billed charges,,,12991.1,90,,percent of total billed charges,,,12991.1,90,,percent of total billed charges,,,11836.33,82,,percent of total billed charges,,,12991.1,90,,percent of total billed charges,,,12269.37,85,,percent of total billed charges,,3608.64,13712.82,
MESH HERNIA REBOUND 1.97,30181570,CDM,,,270,RC,outpatient,,3181.75,3181.75,,2701.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,795.44,22,,percent of total billed charges,,,,,,,,,2863.58,90,,percent of total billed charges,,,2634.49,82.8,,percent of total billed charges,,,2704.49,85,,percent of total billed charges,,,,,,,,,2799.94,88,,percent of total billed charges,,,,,,,,,2430.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,795.44,22,,percent of total billed charges,,,2895.39,91,,percent of total billed charges,,,3022.66,95,,percent of total billed charges,,,2640.85,83,,percent of total billed charges,,,2640.85,83,,percent of total billed charges,,,,,,,,,,,,,,,2640.85,83,,percent of total billed charges,,,3022.66,95,,percent of total billed charges,,,2863.58,90,,percent of total billed charges,,,2863.58,90,,percent of total billed charges,,,2609.04,82,,percent of total billed charges,,,2863.58,90,,percent of total billed charges,,,2704.49,85,,percent of total billed charges,,795.44,3022.66,
MESH HERNIA REBOUND 3.94,30181571,CDM,,,270,RC,outpatient,,4631.25,4631.25,,3931.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1157.81,22,,percent of total billed charges,,,,,,,,,4168.13,90,,percent of total billed charges,,,3834.68,82.8,,percent of total billed charges,,,3936.56,85,,percent of total billed charges,,,,,,,,,4075.5,88,,percent of total billed charges,,,,,,,,,3538.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1157.81,22,,percent of total billed charges,,,4214.44,91,,percent of total billed charges,,,4399.69,95,,percent of total billed charges,,,3843.94,83,,percent of total billed charges,,,3843.94,83,,percent of total billed charges,,,,,,,,,,,,,,,3843.94,83,,percent of total billed charges,,,4399.69,95,,percent of total billed charges,,,4168.13,90,,percent of total billed charges,,,4168.13,90,,percent of total billed charges,,,3797.63,82,,percent of total billed charges,,,4168.13,90,,percent of total billed charges,,,3936.56,85,,percent of total billed charges,,1157.81,4399.69,
STAPLER GIA ENDO ARTICULATING 45MM,30181572,CDM,,,270,RC,outpatient,,1775.87,1775.87,,1507.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,443.97,22,,percent of total billed charges,,,,,,,,,1598.28,90,,percent of total billed charges,,,1470.42,82.8,,percent of total billed charges,,,1509.49,85,,percent of total billed charges,,,,,,,,,1562.77,88,,percent of total billed charges,,,,,,,,,1356.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,443.97,22,,percent of total billed charges,,,1616.04,91,,percent of total billed charges,,,1687.08,95,,percent of total billed charges,,,1473.97,83,,percent of total billed charges,,,1473.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1473.97,83,,percent of total billed charges,,,1687.08,95,,percent of total billed charges,,,1598.28,90,,percent of total billed charges,,,1598.28,90,,percent of total billed charges,,,1456.21,82,,percent of total billed charges,,,1598.28,90,,percent of total billed charges,,,1509.49,85,,percent of total billed charges,,443.97,1687.08,
DEPUY FEMORAL HEAD 40MM +1.5,30181574,CDM,,,278,RC,outpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4782.85,22,,percent of total billed charges,,,,,,,,,17218.25,90,,percent of total billed charges,,,15840.79,82.8,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4782.85,22,,percent of total billed charges,,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,4782.85,18174.82,
DEPUY STEM CORAIL COLLARED SZ15,30181575,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
GRANEE NEEDLE,30181576,CDM,,,278,RC,outpatient,,378,378,,320.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94.5,22,,percent of total billed charges,,,,,,,,,340.2,90,,percent of total billed charges,,,312.98,82.8,,percent of total billed charges,,,321.3,85,,percent of total billed charges,,,,,,,,,332.64,88,,percent of total billed charges,,,,,,,,,288.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94.5,22,,percent of total billed charges,,,343.98,91,,percent of total billed charges,,,359.1,95,,percent of total billed charges,,,313.74,83,,percent of total billed charges,,,313.74,83,,percent of total billed charges,,,,,,,,,,,,,,,313.74,83,,percent of total billed charges,,,359.1,95,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,309.96,82,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,321.3,85,,percent of total billed charges,,94.5,359.1,
MESH PERFIX PLUG MEDIUM,30181577,CDM,,,278,RC,outpatient,,1168.05,1168.05,,991.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,292.01,22,,percent of total billed charges,,,,,,,,,1051.25,90,,percent of total billed charges,,,967.15,82.8,,percent of total billed charges,,,992.84,85,,percent of total billed charges,,,,,,,,,1027.88,88,,percent of total billed charges,,,,,,,,,892.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,292.01,22,,percent of total billed charges,,,1062.93,91,,percent of total billed charges,,,1109.65,95,,percent of total billed charges,,,969.48,83,,percent of total billed charges,,,969.48,83,,percent of total billed charges,,,,,,,,,,,,,,,969.48,83,,percent of total billed charges,,,1109.65,95,,percent of total billed charges,,,1051.25,90,,percent of total billed charges,,,1051.25,90,,percent of total billed charges,,,957.8,82,,percent of total billed charges,,,1051.25,90,,percent of total billed charges,,,992.84,85,,percent of total billed charges,,292.01,1109.65,
ALLOPAC 50CC NON-PURGED,30181578,CDM,,,278,RC,outpatient,,7735,7735,,6567.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1933.75,22,,percent of total billed charges,,,,,,,,,6961.5,90,,percent of total billed charges,,,6404.58,82.8,,percent of total billed charges,,,6574.75,85,,percent of total billed charges,,,,,,,,,6806.8,88,,percent of total billed charges,,,,,,,,,5909.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1933.75,22,,percent of total billed charges,,,7038.85,91,,percent of total billed charges,,,7348.25,95,,percent of total billed charges,,,6420.05,83,,percent of total billed charges,,,6420.05,83,,percent of total billed charges,,,,,,,,,,,,,,,6420.05,83,,percent of total billed charges,,,7348.25,95,,percent of total billed charges,,,6961.5,90,,percent of total billed charges,,,6961.5,90,,percent of total billed charges,,,6342.7,82,,percent of total billed charges,,,6961.5,90,,percent of total billed charges,,,6574.75,85,,percent of total billed charges,,1933.75,7348.25,
MESH PREFIX PLUG LARGE,30181579,CDM,,,278,RC,outpatient,,1179.75,1179.75,,1001.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,294.94,22,,percent of total billed charges,,,,,,,,,1061.78,90,,percent of total billed charges,,,976.83,82.8,,percent of total billed charges,,,1002.79,85,,percent of total billed charges,,,,,,,,,1038.18,88,,percent of total billed charges,,,,,,,,,901.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,294.94,22,,percent of total billed charges,,,1073.57,91,,percent of total billed charges,,,1120.76,95,,percent of total billed charges,,,979.19,83,,percent of total billed charges,,,979.19,83,,percent of total billed charges,,,,,,,,,,,,,,,979.19,83,,percent of total billed charges,,,1120.76,95,,percent of total billed charges,,,1061.78,90,,percent of total billed charges,,,1061.78,90,,percent of total billed charges,,,967.4,82,,percent of total billed charges,,,1061.78,90,,percent of total billed charges,,,1002.79,85,,percent of total billed charges,,294.94,1120.76,
MESH PROLOOP XLGE,30181580,CDM,,,278,RC,outpatient,,893.75,893.75,,758.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,223.44,22,,percent of total billed charges,,,,,,,,,804.38,90,,percent of total billed charges,,,740.03,82.8,,percent of total billed charges,,,759.69,85,,percent of total billed charges,,,,,,,,,786.5,88,,percent of total billed charges,,,,,,,,,682.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,223.44,22,,percent of total billed charges,,,813.31,91,,percent of total billed charges,,,849.06,95,,percent of total billed charges,,,741.81,83,,percent of total billed charges,,,741.81,83,,percent of total billed charges,,,,,,,,,,,,,,,741.81,83,,percent of total billed charges,,,849.06,95,,percent of total billed charges,,,804.38,90,,percent of total billed charges,,,804.38,90,,percent of total billed charges,,,732.88,82,,percent of total billed charges,,,804.38,90,,percent of total billed charges,,,759.69,85,,percent of total billed charges,,223.44,849.06,
ATRIUM MESH PROLOOP ONLAY,30181581,CDM,,,278,RC,outpatient,,329.1,329.1,,279.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.28,22,,percent of total billed charges,,,,,,,,,296.19,90,,percent of total billed charges,,,272.49,82.8,,percent of total billed charges,,,279.74,85,,percent of total billed charges,,,,,,,,,289.61,88,,percent of total billed charges,,,,,,,,,251.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82.28,22,,percent of total billed charges,,,299.48,91,,percent of total billed charges,,,312.65,95,,percent of total billed charges,,,273.15,83,,percent of total billed charges,,,273.15,83,,percent of total billed charges,,,,,,,,,,,,,,,273.15,83,,percent of total billed charges,,,312.65,95,,percent of total billed charges,,,296.19,90,,percent of total billed charges,,,296.19,90,,percent of total billed charges,,,269.86,82,,percent of total billed charges,,,296.19,90,,percent of total billed charges,,,279.74,85,,percent of total billed charges,,82.28,312.65,
DEPUY STEM CORAIL KLA SZ13,30181582,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY SCREW NON LOCKING 42MM,30181583,CDM,,,278,RC,outpatient,,1330.16,1330.16,,1129.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,332.54,22,,percent of total billed charges,,,,,,,,,1197.14,90,,percent of total billed charges,,,1101.37,82.8,,percent of total billed charges,,,1130.64,85,,percent of total billed charges,,,,,,,,,1170.54,88,,percent of total billed charges,,,,,,,,,1016.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,332.54,22,,percent of total billed charges,,,1210.45,91,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1104.03,83,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1090.73,82,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1130.64,85,,percent of total billed charges,,332.54,1263.65,
DEPUY CEMENTLESS EPIPHSYIS SZ1 RT,30181584,CDM,,,278,RC,outpatient,,33055.36,33055.36,,28064,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8263.84,22,,percent of total billed charges,,,,,,,,,29749.82,90,,percent of total billed charges,,,27369.84,82.8,,percent of total billed charges,,,28097.06,85,,percent of total billed charges,,,,,,,,,29088.72,88,,percent of total billed charges,,,,,,,,,25254.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8263.84,22,,percent of total billed charges,,,30080.38,91,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,,,,,,,,,,,,,27435.95,83,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,27105.4,82,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,28097.06,85,,percent of total billed charges,,8263.84,31402.59,
DEPUY STEM HUMERAL SZ12,30181585,CDM,,,278,RC,outpatient,,17244.96,17244.96,,14640.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4311.24,22,,percent of total billed charges,,,,,,,,,15520.46,90,,percent of total billed charges,,,14278.83,82.8,,percent of total billed charges,,,14658.22,85,,percent of total billed charges,,,,,,,,,15175.56,88,,percent of total billed charges,,,,,,,,,13175.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4311.24,22,,percent of total billed charges,,,15692.91,91,,percent of total billed charges,,,16382.71,95,,percent of total billed charges,,,14313.32,83,,percent of total billed charges,,,14313.32,83,,percent of total billed charges,,,,,,,,,,,,,,,14313.32,83,,percent of total billed charges,,,16382.71,95,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,14140.87,82,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,14658.22,85,,percent of total billed charges,,4311.24,16382.71,
DEPUY GUIDE PIN METAGLENE,30181586,CDM,,,278,RC,outpatient,,784,784,,665.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,196,22,,percent of total billed charges,,,,,,,,,705.6,90,,percent of total billed charges,,,649.15,82.8,,percent of total billed charges,,,666.4,85,,percent of total billed charges,,,,,,,,,689.92,88,,percent of total billed charges,,,,,,,,,598.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,196,22,,percent of total billed charges,,,713.44,91,,percent of total billed charges,,,744.8,95,,percent of total billed charges,,,650.72,83,,percent of total billed charges,,,650.72,83,,percent of total billed charges,,,,,,,,,,,,,,,650.72,83,,percent of total billed charges,,,744.8,95,,percent of total billed charges,,,705.6,90,,percent of total billed charges,,,705.6,90,,percent of total billed charges,,,642.88,82,,percent of total billed charges,,,705.6,90,,percent of total billed charges,,,666.4,85,,percent of total billed charges,,196,744.8,
SYNTHES GUIDEWIRE 721,30181587,CDM,,,278,RC,outpatient,,312.38,312.38,,265.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.1,22,,percent of total billed charges,,,,,,,,,281.14,90,,percent of total billed charges,,,258.65,82.8,,percent of total billed charges,,,265.52,85,,percent of total billed charges,,,,,,,,,274.89,88,,percent of total billed charges,,,,,,,,,238.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.1,22,,percent of total billed charges,,,284.27,91,,percent of total billed charges,,,296.76,95,,percent of total billed charges,,,259.28,83,,percent of total billed charges,,,259.28,83,,percent of total billed charges,,,,,,,,,,,,,,,259.28,83,,percent of total billed charges,,,296.76,95,,percent of total billed charges,,,281.14,90,,percent of total billed charges,,,281.14,90,,percent of total billed charges,,,256.15,82,,percent of total billed charges,,,281.14,90,,percent of total billed charges,,,265.52,85,,percent of total billed charges,,78.1,296.76,
DEPUY OSTEOTOME FLEX 8MM X 2.5,30181590,CDM,,,278,RC,outpatient,,4602,4602,,3907.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1150.5,22,,percent of total billed charges,,,,,,,,,4141.8,90,,percent of total billed charges,,,3810.46,82.8,,percent of total billed charges,,,3911.7,85,,percent of total billed charges,,,,,,,,,4049.76,88,,percent of total billed charges,,,,,,,,,3515.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1150.5,22,,percent of total billed charges,,,4187.82,91,,percent of total billed charges,,,4371.9,95,,percent of total billed charges,,,3819.66,83,,percent of total billed charges,,,3819.66,83,,percent of total billed charges,,,,,,,,,,,,,,,3819.66,83,,percent of total billed charges,,,4371.9,95,,percent of total billed charges,,,4141.8,90,,percent of total billed charges,,,4141.8,90,,percent of total billed charges,,,3773.64,82,,percent of total billed charges,,,4141.8,90,,percent of total billed charges,,,3911.7,85,,percent of total billed charges,,1150.5,4371.9,
DEPUY MBT REVISION TIBIAL TRAY SZ3.25,30181591,CDM,,,278,RC,outpatient,,62809.5,62809.5,,53325.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15702.38,22,,percent of total billed charges,,,,,,,,,56528.55,90,,percent of total billed charges,,,52006.27,82.8,,percent of total billed charges,,,53388.08,85,,percent of total billed charges,,,,,,,,,55272.36,88,,percent of total billed charges,,,,,,,,,47986.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15702.38,22,,percent of total billed charges,,,57156.65,91,,percent of total billed charges,,,59669.03,95,,percent of total billed charges,,,52131.89,83,,percent of total billed charges,,,52131.89,83,,percent of total billed charges,,,,,,,,,,,,,,,52131.89,83,,percent of total billed charges,,,59669.03,95,,percent of total billed charges,,,56528.55,90,,percent of total billed charges,,,56528.55,90,,percent of total billed charges,,,51503.79,82,,percent of total billed charges,,,56528.55,90,,percent of total billed charges,,,53388.08,85,,percent of total billed charges,,15702.38,59669.03,
DEPUY INSERT TC3 RP 12.5MM SZ4,30181592,CDM,,,278,RC,outpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5779.25,22,,percent of total billed charges,,,,,,,,,20805.29,90,,percent of total billed charges,,,19140.87,82.8,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5779.25,22,,percent of total billed charges,,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,5779.25,21961.14,
DEPUY FEMUR TC3 RT SZ5,30181593,CDM,,,278,RC,outpatient,,36489.7,36489.7,,30979.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9122.43,22,,percent of total billed charges,,,,,,,,,32840.73,90,,percent of total billed charges,,,30213.47,82.8,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,,,,,,,,32110.94,88,,percent of total billed charges,,,,,,,,,27878.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9122.43,22,,percent of total billed charges,,,33205.63,91,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,,,,,,,,,,,,,30286.45,83,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,29921.55,82,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,9122.43,34665.22,
DEPUY DISTAL AUGMENT RT 8MM SZ4.0,30181594,CDM,,,278,RC,outpatient,,6245.14,6245.14,,5302.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1561.29,22,,percent of total billed charges,,,,,,,,,5620.63,90,,percent of total billed charges,,,5170.98,82.8,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,,,,,,,,5495.72,88,,percent of total billed charges,,,,,,,,,4771.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1561.29,22,,percent of total billed charges,,,5683.08,91,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,,,,,,,,,,,,,5183.47,83,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5121.01,82,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,1561.29,5932.88,
DEPUY FEMORAL STEM 15X30MM,30181595,CDM,,,278,RC,outpatient,,6179.68,6179.68,,5246.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1544.92,22,,percent of total billed charges,,,,,,,,,5561.71,90,,percent of total billed charges,,,5116.78,82.8,,percent of total billed charges,,,5252.73,85,,percent of total billed charges,,,,,,,,,5438.12,88,,percent of total billed charges,,,,,,,,,4721.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1544.92,22,,percent of total billed charges,,,5623.51,91,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5129.13,83,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5067.34,82,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5252.73,85,,percent of total billed charges,,1544.92,5870.7,
DEPUY OSTEOTOME THIN 8MM X 3,30181597,CDM,,,270,RC,outpatient,,3464.5,3464.5,,2941.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,866.13,22,,percent of total billed charges,,,,,,,,,3118.05,90,,percent of total billed charges,,,2868.61,82.8,,percent of total billed charges,,,2944.83,85,,percent of total billed charges,,,,,,,,,3048.76,88,,percent of total billed charges,,,,,,,,,2646.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,866.13,22,,percent of total billed charges,,,3152.7,91,,percent of total billed charges,,,3291.28,95,,percent of total billed charges,,,2875.54,83,,percent of total billed charges,,,2875.54,83,,percent of total billed charges,,,,,,,,,,,,,,,2875.54,83,,percent of total billed charges,,,3291.28,95,,percent of total billed charges,,,3118.05,90,,percent of total billed charges,,,3118.05,90,,percent of total billed charges,,,2840.89,82,,percent of total billed charges,,,3118.05,90,,percent of total billed charges,,,2944.83,85,,percent of total billed charges,,866.13,3291.28,
DEPUY PINNACLE CUP INSERT 36 X 54,30181599,CDM,,,278,RC,outpatient,,12108.98,12108.98,,10280.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3027.25,22,,percent of total billed charges,,,,,,,,,10898.08,90,,percent of total billed charges,,,10026.24,82.8,,percent of total billed charges,,,10292.63,85,,percent of total billed charges,,,,,,,,,10655.9,88,,percent of total billed charges,,,,,,,,,9251.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3027.25,22,,percent of total billed charges,,,11019.17,91,,percent of total billed charges,,,11503.53,95,,percent of total billed charges,,,10050.45,83,,percent of total billed charges,,,10050.45,83,,percent of total billed charges,,,,,,,,,,,,,,,10050.45,83,,percent of total billed charges,,,11503.53,95,,percent of total billed charges,,,10898.08,90,,percent of total billed charges,,,10898.08,90,,percent of total billed charges,,,9929.36,82,,percent of total billed charges,,,10898.08,90,,percent of total billed charges,,,10292.63,85,,percent of total billed charges,,3027.25,11503.53,
DEPUY STEM CORAIL HI OFFSET SZ11,30181600,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY SMARTMIX TOWER,30181605,CDM,,,270,RC,outpatient,,828.17,828.17,,703.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,207.04,22,,percent of total billed charges,,,,,,,,,745.35,90,,percent of total billed charges,,,685.72,82.8,,percent of total billed charges,,,703.94,85,,percent of total billed charges,,,,,,,,,728.79,88,,percent of total billed charges,,,,,,,,,632.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,207.04,22,,percent of total billed charges,,,753.63,91,,percent of total billed charges,,,786.76,95,,percent of total billed charges,,,687.38,83,,percent of total billed charges,,,687.38,83,,percent of total billed charges,,,,,,,,,,,,,,,687.38,83,,percent of total billed charges,,,786.76,95,,percent of total billed charges,,,745.35,90,,percent of total billed charges,,,745.35,90,,percent of total billed charges,,,679.1,82,,percent of total billed charges,,,745.35,90,,percent of total billed charges,,,703.94,85,,percent of total billed charges,,207.04,786.76,
DEPUY STEM CORAIL COLLARED SZ11,30181606,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
SYNTHES SCREW CORTEX 3.5X50MM,30181618,CDM,,,278,RC,outpatient,,267.75,267.75,,227.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.94,22,,percent of total billed charges,,,,,,,,,240.98,90,,percent of total billed charges,,,221.7,82.8,,percent of total billed charges,,,227.59,85,,percent of total billed charges,,,,,,,,,235.62,88,,percent of total billed charges,,,,,,,,,204.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.94,22,,percent of total billed charges,,,243.65,91,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,,,,,,,,,,,,,222.23,83,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,219.56,82,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,227.59,85,,percent of total billed charges,,66.94,254.36,
SYNTHES SCREW CANCEL F-THD 4.0X35MM,30181621,CDM,,,278,RC,outpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.78,22,,percent of total billed charges,,,,,,,,,200.82,90,,percent of total billed charges,,,184.75,82.8,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.78,22,,percent of total billed charges,,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,55.78,211.97,
SYNTHES SCREW CANCEL F-THD 4.0X55MM,30181623,CDM,,,278,RC,outpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.78,22,,percent of total billed charges,,,,,,,,,200.82,90,,percent of total billed charges,,,184.75,82.8,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.78,22,,percent of total billed charges,,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,55.78,211.97,
SYNTHES SCREW CANCEL F-THD 4.0X60MM,30181624,CDM,,,278,RC,outpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.18,22,,percent of total billed charges,,,,,,,,,213.03,90,,percent of total billed charges,,,195.99,82.8,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.18,22,,percent of total billed charges,,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,59.18,224.87,
BIOMET ROUND FAST CUTTING BUR,30181626,CDM,,,270,RC,outpatient,,434,434,,368.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.5,22,,percent of total billed charges,,,,,,,,,390.6,90,,percent of total billed charges,,,359.35,82.8,,percent of total billed charges,,,368.9,85,,percent of total billed charges,,,,,,,,,381.92,88,,percent of total billed charges,,,,,,,,,331.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108.5,22,,percent of total billed charges,,,394.94,91,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,,,,,,,,,,,,,360.22,83,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,355.88,82,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,368.9,85,,percent of total billed charges,,108.5,412.3,
BIOMET TISSUE BUR,30181627,CDM,,,270,RC,outpatient,,490,490,,416.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.5,22,,percent of total billed charges,,,,,,,,,441,90,,percent of total billed charges,,,405.72,82.8,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,,,,,,,,431.2,88,,percent of total billed charges,,,,,,,,,374.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.5,22,,percent of total billed charges,,,445.9,91,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,,,,,,,,,,,,,406.7,83,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,401.8,82,,percent of total billed charges,,,441,90,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,122.5,465.5,
BIOMET KNEE FEMORAL COMPONENT 54MM,30181628,CDM,,,278,RC,outpatient,,25012,25012,,21235.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6253,22,,percent of total billed charges,,,,,,,,,22510.8,90,,percent of total billed charges,,,20709.94,82.8,,percent of total billed charges,,,21260.2,85,,percent of total billed charges,,,,,,,,,22010.56,88,,percent of total billed charges,,,,,,,,,19109.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6253,22,,percent of total billed charges,,,22760.92,91,,percent of total billed charges,,,23761.4,95,,percent of total billed charges,,,20759.96,83,,percent of total billed charges,,,20759.96,83,,percent of total billed charges,,,,,,,,,,,,,,,20759.96,83,,percent of total billed charges,,,23761.4,95,,percent of total billed charges,,,22510.8,90,,percent of total billed charges,,,22510.8,90,,percent of total billed charges,,,20509.84,82,,percent of total billed charges,,,22510.8,90,,percent of total billed charges,,,21260.2,85,,percent of total billed charges,,6253,23761.4,
BIOMET KNEE TIBIAL COMPONENT 37 X 6.5,30181629,CDM,,,278,RC,outpatient,,9087,9087,,7714.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2271.75,22,,percent of total billed charges,,,,,,,,,8178.3,90,,percent of total billed charges,,,7524.04,82.8,,percent of total billed charges,,,7723.95,85,,percent of total billed charges,,,,,,,,,7996.56,88,,percent of total billed charges,,,,,,,,,6942.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2271.75,22,,percent of total billed charges,,,8269.17,91,,percent of total billed charges,,,8632.65,95,,percent of total billed charges,,,7542.21,83,,percent of total billed charges,,,7542.21,83,,percent of total billed charges,,,,,,,,,,,,,,,7542.21,83,,percent of total billed charges,,,8632.65,95,,percent of total billed charges,,,8178.3,90,,percent of total billed charges,,,8178.3,90,,percent of total billed charges,,,7451.34,82,,percent of total billed charges,,,8178.3,90,,percent of total billed charges,,,7723.95,85,,percent of total billed charges,,2271.75,8632.65,
ZIMMER BLADE EXPLANT 52MM X 10,30181631,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
DEPUY PINNACLE CUP SECTOR II 56MM,30181632,CDM,,,278,RC,outpatient,,18892.32,18892.32,,16039.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4723.08,22,,percent of total billed charges,,,,,,,,,17003.09,90,,percent of total billed charges,,,15642.84,82.8,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,,,,,,,,16625.24,88,,percent of total billed charges,,,,,,,,,14433.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4723.08,22,,percent of total billed charges,,,17192.01,91,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15680.63,83,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,15491.7,82,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,4723.08,17947.7,
DEPUY PINNACLE CUP REVISION 64MM,30181635,CDM,,,278,RC,outpatient,,33437.04,33437.04,,28388.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8359.26,22,,percent of total billed charges,,,,,,,,,30093.34,90,,percent of total billed charges,,,27685.87,82.8,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,,,,,,,,29424.6,88,,percent of total billed charges,,,,,,,,,25545.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8359.26,22,,percent of total billed charges,,,30427.71,91,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,,,,,,,,,,,,,27752.74,83,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,27418.37,82,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,8359.26,31765.19,
DEPUY SCREW PINNACLE 6.5X25MM,30181636,CDM,,,278,RC,outpatient,,1075.49,1075.49,,913.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,268.87,22,,percent of total billed charges,,,,,,,,,967.94,90,,percent of total billed charges,,,890.51,82.8,,percent of total billed charges,,,914.17,85,,percent of total billed charges,,,,,,,,,946.43,88,,percent of total billed charges,,,,,,,,,821.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,268.87,22,,percent of total billed charges,,,978.7,91,,percent of total billed charges,,,1021.72,95,,percent of total billed charges,,,892.66,83,,percent of total billed charges,,,892.66,83,,percent of total billed charges,,,,,,,,,,,,,,,892.66,83,,percent of total billed charges,,,1021.72,95,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,881.9,82,,percent of total billed charges,,,967.94,90,,percent of total billed charges,,,914.17,85,,percent of total billed charges,,268.87,1021.72,
MTF DBX PUTTY 5CC,30181637,CDM,,,278,RC,outpatient,,5954.33,5954.33,,5055.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1488.58,22,,percent of total billed charges,,,,,,,,,5358.9,90,,percent of total billed charges,,,4930.19,82.8,,percent of total billed charges,,,5061.18,85,,percent of total billed charges,,,,,,,,,5239.81,88,,percent of total billed charges,,,,,,,,,4549.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1488.58,22,,percent of total billed charges,,,5418.44,91,,percent of total billed charges,,,5656.61,95,,percent of total billed charges,,,4942.09,83,,percent of total billed charges,,,4942.09,83,,percent of total billed charges,,,,,,,,,,,,,,,4942.09,83,,percent of total billed charges,,,5656.61,95,,percent of total billed charges,,,5358.9,90,,percent of total billed charges,,,5358.9,90,,percent of total billed charges,,,4882.55,82,,percent of total billed charges,,,5358.9,90,,percent of total billed charges,,,5061.18,85,,percent of total billed charges,,1488.58,5656.61,
ALLOSOURCE- ACHILLES TENDON,30181644,CDM,,,278,RC,outpatient,,18844.93,18844.93,,15999.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4711.23,22,,percent of total billed charges,,,,,,,,,16960.44,90,,percent of total billed charges,,,15603.6,82.8,,percent of total billed charges,,,16018.19,85,,percent of total billed charges,,,,,,,,,16583.54,88,,percent of total billed charges,,,,,,,,,14397.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4711.23,22,,percent of total billed charges,,,17148.89,91,,percent of total billed charges,,,17902.68,95,,percent of total billed charges,,,15641.29,83,,percent of total billed charges,,,15641.29,83,,percent of total billed charges,,,,,,,,,,,,,,,15641.29,83,,percent of total billed charges,,,17902.68,95,,percent of total billed charges,,,16960.44,90,,percent of total billed charges,,,16960.44,90,,percent of total billed charges,,,15452.84,82,,percent of total billed charges,,,16960.44,90,,percent of total billed charges,,,16018.19,85,,percent of total billed charges,,4711.23,17902.68,
DEPUY PINNACLE CUP SECTOR II 64MM,30181649,CDM,,,278,RC,outpatient,,20679.88,20679.88,,17557.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5169.97,22,,percent of total billed charges,,,,,,,,,18611.89,90,,percent of total billed charges,,,17122.94,82.8,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,,,,,,,,18198.29,88,,percent of total billed charges,,,,,,,,,15799.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5169.97,22,,percent of total billed charges,,,18818.69,91,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17164.3,83,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,16957.5,82,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,5169.97,19645.89,
DEPUY LINER ALTRX +4 44 X 64,30181650,CDM,,,278,RC,outpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4400.13,22,,percent of total billed charges,,,,,,,,,15840.46,90,,percent of total billed charges,,,14573.22,82.8,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4400.13,22,,percent of total billed charges,,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,4400.13,16720.48,
DEPUY FEMORAL HEAD 44MM +1.5,30181651,CDM,,,278,RC,outpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3531.34,22,,percent of total billed charges,,,,,,,,,12712.82,90,,percent of total billed charges,,,11695.79,82.8,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3531.34,22,,percent of total billed charges,,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,3531.34,13419.08,
DEPUY STEM BOWED SZ13.5 X 8,30181652,CDM,,,278,RC,outpatient,,67789.22,67789.22,,57553.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16947.31,22,,percent of total billed charges,,,,,,,,,61010.3,90,,percent of total billed charges,,,56129.47,82.8,,percent of total billed charges,,,57620.84,85,,percent of total billed charges,,,,,,,,,59654.51,88,,percent of total billed charges,,,,,,,,,51790.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16947.31,22,,percent of total billed charges,,,61688.19,91,,percent of total billed charges,,,64399.76,95,,percent of total billed charges,,,56265.05,83,,percent of total billed charges,,,56265.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56265.05,83,,percent of total billed charges,,,64399.76,95,,percent of total billed charges,,,61010.3,90,,percent of total billed charges,,,61010.3,90,,percent of total billed charges,,,55587.16,82,,percent of total billed charges,,,61010.3,90,,percent of total billed charges,,,57620.84,85,,percent of total billed charges,,16947.31,64399.76,
APPLIED LAP TROCAR 5MM 10CM,30181653,CDM,,,270,RC,outpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36,22,,percent of total billed charges,,,,,,,,,129.6,90,,percent of total billed charges,,,119.23,82.8,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36,22,,percent of total billed charges,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,36,136.8,
APPLIED LAP TROCAR SHEATH 5MM,30181654,CDM,,,270,RC,outpatient,,68,68,,57.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17,22,,percent of total billed charges,,,,,,,,,61.2,90,,percent of total billed charges,,,56.3,82.8,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,,,,,,,,59.84,88,,percent of total billed charges,,,,,,,,,51.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17,22,,percent of total billed charges,,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,,,,,,,,,,,,,56.44,83,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,55.76,82,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,17,64.6,
APPLIED LAP TROCAR SHEATH 12MM,30181655,CDM,,,270,RC,outpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,44,167.2,
DEPUY OSTEOTOME FLEX 10MM X 5,30181657,CDM,,,278,RC,outpatient,,2158,2158,,1832.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,539.5,22,,percent of total billed charges,,,,,,,,,1942.2,90,,percent of total billed charges,,,1786.82,82.8,,percent of total billed charges,,,1834.3,85,,percent of total billed charges,,,,,,,,,1899.04,88,,percent of total billed charges,,,,,,,,,1648.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,539.5,22,,percent of total billed charges,,,1963.78,91,,percent of total billed charges,,,2050.1,95,,percent of total billed charges,,,1791.14,83,,percent of total billed charges,,,1791.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1791.14,83,,percent of total billed charges,,,2050.1,95,,percent of total billed charges,,,1942.2,90,,percent of total billed charges,,,1942.2,90,,percent of total billed charges,,,1769.56,82,,percent of total billed charges,,,1942.2,90,,percent of total billed charges,,,1834.3,85,,percent of total billed charges,,539.5,2050.1,
DEPUY INSERT TC3 RP 25MM SZ2.5,30181658,CDM,,,278,RC,outpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5779.25,22,,percent of total billed charges,,,,,,,,,20805.29,90,,percent of total billed charges,,,19140.87,82.8,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5779.25,22,,percent of total billed charges,,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,5779.25,21961.14,
DEPUY DISTAL AUGMENT RT 4MM SZ2.5,30181659,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
LATERAL POSITIONER PADS,30181662,CDM,,,270,RC,outpatient,,193.73,193.73,,164.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.43,22,,percent of total billed charges,,,,,,,,,174.36,90,,percent of total billed charges,,,160.41,82.8,,percent of total billed charges,,,164.67,85,,percent of total billed charges,,,,,,,,,170.48,88,,percent of total billed charges,,,,,,,,,148.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.43,22,,percent of total billed charges,,,176.29,91,,percent of total billed charges,,,184.04,95,,percent of total billed charges,,,160.8,83,,percent of total billed charges,,,160.8,83,,percent of total billed charges,,,,,,,,,,,,,,,160.8,83,,percent of total billed charges,,,184.04,95,,percent of total billed charges,,,174.36,90,,percent of total billed charges,,,174.36,90,,percent of total billed charges,,,158.86,82,,percent of total billed charges,,,174.36,90,,percent of total billed charges,,,164.67,85,,percent of total billed charges,,48.43,184.04,
DEPUY DISTAL AUGMENT RT 8MM SZ2.5,30181665,CDM,,,278,RC,outpatient,,6245.14,6245.14,,5302.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1561.29,22,,percent of total billed charges,,,,,,,,,5620.63,90,,percent of total billed charges,,,5170.98,82.8,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,,,,,,,,5495.72,88,,percent of total billed charges,,,,,,,,,4771.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1561.29,22,,percent of total billed charges,,,5683.08,91,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,,,,,,,,,,,,,5183.47,83,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5121.01,82,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,1561.29,5932.88,
DEPUY POSTERIOR AUGMENT 8MM SZ2.5,30181666,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
DEPUY INSERT TC3 12.5MM SZ2.5,30181667,CDM,,,278,RC,outpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5779.25,22,,percent of total billed charges,,,,,,,,,20805.29,90,,percent of total billed charges,,,19140.87,82.8,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5779.25,22,,percent of total billed charges,,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,5779.25,21961.14,
GRASPER CLUTCH,30181671,CDM,,,270,RC,outpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325,22,,percent of total billed charges,,,,,,,,,1170,90,,percent of total billed charges,,,1076.4,82.8,,percent of total billed charges,,,1105,85,,percent of total billed charges,,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325,22,,percent of total billed charges,,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,325,1235,
ATRIUM MESH CQUR V-PATCH LGE,30181674,CDM,,,278,RC,outpatient,,3724.5,3724.5,,3162.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,931.13,22,,percent of total billed charges,,,,,,,,,3352.05,90,,percent of total billed charges,,,3083.89,82.8,,percent of total billed charges,,,3165.83,85,,percent of total billed charges,,,,,,,,,3277.56,88,,percent of total billed charges,,,,,,,,,2845.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,931.13,22,,percent of total billed charges,,,3389.3,91,,percent of total billed charges,,,3538.28,95,,percent of total billed charges,,,3091.34,83,,percent of total billed charges,,,3091.34,83,,percent of total billed charges,,,,,,,,,,,,,,,3091.34,83,,percent of total billed charges,,,3538.28,95,,percent of total billed charges,,,3352.05,90,,percent of total billed charges,,,3352.05,90,,percent of total billed charges,,,3054.09,82,,percent of total billed charges,,,3352.05,90,,percent of total billed charges,,,3165.83,85,,percent of total billed charges,,931.13,3538.28,
ATRIUM MESH CQUR V-PATCH SML,30181675,CDM,,,278,RC,outpatient,,2262,2262,,1920.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,565.5,22,,percent of total billed charges,,,,,,,,,2035.8,90,,percent of total billed charges,,,1872.94,82.8,,percent of total billed charges,,,1922.7,85,,percent of total billed charges,,,,,,,,,1990.56,88,,percent of total billed charges,,,,,,,,,1728.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,565.5,22,,percent of total billed charges,,,2058.42,91,,percent of total billed charges,,,2148.9,95,,percent of total billed charges,,,1877.46,83,,percent of total billed charges,,,1877.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1877.46,83,,percent of total billed charges,,,2148.9,95,,percent of total billed charges,,,2035.8,90,,percent of total billed charges,,,2035.8,90,,percent of total billed charges,,,1854.84,82,,percent of total billed charges,,,2035.8,90,,percent of total billed charges,,,1922.7,85,,percent of total billed charges,,565.5,2148.9,
ATRIUM MESH CQUR V-PATCH MED,30181676,CDM,,,278,RC,outpatient,,2865.2,2865.2,,2432.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,716.3,22,,percent of total billed charges,,,,,,,,,2578.68,90,,percent of total billed charges,,,2372.39,82.8,,percent of total billed charges,,,2435.42,85,,percent of total billed charges,,,,,,,,,2521.38,88,,percent of total billed charges,,,,,,,,,2189.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,716.3,22,,percent of total billed charges,,,2607.33,91,,percent of total billed charges,,,2721.94,95,,percent of total billed charges,,,2378.12,83,,percent of total billed charges,,,2378.12,83,,percent of total billed charges,,,,,,,,,,,,,,,2378.12,83,,percent of total billed charges,,,2721.94,95,,percent of total billed charges,,,2578.68,90,,percent of total billed charges,,,2578.68,90,,percent of total billed charges,,,2349.46,82,,percent of total billed charges,,,2578.68,90,,percent of total billed charges,,,2435.42,85,,percent of total billed charges,,716.3,2721.94,
ESOPHYX KIT,30181679,CDM,,,270,RC,outpatient,,22100,22100,,18762.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5525,22,,percent of total billed charges,,,,,,,,,19890,90,,percent of total billed charges,,,18298.8,82.8,,percent of total billed charges,,,18785,85,,percent of total billed charges,,,,,,,,,19448,88,,percent of total billed charges,,,,,,,,,16884.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5525,22,,percent of total billed charges,,,20111,91,,percent of total billed charges,,,20995,95,,percent of total billed charges,,,18343,83,,percent of total billed charges,,,18343,83,,percent of total billed charges,,,,,,,,,,,,,,,18343,83,,percent of total billed charges,,,20995,95,,percent of total billed charges,,,19890,90,,percent of total billed charges,,,19890,90,,percent of total billed charges,,,18122,82,,percent of total billed charges,,,19890,90,,percent of total billed charges,,,18785,85,,percent of total billed charges,,5525,20995,
CATH THORACIC STRAIGHT 20FR 16MM,30181680,CDM,,,270,RC,outpatient,,124.4,124.4,,105.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.1,22,,percent of total billed charges,,,,,,,,,111.96,90,,percent of total billed charges,,,103,82.8,,percent of total billed charges,,,105.74,85,,percent of total billed charges,,,,,,,,,109.47,88,,percent of total billed charges,,,,,,,,,95.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.1,22,,percent of total billed charges,,,113.2,91,,percent of total billed charges,,,118.18,95,,percent of total billed charges,,,103.25,83,,percent of total billed charges,,,103.25,83,,percent of total billed charges,,,,,,,,,,,,,,,103.25,83,,percent of total billed charges,,,118.18,95,,percent of total billed charges,,,111.96,90,,percent of total billed charges,,,111.96,90,,percent of total billed charges,,,102.01,82,,percent of total billed charges,,,111.96,90,,percent of total billed charges,,,105.74,85,,percent of total billed charges,,31.1,118.18,
DEPUY PINNACLE CUP SECTOR II 50MM,30181683,CDM,,,278,RC,outpatient,,18892.32,18892.32,,16039.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4723.08,22,,percent of total billed charges,,,,,,,,,17003.09,90,,percent of total billed charges,,,15642.84,82.8,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,,,,,,,,16625.24,88,,percent of total billed charges,,,,,,,,,14433.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4723.08,22,,percent of total billed charges,,,17192.01,91,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15680.63,83,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,15491.7,82,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,4723.08,17947.7,
DEPUY PINNACLE CUP MULTIHOLE 56MM,30181685,CDM,,,278,RC,outpatient,,26741.78,26741.78,,22703.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6685.45,22,,percent of total billed charges,,,,,,,,,24067.6,90,,percent of total billed charges,,,22142.19,82.8,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,,,,,,,,23532.77,88,,percent of total billed charges,,,,,,,,,20430.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6685.45,22,,percent of total billed charges,,,24335.02,91,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,,,,,,,,,,,,,22195.68,83,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,21928.26,82,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,6685.45,25404.69,
ZIMMER BLADE EXPLANT 56MM X 10,30181686,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
ZIMMER BLADE EXPLANT 52MM X 20,30181687,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
S&N ENDO BICEPTOR KIT 9 X 25,30181689,CDM,,,278,RC,outpatient,,1278.55,1278.55,,1085.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,319.64,22,,percent of total billed charges,,,,,,,,,1150.7,90,,percent of total billed charges,,,1058.64,82.8,,percent of total billed charges,,,1086.77,85,,percent of total billed charges,,,,,,,,,1125.12,88,,percent of total billed charges,,,,,,,,,976.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,319.64,22,,percent of total billed charges,,,1163.48,91,,percent of total billed charges,,,1214.62,95,,percent of total billed charges,,,1061.2,83,,percent of total billed charges,,,1061.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1061.2,83,,percent of total billed charges,,,1214.62,95,,percent of total billed charges,,,1150.7,90,,percent of total billed charges,,,1150.7,90,,percent of total billed charges,,,1048.41,82,,percent of total billed charges,,,1150.7,90,,percent of total billed charges,,,1086.77,85,,percent of total billed charges,,319.64,1214.62,
SYNTHES SCREW CANNUL 16MM 6.5X50MM,30181691,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
DEPUY FEMUR SIGMA PS RT SZ3,30181695,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
DEPUY INSERT STABILIZED 10MM SZ3,30181696,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY FEMUR TC3 LT SZ4,30181697,CDM,,,278,RC,outpatient,,36489.7,36489.7,,30979.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9122.43,22,,percent of total billed charges,,,,,,,,,32840.73,90,,percent of total billed charges,,,30213.47,82.8,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,,,,,,,,32110.94,88,,percent of total billed charges,,,,,,,,,27878.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9122.43,22,,percent of total billed charges,,,33205.63,91,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,,,,,,,,,,,,,30286.45,83,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,29921.55,82,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,9122.43,34665.22,
DEPUY DISTAL AUGMENT LT 8MM SZ4.0,30181698,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
DEPUY POSTERIOR AUGMENT 4MM SZ4.0,30181699,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
DEPUY WEDGE STEP 5MM SZ4,30181700,CDM,,,278,RC,outpatient,,15761.79,15761.79,,13381.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3940.45,22,,percent of total billed charges,,,,,,,,,14185.61,90,,percent of total billed charges,,,13050.76,82.8,,percent of total billed charges,,,13397.52,85,,percent of total billed charges,,,,,,,,,13870.38,88,,percent of total billed charges,,,,,,,,,12042.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3940.45,22,,percent of total billed charges,,,14343.23,91,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,,,,,,,,,,,,,13082.29,83,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,12924.67,82,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,13397.52,85,,percent of total billed charges,,3940.45,14973.7,
ALLOPAC 25CC NON-PURGED,30181701,CDM,,,278,RC,outpatient,,8255,8255,,7008.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2063.75,22,,percent of total billed charges,,,,,,,,,7429.5,90,,percent of total billed charges,,,6835.14,82.8,,percent of total billed charges,,,7016.75,85,,percent of total billed charges,,,,,,,,,7264.4,88,,percent of total billed charges,,,,,,,,,6306.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2063.75,22,,percent of total billed charges,,,7512.05,91,,percent of total billed charges,,,7842.25,95,,percent of total billed charges,,,6851.65,83,,percent of total billed charges,,,6851.65,83,,percent of total billed charges,,,,,,,,,,,,,,,6851.65,83,,percent of total billed charges,,,7842.25,95,,percent of total billed charges,,,7429.5,90,,percent of total billed charges,,,7429.5,90,,percent of total billed charges,,,6769.1,82,,percent of total billed charges,,,7429.5,90,,percent of total billed charges,,,7016.75,85,,percent of total billed charges,,2063.75,7842.25,
DEPUY OSTEOTOME THIN 10MM X 2.5,30181720,CDM,,,270,RC,outpatient,,5941,5941,,5043.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1485.25,22,,percent of total billed charges,,,,,,,,,5346.9,90,,percent of total billed charges,,,4919.15,82.8,,percent of total billed charges,,,5049.85,85,,percent of total billed charges,,,,,,,,,5228.08,88,,percent of total billed charges,,,,,,,,,4538.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1485.25,22,,percent of total billed charges,,,5406.31,91,,percent of total billed charges,,,5643.95,95,,percent of total billed charges,,,4931.03,83,,percent of total billed charges,,,4931.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4931.03,83,,percent of total billed charges,,,5643.95,95,,percent of total billed charges,,,5346.9,90,,percent of total billed charges,,,5346.9,90,,percent of total billed charges,,,4871.62,82,,percent of total billed charges,,,5346.9,90,,percent of total billed charges,,,5049.85,85,,percent of total billed charges,,1485.25,5643.95,
DEPUY TIBIAL AUGMENT 10MM SZ2.5,30181721,CDM,,,278,RC,outpatient,,11378.45,11378.45,,9660.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2844.61,22,,percent of total billed charges,,,,,,,,,10240.61,90,,percent of total billed charges,,,9421.36,82.8,,percent of total billed charges,,,9671.68,85,,percent of total billed charges,,,,,,,,,10013.04,88,,percent of total billed charges,,,,,,,,,8693.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2844.61,22,,percent of total billed charges,,,10354.39,91,,percent of total billed charges,,,10809.53,95,,percent of total billed charges,,,9444.11,83,,percent of total billed charges,,,9444.11,83,,percent of total billed charges,,,,,,,,,,,,,,,9444.11,83,,percent of total billed charges,,,10809.53,95,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,9330.33,82,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,9671.68,85,,percent of total billed charges,,2844.61,10809.53,
DEPUY MBT TRAY SLEEVE 29MM,30181722,CDM,,,278,RC,outpatient,,12860.84,12860.84,,10918.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3215.21,22,,percent of total billed charges,,,,,,,,,11574.76,90,,percent of total billed charges,,,10648.78,82.8,,percent of total billed charges,,,10931.71,85,,percent of total billed charges,,,,,,,,,11317.54,88,,percent of total billed charges,,,,,,,,,9825.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3215.21,22,,percent of total billed charges,,,11703.36,91,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10674.5,83,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10545.89,82,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10931.71,85,,percent of total billed charges,,3215.21,12217.8,
DEPUY STEM CEMENTED 13 X 60,30181723,CDM,,,278,RC,outpatient,,6179.68,6179.68,,5246.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1544.92,22,,percent of total billed charges,,,,,,,,,5561.71,90,,percent of total billed charges,,,5116.78,82.8,,percent of total billed charges,,,5252.73,85,,percent of total billed charges,,,,,,,,,5438.12,88,,percent of total billed charges,,,,,,,,,4721.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1544.92,22,,percent of total billed charges,,,5623.51,91,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5129.13,83,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5067.34,82,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5252.73,85,,percent of total billed charges,,1544.92,5870.7,
DEPUY DISTAL AUGMENT 12MM SZ3,30181725,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
DEPUY FEMORAL ADAPTER +2,30181726,CDM,,,278,RC,outpatient,,1765.6,1765.6,,1498.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,441.4,22,,percent of total billed charges,,,,,,,,,1589.04,90,,percent of total billed charges,,,1461.92,82.8,,percent of total billed charges,,,1500.76,85,,percent of total billed charges,,,,,,,,,1553.73,88,,percent of total billed charges,,,,,,,,,1348.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,441.4,22,,percent of total billed charges,,,1606.7,91,,percent of total billed charges,,,1677.32,95,,percent of total billed charges,,,1465.45,83,,percent of total billed charges,,,1465.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.45,83,,percent of total billed charges,,,1677.32,95,,percent of total billed charges,,,1589.04,90,,percent of total billed charges,,,1589.04,90,,percent of total billed charges,,,1447.79,82,,percent of total billed charges,,,1589.04,90,,percent of total billed charges,,,1500.76,85,,percent of total billed charges,,441.4,1677.32,
DEPUY STEM CEMENTED 15 X 60,30181727,CDM,,,278,RC,outpatient,,6179.68,6179.68,,5246.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1544.92,22,,percent of total billed charges,,,,,,,,,5561.71,90,,percent of total billed charges,,,5116.78,82.8,,percent of total billed charges,,,5252.73,85,,percent of total billed charges,,,,,,,,,5438.12,88,,percent of total billed charges,,,,,,,,,4721.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1544.92,22,,percent of total billed charges,,,5623.51,91,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5129.13,83,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5067.34,82,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5252.73,85,,percent of total billed charges,,1544.92,5870.7,
DEPUY INSERT TC3 17.5MM SZ3,30181728,CDM,,,278,RC,outpatient,,15465.58,15465.58,,13130.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3866.4,22,,percent of total billed charges,,,,,,,,,13919.02,90,,percent of total billed charges,,,12805.5,82.8,,percent of total billed charges,,,13145.74,85,,percent of total billed charges,,,,,,,,,13609.71,88,,percent of total billed charges,,,,,,,,,11815.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3866.4,22,,percent of total billed charges,,,14073.68,91,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,,,,,,,,,,,,,12836.43,83,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,12681.78,82,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13145.74,85,,percent of total billed charges,,3866.4,14692.3,
STRYKER HIP SLEEVE UNIPOLAR -0MM,30181731,CDM,,,278,RC,outpatient,,1415.7,1415.7,,1201.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,353.93,22,,percent of total billed charges,,,,,,,,,1274.13,90,,percent of total billed charges,,,1172.2,82.8,,percent of total billed charges,,,1203.35,85,,percent of total billed charges,,,,,,,,,1245.82,88,,percent of total billed charges,,,,,,,,,1081.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,353.93,22,,percent of total billed charges,,,1288.29,91,,percent of total billed charges,,,1344.92,95,,percent of total billed charges,,,1175.03,83,,percent of total billed charges,,,1175.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1175.03,83,,percent of total billed charges,,,1344.92,95,,percent of total billed charges,,,1274.13,90,,percent of total billed charges,,,1274.13,90,,percent of total billed charges,,,1160.87,82,,percent of total billed charges,,,1274.13,90,,percent of total billed charges,,,1203.35,85,,percent of total billed charges,,353.93,1344.92,
SYNTHES SCREW CANCEL 4.0X35MM,30181737,CDM,,,278,RC,outpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.18,22,,percent of total billed charges,,,,,,,,,213.03,90,,percent of total billed charges,,,195.99,82.8,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.18,22,,percent of total billed charges,,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,59.18,224.87,
P.O.S. HIP JOINT ABDUCTOR,30181743,CDM,,,270,RC,outpatient,,6545.89,6545.89,,5557.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1636.47,22,,percent of total billed charges,,,,,,,,,5891.3,90,,percent of total billed charges,,,5420,82.8,,percent of total billed charges,,,5564.01,85,,percent of total billed charges,,,,,,,,,5760.38,88,,percent of total billed charges,,,,,,,,,5001.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1636.47,22,,percent of total billed charges,,,5956.76,91,,percent of total billed charges,,,6218.6,95,,percent of total billed charges,,,5433.09,83,,percent of total billed charges,,,5433.09,83,,percent of total billed charges,,,,,,,,,,,,,,,5433.09,83,,percent of total billed charges,,,6218.6,95,,percent of total billed charges,,,5891.3,90,,percent of total billed charges,,,5891.3,90,,percent of total billed charges,,,5367.63,82,,percent of total billed charges,,,5891.3,90,,percent of total billed charges,,,5564.01,85,,percent of total billed charges,,1636.47,6218.6,
DEPUY STEM CORAIL HI OFFSET SZ14,30181747,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY INSERT XLK 8MM SZ3,30181748,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY PINNACLE CUP SECTOR II 52MM,30181749,CDM,,,278,RC,outpatient,,18892.32,18892.32,,16039.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4723.08,22,,percent of total billed charges,,,,,,,,,17003.09,90,,percent of total billed charges,,,15642.84,82.8,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,,,,,,,,16625.24,88,,percent of total billed charges,,,,,,,,,14433.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4723.08,22,,percent of total billed charges,,,17192.01,91,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15680.63,83,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,15491.7,82,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,4723.08,17947.7,
RTI BIOCLENSE TIBIALIS POSTERIOR TENDON,30181756,CDM,,,270,RC,outpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4225,22,,percent of total billed charges,,,,,,,,,15210,90,,percent of total billed charges,,,13993.2,82.8,,percent of total billed charges,,,14365,85,,percent of total billed charges,,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4225,22,,percent of total billed charges,,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,4225,16055,
NEEDLE TRANSURETHRAL INJECTION 22G,30181761,CDM,,,270,RC,outpatient,,688.31,688.31,,584.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,172.08,22,,percent of total billed charges,,,,,,,,,619.48,90,,percent of total billed charges,,,569.92,82.8,,percent of total billed charges,,,585.06,85,,percent of total billed charges,,,,,,,,,605.71,88,,percent of total billed charges,,,,,,,,,525.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,172.08,22,,percent of total billed charges,,,626.36,91,,percent of total billed charges,,,653.89,95,,percent of total billed charges,,,571.3,83,,percent of total billed charges,,,571.3,83,,percent of total billed charges,,,,,,,,,,,,,,,571.3,83,,percent of total billed charges,,,653.89,95,,percent of total billed charges,,,619.48,90,,percent of total billed charges,,,619.48,90,,percent of total billed charges,,,564.41,82,,percent of total billed charges,,,619.48,90,,percent of total billed charges,,,585.06,85,,percent of total billed charges,,172.08,653.89,
DEPUY-MITEK MICROFIX ANCHOR #4/0,30181770,CDM,,,278,RC,outpatient,,2392,2392,,2030.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,598,22,,percent of total billed charges,,,,,,,,,2152.8,90,,percent of total billed charges,,,1980.58,82.8,,percent of total billed charges,,,2033.2,85,,percent of total billed charges,,,,,,,,,2104.96,88,,percent of total billed charges,,,,,,,,,1827.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,598,22,,percent of total billed charges,,,2176.72,91,,percent of total billed charges,,,2272.4,95,,percent of total billed charges,,,1985.36,83,,percent of total billed charges,,,1985.36,83,,percent of total billed charges,,,,,,,,,,,,,,,1985.36,83,,percent of total billed charges,,,2272.4,95,,percent of total billed charges,,,2152.8,90,,percent of total billed charges,,,2152.8,90,,percent of total billed charges,,,1961.44,82,,percent of total billed charges,,,2152.8,90,,percent of total billed charges,,,2033.2,85,,percent of total billed charges,,598,2272.4,
STRYKER FEMORAL HD UNITRAX 48MM,30181772,CDM,,,278,RC,outpatient,,5362.5,5362.5,,4552.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1340.63,22,,percent of total billed charges,,,,,,,,,4826.25,90,,percent of total billed charges,,,4440.15,82.8,,percent of total billed charges,,,4558.13,85,,percent of total billed charges,,,,,,,,,4719,88,,percent of total billed charges,,,,,,,,,4096.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1340.63,22,,percent of total billed charges,,,4879.88,91,,percent of total billed charges,,,5094.38,95,,percent of total billed charges,,,4450.88,83,,percent of total billed charges,,,4450.88,83,,percent of total billed charges,,,,,,,,,,,,,,,4450.88,83,,percent of total billed charges,,,5094.38,95,,percent of total billed charges,,,4826.25,90,,percent of total billed charges,,,4826.25,90,,percent of total billed charges,,,4397.25,82,,percent of total billed charges,,,4826.25,90,,percent of total billed charges,,,4558.13,85,,percent of total billed charges,,1340.63,5094.38,
DEPUY LINER ALTRX NEUT 32 X 52,30181773,CDM,,,278,RC,outpatient,,10422.17,10422.17,,8848.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2605.54,22,,percent of total billed charges,,,,,,,,,9379.95,90,,percent of total billed charges,,,8629.56,82.8,,percent of total billed charges,,,8858.84,85,,percent of total billed charges,,,,,,,,,9171.51,88,,percent of total billed charges,,,,,,,,,7962.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2605.54,22,,percent of total billed charges,,,9484.17,91,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,,,,,,,,,,,,,8650.4,83,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8546.18,82,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8858.84,85,,percent of total billed charges,,2605.54,9901.06,
DEPUY STEM CORAIL COLLARED SZ10,30181774,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY FEMORAL HEAD 32MM +9,30181775,CDM,,,278,RC,outpatient,,5683.54,5683.54,,4825.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1420.89,22,,percent of total billed charges,,,,,,,,,5115.19,90,,percent of total billed charges,,,4705.97,82.8,,percent of total billed charges,,,4831.01,85,,percent of total billed charges,,,,,,,,,5001.52,88,,percent of total billed charges,,,,,,,,,4342.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1420.89,22,,percent of total billed charges,,,5172.02,91,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,,,,,,,,,,,,,4717.34,83,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4660.5,82,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4831.01,85,,percent of total billed charges,,1420.89,5399.36,
DEPUY FEMUR SIGMA PS LT SZ5,30181776,CDM,,,278,RC,outpatient,,23868.72,23868.72,,20264.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5967.18,22,,percent of total billed charges,,,,,,,,,21481.85,90,,percent of total billed charges,,,19763.3,82.8,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,,,,,,,,21004.47,88,,percent of total billed charges,,,,,,,,,18235.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5967.18,22,,percent of total billed charges,,,21720.54,91,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19811.04,83,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,19572.35,82,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,5967.18,22675.28,
DEPUY INSERT RP 10MM SZ5,30181778,CDM,,,278,RC,outpatient,,11480.69,11480.69,,9747.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2870.17,22,,percent of total billed charges,,,,,,,,,10332.62,90,,percent of total billed charges,,,9506.01,82.8,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,,,,,,,,10103.01,88,,percent of total billed charges,,,,,,,,,8771.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2870.17,22,,percent of total billed charges,,,10447.43,91,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,,,,,,,,,,,,,9528.97,83,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9414.17,82,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,2870.17,10906.66,
DEPUY UPCHARGE PLATFORM TRAY (022),30181781,CDM,,,278,RC,outpatient,,4194.65,4194.65,,3561.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1048.66,22,,percent of total billed charges,,,,,,,,,3775.19,90,,percent of total billed charges,,,3473.17,82.8,,percent of total billed charges,,,3565.45,85,,percent of total billed charges,,,,,,,,,3691.29,88,,percent of total billed charges,,,,,,,,,3204.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1048.66,22,,percent of total billed charges,,,3817.13,91,,percent of total billed charges,,,3984.92,95,,percent of total billed charges,,,3481.56,83,,percent of total billed charges,,,3481.56,83,,percent of total billed charges,,,,,,,,,,,,,,,3481.56,83,,percent of total billed charges,,,3984.92,95,,percent of total billed charges,,,3775.19,90,,percent of total billed charges,,,3775.19,90,,percent of total billed charges,,,3439.61,82,,percent of total billed charges,,,3775.19,90,,percent of total billed charges,,,3565.45,85,,percent of total billed charges,,1048.66,3984.92,
DEPUY UPCHARGE PLATFORM INSERT (023),30181782,CDM,,,278,RC,outpatient,,3192.93,3192.93,,2710.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,798.23,22,,percent of total billed charges,,,,,,,,,2873.64,90,,percent of total billed charges,,,2643.75,82.8,,percent of total billed charges,,,2713.99,85,,percent of total billed charges,,,,,,,,,2809.78,88,,percent of total billed charges,,,,,,,,,2439.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,798.23,22,,percent of total billed charges,,,2905.57,91,,percent of total billed charges,,,3033.28,95,,percent of total billed charges,,,2650.13,83,,percent of total billed charges,,,2650.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2650.13,83,,percent of total billed charges,,,3033.28,95,,percent of total billed charges,,,2873.64,90,,percent of total billed charges,,,2873.64,90,,percent of total billed charges,,,2618.2,82,,percent of total billed charges,,,2873.64,90,,percent of total billed charges,,,2713.99,85,,percent of total billed charges,,798.23,3033.28,
ARIS TOT SLING KIT,30181784,CDM,,,270,RC,outpatient,,7767.5,7767.5,,6594.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1941.88,22,,percent of total billed charges,,,,,,,,,6990.75,90,,percent of total billed charges,,,6431.49,82.8,,percent of total billed charges,,,6602.38,85,,percent of total billed charges,,,,,,,,,6835.4,88,,percent of total billed charges,,,,,,,,,5934.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1941.88,22,,percent of total billed charges,,,7068.43,91,,percent of total billed charges,,,7379.13,95,,percent of total billed charges,,,6447.03,83,,percent of total billed charges,,,6447.03,83,,percent of total billed charges,,,,,,,,,,,,,,,6447.03,83,,percent of total billed charges,,,7379.13,95,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6369.35,82,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6602.38,85,,percent of total billed charges,,1941.88,7379.13,
DEPUY STEM CORAIL COLLARED SZ9,30181786,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY FEMUR SIGMA PS RT SZ5,30181787,CDM,,,278,RC,outpatient,,23868.72,23868.72,,20264.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5967.18,22,,percent of total billed charges,,,,,,,,,21481.85,90,,percent of total billed charges,,,19763.3,82.8,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,,,,,,,,21004.47,88,,percent of total billed charges,,,,,,,,,18235.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5967.18,22,,percent of total billed charges,,,21720.54,91,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19811.04,83,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,19572.35,82,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,5967.18,22675.28,
DEPUY INSERT RP 12.5MM SZ5,30181788,CDM,,,278,RC,outpatient,,11480.69,11480.69,,9747.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2870.17,22,,percent of total billed charges,,,,,,,,,10332.62,90,,percent of total billed charges,,,9506.01,82.8,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,,,,,,,,10103.01,88,,percent of total billed charges,,,,,,,,,8771.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2870.17,22,,percent of total billed charges,,,10447.43,91,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,,,,,,,,,,,,,9528.97,83,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9414.17,82,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,2870.17,10906.66,
DEPUY STEM CORAIL COLLARED SZ13,30181795,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
PEG KIT STANDARD PULL METHOD 20FR,30181801,CDM,,,270,RC,outpatient,,852.44,852.44,,723.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,213.11,22,,percent of total billed charges,,,,,,,,,767.2,90,,percent of total billed charges,,,705.82,82.8,,percent of total billed charges,,,724.57,85,,percent of total billed charges,,,,,,,,,750.15,88,,percent of total billed charges,,,,,,,,,651.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,213.11,22,,percent of total billed charges,,,775.72,91,,percent of total billed charges,,,809.82,95,,percent of total billed charges,,,707.53,83,,percent of total billed charges,,,707.53,83,,percent of total billed charges,,,,,,,,,,,,,,,707.53,83,,percent of total billed charges,,,809.82,95,,percent of total billed charges,,,767.2,90,,percent of total billed charges,,,767.2,90,,percent of total billed charges,,,699,82,,percent of total billed charges,,,767.2,90,,percent of total billed charges,,,724.57,85,,percent of total billed charges,,213.11,809.82,
ATRIUM MESH SECURE 15 X 20CM,30181812,CDM,,,278,RC,outpatient,,4192.5,4192.5,,3559.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1048.13,22,,percent of total billed charges,,,,,,,,,3773.25,90,,percent of total billed charges,,,3471.39,82.8,,percent of total billed charges,,,3563.63,85,,percent of total billed charges,,,,,,,,,3689.4,88,,percent of total billed charges,,,,,,,,,3203.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1048.13,22,,percent of total billed charges,,,3815.18,91,,percent of total billed charges,,,3982.88,95,,percent of total billed charges,,,3479.78,83,,percent of total billed charges,,,3479.78,83,,percent of total billed charges,,,,,,,,,,,,,,,3479.78,83,,percent of total billed charges,,,3982.88,95,,percent of total billed charges,,,3773.25,90,,percent of total billed charges,,,3773.25,90,,percent of total billed charges,,,3437.85,82,,percent of total billed charges,,,3773.25,90,,percent of total billed charges,,,3563.63,85,,percent of total billed charges,,1048.13,3982.88,
ATRIUM MESH SECURE 18 X 23CM,30181813,CDM,,,278,RC,outpatient,,5778.5,5778.5,,4905.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1444.63,22,,percent of total billed charges,,,,,,,,,5200.65,90,,percent of total billed charges,,,4784.6,82.8,,percent of total billed charges,,,4911.73,85,,percent of total billed charges,,,,,,,,,5085.08,88,,percent of total billed charges,,,,,,,,,4414.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1444.63,22,,percent of total billed charges,,,5258.44,91,,percent of total billed charges,,,5489.58,95,,percent of total billed charges,,,4796.16,83,,percent of total billed charges,,,4796.16,83,,percent of total billed charges,,,,,,,,,,,,,,,4796.16,83,,percent of total billed charges,,,5489.58,95,,percent of total billed charges,,,5200.65,90,,percent of total billed charges,,,5200.65,90,,percent of total billed charges,,,4738.37,82,,percent of total billed charges,,,5200.65,90,,percent of total billed charges,,,4911.73,85,,percent of total billed charges,,1444.63,5489.58,
ATRIUM MESH SECURE 20.5 X 30.5CM,30181814,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
ATRIUM MESH SECURE 25.5 X 35.5CM,30181815,CDM,,,278,RC,outpatient,,9815,9815,,8332.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2453.75,22,,percent of total billed charges,,,,,,,,,8833.5,90,,percent of total billed charges,,,8126.82,82.8,,percent of total billed charges,,,8342.75,85,,percent of total billed charges,,,,,,,,,8637.2,88,,percent of total billed charges,,,,,,,,,7498.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2453.75,22,,percent of total billed charges,,,8931.65,91,,percent of total billed charges,,,9324.25,95,,percent of total billed charges,,,8146.45,83,,percent of total billed charges,,,8146.45,83,,percent of total billed charges,,,,,,,,,,,,,,,8146.45,83,,percent of total billed charges,,,9324.25,95,,percent of total billed charges,,,8833.5,90,,percent of total billed charges,,,8833.5,90,,percent of total billed charges,,,8048.3,82,,percent of total billed charges,,,8833.5,90,,percent of total billed charges,,,8342.75,85,,percent of total billed charges,,2453.75,9324.25,
ABSORBA 20TACK HERNIA DEVICE 5MM,30181817,CDM,,,270,RC,outpatient,,3893.5,3893.5,,3305.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,973.38,22,,percent of total billed charges,,,,,,,,,3504.15,90,,percent of total billed charges,,,3223.82,82.8,,percent of total billed charges,,,3309.48,85,,percent of total billed charges,,,,,,,,,3426.28,88,,percent of total billed charges,,,,,,,,,2974.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,973.38,22,,percent of total billed charges,,,3543.09,91,,percent of total billed charges,,,3698.83,95,,percent of total billed charges,,,3231.61,83,,percent of total billed charges,,,3231.61,83,,percent of total billed charges,,,,,,,,,,,,,,,3231.61,83,,percent of total billed charges,,,3698.83,95,,percent of total billed charges,,,3504.15,90,,percent of total billed charges,,,3504.15,90,,percent of total billed charges,,,3192.67,82,,percent of total billed charges,,,3504.15,90,,percent of total billed charges,,,3309.48,85,,percent of total billed charges,,973.38,3698.83,
DEPUY CUSTOM IMPLANT T-F 64MM RT,30181818,CDM,,,278,RC,outpatient,,64675,64675,,54909.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16168.75,22,,percent of total billed charges,,,,,,,,,58207.5,90,,percent of total billed charges,,,53550.9,82.8,,percent of total billed charges,,,54973.75,85,,percent of total billed charges,,,,,,,,,56914,88,,percent of total billed charges,,,,,,,,,49411.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16168.75,22,,percent of total billed charges,,,58854.25,91,,percent of total billed charges,,,61441.25,95,,percent of total billed charges,,,53680.25,83,,percent of total billed charges,,,53680.25,83,,percent of total billed charges,,,,,,,,,,,,,,,53680.25,83,,percent of total billed charges,,,61441.25,95,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,53033.5,82,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,54973.75,85,,percent of total billed charges,,16168.75,61441.25,
GLIDEWIRE ANGLED .038 DIAMETER 150CM,30181819,CDM,,,270,RC,outpatient,,218.33,218.33,,185.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.58,22,,percent of total billed charges,,,,,,,,,196.5,90,,percent of total billed charges,,,180.78,82.8,,percent of total billed charges,,,185.58,85,,percent of total billed charges,,,,,,,,,192.13,88,,percent of total billed charges,,,,,,,,,166.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.58,22,,percent of total billed charges,,,198.68,91,,percent of total billed charges,,,207.41,95,,percent of total billed charges,,,181.21,83,,percent of total billed charges,,,181.21,83,,percent of total billed charges,,,,,,,,,,,,,,,181.21,83,,percent of total billed charges,,,207.41,95,,percent of total billed charges,,,196.5,90,,percent of total billed charges,,,196.5,90,,percent of total billed charges,,,179.03,82,,percent of total billed charges,,,196.5,90,,percent of total billed charges,,,185.58,85,,percent of total billed charges,,54.58,207.41,
DEPUY INSERT STABILIZED 8MM SZ3,30181822,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY INSERT RP 10MM SZ4,30181824,CDM,,,278,RC,outpatient,,11480.69,11480.69,,9747.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2870.17,22,,percent of total billed charges,,,,,,,,,10332.62,90,,percent of total billed charges,,,9506.01,82.8,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,,,,,,,,10103.01,88,,percent of total billed charges,,,,,,,,,8771.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2870.17,22,,percent of total billed charges,,,10447.43,91,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,,,,,,,,,,,,,9528.97,83,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9414.17,82,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,2870.17,10906.66,
DEPUY FEMUR SIGMA PS RT SZ4,30181825,CDM,,,278,RC,outpatient,,23868.72,23868.72,,20264.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5967.18,22,,percent of total billed charges,,,,,,,,,21481.85,90,,percent of total billed charges,,,19763.3,82.8,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,,,,,,,,21004.47,88,,percent of total billed charges,,,,,,,,,18235.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5967.18,22,,percent of total billed charges,,,21720.54,91,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19811.04,83,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,19572.35,82,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,5967.18,22675.28,
RTI MATRIX HD 5X8CM,30181827,CDM,,,278,RC,outpatient,,18850,18850,,16003.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4712.5,22,,percent of total billed charges,,,,,,,,,16965,90,,percent of total billed charges,,,15607.8,82.8,,percent of total billed charges,,,16022.5,85,,percent of total billed charges,,,,,,,,,16588,88,,percent of total billed charges,,,,,,,,,14401.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4712.5,22,,percent of total billed charges,,,17153.5,91,,percent of total billed charges,,,17907.5,95,,percent of total billed charges,,,15645.5,83,,percent of total billed charges,,,15645.5,83,,percent of total billed charges,,,,,,,,,,,,,,,15645.5,83,,percent of total billed charges,,,17907.5,95,,percent of total billed charges,,,16965,90,,percent of total billed charges,,,16965,90,,percent of total billed charges,,,15457,82,,percent of total billed charges,,,16965,90,,percent of total billed charges,,,16022.5,85,,percent of total billed charges,,4712.5,17907.5,
DEPUY STEM BOWED SZ13.5 X 11,30181850,CDM,,,278,RC,outpatient,,68800.94,68800.94,,58412,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17200.24,22,,percent of total billed charges,,,,,,,,,61920.85,90,,percent of total billed charges,,,56967.18,82.8,,percent of total billed charges,,,58480.8,85,,percent of total billed charges,,,,,,,,,60544.83,88,,percent of total billed charges,,,,,,,,,52563.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17200.24,22,,percent of total billed charges,,,62608.86,91,,percent of total billed charges,,,65360.89,95,,percent of total billed charges,,,57104.78,83,,percent of total billed charges,,,57104.78,83,,percent of total billed charges,,,,,,,,,,,,,,,57104.78,83,,percent of total billed charges,,,65360.89,95,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,56416.77,82,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,58480.8,85,,percent of total billed charges,,17200.24,65360.89,
DEPUY RENTAL FEE - INSTRUMENTS 99-000,30181851,CDM,,,270,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
DEPUY LINER CONSTRAINED ESC 36 X 56,30181852,CDM,,,278,RC,outpatient,,36635.17,36635.17,,31103.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9158.79,22,,percent of total billed charges,,,,,,,,,32971.65,90,,percent of total billed charges,,,30333.92,82.8,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,,,,,,,,32238.95,88,,percent of total billed charges,,,,,,,,,27989.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9158.79,22,,percent of total billed charges,,,33338,91,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,,,,,,,,,,,,,30407.19,83,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,30040.84,82,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,9158.79,34803.41,
DEPUY STEM BOWED SZ10.5 X 8,30181853,CDM,,,270,RC,outpatient,,66522.3,66522.3,,56477.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16630.58,22,,percent of total billed charges,,,,,,,,,59870.07,90,,percent of total billed charges,,,55080.46,82.8,,percent of total billed charges,,,56543.96,85,,percent of total billed charges,,,,,,,,,58539.62,88,,percent of total billed charges,,,,,,,,,50823.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16630.58,22,,percent of total billed charges,,,60535.29,91,,percent of total billed charges,,,63196.19,95,,percent of total billed charges,,,55213.51,83,,percent of total billed charges,,,55213.51,83,,percent of total billed charges,,,,,,,,,,,,,,,55213.51,83,,percent of total billed charges,,,63196.19,95,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,54548.29,82,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,56543.96,85,,percent of total billed charges,,16630.58,63196.19,
DEPUY GLENOSPHERE 38MM,30181854,CDM,,,278,RC,outpatient,,17458.81,17458.81,,14822.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4364.7,22,,percent of total billed charges,,,,,,,,,15712.93,90,,percent of total billed charges,,,14455.89,82.8,,percent of total billed charges,,,14839.99,85,,percent of total billed charges,,,,,,,,,15363.75,88,,percent of total billed charges,,,,,,,,,13338.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4364.7,22,,percent of total billed charges,,,15887.52,91,,percent of total billed charges,,,16585.87,95,,percent of total billed charges,,,14490.81,83,,percent of total billed charges,,,14490.81,83,,percent of total billed charges,,,,,,,,,,,,,,,14490.81,83,,percent of total billed charges,,,16585.87,95,,percent of total billed charges,,,15712.93,90,,percent of total billed charges,,,15712.93,90,,percent of total billed charges,,,14316.22,82,,percent of total billed charges,,,15712.93,90,,percent of total billed charges,,,14839.99,85,,percent of total billed charges,,4364.7,16585.87,
MACROPLASTIQUE IMPLANT 2.5ML,30181855,CDM,,,278,RC,outpatient,,3539.25,3539.25,,3004.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,884.81,22,,percent of total billed charges,,,,,,,,,3185.33,90,,percent of total billed charges,,,2930.5,82.8,,percent of total billed charges,,,3008.36,85,,percent of total billed charges,,,,,,,,,3114.54,88,,percent of total billed charges,,,,,,,,,2703.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,884.81,22,,percent of total billed charges,,,3220.72,91,,percent of total billed charges,,,3362.29,95,,percent of total billed charges,,,2937.58,83,,percent of total billed charges,,,2937.58,83,,percent of total billed charges,,,,,,,,,,,,,,,2937.58,83,,percent of total billed charges,,,3362.29,95,,percent of total billed charges,,,3185.33,90,,percent of total billed charges,,,3185.33,90,,percent of total billed charges,,,2902.19,82,,percent of total billed charges,,,3185.33,90,,percent of total billed charges,,,3008.36,85,,percent of total billed charges,,884.81,3362.29,
STONE RETRIEVAL BASKET 1.9FR,30181858,CDM,,,270,RC,outpatient,,1537.58,1537.58,,1305.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.4,22,,percent of total billed charges,,,,,,,,,1383.82,90,,percent of total billed charges,,,1273.12,82.8,,percent of total billed charges,,,1306.94,85,,percent of total billed charges,,,,,,,,,1353.07,88,,percent of total billed charges,,,,,,,,,1174.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.4,22,,percent of total billed charges,,,1399.2,91,,percent of total billed charges,,,1460.7,95,,percent of total billed charges,,,1276.19,83,,percent of total billed charges,,,1276.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1276.19,83,,percent of total billed charges,,,1460.7,95,,percent of total billed charges,,,1383.82,90,,percent of total billed charges,,,1383.82,90,,percent of total billed charges,,,1260.82,82,,percent of total billed charges,,,1383.82,90,,percent of total billed charges,,,1306.94,85,,percent of total billed charges,,384.4,1460.7,
DRAIN JACKSON PRATT FLUTED 19FR,30181865,CDM,,,270,RC,outpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.63,22,,percent of total billed charges,,,,,,,,,236.25,90,,percent of total billed charges,,,217.35,82.8,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.63,22,,percent of total billed charges,,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,65.63,249.38,
SYNTHES DRILL BIT 4.3MM 310.431,30181868,CDM,,,270,RC,outpatient,,1217.84,1217.84,,1033.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,304.46,22,,percent of total billed charges,,,,,,,,,1096.06,90,,percent of total billed charges,,,1008.37,82.8,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,,,,,,,,1071.7,88,,percent of total billed charges,,,,,,,,,930.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,304.46,22,,percent of total billed charges,,,1108.23,91,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1010.81,83,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,998.63,82,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,304.46,1156.95,
SYNTHES SCREW LOCKING 3.5X14MM,30181871,CDM,,,270,RC,outpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,313.59,22,,percent of total billed charges,,,,,,,,,1128.93,90,,percent of total billed charges,,,1038.62,82.8,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,313.59,22,,percent of total billed charges,,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,313.59,1191.65,
DEPUY UPCHARGE CERAMIC LINER(011),30181872,CDM,,,278,RC,outpatient,,4521.53,4521.53,,3838.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1130.38,22,,percent of total billed charges,,,,,,,,,4069.38,90,,percent of total billed charges,,,3743.83,82.8,,percent of total billed charges,,,3843.3,85,,percent of total billed charges,,,,,,,,,3978.95,88,,percent of total billed charges,,,,,,,,,3454.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1130.38,22,,percent of total billed charges,,,4114.59,91,,percent of total billed charges,,,4295.45,95,,percent of total billed charges,,,3752.87,83,,percent of total billed charges,,,3752.87,83,,percent of total billed charges,,,,,,,,,,,,,,,3752.87,83,,percent of total billed charges,,,4295.45,95,,percent of total billed charges,,,4069.38,90,,percent of total billed charges,,,4069.38,90,,percent of total billed charges,,,3707.65,82,,percent of total billed charges,,,4069.38,90,,percent of total billed charges,,,3843.3,85,,percent of total billed charges,,1130.38,4295.45,
SYNTHES SCREW SCHANZ 4.0X25MM,30181885,CDM,,,278,RC,outpatient,,1574.63,1574.63,,1336.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,393.66,22,,percent of total billed charges,,,,,,,,,1417.17,90,,percent of total billed charges,,,1303.79,82.8,,percent of total billed charges,,,1338.44,85,,percent of total billed charges,,,,,,,,,1385.67,88,,percent of total billed charges,,,,,,,,,1203.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,393.66,22,,percent of total billed charges,,,1432.91,91,,percent of total billed charges,,,1495.9,95,,percent of total billed charges,,,1306.94,83,,percent of total billed charges,,,1306.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1306.94,83,,percent of total billed charges,,,1495.9,95,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1291.2,82,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1338.44,85,,percent of total billed charges,,393.66,1495.9,
SYNTHES SCREW SCHANZ 4.0X30MM,30181886,CDM,,,278,RC,outpatient,,1670.5,1670.5,,1418.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,417.63,22,,percent of total billed charges,,,,,,,,,1503.45,90,,percent of total billed charges,,,1383.17,82.8,,percent of total billed charges,,,1419.93,85,,percent of total billed charges,,,,,,,,,1470.04,88,,percent of total billed charges,,,,,,,,,1276.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,417.63,22,,percent of total billed charges,,,1520.16,91,,percent of total billed charges,,,1586.98,95,,percent of total billed charges,,,1386.52,83,,percent of total billed charges,,,1386.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1386.52,83,,percent of total billed charges,,,1586.98,95,,percent of total billed charges,,,1503.45,90,,percent of total billed charges,,,1503.45,90,,percent of total billed charges,,,1369.81,82,,percent of total billed charges,,,1503.45,90,,percent of total billed charges,,,1419.93,85,,percent of total billed charges,,417.63,1586.98,
SYNTHES CLAMP ADJUSTABLE,30181887,CDM,,,278,RC,outpatient,,8282.24,8282.24,,7031.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2070.56,22,,percent of total billed charges,,,,,,,,,7454.02,90,,percent of total billed charges,,,6857.69,82.8,,percent of total billed charges,,,7039.9,85,,percent of total billed charges,,,,,,,,,7288.37,88,,percent of total billed charges,,,,,,,,,6327.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2070.56,22,,percent of total billed charges,,,7536.84,91,,percent of total billed charges,,,7868.13,95,,percent of total billed charges,,,6874.26,83,,percent of total billed charges,,,6874.26,83,,percent of total billed charges,,,,,,,,,,,,,,,6874.26,83,,percent of total billed charges,,,7868.13,95,,percent of total billed charges,,,7454.02,90,,percent of total billed charges,,,7454.02,90,,percent of total billed charges,,,6791.44,82,,percent of total billed charges,,,7454.02,90,,percent of total billed charges,,,7039.9,85,,percent of total billed charges,,2070.56,7868.13,
ZIMMER BLADE EXPLANT 54MM X 10,30181891,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
ZIMMER BLADE EXPLANT 54MM X 20,30181892,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
DEPUY STEM CORAIL COLLARED SZ12,30181899,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY-MITEK ANCHOR INSTRUMENT KIT,30181901,CDM,,,270,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
DEPUY-MITEK QUICKANCHOR PLUS GII,30181902,CDM,,,278,RC,outpatient,,2665,2665,,2262.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,666.25,22,,percent of total billed charges,,,,,,,,,2398.5,90,,percent of total billed charges,,,2206.62,82.8,,percent of total billed charges,,,2265.25,85,,percent of total billed charges,,,,,,,,,2345.2,88,,percent of total billed charges,,,,,,,,,2036.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,666.25,22,,percent of total billed charges,,,2425.15,91,,percent of total billed charges,,,2531.75,95,,percent of total billed charges,,,2211.95,83,,percent of total billed charges,,,2211.95,83,,percent of total billed charges,,,,,,,,,,,,,,,2211.95,83,,percent of total billed charges,,,2531.75,95,,percent of total billed charges,,,2398.5,90,,percent of total billed charges,,,2398.5,90,,percent of total billed charges,,,2185.3,82,,percent of total billed charges,,,2398.5,90,,percent of total billed charges,,,2265.25,85,,percent of total billed charges,,666.25,2531.75,
DEPUY-MITEK QUICKANCHOR SUPER PLUS,30181903,CDM,,,278,RC,outpatient,,4608.5,4608.5,,3912.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1152.13,22,,percent of total billed charges,,,,,,,,,4147.65,90,,percent of total billed charges,,,3815.84,82.8,,percent of total billed charges,,,3917.23,85,,percent of total billed charges,,,,,,,,,4055.48,88,,percent of total billed charges,,,,,,,,,3520.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1152.13,22,,percent of total billed charges,,,4193.74,91,,percent of total billed charges,,,4378.08,95,,percent of total billed charges,,,3825.06,83,,percent of total billed charges,,,3825.06,83,,percent of total billed charges,,,,,,,,,,,,,,,3825.06,83,,percent of total billed charges,,,4378.08,95,,percent of total billed charges,,,4147.65,90,,percent of total billed charges,,,4147.65,90,,percent of total billed charges,,,3778.97,82,,percent of total billed charges,,,4147.65,90,,percent of total billed charges,,,3917.23,85,,percent of total billed charges,,1152.13,4378.08,
DEPUY FEMUR SIGMA PS RT SZ2.5,30181904,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
DEPUY INSERT RP 10MM SZ2.5,30181905,CDM,,,278,RC,outpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3253.11,22,,percent of total billed charges,,,,,,,,,11711.18,90,,percent of total billed charges,,,10774.28,82.8,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3253.11,22,,percent of total billed charges,,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,3253.11,12361.8,
DEPUY MBT KEEL TRAY SZ2.5,30181906,CDM,,,278,RC,outpatient,,22901.45,22901.45,,19443.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5725.36,22,,percent of total billed charges,,,,,,,,,20611.31,90,,percent of total billed charges,,,18962.4,82.8,,percent of total billed charges,,,19466.23,85,,percent of total billed charges,,,,,,,,,20153.28,88,,percent of total billed charges,,,,,,,,,17496.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5725.36,22,,percent of total billed charges,,,20840.32,91,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19008.2,83,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,18779.19,82,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,19466.23,85,,percent of total billed charges,,5725.36,21756.38,
BIOMET KNEE FEMORAL REPICCI II 54MM,30181907,CDM,,,278,RC,outpatient,,26266.5,26266.5,,22300.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6566.63,22,,percent of total billed charges,,,,,,,,,23639.85,90,,percent of total billed charges,,,21748.66,82.8,,percent of total billed charges,,,22326.53,85,,percent of total billed charges,,,,,,,,,23114.52,88,,percent of total billed charges,,,,,,,,,20067.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6566.63,22,,percent of total billed charges,,,23902.52,91,,percent of total billed charges,,,24953.18,95,,percent of total billed charges,,,21801.2,83,,percent of total billed charges,,,21801.2,83,,percent of total billed charges,,,,,,,,,,,,,,,21801.2,83,,percent of total billed charges,,,24953.18,95,,percent of total billed charges,,,23639.85,90,,percent of total billed charges,,,23639.85,90,,percent of total billed charges,,,21538.53,82,,percent of total billed charges,,,23639.85,90,,percent of total billed charges,,,22326.53,85,,percent of total billed charges,,6566.63,24953.18,
BIOMET KNEE TIBIAL COMPONENT 37 X 7.5,30181908,CDM,,,278,RC,outpatient,,9542,9542,,8101.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2385.5,22,,percent of total billed charges,,,,,,,,,8587.8,90,,percent of total billed charges,,,7900.78,82.8,,percent of total billed charges,,,8110.7,85,,percent of total billed charges,,,,,,,,,8396.96,88,,percent of total billed charges,,,,,,,,,7290.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2385.5,22,,percent of total billed charges,,,8683.22,91,,percent of total billed charges,,,9064.9,95,,percent of total billed charges,,,7919.86,83,,percent of total billed charges,,,7919.86,83,,percent of total billed charges,,,,,,,,,,,,,,,7919.86,83,,percent of total billed charges,,,9064.9,95,,percent of total billed charges,,,8587.8,90,,percent of total billed charges,,,8587.8,90,,percent of total billed charges,,,7824.44,82,,percent of total billed charges,,,8587.8,90,,percent of total billed charges,,,8110.7,85,,percent of total billed charges,,2385.5,9064.9,
DEPUY THOCHLEA IMPLANT PFI SZ1,30181909,CDM,,,278,RC,outpatient,,17793.75,17793.75,,15106.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4448.44,22,,percent of total billed charges,,,,,,,,,16014.38,90,,percent of total billed charges,,,14733.23,82.8,,percent of total billed charges,,,15124.69,85,,percent of total billed charges,,,,,,,,,15658.5,88,,percent of total billed charges,,,,,,,,,13594.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4448.44,22,,percent of total billed charges,,,16192.31,91,,percent of total billed charges,,,16904.06,95,,percent of total billed charges,,,14768.81,83,,percent of total billed charges,,,14768.81,83,,percent of total billed charges,,,,,,,,,,,,,,,14768.81,83,,percent of total billed charges,,,16904.06,95,,percent of total billed charges,,,16014.38,90,,percent of total billed charges,,,16014.38,90,,percent of total billed charges,,,14590.88,82,,percent of total billed charges,,,16014.38,90,,percent of total billed charges,,,15124.69,85,,percent of total billed charges,,4448.44,16904.06,
DEPUY THOCHLEA CUTTING B4,30181911,CDM,,,278,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
DEPUY FEMORAL HEAD 44MM -2,30181917,CDM,,,278,RC,outpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3531.34,22,,percent of total billed charges,,,,,,,,,12712.82,90,,percent of total billed charges,,,11695.79,82.8,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3531.34,22,,percent of total billed charges,,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,3531.34,13419.08,
DEPUY LINER ALTRX NEUT 28 X 50,30181925,CDM,,,278,RC,outpatient,,10729.29,10729.29,,9109.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2682.32,22,,percent of total billed charges,,,,,,,,,9656.36,90,,percent of total billed charges,,,8883.85,82.8,,percent of total billed charges,,,9119.9,85,,percent of total billed charges,,,,,,,,,9441.78,88,,percent of total billed charges,,,,,,,,,8197.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2682.32,22,,percent of total billed charges,,,9763.65,91,,percent of total billed charges,,,10192.83,95,,percent of total billed charges,,,8905.31,83,,percent of total billed charges,,,8905.31,83,,percent of total billed charges,,,,,,,,,,,,,,,8905.31,83,,percent of total billed charges,,,10192.83,95,,percent of total billed charges,,,9656.36,90,,percent of total billed charges,,,9656.36,90,,percent of total billed charges,,,8798.02,82,,percent of total billed charges,,,9656.36,90,,percent of total billed charges,,,9119.9,85,,percent of total billed charges,,2682.32,10192.83,
DEPUY STEM ULTIMA SZ3,30181926,CDM,,,278,RC,outpatient,,18959.53,18959.53,,16096.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4739.88,22,,percent of total billed charges,,,,,,,,,17063.58,90,,percent of total billed charges,,,15698.49,82.8,,percent of total billed charges,,,16115.6,85,,percent of total billed charges,,,,,,,,,16684.39,88,,percent of total billed charges,,,,,,,,,14485.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4739.88,22,,percent of total billed charges,,,17253.17,91,,percent of total billed charges,,,18011.55,95,,percent of total billed charges,,,15736.41,83,,percent of total billed charges,,,15736.41,83,,percent of total billed charges,,,,,,,,,,,,,,,15736.41,83,,percent of total billed charges,,,18011.55,95,,percent of total billed charges,,,17063.58,90,,percent of total billed charges,,,17063.58,90,,percent of total billed charges,,,15546.81,82,,percent of total billed charges,,,17063.58,90,,percent of total billed charges,,,16115.6,85,,percent of total billed charges,,4739.88,18011.55,
DEPUY HEAD PFC 28MM+10,30181927,CDM,,,278,RC,outpatient,,7698.34,7698.34,,6535.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1924.59,22,,percent of total billed charges,,,,,,,,,6928.51,90,,percent of total billed charges,,,6374.23,82.8,,percent of total billed charges,,,6543.59,85,,percent of total billed charges,,,,,,,,,6774.54,88,,percent of total billed charges,,,,,,,,,5881.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1924.59,22,,percent of total billed charges,,,7005.49,91,,percent of total billed charges,,,7313.42,95,,percent of total billed charges,,,6389.62,83,,percent of total billed charges,,,6389.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6389.62,83,,percent of total billed charges,,,7313.42,95,,percent of total billed charges,,,6928.51,90,,percent of total billed charges,,,6928.51,90,,percent of total billed charges,,,6312.64,82,,percent of total billed charges,,,6928.51,90,,percent of total billed charges,,,6543.59,85,,percent of total billed charges,,1924.59,7313.42,
DEPUY CENTRALIZER 13MM,30181928,CDM,,,278,RC,outpatient,,863.59,863.59,,733.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,215.9,22,,percent of total billed charges,,,,,,,,,777.23,90,,percent of total billed charges,,,715.05,82.8,,percent of total billed charges,,,734.05,85,,percent of total billed charges,,,,,,,,,759.96,88,,percent of total billed charges,,,,,,,,,659.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,215.9,22,,percent of total billed charges,,,785.87,91,,percent of total billed charges,,,820.41,95,,percent of total billed charges,,,716.78,83,,percent of total billed charges,,,716.78,83,,percent of total billed charges,,,,,,,,,,,,,,,716.78,83,,percent of total billed charges,,,820.41,95,,percent of total billed charges,,,777.23,90,,percent of total billed charges,,,777.23,90,,percent of total billed charges,,,708.14,82,,percent of total billed charges,,,777.23,90,,percent of total billed charges,,,734.05,85,,percent of total billed charges,,215.9,820.41,
DEPUY RENTAL FEE - INSTRUMENTS 97-000,30181929,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
DEPUY PINNACLE CUP SECTOR II 54MM,30181930,CDM,,,278,RC,outpatient,,18892.32,18892.32,,16039.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4723.08,22,,percent of total billed charges,,,,,,,,,17003.09,90,,percent of total billed charges,,,15642.84,82.8,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,,,,,,,,16625.24,88,,percent of total billed charges,,,,,,,,,14433.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4723.08,22,,percent of total billed charges,,,17192.01,91,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15680.63,83,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,15491.7,82,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,4723.08,17947.7,
DRAIN FLUTE 10FR W/TROCAR,30181931,CDM,,,270,RC,outpatient,,199.94,199.94,,169.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.99,22,,percent of total billed charges,,,,,,,,,179.95,90,,percent of total billed charges,,,165.55,82.8,,percent of total billed charges,,,169.95,85,,percent of total billed charges,,,,,,,,,175.95,88,,percent of total billed charges,,,,,,,,,152.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.99,22,,percent of total billed charges,,,181.95,91,,percent of total billed charges,,,189.94,95,,percent of total billed charges,,,165.95,83,,percent of total billed charges,,,165.95,83,,percent of total billed charges,,,,,,,,,,,,,,,165.95,83,,percent of total billed charges,,,189.94,95,,percent of total billed charges,,,179.95,90,,percent of total billed charges,,,179.95,90,,percent of total billed charges,,,163.95,82,,percent of total billed charges,,,179.95,90,,percent of total billed charges,,,169.95,85,,percent of total billed charges,,49.99,189.94,
DRAIN FLUTE 19FR W/TROCAR,30181932,CDM,,,270,RC,outpatient,,201.93,201.93,,171.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.48,22,,percent of total billed charges,,,,,,,,,181.74,90,,percent of total billed charges,,,167.2,82.8,,percent of total billed charges,,,171.64,85,,percent of total billed charges,,,,,,,,,177.7,88,,percent of total billed charges,,,,,,,,,154.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.48,22,,percent of total billed charges,,,183.76,91,,percent of total billed charges,,,191.83,95,,percent of total billed charges,,,167.6,83,,percent of total billed charges,,,167.6,83,,percent of total billed charges,,,,,,,,,,,,,,,167.6,83,,percent of total billed charges,,,191.83,95,,percent of total billed charges,,,181.74,90,,percent of total billed charges,,,181.74,90,,percent of total billed charges,,,165.58,82,,percent of total billed charges,,,181.74,90,,percent of total billed charges,,,171.64,85,,percent of total billed charges,,50.48,191.83,
DEPUY FEMUR SIGMA PS LT SZ4,30181934,CDM,,,278,RC,outpatient,,23868.72,23868.72,,20264.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5967.18,22,,percent of total billed charges,,,,,,,,,21481.85,90,,percent of total billed charges,,,19763.3,82.8,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,,,,,,,,21004.47,88,,percent of total billed charges,,,,,,,,,18235.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5967.18,22,,percent of total billed charges,,,21720.54,91,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19811.04,83,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,19572.35,82,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,5967.18,22675.28,
DEPUY SAWBLADE 90 X 13 (607),30181935,CDM,,,278,RC,outpatient,,550.55,550.55,,467.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,137.64,22,,percent of total billed charges,,,,,,,,,495.5,90,,percent of total billed charges,,,455.86,82.8,,percent of total billed charges,,,467.97,85,,percent of total billed charges,,,,,,,,,484.48,88,,percent of total billed charges,,,,,,,,,420.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,137.64,22,,percent of total billed charges,,,501,91,,percent of total billed charges,,,523.02,95,,percent of total billed charges,,,456.96,83,,percent of total billed charges,,,456.96,83,,percent of total billed charges,,,,,,,,,,,,,,,456.96,83,,percent of total billed charges,,,523.02,95,,percent of total billed charges,,,495.5,90,,percent of total billed charges,,,495.5,90,,percent of total billed charges,,,451.45,82,,percent of total billed charges,,,495.5,90,,percent of total billed charges,,,467.97,85,,percent of total billed charges,,137.64,523.02,
TROCAR MAYO CATGUT 1/2 CIRCLE SZ4D,30181959,CDM,,,270,RC,outpatient,,55.27,55.27,,46.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.82,22,,percent of total billed charges,,,,,,,,,49.74,90,,percent of total billed charges,,,45.76,82.8,,percent of total billed charges,,,46.98,85,,percent of total billed charges,,,,,,,,,48.64,88,,percent of total billed charges,,,,,,,,,42.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.82,22,,percent of total billed charges,,,50.3,91,,percent of total billed charges,,,52.51,95,,percent of total billed charges,,,45.87,83,,percent of total billed charges,,,45.87,83,,percent of total billed charges,,,,,,,,,,,,,,,45.87,83,,percent of total billed charges,,,52.51,95,,percent of total billed charges,,,49.74,90,,percent of total billed charges,,,49.74,90,,percent of total billed charges,,,45.32,82,,percent of total billed charges,,,49.74,90,,percent of total billed charges,,,46.98,85,,percent of total billed charges,,13.82,52.51,
DEPUY LINER CONSTRAINED +4 SZ52,30181978,CDM,,,278,RC,outpatient,,35737.78,35737.78,,30341.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8934.45,22,,percent of total billed charges,,,,,,,,,32164,90,,percent of total billed charges,,,29590.88,82.8,,percent of total billed charges,,,30377.11,85,,percent of total billed charges,,,,,,,,,31449.25,88,,percent of total billed charges,,,,,,,,,27303.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8934.45,22,,percent of total billed charges,,,32521.38,91,,percent of total billed charges,,,33950.89,95,,percent of total billed charges,,,29662.36,83,,percent of total billed charges,,,29662.36,83,,percent of total billed charges,,,,,,,,,,,,,,,29662.36,83,,percent of total billed charges,,,33950.89,95,,percent of total billed charges,,,32164,90,,percent of total billed charges,,,32164,90,,percent of total billed charges,,,29304.98,82,,percent of total billed charges,,,32164,90,,percent of total billed charges,,,30377.11,85,,percent of total billed charges,,8934.45,33950.89,
DEPUY INSERT RP 12.5MM SZ4,30181980,CDM,,,278,RC,outpatient,,11480.69,11480.69,,9747.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2870.17,22,,percent of total billed charges,,,,,,,,,10332.62,90,,percent of total billed charges,,,9506.01,82.8,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,,,,,,,,10103.01,88,,percent of total billed charges,,,,,,,,,8771.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2870.17,22,,percent of total billed charges,,,10447.43,91,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,,,,,,,,,,,,,9528.97,83,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9414.17,82,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,2870.17,10906.66,
DEPUY UPCHARGE GRIPTON CUP(040),30181981,CDM,,,278,RC,outpatient,,2608.65,2608.65,,2214.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,652.16,22,,percent of total billed charges,,,,,,,,,2347.79,90,,percent of total billed charges,,,2159.96,82.8,,percent of total billed charges,,,2217.35,85,,percent of total billed charges,,,,,,,,,2295.61,88,,percent of total billed charges,,,,,,,,,1993.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,652.16,22,,percent of total billed charges,,,2373.87,91,,percent of total billed charges,,,2478.22,95,,percent of total billed charges,,,2165.18,83,,percent of total billed charges,,,2165.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2165.18,83,,percent of total billed charges,,,2478.22,95,,percent of total billed charges,,,2347.79,90,,percent of total billed charges,,,2347.79,90,,percent of total billed charges,,,2139.09,82,,percent of total billed charges,,,2347.79,90,,percent of total billed charges,,,2217.35,85,,percent of total billed charges,,652.16,2478.22,
DEPUY INSERT SIGMA XLK 2 X 12.5,30181982,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY WEDGE STEP 10MM SZ2,30181983,CDM,,,278,RC,outpatient,,13166.27,13166.27,,11178.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3291.57,22,,percent of total billed charges,,,,,,,,,11849.64,90,,percent of total billed charges,,,10901.67,82.8,,percent of total billed charges,,,11191.33,85,,percent of total billed charges,,,,,,,,,11586.32,88,,percent of total billed charges,,,,,,,,,10059.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3291.57,22,,percent of total billed charges,,,11981.31,91,,percent of total billed charges,,,12507.96,95,,percent of total billed charges,,,10928,83,,percent of total billed charges,,,10928,83,,percent of total billed charges,,,,,,,,,,,,,,,10928,83,,percent of total billed charges,,,12507.96,95,,percent of total billed charges,,,11849.64,90,,percent of total billed charges,,,11849.64,90,,percent of total billed charges,,,10796.34,82,,percent of total billed charges,,,11849.64,90,,percent of total billed charges,,,11191.33,85,,percent of total billed charges,,3291.57,12507.96,
DEPUY MODULAR PLUS TIBIAL TRAY SZ2,30181984,CDM,,,278,RC,outpatient,,25576.07,25576.07,,21714.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6394.02,22,,percent of total billed charges,,,,,,,,,23018.46,90,,percent of total billed charges,,,21176.99,82.8,,percent of total billed charges,,,21739.66,85,,percent of total billed charges,,,,,,,,,22506.94,88,,percent of total billed charges,,,,,,,,,19540.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6394.02,22,,percent of total billed charges,,,23274.22,91,,percent of total billed charges,,,24297.27,95,,percent of total billed charges,,,21228.14,83,,percent of total billed charges,,,21228.14,83,,percent of total billed charges,,,,,,,,,,,,,,,21228.14,83,,percent of total billed charges,,,24297.27,95,,percent of total billed charges,,,23018.46,90,,percent of total billed charges,,,23018.46,90,,percent of total billed charges,,,20972.38,82,,percent of total billed charges,,,23018.46,90,,percent of total billed charges,,,21739.66,85,,percent of total billed charges,,6394.02,24297.27,
SMOKE EVAPORATOR REDUCER,30181986,CDM,,,270,RC,outpatient,,51.04,51.04,,43.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.76,22,,percent of total billed charges,,,,,,,,,45.94,90,,percent of total billed charges,,,42.26,82.8,,percent of total billed charges,,,43.38,85,,percent of total billed charges,,,,,,,,,44.92,88,,percent of total billed charges,,,,,,,,,38.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.76,22,,percent of total billed charges,,,46.45,91,,percent of total billed charges,,,48.49,95,,percent of total billed charges,,,42.36,83,,percent of total billed charges,,,42.36,83,,percent of total billed charges,,,,,,,,,,,,,,,42.36,83,,percent of total billed charges,,,48.49,95,,percent of total billed charges,,,45.94,90,,percent of total billed charges,,,45.94,90,,percent of total billed charges,,,41.85,82,,percent of total billed charges,,,45.94,90,,percent of total billed charges,,,43.38,85,,percent of total billed charges,,12.76,48.49,
DEPUY MBT REVISION TIBIAL TRAY SZ3,30181987,CDM,,,278,RC,outpatient,,28838.62,28838.62,,24483.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7209.66,22,,percent of total billed charges,,,,,,,,,25954.76,90,,percent of total billed charges,,,23878.38,82.8,,percent of total billed charges,,,24512.83,85,,percent of total billed charges,,,,,,,,,25377.99,88,,percent of total billed charges,,,,,,,,,22032.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7209.66,22,,percent of total billed charges,,,26243.14,91,,percent of total billed charges,,,27396.69,95,,percent of total billed charges,,,23936.05,83,,percent of total billed charges,,,23936.05,83,,percent of total billed charges,,,,,,,,,,,,,,,23936.05,83,,percent of total billed charges,,,27396.69,95,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,23647.67,82,,percent of total billed charges,,,25954.76,90,,percent of total billed charges,,,24512.83,85,,percent of total billed charges,,7209.66,27396.69,
DEPUY POSTERIOR AUGMENT 8MM SZ3.0,30181988,CDM,,,278,RC,outpatient,,6245.14,6245.14,,5302.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1561.29,22,,percent of total billed charges,,,,,,,,,5620.63,90,,percent of total billed charges,,,5170.98,82.8,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,,,,,,,,5495.72,88,,percent of total billed charges,,,,,,,,,4771.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1561.29,22,,percent of total billed charges,,,5683.08,91,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,,,,,,,,,,,,,5183.47,83,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5121.01,82,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,1561.29,5932.88,
DEPUY MBT STEP WEDGE,30181989,CDM,,,278,RC,outpatient,,11378.45,11378.45,,9660.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2844.61,22,,percent of total billed charges,,,,,,,,,10240.61,90,,percent of total billed charges,,,9421.36,82.8,,percent of total billed charges,,,9671.68,85,,percent of total billed charges,,,,,,,,,10013.04,88,,percent of total billed charges,,,,,,,,,8693.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2844.61,22,,percent of total billed charges,,,10354.39,91,,percent of total billed charges,,,10809.53,95,,percent of total billed charges,,,9444.11,83,,percent of total billed charges,,,9444.11,83,,percent of total billed charges,,,,,,,,,,,,,,,9444.11,83,,percent of total billed charges,,,10809.53,95,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,9330.33,82,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,9671.68,85,,percent of total billed charges,,2844.61,10809.53,
DEPUY STEM FLUTED UNIV 75 X 14,30181990,CDM,,,278,RC,outpatient,,12911.21,12911.21,,10961.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3227.8,22,,percent of total billed charges,,,,,,,,,11620.09,90,,percent of total billed charges,,,10690.48,82.8,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,,,,,,,,11361.86,88,,percent of total billed charges,,,,,,,,,9864.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3227.8,22,,percent of total billed charges,,,11749.2,91,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,,,,,,,,,,,,,10716.3,83,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10587.19,82,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,3227.8,12265.65,
SYNTHES SCREW CANCEL 4.0X20MM,30181992,CDM,,,278,RC,outpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.78,22,,percent of total billed charges,,,,,,,,,200.82,90,,percent of total billed charges,,,184.75,82.8,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.78,22,,percent of total billed charges,,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,55.78,211.97,
DEPUY STEM CORAIL COLLERED SZ14,30181995,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
STAPLER LINEAR RELOAD 45MM,30182003,CDM,,,270,RC,outpatient,,884.59,884.59,,751.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,221.15,22,,percent of total billed charges,,,,,,,,,796.13,90,,percent of total billed charges,,,732.44,82.8,,percent of total billed charges,,,751.9,85,,percent of total billed charges,,,,,,,,,778.44,88,,percent of total billed charges,,,,,,,,,675.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,221.15,22,,percent of total billed charges,,,804.98,91,,percent of total billed charges,,,840.36,95,,percent of total billed charges,,,734.21,83,,percent of total billed charges,,,734.21,83,,percent of total billed charges,,,,,,,,,,,,,,,734.21,83,,percent of total billed charges,,,840.36,95,,percent of total billed charges,,,796.13,90,,percent of total billed charges,,,796.13,90,,percent of total billed charges,,,725.36,82,,percent of total billed charges,,,796.13,90,,percent of total billed charges,,,751.9,85,,percent of total billed charges,,221.15,840.36,
DEPUY STEM BOWED SZ18.0 X 10,30182004,CDM,,,278,RC,outpatient,,68800.94,68800.94,,58412,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17200.24,22,,percent of total billed charges,,,,,,,,,61920.85,90,,percent of total billed charges,,,56967.18,82.8,,percent of total billed charges,,,58480.8,85,,percent of total billed charges,,,,,,,,,60544.83,88,,percent of total billed charges,,,,,,,,,52563.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17200.24,22,,percent of total billed charges,,,62608.86,91,,percent of total billed charges,,,65360.89,95,,percent of total billed charges,,,57104.78,83,,percent of total billed charges,,,57104.78,83,,percent of total billed charges,,,,,,,,,,,,,,,57104.78,83,,percent of total billed charges,,,65360.89,95,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,56416.77,82,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,58480.8,85,,percent of total billed charges,,17200.24,65360.89,
DEPUY FEMUR TC3 LT SZ2.5,30182005,CDM,,,278,RC,outpatient,,36489.7,36489.7,,30979.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9122.43,22,,percent of total billed charges,,,,,,,,,32840.73,90,,percent of total billed charges,,,30213.47,82.8,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,,,,,,,,32110.94,88,,percent of total billed charges,,,,,,,,,27878.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9122.43,22,,percent of total billed charges,,,33205.63,91,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,,,,,,,,,,,,,30286.45,83,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,29921.55,82,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,9122.43,34665.22,
DEPUY INSERT TC3 RP 17.5MM SZ2.5,30182006,CDM,,,278,RC,outpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5779.25,22,,percent of total billed charges,,,,,,,,,20805.29,90,,percent of total billed charges,,,19140.87,82.8,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5779.25,22,,percent of total billed charges,,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,5779.25,21961.14,
DEPUY STEM FLUTED UNIV 75 X 10,30182007,CDM,,,278,RC,outpatient,,12911.21,12911.21,,10961.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3227.8,22,,percent of total billed charges,,,,,,,,,11620.09,90,,percent of total billed charges,,,10690.48,82.8,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,,,,,,,,11361.86,88,,percent of total billed charges,,,,,,,,,9864.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3227.8,22,,percent of total billed charges,,,11749.2,91,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,,,,,,,,,,,,,10716.3,83,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10587.19,82,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,3227.8,12265.65,
DEPUY INSERT LPS 14MM X-SMALL,30182008,CDM,,,278,RC,outpatient,,33343.12,33343.12,,28308.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8335.78,22,,percent of total billed charges,,,,,,,,,30008.81,90,,percent of total billed charges,,,27608.1,82.8,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,,,,,,,,29341.95,88,,percent of total billed charges,,,,,,,,,25474.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8335.78,22,,percent of total billed charges,,,30342.24,91,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,,,,,,,,,,,,,27674.79,83,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,27341.36,82,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,8335.78,31675.96,
DEPUY DISTAL AUGMENT LT 8MM SZ2.5,30182009,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
BIOMET ULTRADRIVE 180MM,30182010,CDM,,,270,RC,outpatient,,4283.5,4283.5,,3636.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1070.88,22,,percent of total billed charges,,,,,,,,,3855.15,90,,percent of total billed charges,,,3546.74,82.8,,percent of total billed charges,,,3640.98,85,,percent of total billed charges,,,,,,,,,3769.48,88,,percent of total billed charges,,,,,,,,,3272.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1070.88,22,,percent of total billed charges,,,3897.99,91,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3555.31,83,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3512.47,82,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3640.98,85,,percent of total billed charges,,1070.88,4069.33,
BIOMET ULTRA DRIVE 11MM DISK DRILL,30182011,CDM,,,270,RC,outpatient,,4283.5,4283.5,,3636.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1070.88,22,,percent of total billed charges,,,,,,,,,3855.15,90,,percent of total billed charges,,,3546.74,82.8,,percent of total billed charges,,,3640.98,85,,percent of total billed charges,,,,,,,,,3769.48,88,,percent of total billed charges,,,,,,,,,3272.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1070.88,22,,percent of total billed charges,,,3897.99,91,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3555.31,83,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3512.47,82,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3640.98,85,,percent of total billed charges,,1070.88,4069.33,
BIOMET ULTRADRIVE 60MM,30182012,CDM,,,270,RC,outpatient,,4524,4524,,3840.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1131,22,,percent of total billed charges,,,,,,,,,4071.6,90,,percent of total billed charges,,,3745.87,82.8,,percent of total billed charges,,,3845.4,85,,percent of total billed charges,,,,,,,,,3981.12,88,,percent of total billed charges,,,,,,,,,3456.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1131,22,,percent of total billed charges,,,4116.84,91,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,,,,,,,,,,,,,3754.92,83,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3709.68,82,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3845.4,85,,percent of total billed charges,,1131,4297.8,
BIOMET ULTRADRIVE IMPLANT KIT,30182013,CDM,,,270,RC,outpatient,,4283.5,4283.5,,3636.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1070.88,22,,percent of total billed charges,,,,,,,,,3855.15,90,,percent of total billed charges,,,3546.74,82.8,,percent of total billed charges,,,3640.98,85,,percent of total billed charges,,,,,,,,,3769.48,88,,percent of total billed charges,,,,,,,,,3272.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1070.88,22,,percent of total billed charges,,,3897.99,91,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3555.31,83,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3512.47,82,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3640.98,85,,percent of total billed charges,,1070.88,4069.33,
SPLINT DENVER LARGE,30182016,CDM,,,270,RC,outpatient,,265.5,265.5,,225.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.38,22,,percent of total billed charges,,,,,,,,,238.95,90,,percent of total billed charges,,,219.83,82.8,,percent of total billed charges,,,225.68,85,,percent of total billed charges,,,,,,,,,233.64,88,,percent of total billed charges,,,,,,,,,202.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.38,22,,percent of total billed charges,,,241.61,91,,percent of total billed charges,,,252.23,95,,percent of total billed charges,,,220.37,83,,percent of total billed charges,,,220.37,83,,percent of total billed charges,,,,,,,,,,,,,,,220.37,83,,percent of total billed charges,,,252.23,95,,percent of total billed charges,,,238.95,90,,percent of total billed charges,,,238.95,90,,percent of total billed charges,,,217.71,82,,percent of total billed charges,,,238.95,90,,percent of total billed charges,,,225.68,85,,percent of total billed charges,,66.38,252.23,
ELECTRODE CUTTING MONO 22FR,30182028,CDM,,,270,RC,outpatient,,648.45,648.45,,550.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,162.11,22,,percent of total billed charges,,,,,,,,,583.61,90,,percent of total billed charges,,,536.92,82.8,,percent of total billed charges,,,551.18,85,,percent of total billed charges,,,,,,,,,570.64,88,,percent of total billed charges,,,,,,,,,495.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,162.11,22,,percent of total billed charges,,,590.09,91,,percent of total billed charges,,,616.03,95,,percent of total billed charges,,,538.21,83,,percent of total billed charges,,,538.21,83,,percent of total billed charges,,,,,,,,,,,,,,,538.21,83,,percent of total billed charges,,,616.03,95,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,531.73,82,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,551.18,85,,percent of total billed charges,,162.11,616.03,
SYNTHES SCREW CANNUL 16MM 6.5X55MM,30182029,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
DEPUY SCREW LOCKING 48MM,30182030,CDM,,,278,RC,outpatient,,2237.76,2237.76,,1899.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,559.44,22,,percent of total billed charges,,,,,,,,,2013.98,90,,percent of total billed charges,,,1852.87,82.8,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,,,,,,,,1969.23,88,,percent of total billed charges,,,,,,,,,1709.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,559.44,22,,percent of total billed charges,,,2036.36,91,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1857.34,83,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1834.96,82,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,559.44,2125.87,
DEPUY HUMERAL CUP HI MOD 38+3,30182031,CDM,,,278,RC,outpatient,,9534.2,9534.2,,8094.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2383.55,22,,percent of total billed charges,,,,,,,,,8580.78,90,,percent of total billed charges,,,7894.32,82.8,,percent of total billed charges,,,8104.07,85,,percent of total billed charges,,,,,,,,,8390.1,88,,percent of total billed charges,,,,,,,,,7284.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2383.55,22,,percent of total billed charges,,,8676.12,91,,percent of total billed charges,,,9057.49,95,,percent of total billed charges,,,7913.39,83,,percent of total billed charges,,,7913.39,83,,percent of total billed charges,,,,,,,,,,,,,,,7913.39,83,,percent of total billed charges,,,9057.49,95,,percent of total billed charges,,,8580.78,90,,percent of total billed charges,,,8580.78,90,,percent of total billed charges,,,7818.04,82,,percent of total billed charges,,,8580.78,90,,percent of total billed charges,,,8104.07,85,,percent of total billed charges,,2383.55,9057.49,
DEPUY STEM HUMERAL SZ8,30182032,CDM,,,278,RC,outpatient,,35653.09,35653.09,,30269.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8913.27,22,,percent of total billed charges,,,,,,,,,32087.78,90,,percent of total billed charges,,,29520.76,82.8,,percent of total billed charges,,,30305.13,85,,percent of total billed charges,,,,,,,,,31374.72,88,,percent of total billed charges,,,,,,,,,27238.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8913.27,22,,percent of total billed charges,,,32444.31,91,,percent of total billed charges,,,33870.44,95,,percent of total billed charges,,,29592.06,83,,percent of total billed charges,,,29592.06,83,,percent of total billed charges,,,,,,,,,,,,,,,29592.06,83,,percent of total billed charges,,,33870.44,95,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,29235.53,82,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,30305.13,85,,percent of total billed charges,,8913.27,33870.44,
DEPUY PINNACLE CUP W/GRIPTION 62MM,30182036,CDM,,,278,RC,outpatient,,31783.05,31783.05,,26983.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7945.76,22,,percent of total billed charges,,,,,,,,,28604.75,90,,percent of total billed charges,,,26316.37,82.8,,percent of total billed charges,,,27015.59,85,,percent of total billed charges,,,,,,,,,27969.08,88,,percent of total billed charges,,,,,,,,,24282.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7945.76,22,,percent of total billed charges,,,28922.58,91,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,,,,,,,,,,,,,26379.93,83,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,26062.1,82,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,27015.59,85,,percent of total billed charges,,7945.76,30193.9,
DEPUY LINER CONSTRAINED +4 SZ56,30182037,CDM,,,278,RC,outpatient,,36991.5,36991.5,,31405.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9247.88,22,,percent of total billed charges,,,,,,,,,33292.35,90,,percent of total billed charges,,,30628.96,82.8,,percent of total billed charges,,,31442.78,85,,percent of total billed charges,,,,,,,,,32552.52,88,,percent of total billed charges,,,,,,,,,28261.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9247.88,22,,percent of total billed charges,,,33662.27,91,,percent of total billed charges,,,35141.93,95,,percent of total billed charges,,,30702.95,83,,percent of total billed charges,,,30702.95,83,,percent of total billed charges,,,,,,,,,,,,,,,30702.95,83,,percent of total billed charges,,,35141.93,95,,percent of total billed charges,,,33292.35,90,,percent of total billed charges,,,33292.35,90,,percent of total billed charges,,,30333.03,82,,percent of total billed charges,,,33292.35,90,,percent of total billed charges,,,31442.78,85,,percent of total billed charges,,9247.88,35141.93,
DEPUY PINNACLE SCREW 40MM,30182038,CDM,,,278,RC,outpatient,,987.87,987.87,,838.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,246.97,22,,percent of total billed charges,,,,,,,,,889.08,90,,percent of total billed charges,,,817.96,82.8,,percent of total billed charges,,,839.69,85,,percent of total billed charges,,,,,,,,,869.33,88,,percent of total billed charges,,,,,,,,,754.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,246.97,22,,percent of total billed charges,,,898.96,91,,percent of total billed charges,,,938.48,95,,percent of total billed charges,,,819.93,83,,percent of total billed charges,,,819.93,83,,percent of total billed charges,,,,,,,,,,,,,,,819.93,83,,percent of total billed charges,,,938.48,95,,percent of total billed charges,,,889.08,90,,percent of total billed charges,,,889.08,90,,percent of total billed charges,,,810.05,82,,percent of total billed charges,,,889.08,90,,percent of total billed charges,,,839.69,85,,percent of total billed charges,,246.97,938.48,
INTEROCCULAR EYE PACK,30182041,CDM,,,270,RC,outpatient,,353.85,353.85,,300.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.46,22,,percent of total billed charges,,,,,,,,,318.47,90,,percent of total billed charges,,,292.99,82.8,,percent of total billed charges,,,300.77,85,,percent of total billed charges,,,,,,,,,311.39,88,,percent of total billed charges,,,,,,,,,270.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.46,22,,percent of total billed charges,,,322,91,,percent of total billed charges,,,336.16,95,,percent of total billed charges,,,293.7,83,,percent of total billed charges,,,293.7,83,,percent of total billed charges,,,,,,,,,,,,,,,293.7,83,,percent of total billed charges,,,336.16,95,,percent of total billed charges,,,318.47,90,,percent of total billed charges,,,318.47,90,,percent of total billed charges,,,290.16,82,,percent of total billed charges,,,318.47,90,,percent of total billed charges,,,300.77,85,,percent of total billed charges,,88.46,336.16,
DEPUY INSERT TC3 RP 10MM SZ2.5,30182042,CDM,,,278,RC,outpatient,,15465.58,15465.58,,13130.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3866.4,22,,percent of total billed charges,,,,,,,,,13919.02,90,,percent of total billed charges,,,12805.5,82.8,,percent of total billed charges,,,13145.74,85,,percent of total billed charges,,,,,,,,,13609.71,88,,percent of total billed charges,,,,,,,,,11815.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3866.4,22,,percent of total billed charges,,,14073.68,91,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,,,,,,,,,,,,,12836.43,83,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,12681.78,82,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13145.74,85,,percent of total billed charges,,3866.4,14692.3,
DEPUY PINNACLE CUP MULTIHOLE 52MM,30182043,CDM,,,278,RC,outpatient,,26741.78,26741.78,,22703.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6685.45,22,,percent of total billed charges,,,,,,,,,24067.6,90,,percent of total billed charges,,,22142.19,82.8,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,,,,,,,,23532.77,88,,percent of total billed charges,,,,,,,,,20430.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6685.45,22,,percent of total billed charges,,,24335.02,91,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,,,,,,,,,,,,,22195.68,83,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,21928.26,82,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,6685.45,25404.69,
DEPUY LINER CONSTRAINED +4 32 X 52,30182044,CDM,,,278,RC,outpatient,,36635.17,36635.17,,31103.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9158.79,22,,percent of total billed charges,,,,,,,,,32971.65,90,,percent of total billed charges,,,30333.92,82.8,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,,,,,,,,32238.95,88,,percent of total billed charges,,,,,,,,,27989.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9158.79,22,,percent of total billed charges,,,33338,91,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,,,,,,,,,,,,,30407.19,83,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,30040.84,82,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,9158.79,34803.41,
GYRUS BERKELEY VACURETTE 8MM,30182046,CDM,,,270,RC,outpatient,,43.7,43.7,,37.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.93,22,,percent of total billed charges,,,,,,,,,39.33,90,,percent of total billed charges,,,36.18,82.8,,percent of total billed charges,,,37.15,85,,percent of total billed charges,,,,,,,,,38.46,88,,percent of total billed charges,,,,,,,,,33.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.93,22,,percent of total billed charges,,,39.77,91,,percent of total billed charges,,,41.52,95,,percent of total billed charges,,,36.27,83,,percent of total billed charges,,,36.27,83,,percent of total billed charges,,,,,,,,,,,,,,,36.27,83,,percent of total billed charges,,,41.52,95,,percent of total billed charges,,,39.33,90,,percent of total billed charges,,,39.33,90,,percent of total billed charges,,,35.83,82,,percent of total billed charges,,,39.33,90,,percent of total billed charges,,,37.15,85,,percent of total billed charges,,10.93,41.52,
GYRUS FALOPE RING BAND,30182047,CDM,,,270,RC,outpatient,,831.88,831.88,,706.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,207.97,22,,percent of total billed charges,,,,,,,,,748.69,90,,percent of total billed charges,,,688.8,82.8,,percent of total billed charges,,,707.1,85,,percent of total billed charges,,,,,,,,,732.05,88,,percent of total billed charges,,,,,,,,,635.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,207.97,22,,percent of total billed charges,,,757.01,91,,percent of total billed charges,,,790.29,95,,percent of total billed charges,,,690.46,83,,percent of total billed charges,,,690.46,83,,percent of total billed charges,,,,,,,,,,,,,,,690.46,83,,percent of total billed charges,,,790.29,95,,percent of total billed charges,,,748.69,90,,percent of total billed charges,,,748.69,90,,percent of total billed charges,,,682.14,82,,percent of total billed charges,,,748.69,90,,percent of total billed charges,,,707.1,85,,percent of total billed charges,,207.97,790.29,
STRYKER ULTRA PLUME AWAY 6.0,30182051,CDM,,,270,RC,outpatient,,187.58,187.58,,159.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.9,22,,percent of total billed charges,,,,,,,,,168.82,90,,percent of total billed charges,,,155.32,82.8,,percent of total billed charges,,,159.44,85,,percent of total billed charges,,,,,,,,,165.07,88,,percent of total billed charges,,,,,,,,,143.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.9,22,,percent of total billed charges,,,170.7,91,,percent of total billed charges,,,178.2,95,,percent of total billed charges,,,155.69,83,,percent of total billed charges,,,155.69,83,,percent of total billed charges,,,,,,,,,,,,,,,155.69,83,,percent of total billed charges,,,178.2,95,,percent of total billed charges,,,168.82,90,,percent of total billed charges,,,168.82,90,,percent of total billed charges,,,153.82,82,,percent of total billed charges,,,168.82,90,,percent of total billed charges,,,159.44,85,,percent of total billed charges,,46.9,178.2,
DEPUY PINNACLE CUP SECTOR II 62MM,30182054,CDM,,,278,RC,outpatient,,18892.32,18892.32,,16039.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4723.08,22,,percent of total billed charges,,,,,,,,,17003.09,90,,percent of total billed charges,,,15642.84,82.8,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,,,,,,,,16625.24,88,,percent of total billed charges,,,,,,,,,14433.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4723.08,22,,percent of total billed charges,,,17192.01,91,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,15680.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15680.63,83,,percent of total billed charges,,,17947.7,95,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,15491.7,82,,percent of total billed charges,,,17003.09,90,,percent of total billed charges,,,16058.47,85,,percent of total billed charges,,4723.08,17947.7,
INTERSPACE HIP SPACER 54MM,30182055,CDM,,,278,RC,outpatient,,22295,22295,,18928.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5573.75,22,,percent of total billed charges,,,,,,,,,20065.5,90,,percent of total billed charges,,,18460.26,82.8,,percent of total billed charges,,,18950.75,85,,percent of total billed charges,,,,,,,,,19619.6,88,,percent of total billed charges,,,,,,,,,17033.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5573.75,22,,percent of total billed charges,,,20288.45,91,,percent of total billed charges,,,21180.25,95,,percent of total billed charges,,,18504.85,83,,percent of total billed charges,,,18504.85,83,,percent of total billed charges,,,,,,,,,,,,,,,18504.85,83,,percent of total billed charges,,,21180.25,95,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,18281.9,82,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,18950.75,85,,percent of total billed charges,,5573.75,21180.25,
DEPUY INSERT RP 10MM SZ3,30182057,CDM,,,278,RC,outpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3253.11,22,,percent of total billed charges,,,,,,,,,11711.18,90,,percent of total billed charges,,,10774.28,82.8,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3253.11,22,,percent of total billed charges,,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,3253.11,12361.8,
DEPUY FEMUR SIGMA PS LT SZ3,30182058,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
BIOMET ULTRA DRIVE 7MM DISK DRILL,30182059,CDM,,,270,RC,outpatient,,4283.5,4283.5,,3636.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1070.88,22,,percent of total billed charges,,,,,,,,,3855.15,90,,percent of total billed charges,,,3546.74,82.8,,percent of total billed charges,,,3640.98,85,,percent of total billed charges,,,,,,,,,3769.48,88,,percent of total billed charges,,,,,,,,,3272.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1070.88,22,,percent of total billed charges,,,3897.99,91,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3555.31,83,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3512.47,82,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3640.98,85,,percent of total billed charges,,1070.88,4069.33,
DEPUY STEM FLUTED UNIV 150 X 10,30182060,CDM,,,278,RC,outpatient,,12911.21,12911.21,,10961.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3227.8,22,,percent of total billed charges,,,,,,,,,11620.09,90,,percent of total billed charges,,,10690.48,82.8,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,,,,,,,,11361.86,88,,percent of total billed charges,,,,,,,,,9864.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3227.8,22,,percent of total billed charges,,,11749.2,91,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,,,,,,,,,,,,,10716.3,83,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10587.19,82,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,3227.8,12265.65,
DEPUY FEMUR TC3 LT SZ2,30182061,CDM,,,278,RC,outpatient,,48160.65,48160.65,,40888.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12040.16,22,,percent of total billed charges,,,,,,,,,43344.59,90,,percent of total billed charges,,,39877.02,82.8,,percent of total billed charges,,,40936.55,85,,percent of total billed charges,,,,,,,,,42381.37,88,,percent of total billed charges,,,,,,,,,36794.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12040.16,22,,percent of total billed charges,,,43826.19,91,,percent of total billed charges,,,45752.62,95,,percent of total billed charges,,,39973.34,83,,percent of total billed charges,,,39973.34,83,,percent of total billed charges,,,,,,,,,,,,,,,39973.34,83,,percent of total billed charges,,,45752.62,95,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,39491.73,82,,percent of total billed charges,,,43344.59,90,,percent of total billed charges,,,40936.55,85,,percent of total billed charges,,12040.16,45752.62,
DEPUY INSERT TC3 12.5MM SZ2,30182062,CDM,,,278,RC,outpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5779.25,22,,percent of total billed charges,,,,,,,,,20805.29,90,,percent of total billed charges,,,19140.87,82.8,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5779.25,22,,percent of total billed charges,,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,5779.25,21961.14,
DEPUY MBT REVISION TIBIAL TRAY SZ2,30182063,CDM,,,278,RC,outpatient,,39076.7,39076.7,,33176.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9769.18,22,,percent of total billed charges,,,,,,,,,35169.03,90,,percent of total billed charges,,,32355.51,82.8,,percent of total billed charges,,,33215.2,85,,percent of total billed charges,,,,,,,,,34387.5,88,,percent of total billed charges,,,,,,,,,29854.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9769.18,22,,percent of total billed charges,,,35559.8,91,,percent of total billed charges,,,37122.87,95,,percent of total billed charges,,,32433.66,83,,percent of total billed charges,,,32433.66,83,,percent of total billed charges,,,,,,,,,,,,,,,32433.66,83,,percent of total billed charges,,,37122.87,95,,percent of total billed charges,,,35169.03,90,,percent of total billed charges,,,35169.03,90,,percent of total billed charges,,,32042.89,82,,percent of total billed charges,,,35169.03,90,,percent of total billed charges,,,33215.2,85,,percent of total billed charges,,9769.18,37122.87,
DEPUY MODULAR PLUS TIBIAL TRAY SZ2.5,30182086,CDM,,,278,RC,outpatient,,25576.07,25576.07,,21714.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6394.02,22,,percent of total billed charges,,,,,,,,,23018.46,90,,percent of total billed charges,,,21176.99,82.8,,percent of total billed charges,,,21739.66,85,,percent of total billed charges,,,,,,,,,22506.94,88,,percent of total billed charges,,,,,,,,,19540.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6394.02,22,,percent of total billed charges,,,23274.22,91,,percent of total billed charges,,,24297.27,95,,percent of total billed charges,,,21228.14,83,,percent of total billed charges,,,21228.14,83,,percent of total billed charges,,,,,,,,,,,,,,,21228.14,83,,percent of total billed charges,,,24297.27,95,,percent of total billed charges,,,23018.46,90,,percent of total billed charges,,,23018.46,90,,percent of total billed charges,,,20972.38,82,,percent of total billed charges,,,23018.46,90,,percent of total billed charges,,,21739.66,85,,percent of total billed charges,,6394.02,24297.27,
DEPUY WEDGE STEP 10MM SZ2.5,30182087,CDM,,,278,RC,outpatient,,13166.27,13166.27,,11178.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3291.57,22,,percent of total billed charges,,,,,,,,,11849.64,90,,percent of total billed charges,,,10901.67,82.8,,percent of total billed charges,,,11191.33,85,,percent of total billed charges,,,,,,,,,11586.32,88,,percent of total billed charges,,,,,,,,,10059.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3291.57,22,,percent of total billed charges,,,11981.31,91,,percent of total billed charges,,,12507.96,95,,percent of total billed charges,,,10928,83,,percent of total billed charges,,,10928,83,,percent of total billed charges,,,,,,,,,,,,,,,10928,83,,percent of total billed charges,,,12507.96,95,,percent of total billed charges,,,11849.64,90,,percent of total billed charges,,,11849.64,90,,percent of total billed charges,,,10796.34,82,,percent of total billed charges,,,11849.64,90,,percent of total billed charges,,,11191.33,85,,percent of total billed charges,,3291.57,12507.96,
DEPUY MBT REVISION TIBIAL TRAY SZ2 15MM,30182088,CDM,,,278,RC,outpatient,,51595.57,51595.57,,43804.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12898.89,22,,percent of total billed charges,,,,,,,,,46436.01,90,,percent of total billed charges,,,42721.13,82.8,,percent of total billed charges,,,43856.23,85,,percent of total billed charges,,,,,,,,,45404.1,88,,percent of total billed charges,,,,,,,,,39419.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12898.89,22,,percent of total billed charges,,,46951.97,91,,percent of total billed charges,,,49015.79,95,,percent of total billed charges,,,42824.32,83,,percent of total billed charges,,,42824.32,83,,percent of total billed charges,,,,,,,,,,,,,,,42824.32,83,,percent of total billed charges,,,49015.79,95,,percent of total billed charges,,,46436.01,90,,percent of total billed charges,,,46436.01,90,,percent of total billed charges,,,42308.37,82,,percent of total billed charges,,,46436.01,90,,percent of total billed charges,,,43856.23,85,,percent of total billed charges,,12898.89,49015.79,
ALLODERM 6 X 16,30182089,CDM,,,278,RC,outpatient,,24804,24804,,21058.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6201,22,,percent of total billed charges,,,,,,,,,22323.6,90,,percent of total billed charges,,,20537.71,82.8,,percent of total billed charges,,,21083.4,85,,percent of total billed charges,,,,,,,,,21827.52,88,,percent of total billed charges,,,,,,,,,18950.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6201,22,,percent of total billed charges,,,22571.64,91,,percent of total billed charges,,,23563.8,95,,percent of total billed charges,,,20587.32,83,,percent of total billed charges,,,20587.32,83,,percent of total billed charges,,,,,,,,,,,,,,,20587.32,83,,percent of total billed charges,,,23563.8,95,,percent of total billed charges,,,22323.6,90,,percent of total billed charges,,,22323.6,90,,percent of total billed charges,,,20339.28,82,,percent of total billed charges,,,22323.6,90,,percent of total billed charges,,,21083.4,85,,percent of total billed charges,,6201,23563.8,
ALLERGAN TISSUE EXPANDER,30182090,CDM,,,278,RC,outpatient,,9067.5,9067.5,,7698.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2266.88,22,,percent of total billed charges,,,,,,,,,8160.75,90,,percent of total billed charges,,,7507.89,82.8,,percent of total billed charges,,,7707.38,85,,percent of total billed charges,,,,,,,,,7979.4,88,,percent of total billed charges,,,,,,,,,6927.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2266.88,22,,percent of total billed charges,,,8251.43,91,,percent of total billed charges,,,8614.13,95,,percent of total billed charges,,,7526.03,83,,percent of total billed charges,,,7526.03,83,,percent of total billed charges,,,,,,,,,,,,,,,7526.03,83,,percent of total billed charges,,,8614.13,95,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,7435.35,82,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,7707.38,85,,percent of total billed charges,,2266.88,8614.13,
ALLERGAN TISSUE EXPANDER 400CC,30182091,CDM,,,278,RC,outpatient,,9067.5,9067.5,,7698.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2266.88,22,,percent of total billed charges,,,,,,,,,8160.75,90,,percent of total billed charges,,,7507.89,82.8,,percent of total billed charges,,,7707.38,85,,percent of total billed charges,,,,,,,,,7979.4,88,,percent of total billed charges,,,,,,,,,6927.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2266.88,22,,percent of total billed charges,,,8251.43,91,,percent of total billed charges,,,8614.13,95,,percent of total billed charges,,,7526.03,83,,percent of total billed charges,,,7526.03,83,,percent of total billed charges,,,,,,,,,,,,,,,7526.03,83,,percent of total billed charges,,,8614.13,95,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,7435.35,82,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,7707.38,85,,percent of total billed charges,,2266.88,8614.13,
SYNTHES K-WIRE THREADED 2.5MM,30182094,CDM,,,278,RC,outpatient,,203.36,203.36,,172.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.84,22,,percent of total billed charges,,,,,,,,,183.02,90,,percent of total billed charges,,,168.38,82.8,,percent of total billed charges,,,172.86,85,,percent of total billed charges,,,,,,,,,178.96,88,,percent of total billed charges,,,,,,,,,155.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.84,22,,percent of total billed charges,,,185.06,91,,percent of total billed charges,,,193.19,95,,percent of total billed charges,,,168.79,83,,percent of total billed charges,,,168.79,83,,percent of total billed charges,,,,,,,,,,,,,,,168.79,83,,percent of total billed charges,,,193.19,95,,percent of total billed charges,,,183.02,90,,percent of total billed charges,,,183.02,90,,percent of total billed charges,,,166.76,82,,percent of total billed charges,,,183.02,90,,percent of total billed charges,,,172.86,85,,percent of total billed charges,,50.84,193.19,
SYNTHES ROD CARBON FIBER 220MM,30182096,CDM,,,278,RC,outpatient,,1530.43,1530.43,,1299.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,382.61,22,,percent of total billed charges,,,,,,,,,1377.39,90,,percent of total billed charges,,,1267.2,82.8,,percent of total billed charges,,,1300.87,85,,percent of total billed charges,,,,,,,,,1346.78,88,,percent of total billed charges,,,,,,,,,1169.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,382.61,22,,percent of total billed charges,,,1392.69,91,,percent of total billed charges,,,1453.91,95,,percent of total billed charges,,,1270.26,83,,percent of total billed charges,,,1270.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1270.26,83,,percent of total billed charges,,,1453.91,95,,percent of total billed charges,,,1377.39,90,,percent of total billed charges,,,1377.39,90,,percent of total billed charges,,,1254.95,82,,percent of total billed charges,,,1377.39,90,,percent of total billed charges,,,1300.87,85,,percent of total billed charges,,382.61,1453.91,
INTERSPACE HIP SPACER 46MM,30182097,CDM,,,278,RC,outpatient,,22295,22295,,18928.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5573.75,22,,percent of total billed charges,,,,,,,,,20065.5,90,,percent of total billed charges,,,18460.26,82.8,,percent of total billed charges,,,18950.75,85,,percent of total billed charges,,,,,,,,,19619.6,88,,percent of total billed charges,,,,,,,,,17033.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5573.75,22,,percent of total billed charges,,,20288.45,91,,percent of total billed charges,,,21180.25,95,,percent of total billed charges,,,18504.85,83,,percent of total billed charges,,,18504.85,83,,percent of total billed charges,,,,,,,,,,,,,,,18504.85,83,,percent of total billed charges,,,21180.25,95,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,18281.9,82,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,18950.75,85,,percent of total billed charges,,5573.75,21180.25,
DEPUY LINER CONSTRAINED +4 SZ50,30182098,CDM,,,278,RC,outpatient,,33951.78,33951.78,,28825.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8487.95,22,,percent of total billed charges,,,,,,,,,30556.6,90,,percent of total billed charges,,,28112.07,82.8,,percent of total billed charges,,,28859.01,85,,percent of total billed charges,,,,,,,,,29877.57,88,,percent of total billed charges,,,,,,,,,25939.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8487.95,22,,percent of total billed charges,,,30896.12,91,,percent of total billed charges,,,32254.19,95,,percent of total billed charges,,,28179.98,83,,percent of total billed charges,,,28179.98,83,,percent of total billed charges,,,,,,,,,,,,,,,28179.98,83,,percent of total billed charges,,,32254.19,95,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,27840.46,82,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,28859.01,85,,percent of total billed charges,,8487.95,32254.19,
DEPUY STEM BOWED SZ16.5 X 7,30182099,CDM,,,278,RC,outpatient,,66522.3,66522.3,,56477.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16630.58,22,,percent of total billed charges,,,,,,,,,59870.07,90,,percent of total billed charges,,,55080.46,82.8,,percent of total billed charges,,,56543.96,85,,percent of total billed charges,,,,,,,,,58539.62,88,,percent of total billed charges,,,,,,,,,50823.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16630.58,22,,percent of total billed charges,,,60535.29,91,,percent of total billed charges,,,63196.19,95,,percent of total billed charges,,,55213.51,83,,percent of total billed charges,,,55213.51,83,,percent of total billed charges,,,,,,,,,,,,,,,55213.51,83,,percent of total billed charges,,,63196.19,95,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,54548.29,82,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,56543.96,85,,percent of total billed charges,,16630.58,63196.19,
TROCAR ENDO DILATING TIP 12MM,30182101,CDM,,,270,RC,outpatient,,184,184,,156.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46,22,,percent of total billed charges,,,,,,,,,165.6,90,,percent of total billed charges,,,152.35,82.8,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,,,,,,,,161.92,88,,percent of total billed charges,,,,,,,,,140.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46,22,,percent of total billed charges,,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,,,,,,,,,,,,,152.72,83,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,150.88,82,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,46,174.8,
TROCAR ENDO DILATING TIP 5MM,30182102,CDM,,,270,RC,outpatient,,184,184,,156.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46,22,,percent of total billed charges,,,,,,,,,165.6,90,,percent of total billed charges,,,152.35,82.8,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,,,,,,,,161.92,88,,percent of total billed charges,,,,,,,,,140.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46,22,,percent of total billed charges,,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,,,,,,,,,,,,,152.72,83,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,150.88,82,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,46,174.8,
DEPUY DISTAL AUGMENT LT 12MM SZ3.0,30182103,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
DEPUY ANCHOR PEG GLENOID 44MM,30182104,CDM,,,278,RC,outpatient,,17098.9,17098.9,,14516.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4274.73,22,,percent of total billed charges,,,,,,,,,15389.01,90,,percent of total billed charges,,,14157.89,82.8,,percent of total billed charges,,,14534.07,85,,percent of total billed charges,,,,,,,,,15047.03,88,,percent of total billed charges,,,,,,,,,13063.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4274.73,22,,percent of total billed charges,,,15560,91,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,,,,,,,,,,,,,14192.09,83,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14021.1,82,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14534.07,85,,percent of total billed charges,,4274.73,16243.96,
REFLUX DISPENSING PIN,30182112,CDM,,,270,RC,outpatient,,18.36,18.36,,15.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.59,22,,percent of total billed charges,,,,,,,,,16.52,90,,percent of total billed charges,,,15.2,82.8,,percent of total billed charges,,,15.61,85,,percent of total billed charges,,,,,,,,,16.16,88,,percent of total billed charges,,,,,,,,,14.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.59,22,,percent of total billed charges,,,16.71,91,,percent of total billed charges,,,17.44,95,,percent of total billed charges,,,15.24,83,,percent of total billed charges,,,15.24,83,,percent of total billed charges,,,,,,,,,,,,,,,15.24,83,,percent of total billed charges,,,17.44,95,,percent of total billed charges,,,16.52,90,,percent of total billed charges,,,16.52,90,,percent of total billed charges,,,15.06,82,,percent of total billed charges,,,16.52,90,,percent of total billed charges,,,15.61,85,,percent of total billed charges,,4.59,17.44,
COLOPLAST RESERVOIR,30182127,CDM,,,278,RC,outpatient,,10887.5,10887.5,,9243.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2721.88,22,,percent of total billed charges,,,,,,,,,9798.75,90,,percent of total billed charges,,,9014.85,82.8,,percent of total billed charges,,,9254.38,85,,percent of total billed charges,,,,,,,,,9581,88,,percent of total billed charges,,,,,,,,,8318.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2721.88,22,,percent of total billed charges,,,9907.63,91,,percent of total billed charges,,,10343.13,95,,percent of total billed charges,,,9036.63,83,,percent of total billed charges,,,9036.63,83,,percent of total billed charges,,,,,,,,,,,,,,,9036.63,83,,percent of total billed charges,,,10343.13,95,,percent of total billed charges,,,9798.75,90,,percent of total billed charges,,,9798.75,90,,percent of total billed charges,,,8927.75,82,,percent of total billed charges,,,9798.75,90,,percent of total billed charges,,,9254.38,85,,percent of total billed charges,,2721.88,10343.13,
COLOPLAST CYLINDERS/PUMP,30182128,CDM,,,278,RC,outpatient,,44616,44616,,37878.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11154,22,,percent of total billed charges,,,,,,,,,40154.4,90,,percent of total billed charges,,,36942.05,82.8,,percent of total billed charges,,,37923.6,85,,percent of total billed charges,,,,,,,,,39262.08,88,,percent of total billed charges,,,,,,,,,34086.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11154,22,,percent of total billed charges,,,40600.56,91,,percent of total billed charges,,,42385.2,95,,percent of total billed charges,,,37031.28,83,,percent of total billed charges,,,37031.28,83,,percent of total billed charges,,,,,,,,,,,,,,,37031.28,83,,percent of total billed charges,,,42385.2,95,,percent of total billed charges,,,40154.4,90,,percent of total billed charges,,,40154.4,90,,percent of total billed charges,,,36585.12,82,,percent of total billed charges,,,40154.4,90,,percent of total billed charges,,,37923.6,85,,percent of total billed charges,,11154,42385.2,
SYNTHES ROD CARBON FIBER 200MM,30182137,CDM,,,278,RC,outpatient,,1623.64,1623.64,,1378.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,405.91,22,,percent of total billed charges,,,,,,,,,1461.28,90,,percent of total billed charges,,,1344.37,82.8,,percent of total billed charges,,,1380.09,85,,percent of total billed charges,,,,,,,,,1428.8,88,,percent of total billed charges,,,,,,,,,1240.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,405.91,22,,percent of total billed charges,,,1477.51,91,,percent of total billed charges,,,1542.46,95,,percent of total billed charges,,,1347.62,83,,percent of total billed charges,,,1347.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1347.62,83,,percent of total billed charges,,,1542.46,95,,percent of total billed charges,,,1461.28,90,,percent of total billed charges,,,1461.28,90,,percent of total billed charges,,,1331.38,82,,percent of total billed charges,,,1461.28,90,,percent of total billed charges,,,1380.09,85,,percent of total billed charges,,405.91,1542.46,
DEPUY DISTAL AUGMENT LT 8MM SZ3.0,30182138,CDM,,,278,RC,outpatient,,6245.14,6245.14,,5302.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1561.29,22,,percent of total billed charges,,,,,,,,,5620.63,90,,percent of total billed charges,,,5170.98,82.8,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,,,,,,,,5495.72,88,,percent of total billed charges,,,,,,,,,4771.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1561.29,22,,percent of total billed charges,,,5683.08,91,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,,,,,,,,,,,,,5183.47,83,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5121.01,82,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,1561.29,5932.88,
DEPUY SPACER TAPERED 12/14,30182139,CDM,,,278,RC,outpatient,,1935.57,1935.57,,1643.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.89,22,,percent of total billed charges,,,,,,,,,1742.01,90,,percent of total billed charges,,,1602.65,82.8,,percent of total billed charges,,,1645.23,85,,percent of total billed charges,,,,,,,,,1703.3,88,,percent of total billed charges,,,,,,,,,1478.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.89,22,,percent of total billed charges,,,1761.37,91,,percent of total billed charges,,,1838.79,95,,percent of total billed charges,,,1606.52,83,,percent of total billed charges,,,1606.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1606.52,83,,percent of total billed charges,,,1838.79,95,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1587.17,82,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1645.23,85,,percent of total billed charges,,483.89,1838.79,
DEPUY OSTEOTOME THIN 8MM X 5,30182149,CDM,,,278,RC,outpatient,,2970.5,2970.5,,2521.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,742.63,22,,percent of total billed charges,,,,,,,,,2673.45,90,,percent of total billed charges,,,2459.57,82.8,,percent of total billed charges,,,2524.93,85,,percent of total billed charges,,,,,,,,,2614.04,88,,percent of total billed charges,,,,,,,,,2269.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,742.63,22,,percent of total billed charges,,,2703.16,91,,percent of total billed charges,,,2821.98,95,,percent of total billed charges,,,2465.52,83,,percent of total billed charges,,,2465.52,83,,percent of total billed charges,,,,,,,,,,,,,,,2465.52,83,,percent of total billed charges,,,2821.98,95,,percent of total billed charges,,,2673.45,90,,percent of total billed charges,,,2673.45,90,,percent of total billed charges,,,2435.81,82,,percent of total billed charges,,,2673.45,90,,percent of total billed charges,,,2524.93,85,,percent of total billed charges,,742.63,2821.98,
DEPUY LINER ALTRX NEUT 32 X 52,30182161,CDM,,,278,RC,outpatient,,10422.17,10422.17,,8848.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2605.54,22,,percent of total billed charges,,,,,,,,,9379.95,90,,percent of total billed charges,,,8629.56,82.8,,percent of total billed charges,,,8858.84,85,,percent of total billed charges,,,,,,,,,9171.51,88,,percent of total billed charges,,,,,,,,,7962.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2605.54,22,,percent of total billed charges,,,9484.17,91,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,,,,,,,,,,,,,8650.4,83,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8546.18,82,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8858.84,85,,percent of total billed charges,,2605.54,9901.06,
DEPUY SCREW BONE 60 X 5.0,30182163,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
DEPUY PINNACLE CUP W/GRIPTION 56MM,30182164,CDM,,,278,RC,outpatient,,31783.05,31783.05,,26983.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7945.76,22,,percent of total billed charges,,,,,,,,,28604.75,90,,percent of total billed charges,,,26316.37,82.8,,percent of total billed charges,,,27015.59,85,,percent of total billed charges,,,,,,,,,27969.08,88,,percent of total billed charges,,,,,,,,,24282.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7945.76,22,,percent of total billed charges,,,28922.58,91,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,,,,,,,,,,,,,26379.93,83,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,26062.1,82,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,27015.59,85,,percent of total billed charges,,7945.76,30193.9,
HIP GRIP COVERSETS ANTERIOR PELVIC,30182165,CDM,,,270,RC,outpatient,,10.89,10.89,,9.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.72,22,,percent of total billed charges,,,,,,,,,9.8,90,,percent of total billed charges,,,9.02,82.8,,percent of total billed charges,,,9.26,85,,percent of total billed charges,,,,,,,,,9.58,88,,percent of total billed charges,,,,,,,,,8.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.72,22,,percent of total billed charges,,,9.91,91,,percent of total billed charges,,,10.35,95,,percent of total billed charges,,,9.04,83,,percent of total billed charges,,,9.04,83,,percent of total billed charges,,,,,,,,,,,,,,,9.04,83,,percent of total billed charges,,,10.35,95,,percent of total billed charges,,,9.8,90,,percent of total billed charges,,,9.8,90,,percent of total billed charges,,,8.93,82,,percent of total billed charges,,,9.8,90,,percent of total billed charges,,,9.26,85,,percent of total billed charges,,2.72,10.35,
DEPUY FEMORAL ROTATING HINGE,30182166,CDM,,,278,RC,outpatient,,52982.02,52982.02,,44981.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13245.51,22,,percent of total billed charges,,,,,,,,,47683.82,90,,percent of total billed charges,,,43869.11,82.8,,percent of total billed charges,,,45034.72,85,,percent of total billed charges,,,,,,,,,46624.18,88,,percent of total billed charges,,,,,,,,,40478.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13245.51,22,,percent of total billed charges,,,48213.64,91,,percent of total billed charges,,,50332.92,95,,percent of total billed charges,,,43975.08,83,,percent of total billed charges,,,43975.08,83,,percent of total billed charges,,,,,,,,,,,,,,,43975.08,83,,percent of total billed charges,,,50332.92,95,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,43445.26,82,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,45034.72,85,,percent of total billed charges,,13245.51,50332.92,
DEPUY TIBIAL INSERT HINGE 12MM SM,30182167,CDM,,,278,RC,outpatient,,33343.12,33343.12,,28308.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8335.78,22,,percent of total billed charges,,,,,,,,,30008.81,90,,percent of total billed charges,,,27608.1,82.8,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,,,,,,,,29341.95,88,,percent of total billed charges,,,,,,,,,25474.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8335.78,22,,percent of total billed charges,,,30342.24,91,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,,,,,,,,,,,,,27674.79,83,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,27341.36,82,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,8335.78,31675.96,
DEPUY POROUS FEMORAL SLEEVE 216,30182168,CDM,,,278,RC,outpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4515.54,22,,percent of total billed charges,,,,,,,,,16255.93,90,,percent of total billed charges,,,14955.45,82.8,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4515.54,22,,percent of total billed charges,,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,4515.54,17159.03,
DEPUY STEM FLUTED UNIV 115 X 14,30182169,CDM,,,278,RC,outpatient,,12911.21,12911.21,,10961.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3227.8,22,,percent of total billed charges,,,,,,,,,11620.09,90,,percent of total billed charges,,,10690.48,82.8,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,,,,,,,,11361.86,88,,percent of total billed charges,,,,,,,,,9864.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3227.8,22,,percent of total billed charges,,,11749.2,91,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,,,,,,,,,,,,,10716.3,83,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10587.19,82,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,3227.8,12265.65,
DEPUY GUIDEWIRE BALL NOSE 3.0 X 80CM,30182170,CDM,,,278,RC,outpatient,,740.18,740.18,,628.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,185.05,22,,percent of total billed charges,,,,,,,,,666.16,90,,percent of total billed charges,,,612.87,82.8,,percent of total billed charges,,,629.15,85,,percent of total billed charges,,,,,,,,,651.36,88,,percent of total billed charges,,,,,,,,,565.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,185.05,22,,percent of total billed charges,,,673.56,91,,percent of total billed charges,,,703.17,95,,percent of total billed charges,,,614.35,83,,percent of total billed charges,,,614.35,83,,percent of total billed charges,,,,,,,,,,,,,,,614.35,83,,percent of total billed charges,,,703.17,95,,percent of total billed charges,,,666.16,90,,percent of total billed charges,,,666.16,90,,percent of total billed charges,,,606.95,82,,percent of total billed charges,,,666.16,90,,percent of total billed charges,,,629.15,85,,percent of total billed charges,,185.05,703.17,
DEPUY PINNACLE CUP W/GRIPTION 60MM,30182171,CDM,,,278,RC,outpatient,,31783.05,31783.05,,26983.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7945.76,22,,percent of total billed charges,,,,,,,,,28604.75,90,,percent of total billed charges,,,26316.37,82.8,,percent of total billed charges,,,27015.59,85,,percent of total billed charges,,,,,,,,,27969.08,88,,percent of total billed charges,,,,,,,,,24282.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7945.76,22,,percent of total billed charges,,,28922.58,91,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,,,,,,,,,,,,,26379.93,83,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,26062.1,82,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,27015.59,85,,percent of total billed charges,,7945.76,30193.9,
DEPUY SCREW BONE 55 X 5.0,30182172,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
DEPUY SCREW BONE TAPER 40 X 5.0,30182173,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
DEPUY LINER CONSTRAINED +4 32 X 54,30182174,CDM,,,278,RC,outpatient,,36635.17,36635.17,,31103.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9158.79,22,,percent of total billed charges,,,,,,,,,32971.65,90,,percent of total billed charges,,,30333.92,82.8,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,,,,,,,,32238.95,88,,percent of total billed charges,,,,,,,,,27989.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9158.79,22,,percent of total billed charges,,,33338,91,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,,,,,,,,,,,,,30407.19,83,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,30040.84,82,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,9158.79,34803.41,
S&N ENDO BICEPTOR KIT 7 X 25,30182175,CDM,,,270,RC,outpatient,,2579.92,2579.92,,2190.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,644.98,22,,percent of total billed charges,,,,,,,,,2321.93,90,,percent of total billed charges,,,2136.17,82.8,,percent of total billed charges,,,2192.93,85,,percent of total billed charges,,,,,,,,,2270.33,88,,percent of total billed charges,,,,,,,,,1971.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,644.98,22,,percent of total billed charges,,,2347.73,91,,percent of total billed charges,,,2450.92,95,,percent of total billed charges,,,2141.33,83,,percent of total billed charges,,,2141.33,83,,percent of total billed charges,,,,,,,,,,,,,,,2141.33,83,,percent of total billed charges,,,2450.92,95,,percent of total billed charges,,,2321.93,90,,percent of total billed charges,,,2321.93,90,,percent of total billed charges,,,2115.53,82,,percent of total billed charges,,,2321.93,90,,percent of total billed charges,,,2192.93,85,,percent of total billed charges,,644.98,2450.92,
LEEP CAUTERY PENCIL,30182176,CDM,,,270,RC,outpatient,,49.56,49.56,,42.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.39,22,,percent of total billed charges,,,,,,,,,44.6,90,,percent of total billed charges,,,41.04,82.8,,percent of total billed charges,,,42.13,85,,percent of total billed charges,,,,,,,,,43.61,88,,percent of total billed charges,,,,,,,,,37.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.39,22,,percent of total billed charges,,,45.1,91,,percent of total billed charges,,,47.08,95,,percent of total billed charges,,,41.13,83,,percent of total billed charges,,,41.13,83,,percent of total billed charges,,,,,,,,,,,,,,,41.13,83,,percent of total billed charges,,,47.08,95,,percent of total billed charges,,,44.6,90,,percent of total billed charges,,,44.6,90,,percent of total billed charges,,,40.64,82,,percent of total billed charges,,,44.6,90,,percent of total billed charges,,,42.13,85,,percent of total billed charges,,12.39,47.08,
ESOPHYX KIT W/O CARTRIDGE SHORT,30182178,CDM,,,270,RC,outpatient,,23237.5,23237.5,,19728.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5809.38,22,,percent of total billed charges,,,,,,,,,20913.75,90,,percent of total billed charges,,,19240.65,82.8,,percent of total billed charges,,,19751.88,85,,percent of total billed charges,,,,,,,,,20449,88,,percent of total billed charges,,,,,,,,,17753.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5809.38,22,,percent of total billed charges,,,21146.13,91,,percent of total billed charges,,,22075.63,95,,percent of total billed charges,,,19287.13,83,,percent of total billed charges,,,19287.13,83,,percent of total billed charges,,,,,,,,,,,,,,,19287.13,83,,percent of total billed charges,,,22075.63,95,,percent of total billed charges,,,20913.75,90,,percent of total billed charges,,,20913.75,90,,percent of total billed charges,,,19054.75,82,,percent of total billed charges,,,20913.75,90,,percent of total billed charges,,,19751.88,85,,percent of total billed charges,,5809.38,22075.63,
ESOPHYX CARTRIDGE FASTENERS 6.5MM,30182179,CDM,,,270,RC,outpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,690.63,22,,percent of total billed charges,,,,,,,,,2486.25,90,,percent of total billed charges,,,2287.35,82.8,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,690.63,22,,percent of total billed charges,,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,690.63,2624.38,
*ESOPHYX CARTRIDGE FASTENERS 7.5MM,30182180,CDM,,,270,RC,outpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,690.63,22,,percent of total billed charges,,,,,,,,,2486.25,90,,percent of total billed charges,,,2287.35,82.8,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,690.63,22,,percent of total billed charges,,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,690.63,2624.38,
DEPUY STEM BOWED SZ13.5,30182182,CDM,,,278,RC,outpatient,,66522.3,66522.3,,56477.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16630.58,22,,percent of total billed charges,,,,,,,,,59870.07,90,,percent of total billed charges,,,55080.46,82.8,,percent of total billed charges,,,56543.96,85,,percent of total billed charges,,,,,,,,,58539.62,88,,percent of total billed charges,,,,,,,,,50823.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16630.58,22,,percent of total billed charges,,,60535.29,91,,percent of total billed charges,,,63196.19,95,,percent of total billed charges,,,55213.51,83,,percent of total billed charges,,,55213.51,83,,percent of total billed charges,,,,,,,,,,,,,,,55213.51,83,,percent of total billed charges,,,63196.19,95,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,54548.29,82,,percent of total billed charges,,,59870.07,90,,percent of total billed charges,,,56543.96,85,,percent of total billed charges,,16630.58,63196.19,
CELL SAVER SERVICE,30182185,CDM,,,270,RC,outpatient,,4446,4446,,3774.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1111.5,22,,percent of total billed charges,,,,,,,,,4001.4,90,,percent of total billed charges,,,3681.29,82.8,,percent of total billed charges,,,3779.1,85,,percent of total billed charges,,,,,,,,,3912.48,88,,percent of total billed charges,,,,,,,,,3396.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1111.5,22,,percent of total billed charges,,,4045.86,91,,percent of total billed charges,,,4223.7,95,,percent of total billed charges,,,3690.18,83,,percent of total billed charges,,,3690.18,83,,percent of total billed charges,,,,,,,,,,,,,,,3690.18,83,,percent of total billed charges,,,4223.7,95,,percent of total billed charges,,,4001.4,90,,percent of total billed charges,,,4001.4,90,,percent of total billed charges,,,3645.72,82,,percent of total billed charges,,,4001.4,90,,percent of total billed charges,,,3779.1,85,,percent of total billed charges,,1111.5,4223.7,
GYRUS HALO CUTTING FORCEP,30182193,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
GYRUS PLASMA SORD PKS,30182194,CDM,,,270,RC,outpatient,,4784,4784,,4061.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1196,22,,percent of total billed charges,,,,,,,,,4305.6,90,,percent of total billed charges,,,3961.15,82.8,,percent of total billed charges,,,4066.4,85,,percent of total billed charges,,,,,,,,,4209.92,88,,percent of total billed charges,,,,,,,,,3654.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1196,22,,percent of total billed charges,,,4353.44,91,,percent of total billed charges,,,4544.8,95,,percent of total billed charges,,,3970.72,83,,percent of total billed charges,,,3970.72,83,,percent of total billed charges,,,,,,,,,,,,,,,3970.72,83,,percent of total billed charges,,,4544.8,95,,percent of total billed charges,,,4305.6,90,,percent of total billed charges,,,4305.6,90,,percent of total billed charges,,,3922.88,82,,percent of total billed charges,,,4305.6,90,,percent of total billed charges,,,4066.4,85,,percent of total billed charges,,1196,4544.8,
DEPUY DISTAL FEM COMPONENT XSM RT,30182195,CDM,,,278,RC,outpatient,,97092.39,97092.39,,82431.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24273.1,22,,percent of total billed charges,,,,,,,,,87383.15,90,,percent of total billed charges,,,80392.5,82.8,,percent of total billed charges,,,82528.53,85,,percent of total billed charges,,,,,,,,,85441.3,88,,percent of total billed charges,,,,,,,,,74178.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24273.1,22,,percent of total billed charges,,,88354.07,91,,percent of total billed charges,,,92237.77,95,,percent of total billed charges,,,80586.68,83,,percent of total billed charges,,,80586.68,83,,percent of total billed charges,,,,,,,,,,,,,,,80586.68,83,,percent of total billed charges,,,92237.77,95,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,79615.76,82,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,82528.53,85,,percent of total billed charges,,24273.1,92237.77,
DEPUY SEGMENTAL COMPONENT 25MM,30182196,CDM,,,278,RC,outpatient,,18773.5,18773.5,,15938.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4693.38,22,,percent of total billed charges,,,,,,,,,16896.15,90,,percent of total billed charges,,,15544.46,82.8,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,,,,,,,,16520.68,88,,percent of total billed charges,,,,,,,,,14342.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4693.38,22,,percent of total billed charges,,,17083.89,91,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,,,,,,,,,,,,,15582.01,83,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15394.27,82,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,4693.38,17834.83,
DEPUY STEM FEMORAL POROUS 16.5 X 150,30182197,CDM,,,278,RC,outpatient,,48015.11,48015.11,,40764.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12003.78,22,,percent of total billed charges,,,,,,,,,43213.6,90,,percent of total billed charges,,,39756.51,82.8,,percent of total billed charges,,,40812.84,85,,percent of total billed charges,,,,,,,,,42253.3,88,,percent of total billed charges,,,,,,,,,36683.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12003.78,22,,percent of total billed charges,,,43693.75,91,,percent of total billed charges,,,45614.35,95,,percent of total billed charges,,,39852.54,83,,percent of total billed charges,,,39852.54,83,,percent of total billed charges,,,,,,,,,,,,,,,39852.54,83,,percent of total billed charges,,,45614.35,95,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,39372.39,82,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,40812.84,85,,percent of total billed charges,,12003.78,45614.35,
DEPUY INSERT HINGE 16MM XSM,30182198,CDM,,,278,RC,outpatient,,33343.12,33343.12,,28308.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8335.78,22,,percent of total billed charges,,,,,,,,,30008.81,90,,percent of total billed charges,,,27608.1,82.8,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,,,,,,,,29341.95,88,,percent of total billed charges,,,,,,,,,25474.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8335.78,22,,percent of total billed charges,,,30342.24,91,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,,,,,,,,,,,,,27674.79,83,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,27341.36,82,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,8335.78,31675.96,
DEPUY STEM CORAIL STD SZ9,30182200,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY INSERT RP 12.5MM SZ3,30182201,CDM,,,278,RC,outpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3253.11,22,,percent of total billed charges,,,,,,,,,11711.18,90,,percent of total billed charges,,,10774.28,82.8,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3253.11,22,,percent of total billed charges,,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,3253.11,12361.8,
CARPEL TUNNEL RELEASE BLADE,30182203,CDM,,,270,RC,outpatient,,1352,1352,,1147.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,338,22,,percent of total billed charges,,,,,,,,,1216.8,90,,percent of total billed charges,,,1119.46,82.8,,percent of total billed charges,,,1149.2,85,,percent of total billed charges,,,,,,,,,1189.76,88,,percent of total billed charges,,,,,,,,,1032.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,338,22,,percent of total billed charges,,,1230.32,91,,percent of total billed charges,,,1284.4,95,,percent of total billed charges,,,1122.16,83,,percent of total billed charges,,,1122.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1122.16,83,,percent of total billed charges,,,1284.4,95,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1108.64,82,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1149.2,85,,percent of total billed charges,,338,1284.4,
DEPUY GUIDE PIN 3.2MM,30182216,CDM,,,278,RC,outpatient,,270,270,,229.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.5,22,,percent of total billed charges,,,,,,,,,243,90,,percent of total billed charges,,,223.56,82.8,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,,,,,,,,237.6,88,,percent of total billed charges,,,,,,,,,206.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.5,22,,percent of total billed charges,,,245.7,91,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,,,,,,,,,,,,,224.1,83,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,243,90,,percent of total billed charges,,,243,90,,percent of total billed charges,,,221.4,82,,percent of total billed charges,,,243,90,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,67.5,256.5,
DEPUY SCREW CANNULATED 80 X 6.5,30182217,CDM,,,278,RC,outpatient,,2046.33,2046.33,,1737.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,511.58,22,,percent of total billed charges,,,,,,,,,1841.7,90,,percent of total billed charges,,,1694.36,82.8,,percent of total billed charges,,,1739.38,85,,percent of total billed charges,,,,,,,,,1800.77,88,,percent of total billed charges,,,,,,,,,1563.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,511.58,22,,percent of total billed charges,,,1862.16,91,,percent of total billed charges,,,1944.01,95,,percent of total billed charges,,,1698.45,83,,percent of total billed charges,,,1698.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1698.45,83,,percent of total billed charges,,,1944.01,95,,percent of total billed charges,,,1841.7,90,,percent of total billed charges,,,1841.7,90,,percent of total billed charges,,,1677.99,82,,percent of total billed charges,,,1841.7,90,,percent of total billed charges,,,1739.38,85,,percent of total billed charges,,511.58,1944.01,
DEPUY SCREW CANNULATED 85 X 6.5,30182218,CDM,,,278,RC,outpatient,,2046.33,2046.33,,1737.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,511.58,22,,percent of total billed charges,,,,,,,,,1841.7,90,,percent of total billed charges,,,1694.36,82.8,,percent of total billed charges,,,1739.38,85,,percent of total billed charges,,,,,,,,,1800.77,88,,percent of total billed charges,,,,,,,,,1563.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,511.58,22,,percent of total billed charges,,,1862.16,91,,percent of total billed charges,,,1944.01,95,,percent of total billed charges,,,1698.45,83,,percent of total billed charges,,,1698.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1698.45,83,,percent of total billed charges,,,1944.01,95,,percent of total billed charges,,,1841.7,90,,percent of total billed charges,,,1841.7,90,,percent of total billed charges,,,1677.99,82,,percent of total billed charges,,,1841.7,90,,percent of total billed charges,,,1739.38,85,,percent of total billed charges,,511.58,1944.01,
DEPUY DRILL BIT CANNULATED 5.0,30182219,CDM,,,278,RC,outpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,503.75,22,,percent of total billed charges,,,,,,,,,1813.5,90,,percent of total billed charges,,,1668.42,82.8,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,503.75,22,,percent of total billed charges,,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,503.75,1914.25,
COLOPLAST INFRAPUBIC CYLINDER SET W/OTR,30182221,CDM,,,278,RC,outpatient,,44616,44616,,37878.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11154,22,,percent of total billed charges,,,,,,,,,40154.4,90,,percent of total billed charges,,,36942.05,82.8,,percent of total billed charges,,,37923.6,85,,percent of total billed charges,,,,,,,,,39262.08,88,,percent of total billed charges,,,,,,,,,34086.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11154,22,,percent of total billed charges,,,40600.56,91,,percent of total billed charges,,,42385.2,95,,percent of total billed charges,,,37031.28,83,,percent of total billed charges,,,37031.28,83,,percent of total billed charges,,,,,,,,,,,,,,,37031.28,83,,percent of total billed charges,,,42385.2,95,,percent of total billed charges,,,40154.4,90,,percent of total billed charges,,,40154.4,90,,percent of total billed charges,,,36585.12,82,,percent of total billed charges,,,40154.4,90,,percent of total billed charges,,,37923.6,85,,percent of total billed charges,,11154,42385.2,
SYNTHES SCREW CANCEL 4.0X26MM,30182222,CDM,,,278,RC,outpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.78,22,,percent of total billed charges,,,,,,,,,200.82,90,,percent of total billed charges,,,184.75,82.8,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.78,22,,percent of total billed charges,,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,55.78,211.97,
SYNTHES SCREW CORTEX TAP 3.5MM,30182223,CDM,,,278,RC,outpatient,,2077.4,2077.4,,1763.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,519.35,22,,percent of total billed charges,,,,,,,,,1869.66,90,,percent of total billed charges,,,1720.09,82.8,,percent of total billed charges,,,1765.79,85,,percent of total billed charges,,,,,,,,,1828.11,88,,percent of total billed charges,,,,,,,,,1587.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,519.35,22,,percent of total billed charges,,,1890.43,91,,percent of total billed charges,,,1973.53,95,,percent of total billed charges,,,1724.24,83,,percent of total billed charges,,,1724.24,83,,percent of total billed charges,,,,,,,,,,,,,,,1724.24,83,,percent of total billed charges,,,1973.53,95,,percent of total billed charges,,,1869.66,90,,percent of total billed charges,,,1869.66,90,,percent of total billed charges,,,1703.47,82,,percent of total billed charges,,,1869.66,90,,percent of total billed charges,,,1765.79,85,,percent of total billed charges,,519.35,1973.53,
S&N ENDO TWINFIX 4.5 W/2 UB,30182224,CDM,,,270,RC,outpatient,,1807,1807,,1534.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,451.75,22,,percent of total billed charges,,,,,,,,,1626.3,90,,percent of total billed charges,,,1496.2,82.8,,percent of total billed charges,,,1535.95,85,,percent of total billed charges,,,,,,,,,1590.16,88,,percent of total billed charges,,,,,,,,,1380.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,451.75,22,,percent of total billed charges,,,1644.37,91,,percent of total billed charges,,,1716.65,95,,percent of total billed charges,,,1499.81,83,,percent of total billed charges,,,1499.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1499.81,83,,percent of total billed charges,,,1716.65,95,,percent of total billed charges,,,1626.3,90,,percent of total billed charges,,,1626.3,90,,percent of total billed charges,,,1481.74,82,,percent of total billed charges,,,1626.3,90,,percent of total billed charges,,,1535.95,85,,percent of total billed charges,,451.75,1716.65,
DEPUY FEMUR SIGMA PS LT SZ2.5,30182230,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
DEPUY INSERT STABILIZED 10MM SZ2.5,30182231,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY PINNACLE CUP W/GRIPTION 58MM,30182232,CDM,,,278,RC,outpatient,,31783.05,31783.05,,26983.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7945.76,22,,percent of total billed charges,,,,,,,,,28604.75,90,,percent of total billed charges,,,26316.37,82.8,,percent of total billed charges,,,27015.59,85,,percent of total billed charges,,,,,,,,,27969.08,88,,percent of total billed charges,,,,,,,,,24282.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7945.76,22,,percent of total billed charges,,,28922.58,91,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,,,,,,,,,,,,,26379.93,83,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,26062.1,82,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,27015.59,85,,percent of total billed charges,,7945.76,30193.9,
DEPUY MBT STEP WEDGE 5MM,30182233,CDM,,,278,RC,outpatient,,15761.79,15761.79,,13381.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3940.45,22,,percent of total billed charges,,,,,,,,,14185.61,90,,percent of total billed charges,,,13050.76,82.8,,percent of total billed charges,,,13397.52,85,,percent of total billed charges,,,,,,,,,13870.38,88,,percent of total billed charges,,,,,,,,,12042.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3940.45,22,,percent of total billed charges,,,14343.23,91,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,,,,,,,,,,,,,13082.29,83,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,12924.67,82,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,13397.52,85,,percent of total billed charges,,3940.45,14973.7,
DEPUY STEM FLUTTED UNIV 115 X 10,30182234,CDM,,,278,RC,outpatient,,12911.21,12911.21,,10961.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3227.8,22,,percent of total billed charges,,,,,,,,,11620.09,90,,percent of total billed charges,,,10690.48,82.8,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,,,,,,,,11361.86,88,,percent of total billed charges,,,,,,,,,9864.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3227.8,22,,percent of total billed charges,,,11749.2,91,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,,,,,,,,,,,,,10716.3,83,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10587.19,82,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,3227.8,12265.65,
DEPUY INSERT RP 15MM SZ2,30182235,CDM,,,278,RC,outpatient,,11793.8,11793.8,,10012.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2948.45,22,,percent of total billed charges,,,,,,,,,10614.42,90,,percent of total billed charges,,,9765.27,82.8,,percent of total billed charges,,,10024.73,85,,percent of total billed charges,,,,,,,,,10378.54,88,,percent of total billed charges,,,,,,,,,9010.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2948.45,22,,percent of total billed charges,,,10732.36,91,,percent of total billed charges,,,11204.11,95,,percent of total billed charges,,,9788.85,83,,percent of total billed charges,,,9788.85,83,,percent of total billed charges,,,,,,,,,,,,,,,9788.85,83,,percent of total billed charges,,,11204.11,95,,percent of total billed charges,,,10614.42,90,,percent of total billed charges,,,10614.42,90,,percent of total billed charges,,,9670.92,82,,percent of total billed charges,,,10614.42,90,,percent of total billed charges,,,10024.73,85,,percent of total billed charges,,2948.45,11204.11,
SYNTHES SCREW CANNUL 16MM 6.5X70MM,30182242,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES PLATE LCP HOOK 3-HOLE 3.5MM,30182246,CDM,,,278,RC,outpatient,,6657.63,6657.63,,5652.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1664.41,22,,percent of total billed charges,,,,,,,,,5991.87,90,,percent of total billed charges,,,5512.52,82.8,,percent of total billed charges,,,5658.99,85,,percent of total billed charges,,,,,,,,,5858.71,88,,percent of total billed charges,,,,,,,,,5086.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1664.41,22,,percent of total billed charges,,,6058.44,91,,percent of total billed charges,,,6324.75,95,,percent of total billed charges,,,5525.83,83,,percent of total billed charges,,,5525.83,83,,percent of total billed charges,,,,,,,,,,,,,,,5525.83,83,,percent of total billed charges,,,6324.75,95,,percent of total billed charges,,,5991.87,90,,percent of total billed charges,,,5991.87,90,,percent of total billed charges,,,5459.26,82,,percent of total billed charges,,,5991.87,90,,percent of total billed charges,,,5658.99,85,,percent of total billed charges,,1664.41,6324.75,
BIOMET KNEE OSTEOTOME 6.5MM,30182248,CDM,,,270,RC,outpatient,,4777.5,4777.5,,4056.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1194.38,22,,percent of total billed charges,,,,,,,,,4299.75,90,,percent of total billed charges,,,3955.77,82.8,,percent of total billed charges,,,4060.88,85,,percent of total billed charges,,,,,,,,,4204.2,88,,percent of total billed charges,,,,,,,,,3650.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1194.38,22,,percent of total billed charges,,,4347.53,91,,percent of total billed charges,,,4538.63,95,,percent of total billed charges,,,3965.33,83,,percent of total billed charges,,,3965.33,83,,percent of total billed charges,,,,,,,,,,,,,,,3965.33,83,,percent of total billed charges,,,4538.63,95,,percent of total billed charges,,,4299.75,90,,percent of total billed charges,,,4299.75,90,,percent of total billed charges,,,3917.55,82,,percent of total billed charges,,,4299.75,90,,percent of total billed charges,,,4060.88,85,,percent of total billed charges,,1194.38,4538.63,
S&N ENDO PROBE 90-DEG WHIRLWIND,30182249,CDM,,,270,RC,outpatient,,1324.05,1324.05,,1124.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,331.01,22,,percent of total billed charges,,,,,,,,,1191.65,90,,percent of total billed charges,,,1096.31,82.8,,percent of total billed charges,,,1125.44,85,,percent of total billed charges,,,,,,,,,1165.16,88,,percent of total billed charges,,,,,,,,,1011.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,331.01,22,,percent of total billed charges,,,1204.89,91,,percent of total billed charges,,,1257.85,95,,percent of total billed charges,,,1098.96,83,,percent of total billed charges,,,1098.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1098.96,83,,percent of total billed charges,,,1257.85,95,,percent of total billed charges,,,1191.65,90,,percent of total billed charges,,,1191.65,90,,percent of total billed charges,,,1085.72,82,,percent of total billed charges,,,1191.65,90,,percent of total billed charges,,,1125.44,85,,percent of total billed charges,,331.01,1257.85,
DEPUY STEM FEMORAL POROUS 18.5 X 200,30182250,CDM,,,278,RC,outpatient,,48015.11,48015.11,,40764.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12003.78,22,,percent of total billed charges,,,,,,,,,43213.6,90,,percent of total billed charges,,,39756.51,82.8,,percent of total billed charges,,,40812.84,85,,percent of total billed charges,,,,,,,,,42253.3,88,,percent of total billed charges,,,,,,,,,36683.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12003.78,22,,percent of total billed charges,,,43693.75,91,,percent of total billed charges,,,45614.35,95,,percent of total billed charges,,,39852.54,83,,percent of total billed charges,,,39852.54,83,,percent of total billed charges,,,,,,,,,,,,,,,39852.54,83,,percent of total billed charges,,,45614.35,95,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,39372.39,82,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,40812.84,85,,percent of total billed charges,,12003.78,45614.35,
DEPUY SEGMENTAL COMPONENT 40MM,30182251,CDM,,,278,RC,outpatient,,18773.5,18773.5,,15938.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4693.38,22,,percent of total billed charges,,,,,,,,,16896.15,90,,percent of total billed charges,,,15544.46,82.8,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,,,,,,,,16520.68,88,,percent of total billed charges,,,,,,,,,14342.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4693.38,22,,percent of total billed charges,,,17083.89,91,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,,,,,,,,,,,,,15582.01,83,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15394.27,82,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,4693.38,17834.83,
DEPUY FEMUR DISTAL XSM LT,30182252,CDM,,,278,RC,outpatient,,97092.39,97092.39,,82431.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24273.1,22,,percent of total billed charges,,,,,,,,,87383.15,90,,percent of total billed charges,,,80392.5,82.8,,percent of total billed charges,,,82528.53,85,,percent of total billed charges,,,,,,,,,85441.3,88,,percent of total billed charges,,,,,,,,,74178.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24273.1,22,,percent of total billed charges,,,88354.07,91,,percent of total billed charges,,,92237.77,95,,percent of total billed charges,,,80586.68,83,,percent of total billed charges,,,80586.68,83,,percent of total billed charges,,,,,,,,,,,,,,,80586.68,83,,percent of total billed charges,,,92237.77,95,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,79615.76,82,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,82528.53,85,,percent of total billed charges,,24273.1,92237.77,
DEPUY INSERT TIBIAL HINGE 12MM XSM,30182253,CDM,,,278,RC,outpatient,,24320.34,24320.34,,20647.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6080.09,22,,percent of total billed charges,,,,,,,,,21888.31,90,,percent of total billed charges,,,20137.24,82.8,,percent of total billed charges,,,20672.29,85,,percent of total billed charges,,,,,,,,,21401.9,88,,percent of total billed charges,,,,,,,,,18580.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6080.09,22,,percent of total billed charges,,,22131.51,91,,percent of total billed charges,,,23104.32,95,,percent of total billed charges,,,20185.88,83,,percent of total billed charges,,,20185.88,83,,percent of total billed charges,,,,,,,,,,,,,,,20185.88,83,,percent of total billed charges,,,23104.32,95,,percent of total billed charges,,,21888.31,90,,percent of total billed charges,,,21888.31,90,,percent of total billed charges,,,19942.68,82,,percent of total billed charges,,,21888.31,90,,percent of total billed charges,,,20672.29,85,,percent of total billed charges,,6080.09,23104.32,
BIOMET ULTRADRIVE 6MM,30182255,CDM,,,270,RC,outpatient,,4946.5,4946.5,,4199.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1236.63,22,,percent of total billed charges,,,,,,,,,4451.85,90,,percent of total billed charges,,,4095.7,82.8,,percent of total billed charges,,,4204.53,85,,percent of total billed charges,,,,,,,,,4352.92,88,,percent of total billed charges,,,,,,,,,3779.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1236.63,22,,percent of total billed charges,,,4501.32,91,,percent of total billed charges,,,4699.18,95,,percent of total billed charges,,,4105.6,83,,percent of total billed charges,,,4105.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4105.6,83,,percent of total billed charges,,,4699.18,95,,percent of total billed charges,,,4451.85,90,,percent of total billed charges,,,4451.85,90,,percent of total billed charges,,,4056.13,82,,percent of total billed charges,,,4451.85,90,,percent of total billed charges,,,4204.53,85,,percent of total billed charges,,1236.63,4699.18,
BIOMET ULTRADRIVE 120MM,30182256,CDM,,,270,RC,outpatient,,4524,4524,,3840.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1131,22,,percent of total billed charges,,,,,,,,,4071.6,90,,percent of total billed charges,,,3745.87,82.8,,percent of total billed charges,,,3845.4,85,,percent of total billed charges,,,,,,,,,3981.12,88,,percent of total billed charges,,,,,,,,,3456.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1131,22,,percent of total billed charges,,,4116.84,91,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,,,,,,,,,,,,,3754.92,83,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3709.68,82,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3845.4,85,,percent of total billed charges,,1131,4297.8,
EYE LENS IMPLANT - TORIC,30182257,CDM,,,278,RC,outpatient,,3217.5,3217.5,,2731.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,804.38,22,,percent of total billed charges,,,,,,,,,2895.75,90,,percent of total billed charges,,,2664.09,82.8,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,,,,,,,,2831.4,88,,percent of total billed charges,,,,,,,,,2458.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,804.38,22,,percent of total billed charges,,,2927.93,91,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2670.53,83,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2638.35,82,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,804.38,3056.63,
BIOPSY FORCEP 230CM ALLIGATOR W/SPKIE,30182264,CDM,,,270,RC,outpatient,,37.14,37.14,,31.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.29,22,,percent of total billed charges,,,,,,,,,33.43,90,,percent of total billed charges,,,30.75,82.8,,percent of total billed charges,,,31.57,85,,percent of total billed charges,,,,,,,,,32.68,88,,percent of total billed charges,,,,,,,,,28.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.29,22,,percent of total billed charges,,,33.8,91,,percent of total billed charges,,,35.28,95,,percent of total billed charges,,,30.83,83,,percent of total billed charges,,,30.83,83,,percent of total billed charges,,,,,,,,,,,,,,,30.83,83,,percent of total billed charges,,,35.28,95,,percent of total billed charges,,,33.43,90,,percent of total billed charges,,,33.43,90,,percent of total billed charges,,,30.45,82,,percent of total billed charges,,,33.43,90,,percent of total billed charges,,,31.57,85,,percent of total billed charges,,9.29,35.28,
BIOPSY FORCEP LARGE CAPACITY ALLIGATOR W,30182265,CDM,,,270,RC,outpatient,,57.77,57.77,,49.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.44,22,,percent of total billed charges,,,,,,,,,51.99,90,,percent of total billed charges,,,47.83,82.8,,percent of total billed charges,,,49.1,85,,percent of total billed charges,,,,,,,,,50.84,88,,percent of total billed charges,,,,,,,,,44.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.44,22,,percent of total billed charges,,,52.57,91,,percent of total billed charges,,,54.88,95,,percent of total billed charges,,,47.95,83,,percent of total billed charges,,,47.95,83,,percent of total billed charges,,,,,,,,,,,,,,,47.95,83,,percent of total billed charges,,,54.88,95,,percent of total billed charges,,,51.99,90,,percent of total billed charges,,,51.99,90,,percent of total billed charges,,,47.37,82,,percent of total billed charges,,,51.99,90,,percent of total billed charges,,,49.1,85,,percent of total billed charges,,14.44,54.88,
PROCERVA HTA ABLATION KIT,30182273,CDM,,,270,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
DRESSING ISLAND 4X10,30182279,CDM,,,270,RC,outpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.25,22,,percent of total billed charges,,,,,,,,,202.5,90,,percent of total billed charges,,,186.3,82.8,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.25,22,,percent of total billed charges,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,56.25,213.75,
DRESSING ISLAND 4X12,30182280,CDM,,,270,RC,outpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.63,22,,percent of total billed charges,,,,,,,,,236.25,90,,percent of total billed charges,,,217.35,82.8,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.63,22,,percent of total billed charges,,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,65.63,249.38,
DEPUY PINNACLE CUP MULTIHOLE 50MM,30182281,CDM,,,278,RC,outpatient,,26741.78,26741.78,,22703.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6685.45,22,,percent of total billed charges,,,,,,,,,24067.6,90,,percent of total billed charges,,,22142.19,82.8,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,,,,,,,,23532.77,88,,percent of total billed charges,,,,,,,,,20430.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6685.45,22,,percent of total billed charges,,,24335.02,91,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,,,,,,,,,,,,,22195.68,83,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,21928.26,82,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,6685.45,25404.69,
DEPUY LINER CONSTRAINED +4 28 X 50,30182282,CDM,,,278,RC,outpatient,,36635.17,36635.17,,31103.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9158.79,22,,percent of total billed charges,,,,,,,,,32971.65,90,,percent of total billed charges,,,30333.92,82.8,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,,,,,,,,32238.95,88,,percent of total billed charges,,,,,,,,,27989.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9158.79,22,,percent of total billed charges,,,33338,91,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,,,,,,,,,,,,,30407.19,83,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,30040.84,82,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,9158.79,34803.41,
DEPUY FEMUR NEUTRAL STD PROXIMAL,30182283,CDM,,,278,RC,outpatient,,56410.06,56410.06,,47892.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14102.52,22,,percent of total billed charges,,,,,,,,,50769.05,90,,percent of total billed charges,,,46707.53,82.8,,percent of total billed charges,,,47948.55,85,,percent of total billed charges,,,,,,,,,49640.85,88,,percent of total billed charges,,,,,,,,,43097.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14102.52,22,,percent of total billed charges,,,51333.15,91,,percent of total billed charges,,,53589.56,95,,percent of total billed charges,,,46820.35,83,,percent of total billed charges,,,46820.35,83,,percent of total billed charges,,,,,,,,,,,,,,,46820.35,83,,percent of total billed charges,,,53589.56,95,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,46256.25,82,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,47948.55,85,,percent of total billed charges,,14102.52,53589.56,
DEPUY STEM FEMORAL POROUS 14.5 X 150,30182284,CDM,,,278,RC,outpatient,,48015.11,48015.11,,40764.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12003.78,22,,percent of total billed charges,,,,,,,,,43213.6,90,,percent of total billed charges,,,39756.51,82.8,,percent of total billed charges,,,40812.84,85,,percent of total billed charges,,,,,,,,,42253.3,88,,percent of total billed charges,,,,,,,,,36683.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12003.78,22,,percent of total billed charges,,,43693.75,91,,percent of total billed charges,,,45614.35,95,,percent of total billed charges,,,39852.54,83,,percent of total billed charges,,,39852.54,83,,percent of total billed charges,,,,,,,,,,,,,,,39852.54,83,,percent of total billed charges,,,45614.35,95,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,39372.39,82,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,40812.84,85,,percent of total billed charges,,12003.78,45614.35,
DEPUY PINNACLE CUP MULTIHOLE 54MM,30182285,CDM,,,278,RC,outpatient,,26741.78,26741.78,,22703.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6685.45,22,,percent of total billed charges,,,,,,,,,24067.6,90,,percent of total billed charges,,,22142.19,82.8,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,,,,,,,,23532.77,88,,percent of total billed charges,,,,,,,,,20430.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6685.45,22,,percent of total billed charges,,,24335.02,91,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,,,,,,,,,,,,,22195.68,83,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,21928.26,82,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,6685.45,25404.69,
DEPUY FEMORAL HEAD 32MM +3,30182286,CDM,,,278,RC,outpatient,,6061.9,6061.9,,5146.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1515.48,22,,percent of total billed charges,,,,,,,,,5455.71,90,,percent of total billed charges,,,5019.25,82.8,,percent of total billed charges,,,5152.62,85,,percent of total billed charges,,,,,,,,,5334.47,88,,percent of total billed charges,,,,,,,,,4631.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1515.48,22,,percent of total billed charges,,,5516.33,91,,percent of total billed charges,,,5758.81,95,,percent of total billed charges,,,5031.38,83,,percent of total billed charges,,,5031.38,83,,percent of total billed charges,,,,,,,,,,,,,,,5031.38,83,,percent of total billed charges,,,5758.81,95,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,4970.76,82,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,5152.62,85,,percent of total billed charges,,1515.48,5758.81,
S&N ENDO BICEPTOR BIOSURE 7 X 15,30182287,CDM,,,278,RC,outpatient,,1584.38,1584.38,,1345.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,396.1,22,,percent of total billed charges,,,,,,,,,1425.94,90,,percent of total billed charges,,,1311.87,82.8,,percent of total billed charges,,,1346.72,85,,percent of total billed charges,,,,,,,,,1394.25,88,,percent of total billed charges,,,,,,,,,1210.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,396.1,22,,percent of total billed charges,,,1441.79,91,,percent of total billed charges,,,1505.16,95,,percent of total billed charges,,,1315.04,83,,percent of total billed charges,,,1315.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1315.04,83,,percent of total billed charges,,,1505.16,95,,percent of total billed charges,,,1425.94,90,,percent of total billed charges,,,1425.94,90,,percent of total billed charges,,,1299.19,82,,percent of total billed charges,,,1425.94,90,,percent of total billed charges,,,1346.72,85,,percent of total billed charges,,396.1,1505.16,
BONE-TENDON-BONE PATELLA 40CM W/ BONE,30182291,CDM,,,278,RC,outpatient,,11700,11700,,9933.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2925,22,,percent of total billed charges,,,,,,,,,10530,90,,percent of total billed charges,,,9687.6,82.8,,percent of total billed charges,,,9945,85,,percent of total billed charges,,,,,,,,,10296,88,,percent of total billed charges,,,,,,,,,8938.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2925,22,,percent of total billed charges,,,10647,91,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,,,,,,,,,,,,,9711,83,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9594,82,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9945,85,,percent of total billed charges,,2925,11115,
S&N ENDO SHOULDER SUSPENSION KIT,30182292,CDM,,,270,RC,outpatient,,599.34,599.34,,508.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149.84,22,,percent of total billed charges,,,,,,,,,539.41,90,,percent of total billed charges,,,496.25,82.8,,percent of total billed charges,,,509.44,85,,percent of total billed charges,,,,,,,,,527.42,88,,percent of total billed charges,,,,,,,,,457.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149.84,22,,percent of total billed charges,,,545.4,91,,percent of total billed charges,,,569.37,95,,percent of total billed charges,,,497.45,83,,percent of total billed charges,,,497.45,83,,percent of total billed charges,,,,,,,,,,,,,,,497.45,83,,percent of total billed charges,,,569.37,95,,percent of total billed charges,,,539.41,90,,percent of total billed charges,,,539.41,90,,percent of total billed charges,,,491.46,82,,percent of total billed charges,,,539.41,90,,percent of total billed charges,,,509.44,85,,percent of total billed charges,,149.84,569.37,
RTI FEMORAL STRUT FRESH FROZEN 6,30182297,CDM,,,278,RC,outpatient,,12584,12584,,10683.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3146,22,,percent of total billed charges,,,,,,,,,11325.6,90,,percent of total billed charges,,,10419.55,82.8,,percent of total billed charges,,,10696.4,85,,percent of total billed charges,,,,,,,,,11073.92,88,,percent of total billed charges,,,,,,,,,9614.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3146,22,,percent of total billed charges,,,11451.44,91,,percent of total billed charges,,,11954.8,95,,percent of total billed charges,,,10444.72,83,,percent of total billed charges,,,10444.72,83,,percent of total billed charges,,,,,,,,,,,,,,,10444.72,83,,percent of total billed charges,,,11954.8,95,,percent of total billed charges,,,11325.6,90,,percent of total billed charges,,,11325.6,90,,percent of total billed charges,,,10318.88,82,,percent of total billed charges,,,11325.6,90,,percent of total billed charges,,,10696.4,85,,percent of total billed charges,,3146,11954.8,
S&N ENDO BUTTON CL ULTRA 1.2,30182298,CDM,,,270,RC,outpatient,,2383.1,2383.1,,2023.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,595.78,22,,percent of total billed charges,,,,,,,,,2144.79,90,,percent of total billed charges,,,1973.21,82.8,,percent of total billed charges,,,2025.64,85,,percent of total billed charges,,,,,,,,,2097.13,88,,percent of total billed charges,,,,,,,,,1820.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,595.78,22,,percent of total billed charges,,,2168.62,91,,percent of total billed charges,,,2263.95,95,,percent of total billed charges,,,1977.97,83,,percent of total billed charges,,,1977.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1977.97,83,,percent of total billed charges,,,2263.95,95,,percent of total billed charges,,,2144.79,90,,percent of total billed charges,,,2144.79,90,,percent of total billed charges,,,1954.14,82,,percent of total billed charges,,,2144.79,90,,percent of total billed charges,,,2025.64,85,,percent of total billed charges,,595.78,2263.95,
S&N ENDO SCREW SOFT SILK 8 X 20,30182299,CDM,,,278,RC,outpatient,,1487.85,1487.85,,1263.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,371.96,22,,percent of total billed charges,,,,,,,,,1339.07,90,,percent of total billed charges,,,1231.94,82.8,,percent of total billed charges,,,1264.67,85,,percent of total billed charges,,,,,,,,,1309.31,88,,percent of total billed charges,,,,,,,,,1136.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,371.96,22,,percent of total billed charges,,,1353.94,91,,percent of total billed charges,,,1413.46,95,,percent of total billed charges,,,1234.92,83,,percent of total billed charges,,,1234.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1234.92,83,,percent of total billed charges,,,1413.46,95,,percent of total billed charges,,,1339.07,90,,percent of total billed charges,,,1339.07,90,,percent of total billed charges,,,1220.04,82,,percent of total billed charges,,,1339.07,90,,percent of total billed charges,,,1264.67,85,,percent of total billed charges,,371.96,1413.46,
S&N ENDO SCREW SOFT SILK 7 X 20,30182300,CDM,,,278,RC,outpatient,,1417,1417,,1203.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,354.25,22,,percent of total billed charges,,,,,,,,,1275.3,90,,percent of total billed charges,,,1173.28,82.8,,percent of total billed charges,,,1204.45,85,,percent of total billed charges,,,,,,,,,1246.96,88,,percent of total billed charges,,,,,,,,,1082.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,354.25,22,,percent of total billed charges,,,1289.47,91,,percent of total billed charges,,,1346.15,95,,percent of total billed charges,,,1176.11,83,,percent of total billed charges,,,1176.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1176.11,83,,percent of total billed charges,,,1346.15,95,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1161.94,82,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1204.45,85,,percent of total billed charges,,354.25,1346.15,
S&N ENDO ACL RENTAL FEE,30182301,CDM,,,270,RC,outpatient,,6467.5,6467.5,,5490.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1616.88,22,,percent of total billed charges,,,,,,,,,5820.75,90,,percent of total billed charges,,,5355.09,82.8,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,,,,,,,,5691.4,88,,percent of total billed charges,,,,,,,,,4941.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1616.88,22,,percent of total billed charges,,,5885.43,91,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,,,,,,,,,,,,,5368.03,83,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5303.35,82,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,1616.88,6144.13,
DEPUY NAIL FUSION TTC,30182302,CDM,,,278,RC,outpatient,,16728.92,16728.92,,14202.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4182.23,22,,percent of total billed charges,,,,,,,,,15056.03,90,,percent of total billed charges,,,13851.55,82.8,,percent of total billed charges,,,14219.58,85,,percent of total billed charges,,,,,,,,,14721.45,88,,percent of total billed charges,,,,,,,,,12780.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4182.23,22,,percent of total billed charges,,,15223.32,91,,percent of total billed charges,,,15892.47,95,,percent of total billed charges,,,13885,83,,percent of total billed charges,,,13885,83,,percent of total billed charges,,,,,,,,,,,,,,,13885,83,,percent of total billed charges,,,15892.47,95,,percent of total billed charges,,,15056.03,90,,percent of total billed charges,,,15056.03,90,,percent of total billed charges,,,13717.71,82,,percent of total billed charges,,,15056.03,90,,percent of total billed charges,,,14219.58,85,,percent of total billed charges,,4182.23,15892.47,
SYNTHES SCREW CANNUL 16MM 6.5X60MM,30182303,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
ALLERGAN SILICONE BREAST IMPLANT 450CC,30182307,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
ALLERGAN NATRELLE SIZER HIGH PROFILE,30182308,CDM,,,270,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
VENTRALEX HERNIA PATCH SM,30182310,CDM,,,278,RC,outpatient,,2718.6,2718.6,,2308.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,679.65,22,,percent of total billed charges,,,,,,,,,2446.74,90,,percent of total billed charges,,,2251,82.8,,percent of total billed charges,,,2310.81,85,,percent of total billed charges,,,,,,,,,2392.37,88,,percent of total billed charges,,,,,,,,,2077.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,679.65,22,,percent of total billed charges,,,2473.93,91,,percent of total billed charges,,,2582.67,95,,percent of total billed charges,,,2256.44,83,,percent of total billed charges,,,2256.44,83,,percent of total billed charges,,,,,,,,,,,,,,,2256.44,83,,percent of total billed charges,,,2582.67,95,,percent of total billed charges,,,2446.74,90,,percent of total billed charges,,,2446.74,90,,percent of total billed charges,,,2229.25,82,,percent of total billed charges,,,2446.74,90,,percent of total billed charges,,,2310.81,85,,percent of total billed charges,,679.65,2582.67,
DEPUY INSERT RP 17.5MM SZ4,30182311,CDM,,,278,RC,outpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3253.11,22,,percent of total billed charges,,,,,,,,,11711.18,90,,percent of total billed charges,,,10774.28,82.8,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3253.11,22,,percent of total billed charges,,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,3253.11,12361.8,
ARISTA 5X3GM,30182313,CDM,,,270,RC,outpatient,,1690,1690,,1434.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,422.5,22,,percent of total billed charges,,,,,,,,,1521,90,,percent of total billed charges,,,1399.32,82.8,,percent of total billed charges,,,1436.5,85,,percent of total billed charges,,,,,,,,,1487.2,88,,percent of total billed charges,,,,,,,,,1291.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,422.5,22,,percent of total billed charges,,,1537.9,91,,percent of total billed charges,,,1605.5,95,,percent of total billed charges,,,1402.7,83,,percent of total billed charges,,,1402.7,83,,percent of total billed charges,,,,,,,,,,,,,,,1402.7,83,,percent of total billed charges,,,1605.5,95,,percent of total billed charges,,,1521,90,,percent of total billed charges,,,1521,90,,percent of total billed charges,,,1385.8,82,,percent of total billed charges,,,1521,90,,percent of total billed charges,,,1436.5,85,,percent of total billed charges,,422.5,1605.5,
ARISTA 5X5GM,30182314,CDM,,,270,RC,outpatient,,2437.5,2437.5,,2069.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,609.38,22,,percent of total billed charges,,,,,,,,,2193.75,90,,percent of total billed charges,,,2018.25,82.8,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,,,,,,,,2145,88,,percent of total billed charges,,,,,,,,,1862.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,609.38,22,,percent of total billed charges,,,2218.13,91,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2023.13,83,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,1998.75,82,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,609.38,2315.63,
ARISTA FLEXITIP APPLICATOR XL,30182315,CDM,,,270,RC,outpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50,22,,percent of total billed charges,,,,,,,,,180,90,,percent of total billed charges,,,165.6,82.8,,percent of total billed charges,,,170,85,,percent of total billed charges,,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50,22,,percent of total billed charges,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,50,190,
S&N ENDO TWINFIX 5.5 W/3 UB,30182316,CDM,,,270,RC,outpatient,,2003.5,2003.5,,1700.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,500.88,22,,percent of total billed charges,,,,,,,,,1803.15,90,,percent of total billed charges,,,1658.9,82.8,,percent of total billed charges,,,1702.98,85,,percent of total billed charges,,,,,,,,,1763.08,88,,percent of total billed charges,,,,,,,,,1530.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,500.88,22,,percent of total billed charges,,,1823.19,91,,percent of total billed charges,,,1903.33,95,,percent of total billed charges,,,1662.91,83,,percent of total billed charges,,,1662.91,83,,percent of total billed charges,,,,,,,,,,,,,,,1662.91,83,,percent of total billed charges,,,1903.33,95,,percent of total billed charges,,,1803.15,90,,percent of total billed charges,,,1803.15,90,,percent of total billed charges,,,1642.87,82,,percent of total billed charges,,,1803.15,90,,percent of total billed charges,,,1702.98,85,,percent of total billed charges,,500.88,1903.33,
S&N ENDO TWINFIX 5.5 W/2 UB,30182317,CDM,,,270,RC,outpatient,,1945.13,1945.13,,1651.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,486.28,22,,percent of total billed charges,,,,,,,,,1750.62,90,,percent of total billed charges,,,1610.57,82.8,,percent of total billed charges,,,1653.36,85,,percent of total billed charges,,,,,,,,,1711.71,88,,percent of total billed charges,,,,,,,,,1486.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,486.28,22,,percent of total billed charges,,,1770.07,91,,percent of total billed charges,,,1847.87,95,,percent of total billed charges,,,1614.46,83,,percent of total billed charges,,,1614.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.46,83,,percent of total billed charges,,,1847.87,95,,percent of total billed charges,,,1750.62,90,,percent of total billed charges,,,1750.62,90,,percent of total billed charges,,,1595.01,82,,percent of total billed charges,,,1750.62,90,,percent of total billed charges,,,1653.36,85,,percent of total billed charges,,486.28,1847.87,
S&N ENDO BICEPTOR KIT 7 X 15,30182318,CDM,,,270,RC,outpatient,,2657.27,2657.27,,2256.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,664.32,22,,percent of total billed charges,,,,,,,,,2391.54,90,,percent of total billed charges,,,2200.22,82.8,,percent of total billed charges,,,2258.68,85,,percent of total billed charges,,,,,,,,,2338.4,88,,percent of total billed charges,,,,,,,,,2030.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,664.32,22,,percent of total billed charges,,,2418.12,91,,percent of total billed charges,,,2524.41,95,,percent of total billed charges,,,2205.53,83,,percent of total billed charges,,,2205.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2205.53,83,,percent of total billed charges,,,2524.41,95,,percent of total billed charges,,,2391.54,90,,percent of total billed charges,,,2391.54,90,,percent of total billed charges,,,2178.96,82,,percent of total billed charges,,,2391.54,90,,percent of total billed charges,,,2258.68,85,,percent of total billed charges,,664.32,2524.41,
S&N ENDO CROCHET HOOK,30182319,CDM,,,270,RC,outpatient,,1795.11,1795.11,,1524.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,448.78,22,,percent of total billed charges,,,,,,,,,1615.6,90,,percent of total billed charges,,,1486.35,82.8,,percent of total billed charges,,,1525.84,85,,percent of total billed charges,,,,,,,,,1579.7,88,,percent of total billed charges,,,,,,,,,1371.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,448.78,22,,percent of total billed charges,,,1633.55,91,,percent of total billed charges,,,1705.35,95,,percent of total billed charges,,,1489.94,83,,percent of total billed charges,,,1489.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1489.94,83,,percent of total billed charges,,,1705.35,95,,percent of total billed charges,,,1615.6,90,,percent of total billed charges,,,1615.6,90,,percent of total billed charges,,,1471.99,82,,percent of total billed charges,,,1615.6,90,,percent of total billed charges,,,1525.84,85,,percent of total billed charges,,448.78,1705.35,
VENTRALEX HERNIA PATCH MED,30182320,CDM,,,278,RC,outpatient,,3521.7,3521.7,,2989.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,880.43,22,,percent of total billed charges,,,,,,,,,3169.53,90,,percent of total billed charges,,,2915.97,82.8,,percent of total billed charges,,,2993.45,85,,percent of total billed charges,,,,,,,,,3099.1,88,,percent of total billed charges,,,,,,,,,2690.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,880.43,22,,percent of total billed charges,,,3204.75,91,,percent of total billed charges,,,3345.62,95,,percent of total billed charges,,,2923.01,83,,percent of total billed charges,,,2923.01,83,,percent of total billed charges,,,,,,,,,,,,,,,2923.01,83,,percent of total billed charges,,,3345.62,95,,percent of total billed charges,,,3169.53,90,,percent of total billed charges,,,3169.53,90,,percent of total billed charges,,,2887.79,82,,percent of total billed charges,,,3169.53,90,,percent of total billed charges,,,2993.45,85,,percent of total billed charges,,880.43,3345.62,
VENTRALEX HERNIA PATCH LG,30182321,CDM,,,278,RC,outpatient,,4097.6,4097.6,,3478.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1024.4,22,,percent of total billed charges,,,,,,,,,3687.84,90,,percent of total billed charges,,,3392.81,82.8,,percent of total billed charges,,,3482.96,85,,percent of total billed charges,,,,,,,,,3605.89,88,,percent of total billed charges,,,,,,,,,3130.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1024.4,22,,percent of total billed charges,,,3728.82,91,,percent of total billed charges,,,3892.72,95,,percent of total billed charges,,,3401.01,83,,percent of total billed charges,,,3401.01,83,,percent of total billed charges,,,,,,,,,,,,,,,3401.01,83,,percent of total billed charges,,,3892.72,95,,percent of total billed charges,,,3687.84,90,,percent of total billed charges,,,3687.84,90,,percent of total billed charges,,,3360.03,82,,percent of total billed charges,,,3687.84,90,,percent of total billed charges,,,3482.96,85,,percent of total billed charges,,1024.4,3892.72,
S&N ENDO ANCHOR TAPERED AWL 3.8,30182322,CDM,,,270,RC,outpatient,,372.83,372.83,,316.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.21,22,,percent of total billed charges,,,,,,,,,335.55,90,,percent of total billed charges,,,308.7,82.8,,percent of total billed charges,,,316.91,85,,percent of total billed charges,,,,,,,,,328.09,88,,percent of total billed charges,,,,,,,,,284.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.21,22,,percent of total billed charges,,,339.28,91,,percent of total billed charges,,,354.19,95,,percent of total billed charges,,,309.45,83,,percent of total billed charges,,,309.45,83,,percent of total billed charges,,,,,,,,,,,,,,,309.45,83,,percent of total billed charges,,,354.19,95,,percent of total billed charges,,,335.55,90,,percent of total billed charges,,,335.55,90,,percent of total billed charges,,,305.72,82,,percent of total billed charges,,,335.55,90,,percent of total billed charges,,,316.91,85,,percent of total billed charges,,93.21,354.19,
S&N ENDO ANCHOR 4.5,30182324,CDM,,,270,RC,outpatient,,2811.9,2811.9,,2387.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,702.98,22,,percent of total billed charges,,,,,,,,,2530.71,90,,percent of total billed charges,,,2328.25,82.8,,percent of total billed charges,,,2390.12,85,,percent of total billed charges,,,,,,,,,2474.47,88,,percent of total billed charges,,,,,,,,,2148.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,702.98,22,,percent of total billed charges,,,2558.83,91,,percent of total billed charges,,,2671.31,95,,percent of total billed charges,,,2333.88,83,,percent of total billed charges,,,2333.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2333.88,83,,percent of total billed charges,,,2671.31,95,,percent of total billed charges,,,2530.71,90,,percent of total billed charges,,,2530.71,90,,percent of total billed charges,,,2305.76,82,,percent of total billed charges,,,2530.71,90,,percent of total billed charges,,,2390.12,85,,percent of total billed charges,,702.98,2671.31,
DEPUY HEAD FX MOD CATH 47MM,30182325,CDM,,,278,RC,outpatient,,4693.78,4693.78,,3985.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1173.45,22,,percent of total billed charges,,,,,,,,,4224.4,90,,percent of total billed charges,,,3886.45,82.8,,percent of total billed charges,,,3989.71,85,,percent of total billed charges,,,,,,,,,4130.53,88,,percent of total billed charges,,,,,,,,,3586.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1173.45,22,,percent of total billed charges,,,4271.34,91,,percent of total billed charges,,,4459.09,95,,percent of total billed charges,,,3895.84,83,,percent of total billed charges,,,3895.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3895.84,83,,percent of total billed charges,,,4459.09,95,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,3848.9,82,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,3989.71,85,,percent of total billed charges,,1173.45,4459.09,
DEPUY SPACER 3 MODULAR CATHEART,30182326,CDM,,,278,RC,outpatient,,1935.57,1935.57,,1643.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.89,22,,percent of total billed charges,,,,,,,,,1742.01,90,,percent of total billed charges,,,1602.65,82.8,,percent of total billed charges,,,1645.23,85,,percent of total billed charges,,,,,,,,,1703.3,88,,percent of total billed charges,,,,,,,,,1478.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.89,22,,percent of total billed charges,,,1761.37,91,,percent of total billed charges,,,1838.79,95,,percent of total billed charges,,,1606.52,83,,percent of total billed charges,,,1606.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1606.52,83,,percent of total billed charges,,,1838.79,95,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1587.17,82,,percent of total billed charges,,,1742.01,90,,percent of total billed charges,,,1645.23,85,,percent of total billed charges,,483.89,1838.79,
MESH VAGINAL UPHOLD,30182328,CDM,,,270,RC,outpatient,,13097.5,13097.5,,11119.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3274.38,22,,percent of total billed charges,,,,,,,,,11787.75,90,,percent of total billed charges,,,10844.73,82.8,,percent of total billed charges,,,11132.88,85,,percent of total billed charges,,,,,,,,,11525.8,88,,percent of total billed charges,,,,,,,,,10006.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3274.38,22,,percent of total billed charges,,,11918.73,91,,percent of total billed charges,,,12442.63,95,,percent of total billed charges,,,10870.93,83,,percent of total billed charges,,,10870.93,83,,percent of total billed charges,,,,,,,,,,,,,,,10870.93,83,,percent of total billed charges,,,12442.63,95,,percent of total billed charges,,,11787.75,90,,percent of total billed charges,,,11787.75,90,,percent of total billed charges,,,10739.95,82,,percent of total billed charges,,,11787.75,90,,percent of total billed charges,,,11132.88,85,,percent of total billed charges,,3274.38,12442.63,
PINS DISTRACTION 14MM,30182329,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
DEPUY LINER CONSTRAINED +4 36 X 58,30182335,CDM,,,278,RC,outpatient,,24183.97,24183.97,,20532.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6045.99,22,,percent of total billed charges,,,,,,,,,21765.57,90,,percent of total billed charges,,,20024.33,82.8,,percent of total billed charges,,,20556.37,85,,percent of total billed charges,,,,,,,,,21281.89,88,,percent of total billed charges,,,,,,,,,18476.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6045.99,22,,percent of total billed charges,,,22007.41,91,,percent of total billed charges,,,22974.77,95,,percent of total billed charges,,,20072.7,83,,percent of total billed charges,,,20072.7,83,,percent of total billed charges,,,,,,,,,,,,,,,20072.7,83,,percent of total billed charges,,,22974.77,95,,percent of total billed charges,,,21765.57,90,,percent of total billed charges,,,21765.57,90,,percent of total billed charges,,,19830.86,82,,percent of total billed charges,,,21765.57,90,,percent of total billed charges,,,20556.37,85,,percent of total billed charges,,6045.99,22974.77,
STRYKER OIL CARTRIDGE,30182337,CDM,,,270,RC,outpatient,,176.4,176.4,,149.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.1,22,,percent of total billed charges,,,,,,,,,158.76,90,,percent of total billed charges,,,146.06,82.8,,percent of total billed charges,,,149.94,85,,percent of total billed charges,,,,,,,,,155.23,88,,percent of total billed charges,,,,,,,,,134.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.1,22,,percent of total billed charges,,,160.52,91,,percent of total billed charges,,,167.58,95,,percent of total billed charges,,,146.41,83,,percent of total billed charges,,,146.41,83,,percent of total billed charges,,,,,,,,,,,,,,,146.41,83,,percent of total billed charges,,,167.58,95,,percent of total billed charges,,,158.76,90,,percent of total billed charges,,,158.76,90,,percent of total billed charges,,,144.65,82,,percent of total billed charges,,,158.76,90,,percent of total billed charges,,,149.94,85,,percent of total billed charges,,44.1,167.58,
STRYKER DIFFUSER,30182338,CDM,,,270,RC,outpatient,,101.44,101.44,,86.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.36,22,,percent of total billed charges,,,,,,,,,91.3,90,,percent of total billed charges,,,83.99,82.8,,percent of total billed charges,,,86.22,85,,percent of total billed charges,,,,,,,,,89.27,88,,percent of total billed charges,,,,,,,,,77.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.36,22,,percent of total billed charges,,,92.31,91,,percent of total billed charges,,,96.37,95,,percent of total billed charges,,,84.2,83,,percent of total billed charges,,,84.2,83,,percent of total billed charges,,,,,,,,,,,,,,,84.2,83,,percent of total billed charges,,,96.37,95,,percent of total billed charges,,,91.3,90,,percent of total billed charges,,,91.3,90,,percent of total billed charges,,,83.18,82,,percent of total billed charges,,,91.3,90,,percent of total billed charges,,,86.22,85,,percent of total billed charges,,25.36,96.37,
ALLERGAN SILICONE BREAST IMPLANT 500CC,30182355,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
GABRIELLE VEST,30182356,CDM,,,270,RC,outpatient,,299.63,299.63,,254.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.91,22,,percent of total billed charges,,,,,,,,,269.67,90,,percent of total billed charges,,,248.09,82.8,,percent of total billed charges,,,254.69,85,,percent of total billed charges,,,,,,,,,263.67,88,,percent of total billed charges,,,,,,,,,228.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.91,22,,percent of total billed charges,,,272.66,91,,percent of total billed charges,,,284.65,95,,percent of total billed charges,,,248.69,83,,percent of total billed charges,,,248.69,83,,percent of total billed charges,,,,,,,,,,,,,,,248.69,83,,percent of total billed charges,,,284.65,95,,percent of total billed charges,,,269.67,90,,percent of total billed charges,,,269.67,90,,percent of total billed charges,,,245.7,82,,percent of total billed charges,,,269.67,90,,percent of total billed charges,,,254.69,85,,percent of total billed charges,,74.91,284.65,
DEPUY HIP POROUS ALTRX 36MM,30182358,CDM,,,278,RC,outpatient,,38243.21,38243.21,,32468.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9560.8,22,,percent of total billed charges,,,,,,,,,34418.89,90,,percent of total billed charges,,,31665.38,82.8,,percent of total billed charges,,,32506.73,85,,percent of total billed charges,,,,,,,,,33654.02,88,,percent of total billed charges,,,,,,,,,29217.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9560.8,22,,percent of total billed charges,,,34801.32,91,,percent of total billed charges,,,36331.05,95,,percent of total billed charges,,,31741.86,83,,percent of total billed charges,,,31741.86,83,,percent of total billed charges,,,,,,,,,,,,,,,31741.86,83,,percent of total billed charges,,,36331.05,95,,percent of total billed charges,,,34418.89,90,,percent of total billed charges,,,34418.89,90,,percent of total billed charges,,,31359.43,82,,percent of total billed charges,,,34418.89,90,,percent of total billed charges,,,32506.73,85,,percent of total billed charges,,9560.8,36331.05,
DEPUY INSERT RP 12.5MM SZ2.5,30182359,CDM,,,278,RC,outpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3253.11,22,,percent of total billed charges,,,,,,,,,11711.18,90,,percent of total billed charges,,,10774.28,82.8,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3253.11,22,,percent of total billed charges,,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,3253.11,12361.8,
DEPUY FEMUR TC3 LT SZ5,30182360,CDM,,,278,RC,outpatient,,36489.7,36489.7,,30979.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9122.43,22,,percent of total billed charges,,,,,,,,,32840.73,90,,percent of total billed charges,,,30213.47,82.8,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,,,,,,,,32110.94,88,,percent of total billed charges,,,,,,,,,27878.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9122.43,22,,percent of total billed charges,,,33205.63,91,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,,,,,,,,,,,,,30286.45,83,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,29921.55,82,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,9122.43,34665.22,
SYNTHES K-WIRE 2.8MM,30182362,CDM,,,278,RC,outpatient,,1037.47,1037.47,,880.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,259.37,22,,percent of total billed charges,,,,,,,,,933.72,90,,percent of total billed charges,,,859.03,82.8,,percent of total billed charges,,,881.85,85,,percent of total billed charges,,,,,,,,,912.97,88,,percent of total billed charges,,,,,,,,,792.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,259.37,22,,percent of total billed charges,,,944.1,91,,percent of total billed charges,,,985.6,95,,percent of total billed charges,,,861.1,83,,percent of total billed charges,,,861.1,83,,percent of total billed charges,,,,,,,,,,,,,,,861.1,83,,percent of total billed charges,,,985.6,95,,percent of total billed charges,,,933.72,90,,percent of total billed charges,,,933.72,90,,percent of total billed charges,,,850.73,82,,percent of total billed charges,,,933.72,90,,percent of total billed charges,,,881.85,85,,percent of total billed charges,,259.37,985.6,
MESH HERNIA REBOUND 2.44  X 3.03,30182363,CDM,,,270,RC,outpatient,,1946.75,1946.75,,1652.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,486.69,22,,percent of total billed charges,,,,,,,,,1752.08,90,,percent of total billed charges,,,1611.91,82.8,,percent of total billed charges,,,1654.74,85,,percent of total billed charges,,,,,,,,,1713.14,88,,percent of total billed charges,,,,,,,,,1487.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,486.69,22,,percent of total billed charges,,,1771.54,91,,percent of total billed charges,,,1849.41,95,,percent of total billed charges,,,1615.8,83,,percent of total billed charges,,,1615.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1615.8,83,,percent of total billed charges,,,1849.41,95,,percent of total billed charges,,,1752.08,90,,percent of total billed charges,,,1752.08,90,,percent of total billed charges,,,1596.34,82,,percent of total billed charges,,,1752.08,90,,percent of total billed charges,,,1654.74,85,,percent of total billed charges,,486.69,1849.41,
DEPUY CUSTOM IMPLANT T-F 74MM RT,30182364,CDM,,,278,RC,outpatient,,64675,64675,,54909.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16168.75,22,,percent of total billed charges,,,,,,,,,58207.5,90,,percent of total billed charges,,,53550.9,82.8,,percent of total billed charges,,,54973.75,85,,percent of total billed charges,,,,,,,,,56914,88,,percent of total billed charges,,,,,,,,,49411.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16168.75,22,,percent of total billed charges,,,58854.25,91,,percent of total billed charges,,,61441.25,95,,percent of total billed charges,,,53680.25,83,,percent of total billed charges,,,53680.25,83,,percent of total billed charges,,,,,,,,,,,,,,,53680.25,83,,percent of total billed charges,,,61441.25,95,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,53033.5,82,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,54973.75,85,,percent of total billed charges,,16168.75,61441.25,
ARTHREX AC GRAFT ROPE,30182365,CDM,,,278,RC,outpatient,,6454.5,6454.5,,5479.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1613.63,22,,percent of total billed charges,,,,,,,,,5809.05,90,,percent of total billed charges,,,5344.33,82.8,,percent of total billed charges,,,5486.33,85,,percent of total billed charges,,,,,,,,,5679.96,88,,percent of total billed charges,,,,,,,,,4931.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1613.63,22,,percent of total billed charges,,,5873.6,91,,percent of total billed charges,,,6131.78,95,,percent of total billed charges,,,5357.24,83,,percent of total billed charges,,,5357.24,83,,percent of total billed charges,,,,,,,,,,,,,,,5357.24,83,,percent of total billed charges,,,6131.78,95,,percent of total billed charges,,,5809.05,90,,percent of total billed charges,,,5809.05,90,,percent of total billed charges,,,5292.69,82,,percent of total billed charges,,,5809.05,90,,percent of total billed charges,,,5486.33,85,,percent of total billed charges,,1613.63,6131.78,
S&N ENDO ANCHOR OSTEORAPTOR 2.9,30182367,CDM,,,278,RC,outpatient,,1996.35,1996.35,,1694.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,499.09,22,,percent of total billed charges,,,,,,,,,1796.72,90,,percent of total billed charges,,,1652.98,82.8,,percent of total billed charges,,,1696.9,85,,percent of total billed charges,,,,,,,,,1756.79,88,,percent of total billed charges,,,,,,,,,1525.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,499.09,22,,percent of total billed charges,,,1816.68,91,,percent of total billed charges,,,1896.53,95,,percent of total billed charges,,,1656.97,83,,percent of total billed charges,,,1656.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1656.97,83,,percent of total billed charges,,,1896.53,95,,percent of total billed charges,,,1796.72,90,,percent of total billed charges,,,1796.72,90,,percent of total billed charges,,,1637.01,82,,percent of total billed charges,,,1796.72,90,,percent of total billed charges,,,1696.9,85,,percent of total billed charges,,499.09,1896.53,
DEPUY KNEE CEMENTED MTB/RP,30182368,CDM,,,278,RC,outpatient,,32605.76,32605.76,,27682.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8151.44,22,,percent of total billed charges,,,,,,,,,29345.18,90,,percent of total billed charges,,,26997.57,82.8,,percent of total billed charges,,,27714.9,85,,percent of total billed charges,,,,,,,,,28693.07,88,,percent of total billed charges,,,,,,,,,24910.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8151.44,22,,percent of total billed charges,,,29671.24,91,,percent of total billed charges,,,30975.47,95,,percent of total billed charges,,,27062.78,83,,percent of total billed charges,,,27062.78,83,,percent of total billed charges,,,,,,,,,,,,,,,27062.78,83,,percent of total billed charges,,,30975.47,95,,percent of total billed charges,,,29345.18,90,,percent of total billed charges,,,29345.18,90,,percent of total billed charges,,,26736.72,82,,percent of total billed charges,,,29345.18,90,,percent of total billed charges,,,27714.9,85,,percent of total billed charges,,8151.44,30975.47,
DEPUY KNEE CEMENTED W/XKL,30182369,CDM,,,278,RC,outpatient,,27652.89,27652.89,,23477.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6913.22,22,,percent of total billed charges,,,,,,,,,24887.6,90,,percent of total billed charges,,,22896.59,82.8,,percent of total billed charges,,,23504.96,85,,percent of total billed charges,,,,,,,,,24334.54,88,,percent of total billed charges,,,,,,,,,21126.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6913.22,22,,percent of total billed charges,,,25164.13,91,,percent of total billed charges,,,26270.25,95,,percent of total billed charges,,,22951.9,83,,percent of total billed charges,,,22951.9,83,,percent of total billed charges,,,,,,,,,,,,,,,22951.9,83,,percent of total billed charges,,,26270.25,95,,percent of total billed charges,,,24887.6,90,,percent of total billed charges,,,24887.6,90,,percent of total billed charges,,,22675.37,82,,percent of total billed charges,,,24887.6,90,,percent of total billed charges,,,23504.96,85,,percent of total billed charges,,6913.22,26270.25,
DEPUY HIP POROUS ALTRX 40/44MM,30182376,CDM,,,278,RC,outpatient,,42018.93,42018.93,,35674.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10504.73,22,,percent of total billed charges,,,,,,,,,37817.04,90,,percent of total billed charges,,,34791.67,82.8,,percent of total billed charges,,,35716.09,85,,percent of total billed charges,,,,,,,,,36976.66,88,,percent of total billed charges,,,,,,,,,32102.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10504.73,22,,percent of total billed charges,,,38237.23,91,,percent of total billed charges,,,39917.98,95,,percent of total billed charges,,,34875.71,83,,percent of total billed charges,,,34875.71,83,,percent of total billed charges,,,,,,,,,,,,,,,34875.71,83,,percent of total billed charges,,,39917.98,95,,percent of total billed charges,,,37817.04,90,,percent of total billed charges,,,37817.04,90,,percent of total billed charges,,,34455.52,82,,percent of total billed charges,,,37817.04,90,,percent of total billed charges,,,35716.09,85,,percent of total billed charges,,10504.73,39917.98,
DRAIN FLUTE 15FR W/TROCAR,30182382,CDM,,,270,RC,outpatient,,194.29,194.29,,164.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.57,22,,percent of total billed charges,,,,,,,,,174.86,90,,percent of total billed charges,,,160.87,82.8,,percent of total billed charges,,,165.15,85,,percent of total billed charges,,,,,,,,,170.98,88,,percent of total billed charges,,,,,,,,,148.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.57,22,,percent of total billed charges,,,176.8,91,,percent of total billed charges,,,184.58,95,,percent of total billed charges,,,161.26,83,,percent of total billed charges,,,161.26,83,,percent of total billed charges,,,,,,,,,,,,,,,161.26,83,,percent of total billed charges,,,184.58,95,,percent of total billed charges,,,174.86,90,,percent of total billed charges,,,174.86,90,,percent of total billed charges,,,159.32,82,,percent of total billed charges,,,174.86,90,,percent of total billed charges,,,165.15,85,,percent of total billed charges,,48.57,184.58,
DEPUY DRILL BIT CANNULATED 5.5,30182383,CDM,,,278,RC,outpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,503.75,22,,percent of total billed charges,,,,,,,,,1813.5,90,,percent of total billed charges,,,1668.42,82.8,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,503.75,22,,percent of total billed charges,,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,503.75,1914.25,
STRYKER BLADE RECIP HEAVY DUTY LON,30182384,CDM,,,270,RC,outpatient,,283.65,283.65,,240.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.91,22,,percent of total billed charges,,,,,,,,,255.29,90,,percent of total billed charges,,,234.86,82.8,,percent of total billed charges,,,241.1,85,,percent of total billed charges,,,,,,,,,249.61,88,,percent of total billed charges,,,,,,,,,216.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70.91,22,,percent of total billed charges,,,258.12,91,,percent of total billed charges,,,269.47,95,,percent of total billed charges,,,235.43,83,,percent of total billed charges,,,235.43,83,,percent of total billed charges,,,,,,,,,,,,,,,235.43,83,,percent of total billed charges,,,269.47,95,,percent of total billed charges,,,255.29,90,,percent of total billed charges,,,255.29,90,,percent of total billed charges,,,232.59,82,,percent of total billed charges,,,255.29,90,,percent of total billed charges,,,241.1,85,,percent of total billed charges,,70.91,269.47,
DEPUY HIP POROUS  ALTRX 28/32MM,30182386,CDM,,,278,RC,outpatient,,37986.33,37986.33,,32250.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9496.58,22,,percent of total billed charges,,,,,,,,,34187.7,90,,percent of total billed charges,,,31452.68,82.8,,percent of total billed charges,,,32288.38,85,,percent of total billed charges,,,,,,,,,33427.97,88,,percent of total billed charges,,,,,,,,,29021.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9496.58,22,,percent of total billed charges,,,34567.56,91,,percent of total billed charges,,,36087.01,95,,percent of total billed charges,,,31528.65,83,,percent of total billed charges,,,31528.65,83,,percent of total billed charges,,,,,,,,,,,,,,,31528.65,83,,percent of total billed charges,,,36087.01,95,,percent of total billed charges,,,34187.7,90,,percent of total billed charges,,,34187.7,90,,percent of total billed charges,,,31148.79,82,,percent of total billed charges,,,34187.7,90,,percent of total billed charges,,,32288.38,85,,percent of total billed charges,,9496.58,36087.01,
DEPUY LINER ALTRX NEUT 32 X 48,30182387,CDM,,,278,RC,outpatient,,10422.17,10422.17,,8848.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2605.54,22,,percent of total billed charges,,,,,,,,,9379.95,90,,percent of total billed charges,,,8629.56,82.8,,percent of total billed charges,,,8858.84,85,,percent of total billed charges,,,,,,,,,9171.51,88,,percent of total billed charges,,,,,,,,,7962.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2605.54,22,,percent of total billed charges,,,9484.17,91,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,,,,,,,,,,,,,8650.4,83,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8546.18,82,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8858.84,85,,percent of total billed charges,,2605.54,9901.06,
DEPUY INSERT TC3 15MM SZ2.5,30182388,CDM,,,278,RC,outpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5779.25,22,,percent of total billed charges,,,,,,,,,20805.29,90,,percent of total billed charges,,,19140.87,82.8,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5779.25,22,,percent of total billed charges,,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,5779.25,21961.14,
DRILL TAP 5.0MM & 3.5MM,30182391,CDM,,,270,RC,outpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,105,22,,percent of total billed charges,,,,,,,,,378,90,,percent of total billed charges,,,347.76,82.8,,percent of total billed charges,,,357,85,,percent of total billed charges,,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,105,22,,percent of total billed charges,,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,105,399,
PROXIMAL SCREW 5.0MM X 30.0MM,30182394,CDM,,,278,RC,outpatient,,1196,1196,,1015.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,299,22,,percent of total billed charges,,,,,,,,,1076.4,90,,percent of total billed charges,,,990.29,82.8,,percent of total billed charges,,,1016.6,85,,percent of total billed charges,,,,,,,,,1052.48,88,,percent of total billed charges,,,,,,,,,913.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,299,22,,percent of total billed charges,,,1088.36,91,,percent of total billed charges,,,1136.2,95,,percent of total billed charges,,,992.68,83,,percent of total billed charges,,,992.68,83,,percent of total billed charges,,,,,,,,,,,,,,,992.68,83,,percent of total billed charges,,,1136.2,95,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,980.72,82,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,1016.6,85,,percent of total billed charges,,299,1136.2,
CAP SCREW ASSEMBLY,30182396,CDM,,,278,RC,outpatient,,1196,1196,,1015.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,299,22,,percent of total billed charges,,,,,,,,,1076.4,90,,percent of total billed charges,,,990.29,82.8,,percent of total billed charges,,,1016.6,85,,percent of total billed charges,,,,,,,,,1052.48,88,,percent of total billed charges,,,,,,,,,913.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,299,22,,percent of total billed charges,,,1088.36,91,,percent of total billed charges,,,1136.2,95,,percent of total billed charges,,,992.68,83,,percent of total billed charges,,,992.68,83,,percent of total billed charges,,,,,,,,,,,,,,,992.68,83,,percent of total billed charges,,,1136.2,95,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,980.72,82,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,1016.6,85,,percent of total billed charges,,299,1136.2,
STRYKER HELIOCOIDAL RASP 3.2MM X 18.3MM,30182400,CDM,,,270,RC,outpatient,,911.82,911.82,,774.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.96,22,,percent of total billed charges,,,,,,,,,820.64,90,,percent of total billed charges,,,754.99,82.8,,percent of total billed charges,,,775.05,85,,percent of total billed charges,,,,,,,,,802.4,88,,percent of total billed charges,,,,,,,,,696.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.96,22,,percent of total billed charges,,,829.76,91,,percent of total billed charges,,,866.23,95,,percent of total billed charges,,,756.81,83,,percent of total billed charges,,,756.81,83,,percent of total billed charges,,,,,,,,,,,,,,,756.81,83,,percent of total billed charges,,,866.23,95,,percent of total billed charges,,,820.64,90,,percent of total billed charges,,,820.64,90,,percent of total billed charges,,,747.69,82,,percent of total billed charges,,,820.64,90,,percent of total billed charges,,,775.05,85,,percent of total billed charges,,227.96,866.23,
DRILL BIT 2.9MM,30182401,CDM,,,270,RC,outpatient,,1365,1365,,1158.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,341.25,22,,percent of total billed charges,,,,,,,,,1228.5,90,,percent of total billed charges,,,1130.22,82.8,,percent of total billed charges,,,1160.25,85,,percent of total billed charges,,,,,,,,,1201.2,88,,percent of total billed charges,,,,,,,,,1042.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,341.25,22,,percent of total billed charges,,,1242.15,91,,percent of total billed charges,,,1296.75,95,,percent of total billed charges,,,1132.95,83,,percent of total billed charges,,,1132.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1132.95,83,,percent of total billed charges,,,1296.75,95,,percent of total billed charges,,,1228.5,90,,percent of total billed charges,,,1228.5,90,,percent of total billed charges,,,1119.3,82,,percent of total billed charges,,,1228.5,90,,percent of total billed charges,,,1160.25,85,,percent of total billed charges,,341.25,1296.75,
SCREW DISTRACTION 12MM STERILE,30182402,CDM,,,270,RC,outpatient,,337.5,337.5,,286.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.38,22,,percent of total billed charges,,,,,,,,,303.75,90,,percent of total billed charges,,,279.45,82.8,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,,,,,,,,297,88,,percent of total billed charges,,,,,,,,,257.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.38,22,,percent of total billed charges,,,307.13,91,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,,,,,,,,,,,,,280.13,83,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,276.75,82,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,84.38,320.63,
SCREW DISTRACTION 14MM STERILE,30182403,CDM,,,270,RC,outpatient,,337.5,337.5,,286.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.38,22,,percent of total billed charges,,,,,,,,,303.75,90,,percent of total billed charges,,,279.45,82.8,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,,,,,,,,297,88,,percent of total billed charges,,,,,,,,,257.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.38,22,,percent of total billed charges,,,307.13,91,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,,,,,,,,,,,,,280.13,83,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,276.75,82,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,84.38,320.63,
BIOMET ULTRADRIVE 7MM,30182411,CDM,,,270,RC,outpatient,,4524,4524,,3840.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1131,22,,percent of total billed charges,,,,,,,,,4071.6,90,,percent of total billed charges,,,3745.87,82.8,,percent of total billed charges,,,3845.4,85,,percent of total billed charges,,,,,,,,,3981.12,88,,percent of total billed charges,,,,,,,,,3456.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1131,22,,percent of total billed charges,,,4116.84,91,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,,,,,,,,,,,,,3754.92,83,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3709.68,82,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3845.4,85,,percent of total billed charges,,1131,4297.8,
DEPUY WEDGE STEP 5MM SZ5,30182412,CDM,,,278,RC,outpatient,,11378.45,11378.45,,9660.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2844.61,22,,percent of total billed charges,,,,,,,,,10240.61,90,,percent of total billed charges,,,9421.36,82.8,,percent of total billed charges,,,9671.68,85,,percent of total billed charges,,,,,,,,,10013.04,88,,percent of total billed charges,,,,,,,,,8693.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2844.61,22,,percent of total billed charges,,,10354.39,91,,percent of total billed charges,,,10809.53,95,,percent of total billed charges,,,9444.11,83,,percent of total billed charges,,,9444.11,83,,percent of total billed charges,,,,,,,,,,,,,,,9444.11,83,,percent of total billed charges,,,10809.53,95,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,9330.33,82,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,9671.68,85,,percent of total billed charges,,2844.61,10809.53,
DEPUY STEM CORAIL SZ18,30182416,CDM,,,278,RC,outpatient,,33799.35,33799.35,,28695.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8449.84,22,,percent of total billed charges,,,,,,,,,30419.42,90,,percent of total billed charges,,,27985.86,82.8,,percent of total billed charges,,,28729.45,85,,percent of total billed charges,,,,,,,,,29743.43,88,,percent of total billed charges,,,,,,,,,25822.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8449.84,22,,percent of total billed charges,,,30757.41,91,,percent of total billed charges,,,32109.38,95,,percent of total billed charges,,,28053.46,83,,percent of total billed charges,,,28053.46,83,,percent of total billed charges,,,,,,,,,,,,,,,28053.46,83,,percent of total billed charges,,,32109.38,95,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,27715.47,82,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,28729.45,85,,percent of total billed charges,,8449.84,32109.38,
DURASEAL EXACT 5ML,30182423,CDM,,,270,RC,outpatient,,4355,4355,,3697.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1088.75,22,,percent of total billed charges,,,,,,,,,3919.5,90,,percent of total billed charges,,,3605.94,82.8,,percent of total billed charges,,,3701.75,85,,percent of total billed charges,,,,,,,,,3832.4,88,,percent of total billed charges,,,,,,,,,3327.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1088.75,22,,percent of total billed charges,,,3963.05,91,,percent of total billed charges,,,4137.25,95,,percent of total billed charges,,,3614.65,83,,percent of total billed charges,,,3614.65,83,,percent of total billed charges,,,,,,,,,,,,,,,3614.65,83,,percent of total billed charges,,,4137.25,95,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3571.1,82,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3701.75,85,,percent of total billed charges,,1088.75,4137.25,
DURASEAL EXTENDED TIP APPLICATOR,30182424,CDM,,,270,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
BIOMET ULTRADRIVE 5MM,30182425,CDM,,,270,RC,outpatient,,4524,4524,,3840.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1131,22,,percent of total billed charges,,,,,,,,,4071.6,90,,percent of total billed charges,,,3745.87,82.8,,percent of total billed charges,,,3845.4,85,,percent of total billed charges,,,,,,,,,3981.12,88,,percent of total billed charges,,,,,,,,,3456.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1131,22,,percent of total billed charges,,,4116.84,91,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,3754.92,83,,percent of total billed charges,,,,,,,,,,,,,,,3754.92,83,,percent of total billed charges,,,4297.8,95,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3709.68,82,,percent of total billed charges,,,4071.6,90,,percent of total billed charges,,,3845.4,85,,percent of total billed charges,,1131,4297.8,
NEUROMONITOR SERVICE - MIDWEST,30182435,CDM,,,270,RC,outpatient,,5525,5525,,4690.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1381.25,22,,percent of total billed charges,,,,,,,,,4972.5,90,,percent of total billed charges,,,4574.7,82.8,,percent of total billed charges,,,4696.25,85,,percent of total billed charges,,,,,,,,,4862,88,,percent of total billed charges,,,,,,,,,4221.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1381.25,22,,percent of total billed charges,,,5027.75,91,,percent of total billed charges,,,5248.75,95,,percent of total billed charges,,,4585.75,83,,percent of total billed charges,,,4585.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4585.75,83,,percent of total billed charges,,,5248.75,95,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4530.5,82,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4696.25,85,,percent of total billed charges,,1381.25,5248.75,
SYNTHES DRILL BIT CANNULATED 2.5MM,30182436,CDM,,,270,RC,outpatient,,832.33,832.33,,706.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208.08,22,,percent of total billed charges,,,,,,,,,749.1,90,,percent of total billed charges,,,689.17,82.8,,percent of total billed charges,,,707.48,85,,percent of total billed charges,,,,,,,,,732.45,88,,percent of total billed charges,,,,,,,,,635.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208.08,22,,percent of total billed charges,,,757.42,91,,percent of total billed charges,,,790.71,95,,percent of total billed charges,,,690.83,83,,percent of total billed charges,,,690.83,83,,percent of total billed charges,,,,,,,,,,,,,,,690.83,83,,percent of total billed charges,,,790.71,95,,percent of total billed charges,,,749.1,90,,percent of total billed charges,,,749.1,90,,percent of total billed charges,,,682.51,82,,percent of total billed charges,,,749.1,90,,percent of total billed charges,,,707.48,85,,percent of total billed charges,,208.08,790.71,
S&N ENDO ACCUPASS 45-DEG,30182443,CDM,,,278,RC,outpatient,,859.95,859.95,,730.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214.99,22,,percent of total billed charges,,,,,,,,,773.96,90,,percent of total billed charges,,,712.04,82.8,,percent of total billed charges,,,730.96,85,,percent of total billed charges,,,,,,,,,756.76,88,,percent of total billed charges,,,,,,,,,657,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214.99,22,,percent of total billed charges,,,782.55,91,,percent of total billed charges,,,816.95,95,,percent of total billed charges,,,713.76,83,,percent of total billed charges,,,713.76,83,,percent of total billed charges,,,,,,,,,,,,,,,713.76,83,,percent of total billed charges,,,816.95,95,,percent of total billed charges,,,773.96,90,,percent of total billed charges,,,773.96,90,,percent of total billed charges,,,705.16,82,,percent of total billed charges,,,773.96,90,,percent of total billed charges,,,730.96,85,,percent of total billed charges,,214.99,816.95,
S&N ENDO ANCHOR OSTEORAPTOR 2.3,30182444,CDM,,,270,RC,outpatient,,2170.35,2170.35,,1842.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,542.59,22,,percent of total billed charges,,,,,,,,,1953.32,90,,percent of total billed charges,,,1797.05,82.8,,percent of total billed charges,,,1844.8,85,,percent of total billed charges,,,,,,,,,1909.91,88,,percent of total billed charges,,,,,,,,,1658.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,542.59,22,,percent of total billed charges,,,1975.02,91,,percent of total billed charges,,,2061.83,95,,percent of total billed charges,,,1801.39,83,,percent of total billed charges,,,1801.39,83,,percent of total billed charges,,,,,,,,,,,,,,,1801.39,83,,percent of total billed charges,,,2061.83,95,,percent of total billed charges,,,1953.32,90,,percent of total billed charges,,,1953.32,90,,percent of total billed charges,,,1779.69,82,,percent of total billed charges,,,1953.32,90,,percent of total billed charges,,,1844.8,85,,percent of total billed charges,,542.59,2061.83,
CONMED SUTURE SAVER KIT,30182445,CDM,,,270,RC,outpatient,,267.3,267.3,,226.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.83,22,,percent of total billed charges,,,,,,,,,240.57,90,,percent of total billed charges,,,221.32,82.8,,percent of total billed charges,,,227.21,85,,percent of total billed charges,,,,,,,,,235.22,88,,percent of total billed charges,,,,,,,,,204.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.83,22,,percent of total billed charges,,,243.24,91,,percent of total billed charges,,,253.94,95,,percent of total billed charges,,,221.86,83,,percent of total billed charges,,,221.86,83,,percent of total billed charges,,,,,,,,,,,,,,,221.86,83,,percent of total billed charges,,,253.94,95,,percent of total billed charges,,,240.57,90,,percent of total billed charges,,,240.57,90,,percent of total billed charges,,,219.19,82,,percent of total billed charges,,,240.57,90,,percent of total billed charges,,,227.21,85,,percent of total billed charges,,66.83,253.94,
SORBAFIX SHOT 30,30182447,CDM,,,270,RC,outpatient,,5037.5,5037.5,,4276.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1259.38,22,,percent of total billed charges,,,,,,,,,4533.75,90,,percent of total billed charges,,,4171.05,82.8,,percent of total billed charges,,,4281.88,85,,percent of total billed charges,,,,,,,,,4433,88,,percent of total billed charges,,,,,,,,,3848.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1259.38,22,,percent of total billed charges,,,4584.13,91,,percent of total billed charges,,,4785.63,95,,percent of total billed charges,,,4181.13,83,,percent of total billed charges,,,4181.13,83,,percent of total billed charges,,,,,,,,,,,,,,,4181.13,83,,percent of total billed charges,,,4785.63,95,,percent of total billed charges,,,4533.75,90,,percent of total billed charges,,,4533.75,90,,percent of total billed charges,,,4130.75,82,,percent of total billed charges,,,4533.75,90,,percent of total billed charges,,,4281.88,85,,percent of total billed charges,,1259.38,4785.63,
MESH VENTRALIGHT W/ECHO 6X8,30182448,CDM,,,270,RC,outpatient,,11261.25,11261.25,,9560.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2815.31,22,,percent of total billed charges,,,,,,,,,10135.13,90,,percent of total billed charges,,,9324.32,82.8,,percent of total billed charges,,,9572.06,85,,percent of total billed charges,,,,,,,,,9909.9,88,,percent of total billed charges,,,,,,,,,8603.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2815.31,22,,percent of total billed charges,,,10247.74,91,,percent of total billed charges,,,10698.19,95,,percent of total billed charges,,,9346.84,83,,percent of total billed charges,,,9346.84,83,,percent of total billed charges,,,,,,,,,,,,,,,9346.84,83,,percent of total billed charges,,,10698.19,95,,percent of total billed charges,,,10135.13,90,,percent of total billed charges,,,10135.13,90,,percent of total billed charges,,,9234.23,82,,percent of total billed charges,,,10135.13,90,,percent of total billed charges,,,9572.06,85,,percent of total billed charges,,2815.31,10698.19,
BONE MILL DISPOSABLE - FINE,30182449,CDM,,,270,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
SYNTHES SCREW CORTEX S-T 2.7X16MM,30182451,CDM,,,278,RC,outpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.46,22,,percent of total billed charges,,,,,,,,,397.66,90,,percent of total billed charges,,,365.84,82.8,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.46,22,,percent of total billed charges,,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,110.46,419.75,
STRYKER BUR ROUND PRECISION 5MM,30182455,CDM,,,270,RC,outpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,568.75,22,,percent of total billed charges,,,,,,,,,2047.5,90,,percent of total billed charges,,,1883.7,82.8,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,568.75,22,,percent of total billed charges,,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,568.75,2161.25,
ALLOPATCH HD THICK 5X5 0.8-1.7,30182456,CDM,,,270,RC,outpatient,,9312.68,9312.68,,7906.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2328.17,22,,percent of total billed charges,,,,,,,,,8381.41,90,,percent of total billed charges,,,7710.9,82.8,,percent of total billed charges,,,7915.78,85,,percent of total billed charges,,,,,,,,,8195.16,88,,percent of total billed charges,,,,,,,,,7114.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2328.17,22,,percent of total billed charges,,,8474.54,91,,percent of total billed charges,,,8847.05,95,,percent of total billed charges,,,7729.52,83,,percent of total billed charges,,,7729.52,83,,percent of total billed charges,,,,,,,,,,,,,,,7729.52,83,,percent of total billed charges,,,8847.05,95,,percent of total billed charges,,,8381.41,90,,percent of total billed charges,,,8381.41,90,,percent of total billed charges,,,7636.4,82,,percent of total billed charges,,,8381.41,90,,percent of total billed charges,,,7915.78,85,,percent of total billed charges,,2328.17,8847.05,
ALLOPATCH HD ULTRA THICK 5X5 1.8-3.9,30182457,CDM,,,270,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
MESH PERFIX PLUG X-LARGE,30182466,CDM,,,270,RC,outpatient,,1121.25,1121.25,,951.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,280.31,22,,percent of total billed charges,,,,,,,,,1009.13,90,,percent of total billed charges,,,928.4,82.8,,percent of total billed charges,,,953.06,85,,percent of total billed charges,,,,,,,,,986.7,88,,percent of total billed charges,,,,,,,,,856.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,280.31,22,,percent of total billed charges,,,1020.34,91,,percent of total billed charges,,,1065.19,95,,percent of total billed charges,,,930.64,83,,percent of total billed charges,,,930.64,83,,percent of total billed charges,,,,,,,,,,,,,,,930.64,83,,percent of total billed charges,,,1065.19,95,,percent of total billed charges,,,1009.13,90,,percent of total billed charges,,,1009.13,90,,percent of total billed charges,,,919.43,82,,percent of total billed charges,,,1009.13,90,,percent of total billed charges,,,953.06,85,,percent of total billed charges,,280.31,1065.19,
DEPUY INSERT TC3 10MM SZ5,30182477,CDM,,,278,RC,outpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5779.25,22,,percent of total billed charges,,,,,,,,,20805.29,90,,percent of total billed charges,,,19140.87,82.8,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5779.25,22,,percent of total billed charges,,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,5779.25,21961.14,
DEPUY TIBIAL AUGMENT 5MM SZ2.5,30182478,CDM,,,278,RC,outpatient,,11378.45,11378.45,,9660.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2844.61,22,,percent of total billed charges,,,,,,,,,10240.61,90,,percent of total billed charges,,,9421.36,82.8,,percent of total billed charges,,,9671.68,85,,percent of total billed charges,,,,,,,,,10013.04,88,,percent of total billed charges,,,,,,,,,8693.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2844.61,22,,percent of total billed charges,,,10354.39,91,,percent of total billed charges,,,10809.53,95,,percent of total billed charges,,,9444.11,83,,percent of total billed charges,,,9444.11,83,,percent of total billed charges,,,,,,,,,,,,,,,9444.11,83,,percent of total billed charges,,,10809.53,95,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,9330.33,82,,percent of total billed charges,,,10240.61,90,,percent of total billed charges,,,9671.68,85,,percent of total billed charges,,2844.61,10809.53,
DEPUY LINER CONSTRAINED +4 36 X 56,30182480,CDM,,,278,RC,outpatient,,33951.78,33951.78,,28825.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8487.95,22,,percent of total billed charges,,,,,,,,,30556.6,90,,percent of total billed charges,,,28112.07,82.8,,percent of total billed charges,,,28859.01,85,,percent of total billed charges,,,,,,,,,29877.57,88,,percent of total billed charges,,,,,,,,,25939.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8487.95,22,,percent of total billed charges,,,30896.12,91,,percent of total billed charges,,,32254.19,95,,percent of total billed charges,,,28179.98,83,,percent of total billed charges,,,28179.98,83,,percent of total billed charges,,,,,,,,,,,,,,,28179.98,83,,percent of total billed charges,,,32254.19,95,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,27840.46,82,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,28859.01,85,,percent of total billed charges,,8487.95,32254.19,
APPLIED BLADED OBTURATOR 5MM X 150,30182481,CDM,,,270,RC,outpatient,,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38,22,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,125.86,82.8,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38,22,,percent of total billed charges,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,38,144.4,
APPLIED BLADED OBTURATOR 12MM X 150,30182482,CDM,,,270,RC,outpatient,,280.43,280.43,,238.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.11,22,,percent of total billed charges,,,,,,,,,252.39,90,,percent of total billed charges,,,232.2,82.8,,percent of total billed charges,,,238.37,85,,percent of total billed charges,,,,,,,,,246.78,88,,percent of total billed charges,,,,,,,,,214.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70.11,22,,percent of total billed charges,,,255.19,91,,percent of total billed charges,,,266.41,95,,percent of total billed charges,,,232.76,83,,percent of total billed charges,,,232.76,83,,percent of total billed charges,,,,,,,,,,,,,,,232.76,83,,percent of total billed charges,,,266.41,95,,percent of total billed charges,,,252.39,90,,percent of total billed charges,,,252.39,90,,percent of total billed charges,,,229.95,82,,percent of total billed charges,,,252.39,90,,percent of total billed charges,,,238.37,85,,percent of total billed charges,,70.11,266.41,
S&N ENDO CANNULA TWIST 7.0,30182483,CDM,,,270,RC,outpatient,,253.05,253.05,,214.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.26,22,,percent of total billed charges,,,,,,,,,227.75,90,,percent of total billed charges,,,209.53,82.8,,percent of total billed charges,,,215.09,85,,percent of total billed charges,,,,,,,,,222.68,88,,percent of total billed charges,,,,,,,,,193.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.26,22,,percent of total billed charges,,,230.28,91,,percent of total billed charges,,,240.4,95,,percent of total billed charges,,,210.03,83,,percent of total billed charges,,,210.03,83,,percent of total billed charges,,,,,,,,,,,,,,,210.03,83,,percent of total billed charges,,,240.4,95,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,207.5,82,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,215.09,85,,percent of total billed charges,,63.26,240.4,
S&N ROD GUIDE BALL TIP 3MM X 1000,30182489,CDM,,,278,RC,outpatient,,1785.55,1785.55,,1515.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,446.39,22,,percent of total billed charges,,,,,,,,,1607,90,,percent of total billed charges,,,1478.44,82.8,,percent of total billed charges,,,1517.72,85,,percent of total billed charges,,,,,,,,,1571.28,88,,percent of total billed charges,,,,,,,,,1364.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,446.39,22,,percent of total billed charges,,,1624.85,91,,percent of total billed charges,,,1696.27,95,,percent of total billed charges,,,1482.01,83,,percent of total billed charges,,,1482.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1482.01,83,,percent of total billed charges,,,1696.27,95,,percent of total billed charges,,,1607,90,,percent of total billed charges,,,1607,90,,percent of total billed charges,,,1464.15,82,,percent of total billed charges,,,1607,90,,percent of total billed charges,,,1517.72,85,,percent of total billed charges,,446.39,1696.27,
SOLYX SIS SYSTEM,30182505,CDM,,,270,RC,outpatient,,7751.25,7751.25,,6580.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1937.81,22,,percent of total billed charges,,,,,,,,,6976.13,90,,percent of total billed charges,,,6418.04,82.8,,percent of total billed charges,,,6588.56,85,,percent of total billed charges,,,,,,,,,6821.1,88,,percent of total billed charges,,,,,,,,,5921.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1937.81,22,,percent of total billed charges,,,7053.64,91,,percent of total billed charges,,,7363.69,95,,percent of total billed charges,,,6433.54,83,,percent of total billed charges,,,6433.54,83,,percent of total billed charges,,,,,,,,,,,,,,,6433.54,83,,percent of total billed charges,,,7363.69,95,,percent of total billed charges,,,6976.13,90,,percent of total billed charges,,,6976.13,90,,percent of total billed charges,,,6356.03,82,,percent of total billed charges,,,6976.13,90,,percent of total billed charges,,,6588.56,85,,percent of total billed charges,,1937.81,7363.69,
DEPUY PINNACLE FLANGE CUSTOM RT 66MM,30182506,CDM,,,278,RC,outpatient,,64675,64675,,54909.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16168.75,22,,percent of total billed charges,,,,,,,,,58207.5,90,,percent of total billed charges,,,53550.9,82.8,,percent of total billed charges,,,54973.75,85,,percent of total billed charges,,,,,,,,,56914,88,,percent of total billed charges,,,,,,,,,49411.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16168.75,22,,percent of total billed charges,,,58854.25,91,,percent of total billed charges,,,61441.25,95,,percent of total billed charges,,,53680.25,83,,percent of total billed charges,,,53680.25,83,,percent of total billed charges,,,,,,,,,,,,,,,53680.25,83,,percent of total billed charges,,,61441.25,95,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,53033.5,82,,percent of total billed charges,,,58207.5,90,,percent of total billed charges,,,54973.75,85,,percent of total billed charges,,16168.75,61441.25,
STOPCOCK PLUG 3MM,30182509,CDM,,,270,RC,outpatient,,115.6,115.6,,98.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.9,22,,percent of total billed charges,,,,,,,,,104.04,90,,percent of total billed charges,,,95.72,82.8,,percent of total billed charges,,,98.26,85,,percent of total billed charges,,,,,,,,,101.73,88,,percent of total billed charges,,,,,,,,,88.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.9,22,,percent of total billed charges,,,105.2,91,,percent of total billed charges,,,109.82,95,,percent of total billed charges,,,95.95,83,,percent of total billed charges,,,95.95,83,,percent of total billed charges,,,,,,,,,,,,,,,95.95,83,,percent of total billed charges,,,109.82,95,,percent of total billed charges,,,104.04,90,,percent of total billed charges,,,104.04,90,,percent of total billed charges,,,94.79,82,,percent of total billed charges,,,104.04,90,,percent of total billed charges,,,98.26,85,,percent of total billed charges,,28.9,109.82,
DRAIN FLUTE 7MM FLAT,30182512,CDM,,,270,RC,outpatient,,124.48,124.48,,105.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.12,22,,percent of total billed charges,,,,,,,,,112.03,90,,percent of total billed charges,,,103.07,82.8,,percent of total billed charges,,,105.81,85,,percent of total billed charges,,,,,,,,,109.54,88,,percent of total billed charges,,,,,,,,,95.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.12,22,,percent of total billed charges,,,113.28,91,,percent of total billed charges,,,118.26,95,,percent of total billed charges,,,103.32,83,,percent of total billed charges,,,103.32,83,,percent of total billed charges,,,,,,,,,,,,,,,103.32,83,,percent of total billed charges,,,118.26,95,,percent of total billed charges,,,112.03,90,,percent of total billed charges,,,112.03,90,,percent of total billed charges,,,102.07,82,,percent of total billed charges,,,112.03,90,,percent of total billed charges,,,105.81,85,,percent of total billed charges,,31.12,118.26,
DEPUY DISTAL AUGMENT LT 4MM SZ2.5,30182513,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
ALLERGAN SILICONE BREAST IMPLANT 400CC,30182514,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
DEPUY INSERT TC3 RP 12.5MM SZ3,30182524,CDM,,,278,RC,outpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5779.25,22,,percent of total billed charges,,,,,,,,,20805.29,90,,percent of total billed charges,,,19140.87,82.8,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5779.25,22,,percent of total billed charges,,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,5779.25,21961.14,
DEPUY INSERT TC3 RP 17.5MM SZ5,30182525,CDM,,,278,RC,outpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5779.25,22,,percent of total billed charges,,,,,,,,,20805.29,90,,percent of total billed charges,,,19140.87,82.8,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5779.25,22,,percent of total billed charges,,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,5779.25,21961.14,
DEPUY STEM FLUTED UNIV 75 X 24,30182526,CDM,,,278,RC,outpatient,,12911.21,12911.21,,10961.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3227.8,22,,percent of total billed charges,,,,,,,,,11620.09,90,,percent of total billed charges,,,10690.48,82.8,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,,,,,,,,11361.86,88,,percent of total billed charges,,,,,,,,,9864.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3227.8,22,,percent of total billed charges,,,11749.2,91,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,,,,,,,,,,,,,10716.3,83,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10587.19,82,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,3227.8,12265.65,
DEPUY DISTAL AUGMENT RT 8MM,30182527,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
DEPUY MBT TRAY SLEEVE 45MM,30182528,CDM,,,270,RC,outpatient,,12860.84,12860.84,,10918.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3215.21,22,,percent of total billed charges,,,,,,,,,11574.76,90,,percent of total billed charges,,,10648.78,82.8,,percent of total billed charges,,,10931.71,85,,percent of total billed charges,,,,,,,,,11317.54,88,,percent of total billed charges,,,,,,,,,9825.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3215.21,22,,percent of total billed charges,,,11703.36,91,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10674.5,83,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10545.89,82,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10931.71,85,,percent of total billed charges,,3215.21,12217.8,
DRILL TWIST 3.2MM,30182532,CDM,,,270,RC,outpatient,,250.28,250.28,,212.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.57,22,,percent of total billed charges,,,,,,,,,225.25,90,,percent of total billed charges,,,207.23,82.8,,percent of total billed charges,,,212.74,85,,percent of total billed charges,,,,,,,,,220.25,88,,percent of total billed charges,,,,,,,,,191.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.57,22,,percent of total billed charges,,,227.75,91,,percent of total billed charges,,,237.77,95,,percent of total billed charges,,,207.73,83,,percent of total billed charges,,,207.73,83,,percent of total billed charges,,,,,,,,,,,,,,,207.73,83,,percent of total billed charges,,,237.77,95,,percent of total billed charges,,,225.25,90,,percent of total billed charges,,,225.25,90,,percent of total billed charges,,,205.23,82,,percent of total billed charges,,,225.25,90,,percent of total billed charges,,,212.74,85,,percent of total billed charges,,62.57,237.77,
DRILL TWIST 4.5MM,30182533,CDM,,,270,RC,outpatient,,250.28,250.28,,212.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.57,22,,percent of total billed charges,,,,,,,,,225.25,90,,percent of total billed charges,,,207.23,82.8,,percent of total billed charges,,,212.74,85,,percent of total billed charges,,,,,,,,,220.25,88,,percent of total billed charges,,,,,,,,,191.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.57,22,,percent of total billed charges,,,227.75,91,,percent of total billed charges,,,237.77,95,,percent of total billed charges,,,207.73,83,,percent of total billed charges,,,207.73,83,,percent of total billed charges,,,,,,,,,,,,,,,207.73,83,,percent of total billed charges,,,237.77,95,,percent of total billed charges,,,225.25,90,,percent of total billed charges,,,225.25,90,,percent of total billed charges,,,205.23,82,,percent of total billed charges,,,225.25,90,,percent of total billed charges,,,212.74,85,,percent of total billed charges,,62.57,237.77,
DEPUY DISTAL AUGMENT LT 12MM SZ2.5,30182534,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
AVAMAX PLUS CEMENT DELIVERY,30182549,CDM,,,270,RC,outpatient,,4508.4,4508.4,,3827.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1127.1,22,,percent of total billed charges,,,,,,,,,4057.56,90,,percent of total billed charges,,,3732.96,82.8,,percent of total billed charges,,,3832.14,85,,percent of total billed charges,,,,,,,,,3967.39,88,,percent of total billed charges,,,,,,,,,3444.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1127.1,22,,percent of total billed charges,,,4102.64,91,,percent of total billed charges,,,4282.98,95,,percent of total billed charges,,,3741.97,83,,percent of total billed charges,,,3741.97,83,,percent of total billed charges,,,,,,,,,,,,,,,3741.97,83,,percent of total billed charges,,,4282.98,95,,percent of total billed charges,,,4057.56,90,,percent of total billed charges,,,4057.56,90,,percent of total billed charges,,,3696.89,82,,percent of total billed charges,,,4057.56,90,,percent of total billed charges,,,3832.14,85,,percent of total billed charges,,1127.1,4282.98,
AVAFLEX PLUS CURVED NEEDLE,30182550,CDM,,,270,RC,outpatient,,2996.57,2996.57,,2544.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,749.14,22,,percent of total billed charges,,,,,,,,,2696.91,90,,percent of total billed charges,,,2481.16,82.8,,percent of total billed charges,,,2547.08,85,,percent of total billed charges,,,,,,,,,2636.98,88,,percent of total billed charges,,,,,,,,,2289.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,749.14,22,,percent of total billed charges,,,2726.88,91,,percent of total billed charges,,,2846.74,95,,percent of total billed charges,,,2487.15,83,,percent of total billed charges,,,2487.15,83,,percent of total billed charges,,,,,,,,,,,,,,,2487.15,83,,percent of total billed charges,,,2846.74,95,,percent of total billed charges,,,2696.91,90,,percent of total billed charges,,,2696.91,90,,percent of total billed charges,,,2457.19,82,,percent of total billed charges,,,2696.91,90,,percent of total billed charges,,,2547.08,85,,percent of total billed charges,,749.14,2846.74,
S&N ENDO CANNULA TWIST 8.5,30182551,CDM,,,270,RC,outpatient,,253.05,253.05,,214.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.26,22,,percent of total billed charges,,,,,,,,,227.75,90,,percent of total billed charges,,,209.53,82.8,,percent of total billed charges,,,215.09,85,,percent of total billed charges,,,,,,,,,222.68,88,,percent of total billed charges,,,,,,,,,193.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.26,22,,percent of total billed charges,,,230.28,91,,percent of total billed charges,,,240.4,95,,percent of total billed charges,,,210.03,83,,percent of total billed charges,,,210.03,83,,percent of total billed charges,,,,,,,,,,,,,,,210.03,83,,percent of total billed charges,,,240.4,95,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,207.5,82,,percent of total billed charges,,,227.75,90,,percent of total billed charges,,,215.09,85,,percent of total billed charges,,63.26,240.4,
MESH VENTRALIGHT W/ECHO 7X9,30182552,CDM,,,278,RC,outpatient,,9912.5,9912.5,,8415.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2478.13,22,,percent of total billed charges,,,,,,,,,8921.25,90,,percent of total billed charges,,,8207.55,82.8,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,,,,,,,,8723,88,,percent of total billed charges,,,,,,,,,7573.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2478.13,22,,percent of total billed charges,,,9020.38,91,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,,,,,,,,,,,,,8227.38,83,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8128.25,82,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,2478.13,9416.88,
MESH VENTRALIGHT W/ECHO 8X10,30182553,CDM,,,270,RC,outpatient,,11635,11635,,9878.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2908.75,22,,percent of total billed charges,,,,,,,,,10471.5,90,,percent of total billed charges,,,9633.78,82.8,,percent of total billed charges,,,9889.75,85,,percent of total billed charges,,,,,,,,,10238.8,88,,percent of total billed charges,,,,,,,,,8889.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2908.75,22,,percent of total billed charges,,,10587.85,91,,percent of total billed charges,,,11053.25,95,,percent of total billed charges,,,9657.05,83,,percent of total billed charges,,,9657.05,83,,percent of total billed charges,,,,,,,,,,,,,,,9657.05,83,,percent of total billed charges,,,11053.25,95,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,9540.7,82,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,9889.75,85,,percent of total billed charges,,2908.75,11053.25,
DEPUY STEM CORAIL KLA SZ10,30182555,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY FEMUR SIGMA PS NL SZ4,30182556,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
DEPUY DISTAL AUGMENT RT 16MM,30182557,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
DEPUY POSTERIOR AUGMENT 8MM,30182558,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
DEPUY MBT STEP WEDGE 10MM SZ4,30182559,CDM,,,278,RC,outpatient,,15761.79,15761.79,,13381.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3940.45,22,,percent of total billed charges,,,,,,,,,14185.61,90,,percent of total billed charges,,,13050.76,82.8,,percent of total billed charges,,,13397.52,85,,percent of total billed charges,,,,,,,,,13870.38,88,,percent of total billed charges,,,,,,,,,12042.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3940.45,22,,percent of total billed charges,,,14343.23,91,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,,,,,,,,,,,,,13082.29,83,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,12924.67,82,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,13397.52,85,,percent of total billed charges,,3940.45,14973.7,
DEPUY INSERT TC3 RP 20MM SZ5,30182560,CDM,,,278,RC,outpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5779.25,22,,percent of total billed charges,,,,,,,,,20805.29,90,,percent of total billed charges,,,19140.87,82.8,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5779.25,22,,percent of total billed charges,,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,5779.25,21961.14,
DEPUY SCREW PROTROSIO 52MM,30182566,CDM,,,278,RC,outpatient,,21625.7,21625.7,,18360.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5406.43,22,,percent of total billed charges,,,,,,,,,19463.13,90,,percent of total billed charges,,,17906.08,82.8,,percent of total billed charges,,,18381.85,85,,percent of total billed charges,,,,,,,,,19030.62,88,,percent of total billed charges,,,,,,,,,16522.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5406.43,22,,percent of total billed charges,,,19679.39,91,,percent of total billed charges,,,20544.42,95,,percent of total billed charges,,,17949.33,83,,percent of total billed charges,,,17949.33,83,,percent of total billed charges,,,,,,,,,,,,,,,17949.33,83,,percent of total billed charges,,,20544.42,95,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,17733.07,82,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,18381.85,85,,percent of total billed charges,,5406.43,20544.42,
DEPUY SCREW SELF TAP 45MM,30182567,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
DEPUY SCREW SELF TAP 40MM,30182568,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
DEPUY SCREW SELF TAP 35MM,30182569,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
DEPUY SCREW SELF TAP 25MM,30182570,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
DEPUY SCREW SELF TAP 30MM,30182571,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
DEPUY STEM BOWED SZ16.5 X 11,30182572,CDM,,,278,RC,outpatient,,68800.94,68800.94,,58412,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17200.24,22,,percent of total billed charges,,,,,,,,,61920.85,90,,percent of total billed charges,,,56967.18,82.8,,percent of total billed charges,,,58480.8,85,,percent of total billed charges,,,,,,,,,60544.83,88,,percent of total billed charges,,,,,,,,,52563.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17200.24,22,,percent of total billed charges,,,62608.86,91,,percent of total billed charges,,,65360.89,95,,percent of total billed charges,,,57104.78,83,,percent of total billed charges,,,57104.78,83,,percent of total billed charges,,,,,,,,,,,,,,,57104.78,83,,percent of total billed charges,,,65360.89,95,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,56416.77,82,,percent of total billed charges,,,61920.85,90,,percent of total billed charges,,,58480.8,85,,percent of total billed charges,,17200.24,65360.89,
SYNTHES SCREW CANCEL 4.0X40MM,30182573,CDM,,,278,RC,outpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.78,22,,percent of total billed charges,,,,,,,,,200.82,90,,percent of total billed charges,,,184.75,82.8,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.78,22,,percent of total billed charges,,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,55.78,211.97,
STRYKER BLADE SAGITTAL DUAL CUT,30182575,CDM,,,270,RC,outpatient,,355.32,355.32,,301.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.83,22,,percent of total billed charges,,,,,,,,,319.79,90,,percent of total billed charges,,,294.2,82.8,,percent of total billed charges,,,302.02,85,,percent of total billed charges,,,,,,,,,312.68,88,,percent of total billed charges,,,,,,,,,271.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.83,22,,percent of total billed charges,,,323.34,91,,percent of total billed charges,,,337.55,95,,percent of total billed charges,,,294.92,83,,percent of total billed charges,,,294.92,83,,percent of total billed charges,,,,,,,,,,,,,,,294.92,83,,percent of total billed charges,,,337.55,95,,percent of total billed charges,,,319.79,90,,percent of total billed charges,,,319.79,90,,percent of total billed charges,,,291.36,82,,percent of total billed charges,,,319.79,90,,percent of total billed charges,,,302.02,85,,percent of total billed charges,,88.83,337.55,
DEPUY LINER CONSTRAINED +4 40 X 66,30182586,CDM,,,278,RC,outpatient,,39314.21,39314.21,,33377.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9828.55,22,,percent of total billed charges,,,,,,,,,35382.79,90,,percent of total billed charges,,,32552.17,82.8,,percent of total billed charges,,,33417.08,85,,percent of total billed charges,,,,,,,,,34596.5,88,,percent of total billed charges,,,,,,,,,30036.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9828.55,22,,percent of total billed charges,,,35775.93,91,,percent of total billed charges,,,37348.5,95,,percent of total billed charges,,,32630.79,83,,percent of total billed charges,,,32630.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32630.79,83,,percent of total billed charges,,,37348.5,95,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,32237.65,82,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,33417.08,85,,percent of total billed charges,,9828.55,37348.5,
DEPUY SCREW SELF TAP 50MM,30182587,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
DEPUY SCREW SELF TAP 60MM,30182588,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
DEPUY SCREW SELF TAP 55MM,30182589,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
BACKSTOP CLEAR GEL X 3FR CATH KIT,30182595,CDM,,,270,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
BALLOON DILATATION CATH KIT 18FR,30182596,CDM,,,270,RC,outpatient,,2506.73,2506.73,,2128.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,626.68,22,,percent of total billed charges,,,,,,,,,2256.06,90,,percent of total billed charges,,,2075.57,82.8,,percent of total billed charges,,,2130.72,85,,percent of total billed charges,,,,,,,,,2205.92,88,,percent of total billed charges,,,,,,,,,1915.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,626.68,22,,percent of total billed charges,,,2281.12,91,,percent of total billed charges,,,2381.39,95,,percent of total billed charges,,,2080.59,83,,percent of total billed charges,,,2080.59,83,,percent of total billed charges,,,,,,,,,,,,,,,2080.59,83,,percent of total billed charges,,,2381.39,95,,percent of total billed charges,,,2256.06,90,,percent of total billed charges,,,2256.06,90,,percent of total billed charges,,,2055.52,82,,percent of total billed charges,,,2256.06,90,,percent of total billed charges,,,2130.72,85,,percent of total billed charges,,626.68,2381.39,
GYRUS THUNDERBEAT 5M 35CM,30182602,CDM,,,270,RC,outpatient,,6251.7,6251.7,,5307.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1562.93,22,,percent of total billed charges,,,,,,,,,5626.53,90,,percent of total billed charges,,,5176.41,82.8,,percent of total billed charges,,,5313.95,85,,percent of total billed charges,,,,,,,,,5501.5,88,,percent of total billed charges,,,,,,,,,4776.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1562.93,22,,percent of total billed charges,,,5689.05,91,,percent of total billed charges,,,5939.12,95,,percent of total billed charges,,,5188.91,83,,percent of total billed charges,,,5188.91,83,,percent of total billed charges,,,,,,,,,,,,,,,5188.91,83,,percent of total billed charges,,,5939.12,95,,percent of total billed charges,,,5626.53,90,,percent of total billed charges,,,5626.53,90,,percent of total billed charges,,,5126.39,82,,percent of total billed charges,,,5626.53,90,,percent of total billed charges,,,5313.95,85,,percent of total billed charges,,1562.93,5939.12,
STRYKER BLADE MICRO SAGITAL LONG MED,30182603,CDM,,,270,RC,outpatient,,314.48,314.48,,266.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.62,22,,percent of total billed charges,,,,,,,,,283.03,90,,percent of total billed charges,,,260.39,82.8,,percent of total billed charges,,,267.31,85,,percent of total billed charges,,,,,,,,,276.74,88,,percent of total billed charges,,,,,,,,,240.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.62,22,,percent of total billed charges,,,286.18,91,,percent of total billed charges,,,298.76,95,,percent of total billed charges,,,261.02,83,,percent of total billed charges,,,261.02,83,,percent of total billed charges,,,,,,,,,,,,,,,261.02,83,,percent of total billed charges,,,298.76,95,,percent of total billed charges,,,283.03,90,,percent of total billed charges,,,283.03,90,,percent of total billed charges,,,257.87,82,,percent of total billed charges,,,283.03,90,,percent of total billed charges,,,267.31,85,,percent of total billed charges,,78.62,298.76,
MESH OVAL MEDIUM 4.3 X 5.5,30182606,CDM,,,278,RC,outpatient,,5791.5,5791.5,,4916.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1447.88,22,,percent of total billed charges,,,,,,,,,5212.35,90,,percent of total billed charges,,,4795.36,82.8,,percent of total billed charges,,,4922.78,85,,percent of total billed charges,,,,,,,,,5096.52,88,,percent of total billed charges,,,,,,,,,4424.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1447.88,22,,percent of total billed charges,,,5270.27,91,,percent of total billed charges,,,5501.93,95,,percent of total billed charges,,,4806.95,83,,percent of total billed charges,,,4806.95,83,,percent of total billed charges,,,,,,,,,,,,,,,4806.95,83,,percent of total billed charges,,,5501.93,95,,percent of total billed charges,,,5212.35,90,,percent of total billed charges,,,5212.35,90,,percent of total billed charges,,,4749.03,82,,percent of total billed charges,,,5212.35,90,,percent of total billed charges,,,4922.78,85,,percent of total billed charges,,1447.88,5501.93,
MESH OVAL LARGE 5.4 X 7.0,30182607,CDM,,,278,RC,outpatient,,7637.5,7637.5,,6484.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1909.38,22,,percent of total billed charges,,,,,,,,,6873.75,90,,percent of total billed charges,,,6323.85,82.8,,percent of total billed charges,,,6491.88,85,,percent of total billed charges,,,,,,,,,6721,88,,percent of total billed charges,,,,,,,,,5835.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1909.38,22,,percent of total billed charges,,,6950.13,91,,percent of total billed charges,,,7255.63,95,,percent of total billed charges,,,6339.13,83,,percent of total billed charges,,,6339.13,83,,percent of total billed charges,,,,,,,,,,,,,,,6339.13,83,,percent of total billed charges,,,7255.63,95,,percent of total billed charges,,,6873.75,90,,percent of total billed charges,,,6873.75,90,,percent of total billed charges,,,6262.75,82,,percent of total billed charges,,,6873.75,90,,percent of total billed charges,,,6491.88,85,,percent of total billed charges,,1909.38,7255.63,
DEPUY INSERT TC3 12.5MM SZ3,30182608,CDM,,,278,RC,outpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5779.25,22,,percent of total billed charges,,,,,,,,,20805.29,90,,percent of total billed charges,,,19140.87,82.8,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5779.25,22,,percent of total billed charges,,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,5779.25,21961.14,
DEPUY BONE CEMENT ENDURANCE,30182609,CDM,,,278,RC,outpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175,22,,percent of total billed charges,,,,,,,,,630,90,,percent of total billed charges,,,579.6,82.8,,percent of total billed charges,,,595,85,,percent of total billed charges,,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175,22,,percent of total billed charges,,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,175,665,
DEPUY KNEE CEMENTED W/AOX,30182611,CDM,,,278,RC,outpatient,,35205.76,35205.76,,29889.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8801.44,22,,percent of total billed charges,,,,,,,,,31685.18,90,,percent of total billed charges,,,29150.37,82.8,,percent of total billed charges,,,29924.9,85,,percent of total billed charges,,,,,,,,,30981.07,88,,percent of total billed charges,,,,,,,,,26897.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8801.44,22,,percent of total billed charges,,,32037.24,91,,percent of total billed charges,,,33445.47,95,,percent of total billed charges,,,29220.78,83,,percent of total billed charges,,,29220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,29220.78,83,,percent of total billed charges,,,33445.47,95,,percent of total billed charges,,,31685.18,90,,percent of total billed charges,,,31685.18,90,,percent of total billed charges,,,28868.72,82,,percent of total billed charges,,,31685.18,90,,percent of total billed charges,,,29924.9,85,,percent of total billed charges,,8801.44,33445.47,
DEPUY INSERT TIBIAL AOX 20MM SZ5,30182612,CDM,,,278,RC,outpatient,,17068.29,17068.29,,14490.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4267.07,22,,percent of total billed charges,,,,,,,,,15361.46,90,,percent of total billed charges,,,14132.54,82.8,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,,,,,,,,15020.1,88,,percent of total billed charges,,,,,,,,,13040.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4267.07,22,,percent of total billed charges,,,15532.14,91,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,,,,,,,,,,,,,14166.68,83,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,13996,82,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,4267.07,16214.88,
I.L.A. NICRON FIBER 200,30182615,CDM,,,270,RC,outpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325,22,,percent of total billed charges,,,,,,,,,1170,90,,percent of total billed charges,,,1076.4,82.8,,percent of total billed charges,,,1105,85,,percent of total billed charges,,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325,22,,percent of total billed charges,,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,325,1235,
STRYKER BUR 4.0 EGG,30182617,CDM,,,270,RC,outpatient,,472.01,472.01,,400.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,118,22,,percent of total billed charges,,,,,,,,,424.81,90,,percent of total billed charges,,,390.82,82.8,,percent of total billed charges,,,401.21,85,,percent of total billed charges,,,,,,,,,415.37,88,,percent of total billed charges,,,,,,,,,360.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,118,22,,percent of total billed charges,,,429.53,91,,percent of total billed charges,,,448.41,95,,percent of total billed charges,,,391.77,83,,percent of total billed charges,,,391.77,83,,percent of total billed charges,,,,,,,,,,,,,,,391.77,83,,percent of total billed charges,,,448.41,95,,percent of total billed charges,,,424.81,90,,percent of total billed charges,,,424.81,90,,percent of total billed charges,,,387.05,82,,percent of total billed charges,,,424.81,90,,percent of total billed charges,,,401.21,85,,percent of total billed charges,,118,448.41,
INTEGRA ACCELL EVO3C 10CC,30182629,CDM,,,278,RC,outpatient,,16508.12,16508.12,,14015.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4127.03,22,,percent of total billed charges,,,,,,,,,14857.31,90,,percent of total billed charges,,,13668.72,82.8,,percent of total billed charges,,,14031.9,85,,percent of total billed charges,,,,,,,,,14527.15,88,,percent of total billed charges,,,,,,,,,12612.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4127.03,22,,percent of total billed charges,,,15022.39,91,,percent of total billed charges,,,15682.71,95,,percent of total billed charges,,,13701.74,83,,percent of total billed charges,,,13701.74,83,,percent of total billed charges,,,,,,,,,,,,,,,13701.74,83,,percent of total billed charges,,,15682.71,95,,percent of total billed charges,,,14857.31,90,,percent of total billed charges,,,14857.31,90,,percent of total billed charges,,,13536.66,82,,percent of total billed charges,,,14857.31,90,,percent of total billed charges,,,14031.9,85,,percent of total billed charges,,4127.03,15682.71,
INTEGRA  MOZAIK STRIP 15CC,30182630,CDM,,,278,RC,outpatient,,11235.51,11235.51,,9538.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2808.88,22,,percent of total billed charges,,,,,,,,,10111.96,90,,percent of total billed charges,,,9303,82.8,,percent of total billed charges,,,9550.18,85,,percent of total billed charges,,,,,,,,,9887.25,88,,percent of total billed charges,,,,,,,,,8583.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2808.88,22,,percent of total billed charges,,,10224.31,91,,percent of total billed charges,,,10673.73,95,,percent of total billed charges,,,9325.47,83,,percent of total billed charges,,,9325.47,83,,percent of total billed charges,,,,,,,,,,,,,,,9325.47,83,,percent of total billed charges,,,10673.73,95,,percent of total billed charges,,,10111.96,90,,percent of total billed charges,,,10111.96,90,,percent of total billed charges,,,9213.12,82,,percent of total billed charges,,,10111.96,90,,percent of total billed charges,,,9550.18,85,,percent of total billed charges,,2808.88,10673.73,
INTEGRA ASPIREX PLUS BONE MARROW KIT,30182631,CDM,,,270,RC,outpatient,,883.42,883.42,,750.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,220.86,22,,percent of total billed charges,,,,,,,,,795.08,90,,percent of total billed charges,,,731.47,82.8,,percent of total billed charges,,,750.91,85,,percent of total billed charges,,,,,,,,,777.41,88,,percent of total billed charges,,,,,,,,,674.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,220.86,22,,percent of total billed charges,,,803.91,91,,percent of total billed charges,,,839.25,95,,percent of total billed charges,,,733.24,83,,percent of total billed charges,,,733.24,83,,percent of total billed charges,,,,,,,,,,,,,,,733.24,83,,percent of total billed charges,,,839.25,95,,percent of total billed charges,,,795.08,90,,percent of total billed charges,,,795.08,90,,percent of total billed charges,,,724.4,82,,percent of total billed charges,,,795.08,90,,percent of total billed charges,,,750.91,85,,percent of total billed charges,,220.86,839.25,
DEPUY NAIL HUMERAL 9 X 220,30182632,CDM,,,278,RC,outpatient,,12857,12857,,10915.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3214.25,22,,percent of total billed charges,,,,,,,,,11571.3,90,,percent of total billed charges,,,10645.6,82.8,,percent of total billed charges,,,10928.45,85,,percent of total billed charges,,,,,,,,,11314.16,88,,percent of total billed charges,,,,,,,,,9822.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3214.25,22,,percent of total billed charges,,,11699.87,91,,percent of total billed charges,,,12214.15,95,,percent of total billed charges,,,10671.31,83,,percent of total billed charges,,,10671.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10671.31,83,,percent of total billed charges,,,12214.15,95,,percent of total billed charges,,,11571.3,90,,percent of total billed charges,,,11571.3,90,,percent of total billed charges,,,10542.74,82,,percent of total billed charges,,,11571.3,90,,percent of total billed charges,,,10928.45,85,,percent of total billed charges,,3214.25,12214.15,
DEPUY NAIL PROXIMAL 10 X 15,30182633,CDM,,,278,RC,outpatient,,6854.25,6854.25,,5819.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1713.56,22,,percent of total billed charges,,,,,,,,,6168.83,90,,percent of total billed charges,,,5675.32,82.8,,percent of total billed charges,,,5826.11,85,,percent of total billed charges,,,,,,,,,6031.74,88,,percent of total billed charges,,,,,,,,,5236.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1713.56,22,,percent of total billed charges,,,6237.37,91,,percent of total billed charges,,,6511.54,95,,percent of total billed charges,,,5689.03,83,,percent of total billed charges,,,5689.03,83,,percent of total billed charges,,,,,,,,,,,,,,,5689.03,83,,percent of total billed charges,,,6511.54,95,,percent of total billed charges,,,6168.83,90,,percent of total billed charges,,,6168.83,90,,percent of total billed charges,,,5620.49,82,,percent of total billed charges,,,6168.83,90,,percent of total billed charges,,,5826.11,85,,percent of total billed charges,,1713.56,6511.54,
DEPUY NAIL HUMERAL 9 X 300,30182634,CDM,,,278,RC,outpatient,,6428.5,6428.5,,5457.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1607.13,22,,percent of total billed charges,,,,,,,,,5785.65,90,,percent of total billed charges,,,5322.8,82.8,,percent of total billed charges,,,5464.23,85,,percent of total billed charges,,,,,,,,,5657.08,88,,percent of total billed charges,,,,,,,,,4911.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1607.13,22,,percent of total billed charges,,,5849.94,91,,percent of total billed charges,,,6107.08,95,,percent of total billed charges,,,5335.66,83,,percent of total billed charges,,,5335.66,83,,percent of total billed charges,,,,,,,,,,,,,,,5335.66,83,,percent of total billed charges,,,6107.08,95,,percent of total billed charges,,,5785.65,90,,percent of total billed charges,,,5785.65,90,,percent of total billed charges,,,5271.37,82,,percent of total billed charges,,,5785.65,90,,percent of total billed charges,,,5464.23,85,,percent of total billed charges,,1607.13,6107.08,
DEPUY POROUS FEMORAL SLEEVE 245,30182635,CDM,,,278,RC,outpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4515.54,22,,percent of total billed charges,,,,,,,,,16255.93,90,,percent of total billed charges,,,14955.45,82.8,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4515.54,22,,percent of total billed charges,,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,4515.54,17159.03,
DEPUY SLEEVE ADAPTER LPS +0MM,30182636,CDM,,,278,RC,outpatient,,6309.03,6309.03,,5356.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1577.26,22,,percent of total billed charges,,,,,,,,,5678.13,90,,percent of total billed charges,,,5223.88,82.8,,percent of total billed charges,,,5362.68,85,,percent of total billed charges,,,,,,,,,5551.95,88,,percent of total billed charges,,,,,,,,,4820.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1577.26,22,,percent of total billed charges,,,5741.22,91,,percent of total billed charges,,,5993.58,95,,percent of total billed charges,,,5236.49,83,,percent of total billed charges,,,5236.49,83,,percent of total billed charges,,,,,,,,,,,,,,,5236.49,83,,percent of total billed charges,,,5993.58,95,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5173.4,82,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5362.68,85,,percent of total billed charges,,1577.26,5993.58,
DEPUY MBT TRAY SLEEVE 53MM,30182637,CDM,,,278,RC,outpatient,,12860.84,12860.84,,10918.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3215.21,22,,percent of total billed charges,,,,,,,,,11574.76,90,,percent of total billed charges,,,10648.78,82.8,,percent of total billed charges,,,10931.71,85,,percent of total billed charges,,,,,,,,,11317.54,88,,percent of total billed charges,,,,,,,,,9825.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3215.21,22,,percent of total billed charges,,,11703.36,91,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,10674.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10674.5,83,,percent of total billed charges,,,12217.8,95,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10545.89,82,,percent of total billed charges,,,11574.76,90,,percent of total billed charges,,,10931.71,85,,percent of total billed charges,,3215.21,12217.8,
DEPUY FEMUR DISTAL XXSM RT,30182638,CDM,,,278,RC,outpatient,,97092.39,97092.39,,82431.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24273.1,22,,percent of total billed charges,,,,,,,,,87383.15,90,,percent of total billed charges,,,80392.5,82.8,,percent of total billed charges,,,82528.53,85,,percent of total billed charges,,,,,,,,,85441.3,88,,percent of total billed charges,,,,,,,,,74178.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24273.1,22,,percent of total billed charges,,,88354.07,91,,percent of total billed charges,,,92237.77,95,,percent of total billed charges,,,80586.68,83,,percent of total billed charges,,,80586.68,83,,percent of total billed charges,,,,,,,,,,,,,,,80586.68,83,,percent of total billed charges,,,92237.77,95,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,79615.76,82,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,82528.53,85,,percent of total billed charges,,24273.1,92237.77,
DEPUY INSERT LPS XXSM 12MM,30182639,CDM,,,278,RC,outpatient,,27579.5,27579.5,,23415,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6894.88,22,,percent of total billed charges,,,,,,,,,24821.55,90,,percent of total billed charges,,,22835.83,82.8,,percent of total billed charges,,,23442.58,85,,percent of total billed charges,,,,,,,,,24269.96,88,,percent of total billed charges,,,,,,,,,21070.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6894.88,22,,percent of total billed charges,,,25097.35,91,,percent of total billed charges,,,26200.53,95,,percent of total billed charges,,,22890.99,83,,percent of total billed charges,,,22890.99,83,,percent of total billed charges,,,,,,,,,,,,,,,22890.99,83,,percent of total billed charges,,,26200.53,95,,percent of total billed charges,,,24821.55,90,,percent of total billed charges,,,24821.55,90,,percent of total billed charges,,,22615.19,82,,percent of total billed charges,,,24821.55,90,,percent of total billed charges,,,23442.58,85,,percent of total billed charges,,6894.88,26200.53,
DEPUY STEM CEMENTED 13 X 120,30182640,CDM,,,278,RC,outpatient,,8116.23,8116.23,,6890.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2029.06,22,,percent of total billed charges,,,,,,,,,7304.61,90,,percent of total billed charges,,,6720.24,82.8,,percent of total billed charges,,,6898.8,85,,percent of total billed charges,,,,,,,,,7142.28,88,,percent of total billed charges,,,,,,,,,6200.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2029.06,22,,percent of total billed charges,,,7385.77,91,,percent of total billed charges,,,7710.42,95,,percent of total billed charges,,,6736.47,83,,percent of total billed charges,,,6736.47,83,,percent of total billed charges,,,,,,,,,,,,,,,6736.47,83,,percent of total billed charges,,,7710.42,95,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,6655.31,82,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,6898.8,85,,percent of total billed charges,,2029.06,7710.42,
DEPUY STEM CEMENTED 13 X 30,30182641,CDM,,,278,RC,outpatient,,6179.68,6179.68,,5246.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1544.92,22,,percent of total billed charges,,,,,,,,,5561.71,90,,percent of total billed charges,,,5116.78,82.8,,percent of total billed charges,,,5252.73,85,,percent of total billed charges,,,,,,,,,5438.12,88,,percent of total billed charges,,,,,,,,,4721.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1544.92,22,,percent of total billed charges,,,5623.51,91,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,5129.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5129.13,83,,percent of total billed charges,,,5870.7,95,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5067.34,82,,percent of total billed charges,,,5561.71,90,,percent of total billed charges,,,5252.73,85,,percent of total billed charges,,1544.92,5870.7,
DEPUY FRACTURE HEAD HIP BALL 41MM,30182643,CDM,,,278,RC,outpatient,,4693.78,4693.78,,3985.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1173.45,22,,percent of total billed charges,,,,,,,,,4224.4,90,,percent of total billed charges,,,3886.45,82.8,,percent of total billed charges,,,3989.71,85,,percent of total billed charges,,,,,,,,,4130.53,88,,percent of total billed charges,,,,,,,,,3586.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1173.45,22,,percent of total billed charges,,,4271.34,91,,percent of total billed charges,,,4459.09,95,,percent of total billed charges,,,3895.84,83,,percent of total billed charges,,,3895.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3895.84,83,,percent of total billed charges,,,4459.09,95,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,3848.9,82,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,3989.71,85,,percent of total billed charges,,1173.45,4459.09,
S&N ENDO BIORAPTOR KIT 2.9,30182645,CDM,,,270,RC,outpatient,,1910.55,1910.55,,1622.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,477.64,22,,percent of total billed charges,,,,,,,,,1719.5,90,,percent of total billed charges,,,1581.94,82.8,,percent of total billed charges,,,1623.97,85,,percent of total billed charges,,,,,,,,,1681.28,88,,percent of total billed charges,,,,,,,,,1459.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,477.64,22,,percent of total billed charges,,,1738.6,91,,percent of total billed charges,,,1815.02,95,,percent of total billed charges,,,1585.76,83,,percent of total billed charges,,,1585.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1585.76,83,,percent of total billed charges,,,1815.02,95,,percent of total billed charges,,,1719.5,90,,percent of total billed charges,,,1719.5,90,,percent of total billed charges,,,1566.65,82,,percent of total billed charges,,,1719.5,90,,percent of total billed charges,,,1623.97,85,,percent of total billed charges,,477.64,1815.02,
AVAMAX VERTEBRAL BALLOON TRAY,30182646,CDM,,,270,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
AUTOLOGOUS CULTURED CHONDROCYTES,30182650,CDM,,,278,RC,outpatient,,225981.6,225981.6,,191858.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56495.4,22,,percent of total billed charges,,,,,,,,,203383.44,90,,percent of total billed charges,,,187112.76,82.8,,percent of total billed charges,,,192084.36,85,,percent of total billed charges,,,,,,,,,198863.81,88,,percent of total billed charges,,,,,,,,,172649.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56495.4,22,,percent of total billed charges,,,205643.26,91,,percent of total billed charges,,,214682.52,95,,percent of total billed charges,,,187564.73,83,,percent of total billed charges,,,187564.73,83,,percent of total billed charges,,,,,,,,,,,,,,,187564.73,83,,percent of total billed charges,,,214682.52,95,,percent of total billed charges,,,203383.44,90,,percent of total billed charges,,,203383.44,90,,percent of total billed charges,,,185304.91,82,,percent of total billed charges,,,203383.44,90,,percent of total billed charges,,,192084.36,85,,percent of total billed charges,,56495.4,214682.52,
DEPUY RENTAL FEE - MORELAND 98-000,30182652,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
DEPUY PINNACLE CUP MULTIHOLE 58MM,30182653,CDM,,,278,RC,outpatient,,16354,16354,,13884.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4088.5,22,,percent of total billed charges,,,,,,,,,14718.6,90,,percent of total billed charges,,,13541.11,82.8,,percent of total billed charges,,,13900.9,85,,percent of total billed charges,,,,,,,,,14391.52,88,,percent of total billed charges,,,,,,,,,12494.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4088.5,22,,percent of total billed charges,,,14882.14,91,,percent of total billed charges,,,15536.3,95,,percent of total billed charges,,,13573.82,83,,percent of total billed charges,,,13573.82,83,,percent of total billed charges,,,,,,,,,,,,,,,13573.82,83,,percent of total billed charges,,,15536.3,95,,percent of total billed charges,,,14718.6,90,,percent of total billed charges,,,14718.6,90,,percent of total billed charges,,,13410.28,82,,percent of total billed charges,,,14718.6,90,,percent of total billed charges,,,13900.9,85,,percent of total billed charges,,4088.5,15536.3,
MICROPORT ADVANCE PATELLA 10MM X 38MM,30182655,CDM,,,278,RC,outpatient,,7163,7163,,6081.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1790.75,22,,percent of total billed charges,,,,,,,,,6446.7,90,,percent of total billed charges,,,5930.96,82.8,,percent of total billed charges,,,6088.55,85,,percent of total billed charges,,,,,,,,,6303.44,88,,percent of total billed charges,,,,,,,,,5472.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1790.75,22,,percent of total billed charges,,,6518.33,91,,percent of total billed charges,,,6804.85,95,,percent of total billed charges,,,5945.29,83,,percent of total billed charges,,,5945.29,83,,percent of total billed charges,,,,,,,,,,,,,,,5945.29,83,,percent of total billed charges,,,6804.85,95,,percent of total billed charges,,,6446.7,90,,percent of total billed charges,,,6446.7,90,,percent of total billed charges,,,5873.66,82,,percent of total billed charges,,,6446.7,90,,percent of total billed charges,,,6088.55,85,,percent of total billed charges,,1790.75,6804.85,
DEPUY INSERT,30182657,CDM,,,278,RC,outpatient,,6061.9,6061.9,,5146.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1515.48,22,,percent of total billed charges,,,,,,,,,5455.71,90,,percent of total billed charges,,,5019.25,82.8,,percent of total billed charges,,,5152.62,85,,percent of total billed charges,,,,,,,,,5334.47,88,,percent of total billed charges,,,,,,,,,4631.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1515.48,22,,percent of total billed charges,,,5516.33,91,,percent of total billed charges,,,5758.81,95,,percent of total billed charges,,,5031.38,83,,percent of total billed charges,,,5031.38,83,,percent of total billed charges,,,,,,,,,,,,,,,5031.38,83,,percent of total billed charges,,,5758.81,95,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,4970.76,82,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,5152.62,85,,percent of total billed charges,,1515.48,5758.81,
MESH VENTRALIGHT W/ECHO 3X3,30182660,CDM,,,278,RC,outpatient,,3315,3315,,2814.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,828.75,22,,percent of total billed charges,,,,,,,,,2983.5,90,,percent of total billed charges,,,2744.82,82.8,,percent of total billed charges,,,2817.75,85,,percent of total billed charges,,,,,,,,,2917.2,88,,percent of total billed charges,,,,,,,,,2532.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,828.75,22,,percent of total billed charges,,,3016.65,91,,percent of total billed charges,,,3149.25,95,,percent of total billed charges,,,2751.45,83,,percent of total billed charges,,,2751.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2751.45,83,,percent of total billed charges,,,3149.25,95,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2718.3,82,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2817.75,85,,percent of total billed charges,,828.75,3149.25,
DRILL BIT SENTINEL CANNULATED 10X229MM,30182663,CDM,,,270,RC,outpatient,,864.76,864.76,,734.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,216.19,22,,percent of total billed charges,,,,,,,,,778.28,90,,percent of total billed charges,,,716.02,82.8,,percent of total billed charges,,,735.05,85,,percent of total billed charges,,,,,,,,,760.99,88,,percent of total billed charges,,,,,,,,,660.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,216.19,22,,percent of total billed charges,,,786.93,91,,percent of total billed charges,,,821.52,95,,percent of total billed charges,,,717.75,83,,percent of total billed charges,,,717.75,83,,percent of total billed charges,,,,,,,,,,,,,,,717.75,83,,percent of total billed charges,,,821.52,95,,percent of total billed charges,,,778.28,90,,percent of total billed charges,,,778.28,90,,percent of total billed charges,,,709.1,82,,percent of total billed charges,,,778.28,90,,percent of total billed charges,,,735.05,85,,percent of total billed charges,,216.19,821.52,
DRILL BIT Y-KNOT,30182665,CDM,,,270,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
DEPUY STEM HUMERAL SZ11,30182666,CDM,,,278,RC,outpatient,,49679.57,49679.57,,42177.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12419.89,22,,percent of total billed charges,,,,,,,,,44711.61,90,,percent of total billed charges,,,41134.68,82.8,,percent of total billed charges,,,42227.63,85,,percent of total billed charges,,,,,,,,,43718.02,88,,percent of total billed charges,,,,,,,,,37955.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12419.89,22,,percent of total billed charges,,,45208.41,91,,percent of total billed charges,,,47195.59,95,,percent of total billed charges,,,41234.04,83,,percent of total billed charges,,,41234.04,83,,percent of total billed charges,,,,,,,,,,,,,,,41234.04,83,,percent of total billed charges,,,47195.59,95,,percent of total billed charges,,,44711.61,90,,percent of total billed charges,,,44711.61,90,,percent of total billed charges,,,40737.25,82,,percent of total billed charges,,,44711.61,90,,percent of total billed charges,,,42227.63,85,,percent of total billed charges,,12419.89,47195.59,
DEPUY ECC GLENOSPHERE 42MM,30182667,CDM,,,278,RC,outpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4954.14,22,,percent of total billed charges,,,,,,,,,17834.9,90,,percent of total billed charges,,,16408.1,82.8,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4954.14,22,,percent of total billed charges,,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,4954.14,18825.72,
DEPUY SPACER +9,30182668,CDM,,,278,RC,outpatient,,16003.46,16003.46,,13586.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4000.87,22,,percent of total billed charges,,,,,,,,,14403.11,90,,percent of total billed charges,,,13250.86,82.8,,percent of total billed charges,,,13602.94,85,,percent of total billed charges,,,,,,,,,14083.04,88,,percent of total billed charges,,,,,,,,,12226.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4000.87,22,,percent of total billed charges,,,14563.15,91,,percent of total billed charges,,,15203.29,95,,percent of total billed charges,,,13282.87,83,,percent of total billed charges,,,13282.87,83,,percent of total billed charges,,,,,,,,,,,,,,,13282.87,83,,percent of total billed charges,,,15203.29,95,,percent of total billed charges,,,14403.11,90,,percent of total billed charges,,,14403.11,90,,percent of total billed charges,,,13122.84,82,,percent of total billed charges,,,14403.11,90,,percent of total billed charges,,,13602.94,85,,percent of total billed charges,,4000.87,15203.29,
DEPUY HUMERAL CUP 42+6,30182669,CDM,,,278,RC,outpatient,,13066.69,13066.69,,11093.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3266.67,22,,percent of total billed charges,,,,,,,,,11760.02,90,,percent of total billed charges,,,10819.22,82.8,,percent of total billed charges,,,11106.69,85,,percent of total billed charges,,,,,,,,,11498.69,88,,percent of total billed charges,,,,,,,,,9982.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3266.67,22,,percent of total billed charges,,,11890.69,91,,percent of total billed charges,,,12413.36,95,,percent of total billed charges,,,10845.35,83,,percent of total billed charges,,,10845.35,83,,percent of total billed charges,,,,,,,,,,,,,,,10845.35,83,,percent of total billed charges,,,12413.36,95,,percent of total billed charges,,,11760.02,90,,percent of total billed charges,,,11760.02,90,,percent of total billed charges,,,10714.69,82,,percent of total billed charges,,,11760.02,90,,percent of total billed charges,,,11106.69,85,,percent of total billed charges,,3266.67,12413.36,
RTI HUMERUS PROXIMAL RIGHT,30182670,CDM,,,278,RC,outpatient,,20150,20150,,17107.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5037.5,22,,percent of total billed charges,,,,,,,,,18135,90,,percent of total billed charges,,,16684.2,82.8,,percent of total billed charges,,,17127.5,85,,percent of total billed charges,,,,,,,,,17732,88,,percent of total billed charges,,,,,,,,,15394.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5037.5,22,,percent of total billed charges,,,18336.5,91,,percent of total billed charges,,,19142.5,95,,percent of total billed charges,,,16724.5,83,,percent of total billed charges,,,16724.5,83,,percent of total billed charges,,,,,,,,,,,,,,,16724.5,83,,percent of total billed charges,,,19142.5,95,,percent of total billed charges,,,18135,90,,percent of total billed charges,,,18135,90,,percent of total billed charges,,,16523,82,,percent of total billed charges,,,18135,90,,percent of total billed charges,,,17127.5,85,,percent of total billed charges,,5037.5,19142.5,
INTEGRA ACCELL EVO3C 5CC,30182671,CDM,,,270,RC,outpatient,,8885.11,8885.11,,7543.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2221.28,22,,percent of total billed charges,,,,,,,,,7996.6,90,,percent of total billed charges,,,7356.87,82.8,,percent of total billed charges,,,7552.34,85,,percent of total billed charges,,,,,,,,,7818.9,88,,percent of total billed charges,,,,,,,,,6788.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2221.28,22,,percent of total billed charges,,,8085.45,91,,percent of total billed charges,,,8440.85,95,,percent of total billed charges,,,7374.64,83,,percent of total billed charges,,,7374.64,83,,percent of total billed charges,,,,,,,,,,,,,,,7374.64,83,,percent of total billed charges,,,8440.85,95,,percent of total billed charges,,,7996.6,90,,percent of total billed charges,,,7996.6,90,,percent of total billed charges,,,7285.79,82,,percent of total billed charges,,,7996.6,90,,percent of total billed charges,,,7552.34,85,,percent of total billed charges,,2221.28,8440.85,
AMNIOTIC ALLOGRAFT 3CM X 3CM,30182672,CDM,,,278,RC,outpatient,,8092.5,8092.5,,6870.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2023.13,22,,percent of total billed charges,,,,,,,,,7283.25,90,,percent of total billed charges,,,6700.59,82.8,,percent of total billed charges,,,6878.63,85,,percent of total billed charges,,,,,,,,,7121.4,88,,percent of total billed charges,,,,,,,,,6182.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2023.13,22,,percent of total billed charges,,,7364.18,91,,percent of total billed charges,,,7687.88,95,,percent of total billed charges,,,6716.78,83,,percent of total billed charges,,,6716.78,83,,percent of total billed charges,,,,,,,,,,,,,,,6716.78,83,,percent of total billed charges,,,7687.88,95,,percent of total billed charges,,,7283.25,90,,percent of total billed charges,,,7283.25,90,,percent of total billed charges,,,6635.85,82,,percent of total billed charges,,,7283.25,90,,percent of total billed charges,,,6878.63,85,,percent of total billed charges,,2023.13,7687.88,
DEPUY DISTAL AUGMENT RT 8MM SZ3.0,30182676,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
SYNTHES SCREW CANNUL 6.5X70MM,30182677,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANNUL 6.5X85MM,30182678,CDM,,,278,RC,outpatient,,2696.27,2696.27,,2289.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,674.07,22,,percent of total billed charges,,,,,,,,,2426.64,90,,percent of total billed charges,,,2232.51,82.8,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,,,,,,,,2372.72,88,,percent of total billed charges,,,,,,,,,2059.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,674.07,22,,percent of total billed charges,,,2453.61,91,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2237.9,83,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2210.94,82,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,674.07,2561.46,
DEPUY FEMUR TC3 RT SZ3,30182682,CDM,,,278,RC,outpatient,,36489.7,36489.7,,30979.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9122.43,22,,percent of total billed charges,,,,,,,,,32840.73,90,,percent of total billed charges,,,30213.47,82.8,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,,,,,,,,32110.94,88,,percent of total billed charges,,,,,,,,,27878.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9122.43,22,,percent of total billed charges,,,33205.63,91,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,30286.45,83,,percent of total billed charges,,,,,,,,,,,,,,,30286.45,83,,percent of total billed charges,,,34665.22,95,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,29921.55,82,,percent of total billed charges,,,32840.73,90,,percent of total billed charges,,,31016.25,85,,percent of total billed charges,,9122.43,34665.22,
DEPUY INSERT TIBIAL AOX 10MM SZ4,30182685,CDM,,,278,RC,outpatient,,17068.29,17068.29,,14490.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4267.07,22,,percent of total billed charges,,,,,,,,,15361.46,90,,percent of total billed charges,,,14132.54,82.8,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,,,,,,,,15020.1,88,,percent of total billed charges,,,,,,,,,13040.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4267.07,22,,percent of total billed charges,,,15532.14,91,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,,,,,,,,,,,,,14166.68,83,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,13996,82,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,4267.07,16214.88,
SYNTHES GUIDEWIRE 1.6MM,30182693,CDM,,,270,RC,outpatient,,446.25,446.25,,378.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,111.56,22,,percent of total billed charges,,,,,,,,,401.63,90,,percent of total billed charges,,,369.5,82.8,,percent of total billed charges,,,379.31,85,,percent of total billed charges,,,,,,,,,392.7,88,,percent of total billed charges,,,,,,,,,340.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,111.56,22,,percent of total billed charges,,,406.09,91,,percent of total billed charges,,,423.94,95,,percent of total billed charges,,,370.39,83,,percent of total billed charges,,,370.39,83,,percent of total billed charges,,,,,,,,,,,,,,,370.39,83,,percent of total billed charges,,,423.94,95,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,365.93,82,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,379.31,85,,percent of total billed charges,,111.56,423.94,
CARTICEL ESSENTIALS KIT,30182694,CDM,,,270,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
DEPUY STEM SUMMIT BASIC SZ3,30182695,CDM,,,278,RC,outpatient,,10372.96,10372.96,,8806.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2593.24,22,,percent of total billed charges,,,,,,,,,9335.66,90,,percent of total billed charges,,,8588.81,82.8,,percent of total billed charges,,,8817.02,85,,percent of total billed charges,,,,,,,,,9128.2,88,,percent of total billed charges,,,,,,,,,7924.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2593.24,22,,percent of total billed charges,,,9439.39,91,,percent of total billed charges,,,9854.31,95,,percent of total billed charges,,,8609.56,83,,percent of total billed charges,,,8609.56,83,,percent of total billed charges,,,,,,,,,,,,,,,8609.56,83,,percent of total billed charges,,,9854.31,95,,percent of total billed charges,,,9335.66,90,,percent of total billed charges,,,9335.66,90,,percent of total billed charges,,,8505.83,82,,percent of total billed charges,,,9335.66,90,,percent of total billed charges,,,8817.02,85,,percent of total billed charges,,2593.24,9854.31,
DEPUY OSTEOTOME RADIAL 10MM X 5,30182696,CDM,,,278,RC,outpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1291.88,22,,percent of total billed charges,,,,,,,,,4650.75,90,,percent of total billed charges,,,4278.69,82.8,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1291.88,22,,percent of total billed charges,,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,1291.88,4909.13,
ZIMMER DRILL BIT 4.5MM,30182698,CDM,,,270,RC,outpatient,,230.7,230.7,,195.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.68,22,,percent of total billed charges,,,,,,,,,207.63,90,,percent of total billed charges,,,191.02,82.8,,percent of total billed charges,,,196.1,85,,percent of total billed charges,,,,,,,,,203.02,88,,percent of total billed charges,,,,,,,,,176.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.68,22,,percent of total billed charges,,,209.94,91,,percent of total billed charges,,,219.17,95,,percent of total billed charges,,,191.48,83,,percent of total billed charges,,,191.48,83,,percent of total billed charges,,,,,,,,,,,,,,,191.48,83,,percent of total billed charges,,,219.17,95,,percent of total billed charges,,,207.63,90,,percent of total billed charges,,,207.63,90,,percent of total billed charges,,,189.17,82,,percent of total billed charges,,,207.63,90,,percent of total billed charges,,,196.1,85,,percent of total billed charges,,57.68,219.17,
INTEGRA ACCELL EVO3C 2.5CC,30182699,CDM,,,270,RC,outpatient,,5074.29,5074.29,,4308.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1268.57,22,,percent of total billed charges,,,,,,,,,4566.86,90,,percent of total billed charges,,,4201.51,82.8,,percent of total billed charges,,,4313.15,85,,percent of total billed charges,,,,,,,,,4465.38,88,,percent of total billed charges,,,,,,,,,3876.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1268.57,22,,percent of total billed charges,,,4617.6,91,,percent of total billed charges,,,4820.58,95,,percent of total billed charges,,,4211.66,83,,percent of total billed charges,,,4211.66,83,,percent of total billed charges,,,,,,,,,,,,,,,4211.66,83,,percent of total billed charges,,,4820.58,95,,percent of total billed charges,,,4566.86,90,,percent of total billed charges,,,4566.86,90,,percent of total billed charges,,,4160.92,82,,percent of total billed charges,,,4566.86,90,,percent of total billed charges,,,4313.15,85,,percent of total billed charges,,1268.57,4820.58,
DEPUY DISTAL AUGMENT RT 4MM SZ4.0,30182701,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
ALLOSOURCE 1/3 FEMORAL STRUT 20CM,30182702,CDM,,,278,RC,outpatient,,4043,4043,,3432.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1010.75,22,,percent of total billed charges,,,,,,,,,3638.7,90,,percent of total billed charges,,,3347.6,82.8,,percent of total billed charges,,,3436.55,85,,percent of total billed charges,,,,,,,,,3557.84,88,,percent of total billed charges,,,,,,,,,3088.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1010.75,22,,percent of total billed charges,,,3679.13,91,,percent of total billed charges,,,3840.85,95,,percent of total billed charges,,,3355.69,83,,percent of total billed charges,,,3355.69,83,,percent of total billed charges,,,,,,,,,,,,,,,3355.69,83,,percent of total billed charges,,,3840.85,95,,percent of total billed charges,,,3638.7,90,,percent of total billed charges,,,3638.7,90,,percent of total billed charges,,,3315.26,82,,percent of total billed charges,,,3638.7,90,,percent of total billed charges,,,3436.55,85,,percent of total billed charges,,1010.75,3840.85,
ALLOSOURCE 1/3 FEMORAL STRUT 30CM,30182703,CDM,,,278,RC,outpatient,,5011.5,5011.5,,4254.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1252.88,22,,percent of total billed charges,,,,,,,,,4510.35,90,,percent of total billed charges,,,4149.52,82.8,,percent of total billed charges,,,4259.78,85,,percent of total billed charges,,,,,,,,,4410.12,88,,percent of total billed charges,,,,,,,,,3828.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1252.88,22,,percent of total billed charges,,,4560.47,91,,percent of total billed charges,,,4760.93,95,,percent of total billed charges,,,4159.55,83,,percent of total billed charges,,,4159.55,83,,percent of total billed charges,,,,,,,,,,,,,,,4159.55,83,,percent of total billed charges,,,4760.93,95,,percent of total billed charges,,,4510.35,90,,percent of total billed charges,,,4510.35,90,,percent of total billed charges,,,4109.43,82,,percent of total billed charges,,,4510.35,90,,percent of total billed charges,,,4259.78,85,,percent of total billed charges,,1252.88,4760.93,
MTF AFT STRAIGHT TUBE,30182720,CDM,,,278,RC,outpatient,,1092,1092,,927.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,273,22,,percent of total billed charges,,,,,,,,,982.8,90,,percent of total billed charges,,,904.18,82.8,,percent of total billed charges,,,928.2,85,,percent of total billed charges,,,,,,,,,960.96,88,,percent of total billed charges,,,,,,,,,834.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,273,22,,percent of total billed charges,,,993.72,91,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,,,,,,,,,,,,,906.36,83,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,895.44,82,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,928.2,85,,percent of total billed charges,,273,1037.4,
MTF AFT DIVERTED TUBE,30182721,CDM,,,278,RC,outpatient,,1612,1612,,1368.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,403,22,,percent of total billed charges,,,,,,,,,1450.8,90,,percent of total billed charges,,,1334.74,82.8,,percent of total billed charges,,,1370.2,85,,percent of total billed charges,,,,,,,,,1418.56,88,,percent of total billed charges,,,,,,,,,1231.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,403,22,,percent of total billed charges,,,1466.92,91,,percent of total billed charges,,,1531.4,95,,percent of total billed charges,,,1337.96,83,,percent of total billed charges,,,1337.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1337.96,83,,percent of total billed charges,,,1531.4,95,,percent of total billed charges,,,1450.8,90,,percent of total billed charges,,,1450.8,90,,percent of total billed charges,,,1321.84,82,,percent of total billed charges,,,1450.8,90,,percent of total billed charges,,,1370.2,85,,percent of total billed charges,,403,1531.4,
SYNTHES SCREW LOCKING 3.5X34MM,30182723,CDM,,,278,RC,outpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,313.59,22,,percent of total billed charges,,,,,,,,,1128.93,90,,percent of total billed charges,,,1038.62,82.8,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,313.59,22,,percent of total billed charges,,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,313.59,1191.65,
SYNTHES SCREW LOCKING 3.5X38MM,30182724,CDM,,,278,RC,outpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,313.59,22,,percent of total billed charges,,,,,,,,,1128.93,90,,percent of total billed charges,,,1038.62,82.8,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,313.59,22,,percent of total billed charges,,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,313.59,1191.65,
SYNTHES SCREW LOCKING 3.5X50MM,30182725,CDM,,,278,RC,outpatient,,1217.84,1217.84,,1033.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,304.46,22,,percent of total billed charges,,,,,,,,,1096.06,90,,percent of total billed charges,,,1008.37,82.8,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,,,,,,,,1071.7,88,,percent of total billed charges,,,,,,,,,930.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,304.46,22,,percent of total billed charges,,,1108.23,91,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1010.81,83,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,998.63,82,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,304.46,1156.95,
DIOMED SCREW SET 9.9MM,30182729,CDM,,,278,RC,outpatient,,1488.5,1488.5,,1263.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,372.13,22,,percent of total billed charges,,,,,,,,,1339.65,90,,percent of total billed charges,,,1232.48,82.8,,percent of total billed charges,,,1265.23,85,,percent of total billed charges,,,,,,,,,1309.88,88,,percent of total billed charges,,,,,,,,,1137.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,372.13,22,,percent of total billed charges,,,1354.54,91,,percent of total billed charges,,,1414.08,95,,percent of total billed charges,,,1235.46,83,,percent of total billed charges,,,1235.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1235.46,83,,percent of total billed charges,,,1414.08,95,,percent of total billed charges,,,1339.65,90,,percent of total billed charges,,,1339.65,90,,percent of total billed charges,,,1220.57,82,,percent of total billed charges,,,1339.65,90,,percent of total billed charges,,,1265.23,85,,percent of total billed charges,,372.13,1414.08,
BIOGIDE PATCH 40X50MM,30182736,CDM,,,278,RC,outpatient,,2535,2535,,2152.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,633.75,22,,percent of total billed charges,,,,,,,,,2281.5,90,,percent of total billed charges,,,2098.98,82.8,,percent of total billed charges,,,2154.75,85,,percent of total billed charges,,,,,,,,,2230.8,88,,percent of total billed charges,,,,,,,,,1936.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,633.75,22,,percent of total billed charges,,,2306.85,91,,percent of total billed charges,,,2408.25,95,,percent of total billed charges,,,2104.05,83,,percent of total billed charges,,,2104.05,83,,percent of total billed charges,,,,,,,,,,,,,,,2104.05,83,,percent of total billed charges,,,2408.25,95,,percent of total billed charges,,,2281.5,90,,percent of total billed charges,,,2281.5,90,,percent of total billed charges,,,2078.7,82,,percent of total billed charges,,,2281.5,90,,percent of total billed charges,,,2154.75,85,,percent of total billed charges,,633.75,2408.25,
DEPUY DISTAL AUGMENT LT 4MM SZ4.0,30182737,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
ALLERGAN NATRELLE SIZER 339CC,30182738,CDM,,,270,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
DEPUY PINNACLE CUP REVISION 58MM,30182739,CDM,,,278,RC,outpatient,,33437.04,33437.04,,28388.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8359.26,22,,percent of total billed charges,,,,,,,,,30093.34,90,,percent of total billed charges,,,27685.87,82.8,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,,,,,,,,29424.6,88,,percent of total billed charges,,,,,,,,,25545.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8359.26,22,,percent of total billed charges,,,30427.71,91,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,,,,,,,,,,,,,27752.74,83,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,27418.37,82,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,8359.26,31765.19,
DEPUY CERAMIC HEAD 32MM +1MM TS,30182740,CDM,,,278,RC,outpatient,,14631.05,14631.05,,12421.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3657.76,22,,percent of total billed charges,,,,,,,,,13167.95,90,,percent of total billed charges,,,12114.51,82.8,,percent of total billed charges,,,12436.39,85,,percent of total billed charges,,,,,,,,,12875.32,88,,percent of total billed charges,,,,,,,,,11178.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3657.76,22,,percent of total billed charges,,,13314.26,91,,percent of total billed charges,,,13899.5,95,,percent of total billed charges,,,12143.77,83,,percent of total billed charges,,,12143.77,83,,percent of total billed charges,,,,,,,,,,,,,,,12143.77,83,,percent of total billed charges,,,13899.5,95,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,11997.46,82,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,12436.39,85,,percent of total billed charges,,3657.76,13899.5,
OBTRYX HALO SLING,30182745,CDM,,,270,RC,outpatient,,9109.1,9109.1,,7733.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2277.28,22,,percent of total billed charges,,,,,,,,,8198.19,90,,percent of total billed charges,,,7542.33,82.8,,percent of total billed charges,,,7742.74,85,,percent of total billed charges,,,,,,,,,8016.01,88,,percent of total billed charges,,,,,,,,,6959.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2277.28,22,,percent of total billed charges,,,8289.28,91,,percent of total billed charges,,,8653.65,95,,percent of total billed charges,,,7560.55,83,,percent of total billed charges,,,7560.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7560.55,83,,percent of total billed charges,,,8653.65,95,,percent of total billed charges,,,8198.19,90,,percent of total billed charges,,,8198.19,90,,percent of total billed charges,,,7469.46,82,,percent of total billed charges,,,8198.19,90,,percent of total billed charges,,,7742.74,85,,percent of total billed charges,,2277.28,8653.65,
SURGICAL PATTIES 1/2 X 1.5,30182746,CDM,,,270,RC,outpatient,,21.56,21.56,,18.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.39,22,,percent of total billed charges,,,,,,,,,19.4,90,,percent of total billed charges,,,17.85,82.8,,percent of total billed charges,,,18.33,85,,percent of total billed charges,,,,,,,,,18.97,88,,percent of total billed charges,,,,,,,,,16.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.39,22,,percent of total billed charges,,,19.62,91,,percent of total billed charges,,,20.48,95,,percent of total billed charges,,,17.89,83,,percent of total billed charges,,,17.89,83,,percent of total billed charges,,,,,,,,,,,,,,,17.89,83,,percent of total billed charges,,,20.48,95,,percent of total billed charges,,,19.4,90,,percent of total billed charges,,,19.4,90,,percent of total billed charges,,,17.68,82,,percent of total billed charges,,,19.4,90,,percent of total billed charges,,,18.33,85,,percent of total billed charges,,5.39,20.48,
I.L.A. LASER END-FIRE,30182748,CDM,,,270,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
MTF AFT DIVERTED BONE TUBE,30182749,CDM,,,278,RC,outpatient,,1612,1612,,1368.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,403,22,,percent of total billed charges,,,,,,,,,1450.8,90,,percent of total billed charges,,,1334.74,82.8,,percent of total billed charges,,,1370.2,85,,percent of total billed charges,,,,,,,,,1418.56,88,,percent of total billed charges,,,,,,,,,1231.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,403,22,,percent of total billed charges,,,1466.92,91,,percent of total billed charges,,,1531.4,95,,percent of total billed charges,,,1337.96,83,,percent of total billed charges,,,1337.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1337.96,83,,percent of total billed charges,,,1531.4,95,,percent of total billed charges,,,1450.8,90,,percent of total billed charges,,,1450.8,90,,percent of total billed charges,,,1321.84,82,,percent of total billed charges,,,1450.8,90,,percent of total billed charges,,,1370.2,85,,percent of total billed charges,,403,1531.4,
CAPIO DELIVERY DEVICE,30182761,CDM,,,270,RC,outpatient,,9301.5,9301.5,,7896.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2325.38,22,,percent of total billed charges,,,,,,,,,8371.35,90,,percent of total billed charges,,,7701.64,82.8,,percent of total billed charges,,,7906.28,85,,percent of total billed charges,,,,,,,,,8185.32,88,,percent of total billed charges,,,,,,,,,7106.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2325.38,22,,percent of total billed charges,,,8464.37,91,,percent of total billed charges,,,8836.43,95,,percent of total billed charges,,,7720.25,83,,percent of total billed charges,,,7720.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7720.25,83,,percent of total billed charges,,,8836.43,95,,percent of total billed charges,,,8371.35,90,,percent of total billed charges,,,8371.35,90,,percent of total billed charges,,,7627.23,82,,percent of total billed charges,,,8371.35,90,,percent of total billed charges,,,7906.28,85,,percent of total billed charges,,2325.38,8836.43,
ARIS PROCESSED DERMIS 6X12CM,30182763,CDM,,,270,RC,outpatient,,12740,12740,,10816.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3185,22,,percent of total billed charges,,,,,,,,,11466,90,,percent of total billed charges,,,10548.72,82.8,,percent of total billed charges,,,10829,85,,percent of total billed charges,,,,,,,,,11211.2,88,,percent of total billed charges,,,,,,,,,9733.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3185,22,,percent of total billed charges,,,11593.4,91,,percent of total billed charges,,,12103,95,,percent of total billed charges,,,10574.2,83,,percent of total billed charges,,,10574.2,83,,percent of total billed charges,,,,,,,,,,,,,,,10574.2,83,,percent of total billed charges,,,12103,95,,percent of total billed charges,,,11466,90,,percent of total billed charges,,,11466,90,,percent of total billed charges,,,10446.8,82,,percent of total billed charges,,,11466,90,,percent of total billed charges,,,10829,85,,percent of total billed charges,,3185,12103,
ALLERGAN SILICONE BREAST IMPLANT 650CC,30182764,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
GUIDEWIRE CORE URO PTFE .038,30182765,CDM,,,270,RC,outpatient,,149.68,149.68,,127.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.42,22,,percent of total billed charges,,,,,,,,,134.71,90,,percent of total billed charges,,,123.94,82.8,,percent of total billed charges,,,127.23,85,,percent of total billed charges,,,,,,,,,131.72,88,,percent of total billed charges,,,,,,,,,114.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.42,22,,percent of total billed charges,,,136.21,91,,percent of total billed charges,,,142.2,95,,percent of total billed charges,,,124.23,83,,percent of total billed charges,,,124.23,83,,percent of total billed charges,,,,,,,,,,,,,,,124.23,83,,percent of total billed charges,,,142.2,95,,percent of total billed charges,,,134.71,90,,percent of total billed charges,,,134.71,90,,percent of total billed charges,,,122.74,82,,percent of total billed charges,,,134.71,90,,percent of total billed charges,,,127.23,85,,percent of total billed charges,,37.42,142.2,
MYOSURE TISSUE REMOVAL DEVICE,30182768,CDM,,,270,RC,outpatient,,8417.5,8417.5,,7146.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2104.38,22,,percent of total billed charges,,,,,,,,,7575.75,90,,percent of total billed charges,,,6969.69,82.8,,percent of total billed charges,,,7154.88,85,,percent of total billed charges,,,,,,,,,7407.4,88,,percent of total billed charges,,,,,,,,,6430.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2104.38,22,,percent of total billed charges,,,7659.93,91,,percent of total billed charges,,,7996.63,95,,percent of total billed charges,,,6986.53,83,,percent of total billed charges,,,6986.53,83,,percent of total billed charges,,,,,,,,,,,,,,,6986.53,83,,percent of total billed charges,,,7996.63,95,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,6902.35,82,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,7154.88,85,,percent of total billed charges,,2104.38,7996.63,
DEPUY LINER CONSTRAINED +4 36 X 60,30182769,CDM,,,278,RC,outpatient,,33951.78,33951.78,,28825.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8487.95,22,,percent of total billed charges,,,,,,,,,30556.6,90,,percent of total billed charges,,,28112.07,82.8,,percent of total billed charges,,,28859.01,85,,percent of total billed charges,,,,,,,,,29877.57,88,,percent of total billed charges,,,,,,,,,25939.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8487.95,22,,percent of total billed charges,,,30896.12,91,,percent of total billed charges,,,32254.19,95,,percent of total billed charges,,,28179.98,83,,percent of total billed charges,,,28179.98,83,,percent of total billed charges,,,,,,,,,,,,,,,28179.98,83,,percent of total billed charges,,,32254.19,95,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,27840.46,82,,percent of total billed charges,,,30556.6,90,,percent of total billed charges,,,28859.01,85,,percent of total billed charges,,8487.95,32254.19,
DEPUY CERAMIC HEAD 36MM +12,30182770,CDM,,,278,RC,outpatient,,8767.27,8767.27,,7443.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2191.82,22,,percent of total billed charges,,,,,,,,,7890.54,90,,percent of total billed charges,,,7259.3,82.8,,percent of total billed charges,,,7452.18,85,,percent of total billed charges,,,,,,,,,7715.2,88,,percent of total billed charges,,,,,,,,,6698.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2191.82,22,,percent of total billed charges,,,7978.22,91,,percent of total billed charges,,,8328.91,95,,percent of total billed charges,,,7276.83,83,,percent of total billed charges,,,7276.83,83,,percent of total billed charges,,,,,,,,,,,,,,,7276.83,83,,percent of total billed charges,,,8328.91,95,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7189.16,82,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7452.18,85,,percent of total billed charges,,2191.82,8328.91,
AMNIOTIC ALLOGRAFT 2CM X 3CM,30182773,CDM,,,278,RC,outpatient,,6142.5,6142.5,,5214.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1535.63,22,,percent of total billed charges,,,,,,,,,5528.25,90,,percent of total billed charges,,,5085.99,82.8,,percent of total billed charges,,,5221.13,85,,percent of total billed charges,,,,,,,,,5405.4,88,,percent of total billed charges,,,,,,,,,4692.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1535.63,22,,percent of total billed charges,,,5589.68,91,,percent of total billed charges,,,5835.38,95,,percent of total billed charges,,,5098.28,83,,percent of total billed charges,,,5098.28,83,,percent of total billed charges,,,,,,,,,,,,,,,5098.28,83,,percent of total billed charges,,,5835.38,95,,percent of total billed charges,,,5528.25,90,,percent of total billed charges,,,5528.25,90,,percent of total billed charges,,,5036.85,82,,percent of total billed charges,,,5528.25,90,,percent of total billed charges,,,5221.13,85,,percent of total billed charges,,1535.63,5835.38,
DEPUY LINER ALTRX NEUT 36 X 54,30182775,CDM,,,278,RC,outpatient,,12874.42,12874.42,,10930.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3218.61,22,,percent of total billed charges,,,,,,,,,11586.98,90,,percent of total billed charges,,,10660.02,82.8,,percent of total billed charges,,,10943.26,85,,percent of total billed charges,,,,,,,,,11329.49,88,,percent of total billed charges,,,,,,,,,9836.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3218.61,22,,percent of total billed charges,,,11715.72,91,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,,,,,,,,,,,,,10685.77,83,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10557.02,82,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10943.26,85,,percent of total billed charges,,3218.61,12230.7,
MESH VENTRALIGHT W/ECHO 6X10,30182776,CDM,,,270,RC,outpatient,,9067.5,9067.5,,7698.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2266.88,22,,percent of total billed charges,,,,,,,,,8160.75,90,,percent of total billed charges,,,7507.89,82.8,,percent of total billed charges,,,7707.38,85,,percent of total billed charges,,,,,,,,,7979.4,88,,percent of total billed charges,,,,,,,,,6927.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2266.88,22,,percent of total billed charges,,,8251.43,91,,percent of total billed charges,,,8614.13,95,,percent of total billed charges,,,7526.03,83,,percent of total billed charges,,,7526.03,83,,percent of total billed charges,,,,,,,,,,,,,,,7526.03,83,,percent of total billed charges,,,8614.13,95,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,7435.35,82,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,7707.38,85,,percent of total billed charges,,2266.88,8614.13,
MESH VENTRALIGHT W/ECHO 10x13,30182777,CDM,,,270,RC,outpatient,,14787.5,14787.5,,12554.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3696.88,22,,percent of total billed charges,,,,,,,,,13308.75,90,,percent of total billed charges,,,12244.05,82.8,,percent of total billed charges,,,12569.38,85,,percent of total billed charges,,,,,,,,,13013,88,,percent of total billed charges,,,,,,,,,11297.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3696.88,22,,percent of total billed charges,,,13456.63,91,,percent of total billed charges,,,14048.13,95,,percent of total billed charges,,,12273.63,83,,percent of total billed charges,,,12273.63,83,,percent of total billed charges,,,,,,,,,,,,,,,12273.63,83,,percent of total billed charges,,,14048.13,95,,percent of total billed charges,,,13308.75,90,,percent of total billed charges,,,13308.75,90,,percent of total billed charges,,,12125.75,82,,percent of total billed charges,,,13308.75,90,,percent of total billed charges,,,12569.38,85,,percent of total billed charges,,3696.88,14048.13,
MESH VENTRALIGHT STD 8X10,30182778,CDM,,,278,RC,outpatient,,8385,8385,,7118.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2096.25,22,,percent of total billed charges,,,,,,,,,7546.5,90,,percent of total billed charges,,,6942.78,82.8,,percent of total billed charges,,,7127.25,85,,percent of total billed charges,,,,,,,,,7378.8,88,,percent of total billed charges,,,,,,,,,6406.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2096.25,22,,percent of total billed charges,,,7630.35,91,,percent of total billed charges,,,7965.75,95,,percent of total billed charges,,,6959.55,83,,percent of total billed charges,,,6959.55,83,,percent of total billed charges,,,,,,,,,,,,,,,6959.55,83,,percent of total billed charges,,,7965.75,95,,percent of total billed charges,,,7546.5,90,,percent of total billed charges,,,7546.5,90,,percent of total billed charges,,,6875.7,82,,percent of total billed charges,,,7546.5,90,,percent of total billed charges,,,7127.25,85,,percent of total billed charges,,2096.25,7965.75,
DEPUY STEM CORAIL SZ16,30182779,CDM,,,278,RC,outpatient,,33799.35,33799.35,,28695.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8449.84,22,,percent of total billed charges,,,,,,,,,30419.42,90,,percent of total billed charges,,,27985.86,82.8,,percent of total billed charges,,,28729.45,85,,percent of total billed charges,,,,,,,,,29743.43,88,,percent of total billed charges,,,,,,,,,25822.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8449.84,22,,percent of total billed charges,,,30757.41,91,,percent of total billed charges,,,32109.38,95,,percent of total billed charges,,,28053.46,83,,percent of total billed charges,,,28053.46,83,,percent of total billed charges,,,,,,,,,,,,,,,28053.46,83,,percent of total billed charges,,,32109.38,95,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,27715.47,82,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,28729.45,85,,percent of total billed charges,,8449.84,32109.38,
S&N ENDO ANCHOR 2.9,30182784,CDM,,,270,RC,outpatient,,2255.5,2255.5,,1914.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,563.88,22,,percent of total billed charges,,,,,,,,,2029.95,90,,percent of total billed charges,,,1867.55,82.8,,percent of total billed charges,,,1917.18,85,,percent of total billed charges,,,,,,,,,1984.84,88,,percent of total billed charges,,,,,,,,,1723.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,563.88,22,,percent of total billed charges,,,2052.51,91,,percent of total billed charges,,,2142.73,95,,percent of total billed charges,,,1872.07,83,,percent of total billed charges,,,1872.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1872.07,83,,percent of total billed charges,,,2142.73,95,,percent of total billed charges,,,2029.95,90,,percent of total billed charges,,,2029.95,90,,percent of total billed charges,,,1849.51,82,,percent of total billed charges,,,2029.95,90,,percent of total billed charges,,,1917.18,85,,percent of total billed charges,,563.88,2142.73,
DEPUY FEMORAL HEAD 36MM +12,30182785,CDM,,,278,RC,outpatient,,8569.34,8569.34,,7275.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2142.34,22,,percent of total billed charges,,,,,,,,,7712.41,90,,percent of total billed charges,,,7095.41,82.8,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,,,,,,,,7541.02,88,,percent of total billed charges,,,,,,,,,6546.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2142.34,22,,percent of total billed charges,,,7798.1,91,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7112.55,83,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7026.86,82,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,2142.34,8140.87,
DOUBLE ARMED SUTURE NEEDLE - 8538,30182786,CDM,,,270,RC,outpatient,,193.28,193.28,,164.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.32,22,,percent of total billed charges,,,,,,,,,173.95,90,,percent of total billed charges,,,160.04,82.8,,percent of total billed charges,,,164.29,85,,percent of total billed charges,,,,,,,,,170.09,88,,percent of total billed charges,,,,,,,,,147.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.32,22,,percent of total billed charges,,,175.88,91,,percent of total billed charges,,,183.62,95,,percent of total billed charges,,,160.42,83,,percent of total billed charges,,,160.42,83,,percent of total billed charges,,,,,,,,,,,,,,,160.42,83,,percent of total billed charges,,,183.62,95,,percent of total billed charges,,,173.95,90,,percent of total billed charges,,,173.95,90,,percent of total billed charges,,,158.49,82,,percent of total billed charges,,,173.95,90,,percent of total billed charges,,,164.29,85,,percent of total billed charges,,48.32,183.62,
RTI PATELLAR TENDON  GRAFT 11MMX100,30182787,CDM,,,278,RC,outpatient,,23400,23400,,19866.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5850,22,,percent of total billed charges,,,,,,,,,21060,90,,percent of total billed charges,,,19375.2,82.8,,percent of total billed charges,,,19890,85,,percent of total billed charges,,,,,,,,,20592,88,,percent of total billed charges,,,,,,,,,17877.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5850,22,,percent of total billed charges,,,21294,91,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,,,,,,,,,,,,,19422,83,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19188,82,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19890,85,,percent of total billed charges,,5850,22230,
BALLOON DILATATION UROMAXULTRA,30182793,CDM,,,270,RC,outpatient,,1576.9,1576.9,,1338.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,394.23,22,,percent of total billed charges,,,,,,,,,1419.21,90,,percent of total billed charges,,,1305.67,82.8,,percent of total billed charges,,,1340.37,85,,percent of total billed charges,,,,,,,,,1387.67,88,,percent of total billed charges,,,,,,,,,1204.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,394.23,22,,percent of total billed charges,,,1434.98,91,,percent of total billed charges,,,1498.06,95,,percent of total billed charges,,,1308.83,83,,percent of total billed charges,,,1308.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1308.83,83,,percent of total billed charges,,,1498.06,95,,percent of total billed charges,,,1419.21,90,,percent of total billed charges,,,1419.21,90,,percent of total billed charges,,,1293.06,82,,percent of total billed charges,,,1419.21,90,,percent of total billed charges,,,1340.37,85,,percent of total billed charges,,394.23,1498.06,
STONE RETRIEVAL BASKET1.9FRX120CM,30182794,CDM,,,270,RC,outpatient,,1344.2,1344.2,,1141.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,336.05,22,,percent of total billed charges,,,,,,,,,1209.78,90,,percent of total billed charges,,,1113,82.8,,percent of total billed charges,,,1142.57,85,,percent of total billed charges,,,,,,,,,1182.9,88,,percent of total billed charges,,,,,,,,,1026.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,336.05,22,,percent of total billed charges,,,1223.22,91,,percent of total billed charges,,,1276.99,95,,percent of total billed charges,,,1115.69,83,,percent of total billed charges,,,1115.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1115.69,83,,percent of total billed charges,,,1276.99,95,,percent of total billed charges,,,1209.78,90,,percent of total billed charges,,,1209.78,90,,percent of total billed charges,,,1102.24,82,,percent of total billed charges,,,1209.78,90,,percent of total billed charges,,,1142.57,85,,percent of total billed charges,,336.05,1276.99,
ZIMMER CEMENT PALACOS-R,30182799,CDM,,,278,RC,outpatient,,1235,1235,,1048.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,308.75,22,,percent of total billed charges,,,,,,,,,1111.5,90,,percent of total billed charges,,,1022.58,82.8,,percent of total billed charges,,,1049.75,85,,percent of total billed charges,,,,,,,,,1086.8,88,,percent of total billed charges,,,,,,,,,943.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,308.75,22,,percent of total billed charges,,,1123.85,91,,percent of total billed charges,,,1173.25,95,,percent of total billed charges,,,1025.05,83,,percent of total billed charges,,,1025.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1025.05,83,,percent of total billed charges,,,1173.25,95,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1012.7,82,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1049.75,85,,percent of total billed charges,,308.75,1173.25,
GENESYS HTA KIT,30182800,CDM,,,270,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ESU PENCIL WAND STERILE SMALL TIP,30182801,CDM,,,270,RC,outpatient,,243.75,243.75,,206.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60.94,22,,percent of total billed charges,,,,,,,,,219.38,90,,percent of total billed charges,,,201.83,82.8,,percent of total billed charges,,,207.19,85,,percent of total billed charges,,,,,,,,,214.5,88,,percent of total billed charges,,,,,,,,,186.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60.94,22,,percent of total billed charges,,,221.81,91,,percent of total billed charges,,,231.56,95,,percent of total billed charges,,,202.31,83,,percent of total billed charges,,,202.31,83,,percent of total billed charges,,,,,,,,,,,,,,,202.31,83,,percent of total billed charges,,,231.56,95,,percent of total billed charges,,,219.38,90,,percent of total billed charges,,,219.38,90,,percent of total billed charges,,,199.88,82,,percent of total billed charges,,,219.38,90,,percent of total billed charges,,,207.19,85,,percent of total billed charges,,60.94,231.56,
S&N ENDO SCREW SOFT SILK 8 X 25,30182802,CDM,,,278,RC,outpatient,,1417,1417,,1203.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,354.25,22,,percent of total billed charges,,,,,,,,,1275.3,90,,percent of total billed charges,,,1173.28,82.8,,percent of total billed charges,,,1204.45,85,,percent of total billed charges,,,,,,,,,1246.96,88,,percent of total billed charges,,,,,,,,,1082.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,354.25,22,,percent of total billed charges,,,1289.47,91,,percent of total billed charges,,,1346.15,95,,percent of total billed charges,,,1176.11,83,,percent of total billed charges,,,1176.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1176.11,83,,percent of total billed charges,,,1346.15,95,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1161.94,82,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1204.45,85,,percent of total billed charges,,354.25,1346.15,
S&N ENDO DRILL BIT 10.0,30182803,CDM,,,270,RC,outpatient,,3120,3120,,2648.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,780,22,,percent of total billed charges,,,,,,,,,2808,90,,percent of total billed charges,,,2583.36,82.8,,percent of total billed charges,,,2652,85,,percent of total billed charges,,,,,,,,,2745.6,88,,percent of total billed charges,,,,,,,,,2383.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,780,22,,percent of total billed charges,,,2839.2,91,,percent of total billed charges,,,2964,95,,percent of total billed charges,,,2589.6,83,,percent of total billed charges,,,2589.6,83,,percent of total billed charges,,,,,,,,,,,,,,,2589.6,83,,percent of total billed charges,,,2964,95,,percent of total billed charges,,,2808,90,,percent of total billed charges,,,2808,90,,percent of total billed charges,,,2558.4,82,,percent of total billed charges,,,2808,90,,percent of total billed charges,,,2652,85,,percent of total billed charges,,780,2964,
BONE PUTTY OS-401,30182814,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
BONE PUTTY APPLIER,30182815,CDM,,,278,RC,outpatient,,2593.5,2593.5,,2201.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,648.38,22,,percent of total billed charges,,,,,,,,,2334.15,90,,percent of total billed charges,,,2147.42,82.8,,percent of total billed charges,,,2204.48,85,,percent of total billed charges,,,,,,,,,2282.28,88,,percent of total billed charges,,,,,,,,,1981.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,648.38,22,,percent of total billed charges,,,2360.09,91,,percent of total billed charges,,,2463.83,95,,percent of total billed charges,,,2152.61,83,,percent of total billed charges,,,2152.61,83,,percent of total billed charges,,,,,,,,,,,,,,,2152.61,83,,percent of total billed charges,,,2463.83,95,,percent of total billed charges,,,2334.15,90,,percent of total billed charges,,,2334.15,90,,percent of total billed charges,,,2126.67,82,,percent of total billed charges,,,2334.15,90,,percent of total billed charges,,,2204.48,85,,percent of total billed charges,,648.38,2463.83,
S&N ENDO PROCEDURE KIT,30182816,CDM,,,270,RC,outpatient,,2288,2288,,1942.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,572,22,,percent of total billed charges,,,,,,,,,2059.2,90,,percent of total billed charges,,,1894.46,82.8,,percent of total billed charges,,,1944.8,85,,percent of total billed charges,,,,,,,,,2013.44,88,,percent of total billed charges,,,,,,,,,1748.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,572,22,,percent of total billed charges,,,2082.08,91,,percent of total billed charges,,,2173.6,95,,percent of total billed charges,,,1899.04,83,,percent of total billed charges,,,1899.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1899.04,83,,percent of total billed charges,,,2173.6,95,,percent of total billed charges,,,2059.2,90,,percent of total billed charges,,,2059.2,90,,percent of total billed charges,,,1876.16,82,,percent of total billed charges,,,2059.2,90,,percent of total billed charges,,,1944.8,85,,percent of total billed charges,,572,2173.6,
S&N ENDO BLADE SHAVER 2.9,30182817,CDM,,,270,RC,outpatient,,4283.5,4283.5,,3636.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1070.88,22,,percent of total billed charges,,,,,,,,,3855.15,90,,percent of total billed charges,,,3546.74,82.8,,percent of total billed charges,,,3640.98,85,,percent of total billed charges,,,,,,,,,3769.48,88,,percent of total billed charges,,,,,,,,,3272.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1070.88,22,,percent of total billed charges,,,3897.99,91,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,3555.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3555.31,83,,percent of total billed charges,,,4069.33,95,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3512.47,82,,percent of total billed charges,,,3855.15,90,,percent of total billed charges,,,3640.98,85,,percent of total billed charges,,1070.88,4069.33,
DEPUY PINNACLE CUP MULTIHOLE 60MM,30182820,CDM,,,278,RC,outpatient,,26741.78,26741.78,,22703.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6685.45,22,,percent of total billed charges,,,,,,,,,24067.6,90,,percent of total billed charges,,,22142.19,82.8,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,,,,,,,,23532.77,88,,percent of total billed charges,,,,,,,,,20430.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6685.45,22,,percent of total billed charges,,,24335.02,91,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,,,,,,,,,,,,,22195.68,83,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,21928.26,82,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,6685.45,25404.69,
DEPUY ALTRX HIP CAP W/GRIPTRON 36MM,30182824,CDM,,,278,RC,outpatient,,39836.68,39836.68,,33821.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9959.17,22,,percent of total billed charges,,,,,,,,,35853.01,90,,percent of total billed charges,,,32984.77,82.8,,percent of total billed charges,,,33861.18,85,,percent of total billed charges,,,,,,,,,35056.28,88,,percent of total billed charges,,,,,,,,,30435.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9959.17,22,,percent of total billed charges,,,36251.38,91,,percent of total billed charges,,,37844.85,95,,percent of total billed charges,,,33064.44,83,,percent of total billed charges,,,33064.44,83,,percent of total billed charges,,,,,,,,,,,,,,,33064.44,83,,percent of total billed charges,,,37844.85,95,,percent of total billed charges,,,35853.01,90,,percent of total billed charges,,,35853.01,90,,percent of total billed charges,,,32666.08,82,,percent of total billed charges,,,35853.01,90,,percent of total billed charges,,,33861.18,85,,percent of total billed charges,,9959.17,37844.85,
DEPUY POROUS FEMORAL SLEEVE SZ15,30182826,CDM,,,278,RC,outpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4515.54,22,,percent of total billed charges,,,,,,,,,16255.93,90,,percent of total billed charges,,,14955.45,82.8,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4515.54,22,,percent of total billed charges,,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,4515.54,17159.03,
DEPUY POSTERIOR AUGMENT 8MM SZ4.0,30182827,CDM,,,278,RC,outpatient,,6245.14,6245.14,,5302.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1561.29,22,,percent of total billed charges,,,,,,,,,5620.63,90,,percent of total billed charges,,,5170.98,82.8,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,,,,,,,,5495.72,88,,percent of total billed charges,,,,,,,,,4771.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1561.29,22,,percent of total billed charges,,,5683.08,91,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,,,,,,,,,,,,,5183.47,83,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5121.01,82,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,1561.29,5932.88,
DEPUY INSERT TC3 RP 17.5MM SZ4,30182828,CDM,,,278,RC,outpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5779.25,22,,percent of total billed charges,,,,,,,,,20805.29,90,,percent of total billed charges,,,19140.87,82.8,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5779.25,22,,percent of total billed charges,,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,5779.25,21961.14,
INTEGRA  MOZAIK STRIP 10CC,30182829,CDM,,,278,RC,outpatient,,9351.16,9351.16,,7939.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2337.79,22,,percent of total billed charges,,,,,,,,,8416.04,90,,percent of total billed charges,,,7742.76,82.8,,percent of total billed charges,,,7948.49,85,,percent of total billed charges,,,,,,,,,8229.02,88,,percent of total billed charges,,,,,,,,,7144.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2337.79,22,,percent of total billed charges,,,8509.56,91,,percent of total billed charges,,,8883.6,95,,percent of total billed charges,,,7761.46,83,,percent of total billed charges,,,7761.46,83,,percent of total billed charges,,,,,,,,,,,,,,,7761.46,83,,percent of total billed charges,,,8883.6,95,,percent of total billed charges,,,8416.04,90,,percent of total billed charges,,,8416.04,90,,percent of total billed charges,,,7667.95,82,,percent of total billed charges,,,8416.04,90,,percent of total billed charges,,,7948.49,85,,percent of total billed charges,,2337.79,8883.6,
CONTRAST OMNIPAQUE-180 10ML,30182841,CDM,,,270,RC,outpatient,,137.61,137.61,,116.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.4,22,,percent of total billed charges,,,,,,,,,123.85,90,,percent of total billed charges,,,113.94,82.8,,percent of total billed charges,,,116.97,85,,percent of total billed charges,,,,,,,,,121.1,88,,percent of total billed charges,,,,,,,,,105.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.4,22,,percent of total billed charges,,,125.23,91,,percent of total billed charges,,,130.73,95,,percent of total billed charges,,,114.22,83,,percent of total billed charges,,,114.22,83,,percent of total billed charges,,,,,,,,,,,,,,,114.22,83,,percent of total billed charges,,,130.73,95,,percent of total billed charges,,,123.85,90,,percent of total billed charges,,,123.85,90,,percent of total billed charges,,,112.84,82,,percent of total billed charges,,,123.85,90,,percent of total billed charges,,,116.97,85,,percent of total billed charges,,34.4,130.73,
NEEDLE WEISS 20GA X 3-1/2,30182843,CDM,,,270,RC,outpatient,,88.98,88.98,,75.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.25,22,,percent of total billed charges,,,,,,,,,80.08,90,,percent of total billed charges,,,73.68,82.8,,percent of total billed charges,,,75.63,85,,percent of total billed charges,,,,,,,,,78.3,88,,percent of total billed charges,,,,,,,,,67.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.25,22,,percent of total billed charges,,,80.97,91,,percent of total billed charges,,,84.53,95,,percent of total billed charges,,,73.85,83,,percent of total billed charges,,,73.85,83,,percent of total billed charges,,,,,,,,,,,,,,,73.85,83,,percent of total billed charges,,,84.53,95,,percent of total billed charges,,,80.08,90,,percent of total billed charges,,,80.08,90,,percent of total billed charges,,,72.96,82,,percent of total billed charges,,,80.08,90,,percent of total billed charges,,,75.63,85,,percent of total billed charges,,22.25,84.53,
STRYKER VAS SYSTEM KIT 15MM,30182845,CDM,,,270,RC,outpatient,,8233.36,8233.36,,6990.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2058.34,22,,percent of total billed charges,,,,,,,,,7410.02,90,,percent of total billed charges,,,6817.22,82.8,,percent of total billed charges,,,6998.36,85,,percent of total billed charges,,,,,,,,,7245.36,88,,percent of total billed charges,,,,,,,,,6290.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2058.34,22,,percent of total billed charges,,,7492.36,91,,percent of total billed charges,,,7821.69,95,,percent of total billed charges,,,6833.69,83,,percent of total billed charges,,,6833.69,83,,percent of total billed charges,,,,,,,,,,,,,,,6833.69,83,,percent of total billed charges,,,7821.69,95,,percent of total billed charges,,,7410.02,90,,percent of total billed charges,,,7410.02,90,,percent of total billed charges,,,6751.36,82,,percent of total billed charges,,,7410.02,90,,percent of total billed charges,,,6998.36,85,,percent of total billed charges,,2058.34,7821.69,
DEPUY PINNACLE CUP MULTIHOLE 62MM,30182849,CDM,,,278,RC,outpatient,,26741.78,26741.78,,22703.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6685.45,22,,percent of total billed charges,,,,,,,,,24067.6,90,,percent of total billed charges,,,22142.19,82.8,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,,,,,,,,23532.77,88,,percent of total billed charges,,,,,,,,,20430.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6685.45,22,,percent of total billed charges,,,24335.02,91,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,22195.68,83,,percent of total billed charges,,,,,,,,,,,,,,,22195.68,83,,percent of total billed charges,,,25404.69,95,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,21928.26,82,,percent of total billed charges,,,24067.6,90,,percent of total billed charges,,,22730.51,85,,percent of total billed charges,,6685.45,25404.69,
DEPUY LINER CONSTRAINED +4 40 X 62,30182850,CDM,,,278,RC,outpatient,,39314.21,39314.21,,33377.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9828.55,22,,percent of total billed charges,,,,,,,,,35382.79,90,,percent of total billed charges,,,32552.17,82.8,,percent of total billed charges,,,33417.08,85,,percent of total billed charges,,,,,,,,,34596.5,88,,percent of total billed charges,,,,,,,,,30036.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9828.55,22,,percent of total billed charges,,,35775.93,91,,percent of total billed charges,,,37348.5,95,,percent of total billed charges,,,32630.79,83,,percent of total billed charges,,,32630.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32630.79,83,,percent of total billed charges,,,37348.5,95,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,32237.65,82,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,33417.08,85,,percent of total billed charges,,9828.55,37348.5,
CELL SAVER FILTER 40 MICRON,30182863,CDM,,,270,RC,outpatient,,122.96,122.96,,104.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.74,22,,percent of total billed charges,,,,,,,,,110.66,90,,percent of total billed charges,,,101.81,82.8,,percent of total billed charges,,,104.52,85,,percent of total billed charges,,,,,,,,,108.2,88,,percent of total billed charges,,,,,,,,,93.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.74,22,,percent of total billed charges,,,111.89,91,,percent of total billed charges,,,116.81,95,,percent of total billed charges,,,102.06,83,,percent of total billed charges,,,102.06,83,,percent of total billed charges,,,,,,,,,,,,,,,102.06,83,,percent of total billed charges,,,116.81,95,,percent of total billed charges,,,110.66,90,,percent of total billed charges,,,110.66,90,,percent of total billed charges,,,100.83,82,,percent of total billed charges,,,110.66,90,,percent of total billed charges,,,104.52,85,,percent of total billed charges,,30.74,116.81,
STAPLER CUTTER CONTOUR CURVED,30182865,CDM,,,270,RC,outpatient,,3011.78,3011.78,,2557,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,752.95,22,,percent of total billed charges,,,,,,,,,2710.6,90,,percent of total billed charges,,,2493.75,82.8,,percent of total billed charges,,,2560.01,85,,percent of total billed charges,,,,,,,,,2650.37,88,,percent of total billed charges,,,,,,,,,2301,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,752.95,22,,percent of total billed charges,,,2740.72,91,,percent of total billed charges,,,2861.19,95,,percent of total billed charges,,,2499.78,83,,percent of total billed charges,,,2499.78,83,,percent of total billed charges,,,,,,,,,,,,,,,2499.78,83,,percent of total billed charges,,,2861.19,95,,percent of total billed charges,,,2710.6,90,,percent of total billed charges,,,2710.6,90,,percent of total billed charges,,,2469.66,82,,percent of total billed charges,,,2710.6,90,,percent of total billed charges,,,2560.01,85,,percent of total billed charges,,752.95,2861.19,
NEEDLE RIGID ENDOSCOPIC 20G,30182866,CDM,,,270,RC,outpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.25,22,,percent of total billed charges,,,,,,,,,202.5,90,,percent of total billed charges,,,186.3,82.8,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.25,22,,percent of total billed charges,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,56.25,213.75,
STRYKER FEMORAL HD 36MM 5+,30182867,CDM,,,278,RC,outpatient,,13968.5,13968.5,,11859.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3492.13,22,,percent of total billed charges,,,,,,,,,12571.65,90,,percent of total billed charges,,,11565.92,82.8,,percent of total billed charges,,,11873.23,85,,percent of total billed charges,,,,,,,,,12292.28,88,,percent of total billed charges,,,,,,,,,10671.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3492.13,22,,percent of total billed charges,,,12711.34,91,,percent of total billed charges,,,13270.08,95,,percent of total billed charges,,,11593.86,83,,percent of total billed charges,,,11593.86,83,,percent of total billed charges,,,,,,,,,,,,,,,11593.86,83,,percent of total billed charges,,,13270.08,95,,percent of total billed charges,,,12571.65,90,,percent of total billed charges,,,12571.65,90,,percent of total billed charges,,,11454.17,82,,percent of total billed charges,,,12571.65,90,,percent of total billed charges,,,11873.23,85,,percent of total billed charges,,3492.13,13270.08,
DEPUY PINNACLE CUP W/GRIPTION 64MM,30182868,CDM,,,278,RC,outpatient,,31783.05,31783.05,,26983.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7945.76,22,,percent of total billed charges,,,,,,,,,28604.75,90,,percent of total billed charges,,,26316.37,82.8,,percent of total billed charges,,,27015.59,85,,percent of total billed charges,,,,,,,,,27969.08,88,,percent of total billed charges,,,,,,,,,24282.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7945.76,22,,percent of total billed charges,,,28922.58,91,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,26379.93,83,,percent of total billed charges,,,,,,,,,,,,,,,26379.93,83,,percent of total billed charges,,,30193.9,95,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,26062.1,82,,percent of total billed charges,,,28604.75,90,,percent of total billed charges,,,27015.59,85,,percent of total billed charges,,7945.76,30193.9,
DEPUY PATELLA 3-PEG 38MM,30182878,CDM,,,278,RC,outpatient,,5578.95,5578.95,,4736.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1394.74,22,,percent of total billed charges,,,,,,,,,5021.06,90,,percent of total billed charges,,,4619.37,82.8,,percent of total billed charges,,,4742.11,85,,percent of total billed charges,,,,,,,,,4909.48,88,,percent of total billed charges,,,,,,,,,4262.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1394.74,22,,percent of total billed charges,,,5076.84,91,,percent of total billed charges,,,5300,95,,percent of total billed charges,,,4630.53,83,,percent of total billed charges,,,4630.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4630.53,83,,percent of total billed charges,,,5300,95,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,4574.74,82,,percent of total billed charges,,,5021.06,90,,percent of total billed charges,,,4742.11,85,,percent of total billed charges,,1394.74,5300,
DEPUY HEAD LARGE TAPER 36 +5,30182879,CDM,,,278,RC,outpatient,,12858.43,12858.43,,10916.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3214.61,22,,percent of total billed charges,,,,,,,,,11572.59,90,,percent of total billed charges,,,10646.78,82.8,,percent of total billed charges,,,10929.67,85,,percent of total billed charges,,,,,,,,,11315.42,88,,percent of total billed charges,,,,,,,,,9823.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3214.61,22,,percent of total billed charges,,,11701.17,91,,percent of total billed charges,,,12215.51,95,,percent of total billed charges,,,10672.5,83,,percent of total billed charges,,,10672.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10672.5,83,,percent of total billed charges,,,12215.51,95,,percent of total billed charges,,,11572.59,90,,percent of total billed charges,,,11572.59,90,,percent of total billed charges,,,10543.91,82,,percent of total billed charges,,,11572.59,90,,percent of total billed charges,,,10929.67,85,,percent of total billed charges,,3214.61,12215.51,
ZIMMER BLADE EXPLANT 60MM X 20,30182880,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
DEPUY STEM GLOBAL HUMERAL 44 X 23,30182887,CDM,,,278,RC,outpatient,,24474.65,24474.65,,20778.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6118.66,22,,percent of total billed charges,,,,,,,,,22027.19,90,,percent of total billed charges,,,20265.01,82.8,,percent of total billed charges,,,20803.45,85,,percent of total billed charges,,,,,,,,,21537.69,88,,percent of total billed charges,,,,,,,,,18698.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6118.66,22,,percent of total billed charges,,,22271.93,91,,percent of total billed charges,,,23250.92,95,,percent of total billed charges,,,20313.96,83,,percent of total billed charges,,,20313.96,83,,percent of total billed charges,,,,,,,,,,,,,,,20313.96,83,,percent of total billed charges,,,23250.92,95,,percent of total billed charges,,,22027.19,90,,percent of total billed charges,,,22027.19,90,,percent of total billed charges,,,20069.21,82,,percent of total billed charges,,,22027.19,90,,percent of total billed charges,,,20803.45,85,,percent of total billed charges,,6118.66,23250.92,
DEPUY INSERT XLK 8MM SZ2.5,30182888,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY SAWBLADE 13 X 90 (130),30182890,CDM,,,278,RC,outpatient,,550.55,550.55,,467.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,137.64,22,,percent of total billed charges,,,,,,,,,495.5,90,,percent of total billed charges,,,455.86,82.8,,percent of total billed charges,,,467.97,85,,percent of total billed charges,,,,,,,,,484.48,88,,percent of total billed charges,,,,,,,,,420.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,137.64,22,,percent of total billed charges,,,501,91,,percent of total billed charges,,,523.02,95,,percent of total billed charges,,,456.96,83,,percent of total billed charges,,,456.96,83,,percent of total billed charges,,,,,,,,,,,,,,,456.96,83,,percent of total billed charges,,,523.02,95,,percent of total billed charges,,,495.5,90,,percent of total billed charges,,,495.5,90,,percent of total billed charges,,,451.45,82,,percent of total billed charges,,,495.5,90,,percent of total billed charges,,,467.97,85,,percent of total billed charges,,137.64,523.02,
DEPUY INSERT XLK 10MM SZ2.5,30182891,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
ALLERGAN SILICONE BREAST IMPLANT 457CC,30182895,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
ALLERGAN TISSUE EXPANDER 500CC,30182900,CDM,,,278,RC,outpatient,,9067.5,9067.5,,7698.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2266.88,22,,percent of total billed charges,,,,,,,,,8160.75,90,,percent of total billed charges,,,7507.89,82.8,,percent of total billed charges,,,7707.38,85,,percent of total billed charges,,,,,,,,,7979.4,88,,percent of total billed charges,,,,,,,,,6927.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2266.88,22,,percent of total billed charges,,,8251.43,91,,percent of total billed charges,,,8614.13,95,,percent of total billed charges,,,7526.03,83,,percent of total billed charges,,,7526.03,83,,percent of total billed charges,,,,,,,,,,,,,,,7526.03,83,,percent of total billed charges,,,8614.13,95,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,7435.35,82,,percent of total billed charges,,,8160.75,90,,percent of total billed charges,,,7707.38,85,,percent of total billed charges,,2266.88,8614.13,
DOUBLE ARMED SUTURE NEEDLE - 8535,30182901,CDM,,,270,RC,outpatient,,193.28,193.28,,164.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.32,22,,percent of total billed charges,,,,,,,,,173.95,90,,percent of total billed charges,,,160.04,82.8,,percent of total billed charges,,,164.29,85,,percent of total billed charges,,,,,,,,,170.09,88,,percent of total billed charges,,,,,,,,,147.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.32,22,,percent of total billed charges,,,175.88,91,,percent of total billed charges,,,183.62,95,,percent of total billed charges,,,160.42,83,,percent of total billed charges,,,160.42,83,,percent of total billed charges,,,,,,,,,,,,,,,160.42,83,,percent of total billed charges,,,183.62,95,,percent of total billed charges,,,173.95,90,,percent of total billed charges,,,173.95,90,,percent of total billed charges,,,158.49,82,,percent of total billed charges,,,173.95,90,,percent of total billed charges,,,164.29,85,,percent of total billed charges,,48.32,183.62,
SYNTHES SCREW CANNUL 16MM 6.5X85MM,30182909,CDM,,,278,RC,outpatient,,2696.27,2696.27,,2289.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,674.07,22,,percent of total billed charges,,,,,,,,,2426.64,90,,percent of total billed charges,,,2232.51,82.8,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,,,,,,,,2372.72,88,,percent of total billed charges,,,,,,,,,2059.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,674.07,22,,percent of total billed charges,,,2453.61,91,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2237.9,83,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2210.94,82,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,674.07,2561.46,
DEPUY STEM CORAIL KLA SZ11,30182912,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DRAPE INCISE EYE POUCH INVISISHIELD,30182913,CDM,,,270,RC,outpatient,,49.64,49.64,,42.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.41,22,,percent of total billed charges,,,,,,,,,44.68,90,,percent of total billed charges,,,41.1,82.8,,percent of total billed charges,,,42.19,85,,percent of total billed charges,,,,,,,,,43.68,88,,percent of total billed charges,,,,,,,,,37.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.41,22,,percent of total billed charges,,,45.17,91,,percent of total billed charges,,,47.16,95,,percent of total billed charges,,,41.2,83,,percent of total billed charges,,,41.2,83,,percent of total billed charges,,,,,,,,,,,,,,,41.2,83,,percent of total billed charges,,,47.16,95,,percent of total billed charges,,,44.68,90,,percent of total billed charges,,,44.68,90,,percent of total billed charges,,,40.7,82,,percent of total billed charges,,,44.68,90,,percent of total billed charges,,,42.19,85,,percent of total billed charges,,12.41,47.16,
ALCON DUOVISC VISOELASTIC SYSTEM SM .40,30182914,CDM,,,278,RC,outpatient,,577.78,577.78,,490.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,144.45,22,,percent of total billed charges,,,,,,,,,520,90,,percent of total billed charges,,,478.4,82.8,,percent of total billed charges,,,491.11,85,,percent of total billed charges,,,,,,,,,508.45,88,,percent of total billed charges,,,,,,,,,441.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,144.45,22,,percent of total billed charges,,,525.78,91,,percent of total billed charges,,,548.89,95,,percent of total billed charges,,,479.56,83,,percent of total billed charges,,,479.56,83,,percent of total billed charges,,,,,,,,,,,,,,,479.56,83,,percent of total billed charges,,,548.89,95,,percent of total billed charges,,,520,90,,percent of total billed charges,,,520,90,,percent of total billed charges,,,473.78,82,,percent of total billed charges,,,520,90,,percent of total billed charges,,,491.11,85,,percent of total billed charges,,144.45,548.89,
DEPUY BODY RECLAIM PROXIMAL 21 X 95,30182915,CDM,,,278,RC,outpatient,,38548.77,38548.77,,32727.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9637.19,22,,percent of total billed charges,,,,,,,,,34693.89,90,,percent of total billed charges,,,31918.38,82.8,,percent of total billed charges,,,32766.45,85,,percent of total billed charges,,,,,,,,,33922.92,88,,percent of total billed charges,,,,,,,,,29451.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9637.19,22,,percent of total billed charges,,,35079.38,91,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,,,,,,,,,,,,,31995.48,83,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,31609.99,82,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,32766.45,85,,percent of total billed charges,,9637.19,36621.33,
DEPUY STEM DISTAL 21 X 140,30182916,CDM,,,278,RC,outpatient,,31338.78,31338.78,,26606.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7834.7,22,,percent of total billed charges,,,,,,,,,28204.9,90,,percent of total billed charges,,,25948.51,82.8,,percent of total billed charges,,,26637.96,85,,percent of total billed charges,,,,,,,,,27578.13,88,,percent of total billed charges,,,,,,,,,23942.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7834.7,22,,percent of total billed charges,,,28518.29,91,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,,,,,,,,,,,,,26011.19,83,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,25697.8,82,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,26637.96,85,,percent of total billed charges,,7834.7,29771.84,
AMNIOTIC ALLOGRAFT 4CM X 6CM,30182928,CDM,,,278,RC,outpatient,,13942.5,13942.5,,11837.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3485.63,22,,percent of total billed charges,,,,,,,,,12548.25,90,,percent of total billed charges,,,11544.39,82.8,,percent of total billed charges,,,11851.13,85,,percent of total billed charges,,,,,,,,,12269.4,88,,percent of total billed charges,,,,,,,,,10652.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3485.63,22,,percent of total billed charges,,,12687.68,91,,percent of total billed charges,,,13245.38,95,,percent of total billed charges,,,11572.28,83,,percent of total billed charges,,,11572.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11572.28,83,,percent of total billed charges,,,13245.38,95,,percent of total billed charges,,,12548.25,90,,percent of total billed charges,,,12548.25,90,,percent of total billed charges,,,11432.85,82,,percent of total billed charges,,,12548.25,90,,percent of total billed charges,,,11851.13,85,,percent of total billed charges,,3485.63,13245.38,
DEPUY GLOBAL ADVANTAGE ECC HD 56 X 18,30182930,CDM,,,278,RC,outpatient,,23402.93,23402.93,,19869.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5850.73,22,,percent of total billed charges,,,,,,,,,21062.64,90,,percent of total billed charges,,,19377.63,82.8,,percent of total billed charges,,,19892.49,85,,percent of total billed charges,,,,,,,,,20594.58,88,,percent of total billed charges,,,,,,,,,17879.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5850.73,22,,percent of total billed charges,,,21296.67,91,,percent of total billed charges,,,22232.78,95,,percent of total billed charges,,,19424.43,83,,percent of total billed charges,,,19424.43,83,,percent of total billed charges,,,,,,,,,,,,,,,19424.43,83,,percent of total billed charges,,,22232.78,95,,percent of total billed charges,,,21062.64,90,,percent of total billed charges,,,21062.64,90,,percent of total billed charges,,,19190.4,82,,percent of total billed charges,,,21062.64,90,,percent of total billed charges,,,19892.49,85,,percent of total billed charges,,5850.73,22232.78,
S&N ENDO BUTTON,30182938,CDM,,,278,RC,outpatient,,2143.05,2143.05,,1819.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,535.76,22,,percent of total billed charges,,,,,,,,,1928.75,90,,percent of total billed charges,,,1774.45,82.8,,percent of total billed charges,,,1821.59,85,,percent of total billed charges,,,,,,,,,1885.88,88,,percent of total billed charges,,,,,,,,,1637.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,535.76,22,,percent of total billed charges,,,1950.18,91,,percent of total billed charges,,,2035.9,95,,percent of total billed charges,,,1778.73,83,,percent of total billed charges,,,1778.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1778.73,83,,percent of total billed charges,,,2035.9,95,,percent of total billed charges,,,1928.75,90,,percent of total billed charges,,,1928.75,90,,percent of total billed charges,,,1757.3,82,,percent of total billed charges,,,1928.75,90,,percent of total billed charges,,,1821.59,85,,percent of total billed charges,,535.76,2035.9,
MTF TRINITY EVOLUTION 10CC,30182940,CDM,,,278,RC,outpatient,,28919.8,28919.8,,24552.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7229.95,22,,percent of total billed charges,,,,,,,,,26027.82,90,,percent of total billed charges,,,23945.59,82.8,,percent of total billed charges,,,24581.83,85,,percent of total billed charges,,,,,,,,,25449.42,88,,percent of total billed charges,,,,,,,,,22094.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7229.95,22,,percent of total billed charges,,,26317.02,91,,percent of total billed charges,,,27473.81,95,,percent of total billed charges,,,24003.43,83,,percent of total billed charges,,,24003.43,83,,percent of total billed charges,,,,,,,,,,,,,,,24003.43,83,,percent of total billed charges,,,27473.81,95,,percent of total billed charges,,,26027.82,90,,percent of total billed charges,,,26027.82,90,,percent of total billed charges,,,23714.24,82,,percent of total billed charges,,,26027.82,90,,percent of total billed charges,,,24581.83,85,,percent of total billed charges,,7229.95,27473.81,
MTF TRINITY EVOLUTION 15CC,30182941,CDM,,,278,RC,outpatient,,36149.75,36149.75,,30691.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9037.44,22,,percent of total billed charges,,,,,,,,,32534.78,90,,percent of total billed charges,,,29931.99,82.8,,percent of total billed charges,,,30727.29,85,,percent of total billed charges,,,,,,,,,31811.78,88,,percent of total billed charges,,,,,,,,,27618.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9037.44,22,,percent of total billed charges,,,32896.27,91,,percent of total billed charges,,,34342.26,95,,percent of total billed charges,,,30004.29,83,,percent of total billed charges,,,30004.29,83,,percent of total billed charges,,,,,,,,,,,,,,,30004.29,83,,percent of total billed charges,,,34342.26,95,,percent of total billed charges,,,32534.78,90,,percent of total billed charges,,,32534.78,90,,percent of total billed charges,,,29642.8,82,,percent of total billed charges,,,32534.78,90,,percent of total billed charges,,,30727.29,85,,percent of total billed charges,,9037.44,34342.26,
MTF TRINITY EVOLUTION 5CC,30182950,CDM,,,278,RC,outpatient,,15893.15,15893.15,,13493.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3973.29,22,,percent of total billed charges,,,,,,,,,14303.84,90,,percent of total billed charges,,,13159.53,82.8,,percent of total billed charges,,,13509.18,85,,percent of total billed charges,,,,,,,,,13985.97,88,,percent of total billed charges,,,,,,,,,12142.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3973.29,22,,percent of total billed charges,,,14462.77,91,,percent of total billed charges,,,15098.49,95,,percent of total billed charges,,,13191.31,83,,percent of total billed charges,,,13191.31,83,,percent of total billed charges,,,,,,,,,,,,,,,13191.31,83,,percent of total billed charges,,,15098.49,95,,percent of total billed charges,,,14303.84,90,,percent of total billed charges,,,14303.84,90,,percent of total billed charges,,,13032.38,82,,percent of total billed charges,,,14303.84,90,,percent of total billed charges,,,13509.18,85,,percent of total billed charges,,3973.29,15098.49,
DEPUY FEMUR SIGMA PS LT SZ2.0,30182951,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
DEPUY INSERT RP 10MM SZ2,30182952,CDM,,,278,RC,outpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3253.11,22,,percent of total billed charges,,,,,,,,,11711.18,90,,percent of total billed charges,,,10774.28,82.8,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3253.11,22,,percent of total billed charges,,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,3253.11,12361.8,
I-STOP FEMALE INCONTINENCE DEVICE,30182959,CDM,,,270,RC,outpatient,,6175,6175,,5242.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1543.75,22,,percent of total billed charges,,,,,,,,,5557.5,90,,percent of total billed charges,,,5112.9,82.8,,percent of total billed charges,,,5248.75,85,,percent of total billed charges,,,,,,,,,5434,88,,percent of total billed charges,,,,,,,,,4717.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1543.75,22,,percent of total billed charges,,,5619.25,91,,percent of total billed charges,,,5866.25,95,,percent of total billed charges,,,5125.25,83,,percent of total billed charges,,,5125.25,83,,percent of total billed charges,,,,,,,,,,,,,,,5125.25,83,,percent of total billed charges,,,5866.25,95,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5063.5,82,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5248.75,85,,percent of total billed charges,,1543.75,5866.25,
TRAY PLEXUFIX NERVE BLOCK,30182960,CDM,,,270,RC,outpatient,,178,178,,151.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.5,22,,percent of total billed charges,,,,,,,,,160.2,90,,percent of total billed charges,,,147.38,82.8,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,,,,,,,,156.64,88,,percent of total billed charges,,,,,,,,,135.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.5,22,,percent of total billed charges,,,161.98,91,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,,,,,,,,,,,,,147.74,83,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,145.96,82,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,44.5,169.1,
MESH VENTRALIGHT W/ECHO 12X14,30182961,CDM,,,270,RC,outpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4225,22,,percent of total billed charges,,,,,,,,,15210,90,,percent of total billed charges,,,13993.2,82.8,,percent of total billed charges,,,14365,85,,percent of total billed charges,,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4225,22,,percent of total billed charges,,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,4225,16055,
DEPUY INSERT RP 15MM SZ2.5,30182962,CDM,,,278,RC,outpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3253.11,22,,percent of total billed charges,,,,,,,,,11711.18,90,,percent of total billed charges,,,10774.28,82.8,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3253.11,22,,percent of total billed charges,,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,3253.11,12361.8,
DEPUY LINER ALTRX NEUT 36 X 52,30182965,CDM,,,278,RC,outpatient,,12874.42,12874.42,,10930.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3218.61,22,,percent of total billed charges,,,,,,,,,11586.98,90,,percent of total billed charges,,,10660.02,82.8,,percent of total billed charges,,,10943.26,85,,percent of total billed charges,,,,,,,,,11329.49,88,,percent of total billed charges,,,,,,,,,9836.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3218.61,22,,percent of total billed charges,,,11715.72,91,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,10685.77,83,,percent of total billed charges,,,,,,,,,,,,,,,10685.77,83,,percent of total billed charges,,,12230.7,95,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10557.02,82,,percent of total billed charges,,,11586.98,90,,percent of total billed charges,,,10943.26,85,,percent of total billed charges,,3218.61,12230.7,
DEPUY LINER CONSTRAINED +4 36 X 58,30182966,CDM,,,278,RC,outpatient,,24183.97,24183.97,,20532.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6045.99,22,,percent of total billed charges,,,,,,,,,21765.57,90,,percent of total billed charges,,,20024.33,82.8,,percent of total billed charges,,,20556.37,85,,percent of total billed charges,,,,,,,,,21281.89,88,,percent of total billed charges,,,,,,,,,18476.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6045.99,22,,percent of total billed charges,,,22007.41,91,,percent of total billed charges,,,22974.77,95,,percent of total billed charges,,,20072.7,83,,percent of total billed charges,,,20072.7,83,,percent of total billed charges,,,,,,,,,,,,,,,20072.7,83,,percent of total billed charges,,,22974.77,95,,percent of total billed charges,,,21765.57,90,,percent of total billed charges,,,21765.57,90,,percent of total billed charges,,,19830.86,82,,percent of total billed charges,,,21765.57,90,,percent of total billed charges,,,20556.37,85,,percent of total billed charges,,6045.99,22974.77,
STENT URETERAL FIRM 5 X 22,30182968,CDM,,,270,RC,outpatient,,682.36,682.36,,579.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,170.59,22,,percent of total billed charges,,,,,,,,,614.12,90,,percent of total billed charges,,,564.99,82.8,,percent of total billed charges,,,580.01,85,,percent of total billed charges,,,,,,,,,600.48,88,,percent of total billed charges,,,,,,,,,521.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,170.59,22,,percent of total billed charges,,,620.95,91,,percent of total billed charges,,,648.24,95,,percent of total billed charges,,,566.36,83,,percent of total billed charges,,,566.36,83,,percent of total billed charges,,,,,,,,,,,,,,,566.36,83,,percent of total billed charges,,,648.24,95,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,559.54,82,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,580.01,85,,percent of total billed charges,,170.59,648.24,
STENT URETERAL FIRM 5 X 24,30182969,CDM,,,270,RC,outpatient,,682.36,682.36,,579.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,170.59,22,,percent of total billed charges,,,,,,,,,614.12,90,,percent of total billed charges,,,564.99,82.8,,percent of total billed charges,,,580.01,85,,percent of total billed charges,,,,,,,,,600.48,88,,percent of total billed charges,,,,,,,,,521.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,170.59,22,,percent of total billed charges,,,620.95,91,,percent of total billed charges,,,648.24,95,,percent of total billed charges,,,566.36,83,,percent of total billed charges,,,566.36,83,,percent of total billed charges,,,,,,,,,,,,,,,566.36,83,,percent of total billed charges,,,648.24,95,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,559.54,82,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,580.01,85,,percent of total billed charges,,170.59,648.24,
DEPUY INSERT XLK 8MM SZ5,30182973,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
MAXCORE BIOPSY CORE INST 18X20,30182975,CDM,,,270,RC,outpatient,,356.1,356.1,,302.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.03,22,,percent of total billed charges,,,,,,,,,320.49,90,,percent of total billed charges,,,294.85,82.8,,percent of total billed charges,,,302.69,85,,percent of total billed charges,,,,,,,,,313.37,88,,percent of total billed charges,,,,,,,,,272.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.03,22,,percent of total billed charges,,,324.05,91,,percent of total billed charges,,,338.3,95,,percent of total billed charges,,,295.56,83,,percent of total billed charges,,,295.56,83,,percent of total billed charges,,,,,,,,,,,,,,,295.56,83,,percent of total billed charges,,,338.3,95,,percent of total billed charges,,,320.49,90,,percent of total billed charges,,,320.49,90,,percent of total billed charges,,,292,82,,percent of total billed charges,,,320.49,90,,percent of total billed charges,,,302.69,85,,percent of total billed charges,,89.03,338.3,
STONE BASKET DAKOTA 1.9X120 8MM,30182976,CDM,,,270,RC,outpatient,,1324.05,1324.05,,1124.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,331.01,22,,percent of total billed charges,,,,,,,,,1191.65,90,,percent of total billed charges,,,1096.31,82.8,,percent of total billed charges,,,1125.44,85,,percent of total billed charges,,,,,,,,,1165.16,88,,percent of total billed charges,,,,,,,,,1011.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,331.01,22,,percent of total billed charges,,,1204.89,91,,percent of total billed charges,,,1257.85,95,,percent of total billed charges,,,1098.96,83,,percent of total billed charges,,,1098.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1098.96,83,,percent of total billed charges,,,1257.85,95,,percent of total billed charges,,,1191.65,90,,percent of total billed charges,,,1191.65,90,,percent of total billed charges,,,1085.72,82,,percent of total billed charges,,,1191.65,90,,percent of total billed charges,,,1125.44,85,,percent of total billed charges,,331.01,1257.85,
STRYKER K-WIRE 3.2 X 450MM,30182978,CDM,,,278,RC,outpatient,,1301.3,1301.3,,1104.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325.33,22,,percent of total billed charges,,,,,,,,,1171.17,90,,percent of total billed charges,,,1077.48,82.8,,percent of total billed charges,,,1106.11,85,,percent of total billed charges,,,,,,,,,1145.14,88,,percent of total billed charges,,,,,,,,,994.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325.33,22,,percent of total billed charges,,,1184.18,91,,percent of total billed charges,,,1236.24,95,,percent of total billed charges,,,1080.08,83,,percent of total billed charges,,,1080.08,83,,percent of total billed charges,,,,,,,,,,,,,,,1080.08,83,,percent of total billed charges,,,1236.24,95,,percent of total billed charges,,,1171.17,90,,percent of total billed charges,,,1171.17,90,,percent of total billed charges,,,1067.07,82,,percent of total billed charges,,,1171.17,90,,percent of total billed charges,,,1106.11,85,,percent of total billed charges,,325.33,1236.24,
STRYKER REAMER 8.0 X 448MM,30182979,CDM,,,278,RC,outpatient,,3013.01,3013.01,,2558.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,753.25,22,,percent of total billed charges,,,,,,,,,2711.71,90,,percent of total billed charges,,,2494.77,82.8,,percent of total billed charges,,,2561.06,85,,percent of total billed charges,,,,,,,,,2651.45,88,,percent of total billed charges,,,,,,,,,2301.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,753.25,22,,percent of total billed charges,,,2741.84,91,,percent of total billed charges,,,2862.36,95,,percent of total billed charges,,,2500.8,83,,percent of total billed charges,,,2500.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2500.8,83,,percent of total billed charges,,,2862.36,95,,percent of total billed charges,,,2711.71,90,,percent of total billed charges,,,2711.71,90,,percent of total billed charges,,,2470.67,82,,percent of total billed charges,,,2711.71,90,,percent of total billed charges,,,2561.06,85,,percent of total billed charges,,753.25,2862.36,
SYNTHES SCREW CANCEL P-THD 4.0MM,30182982,CDM,,,278,RC,outpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.78,22,,percent of total billed charges,,,,,,,,,200.82,90,,percent of total billed charges,,,184.75,82.8,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.78,22,,percent of total billed charges,,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,55.78,211.97,
DEPUY SELF CENT HIP 47X28 BRN,30182985,CDM,,,278,RC,outpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.27,22,,percent of total billed charges,,,,,,,,,7312.56,90,,percent of total billed charges,,,6727.56,82.8,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.27,22,,percent of total billed charges,,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,2031.27,7718.82,
DEPUY CENTRALIZER 10.5MM,30182986,CDM,,,278,RC,outpatient,,919.36,919.36,,780.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,229.84,22,,percent of total billed charges,,,,,,,,,827.42,90,,percent of total billed charges,,,761.23,82.8,,percent of total billed charges,,,781.46,85,,percent of total billed charges,,,,,,,,,809.04,88,,percent of total billed charges,,,,,,,,,702.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,229.84,22,,percent of total billed charges,,,836.62,91,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,,,,,,,,,,,,,763.07,83,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,753.88,82,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,781.46,85,,percent of total billed charges,,229.84,873.39,
DEPUY INSERT TC3 RP 10MM SZ4,30182987,CDM,,,278,RC,outpatient,,15465.58,15465.58,,13130.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3866.4,22,,percent of total billed charges,,,,,,,,,13919.02,90,,percent of total billed charges,,,12805.5,82.8,,percent of total billed charges,,,13145.74,85,,percent of total billed charges,,,,,,,,,13609.71,88,,percent of total billed charges,,,,,,,,,11815.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3866.4,22,,percent of total billed charges,,,14073.68,91,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,,,,,,,,,,,,,12836.43,83,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,12681.78,82,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13145.74,85,,percent of total billed charges,,3866.4,14692.3,
DEPUY STEM GLOBAL HUMERAL 48 X 15,30182988,CDM,,,278,RC,outpatient,,15560.09,15560.09,,13210.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3890.02,22,,percent of total billed charges,,,,,,,,,14004.08,90,,percent of total billed charges,,,12883.75,82.8,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,,,,,,,,13692.88,88,,percent of total billed charges,,,,,,,,,11887.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3890.02,22,,percent of total billed charges,,,14159.68,91,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12914.87,83,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,12759.27,82,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,3890.02,14782.09,
STRYKER PAIN ELECTRODE PAD,30182995,CDM,,,270,RC,outpatient,,337.5,337.5,,286.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.38,22,,percent of total billed charges,,,,,,,,,303.75,90,,percent of total billed charges,,,279.45,82.8,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,,,,,,,,297,88,,percent of total billed charges,,,,,,,,,257.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.38,22,,percent of total billed charges,,,307.13,91,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,,,,,,,,,,,,,280.13,83,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,276.75,82,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,84.38,320.63,
S&N ENDO ACCUPASS SUTURE,30182996,CDM,,,278,RC,outpatient,,825.5,825.5,,700.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.38,22,,percent of total billed charges,,,,,,,,,742.95,90,,percent of total billed charges,,,683.51,82.8,,percent of total billed charges,,,701.68,85,,percent of total billed charges,,,,,,,,,726.44,88,,percent of total billed charges,,,,,,,,,630.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.38,22,,percent of total billed charges,,,751.21,91,,percent of total billed charges,,,784.23,95,,percent of total billed charges,,,685.17,83,,percent of total billed charges,,,685.17,83,,percent of total billed charges,,,,,,,,,,,,,,,685.17,83,,percent of total billed charges,,,784.23,95,,percent of total billed charges,,,742.95,90,,percent of total billed charges,,,742.95,90,,percent of total billed charges,,,676.91,82,,percent of total billed charges,,,742.95,90,,percent of total billed charges,,,701.68,85,,percent of total billed charges,,206.38,784.23,
DEPUY OSTEOTOME FLEX 12MM X 2.5,30182997,CDM,,,270,RC,outpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1218.75,22,,percent of total billed charges,,,,,,,,,4387.5,90,,percent of total billed charges,,,4036.5,82.8,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1218.75,22,,percent of total billed charges,,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,1218.75,4631.25,
DEPUY DISTAL AUGMENT 4MM SZ3.0,30182998,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
DEPUY DISTAL AUGMENT 4MM SZ5,30182999,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
DEPUY POSTERIOR AUGMENT 4MM SZ5.0,30183000,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
CELL SAVER AUTOFUSION BAG,30183001,CDM,,,270,RC,outpatient,,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.25,22,,percent of total billed charges,,,,,,,,,40.5,90,,percent of total billed charges,,,37.26,82.8,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.25,22,,percent of total billed charges,,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,11.25,42.75,
AMNIOFX NERVE WRAP 4CM X 6CM,30183002,CDM,,,278,RC,outpatient,,13942.5,13942.5,,11837.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3485.63,22,,percent of total billed charges,,,,,,,,,12548.25,90,,percent of total billed charges,,,11544.39,82.8,,percent of total billed charges,,,11851.13,85,,percent of total billed charges,,,,,,,,,12269.4,88,,percent of total billed charges,,,,,,,,,10652.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3485.63,22,,percent of total billed charges,,,12687.68,91,,percent of total billed charges,,,13245.38,95,,percent of total billed charges,,,11572.28,83,,percent of total billed charges,,,11572.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11572.28,83,,percent of total billed charges,,,13245.38,95,,percent of total billed charges,,,12548.25,90,,percent of total billed charges,,,12548.25,90,,percent of total billed charges,,,11432.85,82,,percent of total billed charges,,,12548.25,90,,percent of total billed charges,,,11851.13,85,,percent of total billed charges,,3485.63,13245.38,
S&N ENDO BICEPTOR BIOSURE 7 X 25,30183008,CDM,,,278,RC,outpatient,,1638,1638,,1390.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,409.5,22,,percent of total billed charges,,,,,,,,,1474.2,90,,percent of total billed charges,,,1356.26,82.8,,percent of total billed charges,,,1392.3,85,,percent of total billed charges,,,,,,,,,1441.44,88,,percent of total billed charges,,,,,,,,,1251.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,409.5,22,,percent of total billed charges,,,1490.58,91,,percent of total billed charges,,,1556.1,95,,percent of total billed charges,,,1359.54,83,,percent of total billed charges,,,1359.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1359.54,83,,percent of total billed charges,,,1556.1,95,,percent of total billed charges,,,1474.2,90,,percent of total billed charges,,,1474.2,90,,percent of total billed charges,,,1343.16,82,,percent of total billed charges,,,1474.2,90,,percent of total billed charges,,,1392.3,85,,percent of total billed charges,,409.5,1556.1,
DEPUY INSERT STABILIZED 12.5MM SZ4,30183016,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
STRYKER GUIDEWIRE 3 X 800MM,30183018,CDM,,,278,RC,outpatient,,1911.91,1911.91,,1623.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,477.98,22,,percent of total billed charges,,,,,,,,,1720.72,90,,percent of total billed charges,,,1583.06,82.8,,percent of total billed charges,,,1625.12,85,,percent of total billed charges,,,,,,,,,1682.48,88,,percent of total billed charges,,,,,,,,,1460.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,477.98,22,,percent of total billed charges,,,1739.84,91,,percent of total billed charges,,,1816.31,95,,percent of total billed charges,,,1586.89,83,,percent of total billed charges,,,1586.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1586.89,83,,percent of total billed charges,,,1816.31,95,,percent of total billed charges,,,1720.72,90,,percent of total billed charges,,,1720.72,90,,percent of total billed charges,,,1567.77,82,,percent of total billed charges,,,1720.72,90,,percent of total billed charges,,,1625.12,85,,percent of total billed charges,,477.98,1816.31,
DEPUY CERAMIC HEAD 32MM +5MM TS,30183022,CDM,,,278,RC,outpatient,,14631.05,14631.05,,12421.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3657.76,22,,percent of total billed charges,,,,,,,,,13167.95,90,,percent of total billed charges,,,12114.51,82.8,,percent of total billed charges,,,12436.39,85,,percent of total billed charges,,,,,,,,,12875.32,88,,percent of total billed charges,,,,,,,,,11178.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3657.76,22,,percent of total billed charges,,,13314.26,91,,percent of total billed charges,,,13899.5,95,,percent of total billed charges,,,12143.77,83,,percent of total billed charges,,,12143.77,83,,percent of total billed charges,,,,,,,,,,,,,,,12143.77,83,,percent of total billed charges,,,13899.5,95,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,11997.46,82,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,12436.39,85,,percent of total billed charges,,3657.76,13899.5,
DEPUY CROSSLINK FIN GLENOID SZ56,30183023,CDM,,,278,RC,outpatient,,17098.9,17098.9,,14516.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4274.73,22,,percent of total billed charges,,,,,,,,,15389.01,90,,percent of total billed charges,,,14157.89,82.8,,percent of total billed charges,,,14534.07,85,,percent of total billed charges,,,,,,,,,15047.03,88,,percent of total billed charges,,,,,,,,,13063.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4274.73,22,,percent of total billed charges,,,15560,91,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,,,,,,,,,,,,,14192.09,83,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14021.1,82,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14534.07,85,,percent of total billed charges,,4274.73,16243.96,
DEPUY STEM HUMERAL ECCENTRIC 56 X 21,30183024,CDM,,,278,RC,outpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4409.03,22,,percent of total billed charges,,,,,,,,,15872.52,90,,percent of total billed charges,,,14602.72,82.8,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4409.03,22,,percent of total billed charges,,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,4409.03,16754.32,
DEPUY STEM GLOBAL ADVANTAGE 16MM,30183025,CDM,,,278,RC,outpatient,,36482.49,36482.49,,30973.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9120.62,22,,percent of total billed charges,,,,,,,,,32834.24,90,,percent of total billed charges,,,30207.5,82.8,,percent of total billed charges,,,31010.12,85,,percent of total billed charges,,,,,,,,,32104.59,88,,percent of total billed charges,,,,,,,,,27872.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9120.62,22,,percent of total billed charges,,,33199.07,91,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,,,,,,,,,,,,,30280.47,83,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,29915.64,82,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,31010.12,85,,percent of total billed charges,,9120.62,34658.37,
GYRUS VACURETTE 7MM CURVED,30183026,CDM,,,270,RC,outpatient,,46.22,46.22,,39.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.56,22,,percent of total billed charges,,,,,,,,,41.6,90,,percent of total billed charges,,,38.27,82.8,,percent of total billed charges,,,39.29,85,,percent of total billed charges,,,,,,,,,40.67,88,,percent of total billed charges,,,,,,,,,35.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.56,22,,percent of total billed charges,,,42.06,91,,percent of total billed charges,,,43.91,95,,percent of total billed charges,,,38.36,83,,percent of total billed charges,,,38.36,83,,percent of total billed charges,,,,,,,,,,,,,,,38.36,83,,percent of total billed charges,,,43.91,95,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,37.9,82,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,39.29,85,,percent of total billed charges,,11.56,43.91,
GYRUS VACURETTE 7MM STRAIGHT,30183027,CDM,,,270,RC,outpatient,,44.45,44.45,,37.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.11,22,,percent of total billed charges,,,,,,,,,40.01,90,,percent of total billed charges,,,36.8,82.8,,percent of total billed charges,,,37.78,85,,percent of total billed charges,,,,,,,,,39.12,88,,percent of total billed charges,,,,,,,,,33.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.11,22,,percent of total billed charges,,,40.45,91,,percent of total billed charges,,,42.23,95,,percent of total billed charges,,,36.89,83,,percent of total billed charges,,,36.89,83,,percent of total billed charges,,,,,,,,,,,,,,,36.89,83,,percent of total billed charges,,,42.23,95,,percent of total billed charges,,,40.01,90,,percent of total billed charges,,,40.01,90,,percent of total billed charges,,,36.45,82,,percent of total billed charges,,,40.01,90,,percent of total billed charges,,,37.78,85,,percent of total billed charges,,11.11,42.23,
GYRUS VACURETTE 5MM FTIP,30183028,CDM,,,270,RC,outpatient,,40.5,40.5,,34.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.13,22,,percent of total billed charges,,,,,,,,,36.45,90,,percent of total billed charges,,,33.53,82.8,,percent of total billed charges,,,34.43,85,,percent of total billed charges,,,,,,,,,35.64,88,,percent of total billed charges,,,,,,,,,30.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.13,22,,percent of total billed charges,,,36.86,91,,percent of total billed charges,,,38.48,95,,percent of total billed charges,,,33.62,83,,percent of total billed charges,,,33.62,83,,percent of total billed charges,,,,,,,,,,,,,,,33.62,83,,percent of total billed charges,,,38.48,95,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,33.21,82,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,34.43,85,,percent of total billed charges,,10.13,38.48,
GYRUS VACURETTE 6MM FTIP,30183029,CDM,,,270,RC,outpatient,,46.22,46.22,,39.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.56,22,,percent of total billed charges,,,,,,,,,41.6,90,,percent of total billed charges,,,38.27,82.8,,percent of total billed charges,,,39.29,85,,percent of total billed charges,,,,,,,,,40.67,88,,percent of total billed charges,,,,,,,,,35.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.56,22,,percent of total billed charges,,,42.06,91,,percent of total billed charges,,,43.91,95,,percent of total billed charges,,,38.36,83,,percent of total billed charges,,,38.36,83,,percent of total billed charges,,,,,,,,,,,,,,,38.36,83,,percent of total billed charges,,,43.91,95,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,37.9,82,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,39.29,85,,percent of total billed charges,,11.56,43.91,
S&N DRILL BIT LONG 4.0MM,30183036,CDM,,,278,RC,outpatient,,1924.13,1924.13,,1633.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,481.03,22,,percent of total billed charges,,,,,,,,,1731.72,90,,percent of total billed charges,,,1593.18,82.8,,percent of total billed charges,,,1635.51,85,,percent of total billed charges,,,,,,,,,1693.23,88,,percent of total billed charges,,,,,,,,,1470.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,481.03,22,,percent of total billed charges,,,1750.96,91,,percent of total billed charges,,,1827.92,95,,percent of total billed charges,,,1597.03,83,,percent of total billed charges,,,1597.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1597.03,83,,percent of total billed charges,,,1827.92,95,,percent of total billed charges,,,1731.72,90,,percent of total billed charges,,,1731.72,90,,percent of total billed charges,,,1577.79,82,,percent of total billed charges,,,1731.72,90,,percent of total billed charges,,,1635.51,85,,percent of total billed charges,,481.03,1827.92,
ALLERGAN SILICONE BREAST IMPLANT 350CC,30183039,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
SYNTHES SCREW CANNUL 16MM 6.5X65MM,30183040,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
RESERVOIR 3 LITER 150 MICRO,30183042,CDM,,,270,RC,outpatient,,551.04,551.04,,467.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,137.76,22,,percent of total billed charges,,,,,,,,,495.94,90,,percent of total billed charges,,,456.26,82.8,,percent of total billed charges,,,468.38,85,,percent of total billed charges,,,,,,,,,484.92,88,,percent of total billed charges,,,,,,,,,420.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,137.76,22,,percent of total billed charges,,,501.45,91,,percent of total billed charges,,,523.49,95,,percent of total billed charges,,,457.36,83,,percent of total billed charges,,,457.36,83,,percent of total billed charges,,,,,,,,,,,,,,,457.36,83,,percent of total billed charges,,,523.49,95,,percent of total billed charges,,,495.94,90,,percent of total billed charges,,,495.94,90,,percent of total billed charges,,,451.85,82,,percent of total billed charges,,,495.94,90,,percent of total billed charges,,,468.38,85,,percent of total billed charges,,137.76,523.49,
BOWL CS5 125ML HI SPEED FOR CS,30183044,CDM,,,270,RC,outpatient,,839.48,839.48,,712.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,209.87,22,,percent of total billed charges,,,,,,,,,755.53,90,,percent of total billed charges,,,695.09,82.8,,percent of total billed charges,,,713.56,85,,percent of total billed charges,,,,,,,,,738.74,88,,percent of total billed charges,,,,,,,,,641.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,209.87,22,,percent of total billed charges,,,763.93,91,,percent of total billed charges,,,797.51,95,,percent of total billed charges,,,696.77,83,,percent of total billed charges,,,696.77,83,,percent of total billed charges,,,,,,,,,,,,,,,696.77,83,,percent of total billed charges,,,797.51,95,,percent of total billed charges,,,755.53,90,,percent of total billed charges,,,755.53,90,,percent of total billed charges,,,688.37,82,,percent of total billed charges,,,755.53,90,,percent of total billed charges,,,713.56,85,,percent of total billed charges,,209.87,797.51,
NUCELL LARGE,30183045,CDM,,,278,RC,outpatient,,32500,32500,,27592.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8125,22,,percent of total billed charges,,,,,,,,,29250,90,,percent of total billed charges,,,26910,82.8,,percent of total billed charges,,,27625,85,,percent of total billed charges,,,,,,,,,28600,88,,percent of total billed charges,,,,,,,,,24830,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8125,22,,percent of total billed charges,,,29575,91,,percent of total billed charges,,,30875,95,,percent of total billed charges,,,26975,83,,percent of total billed charges,,,26975,83,,percent of total billed charges,,,,,,,,,,,,,,,26975,83,,percent of total billed charges,,,30875,95,,percent of total billed charges,,,29250,90,,percent of total billed charges,,,29250,90,,percent of total billed charges,,,26650,82,,percent of total billed charges,,,29250,90,,percent of total billed charges,,,27625,85,,percent of total billed charges,,8125,30875,
CATH PLEURX PLEURAL,30183047,CDM,,,270,RC,outpatient,,3737.5,3737.5,,3173.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,934.38,22,,percent of total billed charges,,,,,,,,,3363.75,90,,percent of total billed charges,,,3094.65,82.8,,percent of total billed charges,,,3176.88,85,,percent of total billed charges,,,,,,,,,3289,88,,percent of total billed charges,,,,,,,,,2855.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,934.38,22,,percent of total billed charges,,,3401.13,91,,percent of total billed charges,,,3550.63,95,,percent of total billed charges,,,3102.13,83,,percent of total billed charges,,,3102.13,83,,percent of total billed charges,,,,,,,,,,,,,,,3102.13,83,,percent of total billed charges,,,3550.63,95,,percent of total billed charges,,,3363.75,90,,percent of total billed charges,,,3363.75,90,,percent of total billed charges,,,3064.75,82,,percent of total billed charges,,,3363.75,90,,percent of total billed charges,,,3176.88,85,,percent of total billed charges,,934.38,3550.63,
PLEURX DRAINAGE BOTTLE KIT 1000ML,30183048,CDM,,,270,RC,outpatient,,806.96,806.96,,685.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,201.74,22,,percent of total billed charges,,,,,,,,,726.26,90,,percent of total billed charges,,,668.16,82.8,,percent of total billed charges,,,685.92,85,,percent of total billed charges,,,,,,,,,710.12,88,,percent of total billed charges,,,,,,,,,616.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,201.74,22,,percent of total billed charges,,,734.33,91,,percent of total billed charges,,,766.61,95,,percent of total billed charges,,,669.78,83,,percent of total billed charges,,,669.78,83,,percent of total billed charges,,,,,,,,,,,,,,,669.78,83,,percent of total billed charges,,,766.61,95,,percent of total billed charges,,,726.26,90,,percent of total billed charges,,,726.26,90,,percent of total billed charges,,,661.71,82,,percent of total billed charges,,,726.26,90,,percent of total billed charges,,,685.92,85,,percent of total billed charges,,201.74,766.61,
DRAINAGE BOTTLE HOME STARTER KIT,30183049,CDM,,,270,RC,outpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.44,22,,percent of total billed charges,,,,,,,,,1740.38,90,,percent of total billed charges,,,1601.15,82.8,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.44,22,,percent of total billed charges,,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,483.44,1837.06,
PUTTY 10CC H GENIN,30183050,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
DEPUY SLEEVE FEMORAL 34MM,30183051,CDM,,,278,RC,outpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4515.54,22,,percent of total billed charges,,,,,,,,,16255.93,90,,percent of total billed charges,,,14955.45,82.8,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4515.54,22,,percent of total billed charges,,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,4515.54,17159.03,
DEPUY SLEEVE FEMORAL 40MM,30183052,CDM,,,278,RC,outpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4515.54,22,,percent of total billed charges,,,,,,,,,16255.93,90,,percent of total billed charges,,,14955.45,82.8,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4515.54,22,,percent of total billed charges,,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,4515.54,17159.03,
DEPUY TRAY THICK SX 3 15MM,30183053,CDM,,,278,RC,outpatient,,62809.5,62809.5,,53325.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15702.38,22,,percent of total billed charges,,,,,,,,,56528.55,90,,percent of total billed charges,,,52006.27,82.8,,percent of total billed charges,,,53388.08,85,,percent of total billed charges,,,,,,,,,55272.36,88,,percent of total billed charges,,,,,,,,,47986.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15702.38,22,,percent of total billed charges,,,57156.65,91,,percent of total billed charges,,,59669.03,95,,percent of total billed charges,,,52131.89,83,,percent of total billed charges,,,52131.89,83,,percent of total billed charges,,,,,,,,,,,,,,,52131.89,83,,percent of total billed charges,,,59669.03,95,,percent of total billed charges,,,56528.55,90,,percent of total billed charges,,,56528.55,90,,percent of total billed charges,,,51503.79,82,,percent of total billed charges,,,56528.55,90,,percent of total billed charges,,,53388.08,85,,percent of total billed charges,,15702.38,59669.03,
DEPUY STEM TIBIAL 75 X 12MM,30183054,CDM,,,278,RC,outpatient,,12911.21,12911.21,,10961.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3227.8,22,,percent of total billed charges,,,,,,,,,11620.09,90,,percent of total billed charges,,,10690.48,82.8,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,,,,,,,,11361.86,88,,percent of total billed charges,,,,,,,,,9864.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3227.8,22,,percent of total billed charges,,,11749.2,91,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,10716.3,83,,percent of total billed charges,,,,,,,,,,,,,,,10716.3,83,,percent of total billed charges,,,12265.65,95,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10587.19,82,,percent of total billed charges,,,11620.09,90,,percent of total billed charges,,,10974.53,85,,percent of total billed charges,,3227.8,12265.65,
PUTTY 2.5CC H-GENIN,30183057,CDM,,,278,RC,outpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,568.75,22,,percent of total billed charges,,,,,,,,,2047.5,90,,percent of total billed charges,,,1883.7,82.8,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,568.75,22,,percent of total billed charges,,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,568.75,2161.25,
NUCELL SMALL,30183058,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
NUCELL X-LARGE,30183059,CDM,,,278,RC,outpatient,,52000,52000,,44148,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13000,22,,percent of total billed charges,,,,,,,,,46800,90,,percent of total billed charges,,,43056,82.8,,percent of total billed charges,,,44200,85,,percent of total billed charges,,,,,,,,,45760,88,,percent of total billed charges,,,,,,,,,39728,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13000,22,,percent of total billed charges,,,47320,91,,percent of total billed charges,,,49400,95,,percent of total billed charges,,,43160,83,,percent of total billed charges,,,43160,83,,percent of total billed charges,,,,,,,,,,,,,,,43160,83,,percent of total billed charges,,,49400,95,,percent of total billed charges,,,46800,90,,percent of total billed charges,,,46800,90,,percent of total billed charges,,,42640,82,,percent of total billed charges,,,46800,90,,percent of total billed charges,,,44200,85,,percent of total billed charges,,13000,49400,
CAPSULE MINIONE 20FR,30183069,CDM,,,270,RC,outpatient,,1105,1105,,938.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,276.25,22,,percent of total billed charges,,,,,,,,,994.5,90,,percent of total billed charges,,,914.94,82.8,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,,,,,,,,972.4,88,,percent of total billed charges,,,,,,,,,844.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,276.25,22,,percent of total billed charges,,,1005.55,91,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,,,,,,,,,,,,,917.15,83,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,906.1,82,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,276.25,1049.75,
MINIONE FEEDING SET 12,30183070,CDM,,,270,RC,outpatient,,68,68,,57.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17,22,,percent of total billed charges,,,,,,,,,61.2,90,,percent of total billed charges,,,56.3,82.8,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,,,,,,,,59.84,88,,percent of total billed charges,,,,,,,,,51.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17,22,,percent of total billed charges,,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,,,,,,,,,,,,,56.44,83,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,55.76,82,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,17,64.6,
DEPUY BIOLOX DELTA TS HEAD,30183071,CDM,,,278,RC,outpatient,,15329.8,15329.8,,13015,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3832.45,22,,percent of total billed charges,,,,,,,,,13796.82,90,,percent of total billed charges,,,12693.07,82.8,,percent of total billed charges,,,13030.33,85,,percent of total billed charges,,,,,,,,,13490.22,88,,percent of total billed charges,,,,,,,,,11711.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3832.45,22,,percent of total billed charges,,,13950.12,91,,percent of total billed charges,,,14563.31,95,,percent of total billed charges,,,12723.73,83,,percent of total billed charges,,,12723.73,83,,percent of total billed charges,,,,,,,,,,,,,,,12723.73,83,,percent of total billed charges,,,14563.31,95,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,12570.44,82,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,13030.33,85,,percent of total billed charges,,3832.45,14563.31,
RTI PATELLAR TENDON  GRAFT 10MM,30183073,CDM,,,278,RC,outpatient,,23400,23400,,19866.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5850,22,,percent of total billed charges,,,,,,,,,21060,90,,percent of total billed charges,,,19375.2,82.8,,percent of total billed charges,,,19890,85,,percent of total billed charges,,,,,,,,,20592,88,,percent of total billed charges,,,,,,,,,17877.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5850,22,,percent of total billed charges,,,21294,91,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,,,,,,,,,,,,,19422,83,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19188,82,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19890,85,,percent of total billed charges,,5850,22230,
SYNTHES SCREW CANCEL 4.0X45MM,30183074,CDM,,,278,RC,outpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.78,22,,percent of total billed charges,,,,,,,,,200.82,90,,percent of total billed charges,,,184.75,82.8,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.78,22,,percent of total billed charges,,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,55.78,211.97,
UPHOLD  VAGINAL SUPPORT SYSTEM,30183077,CDM,,,270,RC,outpatient,,16275.35,16275.35,,13817.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4068.84,22,,percent of total billed charges,,,,,,,,,14647.82,90,,percent of total billed charges,,,13475.99,82.8,,percent of total billed charges,,,13834.05,85,,percent of total billed charges,,,,,,,,,14322.31,88,,percent of total billed charges,,,,,,,,,12434.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4068.84,22,,percent of total billed charges,,,14810.57,91,,percent of total billed charges,,,15461.58,95,,percent of total billed charges,,,13508.54,83,,percent of total billed charges,,,13508.54,83,,percent of total billed charges,,,,,,,,,,,,,,,13508.54,83,,percent of total billed charges,,,15461.58,95,,percent of total billed charges,,,14647.82,90,,percent of total billed charges,,,14647.82,90,,percent of total billed charges,,,13345.79,82,,percent of total billed charges,,,14647.82,90,,percent of total billed charges,,,13834.05,85,,percent of total billed charges,,4068.84,15461.58,
HOLMIUM LASER LOW WATTAGE SERVICE FEE,30183078,CDM,,,270,RC,outpatient,,4218.5,4218.5,,3581.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1054.63,22,,percent of total billed charges,,,,,,,,,3796.65,90,,percent of total billed charges,,,3492.92,82.8,,percent of total billed charges,,,3585.73,85,,percent of total billed charges,,,,,,,,,3712.28,88,,percent of total billed charges,,,,,,,,,3222.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1054.63,22,,percent of total billed charges,,,3838.84,91,,percent of total billed charges,,,4007.58,95,,percent of total billed charges,,,3501.36,83,,percent of total billed charges,,,3501.36,83,,percent of total billed charges,,,,,,,,,,,,,,,3501.36,83,,percent of total billed charges,,,4007.58,95,,percent of total billed charges,,,3796.65,90,,percent of total billed charges,,,3796.65,90,,percent of total billed charges,,,3459.17,82,,percent of total billed charges,,,3796.65,90,,percent of total billed charges,,,3585.73,85,,percent of total billed charges,,1054.63,4007.58,
HOLMIUM 200 MICRON FIBER,30183079,CDM,,,270,RC,outpatient,,1482,1482,,1258.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,370.5,22,,percent of total billed charges,,,,,,,,,1333.8,90,,percent of total billed charges,,,1227.1,82.8,,percent of total billed charges,,,1259.7,85,,percent of total billed charges,,,,,,,,,1304.16,88,,percent of total billed charges,,,,,,,,,1132.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,370.5,22,,percent of total billed charges,,,1348.62,91,,percent of total billed charges,,,1407.9,95,,percent of total billed charges,,,1230.06,83,,percent of total billed charges,,,1230.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1230.06,83,,percent of total billed charges,,,1407.9,95,,percent of total billed charges,,,1333.8,90,,percent of total billed charges,,,1333.8,90,,percent of total billed charges,,,1215.24,82,,percent of total billed charges,,,1333.8,90,,percent of total billed charges,,,1259.7,85,,percent of total billed charges,,370.5,1407.9,
DEPUY DELTA HEAD 36+ 1.5MM,30183080,CDM,,,278,RC,outpatient,,15329.8,15329.8,,13015,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3832.45,22,,percent of total billed charges,,,,,,,,,13796.82,90,,percent of total billed charges,,,12693.07,82.8,,percent of total billed charges,,,13030.33,85,,percent of total billed charges,,,,,,,,,13490.22,88,,percent of total billed charges,,,,,,,,,11711.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3832.45,22,,percent of total billed charges,,,13950.12,91,,percent of total billed charges,,,14563.31,95,,percent of total billed charges,,,12723.73,83,,percent of total billed charges,,,12723.73,83,,percent of total billed charges,,,,,,,,,,,,,,,12723.73,83,,percent of total billed charges,,,14563.31,95,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,12570.44,82,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,13030.33,85,,percent of total billed charges,,3832.45,14563.31,
ENDO STITCH 7,30183082,CDM,,,270,RC,outpatient,,407.89,407.89,,346.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.97,22,,percent of total billed charges,,,,,,,,,367.1,90,,percent of total billed charges,,,337.73,82.8,,percent of total billed charges,,,346.71,85,,percent of total billed charges,,,,,,,,,358.94,88,,percent of total billed charges,,,,,,,,,311.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.97,22,,percent of total billed charges,,,371.18,91,,percent of total billed charges,,,387.5,95,,percent of total billed charges,,,338.55,83,,percent of total billed charges,,,338.55,83,,percent of total billed charges,,,,,,,,,,,,,,,338.55,83,,percent of total billed charges,,,387.5,95,,percent of total billed charges,,,367.1,90,,percent of total billed charges,,,367.1,90,,percent of total billed charges,,,334.47,82,,percent of total billed charges,,,367.1,90,,percent of total billed charges,,,346.71,85,,percent of total billed charges,,101.97,387.5,
STRYKER BUR NEURO SOFTTOUCH 3.0,30183085,CDM,,,270,RC,outpatient,,1202.5,1202.5,,1020.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,300.63,22,,percent of total billed charges,,,,,,,,,1082.25,90,,percent of total billed charges,,,995.67,82.8,,percent of total billed charges,,,1022.13,85,,percent of total billed charges,,,,,,,,,1058.2,88,,percent of total billed charges,,,,,,,,,918.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,300.63,22,,percent of total billed charges,,,1094.28,91,,percent of total billed charges,,,1142.38,95,,percent of total billed charges,,,998.08,83,,percent of total billed charges,,,998.08,83,,percent of total billed charges,,,,,,,,,,,,,,,998.08,83,,percent of total billed charges,,,1142.38,95,,percent of total billed charges,,,1082.25,90,,percent of total billed charges,,,1082.25,90,,percent of total billed charges,,,986.05,82,,percent of total billed charges,,,1082.25,90,,percent of total billed charges,,,1022.13,85,,percent of total billed charges,,300.63,1142.38,
SYNTHES PROTECTIVE CAP FOR 4.0MM FIXATIO,30183087,CDM,,,270,RC,outpatient,,81.25,81.25,,68.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.31,22,,percent of total billed charges,,,,,,,,,73.13,90,,percent of total billed charges,,,67.28,82.8,,percent of total billed charges,,,69.06,85,,percent of total billed charges,,,,,,,,,71.5,88,,percent of total billed charges,,,,,,,,,62.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.31,22,,percent of total billed charges,,,73.94,91,,percent of total billed charges,,,77.19,95,,percent of total billed charges,,,67.44,83,,percent of total billed charges,,,67.44,83,,percent of total billed charges,,,,,,,,,,,,,,,67.44,83,,percent of total billed charges,,,77.19,95,,percent of total billed charges,,,73.13,90,,percent of total billed charges,,,73.13,90,,percent of total billed charges,,,66.63,82,,percent of total billed charges,,,73.13,90,,percent of total billed charges,,,69.06,85,,percent of total billed charges,,20.31,77.19,
TROCAR ENDO BLADLESS 150MM X 12MM,30183090,CDM,,,270,RC,outpatient,,230.55,230.55,,195.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.64,22,,percent of total billed charges,,,,,,,,,207.5,90,,percent of total billed charges,,,190.9,82.8,,percent of total billed charges,,,195.97,85,,percent of total billed charges,,,,,,,,,202.88,88,,percent of total billed charges,,,,,,,,,176.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.64,22,,percent of total billed charges,,,209.8,91,,percent of total billed charges,,,219.02,95,,percent of total billed charges,,,191.36,83,,percent of total billed charges,,,191.36,83,,percent of total billed charges,,,,,,,,,,,,,,,191.36,83,,percent of total billed charges,,,219.02,95,,percent of total billed charges,,,207.5,90,,percent of total billed charges,,,207.5,90,,percent of total billed charges,,,189.05,82,,percent of total billed charges,,,207.5,90,,percent of total billed charges,,,195.97,85,,percent of total billed charges,,57.64,219.02,
DEPUY DELTA HEAD 36+ 8.5MM,30183091,CDM,,,278,RC,outpatient,,15329.8,15329.8,,13015,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3832.45,22,,percent of total billed charges,,,,,,,,,13796.82,90,,percent of total billed charges,,,12693.07,82.8,,percent of total billed charges,,,13030.33,85,,percent of total billed charges,,,,,,,,,13490.22,88,,percent of total billed charges,,,,,,,,,11711.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3832.45,22,,percent of total billed charges,,,13950.12,91,,percent of total billed charges,,,14563.31,95,,percent of total billed charges,,,12723.73,83,,percent of total billed charges,,,12723.73,83,,percent of total billed charges,,,,,,,,,,,,,,,12723.73,83,,percent of total billed charges,,,14563.31,95,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,12570.44,82,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,13030.33,85,,percent of total billed charges,,3832.45,14563.31,
DEPUY BIOLOX FEM HD 36MM +12,30183093,CDM,,,278,RC,outpatient,,15329.8,15329.8,,13015,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3832.45,22,,percent of total billed charges,,,,,,,,,13796.82,90,,percent of total billed charges,,,12693.07,82.8,,percent of total billed charges,,,13030.33,85,,percent of total billed charges,,,,,,,,,13490.22,88,,percent of total billed charges,,,,,,,,,11711.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3832.45,22,,percent of total billed charges,,,13950.12,91,,percent of total billed charges,,,14563.31,95,,percent of total billed charges,,,12723.73,83,,percent of total billed charges,,,12723.73,83,,percent of total billed charges,,,,,,,,,,,,,,,12723.73,83,,percent of total billed charges,,,14563.31,95,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,12570.44,82,,percent of total billed charges,,,13796.82,90,,percent of total billed charges,,,13030.33,85,,percent of total billed charges,,3832.45,14563.31,
DEPUY BODY RECLAIM PROXIMAL 24 X 55,30183098,CDM,,,278,RC,outpatient,,38548.77,38548.77,,32727.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9637.19,22,,percent of total billed charges,,,,,,,,,34693.89,90,,percent of total billed charges,,,31918.38,82.8,,percent of total billed charges,,,32766.45,85,,percent of total billed charges,,,,,,,,,33922.92,88,,percent of total billed charges,,,,,,,,,29451.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9637.19,22,,percent of total billed charges,,,35079.38,91,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,,,,,,,,,,,,,31995.48,83,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,31609.99,82,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,32766.45,85,,percent of total billed charges,,9637.19,36621.33,
CATH STRAIGHT FILIFORM TIP 6FR,30183100,CDM,,,270,RC,outpatient,,307.58,307.58,,261.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.9,22,,percent of total billed charges,,,,,,,,,276.82,90,,percent of total billed charges,,,254.68,82.8,,percent of total billed charges,,,261.44,85,,percent of total billed charges,,,,,,,,,270.67,88,,percent of total billed charges,,,,,,,,,234.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.9,22,,percent of total billed charges,,,279.9,91,,percent of total billed charges,,,292.2,95,,percent of total billed charges,,,255.29,83,,percent of total billed charges,,,255.29,83,,percent of total billed charges,,,,,,,,,,,,,,,255.29,83,,percent of total billed charges,,,292.2,95,,percent of total billed charges,,,276.82,90,,percent of total billed charges,,,276.82,90,,percent of total billed charges,,,252.22,82,,percent of total billed charges,,,276.82,90,,percent of total billed charges,,,261.44,85,,percent of total billed charges,,76.9,292.2,
CATH WOVEN PHILLIPS FOLLOWER 22FR,30183104,CDM,,,270,RC,outpatient,,752.78,752.78,,639.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,188.2,22,,percent of total billed charges,,,,,,,,,677.5,90,,percent of total billed charges,,,623.3,82.8,,percent of total billed charges,,,639.86,85,,percent of total billed charges,,,,,,,,,662.45,88,,percent of total billed charges,,,,,,,,,575.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,188.2,22,,percent of total billed charges,,,685.03,91,,percent of total billed charges,,,715.14,95,,percent of total billed charges,,,624.81,83,,percent of total billed charges,,,624.81,83,,percent of total billed charges,,,,,,,,,,,,,,,624.81,83,,percent of total billed charges,,,715.14,95,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,617.28,82,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,639.86,85,,percent of total billed charges,,188.2,715.14,
DEPUY POROUS FEMORAL SLEEVE SZ20,30183107,CDM,,,278,RC,outpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4515.54,22,,percent of total billed charges,,,,,,,,,16255.93,90,,percent of total billed charges,,,14955.45,82.8,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4515.54,22,,percent of total billed charges,,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,4515.54,17159.03,
DEPUY LINER ALTRX +4 NEUT 44 X 66,30183108,CDM,,,278,RC,outpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4400.13,22,,percent of total billed charges,,,,,,,,,15840.46,90,,percent of total billed charges,,,14573.22,82.8,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4400.13,22,,percent of total billed charges,,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,4400.13,16720.48,
DEPUY FEMORAL HEAD 44MM +15.5,30183109,CDM,,,278,RC,outpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3531.34,22,,percent of total billed charges,,,,,,,,,12712.82,90,,percent of total billed charges,,,11695.79,82.8,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3531.34,22,,percent of total billed charges,,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,3531.34,13419.08,
DEPUY BODY RECLAIM PROXIMAL 28 X 95,30183110,CDM,,,278,RC,outpatient,,38548.77,38548.77,,32727.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9637.19,22,,percent of total billed charges,,,,,,,,,34693.89,90,,percent of total billed charges,,,31918.38,82.8,,percent of total billed charges,,,32766.45,85,,percent of total billed charges,,,,,,,,,33922.92,88,,percent of total billed charges,,,,,,,,,29451.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9637.19,22,,percent of total billed charges,,,35079.38,91,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,,,,,,,,,,,,,31995.48,83,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,31609.99,82,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,32766.45,85,,percent of total billed charges,,9637.19,36621.33,
DEPUY STEM RECLAIM ANGLED 21 X 190,30183111,CDM,,,278,RC,outpatient,,31338.78,31338.78,,26606.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7834.7,22,,percent of total billed charges,,,,,,,,,28204.9,90,,percent of total billed charges,,,25948.51,82.8,,percent of total billed charges,,,26637.96,85,,percent of total billed charges,,,,,,,,,27578.13,88,,percent of total billed charges,,,,,,,,,23942.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7834.7,22,,percent of total billed charges,,,28518.29,91,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,,,,,,,,,,,,,26011.19,83,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,25697.8,82,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,26637.96,85,,percent of total billed charges,,7834.7,29771.84,
ARTHREX TIGHT ROPE SYNDE REPAIR,30183115,CDM,,,270,RC,outpatient,,5525,5525,,4690.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1381.25,22,,percent of total billed charges,,,,,,,,,4972.5,90,,percent of total billed charges,,,4574.7,82.8,,percent of total billed charges,,,4696.25,85,,percent of total billed charges,,,,,,,,,4862,88,,percent of total billed charges,,,,,,,,,4221.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1381.25,22,,percent of total billed charges,,,5027.75,91,,percent of total billed charges,,,5248.75,95,,percent of total billed charges,,,4585.75,83,,percent of total billed charges,,,4585.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4585.75,83,,percent of total billed charges,,,5248.75,95,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4530.5,82,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4696.25,85,,percent of total billed charges,,1381.25,5248.75,
ARTHREX PLATE 6-HOLE LOCKING DISTAL FIB,30183116,CDM,,,270,RC,outpatient,,4712.5,4712.5,,4000.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1178.13,22,,percent of total billed charges,,,,,,,,,4241.25,90,,percent of total billed charges,,,3901.95,82.8,,percent of total billed charges,,,4005.63,85,,percent of total billed charges,,,,,,,,,4147,88,,percent of total billed charges,,,,,,,,,3600.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1178.13,22,,percent of total billed charges,,,4288.38,91,,percent of total billed charges,,,4476.88,95,,percent of total billed charges,,,3911.38,83,,percent of total billed charges,,,3911.38,83,,percent of total billed charges,,,,,,,,,,,,,,,3911.38,83,,percent of total billed charges,,,4476.88,95,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,3864.25,82,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,4005.63,85,,percent of total billed charges,,1178.13,4476.88,
ARTHREX SCREW LOCKING 12MM X 2.7,30183117,CDM,,,278,RC,outpatient,,735,735,,624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,183.75,22,,percent of total billed charges,,,,,,,,,661.5,90,,percent of total billed charges,,,608.58,82.8,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,,,,,,,,646.8,88,,percent of total billed charges,,,,,,,,,561.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,183.75,22,,percent of total billed charges,,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,,,,,,,,,,,,,610.05,83,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,602.7,82,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,183.75,698.25,
ARTHREX SCREW LOCKING 14MM X 2.7,30183118,CDM,,,278,RC,outpatient,,735,735,,624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,183.75,22,,percent of total billed charges,,,,,,,,,661.5,90,,percent of total billed charges,,,608.58,82.8,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,,,,,,,,646.8,88,,percent of total billed charges,,,,,,,,,561.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,183.75,22,,percent of total billed charges,,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,,,,,,,,,,,,,610.05,83,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,602.7,82,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,183.75,698.25,
ARTHREX SCREW LOCKING 20MM X 2.7,30183119,CDM,,,278,RC,outpatient,,735,735,,624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,183.75,22,,percent of total billed charges,,,,,,,,,661.5,90,,percent of total billed charges,,,608.58,82.8,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,,,,,,,,646.8,88,,percent of total billed charges,,,,,,,,,561.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,183.75,22,,percent of total billed charges,,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,,,,,,,,,,,,,610.05,83,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,602.7,82,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,183.75,698.25,
ARTHREX SCREW LOCKING 12MM X 3.5,30183120,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW CORTICAL 12MM X 3.5,30183121,CDM,,,278,RC,outpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.63,22,,percent of total billed charges,,,,,,,,,236.25,90,,percent of total billed charges,,,217.35,82.8,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.63,22,,percent of total billed charges,,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,65.63,249.38,
ARTHREX SCREW CORTICAL 14MM X 3.5,30183122,CDM,,,278,RC,outpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.63,22,,percent of total billed charges,,,,,,,,,236.25,90,,percent of total billed charges,,,217.35,82.8,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.63,22,,percent of total billed charges,,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,65.63,249.38,
ARTHREX SCREW CORTICAL 16MM X 3.5,30183123,CDM,,,278,RC,outpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.63,22,,percent of total billed charges,,,,,,,,,236.25,90,,percent of total billed charges,,,217.35,82.8,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.63,22,,percent of total billed charges,,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,65.63,249.38,
ARTHREX SCREW CORTICAL 18MM X 3.5,30183124,CDM,,,278,RC,outpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.63,22,,percent of total billed charges,,,,,,,,,236.25,90,,percent of total billed charges,,,217.35,82.8,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.63,22,,percent of total billed charges,,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,65.63,249.38,
ARTHREX DRILL BIT CANNULATED 2.0MM,30183125,CDM,,,270,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
ARTHREX DRILL BIT CANNULATED 2.5MM,30183126,CDM,,,270,RC,outpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,148.75,22,,percent of total billed charges,,,,,,,,,535.5,90,,percent of total billed charges,,,492.66,82.8,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,148.75,22,,percent of total billed charges,,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,148.75,565.25,
ARTHREX DRILL BIT CANNULATED 2.6MM,30183127,CDM,,,270,RC,outpatient,,805,805,,683.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,201.25,22,,percent of total billed charges,,,,,,,,,724.5,90,,percent of total billed charges,,,666.54,82.8,,percent of total billed charges,,,684.25,85,,percent of total billed charges,,,,,,,,,708.4,88,,percent of total billed charges,,,,,,,,,615.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,201.25,22,,percent of total billed charges,,,732.55,91,,percent of total billed charges,,,764.75,95,,percent of total billed charges,,,668.15,83,,percent of total billed charges,,,668.15,83,,percent of total billed charges,,,,,,,,,,,,,,,668.15,83,,percent of total billed charges,,,764.75,95,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,660.1,82,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,684.25,85,,percent of total billed charges,,201.25,764.75,
ARTHREX DRILL BIT 2.5MM,30183128,CDM,,,270,RC,outpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,148.75,22,,percent of total billed charges,,,,,,,,,535.5,90,,percent of total billed charges,,,492.66,82.8,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,148.75,22,,percent of total billed charges,,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,148.75,565.25,
ARTHREX BB-TAK,30183129,CDM,,,278,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
ARTHREX GUIDEWIRE 130MM X 1.35,30183130,CDM,,,278,RC,outpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40,22,,percent of total billed charges,,,,,,,,,144,90,,percent of total billed charges,,,132.48,82.8,,percent of total billed charges,,,136,85,,percent of total billed charges,,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40,22,,percent of total billed charges,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,40,152,
PRODY DRAINAGE BULB HOLDER,30183133,CDM,,,270,RC,outpatient,,122.16,122.16,,103.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.54,22,,percent of total billed charges,,,,,,,,,109.94,90,,percent of total billed charges,,,101.15,82.8,,percent of total billed charges,,,103.84,85,,percent of total billed charges,,,,,,,,,107.5,88,,percent of total billed charges,,,,,,,,,93.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.54,22,,percent of total billed charges,,,111.17,91,,percent of total billed charges,,,116.05,95,,percent of total billed charges,,,101.39,83,,percent of total billed charges,,,101.39,83,,percent of total billed charges,,,,,,,,,,,,,,,101.39,83,,percent of total billed charges,,,116.05,95,,percent of total billed charges,,,109.94,90,,percent of total billed charges,,,109.94,90,,percent of total billed charges,,,100.17,82,,percent of total billed charges,,,109.94,90,,percent of total billed charges,,,103.84,85,,percent of total billed charges,,30.54,116.05,
NEUROMONITORING DEFINITIVE,30183137,CDM,,,270,RC,outpatient,,5200,5200,,4414.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1300,22,,percent of total billed charges,,,,,,,,,4680,90,,percent of total billed charges,,,4305.6,82.8,,percent of total billed charges,,,4420,85,,percent of total billed charges,,,,,,,,,4576,88,,percent of total billed charges,,,,,,,,,3972.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1300,22,,percent of total billed charges,,,4732,91,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,,,,,,,,,,,,,4316,83,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4264,82,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4420,85,,percent of total billed charges,,1300,4940,
DEPUY STEM GLOBAL ADVANTAGE PC 8MM,30183148,CDM,,,278,RC,outpatient,,36482.49,36482.49,,30973.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9120.62,22,,percent of total billed charges,,,,,,,,,32834.24,90,,percent of total billed charges,,,30207.5,82.8,,percent of total billed charges,,,31010.12,85,,percent of total billed charges,,,,,,,,,32104.59,88,,percent of total billed charges,,,,,,,,,27872.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9120.62,22,,percent of total billed charges,,,33199.07,91,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,30280.47,83,,percent of total billed charges,,,,,,,,,,,,,,,30280.47,83,,percent of total billed charges,,,34658.37,95,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,29915.64,82,,percent of total billed charges,,,32834.24,90,,percent of total billed charges,,,31010.12,85,,percent of total billed charges,,9120.62,34658.37,
HEAD HALTERS/CERVICAL TRACTION STANDARD,30183149,CDM,,,270,RC,outpatient,,116.56,116.56,,98.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.14,22,,percent of total billed charges,,,,,,,,,104.9,90,,percent of total billed charges,,,96.51,82.8,,percent of total billed charges,,,99.08,85,,percent of total billed charges,,,,,,,,,102.57,88,,percent of total billed charges,,,,,,,,,89.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.14,22,,percent of total billed charges,,,106.07,91,,percent of total billed charges,,,110.73,95,,percent of total billed charges,,,96.74,83,,percent of total billed charges,,,96.74,83,,percent of total billed charges,,,,,,,,,,,,,,,96.74,83,,percent of total billed charges,,,110.73,95,,percent of total billed charges,,,104.9,90,,percent of total billed charges,,,104.9,90,,percent of total billed charges,,,95.58,82,,percent of total billed charges,,,104.9,90,,percent of total billed charges,,,99.08,85,,percent of total billed charges,,29.14,110.73,
BIOMET HUMERAL NAIL 8MM X 260MM,30183151,CDM,,,278,RC,outpatient,,12857,12857,,10915.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3214.25,22,,percent of total billed charges,,,,,,,,,11571.3,90,,percent of total billed charges,,,10645.6,82.8,,percent of total billed charges,,,10928.45,85,,percent of total billed charges,,,,,,,,,11314.16,88,,percent of total billed charges,,,,,,,,,9822.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3214.25,22,,percent of total billed charges,,,11699.87,91,,percent of total billed charges,,,12214.15,95,,percent of total billed charges,,,10671.31,83,,percent of total billed charges,,,10671.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10671.31,83,,percent of total billed charges,,,12214.15,95,,percent of total billed charges,,,11571.3,90,,percent of total billed charges,,,11571.3,90,,percent of total billed charges,,,10542.74,82,,percent of total billed charges,,,11571.3,90,,percent of total billed charges,,,10928.45,85,,percent of total billed charges,,3214.25,12214.15,
BIOMET HUMERAL NAIL 8MM X 280MM,30183154,CDM,,,278,RC,outpatient,,16380,16380,,13906.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4095,22,,percent of total billed charges,,,,,,,,,14742,90,,percent of total billed charges,,,13562.64,82.8,,percent of total billed charges,,,13923,85,,percent of total billed charges,,,,,,,,,14414.4,88,,percent of total billed charges,,,,,,,,,12514.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4095,22,,percent of total billed charges,,,14905.8,91,,percent of total billed charges,,,15561,95,,percent of total billed charges,,,13595.4,83,,percent of total billed charges,,,13595.4,83,,percent of total billed charges,,,,,,,,,,,,,,,13595.4,83,,percent of total billed charges,,,15561,95,,percent of total billed charges,,,14742,90,,percent of total billed charges,,,14742,90,,percent of total billed charges,,,13431.6,82,,percent of total billed charges,,,14742,90,,percent of total billed charges,,,13923,85,,percent of total billed charges,,4095,15561,
CELL SAVER SERVICE - CANCELLATION FEES,30183155,CDM,,,270,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
ARTHREX PLATE 6-HOLE LOCKING DISTAL-R,30183158,CDM,,,270,RC,outpatient,,4225,4225,,3587.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1056.25,22,,percent of total billed charges,,,,,,,,,3802.5,90,,percent of total billed charges,,,3498.3,82.8,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,,,,,,,,3718,88,,percent of total billed charges,,,,,,,,,3227.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1056.25,22,,percent of total billed charges,,,3844.75,91,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,,,,,,,,,,,,,3506.75,83,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3464.5,82,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,1056.25,4013.75,
ARTHREX SCREW LOCKING 16MM X 2.7,30183159,CDM,,,278,RC,outpatient,,735,735,,624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,183.75,22,,percent of total billed charges,,,,,,,,,661.5,90,,percent of total billed charges,,,608.58,82.8,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,,,,,,,,646.8,88,,percent of total billed charges,,,,,,,,,561.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,183.75,22,,percent of total billed charges,,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,,,,,,,,,,,,,610.05,83,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,602.7,82,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,183.75,698.25,
ARTHREX SCREW LOCKING 14MM X 3.5,30183160,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW LOCKING 20MM X 3.5,30183161,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
STRYKER SCREW LAG 10.5 X 90MM,30183167,CDM,,,278,RC,outpatient,,5200.33,5200.33,,4415.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1300.08,22,,percent of total billed charges,,,,,,,,,4680.3,90,,percent of total billed charges,,,4305.87,82.8,,percent of total billed charges,,,4420.28,85,,percent of total billed charges,,,,,,,,,4576.29,88,,percent of total billed charges,,,,,,,,,3973.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1300.08,22,,percent of total billed charges,,,4732.3,91,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,,,,,,,,,,,,,4316.27,83,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4264.27,82,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4420.28,85,,percent of total billed charges,,1300.08,4940.31,
AMVISC PLUS 0.8ML,30183170,CDM,,,270,RC,outpatient,,385,385,,326.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.25,22,,percent of total billed charges,,,,,,,,,346.5,90,,percent of total billed charges,,,318.78,82.8,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,,,,,,,,338.8,88,,percent of total billed charges,,,,,,,,,294.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.25,22,,percent of total billed charges,,,350.35,91,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,,,,,,,,,,,,,319.55,83,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,315.7,82,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,96.25,365.75,
RTI PATELLAR TENDON  10MM BTB PRESHAPE,30183180,CDM,,,278,RC,outpatient,,23400,23400,,19866.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5850,22,,percent of total billed charges,,,,,,,,,21060,90,,percent of total billed charges,,,19375.2,82.8,,percent of total billed charges,,,19890,85,,percent of total billed charges,,,,,,,,,20592,88,,percent of total billed charges,,,,,,,,,17877.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5850,22,,percent of total billed charges,,,21294,91,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,,,,,,,,,,,,,19422,83,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19188,82,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19890,85,,percent of total billed charges,,5850,22230,
DEPUY STEM CORAIL SZ12,30183181,CDM,,,278,RC,outpatient,,33799.35,33799.35,,28695.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8449.84,22,,percent of total billed charges,,,,,,,,,30419.42,90,,percent of total billed charges,,,27985.86,82.8,,percent of total billed charges,,,28729.45,85,,percent of total billed charges,,,,,,,,,29743.43,88,,percent of total billed charges,,,,,,,,,25822.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8449.84,22,,percent of total billed charges,,,30757.41,91,,percent of total billed charges,,,32109.38,95,,percent of total billed charges,,,28053.46,83,,percent of total billed charges,,,28053.46,83,,percent of total billed charges,,,,,,,,,,,,,,,28053.46,83,,percent of total billed charges,,,32109.38,95,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,27715.47,82,,percent of total billed charges,,,30419.42,90,,percent of total billed charges,,,28729.45,85,,percent of total billed charges,,8449.84,32109.38,
GYRUS THUNDERBEAT 5M 20CM INLINE GRIP,30183182,CDM,,,270,RC,outpatient,,5954,5954,,5054.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1488.5,22,,percent of total billed charges,,,,,,,,,5358.6,90,,percent of total billed charges,,,4929.91,82.8,,percent of total billed charges,,,5060.9,85,,percent of total billed charges,,,,,,,,,5239.52,88,,percent of total billed charges,,,,,,,,,4548.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1488.5,22,,percent of total billed charges,,,5418.14,91,,percent of total billed charges,,,5656.3,95,,percent of total billed charges,,,4941.82,83,,percent of total billed charges,,,4941.82,83,,percent of total billed charges,,,,,,,,,,,,,,,4941.82,83,,percent of total billed charges,,,5656.3,95,,percent of total billed charges,,,5358.6,90,,percent of total billed charges,,,5358.6,90,,percent of total billed charges,,,4882.28,82,,percent of total billed charges,,,5358.6,90,,percent of total billed charges,,,5060.9,85,,percent of total billed charges,,1488.5,5656.3,
GYRUS THUNDERBEAT 5M 10CM INLINE GRIP,30183183,CDM,,,270,RC,outpatient,,6251.7,6251.7,,5307.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1562.93,22,,percent of total billed charges,,,,,,,,,5626.53,90,,percent of total billed charges,,,5176.41,82.8,,percent of total billed charges,,,5313.95,85,,percent of total billed charges,,,,,,,,,5501.5,88,,percent of total billed charges,,,,,,,,,4776.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1562.93,22,,percent of total billed charges,,,5689.05,91,,percent of total billed charges,,,5939.12,95,,percent of total billed charges,,,5188.91,83,,percent of total billed charges,,,5188.91,83,,percent of total billed charges,,,,,,,,,,,,,,,5188.91,83,,percent of total billed charges,,,5939.12,95,,percent of total billed charges,,,5626.53,90,,percent of total billed charges,,,5626.53,90,,percent of total billed charges,,,5126.39,82,,percent of total billed charges,,,5626.53,90,,percent of total billed charges,,,5313.95,85,,percent of total billed charges,,1562.93,5939.12,
DEPUY BIPOLAR HEAD 40 X28CM,30183185,CDM,,,278,RC,outpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.27,22,,percent of total billed charges,,,,,,,,,7312.56,90,,percent of total billed charges,,,6727.56,82.8,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.27,22,,percent of total billed charges,,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,2031.27,7718.82,
AQUAMANTYS MINI EVS,30183187,CDM,,,270,RC,outpatient,,4143.75,4143.75,,3518.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1035.94,22,,percent of total billed charges,,,,,,,,,3729.38,90,,percent of total billed charges,,,3431.03,82.8,,percent of total billed charges,,,3522.19,85,,percent of total billed charges,,,,,,,,,3646.5,88,,percent of total billed charges,,,,,,,,,3165.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1035.94,22,,percent of total billed charges,,,3770.81,91,,percent of total billed charges,,,3936.56,95,,percent of total billed charges,,,3439.31,83,,percent of total billed charges,,,3439.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3439.31,83,,percent of total billed charges,,,3936.56,95,,percent of total billed charges,,,3729.38,90,,percent of total billed charges,,,3729.38,90,,percent of total billed charges,,,3397.88,82,,percent of total billed charges,,,3729.38,90,,percent of total billed charges,,,3522.19,85,,percent of total billed charges,,1035.94,3936.56,
DEPUY EPAK PINNING SYSTEM,30183203,CDM,,,278,RC,outpatient,,3542.5,3542.5,,3007.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,885.63,22,,percent of total billed charges,,,,,,,,,3188.25,90,,percent of total billed charges,,,2933.19,82.8,,percent of total billed charges,,,3011.13,85,,percent of total billed charges,,,,,,,,,3117.4,88,,percent of total billed charges,,,,,,,,,2706.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,885.63,22,,percent of total billed charges,,,3223.68,91,,percent of total billed charges,,,3365.38,95,,percent of total billed charges,,,2940.28,83,,percent of total billed charges,,,2940.28,83,,percent of total billed charges,,,,,,,,,,,,,,,2940.28,83,,percent of total billed charges,,,3365.38,95,,percent of total billed charges,,,3188.25,90,,percent of total billed charges,,,3188.25,90,,percent of total billed charges,,,2904.85,82,,percent of total billed charges,,,3188.25,90,,percent of total billed charges,,,3011.13,85,,percent of total billed charges,,885.63,3365.38,
DEPUY PATELLA ATTUNE DOME 41MM,30183204,CDM,,,278,RC,outpatient,,6897.67,6897.67,,5856.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1724.42,22,,percent of total billed charges,,,,,,,,,6207.9,90,,percent of total billed charges,,,5711.27,82.8,,percent of total billed charges,,,5863.02,85,,percent of total billed charges,,,,,,,,,6069.95,88,,percent of total billed charges,,,,,,,,,5269.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1724.42,22,,percent of total billed charges,,,6276.88,91,,percent of total billed charges,,,6552.79,95,,percent of total billed charges,,,5725.07,83,,percent of total billed charges,,,5725.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5725.07,83,,percent of total billed charges,,,6552.79,95,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,5656.09,82,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,5863.02,85,,percent of total billed charges,,1724.42,6552.79,
DEPUY FEMUR ATTUNE PS SZ 6 L,30183205,CDM,,,278,RC,outpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7070.46,22,,percent of total billed charges,,,,,,,,,25453.65,90,,percent of total billed charges,,,23417.36,82.8,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7070.46,22,,percent of total billed charges,,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,7070.46,26867.74,
DEPUY INSERT AOX PS FB SZ 6 7MM,30183206,CDM,,,278,RC,outpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3119.32,22,,percent of total billed charges,,,,,,,,,11229.54,90,,percent of total billed charges,,,10331.18,82.8,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3119.32,22,,percent of total billed charges,,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,3119.32,11853.41,
DEPUY ATTUNE FB W/DOME PATELLA,30183208,CDM,,,278,RC,outpatient,,37440,37440,,31786.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9360,22,,percent of total billed charges,,,,,,,,,33696,90,,percent of total billed charges,,,31000.32,82.8,,percent of total billed charges,,,31824,85,,percent of total billed charges,,,,,,,,,32947.2,88,,percent of total billed charges,,,,,,,,,28604.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9360,22,,percent of total billed charges,,,34070.4,91,,percent of total billed charges,,,35568,95,,percent of total billed charges,,,31075.2,83,,percent of total billed charges,,,31075.2,83,,percent of total billed charges,,,,,,,,,,,,,,,31075.2,83,,percent of total billed charges,,,35568,95,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,30700.8,82,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,31824,85,,percent of total billed charges,,9360,35568,
DEPUY-MITEK DRILL BIT 2.4MM,30183209,CDM,,,270,RC,outpatient,,1079,1079,,916.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,269.75,22,,percent of total billed charges,,,,,,,,,971.1,90,,percent of total billed charges,,,893.41,82.8,,percent of total billed charges,,,917.15,85,,percent of total billed charges,,,,,,,,,949.52,88,,percent of total billed charges,,,,,,,,,824.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,269.75,22,,percent of total billed charges,,,981.89,91,,percent of total billed charges,,,1025.05,95,,percent of total billed charges,,,895.57,83,,percent of total billed charges,,,895.57,83,,percent of total billed charges,,,,,,,,,,,,,,,895.57,83,,percent of total billed charges,,,1025.05,95,,percent of total billed charges,,,971.1,90,,percent of total billed charges,,,971.1,90,,percent of total billed charges,,,884.78,82,,percent of total billed charges,,,971.1,90,,percent of total billed charges,,,917.15,85,,percent of total billed charges,,269.75,1025.05,
DEPUY SCREW BONE 6.5 X 25,30183225,CDM,,,278,RC,outpatient,,1244.95,1244.95,,1056.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,311.24,22,,percent of total billed charges,,,,,,,,,1120.46,90,,percent of total billed charges,,,1030.82,82.8,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,,,,,,,,1095.56,88,,percent of total billed charges,,,,,,,,,951.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,311.24,22,,percent of total billed charges,,,1132.9,91,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.31,83,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1020.86,82,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,311.24,1182.7,
DEPUY SCREW BONE 6.5 X 20,30183226,CDM,,,278,RC,outpatient,,1244.95,1244.95,,1056.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,311.24,22,,percent of total billed charges,,,,,,,,,1120.46,90,,percent of total billed charges,,,1030.82,82.8,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,,,,,,,,1095.56,88,,percent of total billed charges,,,,,,,,,951.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,311.24,22,,percent of total billed charges,,,1132.9,91,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,1033.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.31,83,,percent of total billed charges,,,1182.7,95,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1020.86,82,,percent of total billed charges,,,1120.46,90,,percent of total billed charges,,,1058.21,85,,percent of total billed charges,,311.24,1182.7,
DEPUY HIP CERAMIC ON CERAMIC,30183227,CDM,,,278,RC,outpatient,,41464.28,41464.28,,35203.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10366.07,22,,percent of total billed charges,,,,,,,,,37317.85,90,,percent of total billed charges,,,34332.42,82.8,,percent of total billed charges,,,35244.64,85,,percent of total billed charges,,,,,,,,,36488.57,88,,percent of total billed charges,,,,,,,,,31678.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10366.07,22,,percent of total billed charges,,,37732.49,91,,percent of total billed charges,,,39391.07,95,,percent of total billed charges,,,34415.35,83,,percent of total billed charges,,,34415.35,83,,percent of total billed charges,,,,,,,,,,,,,,,34415.35,83,,percent of total billed charges,,,39391.07,95,,percent of total billed charges,,,37317.85,90,,percent of total billed charges,,,37317.85,90,,percent of total billed charges,,,34000.71,82,,percent of total billed charges,,,37317.85,90,,percent of total billed charges,,,35244.64,85,,percent of total billed charges,,10366.07,39391.07,
SYNTHES NORIAN INJECTABLE DRILLABLE 5CC,30183228,CDM,,,270,RC,outpatient,,12895.35,12895.35,,10948.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3223.84,22,,percent of total billed charges,,,,,,,,,11605.82,90,,percent of total billed charges,,,10677.35,82.8,,percent of total billed charges,,,10961.05,85,,percent of total billed charges,,,,,,,,,11347.91,88,,percent of total billed charges,,,,,,,,,9852.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3223.84,22,,percent of total billed charges,,,11734.77,91,,percent of total billed charges,,,12250.58,95,,percent of total billed charges,,,10703.14,83,,percent of total billed charges,,,10703.14,83,,percent of total billed charges,,,,,,,,,,,,,,,10703.14,83,,percent of total billed charges,,,12250.58,95,,percent of total billed charges,,,11605.82,90,,percent of total billed charges,,,11605.82,90,,percent of total billed charges,,,10574.19,82,,percent of total billed charges,,,11605.82,90,,percent of total billed charges,,,10961.05,85,,percent of total billed charges,,3223.84,12250.58,
XPS GREENLIGHT LASER SERVICE FEE,30183233,CDM,,,270,RC,outpatient,,5200,5200,,4414.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1300,22,,percent of total billed charges,,,,,,,,,4680,90,,percent of total billed charges,,,4305.6,82.8,,percent of total billed charges,,,4420,85,,percent of total billed charges,,,,,,,,,4576,88,,percent of total billed charges,,,,,,,,,3972.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1300,22,,percent of total billed charges,,,4732,91,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,,,,,,,,,,,,,4316,83,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4264,82,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4420,85,,percent of total billed charges,,1300,4940,
XPS MOXY FIBER,30183234,CDM,,,270,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
MESH VENTRALIGHT STD 6X8,30183235,CDM,,,278,RC,outpatient,,5460,5460,,4635.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1365,22,,percent of total billed charges,,,,,,,,,4914,90,,percent of total billed charges,,,4520.88,82.8,,percent of total billed charges,,,4641,85,,percent of total billed charges,,,,,,,,,4804.8,88,,percent of total billed charges,,,,,,,,,4171.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1365,22,,percent of total billed charges,,,4968.6,91,,percent of total billed charges,,,5187,95,,percent of total billed charges,,,4531.8,83,,percent of total billed charges,,,4531.8,83,,percent of total billed charges,,,,,,,,,,,,,,,4531.8,83,,percent of total billed charges,,,5187,95,,percent of total billed charges,,,4914,90,,percent of total billed charges,,,4914,90,,percent of total billed charges,,,4477.2,82,,percent of total billed charges,,,4914,90,,percent of total billed charges,,,4641,85,,percent of total billed charges,,1365,5187,
BODY REST MOD PROX CONE 25X0MM STD,30183238,CDM,,,278,RC,outpatient,,21391.5,21391.5,,18161.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5347.88,22,,percent of total billed charges,,,,,,,,,19252.35,90,,percent of total billed charges,,,17712.16,82.8,,percent of total billed charges,,,18182.78,85,,percent of total billed charges,,,,,,,,,18824.52,88,,percent of total billed charges,,,,,,,,,16343.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5347.88,22,,percent of total billed charges,,,19466.27,91,,percent of total billed charges,,,20321.93,95,,percent of total billed charges,,,17754.95,83,,percent of total billed charges,,,17754.95,83,,percent of total billed charges,,,,,,,,,,,,,,,17754.95,83,,percent of total billed charges,,,20321.93,95,,percent of total billed charges,,,19252.35,90,,percent of total billed charges,,,19252.35,90,,percent of total billed charges,,,17541.03,82,,percent of total billed charges,,,19252.35,90,,percent of total billed charges,,,18182.78,85,,percent of total billed charges,,5347.88,20321.93,
HEAD V40 COCR LFIT 28MM +4,30183240,CDM,,,278,RC,outpatient,,4647.5,4647.5,,3945.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1161.88,22,,percent of total billed charges,,,,,,,,,4182.75,90,,percent of total billed charges,,,3848.13,82.8,,percent of total billed charges,,,3950.38,85,,percent of total billed charges,,,,,,,,,4089.8,88,,percent of total billed charges,,,,,,,,,3550.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1161.88,22,,percent of total billed charges,,,4229.23,91,,percent of total billed charges,,,4415.13,95,,percent of total billed charges,,,3857.43,83,,percent of total billed charges,,,3857.43,83,,percent of total billed charges,,,,,,,,,,,,,,,3857.43,83,,percent of total billed charges,,,4415.13,95,,percent of total billed charges,,,4182.75,90,,percent of total billed charges,,,4182.75,90,,percent of total billed charges,,,3810.95,82,,percent of total billed charges,,,4182.75,90,,percent of total billed charges,,,3950.38,85,,percent of total billed charges,,1161.88,4415.13,
BODY REST MOD PROX CONE 25MM +10,30183243,CDM,,,278,RC,outpatient,,35594.65,35594.65,,30219.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8898.66,22,,percent of total billed charges,,,,,,,,,32035.19,90,,percent of total billed charges,,,29472.37,82.8,,percent of total billed charges,,,30255.45,85,,percent of total billed charges,,,,,,,,,31323.29,88,,percent of total billed charges,,,,,,,,,27194.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8898.66,22,,percent of total billed charges,,,32391.13,91,,percent of total billed charges,,,33814.92,95,,percent of total billed charges,,,29543.56,83,,percent of total billed charges,,,29543.56,83,,percent of total billed charges,,,,,,,,,,,,,,,29543.56,83,,percent of total billed charges,,,33814.92,95,,percent of total billed charges,,,32035.19,90,,percent of total billed charges,,,32035.19,90,,percent of total billed charges,,,29187.61,82,,percent of total billed charges,,,32035.19,90,,percent of total billed charges,,,30255.45,85,,percent of total billed charges,,8898.66,33814.92,
DEPUY DISTAL AUGMENT 4MM SZ4.0 LEFT,30183244,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
DEPUY BUILD UP TRAY 15MM SZ 4,30183245,CDM,,,278,RC,outpatient,,51595.57,51595.57,,43804.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12898.89,22,,percent of total billed charges,,,,,,,,,46436.01,90,,percent of total billed charges,,,42721.13,82.8,,percent of total billed charges,,,43856.23,85,,percent of total billed charges,,,,,,,,,45404.1,88,,percent of total billed charges,,,,,,,,,39419.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12898.89,22,,percent of total billed charges,,,46951.97,91,,percent of total billed charges,,,49015.79,95,,percent of total billed charges,,,42824.32,83,,percent of total billed charges,,,42824.32,83,,percent of total billed charges,,,,,,,,,,,,,,,42824.32,83,,percent of total billed charges,,,49015.79,95,,percent of total billed charges,,,46436.01,90,,percent of total billed charges,,,46436.01,90,,percent of total billed charges,,,42308.37,82,,percent of total billed charges,,,46436.01,90,,percent of total billed charges,,,43856.23,85,,percent of total billed charges,,12898.89,49015.79,
NEUROMONITORING EMG 1 EXT W/OR W/O PARA,30183246,CDM,,,270,RC,outpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,568.75,22,,percent of total billed charges,,,,,,,,,2047.5,90,,percent of total billed charges,,,1883.7,82.8,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,568.75,22,,percent of total billed charges,,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,568.75,2161.25,
NEUROMONITORING TCMEP UPPER & LOWER,30183247,CDM,,,270,RC,outpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,568.75,22,,percent of total billed charges,,,,,,,,,2047.5,90,,percent of total billed charges,,,1883.7,82.8,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,568.75,22,,percent of total billed charges,,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,568.75,2161.25,
STRYKER RADIOFREQUENCY GENERATOR,30183256,CDM,,,270,RC,outpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2437.5,22,,percent of total billed charges,,,,,,,,,8775,90,,percent of total billed charges,,,8073,82.8,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2437.5,22,,percent of total billed charges,,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,2437.5,9262.5,
STRYKER STERILIZATION BOX W/ELECTRODES,30183257,CDM,,,270,RC,outpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1218.75,22,,percent of total billed charges,,,,,,,,,4387.5,90,,percent of total billed charges,,,4036.5,82.8,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1218.75,22,,percent of total billed charges,,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,1218.75,4631.25,
STRYKER ACTIVE TIP 100MM 18G 10MM,30183258,CDM,,,270,RC,outpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2437.5,22,,percent of total billed charges,,,,,,,,,8775,90,,percent of total billed charges,,,8073,82.8,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2437.5,22,,percent of total billed charges,,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,2437.5,9262.5,
NEEDLE TUOHY EPIDURAL 18G X 3.5,30183261,CDM,,,270,RC,outpatient,,25.61,25.61,,21.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.4,22,,percent of total billed charges,,,,,,,,,23.05,90,,percent of total billed charges,,,21.21,82.8,,percent of total billed charges,,,21.77,85,,percent of total billed charges,,,,,,,,,22.54,88,,percent of total billed charges,,,,,,,,,19.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.4,22,,percent of total billed charges,,,23.31,91,,percent of total billed charges,,,24.33,95,,percent of total billed charges,,,21.26,83,,percent of total billed charges,,,21.26,83,,percent of total billed charges,,,,,,,,,,,,,,,21.26,83,,percent of total billed charges,,,24.33,95,,percent of total billed charges,,,23.05,90,,percent of total billed charges,,,23.05,90,,percent of total billed charges,,,21,82,,percent of total billed charges,,,23.05,90,,percent of total billed charges,,,21.77,85,,percent of total billed charges,,6.4,24.33,
KYPHON XPANDER INFLATION SYRINGE,30183263,CDM,,,270,RC,outpatient,,929.5,929.5,,789.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,232.38,22,,percent of total billed charges,,,,,,,,,836.55,90,,percent of total billed charges,,,769.63,82.8,,percent of total billed charges,,,790.08,85,,percent of total billed charges,,,,,,,,,817.96,88,,percent of total billed charges,,,,,,,,,710.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,232.38,22,,percent of total billed charges,,,845.85,91,,percent of total billed charges,,,883.03,95,,percent of total billed charges,,,771.49,83,,percent of total billed charges,,,771.49,83,,percent of total billed charges,,,,,,,,,,,,,,,771.49,83,,percent of total billed charges,,,883.03,95,,percent of total billed charges,,,836.55,90,,percent of total billed charges,,,836.55,90,,percent of total billed charges,,,762.19,82,,percent of total billed charges,,,836.55,90,,percent of total billed charges,,,790.08,85,,percent of total billed charges,,232.38,883.03,
NEEDLE TUOHY EPIDURAL 22G X 3.5,30183264,CDM,,,270,RC,outpatient,,84.24,84.24,,71.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.06,22,,percent of total billed charges,,,,,,,,,75.82,90,,percent of total billed charges,,,69.75,82.8,,percent of total billed charges,,,71.6,85,,percent of total billed charges,,,,,,,,,74.13,88,,percent of total billed charges,,,,,,,,,64.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.06,22,,percent of total billed charges,,,76.66,91,,percent of total billed charges,,,80.03,95,,percent of total billed charges,,,69.92,83,,percent of total billed charges,,,69.92,83,,percent of total billed charges,,,,,,,,,,,,,,,69.92,83,,percent of total billed charges,,,80.03,95,,percent of total billed charges,,,75.82,90,,percent of total billed charges,,,75.82,90,,percent of total billed charges,,,69.08,82,,percent of total billed charges,,,75.82,90,,percent of total billed charges,,,71.6,85,,percent of total billed charges,,21.06,80.03,
NEEDLE SPINAL CHIBA 22G X 6IN,30183265,CDM,,,270,RC,outpatient,,46.92,46.92,,39.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.73,22,,percent of total billed charges,,,,,,,,,42.23,90,,percent of total billed charges,,,38.85,82.8,,percent of total billed charges,,,39.88,85,,percent of total billed charges,,,,,,,,,41.29,88,,percent of total billed charges,,,,,,,,,35.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.73,22,,percent of total billed charges,,,42.7,91,,percent of total billed charges,,,44.57,95,,percent of total billed charges,,,38.94,83,,percent of total billed charges,,,38.94,83,,percent of total billed charges,,,,,,,,,,,,,,,38.94,83,,percent of total billed charges,,,44.57,95,,percent of total billed charges,,,42.23,90,,percent of total billed charges,,,42.23,90,,percent of total billed charges,,,38.47,82,,percent of total billed charges,,,42.23,90,,percent of total billed charges,,,39.88,85,,percent of total billed charges,,11.73,44.57,
DEPUY SLEEVE DISTAL POROUS 31MM,30183266,CDM,,,278,RC,outpatient,,12552.61,12552.61,,10657.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3138.15,22,,percent of total billed charges,,,,,,,,,11297.35,90,,percent of total billed charges,,,10393.56,82.8,,percent of total billed charges,,,10669.72,85,,percent of total billed charges,,,,,,,,,11046.3,88,,percent of total billed charges,,,,,,,,,9590.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3138.15,22,,percent of total billed charges,,,11422.88,91,,percent of total billed charges,,,11924.98,95,,percent of total billed charges,,,10418.67,83,,percent of total billed charges,,,10418.67,83,,percent of total billed charges,,,,,,,,,,,,,,,10418.67,83,,percent of total billed charges,,,11924.98,95,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,10293.14,82,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,10669.72,85,,percent of total billed charges,,3138.15,11924.98,
DEPUY ATTUNE FEMUR PS SZ 6 RT,30183267,CDM,,,278,RC,outpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7070.46,22,,percent of total billed charges,,,,,,,,,25453.65,90,,percent of total billed charges,,,23417.36,82.8,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7070.46,22,,percent of total billed charges,,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,7070.46,26867.74,
DEPUY PATELLA MEDIALIZED DOME 38MM,30183268,CDM,,,278,RC,outpatient,,6238.64,6238.64,,5296.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1559.66,22,,percent of total billed charges,,,,,,,,,5614.78,90,,percent of total billed charges,,,5165.59,82.8,,percent of total billed charges,,,5302.84,85,,percent of total billed charges,,,,,,,,,5490,88,,percent of total billed charges,,,,,,,,,4766.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1559.66,22,,percent of total billed charges,,,5677.16,91,,percent of total billed charges,,,5926.71,95,,percent of total billed charges,,,5178.07,83,,percent of total billed charges,,,5178.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5178.07,83,,percent of total billed charges,,,5926.71,95,,percent of total billed charges,,,5614.78,90,,percent of total billed charges,,,5614.78,90,,percent of total billed charges,,,5115.68,82,,percent of total billed charges,,,5614.78,90,,percent of total billed charges,,,5302.84,85,,percent of total billed charges,,1559.66,5926.71,
DEPUY TRAY TIBIAL SZ 5,30183269,CDM,,,278,RC,outpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4782.85,22,,percent of total billed charges,,,,,,,,,17218.25,90,,percent of total billed charges,,,15840.79,82.8,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4782.85,22,,percent of total billed charges,,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,4782.85,18174.82,
PAD COVER ALLEN BOW FRAME,30183276,CDM,,,270,RC,outpatient,,560,560,,475.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,140,22,,percent of total billed charges,,,,,,,,,504,90,,percent of total billed charges,,,463.68,82.8,,percent of total billed charges,,,476,85,,percent of total billed charges,,,,,,,,,492.8,88,,percent of total billed charges,,,,,,,,,427.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,140,22,,percent of total billed charges,,,509.6,91,,percent of total billed charges,,,532,95,,percent of total billed charges,,,464.8,83,,percent of total billed charges,,,464.8,83,,percent of total billed charges,,,,,,,,,,,,,,,464.8,83,,percent of total billed charges,,,532,95,,percent of total billed charges,,,504,90,,percent of total billed charges,,,504,90,,percent of total billed charges,,,459.2,82,,percent of total billed charges,,,504,90,,percent of total billed charges,,,476,85,,percent of total billed charges,,140,532,
CELL SAVER ANTICOAGULATION/ASPIRATION AS,30183280,CDM,,,270,RC,outpatient,,136,136,,115.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34,22,,percent of total billed charges,,,,,,,,,122.4,90,,percent of total billed charges,,,112.61,82.8,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,,,,,,,,119.68,88,,percent of total billed charges,,,,,,,,,103.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34,22,,percent of total billed charges,,,123.76,91,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,,,,,,,,,,,,,112.88,83,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,111.52,82,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,34,129.2,
SYNTHES SCREW LOCKING VA 2.7MM X 20MM,30183284,CDM,,,278,RC,outpatient,,1371.5,1371.5,,1164.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,342.88,22,,percent of total billed charges,,,,,,,,,1234.35,90,,percent of total billed charges,,,1135.6,82.8,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,,,,,,,,1206.92,88,,percent of total billed charges,,,,,,,,,1047.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,342.88,22,,percent of total billed charges,,,1248.07,91,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.35,83,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1124.63,82,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,342.88,1302.93,
CELL SAVER CARDIOTOMY RESERVOIR,30183286,CDM,,,270,RC,outpatient,,455,455,,386.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,113.75,22,,percent of total billed charges,,,,,,,,,409.5,90,,percent of total billed charges,,,376.74,82.8,,percent of total billed charges,,,386.75,85,,percent of total billed charges,,,,,,,,,400.4,88,,percent of total billed charges,,,,,,,,,347.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,113.75,22,,percent of total billed charges,,,414.05,91,,percent of total billed charges,,,432.25,95,,percent of total billed charges,,,377.65,83,,percent of total billed charges,,,377.65,83,,percent of total billed charges,,,,,,,,,,,,,,,377.65,83,,percent of total billed charges,,,432.25,95,,percent of total billed charges,,,409.5,90,,percent of total billed charges,,,409.5,90,,percent of total billed charges,,,373.1,82,,percent of total billed charges,,,409.5,90,,percent of total billed charges,,,386.75,85,,percent of total billed charges,,113.75,432.25,
ARTHREX SCREW LOCKING 18MM X 2.7,30183290,CDM,,,278,RC,outpatient,,735,735,,624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,183.75,22,,percent of total billed charges,,,,,,,,,661.5,90,,percent of total billed charges,,,608.58,82.8,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,,,,,,,,646.8,88,,percent of total billed charges,,,,,,,,,561.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,183.75,22,,percent of total billed charges,,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,,,,,,,,,,,,,610.05,83,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,602.7,82,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,183.75,698.25,
ARTHREX SCREW CORTICAL 30MM X 3.5,30183291,CDM,,,278,RC,outpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.63,22,,percent of total billed charges,,,,,,,,,236.25,90,,percent of total billed charges,,,217.35,82.8,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.63,22,,percent of total billed charges,,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,65.63,249.38,
ARTHREX PLATE 5-HOLE LOCKING DISTAL FIB,30183292,CDM,,,270,RC,outpatient,,4225,4225,,3587.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1056.25,22,,percent of total billed charges,,,,,,,,,3802.5,90,,percent of total billed charges,,,3498.3,82.8,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,,,,,,,,3718,88,,percent of total billed charges,,,,,,,,,3227.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1056.25,22,,percent of total billed charges,,,3844.75,91,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,,,,,,,,,,,,,3506.75,83,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3464.5,82,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,1056.25,4013.75,
DEPUY FEMUR ATTUNE PS SZ 5 LFT,30183297,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY INSERT AOX PS 7MM SZ 5,30183298,CDM,,,278,RC,outpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3119.32,22,,percent of total billed charges,,,,,,,,,11229.54,90,,percent of total billed charges,,,10331.18,82.8,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3119.32,22,,percent of total billed charges,,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,3119.32,11853.41,
DEPUY HUMERAL CUP 42MM +3,30183299,CDM,,,278,RC,outpatient,,10688.08,10688.08,,9074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2672.02,22,,percent of total billed charges,,,,,,,,,9619.27,90,,percent of total billed charges,,,8849.73,82.8,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,,,,,,,,9405.51,88,,percent of total billed charges,,,,,,,,,8165.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2672.02,22,,percent of total billed charges,,,9726.15,91,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,,,,,,,,,,,,,8871.11,83,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,8764.23,82,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,2672.02,10153.68,
DEPUY HUMERAL STEM 14 DIA MODULAR,30183300,CDM,,,278,RC,outpatient,,17244.96,17244.96,,14640.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4311.24,22,,percent of total billed charges,,,,,,,,,15520.46,90,,percent of total billed charges,,,14278.83,82.8,,percent of total billed charges,,,14658.22,85,,percent of total billed charges,,,,,,,,,15175.56,88,,percent of total billed charges,,,,,,,,,13175.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4311.24,22,,percent of total billed charges,,,15692.91,91,,percent of total billed charges,,,16382.71,95,,percent of total billed charges,,,14313.32,83,,percent of total billed charges,,,14313.32,83,,percent of total billed charges,,,,,,,,,,,,,,,14313.32,83,,percent of total billed charges,,,16382.71,95,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,14140.87,82,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,14658.22,85,,percent of total billed charges,,4311.24,16382.71,
DEPUY EPIPHYSIS MODULAR SZ 1,30183301,CDM,,,278,RC,outpatient,,33055.36,33055.36,,28064,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8263.84,22,,percent of total billed charges,,,,,,,,,29749.82,90,,percent of total billed charges,,,27369.84,82.8,,percent of total billed charges,,,28097.06,85,,percent of total billed charges,,,,,,,,,29088.72,88,,percent of total billed charges,,,,,,,,,25254.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8263.84,22,,percent of total billed charges,,,30080.38,91,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,,,,,,,,,,,,,27435.95,83,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,27105.4,82,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,28097.06,85,,percent of total billed charges,,8263.84,31402.59,
STOPCOCK EXTENSION SET 12,30183302,CDM,,,270,RC,outpatient,,8.64,8.64,,7.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.16,22,,percent of total billed charges,,,,,,,,,7.78,90,,percent of total billed charges,,,7.15,82.8,,percent of total billed charges,,,7.34,85,,percent of total billed charges,,,,,,,,,7.6,88,,percent of total billed charges,,,,,,,,,6.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.16,22,,percent of total billed charges,,,7.86,91,,percent of total billed charges,,,8.21,95,,percent of total billed charges,,,7.17,83,,percent of total billed charges,,,7.17,83,,percent of total billed charges,,,,,,,,,,,,,,,7.17,83,,percent of total billed charges,,,8.21,95,,percent of total billed charges,,,7.78,90,,percent of total billed charges,,,7.78,90,,percent of total billed charges,,,7.08,82,,percent of total billed charges,,,7.78,90,,percent of total billed charges,,,7.34,85,,percent of total billed charges,,2.16,8.21,
S&N SUTURE PASSER 70 DEG UPWARD,30183303,CDM,,,270,RC,outpatient,,892.78,892.78,,757.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,223.2,22,,percent of total billed charges,,,,,,,,,803.5,90,,percent of total billed charges,,,739.22,82.8,,percent of total billed charges,,,758.86,85,,percent of total billed charges,,,,,,,,,785.65,88,,percent of total billed charges,,,,,,,,,682.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,223.2,22,,percent of total billed charges,,,812.43,91,,percent of total billed charges,,,848.14,95,,percent of total billed charges,,,741.01,83,,percent of total billed charges,,,741.01,83,,percent of total billed charges,,,,,,,,,,,,,,,741.01,83,,percent of total billed charges,,,848.14,95,,percent of total billed charges,,,803.5,90,,percent of total billed charges,,,803.5,90,,percent of total billed charges,,,732.08,82,,percent of total billed charges,,,803.5,90,,percent of total billed charges,,,758.86,85,,percent of total billed charges,,223.2,848.14,
DEPUY ATTUNE FEMUR PS SZ 4 LEFT,30183316,CDM,,,278,RC,outpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7070.46,22,,percent of total billed charges,,,,,,,,,25453.65,90,,percent of total billed charges,,,23417.36,82.8,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7070.46,22,,percent of total billed charges,,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,7070.46,26867.74,
DEPUY ATTUNE FEMUR RIGHT SZ 4,30183317,CDM,,,278,RC,outpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7070.46,22,,percent of total billed charges,,,,,,,,,25453.65,90,,percent of total billed charges,,,23417.36,82.8,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7070.46,22,,percent of total billed charges,,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,7070.46,26867.74,
DEPUY ATTUNE PATELLA DOME SZ 32,30183320,CDM,,,278,RC,outpatient,,6897.67,6897.67,,5856.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1724.42,22,,percent of total billed charges,,,,,,,,,6207.9,90,,percent of total billed charges,,,5711.27,82.8,,percent of total billed charges,,,5863.02,85,,percent of total billed charges,,,,,,,,,6069.95,88,,percent of total billed charges,,,,,,,,,5269.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1724.42,22,,percent of total billed charges,,,6276.88,91,,percent of total billed charges,,,6552.79,95,,percent of total billed charges,,,5725.07,83,,percent of total billed charges,,,5725.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5725.07,83,,percent of total billed charges,,,6552.79,95,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,5656.09,82,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,5863.02,85,,percent of total billed charges,,1724.42,6552.79,
DEPUY ATTUNE INSERT TIBIAL SZ 5 6MM,30183321,CDM,,,278,RC,outpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3119.32,22,,percent of total billed charges,,,,,,,,,11229.54,90,,percent of total billed charges,,,10331.18,82.8,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3119.32,22,,percent of total billed charges,,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,3119.32,11853.41,
DEPUY ATTUNE PATELLA 35MM,30183322,CDM,,,278,RC,outpatient,,6238.64,6238.64,,5296.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1559.66,22,,percent of total billed charges,,,,,,,,,5614.78,90,,percent of total billed charges,,,5165.59,82.8,,percent of total billed charges,,,5302.84,85,,percent of total billed charges,,,,,,,,,5490,88,,percent of total billed charges,,,,,,,,,4766.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1559.66,22,,percent of total billed charges,,,5677.16,91,,percent of total billed charges,,,5926.71,95,,percent of total billed charges,,,5178.07,83,,percent of total billed charges,,,5178.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5178.07,83,,percent of total billed charges,,,5926.71,95,,percent of total billed charges,,,5614.78,90,,percent of total billed charges,,,5614.78,90,,percent of total billed charges,,,5115.68,82,,percent of total billed charges,,,5614.78,90,,percent of total billed charges,,,5302.84,85,,percent of total billed charges,,1559.66,5926.71,
DEPUY HIP BALL MOD 43MM,30183323,CDM,,,278,RC,outpatient,,4693.78,4693.78,,3985.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1173.45,22,,percent of total billed charges,,,,,,,,,4224.4,90,,percent of total billed charges,,,3886.45,82.8,,percent of total billed charges,,,3989.71,85,,percent of total billed charges,,,,,,,,,4130.53,88,,percent of total billed charges,,,,,,,,,3586.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1173.45,22,,percent of total billed charges,,,4271.34,91,,percent of total billed charges,,,4459.09,95,,percent of total billed charges,,,3895.84,83,,percent of total billed charges,,,3895.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3895.84,83,,percent of total billed charges,,,4459.09,95,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,3848.9,82,,percent of total billed charges,,,4224.4,90,,percent of total billed charges,,,3989.71,85,,percent of total billed charges,,1173.45,4459.09,
SURGICAL PATTIES 1/2 X 1,30183325,CDM,,,270,RC,outpatient,,23.74,23.74,,20.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.94,22,,percent of total billed charges,,,,,,,,,21.37,90,,percent of total billed charges,,,19.66,82.8,,percent of total billed charges,,,20.18,85,,percent of total billed charges,,,,,,,,,20.89,88,,percent of total billed charges,,,,,,,,,18.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.94,22,,percent of total billed charges,,,21.6,91,,percent of total billed charges,,,22.55,95,,percent of total billed charges,,,19.7,83,,percent of total billed charges,,,19.7,83,,percent of total billed charges,,,,,,,,,,,,,,,19.7,83,,percent of total billed charges,,,22.55,95,,percent of total billed charges,,,21.37,90,,percent of total billed charges,,,21.37,90,,percent of total billed charges,,,19.47,82,,percent of total billed charges,,,21.37,90,,percent of total billed charges,,,20.18,85,,percent of total billed charges,,5.94,22.55,
DEPUY FEMUR SZ 7 L PS,30183326,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY INSERT AOX SZ 7 6MM,30183327,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY INSERT AOX PS SZ 5 5MM,30183329,CDM,,,278,RC,outpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3119.32,22,,percent of total billed charges,,,,,,,,,11229.54,90,,percent of total billed charges,,,10331.18,82.8,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3119.32,22,,percent of total billed charges,,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,3119.32,11853.41,
SYNTHES SCREW LOCKING 3.5X22MM,30183332,CDM,,,278,RC,outpatient,,1182.35,1182.35,,1003.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,295.59,22,,percent of total billed charges,,,,,,,,,1064.12,90,,percent of total billed charges,,,978.99,82.8,,percent of total billed charges,,,1005,85,,percent of total billed charges,,,,,,,,,1040.47,88,,percent of total billed charges,,,,,,,,,903.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,295.59,22,,percent of total billed charges,,,1075.94,91,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,,,,,,,,,,,,,981.35,83,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,969.53,82,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1005,85,,percent of total billed charges,,295.59,1123.23,
SYNTHES DRILL BIT 2.8MM,30183336,CDM,,,270,RC,outpatient,,1764.3,1764.3,,1497.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,441.08,22,,percent of total billed charges,,,,,,,,,1587.87,90,,percent of total billed charges,,,1460.84,82.8,,percent of total billed charges,,,1499.66,85,,percent of total billed charges,,,,,,,,,1552.58,88,,percent of total billed charges,,,,,,,,,1347.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,441.08,22,,percent of total billed charges,,,1605.51,91,,percent of total billed charges,,,1676.09,95,,percent of total billed charges,,,1464.37,83,,percent of total billed charges,,,1464.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1464.37,83,,percent of total billed charges,,,1676.09,95,,percent of total billed charges,,,1587.87,90,,percent of total billed charges,,,1587.87,90,,percent of total billed charges,,,1446.73,82,,percent of total billed charges,,,1587.87,90,,percent of total billed charges,,,1499.66,85,,percent of total billed charges,,441.08,1676.09,
SYNTHES SCREW LOCKING 3.5 X 75MM,30183339,CDM,,,278,RC,outpatient,,1182.35,1182.35,,1003.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,295.59,22,,percent of total billed charges,,,,,,,,,1064.12,90,,percent of total billed charges,,,978.99,82.8,,percent of total billed charges,,,1005,85,,percent of total billed charges,,,,,,,,,1040.47,88,,percent of total billed charges,,,,,,,,,903.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,295.59,22,,percent of total billed charges,,,1075.94,91,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,,,,,,,,,,,,,981.35,83,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,969.53,82,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1005,85,,percent of total billed charges,,295.59,1123.23,
SYNTHES SCREW LOCKING 3.5 X 80MM,30183340,CDM,,,278,RC,outpatient,,1182.35,1182.35,,1003.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,295.59,22,,percent of total billed charges,,,,,,,,,1064.12,90,,percent of total billed charges,,,978.99,82.8,,percent of total billed charges,,,1005,85,,percent of total billed charges,,,,,,,,,1040.47,88,,percent of total billed charges,,,,,,,,,903.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,295.59,22,,percent of total billed charges,,,1075.94,91,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,,,,,,,,,,,,,981.35,83,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,969.53,82,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1005,85,,percent of total billed charges,,295.59,1123.23,
ESWL SERVICES UNILATERAL,30183345,CDM,,,270,RC,outpatient,,11375,11375,,9657.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2843.75,22,,percent of total billed charges,,,,,,,,,10237.5,90,,percent of total billed charges,,,9418.5,82.8,,percent of total billed charges,,,9668.75,85,,percent of total billed charges,,,,,,,,,10010,88,,percent of total billed charges,,,,,,,,,8690.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2843.75,22,,percent of total billed charges,,,10351.25,91,,percent of total billed charges,,,10806.25,95,,percent of total billed charges,,,9441.25,83,,percent of total billed charges,,,9441.25,83,,percent of total billed charges,,,,,,,,,,,,,,,9441.25,83,,percent of total billed charges,,,10806.25,95,,percent of total billed charges,,,10237.5,90,,percent of total billed charges,,,10237.5,90,,percent of total billed charges,,,9327.5,82,,percent of total billed charges,,,10237.5,90,,percent of total billed charges,,,9668.75,85,,percent of total billed charges,,2843.75,10806.25,
SYNTHES PLATE LCP 3.5MM RIGHT ANGLE,30183346,CDM,,,278,RC,outpatient,,2945.15,2945.15,,2500.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,736.29,22,,percent of total billed charges,,,,,,,,,2650.64,90,,percent of total billed charges,,,2438.58,82.8,,percent of total billed charges,,,2503.38,85,,percent of total billed charges,,,,,,,,,2591.73,88,,percent of total billed charges,,,,,,,,,2250.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,736.29,22,,percent of total billed charges,,,2680.09,91,,percent of total billed charges,,,2797.89,95,,percent of total billed charges,,,2444.47,83,,percent of total billed charges,,,2444.47,83,,percent of total billed charges,,,,,,,,,,,,,,,2444.47,83,,percent of total billed charges,,,2797.89,95,,percent of total billed charges,,,2650.64,90,,percent of total billed charges,,,2650.64,90,,percent of total billed charges,,,2415.02,82,,percent of total billed charges,,,2650.64,90,,percent of total billed charges,,,2503.38,85,,percent of total billed charges,,736.29,2797.89,
SYNTHES SCREW CANCEL 28MM,30183351,CDM,,,278,RC,outpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.78,22,,percent of total billed charges,,,,,,,,,200.82,90,,percent of total billed charges,,,184.75,82.8,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.78,22,,percent of total billed charges,,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,55.78,211.97,
MYOSURE CLASSIC,30183353,CDM,,,270,RC,outpatient,,9737,9737,,8266.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2434.25,22,,percent of total billed charges,,,,,,,,,8763.3,90,,percent of total billed charges,,,8062.24,82.8,,percent of total billed charges,,,8276.45,85,,percent of total billed charges,,,,,,,,,8568.56,88,,percent of total billed charges,,,,,,,,,7439.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2434.25,22,,percent of total billed charges,,,8860.67,91,,percent of total billed charges,,,9250.15,95,,percent of total billed charges,,,8081.71,83,,percent of total billed charges,,,8081.71,83,,percent of total billed charges,,,,,,,,,,,,,,,8081.71,83,,percent of total billed charges,,,9250.15,95,,percent of total billed charges,,,8763.3,90,,percent of total billed charges,,,8763.3,90,,percent of total billed charges,,,7984.34,82,,percent of total billed charges,,,8763.3,90,,percent of total billed charges,,,8276.45,85,,percent of total billed charges,,2434.25,9250.15,
MYOSURE SCOPE SEALS,30183354,CDM,,,270,RC,outpatient,,80.75,80.75,,68.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.19,22,,percent of total billed charges,,,,,,,,,72.68,90,,percent of total billed charges,,,66.86,82.8,,percent of total billed charges,,,68.64,85,,percent of total billed charges,,,,,,,,,71.06,88,,percent of total billed charges,,,,,,,,,61.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.19,22,,percent of total billed charges,,,73.48,91,,percent of total billed charges,,,76.71,95,,percent of total billed charges,,,67.02,83,,percent of total billed charges,,,67.02,83,,percent of total billed charges,,,,,,,,,,,,,,,67.02,83,,percent of total billed charges,,,76.71,95,,percent of total billed charges,,,72.68,90,,percent of total billed charges,,,72.68,90,,percent of total billed charges,,,66.22,82,,percent of total billed charges,,,72.68,90,,percent of total billed charges,,,68.64,85,,percent of total billed charges,,20.19,76.71,
DEPUY WEDGE STEP 10MM SZ3,30183366,CDM,,,278,RC,outpatient,,15761.79,15761.79,,13381.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3940.45,22,,percent of total billed charges,,,,,,,,,14185.61,90,,percent of total billed charges,,,13050.76,82.8,,percent of total billed charges,,,13397.52,85,,percent of total billed charges,,,,,,,,,13870.38,88,,percent of total billed charges,,,,,,,,,12042.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3940.45,22,,percent of total billed charges,,,14343.23,91,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,,,,,,,,,,,,,13082.29,83,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,12924.67,82,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,13397.52,85,,percent of total billed charges,,3940.45,14973.7,
DEPUY INSERT PS SZ 4 6MM,30183367,CDM,,,278,RC,outpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3119.32,22,,percent of total billed charges,,,,,,,,,11229.54,90,,percent of total billed charges,,,10331.18,82.8,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3119.32,22,,percent of total billed charges,,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,3119.32,11853.41,
DEPUY ATTUNE INSERT AOX SZ 6 8MM,30183368,CDM,,,278,RC,outpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3119.32,22,,percent of total billed charges,,,,,,,,,11229.54,90,,percent of total billed charges,,,10331.18,82.8,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3119.32,22,,percent of total billed charges,,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,3119.32,11853.41,
DEPUY ATTUNE FEMUR PS SZ 5 RT,30183369,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY ATTUNE INSERT AOX PS SZ 5 8MM,30183370,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
COVERS ALLEN COMFORT,30183372,CDM,,,270,RC,outpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,105,22,,percent of total billed charges,,,,,,,,,378,90,,percent of total billed charges,,,347.76,82.8,,percent of total billed charges,,,357,85,,percent of total billed charges,,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,105,22,,percent of total billed charges,,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,105,399,
STRYKER BLADE RECIP DBL SIDED OFFSET,30183381,CDM,,,270,RC,outpatient,,343.88,343.88,,291.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.97,22,,percent of total billed charges,,,,,,,,,309.49,90,,percent of total billed charges,,,284.73,82.8,,percent of total billed charges,,,292.3,85,,percent of total billed charges,,,,,,,,,302.61,88,,percent of total billed charges,,,,,,,,,262.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.97,22,,percent of total billed charges,,,312.93,91,,percent of total billed charges,,,326.69,95,,percent of total billed charges,,,285.42,83,,percent of total billed charges,,,285.42,83,,percent of total billed charges,,,,,,,,,,,,,,,285.42,83,,percent of total billed charges,,,326.69,95,,percent of total billed charges,,,309.49,90,,percent of total billed charges,,,309.49,90,,percent of total billed charges,,,281.98,82,,percent of total billed charges,,,309.49,90,,percent of total billed charges,,,292.3,85,,percent of total billed charges,,85.97,326.69,
S&N ENDO TAPERED AWL 3.8MM,30183382,CDM,,,278,RC,outpatient,,360,360,,305.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90,22,,percent of total billed charges,,,,,,,,,324,90,,percent of total billed charges,,,298.08,82.8,,percent of total billed charges,,,306,85,,percent of total billed charges,,,,,,,,,316.8,88,,percent of total billed charges,,,,,,,,,275.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90,22,,percent of total billed charges,,,327.6,91,,percent of total billed charges,,,342,95,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,,,,,,,,,,,,,298.8,83,,percent of total billed charges,,,342,95,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,295.2,82,,percent of total billed charges,,,324,90,,percent of total billed charges,,,306,85,,percent of total billed charges,,90,342,
ALEXIS WOUND PROTECOTR/RETRACTOR,30183389,CDM,,,270,RC,outpatient,,306.6,306.6,,260.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.65,22,,percent of total billed charges,,,,,,,,,275.94,90,,percent of total billed charges,,,253.86,82.8,,percent of total billed charges,,,260.61,85,,percent of total billed charges,,,,,,,,,269.81,88,,percent of total billed charges,,,,,,,,,234.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.65,22,,percent of total billed charges,,,279.01,91,,percent of total billed charges,,,291.27,95,,percent of total billed charges,,,254.48,83,,percent of total billed charges,,,254.48,83,,percent of total billed charges,,,,,,,,,,,,,,,254.48,83,,percent of total billed charges,,,291.27,95,,percent of total billed charges,,,275.94,90,,percent of total billed charges,,,275.94,90,,percent of total billed charges,,,251.41,82,,percent of total billed charges,,,275.94,90,,percent of total billed charges,,,260.61,85,,percent of total billed charges,,76.65,291.27,
CORTICAL STRUTS 2 X 11CM - 24CM,30183392,CDM,,,278,RC,outpatient,,2580.5,2580.5,,2190.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,645.13,22,,percent of total billed charges,,,,,,,,,2322.45,90,,percent of total billed charges,,,2136.65,82.8,,percent of total billed charges,,,2193.43,85,,percent of total billed charges,,,,,,,,,2270.84,88,,percent of total billed charges,,,,,,,,,1971.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,645.13,22,,percent of total billed charges,,,2348.26,91,,percent of total billed charges,,,2451.48,95,,percent of total billed charges,,,2141.82,83,,percent of total billed charges,,,2141.82,83,,percent of total billed charges,,,,,,,,,,,,,,,2141.82,83,,percent of total billed charges,,,2451.48,95,,percent of total billed charges,,,2322.45,90,,percent of total billed charges,,,2322.45,90,,percent of total billed charges,,,2116.01,82,,percent of total billed charges,,,2322.45,90,,percent of total billed charges,,,2193.43,85,,percent of total billed charges,,645.13,2451.48,
GLIDEWIRE UROLOGIC STRAIGHT 150CM,30183401,CDM,,,270,RC,outpatient,,389.27,389.27,,330.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.32,22,,percent of total billed charges,,,,,,,,,350.34,90,,percent of total billed charges,,,322.32,82.8,,percent of total billed charges,,,330.88,85,,percent of total billed charges,,,,,,,,,342.56,88,,percent of total billed charges,,,,,,,,,297.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.32,22,,percent of total billed charges,,,354.24,91,,percent of total billed charges,,,369.81,95,,percent of total billed charges,,,323.09,83,,percent of total billed charges,,,323.09,83,,percent of total billed charges,,,,,,,,,,,,,,,323.09,83,,percent of total billed charges,,,369.81,95,,percent of total billed charges,,,350.34,90,,percent of total billed charges,,,350.34,90,,percent of total billed charges,,,319.2,82,,percent of total billed charges,,,350.34,90,,percent of total billed charges,,,330.88,85,,percent of total billed charges,,97.32,369.81,
CYSTO TABLE DRAIN BAG,30183403,CDM,,,270,RC,outpatient,,143.56,143.56,,121.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.89,22,,percent of total billed charges,,,,,,,,,129.2,90,,percent of total billed charges,,,118.87,82.8,,percent of total billed charges,,,122.03,85,,percent of total billed charges,,,,,,,,,126.33,88,,percent of total billed charges,,,,,,,,,109.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.89,22,,percent of total billed charges,,,130.64,91,,percent of total billed charges,,,136.38,95,,percent of total billed charges,,,119.15,83,,percent of total billed charges,,,119.15,83,,percent of total billed charges,,,,,,,,,,,,,,,119.15,83,,percent of total billed charges,,,136.38,95,,percent of total billed charges,,,129.2,90,,percent of total billed charges,,,129.2,90,,percent of total billed charges,,,117.72,82,,percent of total billed charges,,,129.2,90,,percent of total billed charges,,,122.03,85,,percent of total billed charges,,35.89,136.38,
NAIL FEMORAL KNEE FUSION 11.5 X 70MM,30183405,CDM,,,278,RC,outpatient,,30225,30225,,25661.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7556.25,22,,percent of total billed charges,,,,,,,,,27202.5,90,,percent of total billed charges,,,25026.3,82.8,,percent of total billed charges,,,25691.25,85,,percent of total billed charges,,,,,,,,,26598,88,,percent of total billed charges,,,,,,,,,23091.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7556.25,22,,percent of total billed charges,,,27504.75,91,,percent of total billed charges,,,28713.75,95,,percent of total billed charges,,,25086.75,83,,percent of total billed charges,,,25086.75,83,,percent of total billed charges,,,,,,,,,,,,,,,25086.75,83,,percent of total billed charges,,,28713.75,95,,percent of total billed charges,,,27202.5,90,,percent of total billed charges,,,27202.5,90,,percent of total billed charges,,,24784.5,82,,percent of total billed charges,,,27202.5,90,,percent of total billed charges,,,25691.25,85,,percent of total billed charges,,7556.25,28713.75,
DEPUY GRIPTION CUP REVISION 66MM,30183407,CDM,,,278,RC,outpatient,,33437.04,33437.04,,28388.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8359.26,22,,percent of total billed charges,,,,,,,,,30093.34,90,,percent of total billed charges,,,27685.87,82.8,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,,,,,,,,29424.6,88,,percent of total billed charges,,,,,,,,,25545.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8359.26,22,,percent of total billed charges,,,30427.71,91,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,,,,,,,,,,,,,27752.74,83,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,27418.37,82,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,8359.26,31765.19,
DEPUY LINER PINN CONSTRAINED 60MM,30183408,CDM,,,278,RC,outpatient,,36635.17,36635.17,,31103.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9158.79,22,,percent of total billed charges,,,,,,,,,32971.65,90,,percent of total billed charges,,,30333.92,82.8,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,,,,,,,,32238.95,88,,percent of total billed charges,,,,,,,,,27989.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9158.79,22,,percent of total billed charges,,,33338,91,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,,,,,,,,,,,,,30407.19,83,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,30040.84,82,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,9158.79,34803.41,
MENTOR MEMORYGEL BREAST IMPLANT SMOOTH,30183409,CDM,,,278,RC,outpatient,,6370,6370,,5408.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1592.5,22,,percent of total billed charges,,,,,,,,,5733,90,,percent of total billed charges,,,5274.36,82.8,,percent of total billed charges,,,5414.5,85,,percent of total billed charges,,,,,,,,,5605.6,88,,percent of total billed charges,,,,,,,,,4866.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1592.5,22,,percent of total billed charges,,,5796.7,91,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5287.1,83,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5223.4,82,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5414.5,85,,percent of total billed charges,,1592.5,6051.5,
MENTOR BREAST SIZER ROUND HIGH PROFILE,30183410,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
DEPUY FEMUR ATTUNE PS R SZ 7,30183411,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY INSERT AOX SZ 7 5MM,30183412,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
CYSTOGRAPHIN 300ML BTL,30183413,CDM,,,270,RC,outpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27,22,,percent of total billed charges,,,,,,,,,97.2,90,,percent of total billed charges,,,89.42,82.8,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27,22,,percent of total billed charges,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,27,102.6,
DEPUY CERAMIC HEAD 32MM +9 TS,30183415,CDM,,,278,RC,outpatient,,14631.05,14631.05,,12421.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3657.76,22,,percent of total billed charges,,,,,,,,,13167.95,90,,percent of total billed charges,,,12114.51,82.8,,percent of total billed charges,,,12436.39,85,,percent of total billed charges,,,,,,,,,12875.32,88,,percent of total billed charges,,,,,,,,,11178.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3657.76,22,,percent of total billed charges,,,13314.26,91,,percent of total billed charges,,,13899.5,95,,percent of total billed charges,,,12143.77,83,,percent of total billed charges,,,12143.77,83,,percent of total billed charges,,,,,,,,,,,,,,,12143.77,83,,percent of total billed charges,,,13899.5,95,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,11997.46,82,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,12436.39,85,,percent of total billed charges,,3657.76,13899.5,
ROTATABLE SNARE SMALL COLD,30183422,CDM,,,270,RC,outpatient,,115.2,115.2,,97.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.8,22,,percent of total billed charges,,,,,,,,,103.68,90,,percent of total billed charges,,,95.39,82.8,,percent of total billed charges,,,97.92,85,,percent of total billed charges,,,,,,,,,101.38,88,,percent of total billed charges,,,,,,,,,88.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.8,22,,percent of total billed charges,,,104.83,91,,percent of total billed charges,,,109.44,95,,percent of total billed charges,,,95.62,83,,percent of total billed charges,,,95.62,83,,percent of total billed charges,,,,,,,,,,,,,,,95.62,83,,percent of total billed charges,,,109.44,95,,percent of total billed charges,,,103.68,90,,percent of total billed charges,,,103.68,90,,percent of total billed charges,,,94.46,82,,percent of total billed charges,,,103.68,90,,percent of total billed charges,,,97.92,85,,percent of total billed charges,,28.8,109.44,
DRAIN PENROSE SILICONE LF 5/8X18,30183428,CDM,,,270,RC,outpatient,,31.86,31.86,,27.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.97,22,,percent of total billed charges,,,,,,,,,28.67,90,,percent of total billed charges,,,26.38,82.8,,percent of total billed charges,,,27.08,85,,percent of total billed charges,,,,,,,,,28.04,88,,percent of total billed charges,,,,,,,,,24.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.97,22,,percent of total billed charges,,,28.99,91,,percent of total billed charges,,,30.27,95,,percent of total billed charges,,,26.44,83,,percent of total billed charges,,,26.44,83,,percent of total billed charges,,,,,,,,,,,,,,,26.44,83,,percent of total billed charges,,,30.27,95,,percent of total billed charges,,,28.67,90,,percent of total billed charges,,,28.67,90,,percent of total billed charges,,,26.13,82,,percent of total billed charges,,,28.67,90,,percent of total billed charges,,,27.08,85,,percent of total billed charges,,7.97,30.27,
XPS LASER SERVICE FEE,30183429,CDM,,,270,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
ARTHREX SCREW TENODESIS 5.5 X 10MM,30183430,CDM,,,278,RC,outpatient,,2652,2652,,2251.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,663,22,,percent of total billed charges,,,,,,,,,2386.8,90,,percent of total billed charges,,,2195.86,82.8,,percent of total billed charges,,,2254.2,85,,percent of total billed charges,,,,,,,,,2333.76,88,,percent of total billed charges,,,,,,,,,2026.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,663,22,,percent of total billed charges,,,2413.32,91,,percent of total billed charges,,,2519.4,95,,percent of total billed charges,,,2201.16,83,,percent of total billed charges,,,2201.16,83,,percent of total billed charges,,,,,,,,,,,,,,,2201.16,83,,percent of total billed charges,,,2519.4,95,,percent of total billed charges,,,2386.8,90,,percent of total billed charges,,,2386.8,90,,percent of total billed charges,,,2174.64,82,,percent of total billed charges,,,2386.8,90,,percent of total billed charges,,,2254.2,85,,percent of total billed charges,,663,2519.4,
DEPUY INSERT AOX PS FB SZ 6 5MM,30183432,CDM,,,278,RC,outpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3119.32,22,,percent of total billed charges,,,,,,,,,11229.54,90,,percent of total billed charges,,,10331.18,82.8,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3119.32,22,,percent of total billed charges,,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,3119.32,11853.41,
DEPUY INSERT AOX PS FB SZ 6 10MM,30183433,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY PIN HEADED,30183436,CDM,,,278,RC,outpatient,,5141.5,5141.5,,4365.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1285.38,22,,percent of total billed charges,,,,,,,,,4627.35,90,,percent of total billed charges,,,4257.16,82.8,,percent of total billed charges,,,4370.28,85,,percent of total billed charges,,,,,,,,,4524.52,88,,percent of total billed charges,,,,,,,,,3928.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1285.38,22,,percent of total billed charges,,,4678.77,91,,percent of total billed charges,,,4884.43,95,,percent of total billed charges,,,4267.45,83,,percent of total billed charges,,,4267.45,83,,percent of total billed charges,,,,,,,,,,,,,,,4267.45,83,,percent of total billed charges,,,4884.43,95,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4216.03,82,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4370.28,85,,percent of total billed charges,,1285.38,4884.43,
DEPUY PIN THREADED,30183437,CDM,,,278,RC,outpatient,,5141.5,5141.5,,4365.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1285.38,22,,percent of total billed charges,,,,,,,,,4627.35,90,,percent of total billed charges,,,4257.16,82.8,,percent of total billed charges,,,4370.28,85,,percent of total billed charges,,,,,,,,,4524.52,88,,percent of total billed charges,,,,,,,,,3928.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1285.38,22,,percent of total billed charges,,,4678.77,91,,percent of total billed charges,,,4884.43,95,,percent of total billed charges,,,4267.45,83,,percent of total billed charges,,,4267.45,83,,percent of total billed charges,,,,,,,,,,,,,,,4267.45,83,,percent of total billed charges,,,4884.43,95,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4216.03,82,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4370.28,85,,percent of total billed charges,,1285.38,4884.43,
ZIMMER BLADE EXPLANT 60MM X 10,30183439,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
DEPUY INSERT AOT SZ 6 6MM,30183441,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
SUTURE ETHICON 0-VICRYL,30183442,CDM,,,270,RC,outpatient,,235.15,235.15,,199.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,58.79,22,,percent of total billed charges,,,,,,,,,211.64,90,,percent of total billed charges,,,194.7,82.8,,percent of total billed charges,,,199.88,85,,percent of total billed charges,,,,,,,,,206.93,88,,percent of total billed charges,,,,,,,,,179.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,58.79,22,,percent of total billed charges,,,213.99,91,,percent of total billed charges,,,223.39,95,,percent of total billed charges,,,195.17,83,,percent of total billed charges,,,195.17,83,,percent of total billed charges,,,,,,,,,,,,,,,195.17,83,,percent of total billed charges,,,223.39,95,,percent of total billed charges,,,211.64,90,,percent of total billed charges,,,211.64,90,,percent of total billed charges,,,192.82,82,,percent of total billed charges,,,211.64,90,,percent of total billed charges,,,199.88,85,,percent of total billed charges,,58.79,223.39,
NEUROMONITORING EMG 2 EXT,30183443,CDM,,,270,RC,outpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,568.75,22,,percent of total billed charges,,,,,,,,,2047.5,90,,percent of total billed charges,,,1883.7,82.8,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,568.75,22,,percent of total billed charges,,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,568.75,2161.25,
MEDTRONIC ACCESSORY KIT,30183454,CDM,,,270,RC,outpatient,,337.5,337.5,,286.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.38,22,,percent of total billed charges,,,,,,,,,303.75,90,,percent of total billed charges,,,279.45,82.8,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,,,,,,,,297,88,,percent of total billed charges,,,,,,,,,257.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.38,22,,percent of total billed charges,,,307.13,91,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,,,,,,,,,,,,,280.13,83,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,276.75,82,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,84.38,320.63,
MEDTRONIC COMPACT 1X8 TRIAL LEAD KIT,30183455,CDM,,,270,RC,outpatient,,7280,7280,,6180.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1820,22,,percent of total billed charges,,,,,,,,,6552,90,,percent of total billed charges,,,6027.84,82.8,,percent of total billed charges,,,6188,85,,percent of total billed charges,,,,,,,,,6406.4,88,,percent of total billed charges,,,,,,,,,5561.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1820,22,,percent of total billed charges,,,6624.8,91,,percent of total billed charges,,,6916,95,,percent of total billed charges,,,6042.4,83,,percent of total billed charges,,,6042.4,83,,percent of total billed charges,,,,,,,,,,,,,,,6042.4,83,,percent of total billed charges,,,6916,95,,percent of total billed charges,,,6552,90,,percent of total billed charges,,,6552,90,,percent of total billed charges,,,5969.6,82,,percent of total billed charges,,,6552,90,,percent of total billed charges,,,6188,85,,percent of total billed charges,,1820,6916,
MEDTRONIC LEAD KIT2,30183456,CDM,,,270,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
APPLIED ORTHOPAEDIC PROTECTOR SMALL/MEDI,30183457,CDM,,,270,RC,outpatient,,942.5,942.5,,800.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.63,22,,percent of total billed charges,,,,,,,,,848.25,90,,percent of total billed charges,,,780.39,82.8,,percent of total billed charges,,,801.13,85,,percent of total billed charges,,,,,,,,,829.4,88,,percent of total billed charges,,,,,,,,,720.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.63,22,,percent of total billed charges,,,857.68,91,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,,,,,,,,,,,,,782.28,83,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,772.85,82,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,801.13,85,,percent of total billed charges,,235.63,895.38,
DEPUY FEMUR RT SZ 8,30183459,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY INSERT 5MM SZ 8,30183461,CDM,,,278,RC,outpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3119.32,22,,percent of total billed charges,,,,,,,,,11229.54,90,,percent of total billed charges,,,10331.18,82.8,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3119.32,22,,percent of total billed charges,,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,3119.32,11853.41,
DEPUY STEM MICRO CORAIL SZ6,30183462,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
STRYKER IN-LINE SPECIMENT TRAP,30183465,CDM,,,270,RC,outpatient,,112.77,112.77,,95.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.19,22,,percent of total billed charges,,,,,,,,,101.49,90,,percent of total billed charges,,,93.37,82.8,,percent of total billed charges,,,95.85,85,,percent of total billed charges,,,,,,,,,99.24,88,,percent of total billed charges,,,,,,,,,86.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.19,22,,percent of total billed charges,,,102.62,91,,percent of total billed charges,,,107.13,95,,percent of total billed charges,,,93.6,83,,percent of total billed charges,,,93.6,83,,percent of total billed charges,,,,,,,,,,,,,,,93.6,83,,percent of total billed charges,,,107.13,95,,percent of total billed charges,,,101.49,90,,percent of total billed charges,,,101.49,90,,percent of total billed charges,,,92.47,82,,percent of total billed charges,,,101.49,90,,percent of total billed charges,,,95.85,85,,percent of total billed charges,,28.19,107.13,
DEPUY INSERT STAB 6MM SZ 8,30183466,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
MICROPORT BASE TIBIAL NONPOROUS SZ 4,30183467,CDM,,,278,RC,outpatient,,23933,23933,,20319.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5983.25,22,,percent of total billed charges,,,,,,,,,21539.7,90,,percent of total billed charges,,,19816.52,82.8,,percent of total billed charges,,,20343.05,85,,percent of total billed charges,,,,,,,,,21061.04,88,,percent of total billed charges,,,,,,,,,18284.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5983.25,22,,percent of total billed charges,,,21779.03,91,,percent of total billed charges,,,22736.35,95,,percent of total billed charges,,,19864.39,83,,percent of total billed charges,,,19864.39,83,,percent of total billed charges,,,,,,,,,,,,,,,19864.39,83,,percent of total billed charges,,,22736.35,95,,percent of total billed charges,,,21539.7,90,,percent of total billed charges,,,21539.7,90,,percent of total billed charges,,,19625.06,82,,percent of total billed charges,,,21539.7,90,,percent of total billed charges,,,20343.05,85,,percent of total billed charges,,5983.25,22736.35,
MENTOR TISSUE EXPANDER CPX2,30183476,CDM,,,278,RC,outpatient,,9555,9555,,8112.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2388.75,22,,percent of total billed charges,,,,,,,,,8599.5,90,,percent of total billed charges,,,7911.54,82.8,,percent of total billed charges,,,8121.75,85,,percent of total billed charges,,,,,,,,,8408.4,88,,percent of total billed charges,,,,,,,,,7300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2388.75,22,,percent of total billed charges,,,8695.05,91,,percent of total billed charges,,,9077.25,95,,percent of total billed charges,,,7930.65,83,,percent of total billed charges,,,7930.65,83,,percent of total billed charges,,,,,,,,,,,,,,,7930.65,83,,percent of total billed charges,,,9077.25,95,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,7835.1,82,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,8121.75,85,,percent of total billed charges,,2388.75,9077.25,
KITTNER DISSECTOR SPONGES,30183477,CDM,,,270,RC,outpatient,,222.08,222.08,,188.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.52,22,,percent of total billed charges,,,,,,,,,199.87,90,,percent of total billed charges,,,183.88,82.8,,percent of total billed charges,,,188.77,85,,percent of total billed charges,,,,,,,,,195.43,88,,percent of total billed charges,,,,,,,,,169.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.52,22,,percent of total billed charges,,,202.09,91,,percent of total billed charges,,,210.98,95,,percent of total billed charges,,,184.33,83,,percent of total billed charges,,,184.33,83,,percent of total billed charges,,,,,,,,,,,,,,,184.33,83,,percent of total billed charges,,,210.98,95,,percent of total billed charges,,,199.87,90,,percent of total billed charges,,,199.87,90,,percent of total billed charges,,,182.11,82,,percent of total billed charges,,,199.87,90,,percent of total billed charges,,,188.77,85,,percent of total billed charges,,55.52,210.98,
DEPUY LINER ALTRX NEUT 32 X 54,30183481,CDM,,,278,RC,outpatient,,10422.17,10422.17,,8848.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2605.54,22,,percent of total billed charges,,,,,,,,,9379.95,90,,percent of total billed charges,,,8629.56,82.8,,percent of total billed charges,,,8858.84,85,,percent of total billed charges,,,,,,,,,9171.51,88,,percent of total billed charges,,,,,,,,,7962.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2605.54,22,,percent of total billed charges,,,9484.17,91,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,,,,,,,,,,,,,8650.4,83,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8546.18,82,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8858.84,85,,percent of total billed charges,,2605.54,9901.06,
DEPUY SCREW NON LOCKING 36MM,30183482,CDM,,,278,RC,outpatient,,1330.16,1330.16,,1129.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,332.54,22,,percent of total billed charges,,,,,,,,,1197.14,90,,percent of total billed charges,,,1101.37,82.8,,percent of total billed charges,,,1130.64,85,,percent of total billed charges,,,,,,,,,1170.54,88,,percent of total billed charges,,,,,,,,,1016.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,332.54,22,,percent of total billed charges,,,1210.45,91,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1104.03,83,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1090.73,82,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1130.64,85,,percent of total billed charges,,332.54,1263.65,
DEPUY GLENOSPHERE 42MM,30183483,CDM,,,278,RC,outpatient,,17458.81,17458.81,,14822.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4364.7,22,,percent of total billed charges,,,,,,,,,15712.93,90,,percent of total billed charges,,,14455.89,82.8,,percent of total billed charges,,,14839.99,85,,percent of total billed charges,,,,,,,,,15363.75,88,,percent of total billed charges,,,,,,,,,13338.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4364.7,22,,percent of total billed charges,,,15887.52,91,,percent of total billed charges,,,16585.87,95,,percent of total billed charges,,,14490.81,83,,percent of total billed charges,,,14490.81,83,,percent of total billed charges,,,,,,,,,,,,,,,14490.81,83,,percent of total billed charges,,,16585.87,95,,percent of total billed charges,,,15712.93,90,,percent of total billed charges,,,15712.93,90,,percent of total billed charges,,,14316.22,82,,percent of total billed charges,,,15712.93,90,,percent of total billed charges,,,14839.99,85,,percent of total billed charges,,4364.7,16585.87,
STOPCOCK 4-WAY LRG BORE EXTENSION SETS,30183484,CDM,,,270,RC,outpatient,,13.23,13.23,,11.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.31,22,,percent of total billed charges,,,,,,,,,11.91,90,,percent of total billed charges,,,10.95,82.8,,percent of total billed charges,,,11.25,85,,percent of total billed charges,,,,,,,,,11.64,88,,percent of total billed charges,,,,,,,,,10.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.31,22,,percent of total billed charges,,,12.04,91,,percent of total billed charges,,,12.57,95,,percent of total billed charges,,,10.98,83,,percent of total billed charges,,,10.98,83,,percent of total billed charges,,,,,,,,,,,,,,,10.98,83,,percent of total billed charges,,,12.57,95,,percent of total billed charges,,,11.91,90,,percent of total billed charges,,,11.91,90,,percent of total billed charges,,,10.85,82,,percent of total billed charges,,,11.91,90,,percent of total billed charges,,,11.25,85,,percent of total billed charges,,3.31,12.57,
STRYKER DRILL BIT 4.2 X 180,30183486,CDM,,,270,RC,outpatient,,1941.94,1941.94,,1648.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,485.49,22,,percent of total billed charges,,,,,,,,,1747.75,90,,percent of total billed charges,,,1607.93,82.8,,percent of total billed charges,,,1650.65,85,,percent of total billed charges,,,,,,,,,1708.91,88,,percent of total billed charges,,,,,,,,,1483.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,485.49,22,,percent of total billed charges,,,1767.17,91,,percent of total billed charges,,,1844.84,95,,percent of total billed charges,,,1611.81,83,,percent of total billed charges,,,1611.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1611.81,83,,percent of total billed charges,,,1844.84,95,,percent of total billed charges,,,1747.75,90,,percent of total billed charges,,,1747.75,90,,percent of total billed charges,,,1592.39,82,,percent of total billed charges,,,1747.75,90,,percent of total billed charges,,,1650.65,85,,percent of total billed charges,,485.49,1844.84,
DEPUY ATTUNE INSERT AOX SZ 7 7MM,30183490,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY ATTUNE FEMUR PS SZ 8 LT,30183491,CDM,,,278,RC,outpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7070.46,22,,percent of total billed charges,,,,,,,,,25453.65,90,,percent of total billed charges,,,23417.36,82.8,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7070.46,22,,percent of total billed charges,,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,7070.46,26867.74,
DEPUY OSTEOTOME FLEX 12MM X 5,30183496,CDM,,,278,RC,outpatient,,5687.5,5687.5,,4828.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1421.88,22,,percent of total billed charges,,,,,,,,,5118.75,90,,percent of total billed charges,,,4709.25,82.8,,percent of total billed charges,,,4834.38,85,,percent of total billed charges,,,,,,,,,5005,88,,percent of total billed charges,,,,,,,,,4345.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1421.88,22,,percent of total billed charges,,,5175.63,91,,percent of total billed charges,,,5403.13,95,,percent of total billed charges,,,4720.63,83,,percent of total billed charges,,,4720.63,83,,percent of total billed charges,,,,,,,,,,,,,,,4720.63,83,,percent of total billed charges,,,5403.13,95,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,4663.75,82,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,4834.38,85,,percent of total billed charges,,1421.88,5403.13,
RAPID CURE 20CC,30183500,CDM,,,270,RC,outpatient,,15210,15210,,12913.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3802.5,22,,percent of total billed charges,,,,,,,,,13689,90,,percent of total billed charges,,,12593.88,82.8,,percent of total billed charges,,,12928.5,85,,percent of total billed charges,,,,,,,,,13384.8,88,,percent of total billed charges,,,,,,,,,11620.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3802.5,22,,percent of total billed charges,,,13841.1,91,,percent of total billed charges,,,14449.5,95,,percent of total billed charges,,,12624.3,83,,percent of total billed charges,,,12624.3,83,,percent of total billed charges,,,,,,,,,,,,,,,12624.3,83,,percent of total billed charges,,,14449.5,95,,percent of total billed charges,,,13689,90,,percent of total billed charges,,,13689,90,,percent of total billed charges,,,12472.2,82,,percent of total billed charges,,,13689,90,,percent of total billed charges,,,12928.5,85,,percent of total billed charges,,3802.5,14449.5,
DEPUY FEMORAL HEAD 36MM +15.5,30183501,CDM,,,278,RC,outpatient,,8569.34,8569.34,,7275.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2142.34,22,,percent of total billed charges,,,,,,,,,7712.41,90,,percent of total billed charges,,,7095.41,82.8,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,,,,,,,,7541.02,88,,percent of total billed charges,,,,,,,,,6546.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2142.34,22,,percent of total billed charges,,,7798.1,91,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,7112.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7112.55,83,,percent of total billed charges,,,8140.87,95,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7026.86,82,,percent of total billed charges,,,7712.41,90,,percent of total billed charges,,,7283.94,85,,percent of total billed charges,,2142.34,8140.87,
DEPUY STEM DISTAL RECLAIM 15 X 140,30183502,CDM,,,278,RC,outpatient,,31338.78,31338.78,,26606.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7834.7,22,,percent of total billed charges,,,,,,,,,28204.9,90,,percent of total billed charges,,,25948.51,82.8,,percent of total billed charges,,,26637.96,85,,percent of total billed charges,,,,,,,,,27578.13,88,,percent of total billed charges,,,,,,,,,23942.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7834.7,22,,percent of total billed charges,,,28518.29,91,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,,,,,,,,,,,,,26011.19,83,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,25697.8,82,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,26637.96,85,,percent of total billed charges,,7834.7,29771.84,
SYNTHES SCREW LOCKING 3.5X24MM,30183504,CDM,,,278,RC,outpatient,,1217.84,1217.84,,1033.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,304.46,22,,percent of total billed charges,,,,,,,,,1096.06,90,,percent of total billed charges,,,1008.37,82.8,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,,,,,,,,1071.7,88,,percent of total billed charges,,,,,,,,,930.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,304.46,22,,percent of total billed charges,,,1108.23,91,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,1010.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1010.81,83,,percent of total billed charges,,,1156.95,95,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,998.63,82,,percent of total billed charges,,,1096.06,90,,percent of total billed charges,,,1035.16,85,,percent of total billed charges,,304.46,1156.95,
CATH 30CC 22FR 3-WAY SILICONE,30183505,CDM,,,270,RC,outpatient,,83.36,83.36,,70.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.84,22,,percent of total billed charges,,,,,,,,,75.02,90,,percent of total billed charges,,,69.02,82.8,,percent of total billed charges,,,70.86,85,,percent of total billed charges,,,,,,,,,73.36,88,,percent of total billed charges,,,,,,,,,63.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.84,22,,percent of total billed charges,,,75.86,91,,percent of total billed charges,,,79.19,95,,percent of total billed charges,,,69.19,83,,percent of total billed charges,,,69.19,83,,percent of total billed charges,,,,,,,,,,,,,,,69.19,83,,percent of total billed charges,,,79.19,95,,percent of total billed charges,,,75.02,90,,percent of total billed charges,,,75.02,90,,percent of total billed charges,,,68.36,82,,percent of total billed charges,,,75.02,90,,percent of total billed charges,,,70.86,85,,percent of total billed charges,,20.84,79.19,
ERBE FIAPC CIRCUMFERENTIAL PROBE O.D. 2.,30183507,CDM,,,270,RC,outpatient,,1524.25,1524.25,,1294.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,381.06,22,,percent of total billed charges,,,,,,,,,1371.83,90,,percent of total billed charges,,,1262.08,82.8,,percent of total billed charges,,,1295.61,85,,percent of total billed charges,,,,,,,,,1341.34,88,,percent of total billed charges,,,,,,,,,1164.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,381.06,22,,percent of total billed charges,,,1387.07,91,,percent of total billed charges,,,1448.04,95,,percent of total billed charges,,,1265.13,83,,percent of total billed charges,,,1265.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1265.13,83,,percent of total billed charges,,,1448.04,95,,percent of total billed charges,,,1371.83,90,,percent of total billed charges,,,1371.83,90,,percent of total billed charges,,,1249.89,82,,percent of total billed charges,,,1371.83,90,,percent of total billed charges,,,1295.61,85,,percent of total billed charges,,381.06,1448.04,
APPLIED GELPOINT LAPAROSCOPIC SYSTEM,30183509,CDM,,,270,RC,outpatient,,4225,4225,,3587.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1056.25,22,,percent of total billed charges,,,,,,,,,3802.5,90,,percent of total billed charges,,,3498.3,82.8,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,,,,,,,,3718,88,,percent of total billed charges,,,,,,,,,3227.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1056.25,22,,percent of total billed charges,,,3844.75,91,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,,,,,,,,,,,,,3506.75,83,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3464.5,82,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,1056.25,4013.75,
DEPUY FEMUR ATTUNE 5N RIGHT,30183519,CDM,,,278,RC,outpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7070.46,22,,percent of total billed charges,,,,,,,,,25453.65,90,,percent of total billed charges,,,23417.36,82.8,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7070.46,22,,percent of total billed charges,,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,7070.46,26867.74,
DEPUY CAGE CEMENTED 56 RIGHT PROTRUSIO,30183521,CDM,,,278,RC,outpatient,,21625.7,21625.7,,18360.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5406.43,22,,percent of total billed charges,,,,,,,,,19463.13,90,,percent of total billed charges,,,17906.08,82.8,,percent of total billed charges,,,18381.85,85,,percent of total billed charges,,,,,,,,,19030.62,88,,percent of total billed charges,,,,,,,,,16522.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5406.43,22,,percent of total billed charges,,,19679.39,91,,percent of total billed charges,,,20544.42,95,,percent of total billed charges,,,17949.33,83,,percent of total billed charges,,,17949.33,83,,percent of total billed charges,,,,,,,,,,,,,,,17949.33,83,,percent of total billed charges,,,20544.42,95,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,17733.07,82,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,18381.85,85,,percent of total billed charges,,5406.43,20544.42,
DEPUY SCREW SELF TAP 20MM,30183522,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
STOPCOCK LUER LOCK MALE CONNECTOR,30183524,CDM,,,270,RC,outpatient,,483,483,,410.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,120.75,22,,percent of total billed charges,,,,,,,,,434.7,90,,percent of total billed charges,,,399.92,82.8,,percent of total billed charges,,,410.55,85,,percent of total billed charges,,,,,,,,,425.04,88,,percent of total billed charges,,,,,,,,,369.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,120.75,22,,percent of total billed charges,,,439.53,91,,percent of total billed charges,,,458.85,95,,percent of total billed charges,,,400.89,83,,percent of total billed charges,,,400.89,83,,percent of total billed charges,,,,,,,,,,,,,,,400.89,83,,percent of total billed charges,,,458.85,95,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,396.06,82,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,410.55,85,,percent of total billed charges,,120.75,458.85,
DEPUY FEMUR S-ROM X-SMALL LEFT,30183525,CDM,,,278,RC,outpatient,,30424.94,30424.94,,25830.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7606.24,22,,percent of total billed charges,,,,,,,,,27382.45,90,,percent of total billed charges,,,25191.85,82.8,,percent of total billed charges,,,25861.2,85,,percent of total billed charges,,,,,,,,,26773.95,88,,percent of total billed charges,,,,,,,,,23244.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7606.24,22,,percent of total billed charges,,,27686.7,91,,percent of total billed charges,,,28903.69,95,,percent of total billed charges,,,25252.7,83,,percent of total billed charges,,,25252.7,83,,percent of total billed charges,,,,,,,,,,,,,,,25252.7,83,,percent of total billed charges,,,28903.69,95,,percent of total billed charges,,,27382.45,90,,percent of total billed charges,,,27382.45,90,,percent of total billed charges,,,24948.45,82,,percent of total billed charges,,,27382.45,90,,percent of total billed charges,,,25861.2,85,,percent of total billed charges,,7606.24,28903.69,
DEPUY AUGMENT DISTAL 5MM,30183526,CDM,,,278,RC,outpatient,,6506.18,6506.18,,5523.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1626.55,22,,percent of total billed charges,,,,,,,,,5855.56,90,,percent of total billed charges,,,5387.12,82.8,,percent of total billed charges,,,5530.25,85,,percent of total billed charges,,,,,,,,,5725.44,88,,percent of total billed charges,,,,,,,,,4970.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1626.55,22,,percent of total billed charges,,,5920.62,91,,percent of total billed charges,,,6180.87,95,,percent of total billed charges,,,5400.13,83,,percent of total billed charges,,,5400.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5400.13,83,,percent of total billed charges,,,6180.87,95,,percent of total billed charges,,,5855.56,90,,percent of total billed charges,,,5855.56,90,,percent of total billed charges,,,5335.07,82,,percent of total billed charges,,,5855.56,90,,percent of total billed charges,,,5530.25,85,,percent of total billed charges,,1626.55,6180.87,
SYNTHES SCREW CORTEX 3.5X40MM,30183528,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
SYNTHES SCREW CORTEX 3.5X45MM,30183529,CDM,,,278,RC,outpatient,,325.13,325.13,,276.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,81.28,22,,percent of total billed charges,,,,,,,,,292.62,90,,percent of total billed charges,,,269.21,82.8,,percent of total billed charges,,,276.36,85,,percent of total billed charges,,,,,,,,,286.11,88,,percent of total billed charges,,,,,,,,,248.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,81.28,22,,percent of total billed charges,,,295.87,91,,percent of total billed charges,,,308.87,95,,percent of total billed charges,,,269.86,83,,percent of total billed charges,,,269.86,83,,percent of total billed charges,,,,,,,,,,,,,,,269.86,83,,percent of total billed charges,,,308.87,95,,percent of total billed charges,,,292.62,90,,percent of total billed charges,,,292.62,90,,percent of total billed charges,,,266.61,82,,percent of total billed charges,,,292.62,90,,percent of total billed charges,,,276.36,85,,percent of total billed charges,,81.28,308.87,
SYNTHES PLATE LOW PROFILE 3.5MM CRVD REC,30183530,CDM,,,278,RC,outpatient,,5094.05,5094.05,,4324.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1273.51,22,,percent of total billed charges,,,,,,,,,4584.65,90,,percent of total billed charges,,,4217.87,82.8,,percent of total billed charges,,,4329.94,85,,percent of total billed charges,,,,,,,,,4482.76,88,,percent of total billed charges,,,,,,,,,3891.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1273.51,22,,percent of total billed charges,,,4635.59,91,,percent of total billed charges,,,4839.35,95,,percent of total billed charges,,,4228.06,83,,percent of total billed charges,,,4228.06,83,,percent of total billed charges,,,,,,,,,,,,,,,4228.06,83,,percent of total billed charges,,,4839.35,95,,percent of total billed charges,,,4584.65,90,,percent of total billed charges,,,4584.65,90,,percent of total billed charges,,,4177.12,82,,percent of total billed charges,,,4584.65,90,,percent of total billed charges,,,4329.94,85,,percent of total billed charges,,1273.51,4839.35,
SYNTHES SCREW SHANZ 6.0MM,30183531,CDM,,,278,RC,outpatient,,928.2,928.2,,788.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,232.05,22,,percent of total billed charges,,,,,,,,,835.38,90,,percent of total billed charges,,,768.55,82.8,,percent of total billed charges,,,788.97,85,,percent of total billed charges,,,,,,,,,816.82,88,,percent of total billed charges,,,,,,,,,709.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,232.05,22,,percent of total billed charges,,,844.66,91,,percent of total billed charges,,,881.79,95,,percent of total billed charges,,,770.41,83,,percent of total billed charges,,,770.41,83,,percent of total billed charges,,,,,,,,,,,,,,,770.41,83,,percent of total billed charges,,,881.79,95,,percent of total billed charges,,,835.38,90,,percent of total billed charges,,,835.38,90,,percent of total billed charges,,,761.12,82,,percent of total billed charges,,,835.38,90,,percent of total billed charges,,,788.97,85,,percent of total billed charges,,232.05,881.79,
SYNTHES TEMPLATE BENDING 88MM 3.5,30183532,CDM,,,278,RC,outpatient,,1110.53,1110.53,,942.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,277.63,22,,percent of total billed charges,,,,,,,,,999.48,90,,percent of total billed charges,,,919.52,82.8,,percent of total billed charges,,,943.95,85,,percent of total billed charges,,,,,,,,,977.27,88,,percent of total billed charges,,,,,,,,,848.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,277.63,22,,percent of total billed charges,,,1010.58,91,,percent of total billed charges,,,1055,95,,percent of total billed charges,,,921.74,83,,percent of total billed charges,,,921.74,83,,percent of total billed charges,,,,,,,,,,,,,,,921.74,83,,percent of total billed charges,,,1055,95,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,910.63,82,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,943.95,85,,percent of total billed charges,,277.63,1055,
SYNTHES DRILL BIT 3.5MM,30183533,CDM,,,278,RC,outpatient,,844.9,844.9,,717.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,211.23,22,,percent of total billed charges,,,,,,,,,760.41,90,,percent of total billed charges,,,699.58,82.8,,percent of total billed charges,,,718.17,85,,percent of total billed charges,,,,,,,,,743.51,88,,percent of total billed charges,,,,,,,,,645.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,211.23,22,,percent of total billed charges,,,768.86,91,,percent of total billed charges,,,802.66,95,,percent of total billed charges,,,701.27,83,,percent of total billed charges,,,701.27,83,,percent of total billed charges,,,,,,,,,,,,,,,701.27,83,,percent of total billed charges,,,802.66,95,,percent of total billed charges,,,760.41,90,,percent of total billed charges,,,760.41,90,,percent of total billed charges,,,692.82,82,,percent of total billed charges,,,760.41,90,,percent of total billed charges,,,718.17,85,,percent of total billed charges,,211.23,802.66,
ZIMMER NEXGEN COMPLETE KNEE SOLUTION LAR,30183535,CDM,,,278,RC,outpatient,,21097.77,21097.77,,17912.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5274.44,22,,percent of total billed charges,,,,,,,,,18987.99,90,,percent of total billed charges,,,17468.95,82.8,,percent of total billed charges,,,17933.1,85,,percent of total billed charges,,,,,,,,,18566.04,88,,percent of total billed charges,,,,,,,,,16118.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5274.44,22,,percent of total billed charges,,,19198.97,91,,percent of total billed charges,,,20042.88,95,,percent of total billed charges,,,17511.15,83,,percent of total billed charges,,,17511.15,83,,percent of total billed charges,,,,,,,,,,,,,,,17511.15,83,,percent of total billed charges,,,20042.88,95,,percent of total billed charges,,,18987.99,90,,percent of total billed charges,,,18987.99,90,,percent of total billed charges,,,17300.17,82,,percent of total billed charges,,,18987.99,90,,percent of total billed charges,,,17933.1,85,,percent of total billed charges,,5274.44,20042.88,
NEEDLE SURGICAL ANCHOR 8DC,30183536,CDM,,,270,RC,outpatient,,21.6,21.6,,18.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.4,22,,percent of total billed charges,,,,,,,,,19.44,90,,percent of total billed charges,,,17.88,82.8,,percent of total billed charges,,,18.36,85,,percent of total billed charges,,,,,,,,,19.01,88,,percent of total billed charges,,,,,,,,,16.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.4,22,,percent of total billed charges,,,19.66,91,,percent of total billed charges,,,20.52,95,,percent of total billed charges,,,17.93,83,,percent of total billed charges,,,17.93,83,,percent of total billed charges,,,,,,,,,,,,,,,17.93,83,,percent of total billed charges,,,20.52,95,,percent of total billed charges,,,19.44,90,,percent of total billed charges,,,19.44,90,,percent of total billed charges,,,17.71,82,,percent of total billed charges,,,19.44,90,,percent of total billed charges,,,18.36,85,,percent of total billed charges,,5.4,20.52,
NEEDLE SURGICAL ANCHOR 7DC,30183537,CDM,,,270,RC,outpatient,,21.6,21.6,,18.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.4,22,,percent of total billed charges,,,,,,,,,19.44,90,,percent of total billed charges,,,17.88,82.8,,percent of total billed charges,,,18.36,85,,percent of total billed charges,,,,,,,,,19.01,88,,percent of total billed charges,,,,,,,,,16.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.4,22,,percent of total billed charges,,,19.66,91,,percent of total billed charges,,,20.52,95,,percent of total billed charges,,,17.93,83,,percent of total billed charges,,,17.93,83,,percent of total billed charges,,,,,,,,,,,,,,,17.93,83,,percent of total billed charges,,,20.52,95,,percent of total billed charges,,,19.44,90,,percent of total billed charges,,,19.44,90,,percent of total billed charges,,,17.71,82,,percent of total billed charges,,,19.44,90,,percent of total billed charges,,,18.36,85,,percent of total billed charges,,5.4,20.52,
DEPUY STEM FLUTED UNIV 75 X 16,30183538,CDM,,,278,RC,outpatient,,9024.34,9024.34,,7661.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2256.09,22,,percent of total billed charges,,,,,,,,,8121.91,90,,percent of total billed charges,,,7472.15,82.8,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,,,,,,,,7941.42,88,,percent of total billed charges,,,,,,,,,6894.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2256.09,22,,percent of total billed charges,,,8212.15,91,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,,,,,,,,,,,,,7490.2,83,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7399.96,82,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,2256.09,8573.12,
DEPUY FEMUR S-ROM X-SMALL KEFT,30183539,CDM,,,278,RC,outpatient,,52982.02,52982.02,,44981.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13245.51,22,,percent of total billed charges,,,,,,,,,47683.82,90,,percent of total billed charges,,,43869.11,82.8,,percent of total billed charges,,,45034.72,85,,percent of total billed charges,,,,,,,,,46624.18,88,,percent of total billed charges,,,,,,,,,40478.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13245.51,22,,percent of total billed charges,,,48213.64,91,,percent of total billed charges,,,50332.92,95,,percent of total billed charges,,,43975.08,83,,percent of total billed charges,,,43975.08,83,,percent of total billed charges,,,,,,,,,,,,,,,43975.08,83,,percent of total billed charges,,,50332.92,95,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,43445.26,82,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,45034.72,85,,percent of total billed charges,,13245.51,50332.92,
DEPUY TIBIA PROXIMAL LPS X-SMALL,30183540,CDM,,,278,RC,outpatient,,87360.07,87360.07,,74168.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21840.02,22,,percent of total billed charges,,,,,,,,,78624.06,90,,percent of total billed charges,,,72334.14,82.8,,percent of total billed charges,,,74256.06,85,,percent of total billed charges,,,,,,,,,76876.86,88,,percent of total billed charges,,,,,,,,,66743.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21840.02,22,,percent of total billed charges,,,79497.66,91,,percent of total billed charges,,,82992.07,95,,percent of total billed charges,,,72508.86,83,,percent of total billed charges,,,72508.86,83,,percent of total billed charges,,,,,,,,,,,,,,,72508.86,83,,percent of total billed charges,,,82992.07,95,,percent of total billed charges,,,78624.06,90,,percent of total billed charges,,,78624.06,90,,percent of total billed charges,,,71635.26,82,,percent of total billed charges,,,78624.06,90,,percent of total billed charges,,,74256.06,85,,percent of total billed charges,,21840.02,82992.07,
DEPUY STEM POROUS 13.5 X 125MM,30183541,CDM,,,278,RC,outpatient,,45577.22,45577.22,,38695.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11394.31,22,,percent of total billed charges,,,,,,,,,41019.5,90,,percent of total billed charges,,,37737.94,82.8,,percent of total billed charges,,,38740.64,85,,percent of total billed charges,,,,,,,,,40107.95,88,,percent of total billed charges,,,,,,,,,34821,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11394.31,22,,percent of total billed charges,,,41475.27,91,,percent of total billed charges,,,43298.36,95,,percent of total billed charges,,,37829.09,83,,percent of total billed charges,,,37829.09,83,,percent of total billed charges,,,,,,,,,,,,,,,37829.09,83,,percent of total billed charges,,,43298.36,95,,percent of total billed charges,,,41019.5,90,,percent of total billed charges,,,41019.5,90,,percent of total billed charges,,,37373.32,82,,percent of total billed charges,,,41019.5,90,,percent of total billed charges,,,38740.64,85,,percent of total billed charges,,11394.31,43298.36,
PCMX 3.3% CLEANSING SOLUTION,30183548,CDM,,,270,RC,outpatient,,15.3,15.3,,12.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.83,22,,percent of total billed charges,,,,,,,,,13.77,90,,percent of total billed charges,,,12.67,82.8,,percent of total billed charges,,,13.01,85,,percent of total billed charges,,,,,,,,,13.46,88,,percent of total billed charges,,,,,,,,,11.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.83,22,,percent of total billed charges,,,13.92,91,,percent of total billed charges,,,14.54,95,,percent of total billed charges,,,12.7,83,,percent of total billed charges,,,12.7,83,,percent of total billed charges,,,,,,,,,,,,,,,12.7,83,,percent of total billed charges,,,14.54,95,,percent of total billed charges,,,13.77,90,,percent of total billed charges,,,13.77,90,,percent of total billed charges,,,12.55,82,,percent of total billed charges,,,13.77,90,,percent of total billed charges,,,13.01,85,,percent of total billed charges,,3.83,14.54,
DJO TIBIA POROUS DOWN RIGHT 3D FK 10,30183555,CDM,,,278,RC,outpatient,,19987.5,19987.5,,16969.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4996.88,22,,percent of total billed charges,,,,,,,,,17988.75,90,,percent of total billed charges,,,16549.65,82.8,,percent of total billed charges,,,16989.38,85,,percent of total billed charges,,,,,,,,,17589,88,,percent of total billed charges,,,,,,,,,15270.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4996.88,22,,percent of total billed charges,,,18188.63,91,,percent of total billed charges,,,18988.13,95,,percent of total billed charges,,,16589.63,83,,percent of total billed charges,,,16589.63,83,,percent of total billed charges,,,,,,,,,,,,,,,16589.63,83,,percent of total billed charges,,,18988.13,95,,percent of total billed charges,,,17988.75,90,,percent of total billed charges,,,17988.75,90,,percent of total billed charges,,,16389.75,82,,percent of total billed charges,,,17988.75,90,,percent of total billed charges,,,16989.38,85,,percent of total billed charges,,4996.88,18988.13,
DJO INSERT 9MM 12 RIGHT 3D E-PLUS,30183556,CDM,,,278,RC,outpatient,,5980,5980,,5077.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1495,22,,percent of total billed charges,,,,,,,,,5382,90,,percent of total billed charges,,,4951.44,82.8,,percent of total billed charges,,,5083,85,,percent of total billed charges,,,,,,,,,5262.4,88,,percent of total billed charges,,,,,,,,,4568.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1495,22,,percent of total billed charges,,,5441.8,91,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4963.4,83,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,4903.6,82,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5083,85,,percent of total billed charges,,1495,5681,
DJO SCREW CANCELLOUS 50MM,30183557,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
DJO FEMUR POROUS 3D 2 RIGHT,30183558,CDM,,,278,RC,outpatient,,18232.5,18232.5,,15479.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4558.13,22,,percent of total billed charges,,,,,,,,,16409.25,90,,percent of total billed charges,,,15096.51,82.8,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,,,,,,,,16044.6,88,,percent of total billed charges,,,,,,,,,13929.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4558.13,22,,percent of total billed charges,,,16591.58,91,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15132.98,83,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,14950.65,82,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,4558.13,17320.88,
DJO SAWBLADE 1MM,30183559,CDM,,,270,RC,outpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325,22,,percent of total billed charges,,,,,,,,,1170,90,,percent of total billed charges,,,1076.4,82.8,,percent of total billed charges,,,1105,85,,percent of total billed charges,,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325,22,,percent of total billed charges,,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,325,1235,
SYNTHES PLATE 4HOLE RT MEDIAL LCP 3.5MM,30183560,CDM,,,278,RC,outpatient,,10319.4,10319.4,,8761.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2579.85,22,,percent of total billed charges,,,,,,,,,9287.46,90,,percent of total billed charges,,,8544.46,82.8,,percent of total billed charges,,,8771.49,85,,percent of total billed charges,,,,,,,,,9081.07,88,,percent of total billed charges,,,,,,,,,7884.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2579.85,22,,percent of total billed charges,,,9390.65,91,,percent of total billed charges,,,9803.43,95,,percent of total billed charges,,,8565.1,83,,percent of total billed charges,,,8565.1,83,,percent of total billed charges,,,,,,,,,,,,,,,8565.1,83,,percent of total billed charges,,,9803.43,95,,percent of total billed charges,,,9287.46,90,,percent of total billed charges,,,9287.46,90,,percent of total billed charges,,,8461.91,82,,percent of total billed charges,,,9287.46,90,,percent of total billed charges,,,8771.49,85,,percent of total billed charges,,2579.85,9803.43,
SYNTHES SCREW LOCKING 3.7X40MM,30183561,CDM,,,278,RC,outpatient,,1345.5,1345.5,,1142.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,336.38,22,,percent of total billed charges,,,,,,,,,1210.95,90,,percent of total billed charges,,,1114.07,82.8,,percent of total billed charges,,,1143.68,85,,percent of total billed charges,,,,,,,,,1184.04,88,,percent of total billed charges,,,,,,,,,1027.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,336.38,22,,percent of total billed charges,,,1224.41,91,,percent of total billed charges,,,1278.23,95,,percent of total billed charges,,,1116.77,83,,percent of total billed charges,,,1116.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1116.77,83,,percent of total billed charges,,,1278.23,95,,percent of total billed charges,,,1210.95,90,,percent of total billed charges,,,1210.95,90,,percent of total billed charges,,,1103.31,82,,percent of total billed charges,,,1210.95,90,,percent of total billed charges,,,1143.68,85,,percent of total billed charges,,336.38,1278.23,
SYNTHES SCREW LOCKING 3.7X52MM,30183562,CDM,,,278,RC,outpatient,,1784.58,1784.58,,1515.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,446.15,22,,percent of total billed charges,,,,,,,,,1606.12,90,,percent of total billed charges,,,1477.63,82.8,,percent of total billed charges,,,1516.89,85,,percent of total billed charges,,,,,,,,,1570.43,88,,percent of total billed charges,,,,,,,,,1363.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,446.15,22,,percent of total billed charges,,,1623.97,91,,percent of total billed charges,,,1695.35,95,,percent of total billed charges,,,1481.2,83,,percent of total billed charges,,,1481.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1481.2,83,,percent of total billed charges,,,1695.35,95,,percent of total billed charges,,,1606.12,90,,percent of total billed charges,,,1606.12,90,,percent of total billed charges,,,1463.36,82,,percent of total billed charges,,,1606.12,90,,percent of total billed charges,,,1516.89,85,,percent of total billed charges,,446.15,1695.35,
SYNTHES SCREW LOCKING 3.7X60MM,30183563,CDM,,,278,RC,outpatient,,1784.58,1784.58,,1515.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,446.15,22,,percent of total billed charges,,,,,,,,,1606.12,90,,percent of total billed charges,,,1477.63,82.8,,percent of total billed charges,,,1516.89,85,,percent of total billed charges,,,,,,,,,1570.43,88,,percent of total billed charges,,,,,,,,,1363.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,446.15,22,,percent of total billed charges,,,1623.97,91,,percent of total billed charges,,,1695.35,95,,percent of total billed charges,,,1481.2,83,,percent of total billed charges,,,1481.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1481.2,83,,percent of total billed charges,,,1695.35,95,,percent of total billed charges,,,1606.12,90,,percent of total billed charges,,,1606.12,90,,percent of total billed charges,,,1463.36,82,,percent of total billed charges,,,1606.12,90,,percent of total billed charges,,,1516.89,85,,percent of total billed charges,,446.15,1695.35,
DEPUY HEAD ECCENTRIC 44 X 21,30183565,CDM,,,278,RC,outpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4409.03,22,,percent of total billed charges,,,,,,,,,15872.52,90,,percent of total billed charges,,,14602.72,82.8,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4409.03,22,,percent of total billed charges,,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,4409.03,16754.32,
MENTOR TISSUE EXPANDER 350CC,30183566,CDM,,,278,RC,outpatient,,9555,9555,,8112.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2388.75,22,,percent of total billed charges,,,,,,,,,8599.5,90,,percent of total billed charges,,,7911.54,82.8,,percent of total billed charges,,,8121.75,85,,percent of total billed charges,,,,,,,,,8408.4,88,,percent of total billed charges,,,,,,,,,7300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2388.75,22,,percent of total billed charges,,,8695.05,91,,percent of total billed charges,,,9077.25,95,,percent of total billed charges,,,7930.65,83,,percent of total billed charges,,,7930.65,83,,percent of total billed charges,,,,,,,,,,,,,,,7930.65,83,,percent of total billed charges,,,9077.25,95,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,7835.1,82,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,8121.75,85,,percent of total billed charges,,2388.75,9077.25,
ZIMMER LINER 40MM I.D. SIZE NN,30183573,CDM,,,278,RC,outpatient,,11399.05,11399.05,,9677.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2849.76,22,,percent of total billed charges,,,,,,,,,10259.15,90,,percent of total billed charges,,,9438.41,82.8,,percent of total billed charges,,,9689.19,85,,percent of total billed charges,,,,,,,,,10031.16,88,,percent of total billed charges,,,,,,,,,8708.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2849.76,22,,percent of total billed charges,,,10373.14,91,,percent of total billed charges,,,10829.1,95,,percent of total billed charges,,,9461.21,83,,percent of total billed charges,,,9461.21,83,,percent of total billed charges,,,,,,,,,,,,,,,9461.21,83,,percent of total billed charges,,,10829.1,95,,percent of total billed charges,,,10259.15,90,,percent of total billed charges,,,10259.15,90,,percent of total billed charges,,,9347.22,82,,percent of total billed charges,,,10259.15,90,,percent of total billed charges,,,9689.19,85,,percent of total billed charges,,2849.76,10829.1,
ZIMMER LINER BIPOLAR CUP 22MM I.D.,30183574,CDM,,,278,RC,outpatient,,4550,4550,,3862.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1137.5,22,,percent of total billed charges,,,,,,,,,4095,90,,percent of total billed charges,,,3767.4,82.8,,percent of total billed charges,,,3867.5,85,,percent of total billed charges,,,,,,,,,4004,88,,percent of total billed charges,,,,,,,,,3476.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1137.5,22,,percent of total billed charges,,,4140.5,91,,percent of total billed charges,,,4322.5,95,,percent of total billed charges,,,3776.5,83,,percent of total billed charges,,,3776.5,83,,percent of total billed charges,,,,,,,,,,,,,,,3776.5,83,,percent of total billed charges,,,4322.5,95,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,3731,82,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,3867.5,85,,percent of total billed charges,,1137.5,4322.5,
ZIMMER SHELL BIPOLAR CUP 40MM O.D.,30183575,CDM,,,278,RC,outpatient,,7605,7605,,6456.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1901.25,22,,percent of total billed charges,,,,,,,,,6844.5,90,,percent of total billed charges,,,6296.94,82.8,,percent of total billed charges,,,6464.25,85,,percent of total billed charges,,,,,,,,,6692.4,88,,percent of total billed charges,,,,,,,,,5810.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1901.25,22,,percent of total billed charges,,,6920.55,91,,percent of total billed charges,,,7224.75,95,,percent of total billed charges,,,6312.15,83,,percent of total billed charges,,,6312.15,83,,percent of total billed charges,,,,,,,,,,,,,,,6312.15,83,,percent of total billed charges,,,7224.75,95,,percent of total billed charges,,,6844.5,90,,percent of total billed charges,,,6844.5,90,,percent of total billed charges,,,6236.1,82,,percent of total billed charges,,,6844.5,90,,percent of total billed charges,,,6464.25,85,,percent of total billed charges,,1901.25,7224.75,
ZIMMER HEAD FEMORAL 22MM 12/14 +3.0MM NE,30183576,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
DEPUY ATTUNE FEMUR 6N L,30183578,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
GLIDEWIRE URO 150 X 3.5MM,30183580,CDM,,,270,RC,outpatient,,371.07,371.07,,315.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.77,22,,percent of total billed charges,,,,,,,,,333.96,90,,percent of total billed charges,,,307.25,82.8,,percent of total billed charges,,,315.41,85,,percent of total billed charges,,,,,,,,,326.54,88,,percent of total billed charges,,,,,,,,,283.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.77,22,,percent of total billed charges,,,337.67,91,,percent of total billed charges,,,352.52,95,,percent of total billed charges,,,307.99,83,,percent of total billed charges,,,307.99,83,,percent of total billed charges,,,,,,,,,,,,,,,307.99,83,,percent of total billed charges,,,352.52,95,,percent of total billed charges,,,333.96,90,,percent of total billed charges,,,333.96,90,,percent of total billed charges,,,304.28,82,,percent of total billed charges,,,333.96,90,,percent of total billed charges,,,315.41,85,,percent of total billed charges,,92.77,352.52,
DJO FEMUR POROUS 3D 8 RIGHT,30183581,CDM,,,278,RC,outpatient,,18232.5,18232.5,,15479.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4558.13,22,,percent of total billed charges,,,,,,,,,16409.25,90,,percent of total billed charges,,,15096.51,82.8,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,,,,,,,,16044.6,88,,percent of total billed charges,,,,,,,,,13929.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4558.13,22,,percent of total billed charges,,,16591.58,91,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15132.98,83,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,14950.65,82,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,4558.13,17320.88,
DJO INSERT 13MM 8 RIGHT 3D E-PLUS,30183582,CDM,,,278,RC,outpatient,,5980,5980,,5077.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1495,22,,percent of total billed charges,,,,,,,,,5382,90,,percent of total billed charges,,,4951.44,82.8,,percent of total billed charges,,,5083,85,,percent of total billed charges,,,,,,,,,5262.4,88,,percent of total billed charges,,,,,,,,,4568.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1495,22,,percent of total billed charges,,,5441.8,91,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4963.4,83,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,4903.6,82,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5083,85,,percent of total billed charges,,1495,5681,
DJO TIBIA STEMMED 3D POROUS 8 RIGHT,30183583,CDM,,,278,RC,outpatient,,13487.5,13487.5,,11450.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3371.88,22,,percent of total billed charges,,,,,,,,,12138.75,90,,percent of total billed charges,,,11167.65,82.8,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,,,,,,,,11869,88,,percent of total billed charges,,,,,,,,,10304.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3371.88,22,,percent of total billed charges,,,12273.63,91,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,,,,,,,,,,,,,11194.63,83,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11059.75,82,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,3371.88,12813.13,
DJO INSERT 9MM 6 RIGHT 3D E-PLUS,30183584,CDM,,,278,RC,outpatient,,5980,5980,,5077.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1495,22,,percent of total billed charges,,,,,,,,,5382,90,,percent of total billed charges,,,4951.44,82.8,,percent of total billed charges,,,5083,85,,percent of total billed charges,,,,,,,,,5262.4,88,,percent of total billed charges,,,,,,,,,4568.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1495,22,,percent of total billed charges,,,5441.8,91,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4963.4,83,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,4903.6,82,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5083,85,,percent of total billed charges,,1495,5681,
DJO FEMUR POROUS 3D 6 RIGHT,30183585,CDM,,,278,RC,outpatient,,18232.5,18232.5,,15479.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4558.13,22,,percent of total billed charges,,,,,,,,,16409.25,90,,percent of total billed charges,,,15096.51,82.8,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,,,,,,,,16044.6,88,,percent of total billed charges,,,,,,,,,13929.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4558.13,22,,percent of total billed charges,,,16591.58,91,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15132.98,83,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,14950.65,82,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,4558.13,17320.88,
DJO STEM 150 X 16MM TIBIAL REVISION,30183586,CDM,,,278,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
DJO TIBIA STEMMED REV NON-POROUS 4 RIGHT,30183587,CDM,,,278,RC,outpatient,,11537.5,11537.5,,9795.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2884.38,22,,percent of total billed charges,,,,,,,,,10383.75,90,,percent of total billed charges,,,9553.05,82.8,,percent of total billed charges,,,9806.88,85,,percent of total billed charges,,,,,,,,,10153,88,,percent of total billed charges,,,,,,,,,8814.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2884.38,22,,percent of total billed charges,,,10499.13,91,,percent of total billed charges,,,10960.63,95,,percent of total billed charges,,,9576.13,83,,percent of total billed charges,,,9576.13,83,,percent of total billed charges,,,,,,,,,,,,,,,9576.13,83,,percent of total billed charges,,,10960.63,95,,percent of total billed charges,,,10383.75,90,,percent of total billed charges,,,10383.75,90,,percent of total billed charges,,,9460.75,82,,percent of total billed charges,,,10383.75,90,,percent of total billed charges,,,9806.88,85,,percent of total billed charges,,2884.38,10960.63,
ENDOCUT SCISSOR TIP DISP.,30183588,CDM,,,270,RC,outpatient,,288.75,288.75,,245.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.19,22,,percent of total billed charges,,,,,,,,,259.88,90,,percent of total billed charges,,,239.09,82.8,,percent of total billed charges,,,245.44,85,,percent of total billed charges,,,,,,,,,254.1,88,,percent of total billed charges,,,,,,,,,220.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.19,22,,percent of total billed charges,,,262.76,91,,percent of total billed charges,,,274.31,95,,percent of total billed charges,,,239.66,83,,percent of total billed charges,,,239.66,83,,percent of total billed charges,,,,,,,,,,,,,,,239.66,83,,percent of total billed charges,,,274.31,95,,percent of total billed charges,,,259.88,90,,percent of total billed charges,,,259.88,90,,percent of total billed charges,,,236.78,82,,percent of total billed charges,,,259.88,90,,percent of total billed charges,,,245.44,85,,percent of total billed charges,,72.19,274.31,
DJO STEM 150 X 14MM TIBIAL REVISION,30183590,CDM,,,278,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
DJO INSERT 9MM 8 RIGHT 3D E-PLUS,30183591,CDM,,,278,RC,outpatient,,5980,5980,,5077.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1495,22,,percent of total billed charges,,,,,,,,,5382,90,,percent of total billed charges,,,4951.44,82.8,,percent of total billed charges,,,5083,85,,percent of total billed charges,,,,,,,,,5262.4,88,,percent of total billed charges,,,,,,,,,4568.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1495,22,,percent of total billed charges,,,5441.8,91,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4963.4,83,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,4903.6,82,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5083,85,,percent of total billed charges,,1495,5681,
DJO STEMMED TIBIA BASE 6 RIGHT NON-POROU,30183592,CDM,,,278,RC,outpatient,,14306.5,14306.5,,12146.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3576.63,22,,percent of total billed charges,,,,,,,,,12875.85,90,,percent of total billed charges,,,11845.78,82.8,,percent of total billed charges,,,12160.53,85,,percent of total billed charges,,,,,,,,,12589.72,88,,percent of total billed charges,,,,,,,,,10930.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3576.63,22,,percent of total billed charges,,,13018.92,91,,percent of total billed charges,,,13591.18,95,,percent of total billed charges,,,11874.4,83,,percent of total billed charges,,,11874.4,83,,percent of total billed charges,,,,,,,,,,,,,,,11874.4,83,,percent of total billed charges,,,13591.18,95,,percent of total billed charges,,,12875.85,90,,percent of total billed charges,,,12875.85,90,,percent of total billed charges,,,11731.33,82,,percent of total billed charges,,,12875.85,90,,percent of total billed charges,,,12160.53,85,,percent of total billed charges,,3576.63,13591.18,
SYNTHES PLATE 6 HOLE LEFT LOW BEND PROX,30183593,CDM,,,278,RC,outpatient,,13381.55,13381.55,,11360.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3345.39,22,,percent of total billed charges,,,,,,,,,12043.4,90,,percent of total billed charges,,,11079.92,82.8,,percent of total billed charges,,,11374.32,85,,percent of total billed charges,,,,,,,,,11775.76,88,,percent of total billed charges,,,,,,,,,10223.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3345.39,22,,percent of total billed charges,,,12177.21,91,,percent of total billed charges,,,12712.47,95,,percent of total billed charges,,,11106.69,83,,percent of total billed charges,,,11106.69,83,,percent of total billed charges,,,,,,,,,,,,,,,11106.69,83,,percent of total billed charges,,,12712.47,95,,percent of total billed charges,,,12043.4,90,,percent of total billed charges,,,12043.4,90,,percent of total billed charges,,,10972.87,82,,percent of total billed charges,,,12043.4,90,,percent of total billed charges,,,11374.32,85,,percent of total billed charges,,3345.39,12712.47,
SYNTHES SCREW LOCKING 3.5 X 70MM,30183594,CDM,,,278,RC,outpatient,,1182.35,1182.35,,1003.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,295.59,22,,percent of total billed charges,,,,,,,,,1064.12,90,,percent of total billed charges,,,978.99,82.8,,percent of total billed charges,,,1005,85,,percent of total billed charges,,,,,,,,,1040.47,88,,percent of total billed charges,,,,,,,,,903.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,295.59,22,,percent of total billed charges,,,1075.94,91,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,,,,,,,,,,,,,981.35,83,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,969.53,82,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1005,85,,percent of total billed charges,,295.59,1123.23,
SYNTHES SCREW LOCKING 3.5 X 60MM,30183595,CDM,,,278,RC,outpatient,,1182.35,1182.35,,1003.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,295.59,22,,percent of total billed charges,,,,,,,,,1064.12,90,,percent of total billed charges,,,978.99,82.8,,percent of total billed charges,,,1005,85,,percent of total billed charges,,,,,,,,,1040.47,88,,percent of total billed charges,,,,,,,,,903.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,295.59,22,,percent of total billed charges,,,1075.94,91,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,,,,,,,,,,,,,981.35,83,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,969.53,82,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1005,85,,percent of total billed charges,,295.59,1123.23,
DJO INSERT 11MM 8 RIGHT 3D E-PLUS,30183596,CDM,,,278,RC,outpatient,,5980,5980,,5077.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1495,22,,percent of total billed charges,,,,,,,,,5382,90,,percent of total billed charges,,,4951.44,82.8,,percent of total billed charges,,,5083,85,,percent of total billed charges,,,,,,,,,5262.4,88,,percent of total billed charges,,,,,,,,,4568.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1495,22,,percent of total billed charges,,,5441.8,91,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4963.4,83,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,4903.6,82,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5083,85,,percent of total billed charges,,1495,5681,
ARTHREX IMPLANT DELIVERY SYSTEM,30183597,CDM,,,270,RC,outpatient,,5525,5525,,4690.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1381.25,22,,percent of total billed charges,,,,,,,,,4972.5,90,,percent of total billed charges,,,4574.7,82.8,,percent of total billed charges,,,4696.25,85,,percent of total billed charges,,,,,,,,,4862,88,,percent of total billed charges,,,,,,,,,4221.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1381.25,22,,percent of total billed charges,,,5027.75,91,,percent of total billed charges,,,5248.75,95,,percent of total billed charges,,,4585.75,83,,percent of total billed charges,,,4585.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4585.75,83,,percent of total billed charges,,,5248.75,95,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4530.5,82,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4696.25,85,,percent of total billed charges,,1381.25,5248.75,
ARTHREX REEMER 8MM LP,30183598,CDM,,,270,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
ARTHREX SUTURE PASSING WIRE,30183599,CDM,,,270,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
DEPUY MBT TRAY SLEEVE 46MM,30183600,CDM,,,270,RC,outpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4515.54,22,,percent of total billed charges,,,,,,,,,16255.93,90,,percent of total billed charges,,,14955.45,82.8,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4515.54,22,,percent of total billed charges,,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,4515.54,17159.03,
ERBE APC MEMBRANE FILTER,30183602,CDM,,,270,RC,outpatient,,87.6,87.6,,74.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.9,22,,percent of total billed charges,,,,,,,,,78.84,90,,percent of total billed charges,,,72.53,82.8,,percent of total billed charges,,,74.46,85,,percent of total billed charges,,,,,,,,,77.09,88,,percent of total billed charges,,,,,,,,,66.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.9,22,,percent of total billed charges,,,79.72,91,,percent of total billed charges,,,83.22,95,,percent of total billed charges,,,72.71,83,,percent of total billed charges,,,72.71,83,,percent of total billed charges,,,,,,,,,,,,,,,72.71,83,,percent of total billed charges,,,83.22,95,,percent of total billed charges,,,78.84,90,,percent of total billed charges,,,78.84,90,,percent of total billed charges,,,71.83,82,,percent of total billed charges,,,78.84,90,,percent of total billed charges,,,74.46,85,,percent of total billed charges,,21.9,83.22,
NEUROMONITORING EMG ET,30183606,CDM,,,270,RC,outpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,568.75,22,,percent of total billed charges,,,,,,,,,2047.5,90,,percent of total billed charges,,,1883.7,82.8,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,568.75,22,,percent of total billed charges,,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,568.75,2161.25,
RELIEVA SINUS GUIDE CATHETER F-70C,30183607,CDM,,,270,RC,outpatient,,2886,2886,,2450.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,721.5,22,,percent of total billed charges,,,,,,,,,2597.4,90,,percent of total billed charges,,,2389.61,82.8,,percent of total billed charges,,,2453.1,85,,percent of total billed charges,,,,,,,,,2539.68,88,,percent of total billed charges,,,,,,,,,2204.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,721.5,22,,percent of total billed charges,,,2626.26,91,,percent of total billed charges,,,2741.7,95,,percent of total billed charges,,,2395.38,83,,percent of total billed charges,,,2395.38,83,,percent of total billed charges,,,,,,,,,,,,,,,2395.38,83,,percent of total billed charges,,,2741.7,95,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2366.52,82,,percent of total billed charges,,,2597.4,90,,percent of total billed charges,,,2453.1,85,,percent of total billed charges,,721.5,2741.7,
ESWL SERVICES UNILATERAL- UNITED SHOCKWA,30183608,CDM,,,270,RC,outpatient,,13650,13650,,11588.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3412.5,22,,percent of total billed charges,,,,,,,,,12285,90,,percent of total billed charges,,,11302.2,82.8,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,,,,,,,,12012,88,,percent of total billed charges,,,,,,,,,10428.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3412.5,22,,percent of total billed charges,,,12421.5,91,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,,,,,,,,,,,,,11329.5,83,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11193,82,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,3412.5,12967.5,
STRYKER HEAD V40 COCR LFIT 36MM +0,30183609,CDM,,,278,RC,outpatient,,4647.5,4647.5,,3945.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1161.88,22,,percent of total billed charges,,,,,,,,,4182.75,90,,percent of total billed charges,,,3848.13,82.8,,percent of total billed charges,,,3950.38,85,,percent of total billed charges,,,,,,,,,4089.8,88,,percent of total billed charges,,,,,,,,,3550.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1161.88,22,,percent of total billed charges,,,4229.23,91,,percent of total billed charges,,,4415.13,95,,percent of total billed charges,,,3857.43,83,,percent of total billed charges,,,3857.43,83,,percent of total billed charges,,,,,,,,,,,,,,,3857.43,83,,percent of total billed charges,,,4415.13,95,,percent of total billed charges,,,4182.75,90,,percent of total billed charges,,,4182.75,90,,percent of total billed charges,,,3810.95,82,,percent of total billed charges,,,4182.75,90,,percent of total billed charges,,,3950.38,85,,percent of total billed charges,,1161.88,4415.13,
ESOPHYX SEROSAFUSE IMPLANT FASTNR KIT,30183612,CDM,,,270,RC,outpatient,,27397.5,27397.5,,23260.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6849.38,22,,percent of total billed charges,,,,,,,,,24657.75,90,,percent of total billed charges,,,22685.13,82.8,,percent of total billed charges,,,23287.88,85,,percent of total billed charges,,,,,,,,,24109.8,88,,percent of total billed charges,,,,,,,,,20931.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6849.38,22,,percent of total billed charges,,,24931.73,91,,percent of total billed charges,,,26027.63,95,,percent of total billed charges,,,22739.93,83,,percent of total billed charges,,,22739.93,83,,percent of total billed charges,,,,,,,,,,,,,,,22739.93,83,,percent of total billed charges,,,26027.63,95,,percent of total billed charges,,,24657.75,90,,percent of total billed charges,,,24657.75,90,,percent of total billed charges,,,22465.95,82,,percent of total billed charges,,,24657.75,90,,percent of total billed charges,,,23287.88,85,,percent of total billed charges,,6849.38,26027.63,
ENDO POUCH RETRIEVER 5MM,30183613,CDM,,,270,RC,outpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75,22,,percent of total billed charges,,,,,,,,,270,90,,percent of total billed charges,,,248.4,82.8,,percent of total billed charges,,,255,85,,percent of total billed charges,,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75,22,,percent of total billed charges,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,75,285,
S&N SCREW INTERNAL HEX 80MM,30183615,CDM,,,278,RC,outpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,390,22,,percent of total billed charges,,,,,,,,,1404,90,,percent of total billed charges,,,1291.68,82.8,,percent of total billed charges,,,1326,85,,percent of total billed charges,,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,390,22,,percent of total billed charges,,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,390,1482,
DEPUY INSERT PS SZ 4 7MM,30183617,CDM,,,278,RC,outpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3119.32,22,,percent of total billed charges,,,,,,,,,11229.54,90,,percent of total billed charges,,,10331.18,82.8,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3119.32,22,,percent of total billed charges,,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,3119.32,11853.41,
MEDTRONIC REVEAL LOOP RECORDER,30183619,CDM,,,278,RC,outpatient,,27950,27950,,23729.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6987.5,22,,percent of total billed charges,,,,,,,,,25155,90,,percent of total billed charges,,,23142.6,82.8,,percent of total billed charges,,,23757.5,85,,percent of total billed charges,,,,,,,,,24596,88,,percent of total billed charges,,,,,,,,,21353.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6987.5,22,,percent of total billed charges,,,25434.5,91,,percent of total billed charges,,,26552.5,95,,percent of total billed charges,,,23198.5,83,,percent of total billed charges,,,23198.5,83,,percent of total billed charges,,,,,,,,,,,,,,,23198.5,83,,percent of total billed charges,,,26552.5,95,,percent of total billed charges,,,25155,90,,percent of total billed charges,,,25155,90,,percent of total billed charges,,,22919,82,,percent of total billed charges,,,25155,90,,percent of total billed charges,,,23757.5,85,,percent of total billed charges,,6987.5,26552.5,
DJO UNIPOLAR SLEEVE NEUTRAL,30183620,CDM,,,278,RC,outpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260,22,,percent of total billed charges,,,,,,,,,936,90,,percent of total billed charges,,,861.12,82.8,,percent of total billed charges,,,884,85,,percent of total billed charges,,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260,22,,percent of total billed charges,,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,260,988,
DJO STEM HA 470 12MM POROUS,30183621,CDM,,,278,RC,outpatient,,29250,29250,,24833.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7312.5,22,,percent of total billed charges,,,,,,,,,26325,90,,percent of total billed charges,,,24219,82.8,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,,,,,,,,25740,88,,percent of total billed charges,,,,,,,,,22347,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7312.5,22,,percent of total billed charges,,,26617.5,91,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,,,,,,,,,,,,,24277.5,83,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,23985,82,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,7312.5,27787.5,
DJO HEAD UNIPOLAR 45,30183622,CDM,,,278,RC,outpatient,,3848,3848,,3266.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,962,22,,percent of total billed charges,,,,,,,,,3463.2,90,,percent of total billed charges,,,3186.14,82.8,,percent of total billed charges,,,3270.8,85,,percent of total billed charges,,,,,,,,,3386.24,88,,percent of total billed charges,,,,,,,,,2939.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,962,22,,percent of total billed charges,,,3501.68,91,,percent of total billed charges,,,3655.6,95,,percent of total billed charges,,,3193.84,83,,percent of total billed charges,,,3193.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3193.84,83,,percent of total billed charges,,,3655.6,95,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3155.36,82,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3270.8,85,,percent of total billed charges,,962,3655.6,
DEPUY LINER NEUTRAL 32 X 54MM +4,30183623,CDM,,,278,RC,outpatient,,11806.99,11806.99,,10024.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2951.75,22,,percent of total billed charges,,,,,,,,,10626.29,90,,percent of total billed charges,,,9776.19,82.8,,percent of total billed charges,,,10035.94,85,,percent of total billed charges,,,,,,,,,10390.15,88,,percent of total billed charges,,,,,,,,,9020.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2951.75,22,,percent of total billed charges,,,10744.36,91,,percent of total billed charges,,,11216.64,95,,percent of total billed charges,,,9799.8,83,,percent of total billed charges,,,9799.8,83,,percent of total billed charges,,,,,,,,,,,,,,,9799.8,83,,percent of total billed charges,,,11216.64,95,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,9681.73,82,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,10035.94,85,,percent of total billed charges,,2951.75,11216.64,
DRAIN PENROSE TUBING 1/4,30183625,CDM,,,270,RC,outpatient,,7.43,7.43,,6.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.86,22,,percent of total billed charges,,,,,,,,,6.69,90,,percent of total billed charges,,,6.15,82.8,,percent of total billed charges,,,6.32,85,,percent of total billed charges,,,,,,,,,6.54,88,,percent of total billed charges,,,,,,,,,5.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.86,22,,percent of total billed charges,,,6.76,91,,percent of total billed charges,,,7.06,95,,percent of total billed charges,,,6.17,83,,percent of total billed charges,,,6.17,83,,percent of total billed charges,,,,,,,,,,,,,,,6.17,83,,percent of total billed charges,,,7.06,95,,percent of total billed charges,,,6.69,90,,percent of total billed charges,,,6.69,90,,percent of total billed charges,,,6.09,82,,percent of total billed charges,,,6.69,90,,percent of total billed charges,,,6.32,85,,percent of total billed charges,,1.86,7.06,
SYNTHES PLATE FEMUR HOOK 10-HOLE 4.5PROX,30183626,CDM,,,278,RC,outpatient,,18558.48,18558.48,,15756.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4639.62,22,,percent of total billed charges,,,,,,,,,16702.63,90,,percent of total billed charges,,,15366.42,82.8,,percent of total billed charges,,,15774.71,85,,percent of total billed charges,,,,,,,,,16331.46,88,,percent of total billed charges,,,,,,,,,14178.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4639.62,22,,percent of total billed charges,,,16888.22,91,,percent of total billed charges,,,17630.56,95,,percent of total billed charges,,,15403.54,83,,percent of total billed charges,,,15403.54,83,,percent of total billed charges,,,,,,,,,,,,,,,15403.54,83,,percent of total billed charges,,,17630.56,95,,percent of total billed charges,,,16702.63,90,,percent of total billed charges,,,16702.63,90,,percent of total billed charges,,,15217.95,82,,percent of total billed charges,,,16702.63,90,,percent of total billed charges,,,15774.71,85,,percent of total billed charges,,4639.62,17630.56,
ALLOSOURCE PRESHAPED PATELLA LIGAMENT BT,30183627,CDM,,,278,RC,outpatient,,25867.6,25867.6,,21961.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6466.9,22,,percent of total billed charges,,,,,,,,,23280.84,90,,percent of total billed charges,,,21418.37,82.8,,percent of total billed charges,,,21987.46,85,,percent of total billed charges,,,,,,,,,22763.49,88,,percent of total billed charges,,,,,,,,,19762.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6466.9,22,,percent of total billed charges,,,23539.52,91,,percent of total billed charges,,,24574.22,95,,percent of total billed charges,,,21470.11,83,,percent of total billed charges,,,21470.11,83,,percent of total billed charges,,,,,,,,,,,,,,,21470.11,83,,percent of total billed charges,,,24574.22,95,,percent of total billed charges,,,23280.84,90,,percent of total billed charges,,,23280.84,90,,percent of total billed charges,,,21211.43,82,,percent of total billed charges,,,23280.84,90,,percent of total billed charges,,,21987.46,85,,percent of total billed charges,,6466.9,24574.22,
DJO HEAD UNIPOLAR 44,30183628,CDM,,,278,RC,outpatient,,3848,3848,,3266.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,962,22,,percent of total billed charges,,,,,,,,,3463.2,90,,percent of total billed charges,,,3186.14,82.8,,percent of total billed charges,,,3270.8,85,,percent of total billed charges,,,,,,,,,3386.24,88,,percent of total billed charges,,,,,,,,,2939.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,962,22,,percent of total billed charges,,,3501.68,91,,percent of total billed charges,,,3655.6,95,,percent of total billed charges,,,3193.84,83,,percent of total billed charges,,,3193.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3193.84,83,,percent of total billed charges,,,3655.6,95,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3155.36,82,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3270.8,85,,percent of total billed charges,,962,3655.6,
DJO STEM HA 470 10.5MM POROUS,30183629,CDM,,,278,RC,outpatient,,29250,29250,,24833.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7312.5,22,,percent of total billed charges,,,,,,,,,26325,90,,percent of total billed charges,,,24219,82.8,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,,,,,,,,25740,88,,percent of total billed charges,,,,,,,,,22347,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7312.5,22,,percent of total billed charges,,,26617.5,91,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,,,,,,,,,,,,,24277.5,83,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,23985,82,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,7312.5,27787.5,
SYNTHES SCREW LOCKING 2.7X8MM,30183632,CDM,,,278,RC,outpatient,,1178.13,1178.13,,1000.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,294.53,22,,percent of total billed charges,,,,,,,,,1060.32,90,,percent of total billed charges,,,975.49,82.8,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,,,,,,,,1036.75,88,,percent of total billed charges,,,,,,,,,900.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,294.53,22,,percent of total billed charges,,,1072.1,91,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,,,,,,,,,,,,,977.85,83,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,966.07,82,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,294.53,1119.22,
BIOMET ULTRADRIVE 180MM TIP EXTENDER,30183634,CDM,,,270,RC,outpatient,,4946.5,4946.5,,4199.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1236.63,22,,percent of total billed charges,,,,,,,,,4451.85,90,,percent of total billed charges,,,4095.7,82.8,,percent of total billed charges,,,4204.53,85,,percent of total billed charges,,,,,,,,,4352.92,88,,percent of total billed charges,,,,,,,,,3779.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1236.63,22,,percent of total billed charges,,,4501.32,91,,percent of total billed charges,,,4699.18,95,,percent of total billed charges,,,4105.6,83,,percent of total billed charges,,,4105.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4105.6,83,,percent of total billed charges,,,4699.18,95,,percent of total billed charges,,,4451.85,90,,percent of total billed charges,,,4451.85,90,,percent of total billed charges,,,4056.13,82,,percent of total billed charges,,,4451.85,90,,percent of total billed charges,,,4204.53,85,,percent of total billed charges,,1236.63,4699.18,
STRYKER CANNULA VENOM 18G 100MM 10MM,30183638,CDM,,,270,RC,outpatient,,511.25,511.25,,434.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.81,22,,percent of total billed charges,,,,,,,,,460.13,90,,percent of total billed charges,,,423.32,82.8,,percent of total billed charges,,,434.56,85,,percent of total billed charges,,,,,,,,,449.9,88,,percent of total billed charges,,,,,,,,,390.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.81,22,,percent of total billed charges,,,465.24,91,,percent of total billed charges,,,485.69,95,,percent of total billed charges,,,424.34,83,,percent of total billed charges,,,424.34,83,,percent of total billed charges,,,,,,,,,,,,,,,424.34,83,,percent of total billed charges,,,485.69,95,,percent of total billed charges,,,460.13,90,,percent of total billed charges,,,460.13,90,,percent of total billed charges,,,419.23,82,,percent of total billed charges,,,460.13,90,,percent of total billed charges,,,434.56,85,,percent of total billed charges,,127.81,485.69,
ARTHREX KNIFE BLADE,30183639,CDM,,,270,RC,outpatient,,472.5,472.5,,401.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,118.13,22,,percent of total billed charges,,,,,,,,,425.25,90,,percent of total billed charges,,,391.23,82.8,,percent of total billed charges,,,401.63,85,,percent of total billed charges,,,,,,,,,415.8,88,,percent of total billed charges,,,,,,,,,360.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,118.13,22,,percent of total billed charges,,,429.98,91,,percent of total billed charges,,,448.88,95,,percent of total billed charges,,,392.18,83,,percent of total billed charges,,,392.18,83,,percent of total billed charges,,,,,,,,,,,,,,,392.18,83,,percent of total billed charges,,,448.88,95,,percent of total billed charges,,,425.25,90,,percent of total billed charges,,,425.25,90,,percent of total billed charges,,,387.45,82,,percent of total billed charges,,,425.25,90,,percent of total billed charges,,,401.63,85,,percent of total billed charges,,118.13,448.88,
ARTHREX 10.5LP,30183640,CDM,,,278,RC,outpatient,,1813.5,1813.5,,1539.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,453.38,22,,percent of total billed charges,,,,,,,,,1632.15,90,,percent of total billed charges,,,1501.58,82.8,,percent of total billed charges,,,1541.48,85,,percent of total billed charges,,,,,,,,,1595.88,88,,percent of total billed charges,,,,,,,,,1385.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,453.38,22,,percent of total billed charges,,,1650.29,91,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.21,83,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1487.07,82,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1541.48,85,,percent of total billed charges,,453.38,1722.83,
ARTHREX SCREW BIOCOMPOSITE 8+23,30183641,CDM,,,278,RC,outpatient,,1527.5,1527.5,,1296.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,381.88,22,,percent of total billed charges,,,,,,,,,1374.75,90,,percent of total billed charges,,,1264.77,82.8,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,,,,,,,,1344.2,88,,percent of total billed charges,,,,,,,,,1167.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,381.88,22,,percent of total billed charges,,,1390.03,91,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1267.83,83,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1252.55,82,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,381.88,1451.13,
ARTHREX SCREW BIOCOMPOSITE 10+28,30183642,CDM,,,278,RC,outpatient,,1527.5,1527.5,,1296.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,381.88,22,,percent of total billed charges,,,,,,,,,1374.75,90,,percent of total billed charges,,,1264.77,82.8,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,,,,,,,,1344.2,88,,percent of total billed charges,,,,,,,,,1167.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,381.88,22,,percent of total billed charges,,,1390.03,91,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1267.83,83,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1252.55,82,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,381.88,1451.13,
BRACE CERVICAL COLLAR,30183643,CDM,,,270,RC,outpatient,,337.5,337.5,,286.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.38,22,,percent of total billed charges,,,,,,,,,303.75,90,,percent of total billed charges,,,279.45,82.8,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,,,,,,,,297,88,,percent of total billed charges,,,,,,,,,257.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.38,22,,percent of total billed charges,,,307.13,91,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,,,,,,,,,,,,,280.13,83,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,276.75,82,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,84.38,320.63,
BRACE QUICK DRAW LG BLK,30183644,CDM,,,270,RC,outpatient,,559.65,559.65,,475.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,139.91,22,,percent of total billed charges,,,,,,,,,503.69,90,,percent of total billed charges,,,463.39,82.8,,percent of total billed charges,,,475.7,85,,percent of total billed charges,,,,,,,,,492.49,88,,percent of total billed charges,,,,,,,,,427.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,139.91,22,,percent of total billed charges,,,509.28,91,,percent of total billed charges,,,531.67,95,,percent of total billed charges,,,464.51,83,,percent of total billed charges,,,464.51,83,,percent of total billed charges,,,,,,,,,,,,,,,464.51,83,,percent of total billed charges,,,531.67,95,,percent of total billed charges,,,503.69,90,,percent of total billed charges,,,503.69,90,,percent of total billed charges,,,458.91,82,,percent of total billed charges,,,503.69,90,,percent of total billed charges,,,475.7,85,,percent of total billed charges,,139.91,531.67,
SYNTHES PLATE TUBULAR 5-HOLE 114MM,30183647,CDM,,,278,RC,outpatient,,14935.05,14935.05,,12679.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3733.76,22,,percent of total billed charges,,,,,,,,,13441.55,90,,percent of total billed charges,,,12366.22,82.8,,percent of total billed charges,,,12694.79,85,,percent of total billed charges,,,,,,,,,13142.84,88,,percent of total billed charges,,,,,,,,,11410.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3733.76,22,,percent of total billed charges,,,13590.9,91,,percent of total billed charges,,,14188.3,95,,percent of total billed charges,,,12396.09,83,,percent of total billed charges,,,12396.09,83,,percent of total billed charges,,,,,,,,,,,,,,,12396.09,83,,percent of total billed charges,,,14188.3,95,,percent of total billed charges,,,13441.55,90,,percent of total billed charges,,,13441.55,90,,percent of total billed charges,,,12246.74,82,,percent of total billed charges,,,13441.55,90,,percent of total billed charges,,,12694.79,85,,percent of total billed charges,,3733.76,14188.3,
HOLMIUM 365 FORTEC FIBER,30183648,CDM,,,270,RC,outpatient,,1397.5,1397.5,,1186.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,349.38,22,,percent of total billed charges,,,,,,,,,1257.75,90,,percent of total billed charges,,,1157.13,82.8,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,,,,,,,,1229.8,88,,percent of total billed charges,,,,,,,,,1067.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,349.38,22,,percent of total billed charges,,,1271.73,91,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1159.93,83,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1145.95,82,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,349.38,1327.63,
SYNTHES PLATE DISTAL RADIUS 2.4MM VA 6X3,30183649,CDM,,,278,RC,outpatient,,9762.68,9762.68,,8288.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2440.67,22,,percent of total billed charges,,,,,,,,,8786.41,90,,percent of total billed charges,,,8083.5,82.8,,percent of total billed charges,,,8298.28,85,,percent of total billed charges,,,,,,,,,8591.16,88,,percent of total billed charges,,,,,,,,,7458.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2440.67,22,,percent of total billed charges,,,8884.04,91,,percent of total billed charges,,,9274.55,95,,percent of total billed charges,,,8103.02,83,,percent of total billed charges,,,8103.02,83,,percent of total billed charges,,,,,,,,,,,,,,,8103.02,83,,percent of total billed charges,,,9274.55,95,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8005.4,82,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8298.28,85,,percent of total billed charges,,2440.67,9274.55,
SYNTHES SCREW CORTEX 2.7MM X 12MM,30183650,CDM,,,278,RC,outpatient,,410.27,410.27,,348.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,102.57,22,,percent of total billed charges,,,,,,,,,369.24,90,,percent of total billed charges,,,339.7,82.8,,percent of total billed charges,,,348.73,85,,percent of total billed charges,,,,,,,,,361.04,88,,percent of total billed charges,,,,,,,,,313.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,102.57,22,,percent of total billed charges,,,373.35,91,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,,,,,,,,,,,,,340.52,83,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,336.42,82,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,348.73,85,,percent of total billed charges,,102.57,389.76,
ELECTRODE COAG MONO 22-24FR,30183653,CDM,,,270,RC,outpatient,,557.58,557.58,,473.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,139.4,22,,percent of total billed charges,,,,,,,,,501.82,90,,percent of total billed charges,,,461.68,82.8,,percent of total billed charges,,,473.94,85,,percent of total billed charges,,,,,,,,,490.67,88,,percent of total billed charges,,,,,,,,,425.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,139.4,22,,percent of total billed charges,,,507.4,91,,percent of total billed charges,,,529.7,95,,percent of total billed charges,,,462.79,83,,percent of total billed charges,,,462.79,83,,percent of total billed charges,,,,,,,,,,,,,,,462.79,83,,percent of total billed charges,,,529.7,95,,percent of total billed charges,,,501.82,90,,percent of total billed charges,,,501.82,90,,percent of total billed charges,,,457.22,82,,percent of total billed charges,,,501.82,90,,percent of total billed charges,,,473.94,85,,percent of total billed charges,,139.4,529.7,
DJO UNIPOLAR HEAD 51MM,30183654,CDM,,,278,RC,outpatient,,3848,3848,,3266.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,962,22,,percent of total billed charges,,,,,,,,,3463.2,90,,percent of total billed charges,,,3186.14,82.8,,percent of total billed charges,,,3270.8,85,,percent of total billed charges,,,,,,,,,3386.24,88,,percent of total billed charges,,,,,,,,,2939.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,962,22,,percent of total billed charges,,,3501.68,91,,percent of total billed charges,,,3655.6,95,,percent of total billed charges,,,3193.84,83,,percent of total billed charges,,,3193.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3193.84,83,,percent of total billed charges,,,3655.6,95,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3155.36,82,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3270.8,85,,percent of total billed charges,,962,3655.6,
DJO STEM LIMA REVISION DISTAL 20 X 140MM,30183655,CDM,,,278,RC,outpatient,,39838.5,39838.5,,33822.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9959.63,22,,percent of total billed charges,,,,,,,,,35854.65,90,,percent of total billed charges,,,32986.28,82.8,,percent of total billed charges,,,33862.73,85,,percent of total billed charges,,,,,,,,,35057.88,88,,percent of total billed charges,,,,,,,,,30436.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9959.63,22,,percent of total billed charges,,,36253.04,91,,percent of total billed charges,,,37846.58,95,,percent of total billed charges,,,33065.96,83,,percent of total billed charges,,,33065.96,83,,percent of total billed charges,,,,,,,,,,,,,,,33065.96,83,,percent of total billed charges,,,37846.58,95,,percent of total billed charges,,,35854.65,90,,percent of total billed charges,,,35854.65,90,,percent of total billed charges,,,32667.57,82,,percent of total billed charges,,,35854.65,90,,percent of total billed charges,,,33862.73,85,,percent of total billed charges,,9959.63,37846.58,
DJO BODY LIMA REVISION LAT. 70MM,30183656,CDM,,,278,RC,outpatient,,37492,37492,,31830.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9373,22,,percent of total billed charges,,,,,,,,,33742.8,90,,percent of total billed charges,,,31043.38,82.8,,percent of total billed charges,,,31868.2,85,,percent of total billed charges,,,,,,,,,32992.96,88,,percent of total billed charges,,,,,,,,,28643.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9373,22,,percent of total billed charges,,,34117.72,91,,percent of total billed charges,,,35617.4,95,,percent of total billed charges,,,31118.36,83,,percent of total billed charges,,,31118.36,83,,percent of total billed charges,,,,,,,,,,,,,,,31118.36,83,,percent of total billed charges,,,35617.4,95,,percent of total billed charges,,,33742.8,90,,percent of total billed charges,,,33742.8,90,,percent of total billed charges,,,30743.44,82,,percent of total billed charges,,,33742.8,90,,percent of total billed charges,,,31868.2,85,,percent of total billed charges,,9373,35617.4,
ARTHROCARE REFLEX ULTRA 45,30183657,CDM,,,270,RC,outpatient,,1430,1430,,1214.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,357.5,22,,percent of total billed charges,,,,,,,,,1287,90,,percent of total billed charges,,,1184.04,82.8,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,,,,,,,,1258.4,88,,percent of total billed charges,,,,,,,,,1092.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,357.5,22,,percent of total billed charges,,,1301.3,91,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1186.9,83,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1172.6,82,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,357.5,1358.5,
MEDTRONIC PULSE GENERATOR LEAD 140,30183668,CDM,,,270,RC,outpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,455,22,,percent of total billed charges,,,,,,,,,1638,90,,percent of total billed charges,,,1506.96,82.8,,percent of total billed charges,,,1547,85,,percent of total billed charges,,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,455,22,,percent of total billed charges,,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,455,1729,
MEDTRONIC PULSE GENERATOR LEAD 100,30183669,CDM,,,270,RC,outpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,455,22,,percent of total billed charges,,,,,,,,,1638,90,,percent of total billed charges,,,1506.96,82.8,,percent of total billed charges,,,1547,85,,percent of total billed charges,,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,455,22,,percent of total billed charges,,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,455,1729,
MEDTRONIC PACEMAKER,30183670,CDM,,,278,RC,outpatient,,40670.5,40670.5,,34529.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10167.63,22,,percent of total billed charges,,,,,,,,,36603.45,90,,percent of total billed charges,,,33675.17,82.8,,percent of total billed charges,,,34569.93,85,,percent of total billed charges,,,,,,,,,35790.04,88,,percent of total billed charges,,,,,,,,,31072.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10167.63,22,,percent of total billed charges,,,37010.16,91,,percent of total billed charges,,,38636.98,95,,percent of total billed charges,,,33756.52,83,,percent of total billed charges,,,33756.52,83,,percent of total billed charges,,,,,,,,,,,,,,,33756.52,83,,percent of total billed charges,,,38636.98,95,,percent of total billed charges,,,36603.45,90,,percent of total billed charges,,,36603.45,90,,percent of total billed charges,,,33349.81,82,,percent of total billed charges,,,36603.45,90,,percent of total billed charges,,,34569.93,85,,percent of total billed charges,,10167.63,38636.98,
MEDTRONIC RV LEAD,30183671,CDM,,,278,RC,outpatient,,4829.5,4829.5,,4100.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1207.38,22,,percent of total billed charges,,,,,,,,,4346.55,90,,percent of total billed charges,,,3998.83,82.8,,percent of total billed charges,,,4105.08,85,,percent of total billed charges,,,,,,,,,4249.96,88,,percent of total billed charges,,,,,,,,,3689.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1207.38,22,,percent of total billed charges,,,4394.85,91,,percent of total billed charges,,,4588.03,95,,percent of total billed charges,,,4008.49,83,,percent of total billed charges,,,4008.49,83,,percent of total billed charges,,,,,,,,,,,,,,,4008.49,83,,percent of total billed charges,,,4588.03,95,,percent of total billed charges,,,4346.55,90,,percent of total billed charges,,,4346.55,90,,percent of total billed charges,,,3960.19,82,,percent of total billed charges,,,4346.55,90,,percent of total billed charges,,,4105.08,85,,percent of total billed charges,,1207.38,4588.03,
GREENLIGHT XPS LASER FEE- UNITED SHOCK,30183672,CDM,,,270,RC,outpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1291.88,22,,percent of total billed charges,,,,,,,,,4650.75,90,,percent of total billed charges,,,4278.69,82.8,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1291.88,22,,percent of total billed charges,,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,1291.88,4909.13,
GREENLIGHT XPS FIBER,30183673,CDM,,,270,RC,outpatient,,6825,6825,,5794.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1706.25,22,,percent of total billed charges,,,,,,,,,6142.5,90,,percent of total billed charges,,,5651.1,82.8,,percent of total billed charges,,,5801.25,85,,percent of total billed charges,,,,,,,,,6006,88,,percent of total billed charges,,,,,,,,,5214.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1706.25,22,,percent of total billed charges,,,6210.75,91,,percent of total billed charges,,,6483.75,95,,percent of total billed charges,,,5664.75,83,,percent of total billed charges,,,5664.75,83,,percent of total billed charges,,,,,,,,,,,,,,,5664.75,83,,percent of total billed charges,,,6483.75,95,,percent of total billed charges,,,6142.5,90,,percent of total billed charges,,,6142.5,90,,percent of total billed charges,,,5596.5,82,,percent of total billed charges,,,6142.5,90,,percent of total billed charges,,,5801.25,85,,percent of total billed charges,,1706.25,6483.75,
MEDARTIS SCREW CANNULATED 28MM,30183674,CDM,,,278,RC,outpatient,,2047.5,2047.5,,1738.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,511.88,22,,percent of total billed charges,,,,,,,,,1842.75,90,,percent of total billed charges,,,1695.33,82.8,,percent of total billed charges,,,1740.38,85,,percent of total billed charges,,,,,,,,,1801.8,88,,percent of total billed charges,,,,,,,,,1564.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,511.88,22,,percent of total billed charges,,,1863.23,91,,percent of total billed charges,,,1945.13,95,,percent of total billed charges,,,1699.43,83,,percent of total billed charges,,,1699.43,83,,percent of total billed charges,,,,,,,,,,,,,,,1699.43,83,,percent of total billed charges,,,1945.13,95,,percent of total billed charges,,,1842.75,90,,percent of total billed charges,,,1842.75,90,,percent of total billed charges,,,1678.95,82,,percent of total billed charges,,,1842.75,90,,percent of total billed charges,,,1740.38,85,,percent of total billed charges,,511.88,1945.13,
MEDARTIS K-WIRE 0.8MM,30183675,CDM,,,270,RC,outpatient,,195.75,195.75,,166.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.94,22,,percent of total billed charges,,,,,,,,,176.18,90,,percent of total billed charges,,,162.08,82.8,,percent of total billed charges,,,166.39,85,,percent of total billed charges,,,,,,,,,172.26,88,,percent of total billed charges,,,,,,,,,149.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.94,22,,percent of total billed charges,,,178.13,91,,percent of total billed charges,,,185.96,95,,percent of total billed charges,,,162.47,83,,percent of total billed charges,,,162.47,83,,percent of total billed charges,,,,,,,,,,,,,,,162.47,83,,percent of total billed charges,,,185.96,95,,percent of total billed charges,,,176.18,90,,percent of total billed charges,,,176.18,90,,percent of total billed charges,,,160.52,82,,percent of total billed charges,,,176.18,90,,percent of total billed charges,,,166.39,85,,percent of total billed charges,,48.94,185.96,
MEDARTIS K-WIRE 1.1MM,30183676,CDM,,,270,RC,outpatient,,195.75,195.75,,166.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.94,22,,percent of total billed charges,,,,,,,,,176.18,90,,percent of total billed charges,,,162.08,82.8,,percent of total billed charges,,,166.39,85,,percent of total billed charges,,,,,,,,,172.26,88,,percent of total billed charges,,,,,,,,,149.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.94,22,,percent of total billed charges,,,178.13,91,,percent of total billed charges,,,185.96,95,,percent of total billed charges,,,162.47,83,,percent of total billed charges,,,162.47,83,,percent of total billed charges,,,,,,,,,,,,,,,162.47,83,,percent of total billed charges,,,185.96,95,,percent of total billed charges,,,176.18,90,,percent of total billed charges,,,176.18,90,,percent of total billed charges,,,160.52,82,,percent of total billed charges,,,176.18,90,,percent of total billed charges,,,166.39,85,,percent of total billed charges,,48.94,185.96,
SAFE SHEATH 7FR 13CM,30183677,CDM,,,270,RC,outpatient,,534.8,534.8,,454.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,133.7,22,,percent of total billed charges,,,,,,,,,481.32,90,,percent of total billed charges,,,442.81,82.8,,percent of total billed charges,,,454.58,85,,percent of total billed charges,,,,,,,,,470.62,88,,percent of total billed charges,,,,,,,,,408.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,133.7,22,,percent of total billed charges,,,486.67,91,,percent of total billed charges,,,508.06,95,,percent of total billed charges,,,443.88,83,,percent of total billed charges,,,443.88,83,,percent of total billed charges,,,,,,,,,,,,,,,443.88,83,,percent of total billed charges,,,508.06,95,,percent of total billed charges,,,481.32,90,,percent of total billed charges,,,481.32,90,,percent of total billed charges,,,438.54,82,,percent of total billed charges,,,481.32,90,,percent of total billed charges,,,454.58,85,,percent of total billed charges,,133.7,508.06,
DEPUY REVISE AUGMENT 10MM 50/52MM,30183678,CDM,,,278,RC,outpatient,,21066.96,21066.96,,17885.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5266.74,22,,percent of total billed charges,,,,,,,,,18960.26,90,,percent of total billed charges,,,17443.44,82.8,,percent of total billed charges,,,17906.92,85,,percent of total billed charges,,,,,,,,,18538.92,88,,percent of total billed charges,,,,,,,,,16095.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5266.74,22,,percent of total billed charges,,,19170.93,91,,percent of total billed charges,,,20013.61,95,,percent of total billed charges,,,17485.58,83,,percent of total billed charges,,,17485.58,83,,percent of total billed charges,,,,,,,,,,,,,,,17485.58,83,,percent of total billed charges,,,20013.61,95,,percent of total billed charges,,,18960.26,90,,percent of total billed charges,,,18960.26,90,,percent of total billed charges,,,17274.91,82,,percent of total billed charges,,,18960.26,90,,percent of total billed charges,,,17906.92,85,,percent of total billed charges,,5266.74,20013.61,
DEPUY SCREW TF 65MM,30183679,CDM,,,278,RC,outpatient,,1266.92,1266.92,,1075.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.73,22,,percent of total billed charges,,,,,,,,,1140.23,90,,percent of total billed charges,,,1049.01,82.8,,percent of total billed charges,,,1076.88,85,,percent of total billed charges,,,,,,,,,1114.89,88,,percent of total billed charges,,,,,,,,,967.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.73,22,,percent of total billed charges,,,1152.9,91,,percent of total billed charges,,,1203.57,95,,percent of total billed charges,,,1051.54,83,,percent of total billed charges,,,1051.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1051.54,83,,percent of total billed charges,,,1203.57,95,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1038.87,82,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1076.88,85,,percent of total billed charges,,316.73,1203.57,
DEPUY SCREW TF 55MM,30183680,CDM,,,278,RC,outpatient,,1266.92,1266.92,,1075.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.73,22,,percent of total billed charges,,,,,,,,,1140.23,90,,percent of total billed charges,,,1049.01,82.8,,percent of total billed charges,,,1076.88,85,,percent of total billed charges,,,,,,,,,1114.89,88,,percent of total billed charges,,,,,,,,,967.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.73,22,,percent of total billed charges,,,1152.9,91,,percent of total billed charges,,,1203.57,95,,percent of total billed charges,,,1051.54,83,,percent of total billed charges,,,1051.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1051.54,83,,percent of total billed charges,,,1203.57,95,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1038.87,82,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1076.88,85,,percent of total billed charges,,316.73,1203.57,
DEPUY SCREW TF 50MM,30183681,CDM,,,278,RC,outpatient,,1266.92,1266.92,,1075.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.73,22,,percent of total billed charges,,,,,,,,,1140.23,90,,percent of total billed charges,,,1049.01,82.8,,percent of total billed charges,,,1076.88,85,,percent of total billed charges,,,,,,,,,1114.89,88,,percent of total billed charges,,,,,,,,,967.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.73,22,,percent of total billed charges,,,1152.9,91,,percent of total billed charges,,,1203.57,95,,percent of total billed charges,,,1051.54,83,,percent of total billed charges,,,1051.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1051.54,83,,percent of total billed charges,,,1203.57,95,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1038.87,82,,percent of total billed charges,,,1140.23,90,,percent of total billed charges,,,1076.88,85,,percent of total billed charges,,316.73,1203.57,
DEPUY HEAD TAPER 36 +0  11/13,30183682,CDM,,,278,RC,outpatient,,8767.27,8767.27,,7443.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2191.82,22,,percent of total billed charges,,,,,,,,,7890.54,90,,percent of total billed charges,,,7259.3,82.8,,percent of total billed charges,,,7452.18,85,,percent of total billed charges,,,,,,,,,7715.2,88,,percent of total billed charges,,,,,,,,,6698.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2191.82,22,,percent of total billed charges,,,7978.22,91,,percent of total billed charges,,,8328.91,95,,percent of total billed charges,,,7276.83,83,,percent of total billed charges,,,7276.83,83,,percent of total billed charges,,,,,,,,,,,,,,,7276.83,83,,percent of total billed charges,,,8328.91,95,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7189.16,82,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7452.18,85,,percent of total billed charges,,2191.82,8328.91,
DJO HEAD UNIPOLAR 54,30183683,CDM,,,278,RC,outpatient,,3848,3848,,3266.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,962,22,,percent of total billed charges,,,,,,,,,3463.2,90,,percent of total billed charges,,,3186.14,82.8,,percent of total billed charges,,,3270.8,85,,percent of total billed charges,,,,,,,,,3386.24,88,,percent of total billed charges,,,,,,,,,2939.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,962,22,,percent of total billed charges,,,3501.68,91,,percent of total billed charges,,,3655.6,95,,percent of total billed charges,,,3193.84,83,,percent of total billed charges,,,3193.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3193.84,83,,percent of total billed charges,,,3655.6,95,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3155.36,82,,percent of total billed charges,,,3463.2,90,,percent of total billed charges,,,3270.8,85,,percent of total billed charges,,962,3655.6,
DJO STEM PRESS FIT POROUS HA 16.5MM,30183684,CDM,,,278,RC,outpatient,,29250,29250,,24833.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7312.5,22,,percent of total billed charges,,,,,,,,,26325,90,,percent of total billed charges,,,24219,82.8,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,,,,,,,,25740,88,,percent of total billed charges,,,,,,,,,22347,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7312.5,22,,percent of total billed charges,,,26617.5,91,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,,,,,,,,,,,,,24277.5,83,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,23985,82,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,7312.5,27787.5,
STRYKER ELECTRODE VENOM MONOP 100MM,30183685,CDM,,,270,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
SYNTHES REAMER TUBE SPARE FOR HOLLOW REA,30183686,CDM,,,270,RC,outpatient,,2491.78,2491.78,,2115.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,622.95,22,,percent of total billed charges,,,,,,,,,2242.6,90,,percent of total billed charges,,,2063.19,82.8,,percent of total billed charges,,,2118.01,85,,percent of total billed charges,,,,,,,,,2192.77,88,,percent of total billed charges,,,,,,,,,1903.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,622.95,22,,percent of total billed charges,,,2267.52,91,,percent of total billed charges,,,2367.19,95,,percent of total billed charges,,,2068.18,83,,percent of total billed charges,,,2068.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2068.18,83,,percent of total billed charges,,,2367.19,95,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2043.26,82,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2118.01,85,,percent of total billed charges,,622.95,2367.19,
SYNTHES CONICAL EXTRACTION DEVICE,30183687,CDM,,,270,RC,outpatient,,1508.33,1508.33,,1280.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,377.08,22,,percent of total billed charges,,,,,,,,,1357.5,90,,percent of total billed charges,,,1248.9,82.8,,percent of total billed charges,,,1282.08,85,,percent of total billed charges,,,,,,,,,1327.33,88,,percent of total billed charges,,,,,,,,,1152.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,377.08,22,,percent of total billed charges,,,1372.58,91,,percent of total billed charges,,,1432.91,95,,percent of total billed charges,,,1251.91,83,,percent of total billed charges,,,1251.91,83,,percent of total billed charges,,,,,,,,,,,,,,,1251.91,83,,percent of total billed charges,,,1432.91,95,,percent of total billed charges,,,1357.5,90,,percent of total billed charges,,,1357.5,90,,percent of total billed charges,,,1236.83,82,,percent of total billed charges,,,1357.5,90,,percent of total billed charges,,,1282.08,85,,percent of total billed charges,,377.08,1432.91,
STOPCOCK 3-WAY LRG BORE EXTENSION SETS,30183688,CDM,,,270,RC,outpatient,,4.79,4.79,,4.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.2,22,,percent of total billed charges,,,,,,,,,4.31,90,,percent of total billed charges,,,3.97,82.8,,percent of total billed charges,,,4.07,85,,percent of total billed charges,,,,,,,,,4.22,88,,percent of total billed charges,,,,,,,,,3.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.2,22,,percent of total billed charges,,,4.36,91,,percent of total billed charges,,,4.55,95,,percent of total billed charges,,,3.98,83,,percent of total billed charges,,,3.98,83,,percent of total billed charges,,,,,,,,,,,,,,,3.98,83,,percent of total billed charges,,,4.55,95,,percent of total billed charges,,,4.31,90,,percent of total billed charges,,,4.31,90,,percent of total billed charges,,,3.93,82,,percent of total billed charges,,,4.31,90,,percent of total billed charges,,,4.07,85,,percent of total billed charges,,1.2,4.55,
DEPUY ATTUNE FEMUR 5N L,30183689,CDM,,,278,RC,outpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7070.46,22,,percent of total billed charges,,,,,,,,,25453.65,90,,percent of total billed charges,,,23417.36,82.8,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7070.46,22,,percent of total billed charges,,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,7070.46,26867.74,
AESCULAP TIBIA T2- REVISION,30183690,CDM,,,278,RC,outpatient,,31330,31330,,26599.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7832.5,22,,percent of total billed charges,,,,,,,,,28197,90,,percent of total billed charges,,,25941.24,82.8,,percent of total billed charges,,,26630.5,85,,percent of total billed charges,,,,,,,,,27570.4,88,,percent of total billed charges,,,,,,,,,23936.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7832.5,22,,percent of total billed charges,,,28510.3,91,,percent of total billed charges,,,29763.5,95,,percent of total billed charges,,,26003.9,83,,percent of total billed charges,,,26003.9,83,,percent of total billed charges,,,,,,,,,,,,,,,26003.9,83,,percent of total billed charges,,,29763.5,95,,percent of total billed charges,,,28197,90,,percent of total billed charges,,,28197,90,,percent of total billed charges,,,25690.6,82,,percent of total billed charges,,,28197,90,,percent of total billed charges,,,26630.5,85,,percent of total billed charges,,7832.5,29763.5,
AESCULAP TIBIA AUGMENT T2 8MM,30183691,CDM,,,278,RC,outpatient,,20891,20891,,17736.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5222.75,22,,percent of total billed charges,,,,,,,,,18801.9,90,,percent of total billed charges,,,17297.75,82.8,,percent of total billed charges,,,17757.35,85,,percent of total billed charges,,,,,,,,,18384.08,88,,percent of total billed charges,,,,,,,,,15960.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5222.75,22,,percent of total billed charges,,,19010.81,91,,percent of total billed charges,,,19846.45,95,,percent of total billed charges,,,17339.53,83,,percent of total billed charges,,,17339.53,83,,percent of total billed charges,,,,,,,,,,,,,,,17339.53,83,,percent of total billed charges,,,19846.45,95,,percent of total billed charges,,,18801.9,90,,percent of total billed charges,,,18801.9,90,,percent of total billed charges,,,17130.62,82,,percent of total billed charges,,,18801.9,90,,percent of total billed charges,,,17757.35,85,,percent of total billed charges,,5222.75,19846.45,
AESCULAP TIBIA AUGMENT T2 8MM,30183692,CDM,,,278,RC,outpatient,,20891,20891,,17736.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5222.75,22,,percent of total billed charges,,,,,,,,,18801.9,90,,percent of total billed charges,,,17297.75,82.8,,percent of total billed charges,,,17757.35,85,,percent of total billed charges,,,,,,,,,18384.08,88,,percent of total billed charges,,,,,,,,,15960.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5222.75,22,,percent of total billed charges,,,19010.81,91,,percent of total billed charges,,,19846.45,95,,percent of total billed charges,,,17339.53,83,,percent of total billed charges,,,17339.53,83,,percent of total billed charges,,,,,,,,,,,,,,,17339.53,83,,percent of total billed charges,,,19846.45,95,,percent of total billed charges,,,18801.9,90,,percent of total billed charges,,,18801.9,90,,percent of total billed charges,,,17130.62,82,,percent of total billed charges,,,18801.9,90,,percent of total billed charges,,,17757.35,85,,percent of total billed charges,,5222.75,19846.45,
AESCULAP STEM 92MM,30183693,CDM,,,278,RC,outpatient,,14378,14378,,12206.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3594.5,22,,percent of total billed charges,,,,,,,,,12940.2,90,,percent of total billed charges,,,11904.98,82.8,,percent of total billed charges,,,12221.3,85,,percent of total billed charges,,,,,,,,,12652.64,88,,percent of total billed charges,,,,,,,,,10984.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3594.5,22,,percent of total billed charges,,,13083.98,91,,percent of total billed charges,,,13659.1,95,,percent of total billed charges,,,11933.74,83,,percent of total billed charges,,,11933.74,83,,percent of total billed charges,,,,,,,,,,,,,,,11933.74,83,,percent of total billed charges,,,13659.1,95,,percent of total billed charges,,,12940.2,90,,percent of total billed charges,,,12940.2,90,,percent of total billed charges,,,11789.96,82,,percent of total billed charges,,,12940.2,90,,percent of total billed charges,,,12221.3,85,,percent of total billed charges,,3594.5,13659.1,
AESCULAP VEGA POLY- REV,30183694,CDM,,,278,RC,outpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1218.75,22,,percent of total billed charges,,,,,,,,,4387.5,90,,percent of total billed charges,,,4036.5,82.8,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1218.75,22,,percent of total billed charges,,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,1218.75,4631.25,
DEPUY FEMUR ATTUNE 6N RIGHT,30183696,CDM,,,278,RC,outpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7070.46,22,,percent of total billed charges,,,,,,,,,25453.65,90,,percent of total billed charges,,,23417.36,82.8,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7070.46,22,,percent of total billed charges,,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,7070.46,26867.74,
DEPUY BODY RECLAIM PROXIMAL 20 X 75,30183697,CDM,,,278,RC,outpatient,,38548.77,38548.77,,32727.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9637.19,22,,percent of total billed charges,,,,,,,,,34693.89,90,,percent of total billed charges,,,31918.38,82.8,,percent of total billed charges,,,32766.45,85,,percent of total billed charges,,,,,,,,,33922.92,88,,percent of total billed charges,,,,,,,,,29451.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9637.19,22,,percent of total billed charges,,,35079.38,91,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,,,,,,,,,,,,,31995.48,83,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,31609.99,82,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,32766.45,85,,percent of total billed charges,,9637.19,36621.33,
DEPUY STEM DISTAL RECLAIM 16 X 140,30183698,CDM,,,278,RC,outpatient,,31338.78,31338.78,,26606.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7834.7,22,,percent of total billed charges,,,,,,,,,28204.9,90,,percent of total billed charges,,,25948.51,82.8,,percent of total billed charges,,,26637.96,85,,percent of total billed charges,,,,,,,,,27578.13,88,,percent of total billed charges,,,,,,,,,23942.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7834.7,22,,percent of total billed charges,,,28518.29,91,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,,,,,,,,,,,,,26011.19,83,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,25697.8,82,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,26637.96,85,,percent of total billed charges,,7834.7,29771.84,
APPLIED TROCAR ADV. FIXATION 5X100MM,30183699,CDM,,,270,RC,outpatient,,156,156,,132.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39,22,,percent of total billed charges,,,,,,,,,140.4,90,,percent of total billed charges,,,129.17,82.8,,percent of total billed charges,,,132.6,85,,percent of total billed charges,,,,,,,,,137.28,88,,percent of total billed charges,,,,,,,,,119.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39,22,,percent of total billed charges,,,141.96,91,,percent of total billed charges,,,148.2,95,,percent of total billed charges,,,129.48,83,,percent of total billed charges,,,129.48,83,,percent of total billed charges,,,,,,,,,,,,,,,129.48,83,,percent of total billed charges,,,148.2,95,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,127.92,82,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,132.6,85,,percent of total billed charges,,39,148.2,
APPLIED TROCAR ADV. FIXATION 5X150MM,30183700,CDM,,,270,RC,outpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
DJO STEM 150 X 18MM TIBIAL REVISION,30183704,CDM,,,278,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
STRYKER LONG NAIL KIT R1/5 TI RIGHT 11X3,30183705,CDM,,,278,RC,outpatient,,22854,22854,,19403.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5713.5,22,,percent of total billed charges,,,,,,,,,20568.6,90,,percent of total billed charges,,,18923.11,82.8,,percent of total billed charges,,,19425.9,85,,percent of total billed charges,,,,,,,,,20111.52,88,,percent of total billed charges,,,,,,,,,17460.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5713.5,22,,percent of total billed charges,,,20797.14,91,,percent of total billed charges,,,21711.3,95,,percent of total billed charges,,,18968.82,83,,percent of total billed charges,,,18968.82,83,,percent of total billed charges,,,,,,,,,,,,,,,18968.82,83,,percent of total billed charges,,,21711.3,95,,percent of total billed charges,,,20568.6,90,,percent of total billed charges,,,20568.6,90,,percent of total billed charges,,,18740.28,82,,percent of total billed charges,,,20568.6,90,,percent of total billed charges,,,19425.9,85,,percent of total billed charges,,5713.5,21711.3,
STRYKER SCREW LOCKING T2 F/T 5X47.5MM,30183706,CDM,,,278,RC,outpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,455,22,,percent of total billed charges,,,,,,,,,1638,90,,percent of total billed charges,,,1506.96,82.8,,percent of total billed charges,,,1547,85,,percent of total billed charges,,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,455,22,,percent of total billed charges,,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,455,1729,
DEPUY STEM CORAIL COLLARED SZ16,30183707,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
MICROPORT INSERT TIBIAL 14MM SZ4 RT,30183710,CDM,,,278,RC,outpatient,,5980,5980,,5077.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1495,22,,percent of total billed charges,,,,,,,,,5382,90,,percent of total billed charges,,,4951.44,82.8,,percent of total billed charges,,,5083,85,,percent of total billed charges,,,,,,,,,5262.4,88,,percent of total billed charges,,,,,,,,,4568.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1495,22,,percent of total billed charges,,,5441.8,91,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4963.4,83,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,4903.6,82,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5083,85,,percent of total billed charges,,1495,5681,
MICROPORT STEM 15X30MM,30183711,CDM,,,278,RC,outpatient,,10868,10868,,9226.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2717,22,,percent of total billed charges,,,,,,,,,9781.2,90,,percent of total billed charges,,,8998.7,82.8,,percent of total billed charges,,,9237.8,85,,percent of total billed charges,,,,,,,,,9563.84,88,,percent of total billed charges,,,,,,,,,8303.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2717,22,,percent of total billed charges,,,9889.88,91,,percent of total billed charges,,,10324.6,95,,percent of total billed charges,,,9020.44,83,,percent of total billed charges,,,9020.44,83,,percent of total billed charges,,,,,,,,,,,,,,,9020.44,83,,percent of total billed charges,,,10324.6,95,,percent of total billed charges,,,9781.2,90,,percent of total billed charges,,,9781.2,90,,percent of total billed charges,,,8911.76,82,,percent of total billed charges,,,9781.2,90,,percent of total billed charges,,,9237.8,85,,percent of total billed charges,,2717,10324.6,
MICROPORT AUGMENT TIBIAL SZ 4/3+ 5MM,30183712,CDM,,,278,RC,outpatient,,10939.5,10939.5,,9287.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2734.88,22,,percent of total billed charges,,,,,,,,,9845.55,90,,percent of total billed charges,,,9057.91,82.8,,percent of total billed charges,,,9298.58,85,,percent of total billed charges,,,,,,,,,9626.76,88,,percent of total billed charges,,,,,,,,,8357.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2734.88,22,,percent of total billed charges,,,9954.95,91,,percent of total billed charges,,,10392.53,95,,percent of total billed charges,,,9079.79,83,,percent of total billed charges,,,9079.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9079.79,83,,percent of total billed charges,,,10392.53,95,,percent of total billed charges,,,9845.55,90,,percent of total billed charges,,,9845.55,90,,percent of total billed charges,,,8970.39,82,,percent of total billed charges,,,9845.55,90,,percent of total billed charges,,,9298.58,85,,percent of total billed charges,,2734.88,10392.53,
DJO HEAD CERAMIC 36MM,30183713,CDM,,,278,RC,outpatient,,20085,20085,,17052.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5021.25,22,,percent of total billed charges,,,,,,,,,18076.5,90,,percent of total billed charges,,,16630.38,82.8,,percent of total billed charges,,,17072.25,85,,percent of total billed charges,,,,,,,,,17674.8,88,,percent of total billed charges,,,,,,,,,15344.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5021.25,22,,percent of total billed charges,,,18277.35,91,,percent of total billed charges,,,19080.75,95,,percent of total billed charges,,,16670.55,83,,percent of total billed charges,,,16670.55,83,,percent of total billed charges,,,,,,,,,,,,,,,16670.55,83,,percent of total billed charges,,,19080.75,95,,percent of total billed charges,,,18076.5,90,,percent of total billed charges,,,18076.5,90,,percent of total billed charges,,,16469.7,82,,percent of total billed charges,,,18076.5,90,,percent of total billed charges,,,17072.25,85,,percent of total billed charges,,5021.25,19080.75,
DJO LINER 20DEG HOODED NEUTRAL MP7 HXE-P,30183714,CDM,,,278,RC,outpatient,,18772,18772,,15937.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4693,22,,percent of total billed charges,,,,,,,,,16894.8,90,,percent of total billed charges,,,15543.22,82.8,,percent of total billed charges,,,15956.2,85,,percent of total billed charges,,,,,,,,,16519.36,88,,percent of total billed charges,,,,,,,,,14341.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4693,22,,percent of total billed charges,,,17082.52,91,,percent of total billed charges,,,17833.4,95,,percent of total billed charges,,,15580.76,83,,percent of total billed charges,,,15580.76,83,,percent of total billed charges,,,,,,,,,,,,,,,15580.76,83,,percent of total billed charges,,,17833.4,95,,percent of total billed charges,,,16894.8,90,,percent of total billed charges,,,16894.8,90,,percent of total billed charges,,,15393.04,82,,percent of total billed charges,,,16894.8,90,,percent of total billed charges,,,15956.2,85,,percent of total billed charges,,4693,17833.4,
DJO SHELL W/SCREW HOLES 52MM W/P2 COATIN,30183715,CDM,,,278,RC,outpatient,,18778.5,18778.5,,15942.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4694.63,22,,percent of total billed charges,,,,,,,,,16900.65,90,,percent of total billed charges,,,15548.6,82.8,,percent of total billed charges,,,15961.73,85,,percent of total billed charges,,,,,,,,,16525.08,88,,percent of total billed charges,,,,,,,,,14346.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4694.63,22,,percent of total billed charges,,,17088.44,91,,percent of total billed charges,,,17839.58,95,,percent of total billed charges,,,15586.16,83,,percent of total billed charges,,,15586.16,83,,percent of total billed charges,,,,,,,,,,,,,,,15586.16,83,,percent of total billed charges,,,17839.58,95,,percent of total billed charges,,,16900.65,90,,percent of total billed charges,,,16900.65,90,,percent of total billed charges,,,15398.37,82,,percent of total billed charges,,,16900.65,90,,percent of total billed charges,,,15961.73,85,,percent of total billed charges,,4694.63,17839.58,
DJO SCREW CANCELLOUS 25MM,30183716,CDM,,,278,RC,outpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260,22,,percent of total billed charges,,,,,,,,,936,90,,percent of total billed charges,,,861.12,82.8,,percent of total billed charges,,,884,85,,percent of total billed charges,,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260,22,,percent of total billed charges,,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,260,988,
ZIMMER TIBIAL PLATE WEDGE SZ 5,30183717,CDM,,,278,RC,outpatient,,17084.28,17084.28,,14504.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4271.07,22,,percent of total billed charges,,,,,,,,,15375.85,90,,percent of total billed charges,,,14145.78,82.8,,percent of total billed charges,,,14521.64,85,,percent of total billed charges,,,,,,,,,15034.17,88,,percent of total billed charges,,,,,,,,,13052.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4271.07,22,,percent of total billed charges,,,15546.69,91,,percent of total billed charges,,,16230.07,95,,percent of total billed charges,,,14179.95,83,,percent of total billed charges,,,14179.95,83,,percent of total billed charges,,,,,,,,,,,,,,,14179.95,83,,percent of total billed charges,,,16230.07,95,,percent of total billed charges,,,15375.85,90,,percent of total billed charges,,,15375.85,90,,percent of total billed charges,,,14009.11,82,,percent of total billed charges,,,15375.85,90,,percent of total billed charges,,,14521.64,85,,percent of total billed charges,,4271.07,16230.07,
ZIMMER TIBIAL BLOCK 5MM,30183718,CDM,,,278,RC,outpatient,,7107.88,7107.88,,6034.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1776.97,22,,percent of total billed charges,,,,,,,,,6397.09,90,,percent of total billed charges,,,5885.32,82.8,,percent of total billed charges,,,6041.7,85,,percent of total billed charges,,,,,,,,,6254.93,88,,percent of total billed charges,,,,,,,,,5430.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1776.97,22,,percent of total billed charges,,,6468.17,91,,percent of total billed charges,,,6752.49,95,,percent of total billed charges,,,5899.54,83,,percent of total billed charges,,,5899.54,83,,percent of total billed charges,,,,,,,,,,,,,,,5899.54,83,,percent of total billed charges,,,6752.49,95,,percent of total billed charges,,,6397.09,90,,percent of total billed charges,,,6397.09,90,,percent of total billed charges,,,5828.46,82,,percent of total billed charges,,,6397.09,90,,percent of total billed charges,,,6041.7,85,,percent of total billed charges,,1776.97,6752.49,
ZIMMER STEM EXTENSION OFFSET 12X100MM,30183719,CDM,,,278,RC,outpatient,,20150,20150,,17107.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5037.5,22,,percent of total billed charges,,,,,,,,,18135,90,,percent of total billed charges,,,16684.2,82.8,,percent of total billed charges,,,17127.5,85,,percent of total billed charges,,,,,,,,,17732,88,,percent of total billed charges,,,,,,,,,15394.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5037.5,22,,percent of total billed charges,,,18336.5,91,,percent of total billed charges,,,19142.5,95,,percent of total billed charges,,,16724.5,83,,percent of total billed charges,,,16724.5,83,,percent of total billed charges,,,,,,,,,,,,,,,16724.5,83,,percent of total billed charges,,,19142.5,95,,percent of total billed charges,,,18135,90,,percent of total billed charges,,,18135,90,,percent of total billed charges,,,16523,82,,percent of total billed charges,,,18135,90,,percent of total billed charges,,,17127.5,85,,percent of total billed charges,,5037.5,19142.5,
ZIMMER SURFACE ARTICULAR 14MM EF,30183720,CDM,,,278,RC,outpatient,,16770,16770,,14237.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4192.5,22,,percent of total billed charges,,,,,,,,,15093,90,,percent of total billed charges,,,13885.56,82.8,,percent of total billed charges,,,14254.5,85,,percent of total billed charges,,,,,,,,,14757.6,88,,percent of total billed charges,,,,,,,,,12812.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4192.5,22,,percent of total billed charges,,,15260.7,91,,percent of total billed charges,,,15931.5,95,,percent of total billed charges,,,13919.1,83,,percent of total billed charges,,,13919.1,83,,percent of total billed charges,,,,,,,,,,,,,,,13919.1,83,,percent of total billed charges,,,15931.5,95,,percent of total billed charges,,,15093,90,,percent of total billed charges,,,15093,90,,percent of total billed charges,,,13751.4,82,,percent of total billed charges,,,15093,90,,percent of total billed charges,,,14254.5,85,,percent of total billed charges,,4192.5,15931.5,
SYNTHES 4.0MM/2.5MM 80MM LENGTH,30183721,CDM,,,278,RC,outpatient,,1574.63,1574.63,,1336.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,393.66,22,,percent of total billed charges,,,,,,,,,1417.17,90,,percent of total billed charges,,,1303.79,82.8,,percent of total billed charges,,,1338.44,85,,percent of total billed charges,,,,,,,,,1385.67,88,,percent of total billed charges,,,,,,,,,1203.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,393.66,22,,percent of total billed charges,,,1432.91,91,,percent of total billed charges,,,1495.9,95,,percent of total billed charges,,,1306.94,83,,percent of total billed charges,,,1306.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1306.94,83,,percent of total billed charges,,,1495.9,95,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1291.2,82,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1338.44,85,,percent of total billed charges,,393.66,1495.9,
SYNTHES 4.0MM/3.5MM 80MM LENGTH,30183722,CDM,,,278,RC,outpatient,,1756.95,1756.95,,1491.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,439.24,22,,percent of total billed charges,,,,,,,,,1581.26,90,,percent of total billed charges,,,1454.75,82.8,,percent of total billed charges,,,1493.41,85,,percent of total billed charges,,,,,,,,,1546.12,88,,percent of total billed charges,,,,,,,,,1342.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,439.24,22,,percent of total billed charges,,,1598.82,91,,percent of total billed charges,,,1669.1,95,,percent of total billed charges,,,1458.27,83,,percent of total billed charges,,,1458.27,83,,percent of total billed charges,,,,,,,,,,,,,,,1458.27,83,,percent of total billed charges,,,1669.1,95,,percent of total billed charges,,,1581.26,90,,percent of total billed charges,,,1581.26,90,,percent of total billed charges,,,1440.7,82,,percent of total billed charges,,,1581.26,90,,percent of total billed charges,,,1493.41,85,,percent of total billed charges,,439.24,1669.1,
LDR ROI-C LORDOTIC IMPLANT H 8MM 12X14MM,30183724,CDM,,,278,RC,outpatient,,21937.5,21937.5,,18624.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5484.38,22,,percent of total billed charges,,,,,,,,,19743.75,90,,percent of total billed charges,,,18164.25,82.8,,percent of total billed charges,,,18646.88,85,,percent of total billed charges,,,,,,,,,19305,88,,percent of total billed charges,,,,,,,,,16760.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5484.38,22,,percent of total billed charges,,,19963.13,91,,percent of total billed charges,,,20840.63,95,,percent of total billed charges,,,18208.13,83,,percent of total billed charges,,,18208.13,83,,percent of total billed charges,,,,,,,,,,,,,,,18208.13,83,,percent of total billed charges,,,20840.63,95,,percent of total billed charges,,,19743.75,90,,percent of total billed charges,,,19743.75,90,,percent of total billed charges,,,17988.75,82,,percent of total billed charges,,,19743.75,90,,percent of total billed charges,,,18646.88,85,,percent of total billed charges,,5484.38,20840.63,
LDR ROI-C LONG ANCHORING PLATE,30183725,CDM,,,278,RC,outpatient,,21937.5,21937.5,,18624.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5484.38,22,,percent of total billed charges,,,,,,,,,19743.75,90,,percent of total billed charges,,,18164.25,82.8,,percent of total billed charges,,,18646.88,85,,percent of total billed charges,,,,,,,,,19305,88,,percent of total billed charges,,,,,,,,,16760.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5484.38,22,,percent of total billed charges,,,19963.13,91,,percent of total billed charges,,,20840.63,95,,percent of total billed charges,,,18208.13,83,,percent of total billed charges,,,18208.13,83,,percent of total billed charges,,,,,,,,,,,,,,,18208.13,83,,percent of total billed charges,,,20840.63,95,,percent of total billed charges,,,19743.75,90,,percent of total billed charges,,,19743.75,90,,percent of total billed charges,,,17988.75,82,,percent of total billed charges,,,19743.75,90,,percent of total billed charges,,,18646.88,85,,percent of total billed charges,,5484.38,20840.63,
SYNTHES PLATE LCP 3.5MM RIGHT ANGLE T PL,30183726,CDM,,,278,RC,outpatient,,3353.58,3353.58,,2847.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,838.4,22,,percent of total billed charges,,,,,,,,,3018.22,90,,percent of total billed charges,,,2776.76,82.8,,percent of total billed charges,,,2850.54,85,,percent of total billed charges,,,,,,,,,2951.15,88,,percent of total billed charges,,,,,,,,,2562.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,838.4,22,,percent of total billed charges,,,3051.76,91,,percent of total billed charges,,,3185.9,95,,percent of total billed charges,,,2783.47,83,,percent of total billed charges,,,2783.47,83,,percent of total billed charges,,,,,,,,,,,,,,,2783.47,83,,percent of total billed charges,,,3185.9,95,,percent of total billed charges,,,3018.22,90,,percent of total billed charges,,,3018.22,90,,percent of total billed charges,,,2749.94,82,,percent of total billed charges,,,3018.22,90,,percent of total billed charges,,,2850.54,85,,percent of total billed charges,,838.4,3185.9,
DEPUY STEM CEMENTED 15 X 90,30183727,CDM,,,278,RC,outpatient,,8116.23,8116.23,,6890.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2029.06,22,,percent of total billed charges,,,,,,,,,7304.61,90,,percent of total billed charges,,,6720.24,82.8,,percent of total billed charges,,,6898.8,85,,percent of total billed charges,,,,,,,,,7142.28,88,,percent of total billed charges,,,,,,,,,6200.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2029.06,22,,percent of total billed charges,,,7385.77,91,,percent of total billed charges,,,7710.42,95,,percent of total billed charges,,,6736.47,83,,percent of total billed charges,,,6736.47,83,,percent of total billed charges,,,,,,,,,,,,,,,6736.47,83,,percent of total billed charges,,,7710.42,95,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,6655.31,82,,percent of total billed charges,,,7304.61,90,,percent of total billed charges,,,6898.8,85,,percent of total billed charges,,2029.06,7710.42,
DEPUY SLEEVE FEMORAL 34MM,30183728,CDM,,,278,RC,outpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4515.54,22,,percent of total billed charges,,,,,,,,,16255.93,90,,percent of total billed charges,,,14955.45,82.8,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4515.54,22,,percent of total billed charges,,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,4515.54,17159.03,
DEPUY DISTAL AUGMENT FEM SZ 5 8MM,30183729,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
*APPLIED CLIP APPLIER M/L,30183730,CDM,,,270,RC,outpatient,,735,735,,624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,183.75,22,,percent of total billed charges,,,,,,,,,661.5,90,,percent of total billed charges,,,608.58,82.8,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,,,,,,,,646.8,88,,percent of total billed charges,,,,,,,,,561.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,183.75,22,,percent of total billed charges,,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,,,,,,,,,,,,,610.05,83,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,602.7,82,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,183.75,698.25,
STRYKER BLADE SAGITAL 90DEG.,30183731,CDM,,,270,RC,outpatient,,359.17,359.17,,304.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.79,22,,percent of total billed charges,,,,,,,,,323.25,90,,percent of total billed charges,,,297.39,82.8,,percent of total billed charges,,,305.29,85,,percent of total billed charges,,,,,,,,,316.07,88,,percent of total billed charges,,,,,,,,,274.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.79,22,,percent of total billed charges,,,326.84,91,,percent of total billed charges,,,341.21,95,,percent of total billed charges,,,298.11,83,,percent of total billed charges,,,298.11,83,,percent of total billed charges,,,,,,,,,,,,,,,298.11,83,,percent of total billed charges,,,341.21,95,,percent of total billed charges,,,323.25,90,,percent of total billed charges,,,323.25,90,,percent of total billed charges,,,294.52,82,,percent of total billed charges,,,323.25,90,,percent of total billed charges,,,305.29,85,,percent of total billed charges,,89.79,341.21,
S&N DRILL BIT 2.3,30183732,CDM,,,278,RC,outpatient,,1131,1131,,960.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,282.75,22,,percent of total billed charges,,,,,,,,,1017.9,90,,percent of total billed charges,,,936.47,82.8,,percent of total billed charges,,,961.35,85,,percent of total billed charges,,,,,,,,,995.28,88,,percent of total billed charges,,,,,,,,,864.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,282.75,22,,percent of total billed charges,,,1029.21,91,,percent of total billed charges,,,1074.45,95,,percent of total billed charges,,,938.73,83,,percent of total billed charges,,,938.73,83,,percent of total billed charges,,,,,,,,,,,,,,,938.73,83,,percent of total billed charges,,,1074.45,95,,percent of total billed charges,,,1017.9,90,,percent of total billed charges,,,1017.9,90,,percent of total billed charges,,,927.42,82,,percent of total billed charges,,,1017.9,90,,percent of total billed charges,,,961.35,85,,percent of total billed charges,,282.75,1074.45,
DEPUY INSERT PS 10MM SZ 5,30183733,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY INSERT AOX 5MM SZ 6,30183735,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
SYNTHES SCREW CANNULATED 6.5X70MM,30183736,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANNULATED 6.5X80MM,30183737,CDM,,,278,RC,outpatient,,2696.27,2696.27,,2289.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,674.07,22,,percent of total billed charges,,,,,,,,,2426.64,90,,percent of total billed charges,,,2232.51,82.8,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,,,,,,,,2372.72,88,,percent of total billed charges,,,,,,,,,2059.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,674.07,22,,percent of total billed charges,,,2453.61,91,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2237.9,83,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2210.94,82,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,674.07,2561.46,
SYNTHES SCREW CANNULATED 6.5X90MM,30183738,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
RAPID CURE 10CC,30183739,CDM,,,278,RC,outpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2356.25,22,,percent of total billed charges,,,,,,,,,8482.5,90,,percent of total billed charges,,,7803.9,82.8,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2356.25,22,,percent of total billed charges,,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,2356.25,8953.75,
S&N DRILL GUIDE,30183741,CDM,,,278,RC,outpatient,,2658.5,2658.5,,2257.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,664.63,22,,percent of total billed charges,,,,,,,,,2392.65,90,,percent of total billed charges,,,2201.24,82.8,,percent of total billed charges,,,2259.73,85,,percent of total billed charges,,,,,,,,,2339.48,88,,percent of total billed charges,,,,,,,,,2031.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,664.63,22,,percent of total billed charges,,,2419.24,91,,percent of total billed charges,,,2525.58,95,,percent of total billed charges,,,2206.56,83,,percent of total billed charges,,,2206.56,83,,percent of total billed charges,,,,,,,,,,,,,,,2206.56,83,,percent of total billed charges,,,2525.58,95,,percent of total billed charges,,,2392.65,90,,percent of total billed charges,,,2392.65,90,,percent of total billed charges,,,2179.97,82,,percent of total billed charges,,,2392.65,90,,percent of total billed charges,,,2259.73,85,,percent of total billed charges,,664.63,2525.58,
S&N TROCHAR BLUNT TIP,30183742,CDM,,,278,RC,outpatient,,1131,1131,,960.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,282.75,22,,percent of total billed charges,,,,,,,,,1017.9,90,,percent of total billed charges,,,936.47,82.8,,percent of total billed charges,,,961.35,85,,percent of total billed charges,,,,,,,,,995.28,88,,percent of total billed charges,,,,,,,,,864.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,282.75,22,,percent of total billed charges,,,1029.21,91,,percent of total billed charges,,,1074.45,95,,percent of total billed charges,,,938.73,83,,percent of total billed charges,,,938.73,83,,percent of total billed charges,,,,,,,,,,,,,,,938.73,83,,percent of total billed charges,,,1074.45,95,,percent of total billed charges,,,1017.9,90,,percent of total billed charges,,,1017.9,90,,percent of total billed charges,,,927.42,82,,percent of total billed charges,,,1017.9,90,,percent of total billed charges,,,961.35,85,,percent of total billed charges,,282.75,1074.45,
S&N TROCHAR SHARP TIP,30183743,CDM,,,278,RC,outpatient,,1033.5,1033.5,,877.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,258.38,22,,percent of total billed charges,,,,,,,,,930.15,90,,percent of total billed charges,,,855.74,82.8,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,,,,,,,,909.48,88,,percent of total billed charges,,,,,,,,,789.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,258.38,22,,percent of total billed charges,,,940.49,91,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,,,,,,,,,,,,,857.81,83,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,847.47,82,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,258.38,981.83,
BIOMET HUMERAL NAIL 8MM X 300MM,30183744,CDM,,,278,RC,outpatient,,16380,16380,,13906.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4095,22,,percent of total billed charges,,,,,,,,,14742,90,,percent of total billed charges,,,13562.64,82.8,,percent of total billed charges,,,13923,85,,percent of total billed charges,,,,,,,,,14414.4,88,,percent of total billed charges,,,,,,,,,12514.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4095,22,,percent of total billed charges,,,14905.8,91,,percent of total billed charges,,,15561,95,,percent of total billed charges,,,13595.4,83,,percent of total billed charges,,,13595.4,83,,percent of total billed charges,,,,,,,,,,,,,,,13595.4,83,,percent of total billed charges,,,15561,95,,percent of total billed charges,,,14742,90,,percent of total billed charges,,,14742,90,,percent of total billed charges,,,13431.6,82,,percent of total billed charges,,,14742,90,,percent of total billed charges,,,13923,85,,percent of total billed charges,,4095,15561,
DEPUY INSERT AOX 6MM SZ 5,30183748,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
SYNTHES NAIL HUMERAL 9MM TI 210MM CANNUL,30183749,CDM,,,278,RC,outpatient,,16525.28,16525.28,,14029.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4131.32,22,,percent of total billed charges,,,,,,,,,14872.75,90,,percent of total billed charges,,,13682.93,82.8,,percent of total billed charges,,,14046.49,85,,percent of total billed charges,,,,,,,,,14542.25,88,,percent of total billed charges,,,,,,,,,12625.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4131.32,22,,percent of total billed charges,,,15038,91,,percent of total billed charges,,,15699.02,95,,percent of total billed charges,,,13715.98,83,,percent of total billed charges,,,13715.98,83,,percent of total billed charges,,,,,,,,,,,,,,,13715.98,83,,percent of total billed charges,,,15699.02,95,,percent of total billed charges,,,14872.75,90,,percent of total billed charges,,,14872.75,90,,percent of total billed charges,,,13550.73,82,,percent of total billed charges,,,14872.75,90,,percent of total billed charges,,,14046.49,85,,percent of total billed charges,,4131.32,15699.02,
SYNTHES SCREW LOCKING 4.0 X 30MM,30183750,CDM,,,278,RC,outpatient,,1640.93,1640.93,,1393.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,410.23,22,,percent of total billed charges,,,,,,,,,1476.84,90,,percent of total billed charges,,,1358.69,82.8,,percent of total billed charges,,,1394.79,85,,percent of total billed charges,,,,,,,,,1444.02,88,,percent of total billed charges,,,,,,,,,1253.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,410.23,22,,percent of total billed charges,,,1493.25,91,,percent of total billed charges,,,1558.88,95,,percent of total billed charges,,,1361.97,83,,percent of total billed charges,,,1361.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1361.97,83,,percent of total billed charges,,,1558.88,95,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1345.56,82,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1394.79,85,,percent of total billed charges,,410.23,1558.88,
SYNTHES BLADE SPIRAL 34MM,30183751,CDM,,,278,RC,outpatient,,5060.9,5060.9,,4296.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1265.23,22,,percent of total billed charges,,,,,,,,,4554.81,90,,percent of total billed charges,,,4190.43,82.8,,percent of total billed charges,,,4301.77,85,,percent of total billed charges,,,,,,,,,4453.59,88,,percent of total billed charges,,,,,,,,,3866.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1265.23,22,,percent of total billed charges,,,4605.42,91,,percent of total billed charges,,,4807.86,95,,percent of total billed charges,,,4200.55,83,,percent of total billed charges,,,4200.55,83,,percent of total billed charges,,,,,,,,,,,,,,,4200.55,83,,percent of total billed charges,,,4807.86,95,,percent of total billed charges,,,4554.81,90,,percent of total billed charges,,,4554.81,90,,percent of total billed charges,,,4149.94,82,,percent of total billed charges,,,4554.81,90,,percent of total billed charges,,,4301.77,85,,percent of total billed charges,,1265.23,4807.86,
INVUITY PHONTONSABER Y METAL TIP,30183752,CDM,,,270,RC,outpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,528.13,22,,percent of total billed charges,,,,,,,,,1901.25,90,,percent of total billed charges,,,1749.15,82.8,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,528.13,22,,percent of total billed charges,,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,528.13,2006.88,
GRACILIS TENDON STRAND,30183753,CDM,,,270,RC,outpatient,,5720,5720,,4856.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1430,22,,percent of total billed charges,,,,,,,,,5148,90,,percent of total billed charges,,,4736.16,82.8,,percent of total billed charges,,,4862,85,,percent of total billed charges,,,,,,,,,5033.6,88,,percent of total billed charges,,,,,,,,,4370.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1430,22,,percent of total billed charges,,,5205.2,91,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4747.6,83,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4690.4,82,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4862,85,,percent of total billed charges,,1430,5434,
INVUITY PHOTONSABER Y TAPER TIP,30183754,CDM,,,270,RC,outpatient,,1982.5,1982.5,,1683.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,495.63,22,,percent of total billed charges,,,,,,,,,1784.25,90,,percent of total billed charges,,,1641.51,82.8,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,,,,,,,,1744.6,88,,percent of total billed charges,,,,,,,,,1514.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,495.63,22,,percent of total billed charges,,,1804.08,91,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1645.48,83,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1625.65,82,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,495.63,1883.38,
DEPUY STEM FLUTED UNIV 75 X 18,30183755,CDM,,,278,RC,outpatient,,9024.34,9024.34,,7661.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2256.09,22,,percent of total billed charges,,,,,,,,,8121.91,90,,percent of total billed charges,,,7472.15,82.8,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,,,,,,,,7941.42,88,,percent of total billed charges,,,,,,,,,6894.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2256.09,22,,percent of total billed charges,,,8212.15,91,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,,,,,,,,,,,,,7490.2,83,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7399.96,82,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,2256.09,8573.12,
STRYKER CANNULA VENOM 18G 150MM 10MM,30183757,CDM,,,270,RC,outpatient,,511.25,511.25,,434.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.81,22,,percent of total billed charges,,,,,,,,,460.13,90,,percent of total billed charges,,,423.32,82.8,,percent of total billed charges,,,434.56,85,,percent of total billed charges,,,,,,,,,449.9,88,,percent of total billed charges,,,,,,,,,390.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.81,22,,percent of total billed charges,,,465.24,91,,percent of total billed charges,,,485.69,95,,percent of total billed charges,,,424.34,83,,percent of total billed charges,,,424.34,83,,percent of total billed charges,,,,,,,,,,,,,,,424.34,83,,percent of total billed charges,,,485.69,95,,percent of total billed charges,,,460.13,90,,percent of total billed charges,,,460.13,90,,percent of total billed charges,,,419.23,82,,percent of total billed charges,,,460.13,90,,percent of total billed charges,,,434.56,85,,percent of total billed charges,,127.81,485.69,
MEDTRONIC RV LEAD 52CM,30183758,CDM,,,278,RC,outpatient,,5310.5,5310.5,,4508.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1327.63,22,,percent of total billed charges,,,,,,,,,4779.45,90,,percent of total billed charges,,,4397.09,82.8,,percent of total billed charges,,,4513.93,85,,percent of total billed charges,,,,,,,,,4673.24,88,,percent of total billed charges,,,,,,,,,4057.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1327.63,22,,percent of total billed charges,,,4832.56,91,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4407.72,83,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4354.61,82,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4513.93,85,,percent of total billed charges,,1327.63,5044.98,
MEDTRONIC ATRIAL LEAD 45CM,30183759,CDM,,,278,RC,outpatient,,5310.5,5310.5,,4508.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1327.63,22,,percent of total billed charges,,,,,,,,,4779.45,90,,percent of total billed charges,,,4397.09,82.8,,percent of total billed charges,,,4513.93,85,,percent of total billed charges,,,,,,,,,4673.24,88,,percent of total billed charges,,,,,,,,,4057.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1327.63,22,,percent of total billed charges,,,4832.56,91,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4407.72,83,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4354.61,82,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4513.93,85,,percent of total billed charges,,1327.63,5044.98,
MEDTRONIC PULSE GENERATOR,30183760,CDM,,,278,RC,outpatient,,36517,36517,,31002.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9129.25,22,,percent of total billed charges,,,,,,,,,32865.3,90,,percent of total billed charges,,,30236.08,82.8,,percent of total billed charges,,,31039.45,85,,percent of total billed charges,,,,,,,,,32134.96,88,,percent of total billed charges,,,,,,,,,27898.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9129.25,22,,percent of total billed charges,,,33230.47,91,,percent of total billed charges,,,34691.15,95,,percent of total billed charges,,,30309.11,83,,percent of total billed charges,,,30309.11,83,,percent of total billed charges,,,,,,,,,,,,,,,30309.11,83,,percent of total billed charges,,,34691.15,95,,percent of total billed charges,,,32865.3,90,,percent of total billed charges,,,32865.3,90,,percent of total billed charges,,,29943.94,82,,percent of total billed charges,,,32865.3,90,,percent of total billed charges,,,31039.45,85,,percent of total billed charges,,9129.25,34691.15,
CONMED SMART NAIL 1.5 X 16,30183761,CDM,,,278,RC,outpatient,,955.96,955.96,,811.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,238.99,22,,percent of total billed charges,,,,,,,,,860.36,90,,percent of total billed charges,,,791.53,82.8,,percent of total billed charges,,,812.57,85,,percent of total billed charges,,,,,,,,,841.24,88,,percent of total billed charges,,,,,,,,,730.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,238.99,22,,percent of total billed charges,,,869.92,91,,percent of total billed charges,,,908.16,95,,percent of total billed charges,,,793.45,83,,percent of total billed charges,,,793.45,83,,percent of total billed charges,,,,,,,,,,,,,,,793.45,83,,percent of total billed charges,,,908.16,95,,percent of total billed charges,,,860.36,90,,percent of total billed charges,,,860.36,90,,percent of total billed charges,,,783.89,82,,percent of total billed charges,,,860.36,90,,percent of total billed charges,,,812.57,85,,percent of total billed charges,,238.99,908.16,
JURGAN BALL - DRK BLUE,30183762,CDM,,,270,RC,outpatient,,48.2,48.2,,40.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.05,22,,percent of total billed charges,,,,,,,,,43.38,90,,percent of total billed charges,,,39.91,82.8,,percent of total billed charges,,,40.97,85,,percent of total billed charges,,,,,,,,,42.42,88,,percent of total billed charges,,,,,,,,,36.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.05,22,,percent of total billed charges,,,43.86,91,,percent of total billed charges,,,45.79,95,,percent of total billed charges,,,40.01,83,,percent of total billed charges,,,40.01,83,,percent of total billed charges,,,,,,,,,,,,,,,40.01,83,,percent of total billed charges,,,45.79,95,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,39.52,82,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,40.97,85,,percent of total billed charges,,12.05,45.79,
SYNTHES L PLATE 3 HOLE 2.7LCP 2 HOLE HEA,30183763,CDM,,,278,RC,outpatient,,3674.13,3674.13,,3119.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,918.53,22,,percent of total billed charges,,,,,,,,,3306.72,90,,percent of total billed charges,,,3042.18,82.8,,percent of total billed charges,,,3123.01,85,,percent of total billed charges,,,,,,,,,3233.23,88,,percent of total billed charges,,,,,,,,,2807.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,918.53,22,,percent of total billed charges,,,3343.46,91,,percent of total billed charges,,,3490.42,95,,percent of total billed charges,,,3049.53,83,,percent of total billed charges,,,3049.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3049.53,83,,percent of total billed charges,,,3490.42,95,,percent of total billed charges,,,3306.72,90,,percent of total billed charges,,,3306.72,90,,percent of total billed charges,,,3012.79,82,,percent of total billed charges,,,3306.72,90,,percent of total billed charges,,,3123.01,85,,percent of total billed charges,,918.53,3490.42,
SYNTHES NORIAN INJECTABLE DRILLABLE 5CC,30183765,CDM,,,270,RC,outpatient,,12895.35,12895.35,,10948.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3223.84,22,,percent of total billed charges,,,,,,,,,11605.82,90,,percent of total billed charges,,,10677.35,82.8,,percent of total billed charges,,,10961.05,85,,percent of total billed charges,,,,,,,,,11347.91,88,,percent of total billed charges,,,,,,,,,9852.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3223.84,22,,percent of total billed charges,,,11734.77,91,,percent of total billed charges,,,12250.58,95,,percent of total billed charges,,,10703.14,83,,percent of total billed charges,,,10703.14,83,,percent of total billed charges,,,,,,,,,,,,,,,10703.14,83,,percent of total billed charges,,,12250.58,95,,percent of total billed charges,,,11605.82,90,,percent of total billed charges,,,11605.82,90,,percent of total billed charges,,,10574.19,82,,percent of total billed charges,,,11605.82,90,,percent of total billed charges,,,10961.05,85,,percent of total billed charges,,3223.84,12250.58,
HICKMAN 9FR DUAL LUMEN CATHETER W/INTROD,30183766,CDM,,,270,RC,outpatient,,1227.2,1227.2,,1041.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,306.8,22,,percent of total billed charges,,,,,,,,,1104.48,90,,percent of total billed charges,,,1016.12,82.8,,percent of total billed charges,,,1043.12,85,,percent of total billed charges,,,,,,,,,1079.94,88,,percent of total billed charges,,,,,,,,,937.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,306.8,22,,percent of total billed charges,,,1116.75,91,,percent of total billed charges,,,1165.84,95,,percent of total billed charges,,,1018.58,83,,percent of total billed charges,,,1018.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1018.58,83,,percent of total billed charges,,,1165.84,95,,percent of total billed charges,,,1104.48,90,,percent of total billed charges,,,1104.48,90,,percent of total billed charges,,,1006.3,82,,percent of total billed charges,,,1104.48,90,,percent of total billed charges,,,1043.12,85,,percent of total billed charges,,306.8,1165.84,
BREG BRACE T SCOPE KNEE LG,30183767,CDM,,,270,RC,outpatient,,530.18,530.18,,450.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.55,22,,percent of total billed charges,,,,,,,,,477.16,90,,percent of total billed charges,,,438.99,82.8,,percent of total billed charges,,,450.65,85,,percent of total billed charges,,,,,,,,,466.56,88,,percent of total billed charges,,,,,,,,,405.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.55,22,,percent of total billed charges,,,482.46,91,,percent of total billed charges,,,503.67,95,,percent of total billed charges,,,440.05,83,,percent of total billed charges,,,440.05,83,,percent of total billed charges,,,,,,,,,,,,,,,440.05,83,,percent of total billed charges,,,503.67,95,,percent of total billed charges,,,477.16,90,,percent of total billed charges,,,477.16,90,,percent of total billed charges,,,434.75,82,,percent of total billed charges,,,477.16,90,,percent of total billed charges,,,450.65,85,,percent of total billed charges,,132.55,503.67,
BREG BRACE T SCOPE KNEE XLG,30183768,CDM,,,270,RC,outpatient,,686.28,686.28,,582.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,171.57,22,,percent of total billed charges,,,,,,,,,617.65,90,,percent of total billed charges,,,568.24,82.8,,percent of total billed charges,,,583.34,85,,percent of total billed charges,,,,,,,,,603.93,88,,percent of total billed charges,,,,,,,,,524.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,171.57,22,,percent of total billed charges,,,624.51,91,,percent of total billed charges,,,651.97,95,,percent of total billed charges,,,569.61,83,,percent of total billed charges,,,569.61,83,,percent of total billed charges,,,,,,,,,,,,,,,569.61,83,,percent of total billed charges,,,651.97,95,,percent of total billed charges,,,617.65,90,,percent of total billed charges,,,617.65,90,,percent of total billed charges,,,562.75,82,,percent of total billed charges,,,617.65,90,,percent of total billed charges,,,583.34,85,,percent of total billed charges,,171.57,651.97,
DEPUY FEMUR SIGMA PS RT SZ6,30183769,CDM,,,278,RC,outpatient,,23868.72,23868.72,,20264.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5967.18,22,,percent of total billed charges,,,,,,,,,21481.85,90,,percent of total billed charges,,,19763.3,82.8,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,,,,,,,,21004.47,88,,percent of total billed charges,,,,,,,,,18235.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5967.18,22,,percent of total billed charges,,,21720.54,91,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19811.04,83,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,19572.35,82,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,5967.18,22675.28,
DEPUY STEM CORAIL COLLARED SZ8,30183770,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
ELECTRODE CUTTING MONO 26FR,30183771,CDM,,,270,RC,outpatient,,648.45,648.45,,550.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,162.11,22,,percent of total billed charges,,,,,,,,,583.61,90,,percent of total billed charges,,,536.92,82.8,,percent of total billed charges,,,551.18,85,,percent of total billed charges,,,,,,,,,570.64,88,,percent of total billed charges,,,,,,,,,495.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,162.11,22,,percent of total billed charges,,,590.09,91,,percent of total billed charges,,,616.03,95,,percent of total billed charges,,,538.21,83,,percent of total billed charges,,,538.21,83,,percent of total billed charges,,,,,,,,,,,,,,,538.21,83,,percent of total billed charges,,,616.03,95,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,531.73,82,,percent of total billed charges,,,583.61,90,,percent of total billed charges,,,551.18,85,,percent of total billed charges,,162.11,616.03,
ESWL SERVICES BILATERAL- UNITED SHOCKWA,30183772,CDM,,,270,RC,outpatient,,13650,13650,,11588.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3412.5,22,,percent of total billed charges,,,,,,,,,12285,90,,percent of total billed charges,,,11302.2,82.8,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,,,,,,,,12012,88,,percent of total billed charges,,,,,,,,,10428.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3412.5,22,,percent of total billed charges,,,12421.5,91,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,,,,,,,,,,,,,11329.5,83,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11193,82,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,3412.5,12967.5,
SYNTHES SCREW LOCKING 5.0X30MM,30183773,CDM,,,278,RC,outpatient,,1370.2,1370.2,,1163.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,342.55,22,,percent of total billed charges,,,,,,,,,1233.18,90,,percent of total billed charges,,,1134.53,82.8,,percent of total billed charges,,,1164.67,85,,percent of total billed charges,,,,,,,,,1205.78,88,,percent of total billed charges,,,,,,,,,1046.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,342.55,22,,percent of total billed charges,,,1246.88,91,,percent of total billed charges,,,1301.69,95,,percent of total billed charges,,,1137.27,83,,percent of total billed charges,,,1137.27,83,,percent of total billed charges,,,,,,,,,,,,,,,1137.27,83,,percent of total billed charges,,,1301.69,95,,percent of total billed charges,,,1233.18,90,,percent of total billed charges,,,1233.18,90,,percent of total billed charges,,,1123.56,82,,percent of total billed charges,,,1233.18,90,,percent of total billed charges,,,1164.67,85,,percent of total billed charges,,342.55,1301.69,
SYNTHES PLATE NARROW 7-HOLE 4.5MM,30183774,CDM,,,278,RC,outpatient,,4248.73,4248.73,,3607.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1062.18,22,,percent of total billed charges,,,,,,,,,3823.86,90,,percent of total billed charges,,,3517.95,82.8,,percent of total billed charges,,,3611.42,85,,percent of total billed charges,,,,,,,,,3738.88,88,,percent of total billed charges,,,,,,,,,3246.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1062.18,22,,percent of total billed charges,,,3866.34,91,,percent of total billed charges,,,4036.29,95,,percent of total billed charges,,,3526.45,83,,percent of total billed charges,,,3526.45,83,,percent of total billed charges,,,,,,,,,,,,,,,3526.45,83,,percent of total billed charges,,,4036.29,95,,percent of total billed charges,,,3823.86,90,,percent of total billed charges,,,3823.86,90,,percent of total billed charges,,,3483.96,82,,percent of total billed charges,,,3823.86,90,,percent of total billed charges,,,3611.42,85,,percent of total billed charges,,1062.18,4036.29,
ZIMMER SCREW HEX DRIVER 2MM DISP.,30183775,CDM,,,270,RC,outpatient,,845,845,,717.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,211.25,22,,percent of total billed charges,,,,,,,,,760.5,90,,percent of total billed charges,,,699.66,82.8,,percent of total billed charges,,,718.25,85,,percent of total billed charges,,,,,,,,,743.6,88,,percent of total billed charges,,,,,,,,,645.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,211.25,22,,percent of total billed charges,,,768.95,91,,percent of total billed charges,,,802.75,95,,percent of total billed charges,,,701.35,83,,percent of total billed charges,,,701.35,83,,percent of total billed charges,,,,,,,,,,,,,,,701.35,83,,percent of total billed charges,,,802.75,95,,percent of total billed charges,,,760.5,90,,percent of total billed charges,,,760.5,90,,percent of total billed charges,,,692.9,82,,percent of total billed charges,,,760.5,90,,percent of total billed charges,,,718.25,85,,percent of total billed charges,,211.25,802.75,
ZIMMER FEMUR RIGHT SZ E,30183776,CDM,,,278,RC,outpatient,,40306.83,40306.83,,34220.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10076.71,22,,percent of total billed charges,,,,,,,,,36276.15,90,,percent of total billed charges,,,33374.06,82.8,,percent of total billed charges,,,34260.81,85,,percent of total billed charges,,,,,,,,,35470.01,88,,percent of total billed charges,,,,,,,,,30794.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10076.71,22,,percent of total billed charges,,,36679.22,91,,percent of total billed charges,,,38291.49,95,,percent of total billed charges,,,33454.67,83,,percent of total billed charges,,,33454.67,83,,percent of total billed charges,,,,,,,,,,,,,,,33454.67,83,,percent of total billed charges,,,38291.49,95,,percent of total billed charges,,,36276.15,90,,percent of total billed charges,,,36276.15,90,,percent of total billed charges,,,33051.6,82,,percent of total billed charges,,,36276.15,90,,percent of total billed charges,,,34260.81,85,,percent of total billed charges,,10076.71,38291.49,
ZIMMER LOCK ART SURG 14MM EF 5-6/GREEN,30183777,CDM,,,278,RC,outpatient,,13533.13,13533.13,,11489.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3383.28,22,,percent of total billed charges,,,,,,,,,12179.82,90,,percent of total billed charges,,,11205.43,82.8,,percent of total billed charges,,,11503.16,85,,percent of total billed charges,,,,,,,,,11909.15,88,,percent of total billed charges,,,,,,,,,10339.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3383.28,22,,percent of total billed charges,,,12315.15,91,,percent of total billed charges,,,12856.47,95,,percent of total billed charges,,,11232.5,83,,percent of total billed charges,,,11232.5,83,,percent of total billed charges,,,,,,,,,,,,,,,11232.5,83,,percent of total billed charges,,,12856.47,95,,percent of total billed charges,,,12179.82,90,,percent of total billed charges,,,12179.82,90,,percent of total billed charges,,,11097.17,82,,percent of total billed charges,,,12179.82,90,,percent of total billed charges,,,11503.16,85,,percent of total billed charges,,3383.28,12856.47,
ZIMMER AUGMENT BLOCK SZ E 5MM,30183778,CDM,,,278,RC,outpatient,,7107.88,7107.88,,6034.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1776.97,22,,percent of total billed charges,,,,,,,,,6397.09,90,,percent of total billed charges,,,5885.32,82.8,,percent of total billed charges,,,6041.7,85,,percent of total billed charges,,,,,,,,,6254.93,88,,percent of total billed charges,,,,,,,,,5430.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1776.97,22,,percent of total billed charges,,,6468.17,91,,percent of total billed charges,,,6752.49,95,,percent of total billed charges,,,5899.54,83,,percent of total billed charges,,,5899.54,83,,percent of total billed charges,,,,,,,,,,,,,,,5899.54,83,,percent of total billed charges,,,6752.49,95,,percent of total billed charges,,,6397.09,90,,percent of total billed charges,,,6397.09,90,,percent of total billed charges,,,5828.46,82,,percent of total billed charges,,,6397.09,90,,percent of total billed charges,,,6041.7,85,,percent of total billed charges,,1776.97,6752.49,
ZIMMER STEM EXT. STRAIGHT 15X30,30183779,CDM,,,278,RC,outpatient,,7652.97,7652.97,,6497.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1913.24,22,,percent of total billed charges,,,,,,,,,6887.67,90,,percent of total billed charges,,,6336.66,82.8,,percent of total billed charges,,,6505.02,85,,percent of total billed charges,,,,,,,,,6734.61,88,,percent of total billed charges,,,,,,,,,5846.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1913.24,22,,percent of total billed charges,,,6964.2,91,,percent of total billed charges,,,7270.32,95,,percent of total billed charges,,,6351.97,83,,percent of total billed charges,,,6351.97,83,,percent of total billed charges,,,,,,,,,,,,,,,6351.97,83,,percent of total billed charges,,,7270.32,95,,percent of total billed charges,,,6887.67,90,,percent of total billed charges,,,6887.67,90,,percent of total billed charges,,,6275.44,82,,percent of total billed charges,,,6887.67,90,,percent of total billed charges,,,6505.02,85,,percent of total billed charges,,1913.24,7270.32,
SUTURE GORTEX 4N16A CV-4 36  1/2 TAPER P,30183780,CDM,,,270,RC,outpatient,,184,184,,156.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46,22,,percent of total billed charges,,,,,,,,,165.6,90,,percent of total billed charges,,,152.35,82.8,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,,,,,,,,161.92,88,,percent of total billed charges,,,,,,,,,140.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46,22,,percent of total billed charges,,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,,,,,,,,,,,,,152.72,83,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,150.88,82,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,46,174.8,
BIOMET HUMERAL VERSAMIL NAIL 8MM X 200MM,30183782,CDM,,,278,RC,outpatient,,14384.5,14384.5,,12212.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3596.13,22,,percent of total billed charges,,,,,,,,,12946.05,90,,percent of total billed charges,,,11910.37,82.8,,percent of total billed charges,,,12226.83,85,,percent of total billed charges,,,,,,,,,12658.36,88,,percent of total billed charges,,,,,,,,,10989.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3596.13,22,,percent of total billed charges,,,13089.9,91,,percent of total billed charges,,,13665.28,95,,percent of total billed charges,,,11939.14,83,,percent of total billed charges,,,11939.14,83,,percent of total billed charges,,,,,,,,,,,,,,,11939.14,83,,percent of total billed charges,,,13665.28,95,,percent of total billed charges,,,12946.05,90,,percent of total billed charges,,,12946.05,90,,percent of total billed charges,,,11795.29,82,,percent of total billed charges,,,12946.05,90,,percent of total billed charges,,,12226.83,85,,percent of total billed charges,,3596.13,13665.28,
ARTHREX FIBERWIRE #2 36.6MM 1/2 CIRCLE,30183783,CDM,,,270,RC,outpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,44,167.2,
MEDTRONIC PACEMAKER,30183785,CDM,,,278,RC,outpatient,,39659.82,39659.82,,33671.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9914.96,22,,percent of total billed charges,,,,,,,,,35693.84,90,,percent of total billed charges,,,32838.33,82.8,,percent of total billed charges,,,33710.85,85,,percent of total billed charges,,,,,,,,,34900.64,88,,percent of total billed charges,,,,,,,,,30300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9914.96,22,,percent of total billed charges,,,36090.44,91,,percent of total billed charges,,,37676.83,95,,percent of total billed charges,,,32917.65,83,,percent of total billed charges,,,32917.65,83,,percent of total billed charges,,,,,,,,,,,,,,,32917.65,83,,percent of total billed charges,,,37676.83,95,,percent of total billed charges,,,35693.84,90,,percent of total billed charges,,,35693.84,90,,percent of total billed charges,,,32521.05,82,,percent of total billed charges,,,35693.84,90,,percent of total billed charges,,,33710.85,85,,percent of total billed charges,,9914.96,37676.83,
SYNTHES PLATE DISTAL 5-HOLE LEFT,30183786,CDM,,,278,RC,outpatient,,6400.75,6400.75,,5434.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1600.19,22,,percent of total billed charges,,,,,,,,,5760.68,90,,percent of total billed charges,,,5299.82,82.8,,percent of total billed charges,,,5440.64,85,,percent of total billed charges,,,,,,,,,5632.66,88,,percent of total billed charges,,,,,,,,,4890.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1600.19,22,,percent of total billed charges,,,5824.68,91,,percent of total billed charges,,,6080.71,95,,percent of total billed charges,,,5312.62,83,,percent of total billed charges,,,5312.62,83,,percent of total billed charges,,,,,,,,,,,,,,,5312.62,83,,percent of total billed charges,,,6080.71,95,,percent of total billed charges,,,5760.68,90,,percent of total billed charges,,,5760.68,90,,percent of total billed charges,,,5248.62,82,,percent of total billed charges,,,5760.68,90,,percent of total billed charges,,,5440.64,85,,percent of total billed charges,,1600.19,6080.71,
DEPUY HEAD BIOLOX TS 28MM +15,30183787,CDM,,,278,RC,outpatient,,13897.78,13897.78,,11799.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3474.45,22,,percent of total billed charges,,,,,,,,,12508,90,,percent of total billed charges,,,11507.36,82.8,,percent of total billed charges,,,11813.11,85,,percent of total billed charges,,,,,,,,,12230.05,88,,percent of total billed charges,,,,,,,,,10617.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3474.45,22,,percent of total billed charges,,,12646.98,91,,percent of total billed charges,,,13202.89,95,,percent of total billed charges,,,11535.16,83,,percent of total billed charges,,,11535.16,83,,percent of total billed charges,,,,,,,,,,,,,,,11535.16,83,,percent of total billed charges,,,13202.89,95,,percent of total billed charges,,,12508,90,,percent of total billed charges,,,12508,90,,percent of total billed charges,,,11396.18,82,,percent of total billed charges,,,12508,90,,percent of total billed charges,,,11813.11,85,,percent of total billed charges,,3474.45,13202.89,
DEPUY SCREW NON LOCKING 30MM,30183788,CDM,,,278,RC,outpatient,,1330.16,1330.16,,1129.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,332.54,22,,percent of total billed charges,,,,,,,,,1197.14,90,,percent of total billed charges,,,1101.37,82.8,,percent of total billed charges,,,1130.64,85,,percent of total billed charges,,,,,,,,,1170.54,88,,percent of total billed charges,,,,,,,,,1016.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,332.54,22,,percent of total billed charges,,,1210.45,91,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,1104.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1104.03,83,,percent of total billed charges,,,1263.65,95,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1090.73,82,,percent of total billed charges,,,1197.14,90,,percent of total billed charges,,,1130.64,85,,percent of total billed charges,,332.54,1263.65,
SYNTHES PLATE DISTAL TIBIAL 6 HOLE RIGHT,30183789,CDM,,,278,RC,outpatient,,13039,13039,,11070.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3259.75,22,,percent of total billed charges,,,,,,,,,11735.1,90,,percent of total billed charges,,,10796.29,82.8,,percent of total billed charges,,,11083.15,85,,percent of total billed charges,,,,,,,,,11474.32,88,,percent of total billed charges,,,,,,,,,9961.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3259.75,22,,percent of total billed charges,,,11865.49,91,,percent of total billed charges,,,12387.05,95,,percent of total billed charges,,,10822.37,83,,percent of total billed charges,,,10822.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10822.37,83,,percent of total billed charges,,,12387.05,95,,percent of total billed charges,,,11735.1,90,,percent of total billed charges,,,11735.1,90,,percent of total billed charges,,,10691.98,82,,percent of total billed charges,,,11735.1,90,,percent of total billed charges,,,11083.15,85,,percent of total billed charges,,3259.75,12387.05,
SYNTHES SCREW LOCKING 3.5 X 26MM,30183790,CDM,,,278,RC,outpatient,,274.13,274.13,,232.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.53,22,,percent of total billed charges,,,,,,,,,246.72,90,,percent of total billed charges,,,226.98,82.8,,percent of total billed charges,,,233.01,85,,percent of total billed charges,,,,,,,,,241.23,88,,percent of total billed charges,,,,,,,,,209.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.53,22,,percent of total billed charges,,,249.46,91,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,,,,,,,,,,,,,227.53,83,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,224.79,82,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,233.01,85,,percent of total billed charges,,68.53,260.42,
SYNTHES SCREW LOCKING 3.5 X 45MM,30183791,CDM,,,278,RC,outpatient,,274.13,274.13,,232.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.53,22,,percent of total billed charges,,,,,,,,,246.72,90,,percent of total billed charges,,,226.98,82.8,,percent of total billed charges,,,233.01,85,,percent of total billed charges,,,,,,,,,241.23,88,,percent of total billed charges,,,,,,,,,209.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.53,22,,percent of total billed charges,,,249.46,91,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,,,,,,,,,,,,,227.53,83,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,224.79,82,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,233.01,85,,percent of total billed charges,,68.53,260.42,
SYNTHES SCREW LOCKING 3.5 X 40MM,30183792,CDM,,,278,RC,outpatient,,274.13,274.13,,232.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.53,22,,percent of total billed charges,,,,,,,,,246.72,90,,percent of total billed charges,,,226.98,82.8,,percent of total billed charges,,,233.01,85,,percent of total billed charges,,,,,,,,,241.23,88,,percent of total billed charges,,,,,,,,,209.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.53,22,,percent of total billed charges,,,249.46,91,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,,,,,,,,,,,,,227.53,83,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,224.79,82,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,233.01,85,,percent of total billed charges,,68.53,260.42,
SYNTHES SCREW LOCKING 3.5 X 32MM,30183793,CDM,,,278,RC,outpatient,,274.13,274.13,,232.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.53,22,,percent of total billed charges,,,,,,,,,246.72,90,,percent of total billed charges,,,226.98,82.8,,percent of total billed charges,,,233.01,85,,percent of total billed charges,,,,,,,,,241.23,88,,percent of total billed charges,,,,,,,,,209.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.53,22,,percent of total billed charges,,,249.46,91,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,,,,,,,,,,,,,227.53,83,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,224.79,82,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,233.01,85,,percent of total billed charges,,68.53,260.42,
SYNTHES SCREW LOCKING 3.5 X 28MM,30183794,CDM,,,278,RC,outpatient,,274.13,274.13,,232.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.53,22,,percent of total billed charges,,,,,,,,,246.72,90,,percent of total billed charges,,,226.98,82.8,,percent of total billed charges,,,233.01,85,,percent of total billed charges,,,,,,,,,241.23,88,,percent of total billed charges,,,,,,,,,209.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.53,22,,percent of total billed charges,,,249.46,91,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,227.53,83,,percent of total billed charges,,,,,,,,,,,,,,,227.53,83,,percent of total billed charges,,,260.42,95,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,224.79,82,,percent of total billed charges,,,246.72,90,,percent of total billed charges,,,233.01,85,,percent of total billed charges,,68.53,260.42,
DEPUY LINER CONSTRAINED +4 28 X 48,30183795,CDM,,,278,RC,outpatient,,36635.17,36635.17,,31103.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9158.79,22,,percent of total billed charges,,,,,,,,,32971.65,90,,percent of total billed charges,,,30333.92,82.8,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,,,,,,,,32238.95,88,,percent of total billed charges,,,,,,,,,27989.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9158.79,22,,percent of total billed charges,,,33338,91,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,30407.19,83,,percent of total billed charges,,,,,,,,,,,,,,,30407.19,83,,percent of total billed charges,,,34803.41,95,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,30040.84,82,,percent of total billed charges,,,32971.65,90,,percent of total billed charges,,,31139.89,85,,percent of total billed charges,,9158.79,34803.41,
S&N ENDO SCREW SOFT SILK 9 X 20,30183796,CDM,,,278,RC,outpatient,,1417,1417,,1203.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,354.25,22,,percent of total billed charges,,,,,,,,,1275.3,90,,percent of total billed charges,,,1173.28,82.8,,percent of total billed charges,,,1204.45,85,,percent of total billed charges,,,,,,,,,1246.96,88,,percent of total billed charges,,,,,,,,,1082.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,354.25,22,,percent of total billed charges,,,1289.47,91,,percent of total billed charges,,,1346.15,95,,percent of total billed charges,,,1176.11,83,,percent of total billed charges,,,1176.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1176.11,83,,percent of total billed charges,,,1346.15,95,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1161.94,82,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1204.45,85,,percent of total billed charges,,354.25,1346.15,
MENTOR MEMORYGEL BREAST IMPLANT RND MODE,30183797,CDM,,,278,RC,outpatient,,6370,6370,,5408.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1592.5,22,,percent of total billed charges,,,,,,,,,5733,90,,percent of total billed charges,,,5274.36,82.8,,percent of total billed charges,,,5414.5,85,,percent of total billed charges,,,,,,,,,5605.6,88,,percent of total billed charges,,,,,,,,,4866.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1592.5,22,,percent of total billed charges,,,5796.7,91,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5287.1,83,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5223.4,82,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5414.5,85,,percent of total billed charges,,1592.5,6051.5,
STRYKER ELECTRODE VENOM MONOP 150MM,30183800,CDM,,,270,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
DEPUY BONE CEMENT 3,30183802,CDM,,,270,RC,outpatient,,430.71,430.71,,365.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.68,22,,percent of total billed charges,,,,,,,,,387.64,90,,percent of total billed charges,,,356.63,82.8,,percent of total billed charges,,,366.1,85,,percent of total billed charges,,,,,,,,,379.02,88,,percent of total billed charges,,,,,,,,,329.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.68,22,,percent of total billed charges,,,391.95,91,,percent of total billed charges,,,409.17,95,,percent of total billed charges,,,357.49,83,,percent of total billed charges,,,357.49,83,,percent of total billed charges,,,,,,,,,,,,,,,357.49,83,,percent of total billed charges,,,409.17,95,,percent of total billed charges,,,387.64,90,,percent of total billed charges,,,387.64,90,,percent of total billed charges,,,353.18,82,,percent of total billed charges,,,387.64,90,,percent of total billed charges,,,366.1,85,,percent of total billed charges,,107.68,409.17,
SYNTHES SCREW LOCKING VA 2.4 X 12MM,30183803,CDM,,,278,RC,outpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,338.51,22,,percent of total billed charges,,,,,,,,,1218.62,90,,percent of total billed charges,,,1121.13,82.8,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,338.51,22,,percent of total billed charges,,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,338.51,1286.32,
SYNTHES PLATE 8 HOLE 112MM 3.5MM,30183807,CDM,,,278,RC,outpatient,,5116.15,5116.15,,4343.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1279.04,22,,percent of total billed charges,,,,,,,,,4604.54,90,,percent of total billed charges,,,4236.17,82.8,,percent of total billed charges,,,4348.73,85,,percent of total billed charges,,,,,,,,,4502.21,88,,percent of total billed charges,,,,,,,,,3908.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1279.04,22,,percent of total billed charges,,,4655.7,91,,percent of total billed charges,,,4860.34,95,,percent of total billed charges,,,4246.4,83,,percent of total billed charges,,,4246.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4246.4,83,,percent of total billed charges,,,4860.34,95,,percent of total billed charges,,,4604.54,90,,percent of total billed charges,,,4604.54,90,,percent of total billed charges,,,4195.24,82,,percent of total billed charges,,,4604.54,90,,percent of total billed charges,,,4348.73,85,,percent of total billed charges,,1279.04,4860.34,
SYNTHES TAP FOR SCREW CANCELLOUS 4.0,30183808,CDM,,,278,RC,outpatient,,2077.4,2077.4,,1763.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,519.35,22,,percent of total billed charges,,,,,,,,,1869.66,90,,percent of total billed charges,,,1720.09,82.8,,percent of total billed charges,,,1765.79,85,,percent of total billed charges,,,,,,,,,1828.11,88,,percent of total billed charges,,,,,,,,,1587.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,519.35,22,,percent of total billed charges,,,1890.43,91,,percent of total billed charges,,,1973.53,95,,percent of total billed charges,,,1724.24,83,,percent of total billed charges,,,1724.24,83,,percent of total billed charges,,,,,,,,,,,,,,,1724.24,83,,percent of total billed charges,,,1973.53,95,,percent of total billed charges,,,1869.66,90,,percent of total billed charges,,,1869.66,90,,percent of total billed charges,,,1703.47,82,,percent of total billed charges,,,1869.66,90,,percent of total billed charges,,,1765.79,85,,percent of total billed charges,,519.35,1973.53,
DEPUY FEMUR SZ 5 NARROW CR L,30183809,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY BONE CEMENT 1,30183810,CDM,,,270,RC,outpatient,,1352,1352,,1147.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,338,22,,percent of total billed charges,,,,,,,,,1216.8,90,,percent of total billed charges,,,1119.46,82.8,,percent of total billed charges,,,1149.2,85,,percent of total billed charges,,,,,,,,,1189.76,88,,percent of total billed charges,,,,,,,,,1032.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,338,22,,percent of total billed charges,,,1230.32,91,,percent of total billed charges,,,1284.4,95,,percent of total billed charges,,,1122.16,83,,percent of total billed charges,,,1122.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1122.16,83,,percent of total billed charges,,,1284.4,95,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1108.64,82,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1149.2,85,,percent of total billed charges,,338,1284.4,
DEPUY INSERT CR 5MM SZ 5,30183811,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY STEM FEMORAL 115X16MM,30183812,CDM,,,278,RC,outpatient,,9024.34,9024.34,,7661.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2256.09,22,,percent of total billed charges,,,,,,,,,8121.91,90,,percent of total billed charges,,,7472.15,82.8,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,,,,,,,,7941.42,88,,percent of total billed charges,,,,,,,,,6894.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2256.09,22,,percent of total billed charges,,,8212.15,91,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,,,,,,,,,,,,,7490.2,83,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7399.96,82,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,2256.09,8573.12,
DEPUY BONE HV CEMENT,30183813,CDM,,,270,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
SYNTHES SCREW CORTEX SELF TAPPING 1.5 X,30183814,CDM,,,278,RC,outpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.23,22,,percent of total billed charges,,,,,,,,,332.01,90,,percent of total billed charges,,,305.45,82.8,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.23,22,,percent of total billed charges,,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,92.23,350.46,
SYNTHES SCREW CORTEX 1.5 X 11MM SELF TAP,30183815,CDM,,,278,RC,outpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.23,22,,percent of total billed charges,,,,,,,,,332.01,90,,percent of total billed charges,,,305.45,82.8,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.23,22,,percent of total billed charges,,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,92.23,350.46,
SYNTHES SCREW CORTEX 2.0 X 9MM SELF TAP,30183816,CDM,,,278,RC,outpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.23,22,,percent of total billed charges,,,,,,,,,332.01,90,,percent of total billed charges,,,305.45,82.8,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.23,22,,percent of total billed charges,,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,92.23,350.46,
SYNTHES SCREW CORTEX 1.5 X 9MM SELF TAP,30183817,CDM,,,278,RC,outpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.23,22,,percent of total billed charges,,,,,,,,,332.01,90,,percent of total billed charges,,,305.45,82.8,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.23,22,,percent of total billed charges,,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,92.23,350.46,
SYNTHES SCREW CORTEX 1.5 X 12MM SELF TAP,30183818,CDM,,,278,RC,outpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.23,22,,percent of total billed charges,,,,,,,,,332.01,90,,percent of total billed charges,,,305.45,82.8,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.23,22,,percent of total billed charges,,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,92.23,350.46,
SYNTHES SCREW CORTEX 1.5 X 13MM SELF TAP,30183819,CDM,,,278,RC,outpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.23,22,,percent of total billed charges,,,,,,,,,332.01,90,,percent of total billed charges,,,305.45,82.8,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.23,22,,percent of total billed charges,,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,92.23,350.46,
SYNTHES DRILL BIT J-LATCH 1.0MM,30183820,CDM,,,278,RC,outpatient,,943.67,943.67,,801.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.92,22,,percent of total billed charges,,,,,,,,,849.3,90,,percent of total billed charges,,,781.36,82.8,,percent of total billed charges,,,802.12,85,,percent of total billed charges,,,,,,,,,830.43,88,,percent of total billed charges,,,,,,,,,720.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.92,22,,percent of total billed charges,,,858.74,91,,percent of total billed charges,,,896.49,95,,percent of total billed charges,,,783.25,83,,percent of total billed charges,,,783.25,83,,percent of total billed charges,,,,,,,,,,,,,,,783.25,83,,percent of total billed charges,,,896.49,95,,percent of total billed charges,,,849.3,90,,percent of total billed charges,,,849.3,90,,percent of total billed charges,,,773.81,82,,percent of total billed charges,,,849.3,90,,percent of total billed charges,,,802.12,85,,percent of total billed charges,,235.92,896.49,
SYNTHES DRILL BIT J-LATCH 1.3MM,30183821,CDM,,,278,RC,outpatient,,767.55,767.55,,651.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,191.89,22,,percent of total billed charges,,,,,,,,,690.8,90,,percent of total billed charges,,,635.53,82.8,,percent of total billed charges,,,652.42,85,,percent of total billed charges,,,,,,,,,675.44,88,,percent of total billed charges,,,,,,,,,586.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,191.89,22,,percent of total billed charges,,,698.47,91,,percent of total billed charges,,,729.17,95,,percent of total billed charges,,,637.07,83,,percent of total billed charges,,,637.07,83,,percent of total billed charges,,,,,,,,,,,,,,,637.07,83,,percent of total billed charges,,,729.17,95,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,629.39,82,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,652.42,85,,percent of total billed charges,,191.89,729.17,
SYNTHES DRILL BIT J-LATCH 1.5MM,30183822,CDM,,,278,RC,outpatient,,767.55,767.55,,651.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,191.89,22,,percent of total billed charges,,,,,,,,,690.8,90,,percent of total billed charges,,,635.53,82.8,,percent of total billed charges,,,652.42,85,,percent of total billed charges,,,,,,,,,675.44,88,,percent of total billed charges,,,,,,,,,586.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,191.89,22,,percent of total billed charges,,,698.47,91,,percent of total billed charges,,,729.17,95,,percent of total billed charges,,,637.07,83,,percent of total billed charges,,,637.07,83,,percent of total billed charges,,,,,,,,,,,,,,,637.07,83,,percent of total billed charges,,,729.17,95,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,629.39,82,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,652.42,85,,percent of total billed charges,,191.89,729.17,
DEPUY INSERT RP PS 15MM SZ 5,30183823,CDM,,,278,RC,outpatient,,11480.69,11480.69,,9747.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2870.17,22,,percent of total billed charges,,,,,,,,,10332.62,90,,percent of total billed charges,,,9506.01,82.8,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,,,,,,,,10103.01,88,,percent of total billed charges,,,,,,,,,8771.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2870.17,22,,percent of total billed charges,,,10447.43,91,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,,,,,,,,,,,,,9528.97,83,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9414.17,82,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,2870.17,10906.66,
DEPUY FEMUR CR  SZ 6 NARROW,30183824,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY FEMUR CR  SZ 6 NARROW LEFT,30183825,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
SYNTHES PLATE DORSAL L 2.4MM 2X3HOLE,30183827,CDM,,,278,RC,outpatient,,6022.25,6022.25,,5112.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1505.56,22,,percent of total billed charges,,,,,,,,,5420.03,90,,percent of total billed charges,,,4986.42,82.8,,percent of total billed charges,,,5118.91,85,,percent of total billed charges,,,,,,,,,5299.58,88,,percent of total billed charges,,,,,,,,,4601,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1505.56,22,,percent of total billed charges,,,5480.25,91,,percent of total billed charges,,,5721.14,95,,percent of total billed charges,,,4998.47,83,,percent of total billed charges,,,4998.47,83,,percent of total billed charges,,,,,,,,,,,,,,,4998.47,83,,percent of total billed charges,,,5721.14,95,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,4938.25,82,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,5118.91,85,,percent of total billed charges,,1505.56,5721.14,
SYNTHES PLATE DORSAL L 2.4MM 2X5HOLE,30183828,CDM,,,278,RC,outpatient,,6337.18,6337.18,,5380.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1584.3,22,,percent of total billed charges,,,,,,,,,5703.46,90,,percent of total billed charges,,,5247.19,82.8,,percent of total billed charges,,,5386.6,85,,percent of total billed charges,,,,,,,,,5576.72,88,,percent of total billed charges,,,,,,,,,4841.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1584.3,22,,percent of total billed charges,,,5766.83,91,,percent of total billed charges,,,6020.32,95,,percent of total billed charges,,,5259.86,83,,percent of total billed charges,,,5259.86,83,,percent of total billed charges,,,,,,,,,,,,,,,5259.86,83,,percent of total billed charges,,,6020.32,95,,percent of total billed charges,,,5703.46,90,,percent of total billed charges,,,5703.46,90,,percent of total billed charges,,,5196.49,82,,percent of total billed charges,,,5703.46,90,,percent of total billed charges,,,5386.6,85,,percent of total billed charges,,1584.3,6020.32,
SYNTHES PLATE DORSAL R 2.4MM 22MM,30183829,CDM,,,278,RC,outpatient,,6491.88,6491.88,,5511.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1622.97,22,,percent of total billed charges,,,,,,,,,5842.69,90,,percent of total billed charges,,,5375.28,82.8,,percent of total billed charges,,,5518.1,85,,percent of total billed charges,,,,,,,,,5712.85,88,,percent of total billed charges,,,,,,,,,4959.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1622.97,22,,percent of total billed charges,,,5907.61,91,,percent of total billed charges,,,6167.29,95,,percent of total billed charges,,,5388.26,83,,percent of total billed charges,,,5388.26,83,,percent of total billed charges,,,,,,,,,,,,,,,5388.26,83,,percent of total billed charges,,,6167.29,95,,percent of total billed charges,,,5842.69,90,,percent of total billed charges,,,5842.69,90,,percent of total billed charges,,,5323.34,82,,percent of total billed charges,,,5842.69,90,,percent of total billed charges,,,5518.1,85,,percent of total billed charges,,1622.97,6167.29,
DJO PATELLA E+9 X 38MM,30183830,CDM,,,278,RC,outpatient,,9217,9217,,7825.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2304.25,22,,percent of total billed charges,,,,,,,,,8295.3,90,,percent of total billed charges,,,7631.68,82.8,,percent of total billed charges,,,7834.45,85,,percent of total billed charges,,,,,,,,,8110.96,88,,percent of total billed charges,,,,,,,,,7041.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2304.25,22,,percent of total billed charges,,,8387.47,91,,percent of total billed charges,,,8756.15,95,,percent of total billed charges,,,7650.11,83,,percent of total billed charges,,,7650.11,83,,percent of total billed charges,,,,,,,,,,,,,,,7650.11,83,,percent of total billed charges,,,8756.15,95,,percent of total billed charges,,,8295.3,90,,percent of total billed charges,,,8295.3,90,,percent of total billed charges,,,7557.94,82,,percent of total billed charges,,,8295.3,90,,percent of total billed charges,,,7834.45,85,,percent of total billed charges,,2304.25,8756.15,
DJO INSERT 15MM 12 RIGHT,30183831,CDM,,,278,RC,outpatient,,18089.5,18089.5,,15357.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4522.38,22,,percent of total billed charges,,,,,,,,,16280.55,90,,percent of total billed charges,,,14978.11,82.8,,percent of total billed charges,,,15376.08,85,,percent of total billed charges,,,,,,,,,15918.76,88,,percent of total billed charges,,,,,,,,,13820.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4522.38,22,,percent of total billed charges,,,16461.45,91,,percent of total billed charges,,,17185.03,95,,percent of total billed charges,,,15014.29,83,,percent of total billed charges,,,15014.29,83,,percent of total billed charges,,,,,,,,,,,,,,,15014.29,83,,percent of total billed charges,,,17185.03,95,,percent of total billed charges,,,16280.55,90,,percent of total billed charges,,,16280.55,90,,percent of total billed charges,,,14833.39,82,,percent of total billed charges,,,16280.55,90,,percent of total billed charges,,,15376.08,85,,percent of total billed charges,,4522.38,17185.03,
DJO STEM 100 X 16MM TIBIAL REVISION,30183832,CDM,,,278,RC,outpatient,,10042.5,10042.5,,8526.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2510.63,22,,percent of total billed charges,,,,,,,,,9038.25,90,,percent of total billed charges,,,8315.19,82.8,,percent of total billed charges,,,8536.13,85,,percent of total billed charges,,,,,,,,,8837.4,88,,percent of total billed charges,,,,,,,,,7672.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2510.63,22,,percent of total billed charges,,,9138.68,91,,percent of total billed charges,,,9540.38,95,,percent of total billed charges,,,8335.28,83,,percent of total billed charges,,,8335.28,83,,percent of total billed charges,,,,,,,,,,,,,,,8335.28,83,,percent of total billed charges,,,9540.38,95,,percent of total billed charges,,,9038.25,90,,percent of total billed charges,,,9038.25,90,,percent of total billed charges,,,8234.85,82,,percent of total billed charges,,,9038.25,90,,percent of total billed charges,,,8536.13,85,,percent of total billed charges,,2510.63,9540.38,
DJO BASE STEM TIBIAL REV 10 RIGHT,30183833,CDM,,,278,RC,outpatient,,26110.5,26110.5,,22167.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6527.63,22,,percent of total billed charges,,,,,,,,,23499.45,90,,percent of total billed charges,,,21619.49,82.8,,percent of total billed charges,,,22193.93,85,,percent of total billed charges,,,,,,,,,22977.24,88,,percent of total billed charges,,,,,,,,,19948.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6527.63,22,,percent of total billed charges,,,23760.56,91,,percent of total billed charges,,,24804.98,95,,percent of total billed charges,,,21671.72,83,,percent of total billed charges,,,21671.72,83,,percent of total billed charges,,,,,,,,,,,,,,,21671.72,83,,percent of total billed charges,,,24804.98,95,,percent of total billed charges,,,23499.45,90,,percent of total billed charges,,,23499.45,90,,percent of total billed charges,,,21410.61,82,,percent of total billed charges,,,23499.45,90,,percent of total billed charges,,,22193.93,85,,percent of total billed charges,,6527.63,24804.98,
ZIMMER LPS ART SURFACE 12MM EF 3-4,30183834,CDM,,,278,RC,outpatient,,12733.57,12733.57,,10810.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3183.39,22,,percent of total billed charges,,,,,,,,,11460.21,90,,percent of total billed charges,,,10543.4,82.8,,percent of total billed charges,,,10823.53,85,,percent of total billed charges,,,,,,,,,11205.54,88,,percent of total billed charges,,,,,,,,,9728.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3183.39,22,,percent of total billed charges,,,11587.55,91,,percent of total billed charges,,,12096.89,95,,percent of total billed charges,,,10568.86,83,,percent of total billed charges,,,10568.86,83,,percent of total billed charges,,,,,,,,,,,,,,,10568.86,83,,percent of total billed charges,,,12096.89,95,,percent of total billed charges,,,11460.21,90,,percent of total billed charges,,,11460.21,90,,percent of total billed charges,,,10441.53,82,,percent of total billed charges,,,11460.21,90,,percent of total billed charges,,,10823.53,85,,percent of total billed charges,,3183.39,12096.89,
DEPUY DISTAL AUGMENT 5MM,30183837,CDM,,,278,RC,outpatient,,8177.85,8177.85,,6942.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.46,22,,percent of total billed charges,,,,,,,,,7360.07,90,,percent of total billed charges,,,6771.26,82.8,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,,,,,,,,7196.51,88,,percent of total billed charges,,,,,,,,,6247.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.46,22,,percent of total billed charges,,,7441.84,91,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,6787.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6787.62,83,,percent of total billed charges,,,7768.96,95,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6705.84,82,,percent of total billed charges,,,7360.07,90,,percent of total billed charges,,,6951.17,85,,percent of total billed charges,,2044.46,7768.96,
DEPUY ATTUNE FEMUR CR SZ 4 LT,30183840,CDM,,,278,RC,outpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7070.46,22,,percent of total billed charges,,,,,,,,,25453.65,90,,percent of total billed charges,,,23417.36,82.8,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7070.46,22,,percent of total billed charges,,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,7070.46,26867.74,
DEPUY PINS THREADED STERILE,30183842,CDM,,,278,RC,outpatient,,2944.5,2944.5,,2499.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,736.13,22,,percent of total billed charges,,,,,,,,,2650.05,90,,percent of total billed charges,,,2438.05,82.8,,percent of total billed charges,,,2502.83,85,,percent of total billed charges,,,,,,,,,2591.16,88,,percent of total billed charges,,,,,,,,,2249.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,736.13,22,,percent of total billed charges,,,2679.5,91,,percent of total billed charges,,,2797.28,95,,percent of total billed charges,,,2443.94,83,,percent of total billed charges,,,2443.94,83,,percent of total billed charges,,,,,,,,,,,,,,,2443.94,83,,percent of total billed charges,,,2797.28,95,,percent of total billed charges,,,2650.05,90,,percent of total billed charges,,,2650.05,90,,percent of total billed charges,,,2414.49,82,,percent of total billed charges,,,2650.05,90,,percent of total billed charges,,,2502.83,85,,percent of total billed charges,,736.13,2797.28,
BANDAGE CONFORM STERILE 1,30183843,CDM,,,270,RC,outpatient,,11.81,11.81,,10.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.95,22,,percent of total billed charges,,,,,,,,,10.63,90,,percent of total billed charges,,,9.78,82.8,,percent of total billed charges,,,10.04,85,,percent of total billed charges,,,,,,,,,10.39,88,,percent of total billed charges,,,,,,,,,9.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.95,22,,percent of total billed charges,,,10.75,91,,percent of total billed charges,,,11.22,95,,percent of total billed charges,,,9.8,83,,percent of total billed charges,,,9.8,83,,percent of total billed charges,,,,,,,,,,,,,,,9.8,83,,percent of total billed charges,,,11.22,95,,percent of total billed charges,,,10.63,90,,percent of total billed charges,,,10.63,90,,percent of total billed charges,,,9.68,82,,percent of total billed charges,,,10.63,90,,percent of total billed charges,,,10.04,85,,percent of total billed charges,,2.95,11.22,
STRYKER FULL RADIUS CUTTER 2.5,30183844,CDM,,,270,RC,outpatient,,351.4,351.4,,298.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.85,22,,percent of total billed charges,,,,,,,,,316.26,90,,percent of total billed charges,,,290.96,82.8,,percent of total billed charges,,,298.69,85,,percent of total billed charges,,,,,,,,,309.23,88,,percent of total billed charges,,,,,,,,,268.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.85,22,,percent of total billed charges,,,319.77,91,,percent of total billed charges,,,333.83,95,,percent of total billed charges,,,291.66,83,,percent of total billed charges,,,291.66,83,,percent of total billed charges,,,,,,,,,,,,,,,291.66,83,,percent of total billed charges,,,333.83,95,,percent of total billed charges,,,316.26,90,,percent of total billed charges,,,316.26,90,,percent of total billed charges,,,288.15,82,,percent of total billed charges,,,316.26,90,,percent of total billed charges,,,298.69,85,,percent of total billed charges,,87.85,333.83,
STRYKER BUR HOODED ABRASION 2.0,30183845,CDM,,,270,RC,outpatient,,387.87,387.87,,329.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.97,22,,percent of total billed charges,,,,,,,,,349.08,90,,percent of total billed charges,,,321.16,82.8,,percent of total billed charges,,,329.69,85,,percent of total billed charges,,,,,,,,,341.33,88,,percent of total billed charges,,,,,,,,,296.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.97,22,,percent of total billed charges,,,352.96,91,,percent of total billed charges,,,368.48,95,,percent of total billed charges,,,321.93,83,,percent of total billed charges,,,321.93,83,,percent of total billed charges,,,,,,,,,,,,,,,321.93,83,,percent of total billed charges,,,368.48,95,,percent of total billed charges,,,349.08,90,,percent of total billed charges,,,349.08,90,,percent of total billed charges,,,318.05,82,,percent of total billed charges,,,349.08,90,,percent of total billed charges,,,329.69,85,,percent of total billed charges,,96.97,368.48,
STRYKER BUR HOODED ABRASION 3.0,30183846,CDM,,,270,RC,outpatient,,354.9,354.9,,301.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.73,22,,percent of total billed charges,,,,,,,,,319.41,90,,percent of total billed charges,,,293.86,82.8,,percent of total billed charges,,,301.67,85,,percent of total billed charges,,,,,,,,,312.31,88,,percent of total billed charges,,,,,,,,,271.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.73,22,,percent of total billed charges,,,322.96,91,,percent of total billed charges,,,337.16,95,,percent of total billed charges,,,294.57,83,,percent of total billed charges,,,294.57,83,,percent of total billed charges,,,,,,,,,,,,,,,294.57,83,,percent of total billed charges,,,337.16,95,,percent of total billed charges,,,319.41,90,,percent of total billed charges,,,319.41,90,,percent of total billed charges,,,291.02,82,,percent of total billed charges,,,319.41,90,,percent of total billed charges,,,301.67,85,,percent of total billed charges,,88.73,337.16,
DEPUY INSERT 4 X 5MM FIXED BEARING CR,30183848,CDM,,,278,RC,outpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3119.32,22,,percent of total billed charges,,,,,,,,,11229.54,90,,percent of total billed charges,,,10331.18,82.8,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3119.32,22,,percent of total billed charges,,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,3119.32,11853.41,
DEPUY FEMUR CR  SZ 5N RIGHT,30183849,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
ZIMMER ULNA ASSEMBLY C/M PLASMA SML LT,30183850,CDM,,,278,RC,outpatient,,30023.5,30023.5,,25489.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7505.88,22,,percent of total billed charges,,,,,,,,,27021.15,90,,percent of total billed charges,,,24859.46,82.8,,percent of total billed charges,,,25519.98,85,,percent of total billed charges,,,,,,,,,26420.68,88,,percent of total billed charges,,,,,,,,,22937.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7505.88,22,,percent of total billed charges,,,27321.39,91,,percent of total billed charges,,,28522.33,95,,percent of total billed charges,,,24919.51,83,,percent of total billed charges,,,24919.51,83,,percent of total billed charges,,,,,,,,,,,,,,,24919.51,83,,percent of total billed charges,,,28522.33,95,,percent of total billed charges,,,27021.15,90,,percent of total billed charges,,,27021.15,90,,percent of total billed charges,,,24619.27,82,,percent of total billed charges,,,27021.15,90,,percent of total billed charges,,,25519.98,85,,percent of total billed charges,,7505.88,28522.33,
ZIMMER HUMERAL ASSEMBLY C/M 6IN SML LON,30183851,CDM,,,278,RC,outpatient,,34090.03,34090.03,,28942.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8522.51,22,,percent of total billed charges,,,,,,,,,30681.03,90,,percent of total billed charges,,,28226.54,82.8,,percent of total billed charges,,,28976.53,85,,percent of total billed charges,,,,,,,,,29999.23,88,,percent of total billed charges,,,,,,,,,26044.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8522.51,22,,percent of total billed charges,,,31021.93,91,,percent of total billed charges,,,32385.53,95,,percent of total billed charges,,,28294.72,83,,percent of total billed charges,,,28294.72,83,,percent of total billed charges,,,,,,,,,,,,,,,28294.72,83,,percent of total billed charges,,,32385.53,95,,percent of total billed charges,,,30681.03,90,,percent of total billed charges,,,30681.03,90,,percent of total billed charges,,,27953.82,82,,percent of total billed charges,,,30681.03,90,,percent of total billed charges,,,28976.53,85,,percent of total billed charges,,8522.51,32385.53,
ZIMMER PLUG W/NOZZLE C/M 16MM & 25MM,30183852,CDM,,,278,RC,outpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,552.5,22,,percent of total billed charges,,,,,,,,,1989,90,,percent of total billed charges,,,1829.88,82.8,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,552.5,22,,percent of total billed charges,,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,552.5,2099.5,
ZIMMER CEMENT MIXING SYSTEM VACUUM,30183853,CDM,,,270,RC,outpatient,,863.72,863.72,,733.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,215.93,22,,percent of total billed charges,,,,,,,,,777.35,90,,percent of total billed charges,,,715.16,82.8,,percent of total billed charges,,,734.16,85,,percent of total billed charges,,,,,,,,,760.07,88,,percent of total billed charges,,,,,,,,,659.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,215.93,22,,percent of total billed charges,,,785.99,91,,percent of total billed charges,,,820.53,95,,percent of total billed charges,,,716.89,83,,percent of total billed charges,,,716.89,83,,percent of total billed charges,,,,,,,,,,,,,,,716.89,83,,percent of total billed charges,,,820.53,95,,percent of total billed charges,,,777.35,90,,percent of total billed charges,,,777.35,90,,percent of total billed charges,,,708.25,82,,percent of total billed charges,,,777.35,90,,percent of total billed charges,,,734.16,85,,percent of total billed charges,,215.93,820.53,
ZIMMER PALACOS LV+G W/GENTAMICIN,30183854,CDM,,,270,RC,outpatient,,2771.15,2771.15,,2352.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,692.79,22,,percent of total billed charges,,,,,,,,,2494.04,90,,percent of total billed charges,,,2294.51,82.8,,percent of total billed charges,,,2355.48,85,,percent of total billed charges,,,,,,,,,2438.61,88,,percent of total billed charges,,,,,,,,,2117.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,692.79,22,,percent of total billed charges,,,2521.75,91,,percent of total billed charges,,,2632.59,95,,percent of total billed charges,,,2300.05,83,,percent of total billed charges,,,2300.05,83,,percent of total billed charges,,,,,,,,,,,,,,,2300.05,83,,percent of total billed charges,,,2632.59,95,,percent of total billed charges,,,2494.04,90,,percent of total billed charges,,,2494.04,90,,percent of total billed charges,,,2272.34,82,,percent of total billed charges,,,2494.04,90,,percent of total billed charges,,,2355.48,85,,percent of total billed charges,,692.79,2632.59,
GUIDE WIRE .045 X 6 ST,30183856,CDM,,,270,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
MINI ACUTRAK 2 DRILL LONG,30183857,CDM,,,270,RC,outpatient,,1911,1911,,1622.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,477.75,22,,percent of total billed charges,,,,,,,,,1719.9,90,,percent of total billed charges,,,1582.31,82.8,,percent of total billed charges,,,1624.35,85,,percent of total billed charges,,,,,,,,,1681.68,88,,percent of total billed charges,,,,,,,,,1460,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,477.75,22,,percent of total billed charges,,,1739.01,91,,percent of total billed charges,,,1815.45,95,,percent of total billed charges,,,1586.13,83,,percent of total billed charges,,,1586.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1586.13,83,,percent of total billed charges,,,1815.45,95,,percent of total billed charges,,,1719.9,90,,percent of total billed charges,,,1719.9,90,,percent of total billed charges,,,1567.02,82,,percent of total billed charges,,,1719.9,90,,percent of total billed charges,,,1624.35,85,,percent of total billed charges,,477.75,1815.45,
MINI ACUTRAK 2 BONE SCREW 24MM,30183858,CDM,,,270,RC,outpatient,,3432,3432,,2913.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,858,22,,percent of total billed charges,,,,,,,,,3088.8,90,,percent of total billed charges,,,2841.7,82.8,,percent of total billed charges,,,2917.2,85,,percent of total billed charges,,,,,,,,,3020.16,88,,percent of total billed charges,,,,,,,,,2622.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,858,22,,percent of total billed charges,,,3123.12,91,,percent of total billed charges,,,3260.4,95,,percent of total billed charges,,,2848.56,83,,percent of total billed charges,,,2848.56,83,,percent of total billed charges,,,,,,,,,,,,,,,2848.56,83,,percent of total billed charges,,,3260.4,95,,percent of total billed charges,,,3088.8,90,,percent of total billed charges,,,3088.8,90,,percent of total billed charges,,,2814.24,82,,percent of total billed charges,,,3088.8,90,,percent of total billed charges,,,2917.2,85,,percent of total billed charges,,858,3260.4,
SYNTHES PLATE DORSAL 2.4MM VA 3X5 HOLE,30183859,CDM,,,278,RC,outpatient,,6337.18,6337.18,,5380.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1584.3,22,,percent of total billed charges,,,,,,,,,5703.46,90,,percent of total billed charges,,,5247.19,82.8,,percent of total billed charges,,,5386.6,85,,percent of total billed charges,,,,,,,,,5576.72,88,,percent of total billed charges,,,,,,,,,4841.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1584.3,22,,percent of total billed charges,,,5766.83,91,,percent of total billed charges,,,6020.32,95,,percent of total billed charges,,,5259.86,83,,percent of total billed charges,,,5259.86,83,,percent of total billed charges,,,,,,,,,,,,,,,5259.86,83,,percent of total billed charges,,,6020.32,95,,percent of total billed charges,,,5703.46,90,,percent of total billed charges,,,5703.46,90,,percent of total billed charges,,,5196.49,82,,percent of total billed charges,,,5703.46,90,,percent of total billed charges,,,5386.6,85,,percent of total billed charges,,1584.3,6020.32,
SYNTHES SCREW LOCKING VA 2.4 X 10MM,30183860,CDM,,,278,RC,outpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,338.51,22,,percent of total billed charges,,,,,,,,,1218.62,90,,percent of total billed charges,,,1121.13,82.8,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,338.51,22,,percent of total billed charges,,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,338.51,1286.32,
SYNTHES PLATE DORSAL L 2.4MM 2X3HOLE,30183861,CDM,,,278,RC,outpatient,,6022.25,6022.25,,5112.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1505.56,22,,percent of total billed charges,,,,,,,,,5420.03,90,,percent of total billed charges,,,4986.42,82.8,,percent of total billed charges,,,5118.91,85,,percent of total billed charges,,,,,,,,,5299.58,88,,percent of total billed charges,,,,,,,,,4601,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1505.56,22,,percent of total billed charges,,,5480.25,91,,percent of total billed charges,,,5721.14,95,,percent of total billed charges,,,4998.47,83,,percent of total billed charges,,,4998.47,83,,percent of total billed charges,,,,,,,,,,,,,,,4998.47,83,,percent of total billed charges,,,5721.14,95,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,4938.25,82,,percent of total billed charges,,,5420.03,90,,percent of total billed charges,,,5118.91,85,,percent of total billed charges,,1505.56,5721.14,
SYNTHES PLATE VOLAC DISTAL RADIUS 2.4,30183862,CDM,,,278,RC,outpatient,,9392.5,9392.5,,7974.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2348.13,22,,percent of total billed charges,,,,,,,,,8453.25,90,,percent of total billed charges,,,7776.99,82.8,,percent of total billed charges,,,7983.63,85,,percent of total billed charges,,,,,,,,,8265.4,88,,percent of total billed charges,,,,,,,,,7175.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2348.13,22,,percent of total billed charges,,,8547.18,91,,percent of total billed charges,,,8922.88,95,,percent of total billed charges,,,7795.78,83,,percent of total billed charges,,,7795.78,83,,percent of total billed charges,,,,,,,,,,,,,,,7795.78,83,,percent of total billed charges,,,8922.88,95,,percent of total billed charges,,,8453.25,90,,percent of total billed charges,,,8453.25,90,,percent of total billed charges,,,7701.85,82,,percent of total billed charges,,,8453.25,90,,percent of total billed charges,,,7983.63,85,,percent of total billed charges,,2348.13,8922.88,
SYNTHES SCREW LOCKING VA 2.4 X 14MM,30183863,CDM,,,278,RC,outpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,338.51,22,,percent of total billed charges,,,,,,,,,1218.62,90,,percent of total billed charges,,,1121.13,82.8,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,338.51,22,,percent of total billed charges,,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,338.51,1286.32,
DEPUY CUP PROSTALAC 42X32,30183864,CDM,,,278,RC,outpatient,,6303.83,6303.83,,5351.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1575.96,22,,percent of total billed charges,,,,,,,,,5673.45,90,,percent of total billed charges,,,5219.57,82.8,,percent of total billed charges,,,5358.26,85,,percent of total billed charges,,,,,,,,,5547.37,88,,percent of total billed charges,,,,,,,,,4816.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1575.96,22,,percent of total billed charges,,,5736.49,91,,percent of total billed charges,,,5988.64,95,,percent of total billed charges,,,5232.18,83,,percent of total billed charges,,,5232.18,83,,percent of total billed charges,,,,,,,,,,,,,,,5232.18,83,,percent of total billed charges,,,5988.64,95,,percent of total billed charges,,,5673.45,90,,percent of total billed charges,,,5673.45,90,,percent of total billed charges,,,5169.14,82,,percent of total billed charges,,,5673.45,90,,percent of total billed charges,,,5358.26,85,,percent of total billed charges,,1575.96,5988.64,
DEPUY STEM FEMORAL SZ 3 300MM,30183865,CDM,,,278,RC,outpatient,,24918.92,24918.92,,21156.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6229.73,22,,percent of total billed charges,,,,,,,,,22427.03,90,,percent of total billed charges,,,20632.87,82.8,,percent of total billed charges,,,21181.08,85,,percent of total billed charges,,,,,,,,,21928.65,88,,percent of total billed charges,,,,,,,,,19038.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6229.73,22,,percent of total billed charges,,,22676.22,91,,percent of total billed charges,,,23672.97,95,,percent of total billed charges,,,20682.7,83,,percent of total billed charges,,,20682.7,83,,percent of total billed charges,,,,,,,,,,,,,,,20682.7,83,,percent of total billed charges,,,23672.97,95,,percent of total billed charges,,,22427.03,90,,percent of total billed charges,,,22427.03,90,,percent of total billed charges,,,20433.51,82,,percent of total billed charges,,,22427.03,90,,percent of total billed charges,,,21181.08,85,,percent of total billed charges,,6229.73,23672.97,
STRYKER TAPERED SERRATED DRILL,30183868,CDM,,,270,RC,outpatient,,368.06,368.06,,312.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.02,22,,percent of total billed charges,,,,,,,,,331.25,90,,percent of total billed charges,,,304.75,82.8,,percent of total billed charges,,,312.85,85,,percent of total billed charges,,,,,,,,,323.89,88,,percent of total billed charges,,,,,,,,,281.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.02,22,,percent of total billed charges,,,334.93,91,,percent of total billed charges,,,349.66,95,,percent of total billed charges,,,305.49,83,,percent of total billed charges,,,305.49,83,,percent of total billed charges,,,,,,,,,,,,,,,305.49,83,,percent of total billed charges,,,349.66,95,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,301.81,82,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,312.85,85,,percent of total billed charges,,92.02,349.66,
STRYKER LINDEMANN DRILL,30183869,CDM,,,270,RC,outpatient,,940.16,940.16,,798.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.04,22,,percent of total billed charges,,,,,,,,,846.14,90,,percent of total billed charges,,,778.45,82.8,,percent of total billed charges,,,799.14,85,,percent of total billed charges,,,,,,,,,827.34,88,,percent of total billed charges,,,,,,,,,718.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.04,22,,percent of total billed charges,,,855.55,91,,percent of total billed charges,,,893.15,95,,percent of total billed charges,,,780.33,83,,percent of total billed charges,,,780.33,83,,percent of total billed charges,,,,,,,,,,,,,,,780.33,83,,percent of total billed charges,,,893.15,95,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,770.93,82,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,799.14,85,,percent of total billed charges,,235.04,893.15,
DEPUY FEMUR SIGMA RT SZ 6,30183871,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
SAFE SHEATH 6FR 13CM,30183872,CDM,,,270,RC,outpatient,,534.8,534.8,,454.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,133.7,22,,percent of total billed charges,,,,,,,,,481.32,90,,percent of total billed charges,,,442.81,82.8,,percent of total billed charges,,,454.58,85,,percent of total billed charges,,,,,,,,,470.62,88,,percent of total billed charges,,,,,,,,,408.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,133.7,22,,percent of total billed charges,,,486.67,91,,percent of total billed charges,,,508.06,95,,percent of total billed charges,,,443.88,83,,percent of total billed charges,,,443.88,83,,percent of total billed charges,,,,,,,,,,,,,,,443.88,83,,percent of total billed charges,,,508.06,95,,percent of total billed charges,,,481.32,90,,percent of total billed charges,,,481.32,90,,percent of total billed charges,,,438.54,82,,percent of total billed charges,,,481.32,90,,percent of total billed charges,,,454.58,85,,percent of total billed charges,,133.7,508.06,
BIOMET HEAD MODULAR 36MM,30183875,CDM,,,278,RC,outpatient,,10309,10309,,8752.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2577.25,22,,percent of total billed charges,,,,,,,,,9278.1,90,,percent of total billed charges,,,8535.85,82.8,,percent of total billed charges,,,8762.65,85,,percent of total billed charges,,,,,,,,,9071.92,88,,percent of total billed charges,,,,,,,,,7876.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2577.25,22,,percent of total billed charges,,,9381.19,91,,percent of total billed charges,,,9793.55,95,,percent of total billed charges,,,8556.47,83,,percent of total billed charges,,,8556.47,83,,percent of total billed charges,,,,,,,,,,,,,,,8556.47,83,,percent of total billed charges,,,9793.55,95,,percent of total billed charges,,,9278.1,90,,percent of total billed charges,,,9278.1,90,,percent of total billed charges,,,8453.38,82,,percent of total billed charges,,,9278.1,90,,percent of total billed charges,,,8762.65,85,,percent of total billed charges,,2577.25,9793.55,
SYNTHES SCREW CANNUL 16MM 6.5X100MM,30183876,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
NEEDLE SPINAL QUINKE 25GX3.5  ORANGE,30183879,CDM,,,270,RC,outpatient,,12.98,12.98,,11.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.68,90,,percent of total billed charges,,,10.75,82.8,,percent of total billed charges,,,11.03,85,,percent of total billed charges,,,,,,,,,11.42,88,,percent of total billed charges,,,,,,,,,9.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.81,91,,percent of total billed charges,,,12.33,95,,percent of total billed charges,,,10.77,83,,percent of total billed charges,,,10.77,83,,percent of total billed charges,,,,,,,,,,,,,,,10.77,83,,percent of total billed charges,,,12.33,95,,percent of total billed charges,,,11.68,90,,percent of total billed charges,,,11.68,90,,percent of total billed charges,,,10.64,82,,percent of total billed charges,,,11.68,90,,percent of total billed charges,,,11.03,85,,percent of total billed charges,,3.25,12.33,
DEPUY ATTUNE TKA FB,30183881,CDM,,,278,RC,outpatient,,37440,37440,,31786.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9360,22,,percent of total billed charges,,,,,,,,,33696,90,,percent of total billed charges,,,31000.32,82.8,,percent of total billed charges,,,31824,85,,percent of total billed charges,,,,,,,,,32947.2,88,,percent of total billed charges,,,,,,,,,28604.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9360,22,,percent of total billed charges,,,34070.4,91,,percent of total billed charges,,,35568,95,,percent of total billed charges,,,31075.2,83,,percent of total billed charges,,,31075.2,83,,percent of total billed charges,,,,,,,,,,,,,,,31075.2,83,,percent of total billed charges,,,35568,95,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,30700.8,82,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,31824,85,,percent of total billed charges,,9360,35568,
CURVED PHACO TIP 30 DEG,30183882,CDM,,,270,RC,outpatient,,788.5,788.5,,669.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,197.13,22,,percent of total billed charges,,,,,,,,,709.65,90,,percent of total billed charges,,,652.88,82.8,,percent of total billed charges,,,670.23,85,,percent of total billed charges,,,,,,,,,693.88,88,,percent of total billed charges,,,,,,,,,602.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,197.13,22,,percent of total billed charges,,,717.54,91,,percent of total billed charges,,,749.08,95,,percent of total billed charges,,,654.46,83,,percent of total billed charges,,,654.46,83,,percent of total billed charges,,,,,,,,,,,,,,,654.46,83,,percent of total billed charges,,,749.08,95,,percent of total billed charges,,,709.65,90,,percent of total billed charges,,,709.65,90,,percent of total billed charges,,,646.57,82,,percent of total billed charges,,,709.65,90,,percent of total billed charges,,,670.23,85,,percent of total billed charges,,197.13,749.08,
SYNTHES TAP 6.5MM,30183883,CDM,,,270,RC,outpatient,,4607.85,4607.85,,3912.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1151.96,22,,percent of total billed charges,,,,,,,,,4147.07,90,,percent of total billed charges,,,3815.3,82.8,,percent of total billed charges,,,3916.67,85,,percent of total billed charges,,,,,,,,,4054.91,88,,percent of total billed charges,,,,,,,,,3520.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1151.96,22,,percent of total billed charges,,,4193.14,91,,percent of total billed charges,,,4377.46,95,,percent of total billed charges,,,3824.52,83,,percent of total billed charges,,,3824.52,83,,percent of total billed charges,,,,,,,,,,,,,,,3824.52,83,,percent of total billed charges,,,4377.46,95,,percent of total billed charges,,,4147.07,90,,percent of total billed charges,,,4147.07,90,,percent of total billed charges,,,3778.44,82,,percent of total billed charges,,,4147.07,90,,percent of total billed charges,,,3916.67,85,,percent of total billed charges,,1151.96,4377.46,
SYNTHES SCREW BONE 6.5 X 32MM,30183884,CDM,,,270,RC,outpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.1,22,,percent of total billed charges,,,,,,,,,385.56,90,,percent of total billed charges,,,354.72,82.8,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.1,22,,percent of total billed charges,,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,107.1,406.98,
DEPUY ATTUNE FEMUR CR SZ 4 RT,30183885,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
FORTEC HOLMIUM LASER LOW WATTAGE,30183890,CDM,,,270,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
BRAVO CF CAPSULE DELIVERY DEVICE,30183896,CDM,,,270,RC,outpatient,,2018.9,2018.9,,1714.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,504.73,22,,percent of total billed charges,,,,,,,,,1817.01,90,,percent of total billed charges,,,1671.65,82.8,,percent of total billed charges,,,1716.07,85,,percent of total billed charges,,,,,,,,,1776.63,88,,percent of total billed charges,,,,,,,,,1542.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,504.73,22,,percent of total billed charges,,,1837.2,91,,percent of total billed charges,,,1917.96,95,,percent of total billed charges,,,1675.69,83,,percent of total billed charges,,,1675.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1675.69,83,,percent of total billed charges,,,1917.96,95,,percent of total billed charges,,,1817.01,90,,percent of total billed charges,,,1817.01,90,,percent of total billed charges,,,1655.5,82,,percent of total billed charges,,,1817.01,90,,percent of total billed charges,,,1716.07,85,,percent of total billed charges,,504.73,1917.96,
CIVCO NEEDLE GUIDE SHEATH KIT,30183934,CDM,,,270,RC,outpatient,,128.33,128.33,,108.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.08,22,,percent of total billed charges,,,,,,,,,115.5,90,,percent of total billed charges,,,106.26,82.8,,percent of total billed charges,,,109.08,85,,percent of total billed charges,,,,,,,,,112.93,88,,percent of total billed charges,,,,,,,,,98.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.08,22,,percent of total billed charges,,,116.78,91,,percent of total billed charges,,,121.91,95,,percent of total billed charges,,,106.51,83,,percent of total billed charges,,,106.51,83,,percent of total billed charges,,,,,,,,,,,,,,,106.51,83,,percent of total billed charges,,,121.91,95,,percent of total billed charges,,,115.5,90,,percent of total billed charges,,,115.5,90,,percent of total billed charges,,,105.23,82,,percent of total billed charges,,,115.5,90,,percent of total billed charges,,,109.08,85,,percent of total billed charges,,32.08,121.91,
MEDTRONIC PACEMAKER ADVISA DR MRI SURESC,30183935,CDM,,,278,RC,outpatient,,46949.11,46949.11,,39859.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11737.28,22,,percent of total billed charges,,,,,,,,,42254.2,90,,percent of total billed charges,,,38873.86,82.8,,percent of total billed charges,,,39906.74,85,,percent of total billed charges,,,,,,,,,41315.22,88,,percent of total billed charges,,,,,,,,,35869.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11737.28,22,,percent of total billed charges,,,42723.69,91,,percent of total billed charges,,,44601.65,95,,percent of total billed charges,,,38967.76,83,,percent of total billed charges,,,38967.76,83,,percent of total billed charges,,,,,,,,,,,,,,,38967.76,83,,percent of total billed charges,,,44601.65,95,,percent of total billed charges,,,42254.2,90,,percent of total billed charges,,,42254.2,90,,percent of total billed charges,,,38498.27,82,,percent of total billed charges,,,42254.2,90,,percent of total billed charges,,,39906.74,85,,percent of total billed charges,,11737.28,44601.65,
MEDTRONIC LEAD 45CM MRI CONDITIONAL,30183936,CDM,,,270,RC,outpatient,,5178.55,5178.55,,4396.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1294.64,22,,percent of total billed charges,,,,,,,,,4660.7,90,,percent of total billed charges,,,4287.84,82.8,,percent of total billed charges,,,4401.77,85,,percent of total billed charges,,,,,,,,,4557.12,88,,percent of total billed charges,,,,,,,,,3956.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1294.64,22,,percent of total billed charges,,,4712.48,91,,percent of total billed charges,,,4919.62,95,,percent of total billed charges,,,4298.2,83,,percent of total billed charges,,,4298.2,83,,percent of total billed charges,,,,,,,,,,,,,,,4298.2,83,,percent of total billed charges,,,4919.62,95,,percent of total billed charges,,,4660.7,90,,percent of total billed charges,,,4660.7,90,,percent of total billed charges,,,4246.41,82,,percent of total billed charges,,,4660.7,90,,percent of total billed charges,,,4401.77,85,,percent of total billed charges,,1294.64,4919.62,
MEDTRONIC LEAD 52CM MRI CONDITIONAL,30183937,CDM,,,278,RC,outpatient,,5178.55,5178.55,,4396.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1294.64,22,,percent of total billed charges,,,,,,,,,4660.7,90,,percent of total billed charges,,,4287.84,82.8,,percent of total billed charges,,,4401.77,85,,percent of total billed charges,,,,,,,,,4557.12,88,,percent of total billed charges,,,,,,,,,3956.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1294.64,22,,percent of total billed charges,,,4712.48,91,,percent of total billed charges,,,4919.62,95,,percent of total billed charges,,,4298.2,83,,percent of total billed charges,,,4298.2,83,,percent of total billed charges,,,,,,,,,,,,,,,4298.2,83,,percent of total billed charges,,,4919.62,95,,percent of total billed charges,,,4660.7,90,,percent of total billed charges,,,4660.7,90,,percent of total billed charges,,,4246.41,82,,percent of total billed charges,,,4660.7,90,,percent of total billed charges,,,4401.77,85,,percent of total billed charges,,1294.64,4919.62,
S&N ENDO ANKLE STRAP PES TALARIS,30183944,CDM,,,270,RC,outpatient,,830.2,830.2,,704.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,207.55,22,,percent of total billed charges,,,,,,,,,747.18,90,,percent of total billed charges,,,687.41,82.8,,percent of total billed charges,,,705.67,85,,percent of total billed charges,,,,,,,,,730.58,88,,percent of total billed charges,,,,,,,,,634.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,207.55,22,,percent of total billed charges,,,755.48,91,,percent of total billed charges,,,788.69,95,,percent of total billed charges,,,689.07,83,,percent of total billed charges,,,689.07,83,,percent of total billed charges,,,,,,,,,,,,,,,689.07,83,,percent of total billed charges,,,788.69,95,,percent of total billed charges,,,747.18,90,,percent of total billed charges,,,747.18,90,,percent of total billed charges,,,680.76,82,,percent of total billed charges,,,747.18,90,,percent of total billed charges,,,705.67,85,,percent of total billed charges,,207.55,788.69,
CATH STRAIGHT FILIFORM TIP 5FR,30183945,CDM,,,270,RC,outpatient,,501.62,501.62,,425.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125.41,22,,percent of total billed charges,,,,,,,,,451.46,90,,percent of total billed charges,,,415.34,82.8,,percent of total billed charges,,,426.38,85,,percent of total billed charges,,,,,,,,,441.43,88,,percent of total billed charges,,,,,,,,,383.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125.41,22,,percent of total billed charges,,,456.47,91,,percent of total billed charges,,,476.54,95,,percent of total billed charges,,,416.34,83,,percent of total billed charges,,,416.34,83,,percent of total billed charges,,,,,,,,,,,,,,,416.34,83,,percent of total billed charges,,,476.54,95,,percent of total billed charges,,,451.46,90,,percent of total billed charges,,,451.46,90,,percent of total billed charges,,,411.33,82,,percent of total billed charges,,,451.46,90,,percent of total billed charges,,,426.38,85,,percent of total billed charges,,125.41,476.54,
CATH WOVEN PHILLIPS FOLLOWER 24FR,30183946,CDM,,,270,RC,outpatient,,752.78,752.78,,639.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,188.2,22,,percent of total billed charges,,,,,,,,,677.5,90,,percent of total billed charges,,,623.3,82.8,,percent of total billed charges,,,639.86,85,,percent of total billed charges,,,,,,,,,662.45,88,,percent of total billed charges,,,,,,,,,575.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,188.2,22,,percent of total billed charges,,,685.03,91,,percent of total billed charges,,,715.14,95,,percent of total billed charges,,,624.81,83,,percent of total billed charges,,,624.81,83,,percent of total billed charges,,,,,,,,,,,,,,,624.81,83,,percent of total billed charges,,,715.14,95,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,617.28,82,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,639.86,85,,percent of total billed charges,,188.2,715.14,
STENT URETERAL 5FR X 18CM,30183947,CDM,,,270,RC,outpatient,,904.8,904.8,,768.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,226.2,22,,percent of total billed charges,,,,,,,,,814.32,90,,percent of total billed charges,,,749.17,82.8,,percent of total billed charges,,,769.08,85,,percent of total billed charges,,,,,,,,,796.22,88,,percent of total billed charges,,,,,,,,,691.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,226.2,22,,percent of total billed charges,,,823.37,91,,percent of total billed charges,,,859.56,95,,percent of total billed charges,,,750.98,83,,percent of total billed charges,,,750.98,83,,percent of total billed charges,,,,,,,,,,,,,,,750.98,83,,percent of total billed charges,,,859.56,95,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,741.94,82,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,769.08,85,,percent of total billed charges,,226.2,859.56,
S&N SCREWDRIVER RELEASE HANDLE,30183948,CDM,,,270,RC,outpatient,,1391.13,1391.13,,1181.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,347.78,22,,percent of total billed charges,,,,,,,,,1252.02,90,,percent of total billed charges,,,1151.86,82.8,,percent of total billed charges,,,1182.46,85,,percent of total billed charges,,,,,,,,,1224.19,88,,percent of total billed charges,,,,,,,,,1062.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,347.78,22,,percent of total billed charges,,,1265.93,91,,percent of total billed charges,,,1321.57,95,,percent of total billed charges,,,1154.64,83,,percent of total billed charges,,,1154.64,83,,percent of total billed charges,,,,,,,,,,,,,,,1154.64,83,,percent of total billed charges,,,1321.57,95,,percent of total billed charges,,,1252.02,90,,percent of total billed charges,,,1252.02,90,,percent of total billed charges,,,1140.73,82,,percent of total billed charges,,,1252.02,90,,percent of total billed charges,,,1182.46,85,,percent of total billed charges,,347.78,1321.57,
S&N NAIL TROCHANTERIC 11.5MM X 40CM 130D,30183949,CDM,,,278,RC,outpatient,,15190.5,15190.5,,12896.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3797.63,22,,percent of total billed charges,,,,,,,,,13671.45,90,,percent of total billed charges,,,12577.73,82.8,,percent of total billed charges,,,12911.93,85,,percent of total billed charges,,,,,,,,,13367.64,88,,percent of total billed charges,,,,,,,,,11605.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3797.63,22,,percent of total billed charges,,,13823.36,91,,percent of total billed charges,,,14430.98,95,,percent of total billed charges,,,12608.12,83,,percent of total billed charges,,,12608.12,83,,percent of total billed charges,,,,,,,,,,,,,,,12608.12,83,,percent of total billed charges,,,14430.98,95,,percent of total billed charges,,,13671.45,90,,percent of total billed charges,,,13671.45,90,,percent of total billed charges,,,12456.21,82,,percent of total billed charges,,,13671.45,90,,percent of total billed charges,,,12911.93,85,,percent of total billed charges,,3797.63,14430.98,
S&N DRILL PILOT 4.0MM LONG AO,30183950,CDM,,,278,RC,outpatient,,1796.21,1796.21,,1524.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,449.05,22,,percent of total billed charges,,,,,,,,,1616.59,90,,percent of total billed charges,,,1487.26,82.8,,percent of total billed charges,,,1526.78,85,,percent of total billed charges,,,,,,,,,1580.66,88,,percent of total billed charges,,,,,,,,,1372.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,449.05,22,,percent of total billed charges,,,1634.55,91,,percent of total billed charges,,,1706.4,95,,percent of total billed charges,,,1490.85,83,,percent of total billed charges,,,1490.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1490.85,83,,percent of total billed charges,,,1706.4,95,,percent of total billed charges,,,1616.59,90,,percent of total billed charges,,,1616.59,90,,percent of total billed charges,,,1472.89,82,,percent of total billed charges,,,1616.59,90,,percent of total billed charges,,,1526.78,85,,percent of total billed charges,,449.05,1706.4,
S&N GUIDE PIN THREADED 3.2MM X 343MM,30183951,CDM,,,278,RC,outpatient,,1177.93,1177.93,,1000.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,294.48,22,,percent of total billed charges,,,,,,,,,1060.14,90,,percent of total billed charges,,,975.33,82.8,,percent of total billed charges,,,1001.24,85,,percent of total billed charges,,,,,,,,,1036.58,88,,percent of total billed charges,,,,,,,,,899.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,294.48,22,,percent of total billed charges,,,1071.92,91,,percent of total billed charges,,,1119.03,95,,percent of total billed charges,,,977.68,83,,percent of total billed charges,,,977.68,83,,percent of total billed charges,,,,,,,,,,,,,,,977.68,83,,percent of total billed charges,,,1119.03,95,,percent of total billed charges,,,1060.14,90,,percent of total billed charges,,,1060.14,90,,percent of total billed charges,,,965.9,82,,percent of total billed charges,,,1060.14,90,,percent of total billed charges,,,1001.24,85,,percent of total billed charges,,294.48,1119.03,
S&N SCREW LP 5MM X 60MM TRIGEN,30183952,CDM,,,278,RC,outpatient,,1726.92,1726.92,,1466.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,431.73,22,,percent of total billed charges,,,,,,,,,1554.23,90,,percent of total billed charges,,,1429.89,82.8,,percent of total billed charges,,,1467.88,85,,percent of total billed charges,,,,,,,,,1519.69,88,,percent of total billed charges,,,,,,,,,1319.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,431.73,22,,percent of total billed charges,,,1571.5,91,,percent of total billed charges,,,1640.57,95,,percent of total billed charges,,,1433.34,83,,percent of total billed charges,,,1433.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1433.34,83,,percent of total billed charges,,,1640.57,95,,percent of total billed charges,,,1554.23,90,,percent of total billed charges,,,1554.23,90,,percent of total billed charges,,,1416.07,82,,percent of total billed charges,,,1554.23,90,,percent of total billed charges,,,1467.88,85,,percent of total billed charges,,431.73,1640.57,
S&N SCREW HEX RECON 6.4MM X 100MM,30183953,CDM,,,278,RC,outpatient,,2782.56,2782.56,,2362.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,695.64,22,,percent of total billed charges,,,,,,,,,2504.3,90,,percent of total billed charges,,,2303.96,82.8,,percent of total billed charges,,,2365.18,85,,percent of total billed charges,,,,,,,,,2448.65,88,,percent of total billed charges,,,,,,,,,2125.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,695.64,22,,percent of total billed charges,,,2532.13,91,,percent of total billed charges,,,2643.43,95,,percent of total billed charges,,,2309.52,83,,percent of total billed charges,,,2309.52,83,,percent of total billed charges,,,,,,,,,,,,,,,2309.52,83,,percent of total billed charges,,,2643.43,95,,percent of total billed charges,,,2504.3,90,,percent of total billed charges,,,2504.3,90,,percent of total billed charges,,,2281.7,82,,percent of total billed charges,,,2504.3,90,,percent of total billed charges,,,2365.18,85,,percent of total billed charges,,695.64,2643.43,
S&N SCREW HEX RECON 6.4MM X 90MM,30183954,CDM,,,278,RC,outpatient,,2782.26,2782.26,,2362.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,695.57,22,,percent of total billed charges,,,,,,,,,2504.03,90,,percent of total billed charges,,,2303.71,82.8,,percent of total billed charges,,,2364.92,85,,percent of total billed charges,,,,,,,,,2448.39,88,,percent of total billed charges,,,,,,,,,2125.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,695.57,22,,percent of total billed charges,,,2531.86,91,,percent of total billed charges,,,2643.15,95,,percent of total billed charges,,,2309.28,83,,percent of total billed charges,,,2309.28,83,,percent of total billed charges,,,,,,,,,,,,,,,2309.28,83,,percent of total billed charges,,,2643.15,95,,percent of total billed charges,,,2504.03,90,,percent of total billed charges,,,2504.03,90,,percent of total billed charges,,,2281.45,82,,percent of total billed charges,,,2504.03,90,,percent of total billed charges,,,2364.92,85,,percent of total billed charges,,695.57,2643.15,
DEPUY INSERT RP 15MM SZ3,30183955,CDM,,,278,RC,outpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3253.11,22,,percent of total billed charges,,,,,,,,,11711.18,90,,percent of total billed charges,,,10774.28,82.8,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3253.11,22,,percent of total billed charges,,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,3253.11,12361.8,
SYNTHES SCREW CANNUL 85MM X 6.5MM,30183956,CDM,,,278,RC,outpatient,,2795.65,2795.65,,2373.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,698.91,22,,percent of total billed charges,,,,,,,,,2516.09,90,,percent of total billed charges,,,2314.8,82.8,,percent of total billed charges,,,2376.3,85,,percent of total billed charges,,,,,,,,,2460.17,88,,percent of total billed charges,,,,,,,,,2135.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,698.91,22,,percent of total billed charges,,,2544.04,91,,percent of total billed charges,,,2655.87,95,,percent of total billed charges,,,2320.39,83,,percent of total billed charges,,,2320.39,83,,percent of total billed charges,,,,,,,,,,,,,,,2320.39,83,,percent of total billed charges,,,2655.87,95,,percent of total billed charges,,,2516.09,90,,percent of total billed charges,,,2516.09,90,,percent of total billed charges,,,2292.43,82,,percent of total billed charges,,,2516.09,90,,percent of total billed charges,,,2376.3,85,,percent of total billed charges,,698.91,2655.87,
BARD PHILLIPS 8FR THREADED FOLLOWER,30183957,CDM,,,270,RC,outpatient,,752.78,752.78,,639.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,188.2,22,,percent of total billed charges,,,,,,,,,677.5,90,,percent of total billed charges,,,623.3,82.8,,percent of total billed charges,,,639.86,85,,percent of total billed charges,,,,,,,,,662.45,88,,percent of total billed charges,,,,,,,,,575.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,188.2,22,,percent of total billed charges,,,685.03,91,,percent of total billed charges,,,715.14,95,,percent of total billed charges,,,624.81,83,,percent of total billed charges,,,624.81,83,,percent of total billed charges,,,,,,,,,,,,,,,624.81,83,,percent of total billed charges,,,715.14,95,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,617.28,82,,percent of total billed charges,,,677.5,90,,percent of total billed charges,,,639.86,85,,percent of total billed charges,,188.2,715.14,
SYNTHES SCREW CANNUL 16MM 6.5X75MM,30183958,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
ACUTRAK MICRO DRILL,30183959,CDM,,,270,RC,outpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,502.13,22,,percent of total billed charges,,,,,,,,,1807.65,90,,percent of total billed charges,,,1663.04,82.8,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,502.13,22,,percent of total billed charges,,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,502.13,1908.08,
ACUTRAK WIRE .035 X 6 SINGLE,30183960,CDM,,,270,RC,outpatient,,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.25,22,,percent of total billed charges,,,,,,,,,321.3,90,,percent of total billed charges,,,295.6,82.8,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.25,22,,percent of total billed charges,,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,89.25,339.15,
SYNTHES SCREW CANNULATED 6.5X75MM,30183961,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES 7 HOLE RECON PLATE,30183963,CDM,,,278,RC,outpatient,,4900.68,4900.68,,4160.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1225.17,22,,percent of total billed charges,,,,,,,,,4410.61,90,,percent of total billed charges,,,4057.76,82.8,,percent of total billed charges,,,4165.58,85,,percent of total billed charges,,,,,,,,,4312.6,88,,percent of total billed charges,,,,,,,,,3744.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1225.17,22,,percent of total billed charges,,,4459.62,91,,percent of total billed charges,,,4655.65,95,,percent of total billed charges,,,4067.56,83,,percent of total billed charges,,,4067.56,83,,percent of total billed charges,,,,,,,,,,,,,,,4067.56,83,,percent of total billed charges,,,4655.65,95,,percent of total billed charges,,,4410.61,90,,percent of total billed charges,,,4410.61,90,,percent of total billed charges,,,4018.56,82,,percent of total billed charges,,,4410.61,90,,percent of total billed charges,,,4165.58,85,,percent of total billed charges,,1225.17,4655.65,
DEPUY INSERT AOX SZ 8 7MM,30183965,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY LINER ALTRX NEUT 28 X 48,30183966,CDM,,,278,RC,outpatient,,10729.29,10729.29,,9109.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2682.32,22,,percent of total billed charges,,,,,,,,,9656.36,90,,percent of total billed charges,,,8883.85,82.8,,percent of total billed charges,,,9119.9,85,,percent of total billed charges,,,,,,,,,9441.78,88,,percent of total billed charges,,,,,,,,,8197.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2682.32,22,,percent of total billed charges,,,9763.65,91,,percent of total billed charges,,,10192.83,95,,percent of total billed charges,,,8905.31,83,,percent of total billed charges,,,8905.31,83,,percent of total billed charges,,,,,,,,,,,,,,,8905.31,83,,percent of total billed charges,,,10192.83,95,,percent of total billed charges,,,9656.36,90,,percent of total billed charges,,,9656.36,90,,percent of total billed charges,,,8798.02,82,,percent of total billed charges,,,9656.36,90,,percent of total billed charges,,,9119.9,85,,percent of total billed charges,,2682.32,10192.83,
DEPUY BIOLOX TS HEAD 28MM +5,30183967,CDM,,,278,RC,outpatient,,13897.78,13897.78,,11799.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3474.45,22,,percent of total billed charges,,,,,,,,,12508,90,,percent of total billed charges,,,11507.36,82.8,,percent of total billed charges,,,11813.11,85,,percent of total billed charges,,,,,,,,,12230.05,88,,percent of total billed charges,,,,,,,,,10617.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3474.45,22,,percent of total billed charges,,,12646.98,91,,percent of total billed charges,,,13202.89,95,,percent of total billed charges,,,11535.16,83,,percent of total billed charges,,,11535.16,83,,percent of total billed charges,,,,,,,,,,,,,,,11535.16,83,,percent of total billed charges,,,13202.89,95,,percent of total billed charges,,,12508,90,,percent of total billed charges,,,12508,90,,percent of total billed charges,,,11396.18,82,,percent of total billed charges,,,12508,90,,percent of total billed charges,,,11813.11,85,,percent of total billed charges,,3474.45,13202.89,
CONFORMIS IUNI G2 RIGHT MEDIAL IMPLANT K,30183971,CDM,,,278,RC,outpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9750,22,,percent of total billed charges,,,,,,,,,35100,90,,percent of total billed charges,,,32292,82.8,,percent of total billed charges,,,33150,85,,percent of total billed charges,,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9750,22,,percent of total billed charges,,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,9750,37050,
BARD CATHETER/ELECTRODE BALLOON PACING,30183972,CDM,,,270,RC,outpatient,,1400.69,1400.69,,1189.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,350.17,22,,percent of total billed charges,,,,,,,,,1260.62,90,,percent of total billed charges,,,1159.77,82.8,,percent of total billed charges,,,1190.59,85,,percent of total billed charges,,,,,,,,,1232.61,88,,percent of total billed charges,,,,,,,,,1070.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,350.17,22,,percent of total billed charges,,,1274.63,91,,percent of total billed charges,,,1330.66,95,,percent of total billed charges,,,1162.57,83,,percent of total billed charges,,,1162.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1162.57,83,,percent of total billed charges,,,1330.66,95,,percent of total billed charges,,,1260.62,90,,percent of total billed charges,,,1260.62,90,,percent of total billed charges,,,1148.57,82,,percent of total billed charges,,,1260.62,90,,percent of total billed charges,,,1190.59,85,,percent of total billed charges,,350.17,1330.66,
BARD CATHETER/ELECTRODE NBIH BIPOLAR PAC,30183973,CDM,,,270,RC,outpatient,,1144,1144,,971.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,286,22,,percent of total billed charges,,,,,,,,,1029.6,90,,percent of total billed charges,,,947.23,82.8,,percent of total billed charges,,,972.4,85,,percent of total billed charges,,,,,,,,,1006.72,88,,percent of total billed charges,,,,,,,,,874.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,286,22,,percent of total billed charges,,,1041.04,91,,percent of total billed charges,,,1086.8,95,,percent of total billed charges,,,949.52,83,,percent of total billed charges,,,949.52,83,,percent of total billed charges,,,,,,,,,,,,,,,949.52,83,,percent of total billed charges,,,1086.8,95,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,938.08,82,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,972.4,85,,percent of total billed charges,,286,1086.8,
BARD CATHETER/ELECTRODE NBIH BIPOLAR PAC,30183974,CDM,,,270,RC,outpatient,,1144,1144,,971.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,286,22,,percent of total billed charges,,,,,,,,,1029.6,90,,percent of total billed charges,,,947.23,82.8,,percent of total billed charges,,,972.4,85,,percent of total billed charges,,,,,,,,,1006.72,88,,percent of total billed charges,,,,,,,,,874.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,286,22,,percent of total billed charges,,,1041.04,91,,percent of total billed charges,,,1086.8,95,,percent of total billed charges,,,949.52,83,,percent of total billed charges,,,949.52,83,,percent of total billed charges,,,,,,,,,,,,,,,949.52,83,,percent of total billed charges,,,1086.8,95,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,938.08,82,,percent of total billed charges,,,1029.6,90,,percent of total billed charges,,,972.4,85,,percent of total billed charges,,286,1086.8,
ZIMMER K-WIRE .035 6  STYLE 7,30183976,CDM,,,278,RC,outpatient,,88.08,88.08,,74.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.02,22,,percent of total billed charges,,,,,,,,,79.27,90,,percent of total billed charges,,,72.93,82.8,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,,,,,,,,77.51,88,,percent of total billed charges,,,,,,,,,67.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.02,22,,percent of total billed charges,,,80.15,91,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,,,,,,,,,,,,,73.11,83,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,72.23,82,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,22.02,83.68,
ZIMMER K-WIRE .035 9,30183977,CDM,,,278,RC,outpatient,,88.08,88.08,,74.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.02,22,,percent of total billed charges,,,,,,,,,79.27,90,,percent of total billed charges,,,72.93,82.8,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,,,,,,,,77.51,88,,percent of total billed charges,,,,,,,,,67.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.02,22,,percent of total billed charges,,,80.15,91,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,,,,,,,,,,,,,73.11,83,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,72.23,82,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,22.02,83.68,
ZIMMER K-WIRE .045 6  STYLE 7,30183978,CDM,,,278,RC,outpatient,,88.08,88.08,,74.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.02,22,,percent of total billed charges,,,,,,,,,79.27,90,,percent of total billed charges,,,72.93,82.8,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,,,,,,,,77.51,88,,percent of total billed charges,,,,,,,,,67.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.02,22,,percent of total billed charges,,,80.15,91,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,,,,,,,,,,,,,73.11,83,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,72.23,82,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,22.02,83.68,
ZIMMER K-WIRE .045 9,30183979,CDM,,,278,RC,outpatient,,88.08,88.08,,74.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.02,22,,percent of total billed charges,,,,,,,,,79.27,90,,percent of total billed charges,,,72.93,82.8,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,,,,,,,,77.51,88,,percent of total billed charges,,,,,,,,,67.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.02,22,,percent of total billed charges,,,80.15,91,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,,,,,,,,,,,,,73.11,83,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,72.23,82,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,22.02,83.68,
ZIMMER K-WIRE .062 6,30183980,CDM,,,278,RC,outpatient,,88.08,88.08,,74.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.02,22,,percent of total billed charges,,,,,,,,,79.27,90,,percent of total billed charges,,,72.93,82.8,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,,,,,,,,77.51,88,,percent of total billed charges,,,,,,,,,67.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.02,22,,percent of total billed charges,,,80.15,91,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,,,,,,,,,,,,,73.11,83,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,72.23,82,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,22.02,83.68,
ZIMMER K-WIRE .062 9,30183981,CDM,,,278,RC,outpatient,,88.08,88.08,,74.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.02,22,,percent of total billed charges,,,,,,,,,79.27,90,,percent of total billed charges,,,72.93,82.8,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,,,,,,,,77.51,88,,percent of total billed charges,,,,,,,,,67.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.02,22,,percent of total billed charges,,,80.15,91,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,,,,,,,,,,,,,73.11,83,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,72.23,82,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,22.02,83.68,
DEPUY FEMUR ATTUNE SZ 6 LT CR,30183982,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY INSERT XLK SZ 5 15MM,30183983,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
LEEP RADIUS LOOP ELECTRODE 2.0 X 2.0,30183984,CDM,,,270,RC,outpatient,,185.06,185.06,,157.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.27,22,,percent of total billed charges,,,,,,,,,166.55,90,,percent of total billed charges,,,153.23,82.8,,percent of total billed charges,,,157.3,85,,percent of total billed charges,,,,,,,,,162.85,88,,percent of total billed charges,,,,,,,,,141.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.27,22,,percent of total billed charges,,,168.4,91,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,,,,,,,,,,,,,153.6,83,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,151.75,82,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,157.3,85,,percent of total billed charges,,46.27,175.81,
LEEP RADIUS LOOP ELECTRODE 1.0 X 1.0,30183985,CDM,,,270,RC,outpatient,,189.68,189.68,,161.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.42,22,,percent of total billed charges,,,,,,,,,170.71,90,,percent of total billed charges,,,157.06,82.8,,percent of total billed charges,,,161.23,85,,percent of total billed charges,,,,,,,,,166.92,88,,percent of total billed charges,,,,,,,,,144.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.42,22,,percent of total billed charges,,,172.61,91,,percent of total billed charges,,,180.2,95,,percent of total billed charges,,,157.43,83,,percent of total billed charges,,,157.43,83,,percent of total billed charges,,,,,,,,,,,,,,,157.43,83,,percent of total billed charges,,,180.2,95,,percent of total billed charges,,,170.71,90,,percent of total billed charges,,,170.71,90,,percent of total billed charges,,,155.54,82,,percent of total billed charges,,,170.71,90,,percent of total billed charges,,,161.23,85,,percent of total billed charges,,47.42,180.2,
LEEP RADIUS LOOP ELECTRODE 1.5 X 1.5,30183986,CDM,,,270,RC,outpatient,,185.06,185.06,,157.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.27,22,,percent of total billed charges,,,,,,,,,166.55,90,,percent of total billed charges,,,153.23,82.8,,percent of total billed charges,,,157.3,85,,percent of total billed charges,,,,,,,,,162.85,88,,percent of total billed charges,,,,,,,,,141.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.27,22,,percent of total billed charges,,,168.4,91,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,153.6,83,,percent of total billed charges,,,,,,,,,,,,,,,153.6,83,,percent of total billed charges,,,175.81,95,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,151.75,82,,percent of total billed charges,,,166.55,90,,percent of total billed charges,,,157.3,85,,percent of total billed charges,,46.27,175.81,
SYNTHES BLADE HELICAL 11MM X 95MM,30183987,CDM,,,278,RC,outpatient,,6630,6630,,5628.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1657.5,22,,percent of total billed charges,,,,,,,,,5967,90,,percent of total billed charges,,,5489.64,82.8,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,,,,,,,,5834.4,88,,percent of total billed charges,,,,,,,,,5065.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1657.5,22,,percent of total billed charges,,,6033.3,91,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,,,,,,,,,,,,,5502.9,83,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5436.6,82,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,1657.5,6298.5,
SYNTHES SCREW LOCKING TI 5.0MM X 34MM,30183988,CDM,,,278,RC,outpatient,,2160.28,2160.28,,1834.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,540.07,22,,percent of total billed charges,,,,,,,,,1944.25,90,,percent of total billed charges,,,1788.71,82.8,,percent of total billed charges,,,1836.24,85,,percent of total billed charges,,,,,,,,,1901.05,88,,percent of total billed charges,,,,,,,,,1650.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,540.07,22,,percent of total billed charges,,,1965.85,91,,percent of total billed charges,,,2052.27,95,,percent of total billed charges,,,1793.03,83,,percent of total billed charges,,,1793.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1793.03,83,,percent of total billed charges,,,2052.27,95,,percent of total billed charges,,,1944.25,90,,percent of total billed charges,,,1944.25,90,,percent of total billed charges,,,1771.43,82,,percent of total billed charges,,,1944.25,90,,percent of total billed charges,,,1836.24,85,,percent of total billed charges,,540.07,2052.27,
SYNTHES SCREW CORTEX 1.3 X 9MM SELF TAP,30183989,CDM,,,278,RC,outpatient,,856.8,856.8,,727.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214.2,22,,percent of total billed charges,,,,,,,,,771.12,90,,percent of total billed charges,,,709.43,82.8,,percent of total billed charges,,,728.28,85,,percent of total billed charges,,,,,,,,,753.98,88,,percent of total billed charges,,,,,,,,,654.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214.2,22,,percent of total billed charges,,,779.69,91,,percent of total billed charges,,,813.96,95,,percent of total billed charges,,,711.14,83,,percent of total billed charges,,,711.14,83,,percent of total billed charges,,,,,,,,,,,,,,,711.14,83,,percent of total billed charges,,,813.96,95,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,702.58,82,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,728.28,85,,percent of total billed charges,,214.2,813.96,
SYNTHES SCREW CORTEX 1.3 X 10MM,30183990,CDM,,,278,RC,outpatient,,856.8,856.8,,727.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214.2,22,,percent of total billed charges,,,,,,,,,771.12,90,,percent of total billed charges,,,709.43,82.8,,percent of total billed charges,,,728.28,85,,percent of total billed charges,,,,,,,,,753.98,88,,percent of total billed charges,,,,,,,,,654.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214.2,22,,percent of total billed charges,,,779.69,91,,percent of total billed charges,,,813.96,95,,percent of total billed charges,,,711.14,83,,percent of total billed charges,,,711.14,83,,percent of total billed charges,,,,,,,,,,,,,,,711.14,83,,percent of total billed charges,,,813.96,95,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,702.58,82,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,728.28,85,,percent of total billed charges,,214.2,813.96,
SYNTHES SCREW CORTEX 1.5 X 8MM SELF TAP,30183991,CDM,,,278,RC,outpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.23,22,,percent of total billed charges,,,,,,,,,332.01,90,,percent of total billed charges,,,305.45,82.8,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.23,22,,percent of total billed charges,,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,92.23,350.46,
SYNTHES SCREW CORTEX 2.0 X 10MM SELF TAP,30183992,CDM,,,278,RC,outpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.23,22,,percent of total billed charges,,,,,,,,,332.01,90,,percent of total billed charges,,,305.45,82.8,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.23,22,,percent of total billed charges,,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,92.23,350.46,
SYNTHES SCREW CORTEX 2.0 X 12MM SELF TAP,30183993,CDM,,,278,RC,outpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.23,22,,percent of total billed charges,,,,,,,,,332.01,90,,percent of total billed charges,,,305.45,82.8,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.23,22,,percent of total billed charges,,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,92.23,350.46,
SYNTHES DRILL BIT 1.1MM,30183994,CDM,,,278,RC,outpatient,,795.34,795.34,,675.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,198.84,22,,percent of total billed charges,,,,,,,,,715.81,90,,percent of total billed charges,,,658.54,82.8,,percent of total billed charges,,,676.04,85,,percent of total billed charges,,,,,,,,,699.9,88,,percent of total billed charges,,,,,,,,,607.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,198.84,22,,percent of total billed charges,,,723.76,91,,percent of total billed charges,,,755.57,95,,percent of total billed charges,,,660.13,83,,percent of total billed charges,,,660.13,83,,percent of total billed charges,,,,,,,,,,,,,,,660.13,83,,percent of total billed charges,,,755.57,95,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,652.18,82,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,676.04,85,,percent of total billed charges,,198.84,755.57,
SYNTHES DRILL BIT 1.5MM,30183995,CDM,,,278,RC,outpatient,,767.55,767.55,,651.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,191.89,22,,percent of total billed charges,,,,,,,,,690.8,90,,percent of total billed charges,,,635.53,82.8,,percent of total billed charges,,,652.42,85,,percent of total billed charges,,,,,,,,,675.44,88,,percent of total billed charges,,,,,,,,,586.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,191.89,22,,percent of total billed charges,,,698.47,91,,percent of total billed charges,,,729.17,95,,percent of total billed charges,,,637.07,83,,percent of total billed charges,,,637.07,83,,percent of total billed charges,,,,,,,,,,,,,,,637.07,83,,percent of total billed charges,,,729.17,95,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,629.39,82,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,652.42,85,,percent of total billed charges,,191.89,729.17,
DEPUY HEAD HUMERAL 44 X 15,30183996,CDM,,,278,RC,outpatient,,15560.09,15560.09,,13210.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3890.02,22,,percent of total billed charges,,,,,,,,,14004.08,90,,percent of total billed charges,,,12883.75,82.8,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,,,,,,,,13692.88,88,,percent of total billed charges,,,,,,,,,11887.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3890.02,22,,percent of total billed charges,,,14159.68,91,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,12914.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12914.87,83,,percent of total billed charges,,,14782.09,95,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,12759.27,82,,percent of total billed charges,,,14004.08,90,,percent of total billed charges,,,13226.08,85,,percent of total billed charges,,3890.02,14782.09,
DEPUY STEM HUMERAL SZ 16,30183997,CDM,,,278,RC,outpatient,,17244.96,17244.96,,14640.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4311.24,22,,percent of total billed charges,,,,,,,,,15520.46,90,,percent of total billed charges,,,14278.83,82.8,,percent of total billed charges,,,14658.22,85,,percent of total billed charges,,,,,,,,,15175.56,88,,percent of total billed charges,,,,,,,,,13175.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4311.24,22,,percent of total billed charges,,,15692.91,91,,percent of total billed charges,,,16382.71,95,,percent of total billed charges,,,14313.32,83,,percent of total billed charges,,,14313.32,83,,percent of total billed charges,,,,,,,,,,,,,,,14313.32,83,,percent of total billed charges,,,16382.71,95,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,14140.87,82,,percent of total billed charges,,,15520.46,90,,percent of total billed charges,,,14658.22,85,,percent of total billed charges,,4311.24,16382.71,
ALLOSOURCE PATELLA TENDON ASCEPTIC PRESH,30183998,CDM,,,278,RC,outpatient,,18232.5,18232.5,,15479.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4558.13,22,,percent of total billed charges,,,,,,,,,16409.25,90,,percent of total billed charges,,,15096.51,82.8,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,,,,,,,,16044.6,88,,percent of total billed charges,,,,,,,,,13929.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4558.13,22,,percent of total billed charges,,,16591.58,91,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15132.98,83,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,14950.65,82,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,4558.13,17320.88,
FORCEP DISP. POLYGRAB 20MM,30183999,CDM,,,270,RC,outpatient,,468.2,468.2,,397.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.05,22,,percent of total billed charges,,,,,,,,,421.38,90,,percent of total billed charges,,,387.67,82.8,,percent of total billed charges,,,397.97,85,,percent of total billed charges,,,,,,,,,412.02,88,,percent of total billed charges,,,,,,,,,357.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.05,22,,percent of total billed charges,,,426.06,91,,percent of total billed charges,,,444.79,95,,percent of total billed charges,,,388.61,83,,percent of total billed charges,,,388.61,83,,percent of total billed charges,,,,,,,,,,,,,,,388.61,83,,percent of total billed charges,,,444.79,95,,percent of total billed charges,,,421.38,90,,percent of total billed charges,,,421.38,90,,percent of total billed charges,,,383.92,82,,percent of total billed charges,,,421.38,90,,percent of total billed charges,,,397.97,85,,percent of total billed charges,,117.05,444.79,
SYNTHES SCREW LOCKING 4.0MM X 38,30184000,CDM,,,278,RC,outpatient,,1640.93,1640.93,,1393.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,410.23,22,,percent of total billed charges,,,,,,,,,1476.84,90,,percent of total billed charges,,,1358.69,82.8,,percent of total billed charges,,,1394.79,85,,percent of total billed charges,,,,,,,,,1444.02,88,,percent of total billed charges,,,,,,,,,1253.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,410.23,22,,percent of total billed charges,,,1493.25,91,,percent of total billed charges,,,1558.88,95,,percent of total billed charges,,,1361.97,83,,percent of total billed charges,,,1361.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1361.97,83,,percent of total billed charges,,,1558.88,95,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1345.56,82,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1394.79,85,,percent of total billed charges,,410.23,1558.88,
S&N DRILL GUIDE 2.9MM,30184002,CDM,,,270,RC,outpatient,,2710.5,2710.5,,2301.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,677.63,22,,percent of total billed charges,,,,,,,,,2439.45,90,,percent of total billed charges,,,2244.29,82.8,,percent of total billed charges,,,2303.93,85,,percent of total billed charges,,,,,,,,,2385.24,88,,percent of total billed charges,,,,,,,,,2070.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,677.63,22,,percent of total billed charges,,,2466.56,91,,percent of total billed charges,,,2574.98,95,,percent of total billed charges,,,2249.72,83,,percent of total billed charges,,,2249.72,83,,percent of total billed charges,,,,,,,,,,,,,,,2249.72,83,,percent of total billed charges,,,2574.98,95,,percent of total billed charges,,,2439.45,90,,percent of total billed charges,,,2439.45,90,,percent of total billed charges,,,2222.61,82,,percent of total billed charges,,,2439.45,90,,percent of total billed charges,,,2303.93,85,,percent of total billed charges,,677.63,2574.98,
SYNTHES SCREW CANCEL 6.5X35MM,30184003,CDM,,,278,RC,outpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.18,22,,percent of total billed charges,,,,,,,,,353.43,90,,percent of total billed charges,,,325.16,82.8,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.18,22,,percent of total billed charges,,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,98.18,373.07,
SYNTHES SCREW CANCEL 6.5X25MM,30184004,CDM,,,278,RC,outpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.18,22,,percent of total billed charges,,,,,,,,,353.43,90,,percent of total billed charges,,,325.16,82.8,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.18,22,,percent of total billed charges,,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,98.18,373.07,
S&N ENDO SCREW 7 X 20,30184005,CDM,,,278,RC,outpatient,,1235,1235,,1048.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,308.75,22,,percent of total billed charges,,,,,,,,,1111.5,90,,percent of total billed charges,,,1022.58,82.8,,percent of total billed charges,,,1049.75,85,,percent of total billed charges,,,,,,,,,1086.8,88,,percent of total billed charges,,,,,,,,,943.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,308.75,22,,percent of total billed charges,,,1123.85,91,,percent of total billed charges,,,1173.25,95,,percent of total billed charges,,,1025.05,83,,percent of total billed charges,,,1025.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1025.05,83,,percent of total billed charges,,,1173.25,95,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1012.7,82,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1049.75,85,,percent of total billed charges,,308.75,1173.25,
STONE SWEEPING PARACHUTE 90 CM,30184008,CDM,,,270,RC,outpatient,,2068.63,2068.63,,1756.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,517.16,22,,percent of total billed charges,,,,,,,,,1861.77,90,,percent of total billed charges,,,1712.83,82.8,,percent of total billed charges,,,1758.34,85,,percent of total billed charges,,,,,,,,,1820.39,88,,percent of total billed charges,,,,,,,,,1580.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,517.16,22,,percent of total billed charges,,,1882.45,91,,percent of total billed charges,,,1965.2,95,,percent of total billed charges,,,1716.96,83,,percent of total billed charges,,,1716.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1716.96,83,,percent of total billed charges,,,1965.2,95,,percent of total billed charges,,,1861.77,90,,percent of total billed charges,,,1861.77,90,,percent of total billed charges,,,1696.28,82,,percent of total billed charges,,,1861.77,90,,percent of total billed charges,,,1758.34,85,,percent of total billed charges,,517.16,1965.2,
STONE BASKET ESCAPE 90CM,30184009,CDM,,,270,RC,outpatient,,2704.65,2704.65,,2296.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,676.16,22,,percent of total billed charges,,,,,,,,,2434.19,90,,percent of total billed charges,,,2239.45,82.8,,percent of total billed charges,,,2298.95,85,,percent of total billed charges,,,,,,,,,2380.09,88,,percent of total billed charges,,,,,,,,,2066.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,676.16,22,,percent of total billed charges,,,2461.23,91,,percent of total billed charges,,,2569.42,95,,percent of total billed charges,,,2244.86,83,,percent of total billed charges,,,2244.86,83,,percent of total billed charges,,,,,,,,,,,,,,,2244.86,83,,percent of total billed charges,,,2569.42,95,,percent of total billed charges,,,2434.19,90,,percent of total billed charges,,,2434.19,90,,percent of total billed charges,,,2217.81,82,,percent of total billed charges,,,2434.19,90,,percent of total billed charges,,,2298.95,85,,percent of total billed charges,,676.16,2569.42,
S&N SCREW CANN 1.5 8X20 SOFT SILK,30184011,CDM,,,278,RC,outpatient,,1235,1235,,1048.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,308.75,22,,percent of total billed charges,,,,,,,,,1111.5,90,,percent of total billed charges,,,1022.58,82.8,,percent of total billed charges,,,1049.75,85,,percent of total billed charges,,,,,,,,,1086.8,88,,percent of total billed charges,,,,,,,,,943.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,308.75,22,,percent of total billed charges,,,1123.85,91,,percent of total billed charges,,,1173.25,95,,percent of total billed charges,,,1025.05,83,,percent of total billed charges,,,1025.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1025.05,83,,percent of total billed charges,,,1173.25,95,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1012.7,82,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1049.75,85,,percent of total billed charges,,308.75,1173.25,
DEPUY LINER CONSTRAINED +4 40 X 64,30184014,CDM,,,278,RC,outpatient,,39314.21,39314.21,,33377.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9828.55,22,,percent of total billed charges,,,,,,,,,35382.79,90,,percent of total billed charges,,,32552.17,82.8,,percent of total billed charges,,,33417.08,85,,percent of total billed charges,,,,,,,,,34596.5,88,,percent of total billed charges,,,,,,,,,30036.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9828.55,22,,percent of total billed charges,,,35775.93,91,,percent of total billed charges,,,37348.5,95,,percent of total billed charges,,,32630.79,83,,percent of total billed charges,,,32630.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32630.79,83,,percent of total billed charges,,,37348.5,95,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,32237.65,82,,percent of total billed charges,,,35382.79,90,,percent of total billed charges,,,33417.08,85,,percent of total billed charges,,9828.55,37348.5,
ZIMMER FEMORAL HEAD 40MM +3.5,30184015,CDM,,,278,RC,outpatient,,6648.98,6648.98,,5644.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1662.25,22,,percent of total billed charges,,,,,,,,,5984.08,90,,percent of total billed charges,,,5505.36,82.8,,percent of total billed charges,,,5651.63,85,,percent of total billed charges,,,,,,,,,5851.1,88,,percent of total billed charges,,,,,,,,,5079.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1662.25,22,,percent of total billed charges,,,6050.57,91,,percent of total billed charges,,,6316.53,95,,percent of total billed charges,,,5518.65,83,,percent of total billed charges,,,5518.65,83,,percent of total billed charges,,,,,,,,,,,,,,,5518.65,83,,percent of total billed charges,,,6316.53,95,,percent of total billed charges,,,5984.08,90,,percent of total billed charges,,,5984.08,90,,percent of total billed charges,,,5452.16,82,,percent of total billed charges,,,5984.08,90,,percent of total billed charges,,,5651.63,85,,percent of total billed charges,,1662.25,6316.53,
BRAVO BUFFER PH 7.01 500ML,30184016,CDM,,,270,RC,outpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50,22,,percent of total billed charges,,,,,,,,,180,90,,percent of total billed charges,,,165.6,82.8,,percent of total billed charges,,,170,85,,percent of total billed charges,,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50,22,,percent of total billed charges,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,50,190,
BRAVO BUFFER PH 1.07 500ML,30184017,CDM,,,270,RC,outpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50,22,,percent of total billed charges,,,,,,,,,180,90,,percent of total billed charges,,,165.6,82.8,,percent of total billed charges,,,170,85,,percent of total billed charges,,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50,22,,percent of total billed charges,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,50,190,
COUDE CATH 22FR LUBRICATH,30184019,CDM,,,270,RC,outpatient,,88.72,88.72,,75.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.18,22,,percent of total billed charges,,,,,,,,,79.85,90,,percent of total billed charges,,,73.46,82.8,,percent of total billed charges,,,75.41,85,,percent of total billed charges,,,,,,,,,78.07,88,,percent of total billed charges,,,,,,,,,67.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.18,22,,percent of total billed charges,,,80.74,91,,percent of total billed charges,,,84.28,95,,percent of total billed charges,,,73.64,83,,percent of total billed charges,,,73.64,83,,percent of total billed charges,,,,,,,,,,,,,,,73.64,83,,percent of total billed charges,,,84.28,95,,percent of total billed charges,,,79.85,90,,percent of total billed charges,,,79.85,90,,percent of total billed charges,,,72.75,82,,percent of total billed charges,,,79.85,90,,percent of total billed charges,,,75.41,85,,percent of total billed charges,,22.18,84.28,
3FR OLIVE TIP URETERAL CATHETER,30184020,CDM,,,270,RC,outpatient,,610.89,610.89,,518.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,152.72,22,,percent of total billed charges,,,,,,,,,549.8,90,,percent of total billed charges,,,505.82,82.8,,percent of total billed charges,,,519.26,85,,percent of total billed charges,,,,,,,,,537.58,88,,percent of total billed charges,,,,,,,,,466.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,152.72,22,,percent of total billed charges,,,555.91,91,,percent of total billed charges,,,580.35,95,,percent of total billed charges,,,507.04,83,,percent of total billed charges,,,507.04,83,,percent of total billed charges,,,,,,,,,,,,,,,507.04,83,,percent of total billed charges,,,580.35,95,,percent of total billed charges,,,549.8,90,,percent of total billed charges,,,549.8,90,,percent of total billed charges,,,500.93,82,,percent of total billed charges,,,549.8,90,,percent of total billed charges,,,519.26,85,,percent of total billed charges,,152.72,580.35,
ZIMMER STEM REV. WAGNER 135 NK ANGLE 14X,30184021,CDM,,,278,RC,outpatient,,73125,73125,,62083.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18281.25,22,,percent of total billed charges,,,,,,,,,65812.5,90,,percent of total billed charges,,,60547.5,82.8,,percent of total billed charges,,,62156.25,85,,percent of total billed charges,,,,,,,,,64350,88,,percent of total billed charges,,,,,,,,,55867.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18281.25,22,,percent of total billed charges,,,66543.75,91,,percent of total billed charges,,,69468.75,95,,percent of total billed charges,,,60693.75,83,,percent of total billed charges,,,60693.75,83,,percent of total billed charges,,,,,,,,,,,,,,,60693.75,83,,percent of total billed charges,,,69468.75,95,,percent of total billed charges,,,65812.5,90,,percent of total billed charges,,,65812.5,90,,percent of total billed charges,,,59962.5,82,,percent of total billed charges,,,65812.5,90,,percent of total billed charges,,,62156.25,85,,percent of total billed charges,,18281.25,69468.75,
ZIMMER HEAD FEMORAL 40MM 12/14 +3.5,30184022,CDM,,,278,RC,outpatient,,6648.98,6648.98,,5644.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1662.25,22,,percent of total billed charges,,,,,,,,,5984.08,90,,percent of total billed charges,,,5505.36,82.8,,percent of total billed charges,,,5651.63,85,,percent of total billed charges,,,,,,,,,5851.1,88,,percent of total billed charges,,,,,,,,,5079.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1662.25,22,,percent of total billed charges,,,6050.57,91,,percent of total billed charges,,,6316.53,95,,percent of total billed charges,,,5518.65,83,,percent of total billed charges,,,5518.65,83,,percent of total billed charges,,,,,,,,,,,,,,,5518.65,83,,percent of total billed charges,,,6316.53,95,,percent of total billed charges,,,5984.08,90,,percent of total billed charges,,,5984.08,90,,percent of total billed charges,,,5452.16,82,,percent of total billed charges,,,5984.08,90,,percent of total billed charges,,,5651.63,85,,percent of total billed charges,,1662.25,6316.53,
S&N Q-FIX 1.8MM MINI SUTURE ANCHOR,30184023,CDM,,,278,RC,outpatient,,4854.85,4854.85,,4121.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1213.71,22,,percent of total billed charges,,,,,,,,,4369.37,90,,percent of total billed charges,,,4019.82,82.8,,percent of total billed charges,,,4126.62,85,,percent of total billed charges,,,,,,,,,4272.27,88,,percent of total billed charges,,,,,,,,,3709.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1213.71,22,,percent of total billed charges,,,4417.91,91,,percent of total billed charges,,,4612.11,95,,percent of total billed charges,,,4029.53,83,,percent of total billed charges,,,4029.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4029.53,83,,percent of total billed charges,,,4612.11,95,,percent of total billed charges,,,4369.37,90,,percent of total billed charges,,,4369.37,90,,percent of total billed charges,,,3980.98,82,,percent of total billed charges,,,4369.37,90,,percent of total billed charges,,,4126.62,85,,percent of total billed charges,,1213.71,4612.11,
S&N KIT DISP. FOR 1.8MM Q-FIX,30184024,CDM,,,278,RC,outpatient,,3783,3783,,3211.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,945.75,22,,percent of total billed charges,,,,,,,,,3404.7,90,,percent of total billed charges,,,3132.32,82.8,,percent of total billed charges,,,3215.55,85,,percent of total billed charges,,,,,,,,,3329.04,88,,percent of total billed charges,,,,,,,,,2890.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,945.75,22,,percent of total billed charges,,,3442.53,91,,percent of total billed charges,,,3593.85,95,,percent of total billed charges,,,3139.89,83,,percent of total billed charges,,,3139.89,83,,percent of total billed charges,,,,,,,,,,,,,,,3139.89,83,,percent of total billed charges,,,3593.85,95,,percent of total billed charges,,,3404.7,90,,percent of total billed charges,,,3404.7,90,,percent of total billed charges,,,3102.06,82,,percent of total billed charges,,,3404.7,90,,percent of total billed charges,,,3215.55,85,,percent of total billed charges,,945.75,3593.85,
S&N Q-FIX 2.8MM,30184025,CDM,,,278,RC,outpatient,,3984.5,3984.5,,3382.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,996.13,22,,percent of total billed charges,,,,,,,,,3586.05,90,,percent of total billed charges,,,3299.17,82.8,,percent of total billed charges,,,3386.83,85,,percent of total billed charges,,,,,,,,,3506.36,88,,percent of total billed charges,,,,,,,,,3044.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,996.13,22,,percent of total billed charges,,,3625.9,91,,percent of total billed charges,,,3785.28,95,,percent of total billed charges,,,3307.14,83,,percent of total billed charges,,,3307.14,83,,percent of total billed charges,,,,,,,,,,,,,,,3307.14,83,,percent of total billed charges,,,3785.28,95,,percent of total billed charges,,,3586.05,90,,percent of total billed charges,,,3586.05,90,,percent of total billed charges,,,3267.29,82,,percent of total billed charges,,,3586.05,90,,percent of total billed charges,,,3386.83,85,,percent of total billed charges,,996.13,3785.28,
S&N KIT DISP. FOR 2.8MM Q-FIX,30184026,CDM,,,278,RC,outpatient,,3315,3315,,2814.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,828.75,22,,percent of total billed charges,,,,,,,,,2983.5,90,,percent of total billed charges,,,2744.82,82.8,,percent of total billed charges,,,2817.75,85,,percent of total billed charges,,,,,,,,,2917.2,88,,percent of total billed charges,,,,,,,,,2532.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,828.75,22,,percent of total billed charges,,,3016.65,91,,percent of total billed charges,,,3149.25,95,,percent of total billed charges,,,2751.45,83,,percent of total billed charges,,,2751.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2751.45,83,,percent of total billed charges,,,3149.25,95,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2718.3,82,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2817.75,85,,percent of total billed charges,,828.75,3149.25,
ARTHREX WIRE LOOP NITINOL,30184027,CDM,,,270,RC,outpatient,,210,210,,178.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.5,22,,percent of total billed charges,,,,,,,,,189,90,,percent of total billed charges,,,173.88,82.8,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,,,,,,,,184.8,88,,percent of total billed charges,,,,,,,,,160.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.5,22,,percent of total billed charges,,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,,,,,,,,,,,,,174.3,83,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,172.2,82,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,52.5,199.5,
SYNTHES PLATE LC-DCP 6 HOLE 2.0MM,30184028,CDM,,,278,RC,outpatient,,4187.95,4187.95,,3555.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1046.99,22,,percent of total billed charges,,,,,,,,,3769.16,90,,percent of total billed charges,,,3467.62,82.8,,percent of total billed charges,,,3559.76,85,,percent of total billed charges,,,,,,,,,3685.4,88,,percent of total billed charges,,,,,,,,,3199.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1046.99,22,,percent of total billed charges,,,3811.03,91,,percent of total billed charges,,,3978.55,95,,percent of total billed charges,,,3476,83,,percent of total billed charges,,,3476,83,,percent of total billed charges,,,,,,,,,,,,,,,3476,83,,percent of total billed charges,,,3978.55,95,,percent of total billed charges,,,3769.16,90,,percent of total billed charges,,,3769.16,90,,percent of total billed charges,,,3434.12,82,,percent of total billed charges,,,3769.16,90,,percent of total billed charges,,,3559.76,85,,percent of total billed charges,,1046.99,3978.55,
SYNTHES SCREW CORTEX 2.0 X 11MM SELF TAP,30184029,CDM,,,278,RC,outpatient,,368.9,368.9,,313.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.23,22,,percent of total billed charges,,,,,,,,,332.01,90,,percent of total billed charges,,,305.45,82.8,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,,,,,,,,324.63,88,,percent of total billed charges,,,,,,,,,281.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.23,22,,percent of total billed charges,,,335.7,91,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,306.19,83,,percent of total billed charges,,,,,,,,,,,,,,,306.19,83,,percent of total billed charges,,,350.46,95,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,302.5,82,,percent of total billed charges,,,332.01,90,,percent of total billed charges,,,313.57,85,,percent of total billed charges,,92.23,350.46,
SYNTHES DRILL BIT MQC 1.3MM,30184030,CDM,,,278,RC,outpatient,,767.55,767.55,,651.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,191.89,22,,percent of total billed charges,,,,,,,,,690.8,90,,percent of total billed charges,,,635.53,82.8,,percent of total billed charges,,,652.42,85,,percent of total billed charges,,,,,,,,,675.44,88,,percent of total billed charges,,,,,,,,,586.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,191.89,22,,percent of total billed charges,,,698.47,91,,percent of total billed charges,,,729.17,95,,percent of total billed charges,,,637.07,83,,percent of total billed charges,,,637.07,83,,percent of total billed charges,,,,,,,,,,,,,,,637.07,83,,percent of total billed charges,,,729.17,95,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,629.39,82,,percent of total billed charges,,,690.8,90,,percent of total billed charges,,,652.42,85,,percent of total billed charges,,191.89,729.17,
SYNTHES SCREW CORTEX 1.3 X 11MM,30184031,CDM,,,278,RC,outpatient,,856.8,856.8,,727.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214.2,22,,percent of total billed charges,,,,,,,,,771.12,90,,percent of total billed charges,,,709.43,82.8,,percent of total billed charges,,,728.28,85,,percent of total billed charges,,,,,,,,,753.98,88,,percent of total billed charges,,,,,,,,,654.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214.2,22,,percent of total billed charges,,,779.69,91,,percent of total billed charges,,,813.96,95,,percent of total billed charges,,,711.14,83,,percent of total billed charges,,,711.14,83,,percent of total billed charges,,,,,,,,,,,,,,,711.14,83,,percent of total billed charges,,,813.96,95,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,702.58,82,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,728.28,85,,percent of total billed charges,,214.2,813.96,
ALLODERM 9.6X19.3CM FENESTRATED CONTOURE,30184032,CDM,,,278,RC,outpatient,,41119,41119,,34910.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10279.75,22,,percent of total billed charges,,,,,,,,,37007.1,90,,percent of total billed charges,,,34046.53,82.8,,percent of total billed charges,,,34951.15,85,,percent of total billed charges,,,,,,,,,36184.72,88,,percent of total billed charges,,,,,,,,,31414.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10279.75,22,,percent of total billed charges,,,37418.29,91,,percent of total billed charges,,,39063.05,95,,percent of total billed charges,,,34128.77,83,,percent of total billed charges,,,34128.77,83,,percent of total billed charges,,,,,,,,,,,,,,,34128.77,83,,percent of total billed charges,,,39063.05,95,,percent of total billed charges,,,37007.1,90,,percent of total billed charges,,,37007.1,90,,percent of total billed charges,,,33717.58,82,,percent of total billed charges,,,37007.1,90,,percent of total billed charges,,,34951.15,85,,percent of total billed charges,,10279.75,39063.05,
STRYKER SHAVER LONG HIP AGGR. PLUS 4.0,30184033,CDM,,,270,RC,outpatient,,641.62,641.62,,544.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,160.41,22,,percent of total billed charges,,,,,,,,,577.46,90,,percent of total billed charges,,,531.26,82.8,,percent of total billed charges,,,545.38,85,,percent of total billed charges,,,,,,,,,564.63,88,,percent of total billed charges,,,,,,,,,490.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,160.41,22,,percent of total billed charges,,,583.87,91,,percent of total billed charges,,,609.54,95,,percent of total billed charges,,,532.54,83,,percent of total billed charges,,,532.54,83,,percent of total billed charges,,,,,,,,,,,,,,,532.54,83,,percent of total billed charges,,,609.54,95,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,526.13,82,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,545.38,85,,percent of total billed charges,,160.41,609.54,
STRYKER BURR  BARREL 5.5,30184034,CDM,,,270,RC,outpatient,,680.4,680.4,,577.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,170.1,22,,percent of total billed charges,,,,,,,,,612.36,90,,percent of total billed charges,,,563.37,82.8,,percent of total billed charges,,,578.34,85,,percent of total billed charges,,,,,,,,,598.75,88,,percent of total billed charges,,,,,,,,,519.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,170.1,22,,percent of total billed charges,,,619.16,91,,percent of total billed charges,,,646.38,95,,percent of total billed charges,,,564.73,83,,percent of total billed charges,,,564.73,83,,percent of total billed charges,,,,,,,,,,,,,,,564.73,83,,percent of total billed charges,,,646.38,95,,percent of total billed charges,,,612.36,90,,percent of total billed charges,,,612.36,90,,percent of total billed charges,,,557.93,82,,percent of total billed charges,,,612.36,90,,percent of total billed charges,,,578.34,85,,percent of total billed charges,,170.1,646.38,
S&N PERINEAL PAD SUPINE,30184035,CDM,,,270,RC,outpatient,,639.45,639.45,,542.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.86,22,,percent of total billed charges,,,,,,,,,575.51,90,,percent of total billed charges,,,529.46,82.8,,percent of total billed charges,,,543.53,85,,percent of total billed charges,,,,,,,,,562.72,88,,percent of total billed charges,,,,,,,,,488.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.86,22,,percent of total billed charges,,,581.9,91,,percent of total billed charges,,,607.48,95,,percent of total billed charges,,,530.74,83,,percent of total billed charges,,,530.74,83,,percent of total billed charges,,,,,,,,,,,,,,,530.74,83,,percent of total billed charges,,,607.48,95,,percent of total billed charges,,,575.51,90,,percent of total billed charges,,,575.51,90,,percent of total billed charges,,,524.35,82,,percent of total billed charges,,,575.51,90,,percent of total billed charges,,,543.53,85,,percent of total billed charges,,159.86,607.48,
S&N HIP PAC DISP.,30184036,CDM,,,270,RC,outpatient,,1808.63,1808.63,,1535.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,452.16,22,,percent of total billed charges,,,,,,,,,1627.77,90,,percent of total billed charges,,,1497.55,82.8,,percent of total billed charges,,,1537.34,85,,percent of total billed charges,,,,,,,,,1591.59,88,,percent of total billed charges,,,,,,,,,1381.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,452.16,22,,percent of total billed charges,,,1645.85,91,,percent of total billed charges,,,1718.2,95,,percent of total billed charges,,,1501.16,83,,percent of total billed charges,,,1501.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1501.16,83,,percent of total billed charges,,,1718.2,95,,percent of total billed charges,,,1627.77,90,,percent of total billed charges,,,1627.77,90,,percent of total billed charges,,,1483.08,82,,percent of total billed charges,,,1627.77,90,,percent of total billed charges,,,1537.34,85,,percent of total billed charges,,452.16,1718.2,
S&N BEAVER BLADE,30184037,CDM,,,270,RC,outpatient,,256.8,256.8,,218.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.2,22,,percent of total billed charges,,,,,,,,,231.12,90,,percent of total billed charges,,,212.63,82.8,,percent of total billed charges,,,218.28,85,,percent of total billed charges,,,,,,,,,225.98,88,,percent of total billed charges,,,,,,,,,196.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.2,22,,percent of total billed charges,,,233.69,91,,percent of total billed charges,,,243.96,95,,percent of total billed charges,,,213.14,83,,percent of total billed charges,,,213.14,83,,percent of total billed charges,,,,,,,,,,,,,,,213.14,83,,percent of total billed charges,,,243.96,95,,percent of total billed charges,,,231.12,90,,percent of total billed charges,,,231.12,90,,percent of total billed charges,,,210.58,82,,percent of total billed charges,,,231.12,90,,percent of total billed charges,,,218.28,85,,percent of total billed charges,,64.2,243.96,
S&N WAND 50 DEG CROSS RF-S,30184038,CDM,,,270,RC,outpatient,,1261,1261,,1070.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,315.25,22,,percent of total billed charges,,,,,,,,,1134.9,90,,percent of total billed charges,,,1044.11,82.8,,percent of total billed charges,,,1071.85,85,,percent of total billed charges,,,,,,,,,1109.68,88,,percent of total billed charges,,,,,,,,,963.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,315.25,22,,percent of total billed charges,,,1147.51,91,,percent of total billed charges,,,1197.95,95,,percent of total billed charges,,,1046.63,83,,percent of total billed charges,,,1046.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1046.63,83,,percent of total billed charges,,,1197.95,95,,percent of total billed charges,,,1134.9,90,,percent of total billed charges,,,1134.9,90,,percent of total billed charges,,,1034.02,82,,percent of total billed charges,,,1134.9,90,,percent of total billed charges,,,1071.85,85,,percent of total billed charges,,315.25,1197.95,
S&N SUTURE ANCHOR KNOTLESS BIORAPTOR,30184039,CDM,,,270,RC,outpatient,,2736.83,2736.83,,2323.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,684.21,22,,percent of total billed charges,,,,,,,,,2463.15,90,,percent of total billed charges,,,2266.1,82.8,,percent of total billed charges,,,2326.31,85,,percent of total billed charges,,,,,,,,,2408.41,88,,percent of total billed charges,,,,,,,,,2090.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,684.21,22,,percent of total billed charges,,,2490.52,91,,percent of total billed charges,,,2599.99,95,,percent of total billed charges,,,2271.57,83,,percent of total billed charges,,,2271.57,83,,percent of total billed charges,,,,,,,,,,,,,,,2271.57,83,,percent of total billed charges,,,2599.99,95,,percent of total billed charges,,,2463.15,90,,percent of total billed charges,,,2463.15,90,,percent of total billed charges,,,2244.2,82,,percent of total billed charges,,,2463.15,90,,percent of total billed charges,,,2326.31,85,,percent of total billed charges,,684.21,2599.99,
S&N ULTRABRAID #2,30184040,CDM,,,270,RC,outpatient,,157.6,157.6,,133.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.4,22,,percent of total billed charges,,,,,,,,,141.84,90,,percent of total billed charges,,,130.49,82.8,,percent of total billed charges,,,133.96,85,,percent of total billed charges,,,,,,,,,138.69,88,,percent of total billed charges,,,,,,,,,120.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.4,22,,percent of total billed charges,,,143.42,91,,percent of total billed charges,,,149.72,95,,percent of total billed charges,,,130.81,83,,percent of total billed charges,,,130.81,83,,percent of total billed charges,,,,,,,,,,,,,,,130.81,83,,percent of total billed charges,,,149.72,95,,percent of total billed charges,,,141.84,90,,percent of total billed charges,,,141.84,90,,percent of total billed charges,,,129.23,82,,percent of total billed charges,,,141.84,90,,percent of total billed charges,,,133.96,85,,percent of total billed charges,,39.4,149.72,
S&N HIP CANNULA 7X90 CLEAR TRAC,30184041,CDM,,,270,RC,outpatient,,240.68,240.68,,204.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60.17,22,,percent of total billed charges,,,,,,,,,216.61,90,,percent of total billed charges,,,199.28,82.8,,percent of total billed charges,,,204.58,85,,percent of total billed charges,,,,,,,,,211.8,88,,percent of total billed charges,,,,,,,,,183.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60.17,22,,percent of total billed charges,,,219.02,91,,percent of total billed charges,,,228.65,95,,percent of total billed charges,,,199.76,83,,percent of total billed charges,,,199.76,83,,percent of total billed charges,,,,,,,,,,,,,,,199.76,83,,percent of total billed charges,,,228.65,95,,percent of total billed charges,,,216.61,90,,percent of total billed charges,,,216.61,90,,percent of total billed charges,,,197.36,82,,percent of total billed charges,,,216.61,90,,percent of total billed charges,,,204.58,85,,percent of total billed charges,,60.17,228.65,
DEPUY PINNACLE SHELL DPX REVISION 54MM,30184043,CDM,,,278,RC,outpatient,,33437.04,33437.04,,28388.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8359.26,22,,percent of total billed charges,,,,,,,,,30093.34,90,,percent of total billed charges,,,27685.87,82.8,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,,,,,,,,29424.6,88,,percent of total billed charges,,,,,,,,,25545.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8359.26,22,,percent of total billed charges,,,30427.71,91,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,,,,,,,,,,,,,27752.74,83,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,27418.37,82,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,8359.26,31765.19,
DEPUY SCREW TF 5x60MM,30184044,CDM,,,278,RC,outpatient,,987.87,987.87,,838.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,246.97,22,,percent of total billed charges,,,,,,,,,889.08,90,,percent of total billed charges,,,817.96,82.8,,percent of total billed charges,,,839.69,85,,percent of total billed charges,,,,,,,,,869.33,88,,percent of total billed charges,,,,,,,,,754.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,246.97,22,,percent of total billed charges,,,898.96,91,,percent of total billed charges,,,938.48,95,,percent of total billed charges,,,819.93,83,,percent of total billed charges,,,819.93,83,,percent of total billed charges,,,,,,,,,,,,,,,819.93,83,,percent of total billed charges,,,938.48,95,,percent of total billed charges,,,889.08,90,,percent of total billed charges,,,889.08,90,,percent of total billed charges,,,810.05,82,,percent of total billed charges,,,889.08,90,,percent of total billed charges,,,839.69,85,,percent of total billed charges,,246.97,938.48,
DEPUY INSERT AOX CR SZ 6 6MM,30184047,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY ANCHOR PEG GLENOID SZ52,30184048,CDM,,,278,RC,outpatient,,17098.9,17098.9,,14516.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4274.73,22,,percent of total billed charges,,,,,,,,,15389.01,90,,percent of total billed charges,,,14157.89,82.8,,percent of total billed charges,,,14534.07,85,,percent of total billed charges,,,,,,,,,15047.03,88,,percent of total billed charges,,,,,,,,,13063.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4274.73,22,,percent of total billed charges,,,15560,91,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,,,,,,,,,,,,,14192.09,83,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14021.1,82,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14534.07,85,,percent of total billed charges,,4274.73,16243.96,
ARTHREX IMPLANT SYSTEM BIO-COMP ACHILLES,30184049,CDM,,,278,RC,outpatient,,11310,11310,,9602.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2827.5,22,,percent of total billed charges,,,,,,,,,10179,90,,percent of total billed charges,,,9364.68,82.8,,percent of total billed charges,,,9613.5,85,,percent of total billed charges,,,,,,,,,9952.8,88,,percent of total billed charges,,,,,,,,,8640.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2827.5,22,,percent of total billed charges,,,10292.1,91,,percent of total billed charges,,,10744.5,95,,percent of total billed charges,,,9387.3,83,,percent of total billed charges,,,9387.3,83,,percent of total billed charges,,,,,,,,,,,,,,,9387.3,83,,percent of total billed charges,,,10744.5,95,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,9274.2,82,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,9613.5,85,,percent of total billed charges,,2827.5,10744.5,
CROSSBOW FASCIAL CLOSTURE,30184051,CDM,,,270,RC,outpatient,,560,560,,475.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,140,22,,percent of total billed charges,,,,,,,,,504,90,,percent of total billed charges,,,463.68,82.8,,percent of total billed charges,,,476,85,,percent of total billed charges,,,,,,,,,492.8,88,,percent of total billed charges,,,,,,,,,427.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,140,22,,percent of total billed charges,,,509.6,91,,percent of total billed charges,,,532,95,,percent of total billed charges,,,464.8,83,,percent of total billed charges,,,464.8,83,,percent of total billed charges,,,,,,,,,,,,,,,464.8,83,,percent of total billed charges,,,532,95,,percent of total billed charges,,,504,90,,percent of total billed charges,,,504,90,,percent of total billed charges,,,459.2,82,,percent of total billed charges,,,504,90,,percent of total billed charges,,,476,85,,percent of total billed charges,,140,532,
TRI-FUNNEL REPLACEMENT GASTROSTOMY TUBE,30184052,CDM,,,270,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
CATH STRAIGHT FILIFORM TIP 3FR,30184053,CDM,,,270,RC,outpatient,,501.62,501.62,,425.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125.41,22,,percent of total billed charges,,,,,,,,,451.46,90,,percent of total billed charges,,,415.34,82.8,,percent of total billed charges,,,426.38,85,,percent of total billed charges,,,,,,,,,441.43,88,,percent of total billed charges,,,,,,,,,383.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125.41,22,,percent of total billed charges,,,456.47,91,,percent of total billed charges,,,476.54,95,,percent of total billed charges,,,416.34,83,,percent of total billed charges,,,416.34,83,,percent of total billed charges,,,,,,,,,,,,,,,416.34,83,,percent of total billed charges,,,476.54,95,,percent of total billed charges,,,451.46,90,,percent of total billed charges,,,451.46,90,,percent of total billed charges,,,411.33,82,,percent of total billed charges,,,451.46,90,,percent of total billed charges,,,426.38,85,,percent of total billed charges,,125.41,476.54,
SUTURE ETHIBOND EXCEL OS-4 30,30184059,CDM,,,270,RC,outpatient,,22.19,22.19,,18.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.55,22,,percent of total billed charges,,,,,,,,,19.97,90,,percent of total billed charges,,,18.37,82.8,,percent of total billed charges,,,18.86,85,,percent of total billed charges,,,,,,,,,19.53,88,,percent of total billed charges,,,,,,,,,16.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.55,22,,percent of total billed charges,,,20.19,91,,percent of total billed charges,,,21.08,95,,percent of total billed charges,,,18.42,83,,percent of total billed charges,,,18.42,83,,percent of total billed charges,,,,,,,,,,,,,,,18.42,83,,percent of total billed charges,,,21.08,95,,percent of total billed charges,,,19.97,90,,percent of total billed charges,,,19.97,90,,percent of total billed charges,,,18.2,82,,percent of total billed charges,,,19.97,90,,percent of total billed charges,,,18.86,85,,percent of total billed charges,,5.55,21.08,
DEPUY PINNACLE 100 CUP SECTOR II 52MM,30184070,CDM,,,278,RC,outpatient,,20679.88,20679.88,,17557.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5169.97,22,,percent of total billed charges,,,,,,,,,18611.89,90,,percent of total billed charges,,,17122.94,82.8,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,,,,,,,,18198.29,88,,percent of total billed charges,,,,,,,,,15799.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5169.97,22,,percent of total billed charges,,,18818.69,91,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,17164.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17164.3,83,,percent of total billed charges,,,19645.89,95,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,16957.5,82,,percent of total billed charges,,,18611.89,90,,percent of total billed charges,,,17577.9,85,,percent of total billed charges,,5169.97,19645.89,
DEPUY LINER CERAMIC CESAMAX 52X36,30184071,CDM,,,278,RC,outpatient,,18915.85,18915.85,,16059.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4728.96,22,,percent of total billed charges,,,,,,,,,17024.27,90,,percent of total billed charges,,,15662.32,82.8,,percent of total billed charges,,,16078.47,85,,percent of total billed charges,,,,,,,,,16645.95,88,,percent of total billed charges,,,,,,,,,14451.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4728.96,22,,percent of total billed charges,,,17213.42,91,,percent of total billed charges,,,17970.06,95,,percent of total billed charges,,,15700.16,83,,percent of total billed charges,,,15700.16,83,,percent of total billed charges,,,,,,,,,,,,,,,15700.16,83,,percent of total billed charges,,,17970.06,95,,percent of total billed charges,,,17024.27,90,,percent of total billed charges,,,17024.27,90,,percent of total billed charges,,,15511,82,,percent of total billed charges,,,17024.27,90,,percent of total billed charges,,,16078.47,85,,percent of total billed charges,,4728.96,17970.06,
LEXION PNEUVIEW XE,30184076,CDM,,,270,RC,outpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40,22,,percent of total billed charges,,,,,,,,,144,90,,percent of total billed charges,,,132.48,82.8,,percent of total billed charges,,,136,85,,percent of total billed charges,,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40,22,,percent of total billed charges,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,40,152,
SYNTHES SCREW CORTEX S-T 2.7X10MM,30184078,CDM,,,278,RC,outpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.13,22,,percent of total billed charges,,,,,,,,,374.85,90,,percent of total billed charges,,,344.86,82.8,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.13,22,,percent of total billed charges,,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,104.13,395.68,
SYNTHES SCREW CORTEX S-T 2.7X12MM,30184079,CDM,,,278,RC,outpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.46,22,,percent of total billed charges,,,,,,,,,397.66,90,,percent of total billed charges,,,365.84,82.8,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.46,22,,percent of total billed charges,,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,110.46,419.75,
SYNTHES SCREW CORTEX S-T 2.7X26MM,30184081,CDM,,,278,RC,outpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.46,22,,percent of total billed charges,,,,,,,,,397.66,90,,percent of total billed charges,,,365.84,82.8,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.46,22,,percent of total billed charges,,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,110.46,419.75,
SYNTHES SCREW CORTEX S-T 2.7X28MM,30184082,CDM,,,278,RC,outpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.46,22,,percent of total billed charges,,,,,,,,,397.66,90,,percent of total billed charges,,,365.84,82.8,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.46,22,,percent of total billed charges,,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,110.46,419.75,
SYNTHES SCREW CORTEX S-T 2.7X30MM,30184083,CDM,,,278,RC,outpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.13,22,,percent of total billed charges,,,,,,,,,374.85,90,,percent of total billed charges,,,344.86,82.8,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.13,22,,percent of total billed charges,,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,104.13,395.68,
SYNTHES SCREW CORTEX S-T 2.7X32MM,30184084,CDM,,,278,RC,outpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.13,22,,percent of total billed charges,,,,,,,,,374.85,90,,percent of total billed charges,,,344.86,82.8,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.13,22,,percent of total billed charges,,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,104.13,395.68,
SYNTHES SCREW CORTEX S-T 2.7X34MM,30184085,CDM,,,278,RC,outpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.13,22,,percent of total billed charges,,,,,,,,,374.85,90,,percent of total billed charges,,,344.86,82.8,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.13,22,,percent of total billed charges,,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,104.13,395.68,
SYNTHES SCREW CORTEX S-T 2.7X36MM,30184086,CDM,,,278,RC,outpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.46,22,,percent of total billed charges,,,,,,,,,397.66,90,,percent of total billed charges,,,365.84,82.8,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.46,22,,percent of total billed charges,,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,110.46,419.75,
SYNTHES SCREW CORTEX S-T 2.7X38MM,30184087,CDM,,,278,RC,outpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.46,22,,percent of total billed charges,,,,,,,,,397.66,90,,percent of total billed charges,,,365.84,82.8,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.46,22,,percent of total billed charges,,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,110.46,419.75,
SYNTHES SCREW CORTEX S-T 2.7X40MM,30184088,CDM,,,278,RC,outpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.13,22,,percent of total billed charges,,,,,,,,,374.85,90,,percent of total billed charges,,,344.86,82.8,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.13,22,,percent of total billed charges,,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,104.13,395.68,
SYNTHES SCREW CORTEX S-T 2.7X45MM,30184089,CDM,,,278,RC,outpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.13,22,,percent of total billed charges,,,,,,,,,374.85,90,,percent of total billed charges,,,344.86,82.8,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.13,22,,percent of total billed charges,,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,104.13,395.68,
SYNTHES SCREW CORTEX S-T 2.7X50MM,30184090,CDM,,,278,RC,outpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.13,22,,percent of total billed charges,,,,,,,,,374.85,90,,percent of total billed charges,,,344.86,82.8,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.13,22,,percent of total billed charges,,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,104.13,395.68,
SYNTHES SCREW CORTEX S-T 2.7X55MM,30184091,CDM,,,278,RC,outpatient,,481.95,481.95,,409.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,120.49,22,,percent of total billed charges,,,,,,,,,433.76,90,,percent of total billed charges,,,399.05,82.8,,percent of total billed charges,,,409.66,85,,percent of total billed charges,,,,,,,,,424.12,88,,percent of total billed charges,,,,,,,,,368.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,120.49,22,,percent of total billed charges,,,438.57,91,,percent of total billed charges,,,457.85,95,,percent of total billed charges,,,400.02,83,,percent of total billed charges,,,400.02,83,,percent of total billed charges,,,,,,,,,,,,,,,400.02,83,,percent of total billed charges,,,457.85,95,,percent of total billed charges,,,433.76,90,,percent of total billed charges,,,433.76,90,,percent of total billed charges,,,395.2,82,,percent of total billed charges,,,433.76,90,,percent of total billed charges,,,409.66,85,,percent of total billed charges,,120.49,457.85,
SYNTHES SCREW LOCKING S-T 2.7X24MM W/STA,30184092,CDM,,,278,RC,outpatient,,1143.87,1143.87,,971.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,285.97,22,,percent of total billed charges,,,,,,,,,1029.48,90,,percent of total billed charges,,,947.12,82.8,,percent of total billed charges,,,972.29,85,,percent of total billed charges,,,,,,,,,1006.61,88,,percent of total billed charges,,,,,,,,,873.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,285.97,22,,percent of total billed charges,,,1040.92,91,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,,,,,,,,,,,,,949.41,83,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,937.97,82,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,972.29,85,,percent of total billed charges,,285.97,1086.68,
SYNTHES SCREW LOCKING S-T 2.7X26MM W/STA,30184093,CDM,,,278,RC,outpatient,,1143.87,1143.87,,971.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,285.97,22,,percent of total billed charges,,,,,,,,,1029.48,90,,percent of total billed charges,,,947.12,82.8,,percent of total billed charges,,,972.29,85,,percent of total billed charges,,,,,,,,,1006.61,88,,percent of total billed charges,,,,,,,,,873.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,285.97,22,,percent of total billed charges,,,1040.92,91,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,,,,,,,,,,,,,949.41,83,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,937.97,82,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,972.29,85,,percent of total billed charges,,285.97,1086.68,
SYNTHES SCREW CANCELLOUS 4X5MM,30184095,CDM,,,278,RC,outpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.18,22,,percent of total billed charges,,,,,,,,,213.03,90,,percent of total billed charges,,,195.99,82.8,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.18,22,,percent of total billed charges,,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,59.18,224.87,
SYNTHES SCREW CANN. 4X12MM SHORT THREAD,30184096,CDM,,,278,RC,outpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,486.2,22,,percent of total billed charges,,,,,,,,,1750.32,90,,percent of total billed charges,,,1610.29,82.8,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,486.2,22,,percent of total billed charges,,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,486.2,1847.56,
SYNTHES SCREW CANN. 4X14MM SHORT THREAD,30184097,CDM,,,278,RC,outpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,486.2,22,,percent of total billed charges,,,,,,,,,1750.32,90,,percent of total billed charges,,,1610.29,82.8,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,486.2,22,,percent of total billed charges,,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,486.2,1847.56,
SYNTHES SCREW CANN. 4X20MM SHORT THREAD,30184098,CDM,,,278,RC,outpatient,,2063.23,2063.23,,1751.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,515.81,22,,percent of total billed charges,,,,,,,,,1856.91,90,,percent of total billed charges,,,1708.35,82.8,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,,,,,,,,1815.64,88,,percent of total billed charges,,,,,,,,,1576.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,515.81,22,,percent of total billed charges,,,1877.54,91,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1712.48,83,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1691.85,82,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,515.81,1960.07,
SYNTHES SCREW CANN. 6.5X30MM 16MM THREAD,30184099,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X35MM 16MM THREAD,30184100,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X40MM 16MM THREAD,30184101,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X45MM 16MM THREAD,30184102,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X90MM 16MM THREAD,30184103,CDM,,,278,RC,outpatient,,2696.27,2696.27,,2289.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,674.07,22,,percent of total billed charges,,,,,,,,,2426.64,90,,percent of total billed charges,,,2232.51,82.8,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,,,,,,,,2372.72,88,,percent of total billed charges,,,,,,,,,2059.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,674.07,22,,percent of total billed charges,,,2453.61,91,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2237.9,83,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2210.94,82,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,674.07,2561.46,
SYNTHES SCREW CANN. 6.5X95MM 16MM THREAD,30184104,CDM,,,278,RC,outpatient,,2696.27,2696.27,,2289.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,674.07,22,,percent of total billed charges,,,,,,,,,2426.64,90,,percent of total billed charges,,,2232.51,82.8,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,,,,,,,,2372.72,88,,percent of total billed charges,,,,,,,,,2059.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,674.07,22,,percent of total billed charges,,,2453.61,91,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2237.9,83,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2210.94,82,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,674.07,2561.46,
SYNTHES SCREW CANN. 6.5X105MM 16MM THRE,30184105,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X110MM 16MM THRE,30184106,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X115MM 16MM THRE,30184107,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X120MM 16MM THRE,30184108,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X125MM 16MM THRE,30184109,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X130MM 16MM THRE,30184110,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X50MM 32MM THRE,30184111,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X55MM 32MM THREAD,30184112,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X95MM 32MM THRE,30184113,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X100MM 32MM THRE,30184114,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X100MM 32MM THRE,30184115,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X110MM 32MM THRE,30184116,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X115MM 32MM THRE,30184117,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X120MM 32MM THRE,30184118,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X125MM 32MM THRE,30184119,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANN. 6.5X130MM 32MM THRE,30184120,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW LOCKING S-T 3.5X55MM W/STA,30184122,CDM,,,278,RC,outpatient,,1182.35,1182.35,,1003.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,295.59,22,,percent of total billed charges,,,,,,,,,1064.12,90,,percent of total billed charges,,,978.99,82.8,,percent of total billed charges,,,1005,85,,percent of total billed charges,,,,,,,,,1040.47,88,,percent of total billed charges,,,,,,,,,903.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,295.59,22,,percent of total billed charges,,,1075.94,91,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,981.35,83,,percent of total billed charges,,,,,,,,,,,,,,,981.35,83,,percent of total billed charges,,,1123.23,95,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,969.53,82,,percent of total billed charges,,,1064.12,90,,percent of total billed charges,,,1005,85,,percent of total billed charges,,295.59,1123.23,
SYNTHES SCREW CORTEX S-T 4.5X22MM,30184123,CDM,,,278,RC,outpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.35,22,,percent of total billed charges,,,,,,,,,235.24,90,,percent of total billed charges,,,216.42,82.8,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.35,22,,percent of total billed charges,,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,65.35,248.31,
SYNTHES SCREW CORTEX S-T 4.5X24MM,30184124,CDM,,,278,RC,outpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.35,22,,percent of total billed charges,,,,,,,,,235.24,90,,percent of total billed charges,,,216.42,82.8,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.35,22,,percent of total billed charges,,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,65.35,248.31,
SYNTHES SCREW CORTEX S-T 4.5X26MM,30184125,CDM,,,278,RC,outpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.35,22,,percent of total billed charges,,,,,,,,,235.24,90,,percent of total billed charges,,,216.42,82.8,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.35,22,,percent of total billed charges,,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,65.35,248.31,
SYNTHES SCREW CORTEX S-T 4.5X58MM,30184126,CDM,,,278,RC,outpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.35,22,,percent of total billed charges,,,,,,,,,235.24,90,,percent of total billed charges,,,216.42,82.8,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.35,22,,percent of total billed charges,,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,65.35,248.31,
SYNTHES SCREW CANCELLOUS 6.5X45MM 16MM T,30184134,CDM,,,278,RC,outpatient,,916.5,916.5,,778.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,229.13,22,,percent of total billed charges,,,,,,,,,824.85,90,,percent of total billed charges,,,758.86,82.8,,percent of total billed charges,,,779.03,85,,percent of total billed charges,,,,,,,,,806.52,88,,percent of total billed charges,,,,,,,,,700.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,229.13,22,,percent of total billed charges,,,834.02,91,,percent of total billed charges,,,870.68,95,,percent of total billed charges,,,760.7,83,,percent of total billed charges,,,760.7,83,,percent of total billed charges,,,,,,,,,,,,,,,760.7,83,,percent of total billed charges,,,870.68,95,,percent of total billed charges,,,824.85,90,,percent of total billed charges,,,824.85,90,,percent of total billed charges,,,751.53,82,,percent of total billed charges,,,824.85,90,,percent of total billed charges,,,779.03,85,,percent of total billed charges,,229.13,870.68,
SYNTHES SCREW CANCELLOUS 6.5X50MM 16MM T,30184135,CDM,,,278,RC,outpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.18,22,,percent of total billed charges,,,,,,,,,353.43,90,,percent of total billed charges,,,325.16,82.8,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.18,22,,percent of total billed charges,,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,98.18,373.07,
SYNTHES SCREW CANCELLOUS 6.5X55MM 16MM T,30184136,CDM,,,278,RC,outpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.18,22,,percent of total billed charges,,,,,,,,,353.43,90,,percent of total billed charges,,,325.16,82.8,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.18,22,,percent of total billed charges,,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,98.18,373.07,
SYNTHES SCREW CANCELLOUS 6.5X60MM 16MM T,30184137,CDM,,,278,RC,outpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.18,22,,percent of total billed charges,,,,,,,,,353.43,90,,percent of total billed charges,,,325.16,82.8,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.18,22,,percent of total billed charges,,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,98.18,373.07,
SYNTHES SCREW CANCELLOUS 6.5X65MM 16MM T,30184138,CDM,,,278,RC,outpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.18,22,,percent of total billed charges,,,,,,,,,353.43,90,,percent of total billed charges,,,325.16,82.8,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.18,22,,percent of total billed charges,,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,98.18,373.07,
SYNTHES SCREW CANCELLOUS 6.5X70MM 16MM T,30184139,CDM,,,278,RC,outpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.18,22,,percent of total billed charges,,,,,,,,,353.43,90,,percent of total billed charges,,,325.16,82.8,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.18,22,,percent of total billed charges,,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,98.18,373.07,
SYNTHES SCREW CANCELLOUS 6.5X75MM 16MM T,30184140,CDM,,,278,RC,outpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.18,22,,percent of total billed charges,,,,,,,,,353.43,90,,percent of total billed charges,,,325.16,82.8,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.18,22,,percent of total billed charges,,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,98.18,373.07,
SYNTHES SCREW CANCELLOUS 6.5X80MM 16MM T,30184141,CDM,,,278,RC,outpatient,,416.64,416.64,,353.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.16,22,,percent of total billed charges,,,,,,,,,374.98,90,,percent of total billed charges,,,344.98,82.8,,percent of total billed charges,,,354.14,85,,percent of total billed charges,,,,,,,,,366.64,88,,percent of total billed charges,,,,,,,,,318.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.16,22,,percent of total billed charges,,,379.14,91,,percent of total billed charges,,,395.81,95,,percent of total billed charges,,,345.81,83,,percent of total billed charges,,,345.81,83,,percent of total billed charges,,,,,,,,,,,,,,,345.81,83,,percent of total billed charges,,,395.81,95,,percent of total billed charges,,,374.98,90,,percent of total billed charges,,,374.98,90,,percent of total billed charges,,,341.64,82,,percent of total billed charges,,,374.98,90,,percent of total billed charges,,,354.14,85,,percent of total billed charges,,104.16,395.81,
SYNTHES SCREW CANCELLOUS 6.5X85MM 16MM T,30184142,CDM,,,278,RC,outpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.1,22,,percent of total billed charges,,,,,,,,,385.56,90,,percent of total billed charges,,,354.72,82.8,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.1,22,,percent of total billed charges,,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,107.1,406.98,
SYNTHES SCREW CANCELLOUS 6.5X90MM 16MM T,30184143,CDM,,,278,RC,outpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.1,22,,percent of total billed charges,,,,,,,,,385.56,90,,percent of total billed charges,,,354.72,82.8,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.1,22,,percent of total billed charges,,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,107.1,406.98,
SYNTHES SCREW CANCELLOUS 6.5X100MM 16MM,30184144,CDM,,,278,RC,outpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.1,22,,percent of total billed charges,,,,,,,,,385.56,90,,percent of total billed charges,,,354.72,82.8,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.1,22,,percent of total billed charges,,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,107.1,406.98,
SYNTHES SCREW CANCELLOUS 6.5X105MM 16MM,30184145,CDM,,,278,RC,outpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.1,22,,percent of total billed charges,,,,,,,,,385.56,90,,percent of total billed charges,,,354.72,82.8,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.1,22,,percent of total billed charges,,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,107.1,406.98,
SYNTHES SCREW CANCELLOUS 6.5X110MM 16MM,30184146,CDM,,,278,RC,outpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.1,22,,percent of total billed charges,,,,,,,,,385.56,90,,percent of total billed charges,,,354.72,82.8,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.1,22,,percent of total billed charges,,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,107.1,406.98,
SYNTHES PLATE LCP 9 HOLE 3.5X124MM,30184147,CDM,,,278,RC,outpatient,,3326.05,3326.05,,2823.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,831.51,22,,percent of total billed charges,,,,,,,,,2993.45,90,,percent of total billed charges,,,2753.97,82.8,,percent of total billed charges,,,2827.14,85,,percent of total billed charges,,,,,,,,,2926.92,88,,percent of total billed charges,,,,,,,,,2541.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,831.51,22,,percent of total billed charges,,,3026.71,91,,percent of total billed charges,,,3159.75,95,,percent of total billed charges,,,2760.62,83,,percent of total billed charges,,,2760.62,83,,percent of total billed charges,,,,,,,,,,,,,,,2760.62,83,,percent of total billed charges,,,3159.75,95,,percent of total billed charges,,,2993.45,90,,percent of total billed charges,,,2993.45,90,,percent of total billed charges,,,2727.36,82,,percent of total billed charges,,,2993.45,90,,percent of total billed charges,,,2827.14,85,,percent of total billed charges,,831.51,3159.75,
SYNTHES PLATE LCP 10 HOLE 3.5X137MM,30184148,CDM,,,278,RC,outpatient,,3528.27,3528.27,,2995.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,882.07,22,,percent of total billed charges,,,,,,,,,3175.44,90,,percent of total billed charges,,,2921.41,82.8,,percent of total billed charges,,,2999.03,85,,percent of total billed charges,,,,,,,,,3104.88,88,,percent of total billed charges,,,,,,,,,2695.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,882.07,22,,percent of total billed charges,,,3210.73,91,,percent of total billed charges,,,3351.86,95,,percent of total billed charges,,,2928.46,83,,percent of total billed charges,,,2928.46,83,,percent of total billed charges,,,,,,,,,,,,,,,2928.46,83,,percent of total billed charges,,,3351.86,95,,percent of total billed charges,,,3175.44,90,,percent of total billed charges,,,3175.44,90,,percent of total billed charges,,,2893.18,82,,percent of total billed charges,,,3175.44,90,,percent of total billed charges,,,2999.03,85,,percent of total billed charges,,882.07,3351.86,
SYNTHES PLATE LCP 12 HOLE 3.5X163MM,30184149,CDM,,,278,RC,outpatient,,3779.1,3779.1,,3208.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,944.78,22,,percent of total billed charges,,,,,,,,,3401.19,90,,percent of total billed charges,,,3129.09,82.8,,percent of total billed charges,,,3212.24,85,,percent of total billed charges,,,,,,,,,3325.61,88,,percent of total billed charges,,,,,,,,,2887.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,944.78,22,,percent of total billed charges,,,3438.98,91,,percent of total billed charges,,,3590.15,95,,percent of total billed charges,,,3136.65,83,,percent of total billed charges,,,3136.65,83,,percent of total billed charges,,,,,,,,,,,,,,,3136.65,83,,percent of total billed charges,,,3590.15,95,,percent of total billed charges,,,3401.19,90,,percent of total billed charges,,,3401.19,90,,percent of total billed charges,,,3098.86,82,,percent of total billed charges,,,3401.19,90,,percent of total billed charges,,,3212.24,85,,percent of total billed charges,,944.78,3590.15,
SYNTHES PLATE LCP 14 HOLE 3.5X189MM,30184150,CDM,,,278,RC,outpatient,,5668.65,5668.65,,4812.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1417.16,22,,percent of total billed charges,,,,,,,,,5101.79,90,,percent of total billed charges,,,4693.64,82.8,,percent of total billed charges,,,4818.35,85,,percent of total billed charges,,,,,,,,,4988.41,88,,percent of total billed charges,,,,,,,,,4330.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1417.16,22,,percent of total billed charges,,,5158.47,91,,percent of total billed charges,,,5385.22,95,,percent of total billed charges,,,4704.98,83,,percent of total billed charges,,,4704.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4704.98,83,,percent of total billed charges,,,5385.22,95,,percent of total billed charges,,,5101.79,90,,percent of total billed charges,,,5101.79,90,,percent of total billed charges,,,4648.29,82,,percent of total billed charges,,,5101.79,90,,percent of total billed charges,,,4818.35,85,,percent of total billed charges,,1417.16,5385.22,
SYNTHES SCREW CANCELLOUS 6.5X45MM 32MM T,30184151,CDM,,,278,RC,outpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.18,22,,percent of total billed charges,,,,,,,,,353.43,90,,percent of total billed charges,,,325.16,82.8,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.18,22,,percent of total billed charges,,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,98.18,373.07,
SYNTHES SCREW CANCELLOUS 6.5X65MM 32MM T,30184152,CDM,,,278,RC,outpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.18,22,,percent of total billed charges,,,,,,,,,353.43,90,,percent of total billed charges,,,325.16,82.8,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.18,22,,percent of total billed charges,,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,98.18,373.07,
SYNTHES SCREW CANCELLOUS 6.5X70MM 32MM T,30184153,CDM,,,278,RC,outpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.18,22,,percent of total billed charges,,,,,,,,,353.43,90,,percent of total billed charges,,,325.16,82.8,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.18,22,,percent of total billed charges,,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,98.18,373.07,
SYNTHES SCREW CANCELLOUS 6.5X75MM 32MM T,30184154,CDM,,,278,RC,outpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.18,22,,percent of total billed charges,,,,,,,,,353.43,90,,percent of total billed charges,,,325.16,82.8,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.18,22,,percent of total billed charges,,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,98.18,373.07,
SYNTHES SCREW CANCELLOUS 6.5X80MM 32MM T,30184155,CDM,,,278,RC,outpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.18,22,,percent of total billed charges,,,,,,,,,353.43,90,,percent of total billed charges,,,325.16,82.8,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.18,22,,percent of total billed charges,,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,98.18,373.07,
SYNTHES SCREW CANCELLOUS 6.5X85MM 32MM T,30184156,CDM,,,278,RC,outpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.1,22,,percent of total billed charges,,,,,,,,,385.56,90,,percent of total billed charges,,,354.72,82.8,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.1,22,,percent of total billed charges,,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,107.1,406.98,
SYNTHES SCREW CANCELLOUS 6.5X90MM 32MM T,30184157,CDM,,,278,RC,outpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.1,22,,percent of total billed charges,,,,,,,,,385.56,90,,percent of total billed charges,,,354.72,82.8,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.1,22,,percent of total billed charges,,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,107.1,406.98,
SYNTHES SCREW CANCELLOUS 6.5X95MM 32MM T,30184158,CDM,,,278,RC,outpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.1,22,,percent of total billed charges,,,,,,,,,385.56,90,,percent of total billed charges,,,354.72,82.8,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.1,22,,percent of total billed charges,,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,107.1,406.98,
SYNTHES SCREW CANCELLOUS 6.5X100MM 32MM,30184159,CDM,,,278,RC,outpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.1,22,,percent of total billed charges,,,,,,,,,385.56,90,,percent of total billed charges,,,354.72,82.8,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.1,22,,percent of total billed charges,,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,107.1,406.98,
SYNTHES SCREW CANCELLOUS 6.5X110MM 32MM,30184161,CDM,,,278,RC,outpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.1,22,,percent of total billed charges,,,,,,,,,385.56,90,,percent of total billed charges,,,354.72,82.8,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.1,22,,percent of total billed charges,,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,107.1,406.98,
SYNTHES SCREW CANCELLOUS 6.5X30MM FULLY,30184162,CDM,,,278,RC,outpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.18,22,,percent of total billed charges,,,,,,,,,353.43,90,,percent of total billed charges,,,325.16,82.8,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.18,22,,percent of total billed charges,,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,98.18,373.07,
SYNTHES SCREW LOCKING S-T 4X16MM,30184163,CDM,,,278,RC,outpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,335.65,22,,percent of total billed charges,,,,,,,,,1208.32,90,,percent of total billed charges,,,1111.66,82.8,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,335.65,22,,percent of total billed charges,,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,335.65,1275.45,
SYNTHES SCREW LOCKING S-T 4X18MM,30184164,CDM,,,278,RC,outpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,335.65,22,,percent of total billed charges,,,,,,,,,1208.32,90,,percent of total billed charges,,,1111.66,82.8,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,335.65,22,,percent of total billed charges,,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,335.65,1275.45,
SYNTHES SCREW LOCKING S-T 4X22MM,30184165,CDM,,,278,RC,outpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,335.65,22,,percent of total billed charges,,,,,,,,,1208.32,90,,percent of total billed charges,,,1111.66,82.8,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,335.65,22,,percent of total billed charges,,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,335.65,1275.45,
SYNTHES SCREW LOCKING S-T 4X46MM,30184166,CDM,,,278,RC,outpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,335.65,22,,percent of total billed charges,,,,,,,,,1208.32,90,,percent of total billed charges,,,1111.66,82.8,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,335.65,22,,percent of total billed charges,,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,335.65,1275.45,
SYNTHES SCREW LOCKING S-T 4X50MM,30184167,CDM,,,278,RC,outpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,335.65,22,,percent of total billed charges,,,,,,,,,1208.32,90,,percent of total billed charges,,,1111.66,82.8,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,335.65,22,,percent of total billed charges,,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,335.65,1275.45,
SYNTHES SCREW LOCKING S-T 4X54MM,30184168,CDM,,,278,RC,outpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,335.65,22,,percent of total billed charges,,,,,,,,,1208.32,90,,percent of total billed charges,,,1111.66,82.8,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,335.65,22,,percent of total billed charges,,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,335.65,1275.45,
SYNTHES SCREW LOCKING S-T 4X58MM,30184169,CDM,,,278,RC,outpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,335.65,22,,percent of total billed charges,,,,,,,,,1208.32,90,,percent of total billed charges,,,1111.66,82.8,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,335.65,22,,percent of total billed charges,,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,335.65,1275.45,
SYNTHES SCREW LOCKING S-T 4X62MM,30184170,CDM,,,278,RC,outpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,335.65,22,,percent of total billed charges,,,,,,,,,1208.32,90,,percent of total billed charges,,,1111.66,82.8,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,335.65,22,,percent of total billed charges,,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,335.65,1275.45,
SYNTHES PLATE LCP 4 HOLE 3.5X112MM RIGHT,30184171,CDM,,,278,RC,outpatient,,10199.15,10199.15,,8659.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2549.79,22,,percent of total billed charges,,,,,,,,,9179.24,90,,percent of total billed charges,,,8444.9,82.8,,percent of total billed charges,,,8669.28,85,,percent of total billed charges,,,,,,,,,8975.25,88,,percent of total billed charges,,,,,,,,,7792.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2549.79,22,,percent of total billed charges,,,9281.23,91,,percent of total billed charges,,,9689.19,95,,percent of total billed charges,,,8465.29,83,,percent of total billed charges,,,8465.29,83,,percent of total billed charges,,,,,,,,,,,,,,,8465.29,83,,percent of total billed charges,,,9689.19,95,,percent of total billed charges,,,9179.24,90,,percent of total billed charges,,,9179.24,90,,percent of total billed charges,,,8363.3,82,,percent of total billed charges,,,9179.24,90,,percent of total billed charges,,,8669.28,85,,percent of total billed charges,,2549.79,9689.19,
SYNTHES PLATE LCP 4 HOLE 3.5X112MM LEFT,30184172,CDM,,,278,RC,outpatient,,10199.15,10199.15,,8659.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2549.79,22,,percent of total billed charges,,,,,,,,,9179.24,90,,percent of total billed charges,,,8444.9,82.8,,percent of total billed charges,,,8669.28,85,,percent of total billed charges,,,,,,,,,8975.25,88,,percent of total billed charges,,,,,,,,,7792.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2549.79,22,,percent of total billed charges,,,9281.23,91,,percent of total billed charges,,,9689.19,95,,percent of total billed charges,,,8465.29,83,,percent of total billed charges,,,8465.29,83,,percent of total billed charges,,,,,,,,,,,,,,,8465.29,83,,percent of total billed charges,,,9689.19,95,,percent of total billed charges,,,9179.24,90,,percent of total billed charges,,,9179.24,90,,percent of total billed charges,,,8363.3,82,,percent of total billed charges,,,9179.24,90,,percent of total billed charges,,,8669.28,85,,percent of total billed charges,,2549.79,9689.19,
SYNTHES PLATE LCP 2 HOLE 3.5X86MM RIGHT,30184173,CDM,,,278,RC,outpatient,,9773.73,9773.73,,8297.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2443.43,22,,percent of total billed charges,,,,,,,,,8796.36,90,,percent of total billed charges,,,8092.65,82.8,,percent of total billed charges,,,8307.67,85,,percent of total billed charges,,,,,,,,,8600.88,88,,percent of total billed charges,,,,,,,,,7467.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2443.43,22,,percent of total billed charges,,,8894.09,91,,percent of total billed charges,,,9285.04,95,,percent of total billed charges,,,8112.2,83,,percent of total billed charges,,,8112.2,83,,percent of total billed charges,,,,,,,,,,,,,,,8112.2,83,,percent of total billed charges,,,9285.04,95,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8014.46,82,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8307.67,85,,percent of total billed charges,,2443.43,9285.04,
SYNTHES PLATE LCP 2 HOLE 3.5X86MM LEFT,30184174,CDM,,,278,RC,outpatient,,9773.73,9773.73,,8297.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2443.43,22,,percent of total billed charges,,,,,,,,,8796.36,90,,percent of total billed charges,,,8092.65,82.8,,percent of total billed charges,,,8307.67,85,,percent of total billed charges,,,,,,,,,8600.88,88,,percent of total billed charges,,,,,,,,,7467.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2443.43,22,,percent of total billed charges,,,8894.09,91,,percent of total billed charges,,,9285.04,95,,percent of total billed charges,,,8112.2,83,,percent of total billed charges,,,8112.2,83,,percent of total billed charges,,,,,,,,,,,,,,,8112.2,83,,percent of total billed charges,,,9285.04,95,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8014.46,82,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8307.67,85,,percent of total billed charges,,2443.43,9285.04,
SYNTHES PLATE LCP RECON. 3.5X84MM 6 HOLE,30184175,CDM,,,278,RC,outpatient,,4958.79,4958.79,,4210.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1239.7,22,,percent of total billed charges,,,,,,,,,4462.91,90,,percent of total billed charges,,,4105.88,82.8,,percent of total billed charges,,,4214.97,85,,percent of total billed charges,,,,,,,,,4363.74,88,,percent of total billed charges,,,,,,,,,3788.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1239.7,22,,percent of total billed charges,,,4512.5,91,,percent of total billed charges,,,4710.85,95,,percent of total billed charges,,,4115.8,83,,percent of total billed charges,,,4115.8,83,,percent of total billed charges,,,,,,,,,,,,,,,4115.8,83,,percent of total billed charges,,,4710.85,95,,percent of total billed charges,,,4462.91,90,,percent of total billed charges,,,4462.91,90,,percent of total billed charges,,,4066.21,82,,percent of total billed charges,,,4462.91,90,,percent of total billed charges,,,4214.97,85,,percent of total billed charges,,1239.7,4710.85,
SYNTHES PLATE LCP RECON. 3.5X140MM 10HOL,30184176,CDM,,,278,RC,outpatient,,5304,5304,,4503.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1326,22,,percent of total billed charges,,,,,,,,,4773.6,90,,percent of total billed charges,,,4391.71,82.8,,percent of total billed charges,,,4508.4,85,,percent of total billed charges,,,,,,,,,4667.52,88,,percent of total billed charges,,,,,,,,,4052.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1326,22,,percent of total billed charges,,,4826.64,91,,percent of total billed charges,,,5038.8,95,,percent of total billed charges,,,4402.32,83,,percent of total billed charges,,,4402.32,83,,percent of total billed charges,,,,,,,,,,,,,,,4402.32,83,,percent of total billed charges,,,5038.8,95,,percent of total billed charges,,,4773.6,90,,percent of total billed charges,,,4773.6,90,,percent of total billed charges,,,4349.28,82,,percent of total billed charges,,,4773.6,90,,percent of total billed charges,,,4508.4,85,,percent of total billed charges,,1326,5038.8,
SYNTHES T-PLATE LCP OBLIQE RT 3.5X63,30184177,CDM,,,278,RC,outpatient,,3464.18,3464.18,,2941.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,866.05,22,,percent of total billed charges,,,,,,,,,3117.76,90,,percent of total billed charges,,,2868.34,82.8,,percent of total billed charges,,,2944.55,85,,percent of total billed charges,,,,,,,,,3048.48,88,,percent of total billed charges,,,,,,,,,2646.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,866.05,22,,percent of total billed charges,,,3152.4,91,,percent of total billed charges,,,3290.97,95,,percent of total billed charges,,,2875.27,83,,percent of total billed charges,,,2875.27,83,,percent of total billed charges,,,,,,,,,,,,,,,2875.27,83,,percent of total billed charges,,,3290.97,95,,percent of total billed charges,,,3117.76,90,,percent of total billed charges,,,3117.76,90,,percent of total billed charges,,,2840.63,82,,percent of total billed charges,,,3117.76,90,,percent of total billed charges,,,2944.55,85,,percent of total billed charges,,866.05,3290.97,
SYNTHES T-PLATE LCP OBLIQUE RT 3.5X74,30184178,CDM,,,278,RC,outpatient,,3618.88,3618.88,,3072.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,904.72,22,,percent of total billed charges,,,,,,,,,3256.99,90,,percent of total billed charges,,,2996.43,82.8,,percent of total billed charges,,,3076.05,85,,percent of total billed charges,,,,,,,,,3184.61,88,,percent of total billed charges,,,,,,,,,2764.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,904.72,22,,percent of total billed charges,,,3293.18,91,,percent of total billed charges,,,3437.94,95,,percent of total billed charges,,,3003.67,83,,percent of total billed charges,,,3003.67,83,,percent of total billed charges,,,,,,,,,,,,,,,3003.67,83,,percent of total billed charges,,,3437.94,95,,percent of total billed charges,,,3256.99,90,,percent of total billed charges,,,3256.99,90,,percent of total billed charges,,,2967.48,82,,percent of total billed charges,,,3256.99,90,,percent of total billed charges,,,3076.05,85,,percent of total billed charges,,904.72,3437.94,
SYNTHES T-PLATE LCP OBLIQUE RT 3.5X96,30184179,CDM,,,278,RC,outpatient,,3928.28,3928.28,,3335.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,982.07,22,,percent of total billed charges,,,,,,,,,3535.45,90,,percent of total billed charges,,,3252.62,82.8,,percent of total billed charges,,,3339.04,85,,percent of total billed charges,,,,,,,,,3456.89,88,,percent of total billed charges,,,,,,,,,3001.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,982.07,22,,percent of total billed charges,,,3574.73,91,,percent of total billed charges,,,3731.87,95,,percent of total billed charges,,,3260.47,83,,percent of total billed charges,,,3260.47,83,,percent of total billed charges,,,,,,,,,,,,,,,3260.47,83,,percent of total billed charges,,,3731.87,95,,percent of total billed charges,,,3535.45,90,,percent of total billed charges,,,3535.45,90,,percent of total billed charges,,,3221.19,82,,percent of total billed charges,,,3535.45,90,,percent of total billed charges,,,3339.04,85,,percent of total billed charges,,982.07,3731.87,
SYNTHES T-PLATE LCP OBLIQUE LT 3.5X52MM,30184180,CDM,,,278,RC,outpatient,,3320.53,3320.53,,2819.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,830.13,22,,percent of total billed charges,,,,,,,,,2988.48,90,,percent of total billed charges,,,2749.4,82.8,,percent of total billed charges,,,2822.45,85,,percent of total billed charges,,,,,,,,,2922.07,88,,percent of total billed charges,,,,,,,,,2536.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,830.13,22,,percent of total billed charges,,,3021.68,91,,percent of total billed charges,,,3154.5,95,,percent of total billed charges,,,2756.04,83,,percent of total billed charges,,,2756.04,83,,percent of total billed charges,,,,,,,,,,,,,,,2756.04,83,,percent of total billed charges,,,3154.5,95,,percent of total billed charges,,,2988.48,90,,percent of total billed charges,,,2988.48,90,,percent of total billed charges,,,2722.83,82,,percent of total billed charges,,,2988.48,90,,percent of total billed charges,,,2822.45,85,,percent of total billed charges,,830.13,3154.5,
SYNTHES T-PLATE LCP OBLIQUE LT 3.5X63MM,30184181,CDM,,,278,RC,outpatient,,3475.23,3475.23,,2950.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,868.81,22,,percent of total billed charges,,,,,,,,,3127.71,90,,percent of total billed charges,,,2877.49,82.8,,percent of total billed charges,,,2953.95,85,,percent of total billed charges,,,,,,,,,3058.2,88,,percent of total billed charges,,,,,,,,,2655.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,868.81,22,,percent of total billed charges,,,3162.46,91,,percent of total billed charges,,,3301.47,95,,percent of total billed charges,,,2884.44,83,,percent of total billed charges,,,2884.44,83,,percent of total billed charges,,,,,,,,,,,,,,,2884.44,83,,percent of total billed charges,,,3301.47,95,,percent of total billed charges,,,3127.71,90,,percent of total billed charges,,,3127.71,90,,percent of total billed charges,,,2849.69,82,,percent of total billed charges,,,3127.71,90,,percent of total billed charges,,,2953.95,85,,percent of total billed charges,,868.81,3301.47,
SYNTHES T-PLATE LCP OBLIQUE LT 3.5X74MM,30184182,CDM,,,278,RC,outpatient,,3629.93,3629.93,,3081.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,907.48,22,,percent of total billed charges,,,,,,,,,3266.94,90,,percent of total billed charges,,,3005.58,82.8,,percent of total billed charges,,,3085.44,85,,percent of total billed charges,,,,,,,,,3194.34,88,,percent of total billed charges,,,,,,,,,2773.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,907.48,22,,percent of total billed charges,,,3303.24,91,,percent of total billed charges,,,3448.43,95,,percent of total billed charges,,,3012.84,83,,percent of total billed charges,,,3012.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3012.84,83,,percent of total billed charges,,,3448.43,95,,percent of total billed charges,,,3266.94,90,,percent of total billed charges,,,3266.94,90,,percent of total billed charges,,,2976.54,82,,percent of total billed charges,,,3266.94,90,,percent of total billed charges,,,3085.44,85,,percent of total billed charges,,907.48,3448.43,
SYNTHES T-PLATE LCP OBLIQUE LT 3.5X96MM,30184183,CDM,,,278,RC,outpatient,,3933.8,3933.8,,3339.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,983.45,22,,percent of total billed charges,,,,,,,,,3540.42,90,,percent of total billed charges,,,3257.19,82.8,,percent of total billed charges,,,3343.73,85,,percent of total billed charges,,,,,,,,,3461.74,88,,percent of total billed charges,,,,,,,,,3005.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,983.45,22,,percent of total billed charges,,,3579.76,91,,percent of total billed charges,,,3737.11,95,,percent of total billed charges,,,3265.05,83,,percent of total billed charges,,,3265.05,83,,percent of total billed charges,,,,,,,,,,,,,,,3265.05,83,,percent of total billed charges,,,3737.11,95,,percent of total billed charges,,,3540.42,90,,percent of total billed charges,,,3540.42,90,,percent of total billed charges,,,3225.72,82,,percent of total billed charges,,,3540.42,90,,percent of total billed charges,,,3343.73,85,,percent of total billed charges,,983.45,3737.11,
SYNTHES T-PLATE LCP RT ANGLE 3.5X56MM 4H,30184184,CDM,,,278,RC,outpatient,,3055.33,3055.33,,2593.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,763.83,22,,percent of total billed charges,,,,,,,,,2749.8,90,,percent of total billed charges,,,2529.81,82.8,,percent of total billed charges,,,2597.03,85,,percent of total billed charges,,,,,,,,,2688.69,88,,percent of total billed charges,,,,,,,,,2334.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,763.83,22,,percent of total billed charges,,,2780.35,91,,percent of total billed charges,,,2902.56,95,,percent of total billed charges,,,2535.92,83,,percent of total billed charges,,,2535.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2535.92,83,,percent of total billed charges,,,2902.56,95,,percent of total billed charges,,,2749.8,90,,percent of total billed charges,,,2749.8,90,,percent of total billed charges,,,2505.37,82,,percent of total billed charges,,,2749.8,90,,percent of total billed charges,,,2597.03,85,,percent of total billed charges,,763.83,2902.56,
SYNTHES T-PLATE LCP RT ANGLE 3.5X78MM 6H,30184185,CDM,,,278,RC,outpatient,,3911.7,3911.7,,3321.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,977.93,22,,percent of total billed charges,,,,,,,,,3520.53,90,,percent of total billed charges,,,3238.89,82.8,,percent of total billed charges,,,3324.95,85,,percent of total billed charges,,,,,,,,,3442.3,88,,percent of total billed charges,,,,,,,,,2988.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,977.93,22,,percent of total billed charges,,,3559.65,91,,percent of total billed charges,,,3716.12,95,,percent of total billed charges,,,3246.71,83,,percent of total billed charges,,,3246.71,83,,percent of total billed charges,,,,,,,,,,,,,,,3246.71,83,,percent of total billed charges,,,3716.12,95,,percent of total billed charges,,,3520.53,90,,percent of total billed charges,,,3520.53,90,,percent of total billed charges,,,3207.59,82,,percent of total billed charges,,,3520.53,90,,percent of total billed charges,,,3324.95,85,,percent of total billed charges,,977.93,3716.12,
SYNTHES T-PLATE LCP RT ANGLE 3.5X87MM 7H,30184186,CDM,,,278,RC,outpatient,,4895.15,4895.15,,4155.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1223.79,22,,percent of total billed charges,,,,,,,,,4405.64,90,,percent of total billed charges,,,4053.18,82.8,,percent of total billed charges,,,4160.88,85,,percent of total billed charges,,,,,,,,,4307.73,88,,percent of total billed charges,,,,,,,,,3739.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1223.79,22,,percent of total billed charges,,,4454.59,91,,percent of total billed charges,,,4650.39,95,,percent of total billed charges,,,4062.97,83,,percent of total billed charges,,,4062.97,83,,percent of total billed charges,,,,,,,,,,,,,,,4062.97,83,,percent of total billed charges,,,4650.39,95,,percent of total billed charges,,,4405.64,90,,percent of total billed charges,,,4405.64,90,,percent of total billed charges,,,4014.02,82,,percent of total billed charges,,,4405.64,90,,percent of total billed charges,,,4160.88,85,,percent of total billed charges,,1223.79,4650.39,
SYNTHES PLATE PROX. FEMUR LCP 4.5X133 2H,30184187,CDM,,,278,RC,outpatient,,16536.33,16536.33,,14039.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4134.08,22,,percent of total billed charges,,,,,,,,,14882.7,90,,percent of total billed charges,,,13692.08,82.8,,percent of total billed charges,,,14055.88,85,,percent of total billed charges,,,,,,,,,14551.97,88,,percent of total billed charges,,,,,,,,,12633.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4134.08,22,,percent of total billed charges,,,15048.06,91,,percent of total billed charges,,,15709.51,95,,percent of total billed charges,,,13725.15,83,,percent of total billed charges,,,13725.15,83,,percent of total billed charges,,,,,,,,,,,,,,,13725.15,83,,percent of total billed charges,,,15709.51,95,,percent of total billed charges,,,14882.7,90,,percent of total billed charges,,,14882.7,90,,percent of total billed charges,,,13559.79,82,,percent of total billed charges,,,14882.7,90,,percent of total billed charges,,,14055.88,85,,percent of total billed charges,,4134.08,15709.51,
SYNTHES PLATE PROX. FEMUR LCP 4.5X169 4H,30184188,CDM,,,278,RC,outpatient,,16762.85,16762.85,,14231.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4190.71,22,,percent of total billed charges,,,,,,,,,15086.57,90,,percent of total billed charges,,,13879.64,82.8,,percent of total billed charges,,,14248.42,85,,percent of total billed charges,,,,,,,,,14751.31,88,,percent of total billed charges,,,,,,,,,12806.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4190.71,22,,percent of total billed charges,,,15254.19,91,,percent of total billed charges,,,15924.71,95,,percent of total billed charges,,,13913.17,83,,percent of total billed charges,,,13913.17,83,,percent of total billed charges,,,,,,,,,,,,,,,13913.17,83,,percent of total billed charges,,,15924.71,95,,percent of total billed charges,,,15086.57,90,,percent of total billed charges,,,15086.57,90,,percent of total billed charges,,,13745.54,82,,percent of total billed charges,,,15086.57,90,,percent of total billed charges,,,14248.42,85,,percent of total billed charges,,4190.71,15924.71,
SYNTHES PLATE PROX. FEMUR LCP 4.5X205 6H,30184189,CDM,,,278,RC,outpatient,,17033.58,17033.58,,14461.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4258.4,22,,percent of total billed charges,,,,,,,,,15330.22,90,,percent of total billed charges,,,14103.8,82.8,,percent of total billed charges,,,14478.54,85,,percent of total billed charges,,,,,,,,,14989.55,88,,percent of total billed charges,,,,,,,,,13013.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4258.4,22,,percent of total billed charges,,,15500.56,91,,percent of total billed charges,,,16181.9,95,,percent of total billed charges,,,14137.87,83,,percent of total billed charges,,,14137.87,83,,percent of total billed charges,,,,,,,,,,,,,,,14137.87,83,,percent of total billed charges,,,16181.9,95,,percent of total billed charges,,,15330.22,90,,percent of total billed charges,,,15330.22,90,,percent of total billed charges,,,13967.54,82,,percent of total billed charges,,,15330.22,90,,percent of total billed charges,,,14478.54,85,,percent of total billed charges,,4258.4,16181.9,
SYNTHES PLATE PROX. FEMUR LCP 4.5X241 8H,30184190,CDM,,,278,RC,outpatient,,17657.9,17657.9,,14991.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4414.48,22,,percent of total billed charges,,,,,,,,,15892.11,90,,percent of total billed charges,,,14620.74,82.8,,percent of total billed charges,,,15009.22,85,,percent of total billed charges,,,,,,,,,15538.95,88,,percent of total billed charges,,,,,,,,,13490.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4414.48,22,,percent of total billed charges,,,16068.69,91,,percent of total billed charges,,,16775.01,95,,percent of total billed charges,,,14656.06,83,,percent of total billed charges,,,14656.06,83,,percent of total billed charges,,,,,,,,,,,,,,,14656.06,83,,percent of total billed charges,,,16775.01,95,,percent of total billed charges,,,15892.11,90,,percent of total billed charges,,,15892.11,90,,percent of total billed charges,,,14479.48,82,,percent of total billed charges,,,15892.11,90,,percent of total billed charges,,,15009.22,85,,percent of total billed charges,,4414.48,16775.01,
SYNTHES PLATE PROX. FEMUR LCP 4.5X313 12,30184192,CDM,,,278,RC,outpatient,,19166.23,19166.23,,16272.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4791.56,22,,percent of total billed charges,,,,,,,,,17249.61,90,,percent of total billed charges,,,15869.64,82.8,,percent of total billed charges,,,16291.3,85,,percent of total billed charges,,,,,,,,,16866.28,88,,percent of total billed charges,,,,,,,,,14643,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4791.56,22,,percent of total billed charges,,,17441.27,91,,percent of total billed charges,,,18207.92,95,,percent of total billed charges,,,15907.97,83,,percent of total billed charges,,,15907.97,83,,percent of total billed charges,,,,,,,,,,,,,,,15907.97,83,,percent of total billed charges,,,18207.92,95,,percent of total billed charges,,,17249.61,90,,percent of total billed charges,,,17249.61,90,,percent of total billed charges,,,15716.31,82,,percent of total billed charges,,,17249.61,90,,percent of total billed charges,,,16291.3,85,,percent of total billed charges,,4791.56,18207.92,
SYNTHES PLATE PROX. FEMUR LCP 4.5X349 14,30184193,CDM,,,278,RC,outpatient,,19392.75,19392.75,,16464.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4848.19,22,,percent of total billed charges,,,,,,,,,17453.48,90,,percent of total billed charges,,,16057.2,82.8,,percent of total billed charges,,,16483.84,85,,percent of total billed charges,,,,,,,,,17065.62,88,,percent of total billed charges,,,,,,,,,14816.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4848.19,22,,percent of total billed charges,,,17647.4,91,,percent of total billed charges,,,18423.11,95,,percent of total billed charges,,,16095.98,83,,percent of total billed charges,,,16095.98,83,,percent of total billed charges,,,,,,,,,,,,,,,16095.98,83,,percent of total billed charges,,,18423.11,95,,percent of total billed charges,,,17453.48,90,,percent of total billed charges,,,17453.48,90,,percent of total billed charges,,,15902.06,82,,percent of total billed charges,,,17453.48,90,,percent of total billed charges,,,16483.84,85,,percent of total billed charges,,4848.19,18423.11,
SYNTHES PLATE PROX. FEMUR LCP 4.5X385 16,30184194,CDM,,,278,RC,outpatient,,20033.65,20033.65,,17008.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5008.41,22,,percent of total billed charges,,,,,,,,,18030.29,90,,percent of total billed charges,,,16587.86,82.8,,percent of total billed charges,,,17028.6,85,,percent of total billed charges,,,,,,,,,17629.61,88,,percent of total billed charges,,,,,,,,,15305.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5008.41,22,,percent of total billed charges,,,18230.62,91,,percent of total billed charges,,,19031.97,95,,percent of total billed charges,,,16627.93,83,,percent of total billed charges,,,16627.93,83,,percent of total billed charges,,,,,,,,,,,,,,,16627.93,83,,percent of total billed charges,,,19031.97,95,,percent of total billed charges,,,18030.29,90,,percent of total billed charges,,,18030.29,90,,percent of total billed charges,,,16427.59,82,,percent of total billed charges,,,18030.29,90,,percent of total billed charges,,,17028.6,85,,percent of total billed charges,,5008.41,19031.97,
SYNTHES PLATE PROX. FEMUR LCP 4.5X421 18,30184195,CDM,,,278,RC,outpatient,,20674.55,20674.55,,17552.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5168.64,22,,percent of total billed charges,,,,,,,,,18607.1,90,,percent of total billed charges,,,17118.53,82.8,,percent of total billed charges,,,17573.37,85,,percent of total billed charges,,,,,,,,,18193.6,88,,percent of total billed charges,,,,,,,,,15795.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5168.64,22,,percent of total billed charges,,,18813.84,91,,percent of total billed charges,,,19640.82,95,,percent of total billed charges,,,17159.88,83,,percent of total billed charges,,,17159.88,83,,percent of total billed charges,,,,,,,,,,,,,,,17159.88,83,,percent of total billed charges,,,19640.82,95,,percent of total billed charges,,,18607.1,90,,percent of total billed charges,,,18607.1,90,,percent of total billed charges,,,16953.13,82,,percent of total billed charges,,,18607.1,90,,percent of total billed charges,,,17573.37,85,,percent of total billed charges,,5168.64,19640.82,
SYNTHES CERCLAGE POSITIONING PIN 4.5MM,30184196,CDM,,,278,RC,outpatient,,1792.57,1792.57,,1521.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,448.14,22,,percent of total billed charges,,,,,,,,,1613.31,90,,percent of total billed charges,,,1484.25,82.8,,percent of total billed charges,,,1523.68,85,,percent of total billed charges,,,,,,,,,1577.46,88,,percent of total billed charges,,,,,,,,,1369.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,448.14,22,,percent of total billed charges,,,1631.24,91,,percent of total billed charges,,,1702.94,95,,percent of total billed charges,,,1487.83,83,,percent of total billed charges,,,1487.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1487.83,83,,percent of total billed charges,,,1702.94,95,,percent of total billed charges,,,1613.31,90,,percent of total billed charges,,,1613.31,90,,percent of total billed charges,,,1469.91,82,,percent of total billed charges,,,1613.31,90,,percent of total billed charges,,,1523.68,85,,percent of total billed charges,,448.14,1702.94,
SYNTHES PLATE LCP CURVED 4.5X247MM 13HOL,30184197,CDM,,,278,RC,outpatient,,7077.53,7077.53,,6008.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1769.38,22,,percent of total billed charges,,,,,,,,,6369.78,90,,percent of total billed charges,,,5860.19,82.8,,percent of total billed charges,,,6015.9,85,,percent of total billed charges,,,,,,,,,6228.23,88,,percent of total billed charges,,,,,,,,,5407.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1769.38,22,,percent of total billed charges,,,6440.55,91,,percent of total billed charges,,,6723.65,95,,percent of total billed charges,,,5874.35,83,,percent of total billed charges,,,5874.35,83,,percent of total billed charges,,,,,,,,,,,,,,,5874.35,83,,percent of total billed charges,,,6723.65,95,,percent of total billed charges,,,6369.78,90,,percent of total billed charges,,,6369.78,90,,percent of total billed charges,,,5803.57,82,,percent of total billed charges,,,6369.78,90,,percent of total billed charges,,,6015.9,85,,percent of total billed charges,,1769.38,6723.65,
SYNTHES PLATE LCP CURVED 4.5X265MM 14HOL,30184198,CDM,,,278,RC,outpatient,,7436.65,7436.65,,6313.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1859.16,22,,percent of total billed charges,,,,,,,,,6692.99,90,,percent of total billed charges,,,6157.55,82.8,,percent of total billed charges,,,6321.15,85,,percent of total billed charges,,,,,,,,,6544.25,88,,percent of total billed charges,,,,,,,,,5681.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1859.16,22,,percent of total billed charges,,,6767.35,91,,percent of total billed charges,,,7064.82,95,,percent of total billed charges,,,6172.42,83,,percent of total billed charges,,,6172.42,83,,percent of total billed charges,,,,,,,,,,,,,,,6172.42,83,,percent of total billed charges,,,7064.82,95,,percent of total billed charges,,,6692.99,90,,percent of total billed charges,,,6692.99,90,,percent of total billed charges,,,6098.05,82,,percent of total billed charges,,,6692.99,90,,percent of total billed charges,,,6321.15,85,,percent of total billed charges,,1859.16,7064.82,
SYNTHES PLATE LCP CURVED 4.5X282MM 15HOL,30184199,CDM,,,278,RC,outpatient,,8254.35,8254.35,,7007.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2063.59,22,,percent of total billed charges,,,,,,,,,7428.92,90,,percent of total billed charges,,,6834.6,82.8,,percent of total billed charges,,,7016.2,85,,percent of total billed charges,,,,,,,,,7263.83,88,,percent of total billed charges,,,,,,,,,6306.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2063.59,22,,percent of total billed charges,,,7511.46,91,,percent of total billed charges,,,7841.63,95,,percent of total billed charges,,,6851.11,83,,percent of total billed charges,,,6851.11,83,,percent of total billed charges,,,,,,,,,,,,,,,6851.11,83,,percent of total billed charges,,,7841.63,95,,percent of total billed charges,,,7428.92,90,,percent of total billed charges,,,7428.92,90,,percent of total billed charges,,,6768.57,82,,percent of total billed charges,,,7428.92,90,,percent of total billed charges,,,7016.2,85,,percent of total billed charges,,2063.59,7841.63,
SYNTHES PLATE LCP CURVED 4.5X300MM 16HOL,30184200,CDM,,,278,RC,outpatient,,9033.38,9033.38,,7669.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2258.35,22,,percent of total billed charges,,,,,,,,,8130.04,90,,percent of total billed charges,,,7479.64,82.8,,percent of total billed charges,,,7678.37,85,,percent of total billed charges,,,,,,,,,7949.37,88,,percent of total billed charges,,,,,,,,,6901.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2258.35,22,,percent of total billed charges,,,8220.38,91,,percent of total billed charges,,,8581.71,95,,percent of total billed charges,,,7497.71,83,,percent of total billed charges,,,7497.71,83,,percent of total billed charges,,,,,,,,,,,,,,,7497.71,83,,percent of total billed charges,,,8581.71,95,,percent of total billed charges,,,8130.04,90,,percent of total billed charges,,,8130.04,90,,percent of total billed charges,,,7407.37,82,,percent of total billed charges,,,8130.04,90,,percent of total billed charges,,,7678.37,85,,percent of total billed charges,,2258.35,8581.71,
SYNTHES PLATE LCP CURVED 4.5X318MM 17HOL,30184201,CDM,,,278,RC,outpatient,,9469.85,9469.85,,8039.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2367.46,22,,percent of total billed charges,,,,,,,,,8522.87,90,,percent of total billed charges,,,7841.04,82.8,,percent of total billed charges,,,8049.37,85,,percent of total billed charges,,,,,,,,,8333.47,88,,percent of total billed charges,,,,,,,,,7234.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2367.46,22,,percent of total billed charges,,,8617.56,91,,percent of total billed charges,,,8996.36,95,,percent of total billed charges,,,7859.98,83,,percent of total billed charges,,,7859.98,83,,percent of total billed charges,,,,,,,,,,,,,,,7859.98,83,,percent of total billed charges,,,8996.36,95,,percent of total billed charges,,,8522.87,90,,percent of total billed charges,,,8522.87,90,,percent of total billed charges,,,7765.28,82,,percent of total billed charges,,,8522.87,90,,percent of total billed charges,,,8049.37,85,,percent of total billed charges,,2367.46,8996.36,
SYNTHES PLATE LCP CURVED 4.5X336MM 18HOL,30184202,CDM,,,278,RC,outpatient,,10315.18,10315.18,,8757.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2578.8,22,,percent of total billed charges,,,,,,,,,9283.66,90,,percent of total billed charges,,,8540.97,82.8,,percent of total billed charges,,,8767.9,85,,percent of total billed charges,,,,,,,,,9077.36,88,,percent of total billed charges,,,,,,,,,7880.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2578.8,22,,percent of total billed charges,,,9386.81,91,,percent of total billed charges,,,9799.42,95,,percent of total billed charges,,,8561.6,83,,percent of total billed charges,,,8561.6,83,,percent of total billed charges,,,,,,,,,,,,,,,8561.6,83,,percent of total billed charges,,,9799.42,95,,percent of total billed charges,,,9283.66,90,,percent of total billed charges,,,9283.66,90,,percent of total billed charges,,,8458.45,82,,percent of total billed charges,,,9283.66,90,,percent of total billed charges,,,8767.9,85,,percent of total billed charges,,2578.8,9799.42,
SYNTHES CERCALGE POSITIONING PIN 4.5MM,30184203,CDM,,,278,RC,outpatient,,1740.38,1740.38,,1477.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,435.1,22,,percent of total billed charges,,,,,,,,,1566.34,90,,percent of total billed charges,,,1441.03,82.8,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,,,,,,,,1531.53,88,,percent of total billed charges,,,,,,,,,1329.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,435.1,22,,percent of total billed charges,,,1583.75,91,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.52,83,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1427.11,82,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,435.1,1653.36,
SYNTHES TROCHANTERIC REATTCHMENT DEVICE,30184205,CDM,,,278,RC,outpatient,,18420.35,18420.35,,15638.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4605.09,22,,percent of total billed charges,,,,,,,,,16578.32,90,,percent of total billed charges,,,15252.05,82.8,,percent of total billed charges,,,15657.3,85,,percent of total billed charges,,,,,,,,,16209.91,88,,percent of total billed charges,,,,,,,,,14073.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4605.09,22,,percent of total billed charges,,,16762.52,91,,percent of total billed charges,,,17499.33,95,,percent of total billed charges,,,15288.89,83,,percent of total billed charges,,,15288.89,83,,percent of total billed charges,,,,,,,,,,,,,,,15288.89,83,,percent of total billed charges,,,17499.33,95,,percent of total billed charges,,,16578.32,90,,percent of total billed charges,,,16578.32,90,,percent of total billed charges,,,15104.69,82,,percent of total billed charges,,,16578.32,90,,percent of total billed charges,,,15657.3,85,,percent of total billed charges,,4605.09,17499.33,
SYNTHES TROCHANTERIC REATTCHMENT W/LONG,30184206,CDM,,,278,RC,outpatient,,26547.63,26547.63,,22538.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6636.91,22,,percent of total billed charges,,,,,,,,,23892.87,90,,percent of total billed charges,,,21981.44,82.8,,percent of total billed charges,,,22565.49,85,,percent of total billed charges,,,,,,,,,23361.91,88,,percent of total billed charges,,,,,,,,,20282.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6636.91,22,,percent of total billed charges,,,24158.34,91,,percent of total billed charges,,,25220.25,95,,percent of total billed charges,,,22034.53,83,,percent of total billed charges,,,22034.53,83,,percent of total billed charges,,,,,,,,,,,,,,,22034.53,83,,percent of total billed charges,,,25220.25,95,,percent of total billed charges,,,23892.87,90,,percent of total billed charges,,,23892.87,90,,percent of total billed charges,,,21769.06,82,,percent of total billed charges,,,23892.87,90,,percent of total billed charges,,,22565.49,85,,percent of total billed charges,,6636.91,25220.25,
SYNTHES PLATE DISTAL FIBULA 3H LT 2.7/3.,30184207,CDM,,,278,RC,outpatient,,5850.98,5850.98,,4967.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.75,22,,percent of total billed charges,,,,,,,,,5265.88,90,,percent of total billed charges,,,4844.61,82.8,,percent of total billed charges,,,4973.33,85,,percent of total billed charges,,,,,,,,,5148.86,88,,percent of total billed charges,,,,,,,,,4470.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.75,22,,percent of total billed charges,,,5324.39,91,,percent of total billed charges,,,5558.43,95,,percent of total billed charges,,,4856.31,83,,percent of total billed charges,,,4856.31,83,,percent of total billed charges,,,,,,,,,,,,,,,4856.31,83,,percent of total billed charges,,,5558.43,95,,percent of total billed charges,,,5265.88,90,,percent of total billed charges,,,5265.88,90,,percent of total billed charges,,,4797.8,82,,percent of total billed charges,,,5265.88,90,,percent of total billed charges,,,4973.33,85,,percent of total billed charges,,1462.75,5558.43,
SYNTHES PLATE DISTAL FIBULA 6H LT 2.7/3.,30184208,CDM,,,278,RC,outpatient,,6311.05,6311.05,,5358.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1577.76,22,,percent of total billed charges,,,,,,,,,5679.95,90,,percent of total billed charges,,,5225.55,82.8,,percent of total billed charges,,,5364.39,85,,percent of total billed charges,,,,,,,,,5553.72,88,,percent of total billed charges,,,,,,,,,4821.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1577.76,22,,percent of total billed charges,,,5743.06,91,,percent of total billed charges,,,5995.5,95,,percent of total billed charges,,,5238.17,83,,percent of total billed charges,,,5238.17,83,,percent of total billed charges,,,,,,,,,,,,,,,5238.17,83,,percent of total billed charges,,,5995.5,95,,percent of total billed charges,,,5679.95,90,,percent of total billed charges,,,5679.95,90,,percent of total billed charges,,,5175.06,82,,percent of total billed charges,,,5679.95,90,,percent of total billed charges,,,5364.39,85,,percent of total billed charges,,1577.76,5995.5,
SYNTHES PLATE DISTAL FIBULA 7H RT 2.7/3.,30184209,CDM,,,278,RC,outpatient,,6396.39,6396.39,,5430.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1599.1,22,,percent of total billed charges,,,,,,,,,5756.75,90,,percent of total billed charges,,,5296.21,82.8,,percent of total billed charges,,,5436.93,85,,percent of total billed charges,,,,,,,,,5628.82,88,,percent of total billed charges,,,,,,,,,4886.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1599.1,22,,percent of total billed charges,,,5820.71,91,,percent of total billed charges,,,6076.57,95,,percent of total billed charges,,,5309,83,,percent of total billed charges,,,5309,83,,percent of total billed charges,,,,,,,,,,,,,,,5309,83,,percent of total billed charges,,,6076.57,95,,percent of total billed charges,,,5756.75,90,,percent of total billed charges,,,5756.75,90,,percent of total billed charges,,,5245.04,82,,percent of total billed charges,,,5756.75,90,,percent of total billed charges,,,5436.93,85,,percent of total billed charges,,1599.1,6076.57,
SYNTHES PLATE DISTAL FIBULA 7H LT 2.7/3.,30184210,CDM,,,278,RC,outpatient,,6588.27,6588.27,,5593.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1647.07,22,,percent of total billed charges,,,,,,,,,5929.44,90,,percent of total billed charges,,,5455.09,82.8,,percent of total billed charges,,,5600.03,85,,percent of total billed charges,,,,,,,,,5797.68,88,,percent of total billed charges,,,,,,,,,5033.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1647.07,22,,percent of total billed charges,,,5995.33,91,,percent of total billed charges,,,6258.86,95,,percent of total billed charges,,,5468.26,83,,percent of total billed charges,,,5468.26,83,,percent of total billed charges,,,,,,,,,,,,,,,5468.26,83,,percent of total billed charges,,,6258.86,95,,percent of total billed charges,,,5929.44,90,,percent of total billed charges,,,5929.44,90,,percent of total billed charges,,,5402.38,82,,percent of total billed charges,,,5929.44,90,,percent of total billed charges,,,5600.03,85,,percent of total billed charges,,1647.07,6258.86,
SYNTHES PLATE DISTAL FIBULA 9H RT 2.7/3.,30184211,CDM,,,278,RC,outpatient,,6519.5,6519.5,,5535.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1629.88,22,,percent of total billed charges,,,,,,,,,5867.55,90,,percent of total billed charges,,,5398.15,82.8,,percent of total billed charges,,,5541.58,85,,percent of total billed charges,,,,,,,,,5737.16,88,,percent of total billed charges,,,,,,,,,4980.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1629.88,22,,percent of total billed charges,,,5932.75,91,,percent of total billed charges,,,6193.53,95,,percent of total billed charges,,,5411.19,83,,percent of total billed charges,,,5411.19,83,,percent of total billed charges,,,,,,,,,,,,,,,5411.19,83,,percent of total billed charges,,,6193.53,95,,percent of total billed charges,,,5867.55,90,,percent of total billed charges,,,5867.55,90,,percent of total billed charges,,,5345.99,82,,percent of total billed charges,,,5867.55,90,,percent of total billed charges,,,5541.58,85,,percent of total billed charges,,1629.88,6193.53,
SYNTHES PLATE DISTAL FIBULA 8H LT 2.7/3.,30184212,CDM,,,278,RC,outpatient,,6519.5,6519.5,,5535.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1629.88,22,,percent of total billed charges,,,,,,,,,5867.55,90,,percent of total billed charges,,,5398.15,82.8,,percent of total billed charges,,,5541.58,85,,percent of total billed charges,,,,,,,,,5737.16,88,,percent of total billed charges,,,,,,,,,4980.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1629.88,22,,percent of total billed charges,,,5932.75,91,,percent of total billed charges,,,6193.53,95,,percent of total billed charges,,,5411.19,83,,percent of total billed charges,,,5411.19,83,,percent of total billed charges,,,,,,,,,,,,,,,5411.19,83,,percent of total billed charges,,,6193.53,95,,percent of total billed charges,,,5867.55,90,,percent of total billed charges,,,5867.55,90,,percent of total billed charges,,,5345.99,82,,percent of total billed charges,,,5867.55,90,,percent of total billed charges,,,5541.58,85,,percent of total billed charges,,1629.88,6193.53,
SYNTHES PLATE DISTAL FIBULA 11H RT 2.7/,30184213,CDM,,,278,RC,outpatient,,6618.95,6618.95,,5619.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1654.74,22,,percent of total billed charges,,,,,,,,,5957.06,90,,percent of total billed charges,,,5480.49,82.8,,percent of total billed charges,,,5626.11,85,,percent of total billed charges,,,,,,,,,5824.68,88,,percent of total billed charges,,,,,,,,,5056.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1654.74,22,,percent of total billed charges,,,6023.24,91,,percent of total billed charges,,,6288,95,,percent of total billed charges,,,5493.73,83,,percent of total billed charges,,,5493.73,83,,percent of total billed charges,,,,,,,,,,,,,,,5493.73,83,,percent of total billed charges,,,6288,95,,percent of total billed charges,,,5957.06,90,,percent of total billed charges,,,5957.06,90,,percent of total billed charges,,,5427.54,82,,percent of total billed charges,,,5957.06,90,,percent of total billed charges,,,5626.11,85,,percent of total billed charges,,1654.74,6288,
SYNTHES PLATE DISTAL FIBULA 11H LT 2.7/,30184214,CDM,,,278,RC,outpatient,,6618.95,6618.95,,5619.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1654.74,22,,percent of total billed charges,,,,,,,,,5957.06,90,,percent of total billed charges,,,5480.49,82.8,,percent of total billed charges,,,5626.11,85,,percent of total billed charges,,,,,,,,,5824.68,88,,percent of total billed charges,,,,,,,,,5056.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1654.74,22,,percent of total billed charges,,,6023.24,91,,percent of total billed charges,,,6288,95,,percent of total billed charges,,,5493.73,83,,percent of total billed charges,,,5493.73,83,,percent of total billed charges,,,,,,,,,,,,,,,5493.73,83,,percent of total billed charges,,,6288,95,,percent of total billed charges,,,5957.06,90,,percent of total billed charges,,,5957.06,90,,percent of total billed charges,,,5427.54,82,,percent of total billed charges,,,5957.06,90,,percent of total billed charges,,,5626.11,85,,percent of total billed charges,,1654.74,6288,
DUPLOTIP APPLICATOR 320 FOR TISSEEL,30184215,CDM,,,270,RC,outpatient,,402.15,402.15,,341.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100.54,22,,percent of total billed charges,,,,,,,,,361.94,90,,percent of total billed charges,,,332.98,82.8,,percent of total billed charges,,,341.83,85,,percent of total billed charges,,,,,,,,,353.89,88,,percent of total billed charges,,,,,,,,,307.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100.54,22,,percent of total billed charges,,,365.96,91,,percent of total billed charges,,,382.04,95,,percent of total billed charges,,,333.78,83,,percent of total billed charges,,,333.78,83,,percent of total billed charges,,,,,,,,,,,,,,,333.78,83,,percent of total billed charges,,,382.04,95,,percent of total billed charges,,,361.94,90,,percent of total billed charges,,,361.94,90,,percent of total billed charges,,,329.76,82,,percent of total billed charges,,,361.94,90,,percent of total billed charges,,,341.83,85,,percent of total billed charges,,100.54,382.04,
ARTHREX SUTURE ANCHOR BC 4.75 X 24.5MM,30184224,CDM,,,278,RC,outpatient,,2730,2730,,2317.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,682.5,22,,percent of total billed charges,,,,,,,,,2457,90,,percent of total billed charges,,,2260.44,82.8,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,,,,,,,,2402.4,88,,percent of total billed charges,,,,,,,,,2085.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,682.5,22,,percent of total billed charges,,,2484.3,91,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2265.9,83,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2238.6,82,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,682.5,2593.5,
*SYNTHES SCREW CORTEX ST TI 2.4MM X 12,30184225,CDM,,,278,RC,outpatient,,1105,1105,,938.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,276.25,22,,percent of total billed charges,,,,,,,,,994.5,90,,percent of total billed charges,,,914.94,82.8,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,,,,,,,,972.4,88,,percent of total billed charges,,,,,,,,,844.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,276.25,22,,percent of total billed charges,,,1005.55,91,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,,,,,,,,,,,,,917.15,83,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,906.1,82,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,276.25,1049.75,
S&N GUIDE WIRE TIP THREADED 3.2MM,30184235,CDM,,,270,RC,outpatient,,1406.02,1406.02,,1193.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,351.51,22,,percent of total billed charges,,,,,,,,,1265.42,90,,percent of total billed charges,,,1164.18,82.8,,percent of total billed charges,,,1195.12,85,,percent of total billed charges,,,,,,,,,1237.3,88,,percent of total billed charges,,,,,,,,,1074.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,351.51,22,,percent of total billed charges,,,1279.48,91,,percent of total billed charges,,,1335.72,95,,percent of total billed charges,,,1167,83,,percent of total billed charges,,,1167,83,,percent of total billed charges,,,,,,,,,,,,,,,1167,83,,percent of total billed charges,,,1335.72,95,,percent of total billed charges,,,1265.42,90,,percent of total billed charges,,,1265.42,90,,percent of total billed charges,,,1152.94,82,,percent of total billed charges,,,1265.42,90,,percent of total billed charges,,,1195.12,85,,percent of total billed charges,,351.51,1335.72,
CATH SPIRAL FILIFORM TIP 4FR,30184243,CDM,,,270,RC,outpatient,,593.6,593.6,,503.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,148.4,22,,percent of total billed charges,,,,,,,,,534.24,90,,percent of total billed charges,,,491.5,82.8,,percent of total billed charges,,,504.56,85,,percent of total billed charges,,,,,,,,,522.37,88,,percent of total billed charges,,,,,,,,,453.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,148.4,22,,percent of total billed charges,,,540.18,91,,percent of total billed charges,,,563.92,95,,percent of total billed charges,,,492.69,83,,percent of total billed charges,,,492.69,83,,percent of total billed charges,,,,,,,,,,,,,,,492.69,83,,percent of total billed charges,,,563.92,95,,percent of total billed charges,,,534.24,90,,percent of total billed charges,,,534.24,90,,percent of total billed charges,,,486.75,82,,percent of total billed charges,,,534.24,90,,percent of total billed charges,,,504.56,85,,percent of total billed charges,,148.4,563.92,
ALLOFUSE DBM PUTTY 10CC,30184255,CDM,,,278,RC,outpatient,,6305,6305,,5352.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1576.25,22,,percent of total billed charges,,,,,,,,,5674.5,90,,percent of total billed charges,,,5220.54,82.8,,percent of total billed charges,,,5359.25,85,,percent of total billed charges,,,,,,,,,5548.4,88,,percent of total billed charges,,,,,,,,,4817.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1576.25,22,,percent of total billed charges,,,5737.55,91,,percent of total billed charges,,,5989.75,95,,percent of total billed charges,,,5233.15,83,,percent of total billed charges,,,5233.15,83,,percent of total billed charges,,,,,,,,,,,,,,,5233.15,83,,percent of total billed charges,,,5989.75,95,,percent of total billed charges,,,5674.5,90,,percent of total billed charges,,,5674.5,90,,percent of total billed charges,,,5170.1,82,,percent of total billed charges,,,5674.5,90,,percent of total billed charges,,,5359.25,85,,percent of total billed charges,,1576.25,5989.75,
ALLOSOURCE CORTICAL STRUT 2 X 25 CM (FRO,30184258,CDM,,,278,RC,outpatient,,4563,4563,,3873.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1140.75,22,,percent of total billed charges,,,,,,,,,4106.7,90,,percent of total billed charges,,,3778.16,82.8,,percent of total billed charges,,,3878.55,85,,percent of total billed charges,,,,,,,,,4015.44,88,,percent of total billed charges,,,,,,,,,3486.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1140.75,22,,percent of total billed charges,,,4152.33,91,,percent of total billed charges,,,4334.85,95,,percent of total billed charges,,,3787.29,83,,percent of total billed charges,,,3787.29,83,,percent of total billed charges,,,,,,,,,,,,,,,3787.29,83,,percent of total billed charges,,,4334.85,95,,percent of total billed charges,,,4106.7,90,,percent of total billed charges,,,4106.7,90,,percent of total billed charges,,,3741.66,82,,percent of total billed charges,,,4106.7,90,,percent of total billed charges,,,3878.55,85,,percent of total billed charges,,1140.75,4334.85,
S&N FEMUR OX SZ 6 RT P/S,30184259,CDM,,,278,RC,outpatient,,25285,25285,,21466.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6321.25,22,,percent of total billed charges,,,,,,,,,22756.5,90,,percent of total billed charges,,,20935.98,82.8,,percent of total billed charges,,,21492.25,85,,percent of total billed charges,,,,,,,,,22250.8,88,,percent of total billed charges,,,,,,,,,19317.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6321.25,22,,percent of total billed charges,,,23009.35,91,,percent of total billed charges,,,24020.75,95,,percent of total billed charges,,,20986.55,83,,percent of total billed charges,,,20986.55,83,,percent of total billed charges,,,,,,,,,,,,,,,20986.55,83,,percent of total billed charges,,,24020.75,95,,percent of total billed charges,,,22756.5,90,,percent of total billed charges,,,22756.5,90,,percent of total billed charges,,,20733.7,82,,percent of total billed charges,,,22756.5,90,,percent of total billed charges,,,21492.25,85,,percent of total billed charges,,6321.25,24020.75,
S&N TIBIA RT SZ 6,30184260,CDM,,,278,RC,outpatient,,12122.5,12122.5,,10292,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3030.63,22,,percent of total billed charges,,,,,,,,,10910.25,90,,percent of total billed charges,,,10037.43,82.8,,percent of total billed charges,,,10304.13,85,,percent of total billed charges,,,,,,,,,10667.8,88,,percent of total billed charges,,,,,,,,,9261.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3030.63,22,,percent of total billed charges,,,11031.48,91,,percent of total billed charges,,,11516.38,95,,percent of total billed charges,,,10061.68,83,,percent of total billed charges,,,10061.68,83,,percent of total billed charges,,,,,,,,,,,,,,,10061.68,83,,percent of total billed charges,,,11516.38,95,,percent of total billed charges,,,10910.25,90,,percent of total billed charges,,,10910.25,90,,percent of total billed charges,,,9940.45,82,,percent of total billed charges,,,10910.25,90,,percent of total billed charges,,,10304.13,85,,percent of total billed charges,,3030.63,11516.38,
S&N INSERT SZ 5-6 15MM LEGION PS XLPE,30184261,CDM,,,278,RC,outpatient,,14299.55,14299.55,,12140.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3574.89,22,,percent of total billed charges,,,,,,,,,12869.6,90,,percent of total billed charges,,,11840.03,82.8,,percent of total billed charges,,,12154.62,85,,percent of total billed charges,,,,,,,,,12583.6,88,,percent of total billed charges,,,,,,,,,10924.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3574.89,22,,percent of total billed charges,,,13012.59,91,,percent of total billed charges,,,13584.57,95,,percent of total billed charges,,,11868.63,83,,percent of total billed charges,,,11868.63,83,,percent of total billed charges,,,,,,,,,,,,,,,11868.63,83,,percent of total billed charges,,,13584.57,95,,percent of total billed charges,,,12869.6,90,,percent of total billed charges,,,12869.6,90,,percent of total billed charges,,,11725.63,82,,percent of total billed charges,,,12869.6,90,,percent of total billed charges,,,12154.62,85,,percent of total billed charges,,3574.89,13584.57,
SYNTHES PLATE VA-LCP 4.5MM CURVED 14 HOL,30184264,CDM,,,278,RC,outpatient,,20762.95,20762.95,,17627.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5190.74,22,,percent of total billed charges,,,,,,,,,18686.66,90,,percent of total billed charges,,,17191.72,82.8,,percent of total billed charges,,,17648.51,85,,percent of total billed charges,,,,,,,,,18271.4,88,,percent of total billed charges,,,,,,,,,15862.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5190.74,22,,percent of total billed charges,,,18894.28,91,,percent of total billed charges,,,19724.8,95,,percent of total billed charges,,,17233.25,83,,percent of total billed charges,,,17233.25,83,,percent of total billed charges,,,,,,,,,,,,,,,17233.25,83,,percent of total billed charges,,,19724.8,95,,percent of total billed charges,,,18686.66,90,,percent of total billed charges,,,18686.66,90,,percent of total billed charges,,,17025.62,82,,percent of total billed charges,,,18686.66,90,,percent of total billed charges,,,17648.51,85,,percent of total billed charges,,5190.74,19724.8,
SYNTHES SCREW LOCKING 5.0 X 10MM,30184265,CDM,,,278,RC,outpatient,,2900.63,2900.63,,2462.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,725.16,22,,percent of total billed charges,,,,,,,,,2610.57,90,,percent of total billed charges,,,2401.72,82.8,,percent of total billed charges,,,2465.54,85,,percent of total billed charges,,,,,,,,,2552.55,88,,percent of total billed charges,,,,,,,,,2216.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,725.16,22,,percent of total billed charges,,,2639.57,91,,percent of total billed charges,,,2755.6,95,,percent of total billed charges,,,2407.52,83,,percent of total billed charges,,,2407.52,83,,percent of total billed charges,,,,,,,,,,,,,,,2407.52,83,,percent of total billed charges,,,2755.6,95,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2378.52,82,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2465.54,85,,percent of total billed charges,,725.16,2755.6,
SYNTHES SCREW LOCKING 5.0 X 12MM,30184266,CDM,,,278,RC,outpatient,,2900.63,2900.63,,2462.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,725.16,22,,percent of total billed charges,,,,,,,,,2610.57,90,,percent of total billed charges,,,2401.72,82.8,,percent of total billed charges,,,2465.54,85,,percent of total billed charges,,,,,,,,,2552.55,88,,percent of total billed charges,,,,,,,,,2216.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,725.16,22,,percent of total billed charges,,,2639.57,91,,percent of total billed charges,,,2755.6,95,,percent of total billed charges,,,2407.52,83,,percent of total billed charges,,,2407.52,83,,percent of total billed charges,,,,,,,,,,,,,,,2407.52,83,,percent of total billed charges,,,2755.6,95,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2378.52,82,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2465.54,85,,percent of total billed charges,,725.16,2755.6,
SYNTHES SCREW LOCKING 5.0 X 14MM,30184267,CDM,,,278,RC,outpatient,,2900.63,2900.63,,2462.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,725.16,22,,percent of total billed charges,,,,,,,,,2610.57,90,,percent of total billed charges,,,2401.72,82.8,,percent of total billed charges,,,2465.54,85,,percent of total billed charges,,,,,,,,,2552.55,88,,percent of total billed charges,,,,,,,,,2216.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,725.16,22,,percent of total billed charges,,,2639.57,91,,percent of total billed charges,,,2755.6,95,,percent of total billed charges,,,2407.52,83,,percent of total billed charges,,,2407.52,83,,percent of total billed charges,,,,,,,,,,,,,,,2407.52,83,,percent of total billed charges,,,2755.6,95,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2378.52,82,,percent of total billed charges,,,2610.57,90,,percent of total billed charges,,,2465.54,85,,percent of total billed charges,,725.16,2755.6,
SYNTHES SCREW CONICAL CONNULATED 5.0MM,30184268,CDM,,,278,RC,outpatient,,1618.83,1618.83,,1374.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,404.71,22,,percent of total billed charges,,,,,,,,,1456.95,90,,percent of total billed charges,,,1340.39,82.8,,percent of total billed charges,,,1376.01,85,,percent of total billed charges,,,,,,,,,1424.57,88,,percent of total billed charges,,,,,,,,,1236.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,404.71,22,,percent of total billed charges,,,1473.14,91,,percent of total billed charges,,,1537.89,95,,percent of total billed charges,,,1343.63,83,,percent of total billed charges,,,1343.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1343.63,83,,percent of total billed charges,,,1537.89,95,,percent of total billed charges,,,1456.95,90,,percent of total billed charges,,,1456.95,90,,percent of total billed charges,,,1327.44,82,,percent of total billed charges,,,1456.95,90,,percent of total billed charges,,,1376.01,85,,percent of total billed charges,,404.71,1537.89,
SYNTHES SCREW LOCKING 5 X 26MM ANGLED,30184269,CDM,,,278,RC,outpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,438.18,22,,percent of total billed charges,,,,,,,,,1577.46,90,,percent of total billed charges,,,1451.26,82.8,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,438.18,22,,percent of total billed charges,,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,438.18,1665.09,
SYNTHES SCREW LOCKING 5 X 30MM ANGLE,30184270,CDM,,,278,RC,outpatient,,1701.7,1701.7,,1444.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,425.43,22,,percent of total billed charges,,,,,,,,,1531.53,90,,percent of total billed charges,,,1409.01,82.8,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,,,,,,,,1497.5,88,,percent of total billed charges,,,,,,,,,1300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,425.43,22,,percent of total billed charges,,,1548.55,91,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1412.41,83,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1395.39,82,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,425.43,1616.62,
SYNTHES SCREW LOCKING 5 X 65MM ANGLE,30184271,CDM,,,278,RC,outpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,438.18,22,,percent of total billed charges,,,,,,,,,1577.46,90,,percent of total billed charges,,,1451.26,82.8,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,438.18,22,,percent of total billed charges,,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,438.18,1665.09,
SYNTHES SCREW LOCKING 5 X85MM ANGLED,30184272,CDM,,,278,RC,outpatient,,1701.7,1701.7,,1444.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,425.43,22,,percent of total billed charges,,,,,,,,,1531.53,90,,percent of total billed charges,,,1409.01,82.8,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,,,,,,,,1497.5,88,,percent of total billed charges,,,,,,,,,1300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,425.43,22,,percent of total billed charges,,,1548.55,91,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1412.41,83,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1395.39,82,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,425.43,1616.62,
SYNTHES SCREW LOCKING 5 X 75MM ANGLED,30184273,CDM,,,278,RC,outpatient,,1701.7,1701.7,,1444.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,425.43,22,,percent of total billed charges,,,,,,,,,1531.53,90,,percent of total billed charges,,,1409.01,82.8,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,,,,,,,,1497.5,88,,percent of total billed charges,,,,,,,,,1300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,425.43,22,,percent of total billed charges,,,1548.55,91,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1412.41,83,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1395.39,82,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,425.43,1616.62,
SYNTHES DRILL TIP GUIDE WIRE 2.5 X 200MM,30184274,CDM,,,278,RC,outpatient,,672.35,672.35,,570.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,168.09,22,,percent of total billed charges,,,,,,,,,605.12,90,,percent of total billed charges,,,556.71,82.8,,percent of total billed charges,,,571.5,85,,percent of total billed charges,,,,,,,,,591.67,88,,percent of total billed charges,,,,,,,,,513.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,168.09,22,,percent of total billed charges,,,611.84,91,,percent of total billed charges,,,638.73,95,,percent of total billed charges,,,558.05,83,,percent of total billed charges,,,558.05,83,,percent of total billed charges,,,,,,,,,,,,,,,558.05,83,,percent of total billed charges,,,638.73,95,,percent of total billed charges,,,605.12,90,,percent of total billed charges,,,605.12,90,,percent of total billed charges,,,551.33,82,,percent of total billed charges,,,605.12,90,,percent of total billed charges,,,571.5,85,,percent of total billed charges,,168.09,638.73,
SYNTHES DRILL BIT 4.3MM,30184275,CDM,,,278,RC,outpatient,,1789.13,1789.13,,1518.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,447.28,22,,percent of total billed charges,,,,,,,,,1610.22,90,,percent of total billed charges,,,1481.4,82.8,,percent of total billed charges,,,1520.76,85,,percent of total billed charges,,,,,,,,,1574.43,88,,percent of total billed charges,,,,,,,,,1366.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,447.28,22,,percent of total billed charges,,,1628.11,91,,percent of total billed charges,,,1699.67,95,,percent of total billed charges,,,1484.98,83,,percent of total billed charges,,,1484.98,83,,percent of total billed charges,,,,,,,,,,,,,,,1484.98,83,,percent of total billed charges,,,1699.67,95,,percent of total billed charges,,,1610.22,90,,percent of total billed charges,,,1610.22,90,,percent of total billed charges,,,1467.09,82,,percent of total billed charges,,,1610.22,90,,percent of total billed charges,,,1520.76,85,,percent of total billed charges,,447.28,1699.67,
SYNTHES DRILL BIT QC 2.5,30184276,CDM,,,270,RC,outpatient,,795.34,795.34,,675.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,198.84,22,,percent of total billed charges,,,,,,,,,715.81,90,,percent of total billed charges,,,658.54,82.8,,percent of total billed charges,,,676.04,85,,percent of total billed charges,,,,,,,,,699.9,88,,percent of total billed charges,,,,,,,,,607.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,198.84,22,,percent of total billed charges,,,723.76,91,,percent of total billed charges,,,755.57,95,,percent of total billed charges,,,660.13,83,,percent of total billed charges,,,660.13,83,,percent of total billed charges,,,,,,,,,,,,,,,660.13,83,,percent of total billed charges,,,755.57,95,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,652.18,82,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,676.04,85,,percent of total billed charges,,198.84,755.57,
SYNTHES PLATE PROX HUMERUS 3.5MM 3 HOLE,30184277,CDM,,,278,RC,outpatient,,18299.52,18299.52,,15536.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4574.88,22,,percent of total billed charges,,,,,,,,,16469.57,90,,percent of total billed charges,,,15152,82.8,,percent of total billed charges,,,15554.59,85,,percent of total billed charges,,,,,,,,,16103.58,88,,percent of total billed charges,,,,,,,,,13980.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4574.88,22,,percent of total billed charges,,,16652.56,91,,percent of total billed charges,,,17384.54,95,,percent of total billed charges,,,15188.6,83,,percent of total billed charges,,,15188.6,83,,percent of total billed charges,,,,,,,,,,,,,,,15188.6,83,,percent of total billed charges,,,17384.54,95,,percent of total billed charges,,,16469.57,90,,percent of total billed charges,,,16469.57,90,,percent of total billed charges,,,15005.61,82,,percent of total billed charges,,,16469.57,90,,percent of total billed charges,,,15554.59,85,,percent of total billed charges,,4574.88,17384.54,
DEPUY STEM CORAIL KLA SZ 14,30184278,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY STEM SUMMIT CEMENTED SZ 3,30184279,CDM,,,278,RC,outpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6361.02,22,,percent of total billed charges,,,,,,,,,22899.65,90,,percent of total billed charges,,,21067.68,82.8,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6361.02,22,,percent of total billed charges,,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,6361.02,24171.86,
DEPUY CEMENTRALIZERR 9.25,30184280,CDM,,,278,RC,outpatient,,919.36,919.36,,780.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,229.84,22,,percent of total billed charges,,,,,,,,,827.42,90,,percent of total billed charges,,,761.23,82.8,,percent of total billed charges,,,781.46,85,,percent of total billed charges,,,,,,,,,809.04,88,,percent of total billed charges,,,,,,,,,702.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,229.84,22,,percent of total billed charges,,,836.62,91,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,,,,,,,,,,,,,763.07,83,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,753.88,82,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,781.46,85,,percent of total billed charges,,229.84,873.39,
DEPUY STEM CORAIL COLLERED VESUS SZ 9,30184282,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
SYNTHES PLATE 5-HOLE 2MM,30184283,CDM,,,278,RC,outpatient,,2646.48,2646.48,,2246.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,661.62,22,,percent of total billed charges,,,,,,,,,2381.83,90,,percent of total billed charges,,,2191.29,82.8,,percent of total billed charges,,,2249.51,85,,percent of total billed charges,,,,,,,,,2328.9,88,,percent of total billed charges,,,,,,,,,2021.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,661.62,22,,percent of total billed charges,,,2408.3,91,,percent of total billed charges,,,2514.16,95,,percent of total billed charges,,,2196.58,83,,percent of total billed charges,,,2196.58,83,,percent of total billed charges,,,,,,,,,,,,,,,2196.58,83,,percent of total billed charges,,,2514.16,95,,percent of total billed charges,,,2381.83,90,,percent of total billed charges,,,2381.83,90,,percent of total billed charges,,,2170.11,82,,percent of total billed charges,,,2381.83,90,,percent of total billed charges,,,2249.51,85,,percent of total billed charges,,661.62,2514.16,
SYNTHES PLATE 6-HOLE 2MM,30184284,CDM,,,278,RC,outpatient,,2646.48,2646.48,,2246.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,661.62,22,,percent of total billed charges,,,,,,,,,2381.83,90,,percent of total billed charges,,,2191.29,82.8,,percent of total billed charges,,,2249.51,85,,percent of total billed charges,,,,,,,,,2328.9,88,,percent of total billed charges,,,,,,,,,2021.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,661.62,22,,percent of total billed charges,,,2408.3,91,,percent of total billed charges,,,2514.16,95,,percent of total billed charges,,,2196.58,83,,percent of total billed charges,,,2196.58,83,,percent of total billed charges,,,,,,,,,,,,,,,2196.58,83,,percent of total billed charges,,,2514.16,95,,percent of total billed charges,,,2381.83,90,,percent of total billed charges,,,2381.83,90,,percent of total billed charges,,,2170.11,82,,percent of total billed charges,,,2381.83,90,,percent of total billed charges,,,2249.51,85,,percent of total billed charges,,661.62,2514.16,
SYNTHES PLATE 7-HOLE 2MM,30184285,CDM,,,278,RC,outpatient,,7939.43,7939.43,,6740.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1984.86,22,,percent of total billed charges,,,,,,,,,7145.49,90,,percent of total billed charges,,,6573.85,82.8,,percent of total billed charges,,,6748.52,85,,percent of total billed charges,,,,,,,,,6986.7,88,,percent of total billed charges,,,,,,,,,6065.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1984.86,22,,percent of total billed charges,,,7224.88,91,,percent of total billed charges,,,7542.46,95,,percent of total billed charges,,,6589.73,83,,percent of total billed charges,,,6589.73,83,,percent of total billed charges,,,,,,,,,,,,,,,6589.73,83,,percent of total billed charges,,,7542.46,95,,percent of total billed charges,,,7145.49,90,,percent of total billed charges,,,7145.49,90,,percent of total billed charges,,,6510.33,82,,percent of total billed charges,,,7145.49,90,,percent of total billed charges,,,6748.52,85,,percent of total billed charges,,1984.86,7542.46,
SYNTHES SCREW CORTEX 10 X 2MM,30184286,CDM,,,278,RC,outpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.39,22,,percent of total billed charges,,,,,,,,,476.6,90,,percent of total billed charges,,,438.47,82.8,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.39,22,,percent of total billed charges,,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,132.39,503.07,
SYNTHES SCREW CORTEX 12 X 2MM,30184287,CDM,,,278,RC,outpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.39,22,,percent of total billed charges,,,,,,,,,476.6,90,,percent of total billed charges,,,438.47,82.8,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.39,22,,percent of total billed charges,,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,132.39,503.07,
SYNTHES SCREW CORTEX 14 X 2MM,30184288,CDM,,,278,RC,outpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.39,22,,percent of total billed charges,,,,,,,,,476.6,90,,percent of total billed charges,,,438.47,82.8,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.39,22,,percent of total billed charges,,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,132.39,503.07,
SYNTHES SCREW CORTEX 16 X 2MM,30184289,CDM,,,278,RC,outpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.39,22,,percent of total billed charges,,,,,,,,,476.6,90,,percent of total billed charges,,,438.47,82.8,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.39,22,,percent of total billed charges,,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,132.39,503.07,
SYNTHES SCREW CORTEX 18 X 2MM,30184290,CDM,,,278,RC,outpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.39,22,,percent of total billed charges,,,,,,,,,476.6,90,,percent of total billed charges,,,438.47,82.8,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.39,22,,percent of total billed charges,,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,132.39,503.07,
SYNTHES SCREW LOCKING 9 X 2MM,30184291,CDM,,,278,RC,outpatient,,1187.88,1187.88,,1008.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,296.97,22,,percent of total billed charges,,,,,,,,,1069.09,90,,percent of total billed charges,,,983.56,82.8,,percent of total billed charges,,,1009.7,85,,percent of total billed charges,,,,,,,,,1045.33,88,,percent of total billed charges,,,,,,,,,907.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,296.97,22,,percent of total billed charges,,,1080.97,91,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,,,,,,,,,,,,,985.94,83,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,974.06,82,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1009.7,85,,percent of total billed charges,,296.97,1128.49,
SYNTHES SCREW LOCKING 10 X 2MM,30184292,CDM,,,278,RC,outpatient,,1187.88,1187.88,,1008.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,296.97,22,,percent of total billed charges,,,,,,,,,1069.09,90,,percent of total billed charges,,,983.56,82.8,,percent of total billed charges,,,1009.7,85,,percent of total billed charges,,,,,,,,,1045.33,88,,percent of total billed charges,,,,,,,,,907.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,296.97,22,,percent of total billed charges,,,1080.97,91,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,,,,,,,,,,,,,985.94,83,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,974.06,82,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1009.7,85,,percent of total billed charges,,296.97,1128.49,
SYNTHES SCREW LOCKING 11 X 2MM,30184293,CDM,,,278,RC,outpatient,,1187.88,1187.88,,1008.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,296.97,22,,percent of total billed charges,,,,,,,,,1069.09,90,,percent of total billed charges,,,983.56,82.8,,percent of total billed charges,,,1009.7,85,,percent of total billed charges,,,,,,,,,1045.33,88,,percent of total billed charges,,,,,,,,,907.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,296.97,22,,percent of total billed charges,,,1080.97,91,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,,,,,,,,,,,,,985.94,83,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,974.06,82,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1009.7,85,,percent of total billed charges,,296.97,1128.49,
SYNTHES SCREW LOCKING 14 X 2MM,30184294,CDM,,,278,RC,outpatient,,1187.88,1187.88,,1008.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,296.97,22,,percent of total billed charges,,,,,,,,,1069.09,90,,percent of total billed charges,,,983.56,82.8,,percent of total billed charges,,,1009.7,85,,percent of total billed charges,,,,,,,,,1045.33,88,,percent of total billed charges,,,,,,,,,907.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,296.97,22,,percent of total billed charges,,,1080.97,91,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,,,,,,,,,,,,,985.94,83,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,974.06,82,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1009.7,85,,percent of total billed charges,,296.97,1128.49,
SYNTHES SCREW LOCKING 16 X 2MM,30184295,CDM,,,278,RC,outpatient,,1187.88,1187.88,,1008.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,296.97,22,,percent of total billed charges,,,,,,,,,1069.09,90,,percent of total billed charges,,,983.56,82.8,,percent of total billed charges,,,1009.7,85,,percent of total billed charges,,,,,,,,,1045.33,88,,percent of total billed charges,,,,,,,,,907.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,296.97,22,,percent of total billed charges,,,1080.97,91,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,985.94,83,,percent of total billed charges,,,,,,,,,,,,,,,985.94,83,,percent of total billed charges,,,1128.49,95,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,974.06,82,,percent of total billed charges,,,1069.09,90,,percent of total billed charges,,,1009.7,85,,percent of total billed charges,,296.97,1128.49,
SYNTHES DRILL BIT CALIBRATED 1.5MM,30184296,CDM,,,270,RC,outpatient,,1430.98,1430.98,,1214.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,357.75,22,,percent of total billed charges,,,,,,,,,1287.88,90,,percent of total billed charges,,,1184.85,82.8,,percent of total billed charges,,,1216.33,85,,percent of total billed charges,,,,,,,,,1259.26,88,,percent of total billed charges,,,,,,,,,1093.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,357.75,22,,percent of total billed charges,,,1302.19,91,,percent of total billed charges,,,1359.43,95,,percent of total billed charges,,,1187.71,83,,percent of total billed charges,,,1187.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1187.71,83,,percent of total billed charges,,,1359.43,95,,percent of total billed charges,,,1287.88,90,,percent of total billed charges,,,1287.88,90,,percent of total billed charges,,,1173.4,82,,percent of total billed charges,,,1287.88,90,,percent of total billed charges,,,1216.33,85,,percent of total billed charges,,357.75,1359.43,
MEDTRONIC LEAD BISIL STEROID FIX 58,30184297,CDM,,,278,RC,outpatient,,5310.5,5310.5,,4508.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1327.63,22,,percent of total billed charges,,,,,,,,,4779.45,90,,percent of total billed charges,,,4397.09,82.8,,percent of total billed charges,,,4513.93,85,,percent of total billed charges,,,,,,,,,4673.24,88,,percent of total billed charges,,,,,,,,,4057.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1327.63,22,,percent of total billed charges,,,4832.56,91,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4407.72,83,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4354.61,82,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4513.93,85,,percent of total billed charges,,1327.63,5044.98,
HIP ORTHOSIS ABDUCTION CONTROL BRACE,30184298,CDM,,,270,RC,outpatient,,5911.3,5911.3,,5018.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1477.83,22,,percent of total billed charges,,,,,,,,,5320.17,90,,percent of total billed charges,,,4894.56,82.8,,percent of total billed charges,,,5024.61,85,,percent of total billed charges,,,,,,,,,5201.94,88,,percent of total billed charges,,,,,,,,,4516.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1477.83,22,,percent of total billed charges,,,5379.28,91,,percent of total billed charges,,,5615.74,95,,percent of total billed charges,,,4906.38,83,,percent of total billed charges,,,4906.38,83,,percent of total billed charges,,,,,,,,,,,,,,,4906.38,83,,percent of total billed charges,,,5615.74,95,,percent of total billed charges,,,5320.17,90,,percent of total billed charges,,,5320.17,90,,percent of total billed charges,,,4847.27,82,,percent of total billed charges,,,5320.17,90,,percent of total billed charges,,,5024.61,85,,percent of total billed charges,,1477.83,5615.74,
HIP BRACE- LOWER EXTREMITY PELVIC CONTRO,30184299,CDM,,,278,RC,outpatient,,2461.55,2461.55,,2089.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,615.39,22,,percent of total billed charges,,,,,,,,,2215.4,90,,percent of total billed charges,,,2038.16,82.8,,percent of total billed charges,,,2092.32,85,,percent of total billed charges,,,,,,,,,2166.16,88,,percent of total billed charges,,,,,,,,,1880.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,615.39,22,,percent of total billed charges,,,2240.01,91,,percent of total billed charges,,,2338.47,95,,percent of total billed charges,,,2043.09,83,,percent of total billed charges,,,2043.09,83,,percent of total billed charges,,,,,,,,,,,,,,,2043.09,83,,percent of total billed charges,,,2338.47,95,,percent of total billed charges,,,2215.4,90,,percent of total billed charges,,,2215.4,90,,percent of total billed charges,,,2018.47,82,,percent of total billed charges,,,2215.4,90,,percent of total billed charges,,,2092.32,85,,percent of total billed charges,,615.39,2338.47,
MEDTRONIC SPINAL CORD STIMULATION ELECTR,30184300,CDM,,,270,RC,outpatient,,7280,7280,,6180.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1820,22,,percent of total billed charges,,,,,,,,,6552,90,,percent of total billed charges,,,6027.84,82.8,,percent of total billed charges,,,6188,85,,percent of total billed charges,,,,,,,,,6406.4,88,,percent of total billed charges,,,,,,,,,5561.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1820,22,,percent of total billed charges,,,6624.8,91,,percent of total billed charges,,,6916,95,,percent of total billed charges,,,6042.4,83,,percent of total billed charges,,,6042.4,83,,percent of total billed charges,,,,,,,,,,,,,,,6042.4,83,,percent of total billed charges,,,6916,95,,percent of total billed charges,,,6552,90,,percent of total billed charges,,,6552,90,,percent of total billed charges,,,5969.6,82,,percent of total billed charges,,,6552,90,,percent of total billed charges,,,6188,85,,percent of total billed charges,,1820,6916,
SYTHES SCREW CANNULATED 4.0 X 24MM LONG,30184301,CDM,,,270,RC,outpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,486.2,22,,percent of total billed charges,,,,,,,,,1750.32,90,,percent of total billed charges,,,1610.29,82.8,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,486.2,22,,percent of total billed charges,,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,486.2,1847.56,
CONFORMIS IUNI G2 FEOMORAL IMPLANT LEFT,30184302,CDM,,,278,RC,outpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9750,22,,percent of total billed charges,,,,,,,,,35100,90,,percent of total billed charges,,,32292,82.8,,percent of total billed charges,,,33150,85,,percent of total billed charges,,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9750,22,,percent of total billed charges,,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,9750,37050,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184303,CDM,,,278,RC,outpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,486.2,22,,percent of total billed charges,,,,,,,,,1750.32,90,,percent of total billed charges,,,1610.29,82.8,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,486.2,22,,percent of total billed charges,,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,486.2,1847.56,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184304,CDM,,,278,RC,outpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,486.2,22,,percent of total billed charges,,,,,,,,,1750.32,90,,percent of total billed charges,,,1610.29,82.8,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,486.2,22,,percent of total billed charges,,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,486.2,1847.56,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184305,CDM,,,278,RC,outpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,486.2,22,,percent of total billed charges,,,,,,,,,1750.32,90,,percent of total billed charges,,,1610.29,82.8,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,486.2,22,,percent of total billed charges,,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,486.2,1847.56,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184306,CDM,,,278,RC,outpatient,,2003.17,2003.17,,1700.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,500.79,22,,percent of total billed charges,,,,,,,,,1802.85,90,,percent of total billed charges,,,1658.62,82.8,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,,,,,,,,1762.79,88,,percent of total billed charges,,,,,,,,,1530.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,500.79,22,,percent of total billed charges,,,1822.88,91,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1662.63,83,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1642.6,82,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,500.79,1903.01,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184307,CDM,,,278,RC,outpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,486.2,22,,percent of total billed charges,,,,,,,,,1750.32,90,,percent of total billed charges,,,1610.29,82.8,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,486.2,22,,percent of total billed charges,,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,486.2,1847.56,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184308,CDM,,,278,RC,outpatient,,2063.23,2063.23,,1751.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,515.81,22,,percent of total billed charges,,,,,,,,,1856.91,90,,percent of total billed charges,,,1708.35,82.8,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,,,,,,,,1815.64,88,,percent of total billed charges,,,,,,,,,1576.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,515.81,22,,percent of total billed charges,,,1877.54,91,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1712.48,83,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1691.85,82,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,515.81,1960.07,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184309,CDM,,,278,RC,outpatient,,2003.17,2003.17,,1700.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,500.79,22,,percent of total billed charges,,,,,,,,,1802.85,90,,percent of total billed charges,,,1658.62,82.8,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,,,,,,,,1762.79,88,,percent of total billed charges,,,,,,,,,1530.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,500.79,22,,percent of total billed charges,,,1822.88,91,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1662.63,83,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1642.6,82,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,500.79,1903.01,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184310,CDM,,,278,RC,outpatient,,2063.23,2063.23,,1751.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,515.81,22,,percent of total billed charges,,,,,,,,,1856.91,90,,percent of total billed charges,,,1708.35,82.8,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,,,,,,,,1815.64,88,,percent of total billed charges,,,,,,,,,1576.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,515.81,22,,percent of total billed charges,,,1877.54,91,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1712.48,83,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1691.85,82,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,515.81,1960.07,
SYNTHES SCREW CANNULATED SORT THREAD 4 X,30184311,CDM,,,278,RC,outpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,486.2,22,,percent of total billed charges,,,,,,,,,1750.32,90,,percent of total billed charges,,,1610.29,82.8,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,486.2,22,,percent of total billed charges,,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,486.2,1847.56,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184312,CDM,,,278,RC,outpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,486.2,22,,percent of total billed charges,,,,,,,,,1750.32,90,,percent of total billed charges,,,1610.29,82.8,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,486.2,22,,percent of total billed charges,,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,486.2,1847.56,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184313,CDM,,,278,RC,outpatient,,2003.17,2003.17,,1700.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,500.79,22,,percent of total billed charges,,,,,,,,,1802.85,90,,percent of total billed charges,,,1658.62,82.8,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,,,,,,,,1762.79,88,,percent of total billed charges,,,,,,,,,1530.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,500.79,22,,percent of total billed charges,,,1822.88,91,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1662.63,83,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1642.6,82,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,500.79,1903.01,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184314,CDM,,,278,RC,outpatient,,2043.73,2043.73,,1735.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,510.93,22,,percent of total billed charges,,,,,,,,,1839.36,90,,percent of total billed charges,,,1692.21,82.8,,percent of total billed charges,,,1737.17,85,,percent of total billed charges,,,,,,,,,1798.48,88,,percent of total billed charges,,,,,,,,,1561.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,510.93,22,,percent of total billed charges,,,1859.79,91,,percent of total billed charges,,,1941.54,95,,percent of total billed charges,,,1696.3,83,,percent of total billed charges,,,1696.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1696.3,83,,percent of total billed charges,,,1941.54,95,,percent of total billed charges,,,1839.36,90,,percent of total billed charges,,,1839.36,90,,percent of total billed charges,,,1675.86,82,,percent of total billed charges,,,1839.36,90,,percent of total billed charges,,,1737.17,85,,percent of total billed charges,,510.93,1941.54,
SYNTHES SCREW CANNULATED SHORT THREAD 4,30184315,CDM,,,278,RC,outpatient,,2063.23,2063.23,,1751.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,515.81,22,,percent of total billed charges,,,,,,,,,1856.91,90,,percent of total billed charges,,,1708.35,82.8,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,,,,,,,,1815.64,88,,percent of total billed charges,,,,,,,,,1576.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,515.81,22,,percent of total billed charges,,,1877.54,91,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1712.48,83,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1691.85,82,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,515.81,1960.07,
ZIMMER BLADE EXPLANT 50MM LONG,30184316,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
ZIMMER BLADE EXPLANT 50MM SHORT,30184317,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
FULL COVERAGE SUPPORT BRA MEDIUM,30184318,CDM,,,270,RC,outpatient,,311.63,311.63,,264.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.91,22,,percent of total billed charges,,,,,,,,,280.47,90,,percent of total billed charges,,,258.03,82.8,,percent of total billed charges,,,264.89,85,,percent of total billed charges,,,,,,,,,274.23,88,,percent of total billed charges,,,,,,,,,238.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.91,22,,percent of total billed charges,,,283.58,91,,percent of total billed charges,,,296.05,95,,percent of total billed charges,,,258.65,83,,percent of total billed charges,,,258.65,83,,percent of total billed charges,,,,,,,,,,,,,,,258.65,83,,percent of total billed charges,,,296.05,95,,percent of total billed charges,,,280.47,90,,percent of total billed charges,,,280.47,90,,percent of total billed charges,,,255.54,82,,percent of total billed charges,,,280.47,90,,percent of total billed charges,,,264.89,85,,percent of total billed charges,,77.91,296.05,
FULL COVERAGE SUPPORT BRA LARGE,30184319,CDM,,,270,RC,outpatient,,311.63,311.63,,264.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.91,22,,percent of total billed charges,,,,,,,,,280.47,90,,percent of total billed charges,,,258.03,82.8,,percent of total billed charges,,,264.89,85,,percent of total billed charges,,,,,,,,,274.23,88,,percent of total billed charges,,,,,,,,,238.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.91,22,,percent of total billed charges,,,283.58,91,,percent of total billed charges,,,296.05,95,,percent of total billed charges,,,258.65,83,,percent of total billed charges,,,258.65,83,,percent of total billed charges,,,,,,,,,,,,,,,258.65,83,,percent of total billed charges,,,296.05,95,,percent of total billed charges,,,280.47,90,,percent of total billed charges,,,280.47,90,,percent of total billed charges,,,255.54,82,,percent of total billed charges,,,280.47,90,,percent of total billed charges,,,264.89,85,,percent of total billed charges,,77.91,296.05,
FULL COVERAGE SUPPORT BRA X-LARGE,30184320,CDM,,,270,RC,outpatient,,360.5,360.5,,306.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90.13,22,,percent of total billed charges,,,,,,,,,324.45,90,,percent of total billed charges,,,298.49,82.8,,percent of total billed charges,,,306.43,85,,percent of total billed charges,,,,,,,,,317.24,88,,percent of total billed charges,,,,,,,,,275.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90.13,22,,percent of total billed charges,,,328.06,91,,percent of total billed charges,,,342.48,95,,percent of total billed charges,,,299.22,83,,percent of total billed charges,,,299.22,83,,percent of total billed charges,,,,,,,,,,,,,,,299.22,83,,percent of total billed charges,,,342.48,95,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,295.61,82,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,306.43,85,,percent of total billed charges,,90.13,342.48,
FULL COVERAGE SUPPORT BRA XX-LARGE,30184321,CDM,,,270,RC,outpatient,,360.85,360.85,,306.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90.21,22,,percent of total billed charges,,,,,,,,,324.77,90,,percent of total billed charges,,,298.78,82.8,,percent of total billed charges,,,306.72,85,,percent of total billed charges,,,,,,,,,317.55,88,,percent of total billed charges,,,,,,,,,275.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90.21,22,,percent of total billed charges,,,328.37,91,,percent of total billed charges,,,342.81,95,,percent of total billed charges,,,299.51,83,,percent of total billed charges,,,299.51,83,,percent of total billed charges,,,,,,,,,,,,,,,299.51,83,,percent of total billed charges,,,342.81,95,,percent of total billed charges,,,324.77,90,,percent of total billed charges,,,324.77,90,,percent of total billed charges,,,295.9,82,,percent of total billed charges,,,324.77,90,,percent of total billed charges,,,306.72,85,,percent of total billed charges,,90.21,342.81,
KIRSCHNER WIRE DIA .035 9IN,30184324,CDM,,,270,RC,outpatient,,90.72,90.72,,77.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.68,22,,percent of total billed charges,,,,,,,,,81.65,90,,percent of total billed charges,,,75.12,82.8,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,,,,,,,,79.83,88,,percent of total billed charges,,,,,,,,,69.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.68,22,,percent of total billed charges,,,82.56,91,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,,,,,,,,,,,,,75.3,83,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,74.39,82,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,22.68,86.18,
KIRSCHNER WIRE DIA .035 6,30184325,CDM,,,270,RC,outpatient,,90.72,90.72,,77.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.68,22,,percent of total billed charges,,,,,,,,,81.65,90,,percent of total billed charges,,,75.12,82.8,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,,,,,,,,79.83,88,,percent of total billed charges,,,,,,,,,69.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.68,22,,percent of total billed charges,,,82.56,91,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,,,,,,,,,,,,,75.3,83,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,74.39,82,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,22.68,86.18,
KIRSCHNER WIRE DIA .045 X 9IN,30184326,CDM,,,270,RC,outpatient,,88.08,88.08,,74.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.02,22,,percent of total billed charges,,,,,,,,,79.27,90,,percent of total billed charges,,,72.93,82.8,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,,,,,,,,77.51,88,,percent of total billed charges,,,,,,,,,67.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.02,22,,percent of total billed charges,,,80.15,91,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,73.11,83,,percent of total billed charges,,,,,,,,,,,,,,,73.11,83,,percent of total billed charges,,,83.68,95,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,72.23,82,,percent of total billed charges,,,79.27,90,,percent of total billed charges,,,74.87,85,,percent of total billed charges,,22.02,83.68,
KIRSCHNER WIRE DIA .045 6IN,30184327,CDM,,,270,RC,outpatient,,90.72,90.72,,77.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.68,22,,percent of total billed charges,,,,,,,,,81.65,90,,percent of total billed charges,,,75.12,82.8,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,,,,,,,,79.83,88,,percent of total billed charges,,,,,,,,,69.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.68,22,,percent of total billed charges,,,82.56,91,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,,,,,,,,,,,,,75.3,83,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,74.39,82,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,22.68,86.18,
KIRSCHNER WIRE DIA .062 9IN,30184328,CDM,,,270,RC,outpatient,,90.72,90.72,,77.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.68,22,,percent of total billed charges,,,,,,,,,81.65,90,,percent of total billed charges,,,75.12,82.8,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,,,,,,,,79.83,88,,percent of total billed charges,,,,,,,,,69.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.68,22,,percent of total billed charges,,,82.56,91,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,,,,,,,,,,,,,75.3,83,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,74.39,82,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,22.68,86.18,
KIRSCHNER WIRE DIA .062 6IN,30184329,CDM,,,270,RC,outpatient,,90.72,90.72,,77.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.68,22,,percent of total billed charges,,,,,,,,,81.65,90,,percent of total billed charges,,,75.12,82.8,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,,,,,,,,79.83,88,,percent of total billed charges,,,,,,,,,69.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.68,22,,percent of total billed charges,,,82.56,91,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,,,,,,,,,,,,,75.3,83,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,74.39,82,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,22.68,86.18,
SYNTHES KWIRE THREADED TIP 100MM X 1.6,30184330,CDM,,,270,RC,outpatient,,474.25,474.25,,402.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,118.56,22,,percent of total billed charges,,,,,,,,,426.83,90,,percent of total billed charges,,,392.68,82.8,,percent of total billed charges,,,403.11,85,,percent of total billed charges,,,,,,,,,417.34,88,,percent of total billed charges,,,,,,,,,362.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,118.56,22,,percent of total billed charges,,,431.57,91,,percent of total billed charges,,,450.54,95,,percent of total billed charges,,,393.63,83,,percent of total billed charges,,,393.63,83,,percent of total billed charges,,,,,,,,,,,,,,,393.63,83,,percent of total billed charges,,,450.54,95,,percent of total billed charges,,,426.83,90,,percent of total billed charges,,,426.83,90,,percent of total billed charges,,,388.89,82,,percent of total billed charges,,,426.83,90,,percent of total billed charges,,,403.11,85,,percent of total billed charges,,118.56,450.54,
SYNTHES HOLDING CLAMP 1.6MM,30184331,CDM,,,270,RC,outpatient,,7160.4,7160.4,,6079.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1790.1,22,,percent of total billed charges,,,,,,,,,6444.36,90,,percent of total billed charges,,,5928.81,82.8,,percent of total billed charges,,,6086.34,85,,percent of total billed charges,,,,,,,,,6301.15,88,,percent of total billed charges,,,,,,,,,5470.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1790.1,22,,percent of total billed charges,,,6515.96,91,,percent of total billed charges,,,6802.38,95,,percent of total billed charges,,,5943.13,83,,percent of total billed charges,,,5943.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5943.13,83,,percent of total billed charges,,,6802.38,95,,percent of total billed charges,,,6444.36,90,,percent of total billed charges,,,6444.36,90,,percent of total billed charges,,,5871.53,82,,percent of total billed charges,,,6444.36,90,,percent of total billed charges,,,6086.34,85,,percent of total billed charges,,1790.1,6802.38,
SYNTHES CONNECTING CLAMP 3.0MM,30184332,CDM,,,270,RC,outpatient,,6657.63,6657.63,,5652.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1664.41,22,,percent of total billed charges,,,,,,,,,5991.87,90,,percent of total billed charges,,,5512.52,82.8,,percent of total billed charges,,,5658.99,85,,percent of total billed charges,,,,,,,,,5858.71,88,,percent of total billed charges,,,,,,,,,5086.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1664.41,22,,percent of total billed charges,,,6058.44,91,,percent of total billed charges,,,6324.75,95,,percent of total billed charges,,,5525.83,83,,percent of total billed charges,,,5525.83,83,,percent of total billed charges,,,,,,,,,,,,,,,5525.83,83,,percent of total billed charges,,,6324.75,95,,percent of total billed charges,,,5991.87,90,,percent of total billed charges,,,5991.87,90,,percent of total billed charges,,,5459.26,82,,percent of total billed charges,,,5991.87,90,,percent of total billed charges,,,5658.99,85,,percent of total billed charges,,1664.41,6324.75,
SYNTHES ROD CARBON FIBER 3.0 X 75MM,30184333,CDM,,,278,RC,outpatient,,446.25,446.25,,378.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,111.56,22,,percent of total billed charges,,,,,,,,,401.63,90,,percent of total billed charges,,,369.5,82.8,,percent of total billed charges,,,379.31,85,,percent of total billed charges,,,,,,,,,392.7,88,,percent of total billed charges,,,,,,,,,340.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,111.56,22,,percent of total billed charges,,,406.09,91,,percent of total billed charges,,,423.94,95,,percent of total billed charges,,,370.39,83,,percent of total billed charges,,,370.39,83,,percent of total billed charges,,,,,,,,,,,,,,,370.39,83,,percent of total billed charges,,,423.94,95,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,365.93,82,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,379.31,85,,percent of total billed charges,,111.56,423.94,
ZIMMER DRILL BIT STRAIGHT SHANK 2.0MM,30184336,CDM,,,270,RC,outpatient,,224.03,224.03,,190.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.01,22,,percent of total billed charges,,,,,,,,,201.63,90,,percent of total billed charges,,,185.5,82.8,,percent of total billed charges,,,190.43,85,,percent of total billed charges,,,,,,,,,197.15,88,,percent of total billed charges,,,,,,,,,171.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.01,22,,percent of total billed charges,,,203.87,91,,percent of total billed charges,,,212.83,95,,percent of total billed charges,,,185.94,83,,percent of total billed charges,,,185.94,83,,percent of total billed charges,,,,,,,,,,,,,,,185.94,83,,percent of total billed charges,,,212.83,95,,percent of total billed charges,,,201.63,90,,percent of total billed charges,,,201.63,90,,percent of total billed charges,,,183.7,82,,percent of total billed charges,,,201.63,90,,percent of total billed charges,,,190.43,85,,percent of total billed charges,,56.01,212.83,
STRYKER SHAVER LONG HIP,30184337,CDM,,,270,RC,outpatient,,641.59,641.59,,544.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,160.4,22,,percent of total billed charges,,,,,,,,,577.43,90,,percent of total billed charges,,,531.24,82.8,,percent of total billed charges,,,545.35,85,,percent of total billed charges,,,,,,,,,564.6,88,,percent of total billed charges,,,,,,,,,490.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,160.4,22,,percent of total billed charges,,,583.85,91,,percent of total billed charges,,,609.51,95,,percent of total billed charges,,,532.52,83,,percent of total billed charges,,,532.52,83,,percent of total billed charges,,,,,,,,,,,,,,,532.52,83,,percent of total billed charges,,,609.51,95,,percent of total billed charges,,,577.43,90,,percent of total billed charges,,,577.43,90,,percent of total billed charges,,,526.1,82,,percent of total billed charges,,,577.43,90,,percent of total billed charges,,,545.35,85,,percent of total billed charges,,160.4,609.51,
SYNTHES PLATE LCP ONE-THIRD TUBLAR 7 HOL,30184338,CDM,,,278,RC,outpatient,,1613.3,1613.3,,1369.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,403.33,22,,percent of total billed charges,,,,,,,,,1451.97,90,,percent of total billed charges,,,1335.81,82.8,,percent of total billed charges,,,1371.31,85,,percent of total billed charges,,,,,,,,,1419.7,88,,percent of total billed charges,,,,,,,,,1232.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,403.33,22,,percent of total billed charges,,,1468.1,91,,percent of total billed charges,,,1532.64,95,,percent of total billed charges,,,1339.04,83,,percent of total billed charges,,,1339.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1339.04,83,,percent of total billed charges,,,1532.64,95,,percent of total billed charges,,,1451.97,90,,percent of total billed charges,,,1451.97,90,,percent of total billed charges,,,1322.91,82,,percent of total billed charges,,,1451.97,90,,percent of total billed charges,,,1371.31,85,,percent of total billed charges,,403.33,1532.64,
DEPUY STEM CORAIL KA8,30184342,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY STEM STD CEMENTED SUMMIT SZ 3,30184343,CDM,,,278,RC,outpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6361.02,22,,percent of total billed charges,,,,,,,,,22899.65,90,,percent of total billed charges,,,21067.68,82.8,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6361.02,22,,percent of total billed charges,,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,6361.02,24171.86,
SYNTHES PLATE LCP 5 HOLE 99MM RIGHT,30184344,CDM,,,278,RC,outpatient,,6400.75,6400.75,,5434.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1600.19,22,,percent of total billed charges,,,,,,,,,5760.68,90,,percent of total billed charges,,,5299.82,82.8,,percent of total billed charges,,,5440.64,85,,percent of total billed charges,,,,,,,,,5632.66,88,,percent of total billed charges,,,,,,,,,4890.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1600.19,22,,percent of total billed charges,,,5824.68,91,,percent of total billed charges,,,6080.71,95,,percent of total billed charges,,,5312.62,83,,percent of total billed charges,,,5312.62,83,,percent of total billed charges,,,,,,,,,,,,,,,5312.62,83,,percent of total billed charges,,,6080.71,95,,percent of total billed charges,,,5760.68,90,,percent of total billed charges,,,5760.68,90,,percent of total billed charges,,,5248.62,82,,percent of total billed charges,,,5760.68,90,,percent of total billed charges,,,5440.64,85,,percent of total billed charges,,1600.19,6080.71,
SYNTHES SCREW CORTEX ST 3.5 X 45MM,30184345,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
SYNTHES PLATE DISTAL RADIUS 2.4MM VA 6HO,30184346,CDM,,,278,RC,outpatient,,10357.23,10357.23,,8793.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2589.31,22,,percent of total billed charges,,,,,,,,,9321.51,90,,percent of total billed charges,,,8575.79,82.8,,percent of total billed charges,,,8803.65,85,,percent of total billed charges,,,,,,,,,9114.36,88,,percent of total billed charges,,,,,,,,,7912.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2589.31,22,,percent of total billed charges,,,9425.08,91,,percent of total billed charges,,,9839.37,95,,percent of total billed charges,,,8596.5,83,,percent of total billed charges,,,8596.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8596.5,83,,percent of total billed charges,,,9839.37,95,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,8492.93,82,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,8803.65,85,,percent of total billed charges,,2589.31,9839.37,
SYNTHES SCREW LOCKING VA 2.4 X 22MM,30184347,CDM,,,278,RC,outpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,338.51,22,,percent of total billed charges,,,,,,,,,1218.62,90,,percent of total billed charges,,,1121.13,82.8,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,338.51,22,,percent of total billed charges,,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,338.51,1286.32,
SYNTHES SCREW CORTEX 2.7 X 16MM,30184348,CDM,,,278,RC,outpatient,,410.27,410.27,,348.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,102.57,22,,percent of total billed charges,,,,,,,,,369.24,90,,percent of total billed charges,,,339.7,82.8,,percent of total billed charges,,,348.73,85,,percent of total billed charges,,,,,,,,,361.04,88,,percent of total billed charges,,,,,,,,,313.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,102.57,22,,percent of total billed charges,,,373.35,91,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,,,,,,,,,,,,,340.52,83,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,336.42,82,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,348.73,85,,percent of total billed charges,,102.57,389.76,
S&N SUTURE ANCHOR HEALICOIL 4.5MM,30184349,CDM,,,270,RC,outpatient,,2544.75,2544.75,,2160.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,636.19,22,,percent of total billed charges,,,,,,,,,2290.28,90,,percent of total billed charges,,,2107.05,82.8,,percent of total billed charges,,,2163.04,85,,percent of total billed charges,,,,,,,,,2239.38,88,,percent of total billed charges,,,,,,,,,1944.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,636.19,22,,percent of total billed charges,,,2315.72,91,,percent of total billed charges,,,2417.51,95,,percent of total billed charges,,,2112.14,83,,percent of total billed charges,,,2112.14,83,,percent of total billed charges,,,,,,,,,,,,,,,2112.14,83,,percent of total billed charges,,,2417.51,95,,percent of total billed charges,,,2290.28,90,,percent of total billed charges,,,2290.28,90,,percent of total billed charges,,,2086.7,82,,percent of total billed charges,,,2290.28,90,,percent of total billed charges,,,2163.04,85,,percent of total billed charges,,636.19,2417.51,
S&N FIRSTPASS ST SUTURE PASSER,30184350,CDM,,,270,RC,outpatient,,3102.84,3102.84,,2634.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,775.71,22,,percent of total billed charges,,,,,,,,,2792.56,90,,percent of total billed charges,,,2569.15,82.8,,percent of total billed charges,,,2637.41,85,,percent of total billed charges,,,,,,,,,2730.5,88,,percent of total billed charges,,,,,,,,,2370.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,775.71,22,,percent of total billed charges,,,2823.58,91,,percent of total billed charges,,,2947.7,95,,percent of total billed charges,,,2575.36,83,,percent of total billed charges,,,2575.36,83,,percent of total billed charges,,,,,,,,,,,,,,,2575.36,83,,percent of total billed charges,,,2947.7,95,,percent of total billed charges,,,2792.56,90,,percent of total billed charges,,,2792.56,90,,percent of total billed charges,,,2544.33,82,,percent of total billed charges,,,2792.56,90,,percent of total billed charges,,,2637.41,85,,percent of total billed charges,,775.71,2947.7,
S&N BLADE MENISCETOMY 3.0 SHARP,30184351,CDM,,,270,RC,outpatient,,329.18,329.18,,279.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.3,22,,percent of total billed charges,,,,,,,,,296.26,90,,percent of total billed charges,,,272.56,82.8,,percent of total billed charges,,,279.8,85,,percent of total billed charges,,,,,,,,,289.68,88,,percent of total billed charges,,,,,,,,,251.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82.3,22,,percent of total billed charges,,,299.55,91,,percent of total billed charges,,,312.72,95,,percent of total billed charges,,,273.22,83,,percent of total billed charges,,,273.22,83,,percent of total billed charges,,,,,,,,,,,,,,,273.22,83,,percent of total billed charges,,,312.72,95,,percent of total billed charges,,,296.26,90,,percent of total billed charges,,,296.26,90,,percent of total billed charges,,,269.93,82,,percent of total billed charges,,,296.26,90,,percent of total billed charges,,,279.8,85,,percent of total billed charges,,82.3,312.72,
S&N HIP DISTRACTOR RENTAL TRAY,30184352,CDM,,,270,RC,outpatient,,3867.5,3867.5,,3283.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,966.88,22,,percent of total billed charges,,,,,,,,,3480.75,90,,percent of total billed charges,,,3202.29,82.8,,percent of total billed charges,,,3287.38,85,,percent of total billed charges,,,,,,,,,3403.4,88,,percent of total billed charges,,,,,,,,,2954.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,966.88,22,,percent of total billed charges,,,3519.43,91,,percent of total billed charges,,,3674.13,95,,percent of total billed charges,,,3210.03,83,,percent of total billed charges,,,3210.03,83,,percent of total billed charges,,,,,,,,,,,,,,,3210.03,83,,percent of total billed charges,,,3674.13,95,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3171.35,82,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3287.38,85,,percent of total billed charges,,966.88,3674.13,
SYNTHES SCREW CANCELLOUS 4.0 X 28MM,30184357,CDM,,,278,RC,outpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.78,22,,percent of total billed charges,,,,,,,,,200.82,90,,percent of total billed charges,,,184.75,82.8,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.78,22,,percent of total billed charges,,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,55.78,211.97,
SYNTHES PLATE 3.5LCP 5 HOLE 72MM,30184358,CDM,,,278,RC,outpatient,,2919.02,2919.02,,2478.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,729.76,22,,percent of total billed charges,,,,,,,,,2627.12,90,,percent of total billed charges,,,2416.95,82.8,,percent of total billed charges,,,2481.17,85,,percent of total billed charges,,,,,,,,,2568.74,88,,percent of total billed charges,,,,,,,,,2230.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,729.76,22,,percent of total billed charges,,,2656.31,91,,percent of total billed charges,,,2773.07,95,,percent of total billed charges,,,2422.79,83,,percent of total billed charges,,,2422.79,83,,percent of total billed charges,,,,,,,,,,,,,,,2422.79,83,,percent of total billed charges,,,2773.07,95,,percent of total billed charges,,,2627.12,90,,percent of total billed charges,,,2627.12,90,,percent of total billed charges,,,2393.6,82,,percent of total billed charges,,,2627.12,90,,percent of total billed charges,,,2481.17,85,,percent of total billed charges,,729.76,2773.07,
DEPUY LINER NEUTRAL 32 X 50MM,30184359,CDM,,,278,RC,outpatient,,10422.17,10422.17,,8848.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2605.54,22,,percent of total billed charges,,,,,,,,,9379.95,90,,percent of total billed charges,,,8629.56,82.8,,percent of total billed charges,,,8858.84,85,,percent of total billed charges,,,,,,,,,9171.51,88,,percent of total billed charges,,,,,,,,,7962.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2605.54,22,,percent of total billed charges,,,9484.17,91,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,8650.4,83,,percent of total billed charges,,,,,,,,,,,,,,,8650.4,83,,percent of total billed charges,,,9901.06,95,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8546.18,82,,percent of total billed charges,,,9379.95,90,,percent of total billed charges,,,8858.84,85,,percent of total billed charges,,2605.54,9901.06,
DEPUY LINER 40 X 56MM +4 / 10DEGREE,30184360,CDM,,,278,RC,outpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4400.13,22,,percent of total billed charges,,,,,,,,,15840.46,90,,percent of total billed charges,,,14573.22,82.8,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4400.13,22,,percent of total billed charges,,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,4400.13,16720.48,
DEPUY HEAD 36MM +3,30184361,CDM,,,278,RC,outpatient,,8767.27,8767.27,,7443.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2191.82,22,,percent of total billed charges,,,,,,,,,7890.54,90,,percent of total billed charges,,,7259.3,82.8,,percent of total billed charges,,,7452.18,85,,percent of total billed charges,,,,,,,,,7715.2,88,,percent of total billed charges,,,,,,,,,6698.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2191.82,22,,percent of total billed charges,,,7978.22,91,,percent of total billed charges,,,8328.91,95,,percent of total billed charges,,,7276.83,83,,percent of total billed charges,,,7276.83,83,,percent of total billed charges,,,,,,,,,,,,,,,7276.83,83,,percent of total billed charges,,,8328.91,95,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7189.16,82,,percent of total billed charges,,,7890.54,90,,percent of total billed charges,,,7452.18,85,,percent of total billed charges,,2191.82,8328.91,
MEDTRONIC LEAD KIT VECTRIS SURESCAN,30184362,CDM,,,270,RC,outpatient,,14592.5,14592.5,,12389.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3648.13,22,,percent of total billed charges,,,,,,,,,13133.25,90,,percent of total billed charges,,,12082.59,82.8,,percent of total billed charges,,,12403.63,85,,percent of total billed charges,,,,,,,,,12841.4,88,,percent of total billed charges,,,,,,,,,11148.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3648.13,22,,percent of total billed charges,,,13279.18,91,,percent of total billed charges,,,13862.88,95,,percent of total billed charges,,,12111.78,83,,percent of total billed charges,,,12111.78,83,,percent of total billed charges,,,,,,,,,,,,,,,12111.78,83,,percent of total billed charges,,,13862.88,95,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,11965.85,82,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,12403.63,85,,percent of total billed charges,,3648.13,13862.88,
MEDTRONIC NEURO STIMULATOR SURESSCAN SEN,30184363,CDM,,,278,RC,outpatient,,103350,103350,,87744.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25837.5,22,,percent of total billed charges,,,,,,,,,93015,90,,percent of total billed charges,,,85573.8,82.8,,percent of total billed charges,,,87847.5,85,,percent of total billed charges,,,,,,,,,90948,88,,percent of total billed charges,,,,,,,,,78959.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25837.5,22,,percent of total billed charges,,,94048.5,91,,percent of total billed charges,,,98182.5,95,,percent of total billed charges,,,85780.5,83,,percent of total billed charges,,,85780.5,83,,percent of total billed charges,,,,,,,,,,,,,,,85780.5,83,,percent of total billed charges,,,98182.5,95,,percent of total billed charges,,,93015,90,,percent of total billed charges,,,93015,90,,percent of total billed charges,,,84747,82,,percent of total billed charges,,,93015,90,,percent of total billed charges,,,87847.5,85,,percent of total billed charges,,25837.5,98182.5,
MEDTRONIC PATIENT PROGRAMMER,30184364,CDM,,,270,RC,outpatient,,6792.5,6792.5,,5766.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1698.13,22,,percent of total billed charges,,,,,,,,,6113.25,90,,percent of total billed charges,,,5624.19,82.8,,percent of total billed charges,,,5773.63,85,,percent of total billed charges,,,,,,,,,5977.4,88,,percent of total billed charges,,,,,,,,,5189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1698.13,22,,percent of total billed charges,,,6181.18,91,,percent of total billed charges,,,6452.88,95,,percent of total billed charges,,,5637.78,83,,percent of total billed charges,,,5637.78,83,,percent of total billed charges,,,,,,,,,,,,,,,5637.78,83,,percent of total billed charges,,,6452.88,95,,percent of total billed charges,,,6113.25,90,,percent of total billed charges,,,6113.25,90,,percent of total billed charges,,,5569.85,82,,percent of total billed charges,,,6113.25,90,,percent of total billed charges,,,5773.63,85,,percent of total billed charges,,1698.13,6452.88,
MEDTRONIC PATIENT RECHARGER,30184365,CDM,,,270,RC,outpatient,,13000,13000,,11037,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3250,22,,percent of total billed charges,,,,,,,,,11700,90,,percent of total billed charges,,,10764,82.8,,percent of total billed charges,,,11050,85,,percent of total billed charges,,,,,,,,,11440,88,,percent of total billed charges,,,,,,,,,9932,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3250,22,,percent of total billed charges,,,11830,91,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,,,,,,,,,,,,,10790,83,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,10660,82,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11050,85,,percent of total billed charges,,3250,12350,
EYE LENS IMPLANT ALCON MTA4U0,30184366,CDM,,,278,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
ANTERIOR VITRECTOMY PACK 6 DP,30184367,CDM,,,270,RC,outpatient,,848.51,848.51,,720.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,212.13,22,,percent of total billed charges,,,,,,,,,763.66,90,,percent of total billed charges,,,702.57,82.8,,percent of total billed charges,,,721.23,85,,percent of total billed charges,,,,,,,,,746.69,88,,percent of total billed charges,,,,,,,,,648.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,212.13,22,,percent of total billed charges,,,772.14,91,,percent of total billed charges,,,806.08,95,,percent of total billed charges,,,704.26,83,,percent of total billed charges,,,704.26,83,,percent of total billed charges,,,,,,,,,,,,,,,704.26,83,,percent of total billed charges,,,806.08,95,,percent of total billed charges,,,763.66,90,,percent of total billed charges,,,763.66,90,,percent of total billed charges,,,695.78,82,,percent of total billed charges,,,763.66,90,,percent of total billed charges,,,721.23,85,,percent of total billed charges,,212.13,806.08,
ZIMMER SAWBLADE OXF,30184369,CDM,,,270,RC,outpatient,,2522,2522,,2141.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,630.5,22,,percent of total billed charges,,,,,,,,,2269.8,90,,percent of total billed charges,,,2088.22,82.8,,percent of total billed charges,,,2143.7,85,,percent of total billed charges,,,,,,,,,2219.36,88,,percent of total billed charges,,,,,,,,,1926.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,630.5,22,,percent of total billed charges,,,2295.02,91,,percent of total billed charges,,,2395.9,95,,percent of total billed charges,,,2093.26,83,,percent of total billed charges,,,2093.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2093.26,83,,percent of total billed charges,,,2395.9,95,,percent of total billed charges,,,2269.8,90,,percent of total billed charges,,,2269.8,90,,percent of total billed charges,,,2068.04,82,,percent of total billed charges,,,2269.8,90,,percent of total billed charges,,,2143.7,85,,percent of total billed charges,,630.5,2395.9,
ZIMMER DRILL PINS 1/8 QUICK REL,30184370,CDM,,,270,RC,outpatient,,644,644,,546.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,161,22,,percent of total billed charges,,,,,,,,,579.6,90,,percent of total billed charges,,,533.23,82.8,,percent of total billed charges,,,547.4,85,,percent of total billed charges,,,,,,,,,566.72,88,,percent of total billed charges,,,,,,,,,492.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,161,22,,percent of total billed charges,,,586.04,91,,percent of total billed charges,,,611.8,95,,percent of total billed charges,,,534.52,83,,percent of total billed charges,,,534.52,83,,percent of total billed charges,,,,,,,,,,,,,,,534.52,83,,percent of total billed charges,,,611.8,95,,percent of total billed charges,,,579.6,90,,percent of total billed charges,,,579.6,90,,percent of total billed charges,,,528.08,82,,percent of total billed charges,,,579.6,90,,percent of total billed charges,,,547.4,85,,percent of total billed charges,,161,611.8,
ZIMMER BEARING OXF LT LG SZ 4MM,30184371,CDM,,,270,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
ZIMMER TIBIA SZ E LM UNI,30184372,CDM,,,270,RC,outpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3388.13,22,,percent of total billed charges,,,,,,,,,12197.25,90,,percent of total billed charges,,,11221.47,82.8,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3388.13,22,,percent of total billed charges,,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,3388.13,12874.88,
ZIMMER FEMUR LARGE OXF TWIN PED CMNTD,30184373,CDM,,,278,RC,outpatient,,20345,20345,,17272.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5086.25,22,,percent of total billed charges,,,,,,,,,18310.5,90,,percent of total billed charges,,,16845.66,82.8,,percent of total billed charges,,,17293.25,85,,percent of total billed charges,,,,,,,,,17903.6,88,,percent of total billed charges,,,,,,,,,15543.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5086.25,22,,percent of total billed charges,,,18513.95,91,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,,,,,,,,,,,,,16886.35,83,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,16682.9,82,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,17293.25,85,,percent of total billed charges,,5086.25,19327.75,
DEPUY MOP POROUS ALTREX/GRIPTON 36MM,30184375,CDM,,,278,RC,outpatient,,38243.21,38243.21,,32468.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9560.8,22,,percent of total billed charges,,,,,,,,,34418.89,90,,percent of total billed charges,,,31665.38,82.8,,percent of total billed charges,,,32506.73,85,,percent of total billed charges,,,,,,,,,33654.02,88,,percent of total billed charges,,,,,,,,,29217.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9560.8,22,,percent of total billed charges,,,34801.32,91,,percent of total billed charges,,,36331.05,95,,percent of total billed charges,,,31741.86,83,,percent of total billed charges,,,31741.86,83,,percent of total billed charges,,,,,,,,,,,,,,,31741.86,83,,percent of total billed charges,,,36331.05,95,,percent of total billed charges,,,34418.89,90,,percent of total billed charges,,,34418.89,90,,percent of total billed charges,,,31359.43,82,,percent of total billed charges,,,34418.89,90,,percent of total billed charges,,,32506.73,85,,percent of total billed charges,,9560.8,36331.05,
SYNTHES SCREW CORTEX ST 2.7MM,30184376,CDM,,,278,RC,outpatient,,386.75,386.75,,328.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.69,22,,percent of total billed charges,,,,,,,,,348.08,90,,percent of total billed charges,,,320.23,82.8,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,,,,,,,,340.34,88,,percent of total billed charges,,,,,,,,,295.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.69,22,,percent of total billed charges,,,351.94,91,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,321,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,,,,,,,,,,,,,,321,83,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,317.14,82,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,96.69,367.41,
SYNTHES DRILL BIT QC 2.7 X 100MM,30184377,CDM,,,278,RC,outpatient,,795.34,795.34,,675.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,198.84,22,,percent of total billed charges,,,,,,,,,715.81,90,,percent of total billed charges,,,658.54,82.8,,percent of total billed charges,,,676.04,85,,percent of total billed charges,,,,,,,,,699.9,88,,percent of total billed charges,,,,,,,,,607.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,198.84,22,,percent of total billed charges,,,723.76,91,,percent of total billed charges,,,755.57,95,,percent of total billed charges,,,660.13,83,,percent of total billed charges,,,660.13,83,,percent of total billed charges,,,,,,,,,,,,,,,660.13,83,,percent of total billed charges,,,755.57,95,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,652.18,82,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,676.04,85,,percent of total billed charges,,198.84,755.57,
SYNTHES PLATE DISTAL RADIUS VA 2.4MM 7 H,30184378,CDM,,,278,RC,outpatient,,9210.18,9210.18,,7819.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2302.55,22,,percent of total billed charges,,,,,,,,,8289.16,90,,percent of total billed charges,,,7626.03,82.8,,percent of total billed charges,,,7828.65,85,,percent of total billed charges,,,,,,,,,8104.96,88,,percent of total billed charges,,,,,,,,,7036.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2302.55,22,,percent of total billed charges,,,8381.26,91,,percent of total billed charges,,,8749.67,95,,percent of total billed charges,,,7644.45,83,,percent of total billed charges,,,7644.45,83,,percent of total billed charges,,,,,,,,,,,,,,,7644.45,83,,percent of total billed charges,,,8749.67,95,,percent of total billed charges,,,8289.16,90,,percent of total billed charges,,,8289.16,90,,percent of total billed charges,,,7552.35,82,,percent of total billed charges,,,8289.16,90,,percent of total billed charges,,,7828.65,85,,percent of total billed charges,,2302.55,8749.67,
SYNTHES SCREW CORTEX 2.4 X 14MM,30184379,CDM,,,278,RC,outpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149.92,22,,percent of total billed charges,,,,,,,,,539.72,90,,percent of total billed charges,,,496.54,82.8,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149.92,22,,percent of total billed charges,,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,149.92,569.71,
SYNTHES SCREW CANNULATED 6.5 X 95MM,30184380,CDM,,,278,RC,outpatient,,2795.65,2795.65,,2373.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,698.91,22,,percent of total billed charges,,,,,,,,,2516.09,90,,percent of total billed charges,,,2314.8,82.8,,percent of total billed charges,,,2376.3,85,,percent of total billed charges,,,,,,,,,2460.17,88,,percent of total billed charges,,,,,,,,,2135.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,698.91,22,,percent of total billed charges,,,2544.04,91,,percent of total billed charges,,,2655.87,95,,percent of total billed charges,,,2320.39,83,,percent of total billed charges,,,2320.39,83,,percent of total billed charges,,,,,,,,,,,,,,,2320.39,83,,percent of total billed charges,,,2655.87,95,,percent of total billed charges,,,2516.09,90,,percent of total billed charges,,,2516.09,90,,percent of total billed charges,,,2292.43,82,,percent of total billed charges,,,2516.09,90,,percent of total billed charges,,,2376.3,85,,percent of total billed charges,,698.91,2655.87,
SYNTHES SCREW LOCKING VA 44MM,30184381,CDM,,,278,RC,outpatient,,1469.65,1469.65,,1247.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,367.41,22,,percent of total billed charges,,,,,,,,,1322.69,90,,percent of total billed charges,,,1216.87,82.8,,percent of total billed charges,,,1249.2,85,,percent of total billed charges,,,,,,,,,1293.29,88,,percent of total billed charges,,,,,,,,,1122.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,367.41,22,,percent of total billed charges,,,1337.38,91,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1219.81,83,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1205.11,82,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1249.2,85,,percent of total billed charges,,367.41,1396.17,
SYNTHES SCREW LOCKING VA 40MM,30184382,CDM,,,278,RC,outpatient,,1469.65,1469.65,,1247.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,367.41,22,,percent of total billed charges,,,,,,,,,1322.69,90,,percent of total billed charges,,,1216.87,82.8,,percent of total billed charges,,,1249.2,85,,percent of total billed charges,,,,,,,,,1293.29,88,,percent of total billed charges,,,,,,,,,1122.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,367.41,22,,percent of total billed charges,,,1337.38,91,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1219.81,83,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1205.11,82,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1249.2,85,,percent of total billed charges,,367.41,1396.17,
SYNTHES SCREW LOCKING VA 36MM,30184383,CDM,,,278,RC,outpatient,,1469.65,1469.65,,1247.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,367.41,22,,percent of total billed charges,,,,,,,,,1322.69,90,,percent of total billed charges,,,1216.87,82.8,,percent of total billed charges,,,1249.2,85,,percent of total billed charges,,,,,,,,,1293.29,88,,percent of total billed charges,,,,,,,,,1122.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,367.41,22,,percent of total billed charges,,,1337.38,91,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1219.81,83,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1205.11,82,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1249.2,85,,percent of total billed charges,,367.41,1396.17,
SYNTHES SCREW LOCKING VA 30MM,30184384,CDM,,,278,RC,outpatient,,1469.65,1469.65,,1247.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,367.41,22,,percent of total billed charges,,,,,,,,,1322.69,90,,percent of total billed charges,,,1216.87,82.8,,percent of total billed charges,,,1249.2,85,,percent of total billed charges,,,,,,,,,1293.29,88,,percent of total billed charges,,,,,,,,,1122.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,367.41,22,,percent of total billed charges,,,1337.38,91,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1219.81,83,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1205.11,82,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1249.2,85,,percent of total billed charges,,367.41,1396.17,
SYNTHES SCREW LOCKING VA 28MM,30184385,CDM,,,278,RC,outpatient,,1469.65,1469.65,,1247.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,367.41,22,,percent of total billed charges,,,,,,,,,1322.69,90,,percent of total billed charges,,,1216.87,82.8,,percent of total billed charges,,,1249.2,85,,percent of total billed charges,,,,,,,,,1293.29,88,,percent of total billed charges,,,,,,,,,1122.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,367.41,22,,percent of total billed charges,,,1337.38,91,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,1219.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1219.81,83,,percent of total billed charges,,,1396.17,95,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1205.11,82,,percent of total billed charges,,,1322.69,90,,percent of total billed charges,,,1249.2,85,,percent of total billed charges,,367.41,1396.17,
SYNTHES PLATE CALCANEAL,30184386,CDM,,,278,RC,outpatient,,10188.1,10188.1,,8649.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2547.03,22,,percent of total billed charges,,,,,,,,,9169.29,90,,percent of total billed charges,,,8435.75,82.8,,percent of total billed charges,,,8659.89,85,,percent of total billed charges,,,,,,,,,8965.53,88,,percent of total billed charges,,,,,,,,,7783.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2547.03,22,,percent of total billed charges,,,9271.17,91,,percent of total billed charges,,,9678.7,95,,percent of total billed charges,,,8456.12,83,,percent of total billed charges,,,8456.12,83,,percent of total billed charges,,,,,,,,,,,,,,,8456.12,83,,percent of total billed charges,,,9678.7,95,,percent of total billed charges,,,9169.29,90,,percent of total billed charges,,,9169.29,90,,percent of total billed charges,,,8354.24,82,,percent of total billed charges,,,9169.29,90,,percent of total billed charges,,,8659.89,85,,percent of total billed charges,,2547.03,9678.7,
ARTHREX BB-TAK THREADED,30184387,CDM,,,278,RC,outpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,148.75,22,,percent of total billed charges,,,,,,,,,535.5,90,,percent of total billed charges,,,492.66,82.8,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,148.75,22,,percent of total billed charges,,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,148.75,565.25,
ARTHREX DRILL BIT 2.4MM,30184388,CDM,,,278,RC,outpatient,,553,553,,469.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,138.25,22,,percent of total billed charges,,,,,,,,,497.7,90,,percent of total billed charges,,,457.88,82.8,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,,,,,,,,486.64,88,,percent of total billed charges,,,,,,,,,422.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,138.25,22,,percent of total billed charges,,,503.23,91,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,,,,,,,,,,,,,458.99,83,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,453.46,82,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,138.25,525.35,
ARTHREX SCREW CORTEX LP 2.4 X 10MM,30184389,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW CORTEX LP 2.4 X 12MM,30184390,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW CORTEX LP 2.4 X 14MM,30184391,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW CORTEX LP 2.4 X 16MM,30184392,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW LOCKING LP 2.4 X 8MM,30184393,CDM,,,278,RC,outpatient,,875,875,,742.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.75,22,,percent of total billed charges,,,,,,,,,787.5,90,,percent of total billed charges,,,724.5,82.8,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,,,,,,,,770,88,,percent of total billed charges,,,,,,,,,668.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.75,22,,percent of total billed charges,,,796.25,91,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,,,,,,,,,,,,,726.25,83,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,717.5,82,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,218.75,831.25,
ARTHREX SCREW LOCKING LP 2.4 X 10MM,30184394,CDM,,,278,RC,outpatient,,875,875,,742.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.75,22,,percent of total billed charges,,,,,,,,,787.5,90,,percent of total billed charges,,,724.5,82.8,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,,,,,,,,770,88,,percent of total billed charges,,,,,,,,,668.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.75,22,,percent of total billed charges,,,796.25,91,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,,,,,,,,,,,,,726.25,83,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,717.5,82,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,218.75,831.25,
ARTHREX SCREW LOCKING LP 2.4 X 12MM,30184395,CDM,,,278,RC,outpatient,,875,875,,742.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.75,22,,percent of total billed charges,,,,,,,,,787.5,90,,percent of total billed charges,,,724.5,82.8,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,,,,,,,,770,88,,percent of total billed charges,,,,,,,,,668.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.75,22,,percent of total billed charges,,,796.25,91,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,,,,,,,,,,,,,726.25,83,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,717.5,82,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,218.75,831.25,
ARTHREX SCREW LOCKING LP 2.4 X 14MM,30184396,CDM,,,278,RC,outpatient,,875,875,,742.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.75,22,,percent of total billed charges,,,,,,,,,787.5,90,,percent of total billed charges,,,724.5,82.8,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,,,,,,,,770,88,,percent of total billed charges,,,,,,,,,668.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.75,22,,percent of total billed charges,,,796.25,91,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,,,,,,,,,,,,,726.25,83,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,717.5,82,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,218.75,831.25,
ARTHREX G-WIRE W/TRCR TIP .045  W/LASER,30184397,CDM,,,278,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
ARTHREX DRILL BIT 1.7MM,30184398,CDM,,,278,RC,outpatient,,553,553,,469.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,138.25,22,,percent of total billed charges,,,,,,,,,497.7,90,,percent of total billed charges,,,457.88,82.8,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,,,,,,,,486.64,88,,percent of total billed charges,,,,,,,,,422.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,138.25,22,,percent of total billed charges,,,503.23,91,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,,,,,,,,,,,,,458.99,83,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,453.46,82,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,138.25,525.35,
ARTHREX GUIDE WIRE W/TROCAR TIP .062,30184399,CDM,,,278,RC,outpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,44,167.2,
ARTHREX PLATE LO-PRO STR 2.4MM 6 HOLE,30184400,CDM,,,278,RC,outpatient,,4517.5,4517.5,,3835.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1129.38,22,,percent of total billed charges,,,,,,,,,4065.75,90,,percent of total billed charges,,,3740.49,82.8,,percent of total billed charges,,,3839.88,85,,percent of total billed charges,,,,,,,,,3975.4,88,,percent of total billed charges,,,,,,,,,3451.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1129.38,22,,percent of total billed charges,,,4110.93,91,,percent of total billed charges,,,4291.63,95,,percent of total billed charges,,,3749.53,83,,percent of total billed charges,,,3749.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3749.53,83,,percent of total billed charges,,,4291.63,95,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,3704.35,82,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,3839.88,85,,percent of total billed charges,,1129.38,4291.63,
ARTHREX PLATE LO-PRO STR 2.4MM 7 HOLE,30184401,CDM,,,278,RC,outpatient,,4517.5,4517.5,,3835.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1129.38,22,,percent of total billed charges,,,,,,,,,4065.75,90,,percent of total billed charges,,,3740.49,82.8,,percent of total billed charges,,,3839.88,85,,percent of total billed charges,,,,,,,,,3975.4,88,,percent of total billed charges,,,,,,,,,3451.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1129.38,22,,percent of total billed charges,,,4110.93,91,,percent of total billed charges,,,4291.63,95,,percent of total billed charges,,,3749.53,83,,percent of total billed charges,,,3749.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3749.53,83,,percent of total billed charges,,,4291.63,95,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,3704.35,82,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,3839.88,85,,percent of total billed charges,,1129.38,4291.63,
ARTHREX DRILL CANNULATED 3.5MM,30184402,CDM,,,278,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
ARTHREX BONE TAP CANNULATED 4.5MM,30184403,CDM,,,278,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
ARTHREX BONE TAP CANNULATED 5.5MM,30184404,CDM,,,278,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
ARTHREX GUIDEWIRE W/TRCR TIP .078 X8,30184405,CDM,,,278,RC,outpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50,22,,percent of total billed charges,,,,,,,,,180,90,,percent of total billed charges,,,165.6,82.8,,percent of total billed charges,,,170,85,,percent of total billed charges,,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50,22,,percent of total billed charges,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,50,190,
ARTHREX SCREW PT THD LO-PRO T1 5.5 X 50M,30184406,CDM,,,278,RC,outpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1291.88,22,,percent of total billed charges,,,,,,,,,4650.75,90,,percent of total billed charges,,,4278.69,82.8,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1291.88,22,,percent of total billed charges,,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,1291.88,4909.13,
S&N ULTRATAPE 2MM BLUE 38,30184407,CDM,,,270,RC,outpatient,,386.75,386.75,,328.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.69,22,,percent of total billed charges,,,,,,,,,348.08,90,,percent of total billed charges,,,320.23,82.8,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,,,,,,,,340.34,88,,percent of total billed charges,,,,,,,,,295.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.69,22,,percent of total billed charges,,,351.94,91,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,321,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,,,,,,,,,,,,,,321,83,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,317.14,82,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,96.69,367.41,
S&N HEALICOIL SA PK 5.5MM,30184408,CDM,,,270,RC,outpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,503.75,22,,percent of total billed charges,,,,,,,,,1813.5,90,,percent of total billed charges,,,1668.42,82.8,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,503.75,22,,percent of total billed charges,,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,503.75,1914.25,
S&N MULTIFIX S PEEK 5.5MM,30184409,CDM,,,270,RC,outpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,503.75,22,,percent of total billed charges,,,,,,,,,1813.5,90,,percent of total billed charges,,,1668.42,82.8,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,503.75,22,,percent of total billed charges,,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,503.75,1914.25,
S&N HEALICOIL PK 5.5MM W/UB2-CBR BLK UTP,30184410,CDM,,,270,RC,outpatient,,2269.8,2269.8,,1927.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,567.45,22,,percent of total billed charges,,,,,,,,,2042.82,90,,percent of total billed charges,,,1879.39,82.8,,percent of total billed charges,,,1929.33,85,,percent of total billed charges,,,,,,,,,1997.42,88,,percent of total billed charges,,,,,,,,,1734.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,567.45,22,,percent of total billed charges,,,2065.52,91,,percent of total billed charges,,,2156.31,95,,percent of total billed charges,,,1883.93,83,,percent of total billed charges,,,1883.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1883.93,83,,percent of total billed charges,,,2156.31,95,,percent of total billed charges,,,2042.82,90,,percent of total billed charges,,,2042.82,90,,percent of total billed charges,,,1861.24,82,,percent of total billed charges,,,2042.82,90,,percent of total billed charges,,,1929.33,85,,percent of total billed charges,,567.45,2156.31,
DEPUY STEM SUMMIT STD SZ 5,30184411,CDM,,,278,RC,outpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8814.57,22,,percent of total billed charges,,,,,,,,,31732.45,90,,percent of total billed charges,,,29193.86,82.8,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8814.57,22,,percent of total billed charges,,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,8814.57,33495.37,
DEPUY FEMUR LPS PROXIMAL 15 DEG RT,30184412,CDM,,,278,RC,outpatient,,56410.06,56410.06,,47892.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14102.52,22,,percent of total billed charges,,,,,,,,,50769.05,90,,percent of total billed charges,,,46707.53,82.8,,percent of total billed charges,,,47948.55,85,,percent of total billed charges,,,,,,,,,49640.85,88,,percent of total billed charges,,,,,,,,,43097.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14102.52,22,,percent of total billed charges,,,51333.15,91,,percent of total billed charges,,,53589.56,95,,percent of total billed charges,,,46820.35,83,,percent of total billed charges,,,46820.35,83,,percent of total billed charges,,,,,,,,,,,,,,,46820.35,83,,percent of total billed charges,,,53589.56,95,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,46256.25,82,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,47948.55,85,,percent of total billed charges,,14102.52,53589.56,
DEPUY OSTEOTOME RADIAL 14MM X 5,30184413,CDM,,,278,RC,outpatient,,5687.5,5687.5,,4828.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1421.88,22,,percent of total billed charges,,,,,,,,,5118.75,90,,percent of total billed charges,,,4709.25,82.8,,percent of total billed charges,,,4834.38,85,,percent of total billed charges,,,,,,,,,5005,88,,percent of total billed charges,,,,,,,,,4345.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1421.88,22,,percent of total billed charges,,,5175.63,91,,percent of total billed charges,,,5403.13,95,,percent of total billed charges,,,4720.63,83,,percent of total billed charges,,,4720.63,83,,percent of total billed charges,,,,,,,,,,,,,,,4720.63,83,,percent of total billed charges,,,5403.13,95,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,4663.75,82,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,4834.38,85,,percent of total billed charges,,1421.88,5403.13,
DEPUY TREPHINES 14MM,30184414,CDM,,,278,RC,outpatient,,3549,3549,,3013.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,887.25,22,,percent of total billed charges,,,,,,,,,3194.1,90,,percent of total billed charges,,,2938.57,82.8,,percent of total billed charges,,,3016.65,85,,percent of total billed charges,,,,,,,,,3123.12,88,,percent of total billed charges,,,,,,,,,2711.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,887.25,22,,percent of total billed charges,,,3229.59,91,,percent of total billed charges,,,3371.55,95,,percent of total billed charges,,,2945.67,83,,percent of total billed charges,,,2945.67,83,,percent of total billed charges,,,,,,,,,,,,,,,2945.67,83,,percent of total billed charges,,,3371.55,95,,percent of total billed charges,,,3194.1,90,,percent of total billed charges,,,3194.1,90,,percent of total billed charges,,,2910.18,82,,percent of total billed charges,,,3194.1,90,,percent of total billed charges,,,3016.65,85,,percent of total billed charges,,887.25,3371.55,
DEPUY TREPHINES 14.5MM,30184415,CDM,,,278,RC,outpatient,,3549,3549,,3013.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,887.25,22,,percent of total billed charges,,,,,,,,,3194.1,90,,percent of total billed charges,,,2938.57,82.8,,percent of total billed charges,,,3016.65,85,,percent of total billed charges,,,,,,,,,3123.12,88,,percent of total billed charges,,,,,,,,,2711.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,887.25,22,,percent of total billed charges,,,3229.59,91,,percent of total billed charges,,,3371.55,95,,percent of total billed charges,,,2945.67,83,,percent of total billed charges,,,2945.67,83,,percent of total billed charges,,,,,,,,,,,,,,,2945.67,83,,percent of total billed charges,,,3371.55,95,,percent of total billed charges,,,3194.1,90,,percent of total billed charges,,,3194.1,90,,percent of total billed charges,,,2910.18,82,,percent of total billed charges,,,3194.1,90,,percent of total billed charges,,,3016.65,85,,percent of total billed charges,,887.25,3371.55,
S&N FEMUR OXINIUM PS SZ 5 RT,30184416,CDM,,,278,RC,outpatient,,32523.99,32523.99,,27612.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8131,22,,percent of total billed charges,,,,,,,,,29271.59,90,,percent of total billed charges,,,26929.86,82.8,,percent of total billed charges,,,27645.39,85,,percent of total billed charges,,,,,,,,,28621.11,88,,percent of total billed charges,,,,,,,,,24848.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8131,22,,percent of total billed charges,,,29596.83,91,,percent of total billed charges,,,30897.79,95,,percent of total billed charges,,,26994.91,83,,percent of total billed charges,,,26994.91,83,,percent of total billed charges,,,,,,,,,,,,,,,26994.91,83,,percent of total billed charges,,,30897.79,95,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,26669.67,82,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,27645.39,85,,percent of total billed charges,,8131,30897.79,
S&N LGN PS HIGH FLEX XLPE SZ 5-6 13MM,30184417,CDM,,,278,RC,outpatient,,11895,11895,,10098.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2973.75,22,,percent of total billed charges,,,,,,,,,10705.5,90,,percent of total billed charges,,,9849.06,82.8,,percent of total billed charges,,,10110.75,85,,percent of total billed charges,,,,,,,,,10467.6,88,,percent of total billed charges,,,,,,,,,9087.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2973.75,22,,percent of total billed charges,,,10824.45,91,,percent of total billed charges,,,11300.25,95,,percent of total billed charges,,,9872.85,83,,percent of total billed charges,,,9872.85,83,,percent of total billed charges,,,,,,,,,,,,,,,9872.85,83,,percent of total billed charges,,,11300.25,95,,percent of total billed charges,,,10705.5,90,,percent of total billed charges,,,10705.5,90,,percent of total billed charges,,,9753.9,82,,percent of total billed charges,,,10705.5,90,,percent of total billed charges,,,10110.75,85,,percent of total billed charges,,2973.75,11300.25,
S&N PLATE TIBIA BASE GENISIS II SZ 5 RT,30184418,CDM,,,278,RC,outpatient,,15593.11,15593.11,,13238.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3898.28,22,,percent of total billed charges,,,,,,,,,14033.8,90,,percent of total billed charges,,,12911.1,82.8,,percent of total billed charges,,,13254.14,85,,percent of total billed charges,,,,,,,,,13721.94,88,,percent of total billed charges,,,,,,,,,11913.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3898.28,22,,percent of total billed charges,,,14189.73,91,,percent of total billed charges,,,14813.45,95,,percent of total billed charges,,,12942.28,83,,percent of total billed charges,,,12942.28,83,,percent of total billed charges,,,,,,,,,,,,,,,12942.28,83,,percent of total billed charges,,,14813.45,95,,percent of total billed charges,,,14033.8,90,,percent of total billed charges,,,14033.8,90,,percent of total billed charges,,,12786.35,82,,percent of total billed charges,,,14033.8,90,,percent of total billed charges,,,13254.14,85,,percent of total billed charges,,3898.28,14813.45,
S&N GENESIS PIN & DRILL SET,30184419,CDM,,,270,RC,outpatient,,876.33,876.33,,744,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,219.08,22,,percent of total billed charges,,,,,,,,,788.7,90,,percent of total billed charges,,,725.6,82.8,,percent of total billed charges,,,744.88,85,,percent of total billed charges,,,,,,,,,771.17,88,,percent of total billed charges,,,,,,,,,669.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,219.08,22,,percent of total billed charges,,,797.46,91,,percent of total billed charges,,,832.51,95,,percent of total billed charges,,,727.35,83,,percent of total billed charges,,,727.35,83,,percent of total billed charges,,,,,,,,,,,,,,,727.35,83,,percent of total billed charges,,,832.51,95,,percent of total billed charges,,,788.7,90,,percent of total billed charges,,,788.7,90,,percent of total billed charges,,,718.59,82,,percent of total billed charges,,,788.7,90,,percent of total billed charges,,,744.88,85,,percent of total billed charges,,219.08,832.51,
S&N FEMUR OXINIUM PS SZ 5 LT,30184420,CDM,,,278,RC,outpatient,,27300,27300,,23177.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6825,22,,percent of total billed charges,,,,,,,,,24570,90,,percent of total billed charges,,,22604.4,82.8,,percent of total billed charges,,,23205,85,,percent of total billed charges,,,,,,,,,24024,88,,percent of total billed charges,,,,,,,,,20857.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6825,22,,percent of total billed charges,,,24843,91,,percent of total billed charges,,,25935,95,,percent of total billed charges,,,22659,83,,percent of total billed charges,,,22659,83,,percent of total billed charges,,,,,,,,,,,,,,,22659,83,,percent of total billed charges,,,25935,95,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,22386,82,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,23205,85,,percent of total billed charges,,6825,25935,
LEXION INSUFLOW,30184421,CDM,,,270,RC,outpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,148.75,22,,percent of total billed charges,,,,,,,,,535.5,90,,percent of total billed charges,,,492.66,82.8,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,148.75,22,,percent of total billed charges,,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,148.75,565.25,
DEPUY INSERT TCS RP 15MM SZ 5,30184422,CDM,,,278,RC,outpatient,,15465.58,15465.58,,13130.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3866.4,22,,percent of total billed charges,,,,,,,,,13919.02,90,,percent of total billed charges,,,12805.5,82.8,,percent of total billed charges,,,13145.74,85,,percent of total billed charges,,,,,,,,,13609.71,88,,percent of total billed charges,,,,,,,,,11815.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3866.4,22,,percent of total billed charges,,,14073.68,91,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,12836.43,83,,percent of total billed charges,,,,,,,,,,,,,,,12836.43,83,,percent of total billed charges,,,14692.3,95,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,12681.78,82,,percent of total billed charges,,,13919.02,90,,percent of total billed charges,,,13145.74,85,,percent of total billed charges,,3866.4,14692.3,
DEPUY FEMUR PS SIGMA LT SZ 6,30184423,CDM,,,278,RC,outpatient,,25162.48,25162.48,,21362.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6290.62,22,,percent of total billed charges,,,,,,,,,22646.23,90,,percent of total billed charges,,,20834.53,82.8,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,,,,,,,,22142.98,88,,percent of total billed charges,,,,,,,,,19224.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6290.62,22,,percent of total billed charges,,,22897.86,91,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,20884.86,83,,percent of total billed charges,,,,,,,,,,,,,,,20884.86,83,,percent of total billed charges,,,23904.36,95,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,20633.23,82,,percent of total billed charges,,,22646.23,90,,percent of total billed charges,,,21388.11,85,,percent of total billed charges,,6290.62,23904.36,
DEPUY INSERT RP 10MM SZ 6,30184424,CDM,,,278,RC,outpatient,,11480.69,11480.69,,9747.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2870.17,22,,percent of total billed charges,,,,,,,,,10332.62,90,,percent of total billed charges,,,9506.01,82.8,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,,,,,,,,10103.01,88,,percent of total billed charges,,,,,,,,,8771.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2870.17,22,,percent of total billed charges,,,10447.43,91,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,9528.97,83,,percent of total billed charges,,,,,,,,,,,,,,,9528.97,83,,percent of total billed charges,,,10906.66,95,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9414.17,82,,percent of total billed charges,,,10332.62,90,,percent of total billed charges,,,9758.59,85,,percent of total billed charges,,2870.17,10906.66,
ALLOSOURCE ANTERIOR TIBIALIS,30184425,CDM,,,278,RC,outpatient,,18396.24,18396.24,,15618.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4599.06,22,,percent of total billed charges,,,,,,,,,16556.62,90,,percent of total billed charges,,,15232.09,82.8,,percent of total billed charges,,,15636.8,85,,percent of total billed charges,,,,,,,,,16188.69,88,,percent of total billed charges,,,,,,,,,14054.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4599.06,22,,percent of total billed charges,,,16740.58,91,,percent of total billed charges,,,17476.43,95,,percent of total billed charges,,,15268.88,83,,percent of total billed charges,,,15268.88,83,,percent of total billed charges,,,,,,,,,,,,,,,15268.88,83,,percent of total billed charges,,,17476.43,95,,percent of total billed charges,,,16556.62,90,,percent of total billed charges,,,16556.62,90,,percent of total billed charges,,,15084.92,82,,percent of total billed charges,,,16556.62,90,,percent of total billed charges,,,15636.8,85,,percent of total billed charges,,4599.06,17476.43,
ESOPHYX2 2-LINK,30184426,CDM,,,270,RC,outpatient,,23237.5,23237.5,,19728.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5809.38,22,,percent of total billed charges,,,,,,,,,20913.75,90,,percent of total billed charges,,,19240.65,82.8,,percent of total billed charges,,,19751.88,85,,percent of total billed charges,,,,,,,,,20449,88,,percent of total billed charges,,,,,,,,,17753.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5809.38,22,,percent of total billed charges,,,21146.13,91,,percent of total billed charges,,,22075.63,95,,percent of total billed charges,,,19287.13,83,,percent of total billed charges,,,19287.13,83,,percent of total billed charges,,,,,,,,,,,,,,,19287.13,83,,percent of total billed charges,,,22075.63,95,,percent of total billed charges,,,20913.75,90,,percent of total billed charges,,,20913.75,90,,percent of total billed charges,,,19054.75,82,,percent of total billed charges,,,20913.75,90,,percent of total billed charges,,,19751.88,85,,percent of total billed charges,,5809.38,22075.63,
ZIMMER FEMUR OXFORD TWIN PEG,30184427,CDM,,,278,RC,outpatient,,20345,20345,,17272.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5086.25,22,,percent of total billed charges,,,,,,,,,18310.5,90,,percent of total billed charges,,,16845.66,82.8,,percent of total billed charges,,,17293.25,85,,percent of total billed charges,,,,,,,,,17903.6,88,,percent of total billed charges,,,,,,,,,15543.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5086.25,22,,percent of total billed charges,,,18513.95,91,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,,,,,,,,,,,,,16886.35,83,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,16682.9,82,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,17293.25,85,,percent of total billed charges,,5086.25,19327.75,
ZIMMER TIBIAL TRAY RT MEDIAL,30184428,CDM,,,278,RC,outpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3388.13,22,,percent of total billed charges,,,,,,,,,12197.25,90,,percent of total billed charges,,,11221.47,82.8,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3388.13,22,,percent of total billed charges,,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,3388.13,12874.88,
ZIMMER BEARING ANATOMIC MENISCAL RT MEDI,30184429,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
DEPUY ATTUNE RP TOTAL KNEE,30184432,CDM,,,278,RC,outpatient,,37440,37440,,31786.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9360,22,,percent of total billed charges,,,,,,,,,33696,90,,percent of total billed charges,,,31000.32,82.8,,percent of total billed charges,,,31824,85,,percent of total billed charges,,,,,,,,,32947.2,88,,percent of total billed charges,,,,,,,,,28604.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9360,22,,percent of total billed charges,,,34070.4,91,,percent of total billed charges,,,35568,95,,percent of total billed charges,,,31075.2,83,,percent of total billed charges,,,31075.2,83,,percent of total billed charges,,,,,,,,,,,,,,,31075.2,83,,percent of total billed charges,,,35568,95,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,30700.8,82,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,31824,85,,percent of total billed charges,,9360,35568,
SYNTHES SCREW LOCKING S-T 3.5 X 28MM,30184433,CDM,,,278,RC,outpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,313.59,22,,percent of total billed charges,,,,,,,,,1128.93,90,,percent of total billed charges,,,1038.62,82.8,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,313.59,22,,percent of total billed charges,,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,313.59,1191.65,
SYNTHES SCREW LOCKING S-T 3.5 X 45MM,30184434,CDM,,,278,RC,outpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,313.59,22,,percent of total billed charges,,,,,,,,,1128.93,90,,percent of total billed charges,,,1038.62,82.8,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,313.59,22,,percent of total billed charges,,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,313.59,1191.65,
SYNTHES SCREW CORTEX 3.5 X 24MM,30184435,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
SYNTHES SCREW CORTEX 3.5 X 28MM,30184436,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
SYNTHES K-WIRE 1.6MM 5MM THREAD,30184437,CDM,,,278,RC,outpatient,,195.46,195.46,,165.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.87,22,,percent of total billed charges,,,,,,,,,175.91,90,,percent of total billed charges,,,161.84,82.8,,percent of total billed charges,,,166.14,85,,percent of total billed charges,,,,,,,,,172,88,,percent of total billed charges,,,,,,,,,149.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.87,22,,percent of total billed charges,,,177.87,91,,percent of total billed charges,,,185.69,95,,percent of total billed charges,,,162.23,83,,percent of total billed charges,,,162.23,83,,percent of total billed charges,,,,,,,,,,,,,,,162.23,83,,percent of total billed charges,,,185.69,95,,percent of total billed charges,,,175.91,90,,percent of total billed charges,,,175.91,90,,percent of total billed charges,,,160.28,82,,percent of total billed charges,,,175.91,90,,percent of total billed charges,,,166.14,85,,percent of total billed charges,,48.87,185.69,
DEPUY ATTUNE FB TOTAL KNEE,30184438,CDM,,,278,RC,outpatient,,37440,37440,,31786.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9360,22,,percent of total billed charges,,,,,,,,,33696,90,,percent of total billed charges,,,31000.32,82.8,,percent of total billed charges,,,31824,85,,percent of total billed charges,,,,,,,,,32947.2,88,,percent of total billed charges,,,,,,,,,28604.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9360,22,,percent of total billed charges,,,34070.4,91,,percent of total billed charges,,,35568,95,,percent of total billed charges,,,31075.2,83,,percent of total billed charges,,,31075.2,83,,percent of total billed charges,,,,,,,,,,,,,,,31075.2,83,,percent of total billed charges,,,35568,95,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,30700.8,82,,percent of total billed charges,,,33696,90,,percent of total billed charges,,,31824,85,,percent of total billed charges,,9360,35568,
DEPUY HEAD TAPER 28 +0 14/16,30184439,CDM,,,278,RC,outpatient,,7623.56,7623.56,,6472.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1905.89,22,,percent of total billed charges,,,,,,,,,6861.2,90,,percent of total billed charges,,,6312.31,82.8,,percent of total billed charges,,,6480.03,85,,percent of total billed charges,,,,,,,,,6708.73,88,,percent of total billed charges,,,,,,,,,5824.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1905.89,22,,percent of total billed charges,,,6937.44,91,,percent of total billed charges,,,7242.38,95,,percent of total billed charges,,,6327.55,83,,percent of total billed charges,,,6327.55,83,,percent of total billed charges,,,,,,,,,,,,,,,6327.55,83,,percent of total billed charges,,,7242.38,95,,percent of total billed charges,,,6861.2,90,,percent of total billed charges,,,6861.2,90,,percent of total billed charges,,,6251.32,82,,percent of total billed charges,,,6861.2,90,,percent of total billed charges,,,6480.03,85,,percent of total billed charges,,1905.89,7242.38,
ALLOSOURCE FIBULA RIGHT WHOLE,30184440,CDM,,,278,RC,outpatient,,10335,10335,,8774.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2583.75,22,,percent of total billed charges,,,,,,,,,9301.5,90,,percent of total billed charges,,,8557.38,82.8,,percent of total billed charges,,,8784.75,85,,percent of total billed charges,,,,,,,,,9094.8,88,,percent of total billed charges,,,,,,,,,7895.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2583.75,22,,percent of total billed charges,,,9404.85,91,,percent of total billed charges,,,9818.25,95,,percent of total billed charges,,,8578.05,83,,percent of total billed charges,,,8578.05,83,,percent of total billed charges,,,,,,,,,,,,,,,8578.05,83,,percent of total billed charges,,,9818.25,95,,percent of total billed charges,,,9301.5,90,,percent of total billed charges,,,9301.5,90,,percent of total billed charges,,,8474.7,82,,percent of total billed charges,,,9301.5,90,,percent of total billed charges,,,8784.75,85,,percent of total billed charges,,2583.75,9818.25,
DEPUY CAGE PROTROSIS 56 OD,30184441,CDM,,,278,RC,outpatient,,21625.7,21625.7,,18360.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5406.43,22,,percent of total billed charges,,,,,,,,,19463.13,90,,percent of total billed charges,,,17906.08,82.8,,percent of total billed charges,,,18381.85,85,,percent of total billed charges,,,,,,,,,19030.62,88,,percent of total billed charges,,,,,,,,,16522.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5406.43,22,,percent of total billed charges,,,19679.39,91,,percent of total billed charges,,,20544.42,95,,percent of total billed charges,,,17949.33,83,,percent of total billed charges,,,17949.33,83,,percent of total billed charges,,,,,,,,,,,,,,,17949.33,83,,percent of total billed charges,,,20544.42,95,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,17733.07,82,,percent of total billed charges,,,19463.13,90,,percent of total billed charges,,,18381.85,85,,percent of total billed charges,,5406.43,20544.42,
DEPUY SCREW BONE 15MM,30184442,CDM,,,278,RC,outpatient,,1539.72,1539.72,,1307.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.93,22,,percent of total billed charges,,,,,,,,,1385.75,90,,percent of total billed charges,,,1274.89,82.8,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,,,,,,,,1354.95,88,,percent of total billed charges,,,,,,,,,1176.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.93,22,,percent of total billed charges,,,1401.15,91,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,1277.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1277.97,83,,percent of total billed charges,,,1462.73,95,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1262.57,82,,percent of total billed charges,,,1385.75,90,,percent of total billed charges,,,1308.76,85,,percent of total billed charges,,384.93,1462.73,
ARTHREX TIGHTROPE ABS BUTTON ROUND,30184443,CDM,,,278,RC,outpatient,,1391,1391,,1180.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,347.75,22,,percent of total billed charges,,,,,,,,,1251.9,90,,percent of total billed charges,,,1151.75,82.8,,percent of total billed charges,,,1182.35,85,,percent of total billed charges,,,,,,,,,1224.08,88,,percent of total billed charges,,,,,,,,,1062.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,347.75,22,,percent of total billed charges,,,1265.81,91,,percent of total billed charges,,,1321.45,95,,percent of total billed charges,,,1154.53,83,,percent of total billed charges,,,1154.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1154.53,83,,percent of total billed charges,,,1321.45,95,,percent of total billed charges,,,1251.9,90,,percent of total billed charges,,,1251.9,90,,percent of total billed charges,,,1140.62,82,,percent of total billed charges,,,1251.9,90,,percent of total billed charges,,,1182.35,85,,percent of total billed charges,,347.75,1321.45,
ARTHREX TIGHTROPE ABS IMPLANT OPEN,30184444,CDM,,,278,RC,outpatient,,1261,1261,,1070.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,315.25,22,,percent of total billed charges,,,,,,,,,1134.9,90,,percent of total billed charges,,,1044.11,82.8,,percent of total billed charges,,,1071.85,85,,percent of total billed charges,,,,,,,,,1109.68,88,,percent of total billed charges,,,,,,,,,963.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,315.25,22,,percent of total billed charges,,,1147.51,91,,percent of total billed charges,,,1197.95,95,,percent of total billed charges,,,1046.63,83,,percent of total billed charges,,,1046.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1046.63,83,,percent of total billed charges,,,1197.95,95,,percent of total billed charges,,,1134.9,90,,percent of total billed charges,,,1134.9,90,,percent of total billed charges,,,1034.02,82,,percent of total billed charges,,,1134.9,90,,percent of total billed charges,,,1071.85,85,,percent of total billed charges,,315.25,1197.95,
ARTHREX ACL TIGHTROPE RT,30184445,CDM,,,278,RC,outpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,568.75,22,,percent of total billed charges,,,,,,,,,2047.5,90,,percent of total billed charges,,,1883.7,82.8,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,568.75,22,,percent of total billed charges,,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,568.75,2161.25,
DEPUY HEAD HUMERAL GLOBAL 40 X 15,30184446,CDM,,,278,RC,outpatient,,15528.76,15528.76,,13183.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3882.19,22,,percent of total billed charges,,,,,,,,,13975.88,90,,percent of total billed charges,,,12857.81,82.8,,percent of total billed charges,,,13199.45,85,,percent of total billed charges,,,,,,,,,13665.31,88,,percent of total billed charges,,,,,,,,,11863.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3882.19,22,,percent of total billed charges,,,14131.17,91,,percent of total billed charges,,,14752.32,95,,percent of total billed charges,,,12888.87,83,,percent of total billed charges,,,12888.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12888.87,83,,percent of total billed charges,,,14752.32,95,,percent of total billed charges,,,13975.88,90,,percent of total billed charges,,,13975.88,90,,percent of total billed charges,,,12733.58,82,,percent of total billed charges,,,13975.88,90,,percent of total billed charges,,,13199.45,85,,percent of total billed charges,,3882.19,14752.32,
DEPUY BODY PROX ANATOMIC UNITE SZ 6/8,30184447,CDM,,,278,RC,outpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3163.67,22,,percent of total billed charges,,,,,,,,,11389.19,90,,percent of total billed charges,,,10478.06,82.8,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3163.67,22,,percent of total billed charges,,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,3163.67,12021.93,
DEPUY STEM STD UNITE SZ 10,30184448,CDM,,,278,RC,outpatient,,26023.86,26023.86,,22094.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6505.97,22,,percent of total billed charges,,,,,,,,,23421.47,90,,percent of total billed charges,,,21547.76,82.8,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,,,,,,,,22901,88,,percent of total billed charges,,,,,,,,,19882.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6505.97,22,,percent of total billed charges,,,23681.71,91,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21599.8,83,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,21339.57,82,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,6505.97,24722.67,
DEPUY BODY PROX ANATOMIC UNITE SZ 10,30184449,CDM,,,278,RC,outpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3163.67,22,,percent of total billed charges,,,,,,,,,11389.19,90,,percent of total billed charges,,,10478.06,82.8,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3163.67,22,,percent of total billed charges,,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,3163.67,12021.93,
SYNTHES PLATE VOLAR DISTAL RADIUS 2.4MM,30184450,CDM,,,278,RC,outpatient,,9056,9056,,7688.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2264,22,,percent of total billed charges,,,,,,,,,8150.4,90,,percent of total billed charges,,,7498.37,82.8,,percent of total billed charges,,,7697.6,85,,percent of total billed charges,,,,,,,,,7969.28,88,,percent of total billed charges,,,,,,,,,6918.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2264,22,,percent of total billed charges,,,8240.96,91,,percent of total billed charges,,,8603.2,95,,percent of total billed charges,,,7516.48,83,,percent of total billed charges,,,7516.48,83,,percent of total billed charges,,,,,,,,,,,,,,,7516.48,83,,percent of total billed charges,,,8603.2,95,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,7425.92,82,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,7697.6,85,,percent of total billed charges,,2264,8603.2,
SYNTHES SCREW CORTEX S-T 2.7 X 24MM,30184451,CDM,,,278,RC,outpatient,,386.75,386.75,,328.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.69,22,,percent of total billed charges,,,,,,,,,348.08,90,,percent of total billed charges,,,320.23,82.8,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,,,,,,,,340.34,88,,percent of total billed charges,,,,,,,,,295.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.69,22,,percent of total billed charges,,,351.94,91,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,321,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,,,,,,,,,,,,,,321,83,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,317.14,82,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,96.69,367.41,
SYNTHES SCREW CORTEX S-T 2.7 X 20MM,30184452,CDM,,,278,RC,outpatient,,386.75,386.75,,328.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.69,22,,percent of total billed charges,,,,,,,,,348.08,90,,percent of total billed charges,,,320.23,82.8,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,,,,,,,,340.34,88,,percent of total billed charges,,,,,,,,,295.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.69,22,,percent of total billed charges,,,351.94,91,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,321,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,,,,,,,,,,,,,,321,83,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,317.14,82,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,96.69,367.41,
SYNTHES SCREW LOCKING ANGLE 2.4 X 26MM,30184453,CDM,,,278,RC,outpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,338.51,22,,percent of total billed charges,,,,,,,,,1218.62,90,,percent of total billed charges,,,1121.13,82.8,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,338.51,22,,percent of total billed charges,,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,338.51,1286.32,
ZIMMER HEAD FEMORAL 12/14 28MM +3.5,30184454,CDM,,,278,RC,outpatient,,7988.5,7988.5,,6782.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1997.13,22,,percent of total billed charges,,,,,,,,,7189.65,90,,percent of total billed charges,,,6614.48,82.8,,percent of total billed charges,,,6790.23,85,,percent of total billed charges,,,,,,,,,7029.88,88,,percent of total billed charges,,,,,,,,,6103.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1997.13,22,,percent of total billed charges,,,7269.54,91,,percent of total billed charges,,,7589.08,95,,percent of total billed charges,,,6630.46,83,,percent of total billed charges,,,6630.46,83,,percent of total billed charges,,,,,,,,,,,,,,,6630.46,83,,percent of total billed charges,,,7589.08,95,,percent of total billed charges,,,7189.65,90,,percent of total billed charges,,,7189.65,90,,percent of total billed charges,,,6550.57,82,,percent of total billed charges,,,7189.65,90,,percent of total billed charges,,,6790.23,85,,percent of total billed charges,,1997.13,7589.08,
ARTHREX REAMER LOW PROFILE 11MM,30184456,CDM,,,278,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
ARTHREX TIGHTROPE BTB,30184457,CDM,,,278,RC,outpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,690.63,22,,percent of total billed charges,,,,,,,,,2486.25,90,,percent of total billed charges,,,2287.35,82.8,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,690.63,22,,percent of total billed charges,,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,690.63,2624.38,
ARTHREXTRANS-TIB ACL W/SAWBLD KIT,30184458,CDM,,,278,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
ARTHREX CUTTER II FLIP 10.0 MM,30184459,CDM,,,278,RC,outpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,528.13,22,,percent of total billed charges,,,,,,,,,1901.25,90,,percent of total billed charges,,,1749.15,82.8,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,528.13,22,,percent of total billed charges,,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,528.13,2006.88,
ARTHREX FIBERSTICK 2-0 FIBERWIRE 2-0,30184460,CDM,,,278,RC,outpatient,,285,285,,241.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.25,22,,percent of total billed charges,,,,,,,,,256.5,90,,percent of total billed charges,,,235.98,82.8,,percent of total billed charges,,,242.25,85,,percent of total billed charges,,,,,,,,,250.8,88,,percent of total billed charges,,,,,,,,,217.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.25,22,,percent of total billed charges,,,259.35,91,,percent of total billed charges,,,270.75,95,,percent of total billed charges,,,236.55,83,,percent of total billed charges,,,236.55,83,,percent of total billed charges,,,,,,,,,,,,,,,236.55,83,,percent of total billed charges,,,270.75,95,,percent of total billed charges,,,256.5,90,,percent of total billed charges,,,256.5,90,,percent of total billed charges,,,233.7,82,,percent of total billed charges,,,256.5,90,,percent of total billed charges,,,242.25,85,,percent of total billed charges,,71.25,270.75,
ARTHREX ANCHOR SUTURE BIO-SWVLK C,30184461,CDM,,,278,RC,outpatient,,2437.5,2437.5,,2069.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,609.38,22,,percent of total billed charges,,,,,,,,,2193.75,90,,percent of total billed charges,,,2018.25,82.8,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,,,,,,,,2145,88,,percent of total billed charges,,,,,,,,,1862.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,609.38,22,,percent of total billed charges,,,2218.13,91,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2023.13,83,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,1998.75,82,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,609.38,2315.63,
ARTHREX REAMER LOW PROFILE 5MM,30184462,CDM,,,278,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
SYNTHES PLATE ANTERIOR ARTHRODESIS ANKLE,30184463,CDM,,,278,RC,outpatient,,9641.13,9641.13,,8185.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2410.28,22,,percent of total billed charges,,,,,,,,,8677.02,90,,percent of total billed charges,,,7982.86,82.8,,percent of total billed charges,,,8194.96,85,,percent of total billed charges,,,,,,,,,8484.19,88,,percent of total billed charges,,,,,,,,,7365.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2410.28,22,,percent of total billed charges,,,8773.43,91,,percent of total billed charges,,,9159.07,95,,percent of total billed charges,,,8002.14,83,,percent of total billed charges,,,8002.14,83,,percent of total billed charges,,,,,,,,,,,,,,,8002.14,83,,percent of total billed charges,,,9159.07,95,,percent of total billed charges,,,8677.02,90,,percent of total billed charges,,,8677.02,90,,percent of total billed charges,,,7905.73,82,,percent of total billed charges,,,8677.02,90,,percent of total billed charges,,,8194.96,85,,percent of total billed charges,,2410.28,9159.07,
SYNTHES GUIDE WIRE NON THREADED 2.0MM,30184464,CDM,,,278,RC,outpatient,,398.65,398.65,,338.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,99.66,22,,percent of total billed charges,,,,,,,,,358.79,90,,percent of total billed charges,,,330.08,82.8,,percent of total billed charges,,,338.85,85,,percent of total billed charges,,,,,,,,,350.81,88,,percent of total billed charges,,,,,,,,,304.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,99.66,22,,percent of total billed charges,,,362.77,91,,percent of total billed charges,,,378.72,95,,percent of total billed charges,,,330.88,83,,percent of total billed charges,,,330.88,83,,percent of total billed charges,,,,,,,,,,,,,,,330.88,83,,percent of total billed charges,,,378.72,95,,percent of total billed charges,,,358.79,90,,percent of total billed charges,,,358.79,90,,percent of total billed charges,,,326.89,82,,percent of total billed charges,,,358.79,90,,percent of total billed charges,,,338.85,85,,percent of total billed charges,,99.66,378.72,
SYNTHES SCREW CORTEX 4.5 X 32MM,30184465,CDM,,,278,RC,outpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.35,22,,percent of total billed charges,,,,,,,,,235.24,90,,percent of total billed charges,,,216.42,82.8,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.35,22,,percent of total billed charges,,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,65.35,248.31,
SYNTHES SCREW CORTEX 4.5 X 34MM,30184466,CDM,,,278,RC,outpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.35,22,,percent of total billed charges,,,,,,,,,235.24,90,,percent of total billed charges,,,216.42,82.8,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.35,22,,percent of total billed charges,,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,65.35,248.31,
SYNTHES SCREW CORTEX 4.5 X 46MM,30184467,CDM,,,278,RC,outpatient,,277.28,277.28,,235.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.32,22,,percent of total billed charges,,,,,,,,,249.55,90,,percent of total billed charges,,,229.59,82.8,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,,,,,,,,244.01,88,,percent of total billed charges,,,,,,,,,211.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.32,22,,percent of total billed charges,,,252.32,91,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,,,,,,,,,,,,,230.14,83,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,227.37,82,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,69.32,263.42,
SYNTHES SCREW CORTEX 4.5 X 42MM,30184468,CDM,,,278,RC,outpatient,,277.28,277.28,,235.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.32,22,,percent of total billed charges,,,,,,,,,249.55,90,,percent of total billed charges,,,229.59,82.8,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,,,,,,,,244.01,88,,percent of total billed charges,,,,,,,,,211.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.32,22,,percent of total billed charges,,,252.32,91,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,,,,,,,,,,,,,230.14,83,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,227.37,82,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,69.32,263.42,
SYNTHES SCREW CORTEX 4.5 X  50MM,30184469,CDM,,,278,RC,outpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.35,22,,percent of total billed charges,,,,,,,,,235.24,90,,percent of total billed charges,,,216.42,82.8,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.35,22,,percent of total billed charges,,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,65.35,248.31,
SYNTHES SCREW LOCKING 5.0 X 42MM,30184470,CDM,,,278,RC,outpatient,,1453.66,1453.66,,1234.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,363.42,22,,percent of total billed charges,,,,,,,,,1308.29,90,,percent of total billed charges,,,1203.63,82.8,,percent of total billed charges,,,1235.61,85,,percent of total billed charges,,,,,,,,,1279.22,88,,percent of total billed charges,,,,,,,,,1110.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,363.42,22,,percent of total billed charges,,,1322.83,91,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1206.54,83,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1192,82,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1235.61,85,,percent of total billed charges,,363.42,1380.98,
DEPUY INSERT TC3 SZ 5 12.5MM,30184471,CDM,,,278,RC,outpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5779.25,22,,percent of total billed charges,,,,,,,,,20805.29,90,,percent of total billed charges,,,19140.87,82.8,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5779.25,22,,percent of total billed charges,,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,5779.25,21961.14,
ARTHREX CUTTER FLIP II 8.5MM,30184472,CDM,,,270,RC,outpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,528.13,22,,percent of total billed charges,,,,,,,,,1901.25,90,,percent of total billed charges,,,1749.15,82.8,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,528.13,22,,percent of total billed charges,,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,528.13,2006.88,
ARTHREX CUTTER FLIP II 9.0MM,30184473,CDM,,,270,RC,outpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,528.13,22,,percent of total billed charges,,,,,,,,,1901.25,90,,percent of total billed charges,,,1749.15,82.8,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,528.13,22,,percent of total billed charges,,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,528.13,2006.88,
ARTHREX REAMER LOW PROFILE 9.5MM,30184474,CDM,,,270,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
ARTHREX TIGHTROPE ABS IMPLANT,30184475,CDM,,,278,RC,outpatient,,1196,1196,,1015.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,299,22,,percent of total billed charges,,,,,,,,,1076.4,90,,percent of total billed charges,,,990.29,82.8,,percent of total billed charges,,,1016.6,85,,percent of total billed charges,,,,,,,,,1052.48,88,,percent of total billed charges,,,,,,,,,913.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,299,22,,percent of total billed charges,,,1088.36,91,,percent of total billed charges,,,1136.2,95,,percent of total billed charges,,,992.68,83,,percent of total billed charges,,,992.68,83,,percent of total billed charges,,,,,,,,,,,,,,,992.68,83,,percent of total billed charges,,,1136.2,95,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,980.72,82,,percent of total billed charges,,,1076.4,90,,percent of total billed charges,,,1016.6,85,,percent of total billed charges,,299,1136.2,
ARTHREX TIGERSTICK #2 TIGERWIRE,30184476,CDM,,,278,RC,outpatient,,500.5,500.5,,424.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125.13,22,,percent of total billed charges,,,,,,,,,450.45,90,,percent of total billed charges,,,414.41,82.8,,percent of total billed charges,,,425.43,85,,percent of total billed charges,,,,,,,,,440.44,88,,percent of total billed charges,,,,,,,,,382.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125.13,22,,percent of total billed charges,,,455.46,91,,percent of total billed charges,,,475.48,95,,percent of total billed charges,,,415.42,83,,percent of total billed charges,,,415.42,83,,percent of total billed charges,,,,,,,,,,,,,,,415.42,83,,percent of total billed charges,,,475.48,95,,percent of total billed charges,,,450.45,90,,percent of total billed charges,,,450.45,90,,percent of total billed charges,,,410.41,82,,percent of total billed charges,,,450.45,90,,percent of total billed charges,,,425.43,85,,percent of total billed charges,,125.13,475.48,
ARTHREX FIBERWIRE #1 BLUE 38,30184477,CDM,,,278,RC,outpatient,,136,136,,115.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34,22,,percent of total billed charges,,,,,,,,,122.4,90,,percent of total billed charges,,,112.61,82.8,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,,,,,,,,119.68,88,,percent of total billed charges,,,,,,,,,103.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34,22,,percent of total billed charges,,,123.76,91,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,,,,,,,,,,,,,112.88,83,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,111.52,82,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,34,129.2,
ARTHREX FIBERLOOP #2 BLUE,30184478,CDM,,,278,RC,outpatient,,500.5,500.5,,424.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125.13,22,,percent of total billed charges,,,,,,,,,450.45,90,,percent of total billed charges,,,414.41,82.8,,percent of total billed charges,,,425.43,85,,percent of total billed charges,,,,,,,,,440.44,88,,percent of total billed charges,,,,,,,,,382.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125.13,22,,percent of total billed charges,,,455.46,91,,percent of total billed charges,,,475.48,95,,percent of total billed charges,,,415.42,83,,percent of total billed charges,,,415.42,83,,percent of total billed charges,,,,,,,,,,,,,,,415.42,83,,percent of total billed charges,,,475.48,95,,percent of total billed charges,,,450.45,90,,percent of total billed charges,,,450.45,90,,percent of total billed charges,,,410.41,82,,percent of total billed charges,,,450.45,90,,percent of total billed charges,,,425.43,85,,percent of total billed charges,,125.13,475.48,
APPLIED EPIX LAPAROSCOPIC GRASPER,30184479,CDM,,,270,RC,outpatient,,337.5,337.5,,286.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.38,22,,percent of total billed charges,,,,,,,,,303.75,90,,percent of total billed charges,,,279.45,82.8,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,,,,,,,,297,88,,percent of total billed charges,,,,,,,,,257.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.38,22,,percent of total billed charges,,,307.13,91,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,,,,,,,,,,,,,280.13,83,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,276.75,82,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,84.38,320.63,
ZIMMER OXF BEARING LEFT MEDIAL MENISCAL,30184481,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
ZIMMER OXF FEMORAL MEDIUM PMA,30184482,CDM,,,278,RC,outpatient,,20345,20345,,17272.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5086.25,22,,percent of total billed charges,,,,,,,,,18310.5,90,,percent of total billed charges,,,16845.66,82.8,,percent of total billed charges,,,17293.25,85,,percent of total billed charges,,,,,,,,,17903.6,88,,percent of total billed charges,,,,,,,,,15543.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5086.25,22,,percent of total billed charges,,,18513.95,91,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,,,,,,,,,,,,,16886.35,83,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,16682.9,82,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,17293.25,85,,percent of total billed charges,,5086.25,19327.75,
ZIMMER TRAY TIBIAL LEFT MEDIAL,30184483,CDM,,,278,RC,outpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3388.13,22,,percent of total billed charges,,,,,,,,,12197.25,90,,percent of total billed charges,,,11221.47,82.8,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3388.13,22,,percent of total billed charges,,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,3388.13,12874.88,
S&N FEMUR LEGION OX CONSTRAINED SZ 5 LT,30184484,CDM,,,278,RC,outpatient,,53956.5,53956.5,,45809.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13489.13,22,,percent of total billed charges,,,,,,,,,48560.85,90,,percent of total billed charges,,,44675.98,82.8,,percent of total billed charges,,,45863.03,85,,percent of total billed charges,,,,,,,,,47481.72,88,,percent of total billed charges,,,,,,,,,41222.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13489.13,22,,percent of total billed charges,,,49100.42,91,,percent of total billed charges,,,51258.68,95,,percent of total billed charges,,,44783.9,83,,percent of total billed charges,,,44783.9,83,,percent of total billed charges,,,,,,,,,,,,,,,44783.9,83,,percent of total billed charges,,,51258.68,95,,percent of total billed charges,,,48560.85,90,,percent of total billed charges,,,48560.85,90,,percent of total billed charges,,,44244.33,82,,percent of total billed charges,,,48560.85,90,,percent of total billed charges,,,45863.03,85,,percent of total billed charges,,13489.13,51258.68,
S&N TIBIA LT SZ 5,30184485,CDM,,,278,RC,outpatient,,14573,14573,,12372.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3643.25,22,,percent of total billed charges,,,,,,,,,13115.7,90,,percent of total billed charges,,,12066.44,82.8,,percent of total billed charges,,,12387.05,85,,percent of total billed charges,,,,,,,,,12824.24,88,,percent of total billed charges,,,,,,,,,11133.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3643.25,22,,percent of total billed charges,,,13261.43,91,,percent of total billed charges,,,13844.35,95,,percent of total billed charges,,,12095.59,83,,percent of total billed charges,,,12095.59,83,,percent of total billed charges,,,,,,,,,,,,,,,12095.59,83,,percent of total billed charges,,,13844.35,95,,percent of total billed charges,,,13115.7,90,,percent of total billed charges,,,13115.7,90,,percent of total billed charges,,,11949.86,82,,percent of total billed charges,,,13115.7,90,,percent of total billed charges,,,12387.05,85,,percent of total billed charges,,3643.25,13844.35,
S&N STEM 10 X 120MM,30184486,CDM,,,278,RC,outpatient,,9984,9984,,8476.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2496,22,,percent of total billed charges,,,,,,,,,8985.6,90,,percent of total billed charges,,,8266.75,82.8,,percent of total billed charges,,,8486.4,85,,percent of total billed charges,,,,,,,,,8785.92,88,,percent of total billed charges,,,,,,,,,7627.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2496,22,,percent of total billed charges,,,9085.44,91,,percent of total billed charges,,,9484.8,95,,percent of total billed charges,,,8286.72,83,,percent of total billed charges,,,8286.72,83,,percent of total billed charges,,,,,,,,,,,,,,,8286.72,83,,percent of total billed charges,,,9484.8,95,,percent of total billed charges,,,8985.6,90,,percent of total billed charges,,,8985.6,90,,percent of total billed charges,,,8186.88,82,,percent of total billed charges,,,8985.6,90,,percent of total billed charges,,,8486.4,85,,percent of total billed charges,,2496,9484.8,
S&N INSERT XLPE SZ 5/6,30184487,CDM,,,278,RC,outpatient,,15198.11,15198.11,,12903.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3799.53,22,,percent of total billed charges,,,,,,,,,13678.3,90,,percent of total billed charges,,,12584.04,82.8,,percent of total billed charges,,,12918.39,85,,percent of total billed charges,,,,,,,,,13374.34,88,,percent of total billed charges,,,,,,,,,11611.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3799.53,22,,percent of total billed charges,,,13830.28,91,,percent of total billed charges,,,14438.2,95,,percent of total billed charges,,,12614.43,83,,percent of total billed charges,,,12614.43,83,,percent of total billed charges,,,,,,,,,,,,,,,12614.43,83,,percent of total billed charges,,,14438.2,95,,percent of total billed charges,,,13678.3,90,,percent of total billed charges,,,13678.3,90,,percent of total billed charges,,,12462.45,82,,percent of total billed charges,,,13678.3,90,,percent of total billed charges,,,12918.39,85,,percent of total billed charges,,3799.53,14438.2,
DEPUY LINER 42MM +6,30184488,CDM,,,278,RC,outpatient,,10688.08,10688.08,,9074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2672.02,22,,percent of total billed charges,,,,,,,,,9619.27,90,,percent of total billed charges,,,8849.73,82.8,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,,,,,,,,9405.51,88,,percent of total billed charges,,,,,,,,,8165.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2672.02,22,,percent of total billed charges,,,9726.15,91,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,,,,,,,,,,,,,8871.11,83,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,8764.23,82,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,2672.02,10153.68,
STOPCOCK 3-WAY SWIVEL MALE LL,30184489,CDM,,,270,RC,outpatient,,4.14,4.14,,3.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.04,22,,percent of total billed charges,,,,,,,,,3.73,90,,percent of total billed charges,,,3.43,82.8,,percent of total billed charges,,,3.52,85,,percent of total billed charges,,,,,,,,,3.64,88,,percent of total billed charges,,,,,,,,,3.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.04,22,,percent of total billed charges,,,3.77,91,,percent of total billed charges,,,3.93,95,,percent of total billed charges,,,3.44,83,,percent of total billed charges,,,3.44,83,,percent of total billed charges,,,,,,,,,,,,,,,3.44,83,,percent of total billed charges,,,3.93,95,,percent of total billed charges,,,3.73,90,,percent of total billed charges,,,3.73,90,,percent of total billed charges,,,3.39,82,,percent of total billed charges,,,3.73,90,,percent of total billed charges,,,3.52,85,,percent of total billed charges,,1.04,3.93,
STAPLER RELOAD ECHELON (BLUE),30184490,CDM,,,270,RC,outpatient,,1250.91,1250.91,,1062.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,312.73,22,,percent of total billed charges,,,,,,,,,1125.82,90,,percent of total billed charges,,,1035.75,82.8,,percent of total billed charges,,,1063.27,85,,percent of total billed charges,,,,,,,,,1100.8,88,,percent of total billed charges,,,,,,,,,955.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,312.73,22,,percent of total billed charges,,,1138.33,91,,percent of total billed charges,,,1188.36,95,,percent of total billed charges,,,1038.26,83,,percent of total billed charges,,,1038.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1038.26,83,,percent of total billed charges,,,1188.36,95,,percent of total billed charges,,,1125.82,90,,percent of total billed charges,,,1125.82,90,,percent of total billed charges,,,1025.75,82,,percent of total billed charges,,,1125.82,90,,percent of total billed charges,,,1063.27,85,,percent of total billed charges,,312.73,1188.36,
STAPLER RELOAD ECHELON (WHITE),30184491,CDM,,,270,RC,outpatient,,1250.91,1250.91,,1062.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,312.73,22,,percent of total billed charges,,,,,,,,,1125.82,90,,percent of total billed charges,,,1035.75,82.8,,percent of total billed charges,,,1063.27,85,,percent of total billed charges,,,,,,,,,1100.8,88,,percent of total billed charges,,,,,,,,,955.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,312.73,22,,percent of total billed charges,,,1138.33,91,,percent of total billed charges,,,1188.36,95,,percent of total billed charges,,,1038.26,83,,percent of total billed charges,,,1038.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1038.26,83,,percent of total billed charges,,,1188.36,95,,percent of total billed charges,,,1125.82,90,,percent of total billed charges,,,1125.82,90,,percent of total billed charges,,,1025.75,82,,percent of total billed charges,,,1125.82,90,,percent of total billed charges,,,1063.27,85,,percent of total billed charges,,312.73,1188.36,
STAPLER PWRD ECHELON FLEX 45MM,30184492,CDM,,,270,RC,outpatient,,2367.08,2367.08,,2009.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,591.77,22,,percent of total billed charges,,,,,,,,,2130.37,90,,percent of total billed charges,,,1959.94,82.8,,percent of total billed charges,,,2012.02,85,,percent of total billed charges,,,,,,,,,2083.03,88,,percent of total billed charges,,,,,,,,,1808.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,591.77,22,,percent of total billed charges,,,2154.04,91,,percent of total billed charges,,,2248.73,95,,percent of total billed charges,,,1964.68,83,,percent of total billed charges,,,1964.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1964.68,83,,percent of total billed charges,,,2248.73,95,,percent of total billed charges,,,2130.37,90,,percent of total billed charges,,,2130.37,90,,percent of total billed charges,,,1941.01,82,,percent of total billed charges,,,2130.37,90,,percent of total billed charges,,,2012.02,85,,percent of total billed charges,,591.77,2248.73,
DEPUY INSERT RP SZ 6 12MM,30184493,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY TIBIA ATTUNE RP SZ 5,30184494,CDM,,,278,RC,outpatient,,21286.98,21286.98,,18072.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5321.75,22,,percent of total billed charges,,,,,,,,,19158.28,90,,percent of total billed charges,,,17625.62,82.8,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,,,,,,,,18732.54,88,,percent of total billed charges,,,,,,,,,16263.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5321.75,22,,percent of total billed charges,,,19371.15,91,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,,,,,,,,,,,,,17668.19,83,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,17455.32,82,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,5321.75,20222.63,
DEPUY STEM ENDURANCE SZ 2,30184495,CDM,,,278,RC,outpatient,,24918.92,24918.92,,21156.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6229.73,22,,percent of total billed charges,,,,,,,,,22427.03,90,,percent of total billed charges,,,20632.87,82.8,,percent of total billed charges,,,21181.08,85,,percent of total billed charges,,,,,,,,,21928.65,88,,percent of total billed charges,,,,,,,,,19038.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6229.73,22,,percent of total billed charges,,,22676.22,91,,percent of total billed charges,,,23672.97,95,,percent of total billed charges,,,20682.7,83,,percent of total billed charges,,,20682.7,83,,percent of total billed charges,,,,,,,,,,,,,,,20682.7,83,,percent of total billed charges,,,23672.97,95,,percent of total billed charges,,,22427.03,90,,percent of total billed charges,,,22427.03,90,,percent of total billed charges,,,20433.51,82,,percent of total billed charges,,,22427.03,90,,percent of total billed charges,,,21181.08,85,,percent of total billed charges,,6229.73,23672.97,
ARTHREX SUTURE TAK BIOCOMPOSITE 3 X 14.5,30184496,CDM,,,278,RC,outpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,528.13,22,,percent of total billed charges,,,,,,,,,1901.25,90,,percent of total billed charges,,,1749.15,82.8,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,528.13,22,,percent of total billed charges,,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,528.13,2006.88,
ARTHREX SUTURE TAK DISPOSABLE KIT,30184497,CDM,,,278,RC,outpatient,,942.5,942.5,,800.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.63,22,,percent of total billed charges,,,,,,,,,848.25,90,,percent of total billed charges,,,780.39,82.8,,percent of total billed charges,,,801.13,85,,percent of total billed charges,,,,,,,,,829.4,88,,percent of total billed charges,,,,,,,,,720.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.63,22,,percent of total billed charges,,,857.68,91,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,,,,,,,,,,,,,782.28,83,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,772.85,82,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,801.13,85,,percent of total billed charges,,235.63,895.38,
ALLOSOURCE CANCELLOUS CUBES 30ML,30184498,CDM,,,278,RC,outpatient,,5375.5,5375.5,,4563.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1343.88,22,,percent of total billed charges,,,,,,,,,4837.95,90,,percent of total billed charges,,,4450.91,82.8,,percent of total billed charges,,,4569.18,85,,percent of total billed charges,,,,,,,,,4730.44,88,,percent of total billed charges,,,,,,,,,4106.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1343.88,22,,percent of total billed charges,,,4891.71,91,,percent of total billed charges,,,5106.73,95,,percent of total billed charges,,,4461.67,83,,percent of total billed charges,,,4461.67,83,,percent of total billed charges,,,,,,,,,,,,,,,4461.67,83,,percent of total billed charges,,,5106.73,95,,percent of total billed charges,,,4837.95,90,,percent of total billed charges,,,4837.95,90,,percent of total billed charges,,,4407.91,82,,percent of total billed charges,,,4837.95,90,,percent of total billed charges,,,4569.18,85,,percent of total billed charges,,1343.88,5106.73,
DEPUY INSERT PS SZ 6 18MM,30184499,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY BODY ANATOMIC PROXIMAL 16MM,30184500,CDM,,,278,RC,outpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3163.67,22,,percent of total billed charges,,,,,,,,,11389.19,90,,percent of total billed charges,,,10478.06,82.8,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3163.67,22,,percent of total billed charges,,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,3163.67,12021.93,
DEPUY STEM HUMERAL 16MM,30184501,CDM,,,278,RC,outpatient,,26023.86,26023.86,,22094.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6505.97,22,,percent of total billed charges,,,,,,,,,23421.47,90,,percent of total billed charges,,,21547.76,82.8,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,,,,,,,,22901,88,,percent of total billed charges,,,,,,,,,19882.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6505.97,22,,percent of total billed charges,,,23681.71,91,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21599.8,83,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,21339.57,82,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,6505.97,24722.67,
DEPUY HEAD ECCENTRIC 52MM X 18MM,30184502,CDM,,,278,RC,outpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4409.03,22,,percent of total billed charges,,,,,,,,,15872.52,90,,percent of total billed charges,,,14602.72,82.8,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4409.03,22,,percent of total billed charges,,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,4409.03,16754.32,
DEPUY GUIDE PINS BREAK AWAY,30184503,CDM,,,278,RC,outpatient,,1755,1755,,1490,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,438.75,22,,percent of total billed charges,,,,,,,,,1579.5,90,,percent of total billed charges,,,1453.14,82.8,,percent of total billed charges,,,1491.75,85,,percent of total billed charges,,,,,,,,,1544.4,88,,percent of total billed charges,,,,,,,,,1340.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,438.75,22,,percent of total billed charges,,,1597.05,91,,percent of total billed charges,,,1667.25,95,,percent of total billed charges,,,1456.65,83,,percent of total billed charges,,,1456.65,83,,percent of total billed charges,,,,,,,,,,,,,,,1456.65,83,,percent of total billed charges,,,1667.25,95,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1439.1,82,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1491.75,85,,percent of total billed charges,,438.75,1667.25,
BIS ADULT SENSOR,30184504,CDM,,,270,RC,outpatient,,185.59,185.59,,157.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.4,22,,percent of total billed charges,,,,,,,,,167.03,90,,percent of total billed charges,,,153.67,82.8,,percent of total billed charges,,,157.75,85,,percent of total billed charges,,,,,,,,,163.32,88,,percent of total billed charges,,,,,,,,,141.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.4,22,,percent of total billed charges,,,168.89,91,,percent of total billed charges,,,176.31,95,,percent of total billed charges,,,154.04,83,,percent of total billed charges,,,154.04,83,,percent of total billed charges,,,,,,,,,,,,,,,154.04,83,,percent of total billed charges,,,176.31,95,,percent of total billed charges,,,167.03,90,,percent of total billed charges,,,167.03,90,,percent of total billed charges,,,152.18,82,,percent of total billed charges,,,167.03,90,,percent of total billed charges,,,157.75,85,,percent of total billed charges,,46.4,176.31,
SYNTHES WASHER 13MM,30184505,CDM,,,278,RC,outpatient,,324.6,324.6,,275.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,81.15,22,,percent of total billed charges,,,,,,,,,292.14,90,,percent of total billed charges,,,268.77,82.8,,percent of total billed charges,,,275.91,85,,percent of total billed charges,,,,,,,,,285.65,88,,percent of total billed charges,,,,,,,,,247.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,81.15,22,,percent of total billed charges,,,295.39,91,,percent of total billed charges,,,308.37,95,,percent of total billed charges,,,269.42,83,,percent of total billed charges,,,269.42,83,,percent of total billed charges,,,,,,,,,,,,,,,269.42,83,,percent of total billed charges,,,308.37,95,,percent of total billed charges,,,292.14,90,,percent of total billed charges,,,292.14,90,,percent of total billed charges,,,266.17,82,,percent of total billed charges,,,292.14,90,,percent of total billed charges,,,275.91,85,,percent of total billed charges,,81.15,308.37,
STRYKER BURR TPS ELITE 3.0,30184506,CDM,,,270,RC,outpatient,,940.16,940.16,,798.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.04,22,,percent of total billed charges,,,,,,,,,846.14,90,,percent of total billed charges,,,778.45,82.8,,percent of total billed charges,,,799.14,85,,percent of total billed charges,,,,,,,,,827.34,88,,percent of total billed charges,,,,,,,,,718.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.04,22,,percent of total billed charges,,,855.55,91,,percent of total billed charges,,,893.15,95,,percent of total billed charges,,,780.33,83,,percent of total billed charges,,,780.33,83,,percent of total billed charges,,,,,,,,,,,,,,,780.33,83,,percent of total billed charges,,,893.15,95,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,770.93,82,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,799.14,85,,percent of total billed charges,,235.04,893.15,
STRYKER BURR TPS ELITE HELICOIDAL RASP,30184507,CDM,,,270,RC,outpatient,,940.16,940.16,,798.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.04,22,,percent of total billed charges,,,,,,,,,846.14,90,,percent of total billed charges,,,778.45,82.8,,percent of total billed charges,,,799.14,85,,percent of total billed charges,,,,,,,,,827.34,88,,percent of total billed charges,,,,,,,,,718.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.04,22,,percent of total billed charges,,,855.55,91,,percent of total billed charges,,,893.15,95,,percent of total billed charges,,,780.33,83,,percent of total billed charges,,,780.33,83,,percent of total billed charges,,,,,,,,,,,,,,,780.33,83,,percent of total billed charges,,,893.15,95,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,770.93,82,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,799.14,85,,percent of total billed charges,,235.04,893.15,
SURGICAL PATTIES 1/2 X 1/2,30184508,CDM,,,270,RC,outpatient,,20.18,20.18,,17.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.05,22,,percent of total billed charges,,,,,,,,,18.16,90,,percent of total billed charges,,,16.71,82.8,,percent of total billed charges,,,17.15,85,,percent of total billed charges,,,,,,,,,17.76,88,,percent of total billed charges,,,,,,,,,15.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.05,22,,percent of total billed charges,,,18.36,91,,percent of total billed charges,,,19.17,95,,percent of total billed charges,,,16.75,83,,percent of total billed charges,,,16.75,83,,percent of total billed charges,,,,,,,,,,,,,,,16.75,83,,percent of total billed charges,,,19.17,95,,percent of total billed charges,,,18.16,90,,percent of total billed charges,,,18.16,90,,percent of total billed charges,,,16.55,82,,percent of total billed charges,,,18.16,90,,percent of total billed charges,,,17.15,85,,percent of total billed charges,,5.05,19.17,
ZIMMER TIBIA TRAY OXF UNI SZ C,30184510,CDM,,,278,RC,outpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3388.13,22,,percent of total billed charges,,,,,,,,,12197.25,90,,percent of total billed charges,,,11221.47,82.8,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3388.13,22,,percent of total billed charges,,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,3388.13,12874.88,
S&N SUTURE ULTRABRAID #2,30184511,CDM,,,270,RC,outpatient,,157.12,157.12,,133.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.28,22,,percent of total billed charges,,,,,,,,,141.41,90,,percent of total billed charges,,,130.1,82.8,,percent of total billed charges,,,133.55,85,,percent of total billed charges,,,,,,,,,138.27,88,,percent of total billed charges,,,,,,,,,120.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.28,22,,percent of total billed charges,,,142.98,91,,percent of total billed charges,,,149.26,95,,percent of total billed charges,,,130.41,83,,percent of total billed charges,,,130.41,83,,percent of total billed charges,,,,,,,,,,,,,,,130.41,83,,percent of total billed charges,,,149.26,95,,percent of total billed charges,,,141.41,90,,percent of total billed charges,,,141.41,90,,percent of total billed charges,,,128.84,82,,percent of total billed charges,,,141.41,90,,percent of total billed charges,,,133.55,85,,percent of total billed charges,,39.28,149.26,
DEPUY FEMUR LPS XX-SMALL LEFT,30184512,CDM,,,278,RC,outpatient,,97092.39,97092.39,,82431.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24273.1,22,,percent of total billed charges,,,,,,,,,87383.15,90,,percent of total billed charges,,,80392.5,82.8,,percent of total billed charges,,,82528.53,85,,percent of total billed charges,,,,,,,,,85441.3,88,,percent of total billed charges,,,,,,,,,74178.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24273.1,22,,percent of total billed charges,,,88354.07,91,,percent of total billed charges,,,92237.77,95,,percent of total billed charges,,,80586.68,83,,percent of total billed charges,,,80586.68,83,,percent of total billed charges,,,,,,,,,,,,,,,80586.68,83,,percent of total billed charges,,,92237.77,95,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,79615.76,82,,percent of total billed charges,,,87383.15,90,,percent of total billed charges,,,82528.53,85,,percent of total billed charges,,24273.1,92237.77,
DEPUY SLEEVE LPS +10MM,30184513,CDM,,,278,RC,outpatient,,6309.03,6309.03,,5356.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1577.26,22,,percent of total billed charges,,,,,,,,,5678.13,90,,percent of total billed charges,,,5223.88,82.8,,percent of total billed charges,,,5362.68,85,,percent of total billed charges,,,,,,,,,5551.95,88,,percent of total billed charges,,,,,,,,,4820.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1577.26,22,,percent of total billed charges,,,5741.22,91,,percent of total billed charges,,,5993.58,95,,percent of total billed charges,,,5236.49,83,,percent of total billed charges,,,5236.49,83,,percent of total billed charges,,,,,,,,,,,,,,,5236.49,83,,percent of total billed charges,,,5993.58,95,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5173.4,82,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5362.68,85,,percent of total billed charges,,1577.26,5993.58,
DEPUY INSERT XX-SMALL 16MM,30184514,CDM,,,278,RC,outpatient,,33343.12,33343.12,,28308.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8335.78,22,,percent of total billed charges,,,,,,,,,30008.81,90,,percent of total billed charges,,,27608.1,82.8,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,,,,,,,,29341.95,88,,percent of total billed charges,,,,,,,,,25474.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8335.78,22,,percent of total billed charges,,,30342.24,91,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,,,,,,,,,,,,,27674.79,83,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,27341.36,82,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,8335.78,31675.96,
V-LOC ESTCH NON ABSORABLE 2-0,30184515,CDM,,,270,RC,outpatient,,740.88,740.88,,629.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,185.22,22,,percent of total billed charges,,,,,,,,,666.79,90,,percent of total billed charges,,,613.45,82.8,,percent of total billed charges,,,629.75,85,,percent of total billed charges,,,,,,,,,651.97,88,,percent of total billed charges,,,,,,,,,566.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,185.22,22,,percent of total billed charges,,,674.2,91,,percent of total billed charges,,,703.84,95,,percent of total billed charges,,,614.93,83,,percent of total billed charges,,,614.93,83,,percent of total billed charges,,,,,,,,,,,,,,,614.93,83,,percent of total billed charges,,,703.84,95,,percent of total billed charges,,,666.79,90,,percent of total billed charges,,,666.79,90,,percent of total billed charges,,,607.52,82,,percent of total billed charges,,,666.79,90,,percent of total billed charges,,,629.75,85,,percent of total billed charges,,185.22,703.84,
V-LOC ESTICH 180 ABSORABLE 2-0,30184516,CDM,,,270,RC,outpatient,,810.55,810.55,,688.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,202.64,22,,percent of total billed charges,,,,,,,,,729.5,90,,percent of total billed charges,,,671.14,82.8,,percent of total billed charges,,,688.97,85,,percent of total billed charges,,,,,,,,,713.28,88,,percent of total billed charges,,,,,,,,,619.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,202.64,22,,percent of total billed charges,,,737.6,91,,percent of total billed charges,,,770.02,95,,percent of total billed charges,,,672.76,83,,percent of total billed charges,,,672.76,83,,percent of total billed charges,,,,,,,,,,,,,,,672.76,83,,percent of total billed charges,,,770.02,95,,percent of total billed charges,,,729.5,90,,percent of total billed charges,,,729.5,90,,percent of total billed charges,,,664.65,82,,percent of total billed charges,,,729.5,90,,percent of total billed charges,,,688.97,85,,percent of total billed charges,,202.64,770.02,
CLIP HEM-O-LOK XL,30184518,CDM,,,270,RC,outpatient,,221.79,221.79,,188.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.45,22,,percent of total billed charges,,,,,,,,,199.61,90,,percent of total billed charges,,,183.64,82.8,,percent of total billed charges,,,188.52,85,,percent of total billed charges,,,,,,,,,195.18,88,,percent of total billed charges,,,,,,,,,169.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.45,22,,percent of total billed charges,,,201.83,91,,percent of total billed charges,,,210.7,95,,percent of total billed charges,,,184.09,83,,percent of total billed charges,,,184.09,83,,percent of total billed charges,,,,,,,,,,,,,,,184.09,83,,percent of total billed charges,,,210.7,95,,percent of total billed charges,,,199.61,90,,percent of total billed charges,,,199.61,90,,percent of total billed charges,,,181.87,82,,percent of total billed charges,,,199.61,90,,percent of total billed charges,,,188.52,85,,percent of total billed charges,,55.45,210.7,
GYRUS VACURETTE STRAIGHT 8MM,30184519,CDM,,,270,RC,outpatient,,42.92,42.92,,36.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.73,22,,percent of total billed charges,,,,,,,,,38.63,90,,percent of total billed charges,,,35.54,82.8,,percent of total billed charges,,,36.48,85,,percent of total billed charges,,,,,,,,,37.77,88,,percent of total billed charges,,,,,,,,,32.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.73,22,,percent of total billed charges,,,39.06,91,,percent of total billed charges,,,40.77,95,,percent of total billed charges,,,35.62,83,,percent of total billed charges,,,35.62,83,,percent of total billed charges,,,,,,,,,,,,,,,35.62,83,,percent of total billed charges,,,40.77,95,,percent of total billed charges,,,38.63,90,,percent of total billed charges,,,38.63,90,,percent of total billed charges,,,35.19,82,,percent of total billed charges,,,38.63,90,,percent of total billed charges,,,36.48,85,,percent of total billed charges,,10.73,40.77,
CONFORMIS UNI MEDIAL LEFT IMPLANT KIT,30184520,CDM,,,278,RC,outpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9750,22,,percent of total billed charges,,,,,,,,,35100,90,,percent of total billed charges,,,32292,82.8,,percent of total billed charges,,,33150,85,,percent of total billed charges,,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9750,22,,percent of total billed charges,,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,9750,37050,
PROGENIX PLUS 10CC,30184524,CDM,,,278,RC,outpatient,,10263.5,10263.5,,8713.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2565.88,22,,percent of total billed charges,,,,,,,,,9237.15,90,,percent of total billed charges,,,8498.18,82.8,,percent of total billed charges,,,8723.98,85,,percent of total billed charges,,,,,,,,,9031.88,88,,percent of total billed charges,,,,,,,,,7841.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2565.88,22,,percent of total billed charges,,,9339.79,91,,percent of total billed charges,,,9750.33,95,,percent of total billed charges,,,8518.71,83,,percent of total billed charges,,,8518.71,83,,percent of total billed charges,,,,,,,,,,,,,,,8518.71,83,,percent of total billed charges,,,9750.33,95,,percent of total billed charges,,,9237.15,90,,percent of total billed charges,,,9237.15,90,,percent of total billed charges,,,8416.07,82,,percent of total billed charges,,,9237.15,90,,percent of total billed charges,,,8723.98,85,,percent of total billed charges,,2565.88,9750.33,
MENTOR MEMORYGEL BREAST IMPLANT 4000 SMO,30184525,CDM,,,278,RC,outpatient,,6370,6370,,5408.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1592.5,22,,percent of total billed charges,,,,,,,,,5733,90,,percent of total billed charges,,,5274.36,82.8,,percent of total billed charges,,,5414.5,85,,percent of total billed charges,,,,,,,,,5605.6,88,,percent of total billed charges,,,,,,,,,4866.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1592.5,22,,percent of total billed charges,,,5796.7,91,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5287.1,83,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5223.4,82,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5414.5,85,,percent of total billed charges,,1592.5,6051.5,
MENTOR MEMORYGEL SIZER HIGH PROFILE 450,30184526,CDM,,,270,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
EDGE INSULATED BLADE ELECTRODE 2.75,30184527,CDM,,,270,RC,outpatient,,62.69,62.69,,53.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.67,22,,percent of total billed charges,,,,,,,,,56.42,90,,percent of total billed charges,,,51.91,82.8,,percent of total billed charges,,,53.29,85,,percent of total billed charges,,,,,,,,,55.17,88,,percent of total billed charges,,,,,,,,,47.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.67,22,,percent of total billed charges,,,57.05,91,,percent of total billed charges,,,59.56,95,,percent of total billed charges,,,52.03,83,,percent of total billed charges,,,52.03,83,,percent of total billed charges,,,,,,,,,,,,,,,52.03,83,,percent of total billed charges,,,59.56,95,,percent of total billed charges,,,56.42,90,,percent of total billed charges,,,56.42,90,,percent of total billed charges,,,51.41,82,,percent of total billed charges,,,56.42,90,,percent of total billed charges,,,53.29,85,,percent of total billed charges,,15.67,59.56,
STRYKER BUR PRECISION ROUND 4.0MM,30184528,CDM,,,270,RC,outpatient,,1665.17,1665.17,,1413.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,416.29,22,,percent of total billed charges,,,,,,,,,1498.65,90,,percent of total billed charges,,,1378.76,82.8,,percent of total billed charges,,,1415.39,85,,percent of total billed charges,,,,,,,,,1465.35,88,,percent of total billed charges,,,,,,,,,1272.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,416.29,22,,percent of total billed charges,,,1515.3,91,,percent of total billed charges,,,1581.91,95,,percent of total billed charges,,,1382.09,83,,percent of total billed charges,,,1382.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1382.09,83,,percent of total billed charges,,,1581.91,95,,percent of total billed charges,,,1498.65,90,,percent of total billed charges,,,1498.65,90,,percent of total billed charges,,,1365.44,82,,percent of total billed charges,,,1498.65,90,,percent of total billed charges,,,1415.39,85,,percent of total billed charges,,416.29,1581.91,
SCREW POLYAXIAL 7.0 X 50MM,30184530,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SCREW POLYAXIAL 7.0 X 55MM,30184531,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ROD 6.0 X 90MM,30184532,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
DEPUY WEDGE MBT 5MM SZ 5,30184535,CDM,,,278,RC,outpatient,,15761.79,15761.79,,13381.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3940.45,22,,percent of total billed charges,,,,,,,,,14185.61,90,,percent of total billed charges,,,13050.76,82.8,,percent of total billed charges,,,13397.52,85,,percent of total billed charges,,,,,,,,,13870.38,88,,percent of total billed charges,,,,,,,,,12042.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3940.45,22,,percent of total billed charges,,,14343.23,91,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,13082.29,83,,percent of total billed charges,,,,,,,,,,,,,,,13082.29,83,,percent of total billed charges,,,14973.7,95,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,12924.67,82,,percent of total billed charges,,,14185.61,90,,percent of total billed charges,,,13397.52,85,,percent of total billed charges,,3940.45,14973.7,
DEPUY CUP PINNACLE REVISION SZ 56,30184536,CDM,,,278,RC,outpatient,,33437.04,33437.04,,28388.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8359.26,22,,percent of total billed charges,,,,,,,,,30093.34,90,,percent of total billed charges,,,27685.87,82.8,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,,,,,,,,29424.6,88,,percent of total billed charges,,,,,,,,,25545.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8359.26,22,,percent of total billed charges,,,30427.71,91,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,27752.74,83,,percent of total billed charges,,,,,,,,,,,,,,,27752.74,83,,percent of total billed charges,,,31765.19,95,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,27418.37,82,,percent of total billed charges,,,30093.34,90,,percent of total billed charges,,,28421.48,85,,percent of total billed charges,,8359.26,31765.19,
ARTHREX INSUFLATION TUBING,30184537,CDM,,,270,RC,outpatient,,567,567,,481.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141.75,22,,percent of total billed charges,,,,,,,,,510.3,90,,percent of total billed charges,,,469.48,82.8,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,,,,,,,,498.96,88,,percent of total billed charges,,,,,,,,,433.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141.75,22,,percent of total billed charges,,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,,,,,,,,,,,,,470.61,83,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,464.94,82,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,141.75,538.65,
ZIMMER NECK J MODULAR KINECTIV,30184539,CDM,,,278,RC,outpatient,,14475.5,14475.5,,12289.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3618.88,22,,percent of total billed charges,,,,,,,,,13027.95,90,,percent of total billed charges,,,11985.71,82.8,,percent of total billed charges,,,12304.18,85,,percent of total billed charges,,,,,,,,,12738.44,88,,percent of total billed charges,,,,,,,,,11059.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3618.88,22,,percent of total billed charges,,,13172.71,91,,percent of total billed charges,,,13751.73,95,,percent of total billed charges,,,12014.67,83,,percent of total billed charges,,,12014.67,83,,percent of total billed charges,,,,,,,,,,,,,,,12014.67,83,,percent of total billed charges,,,13751.73,95,,percent of total billed charges,,,13027.95,90,,percent of total billed charges,,,13027.95,90,,percent of total billed charges,,,11869.91,82,,percent of total billed charges,,,13027.95,90,,percent of total billed charges,,,12304.18,85,,percent of total billed charges,,3618.88,13751.73,
ZIMMER HEAD FEMORAL BIOLOX DELTA 32MM +0,30184540,CDM,,,278,RC,outpatient,,17946.5,17946.5,,15236.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4486.63,22,,percent of total billed charges,,,,,,,,,16151.85,90,,percent of total billed charges,,,14859.7,82.8,,percent of total billed charges,,,15254.53,85,,percent of total billed charges,,,,,,,,,15792.92,88,,percent of total billed charges,,,,,,,,,13711.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4486.63,22,,percent of total billed charges,,,16331.32,91,,percent of total billed charges,,,17049.18,95,,percent of total billed charges,,,14895.6,83,,percent of total billed charges,,,14895.6,83,,percent of total billed charges,,,,,,,,,,,,,,,14895.6,83,,percent of total billed charges,,,17049.18,95,,percent of total billed charges,,,16151.85,90,,percent of total billed charges,,,16151.85,90,,percent of total billed charges,,,14716.13,82,,percent of total billed charges,,,16151.85,90,,percent of total billed charges,,,15254.53,85,,percent of total billed charges,,4486.63,17049.18,
SAWBLADE CEMENTED OXF,30184541,CDM,,,270,RC,outpatient,,4992,4992,,4238.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1248,22,,percent of total billed charges,,,,,,,,,4492.8,90,,percent of total billed charges,,,4133.38,82.8,,percent of total billed charges,,,4243.2,85,,percent of total billed charges,,,,,,,,,4392.96,88,,percent of total billed charges,,,,,,,,,3813.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1248,22,,percent of total billed charges,,,4542.72,91,,percent of total billed charges,,,4742.4,95,,percent of total billed charges,,,4143.36,83,,percent of total billed charges,,,4143.36,83,,percent of total billed charges,,,,,,,,,,,,,,,4143.36,83,,percent of total billed charges,,,4742.4,95,,percent of total billed charges,,,4492.8,90,,percent of total billed charges,,,4492.8,90,,percent of total billed charges,,,4093.44,82,,percent of total billed charges,,,4492.8,90,,percent of total billed charges,,,4243.2,85,,percent of total billed charges,,1248,4742.4,
SAWBLADE KEEL CEMENTED OXF,30184542,CDM,,,270,RC,outpatient,,3445,3445,,2924.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,861.25,22,,percent of total billed charges,,,,,,,,,3100.5,90,,percent of total billed charges,,,2852.46,82.8,,percent of total billed charges,,,2928.25,85,,percent of total billed charges,,,,,,,,,3031.6,88,,percent of total billed charges,,,,,,,,,2631.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,861.25,22,,percent of total billed charges,,,3134.95,91,,percent of total billed charges,,,3272.75,95,,percent of total billed charges,,,2859.35,83,,percent of total billed charges,,,2859.35,83,,percent of total billed charges,,,,,,,,,,,,,,,2859.35,83,,percent of total billed charges,,,3272.75,95,,percent of total billed charges,,,3100.5,90,,percent of total billed charges,,,3100.5,90,,percent of total billed charges,,,2824.9,82,,percent of total billed charges,,,3100.5,90,,percent of total billed charges,,,2928.25,85,,percent of total billed charges,,861.25,3272.75,
ZIMMER TIBIAL TRAY SZ B LM PMA OXF,30184543,CDM,,,278,RC,outpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3388.13,22,,percent of total billed charges,,,,,,,,,12197.25,90,,percent of total billed charges,,,11221.47,82.8,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3388.13,22,,percent of total billed charges,,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,3388.13,12874.88,
ARTHREX CANNULA SMOOTH 7 X7 MM,30184545,CDM,,,270,RC,outpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50,22,,percent of total billed charges,,,,,,,,,180,90,,percent of total billed charges,,,165.6,82.8,,percent of total billed charges,,,170,85,,percent of total billed charges,,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50,22,,percent of total billed charges,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,50,190,
ARTHREX SWIVELOCK CLOSED EYELET,30184546,CDM,,,270,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
ARTHREX TIGERTAPE,30184547,CDM,,,270,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
DEPUY STEM CORAIL KLS 15,30184548,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
ZIMMER TRAY TIBIAL UNI SZ C RM PMA,30184550,CDM,,,278,RC,outpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3388.13,22,,percent of total billed charges,,,,,,,,,12197.25,90,,percent of total billed charges,,,11221.47,82.8,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3388.13,22,,percent of total billed charges,,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,3388.13,12874.88,
ZIMMER INSERT BEARING SZ 4 MD RT,30184551,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
SYNTHES SCREW CORTEX ST 2.0MM X 10MM,30184552,CDM,,,278,RC,outpatient,,476,476,,404.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119,22,,percent of total billed charges,,,,,,,,,428.4,90,,percent of total billed charges,,,394.13,82.8,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,,,,,,,,418.88,88,,percent of total billed charges,,,,,,,,,363.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119,22,,percent of total billed charges,,,433.16,91,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,,,,,,,,,,,,,395.08,83,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,390.32,82,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,119,452.2,
SYNTHES SCREW CORTEX ST 2.0 X 20MM,30184553,CDM,,,278,RC,outpatient,,476,476,,404.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119,22,,percent of total billed charges,,,,,,,,,428.4,90,,percent of total billed charges,,,394.13,82.8,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,,,,,,,,418.88,88,,percent of total billed charges,,,,,,,,,363.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119,22,,percent of total billed charges,,,433.16,91,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,,,,,,,,,,,,,395.08,83,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,390.32,82,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,119,452.2,
SYNTHES SCREW LOCKING ST 2.0 X 14MM,30184554,CDM,,,278,RC,outpatient,,1077.38,1077.38,,914.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,269.35,22,,percent of total billed charges,,,,,,,,,969.64,90,,percent of total billed charges,,,892.07,82.8,,percent of total billed charges,,,915.77,85,,percent of total billed charges,,,,,,,,,948.09,88,,percent of total billed charges,,,,,,,,,823.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,269.35,22,,percent of total billed charges,,,980.42,91,,percent of total billed charges,,,1023.51,95,,percent of total billed charges,,,894.23,83,,percent of total billed charges,,,894.23,83,,percent of total billed charges,,,,,,,,,,,,,,,894.23,83,,percent of total billed charges,,,1023.51,95,,percent of total billed charges,,,969.64,90,,percent of total billed charges,,,969.64,90,,percent of total billed charges,,,883.45,82,,percent of total billed charges,,,969.64,90,,percent of total billed charges,,,915.77,85,,percent of total billed charges,,269.35,1023.51,
SYNTHES SCREW LOCKING ST 2.0 X 18MM,30184555,CDM,,,278,RC,outpatient,,1077.38,1077.38,,914.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,269.35,22,,percent of total billed charges,,,,,,,,,969.64,90,,percent of total billed charges,,,892.07,82.8,,percent of total billed charges,,,915.77,85,,percent of total billed charges,,,,,,,,,948.09,88,,percent of total billed charges,,,,,,,,,823.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,269.35,22,,percent of total billed charges,,,980.42,91,,percent of total billed charges,,,1023.51,95,,percent of total billed charges,,,894.23,83,,percent of total billed charges,,,894.23,83,,percent of total billed charges,,,,,,,,,,,,,,,894.23,83,,percent of total billed charges,,,1023.51,95,,percent of total billed charges,,,969.64,90,,percent of total billed charges,,,969.64,90,,percent of total billed charges,,,883.45,82,,percent of total billed charges,,,969.64,90,,percent of total billed charges,,,915.77,85,,percent of total billed charges,,269.35,1023.51,
SYNTHES SHAFT LCP DISTAL RADIUS 5H,30184556,CDM,,,278,RC,outpatient,,15945.15,15945.15,,13537.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3986.29,22,,percent of total billed charges,,,,,,,,,14350.64,90,,percent of total billed charges,,,13202.58,82.8,,percent of total billed charges,,,13553.38,85,,percent of total billed charges,,,,,,,,,14031.73,88,,percent of total billed charges,,,,,,,,,12182.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3986.29,22,,percent of total billed charges,,,14510.09,91,,percent of total billed charges,,,15147.89,95,,percent of total billed charges,,,13234.47,83,,percent of total billed charges,,,13234.47,83,,percent of total billed charges,,,,,,,,,,,,,,,13234.47,83,,percent of total billed charges,,,15147.89,95,,percent of total billed charges,,,14350.64,90,,percent of total billed charges,,,14350.64,90,,percent of total billed charges,,,13075.02,82,,percent of total billed charges,,,14350.64,90,,percent of total billed charges,,,13553.38,85,,percent of total billed charges,,3986.29,15147.89,
SYNTHES PLATE LCP ULNA 2.0MM 7H,30184557,CDM,,,278,RC,outpatient,,7293,7293,,6191.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1823.25,22,,percent of total billed charges,,,,,,,,,6563.7,90,,percent of total billed charges,,,6038.6,82.8,,percent of total billed charges,,,6199.05,85,,percent of total billed charges,,,,,,,,,6417.84,88,,percent of total billed charges,,,,,,,,,5571.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1823.25,22,,percent of total billed charges,,,6636.63,91,,percent of total billed charges,,,6928.35,95,,percent of total billed charges,,,6053.19,83,,percent of total billed charges,,,6053.19,83,,percent of total billed charges,,,,,,,,,,,,,,,6053.19,83,,percent of total billed charges,,,6928.35,95,,percent of total billed charges,,,6563.7,90,,percent of total billed charges,,,6563.7,90,,percent of total billed charges,,,5980.26,82,,percent of total billed charges,,,6563.7,90,,percent of total billed charges,,,6199.05,85,,percent of total billed charges,,1823.25,6928.35,
SYNTHES SCREW LOCKING ST 2.4 X 16MM,30184558,CDM,,,278,RC,outpatient,,1166.43,1166.43,,990.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,291.61,22,,percent of total billed charges,,,,,,,,,1049.79,90,,percent of total billed charges,,,965.8,82.8,,percent of total billed charges,,,991.47,85,,percent of total billed charges,,,,,,,,,1026.46,88,,percent of total billed charges,,,,,,,,,891.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,291.61,22,,percent of total billed charges,,,1061.45,91,,percent of total billed charges,,,1108.11,95,,percent of total billed charges,,,968.14,83,,percent of total billed charges,,,968.14,83,,percent of total billed charges,,,,,,,,,,,,,,,968.14,83,,percent of total billed charges,,,1108.11,95,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,956.47,82,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,991.47,85,,percent of total billed charges,,291.61,1108.11,
SYNTHES SCREW LOCKING ST 2.4 X 18MM,30184559,CDM,,,278,RC,outpatient,,1166.43,1166.43,,990.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,291.61,22,,percent of total billed charges,,,,,,,,,1049.79,90,,percent of total billed charges,,,965.8,82.8,,percent of total billed charges,,,991.47,85,,percent of total billed charges,,,,,,,,,1026.46,88,,percent of total billed charges,,,,,,,,,891.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,291.61,22,,percent of total billed charges,,,1061.45,91,,percent of total billed charges,,,1108.11,95,,percent of total billed charges,,,968.14,83,,percent of total billed charges,,,968.14,83,,percent of total billed charges,,,,,,,,,,,,,,,968.14,83,,percent of total billed charges,,,1108.11,95,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,956.47,82,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,991.47,85,,percent of total billed charges,,291.61,1108.11,
SYNTHES SCREW LOCKING 2.4 X 20MM,30184560,CDM,,,278,RC,outpatient,,1099.48,1099.48,,933.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,274.87,22,,percent of total billed charges,,,,,,,,,989.53,90,,percent of total billed charges,,,910.37,82.8,,percent of total billed charges,,,934.56,85,,percent of total billed charges,,,,,,,,,967.54,88,,percent of total billed charges,,,,,,,,,840,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,274.87,22,,percent of total billed charges,,,1000.53,91,,percent of total billed charges,,,1044.51,95,,percent of total billed charges,,,912.57,83,,percent of total billed charges,,,912.57,83,,percent of total billed charges,,,,,,,,,,,,,,,912.57,83,,percent of total billed charges,,,1044.51,95,,percent of total billed charges,,,989.53,90,,percent of total billed charges,,,989.53,90,,percent of total billed charges,,,901.57,82,,percent of total billed charges,,,989.53,90,,percent of total billed charges,,,934.56,85,,percent of total billed charges,,274.87,1044.51,
SYNTHES SCREW LOCKING ST 2.4 X 14MM,30184561,CDM,,,278,RC,outpatient,,1099.48,1099.48,,933.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,274.87,22,,percent of total billed charges,,,,,,,,,989.53,90,,percent of total billed charges,,,910.37,82.8,,percent of total billed charges,,,934.56,85,,percent of total billed charges,,,,,,,,,967.54,88,,percent of total billed charges,,,,,,,,,840,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,274.87,22,,percent of total billed charges,,,1000.53,91,,percent of total billed charges,,,1044.51,95,,percent of total billed charges,,,912.57,83,,percent of total billed charges,,,912.57,83,,percent of total billed charges,,,,,,,,,,,,,,,912.57,83,,percent of total billed charges,,,1044.51,95,,percent of total billed charges,,,989.53,90,,percent of total billed charges,,,989.53,90,,percent of total billed charges,,,901.57,82,,percent of total billed charges,,,989.53,90,,percent of total billed charges,,,934.56,85,,percent of total billed charges,,274.87,1044.51,
ALLOSOURCE CANCELLOUS CHIPS 30CC,30184562,CDM,,,278,RC,outpatient,,3399.5,3399.5,,2886.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,849.88,22,,percent of total billed charges,,,,,,,,,3059.55,90,,percent of total billed charges,,,2814.79,82.8,,percent of total billed charges,,,2889.58,85,,percent of total billed charges,,,,,,,,,2991.56,88,,percent of total billed charges,,,,,,,,,2597.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,849.88,22,,percent of total billed charges,,,3093.55,91,,percent of total billed charges,,,3229.53,95,,percent of total billed charges,,,2821.59,83,,percent of total billed charges,,,2821.59,83,,percent of total billed charges,,,,,,,,,,,,,,,2821.59,83,,percent of total billed charges,,,3229.53,95,,percent of total billed charges,,,3059.55,90,,percent of total billed charges,,,3059.55,90,,percent of total billed charges,,,2787.59,82,,percent of total billed charges,,,3059.55,90,,percent of total billed charges,,,2889.58,85,,percent of total billed charges,,849.88,3229.53,
STRYKER PENCIL SMOKE EVAC,30184563,CDM,,,270,RC,outpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.25,22,,percent of total billed charges,,,,,,,,,202.5,90,,percent of total billed charges,,,186.3,82.8,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.25,22,,percent of total billed charges,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,56.25,213.75,
DEPUY INSERT ATTUNE RP 14MM SZ 6,30184564,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
STRYKER GEL DBM 5CC,30184566,CDM,,,278,RC,outpatient,,8247.2,8247.2,,7001.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2061.8,22,,percent of total billed charges,,,,,,,,,7422.48,90,,percent of total billed charges,,,6828.68,82.8,,percent of total billed charges,,,7010.12,85,,percent of total billed charges,,,,,,,,,7257.54,88,,percent of total billed charges,,,,,,,,,6300.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2061.8,22,,percent of total billed charges,,,7504.95,91,,percent of total billed charges,,,7834.84,95,,percent of total billed charges,,,6845.18,83,,percent of total billed charges,,,6845.18,83,,percent of total billed charges,,,,,,,,,,,,,,,6845.18,83,,percent of total billed charges,,,7834.84,95,,percent of total billed charges,,,7422.48,90,,percent of total billed charges,,,7422.48,90,,percent of total billed charges,,,6762.7,82,,percent of total billed charges,,,7422.48,90,,percent of total billed charges,,,7010.12,85,,percent of total billed charges,,2061.8,7834.84,
ARTHREX IMPLANT SYSTEM SPEED BRIDGE SELF,30184567,CDM,,,278,RC,outpatient,,11570,11570,,9822.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2892.5,22,,percent of total billed charges,,,,,,,,,10413,90,,percent of total billed charges,,,9579.96,82.8,,percent of total billed charges,,,9834.5,85,,percent of total billed charges,,,,,,,,,10181.6,88,,percent of total billed charges,,,,,,,,,8839.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2892.5,22,,percent of total billed charges,,,10528.7,91,,percent of total billed charges,,,10991.5,95,,percent of total billed charges,,,9603.1,83,,percent of total billed charges,,,9603.1,83,,percent of total billed charges,,,,,,,,,,,,,,,9603.1,83,,percent of total billed charges,,,10991.5,95,,percent of total billed charges,,,10413,90,,percent of total billed charges,,,10413,90,,percent of total billed charges,,,9487.4,82,,percent of total billed charges,,,10413,90,,percent of total billed charges,,,9834.5,85,,percent of total billed charges,,2892.5,10991.5,
DEPUY BODY RECLAIM PROXIMAL 20 X85,30184568,CDM,,,278,RC,outpatient,,38548.77,38548.77,,32727.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9637.19,22,,percent of total billed charges,,,,,,,,,34693.89,90,,percent of total billed charges,,,31918.38,82.8,,percent of total billed charges,,,32766.45,85,,percent of total billed charges,,,,,,,,,33922.92,88,,percent of total billed charges,,,,,,,,,29451.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9637.19,22,,percent of total billed charges,,,35079.38,91,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,31995.48,83,,percent of total billed charges,,,,,,,,,,,,,,,31995.48,83,,percent of total billed charges,,,36621.33,95,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,31609.99,82,,percent of total billed charges,,,34693.89,90,,percent of total billed charges,,,32766.45,85,,percent of total billed charges,,9637.19,36621.33,
DEPUY STEM RECLAIM DISTAL 14 X 190,30184569,CDM,,,278,RC,outpatient,,31338.78,31338.78,,26606.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7834.7,22,,percent of total billed charges,,,,,,,,,28204.9,90,,percent of total billed charges,,,25948.51,82.8,,percent of total billed charges,,,26637.96,85,,percent of total billed charges,,,,,,,,,27578.13,88,,percent of total billed charges,,,,,,,,,23942.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7834.7,22,,percent of total billed charges,,,28518.29,91,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,26011.19,83,,percent of total billed charges,,,,,,,,,,,,,,,26011.19,83,,percent of total billed charges,,,29771.84,95,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,25697.8,82,,percent of total billed charges,,,28204.9,90,,percent of total billed charges,,,26637.96,85,,percent of total billed charges,,7834.7,29771.84,
STRYKER BOWL MIXVAC 3,30184570,CDM,,,270,RC,outpatient,,362.36,362.36,,307.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90.59,22,,percent of total billed charges,,,,,,,,,326.12,90,,percent of total billed charges,,,300.03,82.8,,percent of total billed charges,,,308.01,85,,percent of total billed charges,,,,,,,,,318.88,88,,percent of total billed charges,,,,,,,,,276.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90.59,22,,percent of total billed charges,,,329.75,91,,percent of total billed charges,,,344.24,95,,percent of total billed charges,,,300.76,83,,percent of total billed charges,,,300.76,83,,percent of total billed charges,,,,,,,,,,,,,,,300.76,83,,percent of total billed charges,,,344.24,95,,percent of total billed charges,,,326.12,90,,percent of total billed charges,,,326.12,90,,percent of total billed charges,,,297.14,82,,percent of total billed charges,,,326.12,90,,percent of total billed charges,,,308.01,85,,percent of total billed charges,,90.59,344.24,
MEDTRONIC GRAFTON 1CC PUTTY,30184571,CDM,,,270,RC,outpatient,,1488.5,1488.5,,1263.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,372.13,22,,percent of total billed charges,,,,,,,,,1339.65,90,,percent of total billed charges,,,1232.48,82.8,,percent of total billed charges,,,1265.23,85,,percent of total billed charges,,,,,,,,,1309.88,88,,percent of total billed charges,,,,,,,,,1137.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,372.13,22,,percent of total billed charges,,,1354.54,91,,percent of total billed charges,,,1414.08,95,,percent of total billed charges,,,1235.46,83,,percent of total billed charges,,,1235.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1235.46,83,,percent of total billed charges,,,1414.08,95,,percent of total billed charges,,,1339.65,90,,percent of total billed charges,,,1339.65,90,,percent of total billed charges,,,1220.57,82,,percent of total billed charges,,,1339.65,90,,percent of total billed charges,,,1265.23,85,,percent of total billed charges,,372.13,1414.08,
ZIMMER BEARING LEFT MEDIAL LARGE 3MM,30184572,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
SYNTHES TFN LEFT 11MM 130DEG X 360,30184573,CDM,,,278,RC,outpatient,,21149.7,21149.7,,17956.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5287.43,22,,percent of total billed charges,,,,,,,,,19034.73,90,,percent of total billed charges,,,17511.95,82.8,,percent of total billed charges,,,17977.25,85,,percent of total billed charges,,,,,,,,,18611.74,88,,percent of total billed charges,,,,,,,,,16158.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5287.43,22,,percent of total billed charges,,,19246.23,91,,percent of total billed charges,,,20092.22,95,,percent of total billed charges,,,17554.25,83,,percent of total billed charges,,,17554.25,83,,percent of total billed charges,,,,,,,,,,,,,,,17554.25,83,,percent of total billed charges,,,20092.22,95,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,17342.75,82,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,17977.25,85,,percent of total billed charges,,5287.43,20092.22,
SYNTHES BALDE HELICAL 85MM,30184574,CDM,,,270,RC,outpatient,,6630,6630,,5628.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1657.5,22,,percent of total billed charges,,,,,,,,,5967,90,,percent of total billed charges,,,5489.64,82.8,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,,,,,,,,5834.4,88,,percent of total billed charges,,,,,,,,,5065.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1657.5,22,,percent of total billed charges,,,6033.3,91,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,,,,,,,,,,,,,5502.9,83,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5436.6,82,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,1657.5,6298.5,
SYNTHES DRILL BIT 4.2MM X 145,30184575,CDM,,,270,RC,outpatient,,2227.36,2227.36,,1891.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,556.84,22,,percent of total billed charges,,,,,,,,,2004.62,90,,percent of total billed charges,,,1844.25,82.8,,percent of total billed charges,,,1893.26,85,,percent of total billed charges,,,,,,,,,1960.08,88,,percent of total billed charges,,,,,,,,,1701.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,556.84,22,,percent of total billed charges,,,2026.9,91,,percent of total billed charges,,,2115.99,95,,percent of total billed charges,,,1848.71,83,,percent of total billed charges,,,1848.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1848.71,83,,percent of total billed charges,,,2115.99,95,,percent of total billed charges,,,2004.62,90,,percent of total billed charges,,,2004.62,90,,percent of total billed charges,,,1826.44,82,,percent of total billed charges,,,2004.62,90,,percent of total billed charges,,,1893.26,85,,percent of total billed charges,,556.84,2115.99,
SYNTHES SCREW LOCKING 5.0 X 46MM,30184576,CDM,,,278,RC,outpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,562.71,22,,percent of total billed charges,,,,,,,,,2025.74,90,,percent of total billed charges,,,1863.68,82.8,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,562.71,22,,percent of total billed charges,,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,562.71,2138.28,
SYNTHES SCREW LOCKING 5.0MM X 42MM,30184577,CDM,,,278,RC,outpatient,,2121.6,2121.6,,1801.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,530.4,22,,percent of total billed charges,,,,,,,,,1909.44,90,,percent of total billed charges,,,1756.68,82.8,,percent of total billed charges,,,1803.36,85,,percent of total billed charges,,,,,,,,,1867.01,88,,percent of total billed charges,,,,,,,,,1620.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,530.4,22,,percent of total billed charges,,,1930.66,91,,percent of total billed charges,,,2015.52,95,,percent of total billed charges,,,1760.93,83,,percent of total billed charges,,,1760.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1760.93,83,,percent of total billed charges,,,2015.52,95,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1739.71,82,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1803.36,85,,percent of total billed charges,,530.4,2015.52,
HOLMIUM LASER FEE,30184578,CDM,,,270,RC,outpatient,,4712.5,4712.5,,4000.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1178.13,22,,percent of total billed charges,,,,,,,,,4241.25,90,,percent of total billed charges,,,3901.95,82.8,,percent of total billed charges,,,4005.63,85,,percent of total billed charges,,,,,,,,,4147,88,,percent of total billed charges,,,,,,,,,3600.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1178.13,22,,percent of total billed charges,,,4288.38,91,,percent of total billed charges,,,4476.88,95,,percent of total billed charges,,,3911.38,83,,percent of total billed charges,,,3911.38,83,,percent of total billed charges,,,,,,,,,,,,,,,3911.38,83,,percent of total billed charges,,,4476.88,95,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,3864.25,82,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,4005.63,85,,percent of total billed charges,,1178.13,4476.88,
HOLMIUM LASER FIBER 200MC,30184579,CDM,,,270,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
ARTHREX HEATED INSULFATION TUBING,30184580,CDM,,,270,RC,outpatient,,303.75,303.75,,257.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.94,22,,percent of total billed charges,,,,,,,,,273.38,90,,percent of total billed charges,,,251.51,82.8,,percent of total billed charges,,,258.19,85,,percent of total billed charges,,,,,,,,,267.3,88,,percent of total billed charges,,,,,,,,,232.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.94,22,,percent of total billed charges,,,276.41,91,,percent of total billed charges,,,288.56,95,,percent of total billed charges,,,252.11,83,,percent of total billed charges,,,252.11,83,,percent of total billed charges,,,,,,,,,,,,,,,252.11,83,,percent of total billed charges,,,288.56,95,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,249.08,82,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,258.19,85,,percent of total billed charges,,75.94,288.56,
ALLOSOURCE SEMI-T SINGLE STRAND TENDON,30184581,CDM,,,278,RC,outpatient,,5720,5720,,4856.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1430,22,,percent of total billed charges,,,,,,,,,5148,90,,percent of total billed charges,,,4736.16,82.8,,percent of total billed charges,,,4862,85,,percent of total billed charges,,,,,,,,,5033.6,88,,percent of total billed charges,,,,,,,,,4370.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1430,22,,percent of total billed charges,,,5205.2,91,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4747.6,83,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4690.4,82,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4862,85,,percent of total billed charges,,1430,5434,
ARTHREX BIOCOMPOSITE IMPLANT SYSTEM MPFL,30184582,CDM,,,278,RC,outpatient,,9665.5,9665.5,,8206.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2416.38,22,,percent of total billed charges,,,,,,,,,8698.95,90,,percent of total billed charges,,,8003.03,82.8,,percent of total billed charges,,,8215.68,85,,percent of total billed charges,,,,,,,,,8505.64,88,,percent of total billed charges,,,,,,,,,7384.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2416.38,22,,percent of total billed charges,,,8795.61,91,,percent of total billed charges,,,9182.23,95,,percent of total billed charges,,,8022.37,83,,percent of total billed charges,,,8022.37,83,,percent of total billed charges,,,,,,,,,,,,,,,8022.37,83,,percent of total billed charges,,,9182.23,95,,percent of total billed charges,,,8698.95,90,,percent of total billed charges,,,8698.95,90,,percent of total billed charges,,,7925.71,82,,percent of total billed charges,,,8698.95,90,,percent of total billed charges,,,8215.68,85,,percent of total billed charges,,2416.38,9182.23,
SPINECRAFT OR10 12 X 15 X 6MM,30184583,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
SPINECRAFT SCREW FIXED 4.0 X 14MM,30184584,CDM,,,278,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
SPINECRAFT VELOX 1 LEVE 14MM,30184585,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER NEEDLE VENOM CURVED 100MM 20G,30184586,CDM,,,270,RC,outpatient,,511.28,511.28,,434.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.82,22,,percent of total billed charges,,,,,,,,,460.15,90,,percent of total billed charges,,,423.34,82.8,,percent of total billed charges,,,434.59,85,,percent of total billed charges,,,,,,,,,449.93,88,,percent of total billed charges,,,,,,,,,390.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.82,22,,percent of total billed charges,,,465.26,91,,percent of total billed charges,,,485.72,95,,percent of total billed charges,,,424.36,83,,percent of total billed charges,,,424.36,83,,percent of total billed charges,,,,,,,,,,,,,,,424.36,83,,percent of total billed charges,,,485.72,95,,percent of total billed charges,,,460.15,90,,percent of total billed charges,,,460.15,90,,percent of total billed charges,,,419.25,82,,percent of total billed charges,,,460.15,90,,percent of total billed charges,,,434.59,85,,percent of total billed charges,,127.82,485.72,
DEPUY BIPOLAR 28ID X 40 OD,30184587,CDM,,,278,RC,outpatient,,5424.97,5424.97,,4605.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1356.24,22,,percent of total billed charges,,,,,,,,,4882.47,90,,percent of total billed charges,,,4491.88,82.8,,percent of total billed charges,,,4611.22,85,,percent of total billed charges,,,,,,,,,4773.97,88,,percent of total billed charges,,,,,,,,,4144.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1356.24,22,,percent of total billed charges,,,4936.72,91,,percent of total billed charges,,,5153.72,95,,percent of total billed charges,,,4502.73,83,,percent of total billed charges,,,4502.73,83,,percent of total billed charges,,,,,,,,,,,,,,,4502.73,83,,percent of total billed charges,,,5153.72,95,,percent of total billed charges,,,4882.47,90,,percent of total billed charges,,,4882.47,90,,percent of total billed charges,,,4448.48,82,,percent of total billed charges,,,4882.47,90,,percent of total billed charges,,,4611.22,85,,percent of total billed charges,,1356.24,5153.72,
FLOSEAL FAST PREP 5ML,30184588,CDM,,,270,RC,outpatient,,1503.59,1503.59,,1276.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375.9,22,,percent of total billed charges,,,,,,,,,1353.23,90,,percent of total billed charges,,,1244.97,82.8,,percent of total billed charges,,,1278.05,85,,percent of total billed charges,,,,,,,,,1323.16,88,,percent of total billed charges,,,,,,,,,1148.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,375.9,22,,percent of total billed charges,,,1368.27,91,,percent of total billed charges,,,1428.41,95,,percent of total billed charges,,,1247.98,83,,percent of total billed charges,,,1247.98,83,,percent of total billed charges,,,,,,,,,,,,,,,1247.98,83,,percent of total billed charges,,,1428.41,95,,percent of total billed charges,,,1353.23,90,,percent of total billed charges,,,1353.23,90,,percent of total billed charges,,,1232.94,82,,percent of total billed charges,,,1353.23,90,,percent of total billed charges,,,1278.05,85,,percent of total billed charges,,375.9,1428.41,
DEPUY INSERT PFC 8MM SZ 3,30184589,CDM,,,278,RC,outpatient,,11969.75,11969.75,,10162.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2992.44,22,,percent of total billed charges,,,,,,,,,10772.78,90,,percent of total billed charges,,,9910.95,82.8,,percent of total billed charges,,,10174.29,85,,percent of total billed charges,,,,,,,,,10533.38,88,,percent of total billed charges,,,,,,,,,9144.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2992.44,22,,percent of total billed charges,,,10892.47,91,,percent of total billed charges,,,11371.26,95,,percent of total billed charges,,,9934.89,83,,percent of total billed charges,,,9934.89,83,,percent of total billed charges,,,,,,,,,,,,,,,9934.89,83,,percent of total billed charges,,,11371.26,95,,percent of total billed charges,,,10772.78,90,,percent of total billed charges,,,10772.78,90,,percent of total billed charges,,,9815.2,82,,percent of total billed charges,,,10772.78,90,,percent of total billed charges,,,10174.29,85,,percent of total billed charges,,2992.44,11371.26,
DEPUY LINER ALTRIX 40 X 60MM,30184590,CDM,,,278,RC,outpatient,,14377.35,14377.35,,12206.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3594.34,22,,percent of total billed charges,,,,,,,,,12939.62,90,,percent of total billed charges,,,11904.45,82.8,,percent of total billed charges,,,12220.75,85,,percent of total billed charges,,,,,,,,,12652.07,88,,percent of total billed charges,,,,,,,,,10984.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3594.34,22,,percent of total billed charges,,,13083.39,91,,percent of total billed charges,,,13658.48,95,,percent of total billed charges,,,11933.2,83,,percent of total billed charges,,,11933.2,83,,percent of total billed charges,,,,,,,,,,,,,,,11933.2,83,,percent of total billed charges,,,13658.48,95,,percent of total billed charges,,,12939.62,90,,percent of total billed charges,,,12939.62,90,,percent of total billed charges,,,11789.43,82,,percent of total billed charges,,,12939.62,90,,percent of total billed charges,,,12220.75,85,,percent of total billed charges,,3594.34,13658.48,
DEPUY STEM SUMMIT SZ 2,30184592,CDM,,,278,RC,outpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8814.57,22,,percent of total billed charges,,,,,,,,,31732.45,90,,percent of total billed charges,,,29193.86,82.8,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8814.57,22,,percent of total billed charges,,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,8814.57,33495.37,
ALLOSOURCE CORTICAL STRUT 29CM,30184593,CDM,,,278,RC,outpatient,,4563,4563,,3873.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1140.75,22,,percent of total billed charges,,,,,,,,,4106.7,90,,percent of total billed charges,,,3778.16,82.8,,percent of total billed charges,,,3878.55,85,,percent of total billed charges,,,,,,,,,4015.44,88,,percent of total billed charges,,,,,,,,,3486.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1140.75,22,,percent of total billed charges,,,4152.33,91,,percent of total billed charges,,,4334.85,95,,percent of total billed charges,,,3787.29,83,,percent of total billed charges,,,3787.29,83,,percent of total billed charges,,,,,,,,,,,,,,,3787.29,83,,percent of total billed charges,,,4334.85,95,,percent of total billed charges,,,4106.7,90,,percent of total billed charges,,,4106.7,90,,percent of total billed charges,,,3741.66,82,,percent of total billed charges,,,4106.7,90,,percent of total billed charges,,,3878.55,85,,percent of total billed charges,,1140.75,4334.85,
GRAFT PRESTITCHED 9MM DIAMETER 220MM LEN,30184594,CDM,,,278,RC,outpatient,,15112.5,15112.5,,12830.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3778.13,22,,percent of total billed charges,,,,,,,,,13601.25,90,,percent of total billed charges,,,12513.15,82.8,,percent of total billed charges,,,12845.63,85,,percent of total billed charges,,,,,,,,,13299,88,,percent of total billed charges,,,,,,,,,11545.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3778.13,22,,percent of total billed charges,,,13752.38,91,,percent of total billed charges,,,14356.88,95,,percent of total billed charges,,,12543.38,83,,percent of total billed charges,,,12543.38,83,,percent of total billed charges,,,,,,,,,,,,,,,12543.38,83,,percent of total billed charges,,,14356.88,95,,percent of total billed charges,,,13601.25,90,,percent of total billed charges,,,13601.25,90,,percent of total billed charges,,,12392.25,82,,percent of total billed charges,,,13601.25,90,,percent of total billed charges,,,12845.63,85,,percent of total billed charges,,3778.13,14356.88,
DEPUY SEGMENTAL COMPONENT 30MM,30184595,CDM,,,278,RC,outpatient,,18773.5,18773.5,,15938.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4693.38,22,,percent of total billed charges,,,,,,,,,16896.15,90,,percent of total billed charges,,,15544.46,82.8,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,,,,,,,,16520.68,88,,percent of total billed charges,,,,,,,,,14342.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4693.38,22,,percent of total billed charges,,,17083.89,91,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,,,,,,,,,,,,,15582.01,83,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15394.27,82,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,4693.38,17834.83,
MESH HERNIA PRE CUT 6 X 13CM,30184596,CDM,,,278,RC,outpatient,,476,476,,404.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119,22,,percent of total billed charges,,,,,,,,,428.4,90,,percent of total billed charges,,,394.13,82.8,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,,,,,,,,418.88,88,,percent of total billed charges,,,,,,,,,363.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119,22,,percent of total billed charges,,,433.16,91,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,,,,,,,,,,,,,395.08,83,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,390.32,82,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,119,452.2,
ARTHREX PLATE MTP LOW PROFILE STANDARD,30184597,CDM,,,278,RC,outpatient,,5817.5,5817.5,,4939.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1454.38,22,,percent of total billed charges,,,,,,,,,5235.75,90,,percent of total billed charges,,,4816.89,82.8,,percent of total billed charges,,,4944.88,85,,percent of total billed charges,,,,,,,,,5119.4,88,,percent of total billed charges,,,,,,,,,4444.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1454.38,22,,percent of total billed charges,,,5293.93,91,,percent of total billed charges,,,5526.63,95,,percent of total billed charges,,,4828.53,83,,percent of total billed charges,,,4828.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4828.53,83,,percent of total billed charges,,,5526.63,95,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,4770.35,82,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,4944.88,85,,percent of total billed charges,,1454.38,5526.63,
ARTHREX PLATE MTP LOW PROFILE STANDARD R,30184598,CDM,,,278,RC,outpatient,,5200,5200,,4414.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1300,22,,percent of total billed charges,,,,,,,,,4680,90,,percent of total billed charges,,,4305.6,82.8,,percent of total billed charges,,,4420,85,,percent of total billed charges,,,,,,,,,4576,88,,percent of total billed charges,,,,,,,,,3972.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1300,22,,percent of total billed charges,,,4732,91,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,,,,,,,,,,,,,4316,83,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4264,82,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4420,85,,percent of total billed charges,,1300,4940,
ARTHREX SCREW LOCKING CORTICAL 3MM X 12M,30184599,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW LOCKING CORTICAL 3MM X 16M,30184601,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW LOCKING CORTICAL 3MM X 18M,30184602,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW LOCKING CORTICAL 3MM X 20M,30184603,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW LOCKING CORTICAL 3MM X 24M,30184604,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW CORTICAL 3MM X 14MM,30184605,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW CORTICAL 3MM X 18MM,30184606,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW PT CANNULATED 3MM X 28MM,30184607,CDM,,,278,RC,outpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210,22,,percent of total billed charges,,,,,,,,,756,90,,percent of total billed charges,,,695.52,82.8,,percent of total billed charges,,,714,85,,percent of total billed charges,,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210,22,,percent of total billed charges,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,210,798,
ARTHREX DRILL BIT 2MM,30184608,CDM,,,278,RC,outpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,148.75,22,,percent of total billed charges,,,,,,,,,535.5,90,,percent of total billed charges,,,492.66,82.8,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,148.75,22,,percent of total billed charges,,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,148.75,565.25,
ARTHREX DRILL BIT CANNULATED 2MM,30184609,CDM,,,278,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
ARTHREX K-WIRE .045,30184610,CDM,,,270,RC,outpatient,,59.5,59.5,,50.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.88,22,,percent of total billed charges,,,,,,,,,53.55,90,,percent of total billed charges,,,49.27,82.8,,percent of total billed charges,,,50.58,85,,percent of total billed charges,,,,,,,,,52.36,88,,percent of total billed charges,,,,,,,,,45.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.88,22,,percent of total billed charges,,,54.15,91,,percent of total billed charges,,,56.53,95,,percent of total billed charges,,,49.39,83,,percent of total billed charges,,,49.39,83,,percent of total billed charges,,,,,,,,,,,,,,,49.39,83,,percent of total billed charges,,,56.53,95,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,48.79,82,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,50.58,85,,percent of total billed charges,,14.88,56.53,
STRYKER PROXIMAL INTERPHALANGEAL IMPLANT,30184612,CDM,,,278,RC,outpatient,,17252,17252,,14646.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4313,22,,percent of total billed charges,,,,,,,,,15526.8,90,,percent of total billed charges,,,14284.66,82.8,,percent of total billed charges,,,14664.2,85,,percent of total billed charges,,,,,,,,,15181.76,88,,percent of total billed charges,,,,,,,,,13180.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4313,22,,percent of total billed charges,,,15699.32,91,,percent of total billed charges,,,16389.4,95,,percent of total billed charges,,,14319.16,83,,percent of total billed charges,,,14319.16,83,,percent of total billed charges,,,,,,,,,,,,,,,14319.16,83,,percent of total billed charges,,,16389.4,95,,percent of total billed charges,,,15526.8,90,,percent of total billed charges,,,15526.8,90,,percent of total billed charges,,,14146.64,82,,percent of total billed charges,,,15526.8,90,,percent of total billed charges,,,14664.2,85,,percent of total billed charges,,4313,16389.4,
ARTHREX SCREW BIOCOMPOSITE 10 X 28MM,30184614,CDM,,,278,RC,outpatient,,1527.5,1527.5,,1296.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,381.88,22,,percent of total billed charges,,,,,,,,,1374.75,90,,percent of total billed charges,,,1264.77,82.8,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,,,,,,,,1344.2,88,,percent of total billed charges,,,,,,,,,1167.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,381.88,22,,percent of total billed charges,,,1390.03,91,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1267.83,83,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1252.55,82,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,381.88,1451.13,
ARTHREX REAMER 10MM,30184615,CDM,,,278,RC,outpatient,,1092,1092,,927.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,273,22,,percent of total billed charges,,,,,,,,,982.8,90,,percent of total billed charges,,,904.18,82.8,,percent of total billed charges,,,928.2,85,,percent of total billed charges,,,,,,,,,960.96,88,,percent of total billed charges,,,,,,,,,834.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,273,22,,percent of total billed charges,,,993.72,91,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,,,,,,,,,,,,,906.36,83,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,895.44,82,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,928.2,85,,percent of total billed charges,,273,1037.4,
S&N FAST-FIX 360 STRAIGHT NDL DELIVERY S,30184616,CDM,,,270,RC,outpatient,,3177.46,3177.46,,2697.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,794.37,22,,percent of total billed charges,,,,,,,,,2859.71,90,,percent of total billed charges,,,2630.94,82.8,,percent of total billed charges,,,2700.84,85,,percent of total billed charges,,,,,,,,,2796.16,88,,percent of total billed charges,,,,,,,,,2427.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,794.37,22,,percent of total billed charges,,,2891.49,91,,percent of total billed charges,,,3018.59,95,,percent of total billed charges,,,2637.29,83,,percent of total billed charges,,,2637.29,83,,percent of total billed charges,,,,,,,,,,,,,,,2637.29,83,,percent of total billed charges,,,3018.59,95,,percent of total billed charges,,,2859.71,90,,percent of total billed charges,,,2859.71,90,,percent of total billed charges,,,2605.52,82,,percent of total billed charges,,,2859.71,90,,percent of total billed charges,,,2700.84,85,,percent of total billed charges,,794.37,3018.59,
S&N FAST-FIX 360 CURVED NDL DELIVERY SYS,30184617,CDM,,,270,RC,outpatient,,3177.46,3177.46,,2697.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,794.37,22,,percent of total billed charges,,,,,,,,,2859.71,90,,percent of total billed charges,,,2630.94,82.8,,percent of total billed charges,,,2700.84,85,,percent of total billed charges,,,,,,,,,2796.16,88,,percent of total billed charges,,,,,,,,,2427.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,794.37,22,,percent of total billed charges,,,2891.49,91,,percent of total billed charges,,,3018.59,95,,percent of total billed charges,,,2637.29,83,,percent of total billed charges,,,2637.29,83,,percent of total billed charges,,,,,,,,,,,,,,,2637.29,83,,percent of total billed charges,,,3018.59,95,,percent of total billed charges,,,2859.71,90,,percent of total billed charges,,,2859.71,90,,percent of total billed charges,,,2605.52,82,,percent of total billed charges,,,2859.71,90,,percent of total billed charges,,,2700.84,85,,percent of total billed charges,,794.37,3018.59,
S&N FAST-FIX 360 CANNULA KPSC & SLOTTED,30184618,CDM,,,270,RC,outpatient,,977.15,977.15,,829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,244.29,22,,percent of total billed charges,,,,,,,,,879.44,90,,percent of total billed charges,,,809.08,82.8,,percent of total billed charges,,,830.58,85,,percent of total billed charges,,,,,,,,,859.89,88,,percent of total billed charges,,,,,,,,,746.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,244.29,22,,percent of total billed charges,,,889.21,91,,percent of total billed charges,,,928.29,95,,percent of total billed charges,,,811.03,83,,percent of total billed charges,,,811.03,83,,percent of total billed charges,,,,,,,,,,,,,,,811.03,83,,percent of total billed charges,,,928.29,95,,percent of total billed charges,,,879.44,90,,percent of total billed charges,,,879.44,90,,percent of total billed charges,,,801.26,82,,percent of total billed charges,,,879.44,90,,percent of total billed charges,,,830.58,85,,percent of total billed charges,,244.29,928.29,
STRYKER BUR SWANSON PILOT POINT 3.0MM,30184619,CDM,,,270,RC,outpatient,,368.06,368.06,,312.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.02,22,,percent of total billed charges,,,,,,,,,331.25,90,,percent of total billed charges,,,304.75,82.8,,percent of total billed charges,,,312.85,85,,percent of total billed charges,,,,,,,,,323.89,88,,percent of total billed charges,,,,,,,,,281.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.02,22,,percent of total billed charges,,,334.93,91,,percent of total billed charges,,,349.66,95,,percent of total billed charges,,,305.49,83,,percent of total billed charges,,,305.49,83,,percent of total billed charges,,,,,,,,,,,,,,,305.49,83,,percent of total billed charges,,,349.66,95,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,301.81,82,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,312.85,85,,percent of total billed charges,,92.02,349.66,
STRYKER BUR SWANSON PILOT POINT 2.0MM,30184620,CDM,,,270,RC,outpatient,,368.06,368.06,,312.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.02,22,,percent of total billed charges,,,,,,,,,331.25,90,,percent of total billed charges,,,304.75,82.8,,percent of total billed charges,,,312.85,85,,percent of total billed charges,,,,,,,,,323.89,88,,percent of total billed charges,,,,,,,,,281.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.02,22,,percent of total billed charges,,,334.93,91,,percent of total billed charges,,,349.66,95,,percent of total billed charges,,,305.49,83,,percent of total billed charges,,,305.49,83,,percent of total billed charges,,,,,,,,,,,,,,,305.49,83,,percent of total billed charges,,,349.66,95,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,301.81,82,,percent of total billed charges,,,331.25,90,,percent of total billed charges,,,312.85,85,,percent of total billed charges,,92.02,349.66,
COSEAL SURGICAL SEALANT,30184622,CDM,,,270,RC,outpatient,,3903.97,3903.97,,3314.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975.99,22,,percent of total billed charges,,,,,,,,,3513.57,90,,percent of total billed charges,,,3232.49,82.8,,percent of total billed charges,,,3318.37,85,,percent of total billed charges,,,,,,,,,3435.49,88,,percent of total billed charges,,,,,,,,,2982.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975.99,22,,percent of total billed charges,,,3552.61,91,,percent of total billed charges,,,3708.77,95,,percent of total billed charges,,,3240.3,83,,percent of total billed charges,,,3240.3,83,,percent of total billed charges,,,,,,,,,,,,,,,3240.3,83,,percent of total billed charges,,,3708.77,95,,percent of total billed charges,,,3513.57,90,,percent of total billed charges,,,3513.57,90,,percent of total billed charges,,,3201.26,82,,percent of total billed charges,,,3513.57,90,,percent of total billed charges,,,3318.37,85,,percent of total billed charges,,975.99,3708.77,
MITEK MINI QUICKANCHOR PLUS #0 SUTURE,30184623,CDM,,,270,RC,outpatient,,3185,3185,,2704.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,796.25,22,,percent of total billed charges,,,,,,,,,2866.5,90,,percent of total billed charges,,,2637.18,82.8,,percent of total billed charges,,,2707.25,85,,percent of total billed charges,,,,,,,,,2802.8,88,,percent of total billed charges,,,,,,,,,2433.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,796.25,22,,percent of total billed charges,,,2898.35,91,,percent of total billed charges,,,3025.75,95,,percent of total billed charges,,,2643.55,83,,percent of total billed charges,,,2643.55,83,,percent of total billed charges,,,,,,,,,,,,,,,2643.55,83,,percent of total billed charges,,,3025.75,95,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2611.7,82,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2707.25,85,,percent of total billed charges,,796.25,3025.75,
JRF TENDON ALLOGRAFT GRACILIS 4MM X 23CM,30184624,CDM,,,278,RC,outpatient,,8391.5,8391.5,,7124.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2097.88,22,,percent of total billed charges,,,,,,,,,7552.35,90,,percent of total billed charges,,,6948.16,82.8,,percent of total billed charges,,,7132.78,85,,percent of total billed charges,,,,,,,,,7384.52,88,,percent of total billed charges,,,,,,,,,6411.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2097.88,22,,percent of total billed charges,,,7636.27,91,,percent of total billed charges,,,7971.93,95,,percent of total billed charges,,,6964.95,83,,percent of total billed charges,,,6964.95,83,,percent of total billed charges,,,,,,,,,,,,,,,6964.95,83,,percent of total billed charges,,,7971.93,95,,percent of total billed charges,,,7552.35,90,,percent of total billed charges,,,7552.35,90,,percent of total billed charges,,,6881.03,82,,percent of total billed charges,,,7552.35,90,,percent of total billed charges,,,7132.78,85,,percent of total billed charges,,2097.88,7971.93,
SYNTHES SCREW CORTEX ST 2.4MM T8 STARDRI,30184627,CDM,,,278,RC,outpatient,,565.25,565.25,,479.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141.31,22,,percent of total billed charges,,,,,,,,,508.73,90,,percent of total billed charges,,,468.03,82.8,,percent of total billed charges,,,480.46,85,,percent of total billed charges,,,,,,,,,497.42,88,,percent of total billed charges,,,,,,,,,431.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141.31,22,,percent of total billed charges,,,514.38,91,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,,,,,,,,,,,,,469.16,83,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,463.51,82,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,480.46,85,,percent of total billed charges,,141.31,536.99,
DEPUY INSERT RP STAB 6MM,30184628,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
STRYKER ANTIBIOTIC BONE CEMENT,30184629,CDM,,,278,RC,outpatient,,2748.2,2748.2,,2333.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,687.05,22,,percent of total billed charges,,,,,,,,,2473.38,90,,percent of total billed charges,,,2275.51,82.8,,percent of total billed charges,,,2335.97,85,,percent of total billed charges,,,,,,,,,2418.42,88,,percent of total billed charges,,,,,,,,,2099.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,687.05,22,,percent of total billed charges,,,2500.86,91,,percent of total billed charges,,,2610.79,95,,percent of total billed charges,,,2281.01,83,,percent of total billed charges,,,2281.01,83,,percent of total billed charges,,,,,,,,,,,,,,,2281.01,83,,percent of total billed charges,,,2610.79,95,,percent of total billed charges,,,2473.38,90,,percent of total billed charges,,,2473.38,90,,percent of total billed charges,,,2253.52,82,,percent of total billed charges,,,2473.38,90,,percent of total billed charges,,,2335.97,85,,percent of total billed charges,,687.05,2610.79,
ARTHREX BIO-COMP SWVLK SP 5.5X24.5MM,30184630,CDM,,,270,RC,outpatient,,2730,2730,,2317.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,682.5,22,,percent of total billed charges,,,,,,,,,2457,90,,percent of total billed charges,,,2260.44,82.8,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,,,,,,,,2402.4,88,,percent of total billed charges,,,,,,,,,2085.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,682.5,22,,percent of total billed charges,,,2484.3,91,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2265.9,83,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2238.6,82,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,682.5,2593.5,
ARTHREX FIBERLINK,30184631,CDM,,,270,RC,outpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,148.75,22,,percent of total billed charges,,,,,,,,,535.5,90,,percent of total billed charges,,,492.66,82.8,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,148.75,22,,percent of total billed charges,,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,148.75,565.25,
ARTHREX GEMINI SR8,30184632,CDM,,,270,RC,outpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
SPINECRAFT SCREW VELOX VARIABLE 4.0 X 14,30184634,CDM,,,278,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
SPINECRAFT CAGE ORIO W/PEEK 12X15X8MM,30184635,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
SPINECRAFT DRILL BIT 12MM,30184636,CDM,,,278,RC,outpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,552.5,22,,percent of total billed charges,,,,,,,,,1989,90,,percent of total billed charges,,,1829.88,82.8,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,552.5,22,,percent of total billed charges,,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,552.5,2099.5,
SYNTHES PLATE LCP DISTAL FIBIA 2.7 X 3.5,30184637,CDM,,,278,RC,outpatient,,6500.39,6500.39,,5518.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625.1,22,,percent of total billed charges,,,,,,,,,5850.35,90,,percent of total billed charges,,,5382.32,82.8,,percent of total billed charges,,,5525.33,85,,percent of total billed charges,,,,,,,,,5720.34,88,,percent of total billed charges,,,,,,,,,4966.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625.1,22,,percent of total billed charges,,,5915.35,91,,percent of total billed charges,,,6175.37,95,,percent of total billed charges,,,5395.32,83,,percent of total billed charges,,,5395.32,83,,percent of total billed charges,,,,,,,,,,,,,,,5395.32,83,,percent of total billed charges,,,6175.37,95,,percent of total billed charges,,,5850.35,90,,percent of total billed charges,,,5850.35,90,,percent of total billed charges,,,5330.32,82,,percent of total billed charges,,,5850.35,90,,percent of total billed charges,,,5525.33,85,,percent of total billed charges,,1625.1,6175.37,
SYNTHES SCREW CORTEX 3.5MM,30184638,CDM,,,278,RC,outpatient,,267.75,267.75,,227.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.94,22,,percent of total billed charges,,,,,,,,,240.98,90,,percent of total billed charges,,,221.7,82.8,,percent of total billed charges,,,227.59,85,,percent of total billed charges,,,,,,,,,235.62,88,,percent of total billed charges,,,,,,,,,204.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.94,22,,percent of total billed charges,,,243.65,91,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,222.23,83,,percent of total billed charges,,,,,,,,,,,,,,,222.23,83,,percent of total billed charges,,,254.36,95,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,219.56,82,,percent of total billed charges,,,240.98,90,,percent of total billed charges,,,227.59,85,,percent of total billed charges,,66.94,254.36,
SYNTHES SCREW CANNCELLOUS 4.0MM,30184639,CDM,,,278,RC,outpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.78,22,,percent of total billed charges,,,,,,,,,200.82,90,,percent of total billed charges,,,184.75,82.8,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.78,22,,percent of total billed charges,,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,55.78,211.97,
MESH PERFIX PLUG SMALL,30184640,CDM,,,278,RC,outpatient,,1727.05,1727.05,,1466.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,431.76,22,,percent of total billed charges,,,,,,,,,1554.35,90,,percent of total billed charges,,,1430,82.8,,percent of total billed charges,,,1467.99,85,,percent of total billed charges,,,,,,,,,1519.8,88,,percent of total billed charges,,,,,,,,,1319.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,431.76,22,,percent of total billed charges,,,1571.62,91,,percent of total billed charges,,,1640.7,95,,percent of total billed charges,,,1433.45,83,,percent of total billed charges,,,1433.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1433.45,83,,percent of total billed charges,,,1640.7,95,,percent of total billed charges,,,1554.35,90,,percent of total billed charges,,,1554.35,90,,percent of total billed charges,,,1416.18,82,,percent of total billed charges,,,1554.35,90,,percent of total billed charges,,,1467.99,85,,percent of total billed charges,,431.76,1640.7,
DEPUY HEAD BIPOLAR 28X46,30184641,CDM,,,278,RC,outpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.27,22,,percent of total billed charges,,,,,,,,,7312.56,90,,percent of total billed charges,,,6727.56,82.8,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.27,22,,percent of total billed charges,,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,2031.27,7718.82,
DEPUY BIPOLAR PRIMARY CAP,30184642,CDM,,,278,RC,outpatient,,31200,31200,,26488.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7800,22,,percent of total billed charges,,,,,,,,,28080,90,,percent of total billed charges,,,25833.6,82.8,,percent of total billed charges,,,26520,85,,percent of total billed charges,,,,,,,,,27456,88,,percent of total billed charges,,,,,,,,,23836.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7800,22,,percent of total billed charges,,,28392,91,,percent of total billed charges,,,29640,95,,percent of total billed charges,,,25896,83,,percent of total billed charges,,,25896,83,,percent of total billed charges,,,,,,,,,,,,,,,25896,83,,percent of total billed charges,,,29640,95,,percent of total billed charges,,,28080,90,,percent of total billed charges,,,28080,90,,percent of total billed charges,,,25584,82,,percent of total billed charges,,,28080,90,,percent of total billed charges,,,26520,85,,percent of total billed charges,,7800,29640,
ARTHREX SCREW BC INTER-FERENCE 10X23,30184643,CDM,,,278,RC,outpatient,,1527.5,1527.5,,1296.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,381.88,22,,percent of total billed charges,,,,,,,,,1374.75,90,,percent of total billed charges,,,1264.77,82.8,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,,,,,,,,1344.2,88,,percent of total billed charges,,,,,,,,,1167.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,381.88,22,,percent of total billed charges,,,1390.03,91,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1267.83,83,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1252.55,82,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,381.88,1451.13,
ARTHREX SCREW PT 3.0 X 38MM,30184644,CDM,,,278,RC,outpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210,22,,percent of total billed charges,,,,,,,,,756,90,,percent of total billed charges,,,695.52,82.8,,percent of total billed charges,,,714,85,,percent of total billed charges,,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210,22,,percent of total billed charges,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,210,798,
ARTHREX SCREW CORTICAL 3.0 X 16MM,30184645,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
SCREW POLYAXIAL 6.5 X 50MM,30184646,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SCREW POLYAXIAL 6.5 X 55MM,30184647,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SCREW POLYAXIAL 6.5 X 60MM,30184648,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SCREW POLYAXIAL 7.5 X 55MM,30184649,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SCREW SET,30184650,CDM,,,278,RC,outpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175,22,,percent of total billed charges,,,,,,,,,630,90,,percent of total billed charges,,,579.6,82.8,,percent of total billed charges,,,595,85,,percent of total billed charges,,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175,22,,percent of total billed charges,,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,175,665,
ROD 6.0 X 440MM,30184651,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
PEEK HORNET 25 X 11 X 9MM 0DEG,30184652,CDM,,,278,RC,outpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4225,22,,percent of total billed charges,,,,,,,,,15210,90,,percent of total billed charges,,,13993.2,82.8,,percent of total billed charges,,,14365,85,,percent of total billed charges,,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4225,22,,percent of total billed charges,,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,4225,16055,
PEEK HORNET 25 X 11 X 11MM 0DEG,30184653,CDM,,,278,RC,outpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4225,22,,percent of total billed charges,,,,,,,,,15210,90,,percent of total billed charges,,,13993.2,82.8,,percent of total billed charges,,,14365,85,,percent of total billed charges,,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4225,22,,percent of total billed charges,,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,4225,16055,
ARTHREX BUTTON ABS 8 X 12,30184654,CDM,,,278,RC,outpatient,,929.5,929.5,,789.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,232.38,22,,percent of total billed charges,,,,,,,,,836.55,90,,percent of total billed charges,,,769.63,82.8,,percent of total billed charges,,,790.08,85,,percent of total billed charges,,,,,,,,,817.96,88,,percent of total billed charges,,,,,,,,,710.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,232.38,22,,percent of total billed charges,,,845.85,91,,percent of total billed charges,,,883.03,95,,percent of total billed charges,,,771.49,83,,percent of total billed charges,,,771.49,83,,percent of total billed charges,,,,,,,,,,,,,,,771.49,83,,percent of total billed charges,,,883.03,95,,percent of total billed charges,,,836.55,90,,percent of total billed charges,,,836.55,90,,percent of total billed charges,,,762.19,82,,percent of total billed charges,,,836.55,90,,percent of total billed charges,,,790.08,85,,percent of total billed charges,,232.38,883.03,
SPINECRAFT PLATE VELOX 48MM 3 LEVELS,30184655,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
MESH VITA RECTANGLE 12X12,30184656,CDM,,,270,RC,outpatient,,1160.25,1160.25,,985.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,290.06,22,,percent of total billed charges,,,,,,,,,1044.23,90,,percent of total billed charges,,,960.69,82.8,,percent of total billed charges,,,986.21,85,,percent of total billed charges,,,,,,,,,1021.02,88,,percent of total billed charges,,,,,,,,,886.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,290.06,22,,percent of total billed charges,,,1055.83,91,,percent of total billed charges,,,1102.24,95,,percent of total billed charges,,,963.01,83,,percent of total billed charges,,,963.01,83,,percent of total billed charges,,,,,,,,,,,,,,,963.01,83,,percent of total billed charges,,,1102.24,95,,percent of total billed charges,,,1044.23,90,,percent of total billed charges,,,1044.23,90,,percent of total billed charges,,,951.41,82,,percent of total billed charges,,,1044.23,90,,percent of total billed charges,,,986.21,85,,percent of total billed charges,,290.06,1102.24,
MESH MOSAIC 15CM ROUND,30184657,CDM,,,270,RC,outpatient,,3524.89,3524.89,,2992.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,881.22,22,,percent of total billed charges,,,,,,,,,3172.4,90,,percent of total billed charges,,,2918.61,82.8,,percent of total billed charges,,,2996.16,85,,percent of total billed charges,,,,,,,,,3101.9,88,,percent of total billed charges,,,,,,,,,2693.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,881.22,22,,percent of total billed charges,,,3207.65,91,,percent of total billed charges,,,3348.65,95,,percent of total billed charges,,,2925.66,83,,percent of total billed charges,,,2925.66,83,,percent of total billed charges,,,,,,,,,,,,,,,2925.66,83,,percent of total billed charges,,,3348.65,95,,percent of total billed charges,,,3172.4,90,,percent of total billed charges,,,3172.4,90,,percent of total billed charges,,,2890.41,82,,percent of total billed charges,,,3172.4,90,,percent of total billed charges,,,2996.16,85,,percent of total billed charges,,881.22,3348.65,
MESH MOSAIC 4X6 OBLONG,30184658,CDM,,,270,RC,outpatient,,2150.01,2150.01,,1825.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,537.5,22,,percent of total billed charges,,,,,,,,,1935.01,90,,percent of total billed charges,,,1780.21,82.8,,percent of total billed charges,,,1827.51,85,,percent of total billed charges,,,,,,,,,1892.01,88,,percent of total billed charges,,,,,,,,,1642.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,537.5,22,,percent of total billed charges,,,1956.51,91,,percent of total billed charges,,,2042.51,95,,percent of total billed charges,,,1784.51,83,,percent of total billed charges,,,1784.51,83,,percent of total billed charges,,,,,,,,,,,,,,,1784.51,83,,percent of total billed charges,,,2042.51,95,,percent of total billed charges,,,1935.01,90,,percent of total billed charges,,,1935.01,90,,percent of total billed charges,,,1763.01,82,,percent of total billed charges,,,1935.01,90,,percent of total billed charges,,,1827.51,85,,percent of total billed charges,,537.5,2042.51,
DEPUY FEMUR ATTUNE PS 9 RIGHT,30184659,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY SUMMIT STD CEMENTED SZ 4,30184662,CDM,,,278,RC,outpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6361.02,22,,percent of total billed charges,,,,,,,,,22899.65,90,,percent of total billed charges,,,21067.68,82.8,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6361.02,22,,percent of total billed charges,,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,6361.02,24171.86,
DEPUY PRIMARY BIPOLAR CAP,30184663,CDM,,,278,RC,outpatient,,31200,31200,,26488.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7800,22,,percent of total billed charges,,,,,,,,,28080,90,,percent of total billed charges,,,25833.6,82.8,,percent of total billed charges,,,26520,85,,percent of total billed charges,,,,,,,,,27456,88,,percent of total billed charges,,,,,,,,,23836.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7800,22,,percent of total billed charges,,,28392,91,,percent of total billed charges,,,29640,95,,percent of total billed charges,,,25896,83,,percent of total billed charges,,,25896,83,,percent of total billed charges,,,,,,,,,,,,,,,25896,83,,percent of total billed charges,,,29640,95,,percent of total billed charges,,,28080,90,,percent of total billed charges,,,28080,90,,percent of total billed charges,,,25584,82,,percent of total billed charges,,,28080,90,,percent of total billed charges,,,26520,85,,percent of total billed charges,,7800,29640,
SCREW POLYAXIAL 6.5 X 40MM,30184664,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SCREW RESUCTION 6.5 X 50MM,30184665,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ROD LORDOSES 6.0 X 50MM,30184666,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
PEEK CORTINA 9 X 25 X 9MM,30184667,CDM,,,278,RC,outpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4225,22,,percent of total billed charges,,,,,,,,,15210,90,,percent of total billed charges,,,13993.2,82.8,,percent of total billed charges,,,14365,85,,percent of total billed charges,,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4225,22,,percent of total billed charges,,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,4225,16055,
SCREW POLYAXIAL 6.5 X 45MM,30184668,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
PEEK HORNET 11 X 25 X 11 MM 0 DEG,30184669,CDM,,,278,RC,outpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4225,22,,percent of total billed charges,,,,,,,,,15210,90,,percent of total billed charges,,,13993.2,82.8,,percent of total billed charges,,,14365,85,,percent of total billed charges,,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4225,22,,percent of total billed charges,,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,4225,16055,
SYNTHES PLATE DISTAL RADIUS 7X3,30184671,CDM,,,278,RC,outpatient,,9762.68,9762.68,,8288.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2440.67,22,,percent of total billed charges,,,,,,,,,8786.41,90,,percent of total billed charges,,,8083.5,82.8,,percent of total billed charges,,,8298.28,85,,percent of total billed charges,,,,,,,,,8591.16,88,,percent of total billed charges,,,,,,,,,7458.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2440.67,22,,percent of total billed charges,,,8884.04,91,,percent of total billed charges,,,9274.55,95,,percent of total billed charges,,,8103.02,83,,percent of total billed charges,,,8103.02,83,,percent of total billed charges,,,,,,,,,,,,,,,8103.02,83,,percent of total billed charges,,,9274.55,95,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8005.4,82,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8298.28,85,,percent of total billed charges,,2440.67,9274.55,
SYNTHES SCREW CORTEX 2.4 X 30MM,30184672,CDM,,,278,RC,outpatient,,565.25,565.25,,479.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141.31,22,,percent of total billed charges,,,,,,,,,508.73,90,,percent of total billed charges,,,468.03,82.8,,percent of total billed charges,,,480.46,85,,percent of total billed charges,,,,,,,,,497.42,88,,percent of total billed charges,,,,,,,,,431.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141.31,22,,percent of total billed charges,,,514.38,91,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,,,,,,,,,,,,,469.16,83,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,463.51,82,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,480.46,85,,percent of total billed charges,,141.31,536.99,
SYNTHES PLATE T DORSAL 2.4MM VA,30184673,CDM,,,278,RC,outpatient,,6226.68,6226.68,,5286.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1556.67,22,,percent of total billed charges,,,,,,,,,5604.01,90,,percent of total billed charges,,,5155.69,82.8,,percent of total billed charges,,,5292.68,85,,percent of total billed charges,,,,,,,,,5479.48,88,,percent of total billed charges,,,,,,,,,4757.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1556.67,22,,percent of total billed charges,,,5666.28,91,,percent of total billed charges,,,5915.35,95,,percent of total billed charges,,,5168.14,83,,percent of total billed charges,,,5168.14,83,,percent of total billed charges,,,,,,,,,,,,,,,5168.14,83,,percent of total billed charges,,,5915.35,95,,percent of total billed charges,,,5604.01,90,,percent of total billed charges,,,5604.01,90,,percent of total billed charges,,,5105.88,82,,percent of total billed charges,,,5604.01,90,,percent of total billed charges,,,5292.68,85,,percent of total billed charges,,1556.67,5915.35,
STRYKER  CEMENT TOWER REVOLUTION,30184674,CDM,,,270,RC,outpatient,,674.98,674.98,,573.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,168.75,22,,percent of total billed charges,,,,,,,,,607.48,90,,percent of total billed charges,,,558.88,82.8,,percent of total billed charges,,,573.73,85,,percent of total billed charges,,,,,,,,,593.98,88,,percent of total billed charges,,,,,,,,,515.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,168.75,22,,percent of total billed charges,,,614.23,91,,percent of total billed charges,,,641.23,95,,percent of total billed charges,,,560.23,83,,percent of total billed charges,,,560.23,83,,percent of total billed charges,,,,,,,,,,,,,,,560.23,83,,percent of total billed charges,,,641.23,95,,percent of total billed charges,,,607.48,90,,percent of total billed charges,,,607.48,90,,percent of total billed charges,,,553.48,82,,percent of total billed charges,,,607.48,90,,percent of total billed charges,,,573.73,85,,percent of total billed charges,,168.75,641.23,
MEDIVATORS ENDOCUFF GREEN - ADULT,30184675,CDM,,,270,RC,outpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.25,22,,percent of total billed charges,,,,,,,,,202.5,90,,percent of total billed charges,,,186.3,82.8,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.25,22,,percent of total billed charges,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,56.25,213.75,
DEPUY FEMUR SIGMA SZ 4N RIGHT,30184677,CDM,,,278,RC,outpatient,,23868.72,23868.72,,20264.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5967.18,22,,percent of total billed charges,,,,,,,,,21481.85,90,,percent of total billed charges,,,19763.3,82.8,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,,,,,,,,21004.47,88,,percent of total billed charges,,,,,,,,,18235.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5967.18,22,,percent of total billed charges,,,21720.54,91,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19811.04,83,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,19572.35,82,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,5967.18,22675.28,
DEPUY GLENOID SZ 40,30184678,CDM,,,278,RC,outpatient,,17098.9,17098.9,,14516.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4274.73,22,,percent of total billed charges,,,,,,,,,15389.01,90,,percent of total billed charges,,,14157.89,82.8,,percent of total billed charges,,,14534.07,85,,percent of total billed charges,,,,,,,,,15047.03,88,,percent of total billed charges,,,,,,,,,13063.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4274.73,22,,percent of total billed charges,,,15560,91,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,14192.09,83,,percent of total billed charges,,,,,,,,,,,,,,,14192.09,83,,percent of total billed charges,,,16243.96,95,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14021.1,82,,percent of total billed charges,,,15389.01,90,,percent of total billed charges,,,14534.07,85,,percent of total billed charges,,4274.73,16243.96,
NEUROMONITORING SPECIALTYCARE,30184679,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
DEPUY SUMMIT CEMENTED SZ 5 STD,30184682,CDM,,,278,RC,outpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6361.02,22,,percent of total billed charges,,,,,,,,,22899.65,90,,percent of total billed charges,,,21067.68,82.8,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6361.02,22,,percent of total billed charges,,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,6361.02,24171.86,
DEPUY STEM CENTRALIZER 12MM,30184683,CDM,,,278,RC,outpatient,,904.8,904.8,,768.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,226.2,22,,percent of total billed charges,,,,,,,,,814.32,90,,percent of total billed charges,,,749.17,82.8,,percent of total billed charges,,,769.08,85,,percent of total billed charges,,,,,,,,,796.22,88,,percent of total billed charges,,,,,,,,,691.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,226.2,22,,percent of total billed charges,,,823.37,91,,percent of total billed charges,,,859.56,95,,percent of total billed charges,,,750.98,83,,percent of total billed charges,,,750.98,83,,percent of total billed charges,,,,,,,,,,,,,,,750.98,83,,percent of total billed charges,,,859.56,95,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,741.94,82,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,769.08,85,,percent of total billed charges,,226.2,859.56,
BRACE INNOVATOR DLX+ COOL,30184684,CDM,,,270,RC,outpatient,,641.27,641.27,,544.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,160.32,22,,percent of total billed charges,,,,,,,,,577.14,90,,percent of total billed charges,,,530.97,82.8,,percent of total billed charges,,,545.08,85,,percent of total billed charges,,,,,,,,,564.32,88,,percent of total billed charges,,,,,,,,,489.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,160.32,22,,percent of total billed charges,,,583.56,91,,percent of total billed charges,,,609.21,95,,percent of total billed charges,,,532.25,83,,percent of total billed charges,,,532.25,83,,percent of total billed charges,,,,,,,,,,,,,,,532.25,83,,percent of total billed charges,,,609.21,95,,percent of total billed charges,,,577.14,90,,percent of total billed charges,,,577.14,90,,percent of total billed charges,,,525.84,82,,percent of total billed charges,,,577.14,90,,percent of total billed charges,,,545.08,85,,percent of total billed charges,,160.32,609.21,
SYNTHES DRILL TIP WIRE 2.5 X 300MM,30184685,CDM,,,270,RC,outpatient,,714,714,,606.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.5,22,,percent of total billed charges,,,,,,,,,642.6,90,,percent of total billed charges,,,591.19,82.8,,percent of total billed charges,,,606.9,85,,percent of total billed charges,,,,,,,,,628.32,88,,percent of total billed charges,,,,,,,,,545.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.5,22,,percent of total billed charges,,,649.74,91,,percent of total billed charges,,,678.3,95,,percent of total billed charges,,,592.62,83,,percent of total billed charges,,,592.62,83,,percent of total billed charges,,,,,,,,,,,,,,,592.62,83,,percent of total billed charges,,,678.3,95,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,585.48,82,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,606.9,85,,percent of total billed charges,,178.5,678.3,
SYNTHES DRILL BIT CANNULATED 4.3MM,30184686,CDM,,,278,RC,outpatient,,3364.73,3364.73,,2856.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,841.18,22,,percent of total billed charges,,,,,,,,,3028.26,90,,percent of total billed charges,,,2786,82.8,,percent of total billed charges,,,2860.02,85,,percent of total billed charges,,,,,,,,,2960.96,88,,percent of total billed charges,,,,,,,,,2570.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,841.18,22,,percent of total billed charges,,,3061.9,91,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2792.73,83,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2759.08,82,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2860.02,85,,percent of total billed charges,,841.18,3196.49,
SYNTHES K-WIRE THREADED 2.0MM,30184687,CDM,,,278,RC,outpatient,,410.55,410.55,,348.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,102.64,22,,percent of total billed charges,,,,,,,,,369.5,90,,percent of total billed charges,,,339.94,82.8,,percent of total billed charges,,,348.97,85,,percent of total billed charges,,,,,,,,,361.28,88,,percent of total billed charges,,,,,,,,,313.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,102.64,22,,percent of total billed charges,,,373.6,91,,percent of total billed charges,,,390.02,95,,percent of total billed charges,,,340.76,83,,percent of total billed charges,,,340.76,83,,percent of total billed charges,,,,,,,,,,,,,,,340.76,83,,percent of total billed charges,,,390.02,95,,percent of total billed charges,,,369.5,90,,percent of total billed charges,,,369.5,90,,percent of total billed charges,,,336.65,82,,percent of total billed charges,,,369.5,90,,percent of total billed charges,,,348.97,85,,percent of total billed charges,,102.64,390.02,
SYNTHES SCREW LOCKING 5 X 80MM ANGLED,30184688,CDM,,,278,RC,outpatient,,1701.7,1701.7,,1444.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,425.43,22,,percent of total billed charges,,,,,,,,,1531.53,90,,percent of total billed charges,,,1409.01,82.8,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,,,,,,,,1497.5,88,,percent of total billed charges,,,,,,,,,1300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,425.43,22,,percent of total billed charges,,,1548.55,91,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1412.41,83,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1395.39,82,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,425.43,1616.62,
SYNTHES SCREW LOCKING 5 X 46MM ANGLED,30184689,CDM,,,278,RC,outpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,438.18,22,,percent of total billed charges,,,,,,,,,1577.46,90,,percent of total billed charges,,,1451.26,82.8,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,438.18,22,,percent of total billed charges,,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,438.18,1665.09,
SYNTHES SCREW LOCKING 5 X 44MM ANGLED,30184690,CDM,,,278,RC,outpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,438.18,22,,percent of total billed charges,,,,,,,,,1577.46,90,,percent of total billed charges,,,1451.26,82.8,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,438.18,22,,percent of total billed charges,,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,438.18,1665.09,
SYNTHES SCREW LOCKING 5 X 40MM ANGLED,30184691,CDM,,,278,RC,outpatient,,1701.7,1701.7,,1444.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,425.43,22,,percent of total billed charges,,,,,,,,,1531.53,90,,percent of total billed charges,,,1409.01,82.8,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,,,,,,,,1497.5,88,,percent of total billed charges,,,,,,,,,1300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,425.43,22,,percent of total billed charges,,,1548.55,91,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1412.41,83,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1395.39,82,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,425.43,1616.62,
SYNTHES SCREW LOCKING 5 X 20MM ANGLED,30184692,CDM,,,278,RC,outpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,438.18,22,,percent of total billed charges,,,,,,,,,1577.46,90,,percent of total billed charges,,,1451.26,82.8,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,438.18,22,,percent of total billed charges,,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,438.18,1665.09,
SYNTHES PLATE VA 4.5MM 16 HOLE CONDYLAR,30184693,CDM,,,278,RC,outpatient,,21171.8,21171.8,,17974.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5292.95,22,,percent of total billed charges,,,,,,,,,19054.62,90,,percent of total billed charges,,,17530.25,82.8,,percent of total billed charges,,,17996.03,85,,percent of total billed charges,,,,,,,,,18631.18,88,,percent of total billed charges,,,,,,,,,16175.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5292.95,22,,percent of total billed charges,,,19266.34,91,,percent of total billed charges,,,20113.21,95,,percent of total billed charges,,,17572.59,83,,percent of total billed charges,,,17572.59,83,,percent of total billed charges,,,,,,,,,,,,,,,17572.59,83,,percent of total billed charges,,,20113.21,95,,percent of total billed charges,,,19054.62,90,,percent of total billed charges,,,19054.62,90,,percent of total billed charges,,,17360.88,82,,percent of total billed charges,,,19054.62,90,,percent of total billed charges,,,17996.03,85,,percent of total billed charges,,5292.95,20113.21,
DEPUY FEMUR SIGMA PS SZ 5 LEFT,30184694,CDM,,,278,RC,outpatient,,23868.72,23868.72,,20264.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5967.18,22,,percent of total billed charges,,,,,,,,,21481.85,90,,percent of total billed charges,,,19763.3,82.8,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,,,,,,,,21004.47,88,,percent of total billed charges,,,,,,,,,18235.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5967.18,22,,percent of total billed charges,,,21720.54,91,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,19811.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19811.04,83,,percent of total billed charges,,,22675.28,95,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,19572.35,82,,percent of total billed charges,,,21481.85,90,,percent of total billed charges,,,20288.41,85,,percent of total billed charges,,5967.18,22675.28,
ZIMMER OXF TIBIAL BEARING MEDIUM,30184695,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
DEPUY LINER ALTRX +4 NEUT 36 X 62,30184696,CDM,,,278,RC,outpatient,,14161.81,14161.81,,12023.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3540.45,22,,percent of total billed charges,,,,,,,,,12745.63,90,,percent of total billed charges,,,11725.98,82.8,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,,,,,,,,12462.39,88,,percent of total billed charges,,,,,,,,,10819.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3540.45,22,,percent of total billed charges,,,12887.25,91,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,,,,,,,,,,,,,11754.3,83,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,11612.68,82,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,3540.45,13453.72,
SYNTHES SCREW CORTEX 2.4 X 30MM,30184697,CDM,,,278,RC,outpatient,,472.5,472.5,,401.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,118.13,22,,percent of total billed charges,,,,,,,,,425.25,90,,percent of total billed charges,,,391.23,82.8,,percent of total billed charges,,,401.63,85,,percent of total billed charges,,,,,,,,,415.8,88,,percent of total billed charges,,,,,,,,,360.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,118.13,22,,percent of total billed charges,,,429.98,91,,percent of total billed charges,,,448.88,95,,percent of total billed charges,,,392.18,83,,percent of total billed charges,,,392.18,83,,percent of total billed charges,,,,,,,,,,,,,,,392.18,83,,percent of total billed charges,,,448.88,95,,percent of total billed charges,,,425.25,90,,percent of total billed charges,,,425.25,90,,percent of total billed charges,,,387.45,82,,percent of total billed charges,,,425.25,90,,percent of total billed charges,,,401.63,85,,percent of total billed charges,,118.13,448.88,
SYNTHES SCREW CORTEX 2.4 X 12MM,30184698,CDM,,,278,RC,outpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149.92,22,,percent of total billed charges,,,,,,,,,539.72,90,,percent of total billed charges,,,496.54,82.8,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149.92,22,,percent of total billed charges,,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,149.92,569.71,
HOOD PROTECTOR FOREIGN BODY,30184699,CDM,,,270,RC,outpatient,,283.8,283.8,,240.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.95,22,,percent of total billed charges,,,,,,,,,255.42,90,,percent of total billed charges,,,234.99,82.8,,percent of total billed charges,,,241.23,85,,percent of total billed charges,,,,,,,,,249.74,88,,percent of total billed charges,,,,,,,,,216.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70.95,22,,percent of total billed charges,,,258.26,91,,percent of total billed charges,,,269.61,95,,percent of total billed charges,,,235.55,83,,percent of total billed charges,,,235.55,83,,percent of total billed charges,,,,,,,,,,,,,,,235.55,83,,percent of total billed charges,,,269.61,95,,percent of total billed charges,,,255.42,90,,percent of total billed charges,,,255.42,90,,percent of total billed charges,,,232.72,82,,percent of total billed charges,,,255.42,90,,percent of total billed charges,,,241.23,85,,percent of total billed charges,,70.95,269.61,
ENDOSCOPIC SPRAY SET 360DEG APPLICATOR,30184703,CDM,,,270,RC,outpatient,,931.36,931.36,,790.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,232.84,22,,percent of total billed charges,,,,,,,,,838.22,90,,percent of total billed charges,,,771.17,82.8,,percent of total billed charges,,,791.66,85,,percent of total billed charges,,,,,,,,,819.6,88,,percent of total billed charges,,,,,,,,,711.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,232.84,22,,percent of total billed charges,,,847.54,91,,percent of total billed charges,,,884.79,95,,percent of total billed charges,,,773.03,83,,percent of total billed charges,,,773.03,83,,percent of total billed charges,,,,,,,,,,,,,,,773.03,83,,percent of total billed charges,,,884.79,95,,percent of total billed charges,,,838.22,90,,percent of total billed charges,,,838.22,90,,percent of total billed charges,,,763.72,82,,percent of total billed charges,,,838.22,90,,percent of total billed charges,,,791.66,85,,percent of total billed charges,,232.84,884.79,
TISSEEL SPRAY SET,30184704,CDM,,,270,RC,outpatient,,368.48,368.48,,312.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.12,22,,percent of total billed charges,,,,,,,,,331.63,90,,percent of total billed charges,,,305.1,82.8,,percent of total billed charges,,,313.21,85,,percent of total billed charges,,,,,,,,,324.26,88,,percent of total billed charges,,,,,,,,,281.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.12,22,,percent of total billed charges,,,335.32,91,,percent of total billed charges,,,350.06,95,,percent of total billed charges,,,305.84,83,,percent of total billed charges,,,305.84,83,,percent of total billed charges,,,,,,,,,,,,,,,305.84,83,,percent of total billed charges,,,350.06,95,,percent of total billed charges,,,331.63,90,,percent of total billed charges,,,331.63,90,,percent of total billed charges,,,302.15,82,,percent of total billed charges,,,331.63,90,,percent of total billed charges,,,313.21,85,,percent of total billed charges,,92.12,350.06,
SYNTHES SCREW CORTEX S-T 2.4X12MM STERIL,30184705,CDM,,,278,RC,outpatient,,827.05,827.05,,702.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.76,22,,percent of total billed charges,,,,,,,,,744.35,90,,percent of total billed charges,,,684.8,82.8,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,,,,,,,,727.8,88,,percent of total billed charges,,,,,,,,,631.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.76,22,,percent of total billed charges,,,752.62,91,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,,,,,,,,,,,,,686.45,83,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,678.18,82,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,206.76,785.7,
SYNTHES SCREW CORTEX S-T 2.4X24MM,30184706,CDM,,,278,RC,outpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149.92,22,,percent of total billed charges,,,,,,,,,539.72,90,,percent of total billed charges,,,496.54,82.8,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149.92,22,,percent of total billed charges,,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,149.92,569.71,
ZIMMER NECK MODULAR SZ R,30184708,CDM,,,278,RC,outpatient,,15060.5,15060.5,,12786.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3765.13,22,,percent of total billed charges,,,,,,,,,13554.45,90,,percent of total billed charges,,,12470.09,82.8,,percent of total billed charges,,,12801.43,85,,percent of total billed charges,,,,,,,,,13253.24,88,,percent of total billed charges,,,,,,,,,11506.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3765.13,22,,percent of total billed charges,,,13705.06,91,,percent of total billed charges,,,14307.48,95,,percent of total billed charges,,,12500.22,83,,percent of total billed charges,,,12500.22,83,,percent of total billed charges,,,,,,,,,,,,,,,12500.22,83,,percent of total billed charges,,,14307.48,95,,percent of total billed charges,,,13554.45,90,,percent of total billed charges,,,13554.45,90,,percent of total billed charges,,,12349.61,82,,percent of total billed charges,,,13554.45,90,,percent of total billed charges,,,12801.43,85,,percent of total billed charges,,3765.13,14307.48,
DEPUY LINER 40 X 60 N,30184709,CDM,,,278,RC,outpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4400.13,22,,percent of total billed charges,,,,,,,,,15840.46,90,,percent of total billed charges,,,14573.22,82.8,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4400.13,22,,percent of total billed charges,,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,4400.13,16720.48,
DEPUY STEM CORAIL KLA,30184710,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY HEAD SROM 32MM +0,30184711,CDM,,,278,RC,outpatient,,6061.9,6061.9,,5146.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1515.48,22,,percent of total billed charges,,,,,,,,,5455.71,90,,percent of total billed charges,,,5019.25,82.8,,percent of total billed charges,,,5152.62,85,,percent of total billed charges,,,,,,,,,5334.47,88,,percent of total billed charges,,,,,,,,,4631.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1515.48,22,,percent of total billed charges,,,5516.33,91,,percent of total billed charges,,,5758.81,95,,percent of total billed charges,,,5031.38,83,,percent of total billed charges,,,5031.38,83,,percent of total billed charges,,,,,,,,,,,,,,,5031.38,83,,percent of total billed charges,,,5758.81,95,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,4970.76,82,,percent of total billed charges,,,5455.71,90,,percent of total billed charges,,,5152.62,85,,percent of total billed charges,,1515.48,5758.81,
SYNTHES DRILL BIT 4.5MM QUICK CONNECT,30184712,CDM,,,270,RC,outpatient,,782.74,782.74,,664.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195.69,22,,percent of total billed charges,,,,,,,,,704.47,90,,percent of total billed charges,,,648.11,82.8,,percent of total billed charges,,,665.33,85,,percent of total billed charges,,,,,,,,,688.81,88,,percent of total billed charges,,,,,,,,,598.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195.69,22,,percent of total billed charges,,,712.29,91,,percent of total billed charges,,,743.6,95,,percent of total billed charges,,,649.67,83,,percent of total billed charges,,,649.67,83,,percent of total billed charges,,,,,,,,,,,,,,,649.67,83,,percent of total billed charges,,,743.6,95,,percent of total billed charges,,,704.47,90,,percent of total billed charges,,,704.47,90,,percent of total billed charges,,,641.85,82,,percent of total billed charges,,,704.47,90,,percent of total billed charges,,,665.33,85,,percent of total billed charges,,195.69,743.6,
SPINECRAFT CAGE ORIO W/PEEK 7MM,30184713,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
SPINECRAFT PLATE VELOX 1 LEVE 12MM,30184714,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
SYNTHES BLADE HELICAL TFNA 100MM,30184715,CDM,,,278,RC,outpatient,,6630,6630,,5628.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1657.5,22,,percent of total billed charges,,,,,,,,,5967,90,,percent of total billed charges,,,5489.64,82.8,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,,,,,,,,5834.4,88,,percent of total billed charges,,,,,,,,,5065.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1657.5,22,,percent of total billed charges,,,6033.3,91,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,,,,,,,,,,,,,5502.9,83,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5436.6,82,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,1657.5,6298.5,
SYNTHES TFNA 12MM X 400MM 130DEG RT,30184716,CDM,,,278,RC,outpatient,,21149.7,21149.7,,17956.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5287.43,22,,percent of total billed charges,,,,,,,,,19034.73,90,,percent of total billed charges,,,17511.95,82.8,,percent of total billed charges,,,17977.25,85,,percent of total billed charges,,,,,,,,,18611.74,88,,percent of total billed charges,,,,,,,,,16158.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5287.43,22,,percent of total billed charges,,,19246.23,91,,percent of total billed charges,,,20092.22,95,,percent of total billed charges,,,17554.25,83,,percent of total billed charges,,,17554.25,83,,percent of total billed charges,,,,,,,,,,,,,,,17554.25,83,,percent of total billed charges,,,20092.22,95,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,17342.75,82,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,17977.25,85,,percent of total billed charges,,5287.43,20092.22,
SYNTHES COUNTERSINK 2.7MM,30184717,CDM,,,278,RC,outpatient,,2640.95,2640.95,,2242.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,660.24,22,,percent of total billed charges,,,,,,,,,2376.86,90,,percent of total billed charges,,,2186.71,82.8,,percent of total billed charges,,,2244.81,85,,percent of total billed charges,,,,,,,,,2324.04,88,,percent of total billed charges,,,,,,,,,2017.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,660.24,22,,percent of total billed charges,,,2403.26,91,,percent of total billed charges,,,2508.9,95,,percent of total billed charges,,,2191.99,83,,percent of total billed charges,,,2191.99,83,,percent of total billed charges,,,,,,,,,,,,,,,2191.99,83,,percent of total billed charges,,,2508.9,95,,percent of total billed charges,,,2376.86,90,,percent of total billed charges,,,2376.86,90,,percent of total billed charges,,,2165.58,82,,percent of total billed charges,,,2376.86,90,,percent of total billed charges,,,2244.81,85,,percent of total billed charges,,660.24,2508.9,
SYNTHES SCREW CORTEX 2.7 X 28MM,30184718,CDM,,,278,RC,outpatient,,386.75,386.75,,328.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.69,22,,percent of total billed charges,,,,,,,,,348.08,90,,percent of total billed charges,,,320.23,82.8,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,,,,,,,,340.34,88,,percent of total billed charges,,,,,,,,,295.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.69,22,,percent of total billed charges,,,351.94,91,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,321,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,,,,,,,,,,,,,,321,83,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,317.14,82,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,96.69,367.41,
ZIMMER INSERT BEARING SZ 4 SM RT,30184720,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
DEPUY SCREW LOCKING 24MM,30184721,CDM,,,278,RC,outpatient,,2237.76,2237.76,,1899.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,559.44,22,,percent of total billed charges,,,,,,,,,2013.98,90,,percent of total billed charges,,,1852.87,82.8,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,,,,,,,,1969.23,88,,percent of total billed charges,,,,,,,,,1709.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,559.44,22,,percent of total billed charges,,,2036.36,91,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1857.34,83,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1834.96,82,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,559.44,2125.87,
SYNTHES CLAMP HOLDING 1.25MM,30184723,CDM,,,270,RC,outpatient,,7160.4,7160.4,,6079.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1790.1,22,,percent of total billed charges,,,,,,,,,6444.36,90,,percent of total billed charges,,,5928.81,82.8,,percent of total billed charges,,,6086.34,85,,percent of total billed charges,,,,,,,,,6301.15,88,,percent of total billed charges,,,,,,,,,5470.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1790.1,22,,percent of total billed charges,,,6515.96,91,,percent of total billed charges,,,6802.38,95,,percent of total billed charges,,,5943.13,83,,percent of total billed charges,,,5943.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5943.13,83,,percent of total billed charges,,,6802.38,95,,percent of total billed charges,,,6444.36,90,,percent of total billed charges,,,6444.36,90,,percent of total billed charges,,,5871.53,82,,percent of total billed charges,,,6444.36,90,,percent of total billed charges,,,6086.34,85,,percent of total billed charges,,1790.1,6802.38,
SYNTHES ROD CARBON 3.0 X 60MM,30184724,CDM,,,270,RC,outpatient,,446.25,446.25,,378.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,111.56,22,,percent of total billed charges,,,,,,,,,401.63,90,,percent of total billed charges,,,369.5,82.8,,percent of total billed charges,,,379.31,85,,percent of total billed charges,,,,,,,,,392.7,88,,percent of total billed charges,,,,,,,,,340.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,111.56,22,,percent of total billed charges,,,406.09,91,,percent of total billed charges,,,423.94,95,,percent of total billed charges,,,370.39,83,,percent of total billed charges,,,370.39,83,,percent of total billed charges,,,,,,,,,,,,,,,370.39,83,,percent of total billed charges,,,423.94,95,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,365.93,82,,percent of total billed charges,,,401.63,90,,percent of total billed charges,,,379.31,85,,percent of total billed charges,,111.56,423.94,
SYNTHES KWIRE THREADED TIP 1.25 X 100MM,30184725,CDM,,,270,RC,outpatient,,474.22,474.22,,402.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,118.56,22,,percent of total billed charges,,,,,,,,,426.8,90,,percent of total billed charges,,,392.65,82.8,,percent of total billed charges,,,403.09,85,,percent of total billed charges,,,,,,,,,417.31,88,,percent of total billed charges,,,,,,,,,362.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,118.56,22,,percent of total billed charges,,,431.54,91,,percent of total billed charges,,,450.51,95,,percent of total billed charges,,,393.6,83,,percent of total billed charges,,,393.6,83,,percent of total billed charges,,,,,,,,,,,,,,,393.6,83,,percent of total billed charges,,,450.51,95,,percent of total billed charges,,,426.8,90,,percent of total billed charges,,,426.8,90,,percent of total billed charges,,,388.86,82,,percent of total billed charges,,,426.8,90,,percent of total billed charges,,,403.09,85,,percent of total billed charges,,118.56,450.51,
ROD LORDOSES 6.0 X 60MM,30184726,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
DEPUY INSERT AOX RP 5MM,30184727,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
PROCLAIM 7 ELITE CONTROL SYSTEM,30184731,CDM,,,278,RC,outpatient,,143000,143000,,121407,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35750,22,,percent of total billed charges,,,,,,,,,128700,90,,percent of total billed charges,,,118404,82.8,,percent of total billed charges,,,121550,85,,percent of total billed charges,,,,,,,,,125840,88,,percent of total billed charges,,,,,,,,,109252,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35750,22,,percent of total billed charges,,,130130,91,,percent of total billed charges,,,135850,95,,percent of total billed charges,,,118690,83,,percent of total billed charges,,,118690,83,,percent of total billed charges,,,,,,,,,,,,,,,118690,83,,percent of total billed charges,,,135850,95,,percent of total billed charges,,,128700,90,,percent of total billed charges,,,128700,90,,percent of total billed charges,,,117260,82,,percent of total billed charges,,,128700,90,,percent of total billed charges,,,121550,85,,percent of total billed charges,,35750,135850,
DEPUY INSERT RP SZ 6 10MM,30184732,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
STRYKER FEMORAL HD 28MM 0+,30184733,CDM,,,278,RC,outpatient,,6715.8,6715.8,,5701.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1678.95,22,,percent of total billed charges,,,,,,,,,6044.22,90,,percent of total billed charges,,,5560.68,82.8,,percent of total billed charges,,,5708.43,85,,percent of total billed charges,,,,,,,,,5909.9,88,,percent of total billed charges,,,,,,,,,5130.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1678.95,22,,percent of total billed charges,,,6111.38,91,,percent of total billed charges,,,6380.01,95,,percent of total billed charges,,,5574.11,83,,percent of total billed charges,,,5574.11,83,,percent of total billed charges,,,,,,,,,,,,,,,5574.11,83,,percent of total billed charges,,,6380.01,95,,percent of total billed charges,,,6044.22,90,,percent of total billed charges,,,6044.22,90,,percent of total billed charges,,,5506.96,82,,percent of total billed charges,,,6044.22,90,,percent of total billed charges,,,5708.43,85,,percent of total billed charges,,1678.95,6380.01,
SYNTHES SCREW CORTEX S-T 2.7X10MM,30184736,CDM,,,278,RC,outpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.46,22,,percent of total billed charges,,,,,,,,,397.66,90,,percent of total billed charges,,,365.84,82.8,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.46,22,,percent of total billed charges,,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,110.46,419.75,
SYNTHES SCREW CORTEX S-T 2.7X14MM,30184737,CDM,,,278,RC,outpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.46,22,,percent of total billed charges,,,,,,,,,397.66,90,,percent of total billed charges,,,365.84,82.8,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.46,22,,percent of total billed charges,,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,110.46,419.75,
SYNTHES PLATE LCP 6-HOLE 3.5MM 85MM,30184738,CDM,,,278,RC,outpatient,,2928.25,2928.25,,2486.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,732.06,22,,percent of total billed charges,,,,,,,,,2635.43,90,,percent of total billed charges,,,2424.59,82.8,,percent of total billed charges,,,2489.01,85,,percent of total billed charges,,,,,,,,,2576.86,88,,percent of total billed charges,,,,,,,,,2237.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,732.06,22,,percent of total billed charges,,,2664.71,91,,percent of total billed charges,,,2781.84,95,,percent of total billed charges,,,2430.45,83,,percent of total billed charges,,,2430.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2430.45,83,,percent of total billed charges,,,2781.84,95,,percent of total billed charges,,,2635.43,90,,percent of total billed charges,,,2635.43,90,,percent of total billed charges,,,2401.17,82,,percent of total billed charges,,,2635.43,90,,percent of total billed charges,,,2489.01,85,,percent of total billed charges,,732.06,2781.84,
SYNTHES COUNTERSINK,30184739,CDM,,,278,RC,outpatient,,2640.95,2640.95,,2242.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,660.24,22,,percent of total billed charges,,,,,,,,,2376.86,90,,percent of total billed charges,,,2186.71,82.8,,percent of total billed charges,,,2244.81,85,,percent of total billed charges,,,,,,,,,2324.04,88,,percent of total billed charges,,,,,,,,,2017.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,660.24,22,,percent of total billed charges,,,2403.26,91,,percent of total billed charges,,,2508.9,95,,percent of total billed charges,,,2191.99,83,,percent of total billed charges,,,2191.99,83,,percent of total billed charges,,,,,,,,,,,,,,,2191.99,83,,percent of total billed charges,,,2508.9,95,,percent of total billed charges,,,2376.86,90,,percent of total billed charges,,,2376.86,90,,percent of total billed charges,,,2165.58,82,,percent of total billed charges,,,2376.86,90,,percent of total billed charges,,,2244.81,85,,percent of total billed charges,,660.24,2508.9,
S&N DRILL BIT SHORT 2.7MM W/QC,30184740,CDM,,,278,RC,outpatient,,994.5,994.5,,844.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,248.63,22,,percent of total billed charges,,,,,,,,,895.05,90,,percent of total billed charges,,,823.45,82.8,,percent of total billed charges,,,845.33,85,,percent of total billed charges,,,,,,,,,875.16,88,,percent of total billed charges,,,,,,,,,759.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,248.63,22,,percent of total billed charges,,,905,91,,percent of total billed charges,,,944.78,95,,percent of total billed charges,,,825.44,83,,percent of total billed charges,,,825.44,83,,percent of total billed charges,,,,,,,,,,,,,,,825.44,83,,percent of total billed charges,,,944.78,95,,percent of total billed charges,,,895.05,90,,percent of total billed charges,,,895.05,90,,percent of total billed charges,,,815.49,82,,percent of total billed charges,,,895.05,90,,percent of total billed charges,,,845.33,85,,percent of total billed charges,,248.63,944.78,
S&N PLATE 7 HOLE RT 107MM,30184741,CDM,,,278,RC,outpatient,,7702.5,7702.5,,6539.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1925.63,22,,percent of total billed charges,,,,,,,,,6932.25,90,,percent of total billed charges,,,6377.67,82.8,,percent of total billed charges,,,6547.13,85,,percent of total billed charges,,,,,,,,,6778.2,88,,percent of total billed charges,,,,,,,,,5884.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1925.63,22,,percent of total billed charges,,,7009.28,91,,percent of total billed charges,,,7317.38,95,,percent of total billed charges,,,6393.08,83,,percent of total billed charges,,,6393.08,83,,percent of total billed charges,,,,,,,,,,,,,,,6393.08,83,,percent of total billed charges,,,7317.38,95,,percent of total billed charges,,,6932.25,90,,percent of total billed charges,,,6932.25,90,,percent of total billed charges,,,6316.05,82,,percent of total billed charges,,,6932.25,90,,percent of total billed charges,,,6547.13,85,,percent of total billed charges,,1925.63,7317.38,
S&N SCREW CORTEX 2.7MM S-T 16MM,30184742,CDM,,,278,RC,outpatient,,233.1,233.1,,197.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,58.28,22,,percent of total billed charges,,,,,,,,,209.79,90,,percent of total billed charges,,,193.01,82.8,,percent of total billed charges,,,198.14,85,,percent of total billed charges,,,,,,,,,205.13,88,,percent of total billed charges,,,,,,,,,178.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,58.28,22,,percent of total billed charges,,,212.12,91,,percent of total billed charges,,,221.45,95,,percent of total billed charges,,,193.47,83,,percent of total billed charges,,,193.47,83,,percent of total billed charges,,,,,,,,,,,,,,,193.47,83,,percent of total billed charges,,,221.45,95,,percent of total billed charges,,,209.79,90,,percent of total billed charges,,,209.79,90,,percent of total billed charges,,,191.14,82,,percent of total billed charges,,,209.79,90,,percent of total billed charges,,,198.14,85,,percent of total billed charges,,58.28,221.45,
S&N SCREW CORTEX 2.7MM S-T 18MM,30184743,CDM,,,278,RC,outpatient,,286.13,286.13,,242.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.53,22,,percent of total billed charges,,,,,,,,,257.52,90,,percent of total billed charges,,,236.92,82.8,,percent of total billed charges,,,243.21,85,,percent of total billed charges,,,,,,,,,251.79,88,,percent of total billed charges,,,,,,,,,218.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.53,22,,percent of total billed charges,,,260.38,91,,percent of total billed charges,,,271.82,95,,percent of total billed charges,,,237.49,83,,percent of total billed charges,,,237.49,83,,percent of total billed charges,,,,,,,,,,,,,,,237.49,83,,percent of total billed charges,,,271.82,95,,percent of total billed charges,,,257.52,90,,percent of total billed charges,,,257.52,90,,percent of total billed charges,,,234.63,82,,percent of total billed charges,,,257.52,90,,percent of total billed charges,,,243.21,85,,percent of total billed charges,,71.53,271.82,
S&N SCREW CORTEX 2.7MM S-T 20MM,30184744,CDM,,,278,RC,outpatient,,217.88,217.88,,184.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.47,22,,percent of total billed charges,,,,,,,,,196.09,90,,percent of total billed charges,,,180.4,82.8,,percent of total billed charges,,,185.2,85,,percent of total billed charges,,,,,,,,,191.73,88,,percent of total billed charges,,,,,,,,,166.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.47,22,,percent of total billed charges,,,198.27,91,,percent of total billed charges,,,206.99,95,,percent of total billed charges,,,180.84,83,,percent of total billed charges,,,180.84,83,,percent of total billed charges,,,,,,,,,,,,,,,180.84,83,,percent of total billed charges,,,206.99,95,,percent of total billed charges,,,196.09,90,,percent of total billed charges,,,196.09,90,,percent of total billed charges,,,178.66,82,,percent of total billed charges,,,196.09,90,,percent of total billed charges,,,185.2,85,,percent of total billed charges,,54.47,206.99,
S&N SCREW LOCKING 3.5MM X 10MM,30184745,CDM,,,278,RC,outpatient,,1352,1352,,1147.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,338,22,,percent of total billed charges,,,,,,,,,1216.8,90,,percent of total billed charges,,,1119.46,82.8,,percent of total billed charges,,,1149.2,85,,percent of total billed charges,,,,,,,,,1189.76,88,,percent of total billed charges,,,,,,,,,1032.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,338,22,,percent of total billed charges,,,1230.32,91,,percent of total billed charges,,,1284.4,95,,percent of total billed charges,,,1122.16,83,,percent of total billed charges,,,1122.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1122.16,83,,percent of total billed charges,,,1284.4,95,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1108.64,82,,percent of total billed charges,,,1216.8,90,,percent of total billed charges,,,1149.2,85,,percent of total billed charges,,338,1284.4,
S&N SCREW LOCKING 3.5MM X 12MM,30184746,CDM,,,278,RC,outpatient,,1035.84,1035.84,,879.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,258.96,22,,percent of total billed charges,,,,,,,,,932.26,90,,percent of total billed charges,,,857.68,82.8,,percent of total billed charges,,,880.46,85,,percent of total billed charges,,,,,,,,,911.54,88,,percent of total billed charges,,,,,,,,,791.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,258.96,22,,percent of total billed charges,,,942.61,91,,percent of total billed charges,,,984.05,95,,percent of total billed charges,,,859.75,83,,percent of total billed charges,,,859.75,83,,percent of total billed charges,,,,,,,,,,,,,,,859.75,83,,percent of total billed charges,,,984.05,95,,percent of total billed charges,,,932.26,90,,percent of total billed charges,,,932.26,90,,percent of total billed charges,,,849.39,82,,percent of total billed charges,,,932.26,90,,percent of total billed charges,,,880.46,85,,percent of total billed charges,,258.96,984.05,
S&N SCREW CORTEX S-T 3.5MM X 16MM,30184747,CDM,,,278,RC,outpatient,,213.83,213.83,,181.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.46,22,,percent of total billed charges,,,,,,,,,192.45,90,,percent of total billed charges,,,177.05,82.8,,percent of total billed charges,,,181.76,85,,percent of total billed charges,,,,,,,,,188.17,88,,percent of total billed charges,,,,,,,,,163.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.46,22,,percent of total billed charges,,,194.59,91,,percent of total billed charges,,,203.14,95,,percent of total billed charges,,,177.48,83,,percent of total billed charges,,,177.48,83,,percent of total billed charges,,,,,,,,,,,,,,,177.48,83,,percent of total billed charges,,,203.14,95,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,175.34,82,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,181.76,85,,percent of total billed charges,,53.46,203.14,
S&N SCREW CORTEX S-T 3.5MM X 18MM,30184748,CDM,,,278,RC,outpatient,,213.83,213.83,,181.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.46,22,,percent of total billed charges,,,,,,,,,192.45,90,,percent of total billed charges,,,177.05,82.8,,percent of total billed charges,,,181.76,85,,percent of total billed charges,,,,,,,,,188.17,88,,percent of total billed charges,,,,,,,,,163.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.46,22,,percent of total billed charges,,,194.59,91,,percent of total billed charges,,,203.14,95,,percent of total billed charges,,,177.48,83,,percent of total billed charges,,,177.48,83,,percent of total billed charges,,,,,,,,,,,,,,,177.48,83,,percent of total billed charges,,,203.14,95,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,175.34,82,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,181.76,85,,percent of total billed charges,,53.46,203.14,
S&N SCREW CORTEX S-T 3.5MM X 12MM,30184749,CDM,,,278,RC,outpatient,,278.25,278.25,,236.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.56,22,,percent of total billed charges,,,,,,,,,250.43,90,,percent of total billed charges,,,230.39,82.8,,percent of total billed charges,,,236.51,85,,percent of total billed charges,,,,,,,,,244.86,88,,percent of total billed charges,,,,,,,,,212.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.56,22,,percent of total billed charges,,,253.21,91,,percent of total billed charges,,,264.34,95,,percent of total billed charges,,,230.95,83,,percent of total billed charges,,,230.95,83,,percent of total billed charges,,,,,,,,,,,,,,,230.95,83,,percent of total billed charges,,,264.34,95,,percent of total billed charges,,,250.43,90,,percent of total billed charges,,,250.43,90,,percent of total billed charges,,,228.17,82,,percent of total billed charges,,,250.43,90,,percent of total billed charges,,,236.51,85,,percent of total billed charges,,69.56,264.34,
S&N SCREW CORTEX S-T 3.5MM X 42MM,30184750,CDM,,,278,RC,outpatient,,213.83,213.83,,181.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.46,22,,percent of total billed charges,,,,,,,,,192.45,90,,percent of total billed charges,,,177.05,82.8,,percent of total billed charges,,,181.76,85,,percent of total billed charges,,,,,,,,,188.17,88,,percent of total billed charges,,,,,,,,,163.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.46,22,,percent of total billed charges,,,194.59,91,,percent of total billed charges,,,203.14,95,,percent of total billed charges,,,177.48,83,,percent of total billed charges,,,177.48,83,,percent of total billed charges,,,,,,,,,,,,,,,177.48,83,,percent of total billed charges,,,203.14,95,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,175.34,82,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,181.76,85,,percent of total billed charges,,53.46,203.14,
S&N SCREW CORTEX S-T 3.5MM X 40MM,30184751,CDM,,,278,RC,outpatient,,213.83,213.83,,181.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.46,22,,percent of total billed charges,,,,,,,,,192.45,90,,percent of total billed charges,,,177.05,82.8,,percent of total billed charges,,,181.76,85,,percent of total billed charges,,,,,,,,,188.17,88,,percent of total billed charges,,,,,,,,,163.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.46,22,,percent of total billed charges,,,194.59,91,,percent of total billed charges,,,203.14,95,,percent of total billed charges,,,177.48,83,,percent of total billed charges,,,177.48,83,,percent of total billed charges,,,,,,,,,,,,,,,177.48,83,,percent of total billed charges,,,203.14,95,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,175.34,82,,percent of total billed charges,,,192.45,90,,percent of total billed charges,,,181.76,85,,percent of total billed charges,,53.46,203.14,
S&N DRILL BIT SHORT 3.5MM W/QC,30184752,CDM,,,278,RC,outpatient,,1378,1378,,1169.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,344.5,22,,percent of total billed charges,,,,,,,,,1240.2,90,,percent of total billed charges,,,1140.98,82.8,,percent of total billed charges,,,1171.3,85,,percent of total billed charges,,,,,,,,,1212.64,88,,percent of total billed charges,,,,,,,,,1052.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,344.5,22,,percent of total billed charges,,,1253.98,91,,percent of total billed charges,,,1309.1,95,,percent of total billed charges,,,1143.74,83,,percent of total billed charges,,,1143.74,83,,percent of total billed charges,,,,,,,,,,,,,,,1143.74,83,,percent of total billed charges,,,1309.1,95,,percent of total billed charges,,,1240.2,90,,percent of total billed charges,,,1240.2,90,,percent of total billed charges,,,1129.96,82,,percent of total billed charges,,,1240.2,90,,percent of total billed charges,,,1171.3,85,,percent of total billed charges,,344.5,1309.1,
S&N DRILL BIT 2.0MM W/QC,30184753,CDM,,,278,RC,outpatient,,994.5,994.5,,844.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,248.63,22,,percent of total billed charges,,,,,,,,,895.05,90,,percent of total billed charges,,,823.45,82.8,,percent of total billed charges,,,845.33,85,,percent of total billed charges,,,,,,,,,875.16,88,,percent of total billed charges,,,,,,,,,759.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,248.63,22,,percent of total billed charges,,,905,91,,percent of total billed charges,,,944.78,95,,percent of total billed charges,,,825.44,83,,percent of total billed charges,,,825.44,83,,percent of total billed charges,,,,,,,,,,,,,,,825.44,83,,percent of total billed charges,,,944.78,95,,percent of total billed charges,,,895.05,90,,percent of total billed charges,,,895.05,90,,percent of total billed charges,,,815.49,82,,percent of total billed charges,,,895.05,90,,percent of total billed charges,,,845.33,85,,percent of total billed charges,,248.63,944.78,
SPINECRAFT PLATE VELOX 30MM 2 LEVELS,30184754,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
SPINECRAFT PLATE VELOX 32MM 2 LEVELS,30184755,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER NAIL GAMMA 11X180X125 DEG,30184756,CDM,,,278,RC,outpatient,,13727.55,13727.55,,11654.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3431.89,22,,percent of total billed charges,,,,,,,,,12354.8,90,,percent of total billed charges,,,11366.41,82.8,,percent of total billed charges,,,11668.42,85,,percent of total billed charges,,,,,,,,,12080.24,88,,percent of total billed charges,,,,,,,,,10487.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3431.89,22,,percent of total billed charges,,,12492.07,91,,percent of total billed charges,,,13041.17,95,,percent of total billed charges,,,11393.87,83,,percent of total billed charges,,,11393.87,83,,percent of total billed charges,,,,,,,,,,,,,,,11393.87,83,,percent of total billed charges,,,13041.17,95,,percent of total billed charges,,,12354.8,90,,percent of total billed charges,,,12354.8,90,,percent of total billed charges,,,11256.59,82,,percent of total billed charges,,,12354.8,90,,percent of total billed charges,,,11668.42,85,,percent of total billed charges,,3431.89,13041.17,
STRYKER SCREW LAG 10.5 X 85MM,30184757,CDM,,,278,RC,outpatient,,5200.33,5200.33,,4415.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1300.08,22,,percent of total billed charges,,,,,,,,,4680.3,90,,percent of total billed charges,,,4305.87,82.8,,percent of total billed charges,,,4420.28,85,,percent of total billed charges,,,,,,,,,4576.29,88,,percent of total billed charges,,,,,,,,,3973.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1300.08,22,,percent of total billed charges,,,4732.3,91,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,,,,,,,,,,,,,4316.27,83,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4264.27,82,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4420.28,85,,percent of total billed charges,,1300.08,4940.31,
STRYKER SCREW LOCKING 5 X 35MM,30184758,CDM,,,278,RC,outpatient,,1774,1774,,1506.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,443.5,22,,percent of total billed charges,,,,,,,,,1596.6,90,,percent of total billed charges,,,1468.87,82.8,,percent of total billed charges,,,1507.9,85,,percent of total billed charges,,,,,,,,,1561.12,88,,percent of total billed charges,,,,,,,,,1355.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,443.5,22,,percent of total billed charges,,,1614.34,91,,percent of total billed charges,,,1685.3,95,,percent of total billed charges,,,1472.42,83,,percent of total billed charges,,,1472.42,83,,percent of total billed charges,,,,,,,,,,,,,,,1472.42,83,,percent of total billed charges,,,1685.3,95,,percent of total billed charges,,,1596.6,90,,percent of total billed charges,,,1596.6,90,,percent of total billed charges,,,1454.68,82,,percent of total billed charges,,,1596.6,90,,percent of total billed charges,,,1507.9,85,,percent of total billed charges,,443.5,1685.3,
STRYKER K-WIRE 3 X 285MM,30184759,CDM,,,278,RC,outpatient,,1251.25,1251.25,,1062.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,312.81,22,,percent of total billed charges,,,,,,,,,1126.13,90,,percent of total billed charges,,,1036.04,82.8,,percent of total billed charges,,,1063.56,85,,percent of total billed charges,,,,,,,,,1101.1,88,,percent of total billed charges,,,,,,,,,955.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,312.81,22,,percent of total billed charges,,,1138.64,91,,percent of total billed charges,,,1188.69,95,,percent of total billed charges,,,1038.54,83,,percent of total billed charges,,,1038.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1038.54,83,,percent of total billed charges,,,1188.69,95,,percent of total billed charges,,,1126.13,90,,percent of total billed charges,,,1126.13,90,,percent of total billed charges,,,1026.03,82,,percent of total billed charges,,,1126.13,90,,percent of total billed charges,,,1063.56,85,,percent of total billed charges,,312.81,1188.69,
STRYKER DRILL 4.2 X 300MM,30184760,CDM,,,278,RC,outpatient,,1886.89,1886.89,,1601.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,471.72,22,,percent of total billed charges,,,,,,,,,1698.2,90,,percent of total billed charges,,,1562.34,82.8,,percent of total billed charges,,,1603.86,85,,percent of total billed charges,,,,,,,,,1660.46,88,,percent of total billed charges,,,,,,,,,1441.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,471.72,22,,percent of total billed charges,,,1717.07,91,,percent of total billed charges,,,1792.55,95,,percent of total billed charges,,,1566.12,83,,percent of total billed charges,,,1566.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1566.12,83,,percent of total billed charges,,,1792.55,95,,percent of total billed charges,,,1698.2,90,,percent of total billed charges,,,1698.2,90,,percent of total billed charges,,,1547.25,82,,percent of total billed charges,,,1698.2,90,,percent of total billed charges,,,1603.86,85,,percent of total billed charges,,471.72,1792.55,
STAPLER RELOAD 45 W/TRU-STAPLE TECH,30184761,CDM,,,270,RC,outpatient,,2850.28,2850.28,,2419.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,712.57,22,,percent of total billed charges,,,,,,,,,2565.25,90,,percent of total billed charges,,,2360.03,82.8,,percent of total billed charges,,,2422.74,85,,percent of total billed charges,,,,,,,,,2508.25,88,,percent of total billed charges,,,,,,,,,2177.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,712.57,22,,percent of total billed charges,,,2593.75,91,,percent of total billed charges,,,2707.77,95,,percent of total billed charges,,,2365.73,83,,percent of total billed charges,,,2365.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2365.73,83,,percent of total billed charges,,,2707.77,95,,percent of total billed charges,,,2565.25,90,,percent of total billed charges,,,2565.25,90,,percent of total billed charges,,,2337.23,82,,percent of total billed charges,,,2565.25,90,,percent of total billed charges,,,2422.74,85,,percent of total billed charges,,712.57,2707.77,
STAPLER RELOAD 60MM W/TRI-STAPLE,30184762,CDM,,,270,RC,outpatient,,3033.51,3033.51,,2575.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,758.38,22,,percent of total billed charges,,,,,,,,,2730.16,90,,percent of total billed charges,,,2511.75,82.8,,percent of total billed charges,,,2578.48,85,,percent of total billed charges,,,,,,,,,2669.49,88,,percent of total billed charges,,,,,,,,,2317.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,758.38,22,,percent of total billed charges,,,2760.49,91,,percent of total billed charges,,,2881.83,95,,percent of total billed charges,,,2517.81,83,,percent of total billed charges,,,2517.81,83,,percent of total billed charges,,,,,,,,,,,,,,,2517.81,83,,percent of total billed charges,,,2881.83,95,,percent of total billed charges,,,2730.16,90,,percent of total billed charges,,,2730.16,90,,percent of total billed charges,,,2487.48,82,,percent of total billed charges,,,2730.16,90,,percent of total billed charges,,,2578.48,85,,percent of total billed charges,,758.38,2881.83,
STAPLER GIA 4 HANDLE,30184763,CDM,,,270,RC,outpatient,,2345.74,2345.74,,1991.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,586.44,22,,percent of total billed charges,,,,,,,,,2111.17,90,,percent of total billed charges,,,1942.27,82.8,,percent of total billed charges,,,1993.88,85,,percent of total billed charges,,,,,,,,,2064.25,88,,percent of total billed charges,,,,,,,,,1792.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,586.44,22,,percent of total billed charges,,,2134.62,91,,percent of total billed charges,,,2228.45,95,,percent of total billed charges,,,1946.96,83,,percent of total billed charges,,,1946.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1946.96,83,,percent of total billed charges,,,2228.45,95,,percent of total billed charges,,,2111.17,90,,percent of total billed charges,,,2111.17,90,,percent of total billed charges,,,1923.51,82,,percent of total billed charges,,,2111.17,90,,percent of total billed charges,,,1993.88,85,,percent of total billed charges,,586.44,2228.45,
S&N BLADE SERRATED 3.0,30184764,CDM,,,270,RC,outpatient,,329.18,329.18,,279.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.3,22,,percent of total billed charges,,,,,,,,,296.26,90,,percent of total billed charges,,,272.56,82.8,,percent of total billed charges,,,279.8,85,,percent of total billed charges,,,,,,,,,289.68,88,,percent of total billed charges,,,,,,,,,251.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82.3,22,,percent of total billed charges,,,299.55,91,,percent of total billed charges,,,312.72,95,,percent of total billed charges,,,273.22,83,,percent of total billed charges,,,273.22,83,,percent of total billed charges,,,,,,,,,,,,,,,273.22,83,,percent of total billed charges,,,312.72,95,,percent of total billed charges,,,296.26,90,,percent of total billed charges,,,296.26,90,,percent of total billed charges,,,269.93,82,,percent of total billed charges,,,296.26,90,,percent of total billed charges,,,279.8,85,,percent of total billed charges,,82.3,312.72,
S&N HIP CANNULA 7X110 CLEAR TRAC,30184765,CDM,,,270,RC,outpatient,,239.33,239.33,,203.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.83,22,,percent of total billed charges,,,,,,,,,215.4,90,,percent of total billed charges,,,198.17,82.8,,percent of total billed charges,,,203.43,85,,percent of total billed charges,,,,,,,,,210.61,88,,percent of total billed charges,,,,,,,,,182.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.83,22,,percent of total billed charges,,,217.79,91,,percent of total billed charges,,,227.36,95,,percent of total billed charges,,,198.64,83,,percent of total billed charges,,,198.64,83,,percent of total billed charges,,,,,,,,,,,,,,,198.64,83,,percent of total billed charges,,,227.36,95,,percent of total billed charges,,,215.4,90,,percent of total billed charges,,,215.4,90,,percent of total billed charges,,,196.25,82,,percent of total billed charges,,,215.4,90,,percent of total billed charges,,,203.43,85,,percent of total billed charges,,59.83,227.36,
S&N HIP SYSTEM GENERAL UC,30184766,CDM,,,270,RC,outpatient,,3867.5,3867.5,,3283.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,966.88,22,,percent of total billed charges,,,,,,,,,3480.75,90,,percent of total billed charges,,,3202.29,82.8,,percent of total billed charges,,,3287.38,85,,percent of total billed charges,,,,,,,,,3403.4,88,,percent of total billed charges,,,,,,,,,2954.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,966.88,22,,percent of total billed charges,,,3519.43,91,,percent of total billed charges,,,3674.13,95,,percent of total billed charges,,,3210.03,83,,percent of total billed charges,,,3210.03,83,,percent of total billed charges,,,,,,,,,,,,,,,3210.03,83,,percent of total billed charges,,,3674.13,95,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3171.35,82,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3287.38,85,,percent of total billed charges,,966.88,3674.13,
ZIMMER TRABECULAR METAL OSTEONECROSIS,30184767,CDM,,,278,RC,outpatient,,22109.62,22109.62,,18771.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5527.41,22,,percent of total billed charges,,,,,,,,,19898.66,90,,percent of total billed charges,,,18306.77,82.8,,percent of total billed charges,,,18793.18,85,,percent of total billed charges,,,,,,,,,19456.47,88,,percent of total billed charges,,,,,,,,,16891.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5527.41,22,,percent of total billed charges,,,20119.75,91,,percent of total billed charges,,,21004.14,95,,percent of total billed charges,,,18350.98,83,,percent of total billed charges,,,18350.98,83,,percent of total billed charges,,,,,,,,,,,,,,,18350.98,83,,percent of total billed charges,,,21004.14,95,,percent of total billed charges,,,19898.66,90,,percent of total billed charges,,,19898.66,90,,percent of total billed charges,,,18129.89,82,,percent of total billed charges,,,19898.66,90,,percent of total billed charges,,,18793.18,85,,percent of total billed charges,,5527.41,21004.14,
CONFORMIS INSERT KIT POLY 6MM,30184768,CDM,,,278,RC,outpatient,,8417.5,8417.5,,7146.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2104.38,22,,percent of total billed charges,,,,,,,,,7575.75,90,,percent of total billed charges,,,6969.69,82.8,,percent of total billed charges,,,7154.88,85,,percent of total billed charges,,,,,,,,,7407.4,88,,percent of total billed charges,,,,,,,,,6430.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2104.38,22,,percent of total billed charges,,,7659.93,91,,percent of total billed charges,,,7996.63,95,,percent of total billed charges,,,6986.53,83,,percent of total billed charges,,,6986.53,83,,percent of total billed charges,,,,,,,,,,,,,,,6986.53,83,,percent of total billed charges,,,7996.63,95,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,6902.35,82,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,7154.88,85,,percent of total billed charges,,2104.38,7996.63,
ZIMMER DRILL BIT 3.2MM,30184769,CDM,,,270,RC,outpatient,,230.7,230.7,,195.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.68,22,,percent of total billed charges,,,,,,,,,207.63,90,,percent of total billed charges,,,191.02,82.8,,percent of total billed charges,,,196.1,85,,percent of total billed charges,,,,,,,,,203.02,88,,percent of total billed charges,,,,,,,,,176.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.68,22,,percent of total billed charges,,,209.94,91,,percent of total billed charges,,,219.17,95,,percent of total billed charges,,,191.48,83,,percent of total billed charges,,,191.48,83,,percent of total billed charges,,,,,,,,,,,,,,,191.48,83,,percent of total billed charges,,,219.17,95,,percent of total billed charges,,,207.63,90,,percent of total billed charges,,,207.63,90,,percent of total billed charges,,,189.17,82,,percent of total billed charges,,,207.63,90,,percent of total billed charges,,,196.1,85,,percent of total billed charges,,57.68,219.17,
SCREW REDUCTION 6.5 X 45MM,30184770,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
SCREW POLYAXIAL 7.5 X 50MM,30184771,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ROD LORDOSED 70MM,30184772,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
PEEK CORTINA 8 X 25 X 9MM 0 DEG,30184773,CDM,,,278,RC,outpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4225,22,,percent of total billed charges,,,,,,,,,15210,90,,percent of total billed charges,,,13993.2,82.8,,percent of total billed charges,,,14365,85,,percent of total billed charges,,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4225,22,,percent of total billed charges,,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,4225,16055,
BARD POWERPORT MRI IMIPLANTABLE PORT,30184775,CDM,,,270,RC,outpatient,,5674.5,5674.5,,4817.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1418.63,22,,percent of total billed charges,,,,,,,,,5107.05,90,,percent of total billed charges,,,4698.49,82.8,,percent of total billed charges,,,4823.33,85,,percent of total billed charges,,,,,,,,,4993.56,88,,percent of total billed charges,,,,,,,,,4335.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1418.63,22,,percent of total billed charges,,,5163.8,91,,percent of total billed charges,,,5390.78,95,,percent of total billed charges,,,4709.84,83,,percent of total billed charges,,,4709.84,83,,percent of total billed charges,,,,,,,,,,,,,,,4709.84,83,,percent of total billed charges,,,5390.78,95,,percent of total billed charges,,,5107.05,90,,percent of total billed charges,,,5107.05,90,,percent of total billed charges,,,4653.09,82,,percent of total billed charges,,,5107.05,90,,percent of total billed charges,,,4823.33,85,,percent of total billed charges,,1418.63,5390.78,
SPINECRAFT PEEK CERVICAL OR10 5MM,30184776,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
SPINECRAFT PEEK CERVICAL OR10 4MM,30184777,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
SYNTHES SCREW LOCKING 2.7X10MM,30184778,CDM,,,278,RC,outpatient,,1178.13,1178.13,,1000.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,294.53,22,,percent of total billed charges,,,,,,,,,1060.32,90,,percent of total billed charges,,,975.49,82.8,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,,,,,,,,1036.75,88,,percent of total billed charges,,,,,,,,,900.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,294.53,22,,percent of total billed charges,,,1072.1,91,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,,,,,,,,,,,,,977.85,83,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,966.07,82,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,294.53,1119.22,
SYNTHES SCREW LOCKING 2.7X22MM,30184779,CDM,,,278,RC,outpatient,,1143.87,1143.87,,971.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,285.97,22,,percent of total billed charges,,,,,,,,,1029.48,90,,percent of total billed charges,,,947.12,82.8,,percent of total billed charges,,,972.29,85,,percent of total billed charges,,,,,,,,,1006.61,88,,percent of total billed charges,,,,,,,,,873.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,285.97,22,,percent of total billed charges,,,1040.92,91,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,,,,,,,,,,,,,949.41,83,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,937.97,82,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,972.29,85,,percent of total billed charges,,285.97,1086.68,
ZIMMER TIBIA UNI SZ E,30184780,CDM,,,278,RC,outpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3388.13,22,,percent of total billed charges,,,,,,,,,12197.25,90,,percent of total billed charges,,,11221.47,82.8,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3388.13,22,,percent of total billed charges,,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,3388.13,12874.88,
ZIMMER BEARING LG RT SZ 3,30184781,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
SYNTHES SCREW CORTEX S-T 2.7X18MM,30184787,CDM,,,278,RC,outpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.46,22,,percent of total billed charges,,,,,,,,,397.66,90,,percent of total billed charges,,,365.84,82.8,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.46,22,,percent of total billed charges,,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,110.46,419.75,
SYNTHES SCREW CORTEX S-T 2.7X20MM,30184788,CDM,,,278,RC,outpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.46,22,,percent of total billed charges,,,,,,,,,397.66,90,,percent of total billed charges,,,365.84,82.8,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.46,22,,percent of total billed charges,,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,110.46,419.75,
SYNTHES SCREW CORTEX S-T 2.7X22MM,30184789,CDM,,,278,RC,outpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.46,22,,percent of total billed charges,,,,,,,,,397.66,90,,percent of total billed charges,,,365.84,82.8,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.46,22,,percent of total billed charges,,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,110.46,419.75,
SYNTHES SCREW LOCKING 2.7X12MM,30184790,CDM,,,278,RC,outpatient,,1178.13,1178.13,,1000.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,294.53,22,,percent of total billed charges,,,,,,,,,1060.32,90,,percent of total billed charges,,,975.49,82.8,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,,,,,,,,1036.75,88,,percent of total billed charges,,,,,,,,,900.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,294.53,22,,percent of total billed charges,,,1072.1,91,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,977.85,83,,percent of total billed charges,,,,,,,,,,,,,,,977.85,83,,percent of total billed charges,,,1119.22,95,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,966.07,82,,percent of total billed charges,,,1060.32,90,,percent of total billed charges,,,1001.41,85,,percent of total billed charges,,294.53,1119.22,
SYNTHES DRILL BIT CANNULATED 7.3MM,30184791,CDM,,,278,RC,outpatient,,4270.83,4270.83,,3625.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1067.71,22,,percent of total billed charges,,,,,,,,,3843.75,90,,percent of total billed charges,,,3536.25,82.8,,percent of total billed charges,,,3630.21,85,,percent of total billed charges,,,,,,,,,3758.33,88,,percent of total billed charges,,,,,,,,,3262.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1067.71,22,,percent of total billed charges,,,3886.46,91,,percent of total billed charges,,,4057.29,95,,percent of total billed charges,,,3544.79,83,,percent of total billed charges,,,3544.79,83,,percent of total billed charges,,,,,,,,,,,,,,,3544.79,83,,percent of total billed charges,,,4057.29,95,,percent of total billed charges,,,3843.75,90,,percent of total billed charges,,,3843.75,90,,percent of total billed charges,,,3502.08,82,,percent of total billed charges,,,3843.75,90,,percent of total billed charges,,,3630.21,85,,percent of total billed charges,,1067.71,4057.29,
CARBOJET CO2 TUBESET W/HANDPIECE,30184792,CDM,,,270,RC,outpatient,,1748.5,1748.5,,1484.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,437.13,22,,percent of total billed charges,,,,,,,,,1573.65,90,,percent of total billed charges,,,1447.76,82.8,,percent of total billed charges,,,1486.23,85,,percent of total billed charges,,,,,,,,,1538.68,88,,percent of total billed charges,,,,,,,,,1335.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,437.13,22,,percent of total billed charges,,,1591.14,91,,percent of total billed charges,,,1661.08,95,,percent of total billed charges,,,1451.26,83,,percent of total billed charges,,,1451.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1451.26,83,,percent of total billed charges,,,1661.08,95,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1433.77,82,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1486.23,85,,percent of total billed charges,,437.13,1661.08,
SYNTHES BLADE HELICAL TFNA 95MM,30184793,CDM,,,278,RC,outpatient,,6630,6630,,5628.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1657.5,22,,percent of total billed charges,,,,,,,,,5967,90,,percent of total billed charges,,,5489.64,82.8,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,,,,,,,,5834.4,88,,percent of total billed charges,,,,,,,,,5065.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1657.5,22,,percent of total billed charges,,,6033.3,91,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,,,,,,,,,,,,,5502.9,83,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5436.6,82,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,1657.5,6298.5,
SYNTHES TFNA 11MM X 130DEG,30184794,CDM,,,278,RC,outpatient,,16019.38,16019.38,,13600.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4004.85,22,,percent of total billed charges,,,,,,,,,14417.44,90,,percent of total billed charges,,,13264.05,82.8,,percent of total billed charges,,,13616.47,85,,percent of total billed charges,,,,,,,,,14097.05,88,,percent of total billed charges,,,,,,,,,12238.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4004.85,22,,percent of total billed charges,,,14577.64,91,,percent of total billed charges,,,15218.41,95,,percent of total billed charges,,,13296.09,83,,percent of total billed charges,,,13296.09,83,,percent of total billed charges,,,,,,,,,,,,,,,13296.09,83,,percent of total billed charges,,,15218.41,95,,percent of total billed charges,,,14417.44,90,,percent of total billed charges,,,14417.44,90,,percent of total billed charges,,,13135.89,82,,percent of total billed charges,,,14417.44,90,,percent of total billed charges,,,13616.47,85,,percent of total billed charges,,4004.85,15218.41,
SYNTHES SCREW LOCKING 5.0MM X 22MM,30184795,CDM,,,278,RC,outpatient,,2185.24,2185.24,,1855.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,546.31,22,,percent of total billed charges,,,,,,,,,1966.72,90,,percent of total billed charges,,,1809.38,82.8,,percent of total billed charges,,,1857.45,85,,percent of total billed charges,,,,,,,,,1923.01,88,,percent of total billed charges,,,,,,,,,1669.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,546.31,22,,percent of total billed charges,,,1988.57,91,,percent of total billed charges,,,2075.98,95,,percent of total billed charges,,,1813.75,83,,percent of total billed charges,,,1813.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1813.75,83,,percent of total billed charges,,,2075.98,95,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1791.9,82,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1857.45,85,,percent of total billed charges,,546.31,2075.98,
SYNTHES DRILL BIT 4.2MM,30184796,CDM,,,270,RC,outpatient,,2924.87,2924.87,,2483.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.22,22,,percent of total billed charges,,,,,,,,,2632.38,90,,percent of total billed charges,,,2421.79,82.8,,percent of total billed charges,,,2486.14,85,,percent of total billed charges,,,,,,,,,2573.89,88,,percent of total billed charges,,,,,,,,,2234.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.22,22,,percent of total billed charges,,,2661.63,91,,percent of total billed charges,,,2778.63,95,,percent of total billed charges,,,2427.64,83,,percent of total billed charges,,,2427.64,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.64,83,,percent of total billed charges,,,2778.63,95,,percent of total billed charges,,,2632.38,90,,percent of total billed charges,,,2632.38,90,,percent of total billed charges,,,2398.39,82,,percent of total billed charges,,,2632.38,90,,percent of total billed charges,,,2486.14,85,,percent of total billed charges,,731.22,2778.63,
DEPUY INSERT SZ 6 8MM,30184797,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
STENT URETERAL FIRM 5 X 26,30184798,CDM,,,270,RC,outpatient,,682.36,682.36,,579.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,170.59,22,,percent of total billed charges,,,,,,,,,614.12,90,,percent of total billed charges,,,564.99,82.8,,percent of total billed charges,,,580.01,85,,percent of total billed charges,,,,,,,,,600.48,88,,percent of total billed charges,,,,,,,,,521.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,170.59,22,,percent of total billed charges,,,620.95,91,,percent of total billed charges,,,648.24,95,,percent of total billed charges,,,566.36,83,,percent of total billed charges,,,566.36,83,,percent of total billed charges,,,,,,,,,,,,,,,566.36,83,,percent of total billed charges,,,648.24,95,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,559.54,82,,percent of total billed charges,,,614.12,90,,percent of total billed charges,,,580.01,85,,percent of total billed charges,,170.59,648.24,
SYNTHES PLATE VA LCP DISTAL RADIUS 2.4MM,30184799,CDM,,,278,RC,outpatient,,9419.41,9419.41,,7997.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2354.85,22,,percent of total billed charges,,,,,,,,,8477.47,90,,percent of total billed charges,,,7799.27,82.8,,percent of total billed charges,,,8006.5,85,,percent of total billed charges,,,,,,,,,8289.08,88,,percent of total billed charges,,,,,,,,,7196.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2354.85,22,,percent of total billed charges,,,8571.66,91,,percent of total billed charges,,,8948.44,95,,percent of total billed charges,,,7818.11,83,,percent of total billed charges,,,7818.11,83,,percent of total billed charges,,,,,,,,,,,,,,,7818.11,83,,percent of total billed charges,,,8948.44,95,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,7723.92,82,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,8006.5,85,,percent of total billed charges,,2354.85,8948.44,
SYNTHES SCREW LOCKING 5.0MM X 34MM,30184800,CDM,,,278,RC,outpatient,,2185.24,2185.24,,1855.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,546.31,22,,percent of total billed charges,,,,,,,,,1966.72,90,,percent of total billed charges,,,1809.38,82.8,,percent of total billed charges,,,1857.45,85,,percent of total billed charges,,,,,,,,,1923.01,88,,percent of total billed charges,,,,,,,,,1669.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,546.31,22,,percent of total billed charges,,,1988.57,91,,percent of total billed charges,,,2075.98,95,,percent of total billed charges,,,1813.75,83,,percent of total billed charges,,,1813.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1813.75,83,,percent of total billed charges,,,2075.98,95,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1791.9,82,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1857.45,85,,percent of total billed charges,,546.31,2075.98,
SYNTHES PLATE LCP RT DISTAL RADIUS,30184801,CDM,,,278,RC,outpatient,,15945.15,15945.15,,13537.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3986.29,22,,percent of total billed charges,,,,,,,,,14350.64,90,,percent of total billed charges,,,13202.58,82.8,,percent of total billed charges,,,13553.38,85,,percent of total billed charges,,,,,,,,,14031.73,88,,percent of total billed charges,,,,,,,,,12182.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3986.29,22,,percent of total billed charges,,,14510.09,91,,percent of total billed charges,,,15147.89,95,,percent of total billed charges,,,13234.47,83,,percent of total billed charges,,,13234.47,83,,percent of total billed charges,,,,,,,,,,,,,,,13234.47,83,,percent of total billed charges,,,15147.89,95,,percent of total billed charges,,,14350.64,90,,percent of total billed charges,,,14350.64,90,,percent of total billed charges,,,13075.02,82,,percent of total billed charges,,,14350.64,90,,percent of total billed charges,,,13553.38,85,,percent of total billed charges,,3986.29,15147.89,
SPINECRAFT PLATE VELOX 28MM 2 LEVELS,30184802,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
SPINECRAFT PLATE VELOX 14MM 1 LEVEL,30184804,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
DEPUY PE CUP 38MM+9,30184805,CDM,,,278,RC,outpatient,,10688.08,10688.08,,9074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2672.02,22,,percent of total billed charges,,,,,,,,,9619.27,90,,percent of total billed charges,,,8849.73,82.8,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,,,,,,,,9405.51,88,,percent of total billed charges,,,,,,,,,8165.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2672.02,22,,percent of total billed charges,,,9726.15,91,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,,,,,,,,,,,,,8871.11,83,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,8764.23,82,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,2672.02,10153.68,
CYSTOSCOPE - CONTINUOUS FLOW,30184806,CDM,,,270,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
SYNTHES PLATE DISTAL RADIUS 2.4MM 6 HOLE,30184807,CDM,,,278,RC,outpatient,,9419.41,9419.41,,7997.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2354.85,22,,percent of total billed charges,,,,,,,,,8477.47,90,,percent of total billed charges,,,7799.27,82.8,,percent of total billed charges,,,8006.5,85,,percent of total billed charges,,,,,,,,,8289.08,88,,percent of total billed charges,,,,,,,,,7196.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2354.85,22,,percent of total billed charges,,,8571.66,91,,percent of total billed charges,,,8948.44,95,,percent of total billed charges,,,7818.11,83,,percent of total billed charges,,,7818.11,83,,percent of total billed charges,,,,,,,,,,,,,,,7818.11,83,,percent of total billed charges,,,8948.44,95,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,7723.92,82,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,8006.5,85,,percent of total billed charges,,2354.85,8948.44,
ARTHREX SUTURE ANCHOR 5.5 X 14.7MM BIOCO,30184808,CDM,,,270,RC,outpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,528.13,22,,percent of total billed charges,,,,,,,,,1901.25,90,,percent of total billed charges,,,1749.15,82.8,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,528.13,22,,percent of total billed charges,,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,528.13,2006.88,
ARTHREX SUTURE ANCHOR 5.5 X 14.7MM TRIPL,30184809,CDM,,,270,RC,outpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,552.5,22,,percent of total billed charges,,,,,,,,,1989,90,,percent of total billed charges,,,1829.88,82.8,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,552.5,22,,percent of total billed charges,,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,552.5,2099.5,
CANNISTER LIPOSUCTION 2000CC,30184810,CDM,,,270,RC,outpatient,,80.75,80.75,,68.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.19,22,,percent of total billed charges,,,,,,,,,72.68,90,,percent of total billed charges,,,66.86,82.8,,percent of total billed charges,,,68.64,85,,percent of total billed charges,,,,,,,,,71.06,88,,percent of total billed charges,,,,,,,,,61.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.19,22,,percent of total billed charges,,,73.48,91,,percent of total billed charges,,,76.71,95,,percent of total billed charges,,,67.02,83,,percent of total billed charges,,,67.02,83,,percent of total billed charges,,,,,,,,,,,,,,,67.02,83,,percent of total billed charges,,,76.71,95,,percent of total billed charges,,,72.68,90,,percent of total billed charges,,,72.68,90,,percent of total billed charges,,,66.22,82,,percent of total billed charges,,,72.68,90,,percent of total billed charges,,,68.64,85,,percent of total billed charges,,20.19,76.71,
TUBING ASPIRATION SET,30184811,CDM,,,270,RC,outpatient,,104,104,,88.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26,22,,percent of total billed charges,,,,,,,,,93.6,90,,percent of total billed charges,,,86.11,82.8,,percent of total billed charges,,,88.4,85,,percent of total billed charges,,,,,,,,,91.52,88,,percent of total billed charges,,,,,,,,,79.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26,22,,percent of total billed charges,,,94.64,91,,percent of total billed charges,,,98.8,95,,percent of total billed charges,,,86.32,83,,percent of total billed charges,,,86.32,83,,percent of total billed charges,,,,,,,,,,,,,,,86.32,83,,percent of total billed charges,,,98.8,95,,percent of total billed charges,,,93.6,90,,percent of total billed charges,,,93.6,90,,percent of total billed charges,,,85.28,82,,percent of total billed charges,,,93.6,90,,percent of total billed charges,,,88.4,85,,percent of total billed charges,,26,98.8,
TUBING ASPIRATION- NON STERILE,30184812,CDM,,,270,RC,outpatient,,22.5,22.5,,19.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.63,22,,percent of total billed charges,,,,,,,,,20.25,90,,percent of total billed charges,,,18.63,82.8,,percent of total billed charges,,,19.13,85,,percent of total billed charges,,,,,,,,,19.8,88,,percent of total billed charges,,,,,,,,,17.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.63,22,,percent of total billed charges,,,20.48,91,,percent of total billed charges,,,21.38,95,,percent of total billed charges,,,18.68,83,,percent of total billed charges,,,18.68,83,,percent of total billed charges,,,,,,,,,,,,,,,18.68,83,,percent of total billed charges,,,21.38,95,,percent of total billed charges,,,20.25,90,,percent of total billed charges,,,20.25,90,,percent of total billed charges,,,18.45,82,,percent of total billed charges,,,20.25,90,,percent of total billed charges,,,19.13,85,,percent of total billed charges,,5.63,21.38,
TUBING INFILTRATION SINGLE-SPIKE,30184813,CDM,,,270,RC,outpatient,,85,85,,72.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.25,22,,percent of total billed charges,,,,,,,,,76.5,90,,percent of total billed charges,,,70.38,82.8,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,,,,,,,,74.8,88,,percent of total billed charges,,,,,,,,,64.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.25,22,,percent of total billed charges,,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,,,,,,,,,,,,,70.55,83,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,69.7,82,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,21.25,80.75,
LIPOFILTER,30184814,CDM,,,270,RC,outpatient,,1235,1235,,1048.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,308.75,22,,percent of total billed charges,,,,,,,,,1111.5,90,,percent of total billed charges,,,1022.58,82.8,,percent of total billed charges,,,1049.75,85,,percent of total billed charges,,,,,,,,,1086.8,88,,percent of total billed charges,,,,,,,,,943.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,308.75,22,,percent of total billed charges,,,1123.85,91,,percent of total billed charges,,,1173.25,95,,percent of total billed charges,,,1025.05,83,,percent of total billed charges,,,1025.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1025.05,83,,percent of total billed charges,,,1173.25,95,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1012.7,82,,percent of total billed charges,,,1111.5,90,,percent of total billed charges,,,1049.75,85,,percent of total billed charges,,308.75,1173.25,
DEPUY LINER ALTRX 40 X 56,30184815,CDM,,,278,RC,outpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4400.13,22,,percent of total billed charges,,,,,,,,,15840.46,90,,percent of total billed charges,,,14573.22,82.8,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4400.13,22,,percent of total billed charges,,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,4400.13,16720.48,
DEPUY FEMORAL HEAD 28MM +12,30184816,CDM,,,278,RC,outpatient,,5683.54,5683.54,,4825.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1420.89,22,,percent of total billed charges,,,,,,,,,5115.19,90,,percent of total billed charges,,,4705.97,82.8,,percent of total billed charges,,,4831.01,85,,percent of total billed charges,,,,,,,,,5001.52,88,,percent of total billed charges,,,,,,,,,4342.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1420.89,22,,percent of total billed charges,,,5172.02,91,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,4717.34,83,,percent of total billed charges,,,,,,,,,,,,,,,4717.34,83,,percent of total billed charges,,,5399.36,95,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4660.5,82,,percent of total billed charges,,,5115.19,90,,percent of total billed charges,,,4831.01,85,,percent of total billed charges,,1420.89,5399.36,
DEPUY SEGMENT LPS 85MM,30184817,CDM,,,278,RC,outpatient,,18773.5,18773.5,,15938.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4693.38,22,,percent of total billed charges,,,,,,,,,16896.15,90,,percent of total billed charges,,,15544.46,82.8,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,,,,,,,,16520.68,88,,percent of total billed charges,,,,,,,,,14342.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4693.38,22,,percent of total billed charges,,,17083.89,91,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,,,,,,,,,,,,,15582.01,83,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15394.27,82,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,4693.38,17834.83,
DEPUY STEM CEMENTED LPS 13 X 200MM,30184818,CDM,,,278,RC,outpatient,,44982.15,44982.15,,38189.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11245.54,22,,percent of total billed charges,,,,,,,,,40483.94,90,,percent of total billed charges,,,37245.22,82.8,,percent of total billed charges,,,38234.83,85,,percent of total billed charges,,,,,,,,,39584.29,88,,percent of total billed charges,,,,,,,,,34366.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11245.54,22,,percent of total billed charges,,,40933.76,91,,percent of total billed charges,,,42733.04,95,,percent of total billed charges,,,37335.18,83,,percent of total billed charges,,,37335.18,83,,percent of total billed charges,,,,,,,,,,,,,,,37335.18,83,,percent of total billed charges,,,42733.04,95,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,36885.36,82,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,38234.83,85,,percent of total billed charges,,11245.54,42733.04,
ZIMMER BLADE EXPLANT 48MM X 10,30184819,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
ZIMMER BLADE EXPLANT 48MM X 20,30184820,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
SYNTHES SCREW LAG 95MM,30184821,CDM,,,278,RC,outpatient,,6298.5,6298.5,,5347.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1574.63,22,,percent of total billed charges,,,,,,,,,5668.65,90,,percent of total billed charges,,,5215.16,82.8,,percent of total billed charges,,,5353.73,85,,percent of total billed charges,,,,,,,,,5542.68,88,,percent of total billed charges,,,,,,,,,4812.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1574.63,22,,percent of total billed charges,,,5731.64,91,,percent of total billed charges,,,5983.58,95,,percent of total billed charges,,,5227.76,83,,percent of total billed charges,,,5227.76,83,,percent of total billed charges,,,,,,,,,,,,,,,5227.76,83,,percent of total billed charges,,,5983.58,95,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5164.77,82,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5353.73,85,,percent of total billed charges,,1574.63,5983.58,
SYNTHES TFNA NAIL 11MM X 380MM,30184822,CDM,,,278,RC,outpatient,,22437.74,22437.74,,19049.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5609.44,22,,percent of total billed charges,,,,,,,,,20193.97,90,,percent of total billed charges,,,18578.45,82.8,,percent of total billed charges,,,19072.08,85,,percent of total billed charges,,,,,,,,,19745.21,88,,percent of total billed charges,,,,,,,,,17142.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5609.44,22,,percent of total billed charges,,,20418.34,91,,percent of total billed charges,,,21315.85,95,,percent of total billed charges,,,18623.32,83,,percent of total billed charges,,,18623.32,83,,percent of total billed charges,,,,,,,,,,,,,,,18623.32,83,,percent of total billed charges,,,21315.85,95,,percent of total billed charges,,,20193.97,90,,percent of total billed charges,,,20193.97,90,,percent of total billed charges,,,18398.95,82,,percent of total billed charges,,,20193.97,90,,percent of total billed charges,,,19072.08,85,,percent of total billed charges,,5609.44,21315.85,
SYNTHES SCREW LOCKING 5.0MM X 38MM,30184823,CDM,,,278,RC,outpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,562.71,22,,percent of total billed charges,,,,,,,,,2025.74,90,,percent of total billed charges,,,1863.68,82.8,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,562.71,22,,percent of total billed charges,,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,562.71,2138.28,
SYNTHES SCREW LOCKING 5.0MM X 50MM,30184824,CDM,,,278,RC,outpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,562.71,22,,percent of total billed charges,,,,,,,,,2025.74,90,,percent of total billed charges,,,1863.68,82.8,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,562.71,22,,percent of total billed charges,,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,562.71,2138.28,
SYNTHES EX FIX KIT LARGE,30184825,CDM,,,278,RC,outpatient,,36067.2,36067.2,,30621.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9016.8,22,,percent of total billed charges,,,,,,,,,32460.48,90,,percent of total billed charges,,,29863.64,82.8,,percent of total billed charges,,,30657.12,85,,percent of total billed charges,,,,,,,,,31739.14,88,,percent of total billed charges,,,,,,,,,27555.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9016.8,22,,percent of total billed charges,,,32821.15,91,,percent of total billed charges,,,34263.84,95,,percent of total billed charges,,,29935.78,83,,percent of total billed charges,,,29935.78,83,,percent of total billed charges,,,,,,,,,,,,,,,29935.78,83,,percent of total billed charges,,,34263.84,95,,percent of total billed charges,,,32460.48,90,,percent of total billed charges,,,32460.48,90,,percent of total billed charges,,,29575.1,82,,percent of total billed charges,,,32460.48,90,,percent of total billed charges,,,30657.12,85,,percent of total billed charges,,9016.8,34263.84,
SYNTHES PIN SCHANTZ 5.0,30184826,CDM,,,278,RC,outpatient,,1740.38,1740.38,,1477.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,435.1,22,,percent of total billed charges,,,,,,,,,1566.34,90,,percent of total billed charges,,,1441.03,82.8,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,,,,,,,,1531.53,88,,percent of total billed charges,,,,,,,,,1329.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,435.1,22,,percent of total billed charges,,,1583.75,91,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.52,83,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1427.11,82,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,435.1,1653.36,
SYNTHES ROD ATTACHMENT FOR MULTI PIN,30184827,CDM,,,278,RC,outpatient,,4254.25,4254.25,,3611.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1063.56,22,,percent of total billed charges,,,,,,,,,3828.83,90,,percent of total billed charges,,,3522.52,82.8,,percent of total billed charges,,,3616.11,85,,percent of total billed charges,,,,,,,,,3743.74,88,,percent of total billed charges,,,,,,,,,3250.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1063.56,22,,percent of total billed charges,,,3871.37,91,,percent of total billed charges,,,4041.54,95,,percent of total billed charges,,,3531.03,83,,percent of total billed charges,,,3531.03,83,,percent of total billed charges,,,,,,,,,,,,,,,3531.03,83,,percent of total billed charges,,,4041.54,95,,percent of total billed charges,,,3828.83,90,,percent of total billed charges,,,3828.83,90,,percent of total billed charges,,,3488.49,82,,percent of total billed charges,,,3828.83,90,,percent of total billed charges,,,3616.11,85,,percent of total billed charges,,1063.56,4041.54,
SYNTHES CLAMP ADJUSTABLE LARGE OPEN,30184828,CDM,,,278,RC,outpatient,,5497.38,5497.38,,4667.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1374.35,22,,percent of total billed charges,,,,,,,,,4947.64,90,,percent of total billed charges,,,4551.83,82.8,,percent of total billed charges,,,4672.77,85,,percent of total billed charges,,,,,,,,,4837.69,88,,percent of total billed charges,,,,,,,,,4200,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1374.35,22,,percent of total billed charges,,,5002.62,91,,percent of total billed charges,,,5222.51,95,,percent of total billed charges,,,4562.83,83,,percent of total billed charges,,,4562.83,83,,percent of total billed charges,,,,,,,,,,,,,,,4562.83,83,,percent of total billed charges,,,5222.51,95,,percent of total billed charges,,,4947.64,90,,percent of total billed charges,,,4947.64,90,,percent of total billed charges,,,4507.85,82,,percent of total billed charges,,,4947.64,90,,percent of total billed charges,,,4672.77,85,,percent of total billed charges,,1374.35,5222.51,
SYNTHES ROD CARBON FIBER 11 X 250MM,30184829,CDM,,,278,RC,outpatient,,2447.58,2447.58,,2078,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,611.9,22,,percent of total billed charges,,,,,,,,,2202.82,90,,percent of total billed charges,,,2026.6,82.8,,percent of total billed charges,,,2080.44,85,,percent of total billed charges,,,,,,,,,2153.87,88,,percent of total billed charges,,,,,,,,,1869.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,611.9,22,,percent of total billed charges,,,2227.3,91,,percent of total billed charges,,,2325.2,95,,percent of total billed charges,,,2031.49,83,,percent of total billed charges,,,2031.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2031.49,83,,percent of total billed charges,,,2325.2,95,,percent of total billed charges,,,2202.82,90,,percent of total billed charges,,,2202.82,90,,percent of total billed charges,,,2007.02,82,,percent of total billed charges,,,2202.82,90,,percent of total billed charges,,,2080.44,85,,percent of total billed charges,,611.9,2325.2,
WRIGHT INSERT REVISION CCK,30184830,CDM,,,278,RC,outpatient,,19643,19643,,16676.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4910.75,22,,percent of total billed charges,,,,,,,,,17678.7,90,,percent of total billed charges,,,16264.4,82.8,,percent of total billed charges,,,16696.55,85,,percent of total billed charges,,,,,,,,,17285.84,88,,percent of total billed charges,,,,,,,,,15007.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4910.75,22,,percent of total billed charges,,,17875.13,91,,percent of total billed charges,,,18660.85,95,,percent of total billed charges,,,16303.69,83,,percent of total billed charges,,,16303.69,83,,percent of total billed charges,,,,,,,,,,,,,,,16303.69,83,,percent of total billed charges,,,18660.85,95,,percent of total billed charges,,,17678.7,90,,percent of total billed charges,,,17678.7,90,,percent of total billed charges,,,16107.26,82,,percent of total billed charges,,,17678.7,90,,percent of total billed charges,,,16696.55,85,,percent of total billed charges,,4910.75,18660.85,
ARTHREX SUTURE ANCHOR BC 3.5 X 19.5MM,30184833,CDM,,,278,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
ARTHREX SUTURE ANCHOR BC 3 X 14.5MM,30184834,CDM,,,278,RC,outpatient,,1982.5,1982.5,,1683.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,495.63,22,,percent of total billed charges,,,,,,,,,1784.25,90,,percent of total billed charges,,,1641.51,82.8,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,,,,,,,,1744.6,88,,percent of total billed charges,,,,,,,,,1514.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,495.63,22,,percent of total billed charges,,,1804.08,91,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1645.48,83,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1625.65,82,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,495.63,1883.38,
ARTHREX DRILL KIT PUSH LOCK,30184835,CDM,,,278,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
ARTHREX DRILL KIT SUTURE TAK,30184836,CDM,,,278,RC,outpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260,22,,percent of total billed charges,,,,,,,,,936,90,,percent of total billed charges,,,861.12,82.8,,percent of total billed charges,,,884,85,,percent of total billed charges,,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260,22,,percent of total billed charges,,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,260,988,
PEEK IMPLANT 8 MM X 12 MM X 9 MM,30184837,CDM,,,278,RC,outpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4225,22,,percent of total billed charges,,,,,,,,,15210,90,,percent of total billed charges,,,13993.2,82.8,,percent of total billed charges,,,14365,85,,percent of total billed charges,,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4225,22,,percent of total billed charges,,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,4225,16055,
DEPUY FEMORAL HEAD 28MM +3,30184838,CDM,,,278,RC,outpatient,,6922.18,6922.18,,5876.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1730.55,22,,percent of total billed charges,,,,,,,,,6229.96,90,,percent of total billed charges,,,5731.57,82.8,,percent of total billed charges,,,5883.85,85,,percent of total billed charges,,,,,,,,,6091.52,88,,percent of total billed charges,,,,,,,,,5288.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1730.55,22,,percent of total billed charges,,,6299.18,91,,percent of total billed charges,,,6576.07,95,,percent of total billed charges,,,5745.41,83,,percent of total billed charges,,,5745.41,83,,percent of total billed charges,,,,,,,,,,,,,,,5745.41,83,,percent of total billed charges,,,6576.07,95,,percent of total billed charges,,,6229.96,90,,percent of total billed charges,,,6229.96,90,,percent of total billed charges,,,5676.19,82,,percent of total billed charges,,,6229.96,90,,percent of total billed charges,,,5883.85,85,,percent of total billed charges,,1730.55,6576.07,
SYNTHES SCREW LOCKING 5.0MM X 36MM,30184839,CDM,,,278,RC,outpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,562.71,22,,percent of total billed charges,,,,,,,,,2025.74,90,,percent of total billed charges,,,1863.68,82.8,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,562.71,22,,percent of total billed charges,,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,562.71,2138.28,
ZIMMER BEARING LG LT SZ 7,30184840,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
ZIMMER STEM EXT OFFSET 14MM X 145MM,30184841,CDM,,,278,RC,outpatient,,18538,18538,,15738.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4634.5,22,,percent of total billed charges,,,,,,,,,16684.2,90,,percent of total billed charges,,,15349.46,82.8,,percent of total billed charges,,,15757.3,85,,percent of total billed charges,,,,,,,,,16313.44,88,,percent of total billed charges,,,,,,,,,14163.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4634.5,22,,percent of total billed charges,,,16869.58,91,,percent of total billed charges,,,17611.1,95,,percent of total billed charges,,,15386.54,83,,percent of total billed charges,,,15386.54,83,,percent of total billed charges,,,,,,,,,,,,,,,15386.54,83,,percent of total billed charges,,,17611.1,95,,percent of total billed charges,,,16684.2,90,,percent of total billed charges,,,16684.2,90,,percent of total billed charges,,,15201.16,82,,percent of total billed charges,,,16684.2,90,,percent of total billed charges,,,15757.3,85,,percent of total billed charges,,4634.5,17611.1,
ZIMMER AUGMENT TIBIAL FULL BLOCK 10MM SZ,30184842,CDM,,,278,RC,outpatient,,17810,17810,,15120.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4452.5,22,,percent of total billed charges,,,,,,,,,16029,90,,percent of total billed charges,,,14746.68,82.8,,percent of total billed charges,,,15138.5,85,,percent of total billed charges,,,,,,,,,15672.8,88,,percent of total billed charges,,,,,,,,,13606.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4452.5,22,,percent of total billed charges,,,16207.1,91,,percent of total billed charges,,,16919.5,95,,percent of total billed charges,,,14782.3,83,,percent of total billed charges,,,14782.3,83,,percent of total billed charges,,,,,,,,,,,,,,,14782.3,83,,percent of total billed charges,,,16919.5,95,,percent of total billed charges,,,16029,90,,percent of total billed charges,,,16029,90,,percent of total billed charges,,,14604.2,82,,percent of total billed charges,,,16029,90,,percent of total billed charges,,,15138.5,85,,percent of total billed charges,,4452.5,16919.5,
ZIMMER PLATE TIBIAL WEDGED A/P SZ4,30184843,CDM,,,278,RC,outpatient,,30680,30680,,26047.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7670,22,,percent of total billed charges,,,,,,,,,27612,90,,percent of total billed charges,,,25403.04,82.8,,percent of total billed charges,,,26078,85,,percent of total billed charges,,,,,,,,,26998.4,88,,percent of total billed charges,,,,,,,,,23439.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7670,22,,percent of total billed charges,,,27918.8,91,,percent of total billed charges,,,29146,95,,percent of total billed charges,,,25464.4,83,,percent of total billed charges,,,25464.4,83,,percent of total billed charges,,,,,,,,,,,,,,,25464.4,83,,percent of total billed charges,,,29146,95,,percent of total billed charges,,,27612,90,,percent of total billed charges,,,27612,90,,percent of total billed charges,,,25157.6,82,,percent of total billed charges,,,27612,90,,percent of total billed charges,,,26078,85,,percent of total billed charges,,7670,29146,
ZIMMER SURFACE LPS-FLEX FIXED 3-4 10MM,30184844,CDM,,,278,RC,outpatient,,15762.5,15762.5,,13382.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3940.63,22,,percent of total billed charges,,,,,,,,,14186.25,90,,percent of total billed charges,,,13051.35,82.8,,percent of total billed charges,,,13398.13,85,,percent of total billed charges,,,,,,,,,13871,88,,percent of total billed charges,,,,,,,,,12042.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3940.63,22,,percent of total billed charges,,,14343.88,91,,percent of total billed charges,,,14974.38,95,,percent of total billed charges,,,13082.88,83,,percent of total billed charges,,,13082.88,83,,percent of total billed charges,,,,,,,,,,,,,,,13082.88,83,,percent of total billed charges,,,14974.38,95,,percent of total billed charges,,,14186.25,90,,percent of total billed charges,,,14186.25,90,,percent of total billed charges,,,12925.25,82,,percent of total billed charges,,,14186.25,90,,percent of total billed charges,,,13398.13,85,,percent of total billed charges,,3940.63,14974.38,
ZIMMER SURFACE LPS-FLEX FIXED 3-4 12MM,30184845,CDM,,,278,RC,outpatient,,15762.5,15762.5,,13382.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3940.63,22,,percent of total billed charges,,,,,,,,,14186.25,90,,percent of total billed charges,,,13051.35,82.8,,percent of total billed charges,,,13398.13,85,,percent of total billed charges,,,,,,,,,13871,88,,percent of total billed charges,,,,,,,,,12042.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3940.63,22,,percent of total billed charges,,,14343.88,91,,percent of total billed charges,,,14974.38,95,,percent of total billed charges,,,13082.88,83,,percent of total billed charges,,,13082.88,83,,percent of total billed charges,,,,,,,,,,,,,,,13082.88,83,,percent of total billed charges,,,14974.38,95,,percent of total billed charges,,,14186.25,90,,percent of total billed charges,,,14186.25,90,,percent of total billed charges,,,12925.25,82,,percent of total billed charges,,,14186.25,90,,percent of total billed charges,,,13398.13,85,,percent of total billed charges,,3940.63,14974.38,
ALLODERM TISSUE MATRIX PERF. SM 77SQ CM,30184846,CDM,,,278,RC,outpatient,,22386,22386,,19005.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5596.5,22,,percent of total billed charges,,,,,,,,,20147.4,90,,percent of total billed charges,,,18535.61,82.8,,percent of total billed charges,,,19028.1,85,,percent of total billed charges,,,,,,,,,19699.68,88,,percent of total billed charges,,,,,,,,,17102.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5596.5,22,,percent of total billed charges,,,20371.26,91,,percent of total billed charges,,,21266.7,95,,percent of total billed charges,,,18580.38,83,,percent of total billed charges,,,18580.38,83,,percent of total billed charges,,,,,,,,,,,,,,,18580.38,83,,percent of total billed charges,,,21266.7,95,,percent of total billed charges,,,20147.4,90,,percent of total billed charges,,,20147.4,90,,percent of total billed charges,,,18356.52,82,,percent of total billed charges,,,20147.4,90,,percent of total billed charges,,,19028.1,85,,percent of total billed charges,,5596.5,21266.7,
SCREW POLYAXIAL 3.5 X 12MM,30184847,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
SCREW SET- IR SURGICAL,30184848,CDM,,,278,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
ROD 3.5 X 50MM,30184849,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
SCREW POLYAXIAL 3.5 X 24MM,30184850,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
LINQ IMPLANTABLE CARDIAC MONITOR,30184851,CDM,,,278,RC,outpatient,,30192.5,30192.5,,25633.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7548.13,22,,percent of total billed charges,,,,,,,,,27173.25,90,,percent of total billed charges,,,24999.39,82.8,,percent of total billed charges,,,25663.63,85,,percent of total billed charges,,,,,,,,,26569.4,88,,percent of total billed charges,,,,,,,,,23067.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7548.13,22,,percent of total billed charges,,,27475.18,91,,percent of total billed charges,,,28682.88,95,,percent of total billed charges,,,25059.78,83,,percent of total billed charges,,,25059.78,83,,percent of total billed charges,,,,,,,,,,,,,,,25059.78,83,,percent of total billed charges,,,28682.88,95,,percent of total billed charges,,,27173.25,90,,percent of total billed charges,,,27173.25,90,,percent of total billed charges,,,24757.85,82,,percent of total billed charges,,,27173.25,90,,percent of total billed charges,,,25663.63,85,,percent of total billed charges,,7548.13,28682.88,
HOLMIUM FIBER 200-2,30184852,CDM,,,270,RC,outpatient,,1397.5,1397.5,,1186.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,349.38,22,,percent of total billed charges,,,,,,,,,1257.75,90,,percent of total billed charges,,,1157.13,82.8,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,,,,,,,,1229.8,88,,percent of total billed charges,,,,,,,,,1067.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,349.38,22,,percent of total billed charges,,,1271.73,91,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1159.93,83,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1145.95,82,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,349.38,1327.63,
LINEAR ST 50CM 8 CONTACT,30184853,CDM,,,270,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
O.R. CABLE 2X8 61CM,30184854,CDM,,,270,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
PATIENT TRIAL KIT 52,30184855,CDM,,,270,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
LINEAR ST 70CM 8 CONTACT,30184856,CDM,,,270,RC,outpatient,,12350,12350,,10485.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3087.5,22,,percent of total billed charges,,,,,,,,,11115,90,,percent of total billed charges,,,10225.8,82.8,,percent of total billed charges,,,10497.5,85,,percent of total billed charges,,,,,,,,,10868,88,,percent of total billed charges,,,,,,,,,9435.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3087.5,22,,percent of total billed charges,,,11238.5,91,,percent of total billed charges,,,11732.5,95,,percent of total billed charges,,,10250.5,83,,percent of total billed charges,,,10250.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10250.5,83,,percent of total billed charges,,,11732.5,95,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,10127,82,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,10497.5,85,,percent of total billed charges,,3087.5,11732.5,
CHOICE SPINE PLATE 3-LEVEL 54MM,30184858,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
CHOICE SPINE DRILL 2.7MM X 12MM,30184859,CDM,,,278,RC,outpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,552.5,22,,percent of total billed charges,,,,,,,,,1989,90,,percent of total billed charges,,,1829.88,82.8,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,552.5,22,,percent of total billed charges,,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,552.5,2099.5,
CHOICE SPINE SCREW VARIABLE ANGLE 4.0X14,30184860,CDM,,,278,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
CHOICE SPINE PEEK STEALTH 7MM 6DEG 12X14,30184861,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
CHOICE SPINE PEEK STEALTH 7MM 6DEG 14X16,30184862,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
CHOICE SPINE PEEK STEALTH 8MM 6DEG 14X16,30184863,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
CHOICE SPINE SCREW VARIABLE ANGLE 4X16MM,30184864,CDM,,,278,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
CHOICE SPINE DRILL 2.7 X 10MM,30184865,CDM,,,278,RC,outpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,552.5,22,,percent of total billed charges,,,,,,,,,1989,90,,percent of total billed charges,,,1829.88,82.8,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,552.5,22,,percent of total billed charges,,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,552.5,2099.5,
CHOICE SPINE PLATE 2-LEVEL 30MM,30184866,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
CHOICE SPINE SCREW S-D VARIABLE ANGLE 12,30184867,CDM,,,278,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
DEPUY STEM FLUTED UNIV 75 X 22,30184868,CDM,,,278,RC,outpatient,,9024.34,9024.34,,7661.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2256.09,22,,percent of total billed charges,,,,,,,,,8121.91,90,,percent of total billed charges,,,7472.15,82.8,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,,,,,,,,7941.42,88,,percent of total billed charges,,,,,,,,,6894.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2256.09,22,,percent of total billed charges,,,8212.15,91,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,,,,,,,,,,,,,7490.2,83,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7399.96,82,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,2256.09,8573.12,
SYNTHES SCREW CORTEX 3.5 X 50MM SELF TAP,30184871,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
SYNTHES SCREW CANNUL 6.5X60MM,30184872,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
ZIMMER SCP KIT W/ACCUPORT SIDE-DELIVERY,30184873,CDM,,,278,RC,outpatient,,23725,23725,,20142.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5931.25,22,,percent of total billed charges,,,,,,,,,21352.5,90,,percent of total billed charges,,,19644.3,82.8,,percent of total billed charges,,,20166.25,85,,percent of total billed charges,,,,,,,,,20878,88,,percent of total billed charges,,,,,,,,,18125.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5931.25,22,,percent of total billed charges,,,21589.75,91,,percent of total billed charges,,,22538.75,95,,percent of total billed charges,,,19691.75,83,,percent of total billed charges,,,19691.75,83,,percent of total billed charges,,,,,,,,,,,,,,,19691.75,83,,percent of total billed charges,,,22538.75,95,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,19454.5,82,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,20166.25,85,,percent of total billed charges,,5931.25,22538.75,
ZIMMER ACCUMIX MIXING SYSTEM,30184874,CDM,,,270,RC,outpatient,,1885,1885,,1600.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,471.25,22,,percent of total billed charges,,,,,,,,,1696.5,90,,percent of total billed charges,,,1560.78,82.8,,percent of total billed charges,,,1602.25,85,,percent of total billed charges,,,,,,,,,1658.8,88,,percent of total billed charges,,,,,,,,,1440.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,471.25,22,,percent of total billed charges,,,1715.35,91,,percent of total billed charges,,,1790.75,95,,percent of total billed charges,,,1564.55,83,,percent of total billed charges,,,1564.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1564.55,83,,percent of total billed charges,,,1790.75,95,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1545.7,82,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1602.25,85,,percent of total billed charges,,471.25,1790.75,
S&N ENDO SCREW SOFT SILK 2.0 7MM X 25MM,30184875,CDM,,,278,RC,outpatient,,1487.85,1487.85,,1263.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,371.96,22,,percent of total billed charges,,,,,,,,,1339.07,90,,percent of total billed charges,,,1231.94,82.8,,percent of total billed charges,,,1264.67,85,,percent of total billed charges,,,,,,,,,1309.31,88,,percent of total billed charges,,,,,,,,,1136.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,371.96,22,,percent of total billed charges,,,1353.94,91,,percent of total billed charges,,,1413.46,95,,percent of total billed charges,,,1234.92,83,,percent of total billed charges,,,1234.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1234.92,83,,percent of total billed charges,,,1413.46,95,,percent of total billed charges,,,1339.07,90,,percent of total billed charges,,,1339.07,90,,percent of total billed charges,,,1220.04,82,,percent of total billed charges,,,1339.07,90,,percent of total billed charges,,,1264.67,85,,percent of total billed charges,,371.96,1413.46,
DEPUY SHELL BIPOLAR 57,30184876,CDM,,,278,RC,outpatient,,6675.44,6675.44,,5667.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1668.86,22,,percent of total billed charges,,,,,,,,,6007.9,90,,percent of total billed charges,,,5527.26,82.8,,percent of total billed charges,,,5674.12,85,,percent of total billed charges,,,,,,,,,5874.39,88,,percent of total billed charges,,,,,,,,,5100.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1668.86,22,,percent of total billed charges,,,6074.65,91,,percent of total billed charges,,,6341.67,95,,percent of total billed charges,,,5540.62,83,,percent of total billed charges,,,5540.62,83,,percent of total billed charges,,,,,,,,,,,,,,,5540.62,83,,percent of total billed charges,,,6341.67,95,,percent of total billed charges,,,6007.9,90,,percent of total billed charges,,,6007.9,90,,percent of total billed charges,,,5473.86,82,,percent of total billed charges,,,6007.9,90,,percent of total billed charges,,,5674.12,85,,percent of total billed charges,,1668.86,6341.67,
DEPUY STEM SUMMIT CEMENTED SZ 7 STD,30184877,CDM,,,278,RC,outpatient,,25228.19,25228.19,,21418.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6307.05,22,,percent of total billed charges,,,,,,,,,22705.37,90,,percent of total billed charges,,,20888.94,82.8,,percent of total billed charges,,,21443.96,85,,percent of total billed charges,,,,,,,,,22200.81,88,,percent of total billed charges,,,,,,,,,19274.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6307.05,22,,percent of total billed charges,,,22957.65,91,,percent of total billed charges,,,23966.78,95,,percent of total billed charges,,,20939.4,83,,percent of total billed charges,,,20939.4,83,,percent of total billed charges,,,,,,,,,,,,,,,20939.4,83,,percent of total billed charges,,,23966.78,95,,percent of total billed charges,,,22705.37,90,,percent of total billed charges,,,22705.37,90,,percent of total billed charges,,,20687.12,82,,percent of total billed charges,,,22705.37,90,,percent of total billed charges,,,21443.96,85,,percent of total billed charges,,6307.05,23966.78,
DEPUY STEM GLOBAL UNITED SZ 8,30184878,CDM,,,278,RC,outpatient,,26023.86,26023.86,,22094.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6505.97,22,,percent of total billed charges,,,,,,,,,23421.47,90,,percent of total billed charges,,,21547.76,82.8,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,,,,,,,,22901,88,,percent of total billed charges,,,,,,,,,19882.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6505.97,22,,percent of total billed charges,,,23681.71,91,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21599.8,83,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,21339.57,82,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,6505.97,24722.67,
MONTAGE MRI 16 IMPLANTABLE GENERATOR KIT,30184879,CDM,,,278,RC,outpatient,,110500,110500,,93814.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27625,22,,percent of total billed charges,,,,,,,,,99450,90,,percent of total billed charges,,,91494,82.8,,percent of total billed charges,,,93925,85,,percent of total billed charges,,,,,,,,,97240,88,,percent of total billed charges,,,,,,,,,84422,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27625,22,,percent of total billed charges,,,100555,91,,percent of total billed charges,,,104975,95,,percent of total billed charges,,,91715,83,,percent of total billed charges,,,91715,83,,percent of total billed charges,,,,,,,,,,,,,,,91715,83,,percent of total billed charges,,,104975,95,,percent of total billed charges,,,99450,90,,percent of total billed charges,,,99450,90,,percent of total billed charges,,,90610,82,,percent of total billed charges,,,99450,90,,percent of total billed charges,,,93925,85,,percent of total billed charges,,27625,104975,
AVISTA MRI LEAD KIT 74CM 8 CONTACT,30184880,CDM,,,278,RC,outpatient,,18200,18200,,15451.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4550,22,,percent of total billed charges,,,,,,,,,16380,90,,percent of total billed charges,,,15069.6,82.8,,percent of total billed charges,,,15470,85,,percent of total billed charges,,,,,,,,,16016,88,,percent of total billed charges,,,,,,,,,13904.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4550,22,,percent of total billed charges,,,16562,91,,percent of total billed charges,,,17290,95,,percent of total billed charges,,,15106,83,,percent of total billed charges,,,15106,83,,percent of total billed charges,,,,,,,,,,,,,,,15106,83,,percent of total billed charges,,,17290,95,,percent of total billed charges,,,16380,90,,percent of total billed charges,,,16380,90,,percent of total billed charges,,,14924,82,,percent of total billed charges,,,16380,90,,percent of total billed charges,,,15470,85,,percent of total billed charges,,4550,17290,
PRECISION CHARGING SYSTEM KIT,30184881,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
PRECISION REMOTE CONTROL KIT,30184882,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
CLIK X MRI ANCHOR,30184883,CDM,,,270,RC,outpatient,,2193.75,2193.75,,1862.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,548.44,22,,percent of total billed charges,,,,,,,,,1974.38,90,,percent of total billed charges,,,1816.43,82.8,,percent of total billed charges,,,1864.69,85,,percent of total billed charges,,,,,,,,,1930.5,88,,percent of total billed charges,,,,,,,,,1676.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,548.44,22,,percent of total billed charges,,,1996.31,91,,percent of total billed charges,,,2084.06,95,,percent of total billed charges,,,1820.81,83,,percent of total billed charges,,,1820.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1820.81,83,,percent of total billed charges,,,2084.06,95,,percent of total billed charges,,,1974.38,90,,percent of total billed charges,,,1974.38,90,,percent of total billed charges,,,1798.88,82,,percent of total billed charges,,,1974.38,90,,percent of total billed charges,,,1864.69,85,,percent of total billed charges,,548.44,2084.06,
TUNNELING TOOL LONG 35CM,30184884,CDM,,,270,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
PEEK CAGE 10MM,30184885,CDM,,,278,RC,outpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4225,22,,percent of total billed charges,,,,,,,,,15210,90,,percent of total billed charges,,,13993.2,82.8,,percent of total billed charges,,,14365,85,,percent of total billed charges,,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4225,22,,percent of total billed charges,,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,4225,16055,
DEPUY BIPOLAR SHELL 40OD,30184886,CDM,,,278,RC,outpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.27,22,,percent of total billed charges,,,,,,,,,7312.56,90,,percent of total billed charges,,,6727.56,82.8,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.27,22,,percent of total billed charges,,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,2031.27,7718.82,
DEPUY PRIMARY BIPOLAR METAL HEAD CAP,30184887,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
DEPUY STEM CEMENTED PRIMARY FX CAP,30184888,CDM,,,278,RC,outpatient,,12350,12350,,10485.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3087.5,22,,percent of total billed charges,,,,,,,,,11115,90,,percent of total billed charges,,,10225.8,82.8,,percent of total billed charges,,,10497.5,85,,percent of total billed charges,,,,,,,,,10868,88,,percent of total billed charges,,,,,,,,,9435.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3087.5,22,,percent of total billed charges,,,11238.5,91,,percent of total billed charges,,,11732.5,95,,percent of total billed charges,,,10250.5,83,,percent of total billed charges,,,10250.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10250.5,83,,percent of total billed charges,,,11732.5,95,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,10127,82,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,10497.5,85,,percent of total billed charges,,3087.5,11732.5,
SYNTHES SCREW CANNUL 4.0X50MM,30184891,CDM,,,278,RC,outpatient,,2063.23,2063.23,,1751.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,515.81,22,,percent of total billed charges,,,,,,,,,1856.91,90,,percent of total billed charges,,,1708.35,82.8,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,,,,,,,,1815.64,88,,percent of total billed charges,,,,,,,,,1576.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,515.81,22,,percent of total billed charges,,,1877.54,91,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1712.48,83,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1691.85,82,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,515.81,1960.07,
ARTHREX REAMER 10MM COW PRO,30184892,CDM,,,278,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
ARTHREX SPEED CINCH,30184893,CDM,,,270,RC,outpatient,,2567.5,2567.5,,2179.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,641.88,22,,percent of total billed charges,,,,,,,,,2310.75,90,,percent of total billed charges,,,2125.89,82.8,,percent of total billed charges,,,2182.38,85,,percent of total billed charges,,,,,,,,,2259.4,88,,percent of total billed charges,,,,,,,,,1961.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,641.88,22,,percent of total billed charges,,,2336.43,91,,percent of total billed charges,,,2439.13,95,,percent of total billed charges,,,2131.03,83,,percent of total billed charges,,,2131.03,83,,percent of total billed charges,,,,,,,,,,,,,,,2131.03,83,,percent of total billed charges,,,2439.13,95,,percent of total billed charges,,,2310.75,90,,percent of total billed charges,,,2310.75,90,,percent of total billed charges,,,2105.35,82,,percent of total billed charges,,,2310.75,90,,percent of total billed charges,,,2182.38,85,,percent of total billed charges,,641.88,2439.13,
SCREW POLYAXIAL 5.5 X 45MM,30184894,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
MEDTRONIC PACER,30184895,CDM,,,278,RC,outpatient,,31018,31018,,26334.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7754.5,22,,percent of total billed charges,,,,,,,,,27916.2,90,,percent of total billed charges,,,25682.9,82.8,,percent of total billed charges,,,26365.3,85,,percent of total billed charges,,,,,,,,,27295.84,88,,percent of total billed charges,,,,,,,,,23697.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7754.5,22,,percent of total billed charges,,,28226.38,91,,percent of total billed charges,,,29467.1,95,,percent of total billed charges,,,25744.94,83,,percent of total billed charges,,,25744.94,83,,percent of total billed charges,,,,,,,,,,,,,,,25744.94,83,,percent of total billed charges,,,29467.1,95,,percent of total billed charges,,,27916.2,90,,percent of total billed charges,,,27916.2,90,,percent of total billed charges,,,25434.76,82,,percent of total billed charges,,,27916.2,90,,percent of total billed charges,,,26365.3,85,,percent of total billed charges,,7754.5,29467.1,
DEPUY FEMUR ATTUNE CR SZ 5 RT,30184896,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
INVUITY PHOTONGUIDE WIDE/FLAT,30184897,CDM,,,270,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
SYNTHES SCREW CORTEX S-T 2.7 X 22MM,30184898,CDM,,,278,RC,outpatient,,386.75,386.75,,328.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.69,22,,percent of total billed charges,,,,,,,,,348.08,90,,percent of total billed charges,,,320.23,82.8,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,,,,,,,,340.34,88,,percent of total billed charges,,,,,,,,,295.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.69,22,,percent of total billed charges,,,351.94,91,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,321,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,,,,,,,,,,,,,,321,83,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,317.14,82,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,96.69,367.41,
SYNTHES K-WIRE 1.6MM,30184899,CDM,,,278,RC,outpatient,,111.82,111.82,,94.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.96,22,,percent of total billed charges,,,,,,,,,100.64,90,,percent of total billed charges,,,92.59,82.8,,percent of total billed charges,,,95.05,85,,percent of total billed charges,,,,,,,,,98.4,88,,percent of total billed charges,,,,,,,,,85.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.96,22,,percent of total billed charges,,,101.76,91,,percent of total billed charges,,,106.23,95,,percent of total billed charges,,,92.81,83,,percent of total billed charges,,,92.81,83,,percent of total billed charges,,,,,,,,,,,,,,,92.81,83,,percent of total billed charges,,,106.23,95,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,91.69,82,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,95.05,85,,percent of total billed charges,,27.96,106.23,
ARTHREX CALIBLATOR COOLCUT,30184901,CDM,,,278,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
ARTHREX KIT TENO DISPS 3X8MM,30184902,CDM,,,278,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
ARTHREX SCREW TENO BIO-COMP 3X8MM,30184903,CDM,,,278,RC,outpatient,,2632.5,2632.5,,2234.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,658.13,22,,percent of total billed charges,,,,,,,,,2369.25,90,,percent of total billed charges,,,2179.71,82.8,,percent of total billed charges,,,2237.63,85,,percent of total billed charges,,,,,,,,,2316.6,88,,percent of total billed charges,,,,,,,,,2011.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,658.13,22,,percent of total billed charges,,,2395.58,91,,percent of total billed charges,,,2500.88,95,,percent of total billed charges,,,2184.98,83,,percent of total billed charges,,,2184.98,83,,percent of total billed charges,,,,,,,,,,,,,,,2184.98,83,,percent of total billed charges,,,2500.88,95,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2158.65,82,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2237.63,85,,percent of total billed charges,,658.13,2500.88,
SYNTHES PLATE LCP RECON. 3.5X84MM 5 HOLE,30184904,CDM,,,278,RC,outpatient,,4044.3,4044.3,,3433.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1011.08,22,,percent of total billed charges,,,,,,,,,3639.87,90,,percent of total billed charges,,,3348.68,82.8,,percent of total billed charges,,,3437.66,85,,percent of total billed charges,,,,,,,,,3558.98,88,,percent of total billed charges,,,,,,,,,3089.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1011.08,22,,percent of total billed charges,,,3680.31,91,,percent of total billed charges,,,3842.09,95,,percent of total billed charges,,,3356.77,83,,percent of total billed charges,,,3356.77,83,,percent of total billed charges,,,,,,,,,,,,,,,3356.77,83,,percent of total billed charges,,,3842.09,95,,percent of total billed charges,,,3639.87,90,,percent of total billed charges,,,3639.87,90,,percent of total billed charges,,,3316.33,82,,percent of total billed charges,,,3639.87,90,,percent of total billed charges,,,3437.66,85,,percent of total billed charges,,1011.08,3842.09,
SYNTHES SCREW CORTEX 3.5X10MM,30184905,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
SYNTHES PLATE OLEARANON VA 2.7 X 3.5,30184906,CDM,,,278,RC,outpatient,,9464.33,9464.33,,8035.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2366.08,22,,percent of total billed charges,,,,,,,,,8517.9,90,,percent of total billed charges,,,7836.47,82.8,,percent of total billed charges,,,8044.68,85,,percent of total billed charges,,,,,,,,,8328.61,88,,percent of total billed charges,,,,,,,,,7230.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2366.08,22,,percent of total billed charges,,,8612.54,91,,percent of total billed charges,,,8991.11,95,,percent of total billed charges,,,7855.39,83,,percent of total billed charges,,,7855.39,83,,percent of total billed charges,,,,,,,,,,,,,,,7855.39,83,,percent of total billed charges,,,8991.11,95,,percent of total billed charges,,,8517.9,90,,percent of total billed charges,,,8517.9,90,,percent of total billed charges,,,7760.75,82,,percent of total billed charges,,,8517.9,90,,percent of total billed charges,,,8044.68,85,,percent of total billed charges,,2366.08,8991.11,
SYNTHES SCREW CORTEX 2.7 X 14MM,30184907,CDM,,,278,RC,outpatient,,492.38,492.38,,418.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.1,22,,percent of total billed charges,,,,,,,,,443.14,90,,percent of total billed charges,,,407.69,82.8,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,,,,,,,,433.29,88,,percent of total billed charges,,,,,,,,,376.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.1,22,,percent of total billed charges,,,448.07,91,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,,,,,,,,,,,,,408.68,83,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,403.75,82,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,123.1,467.76,
SYNTHES SCREW LOCKING VA 2.7MM X 10MM,30184908,CDM,,,278,RC,outpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,353.16,22,,percent of total billed charges,,,,,,,,,1271.39,90,,percent of total billed charges,,,1169.67,82.8,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,353.16,22,,percent of total billed charges,,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,353.16,1342.02,
SYNTHES SCREW LOCKING VA 2.7MM X 12MM,30184909,CDM,,,278,RC,outpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,353.16,22,,percent of total billed charges,,,,,,,,,1271.39,90,,percent of total billed charges,,,1169.67,82.8,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,353.16,22,,percent of total billed charges,,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,353.16,1342.02,
SYNTHES SCREW LOCKING VA 2.7MM X 14MM,30184910,CDM,,,278,RC,outpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,353.16,22,,percent of total billed charges,,,,,,,,,1271.39,90,,percent of total billed charges,,,1169.67,82.8,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,353.16,22,,percent of total billed charges,,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,353.16,1342.02,
SYNTHES SCREW LOCKING VA 2.7MM X 22MM,30184911,CDM,,,278,RC,outpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,353.16,22,,percent of total billed charges,,,,,,,,,1271.39,90,,percent of total billed charges,,,1169.67,82.8,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,353.16,22,,percent of total billed charges,,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,353.16,1342.02,
SYNTHES SCREW LOCKING VA 2.7MM X 40MM,30184912,CDM,,,278,RC,outpatient,,1331.53,1331.53,,1130.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,332.88,22,,percent of total billed charges,,,,,,,,,1198.38,90,,percent of total billed charges,,,1102.51,82.8,,percent of total billed charges,,,1131.8,85,,percent of total billed charges,,,,,,,,,1171.75,88,,percent of total billed charges,,,,,,,,,1017.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,332.88,22,,percent of total billed charges,,,1211.69,91,,percent of total billed charges,,,1264.95,95,,percent of total billed charges,,,1105.17,83,,percent of total billed charges,,,1105.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1105.17,83,,percent of total billed charges,,,1264.95,95,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1091.85,82,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1131.8,85,,percent of total billed charges,,332.88,1264.95,
SYNTHES SCREW LOCKING VA 2.7MM X 50MM,30184913,CDM,,,278,RC,outpatient,,1371.5,1371.5,,1164.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,342.88,22,,percent of total billed charges,,,,,,,,,1234.35,90,,percent of total billed charges,,,1135.6,82.8,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,,,,,,,,1206.92,88,,percent of total billed charges,,,,,,,,,1047.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,342.88,22,,percent of total billed charges,,,1248.07,91,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.35,83,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1124.63,82,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,342.88,1302.93,
CAPSULAR TENSION RING EYEJET CTR,30184914,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
ZIMMER KNEE KIT SUBCHONDROPLASTY W/SIDE,30184915,CDM,,,278,RC,outpatient,,23725,23725,,20142.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5931.25,22,,percent of total billed charges,,,,,,,,,21352.5,90,,percent of total billed charges,,,19644.3,82.8,,percent of total billed charges,,,20166.25,85,,percent of total billed charges,,,,,,,,,20878,88,,percent of total billed charges,,,,,,,,,18125.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5931.25,22,,percent of total billed charges,,,21589.75,91,,percent of total billed charges,,,22538.75,95,,percent of total billed charges,,,19691.75,83,,percent of total billed charges,,,19691.75,83,,percent of total billed charges,,,,,,,,,,,,,,,19691.75,83,,percent of total billed charges,,,22538.75,95,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,19454.5,82,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,20166.25,85,,percent of total billed charges,,5931.25,22538.75,
ZIMMER BEARING LG LT SZ 5,30184916,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
DEPUY INSERT SIGMA 2.5 X 10MM STABILIZED,30184917,CDM,,,278,RC,outpatient,,17187.04,17187.04,,14591.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4296.76,22,,percent of total billed charges,,,,,,,,,15468.34,90,,percent of total billed charges,,,14230.87,82.8,,percent of total billed charges,,,14608.98,85,,percent of total billed charges,,,,,,,,,15124.6,88,,percent of total billed charges,,,,,,,,,13130.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4296.76,22,,percent of total billed charges,,,15640.21,91,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,,,,,,,,,,,,,14265.24,83,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14093.37,82,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14608.98,85,,percent of total billed charges,,4296.76,16327.69,
PEEK CAGE 0DEG 25X09X11,30184918,CDM,,,278,RC,outpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4225,22,,percent of total billed charges,,,,,,,,,15210,90,,percent of total billed charges,,,13993.2,82.8,,percent of total billed charges,,,14365,85,,percent of total billed charges,,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4225,22,,percent of total billed charges,,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,4225,16055,
SYNTHES PLATE VOLAR DIST. RAD. 2.4MM 3 H,30184919,CDM,,,278,RC,outpatient,,9762.68,9762.68,,8288.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2440.67,22,,percent of total billed charges,,,,,,,,,8786.41,90,,percent of total billed charges,,,8083.5,82.8,,percent of total billed charges,,,8298.28,85,,percent of total billed charges,,,,,,,,,8591.16,88,,percent of total billed charges,,,,,,,,,7458.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2440.67,22,,percent of total billed charges,,,8884.04,91,,percent of total billed charges,,,9274.55,95,,percent of total billed charges,,,8103.02,83,,percent of total billed charges,,,8103.02,83,,percent of total billed charges,,,,,,,,,,,,,,,8103.02,83,,percent of total billed charges,,,9274.55,95,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8005.4,82,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8298.28,85,,percent of total billed charges,,2440.67,9274.55,
DEPUY HUMERAL STEM CEMENTED SZ 12 STD,30184920,CDM,,,278,RC,outpatient,,35653.09,35653.09,,30269.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8913.27,22,,percent of total billed charges,,,,,,,,,32087.78,90,,percent of total billed charges,,,29520.76,82.8,,percent of total billed charges,,,30305.13,85,,percent of total billed charges,,,,,,,,,31374.72,88,,percent of total billed charges,,,,,,,,,27238.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8913.27,22,,percent of total billed charges,,,32444.31,91,,percent of total billed charges,,,33870.44,95,,percent of total billed charges,,,29592.06,83,,percent of total billed charges,,,29592.06,83,,percent of total billed charges,,,,,,,,,,,,,,,29592.06,83,,percent of total billed charges,,,33870.44,95,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,29235.53,82,,percent of total billed charges,,,32087.78,90,,percent of total billed charges,,,30305.13,85,,percent of total billed charges,,8913.27,33870.44,
DEPUY LINER ALTRX +4 10DEG SZ 58,30184921,CDM,,,278,RC,outpatient,,14161.81,14161.81,,12023.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3540.45,22,,percent of total billed charges,,,,,,,,,12745.63,90,,percent of total billed charges,,,11725.98,82.8,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,,,,,,,,12462.39,88,,percent of total billed charges,,,,,,,,,10819.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3540.45,22,,percent of total billed charges,,,12887.25,91,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,11754.3,83,,percent of total billed charges,,,,,,,,,,,,,,,11754.3,83,,percent of total billed charges,,,13453.72,95,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,11612.68,82,,percent of total billed charges,,,12745.63,90,,percent of total billed charges,,,12037.54,85,,percent of total billed charges,,3540.45,13453.72,
SYNTHES SCREW CORTEX 3.5X30MM,30184922,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
ALLOSOURCE PATELLA HEMI BTB ALLOGRAFT,30184923,CDM,,,278,RC,outpatient,,12480,12480,,10595.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3120,22,,percent of total billed charges,,,,,,,,,11232,90,,percent of total billed charges,,,10333.44,82.8,,percent of total billed charges,,,10608,85,,percent of total billed charges,,,,,,,,,10982.4,88,,percent of total billed charges,,,,,,,,,9534.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3120,22,,percent of total billed charges,,,11356.8,91,,percent of total billed charges,,,11856,95,,percent of total billed charges,,,10358.4,83,,percent of total billed charges,,,10358.4,83,,percent of total billed charges,,,,,,,,,,,,,,,10358.4,83,,percent of total billed charges,,,11856,95,,percent of total billed charges,,,11232,90,,percent of total billed charges,,,11232,90,,percent of total billed charges,,,10233.6,82,,percent of total billed charges,,,11232,90,,percent of total billed charges,,,10608,85,,percent of total billed charges,,3120,11856,
DEPUY INSERT LPS MEDIUM 12MM,30184924,CDM,,,278,RC,outpatient,,24320.34,24320.34,,20647.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6080.09,22,,percent of total billed charges,,,,,,,,,21888.31,90,,percent of total billed charges,,,20137.24,82.8,,percent of total billed charges,,,20672.29,85,,percent of total billed charges,,,,,,,,,21401.9,88,,percent of total billed charges,,,,,,,,,18580.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6080.09,22,,percent of total billed charges,,,22131.51,91,,percent of total billed charges,,,23104.32,95,,percent of total billed charges,,,20185.88,83,,percent of total billed charges,,,20185.88,83,,percent of total billed charges,,,,,,,,,,,,,,,20185.88,83,,percent of total billed charges,,,23104.32,95,,percent of total billed charges,,,21888.31,90,,percent of total billed charges,,,21888.31,90,,percent of total billed charges,,,19942.68,82,,percent of total billed charges,,,21888.31,90,,percent of total billed charges,,,20672.29,85,,percent of total billed charges,,6080.09,23104.32,
DEPUY SLEEVE FEMORAL 34MM,30184925,CDM,,,278,RC,outpatient,,18062.14,18062.14,,15334.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4515.54,22,,percent of total billed charges,,,,,,,,,16255.93,90,,percent of total billed charges,,,14955.45,82.8,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,,,,,,,,15894.68,88,,percent of total billed charges,,,,,,,,,13799.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4515.54,22,,percent of total billed charges,,,16436.55,91,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,14991.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14991.58,83,,percent of total billed charges,,,17159.03,95,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,14810.95,82,,percent of total billed charges,,,16255.93,90,,percent of total billed charges,,,15352.82,85,,percent of total billed charges,,4515.54,17159.03,
DEPUY FEMUR S-ROM LEFT,30184926,CDM,,,278,RC,outpatient,,37437.86,37437.86,,31784.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9359.47,22,,percent of total billed charges,,,,,,,,,33694.07,90,,percent of total billed charges,,,30998.55,82.8,,percent of total billed charges,,,31822.18,85,,percent of total billed charges,,,,,,,,,32945.32,88,,percent of total billed charges,,,,,,,,,28602.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9359.47,22,,percent of total billed charges,,,34068.45,91,,percent of total billed charges,,,35565.97,95,,percent of total billed charges,,,31073.42,83,,percent of total billed charges,,,31073.42,83,,percent of total billed charges,,,,,,,,,,,,,,,31073.42,83,,percent of total billed charges,,,35565.97,95,,percent of total billed charges,,,33694.07,90,,percent of total billed charges,,,33694.07,90,,percent of total billed charges,,,30699.05,82,,percent of total billed charges,,,33694.07,90,,percent of total billed charges,,,31822.18,85,,percent of total billed charges,,9359.47,35565.97,
SYNTHES ROD REAMER 2.5MM,30184927,CDM,,,278,RC,outpatient,,1171.3,1171.3,,994.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,292.83,22,,percent of total billed charges,,,,,,,,,1054.17,90,,percent of total billed charges,,,969.84,82.8,,percent of total billed charges,,,995.61,85,,percent of total billed charges,,,,,,,,,1030.74,88,,percent of total billed charges,,,,,,,,,894.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,292.83,22,,percent of total billed charges,,,1065.88,91,,percent of total billed charges,,,1112.74,95,,percent of total billed charges,,,972.18,83,,percent of total billed charges,,,972.18,83,,percent of total billed charges,,,,,,,,,,,,,,,972.18,83,,percent of total billed charges,,,1112.74,95,,percent of total billed charges,,,1054.17,90,,percent of total billed charges,,,1054.17,90,,percent of total billed charges,,,960.47,82,,percent of total billed charges,,,1054.17,90,,percent of total billed charges,,,995.61,85,,percent of total billed charges,,292.83,1112.74,
SYNTHES ROD TIBIA 9MM X 345,30184928,CDM,,,278,RC,outpatient,,15439.13,15439.13,,13107.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3859.78,22,,percent of total billed charges,,,,,,,,,13895.22,90,,percent of total billed charges,,,12783.6,82.8,,percent of total billed charges,,,13123.26,85,,percent of total billed charges,,,,,,,,,13586.43,88,,percent of total billed charges,,,,,,,,,11795.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3859.78,22,,percent of total billed charges,,,14049.61,91,,percent of total billed charges,,,14667.17,95,,percent of total billed charges,,,12814.48,83,,percent of total billed charges,,,12814.48,83,,percent of total billed charges,,,,,,,,,,,,,,,12814.48,83,,percent of total billed charges,,,14667.17,95,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,12660.09,82,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,13123.26,85,,percent of total billed charges,,3859.78,14667.17,
SYNTHES SCREW LOCKING 4.0MM X 26MM,30184929,CDM,,,278,RC,outpatient,,1248,1248,,1059.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,312,22,,percent of total billed charges,,,,,,,,,1123.2,90,,percent of total billed charges,,,1033.34,82.8,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,,,,,,,,1098.24,88,,percent of total billed charges,,,,,,,,,953.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,312,22,,percent of total billed charges,,,1135.68,91,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1035.84,83,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1023.36,82,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,312,1185.6,
SYNTHES SCREW LOCKING 4.0MM X 30MM,30184930,CDM,,,278,RC,outpatient,,1248,1248,,1059.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,312,22,,percent of total billed charges,,,,,,,,,1123.2,90,,percent of total billed charges,,,1033.34,82.8,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,,,,,,,,1098.24,88,,percent of total billed charges,,,,,,,,,953.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,312,22,,percent of total billed charges,,,1135.68,91,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1035.84,83,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1023.36,82,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,312,1185.6,
SYNTHES SCREW LOCKING 4.0MM X 40MM,30184931,CDM,,,278,RC,outpatient,,1248,1248,,1059.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,312,22,,percent of total billed charges,,,,,,,,,1123.2,90,,percent of total billed charges,,,1033.34,82.8,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,,,,,,,,1098.24,88,,percent of total billed charges,,,,,,,,,953.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,312,22,,percent of total billed charges,,,1135.68,91,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1035.84,83,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1023.36,82,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,312,1185.6,
SYNTHES SCREW LOCKING 4.0MM X 44MM,30184932,CDM,,,278,RC,outpatient,,1248,1248,,1059.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,312,22,,percent of total billed charges,,,,,,,,,1123.2,90,,percent of total billed charges,,,1033.34,82.8,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,,,,,,,,1098.24,88,,percent of total billed charges,,,,,,,,,953.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,312,22,,percent of total billed charges,,,1135.68,91,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1035.84,83,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1023.36,82,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,312,1185.6,
SYNTHES SCREW LOCKING 4.0MM X 50MM,30184933,CDM,,,278,RC,outpatient,,1248,1248,,1059.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,312,22,,percent of total billed charges,,,,,,,,,1123.2,90,,percent of total billed charges,,,1033.34,82.8,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,,,,,,,,1098.24,88,,percent of total billed charges,,,,,,,,,953.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,312,22,,percent of total billed charges,,,1135.68,91,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1035.84,83,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1023.36,82,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,312,1185.6,
SYNTHES SCREW LOCKING 4.0MM X 60MM,30184934,CDM,,,278,RC,outpatient,,1248,1248,,1059.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,312,22,,percent of total billed charges,,,,,,,,,1123.2,90,,percent of total billed charges,,,1033.34,82.8,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,,,,,,,,1098.24,88,,percent of total billed charges,,,,,,,,,953.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,312,22,,percent of total billed charges,,,1135.68,91,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1035.84,83,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1023.36,82,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,312,1185.6,
ZIMMER SIDE DELIVERY CANNULA,30184935,CDM,,,278,RC,outpatient,,3640,3640,,3090.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,910,22,,percent of total billed charges,,,,,,,,,3276,90,,percent of total billed charges,,,3013.92,82.8,,percent of total billed charges,,,3094,85,,percent of total billed charges,,,,,,,,,3203.2,88,,percent of total billed charges,,,,,,,,,2780.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,910,22,,percent of total billed charges,,,3312.4,91,,percent of total billed charges,,,3458,95,,percent of total billed charges,,,3021.2,83,,percent of total billed charges,,,3021.2,83,,percent of total billed charges,,,,,,,,,,,,,,,3021.2,83,,percent of total billed charges,,,3458,95,,percent of total billed charges,,,3276,90,,percent of total billed charges,,,3276,90,,percent of total billed charges,,,2984.8,82,,percent of total billed charges,,,3276,90,,percent of total billed charges,,,3094,85,,percent of total billed charges,,910,3458,
ARTHREX ACL DISPOSABLE KIT,30184936,CDM,,,270,RC,outpatient,,942.5,942.5,,800.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.63,22,,percent of total billed charges,,,,,,,,,848.25,90,,percent of total billed charges,,,780.39,82.8,,percent of total billed charges,,,801.13,85,,percent of total billed charges,,,,,,,,,829.4,88,,percent of total billed charges,,,,,,,,,720.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.63,22,,percent of total billed charges,,,857.68,91,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,,,,,,,,,,,,,782.28,83,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,772.85,82,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,801.13,85,,percent of total billed charges,,235.63,895.38,
ZIMMER TIBIAL TRAY OXFORD LM SZ F,30184937,CDM,,,278,RC,outpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3388.13,22,,percent of total billed charges,,,,,,,,,12197.25,90,,percent of total billed charges,,,11221.47,82.8,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3388.13,22,,percent of total billed charges,,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,3388.13,12874.88,
AVISTA MRI LEAD KIT 56CM 8 CONTACT,30184938,CDM,,,278,RC,outpatient,,18200,18200,,15451.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4550,22,,percent of total billed charges,,,,,,,,,16380,90,,percent of total billed charges,,,15069.6,82.8,,percent of total billed charges,,,15470,85,,percent of total billed charges,,,,,,,,,16016,88,,percent of total billed charges,,,,,,,,,13904.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4550,22,,percent of total billed charges,,,16562,91,,percent of total billed charges,,,17290,95,,percent of total billed charges,,,15106,83,,percent of total billed charges,,,15106,83,,percent of total billed charges,,,,,,,,,,,,,,,15106,83,,percent of total billed charges,,,17290,95,,percent of total billed charges,,,16380,90,,percent of total billed charges,,,16380,90,,percent of total billed charges,,,14924,82,,percent of total billed charges,,,16380,90,,percent of total billed charges,,,15470,85,,percent of total billed charges,,4550,17290,
SYNTHES PLATE TUBULAR 10-HOLE 1/3,30184939,CDM,,,278,RC,outpatient,,1811.23,1811.23,,1537.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,452.81,22,,percent of total billed charges,,,,,,,,,1630.11,90,,percent of total billed charges,,,1499.7,82.8,,percent of total billed charges,,,1539.55,85,,percent of total billed charges,,,,,,,,,1593.88,88,,percent of total billed charges,,,,,,,,,1383.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,452.81,22,,percent of total billed charges,,,1648.22,91,,percent of total billed charges,,,1720.67,95,,percent of total billed charges,,,1503.32,83,,percent of total billed charges,,,1503.32,83,,percent of total billed charges,,,,,,,,,,,,,,,1503.32,83,,percent of total billed charges,,,1720.67,95,,percent of total billed charges,,,1630.11,90,,percent of total billed charges,,,1630.11,90,,percent of total billed charges,,,1485.21,82,,percent of total billed charges,,,1630.11,90,,percent of total billed charges,,,1539.55,85,,percent of total billed charges,,452.81,1720.67,
ZIMMER FEMUR OXFORD TWIN-PEG LG,30184940,CDM,,,278,RC,outpatient,,20345,20345,,17272.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5086.25,22,,percent of total billed charges,,,,,,,,,18310.5,90,,percent of total billed charges,,,16845.66,82.8,,percent of total billed charges,,,17293.25,85,,percent of total billed charges,,,,,,,,,17903.6,88,,percent of total billed charges,,,,,,,,,15543.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5086.25,22,,percent of total billed charges,,,18513.95,91,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,,,,,,,,,,,,,16886.35,83,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,16682.9,82,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,17293.25,85,,percent of total billed charges,,5086.25,19327.75,
ZIMMER BEARING RM MENISCAL 4MM LG,30184941,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
FLOSEAL FIBRIN 10ML,30184942,CDM,,,270,RC,outpatient,,2444.13,2444.13,,2075.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,611.03,22,,percent of total billed charges,,,,,,,,,2199.72,90,,percent of total billed charges,,,2023.74,82.8,,percent of total billed charges,,,2077.51,85,,percent of total billed charges,,,,,,,,,2150.83,88,,percent of total billed charges,,,,,,,,,1867.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,611.03,22,,percent of total billed charges,,,2224.16,91,,percent of total billed charges,,,2321.92,95,,percent of total billed charges,,,2028.63,83,,percent of total billed charges,,,2028.63,83,,percent of total billed charges,,,,,,,,,,,,,,,2028.63,83,,percent of total billed charges,,,2321.92,95,,percent of total billed charges,,,2199.72,90,,percent of total billed charges,,,2199.72,90,,percent of total billed charges,,,2004.19,82,,percent of total billed charges,,,2199.72,90,,percent of total billed charges,,,2077.51,85,,percent of total billed charges,,611.03,2321.92,
MENTOR TISSUE EXPANDER CPX4 350CC,30184944,CDM,,,278,RC,outpatient,,10692.5,10692.5,,9077.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2673.13,22,,percent of total billed charges,,,,,,,,,9623.25,90,,percent of total billed charges,,,8853.39,82.8,,percent of total billed charges,,,9088.63,85,,percent of total billed charges,,,,,,,,,9409.4,88,,percent of total billed charges,,,,,,,,,8169.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2673.13,22,,percent of total billed charges,,,9730.18,91,,percent of total billed charges,,,10157.88,95,,percent of total billed charges,,,8874.78,83,,percent of total billed charges,,,8874.78,83,,percent of total billed charges,,,,,,,,,,,,,,,8874.78,83,,percent of total billed charges,,,10157.88,95,,percent of total billed charges,,,9623.25,90,,percent of total billed charges,,,9623.25,90,,percent of total billed charges,,,8767.85,82,,percent of total billed charges,,,9623.25,90,,percent of total billed charges,,,9088.63,85,,percent of total billed charges,,2673.13,10157.88,
OSTEOAMP GRANULES 2-4MM 5.0CC,30184945,CDM,,,278,RC,outpatient,,7237.1,7237.1,,6144.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1809.28,22,,percent of total billed charges,,,,,,,,,6513.39,90,,percent of total billed charges,,,5992.32,82.8,,percent of total billed charges,,,6151.54,85,,percent of total billed charges,,,,,,,,,6368.65,88,,percent of total billed charges,,,,,,,,,5529.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1809.28,22,,percent of total billed charges,,,6585.76,91,,percent of total billed charges,,,6875.25,95,,percent of total billed charges,,,6006.79,83,,percent of total billed charges,,,6006.79,83,,percent of total billed charges,,,,,,,,,,,,,,,6006.79,83,,percent of total billed charges,,,6875.25,95,,percent of total billed charges,,,6513.39,90,,percent of total billed charges,,,6513.39,90,,percent of total billed charges,,,5934.42,82,,percent of total billed charges,,,6513.39,90,,percent of total billed charges,,,6151.54,85,,percent of total billed charges,,1809.28,6875.25,
CTL CEZANNE II TLIP 11X30X10,30184946,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
CTL SCREW PICASSO II 6.5X40,30184947,CDM,,,278,RC,outpatient,,11137.1,11137.1,,9455.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2784.28,22,,percent of total billed charges,,,,,,,,,10023.39,90,,percent of total billed charges,,,9221.52,82.8,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,,,,,,,,9800.65,88,,percent of total billed charges,,,,,,,,,8508.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2784.28,22,,percent of total billed charges,,,10134.76,91,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9243.79,83,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9132.42,82,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,2784.28,10580.25,
CTL SCREW PICASSO II 6.5X45,30184948,CDM,,,278,RC,outpatient,,11137.1,11137.1,,9455.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2784.28,22,,percent of total billed charges,,,,,,,,,10023.39,90,,percent of total billed charges,,,9221.52,82.8,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,,,,,,,,9800.65,88,,percent of total billed charges,,,,,,,,,8508.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2784.28,22,,percent of total billed charges,,,10134.76,91,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9243.79,83,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9132.42,82,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,2784.28,10580.25,
CTL ROD MLS CURVED 40MM,30184949,CDM,,,278,RC,outpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,553.48,22,,percent of total billed charges,,,,,,,,,1992.51,90,,percent of total billed charges,,,1833.11,82.8,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,553.48,22,,percent of total billed charges,,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,553.48,2103.21,
CTL SCREW SET,30184950,CDM,,,278,RC,outpatient,,1605.5,1605.5,,1363.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,401.38,22,,percent of total billed charges,,,,,,,,,1444.95,90,,percent of total billed charges,,,1329.35,82.8,,percent of total billed charges,,,1364.68,85,,percent of total billed charges,,,,,,,,,1412.84,88,,percent of total billed charges,,,,,,,,,1226.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,401.38,22,,percent of total billed charges,,,1461.01,91,,percent of total billed charges,,,1525.23,95,,percent of total billed charges,,,1332.57,83,,percent of total billed charges,,,1332.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1332.57,83,,percent of total billed charges,,,1525.23,95,,percent of total billed charges,,,1444.95,90,,percent of total billed charges,,,1444.95,90,,percent of total billed charges,,,1316.51,82,,percent of total billed charges,,,1444.95,90,,percent of total billed charges,,,1364.68,85,,percent of total billed charges,,401.38,1525.23,
CTL GUIDE WIRE,30184951,CDM,,,278,RC,outpatient,,893.75,893.75,,758.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,223.44,22,,percent of total billed charges,,,,,,,,,804.38,90,,percent of total billed charges,,,740.03,82.8,,percent of total billed charges,,,759.69,85,,percent of total billed charges,,,,,,,,,786.5,88,,percent of total billed charges,,,,,,,,,682.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,223.44,22,,percent of total billed charges,,,813.31,91,,percent of total billed charges,,,849.06,95,,percent of total billed charges,,,741.81,83,,percent of total billed charges,,,741.81,83,,percent of total billed charges,,,,,,,,,,,,,,,741.81,83,,percent of total billed charges,,,849.06,95,,percent of total billed charges,,,804.38,90,,percent of total billed charges,,,804.38,90,,percent of total billed charges,,,732.88,82,,percent of total billed charges,,,804.38,90,,percent of total billed charges,,,759.69,85,,percent of total billed charges,,223.44,849.06,
CTL JAMSHIDI 11G X 15,30184952,CDM,,,278,RC,outpatient,,1056.25,1056.25,,896.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,264.06,22,,percent of total billed charges,,,,,,,,,950.63,90,,percent of total billed charges,,,874.58,82.8,,percent of total billed charges,,,897.81,85,,percent of total billed charges,,,,,,,,,929.5,88,,percent of total billed charges,,,,,,,,,806.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,264.06,22,,percent of total billed charges,,,961.19,91,,percent of total billed charges,,,1003.44,95,,percent of total billed charges,,,876.69,83,,percent of total billed charges,,,876.69,83,,percent of total billed charges,,,,,,,,,,,,,,,876.69,83,,percent of total billed charges,,,1003.44,95,,percent of total billed charges,,,950.63,90,,percent of total billed charges,,,950.63,90,,percent of total billed charges,,,866.13,82,,percent of total billed charges,,,950.63,90,,percent of total billed charges,,,897.81,85,,percent of total billed charges,,264.06,1003.44,
CTL JAMSHIDI 11G X 15,30184953,CDM,,,278,RC,outpatient,,1056.25,1056.25,,896.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,264.06,22,,percent of total billed charges,,,,,,,,,950.63,90,,percent of total billed charges,,,874.58,82.8,,percent of total billed charges,,,897.81,85,,percent of total billed charges,,,,,,,,,929.5,88,,percent of total billed charges,,,,,,,,,806.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,264.06,22,,percent of total billed charges,,,961.19,91,,percent of total billed charges,,,1003.44,95,,percent of total billed charges,,,876.69,83,,percent of total billed charges,,,876.69,83,,percent of total billed charges,,,,,,,,,,,,,,,876.69,83,,percent of total billed charges,,,1003.44,95,,percent of total billed charges,,,950.63,90,,percent of total billed charges,,,950.63,90,,percent of total billed charges,,,866.13,82,,percent of total billed charges,,,950.63,90,,percent of total billed charges,,,897.81,85,,percent of total billed charges,,264.06,1003.44,
ALLOSOURCE CANCELLOUS CRUSHED 1-4MM 15CC,30184954,CDM,,,278,RC,outpatient,,1722.5,1722.5,,1462.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,430.63,22,,percent of total billed charges,,,,,,,,,1550.25,90,,percent of total billed charges,,,1426.23,82.8,,percent of total billed charges,,,1464.13,85,,percent of total billed charges,,,,,,,,,1515.8,88,,percent of total billed charges,,,,,,,,,1315.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,430.63,22,,percent of total billed charges,,,1567.48,91,,percent of total billed charges,,,1636.38,95,,percent of total billed charges,,,1429.68,83,,percent of total billed charges,,,1429.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1429.68,83,,percent of total billed charges,,,1636.38,95,,percent of total billed charges,,,1550.25,90,,percent of total billed charges,,,1550.25,90,,percent of total billed charges,,,1412.45,82,,percent of total billed charges,,,1550.25,90,,percent of total billed charges,,,1464.13,85,,percent of total billed charges,,430.63,1636.38,
OSTEOAMP GRANULES 2-4MM 1.0CC,30184955,CDM,,,278,RC,outpatient,,2870.73,2870.73,,2437.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,717.68,22,,percent of total billed charges,,,,,,,,,2583.66,90,,percent of total billed charges,,,2376.96,82.8,,percent of total billed charges,,,2440.12,85,,percent of total billed charges,,,,,,,,,2526.24,88,,percent of total billed charges,,,,,,,,,2193.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,717.68,22,,percent of total billed charges,,,2612.36,91,,percent of total billed charges,,,2727.19,95,,percent of total billed charges,,,2382.71,83,,percent of total billed charges,,,2382.71,83,,percent of total billed charges,,,,,,,,,,,,,,,2382.71,83,,percent of total billed charges,,,2727.19,95,,percent of total billed charges,,,2583.66,90,,percent of total billed charges,,,2583.66,90,,percent of total billed charges,,,2354,82,,percent of total billed charges,,,2583.66,90,,percent of total billed charges,,,2440.12,85,,percent of total billed charges,,717.68,2727.19,
CAGE STALIF C-TI 12X6.5 TAPERED,30184956,CDM,,,278,RC,outpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4875,22,,percent of total billed charges,,,,,,,,,17550,90,,percent of total billed charges,,,16146,82.8,,percent of total billed charges,,,16575,85,,percent of total billed charges,,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4875,22,,percent of total billed charges,,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,4875,18525,
SCREW STALIF C ABO 4.0 X 14MM,30184957,CDM,,,278,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
CTL CAGE TLIF CEZANNE 11X30X11,30184958,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
SYNTHES SCREW CANNUL 6.5X75MM,30184959,CDM,,,278,RC,outpatient,,2541.5,2541.5,,2157.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.38,22,,percent of total billed charges,,,,,,,,,2287.35,90,,percent of total billed charges,,,2104.36,82.8,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,,,,,,,,2236.52,88,,percent of total billed charges,,,,,,,,,1941.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.38,22,,percent of total billed charges,,,2312.77,91,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,2109.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2109.45,83,,percent of total billed charges,,,2414.43,95,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2084.03,82,,percent of total billed charges,,,2287.35,90,,percent of total billed charges,,,2160.28,85,,percent of total billed charges,,635.38,2414.43,
SYNTHES SCREW CANNUL 16MM 6.5X80MM,30184960,CDM,,,278,RC,outpatient,,2696.27,2696.27,,2289.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,674.07,22,,percent of total billed charges,,,,,,,,,2426.64,90,,percent of total billed charges,,,2232.51,82.8,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,,,,,,,,2372.72,88,,percent of total billed charges,,,,,,,,,2059.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,674.07,22,,percent of total billed charges,,,2453.61,91,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2237.9,83,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2210.94,82,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,674.07,2561.46,
OSTEOAMP GRANULES <2MM 2.5CC,30184961,CDM,,,278,RC,outpatient,,4583.54,4583.54,,3891.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1145.89,22,,percent of total billed charges,,,,,,,,,4125.19,90,,percent of total billed charges,,,3795.17,82.8,,percent of total billed charges,,,3896.01,85,,percent of total billed charges,,,,,,,,,4033.52,88,,percent of total billed charges,,,,,,,,,3501.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1145.89,22,,percent of total billed charges,,,4171.02,91,,percent of total billed charges,,,4354.36,95,,percent of total billed charges,,,3804.34,83,,percent of total billed charges,,,3804.34,83,,percent of total billed charges,,,,,,,,,,,,,,,3804.34,83,,percent of total billed charges,,,4354.36,95,,percent of total billed charges,,,4125.19,90,,percent of total billed charges,,,4125.19,90,,percent of total billed charges,,,3758.5,82,,percent of total billed charges,,,4125.19,90,,percent of total billed charges,,,3896.01,85,,percent of total billed charges,,1145.89,4354.36,
CAGE STALIF C-TI 14X7.5 TAPERED,30184962,CDM,,,278,RC,outpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4875,22,,percent of total billed charges,,,,,,,,,17550,90,,percent of total billed charges,,,16146,82.8,,percent of total billed charges,,,16575,85,,percent of total billed charges,,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4875,22,,percent of total billed charges,,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,4875,18525,
CAGE STALIF C-TI 14X6.5 TAPERED,30184963,CDM,,,278,RC,outpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4875,22,,percent of total billed charges,,,,,,,,,17550,90,,percent of total billed charges,,,16146,82.8,,percent of total billed charges,,,16575,85,,percent of total billed charges,,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4875,22,,percent of total billed charges,,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,4875,18525,
SCREW STALIF C ABO 4.0 X 15MM,30184964,CDM,,,278,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
STRYKER MATCHSTICK 3.0MM PRECISION NEURO,30184965,CDM,,,270,RC,outpatient,,919.04,919.04,,780.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,229.76,22,,percent of total billed charges,,,,,,,,,827.14,90,,percent of total billed charges,,,760.97,82.8,,percent of total billed charges,,,781.18,85,,percent of total billed charges,,,,,,,,,808.76,88,,percent of total billed charges,,,,,,,,,702.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,229.76,22,,percent of total billed charges,,,836.33,91,,percent of total billed charges,,,873.09,95,,percent of total billed charges,,,762.8,83,,percent of total billed charges,,,762.8,83,,percent of total billed charges,,,,,,,,,,,,,,,762.8,83,,percent of total billed charges,,,873.09,95,,percent of total billed charges,,,827.14,90,,percent of total billed charges,,,827.14,90,,percent of total billed charges,,,753.61,82,,percent of total billed charges,,,827.14,90,,percent of total billed charges,,,781.18,85,,percent of total billed charges,,229.76,873.09,
SURGICAL PATTIES 1  X 1,30184966,CDM,,,270,RC,outpatient,,21.83,21.83,,18.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.46,22,,percent of total billed charges,,,,,,,,,19.65,90,,percent of total billed charges,,,18.08,82.8,,percent of total billed charges,,,18.56,85,,percent of total billed charges,,,,,,,,,19.21,88,,percent of total billed charges,,,,,,,,,16.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.46,22,,percent of total billed charges,,,19.87,91,,percent of total billed charges,,,20.74,95,,percent of total billed charges,,,18.12,83,,percent of total billed charges,,,18.12,83,,percent of total billed charges,,,,,,,,,,,,,,,18.12,83,,percent of total billed charges,,,20.74,95,,percent of total billed charges,,,19.65,90,,percent of total billed charges,,,19.65,90,,percent of total billed charges,,,17.9,82,,percent of total billed charges,,,19.65,90,,percent of total billed charges,,,18.56,85,,percent of total billed charges,,5.46,20.74,
ALLOSOURCE PASTE DBM PLUS 8ML,30184967,CDM,,,278,RC,outpatient,,5232.5,5232.5,,4442.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1308.13,22,,percent of total billed charges,,,,,,,,,4709.25,90,,percent of total billed charges,,,4332.51,82.8,,percent of total billed charges,,,4447.63,85,,percent of total billed charges,,,,,,,,,4604.6,88,,percent of total billed charges,,,,,,,,,3997.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1308.13,22,,percent of total billed charges,,,4761.58,91,,percent of total billed charges,,,4970.88,95,,percent of total billed charges,,,4342.98,83,,percent of total billed charges,,,4342.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4342.98,83,,percent of total billed charges,,,4970.88,95,,percent of total billed charges,,,4709.25,90,,percent of total billed charges,,,4709.25,90,,percent of total billed charges,,,4290.65,82,,percent of total billed charges,,,4709.25,90,,percent of total billed charges,,,4447.63,85,,percent of total billed charges,,1308.13,4970.88,
ELECTRODE BLADE BLUESILK 4  PTFE-INS,30184969,CDM,,,270,RC,outpatient,,70.53,70.53,,59.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.63,22,,percent of total billed charges,,,,,,,,,63.48,90,,percent of total billed charges,,,58.4,82.8,,percent of total billed charges,,,59.95,85,,percent of total billed charges,,,,,,,,,62.07,88,,percent of total billed charges,,,,,,,,,53.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.63,22,,percent of total billed charges,,,64.18,91,,percent of total billed charges,,,67,95,,percent of total billed charges,,,58.54,83,,percent of total billed charges,,,58.54,83,,percent of total billed charges,,,,,,,,,,,,,,,58.54,83,,percent of total billed charges,,,67,95,,percent of total billed charges,,,63.48,90,,percent of total billed charges,,,63.48,90,,percent of total billed charges,,,57.83,82,,percent of total billed charges,,,63.48,90,,percent of total billed charges,,,59.95,85,,percent of total billed charges,,17.63,67,
S&N EXTRACTOR NAIL LARGE,30184970,CDM,,,270,RC,outpatient,,6597.5,6597.5,,5601.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1649.38,22,,percent of total billed charges,,,,,,,,,5937.75,90,,percent of total billed charges,,,5462.73,82.8,,percent of total billed charges,,,5607.88,85,,percent of total billed charges,,,,,,,,,5805.8,88,,percent of total billed charges,,,,,,,,,5040.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1649.38,22,,percent of total billed charges,,,6003.73,91,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,,,,,,,,,,,,,5475.93,83,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5409.95,82,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5607.88,85,,percent of total billed charges,,1649.38,6267.63,
S&N NAIL META-TAN 10MM X 36CM RT,30184971,CDM,,,278,RC,outpatient,,19110,19110,,16224.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4777.5,22,,percent of total billed charges,,,,,,,,,17199,90,,percent of total billed charges,,,15823.08,82.8,,percent of total billed charges,,,16243.5,85,,percent of total billed charges,,,,,,,,,16816.8,88,,percent of total billed charges,,,,,,,,,14600.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4777.5,22,,percent of total billed charges,,,17390.1,91,,percent of total billed charges,,,18154.5,95,,percent of total billed charges,,,15861.3,83,,percent of total billed charges,,,15861.3,83,,percent of total billed charges,,,,,,,,,,,,,,,15861.3,83,,percent of total billed charges,,,18154.5,95,,percent of total billed charges,,,17199,90,,percent of total billed charges,,,17199,90,,percent of total billed charges,,,15670.2,82,,percent of total billed charges,,,17199,90,,percent of total billed charges,,,16243.5,85,,percent of total billed charges,,4777.5,18154.5,
S&N SCREW LOCKING PROXIMAL 5.0 X 75MM,30184972,CDM,,,278,RC,outpatient,,1865.5,1865.5,,1583.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,466.38,22,,percent of total billed charges,,,,,,,,,1678.95,90,,percent of total billed charges,,,1544.63,82.8,,percent of total billed charges,,,1585.68,85,,percent of total billed charges,,,,,,,,,1641.64,88,,percent of total billed charges,,,,,,,,,1425.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,466.38,22,,percent of total billed charges,,,1697.61,91,,percent of total billed charges,,,1772.23,95,,percent of total billed charges,,,1548.37,83,,percent of total billed charges,,,1548.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1548.37,83,,percent of total billed charges,,,1772.23,95,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1529.71,82,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1585.68,85,,percent of total billed charges,,466.38,1772.23,
S&N SCREW LOCKING PROXIMAL 5.0 X 35MM,30184973,CDM,,,278,RC,outpatient,,1865.5,1865.5,,1583.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,466.38,22,,percent of total billed charges,,,,,,,,,1678.95,90,,percent of total billed charges,,,1544.63,82.8,,percent of total billed charges,,,1585.68,85,,percent of total billed charges,,,,,,,,,1641.64,88,,percent of total billed charges,,,,,,,,,1425.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,466.38,22,,percent of total billed charges,,,1697.61,91,,percent of total billed charges,,,1772.23,95,,percent of total billed charges,,,1548.37,83,,percent of total billed charges,,,1548.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1548.37,83,,percent of total billed charges,,,1772.23,95,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1529.71,82,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1585.68,85,,percent of total billed charges,,466.38,1772.23,
CAGE STALIF C-TI 14X5.5 TAPERED,30184974,CDM,,,278,RC,outpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4875,22,,percent of total billed charges,,,,,,,,,17550,90,,percent of total billed charges,,,16146,82.8,,percent of total billed charges,,,16575,85,,percent of total billed charges,,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4875,22,,percent of total billed charges,,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,4875,18525,
CTL SCREW PICASSO II 6.5X35,30184975,CDM,,,278,RC,outpatient,,11137.1,11137.1,,9455.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2784.28,22,,percent of total billed charges,,,,,,,,,10023.39,90,,percent of total billed charges,,,9221.52,82.8,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,,,,,,,,9800.65,88,,percent of total billed charges,,,,,,,,,8508.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2784.28,22,,percent of total billed charges,,,10134.76,91,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9243.79,83,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9132.42,82,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,2784.28,10580.25,
CTL SCREW PICASSO II 7.5X35,30184976,CDM,,,278,RC,outpatient,,11137.1,11137.1,,9455.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2784.28,22,,percent of total billed charges,,,,,,,,,10023.39,90,,percent of total billed charges,,,9221.52,82.8,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,,,,,,,,9800.65,88,,percent of total billed charges,,,,,,,,,8508.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2784.28,22,,percent of total billed charges,,,10134.76,91,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9243.79,83,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9132.42,82,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,2784.28,10580.25,
CTL SCREW PICASSO II 7.5X45,30184977,CDM,,,278,RC,outpatient,,11137.1,11137.1,,9455.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2784.28,22,,percent of total billed charges,,,,,,,,,10023.39,90,,percent of total billed charges,,,9221.52,82.8,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,,,,,,,,9800.65,88,,percent of total billed charges,,,,,,,,,8508.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2784.28,22,,percent of total billed charges,,,10134.76,91,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9243.79,83,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9132.42,82,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,2784.28,10580.25,
CTL ROD 6.0 X 35,30184978,CDM,,,278,RC,outpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,553.48,22,,percent of total billed charges,,,,,,,,,1992.51,90,,percent of total billed charges,,,1833.11,82.8,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,553.48,22,,percent of total billed charges,,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,553.48,2103.21,
CAGE CAGE TLIF CEZANNE II 26X9X11,30184979,CDM,,,278,RC,outpatient,,21125,21125,,17935.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5281.25,22,,percent of total billed charges,,,,,,,,,19012.5,90,,percent of total billed charges,,,17491.5,82.8,,percent of total billed charges,,,17956.25,85,,percent of total billed charges,,,,,,,,,18590,88,,percent of total billed charges,,,,,,,,,16139.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5281.25,22,,percent of total billed charges,,,19223.75,91,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,,,,,,,,,,,,,17533.75,83,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17322.5,82,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17956.25,85,,percent of total billed charges,,5281.25,20068.75,
SYNTHES PLATE VA CONDYLER 12 HOLE RIGHT,30184980,CDM,,,278,RC,outpatient,,17691.05,17691.05,,15019.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4422.76,22,,percent of total billed charges,,,,,,,,,15921.95,90,,percent of total billed charges,,,14648.19,82.8,,percent of total billed charges,,,15037.39,85,,percent of total billed charges,,,,,,,,,15568.12,88,,percent of total billed charges,,,,,,,,,13515.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4422.76,22,,percent of total billed charges,,,16098.86,91,,percent of total billed charges,,,16806.5,95,,percent of total billed charges,,,14683.57,83,,percent of total billed charges,,,14683.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14683.57,83,,percent of total billed charges,,,16806.5,95,,percent of total billed charges,,,15921.95,90,,percent of total billed charges,,,15921.95,90,,percent of total billed charges,,,14506.66,82,,percent of total billed charges,,,15921.95,90,,percent of total billed charges,,,15037.39,85,,percent of total billed charges,,4422.76,16806.5,
SYNTHES SCREW LOCKING 5 X 16MM ANGLED,30184981,CDM,,,278,RC,outpatient,,2503.93,2503.93,,2125.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,625.98,22,,percent of total billed charges,,,,,,,,,2253.54,90,,percent of total billed charges,,,2073.25,82.8,,percent of total billed charges,,,2128.34,85,,percent of total billed charges,,,,,,,,,2203.46,88,,percent of total billed charges,,,,,,,,,1913,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,625.98,22,,percent of total billed charges,,,2278.58,91,,percent of total billed charges,,,2378.73,95,,percent of total billed charges,,,2078.26,83,,percent of total billed charges,,,2078.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2078.26,83,,percent of total billed charges,,,2378.73,95,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2053.22,82,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2128.34,85,,percent of total billed charges,,625.98,2378.73,
SYNTHES SCREW LOCKING 5 X 22MM ANGLED,30184982,CDM,,,278,RC,outpatient,,1701.7,1701.7,,1444.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,425.43,22,,percent of total billed charges,,,,,,,,,1531.53,90,,percent of total billed charges,,,1409.01,82.8,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,,,,,,,,1497.5,88,,percent of total billed charges,,,,,,,,,1300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,425.43,22,,percent of total billed charges,,,1548.55,91,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1412.41,83,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1395.39,82,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,425.43,1616.62,
SYNTHES SCREW LOCKING 5 X 38MM ANGLED,30184983,CDM,,,278,RC,outpatient,,1701.7,1701.7,,1444.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,425.43,22,,percent of total billed charges,,,,,,,,,1531.53,90,,percent of total billed charges,,,1409.01,82.8,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,,,,,,,,1497.5,88,,percent of total billed charges,,,,,,,,,1300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,425.43,22,,percent of total billed charges,,,1548.55,91,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1412.41,83,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1395.39,82,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,425.43,1616.62,
SYNTHES SCREW LOCKING 5 X 50MM ANGLED,30184984,CDM,,,278,RC,outpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,438.18,22,,percent of total billed charges,,,,,,,,,1577.46,90,,percent of total billed charges,,,1451.26,82.8,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,438.18,22,,percent of total billed charges,,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,438.18,1665.09,
SYNTHES SCREW LOCKING 5 X 55MM ANGLED,30184985,CDM,,,278,RC,outpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,438.18,22,,percent of total billed charges,,,,,,,,,1577.46,90,,percent of total billed charges,,,1451.26,82.8,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,438.18,22,,percent of total billed charges,,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,438.18,1665.09,
SYNTHES SCREW LOCKING 5 X 60MM ANGLED,30184986,CDM,,,278,RC,outpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,438.18,22,,percent of total billed charges,,,,,,,,,1577.46,90,,percent of total billed charges,,,1451.26,82.8,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,438.18,22,,percent of total billed charges,,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,438.18,1665.09,
SYNTHES SCREW LOCKING 5 X 70MM ANGLED,30184987,CDM,,,278,RC,outpatient,,1701.7,1701.7,,1444.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,425.43,22,,percent of total billed charges,,,,,,,,,1531.53,90,,percent of total billed charges,,,1409.01,82.8,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,,,,,,,,1497.5,88,,percent of total billed charges,,,,,,,,,1300.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,425.43,22,,percent of total billed charges,,,1548.55,91,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,1412.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1412.41,83,,percent of total billed charges,,,1616.62,95,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1395.39,82,,percent of total billed charges,,,1531.53,90,,percent of total billed charges,,,1446.45,85,,percent of total billed charges,,425.43,1616.62,
SYNTHES SCREW CORTEX 4.5 X 36MM,30184988,CDM,,,278,RC,outpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.35,22,,percent of total billed charges,,,,,,,,,235.24,90,,percent of total billed charges,,,216.42,82.8,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.35,22,,percent of total billed charges,,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,65.35,248.31,
SYNTHES SCREW CORTEX 4.5 X 44MM,30184989,CDM,,,278,RC,outpatient,,277.28,277.28,,235.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.32,22,,percent of total billed charges,,,,,,,,,249.55,90,,percent of total billed charges,,,229.59,82.8,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,,,,,,,,244.01,88,,percent of total billed charges,,,,,,,,,211.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.32,22,,percent of total billed charges,,,252.32,91,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,,,,,,,,,,,,,230.14,83,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,227.37,82,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,69.32,263.42,
ARTHREX DX SWIVELOCK DISP. KIT,30184990,CDM,,,270,RC,outpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,446.88,22,,percent of total billed charges,,,,,,,,,1608.75,90,,percent of total billed charges,,,1480.05,82.8,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,446.88,22,,percent of total billed charges,,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,446.88,1698.13,
ARTHREX DX SWIVELOCK W/FORK EYELET,30184991,CDM,,,270,RC,outpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,690.63,22,,percent of total billed charges,,,,,,,,,2486.25,90,,percent of total billed charges,,,2287.35,82.8,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,690.63,22,,percent of total billed charges,,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,690.63,2624.38,
ARTHREX SUTURETAPE 1.3MM,30184992,CDM,,,270,RC,outpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.63,22,,percent of total billed charges,,,,,,,,,236.25,90,,percent of total billed charges,,,217.35,82.8,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.63,22,,percent of total billed charges,,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,65.63,249.38,
ZIMMER SCREW BONE ST 6.5 X 40MM,30184993,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
ZIMMER SCREW BONE ST 6.5 X 30MM,30184994,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
ZIMMER HEAD FEM COCR 6 DEG 28MM +3.5,30184995,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
ZIMMER DRILL BIT 3.2 X 40MM,30184996,CDM,,,270,RC,outpatient,,728,728,,618.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,182,22,,percent of total billed charges,,,,,,,,,655.2,90,,percent of total billed charges,,,602.78,82.8,,percent of total billed charges,,,618.8,85,,percent of total billed charges,,,,,,,,,640.64,88,,percent of total billed charges,,,,,,,,,556.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,182,22,,percent of total billed charges,,,662.48,91,,percent of total billed charges,,,691.6,95,,percent of total billed charges,,,604.24,83,,percent of total billed charges,,,604.24,83,,percent of total billed charges,,,,,,,,,,,,,,,604.24,83,,percent of total billed charges,,,691.6,95,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,596.96,82,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,618.8,85,,percent of total billed charges,,182,691.6,
ZIMMER BEARING HIP ACT ARTIC 28X50MM,30184997,CDM,,,278,RC,outpatient,,23400,23400,,19866.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5850,22,,percent of total billed charges,,,,,,,,,21060,90,,percent of total billed charges,,,19375.2,82.8,,percent of total billed charges,,,19890,85,,percent of total billed charges,,,,,,,,,20592,88,,percent of total billed charges,,,,,,,,,17877.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5850,22,,percent of total billed charges,,,21294,91,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,,,,,,,,,,,,,19422,83,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19188,82,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19890,85,,percent of total billed charges,,5850,22230,
ZIMMER LINER DUAL MOBILITY G7 50MM H,30184998,CDM,,,278,RC,outpatient,,9912.5,9912.5,,8415.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2478.13,22,,percent of total billed charges,,,,,,,,,8921.25,90,,percent of total billed charges,,,8207.55,82.8,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,,,,,,,,8723,88,,percent of total billed charges,,,,,,,,,7573.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2478.13,22,,percent of total billed charges,,,9020.38,91,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,,,,,,,,,,,,,8227.38,83,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8128.25,82,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,2478.13,9416.88,
ZIMMER SHELL OSSEOTI G7 62MM H,30184999,CDM,,,278,RC,outpatient,,41145,41145,,34932.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10286.25,22,,percent of total billed charges,,,,,,,,,37030.5,90,,percent of total billed charges,,,34068.06,82.8,,percent of total billed charges,,,34973.25,85,,percent of total billed charges,,,,,,,,,36207.6,88,,percent of total billed charges,,,,,,,,,31434.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10286.25,22,,percent of total billed charges,,,37441.95,91,,percent of total billed charges,,,39087.75,95,,percent of total billed charges,,,34150.35,83,,percent of total billed charges,,,34150.35,83,,percent of total billed charges,,,,,,,,,,,,,,,34150.35,83,,percent of total billed charges,,,39087.75,95,,percent of total billed charges,,,37030.5,90,,percent of total billed charges,,,37030.5,90,,percent of total billed charges,,,33738.9,82,,percent of total billed charges,,,37030.5,90,,percent of total billed charges,,,34973.25,85,,percent of total billed charges,,10286.25,39087.75,
PEEK CAGE 12 X 9 25MM,30185000,CDM,,,278,RC,outpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4225,22,,percent of total billed charges,,,,,,,,,15210,90,,percent of total billed charges,,,13993.2,82.8,,percent of total billed charges,,,14365,85,,percent of total billed charges,,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4225,22,,percent of total billed charges,,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,4225,16055,
PEEK CAGE 9 X 9 X 25MM,30185001,CDM,,,278,RC,outpatient,,16900,16900,,14348.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4225,22,,percent of total billed charges,,,,,,,,,15210,90,,percent of total billed charges,,,13993.2,82.8,,percent of total billed charges,,,14365,85,,percent of total billed charges,,,,,,,,,14872,88,,percent of total billed charges,,,,,,,,,12911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4225,22,,percent of total billed charges,,,15379,91,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,14027,83,,percent of total billed charges,,,,,,,,,,,,,,,14027,83,,percent of total billed charges,,,16055,95,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,13858,82,,percent of total billed charges,,,15210,90,,percent of total billed charges,,,14365,85,,percent of total billed charges,,4225,16055,
ZIMMER TIBIA SZ D RM UNI,30185002,CDM,,,278,RC,outpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3388.13,22,,percent of total billed charges,,,,,,,,,12197.25,90,,percent of total billed charges,,,11221.47,82.8,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3388.13,22,,percent of total billed charges,,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,3388.13,12874.88,
DEPUY EPI IMPLANT SZ 2,30185003,CDM,,,278,RC,outpatient,,33055.36,33055.36,,28064,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8263.84,22,,percent of total billed charges,,,,,,,,,29749.82,90,,percent of total billed charges,,,27369.84,82.8,,percent of total billed charges,,,28097.06,85,,percent of total billed charges,,,,,,,,,29088.72,88,,percent of total billed charges,,,,,,,,,25254.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8263.84,22,,percent of total billed charges,,,30080.38,91,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,,,,,,,,,,,,,27435.95,83,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,27105.4,82,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,28097.06,85,,percent of total billed charges,,8263.84,31402.59,
SCREW STALIF C ABO 4.0 X 16MM,30185004,CDM,,,278,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
CTL CAGE PEEK TLIF CEZANNE 11X30X8,30185005,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
MYOSURE REACH DEVICE,30185006,CDM,,,270,RC,outpatient,,10010,10010,,8498.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2502.5,22,,percent of total billed charges,,,,,,,,,9009,90,,percent of total billed charges,,,8288.28,82.8,,percent of total billed charges,,,8508.5,85,,percent of total billed charges,,,,,,,,,8808.8,88,,percent of total billed charges,,,,,,,,,7647.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2502.5,22,,percent of total billed charges,,,9109.1,91,,percent of total billed charges,,,9509.5,95,,percent of total billed charges,,,8308.3,83,,percent of total billed charges,,,8308.3,83,,percent of total billed charges,,,,,,,,,,,,,,,8308.3,83,,percent of total billed charges,,,9509.5,95,,percent of total billed charges,,,9009,90,,percent of total billed charges,,,9009,90,,percent of total billed charges,,,8208.2,82,,percent of total billed charges,,,9009,90,,percent of total billed charges,,,8508.5,85,,percent of total billed charges,,2502.5,9509.5,
SCREW POLYAXIAL 7.5 X 45MM,30185007,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SCREW POLYAXIAL 4.5 X 45MM,30185008,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SCREW POLYAXIAL 5.5 X 40MM,30185009,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ARTHREX PUNCH DISP. KIT FOR CORKSREW FT,30185010,CDM,,,270,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
DURASEAL EXACT SPINE SEALANT 5ML,30185011,CDM,,,270,RC,outpatient,,8561.53,8561.53,,7268.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2140.38,22,,percent of total billed charges,,,,,,,,,7705.38,90,,percent of total billed charges,,,7088.95,82.8,,percent of total billed charges,,,7277.3,85,,percent of total billed charges,,,,,,,,,7534.15,88,,percent of total billed charges,,,,,,,,,6541.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2140.38,22,,percent of total billed charges,,,7790.99,91,,percent of total billed charges,,,8133.45,95,,percent of total billed charges,,,7106.07,83,,percent of total billed charges,,,7106.07,83,,percent of total billed charges,,,,,,,,,,,,,,,7106.07,83,,percent of total billed charges,,,8133.45,95,,percent of total billed charges,,,7705.38,90,,percent of total billed charges,,,7705.38,90,,percent of total billed charges,,,7020.45,82,,percent of total billed charges,,,7705.38,90,,percent of total billed charges,,,7277.3,85,,percent of total billed charges,,2140.38,8133.45,
DURASEAL EXTENDED TIP APPLICATOR 8CM,30185012,CDM,,,270,RC,outpatient,,1665.72,1665.72,,1414.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,416.43,22,,percent of total billed charges,,,,,,,,,1499.15,90,,percent of total billed charges,,,1379.22,82.8,,percent of total billed charges,,,1415.86,85,,percent of total billed charges,,,,,,,,,1465.83,88,,percent of total billed charges,,,,,,,,,1272.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,416.43,22,,percent of total billed charges,,,1515.81,91,,percent of total billed charges,,,1582.43,95,,percent of total billed charges,,,1382.55,83,,percent of total billed charges,,,1382.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1382.55,83,,percent of total billed charges,,,1582.43,95,,percent of total billed charges,,,1499.15,90,,percent of total billed charges,,,1499.15,90,,percent of total billed charges,,,1365.89,82,,percent of total billed charges,,,1499.15,90,,percent of total billed charges,,,1415.86,85,,percent of total billed charges,,416.43,1582.43,
DURAGEN SECURE 3X3 REGENERATION MATRIX,30185013,CDM,,,270,RC,outpatient,,5614.9,5614.9,,4767.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1403.73,22,,percent of total billed charges,,,,,,,,,5053.41,90,,percent of total billed charges,,,4649.14,82.8,,percent of total billed charges,,,4772.67,85,,percent of total billed charges,,,,,,,,,4941.11,88,,percent of total billed charges,,,,,,,,,4289.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1403.73,22,,percent of total billed charges,,,5109.56,91,,percent of total billed charges,,,5334.16,95,,percent of total billed charges,,,4660.37,83,,percent of total billed charges,,,4660.37,83,,percent of total billed charges,,,,,,,,,,,,,,,4660.37,83,,percent of total billed charges,,,5334.16,95,,percent of total billed charges,,,5053.41,90,,percent of total billed charges,,,5053.41,90,,percent of total billed charges,,,4604.22,82,,percent of total billed charges,,,5053.41,90,,percent of total billed charges,,,4772.67,85,,percent of total billed charges,,1403.73,5334.16,
NEUROMONITORING SERVICES - ANS,30185014,CDM,,,270,RC,outpatient,,4550,4550,,3862.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1137.5,22,,percent of total billed charges,,,,,,,,,4095,90,,percent of total billed charges,,,3767.4,82.8,,percent of total billed charges,,,3867.5,85,,percent of total billed charges,,,,,,,,,4004,88,,percent of total billed charges,,,,,,,,,3476.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1137.5,22,,percent of total billed charges,,,4140.5,91,,percent of total billed charges,,,4322.5,95,,percent of total billed charges,,,3776.5,83,,percent of total billed charges,,,3776.5,83,,percent of total billed charges,,,,,,,,,,,,,,,3776.5,83,,percent of total billed charges,,,4322.5,95,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,3731,82,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,3867.5,85,,percent of total billed charges,,1137.5,4322.5,
ZIMMER DRILL BIT 3.2 X 30MM,30185015,CDM,,,270,RC,outpatient,,728,728,,618.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,182,22,,percent of total billed charges,,,,,,,,,655.2,90,,percent of total billed charges,,,602.78,82.8,,percent of total billed charges,,,618.8,85,,percent of total billed charges,,,,,,,,,640.64,88,,percent of total billed charges,,,,,,,,,556.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,182,22,,percent of total billed charges,,,662.48,91,,percent of total billed charges,,,691.6,95,,percent of total billed charges,,,604.24,83,,percent of total billed charges,,,604.24,83,,percent of total billed charges,,,,,,,,,,,,,,,604.24,83,,percent of total billed charges,,,691.6,95,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,596.96,82,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,618.8,85,,percent of total billed charges,,182,691.6,
ZIMMER SHELL OSSEOTI G7 54MM F,30185016,CDM,,,278,RC,outpatient,,41145,41145,,34932.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10286.25,22,,percent of total billed charges,,,,,,,,,37030.5,90,,percent of total billed charges,,,34068.06,82.8,,percent of total billed charges,,,34973.25,85,,percent of total billed charges,,,,,,,,,36207.6,88,,percent of total billed charges,,,,,,,,,31434.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10286.25,22,,percent of total billed charges,,,37441.95,91,,percent of total billed charges,,,39087.75,95,,percent of total billed charges,,,34150.35,83,,percent of total billed charges,,,34150.35,83,,percent of total billed charges,,,,,,,,,,,,,,,34150.35,83,,percent of total billed charges,,,39087.75,95,,percent of total billed charges,,,37030.5,90,,percent of total billed charges,,,37030.5,90,,percent of total billed charges,,,33738.9,82,,percent of total billed charges,,,37030.5,90,,percent of total billed charges,,,34973.25,85,,percent of total billed charges,,10286.25,39087.75,
ZIMMER LINER DUAL MOBILITY G7 44MM F,30185017,CDM,,,278,RC,outpatient,,9912.5,9912.5,,8415.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2478.13,22,,percent of total billed charges,,,,,,,,,8921.25,90,,percent of total billed charges,,,8207.55,82.8,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,,,,,,,,8723,88,,percent of total billed charges,,,,,,,,,7573.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2478.13,22,,percent of total billed charges,,,9020.38,91,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,,,,,,,,,,,,,8227.38,83,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8128.25,82,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,2478.13,9416.88,
ZIMMER BEARING HIP ACT ARTIC 28X44MM,30185018,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
S&N INSERT CONSTRAINED GENESIS 15MM SZ 5,30185019,CDM,,,278,RC,outpatient,,18018,18018,,15297.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4504.5,22,,percent of total billed charges,,,,,,,,,16216.2,90,,percent of total billed charges,,,14918.9,82.8,,percent of total billed charges,,,15315.3,85,,percent of total billed charges,,,,,,,,,15855.84,88,,percent of total billed charges,,,,,,,,,13765.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4504.5,22,,percent of total billed charges,,,16396.38,91,,percent of total billed charges,,,17117.1,95,,percent of total billed charges,,,14954.94,83,,percent of total billed charges,,,14954.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14954.94,83,,percent of total billed charges,,,17117.1,95,,percent of total billed charges,,,16216.2,90,,percent of total billed charges,,,16216.2,90,,percent of total billed charges,,,14774.76,82,,percent of total billed charges,,,16216.2,90,,percent of total billed charges,,,15315.3,85,,percent of total billed charges,,4504.5,17117.1,
SYNTHES SCREW CORTEX S-T 2.7X24MM,30185020,CDM,,,278,RC,outpatient,,429.03,429.03,,364.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.26,22,,percent of total billed charges,,,,,,,,,386.13,90,,percent of total billed charges,,,355.24,82.8,,percent of total billed charges,,,364.68,85,,percent of total billed charges,,,,,,,,,377.55,88,,percent of total billed charges,,,,,,,,,327.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.26,22,,percent of total billed charges,,,390.42,91,,percent of total billed charges,,,407.58,95,,percent of total billed charges,,,356.09,83,,percent of total billed charges,,,356.09,83,,percent of total billed charges,,,,,,,,,,,,,,,356.09,83,,percent of total billed charges,,,407.58,95,,percent of total billed charges,,,386.13,90,,percent of total billed charges,,,386.13,90,,percent of total billed charges,,,351.8,82,,percent of total billed charges,,,386.13,90,,percent of total billed charges,,,364.68,85,,percent of total billed charges,,107.26,407.58,
DEPUY INSERT RP 6MM SZ 8,30185022,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
CTL ROD MIS 6.0 X 70MM,30185023,CDM,,,278,RC,outpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,553.48,22,,percent of total billed charges,,,,,,,,,1992.51,90,,percent of total billed charges,,,1833.11,82.8,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,553.48,22,,percent of total billed charges,,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,553.48,2103.21,
ZIMMER HEAD BIOLOX 36MM + OMM,30185025,CDM,,,278,RC,outpatient,,24700,24700,,20970.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6175,22,,percent of total billed charges,,,,,,,,,22230,90,,percent of total billed charges,,,20451.6,82.8,,percent of total billed charges,,,20995,85,,percent of total billed charges,,,,,,,,,21736,88,,percent of total billed charges,,,,,,,,,18870.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6175,22,,percent of total billed charges,,,22477,91,,percent of total billed charges,,,23465,95,,percent of total billed charges,,,20501,83,,percent of total billed charges,,,20501,83,,percent of total billed charges,,,,,,,,,,,,,,,20501,83,,percent of total billed charges,,,23465,95,,percent of total billed charges,,,22230,90,,percent of total billed charges,,,22230,90,,percent of total billed charges,,,20254,82,,percent of total billed charges,,,22230,90,,percent of total billed charges,,,20995,85,,percent of total billed charges,,6175,23465,
ZIMMER LINER NUETRAL VIVACIT-E JJ 36X54,30185026,CDM,,,278,RC,outpatient,,22295,22295,,18928.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5573.75,22,,percent of total billed charges,,,,,,,,,20065.5,90,,percent of total billed charges,,,18460.26,82.8,,percent of total billed charges,,,18950.75,85,,percent of total billed charges,,,,,,,,,19619.6,88,,percent of total billed charges,,,,,,,,,17033.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5573.75,22,,percent of total billed charges,,,20288.45,91,,percent of total billed charges,,,21180.25,95,,percent of total billed charges,,,18504.85,83,,percent of total billed charges,,,18504.85,83,,percent of total billed charges,,,,,,,,,,,,,,,18504.85,83,,percent of total billed charges,,,21180.25,95,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,18281.9,82,,percent of total billed charges,,,20065.5,90,,percent of total billed charges,,,18950.75,85,,percent of total billed charges,,5573.75,21180.25,
SYNTHES SCREW CANCEL F-THD 4.0X20MM,30185028,CDM,,,278,RC,outpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.18,22,,percent of total billed charges,,,,,,,,,213.03,90,,percent of total billed charges,,,195.99,82.8,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.18,22,,percent of total billed charges,,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,59.18,224.87,
S&N SCREW SOFTSLK 1.5 7X20,30185029,CDM,,,270,RC,outpatient,,1265.36,1265.36,,1074.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.34,22,,percent of total billed charges,,,,,,,,,1138.82,90,,percent of total billed charges,,,1047.72,82.8,,percent of total billed charges,,,1075.56,85,,percent of total billed charges,,,,,,,,,1113.52,88,,percent of total billed charges,,,,,,,,,966.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.34,22,,percent of total billed charges,,,1151.48,91,,percent of total billed charges,,,1202.09,95,,percent of total billed charges,,,1050.25,83,,percent of total billed charges,,,1050.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1050.25,83,,percent of total billed charges,,,1202.09,95,,percent of total billed charges,,,1138.82,90,,percent of total billed charges,,,1138.82,90,,percent of total billed charges,,,1037.6,82,,percent of total billed charges,,,1138.82,90,,percent of total billed charges,,,1075.56,85,,percent of total billed charges,,316.34,1202.09,
S&N SCREW SOFTSLK 1.5 8X20,30185030,CDM,,,270,RC,outpatient,,1265.36,1265.36,,1074.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.34,22,,percent of total billed charges,,,,,,,,,1138.82,90,,percent of total billed charges,,,1047.72,82.8,,percent of total billed charges,,,1075.56,85,,percent of total billed charges,,,,,,,,,1113.52,88,,percent of total billed charges,,,,,,,,,966.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.34,22,,percent of total billed charges,,,1151.48,91,,percent of total billed charges,,,1202.09,95,,percent of total billed charges,,,1050.25,83,,percent of total billed charges,,,1050.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1050.25,83,,percent of total billed charges,,,1202.09,95,,percent of total billed charges,,,1138.82,90,,percent of total billed charges,,,1138.82,90,,percent of total billed charges,,,1037.6,82,,percent of total billed charges,,,1138.82,90,,percent of total billed charges,,,1075.56,85,,percent of total billed charges,,316.34,1202.09,
ARTHREX SUTURE ANCHOR BC SL 4.75 X 22MM,30185031,CDM,,,278,RC,outpatient,,2710.5,2710.5,,2301.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,677.63,22,,percent of total billed charges,,,,,,,,,2439.45,90,,percent of total billed charges,,,2244.29,82.8,,percent of total billed charges,,,2303.93,85,,percent of total billed charges,,,,,,,,,2385.24,88,,percent of total billed charges,,,,,,,,,2070.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,677.63,22,,percent of total billed charges,,,2466.56,91,,percent of total billed charges,,,2574.98,95,,percent of total billed charges,,,2249.72,83,,percent of total billed charges,,,2249.72,83,,percent of total billed charges,,,,,,,,,,,,,,,2249.72,83,,percent of total billed charges,,,2574.98,95,,percent of total billed charges,,,2439.45,90,,percent of total billed charges,,,2439.45,90,,percent of total billed charges,,,2222.61,82,,percent of total billed charges,,,2439.45,90,,percent of total billed charges,,,2303.93,85,,percent of total billed charges,,677.63,2574.98,
ARTHREX FLIPCUTTER II 10MM,30185032,CDM,,,278,RC,outpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,528.13,22,,percent of total billed charges,,,,,,,,,1901.25,90,,percent of total billed charges,,,1749.15,82.8,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,528.13,22,,percent of total billed charges,,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,528.13,2006.88,
FORTEC HOLMIUM LASER HIGH WATTAGE,30185033,CDM,,,270,RC,outpatient,,5070,5070,,4304.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1267.5,22,,percent of total billed charges,,,,,,,,,4563,90,,percent of total billed charges,,,4197.96,82.8,,percent of total billed charges,,,4309.5,85,,percent of total billed charges,,,,,,,,,4461.6,88,,percent of total billed charges,,,,,,,,,3873.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1267.5,22,,percent of total billed charges,,,4613.7,91,,percent of total billed charges,,,4816.5,95,,percent of total billed charges,,,4208.1,83,,percent of total billed charges,,,4208.1,83,,percent of total billed charges,,,,,,,,,,,,,,,4208.1,83,,percent of total billed charges,,,4816.5,95,,percent of total billed charges,,,4563,90,,percent of total billed charges,,,4563,90,,percent of total billed charges,,,4157.4,82,,percent of total billed charges,,,4563,90,,percent of total billed charges,,,4309.5,85,,percent of total billed charges,,1267.5,4816.5,
FORTEC HOLMIUM FIBER 365,30185034,CDM,,,270,RC,outpatient,,1482,1482,,1258.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,370.5,22,,percent of total billed charges,,,,,,,,,1333.8,90,,percent of total billed charges,,,1227.1,82.8,,percent of total billed charges,,,1259.7,85,,percent of total billed charges,,,,,,,,,1304.16,88,,percent of total billed charges,,,,,,,,,1132.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,370.5,22,,percent of total billed charges,,,1348.62,91,,percent of total billed charges,,,1407.9,95,,percent of total billed charges,,,1230.06,83,,percent of total billed charges,,,1230.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1230.06,83,,percent of total billed charges,,,1407.9,95,,percent of total billed charges,,,1333.8,90,,percent of total billed charges,,,1333.8,90,,percent of total billed charges,,,1215.24,82,,percent of total billed charges,,,1333.8,90,,percent of total billed charges,,,1259.7,85,,percent of total billed charges,,370.5,1407.9,
S&N PLATE PRIM RIGHT MTP VLP 2.7MM,30185035,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
S&N K-WIRE 1.1MM X 150MM,30185036,CDM,,,278,RC,outpatient,,728,728,,618.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,182,22,,percent of total billed charges,,,,,,,,,655.2,90,,percent of total billed charges,,,602.78,82.8,,percent of total billed charges,,,618.8,85,,percent of total billed charges,,,,,,,,,640.64,88,,percent of total billed charges,,,,,,,,,556.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,182,22,,percent of total billed charges,,,662.48,91,,percent of total billed charges,,,691.6,95,,percent of total billed charges,,,604.24,83,,percent of total billed charges,,,604.24,83,,percent of total billed charges,,,,,,,,,,,,,,,604.24,83,,percent of total billed charges,,,691.6,95,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,596.96,82,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,618.8,85,,percent of total billed charges,,182,691.6,
S&N KWIRE 1.6MM X 150MM,30185037,CDM,,,278,RC,outpatient,,562.45,562.45,,477.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,140.61,22,,percent of total billed charges,,,,,,,,,506.21,90,,percent of total billed charges,,,465.71,82.8,,percent of total billed charges,,,478.08,85,,percent of total billed charges,,,,,,,,,494.96,88,,percent of total billed charges,,,,,,,,,429.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,140.61,22,,percent of total billed charges,,,511.83,91,,percent of total billed charges,,,534.33,95,,percent of total billed charges,,,466.83,83,,percent of total billed charges,,,466.83,83,,percent of total billed charges,,,,,,,,,,,,,,,466.83,83,,percent of total billed charges,,,534.33,95,,percent of total billed charges,,,506.21,90,,percent of total billed charges,,,506.21,90,,percent of total billed charges,,,461.21,82,,percent of total billed charges,,,506.21,90,,percent of total billed charges,,,478.08,85,,percent of total billed charges,,140.61,534.33,
S&N DRILL 2.0MM X 130MM,30185038,CDM,,,278,RC,outpatient,,968.5,968.5,,822.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,242.13,22,,percent of total billed charges,,,,,,,,,871.65,90,,percent of total billed charges,,,801.92,82.8,,percent of total billed charges,,,823.23,85,,percent of total billed charges,,,,,,,,,852.28,88,,percent of total billed charges,,,,,,,,,739.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,242.13,22,,percent of total billed charges,,,881.34,91,,percent of total billed charges,,,920.08,95,,percent of total billed charges,,,803.86,83,,percent of total billed charges,,,803.86,83,,percent of total billed charges,,,,,,,,,,,,,,,803.86,83,,percent of total billed charges,,,920.08,95,,percent of total billed charges,,,871.65,90,,percent of total billed charges,,,871.65,90,,percent of total billed charges,,,794.17,82,,percent of total billed charges,,,871.65,90,,percent of total billed charges,,,823.23,85,,percent of total billed charges,,242.13,920.08,
S&N SCREW CORTEX 2.7MM S-T 14MM,30185039,CDM,,,278,RC,outpatient,,233.1,233.1,,197.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,58.28,22,,percent of total billed charges,,,,,,,,,209.79,90,,percent of total billed charges,,,193.01,82.8,,percent of total billed charges,,,198.14,85,,percent of total billed charges,,,,,,,,,205.13,88,,percent of total billed charges,,,,,,,,,178.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,58.28,22,,percent of total billed charges,,,212.12,91,,percent of total billed charges,,,221.45,95,,percent of total billed charges,,,193.47,83,,percent of total billed charges,,,193.47,83,,percent of total billed charges,,,,,,,,,,,,,,,193.47,83,,percent of total billed charges,,,221.45,95,,percent of total billed charges,,,209.79,90,,percent of total billed charges,,,209.79,90,,percent of total billed charges,,,191.14,82,,percent of total billed charges,,,209.79,90,,percent of total billed charges,,,198.14,85,,percent of total billed charges,,58.28,221.45,
S&N SCREW CORTEXST VLP 2.7 X 12MM,30185040,CDM,,,278,RC,outpatient,,1417,1417,,1203.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,354.25,22,,percent of total billed charges,,,,,,,,,1275.3,90,,percent of total billed charges,,,1173.28,82.8,,percent of total billed charges,,,1204.45,85,,percent of total billed charges,,,,,,,,,1246.96,88,,percent of total billed charges,,,,,,,,,1082.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,354.25,22,,percent of total billed charges,,,1289.47,91,,percent of total billed charges,,,1346.15,95,,percent of total billed charges,,,1176.11,83,,percent of total billed charges,,,1176.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1176.11,83,,percent of total billed charges,,,1346.15,95,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1161.94,82,,percent of total billed charges,,,1275.3,90,,percent of total billed charges,,,1204.45,85,,percent of total billed charges,,354.25,1346.15,
S&N SCREW CANNULATED 3.0 X 30MM,30185041,CDM,,,278,RC,outpatient,,2333.5,2333.5,,1981.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,583.38,22,,percent of total billed charges,,,,,,,,,2100.15,90,,percent of total billed charges,,,1932.14,82.8,,percent of total billed charges,,,1983.48,85,,percent of total billed charges,,,,,,,,,2053.48,88,,percent of total billed charges,,,,,,,,,1782.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,583.38,22,,percent of total billed charges,,,2123.49,91,,percent of total billed charges,,,2216.83,95,,percent of total billed charges,,,1936.81,83,,percent of total billed charges,,,1936.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1936.81,83,,percent of total billed charges,,,2216.83,95,,percent of total billed charges,,,2100.15,90,,percent of total billed charges,,,2100.15,90,,percent of total billed charges,,,1913.47,82,,percent of total billed charges,,,2100.15,90,,percent of total billed charges,,,1983.48,85,,percent of total billed charges,,583.38,2216.83,
DEPUY LINER ALTRX 32X52 +4,30185042,CDM,,,278,RC,outpatient,,11494.99,11494.99,,9759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2873.75,22,,percent of total billed charges,,,,,,,,,10345.49,90,,percent of total billed charges,,,9517.85,82.8,,percent of total billed charges,,,9770.74,85,,percent of total billed charges,,,,,,,,,10115.59,88,,percent of total billed charges,,,,,,,,,8782.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2873.75,22,,percent of total billed charges,,,10460.44,91,,percent of total billed charges,,,10920.24,95,,percent of total billed charges,,,9540.84,83,,percent of total billed charges,,,9540.84,83,,percent of total billed charges,,,,,,,,,,,,,,,9540.84,83,,percent of total billed charges,,,10920.24,95,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,9425.89,82,,percent of total billed charges,,,10345.49,90,,percent of total billed charges,,,9770.74,85,,percent of total billed charges,,2873.75,10920.24,
ZIMMER SHELL OSSEOTI G7 54MM F 4 HOLE,30185043,CDM,,,278,RC,outpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4834.38,22,,percent of total billed charges,,,,,,,,,17403.75,90,,percent of total billed charges,,,16011.45,82.8,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4834.38,22,,percent of total billed charges,,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,4834.38,18370.63,
ZIMMER DRILL BIT 3.2 X 50MM RNGLC + ACET,30185044,CDM,,,278,RC,outpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260,22,,percent of total billed charges,,,,,,,,,936,90,,percent of total billed charges,,,861.12,82.8,,percent of total billed charges,,,884,85,,percent of total billed charges,,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260,22,,percent of total billed charges,,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,260,988,
ZIMMER SCREW BONE ST 6.5 X 25MM,30185045,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
SYNTHES PLATE LOCKING PROX. LAT. 3.5MM 6,30185046,CDM,,,278,RC,outpatient,,14724.13,14724.13,,12500.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3681.03,22,,percent of total billed charges,,,,,,,,,13251.72,90,,percent of total billed charges,,,12191.58,82.8,,percent of total billed charges,,,12515.51,85,,percent of total billed charges,,,,,,,,,12957.23,88,,percent of total billed charges,,,,,,,,,11249.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3681.03,22,,percent of total billed charges,,,13398.96,91,,percent of total billed charges,,,13987.92,95,,percent of total billed charges,,,12221.03,83,,percent of total billed charges,,,12221.03,83,,percent of total billed charges,,,,,,,,,,,,,,,12221.03,83,,percent of total billed charges,,,13987.92,95,,percent of total billed charges,,,13251.72,90,,percent of total billed charges,,,13251.72,90,,percent of total billed charges,,,12073.79,82,,percent of total billed charges,,,13251.72,90,,percent of total billed charges,,,12515.51,85,,percent of total billed charges,,3681.03,13987.92,
ARTHREX IMPLANT SYS. SPEED BRIDGE BC 4.7,30185047,CDM,,,278,RC,outpatient,,11310,11310,,9602.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2827.5,22,,percent of total billed charges,,,,,,,,,10179,90,,percent of total billed charges,,,9364.68,82.8,,percent of total billed charges,,,9613.5,85,,percent of total billed charges,,,,,,,,,9952.8,88,,percent of total billed charges,,,,,,,,,8640.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2827.5,22,,percent of total billed charges,,,10292.1,91,,percent of total billed charges,,,10744.5,95,,percent of total billed charges,,,9387.3,83,,percent of total billed charges,,,9387.3,83,,percent of total billed charges,,,,,,,,,,,,,,,9387.3,83,,percent of total billed charges,,,10744.5,95,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,9274.2,82,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,9613.5,85,,percent of total billed charges,,2827.5,10744.5,
ARTHREX CANNULA TRIPLE DAM 8.25 X 7MM,30185048,CDM,,,278,RC,outpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
WRIGHT AUGMENT BONE GRAFT 3CC KIT,30185049,CDM,,,278,RC,outpatient,,22717.5,22717.5,,19287.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5679.38,22,,percent of total billed charges,,,,,,,,,20445.75,90,,percent of total billed charges,,,18810.09,82.8,,percent of total billed charges,,,19309.88,85,,percent of total billed charges,,,,,,,,,19991.4,88,,percent of total billed charges,,,,,,,,,17356.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5679.38,22,,percent of total billed charges,,,20672.93,91,,percent of total billed charges,,,21581.63,95,,percent of total billed charges,,,18855.53,83,,percent of total billed charges,,,18855.53,83,,percent of total billed charges,,,,,,,,,,,,,,,18855.53,83,,percent of total billed charges,,,21581.63,95,,percent of total billed charges,,,20445.75,90,,percent of total billed charges,,,20445.75,90,,percent of total billed charges,,,18628.35,82,,percent of total billed charges,,,20445.75,90,,percent of total billed charges,,,19309.88,85,,percent of total billed charges,,5679.38,21581.63,
ARTHREX G-WIRE W/TRCR TIP .086MM,30185050,CDM,,,278,RC,outpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,44,167.2,
ARTHREX DRILL BIT 2.0MM CMP FT CALIBRATE,30185051,CDM,,,278,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
ARTHREX DRILL PROFILE CANNULATED,30185052,CDM,,,278,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
ARTHREX G-WIRE 0.86MM W/LASER LINE SS,30185053,CDM,,,270,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
ARTHREX DRILL BIT 1.7MM CANNULATED,30185054,CDM,,,278,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
ARTHREX G-WIRE 0.86MM W/LASER LINE THRE,30185055,CDM,,,270,RC,outpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40,22,,percent of total billed charges,,,,,,,,,144,90,,percent of total billed charges,,,132.48,82.8,,percent of total billed charges,,,136,85,,percent of total billed charges,,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40,22,,percent of total billed charges,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,40,152,
ARTHREX COUNTERSINK 2.0/2.4MM CANNULATED,30185056,CDM,,,278,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
ARTHREX SCREW QUICKFIX TI CANN 2.0 X 8MM,30185057,CDM,,,278,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
ARTHREX SCREW MICRO 2.5 10MM COMPR FT,30185058,CDM,,,278,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
ARTHREX SCREW MICRO 2.5 8MM COMPR FT,30185059,CDM,,,278,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
ROD LORDOSES 6.0 X 40MM,30185060,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
SYNTHES SCREW LOCKING S-T 3.5 X 26MM,30185061,CDM,,,278,RC,outpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,313.59,22,,percent of total billed charges,,,,,,,,,1128.93,90,,percent of total billed charges,,,1038.62,82.8,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,313.59,22,,percent of total billed charges,,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,313.59,1191.65,
MICROPORT LINER CLASS A 40MM F,30185062,CDM,,,278,RC,outpatient,,20598.5,20598.5,,17488.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5149.63,22,,percent of total billed charges,,,,,,,,,18538.65,90,,percent of total billed charges,,,17055.56,82.8,,percent of total billed charges,,,17508.73,85,,percent of total billed charges,,,,,,,,,18126.68,88,,percent of total billed charges,,,,,,,,,15737.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5149.63,22,,percent of total billed charges,,,18744.64,91,,percent of total billed charges,,,19568.58,95,,percent of total billed charges,,,17096.76,83,,percent of total billed charges,,,17096.76,83,,percent of total billed charges,,,,,,,,,,,,,,,17096.76,83,,percent of total billed charges,,,19568.58,95,,percent of total billed charges,,,18538.65,90,,percent of total billed charges,,,18538.65,90,,percent of total billed charges,,,16890.77,82,,percent of total billed charges,,,18538.65,90,,percent of total billed charges,,,17508.73,85,,percent of total billed charges,,5149.63,19568.58,
MICROPORT HEAD FEMORAL BCH 40MM,30185063,CDM,,,278,RC,outpatient,,39065,39065,,33166.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9766.25,22,,percent of total billed charges,,,,,,,,,35158.5,90,,percent of total billed charges,,,32345.82,82.8,,percent of total billed charges,,,33205.25,85,,percent of total billed charges,,,,,,,,,34377.2,88,,percent of total billed charges,,,,,,,,,29845.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9766.25,22,,percent of total billed charges,,,35549.15,91,,percent of total billed charges,,,37111.75,95,,percent of total billed charges,,,32423.95,83,,percent of total billed charges,,,32423.95,83,,percent of total billed charges,,,,,,,,,,,,,,,32423.95,83,,percent of total billed charges,,,37111.75,95,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,32033.3,82,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,33205.25,85,,percent of total billed charges,,9766.25,37111.75,
MICROPORT NECK SHORT SLT 12/14,30185064,CDM,,,278,RC,outpatient,,28964,28964,,24590.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7241,22,,percent of total billed charges,,,,,,,,,26067.6,90,,percent of total billed charges,,,23982.19,82.8,,percent of total billed charges,,,24619.4,85,,percent of total billed charges,,,,,,,,,25488.32,88,,percent of total billed charges,,,,,,,,,22128.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7241,22,,percent of total billed charges,,,26357.24,91,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,,,,,,,,,,,,,24040.12,83,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,23750.48,82,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,24619.4,85,,percent of total billed charges,,7241,27515.8,
MICROPORT NECK SLEEVE CONSERVE X-LONG,30185065,CDM,,,278,RC,outpatient,,8177,8177,,6942.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2044.25,22,,percent of total billed charges,,,,,,,,,7359.3,90,,percent of total billed charges,,,6770.56,82.8,,percent of total billed charges,,,6950.45,85,,percent of total billed charges,,,,,,,,,7195.76,88,,percent of total billed charges,,,,,,,,,6247.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2044.25,22,,percent of total billed charges,,,7441.07,91,,percent of total billed charges,,,7768.15,95,,percent of total billed charges,,,6786.91,83,,percent of total billed charges,,,6786.91,83,,percent of total billed charges,,,,,,,,,,,,,,,6786.91,83,,percent of total billed charges,,,7768.15,95,,percent of total billed charges,,,7359.3,90,,percent of total billed charges,,,7359.3,90,,percent of total billed charges,,,6705.14,82,,percent of total billed charges,,,7359.3,90,,percent of total billed charges,,,6950.45,85,,percent of total billed charges,,2044.25,7768.15,
FORTEC HOLMIUM FIBER 550,30185066,CDM,,,270,RC,outpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,390,22,,percent of total billed charges,,,,,,,,,1404,90,,percent of total billed charges,,,1291.68,82.8,,percent of total billed charges,,,1326,85,,percent of total billed charges,,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,390,22,,percent of total billed charges,,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,390,1482,
CTL CAGE PEEK TLIF CEZANNE 9X30X11,30185067,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
CTL SCREW PICASSO MIS 5.5X40,30185068,CDM,,,278,RC,outpatient,,11137.1,11137.1,,9455.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2784.28,22,,percent of total billed charges,,,,,,,,,10023.39,90,,percent of total billed charges,,,9221.52,82.8,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,,,,,,,,9800.65,88,,percent of total billed charges,,,,,,,,,8508.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2784.28,22,,percent of total billed charges,,,10134.76,91,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9243.79,83,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9132.42,82,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,2784.28,10580.25,
CTL ROD MIS 90MM,30185069,CDM,,,278,RC,outpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,552.5,22,,percent of total billed charges,,,,,,,,,1989,90,,percent of total billed charges,,,1829.88,82.8,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,552.5,22,,percent of total billed charges,,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,552.5,2099.5,
SYNTHES DRILL BIT 1.5MM 110MM,30185070,CDM,,,278,RC,outpatient,,772.17,772.17,,655.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,193.04,22,,percent of total billed charges,,,,,,,,,694.95,90,,percent of total billed charges,,,639.36,82.8,,percent of total billed charges,,,656.34,85,,percent of total billed charges,,,,,,,,,679.51,88,,percent of total billed charges,,,,,,,,,589.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,193.04,22,,percent of total billed charges,,,702.67,91,,percent of total billed charges,,,733.56,95,,percent of total billed charges,,,640.9,83,,percent of total billed charges,,,640.9,83,,percent of total billed charges,,,,,,,,,,,,,,,640.9,83,,percent of total billed charges,,,733.56,95,,percent of total billed charges,,,694.95,90,,percent of total billed charges,,,694.95,90,,percent of total billed charges,,,633.18,82,,percent of total billed charges,,,694.95,90,,percent of total billed charges,,,656.34,85,,percent of total billed charges,,193.04,733.56,
SYNTHES DRILL BIT 2.7MM 125MM,30185071,CDM,,,278,RC,outpatient,,844.9,844.9,,717.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,211.23,22,,percent of total billed charges,,,,,,,,,760.41,90,,percent of total billed charges,,,699.58,82.8,,percent of total billed charges,,,718.17,85,,percent of total billed charges,,,,,,,,,743.51,88,,percent of total billed charges,,,,,,,,,645.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,211.23,22,,percent of total billed charges,,,768.86,91,,percent of total billed charges,,,802.66,95,,percent of total billed charges,,,701.27,83,,percent of total billed charges,,,701.27,83,,percent of total billed charges,,,,,,,,,,,,,,,701.27,83,,percent of total billed charges,,,802.66,95,,percent of total billed charges,,,760.41,90,,percent of total billed charges,,,760.41,90,,percent of total billed charges,,,692.82,82,,percent of total billed charges,,,760.41,90,,percent of total billed charges,,,718.17,85,,percent of total billed charges,,211.23,802.66,
MENISCAL GUN,30185074,CDM,,,270,RC,outpatient,,1865.5,1865.5,,1583.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,466.38,22,,percent of total billed charges,,,,,,,,,1678.95,90,,percent of total billed charges,,,1544.63,82.8,,percent of total billed charges,,,1585.68,85,,percent of total billed charges,,,,,,,,,1641.64,88,,percent of total billed charges,,,,,,,,,1425.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,466.38,22,,percent of total billed charges,,,1697.61,91,,percent of total billed charges,,,1772.23,95,,percent of total billed charges,,,1548.37,83,,percent of total billed charges,,,1548.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1548.37,83,,percent of total billed charges,,,1772.23,95,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1529.71,82,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1585.68,85,,percent of total billed charges,,466.38,1772.23,
CTL ROD MIS 95MM,30185075,CDM,,,278,RC,outpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,553.48,22,,percent of total billed charges,,,,,,,,,1992.51,90,,percent of total billed charges,,,1833.11,82.8,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,553.48,22,,percent of total billed charges,,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,553.48,2103.21,
SYNTHES SCREW CORTEX 3.5X20MM,30185076,CDM,,,278,RC,outpatient,,275.78,275.78,,234.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.95,22,,percent of total billed charges,,,,,,,,,248.2,90,,percent of total billed charges,,,228.35,82.8,,percent of total billed charges,,,234.41,85,,percent of total billed charges,,,,,,,,,242.69,88,,percent of total billed charges,,,,,,,,,210.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.95,22,,percent of total billed charges,,,250.96,91,,percent of total billed charges,,,261.99,95,,percent of total billed charges,,,228.9,83,,percent of total billed charges,,,228.9,83,,percent of total billed charges,,,,,,,,,,,,,,,228.9,83,,percent of total billed charges,,,261.99,95,,percent of total billed charges,,,248.2,90,,percent of total billed charges,,,248.2,90,,percent of total billed charges,,,226.14,82,,percent of total billed charges,,,248.2,90,,percent of total billed charges,,,234.41,85,,percent of total billed charges,,68.95,261.99,
SPINECRAFT BOLT ILLIAC 7.75 X 70MM,30185077,CDM,,,278,RC,outpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2356.25,22,,percent of total billed charges,,,,,,,,,8482.5,90,,percent of total billed charges,,,7803.9,82.8,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2356.25,22,,percent of total billed charges,,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,2356.25,8953.75,
SPINECRAFT CONNECTOR ILLIAC 26MM,30185078,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
SPINECRAFT SCREW SET LARGE,30185079,CDM,,,278,RC,outpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175,22,,percent of total billed charges,,,,,,,,,630,90,,percent of total billed charges,,,579.6,82.8,,percent of total billed charges,,,595,85,,percent of total billed charges,,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175,22,,percent of total billed charges,,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,175,665,
SPINECRAFT SCREW SET REGULAR,30185080,CDM,,,278,RC,outpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175,22,,percent of total billed charges,,,,,,,,,630,90,,percent of total billed charges,,,579.6,82.8,,percent of total billed charges,,,595,85,,percent of total billed charges,,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175,22,,percent of total billed charges,,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,175,665,
S&N COUPLER OFFSET 6MM,30185081,CDM,,,278,RC,outpatient,,13168.48,13168.48,,11180.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3292.12,22,,percent of total billed charges,,,,,,,,,11851.63,90,,percent of total billed charges,,,10903.5,82.8,,percent of total billed charges,,,11193.21,85,,percent of total billed charges,,,,,,,,,11588.26,88,,percent of total billed charges,,,,,,,,,10060.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3292.12,22,,percent of total billed charges,,,11983.32,91,,percent of total billed charges,,,12510.06,95,,percent of total billed charges,,,10929.84,83,,percent of total billed charges,,,10929.84,83,,percent of total billed charges,,,,,,,,,,,,,,,10929.84,83,,percent of total billed charges,,,12510.06,95,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,10798.15,82,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,11193.21,85,,percent of total billed charges,,3292.12,12510.06,
S&N WEDGES DIGITAL 10MM SZ 5,30185082,CDM,,,278,RC,outpatient,,10647,10647,,9039.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2661.75,22,,percent of total billed charges,,,,,,,,,9582.3,90,,percent of total billed charges,,,8815.72,82.8,,percent of total billed charges,,,9049.95,85,,percent of total billed charges,,,,,,,,,9369.36,88,,percent of total billed charges,,,,,,,,,8134.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2661.75,22,,percent of total billed charges,,,9688.77,91,,percent of total billed charges,,,10114.65,95,,percent of total billed charges,,,8837.01,83,,percent of total billed charges,,,8837.01,83,,percent of total billed charges,,,,,,,,,,,,,,,8837.01,83,,percent of total billed charges,,,10114.65,95,,percent of total billed charges,,,9582.3,90,,percent of total billed charges,,,9582.3,90,,percent of total billed charges,,,8730.54,82,,percent of total billed charges,,,9582.3,90,,percent of total billed charges,,,9049.95,85,,percent of total billed charges,,2661.75,10114.65,
S&N STEM PRESSFIT 20 X 120MM,30185083,CDM,,,278,RC,outpatient,,10483.2,10483.2,,8900.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2620.8,22,,percent of total billed charges,,,,,,,,,9434.88,90,,percent of total billed charges,,,8680.09,82.8,,percent of total billed charges,,,8910.72,85,,percent of total billed charges,,,,,,,,,9225.22,88,,percent of total billed charges,,,,,,,,,8009.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2620.8,22,,percent of total billed charges,,,9539.71,91,,percent of total billed charges,,,9959.04,95,,percent of total billed charges,,,8701.06,83,,percent of total billed charges,,,8701.06,83,,percent of total billed charges,,,,,,,,,,,,,,,8701.06,83,,percent of total billed charges,,,9959.04,95,,percent of total billed charges,,,9434.88,90,,percent of total billed charges,,,9434.88,90,,percent of total billed charges,,,8596.22,82,,percent of total billed charges,,,9434.88,90,,percent of total billed charges,,,8910.72,85,,percent of total billed charges,,2620.8,9959.04,
S&N PLATE BASE REVISION SZ 4 LT,30185084,CDM,,,278,RC,outpatient,,22645.35,22645.35,,19225.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5661.34,22,,percent of total billed charges,,,,,,,,,20380.82,90,,percent of total billed charges,,,18750.35,82.8,,percent of total billed charges,,,19248.55,85,,percent of total billed charges,,,,,,,,,19927.91,88,,percent of total billed charges,,,,,,,,,17301.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5661.34,22,,percent of total billed charges,,,20607.27,91,,percent of total billed charges,,,21513.08,95,,percent of total billed charges,,,18795.64,83,,percent of total billed charges,,,18795.64,83,,percent of total billed charges,,,,,,,,,,,,,,,18795.64,83,,percent of total billed charges,,,21513.08,95,,percent of total billed charges,,,20380.82,90,,percent of total billed charges,,,20380.82,90,,percent of total billed charges,,,18569.19,82,,percent of total billed charges,,,20380.82,90,,percent of total billed charges,,,19248.55,85,,percent of total billed charges,,5661.34,21513.08,
S&N WEDGE TIB. MEDIAL LT 5MM SZ 3/4,30185085,CDM,,,278,RC,outpatient,,12018.83,12018.83,,10203.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3004.71,22,,percent of total billed charges,,,,,,,,,10816.95,90,,percent of total billed charges,,,9951.59,82.8,,percent of total billed charges,,,10216.01,85,,percent of total billed charges,,,,,,,,,10576.57,88,,percent of total billed charges,,,,,,,,,9182.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3004.71,22,,percent of total billed charges,,,10937.14,91,,percent of total billed charges,,,11417.89,95,,percent of total billed charges,,,9975.63,83,,percent of total billed charges,,,9975.63,83,,percent of total billed charges,,,,,,,,,,,,,,,9975.63,83,,percent of total billed charges,,,11417.89,95,,percent of total billed charges,,,10816.95,90,,percent of total billed charges,,,10816.95,90,,percent of total billed charges,,,9855.44,82,,percent of total billed charges,,,10816.95,90,,percent of total billed charges,,,10216.01,85,,percent of total billed charges,,3004.71,11417.89,
S&N WEDGE TIB. LATERAL LT 5MM SZ 3/4,30185086,CDM,,,278,RC,outpatient,,12018.83,12018.83,,10203.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3004.71,22,,percent of total billed charges,,,,,,,,,10816.95,90,,percent of total billed charges,,,9951.59,82.8,,percent of total billed charges,,,10216.01,85,,percent of total billed charges,,,,,,,,,10576.57,88,,percent of total billed charges,,,,,,,,,9182.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3004.71,22,,percent of total billed charges,,,10937.14,91,,percent of total billed charges,,,11417.89,95,,percent of total billed charges,,,9975.63,83,,percent of total billed charges,,,9975.63,83,,percent of total billed charges,,,,,,,,,,,,,,,9975.63,83,,percent of total billed charges,,,11417.89,95,,percent of total billed charges,,,10816.95,90,,percent of total billed charges,,,10816.95,90,,percent of total billed charges,,,9855.44,82,,percent of total billed charges,,,10816.95,90,,percent of total billed charges,,,10216.01,85,,percent of total billed charges,,3004.71,11417.89,
S&N STEM PRESSFIT 16MM X 160MM,30185087,CDM,,,278,RC,outpatient,,10776.35,10776.35,,9149.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2694.09,22,,percent of total billed charges,,,,,,,,,9698.72,90,,percent of total billed charges,,,8922.82,82.8,,percent of total billed charges,,,9159.9,85,,percent of total billed charges,,,,,,,,,9483.19,88,,percent of total billed charges,,,,,,,,,8233.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2694.09,22,,percent of total billed charges,,,9806.48,91,,percent of total billed charges,,,10237.53,95,,percent of total billed charges,,,8944.37,83,,percent of total billed charges,,,8944.37,83,,percent of total billed charges,,,,,,,,,,,,,,,8944.37,83,,percent of total billed charges,,,10237.53,95,,percent of total billed charges,,,9698.72,90,,percent of total billed charges,,,9698.72,90,,percent of total billed charges,,,8836.61,82,,percent of total billed charges,,,9698.72,90,,percent of total billed charges,,,9159.9,85,,percent of total billed charges,,2694.09,10237.53,
S&N INSERT CONSTRAINED 11MM SZ 3/4,30185088,CDM,,,278,RC,outpatient,,23176.47,23176.47,,19676.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5794.12,22,,percent of total billed charges,,,,,,,,,20858.82,90,,percent of total billed charges,,,19190.12,82.8,,percent of total billed charges,,,19700,85,,percent of total billed charges,,,,,,,,,20395.29,88,,percent of total billed charges,,,,,,,,,17706.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5794.12,22,,percent of total billed charges,,,21090.59,91,,percent of total billed charges,,,22017.65,95,,percent of total billed charges,,,19236.47,83,,percent of total billed charges,,,19236.47,83,,percent of total billed charges,,,,,,,,,,,,,,,19236.47,83,,percent of total billed charges,,,22017.65,95,,percent of total billed charges,,,20858.82,90,,percent of total billed charges,,,20858.82,90,,percent of total billed charges,,,19004.71,82,,percent of total billed charges,,,20858.82,90,,percent of total billed charges,,,19700,85,,percent of total billed charges,,5794.12,22017.65,
S&N PINS HEADLESS 65MM,30185089,CDM,,,278,RC,outpatient,,59.33,59.33,,50.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.83,22,,percent of total billed charges,,,,,,,,,53.4,90,,percent of total billed charges,,,49.13,82.8,,percent of total billed charges,,,50.43,85,,percent of total billed charges,,,,,,,,,52.21,88,,percent of total billed charges,,,,,,,,,45.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.83,22,,percent of total billed charges,,,53.99,91,,percent of total billed charges,,,56.36,95,,percent of total billed charges,,,49.24,83,,percent of total billed charges,,,49.24,83,,percent of total billed charges,,,,,,,,,,,,,,,49.24,83,,percent of total billed charges,,,56.36,95,,percent of total billed charges,,,53.4,90,,percent of total billed charges,,,53.4,90,,percent of total billed charges,,,48.65,82,,percent of total billed charges,,,53.4,90,,percent of total billed charges,,,50.43,85,,percent of total billed charges,,14.83,56.36,
S&N PINS RIMMED 65MM,30185090,CDM,,,278,RC,outpatient,,59.33,59.33,,50.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.83,22,,percent of total billed charges,,,,,,,,,53.4,90,,percent of total billed charges,,,49.13,82.8,,percent of total billed charges,,,50.43,85,,percent of total billed charges,,,,,,,,,52.21,88,,percent of total billed charges,,,,,,,,,45.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.83,22,,percent of total billed charges,,,53.99,91,,percent of total billed charges,,,56.36,95,,percent of total billed charges,,,49.24,83,,percent of total billed charges,,,49.24,83,,percent of total billed charges,,,,,,,,,,,,,,,49.24,83,,percent of total billed charges,,,56.36,95,,percent of total billed charges,,,53.4,90,,percent of total billed charges,,,53.4,90,,percent of total billed charges,,,48.65,82,,percent of total billed charges,,,53.4,90,,percent of total billed charges,,,50.43,85,,percent of total billed charges,,14.83,56.36,
S&N PINS RIMMED 45MM,30185091,CDM,,,278,RC,outpatient,,167.52,167.52,,142.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.88,22,,percent of total billed charges,,,,,,,,,150.77,90,,percent of total billed charges,,,138.71,82.8,,percent of total billed charges,,,142.39,85,,percent of total billed charges,,,,,,,,,147.42,88,,percent of total billed charges,,,,,,,,,127.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.88,22,,percent of total billed charges,,,152.44,91,,percent of total billed charges,,,159.14,95,,percent of total billed charges,,,139.04,83,,percent of total billed charges,,,139.04,83,,percent of total billed charges,,,,,,,,,,,,,,,139.04,83,,percent of total billed charges,,,159.14,95,,percent of total billed charges,,,150.77,90,,percent of total billed charges,,,150.77,90,,percent of total billed charges,,,137.37,82,,percent of total billed charges,,,150.77,90,,percent of total billed charges,,,142.39,85,,percent of total billed charges,,41.88,159.14,
SNARE LARIAT,30185092,CDM,,,270,RC,outpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50,22,,percent of total billed charges,,,,,,,,,180,90,,percent of total billed charges,,,165.6,82.8,,percent of total billed charges,,,170,85,,percent of total billed charges,,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50,22,,percent of total billed charges,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,50,190,
SYNTHES PLATE DISTAL RADIUS 3 HOLE LEFT,30185095,CDM,,,278,RC,outpatient,,9762.68,9762.68,,8288.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2440.67,22,,percent of total billed charges,,,,,,,,,8786.41,90,,percent of total billed charges,,,8083.5,82.8,,percent of total billed charges,,,8298.28,85,,percent of total billed charges,,,,,,,,,8591.16,88,,percent of total billed charges,,,,,,,,,7458.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2440.67,22,,percent of total billed charges,,,8884.04,91,,percent of total billed charges,,,9274.55,95,,percent of total billed charges,,,8103.02,83,,percent of total billed charges,,,8103.02,83,,percent of total billed charges,,,,,,,,,,,,,,,8103.02,83,,percent of total billed charges,,,9274.55,95,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8005.4,82,,percent of total billed charges,,,8786.41,90,,percent of total billed charges,,,8298.28,85,,percent of total billed charges,,2440.67,9274.55,
SYNTHES SCREW CORTEX TI 2.7 X 14MM,30185096,CDM,,,278,RC,outpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.1,22,,percent of total billed charges,,,,,,,,,385.56,90,,percent of total billed charges,,,354.72,82.8,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.1,22,,percent of total billed charges,,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,107.1,406.98,
SYNTHES SCREW CORTEX TI 2.7 X 26MM,30185097,CDM,,,278,RC,outpatient,,428.4,428.4,,363.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.1,22,,percent of total billed charges,,,,,,,,,385.56,90,,percent of total billed charges,,,354.72,82.8,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,,,,,,,,376.99,88,,percent of total billed charges,,,,,,,,,327.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.1,22,,percent of total billed charges,,,389.84,91,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,355.57,83,,percent of total billed charges,,,,,,,,,,,,,,,355.57,83,,percent of total billed charges,,,406.98,95,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,351.29,82,,percent of total billed charges,,,385.56,90,,percent of total billed charges,,,364.14,85,,percent of total billed charges,,107.1,406.98,
SYNTHES SCREW LOCKING VA TI 2.4 X 12MM,30185098,CDM,,,278,RC,outpatient,,1408.88,1408.88,,1196.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,352.22,22,,percent of total billed charges,,,,,,,,,1267.99,90,,percent of total billed charges,,,1166.55,82.8,,percent of total billed charges,,,1197.55,85,,percent of total billed charges,,,,,,,,,1239.81,88,,percent of total billed charges,,,,,,,,,1076.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,352.22,22,,percent of total billed charges,,,1282.08,91,,percent of total billed charges,,,1338.44,95,,percent of total billed charges,,,1169.37,83,,percent of total billed charges,,,1169.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1169.37,83,,percent of total billed charges,,,1338.44,95,,percent of total billed charges,,,1267.99,90,,percent of total billed charges,,,1267.99,90,,percent of total billed charges,,,1155.28,82,,percent of total billed charges,,,1267.99,90,,percent of total billed charges,,,1197.55,85,,percent of total billed charges,,352.22,1338.44,
SYNTHES SCREW LOCKING VA TI 2.4 X 14MM,30185099,CDM,,,278,RC,outpatient,,1408.88,1408.88,,1196.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,352.22,22,,percent of total billed charges,,,,,,,,,1267.99,90,,percent of total billed charges,,,1166.55,82.8,,percent of total billed charges,,,1197.55,85,,percent of total billed charges,,,,,,,,,1239.81,88,,percent of total billed charges,,,,,,,,,1076.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,352.22,22,,percent of total billed charges,,,1282.08,91,,percent of total billed charges,,,1338.44,95,,percent of total billed charges,,,1169.37,83,,percent of total billed charges,,,1169.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1169.37,83,,percent of total billed charges,,,1338.44,95,,percent of total billed charges,,,1267.99,90,,percent of total billed charges,,,1267.99,90,,percent of total billed charges,,,1155.28,82,,percent of total billed charges,,,1267.99,90,,percent of total billed charges,,,1197.55,85,,percent of total billed charges,,352.22,1338.44,
SYNTHES SCREW LOCKING VA TI 2.4 X 18MM,30185100,CDM,,,278,RC,outpatient,,1494.68,1494.68,,1268.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,373.67,22,,percent of total billed charges,,,,,,,,,1345.21,90,,percent of total billed charges,,,1237.6,82.8,,percent of total billed charges,,,1270.48,85,,percent of total billed charges,,,,,,,,,1315.32,88,,percent of total billed charges,,,,,,,,,1141.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,373.67,22,,percent of total billed charges,,,1360.16,91,,percent of total billed charges,,,1419.95,95,,percent of total billed charges,,,1240.58,83,,percent of total billed charges,,,1240.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1240.58,83,,percent of total billed charges,,,1419.95,95,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1225.64,82,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1270.48,85,,percent of total billed charges,,373.67,1419.95,
SYNTHES SCREW LOCKING VA TI 2.4 X 20MM,30185101,CDM,,,278,RC,outpatient,,1494.68,1494.68,,1268.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,373.67,22,,percent of total billed charges,,,,,,,,,1345.21,90,,percent of total billed charges,,,1237.6,82.8,,percent of total billed charges,,,1270.48,85,,percent of total billed charges,,,,,,,,,1315.32,88,,percent of total billed charges,,,,,,,,,1141.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,373.67,22,,percent of total billed charges,,,1360.16,91,,percent of total billed charges,,,1419.95,95,,percent of total billed charges,,,1240.58,83,,percent of total billed charges,,,1240.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1240.58,83,,percent of total billed charges,,,1419.95,95,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1225.64,82,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1270.48,85,,percent of total billed charges,,373.67,1419.95,
SYNTHES K-WIRE TI 1.25 X 150M,30185102,CDM,,,278,RC,outpatient,,1049.23,1049.23,,890.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,262.31,22,,percent of total billed charges,,,,,,,,,944.31,90,,percent of total billed charges,,,868.76,82.8,,percent of total billed charges,,,891.85,85,,percent of total billed charges,,,,,,,,,923.32,88,,percent of total billed charges,,,,,,,,,801.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,262.31,22,,percent of total billed charges,,,954.8,91,,percent of total billed charges,,,996.77,95,,percent of total billed charges,,,870.86,83,,percent of total billed charges,,,870.86,83,,percent of total billed charges,,,,,,,,,,,,,,,870.86,83,,percent of total billed charges,,,996.77,95,,percent of total billed charges,,,944.31,90,,percent of total billed charges,,,944.31,90,,percent of total billed charges,,,860.37,82,,percent of total billed charges,,,944.31,90,,percent of total billed charges,,,891.85,85,,percent of total billed charges,,262.31,996.77,
ZIMMER HEAD FEMORAL 12/14 28MM +10.5,30185103,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
CHOICE SPINE PEEK STEALTH 6MM 6DEG 14X16,30185104,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
CHOICE SPINE PLATE FOUR LEVEL 76MM,30185105,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
WRIGHT SCREW PEEK INTERFERENCE,30185106,CDM,,,278,RC,outpatient,,4641,4641,,3940.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1160.25,22,,percent of total billed charges,,,,,,,,,4176.9,90,,percent of total billed charges,,,3842.75,82.8,,percent of total billed charges,,,3944.85,85,,percent of total billed charges,,,,,,,,,4084.08,88,,percent of total billed charges,,,,,,,,,3545.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1160.25,22,,percent of total billed charges,,,4223.31,91,,percent of total billed charges,,,4408.95,95,,percent of total billed charges,,,3852.03,83,,percent of total billed charges,,,3852.03,83,,percent of total billed charges,,,,,,,,,,,,,,,3852.03,83,,percent of total billed charges,,,4408.95,95,,percent of total billed charges,,,4176.9,90,,percent of total billed charges,,,4176.9,90,,percent of total billed charges,,,3805.62,82,,percent of total billed charges,,,4176.9,90,,percent of total billed charges,,,3944.85,85,,percent of total billed charges,,1160.25,4408.95,
WRIGHT SUTURE LOOP GUIDE ROD,30185107,CDM,,,278,RC,outpatient,,1631.5,1631.5,,1385.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,407.88,22,,percent of total billed charges,,,,,,,,,1468.35,90,,percent of total billed charges,,,1350.88,82.8,,percent of total billed charges,,,1386.78,85,,percent of total billed charges,,,,,,,,,1435.72,88,,percent of total billed charges,,,,,,,,,1246.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,407.88,22,,percent of total billed charges,,,1484.67,91,,percent of total billed charges,,,1549.93,95,,percent of total billed charges,,,1354.15,83,,percent of total billed charges,,,1354.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1354.15,83,,percent of total billed charges,,,1549.93,95,,percent of total billed charges,,,1468.35,90,,percent of total billed charges,,,1468.35,90,,percent of total billed charges,,,1337.83,82,,percent of total billed charges,,,1468.35,90,,percent of total billed charges,,,1386.78,85,,percent of total billed charges,,407.88,1549.93,
WRIGHT REAMER CANNULATED 5MM,30185108,CDM,,,278,RC,outpatient,,3874,3874,,3289.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,968.5,22,,percent of total billed charges,,,,,,,,,3486.6,90,,percent of total billed charges,,,3207.67,82.8,,percent of total billed charges,,,3292.9,85,,percent of total billed charges,,,,,,,,,3409.12,88,,percent of total billed charges,,,,,,,,,2959.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,968.5,22,,percent of total billed charges,,,3525.34,91,,percent of total billed charges,,,3680.3,95,,percent of total billed charges,,,3215.42,83,,percent of total billed charges,,,3215.42,83,,percent of total billed charges,,,,,,,,,,,,,,,3215.42,83,,percent of total billed charges,,,3680.3,95,,percent of total billed charges,,,3486.6,90,,percent of total billed charges,,,3486.6,90,,percent of total billed charges,,,3176.68,82,,percent of total billed charges,,,3486.6,90,,percent of total billed charges,,,3292.9,85,,percent of total billed charges,,968.5,3680.3,
WRIGHT K-WIRE JONES 228MM,30185109,CDM,,,278,RC,outpatient,,307.5,307.5,,261.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.88,22,,percent of total billed charges,,,,,,,,,276.75,90,,percent of total billed charges,,,254.61,82.8,,percent of total billed charges,,,261.38,85,,percent of total billed charges,,,,,,,,,270.6,88,,percent of total billed charges,,,,,,,,,234.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.88,22,,percent of total billed charges,,,279.83,91,,percent of total billed charges,,,292.13,95,,percent of total billed charges,,,255.23,83,,percent of total billed charges,,,255.23,83,,percent of total billed charges,,,,,,,,,,,,,,,255.23,83,,percent of total billed charges,,,292.13,95,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,252.15,82,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,261.38,85,,percent of total billed charges,,76.88,292.13,
WRIGHT BEAM SALVATION 7.0 X 80MM,30185110,CDM,,,278,RC,outpatient,,12987,12987,,11025.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3246.75,22,,percent of total billed charges,,,,,,,,,11688.3,90,,percent of total billed charges,,,10753.24,82.8,,percent of total billed charges,,,11038.95,85,,percent of total billed charges,,,,,,,,,11428.56,88,,percent of total billed charges,,,,,,,,,9922.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3246.75,22,,percent of total billed charges,,,11818.17,91,,percent of total billed charges,,,12337.65,95,,percent of total billed charges,,,10779.21,83,,percent of total billed charges,,,10779.21,83,,percent of total billed charges,,,,,,,,,,,,,,,10779.21,83,,percent of total billed charges,,,12337.65,95,,percent of total billed charges,,,11688.3,90,,percent of total billed charges,,,11688.3,90,,percent of total billed charges,,,10649.34,82,,percent of total billed charges,,,11688.3,90,,percent of total billed charges,,,11038.95,85,,percent of total billed charges,,3246.75,12337.65,
WRIGHT DRILL BIT SALVATION 5.0MM,30185111,CDM,,,278,RC,outpatient,,2619.5,2619.5,,2223.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,654.88,22,,percent of total billed charges,,,,,,,,,2357.55,90,,percent of total billed charges,,,2168.95,82.8,,percent of total billed charges,,,2226.58,85,,percent of total billed charges,,,,,,,,,2305.16,88,,percent of total billed charges,,,,,,,,,2001.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,654.88,22,,percent of total billed charges,,,2383.75,91,,percent of total billed charges,,,2488.53,95,,percent of total billed charges,,,2174.19,83,,percent of total billed charges,,,2174.19,83,,percent of total billed charges,,,,,,,,,,,,,,,2174.19,83,,percent of total billed charges,,,2488.53,95,,percent of total billed charges,,,2357.55,90,,percent of total billed charges,,,2357.55,90,,percent of total billed charges,,,2147.99,82,,percent of total billed charges,,,2357.55,90,,percent of total billed charges,,,2226.58,85,,percent of total billed charges,,654.88,2488.53,
WRIGHT PLATE FUSION LG,30185112,CDM,,,278,RC,outpatient,,18869.5,18869.5,,16020.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4717.38,22,,percent of total billed charges,,,,,,,,,16982.55,90,,percent of total billed charges,,,15623.95,82.8,,percent of total billed charges,,,16039.08,85,,percent of total billed charges,,,,,,,,,16605.16,88,,percent of total billed charges,,,,,,,,,14416.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4717.38,22,,percent of total billed charges,,,17171.25,91,,percent of total billed charges,,,17926.03,95,,percent of total billed charges,,,15661.69,83,,percent of total billed charges,,,15661.69,83,,percent of total billed charges,,,,,,,,,,,,,,,15661.69,83,,percent of total billed charges,,,17926.03,95,,percent of total billed charges,,,16982.55,90,,percent of total billed charges,,,16982.55,90,,percent of total billed charges,,,15472.99,82,,percent of total billed charges,,,16982.55,90,,percent of total billed charges,,,16039.08,85,,percent of total billed charges,,4717.38,17926.03,
WRIGHT SCREW LOCKING 3.5 X 22MM,30185113,CDM,,,278,RC,outpatient,,2385.5,2385.5,,2025.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,596.38,22,,percent of total billed charges,,,,,,,,,2146.95,90,,percent of total billed charges,,,1975.19,82.8,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,,,,,,,,2099.24,88,,percent of total billed charges,,,,,,,,,1822.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,596.38,22,,percent of total billed charges,,,2170.81,91,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1979.97,83,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,1956.11,82,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,596.38,2266.23,
WRIGHT SCREW LOCKING 3.5 X 26MM,30185114,CDM,,,278,RC,outpatient,,2385.5,2385.5,,2025.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,596.38,22,,percent of total billed charges,,,,,,,,,2146.95,90,,percent of total billed charges,,,1975.19,82.8,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,,,,,,,,2099.24,88,,percent of total billed charges,,,,,,,,,1822.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,596.38,22,,percent of total billed charges,,,2170.81,91,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1979.97,83,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,1956.11,82,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,596.38,2266.23,
WRIGHT SCREW LOCKING 3.5 X 36MM,30185115,CDM,,,278,RC,outpatient,,2385.5,2385.5,,2025.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,596.38,22,,percent of total billed charges,,,,,,,,,2146.95,90,,percent of total billed charges,,,1975.19,82.8,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,,,,,,,,2099.24,88,,percent of total billed charges,,,,,,,,,1822.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,596.38,22,,percent of total billed charges,,,2170.81,91,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1979.97,83,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,1956.11,82,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,596.38,2266.23,
WRIGHT SCREW LOCKING 3.5 X 46MM,30185116,CDM,,,278,RC,outpatient,,2385.5,2385.5,,2025.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,596.38,22,,percent of total billed charges,,,,,,,,,2146.95,90,,percent of total billed charges,,,1975.19,82.8,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,,,,,,,,2099.24,88,,percent of total billed charges,,,,,,,,,1822.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,596.38,22,,percent of total billed charges,,,2170.81,91,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1979.97,83,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,1956.11,82,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,596.38,2266.23,
WRIGHT SCREW LOW-PRO CORT 3.5 X 36MM,30185117,CDM,,,278,RC,outpatient,,1215.5,1215.5,,1031.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,303.88,22,,percent of total billed charges,,,,,,,,,1093.95,90,,percent of total billed charges,,,1006.43,82.8,,percent of total billed charges,,,1033.18,85,,percent of total billed charges,,,,,,,,,1069.64,88,,percent of total billed charges,,,,,,,,,928.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,303.88,22,,percent of total billed charges,,,1106.11,91,,percent of total billed charges,,,1154.73,95,,percent of total billed charges,,,1008.87,83,,percent of total billed charges,,,1008.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1008.87,83,,percent of total billed charges,,,1154.73,95,,percent of total billed charges,,,1093.95,90,,percent of total billed charges,,,1093.95,90,,percent of total billed charges,,,996.71,82,,percent of total billed charges,,,1093.95,90,,percent of total billed charges,,,1033.18,85,,percent of total billed charges,,303.88,1154.73,
WRIGHT PIN FIXATION 1.4MM LG,30185118,CDM,,,278,RC,outpatient,,861,861,,730.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,215.25,22,,percent of total billed charges,,,,,,,,,774.9,90,,percent of total billed charges,,,712.91,82.8,,percent of total billed charges,,,731.85,85,,percent of total billed charges,,,,,,,,,757.68,88,,percent of total billed charges,,,,,,,,,657.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,215.25,22,,percent of total billed charges,,,783.51,91,,percent of total billed charges,,,817.95,95,,percent of total billed charges,,,714.63,83,,percent of total billed charges,,,714.63,83,,percent of total billed charges,,,,,,,,,,,,,,,714.63,83,,percent of total billed charges,,,817.95,95,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,706.02,82,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,731.85,85,,percent of total billed charges,,215.25,817.95,
WRIGHT DRILL BIT 2.8 X 60MM,30185119,CDM,,,278,RC,outpatient,,1774.5,1774.5,,1506.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,443.63,22,,percent of total billed charges,,,,,,,,,1597.05,90,,percent of total billed charges,,,1469.29,82.8,,percent of total billed charges,,,1508.33,85,,percent of total billed charges,,,,,,,,,1561.56,88,,percent of total billed charges,,,,,,,,,1355.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,443.63,22,,percent of total billed charges,,,1614.8,91,,percent of total billed charges,,,1685.78,95,,percent of total billed charges,,,1472.84,83,,percent of total billed charges,,,1472.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1472.84,83,,percent of total billed charges,,,1685.78,95,,percent of total billed charges,,,1597.05,90,,percent of total billed charges,,,1597.05,90,,percent of total billed charges,,,1455.09,82,,percent of total billed charges,,,1597.05,90,,percent of total billed charges,,,1508.33,85,,percent of total billed charges,,443.63,1685.78,
ARTHREX BIOCOMPOSITE SUTURETAK,30185120,CDM,,,278,RC,outpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,552.5,22,,percent of total billed charges,,,,,,,,,1989,90,,percent of total billed charges,,,1829.88,82.8,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,552.5,22,,percent of total billed charges,,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,552.5,2099.5,
ARTHREX SUTURE LASSO 45 LEFT,30185121,CDM,,,270,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
ACUMED BONE GRAFT DRILL ASSY. 7MM,30185122,CDM,,,270,RC,outpatient,,2801.5,2801.5,,2378.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,700.38,22,,percent of total billed charges,,,,,,,,,2521.35,90,,percent of total billed charges,,,2319.64,82.8,,percent of total billed charges,,,2381.28,85,,percent of total billed charges,,,,,,,,,2465.32,88,,percent of total billed charges,,,,,,,,,2140.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,700.38,22,,percent of total billed charges,,,2549.37,91,,percent of total billed charges,,,2661.43,95,,percent of total billed charges,,,2325.25,83,,percent of total billed charges,,,2325.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2325.25,83,,percent of total billed charges,,,2661.43,95,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2297.23,82,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2381.28,85,,percent of total billed charges,,700.38,2661.43,
ACUMED GRAFT REMOVAL PADDLE ASSY. 6MM,30185123,CDM,,,270,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
WRAP LARGE ARM SUPPORT,30185124,CDM,,,270,RC,outpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.63,22,,percent of total billed charges,,,,,,,,,236.25,90,,percent of total billed charges,,,217.35,82.8,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.63,22,,percent of total billed charges,,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,65.63,249.38,
ZIMMER LINER DUAL MOBILITY G7 40MM D,30185126,CDM,,,278,RC,outpatient,,9912.5,9912.5,,8415.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2478.13,22,,percent of total billed charges,,,,,,,,,8921.25,90,,percent of total billed charges,,,8207.55,82.8,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,,,,,,,,8723,88,,percent of total billed charges,,,,,,,,,7573.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2478.13,22,,percent of total billed charges,,,9020.38,91,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,,,,,,,,,,,,,8227.38,83,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8128.25,82,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,2478.13,9416.88,
ZIMMER BEARING HIP ACT ARTIC 28X40MM,30185127,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
ZIMMER SHELL OSSEOTI G7 50MM D 3 HOLE,30185128,CDM,,,278,RC,outpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4834.38,22,,percent of total billed charges,,,,,,,,,17403.75,90,,percent of total billed charges,,,16011.45,82.8,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4834.38,22,,percent of total billed charges,,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,4834.38,18370.63,
WRIGHT HEAD FEMORAL 36MM 12/14,30185129,CDM,,,278,RC,outpatient,,39065,39065,,33166.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9766.25,22,,percent of total billed charges,,,,,,,,,35158.5,90,,percent of total billed charges,,,32345.82,82.8,,percent of total billed charges,,,33205.25,85,,percent of total billed charges,,,,,,,,,34377.2,88,,percent of total billed charges,,,,,,,,,29845.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9766.25,22,,percent of total billed charges,,,35549.15,91,,percent of total billed charges,,,37111.75,95,,percent of total billed charges,,,32423.95,83,,percent of total billed charges,,,32423.95,83,,percent of total billed charges,,,,,,,,,,,,,,,32423.95,83,,percent of total billed charges,,,37111.75,95,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,32033.3,82,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,33205.25,85,,percent of total billed charges,,9766.25,37111.75,
WRIGHT NECK MODULAR LONG/STRAIGHT 12/14,30185130,CDM,,,278,RC,outpatient,,28964,28964,,24590.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7241,22,,percent of total billed charges,,,,,,,,,26067.6,90,,percent of total billed charges,,,23982.19,82.8,,percent of total billed charges,,,24619.4,85,,percent of total billed charges,,,,,,,,,25488.32,88,,percent of total billed charges,,,,,,,,,22128.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7241,22,,percent of total billed charges,,,26357.24,91,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,,,,,,,,,,,,,24040.12,83,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,23750.48,82,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,24619.4,85,,percent of total billed charges,,7241,27515.8,
ZIMMER SHELL OSSEOTI G7 58MM G,30185131,CDM,,,278,RC,outpatient,,42640,42640,,36201.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10660,22,,percent of total billed charges,,,,,,,,,38376,90,,percent of total billed charges,,,35305.92,82.8,,percent of total billed charges,,,36244,85,,percent of total billed charges,,,,,,,,,37523.2,88,,percent of total billed charges,,,,,,,,,32576.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10660,22,,percent of total billed charges,,,38802.4,91,,percent of total billed charges,,,40508,95,,percent of total billed charges,,,35391.2,83,,percent of total billed charges,,,35391.2,83,,percent of total billed charges,,,,,,,,,,,,,,,35391.2,83,,percent of total billed charges,,,40508,95,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,34964.8,82,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,36244,85,,percent of total billed charges,,10660,40508,
ZIMMER LINER DUAL MOBILITY G7 46MM G,30185132,CDM,,,278,RC,outpatient,,9912.5,9912.5,,8415.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2478.13,22,,percent of total billed charges,,,,,,,,,8921.25,90,,percent of total billed charges,,,8207.55,82.8,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,,,,,,,,8723,88,,percent of total billed charges,,,,,,,,,7573.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2478.13,22,,percent of total billed charges,,,9020.38,91,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,,,,,,,,,,,,,8227.38,83,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8128.25,82,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,2478.13,9416.88,
ZIMMER BEARING HIP ACT ARTIC 28X46MM,30185133,CDM,,,278,RC,outpatient,,23400,23400,,19866.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5850,22,,percent of total billed charges,,,,,,,,,21060,90,,percent of total billed charges,,,19375.2,82.8,,percent of total billed charges,,,19890,85,,percent of total billed charges,,,,,,,,,20592,88,,percent of total billed charges,,,,,,,,,17877.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5850,22,,percent of total billed charges,,,21294,91,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,,,,,,,,,,,,,19422,83,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19188,82,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19890,85,,percent of total billed charges,,5850,22230,
BONE MILL DISPOSABLE - MEDIUM,30185134,CDM,,,270,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
CAGE STALIF C-T 16 X 5.5MM,30185135,CDM,,,278,RC,outpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4875,22,,percent of total billed charges,,,,,,,,,17550,90,,percent of total billed charges,,,16146,82.8,,percent of total billed charges,,,16575,85,,percent of total billed charges,,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4875,22,,percent of total billed charges,,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,4875,18525,
CTL SPACER CORTICAL CERVICAL 5MM,30185136,CDM,,,278,RC,outpatient,,12231.38,12231.38,,10384.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3057.85,22,,percent of total billed charges,,,,,,,,,11008.24,90,,percent of total billed charges,,,10127.58,82.8,,percent of total billed charges,,,10396.67,85,,percent of total billed charges,,,,,,,,,10763.61,88,,percent of total billed charges,,,,,,,,,9344.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3057.85,22,,percent of total billed charges,,,11130.56,91,,percent of total billed charges,,,11619.81,95,,percent of total billed charges,,,10152.05,83,,percent of total billed charges,,,10152.05,83,,percent of total billed charges,,,,,,,,,,,,,,,10152.05,83,,percent of total billed charges,,,11619.81,95,,percent of total billed charges,,,11008.24,90,,percent of total billed charges,,,11008.24,90,,percent of total billed charges,,,10029.73,82,,percent of total billed charges,,,11008.24,90,,percent of total billed charges,,,10396.67,85,,percent of total billed charges,,3057.85,11619.81,
CTL PLATE VANGOGH CERVICAL 12MM,30185137,CDM,,,278,RC,outpatient,,8957,8957,,7604.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2239.25,22,,percent of total billed charges,,,,,,,,,8061.3,90,,percent of total billed charges,,,7416.4,82.8,,percent of total billed charges,,,7613.45,85,,percent of total billed charges,,,,,,,,,7882.16,88,,percent of total billed charges,,,,,,,,,6843.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2239.25,22,,percent of total billed charges,,,8150.87,91,,percent of total billed charges,,,8509.15,95,,percent of total billed charges,,,7434.31,83,,percent of total billed charges,,,7434.31,83,,percent of total billed charges,,,,,,,,,,,,,,,7434.31,83,,percent of total billed charges,,,8509.15,95,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,7344.74,82,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,7613.45,85,,percent of total billed charges,,2239.25,8509.15,
CTL SCREW ST VARIABLE 4.0 X 14,30185138,CDM,,,278,RC,outpatient,,1521,1521,,1291.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,380.25,22,,percent of total billed charges,,,,,,,,,1368.9,90,,percent of total billed charges,,,1259.39,82.8,,percent of total billed charges,,,1292.85,85,,percent of total billed charges,,,,,,,,,1338.48,88,,percent of total billed charges,,,,,,,,,1162.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,380.25,22,,percent of total billed charges,,,1384.11,91,,percent of total billed charges,,,1444.95,95,,percent of total billed charges,,,1262.43,83,,percent of total billed charges,,,1262.43,83,,percent of total billed charges,,,,,,,,,,,,,,,1262.43,83,,percent of total billed charges,,,1444.95,95,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1247.22,82,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1292.85,85,,percent of total billed charges,,380.25,1444.95,
CTL SCREW PICASSO II 6.5 X 50,30185139,CDM,,,278,RC,outpatient,,11137.1,11137.1,,9455.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2784.28,22,,percent of total billed charges,,,,,,,,,10023.39,90,,percent of total billed charges,,,9221.52,82.8,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,,,,,,,,9800.65,88,,percent of total billed charges,,,,,,,,,8508.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2784.28,22,,percent of total billed charges,,,10134.76,91,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9243.79,83,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9132.42,82,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,2784.28,10580.25,
CTL ROD MIS 95MM,30185140,CDM,,,278,RC,outpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,553.48,22,,percent of total billed charges,,,,,,,,,1992.51,90,,percent of total billed charges,,,1833.11,82.8,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,553.48,22,,percent of total billed charges,,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,553.48,2103.21,
CTL ROD MIS 90MM,30185141,CDM,,,278,RC,outpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,553.48,22,,percent of total billed charges,,,,,,,,,1992.51,90,,percent of total billed charges,,,1833.11,82.8,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,553.48,22,,percent of total billed charges,,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,553.48,2103.21,
ZIMMER SCREW BONE ST 6.5 X 35MM,30185142,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
ZIMMER HEAD FEMORAL BIOLOX DELTA 28MM +3,30185143,CDM,,,278,RC,outpatient,,18525,18525,,15727.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4631.25,22,,percent of total billed charges,,,,,,,,,16672.5,90,,percent of total billed charges,,,15338.7,82.8,,percent of total billed charges,,,15746.25,85,,percent of total billed charges,,,,,,,,,16302,88,,percent of total billed charges,,,,,,,,,14153.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4631.25,22,,percent of total billed charges,,,16857.75,91,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,,,,,,,,,,,,,15375.75,83,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15190.5,82,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15746.25,85,,percent of total billed charges,,4631.25,17598.75,
ZIMMER INSERT BEARING SZ 3 MD RT,30185144,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
CORTICAL STRUT 2.0 X 18CM FROZEN,30185145,CDM,,,278,RC,outpatient,,4062.5,4062.5,,3449.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1015.63,22,,percent of total billed charges,,,,,,,,,3656.25,90,,percent of total billed charges,,,3363.75,82.8,,percent of total billed charges,,,3453.13,85,,percent of total billed charges,,,,,,,,,3575,88,,percent of total billed charges,,,,,,,,,3103.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1015.63,22,,percent of total billed charges,,,3696.88,91,,percent of total billed charges,,,3859.38,95,,percent of total billed charges,,,3371.88,83,,percent of total billed charges,,,3371.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3371.88,83,,percent of total billed charges,,,3859.38,95,,percent of total billed charges,,,3656.25,90,,percent of total billed charges,,,3656.25,90,,percent of total billed charges,,,3331.25,82,,percent of total billed charges,,,3656.25,90,,percent of total billed charges,,,3453.13,85,,percent of total billed charges,,1015.63,3859.38,
STRYKER BUR 3.0MM MATCH HEAD,30185146,CDM,,,270,RC,outpatient,,1312.42,1312.42,,1114.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,328.11,22,,percent of total billed charges,,,,,,,,,1181.18,90,,percent of total billed charges,,,1086.68,82.8,,percent of total billed charges,,,1115.56,85,,percent of total billed charges,,,,,,,,,1154.93,88,,percent of total billed charges,,,,,,,,,1002.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,328.11,22,,percent of total billed charges,,,1194.3,91,,percent of total billed charges,,,1246.8,95,,percent of total billed charges,,,1089.31,83,,percent of total billed charges,,,1089.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1089.31,83,,percent of total billed charges,,,1246.8,95,,percent of total billed charges,,,1181.18,90,,percent of total billed charges,,,1181.18,90,,percent of total billed charges,,,1076.18,82,,percent of total billed charges,,,1181.18,90,,percent of total billed charges,,,1115.56,85,,percent of total billed charges,,328.11,1246.8,
CHOICE SPINE PLATE 1-LEVEL 12MM,30185148,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
CHOICE SPINE SCREW 4.0 X 14MM,30185149,CDM,,,278,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
CHOICE SPINE DRILL 2.7MM X 12MM,30185150,CDM,,,278,RC,outpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,552.5,22,,percent of total billed charges,,,,,,,,,1989,90,,percent of total billed charges,,,1829.88,82.8,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,552.5,22,,percent of total billed charges,,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,552.5,2099.5,
S&N TIBIAL GNS II CMT SZ 6 LEFT,30185151,CDM,,,278,RC,outpatient,,14573,14573,,12372.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3643.25,22,,percent of total billed charges,,,,,,,,,13115.7,90,,percent of total billed charges,,,12066.44,82.8,,percent of total billed charges,,,12387.05,85,,percent of total billed charges,,,,,,,,,12824.24,88,,percent of total billed charges,,,,,,,,,11133.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3643.25,22,,percent of total billed charges,,,13261.43,91,,percent of total billed charges,,,13844.35,95,,percent of total billed charges,,,12095.59,83,,percent of total billed charges,,,12095.59,83,,percent of total billed charges,,,,,,,,,,,,,,,12095.59,83,,percent of total billed charges,,,13844.35,95,,percent of total billed charges,,,13115.7,90,,percent of total billed charges,,,13115.7,90,,percent of total billed charges,,,11949.86,82,,percent of total billed charges,,,13115.7,90,,percent of total billed charges,,,12387.05,85,,percent of total billed charges,,3643.25,13844.35,
S&N FEMUR LEGION PS OXIN SZ 7 LEFT,30185152,CDM,,,278,RC,outpatient,,30396.28,30396.28,,25806.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7599.07,22,,percent of total billed charges,,,,,,,,,27356.65,90,,percent of total billed charges,,,25168.12,82.8,,percent of total billed charges,,,25836.84,85,,percent of total billed charges,,,,,,,,,26748.73,88,,percent of total billed charges,,,,,,,,,23222.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7599.07,22,,percent of total billed charges,,,27660.61,91,,percent of total billed charges,,,28876.47,95,,percent of total billed charges,,,25228.91,83,,percent of total billed charges,,,25228.91,83,,percent of total billed charges,,,,,,,,,,,,,,,25228.91,83,,percent of total billed charges,,,28876.47,95,,percent of total billed charges,,,27356.65,90,,percent of total billed charges,,,27356.65,90,,percent of total billed charges,,,24924.95,82,,percent of total billed charges,,,27356.65,90,,percent of total billed charges,,,25836.84,85,,percent of total billed charges,,7599.07,28876.47,
DEPUY BASE TIBIAL MOD SZ 5,30185153,CDM,,,278,RC,outpatient,,25954.31,25954.31,,22035.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6488.58,22,,percent of total billed charges,,,,,,,,,23358.88,90,,percent of total billed charges,,,21490.17,82.8,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,,,,,,,,22839.79,88,,percent of total billed charges,,,,,,,,,19829.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6488.58,22,,percent of total billed charges,,,23618.42,91,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,,,,,,,,,,,,,21542.08,83,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,21282.53,82,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,6488.58,24656.59,
DEPUY ATTUNE TIBIA REVISION FB SZ 6,30185154,CDM,,,278,RC,outpatient,,25954.31,25954.31,,22035.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6488.58,22,,percent of total billed charges,,,,,,,,,23358.88,90,,percent of total billed charges,,,21490.17,82.8,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,,,,,,,,22839.79,88,,percent of total billed charges,,,,,,,,,19829.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6488.58,22,,percent of total billed charges,,,23618.42,91,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,,,,,,,,,,,,,21542.08,83,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,21282.53,82,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,6488.58,24656.59,
DEPUY STEM CEMENTED 14 X 50,30185155,CDM,,,278,RC,outpatient,,8336.19,8336.19,,7077.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2084.05,22,,percent of total billed charges,,,,,,,,,7502.57,90,,percent of total billed charges,,,6902.37,82.8,,percent of total billed charges,,,7085.76,85,,percent of total billed charges,,,,,,,,,7335.85,88,,percent of total billed charges,,,,,,,,,6368.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2084.05,22,,percent of total billed charges,,,7585.93,91,,percent of total billed charges,,,7919.38,95,,percent of total billed charges,,,6919.04,83,,percent of total billed charges,,,6919.04,83,,percent of total billed charges,,,,,,,,,,,,,,,6919.04,83,,percent of total billed charges,,,7919.38,95,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,6835.68,82,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,7085.76,85,,percent of total billed charges,,2084.05,7919.38,
SYNTHES BLADE HELICAL TFNA 105MM,30185156,CDM,,,278,RC,outpatient,,6630,6630,,5628.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1657.5,22,,percent of total billed charges,,,,,,,,,5967,90,,percent of total billed charges,,,5489.64,82.8,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,,,,,,,,5834.4,88,,percent of total billed charges,,,,,,,,,5065.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1657.5,22,,percent of total billed charges,,,6033.3,91,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,,,,,,,,,,,,,5502.9,83,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5436.6,82,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,1657.5,6298.5,
VTI INTERFUSE S 9MM X 20MM 0DEG,30185157,CDM,,,278,RC,outpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9750,22,,percent of total billed charges,,,,,,,,,35100,90,,percent of total billed charges,,,32292,82.8,,percent of total billed charges,,,33150,85,,percent of total billed charges,,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9750,22,,percent of total billed charges,,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,9750,37050,
MENTOR MEMORYGEL BREAST SMOOTH 480CC,30185158,CDM,,,278,RC,outpatient,,6532.5,6532.5,,5546.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1633.13,22,,percent of total billed charges,,,,,,,,,5879.25,90,,percent of total billed charges,,,5408.91,82.8,,percent of total billed charges,,,5552.63,85,,percent of total billed charges,,,,,,,,,5748.6,88,,percent of total billed charges,,,,,,,,,4990.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1633.13,22,,percent of total billed charges,,,5944.58,91,,percent of total billed charges,,,6205.88,95,,percent of total billed charges,,,5421.98,83,,percent of total billed charges,,,5421.98,83,,percent of total billed charges,,,,,,,,,,,,,,,5421.98,83,,percent of total billed charges,,,6205.88,95,,percent of total billed charges,,,5879.25,90,,percent of total billed charges,,,5879.25,90,,percent of total billed charges,,,5356.65,82,,percent of total billed charges,,,5879.25,90,,percent of total billed charges,,,5552.63,85,,percent of total billed charges,,1633.13,6205.88,
CAGE STALIF C-TI 12X5.5 TAPERED,30185159,CDM,,,278,RC,outpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4875,22,,percent of total billed charges,,,,,,,,,17550,90,,percent of total billed charges,,,16146,82.8,,percent of total billed charges,,,16575,85,,percent of total billed charges,,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4875,22,,percent of total billed charges,,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,4875,18525,
CTL ROD MIS 6.0 X 65MM,30185161,CDM,,,278,RC,outpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,553.48,22,,percent of total billed charges,,,,,,,,,1992.51,90,,percent of total billed charges,,,1833.11,82.8,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,553.48,22,,percent of total billed charges,,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,553.48,2103.21,
ZIMMER BEARING RT LG SZ 5,30185162,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
CTL SCREW PICASSO II MIS 7.5 X 45,30185163,CDM,,,278,RC,outpatient,,11137.1,11137.1,,9455.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2784.28,22,,percent of total billed charges,,,,,,,,,10023.39,90,,percent of total billed charges,,,9221.52,82.8,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,,,,,,,,9800.65,88,,percent of total billed charges,,,,,,,,,8508.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2784.28,22,,percent of total billed charges,,,10134.76,91,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,9243.79,83,,percent of total billed charges,,,,,,,,,,,,,,,9243.79,83,,percent of total billed charges,,,10580.25,95,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9132.42,82,,percent of total billed charges,,,10023.39,90,,percent of total billed charges,,,9466.54,85,,percent of total billed charges,,2784.28,10580.25,
SYNTHES TFNA 11 X 170 125DEG,30185164,CDM,,,278,RC,outpatient,,15099.83,15099.83,,12819.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3774.96,22,,percent of total billed charges,,,,,,,,,13589.85,90,,percent of total billed charges,,,12502.66,82.8,,percent of total billed charges,,,12834.86,85,,percent of total billed charges,,,,,,,,,13287.85,88,,percent of total billed charges,,,,,,,,,11536.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3774.96,22,,percent of total billed charges,,,13740.85,91,,percent of total billed charges,,,14344.84,95,,percent of total billed charges,,,12532.86,83,,percent of total billed charges,,,12532.86,83,,percent of total billed charges,,,,,,,,,,,,,,,12532.86,83,,percent of total billed charges,,,14344.84,95,,percent of total billed charges,,,13589.85,90,,percent of total billed charges,,,13589.85,90,,percent of total billed charges,,,12381.86,82,,percent of total billed charges,,,13589.85,90,,percent of total billed charges,,,12834.86,85,,percent of total billed charges,,3774.96,14344.84,
SYNTHES SCREW LOCKING 5.0MM X 40MM,30185165,CDM,,,278,RC,outpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,562.71,22,,percent of total billed charges,,,,,,,,,2025.74,90,,percent of total billed charges,,,1863.68,82.8,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,562.71,22,,percent of total billed charges,,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,562.71,2138.28,
SYNTHES GUIDEWIRE 3.2,30185166,CDM,,,270,RC,outpatient,,1121.58,1121.58,,952.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,280.4,22,,percent of total billed charges,,,,,,,,,1009.42,90,,percent of total billed charges,,,928.67,82.8,,percent of total billed charges,,,953.34,85,,percent of total billed charges,,,,,,,,,986.99,88,,percent of total billed charges,,,,,,,,,856.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,280.4,22,,percent of total billed charges,,,1020.64,91,,percent of total billed charges,,,1065.5,95,,percent of total billed charges,,,930.91,83,,percent of total billed charges,,,930.91,83,,percent of total billed charges,,,,,,,,,,,,,,,930.91,83,,percent of total billed charges,,,1065.5,95,,percent of total billed charges,,,1009.42,90,,percent of total billed charges,,,1009.42,90,,percent of total billed charges,,,919.7,82,,percent of total billed charges,,,1009.42,90,,percent of total billed charges,,,953.34,85,,percent of total billed charges,,280.4,1065.5,
ROD LORDOSED 80MM,30185167,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
VTI INTERFUSE S 10MM 0DEG,30185168,CDM,,,278,RC,outpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9750,22,,percent of total billed charges,,,,,,,,,35100,90,,percent of total billed charges,,,32292,82.8,,percent of total billed charges,,,33150,85,,percent of total billed charges,,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9750,22,,percent of total billed charges,,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,9750,37050,
DEPUY BASE TIBIAL MOD SZ 4,30185169,CDM,,,278,RC,outpatient,,25954.31,25954.31,,22035.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6488.58,22,,percent of total billed charges,,,,,,,,,23358.88,90,,percent of total billed charges,,,21490.17,82.8,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,,,,,,,,22839.79,88,,percent of total billed charges,,,,,,,,,19829.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6488.58,22,,percent of total billed charges,,,23618.42,91,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,,,,,,,,,,,,,21542.08,83,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,21282.53,82,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,6488.58,24656.59,
CTL SPACER CORTICAL CERVICAL 6MM,30185170,CDM,,,278,RC,outpatient,,12231.38,12231.38,,10384.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3057.85,22,,percent of total billed charges,,,,,,,,,11008.24,90,,percent of total billed charges,,,10127.58,82.8,,percent of total billed charges,,,10396.67,85,,percent of total billed charges,,,,,,,,,10763.61,88,,percent of total billed charges,,,,,,,,,9344.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3057.85,22,,percent of total billed charges,,,11130.56,91,,percent of total billed charges,,,11619.81,95,,percent of total billed charges,,,10152.05,83,,percent of total billed charges,,,10152.05,83,,percent of total billed charges,,,,,,,,,,,,,,,10152.05,83,,percent of total billed charges,,,11619.81,95,,percent of total billed charges,,,11008.24,90,,percent of total billed charges,,,11008.24,90,,percent of total billed charges,,,10029.73,82,,percent of total billed charges,,,11008.24,90,,percent of total billed charges,,,10396.67,85,,percent of total billed charges,,3057.85,11619.81,
CTL SCREW ST VARIABLE 4.0 X 12,30185171,CDM,,,278,RC,outpatient,,1521,1521,,1291.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,380.25,22,,percent of total billed charges,,,,,,,,,1368.9,90,,percent of total billed charges,,,1259.39,82.8,,percent of total billed charges,,,1292.85,85,,percent of total billed charges,,,,,,,,,1338.48,88,,percent of total billed charges,,,,,,,,,1162.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,380.25,22,,percent of total billed charges,,,1384.11,91,,percent of total billed charges,,,1444.95,95,,percent of total billed charges,,,1262.43,83,,percent of total billed charges,,,1262.43,83,,percent of total billed charges,,,,,,,,,,,,,,,1262.43,83,,percent of total billed charges,,,1444.95,95,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1247.22,82,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1292.85,85,,percent of total billed charges,,380.25,1444.95,
CTL DRILL BIT 10MM,30185172,CDM,,,278,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
V-LOC REVERSE CUTTING 1/2 CIRCLE 37MM GS,30185173,CDM,,,270,RC,outpatient,,211.28,211.28,,179.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.82,22,,percent of total billed charges,,,,,,,,,190.15,90,,percent of total billed charges,,,174.94,82.8,,percent of total billed charges,,,179.59,85,,percent of total billed charges,,,,,,,,,185.93,88,,percent of total billed charges,,,,,,,,,161.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.82,22,,percent of total billed charges,,,192.26,91,,percent of total billed charges,,,200.72,95,,percent of total billed charges,,,175.36,83,,percent of total billed charges,,,175.36,83,,percent of total billed charges,,,,,,,,,,,,,,,175.36,83,,percent of total billed charges,,,200.72,95,,percent of total billed charges,,,190.15,90,,percent of total billed charges,,,190.15,90,,percent of total billed charges,,,173.25,82,,percent of total billed charges,,,190.15,90,,percent of total billed charges,,,179.59,85,,percent of total billed charges,,52.82,200.72,
ZIMMER HEAD BIOLOX 28MM + 7MM,30185174,CDM,,,278,RC,outpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5785,22,,percent of total billed charges,,,,,,,,,20826,90,,percent of total billed charges,,,19159.92,82.8,,percent of total billed charges,,,19669,85,,percent of total billed charges,,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5785,22,,percent of total billed charges,,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,5785,21983,
ZIMMER SCREW BONE ST 6.5 X 20MM,30185175,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
WRIGHT NECK MODULAR SHORT 12/14,30185176,CDM,,,278,RC,outpatient,,28964,28964,,24590.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7241,22,,percent of total billed charges,,,,,,,,,26067.6,90,,percent of total billed charges,,,23982.19,82.8,,percent of total billed charges,,,24619.4,85,,percent of total billed charges,,,,,,,,,25488.32,88,,percent of total billed charges,,,,,,,,,22128.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7241,22,,percent of total billed charges,,,26357.24,91,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,,,,,,,,,,,,,24040.12,83,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,23750.48,82,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,24619.4,85,,percent of total billed charges,,7241,27515.8,
ARTHREX SCREW ANCHOR 4.5 X 14MM CORKSCRE,30185177,CDM,,,270,RC,outpatient,,1495,1495,,1269.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,373.75,22,,percent of total billed charges,,,,,,,,,1345.5,90,,percent of total billed charges,,,1237.86,82.8,,percent of total billed charges,,,1270.75,85,,percent of total billed charges,,,,,,,,,1315.6,88,,percent of total billed charges,,,,,,,,,1142.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,373.75,22,,percent of total billed charges,,,1360.45,91,,percent of total billed charges,,,1420.25,95,,percent of total billed charges,,,1240.85,83,,percent of total billed charges,,,1240.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1240.85,83,,percent of total billed charges,,,1420.25,95,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1225.9,82,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1270.75,85,,percent of total billed charges,,373.75,1420.25,
CHOICE SPINE PLATE 1-LEVEL 16MM,30185178,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
KYPHON FIRST FRACTURE KIT,30185179,CDM,,,278,RC,outpatient,,24888.5,24888.5,,21130.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6222.13,22,,percent of total billed charges,,,,,,,,,22399.65,90,,percent of total billed charges,,,20607.68,82.8,,percent of total billed charges,,,21155.23,85,,percent of total billed charges,,,,,,,,,21901.88,88,,percent of total billed charges,,,,,,,,,19014.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6222.13,22,,percent of total billed charges,,,22648.54,91,,percent of total billed charges,,,23644.08,95,,percent of total billed charges,,,20657.46,83,,percent of total billed charges,,,20657.46,83,,percent of total billed charges,,,,,,,,,,,,,,,20657.46,83,,percent of total billed charges,,,23644.08,95,,percent of total billed charges,,,22399.65,90,,percent of total billed charges,,,22399.65,90,,percent of total billed charges,,,20408.57,82,,percent of total billed charges,,,22399.65,90,,percent of total billed charges,,,21155.23,85,,percent of total billed charges,,6222.13,23644.08,
KYPHON HVR CEMENT,30185180,CDM,,,278,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
SYNTHES SCREW LOCKING 5.0MM X 30MM,30185181,CDM,,,278,RC,outpatient,,2121.6,2121.6,,1801.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,530.4,22,,percent of total billed charges,,,,,,,,,1909.44,90,,percent of total billed charges,,,1756.68,82.8,,percent of total billed charges,,,1803.36,85,,percent of total billed charges,,,,,,,,,1867.01,88,,percent of total billed charges,,,,,,,,,1620.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,530.4,22,,percent of total billed charges,,,1930.66,91,,percent of total billed charges,,,2015.52,95,,percent of total billed charges,,,1760.93,83,,percent of total billed charges,,,1760.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1760.93,83,,percent of total billed charges,,,2015.52,95,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1739.71,82,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1803.36,85,,percent of total billed charges,,530.4,2015.52,
NOVADAQ KIT,30185182,CDM,,,270,RC,outpatient,,991.25,991.25,,841.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,247.81,22,,percent of total billed charges,,,,,,,,,892.13,90,,percent of total billed charges,,,820.76,82.8,,percent of total billed charges,,,842.56,85,,percent of total billed charges,,,,,,,,,872.3,88,,percent of total billed charges,,,,,,,,,757.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,247.81,22,,percent of total billed charges,,,902.04,91,,percent of total billed charges,,,941.69,95,,percent of total billed charges,,,822.74,83,,percent of total billed charges,,,822.74,83,,percent of total billed charges,,,,,,,,,,,,,,,822.74,83,,percent of total billed charges,,,941.69,95,,percent of total billed charges,,,892.13,90,,percent of total billed charges,,,892.13,90,,percent of total billed charges,,,812.83,82,,percent of total billed charges,,,892.13,90,,percent of total billed charges,,,842.56,85,,percent of total billed charges,,247.81,941.69,
CHOICE SPINE PLATE 1-LEVEL 14MM,30185183,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
CHOICE SPINE PEEK STEALTH 6MM 6DEG 12X14,30185184,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
TUBE GASTROSTOMY MOSS 18FR,30185185,CDM,,,270,RC,outpatient,,1657.5,1657.5,,1407.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,414.38,22,,percent of total billed charges,,,,,,,,,1491.75,90,,percent of total billed charges,,,1372.41,82.8,,percent of total billed charges,,,1408.88,85,,percent of total billed charges,,,,,,,,,1458.6,88,,percent of total billed charges,,,,,,,,,1266.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,414.38,22,,percent of total billed charges,,,1508.33,91,,percent of total billed charges,,,1574.63,95,,percent of total billed charges,,,1375.73,83,,percent of total billed charges,,,1375.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1375.73,83,,percent of total billed charges,,,1574.63,95,,percent of total billed charges,,,1491.75,90,,percent of total billed charges,,,1491.75,90,,percent of total billed charges,,,1359.15,82,,percent of total billed charges,,,1491.75,90,,percent of total billed charges,,,1408.88,85,,percent of total billed charges,,414.38,1574.63,
ALLOSOURCE- ACHILLES TENDON PRE-SHAPED,30185186,CDM,,,278,RC,outpatient,,18232.5,18232.5,,15479.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4558.13,22,,percent of total billed charges,,,,,,,,,16409.25,90,,percent of total billed charges,,,15096.51,82.8,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,,,,,,,,16044.6,88,,percent of total billed charges,,,,,,,,,13929.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4558.13,22,,percent of total billed charges,,,16591.58,91,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15132.98,83,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,14950.65,82,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,4558.13,17320.88,
ARTHREX RF APOLLO MULTIPORT 90,30185187,CDM,,,270,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
DEPUY SLEEVE FEMORAL 20MM,30185188,CDM,,,278,RC,outpatient,,12552.61,12552.61,,10657.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3138.15,22,,percent of total billed charges,,,,,,,,,11297.35,90,,percent of total billed charges,,,10393.56,82.8,,percent of total billed charges,,,10669.72,85,,percent of total billed charges,,,,,,,,,11046.3,88,,percent of total billed charges,,,,,,,,,9590.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3138.15,22,,percent of total billed charges,,,11422.88,91,,percent of total billed charges,,,11924.98,95,,percent of total billed charges,,,10418.67,83,,percent of total billed charges,,,10418.67,83,,percent of total billed charges,,,,,,,,,,,,,,,10418.67,83,,percent of total billed charges,,,11924.98,95,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,10293.14,82,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,10669.72,85,,percent of total billed charges,,3138.15,11924.98,
DEPUY STEM FLUTED UNIV 115 X 22,30185189,CDM,,,278,RC,outpatient,,9024.34,9024.34,,7661.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2256.09,22,,percent of total billed charges,,,,,,,,,8121.91,90,,percent of total billed charges,,,7472.15,82.8,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,,,,,,,,7941.42,88,,percent of total billed charges,,,,,,,,,6894.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2256.09,22,,percent of total billed charges,,,8212.15,91,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,,,,,,,,,,,,,7490.2,83,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7399.96,82,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,2256.09,8573.12,
ALPHATEC SCREW MIS 6.5 X 50MM,30185190,CDM,,,278,RC,outpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2551.25,22,,percent of total billed charges,,,,,,,,,9184.5,90,,percent of total billed charges,,,8449.74,82.8,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2551.25,22,,percent of total billed charges,,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,2551.25,9694.75,
ALPHATEC ROD MIS COCR 45MM,30185191,CDM,,,278,RC,outpatient,,3243.5,3243.5,,2753.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,810.88,22,,percent of total billed charges,,,,,,,,,2919.15,90,,percent of total billed charges,,,2685.62,82.8,,percent of total billed charges,,,2756.98,85,,percent of total billed charges,,,,,,,,,2854.28,88,,percent of total billed charges,,,,,,,,,2478.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,810.88,22,,percent of total billed charges,,,2951.59,91,,percent of total billed charges,,,3081.33,95,,percent of total billed charges,,,2692.11,83,,percent of total billed charges,,,2692.11,83,,percent of total billed charges,,,,,,,,,,,,,,,2692.11,83,,percent of total billed charges,,,3081.33,95,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2659.67,82,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2756.98,85,,percent of total billed charges,,810.88,3081.33,
ALPHATEC SCREW SET,30185192,CDM,,,278,RC,outpatient,,1358.5,1358.5,,1153.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,339.63,22,,percent of total billed charges,,,,,,,,,1222.65,90,,percent of total billed charges,,,1124.84,82.8,,percent of total billed charges,,,1154.73,85,,percent of total billed charges,,,,,,,,,1195.48,88,,percent of total billed charges,,,,,,,,,1037.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,339.63,22,,percent of total billed charges,,,1236.24,91,,percent of total billed charges,,,1290.58,95,,percent of total billed charges,,,1127.56,83,,percent of total billed charges,,,1127.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1127.56,83,,percent of total billed charges,,,1290.58,95,,percent of total billed charges,,,1222.65,90,,percent of total billed charges,,,1222.65,90,,percent of total billed charges,,,1113.97,82,,percent of total billed charges,,,1222.65,90,,percent of total billed charges,,,1154.73,85,,percent of total billed charges,,339.63,1290.58,
ALPHATEC JAMSHIDI TARGET NEEDLE,30185193,CDM,,,270,RC,outpatient,,777,777,,659.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,194.25,22,,percent of total billed charges,,,,,,,,,699.3,90,,percent of total billed charges,,,643.36,82.8,,percent of total billed charges,,,660.45,85,,percent of total billed charges,,,,,,,,,683.76,88,,percent of total billed charges,,,,,,,,,593.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,194.25,22,,percent of total billed charges,,,707.07,91,,percent of total billed charges,,,738.15,95,,percent of total billed charges,,,644.91,83,,percent of total billed charges,,,644.91,83,,percent of total billed charges,,,,,,,,,,,,,,,644.91,83,,percent of total billed charges,,,738.15,95,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,637.14,82,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,660.45,85,,percent of total billed charges,,194.25,738.15,
ALPHATEC GUIDE WIRE,30185194,CDM,,,270,RC,outpatient,,455,455,,386.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,113.75,22,,percent of total billed charges,,,,,,,,,409.5,90,,percent of total billed charges,,,376.74,82.8,,percent of total billed charges,,,386.75,85,,percent of total billed charges,,,,,,,,,400.4,88,,percent of total billed charges,,,,,,,,,347.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,113.75,22,,percent of total billed charges,,,414.05,91,,percent of total billed charges,,,432.25,95,,percent of total billed charges,,,377.65,83,,percent of total billed charges,,,377.65,83,,percent of total billed charges,,,,,,,,,,,,,,,377.65,83,,percent of total billed charges,,,432.25,95,,percent of total billed charges,,,409.5,90,,percent of total billed charges,,,409.5,90,,percent of total billed charges,,,373.1,82,,percent of total billed charges,,,409.5,90,,percent of total billed charges,,,386.75,85,,percent of total billed charges,,113.75,432.25,
CHOICE SPINE PLATE 3-LEVEL 50MM,30185196,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
CHOICE SPINE CAGE 8MM 6DEG 12X14,30185197,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
SYNTHES GUIDEWIRE 2.0MM 150MM,30185198,CDM,,,278,RC,outpatient,,111.82,111.82,,94.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.96,22,,percent of total billed charges,,,,,,,,,100.64,90,,percent of total billed charges,,,92.59,82.8,,percent of total billed charges,,,95.05,85,,percent of total billed charges,,,,,,,,,98.4,88,,percent of total billed charges,,,,,,,,,85.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.96,22,,percent of total billed charges,,,101.76,91,,percent of total billed charges,,,106.23,95,,percent of total billed charges,,,92.81,83,,percent of total billed charges,,,92.81,83,,percent of total billed charges,,,,,,,,,,,,,,,92.81,83,,percent of total billed charges,,,106.23,95,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,91.69,82,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,95.05,85,,percent of total billed charges,,27.96,106.23,
S&N UC HIP ACCESS TRAY,30185199,CDM,,,270,RC,outpatient,,4550,4550,,3862.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1137.5,22,,percent of total billed charges,,,,,,,,,4095,90,,percent of total billed charges,,,3767.4,82.8,,percent of total billed charges,,,3867.5,85,,percent of total billed charges,,,,,,,,,4004,88,,percent of total billed charges,,,,,,,,,3476.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1137.5,22,,percent of total billed charges,,,4140.5,91,,percent of total billed charges,,,4322.5,95,,percent of total billed charges,,,3776.5,83,,percent of total billed charges,,,3776.5,83,,percent of total billed charges,,,,,,,,,,,,,,,3776.5,83,,percent of total billed charges,,,4322.5,95,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,3731,82,,percent of total billed charges,,,4095,90,,percent of total billed charges,,,3867.5,85,,percent of total billed charges,,1137.5,4322.5,
MYOSURE LITE,30185200,CDM,,,270,RC,outpatient,,3559.83,3559.83,,3022.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,889.96,22,,percent of total billed charges,,,,,,,,,3203.85,90,,percent of total billed charges,,,2947.54,82.8,,percent of total billed charges,,,3025.86,85,,percent of total billed charges,,,,,,,,,3132.65,88,,percent of total billed charges,,,,,,,,,2719.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,889.96,22,,percent of total billed charges,,,3239.45,91,,percent of total billed charges,,,3381.84,95,,percent of total billed charges,,,2954.66,83,,percent of total billed charges,,,2954.66,83,,percent of total billed charges,,,,,,,,,,,,,,,2954.66,83,,percent of total billed charges,,,3381.84,95,,percent of total billed charges,,,3203.85,90,,percent of total billed charges,,,3203.85,90,,percent of total billed charges,,,2919.06,82,,percent of total billed charges,,,3203.85,90,,percent of total billed charges,,,3025.86,85,,percent of total billed charges,,889.96,3381.84,
DEPUY STEM FLUTED UNIV 115 X 18,30185201,CDM,,,278,RC,outpatient,,9024.34,9024.34,,7661.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2256.09,22,,percent of total billed charges,,,,,,,,,8121.91,90,,percent of total billed charges,,,7472.15,82.8,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,,,,,,,,7941.42,88,,percent of total billed charges,,,,,,,,,6894.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2256.09,22,,percent of total billed charges,,,8212.15,91,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,7490.2,83,,percent of total billed charges,,,,,,,,,,,,,,,7490.2,83,,percent of total billed charges,,,8573.12,95,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7399.96,82,,percent of total billed charges,,,8121.91,90,,percent of total billed charges,,,7670.69,85,,percent of total billed charges,,2256.09,8573.12,
DEPUY DISTAL AUGMENT 16MM,30185202,CDM,,,278,RC,outpatient,,6245.14,6245.14,,5302.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1561.29,22,,percent of total billed charges,,,,,,,,,5620.63,90,,percent of total billed charges,,,5170.98,82.8,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,,,,,,,,5495.72,88,,percent of total billed charges,,,,,,,,,4771.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1561.29,22,,percent of total billed charges,,,5683.08,91,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,5183.47,83,,percent of total billed charges,,,,,,,,,,,,,,,5183.47,83,,percent of total billed charges,,,5932.88,95,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5121.01,82,,percent of total billed charges,,,5620.63,90,,percent of total billed charges,,,5308.37,85,,percent of total billed charges,,1561.29,5932.88,
VTI INTERFUSE S INTERVERTEBRAL BODY DEVI,30185203,CDM,,,278,RC,outpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9750,22,,percent of total billed charges,,,,,,,,,35100,90,,percent of total billed charges,,,32292,82.8,,percent of total billed charges,,,33150,85,,percent of total billed charges,,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9750,22,,percent of total billed charges,,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,9750,37050,
SCREW REDUCTION 6.5 X 40MM,30185204,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
REVEAL DISTAL ATTACHMENT CAP 13.4MM,30185205,CDM,,,270,RC,outpatient,,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38,22,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,125.86,82.8,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38,22,,percent of total billed charges,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,38,144.4,
ZIMMER SHELL OSSEOTI G7 52MM E,30185206,CDM,,,278,RC,outpatient,,20962.5,20962.5,,17797.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5240.63,22,,percent of total billed charges,,,,,,,,,18866.25,90,,percent of total billed charges,,,17356.95,82.8,,percent of total billed charges,,,17818.13,85,,percent of total billed charges,,,,,,,,,18447,88,,percent of total billed charges,,,,,,,,,16015.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5240.63,22,,percent of total billed charges,,,19075.88,91,,percent of total billed charges,,,19914.38,95,,percent of total billed charges,,,17398.88,83,,percent of total billed charges,,,17398.88,83,,percent of total billed charges,,,,,,,,,,,,,,,17398.88,83,,percent of total billed charges,,,19914.38,95,,percent of total billed charges,,,18866.25,90,,percent of total billed charges,,,18866.25,90,,percent of total billed charges,,,17189.25,82,,percent of total billed charges,,,18866.25,90,,percent of total billed charges,,,17818.13,85,,percent of total billed charges,,5240.63,19914.38,
ZIMMER LINER DUAL MOBILITY G7 42MM E,30185207,CDM,,,278,RC,outpatient,,9912.5,9912.5,,8415.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2478.13,22,,percent of total billed charges,,,,,,,,,8921.25,90,,percent of total billed charges,,,8207.55,82.8,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,,,,,,,,8723,88,,percent of total billed charges,,,,,,,,,7573.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2478.13,22,,percent of total billed charges,,,9020.38,91,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,,,,,,,,,,,,,8227.38,83,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8128.25,82,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,2478.13,9416.88,
ZIMMER BEARING HIP ACT ARTIC 28X42MM,30185208,CDM,,,278,RC,outpatient,,23400,23400,,19866.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5850,22,,percent of total billed charges,,,,,,,,,21060,90,,percent of total billed charges,,,19375.2,82.8,,percent of total billed charges,,,19890,85,,percent of total billed charges,,,,,,,,,20592,88,,percent of total billed charges,,,,,,,,,17877.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5850,22,,percent of total billed charges,,,21294,91,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,,,,,,,,,,,,,19422,83,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19188,82,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19890,85,,percent of total billed charges,,5850,22230,
MYOSURE XL,30185209,CDM,,,270,RC,outpatient,,10829,10829,,9193.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2707.25,22,,percent of total billed charges,,,,,,,,,9746.1,90,,percent of total billed charges,,,8966.41,82.8,,percent of total billed charges,,,9204.65,85,,percent of total billed charges,,,,,,,,,9529.52,88,,percent of total billed charges,,,,,,,,,8273.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2707.25,22,,percent of total billed charges,,,9854.39,91,,percent of total billed charges,,,10287.55,95,,percent of total billed charges,,,8988.07,83,,percent of total billed charges,,,8988.07,83,,percent of total billed charges,,,,,,,,,,,,,,,8988.07,83,,percent of total billed charges,,,10287.55,95,,percent of total billed charges,,,9746.1,90,,percent of total billed charges,,,9746.1,90,,percent of total billed charges,,,8879.78,82,,percent of total billed charges,,,9746.1,90,,percent of total billed charges,,,9204.65,85,,percent of total billed charges,,2707.25,10287.55,
STRYKER BUR ROUND DIAMOND 4.0MM,30185210,CDM,,,270,RC,outpatient,,940.16,940.16,,798.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.04,22,,percent of total billed charges,,,,,,,,,846.14,90,,percent of total billed charges,,,778.45,82.8,,percent of total billed charges,,,799.14,85,,percent of total billed charges,,,,,,,,,827.34,88,,percent of total billed charges,,,,,,,,,718.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.04,22,,percent of total billed charges,,,855.55,91,,percent of total billed charges,,,893.15,95,,percent of total billed charges,,,780.33,83,,percent of total billed charges,,,780.33,83,,percent of total billed charges,,,,,,,,,,,,,,,780.33,83,,percent of total billed charges,,,893.15,95,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,770.93,82,,percent of total billed charges,,,846.14,90,,percent of total billed charges,,,799.14,85,,percent of total billed charges,,235.04,893.15,
STEERING KIT ENHANCED W/STYLET CAP 70CM,30185212,CDM,,,270,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
CLIK ANCHOR HEX WRENCH 7.6CM,30185213,CDM,,,270,RC,outpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75,22,,percent of total billed charges,,,,,,,,,270,90,,percent of total billed charges,,,248.4,82.8,,percent of total billed charges,,,255,85,,percent of total billed charges,,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75,22,,percent of total billed charges,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,75,285,
BOSTON INTRODUCER,30185214,CDM,,,270,RC,outpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75,22,,percent of total billed charges,,,,,,,,,270,90,,percent of total billed charges,,,248.4,82.8,,percent of total billed charges,,,255,85,,percent of total billed charges,,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75,22,,percent of total billed charges,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,75,285,
DEPUY LINER ALTRX +4 10DEG 32X56,30185216,CDM,,,278,RC,outpatient,,11495.12,11495.12,,9759.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2873.78,22,,percent of total billed charges,,,,,,,,,10345.61,90,,percent of total billed charges,,,9517.96,82.8,,percent of total billed charges,,,9770.85,85,,percent of total billed charges,,,,,,,,,10115.71,88,,percent of total billed charges,,,,,,,,,8782.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2873.78,22,,percent of total billed charges,,,10460.56,91,,percent of total billed charges,,,10920.36,95,,percent of total billed charges,,,9540.95,83,,percent of total billed charges,,,9540.95,83,,percent of total billed charges,,,,,,,,,,,,,,,9540.95,83,,percent of total billed charges,,,10920.36,95,,percent of total billed charges,,,10345.61,90,,percent of total billed charges,,,10345.61,90,,percent of total billed charges,,,9426,82,,percent of total billed charges,,,10345.61,90,,percent of total billed charges,,,9770.85,85,,percent of total billed charges,,2873.78,10920.36,
SYNTHES SCREW CORTICAL 2.7 X 14,30185217,CDM,,,278,RC,outpatient,,386.75,386.75,,328.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.69,22,,percent of total billed charges,,,,,,,,,348.08,90,,percent of total billed charges,,,320.23,82.8,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,,,,,,,,340.34,88,,percent of total billed charges,,,,,,,,,295.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.69,22,,percent of total billed charges,,,351.94,91,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,321,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,,,,,,,,,,,,,,321,83,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,317.14,82,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,96.69,367.41,
SYNTHES GUIDEWIRE 1.0,30185218,CDM,,,270,RC,outpatient,,111.82,111.82,,94.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.96,22,,percent of total billed charges,,,,,,,,,100.64,90,,percent of total billed charges,,,92.59,82.8,,percent of total billed charges,,,95.05,85,,percent of total billed charges,,,,,,,,,98.4,88,,percent of total billed charges,,,,,,,,,85.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.96,22,,percent of total billed charges,,,101.76,91,,percent of total billed charges,,,106.23,95,,percent of total billed charges,,,92.81,83,,percent of total billed charges,,,92.81,83,,percent of total billed charges,,,,,,,,,,,,,,,92.81,83,,percent of total billed charges,,,106.23,95,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,91.69,82,,percent of total billed charges,,,100.64,90,,percent of total billed charges,,,95.05,85,,percent of total billed charges,,27.96,106.23,
SYNTHES K-WIRE .045MM,30185219,CDM,,,270,RC,outpatient,,91.84,91.84,,77.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.96,22,,percent of total billed charges,,,,,,,,,82.66,90,,percent of total billed charges,,,76.04,82.8,,percent of total billed charges,,,78.06,85,,percent of total billed charges,,,,,,,,,80.82,88,,percent of total billed charges,,,,,,,,,70.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.96,22,,percent of total billed charges,,,83.57,91,,percent of total billed charges,,,87.25,95,,percent of total billed charges,,,76.23,83,,percent of total billed charges,,,76.23,83,,percent of total billed charges,,,,,,,,,,,,,,,76.23,83,,percent of total billed charges,,,87.25,95,,percent of total billed charges,,,82.66,90,,percent of total billed charges,,,82.66,90,,percent of total billed charges,,,75.31,82,,percent of total billed charges,,,82.66,90,,percent of total billed charges,,,78.06,85,,percent of total billed charges,,22.96,87.25,
CARSON PERINEAL POST PAD,30185220,CDM,,,270,RC,outpatient,,483,483,,410.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,120.75,22,,percent of total billed charges,,,,,,,,,434.7,90,,percent of total billed charges,,,399.92,82.8,,percent of total billed charges,,,410.55,85,,percent of total billed charges,,,,,,,,,425.04,88,,percent of total billed charges,,,,,,,,,369.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,120.75,22,,percent of total billed charges,,,439.53,91,,percent of total billed charges,,,458.85,95,,percent of total billed charges,,,400.89,83,,percent of total billed charges,,,400.89,83,,percent of total billed charges,,,,,,,,,,,,,,,400.89,83,,percent of total billed charges,,,458.85,95,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,396.06,82,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,410.55,85,,percent of total billed charges,,120.75,458.85,
ZIMMER SHELL OSSEOTI G7 56MM F,30185221,CDM,,,278,RC,outpatient,,43940,43940,,37305.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10985,22,,percent of total billed charges,,,,,,,,,39546,90,,percent of total billed charges,,,36382.32,82.8,,percent of total billed charges,,,37349,85,,percent of total billed charges,,,,,,,,,38667.2,88,,percent of total billed charges,,,,,,,,,33570.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10985,22,,percent of total billed charges,,,39985.4,91,,percent of total billed charges,,,41743,95,,percent of total billed charges,,,36470.2,83,,percent of total billed charges,,,36470.2,83,,percent of total billed charges,,,,,,,,,,,,,,,36470.2,83,,percent of total billed charges,,,41743,95,,percent of total billed charges,,,39546,90,,percent of total billed charges,,,39546,90,,percent of total billed charges,,,36030.8,82,,percent of total billed charges,,,39546,90,,percent of total billed charges,,,37349,85,,percent of total billed charges,,10985,41743,
SYNTHES DRILL BIT 1.8MM,30185222,CDM,,,270,RC,outpatient,,1514.5,1514.5,,1285.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,378.63,22,,percent of total billed charges,,,,,,,,,1363.05,90,,percent of total billed charges,,,1254.01,82.8,,percent of total billed charges,,,1287.33,85,,percent of total billed charges,,,,,,,,,1332.76,88,,percent of total billed charges,,,,,,,,,1157.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,378.63,22,,percent of total billed charges,,,1378.2,91,,percent of total billed charges,,,1438.78,95,,percent of total billed charges,,,1257.04,83,,percent of total billed charges,,,1257.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1257.04,83,,percent of total billed charges,,,1438.78,95,,percent of total billed charges,,,1363.05,90,,percent of total billed charges,,,1363.05,90,,percent of total billed charges,,,1241.89,82,,percent of total billed charges,,,1363.05,90,,percent of total billed charges,,,1287.33,85,,percent of total billed charges,,378.63,1438.78,
DEPUY STEM CENTRALIZER 11MM,30185223,CDM,,,278,RC,outpatient,,904.8,904.8,,768.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,226.2,22,,percent of total billed charges,,,,,,,,,814.32,90,,percent of total billed charges,,,749.17,82.8,,percent of total billed charges,,,769.08,85,,percent of total billed charges,,,,,,,,,796.22,88,,percent of total billed charges,,,,,,,,,691.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,226.2,22,,percent of total billed charges,,,823.37,91,,percent of total billed charges,,,859.56,95,,percent of total billed charges,,,750.98,83,,percent of total billed charges,,,750.98,83,,percent of total billed charges,,,,,,,,,,,,,,,750.98,83,,percent of total billed charges,,,859.56,95,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,741.94,82,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,769.08,85,,percent of total billed charges,,226.2,859.56,
SYNTHES SCREW CANNULATED ST 4 X 40MM,30185227,CDM,,,278,RC,outpatient,,2063.23,2063.23,,1751.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,515.81,22,,percent of total billed charges,,,,,,,,,1856.91,90,,percent of total billed charges,,,1708.35,82.8,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,,,,,,,,1815.64,88,,percent of total billed charges,,,,,,,,,1576.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,515.81,22,,percent of total billed charges,,,1877.54,91,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1712.48,83,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1691.85,82,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,515.81,1960.07,
CTL SPACER CERVICAL CORTICAL 7MM,30185228,CDM,,,278,RC,outpatient,,10725,10725,,9105.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2681.25,22,,percent of total billed charges,,,,,,,,,9652.5,90,,percent of total billed charges,,,8880.3,82.8,,percent of total billed charges,,,9116.25,85,,percent of total billed charges,,,,,,,,,9438,88,,percent of total billed charges,,,,,,,,,8193.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2681.25,22,,percent of total billed charges,,,9759.75,91,,percent of total billed charges,,,10188.75,95,,percent of total billed charges,,,8901.75,83,,percent of total billed charges,,,8901.75,83,,percent of total billed charges,,,,,,,,,,,,,,,8901.75,83,,percent of total billed charges,,,10188.75,95,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,8794.5,82,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,9116.25,85,,percent of total billed charges,,2681.25,10188.75,
CTL SPACER CERVICAL CORTICAL 6MM,30185229,CDM,,,278,RC,outpatient,,5362.5,5362.5,,4552.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1340.63,22,,percent of total billed charges,,,,,,,,,4826.25,90,,percent of total billed charges,,,4440.15,82.8,,percent of total billed charges,,,4558.13,85,,percent of total billed charges,,,,,,,,,4719,88,,percent of total billed charges,,,,,,,,,4096.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1340.63,22,,percent of total billed charges,,,4879.88,91,,percent of total billed charges,,,5094.38,95,,percent of total billed charges,,,4450.88,83,,percent of total billed charges,,,4450.88,83,,percent of total billed charges,,,,,,,,,,,,,,,4450.88,83,,percent of total billed charges,,,5094.38,95,,percent of total billed charges,,,4826.25,90,,percent of total billed charges,,,4826.25,90,,percent of total billed charges,,,4397.25,82,,percent of total billed charges,,,4826.25,90,,percent of total billed charges,,,4558.13,85,,percent of total billed charges,,1340.63,5094.38,
DEPUY FEMUR ATTUNE 9 LEFT,30185230,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY INSERT ATTUNE SZ 9,30185231,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
CHOICE SPINE PLATE 2-LEVEL 32MM,30185233,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER FLOWPORT CANNULA,30185234,CDM,,,270,RC,outpatient,,2619.76,2619.76,,2224.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,654.94,22,,percent of total billed charges,,,,,,,,,2357.78,90,,percent of total billed charges,,,2169.16,82.8,,percent of total billed charges,,,2226.8,85,,percent of total billed charges,,,,,,,,,2305.39,88,,percent of total billed charges,,,,,,,,,2001.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,654.94,22,,percent of total billed charges,,,2383.98,91,,percent of total billed charges,,,2488.77,95,,percent of total billed charges,,,2174.4,83,,percent of total billed charges,,,2174.4,83,,percent of total billed charges,,,,,,,,,,,,,,,2174.4,83,,percent of total billed charges,,,2488.77,95,,percent of total billed charges,,,2357.78,90,,percent of total billed charges,,,2357.78,90,,percent of total billed charges,,,2148.2,82,,percent of total billed charges,,,2357.78,90,,percent of total billed charges,,,2226.8,85,,percent of total billed charges,,654.94,2488.77,
STRYKER PORTAL ENTRY KIT,30185235,CDM,,,270,RC,outpatient,,2182.05,2182.05,,1852.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,545.51,22,,percent of total billed charges,,,,,,,,,1963.85,90,,percent of total billed charges,,,1806.74,82.8,,percent of total billed charges,,,1854.74,85,,percent of total billed charges,,,,,,,,,1920.2,88,,percent of total billed charges,,,,,,,,,1667.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,545.51,22,,percent of total billed charges,,,1985.67,91,,percent of total billed charges,,,2072.95,95,,percent of total billed charges,,,1811.1,83,,percent of total billed charges,,,1811.1,83,,percent of total billed charges,,,,,,,,,,,,,,,1811.1,83,,percent of total billed charges,,,2072.95,95,,percent of total billed charges,,,1963.85,90,,percent of total billed charges,,,1963.85,90,,percent of total billed charges,,,1789.28,82,,percent of total billed charges,,,1963.85,90,,percent of total billed charges,,,1854.74,85,,percent of total billed charges,,545.51,2072.95,
STRYKER CINCHLOCK ANCHOR,30185236,CDM,,,270,RC,outpatient,,3287.77,3287.77,,2791.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,821.94,22,,percent of total billed charges,,,,,,,,,2958.99,90,,percent of total billed charges,,,2722.27,82.8,,percent of total billed charges,,,2794.6,85,,percent of total billed charges,,,,,,,,,2893.24,88,,percent of total billed charges,,,,,,,,,2511.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,821.94,22,,percent of total billed charges,,,2991.87,91,,percent of total billed charges,,,3123.38,95,,percent of total billed charges,,,2728.85,83,,percent of total billed charges,,,2728.85,83,,percent of total billed charges,,,,,,,,,,,,,,,2728.85,83,,percent of total billed charges,,,3123.38,95,,percent of total billed charges,,,2958.99,90,,percent of total billed charges,,,2958.99,90,,percent of total billed charges,,,2695.97,82,,percent of total billed charges,,,2958.99,90,,percent of total billed charges,,,2794.6,85,,percent of total billed charges,,821.94,3123.38,
STRYKER CINCHLOCK DRILL,30185237,CDM,,,270,RC,outpatient,,1248.33,1248.33,,1059.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,312.08,22,,percent of total billed charges,,,,,,,,,1123.5,90,,percent of total billed charges,,,1033.62,82.8,,percent of total billed charges,,,1061.08,85,,percent of total billed charges,,,,,,,,,1098.53,88,,percent of total billed charges,,,,,,,,,953.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,312.08,22,,percent of total billed charges,,,1135.98,91,,percent of total billed charges,,,1185.91,95,,percent of total billed charges,,,1036.11,83,,percent of total billed charges,,,1036.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1036.11,83,,percent of total billed charges,,,1185.91,95,,percent of total billed charges,,,1123.5,90,,percent of total billed charges,,,1123.5,90,,percent of total billed charges,,,1023.63,82,,percent of total billed charges,,,1123.5,90,,percent of total billed charges,,,1061.08,85,,percent of total billed charges,,312.08,1185.91,
STRYKER SUTURE X-BRAID,30185238,CDM,,,270,RC,outpatient,,868.14,868.14,,737.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,217.04,22,,percent of total billed charges,,,,,,,,,781.33,90,,percent of total billed charges,,,718.82,82.8,,percent of total billed charges,,,737.92,85,,percent of total billed charges,,,,,,,,,763.96,88,,percent of total billed charges,,,,,,,,,663.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,217.04,22,,percent of total billed charges,,,790.01,91,,percent of total billed charges,,,824.73,95,,percent of total billed charges,,,720.56,83,,percent of total billed charges,,,720.56,83,,percent of total billed charges,,,,,,,,,,,,,,,720.56,83,,percent of total billed charges,,,824.73,95,,percent of total billed charges,,,781.33,90,,percent of total billed charges,,,781.33,90,,percent of total billed charges,,,711.87,82,,percent of total billed charges,,,781.33,90,,percent of total billed charges,,,737.92,85,,percent of total billed charges,,217.04,824.73,
STRYKER SLINGSHOT 45 DEG,30185239,CDM,,,270,RC,outpatient,,2313.87,2313.87,,1964.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,578.47,22,,percent of total billed charges,,,,,,,,,2082.48,90,,percent of total billed charges,,,1915.88,82.8,,percent of total billed charges,,,1966.79,85,,percent of total billed charges,,,,,,,,,2036.21,88,,percent of total billed charges,,,,,,,,,1767.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,578.47,22,,percent of total billed charges,,,2105.62,91,,percent of total billed charges,,,2198.18,95,,percent of total billed charges,,,1920.51,83,,percent of total billed charges,,,1920.51,83,,percent of total billed charges,,,,,,,,,,,,,,,1920.51,83,,percent of total billed charges,,,2198.18,95,,percent of total billed charges,,,2082.48,90,,percent of total billed charges,,,2082.48,90,,percent of total billed charges,,,1897.37,82,,percent of total billed charges,,,2082.48,90,,percent of total billed charges,,,1966.79,85,,percent of total billed charges,,578.47,2198.18,
"STRYKER TRANSPORT CANNULA 4,5,6",30185240,CDM,,,270,RC,outpatient,,653.87,653.87,,555.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,163.47,22,,percent of total billed charges,,,,,,,,,588.48,90,,percent of total billed charges,,,541.4,82.8,,percent of total billed charges,,,555.79,85,,percent of total billed charges,,,,,,,,,575.41,88,,percent of total billed charges,,,,,,,,,499.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,163.47,22,,percent of total billed charges,,,595.02,91,,percent of total billed charges,,,621.18,95,,percent of total billed charges,,,542.71,83,,percent of total billed charges,,,542.71,83,,percent of total billed charges,,,,,,,,,,,,,,,542.71,83,,percent of total billed charges,,,621.18,95,,percent of total billed charges,,,588.48,90,,percent of total billed charges,,,588.48,90,,percent of total billed charges,,,536.17,82,,percent of total billed charges,,,588.48,90,,percent of total billed charges,,,555.79,85,,percent of total billed charges,,163.47,621.18,
DEPUY STEM CORAIL REVISION SZ14 STD,30185241,CDM,,,278,RC,outpatient,,59386.99,59386.99,,50419.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14846.75,22,,percent of total billed charges,,,,,,,,,53448.29,90,,percent of total billed charges,,,49172.43,82.8,,percent of total billed charges,,,50478.94,85,,percent of total billed charges,,,,,,,,,52260.55,88,,percent of total billed charges,,,,,,,,,45371.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14846.75,22,,percent of total billed charges,,,54042.16,91,,percent of total billed charges,,,56417.64,95,,percent of total billed charges,,,49291.2,83,,percent of total billed charges,,,49291.2,83,,percent of total billed charges,,,,,,,,,,,,,,,49291.2,83,,percent of total billed charges,,,56417.64,95,,percent of total billed charges,,,53448.29,90,,percent of total billed charges,,,53448.29,90,,percent of total billed charges,,,48697.33,82,,percent of total billed charges,,,53448.29,90,,percent of total billed charges,,,50478.94,85,,percent of total billed charges,,14846.75,56417.64,
DEPUY BLADE CHISEL 12X5,30185242,CDM,,,278,RC,outpatient,,3861,3861,,3277.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,965.25,22,,percent of total billed charges,,,,,,,,,3474.9,90,,percent of total billed charges,,,3196.91,82.8,,percent of total billed charges,,,3281.85,85,,percent of total billed charges,,,,,,,,,3397.68,88,,percent of total billed charges,,,,,,,,,2949.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,965.25,22,,percent of total billed charges,,,3513.51,91,,percent of total billed charges,,,3667.95,95,,percent of total billed charges,,,3204.63,83,,percent of total billed charges,,,3204.63,83,,percent of total billed charges,,,,,,,,,,,,,,,3204.63,83,,percent of total billed charges,,,3667.95,95,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3166.02,82,,percent of total billed charges,,,3474.9,90,,percent of total billed charges,,,3281.85,85,,percent of total billed charges,,965.25,3667.95,
DEPUY STEM CORAIL COLLARED SZ12,30185243,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
GRAFT TISSUE HUMAN DERMIS,30185244,CDM,,,278,RC,outpatient,,24014.58,24014.58,,20388.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6003.65,22,,percent of total billed charges,,,,,,,,,21613.12,90,,percent of total billed charges,,,19884.07,82.8,,percent of total billed charges,,,20412.39,85,,percent of total billed charges,,,,,,,,,21132.83,88,,percent of total billed charges,,,,,,,,,18347.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6003.65,22,,percent of total billed charges,,,21853.27,91,,percent of total billed charges,,,22813.85,95,,percent of total billed charges,,,19932.1,83,,percent of total billed charges,,,19932.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19932.1,83,,percent of total billed charges,,,22813.85,95,,percent of total billed charges,,,21613.12,90,,percent of total billed charges,,,21613.12,90,,percent of total billed charges,,,19691.96,82,,percent of total billed charges,,,21613.12,90,,percent of total billed charges,,,20412.39,85,,percent of total billed charges,,6003.65,22813.85,
ARTHREX PASSPORT CANNULA 12MM,30185245,CDM,,,278,RC,outpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,105,22,,percent of total billed charges,,,,,,,,,378,90,,percent of total billed charges,,,347.76,82.8,,percent of total billed charges,,,357,85,,percent of total billed charges,,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,105,22,,percent of total billed charges,,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,105,399,
ARTHREX LASSO QUICKPASS 90DEG STRAIGHT,30185246,CDM,,,278,RC,outpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260,22,,percent of total billed charges,,,,,,,,,936,90,,percent of total billed charges,,,861.12,82.8,,percent of total billed charges,,,884,85,,percent of total billed charges,,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260,22,,percent of total billed charges,,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,260,988,
STRYKER ACL DISPOSABLE PACK,30185247,CDM,,,278,RC,outpatient,,1673.75,1673.75,,1421.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,418.44,22,,percent of total billed charges,,,,,,,,,1506.38,90,,percent of total billed charges,,,1385.87,82.8,,percent of total billed charges,,,1422.69,85,,percent of total billed charges,,,,,,,,,1472.9,88,,percent of total billed charges,,,,,,,,,1278.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,418.44,22,,percent of total billed charges,,,1523.11,91,,percent of total billed charges,,,1590.06,95,,percent of total billed charges,,,1389.21,83,,percent of total billed charges,,,1389.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1389.21,83,,percent of total billed charges,,,1590.06,95,,percent of total billed charges,,,1506.38,90,,percent of total billed charges,,,1506.38,90,,percent of total billed charges,,,1372.48,82,,percent of total billed charges,,,1506.38,90,,percent of total billed charges,,,1422.69,85,,percent of total billed charges,,418.44,1590.06,
STRYKER SCREW INTERFERENCE ACL 7X20MM,30185248,CDM,,,278,RC,outpatient,,693,693,,588.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,173.25,22,,percent of total billed charges,,,,,,,,,623.7,90,,percent of total billed charges,,,573.8,82.8,,percent of total billed charges,,,589.05,85,,percent of total billed charges,,,,,,,,,609.84,88,,percent of total billed charges,,,,,,,,,529.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,173.25,22,,percent of total billed charges,,,630.63,91,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,,,,,,,,,,,,,575.19,83,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,568.26,82,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,589.05,85,,percent of total billed charges,,173.25,658.35,
STRYKER SCREW INTERFERENCE ACL 8X20MM,30185249,CDM,,,278,RC,outpatient,,693,693,,588.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,173.25,22,,percent of total billed charges,,,,,,,,,623.7,90,,percent of total billed charges,,,573.8,82.8,,percent of total billed charges,,,589.05,85,,percent of total billed charges,,,,,,,,,609.84,88,,percent of total billed charges,,,,,,,,,529.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,173.25,22,,percent of total billed charges,,,630.63,91,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,,,,,,,,,,,,,575.19,83,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,568.26,82,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,589.05,85,,percent of total billed charges,,173.25,658.35,
SYNTHES REAMER TUBE SPARE FOR HOLLOW REA,30185250,CDM,,,270,RC,outpatient,,2491.78,2491.78,,2115.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,622.95,22,,percent of total billed charges,,,,,,,,,2242.6,90,,percent of total billed charges,,,2063.19,82.8,,percent of total billed charges,,,2118.01,85,,percent of total billed charges,,,,,,,,,2192.77,88,,percent of total billed charges,,,,,,,,,1903.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,622.95,22,,percent of total billed charges,,,2267.52,91,,percent of total billed charges,,,2367.19,95,,percent of total billed charges,,,2068.18,83,,percent of total billed charges,,,2068.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2068.18,83,,percent of total billed charges,,,2367.19,95,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2043.26,82,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2118.01,85,,percent of total billed charges,,622.95,2367.19,
SYNTHES REAMER TUBE SPARE FOR HOLLOW REA,30185251,CDM,,,270,RC,outpatient,,2491.78,2491.78,,2115.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,622.95,22,,percent of total billed charges,,,,,,,,,2242.6,90,,percent of total billed charges,,,2063.19,82.8,,percent of total billed charges,,,2118.01,85,,percent of total billed charges,,,,,,,,,2192.77,88,,percent of total billed charges,,,,,,,,,1903.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,622.95,22,,percent of total billed charges,,,2267.52,91,,percent of total billed charges,,,2367.19,95,,percent of total billed charges,,,2068.18,83,,percent of total billed charges,,,2068.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2068.18,83,,percent of total billed charges,,,2367.19,95,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2043.26,82,,percent of total billed charges,,,2242.6,90,,percent of total billed charges,,,2118.01,85,,percent of total billed charges,,622.95,2367.19,
SYNTHES BLADE HECLICAL 110MM,30185252,CDM,,,278,RC,outpatient,,6630,6630,,5628.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1657.5,22,,percent of total billed charges,,,,,,,,,5967,90,,percent of total billed charges,,,5489.64,82.8,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,,,,,,,,5834.4,88,,percent of total billed charges,,,,,,,,,5065.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1657.5,22,,percent of total billed charges,,,6033.3,91,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,,,,,,,,,,,,,5502.9,83,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5436.6,82,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,1657.5,6298.5,
SYNTHES SCREW LAG 100MM,30185253,CDM,,,278,RC,outpatient,,6298.5,6298.5,,5347.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1574.63,22,,percent of total billed charges,,,,,,,,,5668.65,90,,percent of total billed charges,,,5215.16,82.8,,percent of total billed charges,,,5353.73,85,,percent of total billed charges,,,,,,,,,5542.68,88,,percent of total billed charges,,,,,,,,,4812.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1574.63,22,,percent of total billed charges,,,5731.64,91,,percent of total billed charges,,,5983.58,95,,percent of total billed charges,,,5227.76,83,,percent of total billed charges,,,5227.76,83,,percent of total billed charges,,,,,,,,,,,,,,,5227.76,83,,percent of total billed charges,,,5983.58,95,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5164.77,82,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5353.73,85,,percent of total billed charges,,1574.63,5983.58,
LATERA ABSORABLE NASAL IMPLANT SYSTEM,30185254,CDM,,,278,RC,outpatient,,6467.5,6467.5,,5490.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1616.88,22,,percent of total billed charges,,,,,,,,,5820.75,90,,percent of total billed charges,,,5355.09,82.8,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,,,,,,,,5691.4,88,,percent of total billed charges,,,,,,,,,4941.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1616.88,22,,percent of total billed charges,,,5885.43,91,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,,,,,,,,,,,,,5368.03,83,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5303.35,82,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,1616.88,6144.13,
DEPUY STEM CORAIL HI OFFSET SZ16,30185255,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
SCREW POLYAXIAL 7.5 X 40MM,30185256,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
NASOPORE EXTRAFIRM 8CM,30185258,CDM,,,270,RC,outpatient,,1398.11,1398.11,,1187,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,349.53,22,,percent of total billed charges,,,,,,,,,1258.3,90,,percent of total billed charges,,,1157.64,82.8,,percent of total billed charges,,,1188.39,85,,percent of total billed charges,,,,,,,,,1230.34,88,,percent of total billed charges,,,,,,,,,1068.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,349.53,22,,percent of total billed charges,,,1272.28,91,,percent of total billed charges,,,1328.2,95,,percent of total billed charges,,,1160.43,83,,percent of total billed charges,,,1160.43,83,,percent of total billed charges,,,,,,,,,,,,,,,1160.43,83,,percent of total billed charges,,,1328.2,95,,percent of total billed charges,,,1258.3,90,,percent of total billed charges,,,1258.3,90,,percent of total billed charges,,,1146.45,82,,percent of total billed charges,,,1258.3,90,,percent of total billed charges,,,1188.39,85,,percent of total billed charges,,349.53,1328.2,
SURGICAL PATTIES .5 X 3,30185259,CDM,,,270,RC,outpatient,,23.43,23.43,,19.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.86,22,,percent of total billed charges,,,,,,,,,21.09,90,,percent of total billed charges,,,19.4,82.8,,percent of total billed charges,,,19.92,85,,percent of total billed charges,,,,,,,,,20.62,88,,percent of total billed charges,,,,,,,,,17.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.86,22,,percent of total billed charges,,,21.32,91,,percent of total billed charges,,,22.26,95,,percent of total billed charges,,,19.45,83,,percent of total billed charges,,,19.45,83,,percent of total billed charges,,,,,,,,,,,,,,,19.45,83,,percent of total billed charges,,,22.26,95,,percent of total billed charges,,,21.09,90,,percent of total billed charges,,,21.09,90,,percent of total billed charges,,,19.21,82,,percent of total billed charges,,,21.09,90,,percent of total billed charges,,,19.92,85,,percent of total billed charges,,5.86,22.26,
NEXSTAT TOPICAL HEMOSTATIC POWDER 3G,30185260,CDM,,,270,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
PROPEL STENT REGULAR,30185261,CDM,,,270,RC,outpatient,,8684,8684,,7372.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2171,22,,percent of total billed charges,,,,,,,,,7815.6,90,,percent of total billed charges,,,7190.35,82.8,,percent of total billed charges,,,7381.4,85,,percent of total billed charges,,,,,,,,,7641.92,88,,percent of total billed charges,,,,,,,,,6634.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2171,22,,percent of total billed charges,,,7902.44,91,,percent of total billed charges,,,8249.8,95,,percent of total billed charges,,,7207.72,83,,percent of total billed charges,,,7207.72,83,,percent of total billed charges,,,,,,,,,,,,,,,7207.72,83,,percent of total billed charges,,,8249.8,95,,percent of total billed charges,,,7815.6,90,,percent of total billed charges,,,7815.6,90,,percent of total billed charges,,,7120.88,82,,percent of total billed charges,,,7815.6,90,,percent of total billed charges,,,7381.4,85,,percent of total billed charges,,2171,8249.8,
PROPEL STENT MINI,30185262,CDM,,,270,RC,outpatient,,7767.5,7767.5,,6594.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1941.88,22,,percent of total billed charges,,,,,,,,,6990.75,90,,percent of total billed charges,,,6431.49,82.8,,percent of total billed charges,,,6602.38,85,,percent of total billed charges,,,,,,,,,6835.4,88,,percent of total billed charges,,,,,,,,,5934.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1941.88,22,,percent of total billed charges,,,7068.43,91,,percent of total billed charges,,,7379.13,95,,percent of total billed charges,,,6447.03,83,,percent of total billed charges,,,6447.03,83,,percent of total billed charges,,,,,,,,,,,,,,,6447.03,83,,percent of total billed charges,,,7379.13,95,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6369.35,82,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6602.38,85,,percent of total billed charges,,1941.88,7379.13,
PROPEL STENT CONTOUR,30185263,CDM,,,270,RC,outpatient,,7767.5,7767.5,,6594.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1941.88,22,,percent of total billed charges,,,,,,,,,6990.75,90,,percent of total billed charges,,,6431.49,82.8,,percent of total billed charges,,,6602.38,85,,percent of total billed charges,,,,,,,,,6835.4,88,,percent of total billed charges,,,,,,,,,5934.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1941.88,22,,percent of total billed charges,,,7068.43,91,,percent of total billed charges,,,7379.13,95,,percent of total billed charges,,,6447.03,83,,percent of total billed charges,,,6447.03,83,,percent of total billed charges,,,,,,,,,,,,,,,6447.03,83,,percent of total billed charges,,,7379.13,95,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6369.35,82,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6602.38,85,,percent of total billed charges,,1941.88,7379.13,
CTL PLATE CERVICAL VAN GOGH 14MM,30185264,CDM,,,278,RC,outpatient,,8957,8957,,7604.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2239.25,22,,percent of total billed charges,,,,,,,,,8061.3,90,,percent of total billed charges,,,7416.4,82.8,,percent of total billed charges,,,7613.45,85,,percent of total billed charges,,,,,,,,,7882.16,88,,percent of total billed charges,,,,,,,,,6843.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2239.25,22,,percent of total billed charges,,,8150.87,91,,percent of total billed charges,,,8509.15,95,,percent of total billed charges,,,7434.31,83,,percent of total billed charges,,,7434.31,83,,percent of total billed charges,,,,,,,,,,,,,,,7434.31,83,,percent of total billed charges,,,8509.15,95,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,7344.74,82,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,7613.45,85,,percent of total billed charges,,2239.25,8509.15,
CTL DRILL BIT 12MM,30185265,CDM,,,278,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
WRIGHT PIN INBONE STEINMANN 2.4MM,30185266,CDM,,,278,RC,outpatient,,307.5,307.5,,261.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.88,22,,percent of total billed charges,,,,,,,,,276.75,90,,percent of total billed charges,,,254.61,82.8,,percent of total billed charges,,,261.38,85,,percent of total billed charges,,,,,,,,,270.6,88,,percent of total billed charges,,,,,,,,,234.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.88,22,,percent of total billed charges,,,279.83,91,,percent of total billed charges,,,292.13,95,,percent of total billed charges,,,255.23,83,,percent of total billed charges,,,255.23,83,,percent of total billed charges,,,,,,,,,,,,,,,255.23,83,,percent of total billed charges,,,292.13,95,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,252.15,82,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,261.38,85,,percent of total billed charges,,76.88,292.13,
WRIGHT BEAM SALVATION 7.0 X 75MM,30185267,CDM,,,278,RC,outpatient,,12987,12987,,11025.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3246.75,22,,percent of total billed charges,,,,,,,,,11688.3,90,,percent of total billed charges,,,10753.24,82.8,,percent of total billed charges,,,11038.95,85,,percent of total billed charges,,,,,,,,,11428.56,88,,percent of total billed charges,,,,,,,,,9922.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3246.75,22,,percent of total billed charges,,,11818.17,91,,percent of total billed charges,,,12337.65,95,,percent of total billed charges,,,10779.21,83,,percent of total billed charges,,,10779.21,83,,percent of total billed charges,,,,,,,,,,,,,,,10779.21,83,,percent of total billed charges,,,12337.65,95,,percent of total billed charges,,,11688.3,90,,percent of total billed charges,,,11688.3,90,,percent of total billed charges,,,10649.34,82,,percent of total billed charges,,,11688.3,90,,percent of total billed charges,,,11038.95,85,,percent of total billed charges,,3246.75,12337.65,
WRIGHT TROCAR WIRE SINGLE 1.6 X 150MM,30185268,CDM,,,278,RC,outpatient,,307.5,307.5,,261.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.88,22,,percent of total billed charges,,,,,,,,,276.75,90,,percent of total billed charges,,,254.61,82.8,,percent of total billed charges,,,261.38,85,,percent of total billed charges,,,,,,,,,270.6,88,,percent of total billed charges,,,,,,,,,234.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.88,22,,percent of total billed charges,,,279.83,91,,percent of total billed charges,,,292.13,95,,percent of total billed charges,,,255.23,83,,percent of total billed charges,,,255.23,83,,percent of total billed charges,,,,,,,,,,,,,,,255.23,83,,percent of total billed charges,,,292.13,95,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,252.15,82,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,261.38,85,,percent of total billed charges,,76.88,292.13,
WRIGHT SCREW LOCKING 3.5 X 18MM,30185269,CDM,,,278,RC,outpatient,,2385.5,2385.5,,2025.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,596.38,22,,percent of total billed charges,,,,,,,,,2146.95,90,,percent of total billed charges,,,1975.19,82.8,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,,,,,,,,2099.24,88,,percent of total billed charges,,,,,,,,,1822.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,596.38,22,,percent of total billed charges,,,2170.81,91,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1979.97,83,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,1956.11,82,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,596.38,2266.23,
WRIGHT SCREW LOCKING 3.5 X 24MM,30185270,CDM,,,278,RC,outpatient,,2385.5,2385.5,,2025.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,596.38,22,,percent of total billed charges,,,,,,,,,2146.95,90,,percent of total billed charges,,,1975.19,82.8,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,,,,,,,,2099.24,88,,percent of total billed charges,,,,,,,,,1822.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,596.38,22,,percent of total billed charges,,,2170.81,91,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,1979.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1979.97,83,,percent of total billed charges,,,2266.23,95,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,1956.11,82,,percent of total billed charges,,,2146.95,90,,percent of total billed charges,,,2027.68,85,,percent of total billed charges,,596.38,2266.23,
WRIGHT SCREW CORTEX LOW-PRO 3.5 X 28MM,30185271,CDM,,,278,RC,outpatient,,1215.5,1215.5,,1031.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,303.88,22,,percent of total billed charges,,,,,,,,,1093.95,90,,percent of total billed charges,,,1006.43,82.8,,percent of total billed charges,,,1033.18,85,,percent of total billed charges,,,,,,,,,1069.64,88,,percent of total billed charges,,,,,,,,,928.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,303.88,22,,percent of total billed charges,,,1106.11,91,,percent of total billed charges,,,1154.73,95,,percent of total billed charges,,,1008.87,83,,percent of total billed charges,,,1008.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1008.87,83,,percent of total billed charges,,,1154.73,95,,percent of total billed charges,,,1093.95,90,,percent of total billed charges,,,1093.95,90,,percent of total billed charges,,,996.71,82,,percent of total billed charges,,,1093.95,90,,percent of total billed charges,,,1033.18,85,,percent of total billed charges,,303.88,1154.73,
WRIGHT PIN TEMP FIX 1.1MM SM,30185272,CDM,,,278,RC,outpatient,,861,861,,730.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,215.25,22,,percent of total billed charges,,,,,,,,,774.9,90,,percent of total billed charges,,,712.91,82.8,,percent of total billed charges,,,731.85,85,,percent of total billed charges,,,,,,,,,757.68,88,,percent of total billed charges,,,,,,,,,657.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,215.25,22,,percent of total billed charges,,,783.51,91,,percent of total billed charges,,,817.95,95,,percent of total billed charges,,,714.63,83,,percent of total billed charges,,,714.63,83,,percent of total billed charges,,,,,,,,,,,,,,,714.63,83,,percent of total billed charges,,,817.95,95,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,706.02,82,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,731.85,85,,percent of total billed charges,,215.25,817.95,
WRIGHT K-WIRE 1.2 X 150MM,30185273,CDM,,,278,RC,outpatient,,307.5,307.5,,261.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.88,22,,percent of total billed charges,,,,,,,,,276.75,90,,percent of total billed charges,,,254.61,82.8,,percent of total billed charges,,,261.38,85,,percent of total billed charges,,,,,,,,,270.6,88,,percent of total billed charges,,,,,,,,,234.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.88,22,,percent of total billed charges,,,279.83,91,,percent of total billed charges,,,292.13,95,,percent of total billed charges,,,255.23,83,,percent of total billed charges,,,255.23,83,,percent of total billed charges,,,,,,,,,,,,,,,255.23,83,,percent of total billed charges,,,292.13,95,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,252.15,82,,percent of total billed charges,,,276.75,90,,percent of total billed charges,,,261.38,85,,percent of total billed charges,,76.88,292.13,
WRIGHT DRILL BIT CANNULATED 2.3MM,30185274,CDM,,,278,RC,outpatient,,1943.5,1943.5,,1650.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,485.88,22,,percent of total billed charges,,,,,,,,,1749.15,90,,percent of total billed charges,,,1609.22,82.8,,percent of total billed charges,,,1651.98,85,,percent of total billed charges,,,,,,,,,1710.28,88,,percent of total billed charges,,,,,,,,,1484.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,485.88,22,,percent of total billed charges,,,1768.59,91,,percent of total billed charges,,,1846.33,95,,percent of total billed charges,,,1613.11,83,,percent of total billed charges,,,1613.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1613.11,83,,percent of total billed charges,,,1846.33,95,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1593.67,82,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1651.98,85,,percent of total billed charges,,485.88,1846.33,
WRIGHT SCREW DARCO HEADED SHORT 4.0X42,30185275,CDM,,,278,RC,outpatient,,2801.5,2801.5,,2378.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,700.38,22,,percent of total billed charges,,,,,,,,,2521.35,90,,percent of total billed charges,,,2319.64,82.8,,percent of total billed charges,,,2381.28,85,,percent of total billed charges,,,,,,,,,2465.32,88,,percent of total billed charges,,,,,,,,,2140.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,700.38,22,,percent of total billed charges,,,2549.37,91,,percent of total billed charges,,,2661.43,95,,percent of total billed charges,,,2325.25,83,,percent of total billed charges,,,2325.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2325.25,83,,percent of total billed charges,,,2661.43,95,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2297.23,82,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2381.28,85,,percent of total billed charges,,700.38,2661.43,
WRIGHT SCREW DARCO HEADED SHORT 4.0X44,30185276,CDM,,,278,RC,outpatient,,2801.5,2801.5,,2378.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,700.38,22,,percent of total billed charges,,,,,,,,,2521.35,90,,percent of total billed charges,,,2319.64,82.8,,percent of total billed charges,,,2381.28,85,,percent of total billed charges,,,,,,,,,2465.32,88,,percent of total billed charges,,,,,,,,,2140.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,700.38,22,,percent of total billed charges,,,2549.37,91,,percent of total billed charges,,,2661.43,95,,percent of total billed charges,,,2325.25,83,,percent of total billed charges,,,2325.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2325.25,83,,percent of total billed charges,,,2661.43,95,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2297.23,82,,percent of total billed charges,,,2521.35,90,,percent of total billed charges,,,2381.28,85,,percent of total billed charges,,700.38,2661.43,
WRIGHT SCREW PEEK INTERFERENCE,30185277,CDM,,,278,RC,outpatient,,4641,4641,,3940.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1160.25,22,,percent of total billed charges,,,,,,,,,4176.9,90,,percent of total billed charges,,,3842.75,82.8,,percent of total billed charges,,,3944.85,85,,percent of total billed charges,,,,,,,,,4084.08,88,,percent of total billed charges,,,,,,,,,3545.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1160.25,22,,percent of total billed charges,,,4223.31,91,,percent of total billed charges,,,4408.95,95,,percent of total billed charges,,,3852.03,83,,percent of total billed charges,,,3852.03,83,,percent of total billed charges,,,,,,,,,,,,,,,3852.03,83,,percent of total billed charges,,,4408.95,95,,percent of total billed charges,,,4176.9,90,,percent of total billed charges,,,4176.9,90,,percent of total billed charges,,,3805.62,82,,percent of total billed charges,,,4176.9,90,,percent of total billed charges,,,3944.85,85,,percent of total billed charges,,1160.25,4408.95,
WRIGHT DRILL CANNULATED 4MM,30185278,CDM,,,278,RC,outpatient,,1943.5,1943.5,,1650.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,485.88,22,,percent of total billed charges,,,,,,,,,1749.15,90,,percent of total billed charges,,,1609.22,82.8,,percent of total billed charges,,,1651.98,85,,percent of total billed charges,,,,,,,,,1710.28,88,,percent of total billed charges,,,,,,,,,1484.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,485.88,22,,percent of total billed charges,,,1768.59,91,,percent of total billed charges,,,1846.33,95,,percent of total billed charges,,,1613.11,83,,percent of total billed charges,,,1613.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1613.11,83,,percent of total billed charges,,,1846.33,95,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1593.67,82,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1651.98,85,,percent of total billed charges,,485.88,1846.33,
HOLMIUM 1000-2 FORTEC FIBER,30185279,CDM,,,270,RC,outpatient,,2177.5,2177.5,,1848.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,544.38,22,,percent of total billed charges,,,,,,,,,1959.75,90,,percent of total billed charges,,,1802.97,82.8,,percent of total billed charges,,,1850.88,85,,percent of total billed charges,,,,,,,,,1916.2,88,,percent of total billed charges,,,,,,,,,1663.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,544.38,22,,percent of total billed charges,,,1981.53,91,,percent of total billed charges,,,2068.63,95,,percent of total billed charges,,,1807.33,83,,percent of total billed charges,,,1807.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1807.33,83,,percent of total billed charges,,,2068.63,95,,percent of total billed charges,,,1959.75,90,,percent of total billed charges,,,1959.75,90,,percent of total billed charges,,,1785.55,82,,percent of total billed charges,,,1959.75,90,,percent of total billed charges,,,1850.88,85,,percent of total billed charges,,544.38,2068.63,
COBLATOR WAND ULTRA REFLEX 35-PTR,30185280,CDM,,,270,RC,outpatient,,1827.8,1827.8,,1551.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,456.95,22,,percent of total billed charges,,,,,,,,,1645.02,90,,percent of total billed charges,,,1513.42,82.8,,percent of total billed charges,,,1553.63,85,,percent of total billed charges,,,,,,,,,1608.46,88,,percent of total billed charges,,,,,,,,,1396.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,456.95,22,,percent of total billed charges,,,1663.3,91,,percent of total billed charges,,,1736.41,95,,percent of total billed charges,,,1517.07,83,,percent of total billed charges,,,1517.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1517.07,83,,percent of total billed charges,,,1736.41,95,,percent of total billed charges,,,1645.02,90,,percent of total billed charges,,,1645.02,90,,percent of total billed charges,,,1498.8,82,,percent of total billed charges,,,1645.02,90,,percent of total billed charges,,,1553.63,85,,percent of total billed charges,,456.95,1736.41,
STRYKER BUR DIAMOND 5.5MM,30185281,CDM,,,270,RC,outpatient,,1874.6,1874.6,,1591.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,468.65,22,,percent of total billed charges,,,,,,,,,1687.14,90,,percent of total billed charges,,,1552.17,82.8,,percent of total billed charges,,,1593.41,85,,percent of total billed charges,,,,,,,,,1649.65,88,,percent of total billed charges,,,,,,,,,1432.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,468.65,22,,percent of total billed charges,,,1705.89,91,,percent of total billed charges,,,1780.87,95,,percent of total billed charges,,,1555.92,83,,percent of total billed charges,,,1555.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1555.92,83,,percent of total billed charges,,,1780.87,95,,percent of total billed charges,,,1687.14,90,,percent of total billed charges,,,1687.14,90,,percent of total billed charges,,,1537.17,82,,percent of total billed charges,,,1687.14,90,,percent of total billed charges,,,1593.41,85,,percent of total billed charges,,468.65,1780.87,
PHACO PACK,30185282,CDM,,,270,RC,outpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.88,22,,percent of total billed charges,,,,,,,,,222.75,90,,percent of total billed charges,,,204.93,82.8,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.88,22,,percent of total billed charges,,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,61.88,235.13,
BLADE STAB 15DEG,30185283,CDM,,,270,RC,outpatient,,63.75,63.75,,54.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.94,22,,percent of total billed charges,,,,,,,,,57.38,90,,percent of total billed charges,,,52.79,82.8,,percent of total billed charges,,,54.19,85,,percent of total billed charges,,,,,,,,,56.1,88,,percent of total billed charges,,,,,,,,,48.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.94,22,,percent of total billed charges,,,58.01,91,,percent of total billed charges,,,60.56,95,,percent of total billed charges,,,52.91,83,,percent of total billed charges,,,52.91,83,,percent of total billed charges,,,,,,,,,,,,,,,52.91,83,,percent of total billed charges,,,60.56,95,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,52.28,82,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,54.19,85,,percent of total billed charges,,15.94,60.56,
BLADE TRAPEZOID ANG 2.0 X 2.2MM,30185284,CDM,,,270,RC,outpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,44,167.2,
KNIFE CC & TRAP 2.75 X 3.2 ANG,30185285,CDM,,,270,RC,outpatient,,147.36,147.36,,125.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.84,22,,percent of total billed charges,,,,,,,,,132.62,90,,percent of total billed charges,,,122.01,82.8,,percent of total billed charges,,,125.26,85,,percent of total billed charges,,,,,,,,,129.68,88,,percent of total billed charges,,,,,,,,,112.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.84,22,,percent of total billed charges,,,134.1,91,,percent of total billed charges,,,139.99,95,,percent of total billed charges,,,122.31,83,,percent of total billed charges,,,122.31,83,,percent of total billed charges,,,,,,,,,,,,,,,122.31,83,,percent of total billed charges,,,139.99,95,,percent of total billed charges,,,132.62,90,,percent of total billed charges,,,132.62,90,,percent of total billed charges,,,120.84,82,,percent of total billed charges,,,132.62,90,,percent of total billed charges,,,125.26,85,,percent of total billed charges,,36.84,139.99,
NEEDLE 27G ANTERIOR CHAMBER,30185286,CDM,,,270,RC,outpatient,,17.55,17.55,,14.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.39,22,,percent of total billed charges,,,,,,,,,15.8,90,,percent of total billed charges,,,14.53,82.8,,percent of total billed charges,,,14.92,85,,percent of total billed charges,,,,,,,,,15.44,88,,percent of total billed charges,,,,,,,,,13.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.39,22,,percent of total billed charges,,,15.97,91,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14.57,83,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.39,82,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.92,85,,percent of total billed charges,,4.39,16.67,
ZIMMER SHELL OSSEOTI G7 52MM E 3 HOLE,30185287,CDM,,,278,RC,outpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4834.38,22,,percent of total billed charges,,,,,,,,,17403.75,90,,percent of total billed charges,,,16011.45,82.8,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4834.38,22,,percent of total billed charges,,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,4834.38,18370.63,
DEPUY ATTUNE FEMUR CR SZ 9 LEFT,30185289,CDM,,,278,RC,outpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7070.46,22,,percent of total billed charges,,,,,,,,,25453.65,90,,percent of total billed charges,,,23417.36,82.8,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7070.46,22,,percent of total billed charges,,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,7070.46,26867.74,
DEPUY ATTUNE INSERT CR 7MM,30185290,CDM,,,278,RC,outpatient,,12477.27,12477.27,,10593.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3119.32,22,,percent of total billed charges,,,,,,,,,11229.54,90,,percent of total billed charges,,,10331.18,82.8,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,,,,,,,,10980,88,,percent of total billed charges,,,,,,,,,9532.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3119.32,22,,percent of total billed charges,,,11354.32,91,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,10356.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10356.13,83,,percent of total billed charges,,,11853.41,95,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10231.36,82,,percent of total billed charges,,,11229.54,90,,percent of total billed charges,,,10605.68,85,,percent of total billed charges,,3119.32,11853.41,
DEPUY ATTUNE REVISION TIB TRAY FB SZ 8,30185291,CDM,,,278,RC,outpatient,,25954.31,25954.31,,22035.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6488.58,22,,percent of total billed charges,,,,,,,,,23358.88,90,,percent of total billed charges,,,21490.17,82.8,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,,,,,,,,22839.79,88,,percent of total billed charges,,,,,,,,,19829.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6488.58,22,,percent of total billed charges,,,23618.42,91,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,,,,,,,,,,,,,21542.08,83,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,21282.53,82,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,6488.58,24656.59,
VTI INTERFUSE S 8MM X 20MM 0DEG,30185294,CDM,,,278,RC,outpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9750,22,,percent of total billed charges,,,,,,,,,35100,90,,percent of total billed charges,,,32292,82.8,,percent of total billed charges,,,33150,85,,percent of total billed charges,,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9750,22,,percent of total billed charges,,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,9750,37050,
ZIMMER BEARING PMA RT LARGE SZ 6,30185296,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
DEPUY INSERT ATTUNE 7MM,30185297,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
S&N INSERT LEGION 9MM SZ 5-6,30185298,CDM,,,278,RC,outpatient,,19279.26,19279.26,,16368.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4819.82,22,,percent of total billed charges,,,,,,,,,17351.33,90,,percent of total billed charges,,,15963.23,82.8,,percent of total billed charges,,,16387.37,85,,percent of total billed charges,,,,,,,,,16965.75,88,,percent of total billed charges,,,,,,,,,14729.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4819.82,22,,percent of total billed charges,,,17544.13,91,,percent of total billed charges,,,18315.3,95,,percent of total billed charges,,,16001.79,83,,percent of total billed charges,,,16001.79,83,,percent of total billed charges,,,,,,,,,,,,,,,16001.79,83,,percent of total billed charges,,,18315.3,95,,percent of total billed charges,,,17351.33,90,,percent of total billed charges,,,17351.33,90,,percent of total billed charges,,,15808.99,82,,percent of total billed charges,,,17351.33,90,,percent of total billed charges,,,16387.37,85,,percent of total billed charges,,4819.82,18315.3,
S&N RESURFACING PATELLAR COMPONENT 32MM,30185299,CDM,,,278,RC,outpatient,,5460,5460,,4635.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1365,22,,percent of total billed charges,,,,,,,,,4914,90,,percent of total billed charges,,,4520.88,82.8,,percent of total billed charges,,,4641,85,,percent of total billed charges,,,,,,,,,4804.8,88,,percent of total billed charges,,,,,,,,,4171.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1365,22,,percent of total billed charges,,,4968.6,91,,percent of total billed charges,,,5187,95,,percent of total billed charges,,,4531.8,83,,percent of total billed charges,,,4531.8,83,,percent of total billed charges,,,,,,,,,,,,,,,4531.8,83,,percent of total billed charges,,,5187,95,,percent of total billed charges,,,4914,90,,percent of total billed charges,,,4914,90,,percent of total billed charges,,,4477.2,82,,percent of total billed charges,,,4914,90,,percent of total billed charges,,,4641,85,,percent of total billed charges,,1365,5187,
S&N STEM LONG 12MM X 100MM,30185300,CDM,,,278,RC,outpatient,,10735.08,10735.08,,9114.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2683.77,22,,percent of total billed charges,,,,,,,,,9661.57,90,,percent of total billed charges,,,8888.65,82.8,,percent of total billed charges,,,9124.82,85,,percent of total billed charges,,,,,,,,,9446.87,88,,percent of total billed charges,,,,,,,,,8201.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2683.77,22,,percent of total billed charges,,,9768.92,91,,percent of total billed charges,,,10198.33,95,,percent of total billed charges,,,8910.12,83,,percent of total billed charges,,,8910.12,83,,percent of total billed charges,,,,,,,,,,,,,,,8910.12,83,,percent of total billed charges,,,10198.33,95,,percent of total billed charges,,,9661.57,90,,percent of total billed charges,,,9661.57,90,,percent of total billed charges,,,8802.77,82,,percent of total billed charges,,,9661.57,90,,percent of total billed charges,,,9124.82,85,,percent of total billed charges,,2683.77,10198.33,
STRYKER BURR DIAMOND,30185301,CDM,,,270,RC,outpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,455,22,,percent of total billed charges,,,,,,,,,1638,90,,percent of total billed charges,,,1506.96,82.8,,percent of total billed charges,,,1547,85,,percent of total billed charges,,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,455,22,,percent of total billed charges,,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,455,1729,
STRYKER CINCHLOCK FLEX DRILL BIT,30185302,CDM,,,270,RC,outpatient,,1686.49,1686.49,,1431.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,421.62,22,,percent of total billed charges,,,,,,,,,1517.84,90,,percent of total billed charges,,,1396.41,82.8,,percent of total billed charges,,,1433.52,85,,percent of total billed charges,,,,,,,,,1484.11,88,,percent of total billed charges,,,,,,,,,1288.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,421.62,22,,percent of total billed charges,,,1534.71,91,,percent of total billed charges,,,1602.17,95,,percent of total billed charges,,,1399.79,83,,percent of total billed charges,,,1399.79,83,,percent of total billed charges,,,,,,,,,,,,,,,1399.79,83,,percent of total billed charges,,,1602.17,95,,percent of total billed charges,,,1517.84,90,,percent of total billed charges,,,1517.84,90,,percent of total billed charges,,,1382.92,82,,percent of total billed charges,,,1517.84,90,,percent of total billed charges,,,1433.52,85,,percent of total billed charges,,421.62,1602.17,
STRYKER CINCHLOCK ANCHOR,30185303,CDM,,,270,RC,outpatient,,4216.29,4216.29,,3579.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1054.07,22,,percent of total billed charges,,,,,,,,,3794.66,90,,percent of total billed charges,,,3491.09,82.8,,percent of total billed charges,,,3583.85,85,,percent of total billed charges,,,,,,,,,3710.34,88,,percent of total billed charges,,,,,,,,,3221.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1054.07,22,,percent of total billed charges,,,3836.82,91,,percent of total billed charges,,,4005.48,95,,percent of total billed charges,,,3499.52,83,,percent of total billed charges,,,3499.52,83,,percent of total billed charges,,,,,,,,,,,,,,,3499.52,83,,percent of total billed charges,,,4005.48,95,,percent of total billed charges,,,3794.66,90,,percent of total billed charges,,,3794.66,90,,percent of total billed charges,,,3457.36,82,,percent of total billed charges,,,3794.66,90,,percent of total billed charges,,,3583.85,85,,percent of total billed charges,,1054.07,4005.48,
STRYKER NANOPASS CRESCENT,30185304,CDM,,,270,RC,outpatient,,1916.07,1916.07,,1626.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.02,22,,percent of total billed charges,,,,,,,,,1724.46,90,,percent of total billed charges,,,1586.51,82.8,,percent of total billed charges,,,1628.66,85,,percent of total billed charges,,,,,,,,,1686.14,88,,percent of total billed charges,,,,,,,,,1463.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.02,22,,percent of total billed charges,,,1743.62,91,,percent of total billed charges,,,1820.27,95,,percent of total billed charges,,,1590.34,83,,percent of total billed charges,,,1590.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1590.34,83,,percent of total billed charges,,,1820.27,95,,percent of total billed charges,,,1724.46,90,,percent of total billed charges,,,1724.46,90,,percent of total billed charges,,,1571.18,82,,percent of total billed charges,,,1724.46,90,,percent of total billed charges,,,1628.66,85,,percent of total billed charges,,479.02,1820.27,
ARTHREX SCREW FT 4.0 X 40MM,30185305,CDM,,,278,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
ARTHREX GUIDEWIRE W/TROCAR TIP 1.35MM,30185306,CDM,,,278,RC,outpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40,22,,percent of total billed charges,,,,,,,,,144,90,,percent of total billed charges,,,132.48,82.8,,percent of total billed charges,,,136,85,,percent of total billed charges,,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40,22,,percent of total billed charges,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,40,152,
ARTHREX DRILL BIT 3.2MM FT,30185307,CDM,,,278,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
ARTHREX WASHER 6.0MM TI,30185308,CDM,,,278,RC,outpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.63,22,,percent of total billed charges,,,,,,,,,236.25,90,,percent of total billed charges,,,217.35,82.8,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.63,22,,percent of total billed charges,,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,65.63,249.38,
ARTHREX SCREW CORTEX LP 2.4 X 24MM,30185309,CDM,,,278,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
ARTHREX SCREW CORTEX LP 2.4 X 30MM,30185310,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
SYNTHES PUTTY FAST SET 10CC,30185311,CDM,,,278,RC,outpatient,,26886.6,26886.6,,22826.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6721.65,22,,percent of total billed charges,,,,,,,,,24197.94,90,,percent of total billed charges,,,22262.1,82.8,,percent of total billed charges,,,22853.61,85,,percent of total billed charges,,,,,,,,,23660.21,88,,percent of total billed charges,,,,,,,,,20541.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6721.65,22,,percent of total billed charges,,,24466.81,91,,percent of total billed charges,,,25542.27,95,,percent of total billed charges,,,22315.88,83,,percent of total billed charges,,,22315.88,83,,percent of total billed charges,,,,,,,,,,,,,,,22315.88,83,,percent of total billed charges,,,25542.27,95,,percent of total billed charges,,,24197.94,90,,percent of total billed charges,,,24197.94,90,,percent of total billed charges,,,22047.01,82,,percent of total billed charges,,,24197.94,90,,percent of total billed charges,,,22853.61,85,,percent of total billed charges,,6721.65,25542.27,
SYNTHES PLATE LCP CLAVICLE 7 HOLE LEFT S,30185312,CDM,,,278,RC,outpatient,,10368.93,10368.93,,8803.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2592.23,22,,percent of total billed charges,,,,,,,,,9332.04,90,,percent of total billed charges,,,8585.47,82.8,,percent of total billed charges,,,8813.59,85,,percent of total billed charges,,,,,,,,,9124.66,88,,percent of total billed charges,,,,,,,,,7921.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2592.23,22,,percent of total billed charges,,,9435.73,91,,percent of total billed charges,,,9850.48,95,,percent of total billed charges,,,8606.21,83,,percent of total billed charges,,,8606.21,83,,percent of total billed charges,,,,,,,,,,,,,,,8606.21,83,,percent of total billed charges,,,9850.48,95,,percent of total billed charges,,,9332.04,90,,percent of total billed charges,,,9332.04,90,,percent of total billed charges,,,8502.52,82,,percent of total billed charges,,,9332.04,90,,percent of total billed charges,,,8813.59,85,,percent of total billed charges,,2592.23,9850.48,
ZIMMER STEM REV. WAGNER 135 NK ANGLE 14X,30185313,CDM,,,278,RC,outpatient,,73125,73125,,62083.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18281.25,22,,percent of total billed charges,,,,,,,,,65812.5,90,,percent of total billed charges,,,60547.5,82.8,,percent of total billed charges,,,62156.25,85,,percent of total billed charges,,,,,,,,,64350,88,,percent of total billed charges,,,,,,,,,55867.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18281.25,22,,percent of total billed charges,,,66543.75,91,,percent of total billed charges,,,69468.75,95,,percent of total billed charges,,,60693.75,83,,percent of total billed charges,,,60693.75,83,,percent of total billed charges,,,,,,,,,,,,,,,60693.75,83,,percent of total billed charges,,,69468.75,95,,percent of total billed charges,,,65812.5,90,,percent of total billed charges,,,65812.5,90,,percent of total billed charges,,,59962.5,82,,percent of total billed charges,,,65812.5,90,,percent of total billed charges,,,62156.25,85,,percent of total billed charges,,18281.25,69468.75,
ZIMMER SCREW BONE ST 6.5 X 50MM,30185314,CDM,,,278,RC,outpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,390,22,,percent of total billed charges,,,,,,,,,1404,90,,percent of total billed charges,,,1291.68,82.8,,percent of total billed charges,,,1326,85,,percent of total billed charges,,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,390,22,,percent of total billed charges,,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,390,1482,
ZIMMER SUCTION CUP STERIL G7,30185315,CDM,,,270,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
ZIMMER LINER ARCOMXL G7 10 DEG 40MM F,30185316,CDM,,,278,RC,outpatient,,17875,17875,,15175.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4468.75,22,,percent of total billed charges,,,,,,,,,16087.5,90,,percent of total billed charges,,,14800.5,82.8,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,,,,,,,,15730,88,,percent of total billed charges,,,,,,,,,13656.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4468.75,22,,percent of total billed charges,,,16266.25,91,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14836.25,83,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,14657.5,82,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,4468.75,16981.25,
ARTHREX IMPLANT SYSTEM ACHILLES SPEEDBRI,30185318,CDM,,,278,RC,outpatient,,12967.5,12967.5,,11009.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3241.88,22,,percent of total billed charges,,,,,,,,,11670.75,90,,percent of total billed charges,,,10737.09,82.8,,percent of total billed charges,,,11022.38,85,,percent of total billed charges,,,,,,,,,11411.4,88,,percent of total billed charges,,,,,,,,,9907.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3241.88,22,,percent of total billed charges,,,11800.43,91,,percent of total billed charges,,,12319.13,95,,percent of total billed charges,,,10763.03,83,,percent of total billed charges,,,10763.03,83,,percent of total billed charges,,,,,,,,,,,,,,,10763.03,83,,percent of total billed charges,,,12319.13,95,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,10633.35,82,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,11022.38,85,,percent of total billed charges,,3241.88,12319.13,
DEPUY STEM PROSTALAC RT SZ 3 200MM,30185319,CDM,,,278,RC,outpatient,,32843.27,32843.27,,27883.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8210.82,22,,percent of total billed charges,,,,,,,,,29558.94,90,,percent of total billed charges,,,27194.23,82.8,,percent of total billed charges,,,27916.78,85,,percent of total billed charges,,,,,,,,,28902.08,88,,percent of total billed charges,,,,,,,,,25092.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8210.82,22,,percent of total billed charges,,,29887.38,91,,percent of total billed charges,,,31201.11,95,,percent of total billed charges,,,27259.91,83,,percent of total billed charges,,,27259.91,83,,percent of total billed charges,,,,,,,,,,,,,,,27259.91,83,,percent of total billed charges,,,31201.11,95,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,26931.48,82,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,27916.78,85,,percent of total billed charges,,8210.82,31201.11,
SYNTHES GUIDE WIRE 2.8MM THREADED,30185320,CDM,,,278,RC,outpatient,,821.1,821.1,,697.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,205.28,22,,percent of total billed charges,,,,,,,,,738.99,90,,percent of total billed charges,,,679.87,82.8,,percent of total billed charges,,,697.94,85,,percent of total billed charges,,,,,,,,,722.57,88,,percent of total billed charges,,,,,,,,,627.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,205.28,22,,percent of total billed charges,,,747.2,91,,percent of total billed charges,,,780.05,95,,percent of total billed charges,,,681.51,83,,percent of total billed charges,,,681.51,83,,percent of total billed charges,,,,,,,,,,,,,,,681.51,83,,percent of total billed charges,,,780.05,95,,percent of total billed charges,,,738.99,90,,percent of total billed charges,,,738.99,90,,percent of total billed charges,,,673.3,82,,percent of total billed charges,,,738.99,90,,percent of total billed charges,,,697.94,85,,percent of total billed charges,,205.28,780.05,
SYNTHES SCREW CORTEX 2.4 X 26MM,30185321,CDM,,,278,RC,outpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149.92,22,,percent of total billed charges,,,,,,,,,539.72,90,,percent of total billed charges,,,496.54,82.8,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149.92,22,,percent of total billed charges,,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,149.92,569.71,
SYNTHES SCREW CORTEX 2.4X20MM,30185322,CDM,,,278,RC,outpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149.92,22,,percent of total billed charges,,,,,,,,,539.72,90,,percent of total billed charges,,,496.54,82.8,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149.92,22,,percent of total billed charges,,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,149.92,569.71,
CHOICE SPINE PLATE 2-LEVEL 28MM,30185323,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
ZIMMER BEARING MD RT SZ 5,30185324,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
LOWER EXTREMITY ADDITION SOFT INTERFACE,30185325,CDM,,,270,RC,outpatient,,596.82,596.82,,506.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149.21,22,,percent of total billed charges,,,,,,,,,537.14,90,,percent of total billed charges,,,494.17,82.8,,percent of total billed charges,,,507.3,85,,percent of total billed charges,,,,,,,,,525.2,88,,percent of total billed charges,,,,,,,,,455.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149.21,22,,percent of total billed charges,,,543.11,91,,percent of total billed charges,,,566.98,95,,percent of total billed charges,,,495.36,83,,percent of total billed charges,,,495.36,83,,percent of total billed charges,,,,,,,,,,,,,,,495.36,83,,percent of total billed charges,,,566.98,95,,percent of total billed charges,,,537.14,90,,percent of total billed charges,,,537.14,90,,percent of total billed charges,,,489.39,82,,percent of total billed charges,,,537.14,90,,percent of total billed charges,,,507.3,85,,percent of total billed charges,,149.21,566.98,
LOWER EXTREMITY ADDITION FRACTURE ORTHOS,30185326,CDM,,,270,RC,outpatient,,827.26,827.26,,702.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.82,22,,percent of total billed charges,,,,,,,,,744.53,90,,percent of total billed charges,,,684.97,82.8,,percent of total billed charges,,,703.17,85,,percent of total billed charges,,,,,,,,,727.99,88,,percent of total billed charges,,,,,,,,,632.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.82,22,,percent of total billed charges,,,752.81,91,,percent of total billed charges,,,785.9,95,,percent of total billed charges,,,686.63,83,,percent of total billed charges,,,686.63,83,,percent of total billed charges,,,,,,,,,,,,,,,686.63,83,,percent of total billed charges,,,785.9,95,,percent of total billed charges,,,744.53,90,,percent of total billed charges,,,744.53,90,,percent of total billed charges,,,678.35,82,,percent of total billed charges,,,744.53,90,,percent of total billed charges,,,703.17,85,,percent of total billed charges,,206.82,785.9,
LOWER EXTREMITY ADJ MOTION KNEE JOINT,30185327,CDM,,,270,RC,outpatient,,961.16,961.16,,816.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,240.29,22,,percent of total billed charges,,,,,,,,,865.04,90,,percent of total billed charges,,,795.84,82.8,,percent of total billed charges,,,816.99,85,,percent of total billed charges,,,,,,,,,845.82,88,,percent of total billed charges,,,,,,,,,734.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,240.29,22,,percent of total billed charges,,,874.66,91,,percent of total billed charges,,,913.1,95,,percent of total billed charges,,,797.76,83,,percent of total billed charges,,,797.76,83,,percent of total billed charges,,,,,,,,,,,,,,,797.76,83,,percent of total billed charges,,,913.1,95,,percent of total billed charges,,,865.04,90,,percent of total billed charges,,,865.04,90,,percent of total billed charges,,,788.15,82,,percent of total billed charges,,,865.04,90,,percent of total billed charges,,,816.99,85,,percent of total billed charges,,240.29,913.1,
SCREW POLY AXIAL 7.5 X 55,30185328,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SCREW POLY AXIAL 7.5 X 50,30185329,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SCREW POLY AXIAL 8.5 X 55,30185330,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
XLINK MEDIUM,30185331,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
GUARDIAN TIBIAL HINGE BASE,30185332,CDM,,,278,RC,outpatient,,26650,26650,,22625.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6662.5,22,,percent of total billed charges,,,,,,,,,23985,90,,percent of total billed charges,,,22066.2,82.8,,percent of total billed charges,,,22652.5,85,,percent of total billed charges,,,,,,,,,23452,88,,percent of total billed charges,,,,,,,,,20360.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6662.5,22,,percent of total billed charges,,,24251.5,91,,percent of total billed charges,,,25317.5,95,,percent of total billed charges,,,22119.5,83,,percent of total billed charges,,,22119.5,83,,percent of total billed charges,,,,,,,,,,,,,,,22119.5,83,,percent of total billed charges,,,25317.5,95,,percent of total billed charges,,,23985,90,,percent of total billed charges,,,23985,90,,percent of total billed charges,,,21853,82,,percent of total billed charges,,,23985,90,,percent of total billed charges,,,22652.5,85,,percent of total billed charges,,6662.5,25317.5,
GUARDIAN TIBIAL POLY SPACER,30185333,CDM,,,278,RC,outpatient,,19597.5,19597.5,,16638.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4899.38,22,,percent of total billed charges,,,,,,,,,17637.75,90,,percent of total billed charges,,,16226.73,82.8,,percent of total billed charges,,,16657.88,85,,percent of total billed charges,,,,,,,,,17245.8,88,,percent of total billed charges,,,,,,,,,14972.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4899.38,22,,percent of total billed charges,,,17833.73,91,,percent of total billed charges,,,18617.63,95,,percent of total billed charges,,,16265.93,83,,percent of total billed charges,,,16265.93,83,,percent of total billed charges,,,,,,,,,,,,,,,16265.93,83,,percent of total billed charges,,,18617.63,95,,percent of total billed charges,,,17637.75,90,,percent of total billed charges,,,17637.75,90,,percent of total billed charges,,,16069.95,82,,percent of total billed charges,,,17637.75,90,,percent of total billed charges,,,16657.88,85,,percent of total billed charges,,4899.38,18617.63,
GUARDIAN DISTAL FEMUR PIN KIT,30185334,CDM,,,278,RC,outpatient,,20182.5,20182.5,,17134.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5045.63,22,,percent of total billed charges,,,,,,,,,18164.25,90,,percent of total billed charges,,,16711.11,82.8,,percent of total billed charges,,,17155.13,85,,percent of total billed charges,,,,,,,,,17760.6,88,,percent of total billed charges,,,,,,,,,15419.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5045.63,22,,percent of total billed charges,,,18366.08,91,,percent of total billed charges,,,19173.38,95,,percent of total billed charges,,,16751.48,83,,percent of total billed charges,,,16751.48,83,,percent of total billed charges,,,,,,,,,,,,,,,16751.48,83,,percent of total billed charges,,,19173.38,95,,percent of total billed charges,,,18164.25,90,,percent of total billed charges,,,18164.25,90,,percent of total billed charges,,,16549.65,82,,percent of total billed charges,,,18164.25,90,,percent of total billed charges,,,17155.13,85,,percent of total billed charges,,5045.63,19173.38,
DEPUY MODULER EPIPHYSIS SZ 2 RT,30185335,CDM,,,278,RC,outpatient,,33055.36,33055.36,,28064,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8263.84,22,,percent of total billed charges,,,,,,,,,29749.82,90,,percent of total billed charges,,,27369.84,82.8,,percent of total billed charges,,,28097.06,85,,percent of total billed charges,,,,,,,,,29088.72,88,,percent of total billed charges,,,,,,,,,25254.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8263.84,22,,percent of total billed charges,,,30080.38,91,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,27435.95,83,,percent of total billed charges,,,,,,,,,,,,,,,27435.95,83,,percent of total billed charges,,,31402.59,95,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,27105.4,82,,percent of total billed charges,,,29749.82,90,,percent of total billed charges,,,28097.06,85,,percent of total billed charges,,8263.84,31402.59,
ACUMED GUIDE WIRE ST .035 X 6,30185337,CDM,,,278,RC,outpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40,22,,percent of total billed charges,,,,,,,,,144,90,,percent of total billed charges,,,132.48,82.8,,percent of total billed charges,,,136,85,,percent of total billed charges,,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40,22,,percent of total billed charges,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,40,152,
ACUMED BIOTRAK MINI DRILL,30185338,CDM,,,270,RC,outpatient,,2372.5,2372.5,,2014.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,593.13,22,,percent of total billed charges,,,,,,,,,2135.25,90,,percent of total billed charges,,,1964.43,82.8,,percent of total billed charges,,,2016.63,85,,percent of total billed charges,,,,,,,,,2087.8,88,,percent of total billed charges,,,,,,,,,1812.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,593.13,22,,percent of total billed charges,,,2158.98,91,,percent of total billed charges,,,2253.88,95,,percent of total billed charges,,,1969.18,83,,percent of total billed charges,,,1969.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1969.18,83,,percent of total billed charges,,,2253.88,95,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,1945.45,82,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,2016.63,85,,percent of total billed charges,,593.13,2253.88,
ACUMED GUIDE WIRE ST .045 X 6,30185339,CDM,,,278,RC,outpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36,22,,percent of total billed charges,,,,,,,,,129.6,90,,percent of total billed charges,,,119.23,82.8,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36,22,,percent of total billed charges,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,36,136.8,
ACUMED BIOTRAK DRILL,30185340,CDM,,,270,RC,outpatient,,2372.5,2372.5,,2014.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,593.13,22,,percent of total billed charges,,,,,,,,,2135.25,90,,percent of total billed charges,,,1964.43,82.8,,percent of total billed charges,,,2016.63,85,,percent of total billed charges,,,,,,,,,2087.8,88,,percent of total billed charges,,,,,,,,,1812.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,593.13,22,,percent of total billed charges,,,2158.98,91,,percent of total billed charges,,,2253.88,95,,percent of total billed charges,,,1969.18,83,,percent of total billed charges,,,1969.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1969.18,83,,percent of total billed charges,,,2253.88,95,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,1945.45,82,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,2016.63,85,,percent of total billed charges,,593.13,2253.88,
ACUMED SCREW BIOTRAK 24MM,30185341,CDM,,,278,RC,outpatient,,4270.5,4270.5,,3625.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1067.63,22,,percent of total billed charges,,,,,,,,,3843.45,90,,percent of total billed charges,,,3535.97,82.8,,percent of total billed charges,,,3629.93,85,,percent of total billed charges,,,,,,,,,3758.04,88,,percent of total billed charges,,,,,,,,,3262.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1067.63,22,,percent of total billed charges,,,3886.16,91,,percent of total billed charges,,,4056.98,95,,percent of total billed charges,,,3544.52,83,,percent of total billed charges,,,3544.52,83,,percent of total billed charges,,,,,,,,,,,,,,,3544.52,83,,percent of total billed charges,,,4056.98,95,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3501.81,82,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3629.93,85,,percent of total billed charges,,1067.63,4056.98,
ACUMED SCREW BIOTRAK MINI 24MM,30185342,CDM,,,278,RC,outpatient,,4270.5,4270.5,,3625.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1067.63,22,,percent of total billed charges,,,,,,,,,3843.45,90,,percent of total billed charges,,,3535.97,82.8,,percent of total billed charges,,,3629.93,85,,percent of total billed charges,,,,,,,,,3758.04,88,,percent of total billed charges,,,,,,,,,3262.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1067.63,22,,percent of total billed charges,,,3886.16,91,,percent of total billed charges,,,4056.98,95,,percent of total billed charges,,,3544.52,83,,percent of total billed charges,,,3544.52,83,,percent of total billed charges,,,,,,,,,,,,,,,3544.52,83,,percent of total billed charges,,,4056.98,95,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3501.81,82,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3629.93,85,,percent of total billed charges,,1067.63,4056.98,
ACUMED SCREW BIOTRAK MINI 22MM,30185343,CDM,,,278,RC,outpatient,,4270.5,4270.5,,3625.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1067.63,22,,percent of total billed charges,,,,,,,,,3843.45,90,,percent of total billed charges,,,3535.97,82.8,,percent of total billed charges,,,3629.93,85,,percent of total billed charges,,,,,,,,,3758.04,88,,percent of total billed charges,,,,,,,,,3262.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1067.63,22,,percent of total billed charges,,,3886.16,91,,percent of total billed charges,,,4056.98,95,,percent of total billed charges,,,3544.52,83,,percent of total billed charges,,,3544.52,83,,percent of total billed charges,,,,,,,,,,,,,,,3544.52,83,,percent of total billed charges,,,4056.98,95,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3501.81,82,,percent of total billed charges,,,3843.45,90,,percent of total billed charges,,,3629.93,85,,percent of total billed charges,,1067.63,4056.98,
SYNTHES TFNA NAIL 11MM X 380MM 130DEG,30185344,CDM,,,278,RC,outpatient,,21784.17,21784.17,,18494.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5446.04,22,,percent of total billed charges,,,,,,,,,19605.75,90,,percent of total billed charges,,,18037.29,82.8,,percent of total billed charges,,,18516.54,85,,percent of total billed charges,,,,,,,,,19170.07,88,,percent of total billed charges,,,,,,,,,16643.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5446.04,22,,percent of total billed charges,,,19823.59,91,,percent of total billed charges,,,20694.96,95,,percent of total billed charges,,,18080.86,83,,percent of total billed charges,,,18080.86,83,,percent of total billed charges,,,,,,,,,,,,,,,18080.86,83,,percent of total billed charges,,,20694.96,95,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,17863.02,82,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,18516.54,85,,percent of total billed charges,,5446.04,20694.96,
SYNTHES SCREW 48MM,30185345,CDM,,,278,RC,outpatient,,2121.6,2121.6,,1801.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,530.4,22,,percent of total billed charges,,,,,,,,,1909.44,90,,percent of total billed charges,,,1756.68,82.8,,percent of total billed charges,,,1803.36,85,,percent of total billed charges,,,,,,,,,1867.01,88,,percent of total billed charges,,,,,,,,,1620.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,530.4,22,,percent of total billed charges,,,1930.66,91,,percent of total billed charges,,,2015.52,95,,percent of total billed charges,,,1760.93,83,,percent of total billed charges,,,1760.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1760.93,83,,percent of total billed charges,,,2015.52,95,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1739.71,82,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1803.36,85,,percent of total billed charges,,530.4,2015.52,
SYNTHES SCREW 58MM,30185346,CDM,,,278,RC,outpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,562.71,22,,percent of total billed charges,,,,,,,,,2025.74,90,,percent of total billed charges,,,1863.68,82.8,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,562.71,22,,percent of total billed charges,,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,562.71,2138.28,
SYNTHES DRILL BIT 2.5MM,30185347,CDM,,,270,RC,outpatient,,1242.61,1242.61,,1054.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,310.65,22,,percent of total billed charges,,,,,,,,,1118.35,90,,percent of total billed charges,,,1028.88,82.8,,percent of total billed charges,,,1056.22,85,,percent of total billed charges,,,,,,,,,1093.5,88,,percent of total billed charges,,,,,,,,,949.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,310.65,22,,percent of total billed charges,,,1130.78,91,,percent of total billed charges,,,1180.48,95,,percent of total billed charges,,,1031.37,83,,percent of total billed charges,,,1031.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1031.37,83,,percent of total billed charges,,,1180.48,95,,percent of total billed charges,,,1118.35,90,,percent of total billed charges,,,1118.35,90,,percent of total billed charges,,,1018.94,82,,percent of total billed charges,,,1118.35,90,,percent of total billed charges,,,1056.22,85,,percent of total billed charges,,310.65,1180.48,
SYNTHES PLATE MEDIAL DISTAL TIBIA 2.7 X,30185348,CDM,,,278,RC,outpatient,,17215.12,17215.12,,14615.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4303.78,22,,percent of total billed charges,,,,,,,,,15493.61,90,,percent of total billed charges,,,14254.12,82.8,,percent of total billed charges,,,14632.85,85,,percent of total billed charges,,,,,,,,,15149.31,88,,percent of total billed charges,,,,,,,,,13152.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4303.78,22,,percent of total billed charges,,,15665.76,91,,percent of total billed charges,,,16354.36,95,,percent of total billed charges,,,14288.55,83,,percent of total billed charges,,,14288.55,83,,percent of total billed charges,,,,,,,,,,,,,,,14288.55,83,,percent of total billed charges,,,16354.36,95,,percent of total billed charges,,,15493.61,90,,percent of total billed charges,,,15493.61,90,,percent of total billed charges,,,14116.4,82,,percent of total billed charges,,,15493.61,90,,percent of total billed charges,,,14632.85,85,,percent of total billed charges,,4303.78,16354.36,
SYNTHES SCREW CORTEX 3.5 X 30MM,30185349,CDM,,,278,RC,outpatient,,362.95,362.95,,308.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90.74,22,,percent of total billed charges,,,,,,,,,326.66,90,,percent of total billed charges,,,300.52,82.8,,percent of total billed charges,,,308.51,85,,percent of total billed charges,,,,,,,,,319.4,88,,percent of total billed charges,,,,,,,,,277.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90.74,22,,percent of total billed charges,,,330.28,91,,percent of total billed charges,,,344.8,95,,percent of total billed charges,,,301.25,83,,percent of total billed charges,,,301.25,83,,percent of total billed charges,,,,,,,,,,,,,,,301.25,83,,percent of total billed charges,,,344.8,95,,percent of total billed charges,,,326.66,90,,percent of total billed charges,,,326.66,90,,percent of total billed charges,,,297.62,82,,percent of total billed charges,,,326.66,90,,percent of total billed charges,,,308.51,85,,percent of total billed charges,,90.74,344.8,
SYNTHES SCREW LOCKING VA 3.5 X 24MM,30185350,CDM,,,278,RC,outpatient,,1456.85,1456.85,,1236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,364.21,22,,percent of total billed charges,,,,,,,,,1311.17,90,,percent of total billed charges,,,1206.27,82.8,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,,,,,,,,1282.03,88,,percent of total billed charges,,,,,,,,,1113.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,364.21,22,,percent of total billed charges,,,1325.73,91,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1209.19,83,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1194.62,82,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,364.21,1384.01,
SYNTHES SCREW LOCKING VA 3.5 X 26MM,30185351,CDM,,,278,RC,outpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375.13,22,,percent of total billed charges,,,,,,,,,1350.48,90,,percent of total billed charges,,,1242.44,82.8,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,375.13,22,,percent of total billed charges,,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,375.13,1425.5,
SYNTHES SCREW LOCKING VA 2.7 X 32MM,30185352,CDM,,,278,RC,outpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,353.16,22,,percent of total billed charges,,,,,,,,,1271.39,90,,percent of total billed charges,,,1169.67,82.8,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,353.16,22,,percent of total billed charges,,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,353.16,1342.02,
SYNTHES SCREW LOCKING VA 2.7 X 34MM,30185353,CDM,,,278,RC,outpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,353.16,22,,percent of total billed charges,,,,,,,,,1271.39,90,,percent of total billed charges,,,1169.67,82.8,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,353.16,22,,percent of total billed charges,,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,353.16,1342.02,
SYNTHES SCREW LOCKING VA 2.7 X 36MM,30185354,CDM,,,278,RC,outpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,353.16,22,,percent of total billed charges,,,,,,,,,1271.39,90,,percent of total billed charges,,,1169.67,82.8,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,353.16,22,,percent of total billed charges,,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,353.16,1342.02,
SYNTHES SCREW LOCKING VA 2.7 X 38MM,30185355,CDM,,,278,RC,outpatient,,1371.5,1371.5,,1164.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,342.88,22,,percent of total billed charges,,,,,,,,,1234.35,90,,percent of total billed charges,,,1135.6,82.8,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,,,,,,,,1206.92,88,,percent of total billed charges,,,,,,,,,1047.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,342.88,22,,percent of total billed charges,,,1248.07,91,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.35,83,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1124.63,82,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,342.88,1302.93,
SYNTHES SCREW LOCKING VA 2.7 X 42MM,30185356,CDM,,,278,RC,outpatient,,1371.5,1371.5,,1164.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,342.88,22,,percent of total billed charges,,,,,,,,,1234.35,90,,percent of total billed charges,,,1135.6,82.8,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,,,,,,,,1206.92,88,,percent of total billed charges,,,,,,,,,1047.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,342.88,22,,percent of total billed charges,,,1248.07,91,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.35,83,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1124.63,82,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,342.88,1302.93,
ZIMMER CUP 7MM OFFSET LINER LONGEVITY,30185357,CDM,,,278,RC,outpatient,,16315,16315,,13851.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4078.75,22,,percent of total billed charges,,,,,,,,,14683.5,90,,percent of total billed charges,,,13508.82,82.8,,percent of total billed charges,,,13867.75,85,,percent of total billed charges,,,,,,,,,14357.2,88,,percent of total billed charges,,,,,,,,,12464.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4078.75,22,,percent of total billed charges,,,14846.65,91,,percent of total billed charges,,,15499.25,95,,percent of total billed charges,,,13541.45,83,,percent of total billed charges,,,13541.45,83,,percent of total billed charges,,,,,,,,,,,,,,,13541.45,83,,percent of total billed charges,,,15499.25,95,,percent of total billed charges,,,14683.5,90,,percent of total billed charges,,,14683.5,90,,percent of total billed charges,,,13378.3,82,,percent of total billed charges,,,14683.5,90,,percent of total billed charges,,,13867.75,85,,percent of total billed charges,,4078.75,15499.25,
ZIMMER HEAD BIOLOX 32MM +0MM,30185358,CDM,,,278,RC,outpatient,,21645,21645,,18376.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5411.25,22,,percent of total billed charges,,,,,,,,,19480.5,90,,percent of total billed charges,,,17922.06,82.8,,percent of total billed charges,,,18398.25,85,,percent of total billed charges,,,,,,,,,19047.6,88,,percent of total billed charges,,,,,,,,,16536.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5411.25,22,,percent of total billed charges,,,19696.95,91,,percent of total billed charges,,,20562.75,95,,percent of total billed charges,,,17965.35,83,,percent of total billed charges,,,17965.35,83,,percent of total billed charges,,,,,,,,,,,,,,,17965.35,83,,percent of total billed charges,,,20562.75,95,,percent of total billed charges,,,19480.5,90,,percent of total billed charges,,,19480.5,90,,percent of total billed charges,,,17748.9,82,,percent of total billed charges,,,19480.5,90,,percent of total billed charges,,,18398.25,85,,percent of total billed charges,,5411.25,20562.75,
SYNTHES DRILL CANNULATED 2.0,30185359,CDM,,,278,RC,outpatient,,4148.56,4148.56,,3522.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1037.14,22,,percent of total billed charges,,,,,,,,,3733.7,90,,percent of total billed charges,,,3435.01,82.8,,percent of total billed charges,,,3526.28,85,,percent of total billed charges,,,,,,,,,3650.73,88,,percent of total billed charges,,,,,,,,,3169.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1037.14,22,,percent of total billed charges,,,3775.19,91,,percent of total billed charges,,,3941.13,95,,percent of total billed charges,,,3443.3,83,,percent of total billed charges,,,3443.3,83,,percent of total billed charges,,,,,,,,,,,,,,,3443.3,83,,percent of total billed charges,,,3941.13,95,,percent of total billed charges,,,3733.7,90,,percent of total billed charges,,,3733.7,90,,percent of total billed charges,,,3401.82,82,,percent of total billed charges,,,3733.7,90,,percent of total billed charges,,,3526.28,85,,percent of total billed charges,,1037.14,3941.13,
SYNTHES GUIDE PIN 1.1 THD,30185360,CDM,,,278,RC,outpatient,,341.48,341.48,,289.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.37,22,,percent of total billed charges,,,,,,,,,307.33,90,,percent of total billed charges,,,282.75,82.8,,percent of total billed charges,,,290.26,85,,percent of total billed charges,,,,,,,,,300.5,88,,percent of total billed charges,,,,,,,,,260.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.37,22,,percent of total billed charges,,,310.75,91,,percent of total billed charges,,,324.41,95,,percent of total billed charges,,,283.43,83,,percent of total billed charges,,,283.43,83,,percent of total billed charges,,,,,,,,,,,,,,,283.43,83,,percent of total billed charges,,,324.41,95,,percent of total billed charges,,,307.33,90,,percent of total billed charges,,,307.33,90,,percent of total billed charges,,,280.01,82,,percent of total billed charges,,,307.33,90,,percent of total billed charges,,,290.26,85,,percent of total billed charges,,85.37,324.41,
SYNTHES SCREW HEADLESS COMRESSION 3 X 26,30185361,CDM,,,278,RC,outpatient,,3364.73,3364.73,,2856.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,841.18,22,,percent of total billed charges,,,,,,,,,3028.26,90,,percent of total billed charges,,,2786,82.8,,percent of total billed charges,,,2860.02,85,,percent of total billed charges,,,,,,,,,2960.96,88,,percent of total billed charges,,,,,,,,,2570.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,841.18,22,,percent of total billed charges,,,3061.9,91,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2792.73,83,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2759.08,82,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2860.02,85,,percent of total billed charges,,841.18,3196.49,
SYNTHES SCREW HEADLESS COMRESSION 3 X 29,30185362,CDM,,,278,RC,outpatient,,3364.73,3364.73,,2856.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,841.18,22,,percent of total billed charges,,,,,,,,,3028.26,90,,percent of total billed charges,,,2786,82.8,,percent of total billed charges,,,2860.02,85,,percent of total billed charges,,,,,,,,,2960.96,88,,percent of total billed charges,,,,,,,,,2570.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,841.18,22,,percent of total billed charges,,,3061.9,91,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2792.73,83,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2759.08,82,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2860.02,85,,percent of total billed charges,,841.18,3196.49,
SYNTHES TAP CORTEX 4.5MM,30185363,CDM,,,270,RC,outpatient,,2110.55,2110.55,,1791.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,527.64,22,,percent of total billed charges,,,,,,,,,1899.5,90,,percent of total billed charges,,,1747.54,82.8,,percent of total billed charges,,,1793.97,85,,percent of total billed charges,,,,,,,,,1857.28,88,,percent of total billed charges,,,,,,,,,1612.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,527.64,22,,percent of total billed charges,,,1920.6,91,,percent of total billed charges,,,2005.02,95,,percent of total billed charges,,,1751.76,83,,percent of total billed charges,,,1751.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1751.76,83,,percent of total billed charges,,,2005.02,95,,percent of total billed charges,,,1899.5,90,,percent of total billed charges,,,1899.5,90,,percent of total billed charges,,,1730.65,82,,percent of total billed charges,,,1899.5,90,,percent of total billed charges,,,1793.97,85,,percent of total billed charges,,527.64,2005.02,
ZIMMER INSERT CD 17MM LPS FLEX,30185364,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
STRYKER TUBING 10FT W/WAND,30185365,CDM,,,270,RC,outpatient,,153.94,153.94,,130.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.49,22,,percent of total billed charges,,,,,,,,,138.55,90,,percent of total billed charges,,,127.46,82.8,,percent of total billed charges,,,130.85,85,,percent of total billed charges,,,,,,,,,135.47,88,,percent of total billed charges,,,,,,,,,117.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.49,22,,percent of total billed charges,,,140.09,91,,percent of total billed charges,,,146.24,95,,percent of total billed charges,,,127.77,83,,percent of total billed charges,,,127.77,83,,percent of total billed charges,,,,,,,,,,,,,,,127.77,83,,percent of total billed charges,,,146.24,95,,percent of total billed charges,,,138.55,90,,percent of total billed charges,,,138.55,90,,percent of total billed charges,,,126.23,82,,percent of total billed charges,,,138.55,90,,percent of total billed charges,,,130.85,85,,percent of total billed charges,,38.49,146.24,
SUTURE ETHIBOND EXCEL CX12D,30185366,CDM,,,270,RC,outpatient,,81.31,81.31,,69.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.33,22,,percent of total billed charges,,,,,,,,,73.18,90,,percent of total billed charges,,,67.32,82.8,,percent of total billed charges,,,69.11,85,,percent of total billed charges,,,,,,,,,71.55,88,,percent of total billed charges,,,,,,,,,62.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.33,22,,percent of total billed charges,,,73.99,91,,percent of total billed charges,,,77.24,95,,percent of total billed charges,,,67.49,83,,percent of total billed charges,,,67.49,83,,percent of total billed charges,,,,,,,,,,,,,,,67.49,83,,percent of total billed charges,,,77.24,95,,percent of total billed charges,,,73.18,90,,percent of total billed charges,,,73.18,90,,percent of total billed charges,,,66.67,82,,percent of total billed charges,,,73.18,90,,percent of total billed charges,,,69.11,85,,percent of total billed charges,,20.33,77.24,
DEPUY ATTUNE TIBIA SZ 6 FB,30185367,CDM,,,278,RC,outpatient,,19747.26,19747.26,,16765.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4936.82,22,,percent of total billed charges,,,,,,,,,17772.53,90,,percent of total billed charges,,,16350.73,82.8,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,,,,,,,,17377.59,88,,percent of total billed charges,,,,,,,,,15086.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4936.82,22,,percent of total billed charges,,,17970.01,91,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,,,,,,,,,,,,,16390.23,83,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16192.75,82,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,4936.82,18759.9,
SYNTHES INST. KIT 2.4MM VA LCP,30185368,CDM,,,278,RC,outpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,690.63,22,,percent of total billed charges,,,,,,,,,2486.25,90,,percent of total billed charges,,,2287.35,82.8,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,690.63,22,,percent of total billed charges,,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,690.63,2624.38,
SYNTHES PLATE DIST. RAD. VA LT 5H SHAFT,30185369,CDM,,,278,RC,outpatient,,10508.55,10508.55,,8921.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2627.14,22,,percent of total billed charges,,,,,,,,,9457.7,90,,percent of total billed charges,,,8701.08,82.8,,percent of total billed charges,,,8932.27,85,,percent of total billed charges,,,,,,,,,9247.52,88,,percent of total billed charges,,,,,,,,,8028.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2627.14,22,,percent of total billed charges,,,9562.78,91,,percent of total billed charges,,,9983.12,95,,percent of total billed charges,,,8722.1,83,,percent of total billed charges,,,8722.1,83,,percent of total billed charges,,,,,,,,,,,,,,,8722.1,83,,percent of total billed charges,,,9983.12,95,,percent of total billed charges,,,9457.7,90,,percent of total billed charges,,,9457.7,90,,percent of total billed charges,,,8617.01,82,,percent of total billed charges,,,9457.7,90,,percent of total billed charges,,,8932.27,85,,percent of total billed charges,,2627.14,9983.12,
STRYKER SAMURAI BLADE FULL RADIUS,30185370,CDM,,,270,RC,outpatient,,1624.87,1624.87,,1379.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.22,22,,percent of total billed charges,,,,,,,,,1462.38,90,,percent of total billed charges,,,1345.39,82.8,,percent of total billed charges,,,1381.14,85,,percent of total billed charges,,,,,,,,,1429.89,88,,percent of total billed charges,,,,,,,,,1241.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.22,22,,percent of total billed charges,,,1478.63,91,,percent of total billed charges,,,1543.63,95,,percent of total billed charges,,,1348.64,83,,percent of total billed charges,,,1348.64,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.64,83,,percent of total billed charges,,,1543.63,95,,percent of total billed charges,,,1462.38,90,,percent of total billed charges,,,1462.38,90,,percent of total billed charges,,,1332.39,82,,percent of total billed charges,,,1462.38,90,,percent of total billed charges,,,1381.14,85,,percent of total billed charges,,406.22,1543.63,
STRYKER SERFAX 50-S XL,30185371,CDM,,,270,RC,outpatient,,1483.3,1483.3,,1259.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,370.83,22,,percent of total billed charges,,,,,,,,,1334.97,90,,percent of total billed charges,,,1228.17,82.8,,percent of total billed charges,,,1260.81,85,,percent of total billed charges,,,,,,,,,1305.3,88,,percent of total billed charges,,,,,,,,,1133.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,370.83,22,,percent of total billed charges,,,1349.8,91,,percent of total billed charges,,,1409.14,95,,percent of total billed charges,,,1231.14,83,,percent of total billed charges,,,1231.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1231.14,83,,percent of total billed charges,,,1409.14,95,,percent of total billed charges,,,1334.97,90,,percent of total billed charges,,,1334.97,90,,percent of total billed charges,,,1216.31,82,,percent of total billed charges,,,1334.97,90,,percent of total billed charges,,,1260.81,85,,percent of total billed charges,,370.83,1409.14,
STRYKER SLINGSHOT 70DEG,30185372,CDM,,,270,RC,outpatient,,2361,2361,,2004.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,590.25,22,,percent of total billed charges,,,,,,,,,2124.9,90,,percent of total billed charges,,,1954.91,82.8,,percent of total billed charges,,,2006.85,85,,percent of total billed charges,,,,,,,,,2077.68,88,,percent of total billed charges,,,,,,,,,1803.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,590.25,22,,percent of total billed charges,,,2148.51,91,,percent of total billed charges,,,2242.95,95,,percent of total billed charges,,,1959.63,83,,percent of total billed charges,,,1959.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1959.63,83,,percent of total billed charges,,,2242.95,95,,percent of total billed charges,,,2124.9,90,,percent of total billed charges,,,2124.9,90,,percent of total billed charges,,,1936.02,82,,percent of total billed charges,,,2124.9,90,,percent of total billed charges,,,2006.85,85,,percent of total billed charges,,590.25,2242.95,
STRYKER HIP INSTRUMENTATION SYSTEM USAGE,30185373,CDM,,,270,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
STRYKER PIVOT TRAY USAGE,30185374,CDM,,,270,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
SYNTHES DSTL RAD RT STERILE KIT 2.4MM VA,30185375,CDM,,,278,RC,outpatient,,18232.5,18232.5,,15479.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4558.13,22,,percent of total billed charges,,,,,,,,,16409.25,90,,percent of total billed charges,,,15096.51,82.8,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,,,,,,,,16044.6,88,,percent of total billed charges,,,,,,,,,13929.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4558.13,22,,percent of total billed charges,,,16591.58,91,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15132.98,83,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,14950.65,82,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,4558.13,17320.88,
SYNTHES SCREW CORTEX 22 X 2.4MM STERILE,30185376,CDM,,,278,RC,outpatient,,827.05,827.05,,702.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.76,22,,percent of total billed charges,,,,,,,,,744.35,90,,percent of total billed charges,,,684.8,82.8,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,,,,,,,,727.8,88,,percent of total billed charges,,,,,,,,,631.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.76,22,,percent of total billed charges,,,752.62,91,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,,,,,,,,,,,,,686.45,83,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,678.18,82,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,206.76,785.7,
SYNTHES SCREW LOCKING VA 12 X 2.4MM STER,30185377,CDM,,,278,RC,outpatient,,1635.4,1635.4,,1388.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,408.85,22,,percent of total billed charges,,,,,,,,,1471.86,90,,percent of total billed charges,,,1354.11,82.8,,percent of total billed charges,,,1390.09,85,,percent of total billed charges,,,,,,,,,1439.15,88,,percent of total billed charges,,,,,,,,,1249.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,408.85,22,,percent of total billed charges,,,1488.21,91,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1357.38,83,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1341.03,82,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1390.09,85,,percent of total billed charges,,408.85,1553.63,
SYNTHES SCREW LOCKING VA 16 X 2.4MM STER,30185378,CDM,,,278,RC,outpatient,,1635.4,1635.4,,1388.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,408.85,22,,percent of total billed charges,,,,,,,,,1471.86,90,,percent of total billed charges,,,1354.11,82.8,,percent of total billed charges,,,1390.09,85,,percent of total billed charges,,,,,,,,,1439.15,88,,percent of total billed charges,,,,,,,,,1249.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,408.85,22,,percent of total billed charges,,,1488.21,91,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1357.38,83,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1341.03,82,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1390.09,85,,percent of total billed charges,,408.85,1553.63,
SYNTHES PLATES DIST. RAD 2.4MM VA,30185379,CDM,,,278,RC,outpatient,,1105,1105,,938.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,276.25,22,,percent of total billed charges,,,,,,,,,994.5,90,,percent of total billed charges,,,914.94,82.8,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,,,,,,,,972.4,88,,percent of total billed charges,,,,,,,,,844.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,276.25,22,,percent of total billed charges,,,1005.55,91,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,,,,,,,,,,,,,917.15,83,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,906.1,82,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,276.25,1049.75,
OLYMPUS PK CUTTING FORCEP,30185380,CDM,,,270,RC,outpatient,,5119.4,5119.4,,4346.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1279.85,22,,percent of total billed charges,,,,,,,,,4607.46,90,,percent of total billed charges,,,4238.86,82.8,,percent of total billed charges,,,4351.49,85,,percent of total billed charges,,,,,,,,,4505.07,88,,percent of total billed charges,,,,,,,,,3911.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1279.85,22,,percent of total billed charges,,,4658.65,91,,percent of total billed charges,,,4863.43,95,,percent of total billed charges,,,4249.1,83,,percent of total billed charges,,,4249.1,83,,percent of total billed charges,,,,,,,,,,,,,,,4249.1,83,,percent of total billed charges,,,4863.43,95,,percent of total billed charges,,,4607.46,90,,percent of total billed charges,,,4607.46,90,,percent of total billed charges,,,4197.91,82,,percent of total billed charges,,,4607.46,90,,percent of total billed charges,,,4351.49,85,,percent of total billed charges,,1279.85,4863.43,
AMNIOFILL 500MG,30185383,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
DEPUY HEAD FEMORAL CERAMIC 28MM + 8.5,30185384,CDM,,,278,RC,outpatient,,18783.9,18783.9,,15947.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4695.98,22,,percent of total billed charges,,,,,,,,,16905.51,90,,percent of total billed charges,,,15553.07,82.8,,percent of total billed charges,,,15966.32,85,,percent of total billed charges,,,,,,,,,16529.83,88,,percent of total billed charges,,,,,,,,,14350.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4695.98,22,,percent of total billed charges,,,17093.35,91,,percent of total billed charges,,,17844.71,95,,percent of total billed charges,,,15590.64,83,,percent of total billed charges,,,15590.64,83,,percent of total billed charges,,,,,,,,,,,,,,,15590.64,83,,percent of total billed charges,,,17844.71,95,,percent of total billed charges,,,16905.51,90,,percent of total billed charges,,,16905.51,90,,percent of total billed charges,,,15402.8,82,,percent of total billed charges,,,16905.51,90,,percent of total billed charges,,,15966.32,85,,percent of total billed charges,,4695.98,17844.71,
DEPUY STEM FEMORAL CEMENTLESS SZ 18,30185385,CDM,,,278,RC,outpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16689.95,22,,percent of total billed charges,,,,,,,,,60083.83,90,,percent of total billed charges,,,55277.12,82.8,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16689.95,22,,percent of total billed charges,,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,16689.95,63421.82,
ZIMMER INSERT BEARING SZ 5 SM RT,30185386,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
ZIMMER TRAY TIBIAL SZ AA OXFORD,30185387,CDM,,,278,RC,outpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3388.13,22,,percent of total billed charges,,,,,,,,,12197.25,90,,percent of total billed charges,,,11221.47,82.8,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3388.13,22,,percent of total billed charges,,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,3388.13,12874.88,
ZIMMER SHELL OSSEOTI G7 60MM G,30185388,CDM,,,278,RC,outpatient,,42640,42640,,36201.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10660,22,,percent of total billed charges,,,,,,,,,38376,90,,percent of total billed charges,,,35305.92,82.8,,percent of total billed charges,,,36244,85,,percent of total billed charges,,,,,,,,,37523.2,88,,percent of total billed charges,,,,,,,,,32576.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10660,22,,percent of total billed charges,,,38802.4,91,,percent of total billed charges,,,40508,95,,percent of total billed charges,,,35391.2,83,,percent of total billed charges,,,35391.2,83,,percent of total billed charges,,,,,,,,,,,,,,,35391.2,83,,percent of total billed charges,,,40508,95,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,34964.8,82,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,36244,85,,percent of total billed charges,,10660,40508,
CTL ROD MIS 80MM,30185389,CDM,,,278,RC,outpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,553.48,22,,percent of total billed charges,,,,,,,,,1992.51,90,,percent of total billed charges,,,1833.11,82.8,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,553.48,22,,percent of total billed charges,,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,553.48,2103.21,
CTL ROD MIS 75MM,30185390,CDM,,,278,RC,outpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,553.48,22,,percent of total billed charges,,,,,,,,,1992.51,90,,percent of total billed charges,,,1833.11,82.8,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,553.48,22,,percent of total billed charges,,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,553.48,2103.21,
CATH FOLEY SILICONE L-F 22F 10ML,30185391,CDM,,,270,RC,outpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.75,22,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,45.54,82.8,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.75,22,,percent of total billed charges,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,13.75,52.25,
ALPHATEC SCREW MIS 6.5 X 45MM,30185392,CDM,,,278,RC,outpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2551.25,22,,percent of total billed charges,,,,,,,,,9184.5,90,,percent of total billed charges,,,8449.74,82.8,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2551.25,22,,percent of total billed charges,,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,2551.25,9694.75,
ALPHATEC SCREW MIS 6.5 X 40MM,30185393,CDM,,,278,RC,outpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2551.25,22,,percent of total billed charges,,,,,,,,,9184.5,90,,percent of total billed charges,,,8449.74,82.8,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2551.25,22,,percent of total billed charges,,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,2551.25,9694.75,
ZIMMER TIBIAL TRAY SZ A RM/LL OXF,30185394,CDM,,,278,RC,outpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3388.13,22,,percent of total billed charges,,,,,,,,,12197.25,90,,percent of total billed charges,,,11221.47,82.8,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3388.13,22,,percent of total billed charges,,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,3388.13,12874.88,
S&N FEMORAL COMPONENT SZ 6N LEFT,30185395,CDM,,,278,RC,outpatient,,32523.99,32523.99,,27612.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8131,22,,percent of total billed charges,,,,,,,,,29271.59,90,,percent of total billed charges,,,26929.86,82.8,,percent of total billed charges,,,27645.39,85,,percent of total billed charges,,,,,,,,,28621.11,88,,percent of total billed charges,,,,,,,,,24848.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8131,22,,percent of total billed charges,,,29596.83,91,,percent of total billed charges,,,30897.79,95,,percent of total billed charges,,,26994.91,83,,percent of total billed charges,,,26994.91,83,,percent of total billed charges,,,,,,,,,,,,,,,26994.91,83,,percent of total billed charges,,,30897.79,95,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,26669.67,82,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,27645.39,85,,percent of total billed charges,,8131,30897.79,
BLADE TRICUT 11 X 4,30185396,CDM,,,270,RC,outpatient,,1714.7,1714.7,,1455.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,428.68,22,,percent of total billed charges,,,,,,,,,1543.23,90,,percent of total billed charges,,,1419.77,82.8,,percent of total billed charges,,,1457.5,85,,percent of total billed charges,,,,,,,,,1508.94,88,,percent of total billed charges,,,,,,,,,1310.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,428.68,22,,percent of total billed charges,,,1560.38,91,,percent of total billed charges,,,1628.97,95,,percent of total billed charges,,,1423.2,83,,percent of total billed charges,,,1423.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1423.2,83,,percent of total billed charges,,,1628.97,95,,percent of total billed charges,,,1543.23,90,,percent of total billed charges,,,1543.23,90,,percent of total billed charges,,,1406.05,82,,percent of total billed charges,,,1543.23,90,,percent of total billed charges,,,1457.5,85,,percent of total billed charges,,428.68,1628.97,
BLADE RAD 90 3.5MM,30185397,CDM,,,270,RC,outpatient,,2283.67,2283.67,,1938.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,570.92,22,,percent of total billed charges,,,,,,,,,2055.3,90,,percent of total billed charges,,,1890.88,82.8,,percent of total billed charges,,,1941.12,85,,percent of total billed charges,,,,,,,,,2009.63,88,,percent of total billed charges,,,,,,,,,1744.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,570.92,22,,percent of total billed charges,,,2078.14,91,,percent of total billed charges,,,2169.49,95,,percent of total billed charges,,,1895.45,83,,percent of total billed charges,,,1895.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1895.45,83,,percent of total billed charges,,,2169.49,95,,percent of total billed charges,,,2055.3,90,,percent of total billed charges,,,2055.3,90,,percent of total billed charges,,,1872.61,82,,percent of total billed charges,,,2055.3,90,,percent of total billed charges,,,1941.12,85,,percent of total billed charges,,570.92,2169.49,
BLADE CURVED SINUS 11X4MM,30185398,CDM,,,270,RC,outpatient,,1905.8,1905.8,,1618.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,476.45,22,,percent of total billed charges,,,,,,,,,1715.22,90,,percent of total billed charges,,,1578,82.8,,percent of total billed charges,,,1619.93,85,,percent of total billed charges,,,,,,,,,1677.1,88,,percent of total billed charges,,,,,,,,,1456.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,476.45,22,,percent of total billed charges,,,1734.28,91,,percent of total billed charges,,,1810.51,95,,percent of total billed charges,,,1581.81,83,,percent of total billed charges,,,1581.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1581.81,83,,percent of total billed charges,,,1810.51,95,,percent of total billed charges,,,1715.22,90,,percent of total billed charges,,,1715.22,90,,percent of total billed charges,,,1562.76,82,,percent of total billed charges,,,1715.22,90,,percent of total billed charges,,,1619.93,85,,percent of total billed charges,,476.45,1810.51,
DEPUY HEAD BIOLOX TS 28MM +12,30185399,CDM,,,278,RC,outpatient,,18783.9,18783.9,,15947.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4695.98,22,,percent of total billed charges,,,,,,,,,16905.51,90,,percent of total billed charges,,,15553.07,82.8,,percent of total billed charges,,,15966.32,85,,percent of total billed charges,,,,,,,,,16529.83,88,,percent of total billed charges,,,,,,,,,14350.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4695.98,22,,percent of total billed charges,,,17093.35,91,,percent of total billed charges,,,17844.71,95,,percent of total billed charges,,,15590.64,83,,percent of total billed charges,,,15590.64,83,,percent of total billed charges,,,,,,,,,,,,,,,15590.64,83,,percent of total billed charges,,,17844.71,95,,percent of total billed charges,,,16905.51,90,,percent of total billed charges,,,16905.51,90,,percent of total billed charges,,,15402.8,82,,percent of total billed charges,,,16905.51,90,,percent of total billed charges,,,15966.32,85,,percent of total billed charges,,4695.98,17844.71,
STRYKER NEEDLE INJECTOR,30185402,CDM,,,270,RC,outpatient,,1955.2,1955.2,,1659.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,488.8,22,,percent of total billed charges,,,,,,,,,1759.68,90,,percent of total billed charges,,,1618.91,82.8,,percent of total billed charges,,,1661.92,85,,percent of total billed charges,,,,,,,,,1720.58,88,,percent of total billed charges,,,,,,,,,1493.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,488.8,22,,percent of total billed charges,,,1779.23,91,,percent of total billed charges,,,1857.44,95,,percent of total billed charges,,,1622.82,83,,percent of total billed charges,,,1622.82,83,,percent of total billed charges,,,,,,,,,,,,,,,1622.82,83,,percent of total billed charges,,,1857.44,95,,percent of total billed charges,,,1759.68,90,,percent of total billed charges,,,1759.68,90,,percent of total billed charges,,,1603.26,82,,percent of total billed charges,,,1759.68,90,,percent of total billed charges,,,1661.92,85,,percent of total billed charges,,488.8,1857.44,
WRIGHT HEAD DELTA,30185403,CDM,,,278,RC,outpatient,,39065,39065,,33166.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9766.25,22,,percent of total billed charges,,,,,,,,,35158.5,90,,percent of total billed charges,,,32345.82,82.8,,percent of total billed charges,,,33205.25,85,,percent of total billed charges,,,,,,,,,34377.2,88,,percent of total billed charges,,,,,,,,,29845.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9766.25,22,,percent of total billed charges,,,35549.15,91,,percent of total billed charges,,,37111.75,95,,percent of total billed charges,,,32423.95,83,,percent of total billed charges,,,32423.95,83,,percent of total billed charges,,,,,,,,,,,,,,,32423.95,83,,percent of total billed charges,,,37111.75,95,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,32033.3,82,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,33205.25,85,,percent of total billed charges,,9766.25,37111.75,
WRIGHT MODULAR NECK,30185404,CDM,,,278,RC,outpatient,,28964,28964,,24590.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7241,22,,percent of total billed charges,,,,,,,,,26067.6,90,,percent of total billed charges,,,23982.19,82.8,,percent of total billed charges,,,24619.4,85,,percent of total billed charges,,,,,,,,,25488.32,88,,percent of total billed charges,,,,,,,,,22128.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7241,22,,percent of total billed charges,,,26357.24,91,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,,,,,,,,,,,,,24040.12,83,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,23750.48,82,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,24619.4,85,,percent of total billed charges,,7241,27515.8,
SYNTHES SCREW CORTEX 3.5 X 60MM,30185405,CDM,,,278,RC,outpatient,,275.78,275.78,,234.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.95,22,,percent of total billed charges,,,,,,,,,248.2,90,,percent of total billed charges,,,228.35,82.8,,percent of total billed charges,,,234.41,85,,percent of total billed charges,,,,,,,,,242.69,88,,percent of total billed charges,,,,,,,,,210.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.95,22,,percent of total billed charges,,,250.96,91,,percent of total billed charges,,,261.99,95,,percent of total billed charges,,,228.9,83,,percent of total billed charges,,,228.9,83,,percent of total billed charges,,,,,,,,,,,,,,,228.9,83,,percent of total billed charges,,,261.99,95,,percent of total billed charges,,,248.2,90,,percent of total billed charges,,,248.2,90,,percent of total billed charges,,,226.14,82,,percent of total billed charges,,,248.2,90,,percent of total billed charges,,,234.41,85,,percent of total billed charges,,68.95,261.99,
SYNTHES SCREW CANCEL 4.0X50MM,30185406,CDM,,,278,RC,outpatient,,223.13,223.13,,189.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.78,22,,percent of total billed charges,,,,,,,,,200.82,90,,percent of total billed charges,,,184.75,82.8,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,,,,,,,,196.35,88,,percent of total billed charges,,,,,,,,,170.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.78,22,,percent of total billed charges,,,203.05,91,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,185.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.2,83,,percent of total billed charges,,,211.97,95,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,182.97,82,,percent of total billed charges,,,200.82,90,,percent of total billed charges,,,189.66,85,,percent of total billed charges,,55.78,211.97,
DEPUY LINER ALTRX +4 32 X 50 10DEG,30185407,CDM,,,278,RC,outpatient,,11806.99,11806.99,,10024.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2951.75,22,,percent of total billed charges,,,,,,,,,10626.29,90,,percent of total billed charges,,,9776.19,82.8,,percent of total billed charges,,,10035.94,85,,percent of total billed charges,,,,,,,,,10390.15,88,,percent of total billed charges,,,,,,,,,9020.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2951.75,22,,percent of total billed charges,,,10744.36,91,,percent of total billed charges,,,11216.64,95,,percent of total billed charges,,,9799.8,83,,percent of total billed charges,,,9799.8,83,,percent of total billed charges,,,,,,,,,,,,,,,9799.8,83,,percent of total billed charges,,,11216.64,95,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,9681.73,82,,percent of total billed charges,,,10626.29,90,,percent of total billed charges,,,10035.94,85,,percent of total billed charges,,2951.75,11216.64,
WRIGHT HEAD DELTA SZ 28MM 12/14,30185408,CDM,,,278,RC,outpatient,,39065,39065,,33166.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9766.25,22,,percent of total billed charges,,,,,,,,,35158.5,90,,percent of total billed charges,,,32345.82,82.8,,percent of total billed charges,,,33205.25,85,,percent of total billed charges,,,,,,,,,34377.2,88,,percent of total billed charges,,,,,,,,,29845.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9766.25,22,,percent of total billed charges,,,35549.15,91,,percent of total billed charges,,,37111.75,95,,percent of total billed charges,,,32423.95,83,,percent of total billed charges,,,32423.95,83,,percent of total billed charges,,,,,,,,,,,,,,,32423.95,83,,percent of total billed charges,,,37111.75,95,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,32033.3,82,,percent of total billed charges,,,35158.5,90,,percent of total billed charges,,,33205.25,85,,percent of total billed charges,,9766.25,37111.75,
WRIGHT NECK 8DEG SHORT,30185409,CDM,,,278,RC,outpatient,,28964,28964,,24590.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7241,22,,percent of total billed charges,,,,,,,,,26067.6,90,,percent of total billed charges,,,23982.19,82.8,,percent of total billed charges,,,24619.4,85,,percent of total billed charges,,,,,,,,,25488.32,88,,percent of total billed charges,,,,,,,,,22128.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7241,22,,percent of total billed charges,,,26357.24,91,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,24040.12,83,,percent of total billed charges,,,,,,,,,,,,,,,24040.12,83,,percent of total billed charges,,,27515.8,95,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,23750.48,82,,percent of total billed charges,,,26067.6,90,,percent of total billed charges,,,24619.4,85,,percent of total billed charges,,7241,27515.8,
CTL ROD MIS 6.0 X 60MM,30185410,CDM,,,278,RC,outpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,553.48,22,,percent of total billed charges,,,,,,,,,1992.51,90,,percent of total billed charges,,,1833.11,82.8,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,553.48,22,,percent of total billed charges,,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,553.48,2103.21,
ARTHREX BTB TIGHTROPE,30185411,CDM,,,270,RC,outpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,690.63,22,,percent of total billed charges,,,,,,,,,2486.25,90,,percent of total billed charges,,,2287.35,82.8,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,690.63,22,,percent of total billed charges,,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,690.63,2624.38,
ARTHREX SECONDARY FIXATION KIT ACL/PCL R,30185412,CDM,,,270,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
ARTHREX CUTTER FLIP II 11.0MM,30185413,CDM,,,270,RC,outpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,528.13,22,,percent of total billed charges,,,,,,,,,1901.25,90,,percent of total billed charges,,,1749.15,82.8,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,528.13,22,,percent of total billed charges,,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,528.13,2006.88,
ARTHREX SUTURE ANCHOR BC 2.4 X 11.3MM,30185414,CDM,,,278,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
ARTHREX INSERT KIT PERCUTANEOUS 2.9MM,30185415,CDM,,,278,RC,outpatient,,1430,1430,,1214.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,357.5,22,,percent of total billed charges,,,,,,,,,1287,90,,percent of total billed charges,,,1184.04,82.8,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,,,,,,,,1258.4,88,,percent of total billed charges,,,,,,,,,1092.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,357.5,22,,percent of total billed charges,,,1301.3,91,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1186.9,83,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1172.6,82,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,357.5,1358.5,
ARTHREX DISTAL BICEP IMPLANT SYS BC,30185416,CDM,,,270,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
SYNTHES PLATE DISTAL RADIUS VA LCP 2.4MM,30185417,CDM,,,278,RC,outpatient,,18232.5,18232.5,,15479.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4558.13,22,,percent of total billed charges,,,,,,,,,16409.25,90,,percent of total billed charges,,,15096.51,82.8,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,,,,,,,,16044.6,88,,percent of total billed charges,,,,,,,,,13929.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4558.13,22,,percent of total billed charges,,,16591.58,91,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15132.98,83,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,14950.65,82,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,4558.13,17320.88,
SYNTHES SCREW CORTEX 2.4 X 14MM,30185418,CDM,,,278,RC,outpatient,,827.05,827.05,,702.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.76,22,,percent of total billed charges,,,,,,,,,744.35,90,,percent of total billed charges,,,684.8,82.8,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,,,,,,,,727.8,88,,percent of total billed charges,,,,,,,,,631.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.76,22,,percent of total billed charges,,,752.62,91,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,,,,,,,,,,,,,686.45,83,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,678.18,82,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,206.76,785.7,
MENTOR MEMORYGEL BREAST IMPLANT 4000 SMO,30185419,CDM,,,278,RC,outpatient,,6370,6370,,5408.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1592.5,22,,percent of total billed charges,,,,,,,,,5733,90,,percent of total billed charges,,,5274.36,82.8,,percent of total billed charges,,,5414.5,85,,percent of total billed charges,,,,,,,,,5605.6,88,,percent of total billed charges,,,,,,,,,4866.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1592.5,22,,percent of total billed charges,,,5796.7,91,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5287.1,83,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5223.4,82,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5414.5,85,,percent of total billed charges,,1592.5,6051.5,
DEPUY REVISION TIBIAL TRAY SZ 7,30185421,CDM,,,278,RC,outpatient,,25954.31,25954.31,,22035.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6488.58,22,,percent of total billed charges,,,,,,,,,23358.88,90,,percent of total billed charges,,,21490.17,82.8,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,,,,,,,,22839.79,88,,percent of total billed charges,,,,,,,,,19829.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6488.58,22,,percent of total billed charges,,,23618.42,91,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,,,,,,,,,,,,,21542.08,83,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,21282.53,82,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,6488.58,24656.59,
ZIMMER SHELL OSSEOTI 4 HOLE G7 58MM G,30185422,CDM,,,278,RC,outpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4834.38,22,,percent of total billed charges,,,,,,,,,17403.75,90,,percent of total billed charges,,,16011.45,82.8,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4834.38,22,,percent of total billed charges,,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,4834.38,18370.63,
ZIMMER ACT ARTIC HD ARCOM XL 28X46MM,30185423,CDM,,,278,RC,outpatient,,18070,18070,,15341.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4517.5,22,,percent of total billed charges,,,,,,,,,16263,90,,percent of total billed charges,,,14961.96,82.8,,percent of total billed charges,,,15359.5,85,,percent of total billed charges,,,,,,,,,15901.6,88,,percent of total billed charges,,,,,,,,,13805.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4517.5,22,,percent of total billed charges,,,16443.7,91,,percent of total billed charges,,,17166.5,95,,percent of total billed charges,,,14998.1,83,,percent of total billed charges,,,14998.1,83,,percent of total billed charges,,,,,,,,,,,,,,,14998.1,83,,percent of total billed charges,,,17166.5,95,,percent of total billed charges,,,16263,90,,percent of total billed charges,,,16263,90,,percent of total billed charges,,,14817.4,82,,percent of total billed charges,,,16263,90,,percent of total billed charges,,,15359.5,85,,percent of total billed charges,,4517.5,17166.5,
SYNTHES PLATE LCP RT 4HOLE,30185424,CDM,,,278,RC,outpatient,,6318.65,6318.65,,5364.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1579.66,22,,percent of total billed charges,,,,,,,,,5686.79,90,,percent of total billed charges,,,5231.84,82.8,,percent of total billed charges,,,5370.85,85,,percent of total billed charges,,,,,,,,,5560.41,88,,percent of total billed charges,,,,,,,,,4827.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1579.66,22,,percent of total billed charges,,,5749.97,91,,percent of total billed charges,,,6002.72,95,,percent of total billed charges,,,5244.48,83,,percent of total billed charges,,,5244.48,83,,percent of total billed charges,,,,,,,,,,,,,,,5244.48,83,,percent of total billed charges,,,6002.72,95,,percent of total billed charges,,,5686.79,90,,percent of total billed charges,,,5686.79,90,,percent of total billed charges,,,5181.29,82,,percent of total billed charges,,,5686.79,90,,percent of total billed charges,,,5370.85,85,,percent of total billed charges,,1579.66,6002.72,
SYNTHES BALDE HELICAL 75MM,30185425,CDM,,,270,RC,outpatient,,6630,6630,,5628.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1657.5,22,,percent of total billed charges,,,,,,,,,5967,90,,percent of total billed charges,,,5489.64,82.8,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,,,,,,,,5834.4,88,,percent of total billed charges,,,,,,,,,5065.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1657.5,22,,percent of total billed charges,,,6033.3,91,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,5502.9,83,,percent of total billed charges,,,,,,,,,,,,,,,5502.9,83,,percent of total billed charges,,,6298.5,95,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5436.6,82,,percent of total billed charges,,,5967,90,,percent of total billed charges,,,5635.5,85,,percent of total billed charges,,1657.5,6298.5,
SYNTHES ENDCAP 0MM,30185426,CDM,,,278,RC,outpatient,,2331.55,2331.55,,1979.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,582.89,22,,percent of total billed charges,,,,,,,,,2098.4,90,,percent of total billed charges,,,1930.52,82.8,,percent of total billed charges,,,1981.82,85,,percent of total billed charges,,,,,,,,,2051.76,88,,percent of total billed charges,,,,,,,,,1781.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,582.89,22,,percent of total billed charges,,,2121.71,91,,percent of total billed charges,,,2214.97,95,,percent of total billed charges,,,1935.19,83,,percent of total billed charges,,,1935.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1935.19,83,,percent of total billed charges,,,2214.97,95,,percent of total billed charges,,,2098.4,90,,percent of total billed charges,,,2098.4,90,,percent of total billed charges,,,1911.87,82,,percent of total billed charges,,,2098.4,90,,percent of total billed charges,,,1981.82,85,,percent of total billed charges,,582.89,2214.97,
SYNTHES GUIDE WIRE NON-THREADED,30185427,CDM,,,278,RC,outpatient,,321.75,321.75,,273.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.44,22,,percent of total billed charges,,,,,,,,,289.58,90,,percent of total billed charges,,,266.41,82.8,,percent of total billed charges,,,273.49,85,,percent of total billed charges,,,,,,,,,283.14,88,,percent of total billed charges,,,,,,,,,245.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.44,22,,percent of total billed charges,,,292.79,91,,percent of total billed charges,,,305.66,95,,percent of total billed charges,,,267.05,83,,percent of total billed charges,,,267.05,83,,percent of total billed charges,,,,,,,,,,,,,,,267.05,83,,percent of total billed charges,,,305.66,95,,percent of total billed charges,,,289.58,90,,percent of total billed charges,,,289.58,90,,percent of total billed charges,,,263.84,82,,percent of total billed charges,,,289.58,90,,percent of total billed charges,,,273.49,85,,percent of total billed charges,,80.44,305.66,
SYNTHES SCREW LNG THD HEADLESS 3.0X40MM,30185428,CDM,,,278,RC,outpatient,,3364.73,3364.73,,2856.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,841.18,22,,percent of total billed charges,,,,,,,,,3028.26,90,,percent of total billed charges,,,2786,82.8,,percent of total billed charges,,,2860.02,85,,percent of total billed charges,,,,,,,,,2960.96,88,,percent of total billed charges,,,,,,,,,2570.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,841.18,22,,percent of total billed charges,,,3061.9,91,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2792.73,83,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2759.08,82,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2860.02,85,,percent of total billed charges,,841.18,3196.49,
SYNTHES SCREW LNG THD HEADLESS 3.0X34MM,30185429,CDM,,,278,RC,outpatient,,3364.73,3364.73,,2856.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,841.18,22,,percent of total billed charges,,,,,,,,,3028.26,90,,percent of total billed charges,,,2786,82.8,,percent of total billed charges,,,2860.02,85,,percent of total billed charges,,,,,,,,,2960.96,88,,percent of total billed charges,,,,,,,,,2570.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,841.18,22,,percent of total billed charges,,,3061.9,91,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,2792.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2792.73,83,,percent of total billed charges,,,3196.49,95,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2759.08,82,,percent of total billed charges,,,3028.26,90,,percent of total billed charges,,,2860.02,85,,percent of total billed charges,,841.18,3196.49,
CTL ROD MIS 45MM,30185430,CDM,,,278,RC,outpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,553.48,22,,percent of total billed charges,,,,,,,,,1992.51,90,,percent of total billed charges,,,1833.11,82.8,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,553.48,22,,percent of total billed charges,,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,553.48,2103.21,
CTL ROD MIS 35MM,30185431,CDM,,,278,RC,outpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,553.48,22,,percent of total billed charges,,,,,,,,,1992.51,90,,percent of total billed charges,,,1833.11,82.8,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,553.48,22,,percent of total billed charges,,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,553.48,2103.21,
SYNTHES PLATE PROX. LAT 4HOLE LONG BEND,30185432,CDM,,,278,RC,outpatient,,16138.53,16138.53,,13701.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4034.63,22,,percent of total billed charges,,,,,,,,,14524.68,90,,percent of total billed charges,,,13362.7,82.8,,percent of total billed charges,,,13717.75,85,,percent of total billed charges,,,,,,,,,14201.91,88,,percent of total billed charges,,,,,,,,,12329.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4034.63,22,,percent of total billed charges,,,14686.06,91,,percent of total billed charges,,,15331.6,95,,percent of total billed charges,,,13394.98,83,,percent of total billed charges,,,13394.98,83,,percent of total billed charges,,,,,,,,,,,,,,,13394.98,83,,percent of total billed charges,,,15331.6,95,,percent of total billed charges,,,14524.68,90,,percent of total billed charges,,,14524.68,90,,percent of total billed charges,,,13233.59,82,,percent of total billed charges,,,14524.68,90,,percent of total billed charges,,,13717.75,85,,percent of total billed charges,,4034.63,15331.6,
SYNTHES SCREW LOCKING VA 3.5 X 34MM,30185433,CDM,,,278,RC,outpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375.13,22,,percent of total billed charges,,,,,,,,,1350.48,90,,percent of total billed charges,,,1242.44,82.8,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,375.13,22,,percent of total billed charges,,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,375.13,1425.5,
SYNTHES SCREW LOCKING VA 3.5 X 50MM,30185434,CDM,,,278,RC,outpatient,,1414.4,1414.4,,1200.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,353.6,22,,percent of total billed charges,,,,,,,,,1272.96,90,,percent of total billed charges,,,1171.12,82.8,,percent of total billed charges,,,1202.24,85,,percent of total billed charges,,,,,,,,,1244.67,88,,percent of total billed charges,,,,,,,,,1080.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,353.6,22,,percent of total billed charges,,,1287.1,91,,percent of total billed charges,,,1343.68,95,,percent of total billed charges,,,1173.95,83,,percent of total billed charges,,,1173.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1173.95,83,,percent of total billed charges,,,1343.68,95,,percent of total billed charges,,,1272.96,90,,percent of total billed charges,,,1272.96,90,,percent of total billed charges,,,1159.81,82,,percent of total billed charges,,,1272.96,90,,percent of total billed charges,,,1202.24,85,,percent of total billed charges,,353.6,1343.68,
SYNTHES SCREW LOCKING VA 3.5 X 54MM,30185435,CDM,,,278,RC,outpatient,,1414.4,1414.4,,1200.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,353.6,22,,percent of total billed charges,,,,,,,,,1272.96,90,,percent of total billed charges,,,1171.12,82.8,,percent of total billed charges,,,1202.24,85,,percent of total billed charges,,,,,,,,,1244.67,88,,percent of total billed charges,,,,,,,,,1080.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,353.6,22,,percent of total billed charges,,,1287.1,91,,percent of total billed charges,,,1343.68,95,,percent of total billed charges,,,1173.95,83,,percent of total billed charges,,,1173.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1173.95,83,,percent of total billed charges,,,1343.68,95,,percent of total billed charges,,,1272.96,90,,percent of total billed charges,,,1272.96,90,,percent of total billed charges,,,1159.81,82,,percent of total billed charges,,,1272.96,90,,percent of total billed charges,,,1202.24,85,,percent of total billed charges,,353.6,1343.68,
SYNTHES SCREW LOCKING VA 3.5 X 56MM,30185436,CDM,,,278,RC,outpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375.13,22,,percent of total billed charges,,,,,,,,,1350.48,90,,percent of total billed charges,,,1242.44,82.8,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,375.13,22,,percent of total billed charges,,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,375.13,1425.5,
SYNTHES SCREW LOCKING VA 3.5 X 65MM,30185437,CDM,,,278,RC,outpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375.13,22,,percent of total billed charges,,,,,,,,,1350.48,90,,percent of total billed charges,,,1242.44,82.8,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,375.13,22,,percent of total billed charges,,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,375.13,1425.5,
SYNTHES SCREW LOCKING VA 3.5 X 70MM,30185438,CDM,,,278,RC,outpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375.13,22,,percent of total billed charges,,,,,,,,,1350.48,90,,percent of total billed charges,,,1242.44,82.8,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,375.13,22,,percent of total billed charges,,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,375.13,1425.5,
DEPUY ATTUNE STEM CEMENTED 16X80,30185439,CDM,,,278,RC,outpatient,,8336.19,8336.19,,7077.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2084.05,22,,percent of total billed charges,,,,,,,,,7502.57,90,,percent of total billed charges,,,6902.37,82.8,,percent of total billed charges,,,7085.76,85,,percent of total billed charges,,,,,,,,,7335.85,88,,percent of total billed charges,,,,,,,,,6368.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2084.05,22,,percent of total billed charges,,,7585.93,91,,percent of total billed charges,,,7919.38,95,,percent of total billed charges,,,6919.04,83,,percent of total billed charges,,,6919.04,83,,percent of total billed charges,,,,,,,,,,,,,,,6919.04,83,,percent of total billed charges,,,7919.38,95,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,6835.68,82,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,7085.76,85,,percent of total billed charges,,2084.05,7919.38,
DEPUY ATTUNE FEMUR REV. SZ 7 L,30185440,CDM,,,278,RC,outpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13142.14,22,,percent of total billed charges,,,,,,,,,47311.7,90,,percent of total billed charges,,,43526.77,82.8,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13142.14,22,,percent of total billed charges,,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,13142.14,49940.13,
DEPUY ATTUNE INSERT REV. FB 6MM,30185441,CDM,,,278,RC,outpatient,,19355.77,19355.77,,16433.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4838.94,22,,percent of total billed charges,,,,,,,,,17420.19,90,,percent of total billed charges,,,16026.58,82.8,,percent of total billed charges,,,16452.4,85,,percent of total billed charges,,,,,,,,,17033.08,88,,percent of total billed charges,,,,,,,,,14787.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4838.94,22,,percent of total billed charges,,,17613.75,91,,percent of total billed charges,,,18387.98,95,,percent of total billed charges,,,16065.29,83,,percent of total billed charges,,,16065.29,83,,percent of total billed charges,,,,,,,,,,,,,,,16065.29,83,,percent of total billed charges,,,18387.98,95,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,15871.73,82,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,16452.4,85,,percent of total billed charges,,4838.94,18387.98,
ARTHREX LASSO QUICKPASS 25DEG LEFT TIGHT,30185442,CDM,,,278,RC,outpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260,22,,percent of total billed charges,,,,,,,,,936,90,,percent of total billed charges,,,861.12,82.8,,percent of total billed charges,,,884,85,,percent of total billed charges,,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260,22,,percent of total billed charges,,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,260,988,
ARTHREX LASSO QUICKPASS 25DEG RIGHT TIGH,30185443,CDM,,,278,RC,outpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260,22,,percent of total billed charges,,,,,,,,,936,90,,percent of total billed charges,,,861.12,82.8,,percent of total billed charges,,,884,85,,percent of total billed charges,,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260,22,,percent of total billed charges,,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,260,988,
SCREW LATERAL MASS 14 X 3.5MM,30185444,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
SCREW LATERAL MASS 16 X 3.5MM,30185445,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
SCREW LATERAL MASS 26 X 4.0MM,30185446,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
SCREW PEDICLE 30 X 4.5MM,30185447,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ROD STRAIGHT 240MM,30185448,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
LOCKING NUT,30185449,CDM,,,278,RC,outpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175,22,,percent of total billed charges,,,,,,,,,630,90,,percent of total billed charges,,,579.6,82.8,,percent of total billed charges,,,595,85,,percent of total billed charges,,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175,22,,percent of total billed charges,,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,175,665,
CTL PARALLEL MATISSE 6MM 17X14,30185450,CDM,,,278,RC,outpatient,,10708.75,10708.75,,9091.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2677.19,22,,percent of total billed charges,,,,,,,,,9637.88,90,,percent of total billed charges,,,8866.85,82.8,,percent of total billed charges,,,9102.44,85,,percent of total billed charges,,,,,,,,,9423.7,88,,percent of total billed charges,,,,,,,,,8181.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2677.19,22,,percent of total billed charges,,,9744.96,91,,percent of total billed charges,,,10173.31,95,,percent of total billed charges,,,8888.26,83,,percent of total billed charges,,,8888.26,83,,percent of total billed charges,,,,,,,,,,,,,,,8888.26,83,,percent of total billed charges,,,10173.31,95,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,8781.18,82,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,9102.44,85,,percent of total billed charges,,2677.19,10173.31,
CTL PLATE VAN GOGH CERVICAL 14MM X-LONG,30185451,CDM,,,278,RC,outpatient,,8957,8957,,7604.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2239.25,22,,percent of total billed charges,,,,,,,,,8061.3,90,,percent of total billed charges,,,7416.4,82.8,,percent of total billed charges,,,7613.45,85,,percent of total billed charges,,,,,,,,,7882.16,88,,percent of total billed charges,,,,,,,,,6843.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2239.25,22,,percent of total billed charges,,,8150.87,91,,percent of total billed charges,,,8509.15,95,,percent of total billed charges,,,7434.31,83,,percent of total billed charges,,,7434.31,83,,percent of total billed charges,,,,,,,,,,,,,,,7434.31,83,,percent of total billed charges,,,8509.15,95,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,7344.74,82,,percent of total billed charges,,,8061.3,90,,percent of total billed charges,,,7613.45,85,,percent of total billed charges,,2239.25,8509.15,
DEPUY CAP COP W/GRIPTION,30185452,CDM,,,278,RC,outpatient,,56452.5,56452.5,,47928.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14113.13,22,,percent of total billed charges,,,,,,,,,50807.25,90,,percent of total billed charges,,,46742.67,82.8,,percent of total billed charges,,,47984.63,85,,percent of total billed charges,,,,,,,,,49678.2,88,,percent of total billed charges,,,,,,,,,43129.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14113.13,22,,percent of total billed charges,,,51371.78,91,,percent of total billed charges,,,53629.88,95,,percent of total billed charges,,,46855.58,83,,percent of total billed charges,,,46855.58,83,,percent of total billed charges,,,,,,,,,,,,,,,46855.58,83,,percent of total billed charges,,,53629.88,95,,percent of total billed charges,,,50807.25,90,,percent of total billed charges,,,50807.25,90,,percent of total billed charges,,,46291.05,82,,percent of total billed charges,,,50807.25,90,,percent of total billed charges,,,47984.63,85,,percent of total billed charges,,14113.13,53629.88,
SYNTHES PLATE VA OLECRANON 2H LT,30185453,CDM,,,270,RC,outpatient,,10721.36,10721.36,,9102.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2680.34,22,,percent of total billed charges,,,,,,,,,9649.22,90,,percent of total billed charges,,,8877.29,82.8,,percent of total billed charges,,,9113.16,85,,percent of total billed charges,,,,,,,,,9434.8,88,,percent of total billed charges,,,,,,,,,8191.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2680.34,22,,percent of total billed charges,,,9756.44,91,,percent of total billed charges,,,10185.29,95,,percent of total billed charges,,,8898.73,83,,percent of total billed charges,,,8898.73,83,,percent of total billed charges,,,,,,,,,,,,,,,8898.73,83,,percent of total billed charges,,,10185.29,95,,percent of total billed charges,,,9649.22,90,,percent of total billed charges,,,9649.22,90,,percent of total billed charges,,,8791.52,82,,percent of total billed charges,,,9649.22,90,,percent of total billed charges,,,9113.16,85,,percent of total billed charges,,2680.34,10185.29,
SYNTHES SCREW LOCKING VA 2.7MM X 18MM,30185454,CDM,,,278,RC,outpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,353.16,22,,percent of total billed charges,,,,,,,,,1271.39,90,,percent of total billed charges,,,1169.67,82.8,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,353.16,22,,percent of total billed charges,,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,353.16,1342.02,
SYNTHES SCREW LOCKING VA 2.7MM X 28MM,30185455,CDM,,,278,RC,outpatient,,1371.5,1371.5,,1164.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,342.88,22,,percent of total billed charges,,,,,,,,,1234.35,90,,percent of total billed charges,,,1135.6,82.8,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,,,,,,,,1206.92,88,,percent of total billed charges,,,,,,,,,1047.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,342.88,22,,percent of total billed charges,,,1248.07,91,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.35,83,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1124.63,82,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,342.88,1302.93,
SYNTHES SCREW LOCKING VA 2.7MM X 44MM,30185456,CDM,,,278,RC,outpatient,,1371.5,1371.5,,1164.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,342.88,22,,percent of total billed charges,,,,,,,,,1234.35,90,,percent of total billed charges,,,1135.6,82.8,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,,,,,,,,1206.92,88,,percent of total billed charges,,,,,,,,,1047.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,342.88,22,,percent of total billed charges,,,1248.07,91,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.35,83,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1124.63,82,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,342.88,1302.93,
CAGE C-TI STALIF,30185457,CDM,,,278,RC,outpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4875,22,,percent of total billed charges,,,,,,,,,17550,90,,percent of total billed charges,,,16146,82.8,,percent of total billed charges,,,16575,85,,percent of total billed charges,,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4875,22,,percent of total billed charges,,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,4875,18525,
ARTHREX GUIDE WIRE TROCAR .045  THREADED,30185458,CDM,,,278,RC,outpatient,,195,195,,165.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.75,22,,percent of total billed charges,,,,,,,,,175.5,90,,percent of total billed charges,,,161.46,82.8,,percent of total billed charges,,,165.75,85,,percent of total billed charges,,,,,,,,,171.6,88,,percent of total billed charges,,,,,,,,,148.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.75,22,,percent of total billed charges,,,177.45,91,,percent of total billed charges,,,185.25,95,,percent of total billed charges,,,161.85,83,,percent of total billed charges,,,161.85,83,,percent of total billed charges,,,,,,,,,,,,,,,161.85,83,,percent of total billed charges,,,185.25,95,,percent of total billed charges,,,175.5,90,,percent of total billed charges,,,175.5,90,,percent of total billed charges,,,159.9,82,,percent of total billed charges,,,175.5,90,,percent of total billed charges,,,165.75,85,,percent of total billed charges,,48.75,185.25,
ARTHREX PROFILE DRILL STANDARD CMP FT,30185459,CDM,,,278,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
ARTHREX GUIDE WIRE W/TRCR TIP .045  W/LA,30185460,CDM,,,278,RC,outpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40,22,,percent of total billed charges,,,,,,,,,144,90,,percent of total billed charges,,,132.48,82.8,,percent of total billed charges,,,136,85,,percent of total billed charges,,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40,22,,percent of total billed charges,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,40,152,
ARTHREX DRILL BIT CANNULATED 3MM,30185461,CDM,,,270,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
ARTHREX SCREW CANC. QCKFIX 3 X 32MM,30185462,CDM,,,270,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
ARTHREX SCREW CANC. QCKFIX 3 X 22MM,30185463,CDM,,,270,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
CTL ROD MIS 40MM,30185464,CDM,,,278,RC,outpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,553.48,22,,percent of total billed charges,,,,,,,,,1992.51,90,,percent of total billed charges,,,1833.11,82.8,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,553.48,22,,percent of total billed charges,,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,553.48,2103.21,
SYNTHES SCREW CORTEX T8 24MM STERILE,30185465,CDM,,,278,RC,outpatient,,827.05,827.05,,702.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.76,22,,percent of total billed charges,,,,,,,,,744.35,90,,percent of total billed charges,,,684.8,82.8,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,,,,,,,,727.8,88,,percent of total billed charges,,,,,,,,,631.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.76,22,,percent of total billed charges,,,752.62,91,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,,,,,,,,,,,,,686.45,83,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,678.18,82,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,206.76,785.7,
ARTHREX SWIVELOCK ANCHOR 5.5 X 19.1MM,30185466,CDM,,,270,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
ARTHREX TENO SCREW KIT,30185467,CDM,,,270,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
ARTHREX TENO SWVLK BC 7 X 19.5MM,30185468,CDM,,,278,RC,outpatient,,2827.5,2827.5,,2400.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,706.88,22,,percent of total billed charges,,,,,,,,,2544.75,90,,percent of total billed charges,,,2341.17,82.8,,percent of total billed charges,,,2403.38,85,,percent of total billed charges,,,,,,,,,2488.2,88,,percent of total billed charges,,,,,,,,,2160.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,706.88,22,,percent of total billed charges,,,2573.03,91,,percent of total billed charges,,,2686.13,95,,percent of total billed charges,,,2346.83,83,,percent of total billed charges,,,2346.83,83,,percent of total billed charges,,,,,,,,,,,,,,,2346.83,83,,percent of total billed charges,,,2686.13,95,,percent of total billed charges,,,2544.75,90,,percent of total billed charges,,,2544.75,90,,percent of total billed charges,,,2318.55,82,,percent of total billed charges,,,2544.75,90,,percent of total billed charges,,,2403.38,85,,percent of total billed charges,,706.88,2686.13,
SYNTHES KIT PLATE DISTAL RADIUS 7X3,30185469,CDM,,,278,RC,outpatient,,18232.5,18232.5,,15479.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4558.13,22,,percent of total billed charges,,,,,,,,,16409.25,90,,percent of total billed charges,,,15096.51,82.8,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,,,,,,,,16044.6,88,,percent of total billed charges,,,,,,,,,13929.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4558.13,22,,percent of total billed charges,,,16591.58,91,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,15132.98,83,,percent of total billed charges,,,,,,,,,,,,,,,15132.98,83,,percent of total billed charges,,,17320.88,95,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,14950.65,82,,percent of total billed charges,,,16409.25,90,,percent of total billed charges,,,15497.63,85,,percent of total billed charges,,4558.13,17320.88,
SYNTHES SCREW LOCKING VA 18 X 2.4MM STER,30185470,CDM,,,278,RC,outpatient,,1635.4,1635.4,,1388.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,408.85,22,,percent of total billed charges,,,,,,,,,1471.86,90,,percent of total billed charges,,,1354.11,82.8,,percent of total billed charges,,,1390.09,85,,percent of total billed charges,,,,,,,,,1439.15,88,,percent of total billed charges,,,,,,,,,1249.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,408.85,22,,percent of total billed charges,,,1488.21,91,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1357.38,83,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1341.03,82,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1390.09,85,,percent of total billed charges,,408.85,1553.63,
IR SCREW POLY 6.5 X 40MM,30185471,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
IR SCREW REDUCTION 7.5 X 45MM,30185472,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
IR SCREW REDUCTION 7.5 X 50MM,30185473,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
IR SCREW SET,30185474,CDM,,,278,RC,outpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175,22,,percent of total billed charges,,,,,,,,,630,90,,percent of total billed charges,,,579.6,82.8,,percent of total billed charges,,,595,85,,percent of total billed charges,,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175,22,,percent of total billed charges,,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,175,665,
IR LORDOSED PRE-BENT 5.5 - 50,30185475,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
IR SCREW POLY 7.5 X 45MM,30185476,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
IR SCREW POLY 5.5 X 40MM,30185477,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
IR SCREW POLY 5.5 X 45MM,30185478,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
IR SCREW POLY 6.5 X 45MM,30185479,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
IR SCREW POLY 6.5 X 50MM,30185480,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
IR ROD LONG 450MM,30185481,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
ARTHREX REAMER METATARSAL 22MM,30185482,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
ARTHREX REAMER PHALANGEAL 22MM,30185483,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
ARTHREX REAMER CIRCULAR MTP 22MM,30185484,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
ARTHREX SCREW CORTICAL 3MM X 20MM,30185485,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW VARIABLE LOCKING 3X16MM,30185486,CDM,,,278,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
ARTHREX SCREW VARIABLE LOCKING 3X22MM,30185487,CDM,,,278,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
ARTHREX FLIPCUTTER II 9.5MM,30185488,CDM,,,278,RC,outpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,528.13,22,,percent of total billed charges,,,,,,,,,1901.25,90,,percent of total billed charges,,,1749.15,82.8,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,528.13,22,,percent of total billed charges,,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,528.13,2006.88,
MERETE KNEE SPACER IKA OSTEOBRIDGE,30185489,CDM,,,278,RC,outpatient,,96525,96525,,81949.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24131.25,22,,percent of total billed charges,,,,,,,,,86872.5,90,,percent of total billed charges,,,79922.7,82.8,,percent of total billed charges,,,82046.25,85,,percent of total billed charges,,,,,,,,,84942,88,,percent of total billed charges,,,,,,,,,73745.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24131.25,22,,percent of total billed charges,,,87837.75,91,,percent of total billed charges,,,91698.75,95,,percent of total billed charges,,,80115.75,83,,percent of total billed charges,,,80115.75,83,,percent of total billed charges,,,,,,,,,,,,,,,80115.75,83,,percent of total billed charges,,,91698.75,95,,percent of total billed charges,,,86872.5,90,,percent of total billed charges,,,86872.5,90,,percent of total billed charges,,,79150.5,82,,percent of total billed charges,,,86872.5,90,,percent of total billed charges,,,82046.25,85,,percent of total billed charges,,24131.25,91698.75,
MERETE KNEE NAIL W/OUT COLLAR 200 X 20MM,30185490,CDM,,,278,RC,outpatient,,17875,17875,,15175.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4468.75,22,,percent of total billed charges,,,,,,,,,16087.5,90,,percent of total billed charges,,,14800.5,82.8,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,,,,,,,,15730,88,,percent of total billed charges,,,,,,,,,13656.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4468.75,22,,percent of total billed charges,,,16266.25,91,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14836.25,83,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,14657.5,82,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,4468.75,16981.25,
MERETE KNEE SCREW INTERLOCKING 5 X 38MM,30185491,CDM,,,278,RC,outpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,706.06,22,,percent of total billed charges,,,,,,,,,2541.83,90,,percent of total billed charges,,,2338.48,82.8,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,706.06,22,,percent of total billed charges,,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,706.06,2683.04,
MERETE KNEE SCREW INTERLOCKING 5 X 46MM,30185492,CDM,,,278,RC,outpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,706.06,22,,percent of total billed charges,,,,,,,,,2541.83,90,,percent of total billed charges,,,2338.48,82.8,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,706.06,22,,percent of total billed charges,,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,706.06,2683.04,
MERETE KNEE SCREW INTERLOCKING 5 X 48MM,30185493,CDM,,,278,RC,outpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,706.06,22,,percent of total billed charges,,,,,,,,,2541.83,90,,percent of total billed charges,,,2338.48,82.8,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,706.06,22,,percent of total billed charges,,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,706.06,2683.04,
MERETE KNEE DRILL BIT IKS 4.5MM,30185494,CDM,,,278,RC,outpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,706.06,22,,percent of total billed charges,,,,,,,,,2541.83,90,,percent of total billed charges,,,2338.48,82.8,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,706.06,22,,percent of total billed charges,,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,706.06,2683.04,
SYNTHES DRILL BIT 1.1,30185495,CDM,,,278,RC,outpatient,,868.7,868.7,,737.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,217.18,22,,percent of total billed charges,,,,,,,,,781.83,90,,percent of total billed charges,,,719.28,82.8,,percent of total billed charges,,,738.4,85,,percent of total billed charges,,,,,,,,,764.46,88,,percent of total billed charges,,,,,,,,,663.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,217.18,22,,percent of total billed charges,,,790.52,91,,percent of total billed charges,,,825.27,95,,percent of total billed charges,,,721.02,83,,percent of total billed charges,,,721.02,83,,percent of total billed charges,,,,,,,,,,,,,,,721.02,83,,percent of total billed charges,,,825.27,95,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,712.33,82,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,738.4,85,,percent of total billed charges,,217.18,825.27,
SYNTHES K-WIRE TI 0.8 X 70M,30185496,CDM,,,278,RC,outpatient,,988.98,988.98,,839.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,247.25,22,,percent of total billed charges,,,,,,,,,890.08,90,,percent of total billed charges,,,818.88,82.8,,percent of total billed charges,,,840.63,85,,percent of total billed charges,,,,,,,,,870.3,88,,percent of total billed charges,,,,,,,,,755.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,247.25,22,,percent of total billed charges,,,899.97,91,,percent of total billed charges,,,939.53,95,,percent of total billed charges,,,820.85,83,,percent of total billed charges,,,820.85,83,,percent of total billed charges,,,,,,,,,,,,,,,820.85,83,,percent of total billed charges,,,939.53,95,,percent of total billed charges,,,890.08,90,,percent of total billed charges,,,890.08,90,,percent of total billed charges,,,810.96,82,,percent of total billed charges,,,890.08,90,,percent of total billed charges,,,840.63,85,,percent of total billed charges,,247.25,939.53,
SYNTHES PLATE TI 1.5MM RT PHALANGEAL HEA,30185497,CDM,,,278,RC,outpatient,,4370.28,4370.28,,3710.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1092.57,22,,percent of total billed charges,,,,,,,,,3933.25,90,,percent of total billed charges,,,3618.59,82.8,,percent of total billed charges,,,3714.74,85,,percent of total billed charges,,,,,,,,,3845.85,88,,percent of total billed charges,,,,,,,,,3338.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1092.57,22,,percent of total billed charges,,,3976.95,91,,percent of total billed charges,,,4151.77,95,,percent of total billed charges,,,3627.33,83,,percent of total billed charges,,,3627.33,83,,percent of total billed charges,,,,,,,,,,,,,,,3627.33,83,,percent of total billed charges,,,4151.77,95,,percent of total billed charges,,,3933.25,90,,percent of total billed charges,,,3933.25,90,,percent of total billed charges,,,3583.63,82,,percent of total billed charges,,,3933.25,90,,percent of total billed charges,,,3714.74,85,,percent of total billed charges,,1092.57,4151.77,
SYNTHES SCREW CORTEX 1.5 X 11MM,30185498,CDM,,,278,RC,outpatient,,523.6,523.6,,444.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.9,22,,percent of total billed charges,,,,,,,,,471.24,90,,percent of total billed charges,,,433.54,82.8,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,,,,,,,,460.77,88,,percent of total billed charges,,,,,,,,,400.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.9,22,,percent of total billed charges,,,476.48,91,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,,,,,,,,,,,,,434.59,83,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,429.35,82,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,130.9,497.42,
SYNTHES SCREW CORTEX 1.5 X 12MM,30185499,CDM,,,278,RC,outpatient,,523.6,523.6,,444.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.9,22,,percent of total billed charges,,,,,,,,,471.24,90,,percent of total billed charges,,,433.54,82.8,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,,,,,,,,460.77,88,,percent of total billed charges,,,,,,,,,400.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.9,22,,percent of total billed charges,,,476.48,91,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,,,,,,,,,,,,,434.59,83,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,429.35,82,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,130.9,497.42,
SYNTHES SCREW LOCKING 1.5 X 11MM,30185500,CDM,,,278,RC,outpatient,,1221.03,1221.03,,1036.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,305.26,22,,percent of total billed charges,,,,,,,,,1098.93,90,,percent of total billed charges,,,1011.01,82.8,,percent of total billed charges,,,1037.88,85,,percent of total billed charges,,,,,,,,,1074.51,88,,percent of total billed charges,,,,,,,,,932.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,305.26,22,,percent of total billed charges,,,1111.14,91,,percent of total billed charges,,,1159.98,95,,percent of total billed charges,,,1013.45,83,,percent of total billed charges,,,1013.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1013.45,83,,percent of total billed charges,,,1159.98,95,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1001.24,82,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1037.88,85,,percent of total billed charges,,305.26,1159.98,
SYNTHES SCREW LOCKING 1.5 X 12MM,30185501,CDM,,,278,RC,outpatient,,1221.03,1221.03,,1036.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,305.26,22,,percent of total billed charges,,,,,,,,,1098.93,90,,percent of total billed charges,,,1011.01,82.8,,percent of total billed charges,,,1037.88,85,,percent of total billed charges,,,,,,,,,1074.51,88,,percent of total billed charges,,,,,,,,,932.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,305.26,22,,percent of total billed charges,,,1111.14,91,,percent of total billed charges,,,1159.98,95,,percent of total billed charges,,,1013.45,83,,percent of total billed charges,,,1013.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1013.45,83,,percent of total billed charges,,,1159.98,95,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1001.24,82,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1037.88,85,,percent of total billed charges,,305.26,1159.98,
SYNTHES SCREW LOCKING 1.5 X 15MM,30185502,CDM,,,278,RC,outpatient,,1221.03,1221.03,,1036.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,305.26,22,,percent of total billed charges,,,,,,,,,1098.93,90,,percent of total billed charges,,,1011.01,82.8,,percent of total billed charges,,,1037.88,85,,percent of total billed charges,,,,,,,,,1074.51,88,,percent of total billed charges,,,,,,,,,932.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,305.26,22,,percent of total billed charges,,,1111.14,91,,percent of total billed charges,,,1159.98,95,,percent of total billed charges,,,1013.45,83,,percent of total billed charges,,,1013.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1013.45,83,,percent of total billed charges,,,1159.98,95,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1001.24,82,,percent of total billed charges,,,1098.93,90,,percent of total billed charges,,,1037.88,85,,percent of total billed charges,,305.26,1159.98,
DEPUY IRRISEPT WOUND RINSE,30185503,CDM,,,270,RC,outpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,105,22,,percent of total billed charges,,,,,,,,,378,90,,percent of total billed charges,,,347.76,82.8,,percent of total billed charges,,,357,85,,percent of total billed charges,,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,105,22,,percent of total billed charges,,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,105,399,
DEPUY CAP HIP POROUS GRIPTION TS CERAMIC,30185504,CDM,,,278,RC,outpatient,,56452.5,56452.5,,47928.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14113.13,22,,percent of total billed charges,,,,,,,,,50807.25,90,,percent of total billed charges,,,46742.67,82.8,,percent of total billed charges,,,47984.63,85,,percent of total billed charges,,,,,,,,,49678.2,88,,percent of total billed charges,,,,,,,,,43129.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14113.13,22,,percent of total billed charges,,,51371.78,91,,percent of total billed charges,,,53629.88,95,,percent of total billed charges,,,46855.58,83,,percent of total billed charges,,,46855.58,83,,percent of total billed charges,,,,,,,,,,,,,,,46855.58,83,,percent of total billed charges,,,53629.88,95,,percent of total billed charges,,,50807.25,90,,percent of total billed charges,,,50807.25,90,,percent of total billed charges,,,46291.05,82,,percent of total billed charges,,,50807.25,90,,percent of total billed charges,,,47984.63,85,,percent of total billed charges,,14113.13,53629.88,
DEPUY SMARTMIX CTS BOWL,30185505,CDM,,,270,RC,outpatient,,1176.5,1176.5,,998.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,294.13,22,,percent of total billed charges,,,,,,,,,1058.85,90,,percent of total billed charges,,,974.14,82.8,,percent of total billed charges,,,1000.03,85,,percent of total billed charges,,,,,,,,,1035.32,88,,percent of total billed charges,,,,,,,,,898.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,294.13,22,,percent of total billed charges,,,1070.62,91,,percent of total billed charges,,,1117.68,95,,percent of total billed charges,,,976.5,83,,percent of total billed charges,,,976.5,83,,percent of total billed charges,,,,,,,,,,,,,,,976.5,83,,percent of total billed charges,,,1117.68,95,,percent of total billed charges,,,1058.85,90,,percent of total billed charges,,,1058.85,90,,percent of total billed charges,,,964.73,82,,percent of total billed charges,,,1058.85,90,,percent of total billed charges,,,1000.03,85,,percent of total billed charges,,294.13,1117.68,
S&N JOURNEY UNI TIBINRT S1-2LM/RL10MM,30185506,CDM,,,270,RC,outpatient,,5988.26,5988.26,,5084.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1497.07,22,,percent of total billed charges,,,,,,,,,5389.43,90,,percent of total billed charges,,,4958.28,82.8,,percent of total billed charges,,,5090.02,85,,percent of total billed charges,,,,,,,,,5269.67,88,,percent of total billed charges,,,,,,,,,4575.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1497.07,22,,percent of total billed charges,,,5449.32,91,,percent of total billed charges,,,5688.85,95,,percent of total billed charges,,,4970.26,83,,percent of total billed charges,,,4970.26,83,,percent of total billed charges,,,,,,,,,,,,,,,4970.26,83,,percent of total billed charges,,,5688.85,95,,percent of total billed charges,,,5389.43,90,,percent of total billed charges,,,5389.43,90,,percent of total billed charges,,,4910.37,82,,percent of total billed charges,,,5389.43,90,,percent of total billed charges,,,5090.02,85,,percent of total billed charges,,1497.07,5688.85,
S&N JUNI OX FB FEM SZ 3 LM RL,30185507,CDM,,,278,RC,outpatient,,23770.44,23770.44,,20181.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5942.61,22,,percent of total billed charges,,,,,,,,,21393.4,90,,percent of total billed charges,,,19681.92,82.8,,percent of total billed charges,,,20204.87,85,,percent of total billed charges,,,,,,,,,20917.99,88,,percent of total billed charges,,,,,,,,,18160.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5942.61,22,,percent of total billed charges,,,21631.1,91,,percent of total billed charges,,,22581.92,95,,percent of total billed charges,,,19729.47,83,,percent of total billed charges,,,19729.47,83,,percent of total billed charges,,,,,,,,,,,,,,,19729.47,83,,percent of total billed charges,,,22581.92,95,,percent of total billed charges,,,21393.4,90,,percent of total billed charges,,,21393.4,90,,percent of total billed charges,,,19491.76,82,,percent of total billed charges,,,21393.4,90,,percent of total billed charges,,,20204.87,85,,percent of total billed charges,,5942.61,22581.92,
S&N JRNY UNI TIBIAL BASE LM/RL SZ 2,30185508,CDM,,,278,RC,outpatient,,11374.09,11374.09,,9656.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2843.52,22,,percent of total billed charges,,,,,,,,,10236.68,90,,percent of total billed charges,,,9417.75,82.8,,percent of total billed charges,,,9667.98,85,,percent of total billed charges,,,,,,,,,10009.2,88,,percent of total billed charges,,,,,,,,,8689.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2843.52,22,,percent of total billed charges,,,10350.42,91,,percent of total billed charges,,,10805.39,95,,percent of total billed charges,,,9440.49,83,,percent of total billed charges,,,9440.49,83,,percent of total billed charges,,,,,,,,,,,,,,,9440.49,83,,percent of total billed charges,,,10805.39,95,,percent of total billed charges,,,10236.68,90,,percent of total billed charges,,,10236.68,90,,percent of total billed charges,,,9326.75,82,,percent of total billed charges,,,10236.68,90,,percent of total billed charges,,,9667.98,85,,percent of total billed charges,,2843.52,10805.39,
COBLATOR II WAND PROCISE EZ,30185509,CDM,,,270,RC,outpatient,,1930.5,1930.5,,1638.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,482.63,22,,percent of total billed charges,,,,,,,,,1737.45,90,,percent of total billed charges,,,1598.45,82.8,,percent of total billed charges,,,1640.93,85,,percent of total billed charges,,,,,,,,,1698.84,88,,percent of total billed charges,,,,,,,,,1474.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,482.63,22,,percent of total billed charges,,,1756.76,91,,percent of total billed charges,,,1833.98,95,,percent of total billed charges,,,1602.32,83,,percent of total billed charges,,,1602.32,83,,percent of total billed charges,,,,,,,,,,,,,,,1602.32,83,,percent of total billed charges,,,1833.98,95,,percent of total billed charges,,,1737.45,90,,percent of total billed charges,,,1737.45,90,,percent of total billed charges,,,1583.01,82,,percent of total billed charges,,,1737.45,90,,percent of total billed charges,,,1640.93,85,,percent of total billed charges,,482.63,1833.98,
ARTHREX SCREW CANC. QCKFIX 3 X 36MM PT,30185510,CDM,,,270,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
ARTHREX SCREW COMPR 3.5 MINI 34MM FT,30185511,CDM,,,270,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
ARTHREX SCREW LO-PRO 3X22MM TI,30185512,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW VARIABLE LOCKING 3X14MM,30185513,CDM,,,278,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
ARTHREX SCREW VARIABLE LOCKING 3X18MM,30185514,CDM,,,278,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
BLADE RAD 60DEG,30185515,CDM,,,270,RC,outpatient,,1749.8,1749.8,,1485.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,437.45,22,,percent of total billed charges,,,,,,,,,1574.82,90,,percent of total billed charges,,,1448.83,82.8,,percent of total billed charges,,,1487.33,85,,percent of total billed charges,,,,,,,,,1539.82,88,,percent of total billed charges,,,,,,,,,1336.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,437.45,22,,percent of total billed charges,,,1592.32,91,,percent of total billed charges,,,1662.31,95,,percent of total billed charges,,,1452.33,83,,percent of total billed charges,,,1452.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1452.33,83,,percent of total billed charges,,,1662.31,95,,percent of total billed charges,,,1574.82,90,,percent of total billed charges,,,1574.82,90,,percent of total billed charges,,,1434.84,82,,percent of total billed charges,,,1574.82,90,,percent of total billed charges,,,1487.33,85,,percent of total billed charges,,437.45,1662.31,
ALLOSOURCE ILIUM 1/3RD WEDGE FROZEN,30185516,CDM,,,270,RC,outpatient,,12246,12246,,10396.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3061.5,22,,percent of total billed charges,,,,,,,,,11021.4,90,,percent of total billed charges,,,10139.69,82.8,,percent of total billed charges,,,10409.1,85,,percent of total billed charges,,,,,,,,,10776.48,88,,percent of total billed charges,,,,,,,,,9355.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3061.5,22,,percent of total billed charges,,,11143.86,91,,percent of total billed charges,,,11633.7,95,,percent of total billed charges,,,10164.18,83,,percent of total billed charges,,,10164.18,83,,percent of total billed charges,,,,,,,,,,,,,,,10164.18,83,,percent of total billed charges,,,11633.7,95,,percent of total billed charges,,,11021.4,90,,percent of total billed charges,,,11021.4,90,,percent of total billed charges,,,10041.72,82,,percent of total billed charges,,,11021.4,90,,percent of total billed charges,,,10409.1,85,,percent of total billed charges,,3061.5,11633.7,
SYNTHES TIBIAL NAIL 11MM X 360,30185517,CDM,,,278,RC,outpatient,,14552.85,14552.85,,12355.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3638.21,22,,percent of total billed charges,,,,,,,,,13097.57,90,,percent of total billed charges,,,12049.76,82.8,,percent of total billed charges,,,12369.92,85,,percent of total billed charges,,,,,,,,,12806.51,88,,percent of total billed charges,,,,,,,,,11118.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3638.21,22,,percent of total billed charges,,,13243.09,91,,percent of total billed charges,,,13825.21,95,,percent of total billed charges,,,12078.87,83,,percent of total billed charges,,,12078.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12078.87,83,,percent of total billed charges,,,13825.21,95,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,11933.34,82,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,12369.92,85,,percent of total billed charges,,3638.21,13825.21,
SYNTHES SCREW LOCKING 5.0 X 50MM,30185518,CDM,,,278,RC,outpatient,,1861.93,1861.93,,1580.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,465.48,22,,percent of total billed charges,,,,,,,,,1675.74,90,,percent of total billed charges,,,1541.68,82.8,,percent of total billed charges,,,1582.64,85,,percent of total billed charges,,,,,,,,,1638.5,88,,percent of total billed charges,,,,,,,,,1422.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,465.48,22,,percent of total billed charges,,,1694.36,91,,percent of total billed charges,,,1768.83,95,,percent of total billed charges,,,1545.4,83,,percent of total billed charges,,,1545.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1545.4,83,,percent of total billed charges,,,1768.83,95,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1526.78,82,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1582.64,85,,percent of total billed charges,,465.48,1768.83,
SYNTHES DRILL BIT CALIBRATED 4.3,30185519,CDM,,,278,RC,outpatient,,2281.83,2281.83,,1937.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,570.46,22,,percent of total billed charges,,,,,,,,,2053.65,90,,percent of total billed charges,,,1889.36,82.8,,percent of total billed charges,,,1939.56,85,,percent of total billed charges,,,,,,,,,2008.01,88,,percent of total billed charges,,,,,,,,,1743.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,570.46,22,,percent of total billed charges,,,2076.47,91,,percent of total billed charges,,,2167.74,95,,percent of total billed charges,,,1893.92,83,,percent of total billed charges,,,1893.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1893.92,83,,percent of total billed charges,,,2167.74,95,,percent of total billed charges,,,2053.65,90,,percent of total billed charges,,,2053.65,90,,percent of total billed charges,,,1871.1,82,,percent of total billed charges,,,2053.65,90,,percent of total billed charges,,,1939.56,85,,percent of total billed charges,,570.46,2167.74,
SYNTHES DRILL BIT 4.2,30185520,CDM,,,278,RC,outpatient,,1624.35,1624.35,,1379.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.09,22,,percent of total billed charges,,,,,,,,,1461.92,90,,percent of total billed charges,,,1344.96,82.8,,percent of total billed charges,,,1380.7,85,,percent of total billed charges,,,,,,,,,1429.43,88,,percent of total billed charges,,,,,,,,,1241,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.09,22,,percent of total billed charges,,,1478.16,91,,percent of total billed charges,,,1543.13,95,,percent of total billed charges,,,1348.21,83,,percent of total billed charges,,,1348.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.21,83,,percent of total billed charges,,,1543.13,95,,percent of total billed charges,,,1461.92,90,,percent of total billed charges,,,1461.92,90,,percent of total billed charges,,,1331.97,82,,percent of total billed charges,,,1461.92,90,,percent of total billed charges,,,1380.7,85,,percent of total billed charges,,406.09,1543.13,
ROD LORDORED 3.5 X 90MM,30185521,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
SYNTHES GUIDE WIRE 3.2MM,30185522,CDM,,,270,RC,outpatient,,984.75,984.75,,836.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,246.19,22,,percent of total billed charges,,,,,,,,,886.28,90,,percent of total billed charges,,,815.37,82.8,,percent of total billed charges,,,837.04,85,,percent of total billed charges,,,,,,,,,866.58,88,,percent of total billed charges,,,,,,,,,752.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,246.19,22,,percent of total billed charges,,,896.12,91,,percent of total billed charges,,,935.51,95,,percent of total billed charges,,,817.34,83,,percent of total billed charges,,,817.34,83,,percent of total billed charges,,,,,,,,,,,,,,,817.34,83,,percent of total billed charges,,,935.51,95,,percent of total billed charges,,,886.28,90,,percent of total billed charges,,,886.28,90,,percent of total billed charges,,,807.5,82,,percent of total billed charges,,,886.28,90,,percent of total billed charges,,,837.04,85,,percent of total billed charges,,246.19,935.51,
SYNTHES HELICAL BLADE 105MM,30185523,CDM,,,278,RC,outpatient,,7033.78,7033.78,,5971.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1758.45,22,,percent of total billed charges,,,,,,,,,6330.4,90,,percent of total billed charges,,,5823.97,82.8,,percent of total billed charges,,,5978.71,85,,percent of total billed charges,,,,,,,,,6189.73,88,,percent of total billed charges,,,,,,,,,5373.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1758.45,22,,percent of total billed charges,,,6400.74,91,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,,,,,,,,,,,,,5838.04,83,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5767.7,82,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5978.71,85,,percent of total billed charges,,1758.45,6682.09,
SYNTHES INJECTION CANNULA,30185524,CDM,,,278,RC,outpatient,,3699.02,3699.02,,3140.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,924.76,22,,percent of total billed charges,,,,,,,,,3329.12,90,,percent of total billed charges,,,3062.79,82.8,,percent of total billed charges,,,3144.17,85,,percent of total billed charges,,,,,,,,,3255.14,88,,percent of total billed charges,,,,,,,,,2826.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,924.76,22,,percent of total billed charges,,,3366.11,91,,percent of total billed charges,,,3514.07,95,,percent of total billed charges,,,3070.19,83,,percent of total billed charges,,,3070.19,83,,percent of total billed charges,,,,,,,,,,,,,,,3070.19,83,,percent of total billed charges,,,3514.07,95,,percent of total billed charges,,,3329.12,90,,percent of total billed charges,,,3329.12,90,,percent of total billed charges,,,3033.2,82,,percent of total billed charges,,,3329.12,90,,percent of total billed charges,,,3144.17,85,,percent of total billed charges,,924.76,3514.07,
SYNTHES CEMENT TRAUMACEM V+,30185525,CDM,,,278,RC,outpatient,,4097.34,4097.34,,3478.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1024.34,22,,percent of total billed charges,,,,,,,,,3687.61,90,,percent of total billed charges,,,3392.6,82.8,,percent of total billed charges,,,3482.74,85,,percent of total billed charges,,,,,,,,,3605.66,88,,percent of total billed charges,,,,,,,,,3130.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1024.34,22,,percent of total billed charges,,,3728.58,91,,percent of total billed charges,,,3892.47,95,,percent of total billed charges,,,3400.79,83,,percent of total billed charges,,,3400.79,83,,percent of total billed charges,,,,,,,,,,,,,,,3400.79,83,,percent of total billed charges,,,3892.47,95,,percent of total billed charges,,,3687.61,90,,percent of total billed charges,,,3687.61,90,,percent of total billed charges,,,3359.82,82,,percent of total billed charges,,,3687.61,90,,percent of total billed charges,,,3482.74,85,,percent of total billed charges,,1024.34,3892.47,
SYNTHES SYRINGE KIT TRAUMACEM V+,30185526,CDM,,,278,RC,outpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,390,22,,percent of total billed charges,,,,,,,,,1404,90,,percent of total billed charges,,,1291.68,82.8,,percent of total billed charges,,,1326,85,,percent of total billed charges,,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,390,22,,percent of total billed charges,,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,390,1482,
CHOICE SPINE SCREW 4.0 X 16MM,30185527,CDM,,,278,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
CHOICE SPINE SCREW 4.5 X 16MM,30185528,CDM,,,278,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
ZIMMER TIBIAL TRAY SZ A LM/RL OXF PMA,30185529,CDM,,,278,RC,outpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3388.13,22,,percent of total billed charges,,,,,,,,,12197.25,90,,percent of total billed charges,,,11221.47,82.8,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3388.13,22,,percent of total billed charges,,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,3388.13,12874.88,
IMPLANET JEZZ BAND,30185530,CDM,,,278,RC,outpatient,,5720,5720,,4856.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1430,22,,percent of total billed charges,,,,,,,,,5148,90,,percent of total billed charges,,,4736.16,82.8,,percent of total billed charges,,,4862,85,,percent of total billed charges,,,,,,,,,5033.6,88,,percent of total billed charges,,,,,,,,,4370.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1430,22,,percent of total billed charges,,,5205.2,91,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4747.6,83,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4690.4,82,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4862,85,,percent of total billed charges,,1430,5434,
IMPLANET JEZZ LOCK,30185531,CDM,,,278,RC,outpatient,,18850,18850,,16003.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4712.5,22,,percent of total billed charges,,,,,,,,,16965,90,,percent of total billed charges,,,15607.8,82.8,,percent of total billed charges,,,16022.5,85,,percent of total billed charges,,,,,,,,,16588,88,,percent of total billed charges,,,,,,,,,14401.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4712.5,22,,percent of total billed charges,,,17153.5,91,,percent of total billed charges,,,17907.5,95,,percent of total billed charges,,,15645.5,83,,percent of total billed charges,,,15645.5,83,,percent of total billed charges,,,,,,,,,,,,,,,15645.5,83,,percent of total billed charges,,,17907.5,95,,percent of total billed charges,,,16965,90,,percent of total billed charges,,,16965,90,,percent of total billed charges,,,15457,82,,percent of total billed charges,,,16965,90,,percent of total billed charges,,,16022.5,85,,percent of total billed charges,,4712.5,17907.5,
INFUSE LARGE BONE GRAFT KIT,30185532,CDM,,,278,RC,outpatient,,42705,42705,,36256.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10676.25,22,,percent of total billed charges,,,,,,,,,38434.5,90,,percent of total billed charges,,,35359.74,82.8,,percent of total billed charges,,,36299.25,85,,percent of total billed charges,,,,,,,,,37580.4,88,,percent of total billed charges,,,,,,,,,32626.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10676.25,22,,percent of total billed charges,,,38861.55,91,,percent of total billed charges,,,40569.75,95,,percent of total billed charges,,,35445.15,83,,percent of total billed charges,,,35445.15,83,,percent of total billed charges,,,,,,,,,,,,,,,35445.15,83,,percent of total billed charges,,,40569.75,95,,percent of total billed charges,,,38434.5,90,,percent of total billed charges,,,38434.5,90,,percent of total billed charges,,,35018.1,82,,percent of total billed charges,,,38434.5,90,,percent of total billed charges,,,36299.25,85,,percent of total billed charges,,10676.25,40569.75,
DEPUY INSERT STAB RP 15MM SZ4,30185533,CDM,,,278,RC,outpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3253.11,22,,percent of total billed charges,,,,,,,,,11711.18,90,,percent of total billed charges,,,10774.28,82.8,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3253.11,22,,percent of total billed charges,,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,3253.11,12361.8,
STRYKER RENTAL HIP INSTRUMENTS,30185534,CDM,,,270,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
STRYKER RENTAL HIP ACCESS TRAY,30185535,CDM,,,270,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
DEPUY INSERT FB PLUS SZ. 2.5 15MM,30185537,CDM,,,278,RC,outpatient,,17187.04,17187.04,,14591.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4296.76,22,,percent of total billed charges,,,,,,,,,15468.34,90,,percent of total billed charges,,,14230.87,82.8,,percent of total billed charges,,,14608.98,85,,percent of total billed charges,,,,,,,,,15124.6,88,,percent of total billed charges,,,,,,,,,13130.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4296.76,22,,percent of total billed charges,,,15640.21,91,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,,,,,,,,,,,,,14265.24,83,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14093.37,82,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14608.98,85,,percent of total billed charges,,4296.76,16327.69,
SYNTHES NAIL TIBIAL TI 10X300,30185538,CDM,,,278,RC,outpatient,,14552.85,14552.85,,12355.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3638.21,22,,percent of total billed charges,,,,,,,,,13097.57,90,,percent of total billed charges,,,12049.76,82.8,,percent of total billed charges,,,12369.92,85,,percent of total billed charges,,,,,,,,,12806.51,88,,percent of total billed charges,,,,,,,,,11118.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3638.21,22,,percent of total billed charges,,,13243.09,91,,percent of total billed charges,,,13825.21,95,,percent of total billed charges,,,12078.87,83,,percent of total billed charges,,,12078.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12078.87,83,,percent of total billed charges,,,13825.21,95,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,11933.34,82,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,12369.92,85,,percent of total billed charges,,3638.21,13825.21,
SYNTHES SCREW DUAL CORE 5 X 30MM,30185539,CDM,,,278,RC,outpatient,,1861.93,1861.93,,1580.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,465.48,22,,percent of total billed charges,,,,,,,,,1675.74,90,,percent of total billed charges,,,1541.68,82.8,,percent of total billed charges,,,1582.64,85,,percent of total billed charges,,,,,,,,,1638.5,88,,percent of total billed charges,,,,,,,,,1422.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,465.48,22,,percent of total billed charges,,,1694.36,91,,percent of total billed charges,,,1768.83,95,,percent of total billed charges,,,1545.4,83,,percent of total billed charges,,,1545.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1545.4,83,,percent of total billed charges,,,1768.83,95,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1526.78,82,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1582.64,85,,percent of total billed charges,,465.48,1768.83,
SYNTHES SCREW DUAL CORE 5 X 35MM,30185540,CDM,,,278,RC,outpatient,,1861.93,1861.93,,1580.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,465.48,22,,percent of total billed charges,,,,,,,,,1675.74,90,,percent of total billed charges,,,1541.68,82.8,,percent of total billed charges,,,1582.64,85,,percent of total billed charges,,,,,,,,,1638.5,88,,percent of total billed charges,,,,,,,,,1422.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,465.48,22,,percent of total billed charges,,,1694.36,91,,percent of total billed charges,,,1768.83,95,,percent of total billed charges,,,1545.4,83,,percent of total billed charges,,,1545.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1545.4,83,,percent of total billed charges,,,1768.83,95,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1526.78,82,,percent of total billed charges,,,1675.74,90,,percent of total billed charges,,,1582.64,85,,percent of total billed charges,,465.48,1768.83,
SYNTHES SCREW LOCKING 5 X 26MM,30185541,CDM,,,278,RC,outpatient,,1640.93,1640.93,,1393.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,410.23,22,,percent of total billed charges,,,,,,,,,1476.84,90,,percent of total billed charges,,,1358.69,82.8,,percent of total billed charges,,,1394.79,85,,percent of total billed charges,,,,,,,,,1444.02,88,,percent of total billed charges,,,,,,,,,1253.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,410.23,22,,percent of total billed charges,,,1493.25,91,,percent of total billed charges,,,1558.88,95,,percent of total billed charges,,,1361.97,83,,percent of total billed charges,,,1361.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1361.97,83,,percent of total billed charges,,,1558.88,95,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1345.56,82,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1394.79,85,,percent of total billed charges,,410.23,1558.88,
SYNTHES SCREW LOCKING 4.0 X 34MM,30185542,CDM,,,278,RC,outpatient,,1740.83,1740.83,,1477.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,435.21,22,,percent of total billed charges,,,,,,,,,1566.75,90,,percent of total billed charges,,,1441.41,82.8,,percent of total billed charges,,,1479.71,85,,percent of total billed charges,,,,,,,,,1531.93,88,,percent of total billed charges,,,,,,,,,1329.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,435.21,22,,percent of total billed charges,,,1584.16,91,,percent of total billed charges,,,1653.79,95,,percent of total billed charges,,,1444.89,83,,percent of total billed charges,,,1444.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.89,83,,percent of total billed charges,,,1653.79,95,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1427.48,82,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1479.71,85,,percent of total billed charges,,435.21,1653.79,
SYNTHES PROTECTION SLEEVE 12.0,30185543,CDM,,,270,RC,outpatient,,1016.6,1016.6,,863.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,254.15,22,,percent of total billed charges,,,,,,,,,914.94,90,,percent of total billed charges,,,841.74,82.8,,percent of total billed charges,,,864.11,85,,percent of total billed charges,,,,,,,,,894.61,88,,percent of total billed charges,,,,,,,,,776.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,254.15,22,,percent of total billed charges,,,925.11,91,,percent of total billed charges,,,965.77,95,,percent of total billed charges,,,843.78,83,,percent of total billed charges,,,843.78,83,,percent of total billed charges,,,,,,,,,,,,,,,843.78,83,,percent of total billed charges,,,965.77,95,,percent of total billed charges,,,914.94,90,,percent of total billed charges,,,914.94,90,,percent of total billed charges,,,833.61,82,,percent of total billed charges,,,914.94,90,,percent of total billed charges,,,864.11,85,,percent of total billed charges,,254.15,965.77,
MEDTRONIC AZURE DR MRI SURESCAN,30185544,CDM,,,278,RC,outpatient,,46949.11,46949.11,,39859.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11737.28,22,,percent of total billed charges,,,,,,,,,42254.2,90,,percent of total billed charges,,,38873.86,82.8,,percent of total billed charges,,,39906.74,85,,percent of total billed charges,,,,,,,,,41315.22,88,,percent of total billed charges,,,,,,,,,35869.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11737.28,22,,percent of total billed charges,,,42723.69,91,,percent of total billed charges,,,44601.65,95,,percent of total billed charges,,,38967.76,83,,percent of total billed charges,,,38967.76,83,,percent of total billed charges,,,,,,,,,,,,,,,38967.76,83,,percent of total billed charges,,,44601.65,95,,percent of total billed charges,,,42254.2,90,,percent of total billed charges,,,42254.2,90,,percent of total billed charges,,,38498.27,82,,percent of total billed charges,,,42254.2,90,,percent of total billed charges,,,39906.74,85,,percent of total billed charges,,11737.28,44601.65,
INFUSE SMALL BONE GRAFT KIT,30185546,CDM,,,278,RC,outpatient,,24017.5,24017.5,,20390.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6004.38,22,,percent of total billed charges,,,,,,,,,21615.75,90,,percent of total billed charges,,,19886.49,82.8,,percent of total billed charges,,,20414.88,85,,percent of total billed charges,,,,,,,,,21135.4,88,,percent of total billed charges,,,,,,,,,18349.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6004.38,22,,percent of total billed charges,,,21855.93,91,,percent of total billed charges,,,22816.63,95,,percent of total billed charges,,,19934.53,83,,percent of total billed charges,,,19934.53,83,,percent of total billed charges,,,,,,,,,,,,,,,19934.53,83,,percent of total billed charges,,,22816.63,95,,percent of total billed charges,,,21615.75,90,,percent of total billed charges,,,21615.75,90,,percent of total billed charges,,,19694.35,82,,percent of total billed charges,,,21615.75,90,,percent of total billed charges,,,20414.88,85,,percent of total billed charges,,6004.38,22816.63,
ALPHATEC ROD MIS 45MM,30185547,CDM,,,278,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
SYNTHES SCREW CORTEX 20 X 2.4MM STERILE,30185548,CDM,,,278,RC,outpatient,,827.05,827.05,,702.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.76,22,,percent of total billed charges,,,,,,,,,744.35,90,,percent of total billed charges,,,684.8,82.8,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,,,,,,,,727.8,88,,percent of total billed charges,,,,,,,,,631.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.76,22,,percent of total billed charges,,,752.62,91,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,,,,,,,,,,,,,686.45,83,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,678.18,82,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,206.76,785.7,
SYNTHES PLATE LAT EXT 4 HOLE LT SUP ANT,30185549,CDM,,,278,RC,outpatient,,9259.9,9259.9,,7861.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2314.98,22,,percent of total billed charges,,,,,,,,,8333.91,90,,percent of total billed charges,,,7667.2,82.8,,percent of total billed charges,,,7870.92,85,,percent of total billed charges,,,,,,,,,8148.71,88,,percent of total billed charges,,,,,,,,,7074.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2314.98,22,,percent of total billed charges,,,8426.51,91,,percent of total billed charges,,,8796.91,95,,percent of total billed charges,,,7685.72,83,,percent of total billed charges,,,7685.72,83,,percent of total billed charges,,,,,,,,,,,,,,,7685.72,83,,percent of total billed charges,,,8796.91,95,,percent of total billed charges,,,8333.91,90,,percent of total billed charges,,,8333.91,90,,percent of total billed charges,,,7593.12,82,,percent of total billed charges,,,8333.91,90,,percent of total billed charges,,,7870.92,85,,percent of total billed charges,,2314.98,8796.91,
ZIMMER BEARING LEFT MEDIAL SMALL SZ 3,30185550,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
MENTOR TISSUE EXPANDER CPX4 MED. 350CC,30185551,CDM,,,278,RC,outpatient,,10172.5,10172.5,,8636.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2543.13,22,,percent of total billed charges,,,,,,,,,9155.25,90,,percent of total billed charges,,,8422.83,82.8,,percent of total billed charges,,,8646.63,85,,percent of total billed charges,,,,,,,,,8951.8,88,,percent of total billed charges,,,,,,,,,7771.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2543.13,22,,percent of total billed charges,,,9256.98,91,,percent of total billed charges,,,9663.88,95,,percent of total billed charges,,,8443.18,83,,percent of total billed charges,,,8443.18,83,,percent of total billed charges,,,,,,,,,,,,,,,8443.18,83,,percent of total billed charges,,,9663.88,95,,percent of total billed charges,,,9155.25,90,,percent of total billed charges,,,9155.25,90,,percent of total billed charges,,,8341.45,82,,percent of total billed charges,,,9155.25,90,,percent of total billed charges,,,8646.63,85,,percent of total billed charges,,2543.13,9663.88,
MESH VENTRALIGHT STD 4X6,30185552,CDM,,,278,RC,outpatient,,3714.1,3714.1,,3153.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,928.53,22,,percent of total billed charges,,,,,,,,,3342.69,90,,percent of total billed charges,,,3075.27,82.8,,percent of total billed charges,,,3156.99,85,,percent of total billed charges,,,,,,,,,3268.41,88,,percent of total billed charges,,,,,,,,,2837.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,928.53,22,,percent of total billed charges,,,3379.83,91,,percent of total billed charges,,,3528.4,95,,percent of total billed charges,,,3082.7,83,,percent of total billed charges,,,3082.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3082.7,83,,percent of total billed charges,,,3528.4,95,,percent of total billed charges,,,3342.69,90,,percent of total billed charges,,,3342.69,90,,percent of total billed charges,,,3045.56,82,,percent of total billed charges,,,3342.69,90,,percent of total billed charges,,,3156.99,85,,percent of total billed charges,,928.53,3528.4,
MESH VENTRALIGHT ST 6IN,30185553,CDM,,,278,RC,outpatient,,7039.5,7039.5,,5976.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1759.88,22,,percent of total billed charges,,,,,,,,,6335.55,90,,percent of total billed charges,,,5828.71,82.8,,percent of total billed charges,,,5983.58,85,,percent of total billed charges,,,,,,,,,6194.76,88,,percent of total billed charges,,,,,,,,,5378.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1759.88,22,,percent of total billed charges,,,6405.95,91,,percent of total billed charges,,,6687.53,95,,percent of total billed charges,,,5842.79,83,,percent of total billed charges,,,5842.79,83,,percent of total billed charges,,,,,,,,,,,,,,,5842.79,83,,percent of total billed charges,,,6687.53,95,,percent of total billed charges,,,6335.55,90,,percent of total billed charges,,,6335.55,90,,percent of total billed charges,,,5772.39,82,,percent of total billed charges,,,6335.55,90,,percent of total billed charges,,,5983.58,85,,percent of total billed charges,,1759.88,6687.53,
MESH BARD 1X4,30185554,CDM,,,278,RC,outpatient,,518.7,518.7,,440.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,129.68,22,,percent of total billed charges,,,,,,,,,466.83,90,,percent of total billed charges,,,429.48,82.8,,percent of total billed charges,,,440.9,85,,percent of total billed charges,,,,,,,,,456.46,88,,percent of total billed charges,,,,,,,,,396.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,129.68,22,,percent of total billed charges,,,472.02,91,,percent of total billed charges,,,492.77,95,,percent of total billed charges,,,430.52,83,,percent of total billed charges,,,430.52,83,,percent of total billed charges,,,,,,,,,,,,,,,430.52,83,,percent of total billed charges,,,492.77,95,,percent of total billed charges,,,466.83,90,,percent of total billed charges,,,466.83,90,,percent of total billed charges,,,425.33,82,,percent of total billed charges,,,466.83,90,,percent of total billed charges,,,440.9,85,,percent of total billed charges,,129.68,492.77,
MESH BARD 3X6,30185555,CDM,,,278,RC,outpatient,,719.6,719.6,,610.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,179.9,22,,percent of total billed charges,,,,,,,,,647.64,90,,percent of total billed charges,,,595.83,82.8,,percent of total billed charges,,,611.66,85,,percent of total billed charges,,,,,,,,,633.25,88,,percent of total billed charges,,,,,,,,,549.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,179.9,22,,percent of total billed charges,,,654.84,91,,percent of total billed charges,,,683.62,95,,percent of total billed charges,,,597.27,83,,percent of total billed charges,,,597.27,83,,percent of total billed charges,,,,,,,,,,,,,,,597.27,83,,percent of total billed charges,,,683.62,95,,percent of total billed charges,,,647.64,90,,percent of total billed charges,,,647.64,90,,percent of total billed charges,,,590.07,82,,percent of total billed charges,,,647.64,90,,percent of total billed charges,,,611.66,85,,percent of total billed charges,,179.9,683.62,
MESH BARD 6X6,30185556,CDM,,,278,RC,outpatient,,613.2,613.2,,520.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153.3,22,,percent of total billed charges,,,,,,,,,551.88,90,,percent of total billed charges,,,507.73,82.8,,percent of total billed charges,,,521.22,85,,percent of total billed charges,,,,,,,,,539.62,88,,percent of total billed charges,,,,,,,,,468.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153.3,22,,percent of total billed charges,,,558.01,91,,percent of total billed charges,,,582.54,95,,percent of total billed charges,,,508.96,83,,percent of total billed charges,,,508.96,83,,percent of total billed charges,,,,,,,,,,,,,,,508.96,83,,percent of total billed charges,,,582.54,95,,percent of total billed charges,,,551.88,90,,percent of total billed charges,,,551.88,90,,percent of total billed charges,,,502.82,82,,percent of total billed charges,,,551.88,90,,percent of total billed charges,,,521.22,85,,percent of total billed charges,,153.3,582.54,
MESH PERFIX PLUG X-LARGE,30185557,CDM,,,278,RC,outpatient,,1379.95,1379.95,,1171.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,344.99,22,,percent of total billed charges,,,,,,,,,1241.96,90,,percent of total billed charges,,,1142.6,82.8,,percent of total billed charges,,,1172.96,85,,percent of total billed charges,,,,,,,,,1214.36,88,,percent of total billed charges,,,,,,,,,1054.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,344.99,22,,percent of total billed charges,,,1255.75,91,,percent of total billed charges,,,1310.95,95,,percent of total billed charges,,,1145.36,83,,percent of total billed charges,,,1145.36,83,,percent of total billed charges,,,,,,,,,,,,,,,1145.36,83,,percent of total billed charges,,,1310.95,95,,percent of total billed charges,,,1241.96,90,,percent of total billed charges,,,1241.96,90,,percent of total billed charges,,,1131.56,82,,percent of total billed charges,,,1241.96,90,,percent of total billed charges,,,1172.96,85,,percent of total billed charges,,344.99,1310.95,
DEPUY BODY ANATOMIC PROXIMAL SZ 14,30185558,CDM,,,278,RC,outpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3163.67,22,,percent of total billed charges,,,,,,,,,11389.19,90,,percent of total billed charges,,,10478.06,82.8,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3163.67,22,,percent of total billed charges,,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,3163.67,12021.93,
DEPUY STEM GLOBAL UNITE SZ 14,30185559,CDM,,,278,RC,outpatient,,26023.86,26023.86,,22094.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6505.97,22,,percent of total billed charges,,,,,,,,,23421.47,90,,percent of total billed charges,,,21547.76,82.8,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,,,,,,,,22901,88,,percent of total billed charges,,,,,,,,,19882.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6505.97,22,,percent of total billed charges,,,23681.71,91,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21599.8,83,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,21339.57,82,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,6505.97,24722.67,
ZIMMER PLATE STEMMED TIBIAL SZ 5,30185560,CDM,,,278,RC,outpatient,,23205,23205,,19701.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5801.25,22,,percent of total billed charges,,,,,,,,,20884.5,90,,percent of total billed charges,,,19213.74,82.8,,percent of total billed charges,,,19724.25,85,,percent of total billed charges,,,,,,,,,20420.4,88,,percent of total billed charges,,,,,,,,,17728.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5801.25,22,,percent of total billed charges,,,21116.55,91,,percent of total billed charges,,,22044.75,95,,percent of total billed charges,,,19260.15,83,,percent of total billed charges,,,19260.15,83,,percent of total billed charges,,,,,,,,,,,,,,,19260.15,83,,percent of total billed charges,,,22044.75,95,,percent of total billed charges,,,20884.5,90,,percent of total billed charges,,,20884.5,90,,percent of total billed charges,,,19028.1,82,,percent of total billed charges,,,20884.5,90,,percent of total billed charges,,,19724.25,85,,percent of total billed charges,,5801.25,22044.75,
ZIMMER AUGMENT TIBIAL FULL BLOCK SZ 5,30185561,CDM,,,278,RC,outpatient,,17615,17615,,14955.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4403.75,22,,percent of total billed charges,,,,,,,,,15853.5,90,,percent of total billed charges,,,14585.22,82.8,,percent of total billed charges,,,14972.75,85,,percent of total billed charges,,,,,,,,,15501.2,88,,percent of total billed charges,,,,,,,,,13457.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4403.75,22,,percent of total billed charges,,,16029.65,91,,percent of total billed charges,,,16734.25,95,,percent of total billed charges,,,14620.45,83,,percent of total billed charges,,,14620.45,83,,percent of total billed charges,,,,,,,,,,,,,,,14620.45,83,,percent of total billed charges,,,16734.25,95,,percent of total billed charges,,,15853.5,90,,percent of total billed charges,,,15853.5,90,,percent of total billed charges,,,14444.3,82,,percent of total billed charges,,,15853.5,90,,percent of total billed charges,,,14972.75,85,,percent of total billed charges,,4403.75,16734.25,
ZIMMER INSERT LPS 10M SZ E/F,30185562,CDM,,,278,RC,outpatient,,16575,16575,,14072.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4143.75,22,,percent of total billed charges,,,,,,,,,14917.5,90,,percent of total billed charges,,,13724.1,82.8,,percent of total billed charges,,,14088.75,85,,percent of total billed charges,,,,,,,,,14586,88,,percent of total billed charges,,,,,,,,,12663.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4143.75,22,,percent of total billed charges,,,15083.25,91,,percent of total billed charges,,,15746.25,95,,percent of total billed charges,,,13757.25,83,,percent of total billed charges,,,13757.25,83,,percent of total billed charges,,,,,,,,,,,,,,,13757.25,83,,percent of total billed charges,,,15746.25,95,,percent of total billed charges,,,14917.5,90,,percent of total billed charges,,,14917.5,90,,percent of total billed charges,,,13591.5,82,,percent of total billed charges,,,14917.5,90,,percent of total billed charges,,,14088.75,85,,percent of total billed charges,,4143.75,15746.25,
STRYKER PRECISION BLADE FALCON,30185563,CDM,,,270,RC,outpatient,,3048.5,3048.5,,2588.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,762.13,22,,percent of total billed charges,,,,,,,,,2743.65,90,,percent of total billed charges,,,2524.16,82.8,,percent of total billed charges,,,2591.23,85,,percent of total billed charges,,,,,,,,,2682.68,88,,percent of total billed charges,,,,,,,,,2329.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,762.13,22,,percent of total billed charges,,,2774.14,91,,percent of total billed charges,,,2896.08,95,,percent of total billed charges,,,2530.26,83,,percent of total billed charges,,,2530.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2530.26,83,,percent of total billed charges,,,2896.08,95,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2499.77,82,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2591.23,85,,percent of total billed charges,,762.13,2896.08,
CHOICE SPINE PLATE 2-LEVEL 34MM,30185564,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
CHOICE SPINE PLATE 2-LEVEL 32MM,30185565,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
NEEDLE BMA MAXX REGEN BONE MARROW ASPIRA,30185566,CDM,,,278,RC,outpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2437.5,22,,percent of total billed charges,,,,,,,,,8775,90,,percent of total billed charges,,,8073,82.8,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2437.5,22,,percent of total billed charges,,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,2437.5,9262.5,
DEPUY STEM ENDWANU SZ 3 300MM,30185567,CDM,,,278,RC,outpatient,,35499.75,35499.75,,30139.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8874.94,22,,percent of total billed charges,,,,,,,,,31949.78,90,,percent of total billed charges,,,29393.79,82.8,,percent of total billed charges,,,30174.79,85,,percent of total billed charges,,,,,,,,,31239.78,88,,percent of total billed charges,,,,,,,,,27121.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8874.94,22,,percent of total billed charges,,,32304.77,91,,percent of total billed charges,,,33724.76,95,,percent of total billed charges,,,29464.79,83,,percent of total billed charges,,,29464.79,83,,percent of total billed charges,,,,,,,,,,,,,,,29464.79,83,,percent of total billed charges,,,33724.76,95,,percent of total billed charges,,,31949.78,90,,percent of total billed charges,,,31949.78,90,,percent of total billed charges,,,29109.8,82,,percent of total billed charges,,,31949.78,90,,percent of total billed charges,,,30174.79,85,,percent of total billed charges,,8874.94,33724.76,
ZIMMER DRILL BIT 2.7MM PERIPHERAL,30185568,CDM,,,270,RC,outpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,503.75,22,,percent of total billed charges,,,,,,,,,1813.5,90,,percent of total billed charges,,,1668.42,82.8,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,503.75,22,,percent of total billed charges,,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,503.75,1914.25,
ZIMMER PIN STEINMANN 9IN,30185569,CDM,,,278,RC,outpatient,,1885,1885,,1600.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,471.25,22,,percent of total billed charges,,,,,,,,,1696.5,90,,percent of total billed charges,,,1560.78,82.8,,percent of total billed charges,,,1602.25,85,,percent of total billed charges,,,,,,,,,1658.8,88,,percent of total billed charges,,,,,,,,,1440.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,471.25,22,,percent of total billed charges,,,1715.35,91,,percent of total billed charges,,,1790.75,95,,percent of total billed charges,,,1564.55,83,,percent of total billed charges,,,1564.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1564.55,83,,percent of total billed charges,,,1790.75,95,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1545.7,82,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1602.25,85,,percent of total billed charges,,471.25,1790.75,
ZIMMER DRILL BIT 302MM CENTER,30185570,CDM,,,270,RC,outpatient,,1430,1430,,1214.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,357.5,22,,percent of total billed charges,,,,,,,,,1287,90,,percent of total billed charges,,,1184.04,82.8,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,,,,,,,,1258.4,88,,percent of total billed charges,,,,,,,,,1092.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,357.5,22,,percent of total billed charges,,,1301.3,91,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1186.9,83,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1172.6,82,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,357.5,1358.5,
ZIMMER GLENISPHERE TITANIUM 36MM,30185571,CDM,,,278,RC,outpatient,,27755,27755,,23564,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6938.75,22,,percent of total billed charges,,,,,,,,,24979.5,90,,percent of total billed charges,,,22981.14,82.8,,percent of total billed charges,,,23591.75,85,,percent of total billed charges,,,,,,,,,24424.4,88,,percent of total billed charges,,,,,,,,,21204.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6938.75,22,,percent of total billed charges,,,25257.05,91,,percent of total billed charges,,,26367.25,95,,percent of total billed charges,,,23036.65,83,,percent of total billed charges,,,23036.65,83,,percent of total billed charges,,,,,,,,,,,,,,,23036.65,83,,percent of total billed charges,,,26367.25,95,,percent of total billed charges,,,24979.5,90,,percent of total billed charges,,,24979.5,90,,percent of total billed charges,,,22759.1,82,,percent of total billed charges,,,24979.5,90,,percent of total billed charges,,,23591.75,85,,percent of total billed charges,,6938.75,26367.25,
ZIMMER SCREW LOCKING 4.75 X 35MM,30185572,CDM,,,278,RC,outpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,455,22,,percent of total billed charges,,,,,,,,,1638,90,,percent of total billed charges,,,1506.96,82.8,,percent of total billed charges,,,1547,85,,percent of total billed charges,,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,455,22,,percent of total billed charges,,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,455,1729,
ZIMMER SCREW LOCKING 4.75 X 40MM,30185573,CDM,,,278,RC,outpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,455,22,,percent of total billed charges,,,,,,,,,1638,90,,percent of total billed charges,,,1506.96,82.8,,percent of total billed charges,,,1547,85,,percent of total billed charges,,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,455,22,,percent of total billed charges,,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,455,1729,
ZIMMER STEM PRIMARY MINI HUMERAL SZ 9MM,30185574,CDM,,,278,RC,outpatient,,46020,46020,,39070.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11505,22,,percent of total billed charges,,,,,,,,,41418,90,,percent of total billed charges,,,38104.56,82.8,,percent of total billed charges,,,39117,85,,percent of total billed charges,,,,,,,,,40497.6,88,,percent of total billed charges,,,,,,,,,35159.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11505,22,,percent of total billed charges,,,41878.2,91,,percent of total billed charges,,,43719,95,,percent of total billed charges,,,38196.6,83,,percent of total billed charges,,,38196.6,83,,percent of total billed charges,,,,,,,,,,,,,,,38196.6,83,,percent of total billed charges,,,43719,95,,percent of total billed charges,,,41418,90,,percent of total billed charges,,,41418,90,,percent of total billed charges,,,37736.4,82,,percent of total billed charges,,,41418,90,,percent of total billed charges,,,39117,85,,percent of total billed charges,,11505,43719,
ZIMMER BASEPLATE W/ADAPTOR MINI 25MM,30185575,CDM,,,278,RC,outpatient,,21125,21125,,17935.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5281.25,22,,percent of total billed charges,,,,,,,,,19012.5,90,,percent of total billed charges,,,17491.5,82.8,,percent of total billed charges,,,17956.25,85,,percent of total billed charges,,,,,,,,,18590,88,,percent of total billed charges,,,,,,,,,16139.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5281.25,22,,percent of total billed charges,,,19223.75,91,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,,,,,,,,,,,,,17533.75,83,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17322.5,82,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17956.25,85,,percent of total billed charges,,5281.25,20068.75,
ZIMMER TRAY HUMERAL +5MM,30185576,CDM,,,278,RC,outpatient,,21060,21060,,17879.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5265,22,,percent of total billed charges,,,,,,,,,18954,90,,percent of total billed charges,,,17437.68,82.8,,percent of total billed charges,,,17901,85,,percent of total billed charges,,,,,,,,,18532.8,88,,percent of total billed charges,,,,,,,,,16089.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5265,22,,percent of total billed charges,,,19164.6,91,,percent of total billed charges,,,20007,95,,percent of total billed charges,,,17479.8,83,,percent of total billed charges,,,17479.8,83,,percent of total billed charges,,,,,,,,,,,,,,,17479.8,83,,percent of total billed charges,,,20007,95,,percent of total billed charges,,,18954,90,,percent of total billed charges,,,18954,90,,percent of total billed charges,,,17269.2,82,,percent of total billed charges,,,18954,90,,percent of total billed charges,,,17901,85,,percent of total billed charges,,5265,20007,
ZIMMER BEARING HUMERAL E1 36MM,30185577,CDM,,,278,RC,outpatient,,17160,17160,,14568.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4290,22,,percent of total billed charges,,,,,,,,,15444,90,,percent of total billed charges,,,14208.48,82.8,,percent of total billed charges,,,14586,85,,percent of total billed charges,,,,,,,,,15100.8,88,,percent of total billed charges,,,,,,,,,13110.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4290,22,,percent of total billed charges,,,15615.6,91,,percent of total billed charges,,,16302,95,,percent of total billed charges,,,14242.8,83,,percent of total billed charges,,,14242.8,83,,percent of total billed charges,,,,,,,,,,,,,,,14242.8,83,,percent of total billed charges,,,16302,95,,percent of total billed charges,,,15444,90,,percent of total billed charges,,,15444,90,,percent of total billed charges,,,14071.2,82,,percent of total billed charges,,,15444,90,,percent of total billed charges,,,14586,85,,percent of total billed charges,,4290,16302,
HEMACLEAR B&W X-LARGE,30185578,CDM,,,270,RC,outpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.88,22,,percent of total billed charges,,,,,,,,,330.75,90,,percent of total billed charges,,,304.29,82.8,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.88,22,,percent of total billed charges,,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,91.88,349.13,
"STRYKER CANNULA TRANSPORT 7, 8, 9",30185579,CDM,,,270,RC,outpatient,,496.79,496.79,,421.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.2,22,,percent of total billed charges,,,,,,,,,447.11,90,,percent of total billed charges,,,411.34,82.8,,percent of total billed charges,,,422.27,85,,percent of total billed charges,,,,,,,,,437.18,88,,percent of total billed charges,,,,,,,,,379.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.2,22,,percent of total billed charges,,,452.08,91,,percent of total billed charges,,,471.95,95,,percent of total billed charges,,,412.34,83,,percent of total billed charges,,,412.34,83,,percent of total billed charges,,,,,,,,,,,,,,,412.34,83,,percent of total billed charges,,,471.95,95,,percent of total billed charges,,,447.11,90,,percent of total billed charges,,,447.11,90,,percent of total billed charges,,,407.37,82,,percent of total billed charges,,,447.11,90,,percent of total billed charges,,,422.27,85,,percent of total billed charges,,124.2,471.95,
SYNTHES SCREW CORTEX S-T 2.7X364M,30185580,CDM,,,278,RC,outpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.13,22,,percent of total billed charges,,,,,,,,,374.85,90,,percent of total billed charges,,,344.86,82.8,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.13,22,,percent of total billed charges,,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,104.13,395.68,
SYNTHES DRILL BIT 1.5MM,30185581,CDM,,,270,RC,outpatient,,830.83,830.83,,705.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,207.71,22,,percent of total billed charges,,,,,,,,,747.75,90,,percent of total billed charges,,,687.93,82.8,,percent of total billed charges,,,706.21,85,,percent of total billed charges,,,,,,,,,731.13,88,,percent of total billed charges,,,,,,,,,634.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,207.71,22,,percent of total billed charges,,,756.06,91,,percent of total billed charges,,,789.29,95,,percent of total billed charges,,,689.59,83,,percent of total billed charges,,,689.59,83,,percent of total billed charges,,,,,,,,,,,,,,,689.59,83,,percent of total billed charges,,,789.29,95,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,681.28,82,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,706.21,85,,percent of total billed charges,,207.71,789.29,
SYNTHES SCREW CORTEX ST 2.0 X 16MM,30185582,CDM,,,278,RC,outpatient,,490.28,490.28,,416.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.57,22,,percent of total billed charges,,,,,,,,,441.25,90,,percent of total billed charges,,,405.95,82.8,,percent of total billed charges,,,416.74,85,,percent of total billed charges,,,,,,,,,431.45,88,,percent of total billed charges,,,,,,,,,374.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.57,22,,percent of total billed charges,,,446.15,91,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,,,,,,,,,,,,,406.93,83,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,402.03,82,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,416.74,85,,percent of total billed charges,,122.57,465.77,
SYNTHES CLAMP COMBINATION 8.0/11.0MM,30185583,CDM,,,270,RC,outpatient,,6210.1,6210.1,,5272.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1552.53,22,,percent of total billed charges,,,,,,,,,5589.09,90,,percent of total billed charges,,,5141.96,82.8,,percent of total billed charges,,,5278.59,85,,percent of total billed charges,,,,,,,,,5464.89,88,,percent of total billed charges,,,,,,,,,4744.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1552.53,22,,percent of total billed charges,,,5651.19,91,,percent of total billed charges,,,5899.6,95,,percent of total billed charges,,,5154.38,83,,percent of total billed charges,,,5154.38,83,,percent of total billed charges,,,,,,,,,,,,,,,5154.38,83,,percent of total billed charges,,,5899.6,95,,percent of total billed charges,,,5589.09,90,,percent of total billed charges,,,5589.09,90,,percent of total billed charges,,,5092.28,82,,percent of total billed charges,,,5589.09,90,,percent of total billed charges,,,5278.59,85,,percent of total billed charges,,1552.53,5899.6,
SYNTHES ROD ATTACHEMENT MEDIUM,30185584,CDM,,,278,RC,outpatient,,3757,3757,,3189.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,939.25,22,,percent of total billed charges,,,,,,,,,3381.3,90,,percent of total billed charges,,,3110.8,82.8,,percent of total billed charges,,,3193.45,85,,percent of total billed charges,,,,,,,,,3306.16,88,,percent of total billed charges,,,,,,,,,2870.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,939.25,22,,percent of total billed charges,,,3418.87,91,,percent of total billed charges,,,3569.15,95,,percent of total billed charges,,,3118.31,83,,percent of total billed charges,,,3118.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3118.31,83,,percent of total billed charges,,,3569.15,95,,percent of total billed charges,,,3381.3,90,,percent of total billed charges,,,3381.3,90,,percent of total billed charges,,,3080.74,82,,percent of total billed charges,,,3381.3,90,,percent of total billed charges,,,3193.45,85,,percent of total billed charges,,939.25,3569.15,
SYNTHES CLAMP OPEN ADJ. MEDIUM,30185585,CDM,,,270,RC,outpatient,,4458.68,4458.68,,3785.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1114.67,22,,percent of total billed charges,,,,,,,,,4012.81,90,,percent of total billed charges,,,3691.79,82.8,,percent of total billed charges,,,3789.88,85,,percent of total billed charges,,,,,,,,,3923.64,88,,percent of total billed charges,,,,,,,,,3406.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1114.67,22,,percent of total billed charges,,,4057.4,91,,percent of total billed charges,,,4235.75,95,,percent of total billed charges,,,3700.7,83,,percent of total billed charges,,,3700.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3700.7,83,,percent of total billed charges,,,4235.75,95,,percent of total billed charges,,,4012.81,90,,percent of total billed charges,,,4012.81,90,,percent of total billed charges,,,3656.12,82,,percent of total billed charges,,,4012.81,90,,percent of total billed charges,,,3789.88,85,,percent of total billed charges,,1114.67,4235.75,
SYNTHES CLAMP MULTI-PIN MEDIUM,30185586,CDM,,,270,RC,outpatient,,7116.2,7116.2,,6041.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1779.05,22,,percent of total billed charges,,,,,,,,,6404.58,90,,percent of total billed charges,,,5892.21,82.8,,percent of total billed charges,,,6048.77,85,,percent of total billed charges,,,,,,,,,6262.26,88,,percent of total billed charges,,,,,,,,,5436.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1779.05,22,,percent of total billed charges,,,6475.74,91,,percent of total billed charges,,,6760.39,95,,percent of total billed charges,,,5906.45,83,,percent of total billed charges,,,5906.45,83,,percent of total billed charges,,,,,,,,,,,,,,,5906.45,83,,percent of total billed charges,,,6760.39,95,,percent of total billed charges,,,6404.58,90,,percent of total billed charges,,,6404.58,90,,percent of total billed charges,,,5835.28,82,,percent of total billed charges,,,6404.58,90,,percent of total billed charges,,,6048.77,85,,percent of total billed charges,,1779.05,6760.39,
SYNTHES ROD 8 X 280MM,30185587,CDM,,,278,RC,outpatient,,1547,1547,,1313.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,386.75,22,,percent of total billed charges,,,,,,,,,1392.3,90,,percent of total billed charges,,,1280.92,82.8,,percent of total billed charges,,,1314.95,85,,percent of total billed charges,,,,,,,,,1361.36,88,,percent of total billed charges,,,,,,,,,1181.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,386.75,22,,percent of total billed charges,,,1407.77,91,,percent of total billed charges,,,1469.65,95,,percent of total billed charges,,,1284.01,83,,percent of total billed charges,,,1284.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1284.01,83,,percent of total billed charges,,,1469.65,95,,percent of total billed charges,,,1392.3,90,,percent of total billed charges,,,1392.3,90,,percent of total billed charges,,,1268.54,82,,percent of total billed charges,,,1392.3,90,,percent of total billed charges,,,1314.95,85,,percent of total billed charges,,386.75,1469.65,
SYNTHES ROD 8 X 240MM,30185588,CDM,,,278,RC,outpatient,,1530.43,1530.43,,1299.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,382.61,22,,percent of total billed charges,,,,,,,,,1377.39,90,,percent of total billed charges,,,1267.2,82.8,,percent of total billed charges,,,1300.87,85,,percent of total billed charges,,,,,,,,,1346.78,88,,percent of total billed charges,,,,,,,,,1169.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,382.61,22,,percent of total billed charges,,,1392.69,91,,percent of total billed charges,,,1453.91,95,,percent of total billed charges,,,1270.26,83,,percent of total billed charges,,,1270.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1270.26,83,,percent of total billed charges,,,1453.91,95,,percent of total billed charges,,,1377.39,90,,percent of total billed charges,,,1377.39,90,,percent of total billed charges,,,1254.95,82,,percent of total billed charges,,,1377.39,90,,percent of total billed charges,,,1300.87,85,,percent of total billed charges,,382.61,1453.91,
SYNTHES SCREW SCHANZ 125MM,30185589,CDM,,,278,RC,outpatient,,1574.63,1574.63,,1336.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,393.66,22,,percent of total billed charges,,,,,,,,,1417.17,90,,percent of total billed charges,,,1303.79,82.8,,percent of total billed charges,,,1338.44,85,,percent of total billed charges,,,,,,,,,1385.67,88,,percent of total billed charges,,,,,,,,,1203.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,393.66,22,,percent of total billed charges,,,1432.91,91,,percent of total billed charges,,,1495.9,95,,percent of total billed charges,,,1306.94,83,,percent of total billed charges,,,1306.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1306.94,83,,percent of total billed charges,,,1495.9,95,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1291.2,82,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1338.44,85,,percent of total billed charges,,393.66,1495.9,
SYNTHES SCREW SCHANZ 150MM,30185590,CDM,,,278,RC,outpatient,,1574.63,1574.63,,1336.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,393.66,22,,percent of total billed charges,,,,,,,,,1417.17,90,,percent of total billed charges,,,1303.79,82.8,,percent of total billed charges,,,1338.44,85,,percent of total billed charges,,,,,,,,,1385.67,88,,percent of total billed charges,,,,,,,,,1203.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,393.66,22,,percent of total billed charges,,,1432.91,91,,percent of total billed charges,,,1495.9,95,,percent of total billed charges,,,1306.94,83,,percent of total billed charges,,,1306.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1306.94,83,,percent of total billed charges,,,1495.9,95,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1291.2,82,,percent of total billed charges,,,1417.17,90,,percent of total billed charges,,,1338.44,85,,percent of total billed charges,,393.66,1495.9,
SYNTHES PIN STEINMANN W/THREAD 5 X 200MM,30185591,CDM,,,278,RC,outpatient,,1342.58,1342.58,,1139.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,335.65,22,,percent of total billed charges,,,,,,,,,1208.32,90,,percent of total billed charges,,,1111.66,82.8,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,,,,,,,,1181.47,88,,percent of total billed charges,,,,,,,,,1025.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,335.65,22,,percent of total billed charges,,,1221.75,91,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,1114.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1114.34,83,,percent of total billed charges,,,1275.45,95,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1100.92,82,,percent of total billed charges,,,1208.32,90,,percent of total billed charges,,,1141.19,85,,percent of total billed charges,,335.65,1275.45,
SYNTHES PROTECTIVE CAP FOR 5.0MM FIXATIO,30185592,CDM,,,270,RC,outpatient,,71.49,71.49,,60.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.87,22,,percent of total billed charges,,,,,,,,,64.34,90,,percent of total billed charges,,,59.19,82.8,,percent of total billed charges,,,60.77,85,,percent of total billed charges,,,,,,,,,62.91,88,,percent of total billed charges,,,,,,,,,54.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.87,22,,percent of total billed charges,,,65.06,91,,percent of total billed charges,,,67.92,95,,percent of total billed charges,,,59.34,83,,percent of total billed charges,,,59.34,83,,percent of total billed charges,,,,,,,,,,,,,,,59.34,83,,percent of total billed charges,,,67.92,95,,percent of total billed charges,,,64.34,90,,percent of total billed charges,,,64.34,90,,percent of total billed charges,,,58.62,82,,percent of total billed charges,,,64.34,90,,percent of total billed charges,,,60.77,85,,percent of total billed charges,,17.87,67.92,
ARTHREX MINI TIGHTROPE 1.1MM,30185593,CDM,,,270,RC,outpatient,,5817.5,5817.5,,4939.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1454.38,22,,percent of total billed charges,,,,,,,,,5235.75,90,,percent of total billed charges,,,4816.89,82.8,,percent of total billed charges,,,4944.88,85,,percent of total billed charges,,,,,,,,,5119.4,88,,percent of total billed charges,,,,,,,,,4444.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1454.38,22,,percent of total billed charges,,,5293.93,91,,percent of total billed charges,,,5526.63,95,,percent of total billed charges,,,4828.53,83,,percent of total billed charges,,,4828.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4828.53,83,,percent of total billed charges,,,5526.63,95,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,4770.35,82,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,4944.88,85,,percent of total billed charges,,1454.38,5526.63,
DEPUY ATTUNE FEMUR CR SZ 8 LEFT,30185594,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY ATTUNE INSERT CR AOX 7MM,30185595,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY LINER ALTRX N 40 X 62,30185596,CDM,,,278,RC,outpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4400.13,22,,percent of total billed charges,,,,,,,,,15840.46,90,,percent of total billed charges,,,14573.22,82.8,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4400.13,22,,percent of total billed charges,,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,4400.13,16720.48,
GUARD TEETH BITE BLOCK,30185602,CDM,,,270,RC,outpatient,,78.88,78.88,,66.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.72,22,,percent of total billed charges,,,,,,,,,70.99,90,,percent of total billed charges,,,65.31,82.8,,percent of total billed charges,,,67.05,85,,percent of total billed charges,,,,,,,,,69.41,88,,percent of total billed charges,,,,,,,,,60.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.72,22,,percent of total billed charges,,,71.78,91,,percent of total billed charges,,,74.94,95,,percent of total billed charges,,,65.47,83,,percent of total billed charges,,,65.47,83,,percent of total billed charges,,,,,,,,,,,,,,,65.47,83,,percent of total billed charges,,,74.94,95,,percent of total billed charges,,,70.99,90,,percent of total billed charges,,,70.99,90,,percent of total billed charges,,,64.68,82,,percent of total billed charges,,,70.99,90,,percent of total billed charges,,,67.05,85,,percent of total billed charges,,19.72,74.94,
BERKELEY KIT,30185603,CDM,,,270,RC,outpatient,,294.3,294.3,,249.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.58,22,,percent of total billed charges,,,,,,,,,264.87,90,,percent of total billed charges,,,243.68,82.8,,percent of total billed charges,,,250.16,85,,percent of total billed charges,,,,,,,,,258.98,88,,percent of total billed charges,,,,,,,,,224.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.58,22,,percent of total billed charges,,,267.81,91,,percent of total billed charges,,,279.59,95,,percent of total billed charges,,,244.27,83,,percent of total billed charges,,,244.27,83,,percent of total billed charges,,,,,,,,,,,,,,,244.27,83,,percent of total billed charges,,,279.59,95,,percent of total billed charges,,,264.87,90,,percent of total billed charges,,,264.87,90,,percent of total billed charges,,,241.33,82,,percent of total billed charges,,,264.87,90,,percent of total billed charges,,,250.16,85,,percent of total billed charges,,73.58,279.59,
SYNTHES SCREW LOCKING 2.4 X 20MM,30185604,CDM,,,278,RC,outpatient,,1635.4,1635.4,,1388.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,408.85,22,,percent of total billed charges,,,,,,,,,1471.86,90,,percent of total billed charges,,,1354.11,82.8,,percent of total billed charges,,,1390.09,85,,percent of total billed charges,,,,,,,,,1439.15,88,,percent of total billed charges,,,,,,,,,1249.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,408.85,22,,percent of total billed charges,,,1488.21,91,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1357.38,83,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1341.03,82,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1390.09,85,,percent of total billed charges,,408.85,1553.63,
DEPUY INSERT ATTUNE TIBIAL RP PS 6X5MM,30185605,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
SYNTHES SCREW CORTEX 11 X 2MM,30185606,CDM,,,278,RC,outpatient,,545.44,545.44,,463.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,136.36,22,,percent of total billed charges,,,,,,,,,490.9,90,,percent of total billed charges,,,451.62,82.8,,percent of total billed charges,,,463.62,85,,percent of total billed charges,,,,,,,,,479.99,88,,percent of total billed charges,,,,,,,,,416.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,136.36,22,,percent of total billed charges,,,496.35,91,,percent of total billed charges,,,518.17,95,,percent of total billed charges,,,452.72,83,,percent of total billed charges,,,452.72,83,,percent of total billed charges,,,,,,,,,,,,,,,452.72,83,,percent of total billed charges,,,518.17,95,,percent of total billed charges,,,490.9,90,,percent of total billed charges,,,490.9,90,,percent of total billed charges,,,447.26,82,,percent of total billed charges,,,490.9,90,,percent of total billed charges,,,463.62,85,,percent of total billed charges,,136.36,518.17,
SYNTHES DRILL BIT 1.5MM X 57MM,30185607,CDM,,,270,RC,outpatient,,868.7,868.7,,737.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,217.18,22,,percent of total billed charges,,,,,,,,,781.83,90,,percent of total billed charges,,,719.28,82.8,,percent of total billed charges,,,738.4,85,,percent of total billed charges,,,,,,,,,764.46,88,,percent of total billed charges,,,,,,,,,663.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,217.18,22,,percent of total billed charges,,,790.52,91,,percent of total billed charges,,,825.27,95,,percent of total billed charges,,,721.02,83,,percent of total billed charges,,,721.02,83,,percent of total billed charges,,,,,,,,,,,,,,,721.02,83,,percent of total billed charges,,,825.27,95,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,712.33,82,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,738.4,85,,percent of total billed charges,,217.18,825.27,
ARTHREX SPEEDBRG IMPLANT SYS 4.75X19.1MM,30185608,CDM,,,278,RC,outpatient,,11310,11310,,9602.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2827.5,22,,percent of total billed charges,,,,,,,,,10179,90,,percent of total billed charges,,,9364.68,82.8,,percent of total billed charges,,,9613.5,85,,percent of total billed charges,,,,,,,,,9952.8,88,,percent of total billed charges,,,,,,,,,8640.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2827.5,22,,percent of total billed charges,,,10292.1,91,,percent of total billed charges,,,10744.5,95,,percent of total billed charges,,,9387.3,83,,percent of total billed charges,,,9387.3,83,,percent of total billed charges,,,,,,,,,,,,,,,9387.3,83,,percent of total billed charges,,,10744.5,95,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,9274.2,82,,percent of total billed charges,,,10179,90,,percent of total billed charges,,,9613.5,85,,percent of total billed charges,,2827.5,10744.5,
PROCLAIM MULTILEAD TRIAL CABLE,30185610,CDM,,,278,RC,outpatient,,1430,1430,,1214.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,357.5,22,,percent of total billed charges,,,,,,,,,1287,90,,percent of total billed charges,,,1184.04,82.8,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,,,,,,,,1258.4,88,,percent of total billed charges,,,,,,,,,1092.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,357.5,22,,percent of total billed charges,,,1301.3,91,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1186.9,83,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1172.6,82,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,357.5,1358.5,
ECHO PS POSITIONING SYSTEM MESH 4.5IN,30185611,CDM,,,278,RC,outpatient,,7595.25,7595.25,,6448.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1898.81,22,,percent of total billed charges,,,,,,,,,6835.73,90,,percent of total billed charges,,,6288.87,82.8,,percent of total billed charges,,,6455.96,85,,percent of total billed charges,,,,,,,,,6683.82,88,,percent of total billed charges,,,,,,,,,5802.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1898.81,22,,percent of total billed charges,,,6911.68,91,,percent of total billed charges,,,7215.49,95,,percent of total billed charges,,,6304.06,83,,percent of total billed charges,,,6304.06,83,,percent of total billed charges,,,,,,,,,,,,,,,6304.06,83,,percent of total billed charges,,,7215.49,95,,percent of total billed charges,,,6835.73,90,,percent of total billed charges,,,6835.73,90,,percent of total billed charges,,,6228.11,82,,percent of total billed charges,,,6835.73,90,,percent of total billed charges,,,6455.96,85,,percent of total billed charges,,1898.81,7215.49,
ECHO PS POSITIONING SYSTEM,30185612,CDM,,,278,RC,outpatient,,1092,1092,,927.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,273,22,,percent of total billed charges,,,,,,,,,982.8,90,,percent of total billed charges,,,904.18,82.8,,percent of total billed charges,,,928.2,85,,percent of total billed charges,,,,,,,,,960.96,88,,percent of total billed charges,,,,,,,,,834.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,273,22,,percent of total billed charges,,,993.72,91,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,,,,,,,,,,,,,906.36,83,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,895.44,82,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,928.2,85,,percent of total billed charges,,273,1037.4,
GLENOID WIRE,30185613,CDM,,,270,RC,outpatient,,851.5,851.5,,722.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,212.88,22,,percent of total billed charges,,,,,,,,,766.35,90,,percent of total billed charges,,,705.04,82.8,,percent of total billed charges,,,723.78,85,,percent of total billed charges,,,,,,,,,749.32,88,,percent of total billed charges,,,,,,,,,650.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,212.88,22,,percent of total billed charges,,,774.87,91,,percent of total billed charges,,,808.93,95,,percent of total billed charges,,,706.75,83,,percent of total billed charges,,,706.75,83,,percent of total billed charges,,,,,,,,,,,,,,,706.75,83,,percent of total billed charges,,,808.93,95,,percent of total billed charges,,,766.35,90,,percent of total billed charges,,,766.35,90,,percent of total billed charges,,,698.23,82,,percent of total billed charges,,,766.35,90,,percent of total billed charges,,,723.78,85,,percent of total billed charges,,212.88,808.93,
DRILL KIT EQUINOXE REVERSE SHOULDER,30185614,CDM,,,270,RC,outpatient,,4732,4732,,4017.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1183,22,,percent of total billed charges,,,,,,,,,4258.8,90,,percent of total billed charges,,,3918.1,82.8,,percent of total billed charges,,,4022.2,85,,percent of total billed charges,,,,,,,,,4164.16,88,,percent of total billed charges,,,,,,,,,3615.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1183,22,,percent of total billed charges,,,4306.12,91,,percent of total billed charges,,,4495.4,95,,percent of total billed charges,,,3927.56,83,,percent of total billed charges,,,3927.56,83,,percent of total billed charges,,,,,,,,,,,,,,,3927.56,83,,percent of total billed charges,,,4495.4,95,,percent of total billed charges,,,4258.8,90,,percent of total billed charges,,,4258.8,90,,percent of total billed charges,,,3880.24,82,,percent of total billed charges,,,4258.8,90,,percent of total billed charges,,,4022.2,85,,percent of total billed charges,,1183,4495.4,
PLATE GLENOID EQ REV,30185615,CDM,,,270,RC,outpatient,,25707.5,25707.5,,21825.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6426.88,22,,percent of total billed charges,,,,,,,,,23136.75,90,,percent of total billed charges,,,21285.81,82.8,,percent of total billed charges,,,21851.38,85,,percent of total billed charges,,,,,,,,,22622.6,88,,percent of total billed charges,,,,,,,,,19640.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6426.88,22,,percent of total billed charges,,,23393.83,91,,percent of total billed charges,,,24422.13,95,,percent of total billed charges,,,21337.23,83,,percent of total billed charges,,,21337.23,83,,percent of total billed charges,,,,,,,,,,,,,,,21337.23,83,,percent of total billed charges,,,24422.13,95,,percent of total billed charges,,,23136.75,90,,percent of total billed charges,,,23136.75,90,,percent of total billed charges,,,21080.15,82,,percent of total billed charges,,,23136.75,90,,percent of total billed charges,,,21851.38,85,,percent of total billed charges,,6426.88,24422.13,
SCREW GLENOSPHERE LOCKING EQ REV,30185616,CDM,,,278,RC,outpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,502.13,22,,percent of total billed charges,,,,,,,,,1807.65,90,,percent of total billed charges,,,1663.04,82.8,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,502.13,22,,percent of total billed charges,,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,502.13,1908.08,
SCREW LOCKING CAP KIT 4.5X26MM,30185617,CDM,,,278,RC,outpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,502.13,22,,percent of total billed charges,,,,,,,,,1807.65,90,,percent of total billed charges,,,1663.04,82.8,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,502.13,22,,percent of total billed charges,,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,502.13,1908.08,
SCREW LOCKING CAP KIT 4.5X34MM,30185618,CDM,,,278,RC,outpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,502.13,22,,percent of total billed charges,,,,,,,,,1807.65,90,,percent of total billed charges,,,1663.04,82.8,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,502.13,22,,percent of total billed charges,,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,502.13,1908.08,
SCREW LOCKING CAP KIT 4.5X22MM,30185619,CDM,,,278,RC,outpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,502.13,22,,percent of total billed charges,,,,,,,,,1807.65,90,,percent of total billed charges,,,1663.04,82.8,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,502.13,22,,percent of total billed charges,,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,502.13,1908.08,
LINER HUMERAL EQ REVERSE 42MM +2.5,30185620,CDM,,,270,RC,outpatient,,13487.5,13487.5,,11450.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3371.88,22,,percent of total billed charges,,,,,,,,,12138.75,90,,percent of total billed charges,,,11167.65,82.8,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,,,,,,,,11869,88,,percent of total billed charges,,,,,,,,,10304.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3371.88,22,,percent of total billed charges,,,12273.63,91,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,,,,,,,,,,,,,11194.63,83,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11059.75,82,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,3371.88,12813.13,
PLATE TRAY +5 EQ REVERSE,30185621,CDM,,,270,RC,outpatient,,30160,30160,,25605.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7540,22,,percent of total billed charges,,,,,,,,,27144,90,,percent of total billed charges,,,24972.48,82.8,,percent of total billed charges,,,25636,85,,percent of total billed charges,,,,,,,,,26540.8,88,,percent of total billed charges,,,,,,,,,23042.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7540,22,,percent of total billed charges,,,27445.6,91,,percent of total billed charges,,,28652,95,,percent of total billed charges,,,25032.8,83,,percent of total billed charges,,,25032.8,83,,percent of total billed charges,,,,,,,,,,,,,,,25032.8,83,,percent of total billed charges,,,28652,95,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,24731.2,82,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,25636,85,,percent of total billed charges,,7540,28652,
STEM HUMERAL EQ PRESS FIT 15MM,30185622,CDM,,,270,RC,outpatient,,34008,34008,,28872.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8502,22,,percent of total billed charges,,,,,,,,,30607.2,90,,percent of total billed charges,,,28158.62,82.8,,percent of total billed charges,,,28906.8,85,,percent of total billed charges,,,,,,,,,29927.04,88,,percent of total billed charges,,,,,,,,,25982.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8502,22,,percent of total billed charges,,,30947.28,91,,percent of total billed charges,,,32307.6,95,,percent of total billed charges,,,28226.64,83,,percent of total billed charges,,,28226.64,83,,percent of total billed charges,,,,,,,,,,,,,,,28226.64,83,,percent of total billed charges,,,32307.6,95,,percent of total billed charges,,,30607.2,90,,percent of total billed charges,,,30607.2,90,,percent of total billed charges,,,27886.56,82,,percent of total billed charges,,,30607.2,90,,percent of total billed charges,,,28906.8,85,,percent of total billed charges,,8502,32307.6,
GLENOSPHERE RS EXPANDED 42MM +4MM OFFSET,30185623,CDM,,,270,RC,outpatient,,34242,34242,,29071.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8560.5,22,,percent of total billed charges,,,,,,,,,30817.8,90,,percent of total billed charges,,,28352.38,82.8,,percent of total billed charges,,,29105.7,85,,percent of total billed charges,,,,,,,,,30132.96,88,,percent of total billed charges,,,,,,,,,26160.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8560.5,22,,percent of total billed charges,,,31160.22,91,,percent of total billed charges,,,32529.9,95,,percent of total billed charges,,,28420.86,83,,percent of total billed charges,,,28420.86,83,,percent of total billed charges,,,,,,,,,,,,,,,28420.86,83,,percent of total billed charges,,,32529.9,95,,percent of total billed charges,,,30817.8,90,,percent of total billed charges,,,30817.8,90,,percent of total billed charges,,,28078.44,82,,percent of total billed charges,,,30817.8,90,,percent of total billed charges,,,29105.7,85,,percent of total billed charges,,8560.5,32529.9,
SCREW KIT EQ REVERSE TORQUE DEFINING,30185624,CDM,,,278,RC,outpatient,,4335.5,4335.5,,3680.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1083.88,22,,percent of total billed charges,,,,,,,,,3901.95,90,,percent of total billed charges,,,3589.79,82.8,,percent of total billed charges,,,3685.18,85,,percent of total billed charges,,,,,,,,,3815.24,88,,percent of total billed charges,,,,,,,,,3312.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1083.88,22,,percent of total billed charges,,,3945.31,91,,percent of total billed charges,,,4118.73,95,,percent of total billed charges,,,3598.47,83,,percent of total billed charges,,,3598.47,83,,percent of total billed charges,,,,,,,,,,,,,,,3598.47,83,,percent of total billed charges,,,4118.73,95,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3555.11,82,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3685.18,85,,percent of total billed charges,,1083.88,4118.73,
CTL ROD MIS 45MM,30185625,CDM,,,278,RC,outpatient,,2213.9,2213.9,,1879.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,553.48,22,,percent of total billed charges,,,,,,,,,1992.51,90,,percent of total billed charges,,,1833.11,82.8,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,,,,,,,,1948.23,88,,percent of total billed charges,,,,,,,,,1691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,553.48,22,,percent of total billed charges,,,2014.65,91,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,1837.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1837.54,83,,percent of total billed charges,,,2103.21,95,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1815.4,82,,percent of total billed charges,,,1992.51,90,,percent of total billed charges,,,1881.82,85,,percent of total billed charges,,553.48,2103.21,
MTF STRUT CORTICAL FEMORAL HALVED 250MM,30185626,CDM,,,278,RC,outpatient,,11797.5,11797.5,,10016.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2949.38,22,,percent of total billed charges,,,,,,,,,10617.75,90,,percent of total billed charges,,,9768.33,82.8,,percent of total billed charges,,,10027.88,85,,percent of total billed charges,,,,,,,,,10381.8,88,,percent of total billed charges,,,,,,,,,9013.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2949.38,22,,percent of total billed charges,,,10735.73,91,,percent of total billed charges,,,11207.63,95,,percent of total billed charges,,,9791.93,83,,percent of total billed charges,,,9791.93,83,,percent of total billed charges,,,,,,,,,,,,,,,9791.93,83,,percent of total billed charges,,,11207.63,95,,percent of total billed charges,,,10617.75,90,,percent of total billed charges,,,10617.75,90,,percent of total billed charges,,,9673.95,82,,percent of total billed charges,,,10617.75,90,,percent of total billed charges,,,10027.88,85,,percent of total billed charges,,2949.38,11207.63,
CHOICE SPINE PEEK CAGE 6 X 12 14MM,30185627,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
CHOICE SPINE PEEK CAGE 7 X 12 14MM,30185628,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
SYNTHES PLATE PHALANGEAL BASE 2 HOLES 2M,30185629,CDM,,,278,RC,outpatient,,5895.18,5895.18,,5005.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1473.8,22,,percent of total billed charges,,,,,,,,,5305.66,90,,percent of total billed charges,,,4881.21,82.8,,percent of total billed charges,,,5010.9,85,,percent of total billed charges,,,,,,,,,5187.76,88,,percent of total billed charges,,,,,,,,,4503.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1473.8,22,,percent of total billed charges,,,5364.61,91,,percent of total billed charges,,,5600.42,95,,percent of total billed charges,,,4893,83,,percent of total billed charges,,,4893,83,,percent of total billed charges,,,,,,,,,,,,,,,4893,83,,percent of total billed charges,,,5600.42,95,,percent of total billed charges,,,5305.66,90,,percent of total billed charges,,,5305.66,90,,percent of total billed charges,,,4834.05,82,,percent of total billed charges,,,5305.66,90,,percent of total billed charges,,,5010.9,85,,percent of total billed charges,,1473.8,5600.42,
SYNTHES SCREW CORTEX 8 X 2MM,30185630,CDM,,,278,RC,outpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.39,22,,percent of total billed charges,,,,,,,,,476.6,90,,percent of total billed charges,,,438.47,82.8,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.39,22,,percent of total billed charges,,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,132.39,503.07,
SYNTHES SCREW LOCKING VA 2 X 8MM,30185631,CDM,,,278,RC,outpatient,,1265.23,1265.23,,1074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.31,22,,percent of total billed charges,,,,,,,,,1138.71,90,,percent of total billed charges,,,1047.61,82.8,,percent of total billed charges,,,1075.45,85,,percent of total billed charges,,,,,,,,,1113.4,88,,percent of total billed charges,,,,,,,,,966.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.31,22,,percent of total billed charges,,,1151.36,91,,percent of total billed charges,,,1201.97,95,,percent of total billed charges,,,1050.14,83,,percent of total billed charges,,,1050.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1050.14,83,,percent of total billed charges,,,1201.97,95,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1037.49,82,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1075.45,85,,percent of total billed charges,,316.31,1201.97,
SYNTHES SCREW LOCKING VA 2 X 11MM,30185632,CDM,,,278,RC,outpatient,,1265.23,1265.23,,1074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.31,22,,percent of total billed charges,,,,,,,,,1138.71,90,,percent of total billed charges,,,1047.61,82.8,,percent of total billed charges,,,1075.45,85,,percent of total billed charges,,,,,,,,,1113.4,88,,percent of total billed charges,,,,,,,,,966.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.31,22,,percent of total billed charges,,,1151.36,91,,percent of total billed charges,,,1201.97,95,,percent of total billed charges,,,1050.14,83,,percent of total billed charges,,,1050.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1050.14,83,,percent of total billed charges,,,1201.97,95,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1037.49,82,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1075.45,85,,percent of total billed charges,,316.31,1201.97,
SYNTHES SCREW LOCKING VA 2 X 12MM,30185633,CDM,,,278,RC,outpatient,,1265.23,1265.23,,1074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.31,22,,percent of total billed charges,,,,,,,,,1138.71,90,,percent of total billed charges,,,1047.61,82.8,,percent of total billed charges,,,1075.45,85,,percent of total billed charges,,,,,,,,,1113.4,88,,percent of total billed charges,,,,,,,,,966.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.31,22,,percent of total billed charges,,,1151.36,91,,percent of total billed charges,,,1201.97,95,,percent of total billed charges,,,1050.14,83,,percent of total billed charges,,,1050.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1050.14,83,,percent of total billed charges,,,1201.97,95,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1037.49,82,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1075.45,85,,percent of total billed charges,,316.31,1201.97,
SYNTHES SCREW LOCKING VA 2 X 13MM,30185634,CDM,,,278,RC,outpatient,,1265.23,1265.23,,1074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.31,22,,percent of total billed charges,,,,,,,,,1138.71,90,,percent of total billed charges,,,1047.61,82.8,,percent of total billed charges,,,1075.45,85,,percent of total billed charges,,,,,,,,,1113.4,88,,percent of total billed charges,,,,,,,,,966.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.31,22,,percent of total billed charges,,,1151.36,91,,percent of total billed charges,,,1201.97,95,,percent of total billed charges,,,1050.14,83,,percent of total billed charges,,,1050.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1050.14,83,,percent of total billed charges,,,1201.97,95,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1037.49,82,,percent of total billed charges,,,1138.71,90,,percent of total billed charges,,,1075.45,85,,percent of total billed charges,,316.31,1201.97,
SYNTHES SCREW CANNULATED 4X44MM,30185635,CDM,,,278,RC,outpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,486.2,22,,percent of total billed charges,,,,,,,,,1750.32,90,,percent of total billed charges,,,1610.29,82.8,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,486.2,22,,percent of total billed charges,,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,486.2,1847.56,
SYNTHES SCREW CANNULATED 4X50MM,30185636,CDM,,,278,RC,outpatient,,1944.8,1944.8,,1651.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,486.2,22,,percent of total billed charges,,,,,,,,,1750.32,90,,percent of total billed charges,,,1610.29,82.8,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,,,,,,,,1711.42,88,,percent of total billed charges,,,,,,,,,1485.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,486.2,22,,percent of total billed charges,,,1769.77,91,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,1614.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.18,83,,percent of total billed charges,,,1847.56,95,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1594.74,82,,percent of total billed charges,,,1750.32,90,,percent of total billed charges,,,1653.08,85,,percent of total billed charges,,486.2,1847.56,
DEPUY STEM CORAIL REVISION SZ. 14,30185637,CDM,,,278,RC,outpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16689.95,22,,percent of total billed charges,,,,,,,,,60083.83,90,,percent of total billed charges,,,55277.12,82.8,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16689.95,22,,percent of total billed charges,,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,16689.95,63421.82,
SYNTHES HELICAL BLADE 90MM,30185638,CDM,,,278,RC,outpatient,,6828.9,6828.9,,5797.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1707.23,22,,percent of total billed charges,,,,,,,,,6146.01,90,,percent of total billed charges,,,5654.33,82.8,,percent of total billed charges,,,5804.57,85,,percent of total billed charges,,,,,,,,,6009.43,88,,percent of total billed charges,,,,,,,,,5217.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1707.23,22,,percent of total billed charges,,,6214.3,91,,percent of total billed charges,,,6487.46,95,,percent of total billed charges,,,5667.99,83,,percent of total billed charges,,,5667.99,83,,percent of total billed charges,,,,,,,,,,,,,,,5667.99,83,,percent of total billed charges,,,6487.46,95,,percent of total billed charges,,,6146.01,90,,percent of total billed charges,,,6146.01,90,,percent of total billed charges,,,5599.7,82,,percent of total billed charges,,,6146.01,90,,percent of total billed charges,,,5804.57,85,,percent of total billed charges,,1707.23,6487.46,
STRYKER FLOWPORT II CANNULA W/OBTURATOR,30185639,CDM,,,270,RC,outpatient,,2664.68,2664.68,,2262.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,666.17,22,,percent of total billed charges,,,,,,,,,2398.21,90,,percent of total billed charges,,,2206.36,82.8,,percent of total billed charges,,,2264.98,85,,percent of total billed charges,,,,,,,,,2344.92,88,,percent of total billed charges,,,,,,,,,2035.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,666.17,22,,percent of total billed charges,,,2424.86,91,,percent of total billed charges,,,2531.45,95,,percent of total billed charges,,,2211.68,83,,percent of total billed charges,,,2211.68,83,,percent of total billed charges,,,,,,,,,,,,,,,2211.68,83,,percent of total billed charges,,,2531.45,95,,percent of total billed charges,,,2398.21,90,,percent of total billed charges,,,2398.21,90,,percent of total billed charges,,,2185.04,82,,percent of total billed charges,,,2398.21,90,,percent of total billed charges,,,2264.98,85,,percent of total billed charges,,666.17,2531.45,
STRYKER SERFAX 90-S XL,30185640,CDM,,,270,RC,outpatient,,1421.49,1421.49,,1206.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,355.37,22,,percent of total billed charges,,,,,,,,,1279.34,90,,percent of total billed charges,,,1176.99,82.8,,percent of total billed charges,,,1208.27,85,,percent of total billed charges,,,,,,,,,1250.91,88,,percent of total billed charges,,,,,,,,,1086.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,355.37,22,,percent of total billed charges,,,1293.56,91,,percent of total billed charges,,,1350.42,95,,percent of total billed charges,,,1179.84,83,,percent of total billed charges,,,1179.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1179.84,83,,percent of total billed charges,,,1350.42,95,,percent of total billed charges,,,1279.34,90,,percent of total billed charges,,,1279.34,90,,percent of total billed charges,,,1165.62,82,,percent of total billed charges,,,1279.34,90,,percent of total billed charges,,,1208.27,85,,percent of total billed charges,,355.37,1350.42,
INSIGHT MULTI BAND LIGATOR,30185641,CDM,,,270,RC,outpatient,,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.25,22,,percent of total billed charges,,,,,,,,,422.1,90,,percent of total billed charges,,,388.33,82.8,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.25,22,,percent of total billed charges,,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,117.25,445.55,
SYNTHES K-WIRE TI 1.0,30185642,CDM,,,278,RC,outpatient,,1018.62,1018.62,,864.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,254.66,22,,percent of total billed charges,,,,,,,,,916.76,90,,percent of total billed charges,,,843.42,82.8,,percent of total billed charges,,,865.83,85,,percent of total billed charges,,,,,,,,,896.39,88,,percent of total billed charges,,,,,,,,,778.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,254.66,22,,percent of total billed charges,,,926.94,91,,percent of total billed charges,,,967.69,95,,percent of total billed charges,,,845.45,83,,percent of total billed charges,,,845.45,83,,percent of total billed charges,,,,,,,,,,,,,,,845.45,83,,percent of total billed charges,,,967.69,95,,percent of total billed charges,,,916.76,90,,percent of total billed charges,,,916.76,90,,percent of total billed charges,,,835.27,82,,percent of total billed charges,,,916.76,90,,percent of total billed charges,,,865.83,85,,percent of total billed charges,,254.66,967.69,
SYNTHES DRILL BIT 1.1MM,30185643,CDM,,,270,RC,outpatient,,949,949,,805.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,237.25,22,,percent of total billed charges,,,,,,,,,854.1,90,,percent of total billed charges,,,785.77,82.8,,percent of total billed charges,,,806.65,85,,percent of total billed charges,,,,,,,,,835.12,88,,percent of total billed charges,,,,,,,,,725.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,237.25,22,,percent of total billed charges,,,863.59,91,,percent of total billed charges,,,901.55,95,,percent of total billed charges,,,787.67,83,,percent of total billed charges,,,787.67,83,,percent of total billed charges,,,,,,,,,,,,,,,787.67,83,,percent of total billed charges,,,901.55,95,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,778.18,82,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,806.65,85,,percent of total billed charges,,237.25,901.55,
SYNTHES SCREW CORTEX ST 1.5 X 16MM,30185644,CDM,,,278,RC,outpatient,,523.6,523.6,,444.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.9,22,,percent of total billed charges,,,,,,,,,471.24,90,,percent of total billed charges,,,433.54,82.8,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,,,,,,,,460.77,88,,percent of total billed charges,,,,,,,,,400.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.9,22,,percent of total billed charges,,,476.48,91,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,,,,,,,,,,,,,434.59,83,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,429.35,82,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,130.9,497.42,
SYNTHES SCREW CORTEX ST 1.5 X 18MM,30185645,CDM,,,278,RC,outpatient,,523.6,523.6,,444.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.9,22,,percent of total billed charges,,,,,,,,,471.24,90,,percent of total billed charges,,,433.54,82.8,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,,,,,,,,460.77,88,,percent of total billed charges,,,,,,,,,400.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.9,22,,percent of total billed charges,,,476.48,91,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,,,,,,,,,,,,,434.59,83,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,429.35,82,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,130.9,497.42,
S&N INSERT XLPE PS 13MM SZ 3/4,30185646,CDM,,,278,RC,outpatient,,13364.07,13364.07,,11346.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3341.02,22,,percent of total billed charges,,,,,,,,,12027.66,90,,percent of total billed charges,,,11065.45,82.8,,percent of total billed charges,,,11359.46,85,,percent of total billed charges,,,,,,,,,11760.38,88,,percent of total billed charges,,,,,,,,,10210.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3341.02,22,,percent of total billed charges,,,12161.3,91,,percent of total billed charges,,,12695.87,95,,percent of total billed charges,,,11092.18,83,,percent of total billed charges,,,11092.18,83,,percent of total billed charges,,,,,,,,,,,,,,,11092.18,83,,percent of total billed charges,,,12695.87,95,,percent of total billed charges,,,12027.66,90,,percent of total billed charges,,,12027.66,90,,percent of total billed charges,,,10958.54,82,,percent of total billed charges,,,12027.66,90,,percent of total billed charges,,,11359.46,85,,percent of total billed charges,,3341.02,12695.87,
DEPUY STEM CEMENTED 14 X 30MM,30185647,CDM,,,278,RC,outpatient,,8336.19,8336.19,,7077.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2084.05,22,,percent of total billed charges,,,,,,,,,7502.57,90,,percent of total billed charges,,,6902.37,82.8,,percent of total billed charges,,,7085.76,85,,percent of total billed charges,,,,,,,,,7335.85,88,,percent of total billed charges,,,,,,,,,6368.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2084.05,22,,percent of total billed charges,,,7585.93,91,,percent of total billed charges,,,7919.38,95,,percent of total billed charges,,,6919.04,83,,percent of total billed charges,,,6919.04,83,,percent of total billed charges,,,,,,,,,,,,,,,6919.04,83,,percent of total billed charges,,,7919.38,95,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,6835.68,82,,percent of total billed charges,,,7502.57,90,,percent of total billed charges,,,7085.76,85,,percent of total billed charges,,2084.05,7919.38,
DEPUY ATTUNE CRS FEMORAL RT SZ 6 CEM,30185648,CDM,,,278,RC,outpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13142.14,22,,percent of total billed charges,,,,,,,,,47311.7,90,,percent of total billed charges,,,43526.77,82.8,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13142.14,22,,percent of total billed charges,,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,13142.14,49940.13,
DEPUY BASE PLATE REVISION RP SZ 6 CEM,30185649,CDM,,,278,RC,outpatient,,39503.36,39503.36,,33538.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9875.84,22,,percent of total billed charges,,,,,,,,,35553.02,90,,percent of total billed charges,,,32708.78,82.8,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,,,,,,,,34762.96,88,,percent of total billed charges,,,,,,,,,30180.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9875.84,22,,percent of total billed charges,,,35948.06,91,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32787.79,83,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,32392.76,82,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,9875.84,37528.19,
DEPUY INSERT ATTUNE CRS RP 6MM,30185650,CDM,,,278,RC,outpatient,,23578.82,23578.82,,20018.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5894.71,22,,percent of total billed charges,,,,,,,,,21220.94,90,,percent of total billed charges,,,19523.26,82.8,,percent of total billed charges,,,20042,85,,percent of total billed charges,,,,,,,,,20749.36,88,,percent of total billed charges,,,,,,,,,18014.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5894.71,22,,percent of total billed charges,,,21456.73,91,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,,,,,,,,,,,,,19570.42,83,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,19334.63,82,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,20042,85,,percent of total billed charges,,5894.71,22399.88,
ZIMMER SHELL MULTIHOLE OSSEOTI G7 70MM,30185651,CDM,,,278,RC,outpatient,,42640,42640,,36201.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10660,22,,percent of total billed charges,,,,,,,,,38376,90,,percent of total billed charges,,,35305.92,82.8,,percent of total billed charges,,,36244,85,,percent of total billed charges,,,,,,,,,37523.2,88,,percent of total billed charges,,,,,,,,,32576.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10660,22,,percent of total billed charges,,,38802.4,91,,percent of total billed charges,,,40508,95,,percent of total billed charges,,,35391.2,83,,percent of total billed charges,,,35391.2,83,,percent of total billed charges,,,,,,,,,,,,,,,35391.2,83,,percent of total billed charges,,,40508,95,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,34964.8,82,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,36244,85,,percent of total billed charges,,10660,40508,
ZIMMER LINER DUAL MOBILITY G7 54MM,30185652,CDM,,,278,RC,outpatient,,24180,24180,,20528.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6045,22,,percent of total billed charges,,,,,,,,,21762,90,,percent of total billed charges,,,20021.04,82.8,,percent of total billed charges,,,20553,85,,percent of total billed charges,,,,,,,,,21278.4,88,,percent of total billed charges,,,,,,,,,18473.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6045,22,,percent of total billed charges,,,22003.8,91,,percent of total billed charges,,,22971,95,,percent of total billed charges,,,20069.4,83,,percent of total billed charges,,,20069.4,83,,percent of total billed charges,,,,,,,,,,,,,,,20069.4,83,,percent of total billed charges,,,22971,95,,percent of total billed charges,,,21762,90,,percent of total billed charges,,,21762,90,,percent of total billed charges,,,19827.6,82,,percent of total billed charges,,,21762,90,,percent of total billed charges,,,20553,85,,percent of total billed charges,,6045,22971,
ZIMMER BEARING HIP ACT ARTIC 28X54MM,30185653,CDM,,,278,RC,outpatient,,23400,23400,,19866.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5850,22,,percent of total billed charges,,,,,,,,,21060,90,,percent of total billed charges,,,19375.2,82.8,,percent of total billed charges,,,19890,85,,percent of total billed charges,,,,,,,,,20592,88,,percent of total billed charges,,,,,,,,,17877.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5850,22,,percent of total billed charges,,,21294,91,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,,,,,,,,,,,,,19422,83,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19188,82,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19890,85,,percent of total billed charges,,5850,22230,
STRYKER HEAD FEMORAL 28MM +5MM,30185654,CDM,,,278,RC,outpatient,,9119.5,9119.5,,7742.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2279.88,22,,percent of total billed charges,,,,,,,,,8207.55,90,,percent of total billed charges,,,7550.95,82.8,,percent of total billed charges,,,7751.58,85,,percent of total billed charges,,,,,,,,,8025.16,88,,percent of total billed charges,,,,,,,,,6967.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2279.88,22,,percent of total billed charges,,,8298.75,91,,percent of total billed charges,,,8663.53,95,,percent of total billed charges,,,7569.19,83,,percent of total billed charges,,,7569.19,83,,percent of total billed charges,,,,,,,,,,,,,,,7569.19,83,,percent of total billed charges,,,8663.53,95,,percent of total billed charges,,,8207.55,90,,percent of total billed charges,,,8207.55,90,,percent of total billed charges,,,7477.99,82,,percent of total billed charges,,,8207.55,90,,percent of total billed charges,,,7751.58,85,,percent of total billed charges,,2279.88,8663.53,
SYNTHES NAIL ELASTIC TI 4.0 X 440MM,30185655,CDM,,,278,RC,outpatient,,3442.08,3442.08,,2922.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,860.52,22,,percent of total billed charges,,,,,,,,,3097.87,90,,percent of total billed charges,,,2850.04,82.8,,percent of total billed charges,,,2925.77,85,,percent of total billed charges,,,,,,,,,3029.03,88,,percent of total billed charges,,,,,,,,,2629.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,860.52,22,,percent of total billed charges,,,3132.29,91,,percent of total billed charges,,,3269.98,95,,percent of total billed charges,,,2856.93,83,,percent of total billed charges,,,2856.93,83,,percent of total billed charges,,,,,,,,,,,,,,,2856.93,83,,percent of total billed charges,,,3269.98,95,,percent of total billed charges,,,3097.87,90,,percent of total billed charges,,,3097.87,90,,percent of total billed charges,,,2822.51,82,,percent of total billed charges,,,3097.87,90,,percent of total billed charges,,,2925.77,85,,percent of total billed charges,,860.52,3269.98,
BREAST IMPLANT NATRELLE INSPIRA 600CC,30185656,CDM,,,278,RC,outpatient,,6675.5,6675.5,,5667.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1668.88,22,,percent of total billed charges,,,,,,,,,6007.95,90,,percent of total billed charges,,,5527.31,82.8,,percent of total billed charges,,,5674.18,85,,percent of total billed charges,,,,,,,,,5874.44,88,,percent of total billed charges,,,,,,,,,5100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1668.88,22,,percent of total billed charges,,,6074.71,91,,percent of total billed charges,,,6341.73,95,,percent of total billed charges,,,5540.67,83,,percent of total billed charges,,,5540.67,83,,percent of total billed charges,,,,,,,,,,,,,,,5540.67,83,,percent of total billed charges,,,6341.73,95,,percent of total billed charges,,,6007.95,90,,percent of total billed charges,,,6007.95,90,,percent of total billed charges,,,5473.91,82,,percent of total billed charges,,,6007.95,90,,percent of total billed charges,,,5674.18,85,,percent of total billed charges,,1668.88,6341.73,
DEPUY BONE MV CEMENT,30185657,CDM,,,270,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
PARAGON PLATE STRAIGHT 6 HOLE W/COMPRESS,30185658,CDM,,,278,RC,outpatient,,9717.5,9717.5,,8250.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2429.38,22,,percent of total billed charges,,,,,,,,,8745.75,90,,percent of total billed charges,,,8046.09,82.8,,percent of total billed charges,,,8259.88,85,,percent of total billed charges,,,,,,,,,8551.4,88,,percent of total billed charges,,,,,,,,,7424.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2429.38,22,,percent of total billed charges,,,8842.93,91,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,,,,,,,,,,,,,8065.53,83,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,7968.35,82,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8259.88,85,,percent of total billed charges,,2429.38,9231.63,
PARAGON SCREW BG NON-LOCKING 2.5X16MM,30185659,CDM,,,278,RC,outpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,390,22,,percent of total billed charges,,,,,,,,,1404,90,,percent of total billed charges,,,1291.68,82.8,,percent of total billed charges,,,1326,85,,percent of total billed charges,,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,390,22,,percent of total billed charges,,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,390,1482,
PARAGON SCREW BG NON-LOCKING 2.5X18MM,30185660,CDM,,,278,RC,outpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,390,22,,percent of total billed charges,,,,,,,,,1404,90,,percent of total billed charges,,,1291.68,82.8,,percent of total billed charges,,,1326,85,,percent of total billed charges,,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,390,22,,percent of total billed charges,,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,390,1482,
PARAGON SCREW BG LOCKING 2.5X22MM,30185661,CDM,,,278,RC,outpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,503.75,22,,percent of total billed charges,,,,,,,,,1813.5,90,,percent of total billed charges,,,1668.42,82.8,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,503.75,22,,percent of total billed charges,,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,503.75,1914.25,
PARAGON SCREW BG LOCKING 2.5X12MM,30185662,CDM,,,278,RC,outpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,503.75,22,,percent of total billed charges,,,,,,,,,1813.5,90,,percent of total billed charges,,,1668.42,82.8,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,503.75,22,,percent of total billed charges,,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,503.75,1914.25,
PARAGON SCREW BG LOCKING 2.5X10MM,30185663,CDM,,,278,RC,outpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,503.75,22,,percent of total billed charges,,,,,,,,,1813.5,90,,percent of total billed charges,,,1668.42,82.8,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,503.75,22,,percent of total billed charges,,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,503.75,1914.25,
PARAGON DRILL SOLID AO 1.3 X 100MM,30185664,CDM,,,270,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
PARAGON WIRE OLIVE SMOOTH 1.3MM,30185665,CDM,,,278,RC,outpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260,22,,percent of total billed charges,,,,,,,,,936,90,,percent of total billed charges,,,861.12,82.8,,percent of total billed charges,,,884,85,,percent of total billed charges,,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260,22,,percent of total billed charges,,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,260,988,
SYNTHES KIT PLATE DISTL RAD 2.4MM VA LCP,30185666,CDM,,,278,RC,outpatient,,19144.13,19144.13,,16253.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4786.03,22,,percent of total billed charges,,,,,,,,,17229.72,90,,percent of total billed charges,,,15851.34,82.8,,percent of total billed charges,,,16272.51,85,,percent of total billed charges,,,,,,,,,16846.83,88,,percent of total billed charges,,,,,,,,,14626.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4786.03,22,,percent of total billed charges,,,17421.16,91,,percent of total billed charges,,,18186.92,95,,percent of total billed charges,,,15889.63,83,,percent of total billed charges,,,15889.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15889.63,83,,percent of total billed charges,,,18186.92,95,,percent of total billed charges,,,17229.72,90,,percent of total billed charges,,,17229.72,90,,percent of total billed charges,,,15698.19,82,,percent of total billed charges,,,17229.72,90,,percent of total billed charges,,,16272.51,85,,percent of total billed charges,,4786.03,18186.92,
SYNTHES PLATE TI 1.5MM 10 HOLE,30185667,CDM,,,278,RC,outpatient,,5492.5,5492.5,,4663.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1373.13,22,,percent of total billed charges,,,,,,,,,4943.25,90,,percent of total billed charges,,,4547.79,82.8,,percent of total billed charges,,,4668.63,85,,percent of total billed charges,,,,,,,,,4833.4,88,,percent of total billed charges,,,,,,,,,4196.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1373.13,22,,percent of total billed charges,,,4998.18,91,,percent of total billed charges,,,5217.88,95,,percent of total billed charges,,,4558.78,83,,percent of total billed charges,,,4558.78,83,,percent of total billed charges,,,,,,,,,,,,,,,4558.78,83,,percent of total billed charges,,,5217.88,95,,percent of total billed charges,,,4943.25,90,,percent of total billed charges,,,4943.25,90,,percent of total billed charges,,,4503.85,82,,percent of total billed charges,,,4943.25,90,,percent of total billed charges,,,4668.63,85,,percent of total billed charges,,1373.13,5217.88,
SYNTHES SCREW CORTEX 1.5 X 6MM,30185668,CDM,,,278,RC,outpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154,22,,percent of total billed charges,,,,,,,,,554.4,90,,percent of total billed charges,,,510.05,82.8,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154,22,,percent of total billed charges,,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,154,585.2,
SYNTHES SCREW CORTEX 1.5 X 7MM,30185669,CDM,,,278,RC,outpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154,22,,percent of total billed charges,,,,,,,,,554.4,90,,percent of total billed charges,,,510.05,82.8,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154,22,,percent of total billed charges,,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,154,585.2,
SYNTHES SCREW CORTEX 1.5 X 9MM,30185670,CDM,,,278,RC,outpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154,22,,percent of total billed charges,,,,,,,,,554.4,90,,percent of total billed charges,,,510.05,82.8,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154,22,,percent of total billed charges,,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,154,585.2,
SYNTHES SCREW CORTEX 1.5 X 10MM,30185671,CDM,,,278,RC,outpatient,,539.28,539.28,,457.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,134.82,22,,percent of total billed charges,,,,,,,,,485.35,90,,percent of total billed charges,,,446.52,82.8,,percent of total billed charges,,,458.39,85,,percent of total billed charges,,,,,,,,,474.57,88,,percent of total billed charges,,,,,,,,,412.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,134.82,22,,percent of total billed charges,,,490.74,91,,percent of total billed charges,,,512.32,95,,percent of total billed charges,,,447.6,83,,percent of total billed charges,,,447.6,83,,percent of total billed charges,,,,,,,,,,,,,,,447.6,83,,percent of total billed charges,,,512.32,95,,percent of total billed charges,,,485.35,90,,percent of total billed charges,,,485.35,90,,percent of total billed charges,,,442.21,82,,percent of total billed charges,,,485.35,90,,percent of total billed charges,,,458.39,85,,percent of total billed charges,,134.82,512.32,
SYNTHES SCREW CORTEX 1.5 X 13MM,30185672,CDM,,,278,RC,outpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154,22,,percent of total billed charges,,,,,,,,,554.4,90,,percent of total billed charges,,,510.05,82.8,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154,22,,percent of total billed charges,,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,154,585.2,
S&N BASE TIBIAL MED LT SZ 3,30185673,CDM,,,278,RC,outpatient,,11374.09,11374.09,,9656.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2843.52,22,,percent of total billed charges,,,,,,,,,10236.68,90,,percent of total billed charges,,,9417.75,82.8,,percent of total billed charges,,,9667.98,85,,percent of total billed charges,,,,,,,,,10009.2,88,,percent of total billed charges,,,,,,,,,8689.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2843.52,22,,percent of total billed charges,,,10350.42,91,,percent of total billed charges,,,10805.39,95,,percent of total billed charges,,,9440.49,83,,percent of total billed charges,,,9440.49,83,,percent of total billed charges,,,,,,,,,,,,,,,9440.49,83,,percent of total billed charges,,,10805.39,95,,percent of total billed charges,,,10236.68,90,,percent of total billed charges,,,10236.68,90,,percent of total billed charges,,,9326.75,82,,percent of total billed charges,,,10236.68,90,,percent of total billed charges,,,9667.98,85,,percent of total billed charges,,2843.52,10805.39,
S&N INSERT TIBIAL MED LT 8MM SZ 3-4,30185674,CDM,,,278,RC,outpatient,,5988.26,5988.26,,5084.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1497.07,22,,percent of total billed charges,,,,,,,,,5389.43,90,,percent of total billed charges,,,4958.28,82.8,,percent of total billed charges,,,5090.02,85,,percent of total billed charges,,,,,,,,,5269.67,88,,percent of total billed charges,,,,,,,,,4575.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1497.07,22,,percent of total billed charges,,,5449.32,91,,percent of total billed charges,,,5688.85,95,,percent of total billed charges,,,4970.26,83,,percent of total billed charges,,,4970.26,83,,percent of total billed charges,,,,,,,,,,,,,,,4970.26,83,,percent of total billed charges,,,5688.85,95,,percent of total billed charges,,,5389.43,90,,percent of total billed charges,,,5389.43,90,,percent of total billed charges,,,4910.37,82,,percent of total billed charges,,,5389.43,90,,percent of total billed charges,,,5090.02,85,,percent of total billed charges,,1497.07,5688.85,
STRYKER BUR DIAMOND 4.0MM,30185675,CDM,,,270,RC,outpatient,,1874.6,1874.6,,1591.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,468.65,22,,percent of total billed charges,,,,,,,,,1687.14,90,,percent of total billed charges,,,1552.17,82.8,,percent of total billed charges,,,1593.41,85,,percent of total billed charges,,,,,,,,,1649.65,88,,percent of total billed charges,,,,,,,,,1432.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,468.65,22,,percent of total billed charges,,,1705.89,91,,percent of total billed charges,,,1780.87,95,,percent of total billed charges,,,1555.92,83,,percent of total billed charges,,,1555.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1555.92,83,,percent of total billed charges,,,1780.87,95,,percent of total billed charges,,,1687.14,90,,percent of total billed charges,,,1687.14,90,,percent of total billed charges,,,1537.17,82,,percent of total billed charges,,,1687.14,90,,percent of total billed charges,,,1593.41,85,,percent of total billed charges,,468.65,1780.87,
HEMACLEAR ORANGE LARGE,30185676,CDM,,,270,RC,outpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.88,22,,percent of total billed charges,,,,,,,,,330.75,90,,percent of total billed charges,,,304.29,82.8,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.88,22,,percent of total billed charges,,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,91.88,349.13,
DEPUY HUMERAL CUP PE 38+3,30185677,CDM,,,278,RC,outpatient,,9988.88,9988.88,,8480.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2497.22,22,,percent of total billed charges,,,,,,,,,8989.99,90,,percent of total billed charges,,,8270.79,82.8,,percent of total billed charges,,,8490.55,85,,percent of total billed charges,,,,,,,,,8790.21,88,,percent of total billed charges,,,,,,,,,7631.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2497.22,22,,percent of total billed charges,,,9089.88,91,,percent of total billed charges,,,9489.44,95,,percent of total billed charges,,,8290.77,83,,percent of total billed charges,,,8290.77,83,,percent of total billed charges,,,,,,,,,,,,,,,8290.77,83,,percent of total billed charges,,,9489.44,95,,percent of total billed charges,,,8989.99,90,,percent of total billed charges,,,8989.99,90,,percent of total billed charges,,,8190.88,82,,percent of total billed charges,,,8989.99,90,,percent of total billed charges,,,8490.55,85,,percent of total billed charges,,2497.22,9489.44,
SYNTHES SCREW CORTEX 16 X 2.4MM STERILE,30185678,CDM,,,278,RC,outpatient,,903.5,903.5,,767.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,225.88,22,,percent of total billed charges,,,,,,,,,813.15,90,,percent of total billed charges,,,748.1,82.8,,percent of total billed charges,,,767.98,85,,percent of total billed charges,,,,,,,,,795.08,88,,percent of total billed charges,,,,,,,,,690.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,225.88,22,,percent of total billed charges,,,822.19,91,,percent of total billed charges,,,858.33,95,,percent of total billed charges,,,749.91,83,,percent of total billed charges,,,749.91,83,,percent of total billed charges,,,,,,,,,,,,,,,749.91,83,,percent of total billed charges,,,858.33,95,,percent of total billed charges,,,813.15,90,,percent of total billed charges,,,813.15,90,,percent of total billed charges,,,740.87,82,,percent of total billed charges,,,813.15,90,,percent of total billed charges,,,767.98,85,,percent of total billed charges,,225.88,858.33,
SYNTHES SCREW CORTEX 18 X 2.4MM STERILE,30185679,CDM,,,278,RC,outpatient,,903.5,903.5,,767.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,225.88,22,,percent of total billed charges,,,,,,,,,813.15,90,,percent of total billed charges,,,748.1,82.8,,percent of total billed charges,,,767.98,85,,percent of total billed charges,,,,,,,,,795.08,88,,percent of total billed charges,,,,,,,,,690.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,225.88,22,,percent of total billed charges,,,822.19,91,,percent of total billed charges,,,858.33,95,,percent of total billed charges,,,749.91,83,,percent of total billed charges,,,749.91,83,,percent of total billed charges,,,,,,,,,,,,,,,749.91,83,,percent of total billed charges,,,858.33,95,,percent of total billed charges,,,813.15,90,,percent of total billed charges,,,813.15,90,,percent of total billed charges,,,740.87,82,,percent of total billed charges,,,813.15,90,,percent of total billed charges,,,767.98,85,,percent of total billed charges,,225.88,858.33,
GRAFT REPAIR BIODESIGN OTOLOGIC 2.5X2.5,30185680,CDM,,,278,RC,outpatient,,1742,1742,,1478.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,435.5,22,,percent of total billed charges,,,,,,,,,1567.8,90,,percent of total billed charges,,,1442.38,82.8,,percent of total billed charges,,,1480.7,85,,percent of total billed charges,,,,,,,,,1532.96,88,,percent of total billed charges,,,,,,,,,1330.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,435.5,22,,percent of total billed charges,,,1585.22,91,,percent of total billed charges,,,1654.9,95,,percent of total billed charges,,,1445.86,83,,percent of total billed charges,,,1445.86,83,,percent of total billed charges,,,,,,,,,,,,,,,1445.86,83,,percent of total billed charges,,,1654.9,95,,percent of total billed charges,,,1567.8,90,,percent of total billed charges,,,1567.8,90,,percent of total billed charges,,,1428.44,82,,percent of total billed charges,,,1567.8,90,,percent of total billed charges,,,1480.7,85,,percent of total billed charges,,435.5,1654.9,
ULRICH CAGE 12 X 14 X 7MM 6DEG.,30185682,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
ULRICH PLATE UNION 1 LEVEL 12MM,30185683,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
ULRICH SCREW SELF DRILLING 4.0 X 14MM,30185684,CDM,,,278,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
ULRICH SCREW SELF DRILLING 4.0 X 12MM,30185685,CDM,,,278,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
MEDTRONIC ICD BI VENTRICULAR,30185687,CDM,,,278,RC,outpatient,,199059.84,199059.84,,169001.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49764.96,22,,percent of total billed charges,,,,,,,,,179153.86,90,,percent of total billed charges,,,164821.55,82.8,,percent of total billed charges,,,169200.86,85,,percent of total billed charges,,,,,,,,,175172.66,88,,percent of total billed charges,,,,,,,,,152081.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49764.96,22,,percent of total billed charges,,,181144.45,91,,percent of total billed charges,,,189106.85,95,,percent of total billed charges,,,165219.67,83,,percent of total billed charges,,,165219.67,83,,percent of total billed charges,,,,,,,,,,,,,,,165219.67,83,,percent of total billed charges,,,189106.85,95,,percent of total billed charges,,,179153.86,90,,percent of total billed charges,,,179153.86,90,,percent of total billed charges,,,163229.07,82,,percent of total billed charges,,,179153.86,90,,percent of total billed charges,,,169200.86,85,,percent of total billed charges,,49764.96,189106.85,
STRYKER DRILL ICONIX 1.4MM,30185688,CDM,,,270,RC,outpatient,,1296.88,1296.88,,1101.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,324.22,22,,percent of total billed charges,,,,,,,,,1167.19,90,,percent of total billed charges,,,1073.82,82.8,,percent of total billed charges,,,1102.35,85,,percent of total billed charges,,,,,,,,,1141.25,88,,percent of total billed charges,,,,,,,,,990.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,324.22,22,,percent of total billed charges,,,1180.16,91,,percent of total billed charges,,,1232.04,95,,percent of total billed charges,,,1076.41,83,,percent of total billed charges,,,1076.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1076.41,83,,percent of total billed charges,,,1232.04,95,,percent of total billed charges,,,1167.19,90,,percent of total billed charges,,,1167.19,90,,percent of total billed charges,,,1063.44,82,,percent of total billed charges,,,1167.19,90,,percent of total billed charges,,,1102.35,85,,percent of total billed charges,,324.22,1232.04,
STRYKER ANCHOR 1.4MM W/XBRAID 1.2MM,30185689,CDM,,,270,RC,outpatient,,3474.19,3474.19,,2949.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,868.55,22,,percent of total billed charges,,,,,,,,,3126.77,90,,percent of total billed charges,,,2876.63,82.8,,percent of total billed charges,,,2953.06,85,,percent of total billed charges,,,,,,,,,3057.29,88,,percent of total billed charges,,,,,,,,,2654.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,868.55,22,,percent of total billed charges,,,3161.51,91,,percent of total billed charges,,,3300.48,95,,percent of total billed charges,,,2883.58,83,,percent of total billed charges,,,2883.58,83,,percent of total billed charges,,,,,,,,,,,,,,,2883.58,83,,percent of total billed charges,,,3300.48,95,,percent of total billed charges,,,3126.77,90,,percent of total billed charges,,,3126.77,90,,percent of total billed charges,,,2848.84,82,,percent of total billed charges,,,3126.77,90,,percent of total billed charges,,,2953.06,85,,percent of total billed charges,,868.55,3300.48,
ZIMMER SHELL MULTIHOLE OSSEOTI G7 68MM I,30185691,CDM,,,278,RC,outpatient,,42640,42640,,36201.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10660,22,,percent of total billed charges,,,,,,,,,38376,90,,percent of total billed charges,,,35305.92,82.8,,percent of total billed charges,,,36244,85,,percent of total billed charges,,,,,,,,,37523.2,88,,percent of total billed charges,,,,,,,,,32576.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10660,22,,percent of total billed charges,,,38802.4,91,,percent of total billed charges,,,40508,95,,percent of total billed charges,,,35391.2,83,,percent of total billed charges,,,35391.2,83,,percent of total billed charges,,,,,,,,,,,,,,,35391.2,83,,percent of total billed charges,,,40508,95,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,34964.8,82,,percent of total billed charges,,,38376,90,,percent of total billed charges,,,36244,85,,percent of total billed charges,,10660,40508,
DEPUY FEMORAL BODY PROXIMAL LPS 15DEG LE,30185692,CDM,,,278,RC,outpatient,,56410.06,56410.06,,47892.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14102.52,22,,percent of total billed charges,,,,,,,,,50769.05,90,,percent of total billed charges,,,46707.53,82.8,,percent of total billed charges,,,47948.55,85,,percent of total billed charges,,,,,,,,,49640.85,88,,percent of total billed charges,,,,,,,,,43097.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14102.52,22,,percent of total billed charges,,,51333.15,91,,percent of total billed charges,,,53589.56,95,,percent of total billed charges,,,46820.35,83,,percent of total billed charges,,,46820.35,83,,percent of total billed charges,,,,,,,,,,,,,,,46820.35,83,,percent of total billed charges,,,53589.56,95,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,46256.25,82,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,47948.55,85,,percent of total billed charges,,14102.52,53589.56,
DEPUY STEM CEMENTED LPS 11 X 200MM,30185693,CDM,,,278,RC,outpatient,,44982.15,44982.15,,38189.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11245.54,22,,percent of total billed charges,,,,,,,,,40483.94,90,,percent of total billed charges,,,37245.22,82.8,,percent of total billed charges,,,38234.83,85,,percent of total billed charges,,,,,,,,,39584.29,88,,percent of total billed charges,,,,,,,,,34366.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11245.54,22,,percent of total billed charges,,,40933.76,91,,percent of total billed charges,,,42733.04,95,,percent of total billed charges,,,37335.18,83,,percent of total billed charges,,,37335.18,83,,percent of total billed charges,,,,,,,,,,,,,,,37335.18,83,,percent of total billed charges,,,42733.04,95,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,36885.36,82,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,38234.83,85,,percent of total billed charges,,11245.54,42733.04,
DEPUY INSERT RP 12.5MM,30185694,CDM,,,278,RC,outpatient,,13012.42,13012.42,,11047.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3253.11,22,,percent of total billed charges,,,,,,,,,11711.18,90,,percent of total billed charges,,,10774.28,82.8,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,,,,,,,,11450.93,88,,percent of total billed charges,,,,,,,,,9941.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3253.11,22,,percent of total billed charges,,,11841.3,91,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,10800.31,83,,percent of total billed charges,,,,,,,,,,,,,,,10800.31,83,,percent of total billed charges,,,12361.8,95,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,10670.18,82,,percent of total billed charges,,,11711.18,90,,percent of total billed charges,,,11060.56,85,,percent of total billed charges,,3253.11,12361.8,
ORTHOFIX OSCAR 2 SYSTEM,30185695,CDM,,,270,RC,outpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2437.5,22,,percent of total billed charges,,,,,,,,,8775,90,,percent of total billed charges,,,8073,82.8,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2437.5,22,,percent of total billed charges,,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,2437.5,9262.5,
ORTHOFIX PROBE PIERCER 8MM,30185696,CDM,,,270,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
ORTHOFIX OSTEOTOME 6MM CURVED SERRATED,30185697,CDM,,,270,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
DURAGEN SECURE 2X2 REGENERATION MATRIX,30185698,CDM,,,270,RC,outpatient,,3567.53,3567.53,,3028.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,891.88,22,,percent of total billed charges,,,,,,,,,3210.78,90,,percent of total billed charges,,,2953.91,82.8,,percent of total billed charges,,,3032.4,85,,percent of total billed charges,,,,,,,,,3139.43,88,,percent of total billed charges,,,,,,,,,2725.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,891.88,22,,percent of total billed charges,,,3246.45,91,,percent of total billed charges,,,3389.15,95,,percent of total billed charges,,,2961.05,83,,percent of total billed charges,,,2961.05,83,,percent of total billed charges,,,,,,,,,,,,,,,2961.05,83,,percent of total billed charges,,,3389.15,95,,percent of total billed charges,,,3210.78,90,,percent of total billed charges,,,3210.78,90,,percent of total billed charges,,,2925.37,82,,percent of total billed charges,,,3210.78,90,,percent of total billed charges,,,3032.4,85,,percent of total billed charges,,891.88,3389.15,
ZIMMER FEMUR XL OXFORD TWIN PEG,30185699,CDM,,,278,RC,outpatient,,20345,20345,,17272.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5086.25,22,,percent of total billed charges,,,,,,,,,18310.5,90,,percent of total billed charges,,,16845.66,82.8,,percent of total billed charges,,,17293.25,85,,percent of total billed charges,,,,,,,,,17903.6,88,,percent of total billed charges,,,,,,,,,15543.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5086.25,22,,percent of total billed charges,,,18513.95,91,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,16886.35,83,,percent of total billed charges,,,,,,,,,,,,,,,16886.35,83,,percent of total billed charges,,,19327.75,95,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,16682.9,82,,percent of total billed charges,,,18310.5,90,,percent of total billed charges,,,17293.25,85,,percent of total billed charges,,5086.25,19327.75,
ZIMMER BEARING ANATOMIC MENISCAL XL SZ 5,30185700,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
ZIMMER BEARING XL 5MM,30185702,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
DEPUY LINER ALTRX +4 40 X 64,30185703,CDM,,,278,RC,outpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4400.13,22,,percent of total billed charges,,,,,,,,,15840.46,90,,percent of total billed charges,,,14573.22,82.8,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4400.13,22,,percent of total billed charges,,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,4400.13,16720.48,
SYNTHES PLATE LCP SUP ANT CLAVICLE 6H RT,30185704,CDM,,,278,RC,outpatient,,10192,10192,,8653.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2548,22,,percent of total billed charges,,,,,,,,,9172.8,90,,percent of total billed charges,,,8438.98,82.8,,percent of total billed charges,,,8663.2,85,,percent of total billed charges,,,,,,,,,8968.96,88,,percent of total billed charges,,,,,,,,,7786.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2548,22,,percent of total billed charges,,,9274.72,91,,percent of total billed charges,,,9682.4,95,,percent of total billed charges,,,8459.36,83,,percent of total billed charges,,,8459.36,83,,percent of total billed charges,,,,,,,,,,,,,,,8459.36,83,,percent of total billed charges,,,9682.4,95,,percent of total billed charges,,,9172.8,90,,percent of total billed charges,,,9172.8,90,,percent of total billed charges,,,8357.44,82,,percent of total billed charges,,,9172.8,90,,percent of total billed charges,,,8663.2,85,,percent of total billed charges,,2548,9682.4,
ROD LORDOSED 6.0 X 90MM,30185705,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ZIMMER SHELL OSSEOTI G7 4 HOLE 60MM G,30185706,CDM,,,278,RC,outpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4834.38,22,,percent of total billed charges,,,,,,,,,17403.75,90,,percent of total billed charges,,,16011.45,82.8,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4834.38,22,,percent of total billed charges,,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,4834.38,18370.63,
DEPUY STEM CEMENTED LPS 12 X 125,30185707,CDM,,,278,RC,outpatient,,42441.95,42441.95,,36033.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10610.49,22,,percent of total billed charges,,,,,,,,,38197.76,90,,percent of total billed charges,,,35141.93,82.8,,percent of total billed charges,,,36075.66,85,,percent of total billed charges,,,,,,,,,37348.92,88,,percent of total billed charges,,,,,,,,,32425.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10610.49,22,,percent of total billed charges,,,38622.17,91,,percent of total billed charges,,,40319.85,95,,percent of total billed charges,,,35226.82,83,,percent of total billed charges,,,35226.82,83,,percent of total billed charges,,,,,,,,,,,,,,,35226.82,83,,percent of total billed charges,,,40319.85,95,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,34802.4,82,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,36075.66,85,,percent of total billed charges,,10610.49,40319.85,
DEPUY SEGMENTAL COMPONENT 35MM,30185708,CDM,,,278,RC,outpatient,,18773.5,18773.5,,15938.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4693.38,22,,percent of total billed charges,,,,,,,,,16896.15,90,,percent of total billed charges,,,15544.46,82.8,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,,,,,,,,16520.68,88,,percent of total billed charges,,,,,,,,,14342.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4693.38,22,,percent of total billed charges,,,17083.89,91,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,,,,,,,,,,,,,15582.01,83,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15394.27,82,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,4693.38,17834.83,
DEPUY INSERT LPS XX-SM 12MM,30185709,CDM,,,278,RC,outpatient,,33343.12,33343.12,,28308.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8335.78,22,,percent of total billed charges,,,,,,,,,30008.81,90,,percent of total billed charges,,,27608.1,82.8,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,,,,,,,,29341.95,88,,percent of total billed charges,,,,,,,,,25474.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8335.78,22,,percent of total billed charges,,,30342.24,91,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,,,,,,,,,,,,,27674.79,83,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,27341.36,82,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,8335.78,31675.96,
ULRICH DRILL BIT 12MM,30185710,CDM,,,270,RC,outpatient,,2340,2340,,1986.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,585,22,,percent of total billed charges,,,,,,,,,2106,90,,percent of total billed charges,,,1937.52,82.8,,percent of total billed charges,,,1989,85,,percent of total billed charges,,,,,,,,,2059.2,88,,percent of total billed charges,,,,,,,,,1787.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,585,22,,percent of total billed charges,,,2129.4,91,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1942.2,83,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1918.8,82,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1989,85,,percent of total billed charges,,585,2223,
ULRICH PEEK CERVICAL 6MM 15 X 13 6DEG,30185711,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
ULRICH PLATE  3 LEVEL 45MM,30185712,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
ULRICH PEEK CERVICAL 7MM 15 X 13 6DEG,30185713,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
ULRICH PLATE 2 LEVEL 30MM,30185714,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
KYPHON 15/2 EXPRESS FIRST FRACTURE KIT,30185715,CDM,,,278,RC,outpatient,,25961,25961,,22040.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6490.25,22,,percent of total billed charges,,,,,,,,,23364.9,90,,percent of total billed charges,,,21495.71,82.8,,percent of total billed charges,,,22066.85,85,,percent of total billed charges,,,,,,,,,22845.68,88,,percent of total billed charges,,,,,,,,,19834.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6490.25,22,,percent of total billed charges,,,23624.51,91,,percent of total billed charges,,,24662.95,95,,percent of total billed charges,,,21547.63,83,,percent of total billed charges,,,21547.63,83,,percent of total billed charges,,,,,,,,,,,,,,,21547.63,83,,percent of total billed charges,,,24662.95,95,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,21288.02,82,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,22066.85,85,,percent of total billed charges,,6490.25,24662.95,
KYPHON CEMENT BONE HV-R,30185716,CDM,,,278,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
STRYKER FEMUR TRIATHLON PS RT SZ 6,30185717,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
STRYKER INSERT TRIATHLON PS X3 6-9MM,30185718,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER TIBIA TRIATHLON TRITANIUM SZ 6,30185719,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
SYNTHES SCREW CORTEX S-T 2.7 X 20MM,30185720,CDM,,,278,RC,outpatient,,410.27,410.27,,348.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,102.57,22,,percent of total billed charges,,,,,,,,,369.24,90,,percent of total billed charges,,,339.7,82.8,,percent of total billed charges,,,348.73,85,,percent of total billed charges,,,,,,,,,361.04,88,,percent of total billed charges,,,,,,,,,313.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,102.57,22,,percent of total billed charges,,,373.35,91,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,340.52,83,,percent of total billed charges,,,,,,,,,,,,,,,340.52,83,,percent of total billed charges,,,389.76,95,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,336.42,82,,percent of total billed charges,,,369.24,90,,percent of total billed charges,,,348.73,85,,percent of total billed charges,,102.57,389.76,
SYNTHES SCREW LOCKING 2.7X20MM,30185721,CDM,,,278,RC,outpatient,,1143.87,1143.87,,971.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,285.97,22,,percent of total billed charges,,,,,,,,,1029.48,90,,percent of total billed charges,,,947.12,82.8,,percent of total billed charges,,,972.29,85,,percent of total billed charges,,,,,,,,,1006.61,88,,percent of total billed charges,,,,,,,,,873.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,285.97,22,,percent of total billed charges,,,1040.92,91,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,,,,,,,,,,,,,949.41,83,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,937.97,82,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,972.29,85,,percent of total billed charges,,285.97,1086.68,
SYNTHES LCP PLATE 4 HOLE 40MM,30185722,CDM,,,278,RC,outpatient,,4556.5,4556.5,,3868.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1139.13,22,,percent of total billed charges,,,,,,,,,4100.85,90,,percent of total billed charges,,,3772.78,82.8,,percent of total billed charges,,,3873.03,85,,percent of total billed charges,,,,,,,,,4009.72,88,,percent of total billed charges,,,,,,,,,3481.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1139.13,22,,percent of total billed charges,,,4146.42,91,,percent of total billed charges,,,4328.68,95,,percent of total billed charges,,,3781.9,83,,percent of total billed charges,,,3781.9,83,,percent of total billed charges,,,,,,,,,,,,,,,3781.9,83,,percent of total billed charges,,,4328.68,95,,percent of total billed charges,,,4100.85,90,,percent of total billed charges,,,4100.85,90,,percent of total billed charges,,,3736.33,82,,percent of total billed charges,,,4100.85,90,,percent of total billed charges,,,3873.03,85,,percent of total billed charges,,1139.13,4328.68,
SYNTHES SCREW LOCKING S-T 3.5 X 32MM,30185723,CDM,,,278,RC,outpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,313.59,22,,percent of total billed charges,,,,,,,,,1128.93,90,,percent of total billed charges,,,1038.62,82.8,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,313.59,22,,percent of total billed charges,,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,313.59,1191.65,
SYNTHES SCREW LOCKING S-T 3.5 X 40MM,30185724,CDM,,,278,RC,outpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,313.59,22,,percent of total billed charges,,,,,,,,,1128.93,90,,percent of total billed charges,,,1038.62,82.8,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,313.59,22,,percent of total billed charges,,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,313.59,1191.65,
SYNTHES DRILL BIT QC 2.8 248MM LONG 95MM,30185725,CDM,,,278,RC,outpatient,,1564.94,1564.94,,1328.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,391.24,22,,percent of total billed charges,,,,,,,,,1408.45,90,,percent of total billed charges,,,1295.77,82.8,,percent of total billed charges,,,1330.2,85,,percent of total billed charges,,,,,,,,,1377.15,88,,percent of total billed charges,,,,,,,,,1195.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,391.24,22,,percent of total billed charges,,,1424.1,91,,percent of total billed charges,,,1486.69,95,,percent of total billed charges,,,1298.9,83,,percent of total billed charges,,,1298.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1298.9,83,,percent of total billed charges,,,1486.69,95,,percent of total billed charges,,,1408.45,90,,percent of total billed charges,,,1408.45,90,,percent of total billed charges,,,1283.25,82,,percent of total billed charges,,,1408.45,90,,percent of total billed charges,,,1330.2,85,,percent of total billed charges,,391.24,1486.69,
SYNTHES SCREW LOCKING S-T 2.7X22MM W/STA,30185726,CDM,,,278,RC,outpatient,,1110.53,1110.53,,942.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,277.63,22,,percent of total billed charges,,,,,,,,,999.48,90,,percent of total billed charges,,,919.52,82.8,,percent of total billed charges,,,943.95,85,,percent of total billed charges,,,,,,,,,977.27,88,,percent of total billed charges,,,,,,,,,848.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,277.63,22,,percent of total billed charges,,,1010.58,91,,percent of total billed charges,,,1055,95,,percent of total billed charges,,,921.74,83,,percent of total billed charges,,,921.74,83,,percent of total billed charges,,,,,,,,,,,,,,,921.74,83,,percent of total billed charges,,,1055,95,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,910.63,82,,percent of total billed charges,,,999.48,90,,percent of total billed charges,,,943.95,85,,percent of total billed charges,,277.63,1055,
SYNTHES SCREW CORTEX S-T 2.7 X 22MM,30185727,CDM,,,278,RC,outpatient,,386.75,386.75,,328.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.69,22,,percent of total billed charges,,,,,,,,,348.08,90,,percent of total billed charges,,,320.23,82.8,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,,,,,,,,340.34,88,,percent of total billed charges,,,,,,,,,295.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.69,22,,percent of total billed charges,,,351.94,91,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,321,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,,,,,,,,,,,,,,321,83,,percent of total billed charges,,,367.41,95,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,317.14,82,,percent of total billed charges,,,348.08,90,,percent of total billed charges,,,328.74,85,,percent of total billed charges,,96.69,367.41,
SYNTHES PLATE TIBIA 4 HOLE RT SMALL BEND,30185728,CDM,,,278,RC,outpatient,,14668.88,14668.88,,12453.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3667.22,22,,percent of total billed charges,,,,,,,,,13201.99,90,,percent of total billed charges,,,12145.83,82.8,,percent of total billed charges,,,12468.55,85,,percent of total billed charges,,,,,,,,,12908.61,88,,percent of total billed charges,,,,,,,,,11207.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3667.22,22,,percent of total billed charges,,,13348.68,91,,percent of total billed charges,,,13935.44,95,,percent of total billed charges,,,12175.17,83,,percent of total billed charges,,,12175.17,83,,percent of total billed charges,,,,,,,,,,,,,,,12175.17,83,,percent of total billed charges,,,13935.44,95,,percent of total billed charges,,,13201.99,90,,percent of total billed charges,,,13201.99,90,,percent of total billed charges,,,12028.48,82,,percent of total billed charges,,,13201.99,90,,percent of total billed charges,,,12468.55,85,,percent of total billed charges,,3667.22,13935.44,
SYNTHES SCREW LOCKING VA 3.5 X 30MM,30185729,CDM,,,278,RC,outpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375.13,22,,percent of total billed charges,,,,,,,,,1350.48,90,,percent of total billed charges,,,1242.44,82.8,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,375.13,22,,percent of total billed charges,,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,375.13,1425.5,
SYNTHES SCREW LOCKING VA 3.5 X 32MM,30185730,CDM,,,278,RC,outpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375.13,22,,percent of total billed charges,,,,,,,,,1350.48,90,,percent of total billed charges,,,1242.44,82.8,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,375.13,22,,percent of total billed charges,,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,375.13,1425.5,
SYNTHES SCREW LOCKING VA 3.5 X 40MM,30185731,CDM,,,278,RC,outpatient,,1456.85,1456.85,,1236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,364.21,22,,percent of total billed charges,,,,,,,,,1311.17,90,,percent of total billed charges,,,1206.27,82.8,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,,,,,,,,1282.03,88,,percent of total billed charges,,,,,,,,,1113.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,364.21,22,,percent of total billed charges,,,1325.73,91,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1209.19,83,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1194.62,82,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,364.21,1384.01,
SYNTHES SCREW LOCKING VA 3.5 X 60MM,30185732,CDM,,,278,RC,outpatient,,1456.85,1456.85,,1236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,364.21,22,,percent of total billed charges,,,,,,,,,1311.17,90,,percent of total billed charges,,,1206.27,82.8,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,,,,,,,,1282.03,88,,percent of total billed charges,,,,,,,,,1113.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,364.21,22,,percent of total billed charges,,,1325.73,91,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1209.19,83,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1194.62,82,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,364.21,1384.01,
OLYMPUS HEMOSTATIS DEVICE (EN) VN,30185733,CDM,,,270,RC,outpatient,,635.4,635.4,,539.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,158.85,22,,percent of total billed charges,,,,,,,,,571.86,90,,percent of total billed charges,,,526.11,82.8,,percent of total billed charges,,,540.09,85,,percent of total billed charges,,,,,,,,,559.15,88,,percent of total billed charges,,,,,,,,,485.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,158.85,22,,percent of total billed charges,,,578.21,91,,percent of total billed charges,,,603.63,95,,percent of total billed charges,,,527.38,83,,percent of total billed charges,,,527.38,83,,percent of total billed charges,,,,,,,,,,,,,,,527.38,83,,percent of total billed charges,,,603.63,95,,percent of total billed charges,,,571.86,90,,percent of total billed charges,,,571.86,90,,percent of total billed charges,,,521.03,82,,percent of total billed charges,,,571.86,90,,percent of total billed charges,,,540.09,85,,percent of total billed charges,,158.85,603.63,
CANNULA MERCEDES 4MM SHORT FLARED,30185734,CDM,,,270,RC,outpatient,,434,434,,368.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.5,22,,percent of total billed charges,,,,,,,,,390.6,90,,percent of total billed charges,,,359.35,82.8,,percent of total billed charges,,,368.9,85,,percent of total billed charges,,,,,,,,,381.92,88,,percent of total billed charges,,,,,,,,,331.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108.5,22,,percent of total billed charges,,,394.94,91,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,,,,,,,,,,,,,360.22,83,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,355.88,82,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,368.9,85,,percent of total billed charges,,108.5,412.3,
CANNULA MERCEDES 4MM LONG FLARED,30185735,CDM,,,270,RC,outpatient,,434,434,,368.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.5,22,,percent of total billed charges,,,,,,,,,390.6,90,,percent of total billed charges,,,359.35,82.8,,percent of total billed charges,,,368.9,85,,percent of total billed charges,,,,,,,,,381.92,88,,percent of total billed charges,,,,,,,,,331.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108.5,22,,percent of total billed charges,,,394.94,91,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,,,,,,,,,,,,,360.22,83,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,355.88,82,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,368.9,85,,percent of total billed charges,,108.5,412.3,
CANNULA MERCEDES 4MM  X 30MM,30185736,CDM,,,270,RC,outpatient,,360.5,360.5,,306.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90.13,22,,percent of total billed charges,,,,,,,,,324.45,90,,percent of total billed charges,,,298.49,82.8,,percent of total billed charges,,,306.43,85,,percent of total billed charges,,,,,,,,,317.24,88,,percent of total billed charges,,,,,,,,,275.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90.13,22,,percent of total billed charges,,,328.06,91,,percent of total billed charges,,,342.48,95,,percent of total billed charges,,,299.22,83,,percent of total billed charges,,,299.22,83,,percent of total billed charges,,,,,,,,,,,,,,,299.22,83,,percent of total billed charges,,,342.48,95,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,295.61,82,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,306.43,85,,percent of total billed charges,,90.13,342.48,
CANNULA MERCEDES 4MM X 22MM,30185737,CDM,,,270,RC,outpatient,,385,385,,326.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.25,22,,percent of total billed charges,,,,,,,,,346.5,90,,percent of total billed charges,,,318.78,82.8,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,,,,,,,,338.8,88,,percent of total billed charges,,,,,,,,,294.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.25,22,,percent of total billed charges,,,350.35,91,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,,,,,,,,,,,,,319.55,83,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,315.7,82,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,96.25,365.75,
CANNULA MERCEDES 3MM X 15MM,30185738,CDM,,,270,RC,outpatient,,360.5,360.5,,306.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90.13,22,,percent of total billed charges,,,,,,,,,324.45,90,,percent of total billed charges,,,298.49,82.8,,percent of total billed charges,,,306.43,85,,percent of total billed charges,,,,,,,,,317.24,88,,percent of total billed charges,,,,,,,,,275.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90.13,22,,percent of total billed charges,,,328.06,91,,percent of total billed charges,,,342.48,95,,percent of total billed charges,,,299.22,83,,percent of total billed charges,,,299.22,83,,percent of total billed charges,,,,,,,,,,,,,,,299.22,83,,percent of total billed charges,,,342.48,95,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,295.61,82,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,306.43,85,,percent of total billed charges,,90.13,342.48,
CANNULA MERCEDES 3MM X 22MM,30185739,CDM,,,270,RC,outpatient,,360.5,360.5,,306.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90.13,22,,percent of total billed charges,,,,,,,,,324.45,90,,percent of total billed charges,,,298.49,82.8,,percent of total billed charges,,,306.43,85,,percent of total billed charges,,,,,,,,,317.24,88,,percent of total billed charges,,,,,,,,,275.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90.13,22,,percent of total billed charges,,,328.06,91,,percent of total billed charges,,,342.48,95,,percent of total billed charges,,,299.22,83,,percent of total billed charges,,,299.22,83,,percent of total billed charges,,,,,,,,,,,,,,,299.22,83,,percent of total billed charges,,,342.48,95,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,295.61,82,,percent of total billed charges,,,324.45,90,,percent of total billed charges,,,306.43,85,,percent of total billed charges,,90.13,342.48,
SYNTHES NAIL ELASTIC TI 3.0 X 440MM,30185740,CDM,,,278,RC,outpatient,,3033.23,3033.23,,2575.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,758.31,22,,percent of total billed charges,,,,,,,,,2729.91,90,,percent of total billed charges,,,2511.51,82.8,,percent of total billed charges,,,2578.25,85,,percent of total billed charges,,,,,,,,,2669.24,88,,percent of total billed charges,,,,,,,,,2317.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,758.31,22,,percent of total billed charges,,,2760.24,91,,percent of total billed charges,,,2881.57,95,,percent of total billed charges,,,2517.58,83,,percent of total billed charges,,,2517.58,83,,percent of total billed charges,,,,,,,,,,,,,,,2517.58,83,,percent of total billed charges,,,2881.57,95,,percent of total billed charges,,,2729.91,90,,percent of total billed charges,,,2729.91,90,,percent of total billed charges,,,2487.25,82,,percent of total billed charges,,,2729.91,90,,percent of total billed charges,,,2578.25,85,,percent of total billed charges,,758.31,2881.57,
SYNTHES DRILL BIT 4.5 X 195MM,30185741,CDM,,,270,RC,outpatient,,1326,1326,,1125.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,331.5,22,,percent of total billed charges,,,,,,,,,1193.4,90,,percent of total billed charges,,,1097.93,82.8,,percent of total billed charges,,,1127.1,85,,percent of total billed charges,,,,,,,,,1166.88,88,,percent of total billed charges,,,,,,,,,1013.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,331.5,22,,percent of total billed charges,,,1206.66,91,,percent of total billed charges,,,1259.7,95,,percent of total billed charges,,,1100.58,83,,percent of total billed charges,,,1100.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1100.58,83,,percent of total billed charges,,,1259.7,95,,percent of total billed charges,,,1193.4,90,,percent of total billed charges,,,1193.4,90,,percent of total billed charges,,,1087.32,82,,percent of total billed charges,,,1193.4,90,,percent of total billed charges,,,1127.1,85,,percent of total billed charges,,331.5,1259.7,
ZIMMER CEMENT BONE R,30185742,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
SPINECRAFT SCREW 8.5 X 40MM,30185743,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT SCREW 8.5 X 45MM,30185744,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT SCREW 7.5 X 45MM,30185745,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT SCREW 9.5 X 45MM,30185746,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT SCREW 7.5 X 40MM,30185747,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT SCREW SET,30185748,CDM,,,278,RC,outpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175,22,,percent of total billed charges,,,,,,,,,630,90,,percent of total billed charges,,,579.6,82.8,,percent of total billed charges,,,595,85,,percent of total billed charges,,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175,22,,percent of total billed charges,,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,175,665,
SPINECRAFT WASHER,30185749,CDM,,,278,RC,outpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175,22,,percent of total billed charges,,,,,,,,,630,90,,percent of total billed charges,,,579.6,82.8,,percent of total billed charges,,,595,85,,percent of total billed charges,,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175,22,,percent of total billed charges,,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,175,665,
SPINECRAFT ROD TITANIUM 6.0 X 300,30185750,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
SPINECRAFT ROD LOWDOSED 6.0 X 90,30185751,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
SPINECRAFT CAGE 10MM 0DEG X 22MM,30185752,CDM,,,278,RC,outpatient,,13000,13000,,11037,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3250,22,,percent of total billed charges,,,,,,,,,11700,90,,percent of total billed charges,,,10764,82.8,,percent of total billed charges,,,11050,85,,percent of total billed charges,,,,,,,,,11440,88,,percent of total billed charges,,,,,,,,,9932,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3250,22,,percent of total billed charges,,,11830,91,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,,,,,,,,,,,,,10790,83,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,10660,82,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11050,85,,percent of total billed charges,,3250,12350,
DEPUY ATTUNE TIBIA RP REVISION SZ 8,30185753,CDM,,,278,RC,outpatient,,39503.36,39503.36,,33538.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9875.84,22,,percent of total billed charges,,,,,,,,,35553.02,90,,percent of total billed charges,,,32708.78,82.8,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,,,,,,,,34762.96,88,,percent of total billed charges,,,,,,,,,30180.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9875.84,22,,percent of total billed charges,,,35948.06,91,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32787.79,83,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,32392.76,82,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,9875.84,37528.19,
ULRICH PLATE  2 LEVEL 34MM,30185754,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
ULRICH DRILL BIT 14MM,30185755,CDM,,,270,RC,outpatient,,2210,2210,,1876.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,552.5,22,,percent of total billed charges,,,,,,,,,1989,90,,percent of total billed charges,,,1829.88,82.8,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,,,,,,,,1944.8,88,,percent of total billed charges,,,,,,,,,1688.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,552.5,22,,percent of total billed charges,,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1834.3,83,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1812.2,82,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,552.5,2099.5,
ULRICH SCREWS 4.0 X 16MM,30185756,CDM,,,278,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
IR SCREW REDUCTION 6.5 X 40MM,30185757,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
IR SCREW POLY 6.5 X 45MM,30185758,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
IR ROD LORDOSED 5.5 X 50MM,30185759,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
IR ROD LORDOSED 5.5 X 40MM,30185760,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
IR SCREW SET,30185761,CDM,,,278,RC,outpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175,22,,percent of total billed charges,,,,,,,,,630,90,,percent of total billed charges,,,579.6,82.8,,percent of total billed charges,,,595,85,,percent of total billed charges,,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175,22,,percent of total billed charges,,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,175,665,
DEPUY HEAD HUMERAL 48X18,30185960,CDM,,,278,RC,outpatient,,15528.76,15528.76,,13183.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3882.19,22,,percent of total billed charges,,,,,,,,,13975.88,90,,percent of total billed charges,,,12857.81,82.8,,percent of total billed charges,,,13199.45,85,,percent of total billed charges,,,,,,,,,13665.31,88,,percent of total billed charges,,,,,,,,,11863.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3882.19,22,,percent of total billed charges,,,14131.17,91,,percent of total billed charges,,,14752.32,95,,percent of total billed charges,,,12888.87,83,,percent of total billed charges,,,12888.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12888.87,83,,percent of total billed charges,,,14752.32,95,,percent of total billed charges,,,13975.88,90,,percent of total billed charges,,,13975.88,90,,percent of total billed charges,,,12733.58,82,,percent of total billed charges,,,13975.88,90,,percent of total billed charges,,,13199.45,85,,percent of total billed charges,,3882.19,14752.32,
SCREW POLYAXIAL 6.5 X 35MM,30185961,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ARTHREX SPEEDBRIDGE KIT,30185962,CDM,,,270,RC,outpatient,,12415,12415,,10540.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3103.75,22,,percent of total billed charges,,,,,,,,,11173.5,90,,percent of total billed charges,,,10279.62,82.8,,percent of total billed charges,,,10552.75,85,,percent of total billed charges,,,,,,,,,10925.2,88,,percent of total billed charges,,,,,,,,,9485.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3103.75,22,,percent of total billed charges,,,11297.65,91,,percent of total billed charges,,,11794.25,95,,percent of total billed charges,,,10304.45,83,,percent of total billed charges,,,10304.45,83,,percent of total billed charges,,,,,,,,,,,,,,,10304.45,83,,percent of total billed charges,,,11794.25,95,,percent of total billed charges,,,11173.5,90,,percent of total billed charges,,,11173.5,90,,percent of total billed charges,,,10180.3,82,,percent of total billed charges,,,11173.5,90,,percent of total billed charges,,,10552.75,85,,percent of total billed charges,,3103.75,11794.25,
EX-FUSE DBM PUTTY 5CC,30185963,CDM,,,278,RC,outpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1218.75,22,,percent of total billed charges,,,,,,,,,4387.5,90,,percent of total billed charges,,,4036.5,82.8,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1218.75,22,,percent of total billed charges,,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,1218.75,4631.25,
ZIMMER OXF BEARING LEFT MEDIAL SZ 4,30185964,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
MEDTRONIC VISIA AF MRI VR SURESCAN,30185965,CDM,,,278,RC,outpatient,,166738,166738,,141560.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41684.5,22,,percent of total billed charges,,,,,,,,,150064.2,90,,percent of total billed charges,,,138059.06,82.8,,percent of total billed charges,,,141727.3,85,,percent of total billed charges,,,,,,,,,146729.44,88,,percent of total billed charges,,,,,,,,,127387.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41684.5,22,,percent of total billed charges,,,151731.58,91,,percent of total billed charges,,,158401.1,95,,percent of total billed charges,,,138392.54,83,,percent of total billed charges,,,138392.54,83,,percent of total billed charges,,,,,,,,,,,,,,,138392.54,83,,percent of total billed charges,,,158401.1,95,,percent of total billed charges,,,150064.2,90,,percent of total billed charges,,,150064.2,90,,percent of total billed charges,,,136725.16,82,,percent of total billed charges,,,150064.2,90,,percent of total billed charges,,,141727.3,85,,percent of total billed charges,,41684.5,158401.1,
MEDTRONIC RV LEAD 55CM,30185966,CDM,,,278,RC,outpatient,,40287.33,40287.33,,34203.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10071.83,22,,percent of total billed charges,,,,,,,,,36258.6,90,,percent of total billed charges,,,33357.91,82.8,,percent of total billed charges,,,34244.23,85,,percent of total billed charges,,,,,,,,,35452.85,88,,percent of total billed charges,,,,,,,,,30779.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10071.83,22,,percent of total billed charges,,,36661.47,91,,percent of total billed charges,,,38272.96,95,,percent of total billed charges,,,33438.48,83,,percent of total billed charges,,,33438.48,83,,percent of total billed charges,,,,,,,,,,,,,,,33438.48,83,,percent of total billed charges,,,38272.96,95,,percent of total billed charges,,,36258.6,90,,percent of total billed charges,,,36258.6,90,,percent of total billed charges,,,33035.61,82,,percent of total billed charges,,,36258.6,90,,percent of total billed charges,,,34244.23,85,,percent of total billed charges,,10071.83,38272.96,
EX-FUSE DBM .5CC PUTTY,30185967,CDM,,,278,RC,outpatient,,1170,1170,,993.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,292.5,22,,percent of total billed charges,,,,,,,,,1053,90,,percent of total billed charges,,,968.76,82.8,,percent of total billed charges,,,994.5,85,,percent of total billed charges,,,,,,,,,1029.6,88,,percent of total billed charges,,,,,,,,,893.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,292.5,22,,percent of total billed charges,,,1064.7,91,,percent of total billed charges,,,1111.5,95,,percent of total billed charges,,,971.1,83,,percent of total billed charges,,,971.1,83,,percent of total billed charges,,,,,,,,,,,,,,,971.1,83,,percent of total billed charges,,,1111.5,95,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,959.4,82,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,994.5,85,,percent of total billed charges,,292.5,1111.5,
EXACTECH LINER +2.5,30185968,CDM,,,278,RC,outpatient,,13221,13221,,11224.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3305.25,22,,percent of total billed charges,,,,,,,,,11898.9,90,,percent of total billed charges,,,10946.99,82.8,,percent of total billed charges,,,11237.85,85,,percent of total billed charges,,,,,,,,,11634.48,88,,percent of total billed charges,,,,,,,,,10100.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3305.25,22,,percent of total billed charges,,,12031.11,91,,percent of total billed charges,,,12559.95,95,,percent of total billed charges,,,10973.43,83,,percent of total billed charges,,,10973.43,83,,percent of total billed charges,,,,,,,,,,,,,,,10973.43,83,,percent of total billed charges,,,12559.95,95,,percent of total billed charges,,,11898.9,90,,percent of total billed charges,,,11898.9,90,,percent of total billed charges,,,10841.22,82,,percent of total billed charges,,,11898.9,90,,percent of total billed charges,,,11237.85,85,,percent of total billed charges,,3305.25,12559.95,
EXACTECH GLENOSPHERE 38,30185969,CDM,,,278,RC,outpatient,,24102,24102,,20462.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6025.5,22,,percent of total billed charges,,,,,,,,,21691.8,90,,percent of total billed charges,,,19956.46,82.8,,percent of total billed charges,,,20486.7,85,,percent of total billed charges,,,,,,,,,21209.76,88,,percent of total billed charges,,,,,,,,,18413.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6025.5,22,,percent of total billed charges,,,21932.82,91,,percent of total billed charges,,,22896.9,95,,percent of total billed charges,,,20004.66,83,,percent of total billed charges,,,20004.66,83,,percent of total billed charges,,,,,,,,,,,,,,,20004.66,83,,percent of total billed charges,,,22896.9,95,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,19763.64,82,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,20486.7,85,,percent of total billed charges,,6025.5,22896.9,
EXACTECH STEM HUMORAL 13MM,30185970,CDM,,,278,RC,outpatient,,35366.5,35366.5,,30026.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8841.63,22,,percent of total billed charges,,,,,,,,,31829.85,90,,percent of total billed charges,,,29283.46,82.8,,percent of total billed charges,,,30061.53,85,,percent of total billed charges,,,,,,,,,31122.52,88,,percent of total billed charges,,,,,,,,,27020.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8841.63,22,,percent of total billed charges,,,32183.52,91,,percent of total billed charges,,,33598.18,95,,percent of total billed charges,,,29354.2,83,,percent of total billed charges,,,29354.2,83,,percent of total billed charges,,,,,,,,,,,,,,,29354.2,83,,percent of total billed charges,,,33598.18,95,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,29000.53,82,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,30061.53,85,,percent of total billed charges,,8841.63,33598.18,
EXACTECH HUMERAL TRAY +0,30185971,CDM,,,278,RC,outpatient,,30160,30160,,25605.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7540,22,,percent of total billed charges,,,,,,,,,27144,90,,percent of total billed charges,,,24972.48,82.8,,percent of total billed charges,,,25636,85,,percent of total billed charges,,,,,,,,,26540.8,88,,percent of total billed charges,,,,,,,,,23042.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7540,22,,percent of total billed charges,,,27445.6,91,,percent of total billed charges,,,28652,95,,percent of total billed charges,,,25032.8,83,,percent of total billed charges,,,25032.8,83,,percent of total billed charges,,,,,,,,,,,,,,,25032.8,83,,percent of total billed charges,,,28652,95,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,24731.2,82,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,25636,85,,percent of total billed charges,,7540,28652,
SCREW LOCKING CAP KIT 4.5X18MM,30185972,CDM,,,278,RC,outpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,502.13,22,,percent of total billed charges,,,,,,,,,1807.65,90,,percent of total billed charges,,,1663.04,82.8,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,502.13,22,,percent of total billed charges,,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,502.13,1908.08,
SCREW LOCKING CAP KIT 4.5X30MM,30185973,CDM,,,278,RC,outpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,502.13,22,,percent of total billed charges,,,,,,,,,1807.65,90,,percent of total billed charges,,,1663.04,82.8,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,502.13,22,,percent of total billed charges,,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,502.13,1908.08,
DEPUY NARROW CEMENT NOZZLE,30185974,CDM,,,270,RC,outpatient,,427,427,,362.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,106.75,22,,percent of total billed charges,,,,,,,,,384.3,90,,percent of total billed charges,,,353.56,82.8,,percent of total billed charges,,,362.95,85,,percent of total billed charges,,,,,,,,,375.76,88,,percent of total billed charges,,,,,,,,,326.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,106.75,22,,percent of total billed charges,,,388.57,91,,percent of total billed charges,,,405.65,95,,percent of total billed charges,,,354.41,83,,percent of total billed charges,,,354.41,83,,percent of total billed charges,,,,,,,,,,,,,,,354.41,83,,percent of total billed charges,,,405.65,95,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,350.14,82,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,362.95,85,,percent of total billed charges,,106.75,405.65,
AUTOPLEX W/VERTEPLEX HV,30185975,CDM,,,270,RC,outpatient,,6765.98,6765.98,,5744.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1691.5,22,,percent of total billed charges,,,,,,,,,6089.38,90,,percent of total billed charges,,,5602.23,82.8,,percent of total billed charges,,,5751.08,85,,percent of total billed charges,,,,,,,,,5954.06,88,,percent of total billed charges,,,,,,,,,5169.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1691.5,22,,percent of total billed charges,,,6157.04,91,,percent of total billed charges,,,6427.68,95,,percent of total billed charges,,,5615.76,83,,percent of total billed charges,,,5615.76,83,,percent of total billed charges,,,,,,,,,,,,,,,5615.76,83,,percent of total billed charges,,,6427.68,95,,percent of total billed charges,,,6089.38,90,,percent of total billed charges,,,6089.38,90,,percent of total billed charges,,,5548.1,82,,percent of total billed charges,,,6089.38,90,,percent of total billed charges,,,5751.08,85,,percent of total billed charges,,1691.5,6427.68,
DEPUY INSERT SIGMA PS PLUS SZ 4 10MM,30185976,CDM,,,278,RC,outpatient,,17187.04,17187.04,,14591.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4296.76,22,,percent of total billed charges,,,,,,,,,15468.34,90,,percent of total billed charges,,,14230.87,82.8,,percent of total billed charges,,,14608.98,85,,percent of total billed charges,,,,,,,,,15124.6,88,,percent of total billed charges,,,,,,,,,13130.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4296.76,22,,percent of total billed charges,,,15640.21,91,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,14265.24,83,,percent of total billed charges,,,,,,,,,,,,,,,14265.24,83,,percent of total billed charges,,,16327.69,95,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14093.37,82,,percent of total billed charges,,,15468.34,90,,percent of total billed charges,,,14608.98,85,,percent of total billed charges,,4296.76,16327.69,
ZIMMER BEARING LG 6MM,30185977,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
ZIMMER BLADE EXPLANT TRUNCATED 62MM,30185978,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
ZIMMER BLADE EXPLANT FULL 62MM,30185979,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
ZIMMER TAPER ADAPTER +6MM,30185980,CDM,,,270,RC,outpatient,,2860,2860,,2428.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,715,22,,percent of total billed charges,,,,,,,,,2574,90,,percent of total billed charges,,,2368.08,82.8,,percent of total billed charges,,,2431,85,,percent of total billed charges,,,,,,,,,2516.8,88,,percent of total billed charges,,,,,,,,,2185.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,715,22,,percent of total billed charges,,,2602.6,91,,percent of total billed charges,,,2717,95,,percent of total billed charges,,,2373.8,83,,percent of total billed charges,,,2373.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2373.8,83,,percent of total billed charges,,,2717,95,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2345.2,82,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2431,85,,percent of total billed charges,,715,2717,
ZIMMER HEAD CERAMIC HD 28MM,30185981,CDM,,,278,RC,outpatient,,29900,29900,,25385.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7475,22,,percent of total billed charges,,,,,,,,,26910,90,,percent of total billed charges,,,24757.2,82.8,,percent of total billed charges,,,25415,85,,percent of total billed charges,,,,,,,,,26312,88,,percent of total billed charges,,,,,,,,,22843.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7475,22,,percent of total billed charges,,,27209,91,,percent of total billed charges,,,28405,95,,percent of total billed charges,,,24817,83,,percent of total billed charges,,,24817,83,,percent of total billed charges,,,,,,,,,,,,,,,24817,83,,percent of total billed charges,,,28405,95,,percent of total billed charges,,,26910,90,,percent of total billed charges,,,26910,90,,percent of total billed charges,,,24518,82,,percent of total billed charges,,,26910,90,,percent of total billed charges,,,25415,85,,percent of total billed charges,,7475,28405,
STRYKER SHELL RESTORATION ANATOMIC SZ 66,30185982,CDM,,,278,RC,outpatient,,25132.25,25132.25,,21337.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6283.06,22,,percent of total billed charges,,,,,,,,,22619.03,90,,percent of total billed charges,,,20809.5,82.8,,percent of total billed charges,,,21362.41,85,,percent of total billed charges,,,,,,,,,22116.38,88,,percent of total billed charges,,,,,,,,,19201.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6283.06,22,,percent of total billed charges,,,22870.35,91,,percent of total billed charges,,,23875.64,95,,percent of total billed charges,,,20859.77,83,,percent of total billed charges,,,20859.77,83,,percent of total billed charges,,,,,,,,,,,,,,,20859.77,83,,percent of total billed charges,,,23875.64,95,,percent of total billed charges,,,22619.03,90,,percent of total billed charges,,,22619.03,90,,percent of total billed charges,,,20608.45,82,,percent of total billed charges,,,22619.03,90,,percent of total billed charges,,,21362.41,85,,percent of total billed charges,,6283.06,23875.64,
STRYKER SCREW BONE OSTEOLOCK 40MM,30185983,CDM,,,278,RC,outpatient,,946.4,946.4,,803.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,236.6,22,,percent of total billed charges,,,,,,,,,851.76,90,,percent of total billed charges,,,783.62,82.8,,percent of total billed charges,,,804.44,85,,percent of total billed charges,,,,,,,,,832.83,88,,percent of total billed charges,,,,,,,,,723.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,236.6,22,,percent of total billed charges,,,861.22,91,,percent of total billed charges,,,899.08,95,,percent of total billed charges,,,785.51,83,,percent of total billed charges,,,785.51,83,,percent of total billed charges,,,,,,,,,,,,,,,785.51,83,,percent of total billed charges,,,899.08,95,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,776.05,82,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,804.44,85,,percent of total billed charges,,236.6,899.08,
STRYKER SCREW BONE OSTEOLOCK 30MM,30185984,CDM,,,278,RC,outpatient,,946.4,946.4,,803.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,236.6,22,,percent of total billed charges,,,,,,,,,851.76,90,,percent of total billed charges,,,783.62,82.8,,percent of total billed charges,,,804.44,85,,percent of total billed charges,,,,,,,,,832.83,88,,percent of total billed charges,,,,,,,,,723.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,236.6,22,,percent of total billed charges,,,861.22,91,,percent of total billed charges,,,899.08,95,,percent of total billed charges,,,785.51,83,,percent of total billed charges,,,785.51,83,,percent of total billed charges,,,,,,,,,,,,,,,785.51,83,,percent of total billed charges,,,899.08,95,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,776.05,82,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,804.44,85,,percent of total billed charges,,236.6,899.08,
STRYKER LINER 46MM F,30185985,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER INSERT ADM 28MM OD 52MM,30185986,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
MITEK HEALIX ADVANCE 5.5,30185987,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
MITEK HEALIX ADVANCE KNOTLESS 5.5,30185988,CDM,,,278,RC,outpatient,,3770,3770,,3200.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,942.5,22,,percent of total billed charges,,,,,,,,,3393,90,,percent of total billed charges,,,3121.56,82.8,,percent of total billed charges,,,3204.5,85,,percent of total billed charges,,,,,,,,,3317.6,88,,percent of total billed charges,,,,,,,,,2880.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,942.5,22,,percent of total billed charges,,,3430.7,91,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,,,,,,,,,,,,,3129.1,83,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3091.4,82,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3204.5,85,,percent of total billed charges,,942.5,3581.5,
MITEK HEALIX ADVANCE KNOTLESS 4.75,30185989,CDM,,,278,RC,outpatient,,3770,3770,,3200.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,942.5,22,,percent of total billed charges,,,,,,,,,3393,90,,percent of total billed charges,,,3121.56,82.8,,percent of total billed charges,,,3204.5,85,,percent of total billed charges,,,,,,,,,3317.6,88,,percent of total billed charges,,,,,,,,,2880.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,942.5,22,,percent of total billed charges,,,3430.7,91,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,,,,,,,,,,,,,3129.1,83,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3091.4,82,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3204.5,85,,percent of total billed charges,,942.5,3581.5,
SYNTHES PLATE LCP CLAVICLE 6 HOLE LEFT,30185990,CDM,,,278,RC,outpatient,,9525.1,9525.1,,8086.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2381.28,22,,percent of total billed charges,,,,,,,,,8572.59,90,,percent of total billed charges,,,7886.78,82.8,,percent of total billed charges,,,8096.34,85,,percent of total billed charges,,,,,,,,,8382.09,88,,percent of total billed charges,,,,,,,,,7277.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2381.28,22,,percent of total billed charges,,,8667.84,91,,percent of total billed charges,,,9048.85,95,,percent of total billed charges,,,7905.83,83,,percent of total billed charges,,,7905.83,83,,percent of total billed charges,,,,,,,,,,,,,,,7905.83,83,,percent of total billed charges,,,9048.85,95,,percent of total billed charges,,,8572.59,90,,percent of total billed charges,,,8572.59,90,,percent of total billed charges,,,7810.58,82,,percent of total billed charges,,,8572.59,90,,percent of total billed charges,,,8096.34,85,,percent of total billed charges,,2381.28,9048.85,
IR SCREW POLY 6.5X45,30185991,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
IR SCREW POLY 6.5X50,30185992,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
IR SCREW POLY 7.5X45,30185993,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
IR SCREW POLY 7.5X50,30185994,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
IR SCREW REDUCTION 6.5 X 40,30185995,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
IR SCREW REDUCTION 6.5 X 45,30185996,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
IR ROD LORDOSED 5.5 X 70MM,30185997,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
IR RODS 3.5 X 80MM,30185998,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
IR SCREW POLY 7.5X55,30185999,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
CAGE STALIF C-TI,30186001,CDM,,,278,RC,outpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4875,22,,percent of total billed charges,,,,,,,,,17550,90,,percent of total billed charges,,,16146,82.8,,percent of total billed charges,,,16575,85,,percent of total billed charges,,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4875,22,,percent of total billed charges,,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,4875,18525,
PATIENT TRACKER ENT,30186002,CDM,,,270,RC,outpatient,,1566.5,1566.5,,1329.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,391.63,22,,percent of total billed charges,,,,,,,,,1409.85,90,,percent of total billed charges,,,1297.06,82.8,,percent of total billed charges,,,1331.53,85,,percent of total billed charges,,,,,,,,,1378.52,88,,percent of total billed charges,,,,,,,,,1196.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,391.63,22,,percent of total billed charges,,,1425.52,91,,percent of total billed charges,,,1488.18,95,,percent of total billed charges,,,1300.2,83,,percent of total billed charges,,,1300.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1300.2,83,,percent of total billed charges,,,1488.18,95,,percent of total billed charges,,,1409.85,90,,percent of total billed charges,,,1409.85,90,,percent of total billed charges,,,1284.53,82,,percent of total billed charges,,,1409.85,90,,percent of total billed charges,,,1331.53,85,,percent of total billed charges,,391.63,1488.18,
MALLEABLE SUCTION STD TIP 7FR,30186003,CDM,,,270,RC,outpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,503.75,22,,percent of total billed charges,,,,,,,,,1813.5,90,,percent of total billed charges,,,1668.42,82.8,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,503.75,22,,percent of total billed charges,,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,503.75,1914.25,
INSTRUMENT TRACKER ENT,30186004,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
SUTURE SHUTTLE 45DEG L IDEAL,30186005,CDM,,,270,RC,outpatient,,1989,1989,,1688.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,497.25,22,,percent of total billed charges,,,,,,,,,1790.1,90,,percent of total billed charges,,,1646.89,82.8,,percent of total billed charges,,,1690.65,85,,percent of total billed charges,,,,,,,,,1750.32,88,,percent of total billed charges,,,,,,,,,1519.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,497.25,22,,percent of total billed charges,,,1809.99,91,,percent of total billed charges,,,1889.55,95,,percent of total billed charges,,,1650.87,83,,percent of total billed charges,,,1650.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1650.87,83,,percent of total billed charges,,,1889.55,95,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1630.98,82,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1690.65,85,,percent of total billed charges,,497.25,1889.55,
SYNTHES PLATE LCP CLAVICLE 7 HOLE LEFT S,30186006,CDM,,,278,RC,outpatient,,9773.73,9773.73,,8297.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2443.43,22,,percent of total billed charges,,,,,,,,,8796.36,90,,percent of total billed charges,,,8092.65,82.8,,percent of total billed charges,,,8307.67,85,,percent of total billed charges,,,,,,,,,8600.88,88,,percent of total billed charges,,,,,,,,,7467.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2443.43,22,,percent of total billed charges,,,8894.09,91,,percent of total billed charges,,,9285.04,95,,percent of total billed charges,,,8112.2,83,,percent of total billed charges,,,8112.2,83,,percent of total billed charges,,,,,,,,,,,,,,,8112.2,83,,percent of total billed charges,,,9285.04,95,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8014.46,82,,percent of total billed charges,,,8796.36,90,,percent of total billed charges,,,8307.67,85,,percent of total billed charges,,2443.43,9285.04,
SYNTHES DRILL BIT 2.5MM 110MM,30186007,CDM,,,270,RC,outpatient,,795.34,795.34,,675.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,198.84,22,,percent of total billed charges,,,,,,,,,715.81,90,,percent of total billed charges,,,658.54,82.8,,percent of total billed charges,,,676.04,85,,percent of total billed charges,,,,,,,,,699.9,88,,percent of total billed charges,,,,,,,,,607.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,198.84,22,,percent of total billed charges,,,723.76,91,,percent of total billed charges,,,755.57,95,,percent of total billed charges,,,660.13,83,,percent of total billed charges,,,660.13,83,,percent of total billed charges,,,,,,,,,,,,,,,660.13,83,,percent of total billed charges,,,755.57,95,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,652.18,82,,percent of total billed charges,,,715.81,90,,percent of total billed charges,,,676.04,85,,percent of total billed charges,,198.84,755.57,
ZIMMER SCREW BONE ST 6.5 X 15MM,30186008,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
ZIMMER SHELL OSSEOTI G7 48MM C 3 HOLE,30186009,CDM,,,278,RC,outpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4834.38,22,,percent of total billed charges,,,,,,,,,17403.75,90,,percent of total billed charges,,,16011.45,82.8,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4834.38,22,,percent of total billed charges,,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,4834.38,18370.63,
ZIMMER BEARING HIP ACT ARTIC 28X38MM,30186010,CDM,,,278,RC,outpatient,,23400,23400,,19866.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5850,22,,percent of total billed charges,,,,,,,,,21060,90,,percent of total billed charges,,,19375.2,82.8,,percent of total billed charges,,,19890,85,,percent of total billed charges,,,,,,,,,20592,88,,percent of total billed charges,,,,,,,,,17877.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5850,22,,percent of total billed charges,,,21294,91,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,19422,83,,percent of total billed charges,,,,,,,,,,,,,,,19422,83,,percent of total billed charges,,,22230,95,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19188,82,,percent of total billed charges,,,21060,90,,percent of total billed charges,,,19890,85,,percent of total billed charges,,5850,22230,
ZIMMER LINER DUAL MOBILITY G7 38MM C,30186011,CDM,,,278,RC,outpatient,,9912.5,9912.5,,8415.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2478.13,22,,percent of total billed charges,,,,,,,,,8921.25,90,,percent of total billed charges,,,8207.55,82.8,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,,,,,,,,8723,88,,percent of total billed charges,,,,,,,,,7573.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2478.13,22,,percent of total billed charges,,,9020.38,91,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,8227.38,83,,percent of total billed charges,,,,,,,,,,,,,,,8227.38,83,,percent of total billed charges,,,9416.88,95,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8128.25,82,,percent of total billed charges,,,8921.25,90,,percent of total billed charges,,,8425.63,85,,percent of total billed charges,,2478.13,9416.88,
IR SCREW POLY 6.5X40,30186012,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
STRYKER ANCHOR SUTURE NANOTACK 1.4MM,30186013,CDM,,,278,RC,outpatient,,4091.36,4091.36,,3473.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1022.84,22,,percent of total billed charges,,,,,,,,,3682.22,90,,percent of total billed charges,,,3387.65,82.8,,percent of total billed charges,,,3477.66,85,,percent of total billed charges,,,,,,,,,3600.4,88,,percent of total billed charges,,,,,,,,,3125.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1022.84,22,,percent of total billed charges,,,3723.14,91,,percent of total billed charges,,,3886.79,95,,percent of total billed charges,,,3395.83,83,,percent of total billed charges,,,3395.83,83,,percent of total billed charges,,,,,,,,,,,,,,,3395.83,83,,percent of total billed charges,,,3886.79,95,,percent of total billed charges,,,3682.22,90,,percent of total billed charges,,,3682.22,90,,percent of total billed charges,,,3354.92,82,,percent of total billed charges,,,3682.22,90,,percent of total billed charges,,,3477.66,85,,percent of total billed charges,,1022.84,3886.79,
DEPUY STEM CORAIL REVISION SZ12 STD,30186014,CDM,,,278,RC,outpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16689.95,22,,percent of total billed charges,,,,,,,,,60083.83,90,,percent of total billed charges,,,55277.12,82.8,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16689.95,22,,percent of total billed charges,,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,16689.95,63421.82,
DEPUY INSERT AOX RP 5MM,30186015,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
MERETE NAIL IKA WITHOUT COLLAR 150 X16,30186016,CDM,,,278,RC,outpatient,,25025,25025,,21246.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6256.25,22,,percent of total billed charges,,,,,,,,,22522.5,90,,percent of total billed charges,,,20720.7,82.8,,percent of total billed charges,,,21271.25,85,,percent of total billed charges,,,,,,,,,22022,88,,percent of total billed charges,,,,,,,,,19119.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6256.25,22,,percent of total billed charges,,,22772.75,91,,percent of total billed charges,,,23773.75,95,,percent of total billed charges,,,20770.75,83,,percent of total billed charges,,,20770.75,83,,percent of total billed charges,,,,,,,,,,,,,,,20770.75,83,,percent of total billed charges,,,23773.75,95,,percent of total billed charges,,,22522.5,90,,percent of total billed charges,,,22522.5,90,,percent of total billed charges,,,20520.5,82,,percent of total billed charges,,,22522.5,90,,percent of total billed charges,,,21271.25,85,,percent of total billed charges,,6256.25,23773.75,
MERETE NAIL IKA WITHOUT COLLAR 150 X14,30186017,CDM,,,278,RC,outpatient,,17875,17875,,15175.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4468.75,22,,percent of total billed charges,,,,,,,,,16087.5,90,,percent of total billed charges,,,14800.5,82.8,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,,,,,,,,15730,88,,percent of total billed charges,,,,,,,,,13656.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4468.75,22,,percent of total billed charges,,,16266.25,91,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14836.25,83,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,14657.5,82,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,4468.75,16981.25,
MERETE SCREW INTERLOCKING 36MM,30186018,CDM,,,278,RC,outpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,706.06,22,,percent of total billed charges,,,,,,,,,2541.83,90,,percent of total billed charges,,,2338.48,82.8,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,706.06,22,,percent of total billed charges,,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,706.06,2683.04,
MERETE SCREW INTERLOCKING 40MM,30186019,CDM,,,278,RC,outpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,706.06,22,,percent of total billed charges,,,,,,,,,2541.83,90,,percent of total billed charges,,,2338.48,82.8,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,706.06,22,,percent of total billed charges,,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,706.06,2683.04,
MERETE SCREW INTERLOCKING 36MM,30186020,CDM,,,278,RC,outpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,706.06,22,,percent of total billed charges,,,,,,,,,2541.83,90,,percent of total billed charges,,,2338.48,82.8,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,706.06,22,,percent of total billed charges,,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,706.06,2683.04,
MERETE SCREW INTERLOCKING 44MM,30186021,CDM,,,278,RC,outpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,706.06,22,,percent of total billed charges,,,,,,,,,2541.83,90,,percent of total billed charges,,,2338.48,82.8,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,706.06,22,,percent of total billed charges,,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,706.06,2683.04,
SYNTHES CLAMP COMBINATION MR-CONDITIONAL,30186025,CDM,,,278,RC,outpatient,,6641.05,6641.05,,5638.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1660.26,22,,percent of total billed charges,,,,,,,,,5976.95,90,,percent of total billed charges,,,5498.79,82.8,,percent of total billed charges,,,5644.89,85,,percent of total billed charges,,,,,,,,,5844.12,88,,percent of total billed charges,,,,,,,,,5073.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1660.26,22,,percent of total billed charges,,,6043.36,91,,percent of total billed charges,,,6309,95,,percent of total billed charges,,,5512.07,83,,percent of total billed charges,,,5512.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5512.07,83,,percent of total billed charges,,,6309,95,,percent of total billed charges,,,5976.95,90,,percent of total billed charges,,,5976.95,90,,percent of total billed charges,,,5445.66,82,,percent of total billed charges,,,5976.95,90,,percent of total billed charges,,,5644.89,85,,percent of total billed charges,,1660.26,6309,
SYNTHES CLAMP PIN 6-POSITION MR-CONDITIO,30186026,CDM,,,278,RC,outpatient,,4729.4,4729.4,,4015.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1182.35,22,,percent of total billed charges,,,,,,,,,4256.46,90,,percent of total billed charges,,,3915.94,82.8,,percent of total billed charges,,,4019.99,85,,percent of total billed charges,,,,,,,,,4161.87,88,,percent of total billed charges,,,,,,,,,3613.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1182.35,22,,percent of total billed charges,,,4303.75,91,,percent of total billed charges,,,4492.93,95,,percent of total billed charges,,,3925.4,83,,percent of total billed charges,,,3925.4,83,,percent of total billed charges,,,,,,,,,,,,,,,3925.4,83,,percent of total billed charges,,,4492.93,95,,percent of total billed charges,,,4256.46,90,,percent of total billed charges,,,4256.46,90,,percent of total billed charges,,,3878.11,82,,percent of total billed charges,,,4256.46,90,,percent of total billed charges,,,4019.99,85,,percent of total billed charges,,1182.35,4492.93,
SYNTHES ROD CARBON FIBER 11 X 100MM,30186027,CDM,,,278,RC,outpatient,,2281.83,2281.83,,1937.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,570.46,22,,percent of total billed charges,,,,,,,,,2053.65,90,,percent of total billed charges,,,1889.36,82.8,,percent of total billed charges,,,1939.56,85,,percent of total billed charges,,,,,,,,,2008.01,88,,percent of total billed charges,,,,,,,,,1743.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,570.46,22,,percent of total billed charges,,,2076.47,91,,percent of total billed charges,,,2167.74,95,,percent of total billed charges,,,1893.92,83,,percent of total billed charges,,,1893.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1893.92,83,,percent of total billed charges,,,2167.74,95,,percent of total billed charges,,,2053.65,90,,percent of total billed charges,,,2053.65,90,,percent of total billed charges,,,1871.1,82,,percent of total billed charges,,,2053.65,90,,percent of total billed charges,,,1939.56,85,,percent of total billed charges,,570.46,2167.74,
SYNTHES SCREW SCHANZ 5.0 X 150MM,30186028,CDM,,,278,RC,outpatient,,1773.53,1773.53,,1505.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,443.38,22,,percent of total billed charges,,,,,,,,,1596.18,90,,percent of total billed charges,,,1468.48,82.8,,percent of total billed charges,,,1507.5,85,,percent of total billed charges,,,,,,,,,1560.71,88,,percent of total billed charges,,,,,,,,,1354.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,443.38,22,,percent of total billed charges,,,1613.91,91,,percent of total billed charges,,,1684.85,95,,percent of total billed charges,,,1472.03,83,,percent of total billed charges,,,1472.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1472.03,83,,percent of total billed charges,,,1684.85,95,,percent of total billed charges,,,1596.18,90,,percent of total billed charges,,,1596.18,90,,percent of total billed charges,,,1454.29,82,,percent of total billed charges,,,1596.18,90,,percent of total billed charges,,,1507.5,85,,percent of total billed charges,,443.38,1684.85,
SYNTHES ROD CARBON FIBER 11 X 350MM,30186029,CDM,,,278,RC,outpatient,,2447.58,2447.58,,2078,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,611.9,22,,percent of total billed charges,,,,,,,,,2202.82,90,,percent of total billed charges,,,2026.6,82.8,,percent of total billed charges,,,2080.44,85,,percent of total billed charges,,,,,,,,,2153.87,88,,percent of total billed charges,,,,,,,,,1869.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,611.9,22,,percent of total billed charges,,,2227.3,91,,percent of total billed charges,,,2325.2,95,,percent of total billed charges,,,2031.49,83,,percent of total billed charges,,,2031.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2031.49,83,,percent of total billed charges,,,2325.2,95,,percent of total billed charges,,,2202.82,90,,percent of total billed charges,,,2202.82,90,,percent of total billed charges,,,2007.02,82,,percent of total billed charges,,,2202.82,90,,percent of total billed charges,,,2080.44,85,,percent of total billed charges,,611.9,2325.2,
SPINECRAFT SCREW 7.0 X 55MM,30186031,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT SCREW 7.0 X 50MM,30186032,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT ROD LOWDOSED 6.0 X 100,30186033,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ZIMMER LINER NEU +5MM E1 32MM C,30186034,CDM,,,278,RC,outpatient,,23595,23595,,20032.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5898.75,22,,percent of total billed charges,,,,,,,,,21235.5,90,,percent of total billed charges,,,19536.66,82.8,,percent of total billed charges,,,20055.75,85,,percent of total billed charges,,,,,,,,,20763.6,88,,percent of total billed charges,,,,,,,,,18026.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5898.75,22,,percent of total billed charges,,,21471.45,91,,percent of total billed charges,,,22415.25,95,,percent of total billed charges,,,19583.85,83,,percent of total billed charges,,,19583.85,83,,percent of total billed charges,,,,,,,,,,,,,,,19583.85,83,,percent of total billed charges,,,22415.25,95,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,19347.9,82,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,20055.75,85,,percent of total billed charges,,5898.75,22415.25,
ULRICH PEEK CERVICAL 12X14X10MM,30186035,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
ULRICH PLATE 1 LEVEL 20MM,30186036,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
SPINECRAFT ROD LOWDOSED 6.0 X 70,30186037,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ZIMMER BEARING LEFT LRG SZ 9,30186038,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
STRYKER DRILL ICONIX,30186041,CDM,,,270,RC,outpatient,,1538.16,1538.16,,1305.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.54,22,,percent of total billed charges,,,,,,,,,1384.34,90,,percent of total billed charges,,,1273.6,82.8,,percent of total billed charges,,,1307.44,85,,percent of total billed charges,,,,,,,,,1353.58,88,,percent of total billed charges,,,,,,,,,1175.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.54,22,,percent of total billed charges,,,1399.73,91,,percent of total billed charges,,,1461.25,95,,percent of total billed charges,,,1276.67,83,,percent of total billed charges,,,1276.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1276.67,83,,percent of total billed charges,,,1461.25,95,,percent of total billed charges,,,1384.34,90,,percent of total billed charges,,,1384.34,90,,percent of total billed charges,,,1261.29,82,,percent of total billed charges,,,1384.34,90,,percent of total billed charges,,,1307.44,85,,percent of total billed charges,,384.54,1461.25,
DEPUY TIBIA ATTUNE RP SZ 6,30186042,CDM,,,278,RC,outpatient,,22629.36,22629.36,,19212.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5657.34,22,,percent of total billed charges,,,,,,,,,20366.42,90,,percent of total billed charges,,,18737.11,82.8,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,,,,,,,,19913.84,88,,percent of total billed charges,,,,,,,,,17288.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5657.34,22,,percent of total billed charges,,,20592.72,91,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,,,,,,,,,,,,,18782.37,83,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,18556.08,82,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,5657.34,21497.89,
SYNTHES SCREW LOCKING S-T 3.5 X 36MM,30186043,CDM,,,278,RC,outpatient,,1254.37,1254.37,,1064.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,313.59,22,,percent of total billed charges,,,,,,,,,1128.93,90,,percent of total billed charges,,,1038.62,82.8,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,,,,,,,,1103.85,88,,percent of total billed charges,,,,,,,,,958.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,313.59,22,,percent of total billed charges,,,1141.48,91,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,1041.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1041.13,83,,percent of total billed charges,,,1191.65,95,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1028.58,82,,percent of total billed charges,,,1128.93,90,,percent of total billed charges,,,1066.21,85,,percent of total billed charges,,313.59,1191.65,
DEPUY STEM PRESS FIT 14X110,30186044,CDM,,,278,RC,outpatient,,13175.11,13175.11,,11185.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3293.78,22,,percent of total billed charges,,,,,,,,,11857.6,90,,percent of total billed charges,,,10908.99,82.8,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,,,,,,,,11594.1,88,,percent of total billed charges,,,,,,,,,10065.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3293.78,22,,percent of total billed charges,,,11989.35,91,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,,,,,,,,,,,,,10935.34,83,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,10803.59,82,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,3293.78,12516.35,
DEPUY ATTUNE FEMUR REV. SZ 6 L,30186045,CDM,,,278,RC,outpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13142.14,22,,percent of total billed charges,,,,,,,,,47311.7,90,,percent of total billed charges,,,43526.77,82.8,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13142.14,22,,percent of total billed charges,,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,13142.14,49940.13,
DEPUY HEAD HUMERAL ECCENTRIC 44X15,30186046,CDM,,,278,RC,outpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4409.03,22,,percent of total billed charges,,,,,,,,,15872.52,90,,percent of total billed charges,,,14602.72,82.8,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4409.03,22,,percent of total billed charges,,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,4409.03,16754.32,
ZIMMER ACT ARTIC HD ARCOM XL 28X40MM,30186047,CDM,,,278,RC,outpatient,,18525,18525,,15727.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4631.25,22,,percent of total billed charges,,,,,,,,,16672.5,90,,percent of total billed charges,,,15338.7,82.8,,percent of total billed charges,,,15746.25,85,,percent of total billed charges,,,,,,,,,16302,88,,percent of total billed charges,,,,,,,,,14153.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4631.25,22,,percent of total billed charges,,,16857.75,91,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,,,,,,,,,,,,,15375.75,83,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15190.5,82,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15746.25,85,,percent of total billed charges,,4631.25,17598.75,
STRYKER FEMUR TRIATHLON PS SZ 7 LEFT,30186048,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
STRYKER INSERT TRIATHLON PS SZ 7-9MM,30186049,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER TIBIA INSERT TRIATHLON PS SZ 7,30186050,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER FEMUR TRIATHLON PS SZ 8 LEFT,30186051,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
STRYKER INSERT TRIATHLON PS SZ 8,30186052,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER TIBIA INSERT TRIATHLON CR SZ 8-9,30186053,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
NEEDLE CARR-LOCKE INJECTION 23G,30186054,CDM,,,270,RC,outpatient,,282.27,282.27,,239.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.57,22,,percent of total billed charges,,,,,,,,,254.04,90,,percent of total billed charges,,,233.72,82.8,,percent of total billed charges,,,239.93,85,,percent of total billed charges,,,,,,,,,248.4,88,,percent of total billed charges,,,,,,,,,215.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70.57,22,,percent of total billed charges,,,256.87,91,,percent of total billed charges,,,268.16,95,,percent of total billed charges,,,234.28,83,,percent of total billed charges,,,234.28,83,,percent of total billed charges,,,,,,,,,,,,,,,234.28,83,,percent of total billed charges,,,268.16,95,,percent of total billed charges,,,254.04,90,,percent of total billed charges,,,254.04,90,,percent of total billed charges,,,231.46,82,,percent of total billed charges,,,254.04,90,,percent of total billed charges,,,239.93,85,,percent of total billed charges,,70.57,268.16,
SPINECRAFT SCREW REDUCTION 7.0 50MM,30186055,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
SPINECRAFT SCREW 7.0 X 45MM,30186056,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ARTHREX SCREW BIOCOMP 8X20,30186057,CDM,,,270,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
SYNTHES SCREW CORTEX TI 2.7 X 12MM,30186058,CDM,,,278,RC,outpatient,,458.15,458.15,,388.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,114.54,22,,percent of total billed charges,,,,,,,,,412.34,90,,percent of total billed charges,,,379.35,82.8,,percent of total billed charges,,,389.43,85,,percent of total billed charges,,,,,,,,,403.17,88,,percent of total billed charges,,,,,,,,,350.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,114.54,22,,percent of total billed charges,,,416.92,91,,percent of total billed charges,,,435.24,95,,percent of total billed charges,,,380.26,83,,percent of total billed charges,,,380.26,83,,percent of total billed charges,,,,,,,,,,,,,,,380.26,83,,percent of total billed charges,,,435.24,95,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,375.68,82,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,389.43,85,,percent of total billed charges,,114.54,435.24,
SYNTHES SCREW CORTEX TI 2.7 X 16MM,30186059,CDM,,,278,RC,outpatient,,458.15,458.15,,388.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,114.54,22,,percent of total billed charges,,,,,,,,,412.34,90,,percent of total billed charges,,,379.35,82.8,,percent of total billed charges,,,389.43,85,,percent of total billed charges,,,,,,,,,403.17,88,,percent of total billed charges,,,,,,,,,350.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,114.54,22,,percent of total billed charges,,,416.92,91,,percent of total billed charges,,,435.24,95,,percent of total billed charges,,,380.26,83,,percent of total billed charges,,,380.26,83,,percent of total billed charges,,,,,,,,,,,,,,,380.26,83,,percent of total billed charges,,,435.24,95,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,375.68,82,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,389.43,85,,percent of total billed charges,,114.54,435.24,
SYNTHES SCREW CORTEX TI 2.7 X 18MM,30186060,CDM,,,278,RC,outpatient,,458.15,458.15,,388.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,114.54,22,,percent of total billed charges,,,,,,,,,412.34,90,,percent of total billed charges,,,379.35,82.8,,percent of total billed charges,,,389.43,85,,percent of total billed charges,,,,,,,,,403.17,88,,percent of total billed charges,,,,,,,,,350.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,114.54,22,,percent of total billed charges,,,416.92,91,,percent of total billed charges,,,435.24,95,,percent of total billed charges,,,380.26,83,,percent of total billed charges,,,380.26,83,,percent of total billed charges,,,,,,,,,,,,,,,380.26,83,,percent of total billed charges,,,435.24,95,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,375.68,82,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,389.43,85,,percent of total billed charges,,114.54,435.24,
SYNTHES SCREW LOCKING TI 3.5X10MM,30186061,CDM,,,278,RC,outpatient,,1389.18,1389.18,,1179.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,347.3,22,,percent of total billed charges,,,,,,,,,1250.26,90,,percent of total billed charges,,,1150.24,82.8,,percent of total billed charges,,,1180.8,85,,percent of total billed charges,,,,,,,,,1222.48,88,,percent of total billed charges,,,,,,,,,1061.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,347.3,22,,percent of total billed charges,,,1264.15,91,,percent of total billed charges,,,1319.72,95,,percent of total billed charges,,,1153.02,83,,percent of total billed charges,,,1153.02,83,,percent of total billed charges,,,,,,,,,,,,,,,1153.02,83,,percent of total billed charges,,,1319.72,95,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1139.13,82,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1180.8,85,,percent of total billed charges,,347.3,1319.72,
SYNTHES SCREW LOCKING TI 3.5X16MM,30186062,CDM,,,278,RC,outpatient,,1389.18,1389.18,,1179.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,347.3,22,,percent of total billed charges,,,,,,,,,1250.26,90,,percent of total billed charges,,,1150.24,82.8,,percent of total billed charges,,,1180.8,85,,percent of total billed charges,,,,,,,,,1222.48,88,,percent of total billed charges,,,,,,,,,1061.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,347.3,22,,percent of total billed charges,,,1264.15,91,,percent of total billed charges,,,1319.72,95,,percent of total billed charges,,,1153.02,83,,percent of total billed charges,,,1153.02,83,,percent of total billed charges,,,,,,,,,,,,,,,1153.02,83,,percent of total billed charges,,,1319.72,95,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1139.13,82,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1180.8,85,,percent of total billed charges,,347.3,1319.72,
SYNTHES SCREW CORTEX TI 3.5 X 10MM,30186063,CDM,,,278,RC,outpatient,,293.25,293.25,,248.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.31,22,,percent of total billed charges,,,,,,,,,263.93,90,,percent of total billed charges,,,242.81,82.8,,percent of total billed charges,,,249.26,85,,percent of total billed charges,,,,,,,,,258.06,88,,percent of total billed charges,,,,,,,,,224.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.31,22,,percent of total billed charges,,,266.86,91,,percent of total billed charges,,,278.59,95,,percent of total billed charges,,,243.4,83,,percent of total billed charges,,,243.4,83,,percent of total billed charges,,,,,,,,,,,,,,,243.4,83,,percent of total billed charges,,,278.59,95,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,240.47,82,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,249.26,85,,percent of total billed charges,,73.31,278.59,
SYNTHES SCREW CORTEX TI 3.5 X 12MM,30186064,CDM,,,278,RC,outpatient,,311.1,311.1,,264.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.78,22,,percent of total billed charges,,,,,,,,,279.99,90,,percent of total billed charges,,,257.59,82.8,,percent of total billed charges,,,264.44,85,,percent of total billed charges,,,,,,,,,273.77,88,,percent of total billed charges,,,,,,,,,237.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.78,22,,percent of total billed charges,,,283.1,91,,percent of total billed charges,,,295.55,95,,percent of total billed charges,,,258.21,83,,percent of total billed charges,,,258.21,83,,percent of total billed charges,,,,,,,,,,,,,,,258.21,83,,percent of total billed charges,,,295.55,95,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,255.1,82,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,264.44,85,,percent of total billed charges,,77.78,295.55,
SYNTHES SCREW CORTEX TI 3.5 X 14MM,30186065,CDM,,,278,RC,outpatient,,311.1,311.1,,264.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.78,22,,percent of total billed charges,,,,,,,,,279.99,90,,percent of total billed charges,,,257.59,82.8,,percent of total billed charges,,,264.44,85,,percent of total billed charges,,,,,,,,,273.77,88,,percent of total billed charges,,,,,,,,,237.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.78,22,,percent of total billed charges,,,283.1,91,,percent of total billed charges,,,295.55,95,,percent of total billed charges,,,258.21,83,,percent of total billed charges,,,258.21,83,,percent of total billed charges,,,,,,,,,,,,,,,258.21,83,,percent of total billed charges,,,295.55,95,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,255.1,82,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,264.44,85,,percent of total billed charges,,77.78,295.55,
SYNTHES SCREW CORTEX TI 3.5 X 16MM,30186066,CDM,,,278,RC,outpatient,,311.1,311.1,,264.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.78,22,,percent of total billed charges,,,,,,,,,279.99,90,,percent of total billed charges,,,257.59,82.8,,percent of total billed charges,,,264.44,85,,percent of total billed charges,,,,,,,,,273.77,88,,percent of total billed charges,,,,,,,,,237.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.78,22,,percent of total billed charges,,,283.1,91,,percent of total billed charges,,,295.55,95,,percent of total billed charges,,,258.21,83,,percent of total billed charges,,,258.21,83,,percent of total billed charges,,,,,,,,,,,,,,,258.21,83,,percent of total billed charges,,,295.55,95,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,255.1,82,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,264.44,85,,percent of total billed charges,,77.78,295.55,
SYNTHES SCREW CORTEX TI 3.5 X 42MM,30186067,CDM,,,278,RC,outpatient,,293.25,293.25,,248.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.31,22,,percent of total billed charges,,,,,,,,,263.93,90,,percent of total billed charges,,,242.81,82.8,,percent of total billed charges,,,249.26,85,,percent of total billed charges,,,,,,,,,258.06,88,,percent of total billed charges,,,,,,,,,224.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.31,22,,percent of total billed charges,,,266.86,91,,percent of total billed charges,,,278.59,95,,percent of total billed charges,,,243.4,83,,percent of total billed charges,,,243.4,83,,percent of total billed charges,,,,,,,,,,,,,,,243.4,83,,percent of total billed charges,,,278.59,95,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,240.47,82,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,249.26,85,,percent of total billed charges,,73.31,278.59,
SYNTHES PLATE TUBULAR TI 1/3 10 HOLE,30186068,CDM,,,278,RC,outpatient,,1872.98,1872.98,,1590.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,468.25,22,,percent of total billed charges,,,,,,,,,1685.68,90,,percent of total billed charges,,,1550.83,82.8,,percent of total billed charges,,,1592.03,85,,percent of total billed charges,,,,,,,,,1648.22,88,,percent of total billed charges,,,,,,,,,1430.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,468.25,22,,percent of total billed charges,,,1704.41,91,,percent of total billed charges,,,1779.33,95,,percent of total billed charges,,,1554.57,83,,percent of total billed charges,,,1554.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1554.57,83,,percent of total billed charges,,,1779.33,95,,percent of total billed charges,,,1685.68,90,,percent of total billed charges,,,1685.68,90,,percent of total billed charges,,,1535.84,82,,percent of total billed charges,,,1685.68,90,,percent of total billed charges,,,1592.03,85,,percent of total billed charges,,468.25,1779.33,
SYNTHES SCREW CANNULATED TI 4.0 X 42MM,30186069,CDM,,,278,RC,outpatient,,2138.18,2138.18,,1815.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,534.55,22,,percent of total billed charges,,,,,,,,,1924.36,90,,percent of total billed charges,,,1770.41,82.8,,percent of total billed charges,,,1817.45,85,,percent of total billed charges,,,,,,,,,1881.6,88,,percent of total billed charges,,,,,,,,,1633.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,534.55,22,,percent of total billed charges,,,1945.74,91,,percent of total billed charges,,,2031.27,95,,percent of total billed charges,,,1774.69,83,,percent of total billed charges,,,1774.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1774.69,83,,percent of total billed charges,,,2031.27,95,,percent of total billed charges,,,1924.36,90,,percent of total billed charges,,,1924.36,90,,percent of total billed charges,,,1753.31,82,,percent of total billed charges,,,1924.36,90,,percent of total billed charges,,,1817.45,85,,percent of total billed charges,,534.55,2031.27,
SYNTHES PLATE MEDIAL DISTAL TIB 3.5 LCP,30186070,CDM,,,278,RC,outpatient,,15663.38,15663.38,,13298.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3915.85,22,,percent of total billed charges,,,,,,,,,14097.04,90,,percent of total billed charges,,,12969.28,82.8,,percent of total billed charges,,,13313.87,85,,percent of total billed charges,,,,,,,,,13783.77,88,,percent of total billed charges,,,,,,,,,11966.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3915.85,22,,percent of total billed charges,,,14253.68,91,,percent of total billed charges,,,14880.21,95,,percent of total billed charges,,,13000.61,83,,percent of total billed charges,,,13000.61,83,,percent of total billed charges,,,,,,,,,,,,,,,13000.61,83,,percent of total billed charges,,,14880.21,95,,percent of total billed charges,,,14097.04,90,,percent of total billed charges,,,14097.04,90,,percent of total billed charges,,,12843.97,82,,percent of total billed charges,,,14097.04,90,,percent of total billed charges,,,13313.87,85,,percent of total billed charges,,3915.85,14880.21,
SYNTHES SCREW METAPHYSEAL 2.7 X 40MM,30186071,CDM,,,278,RC,outpatient,,464.1,464.1,,394.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.03,22,,percent of total billed charges,,,,,,,,,417.69,90,,percent of total billed charges,,,384.27,82.8,,percent of total billed charges,,,394.49,85,,percent of total billed charges,,,,,,,,,408.41,88,,percent of total billed charges,,,,,,,,,354.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.03,22,,percent of total billed charges,,,422.33,91,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,,,,,,,,,,,,,385.2,83,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,380.56,82,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,394.49,85,,percent of total billed charges,,116.03,440.9,
SYNTHES PLATE CALC MED RIGHT 2.7 VAL,30186072,CDM,,,278,RC,outpatient,,9193.6,9193.6,,7805.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2298.4,22,,percent of total billed charges,,,,,,,,,8274.24,90,,percent of total billed charges,,,7612.3,82.8,,percent of total billed charges,,,7814.56,85,,percent of total billed charges,,,,,,,,,8090.37,88,,percent of total billed charges,,,,,,,,,7023.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2298.4,22,,percent of total billed charges,,,8366.18,91,,percent of total billed charges,,,8733.92,95,,percent of total billed charges,,,7630.69,83,,percent of total billed charges,,,7630.69,83,,percent of total billed charges,,,,,,,,,,,,,,,7630.69,83,,percent of total billed charges,,,8733.92,95,,percent of total billed charges,,,8274.24,90,,percent of total billed charges,,,8274.24,90,,percent of total billed charges,,,7538.75,82,,percent of total billed charges,,,8274.24,90,,percent of total billed charges,,,7814.56,85,,percent of total billed charges,,2298.4,8733.92,
SYNTHES SCREW METAPHYSEAL 2.7 X 44MM,30186073,CDM,,,278,RC,outpatient,,464.1,464.1,,394.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.03,22,,percent of total billed charges,,,,,,,,,417.69,90,,percent of total billed charges,,,384.27,82.8,,percent of total billed charges,,,394.49,85,,percent of total billed charges,,,,,,,,,408.41,88,,percent of total billed charges,,,,,,,,,354.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.03,22,,percent of total billed charges,,,422.33,91,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,,,,,,,,,,,,,385.2,83,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,380.56,82,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,394.49,85,,percent of total billed charges,,116.03,440.9,
SYNTHES SCREW METAPHYSEAL 2.7 X 52MM,30186074,CDM,,,278,RC,outpatient,,464.1,464.1,,394.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.03,22,,percent of total billed charges,,,,,,,,,417.69,90,,percent of total billed charges,,,384.27,82.8,,percent of total billed charges,,,394.49,85,,percent of total billed charges,,,,,,,,,408.41,88,,percent of total billed charges,,,,,,,,,354.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.03,22,,percent of total billed charges,,,422.33,91,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,,,,,,,,,,,,,385.2,83,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,380.56,82,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,394.49,85,,percent of total billed charges,,116.03,440.9,
SYNTHES SCREW LOCKING VA 2.7 X 56MM,30186075,CDM,,,278,RC,outpatient,,1331.53,1331.53,,1130.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,332.88,22,,percent of total billed charges,,,,,,,,,1198.38,90,,percent of total billed charges,,,1102.51,82.8,,percent of total billed charges,,,1131.8,85,,percent of total billed charges,,,,,,,,,1171.75,88,,percent of total billed charges,,,,,,,,,1017.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,332.88,22,,percent of total billed charges,,,1211.69,91,,percent of total billed charges,,,1264.95,95,,percent of total billed charges,,,1105.17,83,,percent of total billed charges,,,1105.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1105.17,83,,percent of total billed charges,,,1264.95,95,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1091.85,82,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1131.8,85,,percent of total billed charges,,332.88,1264.95,
SYNTHES SCREW LOCKING VA 2.7 X 54MM,30186076,CDM,,,278,RC,outpatient,,1331.53,1331.53,,1130.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,332.88,22,,percent of total billed charges,,,,,,,,,1198.38,90,,percent of total billed charges,,,1102.51,82.8,,percent of total billed charges,,,1131.8,85,,percent of total billed charges,,,,,,,,,1171.75,88,,percent of total billed charges,,,,,,,,,1017.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,332.88,22,,percent of total billed charges,,,1211.69,91,,percent of total billed charges,,,1264.95,95,,percent of total billed charges,,,1105.17,83,,percent of total billed charges,,,1105.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1105.17,83,,percent of total billed charges,,,1264.95,95,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1091.85,82,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1131.8,85,,percent of total billed charges,,332.88,1264.95,
SYNTHES SCREW LOCKING VA 2.7 X 46MM,30186077,CDM,,,278,RC,outpatient,,1331.53,1331.53,,1130.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,332.88,22,,percent of total billed charges,,,,,,,,,1198.38,90,,percent of total billed charges,,,1102.51,82.8,,percent of total billed charges,,,1131.8,85,,percent of total billed charges,,,,,,,,,1171.75,88,,percent of total billed charges,,,,,,,,,1017.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,332.88,22,,percent of total billed charges,,,1211.69,91,,percent of total billed charges,,,1264.95,95,,percent of total billed charges,,,1105.17,83,,percent of total billed charges,,,1105.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1105.17,83,,percent of total billed charges,,,1264.95,95,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1091.85,82,,percent of total billed charges,,,1198.38,90,,percent of total billed charges,,,1131.8,85,,percent of total billed charges,,332.88,1264.95,
SYNTHES SCREW METAPHYSEAL 2.7 X 46MM,30186078,CDM,,,278,RC,outpatient,,464.1,464.1,,394.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.03,22,,percent of total billed charges,,,,,,,,,417.69,90,,percent of total billed charges,,,384.27,82.8,,percent of total billed charges,,,394.49,85,,percent of total billed charges,,,,,,,,,408.41,88,,percent of total billed charges,,,,,,,,,354.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.03,22,,percent of total billed charges,,,422.33,91,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,,,,,,,,,,,,,385.2,83,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,380.56,82,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,394.49,85,,percent of total billed charges,,116.03,440.9,
SYNTHES SCREW METAPHYSEAL 2.7 X 48MM,30186079,CDM,,,278,RC,outpatient,,464.1,464.1,,394.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.03,22,,percent of total billed charges,,,,,,,,,417.69,90,,percent of total billed charges,,,384.27,82.8,,percent of total billed charges,,,394.49,85,,percent of total billed charges,,,,,,,,,408.41,88,,percent of total billed charges,,,,,,,,,354.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.03,22,,percent of total billed charges,,,422.33,91,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,385.2,83,,percent of total billed charges,,,,,,,,,,,,,,,385.2,83,,percent of total billed charges,,,440.9,95,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,380.56,82,,percent of total billed charges,,,417.69,90,,percent of total billed charges,,,394.49,85,,percent of total billed charges,,116.03,440.9,
SYNTHES CENTERING PIN 1.6MM FOR JOYSTICK,30186080,CDM,,,278,RC,outpatient,,1348.1,1348.1,,1144.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,337.03,22,,percent of total billed charges,,,,,,,,,1213.29,90,,percent of total billed charges,,,1116.23,82.8,,percent of total billed charges,,,1145.89,85,,percent of total billed charges,,,,,,,,,1186.33,88,,percent of total billed charges,,,,,,,,,1029.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,337.03,22,,percent of total billed charges,,,1226.77,91,,percent of total billed charges,,,1280.7,95,,percent of total billed charges,,,1118.92,83,,percent of total billed charges,,,1118.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1118.92,83,,percent of total billed charges,,,1280.7,95,,percent of total billed charges,,,1213.29,90,,percent of total billed charges,,,1213.29,90,,percent of total billed charges,,,1105.44,82,,percent of total billed charges,,,1213.29,90,,percent of total billed charges,,,1145.89,85,,percent of total billed charges,,337.03,1280.7,
TOPIFOAM ADHESIVE FOAM PADS,30186081,CDM,,,270,RC,outpatient,,243.75,243.75,,206.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60.94,22,,percent of total billed charges,,,,,,,,,219.38,90,,percent of total billed charges,,,201.83,82.8,,percent of total billed charges,,,207.19,85,,percent of total billed charges,,,,,,,,,214.5,88,,percent of total billed charges,,,,,,,,,186.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60.94,22,,percent of total billed charges,,,221.81,91,,percent of total billed charges,,,231.56,95,,percent of total billed charges,,,202.31,83,,percent of total billed charges,,,202.31,83,,percent of total billed charges,,,,,,,,,,,,,,,202.31,83,,percent of total billed charges,,,231.56,95,,percent of total billed charges,,,219.38,90,,percent of total billed charges,,,219.38,90,,percent of total billed charges,,,199.88,82,,percent of total billed charges,,,219.38,90,,percent of total billed charges,,,207.19,85,,percent of total billed charges,,60.94,231.56,
MEDTRONIC PACEMAKER AZURE XT SR MRI SURS,30186082,CDM,,,278,RC,outpatient,,40168.77,40168.77,,34103.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10042.19,22,,percent of total billed charges,,,,,,,,,36151.89,90,,percent of total billed charges,,,33259.74,82.8,,percent of total billed charges,,,34143.45,85,,percent of total billed charges,,,,,,,,,35348.52,88,,percent of total billed charges,,,,,,,,,30688.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10042.19,22,,percent of total billed charges,,,36553.58,91,,percent of total billed charges,,,38160.33,95,,percent of total billed charges,,,33340.08,83,,percent of total billed charges,,,33340.08,83,,percent of total billed charges,,,,,,,,,,,,,,,33340.08,83,,percent of total billed charges,,,38160.33,95,,percent of total billed charges,,,36151.89,90,,percent of total billed charges,,,36151.89,90,,percent of total billed charges,,,32938.39,82,,percent of total billed charges,,,36151.89,90,,percent of total billed charges,,,34143.45,85,,percent of total billed charges,,10042.19,38160.33,
SYNTHES PLATE LCP 7-HOLE 3.5MM,30186083,CDM,,,278,RC,outpatient,,3038.75,3038.75,,2579.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,759.69,22,,percent of total billed charges,,,,,,,,,2734.88,90,,percent of total billed charges,,,2516.09,82.8,,percent of total billed charges,,,2582.94,85,,percent of total billed charges,,,,,,,,,2674.1,88,,percent of total billed charges,,,,,,,,,2321.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,759.69,22,,percent of total billed charges,,,2765.26,91,,percent of total billed charges,,,2886.81,95,,percent of total billed charges,,,2522.16,83,,percent of total billed charges,,,2522.16,83,,percent of total billed charges,,,,,,,,,,,,,,,2522.16,83,,percent of total billed charges,,,2886.81,95,,percent of total billed charges,,,2734.88,90,,percent of total billed charges,,,2734.88,90,,percent of total billed charges,,,2491.78,82,,percent of total billed charges,,,2734.88,90,,percent of total billed charges,,,2582.94,85,,percent of total billed charges,,759.69,2886.81,
IR SCREW POLY 6.5 X 5.5MM,30186084,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
IR ROD 300MM 5.5MM,30186085,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
CTL CAGE MATISSE 14X12X6MM,30186086,CDM,,,278,RC,outpatient,,10708.75,10708.75,,9091.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2677.19,22,,percent of total billed charges,,,,,,,,,9637.88,90,,percent of total billed charges,,,8866.85,82.8,,percent of total billed charges,,,9102.44,85,,percent of total billed charges,,,,,,,,,9423.7,88,,percent of total billed charges,,,,,,,,,8181.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2677.19,22,,percent of total billed charges,,,9744.96,91,,percent of total billed charges,,,10173.31,95,,percent of total billed charges,,,8888.26,83,,percent of total billed charges,,,8888.26,83,,percent of total billed charges,,,,,,,,,,,,,,,8888.26,83,,percent of total billed charges,,,10173.31,95,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,8781.18,82,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,9102.44,85,,percent of total billed charges,,2677.19,10173.31,
CTL CAGE MATISSE 14X12X7MM,30186087,CDM,,,278,RC,outpatient,,10708.75,10708.75,,9091.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2677.19,22,,percent of total billed charges,,,,,,,,,9637.88,90,,percent of total billed charges,,,8866.85,82.8,,percent of total billed charges,,,9102.44,85,,percent of total billed charges,,,,,,,,,9423.7,88,,percent of total billed charges,,,,,,,,,8181.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2677.19,22,,percent of total billed charges,,,9744.96,91,,percent of total billed charges,,,10173.31,95,,percent of total billed charges,,,8888.26,83,,percent of total billed charges,,,8888.26,83,,percent of total billed charges,,,,,,,,,,,,,,,8888.26,83,,percent of total billed charges,,,10173.31,95,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,8781.18,82,,percent of total billed charges,,,9637.88,90,,percent of total billed charges,,,9102.44,85,,percent of total billed charges,,2677.19,10173.31,
CTL PLATE CERVICAL 28MM,30186088,CDM,,,278,RC,outpatient,,10816,10816,,9182.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2704,22,,percent of total billed charges,,,,,,,,,9734.4,90,,percent of total billed charges,,,8955.65,82.8,,percent of total billed charges,,,9193.6,85,,percent of total billed charges,,,,,,,,,9518.08,88,,percent of total billed charges,,,,,,,,,8263.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2704,22,,percent of total billed charges,,,9842.56,91,,percent of total billed charges,,,10275.2,95,,percent of total billed charges,,,8977.28,83,,percent of total billed charges,,,8977.28,83,,percent of total billed charges,,,,,,,,,,,,,,,8977.28,83,,percent of total billed charges,,,10275.2,95,,percent of total billed charges,,,9734.4,90,,percent of total billed charges,,,9734.4,90,,percent of total billed charges,,,8869.12,82,,percent of total billed charges,,,9734.4,90,,percent of total billed charges,,,9193.6,85,,percent of total billed charges,,2704,10275.2,
CTL SCREW ST VARIABLE 4.5 X 14,30186089,CDM,,,278,RC,outpatient,,1521,1521,,1291.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,380.25,22,,percent of total billed charges,,,,,,,,,1368.9,90,,percent of total billed charges,,,1259.39,82.8,,percent of total billed charges,,,1292.85,85,,percent of total billed charges,,,,,,,,,1338.48,88,,percent of total billed charges,,,,,,,,,1162.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,380.25,22,,percent of total billed charges,,,1384.11,91,,percent of total billed charges,,,1444.95,95,,percent of total billed charges,,,1262.43,83,,percent of total billed charges,,,1262.43,83,,percent of total billed charges,,,,,,,,,,,,,,,1262.43,83,,percent of total billed charges,,,1444.95,95,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1247.22,82,,percent of total billed charges,,,1368.9,90,,percent of total billed charges,,,1292.85,85,,percent of total billed charges,,380.25,1444.95,
S&N LINER ACETABULAR 32MM +4MM SZ E,30186090,CDM,,,278,RC,outpatient,,36172.5,36172.5,,30710.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9043.13,22,,percent of total billed charges,,,,,,,,,32555.25,90,,percent of total billed charges,,,29950.83,82.8,,percent of total billed charges,,,30746.63,85,,percent of total billed charges,,,,,,,,,31831.8,88,,percent of total billed charges,,,,,,,,,27635.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9043.13,22,,percent of total billed charges,,,32916.98,91,,percent of total billed charges,,,34363.88,95,,percent of total billed charges,,,30023.18,83,,percent of total billed charges,,,30023.18,83,,percent of total billed charges,,,,,,,,,,,,,,,30023.18,83,,percent of total billed charges,,,34363.88,95,,percent of total billed charges,,,32555.25,90,,percent of total billed charges,,,32555.25,90,,percent of total billed charges,,,29661.45,82,,percent of total billed charges,,,32555.25,90,,percent of total billed charges,,,30746.63,85,,percent of total billed charges,,9043.13,34363.88,
S&N HEAD FEMORAL 32MM +4 CO-CR,30186091,CDM,,,278,RC,outpatient,,15275,15275,,12968.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3818.75,22,,percent of total billed charges,,,,,,,,,13747.5,90,,percent of total billed charges,,,12647.7,82.8,,percent of total billed charges,,,12983.75,85,,percent of total billed charges,,,,,,,,,13442,88,,percent of total billed charges,,,,,,,,,11670.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3818.75,22,,percent of total billed charges,,,13900.25,91,,percent of total billed charges,,,14511.25,95,,percent of total billed charges,,,12678.25,83,,percent of total billed charges,,,12678.25,83,,percent of total billed charges,,,,,,,,,,,,,,,12678.25,83,,percent of total billed charges,,,14511.25,95,,percent of total billed charges,,,13747.5,90,,percent of total billed charges,,,13747.5,90,,percent of total billed charges,,,12525.5,82,,percent of total billed charges,,,13747.5,90,,percent of total billed charges,,,12983.75,85,,percent of total billed charges,,3818.75,14511.25,
SYNTHES SCREW CORTEX 2.4 X 28MM,30186092,CDM,,,278,RC,outpatient,,827.05,827.05,,702.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.76,22,,percent of total billed charges,,,,,,,,,744.35,90,,percent of total billed charges,,,684.8,82.8,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,,,,,,,,727.8,88,,percent of total billed charges,,,,,,,,,631.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.76,22,,percent of total billed charges,,,752.62,91,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,,,,,,,,,,,,,686.45,83,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,678.18,82,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,206.76,785.7,
SYNTHES PLATE LCP BROAD 9 HOLE,30186093,CDM,,,278,RC,outpatient,,5497.38,5497.38,,4667.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1374.35,22,,percent of total billed charges,,,,,,,,,4947.64,90,,percent of total billed charges,,,4551.83,82.8,,percent of total billed charges,,,4672.77,85,,percent of total billed charges,,,,,,,,,4837.69,88,,percent of total billed charges,,,,,,,,,4200,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1374.35,22,,percent of total billed charges,,,5002.62,91,,percent of total billed charges,,,5222.51,95,,percent of total billed charges,,,4562.83,83,,percent of total billed charges,,,4562.83,83,,percent of total billed charges,,,,,,,,,,,,,,,4562.83,83,,percent of total billed charges,,,5222.51,95,,percent of total billed charges,,,4947.64,90,,percent of total billed charges,,,4947.64,90,,percent of total billed charges,,,4507.85,82,,percent of total billed charges,,,4947.64,90,,percent of total billed charges,,,4672.77,85,,percent of total billed charges,,1374.35,5222.51,
SYNTHES SCREW CORTEX 4.5 X 30MM,30186094,CDM,,,278,RC,outpatient,,261.38,261.38,,221.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.35,22,,percent of total billed charges,,,,,,,,,235.24,90,,percent of total billed charges,,,216.42,82.8,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,,,,,,,,230.01,88,,percent of total billed charges,,,,,,,,,199.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.35,22,,percent of total billed charges,,,237.86,91,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,216.95,83,,percent of total billed charges,,,,,,,,,,,,,,,216.95,83,,percent of total billed charges,,,248.31,95,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,214.33,82,,percent of total billed charges,,,235.24,90,,percent of total billed charges,,,222.17,85,,percent of total billed charges,,65.35,248.31,
ZIMMER SHELL OSSEOTI 4 HOLE G7 56MM F,30186095,CDM,,,278,RC,outpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4834.38,22,,percent of total billed charges,,,,,,,,,17403.75,90,,percent of total billed charges,,,16011.45,82.8,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4834.38,22,,percent of total billed charges,,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,4834.38,18370.63,
ZIMMER HEAD FREEDOM MODULAR 36MM -6MM,30186096,CDM,,,278,RC,outpatient,,17810,17810,,15120.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4452.5,22,,percent of total billed charges,,,,,,,,,16029,90,,percent of total billed charges,,,14746.68,82.8,,percent of total billed charges,,,15138.5,85,,percent of total billed charges,,,,,,,,,15672.8,88,,percent of total billed charges,,,,,,,,,13606.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4452.5,22,,percent of total billed charges,,,16207.1,91,,percent of total billed charges,,,16919.5,95,,percent of total billed charges,,,14782.3,83,,percent of total billed charges,,,14782.3,83,,percent of total billed charges,,,,,,,,,,,,,,,14782.3,83,,percent of total billed charges,,,16919.5,95,,percent of total billed charges,,,16029,90,,percent of total billed charges,,,16029,90,,percent of total billed charges,,,14604.2,82,,percent of total billed charges,,,16029,90,,percent of total billed charges,,,15138.5,85,,percent of total billed charges,,4452.5,16919.5,
ZIMMER LINER FREEDOM CONSTRAINED 36MM F,30186097,CDM,,,278,RC,outpatient,,39390,39390,,33442.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9847.5,22,,percent of total billed charges,,,,,,,,,35451,90,,percent of total billed charges,,,32614.92,82.8,,percent of total billed charges,,,33481.5,85,,percent of total billed charges,,,,,,,,,34663.2,88,,percent of total billed charges,,,,,,,,,30093.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9847.5,22,,percent of total billed charges,,,35844.9,91,,percent of total billed charges,,,37420.5,95,,percent of total billed charges,,,32693.7,83,,percent of total billed charges,,,32693.7,83,,percent of total billed charges,,,,,,,,,,,,,,,32693.7,83,,percent of total billed charges,,,37420.5,95,,percent of total billed charges,,,35451,90,,percent of total billed charges,,,35451,90,,percent of total billed charges,,,32299.8,82,,percent of total billed charges,,,35451,90,,percent of total billed charges,,,33481.5,85,,percent of total billed charges,,9847.5,37420.5,
SPINECRAFT ROD LORDOSED 6.0 X 45MM,30186098,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ZIMMER CEMENT BONE REFOBACIN 1X40,30186099,CDM,,,278,RC,outpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,446.88,22,,percent of total billed charges,,,,,,,,,1608.75,90,,percent of total billed charges,,,1480.05,82.8,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,446.88,22,,percent of total billed charges,,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,446.88,1698.13,
ZIMMER BONE CEMENT R,30186100,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
SPINECRAFT ROD LORDOSED 5.5 X 40MM,30186101,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
SPINECRAFT SCREW 6.0 X 50MM,30186102,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT SCREW 6.0 X 45MM,30186103,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT SCREW 7.0 X 50MM,30186104,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ARTHREX CUTTER FLIP II 10.5MM,30186105,CDM,,,270,RC,outpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,528.13,22,,percent of total billed charges,,,,,,,,,1901.25,90,,percent of total billed charges,,,1749.15,82.8,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,528.13,22,,percent of total billed charges,,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,528.13,2006.88,
ULRICH CAGE PEEK 7MM,30186106,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
PLATE REPLICATOR EQUINOXE 4.5MM,30186107,CDM,,,270,RC,outpatient,,14118,14118,,11986.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3529.5,22,,percent of total billed charges,,,,,,,,,12706.2,90,,percent of total billed charges,,,11689.7,82.8,,percent of total billed charges,,,12000.3,85,,percent of total billed charges,,,,,,,,,12423.84,88,,percent of total billed charges,,,,,,,,,10786.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3529.5,22,,percent of total billed charges,,,12847.38,91,,percent of total billed charges,,,13412.1,95,,percent of total billed charges,,,11717.94,83,,percent of total billed charges,,,11717.94,83,,percent of total billed charges,,,,,,,,,,,,,,,11717.94,83,,percent of total billed charges,,,13412.1,95,,percent of total billed charges,,,12706.2,90,,percent of total billed charges,,,12706.2,90,,percent of total billed charges,,,11576.76,82,,percent of total billed charges,,,12706.2,90,,percent of total billed charges,,,12000.3,85,,percent of total billed charges,,3529.5,13412.1,
GLENOID CAGE CEMENTED LARGE,30186108,CDM,,,278,RC,outpatient,,29211,29211,,24800.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7302.75,22,,percent of total billed charges,,,,,,,,,26289.9,90,,percent of total billed charges,,,24186.71,82.8,,percent of total billed charges,,,24829.35,85,,percent of total billed charges,,,,,,,,,25705.68,88,,percent of total billed charges,,,,,,,,,22317.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7302.75,22,,percent of total billed charges,,,26582.01,91,,percent of total billed charges,,,27750.45,95,,percent of total billed charges,,,24245.13,83,,percent of total billed charges,,,24245.13,83,,percent of total billed charges,,,,,,,,,,,,,,,24245.13,83,,percent of total billed charges,,,27750.45,95,,percent of total billed charges,,,26289.9,90,,percent of total billed charges,,,26289.9,90,,percent of total billed charges,,,23953.02,82,,percent of total billed charges,,,26289.9,90,,percent of total billed charges,,,24829.35,85,,percent of total billed charges,,7302.75,27750.45,
SCREW KIT TORQUE DEFINING SQUARE DRIVE,30186109,CDM,,,270,RC,outpatient,,4335.5,4335.5,,3680.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1083.88,22,,percent of total billed charges,,,,,,,,,3901.95,90,,percent of total billed charges,,,3589.79,82.8,,percent of total billed charges,,,3685.18,85,,percent of total billed charges,,,,,,,,,3815.24,88,,percent of total billed charges,,,,,,,,,3312.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1083.88,22,,percent of total billed charges,,,3945.31,91,,percent of total billed charges,,,4118.73,95,,percent of total billed charges,,,3598.47,83,,percent of total billed charges,,,3598.47,83,,percent of total billed charges,,,,,,,,,,,,,,,3598.47,83,,percent of total billed charges,,,4118.73,95,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3555.11,82,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3685.18,85,,percent of total billed charges,,1083.88,4118.73,
HEAD HUMERAL TALL 44 X 21MM,30186110,CDM,,,278,RC,outpatient,,23088,23088,,19601.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5772,22,,percent of total billed charges,,,,,,,,,20779.2,90,,percent of total billed charges,,,19116.86,82.8,,percent of total billed charges,,,19624.8,85,,percent of total billed charges,,,,,,,,,20317.44,88,,percent of total billed charges,,,,,,,,,17639.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5772,22,,percent of total billed charges,,,21010.08,91,,percent of total billed charges,,,21933.6,95,,percent of total billed charges,,,19163.04,83,,percent of total billed charges,,,19163.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19163.04,83,,percent of total billed charges,,,21933.6,95,,percent of total billed charges,,,20779.2,90,,percent of total billed charges,,,20779.2,90,,percent of total billed charges,,,18932.16,82,,percent of total billed charges,,,20779.2,90,,percent of total billed charges,,,19624.8,85,,percent of total billed charges,,5772,21933.6,
ZIMMER BEARING LEFT MED 5MM,30186111,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
CAGE STALIF C-T 16 X 7.5MM,30186112,CDM,,,278,RC,outpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4875,22,,percent of total billed charges,,,,,,,,,17550,90,,percent of total billed charges,,,16146,82.8,,percent of total billed charges,,,16575,85,,percent of total billed charges,,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4875,22,,percent of total billed charges,,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,4875,18525,
ARTHREX SUTURETAPE FIBERLOOP W/NDL,30186113,CDM,,,270,RC,outpatient,,490,490,,416.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.5,22,,percent of total billed charges,,,,,,,,,441,90,,percent of total billed charges,,,405.72,82.8,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,,,,,,,,431.2,88,,percent of total billed charges,,,,,,,,,374.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.5,22,,percent of total billed charges,,,445.9,91,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,,,,,,,,,,,,,406.7,83,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,401.8,82,,percent of total billed charges,,,441,90,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,122.5,465.5,
DEPUY INSERT TC3 RP 20MM SZ 4,30186114,CDM,,,278,RC,outpatient,,23116.99,23116.99,,19626.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5779.25,22,,percent of total billed charges,,,,,,,,,20805.29,90,,percent of total billed charges,,,19140.87,82.8,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,,,,,,,,20342.95,88,,percent of total billed charges,,,,,,,,,17661.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5779.25,22,,percent of total billed charges,,,21036.46,91,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,19187.1,83,,percent of total billed charges,,,,,,,,,,,,,,,19187.1,83,,percent of total billed charges,,,21961.14,95,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,18955.93,82,,percent of total billed charges,,,20805.29,90,,percent of total billed charges,,,19649.44,85,,percent of total billed charges,,5779.25,21961.14,
DEPUY LINER DURALOC 32X52X4,30186115,CDM,,,278,RC,outpatient,,14450.8,14450.8,,12268.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3612.7,22,,percent of total billed charges,,,,,,,,,13005.72,90,,percent of total billed charges,,,11965.26,82.8,,percent of total billed charges,,,12283.18,85,,percent of total billed charges,,,,,,,,,12716.7,88,,percent of total billed charges,,,,,,,,,11040.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3612.7,22,,percent of total billed charges,,,13150.23,91,,percent of total billed charges,,,13728.26,95,,percent of total billed charges,,,11994.16,83,,percent of total billed charges,,,11994.16,83,,percent of total billed charges,,,,,,,,,,,,,,,11994.16,83,,percent of total billed charges,,,13728.26,95,,percent of total billed charges,,,13005.72,90,,percent of total billed charges,,,13005.72,90,,percent of total billed charges,,,11849.66,82,,percent of total billed charges,,,13005.72,90,,percent of total billed charges,,,12283.18,85,,percent of total billed charges,,3612.7,13728.26,
DEPUY LOCKING RING DURALOC 52MM,30186116,CDM,,,278,RC,outpatient,,2753.86,2753.86,,2338.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,688.47,22,,percent of total billed charges,,,,,,,,,2478.47,90,,percent of total billed charges,,,2280.2,82.8,,percent of total billed charges,,,2340.78,85,,percent of total billed charges,,,,,,,,,2423.4,88,,percent of total billed charges,,,,,,,,,2103.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,688.47,22,,percent of total billed charges,,,2506.01,91,,percent of total billed charges,,,2616.17,95,,percent of total billed charges,,,2285.7,83,,percent of total billed charges,,,2285.7,83,,percent of total billed charges,,,,,,,,,,,,,,,2285.7,83,,percent of total billed charges,,,2616.17,95,,percent of total billed charges,,,2478.47,90,,percent of total billed charges,,,2478.47,90,,percent of total billed charges,,,2258.17,82,,percent of total billed charges,,,2478.47,90,,percent of total billed charges,,,2340.78,85,,percent of total billed charges,,688.47,2616.17,
SYNTHES CONNICAL EXTRACTION SCREW FOR 7.,30186117,CDM,,,278,RC,outpatient,,2502.5,2502.5,,2124.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,625.63,22,,percent of total billed charges,,,,,,,,,2252.25,90,,percent of total billed charges,,,2072.07,82.8,,percent of total billed charges,,,2127.13,85,,percent of total billed charges,,,,,,,,,2202.2,88,,percent of total billed charges,,,,,,,,,1911.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,625.63,22,,percent of total billed charges,,,2277.28,91,,percent of total billed charges,,,2377.38,95,,percent of total billed charges,,,2077.08,83,,percent of total billed charges,,,2077.08,83,,percent of total billed charges,,,,,,,,,,,,,,,2077.08,83,,percent of total billed charges,,,2377.38,95,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2052.05,82,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2127.13,85,,percent of total billed charges,,625.63,2377.38,
DEPUY-MITEK HEALIX 4.5 BLUE,30186118,CDM,,,278,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
DEPUY-MITEK HEALIX 4.5 WHITE,30186119,CDM,,,278,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
DEPUY-MITEK HEALIX KNOTLESS 4.75,30186120,CDM,,,278,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
ENDOFLIP CATH NASAL TIP 16CM,30186121,CDM,,,270,RC,outpatient,,2693.6,2693.6,,2286.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,673.4,22,,percent of total billed charges,,,,,,,,,2424.24,90,,percent of total billed charges,,,2230.3,82.8,,percent of total billed charges,,,2289.56,85,,percent of total billed charges,,,,,,,,,2370.37,88,,percent of total billed charges,,,,,,,,,2057.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,673.4,22,,percent of total billed charges,,,2451.18,91,,percent of total billed charges,,,2558.92,95,,percent of total billed charges,,,2235.69,83,,percent of total billed charges,,,2235.69,83,,percent of total billed charges,,,,,,,,,,,,,,,2235.69,83,,percent of total billed charges,,,2558.92,95,,percent of total billed charges,,,2424.24,90,,percent of total billed charges,,,2424.24,90,,percent of total billed charges,,,2208.75,82,,percent of total billed charges,,,2424.24,90,,percent of total billed charges,,,2289.56,85,,percent of total billed charges,,673.4,2558.92,
S&N HEALICOIL PK 4.5MM W/1 ULTRATAPE,30186122,CDM,,,270,RC,outpatient,,4728.75,4728.75,,4014.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1182.19,22,,percent of total billed charges,,,,,,,,,4255.88,90,,percent of total billed charges,,,3915.41,82.8,,percent of total billed charges,,,4019.44,85,,percent of total billed charges,,,,,,,,,4161.3,88,,percent of total billed charges,,,,,,,,,3612.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1182.19,22,,percent of total billed charges,,,4303.16,91,,percent of total billed charges,,,4492.31,95,,percent of total billed charges,,,3924.86,83,,percent of total billed charges,,,3924.86,83,,percent of total billed charges,,,,,,,,,,,,,,,3924.86,83,,percent of total billed charges,,,4492.31,95,,percent of total billed charges,,,4255.88,90,,percent of total billed charges,,,4255.88,90,,percent of total billed charges,,,3877.58,82,,percent of total billed charges,,,4255.88,90,,percent of total billed charges,,,4019.44,85,,percent of total billed charges,,1182.19,4492.31,
S&N HEALICOIL PK 4.5MM W/1 ULTRATAPE BLU,30186123,CDM,,,270,RC,outpatient,,5674.5,5674.5,,4817.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1418.63,22,,percent of total billed charges,,,,,,,,,5107.05,90,,percent of total billed charges,,,4698.49,82.8,,percent of total billed charges,,,4823.33,85,,percent of total billed charges,,,,,,,,,4993.56,88,,percent of total billed charges,,,,,,,,,4335.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1418.63,22,,percent of total billed charges,,,5163.8,91,,percent of total billed charges,,,5390.78,95,,percent of total billed charges,,,4709.84,83,,percent of total billed charges,,,4709.84,83,,percent of total billed charges,,,,,,,,,,,,,,,4709.84,83,,percent of total billed charges,,,5390.78,95,,percent of total billed charges,,,5107.05,90,,percent of total billed charges,,,5107.05,90,,percent of total billed charges,,,4653.09,82,,percent of total billed charges,,,5107.05,90,,percent of total billed charges,,,4823.33,85,,percent of total billed charges,,1418.63,5390.78,
S&N SUTURE ANCHOR 5.5 KNOTLESS MUTLIFIX,30186124,CDM,,,278,RC,outpatient,,4854.85,4854.85,,4121.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1213.71,22,,percent of total billed charges,,,,,,,,,4369.37,90,,percent of total billed charges,,,4019.82,82.8,,percent of total billed charges,,,4126.62,85,,percent of total billed charges,,,,,,,,,4272.27,88,,percent of total billed charges,,,,,,,,,3709.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1213.71,22,,percent of total billed charges,,,4417.91,91,,percent of total billed charges,,,4612.11,95,,percent of total billed charges,,,4029.53,83,,percent of total billed charges,,,4029.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4029.53,83,,percent of total billed charges,,,4612.11,95,,percent of total billed charges,,,4369.37,90,,percent of total billed charges,,,4369.37,90,,percent of total billed charges,,,3980.98,82,,percent of total billed charges,,,4369.37,90,,percent of total billed charges,,,4126.62,85,,percent of total billed charges,,1213.71,4612.11,
SPINECRAFT ROD LOWDOSED 6.0 X 100MM,30186125,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
SPINECRAFT ROD LOWDOSED 6.0 X 50MM,30186126,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
SYNTHES DRILL BIT 1.1,30186127,CDM,,,278,RC,outpatient,,830.83,830.83,,705.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,207.71,22,,percent of total billed charges,,,,,,,,,747.75,90,,percent of total billed charges,,,687.93,82.8,,percent of total billed charges,,,706.21,85,,percent of total billed charges,,,,,,,,,731.13,88,,percent of total billed charges,,,,,,,,,634.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,207.71,22,,percent of total billed charges,,,756.06,91,,percent of total billed charges,,,789.29,95,,percent of total billed charges,,,689.59,83,,percent of total billed charges,,,689.59,83,,percent of total billed charges,,,,,,,,,,,,,,,689.59,83,,percent of total billed charges,,,789.29,95,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,681.28,82,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,706.21,85,,percent of total billed charges,,207.71,789.29,
SYNTHES K-WIRE 1.0,30186128,CDM,,,278,RC,outpatient,,988.98,988.98,,839.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,247.25,22,,percent of total billed charges,,,,,,,,,890.08,90,,percent of total billed charges,,,818.88,82.8,,percent of total billed charges,,,840.63,85,,percent of total billed charges,,,,,,,,,870.3,88,,percent of total billed charges,,,,,,,,,755.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,247.25,22,,percent of total billed charges,,,899.97,91,,percent of total billed charges,,,939.53,95,,percent of total billed charges,,,820.85,83,,percent of total billed charges,,,820.85,83,,percent of total billed charges,,,,,,,,,,,,,,,820.85,83,,percent of total billed charges,,,939.53,95,,percent of total billed charges,,,890.08,90,,percent of total billed charges,,,890.08,90,,percent of total billed charges,,,810.96,82,,percent of total billed charges,,,890.08,90,,percent of total billed charges,,,840.63,85,,percent of total billed charges,,247.25,939.53,
SYNTHES SCREW CORTEX ST 1.5 X 14MM,30186129,CDM,,,278,RC,outpatient,,523.6,523.6,,444.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.9,22,,percent of total billed charges,,,,,,,,,471.24,90,,percent of total billed charges,,,433.54,82.8,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,,,,,,,,460.77,88,,percent of total billed charges,,,,,,,,,400.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.9,22,,percent of total billed charges,,,476.48,91,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,,,,,,,,,,,,,434.59,83,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,429.35,82,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,130.9,497.42,
SYNTHES SCREW CORTEX ST 1.5 X 15MM,30186130,CDM,,,278,RC,outpatient,,523.6,523.6,,444.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.9,22,,percent of total billed charges,,,,,,,,,471.24,90,,percent of total billed charges,,,433.54,82.8,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,,,,,,,,460.77,88,,percent of total billed charges,,,,,,,,,400.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.9,22,,percent of total billed charges,,,476.48,91,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,434.59,83,,percent of total billed charges,,,,,,,,,,,,,,,434.59,83,,percent of total billed charges,,,497.42,95,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,429.35,82,,percent of total billed charges,,,471.24,90,,percent of total billed charges,,,445.06,85,,percent of total billed charges,,130.9,497.42,
S&N LINER ACETABULAR 36MM +4MM SZ F,30186131,CDM,,,278,RC,outpatient,,30647.5,30647.5,,26019.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7661.88,22,,percent of total billed charges,,,,,,,,,27582.75,90,,percent of total billed charges,,,25376.13,82.8,,percent of total billed charges,,,26050.38,85,,percent of total billed charges,,,,,,,,,26969.8,88,,percent of total billed charges,,,,,,,,,23414.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7661.88,22,,percent of total billed charges,,,27889.23,91,,percent of total billed charges,,,29115.13,95,,percent of total billed charges,,,25437.43,83,,percent of total billed charges,,,25437.43,83,,percent of total billed charges,,,,,,,,,,,,,,,25437.43,83,,percent of total billed charges,,,29115.13,95,,percent of total billed charges,,,27582.75,90,,percent of total billed charges,,,27582.75,90,,percent of total billed charges,,,25130.95,82,,percent of total billed charges,,,27582.75,90,,percent of total billed charges,,,26050.38,85,,percent of total billed charges,,7661.88,29115.13,
S&N HEAD FEMORAL 36MM +0 12/14,30186132,CDM,,,278,RC,outpatient,,30160,30160,,25605.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7540,22,,percent of total billed charges,,,,,,,,,27144,90,,percent of total billed charges,,,24972.48,82.8,,percent of total billed charges,,,25636,85,,percent of total billed charges,,,,,,,,,26540.8,88,,percent of total billed charges,,,,,,,,,23042.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7540,22,,percent of total billed charges,,,27445.6,91,,percent of total billed charges,,,28652,95,,percent of total billed charges,,,25032.8,83,,percent of total billed charges,,,25032.8,83,,percent of total billed charges,,,,,,,,,,,,,,,25032.8,83,,percent of total billed charges,,,28652,95,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,24731.2,82,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,25636,85,,percent of total billed charges,,7540,28652,
MEDTRONIC EVERA MRI DR SURESCAN,30186133,CDM,,,278,RC,outpatient,,191203.16,191203.16,,162331.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47800.79,22,,percent of total billed charges,,,,,,,,,172082.84,90,,percent of total billed charges,,,158316.22,82.8,,percent of total billed charges,,,162522.69,85,,percent of total billed charges,,,,,,,,,168258.78,88,,percent of total billed charges,,,,,,,,,146079.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47800.79,22,,percent of total billed charges,,,173994.88,91,,percent of total billed charges,,,181643,95,,percent of total billed charges,,,158698.62,83,,percent of total billed charges,,,158698.62,83,,percent of total billed charges,,,,,,,,,,,,,,,158698.62,83,,percent of total billed charges,,,181643,95,,percent of total billed charges,,,172082.84,90,,percent of total billed charges,,,172082.84,90,,percent of total billed charges,,,156786.59,82,,percent of total billed charges,,,172082.84,90,,percent of total billed charges,,,162522.69,85,,percent of total billed charges,,47800.79,181643,
ARTHREX TIGERLOOP SUTURE,30186134,CDM,,,270,RC,outpatient,,490,490,,416.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.5,22,,percent of total billed charges,,,,,,,,,441,90,,percent of total billed charges,,,405.72,82.8,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,,,,,,,,431.2,88,,percent of total billed charges,,,,,,,,,374.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.5,22,,percent of total billed charges,,,445.9,91,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,,,,,,,,,,,,,406.7,83,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,401.8,82,,percent of total billed charges,,,441,90,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,122.5,465.5,
ARTHREX IMPLANT ACUTE AC REPAIR,30186135,CDM,,,278,RC,outpatient,,10452,10452,,8873.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2613,22,,percent of total billed charges,,,,,,,,,9406.8,90,,percent of total billed charges,,,8654.26,82.8,,percent of total billed charges,,,8884.2,85,,percent of total billed charges,,,,,,,,,9197.76,88,,percent of total billed charges,,,,,,,,,7985.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2613,22,,percent of total billed charges,,,9511.32,91,,percent of total billed charges,,,9929.4,95,,percent of total billed charges,,,8675.16,83,,percent of total billed charges,,,8675.16,83,,percent of total billed charges,,,,,,,,,,,,,,,8675.16,83,,percent of total billed charges,,,9929.4,95,,percent of total billed charges,,,9406.8,90,,percent of total billed charges,,,9406.8,90,,percent of total billed charges,,,8570.64,82,,percent of total billed charges,,,9406.8,90,,percent of total billed charges,,,8884.2,85,,percent of total billed charges,,2613,9929.4,
STRYKER BLADE ANGLED LONG HIP AGGRESSIVE,30186136,CDM,,,270,RC,outpatient,,552.86,552.86,,469.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,138.22,22,,percent of total billed charges,,,,,,,,,497.57,90,,percent of total billed charges,,,457.77,82.8,,percent of total billed charges,,,469.93,85,,percent of total billed charges,,,,,,,,,486.52,88,,percent of total billed charges,,,,,,,,,422.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,138.22,22,,percent of total billed charges,,,503.1,91,,percent of total billed charges,,,525.22,95,,percent of total billed charges,,,458.87,83,,percent of total billed charges,,,458.87,83,,percent of total billed charges,,,,,,,,,,,,,,,458.87,83,,percent of total billed charges,,,525.22,95,,percent of total billed charges,,,497.57,90,,percent of total billed charges,,,497.57,90,,percent of total billed charges,,,453.35,82,,percent of total billed charges,,,497.57,90,,percent of total billed charges,,,469.93,85,,percent of total billed charges,,138.22,525.22,
STRYKER FEMUR TRIATHLON PS LT SZ 6,30186137,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
ULRICH PLATE 1 LEVEL 14MM,30186138,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
ULRICH SCREW 4.0 X 14MM,30186139,CDM,,,278,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
COAGRASPER MONOPOLAR HEMOSTATIC FORCEP,30186140,CDM,,,270,RC,outpatient,,1722.37,1722.37,,1462.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,430.59,22,,percent of total billed charges,,,,,,,,,1550.13,90,,percent of total billed charges,,,1426.12,82.8,,percent of total billed charges,,,1464.01,85,,percent of total billed charges,,,,,,,,,1515.69,88,,percent of total billed charges,,,,,,,,,1315.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,430.59,22,,percent of total billed charges,,,1567.36,91,,percent of total billed charges,,,1636.25,95,,percent of total billed charges,,,1429.57,83,,percent of total billed charges,,,1429.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1429.57,83,,percent of total billed charges,,,1636.25,95,,percent of total billed charges,,,1550.13,90,,percent of total billed charges,,,1550.13,90,,percent of total billed charges,,,1412.34,82,,percent of total billed charges,,,1550.13,90,,percent of total billed charges,,,1464.01,85,,percent of total billed charges,,430.59,1636.25,
SPINECRAFT ROD LORDOSED 6.0 X 40MM,30186142,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
SPINECRAFT ROD LOWDOSED 6.0 X 80,30186143,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ARTHREX FIBERLOOP,30186144,CDM,,,278,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
ARTHREX SCREW VENTED 9X20MM BC IF,30186145,CDM,,,270,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
PARAGON BONE FENESTRATION PERFORATOR,30186146,CDM,,,278,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
PARAGON DRILL AO 2.0 X 110MM SOLID MEASU,30186147,CDM,,,270,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
PARAGON WIRE OLIVE SMOOTH 1.4MM,30186148,CDM,,,278,RC,outpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260,22,,percent of total billed charges,,,,,,,,,936,90,,percent of total billed charges,,,861.12,82.8,,percent of total billed charges,,,884,85,,percent of total billed charges,,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260,22,,percent of total billed charges,,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,260,988,
PARAGON PLATE MTP 5DEG MEDIUM RIGHT,30186149,CDM,,,278,RC,outpatient,,15372.5,15372.5,,13051.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3843.13,22,,percent of total billed charges,,,,,,,,,13835.25,90,,percent of total billed charges,,,12728.43,82.8,,percent of total billed charges,,,13066.63,85,,percent of total billed charges,,,,,,,,,13527.8,88,,percent of total billed charges,,,,,,,,,11744.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3843.13,22,,percent of total billed charges,,,13988.98,91,,percent of total billed charges,,,14603.88,95,,percent of total billed charges,,,12759.18,83,,percent of total billed charges,,,12759.18,83,,percent of total billed charges,,,,,,,,,,,,,,,12759.18,83,,percent of total billed charges,,,14603.88,95,,percent of total billed charges,,,13835.25,90,,percent of total billed charges,,,13835.25,90,,percent of total billed charges,,,12605.45,82,,percent of total billed charges,,,13835.25,90,,percent of total billed charges,,,13066.63,85,,percent of total billed charges,,3843.13,14603.88,
PARAGON K-WIRE 1.60 X 150MM SMOOTH SINGL,30186150,CDM,,,278,RC,outpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75,22,,percent of total billed charges,,,,,,,,,270,90,,percent of total billed charges,,,248.4,82.8,,percent of total billed charges,,,255,85,,percent of total billed charges,,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75,22,,percent of total billed charges,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,75,285,
PARAGON SCREW LOCKING PLATE 2.7 X 10MM R,30186151,CDM,,,278,RC,outpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,503.75,22,,percent of total billed charges,,,,,,,,,1813.5,90,,percent of total billed charges,,,1668.42,82.8,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,503.75,22,,percent of total billed charges,,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,503.75,1914.25,
PARAGON SCREW LOCKING PLATE 2.7 X 14MM R,30186152,CDM,,,278,RC,outpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,503.75,22,,percent of total billed charges,,,,,,,,,1813.5,90,,percent of total billed charges,,,1668.42,82.8,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,503.75,22,,percent of total billed charges,,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,503.75,1914.25,
PARAGON SCREW LOCKING PLATE 2.7 X 20MM R,30186153,CDM,,,278,RC,outpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,503.75,22,,percent of total billed charges,,,,,,,,,1813.5,90,,percent of total billed charges,,,1668.42,82.8,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,503.75,22,,percent of total billed charges,,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,503.75,1914.25,
PARAGON SCREW LOCKING PLATE 2.7 X 22MM R,30186154,CDM,,,278,RC,outpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,503.75,22,,percent of total billed charges,,,,,,,,,1813.5,90,,percent of total billed charges,,,1668.42,82.8,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,503.75,22,,percent of total billed charges,,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,503.75,1914.25,
PARAGON SCREW NON-LOCKING PLATE 2.7X16M,30186155,CDM,,,278,RC,outpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,390,22,,percent of total billed charges,,,,,,,,,1404,90,,percent of total billed charges,,,1291.68,82.8,,percent of total billed charges,,,1326,85,,percent of total billed charges,,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,390,22,,percent of total billed charges,,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,390,1482,
PARAGON SCREW NON-LOCKING PLATE 2.7X18M,30186156,CDM,,,278,RC,outpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,390,22,,percent of total billed charges,,,,,,,,,1404,90,,percent of total billed charges,,,1291.68,82.8,,percent of total billed charges,,,1326,85,,percent of total billed charges,,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,390,22,,percent of total billed charges,,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,390,1482,
PARAGON SCREW NON-LOCKING PLATE 3.5X18MM,30186157,CDM,,,278,RC,outpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,390,22,,percent of total billed charges,,,,,,,,,1404,90,,percent of total billed charges,,,1291.68,82.8,,percent of total billed charges,,,1326,85,,percent of total billed charges,,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,390,22,,percent of total billed charges,,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,390,1482,
PARAGON SCREW MINI-MONSTER 3.5 X 22MM,30186158,CDM,,,278,RC,outpatient,,2697.5,2697.5,,2290.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,674.38,22,,percent of total billed charges,,,,,,,,,2427.75,90,,percent of total billed charges,,,2233.53,82.8,,percent of total billed charges,,,2292.88,85,,percent of total billed charges,,,,,,,,,2373.8,88,,percent of total billed charges,,,,,,,,,2060.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,674.38,22,,percent of total billed charges,,,2454.73,91,,percent of total billed charges,,,2562.63,95,,percent of total billed charges,,,2238.93,83,,percent of total billed charges,,,2238.93,83,,percent of total billed charges,,,,,,,,,,,,,,,2238.93,83,,percent of total billed charges,,,2562.63,95,,percent of total billed charges,,,2427.75,90,,percent of total billed charges,,,2427.75,90,,percent of total billed charges,,,2211.95,82,,percent of total billed charges,,,2427.75,90,,percent of total billed charges,,,2292.88,85,,percent of total billed charges,,674.38,2562.63,
PARAGON DRILL AO 2.3 X 120MM CANNULATED,30186159,CDM,,,270,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
PARAGON K-WIRE 1.2 X 150MM SMOOTH SINGL,30186160,CDM,,,278,RC,outpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75,22,,percent of total billed charges,,,,,,,,,270,90,,percent of total billed charges,,,248.4,82.8,,percent of total billed charges,,,255,85,,percent of total billed charges,,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75,22,,percent of total billed charges,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,75,285,
S&N FEMORAL COMPONENT SZ 5N LEFT,30186161,CDM,,,278,RC,outpatient,,27300,27300,,23177.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6825,22,,percent of total billed charges,,,,,,,,,24570,90,,percent of total billed charges,,,22604.4,82.8,,percent of total billed charges,,,23205,85,,percent of total billed charges,,,,,,,,,24024,88,,percent of total billed charges,,,,,,,,,20857.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6825,22,,percent of total billed charges,,,24843,91,,percent of total billed charges,,,25935,95,,percent of total billed charges,,,22659,83,,percent of total billed charges,,,22659,83,,percent of total billed charges,,,,,,,,,,,,,,,22659,83,,percent of total billed charges,,,25935,95,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,22386,82,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,23205,85,,percent of total billed charges,,6825,25935,
S&N TIBIAL BASE PLATE SZ 4,30186162,CDM,,,278,RC,outpatient,,8190,8190,,6953.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2047.5,22,,percent of total billed charges,,,,,,,,,7371,90,,percent of total billed charges,,,6781.32,82.8,,percent of total billed charges,,,6961.5,85,,percent of total billed charges,,,,,,,,,7207.2,88,,percent of total billed charges,,,,,,,,,6257.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2047.5,22,,percent of total billed charges,,,7452.9,91,,percent of total billed charges,,,7780.5,95,,percent of total billed charges,,,6797.7,83,,percent of total billed charges,,,6797.7,83,,percent of total billed charges,,,,,,,,,,,,,,,6797.7,83,,percent of total billed charges,,,7780.5,95,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,6715.8,82,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,6961.5,85,,percent of total billed charges,,2047.5,7780.5,
S&N INSERT SZ 3-4 9MM,30186163,CDM,,,278,RC,outpatient,,16261.96,16261.96,,13806.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4065.49,22,,percent of total billed charges,,,,,,,,,14635.76,90,,percent of total billed charges,,,13464.9,82.8,,percent of total billed charges,,,13822.67,85,,percent of total billed charges,,,,,,,,,14310.52,88,,percent of total billed charges,,,,,,,,,12424.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4065.49,22,,percent of total billed charges,,,14798.38,91,,percent of total billed charges,,,15448.86,95,,percent of total billed charges,,,13497.43,83,,percent of total billed charges,,,13497.43,83,,percent of total billed charges,,,,,,,,,,,,,,,13497.43,83,,percent of total billed charges,,,15448.86,95,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,13334.81,82,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,13822.67,85,,percent of total billed charges,,4065.49,15448.86,
SYNTHES HELICAL BLADE 95MM,30186164,CDM,,,278,RC,outpatient,,6828.9,6828.9,,5797.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1707.23,22,,percent of total billed charges,,,,,,,,,6146.01,90,,percent of total billed charges,,,5654.33,82.8,,percent of total billed charges,,,5804.57,85,,percent of total billed charges,,,,,,,,,6009.43,88,,percent of total billed charges,,,,,,,,,5217.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1707.23,22,,percent of total billed charges,,,6214.3,91,,percent of total billed charges,,,6487.46,95,,percent of total billed charges,,,5667.99,83,,percent of total billed charges,,,5667.99,83,,percent of total billed charges,,,,,,,,,,,,,,,5667.99,83,,percent of total billed charges,,,6487.46,95,,percent of total billed charges,,,6146.01,90,,percent of total billed charges,,,6146.01,90,,percent of total billed charges,,,5599.7,82,,percent of total billed charges,,,6146.01,90,,percent of total billed charges,,,5804.57,85,,percent of total billed charges,,1707.23,6487.46,
SYNTHES TFNA 12MM X 360MM 130DEG RT,30186165,CDM,,,278,RC,outpatient,,21149.7,21149.7,,17956.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5287.43,22,,percent of total billed charges,,,,,,,,,19034.73,90,,percent of total billed charges,,,17511.95,82.8,,percent of total billed charges,,,17977.25,85,,percent of total billed charges,,,,,,,,,18611.74,88,,percent of total billed charges,,,,,,,,,16158.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5287.43,22,,percent of total billed charges,,,19246.23,91,,percent of total billed charges,,,20092.22,95,,percent of total billed charges,,,17554.25,83,,percent of total billed charges,,,17554.25,83,,percent of total billed charges,,,,,,,,,,,,,,,17554.25,83,,percent of total billed charges,,,20092.22,95,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,17342.75,82,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,17977.25,85,,percent of total billed charges,,5287.43,20092.22,
SYNTHES ROD REAMER 2.5MM,30186166,CDM,,,278,RC,outpatient,,1172.28,1172.28,,995.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,293.07,22,,percent of total billed charges,,,,,,,,,1055.05,90,,percent of total billed charges,,,970.65,82.8,,percent of total billed charges,,,996.44,85,,percent of total billed charges,,,,,,,,,1031.61,88,,percent of total billed charges,,,,,,,,,895.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,293.07,22,,percent of total billed charges,,,1066.77,91,,percent of total billed charges,,,1113.67,95,,percent of total billed charges,,,972.99,83,,percent of total billed charges,,,972.99,83,,percent of total billed charges,,,,,,,,,,,,,,,972.99,83,,percent of total billed charges,,,1113.67,95,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,961.27,82,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,996.44,85,,percent of total billed charges,,293.07,1113.67,
SYNTHES SCREW HC 2.4 X 22 LONG THREAD,30186167,CDM,,,278,RC,outpatient,,3723.85,3723.85,,3161.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,930.96,22,,percent of total billed charges,,,,,,,,,3351.47,90,,percent of total billed charges,,,3083.35,82.8,,percent of total billed charges,,,3165.27,85,,percent of total billed charges,,,,,,,,,3276.99,88,,percent of total billed charges,,,,,,,,,2845.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,930.96,22,,percent of total billed charges,,,3388.7,91,,percent of total billed charges,,,3537.66,95,,percent of total billed charges,,,3090.8,83,,percent of total billed charges,,,3090.8,83,,percent of total billed charges,,,,,,,,,,,,,,,3090.8,83,,percent of total billed charges,,,3537.66,95,,percent of total billed charges,,,3351.47,90,,percent of total billed charges,,,3351.47,90,,percent of total billed charges,,,3053.56,82,,percent of total billed charges,,,3351.47,90,,percent of total billed charges,,,3165.27,85,,percent of total billed charges,,930.96,3537.66,
SYNTHES SCREW HC 2.4 X 17 LONG THREAD,30186168,CDM,,,278,RC,outpatient,,3723.85,3723.85,,3161.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,930.96,22,,percent of total billed charges,,,,,,,,,3351.47,90,,percent of total billed charges,,,3083.35,82.8,,percent of total billed charges,,,3165.27,85,,percent of total billed charges,,,,,,,,,3276.99,88,,percent of total billed charges,,,,,,,,,2845.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,930.96,22,,percent of total billed charges,,,3388.7,91,,percent of total billed charges,,,3537.66,95,,percent of total billed charges,,,3090.8,83,,percent of total billed charges,,,3090.8,83,,percent of total billed charges,,,,,,,,,,,,,,,3090.8,83,,percent of total billed charges,,,3537.66,95,,percent of total billed charges,,,3351.47,90,,percent of total billed charges,,,3351.47,90,,percent of total billed charges,,,3053.56,82,,percent of total billed charges,,,3351.47,90,,percent of total billed charges,,,3165.27,85,,percent of total billed charges,,930.96,3537.66,
MITEK HEALIX ADVANCE KNOTLESS 4.5,30186169,CDM,,,278,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
DEPUY STEM FEMORAL POROUS 18.5 X 150,30186170,CDM,,,278,RC,outpatient,,48015.11,48015.11,,40764.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12003.78,22,,percent of total billed charges,,,,,,,,,43213.6,90,,percent of total billed charges,,,39756.51,82.8,,percent of total billed charges,,,40812.84,85,,percent of total billed charges,,,,,,,,,42253.3,88,,percent of total billed charges,,,,,,,,,36683.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12003.78,22,,percent of total billed charges,,,43693.75,91,,percent of total billed charges,,,45614.35,95,,percent of total billed charges,,,39852.54,83,,percent of total billed charges,,,39852.54,83,,percent of total billed charges,,,,,,,,,,,,,,,39852.54,83,,percent of total billed charges,,,45614.35,95,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,39372.39,82,,percent of total billed charges,,,43213.6,90,,percent of total billed charges,,,40812.84,85,,percent of total billed charges,,12003.78,45614.35,
SPINECRAFT SCREW REDUCTION 6.0 X 50MM,30186172,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
SYNTHES TFN LEFT 11MM 130DEG,30186173,CDM,,,278,RC,outpatient,,21149.7,21149.7,,17956.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5287.43,22,,percent of total billed charges,,,,,,,,,19034.73,90,,percent of total billed charges,,,17511.95,82.8,,percent of total billed charges,,,17977.25,85,,percent of total billed charges,,,,,,,,,18611.74,88,,percent of total billed charges,,,,,,,,,16158.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5287.43,22,,percent of total billed charges,,,19246.23,91,,percent of total billed charges,,,20092.22,95,,percent of total billed charges,,,17554.25,83,,percent of total billed charges,,,17554.25,83,,percent of total billed charges,,,,,,,,,,,,,,,17554.25,83,,percent of total billed charges,,,20092.22,95,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,17342.75,82,,percent of total billed charges,,,19034.73,90,,percent of total billed charges,,,17977.25,85,,percent of total billed charges,,5287.43,20092.22,
SYNTHES BLADE HELICAL 70MM,30186174,CDM,,,270,RC,outpatient,,6298.5,6298.5,,5347.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1574.63,22,,percent of total billed charges,,,,,,,,,5668.65,90,,percent of total billed charges,,,5215.16,82.8,,percent of total billed charges,,,5353.73,85,,percent of total billed charges,,,,,,,,,5542.68,88,,percent of total billed charges,,,,,,,,,4812.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1574.63,22,,percent of total billed charges,,,5731.64,91,,percent of total billed charges,,,5983.58,95,,percent of total billed charges,,,5227.76,83,,percent of total billed charges,,,5227.76,83,,percent of total billed charges,,,,,,,,,,,,,,,5227.76,83,,percent of total billed charges,,,5983.58,95,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5164.77,82,,percent of total billed charges,,,5668.65,90,,percent of total billed charges,,,5353.73,85,,percent of total billed charges,,1574.63,5983.58,
ESOFLIP CATH 20MM,30186176,CDM,,,270,RC,outpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,503.75,22,,percent of total billed charges,,,,,,,,,1813.5,90,,percent of total billed charges,,,1668.42,82.8,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,503.75,22,,percent of total billed charges,,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,503.75,1914.25,
SPINECRAFT SCREW 6.0 X 50MM,30186177,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT SCREW 6.0 X 40MM,30186178,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SYNTHES DRILL BIT 1.5,30186180,CDM,,,270,RC,outpatient,,868.7,868.7,,737.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,217.18,22,,percent of total billed charges,,,,,,,,,781.83,90,,percent of total billed charges,,,719.28,82.8,,percent of total billed charges,,,738.4,85,,percent of total billed charges,,,,,,,,,764.46,88,,percent of total billed charges,,,,,,,,,663.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,217.18,22,,percent of total billed charges,,,790.52,91,,percent of total billed charges,,,825.27,95,,percent of total billed charges,,,721.02,83,,percent of total billed charges,,,721.02,83,,percent of total billed charges,,,,,,,,,,,,,,,721.02,83,,percent of total billed charges,,,825.27,95,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,712.33,82,,percent of total billed charges,,,781.83,90,,percent of total billed charges,,,738.4,85,,percent of total billed charges,,217.18,825.27,
ZIMMER TRAY TIBIAL SZ AA OXFORD PMA,30186182,CDM,,,278,RC,outpatient,,13552.5,13552.5,,11506.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3388.13,22,,percent of total billed charges,,,,,,,,,12197.25,90,,percent of total billed charges,,,11221.47,82.8,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,,,,,,,,11926.2,88,,percent of total billed charges,,,,,,,,,10354.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3388.13,22,,percent of total billed charges,,,12332.78,91,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,11248.58,83,,percent of total billed charges,,,,,,,,,,,,,,,11248.58,83,,percent of total billed charges,,,12874.88,95,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11113.05,82,,percent of total billed charges,,,12197.25,90,,percent of total billed charges,,,11519.63,85,,percent of total billed charges,,3388.13,12874.88,
ZIMMER HEAD BIOLOX 28MM + OMM,30186183,CDM,,,278,RC,outpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5785,22,,percent of total billed charges,,,,,,,,,20826,90,,percent of total billed charges,,,19159.92,82.8,,percent of total billed charges,,,19669,85,,percent of total billed charges,,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5785,22,,percent of total billed charges,,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,5785,21983,
ZIMMER STEM REV. WAGNER 135 NK ANGLE 17X,30186184,CDM,,,278,RC,outpatient,,78000,78000,,66222,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19500,22,,percent of total billed charges,,,,,,,,,70200,90,,percent of total billed charges,,,64584,82.8,,percent of total billed charges,,,66300,85,,percent of total billed charges,,,,,,,,,68640,88,,percent of total billed charges,,,,,,,,,59592,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19500,22,,percent of total billed charges,,,70980,91,,percent of total billed charges,,,74100,95,,percent of total billed charges,,,64740,83,,percent of total billed charges,,,64740,83,,percent of total billed charges,,,,,,,,,,,,,,,64740,83,,percent of total billed charges,,,74100,95,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,63960,82,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,66300,85,,percent of total billed charges,,19500,74100,
DEPUY STEM SUMMIT CEMENTED SZ 6 STD,30186185,CDM,,,278,RC,outpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6361.02,22,,percent of total billed charges,,,,,,,,,22899.65,90,,percent of total billed charges,,,21067.68,82.8,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6361.02,22,,percent of total billed charges,,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,6361.02,24171.86,
STRYKER FEMUR TRIATHLON CR SZ 6 RT,30186186,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
STRYKER INSERT TRIATHLON CS SZ 6 11MM,30186187,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER INSERT TIBIA TRIATHLON SZ 7 13MM,30186188,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
SYNTHES PLATE DORSAL R 2.4MM 5 HOLE,30186191,CDM,,,278,RC,outpatient,,5375.83,5375.83,,4564.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1343.96,22,,percent of total billed charges,,,,,,,,,4838.25,90,,percent of total billed charges,,,4451.19,82.8,,percent of total billed charges,,,4569.46,85,,percent of total billed charges,,,,,,,,,4730.73,88,,percent of total billed charges,,,,,,,,,4107.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1343.96,22,,percent of total billed charges,,,4892.01,91,,percent of total billed charges,,,5107.04,95,,percent of total billed charges,,,4461.94,83,,percent of total billed charges,,,4461.94,83,,percent of total billed charges,,,,,,,,,,,,,,,4461.94,83,,percent of total billed charges,,,5107.04,95,,percent of total billed charges,,,4838.25,90,,percent of total billed charges,,,4838.25,90,,percent of total billed charges,,,4408.18,82,,percent of total billed charges,,,4838.25,90,,percent of total billed charges,,,4569.46,85,,percent of total billed charges,,1343.96,5107.04,
SYNTHES SCREW CORTEX S-T 2.4X28MM,30186192,CDM,,,278,RC,outpatient,,565.25,565.25,,479.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141.31,22,,percent of total billed charges,,,,,,,,,508.73,90,,percent of total billed charges,,,468.03,82.8,,percent of total billed charges,,,480.46,85,,percent of total billed charges,,,,,,,,,497.42,88,,percent of total billed charges,,,,,,,,,431.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141.31,22,,percent of total billed charges,,,514.38,91,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,,,,,,,,,,,,,469.16,83,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,463.51,82,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,480.46,85,,percent of total billed charges,,141.31,536.99,
SYNTHES SCREW CORTEX S-T 2.4X30MM,30186193,CDM,,,278,RC,outpatient,,565.25,565.25,,479.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141.31,22,,percent of total billed charges,,,,,,,,,508.73,90,,percent of total billed charges,,,468.03,82.8,,percent of total billed charges,,,480.46,85,,percent of total billed charges,,,,,,,,,497.42,88,,percent of total billed charges,,,,,,,,,431.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141.31,22,,percent of total billed charges,,,514.38,91,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,469.16,83,,percent of total billed charges,,,,,,,,,,,,,,,469.16,83,,percent of total billed charges,,,536.99,95,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,463.51,82,,percent of total billed charges,,,508.73,90,,percent of total billed charges,,,480.46,85,,percent of total billed charges,,141.31,536.99,
SYNTHES DRILL BIT 1.8MM,30186194,CDM,,,278,RC,outpatient,,1514.5,1514.5,,1285.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,378.63,22,,percent of total billed charges,,,,,,,,,1363.05,90,,percent of total billed charges,,,1254.01,82.8,,percent of total billed charges,,,1287.33,85,,percent of total billed charges,,,,,,,,,1332.76,88,,percent of total billed charges,,,,,,,,,1157.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,378.63,22,,percent of total billed charges,,,1378.2,91,,percent of total billed charges,,,1438.78,95,,percent of total billed charges,,,1257.04,83,,percent of total billed charges,,,1257.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1257.04,83,,percent of total billed charges,,,1438.78,95,,percent of total billed charges,,,1363.05,90,,percent of total billed charges,,,1363.05,90,,percent of total billed charges,,,1241.89,82,,percent of total billed charges,,,1363.05,90,,percent of total billed charges,,,1287.33,85,,percent of total billed charges,,378.63,1438.78,
SYNTHES DRILL DRILL GUIDE 2.0MM,30186195,CDM,,,270,RC,outpatient,,6370.33,6370.33,,5408.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1592.58,22,,percent of total billed charges,,,,,,,,,5733.3,90,,percent of total billed charges,,,5274.63,82.8,,percent of total billed charges,,,5414.78,85,,percent of total billed charges,,,,,,,,,5605.89,88,,percent of total billed charges,,,,,,,,,4866.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1592.58,22,,percent of total billed charges,,,5797,91,,percent of total billed charges,,,6051.81,95,,percent of total billed charges,,,5287.37,83,,percent of total billed charges,,,5287.37,83,,percent of total billed charges,,,,,,,,,,,,,,,5287.37,83,,percent of total billed charges,,,6051.81,95,,percent of total billed charges,,,5733.3,90,,percent of total billed charges,,,5733.3,90,,percent of total billed charges,,,5223.67,82,,percent of total billed charges,,,5733.3,90,,percent of total billed charges,,,5414.78,85,,percent of total billed charges,,1592.58,6051.81,
SYNTHES PLATE DISTAL FIBULA LCP 2.7/3.5,30186196,CDM,,,278,RC,outpatient,,6207.31,6207.31,,5270.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1551.83,22,,percent of total billed charges,,,,,,,,,5586.58,90,,percent of total billed charges,,,5139.65,82.8,,percent of total billed charges,,,5276.21,85,,percent of total billed charges,,,,,,,,,5462.43,88,,percent of total billed charges,,,,,,,,,4742.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1551.83,22,,percent of total billed charges,,,5648.65,91,,percent of total billed charges,,,5896.94,95,,percent of total billed charges,,,5152.07,83,,percent of total billed charges,,,5152.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5152.07,83,,percent of total billed charges,,,5896.94,95,,percent of total billed charges,,,5586.58,90,,percent of total billed charges,,,5586.58,90,,percent of total billed charges,,,5089.99,82,,percent of total billed charges,,,5586.58,90,,percent of total billed charges,,,5276.21,85,,percent of total billed charges,,1551.83,5896.94,
ULRICH PEEK CERVICAL CAGE 8MM,30186197,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
ULRICH PLATE  2 LEVEL 32MM,30186198,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
IR PLATE LAMINOPLASTY 14MM,30186199,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
IR PLATE LAMINOPLASTY 12MM,30186200,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
IR SCREW DRILLING SET 2.1X4MM,30186201,CDM,,,278,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
IR SCREW DRILLING SET 2.1X6MM,30186202,CDM,,,278,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
CURETTE 11G,30186203,CDM,,,270,RC,outpatient,,3881.48,3881.48,,3295.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,970.37,22,,percent of total billed charges,,,,,,,,,3493.33,90,,percent of total billed charges,,,3213.87,82.8,,percent of total billed charges,,,3299.26,85,,percent of total billed charges,,,,,,,,,3415.7,88,,percent of total billed charges,,,,,,,,,2965.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,970.37,22,,percent of total billed charges,,,3532.15,91,,percent of total billed charges,,,3687.41,95,,percent of total billed charges,,,3221.63,83,,percent of total billed charges,,,3221.63,83,,percent of total billed charges,,,,,,,,,,,,,,,3221.63,83,,percent of total billed charges,,,3687.41,95,,percent of total billed charges,,,3493.33,90,,percent of total billed charges,,,3493.33,90,,percent of total billed charges,,,3182.81,82,,percent of total billed charges,,,3493.33,90,,percent of total billed charges,,,3299.26,85,,percent of total billed charges,,970.37,3687.41,
GORE-TEX SOFT TISSUE PATCH OVAL 1X26X34,30186204,CDM,,,278,RC,outpatient,,22743.5,22743.5,,19309.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5685.88,22,,percent of total billed charges,,,,,,,,,20469.15,90,,percent of total billed charges,,,18831.62,82.8,,percent of total billed charges,,,19331.98,85,,percent of total billed charges,,,,,,,,,20014.28,88,,percent of total billed charges,,,,,,,,,17376.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5685.88,22,,percent of total billed charges,,,20696.59,91,,percent of total billed charges,,,21606.33,95,,percent of total billed charges,,,18877.11,83,,percent of total billed charges,,,18877.11,83,,percent of total billed charges,,,,,,,,,,,,,,,18877.11,83,,percent of total billed charges,,,21606.33,95,,percent of total billed charges,,,20469.15,90,,percent of total billed charges,,,20469.15,90,,percent of total billed charges,,,18649.67,82,,percent of total billed charges,,,20469.15,90,,percent of total billed charges,,,19331.98,85,,percent of total billed charges,,5685.88,21606.33,
MESH VENTRALIGHT ST 12X14 RECTANGLE,30186205,CDM,,,270,RC,outpatient,,11700,11700,,9933.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2925,22,,percent of total billed charges,,,,,,,,,10530,90,,percent of total billed charges,,,9687.6,82.8,,percent of total billed charges,,,9945,85,,percent of total billed charges,,,,,,,,,10296,88,,percent of total billed charges,,,,,,,,,8938.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2925,22,,percent of total billed charges,,,10647,91,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,,,,,,,,,,,,,9711,83,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9594,82,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9945,85,,percent of total billed charges,,2925,11115,
IOVERA SMART TIP 3X7,30186206,CDM,,,270,RC,outpatient,,3575,3575,,3035.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,893.75,22,,percent of total billed charges,,,,,,,,,3217.5,90,,percent of total billed charges,,,2960.1,82.8,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,,,,,,,,3146,88,,percent of total billed charges,,,,,,,,,2731.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,893.75,22,,percent of total billed charges,,,3253.25,91,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2967.25,83,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,2931.5,82,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,893.75,3396.25,
SYNTHES PLATE DF LCP 2.7/3.5MM 3 HOLE,30186207,CDM,,,278,RC,outpatient,,8060,8060,,6842.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2015,22,,percent of total billed charges,,,,,,,,,7254,90,,percent of total billed charges,,,6673.68,82.8,,percent of total billed charges,,,6851,85,,percent of total billed charges,,,,,,,,,7092.8,88,,percent of total billed charges,,,,,,,,,6157.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2015,22,,percent of total billed charges,,,7334.6,91,,percent of total billed charges,,,7657,95,,percent of total billed charges,,,6689.8,83,,percent of total billed charges,,,6689.8,83,,percent of total billed charges,,,,,,,,,,,,,,,6689.8,83,,percent of total billed charges,,,7657,95,,percent of total billed charges,,,7254,90,,percent of total billed charges,,,7254,90,,percent of total billed charges,,,6609.2,82,,percent of total billed charges,,,7254,90,,percent of total billed charges,,,6851,85,,percent of total billed charges,,2015,7657,
SYNTHES PLATE DF LCP 2.7/3.5MM 4 HOLE,30186208,CDM,,,278,RC,outpatient,,6851,6851,,5816.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1712.75,22,,percent of total billed charges,,,,,,,,,6165.9,90,,percent of total billed charges,,,5672.63,82.8,,percent of total billed charges,,,5823.35,85,,percent of total billed charges,,,,,,,,,6028.88,88,,percent of total billed charges,,,,,,,,,5234.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1712.75,22,,percent of total billed charges,,,6234.41,91,,percent of total billed charges,,,6508.45,95,,percent of total billed charges,,,5686.33,83,,percent of total billed charges,,,5686.33,83,,percent of total billed charges,,,,,,,,,,,,,,,5686.33,83,,percent of total billed charges,,,6508.45,95,,percent of total billed charges,,,6165.9,90,,percent of total billed charges,,,6165.9,90,,percent of total billed charges,,,5617.82,82,,percent of total billed charges,,,6165.9,90,,percent of total billed charges,,,5823.35,85,,percent of total billed charges,,1712.75,6508.45,
SYNTHES SCREW CORTEX TI 2.7 X 20MM,30186209,CDM,,,278,RC,outpatient,,458.15,458.15,,388.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,114.54,22,,percent of total billed charges,,,,,,,,,412.34,90,,percent of total billed charges,,,379.35,82.8,,percent of total billed charges,,,389.43,85,,percent of total billed charges,,,,,,,,,403.17,88,,percent of total billed charges,,,,,,,,,350.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,114.54,22,,percent of total billed charges,,,416.92,91,,percent of total billed charges,,,435.24,95,,percent of total billed charges,,,380.26,83,,percent of total billed charges,,,380.26,83,,percent of total billed charges,,,,,,,,,,,,,,,380.26,83,,percent of total billed charges,,,435.24,95,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,375.68,82,,percent of total billed charges,,,412.34,90,,percent of total billed charges,,,389.43,85,,percent of total billed charges,,114.54,435.24,
SYNTHES SCREW LOCKING 2.7 X 10MM,30186210,CDM,,,278,RC,outpatient,,1301.24,1301.24,,1104.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325.31,22,,percent of total billed charges,,,,,,,,,1171.12,90,,percent of total billed charges,,,1077.43,82.8,,percent of total billed charges,,,1106.05,85,,percent of total billed charges,,,,,,,,,1145.09,88,,percent of total billed charges,,,,,,,,,994.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325.31,22,,percent of total billed charges,,,1184.13,91,,percent of total billed charges,,,1236.18,95,,percent of total billed charges,,,1080.03,83,,percent of total billed charges,,,1080.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1080.03,83,,percent of total billed charges,,,1236.18,95,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1067.02,82,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1106.05,85,,percent of total billed charges,,325.31,1236.18,
SYNTHES SCREW CORTEX TI 3.5 X 18MM,30186211,CDM,,,278,RC,outpatient,,293.25,293.25,,248.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.31,22,,percent of total billed charges,,,,,,,,,263.93,90,,percent of total billed charges,,,242.81,82.8,,percent of total billed charges,,,249.26,85,,percent of total billed charges,,,,,,,,,258.06,88,,percent of total billed charges,,,,,,,,,224.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.31,22,,percent of total billed charges,,,266.86,91,,percent of total billed charges,,,278.59,95,,percent of total billed charges,,,243.4,83,,percent of total billed charges,,,243.4,83,,percent of total billed charges,,,,,,,,,,,,,,,243.4,83,,percent of total billed charges,,,278.59,95,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,240.47,82,,percent of total billed charges,,,263.93,90,,percent of total billed charges,,,249.26,85,,percent of total billed charges,,73.31,278.59,
SYNTHES SCREW LOCKING 2.7 X 12MM,30186212,CDM,,,278,RC,outpatient,,1301.24,1301.24,,1104.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325.31,22,,percent of total billed charges,,,,,,,,,1171.12,90,,percent of total billed charges,,,1077.43,82.8,,percent of total billed charges,,,1106.05,85,,percent of total billed charges,,,,,,,,,1145.09,88,,percent of total billed charges,,,,,,,,,994.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325.31,22,,percent of total billed charges,,,1184.13,91,,percent of total billed charges,,,1236.18,95,,percent of total billed charges,,,1080.03,83,,percent of total billed charges,,,1080.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1080.03,83,,percent of total billed charges,,,1236.18,95,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1067.02,82,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1106.05,85,,percent of total billed charges,,325.31,1236.18,
SYNTHES NAIL TIBIAL TI 9X360,30186213,CDM,,,278,RC,outpatient,,14552.85,14552.85,,12355.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3638.21,22,,percent of total billed charges,,,,,,,,,13097.57,90,,percent of total billed charges,,,12049.76,82.8,,percent of total billed charges,,,12369.92,85,,percent of total billed charges,,,,,,,,,12806.51,88,,percent of total billed charges,,,,,,,,,11118.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3638.21,22,,percent of total billed charges,,,13243.09,91,,percent of total billed charges,,,13825.21,95,,percent of total billed charges,,,12078.87,83,,percent of total billed charges,,,12078.87,83,,percent of total billed charges,,,,,,,,,,,,,,,12078.87,83,,percent of total billed charges,,,13825.21,95,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,11933.34,82,,percent of total billed charges,,,13097.57,90,,percent of total billed charges,,,12369.92,85,,percent of total billed charges,,3638.21,13825.21,
SYNTHES SCREW LOCKING 4.0MM X 40,30186214,CDM,,,278,RC,outpatient,,1740.83,1740.83,,1477.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,435.21,22,,percent of total billed charges,,,,,,,,,1566.75,90,,percent of total billed charges,,,1441.41,82.8,,percent of total billed charges,,,1479.71,85,,percent of total billed charges,,,,,,,,,1531.93,88,,percent of total billed charges,,,,,,,,,1329.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,435.21,22,,percent of total billed charges,,,1584.16,91,,percent of total billed charges,,,1653.79,95,,percent of total billed charges,,,1444.89,83,,percent of total billed charges,,,1444.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.89,83,,percent of total billed charges,,,1653.79,95,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1427.48,82,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1479.71,85,,percent of total billed charges,,435.21,1653.79,
SYNTHES SCREW LOCKING 4.0MM X 44,30186215,CDM,,,278,RC,outpatient,,1640.93,1640.93,,1393.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,410.23,22,,percent of total billed charges,,,,,,,,,1476.84,90,,percent of total billed charges,,,1358.69,82.8,,percent of total billed charges,,,1394.79,85,,percent of total billed charges,,,,,,,,,1444.02,88,,percent of total billed charges,,,,,,,,,1253.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,410.23,22,,percent of total billed charges,,,1493.25,91,,percent of total billed charges,,,1558.88,95,,percent of total billed charges,,,1361.97,83,,percent of total billed charges,,,1361.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1361.97,83,,percent of total billed charges,,,1558.88,95,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1345.56,82,,percent of total billed charges,,,1476.84,90,,percent of total billed charges,,,1394.79,85,,percent of total billed charges,,410.23,1558.88,
SYNTHES END CAP 0MM,30186216,CDM,,,278,RC,outpatient,,1746.75,1746.75,,1482.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,436.69,22,,percent of total billed charges,,,,,,,,,1572.08,90,,percent of total billed charges,,,1446.31,82.8,,percent of total billed charges,,,1484.74,85,,percent of total billed charges,,,,,,,,,1537.14,88,,percent of total billed charges,,,,,,,,,1334.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,436.69,22,,percent of total billed charges,,,1589.54,91,,percent of total billed charges,,,1659.41,95,,percent of total billed charges,,,1449.8,83,,percent of total billed charges,,,1449.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1449.8,83,,percent of total billed charges,,,1659.41,95,,percent of total billed charges,,,1572.08,90,,percent of total billed charges,,,1572.08,90,,percent of total billed charges,,,1432.34,82,,percent of total billed charges,,,1572.08,90,,percent of total billed charges,,,1484.74,85,,percent of total billed charges,,436.69,1659.41,
STRYKER FEMUR TRIATHLON PS SZ 7 LEFT,30186217,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
STRYKER TIBIA INSERT TRIATHLON SZ 7 11MM,30186218,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER PATELLA METAL BACK SZ 39,30186219,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
S&N RAP PAC,30186220,CDM,,,278,RC,outpatient,,1799.59,1799.59,,1527.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,449.9,22,,percent of total billed charges,,,,,,,,,1619.63,90,,percent of total billed charges,,,1490.06,82.8,,percent of total billed charges,,,1529.65,85,,percent of total billed charges,,,,,,,,,1583.64,88,,percent of total billed charges,,,,,,,,,1374.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,449.9,22,,percent of total billed charges,,,1637.63,91,,percent of total billed charges,,,1709.61,95,,percent of total billed charges,,,1493.66,83,,percent of total billed charges,,,1493.66,83,,percent of total billed charges,,,,,,,,,,,,,,,1493.66,83,,percent of total billed charges,,,1709.61,95,,percent of total billed charges,,,1619.63,90,,percent of total billed charges,,,1619.63,90,,percent of total billed charges,,,1475.66,82,,percent of total billed charges,,,1619.63,90,,percent of total billed charges,,,1529.65,85,,percent of total billed charges,,449.9,1709.61,
S&N SOFTSILK 7MM X 20MM,30186221,CDM,,,278,RC,outpatient,,1532.51,1532.51,,1301.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,383.13,22,,percent of total billed charges,,,,,,,,,1379.26,90,,percent of total billed charges,,,1268.92,82.8,,percent of total billed charges,,,1302.63,85,,percent of total billed charges,,,,,,,,,1348.61,88,,percent of total billed charges,,,,,,,,,1170.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,383.13,22,,percent of total billed charges,,,1394.58,91,,percent of total billed charges,,,1455.88,95,,percent of total billed charges,,,1271.98,83,,percent of total billed charges,,,1271.98,83,,percent of total billed charges,,,,,,,,,,,,,,,1271.98,83,,percent of total billed charges,,,1455.88,95,,percent of total billed charges,,,1379.26,90,,percent of total billed charges,,,1379.26,90,,percent of total billed charges,,,1256.66,82,,percent of total billed charges,,,1379.26,90,,percent of total billed charges,,,1302.63,85,,percent of total billed charges,,383.13,1455.88,
S&N SOFTSILK 8MM X 20MM,30186222,CDM,,,278,RC,outpatient,,1532.51,1532.51,,1301.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,383.13,22,,percent of total billed charges,,,,,,,,,1379.26,90,,percent of total billed charges,,,1268.92,82.8,,percent of total billed charges,,,1302.63,85,,percent of total billed charges,,,,,,,,,1348.61,88,,percent of total billed charges,,,,,,,,,1170.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,383.13,22,,percent of total billed charges,,,1394.58,91,,percent of total billed charges,,,1455.88,95,,percent of total billed charges,,,1271.98,83,,percent of total billed charges,,,1271.98,83,,percent of total billed charges,,,,,,,,,,,,,,,1271.98,83,,percent of total billed charges,,,1455.88,95,,percent of total billed charges,,,1379.26,90,,percent of total billed charges,,,1379.26,90,,percent of total billed charges,,,1256.66,82,,percent of total billed charges,,,1379.26,90,,percent of total billed charges,,,1302.63,85,,percent of total billed charges,,383.13,1455.88,
SPINECRAFT SCREW 7.0 X 40MM,30186223,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT ROD STRAIGHT 6.0 X 300,30186224,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
SPINECRAFT SCREW 7.5 X 35MM,30186225,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT SCREW 9.5 X 40MM,30186226,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT BOLT ILLIAC 8.5 X 90MM,30186227,CDM,,,278,RC,outpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2356.25,22,,percent of total billed charges,,,,,,,,,8482.5,90,,percent of total billed charges,,,7803.9,82.8,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2356.25,22,,percent of total billed charges,,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,2356.25,8953.75,
SPINECRAFT SCREW 9.5 X 50MM,30186228,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT ROD LORDOSED 6.0 X 120,30186229,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
SPLINT SEPTAL OVAL SHAPED SILICONE 1MM,30186230,CDM,,,270,RC,outpatient,,511,511,,433.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.75,22,,percent of total billed charges,,,,,,,,,459.9,90,,percent of total billed charges,,,423.11,82.8,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,,,,,,,,449.68,88,,percent of total billed charges,,,,,,,,,390.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.75,22,,percent of total billed charges,,,465.01,91,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,,,,,,,,,,,,,424.13,83,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,419.02,82,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,127.75,485.45,
STRYKER INSERT TRIATHLON CS SZ 8 11MM,30186231,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER PATELLA METAL BACK SZ 40,30186232,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
DEPUY-MITEK HEALIX ANCHOR 6.5 BLUE,30186233,CDM,,,278,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
SPINECRAFT SCREW 7.0 X 45MM,30186234,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ZIMMER BEARING LEFT MEDIAL MED. SZ 6,30186235,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
DEPUY SLEEVE CEMENTED 20MM,30186236,CDM,,,278,RC,outpatient,,12552.61,12552.61,,10657.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3138.15,22,,percent of total billed charges,,,,,,,,,11297.35,90,,percent of total billed charges,,,10393.56,82.8,,percent of total billed charges,,,10669.72,85,,percent of total billed charges,,,,,,,,,11046.3,88,,percent of total billed charges,,,,,,,,,9590.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3138.15,22,,percent of total billed charges,,,11422.88,91,,percent of total billed charges,,,11924.98,95,,percent of total billed charges,,,10418.67,83,,percent of total billed charges,,,10418.67,83,,percent of total billed charges,,,,,,,,,,,,,,,10418.67,83,,percent of total billed charges,,,11924.98,95,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,10293.14,82,,percent of total billed charges,,,11297.35,90,,percent of total billed charges,,,10669.72,85,,percent of total billed charges,,3138.15,11924.98,
DEPUY SLEEVE ADAPTER LPS +5MM,30186237,CDM,,,278,RC,outpatient,,6309.03,6309.03,,5356.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1577.26,22,,percent of total billed charges,,,,,,,,,5678.13,90,,percent of total billed charges,,,5223.88,82.8,,percent of total billed charges,,,5362.68,85,,percent of total billed charges,,,,,,,,,5551.95,88,,percent of total billed charges,,,,,,,,,4820.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1577.26,22,,percent of total billed charges,,,5741.22,91,,percent of total billed charges,,,5993.58,95,,percent of total billed charges,,,5236.49,83,,percent of total billed charges,,,5236.49,83,,percent of total billed charges,,,,,,,,,,,,,,,5236.49,83,,percent of total billed charges,,,5993.58,95,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5173.4,82,,percent of total billed charges,,,5678.13,90,,percent of total billed charges,,,5362.68,85,,percent of total billed charges,,1577.26,5993.58,
DEPUY INSERT XX-SMALL 14MM,30186239,CDM,,,278,RC,outpatient,,33343.12,33343.12,,28308.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8335.78,22,,percent of total billed charges,,,,,,,,,30008.81,90,,percent of total billed charges,,,27608.1,82.8,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,,,,,,,,29341.95,88,,percent of total billed charges,,,,,,,,,25474.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8335.78,22,,percent of total billed charges,,,30342.24,91,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,27674.79,83,,percent of total billed charges,,,,,,,,,,,,,,,27674.79,83,,percent of total billed charges,,,31675.96,95,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,27341.36,82,,percent of total billed charges,,,30008.81,90,,percent of total billed charges,,,28341.65,85,,percent of total billed charges,,8335.78,31675.96,
STRYKER FEMUR TRIATHLON CR SZ 8 RT,30186240,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
STRYKER TIBIA INSERT PS SZ 8-9MM,30186241,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
DEPUY INSERT TIBIAL AOX 10MM SZ 2.5,30186242,CDM,,,278,RC,outpatient,,17068.29,17068.29,,14490.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4267.07,22,,percent of total billed charges,,,,,,,,,15361.46,90,,percent of total billed charges,,,14132.54,82.8,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,,,,,,,,15020.1,88,,percent of total billed charges,,,,,,,,,13040.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4267.07,22,,percent of total billed charges,,,15532.14,91,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,,,,,,,,,,,,,14166.68,83,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,13996,82,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,4267.07,16214.88,
DEPUY-MITEK HEALIX KNOTLESS 5.5 HA,30186243,CDM,,,278,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
SYNTHES PLATE TIBIA 3.5MM 6 HOLE VA-LCP,30186244,CDM,,,278,RC,outpatient,,15273.96,15273.96,,12967.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3818.49,22,,percent of total billed charges,,,,,,,,,13746.56,90,,percent of total billed charges,,,12646.84,82.8,,percent of total billed charges,,,12982.87,85,,percent of total billed charges,,,,,,,,,13441.08,88,,percent of total billed charges,,,,,,,,,11669.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3818.49,22,,percent of total billed charges,,,13899.3,91,,percent of total billed charges,,,14510.26,95,,percent of total billed charges,,,12677.39,83,,percent of total billed charges,,,12677.39,83,,percent of total billed charges,,,,,,,,,,,,,,,12677.39,83,,percent of total billed charges,,,14510.26,95,,percent of total billed charges,,,13746.56,90,,percent of total billed charges,,,13746.56,90,,percent of total billed charges,,,12524.65,82,,percent of total billed charges,,,13746.56,90,,percent of total billed charges,,,12982.87,85,,percent of total billed charges,,3818.49,14510.26,
ARTHREX ENDOBLADE PLANTAR FASCIA RELEASE,30186247,CDM,,,270,RC,outpatient,,5817.5,5817.5,,4939.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1454.38,22,,percent of total billed charges,,,,,,,,,5235.75,90,,percent of total billed charges,,,4816.89,82.8,,percent of total billed charges,,,4944.88,85,,percent of total billed charges,,,,,,,,,5119.4,88,,percent of total billed charges,,,,,,,,,4444.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1454.38,22,,percent of total billed charges,,,5293.93,91,,percent of total billed charges,,,5526.63,95,,percent of total billed charges,,,4828.53,83,,percent of total billed charges,,,4828.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4828.53,83,,percent of total billed charges,,,5526.63,95,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,4770.35,82,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,4944.88,85,,percent of total billed charges,,1454.38,5526.63,
ZIMMER BEARING MED. RT SZ 7,30186248,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
PORT POWER INJECTABLE XCELA,30186249,CDM,,,278,RC,outpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,568.75,22,,percent of total billed charges,,,,,,,,,2047.5,90,,percent of total billed charges,,,1883.7,82.8,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,568.75,22,,percent of total billed charges,,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,568.75,2161.25,
MEDTRONIC PACEMAKER AZURE XT DR MRI SURS,30186250,CDM,,,278,RC,outpatient,,50849.11,50849.11,,43170.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12712.28,22,,percent of total billed charges,,,,,,,,,45764.2,90,,percent of total billed charges,,,42103.06,82.8,,percent of total billed charges,,,43221.74,85,,percent of total billed charges,,,,,,,,,44747.22,88,,percent of total billed charges,,,,,,,,,38848.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12712.28,22,,percent of total billed charges,,,46272.69,91,,percent of total billed charges,,,48306.65,95,,percent of total billed charges,,,42204.76,83,,percent of total billed charges,,,42204.76,83,,percent of total billed charges,,,,,,,,,,,,,,,42204.76,83,,percent of total billed charges,,,48306.65,95,,percent of total billed charges,,,45764.2,90,,percent of total billed charges,,,45764.2,90,,percent of total billed charges,,,41696.27,82,,percent of total billed charges,,,45764.2,90,,percent of total billed charges,,,43221.74,85,,percent of total billed charges,,12712.28,48306.65,
VTI INTERFUSE S INTERVERTEBRAL BODY DEVI,30186251,CDM,,,278,RC,outpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9750,22,,percent of total billed charges,,,,,,,,,35100,90,,percent of total billed charges,,,32292,82.8,,percent of total billed charges,,,33150,85,,percent of total billed charges,,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9750,22,,percent of total billed charges,,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,9750,37050,
DEPUY HEAD BIPOLAR 50,30186252,CDM,,,278,RC,outpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.27,22,,percent of total billed charges,,,,,,,,,7312.56,90,,percent of total billed charges,,,6727.56,82.8,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.27,22,,percent of total billed charges,,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,2031.27,7718.82,
SPINECRAFT REVISION SET RENTAL,30186253,CDM,,,270,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
SYNTHES SCREW CANCELLOUS 6.5 X 32 X 135,30186254,CDM,,,278,RC,outpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.39,22,,percent of total billed charges,,,,,,,,,476.6,90,,percent of total billed charges,,,438.47,82.8,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.39,22,,percent of total billed charges,,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,132.39,503.07,
SYNTHES SCREW CANCELLOUS 6.5 X 32 X 140,30186255,CDM,,,278,RC,outpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.39,22,,percent of total billed charges,,,,,,,,,476.6,90,,percent of total billed charges,,,438.47,82.8,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.39,22,,percent of total billed charges,,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,132.39,503.07,
SYNTHES SCREW CANCELLOUS 6.5 X 32 X 150,30186256,CDM,,,278,RC,outpatient,,529.55,529.55,,449.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.39,22,,percent of total billed charges,,,,,,,,,476.6,90,,percent of total billed charges,,,438.47,82.8,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,,,,,,,,466,88,,percent of total billed charges,,,,,,,,,404.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.39,22,,percent of total billed charges,,,481.89,91,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,439.53,83,,percent of total billed charges,,,,,,,,,,,,,,,439.53,83,,percent of total billed charges,,,503.07,95,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,434.23,82,,percent of total billed charges,,,476.6,90,,percent of total billed charges,,,450.12,85,,percent of total billed charges,,132.39,503.07,
DEPUY INSERT SZ 6 15MM,30186257,CDM,,,278,RC,outpatient,,17068.29,17068.29,,14490.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4267.07,22,,percent of total billed charges,,,,,,,,,15361.46,90,,percent of total billed charges,,,14132.54,82.8,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,,,,,,,,15020.1,88,,percent of total billed charges,,,,,,,,,13040.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4267.07,22,,percent of total billed charges,,,15532.14,91,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,,,,,,,,,,,,,14166.68,83,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,13996,82,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,4267.07,16214.88,
SPINECRAFT SCREW 7.5 X 55MM,30186259,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT SCREW 7.5 X 50MM,30186260,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
DEPUY-MITEK QUICKANCHOR GII PLUS,30186261,CDM,,,278,RC,outpatient,,3471,3471,,2946.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,867.75,22,,percent of total billed charges,,,,,,,,,3123.9,90,,percent of total billed charges,,,2873.99,82.8,,percent of total billed charges,,,2950.35,85,,percent of total billed charges,,,,,,,,,3054.48,88,,percent of total billed charges,,,,,,,,,2651.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,867.75,22,,percent of total billed charges,,,3158.61,91,,percent of total billed charges,,,3297.45,95,,percent of total billed charges,,,2880.93,83,,percent of total billed charges,,,2880.93,83,,percent of total billed charges,,,,,,,,,,,,,,,2880.93,83,,percent of total billed charges,,,3297.45,95,,percent of total billed charges,,,3123.9,90,,percent of total billed charges,,,3123.9,90,,percent of total billed charges,,,2846.22,82,,percent of total billed charges,,,3123.9,90,,percent of total billed charges,,,2950.35,85,,percent of total billed charges,,867.75,3297.45,
ZIMMER OXF BEARING LEFT MEDIAL SZ 6 SMAL,30186262,CDM,,,278,RC,outpatient,,6344,6344,,5386.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1586,22,,percent of total billed charges,,,,,,,,,5709.6,90,,percent of total billed charges,,,5252.83,82.8,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,,,,,,,,5582.72,88,,percent of total billed charges,,,,,,,,,4846.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1586,22,,percent of total billed charges,,,5773.04,91,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,5265.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5265.52,83,,percent of total billed charges,,,6026.8,95,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5202.08,82,,percent of total billed charges,,,5709.6,90,,percent of total billed charges,,,5392.4,85,,percent of total billed charges,,1586,6026.8,
ZIMMER INSERT PSN CPS 14MM VE,30186264,CDM,,,278,RC,outpatient,,28405,28405,,24115.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7101.25,22,,percent of total billed charges,,,,,,,,,25564.5,90,,percent of total billed charges,,,23519.34,82.8,,percent of total billed charges,,,24144.25,85,,percent of total billed charges,,,,,,,,,24996.4,88,,percent of total billed charges,,,,,,,,,21701.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7101.25,22,,percent of total billed charges,,,25848.55,91,,percent of total billed charges,,,26984.75,95,,percent of total billed charges,,,23576.15,83,,percent of total billed charges,,,23576.15,83,,percent of total billed charges,,,,,,,,,,,,,,,23576.15,83,,percent of total billed charges,,,26984.75,95,,percent of total billed charges,,,25564.5,90,,percent of total billed charges,,,25564.5,90,,percent of total billed charges,,,23292.1,82,,percent of total billed charges,,,25564.5,90,,percent of total billed charges,,,24144.25,85,,percent of total billed charges,,7101.25,26984.75,
SYNTHES PLATE DISTAL MEDIAL TIB 2.7X3.5,30186265,CDM,,,278,RC,outpatient,,15990.07,15990.07,,13575.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3997.52,22,,percent of total billed charges,,,,,,,,,14391.06,90,,percent of total billed charges,,,13239.78,82.8,,percent of total billed charges,,,13591.56,85,,percent of total billed charges,,,,,,,,,14071.26,88,,percent of total billed charges,,,,,,,,,12216.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3997.52,22,,percent of total billed charges,,,14550.96,91,,percent of total billed charges,,,15190.57,95,,percent of total billed charges,,,13271.76,83,,percent of total billed charges,,,13271.76,83,,percent of total billed charges,,,,,,,,,,,,,,,13271.76,83,,percent of total billed charges,,,15190.57,95,,percent of total billed charges,,,14391.06,90,,percent of total billed charges,,,14391.06,90,,percent of total billed charges,,,13111.86,82,,percent of total billed charges,,,14391.06,90,,percent of total billed charges,,,13591.56,85,,percent of total billed charges,,3997.52,15190.57,
SYNTHES SCREW LOCKING VA 2.7MM X 26MM,30186266,CDM,,,278,RC,outpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,353.16,22,,percent of total billed charges,,,,,,,,,1271.39,90,,percent of total billed charges,,,1169.67,82.8,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,353.16,22,,percent of total billed charges,,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,353.16,1342.02,
SYNTHES SCREW LOCKING VA 2.7MM X 30MM,30186267,CDM,,,278,RC,outpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,353.16,22,,percent of total billed charges,,,,,,,,,1271.39,90,,percent of total billed charges,,,1169.67,82.8,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,353.16,22,,percent of total billed charges,,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,353.16,1342.02,
SYNTHES SCREW CORTEX 2.7 X 40MM,30186268,CDM,,,278,RC,outpatient,,441.84,441.84,,375.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.46,22,,percent of total billed charges,,,,,,,,,397.66,90,,percent of total billed charges,,,365.84,82.8,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,,,,,,,,388.82,88,,percent of total billed charges,,,,,,,,,337.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.46,22,,percent of total billed charges,,,402.07,91,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,366.73,83,,percent of total billed charges,,,,,,,,,,,,,,,366.73,83,,percent of total billed charges,,,419.75,95,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,362.31,82,,percent of total billed charges,,,397.66,90,,percent of total billed charges,,,375.56,85,,percent of total billed charges,,110.46,419.75,
VTI INTERFUSE BODY FUSION DEVICE 12MM,30186269,CDM,,,278,RC,outpatient,,39000,39000,,33111,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9750,22,,percent of total billed charges,,,,,,,,,35100,90,,percent of total billed charges,,,32292,82.8,,percent of total billed charges,,,33150,85,,percent of total billed charges,,,,,,,,,34320,88,,percent of total billed charges,,,,,,,,,29796,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9750,22,,percent of total billed charges,,,35490,91,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,32370,83,,percent of total billed charges,,,,,,,,,,,,,,,32370,83,,percent of total billed charges,,,37050,95,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,31980,82,,percent of total billed charges,,,35100,90,,percent of total billed charges,,,33150,85,,percent of total billed charges,,9750,37050,
EXACTECH LINER CONSTRAINED 38,30186270,CDM,,,278,RC,outpatient,,13487.5,13487.5,,11450.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3371.88,22,,percent of total billed charges,,,,,,,,,12138.75,90,,percent of total billed charges,,,11167.65,82.8,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,,,,,,,,11869,88,,percent of total billed charges,,,,,,,,,10304.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3371.88,22,,percent of total billed charges,,,12273.63,91,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,,,,,,,,,,,,,11194.63,83,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11059.75,82,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,3371.88,12813.13,
IVAS ELITE FRACTURE KIT 11G 15MM,30186271,CDM,,,270,RC,outpatient,,17817.09,17817.09,,15126.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4454.27,22,,percent of total billed charges,,,,,,,,,16035.38,90,,percent of total billed charges,,,14752.55,82.8,,percent of total billed charges,,,15144.53,85,,percent of total billed charges,,,,,,,,,15679.04,88,,percent of total billed charges,,,,,,,,,13612.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4454.27,22,,percent of total billed charges,,,16213.55,91,,percent of total billed charges,,,16926.24,95,,percent of total billed charges,,,14788.18,83,,percent of total billed charges,,,14788.18,83,,percent of total billed charges,,,,,,,,,,,,,,,14788.18,83,,percent of total billed charges,,,16926.24,95,,percent of total billed charges,,,16035.38,90,,percent of total billed charges,,,16035.38,90,,percent of total billed charges,,,14610.01,82,,percent of total billed charges,,,16035.38,90,,percent of total billed charges,,,15144.53,85,,percent of total billed charges,,4454.27,16926.24,
IVAS BIOPSY 11G,30186272,CDM,,,270,RC,outpatient,,608.86,608.86,,516.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,152.22,22,,percent of total billed charges,,,,,,,,,547.97,90,,percent of total billed charges,,,504.14,82.8,,percent of total billed charges,,,517.53,85,,percent of total billed charges,,,,,,,,,535.8,88,,percent of total billed charges,,,,,,,,,465.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,152.22,22,,percent of total billed charges,,,554.06,91,,percent of total billed charges,,,578.42,95,,percent of total billed charges,,,505.35,83,,percent of total billed charges,,,505.35,83,,percent of total billed charges,,,,,,,,,,,,,,,505.35,83,,percent of total billed charges,,,578.42,95,,percent of total billed charges,,,547.97,90,,percent of total billed charges,,,547.97,90,,percent of total billed charges,,,499.27,82,,percent of total billed charges,,,547.97,90,,percent of total billed charges,,,517.53,85,,percent of total billed charges,,152.22,578.42,
ULRICH SCREW RESCUE 4.5 X 14MM,30186273,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
SPINECRAFT SCREW 6.0 X 55MM,30186274,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
GLENOSPHERE RS EXPANDED 42MM,30186275,CDM,,,270,RC,outpatient,,24102,24102,,20462.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6025.5,22,,percent of total billed charges,,,,,,,,,21691.8,90,,percent of total billed charges,,,19956.46,82.8,,percent of total billed charges,,,20486.7,85,,percent of total billed charges,,,,,,,,,21209.76,88,,percent of total billed charges,,,,,,,,,18413.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6025.5,22,,percent of total billed charges,,,21932.82,91,,percent of total billed charges,,,22896.9,95,,percent of total billed charges,,,20004.66,83,,percent of total billed charges,,,20004.66,83,,percent of total billed charges,,,,,,,,,,,,,,,20004.66,83,,percent of total billed charges,,,22896.9,95,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,19763.64,82,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,20486.7,85,,percent of total billed charges,,6025.5,22896.9,
SCREW GLENOSPHERE LOCKING,30186276,CDM,,,278,RC,outpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,502.13,22,,percent of total billed charges,,,,,,,,,1807.65,90,,percent of total billed charges,,,1663.04,82.8,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,502.13,22,,percent of total billed charges,,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,502.13,1908.08,
EXACTECH STEM 15,30186277,CDM,,,278,RC,outpatient,,34008,34008,,28872.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8502,22,,percent of total billed charges,,,,,,,,,30607.2,90,,percent of total billed charges,,,28158.62,82.8,,percent of total billed charges,,,28906.8,85,,percent of total billed charges,,,,,,,,,29927.04,88,,percent of total billed charges,,,,,,,,,25982.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8502,22,,percent of total billed charges,,,30947.28,91,,percent of total billed charges,,,32307.6,95,,percent of total billed charges,,,28226.64,83,,percent of total billed charges,,,28226.64,83,,percent of total billed charges,,,,,,,,,,,,,,,28226.64,83,,percent of total billed charges,,,32307.6,95,,percent of total billed charges,,,30607.2,90,,percent of total billed charges,,,30607.2,90,,percent of total billed charges,,,27886.56,82,,percent of total billed charges,,,30607.2,90,,percent of total billed charges,,,28906.8,85,,percent of total billed charges,,8502,32307.6,
EXACTECH LINER CONSTRAINED 42,30186278,CDM,,,278,RC,outpatient,,13487.5,13487.5,,11450.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3371.88,22,,percent of total billed charges,,,,,,,,,12138.75,90,,percent of total billed charges,,,11167.65,82.8,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,,,,,,,,11869,88,,percent of total billed charges,,,,,,,,,10304.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3371.88,22,,percent of total billed charges,,,12273.63,91,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,,,,,,,,,,,,,11194.63,83,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11059.75,82,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,3371.88,12813.13,
MEDTRONIC VISIA AF MRI VR SURESCAN,30186279,CDM,,,278,RC,outpatient,,166738,166738,,141560.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41684.5,22,,percent of total billed charges,,,,,,,,,150064.2,90,,percent of total billed charges,,,138059.06,82.8,,percent of total billed charges,,,141727.3,85,,percent of total billed charges,,,,,,,,,146729.44,88,,percent of total billed charges,,,,,,,,,127387.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41684.5,22,,percent of total billed charges,,,151731.58,91,,percent of total billed charges,,,158401.1,95,,percent of total billed charges,,,138392.54,83,,percent of total billed charges,,,138392.54,83,,percent of total billed charges,,,,,,,,,,,,,,,138392.54,83,,percent of total billed charges,,,158401.1,95,,percent of total billed charges,,,150064.2,90,,percent of total billed charges,,,150064.2,90,,percent of total billed charges,,,136725.16,82,,percent of total billed charges,,,150064.2,90,,percent of total billed charges,,,141727.3,85,,percent of total billed charges,,41684.5,158401.1,
MEDTRONIC ANTIOBIOTIC POUCH,30186280,CDM,,,278,RC,outpatient,,8417.5,8417.5,,7146.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2104.38,22,,percent of total billed charges,,,,,,,,,7575.75,90,,percent of total billed charges,,,6969.69,82.8,,percent of total billed charges,,,7154.88,85,,percent of total billed charges,,,,,,,,,7407.4,88,,percent of total billed charges,,,,,,,,,6430.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2104.38,22,,percent of total billed charges,,,7659.93,91,,percent of total billed charges,,,7996.63,95,,percent of total billed charges,,,6986.53,83,,percent of total billed charges,,,6986.53,83,,percent of total billed charges,,,,,,,,,,,,,,,6986.53,83,,percent of total billed charges,,,7996.63,95,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,6902.35,82,,percent of total billed charges,,,7575.75,90,,percent of total billed charges,,,7154.88,85,,percent of total billed charges,,2104.38,7996.63,
ABSORBA 15TACKS DEVICE ABS FIXATION,30186281,CDM,,,270,RC,outpatient,,3788.4,3788.4,,3216.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,947.1,22,,percent of total billed charges,,,,,,,,,3409.56,90,,percent of total billed charges,,,3136.8,82.8,,percent of total billed charges,,,3220.14,85,,percent of total billed charges,,,,,,,,,3333.79,88,,percent of total billed charges,,,,,,,,,2894.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,947.1,22,,percent of total billed charges,,,3447.44,91,,percent of total billed charges,,,3598.98,95,,percent of total billed charges,,,3144.37,83,,percent of total billed charges,,,3144.37,83,,percent of total billed charges,,,,,,,,,,,,,,,3144.37,83,,percent of total billed charges,,,3598.98,95,,percent of total billed charges,,,3409.56,90,,percent of total billed charges,,,3409.56,90,,percent of total billed charges,,,3106.49,82,,percent of total billed charges,,,3409.56,90,,percent of total billed charges,,,3220.14,85,,percent of total billed charges,,947.1,3598.98,
SYNTHES PLATE 4H DCP LC 2.7,30186282,CDM,,,278,RC,outpatient,,3989.25,3989.25,,3386.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,997.31,22,,percent of total billed charges,,,,,,,,,3590.33,90,,percent of total billed charges,,,3303.1,82.8,,percent of total billed charges,,,3390.86,85,,percent of total billed charges,,,,,,,,,3510.54,88,,percent of total billed charges,,,,,,,,,3047.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,997.31,22,,percent of total billed charges,,,3630.22,91,,percent of total billed charges,,,3789.79,95,,percent of total billed charges,,,3311.08,83,,percent of total billed charges,,,3311.08,83,,percent of total billed charges,,,,,,,,,,,,,,,3311.08,83,,percent of total billed charges,,,3789.79,95,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3271.19,82,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3390.86,85,,percent of total billed charges,,997.31,3789.79,
ZIMMER SHELL OSSEOTI G7 64MM H,30186283,CDM,,,278,RC,outpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4834.38,22,,percent of total billed charges,,,,,,,,,17403.75,90,,percent of total billed charges,,,16011.45,82.8,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4834.38,22,,percent of total billed charges,,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,4834.38,18370.63,
CATH SUPRAPUBIC INTRODUCER 16FR,30186284,CDM,,,270,RC,outpatient,,554.4,554.4,,470.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,138.6,22,,percent of total billed charges,,,,,,,,,498.96,90,,percent of total billed charges,,,459.04,82.8,,percent of total billed charges,,,471.24,85,,percent of total billed charges,,,,,,,,,487.87,88,,percent of total billed charges,,,,,,,,,423.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,138.6,22,,percent of total billed charges,,,504.5,91,,percent of total billed charges,,,526.68,95,,percent of total billed charges,,,460.15,83,,percent of total billed charges,,,460.15,83,,percent of total billed charges,,,,,,,,,,,,,,,460.15,83,,percent of total billed charges,,,526.68,95,,percent of total billed charges,,,498.96,90,,percent of total billed charges,,,498.96,90,,percent of total billed charges,,,454.61,82,,percent of total billed charges,,,498.96,90,,percent of total billed charges,,,471.24,85,,percent of total billed charges,,138.6,526.68,
SYNTHES DRILL BIT 2.0MM,30186285,CDM,,,270,RC,outpatient,,830.83,830.83,,705.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,207.71,22,,percent of total billed charges,,,,,,,,,747.75,90,,percent of total billed charges,,,687.93,82.8,,percent of total billed charges,,,706.21,85,,percent of total billed charges,,,,,,,,,731.13,88,,percent of total billed charges,,,,,,,,,634.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,207.71,22,,percent of total billed charges,,,756.06,91,,percent of total billed charges,,,789.29,95,,percent of total billed charges,,,689.59,83,,percent of total billed charges,,,689.59,83,,percent of total billed charges,,,,,,,,,,,,,,,689.59,83,,percent of total billed charges,,,789.29,95,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,681.28,82,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,706.21,85,,percent of total billed charges,,207.71,789.29,
SYNTHES SCREW CORTEX 9 X 2MM,30186286,CDM,,,278,RC,outpatient,,545.44,545.44,,463.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,136.36,22,,percent of total billed charges,,,,,,,,,490.9,90,,percent of total billed charges,,,451.62,82.8,,percent of total billed charges,,,463.62,85,,percent of total billed charges,,,,,,,,,479.99,88,,percent of total billed charges,,,,,,,,,416.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,136.36,22,,percent of total billed charges,,,496.35,91,,percent of total billed charges,,,518.17,95,,percent of total billed charges,,,452.72,83,,percent of total billed charges,,,452.72,83,,percent of total billed charges,,,,,,,,,,,,,,,452.72,83,,percent of total billed charges,,,518.17,95,,percent of total billed charges,,,490.9,90,,percent of total billed charges,,,490.9,90,,percent of total billed charges,,,447.26,82,,percent of total billed charges,,,490.9,90,,percent of total billed charges,,,463.62,85,,percent of total billed charges,,136.36,518.17,
SYNTHES SCREW LOCKING 2.4 X 10MM,30186287,CDM,,,278,RC,outpatient,,1635.4,1635.4,,1388.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,408.85,22,,percent of total billed charges,,,,,,,,,1471.86,90,,percent of total billed charges,,,1354.11,82.8,,percent of total billed charges,,,1390.09,85,,percent of total billed charges,,,,,,,,,1439.15,88,,percent of total billed charges,,,,,,,,,1249.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,408.85,22,,percent of total billed charges,,,1488.21,91,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,1357.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1357.38,83,,percent of total billed charges,,,1553.63,95,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1341.03,82,,percent of total billed charges,,,1471.86,90,,percent of total billed charges,,,1390.09,85,,percent of total billed charges,,408.85,1553.63,
ZIMMER LINER NEUTRAL G7 +5MM E1 36MM D,30186288,CDM,,,278,RC,outpatient,,22880,22880,,19425.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5720,22,,percent of total billed charges,,,,,,,,,20592,90,,percent of total billed charges,,,18944.64,82.8,,percent of total billed charges,,,19448,85,,percent of total billed charges,,,,,,,,,20134.4,88,,percent of total billed charges,,,,,,,,,17480.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5720,22,,percent of total billed charges,,,20820.8,91,,percent of total billed charges,,,21736,95,,percent of total billed charges,,,18990.4,83,,percent of total billed charges,,,18990.4,83,,percent of total billed charges,,,,,,,,,,,,,,,18990.4,83,,percent of total billed charges,,,21736,95,,percent of total billed charges,,,20592,90,,percent of total billed charges,,,20592,90,,percent of total billed charges,,,18761.6,82,,percent of total billed charges,,,20592,90,,percent of total billed charges,,,19448,85,,percent of total billed charges,,5720,21736,
ZIMMER LINER NEUTRAL G7 E1 36MM D,30186289,CDM,,,278,RC,outpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5785,22,,percent of total billed charges,,,,,,,,,20826,90,,percent of total billed charges,,,19159.92,82.8,,percent of total billed charges,,,19669,85,,percent of total billed charges,,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5785,22,,percent of total billed charges,,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,5785,21983,
ZIMMER SHELL OSSEOTI G7 62MM H 4 HOLE,30186290,CDM,,,278,RC,outpatient,,19337.5,19337.5,,16417.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4834.38,22,,percent of total billed charges,,,,,,,,,17403.75,90,,percent of total billed charges,,,16011.45,82.8,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,,,,,,,,17017,88,,percent of total billed charges,,,,,,,,,14773.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4834.38,22,,percent of total billed charges,,,17597.13,91,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,16050.13,83,,percent of total billed charges,,,,,,,,,,,,,,,16050.13,83,,percent of total billed charges,,,18370.63,95,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,15856.75,82,,percent of total billed charges,,,17403.75,90,,percent of total billed charges,,,16436.88,85,,percent of total billed charges,,4834.38,18370.63,
MENTOR ULTRAHIGH PROFILE BREAST IMPLANT,30186291,CDM,,,278,RC,outpatient,,6532.5,6532.5,,5546.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1633.13,22,,percent of total billed charges,,,,,,,,,5879.25,90,,percent of total billed charges,,,5408.91,82.8,,percent of total billed charges,,,5552.63,85,,percent of total billed charges,,,,,,,,,5748.6,88,,percent of total billed charges,,,,,,,,,4990.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1633.13,22,,percent of total billed charges,,,5944.58,91,,percent of total billed charges,,,6205.88,95,,percent of total billed charges,,,5421.98,83,,percent of total billed charges,,,5421.98,83,,percent of total billed charges,,,,,,,,,,,,,,,5421.98,83,,percent of total billed charges,,,6205.88,95,,percent of total billed charges,,,5879.25,90,,percent of total billed charges,,,5879.25,90,,percent of total billed charges,,,5356.65,82,,percent of total billed charges,,,5879.25,90,,percent of total billed charges,,,5552.63,85,,percent of total billed charges,,1633.13,6205.88,
DEPUY STEM PROSTALAC LT SZ 3 150MM,30186292,CDM,,,278,RC,outpatient,,32843.27,32843.27,,27883.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8210.82,22,,percent of total billed charges,,,,,,,,,29558.94,90,,percent of total billed charges,,,27194.23,82.8,,percent of total billed charges,,,27916.78,85,,percent of total billed charges,,,,,,,,,28902.08,88,,percent of total billed charges,,,,,,,,,25092.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8210.82,22,,percent of total billed charges,,,29887.38,91,,percent of total billed charges,,,31201.11,95,,percent of total billed charges,,,27259.91,83,,percent of total billed charges,,,27259.91,83,,percent of total billed charges,,,,,,,,,,,,,,,27259.91,83,,percent of total billed charges,,,31201.11,95,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,26931.48,82,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,27916.78,85,,percent of total billed charges,,8210.82,31201.11,
FORCEP RESCUE ALLIGATOR LONG GRASPING 9M,30186293,CDM,,,270,RC,outpatient,,614.18,614.18,,521.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153.55,22,,percent of total billed charges,,,,,,,,,552.76,90,,percent of total billed charges,,,508.54,82.8,,percent of total billed charges,,,522.05,85,,percent of total billed charges,,,,,,,,,540.48,88,,percent of total billed charges,,,,,,,,,469.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153.55,22,,percent of total billed charges,,,558.9,91,,percent of total billed charges,,,583.47,95,,percent of total billed charges,,,509.77,83,,percent of total billed charges,,,509.77,83,,percent of total billed charges,,,,,,,,,,,,,,,509.77,83,,percent of total billed charges,,,583.47,95,,percent of total billed charges,,,552.76,90,,percent of total billed charges,,,552.76,90,,percent of total billed charges,,,503.63,82,,percent of total billed charges,,,552.76,90,,percent of total billed charges,,,522.05,85,,percent of total billed charges,,153.55,583.47,
SYNTHES PLATE VA-LCP 4.5 18 HOLE,30186294,CDM,,,278,RC,outpatient,,21112.72,21112.72,,17924.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5278.18,22,,percent of total billed charges,,,,,,,,,19001.45,90,,percent of total billed charges,,,17481.33,82.8,,percent of total billed charges,,,17945.81,85,,percent of total billed charges,,,,,,,,,18579.19,88,,percent of total billed charges,,,,,,,,,16130.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5278.18,22,,percent of total billed charges,,,19212.58,91,,percent of total billed charges,,,20057.08,95,,percent of total billed charges,,,17523.56,83,,percent of total billed charges,,,17523.56,83,,percent of total billed charges,,,,,,,,,,,,,,,17523.56,83,,percent of total billed charges,,,20057.08,95,,percent of total billed charges,,,19001.45,90,,percent of total billed charges,,,19001.45,90,,percent of total billed charges,,,17312.43,82,,percent of total billed charges,,,19001.45,90,,percent of total billed charges,,,17945.81,85,,percent of total billed charges,,5278.18,20057.08,
SYNTHES SCREW PERIPROSTHETIC UA 5.0 X 10,30186295,CDM,,,278,RC,outpatient,,2503.93,2503.93,,2125.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,625.98,22,,percent of total billed charges,,,,,,,,,2253.54,90,,percent of total billed charges,,,2073.25,82.8,,percent of total billed charges,,,2128.34,85,,percent of total billed charges,,,,,,,,,2203.46,88,,percent of total billed charges,,,,,,,,,1913,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,625.98,22,,percent of total billed charges,,,2278.58,91,,percent of total billed charges,,,2378.73,95,,percent of total billed charges,,,2078.26,83,,percent of total billed charges,,,2078.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2078.26,83,,percent of total billed charges,,,2378.73,95,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2053.22,82,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2128.34,85,,percent of total billed charges,,625.98,2378.73,
SYNTHES SCREW PERIPROSTHETIC UA 5.0 X 12,30186296,CDM,,,278,RC,outpatient,,2503.93,2503.93,,2125.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,625.98,22,,percent of total billed charges,,,,,,,,,2253.54,90,,percent of total billed charges,,,2073.25,82.8,,percent of total billed charges,,,2128.34,85,,percent of total billed charges,,,,,,,,,2203.46,88,,percent of total billed charges,,,,,,,,,1913,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,625.98,22,,percent of total billed charges,,,2278.58,91,,percent of total billed charges,,,2378.73,95,,percent of total billed charges,,,2078.26,83,,percent of total billed charges,,,2078.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2078.26,83,,percent of total billed charges,,,2378.73,95,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2053.22,82,,percent of total billed charges,,,2253.54,90,,percent of total billed charges,,,2128.34,85,,percent of total billed charges,,625.98,2378.73,
SYNTHES SCREW LOCKING 5 X 36MM ANGLED,30186297,CDM,,,278,RC,outpatient,,1752.73,1752.73,,1488.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,438.18,22,,percent of total billed charges,,,,,,,,,1577.46,90,,percent of total billed charges,,,1451.26,82.8,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,,,,,,,,1542.4,88,,percent of total billed charges,,,,,,,,,1339.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,438.18,22,,percent of total billed charges,,,1594.98,91,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,1454.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1454.77,83,,percent of total billed charges,,,1665.09,95,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1437.24,82,,percent of total billed charges,,,1577.46,90,,percent of total billed charges,,,1489.82,85,,percent of total billed charges,,438.18,1665.09,
ZIMMER LINER NUETRAL 36MM,30186298,CDM,,,278,RC,outpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5785,22,,percent of total billed charges,,,,,,,,,20826,90,,percent of total billed charges,,,19159.92,82.8,,percent of total billed charges,,,19669,85,,percent of total billed charges,,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5785,22,,percent of total billed charges,,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,5785,21983,
OVERSTITCH SX SUTURING SYSTEM ENDOSCOPIC,30186300,CDM,,,270,RC,outpatient,,8664.5,8664.5,,7356.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2166.13,22,,percent of total billed charges,,,,,,,,,7798.05,90,,percent of total billed charges,,,7174.21,82.8,,percent of total billed charges,,,7364.83,85,,percent of total billed charges,,,,,,,,,7624.76,88,,percent of total billed charges,,,,,,,,,6619.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2166.13,22,,percent of total billed charges,,,7884.7,91,,percent of total billed charges,,,8231.28,95,,percent of total billed charges,,,7191.54,83,,percent of total billed charges,,,7191.54,83,,percent of total billed charges,,,,,,,,,,,,,,,7191.54,83,,percent of total billed charges,,,8231.28,95,,percent of total billed charges,,,7798.05,90,,percent of total billed charges,,,7798.05,90,,percent of total billed charges,,,7104.89,82,,percent of total billed charges,,,7798.05,90,,percent of total billed charges,,,7364.83,85,,percent of total billed charges,,2166.13,8231.28,
OVERSTITCH SUTURE 2-0 POLYPROPYLENE,30186301,CDM,,,270,RC,outpatient,,547.75,547.75,,465.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,136.94,22,,percent of total billed charges,,,,,,,,,492.98,90,,percent of total billed charges,,,453.54,82.8,,percent of total billed charges,,,465.59,85,,percent of total billed charges,,,,,,,,,482.02,88,,percent of total billed charges,,,,,,,,,418.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,136.94,22,,percent of total billed charges,,,498.45,91,,percent of total billed charges,,,520.36,95,,percent of total billed charges,,,454.63,83,,percent of total billed charges,,,454.63,83,,percent of total billed charges,,,,,,,,,,,,,,,454.63,83,,percent of total billed charges,,,520.36,95,,percent of total billed charges,,,492.98,90,,percent of total billed charges,,,492.98,90,,percent of total billed charges,,,449.16,82,,percent of total billed charges,,,492.98,90,,percent of total billed charges,,,465.59,85,,percent of total billed charges,,136.94,520.36,
OVERSTITCH SUTURE CINCH,30186302,CDM,,,270,RC,outpatient,,661.5,661.5,,561.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,165.38,22,,percent of total billed charges,,,,,,,,,595.35,90,,percent of total billed charges,,,547.72,82.8,,percent of total billed charges,,,562.28,85,,percent of total billed charges,,,,,,,,,582.12,88,,percent of total billed charges,,,,,,,,,505.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,165.38,22,,percent of total billed charges,,,601.97,91,,percent of total billed charges,,,628.43,95,,percent of total billed charges,,,549.05,83,,percent of total billed charges,,,549.05,83,,percent of total billed charges,,,,,,,,,,,,,,,549.05,83,,percent of total billed charges,,,628.43,95,,percent of total billed charges,,,595.35,90,,percent of total billed charges,,,595.35,90,,percent of total billed charges,,,542.43,82,,percent of total billed charges,,,595.35,90,,percent of total billed charges,,,562.28,85,,percent of total billed charges,,165.38,628.43,
ENSIZOR ENDOSCOPIC SCISSORS,30186303,CDM,,,270,RC,outpatient,,2155.83,2155.83,,1830.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,538.96,22,,percent of total billed charges,,,,,,,,,1940.25,90,,percent of total billed charges,,,1785.03,82.8,,percent of total billed charges,,,1832.46,85,,percent of total billed charges,,,,,,,,,1897.13,88,,percent of total billed charges,,,,,,,,,1647.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,538.96,22,,percent of total billed charges,,,1961.81,91,,percent of total billed charges,,,2048.04,95,,percent of total billed charges,,,1789.34,83,,percent of total billed charges,,,1789.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1789.34,83,,percent of total billed charges,,,2048.04,95,,percent of total billed charges,,,1940.25,90,,percent of total billed charges,,,1940.25,90,,percent of total billed charges,,,1767.78,82,,percent of total billed charges,,,1940.25,90,,percent of total billed charges,,,1832.46,85,,percent of total billed charges,,538.96,2048.04,
BACTISURE WOUND LAVAGE,30186304,CDM,,,270,RC,outpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1218.75,22,,percent of total billed charges,,,,,,,,,4387.5,90,,percent of total billed charges,,,4036.5,82.8,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1218.75,22,,percent of total billed charges,,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,1218.75,4631.25,
EVERCROSS 5MM X 80MM,30186305,CDM,,,270,RC,outpatient,,819,819,,695.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,204.75,22,,percent of total billed charges,,,,,,,,,737.1,90,,percent of total billed charges,,,678.13,82.8,,percent of total billed charges,,,696.15,85,,percent of total billed charges,,,,,,,,,720.72,88,,percent of total billed charges,,,,,,,,,625.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,204.75,22,,percent of total billed charges,,,745.29,91,,percent of total billed charges,,,778.05,95,,percent of total billed charges,,,679.77,83,,percent of total billed charges,,,679.77,83,,percent of total billed charges,,,,,,,,,,,,,,,679.77,83,,percent of total billed charges,,,778.05,95,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,671.58,82,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,696.15,85,,percent of total billed charges,,204.75,778.05,
CATHETER BALLOON CHOCOLATE PTA 4.0MM,30186306,CDM,,,270,RC,outpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1291.88,22,,percent of total billed charges,,,,,,,,,4650.75,90,,percent of total billed charges,,,4278.69,82.8,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1291.88,22,,percent of total billed charges,,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,1291.88,4909.13,
TERUMO GLIDEWIRE ANGLED .035/260,30186307,CDM,,,270,RC,outpatient,,532,532,,451.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,133,22,,percent of total billed charges,,,,,,,,,478.8,90,,percent of total billed charges,,,440.5,82.8,,percent of total billed charges,,,452.2,85,,percent of total billed charges,,,,,,,,,468.16,88,,percent of total billed charges,,,,,,,,,406.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,133,22,,percent of total billed charges,,,484.12,91,,percent of total billed charges,,,505.4,95,,percent of total billed charges,,,441.56,83,,percent of total billed charges,,,441.56,83,,percent of total billed charges,,,,,,,,,,,,,,,441.56,83,,percent of total billed charges,,,505.4,95,,percent of total billed charges,,,478.8,90,,percent of total billed charges,,,478.8,90,,percent of total billed charges,,,436.24,82,,percent of total billed charges,,,478.8,90,,percent of total billed charges,,,452.2,85,,percent of total billed charges,,133,505.4,
COOK FLEXOR INTRODUCER GUIDING SHEATH 6F,30186308,CDM,,,270,RC,outpatient,,383.74,383.74,,325.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,95.94,22,,percent of total billed charges,,,,,,,,,345.37,90,,percent of total billed charges,,,317.74,82.8,,percent of total billed charges,,,326.18,85,,percent of total billed charges,,,,,,,,,337.69,88,,percent of total billed charges,,,,,,,,,293.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,95.94,22,,percent of total billed charges,,,349.2,91,,percent of total billed charges,,,364.55,95,,percent of total billed charges,,,318.5,83,,percent of total billed charges,,,318.5,83,,percent of total billed charges,,,,,,,,,,,,,,,318.5,83,,percent of total billed charges,,,364.55,95,,percent of total billed charges,,,345.37,90,,percent of total billed charges,,,345.37,90,,percent of total billed charges,,,314.67,82,,percent of total billed charges,,,345.37,90,,percent of total billed charges,,,326.18,85,,percent of total billed charges,,95.94,364.55,
MERIT CARDIAC CATH PACK CUSTOM,30186309,CDM,,,270,RC,outpatient,,438.34,438.34,,372.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.59,22,,percent of total billed charges,,,,,,,,,394.51,90,,percent of total billed charges,,,362.95,82.8,,percent of total billed charges,,,372.59,85,,percent of total billed charges,,,,,,,,,385.74,88,,percent of total billed charges,,,,,,,,,334.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.59,22,,percent of total billed charges,,,398.89,91,,percent of total billed charges,,,416.42,95,,percent of total billed charges,,,363.82,83,,percent of total billed charges,,,363.82,83,,percent of total billed charges,,,,,,,,,,,,,,,363.82,83,,percent of total billed charges,,,416.42,95,,percent of total billed charges,,,394.51,90,,percent of total billed charges,,,394.51,90,,percent of total billed charges,,,359.44,82,,percent of total billed charges,,,394.51,90,,percent of total billed charges,,,372.59,85,,percent of total billed charges,,109.59,416.42,
MERIT INTRODUCER PRO SHEATH PRELUDE 6FR,30186310,CDM,,,270,RC,outpatient,,79.05,79.05,,67.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.76,22,,percent of total billed charges,,,,,,,,,71.15,90,,percent of total billed charges,,,65.45,82.8,,percent of total billed charges,,,67.19,85,,percent of total billed charges,,,,,,,,,69.56,88,,percent of total billed charges,,,,,,,,,60.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.76,22,,percent of total billed charges,,,71.94,91,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,,,,,,,,,,,,,65.61,83,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,64.82,82,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,67.19,85,,percent of total billed charges,,19.76,75.1,
DRAPE RADPAD YELLOW DADD 4X9 FENESTRATIO,30186311,CDM,,,270,RC,outpatient,,178.64,178.64,,151.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.66,22,,percent of total billed charges,,,,,,,,,160.78,90,,percent of total billed charges,,,147.91,82.8,,percent of total billed charges,,,151.84,85,,percent of total billed charges,,,,,,,,,157.2,88,,percent of total billed charges,,,,,,,,,136.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.66,22,,percent of total billed charges,,,162.56,91,,percent of total billed charges,,,169.71,95,,percent of total billed charges,,,148.27,83,,percent of total billed charges,,,148.27,83,,percent of total billed charges,,,,,,,,,,,,,,,148.27,83,,percent of total billed charges,,,169.71,95,,percent of total billed charges,,,160.78,90,,percent of total billed charges,,,160.78,90,,percent of total billed charges,,,146.48,82,,percent of total billed charges,,,160.78,90,,percent of total billed charges,,,151.84,85,,percent of total billed charges,,44.66,169.71,
ASAHI GUIDEWIRE GLADIUS PERIPHERAL,30186312,CDM,,,270,RC,outpatient,,1105,1105,,938.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,276.25,22,,percent of total billed charges,,,,,,,,,994.5,90,,percent of total billed charges,,,914.94,82.8,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,,,,,,,,972.4,88,,percent of total billed charges,,,,,,,,,844.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,276.25,22,,percent of total billed charges,,,1005.55,91,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,,,,,,,,,,,,,917.15,83,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,906.1,82,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,276.25,1049.75,
CATHETER PIG 5F 65CM SUPER TORQUE ANGIOG,30186313,CDM,,,270,RC,outpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27,22,,percent of total billed charges,,,,,,,,,97.2,90,,percent of total billed charges,,,89.42,82.8,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27,22,,percent of total billed charges,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,27,102.6,
CATHETER BER 4F 100CM TEMPO 4 ANGIOGRAPH,30186314,CDM,,,270,RC,outpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27,22,,percent of total billed charges,,,,,,,,,97.2,90,,percent of total billed charges,,,89.42,82.8,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27,22,,percent of total billed charges,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,27,102.6,
CARDIVA VASCADE CLOSURE SYSTEM 6-7FR,30186315,CDM,,,270,RC,outpatient,,1397.5,1397.5,,1186.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,349.38,22,,percent of total billed charges,,,,,,,,,1257.75,90,,percent of total billed charges,,,1157.13,82.8,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,,,,,,,,1229.8,88,,percent of total billed charges,,,,,,,,,1067.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,349.38,22,,percent of total billed charges,,,1271.73,91,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1159.93,83,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1145.95,82,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,349.38,1327.63,
ENDOFLATOR ENCORE 26MT SINGLE,30186316,CDM,,,270,RC,outpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75,22,,percent of total billed charges,,,,,,,,,270,90,,percent of total billed charges,,,248.4,82.8,,percent of total billed charges,,,255,85,,percent of total billed charges,,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75,22,,percent of total billed charges,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,75,285,
FEMSTOP DEVICE,30186317,CDM,,,270,RC,outpatient,,1643.85,1643.85,,1395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,410.96,22,,percent of total billed charges,,,,,,,,,1479.47,90,,percent of total billed charges,,,1361.11,82.8,,percent of total billed charges,,,1397.27,85,,percent of total billed charges,,,,,,,,,1446.59,88,,percent of total billed charges,,,,,,,,,1255.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,410.96,22,,percent of total billed charges,,,1495.9,91,,percent of total billed charges,,,1561.66,95,,percent of total billed charges,,,1364.4,83,,percent of total billed charges,,,1364.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1364.4,83,,percent of total billed charges,,,1561.66,95,,percent of total billed charges,,,1479.47,90,,percent of total billed charges,,,1479.47,90,,percent of total billed charges,,,1347.96,82,,percent of total billed charges,,,1479.47,90,,percent of total billed charges,,,1397.27,85,,percent of total billed charges,,410.96,1561.66,
ZIMMER INSERT CR 10MM LEFT,30186318,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ZIMMER SCREW PSN FEMALE 2.5 X 25MM,30186319,CDM,,,278,RC,outpatient,,1072.5,1072.5,,910.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,268.13,22,,percent of total billed charges,,,,,,,,,965.25,90,,percent of total billed charges,,,888.03,82.8,,percent of total billed charges,,,911.63,85,,percent of total billed charges,,,,,,,,,943.8,88,,percent of total billed charges,,,,,,,,,819.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,268.13,22,,percent of total billed charges,,,975.98,91,,percent of total billed charges,,,1018.88,95,,percent of total billed charges,,,890.18,83,,percent of total billed charges,,,890.18,83,,percent of total billed charges,,,,,,,,,,,,,,,890.18,83,,percent of total billed charges,,,1018.88,95,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,879.45,82,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,911.63,85,,percent of total billed charges,,268.13,1018.88,
ZIMMER TIBIA POROUS SZ H LEFT,30186320,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER FEMUR PSN CR SZ 11 LEFT,30186321,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
DEPUY STEM REVISION 18 HO,30186322,CDM,,,278,RC,outpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16689.95,22,,percent of total billed charges,,,,,,,,,60083.83,90,,percent of total billed charges,,,55277.12,82.8,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16689.95,22,,percent of total billed charges,,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,16689.95,63421.82,
ZIMMER LINER NUETRAL E1 G7 40MM,30186323,CDM,,,278,RC,outpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5785,22,,percent of total billed charges,,,,,,,,,20826,90,,percent of total billed charges,,,19159.92,82.8,,percent of total billed charges,,,19669,85,,percent of total billed charges,,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5785,22,,percent of total billed charges,,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,5785,21983,
ZIMMER LINER NUETRAL G7 E1 36MM,30186324,CDM,,,278,RC,outpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5785,22,,percent of total billed charges,,,,,,,,,20826,90,,percent of total billed charges,,,19159.92,82.8,,percent of total billed charges,,,19669,85,,percent of total billed charges,,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5785,22,,percent of total billed charges,,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,5785,21983,
ZIMMER LINER NUETRAL G7 E1 40MM,30186325,CDM,,,278,RC,outpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5785,22,,percent of total billed charges,,,,,,,,,20826,90,,percent of total billed charges,,,19159.92,82.8,,percent of total billed charges,,,19669,85,,percent of total billed charges,,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5785,22,,percent of total billed charges,,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,5785,21983,
SYNTHES SCREW CORTEX 4.5 X 54MM,30186326,CDM,,,278,RC,outpatient,,269.25,269.25,,228.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.31,22,,percent of total billed charges,,,,,,,,,242.33,90,,percent of total billed charges,,,222.94,82.8,,percent of total billed charges,,,228.86,85,,percent of total billed charges,,,,,,,,,236.94,88,,percent of total billed charges,,,,,,,,,205.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.31,22,,percent of total billed charges,,,245.02,91,,percent of total billed charges,,,255.79,95,,percent of total billed charges,,,223.48,83,,percent of total billed charges,,,223.48,83,,percent of total billed charges,,,,,,,,,,,,,,,223.48,83,,percent of total billed charges,,,255.79,95,,percent of total billed charges,,,242.33,90,,percent of total billed charges,,,242.33,90,,percent of total billed charges,,,220.79,82,,percent of total billed charges,,,242.33,90,,percent of total billed charges,,,228.86,85,,percent of total billed charges,,67.31,255.79,
TERUMO GLIDEWIRE ANGLED .035/180CM,30186327,CDM,,,270,RC,outpatient,,336.38,336.38,,285.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.1,22,,percent of total billed charges,,,,,,,,,302.74,90,,percent of total billed charges,,,278.52,82.8,,percent of total billed charges,,,285.92,85,,percent of total billed charges,,,,,,,,,296.01,88,,percent of total billed charges,,,,,,,,,256.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.1,22,,percent of total billed charges,,,306.11,91,,percent of total billed charges,,,319.56,95,,percent of total billed charges,,,279.2,83,,percent of total billed charges,,,279.2,83,,percent of total billed charges,,,,,,,,,,,,,,,279.2,83,,percent of total billed charges,,,319.56,95,,percent of total billed charges,,,302.74,90,,percent of total billed charges,,,302.74,90,,percent of total billed charges,,,275.83,82,,percent of total billed charges,,,302.74,90,,percent of total billed charges,,,285.92,85,,percent of total billed charges,,84.1,319.56,
ARTHREX ACL TIGHTROPE RT W/DEPLOYING SUT,30186328,CDM,,,278,RC,outpatient,,2405,2405,,2041.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,601.25,22,,percent of total billed charges,,,,,,,,,2164.5,90,,percent of total billed charges,,,1991.34,82.8,,percent of total billed charges,,,2044.25,85,,percent of total billed charges,,,,,,,,,2116.4,88,,percent of total billed charges,,,,,,,,,1837.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,601.25,22,,percent of total billed charges,,,2188.55,91,,percent of total billed charges,,,2284.75,95,,percent of total billed charges,,,1996.15,83,,percent of total billed charges,,,1996.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1996.15,83,,percent of total billed charges,,,2284.75,95,,percent of total billed charges,,,2164.5,90,,percent of total billed charges,,,2164.5,90,,percent of total billed charges,,,1972.1,82,,percent of total billed charges,,,2164.5,90,,percent of total billed charges,,,2044.25,85,,percent of total billed charges,,601.25,2284.75,
ARTHREX SCREW VENTED 10X30MM BC IF,30186329,CDM,,,278,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
ARTHREX SCREW VENTED 11X30MM BC IF,30186330,CDM,,,278,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
DEPUY INSERT AOX PS FB 10MM,30186331,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY STEM CORAIL REVISION SZ13 STD,30186332,CDM,,,278,RC,outpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16689.95,22,,percent of total billed charges,,,,,,,,,60083.83,90,,percent of total billed charges,,,55277.12,82.8,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16689.95,22,,percent of total billed charges,,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,16689.95,63421.82,
S&N LINER ACETABULAR 36MM SZ G,30186333,CDM,,,278,RC,outpatient,,32240,32240,,27371.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8060,22,,percent of total billed charges,,,,,,,,,29016,90,,percent of total billed charges,,,26694.72,82.8,,percent of total billed charges,,,27404,85,,percent of total billed charges,,,,,,,,,28371.2,88,,percent of total billed charges,,,,,,,,,24631.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8060,22,,percent of total billed charges,,,29338.4,91,,percent of total billed charges,,,30628,95,,percent of total billed charges,,,26759.2,83,,percent of total billed charges,,,26759.2,83,,percent of total billed charges,,,,,,,,,,,,,,,26759.2,83,,percent of total billed charges,,,30628,95,,percent of total billed charges,,,29016,90,,percent of total billed charges,,,29016,90,,percent of total billed charges,,,26436.8,82,,percent of total billed charges,,,29016,90,,percent of total billed charges,,,27404,85,,percent of total billed charges,,8060,30628,
DEPUY TI ROD 480MM,30186334,CDM,,,278,RC,outpatient,,6467.5,6467.5,,5490.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1616.88,22,,percent of total billed charges,,,,,,,,,5820.75,90,,percent of total billed charges,,,5355.09,82.8,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,,,,,,,,5691.4,88,,percent of total billed charges,,,,,,,,,4941.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1616.88,22,,percent of total billed charges,,,5885.43,91,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,,,,,,,,,,,,,5368.03,83,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5303.35,82,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,1616.88,6144.13,
DEPUY SCREW SET,30186335,CDM,,,278,RC,outpatient,,2460,2460,,2088.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,615,22,,percent of total billed charges,,,,,,,,,2214,90,,percent of total billed charges,,,2036.88,82.8,,percent of total billed charges,,,2091,85,,percent of total billed charges,,,,,,,,,2164.8,88,,percent of total billed charges,,,,,,,,,1879.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,615,22,,percent of total billed charges,,,2238.6,91,,percent of total billed charges,,,2337,95,,percent of total billed charges,,,2041.8,83,,percent of total billed charges,,,2041.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2041.8,83,,percent of total billed charges,,,2337,95,,percent of total billed charges,,,2214,90,,percent of total billed charges,,,2214,90,,percent of total billed charges,,,2017.2,82,,percent of total billed charges,,,2214,90,,percent of total billed charges,,,2091,85,,percent of total billed charges,,615,2337,
DEPUY CONNECTOR TOP NOTCH 5.5,30186336,CDM,,,278,RC,outpatient,,12870,12870,,10926.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3217.5,22,,percent of total billed charges,,,,,,,,,11583,90,,percent of total billed charges,,,10656.36,82.8,,percent of total billed charges,,,10939.5,85,,percent of total billed charges,,,,,,,,,11325.6,88,,percent of total billed charges,,,,,,,,,9832.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3217.5,22,,percent of total billed charges,,,11711.7,91,,percent of total billed charges,,,12226.5,95,,percent of total billed charges,,,10682.1,83,,percent of total billed charges,,,10682.1,83,,percent of total billed charges,,,,,,,,,,,,,,,10682.1,83,,percent of total billed charges,,,12226.5,95,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,10553.4,82,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,10939.5,85,,percent of total billed charges,,3217.5,12226.5,
DEPUY CONNECTOR END TO END 5.5,30186337,CDM,,,278,RC,outpatient,,12870,12870,,10926.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3217.5,22,,percent of total billed charges,,,,,,,,,11583,90,,percent of total billed charges,,,10656.36,82.8,,percent of total billed charges,,,10939.5,85,,percent of total billed charges,,,,,,,,,11325.6,88,,percent of total billed charges,,,,,,,,,9832.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3217.5,22,,percent of total billed charges,,,11711.7,91,,percent of total billed charges,,,12226.5,95,,percent of total billed charges,,,10682.1,83,,percent of total billed charges,,,10682.1,83,,percent of total billed charges,,,,,,,,,,,,,,,10682.1,83,,percent of total billed charges,,,12226.5,95,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,10553.4,82,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,10939.5,85,,percent of total billed charges,,3217.5,12226.5,
DEPUY TI ROD 120MM,30186338,CDM,,,278,RC,outpatient,,6467.5,6467.5,,5490.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1616.88,22,,percent of total billed charges,,,,,,,,,5820.75,90,,percent of total billed charges,,,5355.09,82.8,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,,,,,,,,5691.4,88,,percent of total billed charges,,,,,,,,,4941.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1616.88,22,,percent of total billed charges,,,5885.43,91,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,,,,,,,,,,,,,5368.03,83,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5303.35,82,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,1616.88,6144.13,
DEPUY CONNECTOR END TO END,30186339,CDM,,,278,RC,outpatient,,12870,12870,,10926.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3217.5,22,,percent of total billed charges,,,,,,,,,11583,90,,percent of total billed charges,,,10656.36,82.8,,percent of total billed charges,,,10939.5,85,,percent of total billed charges,,,,,,,,,11325.6,88,,percent of total billed charges,,,,,,,,,9832.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3217.5,22,,percent of total billed charges,,,11711.7,91,,percent of total billed charges,,,12226.5,95,,percent of total billed charges,,,10682.1,83,,percent of total billed charges,,,10682.1,83,,percent of total billed charges,,,,,,,,,,,,,,,10682.1,83,,percent of total billed charges,,,12226.5,95,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,10553.4,82,,percent of total billed charges,,,11583,90,,percent of total billed charges,,,10939.5,85,,percent of total billed charges,,3217.5,12226.5,
INFUSE MEDIUM BONE GRAFT KIT,30186340,CDM,,,278,RC,outpatient,,34450,34450,,29248.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8612.5,22,,percent of total billed charges,,,,,,,,,31005,90,,percent of total billed charges,,,28524.6,82.8,,percent of total billed charges,,,29282.5,85,,percent of total billed charges,,,,,,,,,30316,88,,percent of total billed charges,,,,,,,,,26319.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8612.5,22,,percent of total billed charges,,,31349.5,91,,percent of total billed charges,,,32727.5,95,,percent of total billed charges,,,28593.5,83,,percent of total billed charges,,,28593.5,83,,percent of total billed charges,,,,,,,,,,,,,,,28593.5,83,,percent of total billed charges,,,32727.5,95,,percent of total billed charges,,,31005,90,,percent of total billed charges,,,31005,90,,percent of total billed charges,,,28249,82,,percent of total billed charges,,,31005,90,,percent of total billed charges,,,29282.5,85,,percent of total billed charges,,8612.5,32727.5,
ABBOTT PACEMAKER ASSURITY MRI DR RF CELL,30186341,CDM,,,278,RC,outpatient,,33150,33150,,28144.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8287.5,22,,percent of total billed charges,,,,,,,,,29835,90,,percent of total billed charges,,,27448.2,82.8,,percent of total billed charges,,,28177.5,85,,percent of total billed charges,,,,,,,,,29172,88,,percent of total billed charges,,,,,,,,,25326.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8287.5,22,,percent of total billed charges,,,30166.5,91,,percent of total billed charges,,,31492.5,95,,percent of total billed charges,,,27514.5,83,,percent of total billed charges,,,27514.5,83,,percent of total billed charges,,,,,,,,,,,,,,,27514.5,83,,percent of total billed charges,,,31492.5,95,,percent of total billed charges,,,29835,90,,percent of total billed charges,,,29835,90,,percent of total billed charges,,,27183,82,,percent of total billed charges,,,29835,90,,percent of total billed charges,,,28177.5,85,,percent of total billed charges,,8287.5,31492.5,
ABBOTT LEAD TENDRIL STS 46CM MRI,30186342,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
ABBOTT LEAD TENDRIL STS 52CM MRI,30186343,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
ABBOTT INTRODUCER SHEATH PEELAWAY 6F,30186344,CDM,,,270,RC,outpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,148.75,22,,percent of total billed charges,,,,,,,,,535.5,90,,percent of total billed charges,,,492.66,82.8,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,148.75,22,,percent of total billed charges,,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,148.75,565.25,
DEPUY STEM CORAIL REVISION SZ11 STD,30186346,CDM,,,278,RC,outpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16689.95,22,,percent of total billed charges,,,,,,,,,60083.83,90,,percent of total billed charges,,,55277.12,82.8,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16689.95,22,,percent of total billed charges,,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,16689.95,63421.82,
ZIMMER INSERT MVA 11MM,30186347,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ZIMMER TIBIA PORUS SIZE H RIGHT,30186348,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER FEMUR PORUS CR SZ 11,30186349,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
SCREW LOCKING CAP KIT 4.5X46MM,30186350,CDM,,,278,RC,outpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,502.13,22,,percent of total billed charges,,,,,,,,,1807.65,90,,percent of total billed charges,,,1663.04,82.8,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,502.13,22,,percent of total billed charges,,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,502.13,1908.08,
DEPUY OSTEOTOME FLAT LONG,30186351,CDM,,,278,RC,outpatient,,2626,2626,,2229.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,656.5,22,,percent of total billed charges,,,,,,,,,2363.4,90,,percent of total billed charges,,,2174.33,82.8,,percent of total billed charges,,,2232.1,85,,percent of total billed charges,,,,,,,,,2310.88,88,,percent of total billed charges,,,,,,,,,2006.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,656.5,22,,percent of total billed charges,,,2389.66,91,,percent of total billed charges,,,2494.7,95,,percent of total billed charges,,,2179.58,83,,percent of total billed charges,,,2179.58,83,,percent of total billed charges,,,,,,,,,,,,,,,2179.58,83,,percent of total billed charges,,,2494.7,95,,percent of total billed charges,,,2363.4,90,,percent of total billed charges,,,2363.4,90,,percent of total billed charges,,,2153.32,82,,percent of total billed charges,,,2363.4,90,,percent of total billed charges,,,2232.1,85,,percent of total billed charges,,656.5,2494.7,
DEPUY OSTEOTOME FIN SHORT,30186352,CDM,,,278,RC,outpatient,,3256.5,3256.5,,2764.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,814.13,22,,percent of total billed charges,,,,,,,,,2930.85,90,,percent of total billed charges,,,2696.38,82.8,,percent of total billed charges,,,2768.03,85,,percent of total billed charges,,,,,,,,,2865.72,88,,percent of total billed charges,,,,,,,,,2487.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,814.13,22,,percent of total billed charges,,,2963.42,91,,percent of total billed charges,,,3093.68,95,,percent of total billed charges,,,2702.9,83,,percent of total billed charges,,,2702.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2702.9,83,,percent of total billed charges,,,3093.68,95,,percent of total billed charges,,,2930.85,90,,percent of total billed charges,,,2930.85,90,,percent of total billed charges,,,2670.33,82,,percent of total billed charges,,,2930.85,90,,percent of total billed charges,,,2768.03,85,,percent of total billed charges,,814.13,3093.68,
ZIMMER LINER NUETRAL 40MM +5 F,30186354,CDM,,,278,RC,outpatient,,24310,24310,,20639.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6077.5,22,,percent of total billed charges,,,,,,,,,21879,90,,percent of total billed charges,,,20128.68,82.8,,percent of total billed charges,,,20663.5,85,,percent of total billed charges,,,,,,,,,21392.8,88,,percent of total billed charges,,,,,,,,,18572.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6077.5,22,,percent of total billed charges,,,22122.1,91,,percent of total billed charges,,,23094.5,95,,percent of total billed charges,,,20177.3,83,,percent of total billed charges,,,20177.3,83,,percent of total billed charges,,,,,,,,,,,,,,,20177.3,83,,percent of total billed charges,,,23094.5,95,,percent of total billed charges,,,21879,90,,percent of total billed charges,,,21879,90,,percent of total billed charges,,,19934.2,82,,percent of total billed charges,,,21879,90,,percent of total billed charges,,,20663.5,85,,percent of total billed charges,,6077.5,23094.5,
ZIMMER FEMUR PSN CR SZ 7 LEFT,30186355,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER INSERT TIBIAL 10MM MC,30186356,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ZIMMER TIBIA LEFT SZ E,30186357,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
MEDTRONIC NEUROSTIMULATOR WIRELESS EXTER,30186358,CDM,,,270,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
ABBOTT LEAD VENTRICULAR 58CM,30186359,CDM,,,278,RC,outpatient,,29250,29250,,24833.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7312.5,22,,percent of total billed charges,,,,,,,,,26325,90,,percent of total billed charges,,,24219,82.8,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,,,,,,,,25740,88,,percent of total billed charges,,,,,,,,,22347,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7312.5,22,,percent of total billed charges,,,26617.5,91,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,,,,,,,,,,,,,24277.5,83,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,23985,82,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,7312.5,27787.5,
ABBOTT INTRODUCER SHEATH PEELAWAY 8F,30186360,CDM,,,270,RC,outpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,148.75,22,,percent of total billed charges,,,,,,,,,535.5,90,,percent of total billed charges,,,492.66,82.8,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,148.75,22,,percent of total billed charges,,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,148.75,565.25,
ABBOTT ICD ELLIPSE MRI DR36 DF4 CONNECTO,30186361,CDM,,,278,RC,outpatient,,94250,94250,,80018.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23562.5,22,,percent of total billed charges,,,,,,,,,84825,90,,percent of total billed charges,,,78039,82.8,,percent of total billed charges,,,80112.5,85,,percent of total billed charges,,,,,,,,,82940,88,,percent of total billed charges,,,,,,,,,72007,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23562.5,22,,percent of total billed charges,,,85767.5,91,,percent of total billed charges,,,89537.5,95,,percent of total billed charges,,,78227.5,83,,percent of total billed charges,,,78227.5,83,,percent of total billed charges,,,,,,,,,,,,,,,78227.5,83,,percent of total billed charges,,,89537.5,95,,percent of total billed charges,,,84825,90,,percent of total billed charges,,,84825,90,,percent of total billed charges,,,77285,82,,percent of total billed charges,,,84825,90,,percent of total billed charges,,,80112.5,85,,percent of total billed charges,,23562.5,89537.5,
ARTHREX NEEDLE TAPERED W/TANOLOOP,30186362,CDM,,,270,RC,outpatient,,152.16,152.16,,129.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.04,22,,percent of total billed charges,,,,,,,,,136.94,90,,percent of total billed charges,,,125.99,82.8,,percent of total billed charges,,,129.34,85,,percent of total billed charges,,,,,,,,,133.9,88,,percent of total billed charges,,,,,,,,,116.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.04,22,,percent of total billed charges,,,138.47,91,,percent of total billed charges,,,144.55,95,,percent of total billed charges,,,126.29,83,,percent of total billed charges,,,126.29,83,,percent of total billed charges,,,,,,,,,,,,,,,126.29,83,,percent of total billed charges,,,144.55,95,,percent of total billed charges,,,136.94,90,,percent of total billed charges,,,136.94,90,,percent of total billed charges,,,124.77,82,,percent of total billed charges,,,136.94,90,,percent of total billed charges,,,129.34,85,,percent of total billed charges,,38.04,144.55,
DEPUY GLOBAL UNITE REVERSE FX EPI,30186363,CDM,,,278,RC,outpatient,,40066,40066,,34016.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10016.5,22,,percent of total billed charges,,,,,,,,,36059.4,90,,percent of total billed charges,,,33174.65,82.8,,percent of total billed charges,,,34056.1,85,,percent of total billed charges,,,,,,,,,35258.08,88,,percent of total billed charges,,,,,,,,,30610.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10016.5,22,,percent of total billed charges,,,36460.06,91,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,,,,,,,,,,,,,33254.78,83,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,32854.12,82,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,34056.1,85,,percent of total billed charges,,10016.5,38062.7,
S&N BIORAPTOR 2.3PK SUTURE ANCHOR,30186364,CDM,,,270,RC,outpatient,,2207.34,2207.34,,1874.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,551.84,22,,percent of total billed charges,,,,,,,,,1986.61,90,,percent of total billed charges,,,1827.68,82.8,,percent of total billed charges,,,1876.24,85,,percent of total billed charges,,,,,,,,,1942.46,88,,percent of total billed charges,,,,,,,,,1686.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,551.84,22,,percent of total billed charges,,,2008.68,91,,percent of total billed charges,,,2096.97,95,,percent of total billed charges,,,1832.09,83,,percent of total billed charges,,,1832.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1832.09,83,,percent of total billed charges,,,2096.97,95,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1810.02,82,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1876.24,85,,percent of total billed charges,,551.84,2096.97,
EXACTECH STEM HUMERAL 11MM,30186365,CDM,,,278,RC,outpatient,,35366.5,35366.5,,30026.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8841.63,22,,percent of total billed charges,,,,,,,,,31829.85,90,,percent of total billed charges,,,29283.46,82.8,,percent of total billed charges,,,30061.53,85,,percent of total billed charges,,,,,,,,,31122.52,88,,percent of total billed charges,,,,,,,,,27020.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8841.63,22,,percent of total billed charges,,,32183.52,91,,percent of total billed charges,,,33598.18,95,,percent of total billed charges,,,29354.2,83,,percent of total billed charges,,,29354.2,83,,percent of total billed charges,,,,,,,,,,,,,,,29354.2,83,,percent of total billed charges,,,33598.18,95,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,29000.53,82,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,30061.53,85,,percent of total billed charges,,8841.63,33598.18,
EXACTECH LINER HUMERAL 42MM +0MM,30186366,CDM,,,278,RC,outpatient,,13487.5,13487.5,,11450.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3371.88,22,,percent of total billed charges,,,,,,,,,12138.75,90,,percent of total billed charges,,,11167.65,82.8,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,,,,,,,,11869,88,,percent of total billed charges,,,,,,,,,10304.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3371.88,22,,percent of total billed charges,,,12273.63,91,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,,,,,,,,,,,,,11194.63,83,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11059.75,82,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,3371.88,12813.13,
ZIMMER LINER NUETRAL G7 E1 36MM,30186367,CDM,,,278,RC,outpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5785,22,,percent of total billed charges,,,,,,,,,20826,90,,percent of total billed charges,,,19159.92,82.8,,percent of total billed charges,,,19669,85,,percent of total billed charges,,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5785,22,,percent of total billed charges,,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,5785,21983,
ZIMMER FEMUR PSN CR SZ 10 RIGHT,30186368,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER TIBIA RIGHT SZ G,30186369,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER TIBIA LEFT SZ G,30186370,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER FEMUR PSN CR SZ 10 LEFT,30186371,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER INSERT ASF 10MM,30186372,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
MEDTRONIC HAWKONE,30186373,CDM,,,270,RC,outpatient,,24292.13,24292.13,,20624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6073.03,22,,percent of total billed charges,,,,,,,,,21862.92,90,,percent of total billed charges,,,20113.88,82.8,,percent of total billed charges,,,20648.31,85,,percent of total billed charges,,,,,,,,,21377.07,88,,percent of total billed charges,,,,,,,,,18559.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6073.03,22,,percent of total billed charges,,,22105.84,91,,percent of total billed charges,,,23077.52,95,,percent of total billed charges,,,20162.47,83,,percent of total billed charges,,,20162.47,83,,percent of total billed charges,,,,,,,,,,,,,,,20162.47,83,,percent of total billed charges,,,23077.52,95,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,19919.55,82,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,20648.31,85,,percent of total billed charges,,6073.03,23077.52,
MERIT INTRODUCER PRO SHEATH PRELUDE 5FR,30186374,CDM,,,270,RC,outpatient,,79.05,79.05,,67.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.76,22,,percent of total billed charges,,,,,,,,,71.15,90,,percent of total billed charges,,,65.45,82.8,,percent of total billed charges,,,67.19,85,,percent of total billed charges,,,,,,,,,69.56,88,,percent of total billed charges,,,,,,,,,60.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.76,22,,percent of total billed charges,,,71.94,91,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,,,,,,,,,,,,,65.61,83,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,64.82,82,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,67.19,85,,percent of total billed charges,,19.76,75.1,
CSI MICROCATHETER TELEPORT 2.1F X 150CM,30186375,CDM,,,270,RC,outpatient,,4225,4225,,3587.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1056.25,22,,percent of total billed charges,,,,,,,,,3802.5,90,,percent of total billed charges,,,3498.3,82.8,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,,,,,,,,3718,88,,percent of total billed charges,,,,,,,,,3227.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1056.25,22,,percent of total billed charges,,,3844.75,91,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,,,,,,,,,,,,,3506.75,83,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3464.5,82,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,1056.25,4013.75,
DEPUY FEMUR CR  SZ 9 RIGHT,30186376,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
ZIMMER FEMUR PSN PEG SZ F LEFT,30186377,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER INSERT CR 8MM LEFT,30186378,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER INSERT CR 10MM LEFT,30186379,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
MEDTRONIC GENERATOR INTELLIS,30186380,CDM,,,270,RC,outpatient,,149175,149175,,126649.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37293.75,22,,percent of total billed charges,,,,,,,,,134257.5,90,,percent of total billed charges,,,123516.9,82.8,,percent of total billed charges,,,126798.75,85,,percent of total billed charges,,,,,,,,,131274,88,,percent of total billed charges,,,,,,,,,113969.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37293.75,22,,percent of total billed charges,,,135749.25,91,,percent of total billed charges,,,141716.25,95,,percent of total billed charges,,,123815.25,83,,percent of total billed charges,,,123815.25,83,,percent of total billed charges,,,,,,,,,,,,,,,123815.25,83,,percent of total billed charges,,,141716.25,95,,percent of total billed charges,,,134257.5,90,,percent of total billed charges,,,134257.5,90,,percent of total billed charges,,,122323.5,82,,percent of total billed charges,,,134257.5,90,,percent of total billed charges,,,126798.75,85,,percent of total billed charges,,37293.75,141716.25,
MEDTRONIC CONTROLLER,30186381,CDM,,,270,RC,outpatient,,13200,13200,,11206.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3300,22,,percent of total billed charges,,,,,,,,,11880,90,,percent of total billed charges,,,10929.6,82.8,,percent of total billed charges,,,11220,85,,percent of total billed charges,,,,,,,,,11616,88,,percent of total billed charges,,,,,,,,,10084.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3300,22,,percent of total billed charges,,,12012,91,,percent of total billed charges,,,12540,95,,percent of total billed charges,,,10956,83,,percent of total billed charges,,,10956,83,,percent of total billed charges,,,,,,,,,,,,,,,10956,83,,percent of total billed charges,,,12540,95,,percent of total billed charges,,,11880,90,,percent of total billed charges,,,11880,90,,percent of total billed charges,,,10824,82,,percent of total billed charges,,,11880,90,,percent of total billed charges,,,11220,85,,percent of total billed charges,,3300,12540,
MEDTRONIC RECHARGER,30186382,CDM,,,270,RC,outpatient,,11050,11050,,9381.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2762.5,22,,percent of total billed charges,,,,,,,,,9945,90,,percent of total billed charges,,,9149.4,82.8,,percent of total billed charges,,,9392.5,85,,percent of total billed charges,,,,,,,,,9724,88,,percent of total billed charges,,,,,,,,,8442.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2762.5,22,,percent of total billed charges,,,10055.5,91,,percent of total billed charges,,,10497.5,95,,percent of total billed charges,,,9171.5,83,,percent of total billed charges,,,9171.5,83,,percent of total billed charges,,,,,,,,,,,,,,,9171.5,83,,percent of total billed charges,,,10497.5,95,,percent of total billed charges,,,9945,90,,percent of total billed charges,,,9945,90,,percent of total billed charges,,,9061,82,,percent of total billed charges,,,9945,90,,percent of total billed charges,,,9392.5,85,,percent of total billed charges,,2762.5,10497.5,
SPINECRAFT SCREW POLY 6.5 X 45MM,30186383,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
IR SURGICAL REMOVAL TRAY RENTAL,30186384,CDM,,,270,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
IOVERA SMART TIP 1 X 90MM,30186385,CDM,,,270,RC,outpatient,,3770,3770,,3200.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,942.5,22,,percent of total billed charges,,,,,,,,,3393,90,,percent of total billed charges,,,3121.56,82.8,,percent of total billed charges,,,3204.5,85,,percent of total billed charges,,,,,,,,,3317.6,88,,percent of total billed charges,,,,,,,,,2880.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,942.5,22,,percent of total billed charges,,,3430.7,91,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,,,,,,,,,,,,,3129.1,83,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3091.4,82,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3204.5,85,,percent of total billed charges,,942.5,3581.5,
ZIMMER TIBIA PSN CEMENTED SZ G LEFT,30186386,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER FEMUR PSN SZ 12 RIGHT,30186387,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER INSERT PSN 10MM RIGHT,30186388,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
DEPUY ATTUNE FEMUR CRS 5 LEFT,30186389,CDM,,,278,RC,outpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13142.14,22,,percent of total billed charges,,,,,,,,,47311.7,90,,percent of total billed charges,,,43526.77,82.8,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13142.14,22,,percent of total billed charges,,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,13142.14,49940.13,
DEPUY INSERT ATTUNE CRS 5 X 6MM,30186390,CDM,,,278,RC,outpatient,,23578.82,23578.82,,20018.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5894.71,22,,percent of total billed charges,,,,,,,,,21220.94,90,,percent of total billed charges,,,19523.26,82.8,,percent of total billed charges,,,20042,85,,percent of total billed charges,,,,,,,,,20749.36,88,,percent of total billed charges,,,,,,,,,18014.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5894.71,22,,percent of total billed charges,,,21456.73,91,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,,,,,,,,,,,,,19570.42,83,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,19334.63,82,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,20042,85,,percent of total billed charges,,5894.71,22399.88,
DEPUY ATTUNE TIBIA RP REVISION SZ 5,30186391,CDM,,,278,RC,outpatient,,39503.36,39503.36,,33538.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9875.84,22,,percent of total billed charges,,,,,,,,,35553.02,90,,percent of total billed charges,,,32708.78,82.8,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,,,,,,,,34762.96,88,,percent of total billed charges,,,,,,,,,30180.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9875.84,22,,percent of total billed charges,,,35948.06,91,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32787.79,83,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,32392.76,82,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,9875.84,37528.19,
ZIMMER BEARING PSN ASF 11MM,30186393,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ULRICH PEEK CERVICAL 8MM 15 X 13,30186394,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
CATH THORACIC STRAIGHT 20F 20,30186395,CDM,,,270,RC,outpatient,,45.73,45.73,,38.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.43,22,,percent of total billed charges,,,,,,,,,41.16,90,,percent of total billed charges,,,37.86,82.8,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,,,,,,,,40.24,88,,percent of total billed charges,,,,,,,,,34.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.43,22,,percent of total billed charges,,,41.61,91,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,,,,,,,,,,,,,37.96,83,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,37.5,82,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,11.43,43.44,
CATH THORACIC STRAIGHT 32F 20,30186396,CDM,,,270,RC,outpatient,,45.73,45.73,,38.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.43,22,,percent of total billed charges,,,,,,,,,41.16,90,,percent of total billed charges,,,37.86,82.8,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,,,,,,,,40.24,88,,percent of total billed charges,,,,,,,,,34.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.43,22,,percent of total billed charges,,,41.61,91,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,,,,,,,,,,,,,37.96,83,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,37.5,82,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,11.43,43.44,
CATH THORACIC STRAIGHT 16F 20,30186397,CDM,,,270,RC,outpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.75,22,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,45.54,82.8,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.75,22,,percent of total billed charges,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,13.75,52.25,
CATH THORACIC STRAIGHT 28F 20,30186398,CDM,,,270,RC,outpatient,,45.73,45.73,,38.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.43,22,,percent of total billed charges,,,,,,,,,41.16,90,,percent of total billed charges,,,37.86,82.8,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,,,,,,,,40.24,88,,percent of total billed charges,,,,,,,,,34.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.43,22,,percent of total billed charges,,,41.61,91,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,,,,,,,,,,,,,37.96,83,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,37.5,82,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,11.43,43.44,
CATH THORACIC STRAIGHT 36F 20,30186399,CDM,,,270,RC,outpatient,,45.73,45.73,,38.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.43,22,,percent of total billed charges,,,,,,,,,41.16,90,,percent of total billed charges,,,37.86,82.8,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,,,,,,,,40.24,88,,percent of total billed charges,,,,,,,,,34.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.43,22,,percent of total billed charges,,,41.61,91,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,37.96,83,,percent of total billed charges,,,,,,,,,,,,,,,37.96,83,,percent of total billed charges,,,43.44,95,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,37.5,82,,percent of total billed charges,,,41.16,90,,percent of total billed charges,,,38.87,85,,percent of total billed charges,,11.43,43.44,
SYNTHES PLATE ANTERIOR CLAVICLE 3.5 5 HO,30186400,CDM,,,278,RC,outpatient,,8820.7,8820.7,,7488.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2205.18,22,,percent of total billed charges,,,,,,,,,7938.63,90,,percent of total billed charges,,,7303.54,82.8,,percent of total billed charges,,,7497.6,85,,percent of total billed charges,,,,,,,,,7762.22,88,,percent of total billed charges,,,,,,,,,6739.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2205.18,22,,percent of total billed charges,,,8026.84,91,,percent of total billed charges,,,8379.67,95,,percent of total billed charges,,,7321.18,83,,percent of total billed charges,,,7321.18,83,,percent of total billed charges,,,,,,,,,,,,,,,7321.18,83,,percent of total billed charges,,,8379.67,95,,percent of total billed charges,,,7938.63,90,,percent of total billed charges,,,7938.63,90,,percent of total billed charges,,,7232.97,82,,percent of total billed charges,,,7938.63,90,,percent of total billed charges,,,7497.6,85,,percent of total billed charges,,2205.18,8379.67,
SYNTHES PLATE ANTERIOR CLAVICLE 8H RIGHT,30186401,CDM,,,278,RC,outpatient,,9389.77,9389.77,,7971.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2347.44,22,,percent of total billed charges,,,,,,,,,8450.79,90,,percent of total billed charges,,,7774.73,82.8,,percent of total billed charges,,,7981.3,85,,percent of total billed charges,,,,,,,,,8263,88,,percent of total billed charges,,,,,,,,,7173.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2347.44,22,,percent of total billed charges,,,8544.69,91,,percent of total billed charges,,,8920.28,95,,percent of total billed charges,,,7793.51,83,,percent of total billed charges,,,7793.51,83,,percent of total billed charges,,,,,,,,,,,,,,,7793.51,83,,percent of total billed charges,,,8920.28,95,,percent of total billed charges,,,8450.79,90,,percent of total billed charges,,,8450.79,90,,percent of total billed charges,,,7699.61,82,,percent of total billed charges,,,8450.79,90,,percent of total billed charges,,,7981.3,85,,percent of total billed charges,,2347.44,8920.28,
DEPUY STEM FEMORAL CEMENTLESS SZ 15,30186404,CDM,,,278,RC,outpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16689.95,22,,percent of total billed charges,,,,,,,,,60083.83,90,,percent of total billed charges,,,55277.12,82.8,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16689.95,22,,percent of total billed charges,,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,16689.95,63421.82,
DEPUY STEM PROSTALAC 150MM,30186405,CDM,,,278,RC,outpatient,,32843.27,32843.27,,27883.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8210.82,22,,percent of total billed charges,,,,,,,,,29558.94,90,,percent of total billed charges,,,27194.23,82.8,,percent of total billed charges,,,27916.78,85,,percent of total billed charges,,,,,,,,,28902.08,88,,percent of total billed charges,,,,,,,,,25092.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8210.82,22,,percent of total billed charges,,,29887.38,91,,percent of total billed charges,,,31201.11,95,,percent of total billed charges,,,27259.91,83,,percent of total billed charges,,,27259.91,83,,percent of total billed charges,,,,,,,,,,,,,,,27259.91,83,,percent of total billed charges,,,31201.11,95,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,26931.48,82,,percent of total billed charges,,,29558.94,90,,percent of total billed charges,,,27916.78,85,,percent of total billed charges,,8210.82,31201.11,
MERIT INTRODUCER PRO SHEATH PRELUDE 4FR,30186406,CDM,,,270,RC,outpatient,,79.05,79.05,,67.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.76,22,,percent of total billed charges,,,,,,,,,71.15,90,,percent of total billed charges,,,65.45,82.8,,percent of total billed charges,,,67.19,85,,percent of total billed charges,,,,,,,,,69.56,88,,percent of total billed charges,,,,,,,,,60.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.76,22,,percent of total billed charges,,,71.94,91,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,,,,,,,,,,,,,65.61,83,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,64.82,82,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,67.19,85,,percent of total billed charges,,19.76,75.1,
MERIT INTRODUCER PRO SHEATH PRELUDE 7FR,30186407,CDM,,,270,RC,outpatient,,79.05,79.05,,67.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.76,22,,percent of total billed charges,,,,,,,,,71.15,90,,percent of total billed charges,,,65.45,82.8,,percent of total billed charges,,,67.19,85,,percent of total billed charges,,,,,,,,,69.56,88,,percent of total billed charges,,,,,,,,,60.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.76,22,,percent of total billed charges,,,71.94,91,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,,,,,,,,,,,,,65.61,83,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,64.82,82,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,67.19,85,,percent of total billed charges,,19.76,75.1,
MERIT INTRODUCER PRO SHEATH PRELUDE 8FR,30186408,CDM,,,270,RC,outpatient,,79.05,79.05,,67.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.76,22,,percent of total billed charges,,,,,,,,,71.15,90,,percent of total billed charges,,,65.45,82.8,,percent of total billed charges,,,67.19,85,,percent of total billed charges,,,,,,,,,69.56,88,,percent of total billed charges,,,,,,,,,60.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.76,22,,percent of total billed charges,,,71.94,91,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,65.61,83,,percent of total billed charges,,,,,,,,,,,,,,,65.61,83,,percent of total billed charges,,,75.1,95,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,64.82,82,,percent of total billed charges,,,71.15,90,,percent of total billed charges,,,67.19,85,,percent of total billed charges,,19.76,75.1,
TERUMO GLIDEWIRE JWIRE .035/180CM,30186409,CDM,,,270,RC,outpatient,,476,476,,404.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119,22,,percent of total billed charges,,,,,,,,,428.4,90,,percent of total billed charges,,,394.13,82.8,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,,,,,,,,418.88,88,,percent of total billed charges,,,,,,,,,363.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119,22,,percent of total billed charges,,,433.16,91,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,,,,,,,,,,,,,395.08,83,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,390.32,82,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,119,452.2,
MERIT S-MAK MINI ACCESS KIT 5FR,30186410,CDM,,,270,RC,outpatient,,270,270,,229.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.5,22,,percent of total billed charges,,,,,,,,,243,90,,percent of total billed charges,,,223.56,82.8,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,,,,,,,,237.6,88,,percent of total billed charges,,,,,,,,,206.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.5,22,,percent of total billed charges,,,245.7,91,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,,,,,,,,,,,,,224.1,83,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,243,90,,percent of total billed charges,,,243,90,,percent of total billed charges,,,221.4,82,,percent of total billed charges,,,243,90,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,67.5,256.5,
ABBOTT GUIDEWIRE COMMAND ES 0.014,30186411,CDM,,,270,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
CARDIVA VASCADE CLOSURE SYSTEM 5FR,30186412,CDM,,,270,RC,outpatient,,1397.5,1397.5,,1186.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,349.38,22,,percent of total billed charges,,,,,,,,,1257.75,90,,percent of total billed charges,,,1157.13,82.8,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,,,,,,,,1229.8,88,,percent of total billed charges,,,,,,,,,1067.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,349.38,22,,percent of total billed charges,,,1271.73,91,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1159.93,83,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1145.95,82,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,349.38,1327.63,
DRAPE RADPAD PERIPHERAL SHIELD,30186413,CDM,,,270,RC,outpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.25,22,,percent of total billed charges,,,,,,,,,202.5,90,,percent of total billed charges,,,186.3,82.8,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.25,22,,percent of total billed charges,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,56.25,213.75,
ZIMMER LINER NUETRAL G7 E1 40MM,30186414,CDM,,,278,RC,outpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5785,22,,percent of total billed charges,,,,,,,,,20826,90,,percent of total billed charges,,,19159.92,82.8,,percent of total billed charges,,,19669,85,,percent of total billed charges,,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5785,22,,percent of total billed charges,,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,5785,21983,
ZIMMER INSERT TIBIAL 10MM 4-5EF,30186415,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ZIMMER FEMUR CR LEFT SZ 5,30186416,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
TERUMO GLIDEWIRE STIFF .35/260,30186419,CDM,,,270,RC,outpatient,,598.5,598.5,,508.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149.63,22,,percent of total billed charges,,,,,,,,,538.65,90,,percent of total billed charges,,,495.56,82.8,,percent of total billed charges,,,508.73,85,,percent of total billed charges,,,,,,,,,526.68,88,,percent of total billed charges,,,,,,,,,457.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149.63,22,,percent of total billed charges,,,544.64,91,,percent of total billed charges,,,568.58,95,,percent of total billed charges,,,496.76,83,,percent of total billed charges,,,496.76,83,,percent of total billed charges,,,,,,,,,,,,,,,496.76,83,,percent of total billed charges,,,568.58,95,,percent of total billed charges,,,538.65,90,,percent of total billed charges,,,538.65,90,,percent of total billed charges,,,490.77,82,,percent of total billed charges,,,538.65,90,,percent of total billed charges,,,508.73,85,,percent of total billed charges,,149.63,568.58,
TERUMO ANGIO SEAL 6FR,30186420,CDM,,,270,RC,outpatient,,2184,2184,,1854.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,546,22,,percent of total billed charges,,,,,,,,,1965.6,90,,percent of total billed charges,,,1808.35,82.8,,percent of total billed charges,,,1856.4,85,,percent of total billed charges,,,,,,,,,1921.92,88,,percent of total billed charges,,,,,,,,,1668.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,546,22,,percent of total billed charges,,,1987.44,91,,percent of total billed charges,,,2074.8,95,,percent of total billed charges,,,1812.72,83,,percent of total billed charges,,,1812.72,83,,percent of total billed charges,,,,,,,,,,,,,,,1812.72,83,,percent of total billed charges,,,2074.8,95,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1790.88,82,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1856.4,85,,percent of total billed charges,,546,2074.8,
COOK FLEXOR INTRODUCER GUIDING SHEATH 5F,30186421,CDM,,,270,RC,outpatient,,358.61,358.61,,304.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.65,22,,percent of total billed charges,,,,,,,,,322.75,90,,percent of total billed charges,,,296.93,82.8,,percent of total billed charges,,,304.82,85,,percent of total billed charges,,,,,,,,,315.58,88,,percent of total billed charges,,,,,,,,,273.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.65,22,,percent of total billed charges,,,326.34,91,,percent of total billed charges,,,340.68,95,,percent of total billed charges,,,297.65,83,,percent of total billed charges,,,297.65,83,,percent of total billed charges,,,,,,,,,,,,,,,297.65,83,,percent of total billed charges,,,340.68,95,,percent of total billed charges,,,322.75,90,,percent of total billed charges,,,322.75,90,,percent of total billed charges,,,294.06,82,,percent of total billed charges,,,322.75,90,,percent of total billed charges,,,304.82,85,,percent of total billed charges,,89.65,340.68,
COOK FLEXOR INTRODUCER SHEATH 6F 90CM,30186422,CDM,,,270,RC,outpatient,,721.63,721.63,,612.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.41,22,,percent of total billed charges,,,,,,,,,649.47,90,,percent of total billed charges,,,597.51,82.8,,percent of total billed charges,,,613.39,85,,percent of total billed charges,,,,,,,,,635.03,88,,percent of total billed charges,,,,,,,,,551.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.41,22,,percent of total billed charges,,,656.68,91,,percent of total billed charges,,,685.55,95,,percent of total billed charges,,,598.95,83,,percent of total billed charges,,,598.95,83,,percent of total billed charges,,,,,,,,,,,,,,,598.95,83,,percent of total billed charges,,,685.55,95,,percent of total billed charges,,,649.47,90,,percent of total billed charges,,,649.47,90,,percent of total billed charges,,,591.74,82,,percent of total billed charges,,,649.47,90,,percent of total billed charges,,,613.39,85,,percent of total billed charges,,180.41,685.55,
MERIT NEEDLE ANGIOGRAPHIC 18G X 7CM,30186423,CDM,,,270,RC,outpatient,,19.26,19.26,,16.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.82,22,,percent of total billed charges,,,,,,,,,17.33,90,,percent of total billed charges,,,15.95,82.8,,percent of total billed charges,,,16.37,85,,percent of total billed charges,,,,,,,,,16.95,88,,percent of total billed charges,,,,,,,,,14.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.82,22,,percent of total billed charges,,,17.53,91,,percent of total billed charges,,,18.3,95,,percent of total billed charges,,,15.99,83,,percent of total billed charges,,,15.99,83,,percent of total billed charges,,,,,,,,,,,,,,,15.99,83,,percent of total billed charges,,,18.3,95,,percent of total billed charges,,,17.33,90,,percent of total billed charges,,,17.33,90,,percent of total billed charges,,,15.79,82,,percent of total billed charges,,,17.33,90,,percent of total billed charges,,,16.37,85,,percent of total billed charges,,4.82,18.3,
MERIT CATH RIM 5FR X 65CM,30186424,CDM,,,270,RC,outpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50,22,,percent of total billed charges,,,,,,,,,180,90,,percent of total billed charges,,,165.6,82.8,,percent of total billed charges,,,170,85,,percent of total billed charges,,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50,22,,percent of total billed charges,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,50,190,
MERIT CATH LEGATO 4FR,30186425,CDM,,,270,RC,outpatient,,292.5,292.5,,248.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.13,22,,percent of total billed charges,,,,,,,,,263.25,90,,percent of total billed charges,,,242.19,82.8,,percent of total billed charges,,,248.63,85,,percent of total billed charges,,,,,,,,,257.4,88,,percent of total billed charges,,,,,,,,,223.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.13,22,,percent of total billed charges,,,266.18,91,,percent of total billed charges,,,277.88,95,,percent of total billed charges,,,242.78,83,,percent of total billed charges,,,242.78,83,,percent of total billed charges,,,,,,,,,,,,,,,242.78,83,,percent of total billed charges,,,277.88,95,,percent of total billed charges,,,263.25,90,,percent of total billed charges,,,263.25,90,,percent of total billed charges,,,239.85,82,,percent of total billed charges,,,263.25,90,,percent of total billed charges,,,248.63,85,,percent of total billed charges,,73.13,277.88,
FEMORAL INTRODUCER KIT 11FR,30186426,CDM,,,270,RC,outpatient,,159.04,159.04,,135.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.76,22,,percent of total billed charges,,,,,,,,,143.14,90,,percent of total billed charges,,,131.69,82.8,,percent of total billed charges,,,135.18,85,,percent of total billed charges,,,,,,,,,139.96,88,,percent of total billed charges,,,,,,,,,121.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.76,22,,percent of total billed charges,,,144.73,91,,percent of total billed charges,,,151.09,95,,percent of total billed charges,,,132,83,,percent of total billed charges,,,132,83,,percent of total billed charges,,,,,,,,,,,,,,,132,83,,percent of total billed charges,,,151.09,95,,percent of total billed charges,,,143.14,90,,percent of total billed charges,,,143.14,90,,percent of total billed charges,,,130.41,82,,percent of total billed charges,,,143.14,90,,percent of total billed charges,,,135.18,85,,percent of total billed charges,,39.76,151.09,
SOFT-VU SOS OMNI 5FR,30186427,CDM,,,270,RC,outpatient,,1118,1118,,949.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,279.5,22,,percent of total billed charges,,,,,,,,,1006.2,90,,percent of total billed charges,,,925.7,82.8,,percent of total billed charges,,,950.3,85,,percent of total billed charges,,,,,,,,,983.84,88,,percent of total billed charges,,,,,,,,,854.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,279.5,22,,percent of total billed charges,,,1017.38,91,,percent of total billed charges,,,1062.1,95,,percent of total billed charges,,,927.94,83,,percent of total billed charges,,,927.94,83,,percent of total billed charges,,,,,,,,,,,,,,,927.94,83,,percent of total billed charges,,,1062.1,95,,percent of total billed charges,,,1006.2,90,,percent of total billed charges,,,1006.2,90,,percent of total billed charges,,,916.76,82,,percent of total billed charges,,,1006.2,90,,percent of total billed charges,,,950.3,85,,percent of total billed charges,,279.5,1062.1,
AMPLATZ SUPER STIFF 75CM,30186428,CDM,,,270,RC,outpatient,,202.5,202.5,,171.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.63,22,,percent of total billed charges,,,,,,,,,182.25,90,,percent of total billed charges,,,167.67,82.8,,percent of total billed charges,,,172.13,85,,percent of total billed charges,,,,,,,,,178.2,88,,percent of total billed charges,,,,,,,,,154.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.63,22,,percent of total billed charges,,,184.28,91,,percent of total billed charges,,,192.38,95,,percent of total billed charges,,,168.08,83,,percent of total billed charges,,,168.08,83,,percent of total billed charges,,,,,,,,,,,,,,,168.08,83,,percent of total billed charges,,,192.38,95,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,166.05,82,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,172.13,85,,percent of total billed charges,,50.63,192.38,
AMPLATZ SUPER STIFF 145CM,30186429,CDM,,,270,RC,outpatient,,202.5,202.5,,171.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.63,22,,percent of total billed charges,,,,,,,,,182.25,90,,percent of total billed charges,,,167.67,82.8,,percent of total billed charges,,,172.13,85,,percent of total billed charges,,,,,,,,,178.2,88,,percent of total billed charges,,,,,,,,,154.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.63,22,,percent of total billed charges,,,184.28,91,,percent of total billed charges,,,192.38,95,,percent of total billed charges,,,168.08,83,,percent of total billed charges,,,168.08,83,,percent of total billed charges,,,,,,,,,,,,,,,168.08,83,,percent of total billed charges,,,192.38,95,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,166.05,82,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,172.13,85,,percent of total billed charges,,50.63,192.38,
VESSEL LOOP DEVON YELLOW,30186437,CDM,,,270,RC,outpatient,,10.17,10.17,,8.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.54,22,,percent of total billed charges,,,,,,,,,9.15,90,,percent of total billed charges,,,8.42,82.8,,percent of total billed charges,,,8.64,85,,percent of total billed charges,,,,,,,,,8.95,88,,percent of total billed charges,,,,,,,,,7.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.54,22,,percent of total billed charges,,,9.25,91,,percent of total billed charges,,,9.66,95,,percent of total billed charges,,,8.44,83,,percent of total billed charges,,,8.44,83,,percent of total billed charges,,,,,,,,,,,,,,,8.44,83,,percent of total billed charges,,,9.66,95,,percent of total billed charges,,,9.15,90,,percent of total billed charges,,,9.15,90,,percent of total billed charges,,,8.34,82,,percent of total billed charges,,,9.15,90,,percent of total billed charges,,,8.64,85,,percent of total billed charges,,2.54,9.66,
TIP CANNULA BEVELLED VEIN IRRIG.,30186441,CDM,,,270,RC,outpatient,,191.54,191.54,,162.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.89,22,,percent of total billed charges,,,,,,,,,172.39,90,,percent of total billed charges,,,158.6,82.8,,percent of total billed charges,,,162.81,85,,percent of total billed charges,,,,,,,,,168.56,88,,percent of total billed charges,,,,,,,,,146.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.89,22,,percent of total billed charges,,,174.3,91,,percent of total billed charges,,,181.96,95,,percent of total billed charges,,,158.98,83,,percent of total billed charges,,,158.98,83,,percent of total billed charges,,,,,,,,,,,,,,,158.98,83,,percent of total billed charges,,,181.96,95,,percent of total billed charges,,,172.39,90,,percent of total billed charges,,,172.39,90,,percent of total billed charges,,,157.06,82,,percent of total billed charges,,,172.39,90,,percent of total billed charges,,,162.81,85,,percent of total billed charges,,47.89,181.96,
SOFTJAW INSERT SET 33MM,30186442,CDM,,,270,RC,outpatient,,351.15,351.15,,298.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.79,22,,percent of total billed charges,,,,,,,,,316.04,90,,percent of total billed charges,,,290.75,82.8,,percent of total billed charges,,,298.48,85,,percent of total billed charges,,,,,,,,,309.01,88,,percent of total billed charges,,,,,,,,,268.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.79,22,,percent of total billed charges,,,319.55,91,,percent of total billed charges,,,333.59,95,,percent of total billed charges,,,291.45,83,,percent of total billed charges,,,291.45,83,,percent of total billed charges,,,,,,,,,,,,,,,291.45,83,,percent of total billed charges,,,333.59,95,,percent of total billed charges,,,316.04,90,,percent of total billed charges,,,316.04,90,,percent of total billed charges,,,287.94,82,,percent of total billed charges,,,316.04,90,,percent of total billed charges,,,298.48,85,,percent of total billed charges,,87.79,333.59,
STEALTH CLAMP INSERT 60MM,30186443,CDM,,,270,RC,outpatient,,152.8,152.8,,129.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.2,22,,percent of total billed charges,,,,,,,,,137.52,90,,percent of total billed charges,,,126.52,82.8,,percent of total billed charges,,,129.88,85,,percent of total billed charges,,,,,,,,,134.46,88,,percent of total billed charges,,,,,,,,,116.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.2,22,,percent of total billed charges,,,139.05,91,,percent of total billed charges,,,145.16,95,,percent of total billed charges,,,126.82,83,,percent of total billed charges,,,126.82,83,,percent of total billed charges,,,,,,,,,,,,,,,126.82,83,,percent of total billed charges,,,145.16,95,,percent of total billed charges,,,137.52,90,,percent of total billed charges,,,137.52,90,,percent of total billed charges,,,125.3,82,,percent of total billed charges,,,137.52,90,,percent of total billed charges,,,129.88,85,,percent of total billed charges,,38.2,145.16,
VESSEL LOOP MAXI RED 1X406MM,30186444,CDM,,,270,RC,outpatient,,15.75,15.75,,13.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.94,22,,percent of total billed charges,,,,,,,,,14.18,90,,percent of total billed charges,,,13.04,82.8,,percent of total billed charges,,,13.39,85,,percent of total billed charges,,,,,,,,,13.86,88,,percent of total billed charges,,,,,,,,,12.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.94,22,,percent of total billed charges,,,14.33,91,,percent of total billed charges,,,14.96,95,,percent of total billed charges,,,13.07,83,,percent of total billed charges,,,13.07,83,,percent of total billed charges,,,,,,,,,,,,,,,13.07,83,,percent of total billed charges,,,14.96,95,,percent of total billed charges,,,14.18,90,,percent of total billed charges,,,14.18,90,,percent of total billed charges,,,12.92,82,,percent of total billed charges,,,14.18,90,,percent of total billed charges,,,13.39,85,,percent of total billed charges,,3.94,14.96,
CLIPS LIGATING TITANIUM YELLOW SMALL,30186446,CDM,,,270,RC,outpatient,,103.33,103.33,,87.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.83,22,,percent of total billed charges,,,,,,,,,93,90,,percent of total billed charges,,,85.56,82.8,,percent of total billed charges,,,87.83,85,,percent of total billed charges,,,,,,,,,90.93,88,,percent of total billed charges,,,,,,,,,78.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.83,22,,percent of total billed charges,,,94.03,91,,percent of total billed charges,,,98.16,95,,percent of total billed charges,,,85.76,83,,percent of total billed charges,,,85.76,83,,percent of total billed charges,,,,,,,,,,,,,,,85.76,83,,percent of total billed charges,,,98.16,95,,percent of total billed charges,,,93,90,,percent of total billed charges,,,93,90,,percent of total billed charges,,,84.73,82,,percent of total billed charges,,,93,90,,percent of total billed charges,,,87.83,85,,percent of total billed charges,,25.83,98.16,
CLIPS LIGATING TITANIUM MEDIUM,30186447,CDM,,,270,RC,outpatient,,25.34,25.34,,21.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.34,22,,percent of total billed charges,,,,,,,,,22.81,90,,percent of total billed charges,,,20.98,82.8,,percent of total billed charges,,,21.54,85,,percent of total billed charges,,,,,,,,,22.3,88,,percent of total billed charges,,,,,,,,,19.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.34,22,,percent of total billed charges,,,23.06,91,,percent of total billed charges,,,24.07,95,,percent of total billed charges,,,21.03,83,,percent of total billed charges,,,21.03,83,,percent of total billed charges,,,,,,,,,,,,,,,21.03,83,,percent of total billed charges,,,24.07,95,,percent of total billed charges,,,22.81,90,,percent of total billed charges,,,22.81,90,,percent of total billed charges,,,20.78,82,,percent of total billed charges,,,22.81,90,,percent of total billed charges,,,21.54,85,,percent of total billed charges,,6.34,24.07,
CLIPS LIGATING TITANIUM LARGE,30186448,CDM,,,270,RC,outpatient,,123.04,123.04,,104.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.76,22,,percent of total billed charges,,,,,,,,,110.74,90,,percent of total billed charges,,,101.88,82.8,,percent of total billed charges,,,104.58,85,,percent of total billed charges,,,,,,,,,108.28,88,,percent of total billed charges,,,,,,,,,94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.76,22,,percent of total billed charges,,,111.97,91,,percent of total billed charges,,,116.89,95,,percent of total billed charges,,,102.12,83,,percent of total billed charges,,,102.12,83,,percent of total billed charges,,,,,,,,,,,,,,,102.12,83,,percent of total billed charges,,,116.89,95,,percent of total billed charges,,,110.74,90,,percent of total billed charges,,,110.74,90,,percent of total billed charges,,,100.89,82,,percent of total billed charges,,,110.74,90,,percent of total billed charges,,,104.58,85,,percent of total billed charges,,30.76,116.89,
CATH ARTERIAL EMBOLECTOMY 5FR,30186449,CDM,,,270,RC,outpatient,,1245.4,1245.4,,1057.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,311.35,22,,percent of total billed charges,,,,,,,,,1120.86,90,,percent of total billed charges,,,1031.19,82.8,,percent of total billed charges,,,1058.59,85,,percent of total billed charges,,,,,,,,,1095.95,88,,percent of total billed charges,,,,,,,,,951.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,311.35,22,,percent of total billed charges,,,1133.31,91,,percent of total billed charges,,,1183.13,95,,percent of total billed charges,,,1033.68,83,,percent of total billed charges,,,1033.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.68,83,,percent of total billed charges,,,1183.13,95,,percent of total billed charges,,,1120.86,90,,percent of total billed charges,,,1120.86,90,,percent of total billed charges,,,1021.23,82,,percent of total billed charges,,,1120.86,90,,percent of total billed charges,,,1058.59,85,,percent of total billed charges,,311.35,1183.13,
SHUNT KIT CAROTID ARTERY,30186450,CDM,,,270,RC,outpatient,,197.48,197.48,,167.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.37,22,,percent of total billed charges,,,,,,,,,177.73,90,,percent of total billed charges,,,163.51,82.8,,percent of total billed charges,,,167.86,85,,percent of total billed charges,,,,,,,,,173.78,88,,percent of total billed charges,,,,,,,,,150.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.37,22,,percent of total billed charges,,,179.71,91,,percent of total billed charges,,,187.61,95,,percent of total billed charges,,,163.91,83,,percent of total billed charges,,,163.91,83,,percent of total billed charges,,,,,,,,,,,,,,,163.91,83,,percent of total billed charges,,,187.61,95,,percent of total billed charges,,,177.73,90,,percent of total billed charges,,,177.73,90,,percent of total billed charges,,,161.93,82,,percent of total billed charges,,,177.73,90,,percent of total billed charges,,,167.86,85,,percent of total billed charges,,49.37,187.61,
CATH EMBOLECTOMY FOGARTY 60CM 2FR,30186451,CDM,,,270,RC,outpatient,,2577.77,2577.77,,2188.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,644.44,22,,percent of total billed charges,,,,,,,,,2319.99,90,,percent of total billed charges,,,2134.39,82.8,,percent of total billed charges,,,2191.1,85,,percent of total billed charges,,,,,,,,,2268.44,88,,percent of total billed charges,,,,,,,,,1969.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,644.44,22,,percent of total billed charges,,,2345.77,91,,percent of total billed charges,,,2448.88,95,,percent of total billed charges,,,2139.55,83,,percent of total billed charges,,,2139.55,83,,percent of total billed charges,,,,,,,,,,,,,,,2139.55,83,,percent of total billed charges,,,2448.88,95,,percent of total billed charges,,,2319.99,90,,percent of total billed charges,,,2319.99,90,,percent of total billed charges,,,2113.77,82,,percent of total billed charges,,,2319.99,90,,percent of total billed charges,,,2191.1,85,,percent of total billed charges,,644.44,2448.88,
CATH EMBOLECTOMY FOGARTY 80CM 3FR,30186452,CDM,,,270,RC,outpatient,,1245.53,1245.53,,1057.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,311.38,22,,percent of total billed charges,,,,,,,,,1120.98,90,,percent of total billed charges,,,1031.3,82.8,,percent of total billed charges,,,1058.7,85,,percent of total billed charges,,,,,,,,,1096.07,88,,percent of total billed charges,,,,,,,,,951.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,311.38,22,,percent of total billed charges,,,1133.43,91,,percent of total billed charges,,,1183.25,95,,percent of total billed charges,,,1033.79,83,,percent of total billed charges,,,1033.79,83,,percent of total billed charges,,,,,,,,,,,,,,,1033.79,83,,percent of total billed charges,,,1183.25,95,,percent of total billed charges,,,1120.98,90,,percent of total billed charges,,,1120.98,90,,percent of total billed charges,,,1021.33,82,,percent of total billed charges,,,1120.98,90,,percent of total billed charges,,,1058.7,85,,percent of total billed charges,,311.38,1183.25,
CATH IRRIGATION FOGARTY 4FR,30186453,CDM,,,270,RC,outpatient,,320.63,320.63,,272.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.16,22,,percent of total billed charges,,,,,,,,,288.57,90,,percent of total billed charges,,,265.48,82.8,,percent of total billed charges,,,272.54,85,,percent of total billed charges,,,,,,,,,282.15,88,,percent of total billed charges,,,,,,,,,244.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.16,22,,percent of total billed charges,,,291.77,91,,percent of total billed charges,,,304.6,95,,percent of total billed charges,,,266.12,83,,percent of total billed charges,,,266.12,83,,percent of total billed charges,,,,,,,,,,,,,,,266.12,83,,percent of total billed charges,,,304.6,95,,percent of total billed charges,,,288.57,90,,percent of total billed charges,,,288.57,90,,percent of total billed charges,,,262.92,82,,percent of total billed charges,,,288.57,90,,percent of total billed charges,,,272.54,85,,percent of total billed charges,,80.16,304.6,
CATH IRRIGATION FOGARTY 6FR,30186454,CDM,,,270,RC,outpatient,,383.39,383.39,,325.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,95.85,22,,percent of total billed charges,,,,,,,,,345.05,90,,percent of total billed charges,,,317.45,82.8,,percent of total billed charges,,,325.88,85,,percent of total billed charges,,,,,,,,,337.38,88,,percent of total billed charges,,,,,,,,,292.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,95.85,22,,percent of total billed charges,,,348.88,91,,percent of total billed charges,,,364.22,95,,percent of total billed charges,,,318.21,83,,percent of total billed charges,,,318.21,83,,percent of total billed charges,,,,,,,,,,,,,,,318.21,83,,percent of total billed charges,,,364.22,95,,percent of total billed charges,,,345.05,90,,percent of total billed charges,,,345.05,90,,percent of total billed charges,,,314.38,82,,percent of total billed charges,,,345.05,90,,percent of total billed charges,,,325.88,85,,percent of total billed charges,,95.85,364.22,
SYNTHES PLATE PHALANGEAL BASE 1.3 TI,30186455,CDM,,,278,RC,outpatient,,4922.52,4922.52,,4179.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1230.63,22,,percent of total billed charges,,,,,,,,,4430.27,90,,percent of total billed charges,,,4075.85,82.8,,percent of total billed charges,,,4184.14,85,,percent of total billed charges,,,,,,,,,4331.82,88,,percent of total billed charges,,,,,,,,,3760.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1230.63,22,,percent of total billed charges,,,4479.49,91,,percent of total billed charges,,,4676.39,95,,percent of total billed charges,,,4085.69,83,,percent of total billed charges,,,4085.69,83,,percent of total billed charges,,,,,,,,,,,,,,,4085.69,83,,percent of total billed charges,,,4676.39,95,,percent of total billed charges,,,4430.27,90,,percent of total billed charges,,,4430.27,90,,percent of total billed charges,,,4036.47,82,,percent of total billed charges,,,4430.27,90,,percent of total billed charges,,,4184.14,85,,percent of total billed charges,,1230.63,4676.39,
SYNTHES SCREW CORTEX 10MM,30186456,CDM,,,278,RC,outpatient,,471.87,471.87,,400.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.97,22,,percent of total billed charges,,,,,,,,,424.68,90,,percent of total billed charges,,,390.71,82.8,,percent of total billed charges,,,401.09,85,,percent of total billed charges,,,,,,,,,415.25,88,,percent of total billed charges,,,,,,,,,360.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.97,22,,percent of total billed charges,,,429.4,91,,percent of total billed charges,,,448.28,95,,percent of total billed charges,,,391.65,83,,percent of total billed charges,,,391.65,83,,percent of total billed charges,,,,,,,,,,,,,,,391.65,83,,percent of total billed charges,,,448.28,95,,percent of total billed charges,,,424.68,90,,percent of total billed charges,,,424.68,90,,percent of total billed charges,,,386.93,82,,percent of total billed charges,,,424.68,90,,percent of total billed charges,,,401.09,85,,percent of total billed charges,,117.97,448.28,
SYNTHES SCREW LOCKING 9MM,30186457,CDM,,,278,RC,outpatient,,1155.25,1155.25,,980.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,288.81,22,,percent of total billed charges,,,,,,,,,1039.73,90,,percent of total billed charges,,,956.55,82.8,,percent of total billed charges,,,981.96,85,,percent of total billed charges,,,,,,,,,1016.62,88,,percent of total billed charges,,,,,,,,,882.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,288.81,22,,percent of total billed charges,,,1051.28,91,,percent of total billed charges,,,1097.49,95,,percent of total billed charges,,,958.86,83,,percent of total billed charges,,,958.86,83,,percent of total billed charges,,,,,,,,,,,,,,,958.86,83,,percent of total billed charges,,,1097.49,95,,percent of total billed charges,,,1039.73,90,,percent of total billed charges,,,1039.73,90,,percent of total billed charges,,,947.31,82,,percent of total billed charges,,,1039.73,90,,percent of total billed charges,,,981.96,85,,percent of total billed charges,,288.81,1097.49,
SYNTHES SCREW LOCKING 10MM,30186458,CDM,,,278,RC,outpatient,,1155.25,1155.25,,980.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,288.81,22,,percent of total billed charges,,,,,,,,,1039.73,90,,percent of total billed charges,,,956.55,82.8,,percent of total billed charges,,,981.96,85,,percent of total billed charges,,,,,,,,,1016.62,88,,percent of total billed charges,,,,,,,,,882.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,288.81,22,,percent of total billed charges,,,1051.28,91,,percent of total billed charges,,,1097.49,95,,percent of total billed charges,,,958.86,83,,percent of total billed charges,,,958.86,83,,percent of total billed charges,,,,,,,,,,,,,,,958.86,83,,percent of total billed charges,,,1097.49,95,,percent of total billed charges,,,1039.73,90,,percent of total billed charges,,,1039.73,90,,percent of total billed charges,,,947.31,82,,percent of total billed charges,,,1039.73,90,,percent of total billed charges,,,981.96,85,,percent of total billed charges,,288.81,1097.49,
SYNTHES SCREW LOCKING 15MM,30186459,CDM,,,278,RC,outpatient,,978.84,978.84,,831.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,244.71,22,,percent of total billed charges,,,,,,,,,880.96,90,,percent of total billed charges,,,810.48,82.8,,percent of total billed charges,,,832.01,85,,percent of total billed charges,,,,,,,,,861.38,88,,percent of total billed charges,,,,,,,,,747.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,244.71,22,,percent of total billed charges,,,890.74,91,,percent of total billed charges,,,929.9,95,,percent of total billed charges,,,812.44,83,,percent of total billed charges,,,812.44,83,,percent of total billed charges,,,,,,,,,,,,,,,812.44,83,,percent of total billed charges,,,929.9,95,,percent of total billed charges,,,880.96,90,,percent of total billed charges,,,880.96,90,,percent of total billed charges,,,802.65,82,,percent of total billed charges,,,880.96,90,,percent of total billed charges,,,832.01,85,,percent of total billed charges,,244.71,929.9,
SYNTHES DRILL BIT 1.0,30186460,CDM,,,278,RC,outpatient,,830.83,830.83,,705.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,207.71,22,,percent of total billed charges,,,,,,,,,747.75,90,,percent of total billed charges,,,687.93,82.8,,percent of total billed charges,,,706.21,85,,percent of total billed charges,,,,,,,,,731.13,88,,percent of total billed charges,,,,,,,,,634.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,207.71,22,,percent of total billed charges,,,756.06,91,,percent of total billed charges,,,789.29,95,,percent of total billed charges,,,689.59,83,,percent of total billed charges,,,689.59,83,,percent of total billed charges,,,,,,,,,,,,,,,689.59,83,,percent of total billed charges,,,789.29,95,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,681.28,82,,percent of total billed charges,,,747.75,90,,percent of total billed charges,,,706.21,85,,percent of total billed charges,,207.71,789.29,
SYNTHES PLATE CONDYLER 1.5,30186461,CDM,,,278,RC,outpatient,,4655.04,4655.04,,3952.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1163.76,22,,percent of total billed charges,,,,,,,,,4189.54,90,,percent of total billed charges,,,3854.37,82.8,,percent of total billed charges,,,3956.78,85,,percent of total billed charges,,,,,,,,,4096.44,88,,percent of total billed charges,,,,,,,,,3556.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1163.76,22,,percent of total billed charges,,,4236.09,91,,percent of total billed charges,,,4422.29,95,,percent of total billed charges,,,3863.68,83,,percent of total billed charges,,,3863.68,83,,percent of total billed charges,,,,,,,,,,,,,,,3863.68,83,,percent of total billed charges,,,4422.29,95,,percent of total billed charges,,,4189.54,90,,percent of total billed charges,,,4189.54,90,,percent of total billed charges,,,3817.13,82,,percent of total billed charges,,,4189.54,90,,percent of total billed charges,,,3956.78,85,,percent of total billed charges,,1163.76,4422.29,
SYNTHES PLATE PHALANGEAL BASE 2.0,30186462,CDM,,,278,RC,outpatient,,5599.69,5599.69,,4754.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1399.92,22,,percent of total billed charges,,,,,,,,,5039.72,90,,percent of total billed charges,,,4636.54,82.8,,percent of total billed charges,,,4759.74,85,,percent of total billed charges,,,,,,,,,4927.73,88,,percent of total billed charges,,,,,,,,,4278.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1399.92,22,,percent of total billed charges,,,5095.72,91,,percent of total billed charges,,,5319.71,95,,percent of total billed charges,,,4647.74,83,,percent of total billed charges,,,4647.74,83,,percent of total billed charges,,,,,,,,,,,,,,,4647.74,83,,percent of total billed charges,,,5319.71,95,,percent of total billed charges,,,5039.72,90,,percent of total billed charges,,,5039.72,90,,percent of total billed charges,,,4591.75,82,,percent of total billed charges,,,5039.72,90,,percent of total billed charges,,,4759.74,85,,percent of total billed charges,,1399.92,5319.71,
SYNTHES SCREW CORTEX 1.5 X 15MM,30186463,CDM,,,278,RC,outpatient,,504.98,504.98,,428.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126.25,22,,percent of total billed charges,,,,,,,,,454.48,90,,percent of total billed charges,,,418.12,82.8,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,,,,,,,,444.38,88,,percent of total billed charges,,,,,,,,,385.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126.25,22,,percent of total billed charges,,,459.53,91,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,,,,,,,,,,,,,419.13,83,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,414.08,82,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,126.25,479.73,
SYNTHES SCREW LOCKING 1.5 X 9MM,30186464,CDM,,,278,RC,outpatient,,1138.15,1138.15,,966.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.54,22,,percent of total billed charges,,,,,,,,,1024.34,90,,percent of total billed charges,,,942.39,82.8,,percent of total billed charges,,,967.43,85,,percent of total billed charges,,,,,,,,,1001.57,88,,percent of total billed charges,,,,,,,,,869.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.54,22,,percent of total billed charges,,,1035.72,91,,percent of total billed charges,,,1081.24,95,,percent of total billed charges,,,944.66,83,,percent of total billed charges,,,944.66,83,,percent of total billed charges,,,,,,,,,,,,,,,944.66,83,,percent of total billed charges,,,1081.24,95,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,933.28,82,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,967.43,85,,percent of total billed charges,,284.54,1081.24,
SYNTHES SCREW LOCKING 1.5 X 11MM,30186465,CDM,,,278,RC,outpatient,,1138.15,1138.15,,966.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.54,22,,percent of total billed charges,,,,,,,,,1024.34,90,,percent of total billed charges,,,942.39,82.8,,percent of total billed charges,,,967.43,85,,percent of total billed charges,,,,,,,,,1001.57,88,,percent of total billed charges,,,,,,,,,869.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.54,22,,percent of total billed charges,,,1035.72,91,,percent of total billed charges,,,1081.24,95,,percent of total billed charges,,,944.66,83,,percent of total billed charges,,,944.66,83,,percent of total billed charges,,,,,,,,,,,,,,,944.66,83,,percent of total billed charges,,,1081.24,95,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,933.28,82,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,967.43,85,,percent of total billed charges,,284.54,1081.24,
SYNTHES SCREW LOCKING 1.5 X 14MM,30186466,CDM,,,278,RC,outpatient,,1138.15,1138.15,,966.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.54,22,,percent of total billed charges,,,,,,,,,1024.34,90,,percent of total billed charges,,,942.39,82.8,,percent of total billed charges,,,967.43,85,,percent of total billed charges,,,,,,,,,1001.57,88,,percent of total billed charges,,,,,,,,,869.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.54,22,,percent of total billed charges,,,1035.72,91,,percent of total billed charges,,,1081.24,95,,percent of total billed charges,,,944.66,83,,percent of total billed charges,,,944.66,83,,percent of total billed charges,,,,,,,,,,,,,,,944.66,83,,percent of total billed charges,,,1081.24,95,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,933.28,82,,percent of total billed charges,,,1024.34,90,,percent of total billed charges,,,967.43,85,,percent of total billed charges,,284.54,1081.24,
SYNTHES SCREW CORTEX 2.0 x 8MM,30186467,CDM,,,278,RC,outpatient,,490.28,490.28,,416.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.57,22,,percent of total billed charges,,,,,,,,,441.25,90,,percent of total billed charges,,,405.95,82.8,,percent of total billed charges,,,416.74,85,,percent of total billed charges,,,,,,,,,431.45,88,,percent of total billed charges,,,,,,,,,374.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.57,22,,percent of total billed charges,,,446.15,91,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,,,,,,,,,,,,,406.93,83,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,402.03,82,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,416.74,85,,percent of total billed charges,,122.57,465.77,
SYNTHES SCREW CORTEX 2.0 x 13MM,30186468,CDM,,,278,RC,outpatient,,490.28,490.28,,416.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.57,22,,percent of total billed charges,,,,,,,,,441.25,90,,percent of total billed charges,,,405.95,82.8,,percent of total billed charges,,,416.74,85,,percent of total billed charges,,,,,,,,,431.45,88,,percent of total billed charges,,,,,,,,,374.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.57,22,,percent of total billed charges,,,446.15,91,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,,,,,,,,,,,,,406.93,83,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,402.03,82,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,416.74,85,,percent of total billed charges,,122.57,465.77,
SYNTHES SCREW LOCKING 2.0 X 9MM,30186469,CDM,,,278,RC,outpatient,,1183.65,1183.65,,1004.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,295.91,22,,percent of total billed charges,,,,,,,,,1065.29,90,,percent of total billed charges,,,980.06,82.8,,percent of total billed charges,,,1006.1,85,,percent of total billed charges,,,,,,,,,1041.61,88,,percent of total billed charges,,,,,,,,,904.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,295.91,22,,percent of total billed charges,,,1077.12,91,,percent of total billed charges,,,1124.47,95,,percent of total billed charges,,,982.43,83,,percent of total billed charges,,,982.43,83,,percent of total billed charges,,,,,,,,,,,,,,,982.43,83,,percent of total billed charges,,,1124.47,95,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,970.59,82,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,1006.1,85,,percent of total billed charges,,295.91,1124.47,
SYNTHES SCREW LOCKING 2.0 X 11MM,30186470,CDM,,,278,RC,outpatient,,1183.65,1183.65,,1004.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,295.91,22,,percent of total billed charges,,,,,,,,,1065.29,90,,percent of total billed charges,,,980.06,82.8,,percent of total billed charges,,,1006.1,85,,percent of total billed charges,,,,,,,,,1041.61,88,,percent of total billed charges,,,,,,,,,904.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,295.91,22,,percent of total billed charges,,,1077.12,91,,percent of total billed charges,,,1124.47,95,,percent of total billed charges,,,982.43,83,,percent of total billed charges,,,982.43,83,,percent of total billed charges,,,,,,,,,,,,,,,982.43,83,,percent of total billed charges,,,1124.47,95,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,970.59,82,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,1006.1,85,,percent of total billed charges,,295.91,1124.47,
SYNTHES SCREW LOCKING 2.0 X 12MM,30186471,CDM,,,278,RC,outpatient,,1183.65,1183.65,,1004.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,295.91,22,,percent of total billed charges,,,,,,,,,1065.29,90,,percent of total billed charges,,,980.06,82.8,,percent of total billed charges,,,1006.1,85,,percent of total billed charges,,,,,,,,,1041.61,88,,percent of total billed charges,,,,,,,,,904.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,295.91,22,,percent of total billed charges,,,1077.12,91,,percent of total billed charges,,,1124.47,95,,percent of total billed charges,,,982.43,83,,percent of total billed charges,,,982.43,83,,percent of total billed charges,,,,,,,,,,,,,,,982.43,83,,percent of total billed charges,,,1124.47,95,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,970.59,82,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,1006.1,85,,percent of total billed charges,,295.91,1124.47,
SYNTHES SCREW LOCKING 2.0 X 15MM,30186472,CDM,,,278,RC,outpatient,,1183.65,1183.65,,1004.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,295.91,22,,percent of total billed charges,,,,,,,,,1065.29,90,,percent of total billed charges,,,980.06,82.8,,percent of total billed charges,,,1006.1,85,,percent of total billed charges,,,,,,,,,1041.61,88,,percent of total billed charges,,,,,,,,,904.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,295.91,22,,percent of total billed charges,,,1077.12,91,,percent of total billed charges,,,1124.47,95,,percent of total billed charges,,,982.43,83,,percent of total billed charges,,,982.43,83,,percent of total billed charges,,,,,,,,,,,,,,,982.43,83,,percent of total billed charges,,,1124.47,95,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,970.59,82,,percent of total billed charges,,,1065.29,90,,percent of total billed charges,,,1006.1,85,,percent of total billed charges,,295.91,1124.47,
TERUMO GLIDEWIRE ANGLED CATH 4FR,30186473,CDM,,,270,RC,outpatient,,577.5,577.5,,490.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,144.38,22,,percent of total billed charges,,,,,,,,,519.75,90,,percent of total billed charges,,,478.17,82.8,,percent of total billed charges,,,490.88,85,,percent of total billed charges,,,,,,,,,508.2,88,,percent of total billed charges,,,,,,,,,441.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,144.38,22,,percent of total billed charges,,,525.53,91,,percent of total billed charges,,,548.63,95,,percent of total billed charges,,,479.33,83,,percent of total billed charges,,,479.33,83,,percent of total billed charges,,,,,,,,,,,,,,,479.33,83,,percent of total billed charges,,,548.63,95,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,473.55,82,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,490.88,85,,percent of total billed charges,,144.38,548.63,
COOK WIRE GUIDE EXTRA STIFF 0.35 X 260CM,30186474,CDM,,,270,RC,outpatient,,828.8,828.8,,703.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,207.2,22,,percent of total billed charges,,,,,,,,,745.92,90,,percent of total billed charges,,,686.25,82.8,,percent of total billed charges,,,704.48,85,,percent of total billed charges,,,,,,,,,729.34,88,,percent of total billed charges,,,,,,,,,633.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,207.2,22,,percent of total billed charges,,,754.21,91,,percent of total billed charges,,,787.36,95,,percent of total billed charges,,,687.9,83,,percent of total billed charges,,,687.9,83,,percent of total billed charges,,,,,,,,,,,,,,,687.9,83,,percent of total billed charges,,,787.36,95,,percent of total billed charges,,,745.92,90,,percent of total billed charges,,,745.92,90,,percent of total billed charges,,,679.62,82,,percent of total billed charges,,,745.92,90,,percent of total billed charges,,,704.48,85,,percent of total billed charges,,207.2,787.36,
COOK CATH BALLOON CODA LP 9FR,30186475,CDM,,,270,RC,outpatient,,2964,2964,,2516.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,741,22,,percent of total billed charges,,,,,,,,,2667.6,90,,percent of total billed charges,,,2454.19,82.8,,percent of total billed charges,,,2519.4,85,,percent of total billed charges,,,,,,,,,2608.32,88,,percent of total billed charges,,,,,,,,,2264.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,741,22,,percent of total billed charges,,,2697.24,91,,percent of total billed charges,,,2815.8,95,,percent of total billed charges,,,2460.12,83,,percent of total billed charges,,,2460.12,83,,percent of total billed charges,,,,,,,,,,,,,,,2460.12,83,,percent of total billed charges,,,2815.8,95,,percent of total billed charges,,,2667.6,90,,percent of total billed charges,,,2667.6,90,,percent of total billed charges,,,2430.48,82,,percent of total billed charges,,,2667.6,90,,percent of total billed charges,,,2519.4,85,,percent of total billed charges,,741,2815.8,
COAGRASPER G MONOPOLAR 6.5 X 165 STOMACH,30186477,CDM,,,270,RC,outpatient,,1229.74,1229.74,,1044.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,307.44,22,,percent of total billed charges,,,,,,,,,1106.77,90,,percent of total billed charges,,,1018.22,82.8,,percent of total billed charges,,,1045.28,85,,percent of total billed charges,,,,,,,,,1082.17,88,,percent of total billed charges,,,,,,,,,939.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,307.44,22,,percent of total billed charges,,,1119.06,91,,percent of total billed charges,,,1168.25,95,,percent of total billed charges,,,1020.68,83,,percent of total billed charges,,,1020.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1020.68,83,,percent of total billed charges,,,1168.25,95,,percent of total billed charges,,,1106.77,90,,percent of total billed charges,,,1106.77,90,,percent of total billed charges,,,1008.39,82,,percent of total billed charges,,,1106.77,90,,percent of total billed charges,,,1045.28,85,,percent of total billed charges,,307.44,1168.25,
ELECTROSURGICAL KNIFE 2.7X1650X2.0MM STO,30186478,CDM,,,270,RC,outpatient,,6623.5,6623.5,,5623.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1655.88,22,,percent of total billed charges,,,,,,,,,5961.15,90,,percent of total billed charges,,,5484.26,82.8,,percent of total billed charges,,,5629.98,85,,percent of total billed charges,,,,,,,,,5828.68,88,,percent of total billed charges,,,,,,,,,5060.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1655.88,22,,percent of total billed charges,,,6027.39,91,,percent of total billed charges,,,6292.33,95,,percent of total billed charges,,,5497.51,83,,percent of total billed charges,,,5497.51,83,,percent of total billed charges,,,,,,,,,,,,,,,5497.51,83,,percent of total billed charges,,,6292.33,95,,percent of total billed charges,,,5961.15,90,,percent of total billed charges,,,5961.15,90,,percent of total billed charges,,,5431.27,82,,percent of total billed charges,,,5961.15,90,,percent of total billed charges,,,5629.98,85,,percent of total billed charges,,1655.88,6292.33,
ELECTROSURGICAL KNIFE 2.7X2300X1.5MM COL,30186479,CDM,,,270,RC,outpatient,,6623.5,6623.5,,5623.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1655.88,22,,percent of total billed charges,,,,,,,,,5961.15,90,,percent of total billed charges,,,5484.26,82.8,,percent of total billed charges,,,5629.98,85,,percent of total billed charges,,,,,,,,,5828.68,88,,percent of total billed charges,,,,,,,,,5060.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1655.88,22,,percent of total billed charges,,,6027.39,91,,percent of total billed charges,,,6292.33,95,,percent of total billed charges,,,5497.51,83,,percent of total billed charges,,,5497.51,83,,percent of total billed charges,,,,,,,,,,,,,,,5497.51,83,,percent of total billed charges,,,6292.33,95,,percent of total billed charges,,,5961.15,90,,percent of total billed charges,,,5961.15,90,,percent of total billed charges,,,5431.27,82,,percent of total billed charges,,,5961.15,90,,percent of total billed charges,,,5629.98,85,,percent of total billed charges,,1655.88,6292.33,
DEPUY ATTUNE TIBIA AUGMENT SZ 8 5MM,30186480,CDM,,,278,RC,outpatient,,10997.61,10997.61,,9336.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2749.4,22,,percent of total billed charges,,,,,,,,,9897.85,90,,percent of total billed charges,,,9106.02,82.8,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,,,,,,,,9677.9,88,,percent of total billed charges,,,,,,,,,8402.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2749.4,22,,percent of total billed charges,,,10007.83,91,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,,,,,,,,,,,,,9128.02,83,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9018.04,82,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,2749.4,10447.73,
SHEATH INTRODUCER PRELUDE 7FR,30186481,CDM,,,270,RC,outpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.5,22,,percent of total billed charges,,,,,,,,,91.8,90,,percent of total billed charges,,,84.46,82.8,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.5,22,,percent of total billed charges,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,25.5,96.9,
CATH ANGIO PIG 5FR,30186482,CDM,,,270,RC,outpatient,,845,845,,717.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,211.25,22,,percent of total billed charges,,,,,,,,,760.5,90,,percent of total billed charges,,,699.66,82.8,,percent of total billed charges,,,718.25,85,,percent of total billed charges,,,,,,,,,743.6,88,,percent of total billed charges,,,,,,,,,645.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,211.25,22,,percent of total billed charges,,,768.95,91,,percent of total billed charges,,,802.75,95,,percent of total billed charges,,,701.35,83,,percent of total billed charges,,,701.35,83,,percent of total billed charges,,,,,,,,,,,,,,,701.35,83,,percent of total billed charges,,,802.75,95,,percent of total billed charges,,,760.5,90,,percent of total billed charges,,,760.5,90,,percent of total billed charges,,,692.9,82,,percent of total billed charges,,,760.5,90,,percent of total billed charges,,,718.25,85,,percent of total billed charges,,211.25,802.75,
SHEATH CATH CORDIS BRITE TIP 10FR FUSCHI,30186484,CDM,,,270,RC,outpatient,,92,92,,78.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23,22,,percent of total billed charges,,,,,,,,,82.8,90,,percent of total billed charges,,,76.18,82.8,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,,,,,,,,80.96,88,,percent of total billed charges,,,,,,,,,70.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23,22,,percent of total billed charges,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,,,,,,,,,,,,,76.36,83,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,75.44,82,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,23,87.4,
RIGID ARGON PLASMA COAGULATION APPLICATO,30186485,CDM,,,270,RC,outpatient,,1277.9,1277.9,,1084.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,319.48,22,,percent of total billed charges,,,,,,,,,1150.11,90,,percent of total billed charges,,,1058.1,82.8,,percent of total billed charges,,,1086.22,85,,percent of total billed charges,,,,,,,,,1124.55,88,,percent of total billed charges,,,,,,,,,976.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,319.48,22,,percent of total billed charges,,,1162.89,91,,percent of total billed charges,,,1214.01,95,,percent of total billed charges,,,1060.66,83,,percent of total billed charges,,,1060.66,83,,percent of total billed charges,,,,,,,,,,,,,,,1060.66,83,,percent of total billed charges,,,1214.01,95,,percent of total billed charges,,,1150.11,90,,percent of total billed charges,,,1150.11,90,,percent of total billed charges,,,1047.88,82,,percent of total billed charges,,,1150.11,90,,percent of total billed charges,,,1086.22,85,,percent of total billed charges,,319.48,1214.01,
STRYKER BLADE AGGRESSIVE PLUS XL,30186486,CDM,,,270,RC,outpatient,,641.62,641.62,,544.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,160.41,22,,percent of total billed charges,,,,,,,,,577.46,90,,percent of total billed charges,,,531.26,82.8,,percent of total billed charges,,,545.38,85,,percent of total billed charges,,,,,,,,,564.63,88,,percent of total billed charges,,,,,,,,,490.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,160.41,22,,percent of total billed charges,,,583.87,91,,percent of total billed charges,,,609.54,95,,percent of total billed charges,,,532.54,83,,percent of total billed charges,,,532.54,83,,percent of total billed charges,,,,,,,,,,,,,,,532.54,83,,percent of total billed charges,,,609.54,95,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,526.13,82,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,545.38,85,,percent of total billed charges,,160.41,609.54,
SYNTHES TFNA 11MM X 400MM 130DEG RT,30186487,CDM,,,278,RC,outpatient,,21784.17,21784.17,,18494.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5446.04,22,,percent of total billed charges,,,,,,,,,19605.75,90,,percent of total billed charges,,,18037.29,82.8,,percent of total billed charges,,,18516.54,85,,percent of total billed charges,,,,,,,,,19170.07,88,,percent of total billed charges,,,,,,,,,16643.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5446.04,22,,percent of total billed charges,,,19823.59,91,,percent of total billed charges,,,20694.96,95,,percent of total billed charges,,,18080.86,83,,percent of total billed charges,,,18080.86,83,,percent of total billed charges,,,,,,,,,,,,,,,18080.86,83,,percent of total billed charges,,,20694.96,95,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,17863.02,82,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,18516.54,85,,percent of total billed charges,,5446.04,20694.96,
SYNTHES TFNA HELICAL BLADE 110MM,30186488,CDM,,,278,RC,outpatient,,7033.78,7033.78,,5971.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1758.45,22,,percent of total billed charges,,,,,,,,,6330.4,90,,percent of total billed charges,,,5823.97,82.8,,percent of total billed charges,,,5978.71,85,,percent of total billed charges,,,,,,,,,6189.73,88,,percent of total billed charges,,,,,,,,,5373.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1758.45,22,,percent of total billed charges,,,6400.74,91,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,,,,,,,,,,,,,5838.04,83,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5767.7,82,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5978.71,85,,percent of total billed charges,,1758.45,6682.09,
SYNTHES SCREW LOCKING 5.0 X 56MM,30186489,CDM,,,278,RC,outpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,562.71,22,,percent of total billed charges,,,,,,,,,2025.74,90,,percent of total billed charges,,,1863.68,82.8,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,562.71,22,,percent of total billed charges,,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,562.71,2138.28,
SYNTHES TRAUMACEM V+ SYRINGE KIT,30186490,CDM,,,270,RC,outpatient,,1365.78,1365.78,,1159.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,341.45,22,,percent of total billed charges,,,,,,,,,1229.2,90,,percent of total billed charges,,,1130.87,82.8,,percent of total billed charges,,,1160.91,85,,percent of total billed charges,,,,,,,,,1201.89,88,,percent of total billed charges,,,,,,,,,1043.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,341.45,22,,percent of total billed charges,,,1242.86,91,,percent of total billed charges,,,1297.49,95,,percent of total billed charges,,,1133.6,83,,percent of total billed charges,,,1133.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1133.6,83,,percent of total billed charges,,,1297.49,95,,percent of total billed charges,,,1229.2,90,,percent of total billed charges,,,1229.2,90,,percent of total billed charges,,,1119.94,82,,percent of total billed charges,,,1229.2,90,,percent of total billed charges,,,1160.91,85,,percent of total billed charges,,341.45,1297.49,
ABBOTT PACING CABLES,30186491,CDM,,,270,RC,outpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.25,22,,percent of total billed charges,,,,,,,,,202.5,90,,percent of total billed charges,,,186.3,82.8,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.25,22,,percent of total billed charges,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,56.25,213.75,
ABBOTT LEAD VENTRICULAR 65CM,30186492,CDM,,,278,RC,outpatient,,29250,29250,,24833.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7312.5,22,,percent of total billed charges,,,,,,,,,26325,90,,percent of total billed charges,,,24219,82.8,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,,,,,,,,25740,88,,percent of total billed charges,,,,,,,,,22347,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7312.5,22,,percent of total billed charges,,,26617.5,91,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,,,,,,,,,,,,,24277.5,83,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,23985,82,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,7312.5,27787.5,
ABBOTT ICD  FORTIFY ASSURA MRI,30186493,CDM,,,278,RC,outpatient,,94250,94250,,80018.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23562.5,22,,percent of total billed charges,,,,,,,,,84825,90,,percent of total billed charges,,,78039,82.8,,percent of total billed charges,,,80112.5,85,,percent of total billed charges,,,,,,,,,82940,88,,percent of total billed charges,,,,,,,,,72007,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23562.5,22,,percent of total billed charges,,,85767.5,91,,percent of total billed charges,,,89537.5,95,,percent of total billed charges,,,78227.5,83,,percent of total billed charges,,,78227.5,83,,percent of total billed charges,,,,,,,,,,,,,,,78227.5,83,,percent of total billed charges,,,89537.5,95,,percent of total billed charges,,,84825,90,,percent of total billed charges,,,84825,90,,percent of total billed charges,,,77285,82,,percent of total billed charges,,,84825,90,,percent of total billed charges,,,80112.5,85,,percent of total billed charges,,23562.5,89537.5,
ZIMMER TUBE CORING ON IMPLANT,30186494,CDM,,,278,RC,outpatient,,4603.5,4603.5,,3908.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1150.88,22,,percent of total billed charges,,,,,,,,,4143.15,90,,percent of total billed charges,,,3811.7,82.8,,percent of total billed charges,,,3912.98,85,,percent of total billed charges,,,,,,,,,4051.08,88,,percent of total billed charges,,,,,,,,,3517.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1150.88,22,,percent of total billed charges,,,4189.19,91,,percent of total billed charges,,,4373.33,95,,percent of total billed charges,,,3820.91,83,,percent of total billed charges,,,3820.91,83,,percent of total billed charges,,,,,,,,,,,,,,,3820.91,83,,percent of total billed charges,,,4373.33,95,,percent of total billed charges,,,4143.15,90,,percent of total billed charges,,,4143.15,90,,percent of total billed charges,,,3774.87,82,,percent of total billed charges,,,4143.15,90,,percent of total billed charges,,,3912.98,85,,percent of total billed charges,,1150.88,4373.33,
GORE VBX BALLOON EXPANDABLE ENDOPROSTHES,30186497,CDM,,,270,RC,outpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5807.75,22,,percent of total billed charges,,,,,,,,,20907.9,90,,percent of total billed charges,,,19235.27,82.8,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5807.75,22,,percent of total billed charges,,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,5807.75,22069.45,
ENSNARE HEMOSTATIS VALVE ADAPTER,30186498,CDM,,,270,RC,outpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50,22,,percent of total billed charges,,,,,,,,,180,90,,percent of total billed charges,,,165.6,82.8,,percent of total billed charges,,,170,85,,percent of total billed charges,,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50,22,,percent of total billed charges,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,50,190,
EN SNARE SYSTEM 30MM,30186499,CDM,,,270,RC,outpatient,,2632.5,2632.5,,2234.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,658.13,22,,percent of total billed charges,,,,,,,,,2369.25,90,,percent of total billed charges,,,2179.71,82.8,,percent of total billed charges,,,2237.63,85,,percent of total billed charges,,,,,,,,,2316.6,88,,percent of total billed charges,,,,,,,,,2011.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,658.13,22,,percent of total billed charges,,,2395.58,91,,percent of total billed charges,,,2500.88,95,,percent of total billed charges,,,2184.98,83,,percent of total billed charges,,,2184.98,83,,percent of total billed charges,,,,,,,,,,,,,,,2184.98,83,,percent of total billed charges,,,2500.88,95,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2158.65,82,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2237.63,85,,percent of total billed charges,,658.13,2500.88,
CATHETER SINGLE LUMEN SHEATH 17FR,30186500,CDM,,,270,RC,outpatient,,3243.5,3243.5,,2753.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,810.88,22,,percent of total billed charges,,,,,,,,,2919.15,90,,percent of total billed charges,,,2685.62,82.8,,percent of total billed charges,,,2756.98,85,,percent of total billed charges,,,,,,,,,2854.28,88,,percent of total billed charges,,,,,,,,,2478.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,810.88,22,,percent of total billed charges,,,2951.59,91,,percent of total billed charges,,,3081.33,95,,percent of total billed charges,,,2692.11,83,,percent of total billed charges,,,2692.11,83,,percent of total billed charges,,,,,,,,,,,,,,,2692.11,83,,percent of total billed charges,,,3081.33,95,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2659.67,82,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2756.98,85,,percent of total billed charges,,810.88,3081.33,
STENT BIFURCATED AFX2 28X80MM,30186501,CDM,,,278,RC,outpatient,,94243.5,94243.5,,80012.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23560.88,22,,percent of total billed charges,,,,,,,,,84819.15,90,,percent of total billed charges,,,78033.62,82.8,,percent of total billed charges,,,80106.98,85,,percent of total billed charges,,,,,,,,,82934.28,88,,percent of total billed charges,,,,,,,,,72002.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23560.88,22,,percent of total billed charges,,,85761.59,91,,percent of total billed charges,,,89531.33,95,,percent of total billed charges,,,78222.11,83,,percent of total billed charges,,,78222.11,83,,percent of total billed charges,,,,,,,,,,,,,,,78222.11,83,,percent of total billed charges,,,89531.33,95,,percent of total billed charges,,,84819.15,90,,percent of total billed charges,,,84819.15,90,,percent of total billed charges,,,77279.67,82,,percent of total billed charges,,,84819.15,90,,percent of total billed charges,,,80106.98,85,,percent of total billed charges,,23560.88,89531.33,
VELA SUPRARENAL ENDOGRAFT 34X34MM,30186502,CDM,,,278,RC,outpatient,,35743.5,35743.5,,30346.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8935.88,22,,percent of total billed charges,,,,,,,,,32169.15,90,,percent of total billed charges,,,29595.62,82.8,,percent of total billed charges,,,30381.98,85,,percent of total billed charges,,,,,,,,,31454.28,88,,percent of total billed charges,,,,,,,,,27308.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8935.88,22,,percent of total billed charges,,,32526.59,91,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,,,,,,,,,,,,,29667.11,83,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,29309.67,82,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,30381.98,85,,percent of total billed charges,,8935.88,33956.33,
FUJI GASTROSCOPE STERILE HOOD,30186503,CDM,,,270,RC,outpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.88,22,,percent of total billed charges,,,,,,,,,330.75,90,,percent of total billed charges,,,304.29,82.8,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.88,22,,percent of total billed charges,,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,91.88,349.13,
SYNTHES PLATE CLAVICLE 8 HOLE LEFT,30186504,CDM,,,278,RC,outpatient,,10328.7,10328.7,,8769.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2582.18,22,,percent of total billed charges,,,,,,,,,9295.83,90,,percent of total billed charges,,,8552.16,82.8,,percent of total billed charges,,,8779.4,85,,percent of total billed charges,,,,,,,,,9089.26,88,,percent of total billed charges,,,,,,,,,7891.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2582.18,22,,percent of total billed charges,,,9399.12,91,,percent of total billed charges,,,9812.27,95,,percent of total billed charges,,,8572.82,83,,percent of total billed charges,,,8572.82,83,,percent of total billed charges,,,,,,,,,,,,,,,8572.82,83,,percent of total billed charges,,,9812.27,95,,percent of total billed charges,,,9295.83,90,,percent of total billed charges,,,9295.83,90,,percent of total billed charges,,,8469.53,82,,percent of total billed charges,,,9295.83,90,,percent of total billed charges,,,8779.4,85,,percent of total billed charges,,2582.18,9812.27,
FUJI CLONOSCOPE STERILE HOOD,30186505,CDM,,,270,RC,outpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.88,22,,percent of total billed charges,,,,,,,,,330.75,90,,percent of total billed charges,,,304.29,82.8,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.88,22,,percent of total billed charges,,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,91.88,349.13,
DEPUY ATTUNE PRESSFIT KNEE,30186509,CDM,,,278,RC,outpatient,,42250,42250,,35870.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10562.5,22,,percent of total billed charges,,,,,,,,,38025,90,,percent of total billed charges,,,34983,82.8,,percent of total billed charges,,,35912.5,85,,percent of total billed charges,,,,,,,,,37180,88,,percent of total billed charges,,,,,,,,,32279,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10562.5,22,,percent of total billed charges,,,38447.5,91,,percent of total billed charges,,,40137.5,95,,percent of total billed charges,,,35067.5,83,,percent of total billed charges,,,35067.5,83,,percent of total billed charges,,,,,,,,,,,,,,,35067.5,83,,percent of total billed charges,,,40137.5,95,,percent of total billed charges,,,38025,90,,percent of total billed charges,,,38025,90,,percent of total billed charges,,,34645,82,,percent of total billed charges,,,38025,90,,percent of total billed charges,,,35912.5,85,,percent of total billed charges,,10562.5,40137.5,
PERCLOSE,30186510,CDM,,,270,RC,outpatient,,1573,1573,,1335.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,393.25,22,,percent of total billed charges,,,,,,,,,1415.7,90,,percent of total billed charges,,,1302.44,82.8,,percent of total billed charges,,,1337.05,85,,percent of total billed charges,,,,,,,,,1384.24,88,,percent of total billed charges,,,,,,,,,1201.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,393.25,22,,percent of total billed charges,,,1431.43,91,,percent of total billed charges,,,1494.35,95,,percent of total billed charges,,,1305.59,83,,percent of total billed charges,,,1305.59,83,,percent of total billed charges,,,,,,,,,,,,,,,1305.59,83,,percent of total billed charges,,,1494.35,95,,percent of total billed charges,,,1415.7,90,,percent of total billed charges,,,1415.7,90,,percent of total billed charges,,,1289.86,82,,percent of total billed charges,,,1415.7,90,,percent of total billed charges,,,1337.05,85,,percent of total billed charges,,393.25,1494.35,
GUIDEWIRE SAFE T.J TIP .035 X 260CM,30186511,CDM,,,270,RC,outpatient,,143.92,143.92,,122.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.98,22,,percent of total billed charges,,,,,,,,,129.53,90,,percent of total billed charges,,,119.17,82.8,,percent of total billed charges,,,122.33,85,,percent of total billed charges,,,,,,,,,126.65,88,,percent of total billed charges,,,,,,,,,109.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.98,22,,percent of total billed charges,,,130.97,91,,percent of total billed charges,,,136.72,95,,percent of total billed charges,,,119.45,83,,percent of total billed charges,,,119.45,83,,percent of total billed charges,,,,,,,,,,,,,,,119.45,83,,percent of total billed charges,,,136.72,95,,percent of total billed charges,,,129.53,90,,percent of total billed charges,,,129.53,90,,percent of total billed charges,,,118.01,82,,percent of total billed charges,,,129.53,90,,percent of total billed charges,,,122.33,85,,percent of total billed charges,,35.98,136.72,
GUIDEWIRE STANDARD BENTSON 0.35 X 260CM,30186512,CDM,,,270,RC,outpatient,,160.8,160.8,,136.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.2,22,,percent of total billed charges,,,,,,,,,144.72,90,,percent of total billed charges,,,133.14,82.8,,percent of total billed charges,,,136.68,85,,percent of total billed charges,,,,,,,,,141.5,88,,percent of total billed charges,,,,,,,,,122.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.2,22,,percent of total billed charges,,,146.33,91,,percent of total billed charges,,,152.76,95,,percent of total billed charges,,,133.46,83,,percent of total billed charges,,,133.46,83,,percent of total billed charges,,,,,,,,,,,,,,,133.46,83,,percent of total billed charges,,,152.76,95,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,131.86,82,,percent of total billed charges,,,144.72,90,,percent of total billed charges,,,136.68,85,,percent of total billed charges,,40.2,152.76,
GUIDEWIRE ROSEN 0.35 X 260CM,30186513,CDM,,,270,RC,outpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36,22,,percent of total billed charges,,,,,,,,,129.6,90,,percent of total billed charges,,,119.23,82.8,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36,22,,percent of total billed charges,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,36,136.8,
KUMPE SOFTVU 4F 100CM X 0.035,30186514,CDM,,,270,RC,outpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.88,22,,percent of total billed charges,,,,,,,,,222.75,90,,percent of total billed charges,,,204.93,82.8,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.88,22,,percent of total billed charges,,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,61.88,235.13,
STRYKER BURR ROUND STANDARD 3.0,30186515,CDM,,,270,RC,outpatient,,1312.42,1312.42,,1114.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,328.11,22,,percent of total billed charges,,,,,,,,,1181.18,90,,percent of total billed charges,,,1086.68,82.8,,percent of total billed charges,,,1115.56,85,,percent of total billed charges,,,,,,,,,1154.93,88,,percent of total billed charges,,,,,,,,,1002.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,328.11,22,,percent of total billed charges,,,1194.3,91,,percent of total billed charges,,,1246.8,95,,percent of total billed charges,,,1089.31,83,,percent of total billed charges,,,1089.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1089.31,83,,percent of total billed charges,,,1246.8,95,,percent of total billed charges,,,1181.18,90,,percent of total billed charges,,,1181.18,90,,percent of total billed charges,,,1076.18,82,,percent of total billed charges,,,1181.18,90,,percent of total billed charges,,,1115.56,85,,percent of total billed charges,,328.11,1246.8,
SCANLAN TUNNELER SHEATH LRG BLUE,30186516,CDM,,,270,RC,outpatient,,392,392,,332.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98,22,,percent of total billed charges,,,,,,,,,352.8,90,,percent of total billed charges,,,324.58,82.8,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,,,,,,,,344.96,88,,percent of total billed charges,,,,,,,,,299.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98,22,,percent of total billed charges,,,356.72,91,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,,,,,,,,,,,,,325.36,83,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,321.44,82,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,98,372.4,
SCANLAN TUNNELER SHEATH SM GREEN,30186517,CDM,,,270,RC,outpatient,,392,392,,332.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98,22,,percent of total billed charges,,,,,,,,,352.8,90,,percent of total billed charges,,,324.58,82.8,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,,,,,,,,344.96,88,,percent of total billed charges,,,,,,,,,299.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98,22,,percent of total billed charges,,,356.72,91,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,,,,,,,,,,,,,325.36,83,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,321.44,82,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,98,372.4,
SCANLAN TUNNELER SHEATH LRG ORANGE,30186518,CDM,,,270,RC,outpatient,,392,392,,332.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98,22,,percent of total billed charges,,,,,,,,,352.8,90,,percent of total billed charges,,,324.58,82.8,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,,,,,,,,344.96,88,,percent of total billed charges,,,,,,,,,299.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98,22,,percent of total billed charges,,,356.72,91,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,,,,,,,,,,,,,325.36,83,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,321.44,82,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,98,372.4,
SCANLAN TUNNELER SHEATH LRG ORANGE CURVE,30186519,CDM,,,270,RC,outpatient,,392,392,,332.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98,22,,percent of total billed charges,,,,,,,,,352.8,90,,percent of total billed charges,,,324.58,82.8,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,,,,,,,,344.96,88,,percent of total billed charges,,,,,,,,,299.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98,22,,percent of total billed charges,,,356.72,91,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,,,,,,,,,,,,,325.36,83,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,321.44,82,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,98,372.4,
SCANLAN TUNNELER SHEATH SM YELLOW,30186520,CDM,,,270,RC,outpatient,,392,392,,332.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98,22,,percent of total billed charges,,,,,,,,,352.8,90,,percent of total billed charges,,,324.58,82.8,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,,,,,,,,344.96,88,,percent of total billed charges,,,,,,,,,299.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98,22,,percent of total billed charges,,,356.72,91,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,,,,,,,,,,,,,325.36,83,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,321.44,82,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,98,372.4,
SCANLAN TUNNELER SHEATH SM YELLOW CURVED,30186521,CDM,,,270,RC,outpatient,,392,392,,332.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98,22,,percent of total billed charges,,,,,,,,,352.8,90,,percent of total billed charges,,,324.58,82.8,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,,,,,,,,344.96,88,,percent of total billed charges,,,,,,,,,299.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98,22,,percent of total billed charges,,,356.72,91,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,,,,,,,,,,,,,325.36,83,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,321.44,82,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,98,372.4,
RIGID ARGON PLASMA COAGULATION APPLICATO,30186522,CDM,,,270,RC,outpatient,,1104.68,1104.68,,937.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,276.17,22,,percent of total billed charges,,,,,,,,,994.21,90,,percent of total billed charges,,,914.68,82.8,,percent of total billed charges,,,938.98,85,,percent of total billed charges,,,,,,,,,972.12,88,,percent of total billed charges,,,,,,,,,843.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,276.17,22,,percent of total billed charges,,,1005.26,91,,percent of total billed charges,,,1049.45,95,,percent of total billed charges,,,916.88,83,,percent of total billed charges,,,916.88,83,,percent of total billed charges,,,,,,,,,,,,,,,916.88,83,,percent of total billed charges,,,1049.45,95,,percent of total billed charges,,,994.21,90,,percent of total billed charges,,,994.21,90,,percent of total billed charges,,,905.84,82,,percent of total billed charges,,,994.21,90,,percent of total billed charges,,,938.98,85,,percent of total billed charges,,276.17,1049.45,
DEPUY ATTUNE INSERT CRS FB SZ 6,30186523,CDM,,,278,RC,outpatient,,19355.77,19355.77,,16433.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4838.94,22,,percent of total billed charges,,,,,,,,,17420.19,90,,percent of total billed charges,,,16026.58,82.8,,percent of total billed charges,,,16452.4,85,,percent of total billed charges,,,,,,,,,17033.08,88,,percent of total billed charges,,,,,,,,,14787.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4838.94,22,,percent of total billed charges,,,17613.75,91,,percent of total billed charges,,,18387.98,95,,percent of total billed charges,,,16065.29,83,,percent of total billed charges,,,16065.29,83,,percent of total billed charges,,,,,,,,,,,,,,,16065.29,83,,percent of total billed charges,,,18387.98,95,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,15871.73,82,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,16452.4,85,,percent of total billed charges,,4838.94,18387.98,
STEALTH FIBRA SPRING CLIP 6MM,30186525,CDM,,,270,RC,outpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36,22,,percent of total billed charges,,,,,,,,,129.6,90,,percent of total billed charges,,,119.23,82.8,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36,22,,percent of total billed charges,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,36,136.8,
ZIMMER TROCAR DRILL PIN 75MM,30186526,CDM,,,278,RC,outpatient,,2111.85,2111.85,,1792.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,527.96,22,,percent of total billed charges,,,,,,,,,1900.67,90,,percent of total billed charges,,,1748.61,82.8,,percent of total billed charges,,,1795.07,85,,percent of total billed charges,,,,,,,,,1858.43,88,,percent of total billed charges,,,,,,,,,1613.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,527.96,22,,percent of total billed charges,,,1921.78,91,,percent of total billed charges,,,2006.26,95,,percent of total billed charges,,,1752.84,83,,percent of total billed charges,,,1752.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1752.84,83,,percent of total billed charges,,,2006.26,95,,percent of total billed charges,,,1900.67,90,,percent of total billed charges,,,1900.67,90,,percent of total billed charges,,,1731.72,82,,percent of total billed charges,,,1900.67,90,,percent of total billed charges,,,1795.07,85,,percent of total billed charges,,527.96,2006.26,
ZIMMER PATELLA TM 10 X 38MM,30186527,CDM,,,278,RC,outpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1218.75,22,,percent of total billed charges,,,,,,,,,4387.5,90,,percent of total billed charges,,,4036.5,82.8,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1218.75,22,,percent of total billed charges,,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,1218.75,4631.25,
ZIMMER INSERT ASF 10MM 8-11 GH,30186528,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
SPINECRAFT ROD TITANIUM 6.0 X 450MM,30186529,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
SHEATH CATH CORDIS BRITE TIP 10FR FUSCHI,30186531,CDM,,,270,RC,outpatient,,184,184,,156.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46,22,,percent of total billed charges,,,,,,,,,165.6,90,,percent of total billed charges,,,152.35,82.8,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,,,,,,,,161.92,88,,percent of total billed charges,,,,,,,,,140.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46,22,,percent of total billed charges,,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,,,,,,,,,,,,,152.72,83,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,150.88,82,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,46,174.8,
CORDIS BILIARY STENT 10X39MM 135CM PALMA,30186532,CDM,,,278,RC,outpatient,,5466.83,5466.83,,4641.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1366.71,22,,percent of total billed charges,,,,,,,,,4920.15,90,,percent of total billed charges,,,4526.54,82.8,,percent of total billed charges,,,4646.81,85,,percent of total billed charges,,,,,,,,,4810.81,88,,percent of total billed charges,,,,,,,,,4176.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1366.71,22,,percent of total billed charges,,,4974.82,91,,percent of total billed charges,,,5193.49,95,,percent of total billed charges,,,4537.47,83,,percent of total billed charges,,,4537.47,83,,percent of total billed charges,,,,,,,,,,,,,,,4537.47,83,,percent of total billed charges,,,5193.49,95,,percent of total billed charges,,,4920.15,90,,percent of total billed charges,,,4920.15,90,,percent of total billed charges,,,4482.8,82,,percent of total billed charges,,,4920.15,90,,percent of total billed charges,,,4646.81,85,,percent of total billed charges,,1366.71,5193.49,
XENOSURE BIOLOGIC PATH 1X10CM,30186533,CDM,,,270,RC,outpatient,,1755,1755,,1490,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,438.75,22,,percent of total billed charges,,,,,,,,,1579.5,90,,percent of total billed charges,,,1453.14,82.8,,percent of total billed charges,,,1491.75,85,,percent of total billed charges,,,,,,,,,1544.4,88,,percent of total billed charges,,,,,,,,,1340.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,438.75,22,,percent of total billed charges,,,1597.05,91,,percent of total billed charges,,,1667.25,95,,percent of total billed charges,,,1456.65,83,,percent of total billed charges,,,1456.65,83,,percent of total billed charges,,,,,,,,,,,,,,,1456.65,83,,percent of total billed charges,,,1667.25,95,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1439.1,82,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1491.75,85,,percent of total billed charges,,438.75,1667.25,
XENOSURE BIOLOGIC PATH 2X9CM,30186534,CDM,,,270,RC,outpatient,,2184,2184,,1854.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,546,22,,percent of total billed charges,,,,,,,,,1965.6,90,,percent of total billed charges,,,1808.35,82.8,,percent of total billed charges,,,1856.4,85,,percent of total billed charges,,,,,,,,,1921.92,88,,percent of total billed charges,,,,,,,,,1668.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,546,22,,percent of total billed charges,,,1987.44,91,,percent of total billed charges,,,2074.8,95,,percent of total billed charges,,,1812.72,83,,percent of total billed charges,,,1812.72,83,,percent of total billed charges,,,,,,,,,,,,,,,1812.72,83,,percent of total billed charges,,,2074.8,95,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1790.88,82,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1856.4,85,,percent of total billed charges,,546,2074.8,
DEPUY TIBIA REV FB SZ 6,30186535,CDM,,,278,RC,outpatient,,25954.31,25954.31,,22035.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6488.58,22,,percent of total billed charges,,,,,,,,,23358.88,90,,percent of total billed charges,,,21490.17,82.8,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,,,,,,,,22839.79,88,,percent of total billed charges,,,,,,,,,19829.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6488.58,22,,percent of total billed charges,,,23618.42,91,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,21542.08,83,,percent of total billed charges,,,,,,,,,,,,,,,21542.08,83,,percent of total billed charges,,,24656.59,95,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,21282.53,82,,percent of total billed charges,,,23358.88,90,,percent of total billed charges,,,22061.16,85,,percent of total billed charges,,6488.58,24656.59,
ZIMMER LINER NEUTRAL +5MM G7 40MM H,30186536,CDM,,,278,RC,outpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2551.25,22,,percent of total billed charges,,,,,,,,,9184.5,90,,percent of total billed charges,,,8449.74,82.8,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2551.25,22,,percent of total billed charges,,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,2551.25,9694.75,
ZIMMER HEAD BIOLOX +7MM 40MM,30186537,CDM,,,278,RC,outpatient,,26390,26390,,22405.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6597.5,22,,percent of total billed charges,,,,,,,,,23751,90,,percent of total billed charges,,,21850.92,82.8,,percent of total billed charges,,,22431.5,85,,percent of total billed charges,,,,,,,,,23223.2,88,,percent of total billed charges,,,,,,,,,20161.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6597.5,22,,percent of total billed charges,,,24014.9,91,,percent of total billed charges,,,25070.5,95,,percent of total billed charges,,,21903.7,83,,percent of total billed charges,,,21903.7,83,,percent of total billed charges,,,,,,,,,,,,,,,21903.7,83,,percent of total billed charges,,,25070.5,95,,percent of total billed charges,,,23751,90,,percent of total billed charges,,,23751,90,,percent of total billed charges,,,21639.8,82,,percent of total billed charges,,,23751,90,,percent of total billed charges,,,22431.5,85,,percent of total billed charges,,6597.5,25070.5,
ZIMMER STEM REV. WAGNER 135 NK ANGLE16X2,30186538,CDM,,,278,RC,outpatient,,78000,78000,,66222,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19500,22,,percent of total billed charges,,,,,,,,,70200,90,,percent of total billed charges,,,64584,82.8,,percent of total billed charges,,,66300,85,,percent of total billed charges,,,,,,,,,68640,88,,percent of total billed charges,,,,,,,,,59592,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19500,22,,percent of total billed charges,,,70980,91,,percent of total billed charges,,,74100,95,,percent of total billed charges,,,64740,83,,percent of total billed charges,,,64740,83,,percent of total billed charges,,,,,,,,,,,,,,,64740,83,,percent of total billed charges,,,74100,95,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,63960,82,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,66300,85,,percent of total billed charges,,19500,74100,
ZIMMER LINER NUETRAL 32MM,30186541,CDM,,,278,RC,outpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5785,22,,percent of total billed charges,,,,,,,,,20826,90,,percent of total billed charges,,,19159.92,82.8,,percent of total billed charges,,,19669,85,,percent of total billed charges,,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5785,22,,percent of total billed charges,,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,5785,21983,
ARTHREX SCREW BIO TENODESIS W/DRIVER,30186542,CDM,,,270,RC,outpatient,,2632.5,2632.5,,2234.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,658.13,22,,percent of total billed charges,,,,,,,,,2369.25,90,,percent of total billed charges,,,2179.71,82.8,,percent of total billed charges,,,2237.63,85,,percent of total billed charges,,,,,,,,,2316.6,88,,percent of total billed charges,,,,,,,,,2011.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,658.13,22,,percent of total billed charges,,,2395.58,91,,percent of total billed charges,,,2500.88,95,,percent of total billed charges,,,2184.98,83,,percent of total billed charges,,,2184.98,83,,percent of total billed charges,,,,,,,,,,,,,,,2184.98,83,,percent of total billed charges,,,2500.88,95,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2158.65,82,,percent of total billed charges,,,2369.25,90,,percent of total billed charges,,,2237.63,85,,percent of total billed charges,,658.13,2500.88,
LIMB EXTENSION OVATION IX 28X45MM,30186543,CDM,,,278,RC,outpatient,,35743.5,35743.5,,30346.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8935.88,22,,percent of total billed charges,,,,,,,,,32169.15,90,,percent of total billed charges,,,29595.62,82.8,,percent of total billed charges,,,30381.98,85,,percent of total billed charges,,,,,,,,,31454.28,88,,percent of total billed charges,,,,,,,,,27308.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8935.88,22,,percent of total billed charges,,,32526.59,91,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,,,,,,,,,,,,,29667.11,83,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,29309.67,82,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,30381.98,85,,percent of total billed charges,,8935.88,33956.33,
GORE PROPATEN VASCULAR GRAFT,30186544,CDM,,,278,RC,outpatient,,13702,13702,,11633,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3425.5,22,,percent of total billed charges,,,,,,,,,12331.8,90,,percent of total billed charges,,,11345.26,82.8,,percent of total billed charges,,,11646.7,85,,percent of total billed charges,,,,,,,,,12057.76,88,,percent of total billed charges,,,,,,,,,10468.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3425.5,22,,percent of total billed charges,,,12468.82,91,,percent of total billed charges,,,13016.9,95,,percent of total billed charges,,,11372.66,83,,percent of total billed charges,,,11372.66,83,,percent of total billed charges,,,,,,,,,,,,,,,11372.66,83,,percent of total billed charges,,,13016.9,95,,percent of total billed charges,,,12331.8,90,,percent of total billed charges,,,12331.8,90,,percent of total billed charges,,,11235.64,82,,percent of total billed charges,,,12331.8,90,,percent of total billed charges,,,11646.7,85,,percent of total billed charges,,3425.5,13016.9,
FLEXCIL HIGH PRESSURE INJECTION LINE 72,30186545,CDM,,,270,RC,outpatient,,86.37,86.37,,73.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.59,22,,percent of total billed charges,,,,,,,,,77.73,90,,percent of total billed charges,,,71.51,82.8,,percent of total billed charges,,,73.41,85,,percent of total billed charges,,,,,,,,,76.01,88,,percent of total billed charges,,,,,,,,,65.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.59,22,,percent of total billed charges,,,78.6,91,,percent of total billed charges,,,82.05,95,,percent of total billed charges,,,71.69,83,,percent of total billed charges,,,71.69,83,,percent of total billed charges,,,,,,,,,,,,,,,71.69,83,,percent of total billed charges,,,82.05,95,,percent of total billed charges,,,77.73,90,,percent of total billed charges,,,77.73,90,,percent of total billed charges,,,70.82,82,,percent of total billed charges,,,77.73,90,,percent of total billed charges,,,73.41,85,,percent of total billed charges,,21.59,82.05,
SHEATH CATH CORDIS BRITE TIP 5FR 23CM FU,30186548,CDM,,,270,RC,outpatient,,184,184,,156.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46,22,,percent of total billed charges,,,,,,,,,165.6,90,,percent of total billed charges,,,152.35,82.8,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,,,,,,,,161.92,88,,percent of total billed charges,,,,,,,,,140.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46,22,,percent of total billed charges,,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,,,,,,,,,,,,,152.72,83,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,150.88,82,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,46,174.8,
SHEATH CATH CORDIS BRITE TIP 6FR 23CM FU,30186549,CDM,,,270,RC,outpatient,,170,170,,144.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.5,22,,percent of total billed charges,,,,,,,,,153,90,,percent of total billed charges,,,140.76,82.8,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,,,,,,,,149.6,88,,percent of total billed charges,,,,,,,,,129.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.5,22,,percent of total billed charges,,,154.7,91,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,,,,,,,,,,,,,141.1,83,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,139.4,82,,percent of total billed charges,,,153,90,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,42.5,161.5,
SHEATH CATH CORDIS BRITE TIP 8FR 23CM FU,30186550,CDM,,,270,RC,outpatient,,170,170,,144.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.5,22,,percent of total billed charges,,,,,,,,,153,90,,percent of total billed charges,,,140.76,82.8,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,,,,,,,,149.6,88,,percent of total billed charges,,,,,,,,,129.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.5,22,,percent of total billed charges,,,154.7,91,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,,,,,,,,,,,,,141.1,83,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,139.4,82,,percent of total billed charges,,,153,90,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,42.5,161.5,
SHEATH CATH CORDIS BRITE TIP 11FR 23CM F,30186551,CDM,,,270,RC,outpatient,,184,184,,156.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46,22,,percent of total billed charges,,,,,,,,,165.6,90,,percent of total billed charges,,,152.35,82.8,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,,,,,,,,161.92,88,,percent of total billed charges,,,,,,,,,140.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46,22,,percent of total billed charges,,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,,,,,,,,,,,,,152.72,83,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,150.88,82,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,46,174.8,
CATH BERENSTEIN (BERN) 4FR 65CM,30186552,CDM,,,270,RC,outpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27,22,,percent of total billed charges,,,,,,,,,97.2,90,,percent of total billed charges,,,89.42,82.8,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27,22,,percent of total billed charges,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,27,102.6,
CATH SUPER TORQUE MB PIGTAIL 5FR 65CM,30186553,CDM,,,270,RC,outpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210,22,,percent of total billed charges,,,,,,,,,756,90,,percent of total billed charges,,,695.52,82.8,,percent of total billed charges,,,714,85,,percent of total billed charges,,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210,22,,percent of total billed charges,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,210,798,
TERUMO GLIDECATH ANGLED 4FR X 65CM,30186554,CDM,,,270,RC,outpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.6,22,,percent of total billed charges,,,,,,,,,347.76,90,,percent of total billed charges,,,319.94,82.8,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.6,22,,percent of total billed charges,,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,96.6,367.08,
TERUMO GLIDECATH STRAIGHT 4FR X 65CM,30186555,CDM,,,270,RC,outpatient,,577.5,577.5,,490.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,144.38,22,,percent of total billed charges,,,,,,,,,519.75,90,,percent of total billed charges,,,478.17,82.8,,percent of total billed charges,,,490.88,85,,percent of total billed charges,,,,,,,,,508.2,88,,percent of total billed charges,,,,,,,,,441.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,144.38,22,,percent of total billed charges,,,525.53,91,,percent of total billed charges,,,548.63,95,,percent of total billed charges,,,479.33,83,,percent of total billed charges,,,479.33,83,,percent of total billed charges,,,,,,,,,,,,,,,479.33,83,,percent of total billed charges,,,548.63,95,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,473.55,82,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,490.88,85,,percent of total billed charges,,144.38,548.63,
KUMPE SOFTVU 4F 65CM,30186556,CDM,,,270,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
ZIMMER LINER NUETRAL G7 E1 32MM,30186558,CDM,,,278,RC,outpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5785,22,,percent of total billed charges,,,,,,,,,20826,90,,percent of total billed charges,,,19159.92,82.8,,percent of total billed charges,,,19669,85,,percent of total billed charges,,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5785,22,,percent of total billed charges,,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,5785,21983,
ZIMMER INSERT MC 11MM,30186559,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
GORE INTRO SHEATH DRYSEAL FLEX 12FR 33CM,30186560,CDM,,,270,RC,outpatient,,3048.5,3048.5,,2588.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,762.13,22,,percent of total billed charges,,,,,,,,,2743.65,90,,percent of total billed charges,,,2524.16,82.8,,percent of total billed charges,,,2591.23,85,,percent of total billed charges,,,,,,,,,2682.68,88,,percent of total billed charges,,,,,,,,,2329.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,762.13,22,,percent of total billed charges,,,2774.14,91,,percent of total billed charges,,,2896.08,95,,percent of total billed charges,,,2530.26,83,,percent of total billed charges,,,2530.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2530.26,83,,percent of total billed charges,,,2896.08,95,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2499.77,82,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2591.23,85,,percent of total billed charges,,762.13,2896.08,
GORE INTRO SHEATH DRYSEAL FLEX 14FR 33CM,30186561,CDM,,,270,RC,outpatient,,3048.5,3048.5,,2588.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,762.13,22,,percent of total billed charges,,,,,,,,,2743.65,90,,percent of total billed charges,,,2524.16,82.8,,percent of total billed charges,,,2591.23,85,,percent of total billed charges,,,,,,,,,2682.68,88,,percent of total billed charges,,,,,,,,,2329.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,762.13,22,,percent of total billed charges,,,2774.14,91,,percent of total billed charges,,,2896.08,95,,percent of total billed charges,,,2530.26,83,,percent of total billed charges,,,2530.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2530.26,83,,percent of total billed charges,,,2896.08,95,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2499.77,82,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2591.23,85,,percent of total billed charges,,762.13,2896.08,
GORE INTRO SHEATH DRYSEAL FLEX 16FR 33CM,30186562,CDM,,,270,RC,outpatient,,3048.5,3048.5,,2588.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,762.13,22,,percent of total billed charges,,,,,,,,,2743.65,90,,percent of total billed charges,,,2524.16,82.8,,percent of total billed charges,,,2591.23,85,,percent of total billed charges,,,,,,,,,2682.68,88,,percent of total billed charges,,,,,,,,,2329.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,762.13,22,,percent of total billed charges,,,2774.14,91,,percent of total billed charges,,,2896.08,95,,percent of total billed charges,,,2530.26,83,,percent of total billed charges,,,2530.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2530.26,83,,percent of total billed charges,,,2896.08,95,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2499.77,82,,percent of total billed charges,,,2743.65,90,,percent of total billed charges,,,2591.23,85,,percent of total billed charges,,762.13,2896.08,
GORE INTRO SHEATH DRYSEAL FLEX 18FR 33CM,30186563,CDM,,,270,RC,outpatient,,4121,4121,,3498.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1030.25,22,,percent of total billed charges,,,,,,,,,3708.9,90,,percent of total billed charges,,,3412.19,82.8,,percent of total billed charges,,,3502.85,85,,percent of total billed charges,,,,,,,,,3626.48,88,,percent of total billed charges,,,,,,,,,3148.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1030.25,22,,percent of total billed charges,,,3750.11,91,,percent of total billed charges,,,3914.95,95,,percent of total billed charges,,,3420.43,83,,percent of total billed charges,,,3420.43,83,,percent of total billed charges,,,,,,,,,,,,,,,3420.43,83,,percent of total billed charges,,,3914.95,95,,percent of total billed charges,,,3708.9,90,,percent of total billed charges,,,3708.9,90,,percent of total billed charges,,,3379.22,82,,percent of total billed charges,,,3708.9,90,,percent of total billed charges,,,3502.85,85,,percent of total billed charges,,1030.25,3914.95,
GORE INTRO SHEATH DRYSEAL FLEX 20FR 33CM,30186564,CDM,,,270,RC,outpatient,,4121,4121,,3498.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1030.25,22,,percent of total billed charges,,,,,,,,,3708.9,90,,percent of total billed charges,,,3412.19,82.8,,percent of total billed charges,,,3502.85,85,,percent of total billed charges,,,,,,,,,3626.48,88,,percent of total billed charges,,,,,,,,,3148.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1030.25,22,,percent of total billed charges,,,3750.11,91,,percent of total billed charges,,,3914.95,95,,percent of total billed charges,,,3420.43,83,,percent of total billed charges,,,3420.43,83,,percent of total billed charges,,,,,,,,,,,,,,,3420.43,83,,percent of total billed charges,,,3914.95,95,,percent of total billed charges,,,3708.9,90,,percent of total billed charges,,,3708.9,90,,percent of total billed charges,,,3379.22,82,,percent of total billed charges,,,3708.9,90,,percent of total billed charges,,,3502.85,85,,percent of total billed charges,,1030.25,3914.95,
ZIMMER FEMUR POROUS NARROW SZ 11,30186565,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER INSERT ASF MC 12MM,30186566,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ZIMMER BLADE PATELLA REAMER SZ 41,30186568,CDM,,,270,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
EVERCROSS BALLOON 12MM X 40MM,30186569,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
LIMB RIGHT OVATION IX 12X160MM,30186570,CDM,,,278,RC,outpatient,,35743.5,35743.5,,30346.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8935.88,22,,percent of total billed charges,,,,,,,,,32169.15,90,,percent of total billed charges,,,29595.62,82.8,,percent of total billed charges,,,30381.98,85,,percent of total billed charges,,,,,,,,,31454.28,88,,percent of total billed charges,,,,,,,,,27308.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8935.88,22,,percent of total billed charges,,,32526.59,91,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,,,,,,,,,,,,,29667.11,83,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,29309.67,82,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,30381.98,85,,percent of total billed charges,,8935.88,33956.33,
LIMB EXTENSION OVATION IX 12X80MM,30186571,CDM,,,278,RC,outpatient,,35743.5,35743.5,,30346.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8935.88,22,,percent of total billed charges,,,,,,,,,32169.15,90,,percent of total billed charges,,,29595.62,82.8,,percent of total billed charges,,,30381.98,85,,percent of total billed charges,,,,,,,,,31454.28,88,,percent of total billed charges,,,,,,,,,27308.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8935.88,22,,percent of total billed charges,,,32526.59,91,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,,,,,,,,,,,,,29667.11,83,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,29309.67,82,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,30381.98,85,,percent of total billed charges,,8935.88,33956.33,
LIMB LT OVATION IX 28X120MM,30186572,CDM,,,278,RC,outpatient,,35743.5,35743.5,,30346.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8935.88,22,,percent of total billed charges,,,,,,,,,32169.15,90,,percent of total billed charges,,,29595.62,82.8,,percent of total billed charges,,,30381.98,85,,percent of total billed charges,,,,,,,,,31454.28,88,,percent of total billed charges,,,,,,,,,27308.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8935.88,22,,percent of total billed charges,,,32526.59,91,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,29667.11,83,,percent of total billed charges,,,,,,,,,,,,,,,29667.11,83,,percent of total billed charges,,,33956.33,95,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,29309.67,82,,percent of total billed charges,,,32169.15,90,,percent of total billed charges,,,30381.98,85,,percent of total billed charges,,8935.88,33956.33,
MAIN BODY OVATION KIX 34MM,30186573,CDM,,,278,RC,outpatient,,81243.5,81243.5,,68975.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20310.88,22,,percent of total billed charges,,,,,,,,,73119.15,90,,percent of total billed charges,,,67269.62,82.8,,percent of total billed charges,,,69056.98,85,,percent of total billed charges,,,,,,,,,71494.28,88,,percent of total billed charges,,,,,,,,,62070.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20310.88,22,,percent of total billed charges,,,73931.59,91,,percent of total billed charges,,,77181.33,95,,percent of total billed charges,,,67432.11,83,,percent of total billed charges,,,67432.11,83,,percent of total billed charges,,,,,,,,,,,,,,,67432.11,83,,percent of total billed charges,,,77181.33,95,,percent of total billed charges,,,73119.15,90,,percent of total billed charges,,,73119.15,90,,percent of total billed charges,,,66619.67,82,,percent of total billed charges,,,73119.15,90,,percent of total billed charges,,,69056.98,85,,percent of total billed charges,,20310.88,77181.33,
AUTO INJECTOR,30186574,CDM,,,270,RC,outpatient,,3243.5,3243.5,,2753.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,810.88,22,,percent of total billed charges,,,,,,,,,2919.15,90,,percent of total billed charges,,,2685.62,82.8,,percent of total billed charges,,,2756.98,85,,percent of total billed charges,,,,,,,,,2854.28,88,,percent of total billed charges,,,,,,,,,2478.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,810.88,22,,percent of total billed charges,,,2951.59,91,,percent of total billed charges,,,3081.33,95,,percent of total billed charges,,,2692.11,83,,percent of total billed charges,,,2692.11,83,,percent of total billed charges,,,,,,,,,,,,,,,2692.11,83,,percent of total billed charges,,,3081.33,95,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2659.67,82,,percent of total billed charges,,,2919.15,90,,percent of total billed charges,,,2756.98,85,,percent of total billed charges,,810.88,3081.33,
POLYMER CUSTOM SEAL KIT,30186575,CDM,,,270,RC,outpatient,,6493.5,6493.5,,5512.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1623.38,22,,percent of total billed charges,,,,,,,,,5844.15,90,,percent of total billed charges,,,5376.62,82.8,,percent of total billed charges,,,5519.48,85,,percent of total billed charges,,,,,,,,,5714.28,88,,percent of total billed charges,,,,,,,,,4961.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1623.38,22,,percent of total billed charges,,,5909.09,91,,percent of total billed charges,,,6168.83,95,,percent of total billed charges,,,5389.61,83,,percent of total billed charges,,,5389.61,83,,percent of total billed charges,,,,,,,,,,,,,,,5389.61,83,,percent of total billed charges,,,6168.83,95,,percent of total billed charges,,,5844.15,90,,percent of total billed charges,,,5844.15,90,,percent of total billed charges,,,5324.67,82,,percent of total billed charges,,,5844.15,90,,percent of total billed charges,,,5519.48,85,,percent of total billed charges,,1623.38,6168.83,
KUMPE SOFTVU 4F 40CM,30186576,CDM,,,270,RC,outpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.88,22,,percent of total billed charges,,,,,,,,,222.75,90,,percent of total billed charges,,,204.93,82.8,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.88,22,,percent of total billed charges,,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,61.88,235.13,
ZIMMER LINER NUETRAL 36MM +5 F,30186577,CDM,,,278,RC,outpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2551.25,22,,percent of total billed charges,,,,,,,,,9184.5,90,,percent of total billed charges,,,8449.74,82.8,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2551.25,22,,percent of total billed charges,,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,2551.25,9694.75,
ZIMMER BLADE STRYK-76542K-13/21X90X127V,30186578,CDM,,,270,RC,outpatient,,359.1,359.1,,304.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.78,22,,percent of total billed charges,,,,,,,,,323.19,90,,percent of total billed charges,,,297.33,82.8,,percent of total billed charges,,,305.24,85,,percent of total billed charges,,,,,,,,,316.01,88,,percent of total billed charges,,,,,,,,,274.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.78,22,,percent of total billed charges,,,326.78,91,,percent of total billed charges,,,341.15,95,,percent of total billed charges,,,298.05,83,,percent of total billed charges,,,298.05,83,,percent of total billed charges,,,,,,,,,,,,,,,298.05,83,,percent of total billed charges,,,341.15,95,,percent of total billed charges,,,323.19,90,,percent of total billed charges,,,323.19,90,,percent of total billed charges,,,294.46,82,,percent of total billed charges,,,323.19,90,,percent of total billed charges,,,305.24,85,,percent of total billed charges,,89.78,341.15,
SCREW LOCKING CAP KIT 4.5X38MM,30186579,CDM,,,278,RC,outpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,502.13,22,,percent of total billed charges,,,,,,,,,1807.65,90,,percent of total billed charges,,,1663.04,82.8,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,502.13,22,,percent of total billed charges,,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,502.13,1908.08,
ZIMMER INSERT ASF 12MM 8-11GH,30186580,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
STRYKER BUR ROUND 3MM LILAC,30186581,CDM,,,270,RC,outpatient,,1303.51,1303.51,,1106.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325.88,22,,percent of total billed charges,,,,,,,,,1173.16,90,,percent of total billed charges,,,1079.31,82.8,,percent of total billed charges,,,1107.98,85,,percent of total billed charges,,,,,,,,,1147.09,88,,percent of total billed charges,,,,,,,,,995.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325.88,22,,percent of total billed charges,,,1186.19,91,,percent of total billed charges,,,1238.33,95,,percent of total billed charges,,,1081.91,83,,percent of total billed charges,,,1081.91,83,,percent of total billed charges,,,,,,,,,,,,,,,1081.91,83,,percent of total billed charges,,,1238.33,95,,percent of total billed charges,,,1173.16,90,,percent of total billed charges,,,1173.16,90,,percent of total billed charges,,,1068.88,82,,percent of total billed charges,,,1173.16,90,,percent of total billed charges,,,1107.98,85,,percent of total billed charges,,325.88,1238.33,
ZIMMER LINER NEUTRAL +5MM E1 40MM F,30186582,CDM,,,278,RC,outpatient,,22880,22880,,19425.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5720,22,,percent of total billed charges,,,,,,,,,20592,90,,percent of total billed charges,,,18944.64,82.8,,percent of total billed charges,,,19448,85,,percent of total billed charges,,,,,,,,,20134.4,88,,percent of total billed charges,,,,,,,,,17480.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5720,22,,percent of total billed charges,,,20820.8,91,,percent of total billed charges,,,21736,95,,percent of total billed charges,,,18990.4,83,,percent of total billed charges,,,18990.4,83,,percent of total billed charges,,,,,,,,,,,,,,,18990.4,83,,percent of total billed charges,,,21736,95,,percent of total billed charges,,,20592,90,,percent of total billed charges,,,20592,90,,percent of total billed charges,,,18761.6,82,,percent of total billed charges,,,20592,90,,percent of total billed charges,,,19448,85,,percent of total billed charges,,5720,21736,
ZIMMER INSERT MC 14MM LEFT,30186583,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
DEPUY BIPOLAR HEAD 43MM,30186584,CDM,,,278,RC,outpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.27,22,,percent of total billed charges,,,,,,,,,7312.56,90,,percent of total billed charges,,,6727.56,82.8,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.27,22,,percent of total billed charges,,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,2031.27,7718.82,
SPINECRAFT SCREW 6.0 X 35MM,30186585,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT ROD LOWDOSED 6.0 X 60,30186586,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
SPINECRAFT REVISION/REMOVAL SET,30186587,CDM,,,270,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
BREAST IMPLANT MEMORYGEL XTRA 465CC,30186588,CDM,,,278,RC,outpatient,,7982,7982,,6776.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1995.5,22,,percent of total billed charges,,,,,,,,,7183.8,90,,percent of total billed charges,,,6609.1,82.8,,percent of total billed charges,,,6784.7,85,,percent of total billed charges,,,,,,,,,7024.16,88,,percent of total billed charges,,,,,,,,,6098.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1995.5,22,,percent of total billed charges,,,7263.62,91,,percent of total billed charges,,,7582.9,95,,percent of total billed charges,,,6625.06,83,,percent of total billed charges,,,6625.06,83,,percent of total billed charges,,,,,,,,,,,,,,,6625.06,83,,percent of total billed charges,,,7582.9,95,,percent of total billed charges,,,7183.8,90,,percent of total billed charges,,,7183.8,90,,percent of total billed charges,,,6545.24,82,,percent of total billed charges,,,7183.8,90,,percent of total billed charges,,,6784.7,85,,percent of total billed charges,,1995.5,7582.9,
SYNTHES HELICAL BLADE 100MM,30186589,CDM,,,278,RC,outpatient,,7033.78,7033.78,,5971.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1758.45,22,,percent of total billed charges,,,,,,,,,6330.4,90,,percent of total billed charges,,,5823.97,82.8,,percent of total billed charges,,,5978.71,85,,percent of total billed charges,,,,,,,,,6189.73,88,,percent of total billed charges,,,,,,,,,5373.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1758.45,22,,percent of total billed charges,,,6400.74,91,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,,,,,,,,,,,,,5838.04,83,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5767.7,82,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5978.71,85,,percent of total billed charges,,1758.45,6682.09,
ABBOTT WRENCH KIT ASSEMBLY,30186590,CDM,,,270,RC,outpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.63,22,,percent of total billed charges,,,,,,,,,236.25,90,,percent of total billed charges,,,217.35,82.8,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.63,22,,percent of total billed charges,,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,65.63,249.38,
ABBOTT LEAD RV OPTISUREMRI,30186591,CDM,,,278,RC,outpatient,,29250,29250,,24833.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7312.5,22,,percent of total billed charges,,,,,,,,,26325,90,,percent of total billed charges,,,24219,82.8,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,,,,,,,,25740,88,,percent of total billed charges,,,,,,,,,22347,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7312.5,22,,percent of total billed charges,,,26617.5,91,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,24277.5,83,,percent of total billed charges,,,,,,,,,,,,,,,24277.5,83,,percent of total billed charges,,,27787.5,95,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,23985,82,,percent of total billed charges,,,26325,90,,percent of total billed charges,,,24862.5,85,,percent of total billed charges,,7312.5,27787.5,
ABBOTT RV STYLET ACCESSORY KIT,30186592,CDM,,,270,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
ABBOTT RV ADAPTER PIN,30186593,CDM,,,270,RC,outpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210,22,,percent of total billed charges,,,,,,,,,756,90,,percent of total billed charges,,,695.52,82.8,,percent of total billed charges,,,714,85,,percent of total billed charges,,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210,22,,percent of total billed charges,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,210,798,
NUVASIVE CERVICAL CAGE TI 6X17X14MM 7DEG,30186594,CDM,,,278,RC,outpatient,,52487.5,52487.5,,44561.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13121.88,22,,percent of total billed charges,,,,,,,,,47238.75,90,,percent of total billed charges,,,43459.65,82.8,,percent of total billed charges,,,44614.38,85,,percent of total billed charges,,,,,,,,,46189,88,,percent of total billed charges,,,,,,,,,40100.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13121.88,22,,percent of total billed charges,,,47763.63,91,,percent of total billed charges,,,49863.13,95,,percent of total billed charges,,,43564.63,83,,percent of total billed charges,,,43564.63,83,,percent of total billed charges,,,,,,,,,,,,,,,43564.63,83,,percent of total billed charges,,,49863.13,95,,percent of total billed charges,,,47238.75,90,,percent of total billed charges,,,47238.75,90,,percent of total billed charges,,,43039.75,82,,percent of total billed charges,,,47238.75,90,,percent of total billed charges,,,44614.38,85,,percent of total billed charges,,13121.88,49863.13,
NUVASIVE DRILL BIT HELIX-R 2.5X10MM POWE,30186595,CDM,,,270,RC,outpatient,,2398.5,2398.5,,2036.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,599.63,22,,percent of total billed charges,,,,,,,,,2158.65,90,,percent of total billed charges,,,1985.96,82.8,,percent of total billed charges,,,2038.73,85,,percent of total billed charges,,,,,,,,,2110.68,88,,percent of total billed charges,,,,,,,,,1832.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,599.63,22,,percent of total billed charges,,,2182.64,91,,percent of total billed charges,,,2278.58,95,,percent of total billed charges,,,1990.76,83,,percent of total billed charges,,,1990.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1990.76,83,,percent of total billed charges,,,2278.58,95,,percent of total billed charges,,,2158.65,90,,percent of total billed charges,,,2158.65,90,,percent of total billed charges,,,1966.77,82,,percent of total billed charges,,,2158.65,90,,percent of total billed charges,,,2038.73,85,,percent of total billed charges,,599.63,2278.58,
NUVASIVE PLATE HELIX R 42MM 2-LEVEL,30186596,CDM,,,278,RC,outpatient,,10595,10595,,8995.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2648.75,22,,percent of total billed charges,,,,,,,,,9535.5,90,,percent of total billed charges,,,8772.66,82.8,,percent of total billed charges,,,9005.75,85,,percent of total billed charges,,,,,,,,,9323.6,88,,percent of total billed charges,,,,,,,,,8094.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2648.75,22,,percent of total billed charges,,,9641.45,91,,percent of total billed charges,,,10065.25,95,,percent of total billed charges,,,8793.85,83,,percent of total billed charges,,,8793.85,83,,percent of total billed charges,,,,,,,,,,,,,,,8793.85,83,,percent of total billed charges,,,10065.25,95,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,8687.9,82,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,9005.75,85,,percent of total billed charges,,2648.75,10065.25,
NUVASIVE SCREW HELIX R 4X15MM,30186597,CDM,,,278,RC,outpatient,,3659.5,3659.5,,3106.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,914.88,22,,percent of total billed charges,,,,,,,,,3293.55,90,,percent of total billed charges,,,3030.07,82.8,,percent of total billed charges,,,3110.58,85,,percent of total billed charges,,,,,,,,,3220.36,88,,percent of total billed charges,,,,,,,,,2795.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,914.88,22,,percent of total billed charges,,,3330.15,91,,percent of total billed charges,,,3476.53,95,,percent of total billed charges,,,3037.39,83,,percent of total billed charges,,,3037.39,83,,percent of total billed charges,,,,,,,,,,,,,,,3037.39,83,,percent of total billed charges,,,3476.53,95,,percent of total billed charges,,,3293.55,90,,percent of total billed charges,,,3293.55,90,,percent of total billed charges,,,3000.79,82,,percent of total billed charges,,,3293.55,90,,percent of total billed charges,,,3110.58,85,,percent of total billed charges,,914.88,3476.53,
DEPUY ATTUNE CRS FEMORAL RT SZ 5,30186602,CDM,,,278,RC,outpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13142.14,22,,percent of total billed charges,,,,,,,,,47311.7,90,,percent of total billed charges,,,43526.77,82.8,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13142.14,22,,percent of total billed charges,,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,13142.14,49940.13,
ZIMMER INSERT RT MC 13MM,30186603,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ZIMMER BLADE EXPLANT 42MM X 20,30186604,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
ZIMMER BLADE EXPLANT 42MM X 10,30186605,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
ZIMMER BLADE EXPLANT 44MM X 20,30186606,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
ZIMMER BLADE EXPLANT 44MM X 10,30186607,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
ZIMMER BLADE EXPLANT 46MM X 20,30186608,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
ZIMMER BLADE EXPLANT 46MM X 10,30186609,CDM,,,270,RC,outpatient,,4290,4290,,3642.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1072.5,22,,percent of total billed charges,,,,,,,,,3861,90,,percent of total billed charges,,,3552.12,82.8,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,,,,,,,,3775.2,88,,percent of total billed charges,,,,,,,,,3277.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1072.5,22,,percent of total billed charges,,,3903.9,91,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,3560.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3560.7,83,,percent of total billed charges,,,4075.5,95,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3517.8,82,,percent of total billed charges,,,3861,90,,percent of total billed charges,,,3646.5,85,,percent of total billed charges,,1072.5,4075.5,
SYNTHES SCREW CANN. 6.5 X 135MM,30186610,CDM,,,278,RC,outpatient,,2617.75,2617.75,,2222.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,654.44,22,,percent of total billed charges,,,,,,,,,2355.98,90,,percent of total billed charges,,,2167.5,82.8,,percent of total billed charges,,,2225.09,85,,percent of total billed charges,,,,,,,,,2303.62,88,,percent of total billed charges,,,,,,,,,1999.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,654.44,22,,percent of total billed charges,,,2382.15,91,,percent of total billed charges,,,2486.86,95,,percent of total billed charges,,,2172.73,83,,percent of total billed charges,,,2172.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2172.73,83,,percent of total billed charges,,,2486.86,95,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2146.56,82,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2225.09,85,,percent of total billed charges,,654.44,2486.86,
SYNTHES SCREW CANN. 6.5 X140MM,30186611,CDM,,,278,RC,outpatient,,2617.75,2617.75,,2222.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,654.44,22,,percent of total billed charges,,,,,,,,,2355.98,90,,percent of total billed charges,,,2167.5,82.8,,percent of total billed charges,,,2225.09,85,,percent of total billed charges,,,,,,,,,2303.62,88,,percent of total billed charges,,,,,,,,,1999.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,654.44,22,,percent of total billed charges,,,2382.15,91,,percent of total billed charges,,,2486.86,95,,percent of total billed charges,,,2172.73,83,,percent of total billed charges,,,2172.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2172.73,83,,percent of total billed charges,,,2486.86,95,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2146.56,82,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2225.09,85,,percent of total billed charges,,654.44,2486.86,
SYNTHES SCREW CANN. 6.5 X 145MM,30186612,CDM,,,278,RC,outpatient,,2617.75,2617.75,,2222.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,654.44,22,,percent of total billed charges,,,,,,,,,2355.98,90,,percent of total billed charges,,,2167.5,82.8,,percent of total billed charges,,,2225.09,85,,percent of total billed charges,,,,,,,,,2303.62,88,,percent of total billed charges,,,,,,,,,1999.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,654.44,22,,percent of total billed charges,,,2382.15,91,,percent of total billed charges,,,2486.86,95,,percent of total billed charges,,,2172.73,83,,percent of total billed charges,,,2172.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2172.73,83,,percent of total billed charges,,,2486.86,95,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2146.56,82,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2225.09,85,,percent of total billed charges,,654.44,2486.86,
SYNTHES SCREW CANN. 6.5 X 150MM,30186613,CDM,,,278,RC,outpatient,,2617.75,2617.75,,2222.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,654.44,22,,percent of total billed charges,,,,,,,,,2355.98,90,,percent of total billed charges,,,2167.5,82.8,,percent of total billed charges,,,2225.09,85,,percent of total billed charges,,,,,,,,,2303.62,88,,percent of total billed charges,,,,,,,,,1999.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,654.44,22,,percent of total billed charges,,,2382.15,91,,percent of total billed charges,,,2486.86,95,,percent of total billed charges,,,2172.73,83,,percent of total billed charges,,,2172.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2172.73,83,,percent of total billed charges,,,2486.86,95,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2146.56,82,,percent of total billed charges,,,2355.98,90,,percent of total billed charges,,,2225.09,85,,percent of total billed charges,,654.44,2486.86,
SYNTHES SCREW CANNULATED 6.5X145MM 32MM,30186614,CDM,,,278,RC,outpatient,,2696.27,2696.27,,2289.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,674.07,22,,percent of total billed charges,,,,,,,,,2426.64,90,,percent of total billed charges,,,2232.51,82.8,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,,,,,,,,2372.72,88,,percent of total billed charges,,,,,,,,,2059.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,674.07,22,,percent of total billed charges,,,2453.61,91,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,2237.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2237.9,83,,percent of total billed charges,,,2561.46,95,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2210.94,82,,percent of total billed charges,,,2426.64,90,,percent of total billed charges,,,2291.83,85,,percent of total billed charges,,674.07,2561.46,
DEPUY ATTUNE INSERT REV. FB 6MM,30186615,CDM,,,278,RC,outpatient,,19355.77,19355.77,,16433.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4838.94,22,,percent of total billed charges,,,,,,,,,17420.19,90,,percent of total billed charges,,,16026.58,82.8,,percent of total billed charges,,,16452.4,85,,percent of total billed charges,,,,,,,,,17033.08,88,,percent of total billed charges,,,,,,,,,14787.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4838.94,22,,percent of total billed charges,,,17613.75,91,,percent of total billed charges,,,18387.98,95,,percent of total billed charges,,,16065.29,83,,percent of total billed charges,,,16065.29,83,,percent of total billed charges,,,,,,,,,,,,,,,16065.29,83,,percent of total billed charges,,,18387.98,95,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,15871.73,82,,percent of total billed charges,,,17420.19,90,,percent of total billed charges,,,16452.4,85,,percent of total billed charges,,4838.94,18387.98,
MEDTRONIC INTRODUCER ACCESSORY KIT,30186616,CDM,,,270,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
MEDTRONIC ANCHOR INJEX BUMPY,30186617,CDM,,,270,RC,outpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,446.88,22,,percent of total billed charges,,,,,,,,,1608.75,90,,percent of total billed charges,,,1480.05,82.8,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,446.88,22,,percent of total billed charges,,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,446.88,1698.13,
CATHETER RIM 4F X 65CM,30186619,CDM,,,270,RC,outpatient,,273,273,,231.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.25,22,,percent of total billed charges,,,,,,,,,245.7,90,,percent of total billed charges,,,226.04,82.8,,percent of total billed charges,,,232.05,85,,percent of total billed charges,,,,,,,,,240.24,88,,percent of total billed charges,,,,,,,,,208.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.25,22,,percent of total billed charges,,,248.43,91,,percent of total billed charges,,,259.35,95,,percent of total billed charges,,,226.59,83,,percent of total billed charges,,,226.59,83,,percent of total billed charges,,,,,,,,,,,,,,,226.59,83,,percent of total billed charges,,,259.35,95,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,223.86,82,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,232.05,85,,percent of total billed charges,,68.25,259.35,
ZIMMER LINER NEUTRAL +5MM G7 40MM G,30186620,CDM,,,278,RC,outpatient,,24310,24310,,20639.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6077.5,22,,percent of total billed charges,,,,,,,,,21879,90,,percent of total billed charges,,,20128.68,82.8,,percent of total billed charges,,,20663.5,85,,percent of total billed charges,,,,,,,,,21392.8,88,,percent of total billed charges,,,,,,,,,18572.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6077.5,22,,percent of total billed charges,,,22122.1,91,,percent of total billed charges,,,23094.5,95,,percent of total billed charges,,,20177.3,83,,percent of total billed charges,,,20177.3,83,,percent of total billed charges,,,,,,,,,,,,,,,20177.3,83,,percent of total billed charges,,,23094.5,95,,percent of total billed charges,,,21879,90,,percent of total billed charges,,,21879,90,,percent of total billed charges,,,19934.2,82,,percent of total billed charges,,,21879,90,,percent of total billed charges,,,20663.5,85,,percent of total billed charges,,6077.5,23094.5,
SPINECRAFT ROD LOWDOSED 6.0 X 110MM,30186621,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ARTHREX MENISCAL CINCH II,30186622,CDM,,,270,RC,outpatient,,2567.5,2567.5,,2179.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,641.88,22,,percent of total billed charges,,,,,,,,,2310.75,90,,percent of total billed charges,,,2125.89,82.8,,percent of total billed charges,,,2182.38,85,,percent of total billed charges,,,,,,,,,2259.4,88,,percent of total billed charges,,,,,,,,,1961.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,641.88,22,,percent of total billed charges,,,2336.43,91,,percent of total billed charges,,,2439.13,95,,percent of total billed charges,,,2131.03,83,,percent of total billed charges,,,2131.03,83,,percent of total billed charges,,,,,,,,,,,,,,,2131.03,83,,percent of total billed charges,,,2439.13,95,,percent of total billed charges,,,2310.75,90,,percent of total billed charges,,,2310.75,90,,percent of total billed charges,,,2105.35,82,,percent of total billed charges,,,2310.75,90,,percent of total billed charges,,,2182.38,85,,percent of total billed charges,,641.88,2439.13,
ARTHREX SUTURE TENSIONER/CUTTER KNEE,30186623,CDM,,,270,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
ARTHREX PORTAL SKID,30186624,CDM,,,270,RC,outpatient,,337.5,337.5,,286.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.38,22,,percent of total billed charges,,,,,,,,,303.75,90,,percent of total billed charges,,,279.45,82.8,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,,,,,,,,297,88,,percent of total billed charges,,,,,,,,,257.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.38,22,,percent of total billed charges,,,307.13,91,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,,,,,,,,,,,,,280.13,83,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,276.75,82,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,84.38,320.63,
SYNTHES TFNA HELICAL BLADE 85MM,30186625,CDM,,,278,RC,outpatient,,7033.78,7033.78,,5971.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1758.45,22,,percent of total billed charges,,,,,,,,,6330.4,90,,percent of total billed charges,,,5823.97,82.8,,percent of total billed charges,,,5978.71,85,,percent of total billed charges,,,,,,,,,6189.73,88,,percent of total billed charges,,,,,,,,,5373.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1758.45,22,,percent of total billed charges,,,6400.74,91,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,,,,,,,,,,,,,5838.04,83,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5767.7,82,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5978.71,85,,percent of total billed charges,,1758.45,6682.09,
SURGICEL FIBRILLAR ABS 4X4,30186626,CDM,,,270,RC,outpatient,,1666.48,1666.48,,1414.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,416.62,22,,percent of total billed charges,,,,,,,,,1499.83,90,,percent of total billed charges,,,1379.85,82.8,,percent of total billed charges,,,1416.51,85,,percent of total billed charges,,,,,,,,,1466.5,88,,percent of total billed charges,,,,,,,,,1273.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,416.62,22,,percent of total billed charges,,,1516.5,91,,percent of total billed charges,,,1583.16,95,,percent of total billed charges,,,1383.18,83,,percent of total billed charges,,,1383.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1383.18,83,,percent of total billed charges,,,1583.16,95,,percent of total billed charges,,,1499.83,90,,percent of total billed charges,,,1499.83,90,,percent of total billed charges,,,1366.51,82,,percent of total billed charges,,,1499.83,90,,percent of total billed charges,,,1416.51,85,,percent of total billed charges,,416.62,1583.16,
DEPUY GLENOSPHERE +2 42MM,30186627,CDM,,,278,RC,outpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4954.14,22,,percent of total billed charges,,,,,,,,,17834.9,90,,percent of total billed charges,,,16408.1,82.8,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4954.14,22,,percent of total billed charges,,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,4954.14,18825.72,
ZIMMER FEMUR POROUS CR SZ 11 RIGHT,30186628,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER FEMUR POROUS CR SZ 9 LEFT,30186629,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
EXACTECH STEM HUMERAL 9MM,30186630,CDM,,,278,RC,outpatient,,35366.5,35366.5,,30026.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8841.63,22,,percent of total billed charges,,,,,,,,,31829.85,90,,percent of total billed charges,,,29283.46,82.8,,percent of total billed charges,,,30061.53,85,,percent of total billed charges,,,,,,,,,31122.52,88,,percent of total billed charges,,,,,,,,,27020.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8841.63,22,,percent of total billed charges,,,32183.52,91,,percent of total billed charges,,,33598.18,95,,percent of total billed charges,,,29354.2,83,,percent of total billed charges,,,29354.2,83,,percent of total billed charges,,,,,,,,,,,,,,,29354.2,83,,percent of total billed charges,,,33598.18,95,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,29000.53,82,,percent of total billed charges,,,31829.85,90,,percent of total billed charges,,,30061.53,85,,percent of total billed charges,,8841.63,33598.18,
ARTHREX IMPANT SYS. HAND/WRIST BRACE,30186631,CDM,,,270,RC,outpatient,,13884,13884,,11787.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3471,22,,percent of total billed charges,,,,,,,,,12495.6,90,,percent of total billed charges,,,11495.95,82.8,,percent of total billed charges,,,11801.4,85,,percent of total billed charges,,,,,,,,,12217.92,88,,percent of total billed charges,,,,,,,,,10607.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3471,22,,percent of total billed charges,,,12634.44,91,,percent of total billed charges,,,13189.8,95,,percent of total billed charges,,,11523.72,83,,percent of total billed charges,,,11523.72,83,,percent of total billed charges,,,,,,,,,,,,,,,11523.72,83,,percent of total billed charges,,,13189.8,95,,percent of total billed charges,,,12495.6,90,,percent of total billed charges,,,12495.6,90,,percent of total billed charges,,,11384.88,82,,percent of total billed charges,,,12495.6,90,,percent of total billed charges,,,11801.4,85,,percent of total billed charges,,3471,13189.8,
ARTHREX TRAPEZIECTOMY TOOL,30186632,CDM,,,270,RC,outpatient,,2327,2327,,1975.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,581.75,22,,percent of total billed charges,,,,,,,,,2094.3,90,,percent of total billed charges,,,1926.76,82.8,,percent of total billed charges,,,1977.95,85,,percent of total billed charges,,,,,,,,,2047.76,88,,percent of total billed charges,,,,,,,,,1777.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,581.75,22,,percent of total billed charges,,,2117.57,91,,percent of total billed charges,,,2210.65,95,,percent of total billed charges,,,1931.41,83,,percent of total billed charges,,,1931.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1931.41,83,,percent of total billed charges,,,2210.65,95,,percent of total billed charges,,,2094.3,90,,percent of total billed charges,,,2094.3,90,,percent of total billed charges,,,1908.14,82,,percent of total billed charges,,,2094.3,90,,percent of total billed charges,,,1977.95,85,,percent of total billed charges,,581.75,2210.65,
SYNTHES DRILL BIT 2.8,30186633,CDM,,,270,RC,outpatient,,1236.76,1236.76,,1050.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,309.19,22,,percent of total billed charges,,,,,,,,,1113.08,90,,percent of total billed charges,,,1024.04,82.8,,percent of total billed charges,,,1051.25,85,,percent of total billed charges,,,,,,,,,1088.35,88,,percent of total billed charges,,,,,,,,,944.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,309.19,22,,percent of total billed charges,,,1125.45,91,,percent of total billed charges,,,1174.92,95,,percent of total billed charges,,,1026.51,83,,percent of total billed charges,,,1026.51,83,,percent of total billed charges,,,,,,,,,,,,,,,1026.51,83,,percent of total billed charges,,,1174.92,95,,percent of total billed charges,,,1113.08,90,,percent of total billed charges,,,1113.08,90,,percent of total billed charges,,,1014.14,82,,percent of total billed charges,,,1113.08,90,,percent of total billed charges,,,1051.25,85,,percent of total billed charges,,309.19,1174.92,
SYNTHES DRILL BIT 2.5,30186634,CDM,,,270,RC,outpatient,,1236.76,1236.76,,1050.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,309.19,22,,percent of total billed charges,,,,,,,,,1113.08,90,,percent of total billed charges,,,1024.04,82.8,,percent of total billed charges,,,1051.25,85,,percent of total billed charges,,,,,,,,,1088.35,88,,percent of total billed charges,,,,,,,,,944.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,309.19,22,,percent of total billed charges,,,1125.45,91,,percent of total billed charges,,,1174.92,95,,percent of total billed charges,,,1026.51,83,,percent of total billed charges,,,1026.51,83,,percent of total billed charges,,,,,,,,,,,,,,,1026.51,83,,percent of total billed charges,,,1174.92,95,,percent of total billed charges,,,1113.08,90,,percent of total billed charges,,,1113.08,90,,percent of total billed charges,,,1014.14,82,,percent of total billed charges,,,1113.08,90,,percent of total billed charges,,,1051.25,85,,percent of total billed charges,,309.19,1174.92,
SYNTHES PLATE TIBIA LB 64MM,30186635,CDM,,,278,RC,outpatient,,15273.96,15273.96,,12967.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3818.49,22,,percent of total billed charges,,,,,,,,,13746.56,90,,percent of total billed charges,,,12646.84,82.8,,percent of total billed charges,,,12982.87,85,,percent of total billed charges,,,,,,,,,13441.08,88,,percent of total billed charges,,,,,,,,,11669.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3818.49,22,,percent of total billed charges,,,13899.3,91,,percent of total billed charges,,,14510.26,95,,percent of total billed charges,,,12677.39,83,,percent of total billed charges,,,12677.39,83,,percent of total billed charges,,,,,,,,,,,,,,,12677.39,83,,percent of total billed charges,,,14510.26,95,,percent of total billed charges,,,13746.56,90,,percent of total billed charges,,,13746.56,90,,percent of total billed charges,,,12524.65,82,,percent of total billed charges,,,13746.56,90,,percent of total billed charges,,,12982.87,85,,percent of total billed charges,,3818.49,14510.26,
SYNTHES SCREW LOCKING VA 3.5 X 36MM,30186636,CDM,,,278,RC,outpatient,,1456.85,1456.85,,1236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,364.21,22,,percent of total billed charges,,,,,,,,,1311.17,90,,percent of total billed charges,,,1206.27,82.8,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,,,,,,,,1282.03,88,,percent of total billed charges,,,,,,,,,1113.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,364.21,22,,percent of total billed charges,,,1325.73,91,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1209.19,83,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1194.62,82,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,364.21,1384.01,
SYNTHES SCREW LOCKING VA 3.5 X 38MM,30186637,CDM,,,278,RC,outpatient,,1456.85,1456.85,,1236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,364.21,22,,percent of total billed charges,,,,,,,,,1311.17,90,,percent of total billed charges,,,1206.27,82.8,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,,,,,,,,1282.03,88,,percent of total billed charges,,,,,,,,,1113.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,364.21,22,,percent of total billed charges,,,1325.73,91,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1209.19,83,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1194.62,82,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,364.21,1384.01,
SYNTHES SCREW LOCKING VA 3.5 X 75MM,30186638,CDM,,,278,RC,outpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375.13,22,,percent of total billed charges,,,,,,,,,1350.48,90,,percent of total billed charges,,,1242.44,82.8,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,375.13,22,,percent of total billed charges,,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,375.13,1425.5,
SYNTHES SCREW LOCKING VA 3.5 X 85MM,30186639,CDM,,,278,RC,outpatient,,1456.85,1456.85,,1236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,364.21,22,,percent of total billed charges,,,,,,,,,1311.17,90,,percent of total billed charges,,,1206.27,82.8,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,,,,,,,,1282.03,88,,percent of total billed charges,,,,,,,,,1113.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,364.21,22,,percent of total billed charges,,,1325.73,91,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1209.19,83,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1194.62,82,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,364.21,1384.01,
STRYKER SPINEJACK CASE KIT 50MM,30186640,CDM,,,270,RC,outpatient,,27072.5,27072.5,,22984.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6768.13,22,,percent of total billed charges,,,,,,,,,24365.25,90,,percent of total billed charges,,,22416.03,82.8,,percent of total billed charges,,,23011.63,85,,percent of total billed charges,,,,,,,,,23823.8,88,,percent of total billed charges,,,,,,,,,20683.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6768.13,22,,percent of total billed charges,,,24635.98,91,,percent of total billed charges,,,25718.88,95,,percent of total billed charges,,,22470.18,83,,percent of total billed charges,,,22470.18,83,,percent of total billed charges,,,,,,,,,,,,,,,22470.18,83,,percent of total billed charges,,,25718.88,95,,percent of total billed charges,,,24365.25,90,,percent of total billed charges,,,24365.25,90,,percent of total billed charges,,,22199.45,82,,percent of total billed charges,,,24365.25,90,,percent of total billed charges,,,23011.63,85,,percent of total billed charges,,6768.13,25718.88,
STRYKER INJECTOR TRANSFER TUBE,30186641,CDM,,,270,RC,outpatient,,461.23,461.23,,391.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.31,22,,percent of total billed charges,,,,,,,,,415.11,90,,percent of total billed charges,,,381.9,82.8,,percent of total billed charges,,,392.05,85,,percent of total billed charges,,,,,,,,,405.88,88,,percent of total billed charges,,,,,,,,,352.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.31,22,,percent of total billed charges,,,419.72,91,,percent of total billed charges,,,438.17,95,,percent of total billed charges,,,382.82,83,,percent of total billed charges,,,382.82,83,,percent of total billed charges,,,,,,,,,,,,,,,382.82,83,,percent of total billed charges,,,438.17,95,,percent of total billed charges,,,415.11,90,,percent of total billed charges,,,415.11,90,,percent of total billed charges,,,378.21,82,,percent of total billed charges,,,415.11,90,,percent of total billed charges,,,392.05,85,,percent of total billed charges,,115.31,438.17,
MENTOR MEMORYGEL BREAST IMPLANT 325CC,30186642,CDM,,,278,RC,outpatient,,6207.5,6207.5,,5270.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1551.88,22,,percent of total billed charges,,,,,,,,,5586.75,90,,percent of total billed charges,,,5139.81,82.8,,percent of total billed charges,,,5276.38,85,,percent of total billed charges,,,,,,,,,5462.6,88,,percent of total billed charges,,,,,,,,,4742.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1551.88,22,,percent of total billed charges,,,5648.83,91,,percent of total billed charges,,,5897.13,95,,percent of total billed charges,,,5152.23,83,,percent of total billed charges,,,5152.23,83,,percent of total billed charges,,,,,,,,,,,,,,,5152.23,83,,percent of total billed charges,,,5897.13,95,,percent of total billed charges,,,5586.75,90,,percent of total billed charges,,,5586.75,90,,percent of total billed charges,,,5090.15,82,,percent of total billed charges,,,5586.75,90,,percent of total billed charges,,,5276.38,85,,percent of total billed charges,,1551.88,5897.13,
DEPUY PRESSFIT INSERT SZ 6 8MM,30186644,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
EXACTECH CAGE GLENOID CEMENTED MEDIUM BE,30186645,CDM,,,278,RC,outpatient,,29211,29211,,24800.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7302.75,22,,percent of total billed charges,,,,,,,,,26289.9,90,,percent of total billed charges,,,24186.71,82.8,,percent of total billed charges,,,24829.35,85,,percent of total billed charges,,,,,,,,,25705.68,88,,percent of total billed charges,,,,,,,,,22317.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7302.75,22,,percent of total billed charges,,,26582.01,91,,percent of total billed charges,,,27750.45,95,,percent of total billed charges,,,24245.13,83,,percent of total billed charges,,,24245.13,83,,percent of total billed charges,,,,,,,,,,,,,,,24245.13,83,,percent of total billed charges,,,27750.45,95,,percent of total billed charges,,,26289.9,90,,percent of total billed charges,,,26289.9,90,,percent of total billed charges,,,23953.02,82,,percent of total billed charges,,,26289.9,90,,percent of total billed charges,,,24829.35,85,,percent of total billed charges,,7302.75,27750.45,
EXACTECH PLATE REPLICATOR 4.5MM SHORT,30186646,CDM,,,278,RC,outpatient,,18083,18083,,15352.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4520.75,22,,percent of total billed charges,,,,,,,,,16274.7,90,,percent of total billed charges,,,14972.72,82.8,,percent of total billed charges,,,15370.55,85,,percent of total billed charges,,,,,,,,,15913.04,88,,percent of total billed charges,,,,,,,,,13815.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4520.75,22,,percent of total billed charges,,,16455.53,91,,percent of total billed charges,,,17178.85,95,,percent of total billed charges,,,15008.89,83,,percent of total billed charges,,,15008.89,83,,percent of total billed charges,,,,,,,,,,,,,,,15008.89,83,,percent of total billed charges,,,17178.85,95,,percent of total billed charges,,,16274.7,90,,percent of total billed charges,,,16274.7,90,,percent of total billed charges,,,14828.06,82,,percent of total billed charges,,,16274.7,90,,percent of total billed charges,,,15370.55,85,,percent of total billed charges,,4520.75,17178.85,
EXACTECH HEAD HUMERAL EXTRA SHORT 47X15M,30186647,CDM,,,278,RC,outpatient,,23088,23088,,19601.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5772,22,,percent of total billed charges,,,,,,,,,20779.2,90,,percent of total billed charges,,,19116.86,82.8,,percent of total billed charges,,,19624.8,85,,percent of total billed charges,,,,,,,,,20317.44,88,,percent of total billed charges,,,,,,,,,17639.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5772,22,,percent of total billed charges,,,21010.08,91,,percent of total billed charges,,,21933.6,95,,percent of total billed charges,,,19163.04,83,,percent of total billed charges,,,19163.04,83,,percent of total billed charges,,,,,,,,,,,,,,,19163.04,83,,percent of total billed charges,,,21933.6,95,,percent of total billed charges,,,20779.2,90,,percent of total billed charges,,,20779.2,90,,percent of total billed charges,,,18932.16,82,,percent of total billed charges,,,20779.2,90,,percent of total billed charges,,,19624.8,85,,percent of total billed charges,,5772,21933.6,
SPINECRAFT SCREW REDUCTION 6.0 X 45MM,30186648,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
SPINECRAFT ROD LORDOSED 6.0 X 45MM,30186649,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
MITEK HEALIX ADVANCE KNOTLESS 5.5,30186650,CDM,,,278,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
S&N ENDO BICEPTOR KIT SCREW 8 X 15,30186651,CDM,,,270,RC,outpatient,,2657.27,2657.27,,2256.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,664.32,22,,percent of total billed charges,,,,,,,,,2391.54,90,,percent of total billed charges,,,2200.22,82.8,,percent of total billed charges,,,2258.68,85,,percent of total billed charges,,,,,,,,,2338.4,88,,percent of total billed charges,,,,,,,,,2030.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,664.32,22,,percent of total billed charges,,,2418.12,91,,percent of total billed charges,,,2524.41,95,,percent of total billed charges,,,2205.53,83,,percent of total billed charges,,,2205.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2205.53,83,,percent of total billed charges,,,2524.41,95,,percent of total billed charges,,,2391.54,90,,percent of total billed charges,,,2391.54,90,,percent of total billed charges,,,2178.96,82,,percent of total billed charges,,,2391.54,90,,percent of total billed charges,,,2258.68,85,,percent of total billed charges,,664.32,2524.41,
EX-FUSE DBM PUTTY 10CC,30186655,CDM,,,278,RC,outpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2437.5,22,,percent of total billed charges,,,,,,,,,8775,90,,percent of total billed charges,,,8073,82.8,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2437.5,22,,percent of total billed charges,,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,2437.5,9262.5,
SPINECRAFT CROSS CONNECTOR 39-50MM,30186656,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
VTI INTERFUSE B FUSION DEVICE 10MM,30186657,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT REVISION REMOVAL SET,30186658,CDM,,,270,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
SYNTHES PLATE HUMERUS PROX. LCP 3.5,30186659,CDM,,,278,RC,outpatient,,17944.88,17944.88,,15235.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4486.22,22,,percent of total billed charges,,,,,,,,,16150.39,90,,percent of total billed charges,,,14858.36,82.8,,percent of total billed charges,,,15253.15,85,,percent of total billed charges,,,,,,,,,15791.49,88,,percent of total billed charges,,,,,,,,,13709.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4486.22,22,,percent of total billed charges,,,16329.84,91,,percent of total billed charges,,,17047.64,95,,percent of total billed charges,,,14894.25,83,,percent of total billed charges,,,14894.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14894.25,83,,percent of total billed charges,,,17047.64,95,,percent of total billed charges,,,16150.39,90,,percent of total billed charges,,,16150.39,90,,percent of total billed charges,,,14714.8,82,,percent of total billed charges,,,16150.39,90,,percent of total billed charges,,,15253.15,85,,percent of total billed charges,,4486.22,17047.64,
SORBAFIX SHOT 15,30186660,CDM,,,270,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
DEPUY CANAL BRUSH,30186661,CDM,,,270,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
DEPUY TREPHINE 16MM,30186662,CDM,,,278,RC,outpatient,,8333,8333,,7074.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2083.25,22,,percent of total billed charges,,,,,,,,,7499.7,90,,percent of total billed charges,,,6899.72,82.8,,percent of total billed charges,,,7083.05,85,,percent of total billed charges,,,,,,,,,7333.04,88,,percent of total billed charges,,,,,,,,,6366.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2083.25,22,,percent of total billed charges,,,7583.03,91,,percent of total billed charges,,,7916.35,95,,percent of total billed charges,,,6916.39,83,,percent of total billed charges,,,6916.39,83,,percent of total billed charges,,,,,,,,,,,,,,,6916.39,83,,percent of total billed charges,,,7916.35,95,,percent of total billed charges,,,7499.7,90,,percent of total billed charges,,,7499.7,90,,percent of total billed charges,,,6833.06,82,,percent of total billed charges,,,7499.7,90,,percent of total billed charges,,,7083.05,85,,percent of total billed charges,,2083.25,7916.35,
ZIMMER FEMORAL HEAD CERAMIC 36MM -3.0MM,30186663,CDM,,,278,RC,outpatient,,26390,26390,,22405.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6597.5,22,,percent of total billed charges,,,,,,,,,23751,90,,percent of total billed charges,,,21850.92,82.8,,percent of total billed charges,,,22431.5,85,,percent of total billed charges,,,,,,,,,23223.2,88,,percent of total billed charges,,,,,,,,,20161.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6597.5,22,,percent of total billed charges,,,24014.9,91,,percent of total billed charges,,,25070.5,95,,percent of total billed charges,,,21903.7,83,,percent of total billed charges,,,21903.7,83,,percent of total billed charges,,,,,,,,,,,,,,,21903.7,83,,percent of total billed charges,,,25070.5,95,,percent of total billed charges,,,23751,90,,percent of total billed charges,,,23751,90,,percent of total billed charges,,,21639.8,82,,percent of total billed charges,,,23751,90,,percent of total billed charges,,,22431.5,85,,percent of total billed charges,,6597.5,25070.5,
ZIMMER STEM FEMORAL REVISION WAGNER 22X3,30186664,CDM,,,278,RC,outpatient,,78000,78000,,66222,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19500,22,,percent of total billed charges,,,,,,,,,70200,90,,percent of total billed charges,,,64584,82.8,,percent of total billed charges,,,66300,85,,percent of total billed charges,,,,,,,,,68640,88,,percent of total billed charges,,,,,,,,,59592,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19500,22,,percent of total billed charges,,,70980,91,,percent of total billed charges,,,74100,95,,percent of total billed charges,,,64740,83,,percent of total billed charges,,,64740,83,,percent of total billed charges,,,,,,,,,,,,,,,64740,83,,percent of total billed charges,,,74100,95,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,63960,82,,percent of total billed charges,,,70200,90,,percent of total billed charges,,,66300,85,,percent of total billed charges,,19500,74100,
ARTHREX MCL 1B,30186665,CDM,,,278,RC,outpatient,,7767.5,7767.5,,6594.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1941.88,22,,percent of total billed charges,,,,,,,,,6990.75,90,,percent of total billed charges,,,6431.49,82.8,,percent of total billed charges,,,6602.38,85,,percent of total billed charges,,,,,,,,,6835.4,88,,percent of total billed charges,,,,,,,,,5934.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1941.88,22,,percent of total billed charges,,,7068.43,91,,percent of total billed charges,,,7379.13,95,,percent of total billed charges,,,6447.03,83,,percent of total billed charges,,,6447.03,83,,percent of total billed charges,,,,,,,,,,,,,,,6447.03,83,,percent of total billed charges,,,7379.13,95,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6369.35,82,,percent of total billed charges,,,6990.75,90,,percent of total billed charges,,,6602.38,85,,percent of total billed charges,,1941.88,7379.13,
SYNTHES SCREW LOCKING S-T 2.7X28MM W/STA,30186666,CDM,,,278,RC,outpatient,,1143.87,1143.87,,971.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,285.97,22,,percent of total billed charges,,,,,,,,,1029.48,90,,percent of total billed charges,,,947.12,82.8,,percent of total billed charges,,,972.29,85,,percent of total billed charges,,,,,,,,,1006.61,88,,percent of total billed charges,,,,,,,,,873.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,285.97,22,,percent of total billed charges,,,1040.92,91,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,949.41,83,,percent of total billed charges,,,,,,,,,,,,,,,949.41,83,,percent of total billed charges,,,1086.68,95,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,937.97,82,,percent of total billed charges,,,1029.48,90,,percent of total billed charges,,,972.29,85,,percent of total billed charges,,285.97,1086.68,
ZIMMER INSERT CR 10MM RIGHT,30186667,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
SYNTHES SCREW CANNUL 4.0X30MM,30186669,CDM,,,278,RC,outpatient,,2003.17,2003.17,,1700.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,500.79,22,,percent of total billed charges,,,,,,,,,1802.85,90,,percent of total billed charges,,,1658.62,82.8,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,,,,,,,,1762.79,88,,percent of total billed charges,,,,,,,,,1530.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,500.79,22,,percent of total billed charges,,,1822.88,91,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,1662.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1662.63,83,,percent of total billed charges,,,1903.01,95,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1642.6,82,,percent of total billed charges,,,1802.85,90,,percent of total billed charges,,,1702.69,85,,percent of total billed charges,,500.79,1903.01,
ZIMMER LINER CEMENTED CONSTRAINED 36MM,30186670,CDM,,,278,RC,outpatient,,45630,45630,,38739.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11407.5,22,,percent of total billed charges,,,,,,,,,41067,90,,percent of total billed charges,,,37781.64,82.8,,percent of total billed charges,,,38785.5,85,,percent of total billed charges,,,,,,,,,40154.4,88,,percent of total billed charges,,,,,,,,,34861.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11407.5,22,,percent of total billed charges,,,41523.3,91,,percent of total billed charges,,,43348.5,95,,percent of total billed charges,,,37872.9,83,,percent of total billed charges,,,37872.9,83,,percent of total billed charges,,,,,,,,,,,,,,,37872.9,83,,percent of total billed charges,,,43348.5,95,,percent of total billed charges,,,41067,90,,percent of total billed charges,,,41067,90,,percent of total billed charges,,,37416.6,82,,percent of total billed charges,,,41067,90,,percent of total billed charges,,,38785.5,85,,percent of total billed charges,,11407.5,43348.5,
ZIMMER HEAD FEMORAL 36MM +3.5 6 DEG TAPE,30186671,CDM,,,278,RC,outpatient,,10595,10595,,8995.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2648.75,22,,percent of total billed charges,,,,,,,,,9535.5,90,,percent of total billed charges,,,8772.66,82.8,,percent of total billed charges,,,9005.75,85,,percent of total billed charges,,,,,,,,,9323.6,88,,percent of total billed charges,,,,,,,,,8094.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2648.75,22,,percent of total billed charges,,,9641.45,91,,percent of total billed charges,,,10065.25,95,,percent of total billed charges,,,8793.85,83,,percent of total billed charges,,,8793.85,83,,percent of total billed charges,,,,,,,,,,,,,,,8793.85,83,,percent of total billed charges,,,10065.25,95,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,8687.9,82,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,9005.75,85,,percent of total billed charges,,2648.75,10065.25,
ZIMMER BLADE STRYK-76542K-19X19X1.19G,30186672,CDM,,,270,RC,outpatient,,371.7,371.7,,315.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.93,22,,percent of total billed charges,,,,,,,,,334.53,90,,percent of total billed charges,,,307.77,82.8,,percent of total billed charges,,,315.95,85,,percent of total billed charges,,,,,,,,,327.1,88,,percent of total billed charges,,,,,,,,,283.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.93,22,,percent of total billed charges,,,338.25,91,,percent of total billed charges,,,353.12,95,,percent of total billed charges,,,308.51,83,,percent of total billed charges,,,308.51,83,,percent of total billed charges,,,,,,,,,,,,,,,308.51,83,,percent of total billed charges,,,353.12,95,,percent of total billed charges,,,334.53,90,,percent of total billed charges,,,334.53,90,,percent of total billed charges,,,304.79,82,,percent of total billed charges,,,334.53,90,,percent of total billed charges,,,315.95,85,,percent of total billed charges,,92.93,353.12,
SYNTHES SCREW LOCKING 5.0 X 44MM,30186673,CDM,,,278,RC,outpatient,,2121.6,2121.6,,1801.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,530.4,22,,percent of total billed charges,,,,,,,,,1909.44,90,,percent of total billed charges,,,1756.68,82.8,,percent of total billed charges,,,1803.36,85,,percent of total billed charges,,,,,,,,,1867.01,88,,percent of total billed charges,,,,,,,,,1620.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,530.4,22,,percent of total billed charges,,,1930.66,91,,percent of total billed charges,,,2015.52,95,,percent of total billed charges,,,1760.93,83,,percent of total billed charges,,,1760.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1760.93,83,,percent of total billed charges,,,2015.52,95,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1739.71,82,,percent of total billed charges,,,1909.44,90,,percent of total billed charges,,,1803.36,85,,percent of total billed charges,,530.4,2015.52,
NUVASIVE SCREW HELIX R 4X13MM,30186674,CDM,,,278,RC,outpatient,,3653,3653,,3101.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,913.25,22,,percent of total billed charges,,,,,,,,,3287.7,90,,percent of total billed charges,,,3024.68,82.8,,percent of total billed charges,,,3105.05,85,,percent of total billed charges,,,,,,,,,3214.64,88,,percent of total billed charges,,,,,,,,,2790.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,913.25,22,,percent of total billed charges,,,3324.23,91,,percent of total billed charges,,,3470.35,95,,percent of total billed charges,,,3031.99,83,,percent of total billed charges,,,3031.99,83,,percent of total billed charges,,,,,,,,,,,,,,,3031.99,83,,percent of total billed charges,,,3470.35,95,,percent of total billed charges,,,3287.7,90,,percent of total billed charges,,,3287.7,90,,percent of total billed charges,,,2995.46,82,,percent of total billed charges,,,3287.7,90,,percent of total billed charges,,,3105.05,85,,percent of total billed charges,,913.25,3470.35,
NUVASIVE PLATE HELIX  24MM,30186675,CDM,,,278,RC,outpatient,,10588.5,10588.5,,8989.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2647.13,22,,percent of total billed charges,,,,,,,,,9529.65,90,,percent of total billed charges,,,8767.28,82.8,,percent of total billed charges,,,9000.23,85,,percent of total billed charges,,,,,,,,,9317.88,88,,percent of total billed charges,,,,,,,,,8089.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2647.13,22,,percent of total billed charges,,,9635.54,91,,percent of total billed charges,,,10059.08,95,,percent of total billed charges,,,8788.46,83,,percent of total billed charges,,,8788.46,83,,percent of total billed charges,,,,,,,,,,,,,,,8788.46,83,,percent of total billed charges,,,10059.08,95,,percent of total billed charges,,,9529.65,90,,percent of total billed charges,,,9529.65,90,,percent of total billed charges,,,8682.57,82,,percent of total billed charges,,,9529.65,90,,percent of total billed charges,,,9000.23,85,,percent of total billed charges,,2647.13,10059.08,
OLYMPUS ELEVIEW,30186677,CDM,,,270,RC,outpatient,,567,567,,481.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141.75,22,,percent of total billed charges,,,,,,,,,510.3,90,,percent of total billed charges,,,469.48,82.8,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,,,,,,,,498.96,88,,percent of total billed charges,,,,,,,,,433.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141.75,22,,percent of total billed charges,,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,,,,,,,,,,,,,470.61,83,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,464.94,82,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,141.75,538.65,
ZIMMER BEARING MC 12MM,30186678,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
DEPUY HEAD HUMERAL ECCENTRIC 44EZI,30186679,CDM,,,278,RC,outpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4409.03,22,,percent of total billed charges,,,,,,,,,15872.52,90,,percent of total billed charges,,,14602.72,82.8,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4409.03,22,,percent of total billed charges,,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,4409.03,16754.32,
DEPUY BODY 142 DEG SZ 10,30186680,CDM,,,278,RC,outpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3163.67,22,,percent of total billed charges,,,,,,,,,11389.19,90,,percent of total billed charges,,,10478.06,82.8,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3163.67,22,,percent of total billed charges,,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,3163.67,12021.93,
DEPUY STEM UNITE STD SZ 10,30186681,CDM,,,278,RC,outpatient,,26023.86,26023.86,,22094.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6505.97,22,,percent of total billed charges,,,,,,,,,23421.47,90,,percent of total billed charges,,,21547.76,82.8,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,,,,,,,,22901,88,,percent of total billed charges,,,,,,,,,19882.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6505.97,22,,percent of total billed charges,,,23681.71,91,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21599.8,83,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,21339.57,82,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,6505.97,24722.67,
DEPUY GLENOSPHERE ECCENTRIC 42MM +4,30186682,CDM,,,278,RC,outpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4954.14,22,,percent of total billed charges,,,,,,,,,17834.9,90,,percent of total billed charges,,,16408.1,82.8,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4954.14,22,,percent of total billed charges,,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,4954.14,18825.72,
ZIMMER TIBIA POROUS 11MM RIGHT,30186683,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER FEMUR POROUS CR SZ 8 RIGHT,30186684,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER INSERT ASF 12MM 7-12 GH RIGHT,30186685,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ABBOTT LOOP RECORDER,30186686,CDM,,,278,RC,outpatient,,33800,33800,,28696.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8450,22,,percent of total billed charges,,,,,,,,,30420,90,,percent of total billed charges,,,27986.4,82.8,,percent of total billed charges,,,28730,85,,percent of total billed charges,,,,,,,,,29744,88,,percent of total billed charges,,,,,,,,,25823.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8450,22,,percent of total billed charges,,,30758,91,,percent of total billed charges,,,32110,95,,percent of total billed charges,,,28054,83,,percent of total billed charges,,,28054,83,,percent of total billed charges,,,,,,,,,,,,,,,28054,83,,percent of total billed charges,,,32110,95,,percent of total billed charges,,,30420,90,,percent of total billed charges,,,30420,90,,percent of total billed charges,,,27716,82,,percent of total billed charges,,,30420,90,,percent of total billed charges,,,28730,85,,percent of total billed charges,,8450,32110,
S&N HIP PREP KIT,30186687,CDM,,,270,RC,outpatient,,4602,4602,,3907.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1150.5,22,,percent of total billed charges,,,,,,,,,4141.8,90,,percent of total billed charges,,,3810.46,82.8,,percent of total billed charges,,,3911.7,85,,percent of total billed charges,,,,,,,,,4049.76,88,,percent of total billed charges,,,,,,,,,3515.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1150.5,22,,percent of total billed charges,,,4187.82,91,,percent of total billed charges,,,4371.9,95,,percent of total billed charges,,,3819.66,83,,percent of total billed charges,,,3819.66,83,,percent of total billed charges,,,,,,,,,,,,,,,3819.66,83,,percent of total billed charges,,,4371.9,95,,percent of total billed charges,,,4141.8,90,,percent of total billed charges,,,4141.8,90,,percent of total billed charges,,,3773.64,82,,percent of total billed charges,,,4141.8,90,,percent of total billed charges,,,3911.7,85,,percent of total billed charges,,1150.5,4371.9,
ZIMMER INSERT TIBIAL 11MM 7-12GH,30186688,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
GLOBUS RISE SPACER 8X22MM 10 DEG,30186689,CDM,,,278,RC,outpatient,,35750,35750,,30351.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8937.5,22,,percent of total billed charges,,,,,,,,,32175,90,,percent of total billed charges,,,29601,82.8,,percent of total billed charges,,,30387.5,85,,percent of total billed charges,,,,,,,,,31460,88,,percent of total billed charges,,,,,,,,,27313,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8937.5,22,,percent of total billed charges,,,32532.5,91,,percent of total billed charges,,,33962.5,95,,percent of total billed charges,,,29672.5,83,,percent of total billed charges,,,29672.5,83,,percent of total billed charges,,,,,,,,,,,,,,,29672.5,83,,percent of total billed charges,,,33962.5,95,,percent of total billed charges,,,32175,90,,percent of total billed charges,,,32175,90,,percent of total billed charges,,,29315,82,,percent of total billed charges,,,32175,90,,percent of total billed charges,,,30387.5,85,,percent of total billed charges,,8937.5,33962.5,
NUVASIVE SCREW SHANK 5.5X40MM 2S,30186690,CDM,,,278,RC,outpatient,,11970,11970,,10162.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2992.5,22,,percent of total billed charges,,,,,,,,,10773,90,,percent of total billed charges,,,9911.16,82.8,,percent of total billed charges,,,10174.5,85,,percent of total billed charges,,,,,,,,,10533.6,88,,percent of total billed charges,,,,,,,,,9145.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2992.5,22,,percent of total billed charges,,,10892.7,91,,percent of total billed charges,,,11371.5,95,,percent of total billed charges,,,9935.1,83,,percent of total billed charges,,,9935.1,83,,percent of total billed charges,,,,,,,,,,,,,,,9935.1,83,,percent of total billed charges,,,11371.5,95,,percent of total billed charges,,,10773,90,,percent of total billed charges,,,10773,90,,percent of total billed charges,,,9815.4,82,,percent of total billed charges,,,10773,90,,percent of total billed charges,,,10174.5,85,,percent of total billed charges,,2992.5,11371.5,
NUVASIVE SCREW SHANK 5.5X50MM 2S,30186691,CDM,,,278,RC,outpatient,,12967.5,12967.5,,11009.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3241.88,22,,percent of total billed charges,,,,,,,,,11670.75,90,,percent of total billed charges,,,10737.09,82.8,,percent of total billed charges,,,11022.38,85,,percent of total billed charges,,,,,,,,,11411.4,88,,percent of total billed charges,,,,,,,,,9907.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3241.88,22,,percent of total billed charges,,,11800.43,91,,percent of total billed charges,,,12319.13,95,,percent of total billed charges,,,10763.03,83,,percent of total billed charges,,,10763.03,83,,percent of total billed charges,,,,,,,,,,,,,,,10763.03,83,,percent of total billed charges,,,12319.13,95,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,10633.35,82,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,11022.38,85,,percent of total billed charges,,3241.88,12319.13,
NUVASIVE  ROD TULIP PPS SPHERX 5.5MM,30186692,CDM,,,278,RC,outpatient,,8339.5,8339.5,,7080.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2084.88,22,,percent of total billed charges,,,,,,,,,7505.55,90,,percent of total billed charges,,,6905.11,82.8,,percent of total billed charges,,,7088.58,85,,percent of total billed charges,,,,,,,,,7338.76,88,,percent of total billed charges,,,,,,,,,6371.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2084.88,22,,percent of total billed charges,,,7588.95,91,,percent of total billed charges,,,7922.53,95,,percent of total billed charges,,,6921.79,83,,percent of total billed charges,,,6921.79,83,,percent of total billed charges,,,,,,,,,,,,,,,6921.79,83,,percent of total billed charges,,,7922.53,95,,percent of total billed charges,,,7505.55,90,,percent of total billed charges,,,7505.55,90,,percent of total billed charges,,,6838.39,82,,percent of total billed charges,,,7505.55,90,,percent of total billed charges,,,7088.58,85,,percent of total billed charges,,2084.88,7922.53,
NUVASIVE  SCREW LOCK 5.5MM ROD,30186693,CDM,,,278,RC,outpatient,,2444,2444,,2074.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,611,22,,percent of total billed charges,,,,,,,,,2199.6,90,,percent of total billed charges,,,2023.63,82.8,,percent of total billed charges,,,2077.4,85,,percent of total billed charges,,,,,,,,,2150.72,88,,percent of total billed charges,,,,,,,,,1867.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,611,22,,percent of total billed charges,,,2224.04,91,,percent of total billed charges,,,2321.8,95,,percent of total billed charges,,,2028.52,83,,percent of total billed charges,,,2028.52,83,,percent of total billed charges,,,,,,,,,,,,,,,2028.52,83,,percent of total billed charges,,,2321.8,95,,percent of total billed charges,,,2199.6,90,,percent of total billed charges,,,2199.6,90,,percent of total billed charges,,,2004.08,82,,percent of total billed charges,,,2199.6,90,,percent of total billed charges,,,2077.4,85,,percent of total billed charges,,611,2321.8,
NUVASIVE  ROD PRE-BENT 5.5X40MM,30186694,CDM,,,278,RC,outpatient,,5401.5,5401.5,,4585.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1350.38,22,,percent of total billed charges,,,,,,,,,4861.35,90,,percent of total billed charges,,,4472.44,82.8,,percent of total billed charges,,,4591.28,85,,percent of total billed charges,,,,,,,,,4753.32,88,,percent of total billed charges,,,,,,,,,4126.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1350.38,22,,percent of total billed charges,,,4915.37,91,,percent of total billed charges,,,5131.43,95,,percent of total billed charges,,,4483.25,83,,percent of total billed charges,,,4483.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4483.25,83,,percent of total billed charges,,,5131.43,95,,percent of total billed charges,,,4861.35,90,,percent of total billed charges,,,4861.35,90,,percent of total billed charges,,,4429.23,82,,percent of total billed charges,,,4861.35,90,,percent of total billed charges,,,4591.28,85,,percent of total billed charges,,1350.38,5131.43,
NUVASIVE  ROD PRE-BENT 5.5X35MM,30186695,CDM,,,278,RC,outpatient,,5401.5,5401.5,,4585.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1350.38,22,,percent of total billed charges,,,,,,,,,4861.35,90,,percent of total billed charges,,,4472.44,82.8,,percent of total billed charges,,,4591.28,85,,percent of total billed charges,,,,,,,,,4753.32,88,,percent of total billed charges,,,,,,,,,4126.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1350.38,22,,percent of total billed charges,,,4915.37,91,,percent of total billed charges,,,5131.43,95,,percent of total billed charges,,,4483.25,83,,percent of total billed charges,,,4483.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4483.25,83,,percent of total billed charges,,,5131.43,95,,percent of total billed charges,,,4861.35,90,,percent of total billed charges,,,4861.35,90,,percent of total billed charges,,,4429.23,82,,percent of total billed charges,,,4861.35,90,,percent of total billed charges,,,4591.28,85,,percent of total billed charges,,1350.38,5131.43,
STRYKER CMF SCREW MP SD 2.0 X 6MM,30186696,CDM,,,278,RC,outpatient,,522.06,522.06,,443.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.52,22,,percent of total billed charges,,,,,,,,,469.85,90,,percent of total billed charges,,,432.27,82.8,,percent of total billed charges,,,443.75,85,,percent of total billed charges,,,,,,,,,459.41,88,,percent of total billed charges,,,,,,,,,398.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.52,22,,percent of total billed charges,,,475.07,91,,percent of total billed charges,,,495.96,95,,percent of total billed charges,,,433.31,83,,percent of total billed charges,,,433.31,83,,percent of total billed charges,,,,,,,,,,,,,,,433.31,83,,percent of total billed charges,,,495.96,95,,percent of total billed charges,,,469.85,90,,percent of total billed charges,,,469.85,90,,percent of total billed charges,,,428.09,82,,percent of total billed charges,,,469.85,90,,percent of total billed charges,,,443.75,85,,percent of total billed charges,,130.52,495.96,
ZIMMER FEMUR PSN SZ 12 LEFT,30186697,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER BLADE STRYK_76542K_25X90X1.19G,30186698,CDM,,,270,RC,outpatient,,359.1,359.1,,304.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.78,22,,percent of total billed charges,,,,,,,,,323.19,90,,percent of total billed charges,,,297.33,82.8,,percent of total billed charges,,,305.24,85,,percent of total billed charges,,,,,,,,,316.01,88,,percent of total billed charges,,,,,,,,,274.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.78,22,,percent of total billed charges,,,326.78,91,,percent of total billed charges,,,341.15,95,,percent of total billed charges,,,298.05,83,,percent of total billed charges,,,298.05,83,,percent of total billed charges,,,,,,,,,,,,,,,298.05,83,,percent of total billed charges,,,341.15,95,,percent of total billed charges,,,323.19,90,,percent of total billed charges,,,323.19,90,,percent of total billed charges,,,294.46,82,,percent of total billed charges,,,323.19,90,,percent of total billed charges,,,305.24,85,,percent of total billed charges,,89.78,341.15,
DEPUY ATTUNE TIBIA RP REVISION SZ 7,30186700,CDM,,,278,RC,outpatient,,39503.36,39503.36,,33538.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9875.84,22,,percent of total billed charges,,,,,,,,,35553.02,90,,percent of total billed charges,,,32708.78,82.8,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,,,,,,,,34762.96,88,,percent of total billed charges,,,,,,,,,30180.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9875.84,22,,percent of total billed charges,,,35948.06,91,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32787.79,83,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,32392.76,82,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,9875.84,37528.19,
DEPUY PRESSFIT FEMUR CEMTLESS SZ 5 LEFT,30186701,CDM,,,278,RC,outpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10046.3,22,,percent of total billed charges,,,,,,,,,36166.69,90,,percent of total billed charges,,,33273.35,82.8,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10046.3,22,,percent of total billed charges,,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,10046.3,38175.95,
DEPUY INSERT ATTUNE RP PS SZ 9 7MM,30186703,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
SYNTHES PLATE CALC RIGHT 3.5MM 6H,30186704,CDM,,,278,RC,outpatient,,8923.07,8923.07,,7575.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2230.77,22,,percent of total billed charges,,,,,,,,,8030.76,90,,percent of total billed charges,,,7388.3,82.8,,percent of total billed charges,,,7584.61,85,,percent of total billed charges,,,,,,,,,7852.3,88,,percent of total billed charges,,,,,,,,,6817.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2230.77,22,,percent of total billed charges,,,8119.99,91,,percent of total billed charges,,,8476.92,95,,percent of total billed charges,,,7406.15,83,,percent of total billed charges,,,7406.15,83,,percent of total billed charges,,,,,,,,,,,,,,,7406.15,83,,percent of total billed charges,,,8476.92,95,,percent of total billed charges,,,8030.76,90,,percent of total billed charges,,,8030.76,90,,percent of total billed charges,,,7316.92,82,,percent of total billed charges,,,8030.76,90,,percent of total billed charges,,,7584.61,85,,percent of total billed charges,,2230.77,8476.92,
SYNTHES PLATE TIBIA MEDIAL DISTAL 4H 2.7,30186705,CDM,,,278,RC,outpatient,,15194.34,15194.34,,12899.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3798.59,22,,percent of total billed charges,,,,,,,,,13674.91,90,,percent of total billed charges,,,12580.91,82.8,,percent of total billed charges,,,12915.19,85,,percent of total billed charges,,,,,,,,,13371.02,88,,percent of total billed charges,,,,,,,,,11608.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3798.59,22,,percent of total billed charges,,,13826.85,91,,percent of total billed charges,,,14434.62,95,,percent of total billed charges,,,12611.3,83,,percent of total billed charges,,,12611.3,83,,percent of total billed charges,,,,,,,,,,,,,,,12611.3,83,,percent of total billed charges,,,14434.62,95,,percent of total billed charges,,,13674.91,90,,percent of total billed charges,,,13674.91,90,,percent of total billed charges,,,12459.36,82,,percent of total billed charges,,,13674.91,90,,percent of total billed charges,,,12915.19,85,,percent of total billed charges,,3798.59,14434.62,
SYNTHES SCREW METAPHYSEAL 2.7 X 30MM,30186706,CDM,,,278,RC,outpatient,,478.03,478.03,,405.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.51,22,,percent of total billed charges,,,,,,,,,430.23,90,,percent of total billed charges,,,395.81,82.8,,percent of total billed charges,,,406.33,85,,percent of total billed charges,,,,,,,,,420.67,88,,percent of total billed charges,,,,,,,,,365.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.51,22,,percent of total billed charges,,,435.01,91,,percent of total billed charges,,,454.13,95,,percent of total billed charges,,,396.76,83,,percent of total billed charges,,,396.76,83,,percent of total billed charges,,,,,,,,,,,,,,,396.76,83,,percent of total billed charges,,,454.13,95,,percent of total billed charges,,,430.23,90,,percent of total billed charges,,,430.23,90,,percent of total billed charges,,,391.98,82,,percent of total billed charges,,,430.23,90,,percent of total billed charges,,,406.33,85,,percent of total billed charges,,119.51,454.13,
SYNTHES SCREW METAPHYSEAL 2.7 X 38MM,30186707,CDM,,,278,RC,outpatient,,478.03,478.03,,405.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.51,22,,percent of total billed charges,,,,,,,,,430.23,90,,percent of total billed charges,,,395.81,82.8,,percent of total billed charges,,,406.33,85,,percent of total billed charges,,,,,,,,,420.67,88,,percent of total billed charges,,,,,,,,,365.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.51,22,,percent of total billed charges,,,435.01,91,,percent of total billed charges,,,454.13,95,,percent of total billed charges,,,396.76,83,,percent of total billed charges,,,396.76,83,,percent of total billed charges,,,,,,,,,,,,,,,396.76,83,,percent of total billed charges,,,454.13,95,,percent of total billed charges,,,430.23,90,,percent of total billed charges,,,430.23,90,,percent of total billed charges,,,391.98,82,,percent of total billed charges,,,430.23,90,,percent of total billed charges,,,406.33,85,,percent of total billed charges,,119.51,454.13,
SYNTHES SCREW METAPHYSEAL 2.7 X 36MM,30186708,CDM,,,278,RC,outpatient,,492.38,492.38,,418.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.1,22,,percent of total billed charges,,,,,,,,,443.14,90,,percent of total billed charges,,,407.69,82.8,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,,,,,,,,433.29,88,,percent of total billed charges,,,,,,,,,376.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.1,22,,percent of total billed charges,,,448.07,91,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,,,,,,,,,,,,,408.68,83,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,403.75,82,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,123.1,467.76,
SPINECRAFT ROD LORDOSED 6.0 X 110,30186709,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
BSS BALANCE SALT SOLUTION 500ML,30186710,CDM,,,270,RC,outpatient,,59.5,59.5,,50.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.88,22,,percent of total billed charges,,,,,,,,,53.55,90,,percent of total billed charges,,,49.27,82.8,,percent of total billed charges,,,50.58,85,,percent of total billed charges,,,,,,,,,52.36,88,,percent of total billed charges,,,,,,,,,45.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.88,22,,percent of total billed charges,,,54.15,91,,percent of total billed charges,,,56.53,95,,percent of total billed charges,,,49.39,83,,percent of total billed charges,,,49.39,83,,percent of total billed charges,,,,,,,,,,,,,,,49.39,83,,percent of total billed charges,,,56.53,95,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,48.79,82,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,50.58,85,,percent of total billed charges,,14.88,56.53,
ZIMMER LINER NEUTRAL G E1 36MM G7,30186711,CDM,,,278,RC,outpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5785,22,,percent of total billed charges,,,,,,,,,20826,90,,percent of total billed charges,,,19159.92,82.8,,percent of total billed charges,,,19669,85,,percent of total billed charges,,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5785,22,,percent of total billed charges,,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,5785,21983,
DEPUY ATTUNE TIBIA AUGMENT 5MM,30186712,CDM,,,278,RC,outpatient,,10997.61,10997.61,,9336.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2749.4,22,,percent of total billed charges,,,,,,,,,9897.85,90,,percent of total billed charges,,,9106.02,82.8,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,,,,,,,,9677.9,88,,percent of total billed charges,,,,,,,,,8402.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2749.4,22,,percent of total billed charges,,,10007.83,91,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,,,,,,,,,,,,,9128.02,83,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9018.04,82,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,2749.4,10447.73,
DEPUY ATTUNE INSERT CRS 8MM,30186713,CDM,,,278,RC,outpatient,,23578.82,23578.82,,20018.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5894.71,22,,percent of total billed charges,,,,,,,,,21220.94,90,,percent of total billed charges,,,19523.26,82.8,,percent of total billed charges,,,20042,85,,percent of total billed charges,,,,,,,,,20749.36,88,,percent of total billed charges,,,,,,,,,18014.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5894.71,22,,percent of total billed charges,,,21456.73,91,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,,,,,,,,,,,,,19570.42,83,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,19334.63,82,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,20042,85,,percent of total billed charges,,5894.71,22399.88,
DEPUY ATTUNE FEMUR CRS 5MM LEFT,30186714,CDM,,,278,RC,outpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13142.14,22,,percent of total billed charges,,,,,,,,,47311.7,90,,percent of total billed charges,,,43526.77,82.8,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13142.14,22,,percent of total billed charges,,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,13142.14,49940.13,
ZIMMER PATELLA CEMENTED 41MM,30186715,CDM,,,278,RC,outpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,568.75,22,,percent of total billed charges,,,,,,,,,2047.5,90,,percent of total billed charges,,,1883.7,82.8,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,568.75,22,,percent of total billed charges,,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,568.75,2161.25,
ZIMMER STEM EXTENSION 14X30MM,30186716,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
ZIMMER TIBIA PSN CEMENTED SZ H LEFT,30186717,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER INSERT MC 13MM LEFT,30186718,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ZIMMER REAMER BLADE 46MM,30186719,CDM,,,278,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
ZIMMER SCREW HEX 2.5MM,30186720,CDM,,,278,RC,outpatient,,1072.5,1072.5,,910.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,268.13,22,,percent of total billed charges,,,,,,,,,965.25,90,,percent of total billed charges,,,888.03,82.8,,percent of total billed charges,,,911.63,85,,percent of total billed charges,,,,,,,,,943.8,88,,percent of total billed charges,,,,,,,,,819.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,268.13,22,,percent of total billed charges,,,975.98,91,,percent of total billed charges,,,1018.88,95,,percent of total billed charges,,,890.18,83,,percent of total billed charges,,,890.18,83,,percent of total billed charges,,,,,,,,,,,,,,,890.18,83,,percent of total billed charges,,,1018.88,95,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,879.45,82,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,911.63,85,,percent of total billed charges,,268.13,1018.88,
DEPUY ATTUNE TIBIA PRESSFIT RP SZ10,30186721,CDM,,,278,RC,outpatient,,27458.8,27458.8,,23312.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6864.7,22,,percent of total billed charges,,,,,,,,,24712.92,90,,percent of total billed charges,,,22735.89,82.8,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,,,,,,,,24163.74,88,,percent of total billed charges,,,,,,,,,20978.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6864.7,22,,percent of total billed charges,,,24987.51,91,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,,,,,,,,,,,,,22790.8,83,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,22516.22,82,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,6864.7,26085.86,
SYNTHES PLATE TIBIA LB 3.5 VA 10H LEFT,30186722,CDM,,,278,RC,outpatient,,17578.73,17578.73,,14924.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4394.68,22,,percent of total billed charges,,,,,,,,,15820.86,90,,percent of total billed charges,,,14555.19,82.8,,percent of total billed charges,,,14941.92,85,,percent of total billed charges,,,,,,,,,15469.28,88,,percent of total billed charges,,,,,,,,,13430.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4394.68,22,,percent of total billed charges,,,15996.64,91,,percent of total billed charges,,,16699.79,95,,percent of total billed charges,,,14590.35,83,,percent of total billed charges,,,14590.35,83,,percent of total billed charges,,,,,,,,,,,,,,,14590.35,83,,percent of total billed charges,,,16699.79,95,,percent of total billed charges,,,15820.86,90,,percent of total billed charges,,,15820.86,90,,percent of total billed charges,,,14414.56,82,,percent of total billed charges,,,15820.86,90,,percent of total billed charges,,,14941.92,85,,percent of total billed charges,,4394.68,16699.79,
SPINECRAFT ROD TITANIUM 6.0 X 70MM STRAI,30186723,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
SYNTHES SCREW CORTEX 3.5 X 55MM,30186724,CDM,,,278,RC,outpatient,,284.03,284.03,,241.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.01,22,,percent of total billed charges,,,,,,,,,255.63,90,,percent of total billed charges,,,235.18,82.8,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,,,,,,,,249.95,88,,percent of total billed charges,,,,,,,,,217,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.01,22,,percent of total billed charges,,,258.47,91,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,235.74,83,,percent of total billed charges,,,,,,,,,,,,,,,235.74,83,,percent of total billed charges,,,269.83,95,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,232.9,82,,percent of total billed charges,,,255.63,90,,percent of total billed charges,,,241.43,85,,percent of total billed charges,,71.01,269.83,
S&N FEMUR DX COMP. SZ 5 LT MED/RT LAT,30186725,CDM,,,278,RC,outpatient,,27214.79,27214.79,,23105.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6803.7,22,,percent of total billed charges,,,,,,,,,24493.31,90,,percent of total billed charges,,,22533.85,82.8,,percent of total billed charges,,,23132.57,85,,percent of total billed charges,,,,,,,,,23949.02,88,,percent of total billed charges,,,,,,,,,20792.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6803.7,22,,percent of total billed charges,,,24765.46,91,,percent of total billed charges,,,25854.05,95,,percent of total billed charges,,,22588.28,83,,percent of total billed charges,,,22588.28,83,,percent of total billed charges,,,,,,,,,,,,,,,22588.28,83,,percent of total billed charges,,,25854.05,95,,percent of total billed charges,,,24493.31,90,,percent of total billed charges,,,24493.31,90,,percent of total billed charges,,,22316.13,82,,percent of total billed charges,,,24493.31,90,,percent of total billed charges,,,23132.57,85,,percent of total billed charges,,6803.7,25854.05,
S&N BASE TIBIAL SZ 5 LT MED/RT LAT,30186726,CDM,,,278,RC,outpatient,,14631.63,14631.63,,12422.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3657.91,22,,percent of total billed charges,,,,,,,,,13168.47,90,,percent of total billed charges,,,12114.99,82.8,,percent of total billed charges,,,12436.89,85,,percent of total billed charges,,,,,,,,,12875.83,88,,percent of total billed charges,,,,,,,,,11178.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3657.91,22,,percent of total billed charges,,,13314.78,91,,percent of total billed charges,,,13900.05,95,,percent of total billed charges,,,12144.25,83,,percent of total billed charges,,,12144.25,83,,percent of total billed charges,,,,,,,,,,,,,,,12144.25,83,,percent of total billed charges,,,13900.05,95,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,11997.94,82,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,12436.89,85,,percent of total billed charges,,3657.91,13900.05,
S&N INSERT TIBIA SZ 5/6 8MM LT MED/RT LA,30186727,CDM,,,278,RC,outpatient,,6855.94,6855.94,,5820.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1713.99,22,,percent of total billed charges,,,,,,,,,6170.35,90,,percent of total billed charges,,,5676.72,82.8,,percent of total billed charges,,,5827.55,85,,percent of total billed charges,,,,,,,,,6033.23,88,,percent of total billed charges,,,,,,,,,5237.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1713.99,22,,percent of total billed charges,,,6238.91,91,,percent of total billed charges,,,6513.14,95,,percent of total billed charges,,,5690.43,83,,percent of total billed charges,,,5690.43,83,,percent of total billed charges,,,,,,,,,,,,,,,5690.43,83,,percent of total billed charges,,,6513.14,95,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,5621.87,82,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,5827.55,85,,percent of total billed charges,,1713.99,6513.14,
DEPUY HINGE S-ROM SMALL LEFT,30186728,CDM,,,278,RC,outpatient,,52982.02,52982.02,,44981.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13245.51,22,,percent of total billed charges,,,,,,,,,47683.82,90,,percent of total billed charges,,,43869.11,82.8,,percent of total billed charges,,,45034.72,85,,percent of total billed charges,,,,,,,,,46624.18,88,,percent of total billed charges,,,,,,,,,40478.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13245.51,22,,percent of total billed charges,,,48213.64,91,,percent of total billed charges,,,50332.92,95,,percent of total billed charges,,,43975.08,83,,percent of total billed charges,,,43975.08,83,,percent of total billed charges,,,,,,,,,,,,,,,43975.08,83,,percent of total billed charges,,,50332.92,95,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,43445.26,82,,percent of total billed charges,,,47683.82,90,,percent of total billed charges,,,45034.72,85,,percent of total billed charges,,13245.51,50332.92,
S&N LGN PS HIGH FLEX XLPE SZ 5-6 11MM,30186731,CDM,,,278,RC,outpatient,,16261.96,16261.96,,13806.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4065.49,22,,percent of total billed charges,,,,,,,,,14635.76,90,,percent of total billed charges,,,13464.9,82.8,,percent of total billed charges,,,13822.67,85,,percent of total billed charges,,,,,,,,,14310.52,88,,percent of total billed charges,,,,,,,,,12424.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4065.49,22,,percent of total billed charges,,,14798.38,91,,percent of total billed charges,,,15448.86,95,,percent of total billed charges,,,13497.43,83,,percent of total billed charges,,,13497.43,83,,percent of total billed charges,,,,,,,,,,,,,,,13497.43,83,,percent of total billed charges,,,15448.86,95,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,13334.81,82,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,13822.67,85,,percent of total billed charges,,4065.49,15448.86,
DEPUY ATTUNE FEMUR REVISION SZ 7 RIGHT,30186732,CDM,,,278,RC,outpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13142.14,22,,percent of total billed charges,,,,,,,,,47311.7,90,,percent of total billed charges,,,43526.77,82.8,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13142.14,22,,percent of total billed charges,,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,13142.14,49940.13,
DEPUY ATTUNE INSERT RP SZ 7 12MM,30186733,CDM,,,278,RC,outpatient,,23578.82,23578.82,,20018.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5894.71,22,,percent of total billed charges,,,,,,,,,21220.94,90,,percent of total billed charges,,,19523.26,82.8,,percent of total billed charges,,,20042,85,,percent of total billed charges,,,,,,,,,20749.36,88,,percent of total billed charges,,,,,,,,,18014.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5894.71,22,,percent of total billed charges,,,21456.73,91,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,,,,,,,,,,,,,19570.42,83,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,19334.63,82,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,20042,85,,percent of total billed charges,,5894.71,22399.88,
DEPUY SEGMENTAL COMPONENT 105MM,30186734,CDM,,,278,RC,outpatient,,18773.5,18773.5,,15938.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4693.38,22,,percent of total billed charges,,,,,,,,,16896.15,90,,percent of total billed charges,,,15544.46,82.8,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,,,,,,,,16520.68,88,,percent of total billed charges,,,,,,,,,14342.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4693.38,22,,percent of total billed charges,,,17083.89,91,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,,,,,,,,,,,,,15582.01,83,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15394.27,82,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,4693.38,17834.83,
DEPUY STEM CEMENTED LPS 17 X 150MM,30186735,CDM,,,278,RC,outpatient,,44982.15,44982.15,,38189.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11245.54,22,,percent of total billed charges,,,,,,,,,40483.94,90,,percent of total billed charges,,,37245.22,82.8,,percent of total billed charges,,,38234.83,85,,percent of total billed charges,,,,,,,,,39584.29,88,,percent of total billed charges,,,,,,,,,34366.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11245.54,22,,percent of total billed charges,,,40933.76,91,,percent of total billed charges,,,42733.04,95,,percent of total billed charges,,,37335.18,83,,percent of total billed charges,,,37335.18,83,,percent of total billed charges,,,,,,,,,,,,,,,37335.18,83,,percent of total billed charges,,,42733.04,95,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,36885.36,82,,percent of total billed charges,,,40483.94,90,,percent of total billed charges,,,38234.83,85,,percent of total billed charges,,11245.54,42733.04,
CELL SAVER PROF. FEES,30186736,CDM,,,270,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
CELL SAVER EQUIPMENT FEE,30186737,CDM,,,270,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
CELL SAVER AUTOLOG ONE SOURCE PACK,30186738,CDM,,,270,RC,outpatient,,1331.92,1331.92,,1130.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,332.98,22,,percent of total billed charges,,,,,,,,,1198.73,90,,percent of total billed charges,,,1102.83,82.8,,percent of total billed charges,,,1132.13,85,,percent of total billed charges,,,,,,,,,1172.09,88,,percent of total billed charges,,,,,,,,,1017.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,332.98,22,,percent of total billed charges,,,1212.05,91,,percent of total billed charges,,,1265.32,95,,percent of total billed charges,,,1105.49,83,,percent of total billed charges,,,1105.49,83,,percent of total billed charges,,,,,,,,,,,,,,,1105.49,83,,percent of total billed charges,,,1265.32,95,,percent of total billed charges,,,1198.73,90,,percent of total billed charges,,,1198.73,90,,percent of total billed charges,,,1092.17,82,,percent of total billed charges,,,1198.73,90,,percent of total billed charges,,,1132.13,85,,percent of total billed charges,,332.98,1265.32,
ULRICH CAGE CORPECTOMY SMALL,30186739,CDM,,,278,RC,outpatient,,143442,143442,,121782.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35860.5,22,,percent of total billed charges,,,,,,,,,129097.8,90,,percent of total billed charges,,,118769.98,82.8,,percent of total billed charges,,,121925.7,85,,percent of total billed charges,,,,,,,,,126228.96,88,,percent of total billed charges,,,,,,,,,109589.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35860.5,22,,percent of total billed charges,,,130532.22,91,,percent of total billed charges,,,136269.9,95,,percent of total billed charges,,,119056.86,83,,percent of total billed charges,,,119056.86,83,,percent of total billed charges,,,,,,,,,,,,,,,119056.86,83,,percent of total billed charges,,,136269.9,95,,percent of total billed charges,,,129097.8,90,,percent of total billed charges,,,129097.8,90,,percent of total billed charges,,,117622.44,82,,percent of total billed charges,,,129097.8,90,,percent of total billed charges,,,121925.7,85,,percent of total billed charges,,35860.5,136269.9,
ULRICH LOCKING SCREW SET,30186740,CDM,,,270,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
ULRICH PLATE 2 LEVEL 28MM,30186741,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
ULRICH CASSETTE DISP. 12MM,30186742,CDM,,,278,RC,outpatient,,7949.5,7949.5,,6749.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1987.38,22,,percent of total billed charges,,,,,,,,,7154.55,90,,percent of total billed charges,,,6582.19,82.8,,percent of total billed charges,,,6757.08,85,,percent of total billed charges,,,,,,,,,6995.56,88,,percent of total billed charges,,,,,,,,,6073.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1987.38,22,,percent of total billed charges,,,7234.05,91,,percent of total billed charges,,,7552.03,95,,percent of total billed charges,,,6598.09,83,,percent of total billed charges,,,6598.09,83,,percent of total billed charges,,,,,,,,,,,,,,,6598.09,83,,percent of total billed charges,,,7552.03,95,,percent of total billed charges,,,7154.55,90,,percent of total billed charges,,,7154.55,90,,percent of total billed charges,,,6518.59,82,,percent of total billed charges,,,7154.55,90,,percent of total billed charges,,,6757.08,85,,percent of total billed charges,,1987.38,7552.03,
SYNTHES SCREWDRIVER SHAFT T8,30186743,CDM,,,278,RC,outpatient,,3018.67,3018.67,,2562.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,754.67,22,,percent of total billed charges,,,,,,,,,2716.8,90,,percent of total billed charges,,,2499.46,82.8,,percent of total billed charges,,,2565.87,85,,percent of total billed charges,,,,,,,,,2656.43,88,,percent of total billed charges,,,,,,,,,2306.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,754.67,22,,percent of total billed charges,,,2746.99,91,,percent of total billed charges,,,2867.74,95,,percent of total billed charges,,,2505.5,83,,percent of total billed charges,,,2505.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2505.5,83,,percent of total billed charges,,,2867.74,95,,percent of total billed charges,,,2716.8,90,,percent of total billed charges,,,2716.8,90,,percent of total billed charges,,,2475.31,82,,percent of total billed charges,,,2716.8,90,,percent of total billed charges,,,2565.87,85,,percent of total billed charges,,754.67,2867.74,
SYNTHES SCREWDRIVER SHAFT SOLID 2.5MM HE,30186744,CDM,,,278,RC,outpatient,,1007.24,1007.24,,855.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,251.81,22,,percent of total billed charges,,,,,,,,,906.52,90,,percent of total billed charges,,,833.99,82.8,,percent of total billed charges,,,856.15,85,,percent of total billed charges,,,,,,,,,886.37,88,,percent of total billed charges,,,,,,,,,769.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,251.81,22,,percent of total billed charges,,,916.59,91,,percent of total billed charges,,,956.88,95,,percent of total billed charges,,,836.01,83,,percent of total billed charges,,,836.01,83,,percent of total billed charges,,,,,,,,,,,,,,,836.01,83,,percent of total billed charges,,,956.88,95,,percent of total billed charges,,,906.52,90,,percent of total billed charges,,,906.52,90,,percent of total billed charges,,,825.94,82,,percent of total billed charges,,,906.52,90,,percent of total billed charges,,,856.15,85,,percent of total billed charges,,251.81,956.88,
SYNTHES T HANDLE QUICK CONNECT,30186745,CDM,,,270,RC,outpatient,,5463.12,5463.12,,4638.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1365.78,22,,percent of total billed charges,,,,,,,,,4916.81,90,,percent of total billed charges,,,4523.46,82.8,,percent of total billed charges,,,4643.65,85,,percent of total billed charges,,,,,,,,,4807.55,88,,percent of total billed charges,,,,,,,,,4173.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1365.78,22,,percent of total billed charges,,,4971.44,91,,percent of total billed charges,,,5189.96,95,,percent of total billed charges,,,4534.39,83,,percent of total billed charges,,,4534.39,83,,percent of total billed charges,,,,,,,,,,,,,,,4534.39,83,,percent of total billed charges,,,5189.96,95,,percent of total billed charges,,,4916.81,90,,percent of total billed charges,,,4916.81,90,,percent of total billed charges,,,4479.76,82,,percent of total billed charges,,,4916.81,90,,percent of total billed charges,,,4643.65,85,,percent of total billed charges,,1365.78,5189.96,
ZIMMER LINER NUETRAL 36MM +5 G,30186746,CDM,,,278,RC,outpatient,,23595,23595,,20032.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5898.75,22,,percent of total billed charges,,,,,,,,,21235.5,90,,percent of total billed charges,,,19536.66,82.8,,percent of total billed charges,,,20055.75,85,,percent of total billed charges,,,,,,,,,20763.6,88,,percent of total billed charges,,,,,,,,,18026.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5898.75,22,,percent of total billed charges,,,21471.45,91,,percent of total billed charges,,,22415.25,95,,percent of total billed charges,,,19583.85,83,,percent of total billed charges,,,19583.85,83,,percent of total billed charges,,,,,,,,,,,,,,,19583.85,83,,percent of total billed charges,,,22415.25,95,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,19347.9,82,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,20055.75,85,,percent of total billed charges,,5898.75,22415.25,
ZIMMER LINER NEUTRAL G7 36MM,30186747,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT ROD LORDOSED 6.0 X 300,30186748,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
SYNTHES SCREW HEADLESS COMRESSION 3 X 16,30186749,CDM,,,278,RC,outpatient,,3465.67,3465.67,,2942.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,866.42,22,,percent of total billed charges,,,,,,,,,3119.1,90,,percent of total billed charges,,,2869.57,82.8,,percent of total billed charges,,,2945.82,85,,percent of total billed charges,,,,,,,,,3049.79,88,,percent of total billed charges,,,,,,,,,2647.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,866.42,22,,percent of total billed charges,,,3153.76,91,,percent of total billed charges,,,3292.39,95,,percent of total billed charges,,,2876.51,83,,percent of total billed charges,,,2876.51,83,,percent of total billed charges,,,,,,,,,,,,,,,2876.51,83,,percent of total billed charges,,,3292.39,95,,percent of total billed charges,,,3119.1,90,,percent of total billed charges,,,3119.1,90,,percent of total billed charges,,,2841.85,82,,percent of total billed charges,,,3119.1,90,,percent of total billed charges,,,2945.82,85,,percent of total billed charges,,866.42,3292.39,
ZIMMER FEMUR CR RIGHT SZ 11,30186750,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
ZIMMER TIBIA PSN  SZ G RIGHT,30186751,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER MC POLY 12MM RIGHT,30186752,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
SYNTHES SCREW LOCKING VA 3.5 X 16MM,30186753,CDM,,,278,RC,outpatient,,1456.85,1456.85,,1236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,364.21,22,,percent of total billed charges,,,,,,,,,1311.17,90,,percent of total billed charges,,,1206.27,82.8,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,,,,,,,,1282.03,88,,percent of total billed charges,,,,,,,,,1113.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,364.21,22,,percent of total billed charges,,,1325.73,91,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1209.19,83,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1194.62,82,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,364.21,1384.01,
SYNTHES SCREW LOCKING VA 3.5 X 20MM,30186754,CDM,,,278,RC,outpatient,,1456.85,1456.85,,1236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,364.21,22,,percent of total billed charges,,,,,,,,,1311.17,90,,percent of total billed charges,,,1206.27,82.8,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,,,,,,,,1282.03,88,,percent of total billed charges,,,,,,,,,1113.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,364.21,22,,percent of total billed charges,,,1325.73,91,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,1209.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1209.19,83,,percent of total billed charges,,,1384.01,95,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1194.62,82,,percent of total billed charges,,,1311.17,90,,percent of total billed charges,,,1238.32,85,,percent of total billed charges,,364.21,1384.01,
SYNTHES SCREW LOCKING VA 3.5 X 80MM,30186755,CDM,,,278,RC,outpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375.13,22,,percent of total billed charges,,,,,,,,,1350.48,90,,percent of total billed charges,,,1242.44,82.8,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,375.13,22,,percent of total billed charges,,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,375.13,1425.5,
DEPUY GLENOSPHERE 38MM +2,30186756,CDM,,,278,RC,outpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4954.14,22,,percent of total billed charges,,,,,,,,,17834.9,90,,percent of total billed charges,,,16408.1,82.8,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4954.14,22,,percent of total billed charges,,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,4954.14,18825.72,
S&N GRAFIX PL PRIME 5X5 CM,30186757,CDM,,,278,RC,outpatient,,18525,18525,,15727.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4631.25,22,,percent of total billed charges,,,,,,,,,16672.5,90,,percent of total billed charges,,,15338.7,82.8,,percent of total billed charges,,,15746.25,85,,percent of total billed charges,,,,,,,,,16302,88,,percent of total billed charges,,,,,,,,,14153.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4631.25,22,,percent of total billed charges,,,16857.75,91,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,,,,,,,,,,,,,15375.75,83,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15190.5,82,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15746.25,85,,percent of total billed charges,,4631.25,17598.75,
DEPUY HEAD HUMERAL 56 X 18 ECC,30186758,CDM,,,278,RC,outpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4409.03,22,,percent of total billed charges,,,,,,,,,15872.52,90,,percent of total billed charges,,,14602.72,82.8,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4409.03,22,,percent of total billed charges,,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,4409.03,16754.32,
DEPUY BODY PROXIMAL ANATOMIE 142 SZ 16,30186759,CDM,,,278,RC,outpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3163.67,22,,percent of total billed charges,,,,,,,,,11389.19,90,,percent of total billed charges,,,10478.06,82.8,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3163.67,22,,percent of total billed charges,,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,3163.67,12021.93,
ZIMMER LINER NEUTRAL G7 VIT 32MM D,30186760,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ZIMMER HEAD FEMORAL 6DEG COCR 32MM +10.5,30186761,CDM,,,278,RC,outpatient,,10595,10595,,8995.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2648.75,22,,percent of total billed charges,,,,,,,,,9535.5,90,,percent of total billed charges,,,8772.66,82.8,,percent of total billed charges,,,9005.75,85,,percent of total billed charges,,,,,,,,,9323.6,88,,percent of total billed charges,,,,,,,,,8094.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2648.75,22,,percent of total billed charges,,,9641.45,91,,percent of total billed charges,,,10065.25,95,,percent of total billed charges,,,8793.85,83,,percent of total billed charges,,,8793.85,83,,percent of total billed charges,,,,,,,,,,,,,,,8793.85,83,,percent of total billed charges,,,10065.25,95,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,8687.9,82,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,9005.75,85,,percent of total billed charges,,2648.75,10065.25,
ZIMMER LINER NEUTRAL G HGP 32 ID,30186762,CDM,,,278,RC,outpatient,,19630,19630,,16665.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4907.5,22,,percent of total billed charges,,,,,,,,,17667,90,,percent of total billed charges,,,16253.64,82.8,,percent of total billed charges,,,16685.5,85,,percent of total billed charges,,,,,,,,,17274.4,88,,percent of total billed charges,,,,,,,,,14997.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4907.5,22,,percent of total billed charges,,,17863.3,91,,percent of total billed charges,,,18648.5,95,,percent of total billed charges,,,16292.9,83,,percent of total billed charges,,,16292.9,83,,percent of total billed charges,,,,,,,,,,,,,,,16292.9,83,,percent of total billed charges,,,18648.5,95,,percent of total billed charges,,,17667,90,,percent of total billed charges,,,17667,90,,percent of total billed charges,,,16096.6,82,,percent of total billed charges,,,17667,90,,percent of total billed charges,,,16685.5,85,,percent of total billed charges,,4907.5,18648.5,
ZIMMER LINER NEUTRAL G7 E1 +5MM 32MM D,30186763,CDM,,,278,RC,outpatient,,23595,23595,,20032.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5898.75,22,,percent of total billed charges,,,,,,,,,21235.5,90,,percent of total billed charges,,,19536.66,82.8,,percent of total billed charges,,,20055.75,85,,percent of total billed charges,,,,,,,,,20763.6,88,,percent of total billed charges,,,,,,,,,18026.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5898.75,22,,percent of total billed charges,,,21471.45,91,,percent of total billed charges,,,22415.25,95,,percent of total billed charges,,,19583.85,83,,percent of total billed charges,,,19583.85,83,,percent of total billed charges,,,,,,,,,,,,,,,19583.85,83,,percent of total billed charges,,,22415.25,95,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,19347.9,82,,percent of total billed charges,,,21235.5,90,,percent of total billed charges,,,20055.75,85,,percent of total billed charges,,5898.75,22415.25,
SPINECRAFT SCREW  ILLIAC 8.5 X 80MM,30186764,CDM,,,278,RC,outpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2356.25,22,,percent of total billed charges,,,,,,,,,8482.5,90,,percent of total billed charges,,,7803.9,82.8,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2356.25,22,,percent of total billed charges,,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,2356.25,8953.75,
SPINECRAFT CROSS CONNECTOR 50-75MM,30186765,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
SPINECRAFT LATERAL CONNECTOR 35MM,30186766,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
SPINECRAFT COBALT CHROME 6.0 X 450,30186767,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
SPINECRAFT SCREW SET,30186768,CDM,,,278,RC,outpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175,22,,percent of total billed charges,,,,,,,,,630,90,,percent of total billed charges,,,579.6,82.8,,percent of total billed charges,,,595,85,,percent of total billed charges,,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175,22,,percent of total billed charges,,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,175,665,
STRYKER FEMUR TRIATHLON PS RT SZ 5,30186769,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER BASEPLATE TIBIAL SZ 4,30186770,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
STRYKER INSERT TIBIAL PS SZ 4 9MM,30186771,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER PATELLA ASYMMETRIC X3 SZ 32,30186772,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
STRYKER CEMENT SPEEDSET,30186773,CDM,,,278,RC,outpatient,,823.55,823.55,,699.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,205.89,22,,percent of total billed charges,,,,,,,,,741.2,90,,percent of total billed charges,,,681.9,82.8,,percent of total billed charges,,,700.02,85,,percent of total billed charges,,,,,,,,,724.72,88,,percent of total billed charges,,,,,,,,,629.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,205.89,22,,percent of total billed charges,,,749.43,91,,percent of total billed charges,,,782.37,95,,percent of total billed charges,,,683.55,83,,percent of total billed charges,,,683.55,83,,percent of total billed charges,,,,,,,,,,,,,,,683.55,83,,percent of total billed charges,,,782.37,95,,percent of total billed charges,,,741.2,90,,percent of total billed charges,,,741.2,90,,percent of total billed charges,,,675.31,82,,percent of total billed charges,,,741.2,90,,percent of total billed charges,,,700.02,85,,percent of total billed charges,,205.89,782.37,
DRESSING MEPILEX BORDER AG 4X12IN,30186774,CDM,,,270,RC,outpatient,,250.8,250.8,,212.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.7,22,,percent of total billed charges,,,,,,,,,225.72,90,,percent of total billed charges,,,207.66,82.8,,percent of total billed charges,,,213.18,85,,percent of total billed charges,,,,,,,,,220.7,88,,percent of total billed charges,,,,,,,,,191.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.7,22,,percent of total billed charges,,,228.23,91,,percent of total billed charges,,,238.26,95,,percent of total billed charges,,,208.16,83,,percent of total billed charges,,,208.16,83,,percent of total billed charges,,,,,,,,,,,,,,,208.16,83,,percent of total billed charges,,,238.26,95,,percent of total billed charges,,,225.72,90,,percent of total billed charges,,,225.72,90,,percent of total billed charges,,,205.66,82,,percent of total billed charges,,,225.72,90,,percent of total billed charges,,,213.18,85,,percent of total billed charges,,62.7,238.26,
DEPUY GLENOSPHERE ECCENTRIC 42MM +2,30186776,CDM,,,278,RC,outpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4954.14,22,,percent of total billed charges,,,,,,,,,17834.9,90,,percent of total billed charges,,,16408.1,82.8,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4954.14,22,,percent of total billed charges,,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,4954.14,18825.72,
DEPUY STEM CEMENTED LPS 11 X 100,30186777,CDM,,,278,RC,outpatient,,42441.95,42441.95,,36033.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10610.49,22,,percent of total billed charges,,,,,,,,,38197.76,90,,percent of total billed charges,,,35141.93,82.8,,percent of total billed charges,,,36075.66,85,,percent of total billed charges,,,,,,,,,37348.92,88,,percent of total billed charges,,,,,,,,,32425.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10610.49,22,,percent of total billed charges,,,38622.17,91,,percent of total billed charges,,,40319.85,95,,percent of total billed charges,,,35226.82,83,,percent of total billed charges,,,35226.82,83,,percent of total billed charges,,,,,,,,,,,,,,,35226.82,83,,percent of total billed charges,,,40319.85,95,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,34802.4,82,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,36075.66,85,,percent of total billed charges,,10610.49,40319.85,
DEPUY ATTUNE INSERT LPS X-SM 14MM,30186778,CDM,,,278,RC,outpatient,,39351.39,39351.39,,33409.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9837.85,22,,percent of total billed charges,,,,,,,,,35416.25,90,,percent of total billed charges,,,32582.95,82.8,,percent of total billed charges,,,33448.68,85,,percent of total billed charges,,,,,,,,,34629.22,88,,percent of total billed charges,,,,,,,,,30064.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9837.85,22,,percent of total billed charges,,,35809.76,91,,percent of total billed charges,,,37383.82,95,,percent of total billed charges,,,32661.65,83,,percent of total billed charges,,,32661.65,83,,percent of total billed charges,,,,,,,,,,,,,,,32661.65,83,,percent of total billed charges,,,37383.82,95,,percent of total billed charges,,,35416.25,90,,percent of total billed charges,,,35416.25,90,,percent of total billed charges,,,32268.14,82,,percent of total billed charges,,,35416.25,90,,percent of total billed charges,,,33448.68,85,,percent of total billed charges,,9837.85,37383.82,
DEPUY SCREW LOCKING 36MM,30186782,CDM,,,278,RC,outpatient,,2237.76,2237.76,,1899.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,559.44,22,,percent of total billed charges,,,,,,,,,2013.98,90,,percent of total billed charges,,,1852.87,82.8,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,,,,,,,,1969.23,88,,percent of total billed charges,,,,,,,,,1709.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,559.44,22,,percent of total billed charges,,,2036.36,91,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,1857.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1857.34,83,,percent of total billed charges,,,2125.87,95,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1834.96,82,,percent of total billed charges,,,2013.98,90,,percent of total billed charges,,,1902.1,85,,percent of total billed charges,,559.44,2125.87,
SYNTHES SCREW LOCKING 5.0 X 54MM,30186783,CDM,,,278,RC,outpatient,,2185.24,2185.24,,1855.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,546.31,22,,percent of total billed charges,,,,,,,,,1966.72,90,,percent of total billed charges,,,1809.38,82.8,,percent of total billed charges,,,1857.45,85,,percent of total billed charges,,,,,,,,,1923.01,88,,percent of total billed charges,,,,,,,,,1669.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,546.31,22,,percent of total billed charges,,,1988.57,91,,percent of total billed charges,,,2075.98,95,,percent of total billed charges,,,1813.75,83,,percent of total billed charges,,,1813.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1813.75,83,,percent of total billed charges,,,2075.98,95,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1791.9,82,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1857.45,85,,percent of total billed charges,,546.31,2075.98,
SYNTHES PLATE LCP 5 HOLES 2.7 X 49MM,30186784,CDM,,,278,RC,outpatient,,3989.25,3989.25,,3386.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,997.31,22,,percent of total billed charges,,,,,,,,,3590.33,90,,percent of total billed charges,,,3303.1,82.8,,percent of total billed charges,,,3390.86,85,,percent of total billed charges,,,,,,,,,3510.54,88,,percent of total billed charges,,,,,,,,,3047.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,997.31,22,,percent of total billed charges,,,3630.22,91,,percent of total billed charges,,,3789.79,95,,percent of total billed charges,,,3311.08,83,,percent of total billed charges,,,3311.08,83,,percent of total billed charges,,,,,,,,,,,,,,,3311.08,83,,percent of total billed charges,,,3789.79,95,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3271.19,82,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3390.86,85,,percent of total billed charges,,997.31,3789.79,
SYNTHES PLATE LCP 6 HOLES 2.7 X 58MM,30186785,CDM,,,278,RC,outpatient,,3989.25,3989.25,,3386.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,997.31,22,,percent of total billed charges,,,,,,,,,3590.33,90,,percent of total billed charges,,,3303.1,82.8,,percent of total billed charges,,,3390.86,85,,percent of total billed charges,,,,,,,,,3510.54,88,,percent of total billed charges,,,,,,,,,3047.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,997.31,22,,percent of total billed charges,,,3630.22,91,,percent of total billed charges,,,3789.79,95,,percent of total billed charges,,,3311.08,83,,percent of total billed charges,,,3311.08,83,,percent of total billed charges,,,,,,,,,,,,,,,3311.08,83,,percent of total billed charges,,,3789.79,95,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3271.19,82,,percent of total billed charges,,,3590.33,90,,percent of total billed charges,,,3390.86,85,,percent of total billed charges,,997.31,3789.79,
SYNTHES SCREW CORTEX 2.7MM X 10MM,30186786,CDM,,,278,RC,outpatient,,398.37,398.37,,338.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,99.59,22,,percent of total billed charges,,,,,,,,,358.53,90,,percent of total billed charges,,,329.85,82.8,,percent of total billed charges,,,338.61,85,,percent of total billed charges,,,,,,,,,350.57,88,,percent of total billed charges,,,,,,,,,304.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,99.59,22,,percent of total billed charges,,,362.52,91,,percent of total billed charges,,,378.45,95,,percent of total billed charges,,,330.65,83,,percent of total billed charges,,,330.65,83,,percent of total billed charges,,,,,,,,,,,,,,,330.65,83,,percent of total billed charges,,,378.45,95,,percent of total billed charges,,,358.53,90,,percent of total billed charges,,,358.53,90,,percent of total billed charges,,,326.66,82,,percent of total billed charges,,,358.53,90,,percent of total billed charges,,,338.61,85,,percent of total billed charges,,99.59,378.45,
SYNTHES PLATE LCP 4 HOLES 2.0 X 31MM,30186787,CDM,,,278,RC,outpatient,,2475.46,2475.46,,2101.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,618.87,22,,percent of total billed charges,,,,,,,,,2227.91,90,,percent of total billed charges,,,2049.68,82.8,,percent of total billed charges,,,2104.14,85,,percent of total billed charges,,,,,,,,,2178.4,88,,percent of total billed charges,,,,,,,,,1891.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,618.87,22,,percent of total billed charges,,,2252.67,91,,percent of total billed charges,,,2351.69,95,,percent of total billed charges,,,2054.63,83,,percent of total billed charges,,,2054.63,83,,percent of total billed charges,,,,,,,,,,,,,,,2054.63,83,,percent of total billed charges,,,2351.69,95,,percent of total billed charges,,,2227.91,90,,percent of total billed charges,,,2227.91,90,,percent of total billed charges,,,2029.88,82,,percent of total billed charges,,,2227.91,90,,percent of total billed charges,,,2104.14,85,,percent of total billed charges,,618.87,2351.69,
SYNTHES DRILL BIT 1.5 X 110,30186788,CDM,,,270,RC,outpatient,,1473.88,1473.88,,1251.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,368.47,22,,percent of total billed charges,,,,,,,,,1326.49,90,,percent of total billed charges,,,1220.37,82.8,,percent of total billed charges,,,1252.8,85,,percent of total billed charges,,,,,,,,,1297.01,88,,percent of total billed charges,,,,,,,,,1126.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,368.47,22,,percent of total billed charges,,,1341.23,91,,percent of total billed charges,,,1400.19,95,,percent of total billed charges,,,1223.32,83,,percent of total billed charges,,,1223.32,83,,percent of total billed charges,,,,,,,,,,,,,,,1223.32,83,,percent of total billed charges,,,1400.19,95,,percent of total billed charges,,,1326.49,90,,percent of total billed charges,,,1326.49,90,,percent of total billed charges,,,1208.58,82,,percent of total billed charges,,,1326.49,90,,percent of total billed charges,,,1252.8,85,,percent of total billed charges,,368.47,1400.19,
SYNTHES SCREW LOCKING 2.0 X 11MM,30186789,CDM,,,278,RC,outpatient,,1109.68,1109.68,,942.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,277.42,22,,percent of total billed charges,,,,,,,,,998.71,90,,percent of total billed charges,,,918.82,82.8,,percent of total billed charges,,,943.23,85,,percent of total billed charges,,,,,,,,,976.52,88,,percent of total billed charges,,,,,,,,,847.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,277.42,22,,percent of total billed charges,,,1009.81,91,,percent of total billed charges,,,1054.2,95,,percent of total billed charges,,,921.03,83,,percent of total billed charges,,,921.03,83,,percent of total billed charges,,,,,,,,,,,,,,,921.03,83,,percent of total billed charges,,,1054.2,95,,percent of total billed charges,,,998.71,90,,percent of total billed charges,,,998.71,90,,percent of total billed charges,,,909.94,82,,percent of total billed charges,,,998.71,90,,percent of total billed charges,,,943.23,85,,percent of total billed charges,,277.42,1054.2,
SYNTHES SCREW CORTEX 2.0 X 6MM,30186790,CDM,,,278,RC,outpatient,,490.28,490.28,,416.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.57,22,,percent of total billed charges,,,,,,,,,441.25,90,,percent of total billed charges,,,405.95,82.8,,percent of total billed charges,,,416.74,85,,percent of total billed charges,,,,,,,,,431.45,88,,percent of total billed charges,,,,,,,,,374.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.57,22,,percent of total billed charges,,,446.15,91,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,,,,,,,,,,,,,406.93,83,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,402.03,82,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,416.74,85,,percent of total billed charges,,122.57,465.77,
SYNTHES SCREW CORTEX 2.0 X 14MM,30186791,CDM,,,278,RC,outpatient,,490.28,490.28,,416.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.57,22,,percent of total billed charges,,,,,,,,,441.25,90,,percent of total billed charges,,,405.95,82.8,,percent of total billed charges,,,416.74,85,,percent of total billed charges,,,,,,,,,431.45,88,,percent of total billed charges,,,,,,,,,374.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.57,22,,percent of total billed charges,,,446.15,91,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,406.93,83,,percent of total billed charges,,,,,,,,,,,,,,,406.93,83,,percent of total billed charges,,,465.77,95,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,402.03,82,,percent of total billed charges,,,441.25,90,,percent of total billed charges,,,416.74,85,,percent of total billed charges,,122.57,465.77,
DJO CUP EMPOWER,30186792,CDM,,,278,RC,outpatient,,6165.58,6165.58,,5234.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1541.4,22,,percent of total billed charges,,,,,,,,,5549.02,90,,percent of total billed charges,,,5105.1,82.8,,percent of total billed charges,,,5240.74,85,,percent of total billed charges,,,,,,,,,5425.71,88,,percent of total billed charges,,,,,,,,,4710.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1541.4,22,,percent of total billed charges,,,5610.68,91,,percent of total billed charges,,,5857.3,95,,percent of total billed charges,,,5117.43,83,,percent of total billed charges,,,5117.43,83,,percent of total billed charges,,,,,,,,,,,,,,,5117.43,83,,percent of total billed charges,,,5857.3,95,,percent of total billed charges,,,5549.02,90,,percent of total billed charges,,,5549.02,90,,percent of total billed charges,,,5055.78,82,,percent of total billed charges,,,5549.02,90,,percent of total billed charges,,,5240.74,85,,percent of total billed charges,,1541.4,5857.3,
DJO SCREW BONE 40MM,30186793,CDM,,,278,RC,outpatient,,338.7,338.7,,287.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.68,22,,percent of total billed charges,,,,,,,,,304.83,90,,percent of total billed charges,,,280.44,82.8,,percent of total billed charges,,,287.9,85,,percent of total billed charges,,,,,,,,,298.06,88,,percent of total billed charges,,,,,,,,,258.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.68,22,,percent of total billed charges,,,308.22,91,,percent of total billed charges,,,321.77,95,,percent of total billed charges,,,281.12,83,,percent of total billed charges,,,281.12,83,,percent of total billed charges,,,,,,,,,,,,,,,281.12,83,,percent of total billed charges,,,321.77,95,,percent of total billed charges,,,304.83,90,,percent of total billed charges,,,304.83,90,,percent of total billed charges,,,277.73,82,,percent of total billed charges,,,304.83,90,,percent of total billed charges,,,287.9,85,,percent of total billed charges,,84.68,321.77,
DJO LINER EMPOWER,30186794,CDM,,,278,RC,outpatient,,5885.56,5885.56,,4996.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1471.39,22,,percent of total billed charges,,,,,,,,,5297,90,,percent of total billed charges,,,4873.24,82.8,,percent of total billed charges,,,5002.73,85,,percent of total billed charges,,,,,,,,,5179.29,88,,percent of total billed charges,,,,,,,,,4496.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1471.39,22,,percent of total billed charges,,,5355.86,91,,percent of total billed charges,,,5591.28,95,,percent of total billed charges,,,4885.01,83,,percent of total billed charges,,,4885.01,83,,percent of total billed charges,,,,,,,,,,,,,,,4885.01,83,,percent of total billed charges,,,5591.28,95,,percent of total billed charges,,,5297,90,,percent of total billed charges,,,5297,90,,percent of total billed charges,,,4826.16,82,,percent of total billed charges,,,5297,90,,percent of total billed charges,,,5002.73,85,,percent of total billed charges,,1471.39,5591.28,
DJO HEAD FEMORAL BIOLOX CERAMIC,30186795,CDM,,,278,RC,outpatient,,6164.08,6164.08,,5233.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1541.02,22,,percent of total billed charges,,,,,,,,,5547.67,90,,percent of total billed charges,,,5103.86,82.8,,percent of total billed charges,,,5239.47,85,,percent of total billed charges,,,,,,,,,5424.39,88,,percent of total billed charges,,,,,,,,,4709.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1541.02,22,,percent of total billed charges,,,5609.31,91,,percent of total billed charges,,,5855.88,95,,percent of total billed charges,,,5116.19,83,,percent of total billed charges,,,5116.19,83,,percent of total billed charges,,,,,,,,,,,,,,,5116.19,83,,percent of total billed charges,,,5855.88,95,,percent of total billed charges,,,5547.67,90,,percent of total billed charges,,,5547.67,90,,percent of total billed charges,,,5054.55,82,,percent of total billed charges,,,5547.67,90,,percent of total billed charges,,,5239.47,85,,percent of total billed charges,,1541.02,5855.88,
DJO STEM FEMORAL HIP,30186796,CDM,,,278,RC,outpatient,,16947.78,16947.78,,14388.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4236.95,22,,percent of total billed charges,,,,,,,,,15253,90,,percent of total billed charges,,,14032.76,82.8,,percent of total billed charges,,,14405.61,85,,percent of total billed charges,,,,,,,,,14914.05,88,,percent of total billed charges,,,,,,,,,12948.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4236.95,22,,percent of total billed charges,,,15422.48,91,,percent of total billed charges,,,16100.39,95,,percent of total billed charges,,,14066.66,83,,percent of total billed charges,,,14066.66,83,,percent of total billed charges,,,,,,,,,,,,,,,14066.66,83,,percent of total billed charges,,,16100.39,95,,percent of total billed charges,,,15253,90,,percent of total billed charges,,,15253,90,,percent of total billed charges,,,13897.18,82,,percent of total billed charges,,,15253,90,,percent of total billed charges,,,14405.61,85,,percent of total billed charges,,4236.95,16100.39,
DJO CUP EMPOWER 54MM,30186797,CDM,,,278,RC,outpatient,,6165.58,6165.58,,5234.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1541.4,22,,percent of total billed charges,,,,,,,,,5549.02,90,,percent of total billed charges,,,5105.1,82.8,,percent of total billed charges,,,5240.74,85,,percent of total billed charges,,,,,,,,,5425.71,88,,percent of total billed charges,,,,,,,,,4710.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1541.4,22,,percent of total billed charges,,,5610.68,91,,percent of total billed charges,,,5857.3,95,,percent of total billed charges,,,5117.43,83,,percent of total billed charges,,,5117.43,83,,percent of total billed charges,,,,,,,,,,,,,,,5117.43,83,,percent of total billed charges,,,5857.3,95,,percent of total billed charges,,,5549.02,90,,percent of total billed charges,,,5549.02,90,,percent of total billed charges,,,5055.78,82,,percent of total billed charges,,,5549.02,90,,percent of total billed charges,,,5240.74,85,,percent of total billed charges,,1541.4,5857.3,
DJO SCREW BONE 35MM,30186798,CDM,,,278,RC,outpatient,,338.7,338.7,,287.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.68,22,,percent of total billed charges,,,,,,,,,304.83,90,,percent of total billed charges,,,280.44,82.8,,percent of total billed charges,,,287.9,85,,percent of total billed charges,,,,,,,,,298.06,88,,percent of total billed charges,,,,,,,,,258.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.68,22,,percent of total billed charges,,,308.22,91,,percent of total billed charges,,,321.77,95,,percent of total billed charges,,,281.12,83,,percent of total billed charges,,,281.12,83,,percent of total billed charges,,,,,,,,,,,,,,,281.12,83,,percent of total billed charges,,,321.77,95,,percent of total billed charges,,,304.83,90,,percent of total billed charges,,,304.83,90,,percent of total billed charges,,,277.73,82,,percent of total billed charges,,,304.83,90,,percent of total billed charges,,,287.9,85,,percent of total billed charges,,84.68,321.77,
DJO LINER EMPOWER,30186799,CDM,,,278,RC,outpatient,,5885.56,5885.56,,4996.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1471.39,22,,percent of total billed charges,,,,,,,,,5297,90,,percent of total billed charges,,,4873.24,82.8,,percent of total billed charges,,,5002.73,85,,percent of total billed charges,,,,,,,,,5179.29,88,,percent of total billed charges,,,,,,,,,4496.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1471.39,22,,percent of total billed charges,,,5355.86,91,,percent of total billed charges,,,5591.28,95,,percent of total billed charges,,,4885.01,83,,percent of total billed charges,,,4885.01,83,,percent of total billed charges,,,,,,,,,,,,,,,4885.01,83,,percent of total billed charges,,,5591.28,95,,percent of total billed charges,,,5297,90,,percent of total billed charges,,,5297,90,,percent of total billed charges,,,4826.16,82,,percent of total billed charges,,,5297,90,,percent of total billed charges,,,5002.73,85,,percent of total billed charges,,1471.39,5591.28,
DJO HEAD CERAMIC 36MM -4,30186800,CDM,,,278,RC,outpatient,,6164.08,6164.08,,5233.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1541.02,22,,percent of total billed charges,,,,,,,,,5547.67,90,,percent of total billed charges,,,5103.86,82.8,,percent of total billed charges,,,5239.47,85,,percent of total billed charges,,,,,,,,,5424.39,88,,percent of total billed charges,,,,,,,,,4709.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1541.02,22,,percent of total billed charges,,,5609.31,91,,percent of total billed charges,,,5855.88,95,,percent of total billed charges,,,5116.19,83,,percent of total billed charges,,,5116.19,83,,percent of total billed charges,,,,,,,,,,,,,,,5116.19,83,,percent of total billed charges,,,5855.88,95,,percent of total billed charges,,,5547.67,90,,percent of total billed charges,,,5547.67,90,,percent of total billed charges,,,5054.55,82,,percent of total billed charges,,,5547.67,90,,percent of total billed charges,,,5239.47,85,,percent of total billed charges,,1541.02,5855.88,
DJO STEM FEMORAL HIP 11,30186801,CDM,,,278,RC,outpatient,,16947.78,16947.78,,14388.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4236.95,22,,percent of total billed charges,,,,,,,,,15253,90,,percent of total billed charges,,,14032.76,82.8,,percent of total billed charges,,,14405.61,85,,percent of total billed charges,,,,,,,,,14914.05,88,,percent of total billed charges,,,,,,,,,12948.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4236.95,22,,percent of total billed charges,,,15422.48,91,,percent of total billed charges,,,16100.39,95,,percent of total billed charges,,,14066.66,83,,percent of total billed charges,,,14066.66,83,,percent of total billed charges,,,,,,,,,,,,,,,14066.66,83,,percent of total billed charges,,,16100.39,95,,percent of total billed charges,,,15253,90,,percent of total billed charges,,,15253,90,,percent of total billed charges,,,13897.18,82,,percent of total billed charges,,,15253,90,,percent of total billed charges,,,14405.61,85,,percent of total billed charges,,4236.95,16100.39,
SYNTHES DRILL BIT J-LATCH 1.1MM,30186802,CDM,,,270,RC,outpatient,,790.58,790.58,,671.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,197.65,22,,percent of total billed charges,,,,,,,,,711.52,90,,percent of total billed charges,,,654.6,82.8,,percent of total billed charges,,,671.99,85,,percent of total billed charges,,,,,,,,,695.71,88,,percent of total billed charges,,,,,,,,,604,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,197.65,22,,percent of total billed charges,,,719.43,91,,percent of total billed charges,,,751.05,95,,percent of total billed charges,,,656.18,83,,percent of total billed charges,,,656.18,83,,percent of total billed charges,,,,,,,,,,,,,,,656.18,83,,percent of total billed charges,,,751.05,95,,percent of total billed charges,,,711.52,90,,percent of total billed charges,,,711.52,90,,percent of total billed charges,,,648.28,82,,percent of total billed charges,,,711.52,90,,percent of total billed charges,,,671.99,85,,percent of total billed charges,,197.65,751.05,
SYNTHES DRILL BIT QC 1.5MM,30186803,CDM,,,270,RC,outpatient,,772.17,772.17,,655.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,193.04,22,,percent of total billed charges,,,,,,,,,694.95,90,,percent of total billed charges,,,639.36,82.8,,percent of total billed charges,,,656.34,85,,percent of total billed charges,,,,,,,,,679.51,88,,percent of total billed charges,,,,,,,,,589.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,193.04,22,,percent of total billed charges,,,702.67,91,,percent of total billed charges,,,733.56,95,,percent of total billed charges,,,640.9,83,,percent of total billed charges,,,640.9,83,,percent of total billed charges,,,,,,,,,,,,,,,640.9,83,,percent of total billed charges,,,733.56,95,,percent of total billed charges,,,694.95,90,,percent of total billed charges,,,694.95,90,,percent of total billed charges,,,633.18,82,,percent of total billed charges,,,694.95,90,,percent of total billed charges,,,656.34,85,,percent of total billed charges,,193.04,733.56,
SYNTHES PLATE STRAIGHT 6 HOLE 1.5MM,30186804,CDM,,,278,RC,outpatient,,4202.71,4202.71,,3568.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1050.68,22,,percent of total billed charges,,,,,,,,,3782.44,90,,percent of total billed charges,,,3479.84,82.8,,percent of total billed charges,,,3572.3,85,,percent of total billed charges,,,,,,,,,3698.38,88,,percent of total billed charges,,,,,,,,,3210.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1050.68,22,,percent of total billed charges,,,3824.47,91,,percent of total billed charges,,,3992.57,95,,percent of total billed charges,,,3488.25,83,,percent of total billed charges,,,3488.25,83,,percent of total billed charges,,,,,,,,,,,,,,,3488.25,83,,percent of total billed charges,,,3992.57,95,,percent of total billed charges,,,3782.44,90,,percent of total billed charges,,,3782.44,90,,percent of total billed charges,,,3446.22,82,,percent of total billed charges,,,3782.44,90,,percent of total billed charges,,,3572.3,85,,percent of total billed charges,,1050.68,3992.57,
SYNTHES SCREW CORTEX 1.5 9MM,30186805,CDM,,,278,RC,outpatient,,504.98,504.98,,428.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126.25,22,,percent of total billed charges,,,,,,,,,454.48,90,,percent of total billed charges,,,418.12,82.8,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,,,,,,,,444.38,88,,percent of total billed charges,,,,,,,,,385.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126.25,22,,percent of total billed charges,,,459.53,91,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,,,,,,,,,,,,,419.13,83,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,414.08,82,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,126.25,479.73,
SYNTHES SCREW CORTEX 1.5 10MM,30186806,CDM,,,278,RC,outpatient,,504.98,504.98,,428.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126.25,22,,percent of total billed charges,,,,,,,,,454.48,90,,percent of total billed charges,,,418.12,82.8,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,,,,,,,,444.38,88,,percent of total billed charges,,,,,,,,,385.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126.25,22,,percent of total billed charges,,,459.53,91,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,,,,,,,,,,,,,419.13,83,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,414.08,82,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,126.25,479.73,
SYNTHES PLATE DISTAL RADIUS 2.4 3HOLES,30186807,CDM,,,278,RC,outpatient,,4759.5,4759.5,,4040.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1189.88,22,,percent of total billed charges,,,,,,,,,4283.55,90,,percent of total billed charges,,,3940.87,82.8,,percent of total billed charges,,,4045.58,85,,percent of total billed charges,,,,,,,,,4188.36,88,,percent of total billed charges,,,,,,,,,3636.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1189.88,22,,percent of total billed charges,,,4331.15,91,,percent of total billed charges,,,4521.53,95,,percent of total billed charges,,,3950.39,83,,percent of total billed charges,,,3950.39,83,,percent of total billed charges,,,,,,,,,,,,,,,3950.39,83,,percent of total billed charges,,,4521.53,95,,percent of total billed charges,,,4283.55,90,,percent of total billed charges,,,4283.55,90,,percent of total billed charges,,,3902.79,82,,percent of total billed charges,,,4283.55,90,,percent of total billed charges,,,4045.58,85,,percent of total billed charges,,1189.88,4521.53,
SYNTHES SCREW CORTEX 2.4 X 10MM,30186808,CDM,,,278,RC,outpatient,,599.69,599.69,,509.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149.92,22,,percent of total billed charges,,,,,,,,,539.72,90,,percent of total billed charges,,,496.54,82.8,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,,,,,,,,527.73,88,,percent of total billed charges,,,,,,,,,458.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149.92,22,,percent of total billed charges,,,545.72,91,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,497.74,83,,percent of total billed charges,,,,,,,,,,,,,,,497.74,83,,percent of total billed charges,,,569.71,95,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,491.75,82,,percent of total billed charges,,,539.72,90,,percent of total billed charges,,,509.74,85,,percent of total billed charges,,149.92,569.71,
SYNTHES PLATE OLECRANON 2.7/3.5MM 2HOLE,30186809,CDM,,,278,RC,outpatient,,10641.15,10641.15,,9034.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2660.29,22,,percent of total billed charges,,,,,,,,,9577.04,90,,percent of total billed charges,,,8810.87,82.8,,percent of total billed charges,,,9044.98,85,,percent of total billed charges,,,,,,,,,9364.21,88,,percent of total billed charges,,,,,,,,,8129.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2660.29,22,,percent of total billed charges,,,9683.45,91,,percent of total billed charges,,,10109.09,95,,percent of total billed charges,,,8832.15,83,,percent of total billed charges,,,8832.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8832.15,83,,percent of total billed charges,,,10109.09,95,,percent of total billed charges,,,9577.04,90,,percent of total billed charges,,,9577.04,90,,percent of total billed charges,,,8725.74,82,,percent of total billed charges,,,9577.04,90,,percent of total billed charges,,,9044.98,85,,percent of total billed charges,,2660.29,10109.09,
SYNTHES SCREW LOCKING VA 2.7MM X 16MM,30186810,CDM,,,278,RC,outpatient,,1371.5,1371.5,,1164.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,342.88,22,,percent of total billed charges,,,,,,,,,1234.35,90,,percent of total billed charges,,,1135.6,82.8,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,,,,,,,,1206.92,88,,percent of total billed charges,,,,,,,,,1047.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,342.88,22,,percent of total billed charges,,,1248.07,91,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,1138.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.35,83,,percent of total billed charges,,,1302.93,95,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1124.63,82,,percent of total billed charges,,,1234.35,90,,percent of total billed charges,,,1165.78,85,,percent of total billed charges,,342.88,1302.93,
SYNTHES PLATE SUP ANT CLAVICLE 3HOLE RIG,30186811,CDM,,,278,RC,outpatient,,8536.13,8536.13,,7247.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2134.03,22,,percent of total billed charges,,,,,,,,,7682.52,90,,percent of total billed charges,,,7067.92,82.8,,percent of total billed charges,,,7255.71,85,,percent of total billed charges,,,,,,,,,7511.79,88,,percent of total billed charges,,,,,,,,,6521.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2134.03,22,,percent of total billed charges,,,7767.88,91,,percent of total billed charges,,,8109.32,95,,percent of total billed charges,,,7084.99,83,,percent of total billed charges,,,7084.99,83,,percent of total billed charges,,,,,,,,,,,,,,,7084.99,83,,percent of total billed charges,,,8109.32,95,,percent of total billed charges,,,7682.52,90,,percent of total billed charges,,,7682.52,90,,percent of total billed charges,,,6999.63,82,,percent of total billed charges,,,7682.52,90,,percent of total billed charges,,,7255.71,85,,percent of total billed charges,,2134.03,8109.32,
SYNTHES SCREW LOCKING VA 2.7MM X 24MM,30186812,CDM,,,278,RC,outpatient,,1412.65,1412.65,,1199.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,353.16,22,,percent of total billed charges,,,,,,,,,1271.39,90,,percent of total billed charges,,,1169.67,82.8,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,,,,,,,,1243.13,88,,percent of total billed charges,,,,,,,,,1079.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,353.16,22,,percent of total billed charges,,,1285.51,91,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,1172.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.5,83,,percent of total billed charges,,,1342.02,95,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1158.37,82,,percent of total billed charges,,,1271.39,90,,percent of total billed charges,,,1200.75,85,,percent of total billed charges,,353.16,1342.02,
ZIMMER INSERT LPS 10MM,30186813,CDM,,,278,RC,outpatient,,16770,16770,,14237.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4192.5,22,,percent of total billed charges,,,,,,,,,15093,90,,percent of total billed charges,,,13885.56,82.8,,percent of total billed charges,,,14254.5,85,,percent of total billed charges,,,,,,,,,14757.6,88,,percent of total billed charges,,,,,,,,,12812.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4192.5,22,,percent of total billed charges,,,15260.7,91,,percent of total billed charges,,,15931.5,95,,percent of total billed charges,,,13919.1,83,,percent of total billed charges,,,13919.1,83,,percent of total billed charges,,,,,,,,,,,,,,,13919.1,83,,percent of total billed charges,,,15931.5,95,,percent of total billed charges,,,15093,90,,percent of total billed charges,,,15093,90,,percent of total billed charges,,,13751.4,82,,percent of total billed charges,,,15093,90,,percent of total billed charges,,,14254.5,85,,percent of total billed charges,,4192.5,15931.5,
DEPUY STEM SUMMIT 6 HI,30186814,CDM,,,278,RC,outpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6361.02,22,,percent of total billed charges,,,,,,,,,22899.65,90,,percent of total billed charges,,,21067.68,82.8,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6361.02,22,,percent of total billed charges,,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,6361.02,24171.86,
STRYKER 50 S-SWEEP XL,30186815,CDM,,,270,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
DEPUY ATTUNE FEMUR CRS SZ 8 RT,30186816,CDM,,,278,RC,outpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13142.14,22,,percent of total billed charges,,,,,,,,,47311.7,90,,percent of total billed charges,,,43526.77,82.8,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13142.14,22,,percent of total billed charges,,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,13142.14,49940.13,
DEPUY ATTUNE DISTAL AUGMENT SZ 8 4MM,30186817,CDM,,,278,RC,outpatient,,9677.92,9677.92,,8216.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2419.48,22,,percent of total billed charges,,,,,,,,,8710.13,90,,percent of total billed charges,,,8013.32,82.8,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,,,,,,,,8516.57,88,,percent of total billed charges,,,,,,,,,7393.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2419.48,22,,percent of total billed charges,,,8806.91,91,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,,,,,,,,,,,,,8032.67,83,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,7935.89,82,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,2419.48,9194.02,
DEPUY ATTUNE STEM PRESSFIT 20 X 60,30186818,CDM,,,278,RC,outpatient,,13175.11,13175.11,,11185.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3293.78,22,,percent of total billed charges,,,,,,,,,11857.6,90,,percent of total billed charges,,,10908.99,82.8,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,,,,,,,,11594.1,88,,percent of total billed charges,,,,,,,,,10065.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3293.78,22,,percent of total billed charges,,,11989.35,91,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,,,,,,,,,,,,,10935.34,83,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,10803.59,82,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,3293.78,12516.35,
DEPUY ATTUNE INSERT CRS RP SZ 8 10MM,30186819,CDM,,,278,RC,outpatient,,23578.82,23578.82,,20018.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5894.71,22,,percent of total billed charges,,,,,,,,,21220.94,90,,percent of total billed charges,,,19523.26,82.8,,percent of total billed charges,,,20042,85,,percent of total billed charges,,,,,,,,,20749.36,88,,percent of total billed charges,,,,,,,,,18014.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5894.71,22,,percent of total billed charges,,,21456.73,91,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,,,,,,,,,,,,,19570.42,83,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,19334.63,82,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,20042,85,,percent of total billed charges,,5894.71,22399.88,
DEPUY ATTUNE TIBIA SLEEVE M/L 29MM,30186820,CDM,,,278,RC,outpatient,,29060.07,29060.07,,24672,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7265.02,22,,percent of total billed charges,,,,,,,,,26154.06,90,,percent of total billed charges,,,24061.74,82.8,,percent of total billed charges,,,24701.06,85,,percent of total billed charges,,,,,,,,,25572.86,88,,percent of total billed charges,,,,,,,,,22201.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7265.02,22,,percent of total billed charges,,,26444.66,91,,percent of total billed charges,,,27607.07,95,,percent of total billed charges,,,24119.86,83,,percent of total billed charges,,,24119.86,83,,percent of total billed charges,,,,,,,,,,,,,,,24119.86,83,,percent of total billed charges,,,27607.07,95,,percent of total billed charges,,,26154.06,90,,percent of total billed charges,,,26154.06,90,,percent of total billed charges,,,23829.26,82,,percent of total billed charges,,,26154.06,90,,percent of total billed charges,,,24701.06,85,,percent of total billed charges,,7265.02,27607.07,
DEPUY ATTUNE STEM PRESSFIT 16 X 60,30186821,CDM,,,278,RC,outpatient,,13175.11,13175.11,,11185.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3293.78,22,,percent of total billed charges,,,,,,,,,11857.6,90,,percent of total billed charges,,,10908.99,82.8,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,,,,,,,,11594.1,88,,percent of total billed charges,,,,,,,,,10065.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3293.78,22,,percent of total billed charges,,,11989.35,91,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,,,,,,,,,,,,,10935.34,83,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,10803.59,82,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,3293.78,12516.35,
ARTHREX SCREW HEADLESS 7.0 X 80MM,30186822,CDM,,,278,RC,outpatient,,4517.2,4517.2,,3835.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1129.3,22,,percent of total billed charges,,,,,,,,,4065.48,90,,percent of total billed charges,,,3740.24,82.8,,percent of total billed charges,,,3839.62,85,,percent of total billed charges,,,,,,,,,3975.14,88,,percent of total billed charges,,,,,,,,,3451.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1129.3,22,,percent of total billed charges,,,4110.65,91,,percent of total billed charges,,,4291.34,95,,percent of total billed charges,,,3749.28,83,,percent of total billed charges,,,3749.28,83,,percent of total billed charges,,,,,,,,,,,,,,,3749.28,83,,percent of total billed charges,,,4291.34,95,,percent of total billed charges,,,4065.48,90,,percent of total billed charges,,,4065.48,90,,percent of total billed charges,,,3704.1,82,,percent of total billed charges,,,4065.48,90,,percent of total billed charges,,,3839.62,85,,percent of total billed charges,,1129.3,4291.34,
ARTHREX SCREW HEADLESS 7.0 X 85MM,30186823,CDM,,,278,RC,outpatient,,4517.5,4517.5,,3835.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1129.38,22,,percent of total billed charges,,,,,,,,,4065.75,90,,percent of total billed charges,,,3740.49,82.8,,percent of total billed charges,,,3839.88,85,,percent of total billed charges,,,,,,,,,3975.4,88,,percent of total billed charges,,,,,,,,,3451.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1129.38,22,,percent of total billed charges,,,4110.93,91,,percent of total billed charges,,,4291.63,95,,percent of total billed charges,,,3749.53,83,,percent of total billed charges,,,3749.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3749.53,83,,percent of total billed charges,,,4291.63,95,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,3704.35,82,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,3839.88,85,,percent of total billed charges,,1129.38,4291.63,
ARTHREX SCREW HEADLESS 5.0 X 38MM,30186824,CDM,,,278,RC,outpatient,,3087.5,3087.5,,2621.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,771.88,22,,percent of total billed charges,,,,,,,,,2778.75,90,,percent of total billed charges,,,2556.45,82.8,,percent of total billed charges,,,2624.38,85,,percent of total billed charges,,,,,,,,,2717,88,,percent of total billed charges,,,,,,,,,2358.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,771.88,22,,percent of total billed charges,,,2809.63,91,,percent of total billed charges,,,2933.13,95,,percent of total billed charges,,,2562.63,83,,percent of total billed charges,,,2562.63,83,,percent of total billed charges,,,,,,,,,,,,,,,2562.63,83,,percent of total billed charges,,,2933.13,95,,percent of total billed charges,,,2778.75,90,,percent of total billed charges,,,2778.75,90,,percent of total billed charges,,,2531.75,82,,percent of total billed charges,,,2778.75,90,,percent of total billed charges,,,2624.38,85,,percent of total billed charges,,771.88,2933.13,
ARTHREX GUIDEWIRE 1.6MM,30186825,CDM,,,278,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
ARTHREX GUIDEWIRE 2.4MM,30186826,CDM,,,278,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
ARTHREX DRILL BIT 3.2MM,30186827,CDM,,,270,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
ARTHREX DRILL BIT 5.0MM,30186828,CDM,,,270,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
ARTHREX DRILL BIT SYNANITE STAPLE 2.0,30186829,CDM,,,270,RC,outpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210,22,,percent of total billed charges,,,,,,,,,756,90,,percent of total billed charges,,,695.52,82.8,,percent of total billed charges,,,714,85,,percent of total billed charges,,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210,22,,percent of total billed charges,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,210,798,
ARTHREX STAPLE SYNANITE MX 20X20,30186830,CDM,,,278,RC,outpatient,,16217.5,16217.5,,13768.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4054.38,22,,percent of total billed charges,,,,,,,,,14595.75,90,,percent of total billed charges,,,13428.09,82.8,,percent of total billed charges,,,13784.88,85,,percent of total billed charges,,,,,,,,,14271.4,88,,percent of total billed charges,,,,,,,,,12390.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4054.38,22,,percent of total billed charges,,,14757.93,91,,percent of total billed charges,,,15406.63,95,,percent of total billed charges,,,13460.53,83,,percent of total billed charges,,,13460.53,83,,percent of total billed charges,,,,,,,,,,,,,,,13460.53,83,,percent of total billed charges,,,15406.63,95,,percent of total billed charges,,,14595.75,90,,percent of total billed charges,,,14595.75,90,,percent of total billed charges,,,13298.35,82,,percent of total billed charges,,,14595.75,90,,percent of total billed charges,,,13784.88,85,,percent of total billed charges,,4054.38,15406.63,
ARTHREX FIBERTAK DISP. KIT,30186831,CDM,,,270,RC,outpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,446.88,22,,percent of total billed charges,,,,,,,,,1608.75,90,,percent of total billed charges,,,1480.05,82.8,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,446.88,22,,percent of total billed charges,,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,446.88,1698.13,
ARTHREX FIBERTAK SUTURE ANCHOR,30186832,CDM,,,270,RC,outpatient,,3022.5,3022.5,,2566.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,755.63,22,,percent of total billed charges,,,,,,,,,2720.25,90,,percent of total billed charges,,,2502.63,82.8,,percent of total billed charges,,,2569.13,85,,percent of total billed charges,,,,,,,,,2659.8,88,,percent of total billed charges,,,,,,,,,2309.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,755.63,22,,percent of total billed charges,,,2750.48,91,,percent of total billed charges,,,2871.38,95,,percent of total billed charges,,,2508.68,83,,percent of total billed charges,,,2508.68,83,,percent of total billed charges,,,,,,,,,,,,,,,2508.68,83,,percent of total billed charges,,,2871.38,95,,percent of total billed charges,,,2720.25,90,,percent of total billed charges,,,2720.25,90,,percent of total billed charges,,,2478.45,82,,percent of total billed charges,,,2720.25,90,,percent of total billed charges,,,2569.13,85,,percent of total billed charges,,755.63,2871.38,
ULRICH PLATE 1 LEVEL 16MM,30186833,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
SPINECRAFT SCREW 5.5 X 45MM,30186834,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ZIMMER SCREW PSN 2.5 X 25MM FEMAL,30186835,CDM,,,278,RC,outpatient,,1072.5,1072.5,,910.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,268.13,22,,percent of total billed charges,,,,,,,,,965.25,90,,percent of total billed charges,,,888.03,82.8,,percent of total billed charges,,,911.63,85,,percent of total billed charges,,,,,,,,,943.8,88,,percent of total billed charges,,,,,,,,,819.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,268.13,22,,percent of total billed charges,,,975.98,91,,percent of total billed charges,,,1018.88,95,,percent of total billed charges,,,890.18,83,,percent of total billed charges,,,890.18,83,,percent of total billed charges,,,,,,,,,,,,,,,890.18,83,,percent of total billed charges,,,1018.88,95,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,879.45,82,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,911.63,85,,percent of total billed charges,,268.13,1018.88,
ZIMMER SCREW MIS HEADED 48MM,30186836,CDM,,,278,RC,outpatient,,535.5,535.5,,454.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,133.88,22,,percent of total billed charges,,,,,,,,,481.95,90,,percent of total billed charges,,,443.39,82.8,,percent of total billed charges,,,455.18,85,,percent of total billed charges,,,,,,,,,471.24,88,,percent of total billed charges,,,,,,,,,409.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,133.88,22,,percent of total billed charges,,,487.31,91,,percent of total billed charges,,,508.73,95,,percent of total billed charges,,,444.47,83,,percent of total billed charges,,,444.47,83,,percent of total billed charges,,,,,,,,,,,,,,,444.47,83,,percent of total billed charges,,,508.73,95,,percent of total billed charges,,,481.95,90,,percent of total billed charges,,,481.95,90,,percent of total billed charges,,,439.11,82,,percent of total billed charges,,,481.95,90,,percent of total billed charges,,,455.18,85,,percent of total billed charges,,133.88,508.73,
ZIMMER SCREW SET HEX DRIVER 2MM,30186837,CDM,,,278,RC,outpatient,,567,567,,481.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141.75,22,,percent of total billed charges,,,,,,,,,510.3,90,,percent of total billed charges,,,469.48,82.8,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,,,,,,,,498.96,88,,percent of total billed charges,,,,,,,,,433.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141.75,22,,percent of total billed charges,,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,,,,,,,,,,,,,470.61,83,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,464.94,82,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,141.75,538.65,
ZIMMER STEM REV PSN 14X75MM,30186838,CDM,,,278,RC,outpatient,,15174.25,15174.25,,12882.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3793.56,22,,percent of total billed charges,,,,,,,,,13656.83,90,,percent of total billed charges,,,12564.28,82.8,,percent of total billed charges,,,12898.11,85,,percent of total billed charges,,,,,,,,,13353.34,88,,percent of total billed charges,,,,,,,,,11593.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3793.56,22,,percent of total billed charges,,,13808.57,91,,percent of total billed charges,,,14415.54,95,,percent of total billed charges,,,12594.63,83,,percent of total billed charges,,,12594.63,83,,percent of total billed charges,,,,,,,,,,,,,,,12594.63,83,,percent of total billed charges,,,14415.54,95,,percent of total billed charges,,,13656.83,90,,percent of total billed charges,,,13656.83,90,,percent of total billed charges,,,12442.89,82,,percent of total billed charges,,,13656.83,90,,percent of total billed charges,,,12898.11,85,,percent of total billed charges,,3793.56,14415.54,
ZIMMER FEMUR CMT REV PSN SZ 9 RT,30186839,CDM,,,278,RC,outpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16788.28,22,,percent of total billed charges,,,,,,,,,60437.82,90,,percent of total billed charges,,,55602.79,82.8,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16788.28,22,,percent of total billed charges,,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,16788.28,63795.47,
ZIMMER STEM OFFSET PSN REV 13 X135MM,30186840,CDM,,,278,RC,outpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6126.25,22,,percent of total billed charges,,,,,,,,,22054.5,90,,percent of total billed charges,,,20290.14,82.8,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6126.25,22,,percent of total billed charges,,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,6126.25,23279.75,
ZIMMER TIBIA FIXED KEEL PSN SZ F,30186841,CDM,,,278,RC,outpatient,,24033.75,24033.75,,20404.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6008.44,22,,percent of total billed charges,,,,,,,,,21630.38,90,,percent of total billed charges,,,19899.95,82.8,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,,,,,,,,21149.7,88,,percent of total billed charges,,,,,,,,,18361.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6008.44,22,,percent of total billed charges,,,21870.71,91,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,,,,,,,,,,,,,19948.01,83,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,19707.68,82,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,6008.44,22832.06,
ZIMMER TIBIA HALF BLOCK PSN SZ EF 5MM,30186842,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER TIBIA HALF BLOCK PSN SZ EF RM,30186843,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER FEMUR DISTAL AUG SZ 9 5MM,30186844,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER FEMUR DISTAL AUG SZ 95MM,30186845,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER CPS ASF PSN 6-9EF,30186846,CDM,,,278,RC,outpatient,,17135.63,17135.63,,14548.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4283.91,22,,percent of total billed charges,,,,,,,,,15422.07,90,,percent of total billed charges,,,14188.3,82.8,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,,,,,,,,15079.35,88,,percent of total billed charges,,,,,,,,,13091.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4283.91,22,,percent of total billed charges,,,15593.42,91,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14222.57,83,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14051.22,82,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,4283.91,16278.85,
ARTHREX TENODESIS GRAFT SIZING KIT,30186847,CDM,,,270,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
SPINECRAFT SCREW 5.5 X 50MM,30186848,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT SCREW SET,30186849,CDM,,,278,RC,outpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175,22,,percent of total billed charges,,,,,,,,,630,90,,percent of total billed charges,,,579.6,82.8,,percent of total billed charges,,,595,85,,percent of total billed charges,,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175,22,,percent of total billed charges,,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,175,665,
SPINECRAFT ROD REVISION 6.0 T RIGHT,30186850,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
SPINECRAFT ROD REVISION 6.0 T LEFT,30186851,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
SPINECRAFT CROSS CONNECTOR 31-39MM,30186852,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
ZIMMER TROCAR DRILL PIN HEADLESS 75MM,30186853,CDM,,,278,RC,outpatient,,2111.85,2111.85,,1792.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,527.96,22,,percent of total billed charges,,,,,,,,,1900.67,90,,percent of total billed charges,,,1748.61,82.8,,percent of total billed charges,,,1795.07,85,,percent of total billed charges,,,,,,,,,1858.43,88,,percent of total billed charges,,,,,,,,,1613.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,527.96,22,,percent of total billed charges,,,1921.78,91,,percent of total billed charges,,,2006.26,95,,percent of total billed charges,,,1752.84,83,,percent of total billed charges,,,1752.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1752.84,83,,percent of total billed charges,,,2006.26,95,,percent of total billed charges,,,1900.67,90,,percent of total billed charges,,,1900.67,90,,percent of total billed charges,,,1731.72,82,,percent of total billed charges,,,1900.67,90,,percent of total billed charges,,,1795.07,85,,percent of total billed charges,,527.96,2006.26,
ZIMMER TIBIAL AUGMENT RL 5MM,30186854,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER TIBIAL AUGMENT RM 5MM,30186855,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER STEM REVISION PSN 16 X 135MM,30186856,CDM,,,278,RC,outpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6126.25,22,,percent of total billed charges,,,,,,,,,22054.5,90,,percent of total billed charges,,,20290.14,82.8,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6126.25,22,,percent of total billed charges,,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,6126.25,23279.75,
ZIMMER FEMORAL AUGMENT POSTERIOR 15MM,30186857,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER FEMORAL CENTRAL CONE X-LARGE,30186858,CDM,,,278,RC,outpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12075.78,22,,percent of total billed charges,,,,,,,,,43472.82,90,,percent of total billed charges,,,39994.99,82.8,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12075.78,22,,percent of total billed charges,,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,12075.78,45887.97,
ZIMMER FEMUR DISTAL AUG 10MM,30186859,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER INSERT POLY CCK 10MM,30186860,CDM,,,278,RC,outpatient,,23562.5,23562.5,,20004.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5890.63,22,,percent of total billed charges,,,,,,,,,21206.25,90,,percent of total billed charges,,,19509.75,82.8,,percent of total billed charges,,,20028.13,85,,percent of total billed charges,,,,,,,,,20735,88,,percent of total billed charges,,,,,,,,,18001.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5890.63,22,,percent of total billed charges,,,21441.88,91,,percent of total billed charges,,,22384.38,95,,percent of total billed charges,,,19556.88,83,,percent of total billed charges,,,19556.88,83,,percent of total billed charges,,,,,,,,,,,,,,,19556.88,83,,percent of total billed charges,,,22384.38,95,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,19321.25,82,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,20028.13,85,,percent of total billed charges,,5890.63,22384.38,
ZIMMER FEMUR REV PSN SZ 9 R,30186861,CDM,,,278,RC,outpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16788.28,22,,percent of total billed charges,,,,,,,,,60437.82,90,,percent of total billed charges,,,55602.79,82.8,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16788.28,22,,percent of total billed charges,,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,16788.28,63795.47,
ZIMMER STEM REVISION PSN 18 X 135MM,30186862,CDM,,,278,RC,outpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6126.25,22,,percent of total billed charges,,,,,,,,,22054.5,90,,percent of total billed charges,,,20290.14,82.8,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6126.25,22,,percent of total billed charges,,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,6126.25,23279.75,
DEPUY CUP PRESSFIT BI-MENTUM 53,30186863,CDM,,,278,RC,outpatient,,25026.11,25026.11,,21247.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6256.53,22,,percent of total billed charges,,,,,,,,,22523.5,90,,percent of total billed charges,,,20721.62,82.8,,percent of total billed charges,,,21272.19,85,,percent of total billed charges,,,,,,,,,22022.98,88,,percent of total billed charges,,,,,,,,,19119.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6256.53,22,,percent of total billed charges,,,22773.76,91,,percent of total billed charges,,,23774.8,95,,percent of total billed charges,,,20771.67,83,,percent of total billed charges,,,20771.67,83,,percent of total billed charges,,,,,,,,,,,,,,,20771.67,83,,percent of total billed charges,,,23774.8,95,,percent of total billed charges,,,22523.5,90,,percent of total billed charges,,,22523.5,90,,percent of total billed charges,,,20521.41,82,,percent of total billed charges,,,22523.5,90,,percent of total billed charges,,,21272.19,85,,percent of total billed charges,,6256.53,23774.8,
DEPUY LINER PE BI-MENTUM 28/53,30186864,CDM,,,278,RC,outpatient,,15818.92,15818.92,,13430.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3954.73,22,,percent of total billed charges,,,,,,,,,14237.03,90,,percent of total billed charges,,,13098.07,82.8,,percent of total billed charges,,,13446.08,85,,percent of total billed charges,,,,,,,,,13920.65,88,,percent of total billed charges,,,,,,,,,12085.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3954.73,22,,percent of total billed charges,,,14395.22,91,,percent of total billed charges,,,15027.97,95,,percent of total billed charges,,,13129.7,83,,percent of total billed charges,,,13129.7,83,,percent of total billed charges,,,,,,,,,,,,,,,13129.7,83,,percent of total billed charges,,,15027.97,95,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,12971.51,82,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,13446.08,85,,percent of total billed charges,,3954.73,15027.97,
S&N GRAFIX 5X5 CM,30186865,CDM,,,278,RC,outpatient,,18525,18525,,15727.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4631.25,22,,percent of total billed charges,,,,,,,,,16672.5,90,,percent of total billed charges,,,15338.7,82.8,,percent of total billed charges,,,15746.25,85,,percent of total billed charges,,,,,,,,,16302,88,,percent of total billed charges,,,,,,,,,14153.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4631.25,22,,percent of total billed charges,,,16857.75,91,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,,,,,,,,,,,,,15375.75,83,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15190.5,82,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15746.25,85,,percent of total billed charges,,4631.25,17598.75,
DEPUY STEM SUMMIT HIP SZ 4 HI,30186866,CDM,,,278,RC,outpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6361.02,22,,percent of total billed charges,,,,,,,,,22899.65,90,,percent of total billed charges,,,21067.68,82.8,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6361.02,22,,percent of total billed charges,,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,6361.02,24171.86,
ARTHREX TIGER LOOP,30186867,CDM,,,278,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
DEPUY CAP COP POROUS,30186868,CDM,,,278,RC,outpatient,,48750,48750,,41388.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12187.5,22,,percent of total billed charges,,,,,,,,,43875,90,,percent of total billed charges,,,40365,82.8,,percent of total billed charges,,,41437.5,85,,percent of total billed charges,,,,,,,,,42900,88,,percent of total billed charges,,,,,,,,,37245,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12187.5,22,,percent of total billed charges,,,44362.5,91,,percent of total billed charges,,,46312.5,95,,percent of total billed charges,,,40462.5,83,,percent of total billed charges,,,40462.5,83,,percent of total billed charges,,,,,,,,,,,,,,,40462.5,83,,percent of total billed charges,,,46312.5,95,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,39975,82,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,41437.5,85,,percent of total billed charges,,12187.5,46312.5,
BREAST IMPLANT MEMORYGEL XTRA 490CC,30186869,CDM,,,278,RC,outpatient,,7982,7982,,6776.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1995.5,22,,percent of total billed charges,,,,,,,,,7183.8,90,,percent of total billed charges,,,6609.1,82.8,,percent of total billed charges,,,6784.7,85,,percent of total billed charges,,,,,,,,,7024.16,88,,percent of total billed charges,,,,,,,,,6098.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1995.5,22,,percent of total billed charges,,,7263.62,91,,percent of total billed charges,,,7582.9,95,,percent of total billed charges,,,6625.06,83,,percent of total billed charges,,,6625.06,83,,percent of total billed charges,,,,,,,,,,,,,,,6625.06,83,,percent of total billed charges,,,7582.9,95,,percent of total billed charges,,,7183.8,90,,percent of total billed charges,,,7183.8,90,,percent of total billed charges,,,6545.24,82,,percent of total billed charges,,,7183.8,90,,percent of total billed charges,,,6784.7,85,,percent of total billed charges,,1995.5,7582.9,
SYNTHES SCREW CORTEX 4.5X38MM,30186870,CDM,,,278,RC,outpatient,,277.28,277.28,,235.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.32,22,,percent of total billed charges,,,,,,,,,249.55,90,,percent of total billed charges,,,229.59,82.8,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,,,,,,,,244.01,88,,percent of total billed charges,,,,,,,,,211.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.32,22,,percent of total billed charges,,,252.32,91,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,,,,,,,,,,,,,230.14,83,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,227.37,82,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,69.32,263.42,
NEVRO TRIAL LEAD KIT 50CM,30186871,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
NEVRO NEEDLE EPIDURAL CURVED 4,30186872,CDM,,,270,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
ZIMMER LINER NEUTRAL E 32MM,30186874,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SYNTHES SCREW TFNA 90MM,30186875,CDM,,,278,RC,outpatient,,6487.46,6487.46,,5507.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1621.87,22,,percent of total billed charges,,,,,,,,,5838.71,90,,percent of total billed charges,,,5371.62,82.8,,percent of total billed charges,,,5514.34,85,,percent of total billed charges,,,,,,,,,5708.96,88,,percent of total billed charges,,,,,,,,,4956.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1621.87,22,,percent of total billed charges,,,5903.59,91,,percent of total billed charges,,,6163.09,95,,percent of total billed charges,,,5384.59,83,,percent of total billed charges,,,5384.59,83,,percent of total billed charges,,,,,,,,,,,,,,,5384.59,83,,percent of total billed charges,,,6163.09,95,,percent of total billed charges,,,5838.71,90,,percent of total billed charges,,,5838.71,90,,percent of total billed charges,,,5319.72,82,,percent of total billed charges,,,5838.71,90,,percent of total billed charges,,,5514.34,85,,percent of total billed charges,,1621.87,6163.09,
DEPUY INSERT AOX RP POLY SZ 4 15MM,30186876,CDM,,,278,RC,outpatient,,17068.29,17068.29,,14490.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4267.07,22,,percent of total billed charges,,,,,,,,,15361.46,90,,percent of total billed charges,,,14132.54,82.8,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,,,,,,,,15020.1,88,,percent of total billed charges,,,,,,,,,13040.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4267.07,22,,percent of total billed charges,,,15532.14,91,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,,,,,,,,,,,,,14166.68,83,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,13996,82,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,4267.07,16214.88,
DEPUY STEM CORAIL REVISION SZ12 HIGH OFF,30186877,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
SYNTHES PLATE T 12-HOLE LCP 141MM,30186878,CDM,,,278,RC,outpatient,,1815.32,1815.32,,1541.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,453.83,22,,percent of total billed charges,,,,,,,,,1633.79,90,,percent of total billed charges,,,1503.08,82.8,,percent of total billed charges,,,1543.02,85,,percent of total billed charges,,,,,,,,,1597.48,88,,percent of total billed charges,,,,,,,,,1386.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,453.83,22,,percent of total billed charges,,,1651.94,91,,percent of total billed charges,,,1724.55,95,,percent of total billed charges,,,1506.72,83,,percent of total billed charges,,,1506.72,83,,percent of total billed charges,,,,,,,,,,,,,,,1506.72,83,,percent of total billed charges,,,1724.55,95,,percent of total billed charges,,,1633.79,90,,percent of total billed charges,,,1633.79,90,,percent of total billed charges,,,1488.56,82,,percent of total billed charges,,,1633.79,90,,percent of total billed charges,,,1543.02,85,,percent of total billed charges,,453.83,1724.55,
SYNTHES TFNA 11MM X 440MM 130DEG LT,30186879,CDM,,,278,RC,outpatient,,21784.17,21784.17,,18494.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5446.04,22,,percent of total billed charges,,,,,,,,,19605.75,90,,percent of total billed charges,,,18037.29,82.8,,percent of total billed charges,,,18516.54,85,,percent of total billed charges,,,,,,,,,19170.07,88,,percent of total billed charges,,,,,,,,,16643.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5446.04,22,,percent of total billed charges,,,19823.59,91,,percent of total billed charges,,,20694.96,95,,percent of total billed charges,,,18080.86,83,,percent of total billed charges,,,18080.86,83,,percent of total billed charges,,,,,,,,,,,,,,,18080.86,83,,percent of total billed charges,,,20694.96,95,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,17863.02,82,,percent of total billed charges,,,19605.75,90,,percent of total billed charges,,,18516.54,85,,percent of total billed charges,,5446.04,20694.96,
SYNTHES SCREW LOCKING 5.0 X 52MM,30186880,CDM,,,278,RC,outpatient,,2185.24,2185.24,,1855.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,546.31,22,,percent of total billed charges,,,,,,,,,1966.72,90,,percent of total billed charges,,,1809.38,82.8,,percent of total billed charges,,,1857.45,85,,percent of total billed charges,,,,,,,,,1923.01,88,,percent of total billed charges,,,,,,,,,1669.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,546.31,22,,percent of total billed charges,,,1988.57,91,,percent of total billed charges,,,2075.98,95,,percent of total billed charges,,,1813.75,83,,percent of total billed charges,,,1813.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1813.75,83,,percent of total billed charges,,,2075.98,95,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1791.9,82,,percent of total billed charges,,,1966.72,90,,percent of total billed charges,,,1857.45,85,,percent of total billed charges,,546.31,2075.98,
ZIMMER LINER NEUTRAL G7 40MM,30186881,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
DEPUY STEM CORAIL HO SZ 13,30186882,CDM,,,278,RC,outpatient,,31229.32,31229.32,,26513.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7807.33,22,,percent of total billed charges,,,,,,,,,28106.39,90,,percent of total billed charges,,,25857.88,82.8,,percent of total billed charges,,,26544.92,85,,percent of total billed charges,,,,,,,,,27481.8,88,,percent of total billed charges,,,,,,,,,23859.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7807.33,22,,percent of total billed charges,,,28418.68,91,,percent of total billed charges,,,29667.85,95,,percent of total billed charges,,,25920.34,83,,percent of total billed charges,,,25920.34,83,,percent of total billed charges,,,,,,,,,,,,,,,25920.34,83,,percent of total billed charges,,,29667.85,95,,percent of total billed charges,,,28106.39,90,,percent of total billed charges,,,28106.39,90,,percent of total billed charges,,,25608.04,82,,percent of total billed charges,,,28106.39,90,,percent of total billed charges,,,26544.92,85,,percent of total billed charges,,7807.33,29667.85,
S&N GRAFIX PRIME 3X4 CM,30186883,CDM,,,278,RC,outpatient,,8336.25,8336.25,,7077.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2084.06,22,,percent of total billed charges,,,,,,,,,7502.63,90,,percent of total billed charges,,,6902.42,82.8,,percent of total billed charges,,,7085.81,85,,percent of total billed charges,,,,,,,,,7335.9,88,,percent of total billed charges,,,,,,,,,6368.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2084.06,22,,percent of total billed charges,,,7585.99,91,,percent of total billed charges,,,7919.44,95,,percent of total billed charges,,,6919.09,83,,percent of total billed charges,,,6919.09,83,,percent of total billed charges,,,,,,,,,,,,,,,6919.09,83,,percent of total billed charges,,,7919.44,95,,percent of total billed charges,,,7502.63,90,,percent of total billed charges,,,7502.63,90,,percent of total billed charges,,,6835.73,82,,percent of total billed charges,,,7502.63,90,,percent of total billed charges,,,7085.81,85,,percent of total billed charges,,2084.06,7919.44,
BARD POWERPORT MRI IMPLANTABLE PORT 8FR,30186884,CDM,,,278,RC,outpatient,,4815.72,4815.72,,4088.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1203.93,22,,percent of total billed charges,,,,,,,,,4334.15,90,,percent of total billed charges,,,3987.42,82.8,,percent of total billed charges,,,4093.36,85,,percent of total billed charges,,,,,,,,,4237.83,88,,percent of total billed charges,,,,,,,,,3679.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1203.93,22,,percent of total billed charges,,,4382.31,91,,percent of total billed charges,,,4574.93,95,,percent of total billed charges,,,3997.05,83,,percent of total billed charges,,,3997.05,83,,percent of total billed charges,,,,,,,,,,,,,,,3997.05,83,,percent of total billed charges,,,4574.93,95,,percent of total billed charges,,,4334.15,90,,percent of total billed charges,,,4334.15,90,,percent of total billed charges,,,3948.89,82,,percent of total billed charges,,,4334.15,90,,percent of total billed charges,,,4093.36,85,,percent of total billed charges,,1203.93,4574.93,
FEMORAL SPACER MOLD 44A/P X 67M/L,30186885,CDM,,,278,RC,outpatient,,12967.5,12967.5,,11009.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3241.88,22,,percent of total billed charges,,,,,,,,,11670.75,90,,percent of total billed charges,,,10737.09,82.8,,percent of total billed charges,,,11022.38,85,,percent of total billed charges,,,,,,,,,11411.4,88,,percent of total billed charges,,,,,,,,,9907.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3241.88,22,,percent of total billed charges,,,11800.43,91,,percent of total billed charges,,,12319.13,95,,percent of total billed charges,,,10763.03,83,,percent of total billed charges,,,10763.03,83,,percent of total billed charges,,,,,,,,,,,,,,,10763.03,83,,percent of total billed charges,,,12319.13,95,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,10633.35,82,,percent of total billed charges,,,11670.75,90,,percent of total billed charges,,,11022.38,85,,percent of total billed charges,,3241.88,12319.13,
TIBIAL SPACER MOLD 45A/P X 70M/L,30186886,CDM,,,278,RC,outpatient,,12187.5,12187.5,,10347.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3046.88,22,,percent of total billed charges,,,,,,,,,10968.75,90,,percent of total billed charges,,,10091.25,82.8,,percent of total billed charges,,,10359.38,85,,percent of total billed charges,,,,,,,,,10725,88,,percent of total billed charges,,,,,,,,,9311.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3046.88,22,,percent of total billed charges,,,11090.63,91,,percent of total billed charges,,,11578.13,95,,percent of total billed charges,,,10115.63,83,,percent of total billed charges,,,10115.63,83,,percent of total billed charges,,,,,,,,,,,,,,,10115.63,83,,percent of total billed charges,,,11578.13,95,,percent of total billed charges,,,10968.75,90,,percent of total billed charges,,,10968.75,90,,percent of total billed charges,,,9993.75,82,,percent of total billed charges,,,10968.75,90,,percent of total billed charges,,,10359.38,85,,percent of total billed charges,,3046.88,11578.13,
DEPUY GLENOSPHERE 38MM +4,30186887,CDM,,,278,RC,outpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4954.14,22,,percent of total billed charges,,,,,,,,,17834.9,90,,percent of total billed charges,,,16408.1,82.8,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4954.14,22,,percent of total billed charges,,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,4954.14,18825.72,
ARTHREX SUTURE FIBERTAPE CERCUAGE,30186888,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
ARTHREX SUTURE FIBERLINIK,30186889,CDM,,,278,RC,outpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,148.75,22,,percent of total billed charges,,,,,,,,,535.5,90,,percent of total billed charges,,,492.66,82.8,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,148.75,22,,percent of total billed charges,,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,148.75,565.25,
SYNTHES SCREW CORTEX TI 2.4 X 18,30186890,CDM,,,278,RC,outpatient,,643.51,643.51,,546.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,160.88,22,,percent of total billed charges,,,,,,,,,579.16,90,,percent of total billed charges,,,532.83,82.8,,percent of total billed charges,,,546.98,85,,percent of total billed charges,,,,,,,,,566.29,88,,percent of total billed charges,,,,,,,,,491.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,160.88,22,,percent of total billed charges,,,585.59,91,,percent of total billed charges,,,611.33,95,,percent of total billed charges,,,534.11,83,,percent of total billed charges,,,534.11,83,,percent of total billed charges,,,,,,,,,,,,,,,534.11,83,,percent of total billed charges,,,611.33,95,,percent of total billed charges,,,579.16,90,,percent of total billed charges,,,579.16,90,,percent of total billed charges,,,527.68,82,,percent of total billed charges,,,579.16,90,,percent of total billed charges,,,546.98,85,,percent of total billed charges,,160.88,611.33,
OSTEO STEM MEDIUM LONG,30186891,CDM,,,278,RC,outpatient,,21125,21125,,17935.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5281.25,22,,percent of total billed charges,,,,,,,,,19012.5,90,,percent of total billed charges,,,17491.5,82.8,,percent of total billed charges,,,17956.25,85,,percent of total billed charges,,,,,,,,,18590,88,,percent of total billed charges,,,,,,,,,16139.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5281.25,22,,percent of total billed charges,,,19223.75,91,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,,,,,,,,,,,,,17533.75,83,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17322.5,82,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17956.25,85,,percent of total billed charges,,5281.25,20068.75,
OSTEO HEAD LARGE,30186892,CDM,,,278,RC,outpatient,,21125,21125,,17935.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5281.25,22,,percent of total billed charges,,,,,,,,,19012.5,90,,percent of total billed charges,,,17491.5,82.8,,percent of total billed charges,,,17956.25,85,,percent of total billed charges,,,,,,,,,18590,88,,percent of total billed charges,,,,,,,,,16139.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5281.25,22,,percent of total billed charges,,,19223.75,91,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,,,,,,,,,,,,,17533.75,83,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17322.5,82,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17956.25,85,,percent of total billed charges,,5281.25,20068.75,
ZIMMER TIBIA PSN CEMENTED SZ F LEFT,30186893,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER INSERT ASF MC 11MM LEFT,30186894,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
DEPUY STEM CORAIL HIGH COL SZ 16,30186895,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
SYNTHES SCREW CORTEX 2.4 X 26MM,30186896,CDM,,,278,RC,outpatient,,827.05,827.05,,702.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.76,22,,percent of total billed charges,,,,,,,,,744.35,90,,percent of total billed charges,,,684.8,82.8,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,,,,,,,,727.8,88,,percent of total billed charges,,,,,,,,,631.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.76,22,,percent of total billed charges,,,752.62,91,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,,,,,,,,,,,,,686.45,83,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,678.18,82,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,206.76,785.7,
DEPUY ATTUNE CRS FEMOR RIGHT SZ 4,30186897,CDM,,,278,RC,outpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13142.14,22,,percent of total billed charges,,,,,,,,,47311.7,90,,percent of total billed charges,,,43526.77,82.8,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13142.14,22,,percent of total billed charges,,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,13142.14,49940.13,
DEPUY ATTUNE DISTAL AUGMENT SZ 4 4MM,30186898,CDM,,,278,RC,outpatient,,9677.92,9677.92,,8216.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2419.48,22,,percent of total billed charges,,,,,,,,,8710.13,90,,percent of total billed charges,,,8013.32,82.8,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,,,,,,,,8516.57,88,,percent of total billed charges,,,,,,,,,7393.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2419.48,22,,percent of total billed charges,,,8806.91,91,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,,,,,,,,,,,,,8032.67,83,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,7935.89,82,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,2419.48,9194.02,
DEPUY ATTUNE POSTERIOR AUGMENT SZ 4 4MM,30186899,CDM,,,278,RC,outpatient,,9677.92,9677.92,,8216.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2419.48,22,,percent of total billed charges,,,,,,,,,8710.13,90,,percent of total billed charges,,,8013.32,82.8,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,,,,,,,,8516.57,88,,percent of total billed charges,,,,,,,,,7393.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2419.48,22,,percent of total billed charges,,,8806.91,91,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,,,,,,,,,,,,,8032.67,83,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,7935.89,82,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,2419.48,9194.02,
DEPUY STEM 18 X 60MM,30186900,CDM,,,278,RC,outpatient,,13175.11,13175.11,,11185.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3293.78,22,,percent of total billed charges,,,,,,,,,11857.6,90,,percent of total billed charges,,,10908.99,82.8,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,,,,,,,,11594.1,88,,percent of total billed charges,,,,,,,,,10065.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3293.78,22,,percent of total billed charges,,,11989.35,91,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,,,,,,,,,,,,,10935.34,83,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,10803.59,82,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,3293.78,12516.35,
DEPUY ATTUNE INSERT CRS SZ 4 14MM,30186901,CDM,,,278,RC,outpatient,,23578.82,23578.82,,20018.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5894.71,22,,percent of total billed charges,,,,,,,,,21220.94,90,,percent of total billed charges,,,19523.26,82.8,,percent of total billed charges,,,20042,85,,percent of total billed charges,,,,,,,,,20749.36,88,,percent of total billed charges,,,,,,,,,18014.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5894.71,22,,percent of total billed charges,,,21456.73,91,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,,,,,,,,,,,,,19570.42,83,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,19334.63,82,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,20042,85,,percent of total billed charges,,5894.71,22399.88,
DEPUY REVISION TIBIA SZ 3,30186902,CDM,,,278,RC,outpatient,,39503.36,39503.36,,33538.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9875.84,22,,percent of total billed charges,,,,,,,,,35553.02,90,,percent of total billed charges,,,32708.78,82.8,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,,,,,,,,34762.96,88,,percent of total billed charges,,,,,,,,,30180.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9875.84,22,,percent of total billed charges,,,35948.06,91,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32787.79,83,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,32392.76,82,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,9875.84,37528.19,
DEPUY TIBIA AUGMENT RL 10,30186903,CDM,,,278,RC,outpatient,,10997.61,10997.61,,9336.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2749.4,22,,percent of total billed charges,,,,,,,,,9897.85,90,,percent of total billed charges,,,9106.02,82.8,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,,,,,,,,9677.9,88,,percent of total billed charges,,,,,,,,,8402.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2749.4,22,,percent of total billed charges,,,10007.83,91,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,,,,,,,,,,,,,9128.02,83,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9018.04,82,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,2749.4,10447.73,
DEPUY TIBIA AUGMENT RM 10,30186904,CDM,,,278,RC,outpatient,,10997.61,10997.61,,9336.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2749.4,22,,percent of total billed charges,,,,,,,,,9897.85,90,,percent of total billed charges,,,9106.02,82.8,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,,,,,,,,9677.9,88,,percent of total billed charges,,,,,,,,,8402.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2749.4,22,,percent of total billed charges,,,10007.83,91,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,,,,,,,,,,,,,9128.02,83,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9018.04,82,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,2749.4,10447.73,
SPINECRAFT SCREW REDUCTION 7.0 X 45MM,30186905,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
STRYKER TUBING CROSSFLOW INFLOW,30186906,CDM,,,270,RC,outpatient,,496.83,496.83,,421.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.21,22,,percent of total billed charges,,,,,,,,,447.15,90,,percent of total billed charges,,,411.38,82.8,,percent of total billed charges,,,422.31,85,,percent of total billed charges,,,,,,,,,437.21,88,,percent of total billed charges,,,,,,,,,379.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.21,22,,percent of total billed charges,,,452.12,91,,percent of total billed charges,,,471.99,95,,percent of total billed charges,,,412.37,83,,percent of total billed charges,,,412.37,83,,percent of total billed charges,,,,,,,,,,,,,,,412.37,83,,percent of total billed charges,,,471.99,95,,percent of total billed charges,,,447.15,90,,percent of total billed charges,,,447.15,90,,percent of total billed charges,,,407.4,82,,percent of total billed charges,,,447.15,90,,percent of total billed charges,,,422.31,85,,percent of total billed charges,,124.21,471.99,
STRYKER USAGE HIP CHECK & HIP CHECK ROLL,30186907,CDM,,,270,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER TUBING CROSSFLOW OUTFLOW,30186908,CDM,,,270,RC,outpatient,,459.06,459.06,,389.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,114.77,22,,percent of total billed charges,,,,,,,,,413.15,90,,percent of total billed charges,,,380.1,82.8,,percent of total billed charges,,,390.2,85,,percent of total billed charges,,,,,,,,,403.97,88,,percent of total billed charges,,,,,,,,,350.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,114.77,22,,percent of total billed charges,,,417.74,91,,percent of total billed charges,,,436.11,95,,percent of total billed charges,,,381.02,83,,percent of total billed charges,,,381.02,83,,percent of total billed charges,,,,,,,,,,,,,,,381.02,83,,percent of total billed charges,,,436.11,95,,percent of total billed charges,,,413.15,90,,percent of total billed charges,,,413.15,90,,percent of total billed charges,,,376.43,82,,percent of total billed charges,,,413.15,90,,percent of total billed charges,,,390.2,85,,percent of total billed charges,,114.77,436.11,
STRYKER ANCHOR OMEGA 4.75 SINGLE,30186909,CDM,,,270,RC,outpatient,,3087.5,3087.5,,2621.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,771.88,22,,percent of total billed charges,,,,,,,,,2778.75,90,,percent of total billed charges,,,2556.45,82.8,,percent of total billed charges,,,2624.38,85,,percent of total billed charges,,,,,,,,,2717,88,,percent of total billed charges,,,,,,,,,2358.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,771.88,22,,percent of total billed charges,,,2809.63,91,,percent of total billed charges,,,2933.13,95,,percent of total billed charges,,,2562.63,83,,percent of total billed charges,,,2562.63,83,,percent of total billed charges,,,,,,,,,,,,,,,2562.63,83,,percent of total billed charges,,,2933.13,95,,percent of total billed charges,,,2778.75,90,,percent of total billed charges,,,2778.75,90,,percent of total billed charges,,,2531.75,82,,percent of total billed charges,,,2778.75,90,,percent of total billed charges,,,2624.38,85,,percent of total billed charges,,771.88,2933.13,
PHENOL SAFETY APPLICATOR KIT,30186910,CDM,,,270,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
DEPUY GLENOSPHERE ECCENTRIC 38MM +2,30186913,CDM,,,278,RC,outpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4954.14,22,,percent of total billed charges,,,,,,,,,17834.9,90,,percent of total billed charges,,,16408.1,82.8,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4954.14,22,,percent of total billed charges,,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,4954.14,18825.72,
DEPUY GUIDE PIN,30186914,CDM,,,278,RC,outpatient,,949,949,,805.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,237.25,22,,percent of total billed charges,,,,,,,,,854.1,90,,percent of total billed charges,,,785.77,82.8,,percent of total billed charges,,,806.65,85,,percent of total billed charges,,,,,,,,,835.12,88,,percent of total billed charges,,,,,,,,,725.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,237.25,22,,percent of total billed charges,,,863.59,91,,percent of total billed charges,,,901.55,95,,percent of total billed charges,,,787.67,83,,percent of total billed charges,,,787.67,83,,percent of total billed charges,,,,,,,,,,,,,,,787.67,83,,percent of total billed charges,,,901.55,95,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,778.18,82,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,806.65,85,,percent of total billed charges,,237.25,901.55,
S&N GRAFIX PRIME 16MM DISK,30186915,CDM,,,278,RC,outpatient,,3056.63,3056.63,,2595.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,764.16,22,,percent of total billed charges,,,,,,,,,2750.97,90,,percent of total billed charges,,,2530.89,82.8,,percent of total billed charges,,,2598.14,85,,percent of total billed charges,,,,,,,,,2689.83,88,,percent of total billed charges,,,,,,,,,2335.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,764.16,22,,percent of total billed charges,,,2781.53,91,,percent of total billed charges,,,2903.8,95,,percent of total billed charges,,,2537,83,,percent of total billed charges,,,2537,83,,percent of total billed charges,,,,,,,,,,,,,,,2537,83,,percent of total billed charges,,,2903.8,95,,percent of total billed charges,,,2750.97,90,,percent of total billed charges,,,2750.97,90,,percent of total billed charges,,,2506.44,82,,percent of total billed charges,,,2750.97,90,,percent of total billed charges,,,2598.14,85,,percent of total billed charges,,764.16,2903.8,
SYNTHES PROTECTIVE CAP FOR 8.0MM CARBON,30186916,CDM,,,270,RC,outpatient,,52.11,52.11,,44.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.03,22,,percent of total billed charges,,,,,,,,,46.9,90,,percent of total billed charges,,,43.15,82.8,,percent of total billed charges,,,44.29,85,,percent of total billed charges,,,,,,,,,45.86,88,,percent of total billed charges,,,,,,,,,39.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.03,22,,percent of total billed charges,,,47.42,91,,percent of total billed charges,,,49.5,95,,percent of total billed charges,,,43.25,83,,percent of total billed charges,,,43.25,83,,percent of total billed charges,,,,,,,,,,,,,,,43.25,83,,percent of total billed charges,,,49.5,95,,percent of total billed charges,,,46.9,90,,percent of total billed charges,,,46.9,90,,percent of total billed charges,,,42.73,82,,percent of total billed charges,,,46.9,90,,percent of total billed charges,,,44.29,85,,percent of total billed charges,,13.03,49.5,
ZIMMER HEAD FEMORAL 28MM +7 6 DEG,30186917,CDM,,,278,RC,outpatient,,10595,10595,,8995.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2648.75,22,,percent of total billed charges,,,,,,,,,9535.5,90,,percent of total billed charges,,,8772.66,82.8,,percent of total billed charges,,,9005.75,85,,percent of total billed charges,,,,,,,,,9323.6,88,,percent of total billed charges,,,,,,,,,8094.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2648.75,22,,percent of total billed charges,,,9641.45,91,,percent of total billed charges,,,10065.25,95,,percent of total billed charges,,,8793.85,83,,percent of total billed charges,,,8793.85,83,,percent of total billed charges,,,,,,,,,,,,,,,8793.85,83,,percent of total billed charges,,,10065.25,95,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,8687.9,82,,percent of total billed charges,,,9535.5,90,,percent of total billed charges,,,9005.75,85,,percent of total billed charges,,2648.75,10065.25,
SPINECRAFT SCREW 7.0 X 35MM,30186918,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ZIMMER INSERT PSN 13MM RIGHT,30186919,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
PATIENT TRIAL KIT 62,30186920,CDM,,,270,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
S&N GRAFIX PL PRIME 16MM DISC,30186922,CDM,,,278,RC,outpatient,,3056.63,3056.63,,2595.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,764.16,22,,percent of total billed charges,,,,,,,,,2750.97,90,,percent of total billed charges,,,2530.89,82.8,,percent of total billed charges,,,2598.14,85,,percent of total billed charges,,,,,,,,,2689.83,88,,percent of total billed charges,,,,,,,,,2335.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,764.16,22,,percent of total billed charges,,,2781.53,91,,percent of total billed charges,,,2903.8,95,,percent of total billed charges,,,2537,83,,percent of total billed charges,,,2537,83,,percent of total billed charges,,,,,,,,,,,,,,,2537,83,,percent of total billed charges,,,2903.8,95,,percent of total billed charges,,,2750.97,90,,percent of total billed charges,,,2750.97,90,,percent of total billed charges,,,2506.44,82,,percent of total billed charges,,,2750.97,90,,percent of total billed charges,,,2598.14,85,,percent of total billed charges,,764.16,2903.8,
DEPUY STEM STD CEMENTED SUMMIT SZ 2,30186923,CDM,,,278,RC,outpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6361.02,22,,percent of total billed charges,,,,,,,,,22899.65,90,,percent of total billed charges,,,21067.68,82.8,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6361.02,22,,percent of total billed charges,,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,6361.02,24171.86,
DEPUY CEMENTRALIZERR 8.5,30186924,CDM,,,278,RC,outpatient,,919.36,919.36,,780.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,229.84,22,,percent of total billed charges,,,,,,,,,827.42,90,,percent of total billed charges,,,761.23,82.8,,percent of total billed charges,,,781.46,85,,percent of total billed charges,,,,,,,,,809.04,88,,percent of total billed charges,,,,,,,,,702.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,229.84,22,,percent of total billed charges,,,836.62,91,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,,,,,,,,,,,,,763.07,83,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,753.88,82,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,781.46,85,,percent of total billed charges,,229.84,873.39,
STRYKER SUCTION PROBE 90-S CRUISE,30186925,CDM,,,270,RC,outpatient,,942.5,942.5,,800.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.63,22,,percent of total billed charges,,,,,,,,,848.25,90,,percent of total billed charges,,,780.39,82.8,,percent of total billed charges,,,801.13,85,,percent of total billed charges,,,,,,,,,829.4,88,,percent of total billed charges,,,,,,,,,720.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.63,22,,percent of total billed charges,,,857.68,91,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,782.28,83,,percent of total billed charges,,,,,,,,,,,,,,,782.28,83,,percent of total billed charges,,,895.38,95,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,772.85,82,,percent of total billed charges,,,848.25,90,,percent of total billed charges,,,801.13,85,,percent of total billed charges,,235.63,895.38,
ZIMMER FEMUR PSN CR SZ 9 RIGHT,30186926,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER SCREW HEX HEADED 3.5 X 48MM,30186927,CDM,,,278,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
ZIMMER STEM EXTENSION OFFSET 15X145MM,30186928,CDM,,,278,RC,outpatient,,7276.62,7276.62,,6177.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1819.16,22,,percent of total billed charges,,,,,,,,,6548.96,90,,percent of total billed charges,,,6025.04,82.8,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,,,,,,,,6403.43,88,,percent of total billed charges,,,,,,,,,5559.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1819.16,22,,percent of total billed charges,,,6621.72,91,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,,,,,,,,,,,,,6039.59,83,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,5966.83,82,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,1819.16,6912.79,
ZIMMER STEM EXTENSION STRAIGHT 14X145MM,30186929,CDM,,,278,RC,outpatient,,7276.62,7276.62,,6177.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1819.16,22,,percent of total billed charges,,,,,,,,,6548.96,90,,percent of total billed charges,,,6025.04,82.8,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,,,,,,,,6403.43,88,,percent of total billed charges,,,,,,,,,5559.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1819.16,22,,percent of total billed charges,,,6621.72,91,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,,,,,,,,,,,,,6039.59,83,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,5966.83,82,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,1819.16,6912.79,
ZIMMER TIBIA HINGE PLATE SZ 3,30186930,CDM,,,278,RC,outpatient,,31427.57,31427.57,,26682.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7856.89,22,,percent of total billed charges,,,,,,,,,28284.81,90,,percent of total billed charges,,,26022.03,82.8,,percent of total billed charges,,,26713.43,85,,percent of total billed charges,,,,,,,,,27656.26,88,,percent of total billed charges,,,,,,,,,24010.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7856.89,22,,percent of total billed charges,,,28599.09,91,,percent of total billed charges,,,29856.19,95,,percent of total billed charges,,,26084.88,83,,percent of total billed charges,,,26084.88,83,,percent of total billed charges,,,,,,,,,,,,,,,26084.88,83,,percent of total billed charges,,,29856.19,95,,percent of total billed charges,,,28284.81,90,,percent of total billed charges,,,28284.81,90,,percent of total billed charges,,,25770.61,82,,percent of total billed charges,,,28284.81,90,,percent of total billed charges,,,26713.43,85,,percent of total billed charges,,7856.89,29856.19,
ZIMMER FEMORAL HINGE ROTATING SZ D RIGHT,30186931,CDM,,,278,RC,outpatient,,57459.03,57459.03,,48782.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14364.76,22,,percent of total billed charges,,,,,,,,,51713.13,90,,percent of total billed charges,,,47576.08,82.8,,percent of total billed charges,,,48840.18,85,,percent of total billed charges,,,,,,,,,50563.95,88,,percent of total billed charges,,,,,,,,,43898.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14364.76,22,,percent of total billed charges,,,52287.72,91,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,,,,,,,,,,,,,47690.99,83,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,47116.4,82,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,48840.18,85,,percent of total billed charges,,14364.76,54586.08,
ZIMMER AUGMENT BLOCK SZ D 5MM,30186932,CDM,,,278,RC,outpatient,,6483.75,6483.75,,5504.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1620.94,22,,percent of total billed charges,,,,,,,,,5835.38,90,,percent of total billed charges,,,5368.55,82.8,,percent of total billed charges,,,5511.19,85,,percent of total billed charges,,,,,,,,,5705.7,88,,percent of total billed charges,,,,,,,,,4953.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1620.94,22,,percent of total billed charges,,,5900.21,91,,percent of total billed charges,,,6159.56,95,,percent of total billed charges,,,5381.51,83,,percent of total billed charges,,,5381.51,83,,percent of total billed charges,,,,,,,,,,,,,,,5381.51,83,,percent of total billed charges,,,6159.56,95,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5316.68,82,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5511.19,85,,percent of total billed charges,,1620.94,6159.56,
ZIMMER TIBIA AUGMENT BLOCK SZ 4 5MM,30186933,CDM,,,278,RC,outpatient,,6483.75,6483.75,,5504.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1620.94,22,,percent of total billed charges,,,,,,,,,5835.38,90,,percent of total billed charges,,,5368.55,82.8,,percent of total billed charges,,,5511.19,85,,percent of total billed charges,,,,,,,,,5705.7,88,,percent of total billed charges,,,,,,,,,4953.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1620.94,22,,percent of total billed charges,,,5900.21,91,,percent of total billed charges,,,6159.56,95,,percent of total billed charges,,,5381.51,83,,percent of total billed charges,,,5381.51,83,,percent of total billed charges,,,,,,,,,,,,,,,5381.51,83,,percent of total billed charges,,,6159.56,95,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5316.68,82,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5511.19,85,,percent of total billed charges,,1620.94,6159.56,
ZIMMER HINGE POST INSERT SZ D 12MM,30186934,CDM,,,278,RC,outpatient,,12617.41,12617.41,,10712.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3154.35,22,,percent of total billed charges,,,,,,,,,11355.67,90,,percent of total billed charges,,,10447.22,82.8,,percent of total billed charges,,,10724.8,85,,percent of total billed charges,,,,,,,,,11103.32,88,,percent of total billed charges,,,,,,,,,9639.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3154.35,22,,percent of total billed charges,,,11481.84,91,,percent of total billed charges,,,11986.54,95,,percent of total billed charges,,,10472.45,83,,percent of total billed charges,,,10472.45,83,,percent of total billed charges,,,,,,,,,,,,,,,10472.45,83,,percent of total billed charges,,,11986.54,95,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,10346.28,82,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,10724.8,85,,percent of total billed charges,,3154.35,11986.54,
DEPUY PE CUP 42 +9MM,30186935,CDM,,,278,RC,outpatient,,10688.08,10688.08,,9074.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2672.02,22,,percent of total billed charges,,,,,,,,,9619.27,90,,percent of total billed charges,,,8849.73,82.8,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,,,,,,,,9405.51,88,,percent of total billed charges,,,,,,,,,8165.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2672.02,22,,percent of total billed charges,,,9726.15,91,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,8871.11,83,,percent of total billed charges,,,,,,,,,,,,,,,8871.11,83,,percent of total billed charges,,,10153.68,95,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,8764.23,82,,percent of total billed charges,,,9619.27,90,,percent of total billed charges,,,9084.87,85,,percent of total billed charges,,2672.02,10153.68,
SYNTHES SCREW CANCEL F-THD 4.0X40MM,30186936,CDM,,,278,RC,outpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.18,22,,percent of total billed charges,,,,,,,,,213.03,90,,percent of total billed charges,,,195.99,82.8,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.18,22,,percent of total billed charges,,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,59.18,224.87,
SYNTHES SCREW CANCEL P-THD 4.0X40MM,30186937,CDM,,,278,RC,outpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.18,22,,percent of total billed charges,,,,,,,,,213.03,90,,percent of total billed charges,,,195.99,82.8,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.18,22,,percent of total billed charges,,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,59.18,224.87,
DEPUY SURESPACE FEMORAL 53MM A/P,30186938,CDM,,,278,RC,outpatient,,15906.93,15906.93,,13504.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3976.73,22,,percent of total billed charges,,,,,,,,,14316.24,90,,percent of total billed charges,,,13170.94,82.8,,percent of total billed charges,,,13520.89,85,,percent of total billed charges,,,,,,,,,13998.1,88,,percent of total billed charges,,,,,,,,,12152.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3976.73,22,,percent of total billed charges,,,14475.31,91,,percent of total billed charges,,,15111.58,95,,percent of total billed charges,,,13202.75,83,,percent of total billed charges,,,13202.75,83,,percent of total billed charges,,,,,,,,,,,,,,,13202.75,83,,percent of total billed charges,,,15111.58,95,,percent of total billed charges,,,14316.24,90,,percent of total billed charges,,,14316.24,90,,percent of total billed charges,,,13043.68,82,,percent of total billed charges,,,14316.24,90,,percent of total billed charges,,,13520.89,85,,percent of total billed charges,,3976.73,15111.58,
DEPUY SURESPACE TIBIA 52MM A/P,30186939,CDM,,,278,RC,outpatient,,13016.77,13016.77,,11051.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3254.19,22,,percent of total billed charges,,,,,,,,,11715.09,90,,percent of total billed charges,,,10777.89,82.8,,percent of total billed charges,,,11064.25,85,,percent of total billed charges,,,,,,,,,11454.76,88,,percent of total billed charges,,,,,,,,,9944.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3254.19,22,,percent of total billed charges,,,11845.26,91,,percent of total billed charges,,,12365.93,95,,percent of total billed charges,,,10803.92,83,,percent of total billed charges,,,10803.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10803.92,83,,percent of total billed charges,,,12365.93,95,,percent of total billed charges,,,11715.09,90,,percent of total billed charges,,,11715.09,90,,percent of total billed charges,,,10673.75,82,,percent of total billed charges,,,11715.09,90,,percent of total billed charges,,,11064.25,85,,percent of total billed charges,,3254.19,12365.93,
SYNTHES PLATE 5 HOLE RIGHT HUMERUS 3.5MM,30186943,CDM,,,278,RC,outpatient,,17314.77,17314.77,,14700.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4328.69,22,,percent of total billed charges,,,,,,,,,15583.29,90,,percent of total billed charges,,,14336.63,82.8,,percent of total billed charges,,,14717.55,85,,percent of total billed charges,,,,,,,,,15237,88,,percent of total billed charges,,,,,,,,,13228.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4328.69,22,,percent of total billed charges,,,15756.44,91,,percent of total billed charges,,,16449.03,95,,percent of total billed charges,,,14371.26,83,,percent of total billed charges,,,14371.26,83,,percent of total billed charges,,,,,,,,,,,,,,,14371.26,83,,percent of total billed charges,,,16449.03,95,,percent of total billed charges,,,15583.29,90,,percent of total billed charges,,,15583.29,90,,percent of total billed charges,,,14198.11,82,,percent of total billed charges,,,15583.29,90,,percent of total billed charges,,,14717.55,85,,percent of total billed charges,,4328.69,16449.03,
ZIMMER BLADE PATELLA REAMER SZ 38,30186944,CDM,,,270,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
ZIMMER FEMUR POROUS NARROW CR SZ 8,30186945,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER PATELLA VE SZ 35MM,30186946,CDM,,,278,RC,outpatient,,3575,3575,,3035.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,893.75,22,,percent of total billed charges,,,,,,,,,3217.5,90,,percent of total billed charges,,,2960.1,82.8,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,,,,,,,,3146,88,,percent of total billed charges,,,,,,,,,2731.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,893.75,22,,percent of total billed charges,,,3253.25,91,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2967.25,83,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,2931.5,82,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,893.75,3396.25,
DEPUY STEM REVISION CORAIL HO SZ 15,30186947,CDM,,,278,RC,outpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16689.95,22,,percent of total billed charges,,,,,,,,,60083.83,90,,percent of total billed charges,,,55277.12,82.8,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16689.95,22,,percent of total billed charges,,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,16689.95,63421.82,
SYNTHES PLATE HUMERUS PROX. LCP 3.5 2H,30186949,CDM,,,278,RC,outpatient,,18035.75,18035.75,,15312.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4508.94,22,,percent of total billed charges,,,,,,,,,16232.18,90,,percent of total billed charges,,,14933.6,82.8,,percent of total billed charges,,,15330.39,85,,percent of total billed charges,,,,,,,,,15871.46,88,,percent of total billed charges,,,,,,,,,13779.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4508.94,22,,percent of total billed charges,,,16412.53,91,,percent of total billed charges,,,17133.96,95,,percent of total billed charges,,,14969.67,83,,percent of total billed charges,,,14969.67,83,,percent of total billed charges,,,,,,,,,,,,,,,14969.67,83,,percent of total billed charges,,,17133.96,95,,percent of total billed charges,,,16232.18,90,,percent of total billed charges,,,16232.18,90,,percent of total billed charges,,,14789.32,82,,percent of total billed charges,,,16232.18,90,,percent of total billed charges,,,15330.39,85,,percent of total billed charges,,4508.94,17133.96,
MITEK DRILL BIT GRYPHON,30186950,CDM,,,270,RC,outpatient,,2132,2132,,1810.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,533,22,,percent of total billed charges,,,,,,,,,1918.8,90,,percent of total billed charges,,,1765.3,82.8,,percent of total billed charges,,,1812.2,85,,percent of total billed charges,,,,,,,,,1876.16,88,,percent of total billed charges,,,,,,,,,1628.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,533,22,,percent of total billed charges,,,1940.12,91,,percent of total billed charges,,,2025.4,95,,percent of total billed charges,,,1769.56,83,,percent of total billed charges,,,1769.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1769.56,83,,percent of total billed charges,,,2025.4,95,,percent of total billed charges,,,1918.8,90,,percent of total billed charges,,,1918.8,90,,percent of total billed charges,,,1748.24,82,,percent of total billed charges,,,1918.8,90,,percent of total billed charges,,,1812.2,85,,percent of total billed charges,,533,2025.4,
MITEK ANCHOR GRYPHON,30186951,CDM,,,270,RC,outpatient,,4153.5,4153.5,,3526.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1038.38,22,,percent of total billed charges,,,,,,,,,3738.15,90,,percent of total billed charges,,,3439.1,82.8,,percent of total billed charges,,,3530.48,85,,percent of total billed charges,,,,,,,,,3655.08,88,,percent of total billed charges,,,,,,,,,3173.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1038.38,22,,percent of total billed charges,,,3779.69,91,,percent of total billed charges,,,3945.83,95,,percent of total billed charges,,,3447.41,83,,percent of total billed charges,,,3447.41,83,,percent of total billed charges,,,,,,,,,,,,,,,3447.41,83,,percent of total billed charges,,,3945.83,95,,percent of total billed charges,,,3738.15,90,,percent of total billed charges,,,3738.15,90,,percent of total billed charges,,,3405.87,82,,percent of total billed charges,,,3738.15,90,,percent of total billed charges,,,3530.48,85,,percent of total billed charges,,1038.38,3945.83,
SUTURE SHUTTLE 25DEG L,30186952,CDM,,,270,RC,outpatient,,1989,1989,,1688.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,497.25,22,,percent of total billed charges,,,,,,,,,1790.1,90,,percent of total billed charges,,,1646.89,82.8,,percent of total billed charges,,,1690.65,85,,percent of total billed charges,,,,,,,,,1750.32,88,,percent of total billed charges,,,,,,,,,1519.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,497.25,22,,percent of total billed charges,,,1809.99,91,,percent of total billed charges,,,1889.55,95,,percent of total billed charges,,,1650.87,83,,percent of total billed charges,,,1650.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1650.87,83,,percent of total billed charges,,,1889.55,95,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1630.98,82,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1690.65,85,,percent of total billed charges,,497.25,1889.55,
SUTURE SHUTTLE 90DEG,30186953,CDM,,,270,RC,outpatient,,1989,1989,,1688.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,497.25,22,,percent of total billed charges,,,,,,,,,1790.1,90,,percent of total billed charges,,,1646.89,82.8,,percent of total billed charges,,,1690.65,85,,percent of total billed charges,,,,,,,,,1750.32,88,,percent of total billed charges,,,,,,,,,1519.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,497.25,22,,percent of total billed charges,,,1809.99,91,,percent of total billed charges,,,1889.55,95,,percent of total billed charges,,,1650.87,83,,percent of total billed charges,,,1650.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1650.87,83,,percent of total billed charges,,,1889.55,95,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1630.98,82,,percent of total billed charges,,,1790.1,90,,percent of total billed charges,,,1690.65,85,,percent of total billed charges,,497.25,1889.55,
DEPUY STEM CORAIL HIGH COL SZ 13,30186954,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY VELYS NAVIGATION FEE,30186955,CDM,,,270,RC,outpatient,,3867.5,3867.5,,3283.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,966.88,22,,percent of total billed charges,,,,,,,,,3480.75,90,,percent of total billed charges,,,3202.29,82.8,,percent of total billed charges,,,3287.38,85,,percent of total billed charges,,,,,,,,,3403.4,88,,percent of total billed charges,,,,,,,,,2954.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,966.88,22,,percent of total billed charges,,,3519.43,91,,percent of total billed charges,,,3674.13,95,,percent of total billed charges,,,3210.03,83,,percent of total billed charges,,,3210.03,83,,percent of total billed charges,,,,,,,,,,,,,,,3210.03,83,,percent of total billed charges,,,3674.13,95,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3171.35,82,,percent of total billed charges,,,3480.75,90,,percent of total billed charges,,,3287.38,85,,percent of total billed charges,,966.88,3674.13,
SYNTHES PLATE BASE PHALANGEAL 2H 1.5MM,30186956,CDM,,,278,RC,outpatient,,5005.72,5005.72,,4249.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1251.43,22,,percent of total billed charges,,,,,,,,,4505.15,90,,percent of total billed charges,,,4144.74,82.8,,percent of total billed charges,,,4254.86,85,,percent of total billed charges,,,,,,,,,4405.03,88,,percent of total billed charges,,,,,,,,,3824.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1251.43,22,,percent of total billed charges,,,4555.21,91,,percent of total billed charges,,,4755.43,95,,percent of total billed charges,,,4154.75,83,,percent of total billed charges,,,4154.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4154.75,83,,percent of total billed charges,,,4755.43,95,,percent of total billed charges,,,4505.15,90,,percent of total billed charges,,,4505.15,90,,percent of total billed charges,,,4104.69,82,,percent of total billed charges,,,4505.15,90,,percent of total billed charges,,,4254.86,85,,percent of total billed charges,,1251.43,4755.43,
SYNTHES SCREW CORTEX 1.5 11MM,30186957,CDM,,,278,RC,outpatient,,504.98,504.98,,428.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126.25,22,,percent of total billed charges,,,,,,,,,454.48,90,,percent of total billed charges,,,418.12,82.8,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,,,,,,,,444.38,88,,percent of total billed charges,,,,,,,,,385.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126.25,22,,percent of total billed charges,,,459.53,91,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,,,,,,,,,,,,,419.13,83,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,414.08,82,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,126.25,479.73,
SYNTHES SCREW CORTEX 1.5 14MM,30186958,CDM,,,278,RC,outpatient,,504.98,504.98,,428.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126.25,22,,percent of total billed charges,,,,,,,,,454.48,90,,percent of total billed charges,,,418.12,82.8,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,,,,,,,,444.38,88,,percent of total billed charges,,,,,,,,,385.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126.25,22,,percent of total billed charges,,,459.53,91,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,,,,,,,,,,,,,419.13,83,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,414.08,82,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,126.25,479.73,
SYNTHES SCREW CORTEX 1.5 16MM,30186959,CDM,,,278,RC,outpatient,,504.98,504.98,,428.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126.25,22,,percent of total billed charges,,,,,,,,,454.48,90,,percent of total billed charges,,,418.12,82.8,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,,,,,,,,444.38,88,,percent of total billed charges,,,,,,,,,385.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126.25,22,,percent of total billed charges,,,459.53,91,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,,,,,,,,,,,,,419.13,83,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,414.08,82,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,126.25,479.73,
FREELINK REMOTE KIT,30186960,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
BOSTON CLIK ANCHOR,30186961,CDM,,,278,RC,outpatient,,2193.75,2193.75,,1862.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,548.44,22,,percent of total billed charges,,,,,,,,,1974.38,90,,percent of total billed charges,,,1816.43,82.8,,percent of total billed charges,,,1864.69,85,,percent of total billed charges,,,,,,,,,1930.5,88,,percent of total billed charges,,,,,,,,,1676.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,548.44,22,,percent of total billed charges,,,1996.31,91,,percent of total billed charges,,,2084.06,95,,percent of total billed charges,,,1820.81,83,,percent of total billed charges,,,1820.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1820.81,83,,percent of total billed charges,,,2084.06,95,,percent of total billed charges,,,1974.38,90,,percent of total billed charges,,,1974.38,90,,percent of total billed charges,,,1798.88,82,,percent of total billed charges,,,1974.38,90,,percent of total billed charges,,,1864.69,85,,percent of total billed charges,,548.44,2084.06,
ZIMMER FEMUR TIV STD RIGHT SZ 8,30186962,CDM,,,278,RC,outpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4875,22,,percent of total billed charges,,,,,,,,,17550,90,,percent of total billed charges,,,16146,82.8,,percent of total billed charges,,,16575,85,,percent of total billed charges,,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4875,22,,percent of total billed charges,,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,4875,18525,
ZIMMER TIBIA CEMENTED RIGHT SZ E,30186963,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER INSERT PSN RIGHT MC SZ 10,30186964,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
SYNTHES SCREW CANCEL F-THD 4.0X45MM,30186965,CDM,,,278,RC,outpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.18,22,,percent of total billed charges,,,,,,,,,213.03,90,,percent of total billed charges,,,195.99,82.8,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.18,22,,percent of total billed charges,,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,59.18,224.87,
ZIMMER FEMUR PSN CR SZ 10 LEFT,30186966,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
ARTHREX FIBERLOOP 2-0,30186967,CDM,,,278,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
ULRICH SCREWS RESCUE 4.5 X 16MM,30186968,CDM,,,278,RC,outpatient,,2112.5,2112.5,,1793.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,528.13,22,,percent of total billed charges,,,,,,,,,1901.25,90,,percent of total billed charges,,,1749.15,82.8,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,,,,,,,,1859,88,,percent of total billed charges,,,,,,,,,1613.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,528.13,22,,percent of total billed charges,,,1922.38,91,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,1753.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.38,83,,percent of total billed charges,,,2006.88,95,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1732.25,82,,percent of total billed charges,,,1901.25,90,,percent of total billed charges,,,1795.63,85,,percent of total billed charges,,528.13,2006.88,
ULRICH CAGE PEEK 8MM,30186969,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
ULRICH SCREW DRIVER UNION 2.5 HEX,30186970,CDM,,,270,RC,outpatient,,3640,3640,,3090.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,910,22,,percent of total billed charges,,,,,,,,,3276,90,,percent of total billed charges,,,3013.92,82.8,,percent of total billed charges,,,3094,85,,percent of total billed charges,,,,,,,,,3203.2,88,,percent of total billed charges,,,,,,,,,2780.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,910,22,,percent of total billed charges,,,3312.4,91,,percent of total billed charges,,,3458,95,,percent of total billed charges,,,3021.2,83,,percent of total billed charges,,,3021.2,83,,percent of total billed charges,,,,,,,,,,,,,,,3021.2,83,,percent of total billed charges,,,3458,95,,percent of total billed charges,,,3276,90,,percent of total billed charges,,,3276,90,,percent of total billed charges,,,2984.8,82,,percent of total billed charges,,,3276,90,,percent of total billed charges,,,3094,85,,percent of total billed charges,,910,3458,
ZIMMER FEMUR PSN CR CMT SZ 7 LEFT,30186971,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
ZIMMER FEMUR POROUS NARROW CCR SZ 8 RIGH,30186972,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
ZIMMER PATELLA POLY VE 38MM,30186973,CDM,,,270,RC,outpatient,,3575,3575,,3035.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,893.75,22,,percent of total billed charges,,,,,,,,,3217.5,90,,percent of total billed charges,,,2960.1,82.8,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,,,,,,,,3146,88,,percent of total billed charges,,,,,,,,,2731.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,893.75,22,,percent of total billed charges,,,3253.25,91,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2967.25,83,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,2931.5,82,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,893.75,3396.25,
ZIMMER ART SURF POLY VE 12MM 8-11EF,30186974,CDM,,,270,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ABBOTT PRODIGY MRI IPG,30186975,CDM,,,278,RC,outpatient,,126750,126750,,107610.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31687.5,22,,percent of total billed charges,,,,,,,,,114075,90,,percent of total billed charges,,,104949,82.8,,percent of total billed charges,,,107737.5,85,,percent of total billed charges,,,,,,,,,111540,88,,percent of total billed charges,,,,,,,,,96837,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31687.5,22,,percent of total billed charges,,,115342.5,91,,percent of total billed charges,,,120412.5,95,,percent of total billed charges,,,105202.5,83,,percent of total billed charges,,,105202.5,83,,percent of total billed charges,,,,,,,,,,,,,,,105202.5,83,,percent of total billed charges,,,120412.5,95,,percent of total billed charges,,,114075,90,,percent of total billed charges,,,114075,90,,percent of total billed charges,,,103935,82,,percent of total billed charges,,,114075,90,,percent of total billed charges,,,107737.5,85,,percent of total billed charges,,31687.5,120412.5,
URETHRAL DILATOR SET S-CURVE,30186982,CDM,,,270,RC,outpatient,,1239.23,1239.23,,1052.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,309.81,22,,percent of total billed charges,,,,,,,,,1115.31,90,,percent of total billed charges,,,1026.08,82.8,,percent of total billed charges,,,1053.35,85,,percent of total billed charges,,,,,,,,,1090.52,88,,percent of total billed charges,,,,,,,,,946.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,309.81,22,,percent of total billed charges,,,1127.7,91,,percent of total billed charges,,,1177.27,95,,percent of total billed charges,,,1028.56,83,,percent of total billed charges,,,1028.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1028.56,83,,percent of total billed charges,,,1177.27,95,,percent of total billed charges,,,1115.31,90,,percent of total billed charges,,,1115.31,90,,percent of total billed charges,,,1016.17,82,,percent of total billed charges,,,1115.31,90,,percent of total billed charges,,,1053.35,85,,percent of total billed charges,,309.81,1177.27,
WIREGUIDE BENTSON FIXED CORE 0.035 X 145,30186983,CDM,,,270,RC,outpatient,,182.32,182.32,,154.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.58,22,,percent of total billed charges,,,,,,,,,164.09,90,,percent of total billed charges,,,150.96,82.8,,percent of total billed charges,,,154.97,85,,percent of total billed charges,,,,,,,,,160.44,88,,percent of total billed charges,,,,,,,,,139.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.58,22,,percent of total billed charges,,,165.91,91,,percent of total billed charges,,,173.2,95,,percent of total billed charges,,,151.33,83,,percent of total billed charges,,,151.33,83,,percent of total billed charges,,,,,,,,,,,,,,,151.33,83,,percent of total billed charges,,,173.2,95,,percent of total billed charges,,,164.09,90,,percent of total billed charges,,,164.09,90,,percent of total billed charges,,,149.5,82,,percent of total billed charges,,,164.09,90,,percent of total billed charges,,,154.97,85,,percent of total billed charges,,45.58,173.2,
WIREGUIDE BIREWIRE NITINEL CORE .025 X 1,30186984,CDM,,,270,RC,outpatient,,352.73,352.73,,299.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.18,22,,percent of total billed charges,,,,,,,,,317.46,90,,percent of total billed charges,,,292.06,82.8,,percent of total billed charges,,,299.82,85,,percent of total billed charges,,,,,,,,,310.4,88,,percent of total billed charges,,,,,,,,,269.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.18,22,,percent of total billed charges,,,320.98,91,,percent of total billed charges,,,335.09,95,,percent of total billed charges,,,292.77,83,,percent of total billed charges,,,292.77,83,,percent of total billed charges,,,,,,,,,,,,,,,292.77,83,,percent of total billed charges,,,335.09,95,,percent of total billed charges,,,317.46,90,,percent of total billed charges,,,317.46,90,,percent of total billed charges,,,289.24,82,,percent of total billed charges,,,317.46,90,,percent of total billed charges,,,299.82,85,,percent of total billed charges,,88.18,335.09,
GUIDEWIRE 3CM STRAIGHT PTFE .035 X 150CM,30186985,CDM,,,270,RC,outpatient,,316.16,316.16,,268.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.04,22,,percent of total billed charges,,,,,,,,,284.54,90,,percent of total billed charges,,,261.78,82.8,,percent of total billed charges,,,268.74,85,,percent of total billed charges,,,,,,,,,278.22,88,,percent of total billed charges,,,,,,,,,241.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.04,22,,percent of total billed charges,,,287.71,91,,percent of total billed charges,,,300.35,95,,percent of total billed charges,,,262.41,83,,percent of total billed charges,,,262.41,83,,percent of total billed charges,,,,,,,,,,,,,,,262.41,83,,percent of total billed charges,,,300.35,95,,percent of total billed charges,,,284.54,90,,percent of total billed charges,,,284.54,90,,percent of total billed charges,,,259.25,82,,percent of total billed charges,,,284.54,90,,percent of total billed charges,,,268.74,85,,percent of total billed charges,,79.04,300.35,
GUIDEWIRE 3CM ANGLED PTFE .035 X 150CM,30186986,CDM,,,270,RC,outpatient,,318.56,318.56,,270.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.64,22,,percent of total billed charges,,,,,,,,,286.7,90,,percent of total billed charges,,,263.77,82.8,,percent of total billed charges,,,270.78,85,,percent of total billed charges,,,,,,,,,280.33,88,,percent of total billed charges,,,,,,,,,243.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.64,22,,percent of total billed charges,,,289.89,91,,percent of total billed charges,,,302.63,95,,percent of total billed charges,,,264.4,83,,percent of total billed charges,,,264.4,83,,percent of total billed charges,,,,,,,,,,,,,,,264.4,83,,percent of total billed charges,,,302.63,95,,percent of total billed charges,,,286.7,90,,percent of total billed charges,,,286.7,90,,percent of total billed charges,,,261.22,82,,percent of total billed charges,,,286.7,90,,percent of total billed charges,,,270.78,85,,percent of total billed charges,,79.64,302.63,
SAPS SINGLE ACTION PUMP SYSTEM,30186987,CDM,,,270,RC,outpatient,,534.87,534.87,,454.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,133.72,22,,percent of total billed charges,,,,,,,,,481.38,90,,percent of total billed charges,,,442.87,82.8,,percent of total billed charges,,,454.64,85,,percent of total billed charges,,,,,,,,,470.69,88,,percent of total billed charges,,,,,,,,,408.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,133.72,22,,percent of total billed charges,,,486.73,91,,percent of total billed charges,,,508.13,95,,percent of total billed charges,,,443.94,83,,percent of total billed charges,,,443.94,83,,percent of total billed charges,,,,,,,,,,,,,,,443.94,83,,percent of total billed charges,,,508.13,95,,percent of total billed charges,,,481.38,90,,percent of total billed charges,,,481.38,90,,percent of total billed charges,,,438.59,82,,percent of total billed charges,,,481.38,90,,percent of total billed charges,,,454.64,85,,percent of total billed charges,,133.72,508.13,
CAPIOSLIM,30186988,CDM,,,270,RC,outpatient,,3346.2,3346.2,,2840.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,836.55,22,,percent of total billed charges,,,,,,,,,3011.58,90,,percent of total billed charges,,,2770.65,82.8,,percent of total billed charges,,,2844.27,85,,percent of total billed charges,,,,,,,,,2944.66,88,,percent of total billed charges,,,,,,,,,2556.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,836.55,22,,percent of total billed charges,,,3045.04,91,,percent of total billed charges,,,3178.89,95,,percent of total billed charges,,,2777.35,83,,percent of total billed charges,,,2777.35,83,,percent of total billed charges,,,,,,,,,,,,,,,2777.35,83,,percent of total billed charges,,,3178.89,95,,percent of total billed charges,,,3011.58,90,,percent of total billed charges,,,3011.58,90,,percent of total billed charges,,,2743.88,82,,percent of total billed charges,,,3011.58,90,,percent of total billed charges,,,2844.27,85,,percent of total billed charges,,836.55,3178.89,
MONODEK PDO TC & T 26MM 1/2 CIRCLE,30186989,CDM,,,270,RC,outpatient,,311.85,311.85,,264.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.96,22,,percent of total billed charges,,,,,,,,,280.67,90,,percent of total billed charges,,,258.21,82.8,,percent of total billed charges,,,265.07,85,,percent of total billed charges,,,,,,,,,274.43,88,,percent of total billed charges,,,,,,,,,238.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.96,22,,percent of total billed charges,,,283.78,91,,percent of total billed charges,,,296.26,95,,percent of total billed charges,,,258.84,83,,percent of total billed charges,,,258.84,83,,percent of total billed charges,,,,,,,,,,,,,,,258.84,83,,percent of total billed charges,,,296.26,95,,percent of total billed charges,,,280.67,90,,percent of total billed charges,,,280.67,90,,percent of total billed charges,,,255.72,82,,percent of total billed charges,,,280.67,90,,percent of total billed charges,,,265.07,85,,percent of total billed charges,,77.96,296.26,
STENT TRIA SOFT 6F X 24CM,30186990,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
STENT TRIA SOFT 6F X 22CM,30186991,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
STENT TRIA SOFT 6F X 28CM,30186992,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
STENT TRIA SOFT 7F X 26CM,30186993,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
STENT TRIA SOFT 6F X 26CM,30186994,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
ZIMMER LINER NUETRAL 32MM E1,30186995,CDM,,,278,RC,outpatient,,23140,23140,,19645.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5785,22,,percent of total billed charges,,,,,,,,,20826,90,,percent of total billed charges,,,19159.92,82.8,,percent of total billed charges,,,19669,85,,percent of total billed charges,,,,,,,,,20363.2,88,,percent of total billed charges,,,,,,,,,17678.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5785,22,,percent of total billed charges,,,21057.4,91,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,19206.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19206.2,83,,percent of total billed charges,,,21983,95,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,18974.8,82,,percent of total billed charges,,,20826,90,,percent of total billed charges,,,19669,85,,percent of total billed charges,,5785,21983,
ZIMMER SHELL OSSEOTI G7 46MM B 3 HOLE,30186996,CDM,,,278,RC,outpatient,,37505,37505,,31841.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9376.25,22,,percent of total billed charges,,,,,,,,,33754.5,90,,percent of total billed charges,,,31054.14,82.8,,percent of total billed charges,,,31879.25,85,,percent of total billed charges,,,,,,,,,33004.4,88,,percent of total billed charges,,,,,,,,,28653.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9376.25,22,,percent of total billed charges,,,34129.55,91,,percent of total billed charges,,,35629.75,95,,percent of total billed charges,,,31129.15,83,,percent of total billed charges,,,31129.15,83,,percent of total billed charges,,,,,,,,,,,,,,,31129.15,83,,percent of total billed charges,,,35629.75,95,,percent of total billed charges,,,33754.5,90,,percent of total billed charges,,,33754.5,90,,percent of total billed charges,,,30754.1,82,,percent of total billed charges,,,33754.5,90,,percent of total billed charges,,,31879.25,85,,percent of total billed charges,,9376.25,35629.75,
ULRICH CAGE PEEK 6MM 13 X 15 6DEG,30186997,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
ULRICH PLATE 3 LEVEL 48MM,30186998,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
ARTHREX PLATE 2-HOLE,30186999,CDM,,,278,RC,outpatient,,5525,5525,,4690.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1381.25,22,,percent of total billed charges,,,,,,,,,4972.5,90,,percent of total billed charges,,,4574.7,82.8,,percent of total billed charges,,,4696.25,85,,percent of total billed charges,,,,,,,,,4862,88,,percent of total billed charges,,,,,,,,,4221.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1381.25,22,,percent of total billed charges,,,5027.75,91,,percent of total billed charges,,,5248.75,95,,percent of total billed charges,,,4585.75,83,,percent of total billed charges,,,4585.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4585.75,83,,percent of total billed charges,,,5248.75,95,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4530.5,82,,percent of total billed charges,,,4972.5,90,,percent of total billed charges,,,4696.25,85,,percent of total billed charges,,1381.25,5248.75,
ARTHREX TIGHT ROPE XP IMPLANT SYNDESMOSI,30187000,CDM,,,278,RC,outpatient,,9717.5,9717.5,,8250.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2429.38,22,,percent of total billed charges,,,,,,,,,8745.75,90,,percent of total billed charges,,,8046.09,82.8,,percent of total billed charges,,,8259.88,85,,percent of total billed charges,,,,,,,,,8551.4,88,,percent of total billed charges,,,,,,,,,7424.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2429.38,22,,percent of total billed charges,,,8842.93,91,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,,,,,,,,,,,,,8065.53,83,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,7968.35,82,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8259.88,85,,percent of total billed charges,,2429.38,9231.63,
ZIMMER FEMUR PSN CR SZ 7 RIGHT,30187001,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
ZIMMER INSERT PSN RIGHT MC 10MM 6-7EF,30187002,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ZIMMER STEM STRAIGHT EXT 16MM X 145MM,30187003,CDM,,,278,RC,outpatient,,7276.62,7276.62,,6177.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1819.16,22,,percent of total billed charges,,,,,,,,,6548.96,90,,percent of total billed charges,,,6025.04,82.8,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,,,,,,,,6403.43,88,,percent of total billed charges,,,,,,,,,5559.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1819.16,22,,percent of total billed charges,,,6621.72,91,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,,,,,,,,,,,,,6039.59,83,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,5966.83,82,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,1819.16,6912.79,
ZIMMER FEMORAL CENTRAL CONE SMALL,30187004,CDM,,,278,RC,outpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12075.78,22,,percent of total billed charges,,,,,,,,,43472.82,90,,percent of total billed charges,,,39994.99,82.8,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12075.78,22,,percent of total billed charges,,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,12075.78,45887.97,
ZIMMER STEM TIBIAL PLATE SZ 4 ROTATING H,30187005,CDM,,,278,RC,outpatient,,28502.57,28502.57,,24198.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7125.64,22,,percent of total billed charges,,,,,,,,,25652.31,90,,percent of total billed charges,,,23600.13,82.8,,percent of total billed charges,,,24227.18,85,,percent of total billed charges,,,,,,,,,25082.26,88,,percent of total billed charges,,,,,,,,,21775.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7125.64,22,,percent of total billed charges,,,25937.34,91,,percent of total billed charges,,,27077.44,95,,percent of total billed charges,,,23657.13,83,,percent of total billed charges,,,23657.13,83,,percent of total billed charges,,,,,,,,,,,,,,,23657.13,83,,percent of total billed charges,,,27077.44,95,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,23372.11,82,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,24227.18,85,,percent of total billed charges,,7125.64,27077.44,
ZIMMER AUGMENT BLOCK SZ E 10MM,30187006,CDM,,,278,RC,outpatient,,6483.75,6483.75,,5504.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1620.94,22,,percent of total billed charges,,,,,,,,,5835.38,90,,percent of total billed charges,,,5368.55,82.8,,percent of total billed charges,,,5511.19,85,,percent of total billed charges,,,,,,,,,5705.7,88,,percent of total billed charges,,,,,,,,,4953.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1620.94,22,,percent of total billed charges,,,5900.21,91,,percent of total billed charges,,,6159.56,95,,percent of total billed charges,,,5381.51,83,,percent of total billed charges,,,5381.51,83,,percent of total billed charges,,,,,,,,,,,,,,,5381.51,83,,percent of total billed charges,,,6159.56,95,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5316.68,82,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5511.19,85,,percent of total billed charges,,1620.94,6159.56,
ZIMMER TIBIA AUGMENT BLOCK SZ E 10MM,30187007,CDM,,,278,RC,outpatient,,6483.75,6483.75,,5504.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1620.94,22,,percent of total billed charges,,,,,,,,,5835.38,90,,percent of total billed charges,,,5368.55,82.8,,percent of total billed charges,,,5511.19,85,,percent of total billed charges,,,,,,,,,5705.7,88,,percent of total billed charges,,,,,,,,,4953.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1620.94,22,,percent of total billed charges,,,5900.21,91,,percent of total billed charges,,,6159.56,95,,percent of total billed charges,,,5381.51,83,,percent of total billed charges,,,5381.51,83,,percent of total billed charges,,,,,,,,,,,,,,,5381.51,83,,percent of total billed charges,,,6159.56,95,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5316.68,82,,percent of total billed charges,,,5835.38,90,,percent of total billed charges,,,5511.19,85,,percent of total billed charges,,1620.94,6159.56,
ZIMMER STEM STRAIGHT EXT 17MM X 145MM,30187008,CDM,,,278,RC,outpatient,,7276.62,7276.62,,6177.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1819.16,22,,percent of total billed charges,,,,,,,,,6548.96,90,,percent of total billed charges,,,6025.04,82.8,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,,,,,,,,6403.43,88,,percent of total billed charges,,,,,,,,,5559.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1819.16,22,,percent of total billed charges,,,6621.72,91,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,,,,,,,,,,,,,6039.59,83,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,5966.83,82,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,1819.16,6912.79,
ZIMMER FEMORAL CENTRAL CONE LARGE,30187009,CDM,,,278,RC,outpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12075.78,22,,percent of total billed charges,,,,,,,,,43472.82,90,,percent of total billed charges,,,39994.99,82.8,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12075.78,22,,percent of total billed charges,,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,12075.78,45887.97,
ZIMMER SURFACE ROTATING HING E 12MM,30187010,CDM,,,278,RC,outpatient,,12617.41,12617.41,,10712.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3154.35,22,,percent of total billed charges,,,,,,,,,11355.67,90,,percent of total billed charges,,,10447.22,82.8,,percent of total billed charges,,,10724.8,85,,percent of total billed charges,,,,,,,,,11103.32,88,,percent of total billed charges,,,,,,,,,9639.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3154.35,22,,percent of total billed charges,,,11481.84,91,,percent of total billed charges,,,11986.54,95,,percent of total billed charges,,,10472.45,83,,percent of total billed charges,,,10472.45,83,,percent of total billed charges,,,,,,,,,,,,,,,10472.45,83,,percent of total billed charges,,,11986.54,95,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,10346.28,82,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,10724.8,85,,percent of total billed charges,,3154.35,11986.54,
ZIMMER FEMORAL ROTATING HINGE E-LT,30187011,CDM,,,278,RC,outpatient,,57459.03,57459.03,,48782.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14364.76,22,,percent of total billed charges,,,,,,,,,51713.13,90,,percent of total billed charges,,,47576.08,82.8,,percent of total billed charges,,,48840.18,85,,percent of total billed charges,,,,,,,,,50563.95,88,,percent of total billed charges,,,,,,,,,43898.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14364.76,22,,percent of total billed charges,,,52287.72,91,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,,,,,,,,,,,,,47690.99,83,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,47116.4,82,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,48840.18,85,,percent of total billed charges,,14364.76,54586.08,
GYNECARE TVT EXACT,30187012,CDM,,,270,RC,outpatient,,9587.24,9587.24,,8139.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.81,22,,percent of total billed charges,,,,,,,,,8628.52,90,,percent of total billed charges,,,7938.23,82.8,,percent of total billed charges,,,8149.15,85,,percent of total billed charges,,,,,,,,,8436.77,88,,percent of total billed charges,,,,,,,,,7324.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.81,22,,percent of total billed charges,,,8724.39,91,,percent of total billed charges,,,9107.88,95,,percent of total billed charges,,,7957.41,83,,percent of total billed charges,,,7957.41,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.41,83,,percent of total billed charges,,,9107.88,95,,percent of total billed charges,,,8628.52,90,,percent of total billed charges,,,8628.52,90,,percent of total billed charges,,,7861.54,82,,percent of total billed charges,,,8628.52,90,,percent of total billed charges,,,8149.15,85,,percent of total billed charges,,2396.81,9107.88,
SUSPENSORY BAUER & BLACK 0-16 LARGE,30187013,CDM,,,270,RC,outpatient,,131.92,131.92,,112,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.98,22,,percent of total billed charges,,,,,,,,,118.73,90,,percent of total billed charges,,,109.23,82.8,,percent of total billed charges,,,112.13,85,,percent of total billed charges,,,,,,,,,116.09,88,,percent of total billed charges,,,,,,,,,100.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.98,22,,percent of total billed charges,,,120.05,91,,percent of total billed charges,,,125.32,95,,percent of total billed charges,,,109.49,83,,percent of total billed charges,,,109.49,83,,percent of total billed charges,,,,,,,,,,,,,,,109.49,83,,percent of total billed charges,,,125.32,95,,percent of total billed charges,,,118.73,90,,percent of total billed charges,,,118.73,90,,percent of total billed charges,,,108.17,82,,percent of total billed charges,,,118.73,90,,percent of total billed charges,,,112.13,85,,percent of total billed charges,,32.98,125.32,
ZIMMER BEARING VIVACIT-E 28X44MM,30187014,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
ZIMMER BLADE PATELLA REAMER SZ 35,30187015,CDM,,,270,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
ZIMMER FEMUR PSN CR SZ 6 RIGHT,30187016,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
COOPER LONESTAR RETRACTOR RINGS,30187017,CDM,,,270,RC,outpatient,,584.85,584.85,,496.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,146.21,22,,percent of total billed charges,,,,,,,,,526.37,90,,percent of total billed charges,,,484.26,82.8,,percent of total billed charges,,,497.12,85,,percent of total billed charges,,,,,,,,,514.67,88,,percent of total billed charges,,,,,,,,,446.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,146.21,22,,percent of total billed charges,,,532.21,91,,percent of total billed charges,,,555.61,95,,percent of total billed charges,,,485.43,83,,percent of total billed charges,,,485.43,83,,percent of total billed charges,,,,,,,,,,,,,,,485.43,83,,percent of total billed charges,,,555.61,95,,percent of total billed charges,,,526.37,90,,percent of total billed charges,,,526.37,90,,percent of total billed charges,,,479.58,82,,percent of total billed charges,,,526.37,90,,percent of total billed charges,,,497.12,85,,percent of total billed charges,,146.21,555.61,
COOPER LONESTAR GYNE KIT W/8  HOOKS,30187018,CDM,,,270,RC,outpatient,,584.85,584.85,,496.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,146.21,22,,percent of total billed charges,,,,,,,,,526.37,90,,percent of total billed charges,,,484.26,82.8,,percent of total billed charges,,,497.12,85,,percent of total billed charges,,,,,,,,,514.67,88,,percent of total billed charges,,,,,,,,,446.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,146.21,22,,percent of total billed charges,,,532.21,91,,percent of total billed charges,,,555.61,95,,percent of total billed charges,,,485.43,83,,percent of total billed charges,,,485.43,83,,percent of total billed charges,,,,,,,,,,,,,,,485.43,83,,percent of total billed charges,,,555.61,95,,percent of total billed charges,,,526.37,90,,percent of total billed charges,,,526.37,90,,percent of total billed charges,,,479.58,82,,percent of total billed charges,,,526.37,90,,percent of total billed charges,,,497.12,85,,percent of total billed charges,,146.21,555.61,
COOPER LONESTAR SHARP STAY HOOKS 5MM,30187019,CDM,,,270,RC,outpatient,,478.38,478.38,,406.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.6,22,,percent of total billed charges,,,,,,,,,430.54,90,,percent of total billed charges,,,396.1,82.8,,percent of total billed charges,,,406.62,85,,percent of total billed charges,,,,,,,,,420.97,88,,percent of total billed charges,,,,,,,,,365.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.6,22,,percent of total billed charges,,,435.33,91,,percent of total billed charges,,,454.46,95,,percent of total billed charges,,,397.06,83,,percent of total billed charges,,,397.06,83,,percent of total billed charges,,,,,,,,,,,,,,,397.06,83,,percent of total billed charges,,,454.46,95,,percent of total billed charges,,,430.54,90,,percent of total billed charges,,,430.54,90,,percent of total billed charges,,,392.27,82,,percent of total billed charges,,,430.54,90,,percent of total billed charges,,,406.62,85,,percent of total billed charges,,119.6,454.46,
ZIMMER PATELLA CEMENTED 35MM,30187020,CDM,,,278,RC,outpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,568.75,22,,percent of total billed charges,,,,,,,,,2047.5,90,,percent of total billed charges,,,1883.7,82.8,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,568.75,22,,percent of total billed charges,,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,568.75,2161.25,
ZIMMER TIBIA CEMENTED LEFT SZ E,30187021,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER FEMUR PSN CR SZ 7 LEFT,30187022,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
SPINECRAFT POWER T HANDLE,30187023,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
SPINECRAFT ROD STRAIGHT 300MM,30187024,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
ZIMMER FEMUR POROUS CR SZ 9 RIGHT,30187025,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
ZIMMER TIBIA PSN  SZ F RIGHT,30187026,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
CAPIO SUTURE MONODEK 1 X 48IN,30187027,CDM,,,270,RC,outpatient,,364.86,364.86,,309.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.22,22,,percent of total billed charges,,,,,,,,,328.37,90,,percent of total billed charges,,,302.1,82.8,,percent of total billed charges,,,310.13,85,,percent of total billed charges,,,,,,,,,321.08,88,,percent of total billed charges,,,,,,,,,278.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.22,22,,percent of total billed charges,,,332.02,91,,percent of total billed charges,,,346.62,95,,percent of total billed charges,,,302.83,83,,percent of total billed charges,,,302.83,83,,percent of total billed charges,,,,,,,,,,,,,,,302.83,83,,percent of total billed charges,,,346.62,95,,percent of total billed charges,,,328.37,90,,percent of total billed charges,,,328.37,90,,percent of total billed charges,,,299.19,82,,percent of total billed charges,,,328.37,90,,percent of total billed charges,,,310.13,85,,percent of total billed charges,,91.22,346.62,
HEMORRHAGE OCCLUDER PIN W/APPLICATOR,30187028,CDM,,,270,RC,outpatient,,1105,1105,,938.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,276.25,22,,percent of total billed charges,,,,,,,,,994.5,90,,percent of total billed charges,,,914.94,82.8,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,,,,,,,,972.4,88,,percent of total billed charges,,,,,,,,,844.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,276.25,22,,percent of total billed charges,,,1005.55,91,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,,,,,,,,,,,,,917.15,83,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,906.1,82,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,276.25,1049.75,
STANDARD FIBERNET KIT,30187029,CDM,,,270,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER LINER NEUTRAL G7 36MM E,30187030,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ZIMMER TIBIA PSN CEMENTED SZ G 5 DEG RIG,30187031,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER FEMUR CEMENTED SZ 11 RIGHT,30187032,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
IR CAGE PEEK 6DEG 12X14X7,30187033,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
IR SCREW SELF DRILLING VARIABLE 14MM,30187034,CDM,,,278,RC,outpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,446.88,22,,percent of total billed charges,,,,,,,,,1608.75,90,,percent of total billed charges,,,1480.05,82.8,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,446.88,22,,percent of total billed charges,,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,446.88,1698.13,
IR PLATE CERVICAL 4 LEVEL 64MM,30187035,CDM,,,278,RC,outpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2437.5,22,,percent of total billed charges,,,,,,,,,8775,90,,percent of total billed charges,,,8073,82.8,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2437.5,22,,percent of total billed charges,,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,2437.5,9262.5,
IR DRILL BIT 12MM,30187036,CDM,,,270,RC,outpatient,,2340,2340,,1986.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,585,22,,percent of total billed charges,,,,,,,,,2106,90,,percent of total billed charges,,,1937.52,82.8,,percent of total billed charges,,,1989,85,,percent of total billed charges,,,,,,,,,2059.2,88,,percent of total billed charges,,,,,,,,,1787.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,585,22,,percent of total billed charges,,,2129.4,91,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1942.2,83,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1918.8,82,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1989,85,,percent of total billed charges,,585,2223,
IR SCREW SELF DRILLING VARIABLE 16MM,30187037,CDM,,,278,RC,outpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,446.88,22,,percent of total billed charges,,,,,,,,,1608.75,90,,percent of total billed charges,,,1480.05,82.8,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,446.88,22,,percent of total billed charges,,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,446.88,1698.13,
SYNTHES PLATE 3 HOLE LEFT HUMERUS 3.5MM,30187038,CDM,,,278,RC,outpatient,,16634.87,16634.87,,14123,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4158.72,22,,percent of total billed charges,,,,,,,,,14971.38,90,,percent of total billed charges,,,13773.67,82.8,,percent of total billed charges,,,14139.64,85,,percent of total billed charges,,,,,,,,,14638.69,88,,percent of total billed charges,,,,,,,,,12709.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4158.72,22,,percent of total billed charges,,,15137.73,91,,percent of total billed charges,,,15803.13,95,,percent of total billed charges,,,13806.94,83,,percent of total billed charges,,,13806.94,83,,percent of total billed charges,,,,,,,,,,,,,,,13806.94,83,,percent of total billed charges,,,15803.13,95,,percent of total billed charges,,,14971.38,90,,percent of total billed charges,,,14971.38,90,,percent of total billed charges,,,13640.59,82,,percent of total billed charges,,,14971.38,90,,percent of total billed charges,,,14139.64,85,,percent of total billed charges,,4158.72,15803.13,
IR CAGE PEEK 6DEG 12X14X6,30187039,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
IR CAGE PEEK 10DEG 12X14X8,30187040,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
IR CAGE PEEK 10DEG 12X14X7,30187041,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
IR PLATE CERVICAL 4 LEVEL 76MM,30187042,CDM,,,278,RC,outpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2437.5,22,,percent of total billed charges,,,,,,,,,8775,90,,percent of total billed charges,,,8073,82.8,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2437.5,22,,percent of total billed charges,,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,2437.5,9262.5,
IR SCREW SELF DRILLING VARIABLE 4.0 X 18,30187043,CDM,,,278,RC,outpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,446.88,22,,percent of total billed charges,,,,,,,,,1608.75,90,,percent of total billed charges,,,1480.05,82.8,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,446.88,22,,percent of total billed charges,,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,446.88,1698.13,
KYPHON 20/2 BONE TAMP KIT,30187044,CDM,,,278,RC,outpatient,,24375,24375,,20694.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6093.75,22,,percent of total billed charges,,,,,,,,,21937.5,90,,percent of total billed charges,,,20182.5,82.8,,percent of total billed charges,,,20718.75,85,,percent of total billed charges,,,,,,,,,21450,88,,percent of total billed charges,,,,,,,,,18622.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6093.75,22,,percent of total billed charges,,,22181.25,91,,percent of total billed charges,,,23156.25,95,,percent of total billed charges,,,20231.25,83,,percent of total billed charges,,,20231.25,83,,percent of total billed charges,,,,,,,,,,,,,,,20231.25,83,,percent of total billed charges,,,23156.25,95,,percent of total billed charges,,,21937.5,90,,percent of total billed charges,,,21937.5,90,,percent of total billed charges,,,19987.5,82,,percent of total billed charges,,,21937.5,90,,percent of total billed charges,,,20718.75,85,,percent of total billed charges,,6093.75,23156.25,
FIBRINET PLATELET SYSTEM,30187045,CDM,,,278,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
FIBRINET SYSTEM,30187046,CDM,,,278,RC,outpatient,,9717.5,9717.5,,8250.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2429.38,22,,percent of total billed charges,,,,,,,,,8745.75,90,,percent of total billed charges,,,8046.09,82.8,,percent of total billed charges,,,8259.88,85,,percent of total billed charges,,,,,,,,,8551.4,88,,percent of total billed charges,,,,,,,,,7424.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2429.38,22,,percent of total billed charges,,,8842.93,91,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,,,,,,,,,,,,,8065.53,83,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,7968.35,82,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8259.88,85,,percent of total billed charges,,2429.38,9231.63,
ZIMMER LINER NEUTRAL F 40MM,30187047,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ZIMMER BEARING VIVACIT-E 28X42MM,30187048,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
TROCAR MAYO CATGUT 5D 1/2 CIRCL,30187049,CDM,,,270,RC,outpatient,,80.57,80.57,,68.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.14,22,,percent of total billed charges,,,,,,,,,72.51,90,,percent of total billed charges,,,66.71,82.8,,percent of total billed charges,,,68.48,85,,percent of total billed charges,,,,,,,,,70.9,88,,percent of total billed charges,,,,,,,,,61.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.14,22,,percent of total billed charges,,,73.32,91,,percent of total billed charges,,,76.54,95,,percent of total billed charges,,,66.87,83,,percent of total billed charges,,,66.87,83,,percent of total billed charges,,,,,,,,,,,,,,,66.87,83,,percent of total billed charges,,,76.54,95,,percent of total billed charges,,,72.51,90,,percent of total billed charges,,,72.51,90,,percent of total billed charges,,,66.07,82,,percent of total billed charges,,,72.51,90,,percent of total billed charges,,,68.48,85,,percent of total billed charges,,20.14,76.54,
IOVERA SMART TIP 190 W/NERVE STIM,30187050,CDM,,,270,RC,outpatient,,5196.75,5196.75,,4412.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1299.19,22,,percent of total billed charges,,,,,,,,,4677.08,90,,percent of total billed charges,,,4302.91,82.8,,percent of total billed charges,,,4417.24,85,,percent of total billed charges,,,,,,,,,4573.14,88,,percent of total billed charges,,,,,,,,,3970.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1299.19,22,,percent of total billed charges,,,4729.04,91,,percent of total billed charges,,,4936.91,95,,percent of total billed charges,,,4313.3,83,,percent of total billed charges,,,4313.3,83,,percent of total billed charges,,,,,,,,,,,,,,,4313.3,83,,percent of total billed charges,,,4936.91,95,,percent of total billed charges,,,4677.08,90,,percent of total billed charges,,,4677.08,90,,percent of total billed charges,,,4261.34,82,,percent of total billed charges,,,4677.08,90,,percent of total billed charges,,,4417.24,85,,percent of total billed charges,,1299.19,4936.91,
OSTEO FEMORAL HEAD MEDIUM,30187052,CDM,,,278,RC,outpatient,,21125,21125,,17935.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5281.25,22,,percent of total billed charges,,,,,,,,,19012.5,90,,percent of total billed charges,,,17491.5,82.8,,percent of total billed charges,,,17956.25,85,,percent of total billed charges,,,,,,,,,18590,88,,percent of total billed charges,,,,,,,,,16139.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5281.25,22,,percent of total billed charges,,,19223.75,91,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,17533.75,83,,percent of total billed charges,,,,,,,,,,,,,,,17533.75,83,,percent of total billed charges,,,20068.75,95,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17322.5,82,,percent of total billed charges,,,19012.5,90,,percent of total billed charges,,,17956.25,85,,percent of total billed charges,,5281.25,20068.75,
ALLODERM 4 X 12,30187053,CDM,,,278,RC,outpatient,,13734.5,13734.5,,11660.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3433.63,22,,percent of total billed charges,,,,,,,,,12361.05,90,,percent of total billed charges,,,11372.17,82.8,,percent of total billed charges,,,11674.33,85,,percent of total billed charges,,,,,,,,,12086.36,88,,percent of total billed charges,,,,,,,,,10493.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3433.63,22,,percent of total billed charges,,,12498.4,91,,percent of total billed charges,,,13047.78,95,,percent of total billed charges,,,11399.64,83,,percent of total billed charges,,,11399.64,83,,percent of total billed charges,,,,,,,,,,,,,,,11399.64,83,,percent of total billed charges,,,13047.78,95,,percent of total billed charges,,,12361.05,90,,percent of total billed charges,,,12361.05,90,,percent of total billed charges,,,11262.29,82,,percent of total billed charges,,,12361.05,90,,percent of total billed charges,,,11674.33,85,,percent of total billed charges,,3433.63,13047.78,
ARTHREX SUTURE TIGERTAPE CERCLAGE,30187054,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
CATHETER OMNI FLUSH 5F .035 65CM,30187055,CDM,,,270,RC,outpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.63,22,,percent of total billed charges,,,,,,,,,236.25,90,,percent of total billed charges,,,217.35,82.8,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.63,22,,percent of total billed charges,,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,65.63,249.38,
CATHETER OMNI FLUSH 5F .038 100CM,30187056,CDM,,,270,RC,outpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.63,22,,percent of total billed charges,,,,,,,,,236.25,90,,percent of total billed charges,,,217.35,82.8,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.63,22,,percent of total billed charges,,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,65.63,249.38,
CATHETER KUMPE 5F .038 40CM,30187057,CDM,,,270,RC,outpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.88,22,,percent of total billed charges,,,,,,,,,222.75,90,,percent of total billed charges,,,204.93,82.8,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.88,22,,percent of total billed charges,,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,61.88,235.13,
CATHETER COBRA C2 5F .035 65CM,30187058,CDM,,,270,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
CATHETER COBRA C2 5F .035 90CM,30187059,CDM,,,270,RC,outpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.88,22,,percent of total billed charges,,,,,,,,,222.75,90,,percent of total billed charges,,,204.93,82.8,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.88,22,,percent of total billed charges,,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,61.88,235.13,
TERUMO GLIDEWIRE TORQUE DEVICE 0.010 - 0,30187060,CDM,,,270,RC,outpatient,,55.85,55.85,,47.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.96,22,,percent of total billed charges,,,,,,,,,50.27,90,,percent of total billed charges,,,46.24,82.8,,percent of total billed charges,,,47.47,85,,percent of total billed charges,,,,,,,,,49.15,88,,percent of total billed charges,,,,,,,,,42.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.96,22,,percent of total billed charges,,,50.82,91,,percent of total billed charges,,,53.06,95,,percent of total billed charges,,,46.36,83,,percent of total billed charges,,,46.36,83,,percent of total billed charges,,,,,,,,,,,,,,,46.36,83,,percent of total billed charges,,,53.06,95,,percent of total billed charges,,,50.27,90,,percent of total billed charges,,,50.27,90,,percent of total billed charges,,,45.8,82,,percent of total billed charges,,,50.27,90,,percent of total billed charges,,,47.47,85,,percent of total billed charges,,13.96,53.06,
TERUMO GLIDEWIRE STRAIGHT STANDARD 0.35,30187061,CDM,,,270,RC,outpatient,,476,476,,404.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119,22,,percent of total billed charges,,,,,,,,,428.4,90,,percent of total billed charges,,,394.13,82.8,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,,,,,,,,418.88,88,,percent of total billed charges,,,,,,,,,363.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119,22,,percent of total billed charges,,,433.16,91,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,,,,,,,,,,,,,395.08,83,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,390.32,82,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,119,452.2,
TERUMO PROGREAT 2.4,30187062,CDM,,,270,RC,outpatient,,4355,4355,,3697.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1088.75,22,,percent of total billed charges,,,,,,,,,3919.5,90,,percent of total billed charges,,,3605.94,82.8,,percent of total billed charges,,,3701.75,85,,percent of total billed charges,,,,,,,,,3832.4,88,,percent of total billed charges,,,,,,,,,3327.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1088.75,22,,percent of total billed charges,,,3963.05,91,,percent of total billed charges,,,4137.25,95,,percent of total billed charges,,,3614.65,83,,percent of total billed charges,,,3614.65,83,,percent of total billed charges,,,,,,,,,,,,,,,3614.65,83,,percent of total billed charges,,,4137.25,95,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3571.1,82,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3701.75,85,,percent of total billed charges,,1088.75,4137.25,
TERUMO PROGREAT 2.8,30187063,CDM,,,270,RC,outpatient,,4355,4355,,3697.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1088.75,22,,percent of total billed charges,,,,,,,,,3919.5,90,,percent of total billed charges,,,3605.94,82.8,,percent of total billed charges,,,3701.75,85,,percent of total billed charges,,,,,,,,,3832.4,88,,percent of total billed charges,,,,,,,,,3327.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1088.75,22,,percent of total billed charges,,,3963.05,91,,percent of total billed charges,,,4137.25,95,,percent of total billed charges,,,3614.65,83,,percent of total billed charges,,,3614.65,83,,percent of total billed charges,,,,,,,,,,,,,,,3614.65,83,,percent of total billed charges,,,4137.25,95,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3571.1,82,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3701.75,85,,percent of total billed charges,,1088.75,4137.25,
COOK SHEALTH ANSEL 1 8FR 45CM,30187064,CDM,,,270,RC,outpatient,,454.23,454.23,,385.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,113.56,22,,percent of total billed charges,,,,,,,,,408.81,90,,percent of total billed charges,,,376.1,82.8,,percent of total billed charges,,,386.1,85,,percent of total billed charges,,,,,,,,,399.72,88,,percent of total billed charges,,,,,,,,,347.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,113.56,22,,percent of total billed charges,,,413.35,91,,percent of total billed charges,,,431.52,95,,percent of total billed charges,,,377.01,83,,percent of total billed charges,,,377.01,83,,percent of total billed charges,,,,,,,,,,,,,,,377.01,83,,percent of total billed charges,,,431.52,95,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,372.47,82,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,386.1,85,,percent of total billed charges,,113.56,431.52,
COOK SHEALTH ANSEL 1 7FR 45CM,30187065,CDM,,,270,RC,outpatient,,398.09,398.09,,337.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,99.52,22,,percent of total billed charges,,,,,,,,,358.28,90,,percent of total billed charges,,,329.62,82.8,,percent of total billed charges,,,338.38,85,,percent of total billed charges,,,,,,,,,350.32,88,,percent of total billed charges,,,,,,,,,304.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,99.52,22,,percent of total billed charges,,,362.26,91,,percent of total billed charges,,,378.19,95,,percent of total billed charges,,,330.41,83,,percent of total billed charges,,,330.41,83,,percent of total billed charges,,,,,,,,,,,,,,,330.41,83,,percent of total billed charges,,,378.19,95,,percent of total billed charges,,,358.28,90,,percent of total billed charges,,,358.28,90,,percent of total billed charges,,,326.43,82,,percent of total billed charges,,,358.28,90,,percent of total billed charges,,,338.38,85,,percent of total billed charges,,99.52,378.19,
CONTROL WIRE 8CM V18 300CM,30187066,CDM,,,270,RC,outpatient,,778.82,778.82,,661.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,194.71,22,,percent of total billed charges,,,,,,,,,700.94,90,,percent of total billed charges,,,644.86,82.8,,percent of total billed charges,,,662,85,,percent of total billed charges,,,,,,,,,685.36,88,,percent of total billed charges,,,,,,,,,595.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,194.71,22,,percent of total billed charges,,,708.73,91,,percent of total billed charges,,,739.88,95,,percent of total billed charges,,,646.42,83,,percent of total billed charges,,,646.42,83,,percent of total billed charges,,,,,,,,,,,,,,,646.42,83,,percent of total billed charges,,,739.88,95,,percent of total billed charges,,,700.94,90,,percent of total billed charges,,,700.94,90,,percent of total billed charges,,,638.63,82,,percent of total billed charges,,,700.94,90,,percent of total billed charges,,,662,85,,percent of total billed charges,,194.71,739.88,
MERIT CATHETER ONESTEP 5F 10CM,30187067,CDM,,,270,RC,outpatient,,148,148,,125.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37,22,,percent of total billed charges,,,,,,,,,133.2,90,,percent of total billed charges,,,122.54,82.8,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,,,,,,,,130.24,88,,percent of total billed charges,,,,,,,,,113.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37,22,,percent of total billed charges,,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,,,,,,,,,,,,,122.84,83,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,121.36,82,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,37,140.6,
MERIT CATHETER ONESTEP 5F 12CM,30187068,CDM,,,270,RC,outpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75,22,,percent of total billed charges,,,,,,,,,270,90,,percent of total billed charges,,,248.4,82.8,,percent of total billed charges,,,255,85,,percent of total billed charges,,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75,22,,percent of total billed charges,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,75,285,
IR PLATE CERVICAL 1 LEVEL 12MM,30187070,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
ZIMMER FEMUR PERSONA RIGHT 12 STANDARD,30187073,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
ZIMMER TIBIA STEM PERSONA RIGHT H,30187074,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
SYNTHES SCREW CANCELLOUS 4X12MM,30187075,CDM,,,278,RC,outpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.18,22,,percent of total billed charges,,,,,,,,,213.03,90,,percent of total billed charges,,,195.99,82.8,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.18,22,,percent of total billed charges,,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,59.18,224.87,
SYNTHES SCREW CANCELLOUS 4X14MM,30187076,CDM,,,278,RC,outpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.18,22,,percent of total billed charges,,,,,,,,,213.03,90,,percent of total billed charges,,,195.99,82.8,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.18,22,,percent of total billed charges,,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,59.18,224.87,
SYNTHES SCREW CANCELLOUS 4X16MM,30187077,CDM,,,278,RC,outpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.18,22,,percent of total billed charges,,,,,,,,,213.03,90,,percent of total billed charges,,,195.99,82.8,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.18,22,,percent of total billed charges,,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,59.18,224.87,
SYNTHES SCREW CANCELLOUS FT 4X10MM,30187078,CDM,,,278,RC,outpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.18,22,,percent of total billed charges,,,,,,,,,213.03,90,,percent of total billed charges,,,195.99,82.8,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.18,22,,percent of total billed charges,,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,59.18,224.87,
SYNTHES SCREW CANCELLOUS FT 4X12MM,30187079,CDM,,,278,RC,outpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.18,22,,percent of total billed charges,,,,,,,,,213.03,90,,percent of total billed charges,,,195.99,82.8,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.18,22,,percent of total billed charges,,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,59.18,224.87,
COOK FLEXOR ACCESS SHEATH 10.7FR X 55CM,30187080,CDM,,,270,RC,outpatient,,846.3,846.3,,718.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,211.58,22,,percent of total billed charges,,,,,,,,,761.67,90,,percent of total billed charges,,,700.74,82.8,,percent of total billed charges,,,719.36,85,,percent of total billed charges,,,,,,,,,744.74,88,,percent of total billed charges,,,,,,,,,646.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,211.58,22,,percent of total billed charges,,,770.13,91,,percent of total billed charges,,,803.99,95,,percent of total billed charges,,,702.43,83,,percent of total billed charges,,,702.43,83,,percent of total billed charges,,,,,,,,,,,,,,,702.43,83,,percent of total billed charges,,,803.99,95,,percent of total billed charges,,,761.67,90,,percent of total billed charges,,,761.67,90,,percent of total billed charges,,,693.97,82,,percent of total billed charges,,,761.67,90,,percent of total billed charges,,,719.36,85,,percent of total billed charges,,211.58,803.99,
COOK FLEXOR ACCESS SHEATH 12FR X 55CM,30187081,CDM,,,270,RC,outpatient,,846.3,846.3,,718.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,211.58,22,,percent of total billed charges,,,,,,,,,761.67,90,,percent of total billed charges,,,700.74,82.8,,percent of total billed charges,,,719.36,85,,percent of total billed charges,,,,,,,,,744.74,88,,percent of total billed charges,,,,,,,,,646.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,211.58,22,,percent of total billed charges,,,770.13,91,,percent of total billed charges,,,803.99,95,,percent of total billed charges,,,702.43,83,,percent of total billed charges,,,702.43,83,,percent of total billed charges,,,,,,,,,,,,,,,702.43,83,,percent of total billed charges,,,803.99,95,,percent of total billed charges,,,761.67,90,,percent of total billed charges,,,761.67,90,,percent of total billed charges,,,693.97,82,,percent of total billed charges,,,761.67,90,,percent of total billed charges,,,719.36,85,,percent of total billed charges,,211.58,803.99,
COOK FLEXOR YELLOW OPEN ENEDED 5FR X 70,30187082,CDM,,,270,RC,outpatient,,80.08,80.08,,67.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.02,22,,percent of total billed charges,,,,,,,,,72.07,90,,percent of total billed charges,,,66.31,82.8,,percent of total billed charges,,,68.07,85,,percent of total billed charges,,,,,,,,,70.47,88,,percent of total billed charges,,,,,,,,,61.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.02,22,,percent of total billed charges,,,72.87,91,,percent of total billed charges,,,76.08,95,,percent of total billed charges,,,66.47,83,,percent of total billed charges,,,66.47,83,,percent of total billed charges,,,,,,,,,,,,,,,66.47,83,,percent of total billed charges,,,76.08,95,,percent of total billed charges,,,72.07,90,,percent of total billed charges,,,72.07,90,,percent of total billed charges,,,65.67,82,,percent of total billed charges,,,72.07,90,,percent of total billed charges,,,68.07,85,,percent of total billed charges,,20.02,76.08,
GREENLIGHT LASER - MIDWEST THERAPY,30187083,CDM,,,270,RC,outpatient,,6337.5,6337.5,,5380.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1584.38,22,,percent of total billed charges,,,,,,,,,5703.75,90,,percent of total billed charges,,,5247.45,82.8,,percent of total billed charges,,,5386.88,85,,percent of total billed charges,,,,,,,,,5577,88,,percent of total billed charges,,,,,,,,,4841.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1584.38,22,,percent of total billed charges,,,5767.13,91,,percent of total billed charges,,,6020.63,95,,percent of total billed charges,,,5260.13,83,,percent of total billed charges,,,5260.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5260.13,83,,percent of total billed charges,,,6020.63,95,,percent of total billed charges,,,5703.75,90,,percent of total billed charges,,,5703.75,90,,percent of total billed charges,,,5196.75,82,,percent of total billed charges,,,5703.75,90,,percent of total billed charges,,,5386.88,85,,percent of total billed charges,,1584.38,6020.63,
GREENLIGHT XPS MOXY FIBER - MIDWEST THER,30187084,CDM,,,270,RC,outpatient,,6142.5,6142.5,,5214.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1535.63,22,,percent of total billed charges,,,,,,,,,5528.25,90,,percent of total billed charges,,,5085.99,82.8,,percent of total billed charges,,,5221.13,85,,percent of total billed charges,,,,,,,,,5405.4,88,,percent of total billed charges,,,,,,,,,4692.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1535.63,22,,percent of total billed charges,,,5589.68,91,,percent of total billed charges,,,5835.38,95,,percent of total billed charges,,,5098.28,83,,percent of total billed charges,,,5098.28,83,,percent of total billed charges,,,,,,,,,,,,,,,5098.28,83,,percent of total billed charges,,,5835.38,95,,percent of total billed charges,,,5528.25,90,,percent of total billed charges,,,5528.25,90,,percent of total billed charges,,,5036.85,82,,percent of total billed charges,,,5528.25,90,,percent of total billed charges,,,5221.13,85,,percent of total billed charges,,1535.63,5835.38,
DEPUY CEMENTRALIZER 10MM,30187085,CDM,,,270,RC,outpatient,,919.36,919.36,,780.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,229.84,22,,percent of total billed charges,,,,,,,,,827.42,90,,percent of total billed charges,,,761.23,82.8,,percent of total billed charges,,,781.46,85,,percent of total billed charges,,,,,,,,,809.04,88,,percent of total billed charges,,,,,,,,,702.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,229.84,22,,percent of total billed charges,,,836.62,91,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,,,,,,,,,,,,,763.07,83,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,753.88,82,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,781.46,85,,percent of total billed charges,,229.84,873.39,
DEPUY STEM CORAIL HIGH COL SZ 15,30187086,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY INSERT CR RP SZ 10 7MM,30187087,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
LABORIE NEEDLE INJECTION 35CM,30187088,CDM,,,270,RC,outpatient,,416.5,416.5,,353.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.13,22,,percent of total billed charges,,,,,,,,,374.85,90,,percent of total billed charges,,,344.86,82.8,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,,,,,,,,366.52,88,,percent of total billed charges,,,,,,,,,318.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.13,22,,percent of total billed charges,,,379.02,91,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,345.7,83,,percent of total billed charges,,,,,,,,,,,,,,,345.7,83,,percent of total billed charges,,,395.68,95,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,341.53,82,,percent of total billed charges,,,374.85,90,,percent of total billed charges,,,354.03,85,,percent of total billed charges,,104.13,395.68,
LABORIE NEEDLE INJECTION 70CM,30187089,CDM,,,270,RC,outpatient,,518,518,,439.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,129.5,22,,percent of total billed charges,,,,,,,,,466.2,90,,percent of total billed charges,,,428.9,82.8,,percent of total billed charges,,,440.3,85,,percent of total billed charges,,,,,,,,,455.84,88,,percent of total billed charges,,,,,,,,,395.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,129.5,22,,percent of total billed charges,,,471.38,91,,percent of total billed charges,,,492.1,95,,percent of total billed charges,,,429.94,83,,percent of total billed charges,,,429.94,83,,percent of total billed charges,,,,,,,,,,,,,,,429.94,83,,percent of total billed charges,,,492.1,95,,percent of total billed charges,,,466.2,90,,percent of total billed charges,,,466.2,90,,percent of total billed charges,,,424.76,82,,percent of total billed charges,,,466.2,90,,percent of total billed charges,,,440.3,85,,percent of total billed charges,,129.5,492.1,
S&N TIBIAL CONE SHORT 20 ID,30187090,CDM,,,278,RC,outpatient,,38616.5,38616.5,,32785.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9654.13,22,,percent of total billed charges,,,,,,,,,34754.85,90,,percent of total billed charges,,,31974.46,82.8,,percent of total billed charges,,,32824.03,85,,percent of total billed charges,,,,,,,,,33982.52,88,,percent of total billed charges,,,,,,,,,29503.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9654.13,22,,percent of total billed charges,,,35141.02,91,,percent of total billed charges,,,36685.68,95,,percent of total billed charges,,,32051.7,83,,percent of total billed charges,,,32051.7,83,,percent of total billed charges,,,,,,,,,,,,,,,32051.7,83,,percent of total billed charges,,,36685.68,95,,percent of total billed charges,,,34754.85,90,,percent of total billed charges,,,34754.85,90,,percent of total billed charges,,,31665.53,82,,percent of total billed charges,,,34754.85,90,,percent of total billed charges,,,32824.03,85,,percent of total billed charges,,9654.13,36685.68,
S&N WEDGE DISTAL/POST L SZ 4 15D X 5P,30187091,CDM,,,278,RC,outpatient,,19088.03,19088.03,,16205.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4772.01,22,,percent of total billed charges,,,,,,,,,17179.23,90,,percent of total billed charges,,,15804.89,82.8,,percent of total billed charges,,,16224.83,85,,percent of total billed charges,,,,,,,,,16797.47,88,,percent of total billed charges,,,,,,,,,14583.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4772.01,22,,percent of total billed charges,,,17370.11,91,,percent of total billed charges,,,18133.63,95,,percent of total billed charges,,,15843.06,83,,percent of total billed charges,,,15843.06,83,,percent of total billed charges,,,,,,,,,,,,,,,15843.06,83,,percent of total billed charges,,,18133.63,95,,percent of total billed charges,,,17179.23,90,,percent of total billed charges,,,17179.23,90,,percent of total billed charges,,,15652.18,82,,percent of total billed charges,,,17179.23,90,,percent of total billed charges,,,16224.83,85,,percent of total billed charges,,4772.01,18133.63,
S&N WEDGES DISTAL 5MM SZ 4,30187092,CDM,,,278,RC,outpatient,,13043.03,13043.03,,11073.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3260.76,22,,percent of total billed charges,,,,,,,,,11738.73,90,,percent of total billed charges,,,10799.63,82.8,,percent of total billed charges,,,11086.58,85,,percent of total billed charges,,,,,,,,,11477.87,88,,percent of total billed charges,,,,,,,,,9964.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3260.76,22,,percent of total billed charges,,,11869.16,91,,percent of total billed charges,,,12390.88,95,,percent of total billed charges,,,10825.71,83,,percent of total billed charges,,,10825.71,83,,percent of total billed charges,,,,,,,,,,,,,,,10825.71,83,,percent of total billed charges,,,12390.88,95,,percent of total billed charges,,,11738.73,90,,percent of total billed charges,,,11738.73,90,,percent of total billed charges,,,10695.28,82,,percent of total billed charges,,,11738.73,90,,percent of total billed charges,,,11086.58,85,,percent of total billed charges,,3260.76,12390.88,
S&N COUPLER OFFSET 4MM,30187093,CDM,,,278,RC,outpatient,,13168.48,13168.48,,11180.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3292.12,22,,percent of total billed charges,,,,,,,,,11851.63,90,,percent of total billed charges,,,10903.5,82.8,,percent of total billed charges,,,11193.21,85,,percent of total billed charges,,,,,,,,,11588.26,88,,percent of total billed charges,,,,,,,,,10060.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3292.12,22,,percent of total billed charges,,,11983.32,91,,percent of total billed charges,,,12510.06,95,,percent of total billed charges,,,10929.84,83,,percent of total billed charges,,,10929.84,83,,percent of total billed charges,,,,,,,,,,,,,,,10929.84,83,,percent of total billed charges,,,12510.06,95,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,10798.15,82,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,11193.21,85,,percent of total billed charges,,3292.12,12510.06,
S&N FEMUR LEGION OX CONSTRAINED SZ 4 LT,30187094,CDM,,,278,RC,outpatient,,69403.95,69403.95,,58923.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17350.99,22,,percent of total billed charges,,,,,,,,,62463.56,90,,percent of total billed charges,,,57466.47,82.8,,percent of total billed charges,,,58993.36,85,,percent of total billed charges,,,,,,,,,61075.48,88,,percent of total billed charges,,,,,,,,,53024.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17350.99,22,,percent of total billed charges,,,63157.59,91,,percent of total billed charges,,,65933.75,95,,percent of total billed charges,,,57605.28,83,,percent of total billed charges,,,57605.28,83,,percent of total billed charges,,,,,,,,,,,,,,,57605.28,83,,percent of total billed charges,,,65933.75,95,,percent of total billed charges,,,62463.56,90,,percent of total billed charges,,,62463.56,90,,percent of total billed charges,,,56911.24,82,,percent of total billed charges,,,62463.56,90,,percent of total billed charges,,,58993.36,85,,percent of total billed charges,,17350.99,65933.75,
S&N STEM PRESSFIT 16 X 120MM,30187095,CDM,,,278,RC,outpatient,,12842.44,12842.44,,10903.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3210.61,22,,percent of total billed charges,,,,,,,,,11558.2,90,,percent of total billed charges,,,10633.54,82.8,,percent of total billed charges,,,10916.07,85,,percent of total billed charges,,,,,,,,,11301.35,88,,percent of total billed charges,,,,,,,,,9811.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3210.61,22,,percent of total billed charges,,,11686.62,91,,percent of total billed charges,,,12200.32,95,,percent of total billed charges,,,10659.23,83,,percent of total billed charges,,,10659.23,83,,percent of total billed charges,,,,,,,,,,,,,,,10659.23,83,,percent of total billed charges,,,12200.32,95,,percent of total billed charges,,,11558.2,90,,percent of total billed charges,,,11558.2,90,,percent of total billed charges,,,10530.8,82,,percent of total billed charges,,,11558.2,90,,percent of total billed charges,,,10916.07,85,,percent of total billed charges,,3210.61,12200.32,
S&N COUPLER OFFSET 2MM,30187096,CDM,,,278,RC,outpatient,,13168.48,13168.48,,11180.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3292.12,22,,percent of total billed charges,,,,,,,,,11851.63,90,,percent of total billed charges,,,10903.5,82.8,,percent of total billed charges,,,11193.21,85,,percent of total billed charges,,,,,,,,,11588.26,88,,percent of total billed charges,,,,,,,,,10060.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3292.12,22,,percent of total billed charges,,,11983.32,91,,percent of total billed charges,,,12510.06,95,,percent of total billed charges,,,10929.84,83,,percent of total billed charges,,,10929.84,83,,percent of total billed charges,,,,,,,,,,,,,,,10929.84,83,,percent of total billed charges,,,12510.06,95,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,10798.15,82,,percent of total billed charges,,,11851.63,90,,percent of total billed charges,,,11193.21,85,,percent of total billed charges,,3292.12,12510.06,
S&N WEDGE TIBIAL FINNED 10MM SZ4 LT,30187097,CDM,,,278,RC,outpatient,,17271.8,17271.8,,14663.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4317.95,22,,percent of total billed charges,,,,,,,,,15544.62,90,,percent of total billed charges,,,14301.05,82.8,,percent of total billed charges,,,14681.03,85,,percent of total billed charges,,,,,,,,,15199.18,88,,percent of total billed charges,,,,,,,,,13195.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4317.95,22,,percent of total billed charges,,,15717.34,91,,percent of total billed charges,,,16408.21,95,,percent of total billed charges,,,14335.59,83,,percent of total billed charges,,,14335.59,83,,percent of total billed charges,,,,,,,,,,,,,,,14335.59,83,,percent of total billed charges,,,16408.21,95,,percent of total billed charges,,,15544.62,90,,percent of total billed charges,,,15544.62,90,,percent of total billed charges,,,14162.88,82,,percent of total billed charges,,,15544.62,90,,percent of total billed charges,,,14681.03,85,,percent of total billed charges,,4317.95,16408.21,
S&N STEM PRESSFIT 12 X 160MM,30187098,CDM,,,278,RC,outpatient,,13193.51,13193.51,,11201.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3298.38,22,,percent of total billed charges,,,,,,,,,11874.16,90,,percent of total billed charges,,,10924.23,82.8,,percent of total billed charges,,,11214.48,85,,percent of total billed charges,,,,,,,,,11610.29,88,,percent of total billed charges,,,,,,,,,10079.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3298.38,22,,percent of total billed charges,,,12006.09,91,,percent of total billed charges,,,12533.83,95,,percent of total billed charges,,,10950.61,83,,percent of total billed charges,,,10950.61,83,,percent of total billed charges,,,,,,,,,,,,,,,10950.61,83,,percent of total billed charges,,,12533.83,95,,percent of total billed charges,,,11874.16,90,,percent of total billed charges,,,11874.16,90,,percent of total billed charges,,,10818.68,82,,percent of total billed charges,,,11874.16,90,,percent of total billed charges,,,11214.48,85,,percent of total billed charges,,3298.38,12533.83,
DEPUY-MITEK HEALIX PERMATAPE 5.5,30187100,CDM,,,278,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
DEPUY-MITEK HEALIX KNOTLESS 6.5,30187102,CDM,,,278,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
VASCULAR CLOSURE DEVICE 6F/7F,30187103,CDM,,,270,RC,outpatient,,1397.5,1397.5,,1186.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,349.38,22,,percent of total billed charges,,,,,,,,,1257.75,90,,percent of total billed charges,,,1157.13,82.8,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,,,,,,,,1229.8,88,,percent of total billed charges,,,,,,,,,1067.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,349.38,22,,percent of total billed charges,,,1271.73,91,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1159.93,83,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1145.95,82,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,349.38,1327.63,
ZIMMER PATELLA REAMER BLADE SZ 46,30187105,CDM,,,278,RC,outpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1218.75,22,,percent of total billed charges,,,,,,,,,4387.5,90,,percent of total billed charges,,,4036.5,82.8,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1218.75,22,,percent of total billed charges,,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,1218.75,4631.25,
ZIMMER FEMUR CR LEFT SZ 11,30187106,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
PORT POWER INJECTABLE XCELA 8FR,30187107,CDM,,,278,RC,outpatient,,2502.5,2502.5,,2124.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,625.63,22,,percent of total billed charges,,,,,,,,,2252.25,90,,percent of total billed charges,,,2072.07,82.8,,percent of total billed charges,,,2127.13,85,,percent of total billed charges,,,,,,,,,2202.2,88,,percent of total billed charges,,,,,,,,,1911.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,625.63,22,,percent of total billed charges,,,2277.28,91,,percent of total billed charges,,,2377.38,95,,percent of total billed charges,,,2077.08,83,,percent of total billed charges,,,2077.08,83,,percent of total billed charges,,,,,,,,,,,,,,,2077.08,83,,percent of total billed charges,,,2377.38,95,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2052.05,82,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2127.13,85,,percent of total billed charges,,625.63,2377.38,
ZIMMER FEMUR PSN CR SZ 10 RIGHT,30187108,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
ZIMMER REAMER BLADE PATELLA SZ 46,30187109,CDM,,,278,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
UNIFUSE WITH COOPER WIRE 5FR 90CM,30187110,CDM,,,270,RC,outpatient,,1813.5,1813.5,,1539.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,453.38,22,,percent of total billed charges,,,,,,,,,1632.15,90,,percent of total billed charges,,,1501.58,82.8,,percent of total billed charges,,,1541.48,85,,percent of total billed charges,,,,,,,,,1595.88,88,,percent of total billed charges,,,,,,,,,1385.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,453.38,22,,percent of total billed charges,,,1650.29,91,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.21,83,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1487.07,82,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1541.48,85,,percent of total billed charges,,453.38,1722.83,
SYNTHES SCREW CORTEX S-T 4.5X16MM,30187111,CDM,,,278,RC,outpatient,,277.28,277.28,,235.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.32,22,,percent of total billed charges,,,,,,,,,249.55,90,,percent of total billed charges,,,229.59,82.8,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,,,,,,,,244.01,88,,percent of total billed charges,,,,,,,,,211.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.32,22,,percent of total billed charges,,,252.32,91,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,,,,,,,,,,,,,230.14,83,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,227.37,82,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,69.32,263.42,
SYNTHES SCREW CORTEX S-T 4.5X40MM,30187112,CDM,,,278,RC,outpatient,,277.28,277.28,,235.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.32,22,,percent of total billed charges,,,,,,,,,249.55,90,,percent of total billed charges,,,229.59,82.8,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,,,,,,,,244.01,88,,percent of total billed charges,,,,,,,,,211.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.32,22,,percent of total billed charges,,,252.32,91,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,,,,,,,,,,,,,230.14,83,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,227.37,82,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,69.32,263.42,
UNIFUSE WITH COOPER WIRE 5FR 135CM,30187113,CDM,,,270,RC,outpatient,,1813.5,1813.5,,1539.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,453.38,22,,percent of total billed charges,,,,,,,,,1632.15,90,,percent of total billed charges,,,1501.58,82.8,,percent of total billed charges,,,1541.48,85,,percent of total billed charges,,,,,,,,,1595.88,88,,percent of total billed charges,,,,,,,,,1385.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,453.38,22,,percent of total billed charges,,,1650.29,91,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.21,83,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1487.07,82,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1541.48,85,,percent of total billed charges,,453.38,1722.83,
SYNTHES PLATE HUMERUS PERIARTIC 6H 3.5MM,30187114,CDM,,,278,RC,outpatient,,19583.2,19583.2,,16626.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4895.8,22,,percent of total billed charges,,,,,,,,,17624.88,90,,percent of total billed charges,,,16214.89,82.8,,percent of total billed charges,,,16645.72,85,,percent of total billed charges,,,,,,,,,17233.22,88,,percent of total billed charges,,,,,,,,,14961.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4895.8,22,,percent of total billed charges,,,17820.71,91,,percent of total billed charges,,,18604.04,95,,percent of total billed charges,,,16254.06,83,,percent of total billed charges,,,16254.06,83,,percent of total billed charges,,,,,,,,,,,,,,,16254.06,83,,percent of total billed charges,,,18604.04,95,,percent of total billed charges,,,17624.88,90,,percent of total billed charges,,,17624.88,90,,percent of total billed charges,,,16058.22,82,,percent of total billed charges,,,17624.88,90,,percent of total billed charges,,,16645.72,85,,percent of total billed charges,,4895.8,18604.04,
IR CAGE PEEK 6DEG 12X14X8,30187115,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
IR PLATE 3 LEVEL,30187116,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
SYNTHES SCREW LOCKING ST 5.0 X 18MM,30187117,CDM,,,278,RC,outpatient,,1453.66,1453.66,,1234.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,363.42,22,,percent of total billed charges,,,,,,,,,1308.29,90,,percent of total billed charges,,,1203.63,82.8,,percent of total billed charges,,,1235.61,85,,percent of total billed charges,,,,,,,,,1279.22,88,,percent of total billed charges,,,,,,,,,1110.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,363.42,22,,percent of total billed charges,,,1322.83,91,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1206.54,83,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1192,82,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1235.61,85,,percent of total billed charges,,363.42,1380.98,
SYNTHES SCREW LOCKING ST 5.0 X 22MM,30187118,CDM,,,278,RC,outpatient,,1453.66,1453.66,,1234.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,363.42,22,,percent of total billed charges,,,,,,,,,1308.29,90,,percent of total billed charges,,,1203.63,82.8,,percent of total billed charges,,,1235.61,85,,percent of total billed charges,,,,,,,,,1279.22,88,,percent of total billed charges,,,,,,,,,1110.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,363.42,22,,percent of total billed charges,,,1322.83,91,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1206.54,83,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1192,82,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1235.61,85,,percent of total billed charges,,363.42,1380.98,
CATHETER ONE-STEP SUPRAPUBIC,30187119,CDM,,,270,RC,outpatient,,1614.67,1614.67,,1370.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,403.67,22,,percent of total billed charges,,,,,,,,,1453.2,90,,percent of total billed charges,,,1336.95,82.8,,percent of total billed charges,,,1372.47,85,,percent of total billed charges,,,,,,,,,1420.91,88,,percent of total billed charges,,,,,,,,,1233.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,403.67,22,,percent of total billed charges,,,1469.35,91,,percent of total billed charges,,,1533.94,95,,percent of total billed charges,,,1340.18,83,,percent of total billed charges,,,1340.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1340.18,83,,percent of total billed charges,,,1533.94,95,,percent of total billed charges,,,1453.2,90,,percent of total billed charges,,,1453.2,90,,percent of total billed charges,,,1324.03,82,,percent of total billed charges,,,1453.2,90,,percent of total billed charges,,,1372.47,85,,percent of total billed charges,,403.67,1533.94,
ZIMMER INSERT POLY RIGHT MC SZ 11,30187120,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ZIMMER PATELLA VE SZ 32MM,30187121,CDM,,,278,RC,outpatient,,3575,3575,,3035.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,893.75,22,,percent of total billed charges,,,,,,,,,3217.5,90,,percent of total billed charges,,,2960.1,82.8,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,,,,,,,,3146,88,,percent of total billed charges,,,,,,,,,2731.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,893.75,22,,percent of total billed charges,,,3253.25,91,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2967.25,83,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,2931.5,82,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,893.75,3396.25,
ZIMMER BEARING MC 16MM,30187122,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
S&N FEMUR NARROW OX RT PS SZ 5,30187123,CDM,,,278,RC,outpatient,,26000,26000,,22074,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6500,22,,percent of total billed charges,,,,,,,,,23400,90,,percent of total billed charges,,,21528,82.8,,percent of total billed charges,,,22100,85,,percent of total billed charges,,,,,,,,,22880,88,,percent of total billed charges,,,,,,,,,19864,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6500,22,,percent of total billed charges,,,23660,91,,percent of total billed charges,,,24700,95,,percent of total billed charges,,,21580,83,,percent of total billed charges,,,21580,83,,percent of total billed charges,,,,,,,,,,,,,,,21580,83,,percent of total billed charges,,,24700,95,,percent of total billed charges,,,23400,90,,percent of total billed charges,,,23400,90,,percent of total billed charges,,,21320,82,,percent of total billed charges,,,23400,90,,percent of total billed charges,,,22100,85,,percent of total billed charges,,6500,24700,
S&N PLATE TIBIA BASE GENISIS II SZ 4 RT,30187124,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
S&N PATELLA 32MM,30187125,CDM,,,278,RC,outpatient,,6584.24,6584.24,,5590.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1646.06,22,,percent of total billed charges,,,,,,,,,5925.82,90,,percent of total billed charges,,,5451.75,82.8,,percent of total billed charges,,,5596.6,85,,percent of total billed charges,,,,,,,,,5794.13,88,,percent of total billed charges,,,,,,,,,5030.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1646.06,22,,percent of total billed charges,,,5991.66,91,,percent of total billed charges,,,6255.03,95,,percent of total billed charges,,,5464.92,83,,percent of total billed charges,,,5464.92,83,,percent of total billed charges,,,,,,,,,,,,,,,5464.92,83,,percent of total billed charges,,,6255.03,95,,percent of total billed charges,,,5925.82,90,,percent of total billed charges,,,5925.82,90,,percent of total billed charges,,,5399.08,82,,percent of total billed charges,,,5925.82,90,,percent of total billed charges,,,5596.6,85,,percent of total billed charges,,1646.06,6255.03,
S&N INSERT CONSTRAINED 9MM SZ 3/4,30187126,CDM,,,278,RC,outpatient,,22072.83,22072.83,,18739.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5518.21,22,,percent of total billed charges,,,,,,,,,19865.55,90,,percent of total billed charges,,,18276.3,82.8,,percent of total billed charges,,,18761.91,85,,percent of total billed charges,,,,,,,,,19424.09,88,,percent of total billed charges,,,,,,,,,16863.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5518.21,22,,percent of total billed charges,,,20086.28,91,,percent of total billed charges,,,20969.19,95,,percent of total billed charges,,,18320.45,83,,percent of total billed charges,,,18320.45,83,,percent of total billed charges,,,,,,,,,,,,,,,18320.45,83,,percent of total billed charges,,,20969.19,95,,percent of total billed charges,,,19865.55,90,,percent of total billed charges,,,19865.55,90,,percent of total billed charges,,,18099.72,82,,percent of total billed charges,,,19865.55,90,,percent of total billed charges,,,18761.91,85,,percent of total billed charges,,5518.21,20969.19,
IR CAGE PEEK 6DEG 1MM,30187127,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
IR PLATE 3 LEVEL 51MM,30187128,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
NANOCROSS BALLOON 2.0 X 150 X 150,30187130,CDM,,,270,RC,outpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.44,22,,percent of total billed charges,,,,,,,,,1740.38,90,,percent of total billed charges,,,1601.15,82.8,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.44,22,,percent of total billed charges,,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,483.44,1837.06,
IMPACT ADMIRAL BALLOON 4X40,30187131,CDM,,,270,RC,outpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2421.25,22,,percent of total billed charges,,,,,,,,,8716.5,90,,percent of total billed charges,,,8019.18,82.8,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2421.25,22,,percent of total billed charges,,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,2421.25,9200.75,
EVERCROSS BALLOON 4MM X 40MM,30187132,CDM,,,270,RC,outpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2421.25,22,,percent of total billed charges,,,,,,,,,8716.5,90,,percent of total billed charges,,,8019.18,82.8,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2421.25,22,,percent of total billed charges,,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,2421.25,9200.75,
IVAS VERTEPORT CEMENT CANNULA 11G,30187133,CDM,,,270,RC,outpatient,,510.02,510.02,,433.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.51,22,,percent of total billed charges,,,,,,,,,459.02,90,,percent of total billed charges,,,422.3,82.8,,percent of total billed charges,,,433.52,85,,percent of total billed charges,,,,,,,,,448.82,88,,percent of total billed charges,,,,,,,,,389.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.51,22,,percent of total billed charges,,,464.12,91,,percent of total billed charges,,,484.52,95,,percent of total billed charges,,,423.32,83,,percent of total billed charges,,,423.32,83,,percent of total billed charges,,,,,,,,,,,,,,,423.32,83,,percent of total billed charges,,,484.52,95,,percent of total billed charges,,,459.02,90,,percent of total billed charges,,,459.02,90,,percent of total billed charges,,,418.22,82,,percent of total billed charges,,,459.02,90,,percent of total billed charges,,,433.52,85,,percent of total billed charges,,127.51,484.52,
DEPUY HEAD GLOBAL UNITE 40X15ECC,30187134,CDM,,,278,RC,outpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4409.03,22,,percent of total billed charges,,,,,,,,,15872.52,90,,percent of total billed charges,,,14602.72,82.8,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4409.03,22,,percent of total billed charges,,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,4409.03,16754.32,
DEPUY CEMENT 2G,30187135,CDM,,,278,RC,outpatient,,2262,2262,,1920.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,565.5,22,,percent of total billed charges,,,,,,,,,2035.8,90,,percent of total billed charges,,,1872.94,82.8,,percent of total billed charges,,,1922.7,85,,percent of total billed charges,,,,,,,,,1990.56,88,,percent of total billed charges,,,,,,,,,1728.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,565.5,22,,percent of total billed charges,,,2058.42,91,,percent of total billed charges,,,2148.9,95,,percent of total billed charges,,,1877.46,83,,percent of total billed charges,,,1877.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1877.46,83,,percent of total billed charges,,,2148.9,95,,percent of total billed charges,,,2035.8,90,,percent of total billed charges,,,2035.8,90,,percent of total billed charges,,,1854.84,82,,percent of total billed charges,,,2035.8,90,,percent of total billed charges,,,1922.7,85,,percent of total billed charges,,565.5,2148.9,
STRYKER BLADE MAKO NARROW,30187136,CDM,,,270,RC,outpatient,,1982.5,1982.5,,1683.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,495.63,22,,percent of total billed charges,,,,,,,,,1784.25,90,,percent of total billed charges,,,1641.51,82.8,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,,,,,,,,1744.6,88,,percent of total billed charges,,,,,,,,,1514.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,495.63,22,,percent of total billed charges,,,1804.08,91,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1645.48,83,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1625.65,82,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,495.63,1883.38,
STRYKER BLADE MAKO STANDARD,30187137,CDM,,,270,RC,outpatient,,1982.5,1982.5,,1683.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,495.63,22,,percent of total billed charges,,,,,,,,,1784.25,90,,percent of total billed charges,,,1641.51,82.8,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,,,,,,,,1744.6,88,,percent of total billed charges,,,,,,,,,1514.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,495.63,22,,percent of total billed charges,,,1804.08,91,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1645.48,83,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1625.65,82,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,495.63,1883.38,
STRYKER BLADE AGGRESSIVE XL 4.0,30187138,CDM,,,270,RC,outpatient,,641.62,641.62,,544.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,160.41,22,,percent of total billed charges,,,,,,,,,577.46,90,,percent of total billed charges,,,531.26,82.8,,percent of total billed charges,,,545.38,85,,percent of total billed charges,,,,,,,,,564.63,88,,percent of total billed charges,,,,,,,,,490.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,160.41,22,,percent of total billed charges,,,583.87,91,,percent of total billed charges,,,609.54,95,,percent of total billed charges,,,532.54,83,,percent of total billed charges,,,532.54,83,,percent of total billed charges,,,,,,,,,,,,,,,532.54,83,,percent of total billed charges,,,609.54,95,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,526.13,82,,percent of total billed charges,,,577.46,90,,percent of total billed charges,,,545.38,85,,percent of total billed charges,,160.41,609.54,
SYNTHES GUIDEWIRE 1.4MM X 150MM TROCAR,30187139,CDM,,,278,RC,outpatient,,827.05,827.05,,702.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.76,22,,percent of total billed charges,,,,,,,,,744.35,90,,percent of total billed charges,,,684.8,82.8,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,,,,,,,,727.8,88,,percent of total billed charges,,,,,,,,,631.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.76,22,,percent of total billed charges,,,752.62,91,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,686.45,83,,percent of total billed charges,,,,,,,,,,,,,,,686.45,83,,percent of total billed charges,,,785.7,95,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,678.18,82,,percent of total billed charges,,,744.35,90,,percent of total billed charges,,,702.99,85,,percent of total billed charges,,206.76,785.7,
SYNTHES GUIDEWIRE 1.1MM X 150MM TROCAR,30187140,CDM,,,278,RC,outpatient,,714,714,,606.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.5,22,,percent of total billed charges,,,,,,,,,642.6,90,,percent of total billed charges,,,591.19,82.8,,percent of total billed charges,,,606.9,85,,percent of total billed charges,,,,,,,,,628.32,88,,percent of total billed charges,,,,,,,,,545.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.5,22,,percent of total billed charges,,,649.74,91,,percent of total billed charges,,,678.3,95,,percent of total billed charges,,,592.62,83,,percent of total billed charges,,,592.62,83,,percent of total billed charges,,,,,,,,,,,,,,,592.62,83,,percent of total billed charges,,,678.3,95,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,585.48,82,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,606.9,85,,percent of total billed charges,,178.5,678.3,
SYNTHES DRILL BIT CANN. QC 2.7 X 145MM,30187141,CDM,,,270,RC,outpatient,,4558.13,4558.13,,3869.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1139.53,22,,percent of total billed charges,,,,,,,,,4102.32,90,,percent of total billed charges,,,3774.13,82.8,,percent of total billed charges,,,3874.41,85,,percent of total billed charges,,,,,,,,,4011.15,88,,percent of total billed charges,,,,,,,,,3482.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1139.53,22,,percent of total billed charges,,,4147.9,91,,percent of total billed charges,,,4330.22,95,,percent of total billed charges,,,3783.25,83,,percent of total billed charges,,,3783.25,83,,percent of total billed charges,,,,,,,,,,,,,,,3783.25,83,,percent of total billed charges,,,4330.22,95,,percent of total billed charges,,,4102.32,90,,percent of total billed charges,,,4102.32,90,,percent of total billed charges,,,3737.67,82,,percent of total billed charges,,,4102.32,90,,percent of total billed charges,,,3874.41,85,,percent of total billed charges,,1139.53,4330.22,
SYNTHES DRILL BIT CANN. QC 2.0 X 145MM,30187142,CDM,,,270,RC,outpatient,,4309.5,4309.5,,3658.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1077.38,22,,percent of total billed charges,,,,,,,,,3878.55,90,,percent of total billed charges,,,3568.27,82.8,,percent of total billed charges,,,3663.08,85,,percent of total billed charges,,,,,,,,,3792.36,88,,percent of total billed charges,,,,,,,,,3292.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1077.38,22,,percent of total billed charges,,,3921.65,91,,percent of total billed charges,,,4094.03,95,,percent of total billed charges,,,3576.89,83,,percent of total billed charges,,,3576.89,83,,percent of total billed charges,,,,,,,,,,,,,,,3576.89,83,,percent of total billed charges,,,4094.03,95,,percent of total billed charges,,,3878.55,90,,percent of total billed charges,,,3878.55,90,,percent of total billed charges,,,3533.79,82,,percent of total billed charges,,,3878.55,90,,percent of total billed charges,,,3663.08,85,,percent of total billed charges,,1077.38,4094.03,
SYNTHES SCREW CANN COMPRESSION ST 4X40MM,30187143,CDM,,,278,RC,outpatient,,4033.25,4033.25,,3424.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1008.31,22,,percent of total billed charges,,,,,,,,,3629.93,90,,percent of total billed charges,,,3339.53,82.8,,percent of total billed charges,,,3428.26,85,,percent of total billed charges,,,,,,,,,3549.26,88,,percent of total billed charges,,,,,,,,,3081.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1008.31,22,,percent of total billed charges,,,3670.26,91,,percent of total billed charges,,,3831.59,95,,percent of total billed charges,,,3347.6,83,,percent of total billed charges,,,3347.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3347.6,83,,percent of total billed charges,,,3831.59,95,,percent of total billed charges,,,3629.93,90,,percent of total billed charges,,,3629.93,90,,percent of total billed charges,,,3307.27,82,,percent of total billed charges,,,3629.93,90,,percent of total billed charges,,,3428.26,85,,percent of total billed charges,,1008.31,3831.59,
SYNTHES SCREW CANN COMPRESSION ST 3X20MM,30187144,CDM,,,278,RC,outpatient,,4033.25,4033.25,,3424.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1008.31,22,,percent of total billed charges,,,,,,,,,3629.93,90,,percent of total billed charges,,,3339.53,82.8,,percent of total billed charges,,,3428.26,85,,percent of total billed charges,,,,,,,,,3549.26,88,,percent of total billed charges,,,,,,,,,3081.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1008.31,22,,percent of total billed charges,,,3670.26,91,,percent of total billed charges,,,3831.59,95,,percent of total billed charges,,,3347.6,83,,percent of total billed charges,,,3347.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3347.6,83,,percent of total billed charges,,,3831.59,95,,percent of total billed charges,,,3629.93,90,,percent of total billed charges,,,3629.93,90,,percent of total billed charges,,,3307.27,82,,percent of total billed charges,,,3629.93,90,,percent of total billed charges,,,3428.26,85,,percent of total billed charges,,1008.31,3831.59,
STAPLER CUTTER 100MM BLUE,30187145,CDM,,,270,RC,outpatient,,1368.64,1368.64,,1161.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,342.16,22,,percent of total billed charges,,,,,,,,,1231.78,90,,percent of total billed charges,,,1133.23,82.8,,percent of total billed charges,,,1163.34,85,,percent of total billed charges,,,,,,,,,1204.4,88,,percent of total billed charges,,,,,,,,,1045.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,342.16,22,,percent of total billed charges,,,1245.46,91,,percent of total billed charges,,,1300.21,95,,percent of total billed charges,,,1135.97,83,,percent of total billed charges,,,1135.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1135.97,83,,percent of total billed charges,,,1300.21,95,,percent of total billed charges,,,1231.78,90,,percent of total billed charges,,,1231.78,90,,percent of total billed charges,,,1122.28,82,,percent of total billed charges,,,1231.78,90,,percent of total billed charges,,,1163.34,85,,percent of total billed charges,,342.16,1300.21,
STRYKER DRAPE KIT RIO ONE PIECE W/POCKET,30187146,CDM,,,270,RC,outpatient,,351,351,,298,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.75,22,,percent of total billed charges,,,,,,,,,315.9,90,,percent of total billed charges,,,290.63,82.8,,percent of total billed charges,,,298.35,85,,percent of total billed charges,,,,,,,,,308.88,88,,percent of total billed charges,,,,,,,,,268.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.75,22,,percent of total billed charges,,,319.41,91,,percent of total billed charges,,,333.45,95,,percent of total billed charges,,,291.33,83,,percent of total billed charges,,,291.33,83,,percent of total billed charges,,,,,,,,,,,,,,,291.33,83,,percent of total billed charges,,,333.45,95,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,287.82,82,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,298.35,85,,percent of total billed charges,,87.75,333.45,
STRYKER KNEE TRACKING KIT VIZADISC,30187147,CDM,,,270,RC,outpatient,,1368.9,1368.9,,1162.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,342.23,22,,percent of total billed charges,,,,,,,,,1232.01,90,,percent of total billed charges,,,1133.45,82.8,,percent of total billed charges,,,1163.57,85,,percent of total billed charges,,,,,,,,,1204.63,88,,percent of total billed charges,,,,,,,,,1045.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,342.23,22,,percent of total billed charges,,,1245.7,91,,percent of total billed charges,,,1300.46,95,,percent of total billed charges,,,1136.19,83,,percent of total billed charges,,,1136.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1136.19,83,,percent of total billed charges,,,1300.46,95,,percent of total billed charges,,,1232.01,90,,percent of total billed charges,,,1232.01,90,,percent of total billed charges,,,1122.5,82,,percent of total billed charges,,,1232.01,90,,percent of total billed charges,,,1163.57,85,,percent of total billed charges,,342.23,1300.46,
STRYKER HIP TRACKING KIT VIZADISC,30187148,CDM,,,270,RC,outpatient,,1368.9,1368.9,,1162.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,342.23,22,,percent of total billed charges,,,,,,,,,1232.01,90,,percent of total billed charges,,,1133.45,82.8,,percent of total billed charges,,,1163.57,85,,percent of total billed charges,,,,,,,,,1204.63,88,,percent of total billed charges,,,,,,,,,1045.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,342.23,22,,percent of total billed charges,,,1245.7,91,,percent of total billed charges,,,1300.46,95,,percent of total billed charges,,,1136.19,83,,percent of total billed charges,,,1136.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1136.19,83,,percent of total billed charges,,,1300.46,95,,percent of total billed charges,,,1232.01,90,,percent of total billed charges,,,1232.01,90,,percent of total billed charges,,,1122.5,82,,percent of total billed charges,,,1232.01,90,,percent of total billed charges,,,1163.57,85,,percent of total billed charges,,342.23,1300.46,
STRYKER BONE PIN 3.2 X 110MM,30187149,CDM,,,278,RC,outpatient,,873.6,873.6,,741.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.4,22,,percent of total billed charges,,,,,,,,,786.24,90,,percent of total billed charges,,,723.34,82.8,,percent of total billed charges,,,742.56,85,,percent of total billed charges,,,,,,,,,768.77,88,,percent of total billed charges,,,,,,,,,667.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.4,22,,percent of total billed charges,,,794.98,91,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,,,,,,,,,,,,,725.09,83,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,716.35,82,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,742.56,85,,percent of total billed charges,,218.4,829.92,
STRYKER BONE PIN 3.2 X 140MM,30187150,CDM,,,278,RC,outpatient,,873.6,873.6,,741.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.4,22,,percent of total billed charges,,,,,,,,,786.24,90,,percent of total billed charges,,,723.34,82.8,,percent of total billed charges,,,742.56,85,,percent of total billed charges,,,,,,,,,768.77,88,,percent of total billed charges,,,,,,,,,667.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.4,22,,percent of total billed charges,,,794.98,91,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,,,,,,,,,,,,,725.09,83,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,716.35,82,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,742.56,85,,percent of total billed charges,,218.4,829.92,
STRYKER BONE PIN 4 X 110MM,30187151,CDM,,,278,RC,outpatient,,873.6,873.6,,741.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.4,22,,percent of total billed charges,,,,,,,,,786.24,90,,percent of total billed charges,,,723.34,82.8,,percent of total billed charges,,,742.56,85,,percent of total billed charges,,,,,,,,,768.77,88,,percent of total billed charges,,,,,,,,,667.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.4,22,,percent of total billed charges,,,794.98,91,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,,,,,,,,,,,,,725.09,83,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,716.35,82,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,742.56,85,,percent of total billed charges,,218.4,829.92,
STRYKER BONE PIN 4 X 140MM,30187152,CDM,,,278,RC,outpatient,,873.6,873.6,,741.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.4,22,,percent of total billed charges,,,,,,,,,786.24,90,,percent of total billed charges,,,723.34,82.8,,percent of total billed charges,,,742.56,85,,percent of total billed charges,,,,,,,,,768.77,88,,percent of total billed charges,,,,,,,,,667.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.4,22,,percent of total billed charges,,,794.98,91,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,,,,,,,,,,,,,725.09,83,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,716.35,82,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,742.56,85,,percent of total billed charges,,218.4,829.92,
STRYKER BONE PIN 4 X 170MM,30187153,CDM,,,278,RC,outpatient,,873.6,873.6,,741.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.4,22,,percent of total billed charges,,,,,,,,,786.24,90,,percent of total billed charges,,,723.34,82.8,,percent of total billed charges,,,742.56,85,,percent of total billed charges,,,,,,,,,768.77,88,,percent of total billed charges,,,,,,,,,667.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.4,22,,percent of total billed charges,,,794.98,91,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,725.09,83,,percent of total billed charges,,,,,,,,,,,,,,,725.09,83,,percent of total billed charges,,,829.92,95,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,716.35,82,,percent of total billed charges,,,786.24,90,,percent of total billed charges,,,742.56,85,,percent of total billed charges,,218.4,829.92,
STRYKER CHECKPOINT KIT FEMORAL/TIBIAL,30187154,CDM,,,270,RC,outpatient,,651,651,,552.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,162.75,22,,percent of total billed charges,,,,,,,,,585.9,90,,percent of total billed charges,,,539.03,82.8,,percent of total billed charges,,,553.35,85,,percent of total billed charges,,,,,,,,,572.88,88,,percent of total billed charges,,,,,,,,,497.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,162.75,22,,percent of total billed charges,,,592.41,91,,percent of total billed charges,,,618.45,95,,percent of total billed charges,,,540.33,83,,percent of total billed charges,,,540.33,83,,percent of total billed charges,,,,,,,,,,,,,,,540.33,83,,percent of total billed charges,,,618.45,95,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,533.82,82,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,553.35,85,,percent of total billed charges,,162.75,618.45,
STRYKER CHECKPOINT TIBIAL STERILE,30187155,CDM,,,270,RC,outpatient,,369,369,,313.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.25,22,,percent of total billed charges,,,,,,,,,332.1,90,,percent of total billed charges,,,305.53,82.8,,percent of total billed charges,,,313.65,85,,percent of total billed charges,,,,,,,,,324.72,88,,percent of total billed charges,,,,,,,,,281.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.25,22,,percent of total billed charges,,,335.79,91,,percent of total billed charges,,,350.55,95,,percent of total billed charges,,,306.27,83,,percent of total billed charges,,,306.27,83,,percent of total billed charges,,,,,,,,,,,,,,,306.27,83,,percent of total billed charges,,,350.55,95,,percent of total billed charges,,,332.1,90,,percent of total billed charges,,,332.1,90,,percent of total billed charges,,,302.58,82,,percent of total billed charges,,,332.1,90,,percent of total billed charges,,,313.65,85,,percent of total billed charges,,92.25,350.55,
STRYKER CHECKPOINT FEMORAL STERILE,30187156,CDM,,,270,RC,outpatient,,369,369,,313.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.25,22,,percent of total billed charges,,,,,,,,,332.1,90,,percent of total billed charges,,,305.53,82.8,,percent of total billed charges,,,313.65,85,,percent of total billed charges,,,,,,,,,324.72,88,,percent of total billed charges,,,,,,,,,281.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.25,22,,percent of total billed charges,,,335.79,91,,percent of total billed charges,,,350.55,95,,percent of total billed charges,,,306.27,83,,percent of total billed charges,,,306.27,83,,percent of total billed charges,,,,,,,,,,,,,,,306.27,83,,percent of total billed charges,,,350.55,95,,percent of total billed charges,,,332.1,90,,percent of total billed charges,,,332.1,90,,percent of total billed charges,,,302.58,82,,percent of total billed charges,,,332.1,90,,percent of total billed charges,,,313.65,85,,percent of total billed charges,,92.25,350.55,
STRYKER LEG POSITIONER KIT,30187157,CDM,,,270,RC,outpatient,,270,270,,229.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.5,22,,percent of total billed charges,,,,,,,,,243,90,,percent of total billed charges,,,223.56,82.8,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,,,,,,,,237.6,88,,percent of total billed charges,,,,,,,,,206.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.5,22,,percent of total billed charges,,,245.7,91,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,,,,,,,,,,,,,224.1,83,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,243,90,,percent of total billed charges,,,243,90,,percent of total billed charges,,,221.4,82,,percent of total billed charges,,,243,90,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,67.5,256.5,
STRYKER RETRACTOR CORD SILICONE,30187158,CDM,,,270,RC,outpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.75,22,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,42.23,82.8,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.75,22,,percent of total billed charges,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,12.75,48.45,
STRYKER CHECKPOINT HEX 3.5MM IMPACTION,30187159,CDM,,,278,RC,outpatient,,756,756,,641.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,189,22,,percent of total billed charges,,,,,,,,,680.4,90,,percent of total billed charges,,,625.97,82.8,,percent of total billed charges,,,642.6,85,,percent of total billed charges,,,,,,,,,665.28,88,,percent of total billed charges,,,,,,,,,577.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,189,22,,percent of total billed charges,,,687.96,91,,percent of total billed charges,,,718.2,95,,percent of total billed charges,,,627.48,83,,percent of total billed charges,,,627.48,83,,percent of total billed charges,,,,,,,,,,,,,,,627.48,83,,percent of total billed charges,,,718.2,95,,percent of total billed charges,,,680.4,90,,percent of total billed charges,,,680.4,90,,percent of total billed charges,,,619.92,82,,percent of total billed charges,,,680.4,90,,percent of total billed charges,,,642.6,85,,percent of total billed charges,,189,718.2,
STRYKER MICS MALL BURR,30187160,CDM,,,278,RC,outpatient,,499.8,499.8,,424.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.95,22,,percent of total billed charges,,,,,,,,,449.82,90,,percent of total billed charges,,,413.83,82.8,,percent of total billed charges,,,424.83,85,,percent of total billed charges,,,,,,,,,439.82,88,,percent of total billed charges,,,,,,,,,381.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.95,22,,percent of total billed charges,,,454.82,91,,percent of total billed charges,,,474.81,95,,percent of total billed charges,,,414.83,83,,percent of total billed charges,,,414.83,83,,percent of total billed charges,,,,,,,,,,,,,,,414.83,83,,percent of total billed charges,,,474.81,95,,percent of total billed charges,,,449.82,90,,percent of total billed charges,,,449.82,90,,percent of total billed charges,,,409.84,82,,percent of total billed charges,,,449.82,90,,percent of total billed charges,,,424.83,85,,percent of total billed charges,,124.95,474.81,
STRYKER MICS IRRIGATION CLIP,30187161,CDM,,,278,RC,outpatient,,777,777,,659.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,194.25,22,,percent of total billed charges,,,,,,,,,699.3,90,,percent of total billed charges,,,643.36,82.8,,percent of total billed charges,,,660.45,85,,percent of total billed charges,,,,,,,,,683.76,88,,percent of total billed charges,,,,,,,,,593.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,194.25,22,,percent of total billed charges,,,707.07,91,,percent of total billed charges,,,738.15,95,,percent of total billed charges,,,644.91,83,,percent of total billed charges,,,644.91,83,,percent of total billed charges,,,,,,,,,,,,,,,644.91,83,,percent of total billed charges,,,738.15,95,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,637.14,82,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,660.45,85,,percent of total billed charges,,194.25,738.15,
STRYKER IRRIGATION TUBING,30187162,CDM,,,278,RC,outpatient,,777,777,,659.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,194.25,22,,percent of total billed charges,,,,,,,,,699.3,90,,percent of total billed charges,,,643.36,82.8,,percent of total billed charges,,,660.45,85,,percent of total billed charges,,,,,,,,,683.76,88,,percent of total billed charges,,,,,,,,,593.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,194.25,22,,percent of total billed charges,,,707.07,91,,percent of total billed charges,,,738.15,95,,percent of total billed charges,,,644.91,83,,percent of total billed charges,,,644.91,83,,percent of total billed charges,,,,,,,,,,,,,,,644.91,83,,percent of total billed charges,,,738.15,95,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,637.14,82,,percent of total billed charges,,,699.3,90,,percent of total billed charges,,,660.45,85,,percent of total billed charges,,194.25,738.15,
SPINECRAFT SCREW REDUCTION 6.5 X 50 POLY,30187163,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
DEPUY METAGLENE LONG PEG +10MM,30187164,CDM,,,278,RC,outpatient,,19707.03,19707.03,,16731.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4926.76,22,,percent of total billed charges,,,,,,,,,17736.33,90,,percent of total billed charges,,,16317.42,82.8,,percent of total billed charges,,,16750.98,85,,percent of total billed charges,,,,,,,,,17342.19,88,,percent of total billed charges,,,,,,,,,15056.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4926.76,22,,percent of total billed charges,,,17933.4,91,,percent of total billed charges,,,18721.68,95,,percent of total billed charges,,,16356.83,83,,percent of total billed charges,,,16356.83,83,,percent of total billed charges,,,,,,,,,,,,,,,16356.83,83,,percent of total billed charges,,,18721.68,95,,percent of total billed charges,,,17736.33,90,,percent of total billed charges,,,17736.33,90,,percent of total billed charges,,,16159.76,82,,percent of total billed charges,,,17736.33,90,,percent of total billed charges,,,16750.98,85,,percent of total billed charges,,4926.76,18721.68,
DEPUY STEM STD UNITE SZ 12,30187165,CDM,,,278,RC,outpatient,,26023.86,26023.86,,22094.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6505.97,22,,percent of total billed charges,,,,,,,,,23421.47,90,,percent of total billed charges,,,21547.76,82.8,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,,,,,,,,22901,88,,percent of total billed charges,,,,,,,,,19882.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6505.97,22,,percent of total billed charges,,,23681.71,91,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,21599.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21599.8,83,,percent of total billed charges,,,24722.67,95,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,21339.57,82,,percent of total billed charges,,,23421.47,90,,percent of total billed charges,,,22120.28,85,,percent of total billed charges,,6505.97,24722.67,
DEPUY HEAD HUMERAL ECCENTRIC 44 X 18,30187166,CDM,,,278,RC,outpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4409.03,22,,percent of total billed charges,,,,,,,,,15872.52,90,,percent of total billed charges,,,14602.72,82.8,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4409.03,22,,percent of total billed charges,,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,4409.03,16754.32,
STRYKER BLADE SAGITTAL DUAL CUTTING,30187167,CDM,,,270,RC,outpatient,,432.39,432.39,,367.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.1,22,,percent of total billed charges,,,,,,,,,389.15,90,,percent of total billed charges,,,358.02,82.8,,percent of total billed charges,,,367.53,85,,percent of total billed charges,,,,,,,,,380.5,88,,percent of total billed charges,,,,,,,,,330.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108.1,22,,percent of total billed charges,,,393.47,91,,percent of total billed charges,,,410.77,95,,percent of total billed charges,,,358.88,83,,percent of total billed charges,,,358.88,83,,percent of total billed charges,,,,,,,,,,,,,,,358.88,83,,percent of total billed charges,,,410.77,95,,percent of total billed charges,,,389.15,90,,percent of total billed charges,,,389.15,90,,percent of total billed charges,,,354.56,82,,percent of total billed charges,,,389.15,90,,percent of total billed charges,,,367.53,85,,percent of total billed charges,,108.1,410.77,
STRYKER BLADE SAGITTAL PERFORMANCE,30187168,CDM,,,270,RC,outpatient,,432.39,432.39,,367.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.1,22,,percent of total billed charges,,,,,,,,,389.15,90,,percent of total billed charges,,,358.02,82.8,,percent of total billed charges,,,367.53,85,,percent of total billed charges,,,,,,,,,380.5,88,,percent of total billed charges,,,,,,,,,330.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108.1,22,,percent of total billed charges,,,393.47,91,,percent of total billed charges,,,410.77,95,,percent of total billed charges,,,358.88,83,,percent of total billed charges,,,358.88,83,,percent of total billed charges,,,,,,,,,,,,,,,358.88,83,,percent of total billed charges,,,410.77,95,,percent of total billed charges,,,389.15,90,,percent of total billed charges,,,389.15,90,,percent of total billed charges,,,354.56,82,,percent of total billed charges,,,389.15,90,,percent of total billed charges,,,367.53,85,,percent of total billed charges,,108.1,410.77,
STRYKER BLADE SAGITTAL WIDE THICK,30187169,CDM,,,270,RC,outpatient,,292.73,292.73,,248.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.18,22,,percent of total billed charges,,,,,,,,,263.46,90,,percent of total billed charges,,,242.38,82.8,,percent of total billed charges,,,248.82,85,,percent of total billed charges,,,,,,,,,257.6,88,,percent of total billed charges,,,,,,,,,223.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.18,22,,percent of total billed charges,,,266.38,91,,percent of total billed charges,,,278.09,95,,percent of total billed charges,,,242.97,83,,percent of total billed charges,,,242.97,83,,percent of total billed charges,,,,,,,,,,,,,,,242.97,83,,percent of total billed charges,,,278.09,95,,percent of total billed charges,,,263.46,90,,percent of total billed charges,,,263.46,90,,percent of total billed charges,,,240.04,82,,percent of total billed charges,,,263.46,90,,percent of total billed charges,,,248.82,85,,percent of total billed charges,,73.18,278.09,
ZIMMER STEM SLOTTED POROUS 14X200,30187170,CDM,,,278,RC,outpatient,,44460,44460,,37746.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11115,22,,percent of total billed charges,,,,,,,,,40014,90,,percent of total billed charges,,,36812.88,82.8,,percent of total billed charges,,,37791,85,,percent of total billed charges,,,,,,,,,39124.8,88,,percent of total billed charges,,,,,,,,,33967.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11115,22,,percent of total billed charges,,,40458.6,91,,percent of total billed charges,,,42237,95,,percent of total billed charges,,,36901.8,83,,percent of total billed charges,,,36901.8,83,,percent of total billed charges,,,,,,,,,,,,,,,36901.8,83,,percent of total billed charges,,,42237,95,,percent of total billed charges,,,40014,90,,percent of total billed charges,,,40014,90,,percent of total billed charges,,,36457.2,82,,percent of total billed charges,,,40014,90,,percent of total billed charges,,,37791,85,,percent of total billed charges,,11115,42237,
ZIMMER TAPER SLEEVE +0,30187171,CDM,,,270,RC,outpatient,,2860,2860,,2428.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,715,22,,percent of total billed charges,,,,,,,,,2574,90,,percent of total billed charges,,,2368.08,82.8,,percent of total billed charges,,,2431,85,,percent of total billed charges,,,,,,,,,2516.8,88,,percent of total billed charges,,,,,,,,,2185.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,715,22,,percent of total billed charges,,,2602.6,91,,percent of total billed charges,,,2717,95,,percent of total billed charges,,,2373.8,83,,percent of total billed charges,,,2373.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2373.8,83,,percent of total billed charges,,,2717,95,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2345.2,82,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2431,85,,percent of total billed charges,,715,2717,
ZIMMER BODY ARCOS SZ D STD 60MM,30187172,CDM,,,278,RC,outpatient,,81510,81510,,69201.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20377.5,22,,percent of total billed charges,,,,,,,,,73359,90,,percent of total billed charges,,,67490.28,82.8,,percent of total billed charges,,,69283.5,85,,percent of total billed charges,,,,,,,,,71728.8,88,,percent of total billed charges,,,,,,,,,62273.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20377.5,22,,percent of total billed charges,,,74174.1,91,,percent of total billed charges,,,77434.5,95,,percent of total billed charges,,,67653.3,83,,percent of total billed charges,,,67653.3,83,,percent of total billed charges,,,,,,,,,,,,,,,67653.3,83,,percent of total billed charges,,,77434.5,95,,percent of total billed charges,,,73359,90,,percent of total billed charges,,,73359,90,,percent of total billed charges,,,66838.2,82,,percent of total billed charges,,,73359,90,,percent of total billed charges,,,69283.5,85,,percent of total billed charges,,20377.5,77434.5,
ZIMMER GUIDE WIRE BALL NOSE 100CM,30187173,CDM,,,270,RC,outpatient,,858,858,,728.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214.5,22,,percent of total billed charges,,,,,,,,,772.2,90,,percent of total billed charges,,,710.42,82.8,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,,,,,,,,755.04,88,,percent of total billed charges,,,,,,,,,655.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214.5,22,,percent of total billed charges,,,780.78,91,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,,,,,,,,,,,,,712.14,83,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,703.56,82,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,214.5,815.1,
ZIMMER BEARING VIVACIT-E 28X38MM,30187174,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
IMPACT ADMIRAL BALLOON 6X40X130,30187176,CDM,,,270,RC,outpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2421.25,22,,percent of total billed charges,,,,,,,,,8716.5,90,,percent of total billed charges,,,8019.18,82.8,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2421.25,22,,percent of total billed charges,,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,2421.25,9200.75,
MEDTRONIC SPIDER 6MM,30187177,CDM,,,270,RC,outpatient,,10090.08,10090.08,,8566.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2522.52,22,,percent of total billed charges,,,,,,,,,9081.07,90,,percent of total billed charges,,,8354.59,82.8,,percent of total billed charges,,,8576.57,85,,percent of total billed charges,,,,,,,,,8879.27,88,,percent of total billed charges,,,,,,,,,7708.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2522.52,22,,percent of total billed charges,,,9181.97,91,,percent of total billed charges,,,9585.58,95,,percent of total billed charges,,,8374.77,83,,percent of total billed charges,,,8374.77,83,,percent of total billed charges,,,,,,,,,,,,,,,8374.77,83,,percent of total billed charges,,,9585.58,95,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,8273.87,82,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,8576.57,85,,percent of total billed charges,,2522.52,9585.58,
IR PLATE 2 LEVEL 28MM,30187178,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
IR PLATE 3 LEVEL 48MM,30187179,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
KURZ BLADES STERILE,30187180,CDM,,,270,RC,outpatient,,124.8,124.8,,105.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.2,22,,percent of total billed charges,,,,,,,,,112.32,90,,percent of total billed charges,,,103.33,82.8,,percent of total billed charges,,,106.08,85,,percent of total billed charges,,,,,,,,,109.82,88,,percent of total billed charges,,,,,,,,,95.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.2,22,,percent of total billed charges,,,113.57,91,,percent of total billed charges,,,118.56,95,,percent of total billed charges,,,103.58,83,,percent of total billed charges,,,103.58,83,,percent of total billed charges,,,,,,,,,,,,,,,103.58,83,,percent of total billed charges,,,118.56,95,,percent of total billed charges,,,112.32,90,,percent of total billed charges,,,112.32,90,,percent of total billed charges,,,102.34,82,,percent of total billed charges,,,112.32,90,,percent of total billed charges,,,106.08,85,,percent of total billed charges,,31.2,118.56,
TUBE VENT MICRON BOBBIN TITANIUM MINI,30187181,CDM,,,270,RC,outpatient,,285.83,285.83,,242.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.46,22,,percent of total billed charges,,,,,,,,,257.25,90,,percent of total billed charges,,,236.67,82.8,,percent of total billed charges,,,242.96,85,,percent of total billed charges,,,,,,,,,251.53,88,,percent of total billed charges,,,,,,,,,218.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.46,22,,percent of total billed charges,,,260.11,91,,percent of total billed charges,,,271.54,95,,percent of total billed charges,,,237.24,83,,percent of total billed charges,,,237.24,83,,percent of total billed charges,,,,,,,,,,,,,,,237.24,83,,percent of total billed charges,,,271.54,95,,percent of total billed charges,,,257.25,90,,percent of total billed charges,,,257.25,90,,percent of total billed charges,,,234.38,82,,percent of total billed charges,,,257.25,90,,percent of total billed charges,,,242.96,85,,percent of total billed charges,,71.46,271.54,
INTERSTIM PERC. EXTENSION KIT RE-CHARGEA,30187182,CDM,,,270,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
INTERSTIM EXTERNAL TEMP. STIMULATOR,30187183,CDM,,,270,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
INTERSTIM LEAD WIRE MRI RE-CHARGEABLE KI,30187184,CDM,,,270,RC,outpatient,,29601,29601,,25131.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7400.25,22,,percent of total billed charges,,,,,,,,,26640.9,90,,percent of total billed charges,,,24509.63,82.8,,percent of total billed charges,,,25160.85,85,,percent of total billed charges,,,,,,,,,26048.88,88,,percent of total billed charges,,,,,,,,,22615.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7400.25,22,,percent of total billed charges,,,26936.91,91,,percent of total billed charges,,,28120.95,95,,percent of total billed charges,,,24568.83,83,,percent of total billed charges,,,24568.83,83,,percent of total billed charges,,,,,,,,,,,,,,,24568.83,83,,percent of total billed charges,,,28120.95,95,,percent of total billed charges,,,26640.9,90,,percent of total billed charges,,,26640.9,90,,percent of total billed charges,,,24272.82,82,,percent of total billed charges,,,26640.9,90,,percent of total billed charges,,,25160.85,85,,percent of total billed charges,,7400.25,28120.95,
UNIFUSE WITH COOPER WIRE 5FR 90CM X 15CM,30187185,CDM,,,270,RC,outpatient,,1813.5,1813.5,,1539.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,453.38,22,,percent of total billed charges,,,,,,,,,1632.15,90,,percent of total billed charges,,,1501.58,82.8,,percent of total billed charges,,,1541.48,85,,percent of total billed charges,,,,,,,,,1595.88,88,,percent of total billed charges,,,,,,,,,1385.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,453.38,22,,percent of total billed charges,,,1650.29,91,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,1505.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.21,83,,percent of total billed charges,,,1722.83,95,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1487.07,82,,percent of total billed charges,,,1632.15,90,,percent of total billed charges,,,1541.48,85,,percent of total billed charges,,453.38,1722.83,
SHEETING STERILE SILICONE 2X3,30187188,CDM,,,270,RC,outpatient,,823.97,823.97,,699.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,205.99,22,,percent of total billed charges,,,,,,,,,741.57,90,,percent of total billed charges,,,682.25,82.8,,percent of total billed charges,,,700.37,85,,percent of total billed charges,,,,,,,,,725.09,88,,percent of total billed charges,,,,,,,,,629.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,205.99,22,,percent of total billed charges,,,749.81,91,,percent of total billed charges,,,782.77,95,,percent of total billed charges,,,683.9,83,,percent of total billed charges,,,683.9,83,,percent of total billed charges,,,,,,,,,,,,,,,683.9,83,,percent of total billed charges,,,782.77,95,,percent of total billed charges,,,741.57,90,,percent of total billed charges,,,741.57,90,,percent of total billed charges,,,675.66,82,,percent of total billed charges,,,741.57,90,,percent of total billed charges,,,700.37,85,,percent of total billed charges,,205.99,782.77,
MEDTRONIC TUBING IRRIGATION DRILL ACCESS,30187191,CDM,,,270,RC,outpatient,,273.75,273.75,,232.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.44,22,,percent of total billed charges,,,,,,,,,246.38,90,,percent of total billed charges,,,226.67,82.8,,percent of total billed charges,,,232.69,85,,percent of total billed charges,,,,,,,,,240.9,88,,percent of total billed charges,,,,,,,,,209.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.44,22,,percent of total billed charges,,,249.11,91,,percent of total billed charges,,,260.06,95,,percent of total billed charges,,,227.21,83,,percent of total billed charges,,,227.21,83,,percent of total billed charges,,,,,,,,,,,,,,,227.21,83,,percent of total billed charges,,,260.06,95,,percent of total billed charges,,,246.38,90,,percent of total billed charges,,,246.38,90,,percent of total billed charges,,,224.48,82,,percent of total billed charges,,,246.38,90,,percent of total billed charges,,,232.69,85,,percent of total billed charges,,68.44,260.06,
MEDTRONIC NERVE STIMULATOR VARI-STEM III,30187192,CDM,,,270,RC,outpatient,,541.1,541.1,,459.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,135.28,22,,percent of total billed charges,,,,,,,,,486.99,90,,percent of total billed charges,,,448.03,82.8,,percent of total billed charges,,,459.94,85,,percent of total billed charges,,,,,,,,,476.17,88,,percent of total billed charges,,,,,,,,,413.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,135.28,22,,percent of total billed charges,,,492.4,91,,percent of total billed charges,,,514.05,95,,percent of total billed charges,,,449.11,83,,percent of total billed charges,,,449.11,83,,percent of total billed charges,,,,,,,,,,,,,,,449.11,83,,percent of total billed charges,,,514.05,95,,percent of total billed charges,,,486.99,90,,percent of total billed charges,,,486.99,90,,percent of total billed charges,,,443.7,82,,percent of total billed charges,,,486.99,90,,percent of total billed charges,,,459.94,85,,percent of total billed charges,,135.28,514.05,
DRESSING KIT GLASSCOCK ADULT,30187195,CDM,,,270,RC,outpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31,22,,percent of total billed charges,,,,,,,,,111.6,90,,percent of total billed charges,,,102.67,82.8,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31,22,,percent of total billed charges,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,31,117.8,
DRESSING KIT GLASSCOCK PEDS,30187196,CDM,,,270,RC,outpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31,22,,percent of total billed charges,,,,,,,,,111.6,90,,percent of total billed charges,,,102.67,82.8,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31,22,,percent of total billed charges,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,31,117.8,
FACE WRAP UNIVERSAL,30187197,CDM,,,270,RC,outpatient,,168.8,168.8,,143.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.2,22,,percent of total billed charges,,,,,,,,,151.92,90,,percent of total billed charges,,,139.77,82.8,,percent of total billed charges,,,143.48,85,,percent of total billed charges,,,,,,,,,148.54,88,,percent of total billed charges,,,,,,,,,128.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.2,22,,percent of total billed charges,,,153.61,91,,percent of total billed charges,,,160.36,95,,percent of total billed charges,,,140.1,83,,percent of total billed charges,,,140.1,83,,percent of total billed charges,,,,,,,,,,,,,,,140.1,83,,percent of total billed charges,,,160.36,95,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,138.42,82,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,143.48,85,,percent of total billed charges,,42.2,160.36,
CROUCH CORNEAL PROTECTOR,30187198,CDM,,,270,RC,outpatient,,169.36,169.36,,143.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.34,22,,percent of total billed charges,,,,,,,,,152.42,90,,percent of total billed charges,,,140.23,82.8,,percent of total billed charges,,,143.96,85,,percent of total billed charges,,,,,,,,,149.04,88,,percent of total billed charges,,,,,,,,,129.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.34,22,,percent of total billed charges,,,154.12,91,,percent of total billed charges,,,160.89,95,,percent of total billed charges,,,140.57,83,,percent of total billed charges,,,140.57,83,,percent of total billed charges,,,,,,,,,,,,,,,140.57,83,,percent of total billed charges,,,160.89,95,,percent of total billed charges,,,152.42,90,,percent of total billed charges,,,152.42,90,,percent of total billed charges,,,138.88,82,,percent of total billed charges,,,152.42,90,,percent of total billed charges,,,143.96,85,,percent of total billed charges,,42.34,160.89,
NEEDLE BEAVER BLADE W/ 3MM CUTTING,30187200,CDM,,,270,RC,outpatient,,126.37,126.37,,107.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.59,22,,percent of total billed charges,,,,,,,,,113.73,90,,percent of total billed charges,,,104.63,82.8,,percent of total billed charges,,,107.41,85,,percent of total billed charges,,,,,,,,,111.21,88,,percent of total billed charges,,,,,,,,,96.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.59,22,,percent of total billed charges,,,115,91,,percent of total billed charges,,,120.05,95,,percent of total billed charges,,,104.89,83,,percent of total billed charges,,,104.89,83,,percent of total billed charges,,,,,,,,,,,,,,,104.89,83,,percent of total billed charges,,,120.05,95,,percent of total billed charges,,,113.73,90,,percent of total billed charges,,,113.73,90,,percent of total billed charges,,,103.62,82,,percent of total billed charges,,,113.73,90,,percent of total billed charges,,,107.41,85,,percent of total billed charges,,31.59,120.05,
SPONGE NEURO STERILE 1/4 X 1/4  PATTIES,30187201,CDM,,,270,RC,outpatient,,126.88,126.88,,107.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.72,22,,percent of total billed charges,,,,,,,,,114.19,90,,percent of total billed charges,,,105.06,82.8,,percent of total billed charges,,,107.85,85,,percent of total billed charges,,,,,,,,,111.65,88,,percent of total billed charges,,,,,,,,,96.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.72,22,,percent of total billed charges,,,115.46,91,,percent of total billed charges,,,120.54,95,,percent of total billed charges,,,105.31,83,,percent of total billed charges,,,105.31,83,,percent of total billed charges,,,,,,,,,,,,,,,105.31,83,,percent of total billed charges,,,120.54,95,,percent of total billed charges,,,114.19,90,,percent of total billed charges,,,114.19,90,,percent of total billed charges,,,104.04,82,,percent of total billed charges,,,114.19,90,,percent of total billed charges,,,107.85,85,,percent of total billed charges,,31.72,120.54,
NONSTERILE RETRACTOR ADULT,30187203,CDM,,,270,RC,outpatient,,118.92,118.92,,100.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.73,22,,percent of total billed charges,,,,,,,,,107.03,90,,percent of total billed charges,,,98.47,82.8,,percent of total billed charges,,,101.08,85,,percent of total billed charges,,,,,,,,,104.65,88,,percent of total billed charges,,,,,,,,,90.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.73,22,,percent of total billed charges,,,108.22,91,,percent of total billed charges,,,112.97,95,,percent of total billed charges,,,98.7,83,,percent of total billed charges,,,98.7,83,,percent of total billed charges,,,,,,,,,,,,,,,98.7,83,,percent of total billed charges,,,112.97,95,,percent of total billed charges,,,107.03,90,,percent of total billed charges,,,107.03,90,,percent of total billed charges,,,97.51,82,,percent of total billed charges,,,107.03,90,,percent of total billed charges,,,101.08,85,,percent of total billed charges,,29.73,112.97,
MEDTRONIC NASAL SEPTAL BUTTON 2-PART,30187204,CDM,,,270,RC,outpatient,,1956.5,1956.5,,1661.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,489.13,22,,percent of total billed charges,,,,,,,,,1760.85,90,,percent of total billed charges,,,1619.98,82.8,,percent of total billed charges,,,1663.03,85,,percent of total billed charges,,,,,,,,,1721.72,88,,percent of total billed charges,,,,,,,,,1494.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,489.13,22,,percent of total billed charges,,,1780.42,91,,percent of total billed charges,,,1858.68,95,,percent of total billed charges,,,1623.9,83,,percent of total billed charges,,,1623.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1623.9,83,,percent of total billed charges,,,1858.68,95,,percent of total billed charges,,,1760.85,90,,percent of total billed charges,,,1760.85,90,,percent of total billed charges,,,1604.33,82,,percent of total billed charges,,,1760.85,90,,percent of total billed charges,,,1663.03,85,,percent of total billed charges,,489.13,1858.68,
ACCLARENT AERA EUSTACHIAN TUBE BALLOON D,30187206,CDM,,,270,RC,outpatient,,11758.5,11758.5,,9982.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2939.63,22,,percent of total billed charges,,,,,,,,,10582.65,90,,percent of total billed charges,,,9736.04,82.8,,percent of total billed charges,,,9994.73,85,,percent of total billed charges,,,,,,,,,10347.48,88,,percent of total billed charges,,,,,,,,,8983.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2939.63,22,,percent of total billed charges,,,10700.24,91,,percent of total billed charges,,,11170.58,95,,percent of total billed charges,,,9759.56,83,,percent of total billed charges,,,9759.56,83,,percent of total billed charges,,,,,,,,,,,,,,,9759.56,83,,percent of total billed charges,,,11170.58,95,,percent of total billed charges,,,10582.65,90,,percent of total billed charges,,,10582.65,90,,percent of total billed charges,,,9641.97,82,,percent of total billed charges,,,10582.65,90,,percent of total billed charges,,,9994.73,85,,percent of total billed charges,,2939.63,11170.58,
RELIEVA SPINPLUS,30187207,CDM,,,270,RC,outpatient,,12675,12675,,10761.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3168.75,22,,percent of total billed charges,,,,,,,,,11407.5,90,,percent of total billed charges,,,10494.9,82.8,,percent of total billed charges,,,10773.75,85,,percent of total billed charges,,,,,,,,,11154,88,,percent of total billed charges,,,,,,,,,9683.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3168.75,22,,percent of total billed charges,,,11534.25,91,,percent of total billed charges,,,12041.25,95,,percent of total billed charges,,,10520.25,83,,percent of total billed charges,,,10520.25,83,,percent of total billed charges,,,,,,,,,,,,,,,10520.25,83,,percent of total billed charges,,,12041.25,95,,percent of total billed charges,,,11407.5,90,,percent of total billed charges,,,11407.5,90,,percent of total billed charges,,,10393.5,82,,percent of total billed charges,,,11407.5,90,,percent of total billed charges,,,10773.75,85,,percent of total billed charges,,3168.75,12041.25,
ACCLARENT INFLATION DEVICE,30187208,CDM,,,270,RC,outpatient,,521.85,521.85,,443.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.46,22,,percent of total billed charges,,,,,,,,,469.67,90,,percent of total billed charges,,,432.09,82.8,,percent of total billed charges,,,443.57,85,,percent of total billed charges,,,,,,,,,459.23,88,,percent of total billed charges,,,,,,,,,398.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.46,22,,percent of total billed charges,,,474.88,91,,percent of total billed charges,,,495.76,95,,percent of total billed charges,,,433.14,83,,percent of total billed charges,,,433.14,83,,percent of total billed charges,,,,,,,,,,,,,,,433.14,83,,percent of total billed charges,,,495.76,95,,percent of total billed charges,,,469.67,90,,percent of total billed charges,,,469.67,90,,percent of total billed charges,,,427.92,82,,percent of total billed charges,,,469.67,90,,percent of total billed charges,,,443.57,85,,percent of total billed charges,,130.46,495.76,
LEVINE IRRIGATION SUCTION,30187209,CDM,,,270,RC,outpatient,,308.7,308.7,,262.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.18,22,,percent of total billed charges,,,,,,,,,277.83,90,,percent of total billed charges,,,255.6,82.8,,percent of total billed charges,,,262.4,85,,percent of total billed charges,,,,,,,,,271.66,88,,percent of total billed charges,,,,,,,,,235.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.18,22,,percent of total billed charges,,,280.92,91,,percent of total billed charges,,,293.27,95,,percent of total billed charges,,,256.22,83,,percent of total billed charges,,,256.22,83,,percent of total billed charges,,,,,,,,,,,,,,,256.22,83,,percent of total billed charges,,,293.27,95,,percent of total billed charges,,,277.83,90,,percent of total billed charges,,,277.83,90,,percent of total billed charges,,,253.13,82,,percent of total billed charges,,,277.83,90,,percent of total billed charges,,,262.4,85,,percent of total billed charges,,77.18,293.27,
VENT TUBE 1.14MM BOBBIN,30187210,CDM,,,270,RC,outpatient,,60.78,60.78,,51.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.2,22,,percent of total billed charges,,,,,,,,,54.7,90,,percent of total billed charges,,,50.33,82.8,,percent of total billed charges,,,51.66,85,,percent of total billed charges,,,,,,,,,53.49,88,,percent of total billed charges,,,,,,,,,46.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.2,22,,percent of total billed charges,,,55.31,91,,percent of total billed charges,,,57.74,95,,percent of total billed charges,,,50.45,83,,percent of total billed charges,,,50.45,83,,percent of total billed charges,,,,,,,,,,,,,,,50.45,83,,percent of total billed charges,,,57.74,95,,percent of total billed charges,,,54.7,90,,percent of total billed charges,,,54.7,90,,percent of total billed charges,,,49.84,82,,percent of total billed charges,,,54.7,90,,percent of total billed charges,,,51.66,85,,percent of total billed charges,,15.2,57.74,
BURSHIELD DIAMOND 2.3MM X 95MM,30187211,CDM,,,270,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
BURSHIELD DIAMOND 2.3MM X 80MM ROUN,30187212,CDM,,,270,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
BURSHIELD DIAMOND 1.8MM X 95MM,30187213,CDM,,,270,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
NASAL PACKING 3.5CM MAROCEL KENNEDY,30187214,CDM,,,270,RC,outpatient,,297.75,297.75,,252.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.44,22,,percent of total billed charges,,,,,,,,,267.98,90,,percent of total billed charges,,,246.54,82.8,,percent of total billed charges,,,253.09,85,,percent of total billed charges,,,,,,,,,262.02,88,,percent of total billed charges,,,,,,,,,227.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.44,22,,percent of total billed charges,,,270.95,91,,percent of total billed charges,,,282.86,95,,percent of total billed charges,,,247.13,83,,percent of total billed charges,,,247.13,83,,percent of total billed charges,,,,,,,,,,,,,,,247.13,83,,percent of total billed charges,,,282.86,95,,percent of total billed charges,,,267.98,90,,percent of total billed charges,,,267.98,90,,percent of total billed charges,,,244.16,82,,percent of total billed charges,,,267.98,90,,percent of total billed charges,,,253.09,85,,percent of total billed charges,,74.44,282.86,
BLADE ROTATABLE TURBINATE INFERIOR 2MM M,30187215,CDM,,,270,RC,outpatient,,1939.6,1939.6,,1646.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,484.9,22,,percent of total billed charges,,,,,,,,,1745.64,90,,percent of total billed charges,,,1605.99,82.8,,percent of total billed charges,,,1648.66,85,,percent of total billed charges,,,,,,,,,1706.85,88,,percent of total billed charges,,,,,,,,,1481.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,484.9,22,,percent of total billed charges,,,1765.04,91,,percent of total billed charges,,,1842.62,95,,percent of total billed charges,,,1609.87,83,,percent of total billed charges,,,1609.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1609.87,83,,percent of total billed charges,,,1842.62,95,,percent of total billed charges,,,1745.64,90,,percent of total billed charges,,,1745.64,90,,percent of total billed charges,,,1590.47,82,,percent of total billed charges,,,1745.64,90,,percent of total billed charges,,,1648.66,85,,percent of total billed charges,,484.9,1842.62,
BUR DIAMOND 4.0MM LONG ROUND FINE,30187216,CDM,,,270,RC,outpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,455,22,,percent of total billed charges,,,,,,,,,1638,90,,percent of total billed charges,,,1506.96,82.8,,percent of total billed charges,,,1547,85,,percent of total billed charges,,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,455,22,,percent of total billed charges,,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,455,1729,
BUR ULTRA 5MM LONG,30187217,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
BUR ULTRA 4MM LONG,30187218,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
BUR ULTRA 3MM LONG,30187219,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
BUR DIAMOND 3MM LONG ROUND FINE,30187220,CDM,,,270,RC,outpatient,,1384.5,1384.5,,1175.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,346.13,22,,percent of total billed charges,,,,,,,,,1246.05,90,,percent of total billed charges,,,1146.37,82.8,,percent of total billed charges,,,1176.83,85,,percent of total billed charges,,,,,,,,,1218.36,88,,percent of total billed charges,,,,,,,,,1057.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,346.13,22,,percent of total billed charges,,,1259.9,91,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1149.14,83,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1135.29,82,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1176.83,85,,percent of total billed charges,,346.13,1315.28,
BUR DIAMOND 2MM LONG ROUND FINE,30187221,CDM,,,270,RC,outpatient,,1384.5,1384.5,,1175.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,346.13,22,,percent of total billed charges,,,,,,,,,1246.05,90,,percent of total billed charges,,,1146.37,82.8,,percent of total billed charges,,,1176.83,85,,percent of total billed charges,,,,,,,,,1218.36,88,,percent of total billed charges,,,,,,,,,1057.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,346.13,22,,percent of total billed charges,,,1259.9,91,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,1149.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1149.14,83,,percent of total billed charges,,,1315.28,95,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1135.29,82,,percent of total billed charges,,,1246.05,90,,percent of total billed charges,,,1176.83,85,,percent of total billed charges,,346.13,1315.28,
S&N ACL ELITE RENTAL,30187222,CDM,,,270,RC,outpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1218.75,22,,percent of total billed charges,,,,,,,,,4387.5,90,,percent of total billed charges,,,4036.5,82.8,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1218.75,22,,percent of total billed charges,,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,1218.75,4631.25,
S&N ENDOBUTTON CL PAC,30187223,CDM,,,270,RC,outpatient,,2383.1,2383.1,,2023.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,595.78,22,,percent of total billed charges,,,,,,,,,2144.79,90,,percent of total billed charges,,,1973.21,82.8,,percent of total billed charges,,,2025.64,85,,percent of total billed charges,,,,,,,,,2097.13,88,,percent of total billed charges,,,,,,,,,1820.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,595.78,22,,percent of total billed charges,,,2168.62,91,,percent of total billed charges,,,2263.95,95,,percent of total billed charges,,,1977.97,83,,percent of total billed charges,,,1977.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1977.97,83,,percent of total billed charges,,,2263.95,95,,percent of total billed charges,,,2144.79,90,,percent of total billed charges,,,2144.79,90,,percent of total billed charges,,,1954.14,82,,percent of total billed charges,,,2144.79,90,,percent of total billed charges,,,2025.64,85,,percent of total billed charges,,595.78,2263.95,
ROD COBALT CHROME 450MM,30187224,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
SPINECRAFT CROSS CONNECTOR 39-50,30187225,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
SPINECRAFT CROSS CONNECTOR 50-75,30187226,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
SPINECRAFT SCREW SET,30187227,CDM,,,278,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
EXACTECH DRILL BIT KIT,30187228,CDM,,,270,RC,outpatient,,4732,4732,,4017.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1183,22,,percent of total billed charges,,,,,,,,,4258.8,90,,percent of total billed charges,,,3918.1,82.8,,percent of total billed charges,,,4022.2,85,,percent of total billed charges,,,,,,,,,4164.16,88,,percent of total billed charges,,,,,,,,,3615.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1183,22,,percent of total billed charges,,,4306.12,91,,percent of total billed charges,,,4495.4,95,,percent of total billed charges,,,3927.56,83,,percent of total billed charges,,,3927.56,83,,percent of total billed charges,,,,,,,,,,,,,,,3927.56,83,,percent of total billed charges,,,4495.4,95,,percent of total billed charges,,,4258.8,90,,percent of total billed charges,,,4258.8,90,,percent of total billed charges,,,3880.24,82,,percent of total billed charges,,,4258.8,90,,percent of total billed charges,,,4022.2,85,,percent of total billed charges,,1183,4495.4,
EXACTECH SCREW KIT TORQUE DEFINING,30187229,CDM,,,270,RC,outpatient,,4335.5,4335.5,,3680.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1083.88,22,,percent of total billed charges,,,,,,,,,3901.95,90,,percent of total billed charges,,,3589.79,82.8,,percent of total billed charges,,,3685.18,85,,percent of total billed charges,,,,,,,,,3815.24,88,,percent of total billed charges,,,,,,,,,3312.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1083.88,22,,percent of total billed charges,,,3945.31,91,,percent of total billed charges,,,4118.73,95,,percent of total billed charges,,,3598.47,83,,percent of total billed charges,,,3598.47,83,,percent of total billed charges,,,,,,,,,,,,,,,3598.47,83,,percent of total billed charges,,,4118.73,95,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3555.11,82,,percent of total billed charges,,,3901.95,90,,percent of total billed charges,,,3685.18,85,,percent of total billed charges,,1083.88,4118.73,
EXACTECH K-WIRE,30187230,CDM,,,278,RC,outpatient,,851.5,851.5,,722.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,212.88,22,,percent of total billed charges,,,,,,,,,766.35,90,,percent of total billed charges,,,705.04,82.8,,percent of total billed charges,,,723.78,85,,percent of total billed charges,,,,,,,,,749.32,88,,percent of total billed charges,,,,,,,,,650.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,212.88,22,,percent of total billed charges,,,774.87,91,,percent of total billed charges,,,808.93,95,,percent of total billed charges,,,706.75,83,,percent of total billed charges,,,706.75,83,,percent of total billed charges,,,,,,,,,,,,,,,706.75,83,,percent of total billed charges,,,808.93,95,,percent of total billed charges,,,766.35,90,,percent of total billed charges,,,766.35,90,,percent of total billed charges,,,698.23,82,,percent of total billed charges,,,766.35,90,,percent of total billed charges,,,723.78,85,,percent of total billed charges,,212.88,808.93,
EXACTECH PLATE BASE GLENOID STANDARD,30187231,CDM,,,278,RC,outpatient,,25707.5,25707.5,,21825.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6426.88,22,,percent of total billed charges,,,,,,,,,23136.75,90,,percent of total billed charges,,,21285.81,82.8,,percent of total billed charges,,,21851.38,85,,percent of total billed charges,,,,,,,,,22622.6,88,,percent of total billed charges,,,,,,,,,19640.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6426.88,22,,percent of total billed charges,,,23393.83,91,,percent of total billed charges,,,24422.13,95,,percent of total billed charges,,,21337.23,83,,percent of total billed charges,,,21337.23,83,,percent of total billed charges,,,,,,,,,,,,,,,21337.23,83,,percent of total billed charges,,,24422.13,95,,percent of total billed charges,,,23136.75,90,,percent of total billed charges,,,23136.75,90,,percent of total billed charges,,,21080.15,82,,percent of total billed charges,,,23136.75,90,,percent of total billed charges,,,21851.38,85,,percent of total billed charges,,6426.88,24422.13,
EXACTECH SCREW LOCKING GLENOSPHERE,30187232,CDM,,,278,RC,outpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,502.13,22,,percent of total billed charges,,,,,,,,,1807.65,90,,percent of total billed charges,,,1663.04,82.8,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,502.13,22,,percent of total billed charges,,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,502.13,1908.08,
EXACTECH SCREW LOCKING YELLOW,30187233,CDM,,,278,RC,outpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,502.13,22,,percent of total billed charges,,,,,,,,,1807.65,90,,percent of total billed charges,,,1663.04,82.8,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,502.13,22,,percent of total billed charges,,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,502.13,1908.08,
EXACTECH SCREW LOCKING BLACK,30187234,CDM,,,278,RC,outpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,502.13,22,,percent of total billed charges,,,,,,,,,1807.65,90,,percent of total billed charges,,,1663.04,82.8,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,502.13,22,,percent of total billed charges,,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,502.13,1908.08,
EXACTECH SCREW LOCKING BLUE,30187235,CDM,,,278,RC,outpatient,,2008.5,2008.5,,1705.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,502.13,22,,percent of total billed charges,,,,,,,,,1807.65,90,,percent of total billed charges,,,1663.04,82.8,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,,,,,,,,1767.48,88,,percent of total billed charges,,,,,,,,,1534.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,502.13,22,,percent of total billed charges,,,1827.74,91,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,1667.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1667.06,83,,percent of total billed charges,,,1908.08,95,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1646.97,82,,percent of total billed charges,,,1807.65,90,,percent of total billed charges,,,1707.23,85,,percent of total billed charges,,502.13,1908.08,
EXACTECH STEM PRESERVE 7MM,30187236,CDM,,,278,RC,outpatient,,45461,45461,,38596.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11365.25,22,,percent of total billed charges,,,,,,,,,40914.9,90,,percent of total billed charges,,,37641.71,82.8,,percent of total billed charges,,,38641.85,85,,percent of total billed charges,,,,,,,,,40005.68,88,,percent of total billed charges,,,,,,,,,34732.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11365.25,22,,percent of total billed charges,,,41369.51,91,,percent of total billed charges,,,43187.95,95,,percent of total billed charges,,,37732.63,83,,percent of total billed charges,,,37732.63,83,,percent of total billed charges,,,,,,,,,,,,,,,37732.63,83,,percent of total billed charges,,,43187.95,95,,percent of total billed charges,,,40914.9,90,,percent of total billed charges,,,40914.9,90,,percent of total billed charges,,,37278.02,82,,percent of total billed charges,,,40914.9,90,,percent of total billed charges,,,38641.85,85,,percent of total billed charges,,11365.25,43187.95,
EXACTECH ADAPTER TRAY +0MM,30187237,CDM,,,278,RC,outpatient,,30160,30160,,25605.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7540,22,,percent of total billed charges,,,,,,,,,27144,90,,percent of total billed charges,,,24972.48,82.8,,percent of total billed charges,,,25636,85,,percent of total billed charges,,,,,,,,,26540.8,88,,percent of total billed charges,,,,,,,,,23042.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7540,22,,percent of total billed charges,,,27445.6,91,,percent of total billed charges,,,28652,95,,percent of total billed charges,,,25032.8,83,,percent of total billed charges,,,25032.8,83,,percent of total billed charges,,,,,,,,,,,,,,,25032.8,83,,percent of total billed charges,,,28652,95,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,24731.2,82,,percent of total billed charges,,,27144,90,,percent of total billed charges,,,25636,85,,percent of total billed charges,,7540,28652,
EXACTECH GLENOSPHERE 42MM,30187238,CDM,,,278,RC,outpatient,,24102,24102,,20462.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6025.5,22,,percent of total billed charges,,,,,,,,,21691.8,90,,percent of total billed charges,,,19956.46,82.8,,percent of total billed charges,,,20486.7,85,,percent of total billed charges,,,,,,,,,21209.76,88,,percent of total billed charges,,,,,,,,,18413.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6025.5,22,,percent of total billed charges,,,21932.82,91,,percent of total billed charges,,,22896.9,95,,percent of total billed charges,,,20004.66,83,,percent of total billed charges,,,20004.66,83,,percent of total billed charges,,,,,,,,,,,,,,,20004.66,83,,percent of total billed charges,,,22896.9,95,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,19763.64,82,,percent of total billed charges,,,21691.8,90,,percent of total billed charges,,,20486.7,85,,percent of total billed charges,,6025.5,22896.9,
EXACTECH HUMERAL LINER 42MM +0,30187239,CDM,,,278,RC,outpatient,,13487.5,13487.5,,11450.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3371.88,22,,percent of total billed charges,,,,,,,,,12138.75,90,,percent of total billed charges,,,11167.65,82.8,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,,,,,,,,11869,88,,percent of total billed charges,,,,,,,,,10304.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3371.88,22,,percent of total billed charges,,,12273.63,91,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,,,,,,,,,,,,,11194.63,83,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11059.75,82,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,3371.88,12813.13,
HOLMIUM LASER FEE - MIDWEST STONE,30187240,CDM,,,270,RC,outpatient,,5037.5,5037.5,,4276.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1259.38,22,,percent of total billed charges,,,,,,,,,4533.75,90,,percent of total billed charges,,,4171.05,82.8,,percent of total billed charges,,,4281.88,85,,percent of total billed charges,,,,,,,,,4433,88,,percent of total billed charges,,,,,,,,,3848.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1259.38,22,,percent of total billed charges,,,4584.13,91,,percent of total billed charges,,,4785.63,95,,percent of total billed charges,,,4181.13,83,,percent of total billed charges,,,4181.13,83,,percent of total billed charges,,,,,,,,,,,,,,,4181.13,83,,percent of total billed charges,,,4785.63,95,,percent of total billed charges,,,4533.75,90,,percent of total billed charges,,,4533.75,90,,percent of total billed charges,,,4130.75,82,,percent of total billed charges,,,4533.75,90,,percent of total billed charges,,,4281.88,85,,percent of total billed charges,,1259.38,4785.63,
LITHOTRIPSY FEE - MIDWEST STONE,30187241,CDM,,,270,RC,outpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3900,22,,percent of total billed charges,,,,,,,,,14040,90,,percent of total billed charges,,,12916.8,82.8,,percent of total billed charges,,,13260,85,,percent of total billed charges,,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3900,22,,percent of total billed charges,,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,3900,14820,
GLIDEWIRE ANGLED 260CM,30187242,CDM,,,270,RC,outpatient,,808.5,808.5,,686.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,202.13,22,,percent of total billed charges,,,,,,,,,727.65,90,,percent of total billed charges,,,669.44,82.8,,percent of total billed charges,,,687.23,85,,percent of total billed charges,,,,,,,,,711.48,88,,percent of total billed charges,,,,,,,,,617.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,202.13,22,,percent of total billed charges,,,735.74,91,,percent of total billed charges,,,768.08,95,,percent of total billed charges,,,671.06,83,,percent of total billed charges,,,671.06,83,,percent of total billed charges,,,,,,,,,,,,,,,671.06,83,,percent of total billed charges,,,768.08,95,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,662.97,82,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,687.23,85,,percent of total billed charges,,202.13,768.08,
BENTSON WIRE 180CM,30187243,CDM,,,270,RC,outpatient,,129.68,129.68,,110.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.42,22,,percent of total billed charges,,,,,,,,,116.71,90,,percent of total billed charges,,,107.38,82.8,,percent of total billed charges,,,110.23,85,,percent of total billed charges,,,,,,,,,114.12,88,,percent of total billed charges,,,,,,,,,99.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.42,22,,percent of total billed charges,,,118.01,91,,percent of total billed charges,,,123.2,95,,percent of total billed charges,,,107.63,83,,percent of total billed charges,,,107.63,83,,percent of total billed charges,,,,,,,,,,,,,,,107.63,83,,percent of total billed charges,,,123.2,95,,percent of total billed charges,,,116.71,90,,percent of total billed charges,,,116.71,90,,percent of total billed charges,,,106.34,82,,percent of total billed charges,,,116.71,90,,percent of total billed charges,,,110.23,85,,percent of total billed charges,,32.42,123.2,
IMPACT ADMIRAL BALLOON 5X40X130,30187244,CDM,,,270,RC,outpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2421.25,22,,percent of total billed charges,,,,,,,,,8716.5,90,,percent of total billed charges,,,8019.18,82.8,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2421.25,22,,percent of total billed charges,,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,2421.25,9200.75,
IR PLATE 2 LEVEL 30MM,30187245,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
HANDSWITCH DISP. 8FR 3M,30187246,CDM,,,270,RC,outpatient,,168.56,168.56,,143.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.14,22,,percent of total billed charges,,,,,,,,,151.7,90,,percent of total billed charges,,,139.57,82.8,,percent of total billed charges,,,143.28,85,,percent of total billed charges,,,,,,,,,148.33,88,,percent of total billed charges,,,,,,,,,128.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.14,22,,percent of total billed charges,,,153.39,91,,percent of total billed charges,,,160.13,95,,percent of total billed charges,,,139.9,83,,percent of total billed charges,,,139.9,83,,percent of total billed charges,,,,,,,,,,,,,,,139.9,83,,percent of total billed charges,,,160.13,95,,percent of total billed charges,,,151.7,90,,percent of total billed charges,,,151.7,90,,percent of total billed charges,,,138.22,82,,percent of total billed charges,,,151.7,90,,percent of total billed charges,,,143.28,85,,percent of total billed charges,,42.14,160.13,
INTERSTIM WIRELESS STIMULATOR,30187247,CDM,,,278,RC,outpatient,,75920,75920,,64456.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18980,22,,percent of total billed charges,,,,,,,,,68328,90,,percent of total billed charges,,,62861.76,82.8,,percent of total billed charges,,,64532,85,,percent of total billed charges,,,,,,,,,66809.6,88,,percent of total billed charges,,,,,,,,,58002.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18980,22,,percent of total billed charges,,,69087.2,91,,percent of total billed charges,,,72124,95,,percent of total billed charges,,,63013.6,83,,percent of total billed charges,,,63013.6,83,,percent of total billed charges,,,,,,,,,,,,,,,63013.6,83,,percent of total billed charges,,,72124,95,,percent of total billed charges,,,68328,90,,percent of total billed charges,,,68328,90,,percent of total billed charges,,,62254.4,82,,percent of total billed charges,,,68328,90,,percent of total billed charges,,,64532,85,,percent of total billed charges,,18980,72124,
INTERSTIM PATIENT PROGRAMMER & COMMUNICA,30187248,CDM,,,270,RC,outpatient,,12675,12675,,10761.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3168.75,22,,percent of total billed charges,,,,,,,,,11407.5,90,,percent of total billed charges,,,10494.9,82.8,,percent of total billed charges,,,10773.75,85,,percent of total billed charges,,,,,,,,,11154,88,,percent of total billed charges,,,,,,,,,9683.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3168.75,22,,percent of total billed charges,,,11534.25,91,,percent of total billed charges,,,12041.25,95,,percent of total billed charges,,,10520.25,83,,percent of total billed charges,,,10520.25,83,,percent of total billed charges,,,,,,,,,,,,,,,10520.25,83,,percent of total billed charges,,,12041.25,95,,percent of total billed charges,,,11407.5,90,,percent of total billed charges,,,11407.5,90,,percent of total billed charges,,,10393.5,82,,percent of total billed charges,,,11407.5,90,,percent of total billed charges,,,10773.75,85,,percent of total billed charges,,3168.75,12041.25,
INTERSTIM WIRELESS RE-CHARGER KIT,30187249,CDM,,,270,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
INTERSTIM WIRELESS RE-CHARGER BELT,30187250,CDM,,,270,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
INTERSTIM ANTIBIOTIC POUCH,30187251,CDM,,,270,RC,outpatient,,6467.5,6467.5,,5490.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1616.88,22,,percent of total billed charges,,,,,,,,,5820.75,90,,percent of total billed charges,,,5355.09,82.8,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,,,,,,,,5691.4,88,,percent of total billed charges,,,,,,,,,4941.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1616.88,22,,percent of total billed charges,,,5885.43,91,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,5368.03,83,,percent of total billed charges,,,,,,,,,,,,,,,5368.03,83,,percent of total billed charges,,,6144.13,95,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5303.35,82,,percent of total billed charges,,,5820.75,90,,percent of total billed charges,,,5497.38,85,,percent of total billed charges,,1616.88,6144.13,
SYNTHES PLATE 3 HOLE SHORT 54MM 2.4VA LC,30187252,CDM,,,278,RC,outpatient,,9419.41,9419.41,,7997.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2354.85,22,,percent of total billed charges,,,,,,,,,8477.47,90,,percent of total billed charges,,,7799.27,82.8,,percent of total billed charges,,,8006.5,85,,percent of total billed charges,,,,,,,,,8289.08,88,,percent of total billed charges,,,,,,,,,7196.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2354.85,22,,percent of total billed charges,,,8571.66,91,,percent of total billed charges,,,8948.44,95,,percent of total billed charges,,,7818.11,83,,percent of total billed charges,,,7818.11,83,,percent of total billed charges,,,,,,,,,,,,,,,7818.11,83,,percent of total billed charges,,,8948.44,95,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,7723.92,82,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,8006.5,85,,percent of total billed charges,,2354.85,8948.44,
ZIMMER BLADE PATELLA REAMER SZ 35,30187254,CDM,,,278,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
SYNTHES SCREW LOCKING VA 2.4 X 16MM,30187255,CDM,,,278,RC,outpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,338.51,22,,percent of total billed charges,,,,,,,,,1218.62,90,,percent of total billed charges,,,1121.13,82.8,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,338.51,22,,percent of total billed charges,,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,338.51,1286.32,
PROTRACK FIXATION DEVICE 5MM,30187256,CDM,,,270,RC,outpatient,,4400.31,4400.31,,3735.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1100.08,22,,percent of total billed charges,,,,,,,,,3960.28,90,,percent of total billed charges,,,3643.46,82.8,,percent of total billed charges,,,3740.26,85,,percent of total billed charges,,,,,,,,,3872.27,88,,percent of total billed charges,,,,,,,,,3361.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1100.08,22,,percent of total billed charges,,,4004.28,91,,percent of total billed charges,,,4180.29,95,,percent of total billed charges,,,3652.26,83,,percent of total billed charges,,,3652.26,83,,percent of total billed charges,,,,,,,,,,,,,,,3652.26,83,,percent of total billed charges,,,4180.29,95,,percent of total billed charges,,,3960.28,90,,percent of total billed charges,,,3960.28,90,,percent of total billed charges,,,3608.25,82,,percent of total billed charges,,,3960.28,90,,percent of total billed charges,,,3740.26,85,,percent of total billed charges,,1100.08,4180.29,
SECURESTRAP FIXATION DEVICE 5MM ABSORBAB,30187257,CDM,,,270,RC,outpatient,,4572.95,4572.95,,3882.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1143.24,22,,percent of total billed charges,,,,,,,,,4115.66,90,,percent of total billed charges,,,3786.4,82.8,,percent of total billed charges,,,3887.01,85,,percent of total billed charges,,,,,,,,,4024.2,88,,percent of total billed charges,,,,,,,,,3493.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1143.24,22,,percent of total billed charges,,,4161.38,91,,percent of total billed charges,,,4344.3,95,,percent of total billed charges,,,3795.55,83,,percent of total billed charges,,,3795.55,83,,percent of total billed charges,,,,,,,,,,,,,,,3795.55,83,,percent of total billed charges,,,4344.3,95,,percent of total billed charges,,,4115.66,90,,percent of total billed charges,,,4115.66,90,,percent of total billed charges,,,3749.82,82,,percent of total billed charges,,,4115.66,90,,percent of total billed charges,,,3887.01,85,,percent of total billed charges,,1143.24,4344.3,
SECURESTRAP FIXATION DEVICE OPEN,30187258,CDM,,,270,RC,outpatient,,5103.87,5103.87,,4333.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1275.97,22,,percent of total billed charges,,,,,,,,,4593.48,90,,percent of total billed charges,,,4226,82.8,,percent of total billed charges,,,4338.29,85,,percent of total billed charges,,,,,,,,,4491.41,88,,percent of total billed charges,,,,,,,,,3899.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1275.97,22,,percent of total billed charges,,,4644.52,91,,percent of total billed charges,,,4848.68,95,,percent of total billed charges,,,4236.21,83,,percent of total billed charges,,,4236.21,83,,percent of total billed charges,,,,,,,,,,,,,,,4236.21,83,,percent of total billed charges,,,4848.68,95,,percent of total billed charges,,,4593.48,90,,percent of total billed charges,,,4593.48,90,,percent of total billed charges,,,4185.17,82,,percent of total billed charges,,,4593.48,90,,percent of total billed charges,,,4338.29,85,,percent of total billed charges,,1275.97,4848.68,
MESH PROLENE W/KEYHOLD 2 X 12,30187259,CDM,,,278,RC,outpatient,,1082.38,1082.38,,918.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,270.6,22,,percent of total billed charges,,,,,,,,,974.14,90,,percent of total billed charges,,,896.21,82.8,,percent of total billed charges,,,920.02,85,,percent of total billed charges,,,,,,,,,952.49,88,,percent of total billed charges,,,,,,,,,826.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,270.6,22,,percent of total billed charges,,,984.97,91,,percent of total billed charges,,,1028.26,95,,percent of total billed charges,,,898.38,83,,percent of total billed charges,,,898.38,83,,percent of total billed charges,,,,,,,,,,,,,,,898.38,83,,percent of total billed charges,,,1028.26,95,,percent of total billed charges,,,974.14,90,,percent of total billed charges,,,974.14,90,,percent of total billed charges,,,887.55,82,,percent of total billed charges,,,974.14,90,,percent of total billed charges,,,920.02,85,,percent of total billed charges,,270.6,1028.26,
MESH ARTISYN Y-SHAPED,30187260,CDM,,,278,RC,outpatient,,6355.51,6355.51,,5395.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1588.88,22,,percent of total billed charges,,,,,,,,,5719.96,90,,percent of total billed charges,,,5262.36,82.8,,percent of total billed charges,,,5402.18,85,,percent of total billed charges,,,,,,,,,5592.85,88,,percent of total billed charges,,,,,,,,,4855.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1588.88,22,,percent of total billed charges,,,5783.51,91,,percent of total billed charges,,,6037.73,95,,percent of total billed charges,,,5275.07,83,,percent of total billed charges,,,5275.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5275.07,83,,percent of total billed charges,,,6037.73,95,,percent of total billed charges,,,5719.96,90,,percent of total billed charges,,,5719.96,90,,percent of total billed charges,,,5211.52,82,,percent of total billed charges,,,5719.96,90,,percent of total billed charges,,,5402.18,85,,percent of total billed charges,,1588.88,6037.73,
DEPUY EPI IMPLANT SZ 1 LEFT,30187261,CDM,,,278,RC,outpatient,,40066,40066,,34016.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10016.5,22,,percent of total billed charges,,,,,,,,,36059.4,90,,percent of total billed charges,,,33174.65,82.8,,percent of total billed charges,,,34056.1,85,,percent of total billed charges,,,,,,,,,35258.08,88,,percent of total billed charges,,,,,,,,,30610.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10016.5,22,,percent of total billed charges,,,36460.06,91,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,,,,,,,,,,,,,33254.78,83,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,32854.12,82,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,34056.1,85,,percent of total billed charges,,10016.5,38062.7,
DEPUY EPI IMPLANT SZ 1 RIGHT 145DEG,30187263,CDM,,,278,RC,outpatient,,40066,40066,,34016.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10016.5,22,,percent of total billed charges,,,,,,,,,36059.4,90,,percent of total billed charges,,,33174.65,82.8,,percent of total billed charges,,,34056.1,85,,percent of total billed charges,,,,,,,,,35258.08,88,,percent of total billed charges,,,,,,,,,30610.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10016.5,22,,percent of total billed charges,,,36460.06,91,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,,,,,,,,,,,,,33254.78,83,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,32854.12,82,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,34056.1,85,,percent of total billed charges,,10016.5,38062.7,
STENT BILIARY EV3 PROTEGE GPS  SELF-EXPA,30187265,CDM,,,278,RC,outpatient,,8639.61,8639.61,,7335.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2159.9,22,,percent of total billed charges,,,,,,,,,7775.65,90,,percent of total billed charges,,,7153.6,82.8,,percent of total billed charges,,,7343.67,85,,percent of total billed charges,,,,,,,,,7602.86,88,,percent of total billed charges,,,,,,,,,6600.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2159.9,22,,percent of total billed charges,,,7862.05,91,,percent of total billed charges,,,8207.63,95,,percent of total billed charges,,,7170.88,83,,percent of total billed charges,,,7170.88,83,,percent of total billed charges,,,,,,,,,,,,,,,7170.88,83,,percent of total billed charges,,,8207.63,95,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7084.48,82,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7343.67,85,,percent of total billed charges,,2159.9,8207.63,
STENT ABRE VENOUS SELF-EXPANDING SYSTEM,30187266,CDM,,,278,RC,outpatient,,13650,13650,,11588.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3412.5,22,,percent of total billed charges,,,,,,,,,12285,90,,percent of total billed charges,,,11302.2,82.8,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,,,,,,,,12012,88,,percent of total billed charges,,,,,,,,,10428.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3412.5,22,,percent of total billed charges,,,12421.5,91,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,,,,,,,,,,,,,11329.5,83,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11193,82,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,3412.5,12967.5,
EVERCROSS BALLOON 9MM X 40MM X 80MM,30187267,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
AVAFLEX BALLOON KIT 11G 15MM,30187268,CDM,,,270,RC,outpatient,,16740.75,16740.75,,14212.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4185.19,22,,percent of total billed charges,,,,,,,,,15066.68,90,,percent of total billed charges,,,13861.34,82.8,,percent of total billed charges,,,14229.64,85,,percent of total billed charges,,,,,,,,,14731.86,88,,percent of total billed charges,,,,,,,,,12789.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4185.19,22,,percent of total billed charges,,,15234.08,91,,percent of total billed charges,,,15903.71,95,,percent of total billed charges,,,13894.82,83,,percent of total billed charges,,,13894.82,83,,percent of total billed charges,,,,,,,,,,,,,,,13894.82,83,,percent of total billed charges,,,15903.71,95,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,13727.42,82,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,14229.64,85,,percent of total billed charges,,4185.19,15903.71,
ZIMMER FEMUR POROUS NARROW CCR SZ 8 LEFT,30187269,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
ZIMMER PATELLA CEMENTED 38MM,30187270,CDM,,,278,RC,outpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,568.75,22,,percent of total billed charges,,,,,,,,,2047.5,90,,percent of total billed charges,,,1883.7,82.8,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,568.75,22,,percent of total billed charges,,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,568.75,2161.25,
ZIMMER SCP KIT 11G X 120MM,30187271,CDM,,,270,RC,outpatient,,29835,29835,,25329.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7458.75,22,,percent of total billed charges,,,,,,,,,26851.5,90,,percent of total billed charges,,,24703.38,82.8,,percent of total billed charges,,,25359.75,85,,percent of total billed charges,,,,,,,,,26254.8,88,,percent of total billed charges,,,,,,,,,22793.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7458.75,22,,percent of total billed charges,,,27149.85,91,,percent of total billed charges,,,28343.25,95,,percent of total billed charges,,,24763.05,83,,percent of total billed charges,,,24763.05,83,,percent of total billed charges,,,,,,,,,,,,,,,24763.05,83,,percent of total billed charges,,,28343.25,95,,percent of total billed charges,,,26851.5,90,,percent of total billed charges,,,26851.5,90,,percent of total billed charges,,,24464.7,82,,percent of total billed charges,,,26851.5,90,,percent of total billed charges,,,25359.75,85,,percent of total billed charges,,7458.75,28343.25,
SYNTHES GUIDE WIRE SPADE POINT 2.5 X 230,30187272,CDM,,,278,RC,outpatient,,536.55,536.55,,455.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,134.14,22,,percent of total billed charges,,,,,,,,,482.9,90,,percent of total billed charges,,,444.26,82.8,,percent of total billed charges,,,456.07,85,,percent of total billed charges,,,,,,,,,472.16,88,,percent of total billed charges,,,,,,,,,409.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,134.14,22,,percent of total billed charges,,,488.26,91,,percent of total billed charges,,,509.72,95,,percent of total billed charges,,,445.34,83,,percent of total billed charges,,,445.34,83,,percent of total billed charges,,,,,,,,,,,,,,,445.34,83,,percent of total billed charges,,,509.72,95,,percent of total billed charges,,,482.9,90,,percent of total billed charges,,,482.9,90,,percent of total billed charges,,,439.97,82,,percent of total billed charges,,,482.9,90,,percent of total billed charges,,,456.07,85,,percent of total billed charges,,134.14,509.72,
SYNTHES SCREW LAG DHS/DCS 12.7 X 95MM,30187273,CDM,,,278,RC,outpatient,,3974.1,3974.1,,3374.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,993.53,22,,percent of total billed charges,,,,,,,,,3576.69,90,,percent of total billed charges,,,3290.55,82.8,,percent of total billed charges,,,3377.99,85,,percent of total billed charges,,,,,,,,,3497.21,88,,percent of total billed charges,,,,,,,,,3036.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,993.53,22,,percent of total billed charges,,,3616.43,91,,percent of total billed charges,,,3775.4,95,,percent of total billed charges,,,3298.5,83,,percent of total billed charges,,,3298.5,83,,percent of total billed charges,,,,,,,,,,,,,,,3298.5,83,,percent of total billed charges,,,3775.4,95,,percent of total billed charges,,,3576.69,90,,percent of total billed charges,,,3576.69,90,,percent of total billed charges,,,3258.76,82,,percent of total billed charges,,,3576.69,90,,percent of total billed charges,,,3377.99,85,,percent of total billed charges,,993.53,3775.4,
SYNTHES PLATE STD CARREL 8 HOLE 135DEG,30187274,CDM,,,278,RC,outpatient,,8540.16,8540.16,,7250.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2135.04,22,,percent of total billed charges,,,,,,,,,7686.14,90,,percent of total billed charges,,,7071.25,82.8,,percent of total billed charges,,,7259.14,85,,percent of total billed charges,,,,,,,,,7515.34,88,,percent of total billed charges,,,,,,,,,6524.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2135.04,22,,percent of total billed charges,,,7771.55,91,,percent of total billed charges,,,8113.15,95,,percent of total billed charges,,,7088.33,83,,percent of total billed charges,,,7088.33,83,,percent of total billed charges,,,,,,,,,,,,,,,7088.33,83,,percent of total billed charges,,,8113.15,95,,percent of total billed charges,,,7686.14,90,,percent of total billed charges,,,7686.14,90,,percent of total billed charges,,,7002.93,82,,percent of total billed charges,,,7686.14,90,,percent of total billed charges,,,7259.14,85,,percent of total billed charges,,2135.04,8113.15,
SYNTHES PIN POSITIONING CERCLAGE 4.5MM,30187275,CDM,,,278,RC,outpatient,,1846.39,1846.39,,1567.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,461.6,22,,percent of total billed charges,,,,,,,,,1661.75,90,,percent of total billed charges,,,1528.81,82.8,,percent of total billed charges,,,1569.43,85,,percent of total billed charges,,,,,,,,,1624.82,88,,percent of total billed charges,,,,,,,,,1410.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,461.6,22,,percent of total billed charges,,,1680.21,91,,percent of total billed charges,,,1754.07,95,,percent of total billed charges,,,1532.5,83,,percent of total billed charges,,,1532.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1532.5,83,,percent of total billed charges,,,1754.07,95,,percent of total billed charges,,,1661.75,90,,percent of total billed charges,,,1661.75,90,,percent of total billed charges,,,1514.04,82,,percent of total billed charges,,,1661.75,90,,percent of total billed charges,,,1569.43,85,,percent of total billed charges,,461.6,1754.07,
SYNTHES PLATE DISTAL RADIUS 2.4NN LCP,30187276,CDM,,,278,RC,outpatient,,4507.49,4507.49,,3826.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1126.87,22,,percent of total billed charges,,,,,,,,,4056.74,90,,percent of total billed charges,,,3732.2,82.8,,percent of total billed charges,,,3831.37,85,,percent of total billed charges,,,,,,,,,3966.59,88,,percent of total billed charges,,,,,,,,,3443.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1126.87,22,,percent of total billed charges,,,4101.82,91,,percent of total billed charges,,,4282.12,95,,percent of total billed charges,,,3741.22,83,,percent of total billed charges,,,3741.22,83,,percent of total billed charges,,,,,,,,,,,,,,,3741.22,83,,percent of total billed charges,,,4282.12,95,,percent of total billed charges,,,4056.74,90,,percent of total billed charges,,,4056.74,90,,percent of total billed charges,,,3696.14,82,,percent of total billed charges,,,4056.74,90,,percent of total billed charges,,,3831.37,85,,percent of total billed charges,,1126.87,4282.12,
ZIMMER BEARING VIVACIT-E 28X40MM,30187277,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
DEPUY BODY GLBL UNITE ANT 142 SZ 12,30187278,CDM,,,278,RC,outpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3163.67,22,,percent of total billed charges,,,,,,,,,11389.19,90,,percent of total billed charges,,,10478.06,82.8,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3163.67,22,,percent of total billed charges,,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,3163.67,12021.93,
DEPUY BODY GLBL UNITE ANT 135 SZ 12,30187279,CDM,,,278,RC,outpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3163.67,22,,percent of total billed charges,,,,,,,,,11389.19,90,,percent of total billed charges,,,10478.06,82.8,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3163.67,22,,percent of total billed charges,,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,3163.67,12021.93,
DEPUY HEAD ECC GLOBAL UNITE 48X18,30187280,CDM,,,278,RC,outpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4409.03,22,,percent of total billed charges,,,,,,,,,15872.52,90,,percent of total billed charges,,,14602.72,82.8,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4409.03,22,,percent of total billed charges,,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,4409.03,16754.32,
MINI STICK ENVI TRIAXIAL NON-VASCULAR IN,30187281,CDM,,,270,RC,outpatient,,894.4,894.4,,759.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,223.6,22,,percent of total billed charges,,,,,,,,,804.96,90,,percent of total billed charges,,,740.56,82.8,,percent of total billed charges,,,760.24,85,,percent of total billed charges,,,,,,,,,787.07,88,,percent of total billed charges,,,,,,,,,683.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,223.6,22,,percent of total billed charges,,,813.9,91,,percent of total billed charges,,,849.68,95,,percent of total billed charges,,,742.35,83,,percent of total billed charges,,,742.35,83,,percent of total billed charges,,,,,,,,,,,,,,,742.35,83,,percent of total billed charges,,,849.68,95,,percent of total billed charges,,,804.96,90,,percent of total billed charges,,,804.96,90,,percent of total billed charges,,,733.41,82,,percent of total billed charges,,,804.96,90,,percent of total billed charges,,,760.24,85,,percent of total billed charges,,223.6,849.68,
BIOMET NAIL HUMERAL VERSANAIL 8X240MM,30187282,CDM,,,278,RC,outpatient,,9613.5,9613.5,,8161.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2403.38,22,,percent of total billed charges,,,,,,,,,8652.15,90,,percent of total billed charges,,,7959.98,82.8,,percent of total billed charges,,,8171.48,85,,percent of total billed charges,,,,,,,,,8459.88,88,,percent of total billed charges,,,,,,,,,7344.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2403.38,22,,percent of total billed charges,,,8748.29,91,,percent of total billed charges,,,9132.83,95,,percent of total billed charges,,,7979.21,83,,percent of total billed charges,,,7979.21,83,,percent of total billed charges,,,,,,,,,,,,,,,7979.21,83,,percent of total billed charges,,,9132.83,95,,percent of total billed charges,,,8652.15,90,,percent of total billed charges,,,8652.15,90,,percent of total billed charges,,,7883.07,82,,percent of total billed charges,,,8652.15,90,,percent of total billed charges,,,8171.48,85,,percent of total billed charges,,2403.38,9132.83,
ZIMMER FEMUR CEMENTED CR DZ 8 RIGHT,30187283,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
SYNTHES PLATE 3 HOLE LEFT 54MM 2.4VA LC,30187284,CDM,,,278,RC,outpatient,,9419.41,9419.41,,7997.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2354.85,22,,percent of total billed charges,,,,,,,,,8477.47,90,,percent of total billed charges,,,7799.27,82.8,,percent of total billed charges,,,8006.5,85,,percent of total billed charges,,,,,,,,,8289.08,88,,percent of total billed charges,,,,,,,,,7196.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2354.85,22,,percent of total billed charges,,,8571.66,91,,percent of total billed charges,,,8948.44,95,,percent of total billed charges,,,7818.11,83,,percent of total billed charges,,,7818.11,83,,percent of total billed charges,,,,,,,,,,,,,,,7818.11,83,,percent of total billed charges,,,8948.44,95,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,7723.92,82,,percent of total billed charges,,,8477.47,90,,percent of total billed charges,,,8006.5,85,,percent of total billed charges,,2354.85,8948.44,
SPINECRAFT ROD TITANIUM 6.0 X450,30187285,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
SPINECRAFT LATERAL CONNECTOR 25MM,30187286,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
NUVASIVE CERVICAL CAGE TI 6X15X12MM 7DEG,30187287,CDM,,,278,RC,outpatient,,52487.5,52487.5,,44561.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13121.88,22,,percent of total billed charges,,,,,,,,,47238.75,90,,percent of total billed charges,,,43459.65,82.8,,percent of total billed charges,,,44614.38,85,,percent of total billed charges,,,,,,,,,46189,88,,percent of total billed charges,,,,,,,,,40100.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13121.88,22,,percent of total billed charges,,,47763.63,91,,percent of total billed charges,,,49863.13,95,,percent of total billed charges,,,43564.63,83,,percent of total billed charges,,,43564.63,83,,percent of total billed charges,,,,,,,,,,,,,,,43564.63,83,,percent of total billed charges,,,49863.13,95,,percent of total billed charges,,,47238.75,90,,percent of total billed charges,,,47238.75,90,,percent of total billed charges,,,43039.75,82,,percent of total billed charges,,,47238.75,90,,percent of total billed charges,,,44614.38,85,,percent of total billed charges,,13121.88,49863.13,
NUVASIVE PLATE HELIX  22MM,30187288,CDM,,,278,RC,outpatient,,10588.5,10588.5,,8989.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2647.13,22,,percent of total billed charges,,,,,,,,,9529.65,90,,percent of total billed charges,,,8767.28,82.8,,percent of total billed charges,,,9000.23,85,,percent of total billed charges,,,,,,,,,9317.88,88,,percent of total billed charges,,,,,,,,,8089.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2647.13,22,,percent of total billed charges,,,9635.54,91,,percent of total billed charges,,,10059.08,95,,percent of total billed charges,,,8788.46,83,,percent of total billed charges,,,8788.46,83,,percent of total billed charges,,,,,,,,,,,,,,,8788.46,83,,percent of total billed charges,,,10059.08,95,,percent of total billed charges,,,9529.65,90,,percent of total billed charges,,,9529.65,90,,percent of total billed charges,,,8682.57,82,,percent of total billed charges,,,9529.65,90,,percent of total billed charges,,,9000.23,85,,percent of total billed charges,,2647.13,10059.08,
SPINECRAFT OPEN WASHER,30187289,CDM,,,278,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
DEPUY LINER PINNACLE DM 58/49,30187290,CDM,,,278,RC,outpatient,,20235.61,20235.61,,17180.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5058.9,22,,percent of total billed charges,,,,,,,,,18212.05,90,,percent of total billed charges,,,16755.09,82.8,,percent of total billed charges,,,17200.27,85,,percent of total billed charges,,,,,,,,,17807.34,88,,percent of total billed charges,,,,,,,,,15460.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5058.9,22,,percent of total billed charges,,,18414.41,91,,percent of total billed charges,,,19223.83,95,,percent of total billed charges,,,16795.56,83,,percent of total billed charges,,,16795.56,83,,percent of total billed charges,,,,,,,,,,,,,,,16795.56,83,,percent of total billed charges,,,19223.83,95,,percent of total billed charges,,,18212.05,90,,percent of total billed charges,,,18212.05,90,,percent of total billed charges,,,16593.2,82,,percent of total billed charges,,,18212.05,90,,percent of total billed charges,,,17200.27,85,,percent of total billed charges,,5058.9,19223.83,
DEPUY FEMUR NEUTRAL STD LPS,30187291,CDM,,,278,RC,outpatient,,56410.06,56410.06,,47892.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14102.52,22,,percent of total billed charges,,,,,,,,,50769.05,90,,percent of total billed charges,,,46707.53,82.8,,percent of total billed charges,,,47948.55,85,,percent of total billed charges,,,,,,,,,49640.85,88,,percent of total billed charges,,,,,,,,,43097.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14102.52,22,,percent of total billed charges,,,51333.15,91,,percent of total billed charges,,,53589.56,95,,percent of total billed charges,,,46820.35,83,,percent of total billed charges,,,46820.35,83,,percent of total billed charges,,,,,,,,,,,,,,,46820.35,83,,percent of total billed charges,,,53589.56,95,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,46256.25,82,,percent of total billed charges,,,50769.05,90,,percent of total billed charges,,,47948.55,85,,percent of total billed charges,,14102.52,53589.56,
DEPUY SEGMENTAL COMPONENT 125MM,30187292,CDM,,,278,RC,outpatient,,18773.5,18773.5,,15938.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4693.38,22,,percent of total billed charges,,,,,,,,,16896.15,90,,percent of total billed charges,,,15544.46,82.8,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,,,,,,,,16520.68,88,,percent of total billed charges,,,,,,,,,14342.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4693.38,22,,percent of total billed charges,,,17083.89,91,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,,,,,,,,,,,,,15582.01,83,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15394.27,82,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,4693.38,17834.83,
DEPUY STEM CEMENTED LPS 17X125MM,30187293,CDM,,,278,RC,outpatient,,42441.95,42441.95,,36033.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10610.49,22,,percent of total billed charges,,,,,,,,,38197.76,90,,percent of total billed charges,,,35141.93,82.8,,percent of total billed charges,,,36075.66,85,,percent of total billed charges,,,,,,,,,37348.92,88,,percent of total billed charges,,,,,,,,,32425.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10610.49,22,,percent of total billed charges,,,38622.17,91,,percent of total billed charges,,,40319.85,95,,percent of total billed charges,,,35226.82,83,,percent of total billed charges,,,35226.82,83,,percent of total billed charges,,,,,,,,,,,,,,,35226.82,83,,percent of total billed charges,,,40319.85,95,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,34802.4,82,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,36075.66,85,,percent of total billed charges,,10610.49,40319.85,
DEPUY LINER PE MENTUM 28/49,30187294,CDM,,,278,RC,outpatient,,15818.92,15818.92,,13430.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3954.73,22,,percent of total billed charges,,,,,,,,,14237.03,90,,percent of total billed charges,,,13098.07,82.8,,percent of total billed charges,,,13446.08,85,,percent of total billed charges,,,,,,,,,13920.65,88,,percent of total billed charges,,,,,,,,,12085.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3954.73,22,,percent of total billed charges,,,14395.22,91,,percent of total billed charges,,,15027.97,95,,percent of total billed charges,,,13129.7,83,,percent of total billed charges,,,13129.7,83,,percent of total billed charges,,,,,,,,,,,,,,,13129.7,83,,percent of total billed charges,,,15027.97,95,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,12971.51,82,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,13446.08,85,,percent of total billed charges,,3954.73,15027.97,
DEPUY SEGMENT COMPONENT LPS 65MM,30187295,CDM,,,278,RC,outpatient,,18773.5,18773.5,,15938.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4693.38,22,,percent of total billed charges,,,,,,,,,16896.15,90,,percent of total billed charges,,,15544.46,82.8,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,,,,,,,,16520.68,88,,percent of total billed charges,,,,,,,,,14342.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4693.38,22,,percent of total billed charges,,,17083.89,91,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,15582.01,83,,percent of total billed charges,,,,,,,,,,,,,,,15582.01,83,,percent of total billed charges,,,17834.83,95,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15394.27,82,,percent of total billed charges,,,16896.15,90,,percent of total billed charges,,,15957.48,85,,percent of total billed charges,,4693.38,17834.83,
DEPUY STEM CEMENTED LPS 13X125MM,30187296,CDM,,,278,RC,outpatient,,42441.95,42441.95,,36033.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10610.49,22,,percent of total billed charges,,,,,,,,,38197.76,90,,percent of total billed charges,,,35141.93,82.8,,percent of total billed charges,,,36075.66,85,,percent of total billed charges,,,,,,,,,37348.92,88,,percent of total billed charges,,,,,,,,,32425.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10610.49,22,,percent of total billed charges,,,38622.17,91,,percent of total billed charges,,,40319.85,95,,percent of total billed charges,,,35226.82,83,,percent of total billed charges,,,35226.82,83,,percent of total billed charges,,,,,,,,,,,,,,,35226.82,83,,percent of total billed charges,,,40319.85,95,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,34802.4,82,,percent of total billed charges,,,38197.76,90,,percent of total billed charges,,,36075.66,85,,percent of total billed charges,,10610.49,40319.85,
DEPUY ATTUNE INSERT REV. LPS XXSM 16MM,30187297,CDM,,,278,RC,outpatient,,39351.39,39351.39,,33409.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9837.85,22,,percent of total billed charges,,,,,,,,,35416.25,90,,percent of total billed charges,,,32582.95,82.8,,percent of total billed charges,,,33448.68,85,,percent of total billed charges,,,,,,,,,34629.22,88,,percent of total billed charges,,,,,,,,,30064.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9837.85,22,,percent of total billed charges,,,35809.76,91,,percent of total billed charges,,,37383.82,95,,percent of total billed charges,,,32661.65,83,,percent of total billed charges,,,32661.65,83,,percent of total billed charges,,,,,,,,,,,,,,,32661.65,83,,percent of total billed charges,,,37383.82,95,,percent of total billed charges,,,35416.25,90,,percent of total billed charges,,,35416.25,90,,percent of total billed charges,,,32268.14,82,,percent of total billed charges,,,35416.25,90,,percent of total billed charges,,,33448.68,85,,percent of total billed charges,,9837.85,37383.82,
ZIMMER BEARING 1MM MC,30187298,CDM,,,270,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
SYNTHES SCREW CORTEX 1.5 X 12MM,30187299,CDM,,,278,RC,outpatient,,504.98,504.98,,428.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126.25,22,,percent of total billed charges,,,,,,,,,454.48,90,,percent of total billed charges,,,418.12,82.8,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,,,,,,,,444.38,88,,percent of total billed charges,,,,,,,,,385.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126.25,22,,percent of total billed charges,,,459.53,91,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,419.13,83,,percent of total billed charges,,,,,,,,,,,,,,,419.13,83,,percent of total billed charges,,,479.73,95,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,414.08,82,,percent of total billed charges,,,454.48,90,,percent of total billed charges,,,429.23,85,,percent of total billed charges,,126.25,479.73,
SYNTHES SCREW LOCKING 1.5 X 8MM,30187300,CDM,,,278,RC,outpatient,,1172.28,1172.28,,995.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,293.07,22,,percent of total billed charges,,,,,,,,,1055.05,90,,percent of total billed charges,,,970.65,82.8,,percent of total billed charges,,,996.44,85,,percent of total billed charges,,,,,,,,,1031.61,88,,percent of total billed charges,,,,,,,,,895.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,293.07,22,,percent of total billed charges,,,1066.77,91,,percent of total billed charges,,,1113.67,95,,percent of total billed charges,,,972.99,83,,percent of total billed charges,,,972.99,83,,percent of total billed charges,,,,,,,,,,,,,,,972.99,83,,percent of total billed charges,,,1113.67,95,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,961.27,82,,percent of total billed charges,,,1055.05,90,,percent of total billed charges,,,996.44,85,,percent of total billed charges,,293.07,1113.67,
DEPUY ATTUNE PATELLA MEDIAL 38MM,30187301,CDM,,,278,RC,outpatient,,9149.99,9149.99,,7768.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2287.5,22,,percent of total billed charges,,,,,,,,,8234.99,90,,percent of total billed charges,,,7576.19,82.8,,percent of total billed charges,,,7777.49,85,,percent of total billed charges,,,,,,,,,8051.99,88,,percent of total billed charges,,,,,,,,,6990.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2287.5,22,,percent of total billed charges,,,8326.49,91,,percent of total billed charges,,,8692.49,95,,percent of total billed charges,,,7594.49,83,,percent of total billed charges,,,7594.49,83,,percent of total billed charges,,,,,,,,,,,,,,,7594.49,83,,percent of total billed charges,,,8692.49,95,,percent of total billed charges,,,8234.99,90,,percent of total billed charges,,,8234.99,90,,percent of total billed charges,,,7502.99,82,,percent of total billed charges,,,8234.99,90,,percent of total billed charges,,,7777.49,85,,percent of total billed charges,,2287.5,8692.49,
ZIMMER REAMER BLADE 51MM,30187302,CDM,,,278,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
DEPUY EPI 145 IMPLANT SZ 1,30187303,CDM,,,278,RC,outpatient,,40066,40066,,34016.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10016.5,22,,percent of total billed charges,,,,,,,,,36059.4,90,,percent of total billed charges,,,33174.65,82.8,,percent of total billed charges,,,34056.1,85,,percent of total billed charges,,,,,,,,,35258.08,88,,percent of total billed charges,,,,,,,,,30610.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10016.5,22,,percent of total billed charges,,,36460.06,91,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,,,,,,,,,,,,,33254.78,83,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,32854.12,82,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,34056.1,85,,percent of total billed charges,,10016.5,38062.7,
DEPUY ATTUNE PRESSFIT STEM 22X110MM,30187304,CDM,,,278,RC,outpatient,,13175.11,13175.11,,11185.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3293.78,22,,percent of total billed charges,,,,,,,,,11857.6,90,,percent of total billed charges,,,10908.99,82.8,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,,,,,,,,11594.1,88,,percent of total billed charges,,,,,,,,,10065.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3293.78,22,,percent of total billed charges,,,11989.35,91,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,,,,,,,,,,,,,10935.34,83,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,10803.59,82,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,3293.78,12516.35,
DEPUY REV. OFFSET ADAPTOR 2MM,30187305,CDM,,,278,RC,outpatient,,7038.46,7038.46,,5975.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1759.62,22,,percent of total billed charges,,,,,,,,,6334.61,90,,percent of total billed charges,,,5827.84,82.8,,percent of total billed charges,,,5982.69,85,,percent of total billed charges,,,,,,,,,6193.84,88,,percent of total billed charges,,,,,,,,,5377.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1759.62,22,,percent of total billed charges,,,6405,91,,percent of total billed charges,,,6686.54,95,,percent of total billed charges,,,5841.92,83,,percent of total billed charges,,,5841.92,83,,percent of total billed charges,,,,,,,,,,,,,,,5841.92,83,,percent of total billed charges,,,6686.54,95,,percent of total billed charges,,,6334.61,90,,percent of total billed charges,,,6334.61,90,,percent of total billed charges,,,5771.54,82,,percent of total billed charges,,,6334.61,90,,percent of total billed charges,,,5982.69,85,,percent of total billed charges,,1759.62,6686.54,
DEPUY POST AUGMENT SZ 7 8MM,30187306,CDM,,,278,RC,outpatient,,9677.92,9677.92,,8216.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2419.48,22,,percent of total billed charges,,,,,,,,,8710.13,90,,percent of total billed charges,,,8013.32,82.8,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,,,,,,,,8516.57,88,,percent of total billed charges,,,,,,,,,7393.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2419.48,22,,percent of total billed charges,,,8806.91,91,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,,,,,,,,,,,,,8032.67,83,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,7935.89,82,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,2419.48,9194.02,
DEPUY POST AUGMENT SZ 7 4MM,30187307,CDM,,,278,RC,outpatient,,9677.92,9677.92,,8216.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2419.48,22,,percent of total billed charges,,,,,,,,,8710.13,90,,percent of total billed charges,,,8013.32,82.8,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,,,,,,,,8516.57,88,,percent of total billed charges,,,,,,,,,7393.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2419.48,22,,percent of total billed charges,,,8806.91,91,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,,,,,,,,,,,,,8032.67,83,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,7935.89,82,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,2419.48,9194.02,
DEPUY INSERT RP SZ 7 8MM,30187308,CDM,,,278,RC,outpatient,,23578.82,23578.82,,20018.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5894.71,22,,percent of total billed charges,,,,,,,,,21220.94,90,,percent of total billed charges,,,19523.26,82.8,,percent of total billed charges,,,20042,85,,percent of total billed charges,,,,,,,,,20749.36,88,,percent of total billed charges,,,,,,,,,18014.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5894.71,22,,percent of total billed charges,,,21456.73,91,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,,,,,,,,,,,,,19570.42,83,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,19334.63,82,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,20042,85,,percent of total billed charges,,5894.71,22399.88,
SYNTHES PLATE NARROW LCP 12 HOLES 4.5MM,30187309,CDM,,,278,RC,outpatient,,6277.64,6277.64,,5329.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1569.41,22,,percent of total billed charges,,,,,,,,,5649.88,90,,percent of total billed charges,,,5197.89,82.8,,percent of total billed charges,,,5335.99,85,,percent of total billed charges,,,,,,,,,5524.32,88,,percent of total billed charges,,,,,,,,,4796.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1569.41,22,,percent of total billed charges,,,5712.65,91,,percent of total billed charges,,,5963.76,95,,percent of total billed charges,,,5210.44,83,,percent of total billed charges,,,5210.44,83,,percent of total billed charges,,,,,,,,,,,,,,,5210.44,83,,percent of total billed charges,,,5963.76,95,,percent of total billed charges,,,5649.88,90,,percent of total billed charges,,,5649.88,90,,percent of total billed charges,,,5147.66,82,,percent of total billed charges,,,5649.88,90,,percent of total billed charges,,,5335.99,85,,percent of total billed charges,,1569.41,5963.76,
SYNTHES SCREW LOCKING 5.0X28MM,30187310,CDM,,,278,RC,outpatient,,1453.66,1453.66,,1234.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,363.42,22,,percent of total billed charges,,,,,,,,,1308.29,90,,percent of total billed charges,,,1203.63,82.8,,percent of total billed charges,,,1235.61,85,,percent of total billed charges,,,,,,,,,1279.22,88,,percent of total billed charges,,,,,,,,,1110.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,363.42,22,,percent of total billed charges,,,1322.83,91,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1206.54,83,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1192,82,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1235.61,85,,percent of total billed charges,,363.42,1380.98,
SYNTHES SCREW LOCKING 5.0X38MM,30187311,CDM,,,278,RC,outpatient,,1453.66,1453.66,,1234.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,363.42,22,,percent of total billed charges,,,,,,,,,1308.29,90,,percent of total billed charges,,,1203.63,82.8,,percent of total billed charges,,,1235.61,85,,percent of total billed charges,,,,,,,,,1279.22,88,,percent of total billed charges,,,,,,,,,1110.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,363.42,22,,percent of total billed charges,,,1322.83,91,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,1206.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1206.54,83,,percent of total billed charges,,,1380.98,95,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1192,82,,percent of total billed charges,,,1308.29,90,,percent of total billed charges,,,1235.61,85,,percent of total billed charges,,363.42,1380.98,
ZIMMER LINER G7 VE +5MM 40,30187312,CDM,,,278,RC,outpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2551.25,22,,percent of total billed charges,,,,,,,,,9184.5,90,,percent of total billed charges,,,8449.74,82.8,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2551.25,22,,percent of total billed charges,,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,2551.25,9694.75,
SYNTHES SCREW LOCKING ST 2.4 X 12MM,30187313,CDM,,,278,RC,outpatient,,1166.43,1166.43,,990.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,291.61,22,,percent of total billed charges,,,,,,,,,1049.79,90,,percent of total billed charges,,,965.8,82.8,,percent of total billed charges,,,991.47,85,,percent of total billed charges,,,,,,,,,1026.46,88,,percent of total billed charges,,,,,,,,,891.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,291.61,22,,percent of total billed charges,,,1061.45,91,,percent of total billed charges,,,1108.11,95,,percent of total billed charges,,,968.14,83,,percent of total billed charges,,,968.14,83,,percent of total billed charges,,,,,,,,,,,,,,,968.14,83,,percent of total billed charges,,,1108.11,95,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,956.47,82,,percent of total billed charges,,,1049.79,90,,percent of total billed charges,,,991.47,85,,percent of total billed charges,,291.61,1108.11,
DEPUY STEM HUMERAL 10MM,30187314,CDM,,,278,RC,outpatient,,33123.22,33123.22,,28121.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8280.81,22,,percent of total billed charges,,,,,,,,,29810.9,90,,percent of total billed charges,,,27426.03,82.8,,percent of total billed charges,,,28154.74,85,,percent of total billed charges,,,,,,,,,29148.43,88,,percent of total billed charges,,,,,,,,,25306.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8280.81,22,,percent of total billed charges,,,30142.13,91,,percent of total billed charges,,,31467.06,95,,percent of total billed charges,,,27492.27,83,,percent of total billed charges,,,27492.27,83,,percent of total billed charges,,,,,,,,,,,,,,,27492.27,83,,percent of total billed charges,,,31467.06,95,,percent of total billed charges,,,29810.9,90,,percent of total billed charges,,,29810.9,90,,percent of total billed charges,,,27161.04,82,,percent of total billed charges,,,29810.9,90,,percent of total billed charges,,,28154.74,85,,percent of total billed charges,,8280.81,31467.06,
SCISSOR LAPAROSCOPIC DISP. 5MM/35CM,30187315,CDM,,,270,RC,outpatient,,192,192,,163.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48,22,,percent of total billed charges,,,,,,,,,172.8,90,,percent of total billed charges,,,158.98,82.8,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,,,,,,,,168.96,88,,percent of total billed charges,,,,,,,,,146.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48,22,,percent of total billed charges,,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,,,,,,,,,,,,,159.36,83,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,157.44,82,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,48,182.4,
S&N GRAFIX PL PRIME 2X3CM,30187316,CDM,,,278,RC,outpatient,,6792.5,6792.5,,5766.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1698.13,22,,percent of total billed charges,,,,,,,,,6113.25,90,,percent of total billed charges,,,5624.19,82.8,,percent of total billed charges,,,5773.63,85,,percent of total billed charges,,,,,,,,,5977.4,88,,percent of total billed charges,,,,,,,,,5189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1698.13,22,,percent of total billed charges,,,6181.18,91,,percent of total billed charges,,,6452.88,95,,percent of total billed charges,,,5637.78,83,,percent of total billed charges,,,5637.78,83,,percent of total billed charges,,,,,,,,,,,,,,,5637.78,83,,percent of total billed charges,,,6452.88,95,,percent of total billed charges,,,6113.25,90,,percent of total billed charges,,,6113.25,90,,percent of total billed charges,,,5569.85,82,,percent of total billed charges,,,6113.25,90,,percent of total billed charges,,,5773.63,85,,percent of total billed charges,,1698.13,6452.88,
ULRICH TAP NON-CANNULATED 5.5,30187317,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
ULRICH POLY 6.5 X 45MM,30187318,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH ROD 5.5 X 60MM,30187319,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ULRICH SCREW LOCKING SET,30187320,CDM,,,278,RC,outpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175,22,,percent of total billed charges,,,,,,,,,630,90,,percent of total billed charges,,,579.6,82.8,,percent of total billed charges,,,595,85,,percent of total billed charges,,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175,22,,percent of total billed charges,,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,175,665,
ULRICH POLY 6.5 X 40MM,30187321,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH ROD 5.5 X 70MM,30187322,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
MEDTRONIC HAWKONE,30187323,CDM,,,270,RC,outpatient,,24292.13,24292.13,,20624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6073.03,22,,percent of total billed charges,,,,,,,,,21862.92,90,,percent of total billed charges,,,20113.88,82.8,,percent of total billed charges,,,20648.31,85,,percent of total billed charges,,,,,,,,,21377.07,88,,percent of total billed charges,,,,,,,,,18559.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6073.03,22,,percent of total billed charges,,,22105.84,91,,percent of total billed charges,,,23077.52,95,,percent of total billed charges,,,20162.47,83,,percent of total billed charges,,,20162.47,83,,percent of total billed charges,,,,,,,,,,,,,,,20162.47,83,,percent of total billed charges,,,23077.52,95,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,19919.55,82,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,20648.31,85,,percent of total billed charges,,6073.03,23077.52,
SYNTHES PLATE DISTAL RADIUS 6 HOLE RIGHT,30187324,CDM,,,278,RC,outpatient,,10357.23,10357.23,,8793.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2589.31,22,,percent of total billed charges,,,,,,,,,9321.51,90,,percent of total billed charges,,,8575.79,82.8,,percent of total billed charges,,,8803.65,85,,percent of total billed charges,,,,,,,,,9114.36,88,,percent of total billed charges,,,,,,,,,7912.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2589.31,22,,percent of total billed charges,,,9425.08,91,,percent of total billed charges,,,9839.37,95,,percent of total billed charges,,,8596.5,83,,percent of total billed charges,,,8596.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8596.5,83,,percent of total billed charges,,,9839.37,95,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,8492.93,82,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,8803.65,85,,percent of total billed charges,,2589.31,9839.37,
SYNTHES SCREW LOCKING VA TI 2.4 X 16MM,30187325,CDM,,,278,RC,outpatient,,1494.68,1494.68,,1268.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,373.67,22,,percent of total billed charges,,,,,,,,,1345.21,90,,percent of total billed charges,,,1237.6,82.8,,percent of total billed charges,,,1270.48,85,,percent of total billed charges,,,,,,,,,1315.32,88,,percent of total billed charges,,,,,,,,,1141.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,373.67,22,,percent of total billed charges,,,1360.16,91,,percent of total billed charges,,,1419.95,95,,percent of total billed charges,,,1240.58,83,,percent of total billed charges,,,1240.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1240.58,83,,percent of total billed charges,,,1419.95,95,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1225.64,82,,percent of total billed charges,,,1345.21,90,,percent of total billed charges,,,1270.48,85,,percent of total billed charges,,373.67,1419.95,
SYNTHES SCREW CORTEX TI 2.4 X 12MM,30187326,CDM,,,278,RC,outpatient,,662.83,662.83,,562.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,165.71,22,,percent of total billed charges,,,,,,,,,596.55,90,,percent of total billed charges,,,548.82,82.8,,percent of total billed charges,,,563.41,85,,percent of total billed charges,,,,,,,,,583.29,88,,percent of total billed charges,,,,,,,,,506.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,165.71,22,,percent of total billed charges,,,603.18,91,,percent of total billed charges,,,629.69,95,,percent of total billed charges,,,550.15,83,,percent of total billed charges,,,550.15,83,,percent of total billed charges,,,,,,,,,,,,,,,550.15,83,,percent of total billed charges,,,629.69,95,,percent of total billed charges,,,596.55,90,,percent of total billed charges,,,596.55,90,,percent of total billed charges,,,543.52,82,,percent of total billed charges,,,596.55,90,,percent of total billed charges,,,563.41,85,,percent of total billed charges,,165.71,629.69,
SYNTHES SCREW CORTEX TI 2.4 X 22MM,30187327,CDM,,,278,RC,outpatient,,662.83,662.83,,562.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,165.71,22,,percent of total billed charges,,,,,,,,,596.55,90,,percent of total billed charges,,,548.82,82.8,,percent of total billed charges,,,563.41,85,,percent of total billed charges,,,,,,,,,583.29,88,,percent of total billed charges,,,,,,,,,506.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,165.71,22,,percent of total billed charges,,,603.18,91,,percent of total billed charges,,,629.69,95,,percent of total billed charges,,,550.15,83,,percent of total billed charges,,,550.15,83,,percent of total billed charges,,,,,,,,,,,,,,,550.15,83,,percent of total billed charges,,,629.69,95,,percent of total billed charges,,,596.55,90,,percent of total billed charges,,,596.55,90,,percent of total billed charges,,,543.52,82,,percent of total billed charges,,,596.55,90,,percent of total billed charges,,,563.41,85,,percent of total billed charges,,165.71,629.69,
ZIMMER PATELLA POLY VE 41MM,30187328,CDM,,,278,RC,outpatient,,3575,3575,,3035.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,893.75,22,,percent of total billed charges,,,,,,,,,3217.5,90,,percent of total billed charges,,,2960.1,82.8,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,,,,,,,,3146,88,,percent of total billed charges,,,,,,,,,2731.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,893.75,22,,percent of total billed charges,,,3253.25,91,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2967.25,83,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,2931.5,82,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,893.75,3396.25,
ARTHREX PASSPORT BUTTON CANNULA,30187329,CDM,,,278,RC,outpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
OPTION ELITE CAVA FILTER,30187330,CDM,,,270,RC,outpatient,,16575,16575,,14072.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4143.75,22,,percent of total billed charges,,,,,,,,,14917.5,90,,percent of total billed charges,,,13724.1,82.8,,percent of total billed charges,,,14088.75,85,,percent of total billed charges,,,,,,,,,14586,88,,percent of total billed charges,,,,,,,,,12663.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4143.75,22,,percent of total billed charges,,,15083.25,91,,percent of total billed charges,,,15746.25,95,,percent of total billed charges,,,13757.25,83,,percent of total billed charges,,,13757.25,83,,percent of total billed charges,,,,,,,,,,,,,,,13757.25,83,,percent of total billed charges,,,15746.25,95,,percent of total billed charges,,,14917.5,90,,percent of total billed charges,,,14917.5,90,,percent of total billed charges,,,13591.5,82,,percent of total billed charges,,,14917.5,90,,percent of total billed charges,,,14088.75,85,,percent of total billed charges,,4143.75,15746.25,
DEPUY ATTUNE PATELLA MEDIAL 32MM,30187331,CDM,,,278,RC,outpatient,,9149.99,9149.99,,7768.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2287.5,22,,percent of total billed charges,,,,,,,,,8234.99,90,,percent of total billed charges,,,7576.19,82.8,,percent of total billed charges,,,7777.49,85,,percent of total billed charges,,,,,,,,,8051.99,88,,percent of total billed charges,,,,,,,,,6990.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2287.5,22,,percent of total billed charges,,,8326.49,91,,percent of total billed charges,,,8692.49,95,,percent of total billed charges,,,7594.49,83,,percent of total billed charges,,,7594.49,83,,percent of total billed charges,,,,,,,,,,,,,,,7594.49,83,,percent of total billed charges,,,8692.49,95,,percent of total billed charges,,,8234.99,90,,percent of total billed charges,,,8234.99,90,,percent of total billed charges,,,7502.99,82,,percent of total billed charges,,,8234.99,90,,percent of total billed charges,,,7777.49,85,,percent of total billed charges,,2287.5,8692.49,
ZIMMER FEMUR POROUS SZ 11,30187332,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
VASCULAR CLOSURE DEVICE 5F FEMORAL,30187333,CDM,,,270,RC,outpatient,,1397.5,1397.5,,1186.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,349.38,22,,percent of total billed charges,,,,,,,,,1257.75,90,,percent of total billed charges,,,1157.13,82.8,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,,,,,,,,1229.8,88,,percent of total billed charges,,,,,,,,,1067.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,349.38,22,,percent of total billed charges,,,1271.73,91,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,1159.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1159.93,83,,percent of total billed charges,,,1327.63,95,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1145.95,82,,percent of total billed charges,,,1257.75,90,,percent of total billed charges,,,1187.88,85,,percent of total billed charges,,349.38,1327.63,
ULRICH X-LINK XXXS,30187334,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
ULRICH X-LINK MEDIUM,30187335,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
ULRICH POLY 5.5 X 50MM,30187336,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH POLY 5.5 X 55MM,30187337,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH POLY 5.5 X 45MM,30187338,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH POLY 6.5 X 50MM,30187339,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH POLY 7.5 X 45MM,30187340,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH POLY 7.5 X 40MM,30187341,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH POLY 8.5 X 45MM,30187342,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH ILLIAC BOLT SCREW 8.0 X 80,30187343,CDM,,,278,RC,outpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2356.25,22,,percent of total billed charges,,,,,,,,,8482.5,90,,percent of total billed charges,,,7803.9,82.8,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2356.25,22,,percent of total billed charges,,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,2356.25,8953.75,
ULRICH ROD COBALT CHROME 5.5,30187344,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
ULRICH TAP NON-CANNULATED 4.5,30187345,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
ZIMMER BEARING DUAL MOBILITY G,30187346,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
MEDTRONIC SPIDER 5MM,30187347,CDM,,,270,RC,outpatient,,10090.08,10090.08,,8566.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2522.52,22,,percent of total billed charges,,,,,,,,,9081.07,90,,percent of total billed charges,,,8354.59,82.8,,percent of total billed charges,,,8576.57,85,,percent of total billed charges,,,,,,,,,8879.27,88,,percent of total billed charges,,,,,,,,,7708.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2522.52,22,,percent of total billed charges,,,9181.97,91,,percent of total billed charges,,,9585.58,95,,percent of total billed charges,,,8374.77,83,,percent of total billed charges,,,8374.77,83,,percent of total billed charges,,,,,,,,,,,,,,,8374.77,83,,percent of total billed charges,,,9585.58,95,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,8273.87,82,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,8576.57,85,,percent of total billed charges,,2522.52,9585.58,
IMPACT ADMIRAL BALLOON 4X60,30187348,CDM,,,270,RC,outpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2421.25,22,,percent of total billed charges,,,,,,,,,8716.5,90,,percent of total billed charges,,,8019.18,82.8,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2421.25,22,,percent of total billed charges,,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,2421.25,9200.75,
ZIMMER TIBIA RIGHT 5DEG SZ D,30187349,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER BEARING MC 11MM,30187350,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ZIMMER LINER NEUTRAL G7 40MM H,30187351,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH ROD LORDOSED 100MM,30187352,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ULRICH POLY SCREW REDUCTION 6.5 X 55MM,30187353,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH ROD LORDOSED 5.5 X 80MM,30187354,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ULRICH ROD LORDOSED 5.5 X 110MM,30187355,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ULRICH X-LINK CONNECTOR SMALL,30187356,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
IR CAGE PEEK 6DEG 9MM,30187357,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
STEERING KIT ENHANCED W/STYLET CAP 50CM,30187358,CDM,,,270,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
STRYKER BURR ARTHROSCOPIC ROUND,30187359,CDM,,,270,RC,outpatient,,451.01,451.01,,382.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,112.75,22,,percent of total billed charges,,,,,,,,,405.91,90,,percent of total billed charges,,,373.44,82.8,,percent of total billed charges,,,383.36,85,,percent of total billed charges,,,,,,,,,396.89,88,,percent of total billed charges,,,,,,,,,344.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,112.75,22,,percent of total billed charges,,,410.42,91,,percent of total billed charges,,,428.46,95,,percent of total billed charges,,,374.34,83,,percent of total billed charges,,,374.34,83,,percent of total billed charges,,,,,,,,,,,,,,,374.34,83,,percent of total billed charges,,,428.46,95,,percent of total billed charges,,,405.91,90,,percent of total billed charges,,,405.91,90,,percent of total billed charges,,,369.83,82,,percent of total billed charges,,,405.91,90,,percent of total billed charges,,,383.36,85,,percent of total billed charges,,112.75,428.46,
MERETE SCREW INTERLOCKING 34MM,30187361,CDM,,,278,RC,outpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,706.06,22,,percent of total billed charges,,,,,,,,,2541.83,90,,percent of total billed charges,,,2338.48,82.8,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,706.06,22,,percent of total billed charges,,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,706.06,2683.04,
MERETE KNEE NAIL W/COLLAR 200 X 14MM,30187362,CDM,,,278,RC,outpatient,,17875,17875,,15175.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4468.75,22,,percent of total billed charges,,,,,,,,,16087.5,90,,percent of total billed charges,,,14800.5,82.8,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,,,,,,,,15730,88,,percent of total billed charges,,,,,,,,,13656.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4468.75,22,,percent of total billed charges,,,16266.25,91,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14836.25,83,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,14657.5,82,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,4468.75,16981.25,
MEDTRONIC IRRIGATION TUBING,30187363,CDM,,,270,RC,outpatient,,819,819,,695.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,204.75,22,,percent of total billed charges,,,,,,,,,737.1,90,,percent of total billed charges,,,678.13,82.8,,percent of total billed charges,,,696.15,85,,percent of total billed charges,,,,,,,,,720.72,88,,percent of total billed charges,,,,,,,,,625.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,204.75,22,,percent of total billed charges,,,745.29,91,,percent of total billed charges,,,778.05,95,,percent of total billed charges,,,679.77,83,,percent of total billed charges,,,679.77,83,,percent of total billed charges,,,,,,,,,,,,,,,679.77,83,,percent of total billed charges,,,778.05,95,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,671.58,82,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,696.15,85,,percent of total billed charges,,204.75,778.05,
MEDTRONIC BURR 6MM,30187364,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
DEPUY CEMENT GENTAMICIN 40G,30187365,CDM,,,278,RC,outpatient,,1527.5,1527.5,,1296.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,381.88,22,,percent of total billed charges,,,,,,,,,1374.75,90,,percent of total billed charges,,,1264.77,82.8,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,,,,,,,,1344.2,88,,percent of total billed charges,,,,,,,,,1167.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,381.88,22,,percent of total billed charges,,,1390.03,91,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,1267.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1267.83,83,,percent of total billed charges,,,1451.13,95,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1252.55,82,,percent of total billed charges,,,1374.75,90,,percent of total billed charges,,,1298.38,85,,percent of total billed charges,,381.88,1451.13,
S&N INSERT CONSTRAINED ARTICULAR SZ 7-8,30187366,CDM,,,278,RC,outpatient,,22072.83,22072.83,,18739.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5518.21,22,,percent of total billed charges,,,,,,,,,19865.55,90,,percent of total billed charges,,,18276.3,82.8,,percent of total billed charges,,,18761.91,85,,percent of total billed charges,,,,,,,,,19424.09,88,,percent of total billed charges,,,,,,,,,16863.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5518.21,22,,percent of total billed charges,,,20086.28,91,,percent of total billed charges,,,20969.19,95,,percent of total billed charges,,,18320.45,83,,percent of total billed charges,,,18320.45,83,,percent of total billed charges,,,,,,,,,,,,,,,18320.45,83,,percent of total billed charges,,,20969.19,95,,percent of total billed charges,,,19865.55,90,,percent of total billed charges,,,19865.55,90,,percent of total billed charges,,,18099.72,82,,percent of total billed charges,,,19865.55,90,,percent of total billed charges,,,18761.91,85,,percent of total billed charges,,5518.21,20969.19,
BURSHIELD DIAMOND 1.0MM X 95MM,30187367,CDM,,,270,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
IR INTERBODY PEEK 7MM 6DEG 12X15,30187369,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
IR INTERBODY PEEK 8MM 10DEG 12X15,30187370,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
IR PLATE CERVICAL 14MM,30187371,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
AGILON SYNTHETIC PUTTY W/COLLOGEN 3CC,30187372,CDM,,,278,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
SYNTHES PLATE TIBIA VA PROX 8 HOLE RIGHT,30187373,CDM,,,278,RC,outpatient,,19694.55,19694.55,,16720.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4923.64,22,,percent of total billed charges,,,,,,,,,17725.1,90,,percent of total billed charges,,,16307.09,82.8,,percent of total billed charges,,,16740.37,85,,percent of total billed charges,,,,,,,,,17331.2,88,,percent of total billed charges,,,,,,,,,15046.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4923.64,22,,percent of total billed charges,,,17922.04,91,,percent of total billed charges,,,18709.82,95,,percent of total billed charges,,,16346.48,83,,percent of total billed charges,,,16346.48,83,,percent of total billed charges,,,,,,,,,,,,,,,16346.48,83,,percent of total billed charges,,,18709.82,95,,percent of total billed charges,,,17725.1,90,,percent of total billed charges,,,17725.1,90,,percent of total billed charges,,,16149.53,82,,percent of total billed charges,,,17725.1,90,,percent of total billed charges,,,16740.37,85,,percent of total billed charges,,4923.64,18709.82,
SYNTHES SCREW LOCKING VA 3.5 X 28MM,30187374,CDM,,,278,RC,outpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375.13,22,,percent of total billed charges,,,,,,,,,1350.48,90,,percent of total billed charges,,,1242.44,82.8,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,375.13,22,,percent of total billed charges,,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,375.13,1425.5,
ULRICH POLY 7.5 X 50MM,30187375,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH POLY 7.5 X 55MM,30187376,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH ROD LORDOSED 6.0 X 120,30187377,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ULRICH POLY 6.0 X 40MM,30187378,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH ROD 5.5 X 50MM,30187379,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ULRICH ROD 5.5 X 55MM,30187380,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ULRICH ROD 5.5 X 45MM,30187381,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ULRICH POLY 6.5 X 35MM,30187382,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
NUVASIVE PLATE ACP 1.9H 36MM 2-LEVEL,30187383,CDM,,,278,RC,outpatient,,15787.2,15787.2,,13403.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3946.8,22,,percent of total billed charges,,,,,,,,,14208.48,90,,percent of total billed charges,,,13071.8,82.8,,percent of total billed charges,,,13419.12,85,,percent of total billed charges,,,,,,,,,13892.74,88,,percent of total billed charges,,,,,,,,,12061.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3946.8,22,,percent of total billed charges,,,14366.35,91,,percent of total billed charges,,,14997.84,95,,percent of total billed charges,,,13103.38,83,,percent of total billed charges,,,13103.38,83,,percent of total billed charges,,,,,,,,,,,,,,,13103.38,83,,percent of total billed charges,,,14997.84,95,,percent of total billed charges,,,14208.48,90,,percent of total billed charges,,,14208.48,90,,percent of total billed charges,,,12945.5,82,,percent of total billed charges,,,14208.48,90,,percent of total billed charges,,,13419.12,85,,percent of total billed charges,,3946.8,14997.84,
NUVASIVE SCREW ACP 3.5 X 15MM,30187384,CDM,,,278,RC,outpatient,,5026.45,5026.45,,4267.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1256.61,22,,percent of total billed charges,,,,,,,,,4523.81,90,,percent of total billed charges,,,4161.9,82.8,,percent of total billed charges,,,4272.48,85,,percent of total billed charges,,,,,,,,,4423.28,88,,percent of total billed charges,,,,,,,,,3840.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1256.61,22,,percent of total billed charges,,,4574.07,91,,percent of total billed charges,,,4775.13,95,,percent of total billed charges,,,4171.95,83,,percent of total billed charges,,,4171.95,83,,percent of total billed charges,,,,,,,,,,,,,,,4171.95,83,,percent of total billed charges,,,4775.13,95,,percent of total billed charges,,,4523.81,90,,percent of total billed charges,,,4523.81,90,,percent of total billed charges,,,4121.69,82,,percent of total billed charges,,,4523.81,90,,percent of total billed charges,,,4272.48,85,,percent of total billed charges,,1256.61,4775.13,
NUVASIVE SCREW ACP 4.0 X 15MM,30187385,CDM,,,278,RC,outpatient,,5026.45,5026.45,,4267.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1256.61,22,,percent of total billed charges,,,,,,,,,4523.81,90,,percent of total billed charges,,,4161.9,82.8,,percent of total billed charges,,,4272.48,85,,percent of total billed charges,,,,,,,,,4423.28,88,,percent of total billed charges,,,,,,,,,3840.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1256.61,22,,percent of total billed charges,,,4574.07,91,,percent of total billed charges,,,4775.13,95,,percent of total billed charges,,,4171.95,83,,percent of total billed charges,,,4171.95,83,,percent of total billed charges,,,,,,,,,,,,,,,4171.95,83,,percent of total billed charges,,,4775.13,95,,percent of total billed charges,,,4523.81,90,,percent of total billed charges,,,4523.81,90,,percent of total billed charges,,,4121.69,82,,percent of total billed charges,,,4523.81,90,,percent of total billed charges,,,4272.48,85,,percent of total billed charges,,1256.61,4775.13,
NUVASIVE DRILL ACP 11MM,30187386,CDM,,,270,RC,outpatient,,3575,3575,,3035.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,893.75,22,,percent of total billed charges,,,,,,,,,3217.5,90,,percent of total billed charges,,,2960.1,82.8,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,,,,,,,,3146,88,,percent of total billed charges,,,,,,,,,2731.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,893.75,22,,percent of total billed charges,,,3253.25,91,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2967.25,83,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,2931.5,82,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,893.75,3396.25,
SYNTHES SCREW LOCKING 4.0 X 36MM,30187387,CDM,,,278,RC,outpatient,,1740.83,1740.83,,1477.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,435.21,22,,percent of total billed charges,,,,,,,,,1566.75,90,,percent of total billed charges,,,1441.41,82.8,,percent of total billed charges,,,1479.71,85,,percent of total billed charges,,,,,,,,,1531.93,88,,percent of total billed charges,,,,,,,,,1329.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,435.21,22,,percent of total billed charges,,,1584.16,91,,percent of total billed charges,,,1653.79,95,,percent of total billed charges,,,1444.89,83,,percent of total billed charges,,,1444.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.89,83,,percent of total billed charges,,,1653.79,95,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1427.48,82,,percent of total billed charges,,,1566.75,90,,percent of total billed charges,,,1479.71,85,,percent of total billed charges,,435.21,1653.79,
ZIMMER BEARING 14MM MC,30187388,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ZIMMER BEARING 10MM MC,30187389,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ZIMMER FEMUR PSN CR SZ 9 LEFT,30187390,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
ZIMMER FEMUR PSN CR SZ 6 LEFT,30187391,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
ZIMMER TIBIA LEFT 5DEG SZ D,30187392,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER BEARING MC SZ 11,30187393,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ULRICH ROD LORDOSED 6.0 X 90,30187394,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ULRICH TAP NON-CANNULATED 6.5,30187395,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
IR PLATE 1 LEVEL 20MM,30187396,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
IR PEEK 10DEG 9MM,30187397,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
IR SCREW SELF DRILLING VARIABLE 4.5 X 16,30187398,CDM,,,278,RC,outpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,446.88,22,,percent of total billed charges,,,,,,,,,1608.75,90,,percent of total billed charges,,,1480.05,82.8,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,446.88,22,,percent of total billed charges,,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,446.88,1698.13,
EVERLIFT GI 59 10ML,30187399,CDM,,,270,RC,outpatient,,553,553,,469.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,138.25,22,,percent of total billed charges,,,,,,,,,497.7,90,,percent of total billed charges,,,457.88,82.8,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,,,,,,,,486.64,88,,percent of total billed charges,,,,,,,,,422.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,138.25,22,,percent of total billed charges,,,503.23,91,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,,,,,,,,,,,,,458.99,83,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,453.46,82,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,138.25,525.35,
ULRICH ROD LORDOSED 6.0 X 70,30187402,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ULRICH SCREW REDUCTION 6.5 X 40,30187403,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
ULRICH SCREW REDUCTION 6.5 X 45,30187404,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
S&N REGENETEN IMPLANT MEDIUM,30187405,CDM,,,278,RC,outpatient,,32453.46,32453.46,,27552.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8113.37,22,,percent of total billed charges,,,,,,,,,29208.11,90,,percent of total billed charges,,,26871.46,82.8,,percent of total billed charges,,,27585.44,85,,percent of total billed charges,,,,,,,,,28559.04,88,,percent of total billed charges,,,,,,,,,24794.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8113.37,22,,percent of total billed charges,,,29532.65,91,,percent of total billed charges,,,30830.79,95,,percent of total billed charges,,,26936.37,83,,percent of total billed charges,,,26936.37,83,,percent of total billed charges,,,,,,,,,,,,,,,26936.37,83,,percent of total billed charges,,,30830.79,95,,percent of total billed charges,,,29208.11,90,,percent of total billed charges,,,29208.11,90,,percent of total billed charges,,,26611.84,82,,percent of total billed charges,,,29208.11,90,,percent of total billed charges,,,27585.44,85,,percent of total billed charges,,8113.37,30830.79,
S&N BONE ANCHORS,30187406,CDM,,,278,RC,outpatient,,17037.54,17037.54,,14464.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4259.39,22,,percent of total billed charges,,,,,,,,,15333.79,90,,percent of total billed charges,,,14107.08,82.8,,percent of total billed charges,,,14481.91,85,,percent of total billed charges,,,,,,,,,14993.04,88,,percent of total billed charges,,,,,,,,,13016.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4259.39,22,,percent of total billed charges,,,15504.16,91,,percent of total billed charges,,,16185.66,95,,percent of total billed charges,,,14141.16,83,,percent of total billed charges,,,14141.16,83,,percent of total billed charges,,,,,,,,,,,,,,,14141.16,83,,percent of total billed charges,,,16185.66,95,,percent of total billed charges,,,15333.79,90,,percent of total billed charges,,,15333.79,90,,percent of total billed charges,,,13970.78,82,,percent of total billed charges,,,15333.79,90,,percent of total billed charges,,,14481.91,85,,percent of total billed charges,,4259.39,16185.66,
S&N TENDON ANCHORS,30187407,CDM,,,278,RC,outpatient,,17037.54,17037.54,,14464.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4259.39,22,,percent of total billed charges,,,,,,,,,15333.79,90,,percent of total billed charges,,,14107.08,82.8,,percent of total billed charges,,,14481.91,85,,percent of total billed charges,,,,,,,,,14993.04,88,,percent of total billed charges,,,,,,,,,13016.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4259.39,22,,percent of total billed charges,,,15504.16,91,,percent of total billed charges,,,16185.66,95,,percent of total billed charges,,,14141.16,83,,percent of total billed charges,,,14141.16,83,,percent of total billed charges,,,,,,,,,,,,,,,14141.16,83,,percent of total billed charges,,,16185.66,95,,percent of total billed charges,,,15333.79,90,,percent of total billed charges,,,15333.79,90,,percent of total billed charges,,,13970.78,82,,percent of total billed charges,,,15333.79,90,,percent of total billed charges,,,14481.91,85,,percent of total billed charges,,4259.39,16185.66,
FACE & NECK WRAP UNIVERSAL,30187408,CDM,,,270,RC,outpatient,,299.63,299.63,,254.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.91,22,,percent of total billed charges,,,,,,,,,269.67,90,,percent of total billed charges,,,248.09,82.8,,percent of total billed charges,,,254.69,85,,percent of total billed charges,,,,,,,,,263.67,88,,percent of total billed charges,,,,,,,,,228.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.91,22,,percent of total billed charges,,,272.66,91,,percent of total billed charges,,,284.65,95,,percent of total billed charges,,,248.69,83,,percent of total billed charges,,,248.69,83,,percent of total billed charges,,,,,,,,,,,,,,,248.69,83,,percent of total billed charges,,,284.65,95,,percent of total billed charges,,,269.67,90,,percent of total billed charges,,,269.67,90,,percent of total billed charges,,,245.7,82,,percent of total billed charges,,,269.67,90,,percent of total billed charges,,,254.69,85,,percent of total billed charges,,74.91,284.65,
SPLINT FINGER 4-PRONG LARGE,30187409,CDM,,,270,RC,outpatient,,6.3,6.3,,5.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.58,22,,percent of total billed charges,,,,,,,,,5.67,90,,percent of total billed charges,,,5.22,82.8,,percent of total billed charges,,,5.36,85,,percent of total billed charges,,,,,,,,,5.54,88,,percent of total billed charges,,,,,,,,,4.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.58,22,,percent of total billed charges,,,5.73,91,,percent of total billed charges,,,5.99,95,,percent of total billed charges,,,5.23,83,,percent of total billed charges,,,5.23,83,,percent of total billed charges,,,,,,,,,,,,,,,5.23,83,,percent of total billed charges,,,5.99,95,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.17,82,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.36,85,,percent of total billed charges,,1.58,5.99,
SPLINT FINGER 4-PRONG SMALL,30187410,CDM,,,270,RC,outpatient,,6.3,6.3,,5.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.58,22,,percent of total billed charges,,,,,,,,,5.67,90,,percent of total billed charges,,,5.22,82.8,,percent of total billed charges,,,5.36,85,,percent of total billed charges,,,,,,,,,5.54,88,,percent of total billed charges,,,,,,,,,4.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.58,22,,percent of total billed charges,,,5.73,91,,percent of total billed charges,,,5.99,95,,percent of total billed charges,,,5.23,83,,percent of total billed charges,,,5.23,83,,percent of total billed charges,,,,,,,,,,,,,,,5.23,83,,percent of total billed charges,,,5.99,95,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.17,82,,percent of total billed charges,,,5.67,90,,percent of total billed charges,,,5.36,85,,percent of total billed charges,,1.58,5.99,
S&N ENDOBUTTON 20MM,30187411,CDM,,,270,RC,outpatient,,2207.34,2207.34,,1874.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,551.84,22,,percent of total billed charges,,,,,,,,,1986.61,90,,percent of total billed charges,,,1827.68,82.8,,percent of total billed charges,,,1876.24,85,,percent of total billed charges,,,,,,,,,1942.46,88,,percent of total billed charges,,,,,,,,,1686.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,551.84,22,,percent of total billed charges,,,2008.68,91,,percent of total billed charges,,,2096.97,95,,percent of total billed charges,,,1832.09,83,,percent of total billed charges,,,1832.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1832.09,83,,percent of total billed charges,,,2096.97,95,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1810.02,82,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1876.24,85,,percent of total billed charges,,551.84,2096.97,
S&N TRAY RENTAL GRAFTMASTER,30187412,CDM,,,270,RC,outpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1218.75,22,,percent of total billed charges,,,,,,,,,4387.5,90,,percent of total billed charges,,,4036.5,82.8,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1218.75,22,,percent of total billed charges,,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,1218.75,4631.25,
S&N SCREW INTERFERENCE 8X25,30187413,CDM,,,270,RC,outpatient,,4091.95,4091.95,,3474.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1022.99,22,,percent of total billed charges,,,,,,,,,3682.76,90,,percent of total billed charges,,,3388.13,82.8,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,,,,,,,,3600.92,88,,percent of total billed charges,,,,,,,,,3126.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1022.99,22,,percent of total billed charges,,,3723.67,91,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3396.32,83,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3355.4,82,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,1022.99,3887.35,
ZIMMER COMP SIGNATURE GUIDES,30187414,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
ZIMMER STEM HUMERAL MINI 12MM,30187415,CDM,,,278,RC,outpatient,,46020,46020,,39070.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11505,22,,percent of total billed charges,,,,,,,,,41418,90,,percent of total billed charges,,,38104.56,82.8,,percent of total billed charges,,,39117,85,,percent of total billed charges,,,,,,,,,40497.6,88,,percent of total billed charges,,,,,,,,,35159.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11505,22,,percent of total billed charges,,,41878.2,91,,percent of total billed charges,,,43719,95,,percent of total billed charges,,,38196.6,83,,percent of total billed charges,,,38196.6,83,,percent of total billed charges,,,,,,,,,,,,,,,38196.6,83,,percent of total billed charges,,,43719,95,,percent of total billed charges,,,41418,90,,percent of total billed charges,,,41418,90,,percent of total billed charges,,,37736.4,82,,percent of total billed charges,,,41418,90,,percent of total billed charges,,,39117,85,,percent of total billed charges,,11505,43719,
ZIMMER SCREW RVS 6.5 X 25MM,30187416,CDM,,,278,RC,outpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,455,22,,percent of total billed charges,,,,,,,,,1638,90,,percent of total billed charges,,,1506.96,82.8,,percent of total billed charges,,,1547,85,,percent of total billed charges,,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,455,22,,percent of total billed charges,,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,455,1729,
ZIMMER BEARING HUMERAL +3M 366MM,30187417,CDM,,,278,RC,outpatient,,17680,17680,,15010.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4420,22,,percent of total billed charges,,,,,,,,,15912,90,,percent of total billed charges,,,14639.04,82.8,,percent of total billed charges,,,15028,85,,percent of total billed charges,,,,,,,,,15558.4,88,,percent of total billed charges,,,,,,,,,13507.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4420,22,,percent of total billed charges,,,16088.8,91,,percent of total billed charges,,,16796,95,,percent of total billed charges,,,14674.4,83,,percent of total billed charges,,,14674.4,83,,percent of total billed charges,,,,,,,,,,,,,,,14674.4,83,,percent of total billed charges,,,16796,95,,percent of total billed charges,,,15912,90,,percent of total billed charges,,,15912,90,,percent of total billed charges,,,14497.6,82,,percent of total billed charges,,,15912,90,,percent of total billed charges,,,15028,85,,percent of total billed charges,,4420,16796,
ZIMMER TRAY HUMERAL STD,30187418,CDM,,,278,RC,outpatient,,10725,10725,,9105.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2681.25,22,,percent of total billed charges,,,,,,,,,9652.5,90,,percent of total billed charges,,,8880.3,82.8,,percent of total billed charges,,,9116.25,85,,percent of total billed charges,,,,,,,,,9438,88,,percent of total billed charges,,,,,,,,,8193.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2681.25,22,,percent of total billed charges,,,9759.75,91,,percent of total billed charges,,,10188.75,95,,percent of total billed charges,,,8901.75,83,,percent of total billed charges,,,8901.75,83,,percent of total billed charges,,,,,,,,,,,,,,,8901.75,83,,percent of total billed charges,,,10188.75,95,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,8794.5,82,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,9116.25,85,,percent of total billed charges,,2681.25,10188.75,
ZIMMER SCREW LOCKING 4.75 X 30MM,30187419,CDM,,,278,RC,outpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,455,22,,percent of total billed charges,,,,,,,,,1638,90,,percent of total billed charges,,,1506.96,82.8,,percent of total billed charges,,,1547,85,,percent of total billed charges,,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,455,22,,percent of total billed charges,,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,455,1729,
ZIMMER SCREW LOCKING 4.75 X 25MM,30187420,CDM,,,278,RC,outpatient,,1820,1820,,1545.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,455,22,,percent of total billed charges,,,,,,,,,1638,90,,percent of total billed charges,,,1506.96,82.8,,percent of total billed charges,,,1547,85,,percent of total billed charges,,,,,,,,,1601.6,88,,percent of total billed charges,,,,,,,,,1390.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,455,22,,percent of total billed charges,,,1656.2,91,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,1510.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1510.6,83,,percent of total billed charges,,,1729,95,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1492.4,82,,percent of total billed charges,,,1638,90,,percent of total billed charges,,,1547,85,,percent of total billed charges,,455,1729,
ZIMMER GLENOSPHERE STD 36MM,30187421,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
ZIMMER PATELLA VE SZ 29MM,30187422,CDM,,,278,RC,outpatient,,3575,3575,,3035.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,893.75,22,,percent of total billed charges,,,,,,,,,3217.5,90,,percent of total billed charges,,,2960.1,82.8,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,,,,,,,,3146,88,,percent of total billed charges,,,,,,,,,2731.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,893.75,22,,percent of total billed charges,,,3253.25,91,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2967.25,83,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,2931.5,82,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,893.75,3396.25,
ZIMMER TIBIA RIGHT C CEMENTED 5DEG,30187423,CDM,,,278,RC,outpatient,,7587.5,7587.5,,6441.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1896.88,22,,percent of total billed charges,,,,,,,,,6828.75,90,,percent of total billed charges,,,6282.45,82.8,,percent of total billed charges,,,6449.38,85,,percent of total billed charges,,,,,,,,,6677,88,,percent of total billed charges,,,,,,,,,5796.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1896.88,22,,percent of total billed charges,,,6904.63,91,,percent of total billed charges,,,7208.13,95,,percent of total billed charges,,,6297.63,83,,percent of total billed charges,,,6297.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6297.63,83,,percent of total billed charges,,,7208.13,95,,percent of total billed charges,,,6828.75,90,,percent of total billed charges,,,6828.75,90,,percent of total billed charges,,,6221.75,82,,percent of total billed charges,,,6828.75,90,,percent of total billed charges,,,6449.38,85,,percent of total billed charges,,1896.88,7208.13,
ZIMMER FEMUR PSN CR CMT SZ 5 RIGHT,30187424,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
ZIMMER BEARING MC 10MM,30187425,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ARTHREX CARTIFORM DISC 20MM,30187426,CDM,,,278,RC,outpatient,,55250,55250,,46907.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13812.5,22,,percent of total billed charges,,,,,,,,,49725,90,,percent of total billed charges,,,45747,82.8,,percent of total billed charges,,,46962.5,85,,percent of total billed charges,,,,,,,,,48620,88,,percent of total billed charges,,,,,,,,,42211,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13812.5,22,,percent of total billed charges,,,50277.5,91,,percent of total billed charges,,,52487.5,95,,percent of total billed charges,,,45857.5,83,,percent of total billed charges,,,45857.5,83,,percent of total billed charges,,,,,,,,,,,,,,,45857.5,83,,percent of total billed charges,,,52487.5,95,,percent of total billed charges,,,49725,90,,percent of total billed charges,,,49725,90,,percent of total billed charges,,,45305,82,,percent of total billed charges,,,49725,90,,percent of total billed charges,,,46962.5,85,,percent of total billed charges,,13812.5,52487.5,
ARTHREX BIOCARTILAGE 1CC,30187427,CDM,,,278,RC,outpatient,,6370,6370,,5408.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1592.5,22,,percent of total billed charges,,,,,,,,,5733,90,,percent of total billed charges,,,5274.36,82.8,,percent of total billed charges,,,5414.5,85,,percent of total billed charges,,,,,,,,,5605.6,88,,percent of total billed charges,,,,,,,,,4866.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1592.5,22,,percent of total billed charges,,,5796.7,91,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,5287.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5287.1,83,,percent of total billed charges,,,6051.5,95,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5223.4,82,,percent of total billed charges,,,5733,90,,percent of total billed charges,,,5414.5,85,,percent of total billed charges,,1592.5,6051.5,
SYNTHES SCREW TFNA LAG 100MM,30187428,CDM,,,278,RC,outpatient,,8482.5,8482.5,,7201.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2120.63,22,,percent of total billed charges,,,,,,,,,7634.25,90,,percent of total billed charges,,,7023.51,82.8,,percent of total billed charges,,,7210.13,85,,percent of total billed charges,,,,,,,,,7464.6,88,,percent of total billed charges,,,,,,,,,6480.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2120.63,22,,percent of total billed charges,,,7719.08,91,,percent of total billed charges,,,8058.38,95,,percent of total billed charges,,,7040.48,83,,percent of total billed charges,,,7040.48,83,,percent of total billed charges,,,,,,,,,,,,,,,7040.48,83,,percent of total billed charges,,,8058.38,95,,percent of total billed charges,,,7634.25,90,,percent of total billed charges,,,7634.25,90,,percent of total billed charges,,,6955.65,82,,percent of total billed charges,,,7634.25,90,,percent of total billed charges,,,7210.13,85,,percent of total billed charges,,2120.63,8058.38,
SYNTHES TFNA 12MM X 170MM 130DEG RT,30187429,CDM,,,278,RC,outpatient,,19032,19032,,16158.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4758,22,,percent of total billed charges,,,,,,,,,17128.8,90,,percent of total billed charges,,,15758.5,82.8,,percent of total billed charges,,,16177.2,85,,percent of total billed charges,,,,,,,,,16748.16,88,,percent of total billed charges,,,,,,,,,14540.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4758,22,,percent of total billed charges,,,17319.12,91,,percent of total billed charges,,,18080.4,95,,percent of total billed charges,,,15796.56,83,,percent of total billed charges,,,15796.56,83,,percent of total billed charges,,,,,,,,,,,,,,,15796.56,83,,percent of total billed charges,,,18080.4,95,,percent of total billed charges,,,17128.8,90,,percent of total billed charges,,,17128.8,90,,percent of total billed charges,,,15606.24,82,,percent of total billed charges,,,17128.8,90,,percent of total billed charges,,,16177.2,85,,percent of total billed charges,,4758,18080.4,
S&N ANCHOR BIORAPTOR 2.3,30187431,CDM,,,270,RC,outpatient,,2031.58,2031.58,,1724.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,507.9,22,,percent of total billed charges,,,,,,,,,1828.42,90,,percent of total billed charges,,,1682.15,82.8,,percent of total billed charges,,,1726.84,85,,percent of total billed charges,,,,,,,,,1787.79,88,,percent of total billed charges,,,,,,,,,1552.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,507.9,22,,percent of total billed charges,,,1848.74,91,,percent of total billed charges,,,1930,95,,percent of total billed charges,,,1686.21,83,,percent of total billed charges,,,1686.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1686.21,83,,percent of total billed charges,,,1930,95,,percent of total billed charges,,,1828.42,90,,percent of total billed charges,,,1828.42,90,,percent of total billed charges,,,1665.9,82,,percent of total billed charges,,,1828.42,90,,percent of total billed charges,,,1726.84,85,,percent of total billed charges,,507.9,1930,
SYNTHES PLATE NARROW LCP 8H 4.5 X 152MM,30187432,CDM,,,278,RC,outpatient,,6058,6058,,5143.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1514.5,22,,percent of total billed charges,,,,,,,,,5452.2,90,,percent of total billed charges,,,5016.02,82.8,,percent of total billed charges,,,5149.3,85,,percent of total billed charges,,,,,,,,,5331.04,88,,percent of total billed charges,,,,,,,,,4628.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1514.5,22,,percent of total billed charges,,,5512.78,91,,percent of total billed charges,,,5755.1,95,,percent of total billed charges,,,5028.14,83,,percent of total billed charges,,,5028.14,83,,percent of total billed charges,,,,,,,,,,,,,,,5028.14,83,,percent of total billed charges,,,5755.1,95,,percent of total billed charges,,,5452.2,90,,percent of total billed charges,,,5452.2,90,,percent of total billed charges,,,4967.56,82,,percent of total billed charges,,,5452.2,90,,percent of total billed charges,,,5149.3,85,,percent of total billed charges,,1514.5,5755.1,
SYNTHES PLATE PROX HUMERAL 6H 3.5 X 163M,30187433,CDM,,,278,RC,outpatient,,25421.5,25421.5,,21582.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6355.38,22,,percent of total billed charges,,,,,,,,,22879.35,90,,percent of total billed charges,,,21049,82.8,,percent of total billed charges,,,21608.28,85,,percent of total billed charges,,,,,,,,,22370.92,88,,percent of total billed charges,,,,,,,,,19422.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6355.38,22,,percent of total billed charges,,,23133.57,91,,percent of total billed charges,,,24150.43,95,,percent of total billed charges,,,21099.85,83,,percent of total billed charges,,,21099.85,83,,percent of total billed charges,,,,,,,,,,,,,,,21099.85,83,,percent of total billed charges,,,24150.43,95,,percent of total billed charges,,,22879.35,90,,percent of total billed charges,,,22879.35,90,,percent of total billed charges,,,20845.63,82,,percent of total billed charges,,,22879.35,90,,percent of total billed charges,,,21608.28,85,,percent of total billed charges,,6355.38,24150.43,
SYNTHES SCREW CORTEX 4.5 X 28MM,30187434,CDM,,,278,RC,outpatient,,511,511,,433.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.75,22,,percent of total billed charges,,,,,,,,,459.9,90,,percent of total billed charges,,,423.11,82.8,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,,,,,,,,449.68,88,,percent of total billed charges,,,,,,,,,390.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.75,22,,percent of total billed charges,,,465.01,91,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,,,,,,,,,,,,,424.13,83,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,419.02,82,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,127.75,485.45,
STRYKER FEMUR TRIATHLON CR LEFT,30187435,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER BASEPLATE TIBIAL,30187436,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER PATELLA TRIATHLON X3,30187437,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
STRYKER INSERT TRIATHLON CS SZ 3 12MM,30187438,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
SYNTHES SCREW CORTEX S-T 4.5X20MM,30187439,CDM,,,278,RC,outpatient,,511,511,,433.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.75,22,,percent of total billed charges,,,,,,,,,459.9,90,,percent of total billed charges,,,423.11,82.8,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,,,,,,,,449.68,88,,percent of total billed charges,,,,,,,,,390.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.75,22,,percent of total billed charges,,,465.01,91,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,,,,,,,,,,,,,424.13,83,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,419.02,82,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,127.75,485.45,
AGILON SYNTHETIC PUTTY W/COLLOGEN 6CC,30187440,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
ULRICH BOLT ILLIAC 9.0 X 80,30187441,CDM,,,278,RC,outpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2356.25,22,,percent of total billed charges,,,,,,,,,8482.5,90,,percent of total billed charges,,,7803.9,82.8,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2356.25,22,,percent of total billed charges,,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,2356.25,8953.75,
ULRICH ROD TITANIUM 6.0 X 500MM,30187442,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
ULRICH REVISION SET,30187443,CDM,,,278,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
IR DRILL 12MM,30187444,CDM,,,278,RC,outpatient,,2340,2340,,1986.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,585,22,,percent of total billed charges,,,,,,,,,2106,90,,percent of total billed charges,,,1937.52,82.8,,percent of total billed charges,,,1989,85,,percent of total billed charges,,,,,,,,,2059.2,88,,percent of total billed charges,,,,,,,,,1787.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,585,22,,percent of total billed charges,,,2129.4,91,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1942.2,83,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1918.8,82,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1989,85,,percent of total billed charges,,585,2223,
IR SCREW SELF DRILLING VARIABLE 4 X 12MM,30187445,CDM,,,278,RC,outpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,446.88,22,,percent of total billed charges,,,,,,,,,1608.75,90,,percent of total billed charges,,,1480.05,82.8,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,446.88,22,,percent of total billed charges,,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,446.88,1698.13,
DEPUY CAP ALTRX POROUS,30187446,CDM,,,278,RC,outpatient,,38252.5,38252.5,,32476.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9563.13,22,,percent of total billed charges,,,,,,,,,34427.25,90,,percent of total billed charges,,,31673.07,82.8,,percent of total billed charges,,,32514.63,85,,percent of total billed charges,,,,,,,,,33662.2,88,,percent of total billed charges,,,,,,,,,29224.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9563.13,22,,percent of total billed charges,,,34809.78,91,,percent of total billed charges,,,36339.88,95,,percent of total billed charges,,,31749.58,83,,percent of total billed charges,,,31749.58,83,,percent of total billed charges,,,,,,,,,,,,,,,31749.58,83,,percent of total billed charges,,,36339.88,95,,percent of total billed charges,,,34427.25,90,,percent of total billed charges,,,34427.25,90,,percent of total billed charges,,,31367.05,82,,percent of total billed charges,,,34427.25,90,,percent of total billed charges,,,32514.63,85,,percent of total billed charges,,9563.13,36339.88,
LIGASURE EXACT DISSECTOR 20.6MM - 21CM,30187447,CDM,,,270,RC,outpatient,,5556.85,5556.85,,4717.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1389.21,22,,percent of total billed charges,,,,,,,,,5001.17,90,,percent of total billed charges,,,4601.07,82.8,,percent of total billed charges,,,4723.32,85,,percent of total billed charges,,,,,,,,,4890.03,88,,percent of total billed charges,,,,,,,,,4245.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1389.21,22,,percent of total billed charges,,,5056.73,91,,percent of total billed charges,,,5279.01,95,,percent of total billed charges,,,4612.19,83,,percent of total billed charges,,,4612.19,83,,percent of total billed charges,,,,,,,,,,,,,,,4612.19,83,,percent of total billed charges,,,5279.01,95,,percent of total billed charges,,,5001.17,90,,percent of total billed charges,,,5001.17,90,,percent of total billed charges,,,4556.62,82,,percent of total billed charges,,,5001.17,90,,percent of total billed charges,,,4723.32,85,,percent of total billed charges,,1389.21,5279.01,
MERETE KNEE NAIL W/COLLAR 200 X 16MM,30187448,CDM,,,278,RC,outpatient,,17875,17875,,15175.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4468.75,22,,percent of total billed charges,,,,,,,,,16087.5,90,,percent of total billed charges,,,14800.5,82.8,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,,,,,,,,15730,88,,percent of total billed charges,,,,,,,,,13656.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4468.75,22,,percent of total billed charges,,,16266.25,91,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14836.25,83,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,14657.5,82,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,4468.75,16981.25,
MERETE KNEE NAIL W/OUT COLLAR 200 X 18MM,30187449,CDM,,,278,RC,outpatient,,17875,17875,,15175.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4468.75,22,,percent of total billed charges,,,,,,,,,16087.5,90,,percent of total billed charges,,,14800.5,82.8,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,,,,,,,,15730,88,,percent of total billed charges,,,,,,,,,13656.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4468.75,22,,percent of total billed charges,,,16266.25,91,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14836.25,83,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,14657.5,82,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,4468.75,16981.25,
MERETE SCREW INTERLOCKING 5.0 X 30MM,30187450,CDM,,,278,RC,outpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,706.06,22,,percent of total billed charges,,,,,,,,,2541.83,90,,percent of total billed charges,,,2338.48,82.8,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,706.06,22,,percent of total billed charges,,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,706.06,2683.04,
MERETE SCREW INTERLOCKING 5.0 X 32MM,30187451,CDM,,,278,RC,outpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,706.06,22,,percent of total billed charges,,,,,,,,,2541.83,90,,percent of total billed charges,,,2338.48,82.8,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,706.06,22,,percent of total billed charges,,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,706.06,2683.04,
S&N INSERT TIBIAL 8MM SZ 3-4,30187452,CDM,,,278,RC,outpatient,,6855.94,6855.94,,5820.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1713.99,22,,percent of total billed charges,,,,,,,,,6170.35,90,,percent of total billed charges,,,5676.72,82.8,,percent of total billed charges,,,5827.55,85,,percent of total billed charges,,,,,,,,,6033.23,88,,percent of total billed charges,,,,,,,,,5237.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1713.99,22,,percent of total billed charges,,,6238.91,91,,percent of total billed charges,,,6513.14,95,,percent of total billed charges,,,5690.43,83,,percent of total billed charges,,,5690.43,83,,percent of total billed charges,,,,,,,,,,,,,,,5690.43,83,,percent of total billed charges,,,6513.14,95,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,5621.87,82,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,5827.55,85,,percent of total billed charges,,1713.99,6513.14,
S&N BASE TIBIAL RT MED 50MM SZ 4,30187453,CDM,,,278,RC,outpatient,,14631.63,14631.63,,12422.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3657.91,22,,percent of total billed charges,,,,,,,,,13168.47,90,,percent of total billed charges,,,12114.99,82.8,,percent of total billed charges,,,12436.89,85,,percent of total billed charges,,,,,,,,,12875.83,88,,percent of total billed charges,,,,,,,,,11178.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3657.91,22,,percent of total billed charges,,,13314.78,91,,percent of total billed charges,,,13900.05,95,,percent of total billed charges,,,12144.25,83,,percent of total billed charges,,,12144.25,83,,percent of total billed charges,,,,,,,,,,,,,,,12144.25,83,,percent of total billed charges,,,13900.05,95,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,11997.94,82,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,12436.89,85,,percent of total billed charges,,3657.91,13900.05,
S&N FEMORAL COMPONENT RIGHT MED SZ 3,30187454,CDM,,,278,RC,outpatient,,27214.79,27214.79,,23105.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6803.7,22,,percent of total billed charges,,,,,,,,,24493.31,90,,percent of total billed charges,,,22533.85,82.8,,percent of total billed charges,,,23132.57,85,,percent of total billed charges,,,,,,,,,23949.02,88,,percent of total billed charges,,,,,,,,,20792.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6803.7,22,,percent of total billed charges,,,24765.46,91,,percent of total billed charges,,,25854.05,95,,percent of total billed charges,,,22588.28,83,,percent of total billed charges,,,22588.28,83,,percent of total billed charges,,,,,,,,,,,,,,,22588.28,83,,percent of total billed charges,,,25854.05,95,,percent of total billed charges,,,24493.31,90,,percent of total billed charges,,,24493.31,90,,percent of total billed charges,,,22316.13,82,,percent of total billed charges,,,24493.31,90,,percent of total billed charges,,,23132.57,85,,percent of total billed charges,,6803.7,25854.05,
URETHRAL DILATOR TAPERED 6-10FR,30187455,CDM,,,270,RC,outpatient,,863.03,863.03,,732.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,215.76,22,,percent of total billed charges,,,,,,,,,776.73,90,,percent of total billed charges,,,714.59,82.8,,percent of total billed charges,,,733.58,85,,percent of total billed charges,,,,,,,,,759.47,88,,percent of total billed charges,,,,,,,,,659.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,215.76,22,,percent of total billed charges,,,785.36,91,,percent of total billed charges,,,819.88,95,,percent of total billed charges,,,716.31,83,,percent of total billed charges,,,716.31,83,,percent of total billed charges,,,,,,,,,,,,,,,716.31,83,,percent of total billed charges,,,819.88,95,,percent of total billed charges,,,776.73,90,,percent of total billed charges,,,776.73,90,,percent of total billed charges,,,707.68,82,,percent of total billed charges,,,776.73,90,,percent of total billed charges,,,733.58,85,,percent of total billed charges,,215.76,819.88,
ARTHREX DISP. KIT KNOTLESS SUTURETAK OPE,30187456,CDM,,,270,RC,outpatient,,1859,1859,,1578.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,464.75,22,,percent of total billed charges,,,,,,,,,1673.1,90,,percent of total billed charges,,,1539.25,82.8,,percent of total billed charges,,,1580.15,85,,percent of total billed charges,,,,,,,,,1635.92,88,,percent of total billed charges,,,,,,,,,1420.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,464.75,22,,percent of total billed charges,,,1691.69,91,,percent of total billed charges,,,1766.05,95,,percent of total billed charges,,,1542.97,83,,percent of total billed charges,,,1542.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1542.97,83,,percent of total billed charges,,,1766.05,95,,percent of total billed charges,,,1673.1,90,,percent of total billed charges,,,1673.1,90,,percent of total billed charges,,,1524.38,82,,percent of total billed charges,,,1673.1,90,,percent of total billed charges,,,1580.15,85,,percent of total billed charges,,464.75,1766.05,
ARTHREX SCORER CARTIFORM 20MM,30187457,CDM,,,270,RC,outpatient,,1859,1859,,1578.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,464.75,22,,percent of total billed charges,,,,,,,,,1673.1,90,,percent of total billed charges,,,1539.25,82.8,,percent of total billed charges,,,1580.15,85,,percent of total billed charges,,,,,,,,,1635.92,88,,percent of total billed charges,,,,,,,,,1420.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,464.75,22,,percent of total billed charges,,,1691.69,91,,percent of total billed charges,,,1766.05,95,,percent of total billed charges,,,1542.97,83,,percent of total billed charges,,,1542.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1542.97,83,,percent of total billed charges,,,1766.05,95,,percent of total billed charges,,,1673.1,90,,percent of total billed charges,,,1673.1,90,,percent of total billed charges,,,1524.38,82,,percent of total billed charges,,,1673.1,90,,percent of total billed charges,,,1580.15,85,,percent of total billed charges,,464.75,1766.05,
ARTHREX BC KNOTLESS SUTURETAK OPEN REPAI,30187458,CDM,,,270,RC,outpatient,,3952,3952,,3355.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,988,22,,percent of total billed charges,,,,,,,,,3556.8,90,,percent of total billed charges,,,3272.26,82.8,,percent of total billed charges,,,3359.2,85,,percent of total billed charges,,,,,,,,,3477.76,88,,percent of total billed charges,,,,,,,,,3019.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,988,22,,percent of total billed charges,,,3596.32,91,,percent of total billed charges,,,3754.4,95,,percent of total billed charges,,,3280.16,83,,percent of total billed charges,,,3280.16,83,,percent of total billed charges,,,,,,,,,,,,,,,3280.16,83,,percent of total billed charges,,,3754.4,95,,percent of total billed charges,,,3556.8,90,,percent of total billed charges,,,3556.8,90,,percent of total billed charges,,,3240.64,82,,percent of total billed charges,,,3556.8,90,,percent of total billed charges,,,3359.2,85,,percent of total billed charges,,988,3754.4,
ARTHREX MINI BC PUSHLOCK SUTURE ANCHOR,30187459,CDM,,,270,RC,outpatient,,3952,3952,,3355.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,988,22,,percent of total billed charges,,,,,,,,,3556.8,90,,percent of total billed charges,,,3272.26,82.8,,percent of total billed charges,,,3359.2,85,,percent of total billed charges,,,,,,,,,3477.76,88,,percent of total billed charges,,,,,,,,,3019.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,988,22,,percent of total billed charges,,,3596.32,91,,percent of total billed charges,,,3754.4,95,,percent of total billed charges,,,3280.16,83,,percent of total billed charges,,,3280.16,83,,percent of total billed charges,,,,,,,,,,,,,,,3280.16,83,,percent of total billed charges,,,3754.4,95,,percent of total billed charges,,,3556.8,90,,percent of total billed charges,,,3556.8,90,,percent of total billed charges,,,3240.64,82,,percent of total billed charges,,,3556.8,90,,percent of total billed charges,,,3359.2,85,,percent of total billed charges,,988,3754.4,
ZIMMER LINER G7 VIT E +5MM  SIZE D,30187460,CDM,,,278,RC,outpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2551.25,22,,percent of total billed charges,,,,,,,,,9184.5,90,,percent of total billed charges,,,8449.74,82.8,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2551.25,22,,percent of total billed charges,,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,2551.25,9694.75,
DEPUY GLENOSPHERE 38 STD,30187461,CDM,,,278,RC,outpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4954.14,22,,percent of total billed charges,,,,,,,,,17834.9,90,,percent of total billed charges,,,16408.1,82.8,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4954.14,22,,percent of total billed charges,,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,4954.14,18825.72,
ULRICH ROD LORDOSED 6.0 X 50MM,30187463,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ULRICH ROD LORDOSED 6.0 X 45MM,30187464,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ARTHREX ACP KIT SERIES I,30187465,CDM,,,270,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
ARTHREX THROMBINATOR SYSTEM,30187466,CDM,,,270,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
ARTHREX APPLICATOR ASSEMBLY 10CC 1:1,30187467,CDM,,,278,RC,outpatient,,553,553,,469.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,138.25,22,,percent of total billed charges,,,,,,,,,497.7,90,,percent of total billed charges,,,457.88,82.8,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,,,,,,,,486.64,88,,percent of total billed charges,,,,,,,,,422.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,138.25,22,,percent of total billed charges,,,503.23,91,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,,,,,,,,,,,,,458.99,83,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,453.46,82,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,138.25,525.35,
ARTHREX BLENDING CONNECTOR W/MIXER,30187468,CDM,,,278,RC,outpatient,,322.5,322.5,,273.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.63,22,,percent of total billed charges,,,,,,,,,290.25,90,,percent of total billed charges,,,267.03,82.8,,percent of total billed charges,,,274.13,85,,percent of total billed charges,,,,,,,,,283.8,88,,percent of total billed charges,,,,,,,,,246.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.63,22,,percent of total billed charges,,,293.48,91,,percent of total billed charges,,,306.38,95,,percent of total billed charges,,,267.68,83,,percent of total billed charges,,,267.68,83,,percent of total billed charges,,,,,,,,,,,,,,,267.68,83,,percent of total billed charges,,,306.38,95,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,264.45,82,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,274.13,85,,percent of total billed charges,,80.63,306.38,
ZIMMER LINER NEUTRAL G7 36MM D,30187469,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
GORE VBX BALLOON EXPANDABLE 6X59,30187470,CDM,,,270,RC,outpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5807.75,22,,percent of total billed charges,,,,,,,,,20907.9,90,,percent of total billed charges,,,19235.27,82.8,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5807.75,22,,percent of total billed charges,,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,5807.75,22069.45,
GORE VBX BALLOON EXPANDABLE 6X29,30187471,CDM,,,270,RC,outpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5807.75,22,,percent of total billed charges,,,,,,,,,20907.9,90,,percent of total billed charges,,,19235.27,82.8,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5807.75,22,,percent of total billed charges,,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,5807.75,22069.45,
GORE VBX BALLOON EXPANDABLE 7X29,30187472,CDM,,,270,RC,outpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5807.75,22,,percent of total billed charges,,,,,,,,,20907.9,90,,percent of total billed charges,,,19235.27,82.8,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5807.75,22,,percent of total billed charges,,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,5807.75,22069.45,
EVERCROSS BALLOON 5 X 100MM,30187473,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
EVERCROSS BALLOON 7 X 40MM,30187474,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
S&N FEMORAL COMPONENT 6N RIGHT,30187475,CDM,,,278,RC,outpatient,,32523.99,32523.99,,27612.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8131,22,,percent of total billed charges,,,,,,,,,29271.59,90,,percent of total billed charges,,,26929.86,82.8,,percent of total billed charges,,,27645.39,85,,percent of total billed charges,,,,,,,,,28621.11,88,,percent of total billed charges,,,,,,,,,24848.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8131,22,,percent of total billed charges,,,29596.83,91,,percent of total billed charges,,,30897.79,95,,percent of total billed charges,,,26994.91,83,,percent of total billed charges,,,26994.91,83,,percent of total billed charges,,,,,,,,,,,,,,,26994.91,83,,percent of total billed charges,,,30897.79,95,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,26669.67,82,,percent of total billed charges,,,29271.59,90,,percent of total billed charges,,,27645.39,85,,percent of total billed charges,,8131,30897.79,
S&N INSERT SZ 5-6 12MM,30187476,CDM,,,278,RC,outpatient,,16261.96,16261.96,,13806.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4065.49,22,,percent of total billed charges,,,,,,,,,14635.76,90,,percent of total billed charges,,,13464.9,82.8,,percent of total billed charges,,,13822.67,85,,percent of total billed charges,,,,,,,,,14310.52,88,,percent of total billed charges,,,,,,,,,12424.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4065.49,22,,percent of total billed charges,,,14798.38,91,,percent of total billed charges,,,15448.86,95,,percent of total billed charges,,,13497.43,83,,percent of total billed charges,,,13497.43,83,,percent of total billed charges,,,,,,,,,,,,,,,13497.43,83,,percent of total billed charges,,,15448.86,95,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,13334.81,82,,percent of total billed charges,,,14635.76,90,,percent of total billed charges,,,13822.67,85,,percent of total billed charges,,4065.49,15448.86,
AMPLATZ SUPER STIFF STRAIGHT 7 X 180CM,30187477,CDM,,,270,RC,outpatient,,322.5,322.5,,273.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.63,22,,percent of total billed charges,,,,,,,,,290.25,90,,percent of total billed charges,,,267.03,82.8,,percent of total billed charges,,,274.13,85,,percent of total billed charges,,,,,,,,,283.8,88,,percent of total billed charges,,,,,,,,,246.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.63,22,,percent of total billed charges,,,293.48,91,,percent of total billed charges,,,306.38,95,,percent of total billed charges,,,267.68,83,,percent of total billed charges,,,267.68,83,,percent of total billed charges,,,,,,,,,,,,,,,267.68,83,,percent of total billed charges,,,306.38,95,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,264.45,82,,percent of total billed charges,,,290.25,90,,percent of total billed charges,,,274.13,85,,percent of total billed charges,,80.63,306.38,
AMPLATZ SUPER STIFF STRAIGHT 7 X 260CM,30187478,CDM,,,270,RC,outpatient,,337.5,337.5,,286.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.38,22,,percent of total billed charges,,,,,,,,,303.75,90,,percent of total billed charges,,,279.45,82.8,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,,,,,,,,297,88,,percent of total billed charges,,,,,,,,,257.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.38,22,,percent of total billed charges,,,307.13,91,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,280.13,83,,percent of total billed charges,,,,,,,,,,,,,,,280.13,83,,percent of total billed charges,,,320.63,95,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,276.75,82,,percent of total billed charges,,,303.75,90,,percent of total billed charges,,,286.88,85,,percent of total billed charges,,84.38,320.63,
STRYKER TIBIAL BASEPLATE SZ 2,30187479,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER FEMUR TRIATHLON CR #2,30187480,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
ALLOSOURCE FEMORAL STRUT,30187481,CDM,,,278,RC,outpatient,,6357,6357,,5397.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1589.25,22,,percent of total billed charges,,,,,,,,,5721.3,90,,percent of total billed charges,,,5263.6,82.8,,percent of total billed charges,,,5403.45,85,,percent of total billed charges,,,,,,,,,5594.16,88,,percent of total billed charges,,,,,,,,,4856.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1589.25,22,,percent of total billed charges,,,5784.87,91,,percent of total billed charges,,,6039.15,95,,percent of total billed charges,,,5276.31,83,,percent of total billed charges,,,5276.31,83,,percent of total billed charges,,,,,,,,,,,,,,,5276.31,83,,percent of total billed charges,,,6039.15,95,,percent of total billed charges,,,5721.3,90,,percent of total billed charges,,,5721.3,90,,percent of total billed charges,,,5212.74,82,,percent of total billed charges,,,5721.3,90,,percent of total billed charges,,,5403.45,85,,percent of total billed charges,,1589.25,6039.15,
ELECTRODE BIVAP BIPOLAR 22FR,30187482,CDM,,,270,RC,outpatient,,2361.15,2361.15,,2004.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,590.29,22,,percent of total billed charges,,,,,,,,,2125.04,90,,percent of total billed charges,,,1955.03,82.8,,percent of total billed charges,,,2006.98,85,,percent of total billed charges,,,,,,,,,2077.81,88,,percent of total billed charges,,,,,,,,,1803.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,590.29,22,,percent of total billed charges,,,2148.65,91,,percent of total billed charges,,,2243.09,95,,percent of total billed charges,,,1959.75,83,,percent of total billed charges,,,1959.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1959.75,83,,percent of total billed charges,,,2243.09,95,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,1936.14,82,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,2006.98,85,,percent of total billed charges,,590.29,2243.09,
ELECTRODE CUTTING BIPOLAR 26FR,30187483,CDM,,,270,RC,outpatient,,7083.44,7083.44,,6013.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1770.86,22,,percent of total billed charges,,,,,,,,,6375.1,90,,percent of total billed charges,,,5865.09,82.8,,percent of total billed charges,,,6020.92,85,,percent of total billed charges,,,,,,,,,6233.43,88,,percent of total billed charges,,,,,,,,,5411.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1770.86,22,,percent of total billed charges,,,6445.93,91,,percent of total billed charges,,,6729.27,95,,percent of total billed charges,,,5879.26,83,,percent of total billed charges,,,5879.26,83,,percent of total billed charges,,,,,,,,,,,,,,,5879.26,83,,percent of total billed charges,,,6729.27,95,,percent of total billed charges,,,6375.1,90,,percent of total billed charges,,,6375.1,90,,percent of total billed charges,,,5808.42,82,,percent of total billed charges,,,6375.1,90,,percent of total billed charges,,,6020.92,85,,percent of total billed charges,,1770.86,6729.27,
IR PLATE 2 LEVEL 34MM,30187484,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
ULRICH ROD LORDOSED 6.0 X 100MM,30187485,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
IVAS ACCESST CANNULA 11G,30187486,CDM,,,270,RC,outpatient,,498.61,498.61,,423.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.65,22,,percent of total billed charges,,,,,,,,,448.75,90,,percent of total billed charges,,,412.85,82.8,,percent of total billed charges,,,423.82,85,,percent of total billed charges,,,,,,,,,438.78,88,,percent of total billed charges,,,,,,,,,380.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.65,22,,percent of total billed charges,,,453.74,91,,percent of total billed charges,,,473.68,95,,percent of total billed charges,,,413.85,83,,percent of total billed charges,,,413.85,83,,percent of total billed charges,,,,,,,,,,,,,,,413.85,83,,percent of total billed charges,,,473.68,95,,percent of total billed charges,,,448.75,90,,percent of total billed charges,,,448.75,90,,percent of total billed charges,,,408.86,82,,percent of total billed charges,,,448.75,90,,percent of total billed charges,,,423.82,85,,percent of total billed charges,,124.65,473.68,
ULRICH SCREW POLY 5.5 X 40MM,30187487,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH SCREW REDUCTION 5.5 X 40MM,30187488,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
ULRICH SCREW REDUCTION 5.5 X 45MM,30187489,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
ULRICH ROD LORDOSED 5.5 X 70MM,30187490,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ULRICH TAP NON-CANNULATED 4.0,30187491,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
CEMENT PUSHER 5.0MM,30187492,CDM,,,270,RC,outpatient,,495.95,495.95,,421.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.99,22,,percent of total billed charges,,,,,,,,,446.36,90,,percent of total billed charges,,,410.65,82.8,,percent of total billed charges,,,421.56,85,,percent of total billed charges,,,,,,,,,436.44,88,,percent of total billed charges,,,,,,,,,378.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.99,22,,percent of total billed charges,,,451.31,91,,percent of total billed charges,,,471.15,95,,percent of total billed charges,,,411.64,83,,percent of total billed charges,,,411.64,83,,percent of total billed charges,,,,,,,,,,,,,,,411.64,83,,percent of total billed charges,,,471.15,95,,percent of total billed charges,,,446.36,90,,percent of total billed charges,,,446.36,90,,percent of total billed charges,,,406.68,82,,percent of total billed charges,,,446.36,90,,percent of total billed charges,,,421.56,85,,percent of total billed charges,,123.99,471.15,
STRYKER CEMENT SIMPLEX P W/TOBRAMYCIN,30187493,CDM,,,278,RC,outpatient,,2782.33,2782.33,,2362.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,695.58,22,,percent of total billed charges,,,,,,,,,2504.1,90,,percent of total billed charges,,,2303.77,82.8,,percent of total billed charges,,,2364.98,85,,percent of total billed charges,,,,,,,,,2448.45,88,,percent of total billed charges,,,,,,,,,2125.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,695.58,22,,percent of total billed charges,,,2531.92,91,,percent of total billed charges,,,2643.21,95,,percent of total billed charges,,,2309.33,83,,percent of total billed charges,,,2309.33,83,,percent of total billed charges,,,,,,,,,,,,,,,2309.33,83,,percent of total billed charges,,,2643.21,95,,percent of total billed charges,,,2504.1,90,,percent of total billed charges,,,2504.1,90,,percent of total billed charges,,,2281.51,82,,percent of total billed charges,,,2504.1,90,,percent of total billed charges,,,2364.98,85,,percent of total billed charges,,695.58,2643.21,
COOK INTRODUCER 11F 60CM RADIOPAQUE BAND,30187494,CDM,,,270,RC,outpatient,,1982.5,1982.5,,1683.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,495.63,22,,percent of total billed charges,,,,,,,,,1784.25,90,,percent of total billed charges,,,1641.51,82.8,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,,,,,,,,1744.6,88,,percent of total billed charges,,,,,,,,,1514.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,495.63,22,,percent of total billed charges,,,1804.08,91,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1645.48,83,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1625.65,82,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,495.63,1883.38,
CATHETER SOFT-VU ANGIOGRAPHIC 4F 90CM .0,30187495,CDM,,,270,RC,outpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.88,22,,percent of total billed charges,,,,,,,,,222.75,90,,percent of total billed charges,,,204.93,82.8,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.88,22,,percent of total billed charges,,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,61.88,235.13,
CATHETER SOFT-VU ANGIOGRAPHIC 5F 80CM .0,30187496,CDM,,,270,RC,outpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.88,22,,percent of total billed charges,,,,,,,,,222.75,90,,percent of total billed charges,,,204.93,82.8,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.88,22,,percent of total billed charges,,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,61.88,235.13,
CATHETER SOS OMNI 5F 80CM .035,30187497,CDM,,,270,RC,outpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.88,22,,percent of total billed charges,,,,,,,,,222.75,90,,percent of total billed charges,,,204.93,82.8,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.88,22,,percent of total billed charges,,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,61.88,235.13,
S&N HEAD FEMORAL OXI 32MM +0,30187498,CDM,,,278,RC,outpatient,,39292.5,39292.5,,33359.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9823.13,22,,percent of total billed charges,,,,,,,,,35363.25,90,,percent of total billed charges,,,32534.19,82.8,,percent of total billed charges,,,33398.63,85,,percent of total billed charges,,,,,,,,,34577.4,88,,percent of total billed charges,,,,,,,,,30019.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9823.13,22,,percent of total billed charges,,,35756.18,91,,percent of total billed charges,,,37327.88,95,,percent of total billed charges,,,32612.78,83,,percent of total billed charges,,,32612.78,83,,percent of total billed charges,,,,,,,,,,,,,,,32612.78,83,,percent of total billed charges,,,37327.88,95,,percent of total billed charges,,,35363.25,90,,percent of total billed charges,,,35363.25,90,,percent of total billed charges,,,32219.85,82,,percent of total billed charges,,,35363.25,90,,percent of total billed charges,,,33398.63,85,,percent of total billed charges,,9823.13,37327.88,
TERUMO GLIDEWIRE STRAIGHT 260CM,30187499,CDM,,,270,RC,outpatient,,808.5,808.5,,686.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,202.13,22,,percent of total billed charges,,,,,,,,,727.65,90,,percent of total billed charges,,,669.44,82.8,,percent of total billed charges,,,687.23,85,,percent of total billed charges,,,,,,,,,711.48,88,,percent of total billed charges,,,,,,,,,617.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,202.13,22,,percent of total billed charges,,,735.74,91,,percent of total billed charges,,,768.08,95,,percent of total billed charges,,,671.06,83,,percent of total billed charges,,,671.06,83,,percent of total billed charges,,,,,,,,,,,,,,,671.06,83,,percent of total billed charges,,,768.08,95,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,662.97,82,,percent of total billed charges,,,727.65,90,,percent of total billed charges,,,687.23,85,,percent of total billed charges,,202.13,768.08,
TERUMO GLIDECATH ANGLED TAPER 5FR 100CM,30187500,CDM,,,270,RC,outpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.6,22,,percent of total billed charges,,,,,,,,,347.76,90,,percent of total billed charges,,,319.94,82.8,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.6,22,,percent of total billed charges,,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,96.6,367.08,
CATHETER KUMPE  SOFT-VU 5F X 65CM NON BR,30187501,CDM,,,270,RC,outpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.88,22,,percent of total billed charges,,,,,,,,,222.75,90,,percent of total billed charges,,,204.93,82.8,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.88,22,,percent of total billed charges,,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,61.88,235.13,
CATHETER KUMPE  SOFT-VU 5F X 100CM NONBR,30187502,CDM,,,270,RC,outpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.88,22,,percent of total billed charges,,,,,,,,,222.75,90,,percent of total billed charges,,,204.93,82.8,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.88,22,,percent of total billed charges,,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,61.88,235.13,
GUIDEWIRE V-18 CONTROL WIRE 300CM,30187503,CDM,,,270,RC,outpatient,,778.82,778.82,,661.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,194.71,22,,percent of total billed charges,,,,,,,,,700.94,90,,percent of total billed charges,,,644.86,82.8,,percent of total billed charges,,,662,85,,percent of total billed charges,,,,,,,,,685.36,88,,percent of total billed charges,,,,,,,,,595.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,194.71,22,,percent of total billed charges,,,708.73,91,,percent of total billed charges,,,739.88,95,,percent of total billed charges,,,646.42,83,,percent of total billed charges,,,646.42,83,,percent of total billed charges,,,,,,,,,,,,,,,646.42,83,,percent of total billed charges,,,739.88,95,,percent of total billed charges,,,700.94,90,,percent of total billed charges,,,700.94,90,,percent of total billed charges,,,638.63,82,,percent of total billed charges,,,700.94,90,,percent of total billed charges,,,662,85,,percent of total billed charges,,194.71,739.88,
TERUMO GLIDECATH ANGLED TAPER 5FR 65CM,30187504,CDM,,,270,RC,outpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.6,22,,percent of total billed charges,,,,,,,,,347.76,90,,percent of total billed charges,,,319.94,82.8,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.6,22,,percent of total billed charges,,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,96.6,367.08,
TERUMO GLIDECATH STRAIGHT 5F 100CM,30187505,CDM,,,270,RC,outpatient,,577.5,577.5,,490.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,144.38,22,,percent of total billed charges,,,,,,,,,519.75,90,,percent of total billed charges,,,478.17,82.8,,percent of total billed charges,,,490.88,85,,percent of total billed charges,,,,,,,,,508.2,88,,percent of total billed charges,,,,,,,,,441.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,144.38,22,,percent of total billed charges,,,525.53,91,,percent of total billed charges,,,548.63,95,,percent of total billed charges,,,479.33,83,,percent of total billed charges,,,479.33,83,,percent of total billed charges,,,,,,,,,,,,,,,479.33,83,,percent of total billed charges,,,548.63,95,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,473.55,82,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,490.88,85,,percent of total billed charges,,144.38,548.63,
TERUMO GLIDECATH SIMI 5F 100CM,30187506,CDM,,,270,RC,outpatient,,577.5,577.5,,490.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,144.38,22,,percent of total billed charges,,,,,,,,,519.75,90,,percent of total billed charges,,,478.17,82.8,,percent of total billed charges,,,490.88,85,,percent of total billed charges,,,,,,,,,508.2,88,,percent of total billed charges,,,,,,,,,441.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,144.38,22,,percent of total billed charges,,,525.53,91,,percent of total billed charges,,,548.63,95,,percent of total billed charges,,,479.33,83,,percent of total billed charges,,,479.33,83,,percent of total billed charges,,,,,,,,,,,,,,,479.33,83,,percent of total billed charges,,,548.63,95,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,473.55,82,,percent of total billed charges,,,519.75,90,,percent of total billed charges,,,490.88,85,,percent of total billed charges,,144.38,548.63,
TERUMO GLIDECATH SIM2 5F 100CM,30187507,CDM,,,270,RC,outpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.6,22,,percent of total billed charges,,,,,,,,,347.76,90,,percent of total billed charges,,,319.94,82.8,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.6,22,,percent of total billed charges,,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,96.6,367.08,
TERUMO GLIDEWIRE ANGLED 0.035X180CM,30187508,CDM,,,270,RC,outpatient,,1501.5,1501.5,,1274.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375.38,22,,percent of total billed charges,,,,,,,,,1351.35,90,,percent of total billed charges,,,1243.24,82.8,,percent of total billed charges,,,1276.28,85,,percent of total billed charges,,,,,,,,,1321.32,88,,percent of total billed charges,,,,,,,,,1147.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,375.38,22,,percent of total billed charges,,,1366.37,91,,percent of total billed charges,,,1426.43,95,,percent of total billed charges,,,1246.25,83,,percent of total billed charges,,,1246.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1246.25,83,,percent of total billed charges,,,1426.43,95,,percent of total billed charges,,,1351.35,90,,percent of total billed charges,,,1351.35,90,,percent of total billed charges,,,1231.23,82,,percent of total billed charges,,,1351.35,90,,percent of total billed charges,,,1276.28,85,,percent of total billed charges,,375.38,1426.43,
TERUMO GLIDEWIRE ANGLED 0.035X300XM,30187509,CDM,,,270,RC,outpatient,,1673.75,1673.75,,1421.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,418.44,22,,percent of total billed charges,,,,,,,,,1506.38,90,,percent of total billed charges,,,1385.87,82.8,,percent of total billed charges,,,1422.69,85,,percent of total billed charges,,,,,,,,,1472.9,88,,percent of total billed charges,,,,,,,,,1278.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,418.44,22,,percent of total billed charges,,,1523.11,91,,percent of total billed charges,,,1590.06,95,,percent of total billed charges,,,1389.21,83,,percent of total billed charges,,,1389.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1389.21,83,,percent of total billed charges,,,1590.06,95,,percent of total billed charges,,,1506.38,90,,percent of total billed charges,,,1506.38,90,,percent of total billed charges,,,1372.48,82,,percent of total billed charges,,,1506.38,90,,percent of total billed charges,,,1422.69,85,,percent of total billed charges,,418.44,1590.06,
ELECTRODE CUTTING BIPOLAR 24-26FR,30187510,CDM,,,270,RC,outpatient,,2361.15,2361.15,,2004.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,590.29,22,,percent of total billed charges,,,,,,,,,2125.04,90,,percent of total billed charges,,,1955.03,82.8,,percent of total billed charges,,,2006.98,85,,percent of total billed charges,,,,,,,,,2077.81,88,,percent of total billed charges,,,,,,,,,1803.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,590.29,22,,percent of total billed charges,,,2148.65,91,,percent of total billed charges,,,2243.09,95,,percent of total billed charges,,,1959.75,83,,percent of total billed charges,,,1959.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1959.75,83,,percent of total billed charges,,,2243.09,95,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,1936.14,82,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,2006.98,85,,percent of total billed charges,,590.29,2243.09,
ELECTRODE CUTTING BIPOLAR 22FR,30187511,CDM,,,270,RC,outpatient,,7083.44,7083.44,,6013.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1770.86,22,,percent of total billed charges,,,,,,,,,6375.1,90,,percent of total billed charges,,,5865.09,82.8,,percent of total billed charges,,,6020.92,85,,percent of total billed charges,,,,,,,,,6233.43,88,,percent of total billed charges,,,,,,,,,5411.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1770.86,22,,percent of total billed charges,,,6445.93,91,,percent of total billed charges,,,6729.27,95,,percent of total billed charges,,,5879.26,83,,percent of total billed charges,,,5879.26,83,,percent of total billed charges,,,,,,,,,,,,,,,5879.26,83,,percent of total billed charges,,,6729.27,95,,percent of total billed charges,,,6375.1,90,,percent of total billed charges,,,6375.1,90,,percent of total billed charges,,,5808.42,82,,percent of total billed charges,,,6375.1,90,,percent of total billed charges,,,6020.92,85,,percent of total billed charges,,1770.86,6729.27,
ZIMMER BEARING 14MM MC ASF 8-11 E-F,30187512,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ULRICH BOLT ILLIAC 8.0 X 80MM,30187513,CDM,,,278,RC,outpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2356.25,22,,percent of total billed charges,,,,,,,,,8482.5,90,,percent of total billed charges,,,7803.9,82.8,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2356.25,22,,percent of total billed charges,,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,2356.25,8953.75,
ZIMMER LINER G7 +5MM 36MM E,30187514,CDM,,,278,RC,outpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2551.25,22,,percent of total billed charges,,,,,,,,,9184.5,90,,percent of total billed charges,,,8449.74,82.8,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2551.25,22,,percent of total billed charges,,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,2551.25,9694.75,
GORE VBX BALLOON EXPANDABLE ENDOPROSTHES,30187517,CDM,,,270,RC,outpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5807.75,22,,percent of total billed charges,,,,,,,,,20907.9,90,,percent of total billed charges,,,19235.27,82.8,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5807.75,22,,percent of total billed charges,,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,5807.75,22069.45,
GORE VBX BALLOON EXPANDABLE ENDOPROSTHES,30187518,CDM,,,270,RC,outpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5807.75,22,,percent of total billed charges,,,,,,,,,20907.9,90,,percent of total billed charges,,,19235.27,82.8,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5807.75,22,,percent of total billed charges,,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,5807.75,22069.45,
EVERCROSS BALLOON EV3,30187519,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
MEDTRONIC INPACK ADMIRAL 6MM X 60MM X 13,30187520,CDM,,,270,RC,outpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2421.25,22,,percent of total billed charges,,,,,,,,,8716.5,90,,percent of total billed charges,,,8019.18,82.8,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2421.25,22,,percent of total billed charges,,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,2421.25,9200.75,
IR SCREW REDUCTION 6.5 X 50MM,30187521,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
DEPUY TIBIA BASE RP SZ 4,30187522,CDM,,,278,RC,outpatient,,39503.36,39503.36,,33538.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9875.84,22,,percent of total billed charges,,,,,,,,,35553.02,90,,percent of total billed charges,,,32708.78,82.8,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,,,,,,,,34762.96,88,,percent of total billed charges,,,,,,,,,30180.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9875.84,22,,percent of total billed charges,,,35948.06,91,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,32787.79,83,,percent of total billed charges,,,,,,,,,,,,,,,32787.79,83,,percent of total billed charges,,,37528.19,95,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,32392.76,82,,percent of total billed charges,,,35553.02,90,,percent of total billed charges,,,33577.86,85,,percent of total billed charges,,9875.84,37528.19,
DEPUY TIBIA AUGMENT UNIV. 5MM,30187523,CDM,,,278,RC,outpatient,,10997.61,10997.61,,9336.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2749.4,22,,percent of total billed charges,,,,,,,,,9897.85,90,,percent of total billed charges,,,9106.02,82.8,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,,,,,,,,9677.9,88,,percent of total billed charges,,,,,,,,,8402.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2749.4,22,,percent of total billed charges,,,10007.83,91,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,,,,,,,,,,,,,9128.02,83,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9018.04,82,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,2749.4,10447.73,
DEPUY ATTUNE STEM PRESSFIT 14 X 60,30187524,CDM,,,278,RC,outpatient,,13175.11,13175.11,,11185.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3293.78,22,,percent of total billed charges,,,,,,,,,11857.6,90,,percent of total billed charges,,,10908.99,82.8,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,,,,,,,,11594.1,88,,percent of total billed charges,,,,,,,,,10065.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3293.78,22,,percent of total billed charges,,,11989.35,91,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,,,,,,,,,,,,,10935.34,83,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,10803.59,82,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,3293.78,12516.35,
DEPUY ATTUNE INSERT PS RP SZ5 12MM,30187525,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
S&N INSERTER TAPERED HOLD COVER,30187526,CDM,,,270,RC,outpatient,,392.7,392.7,,333.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.18,22,,percent of total billed charges,,,,,,,,,353.43,90,,percent of total billed charges,,,325.16,82.8,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,,,,,,,,345.58,88,,percent of total billed charges,,,,,,,,,300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.18,22,,percent of total billed charges,,,357.36,91,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,325.94,83,,percent of total billed charges,,,,,,,,,,,,,,,325.94,83,,percent of total billed charges,,,373.07,95,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,322.01,82,,percent of total billed charges,,,353.43,90,,percent of total billed charges,,,333.8,85,,percent of total billed charges,,98.18,373.07,
S&N FLEXIBLE DRILL 35MM,30187527,CDM,,,270,RC,outpatient,,2853.5,2853.5,,2422.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,713.38,22,,percent of total billed charges,,,,,,,,,2568.15,90,,percent of total billed charges,,,2362.7,82.8,,percent of total billed charges,,,2425.48,85,,percent of total billed charges,,,,,,,,,2511.08,88,,percent of total billed charges,,,,,,,,,2180.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,713.38,22,,percent of total billed charges,,,2596.69,91,,percent of total billed charges,,,2710.83,95,,percent of total billed charges,,,2368.41,83,,percent of total billed charges,,,2368.41,83,,percent of total billed charges,,,,,,,,,,,,,,,2368.41,83,,percent of total billed charges,,,2710.83,95,,percent of total billed charges,,,2568.15,90,,percent of total billed charges,,,2568.15,90,,percent of total billed charges,,,2339.87,82,,percent of total billed charges,,,2568.15,90,,percent of total billed charges,,,2425.48,85,,percent of total billed charges,,713.38,2710.83,
S&N SHELL 3 HOLE 56MM OD,30187528,CDM,,,278,RC,outpatient,,32402.5,32402.5,,27509.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8100.63,22,,percent of total billed charges,,,,,,,,,29162.25,90,,percent of total billed charges,,,26829.27,82.8,,percent of total billed charges,,,27542.13,85,,percent of total billed charges,,,,,,,,,28514.2,88,,percent of total billed charges,,,,,,,,,24755.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8100.63,22,,percent of total billed charges,,,29486.28,91,,percent of total billed charges,,,30782.38,95,,percent of total billed charges,,,26894.08,83,,percent of total billed charges,,,26894.08,83,,percent of total billed charges,,,,,,,,,,,,,,,26894.08,83,,percent of total billed charges,,,30782.38,95,,percent of total billed charges,,,29162.25,90,,percent of total billed charges,,,29162.25,90,,percent of total billed charges,,,26570.05,82,,percent of total billed charges,,,29162.25,90,,percent of total billed charges,,,27542.13,85,,percent of total billed charges,,8100.63,30782.38,
S&N SCREW HOLE COVER,30187529,CDM,,,270,RC,outpatient,,763,763,,647.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,190.75,22,,percent of total billed charges,,,,,,,,,686.7,90,,percent of total billed charges,,,631.76,82.8,,percent of total billed charges,,,648.55,85,,percent of total billed charges,,,,,,,,,671.44,88,,percent of total billed charges,,,,,,,,,582.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,190.75,22,,percent of total billed charges,,,694.33,91,,percent of total billed charges,,,724.85,95,,percent of total billed charges,,,633.29,83,,percent of total billed charges,,,633.29,83,,percent of total billed charges,,,,,,,,,,,,,,,633.29,83,,percent of total billed charges,,,724.85,95,,percent of total billed charges,,,686.7,90,,percent of total billed charges,,,686.7,90,,percent of total billed charges,,,625.66,82,,percent of total billed charges,,,686.7,90,,percent of total billed charges,,,648.55,85,,percent of total billed charges,,190.75,724.85,
S&N SCREW HEAD CANCELLOUS 35MM,30187530,CDM,,,278,RC,outpatient,,2450.5,2450.5,,2080.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,612.63,22,,percent of total billed charges,,,,,,,,,2205.45,90,,percent of total billed charges,,,2029.01,82.8,,percent of total billed charges,,,2082.93,85,,percent of total billed charges,,,,,,,,,2156.44,88,,percent of total billed charges,,,,,,,,,1872.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,612.63,22,,percent of total billed charges,,,2229.96,91,,percent of total billed charges,,,2327.98,95,,percent of total billed charges,,,2033.92,83,,percent of total billed charges,,,2033.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2033.92,83,,percent of total billed charges,,,2327.98,95,,percent of total billed charges,,,2205.45,90,,percent of total billed charges,,,2205.45,90,,percent of total billed charges,,,2009.41,82,,percent of total billed charges,,,2205.45,90,,percent of total billed charges,,,2082.93,85,,percent of total billed charges,,612.63,2327.98,
S&N INSERT DUAL MOBILITY 28/44MM,30187531,CDM,,,278,RC,outpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2437.5,22,,percent of total billed charges,,,,,,,,,8775,90,,percent of total billed charges,,,8073,82.8,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2437.5,22,,percent of total billed charges,,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,2437.5,9262.5,
S&N LINER DUAL MOBILITY 44/56MM,30187532,CDM,,,278,RC,outpatient,,13000,13000,,11037,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3250,22,,percent of total billed charges,,,,,,,,,11700,90,,percent of total billed charges,,,10764,82.8,,percent of total billed charges,,,11050,85,,percent of total billed charges,,,,,,,,,11440,88,,percent of total billed charges,,,,,,,,,9932,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3250,22,,percent of total billed charges,,,11830,91,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,,,,,,,,,,,,,10790,83,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,10660,82,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11050,85,,percent of total billed charges,,3250,12350,
S&N HEAD FEMORAL 14/16 28MM +4,30187533,CDM,,,278,RC,outpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2437.5,22,,percent of total billed charges,,,,,,,,,8775,90,,percent of total billed charges,,,8073,82.8,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2437.5,22,,percent of total billed charges,,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,2437.5,9262.5,
ULRICH ROD LORDOSED 6.0 X 110,30187534,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
S&N STEM PRESSFIT STRAIGHT 20 X 160MM,30187535,CDM,,,278,RC,outpatient,,13193.51,13193.51,,11201.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3298.38,22,,percent of total billed charges,,,,,,,,,11874.16,90,,percent of total billed charges,,,10924.23,82.8,,percent of total billed charges,,,11214.48,85,,percent of total billed charges,,,,,,,,,11610.29,88,,percent of total billed charges,,,,,,,,,10079.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3298.38,22,,percent of total billed charges,,,12006.09,91,,percent of total billed charges,,,12533.83,95,,percent of total billed charges,,,10950.61,83,,percent of total billed charges,,,10950.61,83,,percent of total billed charges,,,,,,,,,,,,,,,10950.61,83,,percent of total billed charges,,,12533.83,95,,percent of total billed charges,,,11874.16,90,,percent of total billed charges,,,11874.16,90,,percent of total billed charges,,,10818.68,82,,percent of total billed charges,,,11874.16,90,,percent of total billed charges,,,11214.48,85,,percent of total billed charges,,3298.38,12533.83,
S&N INSERT ARTICULAR SZ 7-8 11MM,30187536,CDM,,,278,RC,outpatient,,22070.88,22070.88,,18738.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5517.72,22,,percent of total billed charges,,,,,,,,,19863.79,90,,percent of total billed charges,,,18274.69,82.8,,percent of total billed charges,,,18760.25,85,,percent of total billed charges,,,,,,,,,19422.37,88,,percent of total billed charges,,,,,,,,,16862.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5517.72,22,,percent of total billed charges,,,20084.5,91,,percent of total billed charges,,,20967.34,95,,percent of total billed charges,,,18318.83,83,,percent of total billed charges,,,18318.83,83,,percent of total billed charges,,,,,,,,,,,,,,,18318.83,83,,percent of total billed charges,,,20967.34,95,,percent of total billed charges,,,19863.79,90,,percent of total billed charges,,,19863.79,90,,percent of total billed charges,,,18098.12,82,,percent of total billed charges,,,19863.79,90,,percent of total billed charges,,,18760.25,85,,percent of total billed charges,,5517.72,20967.34,
S&N SCREW-ON TIBIAL WEDGE 5MM,30187537,CDM,,,278,RC,outpatient,,14723.54,14723.54,,12500.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3680.89,22,,percent of total billed charges,,,,,,,,,13251.19,90,,percent of total billed charges,,,12191.09,82.8,,percent of total billed charges,,,12515.01,85,,percent of total billed charges,,,,,,,,,12956.72,88,,percent of total billed charges,,,,,,,,,11248.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3680.89,22,,percent of total billed charges,,,13398.42,91,,percent of total billed charges,,,13987.36,95,,percent of total billed charges,,,12220.54,83,,percent of total billed charges,,,12220.54,83,,percent of total billed charges,,,,,,,,,,,,,,,12220.54,83,,percent of total billed charges,,,13987.36,95,,percent of total billed charges,,,13251.19,90,,percent of total billed charges,,,13251.19,90,,percent of total billed charges,,,12073.3,82,,percent of total billed charges,,,13251.19,90,,percent of total billed charges,,,12515.01,85,,percent of total billed charges,,3680.89,13987.36,
S&N STEM PRESSFIT STRAIGHT 18 X 120MM,30187538,CDM,,,278,RC,outpatient,,12842.44,12842.44,,10903.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3210.61,22,,percent of total billed charges,,,,,,,,,11558.2,90,,percent of total billed charges,,,10633.54,82.8,,percent of total billed charges,,,10916.07,85,,percent of total billed charges,,,,,,,,,11301.35,88,,percent of total billed charges,,,,,,,,,9811.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3210.61,22,,percent of total billed charges,,,11686.62,91,,percent of total billed charges,,,12200.32,95,,percent of total billed charges,,,10659.23,83,,percent of total billed charges,,,10659.23,83,,percent of total billed charges,,,,,,,,,,,,,,,10659.23,83,,percent of total billed charges,,,12200.32,95,,percent of total billed charges,,,11558.2,90,,percent of total billed charges,,,11558.2,90,,percent of total billed charges,,,10530.8,82,,percent of total billed charges,,,11558.2,90,,percent of total billed charges,,,10916.07,85,,percent of total billed charges,,3210.61,12200.32,
S&N SCREW-ON FEMORAL L-WEDGE SZ 7,30187539,CDM,,,278,RC,outpatient,,19088.03,19088.03,,16205.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4772.01,22,,percent of total billed charges,,,,,,,,,17179.23,90,,percent of total billed charges,,,15804.89,82.8,,percent of total billed charges,,,16224.83,85,,percent of total billed charges,,,,,,,,,16797.47,88,,percent of total billed charges,,,,,,,,,14583.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4772.01,22,,percent of total billed charges,,,17370.11,91,,percent of total billed charges,,,18133.63,95,,percent of total billed charges,,,15843.06,83,,percent of total billed charges,,,15843.06,83,,percent of total billed charges,,,,,,,,,,,,,,,15843.06,83,,percent of total billed charges,,,18133.63,95,,percent of total billed charges,,,17179.23,90,,percent of total billed charges,,,17179.23,90,,percent of total billed charges,,,15652.18,82,,percent of total billed charges,,,17179.23,90,,percent of total billed charges,,,16224.83,85,,percent of total billed charges,,4772.01,18133.63,
S&N FEMORAL COMPONENT LEFT SZ 7,30187540,CDM,,,278,RC,outpatient,,69403.95,69403.95,,58923.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17350.99,22,,percent of total billed charges,,,,,,,,,62463.56,90,,percent of total billed charges,,,57466.47,82.8,,percent of total billed charges,,,58993.36,85,,percent of total billed charges,,,,,,,,,61075.48,88,,percent of total billed charges,,,,,,,,,53024.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17350.99,22,,percent of total billed charges,,,63157.59,91,,percent of total billed charges,,,65933.75,95,,percent of total billed charges,,,57605.28,83,,percent of total billed charges,,,57605.28,83,,percent of total billed charges,,,,,,,,,,,,,,,57605.28,83,,percent of total billed charges,,,65933.75,95,,percent of total billed charges,,,62463.56,90,,percent of total billed charges,,,62463.56,90,,percent of total billed charges,,,56911.24,82,,percent of total billed charges,,,62463.56,90,,percent of total billed charges,,,58993.36,85,,percent of total billed charges,,17350.99,65933.75,
S&N TIBIAL BASEPLATE LEFT SZ 7,30187541,CDM,,,278,RC,outpatient,,27741.48,27741.48,,23552.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6935.37,22,,percent of total billed charges,,,,,,,,,24967.33,90,,percent of total billed charges,,,22969.95,82.8,,percent of total billed charges,,,23580.26,85,,percent of total billed charges,,,,,,,,,24412.5,88,,percent of total billed charges,,,,,,,,,21194.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6935.37,22,,percent of total billed charges,,,25244.75,91,,percent of total billed charges,,,26354.41,95,,percent of total billed charges,,,23025.43,83,,percent of total billed charges,,,23025.43,83,,percent of total billed charges,,,,,,,,,,,,,,,23025.43,83,,percent of total billed charges,,,26354.41,95,,percent of total billed charges,,,24967.33,90,,percent of total billed charges,,,24967.33,90,,percent of total billed charges,,,22748.01,82,,percent of total billed charges,,,24967.33,90,,percent of total billed charges,,,23580.26,85,,percent of total billed charges,,6935.37,26354.41,
S&N SCREW-ON TIBIAL WEDGE 5MM,30187542,CDM,,,278,RC,outpatient,,14723.54,14723.54,,12500.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3680.89,22,,percent of total billed charges,,,,,,,,,13251.19,90,,percent of total billed charges,,,12191.09,82.8,,percent of total billed charges,,,12515.01,85,,percent of total billed charges,,,,,,,,,12956.72,88,,percent of total billed charges,,,,,,,,,11248.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3680.89,22,,percent of total billed charges,,,13398.42,91,,percent of total billed charges,,,13987.36,95,,percent of total billed charges,,,12220.54,83,,percent of total billed charges,,,12220.54,83,,percent of total billed charges,,,,,,,,,,,,,,,12220.54,83,,percent of total billed charges,,,13987.36,95,,percent of total billed charges,,,13251.19,90,,percent of total billed charges,,,13251.19,90,,percent of total billed charges,,,12073.3,82,,percent of total billed charges,,,13251.19,90,,percent of total billed charges,,,12515.01,85,,percent of total billed charges,,3680.89,13987.36,
STRYKER CUP TRIDENT II PSL,30187544,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
STRYKER LINER TRIDENT X3,30187545,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER STEM ACCOLADE II 4X132,30187546,CDM,,,278,RC,outpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3900,22,,percent of total billed charges,,,,,,,,,14040,90,,percent of total billed charges,,,12916.8,82.8,,percent of total billed charges,,,13260,85,,percent of total billed charges,,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3900,22,,percent of total billed charges,,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,3900,14820,
STRYKER HEAD FEMORAL V40,30187547,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
STRYKER TIBIA BASEPLATE TRIATHLON,30187548,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER INSERT CS #2 9MM TRIATHLON,30187549,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
ZIMMER RECIP BLADE 10X70,30187550,CDM,,,278,RC,outpatient,,303.75,303.75,,257.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.94,22,,percent of total billed charges,,,,,,,,,273.38,90,,percent of total billed charges,,,251.51,82.8,,percent of total billed charges,,,258.19,85,,percent of total billed charges,,,,,,,,,267.3,88,,percent of total billed charges,,,,,,,,,232.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.94,22,,percent of total billed charges,,,276.41,91,,percent of total billed charges,,,288.56,95,,percent of total billed charges,,,252.11,83,,percent of total billed charges,,,252.11,83,,percent of total billed charges,,,,,,,,,,,,,,,252.11,83,,percent of total billed charges,,,288.56,95,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,249.08,82,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,258.19,85,,percent of total billed charges,,75.94,288.56,
ZIMMER SAGGITAL  BLADE 13X90,30187551,CDM,,,278,RC,outpatient,,303.75,303.75,,257.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.94,22,,percent of total billed charges,,,,,,,,,273.38,90,,percent of total billed charges,,,251.51,82.8,,percent of total billed charges,,,258.19,85,,percent of total billed charges,,,,,,,,,267.3,88,,percent of total billed charges,,,,,,,,,232.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.94,22,,percent of total billed charges,,,276.41,91,,percent of total billed charges,,,288.56,95,,percent of total billed charges,,,252.11,83,,percent of total billed charges,,,252.11,83,,percent of total billed charges,,,,,,,,,,,,,,,252.11,83,,percent of total billed charges,,,288.56,95,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,249.08,82,,percent of total billed charges,,,273.38,90,,percent of total billed charges,,,258.19,85,,percent of total billed charges,,75.94,288.56,
ZIMMER INSERTER FOR UNI ART SURFACE,30187552,CDM,,,278,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
ZIMMER SCREW MIS HEADED 33MM,30187553,CDM,,,278,RC,outpatient,,535.5,535.5,,454.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,133.88,22,,percent of total billed charges,,,,,,,,,481.95,90,,percent of total billed charges,,,443.39,82.8,,percent of total billed charges,,,455.18,85,,percent of total billed charges,,,,,,,,,471.24,88,,percent of total billed charges,,,,,,,,,409.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,133.88,22,,percent of total billed charges,,,487.31,91,,percent of total billed charges,,,508.73,95,,percent of total billed charges,,,444.47,83,,percent of total billed charges,,,444.47,83,,percent of total billed charges,,,,,,,,,,,,,,,444.47,83,,percent of total billed charges,,,508.73,95,,percent of total billed charges,,,481.95,90,,percent of total billed charges,,,481.95,90,,percent of total billed charges,,,439.11,82,,percent of total billed charges,,,481.95,90,,percent of total billed charges,,,455.18,85,,percent of total billed charges,,133.88,508.73,
ZIMMER FEMUR UNI RT SZ 2,30187554,CDM,,,278,RC,outpatient,,14332.5,14332.5,,12168.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3583.13,22,,percent of total billed charges,,,,,,,,,12899.25,90,,percent of total billed charges,,,11867.31,82.8,,percent of total billed charges,,,12182.63,85,,percent of total billed charges,,,,,,,,,12612.6,88,,percent of total billed charges,,,,,,,,,10950.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3583.13,22,,percent of total billed charges,,,13042.58,91,,percent of total billed charges,,,13615.88,95,,percent of total billed charges,,,11895.98,83,,percent of total billed charges,,,11895.98,83,,percent of total billed charges,,,,,,,,,,,,,,,11895.98,83,,percent of total billed charges,,,13615.88,95,,percent of total billed charges,,,12899.25,90,,percent of total billed charges,,,12899.25,90,,percent of total billed charges,,,11752.65,82,,percent of total billed charges,,,12899.25,90,,percent of total billed charges,,,12182.63,85,,percent of total billed charges,,3583.13,13615.88,
ZIMMER TIBIA UNI RT SZ. D,30187555,CDM,,,278,RC,outpatient,,9555,9555,,8112.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2388.75,22,,percent of total billed charges,,,,,,,,,8599.5,90,,percent of total billed charges,,,7911.54,82.8,,percent of total billed charges,,,8121.75,85,,percent of total billed charges,,,,,,,,,8408.4,88,,percent of total billed charges,,,,,,,,,7300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2388.75,22,,percent of total billed charges,,,8695.05,91,,percent of total billed charges,,,9077.25,95,,percent of total billed charges,,,7930.65,83,,percent of total billed charges,,,7930.65,83,,percent of total billed charges,,,,,,,,,,,,,,,7930.65,83,,percent of total billed charges,,,9077.25,95,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,7835.1,82,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,8121.75,85,,percent of total billed charges,,2388.75,9077.25,
ZIMMER ART SURFACE 9MM SZ. D,30187556,CDM,,,278,RC,outpatient,,8190,8190,,6953.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2047.5,22,,percent of total billed charges,,,,,,,,,7371,90,,percent of total billed charges,,,6781.32,82.8,,percent of total billed charges,,,6961.5,85,,percent of total billed charges,,,,,,,,,7207.2,88,,percent of total billed charges,,,,,,,,,6257.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2047.5,22,,percent of total billed charges,,,7452.9,91,,percent of total billed charges,,,7780.5,95,,percent of total billed charges,,,6797.7,83,,percent of total billed charges,,,6797.7,83,,percent of total billed charges,,,,,,,,,,,,,,,6797.7,83,,percent of total billed charges,,,7780.5,95,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,6715.8,82,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,6961.5,85,,percent of total billed charges,,2047.5,7780.5,
ZIMMER TIBIA UNI LT SZ. D,30187557,CDM,,,278,RC,outpatient,,9555,9555,,8112.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2388.75,22,,percent of total billed charges,,,,,,,,,8599.5,90,,percent of total billed charges,,,7911.54,82.8,,percent of total billed charges,,,8121.75,85,,percent of total billed charges,,,,,,,,,8408.4,88,,percent of total billed charges,,,,,,,,,7300.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2388.75,22,,percent of total billed charges,,,8695.05,91,,percent of total billed charges,,,9077.25,95,,percent of total billed charges,,,7930.65,83,,percent of total billed charges,,,7930.65,83,,percent of total billed charges,,,,,,,,,,,,,,,7930.65,83,,percent of total billed charges,,,9077.25,95,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,7835.1,82,,percent of total billed charges,,,8599.5,90,,percent of total billed charges,,,8121.75,85,,percent of total billed charges,,2388.75,9077.25,
ZIMMER FEMUR UNI LT SZ 2,30187558,CDM,,,278,RC,outpatient,,14332.5,14332.5,,12168.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3583.13,22,,percent of total billed charges,,,,,,,,,12899.25,90,,percent of total billed charges,,,11867.31,82.8,,percent of total billed charges,,,12182.63,85,,percent of total billed charges,,,,,,,,,12612.6,88,,percent of total billed charges,,,,,,,,,10950.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3583.13,22,,percent of total billed charges,,,13042.58,91,,percent of total billed charges,,,13615.88,95,,percent of total billed charges,,,11895.98,83,,percent of total billed charges,,,11895.98,83,,percent of total billed charges,,,,,,,,,,,,,,,11895.98,83,,percent of total billed charges,,,13615.88,95,,percent of total billed charges,,,12899.25,90,,percent of total billed charges,,,12899.25,90,,percent of total billed charges,,,11752.65,82,,percent of total billed charges,,,12899.25,90,,percent of total billed charges,,,12182.63,85,,percent of total billed charges,,3583.13,13615.88,
ZIMMER ART SURFACE 9MM SZ. D LT,30187559,CDM,,,278,RC,outpatient,,8190,8190,,6953.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2047.5,22,,percent of total billed charges,,,,,,,,,7371,90,,percent of total billed charges,,,6781.32,82.8,,percent of total billed charges,,,6961.5,85,,percent of total billed charges,,,,,,,,,7207.2,88,,percent of total billed charges,,,,,,,,,6257.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2047.5,22,,percent of total billed charges,,,7452.9,91,,percent of total billed charges,,,7780.5,95,,percent of total billed charges,,,6797.7,83,,percent of total billed charges,,,6797.7,83,,percent of total billed charges,,,,,,,,,,,,,,,6797.7,83,,percent of total billed charges,,,7780.5,95,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,6715.8,82,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,6961.5,85,,percent of total billed charges,,2047.5,7780.5,
AVAFLEX BALLOON KIT 11G X 20MM,30187560,CDM,,,270,RC,outpatient,,16740.75,16740.75,,14212.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4185.19,22,,percent of total billed charges,,,,,,,,,15066.68,90,,percent of total billed charges,,,13861.34,82.8,,percent of total billed charges,,,14229.64,85,,percent of total billed charges,,,,,,,,,14731.86,88,,percent of total billed charges,,,,,,,,,12789.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4185.19,22,,percent of total billed charges,,,15234.08,91,,percent of total billed charges,,,15903.71,95,,percent of total billed charges,,,13894.82,83,,percent of total billed charges,,,13894.82,83,,percent of total billed charges,,,,,,,,,,,,,,,13894.82,83,,percent of total billed charges,,,15903.71,95,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,13727.42,82,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,14229.64,85,,percent of total billed charges,,4185.19,15903.71,
ULRICH ROD LORDOSED 6.0 X 60,30187561,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ZIMMER FEMUR SZ 6 LEFT CCR,30187562,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
ZIMMER BEARING MC 13MM 6-7E/F,30187563,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
DEPUY ATTUNE TIBIA AUGMENT LM/RL SZ 5/6,30187564,CDM,,,278,RC,outpatient,,10997.61,10997.61,,9336.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2749.4,22,,percent of total billed charges,,,,,,,,,9897.85,90,,percent of total billed charges,,,9106.02,82.8,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,,,,,,,,9677.9,88,,percent of total billed charges,,,,,,,,,8402.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2749.4,22,,percent of total billed charges,,,10007.83,91,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,,,,,,,,,,,,,9128.02,83,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9018.04,82,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,2749.4,10447.73,
DEPUY ATTUNE TIBIA AUGMENT RM/LL SZ 5/6,30187565,CDM,,,278,RC,outpatient,,10997.61,10997.61,,9336.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2749.4,22,,percent of total billed charges,,,,,,,,,9897.85,90,,percent of total billed charges,,,9106.02,82.8,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,,,,,,,,9677.9,88,,percent of total billed charges,,,,,,,,,8402.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2749.4,22,,percent of total billed charges,,,10007.83,91,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,9128.02,83,,percent of total billed charges,,,,,,,,,,,,,,,9128.02,83,,percent of total billed charges,,,10447.73,95,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9018.04,82,,percent of total billed charges,,,9897.85,90,,percent of total billed charges,,,9347.97,85,,percent of total billed charges,,2749.4,10447.73,
ULRICH BOLT ILLIAC 8.0 X 70MM,30187566,CDM,,,278,RC,outpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2356.25,22,,percent of total billed charges,,,,,,,,,8482.5,90,,percent of total billed charges,,,7803.9,82.8,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2356.25,22,,percent of total billed charges,,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,2356.25,8953.75,
ULRICH BOLT ILLIAC 8.0 X 90MM,30187567,CDM,,,278,RC,outpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2356.25,22,,percent of total billed charges,,,,,,,,,8482.5,90,,percent of total billed charges,,,7803.9,82.8,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2356.25,22,,percent of total billed charges,,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,2356.25,8953.75,
ULRICH ROD LORDOSED 6.0 X 80,30187568,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ULRICH WASHER,30187569,CDM,,,278,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
STRYKER SPINEJACK CASE KIT 58MM,30187570,CDM,,,270,RC,outpatient,,27072.5,27072.5,,22984.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6768.13,22,,percent of total billed charges,,,,,,,,,24365.25,90,,percent of total billed charges,,,22416.03,82.8,,percent of total billed charges,,,23011.63,85,,percent of total billed charges,,,,,,,,,23823.8,88,,percent of total billed charges,,,,,,,,,20683.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6768.13,22,,percent of total billed charges,,,24635.98,91,,percent of total billed charges,,,25718.88,95,,percent of total billed charges,,,22470.18,83,,percent of total billed charges,,,22470.18,83,,percent of total billed charges,,,,,,,,,,,,,,,22470.18,83,,percent of total billed charges,,,25718.88,95,,percent of total billed charges,,,24365.25,90,,percent of total billed charges,,,24365.25,90,,percent of total billed charges,,,22199.45,82,,percent of total billed charges,,,24365.25,90,,percent of total billed charges,,,23011.63,85,,percent of total billed charges,,6768.13,25718.88,
MERIT CATHETER ONESTEP 5F 15CM,30187571,CDM,,,270,RC,outpatient,,148,148,,125.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37,22,,percent of total billed charges,,,,,,,,,133.2,90,,percent of total billed charges,,,122.54,82.8,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,,,,,,,,130.24,88,,percent of total billed charges,,,,,,,,,113.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37,22,,percent of total billed charges,,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,,,,,,,,,,,,,122.84,83,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,121.36,82,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,37,140.6,
ZIMMER BEARING MC SZ 10,30187572,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
WRIGHT AM SURGICAL BLADE,30187573,CDM,,,270,RC,outpatient,,7488,7488,,6357.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1872,22,,percent of total billed charges,,,,,,,,,6739.2,90,,percent of total billed charges,,,6200.06,82.8,,percent of total billed charges,,,6364.8,85,,percent of total billed charges,,,,,,,,,6589.44,88,,percent of total billed charges,,,,,,,,,5720.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1872,22,,percent of total billed charges,,,6814.08,91,,percent of total billed charges,,,7113.6,95,,percent of total billed charges,,,6215.04,83,,percent of total billed charges,,,6215.04,83,,percent of total billed charges,,,,,,,,,,,,,,,6215.04,83,,percent of total billed charges,,,7113.6,95,,percent of total billed charges,,,6739.2,90,,percent of total billed charges,,,6739.2,90,,percent of total billed charges,,,6140.16,82,,percent of total billed charges,,,6739.2,90,,percent of total billed charges,,,6364.8,85,,percent of total billed charges,,1872,7113.6,
DEPUY STEM CORAIL KLA SZ18,30187574,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
ALLERGAN INSPIRA BREAST IMPLANT 640CC,30187575,CDM,,,278,RC,outpatient,,6675.5,6675.5,,5667.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1668.88,22,,percent of total billed charges,,,,,,,,,6007.95,90,,percent of total billed charges,,,5527.31,82.8,,percent of total billed charges,,,5674.18,85,,percent of total billed charges,,,,,,,,,5874.44,88,,percent of total billed charges,,,,,,,,,5100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1668.88,22,,percent of total billed charges,,,6074.71,91,,percent of total billed charges,,,6341.73,95,,percent of total billed charges,,,5540.67,83,,percent of total billed charges,,,5540.67,83,,percent of total billed charges,,,,,,,,,,,,,,,5540.67,83,,percent of total billed charges,,,6341.73,95,,percent of total billed charges,,,6007.95,90,,percent of total billed charges,,,6007.95,90,,percent of total billed charges,,,5473.91,82,,percent of total billed charges,,,6007.95,90,,percent of total billed charges,,,5674.18,85,,percent of total billed charges,,1668.88,6341.73,
STRYKER TRIATHLON INSERT TIBIAL SZ 3 CS,30187576,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER TRIATHLON FEMUR #4 RT,30187577,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER PATELLA TRIATHLON X3 S33MM,30187578,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
STRYKER TRIATHLON INSERT TIBIAL SZ 4 CS,30187579,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
ZIMMER FEMUR TITANIUM SZ 9 RIGHT,30187580,CDM,,,278,RC,outpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4875,22,,percent of total billed charges,,,,,,,,,17550,90,,percent of total billed charges,,,16146,82.8,,percent of total billed charges,,,16575,85,,percent of total billed charges,,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4875,22,,percent of total billed charges,,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,4875,18525,
ZIMMER FEMUR CR SZ 10 LEFT,30187581,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
DEPUY STEM CORAIL HIGH COL SZ 14,30187582,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
ARTHREX PEEK SWIVELOCK C 4.75X19.1MM,30187583,CDM,,,270,RC,outpatient,,2437.5,2437.5,,2069.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,609.38,22,,percent of total billed charges,,,,,,,,,2193.75,90,,percent of total billed charges,,,2018.25,82.8,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,,,,,,,,2145,88,,percent of total billed charges,,,,,,,,,1862.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,609.38,22,,percent of total billed charges,,,2218.13,91,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2023.13,83,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,1998.75,82,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,609.38,2315.63,
ARTHREX SCORPION MULTIFIRE NEEDLE,30187584,CDM,,,270,RC,outpatient,,1105,1105,,938.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,276.25,22,,percent of total billed charges,,,,,,,,,994.5,90,,percent of total billed charges,,,914.94,82.8,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,,,,,,,,972.4,88,,percent of total billed charges,,,,,,,,,844.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,276.25,22,,percent of total billed charges,,,1005.55,91,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,917.15,83,,percent of total billed charges,,,,,,,,,,,,,,,917.15,83,,percent of total billed charges,,,1049.75,95,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,906.1,82,,percent of total billed charges,,,994.5,90,,percent of total billed charges,,,939.25,85,,percent of total billed charges,,276.25,1049.75,
ARTHREX PEEK SWIVELOCK 5.5,30187586,CDM,,,270,RC,outpatient,,2437.5,2437.5,,2069.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,609.38,22,,percent of total billed charges,,,,,,,,,2193.75,90,,percent of total billed charges,,,2018.25,82.8,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,,,,,,,,2145,88,,percent of total billed charges,,,,,,,,,1862.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,609.38,22,,percent of total billed charges,,,2218.13,91,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2023.13,83,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,1998.75,82,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,609.38,2315.63,
RELIEVA TRACT BALLOON,30187587,CDM,,,270,RC,outpatient,,4517.5,4517.5,,3835.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1129.38,22,,percent of total billed charges,,,,,,,,,4065.75,90,,percent of total billed charges,,,3740.49,82.8,,percent of total billed charges,,,3839.88,85,,percent of total billed charges,,,,,,,,,3975.4,88,,percent of total billed charges,,,,,,,,,3451.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1129.38,22,,percent of total billed charges,,,4110.93,91,,percent of total billed charges,,,4291.63,95,,percent of total billed charges,,,3749.53,83,,percent of total billed charges,,,3749.53,83,,percent of total billed charges,,,,,,,,,,,,,,,3749.53,83,,percent of total billed charges,,,4291.63,95,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,3704.35,82,,percent of total billed charges,,,4065.75,90,,percent of total billed charges,,,3839.88,85,,percent of total billed charges,,1129.38,4291.63,
ZIMMER TIBIA REVISION SZ H,30187588,CDM,,,278,RC,outpatient,,24033.75,24033.75,,20404.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6008.44,22,,percent of total billed charges,,,,,,,,,21630.38,90,,percent of total billed charges,,,19899.95,82.8,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,,,,,,,,21149.7,88,,percent of total billed charges,,,,,,,,,18361.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6008.44,22,,percent of total billed charges,,,21870.71,91,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,,,,,,,,,,,,,19948.01,83,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,19707.68,82,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,6008.44,22832.06,
ZIMMER AUGMENT TIBIAL 10MM,30187589,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER TIBIAL CONE XS,30187590,CDM,,,278,RC,outpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12075.78,22,,percent of total billed charges,,,,,,,,,43472.82,90,,percent of total billed charges,,,39994.99,82.8,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12075.78,22,,percent of total billed charges,,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,12075.78,45887.97,
ZIMMER FEMUR REVISION 11R,30187591,CDM,,,278,RC,outpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16788.28,22,,percent of total billed charges,,,,,,,,,60437.82,90,,percent of total billed charges,,,55602.79,82.8,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16788.28,22,,percent of total billed charges,,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,16788.28,63795.47,
ZIMMER AUGMENT POSTERIOR 10MM,30187592,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER AUGMENT DISTAL 10MM,30187593,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER AUGMENT DISTAL FEMORAL 15MM,30187594,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER STEM STRAIGHT 20 X135,30187595,CDM,,,278,RC,outpatient,,16258.13,16258.13,,13803.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4064.53,22,,percent of total billed charges,,,,,,,,,14632.32,90,,percent of total billed charges,,,13461.73,82.8,,percent of total billed charges,,,13819.41,85,,percent of total billed charges,,,,,,,,,14307.15,88,,percent of total billed charges,,,,,,,,,12421.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4064.53,22,,percent of total billed charges,,,14794.9,91,,percent of total billed charges,,,15445.22,95,,percent of total billed charges,,,13494.25,83,,percent of total billed charges,,,13494.25,83,,percent of total billed charges,,,,,,,,,,,,,,,13494.25,83,,percent of total billed charges,,,15445.22,95,,percent of total billed charges,,,14632.32,90,,percent of total billed charges,,,14632.32,90,,percent of total billed charges,,,13331.67,82,,percent of total billed charges,,,14632.32,90,,percent of total billed charges,,,13819.41,85,,percent of total billed charges,,4064.53,15445.22,
ZIMMER FEMORAL CONE SM.,30187596,CDM,,,278,RC,outpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12075.78,22,,percent of total billed charges,,,,,,,,,43472.82,90,,percent of total billed charges,,,39994.99,82.8,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12075.78,22,,percent of total billed charges,,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,12075.78,45887.97,
ZIMMER INSERT CPS 10MM,30187597,CDM,,,278,RC,outpatient,,17135.63,17135.63,,14548.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4283.91,22,,percent of total billed charges,,,,,,,,,15422.07,90,,percent of total billed charges,,,14188.3,82.8,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,,,,,,,,15079.35,88,,percent of total billed charges,,,,,,,,,13091.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4283.91,22,,percent of total billed charges,,,15593.42,91,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14222.57,83,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14051.22,82,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,4283.91,16278.85,
SUCTION MALLEABLE 9FR,30187599,CDM,,,270,RC,outpatient,,2015,2015,,1710.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,503.75,22,,percent of total billed charges,,,,,,,,,1813.5,90,,percent of total billed charges,,,1668.42,82.8,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,,,,,,,,1773.2,88,,percent of total billed charges,,,,,,,,,1539.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,503.75,22,,percent of total billed charges,,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1652.3,82,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,503.75,1914.25,
BLADE INF TURB 2.9MM,30187600,CDM,,,270,RC,outpatient,,2401.1,2401.1,,2038.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,600.28,22,,percent of total billed charges,,,,,,,,,2160.99,90,,percent of total billed charges,,,1988.11,82.8,,percent of total billed charges,,,2040.94,85,,percent of total billed charges,,,,,,,,,2112.97,88,,percent of total billed charges,,,,,,,,,1834.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,600.28,22,,percent of total billed charges,,,2185,91,,percent of total billed charges,,,2281.05,95,,percent of total billed charges,,,1992.91,83,,percent of total billed charges,,,1992.91,83,,percent of total billed charges,,,,,,,,,,,,,,,1992.91,83,,percent of total billed charges,,,2281.05,95,,percent of total billed charges,,,2160.99,90,,percent of total billed charges,,,2160.99,90,,percent of total billed charges,,,1968.9,82,,percent of total billed charges,,,2160.99,90,,percent of total billed charges,,,2040.94,85,,percent of total billed charges,,600.28,2281.05,
BUR SEPTO 12DEG. CURVED,30187601,CDM,,,270,RC,outpatient,,1733.36,1733.36,,1471.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,433.34,22,,percent of total billed charges,,,,,,,,,1560.02,90,,percent of total billed charges,,,1435.22,82.8,,percent of total billed charges,,,1473.36,85,,percent of total billed charges,,,,,,,,,1525.36,88,,percent of total billed charges,,,,,,,,,1324.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,433.34,22,,percent of total billed charges,,,1577.36,91,,percent of total billed charges,,,1646.69,95,,percent of total billed charges,,,1438.69,83,,percent of total billed charges,,,1438.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1438.69,83,,percent of total billed charges,,,1646.69,95,,percent of total billed charges,,,1560.02,90,,percent of total billed charges,,,1560.02,90,,percent of total billed charges,,,1421.36,82,,percent of total billed charges,,,1560.02,90,,percent of total billed charges,,,1473.36,85,,percent of total billed charges,,433.34,1646.69,
BLADE NAVIGATION TRICUT 13CM,30187602,CDM,,,270,RC,outpatient,,2502.5,2502.5,,2124.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,625.63,22,,percent of total billed charges,,,,,,,,,2252.25,90,,percent of total billed charges,,,2072.07,82.8,,percent of total billed charges,,,2127.13,85,,percent of total billed charges,,,,,,,,,2202.2,88,,percent of total billed charges,,,,,,,,,1911.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,625.63,22,,percent of total billed charges,,,2277.28,91,,percent of total billed charges,,,2377.38,95,,percent of total billed charges,,,2077.08,83,,percent of total billed charges,,,2077.08,83,,percent of total billed charges,,,,,,,,,,,,,,,2077.08,83,,percent of total billed charges,,,2377.38,95,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2052.05,82,,percent of total billed charges,,,2252.25,90,,percent of total billed charges,,,2127.13,85,,percent of total billed charges,,625.63,2377.38,
IR PLATE 2 LEVEL 30MM,30187603,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
ZIMMER STEM REVISION PSN 14 X 135MM,30187604,CDM,,,278,RC,outpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6126.25,22,,percent of total billed charges,,,,,,,,,22054.5,90,,percent of total billed charges,,,20290.14,82.8,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6126.25,22,,percent of total billed charges,,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,6126.25,23279.75,
ZIMMER AUGMENT TIBIAL LATERAL 10MM,30187605,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER TIBIA REVISION SZ G RIGHT,30187606,CDM,,,278,RC,outpatient,,24033.75,24033.75,,20404.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6008.44,22,,percent of total billed charges,,,,,,,,,21630.38,90,,percent of total billed charges,,,19899.95,82.8,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,,,,,,,,21149.7,88,,percent of total billed charges,,,,,,,,,18361.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6008.44,22,,percent of total billed charges,,,21870.71,91,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,,,,,,,,,,,,,19948.01,83,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,19707.68,82,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,6008.44,22832.06,
S&N SCREW BIOSURE 10X25,30187612,CDM,,,278,RC,outpatient,,4091.95,4091.95,,3474.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1022.99,22,,percent of total billed charges,,,,,,,,,3682.76,90,,percent of total billed charges,,,3388.13,82.8,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,,,,,,,,3600.92,88,,percent of total billed charges,,,,,,,,,3126.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1022.99,22,,percent of total billed charges,,,3723.67,91,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3396.32,83,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3355.4,82,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,1022.99,3887.35,
STRYKER CUP TRIDENT II 54E,30187613,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
STRYKER INSERT TRIDENT 36MM ID,30187614,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER STEM ACCOLADE II SZ. 6,30187615,CDM,,,278,RC,outpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3900,22,,percent of total billed charges,,,,,,,,,14040,90,,percent of total billed charges,,,12916.8,82.8,,percent of total billed charges,,,13260,85,,percent of total billed charges,,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3900,22,,percent of total billed charges,,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,3900,14820,
STRYKER HEAD DETAL CERAMIC 36MM,30187616,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
IR INTERBODY PEEK 8MM 6DEG,30187617,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
IR INTERBODY PEEK 6MM 6DEG,30187618,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
STRYKER SHAVER TOMCAT 4.0,30187619,CDM,,,270,RC,outpatient,,466.27,466.27,,395.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.57,22,,percent of total billed charges,,,,,,,,,419.64,90,,percent of total billed charges,,,386.07,82.8,,percent of total billed charges,,,396.33,85,,percent of total billed charges,,,,,,,,,410.32,88,,percent of total billed charges,,,,,,,,,356.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.57,22,,percent of total billed charges,,,424.31,91,,percent of total billed charges,,,442.96,95,,percent of total billed charges,,,387,83,,percent of total billed charges,,,387,83,,percent of total billed charges,,,,,,,,,,,,,,,387,83,,percent of total billed charges,,,442.96,95,,percent of total billed charges,,,419.64,90,,percent of total billed charges,,,419.64,90,,percent of total billed charges,,,382.34,82,,percent of total billed charges,,,419.64,90,,percent of total billed charges,,,396.33,85,,percent of total billed charges,,116.57,442.96,
ALAMO TIBIALIS TENDON FF 1.05 X 28.9CM,30187620,CDM,,,278,RC,outpatient,,11570,11570,,9822.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2892.5,22,,percent of total billed charges,,,,,,,,,10413,90,,percent of total billed charges,,,9579.96,82.8,,percent of total billed charges,,,9834.5,85,,percent of total billed charges,,,,,,,,,10181.6,88,,percent of total billed charges,,,,,,,,,8839.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2892.5,22,,percent of total billed charges,,,10528.7,91,,percent of total billed charges,,,10991.5,95,,percent of total billed charges,,,9603.1,83,,percent of total billed charges,,,9603.1,83,,percent of total billed charges,,,,,,,,,,,,,,,9603.1,83,,percent of total billed charges,,,10991.5,95,,percent of total billed charges,,,10413,90,,percent of total billed charges,,,10413,90,,percent of total billed charges,,,9487.4,82,,percent of total billed charges,,,10413,90,,percent of total billed charges,,,9834.5,85,,percent of total billed charges,,2892.5,10991.5,
SYNTHES SCREW CORTEX S-T 4.5X18MM,30187621,CDM,,,278,RC,outpatient,,277.28,277.28,,235.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.32,22,,percent of total billed charges,,,,,,,,,249.55,90,,percent of total billed charges,,,229.59,82.8,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,,,,,,,,244.01,88,,percent of total billed charges,,,,,,,,,211.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.32,22,,percent of total billed charges,,,252.32,91,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,,,,,,,,,,,,,230.14,83,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,227.37,82,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,69.32,263.42,
ULRICH ROD LORDOSED 6.0 X 40MM,30187622,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ZIMMER BEARING 10MM 8-11EF,30187623,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
DEPUY TRUMATCH BLOCK,30187625,CDM,,,278,RC,outpatient,,8833.5,8833.5,,7499.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2208.38,22,,percent of total billed charges,,,,,,,,,7950.15,90,,percent of total billed charges,,,7314.14,82.8,,percent of total billed charges,,,7508.48,85,,percent of total billed charges,,,,,,,,,7773.48,88,,percent of total billed charges,,,,,,,,,6748.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2208.38,22,,percent of total billed charges,,,8038.49,91,,percent of total billed charges,,,8391.83,95,,percent of total billed charges,,,7331.81,83,,percent of total billed charges,,,7331.81,83,,percent of total billed charges,,,,,,,,,,,,,,,7331.81,83,,percent of total billed charges,,,8391.83,95,,percent of total billed charges,,,7950.15,90,,percent of total billed charges,,,7950.15,90,,percent of total billed charges,,,7243.47,82,,percent of total billed charges,,,7950.15,90,,percent of total billed charges,,,7508.48,85,,percent of total billed charges,,2208.38,8391.83,
ULRICH BOLT ILIAC 9.0 X 80MM,30187626,CDM,,,278,RC,outpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2356.25,22,,percent of total billed charges,,,,,,,,,8482.5,90,,percent of total billed charges,,,7803.9,82.8,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2356.25,22,,percent of total billed charges,,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,2356.25,8953.75,
SCREW LATERAL MASS 24 X 4.0MM,30187627,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
ROD STRAIGHT 3.5 X 30MM,30187628,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
IR TAP 4.0,30187629,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
IR DRILL BIT 2.5,30187630,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
ARTHREX TRIMANO BEACH CHAIR KIT,30187631,CDM,,,270,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
STENT TRIA SOFT 7F X 24CM,30187632,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
GLIDEWIRE UROLOGIC ANGLED .89MM,30187633,CDM,,,270,RC,outpatient,,404.25,404.25,,343.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.06,22,,percent of total billed charges,,,,,,,,,363.83,90,,percent of total billed charges,,,334.72,82.8,,percent of total billed charges,,,343.61,85,,percent of total billed charges,,,,,,,,,355.74,88,,percent of total billed charges,,,,,,,,,308.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.06,22,,percent of total billed charges,,,367.87,91,,percent of total billed charges,,,384.04,95,,percent of total billed charges,,,335.53,83,,percent of total billed charges,,,335.53,83,,percent of total billed charges,,,,,,,,,,,,,,,335.53,83,,percent of total billed charges,,,384.04,95,,percent of total billed charges,,,363.83,90,,percent of total billed charges,,,363.83,90,,percent of total billed charges,,,331.49,82,,percent of total billed charges,,,363.83,90,,percent of total billed charges,,,343.61,85,,percent of total billed charges,,101.06,384.04,
STRYKER FEMUR TRIATHLON CR RT SZ 6,30187637,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER PATELLA TRIATHLON X3,30187638,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
STRYKER TIBIA BASEPLATE SZ 5,30187639,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER INSERT TRIATHLON CS #5 10MM,30187640,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
DEPUY CEMENTRALIZER 13.0,30187641,CDM,,,270,RC,outpatient,,919.36,919.36,,780.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,229.84,22,,percent of total billed charges,,,,,,,,,827.42,90,,percent of total billed charges,,,761.23,82.8,,percent of total billed charges,,,781.46,85,,percent of total billed charges,,,,,,,,,809.04,88,,percent of total billed charges,,,,,,,,,702.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,229.84,22,,percent of total billed charges,,,836.62,91,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,763.07,83,,percent of total billed charges,,,,,,,,,,,,,,,763.07,83,,percent of total billed charges,,,873.39,95,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,753.88,82,,percent of total billed charges,,,827.42,90,,percent of total billed charges,,,781.46,85,,percent of total billed charges,,229.84,873.39,
BOSTON TUNNEL WC TOOL,30187642,CDM,,,270,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
BOSTON OR CABLE 2X80,30187643,CDM,,,270,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
SYNTHES SCREW EXP 6.35  TI POLY 6X50MM,30187644,CDM,,,278,RC,outpatient,,14449.5,14449.5,,12267.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3612.38,22,,percent of total billed charges,,,,,,,,,13004.55,90,,percent of total billed charges,,,11964.19,82.8,,percent of total billed charges,,,12282.08,85,,percent of total billed charges,,,,,,,,,12715.56,88,,percent of total billed charges,,,,,,,,,11039.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3612.38,22,,percent of total billed charges,,,13149.05,91,,percent of total billed charges,,,13727.03,95,,percent of total billed charges,,,11993.09,83,,percent of total billed charges,,,11993.09,83,,percent of total billed charges,,,,,,,,,,,,,,,11993.09,83,,percent of total billed charges,,,13727.03,95,,percent of total billed charges,,,13004.55,90,,percent of total billed charges,,,13004.55,90,,percent of total billed charges,,,11848.59,82,,percent of total billed charges,,,13004.55,90,,percent of total billed charges,,,12282.08,85,,percent of total billed charges,,3612.38,13727.03,
SYNTHES SCREW EXP 6.35  TI POLY 7X50MM,30187645,CDM,,,278,RC,outpatient,,14449.5,14449.5,,12267.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3612.38,22,,percent of total billed charges,,,,,,,,,13004.55,90,,percent of total billed charges,,,11964.19,82.8,,percent of total billed charges,,,12282.08,85,,percent of total billed charges,,,,,,,,,12715.56,88,,percent of total billed charges,,,,,,,,,11039.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3612.38,22,,percent of total billed charges,,,13149.05,91,,percent of total billed charges,,,13727.03,95,,percent of total billed charges,,,11993.09,83,,percent of total billed charges,,,11993.09,83,,percent of total billed charges,,,,,,,,,,,,,,,11993.09,83,,percent of total billed charges,,,13727.03,95,,percent of total billed charges,,,13004.55,90,,percent of total billed charges,,,13004.55,90,,percent of total billed charges,,,11848.59,82,,percent of total billed charges,,,13004.55,90,,percent of total billed charges,,,12282.08,85,,percent of total billed charges,,3612.38,13727.03,
SYNTHES ROD PRE-LORD TI 45MM,30187646,CDM,,,278,RC,outpatient,,4660.53,4660.53,,3956.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1165.13,22,,percent of total billed charges,,,,,,,,,4194.48,90,,percent of total billed charges,,,3858.92,82.8,,percent of total billed charges,,,3961.45,85,,percent of total billed charges,,,,,,,,,4101.27,88,,percent of total billed charges,,,,,,,,,3560.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1165.13,22,,percent of total billed charges,,,4241.08,91,,percent of total billed charges,,,4427.5,95,,percent of total billed charges,,,3868.24,83,,percent of total billed charges,,,3868.24,83,,percent of total billed charges,,,,,,,,,,,,,,,3868.24,83,,percent of total billed charges,,,4427.5,95,,percent of total billed charges,,,4194.48,90,,percent of total billed charges,,,4194.48,90,,percent of total billed charges,,,3821.63,82,,percent of total billed charges,,,4194.48,90,,percent of total billed charges,,,3961.45,85,,percent of total billed charges,,1165.13,4427.5,
SYNTHES SCREW SET EXP 635 TI SI,30187647,CDM,,,278,RC,outpatient,,2879.5,2879.5,,2444.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,719.88,22,,percent of total billed charges,,,,,,,,,2591.55,90,,percent of total billed charges,,,2384.23,82.8,,percent of total billed charges,,,2447.58,85,,percent of total billed charges,,,,,,,,,2533.96,88,,percent of total billed charges,,,,,,,,,2199.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,719.88,22,,percent of total billed charges,,,2620.35,91,,percent of total billed charges,,,2735.53,95,,percent of total billed charges,,,2389.99,83,,percent of total billed charges,,,2389.99,83,,percent of total billed charges,,,,,,,,,,,,,,,2389.99,83,,percent of total billed charges,,,2735.53,95,,percent of total billed charges,,,2591.55,90,,percent of total billed charges,,,2591.55,90,,percent of total billed charges,,,2361.19,82,,percent of total billed charges,,,2591.55,90,,percent of total billed charges,,,2447.58,85,,percent of total billed charges,,719.88,2735.53,
STRYKER PATELLA TRIATHLON SYMMETRIC X3,30187649,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
STRYKER TIBIA BASEPLATE CEMENTED,30187650,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER FEMUR CR TRIATHLON CEMENTED,30187651,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER INSERT CS #4 10MM,30187652,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER BASEPLATE TIBIAL SZ 3,30187653,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
STRYKER TRIATHLON FEMUR SZ 3 RT,30187654,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER INSERT TRIATHLON CS SZ 3 11MM,30187655,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER TRIATHLON FEMUR #4 LFT,30187656,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER INSERT TRIATHLON CS SZ 3 9MM,30187657,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
PATIENT TRIAL KIT 72,30187658,CDM,,,270,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
ZIMMER BEARING MC 11MM 6-7E/F,30187659,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ZIMMER FEMUR POROUS CR SZ 7 LFT,30187660,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER TIBIA POROUS SZ E LFT,30187661,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER FEMUR POROUS CR SZ 8 RT,30187662,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER TIBIA POROUS SZ E RT,30187663,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
STRYKER STEM ACCOLADE II SZ. 5,30187664,CDM,,,278,RC,outpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3900,22,,percent of total billed charges,,,,,,,,,14040,90,,percent of total billed charges,,,12916.8,82.8,,percent of total billed charges,,,13260,85,,percent of total billed charges,,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3900,22,,percent of total billed charges,,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,3900,14820,
STRYKER HEAD UHR 48X28MM,30187665,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
STRYKER HEAD FEMORAL LFIT 28MM,30187666,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
LAPAROVUE VISIBILITY SYSTEM,30187667,CDM,,,270,RC,outpatient,,286.43,286.43,,243.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.61,22,,percent of total billed charges,,,,,,,,,257.79,90,,percent of total billed charges,,,237.16,82.8,,percent of total billed charges,,,243.47,85,,percent of total billed charges,,,,,,,,,252.06,88,,percent of total billed charges,,,,,,,,,218.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.61,22,,percent of total billed charges,,,260.65,91,,percent of total billed charges,,,272.11,95,,percent of total billed charges,,,237.74,83,,percent of total billed charges,,,237.74,83,,percent of total billed charges,,,,,,,,,,,,,,,237.74,83,,percent of total billed charges,,,272.11,95,,percent of total billed charges,,,257.79,90,,percent of total billed charges,,,257.79,90,,percent of total billed charges,,,234.87,82,,percent of total billed charges,,,257.79,90,,percent of total billed charges,,,243.47,85,,percent of total billed charges,,71.61,272.11,
ELECTRO LUBE ANTI-STICK SOLUTION,30187671,CDM,,,270,RC,outpatient,,223.88,223.88,,190.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.97,22,,percent of total billed charges,,,,,,,,,201.49,90,,percent of total billed charges,,,185.37,82.8,,percent of total billed charges,,,190.3,85,,percent of total billed charges,,,,,,,,,197.01,88,,percent of total billed charges,,,,,,,,,171.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.97,22,,percent of total billed charges,,,203.73,91,,percent of total billed charges,,,212.69,95,,percent of total billed charges,,,185.82,83,,percent of total billed charges,,,185.82,83,,percent of total billed charges,,,,,,,,,,,,,,,185.82,83,,percent of total billed charges,,,212.69,95,,percent of total billed charges,,,201.49,90,,percent of total billed charges,,,201.49,90,,percent of total billed charges,,,183.58,82,,percent of total billed charges,,,201.49,90,,percent of total billed charges,,,190.3,85,,percent of total billed charges,,55.97,212.69,
COOPER KOH-EFFICIENT 2.5CM,30187672,CDM,,,270,RC,outpatient,,912.74,912.74,,774.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,228.19,22,,percent of total billed charges,,,,,,,,,821.47,90,,percent of total billed charges,,,755.75,82.8,,percent of total billed charges,,,775.83,85,,percent of total billed charges,,,,,,,,,803.21,88,,percent of total billed charges,,,,,,,,,697.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,228.19,22,,percent of total billed charges,,,830.59,91,,percent of total billed charges,,,867.1,95,,percent of total billed charges,,,757.57,83,,percent of total billed charges,,,757.57,83,,percent of total billed charges,,,,,,,,,,,,,,,757.57,83,,percent of total billed charges,,,867.1,95,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,748.45,82,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,775.83,85,,percent of total billed charges,,228.19,867.1,
COOPER KOH-EFFICIENT 3.0CM,30187673,CDM,,,270,RC,outpatient,,912.74,912.74,,774.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,228.19,22,,percent of total billed charges,,,,,,,,,821.47,90,,percent of total billed charges,,,755.75,82.8,,percent of total billed charges,,,775.83,85,,percent of total billed charges,,,,,,,,,803.21,88,,percent of total billed charges,,,,,,,,,697.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,228.19,22,,percent of total billed charges,,,830.59,91,,percent of total billed charges,,,867.1,95,,percent of total billed charges,,,757.57,83,,percent of total billed charges,,,757.57,83,,percent of total billed charges,,,,,,,,,,,,,,,757.57,83,,percent of total billed charges,,,867.1,95,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,748.45,82,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,775.83,85,,percent of total billed charges,,228.19,867.1,
COOPER KOH-EFFICIENT 3.5CM,30187674,CDM,,,270,RC,outpatient,,912.74,912.74,,774.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,228.19,22,,percent of total billed charges,,,,,,,,,821.47,90,,percent of total billed charges,,,755.75,82.8,,percent of total billed charges,,,775.83,85,,percent of total billed charges,,,,,,,,,803.21,88,,percent of total billed charges,,,,,,,,,697.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,228.19,22,,percent of total billed charges,,,830.59,91,,percent of total billed charges,,,867.1,95,,percent of total billed charges,,,757.57,83,,percent of total billed charges,,,757.57,83,,percent of total billed charges,,,,,,,,,,,,,,,757.57,83,,percent of total billed charges,,,867.1,95,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,748.45,82,,percent of total billed charges,,,821.47,90,,percent of total billed charges,,,775.83,85,,percent of total billed charges,,228.19,867.1,
COOPER KOH-EFFICIENT 4.0CM,30187675,CDM,,,270,RC,outpatient,,1030.26,1030.26,,874.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,257.57,22,,percent of total billed charges,,,,,,,,,927.23,90,,percent of total billed charges,,,853.06,82.8,,percent of total billed charges,,,875.72,85,,percent of total billed charges,,,,,,,,,906.63,88,,percent of total billed charges,,,,,,,,,787.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,257.57,22,,percent of total billed charges,,,937.54,91,,percent of total billed charges,,,978.75,95,,percent of total billed charges,,,855.12,83,,percent of total billed charges,,,855.12,83,,percent of total billed charges,,,,,,,,,,,,,,,855.12,83,,percent of total billed charges,,,978.75,95,,percent of total billed charges,,,927.23,90,,percent of total billed charges,,,927.23,90,,percent of total billed charges,,,844.81,82,,percent of total billed charges,,,927.23,90,,percent of total billed charges,,,875.72,85,,percent of total billed charges,,257.57,978.75,
COOPER RUMI TIP YELLOW,30187676,CDM,,,270,RC,outpatient,,456.26,456.26,,387.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,114.07,22,,percent of total billed charges,,,,,,,,,410.63,90,,percent of total billed charges,,,377.78,82.8,,percent of total billed charges,,,387.82,85,,percent of total billed charges,,,,,,,,,401.51,88,,percent of total billed charges,,,,,,,,,348.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,114.07,22,,percent of total billed charges,,,415.2,91,,percent of total billed charges,,,433.45,95,,percent of total billed charges,,,378.7,83,,percent of total billed charges,,,378.7,83,,percent of total billed charges,,,,,,,,,,,,,,,378.7,83,,percent of total billed charges,,,433.45,95,,percent of total billed charges,,,410.63,90,,percent of total billed charges,,,410.63,90,,percent of total billed charges,,,374.13,82,,percent of total billed charges,,,410.63,90,,percent of total billed charges,,,387.82,85,,percent of total billed charges,,114.07,433.45,
COOPER RUMI TIP LAVENDER,30187677,CDM,,,270,RC,outpatient,,456.26,456.26,,387.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,114.07,22,,percent of total billed charges,,,,,,,,,410.63,90,,percent of total billed charges,,,377.78,82.8,,percent of total billed charges,,,387.82,85,,percent of total billed charges,,,,,,,,,401.51,88,,percent of total billed charges,,,,,,,,,348.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,114.07,22,,percent of total billed charges,,,415.2,91,,percent of total billed charges,,,433.45,95,,percent of total billed charges,,,378.7,83,,percent of total billed charges,,,378.7,83,,percent of total billed charges,,,,,,,,,,,,,,,378.7,83,,percent of total billed charges,,,433.45,95,,percent of total billed charges,,,410.63,90,,percent of total billed charges,,,410.63,90,,percent of total billed charges,,,374.13,82,,percent of total billed charges,,,410.63,90,,percent of total billed charges,,,387.82,85,,percent of total billed charges,,114.07,433.45,
COOPER RUMI TIP WHITE,30187678,CDM,,,270,RC,outpatient,,479.08,479.08,,406.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.77,22,,percent of total billed charges,,,,,,,,,431.17,90,,percent of total billed charges,,,396.68,82.8,,percent of total billed charges,,,407.22,85,,percent of total billed charges,,,,,,,,,421.59,88,,percent of total billed charges,,,,,,,,,366.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.77,22,,percent of total billed charges,,,435.96,91,,percent of total billed charges,,,455.13,95,,percent of total billed charges,,,397.64,83,,percent of total billed charges,,,397.64,83,,percent of total billed charges,,,,,,,,,,,,,,,397.64,83,,percent of total billed charges,,,455.13,95,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,392.85,82,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,407.22,85,,percent of total billed charges,,119.77,455.13,
COOPER RUMI TIP BLUE,30187679,CDM,,,270,RC,outpatient,,479.08,479.08,,406.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.77,22,,percent of total billed charges,,,,,,,,,431.17,90,,percent of total billed charges,,,396.68,82.8,,percent of total billed charges,,,407.22,85,,percent of total billed charges,,,,,,,,,421.59,88,,percent of total billed charges,,,,,,,,,366.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.77,22,,percent of total billed charges,,,435.96,91,,percent of total billed charges,,,455.13,95,,percent of total billed charges,,,397.64,83,,percent of total billed charges,,,397.64,83,,percent of total billed charges,,,,,,,,,,,,,,,397.64,83,,percent of total billed charges,,,455.13,95,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,392.85,82,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,407.22,85,,percent of total billed charges,,119.77,455.13,
COOPER RUMI TIP GREEN,30187680,CDM,,,270,RC,outpatient,,479.08,479.08,,406.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.77,22,,percent of total billed charges,,,,,,,,,431.17,90,,percent of total billed charges,,,396.68,82.8,,percent of total billed charges,,,407.22,85,,percent of total billed charges,,,,,,,,,421.59,88,,percent of total billed charges,,,,,,,,,366.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.77,22,,percent of total billed charges,,,435.96,91,,percent of total billed charges,,,455.13,95,,percent of total billed charges,,,397.64,83,,percent of total billed charges,,,397.64,83,,percent of total billed charges,,,,,,,,,,,,,,,397.64,83,,percent of total billed charges,,,455.13,95,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,392.85,82,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,407.22,85,,percent of total billed charges,,119.77,455.13,
COOPER RUMI TIP ORANGE,30187681,CDM,,,270,RC,outpatient,,479.08,479.08,,406.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.77,22,,percent of total billed charges,,,,,,,,,431.17,90,,percent of total billed charges,,,396.68,82.8,,percent of total billed charges,,,407.22,85,,percent of total billed charges,,,,,,,,,421.59,88,,percent of total billed charges,,,,,,,,,366.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.77,22,,percent of total billed charges,,,435.96,91,,percent of total billed charges,,,455.13,95,,percent of total billed charges,,,397.64,83,,percent of total billed charges,,,397.64,83,,percent of total billed charges,,,,,,,,,,,,,,,397.64,83,,percent of total billed charges,,,455.13,95,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,392.85,82,,percent of total billed charges,,,431.17,90,,percent of total billed charges,,,407.22,85,,percent of total billed charges,,119.77,455.13,
COOPER GYNECOLOGY KIT,30187682,CDM,,,270,RC,outpatient,,962.72,962.72,,817.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,240.68,22,,percent of total billed charges,,,,,,,,,866.45,90,,percent of total billed charges,,,797.13,82.8,,percent of total billed charges,,,818.31,85,,percent of total billed charges,,,,,,,,,847.19,88,,percent of total billed charges,,,,,,,,,735.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,240.68,22,,percent of total billed charges,,,876.08,91,,percent of total billed charges,,,914.58,95,,percent of total billed charges,,,799.06,83,,percent of total billed charges,,,799.06,83,,percent of total billed charges,,,,,,,,,,,,,,,799.06,83,,percent of total billed charges,,,914.58,95,,percent of total billed charges,,,866.45,90,,percent of total billed charges,,,866.45,90,,percent of total billed charges,,,789.43,82,,percent of total billed charges,,,866.45,90,,percent of total billed charges,,,818.31,85,,percent of total billed charges,,240.68,914.58,
INTUITIVE CANNULA SEAL 5-8MM,30187685,CDM,,,270,RC,outpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36,22,,percent of total billed charges,,,,,,,,,129.6,90,,percent of total billed charges,,,119.23,82.8,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36,22,,percent of total billed charges,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,36,136.8,
INTUITIVE OBTURATOR BLADELESS 8MM,30187686,CDM,,,270,RC,outpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.25,22,,percent of total billed charges,,,,,,,,,202.5,90,,percent of total billed charges,,,186.3,82.8,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.25,22,,percent of total billed charges,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,56.25,213.75,
INTUITIVE TIP COVER ACCESSORY,30187687,CDM,,,270,RC,outpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40,22,,percent of total billed charges,,,,,,,,,144,90,,percent of total billed charges,,,132.48,82.8,,percent of total billed charges,,,136,85,,percent of total billed charges,,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40,22,,percent of total billed charges,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,40,152,
TRI-LUMEN TUBESET W/FILTER,30187688,CDM,,,270,RC,outpatient,,844.97,844.97,,717.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,211.24,22,,percent of total billed charges,,,,,,,,,760.47,90,,percent of total billed charges,,,699.64,82.8,,percent of total billed charges,,,718.22,85,,percent of total billed charges,,,,,,,,,743.57,88,,percent of total billed charges,,,,,,,,,645.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,211.24,22,,percent of total billed charges,,,768.92,91,,percent of total billed charges,,,802.72,95,,percent of total billed charges,,,701.33,83,,percent of total billed charges,,,701.33,83,,percent of total billed charges,,,,,,,,,,,,,,,701.33,83,,percent of total billed charges,,,802.72,95,,percent of total billed charges,,,760.47,90,,percent of total billed charges,,,760.47,90,,percent of total billed charges,,,692.88,82,,percent of total billed charges,,,760.47,90,,percent of total billed charges,,,718.22,85,,percent of total billed charges,,211.24,802.72,
TROCAR 8MM ACCESS PORT AIRSEAL,30187689,CDM,,,270,RC,outpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210,22,,percent of total billed charges,,,,,,,,,756,90,,percent of total billed charges,,,695.52,82.8,,percent of total billed charges,,,714,85,,percent of total billed charges,,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210,22,,percent of total billed charges,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,210,798,
TROCAR 5MM ACCESS PORT AIRSEAL,30187690,CDM,,,270,RC,outpatient,,819,819,,695.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,204.75,22,,percent of total billed charges,,,,,,,,,737.1,90,,percent of total billed charges,,,678.13,82.8,,percent of total billed charges,,,696.15,85,,percent of total billed charges,,,,,,,,,720.72,88,,percent of total billed charges,,,,,,,,,625.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,204.75,22,,percent of total billed charges,,,745.29,91,,percent of total billed charges,,,778.05,95,,percent of total billed charges,,,679.77,83,,percent of total billed charges,,,679.77,83,,percent of total billed charges,,,,,,,,,,,,,,,679.77,83,,percent of total billed charges,,,778.05,95,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,671.58,82,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,696.15,85,,percent of total billed charges,,204.75,778.05,
ARTHREX DRILL 6MM CANNULATED,30187691,CDM,,,270,RC,outpatient,,1092,1092,,927.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,273,22,,percent of total billed charges,,,,,,,,,982.8,90,,percent of total billed charges,,,904.18,82.8,,percent of total billed charges,,,928.2,85,,percent of total billed charges,,,,,,,,,960.96,88,,percent of total billed charges,,,,,,,,,834.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,273,22,,percent of total billed charges,,,993.72,91,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,906.36,83,,percent of total billed charges,,,,,,,,,,,,,,,906.36,83,,percent of total billed charges,,,1037.4,95,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,895.44,82,,percent of total billed charges,,,982.8,90,,percent of total billed charges,,,928.2,85,,percent of total billed charges,,273,1037.4,
ARTHREX PIN GLENOID 2.8MM NITINOL,30187692,CDM,,,278,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
ARTHREX STEM HUMERAL SZ 10,30187693,CDM,,,278,RC,outpatient,,16152.5,16152.5,,13713.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4038.13,22,,percent of total billed charges,,,,,,,,,14537.25,90,,percent of total billed charges,,,13374.27,82.8,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,,,,,,,,14214.2,88,,percent of total billed charges,,,,,,,,,12340.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4038.13,22,,percent of total billed charges,,,14698.78,91,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,,,,,,,,,,,,,13406.58,83,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13245.05,82,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,4038.13,15344.88,
ARTHREX CUP SUTURE 36 +2 RIGHT,30187694,CDM,,,278,RC,outpatient,,11602.5,11602.5,,9850.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2900.63,22,,percent of total billed charges,,,,,,,,,10442.25,90,,percent of total billed charges,,,9606.87,82.8,,percent of total billed charges,,,9862.13,85,,percent of total billed charges,,,,,,,,,10210.2,88,,percent of total billed charges,,,,,,,,,8864.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2900.63,22,,percent of total billed charges,,,10558.28,91,,percent of total billed charges,,,11022.38,95,,percent of total billed charges,,,9630.08,83,,percent of total billed charges,,,9630.08,83,,percent of total billed charges,,,,,,,,,,,,,,,9630.08,83,,percent of total billed charges,,,11022.38,95,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,9514.05,82,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,9862.13,85,,percent of total billed charges,,2900.63,11022.38,
ARTHREX INSERT HUMERAL S/36 +3,30187695,CDM,,,278,RC,outpatient,,6597.5,6597.5,,5601.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1649.38,22,,percent of total billed charges,,,,,,,,,5937.75,90,,percent of total billed charges,,,5462.73,82.8,,percent of total billed charges,,,5607.88,85,,percent of total billed charges,,,,,,,,,5805.8,88,,percent of total billed charges,,,,,,,,,5040.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1649.38,22,,percent of total billed charges,,,6003.73,91,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,,,,,,,,,,,,,5475.93,83,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5409.95,82,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5607.88,85,,percent of total billed charges,,1649.38,6267.63,
ARTHREX SCREW NON-LOCKING 4.5 X 32MM,30187696,CDM,,,278,RC,outpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210,22,,percent of total billed charges,,,,,,,,,756,90,,percent of total billed charges,,,695.52,82.8,,percent of total billed charges,,,714,85,,percent of total billed charges,,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210,22,,percent of total billed charges,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,210,798,
ARTHREX SCREW NON-LOCKING 4.5 X 36MM,30187697,CDM,,,278,RC,outpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210,22,,percent of total billed charges,,,,,,,,,756,90,,percent of total billed charges,,,695.52,82.8,,percent of total billed charges,,,714,85,,percent of total billed charges,,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210,22,,percent of total billed charges,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,210,798,
ARTHREX GLENOSPHERE 36/24,30187698,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
ARTHREX BASEPLATE 24MM FULL AUGMENT +2,30187699,CDM,,,278,RC,outpatient,,20800,20800,,17659.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5200,22,,percent of total billed charges,,,,,,,,,18720,90,,percent of total billed charges,,,17222.4,82.8,,percent of total billed charges,,,17680,85,,percent of total billed charges,,,,,,,,,18304,88,,percent of total billed charges,,,,,,,,,15891.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5200,22,,percent of total billed charges,,,18928,91,,percent of total billed charges,,,19760,95,,percent of total billed charges,,,17264,83,,percent of total billed charges,,,17264,83,,percent of total billed charges,,,,,,,,,,,,,,,17264,83,,percent of total billed charges,,,19760,95,,percent of total billed charges,,,18720,90,,percent of total billed charges,,,18720,90,,percent of total billed charges,,,17056,82,,percent of total billed charges,,,18720,90,,percent of total billed charges,,,17680,85,,percent of total billed charges,,5200,19760,
ARTHREX POST MODULAR 30MM,30187700,CDM,,,278,RC,outpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2356.25,22,,percent of total billed charges,,,,,,,,,8482.5,90,,percent of total billed charges,,,7803.9,82.8,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2356.25,22,,percent of total billed charges,,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,2356.25,8953.75,
ARTHREX PIN SET GLENOID SYSTEM,30187701,CDM,,,278,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
ARTHREX DRILL BIT 3.0MM,30187702,CDM,,,270,RC,outpatient,,1241.5,1241.5,,1054.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,310.38,22,,percent of total billed charges,,,,,,,,,1117.35,90,,percent of total billed charges,,,1027.96,82.8,,percent of total billed charges,,,1055.28,85,,percent of total billed charges,,,,,,,,,1092.52,88,,percent of total billed charges,,,,,,,,,948.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,310.38,22,,percent of total billed charges,,,1129.77,91,,percent of total billed charges,,,1179.43,95,,percent of total billed charges,,,1030.45,83,,percent of total billed charges,,,1030.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1030.45,83,,percent of total billed charges,,,1179.43,95,,percent of total billed charges,,,1117.35,90,,percent of total billed charges,,,1117.35,90,,percent of total billed charges,,,1018.03,82,,percent of total billed charges,,,1117.35,90,,percent of total billed charges,,,1055.28,85,,percent of total billed charges,,310.38,1179.43,
ARTHREX REAMER HEAD ANGLED S,30187703,CDM,,,278,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
ARTHREX STEM HUMERAL REVERS SZ 8,30187704,CDM,,,278,RC,outpatient,,16152.5,16152.5,,13713.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4038.13,22,,percent of total billed charges,,,,,,,,,14537.25,90,,percent of total billed charges,,,13374.27,82.8,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,,,,,,,,14214.2,88,,percent of total billed charges,,,,,,,,,12340.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4038.13,22,,percent of total billed charges,,,14698.78,91,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,,,,,,,,,,,,,13406.58,83,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13245.05,82,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,4038.13,15344.88,
ARTHREX CUP SUTURE 36 NEUTRAL,30187705,CDM,,,278,RC,outpatient,,11602.5,11602.5,,9850.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2900.63,22,,percent of total billed charges,,,,,,,,,10442.25,90,,percent of total billed charges,,,9606.87,82.8,,percent of total billed charges,,,9862.13,85,,percent of total billed charges,,,,,,,,,10210.2,88,,percent of total billed charges,,,,,,,,,8864.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2900.63,22,,percent of total billed charges,,,10558.28,91,,percent of total billed charges,,,11022.38,95,,percent of total billed charges,,,9630.08,83,,percent of total billed charges,,,9630.08,83,,percent of total billed charges,,,,,,,,,,,,,,,9630.08,83,,percent of total billed charges,,,11022.38,95,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,9514.05,82,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,9862.13,85,,percent of total billed charges,,2900.63,11022.38,
ARTHREX INSERT HUMERAL S/36 +6,30187706,CDM,,,278,RC,outpatient,,6597.5,6597.5,,5601.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1649.38,22,,percent of total billed charges,,,,,,,,,5937.75,90,,percent of total billed charges,,,5462.73,82.8,,percent of total billed charges,,,5607.88,85,,percent of total billed charges,,,,,,,,,5805.8,88,,percent of total billed charges,,,,,,,,,5040.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1649.38,22,,percent of total billed charges,,,6003.73,91,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,,,,,,,,,,,,,5475.93,83,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5409.95,82,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5607.88,85,,percent of total billed charges,,1649.38,6267.63,
ARTHREX BASEPLATE 24MM MODULAR +2 LAT,30187707,CDM,,,278,RC,outpatient,,14300,14300,,12140.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3575,22,,percent of total billed charges,,,,,,,,,12870,90,,percent of total billed charges,,,11840.4,82.8,,percent of total billed charges,,,12155,85,,percent of total billed charges,,,,,,,,,12584,88,,percent of total billed charges,,,,,,,,,10925.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3575,22,,percent of total billed charges,,,13013,91,,percent of total billed charges,,,13585,95,,percent of total billed charges,,,11869,83,,percent of total billed charges,,,11869,83,,percent of total billed charges,,,,,,,,,,,,,,,11869,83,,percent of total billed charges,,,13585,95,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,11726,82,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,12155,85,,percent of total billed charges,,3575,13585,
ARTHREX SCREW CENTRAL MODULAR 25MM,30187708,CDM,,,278,RC,outpatient,,6175,6175,,5242.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1543.75,22,,percent of total billed charges,,,,,,,,,5557.5,90,,percent of total billed charges,,,5112.9,82.8,,percent of total billed charges,,,5248.75,85,,percent of total billed charges,,,,,,,,,5434,88,,percent of total billed charges,,,,,,,,,4717.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1543.75,22,,percent of total billed charges,,,5619.25,91,,percent of total billed charges,,,5866.25,95,,percent of total billed charges,,,5125.25,83,,percent of total billed charges,,,5125.25,83,,percent of total billed charges,,,,,,,,,,,,,,,5125.25,83,,percent of total billed charges,,,5866.25,95,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5063.5,82,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5248.75,85,,percent of total billed charges,,1543.75,5866.25,
ARTHREX SCREW LOCKING 5.5 X 28MM,30187709,CDM,,,278,RC,outpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210,22,,percent of total billed charges,,,,,,,,,756,90,,percent of total billed charges,,,695.52,82.8,,percent of total billed charges,,,714,85,,percent of total billed charges,,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210,22,,percent of total billed charges,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,210,798,
ARTHREX GLENOSPHERE 36 +4 LAT/24,30187710,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
ARTHREX SCREW GLENOSPHERE,30187711,CDM,,,278,RC,outpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210,22,,percent of total billed charges,,,,,,,,,756,90,,percent of total billed charges,,,695.52,82.8,,percent of total billed charges,,,714,85,,percent of total billed charges,,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210,22,,percent of total billed charges,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,210,798,
ARTHREX DRILL BIT 3.0MM MGS STERILE,30187712,CDM,,,270,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
ARTHREX GLENIOD CALIBRATOR 3D,30187713,CDM,,,270,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
SYNTHES PLATE HUMERUS PERIARTIC 3.5MM,30187715,CDM,,,278,RC,outpatient,,19583.2,19583.2,,16626.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4895.8,22,,percent of total billed charges,,,,,,,,,17624.88,90,,percent of total billed charges,,,16214.89,82.8,,percent of total billed charges,,,16645.72,85,,percent of total billed charges,,,,,,,,,17233.22,88,,percent of total billed charges,,,,,,,,,14961.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4895.8,22,,percent of total billed charges,,,17820.71,91,,percent of total billed charges,,,18604.04,95,,percent of total billed charges,,,16254.06,83,,percent of total billed charges,,,16254.06,83,,percent of total billed charges,,,,,,,,,,,,,,,16254.06,83,,percent of total billed charges,,,18604.04,95,,percent of total billed charges,,,17624.88,90,,percent of total billed charges,,,17624.88,90,,percent of total billed charges,,,16058.22,82,,percent of total billed charges,,,17624.88,90,,percent of total billed charges,,,16645.72,85,,percent of total billed charges,,4895.8,18604.04,
SYNTHES CABLE 1.0 W/CRIMP 750MM,30187716,CDM,,,278,RC,outpatient,,4941.24,4941.24,,4195.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1235.31,22,,percent of total billed charges,,,,,,,,,4447.12,90,,percent of total billed charges,,,4091.35,82.8,,percent of total billed charges,,,4200.05,85,,percent of total billed charges,,,,,,,,,4348.29,88,,percent of total billed charges,,,,,,,,,3775.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1235.31,22,,percent of total billed charges,,,4496.53,91,,percent of total billed charges,,,4694.18,95,,percent of total billed charges,,,4101.23,83,,percent of total billed charges,,,4101.23,83,,percent of total billed charges,,,,,,,,,,,,,,,4101.23,83,,percent of total billed charges,,,4694.18,95,,percent of total billed charges,,,4447.12,90,,percent of total billed charges,,,4447.12,90,,percent of total billed charges,,,4051.82,82,,percent of total billed charges,,,4447.12,90,,percent of total billed charges,,,4200.05,85,,percent of total billed charges,,1235.31,4694.18,
IR PLATE 12MM,30187717,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
STRYKER PULSE LAVAGE EXTENDED TIP,30187718,CDM,,,270,RC,outpatient,,100.4,100.4,,85.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.1,22,,percent of total billed charges,,,,,,,,,90.36,90,,percent of total billed charges,,,83.13,82.8,,percent of total billed charges,,,85.34,85,,percent of total billed charges,,,,,,,,,88.35,88,,percent of total billed charges,,,,,,,,,76.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.1,22,,percent of total billed charges,,,91.36,91,,percent of total billed charges,,,95.38,95,,percent of total billed charges,,,83.33,83,,percent of total billed charges,,,83.33,83,,percent of total billed charges,,,,,,,,,,,,,,,83.33,83,,percent of total billed charges,,,95.38,95,,percent of total billed charges,,,90.36,90,,percent of total billed charges,,,90.36,90,,percent of total billed charges,,,82.33,82,,percent of total billed charges,,,90.36,90,,percent of total billed charges,,,85.34,85,,percent of total billed charges,,25.1,95.38,
STRYKER HIP PRESSURIZER,30187719,CDM,,,270,RC,outpatient,,121.84,121.84,,103.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.46,22,,percent of total billed charges,,,,,,,,,109.66,90,,percent of total billed charges,,,100.88,82.8,,percent of total billed charges,,,103.56,85,,percent of total billed charges,,,,,,,,,107.22,88,,percent of total billed charges,,,,,,,,,93.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.46,22,,percent of total billed charges,,,110.87,91,,percent of total billed charges,,,115.75,95,,percent of total billed charges,,,101.13,83,,percent of total billed charges,,,101.13,83,,percent of total billed charges,,,,,,,,,,,,,,,101.13,83,,percent of total billed charges,,,115.75,95,,percent of total billed charges,,,109.66,90,,percent of total billed charges,,,109.66,90,,percent of total billed charges,,,99.91,82,,percent of total billed charges,,,109.66,90,,percent of total billed charges,,,103.56,85,,percent of total billed charges,,30.46,115.75,
ZIMMER FEMUR CR SZ 6 RIGHT,30187720,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
BOSTON CAPIO SUTURE TC NEEDLE 26MM,30187721,CDM,,,270,RC,outpatient,,364.88,364.88,,309.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.22,22,,percent of total billed charges,,,,,,,,,328.39,90,,percent of total billed charges,,,302.12,82.8,,percent of total billed charges,,,310.15,85,,percent of total billed charges,,,,,,,,,321.09,88,,percent of total billed charges,,,,,,,,,278.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.22,22,,percent of total billed charges,,,332.04,91,,percent of total billed charges,,,346.64,95,,percent of total billed charges,,,302.85,83,,percent of total billed charges,,,302.85,83,,percent of total billed charges,,,,,,,,,,,,,,,302.85,83,,percent of total billed charges,,,346.64,95,,percent of total billed charges,,,328.39,90,,percent of total billed charges,,,328.39,90,,percent of total billed charges,,,299.2,82,,percent of total billed charges,,,328.39,90,,percent of total billed charges,,,310.15,85,,percent of total billed charges,,91.22,346.64,
BOSTON CAPIO SUTURE MONODECK TC NEEDLE 2,30187722,CDM,,,270,RC,outpatient,,364.88,364.88,,309.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.22,22,,percent of total billed charges,,,,,,,,,328.39,90,,percent of total billed charges,,,302.12,82.8,,percent of total billed charges,,,310.15,85,,percent of total billed charges,,,,,,,,,321.09,88,,percent of total billed charges,,,,,,,,,278.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.22,22,,percent of total billed charges,,,332.04,91,,percent of total billed charges,,,346.64,95,,percent of total billed charges,,,302.85,83,,percent of total billed charges,,,302.85,83,,percent of total billed charges,,,,,,,,,,,,,,,302.85,83,,percent of total billed charges,,,346.64,95,,percent of total billed charges,,,328.39,90,,percent of total billed charges,,,328.39,90,,percent of total billed charges,,,299.2,82,,percent of total billed charges,,,328.39,90,,percent of total billed charges,,,310.15,85,,percent of total billed charges,,91.22,346.64,
S&N SCREW REGENESORB 9X25,30187723,CDM,,,270,RC,outpatient,,4091.95,4091.95,,3474.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1022.99,22,,percent of total billed charges,,,,,,,,,3682.76,90,,percent of total billed charges,,,3388.13,82.8,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,,,,,,,,3600.92,88,,percent of total billed charges,,,,,,,,,3126.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1022.99,22,,percent of total billed charges,,,3723.67,91,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3396.32,83,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3355.4,82,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,1022.99,3887.35,
SYNTHES PLATE LCP CLAVICLE 2.7 VA RIGHT,30187724,CDM,,,278,RC,outpatient,,10635.63,10635.63,,9029.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2658.91,22,,percent of total billed charges,,,,,,,,,9572.07,90,,percent of total billed charges,,,8806.3,82.8,,percent of total billed charges,,,9040.29,85,,percent of total billed charges,,,,,,,,,9359.35,88,,percent of total billed charges,,,,,,,,,8125.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2658.91,22,,percent of total billed charges,,,9678.42,91,,percent of total billed charges,,,10103.85,95,,percent of total billed charges,,,8827.57,83,,percent of total billed charges,,,8827.57,83,,percent of total billed charges,,,,,,,,,,,,,,,8827.57,83,,percent of total billed charges,,,10103.85,95,,percent of total billed charges,,,9572.07,90,,percent of total billed charges,,,9572.07,90,,percent of total billed charges,,,8721.22,82,,percent of total billed charges,,,9572.07,90,,percent of total billed charges,,,9040.29,85,,percent of total billed charges,,2658.91,10103.85,
AERIN RHINAER STYLUS,30187725,CDM,,,270,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
DEPUY ATTUNE FEMUR CRS 3MM LEFT,30187726,CDM,,,278,RC,outpatient,,52568.56,52568.56,,44630.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13142.14,22,,percent of total billed charges,,,,,,,,,47311.7,90,,percent of total billed charges,,,43526.77,82.8,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,,,,,,,,46260.33,88,,percent of total billed charges,,,,,,,,,40162.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13142.14,22,,percent of total billed charges,,,47837.39,91,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,43631.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43631.9,83,,percent of total billed charges,,,49940.13,95,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,43106.22,82,,percent of total billed charges,,,47311.7,90,,percent of total billed charges,,,44683.28,85,,percent of total billed charges,,13142.14,49940.13,
DEPUY ATTUNE INSERT PS FB SZ 3 7MM,30187727,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
STRYKER FEMUR CR TRIATHLON CEMENTED SZ 5,30187728,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER INSERT TRIATHLON CS #4 9MM,30187729,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER PATELLA TRIATHLON X3 32MM,30187730,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
SYNTHES TFNA HELICAL BLADE 75MM,30187731,CDM,,,278,RC,outpatient,,7033.78,7033.78,,5971.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1758.45,22,,percent of total billed charges,,,,,,,,,6330.4,90,,percent of total billed charges,,,5823.97,82.8,,percent of total billed charges,,,5978.71,85,,percent of total billed charges,,,,,,,,,6189.73,88,,percent of total billed charges,,,,,,,,,5373.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1758.45,22,,percent of total billed charges,,,6400.74,91,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,5838.04,83,,percent of total billed charges,,,,,,,,,,,,,,,5838.04,83,,percent of total billed charges,,,6682.09,95,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5767.7,82,,percent of total billed charges,,,6330.4,90,,percent of total billed charges,,,5978.71,85,,percent of total billed charges,,1758.45,6682.09,
SYNTHES SCREW LOCKING 5.0MM X 26MM,30187732,CDM,,,278,RC,outpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,562.71,22,,percent of total billed charges,,,,,,,,,2025.74,90,,percent of total billed charges,,,1863.68,82.8,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,562.71,22,,percent of total billed charges,,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,562.71,2138.28,
STRYKER SHAVER CROSSBLADE SMOOTH 3.5MM,30187740,CDM,,,270,RC,outpatient,,640.01,640.01,,543.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,160,22,,percent of total billed charges,,,,,,,,,576.01,90,,percent of total billed charges,,,529.93,82.8,,percent of total billed charges,,,544.01,85,,percent of total billed charges,,,,,,,,,563.21,88,,percent of total billed charges,,,,,,,,,488.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,160,22,,percent of total billed charges,,,582.41,91,,percent of total billed charges,,,608.01,95,,percent of total billed charges,,,531.21,83,,percent of total billed charges,,,531.21,83,,percent of total billed charges,,,,,,,,,,,,,,,531.21,83,,percent of total billed charges,,,608.01,95,,percent of total billed charges,,,576.01,90,,percent of total billed charges,,,576.01,90,,percent of total billed charges,,,524.81,82,,percent of total billed charges,,,576.01,90,,percent of total billed charges,,,544.01,85,,percent of total billed charges,,160,608.01,
S&N FEMORAL COMPONENT SZ 2 RIGHT MED,30187741,CDM,,,278,RC,outpatient,,27182.29,27182.29,,23077.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6795.57,22,,percent of total billed charges,,,,,,,,,24464.06,90,,percent of total billed charges,,,22506.94,82.8,,percent of total billed charges,,,23104.95,85,,percent of total billed charges,,,,,,,,,23920.42,88,,percent of total billed charges,,,,,,,,,20767.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6795.57,22,,percent of total billed charges,,,24735.88,91,,percent of total billed charges,,,25823.18,95,,percent of total billed charges,,,22561.3,83,,percent of total billed charges,,,22561.3,83,,percent of total billed charges,,,,,,,,,,,,,,,22561.3,83,,percent of total billed charges,,,25823.18,95,,percent of total billed charges,,,24464.06,90,,percent of total billed charges,,,24464.06,90,,percent of total billed charges,,,22289.48,82,,percent of total billed charges,,,24464.06,90,,percent of total billed charges,,,23104.95,85,,percent of total billed charges,,6795.57,25823.18,
S&N INSERT TIBIAL 8MM SZ 1-2,30187742,CDM,,,278,RC,outpatient,,6855.94,6855.94,,5820.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1713.99,22,,percent of total billed charges,,,,,,,,,6170.35,90,,percent of total billed charges,,,5676.72,82.8,,percent of total billed charges,,,5827.55,85,,percent of total billed charges,,,,,,,,,6033.23,88,,percent of total billed charges,,,,,,,,,5237.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1713.99,22,,percent of total billed charges,,,6238.91,91,,percent of total billed charges,,,6513.14,95,,percent of total billed charges,,,5690.43,83,,percent of total billed charges,,,5690.43,83,,percent of total billed charges,,,,,,,,,,,,,,,5690.43,83,,percent of total billed charges,,,6513.14,95,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,5621.87,82,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,5827.55,85,,percent of total billed charges,,1713.99,6513.14,
S&N BASE TIBIAL SZ1 41MM,30187743,CDM,,,278,RC,outpatient,,14631.63,14631.63,,12422.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3657.91,22,,percent of total billed charges,,,,,,,,,13168.47,90,,percent of total billed charges,,,12114.99,82.8,,percent of total billed charges,,,12436.89,85,,percent of total billed charges,,,,,,,,,12875.83,88,,percent of total billed charges,,,,,,,,,11178.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3657.91,22,,percent of total billed charges,,,13314.78,91,,percent of total billed charges,,,13900.05,95,,percent of total billed charges,,,12144.25,83,,percent of total billed charges,,,12144.25,83,,percent of total billed charges,,,,,,,,,,,,,,,12144.25,83,,percent of total billed charges,,,13900.05,95,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,11997.94,82,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,12436.89,85,,percent of total billed charges,,3657.91,13900.05,
SYNTHES PLATE TUBULAR 1/3 8 HOLE,30187744,CDM,,,278,RC,outpatient,,1987.05,1987.05,,1687.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,496.76,22,,percent of total billed charges,,,,,,,,,1788.35,90,,percent of total billed charges,,,1645.28,82.8,,percent of total billed charges,,,1688.99,85,,percent of total billed charges,,,,,,,,,1748.6,88,,percent of total billed charges,,,,,,,,,1518.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,496.76,22,,percent of total billed charges,,,1808.22,91,,percent of total billed charges,,,1887.7,95,,percent of total billed charges,,,1649.25,83,,percent of total billed charges,,,1649.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1649.25,83,,percent of total billed charges,,,1887.7,95,,percent of total billed charges,,,1788.35,90,,percent of total billed charges,,,1788.35,90,,percent of total billed charges,,,1629.38,82,,percent of total billed charges,,,1788.35,90,,percent of total billed charges,,,1688.99,85,,percent of total billed charges,,496.76,1887.7,
SYNTHES SCREW LOCKING TI 3.5X12MM,30187745,CDM,,,278,RC,outpatient,,1389.18,1389.18,,1179.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,347.3,22,,percent of total billed charges,,,,,,,,,1250.26,90,,percent of total billed charges,,,1150.24,82.8,,percent of total billed charges,,,1180.8,85,,percent of total billed charges,,,,,,,,,1222.48,88,,percent of total billed charges,,,,,,,,,1061.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,347.3,22,,percent of total billed charges,,,1264.15,91,,percent of total billed charges,,,1319.72,95,,percent of total billed charges,,,1153.02,83,,percent of total billed charges,,,1153.02,83,,percent of total billed charges,,,,,,,,,,,,,,,1153.02,83,,percent of total billed charges,,,1319.72,95,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1139.13,82,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1180.8,85,,percent of total billed charges,,347.3,1319.72,
SYNTHES SCREW LOCKING TI 3.5X14MM,30187746,CDM,,,278,RC,outpatient,,1389.18,1389.18,,1179.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,347.3,22,,percent of total billed charges,,,,,,,,,1250.26,90,,percent of total billed charges,,,1150.24,82.8,,percent of total billed charges,,,1180.8,85,,percent of total billed charges,,,,,,,,,1222.48,88,,percent of total billed charges,,,,,,,,,1061.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,347.3,22,,percent of total billed charges,,,1264.15,91,,percent of total billed charges,,,1319.72,95,,percent of total billed charges,,,1153.02,83,,percent of total billed charges,,,1153.02,83,,percent of total billed charges,,,,,,,,,,,,,,,1153.02,83,,percent of total billed charges,,,1319.72,95,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1139.13,82,,percent of total billed charges,,,1250.26,90,,percent of total billed charges,,,1180.8,85,,percent of total billed charges,,347.3,1319.72,
SYNTHES SCREW CORTEX ST 3.5X40MM,30187747,CDM,,,278,RC,outpatient,,311.1,311.1,,264.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.78,22,,percent of total billed charges,,,,,,,,,279.99,90,,percent of total billed charges,,,257.59,82.8,,percent of total billed charges,,,264.44,85,,percent of total billed charges,,,,,,,,,273.77,88,,percent of total billed charges,,,,,,,,,237.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.78,22,,percent of total billed charges,,,283.1,91,,percent of total billed charges,,,295.55,95,,percent of total billed charges,,,258.21,83,,percent of total billed charges,,,258.21,83,,percent of total billed charges,,,,,,,,,,,,,,,258.21,83,,percent of total billed charges,,,295.55,95,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,255.1,82,,percent of total billed charges,,,279.99,90,,percent of total billed charges,,,264.44,85,,percent of total billed charges,,77.78,295.55,
SYNTHES SCREW CANNULATED LT 4X54MM,30187748,CDM,,,278,RC,outpatient,,2268.37,2268.37,,1925.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,567.09,22,,percent of total billed charges,,,,,,,,,2041.53,90,,percent of total billed charges,,,1878.21,82.8,,percent of total billed charges,,,1928.11,85,,percent of total billed charges,,,,,,,,,1996.17,88,,percent of total billed charges,,,,,,,,,1733.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,567.09,22,,percent of total billed charges,,,2064.22,91,,percent of total billed charges,,,2154.95,95,,percent of total billed charges,,,1882.75,83,,percent of total billed charges,,,1882.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1882.75,83,,percent of total billed charges,,,2154.95,95,,percent of total billed charges,,,2041.53,90,,percent of total billed charges,,,2041.53,90,,percent of total billed charges,,,1860.06,82,,percent of total billed charges,,,2041.53,90,,percent of total billed charges,,,1928.11,85,,percent of total billed charges,,567.09,2154.95,
SYNTHES SCREW CANNULATED LT 4X58MM,30187749,CDM,,,278,RC,outpatient,,2268.37,2268.37,,1925.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,567.09,22,,percent of total billed charges,,,,,,,,,2041.53,90,,percent of total billed charges,,,1878.21,82.8,,percent of total billed charges,,,1928.11,85,,percent of total billed charges,,,,,,,,,1996.17,88,,percent of total billed charges,,,,,,,,,1733.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,567.09,22,,percent of total billed charges,,,2064.22,91,,percent of total billed charges,,,2154.95,95,,percent of total billed charges,,,1882.75,83,,percent of total billed charges,,,1882.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1882.75,83,,percent of total billed charges,,,2154.95,95,,percent of total billed charges,,,2041.53,90,,percent of total billed charges,,,2041.53,90,,percent of total billed charges,,,1860.06,82,,percent of total billed charges,,,2041.53,90,,percent of total billed charges,,,1928.11,85,,percent of total billed charges,,567.09,2154.95,
AIRSEAL OBTURATOR BLADELESS ACCESS PORT,30187753,CDM,,,270,RC,outpatient,,871.5,871.5,,739.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,217.88,22,,percent of total billed charges,,,,,,,,,784.35,90,,percent of total billed charges,,,721.6,82.8,,percent of total billed charges,,,740.78,85,,percent of total billed charges,,,,,,,,,766.92,88,,percent of total billed charges,,,,,,,,,665.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,217.88,22,,percent of total billed charges,,,793.07,91,,percent of total billed charges,,,827.93,95,,percent of total billed charges,,,723.35,83,,percent of total billed charges,,,723.35,83,,percent of total billed charges,,,,,,,,,,,,,,,723.35,83,,percent of total billed charges,,,827.93,95,,percent of total billed charges,,,784.35,90,,percent of total billed charges,,,784.35,90,,percent of total billed charges,,,714.63,82,,percent of total billed charges,,,784.35,90,,percent of total billed charges,,,740.78,85,,percent of total billed charges,,217.88,827.93,
TROCAR VERSAONE BLUNT W/THREADED ANCHOR,30187754,CDM,,,270,RC,outpatient,,1022.32,1022.32,,867.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,255.58,22,,percent of total billed charges,,,,,,,,,920.09,90,,percent of total billed charges,,,846.48,82.8,,percent of total billed charges,,,868.97,85,,percent of total billed charges,,,,,,,,,899.64,88,,percent of total billed charges,,,,,,,,,781.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,255.58,22,,percent of total billed charges,,,930.31,91,,percent of total billed charges,,,971.2,95,,percent of total billed charges,,,848.53,83,,percent of total billed charges,,,848.53,83,,percent of total billed charges,,,,,,,,,,,,,,,848.53,83,,percent of total billed charges,,,971.2,95,,percent of total billed charges,,,920.09,90,,percent of total billed charges,,,920.09,90,,percent of total billed charges,,,838.3,82,,percent of total billed charges,,,920.09,90,,percent of total billed charges,,,868.97,85,,percent of total billed charges,,255.58,971.2,
V-LOC WOUND CLOSURE 180 SZ 0 GS-21,30187755,CDM,,,270,RC,outpatient,,188.08,188.08,,159.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.02,22,,percent of total billed charges,,,,,,,,,169.27,90,,percent of total billed charges,,,155.73,82.8,,percent of total billed charges,,,159.87,85,,percent of total billed charges,,,,,,,,,165.51,88,,percent of total billed charges,,,,,,,,,143.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.02,22,,percent of total billed charges,,,171.15,91,,percent of total billed charges,,,178.68,95,,percent of total billed charges,,,156.11,83,,percent of total billed charges,,,156.11,83,,percent of total billed charges,,,,,,,,,,,,,,,156.11,83,,percent of total billed charges,,,178.68,95,,percent of total billed charges,,,169.27,90,,percent of total billed charges,,,169.27,90,,percent of total billed charges,,,154.23,82,,percent of total billed charges,,,169.27,90,,percent of total billed charges,,,159.87,85,,percent of total billed charges,,47.02,178.68,
ARTHREX REAMER LOW PROFILE,30187756,CDM,,,270,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
ARTHREX GLENOSPHERE 33/24,30187757,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
ARTHREX SCREW LOCKING 5.5 X 24MM,30187758,CDM,,,278,RC,outpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210,22,,percent of total billed charges,,,,,,,,,756,90,,percent of total billed charges,,,695.52,82.8,,percent of total billed charges,,,714,85,,percent of total billed charges,,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210,22,,percent of total billed charges,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,210,798,
ARTHREX SUTURECUP REVERSE 36 +2 RIGHT,30187759,CDM,,,278,RC,outpatient,,11602.5,11602.5,,9850.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2900.63,22,,percent of total billed charges,,,,,,,,,10442.25,90,,percent of total billed charges,,,9606.87,82.8,,percent of total billed charges,,,9862.13,85,,percent of total billed charges,,,,,,,,,10210.2,88,,percent of total billed charges,,,,,,,,,8864.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2900.63,22,,percent of total billed charges,,,10558.28,91,,percent of total billed charges,,,11022.38,95,,percent of total billed charges,,,9630.08,83,,percent of total billed charges,,,9630.08,83,,percent of total billed charges,,,,,,,,,,,,,,,9630.08,83,,percent of total billed charges,,,11022.38,95,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,9514.05,82,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,9862.13,85,,percent of total billed charges,,2900.63,11022.38,
ARTHREX STEM HUMERAL SZ 5 135DEG MODULAR,30187760,CDM,,,278,RC,outpatient,,16152.5,16152.5,,13713.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4038.13,22,,percent of total billed charges,,,,,,,,,14537.25,90,,percent of total billed charges,,,13374.27,82.8,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,,,,,,,,14214.2,88,,percent of total billed charges,,,,,,,,,12340.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4038.13,22,,percent of total billed charges,,,14698.78,91,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,,,,,,,,,,,,,13406.58,83,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13245.05,82,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,4038.13,15344.88,
ARTHREX INSERT HUMERAL 36 +3/33,30187761,CDM,,,278,RC,outpatient,,6597.5,6597.5,,5601.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1649.38,22,,percent of total billed charges,,,,,,,,,5937.75,90,,percent of total billed charges,,,5462.73,82.8,,percent of total billed charges,,,5607.88,85,,percent of total billed charges,,,,,,,,,5805.8,88,,percent of total billed charges,,,,,,,,,5040.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1649.38,22,,percent of total billed charges,,,6003.73,91,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,,,,,,,,,,,,,5475.93,83,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5409.95,82,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5607.88,85,,percent of total billed charges,,1649.38,6267.63,
ARTHREX SPACER REVERS 36 +6MM,30187762,CDM,,,278,RC,outpatient,,3185,3185,,2704.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,796.25,22,,percent of total billed charges,,,,,,,,,2866.5,90,,percent of total billed charges,,,2637.18,82.8,,percent of total billed charges,,,2707.25,85,,percent of total billed charges,,,,,,,,,2802.8,88,,percent of total billed charges,,,,,,,,,2433.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,796.25,22,,percent of total billed charges,,,2898.35,91,,percent of total billed charges,,,3025.75,95,,percent of total billed charges,,,2643.55,83,,percent of total billed charges,,,2643.55,83,,percent of total billed charges,,,,,,,,,,,,,,,2643.55,83,,percent of total billed charges,,,3025.75,95,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2611.7,82,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2707.25,85,,percent of total billed charges,,796.25,3025.75,
ARTHREX GLENOID TARGETER LEG SZ 10,30187763,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
ZIMMER PATELLA TM 10 X 29MM,30187764,CDM,,,278,RC,outpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1218.75,22,,percent of total billed charges,,,,,,,,,4387.5,90,,percent of total billed charges,,,4036.5,82.8,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1218.75,22,,percent of total billed charges,,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,1218.75,4631.25,
ZIMMER FEMUR NARROW SZ 6 RIGHT,30187765,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ELECTRODE COAGULATION BIPOLAR 24-26FR,30187766,CDM,,,270,RC,outpatient,,2361.15,2361.15,,2004.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,590.29,22,,percent of total billed charges,,,,,,,,,2125.04,90,,percent of total billed charges,,,1955.03,82.8,,percent of total billed charges,,,2006.98,85,,percent of total billed charges,,,,,,,,,2077.81,88,,percent of total billed charges,,,,,,,,,1803.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,590.29,22,,percent of total billed charges,,,2148.65,91,,percent of total billed charges,,,2243.09,95,,percent of total billed charges,,,1959.75,83,,percent of total billed charges,,,1959.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1959.75,83,,percent of total billed charges,,,2243.09,95,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,1936.14,82,,percent of total billed charges,,,2125.04,90,,percent of total billed charges,,,2006.98,85,,percent of total billed charges,,590.29,2243.09,
STRYKER CUP TRIDENT II PSL 58F,30187770,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
STRYKER INSERT TRIDENT 0 X3 36MM ID,30187771,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER STEM ACCOLADE II SZ 6 132DEG,30187772,CDM,,,278,RC,outpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3900,22,,percent of total billed charges,,,,,,,,,14040,90,,percent of total billed charges,,,12916.8,82.8,,percent of total billed charges,,,13260,85,,percent of total billed charges,,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3900,22,,percent of total billed charges,,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,3900,14820,
STRYKER HEAD CERAMIC DELTA V-40 36/+5,30187773,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
SYNTHES SCREW CANNULATED 6.5 X 105,30187774,CDM,,,278,RC,outpatient,,2965.89,2965.89,,2518.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,741.47,22,,percent of total billed charges,,,,,,,,,2669.3,90,,percent of total billed charges,,,2455.76,82.8,,percent of total billed charges,,,2521.01,85,,percent of total billed charges,,,,,,,,,2609.98,88,,percent of total billed charges,,,,,,,,,2265.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,741.47,22,,percent of total billed charges,,,2698.96,91,,percent of total billed charges,,,2817.6,95,,percent of total billed charges,,,2461.69,83,,percent of total billed charges,,,2461.69,83,,percent of total billed charges,,,,,,,,,,,,,,,2461.69,83,,percent of total billed charges,,,2817.6,95,,percent of total billed charges,,,2669.3,90,,percent of total billed charges,,,2669.3,90,,percent of total billed charges,,,2432.03,82,,percent of total billed charges,,,2669.3,90,,percent of total billed charges,,,2521.01,85,,percent of total billed charges,,741.47,2817.6,
SYNTHES SCREW CORTEX 4.5 X 70MM,30187775,CDM,,,278,RC,outpatient,,277.28,277.28,,235.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.32,22,,percent of total billed charges,,,,,,,,,249.55,90,,percent of total billed charges,,,229.59,82.8,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,,,,,,,,244.01,88,,percent of total billed charges,,,,,,,,,211.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.32,22,,percent of total billed charges,,,252.32,91,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,230.14,83,,percent of total billed charges,,,,,,,,,,,,,,,230.14,83,,percent of total billed charges,,,263.42,95,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,227.37,82,,percent of total billed charges,,,249.55,90,,percent of total billed charges,,,235.69,85,,percent of total billed charges,,69.32,263.42,
DEPUY LINER PE MENTUM 28/47,30187776,CDM,,,278,RC,outpatient,,15818.92,15818.92,,13430.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3954.73,22,,percent of total billed charges,,,,,,,,,14237.03,90,,percent of total billed charges,,,13098.07,82.8,,percent of total billed charges,,,13446.08,85,,percent of total billed charges,,,,,,,,,13920.65,88,,percent of total billed charges,,,,,,,,,12085.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3954.73,22,,percent of total billed charges,,,14395.22,91,,percent of total billed charges,,,15027.97,95,,percent of total billed charges,,,13129.7,83,,percent of total billed charges,,,13129.7,83,,percent of total billed charges,,,,,,,,,,,,,,,13129.7,83,,percent of total billed charges,,,15027.97,95,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,12971.51,82,,percent of total billed charges,,,14237.03,90,,percent of total billed charges,,,13446.08,85,,percent of total billed charges,,3954.73,15027.97,
VIVAER ARC STYLUS,30187777,CDM,,,270,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
ADVANTAGE FIT SYSTEM,30187778,CDM,,,270,RC,outpatient,,10653.76,10653.76,,9045.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2663.44,22,,percent of total billed charges,,,,,,,,,9588.38,90,,percent of total billed charges,,,8821.31,82.8,,percent of total billed charges,,,9055.7,85,,percent of total billed charges,,,,,,,,,9375.31,88,,percent of total billed charges,,,,,,,,,8139.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2663.44,22,,percent of total billed charges,,,9694.92,91,,percent of total billed charges,,,10121.07,95,,percent of total billed charges,,,8842.62,83,,percent of total billed charges,,,8842.62,83,,percent of total billed charges,,,,,,,,,,,,,,,8842.62,83,,percent of total billed charges,,,10121.07,95,,percent of total billed charges,,,9588.38,90,,percent of total billed charges,,,9588.38,90,,percent of total billed charges,,,8736.08,82,,percent of total billed charges,,,9588.38,90,,percent of total billed charges,,,9055.7,85,,percent of total billed charges,,2663.44,10121.07,
IR PLATE 3 LEVEL 51MM,30187779,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
STRYKER CUP TRIDENT II 50MM D,30187780,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
STRYKER STEM ACCOLADE II SZ 5 132DEG,30187781,CDM,,,278,RC,outpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3900,22,,percent of total billed charges,,,,,,,,,14040,90,,percent of total billed charges,,,12916.8,82.8,,percent of total billed charges,,,13260,85,,percent of total billed charges,,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3900,22,,percent of total billed charges,,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,3900,14820,
STRYKER HEAD FEMORAL V40 36MM +5MM,30187782,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
ZIMMER BEARING DM 28X50MM,30187783,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
DEPUY STEM REVISION 16 HO,30187784,CDM,,,278,RC,outpatient,,66759.81,66759.81,,56679.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16689.95,22,,percent of total billed charges,,,,,,,,,60083.83,90,,percent of total billed charges,,,55277.12,82.8,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,,,,,,,,58748.63,88,,percent of total billed charges,,,,,,,,,51004.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16689.95,22,,percent of total billed charges,,,60751.43,91,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,55410.64,83,,percent of total billed charges,,,,,,,,,,,,,,,55410.64,83,,percent of total billed charges,,,63421.82,95,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,54743.04,82,,percent of total billed charges,,,60083.83,90,,percent of total billed charges,,,56745.84,85,,percent of total billed charges,,16689.95,63421.82,
X-TACK ENDO HELIX 235CM,30187785,CDM,,,270,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
OVERSTITCH SUTURE CINCH LONG,30187786,CDM,,,270,RC,outpatient,,645.19,645.19,,547.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,161.3,22,,percent of total billed charges,,,,,,,,,580.67,90,,percent of total billed charges,,,534.22,82.8,,percent of total billed charges,,,548.41,85,,percent of total billed charges,,,,,,,,,567.77,88,,percent of total billed charges,,,,,,,,,492.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,161.3,22,,percent of total billed charges,,,587.12,91,,percent of total billed charges,,,612.93,95,,percent of total billed charges,,,535.51,83,,percent of total billed charges,,,535.51,83,,percent of total billed charges,,,,,,,,,,,,,,,535.51,83,,percent of total billed charges,,,612.93,95,,percent of total billed charges,,,580.67,90,,percent of total billed charges,,,580.67,90,,percent of total billed charges,,,529.06,82,,percent of total billed charges,,,580.67,90,,percent of total billed charges,,,548.41,85,,percent of total billed charges,,161.3,612.93,
ZIMMER FEMUR CEMENTED CR SZ8 LEFT,30187787,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
BOSTON LEAD KIT,30187788,CDM,,,270,RC,outpatient,,12350,12350,,10485.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3087.5,22,,percent of total billed charges,,,,,,,,,11115,90,,percent of total billed charges,,,10225.8,82.8,,percent of total billed charges,,,10497.5,85,,percent of total billed charges,,,,,,,,,10868,88,,percent of total billed charges,,,,,,,,,9435.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3087.5,22,,percent of total billed charges,,,11238.5,91,,percent of total billed charges,,,11732.5,95,,percent of total billed charges,,,10250.5,83,,percent of total billed charges,,,10250.5,83,,percent of total billed charges,,,,,,,,,,,,,,,10250.5,83,,percent of total billed charges,,,11732.5,95,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,10127,82,,percent of total billed charges,,,11115,90,,percent of total billed charges,,,10497.5,85,,percent of total billed charges,,3087.5,11732.5,
DEPUY-MITEK ANCHOR PERMATAPE PEEK 5.5MM,30187789,CDM,,,278,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
S&N HEAD FEMORAL 36MM XL,30187790,CDM,,,278,RC,outpatient,,35977.5,35977.5,,30544.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8994.38,22,,percent of total billed charges,,,,,,,,,32379.75,90,,percent of total billed charges,,,29789.37,82.8,,percent of total billed charges,,,30580.88,85,,percent of total billed charges,,,,,,,,,31660.2,88,,percent of total billed charges,,,,,,,,,27486.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8994.38,22,,percent of total billed charges,,,32739.53,91,,percent of total billed charges,,,34178.63,95,,percent of total billed charges,,,29861.33,83,,percent of total billed charges,,,29861.33,83,,percent of total billed charges,,,,,,,,,,,,,,,29861.33,83,,percent of total billed charges,,,34178.63,95,,percent of total billed charges,,,32379.75,90,,percent of total billed charges,,,32379.75,90,,percent of total billed charges,,,29501.55,82,,percent of total billed charges,,,32379.75,90,,percent of total billed charges,,,30580.88,85,,percent of total billed charges,,8994.38,34178.63,
STRYKER BASEPLATE TIBIAL SZ 6,30187791,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER INSERT TIBIAL SZ 6 10MM,30187792,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER PATELLA SZ S36MM,30187793,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
ENDOSCOPIC SCISSORS COLONIC LENGTH,30187794,CDM,,,270,RC,outpatient,,2155.83,2155.83,,1830.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,538.96,22,,percent of total billed charges,,,,,,,,,1940.25,90,,percent of total billed charges,,,1785.03,82.8,,percent of total billed charges,,,1832.46,85,,percent of total billed charges,,,,,,,,,1897.13,88,,percent of total billed charges,,,,,,,,,1647.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,538.96,22,,percent of total billed charges,,,1961.81,91,,percent of total billed charges,,,2048.04,95,,percent of total billed charges,,,1789.34,83,,percent of total billed charges,,,1789.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1789.34,83,,percent of total billed charges,,,2048.04,95,,percent of total billed charges,,,1940.25,90,,percent of total billed charges,,,1940.25,90,,percent of total billed charges,,,1767.78,82,,percent of total billed charges,,,1940.25,90,,percent of total billed charges,,,1832.46,85,,percent of total billed charges,,538.96,2048.04,
GORE VBX BALLOON EXPANDABLE 6X29,30187795,CDM,,,270,RC,outpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5807.75,22,,percent of total billed charges,,,,,,,,,20907.9,90,,percent of total billed charges,,,19235.27,82.8,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5807.75,22,,percent of total billed charges,,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,5807.75,22069.45,
STRYKER INSERT TRIDENT 0 X3 36MM ID E,30187796,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
KYPHON TRAY FIRST FRACTURE,30187797,CDM,,,278,RC,outpatient,,25961,25961,,22040.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6490.25,22,,percent of total billed charges,,,,,,,,,23364.9,90,,percent of total billed charges,,,21495.71,82.8,,percent of total billed charges,,,22066.85,85,,percent of total billed charges,,,,,,,,,22845.68,88,,percent of total billed charges,,,,,,,,,19834.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6490.25,22,,percent of total billed charges,,,23624.51,91,,percent of total billed charges,,,24662.95,95,,percent of total billed charges,,,21547.63,83,,percent of total billed charges,,,21547.63,83,,percent of total billed charges,,,,,,,,,,,,,,,21547.63,83,,percent of total billed charges,,,24662.95,95,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,21288.02,82,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,22066.85,85,,percent of total billed charges,,6490.25,24662.95,
STRYKER INSERT TRIATHLON CS SZ 3 10MM,30187798,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
G-TUBE STRAIGHT 16FR,30187800,CDM,,,270,RC,outpatient,,456.4,456.4,,387.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,114.1,22,,percent of total billed charges,,,,,,,,,410.76,90,,percent of total billed charges,,,377.9,82.8,,percent of total billed charges,,,387.94,85,,percent of total billed charges,,,,,,,,,401.63,88,,percent of total billed charges,,,,,,,,,348.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,114.1,22,,percent of total billed charges,,,415.32,91,,percent of total billed charges,,,433.58,95,,percent of total billed charges,,,378.81,83,,percent of total billed charges,,,378.81,83,,percent of total billed charges,,,,,,,,,,,,,,,378.81,83,,percent of total billed charges,,,433.58,95,,percent of total billed charges,,,410.76,90,,percent of total billed charges,,,410.76,90,,percent of total billed charges,,,374.25,82,,percent of total billed charges,,,410.76,90,,percent of total billed charges,,,387.94,85,,percent of total billed charges,,114.1,433.58,
GASTROSTOMY FEEDING TUBE INSERTION KIT 2,30187801,CDM,,,270,RC,outpatient,,1465.75,1465.75,,1244.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,366.44,22,,percent of total billed charges,,,,,,,,,1319.18,90,,percent of total billed charges,,,1213.64,82.8,,percent of total billed charges,,,1245.89,85,,percent of total billed charges,,,,,,,,,1289.86,88,,percent of total billed charges,,,,,,,,,1119.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,366.44,22,,percent of total billed charges,,,1333.83,91,,percent of total billed charges,,,1392.46,95,,percent of total billed charges,,,1216.57,83,,percent of total billed charges,,,1216.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1216.57,83,,percent of total billed charges,,,1392.46,95,,percent of total billed charges,,,1319.18,90,,percent of total billed charges,,,1319.18,90,,percent of total billed charges,,,1201.92,82,,percent of total billed charges,,,1319.18,90,,percent of total billed charges,,,1245.89,85,,percent of total billed charges,,366.44,1392.46,
LITHOVUE STANDARD DEFLECTION SCOPE,30187803,CDM,,,270,RC,outpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2437.5,22,,percent of total billed charges,,,,,,,,,8775,90,,percent of total billed charges,,,8073,82.8,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2437.5,22,,percent of total billed charges,,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,2437.5,9262.5,
ZIMMER FEMUR NARROW SZ 5 LEFT,30187804,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER FEMUR NARROW SZ 5 RIGHT,30187805,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER TIBIA POROUS SZ D RIGHT,30187806,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER BEARING MC RIGH 10MM,30187807,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
IR PLATE 2 LEVEL 32MM,30187808,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
MENTOR MEMORYGEL BREAST IMPLANT 250CC,30187809,CDM,,,278,RC,outpatient,,6402.5,6402.5,,5435.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1600.63,22,,percent of total billed charges,,,,,,,,,5762.25,90,,percent of total billed charges,,,5301.27,82.8,,percent of total billed charges,,,5442.13,85,,percent of total billed charges,,,,,,,,,5634.2,88,,percent of total billed charges,,,,,,,,,4891.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1600.63,22,,percent of total billed charges,,,5826.28,91,,percent of total billed charges,,,6082.38,95,,percent of total billed charges,,,5314.08,83,,percent of total billed charges,,,5314.08,83,,percent of total billed charges,,,,,,,,,,,,,,,5314.08,83,,percent of total billed charges,,,6082.38,95,,percent of total billed charges,,,5762.25,90,,percent of total billed charges,,,5762.25,90,,percent of total billed charges,,,5250.05,82,,percent of total billed charges,,,5762.25,90,,percent of total billed charges,,,5442.13,85,,percent of total billed charges,,1600.63,6082.38,
DEPUY SLEEVE POROUS 37MM,30187810,CDM,,,278,RC,outpatient,,29060.07,29060.07,,24672,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7265.02,22,,percent of total billed charges,,,,,,,,,26154.06,90,,percent of total billed charges,,,24061.74,82.8,,percent of total billed charges,,,24701.06,85,,percent of total billed charges,,,,,,,,,25572.86,88,,percent of total billed charges,,,,,,,,,22201.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7265.02,22,,percent of total billed charges,,,26444.66,91,,percent of total billed charges,,,27607.07,95,,percent of total billed charges,,,24119.86,83,,percent of total billed charges,,,24119.86,83,,percent of total billed charges,,,,,,,,,,,,,,,24119.86,83,,percent of total billed charges,,,27607.07,95,,percent of total billed charges,,,26154.06,90,,percent of total billed charges,,,26154.06,90,,percent of total billed charges,,,23829.26,82,,percent of total billed charges,,,26154.06,90,,percent of total billed charges,,,24701.06,85,,percent of total billed charges,,7265.02,27607.07,
ULRICH X-LINK CONNECTOR X-SMALL,30187811,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
FALOPE-RING BAND APPLICATOR KIT,30187812,CDM,,,270,RC,outpatient,,2099.5,2099.5,,1782.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,524.88,22,,percent of total billed charges,,,,,,,,,1889.55,90,,percent of total billed charges,,,1738.39,82.8,,percent of total billed charges,,,1784.58,85,,percent of total billed charges,,,,,,,,,1847.56,88,,percent of total billed charges,,,,,,,,,1604.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,524.88,22,,percent of total billed charges,,,1910.55,91,,percent of total billed charges,,,1994.53,95,,percent of total billed charges,,,1742.59,83,,percent of total billed charges,,,1742.59,83,,percent of total billed charges,,,,,,,,,,,,,,,1742.59,83,,percent of total billed charges,,,1994.53,95,,percent of total billed charges,,,1889.55,90,,percent of total billed charges,,,1889.55,90,,percent of total billed charges,,,1721.59,82,,percent of total billed charges,,,1889.55,90,,percent of total billed charges,,,1784.58,85,,percent of total billed charges,,524.88,1994.53,
AERIN VIVAER,30187813,CDM,,,270,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
ARTHREX LASSO QUICKPASS 45DEG CURVED LEF,30187814,CDM,,,278,RC,outpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260,22,,percent of total billed charges,,,,,,,,,936,90,,percent of total billed charges,,,861.12,82.8,,percent of total billed charges,,,884,85,,percent of total billed charges,,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260,22,,percent of total billed charges,,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,260,988,
ARTHREX LASSO QUICKPASS 45DEG CURVE RIGH,30187815,CDM,,,278,RC,outpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260,22,,percent of total billed charges,,,,,,,,,936,90,,percent of total billed charges,,,861.12,82.8,,percent of total billed charges,,,884,85,,percent of total billed charges,,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260,22,,percent of total billed charges,,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,260,988,
ARTHREX FIBERTAK,30187816,CDM,,,270,RC,outpatient,,2730,2730,,2317.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,682.5,22,,percent of total billed charges,,,,,,,,,2457,90,,percent of total billed charges,,,2260.44,82.8,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,,,,,,,,2402.4,88,,percent of total billed charges,,,,,,,,,2085.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,682.5,22,,percent of total billed charges,,,2484.3,91,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2265.9,83,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2238.6,82,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,682.5,2593.5,
ARTHREX FIBERTAK STRAIGHT KIT,30187817,CDM,,,270,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
ARTHREX FIBERTAK CURVED KIT,30187818,CDM,,,270,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
ARTHREX SUTURE ANCHOR BC 2.9 X 12.5MM,30187819,CDM,,,278,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
ARTHREX KNIFE RETRACT. CANN. STRAIGHT,30187820,CDM,,,270,RC,outpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325,22,,percent of total billed charges,,,,,,,,,1170,90,,percent of total billed charges,,,1076.4,82.8,,percent of total billed charges,,,1105,85,,percent of total billed charges,,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325,22,,percent of total billed charges,,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,325,1235,
ARTHREX SUTURE TAPE WH/BL 1.7MM,30187821,CDM,,,270,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
ARTHREX CANNULA CRYSTAL PARTIALLY THREAD,30187822,CDM,,,270,RC,outpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50,22,,percent of total billed charges,,,,,,,,,180,90,,percent of total billed charges,,,165.6,82.8,,percent of total billed charges,,,170,85,,percent of total billed charges,,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50,22,,percent of total billed charges,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,50,190,
ARTHREX CANNULA TWIST-IN,30187823,CDM,,,270,RC,outpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50,22,,percent of total billed charges,,,,,,,,,180,90,,percent of total billed charges,,,165.6,82.8,,percent of total billed charges,,,170,85,,percent of total billed charges,,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50,22,,percent of total billed charges,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,50,190,
ARTHREX TIGHTROPE II RT RECON,30187824,CDM,,,270,RC,outpatient,,3672.5,3672.5,,3117.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,918.13,22,,percent of total billed charges,,,,,,,,,3305.25,90,,percent of total billed charges,,,3040.83,82.8,,percent of total billed charges,,,3121.63,85,,percent of total billed charges,,,,,,,,,3231.8,88,,percent of total billed charges,,,,,,,,,2805.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,918.13,22,,percent of total billed charges,,,3341.98,91,,percent of total billed charges,,,3488.88,95,,percent of total billed charges,,,3048.18,83,,percent of total billed charges,,,3048.18,83,,percent of total billed charges,,,,,,,,,,,,,,,3048.18,83,,percent of total billed charges,,,3488.88,95,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3011.45,82,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3121.63,85,,percent of total billed charges,,918.13,3488.88,
ARTHREX TIGHTROPE II RT W/ DEPLOYING SUT,30187825,CDM,,,270,RC,outpatient,,3022.5,3022.5,,2566.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,755.63,22,,percent of total billed charges,,,,,,,,,2720.25,90,,percent of total billed charges,,,2502.63,82.8,,percent of total billed charges,,,2569.13,85,,percent of total billed charges,,,,,,,,,2659.8,88,,percent of total billed charges,,,,,,,,,2309.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,755.63,22,,percent of total billed charges,,,2750.48,91,,percent of total billed charges,,,2871.38,95,,percent of total billed charges,,,2508.68,83,,percent of total billed charges,,,2508.68,83,,percent of total billed charges,,,,,,,,,,,,,,,2508.68,83,,percent of total billed charges,,,2871.38,95,,percent of total billed charges,,,2720.25,90,,percent of total billed charges,,,2720.25,90,,percent of total billed charges,,,2478.45,82,,percent of total billed charges,,,2720.25,90,,percent of total billed charges,,,2569.13,85,,percent of total billed charges,,755.63,2871.38,
ARTHREX TIGHTROPE BUTTON EXTENDER,30187826,CDM,,,270,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
ARTHREX T-ROPE CLOSED DRL 4MM,30187827,CDM,,,270,RC,outpatient,,875,875,,742.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.75,22,,percent of total billed charges,,,,,,,,,787.5,90,,percent of total billed charges,,,724.5,82.8,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,,,,,,,,770,88,,percent of total billed charges,,,,,,,,,668.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.75,22,,percent of total billed charges,,,796.25,91,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,,,,,,,,,,,,,726.25,83,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,717.5,82,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,218.75,831.25,
ARTHREX SCREW BIOCOMP 7X20 VENTED,30187828,CDM,,,270,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
ARTHREX SECONDARY FIXATION BIOSWVLK 4.75,30187829,CDM,,,270,RC,outpatient,,4712.5,4712.5,,4000.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1178.13,22,,percent of total billed charges,,,,,,,,,4241.25,90,,percent of total billed charges,,,3901.95,82.8,,percent of total billed charges,,,4005.63,85,,percent of total billed charges,,,,,,,,,4147,88,,percent of total billed charges,,,,,,,,,3600.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1178.13,22,,percent of total billed charges,,,4288.38,91,,percent of total billed charges,,,4476.88,95,,percent of total billed charges,,,3911.38,83,,percent of total billed charges,,,3911.38,83,,percent of total billed charges,,,,,,,,,,,,,,,3911.38,83,,percent of total billed charges,,,4476.88,95,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,3864.25,82,,percent of total billed charges,,,4241.25,90,,percent of total billed charges,,,4005.63,85,,percent of total billed charges,,1178.13,4476.88,
ARTHREX REEMER 7MM LP,30187830,CDM,,,270,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
ARTHREX REEMER 8MM LP,30187831,CDM,,,270,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
ARTHREX REAMER 9MM LP,30187832,CDM,,,270,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
ARTHREX ARTHROFLEX 40X70X2.0MM,30187833,CDM,,,270,RC,outpatient,,24713,24713,,20981.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6178.25,22,,percent of total billed charges,,,,,,,,,22241.7,90,,percent of total billed charges,,,20462.36,82.8,,percent of total billed charges,,,21006.05,85,,percent of total billed charges,,,,,,,,,21747.44,88,,percent of total billed charges,,,,,,,,,18880.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6178.25,22,,percent of total billed charges,,,22488.83,91,,percent of total billed charges,,,23477.35,95,,percent of total billed charges,,,20511.79,83,,percent of total billed charges,,,20511.79,83,,percent of total billed charges,,,,,,,,,,,,,,,20511.79,83,,percent of total billed charges,,,23477.35,95,,percent of total billed charges,,,22241.7,90,,percent of total billed charges,,,22241.7,90,,percent of total billed charges,,,20264.66,82,,percent of total billed charges,,,22241.7,90,,percent of total billed charges,,,21006.05,85,,percent of total billed charges,,6178.25,23477.35,
ARTHREX T-ROPE K-LESS W/DRIVER,30187834,CDM,,,270,RC,outpatient,,9717.5,9717.5,,8250.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2429.38,22,,percent of total billed charges,,,,,,,,,8745.75,90,,percent of total billed charges,,,8046.09,82.8,,percent of total billed charges,,,8259.88,85,,percent of total billed charges,,,,,,,,,8551.4,88,,percent of total billed charges,,,,,,,,,7424.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2429.38,22,,percent of total billed charges,,,8842.93,91,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,8065.53,83,,percent of total billed charges,,,,,,,,,,,,,,,8065.53,83,,percent of total billed charges,,,9231.63,95,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,7968.35,82,,percent of total billed charges,,,8745.75,90,,percent of total billed charges,,,8259.88,85,,percent of total billed charges,,2429.38,9231.63,
ARTHREX SWIVELOCK KNOTLESS 4.75MM BC,30187835,CDM,,,270,RC,outpatient,,2990,2990,,2538.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,747.5,22,,percent of total billed charges,,,,,,,,,2691,90,,percent of total billed charges,,,2475.72,82.8,,percent of total billed charges,,,2541.5,85,,percent of total billed charges,,,,,,,,,2631.2,88,,percent of total billed charges,,,,,,,,,2284.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,747.5,22,,percent of total billed charges,,,2720.9,91,,percent of total billed charges,,,2840.5,95,,percent of total billed charges,,,2481.7,83,,percent of total billed charges,,,2481.7,83,,percent of total billed charges,,,,,,,,,,,,,,,2481.7,83,,percent of total billed charges,,,2840.5,95,,percent of total billed charges,,,2691,90,,percent of total billed charges,,,2691,90,,percent of total billed charges,,,2451.8,82,,percent of total billed charges,,,2691,90,,percent of total billed charges,,,2541.5,85,,percent of total billed charges,,747.5,2840.5,
ARTHREX SWIVELOCK KNOTLESS 5.5MM BC,30187836,CDM,,,270,RC,outpatient,,2990,2990,,2538.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,747.5,22,,percent of total billed charges,,,,,,,,,2691,90,,percent of total billed charges,,,2475.72,82.8,,percent of total billed charges,,,2541.5,85,,percent of total billed charges,,,,,,,,,2631.2,88,,percent of total billed charges,,,,,,,,,2284.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,747.5,22,,percent of total billed charges,,,2720.9,91,,percent of total billed charges,,,2840.5,95,,percent of total billed charges,,,2481.7,83,,percent of total billed charges,,,2481.7,83,,percent of total billed charges,,,,,,,,,,,,,,,2481.7,83,,percent of total billed charges,,,2840.5,95,,percent of total billed charges,,,2691,90,,percent of total billed charges,,,2691,90,,percent of total billed charges,,,2451.8,82,,percent of total billed charges,,,2691,90,,percent of total billed charges,,,2541.5,85,,percent of total billed charges,,747.5,2840.5,
ARTHREX SPEEDBRIDGE IMPLANT SYSTEM,30187837,CDM,,,278,RC,outpatient,,13975,13975,,11864.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3493.75,22,,percent of total billed charges,,,,,,,,,12577.5,90,,percent of total billed charges,,,11571.3,82.8,,percent of total billed charges,,,11878.75,85,,percent of total billed charges,,,,,,,,,12298,88,,percent of total billed charges,,,,,,,,,10676.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3493.75,22,,percent of total billed charges,,,12717.25,91,,percent of total billed charges,,,13276.25,95,,percent of total billed charges,,,11599.25,83,,percent of total billed charges,,,11599.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11599.25,83,,percent of total billed charges,,,13276.25,95,,percent of total billed charges,,,12577.5,90,,percent of total billed charges,,,12577.5,90,,percent of total billed charges,,,11459.5,82,,percent of total billed charges,,,12577.5,90,,percent of total billed charges,,,11878.75,85,,percent of total billed charges,,3493.75,13276.25,
ARTHREX FIBERSTITCH IMPLANT CURVED,30187838,CDM,,,278,RC,outpatient,,3217.5,3217.5,,2731.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,804.38,22,,percent of total billed charges,,,,,,,,,2895.75,90,,percent of total billed charges,,,2664.09,82.8,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,,,,,,,,2831.4,88,,percent of total billed charges,,,,,,,,,2458.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,804.38,22,,percent of total billed charges,,,2927.93,91,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2670.53,83,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2638.35,82,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,804.38,3056.63,
ARTHREX FIBERSTITCH IMPLANT 24 DEG CURVE,30187841,CDM,,,278,RC,outpatient,,3217.5,3217.5,,2731.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,804.38,22,,percent of total billed charges,,,,,,,,,2895.75,90,,percent of total billed charges,,,2664.09,82.8,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,,,,,,,,2831.4,88,,percent of total billed charges,,,,,,,,,2458.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,804.38,22,,percent of total billed charges,,,2927.93,91,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2670.53,83,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2638.35,82,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,804.38,3056.63,
ARTHREX FIBERSTITCH IMPLANT REVERSE CURV,30187842,CDM,,,278,RC,outpatient,,3217.5,3217.5,,2731.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,804.38,22,,percent of total billed charges,,,,,,,,,2895.75,90,,percent of total billed charges,,,2664.09,82.8,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,,,,,,,,2831.4,88,,percent of total billed charges,,,,,,,,,2458.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,804.38,22,,percent of total billed charges,,,2927.93,91,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2670.53,83,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2638.35,82,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,804.38,3056.63,
ARTHREX FIBERSTITCH IMPLANT STRAIGHT,30187843,CDM,,,278,RC,outpatient,,3217.5,3217.5,,2731.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,804.38,22,,percent of total billed charges,,,,,,,,,2895.75,90,,percent of total billed charges,,,2664.09,82.8,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,,,,,,,,2831.4,88,,percent of total billed charges,,,,,,,,,2458.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,804.38,22,,percent of total billed charges,,,2927.93,91,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2670.53,83,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2638.35,82,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,804.38,3056.63,
ARTHREX KNOT PUSHER/SUTURE CUTTER,30187844,CDM,,,270,RC,outpatient,,1430,1430,,1214.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,357.5,22,,percent of total billed charges,,,,,,,,,1287,90,,percent of total billed charges,,,1184.04,82.8,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,,,,,,,,1258.4,88,,percent of total billed charges,,,,,,,,,1092.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,357.5,22,,percent of total billed charges,,,1301.3,91,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1186.9,83,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1172.6,82,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,357.5,1358.5,
ARTHREX CANNULA TRIPLEDAM 7 X 7MM,30187845,CDM,,,278,RC,outpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
ELECTRODE COLLINS COAGULATING KNIFE,30187846,CDM,,,270,RC,outpatient,,2587.46,2587.46,,2196.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,646.87,22,,percent of total billed charges,,,,,,,,,2328.71,90,,percent of total billed charges,,,2142.42,82.8,,percent of total billed charges,,,2199.34,85,,percent of total billed charges,,,,,,,,,2276.96,88,,percent of total billed charges,,,,,,,,,1976.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,646.87,22,,percent of total billed charges,,,2354.59,91,,percent of total billed charges,,,2458.09,95,,percent of total billed charges,,,2147.59,83,,percent of total billed charges,,,2147.59,83,,percent of total billed charges,,,,,,,,,,,,,,,2147.59,83,,percent of total billed charges,,,2458.09,95,,percent of total billed charges,,,2328.71,90,,percent of total billed charges,,,2328.71,90,,percent of total billed charges,,,2121.72,82,,percent of total billed charges,,,2328.71,90,,percent of total billed charges,,,2199.34,85,,percent of total billed charges,,646.87,2458.09,
ULRICH SCREW POLY 7.5 X 55MM,30187847,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH SCREW REDUCTION 7.5 X 55MM,30187848,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
ULRICH ROD LORDOSED 6.0 X 110MM,30187849,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ULRICH SCREW POLY 7.5 X 50MM,30187850,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
STRYKER SCREW LP 6.5X25MM,30187851,CDM,,,278,RC,outpatient,,946.4,946.4,,803.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,236.6,22,,percent of total billed charges,,,,,,,,,851.76,90,,percent of total billed charges,,,783.62,82.8,,percent of total billed charges,,,804.44,85,,percent of total billed charges,,,,,,,,,832.83,88,,percent of total billed charges,,,,,,,,,723.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,236.6,22,,percent of total billed charges,,,861.22,91,,percent of total billed charges,,,899.08,95,,percent of total billed charges,,,785.51,83,,percent of total billed charges,,,785.51,83,,percent of total billed charges,,,,,,,,,,,,,,,785.51,83,,percent of total billed charges,,,899.08,95,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,776.05,82,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,804.44,85,,percent of total billed charges,,236.6,899.08,
STRYKER STEM #4 35MM,30187852,CDM,,,278,RC,outpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3900,22,,percent of total billed charges,,,,,,,,,14040,90,,percent of total billed charges,,,12916.8,82.8,,percent of total billed charges,,,13260,85,,percent of total billed charges,,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3900,22,,percent of total billed charges,,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,3900,14820,
STRYKER HEAD DELTA V-40 36MM,30187853,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
ULRICH SCREW POLY 6.5 X 55,30187854,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH SCREW POLY 6.5 X 50,30187855,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
DEPUY GLENOSPHERE 42MM STD,30187857,CDM,,,278,RC,outpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4954.14,22,,percent of total billed charges,,,,,,,,,17834.9,90,,percent of total billed charges,,,16408.1,82.8,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4954.14,22,,percent of total billed charges,,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,4954.14,18825.72,
ENDOSCOPIC MARKER 10ML TATTOO,30187858,CDM,,,270,RC,outpatient,,211.2,211.2,,179.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.8,22,,percent of total billed charges,,,,,,,,,190.08,90,,percent of total billed charges,,,174.87,82.8,,percent of total billed charges,,,179.52,85,,percent of total billed charges,,,,,,,,,185.86,88,,percent of total billed charges,,,,,,,,,161.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.8,22,,percent of total billed charges,,,192.19,91,,percent of total billed charges,,,200.64,95,,percent of total billed charges,,,175.3,83,,percent of total billed charges,,,175.3,83,,percent of total billed charges,,,,,,,,,,,,,,,175.3,83,,percent of total billed charges,,,200.64,95,,percent of total billed charges,,,190.08,90,,percent of total billed charges,,,190.08,90,,percent of total billed charges,,,173.18,82,,percent of total billed charges,,,190.08,90,,percent of total billed charges,,,179.52,85,,percent of total billed charges,,52.8,200.64,
ULRICH TAP NON-CANNULATED 5.5,30187859,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
SPINECRAFT ROD 6.0 X 300MM,30187860,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
ZIMMER BEARING HUMERAL 36MM STD,30187861,CDM,,,278,RC,outpatient,,10725,10725,,9105.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2681.25,22,,percent of total billed charges,,,,,,,,,9652.5,90,,percent of total billed charges,,,8880.3,82.8,,percent of total billed charges,,,9116.25,85,,percent of total billed charges,,,,,,,,,9438,88,,percent of total billed charges,,,,,,,,,8193.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2681.25,22,,percent of total billed charges,,,9759.75,91,,percent of total billed charges,,,10188.75,95,,percent of total billed charges,,,8901.75,83,,percent of total billed charges,,,8901.75,83,,percent of total billed charges,,,,,,,,,,,,,,,8901.75,83,,percent of total billed charges,,,10188.75,95,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,8794.5,82,,percent of total billed charges,,,9652.5,90,,percent of total billed charges,,,9116.25,85,,percent of total billed charges,,2681.25,10188.75,
ZIMMER ADAPTOR TAPER VERSA-DIAL 25MM,30187862,CDM,,,278,RC,outpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325,22,,percent of total billed charges,,,,,,,,,1170,90,,percent of total billed charges,,,1076.4,82.8,,percent of total billed charges,,,1105,85,,percent of total billed charges,,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325,22,,percent of total billed charges,,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,325,1235,
ZIMMER LINER NEUTRAL SZ E 36MM +5,30187863,CDM,,,278,RC,outpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2551.25,22,,percent of total billed charges,,,,,,,,,9184.5,90,,percent of total billed charges,,,8449.74,82.8,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2551.25,22,,percent of total billed charges,,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,2551.25,9694.75,
IR PLATE 2 LEVEL 30MM,30187864,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
IR PLATE 2 LEVEL 34MM,30187865,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
IR DRILL 12MM,30187866,CDM,,,278,RC,outpatient,,2340,2340,,1986.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,585,22,,percent of total billed charges,,,,,,,,,2106,90,,percent of total billed charges,,,1937.52,82.8,,percent of total billed charges,,,1989,85,,percent of total billed charges,,,,,,,,,2059.2,88,,percent of total billed charges,,,,,,,,,1787.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,585,22,,percent of total billed charges,,,2129.4,91,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1942.2,83,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1918.8,82,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1989,85,,percent of total billed charges,,585,2223,
DEPUY STEM CORAIL STD SZ 18,30187868,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
GORE VBX BALLOON EXPANDABLE ENDOPROSTHES,30187869,CDM,,,270,RC,outpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5807.75,22,,percent of total billed charges,,,,,,,,,20907.9,90,,percent of total billed charges,,,19235.27,82.8,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5807.75,22,,percent of total billed charges,,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,5807.75,22069.45,
GORE VBX BALLOON EXPANDABLE ENDOPROSTHES,30187870,CDM,,,270,RC,outpatient,,23231,23231,,19723.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5807.75,22,,percent of total billed charges,,,,,,,,,20907.9,90,,percent of total billed charges,,,19235.27,82.8,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,,,,,,,,20443.28,88,,percent of total billed charges,,,,,,,,,17748.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5807.75,22,,percent of total billed charges,,,21140.21,91,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,19281.73,83,,percent of total billed charges,,,,,,,,,,,,,,,19281.73,83,,percent of total billed charges,,,22069.45,95,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19049.42,82,,percent of total billed charges,,,20907.9,90,,percent of total billed charges,,,19746.35,85,,percent of total billed charges,,5807.75,22069.45,
AMPLATZ GOOSE NECK MICROSNARE KIT,30187871,CDM,,,270,RC,outpatient,,4256.79,4256.79,,3614.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1064.2,22,,percent of total billed charges,,,,,,,,,3831.11,90,,percent of total billed charges,,,3524.62,82.8,,percent of total billed charges,,,3618.27,85,,percent of total billed charges,,,,,,,,,3745.98,88,,percent of total billed charges,,,,,,,,,3252.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1064.2,22,,percent of total billed charges,,,3873.68,91,,percent of total billed charges,,,4043.95,95,,percent of total billed charges,,,3533.14,83,,percent of total billed charges,,,3533.14,83,,percent of total billed charges,,,,,,,,,,,,,,,3533.14,83,,percent of total billed charges,,,4043.95,95,,percent of total billed charges,,,3831.11,90,,percent of total billed charges,,,3831.11,90,,percent of total billed charges,,,3490.57,82,,percent of total billed charges,,,3831.11,90,,percent of total billed charges,,,3618.27,85,,percent of total billed charges,,1064.2,4043.95,
CAPSULAR TENSION RING 14C,30187873,CDM,,,278,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
ZIMMER TIBIA CENTRAL CONE LARGE,30187874,CDM,,,278,RC,outpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12075.78,22,,percent of total billed charges,,,,,,,,,43472.82,90,,percent of total billed charges,,,39994.99,82.8,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12075.78,22,,percent of total billed charges,,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,12075.78,45887.97,
ZIMMER FEMORAL ROTATING HINGE F-RT,30187875,CDM,,,278,RC,outpatient,,57459.03,57459.03,,48782.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14364.76,22,,percent of total billed charges,,,,,,,,,51713.13,90,,percent of total billed charges,,,47576.08,82.8,,percent of total billed charges,,,48840.18,85,,percent of total billed charges,,,,,,,,,50563.95,88,,percent of total billed charges,,,,,,,,,43898.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14364.76,22,,percent of total billed charges,,,52287.72,91,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,,,,,,,,,,,,,47690.99,83,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,47116.4,82,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,48840.18,85,,percent of total billed charges,,14364.76,54586.08,
ZIMMER STEM EXTENSION STRAIGHT 75MM,30187876,CDM,,,278,RC,outpatient,,7276.62,7276.62,,6177.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1819.16,22,,percent of total billed charges,,,,,,,,,6548.96,90,,percent of total billed charges,,,6025.04,82.8,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,,,,,,,,6403.43,88,,percent of total billed charges,,,,,,,,,5559.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1819.16,22,,percent of total billed charges,,,6621.72,91,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,,,,,,,,,,,,,6039.59,83,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,5966.83,82,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,1819.16,6912.79,
ZIMMER FEMORAL CENTRAL CONE MEDIUM,30187877,CDM,,,278,RC,outpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12075.78,22,,percent of total billed charges,,,,,,,,,43472.82,90,,percent of total billed charges,,,39994.99,82.8,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12075.78,22,,percent of total billed charges,,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,12075.78,45887.97,
ZIMMER AUGMENT BLOCK DISTAL ONLY 20MM,30187878,CDM,,,278,RC,outpatient,,7564.38,7564.38,,6422.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1891.1,22,,percent of total billed charges,,,,,,,,,6807.94,90,,percent of total billed charges,,,6263.31,82.8,,percent of total billed charges,,,6429.72,85,,percent of total billed charges,,,,,,,,,6656.65,88,,percent of total billed charges,,,,,,,,,5779.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1891.1,22,,percent of total billed charges,,,6883.59,91,,percent of total billed charges,,,7186.16,95,,percent of total billed charges,,,6278.44,83,,percent of total billed charges,,,6278.44,83,,percent of total billed charges,,,,,,,,,,,,,,,6278.44,83,,percent of total billed charges,,,7186.16,95,,percent of total billed charges,,,6807.94,90,,percent of total billed charges,,,6807.94,90,,percent of total billed charges,,,6202.79,82,,percent of total billed charges,,,6807.94,90,,percent of total billed charges,,,6429.72,85,,percent of total billed charges,,1891.1,7186.16,
ZIMMER PLATE HINGE STEM TIBIAL SZ 5,30187879,CDM,,,278,RC,outpatient,,28502.57,28502.57,,24198.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7125.64,22,,percent of total billed charges,,,,,,,,,25652.31,90,,percent of total billed charges,,,23600.13,82.8,,percent of total billed charges,,,24227.18,85,,percent of total billed charges,,,,,,,,,25082.26,88,,percent of total billed charges,,,,,,,,,21775.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7125.64,22,,percent of total billed charges,,,25937.34,91,,percent of total billed charges,,,27077.44,95,,percent of total billed charges,,,23657.13,83,,percent of total billed charges,,,23657.13,83,,percent of total billed charges,,,,,,,,,,,,,,,23657.13,83,,percent of total billed charges,,,27077.44,95,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,23372.11,82,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,24227.18,85,,percent of total billed charges,,7125.64,27077.44,
ZIMMER AUGMENT BLOCK HINGE FULL TIBIAL 1,30187880,CDM,,,278,RC,outpatient,,10304.84,10304.84,,8748.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2576.21,22,,percent of total billed charges,,,,,,,,,9274.36,90,,percent of total billed charges,,,8532.41,82.8,,percent of total billed charges,,,8759.11,85,,percent of total billed charges,,,,,,,,,9068.26,88,,percent of total billed charges,,,,,,,,,7872.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2576.21,22,,percent of total billed charges,,,9377.4,91,,percent of total billed charges,,,9789.6,95,,percent of total billed charges,,,8553.02,83,,percent of total billed charges,,,8553.02,83,,percent of total billed charges,,,,,,,,,,,,,,,8553.02,83,,percent of total billed charges,,,9789.6,95,,percent of total billed charges,,,9274.36,90,,percent of total billed charges,,,9274.36,90,,percent of total billed charges,,,8449.97,82,,percent of total billed charges,,,9274.36,90,,percent of total billed charges,,,8759.11,85,,percent of total billed charges,,2576.21,9789.6,
ZIMMER HINGE ARTICULAR SURFACE 17MM SZ F,30187881,CDM,,,278,RC,outpatient,,12617.41,12617.41,,10712.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3154.35,22,,percent of total billed charges,,,,,,,,,11355.67,90,,percent of total billed charges,,,10447.22,82.8,,percent of total billed charges,,,10724.8,85,,percent of total billed charges,,,,,,,,,11103.32,88,,percent of total billed charges,,,,,,,,,9639.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3154.35,22,,percent of total billed charges,,,11481.84,91,,percent of total billed charges,,,11986.54,95,,percent of total billed charges,,,10472.45,83,,percent of total billed charges,,,10472.45,83,,percent of total billed charges,,,,,,,,,,,,,,,10472.45,83,,percent of total billed charges,,,11986.54,95,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,10346.28,82,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,10724.8,85,,percent of total billed charges,,3154.35,11986.54,
DEPUY GLENOSPHERE 42MM +4MM,30187882,CDM,,,278,RC,outpatient,,19816.55,19816.55,,16824.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4954.14,22,,percent of total billed charges,,,,,,,,,17834.9,90,,percent of total billed charges,,,16408.1,82.8,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,,,,,,,,17438.56,88,,percent of total billed charges,,,,,,,,,15139.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4954.14,22,,percent of total billed charges,,,18033.06,91,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,16447.74,83,,percent of total billed charges,,,,,,,,,,,,,,,16447.74,83,,percent of total billed charges,,,18825.72,95,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16249.57,82,,percent of total billed charges,,,17834.9,90,,percent of total billed charges,,,16844.07,85,,percent of total billed charges,,4954.14,18825.72,
COOK STOPCOCK SANANTONIO,30187883,CDM,,,270,RC,outpatient,,82.71,82.71,,70.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.68,22,,percent of total billed charges,,,,,,,,,74.44,90,,percent of total billed charges,,,68.48,82.8,,percent of total billed charges,,,70.3,85,,percent of total billed charges,,,,,,,,,72.78,88,,percent of total billed charges,,,,,,,,,63.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.68,22,,percent of total billed charges,,,75.27,91,,percent of total billed charges,,,78.57,95,,percent of total billed charges,,,68.65,83,,percent of total billed charges,,,68.65,83,,percent of total billed charges,,,,,,,,,,,,,,,68.65,83,,percent of total billed charges,,,78.57,95,,percent of total billed charges,,,74.44,90,,percent of total billed charges,,,74.44,90,,percent of total billed charges,,,67.82,82,,percent of total billed charges,,,74.44,90,,percent of total billed charges,,,70.3,85,,percent of total billed charges,,20.68,78.57,
EVERCROSS BALLOON 4 X 60MM,30187885,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
KYPHON INTRODUCER NEEDLE BEVEL,30187886,CDM,,,278,RC,outpatient,,3003,3003,,2549.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,750.75,22,,percent of total billed charges,,,,,,,,,2702.7,90,,percent of total billed charges,,,2486.48,82.8,,percent of total billed charges,,,2552.55,85,,percent of total billed charges,,,,,,,,,2642.64,88,,percent of total billed charges,,,,,,,,,2294.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,750.75,22,,percent of total billed charges,,,2732.73,91,,percent of total billed charges,,,2852.85,95,,percent of total billed charges,,,2492.49,83,,percent of total billed charges,,,2492.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2492.49,83,,percent of total billed charges,,,2852.85,95,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2462.46,82,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2552.55,85,,percent of total billed charges,,750.75,2852.85,
KYPHON INTRODUCER NEEDLE DIAMOND,30187887,CDM,,,278,RC,outpatient,,3003,3003,,2549.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,750.75,22,,percent of total billed charges,,,,,,,,,2702.7,90,,percent of total billed charges,,,2486.48,82.8,,percent of total billed charges,,,2552.55,85,,percent of total billed charges,,,,,,,,,2642.64,88,,percent of total billed charges,,,,,,,,,2294.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,750.75,22,,percent of total billed charges,,,2732.73,91,,percent of total billed charges,,,2852.85,95,,percent of total billed charges,,,2492.49,83,,percent of total billed charges,,,2492.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2492.49,83,,percent of total billed charges,,,2852.85,95,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2462.46,82,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2552.55,85,,percent of total billed charges,,750.75,2852.85,
KYPHON 15/2 FRACTURE KIT,30187888,CDM,,,278,RC,outpatient,,25961,25961,,22040.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6490.25,22,,percent of total billed charges,,,,,,,,,23364.9,90,,percent of total billed charges,,,21495.71,82.8,,percent of total billed charges,,,22066.85,85,,percent of total billed charges,,,,,,,,,22845.68,88,,percent of total billed charges,,,,,,,,,19834.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6490.25,22,,percent of total billed charges,,,23624.51,91,,percent of total billed charges,,,24662.95,95,,percent of total billed charges,,,21547.63,83,,percent of total billed charges,,,21547.63,83,,percent of total billed charges,,,,,,,,,,,,,,,21547.63,83,,percent of total billed charges,,,24662.95,95,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,21288.02,82,,percent of total billed charges,,,23364.9,90,,percent of total billed charges,,,22066.85,85,,percent of total billed charges,,6490.25,24662.95,
ZIMMER FEMUR POROUS CR SZ 8 RIGHT,30187889,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER CPS LEFT 12MM,30187890,CDM,,,278,RC,outpatient,,17135.63,17135.63,,14548.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4283.91,22,,percent of total billed charges,,,,,,,,,15422.07,90,,percent of total billed charges,,,14188.3,82.8,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,,,,,,,,15079.35,88,,percent of total billed charges,,,,,,,,,13091.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4283.91,22,,percent of total billed charges,,,15593.42,91,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14222.57,83,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14051.22,82,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,4283.91,16278.85,
ZIMMER AUGMENT DISTAL FEMUR 5MM,30187891,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER REVISION FEMUR CR STD SZ 5 LEFT,30187892,CDM,,,278,RC,outpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16788.28,22,,percent of total billed charges,,,,,,,,,60437.82,90,,percent of total billed charges,,,55602.79,82.8,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16788.28,22,,percent of total billed charges,,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,16788.28,63795.47,
ZIMMER AUGMENT POST FEMUR 55MM,30187893,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER FEMUR CEMENTED REVISION SZ D LEFT,30187894,CDM,,,278,RC,outpatient,,24033.75,24033.75,,20404.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6008.44,22,,percent of total billed charges,,,,,,,,,21630.38,90,,percent of total billed charges,,,19899.95,82.8,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,,,,,,,,21149.7,88,,percent of total billed charges,,,,,,,,,18361.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6008.44,22,,percent of total billed charges,,,21870.71,91,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,,,,,,,,,,,,,19948.01,83,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,19707.68,82,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,6008.44,22832.06,
ZIMMER AUGMENT TIBIAL 5MM,30187895,CDM,,,278,RC,outpatient,,10637.5,10637.5,,9031.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2659.38,22,,percent of total billed charges,,,,,,,,,9573.75,90,,percent of total billed charges,,,8807.85,82.8,,percent of total billed charges,,,9041.88,85,,percent of total billed charges,,,,,,,,,9361,88,,percent of total billed charges,,,,,,,,,8127.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2659.38,22,,percent of total billed charges,,,9680.13,91,,percent of total billed charges,,,10105.63,95,,percent of total billed charges,,,8829.13,83,,percent of total billed charges,,,8829.13,83,,percent of total billed charges,,,,,,,,,,,,,,,8829.13,83,,percent of total billed charges,,,10105.63,95,,percent of total billed charges,,,9573.75,90,,percent of total billed charges,,,9573.75,90,,percent of total billed charges,,,8722.75,82,,percent of total billed charges,,,9573.75,90,,percent of total billed charges,,,9041.88,85,,percent of total billed charges,,2659.38,10105.63,
ZIMMER AUGMENT TIBIAL MEDIAL 5MM,30187896,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER STEM OFFSET 12 X 135MM,30187897,CDM,,,278,RC,outpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6126.25,22,,percent of total billed charges,,,,,,,,,22054.5,90,,percent of total billed charges,,,20290.14,82.8,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6126.25,22,,percent of total billed charges,,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,6126.25,23279.75,
LIGASURE SMALL JAW OPEN SEALER/DIVIDER,30187898,CDM,,,270,RC,outpatient,,4459,4459,,3785.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1114.75,22,,percent of total billed charges,,,,,,,,,4013.1,90,,percent of total billed charges,,,3692.05,82.8,,percent of total billed charges,,,3790.15,85,,percent of total billed charges,,,,,,,,,3923.92,88,,percent of total billed charges,,,,,,,,,3406.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1114.75,22,,percent of total billed charges,,,4057.69,91,,percent of total billed charges,,,4236.05,95,,percent of total billed charges,,,3700.97,83,,percent of total billed charges,,,3700.97,83,,percent of total billed charges,,,,,,,,,,,,,,,3700.97,83,,percent of total billed charges,,,4236.05,95,,percent of total billed charges,,,4013.1,90,,percent of total billed charges,,,4013.1,90,,percent of total billed charges,,,3656.38,82,,percent of total billed charges,,,4013.1,90,,percent of total billed charges,,,3790.15,85,,percent of total billed charges,,1114.75,4236.05,
EMG NEEDLE ELECTRODE PAIRED SUBDERMAL,30187899,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
SURECLIP 11MM HEMOSTATSIS CLIP,30187900,CDM,,,270,RC,outpatient,,611.65,611.65,,519.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,152.91,22,,percent of total billed charges,,,,,,,,,550.49,90,,percent of total billed charges,,,506.45,82.8,,percent of total billed charges,,,519.9,85,,percent of total billed charges,,,,,,,,,538.25,88,,percent of total billed charges,,,,,,,,,467.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,152.91,22,,percent of total billed charges,,,556.6,91,,percent of total billed charges,,,581.07,95,,percent of total billed charges,,,507.67,83,,percent of total billed charges,,,507.67,83,,percent of total billed charges,,,,,,,,,,,,,,,507.67,83,,percent of total billed charges,,,581.07,95,,percent of total billed charges,,,550.49,90,,percent of total billed charges,,,550.49,90,,percent of total billed charges,,,501.55,82,,percent of total billed charges,,,550.49,90,,percent of total billed charges,,,519.9,85,,percent of total billed charges,,152.91,581.07,
FORTEC HOLMIUM LASER HIGH WATTAGE,30187902,CDM,,,270,RC,outpatient,,3445,3445,,2924.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,861.25,22,,percent of total billed charges,,,,,,,,,3100.5,90,,percent of total billed charges,,,2852.46,82.8,,percent of total billed charges,,,2928.25,85,,percent of total billed charges,,,,,,,,,3031.6,88,,percent of total billed charges,,,,,,,,,2631.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,861.25,22,,percent of total billed charges,,,3134.95,91,,percent of total billed charges,,,3272.75,95,,percent of total billed charges,,,2859.35,83,,percent of total billed charges,,,2859.35,83,,percent of total billed charges,,,,,,,,,,,,,,,2859.35,83,,percent of total billed charges,,,3272.75,95,,percent of total billed charges,,,3100.5,90,,percent of total billed charges,,,3100.5,90,,percent of total billed charges,,,2824.9,82,,percent of total billed charges,,,3100.5,90,,percent of total billed charges,,,2928.25,85,,percent of total billed charges,,861.25,3272.75,
ULRICH SCREW POLY 6.5 X 45,30187903,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH SCREW POLY 6.5 X 40,30187904,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ZIMMER TIBIA REVISION SZ C RIGHT,30187905,CDM,,,278,RC,outpatient,,24033.75,24033.75,,20404.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6008.44,22,,percent of total billed charges,,,,,,,,,21630.38,90,,percent of total billed charges,,,19899.95,82.8,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,,,,,,,,21149.7,88,,percent of total billed charges,,,,,,,,,18361.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6008.44,22,,percent of total billed charges,,,21870.71,91,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,,,,,,,,,,,,,19948.01,83,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,19707.68,82,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,6008.44,22832.06,
ZIMMER BLOCK LATERAL TIBIA 10MM,30187906,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER BLOCK MEDIAL TIBIA 10MM,30187907,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER DISTAL AUGMENT FEMUR SZ 5 10MM,30187908,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER FEMUR REVISION PSN SZ 5 RIGHT,30187909,CDM,,,278,RC,outpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16788.28,22,,percent of total billed charges,,,,,,,,,60437.82,90,,percent of total billed charges,,,55602.79,82.8,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16788.28,22,,percent of total billed charges,,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,16788.28,63795.47,
ZIMMER INSERT CCK 12MM RIGHT,30187910,CDM,,,278,RC,outpatient,,23562.5,23562.5,,20004.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5890.63,22,,percent of total billed charges,,,,,,,,,21206.25,90,,percent of total billed charges,,,19509.75,82.8,,percent of total billed charges,,,20028.13,85,,percent of total billed charges,,,,,,,,,20735,88,,percent of total billed charges,,,,,,,,,18001.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5890.63,22,,percent of total billed charges,,,21441.88,91,,percent of total billed charges,,,22384.38,95,,percent of total billed charges,,,19556.88,83,,percent of total billed charges,,,19556.88,83,,percent of total billed charges,,,,,,,,,,,,,,,19556.88,83,,percent of total billed charges,,,22384.38,95,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,19321.25,82,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,20028.13,85,,percent of total billed charges,,5890.63,22384.38,
ZIMMER FEMUR TIN SZ 7 LEFT,30187911,CDM,,,278,RC,outpatient,,19500,19500,,16555.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4875,22,,percent of total billed charges,,,,,,,,,17550,90,,percent of total billed charges,,,16146,82.8,,percent of total billed charges,,,16575,85,,percent of total billed charges,,,,,,,,,17160,88,,percent of total billed charges,,,,,,,,,14898,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4875,22,,percent of total billed charges,,,17745,91,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,16185,83,,percent of total billed charges,,,,,,,,,,,,,,,16185,83,,percent of total billed charges,,,18525,95,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,15990,82,,percent of total billed charges,,,17550,90,,percent of total billed charges,,,16575,85,,percent of total billed charges,,4875,18525,
SYNTHES SCREW TFNA 105MM,30187912,CDM,,,278,RC,outpatient,,6682.07,6682.07,,5673.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1670.52,22,,percent of total billed charges,,,,,,,,,6013.86,90,,percent of total billed charges,,,5532.75,82.8,,percent of total billed charges,,,5679.76,85,,percent of total billed charges,,,,,,,,,5880.22,88,,percent of total billed charges,,,,,,,,,5105.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1670.52,22,,percent of total billed charges,,,6080.68,91,,percent of total billed charges,,,6347.97,95,,percent of total billed charges,,,5546.12,83,,percent of total billed charges,,,5546.12,83,,percent of total billed charges,,,,,,,,,,,,,,,5546.12,83,,percent of total billed charges,,,6347.97,95,,percent of total billed charges,,,6013.86,90,,percent of total billed charges,,,6013.86,90,,percent of total billed charges,,,5479.3,82,,percent of total billed charges,,,6013.86,90,,percent of total billed charges,,,5679.76,85,,percent of total billed charges,,1670.52,6347.97,
SYNTHES SCREW METAPHYSEAL 2.7 X 10MM,30187913,CDM,,,278,RC,outpatient,,492.38,492.38,,418.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.1,22,,percent of total billed charges,,,,,,,,,443.14,90,,percent of total billed charges,,,407.69,82.8,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,,,,,,,,433.29,88,,percent of total billed charges,,,,,,,,,376.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.1,22,,percent of total billed charges,,,448.07,91,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,,,,,,,,,,,,,408.68,83,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,403.75,82,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,123.1,467.76,
SYNTHES SCREW METAPHYSEAL 2.7 X 16MM,30187914,CDM,,,278,RC,outpatient,,492.38,492.38,,418.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.1,22,,percent of total billed charges,,,,,,,,,443.14,90,,percent of total billed charges,,,407.69,82.8,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,,,,,,,,433.29,88,,percent of total billed charges,,,,,,,,,376.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.1,22,,percent of total billed charges,,,448.07,91,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,,,,,,,,,,,,,408.68,83,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,403.75,82,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,123.1,467.76,
SYNTHES SCREW METAPHYSEAL 2.7 X 18MM,30187915,CDM,,,278,RC,outpatient,,492.38,492.38,,418.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.1,22,,percent of total billed charges,,,,,,,,,443.14,90,,percent of total billed charges,,,407.69,82.8,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,,,,,,,,433.29,88,,percent of total billed charges,,,,,,,,,376.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.1,22,,percent of total billed charges,,,448.07,91,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,,,,,,,,,,,,,408.68,83,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,403.75,82,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,123.1,467.76,
STRYKER STEM ACCOLADE II SZ 4 132DEG,30187916,CDM,,,278,RC,outpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3900,22,,percent of total billed charges,,,,,,,,,14040,90,,percent of total billed charges,,,12916.8,82.8,,percent of total billed charges,,,13260,85,,percent of total billed charges,,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3900,22,,percent of total billed charges,,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,3900,14820,
STRYKER CUP TRIDENT II 52E,30187917,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
S&N SCREW INTERFERENCE 8X20,30187918,CDM,,,270,RC,outpatient,,4091.95,4091.95,,3474.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1022.99,22,,percent of total billed charges,,,,,,,,,3682.76,90,,percent of total billed charges,,,3388.13,82.8,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,,,,,,,,3600.92,88,,percent of total billed charges,,,,,,,,,3126.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1022.99,22,,percent of total billed charges,,,3723.67,91,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3396.32,83,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3355.4,82,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,1022.99,3887.35,
ULRICH BOLT ILIAC 8.0 X 70MM,30187919,CDM,,,278,RC,outpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2356.25,22,,percent of total billed charges,,,,,,,,,8482.5,90,,percent of total billed charges,,,7803.9,82.8,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2356.25,22,,percent of total billed charges,,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,2356.25,8953.75,
ULRICH TAP NON-CANNULATED 7.5,30187920,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
ULRICH SCREW REDUCTION 7.5 X 50MM,30187923,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
STRYKER TIBIA INSERT SZ 5 11MM,30187924,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
BLADDER EVACUATOR ELLIK,30187925,CDM,,,270,RC,outpatient,,81.35,81.35,,69.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.34,22,,percent of total billed charges,,,,,,,,,73.22,90,,percent of total billed charges,,,67.36,82.8,,percent of total billed charges,,,69.15,85,,percent of total billed charges,,,,,,,,,71.59,88,,percent of total billed charges,,,,,,,,,62.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.34,22,,percent of total billed charges,,,74.03,91,,percent of total billed charges,,,77.28,95,,percent of total billed charges,,,67.52,83,,percent of total billed charges,,,67.52,83,,percent of total billed charges,,,,,,,,,,,,,,,67.52,83,,percent of total billed charges,,,77.28,95,,percent of total billed charges,,,73.22,90,,percent of total billed charges,,,73.22,90,,percent of total billed charges,,,66.71,82,,percent of total billed charges,,,73.22,90,,percent of total billed charges,,,69.15,85,,percent of total billed charges,,20.34,77.28,
STRYKER FEMUR SZ 7 LEFT,30187926,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER INSERT TIBIA CS SZ 6,30187927,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STAPLER SEPTO,30187928,CDM,,,270,RC,outpatient,,1171.82,1171.82,,994.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,292.96,22,,percent of total billed charges,,,,,,,,,1054.64,90,,percent of total billed charges,,,970.27,82.8,,percent of total billed charges,,,996.05,85,,percent of total billed charges,,,,,,,,,1031.2,88,,percent of total billed charges,,,,,,,,,895.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,292.96,22,,percent of total billed charges,,,1066.36,91,,percent of total billed charges,,,1113.23,95,,percent of total billed charges,,,972.61,83,,percent of total billed charges,,,972.61,83,,percent of total billed charges,,,,,,,,,,,,,,,972.61,83,,percent of total billed charges,,,1113.23,95,,percent of total billed charges,,,1054.64,90,,percent of total billed charges,,,1054.64,90,,percent of total billed charges,,,960.89,82,,percent of total billed charges,,,1054.64,90,,percent of total billed charges,,,996.05,85,,percent of total billed charges,,292.96,1113.23,
DEPUY POST AUGMENT SZ 6 8MM,30187931,CDM,,,278,RC,outpatient,,9677.92,9677.92,,8216.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2419.48,22,,percent of total billed charges,,,,,,,,,8710.13,90,,percent of total billed charges,,,8013.32,82.8,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,,,,,,,,8516.57,88,,percent of total billed charges,,,,,,,,,7393.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2419.48,22,,percent of total billed charges,,,8806.91,91,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,8032.67,83,,percent of total billed charges,,,,,,,,,,,,,,,8032.67,83,,percent of total billed charges,,,9194.02,95,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,7935.89,82,,percent of total billed charges,,,8710.13,90,,percent of total billed charges,,,8226.23,85,,percent of total billed charges,,2419.48,9194.02,
DEPUY ATTUNE SLEEVE FEMORAL 40MM,30187932,CDM,,,278,RC,outpatient,,25743.19,25743.19,,21855.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6435.8,22,,percent of total billed charges,,,,,,,,,23168.87,90,,percent of total billed charges,,,21315.36,82.8,,percent of total billed charges,,,21881.71,85,,percent of total billed charges,,,,,,,,,22654.01,88,,percent of total billed charges,,,,,,,,,19667.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6435.8,22,,percent of total billed charges,,,23426.3,91,,percent of total billed charges,,,24456.03,95,,percent of total billed charges,,,21366.85,83,,percent of total billed charges,,,21366.85,83,,percent of total billed charges,,,,,,,,,,,,,,,21366.85,83,,percent of total billed charges,,,24456.03,95,,percent of total billed charges,,,23168.87,90,,percent of total billed charges,,,23168.87,90,,percent of total billed charges,,,21109.42,82,,percent of total billed charges,,,23168.87,90,,percent of total billed charges,,,21881.71,85,,percent of total billed charges,,6435.8,24456.03,
DEPUY ATTUNE INSERT CRS SZ 6 8MM,30187933,CDM,,,278,RC,outpatient,,23578.82,23578.82,,20018.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5894.71,22,,percent of total billed charges,,,,,,,,,21220.94,90,,percent of total billed charges,,,19523.26,82.8,,percent of total billed charges,,,20042,85,,percent of total billed charges,,,,,,,,,20749.36,88,,percent of total billed charges,,,,,,,,,18014.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5894.71,22,,percent of total billed charges,,,21456.73,91,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,19570.42,83,,percent of total billed charges,,,,,,,,,,,,,,,19570.42,83,,percent of total billed charges,,,22399.88,95,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,19334.63,82,,percent of total billed charges,,,21220.94,90,,percent of total billed charges,,,20042,85,,percent of total billed charges,,5894.71,22399.88,
ARTHREX INSERT HUMERAL 36 +6/33 COMBO,30187934,CDM,,,278,RC,outpatient,,6597.5,6597.5,,5601.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1649.38,22,,percent of total billed charges,,,,,,,,,5937.75,90,,percent of total billed charges,,,5462.73,82.8,,percent of total billed charges,,,5607.88,85,,percent of total billed charges,,,,,,,,,5805.8,88,,percent of total billed charges,,,,,,,,,5040.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1649.38,22,,percent of total billed charges,,,6003.73,91,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,5475.93,83,,percent of total billed charges,,,,,,,,,,,,,,,5475.93,83,,percent of total billed charges,,,6267.63,95,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5409.95,82,,percent of total billed charges,,,5937.75,90,,percent of total billed charges,,,5607.88,85,,percent of total billed charges,,1649.38,6267.63,
ARTHREX GLENOSPHERE 33 +4 LAT/24,30187935,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
ARTHREX SCREW CENTRAL MODULAR 30MM,30187936,CDM,,,278,RC,outpatient,,6175,6175,,5242.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1543.75,22,,percent of total billed charges,,,,,,,,,5557.5,90,,percent of total billed charges,,,5112.9,82.8,,percent of total billed charges,,,5248.75,85,,percent of total billed charges,,,,,,,,,5434,88,,percent of total billed charges,,,,,,,,,4717.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1543.75,22,,percent of total billed charges,,,5619.25,91,,percent of total billed charges,,,5866.25,95,,percent of total billed charges,,,5125.25,83,,percent of total billed charges,,,5125.25,83,,percent of total billed charges,,,,,,,,,,,,,,,5125.25,83,,percent of total billed charges,,,5866.25,95,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5063.5,82,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5248.75,85,,percent of total billed charges,,1543.75,5866.25,
BOSTON URETERAL ACCESS GUIDE 11/13 X 36M,30187937,CDM,,,270,RC,outpatient,,841.4,841.4,,714.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210.35,22,,percent of total billed charges,,,,,,,,,757.26,90,,percent of total billed charges,,,696.68,82.8,,percent of total billed charges,,,715.19,85,,percent of total billed charges,,,,,,,,,740.43,88,,percent of total billed charges,,,,,,,,,642.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210.35,22,,percent of total billed charges,,,765.67,91,,percent of total billed charges,,,799.33,95,,percent of total billed charges,,,698.36,83,,percent of total billed charges,,,698.36,83,,percent of total billed charges,,,,,,,,,,,,,,,698.36,83,,percent of total billed charges,,,799.33,95,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,689.95,82,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,715.19,85,,percent of total billed charges,,210.35,799.33,
S&N ENDOBUTTON 25MM,30187938,CDM,,,270,RC,outpatient,,2207.34,2207.34,,1874.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,551.84,22,,percent of total billed charges,,,,,,,,,1986.61,90,,percent of total billed charges,,,1827.68,82.8,,percent of total billed charges,,,1876.24,85,,percent of total billed charges,,,,,,,,,1942.46,88,,percent of total billed charges,,,,,,,,,1686.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,551.84,22,,percent of total billed charges,,,2008.68,91,,percent of total billed charges,,,2096.97,95,,percent of total billed charges,,,1832.09,83,,percent of total billed charges,,,1832.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1832.09,83,,percent of total billed charges,,,2096.97,95,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1810.02,82,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1876.24,85,,percent of total billed charges,,551.84,2096.97,
S&N SCREW BIO 9X25,30187939,CDM,,,270,RC,outpatient,,4091.95,4091.95,,3474.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1022.99,22,,percent of total billed charges,,,,,,,,,3682.76,90,,percent of total billed charges,,,3388.13,82.8,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,,,,,,,,3600.92,88,,percent of total billed charges,,,,,,,,,3126.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1022.99,22,,percent of total billed charges,,,3723.67,91,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3396.32,83,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3355.4,82,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,1022.99,3887.35,
ZIMMER LINER G7 VIT E +5MM 40MM,30187940,CDM,,,278,RC,outpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2551.25,22,,percent of total billed charges,,,,,,,,,9184.5,90,,percent of total billed charges,,,8449.74,82.8,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2551.25,22,,percent of total billed charges,,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,2551.25,9694.75,
ZIMMER STEM OFFSET REV 3MM 20X135MM,30187941,CDM,,,278,RC,outpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6126.25,22,,percent of total billed charges,,,,,,,,,22054.5,90,,percent of total billed charges,,,20290.14,82.8,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6126.25,22,,percent of total billed charges,,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,6126.25,23279.75,
ZIMMER AUGMENT POSTERIOR FEMUR SZ11,30187942,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER BEARING CPS 10MM,30187943,CDM,,,278,RC,outpatient,,17135.63,17135.63,,14548.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4283.91,22,,percent of total billed charges,,,,,,,,,15422.07,90,,percent of total billed charges,,,14188.3,82.8,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,,,,,,,,15079.35,88,,percent of total billed charges,,,,,,,,,13091.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4283.91,22,,percent of total billed charges,,,15593.42,91,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14222.57,83,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14051.22,82,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,4283.91,16278.85,
ZIMMER FEMUR REVISION PSN LEFT SZ 11,30187944,CDM,,,278,RC,outpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16788.28,22,,percent of total billed charges,,,,,,,,,60437.82,90,,percent of total billed charges,,,55602.79,82.8,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16788.28,22,,percent of total billed charges,,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,16788.28,63795.47,
ZIMMER TIBIA BLOCK 5MM,30187945,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER TIBIA BLOCK 5MM LL,30187946,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER TIBIA REVISION LEFT SZ H-L,30187947,CDM,,,278,RC,outpatient,,24033.75,24033.75,,20404.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6008.44,22,,percent of total billed charges,,,,,,,,,21630.38,90,,percent of total billed charges,,,19899.95,82.8,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,,,,,,,,21149.7,88,,percent of total billed charges,,,,,,,,,18361.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6008.44,22,,percent of total billed charges,,,21870.71,91,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,,,,,,,,,,,,,19948.01,83,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,19707.68,82,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,6008.44,22832.06,
SYNTHES TFNA 12MM X 125MM,30187948,CDM,,,278,RC,outpatient,,16019.38,16019.38,,13600.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4004.85,22,,percent of total billed charges,,,,,,,,,14417.44,90,,percent of total billed charges,,,13264.05,82.8,,percent of total billed charges,,,13616.47,85,,percent of total billed charges,,,,,,,,,14097.05,88,,percent of total billed charges,,,,,,,,,12238.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4004.85,22,,percent of total billed charges,,,14577.64,91,,percent of total billed charges,,,15218.41,95,,percent of total billed charges,,,13296.09,83,,percent of total billed charges,,,13296.09,83,,percent of total billed charges,,,,,,,,,,,,,,,13296.09,83,,percent of total billed charges,,,15218.41,95,,percent of total billed charges,,,14417.44,90,,percent of total billed charges,,,14417.44,90,,percent of total billed charges,,,13135.89,82,,percent of total billed charges,,,14417.44,90,,percent of total billed charges,,,13616.47,85,,percent of total billed charges,,4004.85,15218.41,
STRYKER FEMUR TRIATHLON CR LEFT SZ 6,30187949,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER INSERT TIBIA CS SZ 6 12MM,30187950,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
SYNTHES PLATE LCP CLAVICLE 6 HOLE RIGHT,30187951,CDM,,,278,RC,outpatient,,10105.16,10105.16,,8579.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2526.29,22,,percent of total billed charges,,,,,,,,,9094.64,90,,percent of total billed charges,,,8367.07,82.8,,percent of total billed charges,,,8589.39,85,,percent of total billed charges,,,,,,,,,8892.54,88,,percent of total billed charges,,,,,,,,,7720.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2526.29,22,,percent of total billed charges,,,9195.7,91,,percent of total billed charges,,,9599.9,95,,percent of total billed charges,,,8387.28,83,,percent of total billed charges,,,8387.28,83,,percent of total billed charges,,,,,,,,,,,,,,,8387.28,83,,percent of total billed charges,,,9599.9,95,,percent of total billed charges,,,9094.64,90,,percent of total billed charges,,,9094.64,90,,percent of total billed charges,,,8286.23,82,,percent of total billed charges,,,9094.64,90,,percent of total billed charges,,,8589.39,85,,percent of total billed charges,,2526.29,9599.9,
SYNTHES PLATE TIBIA 8 HOLE LEFT,30187952,CDM,,,278,RC,outpatient,,19694.55,19694.55,,16720.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4923.64,22,,percent of total billed charges,,,,,,,,,17725.1,90,,percent of total billed charges,,,16307.09,82.8,,percent of total billed charges,,,16740.37,85,,percent of total billed charges,,,,,,,,,17331.2,88,,percent of total billed charges,,,,,,,,,15046.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4923.64,22,,percent of total billed charges,,,17922.04,91,,percent of total billed charges,,,18709.82,95,,percent of total billed charges,,,16346.48,83,,percent of total billed charges,,,16346.48,83,,percent of total billed charges,,,,,,,,,,,,,,,16346.48,83,,percent of total billed charges,,,18709.82,95,,percent of total billed charges,,,17725.1,90,,percent of total billed charges,,,17725.1,90,,percent of total billed charges,,,16149.53,82,,percent of total billed charges,,,17725.1,90,,percent of total billed charges,,,16740.37,85,,percent of total billed charges,,4923.64,18709.82,
SYNTHES SCREW LOCKING VA 3.5 X 85MM,30187953,CDM,,,278,RC,outpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375.13,22,,percent of total billed charges,,,,,,,,,1350.48,90,,percent of total billed charges,,,1242.44,82.8,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,375.13,22,,percent of total billed charges,,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,375.13,1425.5,
SYNTHES SCREW LOCKING VA 3.5 X 90MM,30187954,CDM,,,278,RC,outpatient,,1500.53,1500.53,,1273.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375.13,22,,percent of total billed charges,,,,,,,,,1350.48,90,,percent of total billed charges,,,1242.44,82.8,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,,,,,,,,1320.47,88,,percent of total billed charges,,,,,,,,,1146.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,375.13,22,,percent of total billed charges,,,1365.48,91,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,1245.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1245.44,83,,percent of total billed charges,,,1425.5,95,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1230.43,82,,percent of total billed charges,,,1350.48,90,,percent of total billed charges,,,1275.45,85,,percent of total billed charges,,375.13,1425.5,
ULRICH SCREW POLY 7.5 X 45MM,30187955,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SYNTHES NAIL TIBIA 10 X 390MM,30187956,CDM,,,278,RC,outpatient,,15439.13,15439.13,,13107.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3859.78,22,,percent of total billed charges,,,,,,,,,13895.22,90,,percent of total billed charges,,,12783.6,82.8,,percent of total billed charges,,,13123.26,85,,percent of total billed charges,,,,,,,,,13586.43,88,,percent of total billed charges,,,,,,,,,11795.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3859.78,22,,percent of total billed charges,,,14049.61,91,,percent of total billed charges,,,14667.17,95,,percent of total billed charges,,,12814.48,83,,percent of total billed charges,,,12814.48,83,,percent of total billed charges,,,,,,,,,,,,,,,12814.48,83,,percent of total billed charges,,,14667.17,95,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,12660.09,82,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,13123.26,85,,percent of total billed charges,,3859.78,14667.17,
SYNTHES SCREW LOCKING 5.0 X 60MM,30187957,CDM,,,278,RC,outpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,562.71,22,,percent of total billed charges,,,,,,,,,2025.74,90,,percent of total billed charges,,,1863.68,82.8,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,562.71,22,,percent of total billed charges,,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,562.71,2138.28,
GORE VBX BALLOON EXPANDABLE 6X39,30187958,CDM,,,270,RC,outpatient,,24160.5,24160.5,,20512.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6040.13,22,,percent of total billed charges,,,,,,,,,21744.45,90,,percent of total billed charges,,,20004.89,82.8,,percent of total billed charges,,,20536.43,85,,percent of total billed charges,,,,,,,,,21261.24,88,,percent of total billed charges,,,,,,,,,18458.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6040.13,22,,percent of total billed charges,,,21986.06,91,,percent of total billed charges,,,22952.48,95,,percent of total billed charges,,,20053.22,83,,percent of total billed charges,,,20053.22,83,,percent of total billed charges,,,,,,,,,,,,,,,20053.22,83,,percent of total billed charges,,,22952.48,95,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,19811.61,82,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,20536.43,85,,percent of total billed charges,,6040.13,22952.48,
EVERCROSS BALLOON 7 X 80MM,30187959,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
EVERCROSS BALLOON 4 X 200MM,30187960,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
INPACT ADMIRAL PTA BALLOON CATH 6X80X130,30187961,CDM,,,270,RC,outpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2421.25,22,,percent of total billed charges,,,,,,,,,8716.5,90,,percent of total billed charges,,,8019.18,82.8,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2421.25,22,,percent of total billed charges,,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,2421.25,9200.75,
STRYKER SHELL CLUSTERHOLE 50D,30187962,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
DEPUY TRUMATCH BLOCK,30187963,CDM,,,278,RC,outpatient,,8833.5,8833.5,,7499.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2208.38,22,,percent of total billed charges,,,,,,,,,7950.15,90,,percent of total billed charges,,,7314.14,82.8,,percent of total billed charges,,,7508.48,85,,percent of total billed charges,,,,,,,,,7773.48,88,,percent of total billed charges,,,,,,,,,6748.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2208.38,22,,percent of total billed charges,,,8038.49,91,,percent of total billed charges,,,8391.83,95,,percent of total billed charges,,,7331.81,83,,percent of total billed charges,,,7331.81,83,,percent of total billed charges,,,,,,,,,,,,,,,7331.81,83,,percent of total billed charges,,,8391.83,95,,percent of total billed charges,,,7950.15,90,,percent of total billed charges,,,7950.15,90,,percent of total billed charges,,,7243.47,82,,percent of total billed charges,,,7950.15,90,,percent of total billed charges,,,7508.48,85,,percent of total billed charges,,2208.38,8391.83,
STRYKER PATELLA SZ 33X9MM,30187964,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
S&N INSERT HIGH FLEX SZ 3-4 10MM,30187965,CDM,,,278,RC,outpatient,,13650,13650,,11588.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3412.5,22,,percent of total billed charges,,,,,,,,,12285,90,,percent of total billed charges,,,11302.2,82.8,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,,,,,,,,12012,88,,percent of total billed charges,,,,,,,,,10428.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3412.5,22,,percent of total billed charges,,,12421.5,91,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,,,,,,,,,,,,,11329.5,83,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11193,82,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,3412.5,12967.5,
SYNTHES SCREW CANCEL F-THD 4.0X16MM,30187967,CDM,,,278,RC,outpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.18,22,,percent of total billed charges,,,,,,,,,213.03,90,,percent of total billed charges,,,195.99,82.8,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.18,22,,percent of total billed charges,,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,59.18,224.87,
SYNTHES SCREW CANCEL F-THD 4.0X18MM,30187968,CDM,,,278,RC,outpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.18,22,,percent of total billed charges,,,,,,,,,213.03,90,,percent of total billed charges,,,195.99,82.8,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.18,22,,percent of total billed charges,,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,59.18,224.87,
STRYKER CUP CLUSTERHOLE 54E,30187970,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
STRYKER FEMUR PRESSFIT SZ2 RIGHT,30187971,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
STRYKER INSERT PRESSFIT X3,30187972,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER TIBIA TRIATHLON TRITANIUM SZ 2,30187973,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER PATELLA METAL BACK SZ A32,30187974,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
S&N SCREW BIOSURE 10X25MM,30187975,CDM,,,270,RC,outpatient,,4091.95,4091.95,,3474.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1022.99,22,,percent of total billed charges,,,,,,,,,3682.76,90,,percent of total billed charges,,,3388.13,82.8,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,,,,,,,,3600.92,88,,percent of total billed charges,,,,,,,,,3126.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1022.99,22,,percent of total billed charges,,,3723.67,91,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,3396.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3396.32,83,,percent of total billed charges,,,3887.35,95,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3355.4,82,,percent of total billed charges,,,3682.76,90,,percent of total billed charges,,,3478.16,85,,percent of total billed charges,,1022.99,3887.35,
S&N GUIDE LGNP KIT LEFT F4/T3,30187976,CDM,,,278,RC,outpatient,,3412.5,3412.5,,2897.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,853.13,22,,percent of total billed charges,,,,,,,,,3071.25,90,,percent of total billed charges,,,2825.55,82.8,,percent of total billed charges,,,2900.63,85,,percent of total billed charges,,,,,,,,,3003,88,,percent of total billed charges,,,,,,,,,2607.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,853.13,22,,percent of total billed charges,,,3105.38,91,,percent of total billed charges,,,3241.88,95,,percent of total billed charges,,,2832.38,83,,percent of total billed charges,,,2832.38,83,,percent of total billed charges,,,,,,,,,,,,,,,2832.38,83,,percent of total billed charges,,,3241.88,95,,percent of total billed charges,,,3071.25,90,,percent of total billed charges,,,3071.25,90,,percent of total billed charges,,,2798.25,82,,percent of total billed charges,,,3071.25,90,,percent of total billed charges,,,2900.63,85,,percent of total billed charges,,853.13,3241.88,
S&N FEMUR SZ 4 LEFT,30187977,CDM,,,278,RC,outpatient,,26000,26000,,22074,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6500,22,,percent of total billed charges,,,,,,,,,23400,90,,percent of total billed charges,,,21528,82.8,,percent of total billed charges,,,22100,85,,percent of total billed charges,,,,,,,,,22880,88,,percent of total billed charges,,,,,,,,,19864,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6500,22,,percent of total billed charges,,,23660,91,,percent of total billed charges,,,24700,95,,percent of total billed charges,,,21580,83,,percent of total billed charges,,,21580,83,,percent of total billed charges,,,,,,,,,,,,,,,21580,83,,percent of total billed charges,,,24700,95,,percent of total billed charges,,,23400,90,,percent of total billed charges,,,23400,90,,percent of total billed charges,,,21320,82,,percent of total billed charges,,,23400,90,,percent of total billed charges,,,22100,85,,percent of total billed charges,,6500,24700,
S&N TIBIAL BASEPLATE LEFT SZ 3,30187978,CDM,,,278,RC,outpatient,,8190,8190,,6953.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2047.5,22,,percent of total billed charges,,,,,,,,,7371,90,,percent of total billed charges,,,6781.32,82.8,,percent of total billed charges,,,6961.5,85,,percent of total billed charges,,,,,,,,,7207.2,88,,percent of total billed charges,,,,,,,,,6257.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2047.5,22,,percent of total billed charges,,,7452.9,91,,percent of total billed charges,,,7780.5,95,,percent of total billed charges,,,6797.7,83,,percent of total billed charges,,,6797.7,83,,percent of total billed charges,,,,,,,,,,,,,,,6797.7,83,,percent of total billed charges,,,7780.5,95,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,6715.8,82,,percent of total billed charges,,,7371,90,,percent of total billed charges,,,6961.5,85,,percent of total billed charges,,2047.5,7780.5,
S&N RESURFACING PATELLA 32MM,30187979,CDM,,,278,RC,outpatient,,5200,5200,,4414.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1300,22,,percent of total billed charges,,,,,,,,,4680,90,,percent of total billed charges,,,4305.6,82.8,,percent of total billed charges,,,4420,85,,percent of total billed charges,,,,,,,,,4576,88,,percent of total billed charges,,,,,,,,,3972.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1300,22,,percent of total billed charges,,,4732,91,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,,,,,,,,,,,,,4316,83,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4264,82,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4420,85,,percent of total billed charges,,1300,4940,
ULRICH ROD LORDOSED 6.0X90MM,30187980,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
STRYKER INSERT TRIDENT X3 36MM,30187981,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER PATELLA X3 SZ 31MM,30187982,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
ZIMMER TIBIA CENTRAL CONE MEDIUM,30187983,CDM,,,278,RC,outpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12075.78,22,,percent of total billed charges,,,,,,,,,43472.82,90,,percent of total billed charges,,,39994.99,82.8,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12075.78,22,,percent of total billed charges,,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,12075.78,45887.97,
STRYKER HUMERAL STEM 11 X 95MM,30187984,CDM,,,278,RC,outpatient,,38472.72,38472.72,,32663.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9618.18,22,,percent of total billed charges,,,,,,,,,34625.45,90,,percent of total billed charges,,,31855.41,82.8,,percent of total billed charges,,,32701.81,85,,percent of total billed charges,,,,,,,,,33855.99,88,,percent of total billed charges,,,,,,,,,29393.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9618.18,22,,percent of total billed charges,,,35010.18,91,,percent of total billed charges,,,36549.08,95,,percent of total billed charges,,,31932.36,83,,percent of total billed charges,,,31932.36,83,,percent of total billed charges,,,,,,,,,,,,,,,31932.36,83,,percent of total billed charges,,,36549.08,95,,percent of total billed charges,,,34625.45,90,,percent of total billed charges,,,34625.45,90,,percent of total billed charges,,,31547.63,82,,percent of total billed charges,,,34625.45,90,,percent of total billed charges,,,32701.81,85,,percent of total billed charges,,9618.18,36549.08,
STRYKER HUMERAL CUP 32MM,30187985,CDM,,,278,RC,outpatient,,13000,13000,,11037,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3250,22,,percent of total billed charges,,,,,,,,,11700,90,,percent of total billed charges,,,10764,82.8,,percent of total billed charges,,,11050,85,,percent of total billed charges,,,,,,,,,11440,88,,percent of total billed charges,,,,,,,,,9932,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3250,22,,percent of total billed charges,,,11830,91,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,,,,,,,,,,,,,10790,83,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,10660,82,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11050,85,,percent of total billed charges,,3250,12350,
STRYKER HUMERAL INSERT 32MM,30187986,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER BASEPLATE,30187987,CDM,,,278,RC,outpatient,,14300,14300,,12140.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3575,22,,percent of total billed charges,,,,,,,,,12870,90,,percent of total billed charges,,,11840.4,82.8,,percent of total billed charges,,,12155,85,,percent of total billed charges,,,,,,,,,12584,88,,percent of total billed charges,,,,,,,,,10925.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3575,22,,percent of total billed charges,,,13013,91,,percent of total billed charges,,,13585,95,,percent of total billed charges,,,11869,83,,percent of total billed charges,,,11869,83,,percent of total billed charges,,,,,,,,,,,,,,,11869,83,,percent of total billed charges,,,13585,95,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,11726,82,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,12155,85,,percent of total billed charges,,3575,13585,
STRYKER SCREW PERIPHERAL 4.5 X 28MM,30187988,CDM,,,278,RC,outpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325,22,,percent of total billed charges,,,,,,,,,1170,90,,percent of total billed charges,,,1076.4,82.8,,percent of total billed charges,,,1105,85,,percent of total billed charges,,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325,22,,percent of total billed charges,,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,325,1235,
STRYKER SCREW CENTER 6.5 X 32MM,30187989,CDM,,,278,RC,outpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325,22,,percent of total billed charges,,,,,,,,,1170,90,,percent of total billed charges,,,1076.4,82.8,,percent of total billed charges,,,1105,85,,percent of total billed charges,,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325,22,,percent of total billed charges,,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,325,1235,
STRYKER GLENOSPHERE 32X2 CONCENTRIC,30187990,CDM,,,278,RC,outpatient,,13000,13000,,11037,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3250,22,,percent of total billed charges,,,,,,,,,11700,90,,percent of total billed charges,,,10764,82.8,,percent of total billed charges,,,11050,85,,percent of total billed charges,,,,,,,,,11440,88,,percent of total billed charges,,,,,,,,,9932,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3250,22,,percent of total billed charges,,,11830,91,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,,,,,,,,,,,,,10790,83,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,10660,82,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11050,85,,percent of total billed charges,,3250,12350,
STRYKER DRILL BIT PERIPHERAL SCREW,30187991,CDM,,,278,RC,outpatient,,490,490,,416.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.5,22,,percent of total billed charges,,,,,,,,,441,90,,percent of total billed charges,,,405.72,82.8,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,,,,,,,,431.2,88,,percent of total billed charges,,,,,,,,,374.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.5,22,,percent of total billed charges,,,445.9,91,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,,,,,,,,,,,,,406.7,83,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,401.8,82,,percent of total billed charges,,,441,90,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,122.5,465.5,
STRYKER NITINOL PILOT WIRE,30187992,CDM,,,278,RC,outpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.25,22,,percent of total billed charges,,,,,,,,,202.5,90,,percent of total billed charges,,,186.3,82.8,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.25,22,,percent of total billed charges,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,56.25,213.75,
ZIMMER FEMUR REVISION STANDARD 11R,30187993,CDM,,,278,RC,outpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16788.28,22,,percent of total billed charges,,,,,,,,,60437.82,90,,percent of total billed charges,,,55602.79,82.8,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16788.28,22,,percent of total billed charges,,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,16788.28,63795.47,
S&N ENDO BUTTON 25CM CONT. LOOP,30187994,CDM,,,270,RC,outpatient,,2207.34,2207.34,,1874.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,551.84,22,,percent of total billed charges,,,,,,,,,1986.61,90,,percent of total billed charges,,,1827.68,82.8,,percent of total billed charges,,,1876.24,85,,percent of total billed charges,,,,,,,,,1942.46,88,,percent of total billed charges,,,,,,,,,1686.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,551.84,22,,percent of total billed charges,,,2008.68,91,,percent of total billed charges,,,2096.97,95,,percent of total billed charges,,,1832.09,83,,percent of total billed charges,,,1832.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1832.09,83,,percent of total billed charges,,,2096.97,95,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1810.02,82,,percent of total billed charges,,,1986.61,90,,percent of total billed charges,,,1876.24,85,,percent of total billed charges,,551.84,2096.97,
SPIRAL SNARE 20MM HOT,30187995,CDM,,,270,RC,outpatient,,54.47,54.47,,46.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.62,22,,percent of total billed charges,,,,,,,,,49.02,90,,percent of total billed charges,,,45.1,82.8,,percent of total billed charges,,,46.3,85,,percent of total billed charges,,,,,,,,,47.93,88,,percent of total billed charges,,,,,,,,,41.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.62,22,,percent of total billed charges,,,49.57,91,,percent of total billed charges,,,51.75,95,,percent of total billed charges,,,45.21,83,,percent of total billed charges,,,45.21,83,,percent of total billed charges,,,,,,,,,,,,,,,45.21,83,,percent of total billed charges,,,51.75,95,,percent of total billed charges,,,49.02,90,,percent of total billed charges,,,49.02,90,,percent of total billed charges,,,44.67,82,,percent of total billed charges,,,49.02,90,,percent of total billed charges,,,46.3,85,,percent of total billed charges,,13.62,51.75,
NANOCROSS BALLOON 5.0 X 40,30187996,CDM,,,270,RC,outpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.44,22,,percent of total billed charges,,,,,,,,,1740.38,90,,percent of total billed charges,,,1601.15,82.8,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.44,22,,percent of total billed charges,,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,483.44,1837.06,
DEPUY EPI IMPLANT SZ 2 RIGHT 145DEG,30187997,CDM,,,278,RC,outpatient,,40066,40066,,34016.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10016.5,22,,percent of total billed charges,,,,,,,,,36059.4,90,,percent of total billed charges,,,33174.65,82.8,,percent of total billed charges,,,34056.1,85,,percent of total billed charges,,,,,,,,,35258.08,88,,percent of total billed charges,,,,,,,,,30610.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10016.5,22,,percent of total billed charges,,,36460.06,91,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,33254.78,83,,percent of total billed charges,,,,,,,,,,,,,,,33254.78,83,,percent of total billed charges,,,38062.7,95,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,32854.12,82,,percent of total billed charges,,,36059.4,90,,percent of total billed charges,,,34056.1,85,,percent of total billed charges,,10016.5,38062.7,
IMPACT ADMIRAL BALLOON 4X200X130,30187998,CDM,,,270,RC,outpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2421.25,22,,percent of total billed charges,,,,,,,,,8716.5,90,,percent of total billed charges,,,8019.18,82.8,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2421.25,22,,percent of total billed charges,,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,2421.25,9200.75,
ZIMMER STEM REVISION PSN 15 X 135MM,30187999,CDM,,,278,RC,outpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6126.25,22,,percent of total billed charges,,,,,,,,,22054.5,90,,percent of total billed charges,,,20290.14,82.8,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6126.25,22,,percent of total billed charges,,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,6126.25,23279.75,
ZIMMER FEMUR PSN SZ 11 LEFT,30188000,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
ZIMMER FEMORAL AUGMENT 10MM,30188001,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER FEMUR REVISION SZ 7 RIGHT,30188002,CDM,,,278,RC,outpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16788.28,22,,percent of total billed charges,,,,,,,,,60437.82,90,,percent of total billed charges,,,55602.79,82.8,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16788.28,22,,percent of total billed charges,,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,16788.28,63795.47,
EVERCROSS BALLOON 6 X 40MM,30188004,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
ULRICH CONNECTOR LATERAL 15MM,30188005,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
ULRICH CONNECTOR LATERAL 30MM,30188006,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
INPACT ADMIRAL PTA BALLOON CATH 5X250X13,30188007,CDM,,,270,RC,outpatient,,21417.5,21417.5,,18183.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5354.38,22,,percent of total billed charges,,,,,,,,,19275.75,90,,percent of total billed charges,,,17733.69,82.8,,percent of total billed charges,,,18204.88,85,,percent of total billed charges,,,,,,,,,18847.4,88,,percent of total billed charges,,,,,,,,,16362.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5354.38,22,,percent of total billed charges,,,19489.93,91,,percent of total billed charges,,,20346.63,95,,percent of total billed charges,,,17776.53,83,,percent of total billed charges,,,17776.53,83,,percent of total billed charges,,,,,,,,,,,,,,,17776.53,83,,percent of total billed charges,,,20346.63,95,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,17562.35,82,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,18204.88,85,,percent of total billed charges,,5354.38,20346.63,
INPACT ADMIRAL PTA BALLOON CATH 5X150X13,30188008,CDM,,,270,RC,outpatient,,11635,11635,,9878.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2908.75,22,,percent of total billed charges,,,,,,,,,10471.5,90,,percent of total billed charges,,,9633.78,82.8,,percent of total billed charges,,,9889.75,85,,percent of total billed charges,,,,,,,,,10238.8,88,,percent of total billed charges,,,,,,,,,8889.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2908.75,22,,percent of total billed charges,,,10587.85,91,,percent of total billed charges,,,11053.25,95,,percent of total billed charges,,,9657.05,83,,percent of total billed charges,,,9657.05,83,,percent of total billed charges,,,,,,,,,,,,,,,9657.05,83,,percent of total billed charges,,,11053.25,95,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,9540.7,82,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,9889.75,85,,percent of total billed charges,,2908.75,11053.25,
EVERCROSS BALLOON 6X150MM,30188009,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
CATH DUAL LUMEN URETERAL 10FR,30188010,CDM,,,270,RC,outpatient,,473.27,473.27,,401.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,118.32,22,,percent of total billed charges,,,,,,,,,425.94,90,,percent of total billed charges,,,391.87,82.8,,percent of total billed charges,,,402.28,85,,percent of total billed charges,,,,,,,,,416.48,88,,percent of total billed charges,,,,,,,,,361.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,118.32,22,,percent of total billed charges,,,430.68,91,,percent of total billed charges,,,449.61,95,,percent of total billed charges,,,392.81,83,,percent of total billed charges,,,392.81,83,,percent of total billed charges,,,,,,,,,,,,,,,392.81,83,,percent of total billed charges,,,449.61,95,,percent of total billed charges,,,425.94,90,,percent of total billed charges,,,425.94,90,,percent of total billed charges,,,388.08,82,,percent of total billed charges,,,425.94,90,,percent of total billed charges,,,402.28,85,,percent of total billed charges,,118.32,449.61,
DEPUY SURESPACE TIBIA SPACER SML,30188013,CDM,,,278,RC,outpatient,,13016.77,13016.77,,11051.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3254.19,22,,percent of total billed charges,,,,,,,,,11715.09,90,,percent of total billed charges,,,10777.89,82.8,,percent of total billed charges,,,11064.25,85,,percent of total billed charges,,,,,,,,,11454.76,88,,percent of total billed charges,,,,,,,,,9944.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3254.19,22,,percent of total billed charges,,,11845.26,91,,percent of total billed charges,,,12365.93,95,,percent of total billed charges,,,10803.92,83,,percent of total billed charges,,,10803.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10803.92,83,,percent of total billed charges,,,12365.93,95,,percent of total billed charges,,,11715.09,90,,percent of total billed charges,,,11715.09,90,,percent of total billed charges,,,10673.75,82,,percent of total billed charges,,,11715.09,90,,percent of total billed charges,,,11064.25,85,,percent of total billed charges,,3254.19,12365.93,
DEPUY SURESPACE FEMUR SPACER SML,30188014,CDM,,,278,RC,outpatient,,15906.93,15906.93,,13504.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3976.73,22,,percent of total billed charges,,,,,,,,,14316.24,90,,percent of total billed charges,,,13170.94,82.8,,percent of total billed charges,,,13520.89,85,,percent of total billed charges,,,,,,,,,13998.1,88,,percent of total billed charges,,,,,,,,,12152.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3976.73,22,,percent of total billed charges,,,14475.31,91,,percent of total billed charges,,,15111.58,95,,percent of total billed charges,,,13202.75,83,,percent of total billed charges,,,13202.75,83,,percent of total billed charges,,,,,,,,,,,,,,,13202.75,83,,percent of total billed charges,,,15111.58,95,,percent of total billed charges,,,14316.24,90,,percent of total billed charges,,,14316.24,90,,percent of total billed charges,,,13043.68,82,,percent of total billed charges,,,14316.24,90,,percent of total billed charges,,,13520.89,85,,percent of total billed charges,,3976.73,15111.58,
COOK NEPHROSTOMY TUBE SET 10.0,30188015,CDM,,,270,RC,outpatient,,1112.28,1112.28,,944.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,278.07,22,,percent of total billed charges,,,,,,,,,1001.05,90,,percent of total billed charges,,,920.97,82.8,,percent of total billed charges,,,945.44,85,,percent of total billed charges,,,,,,,,,978.81,88,,percent of total billed charges,,,,,,,,,849.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,278.07,22,,percent of total billed charges,,,1012.17,91,,percent of total billed charges,,,1056.67,95,,percent of total billed charges,,,923.19,83,,percent of total billed charges,,,923.19,83,,percent of total billed charges,,,,,,,,,,,,,,,923.19,83,,percent of total billed charges,,,1056.67,95,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,912.07,82,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,945.44,85,,percent of total billed charges,,278.07,1056.67,
ULRICH TI ROD 6.0 X 500,30188016,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
ULRICH PARELLEL CONNECTOR REVISION,30188017,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
ULRICH SCREW POLY 8.5 X 55MM,30188018,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH SCREW POLY 8.5 X 50MM,30188019,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
GORE VBX BALLOON EXPANDABLE 6X19,30188020,CDM,,,270,RC,outpatient,,19974.5,19974.5,,16958.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4993.63,22,,percent of total billed charges,,,,,,,,,17977.05,90,,percent of total billed charges,,,16538.89,82.8,,percent of total billed charges,,,16978.33,85,,percent of total billed charges,,,,,,,,,17577.56,88,,percent of total billed charges,,,,,,,,,15260.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4993.63,22,,percent of total billed charges,,,18176.8,91,,percent of total billed charges,,,18975.78,95,,percent of total billed charges,,,16578.84,83,,percent of total billed charges,,,16578.84,83,,percent of total billed charges,,,,,,,,,,,,,,,16578.84,83,,percent of total billed charges,,,18975.78,95,,percent of total billed charges,,,17977.05,90,,percent of total billed charges,,,17977.05,90,,percent of total billed charges,,,16379.09,82,,percent of total billed charges,,,17977.05,90,,percent of total billed charges,,,16978.33,85,,percent of total billed charges,,4993.63,18975.78,
GORE VBX BALLOON EXPANDABLE 5X19,30188021,CDM,,,270,RC,outpatient,,19974.5,19974.5,,16958.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4993.63,22,,percent of total billed charges,,,,,,,,,17977.05,90,,percent of total billed charges,,,16538.89,82.8,,percent of total billed charges,,,16978.33,85,,percent of total billed charges,,,,,,,,,17577.56,88,,percent of total billed charges,,,,,,,,,15260.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4993.63,22,,percent of total billed charges,,,18176.8,91,,percent of total billed charges,,,18975.78,95,,percent of total billed charges,,,16578.84,83,,percent of total billed charges,,,16578.84,83,,percent of total billed charges,,,,,,,,,,,,,,,16578.84,83,,percent of total billed charges,,,18975.78,95,,percent of total billed charges,,,17977.05,90,,percent of total billed charges,,,17977.05,90,,percent of total billed charges,,,16379.09,82,,percent of total billed charges,,,17977.05,90,,percent of total billed charges,,,16978.33,85,,percent of total billed charges,,4993.63,18975.78,
EVERCROSS BALLOON 6 X 80MM,30188022,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
EVERCROSS BALLOON 10 X 40MM,30188023,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
IMPACT ADMIRAL BALLOON 5X80X130,30188024,CDM,,,270,RC,outpatient,,9685,9685,,8222.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2421.25,22,,percent of total billed charges,,,,,,,,,8716.5,90,,percent of total billed charges,,,8019.18,82.8,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,,,,,,,,8522.8,88,,percent of total billed charges,,,,,,,,,7399.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2421.25,22,,percent of total billed charges,,,8813.35,91,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,8038.55,83,,percent of total billed charges,,,,,,,,,,,,,,,8038.55,83,,percent of total billed charges,,,9200.75,95,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,7941.7,82,,percent of total billed charges,,,8716.5,90,,percent of total billed charges,,,8232.25,85,,percent of total billed charges,,2421.25,9200.75,
SYNTHES PLATE VOLAR DIST. RAD. 2.4MM 6H,30188025,CDM,,,278,RC,outpatient,,10357.23,10357.23,,8793.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2589.31,22,,percent of total billed charges,,,,,,,,,9321.51,90,,percent of total billed charges,,,8575.79,82.8,,percent of total billed charges,,,8803.65,85,,percent of total billed charges,,,,,,,,,9114.36,88,,percent of total billed charges,,,,,,,,,7912.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2589.31,22,,percent of total billed charges,,,9425.08,91,,percent of total billed charges,,,9839.37,95,,percent of total billed charges,,,8596.5,83,,percent of total billed charges,,,8596.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8596.5,83,,percent of total billed charges,,,9839.37,95,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,8492.93,82,,percent of total billed charges,,,9321.51,90,,percent of total billed charges,,,8803.65,85,,percent of total billed charges,,2589.31,9839.37,
STRYKER SCREW PERIPHERAL 4.5 X32MM,30188026,CDM,,,278,RC,outpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325,22,,percent of total billed charges,,,,,,,,,1170,90,,percent of total billed charges,,,1076.4,82.8,,percent of total billed charges,,,1105,85,,percent of total billed charges,,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325,22,,percent of total billed charges,,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,325,1235,
STRYKER STEM HUMERAL FRACTURE 11MM,30188027,CDM,,,278,RC,outpatient,,29281.01,29281.01,,24859.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7320.25,22,,percent of total billed charges,,,,,,,,,26352.91,90,,percent of total billed charges,,,24244.68,82.8,,percent of total billed charges,,,24888.86,85,,percent of total billed charges,,,,,,,,,25767.29,88,,percent of total billed charges,,,,,,,,,22370.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7320.25,22,,percent of total billed charges,,,26645.72,91,,percent of total billed charges,,,27816.96,95,,percent of total billed charges,,,24303.24,83,,percent of total billed charges,,,24303.24,83,,percent of total billed charges,,,,,,,,,,,,,,,24303.24,83,,percent of total billed charges,,,27816.96,95,,percent of total billed charges,,,26352.91,90,,percent of total billed charges,,,26352.91,90,,percent of total billed charges,,,24010.43,82,,percent of total billed charges,,,26352.91,90,,percent of total billed charges,,,24888.86,85,,percent of total billed charges,,7320.25,27816.96,
FORTEC HOLMIUM FIBER 1000,30188028,CDM,,,270,RC,outpatient,,2307.5,2307.5,,1959.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,576.88,22,,percent of total billed charges,,,,,,,,,2076.75,90,,percent of total billed charges,,,1910.61,82.8,,percent of total billed charges,,,1961.38,85,,percent of total billed charges,,,,,,,,,2030.6,88,,percent of total billed charges,,,,,,,,,1762.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,576.88,22,,percent of total billed charges,,,2099.83,91,,percent of total billed charges,,,2192.13,95,,percent of total billed charges,,,1915.23,83,,percent of total billed charges,,,1915.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1915.23,83,,percent of total billed charges,,,2192.13,95,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,1892.15,82,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,1961.38,85,,percent of total billed charges,,576.88,2192.13,
ARTHREX SCREW INTERFERENCE 9X30MM,30188029,CDM,,,278,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
TRUSPAN  MENISCAL RPR. 12DEG NEEDLE,30188030,CDM,,,270,RC,outpatient,,5076.5,5076.5,,4309.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1269.13,22,,percent of total billed charges,,,,,,,,,4568.85,90,,percent of total billed charges,,,4203.34,82.8,,percent of total billed charges,,,4315.03,85,,percent of total billed charges,,,,,,,,,4467.32,88,,percent of total billed charges,,,,,,,,,3878.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1269.13,22,,percent of total billed charges,,,4619.62,91,,percent of total billed charges,,,4822.68,95,,percent of total billed charges,,,4213.5,83,,percent of total billed charges,,,4213.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4213.5,83,,percent of total billed charges,,,4822.68,95,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4162.73,82,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4315.03,85,,percent of total billed charges,,1269.13,4822.68,
ECHO2 POSITIONING SYSTEM W/VENT 18X23CM,30188031,CDM,,,270,RC,outpatient,,10758.15,10758.15,,9133.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2689.54,22,,percent of total billed charges,,,,,,,,,9682.34,90,,percent of total billed charges,,,8907.75,82.8,,percent of total billed charges,,,9144.43,85,,percent of total billed charges,,,,,,,,,9467.17,88,,percent of total billed charges,,,,,,,,,8219.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2689.54,22,,percent of total billed charges,,,9789.92,91,,percent of total billed charges,,,10220.24,95,,percent of total billed charges,,,8929.26,83,,percent of total billed charges,,,8929.26,83,,percent of total billed charges,,,,,,,,,,,,,,,8929.26,83,,percent of total billed charges,,,10220.24,95,,percent of total billed charges,,,9682.34,90,,percent of total billed charges,,,9682.34,90,,percent of total billed charges,,,8821.68,82,,percent of total billed charges,,,9682.34,90,,percent of total billed charges,,,9144.43,85,,percent of total billed charges,,2689.54,10220.24,
ECHO2 POSITIONING SYSTEM W/VENT 15X20CM,30188032,CDM,,,270,RC,outpatient,,5168.8,5168.8,,4388.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1292.2,22,,percent of total billed charges,,,,,,,,,4651.92,90,,percent of total billed charges,,,4279.77,82.8,,percent of total billed charges,,,4393.48,85,,percent of total billed charges,,,,,,,,,4548.54,88,,percent of total billed charges,,,,,,,,,3948.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1292.2,22,,percent of total billed charges,,,4703.61,91,,percent of total billed charges,,,4910.36,95,,percent of total billed charges,,,4290.1,83,,percent of total billed charges,,,4290.1,83,,percent of total billed charges,,,,,,,,,,,,,,,4290.1,83,,percent of total billed charges,,,4910.36,95,,percent of total billed charges,,,4651.92,90,,percent of total billed charges,,,4651.92,90,,percent of total billed charges,,,4238.42,82,,percent of total billed charges,,,4651.92,90,,percent of total billed charges,,,4393.48,85,,percent of total billed charges,,1292.2,4910.36,
PERMAFIX FASTENERS 15,30188033,CDM,,,270,RC,outpatient,,14300,14300,,12140.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3575,22,,percent of total billed charges,,,,,,,,,12870,90,,percent of total billed charges,,,11840.4,82.8,,percent of total billed charges,,,12155,85,,percent of total billed charges,,,,,,,,,12584,88,,percent of total billed charges,,,,,,,,,10925.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3575,22,,percent of total billed charges,,,13013,91,,percent of total billed charges,,,13585,95,,percent of total billed charges,,,11869,83,,percent of total billed charges,,,11869,83,,percent of total billed charges,,,,,,,,,,,,,,,11869,83,,percent of total billed charges,,,13585,95,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,11726,82,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,12155,85,,percent of total billed charges,,3575,13585,
IR PLATE 1 LEVEL 18MM,30188034,CDM,,,278,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
IR SCREW REVERSE 4.5X14,30188035,CDM,,,278,RC,outpatient,,1787.5,1787.5,,1517.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,446.88,22,,percent of total billed charges,,,,,,,,,1608.75,90,,percent of total billed charges,,,1480.05,82.8,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,,,,,,,,1573,88,,percent of total billed charges,,,,,,,,,1365.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,446.88,22,,percent of total billed charges,,,1626.63,91,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,1483.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1483.63,83,,percent of total billed charges,,,1698.13,95,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1465.75,82,,percent of total billed charges,,,1608.75,90,,percent of total billed charges,,,1519.38,85,,percent of total billed charges,,446.88,1698.13,
ZIMMER INSERT CPS 12MM,30188036,CDM,,,278,RC,outpatient,,17135.63,17135.63,,14548.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4283.91,22,,percent of total billed charges,,,,,,,,,15422.07,90,,percent of total billed charges,,,14188.3,82.8,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,,,,,,,,15079.35,88,,percent of total billed charges,,,,,,,,,13091.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4283.91,22,,percent of total billed charges,,,15593.42,91,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14222.57,83,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14051.22,82,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,4283.91,16278.85,
ZIMMER STEM OFFSET 6MM 14X135,30188037,CDM,,,278,RC,outpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6126.25,22,,percent of total billed charges,,,,,,,,,22054.5,90,,percent of total billed charges,,,20290.14,82.8,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6126.25,22,,percent of total billed charges,,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,6126.25,23279.75,
ZIMMER AUGMENT POST FEMUR SZ 5 10MM,30188038,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
COOK BILIARY DRAINAGE CATH 14FR,30188039,CDM,,,270,RC,outpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.74,22,,percent of total billed charges,,,,,,,,,650.66,90,,percent of total billed charges,,,598.61,82.8,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.74,22,,percent of total billed charges,,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,180.74,686.81,
COOK MULTIPURPOSE DRAINAGE SET 14FR,30188040,CDM,,,270,RC,outpatient,,1393.15,1393.15,,1182.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,348.29,22,,percent of total billed charges,,,,,,,,,1253.84,90,,percent of total billed charges,,,1153.53,82.8,,percent of total billed charges,,,1184.18,85,,percent of total billed charges,,,,,,,,,1225.97,88,,percent of total billed charges,,,,,,,,,1064.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,348.29,22,,percent of total billed charges,,,1267.77,91,,percent of total billed charges,,,1323.49,95,,percent of total billed charges,,,1156.31,83,,percent of total billed charges,,,1156.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1156.31,83,,percent of total billed charges,,,1323.49,95,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1142.38,82,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1184.18,85,,percent of total billed charges,,348.29,1323.49,
AMPLATZ UTERAL STENT 8.5FR 24CM,30188042,CDM,,,270,RC,outpatient,,1073.22,1073.22,,911.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,268.31,22,,percent of total billed charges,,,,,,,,,965.9,90,,percent of total billed charges,,,888.63,82.8,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,,,,,,,,944.43,88,,percent of total billed charges,,,,,,,,,819.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,268.31,22,,percent of total billed charges,,,976.63,91,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,,,,,,,,,,,,,890.77,83,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,880.04,82,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,268.31,1019.56,
EAR PACKING MEROCEL 12X15MM,30188043,CDM,,,270,RC,outpatient,,135.2,135.2,,114.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.8,22,,percent of total billed charges,,,,,,,,,121.68,90,,percent of total billed charges,,,111.95,82.8,,percent of total billed charges,,,114.92,85,,percent of total billed charges,,,,,,,,,118.98,88,,percent of total billed charges,,,,,,,,,103.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.8,22,,percent of total billed charges,,,123.03,91,,percent of total billed charges,,,128.44,95,,percent of total billed charges,,,112.22,83,,percent of total billed charges,,,112.22,83,,percent of total billed charges,,,,,,,,,,,,,,,112.22,83,,percent of total billed charges,,,128.44,95,,percent of total billed charges,,,121.68,90,,percent of total billed charges,,,121.68,90,,percent of total billed charges,,,110.86,82,,percent of total billed charges,,,121.68,90,,percent of total billed charges,,,114.92,85,,percent of total billed charges,,33.8,128.44,
SYNTHES SCREW LOCKING VA 2.4 X 18MM,30188044,CDM,,,278,RC,outpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,338.51,22,,percent of total billed charges,,,,,,,,,1218.62,90,,percent of total billed charges,,,1121.13,82.8,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,338.51,22,,percent of total billed charges,,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,338.51,1286.32,
STRYKER INSERT TRIATHLON CS #4 12MM,30188045,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
COOK CATH DRAINAGE LOCKING LOOP 16FR,30188046,CDM,,,270,RC,outpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.74,22,,percent of total billed charges,,,,,,,,,650.66,90,,percent of total billed charges,,,598.61,82.8,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.74,22,,percent of total billed charges,,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,180.74,686.81,
COOK CATH DRAINAGE LOCKING LOOP 18FR,30188047,CDM,,,270,RC,outpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.74,22,,percent of total billed charges,,,,,,,,,650.66,90,,percent of total billed charges,,,598.61,82.8,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.74,22,,percent of total billed charges,,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,180.74,686.81,
COOK DRAIN CATH MAC-LOC MULTIPURPOSE 8.5,30188048,CDM,,,270,RC,outpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.74,22,,percent of total billed charges,,,,,,,,,650.66,90,,percent of total billed charges,,,598.61,82.8,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.74,22,,percent of total billed charges,,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,180.74,686.81,
COOK DRAIN CATH MAC-LOC MULTIPURPOSE 12F,30188049,CDM,,,270,RC,outpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.74,22,,percent of total billed charges,,,,,,,,,650.66,90,,percent of total billed charges,,,598.61,82.8,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.74,22,,percent of total billed charges,,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,180.74,686.81,
COOK DRAIN CATH MAC-LOC MULTIPURPOSE 14F,30188050,CDM,,,270,RC,outpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.74,22,,percent of total billed charges,,,,,,,,,650.66,90,,percent of total billed charges,,,598.61,82.8,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.74,22,,percent of total billed charges,,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,180.74,686.81,
STRYKER PATELLA X3 8MM,30188051,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
STRYKER INSERT TIBA SZ 5 CS,30188052,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
COOK NEPHROSTOMY TUBE SET 12.0,30188053,CDM,,,270,RC,outpatient,,1112.28,1112.28,,944.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,278.07,22,,percent of total billed charges,,,,,,,,,1001.05,90,,percent of total billed charges,,,920.97,82.8,,percent of total billed charges,,,945.44,85,,percent of total billed charges,,,,,,,,,978.81,88,,percent of total billed charges,,,,,,,,,849.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,278.07,22,,percent of total billed charges,,,1012.17,91,,percent of total billed charges,,,1056.67,95,,percent of total billed charges,,,923.19,83,,percent of total billed charges,,,923.19,83,,percent of total billed charges,,,,,,,,,,,,,,,923.19,83,,percent of total billed charges,,,1056.67,95,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,912.07,82,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,945.44,85,,percent of total billed charges,,278.07,1056.67,
COOK NEPHROSTOMY TUBE 10.0,30188054,CDM,,,270,RC,outpatient,,556.64,556.64,,472.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,139.16,22,,percent of total billed charges,,,,,,,,,500.98,90,,percent of total billed charges,,,460.9,82.8,,percent of total billed charges,,,473.14,85,,percent of total billed charges,,,,,,,,,489.84,88,,percent of total billed charges,,,,,,,,,425.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,139.16,22,,percent of total billed charges,,,506.54,91,,percent of total billed charges,,,528.81,95,,percent of total billed charges,,,462.01,83,,percent of total billed charges,,,462.01,83,,percent of total billed charges,,,,,,,,,,,,,,,462.01,83,,percent of total billed charges,,,528.81,95,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,456.44,82,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,473.14,85,,percent of total billed charges,,139.16,528.81,
COOK NEPHROSTOMY TUBE 12.0,30188055,CDM,,,270,RC,outpatient,,556.64,556.64,,472.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,139.16,22,,percent of total billed charges,,,,,,,,,500.98,90,,percent of total billed charges,,,460.9,82.8,,percent of total billed charges,,,473.14,85,,percent of total billed charges,,,,,,,,,489.84,88,,percent of total billed charges,,,,,,,,,425.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,139.16,22,,percent of total billed charges,,,506.54,91,,percent of total billed charges,,,528.81,95,,percent of total billed charges,,,462.01,83,,percent of total billed charges,,,462.01,83,,percent of total billed charges,,,,,,,,,,,,,,,462.01,83,,percent of total billed charges,,,528.81,95,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,456.44,82,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,473.14,85,,percent of total billed charges,,139.16,528.81,
COOK NEPHROSTOMY TUBE 14.0,30188056,CDM,,,270,RC,outpatient,,556.64,556.64,,472.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,139.16,22,,percent of total billed charges,,,,,,,,,500.98,90,,percent of total billed charges,,,460.9,82.8,,percent of total billed charges,,,473.14,85,,percent of total billed charges,,,,,,,,,489.84,88,,percent of total billed charges,,,,,,,,,425.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,139.16,22,,percent of total billed charges,,,506.54,91,,percent of total billed charges,,,528.81,95,,percent of total billed charges,,,462.01,83,,percent of total billed charges,,,462.01,83,,percent of total billed charges,,,,,,,,,,,,,,,462.01,83,,percent of total billed charges,,,528.81,95,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,456.44,82,,percent of total billed charges,,,500.98,90,,percent of total billed charges,,,473.14,85,,percent of total billed charges,,139.16,528.81,
COOK CONNECTING TUBE,30188057,CDM,,,270,RC,outpatient,,137.68,137.68,,116.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.42,22,,percent of total billed charges,,,,,,,,,123.91,90,,percent of total billed charges,,,114,82.8,,percent of total billed charges,,,117.03,85,,percent of total billed charges,,,,,,,,,121.16,88,,percent of total billed charges,,,,,,,,,105.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.42,22,,percent of total billed charges,,,125.29,91,,percent of total billed charges,,,130.8,95,,percent of total billed charges,,,114.27,83,,percent of total billed charges,,,114.27,83,,percent of total billed charges,,,,,,,,,,,,,,,114.27,83,,percent of total billed charges,,,130.8,95,,percent of total billed charges,,,123.91,90,,percent of total billed charges,,,123.91,90,,percent of total billed charges,,,112.9,82,,percent of total billed charges,,,123.91,90,,percent of total billed charges,,,117.03,85,,percent of total billed charges,,34.42,130.8,
AMPLATZ URETHERAL STENT 8.5FR 26CM,30188058,CDM,,,270,RC,outpatient,,1073.22,1073.22,,911.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,268.31,22,,percent of total billed charges,,,,,,,,,965.9,90,,percent of total billed charges,,,888.63,82.8,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,,,,,,,,944.43,88,,percent of total billed charges,,,,,,,,,819.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,268.31,22,,percent of total billed charges,,,976.63,91,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,,,,,,,,,,,,,890.77,83,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,880.04,82,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,268.31,1019.56,
AMPLATZ URETHERAL STENT 8.5FR 28CM,30188059,CDM,,,270,RC,outpatient,,1073.22,1073.22,,911.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,268.31,22,,percent of total billed charges,,,,,,,,,965.9,90,,percent of total billed charges,,,888.63,82.8,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,,,,,,,,944.43,88,,percent of total billed charges,,,,,,,,,819.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,268.31,22,,percent of total billed charges,,,976.63,91,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,,,,,,,,,,,,,890.77,83,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,880.04,82,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,268.31,1019.56,
AMPLATZ URETHERAL STENT 10.2FR 26CM,30188060,CDM,,,270,RC,outpatient,,1073.22,1073.22,,911.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,268.31,22,,percent of total billed charges,,,,,,,,,965.9,90,,percent of total billed charges,,,888.63,82.8,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,,,,,,,,944.43,88,,percent of total billed charges,,,,,,,,,819.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,268.31,22,,percent of total billed charges,,,976.63,91,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,,,,,,,,,,,,,890.77,83,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,880.04,82,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,268.31,1019.56,
AMPLATZ URETHERAL STENT 10.2FR 28CM,30188061,CDM,,,270,RC,outpatient,,1073.22,1073.22,,911.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,268.31,22,,percent of total billed charges,,,,,,,,,965.9,90,,percent of total billed charges,,,888.63,82.8,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,,,,,,,,944.43,88,,percent of total billed charges,,,,,,,,,819.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,268.31,22,,percent of total billed charges,,,976.63,91,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,,,,,,,,,,,,,890.77,83,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,880.04,82,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,268.31,1019.56,
CAPE NEPHROUNETEROSTONY STENT 10.2 X 28C,30188062,CDM,,,270,RC,outpatient,,898.24,898.24,,762.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,224.56,22,,percent of total billed charges,,,,,,,,,808.42,90,,percent of total billed charges,,,743.74,82.8,,percent of total billed charges,,,763.5,85,,percent of total billed charges,,,,,,,,,790.45,88,,percent of total billed charges,,,,,,,,,686.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,224.56,22,,percent of total billed charges,,,817.4,91,,percent of total billed charges,,,853.33,95,,percent of total billed charges,,,745.54,83,,percent of total billed charges,,,745.54,83,,percent of total billed charges,,,,,,,,,,,,,,,745.54,83,,percent of total billed charges,,,853.33,95,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,736.56,82,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,763.5,85,,percent of total billed charges,,224.56,853.33,
SYNTHES RT6 HEADHOLE 2 SHAFT HOLE,30188063,CDM,,,278,RC,outpatient,,9056,9056,,7688.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2264,22,,percent of total billed charges,,,,,,,,,8150.4,90,,percent of total billed charges,,,7498.37,82.8,,percent of total billed charges,,,7697.6,85,,percent of total billed charges,,,,,,,,,7969.28,88,,percent of total billed charges,,,,,,,,,6918.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2264,22,,percent of total billed charges,,,8240.96,91,,percent of total billed charges,,,8603.2,95,,percent of total billed charges,,,7516.48,83,,percent of total billed charges,,,7516.48,83,,percent of total billed charges,,,,,,,,,,,,,,,7516.48,83,,percent of total billed charges,,,8603.2,95,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,7425.92,82,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,7697.6,85,,percent of total billed charges,,2264,8603.2,
SYNTHES LT6 HEADHOLE 2 SHAFT HOLE,30188064,CDM,,,278,RC,outpatient,,9056,9056,,7688.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2264,22,,percent of total billed charges,,,,,,,,,8150.4,90,,percent of total billed charges,,,7498.37,82.8,,percent of total billed charges,,,7697.6,85,,percent of total billed charges,,,,,,,,,7969.28,88,,percent of total billed charges,,,,,,,,,6918.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2264,22,,percent of total billed charges,,,8240.96,91,,percent of total billed charges,,,8603.2,95,,percent of total billed charges,,,7516.48,83,,percent of total billed charges,,,7516.48,83,,percent of total billed charges,,,,,,,,,,,,,,,7516.48,83,,percent of total billed charges,,,8603.2,95,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,7425.92,82,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,7697.6,85,,percent of total billed charges,,2264,8603.2,
SYNTHES LT6 HEADHOLE 2 SHAFT HOLE,30188065,CDM,,,278,RC,outpatient,,9056,9056,,7688.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2264,22,,percent of total billed charges,,,,,,,,,8150.4,90,,percent of total billed charges,,,7498.37,82.8,,percent of total billed charges,,,7697.6,85,,percent of total billed charges,,,,,,,,,7969.28,88,,percent of total billed charges,,,,,,,,,6918.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2264,22,,percent of total billed charges,,,8240.96,91,,percent of total billed charges,,,8603.2,95,,percent of total billed charges,,,7516.48,83,,percent of total billed charges,,,7516.48,83,,percent of total billed charges,,,,,,,,,,,,,,,7516.48,83,,percent of total billed charges,,,8603.2,95,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,7425.92,82,,percent of total billed charges,,,8150.4,90,,percent of total billed charges,,,7697.6,85,,percent of total billed charges,,2264,8603.2,
SYNTHES 18 1.8 VA BUTTRESS,30188066,CDM,,,278,RC,outpatient,,1354.02,1354.02,,1149.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,338.51,22,,percent of total billed charges,,,,,,,,,1218.62,90,,percent of total billed charges,,,1121.13,82.8,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,,,,,,,,1191.54,88,,percent of total billed charges,,,,,,,,,1034.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,338.51,22,,percent of total billed charges,,,1232.16,91,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,1123.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1123.84,83,,percent of total billed charges,,,1286.32,95,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1110.3,82,,percent of total billed charges,,,1218.62,90,,percent of total billed charges,,,1150.92,85,,percent of total billed charges,,338.51,1286.32,
ZIMMER BEARING MC 12MM,30188067,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ZIMMER TIBIA SZ J LEFT,30188068,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER BEARING MC 12MM 6-7CD,30188069,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ARTHREX REAMER SMALL,30188070,CDM,,,270,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
ARTHREX STEM HUMERAL SZ 9,30188071,CDM,,,278,RC,outpatient,,16152.5,16152.5,,13713.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4038.13,22,,percent of total billed charges,,,,,,,,,14537.25,90,,percent of total billed charges,,,13374.27,82.8,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,,,,,,,,14214.2,88,,percent of total billed charges,,,,,,,,,12340.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4038.13,22,,percent of total billed charges,,,14698.78,91,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,,,,,,,,,,,,,13406.58,83,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13245.05,82,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,4038.13,15344.88,
ARTHREX SCREW LOCKING 5.5 X 20MM,30188072,CDM,,,278,RC,outpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210,22,,percent of total billed charges,,,,,,,,,756,90,,percent of total billed charges,,,695.52,82.8,,percent of total billed charges,,,714,85,,percent of total billed charges,,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210,22,,percent of total billed charges,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,210,798,
ARTHREX CUP REVERS 36 +2 LEFT,30188073,CDM,,,278,RC,outpatient,,11602.5,11602.5,,9850.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2900.63,22,,percent of total billed charges,,,,,,,,,10442.25,90,,percent of total billed charges,,,9606.87,82.8,,percent of total billed charges,,,9862.13,85,,percent of total billed charges,,,,,,,,,10210.2,88,,percent of total billed charges,,,,,,,,,8864.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2900.63,22,,percent of total billed charges,,,10558.28,91,,percent of total billed charges,,,11022.38,95,,percent of total billed charges,,,9630.08,83,,percent of total billed charges,,,9630.08,83,,percent of total billed charges,,,,,,,,,,,,,,,9630.08,83,,percent of total billed charges,,,11022.38,95,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,9514.05,82,,percent of total billed charges,,,10442.25,90,,percent of total billed charges,,,9862.13,85,,percent of total billed charges,,2900.63,11022.38,
ARTHREX GLENOID SYSTEM 30MM,30188074,CDM,,,278,RC,outpatient,,6175,6175,,5242.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1543.75,22,,percent of total billed charges,,,,,,,,,5557.5,90,,percent of total billed charges,,,5112.9,82.8,,percent of total billed charges,,,5248.75,85,,percent of total billed charges,,,,,,,,,5434,88,,percent of total billed charges,,,,,,,,,4717.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1543.75,22,,percent of total billed charges,,,5619.25,91,,percent of total billed charges,,,5866.25,95,,percent of total billed charges,,,5125.25,83,,percent of total billed charges,,,5125.25,83,,percent of total billed charges,,,,,,,,,,,,,,,5125.25,83,,percent of total billed charges,,,5866.25,95,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5063.5,82,,percent of total billed charges,,,5557.5,90,,percent of total billed charges,,,5248.75,85,,percent of total billed charges,,1543.75,5866.25,
JAW BRA,30188076,CDM,,,270,RC,outpatient,,182,182,,154.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.5,22,,percent of total billed charges,,,,,,,,,163.8,90,,percent of total billed charges,,,150.7,82.8,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,,,,,,,,160.16,88,,percent of total billed charges,,,,,,,,,139.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.5,22,,percent of total billed charges,,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,149.24,82,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,45.5,172.9,
NEUROVISION STIMULATION PROBE HUMMINGBIR,30188077,CDM,,,270,RC,outpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,148.75,22,,percent of total billed charges,,,,,,,,,535.5,90,,percent of total billed charges,,,492.66,82.8,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,148.75,22,,percent of total billed charges,,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,148.75,565.25,
S&N PATELLA 35MM,30188078,CDM,,,278,RC,outpatient,,5200,5200,,4414.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1300,22,,percent of total billed charges,,,,,,,,,4680,90,,percent of total billed charges,,,4305.6,82.8,,percent of total billed charges,,,4420,85,,percent of total billed charges,,,,,,,,,4576,88,,percent of total billed charges,,,,,,,,,3972.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1300,22,,percent of total billed charges,,,4732,91,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,,,,,,,,,,,,,4316,83,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4264,82,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4420,85,,percent of total billed charges,,1300,4940,
STRYKER CUP CLUSTERHOLE 56MM F,30188079,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
STRYKER INSERT X3 36MM F,30188080,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER INSERT 36MM 0DEG,30188081,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER INSERT TRIATHLON CS SZ 2 12MM,30188082,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER PATELLA TRIATHLON X3,30188083,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
EVERCROSS BALLOON 5 X 200MM,30188084,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
INPACT ADMIRAL PTA BALLOON CATH 6X150X13,30188085,CDM,,,270,RC,outpatient,,11635,11635,,9878.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2908.75,22,,percent of total billed charges,,,,,,,,,10471.5,90,,percent of total billed charges,,,9633.78,82.8,,percent of total billed charges,,,9889.75,85,,percent of total billed charges,,,,,,,,,10238.8,88,,percent of total billed charges,,,,,,,,,8889.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2908.75,22,,percent of total billed charges,,,10587.85,91,,percent of total billed charges,,,11053.25,95,,percent of total billed charges,,,9657.05,83,,percent of total billed charges,,,9657.05,83,,percent of total billed charges,,,,,,,,,,,,,,,9657.05,83,,percent of total billed charges,,,11053.25,95,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,9540.7,82,,percent of total billed charges,,,10471.5,90,,percent of total billed charges,,,9889.75,85,,percent of total billed charges,,2908.75,11053.25,
VISIPRO STENT 6 X 27MM,30188086,CDM,,,270,RC,outpatient,,8008.98,8008.98,,6799.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2002.25,22,,percent of total billed charges,,,,,,,,,7208.08,90,,percent of total billed charges,,,6631.44,82.8,,percent of total billed charges,,,6807.63,85,,percent of total billed charges,,,,,,,,,7047.9,88,,percent of total billed charges,,,,,,,,,6118.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2002.25,22,,percent of total billed charges,,,7288.17,91,,percent of total billed charges,,,7608.53,95,,percent of total billed charges,,,6647.45,83,,percent of total billed charges,,,6647.45,83,,percent of total billed charges,,,,,,,,,,,,,,,6647.45,83,,percent of total billed charges,,,7608.53,95,,percent of total billed charges,,,7208.08,90,,percent of total billed charges,,,7208.08,90,,percent of total billed charges,,,6567.36,82,,percent of total billed charges,,,7208.08,90,,percent of total billed charges,,,6807.63,85,,percent of total billed charges,,2002.25,7608.53,
STRYKER HEAD DELTA V-40 36MM -5MM,30188087,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
STRYKER SHELL CLUSTERHOLE 48MM D,30188088,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
STRYKER BASEPLATE 28 X 10.05MM,30188089,CDM,,,278,RC,outpatient,,14300,14300,,12140.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3575,22,,percent of total billed charges,,,,,,,,,12870,90,,percent of total billed charges,,,11840.4,82.8,,percent of total billed charges,,,12155,85,,percent of total billed charges,,,,,,,,,12584,88,,percent of total billed charges,,,,,,,,,10925.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3575,22,,percent of total billed charges,,,13013,91,,percent of total billed charges,,,13585,95,,percent of total billed charges,,,11869,83,,percent of total billed charges,,,11869,83,,percent of total billed charges,,,,,,,,,,,,,,,11869,83,,percent of total billed charges,,,13585,95,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,11726,82,,percent of total billed charges,,,12870,90,,percent of total billed charges,,,12155,85,,percent of total billed charges,,3575,13585,
STRYKER SCREW PERIPHERAL 4.5 X 24MM,30188090,CDM,,,278,RC,outpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325,22,,percent of total billed charges,,,,,,,,,1170,90,,percent of total billed charges,,,1076.4,82.8,,percent of total billed charges,,,1105,85,,percent of total billed charges,,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325,22,,percent of total billed charges,,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,325,1235,
ARTHREX STEM HUMERAL SZ 6,30188091,CDM,,,278,RC,outpatient,,16152.5,16152.5,,13713.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4038.13,22,,percent of total billed charges,,,,,,,,,14537.25,90,,percent of total billed charges,,,13374.27,82.8,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,,,,,,,,14214.2,88,,percent of total billed charges,,,,,,,,,12340.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4038.13,22,,percent of total billed charges,,,14698.78,91,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,,,,,,,,,,,,,13406.58,83,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13245.05,82,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,4038.13,15344.88,
ARTHREX GLENOID SYSTEM SHOULDER IMPLANT,30188092,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
ARTHREX BREAKAWAY PINS,30188093,CDM,,,270,RC,outpatient,,277.5,277.5,,235.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.38,22,,percent of total billed charges,,,,,,,,,249.75,90,,percent of total billed charges,,,229.77,82.8,,percent of total billed charges,,,235.88,85,,percent of total billed charges,,,,,,,,,244.2,88,,percent of total billed charges,,,,,,,,,212.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.38,22,,percent of total billed charges,,,252.53,91,,percent of total billed charges,,,263.63,95,,percent of total billed charges,,,230.33,83,,percent of total billed charges,,,230.33,83,,percent of total billed charges,,,,,,,,,,,,,,,230.33,83,,percent of total billed charges,,,263.63,95,,percent of total billed charges,,,249.75,90,,percent of total billed charges,,,249.75,90,,percent of total billed charges,,,227.55,82,,percent of total billed charges,,,249.75,90,,percent of total billed charges,,,235.88,85,,percent of total billed charges,,69.38,263.63,
ARTHREX ENTRY PIN 2.4MM,30188094,CDM,,,270,RC,outpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
S&N FEMORAL COMPONENT UNI LAT SZ 8 LEFT,30188095,CDM,,,278,RC,outpatient,,27227.79,27227.79,,23116.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6806.95,22,,percent of total billed charges,,,,,,,,,24505.01,90,,percent of total billed charges,,,22544.61,82.8,,percent of total billed charges,,,23143.62,85,,percent of total billed charges,,,,,,,,,23960.46,88,,percent of total billed charges,,,,,,,,,20802.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6806.95,22,,percent of total billed charges,,,24777.29,91,,percent of total billed charges,,,25866.4,95,,percent of total billed charges,,,22599.07,83,,percent of total billed charges,,,22599.07,83,,percent of total billed charges,,,,,,,,,,,,,,,22599.07,83,,percent of total billed charges,,,25866.4,95,,percent of total billed charges,,,24505.01,90,,percent of total billed charges,,,24505.01,90,,percent of total billed charges,,,22326.79,82,,percent of total billed charges,,,24505.01,90,,percent of total billed charges,,,23143.62,85,,percent of total billed charges,,6806.95,25866.4,
S&N TIBIAL BASEPLATE UNI SZ 6 LEFT,30188096,CDM,,,278,RC,outpatient,,6855.94,6855.94,,5820.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1713.99,22,,percent of total billed charges,,,,,,,,,6170.35,90,,percent of total billed charges,,,5676.72,82.8,,percent of total billed charges,,,5827.55,85,,percent of total billed charges,,,,,,,,,6033.23,88,,percent of total billed charges,,,,,,,,,5237.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1713.99,22,,percent of total billed charges,,,6238.91,91,,percent of total billed charges,,,6513.14,95,,percent of total billed charges,,,5690.43,83,,percent of total billed charges,,,5690.43,83,,percent of total billed charges,,,,,,,,,,,,,,,5690.43,83,,percent of total billed charges,,,6513.14,95,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,5621.87,82,,percent of total billed charges,,,6170.35,90,,percent of total billed charges,,,5827.55,85,,percent of total billed charges,,1713.99,6513.14,
S&N TIBIAL INSERT UNI 12MM SZ 5-6,30188097,CDM,,,278,RC,outpatient,,14631.63,14631.63,,12422.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3657.91,22,,percent of total billed charges,,,,,,,,,13168.47,90,,percent of total billed charges,,,12114.99,82.8,,percent of total billed charges,,,12436.89,85,,percent of total billed charges,,,,,,,,,12875.83,88,,percent of total billed charges,,,,,,,,,11178.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3657.91,22,,percent of total billed charges,,,13314.78,91,,percent of total billed charges,,,13900.05,95,,percent of total billed charges,,,12144.25,83,,percent of total billed charges,,,12144.25,83,,percent of total billed charges,,,,,,,,,,,,,,,12144.25,83,,percent of total billed charges,,,13900.05,95,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,11997.94,82,,percent of total billed charges,,,13168.47,90,,percent of total billed charges,,,12436.89,85,,percent of total billed charges,,3657.91,13900.05,
AVAFLEX BALLOON KIT 10G X 20MM,30188098,CDM,,,270,RC,outpatient,,16740.75,16740.75,,14212.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4185.19,22,,percent of total billed charges,,,,,,,,,15066.68,90,,percent of total billed charges,,,13861.34,82.8,,percent of total billed charges,,,14229.64,85,,percent of total billed charges,,,,,,,,,14731.86,88,,percent of total billed charges,,,,,,,,,12789.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4185.19,22,,percent of total billed charges,,,15234.08,91,,percent of total billed charges,,,15903.71,95,,percent of total billed charges,,,13894.82,83,,percent of total billed charges,,,13894.82,83,,percent of total billed charges,,,,,,,,,,,,,,,13894.82,83,,percent of total billed charges,,,15903.71,95,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,13727.42,82,,percent of total billed charges,,,15066.68,90,,percent of total billed charges,,,14229.64,85,,percent of total billed charges,,4185.19,15903.71,
FORTEC HOLMIUM LASER HIGH WATTAGE,30188099,CDM,,,270,RC,outpatient,,1378,1378,,1169.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,344.5,22,,percent of total billed charges,,,,,,,,,1240.2,90,,percent of total billed charges,,,1140.98,82.8,,percent of total billed charges,,,1171.3,85,,percent of total billed charges,,,,,,,,,1212.64,88,,percent of total billed charges,,,,,,,,,1052.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,344.5,22,,percent of total billed charges,,,1253.98,91,,percent of total billed charges,,,1309.1,95,,percent of total billed charges,,,1143.74,83,,percent of total billed charges,,,1143.74,83,,percent of total billed charges,,,,,,,,,,,,,,,1143.74,83,,percent of total billed charges,,,1309.1,95,,percent of total billed charges,,,1240.2,90,,percent of total billed charges,,,1240.2,90,,percent of total billed charges,,,1129.96,82,,percent of total billed charges,,,1240.2,90,,percent of total billed charges,,,1171.3,85,,percent of total billed charges,,344.5,1309.1,
STRYKER FEMUR PRESSFIT SZ3 RIGHT,30188100,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
STRYKER FEMUR PRESSFIT SZ2 LEFT,30188101,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
STRYKER INSERT PS #2 10MM TRIATHLON,30188102,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER PATELLA METAL BACK SZ A29X9,30188103,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
SYNTHES PLATE LCP CLAVICLE 2.7 VA LEFT,30188104,CDM,,,278,RC,outpatient,,11851.13,11851.13,,10061.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2962.78,22,,percent of total billed charges,,,,,,,,,10666.02,90,,percent of total billed charges,,,9812.74,82.8,,percent of total billed charges,,,10073.46,85,,percent of total billed charges,,,,,,,,,10428.99,88,,percent of total billed charges,,,,,,,,,9054.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2962.78,22,,percent of total billed charges,,,10784.53,91,,percent of total billed charges,,,11258.57,95,,percent of total billed charges,,,9836.44,83,,percent of total billed charges,,,9836.44,83,,percent of total billed charges,,,,,,,,,,,,,,,9836.44,83,,percent of total billed charges,,,11258.57,95,,percent of total billed charges,,,10666.02,90,,percent of total billed charges,,,10666.02,90,,percent of total billed charges,,,9717.93,82,,percent of total billed charges,,,10666.02,90,,percent of total billed charges,,,10073.46,85,,percent of total billed charges,,2962.78,11258.57,
SYNTHES SCREW METAPHYSEAL 2.7 X 20MM,30188105,CDM,,,278,RC,outpatient,,492.38,492.38,,418.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.1,22,,percent of total billed charges,,,,,,,,,443.14,90,,percent of total billed charges,,,407.69,82.8,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,,,,,,,,433.29,88,,percent of total billed charges,,,,,,,,,376.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.1,22,,percent of total billed charges,,,448.07,91,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,408.68,83,,percent of total billed charges,,,,,,,,,,,,,,,408.68,83,,percent of total billed charges,,,467.76,95,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,403.75,82,,percent of total billed charges,,,443.14,90,,percent of total billed charges,,,418.52,85,,percent of total billed charges,,123.1,467.76,
GORE VBX BALLOON EXPANDABLE 8X59,30188106,CDM,,,270,RC,outpatient,,24160.5,24160.5,,20512.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6040.13,22,,percent of total billed charges,,,,,,,,,21744.45,90,,percent of total billed charges,,,20004.89,82.8,,percent of total billed charges,,,20536.43,85,,percent of total billed charges,,,,,,,,,21261.24,88,,percent of total billed charges,,,,,,,,,18458.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6040.13,22,,percent of total billed charges,,,21986.06,91,,percent of total billed charges,,,22952.48,95,,percent of total billed charges,,,20053.22,83,,percent of total billed charges,,,20053.22,83,,percent of total billed charges,,,,,,,,,,,,,,,20053.22,83,,percent of total billed charges,,,22952.48,95,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,19811.61,82,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,20536.43,85,,percent of total billed charges,,6040.13,22952.48,
GORE VBX BALLOON EXPANDABLE 8X39,30188107,CDM,,,270,RC,outpatient,,24160.5,24160.5,,20512.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6040.13,22,,percent of total billed charges,,,,,,,,,21744.45,90,,percent of total billed charges,,,20004.89,82.8,,percent of total billed charges,,,20536.43,85,,percent of total billed charges,,,,,,,,,21261.24,88,,percent of total billed charges,,,,,,,,,18458.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6040.13,22,,percent of total billed charges,,,21986.06,91,,percent of total billed charges,,,22952.48,95,,percent of total billed charges,,,20053.22,83,,percent of total billed charges,,,20053.22,83,,percent of total billed charges,,,,,,,,,,,,,,,20053.22,83,,percent of total billed charges,,,22952.48,95,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,19811.61,82,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,20536.43,85,,percent of total billed charges,,6040.13,22952.48,
SYNTHES SCREW LAG 95MM,30188108,CDM,,,278,RC,outpatient,,6682.07,6682.07,,5673.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1670.52,22,,percent of total billed charges,,,,,,,,,6013.86,90,,percent of total billed charges,,,5532.75,82.8,,percent of total billed charges,,,5679.76,85,,percent of total billed charges,,,,,,,,,5880.22,88,,percent of total billed charges,,,,,,,,,5105.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1670.52,22,,percent of total billed charges,,,6080.68,91,,percent of total billed charges,,,6347.97,95,,percent of total billed charges,,,5546.12,83,,percent of total billed charges,,,5546.12,83,,percent of total billed charges,,,,,,,,,,,,,,,5546.12,83,,percent of total billed charges,,,6347.97,95,,percent of total billed charges,,,6013.86,90,,percent of total billed charges,,,6013.86,90,,percent of total billed charges,,,5479.3,82,,percent of total billed charges,,,6013.86,90,,percent of total billed charges,,,5679.76,85,,percent of total billed charges,,1670.52,6347.97,
SYNTHES SCREW CANCELLOUS FT 4X14MM,30188109,CDM,,,278,RC,outpatient,,236.7,236.7,,200.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.18,22,,percent of total billed charges,,,,,,,,,213.03,90,,percent of total billed charges,,,195.99,82.8,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,,,,,,,,208.3,88,,percent of total billed charges,,,,,,,,,180.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.18,22,,percent of total billed charges,,,215.4,91,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,196.46,83,,percent of total billed charges,,,,,,,,,,,,,,,196.46,83,,percent of total billed charges,,,224.87,95,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,194.09,82,,percent of total billed charges,,,213.03,90,,percent of total billed charges,,,201.2,85,,percent of total billed charges,,59.18,224.87,
DEPUY GLENOID M 26.5,30188110,CDM,,,278,RC,outpatient,,19821.75,19821.75,,16828.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4955.44,22,,percent of total billed charges,,,,,,,,,17839.58,90,,percent of total billed charges,,,16412.41,82.8,,percent of total billed charges,,,16848.49,85,,percent of total billed charges,,,,,,,,,17443.14,88,,percent of total billed charges,,,,,,,,,15143.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4955.44,22,,percent of total billed charges,,,18037.79,91,,percent of total billed charges,,,18830.66,95,,percent of total billed charges,,,16452.05,83,,percent of total billed charges,,,16452.05,83,,percent of total billed charges,,,,,,,,,,,,,,,16452.05,83,,percent of total billed charges,,,18830.66,95,,percent of total billed charges,,,17839.58,90,,percent of total billed charges,,,17839.58,90,,percent of total billed charges,,,16253.84,82,,percent of total billed charges,,,17839.58,90,,percent of total billed charges,,,16848.49,85,,percent of total billed charges,,4955.44,18830.66,
ANATOMCOFFSET ADAPTER,30188111,CDM,,,278,RC,outpatient,,1738.75,1738.75,,1476.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,434.69,22,,percent of total billed charges,,,,,,,,,1564.88,90,,percent of total billed charges,,,1439.69,82.8,,percent of total billed charges,,,1477.94,85,,percent of total billed charges,,,,,,,,,1530.1,88,,percent of total billed charges,,,,,,,,,1328.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,434.69,22,,percent of total billed charges,,,1582.26,91,,percent of total billed charges,,,1651.81,95,,percent of total billed charges,,,1443.16,83,,percent of total billed charges,,,1443.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1443.16,83,,percent of total billed charges,,,1651.81,95,,percent of total billed charges,,,1564.88,90,,percent of total billed charges,,,1564.88,90,,percent of total billed charges,,,1425.78,82,,percent of total billed charges,,,1564.88,90,,percent of total billed charges,,,1477.94,85,,percent of total billed charges,,434.69,1651.81,
DEPUY SHORTSTEM S32,30188112,CDM,,,278,RC,outpatient,,36140,36140,,30682.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9035,22,,percent of total billed charges,,,,,,,,,32526,90,,percent of total billed charges,,,29923.92,82.8,,percent of total billed charges,,,30719,85,,percent of total billed charges,,,,,,,,,31803.2,88,,percent of total billed charges,,,,,,,,,27610.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9035,22,,percent of total billed charges,,,32887.4,91,,percent of total billed charges,,,34333,95,,percent of total billed charges,,,29996.2,83,,percent of total billed charges,,,29996.2,83,,percent of total billed charges,,,,,,,,,,,,,,,29996.2,83,,percent of total billed charges,,,34333,95,,percent of total billed charges,,,32526,90,,percent of total billed charges,,,32526,90,,percent of total billed charges,,,29634.8,82,,percent of total billed charges,,,32526,90,,percent of total billed charges,,,30719,85,,percent of total billed charges,,9035,34333,
DEPUY HUM HEAD 42X16.5,30188113,CDM,,,278,RC,outpatient,,17630.93,17630.93,,14968.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4407.73,22,,percent of total billed charges,,,,,,,,,15867.84,90,,percent of total billed charges,,,14598.41,82.8,,percent of total billed charges,,,14986.29,85,,percent of total billed charges,,,,,,,,,15515.22,88,,percent of total billed charges,,,,,,,,,13470.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4407.73,22,,percent of total billed charges,,,16044.15,91,,percent of total billed charges,,,16749.38,95,,percent of total billed charges,,,14633.67,83,,percent of total billed charges,,,14633.67,83,,percent of total billed charges,,,,,,,,,,,,,,,14633.67,83,,percent of total billed charges,,,16749.38,95,,percent of total billed charges,,,15867.84,90,,percent of total billed charges,,,15867.84,90,,percent of total billed charges,,,14457.36,82,,percent of total billed charges,,,15867.84,90,,percent of total billed charges,,,14986.29,85,,percent of total billed charges,,4407.73,16749.38,
DEPUY 3PKRESECTIONPIN,30188114,CDM,,,278,RC,outpatient,,1217.13,1217.13,,1033.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,304.28,22,,percent of total billed charges,,,,,,,,,1095.42,90,,percent of total billed charges,,,1007.78,82.8,,percent of total billed charges,,,1034.56,85,,percent of total billed charges,,,,,,,,,1071.07,88,,percent of total billed charges,,,,,,,,,929.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,304.28,22,,percent of total billed charges,,,1107.59,91,,percent of total billed charges,,,1156.27,95,,percent of total billed charges,,,1010.22,83,,percent of total billed charges,,,1010.22,83,,percent of total billed charges,,,,,,,,,,,,,,,1010.22,83,,percent of total billed charges,,,1156.27,95,,percent of total billed charges,,,1095.42,90,,percent of total billed charges,,,1095.42,90,,percent of total billed charges,,,998.05,82,,percent of total billed charges,,,1095.42,90,,percent of total billed charges,,,1034.56,85,,percent of total billed charges,,304.28,1156.27,
DEPUY HUMERAL PIN3.5X130,30188115,CDM,,,278,RC,outpatient,,786.45,786.45,,667.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,196.61,22,,percent of total billed charges,,,,,,,,,707.81,90,,percent of total billed charges,,,651.18,82.8,,percent of total billed charges,,,668.48,85,,percent of total billed charges,,,,,,,,,692.08,88,,percent of total billed charges,,,,,,,,,600.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,196.61,22,,percent of total billed charges,,,715.67,91,,percent of total billed charges,,,747.13,95,,percent of total billed charges,,,652.75,83,,percent of total billed charges,,,652.75,83,,percent of total billed charges,,,,,,,,,,,,,,,652.75,83,,percent of total billed charges,,,747.13,95,,percent of total billed charges,,,707.81,90,,percent of total billed charges,,,707.81,90,,percent of total billed charges,,,644.89,82,,percent of total billed charges,,,707.81,90,,percent of total billed charges,,,668.48,85,,percent of total billed charges,,196.61,747.13,
DEPUY GLENOID PIN,30188116,CDM,,,278,RC,outpatient,,1043.25,1043.25,,885.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260.81,22,,percent of total billed charges,,,,,,,,,938.93,90,,percent of total billed charges,,,863.81,82.8,,percent of total billed charges,,,886.76,85,,percent of total billed charges,,,,,,,,,918.06,88,,percent of total billed charges,,,,,,,,,797.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260.81,22,,percent of total billed charges,,,949.36,91,,percent of total billed charges,,,991.09,95,,percent of total billed charges,,,865.9,83,,percent of total billed charges,,,865.9,83,,percent of total billed charges,,,,,,,,,,,,,,,865.9,83,,percent of total billed charges,,,991.09,95,,percent of total billed charges,,,938.93,90,,percent of total billed charges,,,938.93,90,,percent of total billed charges,,,855.47,82,,percent of total billed charges,,,938.93,90,,percent of total billed charges,,,886.76,85,,percent of total billed charges,,260.81,991.09,
DEPUY SIZER HANDLE,30188117,CDM,,,270,RC,outpatient,,539.28,539.28,,457.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,134.82,22,,percent of total billed charges,,,,,,,,,485.35,90,,percent of total billed charges,,,446.52,82.8,,percent of total billed charges,,,458.39,85,,percent of total billed charges,,,,,,,,,474.57,88,,percent of total billed charges,,,,,,,,,412.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,134.82,22,,percent of total billed charges,,,490.74,91,,percent of total billed charges,,,512.32,95,,percent of total billed charges,,,447.6,83,,percent of total billed charges,,,447.6,83,,percent of total billed charges,,,,,,,,,,,,,,,447.6,83,,percent of total billed charges,,,512.32,95,,percent of total billed charges,,,485.35,90,,percent of total billed charges,,,485.35,90,,percent of total billed charges,,,442.21,82,,percent of total billed charges,,,485.35,90,,percent of total billed charges,,,458.39,85,,percent of total billed charges,,134.82,512.32,
GORE VIABAHN 11MMx79MM 8FR135CM,30188118,CDM,,,270,RC,outpatient,,26507,26507,,22504.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6626.75,22,,percent of total billed charges,,,,,,,,,23856.3,90,,percent of total billed charges,,,21947.8,82.8,,percent of total billed charges,,,22530.95,85,,percent of total billed charges,,,,,,,,,23326.16,88,,percent of total billed charges,,,,,,,,,20251.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6626.75,22,,percent of total billed charges,,,24121.37,91,,percent of total billed charges,,,25181.65,95,,percent of total billed charges,,,22000.81,83,,percent of total billed charges,,,22000.81,83,,percent of total billed charges,,,,,,,,,,,,,,,22000.81,83,,percent of total billed charges,,,25181.65,95,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,21735.74,82,,percent of total billed charges,,,23856.3,90,,percent of total billed charges,,,22530.95,85,,percent of total billed charges,,6626.75,25181.65,
GORE VIABAHN HEPARIN 35 RO 13MMX10CM,30188119,CDM,,,270,RC,outpatient,,26006.5,26006.5,,22079.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6501.63,22,,percent of total billed charges,,,,,,,,,23405.85,90,,percent of total billed charges,,,21533.38,82.8,,percent of total billed charges,,,22105.53,85,,percent of total billed charges,,,,,,,,,22885.72,88,,percent of total billed charges,,,,,,,,,19868.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6501.63,22,,percent of total billed charges,,,23665.92,91,,percent of total billed charges,,,24706.18,95,,percent of total billed charges,,,21585.4,83,,percent of total billed charges,,,21585.4,83,,percent of total billed charges,,,,,,,,,,,,,,,21585.4,83,,percent of total billed charges,,,24706.18,95,,percent of total billed charges,,,23405.85,90,,percent of total billed charges,,,23405.85,90,,percent of total billed charges,,,21325.33,82,,percent of total billed charges,,,23405.85,90,,percent of total billed charges,,,22105.53,85,,percent of total billed charges,,6501.63,24706.18,
DRAIN JACKSON HUBLESS SILICONE 15FR,30188120,CDM,,,270,RC,outpatient,,152.66,152.66,,129.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.17,22,,percent of total billed charges,,,,,,,,,137.39,90,,percent of total billed charges,,,126.4,82.8,,percent of total billed charges,,,129.76,85,,percent of total billed charges,,,,,,,,,134.34,88,,percent of total billed charges,,,,,,,,,116.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.17,22,,percent of total billed charges,,,138.92,91,,percent of total billed charges,,,145.03,95,,percent of total billed charges,,,126.71,83,,percent of total billed charges,,,126.71,83,,percent of total billed charges,,,,,,,,,,,,,,,126.71,83,,percent of total billed charges,,,145.03,95,,percent of total billed charges,,,137.39,90,,percent of total billed charges,,,137.39,90,,percent of total billed charges,,,125.18,82,,percent of total billed charges,,,137.39,90,,percent of total billed charges,,,129.76,85,,percent of total billed charges,,38.17,145.03,
URETERAL STENT TRIA FIRM 4.8Fx20CM,30188122,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
URETERAL STENT TRIA FIRM 4.8Fx22CM,30188123,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
URETERAL STENT TRIA FIRM 4.8Fx24CM,30188124,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
URETERAL STENT TRIA FIRM 4.8Fx26CM,30188125,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
URETERAL STENT TRIA FIRM 4.8Fx28CM,30188126,CDM,,,270,RC,outpatient,,1293.5,1293.5,,1098.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,323.38,22,,percent of total billed charges,,,,,,,,,1164.15,90,,percent of total billed charges,,,1071.02,82.8,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,,,,,,,,1138.28,88,,percent of total billed charges,,,,,,,,,988.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,323.38,22,,percent of total billed charges,,,1177.09,91,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,1073.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1073.61,83,,percent of total billed charges,,,1228.83,95,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1060.67,82,,percent of total billed charges,,,1164.15,90,,percent of total billed charges,,,1099.48,85,,percent of total billed charges,,323.38,1228.83,
NANOCROSS BALLOON 6X40,30188127,CDM,,,270,RC,outpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.44,22,,percent of total billed charges,,,,,,,,,1740.38,90,,percent of total billed charges,,,1601.15,82.8,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.44,22,,percent of total billed charges,,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,483.44,1837.06,
IMPACT ADMIRAL BALLOON 6X200X130,30188128,CDM,,,270,RC,outpatient,,19467.5,19467.5,,16527.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4866.88,22,,percent of total billed charges,,,,,,,,,17520.75,90,,percent of total billed charges,,,16119.09,82.8,,percent of total billed charges,,,16547.38,85,,percent of total billed charges,,,,,,,,,17131.4,88,,percent of total billed charges,,,,,,,,,14873.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4866.88,22,,percent of total billed charges,,,17715.43,91,,percent of total billed charges,,,18494.13,95,,percent of total billed charges,,,16158.03,83,,percent of total billed charges,,,16158.03,83,,percent of total billed charges,,,,,,,,,,,,,,,16158.03,83,,percent of total billed charges,,,18494.13,95,,percent of total billed charges,,,17520.75,90,,percent of total billed charges,,,17520.75,90,,percent of total billed charges,,,15963.35,82,,percent of total billed charges,,,17520.75,90,,percent of total billed charges,,,16547.38,85,,percent of total billed charges,,4866.88,18494.13,
STRYKER,30188129,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
STRYKER MDM LINER,30188130,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER MDM LINER/INSERT,30188131,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER FEMORAL HEAD,30188132,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
ZIMMER SCREW HEX HEADED 3.5 X 27MM,30188133,CDM,,,278,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
ZIMMER ART SURFACE 12MM 3-5+ EF,30188134,CDM,,,278,RC,outpatient,,23562.5,23562.5,,20004.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5890.63,22,,percent of total billed charges,,,,,,,,,21206.25,90,,percent of total billed charges,,,19509.75,82.8,,percent of total billed charges,,,20028.13,85,,percent of total billed charges,,,,,,,,,20735,88,,percent of total billed charges,,,,,,,,,18001.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5890.63,22,,percent of total billed charges,,,21441.88,91,,percent of total billed charges,,,22384.38,95,,percent of total billed charges,,,19556.88,83,,percent of total billed charges,,,19556.88,83,,percent of total billed charges,,,,,,,,,,,,,,,19556.88,83,,percent of total billed charges,,,22384.38,95,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,19321.25,82,,percent of total billed charges,,,21206.25,90,,percent of total billed charges,,,20028.13,85,,percent of total billed charges,,5890.63,22384.38,
ZIMMER TIBIA FIXED KEEL PSN SZ E,30188135,CDM,,,278,RC,outpatient,,24033.75,24033.75,,20404.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6008.44,22,,percent of total billed charges,,,,,,,,,21630.38,90,,percent of total billed charges,,,19899.95,82.8,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,,,,,,,,21149.7,88,,percent of total billed charges,,,,,,,,,18361.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6008.44,22,,percent of total billed charges,,,21870.71,91,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,19948.01,83,,percent of total billed charges,,,,,,,,,,,,,,,19948.01,83,,percent of total billed charges,,,22832.06,95,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,19707.68,82,,percent of total billed charges,,,21630.38,90,,percent of total billed charges,,,20428.69,85,,percent of total billed charges,,6008.44,22832.06,
ZIMMER TIBIA HALF BLOCK PSN SZ EF 10MM,30188136,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER TIBIA HALF BLOCK PSN SZ EF LM 10M,30188137,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
ZIMMER STEM OFFSET 6MM 12X135MM,30188138,CDM,,,278,RC,outpatient,,24505,24505,,20804.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6126.25,22,,percent of total billed charges,,,,,,,,,22054.5,90,,percent of total billed charges,,,20290.14,82.8,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,,,,,,,,21564.4,88,,percent of total billed charges,,,,,,,,,18721.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6126.25,22,,percent of total billed charges,,,22299.55,91,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,20339.15,83,,percent of total billed charges,,,,,,,,,,,,,,,20339.15,83,,percent of total billed charges,,,23279.75,95,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20094.1,82,,percent of total billed charges,,,22054.5,90,,percent of total billed charges,,,20829.25,85,,percent of total billed charges,,6126.25,23279.75,
STRYKER SCREW LOCKING T2 F/T 5X40MM,30188139,CDM,,,278,RC,outpatient,,1774.37,1774.37,,1506.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,443.59,22,,percent of total billed charges,,,,,,,,,1596.93,90,,percent of total billed charges,,,1469.18,82.8,,percent of total billed charges,,,1508.21,85,,percent of total billed charges,,,,,,,,,1561.45,88,,percent of total billed charges,,,,,,,,,1355.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,443.59,22,,percent of total billed charges,,,1614.68,91,,percent of total billed charges,,,1685.65,95,,percent of total billed charges,,,1472.73,83,,percent of total billed charges,,,1472.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1472.73,83,,percent of total billed charges,,,1685.65,95,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1454.98,82,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1508.21,85,,percent of total billed charges,,443.59,1685.65,
STRYKER GUIDE WIRE TIP 3X1000,30188140,CDM,,,278,RC,outpatient,,1997,1997,,1695.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,499.25,22,,percent of total billed charges,,,,,,,,,1797.3,90,,percent of total billed charges,,,1653.52,82.8,,percent of total billed charges,,,1697.45,85,,percent of total billed charges,,,,,,,,,1757.36,88,,percent of total billed charges,,,,,,,,,1525.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,499.25,22,,percent of total billed charges,,,1817.27,91,,percent of total billed charges,,,1897.15,95,,percent of total billed charges,,,1657.51,83,,percent of total billed charges,,,1657.51,83,,percent of total billed charges,,,,,,,,,,,,,,,1657.51,83,,percent of total billed charges,,,1897.15,95,,percent of total billed charges,,,1797.3,90,,percent of total billed charges,,,1797.3,90,,percent of total billed charges,,,1637.54,82,,percent of total billed charges,,,1797.3,90,,percent of total billed charges,,,1697.45,85,,percent of total billed charges,,499.25,1897.15,
ZIMMER FEMUR LEFT CR SZ 12,30188141,CDM,,,278,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
ZIMMER INSERT MC 11MM,30188142,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
SCREW LATERAL MASS 12 X 3.5MM,30188145,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
SCREW SET,30188146,CDM,,,278,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
IR RODS 3.5 X 30MM LORDOSED,30188147,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
IR DRILL BIT 2.0,30188148,CDM,,,278,RC,outpatient,,2340,2340,,1986.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,585,22,,percent of total billed charges,,,,,,,,,2106,90,,percent of total billed charges,,,1937.52,82.8,,percent of total billed charges,,,1989,85,,percent of total billed charges,,,,,,,,,2059.2,88,,percent of total billed charges,,,,,,,,,1787.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,585,22,,percent of total billed charges,,,2129.4,91,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1942.2,83,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1918.8,82,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1989,85,,percent of total billed charges,,585,2223,
STRYKER SHELL CLUSTERHOLE 58F,30188149,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
STRYKER STEM ACCOLADE II SZ. 7,30188150,CDM,,,278,RC,outpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3900,22,,percent of total billed charges,,,,,,,,,14040,90,,percent of total billed charges,,,12916.8,82.8,,percent of total billed charges,,,13260,85,,percent of total billed charges,,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3900,22,,percent of total billed charges,,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,3900,14820,
INPACT ADMIRAL PTA BALLOON CATH 5X120X13,30188151,CDM,,,270,RC,outpatient,,10660,10660,,9050.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2665,22,,percent of total billed charges,,,,,,,,,9594,90,,percent of total billed charges,,,8826.48,82.8,,percent of total billed charges,,,9061,85,,percent of total billed charges,,,,,,,,,9380.8,88,,percent of total billed charges,,,,,,,,,8144.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2665,22,,percent of total billed charges,,,9700.6,91,,percent of total billed charges,,,10127,95,,percent of total billed charges,,,8847.8,83,,percent of total billed charges,,,8847.8,83,,percent of total billed charges,,,,,,,,,,,,,,,8847.8,83,,percent of total billed charges,,,10127,95,,percent of total billed charges,,,9594,90,,percent of total billed charges,,,9594,90,,percent of total billed charges,,,8741.2,82,,percent of total billed charges,,,9594,90,,percent of total billed charges,,,9061,85,,percent of total billed charges,,2665,10127,
ARTHREX STEM HUMERAL REVERS SZ 7,30188152,CDM,,,278,RC,outpatient,,16152.5,16152.5,,13713.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4038.13,22,,percent of total billed charges,,,,,,,,,14537.25,90,,percent of total billed charges,,,13374.27,82.8,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,,,,,,,,14214.2,88,,percent of total billed charges,,,,,,,,,12340.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4038.13,22,,percent of total billed charges,,,14698.78,91,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,13406.58,83,,percent of total billed charges,,,,,,,,,,,,,,,13406.58,83,,percent of total billed charges,,,15344.88,95,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13245.05,82,,percent of total billed charges,,,14537.25,90,,percent of total billed charges,,,13729.63,85,,percent of total billed charges,,4038.13,15344.88,
ULRICH SCREW POLY 5.5 X 45,30188153,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
DEPUY PIN HINGE LPS XX-XS,30188154,CDM,,,278,RC,outpatient,,4016.55,4016.55,,3410.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1004.14,22,,percent of total billed charges,,,,,,,,,3614.9,90,,percent of total billed charges,,,3325.7,82.8,,percent of total billed charges,,,3414.07,85,,percent of total billed charges,,,,,,,,,3534.56,88,,percent of total billed charges,,,,,,,,,3068.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1004.14,22,,percent of total billed charges,,,3655.06,91,,percent of total billed charges,,,3815.72,95,,percent of total billed charges,,,3333.74,83,,percent of total billed charges,,,3333.74,83,,percent of total billed charges,,,,,,,,,,,,,,,3333.74,83,,percent of total billed charges,,,3815.72,95,,percent of total billed charges,,,3614.9,90,,percent of total billed charges,,,3614.9,90,,percent of total billed charges,,,3293.57,82,,percent of total billed charges,,,3614.9,90,,percent of total billed charges,,,3414.07,85,,percent of total billed charges,,1004.14,3815.72,
VENT TUBE 1.14MM BOBBIN W/FLANGE,30188155,CDM,,,270,RC,outpatient,,89.36,89.36,,75.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.34,22,,percent of total billed charges,,,,,,,,,80.42,90,,percent of total billed charges,,,73.99,82.8,,percent of total billed charges,,,75.96,85,,percent of total billed charges,,,,,,,,,78.64,88,,percent of total billed charges,,,,,,,,,68.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.34,22,,percent of total billed charges,,,81.32,91,,percent of total billed charges,,,84.89,95,,percent of total billed charges,,,74.17,83,,percent of total billed charges,,,74.17,83,,percent of total billed charges,,,,,,,,,,,,,,,74.17,83,,percent of total billed charges,,,84.89,95,,percent of total billed charges,,,80.42,90,,percent of total billed charges,,,80.42,90,,percent of total billed charges,,,73.28,82,,percent of total billed charges,,,80.42,90,,percent of total billed charges,,,75.96,85,,percent of total billed charges,,22.34,84.89,
STRYKER INSERT #4 11MM,30188156,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
ULRICH OFF SET CONNECTOR 30MM,30188157,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
ULRICH OFF SET CONNECTOR 15MM,30188158,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
ULRICH TAP  7.0,30188159,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
ULRICH BOLT PELVIC 8.0 X 90,30188160,CDM,,,278,RC,outpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2356.25,22,,percent of total billed charges,,,,,,,,,8482.5,90,,percent of total billed charges,,,7803.9,82.8,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2356.25,22,,percent of total billed charges,,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,2356.25,8953.75,
ULRICH SCREW POLY 7.5 X 45,30188161,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH SCREW POLY 7.5 X 50,30188162,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
BLADE QUADCUT 3.4MM X 13CM,30188163,CDM,,,270,RC,outpatient,,2788.5,2788.5,,2367.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,697.13,22,,percent of total billed charges,,,,,,,,,2509.65,90,,percent of total billed charges,,,2308.88,82.8,,percent of total billed charges,,,2370.23,85,,percent of total billed charges,,,,,,,,,2453.88,88,,percent of total billed charges,,,,,,,,,2130.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,697.13,22,,percent of total billed charges,,,2537.54,91,,percent of total billed charges,,,2649.08,95,,percent of total billed charges,,,2314.46,83,,percent of total billed charges,,,2314.46,83,,percent of total billed charges,,,,,,,,,,,,,,,2314.46,83,,percent of total billed charges,,,2649.08,95,,percent of total billed charges,,,2509.65,90,,percent of total billed charges,,,2509.65,90,,percent of total billed charges,,,2286.57,82,,percent of total billed charges,,,2509.65,90,,percent of total billed charges,,,2370.23,85,,percent of total billed charges,,697.13,2649.08,
SYNTHES BONE HARVESTING KIT 520MM STERIL,30188164,CDM,,,278,RC,outpatient,,20163,20163,,17118.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5040.75,22,,percent of total billed charges,,,,,,,,,18146.7,90,,percent of total billed charges,,,16694.96,82.8,,percent of total billed charges,,,17138.55,85,,percent of total billed charges,,,,,,,,,17743.44,88,,percent of total billed charges,,,,,,,,,15404.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5040.75,22,,percent of total billed charges,,,18348.33,91,,percent of total billed charges,,,19154.85,95,,percent of total billed charges,,,16735.29,83,,percent of total billed charges,,,16735.29,83,,percent of total billed charges,,,,,,,,,,,,,,,16735.29,83,,percent of total billed charges,,,19154.85,95,,percent of total billed charges,,,18146.7,90,,percent of total billed charges,,,18146.7,90,,percent of total billed charges,,,16533.66,82,,percent of total billed charges,,,18146.7,90,,percent of total billed charges,,,17138.55,85,,percent of total billed charges,,5040.75,19154.85,
SYNTHES REAMER HEAD 15.5MM,30188165,CDM,,,278,RC,outpatient,,4933.5,4933.5,,4188.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1233.38,22,,percent of total billed charges,,,,,,,,,4440.15,90,,percent of total billed charges,,,4084.94,82.8,,percent of total billed charges,,,4193.48,85,,percent of total billed charges,,,,,,,,,4341.48,88,,percent of total billed charges,,,,,,,,,3769.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1233.38,22,,percent of total billed charges,,,4489.49,91,,percent of total billed charges,,,4686.83,95,,percent of total billed charges,,,4094.81,83,,percent of total billed charges,,,4094.81,83,,percent of total billed charges,,,,,,,,,,,,,,,4094.81,83,,percent of total billed charges,,,4686.83,95,,percent of total billed charges,,,4440.15,90,,percent of total billed charges,,,4440.15,90,,percent of total billed charges,,,4045.47,82,,percent of total billed charges,,,4440.15,90,,percent of total billed charges,,,4193.48,85,,percent of total billed charges,,1233.38,4686.83,
S&N INSERT HIGH FLEXION SZ7-8 9MM,30188166,CDM,,,278,RC,outpatient,,13000,13000,,11037,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3250,22,,percent of total billed charges,,,,,,,,,11700,90,,percent of total billed charges,,,10764,82.8,,percent of total billed charges,,,11050,85,,percent of total billed charges,,,,,,,,,11440,88,,percent of total billed charges,,,,,,,,,9932,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3250,22,,percent of total billed charges,,,11830,91,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,10790,83,,percent of total billed charges,,,,,,,,,,,,,,,10790,83,,percent of total billed charges,,,12350,95,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,10660,82,,percent of total billed charges,,,11700,90,,percent of total billed charges,,,11050,85,,percent of total billed charges,,3250,12350,
BLADE QUADCUT 4.3MM X 13CM,30188167,CDM,,,270,RC,outpatient,,2788.5,2788.5,,2367.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,697.13,22,,percent of total billed charges,,,,,,,,,2509.65,90,,percent of total billed charges,,,2308.88,82.8,,percent of total billed charges,,,2370.23,85,,percent of total billed charges,,,,,,,,,2453.88,88,,percent of total billed charges,,,,,,,,,2130.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,697.13,22,,percent of total billed charges,,,2537.54,91,,percent of total billed charges,,,2649.08,95,,percent of total billed charges,,,2314.46,83,,percent of total billed charges,,,2314.46,83,,percent of total billed charges,,,,,,,,,,,,,,,2314.46,83,,percent of total billed charges,,,2649.08,95,,percent of total billed charges,,,2509.65,90,,percent of total billed charges,,,2509.65,90,,percent of total billed charges,,,2286.57,82,,percent of total billed charges,,,2509.65,90,,percent of total billed charges,,,2370.23,85,,percent of total billed charges,,697.13,2649.08,
MERZ PROLARYN GEL 1CC INJECTABLE IMPLANT,30188168,CDM,,,278,RC,outpatient,,4062.5,4062.5,,3449.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1015.63,22,,percent of total billed charges,,,,,,,,,3656.25,90,,percent of total billed charges,,,3363.75,82.8,,percent of total billed charges,,,3453.13,85,,percent of total billed charges,,,,,,,,,3575,88,,percent of total billed charges,,,,,,,,,3103.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1015.63,22,,percent of total billed charges,,,3696.88,91,,percent of total billed charges,,,3859.38,95,,percent of total billed charges,,,3371.88,83,,percent of total billed charges,,,3371.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3371.88,83,,percent of total billed charges,,,3859.38,95,,percent of total billed charges,,,3656.25,90,,percent of total billed charges,,,3656.25,90,,percent of total billed charges,,,3331.25,82,,percent of total billed charges,,,3656.25,90,,percent of total billed charges,,,3453.13,85,,percent of total billed charges,,1015.63,3859.38,
ULRICH SCREW POLY 5.5 X 40,30188169,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH ROD LORDOSED 5.5 X 90MM,30188170,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
ATLIS SINGLE INCISION SLING SYSTEM,30188171,CDM,,,270,RC,outpatient,,14930.5,14930.5,,12675.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3732.63,22,,percent of total billed charges,,,,,,,,,13437.45,90,,percent of total billed charges,,,12362.45,82.8,,percent of total billed charges,,,12690.93,85,,percent of total billed charges,,,,,,,,,13138.84,88,,percent of total billed charges,,,,,,,,,11406.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3732.63,22,,percent of total billed charges,,,13586.76,91,,percent of total billed charges,,,14183.98,95,,percent of total billed charges,,,12392.32,83,,percent of total billed charges,,,12392.32,83,,percent of total billed charges,,,,,,,,,,,,,,,12392.32,83,,percent of total billed charges,,,14183.98,95,,percent of total billed charges,,,13437.45,90,,percent of total billed charges,,,13437.45,90,,percent of total billed charges,,,12243.01,82,,percent of total billed charges,,,13437.45,90,,percent of total billed charges,,,12690.93,85,,percent of total billed charges,,3732.63,14183.98,
DEPUY HEAD ECCENTRIC 48X21,30188172,CDM,,,278,RC,outpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4409.03,22,,percent of total billed charges,,,,,,,,,15872.52,90,,percent of total billed charges,,,14602.72,82.8,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4409.03,22,,percent of total billed charges,,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,4409.03,16754.32,
DEPUY BODY PROXIMAL 135 SZ12,30188173,CDM,,,278,RC,outpatient,,12654.66,12654.66,,10743.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3163.67,22,,percent of total billed charges,,,,,,,,,11389.19,90,,percent of total billed charges,,,10478.06,82.8,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,,,,,,,,11136.1,88,,percent of total billed charges,,,,,,,,,9668.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3163.67,22,,percent of total billed charges,,,11515.74,91,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,10503.37,83,,percent of total billed charges,,,,,,,,,,,,,,,10503.37,83,,percent of total billed charges,,,12021.93,95,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10376.82,82,,percent of total billed charges,,,11389.19,90,,percent of total billed charges,,,10756.46,85,,percent of total billed charges,,3163.67,12021.93,
DEPUY TRUMATCH SHLDER BLOCK 2.5,30188174,CDM,,,278,RC,outpatient,,16588,16588,,14083.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4147,22,,percent of total billed charges,,,,,,,,,14929.2,90,,percent of total billed charges,,,13734.86,82.8,,percent of total billed charges,,,14099.8,85,,percent of total billed charges,,,,,,,,,14597.44,88,,percent of total billed charges,,,,,,,,,12673.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4147,22,,percent of total billed charges,,,15095.08,91,,percent of total billed charges,,,15758.6,95,,percent of total billed charges,,,13768.04,83,,percent of total billed charges,,,13768.04,83,,percent of total billed charges,,,,,,,,,,,,,,,13768.04,83,,percent of total billed charges,,,15758.6,95,,percent of total billed charges,,,14929.2,90,,percent of total billed charges,,,14929.2,90,,percent of total billed charges,,,13602.16,82,,percent of total billed charges,,,14929.2,90,,percent of total billed charges,,,14099.8,85,,percent of total billed charges,,4147,15758.6,
CENTINEL PRODISC IMPLANT LARGE 5MM,30188175,CDM,,,278,RC,outpatient,,48750,48750,,41388.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12187.5,22,,percent of total billed charges,,,,,,,,,43875,90,,percent of total billed charges,,,40365,82.8,,percent of total billed charges,,,41437.5,85,,percent of total billed charges,,,,,,,,,42900,88,,percent of total billed charges,,,,,,,,,37245,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12187.5,22,,percent of total billed charges,,,44362.5,91,,percent of total billed charges,,,46312.5,95,,percent of total billed charges,,,40462.5,83,,percent of total billed charges,,,40462.5,83,,percent of total billed charges,,,,,,,,,,,,,,,40462.5,83,,percent of total billed charges,,,46312.5,95,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,39975,82,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,41437.5,85,,percent of total billed charges,,12187.5,46312.5,
CENTINEL MILING BIT 2.0MM CYLINDRIC SHAF,30188176,CDM,,,278,RC,outpatient,,1996.8,1996.8,,1695.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,499.2,22,,percent of total billed charges,,,,,,,,,1797.12,90,,percent of total billed charges,,,1653.35,82.8,,percent of total billed charges,,,1697.28,85,,percent of total billed charges,,,,,,,,,1757.18,88,,percent of total billed charges,,,,,,,,,1525.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,499.2,22,,percent of total billed charges,,,1817.09,91,,percent of total billed charges,,,1896.96,95,,percent of total billed charges,,,1657.34,83,,percent of total billed charges,,,1657.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1657.34,83,,percent of total billed charges,,,1896.96,95,,percent of total billed charges,,,1797.12,90,,percent of total billed charges,,,1797.12,90,,percent of total billed charges,,,1637.38,82,,percent of total billed charges,,,1797.12,90,,percent of total billed charges,,,1697.28,85,,percent of total billed charges,,499.2,1896.96,
CENTINEL INSERTION TIP L/L DEEP 5MM,30188177,CDM,,,278,RC,outpatient,,2242.5,2242.5,,1903.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,560.63,22,,percent of total billed charges,,,,,,,,,2018.25,90,,percent of total billed charges,,,1856.79,82.8,,percent of total billed charges,,,1906.13,85,,percent of total billed charges,,,,,,,,,1973.4,88,,percent of total billed charges,,,,,,,,,1713.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,560.63,22,,percent of total billed charges,,,2040.68,91,,percent of total billed charges,,,2130.38,95,,percent of total billed charges,,,1861.28,83,,percent of total billed charges,,,1861.28,83,,percent of total billed charges,,,,,,,,,,,,,,,1861.28,83,,percent of total billed charges,,,2130.38,95,,percent of total billed charges,,,2018.25,90,,percent of total billed charges,,,2018.25,90,,percent of total billed charges,,,1838.85,82,,percent of total billed charges,,,2018.25,90,,percent of total billed charges,,,1906.13,85,,percent of total billed charges,,560.63,2130.38,
CENTINEL SCREW RETAINER 3.5X14MM,30188178,CDM,,,278,RC,outpatient,,1193.4,1193.4,,1013.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,298.35,22,,percent of total billed charges,,,,,,,,,1074.06,90,,percent of total billed charges,,,988.14,82.8,,percent of total billed charges,,,1014.39,85,,percent of total billed charges,,,,,,,,,1050.19,88,,percent of total billed charges,,,,,,,,,911.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,298.35,22,,percent of total billed charges,,,1085.99,91,,percent of total billed charges,,,1133.73,95,,percent of total billed charges,,,990.52,83,,percent of total billed charges,,,990.52,83,,percent of total billed charges,,,,,,,,,,,,,,,990.52,83,,percent of total billed charges,,,1133.73,95,,percent of total billed charges,,,1074.06,90,,percent of total billed charges,,,1074.06,90,,percent of total billed charges,,,978.59,82,,percent of total billed charges,,,1074.06,90,,percent of total billed charges,,,1014.39,85,,percent of total billed charges,,298.35,1133.73,
CENTINEL NUT RETAINER,30188179,CDM,,,278,RC,outpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.6,22,,percent of total billed charges,,,,,,,,,347.76,90,,percent of total billed charges,,,319.94,82.8,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.6,22,,percent of total billed charges,,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,96.6,367.08,
HOLMIUM MASTERPULSE HF,30188180,CDM,,,270,RC,outpatient,,5310.5,5310.5,,4508.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1327.63,22,,percent of total billed charges,,,,,,,,,4779.45,90,,percent of total billed charges,,,4397.09,82.8,,percent of total billed charges,,,4513.93,85,,percent of total billed charges,,,,,,,,,4673.24,88,,percent of total billed charges,,,,,,,,,4057.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1327.63,22,,percent of total billed charges,,,4832.56,91,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4407.72,83,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4354.61,82,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4513.93,85,,percent of total billed charges,,1327.63,5044.98,
ZIMMER BEARING MC 12MM 6-7C/D,30188181,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
CENTINEL PRODISC C IMPLANT LARGE-DEEP 6M,30188182,CDM,,,278,RC,outpatient,,48750,48750,,41388.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12187.5,22,,percent of total billed charges,,,,,,,,,43875,90,,percent of total billed charges,,,40365,82.8,,percent of total billed charges,,,41437.5,85,,percent of total billed charges,,,,,,,,,42900,88,,percent of total billed charges,,,,,,,,,37245,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12187.5,22,,percent of total billed charges,,,44362.5,91,,percent of total billed charges,,,46312.5,95,,percent of total billed charges,,,40462.5,83,,percent of total billed charges,,,40462.5,83,,percent of total billed charges,,,,,,,,,,,,,,,40462.5,83,,percent of total billed charges,,,46312.5,95,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,39975,82,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,41437.5,85,,percent of total billed charges,,12187.5,46312.5,
CENTINEL INSERTION TIP L/L DEEP 6MM,30188183,CDM,,,278,RC,outpatient,,2242.5,2242.5,,1903.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,560.63,22,,percent of total billed charges,,,,,,,,,2018.25,90,,percent of total billed charges,,,1856.79,82.8,,percent of total billed charges,,,1906.13,85,,percent of total billed charges,,,,,,,,,1973.4,88,,percent of total billed charges,,,,,,,,,1713.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,560.63,22,,percent of total billed charges,,,2040.68,91,,percent of total billed charges,,,2130.38,95,,percent of total billed charges,,,1861.28,83,,percent of total billed charges,,,1861.28,83,,percent of total billed charges,,,,,,,,,,,,,,,1861.28,83,,percent of total billed charges,,,2130.38,95,,percent of total billed charges,,,2018.25,90,,percent of total billed charges,,,2018.25,90,,percent of total billed charges,,,1838.85,82,,percent of total billed charges,,,2018.25,90,,percent of total billed charges,,,1906.13,85,,percent of total billed charges,,560.63,2130.38,
CENTINEL SCREW RETAINER 3.5X12MM,30188184,CDM,,,278,RC,outpatient,,1193.4,1193.4,,1013.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,298.35,22,,percent of total billed charges,,,,,,,,,1074.06,90,,percent of total billed charges,,,988.14,82.8,,percent of total billed charges,,,1014.39,85,,percent of total billed charges,,,,,,,,,1050.19,88,,percent of total billed charges,,,,,,,,,911.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,298.35,22,,percent of total billed charges,,,1085.99,91,,percent of total billed charges,,,1133.73,95,,percent of total billed charges,,,990.52,83,,percent of total billed charges,,,990.52,83,,percent of total billed charges,,,,,,,,,,,,,,,990.52,83,,percent of total billed charges,,,1133.73,95,,percent of total billed charges,,,1074.06,90,,percent of total billed charges,,,1074.06,90,,percent of total billed charges,,,978.59,82,,percent of total billed charges,,,1074.06,90,,percent of total billed charges,,,1014.39,85,,percent of total billed charges,,298.35,1133.73,
CENTINEL FIXATION PIN SHARP,30188185,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
CENTINEL FIXATION PIN BLUNT,30188186,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
CENTINEL PRODISC C IMPLANT LARGE 6MM,30188187,CDM,,,278,RC,outpatient,,48750,48750,,41388.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12187.5,22,,percent of total billed charges,,,,,,,,,43875,90,,percent of total billed charges,,,40365,82.8,,percent of total billed charges,,,41437.5,85,,percent of total billed charges,,,,,,,,,42900,88,,percent of total billed charges,,,,,,,,,37245,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12187.5,22,,percent of total billed charges,,,44362.5,91,,percent of total billed charges,,,46312.5,95,,percent of total billed charges,,,40462.5,83,,percent of total billed charges,,,40462.5,83,,percent of total billed charges,,,,,,,,,,,,,,,40462.5,83,,percent of total billed charges,,,46312.5,95,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,39975,82,,percent of total billed charges,,,43875,90,,percent of total billed charges,,,41437.5,85,,percent of total billed charges,,12187.5,46312.5,
BLADE 4.0MM RAD 40 CURVED ROTATABLE BLAD,30188188,CDM,,,270,RC,outpatient,,2730,2730,,2317.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,682.5,22,,percent of total billed charges,,,,,,,,,2457,90,,percent of total billed charges,,,2260.44,82.8,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,,,,,,,,2402.4,88,,percent of total billed charges,,,,,,,,,2085.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,682.5,22,,percent of total billed charges,,,2484.3,91,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2265.9,83,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2238.6,82,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,682.5,2593.5,
MEDTRONIC MEDIUM BALL TIP 16.5CM,30188189,CDM,,,270,RC,outpatient,,2067,2067,,1754.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,516.75,22,,percent of total billed charges,,,,,,,,,1860.3,90,,percent of total billed charges,,,1711.48,82.8,,percent of total billed charges,,,1756.95,85,,percent of total billed charges,,,,,,,,,1818.96,88,,percent of total billed charges,,,,,,,,,1579.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,516.75,22,,percent of total billed charges,,,1880.97,91,,percent of total billed charges,,,1963.65,95,,percent of total billed charges,,,1715.61,83,,percent of total billed charges,,,1715.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1715.61,83,,percent of total billed charges,,,1963.65,95,,percent of total billed charges,,,1860.3,90,,percent of total billed charges,,,1860.3,90,,percent of total billed charges,,,1694.94,82,,percent of total billed charges,,,1860.3,90,,percent of total billed charges,,,1756.95,85,,percent of total billed charges,,516.75,1963.65,
ULRICH SCREW POLY 5.5 X 50,30188190,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
ULRICH ILLIAC BOLT SCREW 8.0 X 70,30188191,CDM,,,278,RC,outpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2356.25,22,,percent of total billed charges,,,,,,,,,8482.5,90,,percent of total billed charges,,,7803.9,82.8,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2356.25,22,,percent of total billed charges,,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,2356.25,8953.75,
SYNTHES SCREW CORTEX ST 2.7 X 18,30188195,CDM,,,278,RC,outpatient,,454.51,454.51,,385.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,113.63,22,,percent of total billed charges,,,,,,,,,409.06,90,,percent of total billed charges,,,376.33,82.8,,percent of total billed charges,,,386.33,85,,percent of total billed charges,,,,,,,,,399.97,88,,percent of total billed charges,,,,,,,,,347.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,113.63,22,,percent of total billed charges,,,413.6,91,,percent of total billed charges,,,431.78,95,,percent of total billed charges,,,377.24,83,,percent of total billed charges,,,377.24,83,,percent of total billed charges,,,,,,,,,,,,,,,377.24,83,,percent of total billed charges,,,431.78,95,,percent of total billed charges,,,409.06,90,,percent of total billed charges,,,409.06,90,,percent of total billed charges,,,372.7,82,,percent of total billed charges,,,409.06,90,,percent of total billed charges,,,386.33,85,,percent of total billed charges,,113.63,431.78,
SYNTHES PLATE LAT DIST FIB 5 HOLE,30188196,CDM,,,278,RC,outpatient,,7362.03,7362.03,,6250.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1840.51,22,,percent of total billed charges,,,,,,,,,6625.83,90,,percent of total billed charges,,,6095.76,82.8,,percent of total billed charges,,,6257.73,85,,percent of total billed charges,,,,,,,,,6478.59,88,,percent of total billed charges,,,,,,,,,5624.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1840.51,22,,percent of total billed charges,,,6699.45,91,,percent of total billed charges,,,6993.93,95,,percent of total billed charges,,,6110.48,83,,percent of total billed charges,,,6110.48,83,,percent of total billed charges,,,,,,,,,,,,,,,6110.48,83,,percent of total billed charges,,,6993.93,95,,percent of total billed charges,,,6625.83,90,,percent of total billed charges,,,6625.83,90,,percent of total billed charges,,,6036.86,82,,percent of total billed charges,,,6625.83,90,,percent of total billed charges,,,6257.73,85,,percent of total billed charges,,1840.51,6993.93,
SYNTHES SCREW LOCKING 2.7 X 14MM,30188197,CDM,,,278,RC,outpatient,,1301.24,1301.24,,1104.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325.31,22,,percent of total billed charges,,,,,,,,,1171.12,90,,percent of total billed charges,,,1077.43,82.8,,percent of total billed charges,,,1106.05,85,,percent of total billed charges,,,,,,,,,1145.09,88,,percent of total billed charges,,,,,,,,,994.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325.31,22,,percent of total billed charges,,,1184.13,91,,percent of total billed charges,,,1236.18,95,,percent of total billed charges,,,1080.03,83,,percent of total billed charges,,,1080.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1080.03,83,,percent of total billed charges,,,1236.18,95,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1067.02,82,,percent of total billed charges,,,1171.12,90,,percent of total billed charges,,,1106.05,85,,percent of total billed charges,,325.31,1236.18,
IMPLANET JAZZ PF CONNECTOR 6MM,30188198,CDM,,,278,RC,outpatient,,15080,15080,,12802.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3770,22,,percent of total billed charges,,,,,,,,,13572,90,,percent of total billed charges,,,12486.24,82.8,,percent of total billed charges,,,12818,85,,percent of total billed charges,,,,,,,,,13270.4,88,,percent of total billed charges,,,,,,,,,11521.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3770,22,,percent of total billed charges,,,13722.8,91,,percent of total billed charges,,,14326,95,,percent of total billed charges,,,12516.4,83,,percent of total billed charges,,,12516.4,83,,percent of total billed charges,,,,,,,,,,,,,,,12516.4,83,,percent of total billed charges,,,14326,95,,percent of total billed charges,,,13572,90,,percent of total billed charges,,,13572,90,,percent of total billed charges,,,12365.6,82,,percent of total billed charges,,,13572,90,,percent of total billed charges,,,12818,85,,percent of total billed charges,,3770,14326,
IMPLANET JAZZ PASSER BAND,30188199,CDM,,,278,RC,outpatient,,5720,5720,,4856.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1430,22,,percent of total billed charges,,,,,,,,,5148,90,,percent of total billed charges,,,4736.16,82.8,,percent of total billed charges,,,4862,85,,percent of total billed charges,,,,,,,,,5033.6,88,,percent of total billed charges,,,,,,,,,4370.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1430,22,,percent of total billed charges,,,5205.2,91,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,4747.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4747.6,83,,percent of total billed charges,,,5434,95,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4690.4,82,,percent of total billed charges,,,5148,90,,percent of total billed charges,,,4862,85,,percent of total billed charges,,1430,5434,
STRYKER INSERT TRIATHLON CS SZ 2 11MM,30188200,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER FEMUR TRIATHLON PS RT SZ 7,30188201,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER INSERT TIBIAL SZ 6 9MM,30188202,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
ZIMMER TIBIA POROUS SZ D LEFT,30188203,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ZIMMER FEMUR CR SZ 6 LEFT,30188204,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
DEPUY INSERT RP SZ 4 7MM,30188205,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
STRYKER STEM HIP 132DEG #7 37X114MM,30188206,CDM,,,278,RC,outpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3900,22,,percent of total billed charges,,,,,,,,,14040,90,,percent of total billed charges,,,12916.8,82.8,,percent of total billed charges,,,13260,85,,percent of total billed charges,,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3900,22,,percent of total billed charges,,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,3900,14820,
STRYKER CUP CLUSTERHOLE 46C,30188207,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
STRYKER LINER MDM 36MM C,30188208,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER LINER MDM 22.2MM 36C,30188209,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER STEM  ACCOLADE II 132 DEG SZ 3,30188210,CDM,,,278,RC,outpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3900,22,,percent of total billed charges,,,,,,,,,14040,90,,percent of total billed charges,,,12916.8,82.8,,percent of total billed charges,,,13260,85,,percent of total billed charges,,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3900,22,,percent of total billed charges,,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,3900,14820,
STRYKER HEAD V40 COCR 22.2MM +3,30188211,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
STRYKER INSERT TRIDENT 36MM,30188212,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER STEM #2 127DEG,30188214,CDM,,,278,RC,outpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3900,22,,percent of total billed charges,,,,,,,,,14040,90,,percent of total billed charges,,,12916.8,82.8,,percent of total billed charges,,,13260,85,,percent of total billed charges,,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3900,22,,percent of total billed charges,,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,3900,14820,
ZIMMER TIBIA RIGHT SZ F,30188215,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
STRYKER INSERT TRIATHLON CS SZ 2 10MM,30188217,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
DEPUY STEM SUMMIT 5 HI,30188218,CDM,,,278,RC,outpatient,,25444.06,25444.06,,21602.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6361.02,22,,percent of total billed charges,,,,,,,,,22899.65,90,,percent of total billed charges,,,21067.68,82.8,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,,,,,,,,22390.77,88,,percent of total billed charges,,,,,,,,,19439.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6361.02,22,,percent of total billed charges,,,23154.09,91,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,21118.57,83,,percent of total billed charges,,,,,,,,,,,,,,,21118.57,83,,percent of total billed charges,,,24171.86,95,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,20864.13,82,,percent of total billed charges,,,22899.65,90,,percent of total billed charges,,,21627.45,85,,percent of total billed charges,,6361.02,24171.86,
ZIMMER DVR CROSSLOCK PLATE LEFT,30188219,CDM,,,278,RC,outpatient,,5323.5,5323.5,,4519.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1330.88,22,,percent of total billed charges,,,,,,,,,4791.15,90,,percent of total billed charges,,,4407.86,82.8,,percent of total billed charges,,,4524.98,85,,percent of total billed charges,,,,,,,,,4684.68,88,,percent of total billed charges,,,,,,,,,4067.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1330.88,22,,percent of total billed charges,,,4844.39,91,,percent of total billed charges,,,5057.33,95,,percent of total billed charges,,,4418.51,83,,percent of total billed charges,,,4418.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4418.51,83,,percent of total billed charges,,,5057.33,95,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4365.27,82,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4524.98,85,,percent of total billed charges,,1330.88,5057.33,
ZIMMER K-WIRE SS 1.6X127MM,30188220,CDM,,,278,RC,outpatient,,247.5,247.5,,210.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.88,22,,percent of total billed charges,,,,,,,,,222.75,90,,percent of total billed charges,,,204.93,82.8,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,,,,,,,,217.8,88,,percent of total billed charges,,,,,,,,,189.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.88,22,,percent of total billed charges,,,225.23,91,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,205.43,83,,percent of total billed charges,,,,,,,,,,,,,,,205.43,83,,percent of total billed charges,,,235.13,95,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,202.95,82,,percent of total billed charges,,,222.75,90,,percent of total billed charges,,,210.38,85,,percent of total billed charges,,61.88,235.13,
ZIMMER DRILL BIT 2.2MM,30188221,CDM,,,278,RC,outpatient,,651,651,,552.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,162.75,22,,percent of total billed charges,,,,,,,,,585.9,90,,percent of total billed charges,,,539.03,82.8,,percent of total billed charges,,,553.35,85,,percent of total billed charges,,,,,,,,,572.88,88,,percent of total billed charges,,,,,,,,,497.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,162.75,22,,percent of total billed charges,,,592.41,91,,percent of total billed charges,,,618.45,95,,percent of total billed charges,,,540.33,83,,percent of total billed charges,,,540.33,83,,percent of total billed charges,,,,,,,,,,,,,,,540.33,83,,percent of total billed charges,,,618.45,95,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,533.82,82,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,553.35,85,,percent of total billed charges,,162.75,618.45,
ZIMMER SCREW NON-LOCK 2.7X13MM,30188222,CDM,,,278,RC,outpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
ZIMMER SCREW NON-LOCK 2.7X16MM,30188223,CDM,,,278,RC,outpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
ZIMMER SCREW LOCKING  2.7X16MM,30188224,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ZIMMER SCREW LOCKING  2.7X18MM,30188225,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ZIMMER SCREW LOCKING  2.7X14MM,30188226,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ZIMMER SCREW CANCELLOUS 4X16MM,30188227,CDM,,,278,RC,outpatient,,424.55,424.55,,360.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,106.14,22,,percent of total billed charges,,,,,,,,,382.1,90,,percent of total billed charges,,,351.53,82.8,,percent of total billed charges,,,360.87,85,,percent of total billed charges,,,,,,,,,373.6,88,,percent of total billed charges,,,,,,,,,324.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,106.14,22,,percent of total billed charges,,,386.34,91,,percent of total billed charges,,,403.32,95,,percent of total billed charges,,,352.38,83,,percent of total billed charges,,,352.38,83,,percent of total billed charges,,,,,,,,,,,,,,,352.38,83,,percent of total billed charges,,,403.32,95,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,348.13,82,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,360.87,85,,percent of total billed charges,,106.14,403.32,
ZIMMER PLATE LOCKING FIBULA 8H 132MM,30188228,CDM,,,278,RC,outpatient,,4627.61,4627.61,,3928.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1156.9,22,,percent of total billed charges,,,,,,,,,4164.85,90,,percent of total billed charges,,,3831.66,82.8,,percent of total billed charges,,,3933.47,85,,percent of total billed charges,,,,,,,,,4072.3,88,,percent of total billed charges,,,,,,,,,3535.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1156.9,22,,percent of total billed charges,,,4211.13,91,,percent of total billed charges,,,4396.23,95,,percent of total billed charges,,,3840.92,83,,percent of total billed charges,,,3840.92,83,,percent of total billed charges,,,,,,,,,,,,,,,3840.92,83,,percent of total billed charges,,,4396.23,95,,percent of total billed charges,,,4164.85,90,,percent of total billed charges,,,4164.85,90,,percent of total billed charges,,,3794.64,82,,percent of total billed charges,,,4164.85,90,,percent of total billed charges,,,3933.47,85,,percent of total billed charges,,1156.9,4396.23,
ZIMMER SCREW PERI 3.5X22 W/2.7MM HEAD,30188229,CDM,,,278,RC,outpatient,,257.1,257.1,,218.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.28,22,,percent of total billed charges,,,,,,,,,231.39,90,,percent of total billed charges,,,212.88,82.8,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,,,,,,,,226.25,88,,percent of total billed charges,,,,,,,,,196.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.28,22,,percent of total billed charges,,,233.96,91,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,,,,,,,,,,,,,213.39,83,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,210.82,82,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,64.28,244.25,
ZIMMER SCREW PERI 3.5X14 W/2.7MM HEAD,30188230,CDM,,,278,RC,outpatient,,257.1,257.1,,218.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.28,22,,percent of total billed charges,,,,,,,,,231.39,90,,percent of total billed charges,,,212.88,82.8,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,,,,,,,,226.25,88,,percent of total billed charges,,,,,,,,,196.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.28,22,,percent of total billed charges,,,233.96,91,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,,,,,,,,,,,,,213.39,83,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,210.82,82,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,64.28,244.25,
ZIMMER SCREW PERI 3.5X18 W/2.7MM HEAD,30188231,CDM,,,278,RC,outpatient,,257.1,257.1,,218.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.28,22,,percent of total billed charges,,,,,,,,,231.39,90,,percent of total billed charges,,,212.88,82.8,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,,,,,,,,226.25,88,,percent of total billed charges,,,,,,,,,196.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.28,22,,percent of total billed charges,,,233.96,91,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,,,,,,,,,,,,,213.39,83,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,210.82,82,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,64.28,244.25,
ZIMMER SCREW PERI 3.5X16 W/2.7MM HEAD,30188232,CDM,,,278,RC,outpatient,,257.1,257.1,,218.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.28,22,,percent of total billed charges,,,,,,,,,231.39,90,,percent of total billed charges,,,212.88,82.8,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,,,,,,,,226.25,88,,percent of total billed charges,,,,,,,,,196.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.28,22,,percent of total billed charges,,,233.96,91,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,,,,,,,,,,,,,213.39,83,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,210.82,82,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,64.28,244.25,
ZIMMER SCREW LOCKING 2.7X18MM,30188233,CDM,,,278,RC,outpatient,,715.26,715.26,,607.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.82,22,,percent of total billed charges,,,,,,,,,643.73,90,,percent of total billed charges,,,592.24,82.8,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,,,,,,,,629.43,88,,percent of total billed charges,,,,,,,,,546.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.82,22,,percent of total billed charges,,,650.89,91,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,,,,,,,,,,,,,593.67,83,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,586.51,82,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,178.82,679.5,
ZIMMER DRILL STANDARD 2.0MM,30188234,CDM,,,278,RC,outpatient,,1285.44,1285.44,,1091.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,321.36,22,,percent of total billed charges,,,,,,,,,1156.9,90,,percent of total billed charges,,,1064.34,82.8,,percent of total billed charges,,,1092.62,85,,percent of total billed charges,,,,,,,,,1131.19,88,,percent of total billed charges,,,,,,,,,982.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,321.36,22,,percent of total billed charges,,,1169.75,91,,percent of total billed charges,,,1221.17,95,,percent of total billed charges,,,1066.92,83,,percent of total billed charges,,,1066.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1066.92,83,,percent of total billed charges,,,1221.17,95,,percent of total billed charges,,,1156.9,90,,percent of total billed charges,,,1156.9,90,,percent of total billed charges,,,1054.06,82,,percent of total billed charges,,,1156.9,90,,percent of total billed charges,,,1092.62,85,,percent of total billed charges,,321.36,1221.17,
ZIMMER DRILL BIT QC 3.5X110MM,30188235,CDM,,,278,RC,outpatient,,484.54,484.54,,411.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,121.14,22,,percent of total billed charges,,,,,,,,,436.09,90,,percent of total billed charges,,,401.2,82.8,,percent of total billed charges,,,411.86,85,,percent of total billed charges,,,,,,,,,426.4,88,,percent of total billed charges,,,,,,,,,370.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,121.14,22,,percent of total billed charges,,,440.93,91,,percent of total billed charges,,,460.31,95,,percent of total billed charges,,,402.17,83,,percent of total billed charges,,,402.17,83,,percent of total billed charges,,,,,,,,,,,,,,,402.17,83,,percent of total billed charges,,,460.31,95,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,397.32,82,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,411.86,85,,percent of total billed charges,,121.14,460.31,
ZIMMER DRILL BIT QC 2.5X110MM,30188236,CDM,,,278,RC,outpatient,,484.54,484.54,,411.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,121.14,22,,percent of total billed charges,,,,,,,,,436.09,90,,percent of total billed charges,,,401.2,82.8,,percent of total billed charges,,,411.86,85,,percent of total billed charges,,,,,,,,,426.4,88,,percent of total billed charges,,,,,,,,,370.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,121.14,22,,percent of total billed charges,,,440.93,91,,percent of total billed charges,,,460.31,95,,percent of total billed charges,,,402.17,83,,percent of total billed charges,,,402.17,83,,percent of total billed charges,,,,,,,,,,,,,,,402.17,83,,percent of total billed charges,,,460.31,95,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,397.32,82,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,411.86,85,,percent of total billed charges,,121.14,460.31,
ZIMMER SCREW PERI 3.5X12MM W/2.7MM HEAD,30188237,CDM,,,278,RC,outpatient,,257.1,257.1,,218.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.28,22,,percent of total billed charges,,,,,,,,,231.39,90,,percent of total billed charges,,,212.88,82.8,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,,,,,,,,226.25,88,,percent of total billed charges,,,,,,,,,196.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.28,22,,percent of total billed charges,,,233.96,91,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,,,,,,,,,,,,,213.39,83,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,210.82,82,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,64.28,244.25,
ZIMMER PLATE LOCKING FIBULA 8H 132MM RT,30188238,CDM,,,278,RC,outpatient,,4627.61,4627.61,,3928.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1156.9,22,,percent of total billed charges,,,,,,,,,4164.85,90,,percent of total billed charges,,,3831.66,82.8,,percent of total billed charges,,,3933.47,85,,percent of total billed charges,,,,,,,,,4072.3,88,,percent of total billed charges,,,,,,,,,3535.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1156.9,22,,percent of total billed charges,,,4211.13,91,,percent of total billed charges,,,4396.23,95,,percent of total billed charges,,,3840.92,83,,percent of total billed charges,,,3840.92,83,,percent of total billed charges,,,,,,,,,,,,,,,3840.92,83,,percent of total billed charges,,,4396.23,95,,percent of total billed charges,,,4164.85,90,,percent of total billed charges,,,4164.85,90,,percent of total billed charges,,,3794.64,82,,percent of total billed charges,,,4164.85,90,,percent of total billed charges,,,3933.47,85,,percent of total billed charges,,1156.9,4396.23,
ZIMMER PLATE LOCKING FIBULA 10H 158MM RT,30188239,CDM,,,278,RC,outpatient,,4927.52,4927.52,,4183.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1231.88,22,,percent of total billed charges,,,,,,,,,4434.77,90,,percent of total billed charges,,,4079.99,82.8,,percent of total billed charges,,,4188.39,85,,percent of total billed charges,,,,,,,,,4336.22,88,,percent of total billed charges,,,,,,,,,3764.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1231.88,22,,percent of total billed charges,,,4484.04,91,,percent of total billed charges,,,4681.14,95,,percent of total billed charges,,,4089.84,83,,percent of total billed charges,,,4089.84,83,,percent of total billed charges,,,,,,,,,,,,,,,4089.84,83,,percent of total billed charges,,,4681.14,95,,percent of total billed charges,,,4434.77,90,,percent of total billed charges,,,4434.77,90,,percent of total billed charges,,,4040.57,82,,percent of total billed charges,,,4434.77,90,,percent of total billed charges,,,4188.39,85,,percent of total billed charges,,1231.88,4681.14,
ZIMMER DRILL STANDARD 2.0MM,30188240,CDM,,,278,RC,outpatient,,1285.44,1285.44,,1091.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,321.36,22,,percent of total billed charges,,,,,,,,,1156.9,90,,percent of total billed charges,,,1064.34,82.8,,percent of total billed charges,,,1092.62,85,,percent of total billed charges,,,,,,,,,1131.19,88,,percent of total billed charges,,,,,,,,,982.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,321.36,22,,percent of total billed charges,,,1169.75,91,,percent of total billed charges,,,1221.17,95,,percent of total billed charges,,,1066.92,83,,percent of total billed charges,,,1066.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1066.92,83,,percent of total billed charges,,,1221.17,95,,percent of total billed charges,,,1156.9,90,,percent of total billed charges,,,1156.9,90,,percent of total billed charges,,,1054.06,82,,percent of total billed charges,,,1156.9,90,,percent of total billed charges,,,1092.62,85,,percent of total billed charges,,321.36,1221.17,
ZIMMER SCREW LOCKING 2.7X14MM,30188241,CDM,,,278,RC,outpatient,,715.26,715.26,,607.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.82,22,,percent of total billed charges,,,,,,,,,643.73,90,,percent of total billed charges,,,592.24,82.8,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,,,,,,,,629.43,88,,percent of total billed charges,,,,,,,,,546.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.82,22,,percent of total billed charges,,,650.89,91,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,,,,,,,,,,,,,593.67,83,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,586.51,82,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,178.82,679.5,
ZIMMER SCREW LOCKING 2.7X16MM,30188242,CDM,,,278,RC,outpatient,,715.26,715.26,,607.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.82,22,,percent of total billed charges,,,,,,,,,643.73,90,,percent of total billed charges,,,592.24,82.8,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,,,,,,,,629.43,88,,percent of total billed charges,,,,,,,,,546.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.82,22,,percent of total billed charges,,,650.89,91,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,,,,,,,,,,,,,593.67,83,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,586.51,82,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,178.82,679.5,
ZIMMER DRILL BIT SS 2.9 KIT,30188243,CDM,,,278,RC,outpatient,,4823.33,4823.33,,4095.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1205.83,22,,percent of total billed charges,,,,,,,,,4341,90,,percent of total billed charges,,,3993.72,82.8,,percent of total billed charges,,,4099.83,85,,percent of total billed charges,,,,,,,,,4244.53,88,,percent of total billed charges,,,,,,,,,3685.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1205.83,22,,percent of total billed charges,,,4389.23,91,,percent of total billed charges,,,4582.16,95,,percent of total billed charges,,,4003.36,83,,percent of total billed charges,,,4003.36,83,,percent of total billed charges,,,,,,,,,,,,,,,4003.36,83,,percent of total billed charges,,,4582.16,95,,percent of total billed charges,,,4341,90,,percent of total billed charges,,,4341,90,,percent of total billed charges,,,3955.13,82,,percent of total billed charges,,,4341,90,,percent of total billed charges,,,4099.83,85,,percent of total billed charges,,1205.83,4582.16,
ULRICH SCREW POLY 6.5 X 35MM,30188245,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SYNTHES NAIL TIBIA 9X285S,30188246,CDM,,,278,RC,outpatient,,15439.13,15439.13,,13107.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3859.78,22,,percent of total billed charges,,,,,,,,,13895.22,90,,percent of total billed charges,,,12783.6,82.8,,percent of total billed charges,,,13123.26,85,,percent of total billed charges,,,,,,,,,13586.43,88,,percent of total billed charges,,,,,,,,,11795.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3859.78,22,,percent of total billed charges,,,14049.61,91,,percent of total billed charges,,,14667.17,95,,percent of total billed charges,,,12814.48,83,,percent of total billed charges,,,12814.48,83,,percent of total billed charges,,,,,,,,,,,,,,,12814.48,83,,percent of total billed charges,,,14667.17,95,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,12660.09,82,,percent of total billed charges,,,13895.22,90,,percent of total billed charges,,,13123.26,85,,percent of total billed charges,,3859.78,14667.17,
SYNTHES SCREW LOCKING 4.0X30,30188247,CDM,,,278,RC,outpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,562.71,22,,percent of total billed charges,,,,,,,,,2025.74,90,,percent of total billed charges,,,1863.68,82.8,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,562.71,22,,percent of total billed charges,,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,562.71,2138.28,
SYNTHES SCREW LOCKING 4.0X32,30188248,CDM,,,278,RC,outpatient,,2250.82,2250.82,,1910.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,562.71,22,,percent of total billed charges,,,,,,,,,2025.74,90,,percent of total billed charges,,,1863.68,82.8,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,,,,,,,,1980.72,88,,percent of total billed charges,,,,,,,,,1719.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,562.71,22,,percent of total billed charges,,,2048.25,91,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,1868.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1868.18,83,,percent of total billed charges,,,2138.28,95,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1845.67,82,,percent of total billed charges,,,2025.74,90,,percent of total billed charges,,,1913.2,85,,percent of total billed charges,,562.71,2138.28,
SYNTHES END CAP 15MM,30188249,CDM,,,270,RC,outpatient,,2743.2,2743.2,,2328.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,685.8,22,,percent of total billed charges,,,,,,,,,2468.88,90,,percent of total billed charges,,,2271.37,82.8,,percent of total billed charges,,,2331.72,85,,percent of total billed charges,,,,,,,,,2414.02,88,,percent of total billed charges,,,,,,,,,2095.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,685.8,22,,percent of total billed charges,,,2496.31,91,,percent of total billed charges,,,2606.04,95,,percent of total billed charges,,,2276.86,83,,percent of total billed charges,,,2276.86,83,,percent of total billed charges,,,,,,,,,,,,,,,2276.86,83,,percent of total billed charges,,,2606.04,95,,percent of total billed charges,,,2468.88,90,,percent of total billed charges,,,2468.88,90,,percent of total billed charges,,,2249.42,82,,percent of total billed charges,,,2468.88,90,,percent of total billed charges,,,2331.72,85,,percent of total billed charges,,685.8,2606.04,
SYNTHES DRILL BIT 3.5MM,30188250,CDM,,,270,RC,outpatient,,1289.54,1289.54,,1094.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,322.39,22,,percent of total billed charges,,,,,,,,,1160.59,90,,percent of total billed charges,,,1067.74,82.8,,percent of total billed charges,,,1096.11,85,,percent of total billed charges,,,,,,,,,1134.8,88,,percent of total billed charges,,,,,,,,,985.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,322.39,22,,percent of total billed charges,,,1173.48,91,,percent of total billed charges,,,1225.06,95,,percent of total billed charges,,,1070.32,83,,percent of total billed charges,,,1070.32,83,,percent of total billed charges,,,,,,,,,,,,,,,1070.32,83,,percent of total billed charges,,,1225.06,95,,percent of total billed charges,,,1160.59,90,,percent of total billed charges,,,1160.59,90,,percent of total billed charges,,,1057.42,82,,percent of total billed charges,,,1160.59,90,,percent of total billed charges,,,1096.11,85,,percent of total billed charges,,322.39,1225.06,
OLYMPUS ITIND SYSTEM IMPLANT & SNARE,30188251,CDM,,,278,RC,outpatient,,17647.5,17647.5,,14982.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4411.88,22,,percent of total billed charges,,,,,,,,,15882.75,90,,percent of total billed charges,,,14612.13,82.8,,percent of total billed charges,,,15000.38,85,,percent of total billed charges,,,,,,,,,15529.8,88,,percent of total billed charges,,,,,,,,,13482.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4411.88,22,,percent of total billed charges,,,16059.23,91,,percent of total billed charges,,,16765.13,95,,percent of total billed charges,,,14647.43,83,,percent of total billed charges,,,14647.43,83,,percent of total billed charges,,,,,,,,,,,,,,,14647.43,83,,percent of total billed charges,,,16765.13,95,,percent of total billed charges,,,15882.75,90,,percent of total billed charges,,,15882.75,90,,percent of total billed charges,,,14470.95,82,,percent of total billed charges,,,15882.75,90,,percent of total billed charges,,,15000.38,85,,percent of total billed charges,,4411.88,16765.13,
ZIMMER PLATE DVR STANDARD LEFT,30188252,CDM,,,278,RC,outpatient,,5323.5,5323.5,,4519.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1330.88,22,,percent of total billed charges,,,,,,,,,4791.15,90,,percent of total billed charges,,,4407.86,82.8,,percent of total billed charges,,,4524.98,85,,percent of total billed charges,,,,,,,,,4684.68,88,,percent of total billed charges,,,,,,,,,4067.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1330.88,22,,percent of total billed charges,,,4844.39,91,,percent of total billed charges,,,5057.33,95,,percent of total billed charges,,,4418.51,83,,percent of total billed charges,,,4418.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4418.51,83,,percent of total billed charges,,,5057.33,95,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4365.27,82,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4524.98,85,,percent of total billed charges,,1330.88,5057.33,
ZIMMER SCREW LOCKING  2.7X20MM,30188253,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ZIMMER SCREW LOCKING  2.7X22MM,30188254,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ZIMMER SCREW MD 2.7 X 18MM,30188255,CDM,,,278,RC,outpatient,,1033.5,1033.5,,877.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,258.38,22,,percent of total billed charges,,,,,,,,,930.15,90,,percent of total billed charges,,,855.74,82.8,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,,,,,,,,909.48,88,,percent of total billed charges,,,,,,,,,789.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,258.38,22,,percent of total billed charges,,,940.49,91,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,,,,,,,,,,,,,857.81,83,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,847.47,82,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,258.38,981.83,
ZIMMER SCREW MD 2.7 X 26MM,30188256,CDM,,,278,RC,outpatient,,1033.5,1033.5,,877.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,258.38,22,,percent of total billed charges,,,,,,,,,930.15,90,,percent of total billed charges,,,855.74,82.8,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,,,,,,,,909.48,88,,percent of total billed charges,,,,,,,,,789.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,258.38,22,,percent of total billed charges,,,940.49,91,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,,,,,,,,,,,,,857.81,83,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,847.47,82,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,258.38,981.83,
ZIMMER SCREW NON-LOCKING  2.7X22MM,30188257,CDM,,,278,RC,outpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
ZIMMER PLATE DVR WIDE LEFT,30188258,CDM,,,278,RC,outpatient,,5323.5,5323.5,,4519.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1330.88,22,,percent of total billed charges,,,,,,,,,4791.15,90,,percent of total billed charges,,,4407.86,82.8,,percent of total billed charges,,,4524.98,85,,percent of total billed charges,,,,,,,,,4684.68,88,,percent of total billed charges,,,,,,,,,4067.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1330.88,22,,percent of total billed charges,,,4844.39,91,,percent of total billed charges,,,5057.33,95,,percent of total billed charges,,,4418.51,83,,percent of total billed charges,,,4418.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4418.51,83,,percent of total billed charges,,,5057.33,95,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4365.27,82,,percent of total billed charges,,,4791.15,90,,percent of total billed charges,,,4524.98,85,,percent of total billed charges,,1330.88,5057.33,
SYNTHES SCREW CANNULATED 4X40MM,30188259,CDM,,,278,RC,outpatient,,2063.23,2063.23,,1751.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,515.81,22,,percent of total billed charges,,,,,,,,,1856.91,90,,percent of total billed charges,,,1708.35,82.8,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,,,,,,,,1815.64,88,,percent of total billed charges,,,,,,,,,1576.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,515.81,22,,percent of total billed charges,,,1877.54,91,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,1712.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1712.48,83,,percent of total billed charges,,,1960.07,95,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1691.85,82,,percent of total billed charges,,,1856.91,90,,percent of total billed charges,,,1753.75,85,,percent of total billed charges,,515.81,1960.07,
SYNTHES FIBULINK SYNDESMOSIS REPAIR KIT,30188260,CDM,,,278,RC,outpatient,,14144,14144,,12008.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3536,22,,percent of total billed charges,,,,,,,,,12729.6,90,,percent of total billed charges,,,11711.23,82.8,,percent of total billed charges,,,12022.4,85,,percent of total billed charges,,,,,,,,,12446.72,88,,percent of total billed charges,,,,,,,,,10806.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3536,22,,percent of total billed charges,,,12871.04,91,,percent of total billed charges,,,13436.8,95,,percent of total billed charges,,,11739.52,83,,percent of total billed charges,,,11739.52,83,,percent of total billed charges,,,,,,,,,,,,,,,11739.52,83,,percent of total billed charges,,,13436.8,95,,percent of total billed charges,,,12729.6,90,,percent of total billed charges,,,12729.6,90,,percent of total billed charges,,,11598.08,82,,percent of total billed charges,,,12729.6,90,,percent of total billed charges,,,12022.4,85,,percent of total billed charges,,3536,13436.8,
STRYKER HEAD BIPOLAR UHR 26X47,30188261,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
STRYKER HEAD FEMORAL 26MM,30188262,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
STRYKER INSERT TRIATHLON CS SZ 2 13MM,30188263,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
ARTHREX TENODESIS IMPLANT SYSTEM 3.9BC,30188264,CDM,,,278,RC,outpatient,,5200,5200,,4414.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1300,22,,percent of total billed charges,,,,,,,,,4680,90,,percent of total billed charges,,,4305.6,82.8,,percent of total billed charges,,,4420,85,,percent of total billed charges,,,,,,,,,4576,88,,percent of total billed charges,,,,,,,,,3972.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1300,22,,percent of total billed charges,,,4732,91,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,,,,,,,,,,,,,4316,83,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4264,82,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4420,85,,percent of total billed charges,,1300,4940,
STRYKER INSERT TRIATHLON #5 12MM,30188265,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER BLADE SHAVER AGRESSIVE MAX,30188266,CDM,,,270,RC,outpatient,,991.45,991.45,,841.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,247.86,22,,percent of total billed charges,,,,,,,,,892.31,90,,percent of total billed charges,,,820.92,82.8,,percent of total billed charges,,,842.73,85,,percent of total billed charges,,,,,,,,,872.48,88,,percent of total billed charges,,,,,,,,,757.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,247.86,22,,percent of total billed charges,,,902.22,91,,percent of total billed charges,,,941.88,95,,percent of total billed charges,,,822.9,83,,percent of total billed charges,,,822.9,83,,percent of total billed charges,,,,,,,,,,,,,,,822.9,83,,percent of total billed charges,,,941.88,95,,percent of total billed charges,,,892.31,90,,percent of total billed charges,,,892.31,90,,percent of total billed charges,,,812.99,82,,percent of total billed charges,,,892.31,90,,percent of total billed charges,,,842.73,85,,percent of total billed charges,,247.86,941.88,
EXTRACORPOREAL LITHOTRIPSY RIGHT - UNITE,30188267,CDM,,,270,RC,outpatient,,13650,13650,,11588.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3412.5,22,,percent of total billed charges,,,,,,,,,12285,90,,percent of total billed charges,,,11302.2,82.8,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,,,,,,,,12012,88,,percent of total billed charges,,,,,,,,,10428.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3412.5,22,,percent of total billed charges,,,12421.5,91,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,,,,,,,,,,,,,11329.5,83,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11193,82,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,3412.5,12967.5,
GORE VBX BALLOON EXPANDABLE 8X39,30188268,CDM,,,270,RC,outpatient,,24160.5,24160.5,,20512.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6040.13,22,,percent of total billed charges,,,,,,,,,21744.45,90,,percent of total billed charges,,,20004.89,82.8,,percent of total billed charges,,,20536.43,85,,percent of total billed charges,,,,,,,,,21261.24,88,,percent of total billed charges,,,,,,,,,18458.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6040.13,22,,percent of total billed charges,,,21986.06,91,,percent of total billed charges,,,22952.48,95,,percent of total billed charges,,,20053.22,83,,percent of total billed charges,,,20053.22,83,,percent of total billed charges,,,,,,,,,,,,,,,20053.22,83,,percent of total billed charges,,,22952.48,95,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,19811.61,82,,percent of total billed charges,,,21744.45,90,,percent of total billed charges,,,20536.43,85,,percent of total billed charges,,6040.13,22952.48,
MTF PROFILE COSTAL CARTILAGE SHEET,30188269,CDM,,,278,RC,outpatient,,3042,3042,,2582.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,760.5,22,,percent of total billed charges,,,,,,,,,2737.8,90,,percent of total billed charges,,,2518.78,82.8,,percent of total billed charges,,,2585.7,85,,percent of total billed charges,,,,,,,,,2676.96,88,,percent of total billed charges,,,,,,,,,2324.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,760.5,22,,percent of total billed charges,,,2768.22,91,,percent of total billed charges,,,2889.9,95,,percent of total billed charges,,,2524.86,83,,percent of total billed charges,,,2524.86,83,,percent of total billed charges,,,,,,,,,,,,,,,2524.86,83,,percent of total billed charges,,,2889.9,95,,percent of total billed charges,,,2737.8,90,,percent of total billed charges,,,2737.8,90,,percent of total billed charges,,,2494.44,82,,percent of total billed charges,,,2737.8,90,,percent of total billed charges,,,2585.7,85,,percent of total billed charges,,760.5,2889.9,
ARTHREX TENODESIS IMPLANT SYSTEM 4.75,30188270,CDM,,,278,RC,outpatient,,5200,5200,,4414.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1300,22,,percent of total billed charges,,,,,,,,,4680,90,,percent of total billed charges,,,4305.6,82.8,,percent of total billed charges,,,4420,85,,percent of total billed charges,,,,,,,,,4576,88,,percent of total billed charges,,,,,,,,,3972.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1300,22,,percent of total billed charges,,,4732,91,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,,,,,,,,,,,,,4316,83,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4264,82,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4420,85,,percent of total billed charges,,1300,4940,
STRYKER HEAD UHR 48X26MM,30188271,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
ARTHREX PASSPORT BUTTON CANNULA,30188272,CDM,,,278,RC,outpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
ARTHREX FIBERTAK DR SUTURE ANCHOR BLUE,30188273,CDM,,,278,RC,outpatient,,3055,3055,,2593.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,763.75,22,,percent of total billed charges,,,,,,,,,2749.5,90,,percent of total billed charges,,,2529.54,82.8,,percent of total billed charges,,,2596.75,85,,percent of total billed charges,,,,,,,,,2688.4,88,,percent of total billed charges,,,,,,,,,2334.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,763.75,22,,percent of total billed charges,,,2780.05,91,,percent of total billed charges,,,2902.25,95,,percent of total billed charges,,,2535.65,83,,percent of total billed charges,,,2535.65,83,,percent of total billed charges,,,,,,,,,,,,,,,2535.65,83,,percent of total billed charges,,,2902.25,95,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2505.1,82,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2596.75,85,,percent of total billed charges,,763.75,2902.25,
ARTHREX FIBERTAK DR SUTURE ANCHOR BLACK/,30188274,CDM,,,278,RC,outpatient,,3055,3055,,2593.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,763.75,22,,percent of total billed charges,,,,,,,,,2749.5,90,,percent of total billed charges,,,2529.54,82.8,,percent of total billed charges,,,2596.75,85,,percent of total billed charges,,,,,,,,,2688.4,88,,percent of total billed charges,,,,,,,,,2334.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,763.75,22,,percent of total billed charges,,,2780.05,91,,percent of total billed charges,,,2902.25,95,,percent of total billed charges,,,2535.65,83,,percent of total billed charges,,,2535.65,83,,percent of total billed charges,,,,,,,,,,,,,,,2535.65,83,,percent of total billed charges,,,2902.25,95,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2505.1,82,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2596.75,85,,percent of total billed charges,,763.75,2902.25,
ZIMMER TIBIAL CENTRAL CONE,30188278,CDM,,,278,RC,outpatient,,48303.13,48303.13,,41009.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12075.78,22,,percent of total billed charges,,,,,,,,,43472.82,90,,percent of total billed charges,,,39994.99,82.8,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,,,,,,,,42506.75,88,,percent of total billed charges,,,,,,,,,36903.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12075.78,22,,percent of total billed charges,,,43955.85,91,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,40091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,40091.6,83,,percent of total billed charges,,,45887.97,95,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,39608.57,82,,percent of total billed charges,,,43472.82,90,,percent of total billed charges,,,41057.66,85,,percent of total billed charges,,12075.78,45887.97,
ZIMMER SCREW CANCELLOUS 4X10MM,30188279,CDM,,,278,RC,outpatient,,424.55,424.55,,360.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,106.14,22,,percent of total billed charges,,,,,,,,,382.1,90,,percent of total billed charges,,,351.53,82.8,,percent of total billed charges,,,360.87,85,,percent of total billed charges,,,,,,,,,373.6,88,,percent of total billed charges,,,,,,,,,324.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,106.14,22,,percent of total billed charges,,,386.34,91,,percent of total billed charges,,,403.32,95,,percent of total billed charges,,,352.38,83,,percent of total billed charges,,,352.38,83,,percent of total billed charges,,,,,,,,,,,,,,,352.38,83,,percent of total billed charges,,,403.32,95,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,348.13,82,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,360.87,85,,percent of total billed charges,,106.14,403.32,
ZIMMER PLATE LOCKING FIBULA 6H 106MM RT,30188280,CDM,,,278,RC,outpatient,,4284.8,4284.8,,3637.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1071.2,22,,percent of total billed charges,,,,,,,,,3856.32,90,,percent of total billed charges,,,3547.81,82.8,,percent of total billed charges,,,3642.08,85,,percent of total billed charges,,,,,,,,,3770.62,88,,percent of total billed charges,,,,,,,,,3273.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1071.2,22,,percent of total billed charges,,,3899.17,91,,percent of total billed charges,,,4070.56,95,,percent of total billed charges,,,3556.38,83,,percent of total billed charges,,,3556.38,83,,percent of total billed charges,,,,,,,,,,,,,,,3556.38,83,,percent of total billed charges,,,4070.56,95,,percent of total billed charges,,,3856.32,90,,percent of total billed charges,,,3856.32,90,,percent of total billed charges,,,3513.54,82,,percent of total billed charges,,,3856.32,90,,percent of total billed charges,,,3642.08,85,,percent of total billed charges,,1071.2,4070.56,
ZIMMER SCREW LOCKING 3.5X12MM,30188281,CDM,,,278,RC,outpatient,,669.13,669.13,,568.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,167.28,22,,percent of total billed charges,,,,,,,,,602.22,90,,percent of total billed charges,,,554.04,82.8,,percent of total billed charges,,,568.76,85,,percent of total billed charges,,,,,,,,,588.83,88,,percent of total billed charges,,,,,,,,,511.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,167.28,22,,percent of total billed charges,,,608.91,91,,percent of total billed charges,,,635.67,95,,percent of total billed charges,,,555.38,83,,percent of total billed charges,,,555.38,83,,percent of total billed charges,,,,,,,,,,,,,,,555.38,83,,percent of total billed charges,,,635.67,95,,percent of total billed charges,,,602.22,90,,percent of total billed charges,,,602.22,90,,percent of total billed charges,,,548.69,82,,percent of total billed charges,,,602.22,90,,percent of total billed charges,,,568.76,85,,percent of total billed charges,,167.28,635.67,
ZIMMER SCREW LOCKING 2.7X10MM,30188282,CDM,,,278,RC,outpatient,,715.26,715.26,,607.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.82,22,,percent of total billed charges,,,,,,,,,643.73,90,,percent of total billed charges,,,592.24,82.8,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,,,,,,,,629.43,88,,percent of total billed charges,,,,,,,,,546.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.82,22,,percent of total billed charges,,,650.89,91,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,,,,,,,,,,,,,593.67,83,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,586.51,82,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,178.82,679.5,
ZIMMER SCREW LOCKING 2.7X12MM,30188283,CDM,,,278,RC,outpatient,,715.26,715.26,,607.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.82,22,,percent of total billed charges,,,,,,,,,643.73,90,,percent of total billed charges,,,592.24,82.8,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,,,,,,,,629.43,88,,percent of total billed charges,,,,,,,,,546.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.82,22,,percent of total billed charges,,,650.89,91,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,,,,,,,,,,,,,593.67,83,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,586.51,82,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,178.82,679.5,
ARTHREX LABRAL TAPE WHITE/BLACK 1.5MM,30188284,CDM,,,270,RC,outpatient,,490,490,,416.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.5,22,,percent of total billed charges,,,,,,,,,441,90,,percent of total billed charges,,,405.72,82.8,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,,,,,,,,431.2,88,,percent of total billed charges,,,,,,,,,374.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.5,22,,percent of total billed charges,,,445.9,91,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,,,,,,,,,,,,,406.7,83,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,401.8,82,,percent of total billed charges,,,441,90,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,122.5,465.5,
ARTHREX PASSPORT BUTTON CANNULA 40,30188285,CDM,,,278,RC,outpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
ARTHREX PASSPORT BUTTON CANNULA 50,30188286,CDM,,,278,RC,outpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
ARTHREX SUTURETAPE TIGERLINK 1.3MM WH/BL,30188287,CDM,,,270,RC,outpatient,,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,148.75,22,,percent of total billed charges,,,,,,,,,535.5,90,,percent of total billed charges,,,492.66,82.8,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,148.75,22,,percent of total billed charges,,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,148.75,565.25,
ZIMMER ZIPTIGHT ANKLE SYN. SYSTEM,30188288,CDM,,,278,RC,outpatient,,4179.5,4179.5,,3548.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1044.88,22,,percent of total billed charges,,,,,,,,,3761.55,90,,percent of total billed charges,,,3460.63,82.8,,percent of total billed charges,,,3552.58,85,,percent of total billed charges,,,,,,,,,3677.96,88,,percent of total billed charges,,,,,,,,,3193.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1044.88,22,,percent of total billed charges,,,3803.35,91,,percent of total billed charges,,,3970.53,95,,percent of total billed charges,,,3468.99,83,,percent of total billed charges,,,3468.99,83,,percent of total billed charges,,,,,,,,,,,,,,,3468.99,83,,percent of total billed charges,,,3970.53,95,,percent of total billed charges,,,3761.55,90,,percent of total billed charges,,,3761.55,90,,percent of total billed charges,,,3427.19,82,,percent of total billed charges,,,3761.55,90,,percent of total billed charges,,,3552.58,85,,percent of total billed charges,,1044.88,3970.53,
ULRICH SCREW REDUCTION 5.5 X 50MM,30188289,CDM,,,278,RC,outpatient,,8775,8775,,7449.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2193.75,22,,percent of total billed charges,,,,,,,,,7897.5,90,,percent of total billed charges,,,7265.7,82.8,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,,,,,,,,7722,88,,percent of total billed charges,,,,,,,,,6704.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2193.75,22,,percent of total billed charges,,,7985.25,91,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,7283.25,83,,percent of total billed charges,,,,,,,,,,,,,,,7283.25,83,,percent of total billed charges,,,8336.25,95,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7195.5,82,,percent of total billed charges,,,7897.5,90,,percent of total billed charges,,,7458.75,85,,percent of total billed charges,,2193.75,8336.25,
MERETE NAIL IKA WITHOUT COLLAR 200 X16,30188290,CDM,,,278,RC,outpatient,,17875,17875,,15175.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4468.75,22,,percent of total billed charges,,,,,,,,,16087.5,90,,percent of total billed charges,,,14800.5,82.8,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,,,,,,,,15730,88,,percent of total billed charges,,,,,,,,,13656.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4468.75,22,,percent of total billed charges,,,16266.25,91,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14836.25,83,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,14657.5,82,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,4468.75,16981.25,
MERETE NAIL IKA WITHOUT COLLAR 200 X12,30188291,CDM,,,278,RC,outpatient,,17875,17875,,15175.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4468.75,22,,percent of total billed charges,,,,,,,,,16087.5,90,,percent of total billed charges,,,14800.5,82.8,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,,,,,,,,15730,88,,percent of total billed charges,,,,,,,,,13656.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4468.75,22,,percent of total billed charges,,,16266.25,91,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,14836.25,83,,percent of total billed charges,,,,,,,,,,,,,,,14836.25,83,,percent of total billed charges,,,16981.25,95,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,14657.5,82,,percent of total billed charges,,,16087.5,90,,percent of total billed charges,,,15193.75,85,,percent of total billed charges,,4468.75,16981.25,
MERETE SCREW INTERLOCKING 28MM,30188292,CDM,,,278,RC,outpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,706.06,22,,percent of total billed charges,,,,,,,,,2541.83,90,,percent of total billed charges,,,2338.48,82.8,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,706.06,22,,percent of total billed charges,,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,706.06,2683.04,
MERETE SCREW INTERLOCKING 26MM,30188293,CDM,,,278,RC,outpatient,,2824.25,2824.25,,2397.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,706.06,22,,percent of total billed charges,,,,,,,,,2541.83,90,,percent of total billed charges,,,2338.48,82.8,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,,,,,,,,2485.34,88,,percent of total billed charges,,,,,,,,,2157.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,706.06,22,,percent of total billed charges,,,2570.07,91,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,2344.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2344.13,83,,percent of total billed charges,,,2683.04,95,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2315.89,82,,percent of total billed charges,,,2541.83,90,,percent of total billed charges,,,2400.61,85,,percent of total billed charges,,706.06,2683.04,
IR CAGE INTERBODY 6DEG 7X12X14,30188294,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
STRYKER SCREW LAG 10.5 X 80MM,30188296,CDM,,,278,RC,outpatient,,5200.33,5200.33,,4415.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1300.08,22,,percent of total billed charges,,,,,,,,,4680.3,90,,percent of total billed charges,,,4305.87,82.8,,percent of total billed charges,,,4420.28,85,,percent of total billed charges,,,,,,,,,4576.29,88,,percent of total billed charges,,,,,,,,,3973.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1300.08,22,,percent of total billed charges,,,4732.3,91,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,,,,,,,,,,,,,4316.27,83,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4264.27,82,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4420.28,85,,percent of total billed charges,,1300.08,4940.31,
ULRICH ROD LORDOSED 5.5 X 120MM,30188297,CDM,,,278,RC,outpatient,,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
COOK DUAL LUMEN ACCESS CATH W/HYDROPHILI,30188298,CDM,,,270,RC,outpatient,,354.68,354.68,,301.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.67,22,,percent of total billed charges,,,,,,,,,319.21,90,,percent of total billed charges,,,293.68,82.8,,percent of total billed charges,,,301.48,85,,percent of total billed charges,,,,,,,,,312.12,88,,percent of total billed charges,,,,,,,,,270.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.67,22,,percent of total billed charges,,,322.76,91,,percent of total billed charges,,,336.95,95,,percent of total billed charges,,,294.38,83,,percent of total billed charges,,,294.38,83,,percent of total billed charges,,,,,,,,,,,,,,,294.38,83,,percent of total billed charges,,,336.95,95,,percent of total billed charges,,,319.21,90,,percent of total billed charges,,,319.21,90,,percent of total billed charges,,,290.84,82,,percent of total billed charges,,,319.21,90,,percent of total billed charges,,,301.48,85,,percent of total billed charges,,88.67,336.95,
COOK STENT BLACK SILICONE 22CM,30188299,CDM,,,270,RC,outpatient,,819.91,819.91,,696.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,204.98,22,,percent of total billed charges,,,,,,,,,737.92,90,,percent of total billed charges,,,678.89,82.8,,percent of total billed charges,,,696.92,85,,percent of total billed charges,,,,,,,,,721.52,88,,percent of total billed charges,,,,,,,,,626.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,204.98,22,,percent of total billed charges,,,746.12,91,,percent of total billed charges,,,778.91,95,,percent of total billed charges,,,680.53,83,,percent of total billed charges,,,680.53,83,,percent of total billed charges,,,,,,,,,,,,,,,680.53,83,,percent of total billed charges,,,778.91,95,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,672.33,82,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,696.92,85,,percent of total billed charges,,204.98,778.91,
COOK STENT BLACK SILICONE 24CM,30188300,CDM,,,270,RC,outpatient,,819.91,819.91,,696.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,204.98,22,,percent of total billed charges,,,,,,,,,737.92,90,,percent of total billed charges,,,678.89,82.8,,percent of total billed charges,,,696.92,85,,percent of total billed charges,,,,,,,,,721.52,88,,percent of total billed charges,,,,,,,,,626.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,204.98,22,,percent of total billed charges,,,746.12,91,,percent of total billed charges,,,778.91,95,,percent of total billed charges,,,680.53,83,,percent of total billed charges,,,680.53,83,,percent of total billed charges,,,,,,,,,,,,,,,680.53,83,,percent of total billed charges,,,778.91,95,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,672.33,82,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,696.92,85,,percent of total billed charges,,204.98,778.91,
COOK STENT BLACK SILICONE 26CM,30188301,CDM,,,270,RC,outpatient,,819.91,819.91,,696.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,204.98,22,,percent of total billed charges,,,,,,,,,737.92,90,,percent of total billed charges,,,678.89,82.8,,percent of total billed charges,,,696.92,85,,percent of total billed charges,,,,,,,,,721.52,88,,percent of total billed charges,,,,,,,,,626.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,204.98,22,,percent of total billed charges,,,746.12,91,,percent of total billed charges,,,778.91,95,,percent of total billed charges,,,680.53,83,,percent of total billed charges,,,680.53,83,,percent of total billed charges,,,,,,,,,,,,,,,680.53,83,,percent of total billed charges,,,778.91,95,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,672.33,82,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,696.92,85,,percent of total billed charges,,204.98,778.91,
COOK STENT BLACK SILICONE 28CM,30188302,CDM,,,270,RC,outpatient,,819.91,819.91,,696.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,204.98,22,,percent of total billed charges,,,,,,,,,737.92,90,,percent of total billed charges,,,678.89,82.8,,percent of total billed charges,,,696.92,85,,percent of total billed charges,,,,,,,,,721.52,88,,percent of total billed charges,,,,,,,,,626.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,204.98,22,,percent of total billed charges,,,746.12,91,,percent of total billed charges,,,778.91,95,,percent of total billed charges,,,680.53,83,,percent of total billed charges,,,680.53,83,,percent of total billed charges,,,,,,,,,,,,,,,680.53,83,,percent of total billed charges,,,778.91,95,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,672.33,82,,percent of total billed charges,,,737.92,90,,percent of total billed charges,,,696.92,85,,percent of total billed charges,,204.98,778.91,
JRF TENDON VERSAGRAFT 3.5,30188304,CDM,,,278,RC,outpatient,,8385,8385,,7118.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2096.25,22,,percent of total billed charges,,,,,,,,,7546.5,90,,percent of total billed charges,,,6942.78,82.8,,percent of total billed charges,,,7127.25,85,,percent of total billed charges,,,,,,,,,7378.8,88,,percent of total billed charges,,,,,,,,,6406.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2096.25,22,,percent of total billed charges,,,7630.35,91,,percent of total billed charges,,,7965.75,95,,percent of total billed charges,,,6959.55,83,,percent of total billed charges,,,6959.55,83,,percent of total billed charges,,,,,,,,,,,,,,,6959.55,83,,percent of total billed charges,,,7965.75,95,,percent of total billed charges,,,7546.5,90,,percent of total billed charges,,,7546.5,90,,percent of total billed charges,,,6875.7,82,,percent of total billed charges,,,7546.5,90,,percent of total billed charges,,,7127.25,85,,percent of total billed charges,,2096.25,7965.75,
COOK INTRODUCER PEEL-AWAY 22FR,30188305,CDM,,,270,RC,outpatient,,373.2,373.2,,316.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.3,22,,percent of total billed charges,,,,,,,,,335.88,90,,percent of total billed charges,,,309.01,82.8,,percent of total billed charges,,,317.22,85,,percent of total billed charges,,,,,,,,,328.42,88,,percent of total billed charges,,,,,,,,,285.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.3,22,,percent of total billed charges,,,339.61,91,,percent of total billed charges,,,354.54,95,,percent of total billed charges,,,309.76,83,,percent of total billed charges,,,309.76,83,,percent of total billed charges,,,,,,,,,,,,,,,309.76,83,,percent of total billed charges,,,354.54,95,,percent of total billed charges,,,335.88,90,,percent of total billed charges,,,335.88,90,,percent of total billed charges,,,306.02,82,,percent of total billed charges,,,335.88,90,,percent of total billed charges,,,317.22,85,,percent of total billed charges,,93.3,354.54,
ARTHREX AC REPAIR LOW PROFILE,30188306,CDM,,,278,RC,outpatient,,11121.5,11121.5,,9442.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2780.38,22,,percent of total billed charges,,,,,,,,,10009.35,90,,percent of total billed charges,,,9208.6,82.8,,percent of total billed charges,,,9453.28,85,,percent of total billed charges,,,,,,,,,9786.92,88,,percent of total billed charges,,,,,,,,,8496.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2780.38,22,,percent of total billed charges,,,10120.57,91,,percent of total billed charges,,,10565.43,95,,percent of total billed charges,,,9230.85,83,,percent of total billed charges,,,9230.85,83,,percent of total billed charges,,,,,,,,,,,,,,,9230.85,83,,percent of total billed charges,,,10565.43,95,,percent of total billed charges,,,10009.35,90,,percent of total billed charges,,,10009.35,90,,percent of total billed charges,,,9119.63,82,,percent of total billed charges,,,10009.35,90,,percent of total billed charges,,,9453.28,85,,percent of total billed charges,,2780.38,10565.43,
ARTHREX PASSPORT CANNULA 10X4,30188307,CDM,,,278,RC,outpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
ABBOTT PACEMAKER ASSURITY SR MRI SINGLE,30188308,CDM,,,278,RC,outpatient,,27950,27950,,23729.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6987.5,22,,percent of total billed charges,,,,,,,,,25155,90,,percent of total billed charges,,,23142.6,82.8,,percent of total billed charges,,,23757.5,85,,percent of total billed charges,,,,,,,,,24596,88,,percent of total billed charges,,,,,,,,,21353.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6987.5,22,,percent of total billed charges,,,25434.5,91,,percent of total billed charges,,,26552.5,95,,percent of total billed charges,,,23198.5,83,,percent of total billed charges,,,23198.5,83,,percent of total billed charges,,,,,,,,,,,,,,,23198.5,83,,percent of total billed charges,,,26552.5,95,,percent of total billed charges,,,25155,90,,percent of total billed charges,,,25155,90,,percent of total billed charges,,,22919,82,,percent of total billed charges,,,25155,90,,percent of total billed charges,,,23757.5,85,,percent of total billed charges,,6987.5,26552.5,
ULRICH Z-ROD 300MM,30188309,CDM,,,278,RC,outpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1218.75,22,,percent of total billed charges,,,,,,,,,4387.5,90,,percent of total billed charges,,,4036.5,82.8,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1218.75,22,,percent of total billed charges,,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,1218.75,4631.25,
TERUMO PROGREAT MICROCATHETER 2.8 X 110C,30188310,CDM,,,270,RC,outpatient,,3858.4,3858.4,,3275.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,964.6,22,,percent of total billed charges,,,,,,,,,3472.56,90,,percent of total billed charges,,,3194.76,82.8,,percent of total billed charges,,,3279.64,85,,percent of total billed charges,,,,,,,,,3395.39,88,,percent of total billed charges,,,,,,,,,2947.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,964.6,22,,percent of total billed charges,,,3511.14,91,,percent of total billed charges,,,3665.48,95,,percent of total billed charges,,,3202.47,83,,percent of total billed charges,,,3202.47,83,,percent of total billed charges,,,,,,,,,,,,,,,3202.47,83,,percent of total billed charges,,,3665.48,95,,percent of total billed charges,,,3472.56,90,,percent of total billed charges,,,3472.56,90,,percent of total billed charges,,,3163.89,82,,percent of total billed charges,,,3472.56,90,,percent of total billed charges,,,3279.64,85,,percent of total billed charges,,964.6,3665.48,
ZIMMER SCREW NON LOCKING 1.5X13MM,30188311,CDM,,,278,RC,outpatient,,574,574,,487.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,143.5,22,,percent of total billed charges,,,,,,,,,516.6,90,,percent of total billed charges,,,475.27,82.8,,percent of total billed charges,,,487.9,85,,percent of total billed charges,,,,,,,,,505.12,88,,percent of total billed charges,,,,,,,,,438.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,143.5,22,,percent of total billed charges,,,522.34,91,,percent of total billed charges,,,545.3,95,,percent of total billed charges,,,476.42,83,,percent of total billed charges,,,476.42,83,,percent of total billed charges,,,,,,,,,,,,,,,476.42,83,,percent of total billed charges,,,545.3,95,,percent of total billed charges,,,516.6,90,,percent of total billed charges,,,516.6,90,,percent of total billed charges,,,470.68,82,,percent of total billed charges,,,516.6,90,,percent of total billed charges,,,487.9,85,,percent of total billed charges,,143.5,545.3,
ZIMMER K-WIRE .35X6,30188312,CDM,,,278,RC,outpatient,,482.09,482.09,,409.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,120.52,22,,percent of total billed charges,,,,,,,,,433.88,90,,percent of total billed charges,,,399.17,82.8,,percent of total billed charges,,,409.78,85,,percent of total billed charges,,,,,,,,,424.24,88,,percent of total billed charges,,,,,,,,,368.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,120.52,22,,percent of total billed charges,,,438.7,91,,percent of total billed charges,,,457.99,95,,percent of total billed charges,,,400.13,83,,percent of total billed charges,,,400.13,83,,percent of total billed charges,,,,,,,,,,,,,,,400.13,83,,percent of total billed charges,,,457.99,95,,percent of total billed charges,,,433.88,90,,percent of total billed charges,,,433.88,90,,percent of total billed charges,,,395.31,82,,percent of total billed charges,,,433.88,90,,percent of total billed charges,,,409.78,85,,percent of total billed charges,,120.52,457.99,
ZIMMER DRILL BIT 1.1MM,30188313,CDM,,,278,RC,outpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.88,22,,percent of total billed charges,,,,,,,,,330.75,90,,percent of total billed charges,,,304.29,82.8,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.88,22,,percent of total billed charges,,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,91.88,349.13,
ZIMMER SCREW NON-LOCK 2.7X14MM,30188314,CDM,,,278,RC,outpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
ZIMMER SCREW NON-LOCK 2.7X26MM,30188315,CDM,,,278,RC,outpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
ZIMMER SCREW LOCKING  MD 2.7X20MM,30188316,CDM,,,278,RC,outpatient,,1033.5,1033.5,,877.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,258.38,22,,percent of total billed charges,,,,,,,,,930.15,90,,percent of total billed charges,,,855.74,82.8,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,,,,,,,,909.48,88,,percent of total billed charges,,,,,,,,,789.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,258.38,22,,percent of total billed charges,,,940.49,91,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,,,,,,,,,,,,,857.81,83,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,847.47,82,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,258.38,981.83,
ZIMMER SCREW LOCKING  MD 2.7X22MM,30188317,CDM,,,278,RC,outpatient,,1033.5,1033.5,,877.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,258.38,22,,percent of total billed charges,,,,,,,,,930.15,90,,percent of total billed charges,,,855.74,82.8,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,,,,,,,,909.48,88,,percent of total billed charges,,,,,,,,,789.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,258.38,22,,percent of total billed charges,,,940.49,91,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,,,,,,,,,,,,,857.81,83,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,847.47,82,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,258.38,981.83,
ZIMMER SCREW LOCKING  2.7X13MM,30188318,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ZIMMER PLATE ULNA PROX 5H RIGHT,30188319,CDM,,,278,RC,outpatient,,4841.59,4841.59,,4110.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1210.4,22,,percent of total billed charges,,,,,,,,,4357.43,90,,percent of total billed charges,,,4008.84,82.8,,percent of total billed charges,,,4115.35,85,,percent of total billed charges,,,,,,,,,4260.6,88,,percent of total billed charges,,,,,,,,,3698.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1210.4,22,,percent of total billed charges,,,4405.85,91,,percent of total billed charges,,,4599.51,95,,percent of total billed charges,,,4018.52,83,,percent of total billed charges,,,4018.52,83,,percent of total billed charges,,,,,,,,,,,,,,,4018.52,83,,percent of total billed charges,,,4599.51,95,,percent of total billed charges,,,4357.43,90,,percent of total billed charges,,,4357.43,90,,percent of total billed charges,,,3970.1,82,,percent of total billed charges,,,4357.43,90,,percent of total billed charges,,,4115.35,85,,percent of total billed charges,,1210.4,4599.51,
ZIMMER SCREW PERI 3.5X20 W/2.7MM HEAD,30188320,CDM,,,278,RC,outpatient,,257.1,257.1,,218.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.28,22,,percent of total billed charges,,,,,,,,,231.39,90,,percent of total billed charges,,,212.88,82.8,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,,,,,,,,226.25,88,,percent of total billed charges,,,,,,,,,196.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.28,22,,percent of total billed charges,,,233.96,91,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,213.39,83,,percent of total billed charges,,,,,,,,,,,,,,,213.39,83,,percent of total billed charges,,,244.25,95,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,210.82,82,,percent of total billed charges,,,231.39,90,,percent of total billed charges,,,218.54,85,,percent of total billed charges,,64.28,244.25,
ZIMMER SCREW CORTICAL ST 2.7X50MM,30188321,CDM,,,278,RC,outpatient,,168.8,168.8,,143.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.2,22,,percent of total billed charges,,,,,,,,,151.92,90,,percent of total billed charges,,,139.77,82.8,,percent of total billed charges,,,143.48,85,,percent of total billed charges,,,,,,,,,148.54,88,,percent of total billed charges,,,,,,,,,128.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.2,22,,percent of total billed charges,,,153.61,91,,percent of total billed charges,,,160.36,95,,percent of total billed charges,,,140.1,83,,percent of total billed charges,,,140.1,83,,percent of total billed charges,,,,,,,,,,,,,,,140.1,83,,percent of total billed charges,,,160.36,95,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,138.42,82,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,143.48,85,,percent of total billed charges,,42.2,160.36,
ZIMMER SCREW LOCKING 2.7X34MM,30188322,CDM,,,278,RC,outpatient,,715.26,715.26,,607.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.82,22,,percent of total billed charges,,,,,,,,,643.73,90,,percent of total billed charges,,,592.24,82.8,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,,,,,,,,629.43,88,,percent of total billed charges,,,,,,,,,546.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.82,22,,percent of total billed charges,,,650.89,91,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,593.67,83,,percent of total billed charges,,,,,,,,,,,,,,,593.67,83,,percent of total billed charges,,,679.5,95,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,586.51,82,,percent of total billed charges,,,643.73,90,,percent of total billed charges,,,607.97,85,,percent of total billed charges,,178.82,679.5,
ZIMMER SCREW LOCKING W/2.7MM HEAD 3.5X18,30188323,CDM,,,278,RC,outpatient,,669.13,669.13,,568.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,167.28,22,,percent of total billed charges,,,,,,,,,602.22,90,,percent of total billed charges,,,554.04,82.8,,percent of total billed charges,,,568.76,85,,percent of total billed charges,,,,,,,,,588.83,88,,percent of total billed charges,,,,,,,,,511.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,167.28,22,,percent of total billed charges,,,608.91,91,,percent of total billed charges,,,635.67,95,,percent of total billed charges,,,555.38,83,,percent of total billed charges,,,555.38,83,,percent of total billed charges,,,,,,,,,,,,,,,555.38,83,,percent of total billed charges,,,635.67,95,,percent of total billed charges,,,602.22,90,,percent of total billed charges,,,602.22,90,,percent of total billed charges,,,548.69,82,,percent of total billed charges,,,602.22,90,,percent of total billed charges,,,568.76,85,,percent of total billed charges,,167.28,635.67,
ZIMMER SCREW CORITCAL ST 2.7X20MM,30188324,CDM,,,278,RC,outpatient,,168.8,168.8,,143.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.2,22,,percent of total billed charges,,,,,,,,,151.92,90,,percent of total billed charges,,,139.77,82.8,,percent of total billed charges,,,143.48,85,,percent of total billed charges,,,,,,,,,148.54,88,,percent of total billed charges,,,,,,,,,128.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.2,22,,percent of total billed charges,,,153.61,91,,percent of total billed charges,,,160.36,95,,percent of total billed charges,,,140.1,83,,percent of total billed charges,,,140.1,83,,percent of total billed charges,,,,,,,,,,,,,,,140.1,83,,percent of total billed charges,,,160.36,95,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,138.42,82,,percent of total billed charges,,,151.92,90,,percent of total billed charges,,,143.48,85,,percent of total billed charges,,42.2,160.36,
ZIMMER DRILL BIT Q-C 2.0MM,30188325,CDM,,,278,RC,outpatient,,484.54,484.54,,411.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,121.14,22,,percent of total billed charges,,,,,,,,,436.09,90,,percent of total billed charges,,,401.2,82.8,,percent of total billed charges,,,411.86,85,,percent of total billed charges,,,,,,,,,426.4,88,,percent of total billed charges,,,,,,,,,370.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,121.14,22,,percent of total billed charges,,,440.93,91,,percent of total billed charges,,,460.31,95,,percent of total billed charges,,,402.17,83,,percent of total billed charges,,,402.17,83,,percent of total billed charges,,,,,,,,,,,,,,,402.17,83,,percent of total billed charges,,,460.31,95,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,397.32,82,,percent of total billed charges,,,436.09,90,,percent of total billed charges,,,411.86,85,,percent of total billed charges,,121.14,460.31,
STRYKER SCREW LAG 10.5X100,30188326,CDM,,,278,RC,outpatient,,5200.33,5200.33,,4415.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1300.08,22,,percent of total billed charges,,,,,,,,,4680.3,90,,percent of total billed charges,,,4305.87,82.8,,percent of total billed charges,,,4420.28,85,,percent of total billed charges,,,,,,,,,4576.29,88,,percent of total billed charges,,,,,,,,,3973.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1300.08,22,,percent of total billed charges,,,4732.3,91,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,,,,,,,,,,,,,4316.27,83,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4264.27,82,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4420.28,85,,percent of total billed charges,,1300.08,4940.31,
STRYKER SCREW LOCKING FT 5X42MM,30188327,CDM,,,278,RC,outpatient,,1774.37,1774.37,,1506.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,443.59,22,,percent of total billed charges,,,,,,,,,1596.93,90,,percent of total billed charges,,,1469.18,82.8,,percent of total billed charges,,,1508.21,85,,percent of total billed charges,,,,,,,,,1561.45,88,,percent of total billed charges,,,,,,,,,1355.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,443.59,22,,percent of total billed charges,,,1614.68,91,,percent of total billed charges,,,1685.65,95,,percent of total billed charges,,,1472.73,83,,percent of total billed charges,,,1472.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1472.73,83,,percent of total billed charges,,,1685.65,95,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1454.98,82,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1508.21,85,,percent of total billed charges,,443.59,1685.65,
STRYKER GAMMA NAIL KIT 11X180MM X 130DEG,30188328,CDM,,,278,RC,outpatient,,13727.55,13727.55,,11654.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3431.89,22,,percent of total billed charges,,,,,,,,,12354.8,90,,percent of total billed charges,,,11366.41,82.8,,percent of total billed charges,,,11668.42,85,,percent of total billed charges,,,,,,,,,12080.24,88,,percent of total billed charges,,,,,,,,,10487.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3431.89,22,,percent of total billed charges,,,12492.07,91,,percent of total billed charges,,,13041.17,95,,percent of total billed charges,,,11393.87,83,,percent of total billed charges,,,11393.87,83,,percent of total billed charges,,,,,,,,,,,,,,,11393.87,83,,percent of total billed charges,,,13041.17,95,,percent of total billed charges,,,12354.8,90,,percent of total billed charges,,,12354.8,90,,percent of total billed charges,,,11256.59,82,,percent of total billed charges,,,12354.8,90,,percent of total billed charges,,,11668.42,85,,percent of total billed charges,,3431.89,13041.17,
UROVAC BLADDER EVACUATOR,30188329,CDM,,,270,RC,outpatient,,190.96,190.96,,162.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.74,22,,percent of total billed charges,,,,,,,,,171.86,90,,percent of total billed charges,,,158.11,82.8,,percent of total billed charges,,,162.32,85,,percent of total billed charges,,,,,,,,,168.04,88,,percent of total billed charges,,,,,,,,,145.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.74,22,,percent of total billed charges,,,173.77,91,,percent of total billed charges,,,181.41,95,,percent of total billed charges,,,158.5,83,,percent of total billed charges,,,158.5,83,,percent of total billed charges,,,,,,,,,,,,,,,158.5,83,,percent of total billed charges,,,181.41,95,,percent of total billed charges,,,171.86,90,,percent of total billed charges,,,171.86,90,,percent of total billed charges,,,156.59,82,,percent of total billed charges,,,171.86,90,,percent of total billed charges,,,162.32,85,,percent of total billed charges,,47.74,181.41,
SCREW LATERAL MASS 28 x 3.5,30188330,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
SCREW LATERAL MASS 16 X 4.0MM,30188331,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
SCREW LATERAL MASS 5.5 X 30MM,30188332,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SCREW LATERAL MASS 14 X 4.0MM,30188333,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
ULRICH TRANSITION ROD SPECIALTY 3.5-5.5,30188334,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
BIOPSY FORCEP ALLIGATOR CUP SINGLE-USE,30188335,CDM,,,270,RC,outpatient,,208.28,208.28,,176.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.07,22,,percent of total billed charges,,,,,,,,,187.45,90,,percent of total billed charges,,,172.46,82.8,,percent of total billed charges,,,177.04,85,,percent of total billed charges,,,,,,,,,183.29,88,,percent of total billed charges,,,,,,,,,159.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.07,22,,percent of total billed charges,,,189.53,91,,percent of total billed charges,,,197.87,95,,percent of total billed charges,,,172.87,83,,percent of total billed charges,,,172.87,83,,percent of total billed charges,,,,,,,,,,,,,,,172.87,83,,percent of total billed charges,,,197.87,95,,percent of total billed charges,,,187.45,90,,percent of total billed charges,,,187.45,90,,percent of total billed charges,,,170.79,82,,percent of total billed charges,,,187.45,90,,percent of total billed charges,,,177.04,85,,percent of total billed charges,,52.07,197.87,
BRUSH CYTOLOGY 2.0 SINGLE-USE,30188336,CDM,,,270,RC,outpatient,,133.6,133.6,,113.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.4,22,,percent of total billed charges,,,,,,,,,120.24,90,,percent of total billed charges,,,110.62,82.8,,percent of total billed charges,,,113.56,85,,percent of total billed charges,,,,,,,,,117.57,88,,percent of total billed charges,,,,,,,,,102.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.4,22,,percent of total billed charges,,,121.58,91,,percent of total billed charges,,,126.92,95,,percent of total billed charges,,,110.89,83,,percent of total billed charges,,,110.89,83,,percent of total billed charges,,,,,,,,,,,,,,,110.89,83,,percent of total billed charges,,,126.92,95,,percent of total billed charges,,,120.24,90,,percent of total billed charges,,,120.24,90,,percent of total billed charges,,,109.55,82,,percent of total billed charges,,,120.24,90,,percent of total billed charges,,,113.56,85,,percent of total billed charges,,33.4,126.92,
OLYMPUS GUIDESHEATH 1.91MM,30188337,CDM,,,270,RC,outpatient,,1755,1755,,1490,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,438.75,22,,percent of total billed charges,,,,,,,,,1579.5,90,,percent of total billed charges,,,1453.14,82.8,,percent of total billed charges,,,1491.75,85,,percent of total billed charges,,,,,,,,,1544.4,88,,percent of total billed charges,,,,,,,,,1340.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,438.75,22,,percent of total billed charges,,,1597.05,91,,percent of total billed charges,,,1667.25,95,,percent of total billed charges,,,1456.65,83,,percent of total billed charges,,,1456.65,83,,percent of total billed charges,,,,,,,,,,,,,,,1456.65,83,,percent of total billed charges,,,1667.25,95,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1439.1,82,,percent of total billed charges,,,1579.5,90,,percent of total billed charges,,,1491.75,85,,percent of total billed charges,,438.75,1667.25,
OLYMPUS VIZISHOT 22G,30188338,CDM,,,270,RC,outpatient,,1547,1547,,1313.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,386.75,22,,percent of total billed charges,,,,,,,,,1392.3,90,,percent of total billed charges,,,1280.92,82.8,,percent of total billed charges,,,1314.95,85,,percent of total billed charges,,,,,,,,,1361.36,88,,percent of total billed charges,,,,,,,,,1181.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,386.75,22,,percent of total billed charges,,,1407.77,91,,percent of total billed charges,,,1469.65,95,,percent of total billed charges,,,1284.01,83,,percent of total billed charges,,,1284.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1284.01,83,,percent of total billed charges,,,1469.65,95,,percent of total billed charges,,,1392.3,90,,percent of total billed charges,,,1392.3,90,,percent of total billed charges,,,1268.54,82,,percent of total billed charges,,,1392.3,90,,percent of total billed charges,,,1314.95,85,,percent of total billed charges,,386.75,1469.65,
MERZ PROLARYN PLUS 1.0CC KIT,30188339,CDM,,,278,RC,outpatient,,4420,4420,,3752.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1105,22,,percent of total billed charges,,,,,,,,,3978,90,,percent of total billed charges,,,3659.76,82.8,,percent of total billed charges,,,3757,85,,percent of total billed charges,,,,,,,,,3889.6,88,,percent of total billed charges,,,,,,,,,3376.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1105,22,,percent of total billed charges,,,4022.2,91,,percent of total billed charges,,,4199,95,,percent of total billed charges,,,3668.6,83,,percent of total billed charges,,,3668.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3668.6,83,,percent of total billed charges,,,4199,95,,percent of total billed charges,,,3978,90,,percent of total billed charges,,,3978,90,,percent of total billed charges,,,3624.4,82,,percent of total billed charges,,,3978,90,,percent of total billed charges,,,3757,85,,percent of total billed charges,,1105,4199,
FORTEC LASER FIBER DUST THULIUM,30188340,CDM,,,270,RC,outpatient,,5310.5,5310.5,,4508.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1327.63,22,,percent of total billed charges,,,,,,,,,4779.45,90,,percent of total billed charges,,,4397.09,82.8,,percent of total billed charges,,,4513.93,85,,percent of total billed charges,,,,,,,,,4673.24,88,,percent of total billed charges,,,,,,,,,4057.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1327.63,22,,percent of total billed charges,,,4832.56,91,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,4407.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4407.72,83,,percent of total billed charges,,,5044.98,95,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4354.61,82,,percent of total billed charges,,,4779.45,90,,percent of total billed charges,,,4513.93,85,,percent of total billed charges,,1327.63,5044.98,
FORTEC FIBER THULIUM TFL 272,30188341,CDM,,,270,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
FORTEC FLEXIBLE UTERSCOPE 7FR,30188342,CDM,,,270,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
ZIMMER LINER NEUTRAL G7 40MM,30188343,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
STRYKER STEM #8 132DEG,30188344,CDM,,,278,RC,outpatient,,15600,15600,,13244.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3900,22,,percent of total billed charges,,,,,,,,,14040,90,,percent of total billed charges,,,12916.8,82.8,,percent of total billed charges,,,13260,85,,percent of total billed charges,,,,,,,,,13728,88,,percent of total billed charges,,,,,,,,,11918.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3900,22,,percent of total billed charges,,,14196,91,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,12948,83,,percent of total billed charges,,,,,,,,,,,,,,,12948,83,,percent of total billed charges,,,14820,95,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,12792,82,,percent of total billed charges,,,14040,90,,percent of total billed charges,,,13260,85,,percent of total billed charges,,3900,14820,
STRYKER HEAD BIPOLAR 26MM,30188345,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
BARD ROTAREX 6F 135CM,30188346,CDM,,,270,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
STRYKER SCREW LOCKING 8 X 17.5MM,30188347,CDM,,,278,RC,outpatient,,1864.01,1864.01,,1582.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,466,22,,percent of total billed charges,,,,,,,,,1677.61,90,,percent of total billed charges,,,1543.4,82.8,,percent of total billed charges,,,1584.41,85,,percent of total billed charges,,,,,,,,,1640.33,88,,percent of total billed charges,,,,,,,,,1424.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,466,22,,percent of total billed charges,,,1696.25,91,,percent of total billed charges,,,1770.81,95,,percent of total billed charges,,,1547.13,83,,percent of total billed charges,,,1547.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1547.13,83,,percent of total billed charges,,,1770.81,95,,percent of total billed charges,,,1677.61,90,,percent of total billed charges,,,1677.61,90,,percent of total billed charges,,,1528.49,82,,percent of total billed charges,,,1677.61,90,,percent of total billed charges,,,1584.41,85,,percent of total billed charges,,466,1770.81,
ADMIRAL IN PACT 6X250X130,30188349,CDM,,,270,RC,outpatient,,21417.5,21417.5,,18183.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5354.38,22,,percent of total billed charges,,,,,,,,,19275.75,90,,percent of total billed charges,,,17733.69,82.8,,percent of total billed charges,,,18204.88,85,,percent of total billed charges,,,,,,,,,18847.4,88,,percent of total billed charges,,,,,,,,,16362.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5354.38,22,,percent of total billed charges,,,19489.93,91,,percent of total billed charges,,,20346.63,95,,percent of total billed charges,,,17776.53,83,,percent of total billed charges,,,17776.53,83,,percent of total billed charges,,,,,,,,,,,,,,,17776.53,83,,percent of total billed charges,,,20346.63,95,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,17562.35,82,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,18204.88,85,,percent of total billed charges,,5354.38,20346.63,
DAT DUAL ACTION TISSUE CLIP 15MM,30188350,CDM,,,270,RC,outpatient,,2236,2236,,1898.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,559,22,,percent of total billed charges,,,,,,,,,2012.4,90,,percent of total billed charges,,,1851.41,82.8,,percent of total billed charges,,,1900.6,85,,percent of total billed charges,,,,,,,,,1967.68,88,,percent of total billed charges,,,,,,,,,1708.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,559,22,,percent of total billed charges,,,2034.76,91,,percent of total billed charges,,,2124.2,95,,percent of total billed charges,,,1855.88,83,,percent of total billed charges,,,1855.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1855.88,83,,percent of total billed charges,,,2124.2,95,,percent of total billed charges,,,2012.4,90,,percent of total billed charges,,,2012.4,90,,percent of total billed charges,,,1833.52,82,,percent of total billed charges,,,2012.4,90,,percent of total billed charges,,,1900.6,85,,percent of total billed charges,,559,2124.2,
CLIP WECK HEMOCLIP MD-LG,30188351,CDM,,,270,RC,outpatient,,221.79,221.79,,188.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.45,22,,percent of total billed charges,,,,,,,,,199.61,90,,percent of total billed charges,,,183.64,82.8,,percent of total billed charges,,,188.52,85,,percent of total billed charges,,,,,,,,,195.18,88,,percent of total billed charges,,,,,,,,,169.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.45,22,,percent of total billed charges,,,201.83,91,,percent of total billed charges,,,210.7,95,,percent of total billed charges,,,184.09,83,,percent of total billed charges,,,184.09,83,,percent of total billed charges,,,,,,,,,,,,,,,184.09,83,,percent of total billed charges,,,210.7,95,,percent of total billed charges,,,199.61,90,,percent of total billed charges,,,199.61,90,,percent of total billed charges,,,181.87,82,,percent of total billed charges,,,199.61,90,,percent of total billed charges,,,188.52,85,,percent of total billed charges,,55.45,210.7,
ZIMMER PLATE CLAVICLE NARROW 10H,30188352,CDM,,,278,RC,outpatient,,8794.5,8794.5,,7466.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2198.63,22,,percent of total billed charges,,,,,,,,,7915.05,90,,percent of total billed charges,,,7281.85,82.8,,percent of total billed charges,,,7475.33,85,,percent of total billed charges,,,,,,,,,7739.16,88,,percent of total billed charges,,,,,,,,,6719,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2198.63,22,,percent of total billed charges,,,8003,91,,percent of total billed charges,,,8354.78,95,,percent of total billed charges,,,7299.44,83,,percent of total billed charges,,,7299.44,83,,percent of total billed charges,,,,,,,,,,,,,,,7299.44,83,,percent of total billed charges,,,8354.78,95,,percent of total billed charges,,,7915.05,90,,percent of total billed charges,,,7915.05,90,,percent of total billed charges,,,7211.49,82,,percent of total billed charges,,,7915.05,90,,percent of total billed charges,,,7475.33,85,,percent of total billed charges,,2198.63,8354.78,
ZIMMER DRILL BIT 2.2 X 135MM,30188353,CDM,,,278,RC,outpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.88,22,,percent of total billed charges,,,,,,,,,330.75,90,,percent of total billed charges,,,304.29,82.8,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.88,22,,percent of total billed charges,,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,91.88,349.13,
ZIMMER DRILL STOP 2.2MM,30188354,CDM,,,278,RC,outpatient,,202.5,202.5,,171.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.63,22,,percent of total billed charges,,,,,,,,,182.25,90,,percent of total billed charges,,,167.67,82.8,,percent of total billed charges,,,172.13,85,,percent of total billed charges,,,,,,,,,178.2,88,,percent of total billed charges,,,,,,,,,154.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.63,22,,percent of total billed charges,,,184.28,91,,percent of total billed charges,,,192.38,95,,percent of total billed charges,,,168.08,83,,percent of total billed charges,,,168.08,83,,percent of total billed charges,,,,,,,,,,,,,,,168.08,83,,percent of total billed charges,,,192.38,95,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,166.05,82,,percent of total billed charges,,,182.25,90,,percent of total billed charges,,,172.13,85,,percent of total billed charges,,50.63,192.38,
ZIMMER SCREW MD 2.7 X 16MM,30188355,CDM,,,278,RC,outpatient,,1033.5,1033.5,,877.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,258.38,22,,percent of total billed charges,,,,,,,,,930.15,90,,percent of total billed charges,,,855.74,82.8,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,,,,,,,,909.48,88,,percent of total billed charges,,,,,,,,,789.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,258.38,22,,percent of total billed charges,,,940.49,91,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,,,,,,,,,,,,,857.81,83,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,847.47,82,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,258.38,981.83,
ZIMMER SCREW MD 2.7 X 14MM,30188356,CDM,,,278,RC,outpatient,,1033.5,1033.5,,877.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,258.38,22,,percent of total billed charges,,,,,,,,,930.15,90,,percent of total billed charges,,,855.74,82.8,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,,,,,,,,909.48,88,,percent of total billed charges,,,,,,,,,789.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,258.38,22,,percent of total billed charges,,,940.49,91,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,857.81,83,,percent of total billed charges,,,,,,,,,,,,,,,857.81,83,,percent of total billed charges,,,981.83,95,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,847.47,82,,percent of total billed charges,,,930.15,90,,percent of total billed charges,,,878.48,85,,percent of total billed charges,,258.38,981.83,
TELEFLEX UROLIFT HANDLE,30188357,CDM,,,278,RC,outpatient,,6662.5,6662.5,,5656.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1665.63,22,,percent of total billed charges,,,,,,,,,5996.25,90,,percent of total billed charges,,,5516.55,82.8,,percent of total billed charges,,,5663.13,85,,percent of total billed charges,,,,,,,,,5863,88,,percent of total billed charges,,,,,,,,,5090.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1665.63,22,,percent of total billed charges,,,6062.88,91,,percent of total billed charges,,,6329.38,95,,percent of total billed charges,,,5529.88,83,,percent of total billed charges,,,5529.88,83,,percent of total billed charges,,,,,,,,,,,,,,,5529.88,83,,percent of total billed charges,,,6329.38,95,,percent of total billed charges,,,5996.25,90,,percent of total billed charges,,,5996.25,90,,percent of total billed charges,,,5463.25,82,,percent of total billed charges,,,5996.25,90,,percent of total billed charges,,,5663.13,85,,percent of total billed charges,,1665.63,6329.38,
TELEFLEX UROLIFT IMPANT CARTRIDGE,30188358,CDM,,,278,RC,outpatient,,6662.5,6662.5,,5656.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1665.63,22,,percent of total billed charges,,,,,,,,,5996.25,90,,percent of total billed charges,,,5516.55,82.8,,percent of total billed charges,,,5663.13,85,,percent of total billed charges,,,,,,,,,5863,88,,percent of total billed charges,,,,,,,,,5090.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1665.63,22,,percent of total billed charges,,,6062.88,91,,percent of total billed charges,,,6329.38,95,,percent of total billed charges,,,5529.88,83,,percent of total billed charges,,,5529.88,83,,percent of total billed charges,,,,,,,,,,,,,,,5529.88,83,,percent of total billed charges,,,6329.38,95,,percent of total billed charges,,,5996.25,90,,percent of total billed charges,,,5996.25,90,,percent of total billed charges,,,5463.25,82,,percent of total billed charges,,,5996.25,90,,percent of total billed charges,,,5663.13,85,,percent of total billed charges,,1665.63,6329.38,
V-LOC 90 VIOLET 3-0 6  V-20,30188359,CDM,,,270,RC,outpatient,,182.72,182.72,,155.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.68,22,,percent of total billed charges,,,,,,,,,164.45,90,,percent of total billed charges,,,151.29,82.8,,percent of total billed charges,,,155.31,85,,percent of total billed charges,,,,,,,,,160.79,88,,percent of total billed charges,,,,,,,,,139.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.68,22,,percent of total billed charges,,,166.28,91,,percent of total billed charges,,,173.58,95,,percent of total billed charges,,,151.66,83,,percent of total billed charges,,,151.66,83,,percent of total billed charges,,,,,,,,,,,,,,,151.66,83,,percent of total billed charges,,,173.58,95,,percent of total billed charges,,,164.45,90,,percent of total billed charges,,,164.45,90,,percent of total billed charges,,,149.83,82,,percent of total billed charges,,,164.45,90,,percent of total billed charges,,,155.31,85,,percent of total billed charges,,45.68,173.58,
TRUSPAN  MENISCAL RPR. 0DEG NEEDLE,30188360,CDM,,,270,RC,outpatient,,5076.5,5076.5,,4309.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1269.13,22,,percent of total billed charges,,,,,,,,,4568.85,90,,percent of total billed charges,,,4203.34,82.8,,percent of total billed charges,,,4315.03,85,,percent of total billed charges,,,,,,,,,4467.32,88,,percent of total billed charges,,,,,,,,,3878.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1269.13,22,,percent of total billed charges,,,4619.62,91,,percent of total billed charges,,,4822.68,95,,percent of total billed charges,,,4213.5,83,,percent of total billed charges,,,4213.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4213.5,83,,percent of total billed charges,,,4822.68,95,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4162.73,82,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4315.03,85,,percent of total billed charges,,1269.13,4822.68,
TRUSPAN  MENISCAL RPR. 24DEG NEEDLE,30188361,CDM,,,270,RC,outpatient,,5076.5,5076.5,,4309.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1269.13,22,,percent of total billed charges,,,,,,,,,4568.85,90,,percent of total billed charges,,,4203.34,82.8,,percent of total billed charges,,,4315.03,85,,percent of total billed charges,,,,,,,,,4467.32,88,,percent of total billed charges,,,,,,,,,3878.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1269.13,22,,percent of total billed charges,,,4619.62,91,,percent of total billed charges,,,4822.68,95,,percent of total billed charges,,,4213.5,83,,percent of total billed charges,,,4213.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4213.5,83,,percent of total billed charges,,,4822.68,95,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4162.73,82,,percent of total billed charges,,,4568.85,90,,percent of total billed charges,,,4315.03,85,,percent of total billed charges,,1269.13,4822.68,
STRYKER INSERT TRIATHLON CS #7 10MM,30188362,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER FEMUR CR BEADED #2,30188363,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
STRYKER PATELLA S31X9,30188364,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
BODY REST MOD PROX CONE 23MM +10,30188365,CDM,,,278,RC,outpatient,,27917.18,27917.18,,23701.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6979.3,22,,percent of total billed charges,,,,,,,,,25125.46,90,,percent of total billed charges,,,23115.43,82.8,,percent of total billed charges,,,23729.6,85,,percent of total billed charges,,,,,,,,,24567.12,88,,percent of total billed charges,,,,,,,,,21328.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6979.3,22,,percent of total billed charges,,,25404.63,91,,percent of total billed charges,,,26521.32,95,,percent of total billed charges,,,23171.26,83,,percent of total billed charges,,,23171.26,83,,percent of total billed charges,,,,,,,,,,,,,,,23171.26,83,,percent of total billed charges,,,26521.32,95,,percent of total billed charges,,,25125.46,90,,percent of total billed charges,,,25125.46,90,,percent of total billed charges,,,22892.09,82,,percent of total billed charges,,,25125.46,90,,percent of total billed charges,,,23729.6,85,,percent of total billed charges,,6979.3,26521.32,
STRYKER STEM 155 X 16MM,30188366,CDM,,,278,RC,outpatient,,20002.13,20002.13,,16981.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5000.53,22,,percent of total billed charges,,,,,,,,,18001.92,90,,percent of total billed charges,,,16561.76,82.8,,percent of total billed charges,,,17001.81,85,,percent of total billed charges,,,,,,,,,17601.87,88,,percent of total billed charges,,,,,,,,,15281.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5000.53,22,,percent of total billed charges,,,18201.94,91,,percent of total billed charges,,,19002.02,95,,percent of total billed charges,,,16601.77,83,,percent of total billed charges,,,16601.77,83,,percent of total billed charges,,,,,,,,,,,,,,,16601.77,83,,percent of total billed charges,,,19002.02,95,,percent of total billed charges,,,18001.92,90,,percent of total billed charges,,,18001.92,90,,percent of total billed charges,,,16401.75,82,,percent of total billed charges,,,18001.92,90,,percent of total billed charges,,,17001.81,85,,percent of total billed charges,,5000.53,19002.02,
STRYKER INSERT CS SZ 2 9MM,30188367,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER PLATE DECREASED 7 HOLE RIGHT,30188368,CDM,,,278,RC,outpatient,,10949.51,10949.51,,9296.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2737.38,22,,percent of total billed charges,,,,,,,,,9854.56,90,,percent of total billed charges,,,9066.19,82.8,,percent of total billed charges,,,9307.08,85,,percent of total billed charges,,,,,,,,,9635.57,88,,percent of total billed charges,,,,,,,,,8365.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2737.38,22,,percent of total billed charges,,,9964.05,91,,percent of total billed charges,,,10402.03,95,,percent of total billed charges,,,9088.09,83,,percent of total billed charges,,,9088.09,83,,percent of total billed charges,,,,,,,,,,,,,,,9088.09,83,,percent of total billed charges,,,10402.03,95,,percent of total billed charges,,,9854.56,90,,percent of total billed charges,,,9854.56,90,,percent of total billed charges,,,8978.6,82,,percent of total billed charges,,,9854.56,90,,percent of total billed charges,,,9307.08,85,,percent of total billed charges,,2737.38,10402.03,
STRYKER SCREW LOCKING FT 3.5X14MM,30188369,CDM,,,278,RC,outpatient,,1918.22,1918.22,,1628.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.56,22,,percent of total billed charges,,,,,,,,,1726.4,90,,percent of total billed charges,,,1588.29,82.8,,percent of total billed charges,,,1630.49,85,,percent of total billed charges,,,,,,,,,1688.03,88,,percent of total billed charges,,,,,,,,,1465.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.56,22,,percent of total billed charges,,,1745.58,91,,percent of total billed charges,,,1822.31,95,,percent of total billed charges,,,1592.12,83,,percent of total billed charges,,,1592.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1592.12,83,,percent of total billed charges,,,1822.31,95,,percent of total billed charges,,,1726.4,90,,percent of total billed charges,,,1726.4,90,,percent of total billed charges,,,1572.94,82,,percent of total billed charges,,,1726.4,90,,percent of total billed charges,,,1630.49,85,,percent of total billed charges,,479.56,1822.31,
STRYKER SCREW LOCKING FT 3.5X16MM,30188370,CDM,,,278,RC,outpatient,,1918.22,1918.22,,1628.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.56,22,,percent of total billed charges,,,,,,,,,1726.4,90,,percent of total billed charges,,,1588.29,82.8,,percent of total billed charges,,,1630.49,85,,percent of total billed charges,,,,,,,,,1688.03,88,,percent of total billed charges,,,,,,,,,1465.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.56,22,,percent of total billed charges,,,1745.58,91,,percent of total billed charges,,,1822.31,95,,percent of total billed charges,,,1592.12,83,,percent of total billed charges,,,1592.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1592.12,83,,percent of total billed charges,,,1822.31,95,,percent of total billed charges,,,1726.4,90,,percent of total billed charges,,,1726.4,90,,percent of total billed charges,,,1572.94,82,,percent of total billed charges,,,1726.4,90,,percent of total billed charges,,,1630.49,85,,percent of total billed charges,,479.56,1822.31,
STRYKER SCREW BONE FT 3.5X14MM,30188371,CDM,,,278,RC,outpatient,,1043.32,1043.32,,885.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260.83,22,,percent of total billed charges,,,,,,,,,938.99,90,,percent of total billed charges,,,863.87,82.8,,percent of total billed charges,,,886.82,85,,percent of total billed charges,,,,,,,,,918.12,88,,percent of total billed charges,,,,,,,,,797.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260.83,22,,percent of total billed charges,,,949.42,91,,percent of total billed charges,,,991.15,95,,percent of total billed charges,,,865.96,83,,percent of total billed charges,,,865.96,83,,percent of total billed charges,,,,,,,,,,,,,,,865.96,83,,percent of total billed charges,,,991.15,95,,percent of total billed charges,,,938.99,90,,percent of total billed charges,,,938.99,90,,percent of total billed charges,,,855.52,82,,percent of total billed charges,,,938.99,90,,percent of total billed charges,,,886.82,85,,percent of total billed charges,,260.83,991.15,
STRYKER SCREW BONE FT 3.5X16MM,30188372,CDM,,,278,RC,outpatient,,1043.32,1043.32,,885.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260.83,22,,percent of total billed charges,,,,,,,,,938.99,90,,percent of total billed charges,,,863.87,82.8,,percent of total billed charges,,,886.82,85,,percent of total billed charges,,,,,,,,,918.12,88,,percent of total billed charges,,,,,,,,,797.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260.83,22,,percent of total billed charges,,,949.42,91,,percent of total billed charges,,,991.15,95,,percent of total billed charges,,,865.96,83,,percent of total billed charges,,,865.96,83,,percent of total billed charges,,,,,,,,,,,,,,,865.96,83,,percent of total billed charges,,,991.15,95,,percent of total billed charges,,,938.99,90,,percent of total billed charges,,,938.99,90,,percent of total billed charges,,,855.52,82,,percent of total billed charges,,,938.99,90,,percent of total billed charges,,,886.82,85,,percent of total billed charges,,260.83,991.15,
STRYKER DRILL BIT AO 2.6X135MM SCALED,30188373,CDM,,,278,RC,outpatient,,1571.57,1571.57,,1334.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,392.89,22,,percent of total billed charges,,,,,,,,,1414.41,90,,percent of total billed charges,,,1301.26,82.8,,percent of total billed charges,,,1335.83,85,,percent of total billed charges,,,,,,,,,1382.98,88,,percent of total billed charges,,,,,,,,,1200.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,392.89,22,,percent of total billed charges,,,1430.13,91,,percent of total billed charges,,,1492.99,95,,percent of total billed charges,,,1304.4,83,,percent of total billed charges,,,1304.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1304.4,83,,percent of total billed charges,,,1492.99,95,,percent of total billed charges,,,1414.41,90,,percent of total billed charges,,,1414.41,90,,percent of total billed charges,,,1288.69,82,,percent of total billed charges,,,1414.41,90,,percent of total billed charges,,,1335.83,85,,percent of total billed charges,,392.89,1492.99,
ZIMMER STEM STRAIGHT 11 X 145MM,30188374,CDM,,,278,RC,outpatient,,7276.62,7276.62,,6177.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1819.16,22,,percent of total billed charges,,,,,,,,,6548.96,90,,percent of total billed charges,,,6025.04,82.8,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,,,,,,,,6403.43,88,,percent of total billed charges,,,,,,,,,5559.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1819.16,22,,percent of total billed charges,,,6621.72,91,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,6039.59,83,,percent of total billed charges,,,,,,,,,,,,,,,6039.59,83,,percent of total billed charges,,,6912.79,95,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,5966.83,82,,percent of total billed charges,,,6548.96,90,,percent of total billed charges,,,6185.13,85,,percent of total billed charges,,1819.16,6912.79,
ZIMMER FEMUR ROTATING HINGE D LEFT,30188375,CDM,,,278,RC,outpatient,,57459.03,57459.03,,48782.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14364.76,22,,percent of total billed charges,,,,,,,,,51713.13,90,,percent of total billed charges,,,47576.08,82.8,,percent of total billed charges,,,48840.18,85,,percent of total billed charges,,,,,,,,,50563.95,88,,percent of total billed charges,,,,,,,,,43898.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14364.76,22,,percent of total billed charges,,,52287.72,91,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,,,,,,,,,,,,,47690.99,83,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,47116.4,82,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,48840.18,85,,percent of total billed charges,,14364.76,54586.08,
ZIMMER TIBIAL PLATE NONMOD SZ 3,30188376,CDM,,,278,RC,outpatient,,28502.57,28502.57,,24198.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7125.64,22,,percent of total billed charges,,,,,,,,,25652.31,90,,percent of total billed charges,,,23600.13,82.8,,percent of total billed charges,,,24227.18,85,,percent of total billed charges,,,,,,,,,25082.26,88,,percent of total billed charges,,,,,,,,,21775.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7125.64,22,,percent of total billed charges,,,25937.34,91,,percent of total billed charges,,,27077.44,95,,percent of total billed charges,,,23657.13,83,,percent of total billed charges,,,23657.13,83,,percent of total billed charges,,,,,,,,,,,,,,,23657.13,83,,percent of total billed charges,,,27077.44,95,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,23372.11,82,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,24227.18,85,,percent of total billed charges,,7125.64,27077.44,
DEPUY GLENOID REAMER HEAD,30188377,CDM,,,278,RC,outpatient,,9490,9490,,8057.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2372.5,22,,percent of total billed charges,,,,,,,,,8541,90,,percent of total billed charges,,,7857.72,82.8,,percent of total billed charges,,,8066.5,85,,percent of total billed charges,,,,,,,,,8351.2,88,,percent of total billed charges,,,,,,,,,7250.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2372.5,22,,percent of total billed charges,,,8635.9,91,,percent of total billed charges,,,9015.5,95,,percent of total billed charges,,,7876.7,83,,percent of total billed charges,,,7876.7,83,,percent of total billed charges,,,,,,,,,,,,,,,7876.7,83,,percent of total billed charges,,,9015.5,95,,percent of total billed charges,,,8541,90,,percent of total billed charges,,,8541,90,,percent of total billed charges,,,7781.8,82,,percent of total billed charges,,,8541,90,,percent of total billed charges,,,8066.5,85,,percent of total billed charges,,2372.5,9015.5,
ZIMMER POLY CPS 10MM RIGHT,30188378,CDM,,,278,RC,outpatient,,17135.63,17135.63,,14548.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4283.91,22,,percent of total billed charges,,,,,,,,,15422.07,90,,percent of total billed charges,,,14188.3,82.8,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,,,,,,,,15079.35,88,,percent of total billed charges,,,,,,,,,13091.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4283.91,22,,percent of total billed charges,,,15593.42,91,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14222.57,83,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14051.22,82,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,4283.91,16278.85,
DEPUY REAMER SHAFT TIP,30188379,CDM,,,278,RC,outpatient,,3360.5,3360.5,,2853.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,840.13,22,,percent of total billed charges,,,,,,,,,3024.45,90,,percent of total billed charges,,,2782.49,82.8,,percent of total billed charges,,,2856.43,85,,percent of total billed charges,,,,,,,,,2957.24,88,,percent of total billed charges,,,,,,,,,2567.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,840.13,22,,percent of total billed charges,,,3058.06,91,,percent of total billed charges,,,3192.48,95,,percent of total billed charges,,,2789.22,83,,percent of total billed charges,,,2789.22,83,,percent of total billed charges,,,,,,,,,,,,,,,2789.22,83,,percent of total billed charges,,,3192.48,95,,percent of total billed charges,,,3024.45,90,,percent of total billed charges,,,3024.45,90,,percent of total billed charges,,,2755.61,82,,percent of total billed charges,,,3024.45,90,,percent of total billed charges,,,2856.43,85,,percent of total billed charges,,840.13,3192.48,
ARTHREX IMPLANT DELIVERY SYSTEM LNT 4.75,30188380,CDM,,,278,RC,outpatient,,5590,5590,,4745.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1397.5,22,,percent of total billed charges,,,,,,,,,5031,90,,percent of total billed charges,,,4628.52,82.8,,percent of total billed charges,,,4751.5,85,,percent of total billed charges,,,,,,,,,4919.2,88,,percent of total billed charges,,,,,,,,,4270.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1397.5,22,,percent of total billed charges,,,5086.9,91,,percent of total billed charges,,,5310.5,95,,percent of total billed charges,,,4639.7,83,,percent of total billed charges,,,4639.7,83,,percent of total billed charges,,,,,,,,,,,,,,,4639.7,83,,percent of total billed charges,,,5310.5,95,,percent of total billed charges,,,5031,90,,percent of total billed charges,,,5031,90,,percent of total billed charges,,,4583.8,82,,percent of total billed charges,,,5031,90,,percent of total billed charges,,,4751.5,85,,percent of total billed charges,,1397.5,5310.5,
SENSOR-URETERORENOCOPE 9FR DISP.,30188381,CDM,,,270,RC,outpatient,,8439.21,8439.21,,7164.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2109.8,22,,percent of total billed charges,,,,,,,,,7595.29,90,,percent of total billed charges,,,6987.67,82.8,,percent of total billed charges,,,7173.33,85,,percent of total billed charges,,,,,,,,,7426.5,88,,percent of total billed charges,,,,,,,,,6447.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2109.8,22,,percent of total billed charges,,,7679.68,91,,percent of total billed charges,,,8017.25,95,,percent of total billed charges,,,7004.54,83,,percent of total billed charges,,,7004.54,83,,percent of total billed charges,,,,,,,,,,,,,,,7004.54,83,,percent of total billed charges,,,8017.25,95,,percent of total billed charges,,,7595.29,90,,percent of total billed charges,,,7595.29,90,,percent of total billed charges,,,6920.15,82,,percent of total billed charges,,,7595.29,90,,percent of total billed charges,,,7173.33,85,,percent of total billed charges,,2109.8,8017.25,
STRYKER FEMUR CR #4 LEFT,30188382,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
STRYKER TIBIA TRIATHLON TRITANIUM SZ 4,30188383,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER PATELLA METAL BACK SZ 36 X 10MM,30188384,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
STRYKER RESTRICTOR CEMENT MEDIUM,30188385,CDM,,,278,RC,outpatient,,1001,1001,,849.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,250.25,22,,percent of total billed charges,,,,,,,,,900.9,90,,percent of total billed charges,,,828.83,82.8,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,,,,,,,,880.88,88,,percent of total billed charges,,,,,,,,,764.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,250.25,22,,percent of total billed charges,,,910.91,91,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,,,,,,,,,,,,,830.83,83,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,820.82,82,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,250.25,950.95,
STRYKER STEM CEMENTED SZ 7 132DEG,30188386,CDM,,,278,RC,outpatient,,11700,11700,,9933.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2925,22,,percent of total billed charges,,,,,,,,,10530,90,,percent of total billed charges,,,9687.6,82.8,,percent of total billed charges,,,9945,85,,percent of total billed charges,,,,,,,,,10296,88,,percent of total billed charges,,,,,,,,,8938.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2925,22,,percent of total billed charges,,,10647,91,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,,,,,,,,,,,,,9711,83,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9594,82,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9945,85,,percent of total billed charges,,2925,11115,
STRYKER CEMENT SPACER 15MM,30188387,CDM,,,278,RC,outpatient,,1001,1001,,849.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,250.25,22,,percent of total billed charges,,,,,,,,,900.9,90,,percent of total billed charges,,,828.83,82.8,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,,,,,,,,880.88,88,,percent of total billed charges,,,,,,,,,764.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,250.25,22,,percent of total billed charges,,,910.91,91,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,,,,,,,,,,,,,830.83,83,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,820.82,82,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,250.25,950.95,
STRYKER HEAD FEMORAL 26MM -3MM,30188388,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
ZIMMER SCREW NON-LOCK 2.7X18MM,30188389,CDM,,,278,RC,outpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
STRYKER STEM CEMENTED SZ 4 35X137MM,30188390,CDM,,,278,RC,outpatient,,11700,11700,,9933.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2925,22,,percent of total billed charges,,,,,,,,,10530,90,,percent of total billed charges,,,9687.6,82.8,,percent of total billed charges,,,9945,85,,percent of total billed charges,,,,,,,,,10296,88,,percent of total billed charges,,,,,,,,,8938.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2925,22,,percent of total billed charges,,,10647,91,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,,,,,,,,,,,,,9711,83,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9594,82,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9945,85,,percent of total billed charges,,2925,11115,
STRYKER HEAD 44X26MM,30188391,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
STRYKER SPACER CEMENT 11MM,30188392,CDM,,,278,RC,outpatient,,1001,1001,,849.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,250.25,22,,percent of total billed charges,,,,,,,,,900.9,90,,percent of total billed charges,,,828.83,82.8,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,,,,,,,,880.88,88,,percent of total billed charges,,,,,,,,,764.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,250.25,22,,percent of total billed charges,,,910.91,91,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,,,,,,,,,,,,,830.83,83,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,820.82,82,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,250.25,950.95,
ZIMMER FEMUR CEMENTLESS SZ 7 RIGHT,30188393,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER POLY RIGHT MC 12MM,30188394,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ZIMMER SHELL MULTIHOLE OSSEOTI G7 64MM I,30188395,CDM,,,278,RC,outpatient,,20962.5,20962.5,,17797.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5240.63,22,,percent of total billed charges,,,,,,,,,18866.25,90,,percent of total billed charges,,,17356.95,82.8,,percent of total billed charges,,,17818.13,85,,percent of total billed charges,,,,,,,,,18447,88,,percent of total billed charges,,,,,,,,,16015.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5240.63,22,,percent of total billed charges,,,19075.88,91,,percent of total billed charges,,,19914.38,95,,percent of total billed charges,,,17398.88,83,,percent of total billed charges,,,17398.88,83,,percent of total billed charges,,,,,,,,,,,,,,,17398.88,83,,percent of total billed charges,,,19914.38,95,,percent of total billed charges,,,18866.25,90,,percent of total billed charges,,,18866.25,90,,percent of total billed charges,,,17189.25,82,,percent of total billed charges,,,18866.25,90,,percent of total billed charges,,,17818.13,85,,percent of total billed charges,,5240.63,19914.38,
STRYKER FEMUR TRIATHLON CR SZ 5 RT,30188396,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
STRYKER TIBIA TRIATHLON TRITANIUM SZ 5,30188397,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
S&N ENDO SCREW BIOSURE 6 X 20,30188398,CDM,,,278,RC,outpatient,,1771.51,1771.51,,1504.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,442.88,22,,percent of total billed charges,,,,,,,,,1594.36,90,,percent of total billed charges,,,1466.81,82.8,,percent of total billed charges,,,1505.78,85,,percent of total billed charges,,,,,,,,,1558.93,88,,percent of total billed charges,,,,,,,,,1353.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,442.88,22,,percent of total billed charges,,,1612.07,91,,percent of total billed charges,,,1682.93,95,,percent of total billed charges,,,1470.35,83,,percent of total billed charges,,,1470.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1470.35,83,,percent of total billed charges,,,1682.93,95,,percent of total billed charges,,,1594.36,90,,percent of total billed charges,,,1594.36,90,,percent of total billed charges,,,1452.64,82,,percent of total billed charges,,,1594.36,90,,percent of total billed charges,,,1505.78,85,,percent of total billed charges,,442.88,1682.93,
S&N HEALICOIL KNOTLESS 5.0,30188399,CDM,,,278,RC,outpatient,,7566,7566,,6423.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1891.5,22,,percent of total billed charges,,,,,,,,,6809.4,90,,percent of total billed charges,,,6264.65,82.8,,percent of total billed charges,,,6431.1,85,,percent of total billed charges,,,,,,,,,6658.08,88,,percent of total billed charges,,,,,,,,,5780.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1891.5,22,,percent of total billed charges,,,6885.06,91,,percent of total billed charges,,,7187.7,95,,percent of total billed charges,,,6279.78,83,,percent of total billed charges,,,6279.78,83,,percent of total billed charges,,,,,,,,,,,,,,,6279.78,83,,percent of total billed charges,,,7187.7,95,,percent of total billed charges,,,6809.4,90,,percent of total billed charges,,,6809.4,90,,percent of total billed charges,,,6204.12,82,,percent of total billed charges,,,6809.4,90,,percent of total billed charges,,,6431.1,85,,percent of total billed charges,,1891.5,7187.7,
FORTEC FIBER HOLMIUM MP 200,30188400,CDM,,,270,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
ARTHREX GUIDE WIRE 1.6,30188401,CDM,,,278,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
ARTHREX REAMER MET,30188402,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
ARTHREX REAMER PHAL.,30188403,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
ARTHREX SCREW NL 3.0 X 16MM,30188404,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW NL 3.0 X 12MM,30188405,CDM,,,278,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ARTHREX SCREW VAL 3.0 X 20MM,30188406,CDM,,,278,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
ARTHREX SCREW VALL 3.0 X 16MM,30188407,CDM,,,278,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
ARTHREX COUNTERSINK,30188408,CDM,,,278,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
DEPUY SCREW CENTER METAGLENE 2MM,30188409,CDM,,,278,RC,outpatient,,32545.5,32545.5,,27631.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8136.38,22,,percent of total billed charges,,,,,,,,,29290.95,90,,percent of total billed charges,,,26947.67,82.8,,percent of total billed charges,,,27663.68,85,,percent of total billed charges,,,,,,,,,28640.04,88,,percent of total billed charges,,,,,,,,,24864.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8136.38,22,,percent of total billed charges,,,29616.41,91,,percent of total billed charges,,,30918.23,95,,percent of total billed charges,,,27012.77,83,,percent of total billed charges,,,27012.77,83,,percent of total billed charges,,,,,,,,,,,,,,,27012.77,83,,percent of total billed charges,,,30918.23,95,,percent of total billed charges,,,29290.95,90,,percent of total billed charges,,,29290.95,90,,percent of total billed charges,,,26687.31,82,,percent of total billed charges,,,29290.95,90,,percent of total billed charges,,,27663.68,85,,percent of total billed charges,,8136.38,30918.23,
DEPUY SCREW CENTER METAGLENE 6C30MM,30188410,CDM,,,278,RC,outpatient,,5772,5772,,4900.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1443,22,,percent of total billed charges,,,,,,,,,5194.8,90,,percent of total billed charges,,,4779.22,82.8,,percent of total billed charges,,,4906.2,85,,percent of total billed charges,,,,,,,,,5079.36,88,,percent of total billed charges,,,,,,,,,4409.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1443,22,,percent of total billed charges,,,5252.52,91,,percent of total billed charges,,,5483.4,95,,percent of total billed charges,,,4790.76,83,,percent of total billed charges,,,4790.76,83,,percent of total billed charges,,,,,,,,,,,,,,,4790.76,83,,percent of total billed charges,,,5483.4,95,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,4733.04,82,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,4906.2,85,,percent of total billed charges,,1443,5483.4,
DEPUY SCREW CENTER METAGLENE COLLET,30188411,CDM,,,278,RC,outpatient,,5687.5,5687.5,,4828.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1421.88,22,,percent of total billed charges,,,,,,,,,5118.75,90,,percent of total billed charges,,,4709.25,82.8,,percent of total billed charges,,,4834.38,85,,percent of total billed charges,,,,,,,,,5005,88,,percent of total billed charges,,,,,,,,,4345.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1421.88,22,,percent of total billed charges,,,5175.63,91,,percent of total billed charges,,,5403.13,95,,percent of total billed charges,,,4720.63,83,,percent of total billed charges,,,4720.63,83,,percent of total billed charges,,,,,,,,,,,,,,,4720.63,83,,percent of total billed charges,,,5403.13,95,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,4663.75,82,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,4834.38,85,,percent of total billed charges,,1421.88,5403.13,
SHEATH CLEAR RENAL,30188413,CDM,,,270,RC,outpatient,,470.82,470.82,,399.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.71,22,,percent of total billed charges,,,,,,,,,423.74,90,,percent of total billed charges,,,389.84,82.8,,percent of total billed charges,,,400.2,85,,percent of total billed charges,,,,,,,,,414.32,88,,percent of total billed charges,,,,,,,,,359.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.71,22,,percent of total billed charges,,,428.45,91,,percent of total billed charges,,,447.28,95,,percent of total billed charges,,,390.78,83,,percent of total billed charges,,,390.78,83,,percent of total billed charges,,,,,,,,,,,,,,,390.78,83,,percent of total billed charges,,,447.28,95,,percent of total billed charges,,,423.74,90,,percent of total billed charges,,,423.74,90,,percent of total billed charges,,,386.07,82,,percent of total billed charges,,,423.74,90,,percent of total billed charges,,,400.2,85,,percent of total billed charges,,117.71,447.28,
CATHETER OCCLUDER BALLOON 26FR 65CM,30188414,CDM,,,270,RC,outpatient,,920.27,920.27,,781.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,230.07,22,,percent of total billed charges,,,,,,,,,828.24,90,,percent of total billed charges,,,761.98,82.8,,percent of total billed charges,,,782.23,85,,percent of total billed charges,,,,,,,,,809.84,88,,percent of total billed charges,,,,,,,,,703.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,230.07,22,,percent of total billed charges,,,837.45,91,,percent of total billed charges,,,874.26,95,,percent of total billed charges,,,763.82,83,,percent of total billed charges,,,763.82,83,,percent of total billed charges,,,,,,,,,,,,,,,763.82,83,,percent of total billed charges,,,874.26,95,,percent of total billed charges,,,828.24,90,,percent of total billed charges,,,828.24,90,,percent of total billed charges,,,754.62,82,,percent of total billed charges,,,828.24,90,,percent of total billed charges,,,782.23,85,,percent of total billed charges,,230.07,874.26,
STONE RETRIEVAL BASKET SEGURA HEMOSPHERE,30188415,CDM,,,270,RC,outpatient,,1178.78,1178.78,,1000.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,294.7,22,,percent of total billed charges,,,,,,,,,1060.9,90,,percent of total billed charges,,,976.03,82.8,,percent of total billed charges,,,1001.96,85,,percent of total billed charges,,,,,,,,,1037.33,88,,percent of total billed charges,,,,,,,,,900.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,294.7,22,,percent of total billed charges,,,1072.69,91,,percent of total billed charges,,,1119.84,95,,percent of total billed charges,,,978.39,83,,percent of total billed charges,,,978.39,83,,percent of total billed charges,,,,,,,,,,,,,,,978.39,83,,percent of total billed charges,,,1119.84,95,,percent of total billed charges,,,1060.9,90,,percent of total billed charges,,,1060.9,90,,percent of total billed charges,,,966.6,82,,percent of total billed charges,,,1060.9,90,,percent of total billed charges,,,1001.96,85,,percent of total billed charges,,294.7,1119.84,
ZIMMER SHELL LINER G7 40MM +5MM,30188416,CDM,,,278,RC,outpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2551.25,22,,percent of total billed charges,,,,,,,,,9184.5,90,,percent of total billed charges,,,8449.74,82.8,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2551.25,22,,percent of total billed charges,,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,2551.25,9694.75,
ZIMMER SCREW FEMALE 2.5 X 25MM,30188417,CDM,,,278,RC,outpatient,,1072.5,1072.5,,910.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,268.13,22,,percent of total billed charges,,,,,,,,,965.25,90,,percent of total billed charges,,,888.03,82.8,,percent of total billed charges,,,911.63,85,,percent of total billed charges,,,,,,,,,943.8,88,,percent of total billed charges,,,,,,,,,819.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,268.13,22,,percent of total billed charges,,,975.98,91,,percent of total billed charges,,,1018.88,95,,percent of total billed charges,,,890.18,83,,percent of total billed charges,,,890.18,83,,percent of total billed charges,,,,,,,,,,,,,,,890.18,83,,percent of total billed charges,,,1018.88,95,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,879.45,82,,percent of total billed charges,,,965.25,90,,percent of total billed charges,,,911.63,85,,percent of total billed charges,,268.13,1018.88,
COOK CAPTURA 3-PRONG GRASPER,30188418,CDM,,,270,RC,outpatient,,1247.81,1247.81,,1059.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,311.95,22,,percent of total billed charges,,,,,,,,,1123.03,90,,percent of total billed charges,,,1033.19,82.8,,percent of total billed charges,,,1060.64,85,,percent of total billed charges,,,,,,,,,1098.07,88,,percent of total billed charges,,,,,,,,,953.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,311.95,22,,percent of total billed charges,,,1135.51,91,,percent of total billed charges,,,1185.42,95,,percent of total billed charges,,,1035.68,83,,percent of total billed charges,,,1035.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1035.68,83,,percent of total billed charges,,,1185.42,95,,percent of total billed charges,,,1123.03,90,,percent of total billed charges,,,1123.03,90,,percent of total billed charges,,,1023.2,82,,percent of total billed charges,,,1123.03,90,,percent of total billed charges,,,1060.64,85,,percent of total billed charges,,311.95,1185.42,
BOSTON AMPLATZ DILATOR/SHEATH SET 8-30F,30188419,CDM,,,270,RC,outpatient,,1385.61,1385.61,,1176.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,346.4,22,,percent of total billed charges,,,,,,,,,1247.05,90,,percent of total billed charges,,,1147.29,82.8,,percent of total billed charges,,,1177.77,85,,percent of total billed charges,,,,,,,,,1219.34,88,,percent of total billed charges,,,,,,,,,1058.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,346.4,22,,percent of total billed charges,,,1260.91,91,,percent of total billed charges,,,1316.33,95,,percent of total billed charges,,,1150.06,83,,percent of total billed charges,,,1150.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1150.06,83,,percent of total billed charges,,,1316.33,95,,percent of total billed charges,,,1247.05,90,,percent of total billed charges,,,1247.05,90,,percent of total billed charges,,,1136.2,82,,percent of total billed charges,,,1247.05,90,,percent of total billed charges,,,1177.77,85,,percent of total billed charges,,346.4,1316.33,
BOSTON CATH MALICOT RE-ENTRY NEPHROSTOMY,30188420,CDM,,,270,RC,outpatient,,502.53,502.53,,426.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125.63,22,,percent of total billed charges,,,,,,,,,452.28,90,,percent of total billed charges,,,416.09,82.8,,percent of total billed charges,,,427.15,85,,percent of total billed charges,,,,,,,,,442.23,88,,percent of total billed charges,,,,,,,,,383.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125.63,22,,percent of total billed charges,,,457.3,91,,percent of total billed charges,,,477.4,95,,percent of total billed charges,,,417.1,83,,percent of total billed charges,,,417.1,83,,percent of total billed charges,,,,,,,,,,,,,,,417.1,83,,percent of total billed charges,,,477.4,95,,percent of total billed charges,,,452.28,90,,percent of total billed charges,,,452.28,90,,percent of total billed charges,,,412.07,82,,percent of total billed charges,,,452.28,90,,percent of total billed charges,,,427.15,85,,percent of total billed charges,,125.63,477.4,
BOSTON BALLOON CLEAR NEPHROMAX HIGH PRES,30188421,CDM,,,270,RC,outpatient,,1778.01,1778.01,,1509.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,444.5,22,,percent of total billed charges,,,,,,,,,1600.21,90,,percent of total billed charges,,,1472.19,82.8,,percent of total billed charges,,,1511.31,85,,percent of total billed charges,,,,,,,,,1564.65,88,,percent of total billed charges,,,,,,,,,1358.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,444.5,22,,percent of total billed charges,,,1617.99,91,,percent of total billed charges,,,1689.11,95,,percent of total billed charges,,,1475.75,83,,percent of total billed charges,,,1475.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1475.75,83,,percent of total billed charges,,,1689.11,95,,percent of total billed charges,,,1600.21,90,,percent of total billed charges,,,1600.21,90,,percent of total billed charges,,,1457.97,82,,percent of total billed charges,,,1600.21,90,,percent of total billed charges,,,1511.31,85,,percent of total billed charges,,444.5,1689.11,
BOSTON CATHETER BERN 65CM TORQUEABLE,30188422,CDM,,,270,RC,outpatient,,140.64,140.64,,119.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.16,22,,percent of total billed charges,,,,,,,,,126.58,90,,percent of total billed charges,,,116.45,82.8,,percent of total billed charges,,,119.54,85,,percent of total billed charges,,,,,,,,,123.76,88,,percent of total billed charges,,,,,,,,,107.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.16,22,,percent of total billed charges,,,127.98,91,,percent of total billed charges,,,133.61,95,,percent of total billed charges,,,116.73,83,,percent of total billed charges,,,116.73,83,,percent of total billed charges,,,,,,,,,,,,,,,116.73,83,,percent of total billed charges,,,133.61,95,,percent of total billed charges,,,126.58,90,,percent of total billed charges,,,126.58,90,,percent of total billed charges,,,115.32,82,,percent of total billed charges,,,126.58,90,,percent of total billed charges,,,119.54,85,,percent of total billed charges,,35.16,133.61,
BOSTON DILATOR/SHEATH SET 8-10F,30188423,CDM,,,270,RC,outpatient,,369.83,369.83,,313.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.46,22,,percent of total billed charges,,,,,,,,,332.85,90,,percent of total billed charges,,,306.22,82.8,,percent of total billed charges,,,314.36,85,,percent of total billed charges,,,,,,,,,325.45,88,,percent of total billed charges,,,,,,,,,282.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.46,22,,percent of total billed charges,,,336.55,91,,percent of total billed charges,,,351.34,95,,percent of total billed charges,,,306.96,83,,percent of total billed charges,,,306.96,83,,percent of total billed charges,,,,,,,,,,,,,,,306.96,83,,percent of total billed charges,,,351.34,95,,percent of total billed charges,,,332.85,90,,percent of total billed charges,,,332.85,90,,percent of total billed charges,,,303.26,82,,percent of total billed charges,,,332.85,90,,percent of total billed charges,,,314.36,85,,percent of total billed charges,,92.46,351.34,
ARTHREX ANCHOR DBLE LOADED W/TAPES 5.5,30188424,CDM,,,270,RC,outpatient,,2307.5,2307.5,,1959.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,576.88,22,,percent of total billed charges,,,,,,,,,2076.75,90,,percent of total billed charges,,,1910.61,82.8,,percent of total billed charges,,,1961.38,85,,percent of total billed charges,,,,,,,,,2030.6,88,,percent of total billed charges,,,,,,,,,1762.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,576.88,22,,percent of total billed charges,,,2099.83,91,,percent of total billed charges,,,2192.13,95,,percent of total billed charges,,,1915.23,83,,percent of total billed charges,,,1915.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1915.23,83,,percent of total billed charges,,,2192.13,95,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,1892.15,82,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,1961.38,85,,percent of total billed charges,,576.88,2192.13,
ARTHREX ANCHOR DBLE LOADED W/TAPES 4.75,30188425,CDM,,,270,RC,outpatient,,2307.5,2307.5,,1959.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,576.88,22,,percent of total billed charges,,,,,,,,,2076.75,90,,percent of total billed charges,,,1910.61,82.8,,percent of total billed charges,,,1961.38,85,,percent of total billed charges,,,,,,,,,2030.6,88,,percent of total billed charges,,,,,,,,,1762.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,576.88,22,,percent of total billed charges,,,2099.83,91,,percent of total billed charges,,,2192.13,95,,percent of total billed charges,,,1915.23,83,,percent of total billed charges,,,1915.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1915.23,83,,percent of total billed charges,,,2192.13,95,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,1892.15,82,,percent of total billed charges,,,2076.75,90,,percent of total billed charges,,,1961.38,85,,percent of total billed charges,,576.88,2192.13,
ARTHREX ANCHOR BAILOUT,30188426,CDM,,,270,RC,outpatient,,2827.5,2827.5,,2400.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,706.88,22,,percent of total billed charges,,,,,,,,,2544.75,90,,percent of total billed charges,,,2341.17,82.8,,percent of total billed charges,,,2403.38,85,,percent of total billed charges,,,,,,,,,2488.2,88,,percent of total billed charges,,,,,,,,,2160.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,706.88,22,,percent of total billed charges,,,2573.03,91,,percent of total billed charges,,,2686.13,95,,percent of total billed charges,,,2346.83,83,,percent of total billed charges,,,2346.83,83,,percent of total billed charges,,,,,,,,,,,,,,,2346.83,83,,percent of total billed charges,,,2686.13,95,,percent of total billed charges,,,2544.75,90,,percent of total billed charges,,,2544.75,90,,percent of total billed charges,,,2318.55,82,,percent of total billed charges,,,2544.75,90,,percent of total billed charges,,,2403.38,85,,percent of total billed charges,,706.88,2686.13,
ARTHREX SUTURE ANCHOR SUTURETAK 2.4 X 12,30188427,CDM,,,270,RC,outpatient,,1982.5,1982.5,,1683.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,495.63,22,,percent of total billed charges,,,,,,,,,1784.25,90,,percent of total billed charges,,,1641.51,82.8,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,,,,,,,,1744.6,88,,percent of total billed charges,,,,,,,,,1514.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,495.63,22,,percent of total billed charges,,,1804.08,91,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,1645.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1645.48,83,,percent of total billed charges,,,1883.38,95,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1625.65,82,,percent of total billed charges,,,1784.25,90,,percent of total billed charges,,,1685.13,85,,percent of total billed charges,,495.63,1883.38,
ARTHREX FIBERTAK SUTURE ANCHOR W1.3MM SU,30188428,CDM,,,270,RC,outpatient,,2405,2405,,2041.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,601.25,22,,percent of total billed charges,,,,,,,,,2164.5,90,,percent of total billed charges,,,1991.34,82.8,,percent of total billed charges,,,2044.25,85,,percent of total billed charges,,,,,,,,,2116.4,88,,percent of total billed charges,,,,,,,,,1837.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,601.25,22,,percent of total billed charges,,,2188.55,91,,percent of total billed charges,,,2284.75,95,,percent of total billed charges,,,1996.15,83,,percent of total billed charges,,,1996.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1996.15,83,,percent of total billed charges,,,2284.75,95,,percent of total billed charges,,,2164.5,90,,percent of total billed charges,,,2164.5,90,,percent of total billed charges,,,1972.1,82,,percent of total billed charges,,,2164.5,90,,percent of total billed charges,,,2044.25,85,,percent of total billed charges,,601.25,2284.75,
ARTHREX FIBERTAK DRILL STRAIGHT,30188429,CDM,,,270,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
ARTHREX SWIVELOCK BC 5.5X24.5MM,30188430,CDM,,,270,RC,outpatient,,2730,2730,,2317.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,682.5,22,,percent of total billed charges,,,,,,,,,2457,90,,percent of total billed charges,,,2260.44,82.8,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,,,,,,,,2402.4,88,,percent of total billed charges,,,,,,,,,2085.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,682.5,22,,percent of total billed charges,,,2484.3,91,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2265.9,83,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2238.6,82,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,682.5,2593.5,
ARTHREX BIO-SUTURE TAK KIT 2.4MM,30188431,CDM,,,270,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
STRYKER INSERT X3 36MM ID,30188432,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER CUP CLUSTERHOLE 60G,30188433,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
STRYKER STEM CEMENTED 132NK,30188434,CDM,,,278,RC,outpatient,,11700,11700,,9933.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2925,22,,percent of total billed charges,,,,,,,,,10530,90,,percent of total billed charges,,,9687.6,82.8,,percent of total billed charges,,,9945,85,,percent of total billed charges,,,,,,,,,10296,88,,percent of total billed charges,,,,,,,,,8938.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2925,22,,percent of total billed charges,,,10647,91,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,,,,,,,,,,,,,9711,83,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9594,82,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9945,85,,percent of total billed charges,,2925,11115,
STRYKER HEAD COCR 26MM +4,30188435,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
STRYKER HEAD BIPOLAR 26MM X 50MM,30188436,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
STRYKER NAIL GAMMA 10X170MM 130DEG,30188437,CDM,,,278,RC,outpatient,,16162.58,16162.58,,13722.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4040.65,22,,percent of total billed charges,,,,,,,,,14546.32,90,,percent of total billed charges,,,13382.62,82.8,,percent of total billed charges,,,13738.19,85,,percent of total billed charges,,,,,,,,,14223.07,88,,percent of total billed charges,,,,,,,,,12348.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4040.65,22,,percent of total billed charges,,,14707.95,91,,percent of total billed charges,,,15354.45,95,,percent of total billed charges,,,13414.94,83,,percent of total billed charges,,,13414.94,83,,percent of total billed charges,,,,,,,,,,,,,,,13414.94,83,,percent of total billed charges,,,15354.45,95,,percent of total billed charges,,,14546.32,90,,percent of total billed charges,,,14546.32,90,,percent of total billed charges,,,13253.32,82,,percent of total billed charges,,,14546.32,90,,percent of total billed charges,,,13738.19,85,,percent of total billed charges,,4040.65,15354.45,
STRYKER SCREW FT 5X30MM,30188438,CDM,,,278,RC,outpatient,,1774.37,1774.37,,1506.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,443.59,22,,percent of total billed charges,,,,,,,,,1596.93,90,,percent of total billed charges,,,1469.18,82.8,,percent of total billed charges,,,1508.21,85,,percent of total billed charges,,,,,,,,,1561.45,88,,percent of total billed charges,,,,,,,,,1355.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,443.59,22,,percent of total billed charges,,,1614.68,91,,percent of total billed charges,,,1685.65,95,,percent of total billed charges,,,1472.73,83,,percent of total billed charges,,,1472.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1472.73,83,,percent of total billed charges,,,1685.65,95,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1454.98,82,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1508.21,85,,percent of total billed charges,,443.59,1685.65,
ZIMMER PLATE TIBIAL SZ I ROTATING HINGE,30188439,CDM,,,278,RC,outpatient,,28502.57,28502.57,,24198.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7125.64,22,,percent of total billed charges,,,,,,,,,25652.31,90,,percent of total billed charges,,,23600.13,82.8,,percent of total billed charges,,,24227.18,85,,percent of total billed charges,,,,,,,,,25082.26,88,,percent of total billed charges,,,,,,,,,21775.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7125.64,22,,percent of total billed charges,,,25937.34,91,,percent of total billed charges,,,27077.44,95,,percent of total billed charges,,,23657.13,83,,percent of total billed charges,,,23657.13,83,,percent of total billed charges,,,,,,,,,,,,,,,23657.13,83,,percent of total billed charges,,,27077.44,95,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,23372.11,82,,percent of total billed charges,,,25652.31,90,,percent of total billed charges,,,24227.18,85,,percent of total billed charges,,7125.64,27077.44,
ZIMMER FEMUR ROTATING HINGE SZ C RIGHT,30188440,CDM,,,278,RC,outpatient,,57459.03,57459.03,,48782.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14364.76,22,,percent of total billed charges,,,,,,,,,51713.13,90,,percent of total billed charges,,,47576.08,82.8,,percent of total billed charges,,,48840.18,85,,percent of total billed charges,,,,,,,,,50563.95,88,,percent of total billed charges,,,,,,,,,43898.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14364.76,22,,percent of total billed charges,,,52287.72,91,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,47690.99,83,,percent of total billed charges,,,,,,,,,,,,,,,47690.99,83,,percent of total billed charges,,,54586.08,95,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,47116.4,82,,percent of total billed charges,,,51713.13,90,,percent of total billed charges,,,48840.18,85,,percent of total billed charges,,14364.76,54586.08,
ZIMMER SURFACE RHA SZ C 12MM,30188441,CDM,,,278,RC,outpatient,,12617.41,12617.41,,10712.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3154.35,22,,percent of total billed charges,,,,,,,,,11355.67,90,,percent of total billed charges,,,10447.22,82.8,,percent of total billed charges,,,10724.8,85,,percent of total billed charges,,,,,,,,,11103.32,88,,percent of total billed charges,,,,,,,,,9639.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3154.35,22,,percent of total billed charges,,,11481.84,91,,percent of total billed charges,,,11986.54,95,,percent of total billed charges,,,10472.45,83,,percent of total billed charges,,,10472.45,83,,percent of total billed charges,,,,,,,,,,,,,,,10472.45,83,,percent of total billed charges,,,11986.54,95,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,10346.28,82,,percent of total billed charges,,,11355.67,90,,percent of total billed charges,,,10724.8,85,,percent of total billed charges,,3154.35,11986.54,
ZIMMER SURFACE SEGMENTAL ART SZ C 12MM,30188442,CDM,,,278,RC,outpatient,,13434.33,13434.33,,11405.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3358.58,22,,percent of total billed charges,,,,,,,,,12090.9,90,,percent of total billed charges,,,11123.63,82.8,,percent of total billed charges,,,11419.18,85,,percent of total billed charges,,,,,,,,,11822.21,88,,percent of total billed charges,,,,,,,,,10263.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3358.58,22,,percent of total billed charges,,,12225.24,91,,percent of total billed charges,,,12762.61,95,,percent of total billed charges,,,11150.49,83,,percent of total billed charges,,,11150.49,83,,percent of total billed charges,,,,,,,,,,,,,,,11150.49,83,,percent of total billed charges,,,12762.61,95,,percent of total billed charges,,,12090.9,90,,percent of total billed charges,,,12090.9,90,,percent of total billed charges,,,11016.15,82,,percent of total billed charges,,,12090.9,90,,percent of total billed charges,,,11419.18,85,,percent of total billed charges,,3358.58,12762.61,
ZIMMER FEMORAL BONE CEMENT PREP KIT,30188443,CDM,,,278,RC,outpatient,,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208,22,,percent of total billed charges,,,,,,,,,748.8,90,,percent of total billed charges,,,688.9,82.8,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208,22,,percent of total billed charges,,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,208,790.4,
ZIMMER SCREWDRIVER 2MM HEX,30188444,CDM,,,278,RC,outpatient,,567,567,,481.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141.75,22,,percent of total billed charges,,,,,,,,,510.3,90,,percent of total billed charges,,,469.48,82.8,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,,,,,,,,498.96,88,,percent of total billed charges,,,,,,,,,433.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141.75,22,,percent of total billed charges,,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,,,,,,,,,,,,,470.61,83,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,464.94,82,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,141.75,538.65,
ARTHREX FIBERTAK RC SUTURE ANCHOR WHITE/,30188445,CDM,,,278,RC,outpatient,,3055,3055,,2593.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,763.75,22,,percent of total billed charges,,,,,,,,,2749.5,90,,percent of total billed charges,,,2529.54,82.8,,percent of total billed charges,,,2596.75,85,,percent of total billed charges,,,,,,,,,2688.4,88,,percent of total billed charges,,,,,,,,,2334.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,763.75,22,,percent of total billed charges,,,2780.05,91,,percent of total billed charges,,,2902.25,95,,percent of total billed charges,,,2535.65,83,,percent of total billed charges,,,2535.65,83,,percent of total billed charges,,,,,,,,,,,,,,,2535.65,83,,percent of total billed charges,,,2902.25,95,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2505.1,82,,percent of total billed charges,,,2749.5,90,,percent of total billed charges,,,2596.75,85,,percent of total billed charges,,763.75,2902.25,
ARTHREX DISPOSABLE INSTRUMENT KIT,30188446,CDM,,,270,RC,outpatient,,1917.5,1917.5,,1627.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.38,22,,percent of total billed charges,,,,,,,,,1725.75,90,,percent of total billed charges,,,1587.69,82.8,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,,,,,,,,1687.4,88,,percent of total billed charges,,,,,,,,,1464.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.38,22,,percent of total billed charges,,,1744.93,91,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,1591.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1591.53,83,,percent of total billed charges,,,1821.63,95,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1572.35,82,,percent of total billed charges,,,1725.75,90,,percent of total billed charges,,,1629.88,85,,percent of total billed charges,,479.38,1821.63,
ZIMMER DRILL CANNULATED 2.7MM,30188447,CDM,,,278,RC,outpatient,,3299.34,3299.34,,2801.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,824.84,22,,percent of total billed charges,,,,,,,,,2969.41,90,,percent of total billed charges,,,2731.85,82.8,,percent of total billed charges,,,2804.44,85,,percent of total billed charges,,,,,,,,,2903.42,88,,percent of total billed charges,,,,,,,,,2520.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,824.84,22,,percent of total billed charges,,,3002.4,91,,percent of total billed charges,,,3134.37,95,,percent of total billed charges,,,2738.45,83,,percent of total billed charges,,,2738.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2738.45,83,,percent of total billed charges,,,3134.37,95,,percent of total billed charges,,,2969.41,90,,percent of total billed charges,,,2969.41,90,,percent of total billed charges,,,2705.46,82,,percent of total billed charges,,,2969.41,90,,percent of total billed charges,,,2804.44,85,,percent of total billed charges,,824.84,3134.37,
ZIMMER SCREW CANNULATED 4.0 X48MM,30188448,CDM,,,278,RC,outpatient,,1164.8,1164.8,,988.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,291.2,22,,percent of total billed charges,,,,,,,,,1048.32,90,,percent of total billed charges,,,964.45,82.8,,percent of total billed charges,,,990.08,85,,percent of total billed charges,,,,,,,,,1025.02,88,,percent of total billed charges,,,,,,,,,889.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,291.2,22,,percent of total billed charges,,,1059.97,91,,percent of total billed charges,,,1106.56,95,,percent of total billed charges,,,966.78,83,,percent of total billed charges,,,966.78,83,,percent of total billed charges,,,,,,,,,,,,,,,966.78,83,,percent of total billed charges,,,1106.56,95,,percent of total billed charges,,,1048.32,90,,percent of total billed charges,,,1048.32,90,,percent of total billed charges,,,955.14,82,,percent of total billed charges,,,1048.32,90,,percent of total billed charges,,,990.08,85,,percent of total billed charges,,291.2,1106.56,
ZIMMER PLATE LOCKING FIBULA 4H 80MM LT,30188449,CDM,,,278,RC,outpatient,,4006.34,4006.34,,3401.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1001.59,22,,percent of total billed charges,,,,,,,,,3605.71,90,,percent of total billed charges,,,3317.25,82.8,,percent of total billed charges,,,3405.39,85,,percent of total billed charges,,,,,,,,,3525.58,88,,percent of total billed charges,,,,,,,,,3060.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1001.59,22,,percent of total billed charges,,,3645.77,91,,percent of total billed charges,,,3806.02,95,,percent of total billed charges,,,3325.26,83,,percent of total billed charges,,,3325.26,83,,percent of total billed charges,,,,,,,,,,,,,,,3325.26,83,,percent of total billed charges,,,3806.02,95,,percent of total billed charges,,,3605.71,90,,percent of total billed charges,,,3605.71,90,,percent of total billed charges,,,3285.2,82,,percent of total billed charges,,,3605.71,90,,percent of total billed charges,,,3405.39,85,,percent of total billed charges,,1001.59,3806.02,
ZIMMER WASHER,30188450,CDM,,,278,RC,outpatient,,276.9,276.9,,235.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.23,22,,percent of total billed charges,,,,,,,,,249.21,90,,percent of total billed charges,,,229.27,82.8,,percent of total billed charges,,,235.37,85,,percent of total billed charges,,,,,,,,,243.67,88,,percent of total billed charges,,,,,,,,,211.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.23,22,,percent of total billed charges,,,251.98,91,,percent of total billed charges,,,263.06,95,,percent of total billed charges,,,229.83,83,,percent of total billed charges,,,229.83,83,,percent of total billed charges,,,,,,,,,,,,,,,229.83,83,,percent of total billed charges,,,263.06,95,,percent of total billed charges,,,249.21,90,,percent of total billed charges,,,249.21,90,,percent of total billed charges,,,227.06,82,,percent of total billed charges,,,249.21,90,,percent of total billed charges,,,235.37,85,,percent of total billed charges,,69.23,263.06,
ZIMMER DRILL STANDARD 2.7MM,30188451,CDM,,,278,RC,outpatient,,853.72,853.72,,724.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,213.43,22,,percent of total billed charges,,,,,,,,,768.35,90,,percent of total billed charges,,,706.88,82.8,,percent of total billed charges,,,725.66,85,,percent of total billed charges,,,,,,,,,751.27,88,,percent of total billed charges,,,,,,,,,652.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,213.43,22,,percent of total billed charges,,,776.89,91,,percent of total billed charges,,,811.03,95,,percent of total billed charges,,,708.59,83,,percent of total billed charges,,,708.59,83,,percent of total billed charges,,,,,,,,,,,,,,,708.59,83,,percent of total billed charges,,,811.03,95,,percent of total billed charges,,,768.35,90,,percent of total billed charges,,,768.35,90,,percent of total billed charges,,,700.05,82,,percent of total billed charges,,,768.35,90,,percent of total billed charges,,,725.66,85,,percent of total billed charges,,213.43,811.03,
STRYKER CUP CLUSTERHOLE 52E,30188452,CDM,,,278,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
MEDTRONIC ELECTRODE 2-CHANNEL SUBDERMAL,30188453,CDM,,,270,RC,outpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.88,22,,percent of total billed charges,,,,,,,,,330.75,90,,percent of total billed charges,,,304.29,82.8,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.88,22,,percent of total billed charges,,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,91.88,349.13,
COOK SEIDMAN ANTEGRADE STENT SET,30188454,CDM,,,270,RC,outpatient,,693.77,693.77,,589.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,173.44,22,,percent of total billed charges,,,,,,,,,624.39,90,,percent of total billed charges,,,574.44,82.8,,percent of total billed charges,,,589.7,85,,percent of total billed charges,,,,,,,,,610.52,88,,percent of total billed charges,,,,,,,,,530.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,173.44,22,,percent of total billed charges,,,631.33,91,,percent of total billed charges,,,659.08,95,,percent of total billed charges,,,575.83,83,,percent of total billed charges,,,575.83,83,,percent of total billed charges,,,,,,,,,,,,,,,575.83,83,,percent of total billed charges,,,659.08,95,,percent of total billed charges,,,624.39,90,,percent of total billed charges,,,624.39,90,,percent of total billed charges,,,568.89,82,,percent of total billed charges,,,624.39,90,,percent of total billed charges,,,589.7,85,,percent of total billed charges,,173.44,659.08,
ZIMMER TIBIA SZ E LEFT,30188456,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
STRYKER LINER CEMENTLESS E 42MM,30188457,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER BIOLOX FEMORAL HEAD 28MM,30188458,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
STRYKER INSERT RESTORATION ADM/MDM 28MM,30188459,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
ARTHREX FIBERTAK PERCUTANEOUS INSERTION,30188460,CDM,,,270,RC,outpatient,,1462.5,1462.5,,1241.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.63,22,,percent of total billed charges,,,,,,,,,1316.25,90,,percent of total billed charges,,,1210.95,82.8,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,,,,,,,,1287,88,,percent of total billed charges,,,,,,,,,1117.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.63,22,,percent of total billed charges,,,1330.88,91,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,1213.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1213.88,83,,percent of total billed charges,,,1389.38,95,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1199.25,82,,percent of total billed charges,,,1316.25,90,,percent of total billed charges,,,1243.13,85,,percent of total billed charges,,365.63,1389.38,
ARTHREX PASSPORT BUTTON CANNULA 12X5,30188461,CDM,,,278,RC,outpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,105,22,,percent of total billed charges,,,,,,,,,378,90,,percent of total billed charges,,,347.76,82.8,,percent of total billed charges,,,357,85,,percent of total billed charges,,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,105,22,,percent of total billed charges,,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,105,399,
ARTHREX TIGERLINK SUTURE 0.9MM,30188462,CDM,,,278,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
ARTHREX FIBERWIRE SUTURE 0,30188463,CDM,,,278,RC,outpatient,,168,168,,142.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42,22,,percent of total billed charges,,,,,,,,,151.2,90,,percent of total billed charges,,,139.1,82.8,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,,,,,,,,147.84,88,,percent of total billed charges,,,,,,,,,128.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42,22,,percent of total billed charges,,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,,,,,,,,,,,,,139.44,83,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,137.76,82,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,42,159.6,
ARTHREX GRAFT SPREADER,30188464,CDM,,,270,RC,outpatient,,2437.5,2437.5,,2069.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,609.38,22,,percent of total billed charges,,,,,,,,,2193.75,90,,percent of total billed charges,,,2018.25,82.8,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,,,,,,,,2145,88,,percent of total billed charges,,,,,,,,,1862.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,609.38,22,,percent of total billed charges,,,2218.13,91,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2023.13,83,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,1998.75,82,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,609.38,2315.63,
ARTHREX TISSUE TAK TENDON ANCHOR,30188465,CDM,,,278,RC,outpatient,,5687.5,5687.5,,4828.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1421.88,22,,percent of total billed charges,,,,,,,,,5118.75,90,,percent of total billed charges,,,4709.25,82.8,,percent of total billed charges,,,4834.38,85,,percent of total billed charges,,,,,,,,,5005,88,,percent of total billed charges,,,,,,,,,4345.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1421.88,22,,percent of total billed charges,,,5175.63,91,,percent of total billed charges,,,5403.13,95,,percent of total billed charges,,,4720.63,83,,percent of total billed charges,,,4720.63,83,,percent of total billed charges,,,,,,,,,,,,,,,4720.63,83,,percent of total billed charges,,,5403.13,95,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,4663.75,82,,percent of total billed charges,,,5118.75,90,,percent of total billed charges,,,4834.38,85,,percent of total billed charges,,1421.88,5403.13,
DEPUY OSTEOTOME FLAT SHORT,30188466,CDM,,,278,RC,outpatient,,3107,3107,,2637.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,776.75,22,,percent of total billed charges,,,,,,,,,2796.3,90,,percent of total billed charges,,,2572.6,82.8,,percent of total billed charges,,,2640.95,85,,percent of total billed charges,,,,,,,,,2734.16,88,,percent of total billed charges,,,,,,,,,2373.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,776.75,22,,percent of total billed charges,,,2827.37,91,,percent of total billed charges,,,2951.65,95,,percent of total billed charges,,,2578.81,83,,percent of total billed charges,,,2578.81,83,,percent of total billed charges,,,,,,,,,,,,,,,2578.81,83,,percent of total billed charges,,,2951.65,95,,percent of total billed charges,,,2796.3,90,,percent of total billed charges,,,2796.3,90,,percent of total billed charges,,,2547.74,82,,percent of total billed charges,,,2796.3,90,,percent of total billed charges,,,2640.95,85,,percent of total billed charges,,776.75,2951.65,
DEPUY OSTEOTOME FLAT MEDIUM,30188467,CDM,,,278,RC,outpatient,,3256.5,3256.5,,2764.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,814.13,22,,percent of total billed charges,,,,,,,,,2930.85,90,,percent of total billed charges,,,2696.38,82.8,,percent of total billed charges,,,2768.03,85,,percent of total billed charges,,,,,,,,,2865.72,88,,percent of total billed charges,,,,,,,,,2487.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,814.13,22,,percent of total billed charges,,,2963.42,91,,percent of total billed charges,,,3093.68,95,,percent of total billed charges,,,2702.9,83,,percent of total billed charges,,,2702.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2702.9,83,,percent of total billed charges,,,3093.68,95,,percent of total billed charges,,,2930.85,90,,percent of total billed charges,,,2930.85,90,,percent of total billed charges,,,2670.33,82,,percent of total billed charges,,,2930.85,90,,percent of total billed charges,,,2768.03,85,,percent of total billed charges,,814.13,3093.68,
ZIMMER LINER G7 36MM +5,30188468,CDM,,,278,RC,outpatient,,10205,10205,,8664.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2551.25,22,,percent of total billed charges,,,,,,,,,9184.5,90,,percent of total billed charges,,,8449.74,82.8,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,,,,,,,,8980.4,88,,percent of total billed charges,,,,,,,,,7796.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2551.25,22,,percent of total billed charges,,,9286.55,91,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,8470.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8470.15,83,,percent of total billed charges,,,9694.75,95,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8368.1,82,,percent of total billed charges,,,9184.5,90,,percent of total billed charges,,,8674.25,85,,percent of total billed charges,,2551.25,9694.75,
SPINECRAFT SCREW 3.5 X 14MM,30188469,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
SPINECRAFT SET SCREW,30188470,CDM,,,278,RC,outpatient,,700,700,,594.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175,22,,percent of total billed charges,,,,,,,,,630,90,,percent of total billed charges,,,579.6,82.8,,percent of total billed charges,,,595,85,,percent of total billed charges,,,,,,,,,616,88,,percent of total billed charges,,,,,,,,,534.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175,22,,percent of total billed charges,,,637,91,,percent of total billed charges,,,665,95,,percent of total billed charges,,,581,83,,percent of total billed charges,,,581,83,,percent of total billed charges,,,,,,,,,,,,,,,581,83,,percent of total billed charges,,,665,95,,percent of total billed charges,,,630,90,,percent of total billed charges,,,630,90,,percent of total billed charges,,,574,82,,percent of total billed charges,,,630,90,,percent of total billed charges,,,595,85,,percent of total billed charges,,175,665,
SPINECRAFT DRILL 2.4,30188471,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
SPINECRAFT ROD LORDOSED 4.0 X 325,30188472,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
SPINECRAFT SCREW 5.0 X 30,30188473,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
ARTHREX DECELLULARIZED DERMIS,30188474,CDM,,,270,RC,outpatient,,7800,7800,,6622.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1950,22,,percent of total billed charges,,,,,,,,,7020,90,,percent of total billed charges,,,6458.4,82.8,,percent of total billed charges,,,6630,85,,percent of total billed charges,,,,,,,,,6864,88,,percent of total billed charges,,,,,,,,,5959.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1950,22,,percent of total billed charges,,,7098,91,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,6474,83,,percent of total billed charges,,,,,,,,,,,,,,,6474,83,,percent of total billed charges,,,7410,95,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6396,82,,percent of total billed charges,,,7020,90,,percent of total billed charges,,,6630,85,,percent of total billed charges,,1950,7410,
ZIMMER SCREW PEG 2.5 X 10MM,30188475,CDM,,,278,RC,outpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154,22,,percent of total billed charges,,,,,,,,,554.4,90,,percent of total billed charges,,,510.05,82.8,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154,22,,percent of total billed charges,,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,154,585.2,
ZIMMER SCREW PEG 2.5 X 12MM,30188476,CDM,,,278,RC,outpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154,22,,percent of total billed charges,,,,,,,,,554.4,90,,percent of total billed charges,,,510.05,82.8,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154,22,,percent of total billed charges,,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,154,585.2,
ZIMMER SCREW PEG 2.5 X 11MM,30188477,CDM,,,278,RC,outpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154,22,,percent of total billed charges,,,,,,,,,554.4,90,,percent of total billed charges,,,510.05,82.8,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154,22,,percent of total billed charges,,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,154,585.2,
ZIMMER DRILL BIT 2.0 QC,30188478,CDM,,,278,RC,outpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.88,22,,percent of total billed charges,,,,,,,,,330.75,90,,percent of total billed charges,,,304.29,82.8,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.88,22,,percent of total billed charges,,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,91.88,349.13,
ZIMMER DRILL BIT 2.5 QC,30188479,CDM,,,278,RC,outpatient,,367.5,367.5,,312.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.88,22,,percent of total billed charges,,,,,,,,,330.75,90,,percent of total billed charges,,,304.29,82.8,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,,,,,,,,323.4,88,,percent of total billed charges,,,,,,,,,280.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.88,22,,percent of total billed charges,,,334.43,91,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,305.03,83,,percent of total billed charges,,,,,,,,,,,,,,,305.03,83,,percent of total billed charges,,,349.13,95,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,301.35,82,,percent of total billed charges,,,330.75,90,,percent of total billed charges,,,312.38,85,,percent of total billed charges,,91.88,349.13,
STRYKER SCREW LOCKING T2 F/T 5X37.5MM,30188480,CDM,,,278,RC,outpatient,,1774.37,1774.37,,1506.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,443.59,22,,percent of total billed charges,,,,,,,,,1596.93,90,,percent of total billed charges,,,1469.18,82.8,,percent of total billed charges,,,1508.21,85,,percent of total billed charges,,,,,,,,,1561.45,88,,percent of total billed charges,,,,,,,,,1355.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,443.59,22,,percent of total billed charges,,,1614.68,91,,percent of total billed charges,,,1685.65,95,,percent of total billed charges,,,1472.73,83,,percent of total billed charges,,,1472.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1472.73,83,,percent of total billed charges,,,1685.65,95,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1454.98,82,,percent of total billed charges,,,1596.93,90,,percent of total billed charges,,,1508.21,85,,percent of total billed charges,,443.59,1685.65,
SPINECRAFT SCREW 3.5 X 16MM,30188481,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
DERMIS ON DEMAND 15.0 X 4.5 X 3.0MM,30188482,CDM,,,278,RC,outpatient,,5817.5,5817.5,,4939.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1454.38,22,,percent of total billed charges,,,,,,,,,5235.75,90,,percent of total billed charges,,,4816.89,82.8,,percent of total billed charges,,,4944.88,85,,percent of total billed charges,,,,,,,,,5119.4,88,,percent of total billed charges,,,,,,,,,4444.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1454.38,22,,percent of total billed charges,,,5293.93,91,,percent of total billed charges,,,5526.63,95,,percent of total billed charges,,,4828.53,83,,percent of total billed charges,,,4828.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4828.53,83,,percent of total billed charges,,,5526.63,95,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,4770.35,82,,percent of total billed charges,,,5235.75,90,,percent of total billed charges,,,4944.88,85,,percent of total billed charges,,1454.38,5526.63,
TERUMO GLIDECATH STRAIGHT 4FR X 120CM,30188483,CDM,,,270,RC,outpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.6,22,,percent of total billed charges,,,,,,,,,347.76,90,,percent of total billed charges,,,319.94,82.8,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.6,22,,percent of total billed charges,,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,96.6,367.08,
TERUMO GLIDECATH ANGLED 4FR X 120CM,30188484,CDM,,,270,RC,outpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.6,22,,percent of total billed charges,,,,,,,,,347.76,90,,percent of total billed charges,,,319.94,82.8,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.6,22,,percent of total billed charges,,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,96.6,367.08,
TERUMO GLIDECATH STRAIGHT 4FR X 150CM,30188485,CDM,,,270,RC,outpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.6,22,,percent of total billed charges,,,,,,,,,347.76,90,,percent of total billed charges,,,319.94,82.8,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.6,22,,percent of total billed charges,,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,96.6,367.08,
TERUMO GLIDECATH ANGLED 4FR X 150CM,30188486,CDM,,,270,RC,outpatient,,386.4,386.4,,328.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.6,22,,percent of total billed charges,,,,,,,,,347.76,90,,percent of total billed charges,,,319.94,82.8,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,,,,,,,,340.03,88,,percent of total billed charges,,,,,,,,,295.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.6,22,,percent of total billed charges,,,351.62,91,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,320.71,83,,percent of total billed charges,,,,,,,,,,,,,,,320.71,83,,percent of total billed charges,,,367.08,95,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,316.85,82,,percent of total billed charges,,,347.76,90,,percent of total billed charges,,,328.44,85,,percent of total billed charges,,96.6,367.08,
TERUMO GLIDECATH STRAIGHT 5FXP X 150CM,30188487,CDM,,,270,RC,outpatient,,386.82,386.82,,328.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.71,22,,percent of total billed charges,,,,,,,,,348.14,90,,percent of total billed charges,,,320.29,82.8,,percent of total billed charges,,,328.8,85,,percent of total billed charges,,,,,,,,,340.4,88,,percent of total billed charges,,,,,,,,,295.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.71,22,,percent of total billed charges,,,352.01,91,,percent of total billed charges,,,367.48,95,,percent of total billed charges,,,321.06,83,,percent of total billed charges,,,321.06,83,,percent of total billed charges,,,,,,,,,,,,,,,321.06,83,,percent of total billed charges,,,367.48,95,,percent of total billed charges,,,348.14,90,,percent of total billed charges,,,348.14,90,,percent of total billed charges,,,317.19,82,,percent of total billed charges,,,348.14,90,,percent of total billed charges,,,328.8,85,,percent of total billed charges,,96.71,367.48,
ULRICH TAP  5.5,30188488,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
SPINECRAFT SCREW POLY 6.5 X 40MM,30188489,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
UNIFUSE WITH COOPER WIRE 5FR 90 X 40CM,30188490,CDM,,,270,RC,outpatient,,1995.5,1995.5,,1694.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,498.88,22,,percent of total billed charges,,,,,,,,,1795.95,90,,percent of total billed charges,,,1652.27,82.8,,percent of total billed charges,,,1696.18,85,,percent of total billed charges,,,,,,,,,1756.04,88,,percent of total billed charges,,,,,,,,,1524.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,498.88,22,,percent of total billed charges,,,1815.91,91,,percent of total billed charges,,,1895.73,95,,percent of total billed charges,,,1656.27,83,,percent of total billed charges,,,1656.27,83,,percent of total billed charges,,,,,,,,,,,,,,,1656.27,83,,percent of total billed charges,,,1895.73,95,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1636.31,82,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1696.18,85,,percent of total billed charges,,498.88,1895.73,
UNIFUSE WITH COOPER WIRE 5FR 135 X 30CM,30188491,CDM,,,270,RC,outpatient,,1995.5,1995.5,,1694.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,498.88,22,,percent of total billed charges,,,,,,,,,1795.95,90,,percent of total billed charges,,,1652.27,82.8,,percent of total billed charges,,,1696.18,85,,percent of total billed charges,,,,,,,,,1756.04,88,,percent of total billed charges,,,,,,,,,1524.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,498.88,22,,percent of total billed charges,,,1815.91,91,,percent of total billed charges,,,1895.73,95,,percent of total billed charges,,,1656.27,83,,percent of total billed charges,,,1656.27,83,,percent of total billed charges,,,,,,,,,,,,,,,1656.27,83,,percent of total billed charges,,,1895.73,95,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1636.31,82,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1696.18,85,,percent of total billed charges,,498.88,1895.73,
ZIMMER DVR ANATOMIC NARROW LEFT,30188492,CDM,,,278,RC,outpatient,,4751.5,4751.5,,4034.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1187.88,22,,percent of total billed charges,,,,,,,,,4276.35,90,,percent of total billed charges,,,3934.24,82.8,,percent of total billed charges,,,4038.78,85,,percent of total billed charges,,,,,,,,,4181.32,88,,percent of total billed charges,,,,,,,,,3630.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1187.88,22,,percent of total billed charges,,,4323.87,91,,percent of total billed charges,,,4513.93,95,,percent of total billed charges,,,3943.75,83,,percent of total billed charges,,,3943.75,83,,percent of total billed charges,,,,,,,,,,,,,,,3943.75,83,,percent of total billed charges,,,4513.93,95,,percent of total billed charges,,,4276.35,90,,percent of total billed charges,,,4276.35,90,,percent of total billed charges,,,3896.23,82,,percent of total billed charges,,,4276.35,90,,percent of total billed charges,,,4038.78,85,,percent of total billed charges,,1187.88,4513.93,
ZIMMER DRILL BIT FAST 2.0MM,30188493,CDM,,,278,RC,outpatient,,693,693,,588.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,173.25,22,,percent of total billed charges,,,,,,,,,623.7,90,,percent of total billed charges,,,573.8,82.8,,percent of total billed charges,,,589.05,85,,percent of total billed charges,,,,,,,,,609.84,88,,percent of total billed charges,,,,,,,,,529.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,173.25,22,,percent of total billed charges,,,630.63,91,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,,,,,,,,,,,,,575.19,83,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,568.26,82,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,589.05,85,,percent of total billed charges,,173.25,658.35,
ZIMMER DRILL BIT DVR 2.5MM NS,30188494,CDM,,,278,RC,outpatient,,693,693,,588.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,173.25,22,,percent of total billed charges,,,,,,,,,623.7,90,,percent of total billed charges,,,573.8,82.8,,percent of total billed charges,,,589.05,85,,percent of total billed charges,,,,,,,,,609.84,88,,percent of total billed charges,,,,,,,,,529.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,173.25,22,,percent of total billed charges,,,630.63,91,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,,,,,,,,,,,,,575.19,83,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,568.26,82,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,589.05,85,,percent of total billed charges,,173.25,658.35,
ZIMMER SCREW CORTICAL 3.5X12MM,30188495,CDM,,,278,RC,outpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154,22,,percent of total billed charges,,,,,,,,,554.4,90,,percent of total billed charges,,,510.05,82.8,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154,22,,percent of total billed charges,,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,154,585.2,
ZIMMER SCREW CORTICAL 3.5X14MM,30188496,CDM,,,278,RC,outpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154,22,,percent of total billed charges,,,,,,,,,554.4,90,,percent of total billed charges,,,510.05,82.8,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154,22,,percent of total billed charges,,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,154,585.2,
ZIMMER PEG PARTIAL THREAD 2.5X18MM,30188497,CDM,,,278,RC,outpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154,22,,percent of total billed charges,,,,,,,,,554.4,90,,percent of total billed charges,,,510.05,82.8,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154,22,,percent of total billed charges,,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,154,585.2,
ZIMMER PEG PARTIAL THREAD 2.5X20MM,30188498,CDM,,,278,RC,outpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154,22,,percent of total billed charges,,,,,,,,,554.4,90,,percent of total billed charges,,,510.05,82.8,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154,22,,percent of total billed charges,,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,154,585.2,
ZIMMER PEG PARTIAL THREAD 2.5X22MM,30188499,CDM,,,278,RC,outpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154,22,,percent of total billed charges,,,,,,,,,554.4,90,,percent of total billed charges,,,510.05,82.8,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154,22,,percent of total billed charges,,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,154,585.2,
BIOTRONIK PACEMAKER DUAL CHAMBER EDORA 8,30188500,CDM,,,278,RC,outpatient,,23725,23725,,20142.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5931.25,22,,percent of total billed charges,,,,,,,,,21352.5,90,,percent of total billed charges,,,19644.3,82.8,,percent of total billed charges,,,20166.25,85,,percent of total billed charges,,,,,,,,,20878,88,,percent of total billed charges,,,,,,,,,18125.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5931.25,22,,percent of total billed charges,,,21589.75,91,,percent of total billed charges,,,22538.75,95,,percent of total billed charges,,,19691.75,83,,percent of total billed charges,,,19691.75,83,,percent of total billed charges,,,,,,,,,,,,,,,19691.75,83,,percent of total billed charges,,,22538.75,95,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,19454.5,82,,percent of total billed charges,,,21352.5,90,,percent of total billed charges,,,20166.25,85,,percent of total billed charges,,5931.25,22538.75,
ZIMMER FEMUR NARROW SZ 6 LEFT,30188501,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER SCREW BONE 6.5X40 ST,30188502,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
MEDTRONIC BUR ROUND 4.5,30188503,CDM,,,270,RC,outpatient,,2517.65,2517.65,,2137.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,629.41,22,,percent of total billed charges,,,,,,,,,2265.89,90,,percent of total billed charges,,,2084.61,82.8,,percent of total billed charges,,,2140,85,,percent of total billed charges,,,,,,,,,2215.53,88,,percent of total billed charges,,,,,,,,,1923.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,629.41,22,,percent of total billed charges,,,2291.06,91,,percent of total billed charges,,,2391.77,95,,percent of total billed charges,,,2089.65,83,,percent of total billed charges,,,2089.65,83,,percent of total billed charges,,,,,,,,,,,,,,,2089.65,83,,percent of total billed charges,,,2391.77,95,,percent of total billed charges,,,2265.89,90,,percent of total billed charges,,,2265.89,90,,percent of total billed charges,,,2064.47,82,,percent of total billed charges,,,2265.89,90,,percent of total billed charges,,,2140,85,,percent of total billed charges,,629.41,2391.77,
MEDTRONIC BUR ROUND 3.2,30188504,CDM,,,270,RC,outpatient,,2465.65,2465.65,,2093.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,616.41,22,,percent of total billed charges,,,,,,,,,2219.09,90,,percent of total billed charges,,,2041.56,82.8,,percent of total billed charges,,,2095.8,85,,percent of total billed charges,,,,,,,,,2169.77,88,,percent of total billed charges,,,,,,,,,1883.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,616.41,22,,percent of total billed charges,,,2243.74,91,,percent of total billed charges,,,2342.37,95,,percent of total billed charges,,,2046.49,83,,percent of total billed charges,,,2046.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2046.49,83,,percent of total billed charges,,,2342.37,95,,percent of total billed charges,,,2219.09,90,,percent of total billed charges,,,2219.09,90,,percent of total billed charges,,,2021.83,82,,percent of total billed charges,,,2219.09,90,,percent of total billed charges,,,2095.8,85,,percent of total billed charges,,616.41,2342.37,
IR PLATE CERVICAL 4 LEVEL 72MM,30188505,CDM,,,278,RC,outpatient,,9750,9750,,8277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2437.5,22,,percent of total billed charges,,,,,,,,,8775,90,,percent of total billed charges,,,8073,82.8,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,,,,,,,,8580,88,,percent of total billed charges,,,,,,,,,7449,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2437.5,22,,percent of total billed charges,,,8872.5,91,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,8092.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8092.5,83,,percent of total billed charges,,,9262.5,95,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,7995,82,,percent of total billed charges,,,8775,90,,percent of total billed charges,,,8287.5,85,,percent of total billed charges,,2437.5,9262.5,
SPINECRAFT SCREW POLY 6.5 X 50MM,30188506,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
SPINECRAFT ROD TITANIUM 5.5 X 300MM,30188507,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
ZIMMER SCREW CANCELLOUS 4X14MM,30188508,CDM,,,278,RC,outpatient,,424.55,424.55,,360.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,106.14,22,,percent of total billed charges,,,,,,,,,382.1,90,,percent of total billed charges,,,351.53,82.8,,percent of total billed charges,,,360.87,85,,percent of total billed charges,,,,,,,,,373.6,88,,percent of total billed charges,,,,,,,,,324.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,106.14,22,,percent of total billed charges,,,386.34,91,,percent of total billed charges,,,403.32,95,,percent of total billed charges,,,352.38,83,,percent of total billed charges,,,352.38,83,,percent of total billed charges,,,,,,,,,,,,,,,352.38,83,,percent of total billed charges,,,403.32,95,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,348.13,82,,percent of total billed charges,,,382.1,90,,percent of total billed charges,,,360.87,85,,percent of total billed charges,,106.14,403.32,
ZIMMER PLATE LOCKING FIBULA 4H 80MM RT,30188509,CDM,,,278,RC,outpatient,,4006.34,4006.34,,3401.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1001.59,22,,percent of total billed charges,,,,,,,,,3605.71,90,,percent of total billed charges,,,3317.25,82.8,,percent of total billed charges,,,3405.39,85,,percent of total billed charges,,,,,,,,,3525.58,88,,percent of total billed charges,,,,,,,,,3060.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1001.59,22,,percent of total billed charges,,,3645.77,91,,percent of total billed charges,,,3806.02,95,,percent of total billed charges,,,3325.26,83,,percent of total billed charges,,,3325.26,83,,percent of total billed charges,,,,,,,,,,,,,,,3325.26,83,,percent of total billed charges,,,3806.02,95,,percent of total billed charges,,,3605.71,90,,percent of total billed charges,,,3605.71,90,,percent of total billed charges,,,3285.2,82,,percent of total billed charges,,,3605.71,90,,percent of total billed charges,,,3405.39,85,,percent of total billed charges,,1001.59,3806.02,
STRYKER BASEPLATE TIBIAL SZ 6,30188510,CDM,,,278,RC,outpatient,,9100,9100,,7725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2275,22,,percent of total billed charges,,,,,,,,,8190,90,,percent of total billed charges,,,7534.8,82.8,,percent of total billed charges,,,7735,85,,percent of total billed charges,,,,,,,,,8008,88,,percent of total billed charges,,,,,,,,,6952.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2275,22,,percent of total billed charges,,,8281,91,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,7553,83,,percent of total billed charges,,,,,,,,,,,,,,,7553,83,,percent of total billed charges,,,8645,95,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7462,82,,percent of total billed charges,,,8190,90,,percent of total billed charges,,,7735,85,,percent of total billed charges,,2275,8645,
STRYKER FEMORAL COMPONENT SZ 6 LEFT,30188511,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER INSERT TIBIAL SZ 6 9MM,30188512,CDM,,,278,RC,outpatient,,15536.95,15536.95,,13190.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3884.24,22,,percent of total billed charges,,,,,,,,,13983.26,90,,percent of total billed charges,,,12864.59,82.8,,percent of total billed charges,,,13206.41,85,,percent of total billed charges,,,,,,,,,13672.52,88,,percent of total billed charges,,,,,,,,,11870.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3884.24,22,,percent of total billed charges,,,14138.62,91,,percent of total billed charges,,,14760.1,95,,percent of total billed charges,,,12895.67,83,,percent of total billed charges,,,12895.67,83,,percent of total billed charges,,,,,,,,,,,,,,,12895.67,83,,percent of total billed charges,,,14760.1,95,,percent of total billed charges,,,13983.26,90,,percent of total billed charges,,,13983.26,90,,percent of total billed charges,,,12740.3,82,,percent of total billed charges,,,13983.26,90,,percent of total billed charges,,,13206.41,85,,percent of total billed charges,,3884.24,14760.1,
ULRICH END PLATE 10DEG 16X13,30188513,CDM,,,278,RC,outpatient,,45285.5,45285.5,,38447.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11321.38,22,,percent of total billed charges,,,,,,,,,40756.95,90,,percent of total billed charges,,,37496.39,82.8,,percent of total billed charges,,,38492.68,85,,percent of total billed charges,,,,,,,,,39851.24,88,,percent of total billed charges,,,,,,,,,34598.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11321.38,22,,percent of total billed charges,,,41209.81,91,,percent of total billed charges,,,43021.23,95,,percent of total billed charges,,,37586.97,83,,percent of total billed charges,,,37586.97,83,,percent of total billed charges,,,,,,,,,,,,,,,37586.97,83,,percent of total billed charges,,,43021.23,95,,percent of total billed charges,,,40756.95,90,,percent of total billed charges,,,40756.95,90,,percent of total billed charges,,,37134.11,82,,percent of total billed charges,,,40756.95,90,,percent of total billed charges,,,38492.68,85,,percent of total billed charges,,11321.38,43021.23,
ULRICH CAGE CORPECTOMY 19-27MM,30188514,CDM,,,278,RC,outpatient,,145288,145288,,123349.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36322,22,,percent of total billed charges,,,,,,,,,130759.2,90,,percent of total billed charges,,,120298.46,82.8,,percent of total billed charges,,,123494.8,85,,percent of total billed charges,,,,,,,,,127853.44,88,,percent of total billed charges,,,,,,,,,111000.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36322,22,,percent of total billed charges,,,132212.08,91,,percent of total billed charges,,,138023.6,95,,percent of total billed charges,,,120589.04,83,,percent of total billed charges,,,120589.04,83,,percent of total billed charges,,,,,,,,,,,,,,,120589.04,83,,percent of total billed charges,,,138023.6,95,,percent of total billed charges,,,130759.2,90,,percent of total billed charges,,,130759.2,90,,percent of total billed charges,,,119136.16,82,,percent of total billed charges,,,130759.2,90,,percent of total billed charges,,,123494.8,85,,percent of total billed charges,,36322,138023.6,
STRYKER INSERT MDM X3 36C,30188515,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER FEMUR TRIATHLON CR SZ 5 LEFT,30188516,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
STRYKER PATELLA S33MM,30188517,CDM,,,278,RC,outpatient,,3900,3900,,3311.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,975,22,,percent of total billed charges,,,,,,,,,3510,90,,percent of total billed charges,,,3229.2,82.8,,percent of total billed charges,,,3315,85,,percent of total billed charges,,,,,,,,,3432,88,,percent of total billed charges,,,,,,,,,2979.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,975,22,,percent of total billed charges,,,3549,91,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,3237,83,,percent of total billed charges,,,,,,,,,,,,,,,3237,83,,percent of total billed charges,,,3705,95,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3198,82,,percent of total billed charges,,,3510,90,,percent of total billed charges,,,3315,85,,percent of total billed charges,,975,3705,
DEPUY ATTUNE INSERT PS RP SZ7 12MM,30188518,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY ATTUNE STEM PF 22X60MM,30188519,CDM,,,278,RC,outpatient,,13175.11,13175.11,,11185.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3293.78,22,,percent of total billed charges,,,,,,,,,11857.6,90,,percent of total billed charges,,,10908.99,82.8,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,,,,,,,,11594.1,88,,percent of total billed charges,,,,,,,,,10065.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3293.78,22,,percent of total billed charges,,,11989.35,91,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,10935.34,83,,percent of total billed charges,,,,,,,,,,,,,,,10935.34,83,,percent of total billed charges,,,12516.35,95,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,10803.59,82,,percent of total billed charges,,,11857.6,90,,percent of total billed charges,,,11198.84,85,,percent of total billed charges,,3293.78,12516.35,
STRYKER INSERT CS SZ 2 14MM,30188520,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
DEPUY METAGLENE CS 10MM,30188521,CDM,,,278,RC,outpatient,,25993.5,25993.5,,22068.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6498.38,22,,percent of total billed charges,,,,,,,,,23394.15,90,,percent of total billed charges,,,21522.62,82.8,,percent of total billed charges,,,22094.48,85,,percent of total billed charges,,,,,,,,,22874.28,88,,percent of total billed charges,,,,,,,,,19859.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6498.38,22,,percent of total billed charges,,,23654.09,91,,percent of total billed charges,,,24693.83,95,,percent of total billed charges,,,21574.61,83,,percent of total billed charges,,,21574.61,83,,percent of total billed charges,,,,,,,,,,,,,,,21574.61,83,,percent of total billed charges,,,24693.83,95,,percent of total billed charges,,,23394.15,90,,percent of total billed charges,,,23394.15,90,,percent of total billed charges,,,21314.67,82,,percent of total billed charges,,,23394.15,90,,percent of total billed charges,,,22094.48,85,,percent of total billed charges,,6498.38,24693.83,
DEPUY SCREW METAGLENE 6X15MM,30188522,CDM,,,278,RC,outpatient,,5772,5772,,4900.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1443,22,,percent of total billed charges,,,,,,,,,5194.8,90,,percent of total billed charges,,,4779.22,82.8,,percent of total billed charges,,,4906.2,85,,percent of total billed charges,,,,,,,,,5079.36,88,,percent of total billed charges,,,,,,,,,4409.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1443,22,,percent of total billed charges,,,5252.52,91,,percent of total billed charges,,,5483.4,95,,percent of total billed charges,,,4790.76,83,,percent of total billed charges,,,4790.76,83,,percent of total billed charges,,,,,,,,,,,,,,,4790.76,83,,percent of total billed charges,,,5483.4,95,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,4733.04,82,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,4906.2,85,,percent of total billed charges,,1443,5483.4,
DEPUY OSTEOTOME BLADE SHORT RADIAL,30188523,CDM,,,278,RC,outpatient,,3107,3107,,2637.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,776.75,22,,percent of total billed charges,,,,,,,,,2796.3,90,,percent of total billed charges,,,2572.6,82.8,,percent of total billed charges,,,2640.95,85,,percent of total billed charges,,,,,,,,,2734.16,88,,percent of total billed charges,,,,,,,,,2373.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,776.75,22,,percent of total billed charges,,,2827.37,91,,percent of total billed charges,,,2951.65,95,,percent of total billed charges,,,2578.81,83,,percent of total billed charges,,,2578.81,83,,percent of total billed charges,,,,,,,,,,,,,,,2578.81,83,,percent of total billed charges,,,2951.65,95,,percent of total billed charges,,,2796.3,90,,percent of total billed charges,,,2796.3,90,,percent of total billed charges,,,2547.74,82,,percent of total billed charges,,,2796.3,90,,percent of total billed charges,,,2640.95,85,,percent of total billed charges,,776.75,2951.65,
STRYKER INSERT MDM 42E,30188524,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER HEAD FEMORAL 28MM +4,30188525,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
ZIMMER FEMUR CR TM SZ 6 RIGHT,30188526,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
ZIMMER FEMUR CMT REV PSN SZ 9 LEFT,30188527,CDM,,,278,RC,outpatient,,67153.13,67153.13,,57013.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16788.28,22,,percent of total billed charges,,,,,,,,,60437.82,90,,percent of total billed charges,,,55602.79,82.8,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,,,,,,,,59094.75,88,,percent of total billed charges,,,,,,,,,51304.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16788.28,22,,percent of total billed charges,,,61109.35,91,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,55737.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55737.1,83,,percent of total billed charges,,,63795.47,95,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,55065.57,82,,percent of total billed charges,,,60437.82,90,,percent of total billed charges,,,57080.16,85,,percent of total billed charges,,16788.28,63795.47,
ZIMMER HEX DRIVER 2MM,30188528,CDM,,,278,RC,outpatient,,567,567,,481.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141.75,22,,percent of total billed charges,,,,,,,,,510.3,90,,percent of total billed charges,,,469.48,82.8,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,,,,,,,,498.96,88,,percent of total billed charges,,,,,,,,,433.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141.75,22,,percent of total billed charges,,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,,,,,,,,,,,,,470.61,83,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,464.94,82,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,141.75,538.65,
ZIMMER BEARING CPS 10MM LEFT,30188529,CDM,,,278,RC,outpatient,,17135.63,17135.63,,14548.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4283.91,22,,percent of total billed charges,,,,,,,,,15422.07,90,,percent of total billed charges,,,14188.3,82.8,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,,,,,,,,15079.35,88,,percent of total billed charges,,,,,,,,,13091.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4283.91,22,,percent of total billed charges,,,15593.42,91,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,14222.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14222.57,83,,percent of total billed charges,,,16278.85,95,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14051.22,82,,percent of total billed charges,,,15422.07,90,,percent of total billed charges,,,14565.29,85,,percent of total billed charges,,4283.91,16278.85,
ZIMMER LINER NEUTRAL FREEDOM CONT 36MM,30188530,CDM,,,278,RC,outpatient,,29655.6,29655.6,,25177.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7413.9,22,,percent of total billed charges,,,,,,,,,26690.04,90,,percent of total billed charges,,,24554.84,82.8,,percent of total billed charges,,,25207.26,85,,percent of total billed charges,,,,,,,,,26096.93,88,,percent of total billed charges,,,,,,,,,22656.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7413.9,22,,percent of total billed charges,,,26986.6,91,,percent of total billed charges,,,28172.82,95,,percent of total billed charges,,,24614.15,83,,percent of total billed charges,,,24614.15,83,,percent of total billed charges,,,,,,,,,,,,,,,24614.15,83,,percent of total billed charges,,,28172.82,95,,percent of total billed charges,,,26690.04,90,,percent of total billed charges,,,26690.04,90,,percent of total billed charges,,,24317.59,82,,percent of total billed charges,,,26690.04,90,,percent of total billed charges,,,25207.26,85,,percent of total billed charges,,7413.9,28172.82,
ZIMMER HEAD FREEDOM CONT 36MM X +0,30188531,CDM,,,278,RC,outpatient,,12721.8,12721.8,,10800.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3180.45,22,,percent of total billed charges,,,,,,,,,11449.62,90,,percent of total billed charges,,,10533.65,82.8,,percent of total billed charges,,,10813.53,85,,percent of total billed charges,,,,,,,,,11195.18,88,,percent of total billed charges,,,,,,,,,9719.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3180.45,22,,percent of total billed charges,,,11576.84,91,,percent of total billed charges,,,12085.71,95,,percent of total billed charges,,,10559.09,83,,percent of total billed charges,,,10559.09,83,,percent of total billed charges,,,,,,,,,,,,,,,10559.09,83,,percent of total billed charges,,,12085.71,95,,percent of total billed charges,,,11449.62,90,,percent of total billed charges,,,11449.62,90,,percent of total billed charges,,,10431.88,82,,percent of total billed charges,,,11449.62,90,,percent of total billed charges,,,10813.53,85,,percent of total billed charges,,3180.45,12085.71,
STRYKER RESTRICTOR CEMENT UNV. MEDIUM,30188532,CDM,,,278,RC,outpatient,,1001,1001,,849.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,250.25,22,,percent of total billed charges,,,,,,,,,900.9,90,,percent of total billed charges,,,828.83,82.8,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,,,,,,,,880.88,88,,percent of total billed charges,,,,,,,,,764.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,250.25,22,,percent of total billed charges,,,910.91,91,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,,,,,,,,,,,,,830.83,83,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,820.82,82,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,250.25,950.95,
STRYKER SPACER DISTAL OSTEONICS UNV.,30188533,CDM,,,278,RC,outpatient,,1001,1001,,849.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,250.25,22,,percent of total billed charges,,,,,,,,,900.9,90,,percent of total billed charges,,,828.83,82.8,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,,,,,,,,880.88,88,,percent of total billed charges,,,,,,,,,764.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,250.25,22,,percent of total billed charges,,,910.91,91,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,,,,,,,,,,,,,830.83,83,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,820.82,82,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,250.25,950.95,
STRYKER STEM ACCOLADE CS 127NK,30188534,CDM,,,278,RC,outpatient,,11700,11700,,9933.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2925,22,,percent of total billed charges,,,,,,,,,10530,90,,percent of total billed charges,,,9687.6,82.8,,percent of total billed charges,,,9945,85,,percent of total billed charges,,,,,,,,,10296,88,,percent of total billed charges,,,,,,,,,8938.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2925,22,,percent of total billed charges,,,10647,91,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,,,,,,,,,,,,,9711,83,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9594,82,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9945,85,,percent of total billed charges,,2925,11115,
STRYKER BIPOLAR UHR 26X45MM,30188535,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
BOSTON GUIDEWIRE ZEBRA 3CM STRAIGHT,30188536,CDM,,,270,RC,outpatient,,384.16,384.16,,326.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.04,22,,percent of total billed charges,,,,,,,,,345.74,90,,percent of total billed charges,,,318.08,82.8,,percent of total billed charges,,,326.54,85,,percent of total billed charges,,,,,,,,,338.06,88,,percent of total billed charges,,,,,,,,,293.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.04,22,,percent of total billed charges,,,349.59,91,,percent of total billed charges,,,364.95,95,,percent of total billed charges,,,318.85,83,,percent of total billed charges,,,318.85,83,,percent of total billed charges,,,,,,,,,,,,,,,318.85,83,,percent of total billed charges,,,364.95,95,,percent of total billed charges,,,345.74,90,,percent of total billed charges,,,345.74,90,,percent of total billed charges,,,315.01,82,,percent of total billed charges,,,345.74,90,,percent of total billed charges,,,326.54,85,,percent of total billed charges,,96.04,364.95,
BOSTON GUIDEWIRE ZEBRA 3CM ANGLED,30188537,CDM,,,270,RC,outpatient,,384.16,384.16,,326.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.04,22,,percent of total billed charges,,,,,,,,,345.74,90,,percent of total billed charges,,,318.08,82.8,,percent of total billed charges,,,326.54,85,,percent of total billed charges,,,,,,,,,338.06,88,,percent of total billed charges,,,,,,,,,293.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.04,22,,percent of total billed charges,,,349.59,91,,percent of total billed charges,,,364.95,95,,percent of total billed charges,,,318.85,83,,percent of total billed charges,,,318.85,83,,percent of total billed charges,,,,,,,,,,,,,,,318.85,83,,percent of total billed charges,,,364.95,95,,percent of total billed charges,,,345.74,90,,percent of total billed charges,,,345.74,90,,percent of total billed charges,,,315.01,82,,percent of total billed charges,,,345.74,90,,percent of total billed charges,,,326.54,85,,percent of total billed charges,,96.04,364.95,
BOSTON BALLOON KIT NEPHROMAX 20CM X 30FR,30188538,CDM,,,270,RC,outpatient,,1695.79,1695.79,,1439.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,423.95,22,,percent of total billed charges,,,,,,,,,1526.21,90,,percent of total billed charges,,,1404.11,82.8,,percent of total billed charges,,,1441.42,85,,percent of total billed charges,,,,,,,,,1492.3,88,,percent of total billed charges,,,,,,,,,1295.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,423.95,22,,percent of total billed charges,,,1543.17,91,,percent of total billed charges,,,1611,95,,percent of total billed charges,,,1407.51,83,,percent of total billed charges,,,1407.51,83,,percent of total billed charges,,,,,,,,,,,,,,,1407.51,83,,percent of total billed charges,,,1611,95,,percent of total billed charges,,,1526.21,90,,percent of total billed charges,,,1526.21,90,,percent of total billed charges,,,1390.55,82,,percent of total billed charges,,,1526.21,90,,percent of total billed charges,,,1441.42,85,,percent of total billed charges,,423.95,1611,
BOSTON ZIPWIRE BENTSON .035X150 STIFF AN,30188539,CDM,,,270,RC,outpatient,,373.03,373.03,,316.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.26,22,,percent of total billed charges,,,,,,,,,335.73,90,,percent of total billed charges,,,308.87,82.8,,percent of total billed charges,,,317.08,85,,percent of total billed charges,,,,,,,,,328.27,88,,percent of total billed charges,,,,,,,,,284.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.26,22,,percent of total billed charges,,,339.46,91,,percent of total billed charges,,,354.38,95,,percent of total billed charges,,,309.61,83,,percent of total billed charges,,,309.61,83,,percent of total billed charges,,,,,,,,,,,,,,,309.61,83,,percent of total billed charges,,,354.38,95,,percent of total billed charges,,,335.73,90,,percent of total billed charges,,,335.73,90,,percent of total billed charges,,,305.88,82,,percent of total billed charges,,,335.73,90,,percent of total billed charges,,,317.08,85,,percent of total billed charges,,93.26,354.38,
BOSTON ZIPWIRE BENTSON .035X150 STD ANGL,30188540,CDM,,,270,RC,outpatient,,373.03,373.03,,316.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.26,22,,percent of total billed charges,,,,,,,,,335.73,90,,percent of total billed charges,,,308.87,82.8,,percent of total billed charges,,,317.08,85,,percent of total billed charges,,,,,,,,,328.27,88,,percent of total billed charges,,,,,,,,,284.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.26,22,,percent of total billed charges,,,339.46,91,,percent of total billed charges,,,354.38,95,,percent of total billed charges,,,309.61,83,,percent of total billed charges,,,309.61,83,,percent of total billed charges,,,,,,,,,,,,,,,309.61,83,,percent of total billed charges,,,354.38,95,,percent of total billed charges,,,335.73,90,,percent of total billed charges,,,335.73,90,,percent of total billed charges,,,305.88,82,,percent of total billed charges,,,335.73,90,,percent of total billed charges,,,317.08,85,,percent of total billed charges,,93.26,354.38,
BOSTON Y-ADAPTER GATEWAY ADVANTAGE,30188541,CDM,,,270,RC,outpatient,,126.64,126.64,,107.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.66,22,,percent of total billed charges,,,,,,,,,113.98,90,,percent of total billed charges,,,104.86,82.8,,percent of total billed charges,,,107.64,85,,percent of total billed charges,,,,,,,,,111.44,88,,percent of total billed charges,,,,,,,,,96.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.66,22,,percent of total billed charges,,,115.24,91,,percent of total billed charges,,,120.31,95,,percent of total billed charges,,,105.11,83,,percent of total billed charges,,,105.11,83,,percent of total billed charges,,,,,,,,,,,,,,,105.11,83,,percent of total billed charges,,,120.31,95,,percent of total billed charges,,,113.98,90,,percent of total billed charges,,,113.98,90,,percent of total billed charges,,,103.84,82,,percent of total billed charges,,,113.98,90,,percent of total billed charges,,,107.64,85,,percent of total billed charges,,31.66,120.31,
COOPER STAPLER SKIN INSORB,30188542,CDM,,,270,RC,outpatient,,433.58,433.58,,368.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.4,22,,percent of total billed charges,,,,,,,,,390.22,90,,percent of total billed charges,,,359,82.8,,percent of total billed charges,,,368.54,85,,percent of total billed charges,,,,,,,,,381.55,88,,percent of total billed charges,,,,,,,,,331.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108.4,22,,percent of total billed charges,,,394.56,91,,percent of total billed charges,,,411.9,95,,percent of total billed charges,,,359.87,83,,percent of total billed charges,,,359.87,83,,percent of total billed charges,,,,,,,,,,,,,,,359.87,83,,percent of total billed charges,,,411.9,95,,percent of total billed charges,,,390.22,90,,percent of total billed charges,,,390.22,90,,percent of total billed charges,,,355.54,82,,percent of total billed charges,,,390.22,90,,percent of total billed charges,,,368.54,85,,percent of total billed charges,,108.4,411.9,
STRYKER SCREW LAG 10.5 X 110MM,30188543,CDM,,,278,RC,outpatient,,5200.33,5200.33,,4415.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1300.08,22,,percent of total billed charges,,,,,,,,,4680.3,90,,percent of total billed charges,,,4305.87,82.8,,percent of total billed charges,,,4420.28,85,,percent of total billed charges,,,,,,,,,4576.29,88,,percent of total billed charges,,,,,,,,,3973.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1300.08,22,,percent of total billed charges,,,4732.3,91,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,4316.27,83,,percent of total billed charges,,,,,,,,,,,,,,,4316.27,83,,percent of total billed charges,,,4940.31,95,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4264.27,82,,percent of total billed charges,,,4680.3,90,,percent of total billed charges,,,4420.28,85,,percent of total billed charges,,1300.08,4940.31,
ZIMMER UC POLY PSN ASF 13MM,30188544,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
MENTOR MEMORYGEL BREAST IMPLANT 750CC,30188545,CDM,,,278,RC,outpatient,,6825,6825,,5794.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1706.25,22,,percent of total billed charges,,,,,,,,,6142.5,90,,percent of total billed charges,,,5651.1,82.8,,percent of total billed charges,,,5801.25,85,,percent of total billed charges,,,,,,,,,6006,88,,percent of total billed charges,,,,,,,,,5214.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1706.25,22,,percent of total billed charges,,,6210.75,91,,percent of total billed charges,,,6483.75,95,,percent of total billed charges,,,5664.75,83,,percent of total billed charges,,,5664.75,83,,percent of total billed charges,,,,,,,,,,,,,,,5664.75,83,,percent of total billed charges,,,6483.75,95,,percent of total billed charges,,,6142.5,90,,percent of total billed charges,,,6142.5,90,,percent of total billed charges,,,5596.5,82,,percent of total billed charges,,,6142.5,90,,percent of total billed charges,,,5801.25,85,,percent of total billed charges,,1706.25,6483.75,
ULRICH BOLT ILLIAC 10.0 X 70MM,30188546,CDM,,,278,RC,outpatient,,9425,9425,,8001.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2356.25,22,,percent of total billed charges,,,,,,,,,8482.5,90,,percent of total billed charges,,,7803.9,82.8,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,,,,,,,,8294,88,,percent of total billed charges,,,,,,,,,7200.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2356.25,22,,percent of total billed charges,,,8576.75,91,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,7822.75,83,,percent of total billed charges,,,,,,,,,,,,,,,7822.75,83,,percent of total billed charges,,,8953.75,95,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,7728.5,82,,percent of total billed charges,,,8482.5,90,,percent of total billed charges,,,8011.25,85,,percent of total billed charges,,2356.25,8953.75,
STRYKER INSERT CS SZ 2 10MM,30188547,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER FEMUR CR #4,30188548,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
STRYKER FEMUR TRIATHLON PS SZ4 LFT,30188549,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER INSERT TIBA SZ 4 TS,30188550,CDM,,,278,RC,outpatient,,15536.95,15536.95,,13190.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3884.24,22,,percent of total billed charges,,,,,,,,,13983.26,90,,percent of total billed charges,,,12864.59,82.8,,percent of total billed charges,,,13206.41,85,,percent of total billed charges,,,,,,,,,13672.52,88,,percent of total billed charges,,,,,,,,,11870.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3884.24,22,,percent of total billed charges,,,14138.62,91,,percent of total billed charges,,,14760.1,95,,percent of total billed charges,,,12895.67,83,,percent of total billed charges,,,12895.67,83,,percent of total billed charges,,,,,,,,,,,,,,,12895.67,83,,percent of total billed charges,,,14760.1,95,,percent of total billed charges,,,13983.26,90,,percent of total billed charges,,,13983.26,90,,percent of total billed charges,,,12740.3,82,,percent of total billed charges,,,13983.26,90,,percent of total billed charges,,,13206.41,85,,percent of total billed charges,,3884.24,14760.1,
ZIMMER MC VE ASF 14MM RIGHT,30188551,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ZIMMER TIBIA PSN SZ J RIGHT,30188552,CDM,,,278,RC,outpatient,,9587.5,9587.5,,8139.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2396.88,22,,percent of total billed charges,,,,,,,,,8628.75,90,,percent of total billed charges,,,7938.45,82.8,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,,,,,,,,8437,88,,percent of total billed charges,,,,,,,,,7324.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2396.88,22,,percent of total billed charges,,,8724.63,91,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,7957.63,83,,percent of total billed charges,,,,,,,,,,,,,,,7957.63,83,,percent of total billed charges,,,9108.13,95,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,7861.75,82,,percent of total billed charges,,,8628.75,90,,percent of total billed charges,,,8149.38,85,,percent of total billed charges,,2396.88,9108.13,
ARTHREX BONE GRAFT HARVESTER 8MM,30188553,CDM,,,278,RC,outpatient,,3672.5,3672.5,,3117.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,918.13,22,,percent of total billed charges,,,,,,,,,3305.25,90,,percent of total billed charges,,,3040.83,82.8,,percent of total billed charges,,,3121.63,85,,percent of total billed charges,,,,,,,,,3231.8,88,,percent of total billed charges,,,,,,,,,2805.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,918.13,22,,percent of total billed charges,,,3341.98,91,,percent of total billed charges,,,3488.88,95,,percent of total billed charges,,,3048.18,83,,percent of total billed charges,,,3048.18,83,,percent of total billed charges,,,,,,,,,,,,,,,3048.18,83,,percent of total billed charges,,,3488.88,95,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3011.45,82,,percent of total billed charges,,,3305.25,90,,percent of total billed charges,,,3121.63,85,,percent of total billed charges,,918.13,3488.88,
ARTHREX SCREW LP TI 4.5X32MM,30188554,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
ARTHREX SCREW LP TI 4.5X34MM,30188555,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
ARTHREX SCREW LP TI 4.5X36MM,30188556,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
ARTHREX SCREW LP TI 4.5X38MM,30188557,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
ARTHREX SCREW LP TI 4.5X48MM,30188558,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
ARTHREX SCREW LP TI 4.5X50MM,30188559,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
ARTHREX SCREW LP TI 4.5X60MM,30188560,CDM,,,278,RC,outpatient,,525,525,,445.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.25,22,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,434.7,82.8,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,,,,,,,,462,88,,percent of total billed charges,,,,,,,,,401.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.25,22,,percent of total billed charges,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,430.5,82,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,131.25,498.75,
ARTHREX G-WIRE W/TROCAR TIP .094X8,30188561,CDM,,,278,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
ARTHREX BB-TAK LARGE THREADED,30188562,CDM,,,278,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
ARTHREX DRILL BIT CALIBRATED 3.0MM LONG,30188563,CDM,,,278,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
ARTHREX DRILL BIT SOLID 5.5MM LONG,30188564,CDM,,,278,RC,outpatient,,975,975,,827.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.75,22,,percent of total billed charges,,,,,,,,,877.5,90,,percent of total billed charges,,,807.3,82.8,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,,,,,,,,858,88,,percent of total billed charges,,,,,,,,,744.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.75,22,,percent of total billed charges,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,,,,,,,,,,,,,809.25,83,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,799.5,82,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,243.75,926.25,
ARTHREX ANKLE FUSION PLATE ANTERIOR TT R,30188565,CDM,,,278,RC,outpatient,,13487.5,13487.5,,11450.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3371.88,22,,percent of total billed charges,,,,,,,,,12138.75,90,,percent of total billed charges,,,11167.65,82.8,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,,,,,,,,11869,88,,percent of total billed charges,,,,,,,,,10304.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3371.88,22,,percent of total billed charges,,,12273.63,91,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,11194.63,83,,percent of total billed charges,,,,,,,,,,,,,,,11194.63,83,,percent of total billed charges,,,12813.13,95,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11059.75,82,,percent of total billed charges,,,12138.75,90,,percent of total billed charges,,,11464.38,85,,percent of total billed charges,,3371.88,12813.13,
ARTHREX ALLOSYNC PURE 5CC,30188566,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
BOSTON URETERAL ACCESS SHEATH 11/13 X 46,30188567,CDM,,,270,RC,outpatient,,841.4,841.4,,714.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210.35,22,,percent of total billed charges,,,,,,,,,757.26,90,,percent of total billed charges,,,696.68,82.8,,percent of total billed charges,,,715.19,85,,percent of total billed charges,,,,,,,,,740.43,88,,percent of total billed charges,,,,,,,,,642.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210.35,22,,percent of total billed charges,,,765.67,91,,percent of total billed charges,,,799.33,95,,percent of total billed charges,,,698.36,83,,percent of total billed charges,,,698.36,83,,percent of total billed charges,,,,,,,,,,,,,,,698.36,83,,percent of total billed charges,,,799.33,95,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,689.95,82,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,715.19,85,,percent of total billed charges,,210.35,799.33,
BOSTON URETERAL ACCESS SHEATH 12/14 X 36,30188568,CDM,,,270,RC,outpatient,,841.4,841.4,,714.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210.35,22,,percent of total billed charges,,,,,,,,,757.26,90,,percent of total billed charges,,,696.68,82.8,,percent of total billed charges,,,715.19,85,,percent of total billed charges,,,,,,,,,740.43,88,,percent of total billed charges,,,,,,,,,642.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210.35,22,,percent of total billed charges,,,765.67,91,,percent of total billed charges,,,799.33,95,,percent of total billed charges,,,698.36,83,,percent of total billed charges,,,698.36,83,,percent of total billed charges,,,,,,,,,,,,,,,698.36,83,,percent of total billed charges,,,799.33,95,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,689.95,82,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,715.19,85,,percent of total billed charges,,210.35,799.33,
BOSTON URETERAL ACCESS SHEATH 12/14 X 46,30188569,CDM,,,270,RC,outpatient,,841.4,841.4,,714.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210.35,22,,percent of total billed charges,,,,,,,,,757.26,90,,percent of total billed charges,,,696.68,82.8,,percent of total billed charges,,,715.19,85,,percent of total billed charges,,,,,,,,,740.43,88,,percent of total billed charges,,,,,,,,,642.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210.35,22,,percent of total billed charges,,,765.67,91,,percent of total billed charges,,,799.33,95,,percent of total billed charges,,,698.36,83,,percent of total billed charges,,,698.36,83,,percent of total billed charges,,,,,,,,,,,,,,,698.36,83,,percent of total billed charges,,,799.33,95,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,689.95,82,,percent of total billed charges,,,757.26,90,,percent of total billed charges,,,715.19,85,,percent of total billed charges,,210.35,799.33,
STRYKER FEMUR CR #8 LFT,30188570,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER INSERT CS SZ 7 9MM,30188571,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
ZIMMER TIBIA RIGHT CR SZ F,30188572,CDM,,,278,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
SYNTHES GUIDEWIRE 1.6X150MM,30188573,CDM,,,278,RC,outpatient,,372.4,372.4,,316.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.1,22,,percent of total billed charges,,,,,,,,,335.16,90,,percent of total billed charges,,,308.35,82.8,,percent of total billed charges,,,316.54,85,,percent of total billed charges,,,,,,,,,327.71,88,,percent of total billed charges,,,,,,,,,284.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.1,22,,percent of total billed charges,,,338.88,91,,percent of total billed charges,,,353.78,95,,percent of total billed charges,,,309.09,83,,percent of total billed charges,,,309.09,83,,percent of total billed charges,,,,,,,,,,,,,,,309.09,83,,percent of total billed charges,,,353.78,95,,percent of total billed charges,,,335.16,90,,percent of total billed charges,,,335.16,90,,percent of total billed charges,,,305.37,82,,percent of total billed charges,,,335.16,90,,percent of total billed charges,,,316.54,85,,percent of total billed charges,,93.1,353.78,
BIOTRONIK PACEMAKER BIOMONITOR IIIM,30188574,CDM,,,278,RC,outpatient,,27300,27300,,23177.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6825,22,,percent of total billed charges,,,,,,,,,24570,90,,percent of total billed charges,,,22604.4,82.8,,percent of total billed charges,,,23205,85,,percent of total billed charges,,,,,,,,,24024,88,,percent of total billed charges,,,,,,,,,20857.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6825,22,,percent of total billed charges,,,24843,91,,percent of total billed charges,,,25935,95,,percent of total billed charges,,,22659,83,,percent of total billed charges,,,22659,83,,percent of total billed charges,,,,,,,,,,,,,,,22659,83,,percent of total billed charges,,,25935,95,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,22386,82,,percent of total billed charges,,,24570,90,,percent of total billed charges,,,23205,85,,percent of total billed charges,,6825,25935,
SURETRAC ELASTIC TRACTION SYSTEM 11MM,30188575,CDM,,,270,RC,outpatient,,1924,1924,,1633.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,481,22,,percent of total billed charges,,,,,,,,,1731.6,90,,percent of total billed charges,,,1593.07,82.8,,percent of total billed charges,,,1635.4,85,,percent of total billed charges,,,,,,,,,1693.12,88,,percent of total billed charges,,,,,,,,,1469.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,481,22,,percent of total billed charges,,,1750.84,91,,percent of total billed charges,,,1827.8,95,,percent of total billed charges,,,1596.92,83,,percent of total billed charges,,,1596.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1596.92,83,,percent of total billed charges,,,1827.8,95,,percent of total billed charges,,,1731.6,90,,percent of total billed charges,,,1731.6,90,,percent of total billed charges,,,1577.68,82,,percent of total billed charges,,,1731.6,90,,percent of total billed charges,,,1635.4,85,,percent of total billed charges,,481,1827.8,
ULTRASOUND GUIDED BIOPSY PROCEDURE FEE,30188576,CDM,,,270,RC,outpatient,,8450,8450,,7174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2112.5,22,,percent of total billed charges,,,,,,,,,7605,90,,percent of total billed charges,,,6996.6,82.8,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,,,,,,,,7436,88,,percent of total billed charges,,,,,,,,,6455.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2112.5,22,,percent of total billed charges,,,7689.5,91,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,7013.5,83,,percent of total billed charges,,,,,,,,,,,,,,,7013.5,83,,percent of total billed charges,,,8027.5,95,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,6929,82,,percent of total billed charges,,,7605,90,,percent of total billed charges,,,7182.5,85,,percent of total billed charges,,2112.5,8027.5,
STRYKER FEMUR TRIATHLON CR SZ 7 LEFT,30188577,CDM,,,278,RC,outpatient,,14950,14950,,12692.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3737.5,22,,percent of total billed charges,,,,,,,,,13455,90,,percent of total billed charges,,,12378.6,82.8,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,,,,,,,,13156,88,,percent of total billed charges,,,,,,,,,11421.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3737.5,22,,percent of total billed charges,,,13604.5,91,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,12408.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12408.5,83,,percent of total billed charges,,,14202.5,95,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12259,82,,percent of total billed charges,,,13455,90,,percent of total billed charges,,,12707.5,85,,percent of total billed charges,,3737.5,14202.5,
STRYKER INSERT TIBIA CS SZ 6 11MM,30188578,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
STRYKER INSERT CS #4 10MM,30188579,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
ZIMMER DRILL BIT CALIB 2.7MM,30188580,CDM,,,278,RC,outpatient,,728,728,,618.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,182,22,,percent of total billed charges,,,,,,,,,655.2,90,,percent of total billed charges,,,602.78,82.8,,percent of total billed charges,,,618.8,85,,percent of total billed charges,,,,,,,,,640.64,88,,percent of total billed charges,,,,,,,,,556.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,182,22,,percent of total billed charges,,,662.48,91,,percent of total billed charges,,,691.6,95,,percent of total billed charges,,,604.24,83,,percent of total billed charges,,,604.24,83,,percent of total billed charges,,,,,,,,,,,,,,,604.24,83,,percent of total billed charges,,,691.6,95,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,596.96,82,,percent of total billed charges,,,655.2,90,,percent of total billed charges,,,618.8,85,,percent of total billed charges,,182,691.6,
ZIMMER K-WIRE S3 2.0 X 152MM,30188581,CDM,,,278,RC,outpatient,,285,285,,241.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.25,22,,percent of total billed charges,,,,,,,,,256.5,90,,percent of total billed charges,,,235.98,82.8,,percent of total billed charges,,,242.25,85,,percent of total billed charges,,,,,,,,,250.8,88,,percent of total billed charges,,,,,,,,,217.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.25,22,,percent of total billed charges,,,259.35,91,,percent of total billed charges,,,270.75,95,,percent of total billed charges,,,236.55,83,,percent of total billed charges,,,236.55,83,,percent of total billed charges,,,,,,,,,,,,,,,236.55,83,,percent of total billed charges,,,270.75,95,,percent of total billed charges,,,256.5,90,,percent of total billed charges,,,256.5,90,,percent of total billed charges,,,233.7,82,,percent of total billed charges,,,256.5,90,,percent of total billed charges,,,242.25,85,,percent of total billed charges,,71.25,270.75,
ZIMMER PLATE HUM LO 11 HOLE 190MM,30188582,CDM,,,278,RC,outpatient,,12584,12584,,10683.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3146,22,,percent of total billed charges,,,,,,,,,11325.6,90,,percent of total billed charges,,,10419.55,82.8,,percent of total billed charges,,,10696.4,85,,percent of total billed charges,,,,,,,,,11073.92,88,,percent of total billed charges,,,,,,,,,9614.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3146,22,,percent of total billed charges,,,11451.44,91,,percent of total billed charges,,,11954.8,95,,percent of total billed charges,,,10444.72,83,,percent of total billed charges,,,10444.72,83,,percent of total billed charges,,,,,,,,,,,,,,,10444.72,83,,percent of total billed charges,,,11954.8,95,,percent of total billed charges,,,11325.6,90,,percent of total billed charges,,,11325.6,90,,percent of total billed charges,,,10318.88,82,,percent of total billed charges,,,11325.6,90,,percent of total billed charges,,,10696.4,85,,percent of total billed charges,,3146,11954.8,
ZIMMER SCREW CORTICAL ST 3.5X20MM,30188583,CDM,,,278,RC,outpatient,,195.2,195.2,,165.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.8,22,,percent of total billed charges,,,,,,,,,175.68,90,,percent of total billed charges,,,161.63,82.8,,percent of total billed charges,,,165.92,85,,percent of total billed charges,,,,,,,,,171.78,88,,percent of total billed charges,,,,,,,,,149.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.8,22,,percent of total billed charges,,,177.63,91,,percent of total billed charges,,,185.44,95,,percent of total billed charges,,,162.02,83,,percent of total billed charges,,,162.02,83,,percent of total billed charges,,,,,,,,,,,,,,,162.02,83,,percent of total billed charges,,,185.44,95,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,160.06,82,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,165.92,85,,percent of total billed charges,,48.8,185.44,
ZIMMER SCREW CORTICAL ST 3.5X18MM,30188584,CDM,,,278,RC,outpatient,,195.2,195.2,,165.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.8,22,,percent of total billed charges,,,,,,,,,175.68,90,,percent of total billed charges,,,161.63,82.8,,percent of total billed charges,,,165.92,85,,percent of total billed charges,,,,,,,,,171.78,88,,percent of total billed charges,,,,,,,,,149.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.8,22,,percent of total billed charges,,,177.63,91,,percent of total billed charges,,,185.44,95,,percent of total billed charges,,,162.02,83,,percent of total billed charges,,,162.02,83,,percent of total billed charges,,,,,,,,,,,,,,,162.02,83,,percent of total billed charges,,,185.44,95,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,160.06,82,,percent of total billed charges,,,175.68,90,,percent of total billed charges,,,165.92,85,,percent of total billed charges,,48.8,185.44,
ZIMMER SCREW CORTICAL T15 3.5X20MM,30188585,CDM,,,278,RC,outpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,105,22,,percent of total billed charges,,,,,,,,,378,90,,percent of total billed charges,,,347.76,82.8,,percent of total billed charges,,,357,85,,percent of total billed charges,,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,105,22,,percent of total billed charges,,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,105,399,
ZIMMER SCREW CORTICAL T15 3.5X22MM,30188586,CDM,,,278,RC,outpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,105,22,,percent of total billed charges,,,,,,,,,378,90,,percent of total billed charges,,,347.76,82.8,,percent of total billed charges,,,357,85,,percent of total billed charges,,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,105,22,,percent of total billed charges,,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,105,399,
ZIMMER SCREW CORTICAL T15 3.5X28MM,30188587,CDM,,,278,RC,outpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,105,22,,percent of total billed charges,,,,,,,,,378,90,,percent of total billed charges,,,347.76,82.8,,percent of total billed charges,,,357,85,,percent of total billed charges,,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,105,22,,percent of total billed charges,,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,105,399,
ZIMMER SCREW CORTICAL T15 3.5X26MM,30188588,CDM,,,278,RC,outpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,105,22,,percent of total billed charges,,,,,,,,,378,90,,percent of total billed charges,,,347.76,82.8,,percent of total billed charges,,,357,85,,percent of total billed charges,,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,105,22,,percent of total billed charges,,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,105,399,
ZIMMER SCREW LOCKING CANC 4.0 X 34MM,30188589,CDM,,,278,RC,outpatient,,858,858,,728.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214.5,22,,percent of total billed charges,,,,,,,,,772.2,90,,percent of total billed charges,,,710.42,82.8,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,,,,,,,,755.04,88,,percent of total billed charges,,,,,,,,,655.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214.5,22,,percent of total billed charges,,,780.78,91,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,,,,,,,,,,,,,712.14,83,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,703.56,82,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,214.5,815.1,
ZIMMER SCREW LOCKING CANC 4.0 X 36MM,30188590,CDM,,,278,RC,outpatient,,858,858,,728.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214.5,22,,percent of total billed charges,,,,,,,,,772.2,90,,percent of total billed charges,,,710.42,82.8,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,,,,,,,,755.04,88,,percent of total billed charges,,,,,,,,,655.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214.5,22,,percent of total billed charges,,,780.78,91,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,,,,,,,,,,,,,712.14,83,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,703.56,82,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,214.5,815.1,
ZIMMER SCREW LOCKING CANC 4.0 X 32MM,30188591,CDM,,,278,RC,outpatient,,858,858,,728.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214.5,22,,percent of total billed charges,,,,,,,,,772.2,90,,percent of total billed charges,,,710.42,82.8,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,,,,,,,,755.04,88,,percent of total billed charges,,,,,,,,,655.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214.5,22,,percent of total billed charges,,,780.78,91,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,,,,,,,,,,,,,712.14,83,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,703.56,82,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,214.5,815.1,
ZIMMER SCREW LOCKING CANC 4.0 X 30MM,30188592,CDM,,,278,RC,outpatient,,858,858,,728.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214.5,22,,percent of total billed charges,,,,,,,,,772.2,90,,percent of total billed charges,,,710.42,82.8,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,,,,,,,,755.04,88,,percent of total billed charges,,,,,,,,,655.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214.5,22,,percent of total billed charges,,,780.78,91,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,,,,,,,,,,,,,712.14,83,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,703.56,82,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,214.5,815.1,
ZIMMER SCREW LOCKING CANC 4.0 X 55MM,30188593,CDM,,,278,RC,outpatient,,858,858,,728.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214.5,22,,percent of total billed charges,,,,,,,,,772.2,90,,percent of total billed charges,,,710.42,82.8,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,,,,,,,,755.04,88,,percent of total billed charges,,,,,,,,,655.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214.5,22,,percent of total billed charges,,,780.78,91,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,,,,,,,,,,,,,712.14,83,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,703.56,82,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,214.5,815.1,
ZIMMER SCREW LOCKING CANC 4.0 X 22MM,30188594,CDM,,,278,RC,outpatient,,858,858,,728.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214.5,22,,percent of total billed charges,,,,,,,,,772.2,90,,percent of total billed charges,,,710.42,82.8,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,,,,,,,,755.04,88,,percent of total billed charges,,,,,,,,,655.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214.5,22,,percent of total billed charges,,,780.78,91,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,,,,,,,,,,,,,712.14,83,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,703.56,82,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,214.5,815.1,
ZIMMER SCREW TI MD 3.5 X 22MM,30188595,CDM,,,278,RC,outpatient,,1176.5,1176.5,,998.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,294.13,22,,percent of total billed charges,,,,,,,,,1058.85,90,,percent of total billed charges,,,974.14,82.8,,percent of total billed charges,,,1000.03,85,,percent of total billed charges,,,,,,,,,1035.32,88,,percent of total billed charges,,,,,,,,,898.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,294.13,22,,percent of total billed charges,,,1070.62,91,,percent of total billed charges,,,1117.68,95,,percent of total billed charges,,,976.5,83,,percent of total billed charges,,,976.5,83,,percent of total billed charges,,,,,,,,,,,,,,,976.5,83,,percent of total billed charges,,,1117.68,95,,percent of total billed charges,,,1058.85,90,,percent of total billed charges,,,1058.85,90,,percent of total billed charges,,,964.73,82,,percent of total billed charges,,,1058.85,90,,percent of total billed charges,,,1000.03,85,,percent of total billed charges,,294.13,1117.68,
STRYKER INSERT TIBA CS SZ 4 14MM,30188596,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
DEPUY STEM CORAIL HIGH COL SZ 11,30188597,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
SCREW LATERAL MASS 20 X 3.5MM,30188598,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
SCREW LATERAL MASS 25 X 5.0,30188599,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
ULRICH DRILL 2.4,30188600,CDM,,,278,RC,outpatient,,2340,2340,,1986.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,585,22,,percent of total billed charges,,,,,,,,,2106,90,,percent of total billed charges,,,1937.52,82.8,,percent of total billed charges,,,1989,85,,percent of total billed charges,,,,,,,,,2059.2,88,,percent of total billed charges,,,,,,,,,1787.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,585,22,,percent of total billed charges,,,2129.4,91,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1942.2,83,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1918.8,82,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1989,85,,percent of total billed charges,,585,2223,
SYNTHES DRILL BIT LARGE STEPPED QC 4.5/6,30188601,CDM,,,270,RC,outpatient,,5122.91,5122.91,,4349.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1280.73,22,,percent of total billed charges,,,,,,,,,4610.62,90,,percent of total billed charges,,,4241.77,82.8,,percent of total billed charges,,,4354.47,85,,percent of total billed charges,,,,,,,,,4508.16,88,,percent of total billed charges,,,,,,,,,3913.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1280.73,22,,percent of total billed charges,,,4661.85,91,,percent of total billed charges,,,4866.76,95,,percent of total billed charges,,,4252.02,83,,percent of total billed charges,,,4252.02,83,,percent of total billed charges,,,,,,,,,,,,,,,4252.02,83,,percent of total billed charges,,,4866.76,95,,percent of total billed charges,,,4610.62,90,,percent of total billed charges,,,4610.62,90,,percent of total billed charges,,,4200.79,82,,percent of total billed charges,,,4610.62,90,,percent of total billed charges,,,4354.47,85,,percent of total billed charges,,1280.73,4866.76,
SYNTHES FRN CANN 380X10 RIGHT,30188602,CDM,,,278,RC,outpatient,,19234.74,19234.74,,16330.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4808.69,22,,percent of total billed charges,,,,,,,,,17311.27,90,,percent of total billed charges,,,15926.36,82.8,,percent of total billed charges,,,16349.53,85,,percent of total billed charges,,,,,,,,,16926.57,88,,percent of total billed charges,,,,,,,,,14695.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4808.69,22,,percent of total billed charges,,,17503.61,91,,percent of total billed charges,,,18273,95,,percent of total billed charges,,,15964.83,83,,percent of total billed charges,,,15964.83,83,,percent of total billed charges,,,,,,,,,,,,,,,15964.83,83,,percent of total billed charges,,,18273,95,,percent of total billed charges,,,17311.27,90,,percent of total billed charges,,,17311.27,90,,percent of total billed charges,,,15772.49,82,,percent of total billed charges,,,17311.27,90,,percent of total billed charges,,,16349.53,85,,percent of total billed charges,,4808.69,18273,
SYNTHES SCREW TI RECON 6.5 X 85,30188603,CDM,,,278,RC,outpatient,,2321.15,2321.15,,1970.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,580.29,22,,percent of total billed charges,,,,,,,,,2089.04,90,,percent of total billed charges,,,1921.91,82.8,,percent of total billed charges,,,1972.98,85,,percent of total billed charges,,,,,,,,,2042.61,88,,percent of total billed charges,,,,,,,,,1773.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,580.29,22,,percent of total billed charges,,,2112.25,91,,percent of total billed charges,,,2205.09,95,,percent of total billed charges,,,1926.55,83,,percent of total billed charges,,,1926.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1926.55,83,,percent of total billed charges,,,2205.09,95,,percent of total billed charges,,,2089.04,90,,percent of total billed charges,,,2089.04,90,,percent of total billed charges,,,1903.34,82,,percent of total billed charges,,,2089.04,90,,percent of total billed charges,,,1972.98,85,,percent of total billed charges,,580.29,2205.09,
STRYKER SCREW LP 6.5X30MM,30188604,CDM,,,278,RC,outpatient,,946.4,946.4,,803.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,236.6,22,,percent of total billed charges,,,,,,,,,851.76,90,,percent of total billed charges,,,783.62,82.8,,percent of total billed charges,,,804.44,85,,percent of total billed charges,,,,,,,,,832.83,88,,percent of total billed charges,,,,,,,,,723.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,236.6,22,,percent of total billed charges,,,861.22,91,,percent of total billed charges,,,899.08,95,,percent of total billed charges,,,785.51,83,,percent of total billed charges,,,785.51,83,,percent of total billed charges,,,,,,,,,,,,,,,785.51,83,,percent of total billed charges,,,899.08,95,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,776.05,82,,percent of total billed charges,,,851.76,90,,percent of total billed charges,,,804.44,85,,percent of total billed charges,,236.6,899.08,
DEPUY-MITEK TENODESIS KIT,30188605,CDM,,,278,RC,outpatient,,5141.5,5141.5,,4365.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1285.38,22,,percent of total billed charges,,,,,,,,,4627.35,90,,percent of total billed charges,,,4257.16,82.8,,percent of total billed charges,,,4370.28,85,,percent of total billed charges,,,,,,,,,4524.52,88,,percent of total billed charges,,,,,,,,,3928.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1285.38,22,,percent of total billed charges,,,4678.77,91,,percent of total billed charges,,,4884.43,95,,percent of total billed charges,,,4267.45,83,,percent of total billed charges,,,4267.45,83,,percent of total billed charges,,,,,,,,,,,,,,,4267.45,83,,percent of total billed charges,,,4884.43,95,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4216.03,82,,percent of total billed charges,,,4627.35,90,,percent of total billed charges,,,4370.28,85,,percent of total billed charges,,1285.38,4884.43,
DEPUY-MITEK QUICKANCHOR SUPER,30188606,CDM,,,278,RC,outpatient,,4589,4589,,3896.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1147.25,22,,percent of total billed charges,,,,,,,,,4130.1,90,,percent of total billed charges,,,3799.69,82.8,,percent of total billed charges,,,3900.65,85,,percent of total billed charges,,,,,,,,,4038.32,88,,percent of total billed charges,,,,,,,,,3506,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1147.25,22,,percent of total billed charges,,,4175.99,91,,percent of total billed charges,,,4359.55,95,,percent of total billed charges,,,3808.87,83,,percent of total billed charges,,,3808.87,83,,percent of total billed charges,,,,,,,,,,,,,,,3808.87,83,,percent of total billed charges,,,4359.55,95,,percent of total billed charges,,,4130.1,90,,percent of total billed charges,,,4130.1,90,,percent of total billed charges,,,3762.98,82,,percent of total billed charges,,,4130.1,90,,percent of total billed charges,,,3900.65,85,,percent of total billed charges,,1147.25,4359.55,
STRYKER FEMUR CEMENTED #4 RIGHT,30188607,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
MEDTRONIC HAWKONE LARGE SHORT,30188608,CDM,,,270,RC,outpatient,,24292.13,24292.13,,20624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6073.03,22,,percent of total billed charges,,,,,,,,,21862.92,90,,percent of total billed charges,,,20113.88,82.8,,percent of total billed charges,,,20648.31,85,,percent of total billed charges,,,,,,,,,21377.07,88,,percent of total billed charges,,,,,,,,,18559.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6073.03,22,,percent of total billed charges,,,22105.84,91,,percent of total billed charges,,,23077.52,95,,percent of total billed charges,,,20162.47,83,,percent of total billed charges,,,20162.47,83,,percent of total billed charges,,,,,,,,,,,,,,,20162.47,83,,percent of total billed charges,,,23077.52,95,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,19919.55,82,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,20648.31,85,,percent of total billed charges,,6073.03,23077.52,
MEDTRONIC VIANCE STANDARD EV3 150CM,30188609,CDM,,,270,RC,outpatient,,11319.82,11319.82,,9610.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2829.96,22,,percent of total billed charges,,,,,,,,,10187.84,90,,percent of total billed charges,,,9372.81,82.8,,percent of total billed charges,,,9621.85,85,,percent of total billed charges,,,,,,,,,9961.44,88,,percent of total billed charges,,,,,,,,,8648.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2829.96,22,,percent of total billed charges,,,10301.04,91,,percent of total billed charges,,,10753.83,95,,percent of total billed charges,,,9395.45,83,,percent of total billed charges,,,9395.45,83,,percent of total billed charges,,,,,,,,,,,,,,,9395.45,83,,percent of total billed charges,,,10753.83,95,,percent of total billed charges,,,10187.84,90,,percent of total billed charges,,,10187.84,90,,percent of total billed charges,,,9282.25,82,,percent of total billed charges,,,10187.84,90,,percent of total billed charges,,,9621.85,85,,percent of total billed charges,,2829.96,10753.83,
ULRICH TAP  4.5,30188610,CDM,,,278,RC,outpatient,,2925,2925,,2483.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731.25,22,,percent of total billed charges,,,,,,,,,2632.5,90,,percent of total billed charges,,,2421.9,82.8,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,,,,,,,,2574,88,,percent of total billed charges,,,,,,,,,2234.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731.25,22,,percent of total billed charges,,,2661.75,91,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,2427.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2427.75,83,,percent of total billed charges,,,2778.75,95,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2398.5,82,,percent of total billed charges,,,2632.5,90,,percent of total billed charges,,,2486.25,85,,percent of total billed charges,,731.25,2778.75,
IMPACT ADMIRAL BALLOON 4X250X130,30188611,CDM,,,270,RC,outpatient,,21417.5,21417.5,,18183.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5354.38,22,,percent of total billed charges,,,,,,,,,19275.75,90,,percent of total billed charges,,,17733.69,82.8,,percent of total billed charges,,,18204.88,85,,percent of total billed charges,,,,,,,,,18847.4,88,,percent of total billed charges,,,,,,,,,16362.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5354.38,22,,percent of total billed charges,,,19489.93,91,,percent of total billed charges,,,20346.63,95,,percent of total billed charges,,,17776.53,83,,percent of total billed charges,,,17776.53,83,,percent of total billed charges,,,,,,,,,,,,,,,17776.53,83,,percent of total billed charges,,,20346.63,95,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,17562.35,82,,percent of total billed charges,,,19275.75,90,,percent of total billed charges,,,18204.88,85,,percent of total billed charges,,5354.38,20346.63,
STRYKER HEAD BIPOLAR 26MM X 53MM,30188612,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
STRYKER HEAD BIPOLAR 28MM,30188613,CDM,,,278,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
NEXTMED ESWL,30188614,CDM,,,270,RC,outpatient,,16250,16250,,13796.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4062.5,22,,percent of total billed charges,,,,,,,,,14625,90,,percent of total billed charges,,,13455,82.8,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,,,,,,,,14300,88,,percent of total billed charges,,,,,,,,,12415,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4062.5,22,,percent of total billed charges,,,14787.5,91,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,13487.5,83,,percent of total billed charges,,,,,,,,,,,,,,,13487.5,83,,percent of total billed charges,,,15437.5,95,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13325,82,,percent of total billed charges,,,14625,90,,percent of total billed charges,,,13812.5,85,,percent of total billed charges,,4062.5,15437.5,
SYNTHES PLATE DISTAL TIBIAL 3.5 X 10 HOL,30188615,CDM,,,270,RC,outpatient,,14120.28,14120.28,,11988.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3530.07,22,,percent of total billed charges,,,,,,,,,12708.25,90,,percent of total billed charges,,,11691.59,82.8,,percent of total billed charges,,,12002.24,85,,percent of total billed charges,,,,,,,,,12425.85,88,,percent of total billed charges,,,,,,,,,10787.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3530.07,22,,percent of total billed charges,,,12849.45,91,,percent of total billed charges,,,13414.27,95,,percent of total billed charges,,,11719.83,83,,percent of total billed charges,,,11719.83,83,,percent of total billed charges,,,,,,,,,,,,,,,11719.83,83,,percent of total billed charges,,,13414.27,95,,percent of total billed charges,,,12708.25,90,,percent of total billed charges,,,12708.25,90,,percent of total billed charges,,,11578.63,82,,percent of total billed charges,,,12708.25,90,,percent of total billed charges,,,12002.24,85,,percent of total billed charges,,3530.07,13414.27,
FORTEC ULTRASOUND,30188616,CDM,,,270,RC,outpatient,,5850,5850,,4966.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1462.5,22,,percent of total billed charges,,,,,,,,,5265,90,,percent of total billed charges,,,4843.8,82.8,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,,,,,,,,5148,88,,percent of total billed charges,,,,,,,,,4469.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1462.5,22,,percent of total billed charges,,,5323.5,91,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,4855.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4855.5,83,,percent of total billed charges,,,5557.5,95,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4797,82,,percent of total billed charges,,,5265,90,,percent of total billed charges,,,4972.5,85,,percent of total billed charges,,1462.5,5557.5,
FORTEC TRANSDUCER BK 9048,30188617,CDM,,,270,RC,outpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325,22,,percent of total billed charges,,,,,,,,,1170,90,,percent of total billed charges,,,1076.4,82.8,,percent of total billed charges,,,1105,85,,percent of total billed charges,,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325,22,,percent of total billed charges,,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,325,1235,
FORTEC TRANSDUCER COVER,30188618,CDM,,,270,RC,outpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50,22,,percent of total billed charges,,,,,,,,,180,90,,percent of total billed charges,,,165.6,82.8,,percent of total billed charges,,,170,85,,percent of total billed charges,,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50,22,,percent of total billed charges,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,50,190,
FORTEC PRECISION POINT,30188619,CDM,,,270,RC,outpatient,,1540.5,1540.5,,1307.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,385.13,22,,percent of total billed charges,,,,,,,,,1386.45,90,,percent of total billed charges,,,1275.53,82.8,,percent of total billed charges,,,1309.43,85,,percent of total billed charges,,,,,,,,,1355.64,88,,percent of total billed charges,,,,,,,,,1176.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,385.13,22,,percent of total billed charges,,,1401.86,91,,percent of total billed charges,,,1463.48,95,,percent of total billed charges,,,1278.62,83,,percent of total billed charges,,,1278.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1278.62,83,,percent of total billed charges,,,1463.48,95,,percent of total billed charges,,,1386.45,90,,percent of total billed charges,,,1386.45,90,,percent of total billed charges,,,1263.21,82,,percent of total billed charges,,,1386.45,90,,percent of total billed charges,,,1309.43,85,,percent of total billed charges,,385.13,1463.48,
FORTEC FIBER THULIUM TFL 365,30188620,CDM,,,270,RC,outpatient,,1625,1625,,1379.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,406.25,22,,percent of total billed charges,,,,,,,,,1462.5,90,,percent of total billed charges,,,1345.5,82.8,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,,,,,,,,1430,88,,percent of total billed charges,,,,,,,,,1241.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,406.25,22,,percent of total billed charges,,,1478.75,91,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,1348.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1348.75,83,,percent of total billed charges,,,1543.75,95,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1332.5,82,,percent of total billed charges,,,1462.5,90,,percent of total billed charges,,,1381.25,85,,percent of total billed charges,,406.25,1543.75,
AMPLATZ URETHERAL STENT 10.2FR 24CM,30188621,CDM,,,270,RC,outpatient,,1073.22,1073.22,,911.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,268.31,22,,percent of total billed charges,,,,,,,,,965.9,90,,percent of total billed charges,,,888.63,82.8,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,,,,,,,,944.43,88,,percent of total billed charges,,,,,,,,,819.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,268.31,22,,percent of total billed charges,,,976.63,91,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,890.77,83,,percent of total billed charges,,,,,,,,,,,,,,,890.77,83,,percent of total billed charges,,,1019.56,95,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,880.04,82,,percent of total billed charges,,,965.9,90,,percent of total billed charges,,,912.24,85,,percent of total billed charges,,268.31,1019.56,
MEDTRONIC HAWKONE LARGE,30188622,CDM,,,270,RC,outpatient,,24292.13,24292.13,,20624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6073.03,22,,percent of total billed charges,,,,,,,,,21862.92,90,,percent of total billed charges,,,20113.88,82.8,,percent of total billed charges,,,20648.31,85,,percent of total billed charges,,,,,,,,,21377.07,88,,percent of total billed charges,,,,,,,,,18559.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6073.03,22,,percent of total billed charges,,,22105.84,91,,percent of total billed charges,,,23077.52,95,,percent of total billed charges,,,20162.47,83,,percent of total billed charges,,,20162.47,83,,percent of total billed charges,,,,,,,,,,,,,,,20162.47,83,,percent of total billed charges,,,23077.52,95,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,19919.55,82,,percent of total billed charges,,,21862.92,90,,percent of total billed charges,,,20648.31,85,,percent of total billed charges,,6073.03,23077.52,
ZIMMER POLY R MC VE 10MM 8-9/CD,30188623,CDM,,,278,RC,outpatient,,8287.5,8287.5,,7036.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2071.88,22,,percent of total billed charges,,,,,,,,,7458.75,90,,percent of total billed charges,,,6862.05,82.8,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,,,,,,,,7293,88,,percent of total billed charges,,,,,,,,,6331.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2071.88,22,,percent of total billed charges,,,7541.63,91,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,6878.63,83,,percent of total billed charges,,,,,,,,,,,,,,,6878.63,83,,percent of total billed charges,,,7873.13,95,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,6795.75,82,,percent of total billed charges,,,7458.75,90,,percent of total billed charges,,,7044.38,85,,percent of total billed charges,,2071.88,7873.13,
ARTHREX SUTURE TAK PERC KIT 3.0MM,30188624,CDM,,,278,RC,outpatient,,1267.5,1267.5,,1076.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.88,22,,percent of total billed charges,,,,,,,,,1140.75,90,,percent of total billed charges,,,1049.49,82.8,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,,,,,,,,1115.4,88,,percent of total billed charges,,,,,,,,,968.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.88,22,,percent of total billed charges,,,1153.43,91,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,1052.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.03,83,,percent of total billed charges,,,1204.13,95,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1039.35,82,,percent of total billed charges,,,1140.75,90,,percent of total billed charges,,,1077.38,85,,percent of total billed charges,,316.88,1204.13,
ARTHREX SUTURE TAK DL W/SUTURE TAPE 3.0M,30188625,CDM,,,278,RC,outpatient,,2340,2340,,1986.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,585,22,,percent of total billed charges,,,,,,,,,2106,90,,percent of total billed charges,,,1937.52,82.8,,percent of total billed charges,,,1989,85,,percent of total billed charges,,,,,,,,,2059.2,88,,percent of total billed charges,,,,,,,,,1787.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,585,22,,percent of total billed charges,,,2129.4,91,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,1942.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1942.2,83,,percent of total billed charges,,,2223,95,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1918.8,82,,percent of total billed charges,,,2106,90,,percent of total billed charges,,,1989,85,,percent of total billed charges,,585,2223,
DEPUY HEAD HUMERAL SZ 48 +3,30188626,CDM,,,278,RC,outpatient,,16477.5,16477.5,,13989.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4119.38,22,,percent of total billed charges,,,,,,,,,14829.75,90,,percent of total billed charges,,,13643.37,82.8,,percent of total billed charges,,,14005.88,85,,percent of total billed charges,,,,,,,,,14500.2,88,,percent of total billed charges,,,,,,,,,12588.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4119.38,22,,percent of total billed charges,,,14994.53,91,,percent of total billed charges,,,15653.63,95,,percent of total billed charges,,,13676.33,83,,percent of total billed charges,,,13676.33,83,,percent of total billed charges,,,,,,,,,,,,,,,13676.33,83,,percent of total billed charges,,,15653.63,95,,percent of total billed charges,,,14829.75,90,,percent of total billed charges,,,14829.75,90,,percent of total billed charges,,,13511.55,82,,percent of total billed charges,,,14829.75,90,,percent of total billed charges,,,14005.88,85,,percent of total billed charges,,4119.38,15653.63,
DEPUY PLATE ANCHOR SZ 48,30188627,CDM,,,278,RC,outpatient,,41340,41340,,35097.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10335,22,,percent of total billed charges,,,,,,,,,37206,90,,percent of total billed charges,,,34229.52,82.8,,percent of total billed charges,,,35139,85,,percent of total billed charges,,,,,,,,,36379.2,88,,percent of total billed charges,,,,,,,,,31583.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10335,22,,percent of total billed charges,,,37619.4,91,,percent of total billed charges,,,39273,95,,percent of total billed charges,,,34312.2,83,,percent of total billed charges,,,34312.2,83,,percent of total billed charges,,,,,,,,,,,,,,,34312.2,83,,percent of total billed charges,,,39273,95,,percent of total billed charges,,,37206,90,,percent of total billed charges,,,37206,90,,percent of total billed charges,,,33898.8,82,,percent of total billed charges,,,37206,90,,percent of total billed charges,,,35139,85,,percent of total billed charges,,10335,39273,
DEPUY PLATE SZ 52,30188628,CDM,,,278,RC,outpatient,,41340,41340,,35097.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10335,22,,percent of total billed charges,,,,,,,,,37206,90,,percent of total billed charges,,,34229.52,82.8,,percent of total billed charges,,,35139,85,,percent of total billed charges,,,,,,,,,36379.2,88,,percent of total billed charges,,,,,,,,,31583.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10335,22,,percent of total billed charges,,,37619.4,91,,percent of total billed charges,,,39273,95,,percent of total billed charges,,,34312.2,83,,percent of total billed charges,,,34312.2,83,,percent of total billed charges,,,,,,,,,,,,,,,34312.2,83,,percent of total billed charges,,,39273,95,,percent of total billed charges,,,37206,90,,percent of total billed charges,,,37206,90,,percent of total billed charges,,,33898.8,82,,percent of total billed charges,,,37206,90,,percent of total billed charges,,,35139,85,,percent of total billed charges,,10335,39273,
DEPUY HEAD HUMERAL SZ 52 +3,30188629,CDM,,,278,RC,outpatient,,16477.5,16477.5,,13989.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4119.38,22,,percent of total billed charges,,,,,,,,,14829.75,90,,percent of total billed charges,,,13643.37,82.8,,percent of total billed charges,,,14005.88,85,,percent of total billed charges,,,,,,,,,14500.2,88,,percent of total billed charges,,,,,,,,,12588.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4119.38,22,,percent of total billed charges,,,14994.53,91,,percent of total billed charges,,,15653.63,95,,percent of total billed charges,,,13676.33,83,,percent of total billed charges,,,13676.33,83,,percent of total billed charges,,,,,,,,,,,,,,,13676.33,83,,percent of total billed charges,,,15653.63,95,,percent of total billed charges,,,14829.75,90,,percent of total billed charges,,,14829.75,90,,percent of total billed charges,,,13511.55,82,,percent of total billed charges,,,14829.75,90,,percent of total billed charges,,,14005.88,85,,percent of total billed charges,,4119.38,15653.63,
DEPUY METAGLENE SCREW CTR +4,30188630,CDM,,,278,RC,outpatient,,34170.5,34170.5,,29010.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8542.63,22,,percent of total billed charges,,,,,,,,,30753.45,90,,percent of total billed charges,,,28293.17,82.8,,percent of total billed charges,,,29044.93,85,,percent of total billed charges,,,,,,,,,30070.04,88,,percent of total billed charges,,,,,,,,,26106.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8542.63,22,,percent of total billed charges,,,31095.16,91,,percent of total billed charges,,,32461.98,95,,percent of total billed charges,,,28361.52,83,,percent of total billed charges,,,28361.52,83,,percent of total billed charges,,,,,,,,,,,,,,,28361.52,83,,percent of total billed charges,,,32461.98,95,,percent of total billed charges,,,30753.45,90,,percent of total billed charges,,,30753.45,90,,percent of total billed charges,,,28019.81,82,,percent of total billed charges,,,30753.45,90,,percent of total billed charges,,,29044.93,85,,percent of total billed charges,,8542.63,32461.98,
CLIPS LIGATING TITANIUM LARGE ORANGE,30188631,CDM,,,270,RC,outpatient,,47.6,47.6,,40.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.9,22,,percent of total billed charges,,,,,,,,,42.84,90,,percent of total billed charges,,,39.41,82.8,,percent of total billed charges,,,40.46,85,,percent of total billed charges,,,,,,,,,41.89,88,,percent of total billed charges,,,,,,,,,36.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.9,22,,percent of total billed charges,,,43.32,91,,percent of total billed charges,,,45.22,95,,percent of total billed charges,,,39.51,83,,percent of total billed charges,,,39.51,83,,percent of total billed charges,,,,,,,,,,,,,,,39.51,83,,percent of total billed charges,,,45.22,95,,percent of total billed charges,,,42.84,90,,percent of total billed charges,,,42.84,90,,percent of total billed charges,,,39.03,82,,percent of total billed charges,,,42.84,90,,percent of total billed charges,,,40.46,85,,percent of total billed charges,,11.9,45.22,
FORTEC PROBE ULTRASOUND 8848,30188632,CDM,,,270,RC,outpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325,22,,percent of total billed charges,,,,,,,,,1170,90,,percent of total billed charges,,,1076.4,82.8,,percent of total billed charges,,,1105,85,,percent of total billed charges,,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325,22,,percent of total billed charges,,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,325,1235,
STRYKER STEM ACCOLADE SZ 3 35X131MM,30188633,CDM,,,278,RC,outpatient,,11700,11700,,9933.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2925,22,,percent of total billed charges,,,,,,,,,10530,90,,percent of total billed charges,,,9687.6,82.8,,percent of total billed charges,,,9945,85,,percent of total billed charges,,,,,,,,,10296,88,,percent of total billed charges,,,,,,,,,8938.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2925,22,,percent of total billed charges,,,10647,91,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,9711,83,,percent of total billed charges,,,,,,,,,,,,,,,9711,83,,percent of total billed charges,,,11115,95,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9594,82,,percent of total billed charges,,,10530,90,,percent of total billed charges,,,9945,85,,percent of total billed charges,,2925,11115,
STRYKER SPACER CEMENT 9MM,30188634,CDM,,,278,RC,outpatient,,1001,1001,,849.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,250.25,22,,percent of total billed charges,,,,,,,,,900.9,90,,percent of total billed charges,,,828.83,82.8,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,,,,,,,,880.88,88,,percent of total billed charges,,,,,,,,,764.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,250.25,22,,percent of total billed charges,,,910.91,91,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,830.83,83,,percent of total billed charges,,,,,,,,,,,,,,,830.83,83,,percent of total billed charges,,,950.95,95,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,820.82,82,,percent of total billed charges,,,900.9,90,,percent of total billed charges,,,850.85,85,,percent of total billed charges,,250.25,950.95,
AGILITI LASER PREMIUM STONE TREATEMENT,30188635,CDM,,,270,RC,outpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1218.75,22,,percent of total billed charges,,,,,,,,,4387.5,90,,percent of total billed charges,,,4036.5,82.8,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1218.75,22,,percent of total billed charges,,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,1218.75,4631.25,
AGILITI FIBER QUANTA OF,30188636,CDM,,,270,RC,outpatient,,3185,3185,,2704.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,796.25,22,,percent of total billed charges,,,,,,,,,2866.5,90,,percent of total billed charges,,,2637.18,82.8,,percent of total billed charges,,,2707.25,85,,percent of total billed charges,,,,,,,,,2802.8,88,,percent of total billed charges,,,,,,,,,2433.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,796.25,22,,percent of total billed charges,,,2898.35,91,,percent of total billed charges,,,3025.75,95,,percent of total billed charges,,,2643.55,83,,percent of total billed charges,,,2643.55,83,,percent of total billed charges,,,,,,,,,,,,,,,2643.55,83,,percent of total billed charges,,,3025.75,95,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2611.7,82,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2707.25,85,,percent of total billed charges,,796.25,3025.75,
STRYKER TIBIA TRIATHLON TRITANIUM SZ 3,30188637,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER SCREW PERIPHERAL 4.5 X20MM,30188638,CDM,,,278,RC,outpatient,,1300,1300,,1103.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325,22,,percent of total billed charges,,,,,,,,,1170,90,,percent of total billed charges,,,1076.4,82.8,,percent of total billed charges,,,1105,85,,percent of total billed charges,,,,,,,,,1144,88,,percent of total billed charges,,,,,,,,,993.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325,22,,percent of total billed charges,,,1183,91,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,1079,83,,percent of total billed charges,,,,,,,,,,,,,,,1079,83,,percent of total billed charges,,,1235,95,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1066,82,,percent of total billed charges,,,1170,90,,percent of total billed charges,,,1105,85,,percent of total billed charges,,325,1235,
STRYKER HUMERAL INSERT 32X4MM STD,30188639,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
STRYKER STEM PF HUMERAL 12X96MM,30188640,CDM,,,278,RC,outpatient,,38472.72,38472.72,,32663.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9618.18,22,,percent of total billed charges,,,,,,,,,34625.45,90,,percent of total billed charges,,,31855.41,82.8,,percent of total billed charges,,,32701.81,85,,percent of total billed charges,,,,,,,,,33855.99,88,,percent of total billed charges,,,,,,,,,29393.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9618.18,22,,percent of total billed charges,,,35010.18,91,,percent of total billed charges,,,36549.08,95,,percent of total billed charges,,,31932.36,83,,percent of total billed charges,,,31932.36,83,,percent of total billed charges,,,,,,,,,,,,,,,31932.36,83,,percent of total billed charges,,,36549.08,95,,percent of total billed charges,,,34625.45,90,,percent of total billed charges,,,34625.45,90,,percent of total billed charges,,,31547.63,82,,percent of total billed charges,,,34625.45,90,,percent of total billed charges,,,32701.81,85,,percent of total billed charges,,9618.18,36549.08,
ZIMMER SCREW NON-LOCK 2.7X24MM,30188641,CDM,,,278,RC,outpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
TORNIER GUIDEWIRE .2 X 220MM,30188642,CDM,,,278,RC,outpatient,,1137.5,1137.5,,965.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.38,22,,percent of total billed charges,,,,,,,,,1023.75,90,,percent of total billed charges,,,941.85,82.8,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,,,,,,,,1001,88,,percent of total billed charges,,,,,,,,,869.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.38,22,,percent of total billed charges,,,1035.13,91,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,944.13,83,,percent of total billed charges,,,,,,,,,,,,,,,944.13,83,,percent of total billed charges,,,1080.63,95,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,932.75,82,,percent of total billed charges,,,1023.75,90,,percent of total billed charges,,,966.88,85,,percent of total billed charges,,284.38,1080.63,
TORNIER GLENOID GUIDE PSI,30188643,CDM,,,278,RC,outpatient,,7475,7475,,6346.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1868.75,22,,percent of total billed charges,,,,,,,,,6727.5,90,,percent of total billed charges,,,6189.3,82.8,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,,,,,,,,6578,88,,percent of total billed charges,,,,,,,,,5710.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1868.75,22,,percent of total billed charges,,,6802.25,91,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,6204.25,83,,percent of total billed charges,,,,,,,,,,,,,,,6204.25,83,,percent of total billed charges,,,7101.25,95,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6129.5,82,,percent of total billed charges,,,6727.5,90,,percent of total billed charges,,,6353.75,85,,percent of total billed charges,,1868.75,7101.25,
ULRICH HOOKS,30188644,CDM,,,278,RC,outpatient,,8125,8125,,6898.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.25,22,,percent of total billed charges,,,,,,,,,7312.5,90,,percent of total billed charges,,,6727.5,82.8,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,,,,,,,,7150,88,,percent of total billed charges,,,,,,,,,6207.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.25,22,,percent of total billed charges,,,7393.75,91,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,6743.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.75,83,,percent of total billed charges,,,7718.75,95,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6662.5,82,,percent of total billed charges,,,7312.5,90,,percent of total billed charges,,,6906.25,85,,percent of total billed charges,,2031.25,7718.75,
STRYKER TIBIA TRIATHLON TRITANIUM SZ 4,30188645,CDM,,,278,RC,outpatient,,10400,10400,,8829.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2600,22,,percent of total billed charges,,,,,,,,,9360,90,,percent of total billed charges,,,8611.2,82.8,,percent of total billed charges,,,8840,85,,percent of total billed charges,,,,,,,,,9152,88,,percent of total billed charges,,,,,,,,,7945.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2600,22,,percent of total billed charges,,,9464,91,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,8632,83,,percent of total billed charges,,,,,,,,,,,,,,,8632,83,,percent of total billed charges,,,9880,95,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8528,82,,percent of total billed charges,,,9360,90,,percent of total billed charges,,,8840,85,,percent of total billed charges,,2600,9880,
FORTEC HOLMIUM FIBER 272 EXCALIBUR,30188646,CDM,,,270,RC,outpatient,,2372.5,2372.5,,2014.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,593.13,22,,percent of total billed charges,,,,,,,,,2135.25,90,,percent of total billed charges,,,1964.43,82.8,,percent of total billed charges,,,2016.63,85,,percent of total billed charges,,,,,,,,,2087.8,88,,percent of total billed charges,,,,,,,,,1812.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,593.13,22,,percent of total billed charges,,,2158.98,91,,percent of total billed charges,,,2253.88,95,,percent of total billed charges,,,1969.18,83,,percent of total billed charges,,,1969.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1969.18,83,,percent of total billed charges,,,2253.88,95,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,1945.45,82,,percent of total billed charges,,,2135.25,90,,percent of total billed charges,,,2016.63,85,,percent of total billed charges,,593.13,2253.88,
ZIMMER FEMORAL AUGMENT 5MM,30188803,CDM,,,278,RC,outpatient,,10367.5,10367.5,,8802.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2591.88,22,,percent of total billed charges,,,,,,,,,9330.75,90,,percent of total billed charges,,,8584.29,82.8,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,,,,,,,,9123.4,88,,percent of total billed charges,,,,,,,,,7920.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2591.88,22,,percent of total billed charges,,,9434.43,91,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,8605.03,83,,percent of total billed charges,,,,,,,,,,,,,,,8605.03,83,,percent of total billed charges,,,9849.13,95,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8501.35,82,,percent of total billed charges,,,9330.75,90,,percent of total billed charges,,,8812.38,85,,percent of total billed charges,,2591.88,9849.13,
COOK NEPHROSTOMY TUBE SET 14.0,30188954,CDM,,,270,RC,outpatient,,1112.28,1112.28,,944.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,278.07,22,,percent of total billed charges,,,,,,,,,1001.05,90,,percent of total billed charges,,,920.97,82.8,,percent of total billed charges,,,945.44,85,,percent of total billed charges,,,,,,,,,978.81,88,,percent of total billed charges,,,,,,,,,849.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,278.07,22,,percent of total billed charges,,,1012.17,91,,percent of total billed charges,,,1056.67,95,,percent of total billed charges,,,923.19,83,,percent of total billed charges,,,923.19,83,,percent of total billed charges,,,,,,,,,,,,,,,923.19,83,,percent of total billed charges,,,1056.67,95,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,912.07,82,,percent of total billed charges,,,1001.05,90,,percent of total billed charges,,,945.44,85,,percent of total billed charges,,278.07,1056.67,
DEPUY ATTUNE INSERT MS SZ5-6,30188955,CDM,,,278,RC,outpatient,,10005.39,10005.39,,8494.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2501.35,22,,percent of total billed charges,,,,,,,,,9004.85,90,,percent of total billed charges,,,8284.46,82.8,,percent of total billed charges,,,8504.58,85,,percent of total billed charges,,,,,,,,,8804.74,88,,percent of total billed charges,,,,,,,,,7644.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2501.35,22,,percent of total billed charges,,,9104.9,91,,percent of total billed charges,,,9505.12,95,,percent of total billed charges,,,8304.47,83,,percent of total billed charges,,,8304.47,83,,percent of total billed charges,,,,,,,,,,,,,,,8304.47,83,,percent of total billed charges,,,9505.12,95,,percent of total billed charges,,,9004.85,90,,percent of total billed charges,,,9004.85,90,,percent of total billed charges,,,8204.42,82,,percent of total billed charges,,,9004.85,90,,percent of total billed charges,,,8504.58,85,,percent of total billed charges,,2501.35,9505.12,
DEPUY ATTUNE TIBIA BASE SZ 5,30188956,CDM,,,278,RC,outpatient,,12941.11,12941.11,,10987,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3235.28,22,,percent of total billed charges,,,,,,,,,11647,90,,percent of total billed charges,,,10715.24,82.8,,percent of total billed charges,,,10999.94,85,,percent of total billed charges,,,,,,,,,11388.18,88,,percent of total billed charges,,,,,,,,,9887.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3235.28,22,,percent of total billed charges,,,11776.41,91,,percent of total billed charges,,,12294.05,95,,percent of total billed charges,,,10741.12,83,,percent of total billed charges,,,10741.12,83,,percent of total billed charges,,,,,,,,,,,,,,,10741.12,83,,percent of total billed charges,,,12294.05,95,,percent of total billed charges,,,11647,90,,percent of total billed charges,,,11647,90,,percent of total billed charges,,,10611.71,82,,percent of total billed charges,,,11647,90,,percent of total billed charges,,,10999.94,85,,percent of total billed charges,,3235.28,12294.05,
BAG URINARY DRAIN 4000ML,30190001,CDM,,,270,RC,outpatient,,37.71,37.71,,32.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.43,22,,percent of total billed charges,,,,,,,,,33.94,90,,percent of total billed charges,,,31.22,82.8,,percent of total billed charges,,,32.05,85,,percent of total billed charges,,,,,,,,,33.18,88,,percent of total billed charges,,,,,,,,,28.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.43,22,,percent of total billed charges,,,34.32,91,,percent of total billed charges,,,35.82,95,,percent of total billed charges,,,31.3,83,,percent of total billed charges,,,31.3,83,,percent of total billed charges,,,,,,,,,,,,,,,31.3,83,,percent of total billed charges,,,35.82,95,,percent of total billed charges,,,33.94,90,,percent of total billed charges,,,33.94,90,,percent of total billed charges,,,30.92,82,,percent of total billed charges,,,33.94,90,,percent of total billed charges,,,32.05,85,,percent of total billed charges,,9.43,35.82,
RAPID RHINO EPISTAXIS ANTERIOR 4.5,30200009,CDM,,,270,RC,outpatient,,319.28,319.28,,271.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.82,22,,percent of total billed charges,,,,,,,,,287.35,90,,percent of total billed charges,,,264.36,82.8,,percent of total billed charges,,,271.39,85,,percent of total billed charges,,,,,,,,,280.97,88,,percent of total billed charges,,,,,,,,,243.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.82,22,,percent of total billed charges,,,290.54,91,,percent of total billed charges,,,303.32,95,,percent of total billed charges,,,265,83,,percent of total billed charges,,,265,83,,percent of total billed charges,,,,,,,,,,,,,,,265,83,,percent of total billed charges,,,303.32,95,,percent of total billed charges,,,287.35,90,,percent of total billed charges,,,287.35,90,,percent of total billed charges,,,261.81,82,,percent of total billed charges,,,287.35,90,,percent of total billed charges,,,271.39,85,,percent of total billed charges,,79.82,303.32,
RAPID RHINO EPISTAXIS ANTERIOR 5.5,30200010,CDM,,,270,RC,outpatient,,319.28,319.28,,271.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.82,22,,percent of total billed charges,,,,,,,,,287.35,90,,percent of total billed charges,,,264.36,82.8,,percent of total billed charges,,,271.39,85,,percent of total billed charges,,,,,,,,,280.97,88,,percent of total billed charges,,,,,,,,,243.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.82,22,,percent of total billed charges,,,290.54,91,,percent of total billed charges,,,303.32,95,,percent of total billed charges,,,265,83,,percent of total billed charges,,,265,83,,percent of total billed charges,,,,,,,,,,,,,,,265,83,,percent of total billed charges,,,303.32,95,,percent of total billed charges,,,287.35,90,,percent of total billed charges,,,287.35,90,,percent of total billed charges,,,261.81,82,,percent of total billed charges,,,287.35,90,,percent of total billed charges,,,271.39,85,,percent of total billed charges,,79.82,303.32,
*RAPID RHINO EPISTAXIS ANTERIOR W/,30200011,CDM,,,270,RC,outpatient,,204,204,,173.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51,22,,percent of total billed charges,,,,,,,,,183.6,90,,percent of total billed charges,,,168.91,82.8,,percent of total billed charges,,,173.4,85,,percent of total billed charges,,,,,,,,,179.52,88,,percent of total billed charges,,,,,,,,,155.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51,22,,percent of total billed charges,,,185.64,91,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,,,,,,,,,,,,,169.32,83,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,167.28,82,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,173.4,85,,percent of total billed charges,,51,193.8,
*RAPID RHINO 7.5 ANT/POST W/AIRWAY,30200012,CDM,,,270,RC,outpatient,,226.13,226.13,,191.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.53,22,,percent of total billed charges,,,,,,,,,203.52,90,,percent of total billed charges,,,187.24,82.8,,percent of total billed charges,,,192.21,85,,percent of total billed charges,,,,,,,,,198.99,88,,percent of total billed charges,,,,,,,,,172.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.53,22,,percent of total billed charges,,,205.78,91,,percent of total billed charges,,,214.82,95,,percent of total billed charges,,,187.69,83,,percent of total billed charges,,,187.69,83,,percent of total billed charges,,,,,,,,,,,,,,,187.69,83,,percent of total billed charges,,,214.82,95,,percent of total billed charges,,,203.52,90,,percent of total billed charges,,,203.52,90,,percent of total billed charges,,,185.43,82,,percent of total billed charges,,,203.52,90,,percent of total billed charges,,,192.21,85,,percent of total billed charges,,56.53,214.82,
*RAPID RHINO PAC,30200013,CDM,,,270,RC,outpatient,,232.5,232.5,,197.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,58.13,22,,percent of total billed charges,,,,,,,,,209.25,90,,percent of total billed charges,,,192.51,82.8,,percent of total billed charges,,,197.63,85,,percent of total billed charges,,,,,,,,,204.6,88,,percent of total billed charges,,,,,,,,,177.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,58.13,22,,percent of total billed charges,,,211.58,91,,percent of total billed charges,,,220.88,95,,percent of total billed charges,,,192.98,83,,percent of total billed charges,,,192.98,83,,percent of total billed charges,,,,,,,,,,,,,,,192.98,83,,percent of total billed charges,,,220.88,95,,percent of total billed charges,,,209.25,90,,percent of total billed charges,,,209.25,90,,percent of total billed charges,,,190.65,82,,percent of total billed charges,,,209.25,90,,percent of total billed charges,,,197.63,85,,percent of total billed charges,,58.13,220.88,
*RAPID RHINO EPISTAXIS ANTERIOR,30200016,CDM,,,270,RC,outpatient,,271.5,271.5,,230.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.88,22,,percent of total billed charges,,,,,,,,,244.35,90,,percent of total billed charges,,,224.8,82.8,,percent of total billed charges,,,230.78,85,,percent of total billed charges,,,,,,,,,238.92,88,,percent of total billed charges,,,,,,,,,207.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.88,22,,percent of total billed charges,,,247.07,91,,percent of total billed charges,,,257.93,95,,percent of total billed charges,,,225.35,83,,percent of total billed charges,,,225.35,83,,percent of total billed charges,,,,,,,,,,,,,,,225.35,83,,percent of total billed charges,,,257.93,95,,percent of total billed charges,,,244.35,90,,percent of total billed charges,,,244.35,90,,percent of total billed charges,,,222.63,82,,percent of total billed charges,,,244.35,90,,percent of total billed charges,,,230.78,85,,percent of total billed charges,,67.88,257.93,
CO2 DETECTOR,30200020,CDM,,,270,RC,outpatient,,81.16,81.16,,68.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.29,22,,percent of total billed charges,,,,,,,,,73.04,90,,percent of total billed charges,,,67.2,82.8,,percent of total billed charges,,,68.99,85,,percent of total billed charges,,,,,,,,,71.42,88,,percent of total billed charges,,,,,,,,,62.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.29,22,,percent of total billed charges,,,73.86,91,,percent of total billed charges,,,77.1,95,,percent of total billed charges,,,67.36,83,,percent of total billed charges,,,67.36,83,,percent of total billed charges,,,,,,,,,,,,,,,67.36,83,,percent of total billed charges,,,77.1,95,,percent of total billed charges,,,73.04,90,,percent of total billed charges,,,73.04,90,,percent of total billed charges,,,66.55,82,,percent of total billed charges,,,73.04,90,,percent of total billed charges,,,68.99,85,,percent of total billed charges,,20.29,77.1,
C-COLLAR ADULT ADJUSTABLE,30200024,CDM,,,270,RC,outpatient,,49.13,49.13,,41.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.28,22,,percent of total billed charges,,,,,,,,,44.22,90,,percent of total billed charges,,,40.68,82.8,,percent of total billed charges,,,41.76,85,,percent of total billed charges,,,,,,,,,43.23,88,,percent of total billed charges,,,,,,,,,37.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.28,22,,percent of total billed charges,,,44.71,91,,percent of total billed charges,,,46.67,95,,percent of total billed charges,,,40.78,83,,percent of total billed charges,,,40.78,83,,percent of total billed charges,,,,,,,,,,,,,,,40.78,83,,percent of total billed charges,,,46.67,95,,percent of total billed charges,,,44.22,90,,percent of total billed charges,,,44.22,90,,percent of total billed charges,,,40.29,82,,percent of total billed charges,,,44.22,90,,percent of total billed charges,,,41.76,85,,percent of total billed charges,,12.28,46.67,
C-COLLAR PEDS ADJUSTABLE,30200025,CDM,,,270,RC,outpatient,,49.47,49.47,,42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.37,22,,percent of total billed charges,,,,,,,,,44.52,90,,percent of total billed charges,,,40.96,82.8,,percent of total billed charges,,,42.05,85,,percent of total billed charges,,,,,,,,,43.53,88,,percent of total billed charges,,,,,,,,,37.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.37,22,,percent of total billed charges,,,45.02,91,,percent of total billed charges,,,47,95,,percent of total billed charges,,,41.06,83,,percent of total billed charges,,,41.06,83,,percent of total billed charges,,,,,,,,,,,,,,,41.06,83,,percent of total billed charges,,,47,95,,percent of total billed charges,,,44.52,90,,percent of total billed charges,,,44.52,90,,percent of total billed charges,,,40.57,82,,percent of total billed charges,,,44.52,90,,percent of total billed charges,,,42.05,85,,percent of total billed charges,,12.37,47,
SPLINT FINGER METAL WHITE FOAM PAD,30200027,CDM,,,270,RC,outpatient,,26.96,26.96,,22.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.74,22,,percent of total billed charges,,,,,,,,,24.26,90,,percent of total billed charges,,,22.32,82.8,,percent of total billed charges,,,22.92,85,,percent of total billed charges,,,,,,,,,23.72,88,,percent of total billed charges,,,,,,,,,20.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.74,22,,percent of total billed charges,,,24.53,91,,percent of total billed charges,,,25.61,95,,percent of total billed charges,,,22.38,83,,percent of total billed charges,,,22.38,83,,percent of total billed charges,,,,,,,,,,,,,,,22.38,83,,percent of total billed charges,,,25.61,95,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,22.11,82,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,22.92,85,,percent of total billed charges,,6.74,25.61,
PRESSURE INFUSION BAG 1000ML DISP.,30200030,CDM,,,270,RC,outpatient,,83.98,83.98,,71.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21,22,,percent of total billed charges,,,,,,,,,75.58,90,,percent of total billed charges,,,69.54,82.8,,percent of total billed charges,,,71.38,85,,percent of total billed charges,,,,,,,,,73.9,88,,percent of total billed charges,,,,,,,,,64.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21,22,,percent of total billed charges,,,76.42,91,,percent of total billed charges,,,79.78,95,,percent of total billed charges,,,69.7,83,,percent of total billed charges,,,69.7,83,,percent of total billed charges,,,,,,,,,,,,,,,69.7,83,,percent of total billed charges,,,79.78,95,,percent of total billed charges,,,75.58,90,,percent of total billed charges,,,75.58,90,,percent of total billed charges,,,68.86,82,,percent of total billed charges,,,75.58,90,,percent of total billed charges,,,71.38,85,,percent of total billed charges,,21,79.78,
TRACH 6.5 CUFFED,30200031,CDM,,,270,RC,outpatient,,12.38,12.38,,10.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.1,22,,percent of total billed charges,,,,,,,,,11.14,90,,percent of total billed charges,,,10.25,82.8,,percent of total billed charges,,,10.52,85,,percent of total billed charges,,,,,,,,,10.89,88,,percent of total billed charges,,,,,,,,,9.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.1,22,,percent of total billed charges,,,11.27,91,,percent of total billed charges,,,11.76,95,,percent of total billed charges,,,10.28,83,,percent of total billed charges,,,10.28,83,,percent of total billed charges,,,,,,,,,,,,,,,10.28,83,,percent of total billed charges,,,11.76,95,,percent of total billed charges,,,11.14,90,,percent of total billed charges,,,11.14,90,,percent of total billed charges,,,10.15,82,,percent of total billed charges,,,11.14,90,,percent of total billed charges,,,10.52,85,,percent of total billed charges,,3.1,11.76,
TRACH 8.5 CUFFED,30200033,CDM,,,270,RC,outpatient,,24.71,24.71,,20.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.18,22,,percent of total billed charges,,,,,,,,,22.24,90,,percent of total billed charges,,,20.46,82.8,,percent of total billed charges,,,21,85,,percent of total billed charges,,,,,,,,,21.74,88,,percent of total billed charges,,,,,,,,,18.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.18,22,,percent of total billed charges,,,22.49,91,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,20.51,83,,percent of total billed charges,,,,,,,,,,,,,,,20.51,83,,percent of total billed charges,,,23.47,95,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,20.26,82,,percent of total billed charges,,,22.24,90,,percent of total billed charges,,,21,85,,percent of total billed charges,,6.18,23.47,
SPLINT FINGER #3,30200034,CDM,,,270,RC,outpatient,,27,27,,22.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.75,22,,percent of total billed charges,,,,,,,,,24.3,90,,percent of total billed charges,,,22.36,82.8,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,,,,,,,,23.76,88,,percent of total billed charges,,,,,,,,,20.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.75,22,,percent of total billed charges,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,,,,,,,,,,,,,22.41,83,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.14,82,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,6.75,25.65,
TRACH 9.0 CUFFED,30200035,CDM,,,270,RC,outpatient,,24.75,24.75,,21.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.19,22,,percent of total billed charges,,,,,,,,,22.28,90,,percent of total billed charges,,,20.49,82.8,,percent of total billed charges,,,21.04,85,,percent of total billed charges,,,,,,,,,21.78,88,,percent of total billed charges,,,,,,,,,18.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.19,22,,percent of total billed charges,,,22.52,91,,percent of total billed charges,,,23.51,95,,percent of total billed charges,,,20.54,83,,percent of total billed charges,,,20.54,83,,percent of total billed charges,,,,,,,,,,,,,,,20.54,83,,percent of total billed charges,,,23.51,95,,percent of total billed charges,,,22.28,90,,percent of total billed charges,,,22.28,90,,percent of total billed charges,,,20.3,82,,percent of total billed charges,,,22.28,90,,percent of total billed charges,,,21.04,85,,percent of total billed charges,,6.19,23.51,
INFANT PROBE DISPOSABLE,30200039,CDM,,,270,RC,outpatient,,84.41,84.41,,71.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.1,22,,percent of total billed charges,,,,,,,,,75.97,90,,percent of total billed charges,,,69.89,82.8,,percent of total billed charges,,,71.75,85,,percent of total billed charges,,,,,,,,,74.28,88,,percent of total billed charges,,,,,,,,,64.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.1,22,,percent of total billed charges,,,76.81,91,,percent of total billed charges,,,80.19,95,,percent of total billed charges,,,70.06,83,,percent of total billed charges,,,70.06,83,,percent of total billed charges,,,,,,,,,,,,,,,70.06,83,,percent of total billed charges,,,80.19,95,,percent of total billed charges,,,75.97,90,,percent of total billed charges,,,75.97,90,,percent of total billed charges,,,69.22,82,,percent of total billed charges,,,75.97,90,,percent of total billed charges,,,71.75,85,,percent of total billed charges,,21.1,80.19,
PEDIATRIC PROBE DISPOSABLE,30200040,CDM,,,270,RC,outpatient,,91.22,91.22,,77.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.81,22,,percent of total billed charges,,,,,,,,,82.1,90,,percent of total billed charges,,,75.53,82.8,,percent of total billed charges,,,77.54,85,,percent of total billed charges,,,,,,,,,80.27,88,,percent of total billed charges,,,,,,,,,69.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.81,22,,percent of total billed charges,,,83.01,91,,percent of total billed charges,,,86.66,95,,percent of total billed charges,,,75.71,83,,percent of total billed charges,,,75.71,83,,percent of total billed charges,,,,,,,,,,,,,,,75.71,83,,percent of total billed charges,,,86.66,95,,percent of total billed charges,,,82.1,90,,percent of total billed charges,,,82.1,90,,percent of total billed charges,,,74.8,82,,percent of total billed charges,,,82.1,90,,percent of total billed charges,,,77.54,85,,percent of total billed charges,,22.81,86.66,
COTTON ROLL STERILE,30200041,CDM,,,270,RC,outpatient,,66.98,66.98,,56.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.75,22,,percent of total billed charges,,,,,,,,,60.28,90,,percent of total billed charges,,,55.46,82.8,,percent of total billed charges,,,56.93,85,,percent of total billed charges,,,,,,,,,58.94,88,,percent of total billed charges,,,,,,,,,51.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.75,22,,percent of total billed charges,,,60.95,91,,percent of total billed charges,,,63.63,95,,percent of total billed charges,,,55.59,83,,percent of total billed charges,,,55.59,83,,percent of total billed charges,,,,,,,,,,,,,,,55.59,83,,percent of total billed charges,,,63.63,95,,percent of total billed charges,,,60.28,90,,percent of total billed charges,,,60.28,90,,percent of total billed charges,,,54.92,82,,percent of total billed charges,,,60.28,90,,percent of total billed charges,,,56.93,85,,percent of total billed charges,,16.75,63.63,
SHOULDER IMMO WOMEN SMALL,30200042,CDM,,,270,RC,outpatient,,61.46,61.46,,52.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.37,22,,percent of total billed charges,,,,,,,,,55.31,90,,percent of total billed charges,,,50.89,82.8,,percent of total billed charges,,,52.24,85,,percent of total billed charges,,,,,,,,,54.08,88,,percent of total billed charges,,,,,,,,,46.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.37,22,,percent of total billed charges,,,55.93,91,,percent of total billed charges,,,58.39,95,,percent of total billed charges,,,51.01,83,,percent of total billed charges,,,51.01,83,,percent of total billed charges,,,,,,,,,,,,,,,51.01,83,,percent of total billed charges,,,58.39,95,,percent of total billed charges,,,55.31,90,,percent of total billed charges,,,55.31,90,,percent of total billed charges,,,50.4,82,,percent of total billed charges,,,55.31,90,,percent of total billed charges,,,52.24,85,,percent of total billed charges,,15.37,58.39,
SHOULDER IMMO WOMEN MEDIUM,30200043,CDM,,,270,RC,outpatient,,58.14,58.14,,49.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.54,22,,percent of total billed charges,,,,,,,,,52.33,90,,percent of total billed charges,,,48.14,82.8,,percent of total billed charges,,,49.42,85,,percent of total billed charges,,,,,,,,,51.16,88,,percent of total billed charges,,,,,,,,,44.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.54,22,,percent of total billed charges,,,52.91,91,,percent of total billed charges,,,55.23,95,,percent of total billed charges,,,48.26,83,,percent of total billed charges,,,48.26,83,,percent of total billed charges,,,,,,,,,,,,,,,48.26,83,,percent of total billed charges,,,55.23,95,,percent of total billed charges,,,52.33,90,,percent of total billed charges,,,52.33,90,,percent of total billed charges,,,47.67,82,,percent of total billed charges,,,52.33,90,,percent of total billed charges,,,49.42,85,,percent of total billed charges,,14.54,55.23,
SHOULDER IMMO WOMEN X-LGE,30200044,CDM,,,270,RC,outpatient,,61.46,61.46,,52.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.37,22,,percent of total billed charges,,,,,,,,,55.31,90,,percent of total billed charges,,,50.89,82.8,,percent of total billed charges,,,52.24,85,,percent of total billed charges,,,,,,,,,54.08,88,,percent of total billed charges,,,,,,,,,46.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.37,22,,percent of total billed charges,,,55.93,91,,percent of total billed charges,,,58.39,95,,percent of total billed charges,,,51.01,83,,percent of total billed charges,,,51.01,83,,percent of total billed charges,,,,,,,,,,,,,,,51.01,83,,percent of total billed charges,,,58.39,95,,percent of total billed charges,,,55.31,90,,percent of total billed charges,,,55.31,90,,percent of total billed charges,,,50.4,82,,percent of total billed charges,,,55.31,90,,percent of total billed charges,,,52.24,85,,percent of total billed charges,,15.37,58.39,
RAPID RHINO EPISTAXIS ANTERIOR 7.5,30200051,CDM,,,270,RC,outpatient,,290.25,290.25,,246.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.56,22,,percent of total billed charges,,,,,,,,,261.23,90,,percent of total billed charges,,,240.33,82.8,,percent of total billed charges,,,246.71,85,,percent of total billed charges,,,,,,,,,255.42,88,,percent of total billed charges,,,,,,,,,221.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.56,22,,percent of total billed charges,,,264.13,91,,percent of total billed charges,,,275.74,95,,percent of total billed charges,,,240.91,83,,percent of total billed charges,,,240.91,83,,percent of total billed charges,,,,,,,,,,,,,,,240.91,83,,percent of total billed charges,,,275.74,95,,percent of total billed charges,,,261.23,90,,percent of total billed charges,,,261.23,90,,percent of total billed charges,,,238.01,82,,percent of total billed charges,,,261.23,90,,percent of total billed charges,,,246.71,85,,percent of total billed charges,,72.56,275.74,
NEEDLE EZ I/O BARIATRIC,30200052,CDM,,,270,RC,outpatient,,805,805,,683.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,201.25,22,,percent of total billed charges,,,,,,,,,724.5,90,,percent of total billed charges,,,666.54,82.8,,percent of total billed charges,,,684.25,85,,percent of total billed charges,,,,,,,,,708.4,88,,percent of total billed charges,,,,,,,,,615.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,201.25,22,,percent of total billed charges,,,732.55,91,,percent of total billed charges,,,764.75,95,,percent of total billed charges,,,668.15,83,,percent of total billed charges,,,668.15,83,,percent of total billed charges,,,,,,,,,,,,,,,668.15,83,,percent of total billed charges,,,764.75,95,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,660.1,82,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,684.25,85,,percent of total billed charges,,201.25,764.75,
SPLINT FINGER METAL WHITE FOAM PAD 1,30200057,CDM,,,270,RC,outpatient,,7.07,7.07,,6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.77,22,,percent of total billed charges,,,,,,,,,6.36,90,,percent of total billed charges,,,5.85,82.8,,percent of total billed charges,,,6.01,85,,percent of total billed charges,,,,,,,,,6.22,88,,percent of total billed charges,,,,,,,,,5.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.77,22,,percent of total billed charges,,,6.43,91,,percent of total billed charges,,,6.72,95,,percent of total billed charges,,,5.87,83,,percent of total billed charges,,,5.87,83,,percent of total billed charges,,,,,,,,,,,,,,,5.87,83,,percent of total billed charges,,,6.72,95,,percent of total billed charges,,,6.36,90,,percent of total billed charges,,,6.36,90,,percent of total billed charges,,,5.8,82,,percent of total billed charges,,,6.36,90,,percent of total billed charges,,,6.01,85,,percent of total billed charges,,1.77,6.72,
QUICK PRESSURE MONITOR SET,30200059,CDM,,,270,RC,outpatient,,810.83,810.83,,688.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,202.71,22,,percent of total billed charges,,,,,,,,,729.75,90,,percent of total billed charges,,,671.37,82.8,,percent of total billed charges,,,689.21,85,,percent of total billed charges,,,,,,,,,713.53,88,,percent of total billed charges,,,,,,,,,619.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,202.71,22,,percent of total billed charges,,,737.86,91,,percent of total billed charges,,,770.29,95,,percent of total billed charges,,,672.99,83,,percent of total billed charges,,,672.99,83,,percent of total billed charges,,,,,,,,,,,,,,,672.99,83,,percent of total billed charges,,,770.29,95,,percent of total billed charges,,,729.75,90,,percent of total billed charges,,,729.75,90,,percent of total billed charges,,,664.88,82,,percent of total billed charges,,,729.75,90,,percent of total billed charges,,,689.21,85,,percent of total billed charges,,202.71,770.29,
TRACH UNCUFFED SZ 4.0 MURPHY,30200060,CDM,,,270,RC,outpatient,,16.2,16.2,,13.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.05,22,,percent of total billed charges,,,,,,,,,14.58,90,,percent of total billed charges,,,13.41,82.8,,percent of total billed charges,,,13.77,85,,percent of total billed charges,,,,,,,,,14.26,88,,percent of total billed charges,,,,,,,,,12.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.05,22,,percent of total billed charges,,,14.74,91,,percent of total billed charges,,,15.39,95,,percent of total billed charges,,,13.45,83,,percent of total billed charges,,,13.45,83,,percent of total billed charges,,,,,,,,,,,,,,,13.45,83,,percent of total billed charges,,,15.39,95,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,13.28,82,,percent of total billed charges,,,14.58,90,,percent of total billed charges,,,13.77,85,,percent of total billed charges,,4.05,15.39,
C-COLLAR ADULT NO NECK,30200061,CDM,,,270,RC,outpatient,,54.32,54.32,,46.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.58,22,,percent of total billed charges,,,,,,,,,48.89,90,,percent of total billed charges,,,44.98,82.8,,percent of total billed charges,,,46.17,85,,percent of total billed charges,,,,,,,,,47.8,88,,percent of total billed charges,,,,,,,,,41.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.58,22,,percent of total billed charges,,,49.43,91,,percent of total billed charges,,,51.6,95,,percent of total billed charges,,,45.09,83,,percent of total billed charges,,,45.09,83,,percent of total billed charges,,,,,,,,,,,,,,,45.09,83,,percent of total billed charges,,,51.6,95,,percent of total billed charges,,,48.89,90,,percent of total billed charges,,,48.89,90,,percent of total billed charges,,,44.54,82,,percent of total billed charges,,,48.89,90,,percent of total billed charges,,,46.17,85,,percent of total billed charges,,13.58,51.6,
EPISTAT NASAL CATHETER,30200062,CDM,,,270,RC,outpatient,,825.5,825.5,,700.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.38,22,,percent of total billed charges,,,,,,,,,742.95,90,,percent of total billed charges,,,683.51,82.8,,percent of total billed charges,,,701.68,85,,percent of total billed charges,,,,,,,,,726.44,88,,percent of total billed charges,,,,,,,,,630.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.38,22,,percent of total billed charges,,,751.21,91,,percent of total billed charges,,,784.23,95,,percent of total billed charges,,,685.17,83,,percent of total billed charges,,,685.17,83,,percent of total billed charges,,,,,,,,,,,,,,,685.17,83,,percent of total billed charges,,,784.23,95,,percent of total billed charges,,,742.95,90,,percent of total billed charges,,,742.95,90,,percent of total billed charges,,,676.91,82,,percent of total billed charges,,,742.95,90,,percent of total billed charges,,,701.68,85,,percent of total billed charges,,206.38,784.23,
EXTRACTOR FOREIGN BODY NASAL,30200063,CDM,,,270,RC,outpatient,,262.13,262.13,,222.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.53,22,,percent of total billed charges,,,,,,,,,235.92,90,,percent of total billed charges,,,217.04,82.8,,percent of total billed charges,,,222.81,85,,percent of total billed charges,,,,,,,,,230.67,88,,percent of total billed charges,,,,,,,,,200.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.53,22,,percent of total billed charges,,,238.54,91,,percent of total billed charges,,,249.02,95,,percent of total billed charges,,,217.57,83,,percent of total billed charges,,,217.57,83,,percent of total billed charges,,,,,,,,,,,,,,,217.57,83,,percent of total billed charges,,,249.02,95,,percent of total billed charges,,,235.92,90,,percent of total billed charges,,,235.92,90,,percent of total billed charges,,,214.95,82,,percent of total billed charges,,,235.92,90,,percent of total billed charges,,,222.81,85,,percent of total billed charges,,65.53,249.02,
NASAL INTRANASAL MUCOSAL ATOMIZATION DEV,30200064,CDM,,,270,RC,outpatient,,53.89,53.89,,45.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.47,22,,percent of total billed charges,,,,,,,,,48.5,90,,percent of total billed charges,,,44.62,82.8,,percent of total billed charges,,,45.81,85,,percent of total billed charges,,,,,,,,,47.42,88,,percent of total billed charges,,,,,,,,,41.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.47,22,,percent of total billed charges,,,49.04,91,,percent of total billed charges,,,51.2,95,,percent of total billed charges,,,44.73,83,,percent of total billed charges,,,44.73,83,,percent of total billed charges,,,,,,,,,,,,,,,44.73,83,,percent of total billed charges,,,51.2,95,,percent of total billed charges,,,48.5,90,,percent of total billed charges,,,48.5,90,,percent of total billed charges,,,44.19,82,,percent of total billed charges,,,48.5,90,,percent of total billed charges,,,45.81,85,,percent of total billed charges,,13.47,51.2,
C-COLLAR BABY NO NECK,30200065,CDM,,,270,RC,outpatient,,76.5,76.5,,64.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.13,22,,percent of total billed charges,,,,,,,,,68.85,90,,percent of total billed charges,,,63.34,82.8,,percent of total billed charges,,,65.03,85,,percent of total billed charges,,,,,,,,,67.32,88,,percent of total billed charges,,,,,,,,,58.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.13,22,,percent of total billed charges,,,69.62,91,,percent of total billed charges,,,72.68,95,,percent of total billed charges,,,63.5,83,,percent of total billed charges,,,63.5,83,,percent of total billed charges,,,,,,,,,,,,,,,63.5,83,,percent of total billed charges,,,72.68,95,,percent of total billed charges,,,68.85,90,,percent of total billed charges,,,68.85,90,,percent of total billed charges,,,62.73,82,,percent of total billed charges,,,68.85,90,,percent of total billed charges,,,65.03,85,,percent of total billed charges,,19.13,72.68,
EZ-IO STABILIZER,30200066,CDM,,,270,RC,outpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36,22,,percent of total billed charges,,,,,,,,,129.6,90,,percent of total billed charges,,,119.23,82.8,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36,22,,percent of total billed charges,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,36,136.8,
AIRWAY NASO 12FR,30200067,CDM,,,270,RC,outpatient,,40.59,40.59,,34.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.15,22,,percent of total billed charges,,,,,,,,,36.53,90,,percent of total billed charges,,,33.61,82.8,,percent of total billed charges,,,34.5,85,,percent of total billed charges,,,,,,,,,35.72,88,,percent of total billed charges,,,,,,,,,31.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.15,22,,percent of total billed charges,,,36.94,91,,percent of total billed charges,,,38.56,95,,percent of total billed charges,,,33.69,83,,percent of total billed charges,,,33.69,83,,percent of total billed charges,,,,,,,,,,,,,,,33.69,83,,percent of total billed charges,,,38.56,95,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,33.28,82,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,34.5,85,,percent of total billed charges,,10.15,38.56,
AIRWAY NASO 14FR,30200068,CDM,,,270,RC,outpatient,,40.59,40.59,,34.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.15,22,,percent of total billed charges,,,,,,,,,36.53,90,,percent of total billed charges,,,33.61,82.8,,percent of total billed charges,,,34.5,85,,percent of total billed charges,,,,,,,,,35.72,88,,percent of total billed charges,,,,,,,,,31.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.15,22,,percent of total billed charges,,,36.94,91,,percent of total billed charges,,,38.56,95,,percent of total billed charges,,,33.69,83,,percent of total billed charges,,,33.69,83,,percent of total billed charges,,,,,,,,,,,,,,,33.69,83,,percent of total billed charges,,,38.56,95,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,33.28,82,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,34.5,85,,percent of total billed charges,,10.15,38.56,
AIRWAY NASO 18FR,30200069,CDM,,,270,RC,outpatient,,40.59,40.59,,34.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.15,22,,percent of total billed charges,,,,,,,,,36.53,90,,percent of total billed charges,,,33.61,82.8,,percent of total billed charges,,,34.5,85,,percent of total billed charges,,,,,,,,,35.72,88,,percent of total billed charges,,,,,,,,,31.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.15,22,,percent of total billed charges,,,36.94,91,,percent of total billed charges,,,38.56,95,,percent of total billed charges,,,33.69,83,,percent of total billed charges,,,33.69,83,,percent of total billed charges,,,,,,,,,,,,,,,33.69,83,,percent of total billed charges,,,38.56,95,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,33.28,82,,percent of total billed charges,,,36.53,90,,percent of total billed charges,,,34.5,85,,percent of total billed charges,,10.15,38.56,
TOURNI-COT SIZE XL,30200071,CDM,,,270,RC,outpatient,,24.75,24.75,,21.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.19,22,,percent of total billed charges,,,,,,,,,22.28,90,,percent of total billed charges,,,20.49,82.8,,percent of total billed charges,,,21.04,85,,percent of total billed charges,,,,,,,,,21.78,88,,percent of total billed charges,,,,,,,,,18.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.19,22,,percent of total billed charges,,,22.52,91,,percent of total billed charges,,,23.51,95,,percent of total billed charges,,,20.54,83,,percent of total billed charges,,,20.54,83,,percent of total billed charges,,,,,,,,,,,,,,,20.54,83,,percent of total billed charges,,,23.51,95,,percent of total billed charges,,,22.28,90,,percent of total billed charges,,,22.28,90,,percent of total billed charges,,,20.3,82,,percent of total billed charges,,,22.28,90,,percent of total billed charges,,,21.04,85,,percent of total billed charges,,6.19,23.51,
TOURNI-COT SIZE SMALL,30200072,CDM,,,270,RC,outpatient,,28.33,28.33,,24.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.08,22,,percent of total billed charges,,,,,,,,,25.5,90,,percent of total billed charges,,,23.46,82.8,,percent of total billed charges,,,24.08,85,,percent of total billed charges,,,,,,,,,24.93,88,,percent of total billed charges,,,,,,,,,21.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.08,22,,percent of total billed charges,,,25.78,91,,percent of total billed charges,,,26.91,95,,percent of total billed charges,,,23.51,83,,percent of total billed charges,,,23.51,83,,percent of total billed charges,,,,,,,,,,,,,,,23.51,83,,percent of total billed charges,,,26.91,95,,percent of total billed charges,,,25.5,90,,percent of total billed charges,,,25.5,90,,percent of total billed charges,,,23.23,82,,percent of total billed charges,,,25.5,90,,percent of total billed charges,,,24.08,85,,percent of total billed charges,,7.08,26.91,
POPE EAR WICK 24MM,30200073,CDM,,,270,RC,outpatient,,82.45,82.45,,70,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.61,22,,percent of total billed charges,,,,,,,,,74.21,90,,percent of total billed charges,,,68.27,82.8,,percent of total billed charges,,,70.08,85,,percent of total billed charges,,,,,,,,,72.56,88,,percent of total billed charges,,,,,,,,,62.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.61,22,,percent of total billed charges,,,75.03,91,,percent of total billed charges,,,78.33,95,,percent of total billed charges,,,68.43,83,,percent of total billed charges,,,68.43,83,,percent of total billed charges,,,,,,,,,,,,,,,68.43,83,,percent of total billed charges,,,78.33,95,,percent of total billed charges,,,74.21,90,,percent of total billed charges,,,74.21,90,,percent of total billed charges,,,67.61,82,,percent of total billed charges,,,74.21,90,,percent of total billed charges,,,70.08,85,,percent of total billed charges,,20.61,78.33,
EZ-IO NEEDLE & STABILIZER 25MM X15G,30200074,CDM,,,270,RC,outpatient,,887.9,887.9,,753.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,221.98,22,,percent of total billed charges,,,,,,,,,799.11,90,,percent of total billed charges,,,735.18,82.8,,percent of total billed charges,,,754.72,85,,percent of total billed charges,,,,,,,,,781.35,88,,percent of total billed charges,,,,,,,,,678.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,221.98,22,,percent of total billed charges,,,807.99,91,,percent of total billed charges,,,843.51,95,,percent of total billed charges,,,736.96,83,,percent of total billed charges,,,736.96,83,,percent of total billed charges,,,,,,,,,,,,,,,736.96,83,,percent of total billed charges,,,843.51,95,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,728.08,82,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,754.72,85,,percent of total billed charges,,221.98,843.51,
NEEDLE EZ I/O ADULT 15GA 25MM,30210047,CDM,,,270,RC,outpatient,,887.9,887.9,,753.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,221.98,22,,percent of total billed charges,,,,,,,,,799.11,90,,percent of total billed charges,,,735.18,82.8,,percent of total billed charges,,,754.72,85,,percent of total billed charges,,,,,,,,,781.35,88,,percent of total billed charges,,,,,,,,,678.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,221.98,22,,percent of total billed charges,,,807.99,91,,percent of total billed charges,,,843.51,95,,percent of total billed charges,,,736.96,83,,percent of total billed charges,,,736.96,83,,percent of total billed charges,,,,,,,,,,,,,,,736.96,83,,percent of total billed charges,,,843.51,95,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,728.08,82,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,754.72,85,,percent of total billed charges,,221.98,843.51,
NEEDLE EZ I/O PEDIATRIC,30210058,CDM,,,270,RC,outpatient,,887.9,887.9,,753.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,221.98,22,,percent of total billed charges,,,,,,,,,799.11,90,,percent of total billed charges,,,735.18,82.8,,percent of total billed charges,,,754.72,85,,percent of total billed charges,,,,,,,,,781.35,88,,percent of total billed charges,,,,,,,,,678.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,221.98,22,,percent of total billed charges,,,807.99,91,,percent of total billed charges,,,843.51,95,,percent of total billed charges,,,736.96,83,,percent of total billed charges,,,736.96,83,,percent of total billed charges,,,,,,,,,,,,,,,736.96,83,,percent of total billed charges,,,843.51,95,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,728.08,82,,percent of total billed charges,,,799.11,90,,percent of total billed charges,,,754.72,85,,percent of total billed charges,,221.98,843.51,
NEEDLE EZ I/O ADULT 15GA 45MM W/STABILIZ,30210059,CDM,,,270,RC,outpatient,,882.7,882.7,,749.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,220.68,22,,percent of total billed charges,,,,,,,,,794.43,90,,percent of total billed charges,,,730.88,82.8,,percent of total billed charges,,,750.3,85,,percent of total billed charges,,,,,,,,,776.78,88,,percent of total billed charges,,,,,,,,,674.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,220.68,22,,percent of total billed charges,,,803.26,91,,percent of total billed charges,,,838.57,95,,percent of total billed charges,,,732.64,83,,percent of total billed charges,,,732.64,83,,percent of total billed charges,,,,,,,,,,,,,,,732.64,83,,percent of total billed charges,,,838.57,95,,percent of total billed charges,,,794.43,90,,percent of total billed charges,,,794.43,90,,percent of total billed charges,,,723.81,82,,percent of total billed charges,,,794.43,90,,percent of total billed charges,,,750.3,85,,percent of total billed charges,,220.68,838.57,
TUBING MICROSTREAM INTUBATED CO2 FILTER,30230011,CDM,,,270,RC,outpatient,,122.16,122.16,,103.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.54,22,,percent of total billed charges,,,,,,,,,109.94,90,,percent of total billed charges,,,101.15,82.8,,percent of total billed charges,,,103.84,85,,percent of total billed charges,,,,,,,,,107.5,88,,percent of total billed charges,,,,,,,,,93.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.54,22,,percent of total billed charges,,,111.17,91,,percent of total billed charges,,,116.05,95,,percent of total billed charges,,,101.39,83,,percent of total billed charges,,,101.39,83,,percent of total billed charges,,,,,,,,,,,,,,,101.39,83,,percent of total billed charges,,,116.05,95,,percent of total billed charges,,,109.94,90,,percent of total billed charges,,,109.94,90,,percent of total billed charges,,,100.17,82,,percent of total billed charges,,,109.94,90,,percent of total billed charges,,,103.84,85,,percent of total billed charges,,30.54,116.05,
AMNISURE ROM KIT,30250289,CDM,,,270,RC,outpatient,,371,371,,314.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.75,22,,percent of total billed charges,,,,,,,,,333.9,90,,percent of total billed charges,,,307.19,82.8,,percent of total billed charges,,,315.35,85,,percent of total billed charges,,,,,,,,,326.48,88,,percent of total billed charges,,,,,,,,,283.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.75,22,,percent of total billed charges,,,337.61,91,,percent of total billed charges,,,352.45,95,,percent of total billed charges,,,307.93,83,,percent of total billed charges,,,307.93,83,,percent of total billed charges,,,,,,,,,,,,,,,307.93,83,,percent of total billed charges,,,352.45,95,,percent of total billed charges,,,333.9,90,,percent of total billed charges,,,333.9,90,,percent of total billed charges,,,304.22,82,,percent of total billed charges,,,333.9,90,,percent of total billed charges,,,315.35,85,,percent of total billed charges,,92.75,352.45,
CONTRAST ISOVUE-300 30ML,30260083,CDM,,,270,RC,outpatient,,43.77,43.77,,37.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.94,22,,percent of total billed charges,,,,,,,,,39.39,90,,percent of total billed charges,,,36.24,82.8,,percent of total billed charges,,,37.2,85,,percent of total billed charges,,,,,,,,,38.52,88,,percent of total billed charges,,,,,,,,,33.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.94,22,,percent of total billed charges,,,39.83,91,,percent of total billed charges,,,41.58,95,,percent of total billed charges,,,36.33,83,,percent of total billed charges,,,36.33,83,,percent of total billed charges,,,,,,,,,,,,,,,36.33,83,,percent of total billed charges,,,41.58,95,,percent of total billed charges,,,39.39,90,,percent of total billed charges,,,39.39,90,,percent of total billed charges,,,35.89,82,,percent of total billed charges,,,39.39,90,,percent of total billed charges,,,37.2,85,,percent of total billed charges,,10.94,41.58,
*SMART CT PICC BIOFLO 5FR DUAL LUMEN,30260092,CDM,,,270,RC,outpatient,,1510.6,1510.6,,1282.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,377.65,22,,percent of total billed charges,,,,,,,,,1359.54,90,,percent of total billed charges,,,1250.78,82.8,,percent of total billed charges,,,1284.01,85,,percent of total billed charges,,,,,,,,,1329.33,88,,percent of total billed charges,,,,,,,,,1154.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,377.65,22,,percent of total billed charges,,,1374.65,91,,percent of total billed charges,,,1435.07,95,,percent of total billed charges,,,1253.8,83,,percent of total billed charges,,,1253.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1253.8,83,,percent of total billed charges,,,1435.07,95,,percent of total billed charges,,,1359.54,90,,percent of total billed charges,,,1359.54,90,,percent of total billed charges,,,1238.69,82,,percent of total billed charges,,,1359.54,90,,percent of total billed charges,,,1284.01,85,,percent of total billed charges,,377.65,1435.07,
GLIDEWIRE ANGLED 150CM,30260093,CDM,,,270,RC,outpatient,,640.5,640.5,,543.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,160.13,22,,percent of total billed charges,,,,,,,,,576.45,90,,percent of total billed charges,,,530.33,82.8,,percent of total billed charges,,,544.43,85,,percent of total billed charges,,,,,,,,,563.64,88,,percent of total billed charges,,,,,,,,,489.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,160.13,22,,percent of total billed charges,,,582.86,91,,percent of total billed charges,,,608.48,95,,percent of total billed charges,,,531.62,83,,percent of total billed charges,,,531.62,83,,percent of total billed charges,,,,,,,,,,,,,,,531.62,83,,percent of total billed charges,,,608.48,95,,percent of total billed charges,,,576.45,90,,percent of total billed charges,,,576.45,90,,percent of total billed charges,,,525.21,82,,percent of total billed charges,,,576.45,90,,percent of total billed charges,,,544.43,85,,percent of total billed charges,,160.13,608.48,
TRAY EPIDURAL PERIFIX SINGLE DOSE,30260094,CDM,,,270,RC,outpatient,,123.98,123.98,,105.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31,22,,percent of total billed charges,,,,,,,,,111.58,90,,percent of total billed charges,,,102.66,82.8,,percent of total billed charges,,,105.38,85,,percent of total billed charges,,,,,,,,,109.1,88,,percent of total billed charges,,,,,,,,,94.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31,22,,percent of total billed charges,,,112.82,91,,percent of total billed charges,,,117.78,95,,percent of total billed charges,,,102.9,83,,percent of total billed charges,,,102.9,83,,percent of total billed charges,,,,,,,,,,,,,,,102.9,83,,percent of total billed charges,,,117.78,95,,percent of total billed charges,,,111.58,90,,percent of total billed charges,,,111.58,90,,percent of total billed charges,,,101.66,82,,percent of total billed charges,,,111.58,90,,percent of total billed charges,,,105.38,85,,percent of total billed charges,,31,117.78,
CATH DRAINAGE MULTIPURPOSE 12FR,30260095,CDM,,,270,RC,outpatient,,1393.15,1393.15,,1182.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,348.29,22,,percent of total billed charges,,,,,,,,,1253.84,90,,percent of total billed charges,,,1153.53,82.8,,percent of total billed charges,,,1184.18,85,,percent of total billed charges,,,,,,,,,1225.97,88,,percent of total billed charges,,,,,,,,,1064.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,348.29,22,,percent of total billed charges,,,1267.77,91,,percent of total billed charges,,,1323.49,95,,percent of total billed charges,,,1156.31,83,,percent of total billed charges,,,1156.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1156.31,83,,percent of total billed charges,,,1323.49,95,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1142.38,82,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1184.18,85,,percent of total billed charges,,348.29,1323.49,
*AVAMAX 13G NEEDLE PACK,30260099,CDM,,,270,RC,outpatient,,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260,22,,percent of total billed charges,,,,,,,,,936,90,,percent of total billed charges,,,861.12,82.8,,percent of total billed charges,,,884,85,,percent of total billed charges,,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260,22,,percent of total billed charges,,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,260,988,
COAXIAL BONE BIOPSY NEEDLE 11G X 12CM,30260100,CDM,,,270,RC,outpatient,,856.8,856.8,,727.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214.2,22,,percent of total billed charges,,,,,,,,,771.12,90,,percent of total billed charges,,,709.43,82.8,,percent of total billed charges,,,728.28,85,,percent of total billed charges,,,,,,,,,753.98,88,,percent of total billed charges,,,,,,,,,654.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214.2,22,,percent of total billed charges,,,779.69,91,,percent of total billed charges,,,813.96,95,,percent of total billed charges,,,711.14,83,,percent of total billed charges,,,711.14,83,,percent of total billed charges,,,,,,,,,,,,,,,711.14,83,,percent of total billed charges,,,813.96,95,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,702.58,82,,percent of total billed charges,,,771.12,90,,percent of total billed charges,,,728.28,85,,percent of total billed charges,,214.2,813.96,
COAXIAL BONE BIOPSY NEEDLE 13G X 12CM,30260104,CDM,,,270,RC,outpatient,,735,735,,624.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,183.75,22,,percent of total billed charges,,,,,,,,,661.5,90,,percent of total billed charges,,,608.58,82.8,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,,,,,,,,646.8,88,,percent of total billed charges,,,,,,,,,561.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,183.75,22,,percent of total billed charges,,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,,,,,,,,,,,,,610.05,83,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,602.7,82,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,183.75,698.25,
CATHETER ANGIOGRAPHY PERIPHERAL 5FR 70CM,30260110,CDM,,,270,RC,outpatient,,147.68,147.68,,125.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.92,22,,percent of total billed charges,,,,,,,,,132.91,90,,percent of total billed charges,,,122.28,82.8,,percent of total billed charges,,,125.53,85,,percent of total billed charges,,,,,,,,,129.96,88,,percent of total billed charges,,,,,,,,,112.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.92,22,,percent of total billed charges,,,134.39,91,,percent of total billed charges,,,140.3,95,,percent of total billed charges,,,122.57,83,,percent of total billed charges,,,122.57,83,,percent of total billed charges,,,,,,,,,,,,,,,122.57,83,,percent of total billed charges,,,140.3,95,,percent of total billed charges,,,132.91,90,,percent of total billed charges,,,132.91,90,,percent of total billed charges,,,121.1,82,,percent of total billed charges,,,132.91,90,,percent of total billed charges,,,125.53,85,,percent of total billed charges,,36.92,140.3,
CATHETER ANGIOGRAPHY 5FR 90CML PIGTAIL,30260111,CDM,,,270,RC,outpatient,,147.68,147.68,,125.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.92,22,,percent of total billed charges,,,,,,,,,132.91,90,,percent of total billed charges,,,122.28,82.8,,percent of total billed charges,,,125.53,85,,percent of total billed charges,,,,,,,,,129.96,88,,percent of total billed charges,,,,,,,,,112.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.92,22,,percent of total billed charges,,,134.39,91,,percent of total billed charges,,,140.3,95,,percent of total billed charges,,,122.57,83,,percent of total billed charges,,,122.57,83,,percent of total billed charges,,,,,,,,,,,,,,,122.57,83,,percent of total billed charges,,,140.3,95,,percent of total billed charges,,,132.91,90,,percent of total billed charges,,,132.91,90,,percent of total billed charges,,,121.1,82,,percent of total billed charges,,,132.91,90,,percent of total billed charges,,,125.53,85,,percent of total billed charges,,36.92,140.3,
SET INTRODUCER CATHETER 5FR 13CML SHEATH,30260112,CDM,,,270,RC,outpatient,,274.58,274.58,,233.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.65,22,,percent of total billed charges,,,,,,,,,247.12,90,,percent of total billed charges,,,227.35,82.8,,percent of total billed charges,,,233.39,85,,percent of total billed charges,,,,,,,,,241.63,88,,percent of total billed charges,,,,,,,,,209.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.65,22,,percent of total billed charges,,,249.87,91,,percent of total billed charges,,,260.85,95,,percent of total billed charges,,,227.9,83,,percent of total billed charges,,,227.9,83,,percent of total billed charges,,,,,,,,,,,,,,,227.9,83,,percent of total billed charges,,,260.85,95,,percent of total billed charges,,,247.12,90,,percent of total billed charges,,,247.12,90,,percent of total billed charges,,,225.16,82,,percent of total billed charges,,,247.12,90,,percent of total billed charges,,,233.39,85,,percent of total billed charges,,68.65,260.85,
DILATOR INTERVENTIONAL CATH 6FR .038MM,30260113,CDM,,,270,RC,outpatient,,61.2,61.2,,51.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.3,22,,percent of total billed charges,,,,,,,,,55.08,90,,percent of total billed charges,,,50.67,82.8,,percent of total billed charges,,,52.02,85,,percent of total billed charges,,,,,,,,,53.86,88,,percent of total billed charges,,,,,,,,,46.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.3,22,,percent of total billed charges,,,55.69,91,,percent of total billed charges,,,58.14,95,,percent of total billed charges,,,50.8,83,,percent of total billed charges,,,50.8,83,,percent of total billed charges,,,,,,,,,,,,,,,50.8,83,,percent of total billed charges,,,58.14,95,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,50.18,82,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,52.02,85,,percent of total billed charges,,15.3,58.14,
DILATOR INTERVENTIONAL CATH 8FR .035MM,30260114,CDM,,,270,RC,outpatient,,61.2,61.2,,51.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.3,22,,percent of total billed charges,,,,,,,,,55.08,90,,percent of total billed charges,,,50.67,82.8,,percent of total billed charges,,,52.02,85,,percent of total billed charges,,,,,,,,,53.86,88,,percent of total billed charges,,,,,,,,,46.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.3,22,,percent of total billed charges,,,55.69,91,,percent of total billed charges,,,58.14,95,,percent of total billed charges,,,50.8,83,,percent of total billed charges,,,50.8,83,,percent of total billed charges,,,,,,,,,,,,,,,50.8,83,,percent of total billed charges,,,58.14,95,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,50.18,82,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,52.02,85,,percent of total billed charges,,15.3,58.14,
DILATOR INTERVENTIONAL CATH 10FR .038MM,30260115,CDM,,,270,RC,outpatient,,61.2,61.2,,51.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.3,22,,percent of total billed charges,,,,,,,,,55.08,90,,percent of total billed charges,,,50.67,82.8,,percent of total billed charges,,,52.02,85,,percent of total billed charges,,,,,,,,,53.86,88,,percent of total billed charges,,,,,,,,,46.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.3,22,,percent of total billed charges,,,55.69,91,,percent of total billed charges,,,58.14,95,,percent of total billed charges,,,50.8,83,,percent of total billed charges,,,50.8,83,,percent of total billed charges,,,,,,,,,,,,,,,50.8,83,,percent of total billed charges,,,58.14,95,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,50.18,82,,percent of total billed charges,,,55.08,90,,percent of total billed charges,,,52.02,85,,percent of total billed charges,,15.3,58.14,
GUIDEWIRE VASCULAR FIXED CORE .035IN DIA,30260116,CDM,,,270,RC,outpatient,,119.28,119.28,,101.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.82,22,,percent of total billed charges,,,,,,,,,107.35,90,,percent of total billed charges,,,98.76,82.8,,percent of total billed charges,,,101.39,85,,percent of total billed charges,,,,,,,,,104.97,88,,percent of total billed charges,,,,,,,,,91.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.82,22,,percent of total billed charges,,,108.54,91,,percent of total billed charges,,,113.32,95,,percent of total billed charges,,,99,83,,percent of total billed charges,,,99,83,,percent of total billed charges,,,,,,,,,,,,,,,99,83,,percent of total billed charges,,,113.32,95,,percent of total billed charges,,,107.35,90,,percent of total billed charges,,,107.35,90,,percent of total billed charges,,,97.81,82,,percent of total billed charges,,,107.35,90,,percent of total billed charges,,,101.39,85,,percent of total billed charges,,29.82,113.32,
GUIDEWIRE VASCULAR FIXED CORE SS .035IN,30260117,CDM,,,270,RC,outpatient,,101.28,101.28,,85.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.32,22,,percent of total billed charges,,,,,,,,,91.15,90,,percent of total billed charges,,,83.86,82.8,,percent of total billed charges,,,86.09,85,,percent of total billed charges,,,,,,,,,89.13,88,,percent of total billed charges,,,,,,,,,77.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.32,22,,percent of total billed charges,,,92.16,91,,percent of total billed charges,,,96.22,95,,percent of total billed charges,,,84.06,83,,percent of total billed charges,,,84.06,83,,percent of total billed charges,,,,,,,,,,,,,,,84.06,83,,percent of total billed charges,,,96.22,95,,percent of total billed charges,,,91.15,90,,percent of total billed charges,,,91.15,90,,percent of total billed charges,,,83.05,82,,percent of total billed charges,,,91.15,90,,percent of total billed charges,,,86.09,85,,percent of total billed charges,,25.32,96.22,
GUIDEWIRE VASCULAR FIXED CORE .035IN DIA,30260118,CDM,,,270,RC,outpatient,,136.56,136.56,,115.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.14,22,,percent of total billed charges,,,,,,,,,122.9,90,,percent of total billed charges,,,113.07,82.8,,percent of total billed charges,,,116.08,85,,percent of total billed charges,,,,,,,,,120.17,88,,percent of total billed charges,,,,,,,,,104.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.14,22,,percent of total billed charges,,,124.27,91,,percent of total billed charges,,,129.73,95,,percent of total billed charges,,,113.34,83,,percent of total billed charges,,,113.34,83,,percent of total billed charges,,,,,,,,,,,,,,,113.34,83,,percent of total billed charges,,,129.73,95,,percent of total billed charges,,,122.9,90,,percent of total billed charges,,,122.9,90,,percent of total billed charges,,,111.98,82,,percent of total billed charges,,,122.9,90,,percent of total billed charges,,,116.08,85,,percent of total billed charges,,34.14,129.73,
DENALI JUGULAR FILTER,30260119,CDM,,,270,RC,outpatient,,10887.5,10887.5,,9243.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2721.88,22,,percent of total billed charges,,,,,,,,,9798.75,90,,percent of total billed charges,,,9014.85,82.8,,percent of total billed charges,,,9254.38,85,,percent of total billed charges,,,,,,,,,9581,88,,percent of total billed charges,,,,,,,,,8318.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2721.88,22,,percent of total billed charges,,,9907.63,91,,percent of total billed charges,,,10343.13,95,,percent of total billed charges,,,9036.63,83,,percent of total billed charges,,,9036.63,83,,percent of total billed charges,,,,,,,,,,,,,,,9036.63,83,,percent of total billed charges,,,10343.13,95,,percent of total billed charges,,,9798.75,90,,percent of total billed charges,,,9798.75,90,,percent of total billed charges,,,8927.75,82,,percent of total billed charges,,,9798.75,90,,percent of total billed charges,,,9254.38,85,,percent of total billed charges,,2721.88,10343.13,
DENALI FEMORAL FILTER,30260120,CDM,,,270,RC,outpatient,,10042.5,10042.5,,8526.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2510.63,22,,percent of total billed charges,,,,,,,,,9038.25,90,,percent of total billed charges,,,8315.19,82.8,,percent of total billed charges,,,8536.13,85,,percent of total billed charges,,,,,,,,,8837.4,88,,percent of total billed charges,,,,,,,,,7672.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2510.63,22,,percent of total billed charges,,,9138.68,91,,percent of total billed charges,,,9540.38,95,,percent of total billed charges,,,8335.28,83,,percent of total billed charges,,,8335.28,83,,percent of total billed charges,,,,,,,,,,,,,,,8335.28,83,,percent of total billed charges,,,9540.38,95,,percent of total billed charges,,,9038.25,90,,percent of total billed charges,,,9038.25,90,,percent of total billed charges,,,8234.85,82,,percent of total billed charges,,,9038.25,90,,percent of total billed charges,,,8536.13,85,,percent of total billed charges,,2510.63,9540.38,
MACROBORE EXT SET 30  W/OL NON-DEHP,30260122,CDM,,,270,RC,outpatient,,7.97,7.97,,6.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.99,22,,percent of total billed charges,,,,,,,,,7.17,90,,percent of total billed charges,,,6.6,82.8,,percent of total billed charges,,,6.77,85,,percent of total billed charges,,,,,,,,,7.01,88,,percent of total billed charges,,,,,,,,,6.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.99,22,,percent of total billed charges,,,7.25,91,,percent of total billed charges,,,7.57,95,,percent of total billed charges,,,6.62,83,,percent of total billed charges,,,6.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6.62,83,,percent of total billed charges,,,7.57,95,,percent of total billed charges,,,7.17,90,,percent of total billed charges,,,7.17,90,,percent of total billed charges,,,6.54,82,,percent of total billed charges,,,7.17,90,,percent of total billed charges,,,6.77,85,,percent of total billed charges,,1.99,7.57,
CENTEZE CENTESIS CATH 5FR 10CM 19GA 12CM,30260125,CDM,,,270,RC,outpatient,,128,128,,108.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32,22,,percent of total billed charges,,,,,,,,,115.2,90,,percent of total billed charges,,,105.98,82.8,,percent of total billed charges,,,108.8,85,,percent of total billed charges,,,,,,,,,112.64,88,,percent of total billed charges,,,,,,,,,97.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32,22,,percent of total billed charges,,,116.48,91,,percent of total billed charges,,,121.6,95,,percent of total billed charges,,,106.24,83,,percent of total billed charges,,,106.24,83,,percent of total billed charges,,,,,,,,,,,,,,,106.24,83,,percent of total billed charges,,,121.6,95,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,104.96,82,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,108.8,85,,percent of total billed charges,,32,121.6,
PICC BIOFLOW POWER INJECTABLE MST KIT W/,30260129,CDM,,,270,RC,outpatient,,1007.5,1007.5,,855.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,251.88,22,,percent of total billed charges,,,,,,,,,906.75,90,,percent of total billed charges,,,834.21,82.8,,percent of total billed charges,,,856.38,85,,percent of total billed charges,,,,,,,,,886.6,88,,percent of total billed charges,,,,,,,,,769.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,251.88,22,,percent of total billed charges,,,916.83,91,,percent of total billed charges,,,957.13,95,,percent of total billed charges,,,836.23,83,,percent of total billed charges,,,836.23,83,,percent of total billed charges,,,,,,,,,,,,,,,836.23,83,,percent of total billed charges,,,957.13,95,,percent of total billed charges,,,906.75,90,,percent of total billed charges,,,906.75,90,,percent of total billed charges,,,826.15,82,,percent of total billed charges,,,906.75,90,,percent of total billed charges,,,856.38,85,,percent of total billed charges,,251.88,957.13,
MEMBRANE KIT,30260131,CDM,,,270,RC,outpatient,,176.67,176.67,,149.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.17,22,,percent of total billed charges,,,,,,,,,159,90,,percent of total billed charges,,,146.28,82.8,,percent of total billed charges,,,150.17,85,,percent of total billed charges,,,,,,,,,155.47,88,,percent of total billed charges,,,,,,,,,134.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.17,22,,percent of total billed charges,,,160.77,91,,percent of total billed charges,,,167.84,95,,percent of total billed charges,,,146.64,83,,percent of total billed charges,,,146.64,83,,percent of total billed charges,,,,,,,,,,,,,,,146.64,83,,percent of total billed charges,,,167.84,95,,percent of total billed charges,,,159,90,,percent of total billed charges,,,159,90,,percent of total billed charges,,,144.87,82,,percent of total billed charges,,,159,90,,percent of total billed charges,,,150.17,85,,percent of total billed charges,,44.17,167.84,
DILATOR VASCULAR 8FR,30260142,CDM,,,270,RC,outpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.7,22,,percent of total billed charges,,,,,,,,,63.73,90,,percent of total billed charges,,,58.63,82.8,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.7,22,,percent of total billed charges,,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,17.7,67.27,
VASCULAR FIXED CORE TSCF-35-145-3,30260143,CDM,,,270,RC,outpatient,,92.96,92.96,,78.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.24,22,,percent of total billed charges,,,,,,,,,83.66,90,,percent of total billed charges,,,76.97,82.8,,percent of total billed charges,,,79.02,85,,percent of total billed charges,,,,,,,,,81.8,88,,percent of total billed charges,,,,,,,,,71.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.24,22,,percent of total billed charges,,,84.59,91,,percent of total billed charges,,,88.31,95,,percent of total billed charges,,,77.16,83,,percent of total billed charges,,,77.16,83,,percent of total billed charges,,,,,,,,,,,,,,,77.16,83,,percent of total billed charges,,,88.31,95,,percent of total billed charges,,,83.66,90,,percent of total billed charges,,,83.66,90,,percent of total billed charges,,,76.23,82,,percent of total billed charges,,,83.66,90,,percent of total billed charges,,,79.02,85,,percent of total billed charges,,23.24,88.31,
NANOCROSS BALLOON 2.5 -2.0 X 210MM,30260144,CDM,,,270,RC,outpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.44,22,,percent of total billed charges,,,,,,,,,1740.38,90,,percent of total billed charges,,,1601.15,82.8,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.44,22,,percent of total billed charges,,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,483.44,1837.06,
NANOCROSS BALLOON 5.0 X 200MM,30260145,CDM,,,270,RC,outpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.44,22,,percent of total billed charges,,,,,,,,,1740.38,90,,percent of total billed charges,,,1601.15,82.8,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.44,22,,percent of total billed charges,,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,483.44,1837.06,
STENT PROTEGE 5 X 120MM,30260146,CDM,,,278,RC,outpatient,,10531.5,10531.5,,8941.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2632.88,22,,percent of total billed charges,,,,,,,,,9478.35,90,,percent of total billed charges,,,8720.08,82.8,,percent of total billed charges,,,8951.78,85,,percent of total billed charges,,,,,,,,,9267.72,88,,percent of total billed charges,,,,,,,,,8046.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2632.88,22,,percent of total billed charges,,,9583.67,91,,percent of total billed charges,,,10004.93,95,,percent of total billed charges,,,8741.15,83,,percent of total billed charges,,,8741.15,83,,percent of total billed charges,,,,,,,,,,,,,,,8741.15,83,,percent of total billed charges,,,10004.93,95,,percent of total billed charges,,,9478.35,90,,percent of total billed charges,,,9478.35,90,,percent of total billed charges,,,8635.83,82,,percent of total billed charges,,,9478.35,90,,percent of total billed charges,,,8951.78,85,,percent of total billed charges,,2632.88,10004.93,
EVERCROSS BALLOON 12MM X 40MM,30260147,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
EVERCROSS BALLOON 10MM X 40MM,30260148,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
TRAILBLAZER CATH 0.014 X 150CM,30260149,CDM,,,270,RC,outpatient,,1040.55,1040.55,,883.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260.14,22,,percent of total billed charges,,,,,,,,,936.5,90,,percent of total billed charges,,,861.58,82.8,,percent of total billed charges,,,884.47,85,,percent of total billed charges,,,,,,,,,915.68,88,,percent of total billed charges,,,,,,,,,794.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260.14,22,,percent of total billed charges,,,946.9,91,,percent of total billed charges,,,988.52,95,,percent of total billed charges,,,863.66,83,,percent of total billed charges,,,863.66,83,,percent of total billed charges,,,,,,,,,,,,,,,863.66,83,,percent of total billed charges,,,988.52,95,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,853.25,82,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,884.47,85,,percent of total billed charges,,260.14,988.52,
NANOCROSS BALLOON 2.0 -1.50 X 210MM,30260150,CDM,,,270,RC,outpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.44,22,,percent of total billed charges,,,,,,,,,1740.38,90,,percent of total billed charges,,,1601.15,82.8,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.44,22,,percent of total billed charges,,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,483.44,1837.06,
NANOCROSS BALLOON 5.0 X 100MM,30260151,CDM,,,270,RC,outpatient,,1740.38,1740.38,,1477.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,435.1,22,,percent of total billed charges,,,,,,,,,1566.34,90,,percent of total billed charges,,,1441.03,82.8,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,,,,,,,,1531.53,88,,percent of total billed charges,,,,,,,,,1329.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,435.1,22,,percent of total billed charges,,,1583.75,91,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.52,83,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1427.11,82,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,435.1,1653.36,
GUIDEWIRE FIXED CORE .035IN 145CM SAFET-,30260154,CDM,,,270,RC,outpatient,,90.64,90.64,,76.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.66,22,,percent of total billed charges,,,,,,,,,81.58,90,,percent of total billed charges,,,75.05,82.8,,percent of total billed charges,,,77.04,85,,percent of total billed charges,,,,,,,,,79.76,88,,percent of total billed charges,,,,,,,,,69.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.66,22,,percent of total billed charges,,,82.48,91,,percent of total billed charges,,,86.11,95,,percent of total billed charges,,,75.23,83,,percent of total billed charges,,,75.23,83,,percent of total billed charges,,,,,,,,,,,,,,,75.23,83,,percent of total billed charges,,,86.11,95,,percent of total billed charges,,,81.58,90,,percent of total billed charges,,,81.58,90,,percent of total billed charges,,,74.32,82,,percent of total billed charges,,,81.58,90,,percent of total billed charges,,,77.04,85,,percent of total billed charges,,22.66,86.11,
BARD PICC SOLO CATHETER KIT 5F,30260155,CDM,,,270,RC,outpatient,,839.8,839.8,,712.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,209.95,22,,percent of total billed charges,,,,,,,,,755.82,90,,percent of total billed charges,,,695.35,82.8,,percent of total billed charges,,,713.83,85,,percent of total billed charges,,,,,,,,,739.02,88,,percent of total billed charges,,,,,,,,,641.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,209.95,22,,percent of total billed charges,,,764.22,91,,percent of total billed charges,,,797.81,95,,percent of total billed charges,,,697.03,83,,percent of total billed charges,,,697.03,83,,percent of total billed charges,,,,,,,,,,,,,,,697.03,83,,percent of total billed charges,,,797.81,95,,percent of total billed charges,,,755.82,90,,percent of total billed charges,,,755.82,90,,percent of total billed charges,,,688.64,82,,percent of total billed charges,,,755.82,90,,percent of total billed charges,,,713.83,85,,percent of total billed charges,,209.95,797.81,
BARD PICC DUAL-LUMEN CATHETER KIT 5F,30260156,CDM,,,270,RC,outpatient,,865.15,865.15,,734.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,216.29,22,,percent of total billed charges,,,,,,,,,778.64,90,,percent of total billed charges,,,716.34,82.8,,percent of total billed charges,,,735.38,85,,percent of total billed charges,,,,,,,,,761.33,88,,percent of total billed charges,,,,,,,,,660.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,216.29,22,,percent of total billed charges,,,787.29,91,,percent of total billed charges,,,821.89,95,,percent of total billed charges,,,718.07,83,,percent of total billed charges,,,718.07,83,,percent of total billed charges,,,,,,,,,,,,,,,718.07,83,,percent of total billed charges,,,821.89,95,,percent of total billed charges,,,778.64,90,,percent of total billed charges,,,778.64,90,,percent of total billed charges,,,709.42,82,,percent of total billed charges,,,778.64,90,,percent of total billed charges,,,735.38,85,,percent of total billed charges,,216.29,821.89,
SHEATH FLEXOR ANSEL GUIDING 9F 45CM,30260160,CDM,,,270,RC,outpatient,,454.23,454.23,,385.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,113.56,22,,percent of total billed charges,,,,,,,,,408.81,90,,percent of total billed charges,,,376.1,82.8,,percent of total billed charges,,,386.1,85,,percent of total billed charges,,,,,,,,,399.72,88,,percent of total billed charges,,,,,,,,,347.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,113.56,22,,percent of total billed charges,,,413.35,91,,percent of total billed charges,,,431.52,95,,percent of total billed charges,,,377.01,83,,percent of total billed charges,,,377.01,83,,percent of total billed charges,,,,,,,,,,,,,,,377.01,83,,percent of total billed charges,,,431.52,95,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,372.47,82,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,386.1,85,,percent of total billed charges,,113.56,431.52,
TRAILBLAZER CATH 0.014 X 135CM,30260162,CDM,,,270,RC,outpatient,,1040.55,1040.55,,883.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260.14,22,,percent of total billed charges,,,,,,,,,936.5,90,,percent of total billed charges,,,861.58,82.8,,percent of total billed charges,,,884.47,85,,percent of total billed charges,,,,,,,,,915.68,88,,percent of total billed charges,,,,,,,,,794.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260.14,22,,percent of total billed charges,,,946.9,91,,percent of total billed charges,,,988.52,95,,percent of total billed charges,,,863.66,83,,percent of total billed charges,,,863.66,83,,percent of total billed charges,,,,,,,,,,,,,,,863.66,83,,percent of total billed charges,,,988.52,95,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,853.25,82,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,884.47,85,,percent of total billed charges,,260.14,988.52,
TRAILBLAZER CATH 0.014 X 90CM,30260163,CDM,,,270,RC,outpatient,,1040.55,1040.55,,883.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260.14,22,,percent of total billed charges,,,,,,,,,936.5,90,,percent of total billed charges,,,861.58,82.8,,percent of total billed charges,,,884.47,85,,percent of total billed charges,,,,,,,,,915.68,88,,percent of total billed charges,,,,,,,,,794.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260.14,22,,percent of total billed charges,,,946.9,91,,percent of total billed charges,,,988.52,95,,percent of total billed charges,,,863.66,83,,percent of total billed charges,,,863.66,83,,percent of total billed charges,,,,,,,,,,,,,,,863.66,83,,percent of total billed charges,,,988.52,95,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,853.25,82,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,884.47,85,,percent of total billed charges,,260.14,988.52,
TRAILBLAZER CATH 0.035 X 135CM,30260164,CDM,,,270,RC,outpatient,,1040.55,1040.55,,883.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260.14,22,,percent of total billed charges,,,,,,,,,936.5,90,,percent of total billed charges,,,861.58,82.8,,percent of total billed charges,,,884.47,85,,percent of total billed charges,,,,,,,,,915.68,88,,percent of total billed charges,,,,,,,,,794.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260.14,22,,percent of total billed charges,,,946.9,91,,percent of total billed charges,,,988.52,95,,percent of total billed charges,,,863.66,83,,percent of total billed charges,,,863.66,83,,percent of total billed charges,,,,,,,,,,,,,,,863.66,83,,percent of total billed charges,,,988.52,95,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,853.25,82,,percent of total billed charges,,,936.5,90,,percent of total billed charges,,,884.47,85,,percent of total billed charges,,260.14,988.52,
TRAILBLAZER CATH ANGLED 0.014 X 150CM,30260165,CDM,,,270,RC,outpatient,,1359.09,1359.09,,1153.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,339.77,22,,percent of total billed charges,,,,,,,,,1223.18,90,,percent of total billed charges,,,1125.33,82.8,,percent of total billed charges,,,1155.23,85,,percent of total billed charges,,,,,,,,,1196,88,,percent of total billed charges,,,,,,,,,1038.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,339.77,22,,percent of total billed charges,,,1236.77,91,,percent of total billed charges,,,1291.14,95,,percent of total billed charges,,,1128.04,83,,percent of total billed charges,,,1128.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1128.04,83,,percent of total billed charges,,,1291.14,95,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1114.45,82,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1155.23,85,,percent of total billed charges,,339.77,1291.14,
TRAILBLAZER CATH ANGLED 0.014 X 90CM,30260166,CDM,,,270,RC,outpatient,,1359.09,1359.09,,1153.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,339.77,22,,percent of total billed charges,,,,,,,,,1223.18,90,,percent of total billed charges,,,1125.33,82.8,,percent of total billed charges,,,1155.23,85,,percent of total billed charges,,,,,,,,,1196,88,,percent of total billed charges,,,,,,,,,1038.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,339.77,22,,percent of total billed charges,,,1236.77,91,,percent of total billed charges,,,1291.14,95,,percent of total billed charges,,,1128.04,83,,percent of total billed charges,,,1128.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1128.04,83,,percent of total billed charges,,,1291.14,95,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1114.45,82,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1155.23,85,,percent of total billed charges,,339.77,1291.14,
TRAILBLAZER CATH ANGLED 0.035 X 90CM,30260167,CDM,,,270,RC,outpatient,,1359.09,1359.09,,1153.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,339.77,22,,percent of total billed charges,,,,,,,,,1223.18,90,,percent of total billed charges,,,1125.33,82.8,,percent of total billed charges,,,1155.23,85,,percent of total billed charges,,,,,,,,,1196,88,,percent of total billed charges,,,,,,,,,1038.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,339.77,22,,percent of total billed charges,,,1236.77,91,,percent of total billed charges,,,1291.14,95,,percent of total billed charges,,,1128.04,83,,percent of total billed charges,,,1128.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1128.04,83,,percent of total billed charges,,,1291.14,95,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1114.45,82,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1155.23,85,,percent of total billed charges,,339.77,1291.14,
TRAILBLAZER CATH ANGLED 0.035 X 135CM,30260168,CDM,,,270,RC,outpatient,,1359.09,1359.09,,1153.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,339.77,22,,percent of total billed charges,,,,,,,,,1223.18,90,,percent of total billed charges,,,1125.33,82.8,,percent of total billed charges,,,1155.23,85,,percent of total billed charges,,,,,,,,,1196,88,,percent of total billed charges,,,,,,,,,1038.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,339.77,22,,percent of total billed charges,,,1236.77,91,,percent of total billed charges,,,1291.14,95,,percent of total billed charges,,,1128.04,83,,percent of total billed charges,,,1128.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1128.04,83,,percent of total billed charges,,,1291.14,95,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1114.45,82,,percent of total billed charges,,,1223.18,90,,percent of total billed charges,,,1155.23,85,,percent of total billed charges,,339.77,1291.14,
CHOCOLATE BALLOON PTA 5.0 X 40MM,30260169,CDM,,,270,RC,outpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1291.88,22,,percent of total billed charges,,,,,,,,,4650.75,90,,percent of total billed charges,,,4278.69,82.8,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1291.88,22,,percent of total billed charges,,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,1291.88,4909.13,
NANOCROSS BALLOON 2.0 X 80MM,30260170,CDM,,,270,RC,outpatient,,1740.38,1740.38,,1477.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,435.1,22,,percent of total billed charges,,,,,,,,,1566.34,90,,percent of total billed charges,,,1441.03,82.8,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,,,,,,,,1531.53,88,,percent of total billed charges,,,,,,,,,1329.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,435.1,22,,percent of total billed charges,,,1583.75,91,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.52,83,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1427.11,82,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,435.1,1653.36,
NANOCROSS BALLOON 2.5 X 40MM,30260171,CDM,,,270,RC,outpatient,,1740.38,1740.38,,1477.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,435.1,22,,percent of total billed charges,,,,,,,,,1566.34,90,,percent of total billed charges,,,1441.03,82.8,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,,,,,,,,1531.53,88,,percent of total billed charges,,,,,,,,,1329.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,435.1,22,,percent of total billed charges,,,1583.75,91,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.52,83,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1427.11,82,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,435.1,1653.36,
MEDTRONIC SILVERHAWK,30260172,CDM,,,270,RC,outpatient,,19144.13,19144.13,,16253.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4786.03,22,,percent of total billed charges,,,,,,,,,17229.72,90,,percent of total billed charges,,,15851.34,82.8,,percent of total billed charges,,,16272.51,85,,percent of total billed charges,,,,,,,,,16846.83,88,,percent of total billed charges,,,,,,,,,14626.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4786.03,22,,percent of total billed charges,,,17421.16,91,,percent of total billed charges,,,18186.92,95,,percent of total billed charges,,,15889.63,83,,percent of total billed charges,,,15889.63,83,,percent of total billed charges,,,,,,,,,,,,,,,15889.63,83,,percent of total billed charges,,,18186.92,95,,percent of total billed charges,,,17229.72,90,,percent of total billed charges,,,17229.72,90,,percent of total billed charges,,,15698.19,82,,percent of total billed charges,,,17229.72,90,,percent of total billed charges,,,16272.51,85,,percent of total billed charges,,4786.03,18186.92,
MEDTRONIC VENASEAL CLOSURE SYSTEM,30260173,CDM,,,270,RC,outpatient,,14228.5,14228.5,,12080,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3557.13,22,,percent of total billed charges,,,,,,,,,12805.65,90,,percent of total billed charges,,,11781.2,82.8,,percent of total billed charges,,,12094.23,85,,percent of total billed charges,,,,,,,,,12521.08,88,,percent of total billed charges,,,,,,,,,10870.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3557.13,22,,percent of total billed charges,,,12947.94,91,,percent of total billed charges,,,13517.08,95,,percent of total billed charges,,,11809.66,83,,percent of total billed charges,,,11809.66,83,,percent of total billed charges,,,,,,,,,,,,,,,11809.66,83,,percent of total billed charges,,,13517.08,95,,percent of total billed charges,,,12805.65,90,,percent of total billed charges,,,12805.65,90,,percent of total billed charges,,,11667.37,82,,percent of total billed charges,,,12805.65,90,,percent of total billed charges,,,12094.23,85,,percent of total billed charges,,3557.13,13517.08,
NANOCROSS BALLOON 5.0 X 80MM,30260174,CDM,,,270,RC,outpatient,,1740.38,1740.38,,1477.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,435.1,22,,percent of total billed charges,,,,,,,,,1566.34,90,,percent of total billed charges,,,1441.03,82.8,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,,,,,,,,1531.53,88,,percent of total billed charges,,,,,,,,,1329.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,435.1,22,,percent of total billed charges,,,1583.75,91,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.52,83,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1427.11,82,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,435.1,1653.36,
NANOCROSS BALLOON 4.0 X 40MM,30260175,CDM,,,270,RC,outpatient,,1740.38,1740.38,,1477.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,435.1,22,,percent of total billed charges,,,,,,,,,1566.34,90,,percent of total billed charges,,,1441.03,82.8,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,,,,,,,,1531.53,88,,percent of total billed charges,,,,,,,,,1329.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,435.1,22,,percent of total billed charges,,,1583.75,91,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.52,83,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1427.11,82,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,435.1,1653.36,
IMPACT ADMIRAL BALLOON 5X200X130CM,30260176,CDM,,,270,RC,outpatient,,14592.5,14592.5,,12389.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3648.13,22,,percent of total billed charges,,,,,,,,,13133.25,90,,percent of total billed charges,,,12082.59,82.8,,percent of total billed charges,,,12403.63,85,,percent of total billed charges,,,,,,,,,12841.4,88,,percent of total billed charges,,,,,,,,,11148.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3648.13,22,,percent of total billed charges,,,13279.18,91,,percent of total billed charges,,,13862.88,95,,percent of total billed charges,,,12111.78,83,,percent of total billed charges,,,12111.78,83,,percent of total billed charges,,,,,,,,,,,,,,,12111.78,83,,percent of total billed charges,,,13862.88,95,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,11965.85,82,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,12403.63,85,,percent of total billed charges,,3648.13,13862.88,
EVERFLEX PROTEGE 6X150,30260177,CDM,,,270,RC,outpatient,,11162.13,11162.13,,9476.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2790.53,22,,percent of total billed charges,,,,,,,,,10045.92,90,,percent of total billed charges,,,9242.24,82.8,,percent of total billed charges,,,9487.81,85,,percent of total billed charges,,,,,,,,,9822.67,88,,percent of total billed charges,,,,,,,,,8527.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2790.53,22,,percent of total billed charges,,,10157.54,91,,percent of total billed charges,,,10604.02,95,,percent of total billed charges,,,9264.57,83,,percent of total billed charges,,,9264.57,83,,percent of total billed charges,,,,,,,,,,,,,,,9264.57,83,,percent of total billed charges,,,10604.02,95,,percent of total billed charges,,,10045.92,90,,percent of total billed charges,,,10045.92,90,,percent of total billed charges,,,9152.95,82,,percent of total billed charges,,,10045.92,90,,percent of total billed charges,,,9487.81,85,,percent of total billed charges,,2790.53,10604.02,
EVERCROSS BALLOON 4 X 100MM,30260183,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
EVERCROSS BALLOON 4 X 40MM,30260184,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
EVERFLEX PROTEGE 6X200,30260185,CDM,,,270,RC,outpatient,,20621.58,20621.58,,17507.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5155.4,22,,percent of total billed charges,,,,,,,,,18559.42,90,,percent of total billed charges,,,17074.67,82.8,,percent of total billed charges,,,17528.34,85,,percent of total billed charges,,,,,,,,,18146.99,88,,percent of total billed charges,,,,,,,,,15754.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5155.4,22,,percent of total billed charges,,,18765.64,91,,percent of total billed charges,,,19590.5,95,,percent of total billed charges,,,17115.91,83,,percent of total billed charges,,,17115.91,83,,percent of total billed charges,,,,,,,,,,,,,,,17115.91,83,,percent of total billed charges,,,19590.5,95,,percent of total billed charges,,,18559.42,90,,percent of total billed charges,,,18559.42,90,,percent of total billed charges,,,16909.7,82,,percent of total billed charges,,,18559.42,90,,percent of total billed charges,,,17528.34,85,,percent of total billed charges,,5155.4,19590.5,
EVERCROSS BALLOON 6 X 150MM,30260186,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
EVERFLEX PROTEGE 6X80,30260187,CDM,,,270,RC,outpatient,,8639.61,8639.61,,7335.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2159.9,22,,percent of total billed charges,,,,,,,,,7775.65,90,,percent of total billed charges,,,7153.6,82.8,,percent of total billed charges,,,7343.67,85,,percent of total billed charges,,,,,,,,,7602.86,88,,percent of total billed charges,,,,,,,,,6600.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2159.9,22,,percent of total billed charges,,,7862.05,91,,percent of total billed charges,,,8207.63,95,,percent of total billed charges,,,7170.88,83,,percent of total billed charges,,,7170.88,83,,percent of total billed charges,,,,,,,,,,,,,,,7170.88,83,,percent of total billed charges,,,8207.63,95,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7084.48,82,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7343.67,85,,percent of total billed charges,,2159.9,8207.63,
CATH DRAINAGE 8.5FR (NC),30260188,CDM,,,270,RC,outpatient,,1393.15,1393.15,,1182.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,348.29,22,,percent of total billed charges,,,,,,,,,1253.84,90,,percent of total billed charges,,,1153.53,82.8,,percent of total billed charges,,,1184.18,85,,percent of total billed charges,,,,,,,,,1225.97,88,,percent of total billed charges,,,,,,,,,1064.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,348.29,22,,percent of total billed charges,,,1267.77,91,,percent of total billed charges,,,1323.49,95,,percent of total billed charges,,,1156.31,83,,percent of total billed charges,,,1156.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1156.31,83,,percent of total billed charges,,,1323.49,95,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1142.38,82,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1184.18,85,,percent of total billed charges,,348.29,1323.49,
DILATOR INTERVENTIONAL CATH 9FR 20CM,30260189,CDM,,,270,RC,outpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.7,22,,percent of total billed charges,,,,,,,,,63.73,90,,percent of total billed charges,,,58.63,82.8,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.7,22,,percent of total billed charges,,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,17.7,67.27,
DILATOR INTERVENTIONAL CATH 6FR 20CM,30260190,CDM,,,270,RC,outpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.7,22,,percent of total billed charges,,,,,,,,,63.73,90,,percent of total billed charges,,,58.63,82.8,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.7,22,,percent of total billed charges,,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,17.7,67.27,
DILATOR INTERVENTIONAL CATH 7FR 20CM,30260191,CDM,,,270,RC,outpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.7,22,,percent of total billed charges,,,,,,,,,63.73,90,,percent of total billed charges,,,58.63,82.8,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.7,22,,percent of total billed charges,,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,17.7,67.27,
DILATOR INTERVENTIONAL CATH 11FR 20CM,30260192,CDM,,,270,RC,outpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.7,22,,percent of total billed charges,,,,,,,,,63.73,90,,percent of total billed charges,,,58.63,82.8,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.7,22,,percent of total billed charges,,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,17.7,67.27,
DILATOR INTERVENTIONAL CATH 12FR 20CM,30260193,CDM,,,270,RC,outpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.7,22,,percent of total billed charges,,,,,,,,,63.73,90,,percent of total billed charges,,,58.63,82.8,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.7,22,,percent of total billed charges,,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,17.7,67.27,
DILATOR INTERVENTIONAL CATH 14FR 20CM,30260194,CDM,,,270,RC,outpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.7,22,,percent of total billed charges,,,,,,,,,63.73,90,,percent of total billed charges,,,58.63,82.8,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.7,22,,percent of total billed charges,,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,17.7,67.27,
DILATOR INTERVENTIONAL CATH 16FR 20CM,30260195,CDM,,,270,RC,outpatient,,70.81,70.81,,60.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.7,22,,percent of total billed charges,,,,,,,,,63.73,90,,percent of total billed charges,,,58.63,82.8,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,,,,,,,,62.31,88,,percent of total billed charges,,,,,,,,,54.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.7,22,,percent of total billed charges,,,64.44,91,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,58.77,83,,percent of total billed charges,,,,,,,,,,,,,,,58.77,83,,percent of total billed charges,,,67.27,95,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,58.06,82,,percent of total billed charges,,,63.73,90,,percent of total billed charges,,,60.19,85,,percent of total billed charges,,17.7,67.27,
GLIDEWIRE ANGLED STIFF SHAFT 150CM,30260199,CDM,,,270,RC,outpatient,,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.25,22,,percent of total billed charges,,,,,,,,,321.3,90,,percent of total billed charges,,,295.6,82.8,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.25,22,,percent of total billed charges,,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,89.25,339.15,
FEEDING DEVICE G-JET 18F X 30CM,30260200,CDM,,,270,RC,outpatient,,1943.5,1943.5,,1650.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,485.88,22,,percent of total billed charges,,,,,,,,,1749.15,90,,percent of total billed charges,,,1609.22,82.8,,percent of total billed charges,,,1651.98,85,,percent of total billed charges,,,,,,,,,1710.28,88,,percent of total billed charges,,,,,,,,,1484.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,485.88,22,,percent of total billed charges,,,1768.59,91,,percent of total billed charges,,,1846.33,95,,percent of total billed charges,,,1613.11,83,,percent of total billed charges,,,1613.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1613.11,83,,percent of total billed charges,,,1846.33,95,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1593.67,82,,percent of total billed charges,,,1749.15,90,,percent of total billed charges,,,1651.98,85,,percent of total billed charges,,485.88,1846.33,
LAPAROSCOPIC INTRODUCER KIT 22FR DILATOR,30260201,CDM,,,270,RC,outpatient,,1513.4,1513.4,,1284.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,378.35,22,,percent of total billed charges,,,,,,,,,1362.06,90,,percent of total billed charges,,,1253.1,82.8,,percent of total billed charges,,,1286.39,85,,percent of total billed charges,,,,,,,,,1331.79,88,,percent of total billed charges,,,,,,,,,1156.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,378.35,22,,percent of total billed charges,,,1377.19,91,,percent of total billed charges,,,1437.73,95,,percent of total billed charges,,,1256.12,83,,percent of total billed charges,,,1256.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1256.12,83,,percent of total billed charges,,,1437.73,95,,percent of total billed charges,,,1362.06,90,,percent of total billed charges,,,1362.06,90,,percent of total billed charges,,,1240.99,82,,percent of total billed charges,,,1362.06,90,,percent of total billed charges,,,1286.39,85,,percent of total billed charges,,378.35,1437.73,
PLEURX PLEURAL CATH & STARTER KIT,30260203,CDM,,,270,RC,outpatient,,11760.78,11760.78,,9984.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2940.2,22,,percent of total billed charges,,,,,,,,,10584.7,90,,percent of total billed charges,,,9737.93,82.8,,percent of total billed charges,,,9996.66,85,,percent of total billed charges,,,,,,,,,10349.49,88,,percent of total billed charges,,,,,,,,,8985.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2940.2,22,,percent of total billed charges,,,10702.31,91,,percent of total billed charges,,,11172.74,95,,percent of total billed charges,,,9761.45,83,,percent of total billed charges,,,9761.45,83,,percent of total billed charges,,,,,,,,,,,,,,,9761.45,83,,percent of total billed charges,,,11172.74,95,,percent of total billed charges,,,10584.7,90,,percent of total billed charges,,,10584.7,90,,percent of total billed charges,,,9643.84,82,,percent of total billed charges,,,10584.7,90,,percent of total billed charges,,,9996.66,85,,percent of total billed charges,,2940.2,11172.74,
EVERCROSS BALLOON 8MM X 40MM,30260208,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
EVERCROSS BALLOON 10MM X 60MM,30260209,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
COOK DRAIN CATH MULTI-PURPOSE 10.2FR,30260210,CDM,,,270,RC,outpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.74,22,,percent of total billed charges,,,,,,,,,650.66,90,,percent of total billed charges,,,598.61,82.8,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.74,22,,percent of total billed charges,,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,180.74,686.81,
CHOCOLATE BALLOON PTA 2.5 X 40MM,30260212,CDM,,,270,RC,outpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1291.88,22,,percent of total billed charges,,,,,,,,,4650.75,90,,percent of total billed charges,,,4278.69,82.8,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1291.88,22,,percent of total billed charges,,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,1291.88,4909.13,
VISIPRO STENT 10 X 27MM,30260213,CDM,,,270,RC,outpatient,,8008.98,8008.98,,6799.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2002.25,22,,percent of total billed charges,,,,,,,,,7208.08,90,,percent of total billed charges,,,6631.44,82.8,,percent of total billed charges,,,6807.63,85,,percent of total billed charges,,,,,,,,,7047.9,88,,percent of total billed charges,,,,,,,,,6118.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2002.25,22,,percent of total billed charges,,,7288.17,91,,percent of total billed charges,,,7608.53,95,,percent of total billed charges,,,6647.45,83,,percent of total billed charges,,,6647.45,83,,percent of total billed charges,,,,,,,,,,,,,,,6647.45,83,,percent of total billed charges,,,7608.53,95,,percent of total billed charges,,,7208.08,90,,percent of total billed charges,,,7208.08,90,,percent of total billed charges,,,6567.36,82,,percent of total billed charges,,,7208.08,90,,percent of total billed charges,,,6807.63,85,,percent of total billed charges,,2002.25,7608.53,
CHOCOLATE BALLOON PTA 3.0 X 120MM,30260214,CDM,,,270,RC,outpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1291.88,22,,percent of total billed charges,,,,,,,,,4650.75,90,,percent of total billed charges,,,4278.69,82.8,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1291.88,22,,percent of total billed charges,,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,1291.88,4909.13,
CHOCOLATE BALLOON PTA 6.0 X 80MM,30260215,CDM,,,270,RC,outpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1291.88,22,,percent of total billed charges,,,,,,,,,4650.75,90,,percent of total billed charges,,,4278.69,82.8,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1291.88,22,,percent of total billed charges,,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,1291.88,4909.13,
CHOCOLATE BALLOON PTA 3.0 X 40MM,30260216,CDM,,,270,RC,outpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1291.88,22,,percent of total billed charges,,,,,,,,,4650.75,90,,percent of total billed charges,,,4278.69,82.8,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1291.88,22,,percent of total billed charges,,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,1291.88,4909.13,
CHOCOLATE BALLOON PTA 3.0 X 80MM,30260217,CDM,,,270,RC,outpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1291.88,22,,percent of total billed charges,,,,,,,,,4650.75,90,,percent of total billed charges,,,4278.69,82.8,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1291.88,22,,percent of total billed charges,,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,1291.88,4909.13,
IMPACT ADMIRAL BALLOON 4X80X130CM,30260218,CDM,,,270,RC,outpatient,,14592.5,14592.5,,12389.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3648.13,22,,percent of total billed charges,,,,,,,,,13133.25,90,,percent of total billed charges,,,12082.59,82.8,,percent of total billed charges,,,12403.63,85,,percent of total billed charges,,,,,,,,,12841.4,88,,percent of total billed charges,,,,,,,,,11148.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3648.13,22,,percent of total billed charges,,,13279.18,91,,percent of total billed charges,,,13862.88,95,,percent of total billed charges,,,12111.78,83,,percent of total billed charges,,,12111.78,83,,percent of total billed charges,,,,,,,,,,,,,,,12111.78,83,,percent of total billed charges,,,13862.88,95,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,11965.85,82,,percent of total billed charges,,,13133.25,90,,percent of total billed charges,,,12403.63,85,,percent of total billed charges,,3648.13,13862.88,
CHOCOLATE BALLOON PTA 4.0 X 80MM,30260219,CDM,,,270,RC,outpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1291.88,22,,percent of total billed charges,,,,,,,,,4650.75,90,,percent of total billed charges,,,4278.69,82.8,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1291.88,22,,percent of total billed charges,,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,1291.88,4909.13,
CHOCOLATE BALLOON PTA 4.0 X 120MM,30260220,CDM,,,270,RC,outpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1291.88,22,,percent of total billed charges,,,,,,,,,4650.75,90,,percent of total billed charges,,,4278.69,82.8,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1291.88,22,,percent of total billed charges,,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,1291.88,4909.13,
CHOCOLATE BALLOON PTA 3.5 X 40MM,30260221,CDM,,,270,RC,outpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1291.88,22,,percent of total billed charges,,,,,,,,,4650.75,90,,percent of total billed charges,,,4278.69,82.8,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1291.88,22,,percent of total billed charges,,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,1291.88,4909.13,
NANOCROSS BALLOON 3.0 X 80MM,30260222,CDM,,,270,RC,outpatient,,1740.38,1740.38,,1477.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,435.1,22,,percent of total billed charges,,,,,,,,,1566.34,90,,percent of total billed charges,,,1441.03,82.8,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,,,,,,,,1531.53,88,,percent of total billed charges,,,,,,,,,1329.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,435.1,22,,percent of total billed charges,,,1583.75,91,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,1444.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1444.52,83,,percent of total billed charges,,,1653.36,95,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1427.11,82,,percent of total billed charges,,,1566.34,90,,percent of total billed charges,,,1479.32,85,,percent of total billed charges,,435.1,1653.36,
SPIDER DISTAL PROTECTION DEVICE 7.0MM,30260223,CDM,,,270,RC,outpatient,,10090.08,10090.08,,8566.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2522.52,22,,percent of total billed charges,,,,,,,,,9081.07,90,,percent of total billed charges,,,8354.59,82.8,,percent of total billed charges,,,8576.57,85,,percent of total billed charges,,,,,,,,,8879.27,88,,percent of total billed charges,,,,,,,,,7708.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2522.52,22,,percent of total billed charges,,,9181.97,91,,percent of total billed charges,,,9585.58,95,,percent of total billed charges,,,8374.77,83,,percent of total billed charges,,,8374.77,83,,percent of total billed charges,,,,,,,,,,,,,,,8374.77,83,,percent of total billed charges,,,9585.58,95,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,8273.87,82,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,8576.57,85,,percent of total billed charges,,2522.52,9585.58,
CATH PHILIPS ASPIRATION 6F X 130CM STRAI,30260225,CDM,,,270,RC,outpatient,,10075,10075,,8553.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2518.75,22,,percent of total billed charges,,,,,,,,,9067.5,90,,percent of total billed charges,,,8342.1,82.8,,percent of total billed charges,,,8563.75,85,,percent of total billed charges,,,,,,,,,8866,88,,percent of total billed charges,,,,,,,,,7697.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2518.75,22,,percent of total billed charges,,,9168.25,91,,percent of total billed charges,,,9571.25,95,,percent of total billed charges,,,8362.25,83,,percent of total billed charges,,,8362.25,83,,percent of total billed charges,,,,,,,,,,,,,,,8362.25,83,,percent of total billed charges,,,9571.25,95,,percent of total billed charges,,,9067.5,90,,percent of total billed charges,,,9067.5,90,,percent of total billed charges,,,8261.5,82,,percent of total billed charges,,,9067.5,90,,percent of total billed charges,,,8563.75,85,,percent of total billed charges,,2518.75,9571.25,
MEDTRONIC ABRE VENOUS STENT SYSTEM 16X12,30260226,CDM,,,270,RC,outpatient,,13650,13650,,11588.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3412.5,22,,percent of total billed charges,,,,,,,,,12285,90,,percent of total billed charges,,,11302.2,82.8,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,,,,,,,,12012,88,,percent of total billed charges,,,,,,,,,10428.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3412.5,22,,percent of total billed charges,,,12421.5,91,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,11329.5,83,,percent of total billed charges,,,,,,,,,,,,,,,11329.5,83,,percent of total billed charges,,,12967.5,95,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11193,82,,percent of total billed charges,,,12285,90,,percent of total billed charges,,,11602.5,85,,percent of total billed charges,,3412.5,12967.5,
EVERFLEX PROTEGE 8 X 40,30260227,CDM,,,270,RC,outpatient,,8639.61,8639.61,,7335.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2159.9,22,,percent of total billed charges,,,,,,,,,7775.65,90,,percent of total billed charges,,,7153.6,82.8,,percent of total billed charges,,,7343.67,85,,percent of total billed charges,,,,,,,,,7602.86,88,,percent of total billed charges,,,,,,,,,6600.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2159.9,22,,percent of total billed charges,,,7862.05,91,,percent of total billed charges,,,8207.63,95,,percent of total billed charges,,,7170.88,83,,percent of total billed charges,,,7170.88,83,,percent of total billed charges,,,,,,,,,,,,,,,7170.88,83,,percent of total billed charges,,,8207.63,95,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7084.48,82,,percent of total billed charges,,,7775.65,90,,percent of total billed charges,,,7343.67,85,,percent of total billed charges,,2159.9,8207.63,
SHOCKWAVE CATH M5+ IVL 5.5X60X135,30260228,CDM,,,278,RC,outpatient,,22425,22425,,19038.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5606.25,22,,percent of total billed charges,,,,,,,,,20182.5,90,,percent of total billed charges,,,18567.9,82.8,,percent of total billed charges,,,19061.25,85,,percent of total billed charges,,,,,,,,,19734,88,,percent of total billed charges,,,,,,,,,17132.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5606.25,22,,percent of total billed charges,,,20406.75,91,,percent of total billed charges,,,21303.75,95,,percent of total billed charges,,,18612.75,83,,percent of total billed charges,,,18612.75,83,,percent of total billed charges,,,,,,,,,,,,,,,18612.75,83,,percent of total billed charges,,,21303.75,95,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,18388.5,82,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,19061.25,85,,percent of total billed charges,,5606.25,21303.75,
NANOCROSS BALLOON 4.0 X 150MM,30260229,CDM,,,270,RC,outpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.44,22,,percent of total billed charges,,,,,,,,,1740.38,90,,percent of total billed charges,,,1601.15,82.8,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.44,22,,percent of total billed charges,,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,483.44,1837.06,
IMPACT ADMIRAL BALLOON 4X120X130,30260230,CDM,,,270,RC,outpatient,,19467.5,19467.5,,16527.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4866.88,22,,percent of total billed charges,,,,,,,,,17520.75,90,,percent of total billed charges,,,16119.09,82.8,,percent of total billed charges,,,16547.38,85,,percent of total billed charges,,,,,,,,,17131.4,88,,percent of total billed charges,,,,,,,,,14873.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4866.88,22,,percent of total billed charges,,,17715.43,91,,percent of total billed charges,,,18494.13,95,,percent of total billed charges,,,16158.03,83,,percent of total billed charges,,,16158.03,83,,percent of total billed charges,,,,,,,,,,,,,,,16158.03,83,,percent of total billed charges,,,18494.13,95,,percent of total billed charges,,,17520.75,90,,percent of total billed charges,,,17520.75,90,,percent of total billed charges,,,15963.35,82,,percent of total billed charges,,,17520.75,90,,percent of total billed charges,,,16547.38,85,,percent of total billed charges,,4866.88,18494.13,
NANOCROSS BALLOON 2.5 X 150MM,30260231,CDM,,,270,RC,outpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.44,22,,percent of total billed charges,,,,,,,,,1740.38,90,,percent of total billed charges,,,1601.15,82.8,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.44,22,,percent of total billed charges,,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,483.44,1837.06,
NANOCROSS BALLOON 3.0-2.5 X 210MM,30260232,CDM,,,270,RC,outpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.44,22,,percent of total billed charges,,,,,,,,,1740.38,90,,percent of total billed charges,,,1601.15,82.8,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.44,22,,percent of total billed charges,,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,483.44,1837.06,
GLIDEWIRE STRAIGHT 150CM,30260233,CDM,,,270,RC,outpatient,,424.97,424.97,,360.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,106.24,22,,percent of total billed charges,,,,,,,,,382.47,90,,percent of total billed charges,,,351.88,82.8,,percent of total billed charges,,,361.22,85,,percent of total billed charges,,,,,,,,,373.97,88,,percent of total billed charges,,,,,,,,,324.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,106.24,22,,percent of total billed charges,,,386.72,91,,percent of total billed charges,,,403.72,95,,percent of total billed charges,,,352.73,83,,percent of total billed charges,,,352.73,83,,percent of total billed charges,,,,,,,,,,,,,,,352.73,83,,percent of total billed charges,,,403.72,95,,percent of total billed charges,,,382.47,90,,percent of total billed charges,,,382.47,90,,percent of total billed charges,,,348.48,82,,percent of total billed charges,,,382.47,90,,percent of total billed charges,,,361.22,85,,percent of total billed charges,,106.24,403.72,
UNIFUSE CATHETER  5F 135X50CM,30260234,CDM,,,270,RC,outpatient,,1995.5,1995.5,,1694.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,498.88,22,,percent of total billed charges,,,,,,,,,1795.95,90,,percent of total billed charges,,,1652.27,82.8,,percent of total billed charges,,,1696.18,85,,percent of total billed charges,,,,,,,,,1756.04,88,,percent of total billed charges,,,,,,,,,1524.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,498.88,22,,percent of total billed charges,,,1815.91,91,,percent of total billed charges,,,1895.73,95,,percent of total billed charges,,,1656.27,83,,percent of total billed charges,,,1656.27,83,,percent of total billed charges,,,,,,,,,,,,,,,1656.27,83,,percent of total billed charges,,,1895.73,95,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1636.31,82,,percent of total billed charges,,,1795.95,90,,percent of total billed charges,,,1696.18,85,,percent of total billed charges,,498.88,1895.73,
EVERCROSS BALLOON 4MM X 80MM,30260235,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
EVERCROSS BALLOON 6MM X 100MM,30260236,CDM,,,270,RC,outpatient,,824.67,824.67,,700.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.17,22,,percent of total billed charges,,,,,,,,,742.2,90,,percent of total billed charges,,,682.83,82.8,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,,,,,,,,725.71,88,,percent of total billed charges,,,,,,,,,630.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.17,22,,percent of total billed charges,,,750.45,91,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,684.48,83,,percent of total billed charges,,,,,,,,,,,,,,,684.48,83,,percent of total billed charges,,,783.44,95,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,676.23,82,,percent of total billed charges,,,742.2,90,,percent of total billed charges,,,700.97,85,,percent of total billed charges,,206.17,783.44,
SHEATH INTRODUCER PINNACLE 4FR 10CM,30260237,CDM,,,270,RC,outpatient,,828.8,828.8,,703.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,207.2,22,,percent of total billed charges,,,,,,,,,745.92,90,,percent of total billed charges,,,686.25,82.8,,percent of total billed charges,,,704.48,85,,percent of total billed charges,,,,,,,,,729.34,88,,percent of total billed charges,,,,,,,,,633.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,207.2,22,,percent of total billed charges,,,754.21,91,,percent of total billed charges,,,787.36,95,,percent of total billed charges,,,687.9,83,,percent of total billed charges,,,687.9,83,,percent of total billed charges,,,,,,,,,,,,,,,687.9,83,,percent of total billed charges,,,787.36,95,,percent of total billed charges,,,745.92,90,,percent of total billed charges,,,745.92,90,,percent of total billed charges,,,679.62,82,,percent of total billed charges,,,745.92,90,,percent of total billed charges,,,704.48,85,,percent of total billed charges,,207.2,787.36,
BARD PTA CATH ATLAS 14MM X 4CM X 75CM,30260238,CDM,,,270,RC,outpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,568.75,22,,percent of total billed charges,,,,,,,,,2047.5,90,,percent of total billed charges,,,1883.7,82.8,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,568.75,22,,percent of total billed charges,,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,568.75,2161.25,
BARD PTA CATH ATLAS GOLD 14MM X 4CM  7F,30260239,CDM,,,270,RC,outpatient,,2600,2600,,2207.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,650,22,,percent of total billed charges,,,,,,,,,2340,90,,percent of total billed charges,,,2152.8,82.8,,percent of total billed charges,,,2210,85,,percent of total billed charges,,,,,,,,,2288,88,,percent of total billed charges,,,,,,,,,1986.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,650,22,,percent of total billed charges,,,2366,91,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,2158,83,,percent of total billed charges,,,,,,,,,,,,,,,2158,83,,percent of total billed charges,,,2470,95,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2132,82,,percent of total billed charges,,,2340,90,,percent of total billed charges,,,2210,85,,percent of total billed charges,,650,2470,
BARD PTA CATH ATLAS 16MM X 40MM X 75CM,30260240,CDM,,,270,RC,outpatient,,2437.5,2437.5,,2069.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,609.38,22,,percent of total billed charges,,,,,,,,,2193.75,90,,percent of total billed charges,,,2018.25,82.8,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,,,,,,,,2145,88,,percent of total billed charges,,,,,,,,,1862.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,609.38,22,,percent of total billed charges,,,2218.13,91,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2023.13,83,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,1998.75,82,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,609.38,2315.63,
BARD PTA CATH ATLAS GOLD 16MM X 4CM  8F,30260241,CDM,,,270,RC,outpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,690.63,22,,percent of total billed charges,,,,,,,,,2486.25,90,,percent of total billed charges,,,2287.35,82.8,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,690.63,22,,percent of total billed charges,,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,690.63,2624.38,
BARD PTA CATH ATLAS 18MM X 40MM X 75CM,30260242,CDM,,,270,RC,outpatient,,2437.5,2437.5,,2069.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,609.38,22,,percent of total billed charges,,,,,,,,,2193.75,90,,percent of total billed charges,,,2018.25,82.8,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,,,,,,,,2145,88,,percent of total billed charges,,,,,,,,,1862.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,609.38,22,,percent of total billed charges,,,2218.13,91,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,2023.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2023.13,83,,percent of total billed charges,,,2315.63,95,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,1998.75,82,,percent of total billed charges,,,2193.75,90,,percent of total billed charges,,,2071.88,85,,percent of total billed charges,,609.38,2315.63,
BARD PTA CATH ATLAS GOLD 18MM X 4CM  8F,30260243,CDM,,,270,RC,outpatient,,2762.5,2762.5,,2345.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,690.63,22,,percent of total billed charges,,,,,,,,,2486.25,90,,percent of total billed charges,,,2287.35,82.8,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,,,,,,,,2431,88,,percent of total billed charges,,,,,,,,,2110.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,690.63,22,,percent of total billed charges,,,2513.88,91,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,2292.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2292.88,83,,percent of total billed charges,,,2624.38,95,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2265.25,82,,percent of total billed charges,,,2486.25,90,,percent of total billed charges,,,2348.13,85,,percent of total billed charges,,690.63,2624.38,
BARD PTA CATH ATLAS 20MM X 40MM 9F,30260244,CDM,,,270,RC,outpatient,,3250,3250,,2759.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.5,22,,percent of total billed charges,,,,,,,,,2925,90,,percent of total billed charges,,,2691,82.8,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,,,,,,,,2860,88,,percent of total billed charges,,,,,,,,,2483,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.5,22,,percent of total billed charges,,,2957.5,91,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,2697.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.5,83,,percent of total billed charges,,,3087.5,95,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2665,82,,percent of total billed charges,,,2925,90,,percent of total billed charges,,,2762.5,85,,percent of total billed charges,,812.5,3087.5,
NANOCROSS BALLOON 6.0 X 200MM,30260245,CDM,,,270,RC,outpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.44,22,,percent of total billed charges,,,,,,,,,1740.38,90,,percent of total billed charges,,,1601.15,82.8,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.44,22,,percent of total billed charges,,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,483.44,1837.06,
NANOCROSS BALLOON 3.0 X 150MM,30260246,CDM,,,270,RC,outpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.44,22,,percent of total billed charges,,,,,,,,,1740.38,90,,percent of total billed charges,,,1601.15,82.8,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.44,22,,percent of total billed charges,,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,483.44,1837.06,
CHOCOLATE BALLOON PTA 5.0 X 120MM,30260247,CDM,,,270,RC,outpatient,,5167.5,5167.5,,4387.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1291.88,22,,percent of total billed charges,,,,,,,,,4650.75,90,,percent of total billed charges,,,4278.69,82.8,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,,,,,,,,4547.4,88,,percent of total billed charges,,,,,,,,,3947.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1291.88,22,,percent of total billed charges,,,4702.43,91,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,4289.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4289.03,83,,percent of total billed charges,,,4909.13,95,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4237.35,82,,percent of total billed charges,,,4650.75,90,,percent of total billed charges,,,4392.38,85,,percent of total billed charges,,1291.88,4909.13,
SPIDER DISTAL PROTECTION DEVICE 3.0MM,30260249,CDM,,,270,RC,outpatient,,10090.08,10090.08,,8566.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2522.52,22,,percent of total billed charges,,,,,,,,,9081.07,90,,percent of total billed charges,,,8354.59,82.8,,percent of total billed charges,,,8576.57,85,,percent of total billed charges,,,,,,,,,8879.27,88,,percent of total billed charges,,,,,,,,,7708.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2522.52,22,,percent of total billed charges,,,9181.97,91,,percent of total billed charges,,,9585.58,95,,percent of total billed charges,,,8374.77,83,,percent of total billed charges,,,8374.77,83,,percent of total billed charges,,,,,,,,,,,,,,,8374.77,83,,percent of total billed charges,,,9585.58,95,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,8273.87,82,,percent of total billed charges,,,9081.07,90,,percent of total billed charges,,,8576.57,85,,percent of total billed charges,,2522.52,9585.58,
NANOCROSS BALLOON 3.5 X 150MM,30260250,CDM,,,270,RC,outpatient,,1933.75,1933.75,,1641.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.44,22,,percent of total billed charges,,,,,,,,,1740.38,90,,percent of total billed charges,,,1601.15,82.8,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,,,,,,,,1701.7,88,,percent of total billed charges,,,,,,,,,1477.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.44,22,,percent of total billed charges,,,1759.71,91,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,1605.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1605.01,83,,percent of total billed charges,,,1837.06,95,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1585.68,82,,percent of total billed charges,,,1740.38,90,,percent of total billed charges,,,1643.69,85,,percent of total billed charges,,483.44,1837.06,
SHOCKWAVE CATH M5+ IVL 7.0X60X135,30260251,CDM,,,278,RC,outpatient,,22425,22425,,19038.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5606.25,22,,percent of total billed charges,,,,,,,,,20182.5,90,,percent of total billed charges,,,18567.9,82.8,,percent of total billed charges,,,19061.25,85,,percent of total billed charges,,,,,,,,,19734,88,,percent of total billed charges,,,,,,,,,17132.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5606.25,22,,percent of total billed charges,,,20406.75,91,,percent of total billed charges,,,21303.75,95,,percent of total billed charges,,,18612.75,83,,percent of total billed charges,,,18612.75,83,,percent of total billed charges,,,,,,,,,,,,,,,18612.75,83,,percent of total billed charges,,,21303.75,95,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,18388.5,82,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,19061.25,85,,percent of total billed charges,,5606.25,21303.75,
SHOCKWAVE CATH M5+ IVL 8.0X60X135,30260252,CDM,,,278,RC,outpatient,,22425,22425,,19038.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5606.25,22,,percent of total billed charges,,,,,,,,,20182.5,90,,percent of total billed charges,,,18567.9,82.8,,percent of total billed charges,,,19061.25,85,,percent of total billed charges,,,,,,,,,19734,88,,percent of total billed charges,,,,,,,,,17132.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5606.25,22,,percent of total billed charges,,,20406.75,91,,percent of total billed charges,,,21303.75,95,,percent of total billed charges,,,18612.75,83,,percent of total billed charges,,,18612.75,83,,percent of total billed charges,,,,,,,,,,,,,,,18612.75,83,,percent of total billed charges,,,21303.75,95,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,18388.5,82,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,19061.25,85,,percent of total billed charges,,5606.25,21303.75,
APPLETON CAMBRIDGE RF SYSTEM RENTAL,30260253,CDM,,,270,RC,outpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1218.75,22,,percent of total billed charges,,,,,,,,,4387.5,90,,percent of total billed charges,,,4036.5,82.8,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1218.75,22,,percent of total billed charges,,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,1218.75,4631.25,
APPLETON ELECTRODE COOLED ONE-PIECE SHAR,30260254,CDM,,,270,RC,outpatient,,8021,8021,,6809.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2005.25,22,,percent of total billed charges,,,,,,,,,7218.9,90,,percent of total billed charges,,,6641.39,82.8,,percent of total billed charges,,,6817.85,85,,percent of total billed charges,,,,,,,,,7058.48,88,,percent of total billed charges,,,,,,,,,6128.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2005.25,22,,percent of total billed charges,,,7299.11,91,,percent of total billed charges,,,7619.95,95,,percent of total billed charges,,,6657.43,83,,percent of total billed charges,,,6657.43,83,,percent of total billed charges,,,,,,,,,,,,,,,6657.43,83,,percent of total billed charges,,,7619.95,95,,percent of total billed charges,,,7218.9,90,,percent of total billed charges,,,7218.9,90,,percent of total billed charges,,,6577.22,82,,percent of total billed charges,,,7218.9,90,,percent of total billed charges,,,6817.85,85,,percent of total billed charges,,2005.25,7619.95,
APPLETON TUBING SET COOLED ELECTRODES,30260255,CDM,,,270,RC,outpatient,,255,255,,216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.75,22,,percent of total billed charges,,,,,,,,,229.5,90,,percent of total billed charges,,,211.14,82.8,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,,,,,,,,224.4,88,,percent of total billed charges,,,,,,,,,194.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.75,22,,percent of total billed charges,,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,209.1,82,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,63.75,242.25,
APPLETON GROUND PAD,30260256,CDM,,,270,RC,outpatient,,217.5,217.5,,184.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.38,22,,percent of total billed charges,,,,,,,,,195.75,90,,percent of total billed charges,,,180.09,82.8,,percent of total billed charges,,,184.88,85,,percent of total billed charges,,,,,,,,,191.4,88,,percent of total billed charges,,,,,,,,,166.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.38,22,,percent of total billed charges,,,197.93,91,,percent of total billed charges,,,206.63,95,,percent of total billed charges,,,180.53,83,,percent of total billed charges,,,180.53,83,,percent of total billed charges,,,,,,,,,,,,,,,180.53,83,,percent of total billed charges,,,206.63,95,,percent of total billed charges,,,195.75,90,,percent of total billed charges,,,195.75,90,,percent of total billed charges,,,178.35,82,,percent of total billed charges,,,195.75,90,,percent of total billed charges,,,184.88,85,,percent of total billed charges,,54.38,206.63,
SHOCKWAVE CATH M5+ IVL 6.0MMX60MMX135CM,30260257,CDM,,,278,RC,outpatient,,22425,22425,,19038.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5606.25,22,,percent of total billed charges,,,,,,,,,20182.5,90,,percent of total billed charges,,,18567.9,82.8,,percent of total billed charges,,,19061.25,85,,percent of total billed charges,,,,,,,,,19734,88,,percent of total billed charges,,,,,,,,,17132.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5606.25,22,,percent of total billed charges,,,20406.75,91,,percent of total billed charges,,,21303.75,95,,percent of total billed charges,,,18612.75,83,,percent of total billed charges,,,18612.75,83,,percent of total billed charges,,,,,,,,,,,,,,,18612.75,83,,percent of total billed charges,,,21303.75,95,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,18388.5,82,,percent of total billed charges,,,20182.5,90,,percent of total billed charges,,,19061.25,85,,percent of total billed charges,,5606.25,21303.75,
BIOPSY SYSTEM ONCONTROL 102MM,30260258,CDM,,,270,RC,outpatient,,1142.9,1142.9,,970.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,285.73,22,,percent of total billed charges,,,,,,,,,1028.61,90,,percent of total billed charges,,,946.32,82.8,,percent of total billed charges,,,971.47,85,,percent of total billed charges,,,,,,,,,1005.75,88,,percent of total billed charges,,,,,,,,,873.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,285.73,22,,percent of total billed charges,,,1040.04,91,,percent of total billed charges,,,1085.76,95,,percent of total billed charges,,,948.61,83,,percent of total billed charges,,,948.61,83,,percent of total billed charges,,,,,,,,,,,,,,,948.61,83,,percent of total billed charges,,,1085.76,95,,percent of total billed charges,,,1028.61,90,,percent of total billed charges,,,1028.61,90,,percent of total billed charges,,,937.18,82,,percent of total billed charges,,,1028.61,90,,percent of total billed charges,,,971.47,85,,percent of total billed charges,,285.73,1085.76,
CAPE NEPHROUNETEROSTONY STENT 10.2 X 26C,30260259,CDM,,,270,RC,outpatient,,898.24,898.24,,762.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,224.56,22,,percent of total billed charges,,,,,,,,,808.42,90,,percent of total billed charges,,,743.74,82.8,,percent of total billed charges,,,763.5,85,,percent of total billed charges,,,,,,,,,790.45,88,,percent of total billed charges,,,,,,,,,686.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,224.56,22,,percent of total billed charges,,,817.4,91,,percent of total billed charges,,,853.33,95,,percent of total billed charges,,,745.54,83,,percent of total billed charges,,,745.54,83,,percent of total billed charges,,,,,,,,,,,,,,,745.54,83,,percent of total billed charges,,,853.33,95,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,736.56,82,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,763.5,85,,percent of total billed charges,,224.56,853.33,
CAPE NEPHROUNETEROSTONY STENT 8.5 X 28CM,30260260,CDM,,,270,RC,outpatient,,898.24,898.24,,762.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,224.56,22,,percent of total billed charges,,,,,,,,,808.42,90,,percent of total billed charges,,,743.74,82.8,,percent of total billed charges,,,763.5,85,,percent of total billed charges,,,,,,,,,790.45,88,,percent of total billed charges,,,,,,,,,686.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,224.56,22,,percent of total billed charges,,,817.4,91,,percent of total billed charges,,,853.33,95,,percent of total billed charges,,,745.54,83,,percent of total billed charges,,,745.54,83,,percent of total billed charges,,,,,,,,,,,,,,,745.54,83,,percent of total billed charges,,,853.33,95,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,736.56,82,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,763.5,85,,percent of total billed charges,,224.56,853.33,
CAPE NEPHROUNETEROSTONY STENT 8.5 X 26CM,30260261,CDM,,,270,RC,outpatient,,898.24,898.24,,762.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,224.56,22,,percent of total billed charges,,,,,,,,,808.42,90,,percent of total billed charges,,,743.74,82.8,,percent of total billed charges,,,763.5,85,,percent of total billed charges,,,,,,,,,790.45,88,,percent of total billed charges,,,,,,,,,686.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,224.56,22,,percent of total billed charges,,,817.4,91,,percent of total billed charges,,,853.33,95,,percent of total billed charges,,,745.54,83,,percent of total billed charges,,,745.54,83,,percent of total billed charges,,,,,,,,,,,,,,,745.54,83,,percent of total billed charges,,,853.33,95,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,736.56,82,,percent of total billed charges,,,808.42,90,,percent of total billed charges,,,763.5,85,,percent of total billed charges,,224.56,853.33,
GALT STIFF MINI ACCESS 4F X 10CM,30260262,CDM,,,270,RC,outpatient,,301.73,301.73,,256.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.43,22,,percent of total billed charges,,,,,,,,,271.56,90,,percent of total billed charges,,,249.83,82.8,,percent of total billed charges,,,256.47,85,,percent of total billed charges,,,,,,,,,265.52,88,,percent of total billed charges,,,,,,,,,230.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.43,22,,percent of total billed charges,,,274.57,91,,percent of total billed charges,,,286.64,95,,percent of total billed charges,,,250.44,83,,percent of total billed charges,,,250.44,83,,percent of total billed charges,,,,,,,,,,,,,,,250.44,83,,percent of total billed charges,,,286.64,95,,percent of total billed charges,,,271.56,90,,percent of total billed charges,,,271.56,90,,percent of total billed charges,,,247.42,82,,percent of total billed charges,,,271.56,90,,percent of total billed charges,,,256.47,85,,percent of total billed charges,,75.43,286.64,
GLIDE SHEATH SLENDER 5FR RADIAL ACCESS,30260263,CDM,,,270,RC,outpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
GLIDE SHEATH SLENDER 6FR RADIAL ACCESS,30260264,CDM,,,270,RC,outpatient,,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
CATH FOGARTY EMBOLECTOMY 4FR X 80CM,30260265,CDM,,,270,RC,outpatient,,1132.63,1132.63,,961.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,283.16,22,,percent of total billed charges,,,,,,,,,1019.37,90,,percent of total billed charges,,,937.82,82.8,,percent of total billed charges,,,962.74,85,,percent of total billed charges,,,,,,,,,996.71,88,,percent of total billed charges,,,,,,,,,865.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,283.16,22,,percent of total billed charges,,,1030.69,91,,percent of total billed charges,,,1076,95,,percent of total billed charges,,,940.08,83,,percent of total billed charges,,,940.08,83,,percent of total billed charges,,,,,,,,,,,,,,,940.08,83,,percent of total billed charges,,,1076,95,,percent of total billed charges,,,1019.37,90,,percent of total billed charges,,,1019.37,90,,percent of total billed charges,,,928.76,82,,percent of total billed charges,,,1019.37,90,,percent of total billed charges,,,962.74,85,,percent of total billed charges,,283.16,1076,
CATH FOGARTY EMBOLECTOMY 5.5F X 80CM,30260266,CDM,,,270,RC,outpatient,,1472.97,1472.97,,1250.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,368.24,22,,percent of total billed charges,,,,,,,,,1325.67,90,,percent of total billed charges,,,1219.62,82.8,,percent of total billed charges,,,1252.02,85,,percent of total billed charges,,,,,,,,,1296.21,88,,percent of total billed charges,,,,,,,,,1125.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,368.24,22,,percent of total billed charges,,,1340.4,91,,percent of total billed charges,,,1399.32,95,,percent of total billed charges,,,1222.57,83,,percent of total billed charges,,,1222.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1222.57,83,,percent of total billed charges,,,1399.32,95,,percent of total billed charges,,,1325.67,90,,percent of total billed charges,,,1325.67,90,,percent of total billed charges,,,1207.84,82,,percent of total billed charges,,,1325.67,90,,percent of total billed charges,,,1252.02,85,,percent of total billed charges,,368.24,1399.32,
CATH FOGARTY EMBOLECTOMY 6F X 80CM,30260267,CDM,,,270,RC,outpatient,,1466.99,1466.99,,1245.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,366.75,22,,percent of total billed charges,,,,,,,,,1320.29,90,,percent of total billed charges,,,1214.67,82.8,,percent of total billed charges,,,1246.94,85,,percent of total billed charges,,,,,,,,,1290.95,88,,percent of total billed charges,,,,,,,,,1120.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,366.75,22,,percent of total billed charges,,,1334.96,91,,percent of total billed charges,,,1393.64,95,,percent of total billed charges,,,1217.6,83,,percent of total billed charges,,,1217.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1217.6,83,,percent of total billed charges,,,1393.64,95,,percent of total billed charges,,,1320.29,90,,percent of total billed charges,,,1320.29,90,,percent of total billed charges,,,1202.93,82,,percent of total billed charges,,,1320.29,90,,percent of total billed charges,,,1246.94,85,,percent of total billed charges,,366.75,1393.64,
CATH PHILIPS ASPIRATION QUICK CLEAR 8F,30260268,CDM,,,270,RC,outpatient,,18525,18525,,15727.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4631.25,22,,percent of total billed charges,,,,,,,,,16672.5,90,,percent of total billed charges,,,15338.7,82.8,,percent of total billed charges,,,15746.25,85,,percent of total billed charges,,,,,,,,,16302,88,,percent of total billed charges,,,,,,,,,14153.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4631.25,22,,percent of total billed charges,,,16857.75,91,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,15375.75,83,,percent of total billed charges,,,,,,,,,,,,,,,15375.75,83,,percent of total billed charges,,,17598.75,95,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15190.5,82,,percent of total billed charges,,,16672.5,90,,percent of total billed charges,,,15746.25,85,,percent of total billed charges,,4631.25,17598.75,
INTRODUCER KIT - GASTROSTOMY FEEDING,30260269,CDM,,,270,RC,outpatient,,1748.5,1748.5,,1484.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,437.13,22,,percent of total billed charges,,,,,,,,,1573.65,90,,percent of total billed charges,,,1447.76,82.8,,percent of total billed charges,,,1486.23,85,,percent of total billed charges,,,,,,,,,1538.68,88,,percent of total billed charges,,,,,,,,,1335.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,437.13,22,,percent of total billed charges,,,1591.14,91,,percent of total billed charges,,,1661.08,95,,percent of total billed charges,,,1451.26,83,,percent of total billed charges,,,1451.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1451.26,83,,percent of total billed charges,,,1661.08,95,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1433.77,82,,percent of total billed charges,,,1573.65,90,,percent of total billed charges,,,1486.23,85,,percent of total billed charges,,437.13,1661.08,
MIC GASTROSTOMY FEEDING TUBE 18FR,30260270,CDM,,,270,RC,outpatient,,283.13,283.13,,240.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.78,22,,percent of total billed charges,,,,,,,,,254.82,90,,percent of total billed charges,,,234.43,82.8,,percent of total billed charges,,,240.66,85,,percent of total billed charges,,,,,,,,,249.15,88,,percent of total billed charges,,,,,,,,,216.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70.78,22,,percent of total billed charges,,,257.65,91,,percent of total billed charges,,,268.97,95,,percent of total billed charges,,,235,83,,percent of total billed charges,,,235,83,,percent of total billed charges,,,,,,,,,,,,,,,235,83,,percent of total billed charges,,,268.97,95,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,232.17,82,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,240.66,85,,percent of total billed charges,,70.78,268.97,
MIC GASTROSTOMY FEEDING TUBE 20FR,30260271,CDM,,,270,RC,outpatient,,283.13,283.13,,240.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.78,22,,percent of total billed charges,,,,,,,,,254.82,90,,percent of total billed charges,,,234.43,82.8,,percent of total billed charges,,,240.66,85,,percent of total billed charges,,,,,,,,,249.15,88,,percent of total billed charges,,,,,,,,,216.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70.78,22,,percent of total billed charges,,,257.65,91,,percent of total billed charges,,,268.97,95,,percent of total billed charges,,,235,83,,percent of total billed charges,,,235,83,,percent of total billed charges,,,,,,,,,,,,,,,235,83,,percent of total billed charges,,,268.97,95,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,232.17,82,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,240.66,85,,percent of total billed charges,,70.78,268.97,
MIC GASTROSTOMY FEEDING TUBE 22FR,30260272,CDM,,,270,RC,outpatient,,283.13,283.13,,240.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.78,22,,percent of total billed charges,,,,,,,,,254.82,90,,percent of total billed charges,,,234.43,82.8,,percent of total billed charges,,,240.66,85,,percent of total billed charges,,,,,,,,,249.15,88,,percent of total billed charges,,,,,,,,,216.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70.78,22,,percent of total billed charges,,,257.65,91,,percent of total billed charges,,,268.97,95,,percent of total billed charges,,,235,83,,percent of total billed charges,,,235,83,,percent of total billed charges,,,,,,,,,,,,,,,235,83,,percent of total billed charges,,,268.97,95,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,232.17,82,,percent of total billed charges,,,254.82,90,,percent of total billed charges,,,240.66,85,,percent of total billed charges,,70.78,268.97,
MIC GASTRIC JEJUNAL FEEDING TUBE KIT 18F,30260273,CDM,,,270,RC,outpatient,,1497.54,1497.54,,1271.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,374.39,22,,percent of total billed charges,,,,,,,,,1347.79,90,,percent of total billed charges,,,1239.96,82.8,,percent of total billed charges,,,1272.91,85,,percent of total billed charges,,,,,,,,,1317.84,88,,percent of total billed charges,,,,,,,,,1144.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,374.39,22,,percent of total billed charges,,,1362.76,91,,percent of total billed charges,,,1422.66,95,,percent of total billed charges,,,1242.96,83,,percent of total billed charges,,,1242.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1242.96,83,,percent of total billed charges,,,1422.66,95,,percent of total billed charges,,,1347.79,90,,percent of total billed charges,,,1347.79,90,,percent of total billed charges,,,1227.98,82,,percent of total billed charges,,,1347.79,90,,percent of total billed charges,,,1272.91,85,,percent of total billed charges,,374.39,1422.66,
MIC GASTRIC JEJUNAL FEEDING TUBE KIT 22F,30260274,CDM,,,270,RC,outpatient,,1497.54,1497.54,,1271.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,374.39,22,,percent of total billed charges,,,,,,,,,1347.79,90,,percent of total billed charges,,,1239.96,82.8,,percent of total billed charges,,,1272.91,85,,percent of total billed charges,,,,,,,,,1317.84,88,,percent of total billed charges,,,,,,,,,1144.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,374.39,22,,percent of total billed charges,,,1362.76,91,,percent of total billed charges,,,1422.66,95,,percent of total billed charges,,,1242.96,83,,percent of total billed charges,,,1242.96,83,,percent of total billed charges,,,,,,,,,,,,,,,1242.96,83,,percent of total billed charges,,,1422.66,95,,percent of total billed charges,,,1347.79,90,,percent of total billed charges,,,1347.79,90,,percent of total billed charges,,,1227.98,82,,percent of total billed charges,,,1347.79,90,,percent of total billed charges,,,1272.91,85,,percent of total billed charges,,374.39,1422.66,
COOK BILIARY DRAINAGE CATH 8.5F,30260275,CDM,,,270,RC,outpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.74,22,,percent of total billed charges,,,,,,,,,650.66,90,,percent of total billed charges,,,598.61,82.8,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.74,22,,percent of total billed charges,,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,180.74,686.81,
COOK BILIARY DRAINAGE CATH 10.2F,30260276,CDM,,,270,RC,outpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.74,22,,percent of total billed charges,,,,,,,,,650.66,90,,percent of total billed charges,,,598.61,82.8,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.74,22,,percent of total billed charges,,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,180.74,686.81,
COOK BILIARY DRAINAGE CATH 12F,30260277,CDM,,,270,RC,outpatient,,722.96,722.96,,613.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.74,22,,percent of total billed charges,,,,,,,,,650.66,90,,percent of total billed charges,,,598.61,82.8,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,,,,,,,,636.2,88,,percent of total billed charges,,,,,,,,,552.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.74,22,,percent of total billed charges,,,657.89,91,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,600.06,83,,percent of total billed charges,,,,,,,,,,,,,,,600.06,83,,percent of total billed charges,,,686.81,95,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,592.83,82,,percent of total billed charges,,,650.66,90,,percent of total billed charges,,,614.52,85,,percent of total billed charges,,180.74,686.81,
COOK LIVER ACCESS & BIOPSY SET 18G,30260278,CDM,,,270,RC,outpatient,,3523,3523,,2991.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,880.75,22,,percent of total billed charges,,,,,,,,,3170.7,90,,percent of total billed charges,,,2917.04,82.8,,percent of total billed charges,,,2994.55,85,,percent of total billed charges,,,,,,,,,3100.24,88,,percent of total billed charges,,,,,,,,,2691.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,880.75,22,,percent of total billed charges,,,3205.93,91,,percent of total billed charges,,,3346.85,95,,percent of total billed charges,,,2924.09,83,,percent of total billed charges,,,2924.09,83,,percent of total billed charges,,,,,,,,,,,,,,,2924.09,83,,percent of total billed charges,,,3346.85,95,,percent of total billed charges,,,3170.7,90,,percent of total billed charges,,,3170.7,90,,percent of total billed charges,,,2888.86,82,,percent of total billed charges,,,3170.7,90,,percent of total billed charges,,,2994.55,85,,percent of total billed charges,,880.75,3346.85,
MERIT MICROSPHERE 1ML SYRINGE,30260279,CDM,,,270,RC,outpatient,,1560,1560,,1324.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,390,22,,percent of total billed charges,,,,,,,,,1404,90,,percent of total billed charges,,,1291.68,82.8,,percent of total billed charges,,,1326,85,,percent of total billed charges,,,,,,,,,1372.8,88,,percent of total billed charges,,,,,,,,,1191.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,390,22,,percent of total billed charges,,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1294.8,83,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1279.2,82,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,390,1482,
MERIT MICROSPHERE 2ML SYRINGE,30260280,CDM,,,270,RC,outpatient,,1579.5,1579.5,,1341,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,394.88,22,,percent of total billed charges,,,,,,,,,1421.55,90,,percent of total billed charges,,,1307.83,82.8,,percent of total billed charges,,,1342.58,85,,percent of total billed charges,,,,,,,,,1389.96,88,,percent of total billed charges,,,,,,,,,1206.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,394.88,22,,percent of total billed charges,,,1437.35,91,,percent of total billed charges,,,1500.53,95,,percent of total billed charges,,,1310.99,83,,percent of total billed charges,,,1310.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1310.99,83,,percent of total billed charges,,,1500.53,95,,percent of total billed charges,,,1421.55,90,,percent of total billed charges,,,1421.55,90,,percent of total billed charges,,,1295.19,82,,percent of total billed charges,,,1421.55,90,,percent of total billed charges,,,1342.58,85,,percent of total billed charges,,394.88,1500.53,
MERIT MEDALLION SYRINGE 1ML,30260281,CDM,,,270,RC,outpatient,,17.55,17.55,,14.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.39,22,,percent of total billed charges,,,,,,,,,15.8,90,,percent of total billed charges,,,14.53,82.8,,percent of total billed charges,,,14.92,85,,percent of total billed charges,,,,,,,,,15.44,88,,percent of total billed charges,,,,,,,,,13.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.39,22,,percent of total billed charges,,,15.97,91,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14.57,83,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.39,82,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.92,85,,percent of total billed charges,,4.39,16.67,
MERIT MEDALLION SYRINGE 3ML,30260282,CDM,,,270,RC,outpatient,,17.55,17.55,,14.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.39,22,,percent of total billed charges,,,,,,,,,15.8,90,,percent of total billed charges,,,14.53,82.8,,percent of total billed charges,,,14.92,85,,percent of total billed charges,,,,,,,,,15.44,88,,percent of total billed charges,,,,,,,,,13.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.39,22,,percent of total billed charges,,,15.97,91,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14.57,83,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.39,82,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.92,85,,percent of total billed charges,,4.39,16.67,
MERIT MEDALLION SYRINGE 10ML,30260283,CDM,,,270,RC,outpatient,,17.55,17.55,,14.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.39,22,,percent of total billed charges,,,,,,,,,15.8,90,,percent of total billed charges,,,14.53,82.8,,percent of total billed charges,,,14.92,85,,percent of total billed charges,,,,,,,,,15.44,88,,percent of total billed charges,,,,,,,,,13.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.39,22,,percent of total billed charges,,,15.97,91,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,14.57,83,,percent of total billed charges,,,,,,,,,,,,,,,14.57,83,,percent of total billed charges,,,16.67,95,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.39,82,,percent of total billed charges,,,15.8,90,,percent of total billed charges,,,14.92,85,,percent of total billed charges,,4.39,16.67,
URESIL ASPIRATION FLUSH ADAPTER,30260284,CDM,,,270,RC,outpatient,,188.1,188.1,,159.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.03,22,,percent of total billed charges,,,,,,,,,169.29,90,,percent of total billed charges,,,155.75,82.8,,percent of total billed charges,,,159.89,85,,percent of total billed charges,,,,,,,,,165.53,88,,percent of total billed charges,,,,,,,,,143.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.03,22,,percent of total billed charges,,,171.17,91,,percent of total billed charges,,,178.7,95,,percent of total billed charges,,,156.12,83,,percent of total billed charges,,,156.12,83,,percent of total billed charges,,,,,,,,,,,,,,,156.12,83,,percent of total billed charges,,,178.7,95,,percent of total billed charges,,,169.29,90,,percent of total billed charges,,,169.29,90,,percent of total billed charges,,,154.24,82,,percent of total billed charges,,,169.29,90,,percent of total billed charges,,,159.89,85,,percent of total billed charges,,47.03,178.7,
CATH IVUS VISION PV .014 RX DIGITAL,30260286,CDM,,,270,RC,outpatient,,4875,4875,,4138.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1218.75,22,,percent of total billed charges,,,,,,,,,4387.5,90,,percent of total billed charges,,,4036.5,82.8,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,,,,,,,,4290,88,,percent of total billed charges,,,,,,,,,3724.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1218.75,22,,percent of total billed charges,,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,,,,,,,,,,,,,4046.25,83,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,3997.5,82,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,1218.75,4631.25,
CATH IVUS VISION PV .035 RX DIGITAL,30260287,CDM,,,270,RC,outpatient,,6337.5,6337.5,,5380.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1584.38,22,,percent of total billed charges,,,,,,,,,5703.75,90,,percent of total billed charges,,,5247.45,82.8,,percent of total billed charges,,,5386.88,85,,percent of total billed charges,,,,,,,,,5577,88,,percent of total billed charges,,,,,,,,,4841.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1584.38,22,,percent of total billed charges,,,5767.13,91,,percent of total billed charges,,,6020.63,95,,percent of total billed charges,,,5260.13,83,,percent of total billed charges,,,5260.13,83,,percent of total billed charges,,,,,,,,,,,,,,,5260.13,83,,percent of total billed charges,,,6020.63,95,,percent of total billed charges,,,5703.75,90,,percent of total billed charges,,,5703.75,90,,percent of total billed charges,,,5196.75,82,,percent of total billed charges,,,5703.75,90,,percent of total billed charges,,,5386.88,85,,percent of total billed charges,,1584.38,6020.63,
NEEDLE BARD BIO 16 X 10,30270009,CDM,,,270,RC,outpatient,,328.73,328.73,,279.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.18,22,,percent of total billed charges,,,,,,,,,295.86,90,,percent of total billed charges,,,272.19,82.8,,percent of total billed charges,,,279.42,85,,percent of total billed charges,,,,,,,,,289.28,88,,percent of total billed charges,,,,,,,,,251.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82.18,22,,percent of total billed charges,,,299.14,91,,percent of total billed charges,,,312.29,95,,percent of total billed charges,,,272.85,83,,percent of total billed charges,,,272.85,83,,percent of total billed charges,,,,,,,,,,,,,,,272.85,83,,percent of total billed charges,,,312.29,95,,percent of total billed charges,,,295.86,90,,percent of total billed charges,,,295.86,90,,percent of total billed charges,,,269.56,82,,percent of total billed charges,,,295.86,90,,percent of total billed charges,,,279.42,85,,percent of total billed charges,,82.18,312.29,
TRAY PARACENTESIS ABDOMINAL LARGE VOLUME,30270021,CDM,,,270,RC,outpatient,,466.67,466.67,,396.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.67,22,,percent of total billed charges,,,,,,,,,420,90,,percent of total billed charges,,,386.4,82.8,,percent of total billed charges,,,396.67,85,,percent of total billed charges,,,,,,,,,410.67,88,,percent of total billed charges,,,,,,,,,356.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.67,22,,percent of total billed charges,,,424.67,91,,percent of total billed charges,,,443.34,95,,percent of total billed charges,,,387.34,83,,percent of total billed charges,,,387.34,83,,percent of total billed charges,,,,,,,,,,,,,,,387.34,83,,percent of total billed charges,,,443.34,95,,percent of total billed charges,,,420,90,,percent of total billed charges,,,420,90,,percent of total billed charges,,,382.67,82,,percent of total billed charges,,,420,90,,percent of total billed charges,,,396.67,85,,percent of total billed charges,,116.67,443.34,
NEEDLE BIOPSY FRANSEEN LUNG 18 X 15,30290004,CDM,,,270,RC,outpatient,,194.48,194.48,,165.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.62,22,,percent of total billed charges,,,,,,,,,175.03,90,,percent of total billed charges,,,161.03,82.8,,percent of total billed charges,,,165.31,85,,percent of total billed charges,,,,,,,,,171.14,88,,percent of total billed charges,,,,,,,,,148.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.62,22,,percent of total billed charges,,,176.98,91,,percent of total billed charges,,,184.76,95,,percent of total billed charges,,,161.42,83,,percent of total billed charges,,,161.42,83,,percent of total billed charges,,,,,,,,,,,,,,,161.42,83,,percent of total billed charges,,,184.76,95,,percent of total billed charges,,,175.03,90,,percent of total billed charges,,,175.03,90,,percent of total billed charges,,,159.47,82,,percent of total billed charges,,,175.03,90,,percent of total billed charges,,,165.31,85,,percent of total billed charges,,48.62,184.76,
NEEDLE BIOPSY FRANSEEN LUNG 20 X 20,30290005,CDM,,,270,RC,outpatient,,194.48,194.48,,165.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.62,22,,percent of total billed charges,,,,,,,,,175.03,90,,percent of total billed charges,,,161.03,82.8,,percent of total billed charges,,,165.31,85,,percent of total billed charges,,,,,,,,,171.14,88,,percent of total billed charges,,,,,,,,,148.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.62,22,,percent of total billed charges,,,176.98,91,,percent of total billed charges,,,184.76,95,,percent of total billed charges,,,161.42,83,,percent of total billed charges,,,161.42,83,,percent of total billed charges,,,,,,,,,,,,,,,161.42,83,,percent of total billed charges,,,184.76,95,,percent of total billed charges,,,175.03,90,,percent of total billed charges,,,175.03,90,,percent of total billed charges,,,159.47,82,,percent of total billed charges,,,175.03,90,,percent of total billed charges,,,165.31,85,,percent of total billed charges,,48.62,184.76,
NEEDLE BIOPSY FRANSEEN LUNG 20 X 15,30290006,CDM,,,270,RC,outpatient,,218.55,218.55,,185.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.64,22,,percent of total billed charges,,,,,,,,,196.7,90,,percent of total billed charges,,,180.96,82.8,,percent of total billed charges,,,185.77,85,,percent of total billed charges,,,,,,,,,192.32,88,,percent of total billed charges,,,,,,,,,166.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.64,22,,percent of total billed charges,,,198.88,91,,percent of total billed charges,,,207.62,95,,percent of total billed charges,,,181.4,83,,percent of total billed charges,,,181.4,83,,percent of total billed charges,,,,,,,,,,,,,,,181.4,83,,percent of total billed charges,,,207.62,95,,percent of total billed charges,,,196.7,90,,percent of total billed charges,,,196.7,90,,percent of total billed charges,,,179.21,82,,percent of total billed charges,,,196.7,90,,percent of total billed charges,,,185.77,85,,percent of total billed charges,,54.64,207.62,
NEEDLE NERVE BLOCK 22GA X 2,30330004,CDM,,,270,RC,outpatient,,116.22,116.22,,98.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.06,22,,percent of total billed charges,,,,,,,,,104.6,90,,percent of total billed charges,,,96.23,82.8,,percent of total billed charges,,,98.79,85,,percent of total billed charges,,,,,,,,,102.27,88,,percent of total billed charges,,,,,,,,,88.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.06,22,,percent of total billed charges,,,105.76,91,,percent of total billed charges,,,110.41,95,,percent of total billed charges,,,96.46,83,,percent of total billed charges,,,96.46,83,,percent of total billed charges,,,,,,,,,,,,,,,96.46,83,,percent of total billed charges,,,110.41,95,,percent of total billed charges,,,104.6,90,,percent of total billed charges,,,104.6,90,,percent of total billed charges,,,95.3,82,,percent of total billed charges,,,104.6,90,,percent of total billed charges,,,98.79,85,,percent of total billed charges,,29.06,110.41,
NEEDLE SPINAL GERTIE MARX 25 X 124MM,30330005,CDM,,,270,RC,outpatient,,109.2,109.2,,92.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.3,22,,percent of total billed charges,,,,,,,,,98.28,90,,percent of total billed charges,,,90.42,82.8,,percent of total billed charges,,,92.82,85,,percent of total billed charges,,,,,,,,,96.1,88,,percent of total billed charges,,,,,,,,,83.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.3,22,,percent of total billed charges,,,99.37,91,,percent of total billed charges,,,103.74,95,,percent of total billed charges,,,90.64,83,,percent of total billed charges,,,90.64,83,,percent of total billed charges,,,,,,,,,,,,,,,90.64,83,,percent of total billed charges,,,103.74,95,,percent of total billed charges,,,98.28,90,,percent of total billed charges,,,98.28,90,,percent of total billed charges,,,89.54,82,,percent of total billed charges,,,98.28,90,,percent of total billed charges,,,92.82,85,,percent of total billed charges,,27.3,103.74,
RANGER STANDARD FLOW W/EXT SET,30330009,CDM,,,270,RC,outpatient,,83.22,83.22,,70.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.81,22,,percent of total billed charges,,,,,,,,,74.9,90,,percent of total billed charges,,,68.91,82.8,,percent of total billed charges,,,70.74,85,,percent of total billed charges,,,,,,,,,73.23,88,,percent of total billed charges,,,,,,,,,63.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.81,22,,percent of total billed charges,,,75.73,91,,percent of total billed charges,,,79.06,95,,percent of total billed charges,,,69.07,83,,percent of total billed charges,,,69.07,83,,percent of total billed charges,,,,,,,,,,,,,,,69.07,83,,percent of total billed charges,,,79.06,95,,percent of total billed charges,,,74.9,90,,percent of total billed charges,,,74.9,90,,percent of total billed charges,,,68.24,82,,percent of total billed charges,,,74.9,90,,percent of total billed charges,,,70.74,85,,percent of total billed charges,,20.81,79.06,
PRESSURE INFUSER BAG 1000ML,30330010,CDM,,,270,RC,outpatient,,123.76,123.76,,105.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.94,22,,percent of total billed charges,,,,,,,,,111.38,90,,percent of total billed charges,,,102.47,82.8,,percent of total billed charges,,,105.2,85,,percent of total billed charges,,,,,,,,,108.91,88,,percent of total billed charges,,,,,,,,,94.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.94,22,,percent of total billed charges,,,112.62,91,,percent of total billed charges,,,117.57,95,,percent of total billed charges,,,102.72,83,,percent of total billed charges,,,102.72,83,,percent of total billed charges,,,,,,,,,,,,,,,102.72,83,,percent of total billed charges,,,117.57,95,,percent of total billed charges,,,111.38,90,,percent of total billed charges,,,111.38,90,,percent of total billed charges,,,101.48,82,,percent of total billed charges,,,111.38,90,,percent of total billed charges,,,105.2,85,,percent of total billed charges,,30.94,117.57,
*C-FUSOR 1000ML UNIT,30330011,CDM,,,270,RC,outpatient,,521.43,521.43,,442.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.36,22,,percent of total billed charges,,,,,,,,,469.29,90,,percent of total billed charges,,,431.74,82.8,,percent of total billed charges,,,443.22,85,,percent of total billed charges,,,,,,,,,458.86,88,,percent of total billed charges,,,,,,,,,398.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.36,22,,percent of total billed charges,,,474.5,91,,percent of total billed charges,,,495.36,95,,percent of total billed charges,,,432.79,83,,percent of total billed charges,,,432.79,83,,percent of total billed charges,,,,,,,,,,,,,,,432.79,83,,percent of total billed charges,,,495.36,95,,percent of total billed charges,,,469.29,90,,percent of total billed charges,,,469.29,90,,percent of total billed charges,,,427.57,82,,percent of total billed charges,,,469.29,90,,percent of total billed charges,,,443.22,85,,percent of total billed charges,,130.36,495.36,
TRAY EPIDURAL ESPOCAN CSE,30330017,CDM,,,270,RC,outpatient,,342.73,342.73,,290.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.68,22,,percent of total billed charges,,,,,,,,,308.46,90,,percent of total billed charges,,,283.78,82.8,,percent of total billed charges,,,291.32,85,,percent of total billed charges,,,,,,,,,301.6,88,,percent of total billed charges,,,,,,,,,261.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.68,22,,percent of total billed charges,,,311.88,91,,percent of total billed charges,,,325.59,95,,percent of total billed charges,,,284.47,83,,percent of total billed charges,,,284.47,83,,percent of total billed charges,,,,,,,,,,,,,,,284.47,83,,percent of total billed charges,,,325.59,95,,percent of total billed charges,,,308.46,90,,percent of total billed charges,,,308.46,90,,percent of total billed charges,,,281.04,82,,percent of total billed charges,,,308.46,90,,percent of total billed charges,,,291.32,85,,percent of total billed charges,,85.68,325.59,
*AIRWAY KING LTD #4,30330023,CDM,,,270,RC,outpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.5,22,,percent of total billed charges,,,,,,,,,365.4,90,,percent of total billed charges,,,336.17,82.8,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.5,22,,percent of total billed charges,,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,101.5,385.7,
SENSOR SKIN TEMPERATURE,30330024,CDM,,,270,RC,outpatient,,42.19,42.19,,35.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.55,22,,percent of total billed charges,,,,,,,,,37.97,90,,percent of total billed charges,,,34.93,82.8,,percent of total billed charges,,,35.86,85,,percent of total billed charges,,,,,,,,,37.13,88,,percent of total billed charges,,,,,,,,,32.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.55,22,,percent of total billed charges,,,38.39,91,,percent of total billed charges,,,40.08,95,,percent of total billed charges,,,35.02,83,,percent of total billed charges,,,35.02,83,,percent of total billed charges,,,,,,,,,,,,,,,35.02,83,,percent of total billed charges,,,40.08,95,,percent of total billed charges,,,37.97,90,,percent of total billed charges,,,37.97,90,,percent of total billed charges,,,34.6,82,,percent of total billed charges,,,37.97,90,,percent of total billed charges,,,35.86,85,,percent of total billed charges,,10.55,40.08,
*ESOPHAGEAL STETHOSCOPE W/TEMP SENSOR,30330025,CDM,,,270,RC,outpatient,,50.83,50.83,,43.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.71,22,,percent of total billed charges,,,,,,,,,45.75,90,,percent of total billed charges,,,42.09,82.8,,percent of total billed charges,,,43.21,85,,percent of total billed charges,,,,,,,,,44.73,88,,percent of total billed charges,,,,,,,,,38.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.71,22,,percent of total billed charges,,,46.26,91,,percent of total billed charges,,,48.29,95,,percent of total billed charges,,,42.19,83,,percent of total billed charges,,,42.19,83,,percent of total billed charges,,,,,,,,,,,,,,,42.19,83,,percent of total billed charges,,,48.29,95,,percent of total billed charges,,,45.75,90,,percent of total billed charges,,,45.75,90,,percent of total billed charges,,,41.68,82,,percent of total billed charges,,,45.75,90,,percent of total billed charges,,,43.21,85,,percent of total billed charges,,12.71,48.29,
DEPUY BODY GLBL UNITE 52X21,30330026,CDM,,,278,RC,outpatient,,17636.13,17636.13,,14973.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4409.03,22,,percent of total billed charges,,,,,,,,,15872.52,90,,percent of total billed charges,,,14602.72,82.8,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,,,,,,,,15519.79,88,,percent of total billed charges,,,,,,,,,13474,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4409.03,22,,percent of total billed charges,,,16048.88,91,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,14637.99,83,,percent of total billed charges,,,,,,,,,,,,,,,14637.99,83,,percent of total billed charges,,,16754.32,95,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14461.63,82,,percent of total billed charges,,,15872.52,90,,percent of total billed charges,,,14990.71,85,,percent of total billed charges,,4409.03,16754.32,
AIRWAY LMA UNIQUE SIZE 1.5,30330031,CDM,,,270,RC,outpatient,,114.48,114.48,,97.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.62,22,,percent of total billed charges,,,,,,,,,103.03,90,,percent of total billed charges,,,94.79,82.8,,percent of total billed charges,,,97.31,85,,percent of total billed charges,,,,,,,,,100.74,88,,percent of total billed charges,,,,,,,,,87.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.62,22,,percent of total billed charges,,,104.18,91,,percent of total billed charges,,,108.76,95,,percent of total billed charges,,,95.02,83,,percent of total billed charges,,,95.02,83,,percent of total billed charges,,,,,,,,,,,,,,,95.02,83,,percent of total billed charges,,,108.76,95,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,93.87,82,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,97.31,85,,percent of total billed charges,,28.62,108.76,
AIRWAY LMA UNIQUE SIZE 2,30330032,CDM,,,270,RC,outpatient,,114.48,114.48,,97.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.62,22,,percent of total billed charges,,,,,,,,,103.03,90,,percent of total billed charges,,,94.79,82.8,,percent of total billed charges,,,97.31,85,,percent of total billed charges,,,,,,,,,100.74,88,,percent of total billed charges,,,,,,,,,87.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.62,22,,percent of total billed charges,,,104.18,91,,percent of total billed charges,,,108.76,95,,percent of total billed charges,,,95.02,83,,percent of total billed charges,,,95.02,83,,percent of total billed charges,,,,,,,,,,,,,,,95.02,83,,percent of total billed charges,,,108.76,95,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,93.87,82,,percent of total billed charges,,,103.03,90,,percent of total billed charges,,,97.31,85,,percent of total billed charges,,28.62,108.76,
AIRWAY LMA UNIQUE SIZE 2.5,30330033,CDM,,,270,RC,outpatient,,78.99,78.99,,67.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.75,22,,percent of total billed charges,,,,,,,,,71.09,90,,percent of total billed charges,,,65.4,82.8,,percent of total billed charges,,,67.14,85,,percent of total billed charges,,,,,,,,,69.51,88,,percent of total billed charges,,,,,,,,,60.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.75,22,,percent of total billed charges,,,71.88,91,,percent of total billed charges,,,75.04,95,,percent of total billed charges,,,65.56,83,,percent of total billed charges,,,65.56,83,,percent of total billed charges,,,,,,,,,,,,,,,65.56,83,,percent of total billed charges,,,75.04,95,,percent of total billed charges,,,71.09,90,,percent of total billed charges,,,71.09,90,,percent of total billed charges,,,64.77,82,,percent of total billed charges,,,71.09,90,,percent of total billed charges,,,67.14,85,,percent of total billed charges,,19.75,75.04,
ESOPHOGEAL TAP PROBES 18FR,30330035,CDM,,,270,RC,outpatient,,46.22,46.22,,39.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.56,22,,percent of total billed charges,,,,,,,,,41.6,90,,percent of total billed charges,,,38.27,82.8,,percent of total billed charges,,,39.29,85,,percent of total billed charges,,,,,,,,,40.67,88,,percent of total billed charges,,,,,,,,,35.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.56,22,,percent of total billed charges,,,42.06,91,,percent of total billed charges,,,43.91,95,,percent of total billed charges,,,38.36,83,,percent of total billed charges,,,38.36,83,,percent of total billed charges,,,,,,,,,,,,,,,38.36,83,,percent of total billed charges,,,43.91,95,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,37.9,82,,percent of total billed charges,,,41.6,90,,percent of total billed charges,,,39.29,85,,percent of total billed charges,,11.56,43.91,
AIRWAY NASO PVC 32FR,30330037,CDM,,,270,RC,outpatient,,21.04,21.04,,17.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.26,22,,percent of total billed charges,,,,,,,,,18.94,90,,percent of total billed charges,,,17.42,82.8,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,,,,,,,,18.52,88,,percent of total billed charges,,,,,,,,,16.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.26,22,,percent of total billed charges,,,19.15,91,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,17.46,83,,percent of total billed charges,,,,,,,,,,,,,,,17.46,83,,percent of total billed charges,,,19.99,95,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.25,82,,percent of total billed charges,,,18.94,90,,percent of total billed charges,,,17.88,85,,percent of total billed charges,,5.26,19.99,
AIRWAY NASO PVC 34FR,30330038,CDM,,,270,RC,outpatient,,15.73,15.73,,13.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.93,22,,percent of total billed charges,,,,,,,,,14.16,90,,percent of total billed charges,,,13.02,82.8,,percent of total billed charges,,,13.37,85,,percent of total billed charges,,,,,,,,,13.84,88,,percent of total billed charges,,,,,,,,,12.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.93,22,,percent of total billed charges,,,14.31,91,,percent of total billed charges,,,14.94,95,,percent of total billed charges,,,13.06,83,,percent of total billed charges,,,13.06,83,,percent of total billed charges,,,,,,,,,,,,,,,13.06,83,,percent of total billed charges,,,14.94,95,,percent of total billed charges,,,14.16,90,,percent of total billed charges,,,14.16,90,,percent of total billed charges,,,12.9,82,,percent of total billed charges,,,14.16,90,,percent of total billed charges,,,13.37,85,,percent of total billed charges,,3.93,14.94,
AIRWAY NASO PVC 36FR,30330039,CDM,,,270,RC,outpatient,,15.93,15.93,,13.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.98,22,,percent of total billed charges,,,,,,,,,14.34,90,,percent of total billed charges,,,13.19,82.8,,percent of total billed charges,,,13.54,85,,percent of total billed charges,,,,,,,,,14.02,88,,percent of total billed charges,,,,,,,,,12.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.98,22,,percent of total billed charges,,,14.5,91,,percent of total billed charges,,,15.13,95,,percent of total billed charges,,,13.22,83,,percent of total billed charges,,,13.22,83,,percent of total billed charges,,,,,,,,,,,,,,,13.22,83,,percent of total billed charges,,,15.13,95,,percent of total billed charges,,,14.34,90,,percent of total billed charges,,,14.34,90,,percent of total billed charges,,,13.06,82,,percent of total billed charges,,,14.34,90,,percent of total billed charges,,,13.54,85,,percent of total billed charges,,3.98,15.13,
GLIDESCOPE COVER 3 STAT,30330041,CDM,,,270,RC,outpatient,,138.24,138.24,,117.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.56,22,,percent of total billed charges,,,,,,,,,124.42,90,,percent of total billed charges,,,114.46,82.8,,percent of total billed charges,,,117.5,85,,percent of total billed charges,,,,,,,,,121.65,88,,percent of total billed charges,,,,,,,,,105.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.56,22,,percent of total billed charges,,,125.8,91,,percent of total billed charges,,,131.33,95,,percent of total billed charges,,,114.74,83,,percent of total billed charges,,,114.74,83,,percent of total billed charges,,,,,,,,,,,,,,,114.74,83,,percent of total billed charges,,,131.33,95,,percent of total billed charges,,,124.42,90,,percent of total billed charges,,,124.42,90,,percent of total billed charges,,,113.36,82,,percent of total billed charges,,,124.42,90,,percent of total billed charges,,,117.5,85,,percent of total billed charges,,34.56,131.33,
INTRODUCER TRACH COUDE15FR 70CM,30330044,CDM,,,270,RC,outpatient,,47.57,47.57,,40.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.89,22,,percent of total billed charges,,,,,,,,,42.81,90,,percent of total billed charges,,,39.39,82.8,,percent of total billed charges,,,40.43,85,,percent of total billed charges,,,,,,,,,41.86,88,,percent of total billed charges,,,,,,,,,36.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.89,22,,percent of total billed charges,,,43.29,91,,percent of total billed charges,,,45.19,95,,percent of total billed charges,,,39.48,83,,percent of total billed charges,,,39.48,83,,percent of total billed charges,,,,,,,,,,,,,,,39.48,83,,percent of total billed charges,,,45.19,95,,percent of total billed charges,,,42.81,90,,percent of total billed charges,,,42.81,90,,percent of total billed charges,,,39.01,82,,percent of total billed charges,,,42.81,90,,percent of total billed charges,,,40.43,85,,percent of total billed charges,,11.89,45.19,
TRAY PENCAN LIDO ONLY,30330048,CDM,,,270,RC,outpatient,,140.21,140.21,,119.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.05,22,,percent of total billed charges,,,,,,,,,126.19,90,,percent of total billed charges,,,116.09,82.8,,percent of total billed charges,,,119.18,85,,percent of total billed charges,,,,,,,,,123.38,88,,percent of total billed charges,,,,,,,,,107.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.05,22,,percent of total billed charges,,,127.59,91,,percent of total billed charges,,,133.2,95,,percent of total billed charges,,,116.37,83,,percent of total billed charges,,,116.37,83,,percent of total billed charges,,,,,,,,,,,,,,,116.37,83,,percent of total billed charges,,,133.2,95,,percent of total billed charges,,,126.19,90,,percent of total billed charges,,,126.19,90,,percent of total billed charges,,,114.97,82,,percent of total billed charges,,,126.19,90,,percent of total billed charges,,,119.18,85,,percent of total billed charges,,35.05,133.2,
*NEEDLE SONOTAP 22G X 50MM,30330049,CDM,,,270,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
*NEEDLE STIMUPLEX ULTRA 22G X 2,30330052,CDM,,,270,RC,outpatient,,104.98,104.98,,89.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.25,22,,percent of total billed charges,,,,,,,,,94.48,90,,percent of total billed charges,,,86.92,82.8,,percent of total billed charges,,,89.23,85,,percent of total billed charges,,,,,,,,,92.38,88,,percent of total billed charges,,,,,,,,,80.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.25,22,,percent of total billed charges,,,95.53,91,,percent of total billed charges,,,99.73,95,,percent of total billed charges,,,87.13,83,,percent of total billed charges,,,87.13,83,,percent of total billed charges,,,,,,,,,,,,,,,87.13,83,,percent of total billed charges,,,99.73,95,,percent of total billed charges,,,94.48,90,,percent of total billed charges,,,94.48,90,,percent of total billed charges,,,86.08,82,,percent of total billed charges,,,94.48,90,,percent of total billed charges,,,89.23,85,,percent of total billed charges,,26.25,99.73,
AIRWAY LMA SUPREME SIZE 3,30330053,CDM,,,270,RC,outpatient,,193.13,193.13,,163.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.28,22,,percent of total billed charges,,,,,,,,,173.82,90,,percent of total billed charges,,,159.91,82.8,,percent of total billed charges,,,164.16,85,,percent of total billed charges,,,,,,,,,169.95,88,,percent of total billed charges,,,,,,,,,147.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.28,22,,percent of total billed charges,,,175.75,91,,percent of total billed charges,,,183.47,95,,percent of total billed charges,,,160.3,83,,percent of total billed charges,,,160.3,83,,percent of total billed charges,,,,,,,,,,,,,,,160.3,83,,percent of total billed charges,,,183.47,95,,percent of total billed charges,,,173.82,90,,percent of total billed charges,,,173.82,90,,percent of total billed charges,,,158.37,82,,percent of total billed charges,,,173.82,90,,percent of total billed charges,,,164.16,85,,percent of total billed charges,,48.28,183.47,
AIRWAY LMA SUPREME SIZE 4,30330054,CDM,,,270,RC,outpatient,,193.13,193.13,,163.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.28,22,,percent of total billed charges,,,,,,,,,173.82,90,,percent of total billed charges,,,159.91,82.8,,percent of total billed charges,,,164.16,85,,percent of total billed charges,,,,,,,,,169.95,88,,percent of total billed charges,,,,,,,,,147.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.28,22,,percent of total billed charges,,,175.75,91,,percent of total billed charges,,,183.47,95,,percent of total billed charges,,,160.3,83,,percent of total billed charges,,,160.3,83,,percent of total billed charges,,,,,,,,,,,,,,,160.3,83,,percent of total billed charges,,,183.47,95,,percent of total billed charges,,,173.82,90,,percent of total billed charges,,,173.82,90,,percent of total billed charges,,,158.37,82,,percent of total billed charges,,,173.82,90,,percent of total billed charges,,,164.16,85,,percent of total billed charges,,48.28,183.47,
AIRWAY LMA SUPREME SIZE 5,30330055,CDM,,,270,RC,outpatient,,193.6,193.6,,164.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.4,22,,percent of total billed charges,,,,,,,,,174.24,90,,percent of total billed charges,,,160.3,82.8,,percent of total billed charges,,,164.56,85,,percent of total billed charges,,,,,,,,,170.37,88,,percent of total billed charges,,,,,,,,,147.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.4,22,,percent of total billed charges,,,176.18,91,,percent of total billed charges,,,183.92,95,,percent of total billed charges,,,160.69,83,,percent of total billed charges,,,160.69,83,,percent of total billed charges,,,,,,,,,,,,,,,160.69,83,,percent of total billed charges,,,183.92,95,,percent of total billed charges,,,174.24,90,,percent of total billed charges,,,174.24,90,,percent of total billed charges,,,158.75,82,,percent of total billed charges,,,174.24,90,,percent of total billed charges,,,164.56,85,,percent of total billed charges,,48.4,183.92,
AIRWAY GUEDEL 70MM WHITE,30330056,CDM,,,270,RC,outpatient,,6.55,6.55,,5.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.64,22,,percent of total billed charges,,,,,,,,,5.9,90,,percent of total billed charges,,,5.42,82.8,,percent of total billed charges,,,5.57,85,,percent of total billed charges,,,,,,,,,5.76,88,,percent of total billed charges,,,,,,,,,5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.64,22,,percent of total billed charges,,,5.96,91,,percent of total billed charges,,,6.22,95,,percent of total billed charges,,,5.44,83,,percent of total billed charges,,,5.44,83,,percent of total billed charges,,,,,,,,,,,,,,,5.44,83,,percent of total billed charges,,,6.22,95,,percent of total billed charges,,,5.9,90,,percent of total billed charges,,,5.9,90,,percent of total billed charges,,,5.37,82,,percent of total billed charges,,,5.9,90,,percent of total billed charges,,,5.57,85,,percent of total billed charges,,1.64,6.22,
NEEDLE PENCIL PT 22GX5,30330058,CDM,,,270,RC,outpatient,,38.45,38.45,,32.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.61,22,,percent of total billed charges,,,,,,,,,34.61,90,,percent of total billed charges,,,31.84,82.8,,percent of total billed charges,,,32.68,85,,percent of total billed charges,,,,,,,,,33.84,88,,percent of total billed charges,,,,,,,,,29.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.61,22,,percent of total billed charges,,,34.99,91,,percent of total billed charges,,,36.53,95,,percent of total billed charges,,,31.91,83,,percent of total billed charges,,,31.91,83,,percent of total billed charges,,,,,,,,,,,,,,,31.91,83,,percent of total billed charges,,,36.53,95,,percent of total billed charges,,,34.61,90,,percent of total billed charges,,,34.61,90,,percent of total billed charges,,,31.53,82,,percent of total billed charges,,,34.61,90,,percent of total billed charges,,,32.68,85,,percent of total billed charges,,9.61,36.53,
INTUBATION STYLET 10FR,30330059,CDM,,,270,RC,outpatient,,33.44,33.44,,28.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.36,22,,percent of total billed charges,,,,,,,,,30.1,90,,percent of total billed charges,,,27.69,82.8,,percent of total billed charges,,,28.42,85,,percent of total billed charges,,,,,,,,,29.43,88,,percent of total billed charges,,,,,,,,,25.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.36,22,,percent of total billed charges,,,30.43,91,,percent of total billed charges,,,31.77,95,,percent of total billed charges,,,27.76,83,,percent of total billed charges,,,27.76,83,,percent of total billed charges,,,,,,,,,,,,,,,27.76,83,,percent of total billed charges,,,31.77,95,,percent of total billed charges,,,30.1,90,,percent of total billed charges,,,30.1,90,,percent of total billed charges,,,27.42,82,,percent of total billed charges,,,30.1,90,,percent of total billed charges,,,28.42,85,,percent of total billed charges,,8.36,31.77,
DRYLINE WATER TRAP ADULT,30330066,CDM,,,270,RC,outpatient,,138.6,138.6,,117.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.65,22,,percent of total billed charges,,,,,,,,,124.74,90,,percent of total billed charges,,,114.76,82.8,,percent of total billed charges,,,117.81,85,,percent of total billed charges,,,,,,,,,121.97,88,,percent of total billed charges,,,,,,,,,105.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.65,22,,percent of total billed charges,,,126.13,91,,percent of total billed charges,,,131.67,95,,percent of total billed charges,,,115.04,83,,percent of total billed charges,,,115.04,83,,percent of total billed charges,,,,,,,,,,,,,,,115.04,83,,percent of total billed charges,,,131.67,95,,percent of total billed charges,,,124.74,90,,percent of total billed charges,,,124.74,90,,percent of total billed charges,,,113.65,82,,percent of total billed charges,,,124.74,90,,percent of total billed charges,,,117.81,85,,percent of total billed charges,,34.65,131.67,
BAT MASK ADULT LARGE,30330069,CDM,,,270,RC,outpatient,,50.49,50.49,,42.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.62,22,,percent of total billed charges,,,,,,,,,45.44,90,,percent of total billed charges,,,41.81,82.8,,percent of total billed charges,,,42.92,85,,percent of total billed charges,,,,,,,,,44.43,88,,percent of total billed charges,,,,,,,,,38.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.62,22,,percent of total billed charges,,,45.95,91,,percent of total billed charges,,,47.97,95,,percent of total billed charges,,,41.91,83,,percent of total billed charges,,,41.91,83,,percent of total billed charges,,,,,,,,,,,,,,,41.91,83,,percent of total billed charges,,,47.97,95,,percent of total billed charges,,,45.44,90,,percent of total billed charges,,,45.44,90,,percent of total billed charges,,,41.4,82,,percent of total billed charges,,,45.44,90,,percent of total billed charges,,,42.92,85,,percent of total billed charges,,12.62,47.97,
ARTERIAL CATHERIZATION SET 20G X 1 3/4,30330071,CDM,,,270,RC,outpatient,,75.31,75.31,,63.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.83,22,,percent of total billed charges,,,,,,,,,67.78,90,,percent of total billed charges,,,62.36,82.8,,percent of total billed charges,,,64.01,85,,percent of total billed charges,,,,,,,,,66.27,88,,percent of total billed charges,,,,,,,,,57.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.83,22,,percent of total billed charges,,,68.53,91,,percent of total billed charges,,,71.54,95,,percent of total billed charges,,,62.51,83,,percent of total billed charges,,,62.51,83,,percent of total billed charges,,,,,,,,,,,,,,,62.51,83,,percent of total billed charges,,,71.54,95,,percent of total billed charges,,,67.78,90,,percent of total billed charges,,,67.78,90,,percent of total billed charges,,,61.75,82,,percent of total billed charges,,,67.78,90,,percent of total billed charges,,,64.01,85,,percent of total billed charges,,18.83,71.54,
NEEDLE SPINAL GERTIE MARX SET 17 X 125MM,30330074,CDM,,,270,RC,outpatient,,243.38,243.38,,206.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60.85,22,,percent of total billed charges,,,,,,,,,219.04,90,,percent of total billed charges,,,201.52,82.8,,percent of total billed charges,,,206.87,85,,percent of total billed charges,,,,,,,,,214.17,88,,percent of total billed charges,,,,,,,,,185.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60.85,22,,percent of total billed charges,,,221.48,91,,percent of total billed charges,,,231.21,95,,percent of total billed charges,,,202.01,83,,percent of total billed charges,,,202.01,83,,percent of total billed charges,,,,,,,,,,,,,,,202.01,83,,percent of total billed charges,,,231.21,95,,percent of total billed charges,,,219.04,90,,percent of total billed charges,,,219.04,90,,percent of total billed charges,,,199.57,82,,percent of total billed charges,,,219.04,90,,percent of total billed charges,,,206.87,85,,percent of total billed charges,,60.85,231.21,
AIRWAY ORAL AGT PREFORMED CUFFED 7.0,30330075,CDM,,,270,RC,outpatient,,44.96,44.96,,38.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.24,22,,percent of total billed charges,,,,,,,,,40.46,90,,percent of total billed charges,,,37.23,82.8,,percent of total billed charges,,,38.22,85,,percent of total billed charges,,,,,,,,,39.56,88,,percent of total billed charges,,,,,,,,,34.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.24,22,,percent of total billed charges,,,40.91,91,,percent of total billed charges,,,42.71,95,,percent of total billed charges,,,37.32,83,,percent of total billed charges,,,37.32,83,,percent of total billed charges,,,,,,,,,,,,,,,37.32,83,,percent of total billed charges,,,42.71,95,,percent of total billed charges,,,40.46,90,,percent of total billed charges,,,40.46,90,,percent of total billed charges,,,36.87,82,,percent of total billed charges,,,40.46,90,,percent of total billed charges,,,38.22,85,,percent of total billed charges,,11.24,42.71,
AIRWAY ORAL AGT PREFORMED CUFFED 8.0,30330076,CDM,,,270,RC,outpatient,,44.1,44.1,,37.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.03,22,,percent of total billed charges,,,,,,,,,39.69,90,,percent of total billed charges,,,36.51,82.8,,percent of total billed charges,,,37.49,85,,percent of total billed charges,,,,,,,,,38.81,88,,percent of total billed charges,,,,,,,,,33.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.03,22,,percent of total billed charges,,,40.13,91,,percent of total billed charges,,,41.9,95,,percent of total billed charges,,,36.6,83,,percent of total billed charges,,,36.6,83,,percent of total billed charges,,,,,,,,,,,,,,,36.6,83,,percent of total billed charges,,,41.9,95,,percent of total billed charges,,,39.69,90,,percent of total billed charges,,,39.69,90,,percent of total billed charges,,,36.16,82,,percent of total billed charges,,,39.69,90,,percent of total billed charges,,,37.49,85,,percent of total billed charges,,11.03,41.9,
TRACH TUBE UNCUFFED 4MM,30330077,CDM,,,270,RC,outpatient,,14.11,14.11,,11.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.53,22,,percent of total billed charges,,,,,,,,,12.7,90,,percent of total billed charges,,,11.68,82.8,,percent of total billed charges,,,11.99,85,,percent of total billed charges,,,,,,,,,12.42,88,,percent of total billed charges,,,,,,,,,10.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.53,22,,percent of total billed charges,,,12.84,91,,percent of total billed charges,,,13.4,95,,percent of total billed charges,,,11.71,83,,percent of total billed charges,,,11.71,83,,percent of total billed charges,,,,,,,,,,,,,,,11.71,83,,percent of total billed charges,,,13.4,95,,percent of total billed charges,,,12.7,90,,percent of total billed charges,,,12.7,90,,percent of total billed charges,,,11.57,82,,percent of total billed charges,,,12.7,90,,percent of total billed charges,,,11.99,85,,percent of total billed charges,,3.53,13.4,
NEEDLE NERVE BLOCK 21GA X 4,30330078,CDM,,,270,RC,outpatient,,112.37,112.37,,95.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.09,22,,percent of total billed charges,,,,,,,,,101.13,90,,percent of total billed charges,,,93.04,82.8,,percent of total billed charges,,,95.51,85,,percent of total billed charges,,,,,,,,,98.89,88,,percent of total billed charges,,,,,,,,,85.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.09,22,,percent of total billed charges,,,102.26,91,,percent of total billed charges,,,106.75,95,,percent of total billed charges,,,93.27,83,,percent of total billed charges,,,93.27,83,,percent of total billed charges,,,,,,,,,,,,,,,93.27,83,,percent of total billed charges,,,106.75,95,,percent of total billed charges,,,101.13,90,,percent of total billed charges,,,101.13,90,,percent of total billed charges,,,92.14,82,,percent of total billed charges,,,101.13,90,,percent of total billed charges,,,95.51,85,,percent of total billed charges,,28.09,106.75,
NEEDLE SONOBLOCK 22G X 2  FACET TIP,30330079,CDM,,,270,RC,outpatient,,122,122,,103.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.5,22,,percent of total billed charges,,,,,,,,,109.8,90,,percent of total billed charges,,,101.02,82.8,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,,,,,,,,107.36,88,,percent of total billed charges,,,,,,,,,93.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.5,22,,percent of total billed charges,,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,100.04,82,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,30.5,115.9,
NEEDLE SONOBLOCK 21G X 4  FACET TIP,30330080,CDM,,,270,RC,outpatient,,134,134,,113.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.5,22,,percent of total billed charges,,,,,,,,,120.6,90,,percent of total billed charges,,,110.95,82.8,,percent of total billed charges,,,113.9,85,,percent of total billed charges,,,,,,,,,117.92,88,,percent of total billed charges,,,,,,,,,102.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.5,22,,percent of total billed charges,,,121.94,91,,percent of total billed charges,,,127.3,95,,percent of total billed charges,,,111.22,83,,percent of total billed charges,,,111.22,83,,percent of total billed charges,,,,,,,,,,,,,,,111.22,83,,percent of total billed charges,,,127.3,95,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,109.88,82,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,113.9,85,,percent of total billed charges,,33.5,127.3,
CATHETER RADIAL ARTERY KIT 20G X 1 3/4,30330084,CDM,,,270,RC,outpatient,,75.48,75.48,,64.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.87,22,,percent of total billed charges,,,,,,,,,67.93,90,,percent of total billed charges,,,62.5,82.8,,percent of total billed charges,,,64.16,85,,percent of total billed charges,,,,,,,,,66.42,88,,percent of total billed charges,,,,,,,,,57.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.87,22,,percent of total billed charges,,,68.69,91,,percent of total billed charges,,,71.71,95,,percent of total billed charges,,,62.65,83,,percent of total billed charges,,,62.65,83,,percent of total billed charges,,,,,,,,,,,,,,,62.65,83,,percent of total billed charges,,,71.71,95,,percent of total billed charges,,,67.93,90,,percent of total billed charges,,,67.93,90,,percent of total billed charges,,,61.89,82,,percent of total billed charges,,,67.93,90,,percent of total billed charges,,,64.16,85,,percent of total billed charges,,18.87,71.71,
STRYKER TIBIAL BASEPLATE,30330103,CDM,,,278,RC,outpatient,,7150,7150,,6070.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1787.5,22,,percent of total billed charges,,,,,,,,,6435,90,,percent of total billed charges,,,5920.2,82.8,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,,,,,,,,6292,88,,percent of total billed charges,,,,,,,,,5462.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1787.5,22,,percent of total billed charges,,,6506.5,91,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,5934.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5934.5,83,,percent of total billed charges,,,6792.5,95,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,5863,82,,percent of total billed charges,,,6435,90,,percent of total billed charges,,,6077.5,85,,percent of total billed charges,,1787.5,6792.5,
STRYKER TIBIAL BEARING INSERT,30330104,CDM,,,278,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
CATH PHILIPS ASPIRATION 10FX85CM,30330106,CDM,,,270,RC,outpatient,,22750,22750,,19314.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5687.5,22,,percent of total billed charges,,,,,,,,,20475,90,,percent of total billed charges,,,18837,82.8,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,,,,,,,,20020,88,,percent of total billed charges,,,,,,,,,17381,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5687.5,22,,percent of total billed charges,,,20702.5,91,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,18882.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18882.5,83,,percent of total billed charges,,,21612.5,95,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,18655,82,,percent of total billed charges,,,20475,90,,percent of total billed charges,,,19337.5,85,,percent of total billed charges,,5687.5,21612.5,
QUICKTRACH 4.0MM,30330117,CDM,,,270,RC,outpatient,,981.24,981.24,,833.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,245.31,22,,percent of total billed charges,,,,,,,,,883.12,90,,percent of total billed charges,,,812.47,82.8,,percent of total billed charges,,,834.05,85,,percent of total billed charges,,,,,,,,,863.49,88,,percent of total billed charges,,,,,,,,,749.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,245.31,22,,percent of total billed charges,,,892.93,91,,percent of total billed charges,,,932.18,95,,percent of total billed charges,,,814.43,83,,percent of total billed charges,,,814.43,83,,percent of total billed charges,,,,,,,,,,,,,,,814.43,83,,percent of total billed charges,,,932.18,95,,percent of total billed charges,,,883.12,90,,percent of total billed charges,,,883.12,90,,percent of total billed charges,,,804.62,82,,percent of total billed charges,,,883.12,90,,percent of total billed charges,,,834.05,85,,percent of total billed charges,,245.31,932.18,
QUICKTRACH 2.0MM,30330118,CDM,,,270,RC,outpatient,,981.24,981.24,,833.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,245.31,22,,percent of total billed charges,,,,,,,,,883.12,90,,percent of total billed charges,,,812.47,82.8,,percent of total billed charges,,,834.05,85,,percent of total billed charges,,,,,,,,,863.49,88,,percent of total billed charges,,,,,,,,,749.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,245.31,22,,percent of total billed charges,,,892.93,91,,percent of total billed charges,,,932.18,95,,percent of total billed charges,,,814.43,83,,percent of total billed charges,,,814.43,83,,percent of total billed charges,,,,,,,,,,,,,,,814.43,83,,percent of total billed charges,,,932.18,95,,percent of total billed charges,,,883.12,90,,percent of total billed charges,,,883.12,90,,percent of total billed charges,,,804.62,82,,percent of total billed charges,,,883.12,90,,percent of total billed charges,,,834.05,85,,percent of total billed charges,,245.31,932.18,
SENSOR SPO2 RD ADULT,30330119,CDM,,,270,RC,outpatient,,112.32,112.32,,95.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.08,22,,percent of total billed charges,,,,,,,,,101.09,90,,percent of total billed charges,,,93,82.8,,percent of total billed charges,,,95.47,85,,percent of total billed charges,,,,,,,,,98.84,88,,percent of total billed charges,,,,,,,,,85.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.08,22,,percent of total billed charges,,,102.21,91,,percent of total billed charges,,,106.7,95,,percent of total billed charges,,,93.23,83,,percent of total billed charges,,,93.23,83,,percent of total billed charges,,,,,,,,,,,,,,,93.23,83,,percent of total billed charges,,,106.7,95,,percent of total billed charges,,,101.09,90,,percent of total billed charges,,,101.09,90,,percent of total billed charges,,,92.1,82,,percent of total billed charges,,,101.09,90,,percent of total billed charges,,,95.47,85,,percent of total billed charges,,28.08,106.7,
SENSOR SPO2 RD INFANT,30330120,CDM,,,270,RC,outpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36,22,,percent of total billed charges,,,,,,,,,129.6,90,,percent of total billed charges,,,119.23,82.8,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36,22,,percent of total billed charges,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,36,136.8,
LEG LYMPH BANDAGE KIT,30340013,CDM,,,270,RC,outpatient,,1088.73,1088.73,,924.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,272.18,22,,percent of total billed charges,,,,,,,,,979.86,90,,percent of total billed charges,,,901.47,82.8,,percent of total billed charges,,,925.42,85,,percent of total billed charges,,,,,,,,,958.08,88,,percent of total billed charges,,,,,,,,,831.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,272.18,22,,percent of total billed charges,,,990.74,91,,percent of total billed charges,,,1034.29,95,,percent of total billed charges,,,903.65,83,,percent of total billed charges,,,903.65,83,,percent of total billed charges,,,,,,,,,,,,,,,903.65,83,,percent of total billed charges,,,1034.29,95,,percent of total billed charges,,,979.86,90,,percent of total billed charges,,,979.86,90,,percent of total billed charges,,,892.76,82,,percent of total billed charges,,,979.86,90,,percent of total billed charges,,,925.42,85,,percent of total billed charges,,272.18,1034.29,
ROSIDAL K 10X5CM,30340014,CDM,,,270,RC,outpatient,,63.54,63.54,,53.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.89,22,,percent of total billed charges,,,,,,,,,57.19,90,,percent of total billed charges,,,52.61,82.8,,percent of total billed charges,,,54.01,85,,percent of total billed charges,,,,,,,,,55.92,88,,percent of total billed charges,,,,,,,,,48.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.89,22,,percent of total billed charges,,,57.82,91,,percent of total billed charges,,,60.36,95,,percent of total billed charges,,,52.74,83,,percent of total billed charges,,,52.74,83,,percent of total billed charges,,,,,,,,,,,,,,,52.74,83,,percent of total billed charges,,,60.36,95,,percent of total billed charges,,,57.19,90,,percent of total billed charges,,,57.19,90,,percent of total billed charges,,,52.1,82,,percent of total billed charges,,,57.19,90,,percent of total billed charges,,,54.01,85,,percent of total billed charges,,15.89,60.36,
ROSIDAL K 12X5CM,30340015,CDM,,,270,RC,outpatient,,77.99,77.99,,66.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.5,22,,percent of total billed charges,,,,,,,,,70.19,90,,percent of total billed charges,,,64.58,82.8,,percent of total billed charges,,,66.29,85,,percent of total billed charges,,,,,,,,,68.63,88,,percent of total billed charges,,,,,,,,,59.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.5,22,,percent of total billed charges,,,70.97,91,,percent of total billed charges,,,74.09,95,,percent of total billed charges,,,64.73,83,,percent of total billed charges,,,64.73,83,,percent of total billed charges,,,,,,,,,,,,,,,64.73,83,,percent of total billed charges,,,74.09,95,,percent of total billed charges,,,70.19,90,,percent of total billed charges,,,70.19,90,,percent of total billed charges,,,63.95,82,,percent of total billed charges,,,70.19,90,,percent of total billed charges,,,66.29,85,,percent of total billed charges,,19.5,74.09,
MOLLEAST WRAP 6X4CM,30340016,CDM,,,270,RC,outpatient,,3.83,3.83,,3.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.96,22,,percent of total billed charges,,,,,,,,,3.45,90,,percent of total billed charges,,,3.17,82.8,,percent of total billed charges,,,3.26,85,,percent of total billed charges,,,,,,,,,3.37,88,,percent of total billed charges,,,,,,,,,2.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.96,22,,percent of total billed charges,,,3.49,91,,percent of total billed charges,,,3.64,95,,percent of total billed charges,,,3.18,83,,percent of total billed charges,,,3.18,83,,percent of total billed charges,,,,,,,,,,,,,,,3.18,83,,percent of total billed charges,,,3.64,95,,percent of total billed charges,,,3.45,90,,percent of total billed charges,,,3.45,90,,percent of total billed charges,,,3.14,82,,percent of total billed charges,,,3.45,90,,percent of total billed charges,,,3.26,85,,percent of total billed charges,,0.96,3.64,
GRAY FOAM 1/2  3X6,30340017,CDM,,,270,RC,outpatient,,167.2,167.2,,141.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.8,22,,percent of total billed charges,,,,,,,,,150.48,90,,percent of total billed charges,,,138.44,82.8,,percent of total billed charges,,,142.12,85,,percent of total billed charges,,,,,,,,,147.14,88,,percent of total billed charges,,,,,,,,,127.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.8,22,,percent of total billed charges,,,152.15,91,,percent of total billed charges,,,158.84,95,,percent of total billed charges,,,138.78,83,,percent of total billed charges,,,138.78,83,,percent of total billed charges,,,,,,,,,,,,,,,138.78,83,,percent of total billed charges,,,158.84,95,,percent of total billed charges,,,150.48,90,,percent of total billed charges,,,150.48,90,,percent of total billed charges,,,137.1,82,,percent of total billed charges,,,150.48,90,,percent of total billed charges,,,142.12,85,,percent of total billed charges,,41.8,158.84,
GRAY FOAM 1  3X6,30340018,CDM,,,270,RC,outpatient,,271.38,271.38,,230.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.85,22,,percent of total billed charges,,,,,,,,,244.24,90,,percent of total billed charges,,,224.7,82.8,,percent of total billed charges,,,230.67,85,,percent of total billed charges,,,,,,,,,238.81,88,,percent of total billed charges,,,,,,,,,207.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.85,22,,percent of total billed charges,,,246.96,91,,percent of total billed charges,,,257.81,95,,percent of total billed charges,,,225.25,83,,percent of total billed charges,,,225.25,83,,percent of total billed charges,,,,,,,,,,,,,,,225.25,83,,percent of total billed charges,,,257.81,95,,percent of total billed charges,,,244.24,90,,percent of total billed charges,,,244.24,90,,percent of total billed charges,,,222.53,82,,percent of total billed charges,,,244.24,90,,percent of total billed charges,,,230.67,85,,percent of total billed charges,,67.85,257.81,
ROSIDAL K 6X5CM,30340020,CDM,,,270,RC,outpatient,,44.78,44.78,,38.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.2,22,,percent of total billed charges,,,,,,,,,40.3,90,,percent of total billed charges,,,37.08,82.8,,percent of total billed charges,,,38.06,85,,percent of total billed charges,,,,,,,,,39.41,88,,percent of total billed charges,,,,,,,,,34.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.2,22,,percent of total billed charges,,,40.75,91,,percent of total billed charges,,,42.54,95,,percent of total billed charges,,,37.17,83,,percent of total billed charges,,,37.17,83,,percent of total billed charges,,,,,,,,,,,,,,,37.17,83,,percent of total billed charges,,,42.54,95,,percent of total billed charges,,,40.3,90,,percent of total billed charges,,,40.3,90,,percent of total billed charges,,,36.72,82,,percent of total billed charges,,,40.3,90,,percent of total billed charges,,,38.06,85,,percent of total billed charges,,11.2,42.54,
ROSIDAL K 8X5CM,30340021,CDM,,,270,RC,outpatient,,56.31,56.31,,47.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.08,22,,percent of total billed charges,,,,,,,,,50.68,90,,percent of total billed charges,,,46.62,82.8,,percent of total billed charges,,,47.86,85,,percent of total billed charges,,,,,,,,,49.55,88,,percent of total billed charges,,,,,,,,,43.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.08,22,,percent of total billed charges,,,51.24,91,,percent of total billed charges,,,53.49,95,,percent of total billed charges,,,46.74,83,,percent of total billed charges,,,46.74,83,,percent of total billed charges,,,,,,,,,,,,,,,46.74,83,,percent of total billed charges,,,53.49,95,,percent of total billed charges,,,50.68,90,,percent of total billed charges,,,50.68,90,,percent of total billed charges,,,46.17,82,,percent of total billed charges,,,50.68,90,,percent of total billed charges,,,47.86,85,,percent of total billed charges,,14.08,53.49,
ISOBAND 15 X 5CM,30340022,CDM,,,270,RC,outpatient,,103.6,103.6,,87.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.9,22,,percent of total billed charges,,,,,,,,,93.24,90,,percent of total billed charges,,,85.78,82.8,,percent of total billed charges,,,88.06,85,,percent of total billed charges,,,,,,,,,91.17,88,,percent of total billed charges,,,,,,,,,79.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.9,22,,percent of total billed charges,,,94.28,91,,percent of total billed charges,,,98.42,95,,percent of total billed charges,,,85.99,83,,percent of total billed charges,,,85.99,83,,percent of total billed charges,,,,,,,,,,,,,,,85.99,83,,percent of total billed charges,,,98.42,95,,percent of total billed charges,,,93.24,90,,percent of total billed charges,,,93.24,90,,percent of total billed charges,,,84.95,82,,percent of total billed charges,,,93.24,90,,percent of total billed charges,,,88.06,85,,percent of total billed charges,,25.9,98.42,
TRANSELAST CLASSIC 6 X 4CM,30340023,CDM,,,270,RC,outpatient,,5.4,5.4,,4.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.35,22,,percent of total billed charges,,,,,,,,,4.86,90,,percent of total billed charges,,,4.47,82.8,,percent of total billed charges,,,4.59,85,,percent of total billed charges,,,,,,,,,4.75,88,,percent of total billed charges,,,,,,,,,4.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.35,22,,percent of total billed charges,,,4.91,91,,percent of total billed charges,,,5.13,95,,percent of total billed charges,,,4.48,83,,percent of total billed charges,,,4.48,83,,percent of total billed charges,,,,,,,,,,,,,,,4.48,83,,percent of total billed charges,,,5.13,95,,percent of total billed charges,,,4.86,90,,percent of total billed charges,,,4.86,90,,percent of total billed charges,,,4.43,82,,percent of total billed charges,,,4.86,90,,percent of total billed charges,,,4.59,85,,percent of total billed charges,,1.35,5.13,
ARTIFLEX 10 X 3CM,30340024,CDM,,,270,RC,outpatient,,29.25,29.25,,24.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.31,22,,percent of total billed charges,,,,,,,,,26.33,90,,percent of total billed charges,,,24.22,82.8,,percent of total billed charges,,,24.86,85,,percent of total billed charges,,,,,,,,,25.74,88,,percent of total billed charges,,,,,,,,,22.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.31,22,,percent of total billed charges,,,26.62,91,,percent of total billed charges,,,27.79,95,,percent of total billed charges,,,24.28,83,,percent of total billed charges,,,24.28,83,,percent of total billed charges,,,,,,,,,,,,,,,24.28,83,,percent of total billed charges,,,27.79,95,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,23.99,82,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,24.86,85,,percent of total billed charges,,7.31,27.79,
ARTIFLEX 15 X 3CM,30340025,CDM,,,270,RC,outpatient,,40.5,40.5,,34.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.13,22,,percent of total billed charges,,,,,,,,,36.45,90,,percent of total billed charges,,,33.53,82.8,,percent of total billed charges,,,34.43,85,,percent of total billed charges,,,,,,,,,35.64,88,,percent of total billed charges,,,,,,,,,30.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.13,22,,percent of total billed charges,,,36.86,91,,percent of total billed charges,,,38.48,95,,percent of total billed charges,,,33.62,83,,percent of total billed charges,,,33.62,83,,percent of total billed charges,,,,,,,,,,,,,,,33.62,83,,percent of total billed charges,,,38.48,95,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,33.21,82,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,34.43,85,,percent of total billed charges,,10.13,38.48,
*BRACE FOOTDROP 670 RIGHT LARGE,30340028,CDM,,,270,RC,outpatient,,428.05,428.05,,363.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.01,22,,percent of total billed charges,,,,,,,,,385.25,90,,percent of total billed charges,,,354.43,82.8,,percent of total billed charges,,,363.84,85,,percent of total billed charges,,,,,,,,,376.68,88,,percent of total billed charges,,,,,,,,,327.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.01,22,,percent of total billed charges,,,389.53,91,,percent of total billed charges,,,406.65,95,,percent of total billed charges,,,355.28,83,,percent of total billed charges,,,355.28,83,,percent of total billed charges,,,,,,,,,,,,,,,355.28,83,,percent of total billed charges,,,406.65,95,,percent of total billed charges,,,385.25,90,,percent of total billed charges,,,385.25,90,,percent of total billed charges,,,351,82,,percent of total billed charges,,,385.25,90,,percent of total billed charges,,,363.84,85,,percent of total billed charges,,107.01,406.65,
LUMBAR ROLL ORIGINAL MAKENZIE,30340029,CDM,,,270,RC,outpatient,,198.75,198.75,,168.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.69,22,,percent of total billed charges,,,,,,,,,178.88,90,,percent of total billed charges,,,164.57,82.8,,percent of total billed charges,,,168.94,85,,percent of total billed charges,,,,,,,,,174.9,88,,percent of total billed charges,,,,,,,,,151.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.69,22,,percent of total billed charges,,,180.86,91,,percent of total billed charges,,,188.81,95,,percent of total billed charges,,,164.96,83,,percent of total billed charges,,,164.96,83,,percent of total billed charges,,,,,,,,,,,,,,,164.96,83,,percent of total billed charges,,,188.81,95,,percent of total billed charges,,,178.88,90,,percent of total billed charges,,,178.88,90,,percent of total billed charges,,,162.98,82,,percent of total billed charges,,,178.88,90,,percent of total billed charges,,,168.94,85,,percent of total billed charges,,49.69,188.81,
STATLOCK PICC PLUS VAR. WINGED CATHETER,30450004,CDM,,,270,RC,outpatient,,69.85,69.85,,59.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.46,22,,percent of total billed charges,,,,,,,,,62.87,90,,percent of total billed charges,,,57.84,82.8,,percent of total billed charges,,,59.37,85,,percent of total billed charges,,,,,,,,,61.47,88,,percent of total billed charges,,,,,,,,,53.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.46,22,,percent of total billed charges,,,63.56,91,,percent of total billed charges,,,66.36,95,,percent of total billed charges,,,57.98,83,,percent of total billed charges,,,57.98,83,,percent of total billed charges,,,,,,,,,,,,,,,57.98,83,,percent of total billed charges,,,66.36,95,,percent of total billed charges,,,62.87,90,,percent of total billed charges,,,62.87,90,,percent of total billed charges,,,57.28,82,,percent of total billed charges,,,62.87,90,,percent of total billed charges,,,59.37,85,,percent of total billed charges,,17.46,66.36,
NEEDLE EMG CONCENTRIC 26G X 1.5 GREEN,30450011,CDM,,,270,RC,outpatient,,57.46,57.46,,48.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.37,22,,percent of total billed charges,,,,,,,,,51.71,90,,percent of total billed charges,,,47.58,82.8,,percent of total billed charges,,,48.84,85,,percent of total billed charges,,,,,,,,,50.56,88,,percent of total billed charges,,,,,,,,,43.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.37,22,,percent of total billed charges,,,52.29,91,,percent of total billed charges,,,54.59,95,,percent of total billed charges,,,47.69,83,,percent of total billed charges,,,47.69,83,,percent of total billed charges,,,,,,,,,,,,,,,47.69,83,,percent of total billed charges,,,54.59,95,,percent of total billed charges,,,51.71,90,,percent of total billed charges,,,51.71,90,,percent of total billed charges,,,47.12,82,,percent of total billed charges,,,51.71,90,,percent of total billed charges,,,48.84,85,,percent of total billed charges,,14.37,54.59,
NEEDLE EMG CONCENTRIC 26G X 2.0 BLUE,30450012,CDM,,,270,RC,outpatient,,57.46,57.46,,48.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.37,22,,percent of total billed charges,,,,,,,,,51.71,90,,percent of total billed charges,,,47.58,82.8,,percent of total billed charges,,,48.84,85,,percent of total billed charges,,,,,,,,,50.56,88,,percent of total billed charges,,,,,,,,,43.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.37,22,,percent of total billed charges,,,52.29,91,,percent of total billed charges,,,54.59,95,,percent of total billed charges,,,47.69,83,,percent of total billed charges,,,47.69,83,,percent of total billed charges,,,,,,,,,,,,,,,47.69,83,,percent of total billed charges,,,54.59,95,,percent of total billed charges,,,51.71,90,,percent of total billed charges,,,51.71,90,,percent of total billed charges,,,47.12,82,,percent of total billed charges,,,51.71,90,,percent of total billed charges,,,48.84,85,,percent of total billed charges,,14.37,54.59,
P.O.S. HIP ADJ BRACE 0-60,30480017,CDM,,,270,RC,outpatient,,6697.15,6697.15,,5685.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1674.29,22,,percent of total billed charges,,,,,,,,,6027.44,90,,percent of total billed charges,,,5545.24,82.8,,percent of total billed charges,,,5692.58,85,,percent of total billed charges,,,,,,,,,5893.49,88,,percent of total billed charges,,,,,,,,,5116.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1674.29,22,,percent of total billed charges,,,6094.41,91,,percent of total billed charges,,,6362.29,95,,percent of total billed charges,,,5558.63,83,,percent of total billed charges,,,5558.63,83,,percent of total billed charges,,,,,,,,,,,,,,,5558.63,83,,percent of total billed charges,,,6362.29,95,,percent of total billed charges,,,6027.44,90,,percent of total billed charges,,,6027.44,90,,percent of total billed charges,,,5491.66,82,,percent of total billed charges,,,6027.44,90,,percent of total billed charges,,,5692.58,85,,percent of total billed charges,,1674.29,6362.29,
BOOT WALKING MEDIUM,30650009,CDM,,,270,RC,outpatient,,364,364,,309.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91,22,,percent of total billed charges,,,,,,,,,327.6,90,,percent of total billed charges,,,301.39,82.8,,percent of total billed charges,,,309.4,85,,percent of total billed charges,,,,,,,,,320.32,88,,percent of total billed charges,,,,,,,,,278.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91,22,,percent of total billed charges,,,331.24,91,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,,,,,,,,,,,,,302.12,83,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,298.48,82,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,309.4,85,,percent of total billed charges,,91,345.8,
DRESSING PROMOGRAN 4.34 SQ. IN,30810006,CDM,,,270,RC,outpatient,,63.16,63.16,,53.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.79,22,,percent of total billed charges,,,,,,,,,56.84,90,,percent of total billed charges,,,52.3,82.8,,percent of total billed charges,,,53.69,85,,percent of total billed charges,,,,,,,,,55.58,88,,percent of total billed charges,,,,,,,,,48.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.79,22,,percent of total billed charges,,,57.48,91,,percent of total billed charges,,,60,95,,percent of total billed charges,,,52.42,83,,percent of total billed charges,,,52.42,83,,percent of total billed charges,,,,,,,,,,,,,,,52.42,83,,percent of total billed charges,,,60,95,,percent of total billed charges,,,56.84,90,,percent of total billed charges,,,56.84,90,,percent of total billed charges,,,51.79,82,,percent of total billed charges,,,56.84,90,,percent of total billed charges,,,53.69,85,,percent of total billed charges,,15.79,60,
*DRESSING AQUACEL HYDROFIBER 6X6,30810010,CDM,,,270,RC,outpatient,,68.68,68.68,,58.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.17,22,,percent of total billed charges,,,,,,,,,61.81,90,,percent of total billed charges,,,56.87,82.8,,percent of total billed charges,,,58.38,85,,percent of total billed charges,,,,,,,,,60.44,88,,percent of total billed charges,,,,,,,,,52.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.17,22,,percent of total billed charges,,,62.5,91,,percent of total billed charges,,,65.25,95,,percent of total billed charges,,,57,83,,percent of total billed charges,,,57,83,,percent of total billed charges,,,,,,,,,,,,,,,57,83,,percent of total billed charges,,,65.25,95,,percent of total billed charges,,,61.81,90,,percent of total billed charges,,,61.81,90,,percent of total billed charges,,,56.32,82,,percent of total billed charges,,,61.81,90,,percent of total billed charges,,,58.38,85,,percent of total billed charges,,17.17,65.25,
*KCI GRANUFOAM SILVER LGE M8275099,30810012,CDM,,,270,RC,outpatient,,599.2,599.2,,508.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149.8,22,,percent of total billed charges,,,,,,,,,539.28,90,,percent of total billed charges,,,496.14,82.8,,percent of total billed charges,,,509.32,85,,percent of total billed charges,,,,,,,,,527.3,88,,percent of total billed charges,,,,,,,,,457.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149.8,22,,percent of total billed charges,,,545.27,91,,percent of total billed charges,,,569.24,95,,percent of total billed charges,,,497.34,83,,percent of total billed charges,,,497.34,83,,percent of total billed charges,,,,,,,,,,,,,,,497.34,83,,percent of total billed charges,,,569.24,95,,percent of total billed charges,,,539.28,90,,percent of total billed charges,,,539.28,90,,percent of total billed charges,,,491.34,82,,percent of total billed charges,,,539.28,90,,percent of total billed charges,,,509.32,85,,percent of total billed charges,,149.8,569.24,
*DRESSING APLIGRAF,30810013,CDM,Q4101,HCPCS,270,RC,outpatient,,11076,11076,,9403.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2769,22,,percent of total billed charges,,,,,,,,,9968.4,90,,percent of total billed charges,,,9170.93,82.8,,percent of total billed charges,,,9414.6,85,,percent of total billed charges,,,,,,,,,9746.88,88,,percent of total billed charges,,,,,,,,,8462.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2769,22,,percent of total billed charges,,,10079.16,91,,percent of total billed charges,,,10522.2,95,,percent of total billed charges,,,9193.08,83,,percent of total billed charges,,,9193.08,83,,percent of total billed charges,,,,,,,,,,,,,,,9193.08,83,,percent of total billed charges,,,10522.2,95,,percent of total billed charges,,,9968.4,90,,percent of total billed charges,,,9968.4,90,,percent of total billed charges,,,9082.32,82,,percent of total billed charges,,,9968.4,90,,percent of total billed charges,,,9414.6,85,,percent of total billed charges,,2769,10522.2,
V.A.C. GRANUFOAM DRESSING LG,30810017,CDM,,,270,RC,outpatient,,394.32,394.32,,334.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.58,22,,percent of total billed charges,,,,,,,,,354.89,90,,percent of total billed charges,,,326.5,82.8,,percent of total billed charges,,,335.17,85,,percent of total billed charges,,,,,,,,,347,88,,percent of total billed charges,,,,,,,,,301.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.58,22,,percent of total billed charges,,,358.83,91,,percent of total billed charges,,,374.6,95,,percent of total billed charges,,,327.29,83,,percent of total billed charges,,,327.29,83,,percent of total billed charges,,,,,,,,,,,,,,,327.29,83,,percent of total billed charges,,,374.6,95,,percent of total billed charges,,,354.89,90,,percent of total billed charges,,,354.89,90,,percent of total billed charges,,,323.34,82,,percent of total billed charges,,,354.89,90,,percent of total billed charges,,,335.17,85,,percent of total billed charges,,98.58,374.6,
*PAD CADEXOMER IODINE GEL,30810018,CDM,,,270,RC,outpatient,,41.67,41.67,,35.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.42,22,,percent of total billed charges,,,,,,,,,37.5,90,,percent of total billed charges,,,34.5,82.8,,percent of total billed charges,,,35.42,85,,percent of total billed charges,,,,,,,,,36.67,88,,percent of total billed charges,,,,,,,,,31.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.42,22,,percent of total billed charges,,,37.92,91,,percent of total billed charges,,,39.59,95,,percent of total billed charges,,,34.59,83,,percent of total billed charges,,,34.59,83,,percent of total billed charges,,,,,,,,,,,,,,,34.59,83,,percent of total billed charges,,,39.59,95,,percent of total billed charges,,,37.5,90,,percent of total billed charges,,,37.5,90,,percent of total billed charges,,,34.17,82,,percent of total billed charges,,,37.5,90,,percent of total billed charges,,,35.42,85,,percent of total billed charges,,10.42,39.59,
*DRESSING AQUACEL AG HYDROGIBER RIBBON,30810019,CDM,,,270,RC,outpatient,,84.88,84.88,,72.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.22,22,,percent of total billed charges,,,,,,,,,76.39,90,,percent of total billed charges,,,70.28,82.8,,percent of total billed charges,,,72.15,85,,percent of total billed charges,,,,,,,,,74.69,88,,percent of total billed charges,,,,,,,,,64.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.22,22,,percent of total billed charges,,,77.24,91,,percent of total billed charges,,,80.64,95,,percent of total billed charges,,,70.45,83,,percent of total billed charges,,,70.45,83,,percent of total billed charges,,,,,,,,,,,,,,,70.45,83,,percent of total billed charges,,,80.64,95,,percent of total billed charges,,,76.39,90,,percent of total billed charges,,,76.39,90,,percent of total billed charges,,,69.6,82,,percent of total billed charges,,,76.39,90,,percent of total billed charges,,,72.15,85,,percent of total billed charges,,21.22,80.64,
*KCI VACUM DRAPE 30.5 X 26CM,30810020,CDM,,,270,RC,outpatient,,62.39,62.39,,52.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.6,22,,percent of total billed charges,,,,,,,,,56.15,90,,percent of total billed charges,,,51.66,82.8,,percent of total billed charges,,,53.03,85,,percent of total billed charges,,,,,,,,,54.9,88,,percent of total billed charges,,,,,,,,,47.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.6,22,,percent of total billed charges,,,56.77,91,,percent of total billed charges,,,59.27,95,,percent of total billed charges,,,51.78,83,,percent of total billed charges,,,51.78,83,,percent of total billed charges,,,,,,,,,,,,,,,51.78,83,,percent of total billed charges,,,59.27,95,,percent of total billed charges,,,56.15,90,,percent of total billed charges,,,56.15,90,,percent of total billed charges,,,51.16,82,,percent of total billed charges,,,56.15,90,,percent of total billed charges,,,53.03,85,,percent of total billed charges,,15.6,59.27,
*DRESSING AQUACEL-AG 3/4 x18,30810021,CDM,,,270,RC,outpatient,,92.08,92.08,,78.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.02,22,,percent of total billed charges,,,,,,,,,82.87,90,,percent of total billed charges,,,76.24,82.8,,percent of total billed charges,,,78.27,85,,percent of total billed charges,,,,,,,,,81.03,88,,percent of total billed charges,,,,,,,,,70.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.02,22,,percent of total billed charges,,,83.79,91,,percent of total billed charges,,,87.48,95,,percent of total billed charges,,,76.43,83,,percent of total billed charges,,,76.43,83,,percent of total billed charges,,,,,,,,,,,,,,,76.43,83,,percent of total billed charges,,,87.48,95,,percent of total billed charges,,,82.87,90,,percent of total billed charges,,,82.87,90,,percent of total billed charges,,,75.51,82,,percent of total billed charges,,,82.87,90,,percent of total billed charges,,,78.27,85,,percent of total billed charges,,23.02,87.48,
*DRESSING AQUACEL AG W/IONIC SILVER,30810022,CDM,,,270,RC,outpatient,,75.31,75.31,,63.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.83,22,,percent of total billed charges,,,,,,,,,67.78,90,,percent of total billed charges,,,62.36,82.8,,percent of total billed charges,,,64.01,85,,percent of total billed charges,,,,,,,,,66.27,88,,percent of total billed charges,,,,,,,,,57.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.83,22,,percent of total billed charges,,,68.53,91,,percent of total billed charges,,,71.54,95,,percent of total billed charges,,,62.51,83,,percent of total billed charges,,,62.51,83,,percent of total billed charges,,,,,,,,,,,,,,,62.51,83,,percent of total billed charges,,,71.54,95,,percent of total billed charges,,,67.78,90,,percent of total billed charges,,,67.78,90,,percent of total billed charges,,,61.75,82,,percent of total billed charges,,,67.78,90,,percent of total billed charges,,,64.01,85,,percent of total billed charges,,18.83,71.54,
*KCI VERSAFOAM 10X15 M8275067,30810023,CDM,,,270,RC,outpatient,,407.89,407.89,,346.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.97,22,,percent of total billed charges,,,,,,,,,367.1,90,,percent of total billed charges,,,337.73,82.8,,percent of total billed charges,,,346.71,85,,percent of total billed charges,,,,,,,,,358.94,88,,percent of total billed charges,,,,,,,,,311.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.97,22,,percent of total billed charges,,,371.18,91,,percent of total billed charges,,,387.5,95,,percent of total billed charges,,,338.55,83,,percent of total billed charges,,,338.55,83,,percent of total billed charges,,,,,,,,,,,,,,,338.55,83,,percent of total billed charges,,,387.5,95,,percent of total billed charges,,,367.1,90,,percent of total billed charges,,,367.1,90,,percent of total billed charges,,,334.47,82,,percent of total billed charges,,,367.1,90,,percent of total billed charges,,,346.71,85,,percent of total billed charges,,101.97,387.5,
*DRESSING MAXORB EXTRA 4X4,30810024,CDM,,,270,RC,outpatient,,47.94,47.94,,40.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.99,22,,percent of total billed charges,,,,,,,,,43.15,90,,percent of total billed charges,,,39.69,82.8,,percent of total billed charges,,,40.75,85,,percent of total billed charges,,,,,,,,,42.19,88,,percent of total billed charges,,,,,,,,,36.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.99,22,,percent of total billed charges,,,43.63,91,,percent of total billed charges,,,45.54,95,,percent of total billed charges,,,39.79,83,,percent of total billed charges,,,39.79,83,,percent of total billed charges,,,,,,,,,,,,,,,39.79,83,,percent of total billed charges,,,45.54,95,,percent of total billed charges,,,43.15,90,,percent of total billed charges,,,43.15,90,,percent of total billed charges,,,39.31,82,,percent of total billed charges,,,43.15,90,,percent of total billed charges,,,40.75,85,,percent of total billed charges,,11.99,45.54,
DRESSING COMPRESSION 4-LAYER,30810026,CDM,,,270,RC,outpatient,,81.08,81.08,,68.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.27,22,,percent of total billed charges,,,,,,,,,72.97,90,,percent of total billed charges,,,67.13,82.8,,percent of total billed charges,,,68.92,85,,percent of total billed charges,,,,,,,,,71.35,88,,percent of total billed charges,,,,,,,,,61.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.27,22,,percent of total billed charges,,,73.78,91,,percent of total billed charges,,,77.03,95,,percent of total billed charges,,,67.3,83,,percent of total billed charges,,,67.3,83,,percent of total billed charges,,,,,,,,,,,,,,,67.3,83,,percent of total billed charges,,,77.03,95,,percent of total billed charges,,,72.97,90,,percent of total billed charges,,,72.97,90,,percent of total billed charges,,,66.49,82,,percent of total billed charges,,,72.97,90,,percent of total billed charges,,,68.92,85,,percent of total billed charges,,20.27,77.03,
 * HYDROGEL SKINTEGRITY 4OZ,30810027,CDM,,,270,RC,outpatient,,47.86,47.86,,40.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.97,22,,percent of total billed charges,,,,,,,,,43.07,90,,percent of total billed charges,,,39.63,82.8,,percent of total billed charges,,,40.68,85,,percent of total billed charges,,,,,,,,,42.12,88,,percent of total billed charges,,,,,,,,,36.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.97,22,,percent of total billed charges,,,43.55,91,,percent of total billed charges,,,45.47,95,,percent of total billed charges,,,39.72,83,,percent of total billed charges,,,39.72,83,,percent of total billed charges,,,,,,,,,,,,,,,39.72,83,,percent of total billed charges,,,45.47,95,,percent of total billed charges,,,43.07,90,,percent of total billed charges,,,43.07,90,,percent of total billed charges,,,39.25,82,,percent of total billed charges,,,43.07,90,,percent of total billed charges,,,40.68,85,,percent of total billed charges,,11.97,45.47,
*DRESSING AQUACEL HYDROFIBER 4 X 4,30810029,CDM,,,270,RC,outpatient,,28.53,28.53,,24.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.13,22,,percent of total billed charges,,,,,,,,,25.68,90,,percent of total billed charges,,,23.62,82.8,,percent of total billed charges,,,24.25,85,,percent of total billed charges,,,,,,,,,25.11,88,,percent of total billed charges,,,,,,,,,21.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.13,22,,percent of total billed charges,,,25.96,91,,percent of total billed charges,,,27.1,95,,percent of total billed charges,,,23.68,83,,percent of total billed charges,,,23.68,83,,percent of total billed charges,,,,,,,,,,,,,,,23.68,83,,percent of total billed charges,,,27.1,95,,percent of total billed charges,,,25.68,90,,percent of total billed charges,,,25.68,90,,percent of total billed charges,,,23.39,82,,percent of total billed charges,,,25.68,90,,percent of total billed charges,,,24.25,85,,percent of total billed charges,,7.13,27.1,
DRESSING PROMOGRAN PRISMA 4.34SQ IN,30810030,CDM,,,270,RC,outpatient,,75.99,75.99,,64.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19,22,,percent of total billed charges,,,,,,,,,68.39,90,,percent of total billed charges,,,62.92,82.8,,percent of total billed charges,,,64.59,85,,percent of total billed charges,,,,,,,,,66.87,88,,percent of total billed charges,,,,,,,,,58.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19,22,,percent of total billed charges,,,69.15,91,,percent of total billed charges,,,72.19,95,,percent of total billed charges,,,63.07,83,,percent of total billed charges,,,63.07,83,,percent of total billed charges,,,,,,,,,,,,,,,63.07,83,,percent of total billed charges,,,72.19,95,,percent of total billed charges,,,68.39,90,,percent of total billed charges,,,68.39,90,,percent of total billed charges,,,62.31,82,,percent of total billed charges,,,68.39,90,,percent of total billed charges,,,64.59,85,,percent of total billed charges,,19,72.19,
*KCI GRANUFOAM BRIDGE M8275042,30810031,CDM,,,270,RC,outpatient,,375.34,375.34,,318.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.84,22,,percent of total billed charges,,,,,,,,,337.81,90,,percent of total billed charges,,,310.78,82.8,,percent of total billed charges,,,319.04,85,,percent of total billed charges,,,,,,,,,330.3,88,,percent of total billed charges,,,,,,,,,286.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.84,22,,percent of total billed charges,,,341.56,91,,percent of total billed charges,,,356.57,95,,percent of total billed charges,,,311.53,83,,percent of total billed charges,,,311.53,83,,percent of total billed charges,,,,,,,,,,,,,,,311.53,83,,percent of total billed charges,,,356.57,95,,percent of total billed charges,,,337.81,90,,percent of total billed charges,,,337.81,90,,percent of total billed charges,,,307.78,82,,percent of total billed charges,,,337.81,90,,percent of total billed charges,,,319.04,85,,percent of total billed charges,,93.84,356.57,
*DRESSING IODOFLEX CADEXOMER IODINE GEL,30810032,CDM,,,270,RC,outpatient,,78.46,78.46,,66.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.62,22,,percent of total billed charges,,,,,,,,,70.61,90,,percent of total billed charges,,,64.96,82.8,,percent of total billed charges,,,66.69,85,,percent of total billed charges,,,,,,,,,69.04,88,,percent of total billed charges,,,,,,,,,59.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.62,22,,percent of total billed charges,,,71.4,91,,percent of total billed charges,,,74.54,95,,percent of total billed charges,,,65.12,83,,percent of total billed charges,,,65.12,83,,percent of total billed charges,,,,,,,,,,,,,,,65.12,83,,percent of total billed charges,,,74.54,95,,percent of total billed charges,,,70.61,90,,percent of total billed charges,,,70.61,90,,percent of total billed charges,,,64.34,82,,percent of total billed charges,,,70.61,90,,percent of total billed charges,,,66.69,85,,percent of total billed charges,,19.62,74.54,
*DRESSING STRATASORB 4 X 4,30810037,CDM,,,270,RC,outpatient,,9.03,9.03,,7.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.26,22,,percent of total billed charges,,,,,,,,,8.13,90,,percent of total billed charges,,,7.48,82.8,,percent of total billed charges,,,7.68,85,,percent of total billed charges,,,,,,,,,7.95,88,,percent of total billed charges,,,,,,,,,6.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.26,22,,percent of total billed charges,,,8.22,91,,percent of total billed charges,,,8.58,95,,percent of total billed charges,,,7.49,83,,percent of total billed charges,,,7.49,83,,percent of total billed charges,,,,,,,,,,,,,,,7.49,83,,percent of total billed charges,,,8.58,95,,percent of total billed charges,,,8.13,90,,percent of total billed charges,,,8.13,90,,percent of total billed charges,,,7.4,82,,percent of total billed charges,,,8.13,90,,percent of total billed charges,,,7.68,85,,percent of total billed charges,,2.26,8.58,
DRESSING OPTIFOAM 4 X 4,30810038,CDM,,,270,RC,outpatient,,21.96,21.96,,18.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.49,22,,percent of total billed charges,,,,,,,,,19.76,90,,percent of total billed charges,,,18.18,82.8,,percent of total billed charges,,,18.67,85,,percent of total billed charges,,,,,,,,,19.32,88,,percent of total billed charges,,,,,,,,,16.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.49,22,,percent of total billed charges,,,19.98,91,,percent of total billed charges,,,20.86,95,,percent of total billed charges,,,18.23,83,,percent of total billed charges,,,18.23,83,,percent of total billed charges,,,,,,,,,,,,,,,18.23,83,,percent of total billed charges,,,20.86,95,,percent of total billed charges,,,19.76,90,,percent of total billed charges,,,19.76,90,,percent of total billed charges,,,18.01,82,,percent of total billed charges,,,19.76,90,,percent of total billed charges,,,18.67,85,,percent of total billed charges,,5.49,20.86,
GAUZE BORDER 4 X 4,30810039,CDM,,,270,RC,outpatient,,4.82,4.82,,4.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.21,22,,percent of total billed charges,,,,,,,,,4.34,90,,percent of total billed charges,,,3.99,82.8,,percent of total billed charges,,,4.1,85,,percent of total billed charges,,,,,,,,,4.24,88,,percent of total billed charges,,,,,,,,,3.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.21,22,,percent of total billed charges,,,4.39,91,,percent of total billed charges,,,4.58,95,,percent of total billed charges,,,4,83,,percent of total billed charges,,,4,83,,percent of total billed charges,,,,,,,,,,,,,,,4,83,,percent of total billed charges,,,4.58,95,,percent of total billed charges,,,4.34,90,,percent of total billed charges,,,4.34,90,,percent of total billed charges,,,3.95,82,,percent of total billed charges,,,4.34,90,,percent of total billed charges,,,4.1,85,,percent of total billed charges,,1.21,4.58,
GAUZE BORDER 6 X 6,30810040,CDM,,,270,RC,outpatient,,7.07,7.07,,6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.77,22,,percent of total billed charges,,,,,,,,,6.36,90,,percent of total billed charges,,,5.85,82.8,,percent of total billed charges,,,6.01,85,,percent of total billed charges,,,,,,,,,6.22,88,,percent of total billed charges,,,,,,,,,5.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.77,22,,percent of total billed charges,,,6.43,91,,percent of total billed charges,,,6.72,95,,percent of total billed charges,,,5.87,83,,percent of total billed charges,,,5.87,83,,percent of total billed charges,,,,,,,,,,,,,,,5.87,83,,percent of total billed charges,,,6.72,95,,percent of total billed charges,,,6.36,90,,percent of total billed charges,,,6.36,90,,percent of total billed charges,,,5.8,82,,percent of total billed charges,,,6.36,90,,percent of total billed charges,,,6.01,85,,percent of total billed charges,,1.77,6.72,
CASTING SYSTEM 3  NO BOOT,30810041,CDM,,,270,RC,outpatient,,856.46,856.46,,727.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214.12,22,,percent of total billed charges,,,,,,,,,770.81,90,,percent of total billed charges,,,709.15,82.8,,percent of total billed charges,,,727.99,85,,percent of total billed charges,,,,,,,,,753.68,88,,percent of total billed charges,,,,,,,,,654.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214.12,22,,percent of total billed charges,,,779.38,91,,percent of total billed charges,,,813.64,95,,percent of total billed charges,,,710.86,83,,percent of total billed charges,,,710.86,83,,percent of total billed charges,,,,,,,,,,,,,,,710.86,83,,percent of total billed charges,,,813.64,95,,percent of total billed charges,,,770.81,90,,percent of total billed charges,,,770.81,90,,percent of total billed charges,,,702.3,82,,percent of total billed charges,,,770.81,90,,percent of total billed charges,,,727.99,85,,percent of total billed charges,,214.12,813.64,
BOOT REGULAR TCC-EZ,30810044,CDM,,,270,RC,outpatient,,476,476,,404.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119,22,,percent of total billed charges,,,,,,,,,428.4,90,,percent of total billed charges,,,394.13,82.8,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,,,,,,,,418.88,88,,percent of total billed charges,,,,,,,,,363.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119,22,,percent of total billed charges,,,433.16,91,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,,,,,,,,,,,,,395.08,83,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,390.32,82,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,119,452.2,
BOOT LARGE TCC-EZ,30810045,CDM,,,270,RC,outpatient,,578.13,578.13,,490.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,144.53,22,,percent of total billed charges,,,,,,,,,520.32,90,,percent of total billed charges,,,478.69,82.8,,percent of total billed charges,,,491.41,85,,percent of total billed charges,,,,,,,,,508.75,88,,percent of total billed charges,,,,,,,,,441.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,144.53,22,,percent of total billed charges,,,526.1,91,,percent of total billed charges,,,549.22,95,,percent of total billed charges,,,479.85,83,,percent of total billed charges,,,479.85,83,,percent of total billed charges,,,,,,,,,,,,,,,479.85,83,,percent of total billed charges,,,549.22,95,,percent of total billed charges,,,520.32,90,,percent of total billed charges,,,520.32,90,,percent of total billed charges,,,474.07,82,,percent of total billed charges,,,520.32,90,,percent of total billed charges,,,491.41,85,,percent of total billed charges,,144.53,549.22,
*DRESSING BIATIAN SILICONE FOAM 4 X 4,30810046,CDM,,,270,RC,outpatient,,26.28,26.28,,22.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.57,22,,percent of total billed charges,,,,,,,,,23.65,90,,percent of total billed charges,,,21.76,82.8,,percent of total billed charges,,,22.34,85,,percent of total billed charges,,,,,,,,,23.13,88,,percent of total billed charges,,,,,,,,,20.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.57,22,,percent of total billed charges,,,23.91,91,,percent of total billed charges,,,24.97,95,,percent of total billed charges,,,21.81,83,,percent of total billed charges,,,21.81,83,,percent of total billed charges,,,,,,,,,,,,,,,21.81,83,,percent of total billed charges,,,24.97,95,,percent of total billed charges,,,23.65,90,,percent of total billed charges,,,23.65,90,,percent of total billed charges,,,21.55,82,,percent of total billed charges,,,23.65,90,,percent of total billed charges,,,22.34,85,,percent of total billed charges,,6.57,24.97,
INTERDRY SHEET 10X36,30810047,CDM,,,270,RC,outpatient,,293.01,293.01,,248.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.25,22,,percent of total billed charges,,,,,,,,,263.71,90,,percent of total billed charges,,,242.61,82.8,,percent of total billed charges,,,249.06,85,,percent of total billed charges,,,,,,,,,257.85,88,,percent of total billed charges,,,,,,,,,223.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.25,22,,percent of total billed charges,,,266.64,91,,percent of total billed charges,,,278.36,95,,percent of total billed charges,,,243.2,83,,percent of total billed charges,,,243.2,83,,percent of total billed charges,,,,,,,,,,,,,,,243.2,83,,percent of total billed charges,,,278.36,95,,percent of total billed charges,,,263.71,90,,percent of total billed charges,,,263.71,90,,percent of total billed charges,,,240.27,82,,percent of total billed charges,,,263.71,90,,percent of total billed charges,,,249.06,85,,percent of total billed charges,,73.25,278.36,
BRAVA PROTECTIVE SHEET 4 X 4,30810048,CDM,,,270,RC,outpatient,,11.64,11.64,,9.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.91,22,,percent of total billed charges,,,,,,,,,10.48,90,,percent of total billed charges,,,9.64,82.8,,percent of total billed charges,,,9.89,85,,percent of total billed charges,,,,,,,,,10.24,88,,percent of total billed charges,,,,,,,,,8.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.91,22,,percent of total billed charges,,,10.59,91,,percent of total billed charges,,,11.06,95,,percent of total billed charges,,,9.66,83,,percent of total billed charges,,,9.66,83,,percent of total billed charges,,,,,,,,,,,,,,,9.66,83,,percent of total billed charges,,,11.06,95,,percent of total billed charges,,,10.48,90,,percent of total billed charges,,,10.48,90,,percent of total billed charges,,,9.54,82,,percent of total billed charges,,,10.48,90,,percent of total billed charges,,,9.89,85,,percent of total billed charges,,2.91,11.06,
*DRESSING POLYMEM WOUND FILLER 3.0 X 3.0,30810050,CDM,,,270,RC,outpatient,,103.12,103.12,,87.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.78,22,,percent of total billed charges,,,,,,,,,92.81,90,,percent of total billed charges,,,85.38,82.8,,percent of total billed charges,,,87.65,85,,percent of total billed charges,,,,,,,,,90.75,88,,percent of total billed charges,,,,,,,,,78.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.78,22,,percent of total billed charges,,,93.84,91,,percent of total billed charges,,,97.96,95,,percent of total billed charges,,,85.59,83,,percent of total billed charges,,,85.59,83,,percent of total billed charges,,,,,,,,,,,,,,,85.59,83,,percent of total billed charges,,,97.96,95,,percent of total billed charges,,,92.81,90,,percent of total billed charges,,,92.81,90,,percent of total billed charges,,,84.56,82,,percent of total billed charges,,,92.81,90,,percent of total billed charges,,,87.65,85,,percent of total billed charges,,25.78,97.96,
*DRESSING POLYMEM SILVER ROPE 0.4 X 14,30810051,CDM,,,270,RC,outpatient,,215.03,215.03,,182.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.76,22,,percent of total billed charges,,,,,,,,,193.53,90,,percent of total billed charges,,,178.04,82.8,,percent of total billed charges,,,182.78,85,,percent of total billed charges,,,,,,,,,189.23,88,,percent of total billed charges,,,,,,,,,164.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.76,22,,percent of total billed charges,,,195.68,91,,percent of total billed charges,,,204.28,95,,percent of total billed charges,,,178.47,83,,percent of total billed charges,,,178.47,83,,percent of total billed charges,,,,,,,,,,,,,,,178.47,83,,percent of total billed charges,,,204.28,95,,percent of total billed charges,,,193.53,90,,percent of total billed charges,,,193.53,90,,percent of total billed charges,,,176.32,82,,percent of total billed charges,,,193.53,90,,percent of total billed charges,,,182.78,85,,percent of total billed charges,,53.76,204.28,
*DRESSING POLYMEM MAX 8 X 8,30810052,CDM,,,270,RC,outpatient,,298.5,298.5,,253.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.63,22,,percent of total billed charges,,,,,,,,,268.65,90,,percent of total billed charges,,,247.16,82.8,,percent of total billed charges,,,253.73,85,,percent of total billed charges,,,,,,,,,262.68,88,,percent of total billed charges,,,,,,,,,228.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.63,22,,percent of total billed charges,,,271.64,91,,percent of total billed charges,,,283.58,95,,percent of total billed charges,,,247.76,83,,percent of total billed charges,,,247.76,83,,percent of total billed charges,,,,,,,,,,,,,,,247.76,83,,percent of total billed charges,,,283.58,95,,percent of total billed charges,,,268.65,90,,percent of total billed charges,,,268.65,90,,percent of total billed charges,,,244.77,82,,percent of total billed charges,,,268.65,90,,percent of total billed charges,,,253.73,85,,percent of total billed charges,,74.63,283.58,
BRAVA PROTECTIVE SHEET 8 X 8,30810060,CDM,,,270,RC,outpatient,,68.34,68.34,,58.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.09,22,,percent of total billed charges,,,,,,,,,61.51,90,,percent of total billed charges,,,56.59,82.8,,percent of total billed charges,,,58.09,85,,percent of total billed charges,,,,,,,,,60.14,88,,percent of total billed charges,,,,,,,,,52.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.09,22,,percent of total billed charges,,,62.19,91,,percent of total billed charges,,,64.92,95,,percent of total billed charges,,,56.72,83,,percent of total billed charges,,,56.72,83,,percent of total billed charges,,,,,,,,,,,,,,,56.72,83,,percent of total billed charges,,,64.92,95,,percent of total billed charges,,,61.51,90,,percent of total billed charges,,,61.51,90,,percent of total billed charges,,,56.04,82,,percent of total billed charges,,,61.51,90,,percent of total billed charges,,,58.09,85,,percent of total billed charges,,17.09,64.92,
BOOT LARGE CHARCOT TCC-EZ,30810061,CDM,,,270,RC,outpatient,,651,651,,552.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,162.75,22,,percent of total billed charges,,,,,,,,,585.9,90,,percent of total billed charges,,,539.03,82.8,,percent of total billed charges,,,553.35,85,,percent of total billed charges,,,,,,,,,572.88,88,,percent of total billed charges,,,,,,,,,497.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,162.75,22,,percent of total billed charges,,,592.41,91,,percent of total billed charges,,,618.45,95,,percent of total billed charges,,,540.33,83,,percent of total billed charges,,,540.33,83,,percent of total billed charges,,,,,,,,,,,,,,,540.33,83,,percent of total billed charges,,,618.45,95,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,533.82,82,,percent of total billed charges,,,585.9,90,,percent of total billed charges,,,553.35,85,,percent of total billed charges,,162.75,618.45,
BOOT EXTRA LARGE TCC-EZ,30810065,CDM,,,270,RC,outpatient,,606.69,606.69,,515.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,151.67,22,,percent of total billed charges,,,,,,,,,546.02,90,,percent of total billed charges,,,502.34,82.8,,percent of total billed charges,,,515.69,85,,percent of total billed charges,,,,,,,,,533.89,88,,percent of total billed charges,,,,,,,,,463.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,151.67,22,,percent of total billed charges,,,552.09,91,,percent of total billed charges,,,576.36,95,,percent of total billed charges,,,503.55,83,,percent of total billed charges,,,503.55,83,,percent of total billed charges,,,,,,,,,,,,,,,503.55,83,,percent of total billed charges,,,576.36,95,,percent of total billed charges,,,546.02,90,,percent of total billed charges,,,546.02,90,,percent of total billed charges,,,497.49,82,,percent of total billed charges,,,546.02,90,,percent of total billed charges,,,515.69,85,,percent of total billed charges,,151.67,576.36,
ATRAC-TAIN CREAM 5 OZ COLOPLAST,30810066,CDM,,,270,RC,outpatient,,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.25,22,,percent of total billed charges,,,,,,,,,40.5,90,,percent of total billed charges,,,37.26,82.8,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.25,22,,percent of total billed charges,,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,11.25,42.75,
CASTING SYSTEM 4 -NO BOOT,30810068,CDM,,,270,RC,outpatient,,831.6,831.6,,706.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,207.9,22,,percent of total billed charges,,,,,,,,,748.44,90,,percent of total billed charges,,,688.56,82.8,,percent of total billed charges,,,706.86,85,,percent of total billed charges,,,,,,,,,731.81,88,,percent of total billed charges,,,,,,,,,635.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,207.9,22,,percent of total billed charges,,,756.76,91,,percent of total billed charges,,,790.02,95,,percent of total billed charges,,,690.23,83,,percent of total billed charges,,,690.23,83,,percent of total billed charges,,,,,,,,,,,,,,,690.23,83,,percent of total billed charges,,,790.02,95,,percent of total billed charges,,,748.44,90,,percent of total billed charges,,,748.44,90,,percent of total billed charges,,,681.91,82,,percent of total billed charges,,,748.44,90,,percent of total billed charges,,,706.86,85,,percent of total billed charges,,207.9,790.02,
DRESSING OASIS WOUND MATRIX 3X3.5CM,30810069,CDM,,,270,RC,outpatient,,1023.75,1023.75,,869.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,255.94,22,,percent of total billed charges,,,,,,,,,921.38,90,,percent of total billed charges,,,847.67,82.8,,percent of total billed charges,,,870.19,85,,percent of total billed charges,,,,,,,,,900.9,88,,percent of total billed charges,,,,,,,,,782.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,255.94,22,,percent of total billed charges,,,931.61,91,,percent of total billed charges,,,972.56,95,,percent of total billed charges,,,849.71,83,,percent of total billed charges,,,849.71,83,,percent of total billed charges,,,,,,,,,,,,,,,849.71,83,,percent of total billed charges,,,972.56,95,,percent of total billed charges,,,921.38,90,,percent of total billed charges,,,921.38,90,,percent of total billed charges,,,839.48,82,,percent of total billed charges,,,921.38,90,,percent of total billed charges,,,870.19,85,,percent of total billed charges,,255.94,972.56,
DRESSING PREVENA 20CM PEEL & STICK,30810072,CDM,,,270,RC,outpatient,,1955.85,1955.85,,1660.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,488.96,22,,percent of total billed charges,,,,,,,,,1760.27,90,,percent of total billed charges,,,1619.44,82.8,,percent of total billed charges,,,1662.47,85,,percent of total billed charges,,,,,,,,,1721.15,88,,percent of total billed charges,,,,,,,,,1494.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,488.96,22,,percent of total billed charges,,,1779.82,91,,percent of total billed charges,,,1858.06,95,,percent of total billed charges,,,1623.36,83,,percent of total billed charges,,,1623.36,83,,percent of total billed charges,,,,,,,,,,,,,,,1623.36,83,,percent of total billed charges,,,1858.06,95,,percent of total billed charges,,,1760.27,90,,percent of total billed charges,,,1760.27,90,,percent of total billed charges,,,1603.8,82,,percent of total billed charges,,,1760.27,90,,percent of total billed charges,,,1662.47,85,,percent of total billed charges,,488.96,1858.06,
ALLEVYN LIFE DRESSING 5 1/16 3X3  PAD,30810075,CDM,,,270,RC,outpatient,,32.27,32.27,,27.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.07,22,,percent of total billed charges,,,,,,,,,29.04,90,,percent of total billed charges,,,26.72,82.8,,percent of total billed charges,,,27.43,85,,percent of total billed charges,,,,,,,,,28.4,88,,percent of total billed charges,,,,,,,,,24.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.07,22,,percent of total billed charges,,,29.37,91,,percent of total billed charges,,,30.66,95,,percent of total billed charges,,,26.78,83,,percent of total billed charges,,,26.78,83,,percent of total billed charges,,,,,,,,,,,,,,,26.78,83,,percent of total billed charges,,,30.66,95,,percent of total billed charges,,,29.04,90,,percent of total billed charges,,,29.04,90,,percent of total billed charges,,,26.46,82,,percent of total billed charges,,,29.04,90,,percent of total billed charges,,,27.43,85,,percent of total billed charges,,8.07,30.66,
ALLEVYN LIFE DRESSING 6 1/16 4X4  PAD,30810076,CDM,,,270,RC,outpatient,,44.31,44.31,,37.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.08,22,,percent of total billed charges,,,,,,,,,39.88,90,,percent of total billed charges,,,36.69,82.8,,percent of total billed charges,,,37.66,85,,percent of total billed charges,,,,,,,,,38.99,88,,percent of total billed charges,,,,,,,,,33.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.08,22,,percent of total billed charges,,,40.32,91,,percent of total billed charges,,,42.09,95,,percent of total billed charges,,,36.78,83,,percent of total billed charges,,,36.78,83,,percent of total billed charges,,,,,,,,,,,,,,,36.78,83,,percent of total billed charges,,,42.09,95,,percent of total billed charges,,,39.88,90,,percent of total billed charges,,,39.88,90,,percent of total billed charges,,,36.33,82,,percent of total billed charges,,,39.88,90,,percent of total billed charges,,,37.66,85,,percent of total billed charges,,11.08,42.09,
ANASEPT ANTIMICROBIAL SKIN & WOUND GEL,30810077,CDM,,,270,RC,outpatient,,288.71,288.71,,245.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.18,22,,percent of total billed charges,,,,,,,,,259.84,90,,percent of total billed charges,,,239.05,82.8,,percent of total billed charges,,,245.4,85,,percent of total billed charges,,,,,,,,,254.06,88,,percent of total billed charges,,,,,,,,,220.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.18,22,,percent of total billed charges,,,262.73,91,,percent of total billed charges,,,274.27,95,,percent of total billed charges,,,239.63,83,,percent of total billed charges,,,239.63,83,,percent of total billed charges,,,,,,,,,,,,,,,239.63,83,,percent of total billed charges,,,274.27,95,,percent of total billed charges,,,259.84,90,,percent of total billed charges,,,259.84,90,,percent of total billed charges,,,236.74,82,,percent of total billed charges,,,259.84,90,,percent of total billed charges,,,245.4,85,,percent of total billed charges,,72.18,274.27,
DRESSING ALLEVYN LIFE FOAM SACRUM SMALL,30810078,CDM,,,270,RC,outpatient,,59.39,59.39,,50.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.85,22,,percent of total billed charges,,,,,,,,,53.45,90,,percent of total billed charges,,,49.17,82.8,,percent of total billed charges,,,50.48,85,,percent of total billed charges,,,,,,,,,52.26,88,,percent of total billed charges,,,,,,,,,45.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.85,22,,percent of total billed charges,,,54.04,91,,percent of total billed charges,,,56.42,95,,percent of total billed charges,,,49.29,83,,percent of total billed charges,,,49.29,83,,percent of total billed charges,,,,,,,,,,,,,,,49.29,83,,percent of total billed charges,,,56.42,95,,percent of total billed charges,,,53.45,90,,percent of total billed charges,,,53.45,90,,percent of total billed charges,,,48.7,82,,percent of total billed charges,,,53.45,90,,percent of total billed charges,,,50.48,85,,percent of total billed charges,,14.85,56.42,
KCI PREVENA INCISION MANAGEMENT SYSTEM,30810079,CDM,,,270,RC,outpatient,,3217.5,3217.5,,2731.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,804.38,22,,percent of total billed charges,,,,,,,,,2895.75,90,,percent of total billed charges,,,2664.09,82.8,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,,,,,,,,2831.4,88,,percent of total billed charges,,,,,,,,,2458.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,804.38,22,,percent of total billed charges,,,2927.93,91,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,2670.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2670.53,83,,percent of total billed charges,,,3056.63,95,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2638.35,82,,percent of total billed charges,,,2895.75,90,,percent of total billed charges,,,2734.88,85,,percent of total billed charges,,804.38,3056.63,
ULTRA MIST APPLICATOR,30810080,CDM,,,270,RC,outpatient,,378,378,,320.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94.5,22,,percent of total billed charges,,,,,,,,,340.2,90,,percent of total billed charges,,,312.98,82.8,,percent of total billed charges,,,321.3,85,,percent of total billed charges,,,,,,,,,332.64,88,,percent of total billed charges,,,,,,,,,288.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94.5,22,,percent of total billed charges,,,343.98,91,,percent of total billed charges,,,359.1,95,,percent of total billed charges,,,313.74,83,,percent of total billed charges,,,313.74,83,,percent of total billed charges,,,,,,,,,,,,,,,313.74,83,,percent of total billed charges,,,359.1,95,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,309.96,82,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,321.3,85,,percent of total billed charges,,94.5,359.1,
DRESSING PREVENA 13CM PEEL & PLACE,30810082,CDM,,,270,RC,outpatient,,1955.85,1955.85,,1660.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,488.96,22,,percent of total billed charges,,,,,,,,,1760.27,90,,percent of total billed charges,,,1619.44,82.8,,percent of total billed charges,,,1662.47,85,,percent of total billed charges,,,,,,,,,1721.15,88,,percent of total billed charges,,,,,,,,,1494.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,488.96,22,,percent of total billed charges,,,1779.82,91,,percent of total billed charges,,,1858.06,95,,percent of total billed charges,,,1623.36,83,,percent of total billed charges,,,1623.36,83,,percent of total billed charges,,,,,,,,,,,,,,,1623.36,83,,percent of total billed charges,,,1858.06,95,,percent of total billed charges,,,1760.27,90,,percent of total billed charges,,,1760.27,90,,percent of total billed charges,,,1603.8,82,,percent of total billed charges,,,1760.27,90,,percent of total billed charges,,,1662.47,85,,percent of total billed charges,,488.96,1858.06,
DRESSING PREVENA PLUS KIT,30810083,CDM,,,270,RC,outpatient,,2512.77,2512.77,,2133.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,628.19,22,,percent of total billed charges,,,,,,,,,2261.49,90,,percent of total billed charges,,,2080.57,82.8,,percent of total billed charges,,,2135.85,85,,percent of total billed charges,,,,,,,,,2211.24,88,,percent of total billed charges,,,,,,,,,1919.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,628.19,22,,percent of total billed charges,,,2286.62,91,,percent of total billed charges,,,2387.13,95,,percent of total billed charges,,,2085.6,83,,percent of total billed charges,,,2085.6,83,,percent of total billed charges,,,,,,,,,,,,,,,2085.6,83,,percent of total billed charges,,,2387.13,95,,percent of total billed charges,,,2261.49,90,,percent of total billed charges,,,2261.49,90,,percent of total billed charges,,,2060.47,82,,percent of total billed charges,,,2261.49,90,,percent of total billed charges,,,2135.85,85,,percent of total billed charges,,628.19,2387.13,
PREVENA PLUS SYSTEM KIT,30810084,CDM,,,270,RC,outpatient,,4225,4225,,3587.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1056.25,22,,percent of total billed charges,,,,,,,,,3802.5,90,,percent of total billed charges,,,3498.3,82.8,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,,,,,,,,3718,88,,percent of total billed charges,,,,,,,,,3227.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1056.25,22,,percent of total billed charges,,,3844.75,91,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,3506.75,83,,percent of total billed charges,,,,,,,,,,,,,,,3506.75,83,,percent of total billed charges,,,4013.75,95,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3464.5,82,,percent of total billed charges,,,3802.5,90,,percent of total billed charges,,,3591.25,85,,percent of total billed charges,,1056.25,4013.75,
*KCI HARVESTER 5CM X 5CM,30810085,CDM,,,270,RC,outpatient,,2275,2275,,1931.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,568.75,22,,percent of total billed charges,,,,,,,,,2047.5,90,,percent of total billed charges,,,1883.7,82.8,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,,,,,,,,2002,88,,percent of total billed charges,,,,,,,,,1738.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,568.75,22,,percent of total billed charges,,,2070.25,91,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,1888.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1888.25,83,,percent of total billed charges,,,2161.25,95,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1865.5,82,,percent of total billed charges,,,2047.5,90,,percent of total billed charges,,,1933.75,85,,percent of total billed charges,,568.75,2161.25,
*KCI HARVESTER EXTENSION STRAP,30810086,CDM,,,270,RC,outpatient,,262.5,262.5,,222.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.63,22,,percent of total billed charges,,,,,,,,,236.25,90,,percent of total billed charges,,,217.35,82.8,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,,,,,,,,231,88,,percent of total billed charges,,,,,,,,,200.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.63,22,,percent of total billed charges,,,238.88,91,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,217.88,83,,percent of total billed charges,,,,,,,,,,,,,,,217.88,83,,percent of total billed charges,,,249.38,95,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,215.25,82,,percent of total billed charges,,,236.25,90,,percent of total billed charges,,,223.13,85,,percent of total billed charges,,65.63,249.38,
ACTICOAT FLEX 7 4 X5,30810088,CDM,,,270,RC,outpatient,,157.17,157.17,,133.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.29,22,,percent of total billed charges,,,,,,,,,141.45,90,,percent of total billed charges,,,130.14,82.8,,percent of total billed charges,,,133.59,85,,percent of total billed charges,,,,,,,,,138.31,88,,percent of total billed charges,,,,,,,,,120.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.29,22,,percent of total billed charges,,,143.02,91,,percent of total billed charges,,,149.31,95,,percent of total billed charges,,,130.45,83,,percent of total billed charges,,,130.45,83,,percent of total billed charges,,,,,,,,,,,,,,,130.45,83,,percent of total billed charges,,,149.31,95,,percent of total billed charges,,,141.45,90,,percent of total billed charges,,,141.45,90,,percent of total billed charges,,,128.88,82,,percent of total billed charges,,,141.45,90,,percent of total billed charges,,,133.59,85,,percent of total billed charges,,39.29,149.31,
DRESSING PICO 4  X 12,30810089,CDM,,,270,RC,outpatient,,1796.17,1796.17,,1524.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,449.04,22,,percent of total billed charges,,,,,,,,,1616.55,90,,percent of total billed charges,,,1487.23,82.8,,percent of total billed charges,,,1526.74,85,,percent of total billed charges,,,,,,,,,1580.63,88,,percent of total billed charges,,,,,,,,,1372.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,449.04,22,,percent of total billed charges,,,1634.51,91,,percent of total billed charges,,,1706.36,95,,percent of total billed charges,,,1490.82,83,,percent of total billed charges,,,1490.82,83,,percent of total billed charges,,,,,,,,,,,,,,,1490.82,83,,percent of total billed charges,,,1706.36,95,,percent of total billed charges,,,1616.55,90,,percent of total billed charges,,,1616.55,90,,percent of total billed charges,,,1472.86,82,,percent of total billed charges,,,1616.55,90,,percent of total billed charges,,,1526.74,85,,percent of total billed charges,,449.04,1706.36,
DRESSING PICO 6  X 8,30810090,CDM,,,270,RC,outpatient,,1894.64,1894.64,,1608.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,473.66,22,,percent of total billed charges,,,,,,,,,1705.18,90,,percent of total billed charges,,,1568.76,82.8,,percent of total billed charges,,,1610.44,85,,percent of total billed charges,,,,,,,,,1667.28,88,,percent of total billed charges,,,,,,,,,1447.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,473.66,22,,percent of total billed charges,,,1724.12,91,,percent of total billed charges,,,1799.91,95,,percent of total billed charges,,,1572.55,83,,percent of total billed charges,,,1572.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1572.55,83,,percent of total billed charges,,,1799.91,95,,percent of total billed charges,,,1705.18,90,,percent of total billed charges,,,1705.18,90,,percent of total billed charges,,,1553.6,82,,percent of total billed charges,,,1705.18,90,,percent of total billed charges,,,1610.44,85,,percent of total billed charges,,473.66,1799.91,
DRESSING PICO 8  X 8,30810091,CDM,,,270,RC,outpatient,,1697.63,1697.63,,1441.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,424.41,22,,percent of total billed charges,,,,,,,,,1527.87,90,,percent of total billed charges,,,1405.64,82.8,,percent of total billed charges,,,1442.99,85,,percent of total billed charges,,,,,,,,,1493.91,88,,percent of total billed charges,,,,,,,,,1296.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,424.41,22,,percent of total billed charges,,,1544.84,91,,percent of total billed charges,,,1612.75,95,,percent of total billed charges,,,1409.03,83,,percent of total billed charges,,,1409.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1409.03,83,,percent of total billed charges,,,1612.75,95,,percent of total billed charges,,,1527.87,90,,percent of total billed charges,,,1527.87,90,,percent of total billed charges,,,1392.06,82,,percent of total billed charges,,,1527.87,90,,percent of total billed charges,,,1442.99,85,,percent of total billed charges,,424.41,1612.75,
DRESSING ADAPTIC TOUCH 2X3,30810092,CDM,,,270,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DRESSING PICO 4  X 8,30810093,CDM,,,270,RC,outpatient,,1941.12,1941.12,,1648.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,485.28,22,,percent of total billed charges,,,,,,,,,1747.01,90,,percent of total billed charges,,,1607.25,82.8,,percent of total billed charges,,,1649.95,85,,percent of total billed charges,,,,,,,,,1708.19,88,,percent of total billed charges,,,,,,,,,1483.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,485.28,22,,percent of total billed charges,,,1766.42,91,,percent of total billed charges,,,1844.06,95,,percent of total billed charges,,,1611.13,83,,percent of total billed charges,,,1611.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1611.13,83,,percent of total billed charges,,,1844.06,95,,percent of total billed charges,,,1747.01,90,,percent of total billed charges,,,1747.01,90,,percent of total billed charges,,,1591.72,82,,percent of total billed charges,,,1747.01,90,,percent of total billed charges,,,1649.95,85,,percent of total billed charges,,485.28,1844.06,
RENASYS ADHESIVE GEL PATCH,30810094,CDM,,,270,RC,outpatient,,153.23,153.23,,130.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.31,22,,percent of total billed charges,,,,,,,,,137.91,90,,percent of total billed charges,,,126.87,82.8,,percent of total billed charges,,,130.25,85,,percent of total billed charges,,,,,,,,,134.84,88,,percent of total billed charges,,,,,,,,,117.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.31,22,,percent of total billed charges,,,139.44,91,,percent of total billed charges,,,145.57,95,,percent of total billed charges,,,127.18,83,,percent of total billed charges,,,127.18,83,,percent of total billed charges,,,,,,,,,,,,,,,127.18,83,,percent of total billed charges,,,145.57,95,,percent of total billed charges,,,137.91,90,,percent of total billed charges,,,137.91,90,,percent of total billed charges,,,125.65,82,,percent of total billed charges,,,137.91,90,,percent of total billed charges,,,130.25,85,,percent of total billed charges,,38.31,145.57,
DRESSING OASIS ULTRA TRI-LAYER 7 X 20CM,30810095,CDM,,,270,RC,outpatient,,11136.06,11136.06,,9454.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2784.02,22,,percent of total billed charges,,,,,,,,,10022.45,90,,percent of total billed charges,,,9220.66,82.8,,percent of total billed charges,,,9465.65,85,,percent of total billed charges,,,,,,,,,9799.73,88,,percent of total billed charges,,,,,,,,,8507.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2784.02,22,,percent of total billed charges,,,10133.81,91,,percent of total billed charges,,,10579.26,95,,percent of total billed charges,,,9242.93,83,,percent of total billed charges,,,9242.93,83,,percent of total billed charges,,,,,,,,,,,,,,,9242.93,83,,percent of total billed charges,,,10579.26,95,,percent of total billed charges,,,10022.45,90,,percent of total billed charges,,,10022.45,90,,percent of total billed charges,,,9131.57,82,,percent of total billed charges,,,10022.45,90,,percent of total billed charges,,,9465.65,85,,percent of total billed charges,,2784.02,10579.26,
TRANSMETATURSAL AMPUTUTIM BOOT TCC-EZ,30810096,CDM,,,270,RC,outpatient,,630,630,,534.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,157.5,22,,percent of total billed charges,,,,,,,,,567,90,,percent of total billed charges,,,521.64,82.8,,percent of total billed charges,,,535.5,85,,percent of total billed charges,,,,,,,,,554.4,88,,percent of total billed charges,,,,,,,,,481.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,157.5,22,,percent of total billed charges,,,573.3,91,,percent of total billed charges,,,598.5,95,,percent of total billed charges,,,522.9,83,,percent of total billed charges,,,522.9,83,,percent of total billed charges,,,,,,,,,,,,,,,522.9,83,,percent of total billed charges,,,598.5,95,,percent of total billed charges,,,567,90,,percent of total billed charges,,,567,90,,percent of total billed charges,,,516.6,82,,percent of total billed charges,,,567,90,,percent of total billed charges,,,535.5,85,,percent of total billed charges,,157.5,598.5,
*KCI PREVENA CANISTER 45ML,30810097,CDM,,,270,RC,outpatient,,189.12,189.12,,160.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.28,22,,percent of total billed charges,,,,,,,,,170.21,90,,percent of total billed charges,,,156.59,82.8,,percent of total billed charges,,,160.75,85,,percent of total billed charges,,,,,,,,,166.43,88,,percent of total billed charges,,,,,,,,,144.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.28,22,,percent of total billed charges,,,172.1,91,,percent of total billed charges,,,179.66,95,,percent of total billed charges,,,156.97,83,,percent of total billed charges,,,156.97,83,,percent of total billed charges,,,,,,,,,,,,,,,156.97,83,,percent of total billed charges,,,179.66,95,,percent of total billed charges,,,170.21,90,,percent of total billed charges,,,170.21,90,,percent of total billed charges,,,155.08,82,,percent of total billed charges,,,170.21,90,,percent of total billed charges,,,160.75,85,,percent of total billed charges,,47.28,179.66,
DRESSING PICO 4  X 16,30810098,CDM,,,270,RC,outpatient,,1695.4,1695.4,,1439.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,423.85,22,,percent of total billed charges,,,,,,,,,1525.86,90,,percent of total billed charges,,,1403.79,82.8,,percent of total billed charges,,,1441.09,85,,percent of total billed charges,,,,,,,,,1491.95,88,,percent of total billed charges,,,,,,,,,1295.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,423.85,22,,percent of total billed charges,,,1542.81,91,,percent of total billed charges,,,1610.63,95,,percent of total billed charges,,,1407.18,83,,percent of total billed charges,,,1407.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1407.18,83,,percent of total billed charges,,,1610.63,95,,percent of total billed charges,,,1525.86,90,,percent of total billed charges,,,1525.86,90,,percent of total billed charges,,,1390.23,82,,percent of total billed charges,,,1525.86,90,,percent of total billed charges,,,1441.09,85,,percent of total billed charges,,423.85,1610.63,
STIMULEN POWDER 1 GR.,30810099,CDM,,,270,RC,outpatient,,87.72,87.72,,74.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.93,22,,percent of total billed charges,,,,,,,,,78.95,90,,percent of total billed charges,,,72.63,82.8,,percent of total billed charges,,,74.56,85,,percent of total billed charges,,,,,,,,,77.19,88,,percent of total billed charges,,,,,,,,,67.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.93,22,,percent of total billed charges,,,79.83,91,,percent of total billed charges,,,83.33,95,,percent of total billed charges,,,72.81,83,,percent of total billed charges,,,72.81,83,,percent of total billed charges,,,,,,,,,,,,,,,72.81,83,,percent of total billed charges,,,83.33,95,,percent of total billed charges,,,78.95,90,,percent of total billed charges,,,78.95,90,,percent of total billed charges,,,71.93,82,,percent of total billed charges,,,78.95,90,,percent of total billed charges,,,74.56,85,,percent of total billed charges,,21.93,83.33,
COBAN 2 LAYER SYSTEM COMPRESSION XL,30810100,CDM,,,270,RC,outpatient,,95.92,95.92,,81.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.98,22,,percent of total billed charges,,,,,,,,,86.33,90,,percent of total billed charges,,,79.42,82.8,,percent of total billed charges,,,81.53,85,,percent of total billed charges,,,,,,,,,84.41,88,,percent of total billed charges,,,,,,,,,73.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.98,22,,percent of total billed charges,,,87.29,91,,percent of total billed charges,,,91.12,95,,percent of total billed charges,,,79.61,83,,percent of total billed charges,,,79.61,83,,percent of total billed charges,,,,,,,,,,,,,,,79.61,83,,percent of total billed charges,,,91.12,95,,percent of total billed charges,,,86.33,90,,percent of total billed charges,,,86.33,90,,percent of total billed charges,,,78.65,82,,percent of total billed charges,,,86.33,90,,percent of total billed charges,,,81.53,85,,percent of total billed charges,,23.98,91.12,
PREVENA PLUS 125 THERAPY UNIT 14 DAY,30810101,CDM,,,270,RC,outpatient,,2940.8,2940.8,,2496.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,735.2,22,,percent of total billed charges,,,,,,,,,2646.72,90,,percent of total billed charges,,,2434.98,82.8,,percent of total billed charges,,,2499.68,85,,percent of total billed charges,,,,,,,,,2587.9,88,,percent of total billed charges,,,,,,,,,2246.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,735.2,22,,percent of total billed charges,,,2676.13,91,,percent of total billed charges,,,2793.76,95,,percent of total billed charges,,,2440.86,83,,percent of total billed charges,,,2440.86,83,,percent of total billed charges,,,,,,,,,,,,,,,2440.86,83,,percent of total billed charges,,,2793.76,95,,percent of total billed charges,,,2646.72,90,,percent of total billed charges,,,2646.72,90,,percent of total billed charges,,,2411.46,82,,percent of total billed charges,,,2646.72,90,,percent of total billed charges,,,2499.68,85,,percent of total billed charges,,735.2,2793.76,
DRESSING PICO 6  X 6,30810102,CDM,,,270,RC,outpatient,,1870.07,1870.07,,1587.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,467.52,22,,percent of total billed charges,,,,,,,,,1683.06,90,,percent of total billed charges,,,1548.42,82.8,,percent of total billed charges,,,1589.56,85,,percent of total billed charges,,,,,,,,,1645.66,88,,percent of total billed charges,,,,,,,,,1428.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,467.52,22,,percent of total billed charges,,,1701.76,91,,percent of total billed charges,,,1776.57,95,,percent of total billed charges,,,1552.16,83,,percent of total billed charges,,,1552.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1552.16,83,,percent of total billed charges,,,1776.57,95,,percent of total billed charges,,,1683.06,90,,percent of total billed charges,,,1683.06,90,,percent of total billed charges,,,1533.46,82,,percent of total billed charges,,,1683.06,90,,percent of total billed charges,,,1589.56,85,,percent of total billed charges,,467.52,1776.57,
KCI PREVENA CANISTER 150ML,30810103,CDM,,,270,RC,outpatient,,198.9,198.9,,168.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.73,22,,percent of total billed charges,,,,,,,,,179.01,90,,percent of total billed charges,,,164.69,82.8,,percent of total billed charges,,,169.07,85,,percent of total billed charges,,,,,,,,,175.03,88,,percent of total billed charges,,,,,,,,,151.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.73,22,,percent of total billed charges,,,181,91,,percent of total billed charges,,,188.96,95,,percent of total billed charges,,,165.09,83,,percent of total billed charges,,,165.09,83,,percent of total billed charges,,,,,,,,,,,,,,,165.09,83,,percent of total billed charges,,,188.96,95,,percent of total billed charges,,,179.01,90,,percent of total billed charges,,,179.01,90,,percent of total billed charges,,,163.1,82,,percent of total billed charges,,,179.01,90,,percent of total billed charges,,,169.07,85,,percent of total billed charges,,49.73,188.96,
DRESSING PICO MULTISITE 15 X 20CM,30810104,CDM,,,270,RC,outpatient,,1463.09,1463.09,,1242.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.77,22,,percent of total billed charges,,,,,,,,,1316.78,90,,percent of total billed charges,,,1211.44,82.8,,percent of total billed charges,,,1243.63,85,,percent of total billed charges,,,,,,,,,1287.52,88,,percent of total billed charges,,,,,,,,,1117.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.77,22,,percent of total billed charges,,,1331.41,91,,percent of total billed charges,,,1389.94,95,,percent of total billed charges,,,1214.36,83,,percent of total billed charges,,,1214.36,83,,percent of total billed charges,,,,,,,,,,,,,,,1214.36,83,,percent of total billed charges,,,1389.94,95,,percent of total billed charges,,,1316.78,90,,percent of total billed charges,,,1316.78,90,,percent of total billed charges,,,1199.73,82,,percent of total billed charges,,,1316.78,90,,percent of total billed charges,,,1243.63,85,,percent of total billed charges,,365.77,1389.94,
DRESSING OASIS WOUND MATRIX 5X7CM,30810105,CDM,,,270,RC,outpatient,,2088.06,2088.06,,1772.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,522.02,22,,percent of total billed charges,,,,,,,,,1879.25,90,,percent of total billed charges,,,1728.91,82.8,,percent of total billed charges,,,1774.85,85,,percent of total billed charges,,,,,,,,,1837.49,88,,percent of total billed charges,,,,,,,,,1595.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,522.02,22,,percent of total billed charges,,,1900.13,91,,percent of total billed charges,,,1983.66,95,,percent of total billed charges,,,1733.09,83,,percent of total billed charges,,,1733.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1733.09,83,,percent of total billed charges,,,1983.66,95,,percent of total billed charges,,,1879.25,90,,percent of total billed charges,,,1879.25,90,,percent of total billed charges,,,1712.21,82,,percent of total billed charges,,,1879.25,90,,percent of total billed charges,,,1774.85,85,,percent of total billed charges,,522.02,1983.66,
DRESSING PICO 6  X 12,30810106,CDM,,,270,RC,outpatient,,1463.04,1463.04,,1242.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.76,22,,percent of total billed charges,,,,,,,,,1316.74,90,,percent of total billed charges,,,1211.4,82.8,,percent of total billed charges,,,1243.58,85,,percent of total billed charges,,,,,,,,,1287.48,88,,percent of total billed charges,,,,,,,,,1117.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.76,22,,percent of total billed charges,,,1331.37,91,,percent of total billed charges,,,1389.89,95,,percent of total billed charges,,,1214.32,83,,percent of total billed charges,,,1214.32,83,,percent of total billed charges,,,,,,,,,,,,,,,1214.32,83,,percent of total billed charges,,,1389.89,95,,percent of total billed charges,,,1316.74,90,,percent of total billed charges,,,1316.74,90,,percent of total billed charges,,,1199.69,82,,percent of total billed charges,,,1316.74,90,,percent of total billed charges,,,1243.58,85,,percent of total billed charges,,365.76,1389.89,
PLUROGEL BURN & WOUND DRESSING 1.75OZ,30810108,CDM,,,270,RC,outpatient,,648.9,648.9,,550.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,162.23,22,,percent of total billed charges,,,,,,,,,584.01,90,,percent of total billed charges,,,537.29,82.8,,percent of total billed charges,,,551.57,85,,percent of total billed charges,,,,,,,,,571.03,88,,percent of total billed charges,,,,,,,,,495.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,162.23,22,,percent of total billed charges,,,590.5,91,,percent of total billed charges,,,616.46,95,,percent of total billed charges,,,538.59,83,,percent of total billed charges,,,538.59,83,,percent of total billed charges,,,,,,,,,,,,,,,538.59,83,,percent of total billed charges,,,616.46,95,,percent of total billed charges,,,584.01,90,,percent of total billed charges,,,584.01,90,,percent of total billed charges,,,532.1,82,,percent of total billed charges,,,584.01,90,,percent of total billed charges,,,551.57,85,,percent of total billed charges,,162.23,616.46,
DRESSING POLYMEM MAX 4.5X4.5,30810110,CDM,,,270,RC,outpatient,,42.75,42.75,,36.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.69,22,,percent of total billed charges,,,,,,,,,38.48,90,,percent of total billed charges,,,35.4,82.8,,percent of total billed charges,,,36.34,85,,percent of total billed charges,,,,,,,,,37.62,88,,percent of total billed charges,,,,,,,,,32.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.69,22,,percent of total billed charges,,,38.9,91,,percent of total billed charges,,,40.61,95,,percent of total billed charges,,,35.48,83,,percent of total billed charges,,,35.48,83,,percent of total billed charges,,,,,,,,,,,,,,,35.48,83,,percent of total billed charges,,,40.61,95,,percent of total billed charges,,,38.48,90,,percent of total billed charges,,,38.48,90,,percent of total billed charges,,,35.06,82,,percent of total billed charges,,,38.48,90,,percent of total billed charges,,,36.34,85,,percent of total billed charges,,10.69,40.61,
DRESSING POLYMEM MAX 8 X8,30810111,CDM,,,270,RC,outpatient,,109.7,109.7,,93.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.43,22,,percent of total billed charges,,,,,,,,,98.73,90,,percent of total billed charges,,,90.83,82.8,,percent of total billed charges,,,93.25,85,,percent of total billed charges,,,,,,,,,96.54,88,,percent of total billed charges,,,,,,,,,83.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.43,22,,percent of total billed charges,,,99.83,91,,percent of total billed charges,,,104.22,95,,percent of total billed charges,,,91.05,83,,percent of total billed charges,,,91.05,83,,percent of total billed charges,,,,,,,,,,,,,,,91.05,83,,percent of total billed charges,,,104.22,95,,percent of total billed charges,,,98.73,90,,percent of total billed charges,,,98.73,90,,percent of total billed charges,,,89.95,82,,percent of total billed charges,,,98.73,90,,percent of total billed charges,,,93.25,85,,percent of total billed charges,,27.43,104.22,
DRESSING POLYMEM WIC 3X3,30810112,CDM,,,270,RC,outpatient,,38.25,38.25,,32.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.56,22,,percent of total billed charges,,,,,,,,,34.43,90,,percent of total billed charges,,,31.67,82.8,,percent of total billed charges,,,32.51,85,,percent of total billed charges,,,,,,,,,33.66,88,,percent of total billed charges,,,,,,,,,29.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.56,22,,percent of total billed charges,,,34.81,91,,percent of total billed charges,,,36.34,95,,percent of total billed charges,,,31.75,83,,percent of total billed charges,,,31.75,83,,percent of total billed charges,,,,,,,,,,,,,,,31.75,83,,percent of total billed charges,,,36.34,95,,percent of total billed charges,,,34.43,90,,percent of total billed charges,,,34.43,90,,percent of total billed charges,,,31.37,82,,percent of total billed charges,,,34.43,90,,percent of total billed charges,,,32.51,85,,percent of total billed charges,,9.56,36.34,
TRIAD HYDROPHILIC WOUND PASTE,30810113,CDM,,,270,RC,outpatient,,71.32,71.32,,60.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.83,22,,percent of total billed charges,,,,,,,,,64.19,90,,percent of total billed charges,,,59.05,82.8,,percent of total billed charges,,,60.62,85,,percent of total billed charges,,,,,,,,,62.76,88,,percent of total billed charges,,,,,,,,,54.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.83,22,,percent of total billed charges,,,64.9,91,,percent of total billed charges,,,67.75,95,,percent of total billed charges,,,59.2,83,,percent of total billed charges,,,59.2,83,,percent of total billed charges,,,,,,,,,,,,,,,59.2,83,,percent of total billed charges,,,67.75,95,,percent of total billed charges,,,64.19,90,,percent of total billed charges,,,64.19,90,,percent of total billed charges,,,58.48,82,,percent of total billed charges,,,64.19,90,,percent of total billed charges,,,60.62,85,,percent of total billed charges,,17.83,67.75,
DRESSING MEPITEL SAFETAC 8X12IN,30810115,CDM,,,270,RC,outpatient,,191.73,191.73,,162.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.93,22,,percent of total billed charges,,,,,,,,,172.56,90,,percent of total billed charges,,,158.75,82.8,,percent of total billed charges,,,162.97,85,,percent of total billed charges,,,,,,,,,168.72,88,,percent of total billed charges,,,,,,,,,146.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.93,22,,percent of total billed charges,,,174.47,91,,percent of total billed charges,,,182.14,95,,percent of total billed charges,,,159.14,83,,percent of total billed charges,,,159.14,83,,percent of total billed charges,,,,,,,,,,,,,,,159.14,83,,percent of total billed charges,,,182.14,95,,percent of total billed charges,,,172.56,90,,percent of total billed charges,,,172.56,90,,percent of total billed charges,,,157.22,82,,percent of total billed charges,,,172.56,90,,percent of total billed charges,,,162.97,85,,percent of total billed charges,,47.93,182.14,
DRESSING POLYMEM WIC SILVER ROPE 14,30810117,CDM,,,270,RC,outpatient,,113.84,113.84,,96.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.46,22,,percent of total billed charges,,,,,,,,,102.46,90,,percent of total billed charges,,,94.26,82.8,,percent of total billed charges,,,96.76,85,,percent of total billed charges,,,,,,,,,100.18,88,,percent of total billed charges,,,,,,,,,86.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.46,22,,percent of total billed charges,,,103.59,91,,percent of total billed charges,,,108.15,95,,percent of total billed charges,,,94.49,83,,percent of total billed charges,,,94.49,83,,percent of total billed charges,,,,,,,,,,,,,,,94.49,83,,percent of total billed charges,,,108.15,95,,percent of total billed charges,,,102.46,90,,percent of total billed charges,,,102.46,90,,percent of total billed charges,,,93.35,82,,percent of total billed charges,,,102.46,90,,percent of total billed charges,,,96.76,85,,percent of total billed charges,,28.46,108.15,
DRESSING POLYMEM #3 OVAL,30810118,CDM,,,270,RC,outpatient,,24.12,24.12,,20.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.03,22,,percent of total billed charges,,,,,,,,,21.71,90,,percent of total billed charges,,,19.97,82.8,,percent of total billed charges,,,20.5,85,,percent of total billed charges,,,,,,,,,21.23,88,,percent of total billed charges,,,,,,,,,18.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.03,22,,percent of total billed charges,,,21.95,91,,percent of total billed charges,,,22.91,95,,percent of total billed charges,,,20.02,83,,percent of total billed charges,,,20.02,83,,percent of total billed charges,,,,,,,,,,,,,,,20.02,83,,percent of total billed charges,,,22.91,95,,percent of total billed charges,,,21.71,90,,percent of total billed charges,,,21.71,90,,percent of total billed charges,,,19.78,82,,percent of total billed charges,,,21.71,90,,percent of total billed charges,,,20.5,85,,percent of total billed charges,,6.03,22.91,
DRESSING AQUACEL EXTRA 6X6,30810119,CDM,,,270,RC,outpatient,,58.02,58.02,,49.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.51,22,,percent of total billed charges,,,,,,,,,52.22,90,,percent of total billed charges,,,48.04,82.8,,percent of total billed charges,,,49.32,85,,percent of total billed charges,,,,,,,,,51.06,88,,percent of total billed charges,,,,,,,,,44.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.51,22,,percent of total billed charges,,,52.8,91,,percent of total billed charges,,,55.12,95,,percent of total billed charges,,,48.16,83,,percent of total billed charges,,,48.16,83,,percent of total billed charges,,,,,,,,,,,,,,,48.16,83,,percent of total billed charges,,,55.12,95,,percent of total billed charges,,,52.22,90,,percent of total billed charges,,,52.22,90,,percent of total billed charges,,,47.58,82,,percent of total billed charges,,,52.22,90,,percent of total billed charges,,,49.32,85,,percent of total billed charges,,14.51,55.12,
DRESSING AQUACEL EXTRA 4X5,30810120,CDM,,,270,RC,outpatient,,28.44,28.44,,24.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.11,22,,percent of total billed charges,,,,,,,,,25.6,90,,percent of total billed charges,,,23.55,82.8,,percent of total billed charges,,,24.17,85,,percent of total billed charges,,,,,,,,,25.03,88,,percent of total billed charges,,,,,,,,,21.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.11,22,,percent of total billed charges,,,25.88,91,,percent of total billed charges,,,27.02,95,,percent of total billed charges,,,23.61,83,,percent of total billed charges,,,23.61,83,,percent of total billed charges,,,,,,,,,,,,,,,23.61,83,,percent of total billed charges,,,27.02,95,,percent of total billed charges,,,25.6,90,,percent of total billed charges,,,25.6,90,,percent of total billed charges,,,23.32,82,,percent of total billed charges,,,25.6,90,,percent of total billed charges,,,24.17,85,,percent of total billed charges,,7.11,27.02,
DRESSING AQUACEL AG 6X6,30810121,CDM,,,270,RC,outpatient,,159.09,159.09,,135.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.77,22,,percent of total billed charges,,,,,,,,,143.18,90,,percent of total billed charges,,,131.73,82.8,,percent of total billed charges,,,135.23,85,,percent of total billed charges,,,,,,,,,140,88,,percent of total billed charges,,,,,,,,,121.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.77,22,,percent of total billed charges,,,144.77,91,,percent of total billed charges,,,151.14,95,,percent of total billed charges,,,132.04,83,,percent of total billed charges,,,132.04,83,,percent of total billed charges,,,,,,,,,,,,,,,132.04,83,,percent of total billed charges,,,151.14,95,,percent of total billed charges,,,143.18,90,,percent of total billed charges,,,143.18,90,,percent of total billed charges,,,130.45,82,,percent of total billed charges,,,143.18,90,,percent of total billed charges,,,135.23,85,,percent of total billed charges,,39.77,151.14,
DRESSING AQUACEL AG 4X5,30810122,CDM,,,270,RC,outpatient,,75.12,75.12,,63.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.78,22,,percent of total billed charges,,,,,,,,,67.61,90,,percent of total billed charges,,,62.2,82.8,,percent of total billed charges,,,63.85,85,,percent of total billed charges,,,,,,,,,66.11,88,,percent of total billed charges,,,,,,,,,57.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.78,22,,percent of total billed charges,,,68.36,91,,percent of total billed charges,,,71.36,95,,percent of total billed charges,,,62.35,83,,percent of total billed charges,,,62.35,83,,percent of total billed charges,,,,,,,,,,,,,,,62.35,83,,percent of total billed charges,,,71.36,95,,percent of total billed charges,,,67.61,90,,percent of total billed charges,,,67.61,90,,percent of total billed charges,,,61.6,82,,percent of total billed charges,,,67.61,90,,percent of total billed charges,,,63.85,85,,percent of total billed charges,,18.78,71.36,
DRESSING AQUACEL AG .75X18,30810123,CDM,,,270,RC,outpatient,,83.15,83.15,,70.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.79,22,,percent of total billed charges,,,,,,,,,74.84,90,,percent of total billed charges,,,68.85,82.8,,percent of total billed charges,,,70.68,85,,percent of total billed charges,,,,,,,,,73.17,88,,percent of total billed charges,,,,,,,,,63.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.79,22,,percent of total billed charges,,,75.67,91,,percent of total billed charges,,,78.99,95,,percent of total billed charges,,,69.01,83,,percent of total billed charges,,,69.01,83,,percent of total billed charges,,,,,,,,,,,,,,,69.01,83,,percent of total billed charges,,,78.99,95,,percent of total billed charges,,,74.84,90,,percent of total billed charges,,,74.84,90,,percent of total billed charges,,,68.18,82,,percent of total billed charges,,,74.84,90,,percent of total billed charges,,,70.68,85,,percent of total billed charges,,20.79,78.99,
DRESSING CONVAMAX 10X10CM SUPERABSORBER,30810124,CDM,,,270,RC,outpatient,,17.8,17.8,,15.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.45,22,,percent of total billed charges,,,,,,,,,16.02,90,,percent of total billed charges,,,14.74,82.8,,percent of total billed charges,,,15.13,85,,percent of total billed charges,,,,,,,,,15.66,88,,percent of total billed charges,,,,,,,,,13.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.45,22,,percent of total billed charges,,,16.2,91,,percent of total billed charges,,,16.91,95,,percent of total billed charges,,,14.77,83,,percent of total billed charges,,,14.77,83,,percent of total billed charges,,,,,,,,,,,,,,,14.77,83,,percent of total billed charges,,,16.91,95,,percent of total billed charges,,,16.02,90,,percent of total billed charges,,,16.02,90,,percent of total billed charges,,,14.6,82,,percent of total billed charges,,,16.02,90,,percent of total billed charges,,,15.13,85,,percent of total billed charges,,4.45,16.91,
COBAN 2 LAYER LITE COMPRESSION THERAPY,30813699,CDM,,,270,RC,outpatient,,83.25,83.25,,70.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.81,22,,percent of total billed charges,,,,,,,,,74.93,90,,percent of total billed charges,,,68.93,82.8,,percent of total billed charges,,,70.76,85,,percent of total billed charges,,,,,,,,,73.26,88,,percent of total billed charges,,,,,,,,,63.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.81,22,,percent of total billed charges,,,75.76,91,,percent of total billed charges,,,79.09,95,,percent of total billed charges,,,69.1,83,,percent of total billed charges,,,69.1,83,,percent of total billed charges,,,,,,,,,,,,,,,69.1,83,,percent of total billed charges,,,79.09,95,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,68.27,82,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,70.76,85,,percent of total billed charges,,20.81,79.09,
COBAN 2 LAYER SYSTEM COMPRESSION,30813700,CDM,,,270,RC,outpatient,,84.97,84.97,,72.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.24,22,,percent of total billed charges,,,,,,,,,76.47,90,,percent of total billed charges,,,70.36,82.8,,percent of total billed charges,,,72.22,85,,percent of total billed charges,,,,,,,,,74.77,88,,percent of total billed charges,,,,,,,,,64.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.24,22,,percent of total billed charges,,,77.32,91,,percent of total billed charges,,,80.72,95,,percent of total billed charges,,,70.53,83,,percent of total billed charges,,,70.53,83,,percent of total billed charges,,,,,,,,,,,,,,,70.53,83,,percent of total billed charges,,,80.72,95,,percent of total billed charges,,,76.47,90,,percent of total billed charges,,,76.47,90,,percent of total billed charges,,,69.68,82,,percent of total billed charges,,,76.47,90,,percent of total billed charges,,,72.22,85,,percent of total billed charges,,21.24,80.72,
* DIETARY CONSULTATION (V0406),5220032,CDM,99211,CPT,942,RC,outpatient,,91,91,,77.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.75,22,,percent of total billed charges,,,,,,,,,81.9,90,,percent of total billed charges,,,75.35,82.8,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,,,,,,,,80.08,88,,percent of total billed charges,,,,,,,,,69.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.75,22,,percent of total billed charges,,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,,,,,,,,,,,,,75.53,83,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,74.62,82,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,22.75,86.45,
O/P CONSULT DIABETIC NUTRITION 30 MIN,5220035,CDM,G0108,HCPCS,510,RC,outpatient,,182,182,,154.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.5,22,,percent of total billed charges,,,,,,,,,163.8,90,,percent of total billed charges,,,150.7,82.8,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,,,,,,,,160.16,88,,percent of total billed charges,,,,,,,,,139.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.5,22,,percent of total billed charges,,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,149.24,82,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,45.5,172.9,
MNT-RE-ASSESSMENT/INTERVENTION 15 MIN,5220040,CDM,97803,CPT,942,RC,outpatient,,95,95,,80.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.75,22,,percent of total billed charges,,,,,,,,,85.5,90,,percent of total billed charges,,,78.66,82.8,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,,,,,,,,83.6,88,,percent of total billed charges,,,,,,,,,72.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.75,22,,percent of total billed charges,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,,,,,,,,,,,,,78.85,83,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,77.9,82,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,23.75,90.25,
MNT-INIT ASSESSMENT/INTERVENTION 15 MIN,5220045,CDM,97802,CPT,942,RC,outpatient,,255,255,,216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.75,22,,percent of total billed charges,,,,,,,,,229.5,90,,percent of total billed charges,,,211.14,82.8,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,,,,,,,,224.4,88,,percent of total billed charges,,,,,,,,,194.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.75,22,,percent of total billed charges,,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,209.1,82,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,63.75,242.25,
* DIETARY ASSESSMENT (V0306),52999995,CDM,,,942,RC,outpatient,,32,32,,27.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8,22,,percent of total billed charges,,,,,,,,,28.8,90,,percent of total billed charges,,,26.5,82.8,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,,,,,,,,28.16,88,,percent of total billed charges,,,,,,,,,24.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8,22,,percent of total billed charges,,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,,,,,,,,,,,,,26.56,83,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,26.24,82,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,8,30.4,
STRESS TEST,12801639,CDM,93017,CPT,482,RC,outpatient,,1671,1671,,1418.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,417.75,22,,percent of total billed charges,,,,,,,,,1503.9,90,,percent of total billed charges,,,1383.59,82.8,,percent of total billed charges,,,1420.35,85,,percent of total billed charges,,,,,,,,,1470.48,88,,percent of total billed charges,,,,,,,,,1276.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,417.75,22,,percent of total billed charges,,,1520.61,91,,percent of total billed charges,,,1587.45,95,,percent of total billed charges,,,1386.93,83,,percent of total billed charges,,,1386.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1386.93,83,,percent of total billed charges,,,1587.45,95,,percent of total billed charges,,,1503.9,90,,percent of total billed charges,,,1503.9,90,,percent of total billed charges,,,1370.22,82,,percent of total billed charges,,,1503.9,90,,percent of total billed charges,,,1420.35,85,,percent of total billed charges,,417.75,1587.45,
X RHC ECG TRACING ONLY,14800001,CDM,93005,CPT,730,RC,outpatient,,140,140,,118.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35,22,,percent of total billed charges,,,,,,,,,126,90,,percent of total billed charges,,,115.92,82.8,,percent of total billed charges,,,119,85,,percent of total billed charges,,,,,,,,,123.2,88,,percent of total billed charges,,,,,,,,,106.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35,22,,percent of total billed charges,,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,133,95,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,114.8,82,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,35,133,
EVENT MONITOR HOOK-UP,14800276,CDM,93270,CPT,731,RC,outpatient,,870,870,,738.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,217.5,22,,percent of total billed charges,,,,,,,,,783,90,,percent of total billed charges,,,720.36,82.8,,percent of total billed charges,,,739.5,85,,percent of total billed charges,,,,,,,,,765.6,88,,percent of total billed charges,,,,,,,,,664.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,217.5,22,,percent of total billed charges,,,791.7,91,,percent of total billed charges,,,826.5,95,,percent of total billed charges,,,722.1,83,,percent of total billed charges,,,722.1,83,,percent of total billed charges,,,,,,,,,,,,,,,722.1,83,,percent of total billed charges,,,826.5,95,,percent of total billed charges,,,783,90,,percent of total billed charges,,,783,90,,percent of total billed charges,,,713.4,82,,percent of total billed charges,,,783,90,,percent of total billed charges,,,739.5,85,,percent of total billed charges,,217.5,826.5,
PAXT EKG 12 LEADS WITH INTERP,14800300,CDM,93000,CPT,730,RC,outpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.75,22,,percent of total billed charges,,,,,,,,,236.7,90,,percent of total billed charges,,,217.76,82.8,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.75,22,,percent of total billed charges,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,65.75,249.85,
PAXT EKG TRACING,14800305,CDM,93005,CPT,730,RC,outpatient,,480,480,,407.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,120,22,,percent of total billed charges,,,,,,,,,432,90,,percent of total billed charges,,,397.44,82.8,,percent of total billed charges,,,408,85,,percent of total billed charges,,,,,,,,,422.4,88,,percent of total billed charges,,,,,,,,,366.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,120,22,,percent of total billed charges,,,436.8,91,,percent of total billed charges,,,456,95,,percent of total billed charges,,,398.4,83,,percent of total billed charges,,,398.4,83,,percent of total billed charges,,,,,,,,,,,,,,,398.4,83,,percent of total billed charges,,,456,95,,percent of total billed charges,,,432,90,,percent of total billed charges,,,432,90,,percent of total billed charges,,,393.6,82,,percent of total billed charges,,,432,90,,percent of total billed charges,,,408,85,,percent of total billed charges,,120,456,
ZIO XT PATCH PLACEMENT 48 HOURS-7 DAYS,14800400,CDM,93243,CPT,731,RC,outpatient,,677,677,,574.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,169.25,22,,percent of total billed charges,,,,,,,,,609.3,90,,percent of total billed charges,,,560.56,82.8,,percent of total billed charges,,,575.45,85,,percent of total billed charges,,,,,,,,,595.76,88,,percent of total billed charges,,,,,,,,,517.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,169.25,22,,percent of total billed charges,,,616.07,91,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,,,,,,,,,,,,,561.91,83,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,555.14,82,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,575.45,85,,percent of total billed charges,,169.25,643.15,
ZIO XT PATCH PLACEMENT 7 DAYS UP TO 15,14800403,CDM,93247,CPT,731,RC,outpatient,,677,677,,574.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,169.25,22,,percent of total billed charges,,,,,,,,,609.3,90,,percent of total billed charges,,,560.56,82.8,,percent of total billed charges,,,575.45,85,,percent of total billed charges,,,,,,,,,595.76,88,,percent of total billed charges,,,,,,,,,517.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,169.25,22,,percent of total billed charges,,,616.07,91,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,,,,,,,,,,,,,561.91,83,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,555.14,82,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,575.45,85,,percent of total billed charges,,169.25,643.15,
ZIO XT PATCH PLCMENT 48 HOURS-7 DAYS IN,14800405,CDM,93242,CPT,731,RC,outpatient,,677,677,,574.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,169.25,22,,percent of total billed charges,,,,,,,,,609.3,90,,percent of total billed charges,,,560.56,82.8,,percent of total billed charges,,,575.45,85,,percent of total billed charges,,,,,,,,,595.76,88,,percent of total billed charges,,,,,,,,,517.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,169.25,22,,percent of total billed charges,,,616.07,91,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,,,,,,,,,,,,,561.91,83,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,555.14,82,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,575.45,85,,percent of total billed charges,,169.25,643.15,
ZIO XT PATCH PLCMT 7 DAYS UP TO 15 IN,14800406,CDM,93246,CPT,731,RC,outpatient,,677,677,,574.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,169.25,22,,percent of total billed charges,,,,,,,,,609.3,90,,percent of total billed charges,,,560.56,82.8,,percent of total billed charges,,,575.45,85,,percent of total billed charges,,,,,,,,,595.76,88,,percent of total billed charges,,,,,,,,,517.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,169.25,22,,percent of total billed charges,,,616.07,91,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,,,,,,,,,,,,,561.91,83,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,555.14,82,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,575.45,85,,percent of total billed charges,,169.25,643.15,
EEG COMA OR SLEEP ONLY,14801590,CDM,95822,CPT,740,RC,outpatient,TC,1881,1881,,1596.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,470.25,22,,percent of total billed charges,,,,,,,,,1692.9,90,,percent of total billed charges,,,1557.47,82.8,,percent of total billed charges,,,1598.85,85,,percent of total billed charges,,,,,,,,,1655.28,88,,percent of total billed charges,,,,,,,,,1437.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,470.25,22,,percent of total billed charges,,,1711.71,91,,percent of total billed charges,,,1786.95,95,,percent of total billed charges,,,1561.23,83,,percent of total billed charges,,,1561.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1561.23,83,,percent of total billed charges,,,1786.95,95,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1542.42,82,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1598.85,85,,percent of total billed charges,,470.25,1786.95,
EEG AWAKE AND DROWSY,14801591,CDM,95816,CPT,740,RC,outpatient,,2259,2259,,1917.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,564.75,22,,percent of total billed charges,,,,,,,,,2033.1,90,,percent of total billed charges,,,1870.45,82.8,,percent of total billed charges,,,1920.15,85,,percent of total billed charges,,,,,,,,,1987.92,88,,percent of total billed charges,,,,,,,,,1725.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,564.75,22,,percent of total billed charges,,,2055.69,91,,percent of total billed charges,,,2146.05,95,,percent of total billed charges,,,1874.97,83,,percent of total billed charges,,,1874.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1874.97,83,,percent of total billed charges,,,2146.05,95,,percent of total billed charges,,,2033.1,90,,percent of total billed charges,,,2033.1,90,,percent of total billed charges,,,1852.38,82,,percent of total billed charges,,,2033.1,90,,percent of total billed charges,,,1920.15,85,,percent of total billed charges,,564.75,2146.05,
EEG EXTENDED MONITORING 61-119 MINUTES,14801593,CDM,95813,CPT,740,RC,outpatient,TC,2332,2332,,1979.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,583,22,,percent of total billed charges,,,,,,,,,2098.8,90,,percent of total billed charges,,,1930.9,82.8,,percent of total billed charges,,,1982.2,85,,percent of total billed charges,,,,,,,,,2052.16,88,,percent of total billed charges,,,,,,,,,1781.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,583,22,,percent of total billed charges,,,2122.12,91,,percent of total billed charges,,,2215.4,95,,percent of total billed charges,,,1935.56,83,,percent of total billed charges,,,1935.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1935.56,83,,percent of total billed charges,,,2215.4,95,,percent of total billed charges,,,2098.8,90,,percent of total billed charges,,,2098.8,90,,percent of total billed charges,,,1912.24,82,,percent of total billed charges,,,2098.8,90,,percent of total billed charges,,,1982.2,85,,percent of total billed charges,,583,2215.4,
EEG EXTENDED MONITORING 41-60 MINUTES,14801594,CDM,95812,CPT,740,RC,outpatient,TC,1881,1881,,1596.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,470.25,22,,percent of total billed charges,,,,,,,,,1692.9,90,,percent of total billed charges,,,1557.47,82.8,,percent of total billed charges,,,1598.85,85,,percent of total billed charges,,,,,,,,,1655.28,88,,percent of total billed charges,,,,,,,,,1437.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,470.25,22,,percent of total billed charges,,,1711.71,91,,percent of total billed charges,,,1786.95,95,,percent of total billed charges,,,1561.23,83,,percent of total billed charges,,,1561.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1561.23,83,,percent of total billed charges,,,1786.95,95,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1542.42,82,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1598.85,85,,percent of total billed charges,,470.25,1786.95,
ELECTROCARDIOGRAM COMPLETE,14801595,CDM,93000,CPT,730,RC,outpatient,,572,572,,485.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,143,22,,percent of total billed charges,,,,,,,,,514.8,90,,percent of total billed charges,,,473.62,82.8,,percent of total billed charges,,,486.2,85,,percent of total billed charges,,,,,,,,,503.36,88,,percent of total billed charges,,,,,,,,,437.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,143,22,,percent of total billed charges,,,520.52,91,,percent of total billed charges,,,543.4,95,,percent of total billed charges,,,474.76,83,,percent of total billed charges,,,474.76,83,,percent of total billed charges,,,,,,,,,,,,,,,474.76,83,,percent of total billed charges,,,543.4,95,,percent of total billed charges,,,514.8,90,,percent of total billed charges,,,514.8,90,,percent of total billed charges,,,469.04,82,,percent of total billed charges,,,514.8,90,,percent of total billed charges,,,486.2,85,,percent of total billed charges,,143,543.4,
EKG,14801597,CDM,93005,CPT,730,RC,outpatient,XP,495,495,,420.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.75,22,,percent of total billed charges,,,,,,,,,445.5,90,,percent of total billed charges,,,409.86,82.8,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,,,,,,,,435.6,88,,percent of total billed charges,,,,,,,,,378.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.75,22,,percent of total billed charges,,,450.45,91,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,,,,,,,,,,,,,410.85,83,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,405.9,82,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,123.75,470.25,
CLINICS EKG,14801598,CDM,93000,CPT,730,RC,outpatient,,573,573,,486.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,143.25,22,,percent of total billed charges,,,,,,,,,515.7,90,,percent of total billed charges,,,474.44,82.8,,percent of total billed charges,,,487.05,85,,percent of total billed charges,,,,,,,,,504.24,88,,percent of total billed charges,,,,,,,,,437.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,143.25,22,,percent of total billed charges,,,521.43,91,,percent of total billed charges,,,544.35,95,,percent of total billed charges,,,475.59,83,,percent of total billed charges,,,475.59,83,,percent of total billed charges,,,,,,,,,,,,,,,475.59,83,,percent of total billed charges,,,544.35,95,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,469.86,82,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,487.05,85,,percent of total billed charges,,143.25,544.35,
EKG PAXTON MCR INITIAL PREVET EXAM,14801599,CDM,G0404,HCPCS,730,RC,outpatient,,573,573,,486.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,143.25,22,,percent of total billed charges,,,,,,,,,515.7,90,,percent of total billed charges,,,474.44,82.8,,percent of total billed charges,,,487.05,85,,percent of total billed charges,,,,,,,,,504.24,88,,percent of total billed charges,,,,,,,,,437.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,143.25,22,,percent of total billed charges,,,521.43,91,,percent of total billed charges,,,544.35,95,,percent of total billed charges,,,475.59,83,,percent of total billed charges,,,475.59,83,,percent of total billed charges,,,,,,,,,,,,,,,475.59,83,,percent of total billed charges,,,544.35,95,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,469.86,82,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,487.05,85,,percent of total billed charges,,143.25,544.35,
X RHC NDX HEART RATE VARIABILITY,14801600,CDM,95921,CPT,740,RC,outpatient,TC,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.25,22,,percent of total billed charges,,,,,,,,,94.5,90,,percent of total billed charges,,,86.94,82.8,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.25,22,,percent of total billed charges,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,26.25,99.75,
X RHC NDX HEART RATE VARIABILITY,14801601,CDM,95921,CPT,740,RC,outpatient,TC,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
RHYTHM STRIP,14801613,CDM,93041,CPT,730,RC,outpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45,22,,percent of total billed charges,,,,,,,,,162,90,,percent of total billed charges,,,149.04,82.8,,percent of total billed charges,,,153,85,,percent of total billed charges,,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45,22,,percent of total billed charges,,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,45,171,
HOLTER MONITOR SET UP AND RECORDING,14801622,CDM,93225,CPT,731,RC,outpatient,,870,870,,738.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,217.5,22,,percent of total billed charges,,,,,,,,,783,90,,percent of total billed charges,,,720.36,82.8,,percent of total billed charges,,,739.5,85,,percent of total billed charges,,,,,,,,,765.6,88,,percent of total billed charges,,,,,,,,,664.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,217.5,22,,percent of total billed charges,,,791.7,91,,percent of total billed charges,,,826.5,95,,percent of total billed charges,,,722.1,83,,percent of total billed charges,,,722.1,83,,percent of total billed charges,,,,,,,,,,,,,,,722.1,83,,percent of total billed charges,,,826.5,95,,percent of total billed charges,,,783,90,,percent of total billed charges,,,783,90,,percent of total billed charges,,,713.4,82,,percent of total billed charges,,,783,90,,percent of total billed charges,,,739.5,85,,percent of total billed charges,,217.5,826.5,
HOLTER MONITOR SCANNING,14801623,CDM,93226,CPT,731,RC,outpatient,,1031,1031,,875.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,257.75,22,,percent of total billed charges,,,,,,,,,927.9,90,,percent of total billed charges,,,853.67,82.8,,percent of total billed charges,,,876.35,85,,percent of total billed charges,,,,,,,,,907.28,88,,percent of total billed charges,,,,,,,,,787.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,257.75,22,,percent of total billed charges,,,938.21,91,,percent of total billed charges,,,979.45,95,,percent of total billed charges,,,855.73,83,,percent of total billed charges,,,855.73,83,,percent of total billed charges,,,,,,,,,,,,,,,855.73,83,,percent of total billed charges,,,979.45,95,,percent of total billed charges,,,927.9,90,,percent of total billed charges,,,927.9,90,,percent of total billed charges,,,845.42,82,,percent of total billed charges,,,927.9,90,,percent of total billed charges,,,876.35,85,,percent of total billed charges,,257.75,979.45,
*EKG- THOPIAH(V-8-17),14801625,CDM,93005,CPT,730,RC,outpatient,,495,495,,420.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.75,22,,percent of total billed charges,,,,,,,,,445.5,90,,percent of total billed charges,,,409.86,82.8,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,,,,,,,,435.6,88,,percent of total billed charges,,,,,,,,,378.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.75,22,,percent of total billed charges,,,450.45,91,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,,,,,,,,,,,,,410.85,83,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,405.9,82,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,123.75,470.25,
*INTERPRETATION OF EKG THOPIAH(V-8-17),14801626,CDM,93010,CPT,730,RC,outpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.5,22,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,64.58,82.8,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.5,22,,percent of total billed charges,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,19.5,74.1,
TILT TABLE TEST,14900001,CDM,93660,CPT,480,RC,outpatient,TC,3552,3552,,3015.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,888,22,,percent of total billed charges,,,,,,,,,3196.8,90,,percent of total billed charges,,,2941.06,82.8,,percent of total billed charges,,,3019.2,85,,percent of total billed charges,,,,,,,,,3125.76,88,,percent of total billed charges,,,,,,,,,2713.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,888,22,,percent of total billed charges,,,3232.32,91,,percent of total billed charges,,,3374.4,95,,percent of total billed charges,,,2948.16,83,,percent of total billed charges,,,2948.16,83,,percent of total billed charges,,,,,,,,,,,,,,,2948.16,83,,percent of total billed charges,,,3374.4,95,,percent of total billed charges,,,3196.8,90,,percent of total billed charges,,,3196.8,90,,percent of total billed charges,,,2912.64,82,,percent of total billed charges,,,3196.8,90,,percent of total billed charges,,,3019.2,85,,percent of total billed charges,,888,3374.4,
PRO FEE TILT TABLE,14900002,CDM,93660,CPT,480,RC,outpatient,26,515,515,,437.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,128.75,22,,percent of total billed charges,,,,,,,,,463.5,90,,percent of total billed charges,,,426.42,82.8,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,,,,,,,,453.2,88,,percent of total billed charges,,,,,,,,,393.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,128.75,22,,percent of total billed charges,,,468.65,91,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,,,,,,,,,,,,,427.45,83,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,422.3,82,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,128.75,489.25,
CLSED TREATMENT SHAFT FRACTURE EA,2050701,CDM,26725,CPT,450,RC,outpatient,,977,977,,829.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,244.25,22,,percent of total billed charges,,,,,,,,,879.3,90,,percent of total billed charges,,,808.96,82.8,,percent of total billed charges,,,830.45,85,,percent of total billed charges,,,,,,,,,859.76,88,,percent of total billed charges,,,,,,,,,746.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,244.25,22,,percent of total billed charges,,,889.07,91,,percent of total billed charges,,,928.15,95,,percent of total billed charges,,,810.91,83,,percent of total billed charges,,,810.91,83,,percent of total billed charges,,,,,,,,,,,,,,,810.91,83,,percent of total billed charges,,,928.15,95,,percent of total billed charges,,,879.3,90,,percent of total billed charges,,,879.3,90,,percent of total billed charges,,,801.14,82,,percent of total billed charges,,,879.3,90,,percent of total billed charges,,,830.45,85,,percent of total billed charges,,244.25,928.15,
FF MONITORING PRESSURE COMPART SYNDROME,18601170,CDM,20950,CPT,361,RC,outpatient,,874,874,,742.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.5,22,,percent of total billed charges,,,,,,,,,786.6,90,,percent of total billed charges,,,723.67,82.8,,percent of total billed charges,,,742.9,85,,percent of total billed charges,,,,,,,,,769.12,88,,percent of total billed charges,,,,,,,,,667.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.5,22,,percent of total billed charges,,,795.34,91,,percent of total billed charges,,,830.3,95,,percent of total billed charges,,,725.42,83,,percent of total billed charges,,,725.42,83,,percent of total billed charges,,,,,,,,,,,,,,,725.42,83,,percent of total billed charges,,,830.3,95,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,716.68,82,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,742.9,85,,percent of total billed charges,,218.5,830.3,
* GOWNS ER IV (V0306),20310037,CDM,,,270,RC,outpatient,,25,25,,21.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.25,22,,percent of total billed charges,,,,,,,,,22.5,90,,percent of total billed charges,,,20.7,82.8,,percent of total billed charges,,,21.25,85,,percent of total billed charges,,,,,,,,,22,88,,percent of total billed charges,,,,,,,,,19.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.25,22,,percent of total billed charges,,,22.75,91,,percent of total billed charges,,,23.75,95,,percent of total billed charges,,,20.75,83,,percent of total billed charges,,,20.75,83,,percent of total billed charges,,,,,,,,,,,,,,,20.75,83,,percent of total billed charges,,,23.75,95,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,20.5,82,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,21.25,85,,percent of total billed charges,,6.25,23.75,
PF CLOSED REDUCTION FINGER WO ANEST,20400112,CDM,26775,CPT,450,RC,outpatient,,484,484,,410.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,121,22,,percent of total billed charges,,,,,,,,,435.6,90,,percent of total billed charges,,,400.75,82.8,,percent of total billed charges,,,411.4,85,,percent of total billed charges,,,,,,,,,425.92,88,,percent of total billed charges,,,,,,,,,369.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,121,22,,percent of total billed charges,,,440.44,91,,percent of total billed charges,,,459.8,95,,percent of total billed charges,,,401.72,83,,percent of total billed charges,,,401.72,83,,percent of total billed charges,,,,,,,,,,,,,,,401.72,83,,percent of total billed charges,,,459.8,95,,percent of total billed charges,,,435.6,90,,percent of total billed charges,,,435.6,90,,percent of total billed charges,,,396.88,82,,percent of total billed charges,,,435.6,90,,percent of total billed charges,,,411.4,85,,percent of total billed charges,,121,459.8,
FF CLOSED TRTMT HIP DISLTN W ANESTHESIA,20500100,CDM,27252,CPT,450,RC,outpatient,,10960,10960,,9305.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2740,22,,percent of total billed charges,,,,,,,,,9864,90,,percent of total billed charges,,,9074.88,82.8,,percent of total billed charges,,,9316,85,,percent of total billed charges,,,,,,,,,9644.8,88,,percent of total billed charges,,,,,,,,,8373.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2740,22,,percent of total billed charges,,,9973.6,91,,percent of total billed charges,,,10412,95,,percent of total billed charges,,,9096.8,83,,percent of total billed charges,,,9096.8,83,,percent of total billed charges,,,,,,,,,,,,,,,9096.8,83,,percent of total billed charges,,,10412,95,,percent of total billed charges,,,9864,90,,percent of total billed charges,,,9864,90,,percent of total billed charges,,,8987.2,82,,percent of total billed charges,,,9864,90,,percent of total billed charges,,,9316,85,,percent of total billed charges,,2740,10412,
FF CLOSED TRTMT HIP DISLTN W ANETH,20500101,CDM,27252,CPT,450,RC,outpatient,,10960,10960,,9305.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2740,22,,percent of total billed charges,,,,,,,,,9864,90,,percent of total billed charges,,,9074.88,82.8,,percent of total billed charges,,,9316,85,,percent of total billed charges,,,,,,,,,9644.8,88,,percent of total billed charges,,,,,,,,,8373.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2740,22,,percent of total billed charges,,,9973.6,91,,percent of total billed charges,,,10412,95,,percent of total billed charges,,,9096.8,83,,percent of total billed charges,,,9096.8,83,,percent of total billed charges,,,,,,,,,,,,,,,9096.8,83,,percent of total billed charges,,,10412,95,,percent of total billed charges,,,9864,90,,percent of total billed charges,,,9864,90,,percent of total billed charges,,,8987.2,82,,percent of total billed charges,,,9864,90,,percent of total billed charges,,,9316,85,,percent of total billed charges,,2740,10412,
FF INJECTION INTO HEMORRHOID,20500102,CDM,46500,CPT,450,RC,outpatient,,5305,5305,,4503.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1326.25,22,,percent of total billed charges,,,,,,,,,4774.5,90,,percent of total billed charges,,,4392.54,82.8,,percent of total billed charges,,,4509.25,85,,percent of total billed charges,,,,,,,,,4668.4,88,,percent of total billed charges,,,,,,,,,4053.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1326.25,22,,percent of total billed charges,,,4827.55,91,,percent of total billed charges,,,5039.75,95,,percent of total billed charges,,,4403.15,83,,percent of total billed charges,,,4403.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4403.15,83,,percent of total billed charges,,,5039.75,95,,percent of total billed charges,,,4774.5,90,,percent of total billed charges,,,4774.5,90,,percent of total billed charges,,,4350.1,82,,percent of total billed charges,,,4774.5,90,,percent of total billed charges,,,4509.25,85,,percent of total billed charges,,1326.25,5039.75,
FF WOUND DEBRIDE OF SOFT TISSUE EACH ADD,20500103,CDM,11045,CPT,450,RC,outpatient,,1514,1514,,1285.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,378.5,22,,percent of total billed charges,,,,,,,,,1362.6,90,,percent of total billed charges,,,1253.59,82.8,,percent of total billed charges,,,1286.9,85,,percent of total billed charges,,,,,,,,,1332.32,88,,percent of total billed charges,,,,,,,,,1156.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,378.5,22,,percent of total billed charges,,,1377.74,91,,percent of total billed charges,,,1438.3,95,,percent of total billed charges,,,1256.62,83,,percent of total billed charges,,,1256.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1256.62,83,,percent of total billed charges,,,1438.3,95,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1241.48,82,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1286.9,85,,percent of total billed charges,,378.5,1438.3,
FF CLOSED TREATMENT NURSEMAID ELBOW,20500104,CDM,24640,CPT,450,RC,outpatient,,1171,1171,,994.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,292.75,22,,percent of total billed charges,,,,,,,,,1053.9,90,,percent of total billed charges,,,969.59,82.8,,percent of total billed charges,,,995.35,85,,percent of total billed charges,,,,,,,,,1030.48,88,,percent of total billed charges,,,,,,,,,894.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,292.75,22,,percent of total billed charges,,,1065.61,91,,percent of total billed charges,,,1112.45,95,,percent of total billed charges,,,971.93,83,,percent of total billed charges,,,971.93,83,,percent of total billed charges,,,,,,,,,,,,,,,971.93,83,,percent of total billed charges,,,1112.45,95,,percent of total billed charges,,,1053.9,90,,percent of total billed charges,,,1053.9,90,,percent of total billed charges,,,960.22,82,,percent of total billed charges,,,1053.9,90,,percent of total billed charges,,,995.35,85,,percent of total billed charges,,292.75,1112.45,
FF CLOSED REDUCTION CLAVICLE WO ANEST,20500105,CDM,23505,CPT,450,RC,outpatient,,1550,1550,,1315.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,387.5,22,,percent of total billed charges,,,,,,,,,1395,90,,percent of total billed charges,,,1283.4,82.8,,percent of total billed charges,,,1317.5,85,,percent of total billed charges,,,,,,,,,1364,88,,percent of total billed charges,,,,,,,,,1184.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,387.5,22,,percent of total billed charges,,,1410.5,91,,percent of total billed charges,,,1472.5,95,,percent of total billed charges,,,1286.5,83,,percent of total billed charges,,,1286.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1286.5,83,,percent of total billed charges,,,1472.5,95,,percent of total billed charges,,,1395,90,,percent of total billed charges,,,1395,90,,percent of total billed charges,,,1271,82,,percent of total billed charges,,,1395,90,,percent of total billed charges,,,1317.5,85,,percent of total billed charges,,387.5,1472.5,
FF APPLICATION OF LONG LEG CAST,20500106,CDM,29345,CPT,450,RC,outpatient,,1132,1132,,961.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,283,22,,percent of total billed charges,,,,,,,,,1018.8,90,,percent of total billed charges,,,937.3,82.8,,percent of total billed charges,,,962.2,85,,percent of total billed charges,,,,,,,,,996.16,88,,percent of total billed charges,,,,,,,,,864.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,283,22,,percent of total billed charges,,,1030.12,91,,percent of total billed charges,,,1075.4,95,,percent of total billed charges,,,939.56,83,,percent of total billed charges,,,939.56,83,,percent of total billed charges,,,,,,,,,,,,,,,939.56,83,,percent of total billed charges,,,1075.4,95,,percent of total billed charges,,,1018.8,90,,percent of total billed charges,,,1018.8,90,,percent of total billed charges,,,928.24,82,,percent of total billed charges,,,1018.8,90,,percent of total billed charges,,,962.2,85,,percent of total billed charges,,283,1075.4,
FF CLOSED REDUCTION FIBULA WO ANEST,20500107,CDM,27781,CPT,450,RC,outpatient,,5667,5667,,4811.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1416.75,22,,percent of total billed charges,,,,,,,,,5100.3,90,,percent of total billed charges,,,4692.28,82.8,,percent of total billed charges,,,4816.95,85,,percent of total billed charges,,,,,,,,,4986.96,88,,percent of total billed charges,,,,,,,,,4329.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1416.75,22,,percent of total billed charges,,,5156.97,91,,percent of total billed charges,,,5383.65,95,,percent of total billed charges,,,4703.61,83,,percent of total billed charges,,,4703.61,83,,percent of total billed charges,,,,,,,,,,,,,,,4703.61,83,,percent of total billed charges,,,5383.65,95,,percent of total billed charges,,,5100.3,90,,percent of total billed charges,,,5100.3,90,,percent of total billed charges,,,4646.94,82,,percent of total billed charges,,,5100.3,90,,percent of total billed charges,,,4816.95,85,,percent of total billed charges,,1416.75,5383.65,
FF CLOSED REDUCTION TIBIA W/O ANESTHESIA,20500108,CDM,27532,CPT,450,RC,outpatient,,10001,10001,,8490.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2500.25,22,,percent of total billed charges,,,,,,,,,9000.9,90,,percent of total billed charges,,,8280.83,82.8,,percent of total billed charges,,,8500.85,85,,percent of total billed charges,,,,,,,,,8800.88,88,,percent of total billed charges,,,,,,,,,7640.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2500.25,22,,percent of total billed charges,,,9100.91,91,,percent of total billed charges,,,9500.95,95,,percent of total billed charges,,,8300.83,83,,percent of total billed charges,,,8300.83,83,,percent of total billed charges,,,,,,,,,,,,,,,8300.83,83,,percent of total billed charges,,,9500.95,95,,percent of total billed charges,,,9000.9,90,,percent of total billed charges,,,9000.9,90,,percent of total billed charges,,,8200.82,82,,percent of total billed charges,,,9000.9,90,,percent of total billed charges,,,8500.85,85,,percent of total billed charges,,2500.25,9500.95,
FF OPEN TX INTERPHALANGEAL JOINT DISL,20500109,CDM,26765,CPT,450,RC,outpatient,,9315,9315,,7908.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2328.75,22,,percent of total billed charges,,,,,,,,,8383.5,90,,percent of total billed charges,,,7712.82,82.8,,percent of total billed charges,,,7917.75,85,,percent of total billed charges,,,,,,,,,8197.2,88,,percent of total billed charges,,,,,,,,,7116.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2328.75,22,,percent of total billed charges,,,8476.65,91,,percent of total billed charges,,,8849.25,95,,percent of total billed charges,,,7731.45,83,,percent of total billed charges,,,7731.45,83,,percent of total billed charges,,,,,,,,,,,,,,,7731.45,83,,percent of total billed charges,,,8849.25,95,,percent of total billed charges,,,8383.5,90,,percent of total billed charges,,,8383.5,90,,percent of total billed charges,,,7638.3,82,,percent of total billed charges,,,8383.5,90,,percent of total billed charges,,,7917.75,85,,percent of total billed charges,,2328.75,8849.25,
FF CLOSED REDUCTION ANKLE WO ANEST,20500110,CDM,27818,CPT,450,RC,outpatient,,2167,2167,,1839.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,541.75,22,,percent of total billed charges,,,,,,,,,1950.3,90,,percent of total billed charges,,,1794.28,82.8,,percent of total billed charges,,,1841.95,85,,percent of total billed charges,,,,,,,,,1906.96,88,,percent of total billed charges,,,,,,,,,1655.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,541.75,22,,percent of total billed charges,,,1971.97,91,,percent of total billed charges,,,2058.65,95,,percent of total billed charges,,,1798.61,83,,percent of total billed charges,,,1798.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1798.61,83,,percent of total billed charges,,,2058.65,95,,percent of total billed charges,,,1950.3,90,,percent of total billed charges,,,1950.3,90,,percent of total billed charges,,,1776.94,82,,percent of total billed charges,,,1950.3,90,,percent of total billed charges,,,1841.95,85,,percent of total billed charges,,541.75,2058.65,
FF CLOSED RED POST HIP ARTH W ANETH,20500111,CDM,27266,CPT,450,RC,outpatient,,5769,5769,,4897.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1442.25,22,,percent of total billed charges,,,,,,,,,5192.1,90,,percent of total billed charges,,,4776.73,82.8,,percent of total billed charges,,,4903.65,85,,percent of total billed charges,,,,,,,,,5076.72,88,,percent of total billed charges,,,,,,,,,4407.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1442.25,22,,percent of total billed charges,,,5249.79,91,,percent of total billed charges,,,5480.55,95,,percent of total billed charges,,,4788.27,83,,percent of total billed charges,,,4788.27,83,,percent of total billed charges,,,,,,,,,,,,,,,4788.27,83,,percent of total billed charges,,,5480.55,95,,percent of total billed charges,,,5192.1,90,,percent of total billed charges,,,5192.1,90,,percent of total billed charges,,,4730.58,82,,percent of total billed charges,,,5192.1,90,,percent of total billed charges,,,4903.65,85,,percent of total billed charges,,1442.25,5480.55,
FF DRAINAGE OF FINGER ABSCESS,20500112,CDM,26010,CPT,450,RC,outpatient,,1088,1088,,923.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,272,22,,percent of total billed charges,,,,,,,,,979.2,90,,percent of total billed charges,,,900.86,82.8,,percent of total billed charges,,,924.8,85,,percent of total billed charges,,,,,,,,,957.44,88,,percent of total billed charges,,,,,,,,,831.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,272,22,,percent of total billed charges,,,990.08,91,,percent of total billed charges,,,1033.6,95,,percent of total billed charges,,,903.04,83,,percent of total billed charges,,,903.04,83,,percent of total billed charges,,,,,,,,,,,,,,,903.04,83,,percent of total billed charges,,,1033.6,95,,percent of total billed charges,,,979.2,90,,percent of total billed charges,,,979.2,90,,percent of total billed charges,,,892.16,82,,percent of total billed charges,,,979.2,90,,percent of total billed charges,,,924.8,85,,percent of total billed charges,,272,1033.6,
FF I&D PERIANAL ABSCESS SUPERFICIAL,20500113,CDM,46050,CPT,450,RC,outpatient,,4499,4499,,3819.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1124.75,22,,percent of total billed charges,,,,,,,,,4049.1,90,,percent of total billed charges,,,3725.17,82.8,,percent of total billed charges,,,3824.15,85,,percent of total billed charges,,,,,,,,,3959.12,88,,percent of total billed charges,,,,,,,,,3437.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1124.75,22,,percent of total billed charges,,,4094.09,91,,percent of total billed charges,,,4274.05,95,,percent of total billed charges,,,3734.17,83,,percent of total billed charges,,,3734.17,83,,percent of total billed charges,,,,,,,,,,,,,,,3734.17,83,,percent of total billed charges,,,4274.05,95,,percent of total billed charges,,,4049.1,90,,percent of total billed charges,,,4049.1,90,,percent of total billed charges,,,3689.18,82,,percent of total billed charges,,,4049.1,90,,percent of total billed charges,,,3824.15,85,,percent of total billed charges,,1124.75,4274.05,
FF DRAINAGE OF ABDOMEN ABSCESS,20500114,CDM,49020,CPT,450,RC,outpatient,,7671,7671,,6512.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1917.75,22,,percent of total billed charges,,,,,,,,,6903.9,90,,percent of total billed charges,,,6351.59,82.8,,percent of total billed charges,,,6520.35,85,,percent of total billed charges,,,,,,,,,6750.48,88,,percent of total billed charges,,,,,,,,,5860.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1917.75,22,,percent of total billed charges,,,6980.61,91,,percent of total billed charges,,,7287.45,95,,percent of total billed charges,,,6366.93,83,,percent of total billed charges,,,6366.93,83,,percent of total billed charges,,,,,,,,,,,,,,,6366.93,83,,percent of total billed charges,,,7287.45,95,,percent of total billed charges,,,6903.9,90,,percent of total billed charges,,,6903.9,90,,percent of total billed charges,,,6290.22,82,,percent of total billed charges,,,6903.9,90,,percent of total billed charges,,,6520.35,85,,percent of total billed charges,,1917.75,7287.45,
FF CLSD TR FRACTURE RADIUS/ULNA,20500115,CDM,25600,CPT,450,RC,outpatient,,1138,1138,,966.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.5,22,,percent of total billed charges,,,,,,,,,1024.2,90,,percent of total billed charges,,,942.26,82.8,,percent of total billed charges,,,967.3,85,,percent of total billed charges,,,,,,,,,1001.44,88,,percent of total billed charges,,,,,,,,,869.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.5,22,,percent of total billed charges,,,1035.58,91,,percent of total billed charges,,,1081.1,95,,percent of total billed charges,,,944.54,83,,percent of total billed charges,,,944.54,83,,percent of total billed charges,,,,,,,,,,,,,,,944.54,83,,percent of total billed charges,,,1081.1,95,,percent of total billed charges,,,1024.2,90,,percent of total billed charges,,,1024.2,90,,percent of total billed charges,,,933.16,82,,percent of total billed charges,,,1024.2,90,,percent of total billed charges,,,967.3,85,,percent of total billed charges,,284.5,1081.1,
FF ABN PARACENTESIS W/O IMAGING GUIDANCE,20500116,CDM,49082,CPT,450,RC,outpatient,,2725,2725,,2313.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,681.25,22,,percent of total billed charges,,,,,,,,,2452.5,90,,percent of total billed charges,,,2256.3,82.8,,percent of total billed charges,,,2316.25,85,,percent of total billed charges,,,,,,,,,2398,88,,percent of total billed charges,,,,,,,,,2081.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,681.25,22,,percent of total billed charges,,,2479.75,91,,percent of total billed charges,,,2588.75,95,,percent of total billed charges,,,2261.75,83,,percent of total billed charges,,,2261.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2261.75,83,,percent of total billed charges,,,2588.75,95,,percent of total billed charges,,,2452.5,90,,percent of total billed charges,,,2452.5,90,,percent of total billed charges,,,2234.5,82,,percent of total billed charges,,,2452.5,90,,percent of total billed charges,,,2316.25,85,,percent of total billed charges,,681.25,2588.75,
FF IRRIGATION CORPORA CAVERNOSA PRIAPISM,20500117,CDM,54220,CPT,450,RC,outpatient,,1307,1307,,1109.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,326.75,22,,percent of total billed charges,,,,,,,,,1176.3,90,,percent of total billed charges,,,1082.2,82.8,,percent of total billed charges,,,1110.95,85,,percent of total billed charges,,,,,,,,,1150.16,88,,percent of total billed charges,,,,,,,,,998.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,326.75,22,,percent of total billed charges,,,1189.37,91,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1084.81,83,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1071.74,82,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1110.95,85,,percent of total billed charges,,326.75,1241.65,
FF REPAIR BLOOD VESSEL LESION,20500118,CDM,35226,CPT,450,RC,outpatient,,1563,1563,,1326.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,390.75,22,,percent of total billed charges,,,,,,,,,1406.7,90,,percent of total billed charges,,,1294.16,82.8,,percent of total billed charges,,,1328.55,85,,percent of total billed charges,,,,,,,,,1375.44,88,,percent of total billed charges,,,,,,,,,1194.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,390.75,22,,percent of total billed charges,,,1422.33,91,,percent of total billed charges,,,1484.85,95,,percent of total billed charges,,,1297.29,83,,percent of total billed charges,,,1297.29,83,,percent of total billed charges,,,,,,,,,,,,,,,1297.29,83,,percent of total billed charges,,,1484.85,95,,percent of total billed charges,,,1406.7,90,,percent of total billed charges,,,1406.7,90,,percent of total billed charges,,,1281.66,82,,percent of total billed charges,,,1406.7,90,,percent of total billed charges,,,1328.55,85,,percent of total billed charges,,390.75,1484.85,
FF REMOVAL OF FOREIGN BODY ANUS,20500119,CDM,46999,CPT,450,RC,outpatient,,2254,2254,,1913.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,563.5,22,,percent of total billed charges,,,,,,,,,2028.6,90,,percent of total billed charges,,,1866.31,82.8,,percent of total billed charges,,,1915.9,85,,percent of total billed charges,,,,,,,,,1983.52,88,,percent of total billed charges,,,,,,,,,1722.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,563.5,22,,percent of total billed charges,,,2051.14,91,,percent of total billed charges,,,2141.3,95,,percent of total billed charges,,,1870.82,83,,percent of total billed charges,,,1870.82,83,,percent of total billed charges,,,,,,,,,,,,,,,1870.82,83,,percent of total billed charges,,,2141.3,95,,percent of total billed charges,,,2028.6,90,,percent of total billed charges,,,2028.6,90,,percent of total billed charges,,,1848.28,82,,percent of total billed charges,,,2028.6,90,,percent of total billed charges,,,1915.9,85,,percent of total billed charges,,563.5,2141.3,
EXTENDED RECOVERY 1ST HOUR,20500200,CDM,,,710,RC,outpatient,,737,737,,625.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,184.25,22,,percent of total billed charges,,,,,,,,,663.3,90,,percent of total billed charges,,,610.24,82.8,,percent of total billed charges,,,626.45,85,,percent of total billed charges,,,,,,,,,648.56,88,,percent of total billed charges,,,,,,,,,563.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,184.25,22,,percent of total billed charges,,,670.67,91,,percent of total billed charges,,,700.15,95,,percent of total billed charges,,,611.71,83,,percent of total billed charges,,,611.71,83,,percent of total billed charges,,,,,,,,,,,,,,,611.71,83,,percent of total billed charges,,,700.15,95,,percent of total billed charges,,,663.3,90,,percent of total billed charges,,,663.3,90,,percent of total billed charges,,,604.34,82,,percent of total billed charges,,,663.3,90,,percent of total billed charges,,,626.45,85,,percent of total billed charges,,184.25,700.15,
EXTENDED RECOVERY EACH ADDTL HOUR,20500201,CDM,,,710,RC,outpatient,,458,458,,388.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,114.5,22,,percent of total billed charges,,,,,,,,,412.2,90,,percent of total billed charges,,,379.22,82.8,,percent of total billed charges,,,389.3,85,,percent of total billed charges,,,,,,,,,403.04,88,,percent of total billed charges,,,,,,,,,349.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,114.5,22,,percent of total billed charges,,,416.78,91,,percent of total billed charges,,,435.1,95,,percent of total billed charges,,,380.14,83,,percent of total billed charges,,,380.14,83,,percent of total billed charges,,,,,,,,,,,,,,,380.14,83,,percent of total billed charges,,,435.1,95,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,375.56,82,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,389.3,85,,percent of total billed charges,,114.5,435.1,
FF ADMINISTRATION PNU VACCINE,20500330,CDM,G0009,HCPCS,771,RC,outpatient,,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.25,22,,percent of total billed charges,,,,,,,,,155.7,90,,percent of total billed charges,,,143.24,82.8,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.25,22,,percent of total billed charges,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,43.25,164.35,
FF ADMINISTRATION FLU VACCINE,20500348,CDM,G0008,HCPCS,771,RC,outpatient,,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.25,22,,percent of total billed charges,,,,,,,,,155.7,90,,percent of total billed charges,,,143.24,82.8,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.25,22,,percent of total billed charges,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,43.25,164.35,
FF DRUG SCREENING COLLECTION,20500355,CDM,80306,CPT,300,RC,outpatient,,395,395,,335.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.75,22,,percent of total billed charges,,,,,,,,,355.5,90,,percent of total billed charges,,,327.06,82.8,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,,,,,,,,347.6,88,,percent of total billed charges,,,,,,,,,301.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.75,22,,percent of total billed charges,,,359.45,91,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,,,,,,,,,,,,,327.85,83,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,323.9,82,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,98.75,375.25,
FF ER VISIT LEVEL 2,20500371,CDM,99282,CPT,450,RC,outpatient,,1538,1538,,1305.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.5,22,,percent of total billed charges,,,,,,,,,1384.2,90,,percent of total billed charges,,,1273.46,82.8,,percent of total billed charges,,,1307.3,85,,percent of total billed charges,,,,,,,,,1353.44,88,,percent of total billed charges,,,,,,,,,1175.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.5,22,,percent of total billed charges,,,1399.58,91,,percent of total billed charges,,,1461.1,95,,percent of total billed charges,,,1276.54,83,,percent of total billed charges,,,1276.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1276.54,83,,percent of total billed charges,,,1461.1,95,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1261.16,82,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1307.3,85,,percent of total billed charges,,384.5,1461.1,
FF INCISION DRAINEG BARTHO GLND ABCESS,20500380,CDM,56420,CPT,450,RC,outpatient,,984,984,,835.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,246,22,,percent of total billed charges,,,,,,,,,885.6,90,,percent of total billed charges,,,814.75,82.8,,percent of total billed charges,,,836.4,85,,percent of total billed charges,,,,,,,,,865.92,88,,percent of total billed charges,,,,,,,,,751.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,246,22,,percent of total billed charges,,,895.44,91,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,,,,,,,,,,,,,816.72,83,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,806.88,82,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,836.4,85,,percent of total billed charges,,246,934.8,
FF CAST REMOVAL,20500389,CDM,29700,CPT,450,RC,outpatient,,415,415,,352.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,103.75,22,,percent of total billed charges,,,,,,,,,373.5,90,,percent of total billed charges,,,343.62,82.8,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,,,,,,,,365.2,88,,percent of total billed charges,,,,,,,,,317.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,103.75,22,,percent of total billed charges,,,377.65,91,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,,,,,,,,,,,,,344.45,83,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,340.3,82,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,103.75,394.25,
TREATMENT ROOM NEW PATIENT - ED,20500390,CDM,99202,CPT,761,RC,outpatient,,329,329,,279.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.25,22,,percent of total billed charges,,,,,,,,,296.1,90,,percent of total billed charges,,,272.41,82.8,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,,,,,,,,289.52,88,,percent of total billed charges,,,,,,,,,251.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82.25,22,,percent of total billed charges,,,299.39,91,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,,,,,,,,,,,,,273.07,83,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,269.78,82,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,82.25,312.55,
FF INSERT NON-INDWELLING BLADDER CATH,20500395,CDM,51701,CPT,450,RC,outpatient,,252,252,,213.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63,22,,percent of total billed charges,,,,,,,,,226.8,90,,percent of total billed charges,,,208.66,82.8,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,,,,,,,,221.76,88,,percent of total billed charges,,,,,,,,,192.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63,22,,percent of total billed charges,,,229.32,91,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,,,,,,,,,,,,,209.16,83,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,206.64,82,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,63,239.4,
TREATMENT ROOM- ED,20500398,CDM,G0463,HCPCS,761,RC,outpatient,,641,641,,544.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,160.25,22,,percent of total billed charges,,,,,,,,,576.9,90,,percent of total billed charges,,,530.75,82.8,,percent of total billed charges,,,544.85,85,,percent of total billed charges,,,,,,,,,564.08,88,,percent of total billed charges,,,,,,,,,489.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,160.25,22,,percent of total billed charges,,,583.31,91,,percent of total billed charges,,,608.95,95,,percent of total billed charges,,,532.03,83,,percent of total billed charges,,,532.03,83,,percent of total billed charges,,,,,,,,,,,,,,,532.03,83,,percent of total billed charges,,,608.95,95,,percent of total billed charges,,,576.9,90,,percent of total billed charges,,,576.9,90,,percent of total billed charges,,,525.62,82,,percent of total billed charges,,,576.9,90,,percent of total billed charges,,,544.85,85,,percent of total billed charges,,160.25,608.95,
FF CLSD TR DISTAL RADIAL WITH MANIPULAT,20500400,CDM,25605,CPT,450,RC,outpatient,,2970,2970,,2521.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,742.5,22,,percent of total billed charges,,,,,,,,,2673,90,,percent of total billed charges,,,2459.16,82.8,,percent of total billed charges,,,2524.5,85,,percent of total billed charges,,,,,,,,,2613.6,88,,percent of total billed charges,,,,,,,,,2269.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,742.5,22,,percent of total billed charges,,,2702.7,91,,percent of total billed charges,,,2821.5,95,,percent of total billed charges,,,2465.1,83,,percent of total billed charges,,,2465.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2465.1,83,,percent of total billed charges,,,2821.5,95,,percent of total billed charges,,,2673,90,,percent of total billed charges,,,2673,90,,percent of total billed charges,,,2435.4,82,,percent of total billed charges,,,2673,90,,percent of total billed charges,,,2524.5,85,,percent of total billed charges,,742.5,2821.5,
FF ER VISIT LEVEL 5,20500413,CDM,99285,CPT,450,RC,outpatient,,5624,5624,,4774.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1406,22,,percent of total billed charges,,,,,,,,,5061.6,90,,percent of total billed charges,,,4656.67,82.8,,percent of total billed charges,,,4780.4,85,,percent of total billed charges,,,,,,,,,4949.12,88,,percent of total billed charges,,,,,,,,,4296.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1406,22,,percent of total billed charges,,,5117.84,91,,percent of total billed charges,,,5342.8,95,,percent of total billed charges,,,4667.92,83,,percent of total billed charges,,,4667.92,83,,percent of total billed charges,,,,,,,,,,,,,,,4667.92,83,,percent of total billed charges,,,5342.8,95,,percent of total billed charges,,,5061.6,90,,percent of total billed charges,,,5061.6,90,,percent of total billed charges,,,4611.68,82,,percent of total billed charges,,,5061.6,90,,percent of total billed charges,,,4780.4,85,,percent of total billed charges,,1406,5342.8,
FF ER VISIT LEVEL 1,20500421,CDM,99281,CPT,450,RC,outpatient,,893,893,,758.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,223.25,22,,percent of total billed charges,,,,,,,,,803.7,90,,percent of total billed charges,,,739.4,82.8,,percent of total billed charges,,,759.05,85,,percent of total billed charges,,,,,,,,,785.84,88,,percent of total billed charges,,,,,,,,,682.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,223.25,22,,percent of total billed charges,,,812.63,91,,percent of total billed charges,,,848.35,95,,percent of total billed charges,,,741.19,83,,percent of total billed charges,,,741.19,83,,percent of total billed charges,,,,,,,,,,,,,,,741.19,83,,percent of total billed charges,,,848.35,95,,percent of total billed charges,,,803.7,90,,percent of total billed charges,,,803.7,90,,percent of total billed charges,,,732.26,82,,percent of total billed charges,,,803.7,90,,percent of total billed charges,,,759.05,85,,percent of total billed charges,,223.25,848.35,
FF ER VISIT LEVEL 3,20500454,CDM,99283,CPT,450,RC,outpatient,,2358,2358,,2001.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,589.5,22,,percent of total billed charges,,,,,,,,,2122.2,90,,percent of total billed charges,,,1952.42,82.8,,percent of total billed charges,,,2004.3,85,,percent of total billed charges,,,,,,,,,2075.04,88,,percent of total billed charges,,,,,,,,,1801.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,589.5,22,,percent of total billed charges,,,2145.78,91,,percent of total billed charges,,,2240.1,95,,percent of total billed charges,,,1957.14,83,,percent of total billed charges,,,1957.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1957.14,83,,percent of total billed charges,,,2240.1,95,,percent of total billed charges,,,2122.2,90,,percent of total billed charges,,,2122.2,90,,percent of total billed charges,,,1933.56,82,,percent of total billed charges,,,2122.2,90,,percent of total billed charges,,,2004.3,85,,percent of total billed charges,,589.5,2240.1,
FF ER VISIT LEVEL 4,20500462,CDM,99284,CPT,450,RC,outpatient,,3766,3766,,3197.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,941.5,22,,percent of total billed charges,,,,,,,,,3389.4,90,,percent of total billed charges,,,3118.25,82.8,,percent of total billed charges,,,3201.1,85,,percent of total billed charges,,,,,,,,,3314.08,88,,percent of total billed charges,,,,,,,,,2877.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,941.5,22,,percent of total billed charges,,,3427.06,91,,percent of total billed charges,,,3577.7,95,,percent of total billed charges,,,3125.78,83,,percent of total billed charges,,,3125.78,83,,percent of total billed charges,,,,,,,,,,,,,,,3125.78,83,,percent of total billed charges,,,3577.7,95,,percent of total billed charges,,,3389.4,90,,percent of total billed charges,,,3389.4,90,,percent of total billed charges,,,3088.12,82,,percent of total billed charges,,,3389.4,90,,percent of total billed charges,,,3201.1,85,,percent of total billed charges,,941.5,3577.7,
* FF CO2 MONITOR USAGE (V1104),20500488,CDM,,,270,RC,outpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.75,22,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,48.85,82.8,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,,,,,,,,51.92,88,,percent of total billed charges,,,,,,,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.75,22,,percent of total billed charges,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,14.75,56.05,
FF MONITORING PRESSURE COMPART SYNDROME,20500490,CDM,20950,CPT,450,RC,outpatient,,1048,1048,,889.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,262,22,,percent of total billed charges,,,,,,,,,943.2,90,,percent of total billed charges,,,867.74,82.8,,percent of total billed charges,,,890.8,85,,percent of total billed charges,,,,,,,,,922.24,88,,percent of total billed charges,,,,,,,,,800.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,262,22,,percent of total billed charges,,,953.68,91,,percent of total billed charges,,,995.6,95,,percent of total billed charges,,,869.84,83,,percent of total billed charges,,,869.84,83,,percent of total billed charges,,,,,,,,,,,,,,,869.84,83,,percent of total billed charges,,,995.6,95,,percent of total billed charges,,,943.2,90,,percent of total billed charges,,,943.2,90,,percent of total billed charges,,,859.36,82,,percent of total billed charges,,,943.2,90,,percent of total billed charges,,,890.8,85,,percent of total billed charges,,262,995.6,
FF BONE MARROW NEEDLE BIOPSY,20500500,CDM,38221,CPT,450,RC,outpatient,,1960,1960,,1664.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,490,22,,percent of total billed charges,,,,,,,,,1764,90,,percent of total billed charges,,,1622.88,82.8,,percent of total billed charges,,,1666,85,,percent of total billed charges,,,,,,,,,1724.8,88,,percent of total billed charges,,,,,,,,,1497.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,490,22,,percent of total billed charges,,,1783.6,91,,percent of total billed charges,,,1862,95,,percent of total billed charges,,,1626.8,83,,percent of total billed charges,,,1626.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1626.8,83,,percent of total billed charges,,,1862,95,,percent of total billed charges,,,1764,90,,percent of total billed charges,,,1764,90,,percent of total billed charges,,,1607.2,82,,percent of total billed charges,,,1764,90,,percent of total billed charges,,,1666,85,,percent of total billed charges,,490,1862,
FF THORACENTESIS,20500511,CDM,32554,CPT,450,RC,outpatient,,2536,2536,,2153.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,634,22,,percent of total billed charges,,,,,,,,,2282.4,90,,percent of total billed charges,,,2099.81,82.8,,percent of total billed charges,,,2155.6,85,,percent of total billed charges,,,,,,,,,2231.68,88,,percent of total billed charges,,,,,,,,,1937.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,634,22,,percent of total billed charges,,,2307.76,91,,percent of total billed charges,,,2409.2,95,,percent of total billed charges,,,2104.88,83,,percent of total billed charges,,,2104.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2104.88,83,,percent of total billed charges,,,2409.2,95,,percent of total billed charges,,,2282.4,90,,percent of total billed charges,,,2282.4,90,,percent of total billed charges,,,2079.52,82,,percent of total billed charges,,,2282.4,90,,percent of total billed charges,,,2155.6,85,,percent of total billed charges,,634,2409.2,
FF BLOOD ADMINISTRATION SERVICE,20500530,CDM,36430,CPT,391,RC,outpatient,,1766,1766,,1499.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,441.5,22,,percent of total billed charges,,,,,,,,,1589.4,90,,percent of total billed charges,,,1462.25,82.8,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,,,,,,,,1554.08,88,,percent of total billed charges,,,,,,,,,1349.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,441.5,22,,percent of total billed charges,,,1607.06,91,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.78,83,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1448.12,82,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,441.5,1677.7,
FF BLOOD ADMIN UP TO 4 HOURS(V-11-20),20500531,CDM,36430,CPT,391,RC,outpatient,,2764,2764,,2346.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,691,22,,percent of total billed charges,,,,,,,,,2487.6,90,,percent of total billed charges,,,2288.59,82.8,,percent of total billed charges,,,2349.4,85,,percent of total billed charges,,,,,,,,,2432.32,88,,percent of total billed charges,,,,,,,,,2111.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,691,22,,percent of total billed charges,,,2515.24,91,,percent of total billed charges,,,2625.8,95,,percent of total billed charges,,,2294.12,83,,percent of total billed charges,,,2294.12,83,,percent of total billed charges,,,,,,,,,,,,,,,2294.12,83,,percent of total billed charges,,,2625.8,95,,percent of total billed charges,,,2487.6,90,,percent of total billed charges,,,2487.6,90,,percent of total billed charges,,,2266.48,82,,percent of total billed charges,,,2487.6,90,,percent of total billed charges,,,2349.4,85,,percent of total billed charges,,691,2625.8,
FF BLOOD ADMIN UP TO 6 HOURS(V-11-20),20500532,CDM,36430,CPT,391,RC,outpatient,,2179,2179,,1849.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,544.75,22,,percent of total billed charges,,,,,,,,,1961.1,90,,percent of total billed charges,,,1804.21,82.8,,percent of total billed charges,,,1852.15,85,,percent of total billed charges,,,,,,,,,1917.52,88,,percent of total billed charges,,,,,,,,,1664.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,544.75,22,,percent of total billed charges,,,1982.89,91,,percent of total billed charges,,,2070.05,95,,percent of total billed charges,,,1808.57,83,,percent of total billed charges,,,1808.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1808.57,83,,percent of total billed charges,,,2070.05,95,,percent of total billed charges,,,1961.1,90,,percent of total billed charges,,,1961.1,90,,percent of total billed charges,,,1786.78,82,,percent of total billed charges,,,1961.1,90,,percent of total billed charges,,,1852.15,85,,percent of total billed charges,,544.75,2070.05,
FF BLOOD ADMIN OVER 6 HOURS(V-11-20),20500533,CDM,36430,CPT,391,RC,outpatient,,3322,3322,,2820.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,830.5,22,,percent of total billed charges,,,,,,,,,2989.8,90,,percent of total billed charges,,,2750.62,82.8,,percent of total billed charges,,,2823.7,85,,percent of total billed charges,,,,,,,,,2923.36,88,,percent of total billed charges,,,,,,,,,2538.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,830.5,22,,percent of total billed charges,,,3023.02,91,,percent of total billed charges,,,3155.9,95,,percent of total billed charges,,,2757.26,83,,percent of total billed charges,,,2757.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2757.26,83,,percent of total billed charges,,,3155.9,95,,percent of total billed charges,,,2989.8,90,,percent of total billed charges,,,2989.8,90,,percent of total billed charges,,,2724.04,82,,percent of total billed charges,,,2989.8,90,,percent of total billed charges,,,2823.7,85,,percent of total billed charges,,830.5,3155.9,
FF URETHRA CATHETERIZATION,20500535,CDM,51702,CPT,450,RC,outpatient,,635,635,,539.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,158.75,22,,percent of total billed charges,,,,,,,,,571.5,90,,percent of total billed charges,,,525.78,82.8,,percent of total billed charges,,,539.75,85,,percent of total billed charges,,,,,,,,,558.8,88,,percent of total billed charges,,,,,,,,,485.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,158.75,22,,percent of total billed charges,,,577.85,91,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,,,,,,,,,,,,,527.05,83,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,520.7,82,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,539.75,85,,percent of total billed charges,,158.75,603.25,
FF GASTROSTOMY TUBE CHANGE,20500540,CDM,43762,CPT,450,RC,outpatient,,826,826,,701.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.5,22,,percent of total billed charges,,,,,,,,,743.4,90,,percent of total billed charges,,,683.93,82.8,,percent of total billed charges,,,702.1,85,,percent of total billed charges,,,,,,,,,726.88,88,,percent of total billed charges,,,,,,,,,631.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.5,22,,percent of total billed charges,,,751.66,91,,percent of total billed charges,,,784.7,95,,percent of total billed charges,,,685.58,83,,percent of total billed charges,,,685.58,83,,percent of total billed charges,,,,,,,,,,,,,,,685.58,83,,percent of total billed charges,,,784.7,95,,percent of total billed charges,,,743.4,90,,percent of total billed charges,,,743.4,90,,percent of total billed charges,,,677.32,82,,percent of total billed charges,,,743.4,90,,percent of total billed charges,,,702.1,85,,percent of total billed charges,,206.5,784.7,
"FF IV INFUSION, HYDRATION, UP TO 1 HOUR",20500560,CDM,96360,CPT,450,RC,outpatient,XU,1000,1000,,849,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,250,22,,percent of total billed charges,,,,,,,,,900,90,,percent of total billed charges,,,828,82.8,,percent of total billed charges,,,850,85,,percent of total billed charges,,,,,,,,,880,88,,percent of total billed charges,,,,,,,,,764,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,250,22,,percent of total billed charges,,,910,91,,percent of total billed charges,,,950,95,,percent of total billed charges,,,830,83,,percent of total billed charges,,,830,83,,percent of total billed charges,,,,,,,,,,,,,,,830,83,,percent of total billed charges,,,950,95,,percent of total billed charges,,,900,90,,percent of total billed charges,,,900,90,,percent of total billed charges,,,820,82,,percent of total billed charges,,,900,90,,percent of total billed charges,,,850,85,,percent of total billed charges,,250,950,
"FF IV INFUSION, HYDRATION, ADDT'L HOUR",20500561,CDM,96361,CPT,450,RC,outpatient,XU,302,302,,256.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.5,22,,percent of total billed charges,,,,,,,,,271.8,90,,percent of total billed charges,,,250.06,82.8,,percent of total billed charges,,,256.7,85,,percent of total billed charges,,,,,,,,,265.76,88,,percent of total billed charges,,,,,,,,,230.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.5,22,,percent of total billed charges,,,274.82,91,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,,,,,,,,,,,,,250.66,83,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,247.64,82,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,256.7,85,,percent of total billed charges,,75.5,286.9,
"FF IV INFUSION, THERAPEUTIC, UP TO 1 HR",20500562,CDM,96365,CPT,450,RC,outpatient,XU,1000,1000,,849,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,250,22,,percent of total billed charges,,,,,,,,,900,90,,percent of total billed charges,,,828,82.8,,percent of total billed charges,,,850,85,,percent of total billed charges,,,,,,,,,880,88,,percent of total billed charges,,,,,,,,,764,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,250,22,,percent of total billed charges,,,910,91,,percent of total billed charges,,,950,95,,percent of total billed charges,,,830,83,,percent of total billed charges,,,830,83,,percent of total billed charges,,,,,,,,,,,,,,,830,83,,percent of total billed charges,,,950,95,,percent of total billed charges,,,900,90,,percent of total billed charges,,,900,90,,percent of total billed charges,,,820,82,,percent of total billed charges,,,900,90,,percent of total billed charges,,,850,85,,percent of total billed charges,,250,950,
"FF IV INFUSION, THERAPEUTIC, ADDT'L HR",20500563,CDM,96366,CPT,450,RC,outpatient,XU,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
FF CONCURRENT ADDTL MEDICATED SOLUTION,20500564,CDM,96368,CPT,450,RC,outpatient,XU,653,653,,554.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,163.25,22,,percent of total billed charges,,,,,,,,,587.7,90,,percent of total billed charges,,,540.68,82.8,,percent of total billed charges,,,555.05,85,,percent of total billed charges,,,,,,,,,574.64,88,,percent of total billed charges,,,,,,,,,498.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,163.25,22,,percent of total billed charges,,,594.23,91,,percent of total billed charges,,,620.35,95,,percent of total billed charges,,,541.99,83,,percent of total billed charges,,,541.99,83,,percent of total billed charges,,,,,,,,,,,,,,,541.99,83,,percent of total billed charges,,,620.35,95,,percent of total billed charges,,,587.7,90,,percent of total billed charges,,,587.7,90,,percent of total billed charges,,,535.46,82,,percent of total billed charges,,,587.7,90,,percent of total billed charges,,,555.05,85,,percent of total billed charges,,163.25,620.35,
"FF IVP, SINGLE OR INITIAL",20500565,CDM,96374,CPT,450,RC,outpatient,XU,523,523,,444.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.75,22,,percent of total billed charges,,,,,,,,,470.7,90,,percent of total billed charges,,,433.04,82.8,,percent of total billed charges,,,444.55,85,,percent of total billed charges,,,,,,,,,460.24,88,,percent of total billed charges,,,,,,,,,399.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.75,22,,percent of total billed charges,,,475.93,91,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,,,,,,,,,,,,,434.09,83,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,428.86,82,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,444.55,85,,percent of total billed charges,,130.75,496.85,
"FF IVP, EA ADDTL NEW SUBSTANCE/DRUG",20500566,CDM,96375,CPT,450,RC,outpatient,XU,431,431,,365.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.75,22,,percent of total billed charges,,,,,,,,,387.9,90,,percent of total billed charges,,,356.87,82.8,,percent of total billed charges,,,366.35,85,,percent of total billed charges,,,,,,,,,379.28,88,,percent of total billed charges,,,,,,,,,329.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.75,22,,percent of total billed charges,,,392.21,91,,percent of total billed charges,,,409.45,95,,percent of total billed charges,,,357.73,83,,percent of total billed charges,,,357.73,83,,percent of total billed charges,,,,,,,,,,,,,,,357.73,83,,percent of total billed charges,,,409.45,95,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,353.42,82,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,366.35,85,,percent of total billed charges,,107.75,409.45,
FF IM/SQ INJECTION,20500567,CDM,96372,CPT,450,RC,outpatient,XU,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.75,22,,percent of total billed charges,,,,,,,,,449.1,90,,percent of total billed charges,,,413.17,82.8,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.75,22,,percent of total billed charges,,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,124.75,474.05,
FF IVP SEQUENTIAL SAME SUBSTANCE,20500570,CDM,96376,CPT,450,RC,outpatient,XU,373,373,,316.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.25,22,,percent of total billed charges,,,,,,,,,335.7,90,,percent of total billed charges,,,308.84,82.8,,percent of total billed charges,,,317.05,85,,percent of total billed charges,,,,,,,,,328.24,88,,percent of total billed charges,,,,,,,,,284.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.25,22,,percent of total billed charges,,,339.43,91,,percent of total billed charges,,,354.35,95,,percent of total billed charges,,,309.59,83,,percent of total billed charges,,,309.59,83,,percent of total billed charges,,,,,,,,,,,,,,,309.59,83,,percent of total billed charges,,,354.35,95,,percent of total billed charges,,,335.7,90,,percent of total billed charges,,,335.7,90,,percent of total billed charges,,,305.86,82,,percent of total billed charges,,,335.7,90,,percent of total billed charges,,,317.05,85,,percent of total billed charges,,93.25,354.35,
FF IN DWELLING CATHETER FOLEY,20500705,CDM,51702,CPT,450,RC,outpatient,,490,490,,416.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.5,22,,percent of total billed charges,,,,,,,,,441,90,,percent of total billed charges,,,405.72,82.8,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,,,,,,,,431.2,88,,percent of total billed charges,,,,,,,,,374.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.5,22,,percent of total billed charges,,,445.9,91,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,,,,,,,,,,,,,406.7,83,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,401.8,82,,percent of total billed charges,,,441,90,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,122.5,465.5,
FF CRITICAL CARE ADDITIONAL 30 MIN,20500708,CDM,99292,CPT,450,RC,outpatient,,1052,1052,,893.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,263,22,,percent of total billed charges,,,,,,,,,946.8,90,,percent of total billed charges,,,871.06,82.8,,percent of total billed charges,,,894.2,85,,percent of total billed charges,,,,,,,,,925.76,88,,percent of total billed charges,,,,,,,,,803.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,263,22,,percent of total billed charges,,,957.32,91,,percent of total billed charges,,,999.4,95,,percent of total billed charges,,,873.16,83,,percent of total billed charges,,,873.16,83,,percent of total billed charges,,,,,,,,,,,,,,,873.16,83,,percent of total billed charges,,,999.4,95,,percent of total billed charges,,,946.8,90,,percent of total billed charges,,,946.8,90,,percent of total billed charges,,,862.64,82,,percent of total billed charges,,,946.8,90,,percent of total billed charges,,,894.2,85,,percent of total billed charges,,263,999.4,
FF IMMUNIZATION ADMINISTRATION,20500720,CDM,90471,CPT,450,RC,outpatient,,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.75,22,,percent of total billed charges,,,,,,,,,449.1,90,,percent of total billed charges,,,413.17,82.8,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.75,22,,percent of total billed charges,,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,124.75,474.05,
FF CLOSED TREATMNT OF FIBULA FRACTURE WO,20500780,CDM,27780,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
COMPLEX UROFLOWMETRY,20500785,CDM,51741,CPT,450,RC,outpatient,,1662,1662,,1411.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,415.5,22,,percent of total billed charges,,,,,,,,,1495.8,90,,percent of total billed charges,,,1376.14,82.8,,percent of total billed charges,,,1412.7,85,,percent of total billed charges,,,,,,,,,1462.56,88,,percent of total billed charges,,,,,,,,,1269.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,415.5,22,,percent of total billed charges,,,1512.42,91,,percent of total billed charges,,,1578.9,95,,percent of total billed charges,,,1379.46,83,,percent of total billed charges,,,1379.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1379.46,83,,percent of total billed charges,,,1578.9,95,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1362.84,82,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1412.7,85,,percent of total billed charges,,415.5,1578.9,
MEASUR POST VOID URINE ULTRASOUND,20500786,CDM,51798,CPT,450,RC,outpatient,,335,335,,284.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.75,22,,percent of total billed charges,,,,,,,,,301.5,90,,percent of total billed charges,,,277.38,82.8,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,,,,,,,,294.8,88,,percent of total billed charges,,,,,,,,,255.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.75,22,,percent of total billed charges,,,304.85,91,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,,,,,,,,,,,,,278.05,83,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,274.7,82,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,83.75,318.25,
FF SUTURE REPAIR VAGINAL TEAR  NON OB,20500789,CDM,57200,CPT,450,RC,outpatient,,4941,4941,,4194.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1235.25,22,,percent of total billed charges,,,,,,,,,4446.9,90,,percent of total billed charges,,,4091.15,82.8,,percent of total billed charges,,,4199.85,85,,percent of total billed charges,,,,,,,,,4348.08,88,,percent of total billed charges,,,,,,,,,3774.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1235.25,22,,percent of total billed charges,,,4496.31,91,,percent of total billed charges,,,4693.95,95,,percent of total billed charges,,,4101.03,83,,percent of total billed charges,,,4101.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4101.03,83,,percent of total billed charges,,,4693.95,95,,percent of total billed charges,,,4446.9,90,,percent of total billed charges,,,4446.9,90,,percent of total billed charges,,,4051.62,82,,percent of total billed charges,,,4446.9,90,,percent of total billed charges,,,4199.85,85,,percent of total billed charges,,1235.25,4693.95,
FF ASPIRATION OF BREAST,20500790,CDM,19000,CPT,450,RC,outpatient,,1157,1157,,982.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,289.25,22,,percent of total billed charges,,,,,,,,,1041.3,90,,percent of total billed charges,,,958,82.8,,percent of total billed charges,,,983.45,85,,percent of total billed charges,,,,,,,,,1018.16,88,,percent of total billed charges,,,,,,,,,883.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,289.25,22,,percent of total billed charges,,,1052.87,91,,percent of total billed charges,,,1099.15,95,,percent of total billed charges,,,960.31,83,,percent of total billed charges,,,960.31,83,,percent of total billed charges,,,,,,,,,,,,,,,960.31,83,,percent of total billed charges,,,1099.15,95,,percent of total billed charges,,,1041.3,90,,percent of total billed charges,,,1041.3,90,,percent of total billed charges,,,948.74,82,,percent of total billed charges,,,1041.3,90,,percent of total billed charges,,,983.45,85,,percent of total billed charges,,289.25,1099.15,
FF ASP/INJ GANGLION CYST,20500791,CDM,20612,CPT,450,RC,outpatient,,1943,1943,,1649.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,485.75,22,,percent of total billed charges,,,,,,,,,1748.7,90,,percent of total billed charges,,,1608.8,82.8,,percent of total billed charges,,,1651.55,85,,percent of total billed charges,,,,,,,,,1709.84,88,,percent of total billed charges,,,,,,,,,1484.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,485.75,22,,percent of total billed charges,,,1768.13,91,,percent of total billed charges,,,1845.85,95,,percent of total billed charges,,,1612.69,83,,percent of total billed charges,,,1612.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1612.69,83,,percent of total billed charges,,,1845.85,95,,percent of total billed charges,,,1748.7,90,,percent of total billed charges,,,1748.7,90,,percent of total billed charges,,,1593.26,82,,percent of total billed charges,,,1748.7,90,,percent of total billed charges,,,1651.55,85,,percent of total billed charges,,485.75,1845.85,
FF EVACUATION OF SUBUNGUAL HEMATOMA,20500799,CDM,11740,CPT,450,RC,outpatient,,543,543,,461.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,135.75,22,,percent of total billed charges,,,,,,,,,488.7,90,,percent of total billed charges,,,449.6,82.8,,percent of total billed charges,,,461.55,85,,percent of total billed charges,,,,,,,,,477.84,88,,percent of total billed charges,,,,,,,,,414.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,135.75,22,,percent of total billed charges,,,494.13,91,,percent of total billed charges,,,515.85,95,,percent of total billed charges,,,450.69,83,,percent of total billed charges,,,450.69,83,,percent of total billed charges,,,,,,,,,,,,,,,450.69,83,,percent of total billed charges,,,515.85,95,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,445.26,82,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,461.55,85,,percent of total billed charges,,135.75,515.85,
FF ARTHRO/ASP/INJ MAJOR JT OR BURSA,20500800,CDM,20610,CPT,450,RC,outpatient,TC,2329,2329,,1977.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,582.25,22,,percent of total billed charges,,,,,,,,,2096.1,90,,percent of total billed charges,,,1928.41,82.8,,percent of total billed charges,,,1979.65,85,,percent of total billed charges,,,,,,,,,2049.52,88,,percent of total billed charges,,,,,,,,,1779.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,582.25,22,,percent of total billed charges,,,2119.39,91,,percent of total billed charges,,,2212.55,95,,percent of total billed charges,,,1933.07,83,,percent of total billed charges,,,1933.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1933.07,83,,percent of total billed charges,,,2212.55,95,,percent of total billed charges,,,2096.1,90,,percent of total billed charges,,,2096.1,90,,percent of total billed charges,,,1909.78,82,,percent of total billed charges,,,2096.1,90,,percent of total billed charges,,,1979.65,85,,percent of total billed charges,,582.25,2212.55,
FF ASPIRATION OF HEMATOMA,20500801,CDM,10160,CPT,450,RC,outpatient,,627,627,,532.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,156.75,22,,percent of total billed charges,,,,,,,,,564.3,90,,percent of total billed charges,,,519.16,82.8,,percent of total billed charges,,,532.95,85,,percent of total billed charges,,,,,,,,,551.76,88,,percent of total billed charges,,,,,,,,,479.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,156.75,22,,percent of total billed charges,,,570.57,91,,percent of total billed charges,,,595.65,95,,percent of total billed charges,,,520.41,83,,percent of total billed charges,,,520.41,83,,percent of total billed charges,,,,,,,,,,,,,,,520.41,83,,percent of total billed charges,,,595.65,95,,percent of total billed charges,,,564.3,90,,percent of total billed charges,,,564.3,90,,percent of total billed charges,,,514.14,82,,percent of total billed charges,,,564.3,90,,percent of total billed charges,,,532.95,85,,percent of total billed charges,,156.75,595.65,
FF BURN DRESSING DEBRIDEMENT SMALL,20500802,CDM,16020,CPT,450,RC,outpatient,,1139,1139,,967.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.75,22,,percent of total billed charges,,,,,,,,,1025.1,90,,percent of total billed charges,,,943.09,82.8,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,,,,,,,,1002.32,88,,percent of total billed charges,,,,,,,,,870.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.75,22,,percent of total billed charges,,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,,,,,,,,,,,,,945.37,83,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,933.98,82,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,284.75,1082.05,
FF BURN DRESSING LARGE,20500803,CDM,16030,CPT,450,RC,outpatient,,1366,1366,,1159.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,341.5,22,,percent of total billed charges,,,,,,,,,1229.4,90,,percent of total billed charges,,,1131.05,82.8,,percent of total billed charges,,,1161.1,85,,percent of total billed charges,,,,,,,,,1202.08,88,,percent of total billed charges,,,,,,,,,1043.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,341.5,22,,percent of total billed charges,,,1243.06,91,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1133.78,83,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1120.12,82,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1161.1,85,,percent of total billed charges,,341.5,1297.7,
FF BURN SIMPLE TREATMENT,20500804,CDM,16000,CPT,450,RC,outpatient,,761,761,,646.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,190.25,22,,percent of total billed charges,,,,,,,,,684.9,90,,percent of total billed charges,,,630.11,82.8,,percent of total billed charges,,,646.85,85,,percent of total billed charges,,,,,,,,,669.68,88,,percent of total billed charges,,,,,,,,,581.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,190.25,22,,percent of total billed charges,,,692.51,91,,percent of total billed charges,,,722.95,95,,percent of total billed charges,,,631.63,83,,percent of total billed charges,,,631.63,83,,percent of total billed charges,,,,,,,,,,,,,,,631.63,83,,percent of total billed charges,,,722.95,95,,percent of total billed charges,,,684.9,90,,percent of total billed charges,,,684.9,90,,percent of total billed charges,,,624.02,82,,percent of total billed charges,,,684.9,90,,percent of total billed charges,,,646.85,85,,percent of total billed charges,,190.25,722.95,
FF CAST REMOVAL LONG LEG ARM,20500805,CDM,29705,CPT,450,RC,outpatient,,415,415,,352.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,103.75,22,,percent of total billed charges,,,,,,,,,373.5,90,,percent of total billed charges,,,343.62,82.8,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,,,,,,,,365.2,88,,percent of total billed charges,,,,,,,,,317.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,103.75,22,,percent of total billed charges,,,377.65,91,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,,,,,,,,,,,,,344.45,83,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,340.3,82,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,103.75,394.25,
FF CATHETERIZ URINARY COMPLEX,20500806,CDM,51703,CPT,450,RC,outpatient,,442,442,,375.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.5,22,,percent of total billed charges,,,,,,,,,397.8,90,,percent of total billed charges,,,365.98,82.8,,percent of total billed charges,,,375.7,85,,percent of total billed charges,,,,,,,,,388.96,88,,percent of total billed charges,,,,,,,,,337.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.5,22,,percent of total billed charges,,,402.22,91,,percent of total billed charges,,,419.9,95,,percent of total billed charges,,,366.86,83,,percent of total billed charges,,,366.86,83,,percent of total billed charges,,,,,,,,,,,,,,,366.86,83,,percent of total billed charges,,,419.9,95,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,362.44,82,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,375.7,85,,percent of total billed charges,,110.5,419.9,
FF CLOSED TRTMT HIP DISLTN WO ANESTHESIA,20500807,CDM,27250,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
FF CRITICAL CARE 30-74 MIN,20500808,CDM,99291,CPT,450,RC,outpatient,,6834,6834,,5802.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1708.5,22,,percent of total billed charges,,,,,,,,,6150.6,90,,percent of total billed charges,,,5658.55,82.8,,percent of total billed charges,,,5808.9,85,,percent of total billed charges,,,,,,,,,6013.92,88,,percent of total billed charges,,,,,,,,,5221.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1708.5,22,,percent of total billed charges,,,6218.94,91,,percent of total billed charges,,,6492.3,95,,percent of total billed charges,,,5672.22,83,,percent of total billed charges,,,5672.22,83,,percent of total billed charges,,,,,,,,,,,,,,,5672.22,83,,percent of total billed charges,,,6492.3,95,,percent of total billed charges,,,6150.6,90,,percent of total billed charges,,,6150.6,90,,percent of total billed charges,,,5603.88,82,,percent of total billed charges,,,6150.6,90,,percent of total billed charges,,,5808.9,85,,percent of total billed charges,,1708.5,6492.3,
FF CV CATHETER PLACEMENT,20500809,CDM,36556,CPT,450,RC,outpatient,,2953,2953,,2507.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,738.25,22,,percent of total billed charges,,,,,,,,,2657.7,90,,percent of total billed charges,,,2445.08,82.8,,percent of total billed charges,,,2510.05,85,,percent of total billed charges,,,,,,,,,2598.64,88,,percent of total billed charges,,,,,,,,,2256.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,738.25,22,,percent of total billed charges,,,2687.23,91,,percent of total billed charges,,,2805.35,95,,percent of total billed charges,,,2450.99,83,,percent of total billed charges,,,2450.99,83,,percent of total billed charges,,,,,,,,,,,,,,,2450.99,83,,percent of total billed charges,,,2805.35,95,,percent of total billed charges,,,2657.7,90,,percent of total billed charges,,,2657.7,90,,percent of total billed charges,,,2421.46,82,,percent of total billed charges,,,2657.7,90,,percent of total billed charges,,,2510.05,85,,percent of total billed charges,,738.25,2805.35,
FF WOUND DEBRIDE OF SOFT TISSUE FIRST 20,20500810,CDM,11042,CPT,450,RC,outpatient,,3359,3359,,2851.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,839.75,22,,percent of total billed charges,,,,,,,,,3023.1,90,,percent of total billed charges,,,2781.25,82.8,,percent of total billed charges,,,2855.15,85,,percent of total billed charges,,,,,,,,,2955.92,88,,percent of total billed charges,,,,,,,,,2566.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,839.75,22,,percent of total billed charges,,,3056.69,91,,percent of total billed charges,,,3191.05,95,,percent of total billed charges,,,2787.97,83,,percent of total billed charges,,,2787.97,83,,percent of total billed charges,,,,,,,,,,,,,,,2787.97,83,,percent of total billed charges,,,3191.05,95,,percent of total billed charges,,,3023.1,90,,percent of total billed charges,,,3023.1,90,,percent of total billed charges,,,2754.38,82,,percent of total billed charges,,,3023.1,90,,percent of total billed charges,,,2855.15,85,,percent of total billed charges,,839.75,3191.05,
FF CLSED TRT ULNAR RADL SHFT W/O MANIP,20500811,CDM,25560,CPT,450,RC,outpatient,,984,984,,835.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,246,22,,percent of total billed charges,,,,,,,,,885.6,90,,percent of total billed charges,,,814.75,82.8,,percent of total billed charges,,,836.4,85,,percent of total billed charges,,,,,,,,,865.92,88,,percent of total billed charges,,,,,,,,,751.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,246,22,,percent of total billed charges,,,895.44,91,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,,,,,,,,,,,,,816.72,83,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,806.88,82,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,836.4,85,,percent of total billed charges,,246,934.8,
FF ENDOTRACHEAL INTUBATION,20500812,CDM,31500,CPT,450,RC,outpatient,,2052,2052,,1742.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,513,22,,percent of total billed charges,,,,,,,,,1846.8,90,,percent of total billed charges,,,1699.06,82.8,,percent of total billed charges,,,1744.2,85,,percent of total billed charges,,,,,,,,,1805.76,88,,percent of total billed charges,,,,,,,,,1567.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,513,22,,percent of total billed charges,,,1867.32,91,,percent of total billed charges,,,1949.4,95,,percent of total billed charges,,,1703.16,83,,percent of total billed charges,,,1703.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1703.16,83,,percent of total billed charges,,,1949.4,95,,percent of total billed charges,,,1846.8,90,,percent of total billed charges,,,1846.8,90,,percent of total billed charges,,,1682.64,82,,percent of total billed charges,,,1846.8,90,,percent of total billed charges,,,1744.2,85,,percent of total billed charges,,513,1949.4,
FF ER TRACH CRICOTHYROID,20500813,CDM,31605,CPT,450,RC,outpatient,,2903,2903,,2464.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,725.75,22,,percent of total billed charges,,,,,,,,,2612.7,90,,percent of total billed charges,,,2403.68,82.8,,percent of total billed charges,,,2467.55,85,,percent of total billed charges,,,,,,,,,2554.64,88,,percent of total billed charges,,,,,,,,,2217.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,725.75,22,,percent of total billed charges,,,2641.73,91,,percent of total billed charges,,,2757.85,95,,percent of total billed charges,,,2409.49,83,,percent of total billed charges,,,2409.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2409.49,83,,percent of total billed charges,,,2757.85,95,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2380.46,82,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2467.55,85,,percent of total billed charges,,725.75,2757.85,
FF ER TRACH TRANSTRACHEAL,20500814,CDM,31603,CPT,450,RC,outpatient,,2903,2903,,2464.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,725.75,22,,percent of total billed charges,,,,,,,,,2612.7,90,,percent of total billed charges,,,2403.68,82.8,,percent of total billed charges,,,2467.55,85,,percent of total billed charges,,,,,,,,,2554.64,88,,percent of total billed charges,,,,,,,,,2217.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,725.75,22,,percent of total billed charges,,,2641.73,91,,percent of total billed charges,,,2757.85,95,,percent of total billed charges,,,2409.49,83,,percent of total billed charges,,,2409.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2409.49,83,,percent of total billed charges,,,2757.85,95,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2380.46,82,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2467.55,85,,percent of total billed charges,,725.75,2757.85,
FF FC EAR NOSE LYR > 30 CM,20500815,CDM,12057,CPT,450,RC,outpatient,,1914,1914,,1624.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,478.5,22,,percent of total billed charges,,,,,,,,,1722.6,90,,percent of total billed charges,,,1584.79,82.8,,percent of total billed charges,,,1626.9,85,,percent of total billed charges,,,,,,,,,1684.32,88,,percent of total billed charges,,,,,,,,,1462.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,478.5,22,,percent of total billed charges,,,1741.74,91,,percent of total billed charges,,,1818.3,95,,percent of total billed charges,,,1588.62,83,,percent of total billed charges,,,1588.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1588.62,83,,percent of total billed charges,,,1818.3,95,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1569.48,82,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1626.9,85,,percent of total billed charges,,478.5,1818.3,
FF FC EAR NOSE LYR 0 TO 2.5 CM,20500816,CDM,12051,CPT,450,RC,outpatient,,1737,1737,,1474.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,434.25,22,,percent of total billed charges,,,,,,,,,1563.3,90,,percent of total billed charges,,,1438.24,82.8,,percent of total billed charges,,,1476.45,85,,percent of total billed charges,,,,,,,,,1528.56,88,,percent of total billed charges,,,,,,,,,1327.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,434.25,22,,percent of total billed charges,,,1580.67,91,,percent of total billed charges,,,1650.15,95,,percent of total billed charges,,,1441.71,83,,percent of total billed charges,,,1441.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1441.71,83,,percent of total billed charges,,,1650.15,95,,percent of total billed charges,,,1563.3,90,,percent of total billed charges,,,1563.3,90,,percent of total billed charges,,,1424.34,82,,percent of total billed charges,,,1563.3,90,,percent of total billed charges,,,1476.45,85,,percent of total billed charges,,434.25,1650.15,
FF FC EAR NOSE LYR 12.6 TO 20 CM,20500817,CDM,12055,CPT,450,RC,outpatient,,856,856,,726.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214,22,,percent of total billed charges,,,,,,,,,770.4,90,,percent of total billed charges,,,708.77,82.8,,percent of total billed charges,,,727.6,85,,percent of total billed charges,,,,,,,,,753.28,88,,percent of total billed charges,,,,,,,,,653.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214,22,,percent of total billed charges,,,778.96,91,,percent of total billed charges,,,813.2,95,,percent of total billed charges,,,710.48,83,,percent of total billed charges,,,710.48,83,,percent of total billed charges,,,,,,,,,,,,,,,710.48,83,,percent of total billed charges,,,813.2,95,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,701.92,82,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,727.6,85,,percent of total billed charges,,214,813.2,
FF FC EAR NOSE LYR 2.6 TO 5.0 CM,20500818,CDM,12052,CPT,450,RC,outpatient,,1398,1398,,1186.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,349.5,22,,percent of total billed charges,,,,,,,,,1258.2,90,,percent of total billed charges,,,1157.54,82.8,,percent of total billed charges,,,1188.3,85,,percent of total billed charges,,,,,,,,,1230.24,88,,percent of total billed charges,,,,,,,,,1068.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,349.5,22,,percent of total billed charges,,,1272.18,91,,percent of total billed charges,,,1328.1,95,,percent of total billed charges,,,1160.34,83,,percent of total billed charges,,,1160.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1160.34,83,,percent of total billed charges,,,1328.1,95,,percent of total billed charges,,,1258.2,90,,percent of total billed charges,,,1258.2,90,,percent of total billed charges,,,1146.36,82,,percent of total billed charges,,,1258.2,90,,percent of total billed charges,,,1188.3,85,,percent of total billed charges,,349.5,1328.1,
FF FC EAR NOSE LYR 20.1 TO 30 CM,20500819,CDM,12056,CPT,450,RC,outpatient,,922,922,,782.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,230.5,22,,percent of total billed charges,,,,,,,,,829.8,90,,percent of total billed charges,,,763.42,82.8,,percent of total billed charges,,,783.7,85,,percent of total billed charges,,,,,,,,,811.36,88,,percent of total billed charges,,,,,,,,,704.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,230.5,22,,percent of total billed charges,,,839.02,91,,percent of total billed charges,,,875.9,95,,percent of total billed charges,,,765.26,83,,percent of total billed charges,,,765.26,83,,percent of total billed charges,,,,,,,,,,,,,,,765.26,83,,percent of total billed charges,,,875.9,95,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,756.04,82,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,783.7,85,,percent of total billed charges,,230.5,875.9,
FF FC EAR NOSE LYR 5.1 TO 7.5 CM,20500820,CDM,12053,CPT,450,RC,outpatient,,1554,1554,,1319.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,388.5,22,,percent of total billed charges,,,,,,,,,1398.6,90,,percent of total billed charges,,,1286.71,82.8,,percent of total billed charges,,,1320.9,85,,percent of total billed charges,,,,,,,,,1367.52,88,,percent of total billed charges,,,,,,,,,1187.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,388.5,22,,percent of total billed charges,,,1414.14,91,,percent of total billed charges,,,1476.3,95,,percent of total billed charges,,,1289.82,83,,percent of total billed charges,,,1289.82,83,,percent of total billed charges,,,,,,,,,,,,,,,1289.82,83,,percent of total billed charges,,,1476.3,95,,percent of total billed charges,,,1398.6,90,,percent of total billed charges,,,1398.6,90,,percent of total billed charges,,,1274.28,82,,percent of total billed charges,,,1398.6,90,,percent of total billed charges,,,1320.9,85,,percent of total billed charges,,388.5,1476.3,
FF FC EAR NOSE LYR 7.6 TO 12.5 CM,20500821,CDM,12054,CPT,450,RC,outpatient,,1622,1622,,1377.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,405.5,22,,percent of total billed charges,,,,,,,,,1459.8,90,,percent of total billed charges,,,1343.02,82.8,,percent of total billed charges,,,1378.7,85,,percent of total billed charges,,,,,,,,,1427.36,88,,percent of total billed charges,,,,,,,,,1239.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,405.5,22,,percent of total billed charges,,,1476.02,91,,percent of total billed charges,,,1540.9,95,,percent of total billed charges,,,1346.26,83,,percent of total billed charges,,,1346.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1346.26,83,,percent of total billed charges,,,1540.9,95,,percent of total billed charges,,,1459.8,90,,percent of total billed charges,,,1459.8,90,,percent of total billed charges,,,1330.04,82,,percent of total billed charges,,,1459.8,90,,percent of total billed charges,,,1378.7,85,,percent of total billed charges,,405.5,1540.9,
FF FRACTURE DISTAL PHALANX,20500823,CDM,26720,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
FF FRACTURE MALLEOLUS LATERAL,20500824,CDM,27788,CPT,450,RC,outpatient,,1422,1422,,1207.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,355.5,22,,percent of total billed charges,,,,,,,,,1279.8,90,,percent of total billed charges,,,1177.42,82.8,,percent of total billed charges,,,1208.7,85,,percent of total billed charges,,,,,,,,,1251.36,88,,percent of total billed charges,,,,,,,,,1086.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,355.5,22,,percent of total billed charges,,,1294.02,91,,percent of total billed charges,,,1350.9,95,,percent of total billed charges,,,1180.26,83,,percent of total billed charges,,,1180.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1180.26,83,,percent of total billed charges,,,1350.9,95,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1166.04,82,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1208.7,85,,percent of total billed charges,,355.5,1350.9,
FF FRACTURE MALLEOLUS MEDIAL,20500825,CDM,27760,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
FF FRACTURE METATARSAL,20500826,CDM,28470,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
FF FRACTURE NR CARPAL,20500827,CDM,25630,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
FF FRACTURE NR CLAVICLE,20500828,CDM,23500,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
FF FRACTURE NR HUMERUS NECK,20500829,CDM,24500,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
FF FRACTURE NR METACARPAL,20500830,CDM,26600,CPT,450,RC,outpatient,,1707,1707,,1449.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,426.75,22,,percent of total billed charges,,,,,,,,,1536.3,90,,percent of total billed charges,,,1413.4,82.8,,percent of total billed charges,,,1450.95,85,,percent of total billed charges,,,,,,,,,1502.16,88,,percent of total billed charges,,,,,,,,,1304.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,426.75,22,,percent of total billed charges,,,1553.37,91,,percent of total billed charges,,,1621.65,95,,percent of total billed charges,,,1416.81,83,,percent of total billed charges,,,1416.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1416.81,83,,percent of total billed charges,,,1621.65,95,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1399.74,82,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1450.95,85,,percent of total billed charges,,426.75,1621.65,
FF CLOSED TX NOSE FX W/STABLJ,20500831,CDM,21320,CPT,450,RC,outpatient,,2903,2903,,2464.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,725.75,22,,percent of total billed charges,,,,,,,,,2612.7,90,,percent of total billed charges,,,2403.68,82.8,,percent of total billed charges,,,2467.55,85,,percent of total billed charges,,,,,,,,,2554.64,88,,percent of total billed charges,,,,,,,,,2217.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,725.75,22,,percent of total billed charges,,,2641.73,91,,percent of total billed charges,,,2757.85,95,,percent of total billed charges,,,2409.49,83,,percent of total billed charges,,,2409.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2409.49,83,,percent of total billed charges,,,2757.85,95,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2380.46,82,,percent of total billed charges,,,2612.7,90,,percent of total billed charges,,,2467.55,85,,percent of total billed charges,,725.75,2757.85,
FF FRACTURE NR RADIAL SHAFT,20500832,CDM,25500,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
FF FRACTURE NR ULNAR OLECRANON,20500833,CDM,24620,CPT,450,RC,outpatient,,4617,4617,,3919.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1154.25,22,,percent of total billed charges,,,,,,,,,4155.3,90,,percent of total billed charges,,,3822.88,82.8,,percent of total billed charges,,,3924.45,85,,percent of total billed charges,,,,,,,,,4062.96,88,,percent of total billed charges,,,,,,,,,3527.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1154.25,22,,percent of total billed charges,,,4201.47,91,,percent of total billed charges,,,4386.15,95,,percent of total billed charges,,,3832.11,83,,percent of total billed charges,,,3832.11,83,,percent of total billed charges,,,,,,,,,,,,,,,3832.11,83,,percent of total billed charges,,,4386.15,95,,percent of total billed charges,,,4155.3,90,,percent of total billed charges,,,4155.3,90,,percent of total billed charges,,,3785.94,82,,percent of total billed charges,,,4155.3,90,,percent of total billed charges,,,3924.45,85,,percent of total billed charges,,1154.25,4386.15,
FF FRACTURE PROXIMAL PHALANX,20500834,CDM,26740,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
FF FRACTURE TARSAL,20500835,CDM,28450,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
FF FRACTURE TOE PHALANX,20500836,CDM,28515,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
FF HEMORRHAGE CERVICAL PACK,20500839,CDM,57180,CPT,450,RC,outpatient,,876,876,,743.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,219,22,,percent of total billed charges,,,,,,,,,788.4,90,,percent of total billed charges,,,725.33,82.8,,percent of total billed charges,,,744.6,85,,percent of total billed charges,,,,,,,,,770.88,88,,percent of total billed charges,,,,,,,,,669.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,219,22,,percent of total billed charges,,,797.16,91,,percent of total billed charges,,,832.2,95,,percent of total billed charges,,,727.08,83,,percent of total billed charges,,,727.08,83,,percent of total billed charges,,,,,,,,,,,,,,,727.08,83,,percent of total billed charges,,,832.2,95,,percent of total billed charges,,,788.4,90,,percent of total billed charges,,,788.4,90,,percent of total billed charges,,,718.32,82,,percent of total billed charges,,,788.4,90,,percent of total billed charges,,,744.6,85,,percent of total billed charges,,219,832.2,
FF BURN DRESSING DEBRIDEMENT MEDIUM,20500841,CDM,16025,CPT,450,RC,outpatient,,1139,1139,,967.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.75,22,,percent of total billed charges,,,,,,,,,1025.1,90,,percent of total billed charges,,,943.09,82.8,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,,,,,,,,1002.32,88,,percent of total billed charges,,,,,,,,,870.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.75,22,,percent of total billed charges,,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,,,,,,,,,,,,,945.37,83,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,933.98,82,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,284.75,1082.05,
FF I&D ABCESS MOUTH,20500842,CDM,40800,CPT,450,RC,outpatient,,768,768,,652.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192,22,,percent of total billed charges,,,,,,,,,691.2,90,,percent of total billed charges,,,635.9,82.8,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,,,,,,,,675.84,88,,percent of total billed charges,,,,,,,,,586.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192,22,,percent of total billed charges,,,698.88,91,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,,,,,,,,,,,,,637.44,83,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,629.76,82,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,192,729.6,
FF I&D ABCESS PERITONSELLEN,20500843,CDM,42700,CPT,450,RC,outpatient,,768,768,,652.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192,22,,percent of total billed charges,,,,,,,,,691.2,90,,percent of total billed charges,,,635.9,82.8,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,,,,,,,,675.84,88,,percent of total billed charges,,,,,,,,,586.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192,22,,percent of total billed charges,,,698.88,91,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,,,,,,,,,,,,,637.44,83,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,629.76,82,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,192,729.6,
FF I&D ABSCESS COMPLEX,20500844,CDM,10061,CPT,450,RC,outpatient,,1334,1334,,1132.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,333.5,22,,percent of total billed charges,,,,,,,,,1200.6,90,,percent of total billed charges,,,1104.55,82.8,,percent of total billed charges,,,1133.9,85,,percent of total billed charges,,,,,,,,,1173.92,88,,percent of total billed charges,,,,,,,,,1019.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,333.5,22,,percent of total billed charges,,,1213.94,91,,percent of total billed charges,,,1267.3,95,,percent of total billed charges,,,1107.22,83,,percent of total billed charges,,,1107.22,83,,percent of total billed charges,,,,,,,,,,,,,,,1107.22,83,,percent of total billed charges,,,1267.3,95,,percent of total billed charges,,,1200.6,90,,percent of total billed charges,,,1200.6,90,,percent of total billed charges,,,1093.88,82,,percent of total billed charges,,,1200.6,90,,percent of total billed charges,,,1133.9,85,,percent of total billed charges,,333.5,1267.3,
FF I&D BURSA (ANKLE),20500845,CDM,27604,CPT,450,RC,outpatient,,7256,7256,,6160.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1814,22,,percent of total billed charges,,,,,,,,,6530.4,90,,percent of total billed charges,,,6007.97,82.8,,percent of total billed charges,,,6167.6,85,,percent of total billed charges,,,,,,,,,6385.28,88,,percent of total billed charges,,,,,,,,,5543.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1814,22,,percent of total billed charges,,,6602.96,91,,percent of total billed charges,,,6893.2,95,,percent of total billed charges,,,6022.48,83,,percent of total billed charges,,,6022.48,83,,percent of total billed charges,,,,,,,,,,,,,,,6022.48,83,,percent of total billed charges,,,6893.2,95,,percent of total billed charges,,,6530.4,90,,percent of total billed charges,,,6530.4,90,,percent of total billed charges,,,5949.92,82,,percent of total billed charges,,,6530.4,90,,percent of total billed charges,,,6167.6,85,,percent of total billed charges,,1814,6893.2,
FF I&D BURSA (ELBOW),20500846,CDM,23931,CPT,450,RC,outpatient,,5810,5810,,4932.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1452.5,22,,percent of total billed charges,,,,,,,,,5229,90,,percent of total billed charges,,,4810.68,82.8,,percent of total billed charges,,,4938.5,85,,percent of total billed charges,,,,,,,,,5112.8,88,,percent of total billed charges,,,,,,,,,4438.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1452.5,22,,percent of total billed charges,,,5287.1,91,,percent of total billed charges,,,5519.5,95,,percent of total billed charges,,,4822.3,83,,percent of total billed charges,,,4822.3,83,,percent of total billed charges,,,,,,,,,,,,,,,4822.3,83,,percent of total billed charges,,,5519.5,95,,percent of total billed charges,,,5229,90,,percent of total billed charges,,,5229,90,,percent of total billed charges,,,4764.2,82,,percent of total billed charges,,,5229,90,,percent of total billed charges,,,4938.5,85,,percent of total billed charges,,1452.5,5519.5,
FF I&D BURSA (FOOT),20500847,CDM,28001,CPT,450,RC,outpatient,,4167,4167,,3537.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1041.75,22,,percent of total billed charges,,,,,,,,,3750.3,90,,percent of total billed charges,,,3450.28,82.8,,percent of total billed charges,,,3541.95,85,,percent of total billed charges,,,,,,,,,3666.96,88,,percent of total billed charges,,,,,,,,,3183.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1041.75,22,,percent of total billed charges,,,3791.97,91,,percent of total billed charges,,,3958.65,95,,percent of total billed charges,,,3458.61,83,,percent of total billed charges,,,3458.61,83,,percent of total billed charges,,,,,,,,,,,,,,,3458.61,83,,percent of total billed charges,,,3958.65,95,,percent of total billed charges,,,3750.3,90,,percent of total billed charges,,,3750.3,90,,percent of total billed charges,,,3416.94,82,,percent of total billed charges,,,3750.3,90,,percent of total billed charges,,,3541.95,85,,percent of total billed charges,,1041.75,3958.65,
FF I&D BURSA (KNEE),20500848,CDM,27301,CPT,450,RC,outpatient,,5810,5810,,4932.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1452.5,22,,percent of total billed charges,,,,,,,,,5229,90,,percent of total billed charges,,,4810.68,82.8,,percent of total billed charges,,,4938.5,85,,percent of total billed charges,,,,,,,,,5112.8,88,,percent of total billed charges,,,,,,,,,4438.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1452.5,22,,percent of total billed charges,,,5287.1,91,,percent of total billed charges,,,5519.5,95,,percent of total billed charges,,,4822.3,83,,percent of total billed charges,,,4822.3,83,,percent of total billed charges,,,,,,,,,,,,,,,4822.3,83,,percent of total billed charges,,,5519.5,95,,percent of total billed charges,,,5229,90,,percent of total billed charges,,,5229,90,,percent of total billed charges,,,4764.2,82,,percent of total billed charges,,,5229,90,,percent of total billed charges,,,4938.5,85,,percent of total billed charges,,1452.5,5519.5,
FF I&D PERIRECTAL ABSCESS,20500849,CDM,46040,CPT,450,RC,outpatient,,6439,6439,,5466.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1609.75,22,,percent of total billed charges,,,,,,,,,5795.1,90,,percent of total billed charges,,,5331.49,82.8,,percent of total billed charges,,,5473.15,85,,percent of total billed charges,,,,,,,,,5666.32,88,,percent of total billed charges,,,,,,,,,4919.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1609.75,22,,percent of total billed charges,,,5859.49,91,,percent of total billed charges,,,6117.05,95,,percent of total billed charges,,,5344.37,83,,percent of total billed charges,,,5344.37,83,,percent of total billed charges,,,,,,,,,,,,,,,5344.37,83,,percent of total billed charges,,,6117.05,95,,percent of total billed charges,,,5795.1,90,,percent of total billed charges,,,5795.1,90,,percent of total billed charges,,,5279.98,82,,percent of total billed charges,,,5795.1,90,,percent of total billed charges,,,5473.15,85,,percent of total billed charges,,1609.75,6117.05,
FF I&D POLONIDAL CYST,20500850,CDM,10080,CPT,450,RC,outpatient,,569,569,,483.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,142.25,22,,percent of total billed charges,,,,,,,,,512.1,90,,percent of total billed charges,,,471.13,82.8,,percent of total billed charges,,,483.65,85,,percent of total billed charges,,,,,,,,,500.72,88,,percent of total billed charges,,,,,,,,,434.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,142.25,22,,percent of total billed charges,,,517.79,91,,percent of total billed charges,,,540.55,95,,percent of total billed charges,,,472.27,83,,percent of total billed charges,,,472.27,83,,percent of total billed charges,,,,,,,,,,,,,,,472.27,83,,percent of total billed charges,,,540.55,95,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,466.58,82,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,483.65,85,,percent of total billed charges,,142.25,540.55,
 FF INJ BURSA (INTERMEDIATE JNT),20500852,CDM,20605,CPT,450,RC,outpatient,,678,678,,575.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,169.5,22,,percent of total billed charges,,,,,,,,,610.2,90,,percent of total billed charges,,,561.38,82.8,,percent of total billed charges,,,576.3,85,,percent of total billed charges,,,,,,,,,596.64,88,,percent of total billed charges,,,,,,,,,517.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,169.5,22,,percent of total billed charges,,,616.98,91,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,,,,,,,,,,,,,562.74,83,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,555.96,82,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,576.3,85,,percent of total billed charges,,169.5,644.1,
FF INJECTION OF AA&/STRD PERIPHERAL NERV,20500853,CDM,64450,CPT,450,RC,outpatient,,1449,1449,,1230.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,362.25,22,,percent of total billed charges,,,,,,,,,1304.1,90,,percent of total billed charges,,,1199.77,82.8,,percent of total billed charges,,,1231.65,85,,percent of total billed charges,,,,,,,,,1275.12,88,,percent of total billed charges,,,,,,,,,1107.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,362.25,22,,percent of total billed charges,,,1318.59,91,,percent of total billed charges,,,1376.55,95,,percent of total billed charges,,,1202.67,83,,percent of total billed charges,,,1202.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1202.67,83,,percent of total billed charges,,,1376.55,95,,percent of total billed charges,,,1304.1,90,,percent of total billed charges,,,1304.1,90,,percent of total billed charges,,,1188.18,82,,percent of total billed charges,,,1304.1,90,,percent of total billed charges,,,1231.65,85,,percent of total billed charges,,362.25,1376.55,
FF INJECTION BURSA,20500854,CDM,20600,CPT,450,RC,outpatient,,678,678,,575.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,169.5,22,,percent of total billed charges,,,,,,,,,610.2,90,,percent of total billed charges,,,561.38,82.8,,percent of total billed charges,,,576.3,85,,percent of total billed charges,,,,,,,,,596.64,88,,percent of total billed charges,,,,,,,,,517.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,169.5,22,,percent of total billed charges,,,616.98,91,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,,,,,,,,,,,,,562.74,83,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,555.96,82,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,576.3,85,,percent of total billed charges,,169.5,644.1,
FF INJECTION OF SINGLE TENDON SHEATH,20500855,CDM,20550,CPT,450,RC,outpatient,,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208,22,,percent of total billed charges,,,,,,,,,748.8,90,,percent of total billed charges,,,688.9,82.8,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208,22,,percent of total billed charges,,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,208,790.4,
FF IRRIGATION EAR ONE OR BOTH,20500856,CDM,69210,CPT,450,RC,outpatient,,529,529,,449.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.25,22,,percent of total billed charges,,,,,,,,,476.1,90,,percent of total billed charges,,,438.01,82.8,,percent of total billed charges,,,449.65,85,,percent of total billed charges,,,,,,,,,465.52,88,,percent of total billed charges,,,,,,,,,404.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.25,22,,percent of total billed charges,,,481.39,91,,percent of total billed charges,,,502.55,95,,percent of total billed charges,,,439.07,83,,percent of total billed charges,,,439.07,83,,percent of total billed charges,,,,,,,,,,,,,,,439.07,83,,percent of total billed charges,,,502.55,95,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,433.78,82,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,449.65,85,,percent of total billed charges,,132.25,502.55,
FF LUMBAR PUNCTURE DIAG,20500857,CDM,62270,CPT,450,RC,outpatient,,3102,3102,,2633.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,775.5,22,,percent of total billed charges,,,,,,,,,2791.8,90,,percent of total billed charges,,,2568.46,82.8,,percent of total billed charges,,,2636.7,85,,percent of total billed charges,,,,,,,,,2729.76,88,,percent of total billed charges,,,,,,,,,2369.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,775.5,22,,percent of total billed charges,,,2822.82,91,,percent of total billed charges,,,2946.9,95,,percent of total billed charges,,,2574.66,83,,percent of total billed charges,,,2574.66,83,,percent of total billed charges,,,,,,,,,,,,,,,2574.66,83,,percent of total billed charges,,,2946.9,95,,percent of total billed charges,,,2791.8,90,,percent of total billed charges,,,2791.8,90,,percent of total billed charges,,,2543.64,82,,percent of total billed charges,,,2791.8,90,,percent of total billed charges,,,2636.7,85,,percent of total billed charges,,775.5,2946.9,
FF INJ/ASP MD JNT ELBOW ANKLE,20500858,CDM,20605,CPT,450,RC,outpatient,,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208,22,,percent of total billed charges,,,,,,,,,748.8,90,,percent of total billed charges,,,688.9,82.8,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208,22,,percent of total billed charges,,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,208,790.4,
FF INJ/ASP SM JNT FINGER TOE,20500859,CDM,20600,CPT,450,RC,outpatient,,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208,22,,percent of total billed charges,,,,,,,,,748.8,90,,percent of total billed charges,,,688.9,82.8,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208,22,,percent of total billed charges,,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,208,790.4,
FF NASAL HEMORRHAGE,20500861,CDM,30905,CPT,450,RC,outpatient,,830,830,,704.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,207.5,22,,percent of total billed charges,,,,,,,,,747,90,,percent of total billed charges,,,687.24,82.8,,percent of total billed charges,,,705.5,85,,percent of total billed charges,,,,,,,,,730.4,88,,percent of total billed charges,,,,,,,,,634.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,207.5,22,,percent of total billed charges,,,755.3,91,,percent of total billed charges,,,788.5,95,,percent of total billed charges,,,688.9,83,,percent of total billed charges,,,688.9,83,,percent of total billed charges,,,,,,,,,,,,,,,688.9,83,,percent of total billed charges,,,788.5,95,,percent of total billed charges,,,747,90,,percent of total billed charges,,,747,90,,percent of total billed charges,,,680.6,82,,percent of total billed charges,,,747,90,,percent of total billed charges,,,705.5,85,,percent of total billed charges,,207.5,788.5,
FF NASAL HEMORRHAGE ANT COMPLEX,20500862,CDM,30903,CPT,450,RC,outpatient,,1357,1357,,1152.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,339.25,22,,percent of total billed charges,,,,,,,,,1221.3,90,,percent of total billed charges,,,1123.6,82.8,,percent of total billed charges,,,1153.45,85,,percent of total billed charges,,,,,,,,,1194.16,88,,percent of total billed charges,,,,,,,,,1036.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,339.25,22,,percent of total billed charges,,,1234.87,91,,percent of total billed charges,,,1289.15,95,,percent of total billed charges,,,1126.31,83,,percent of total billed charges,,,1126.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1126.31,83,,percent of total billed charges,,,1289.15,95,,percent of total billed charges,,,1221.3,90,,percent of total billed charges,,,1221.3,90,,percent of total billed charges,,,1112.74,82,,percent of total billed charges,,,1221.3,90,,percent of total billed charges,,,1153.45,85,,percent of total billed charges,,339.25,1289.15,
FF NASAL HEMORRHAGE ANT SIMPLE,20500863,CDM,30901,CPT,450,RC,outpatient,,995,995,,844.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,248.75,22,,percent of total billed charges,,,,,,,,,895.5,90,,percent of total billed charges,,,823.86,82.8,,percent of total billed charges,,,845.75,85,,percent of total billed charges,,,,,,,,,875.6,88,,percent of total billed charges,,,,,,,,,760.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,248.75,22,,percent of total billed charges,,,905.45,91,,percent of total billed charges,,,945.25,95,,percent of total billed charges,,,825.85,83,,percent of total billed charges,,,825.85,83,,percent of total billed charges,,,,,,,,,,,,,,,825.85,83,,percent of total billed charges,,,945.25,95,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,815.9,82,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,845.75,85,,percent of total billed charges,,248.75,945.25,
FF NK HD FT GEN LYR 12.6 TO 20 CM,20500867,CDM,12045,CPT,450,RC,outpatient,,786,786,,667.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,196.5,22,,percent of total billed charges,,,,,,,,,707.4,90,,percent of total billed charges,,,650.81,82.8,,percent of total billed charges,,,668.1,85,,percent of total billed charges,,,,,,,,,691.68,88,,percent of total billed charges,,,,,,,,,600.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,196.5,22,,percent of total billed charges,,,715.26,91,,percent of total billed charges,,,746.7,95,,percent of total billed charges,,,652.38,83,,percent of total billed charges,,,652.38,83,,percent of total billed charges,,,,,,,,,,,,,,,652.38,83,,percent of total billed charges,,,746.7,95,,percent of total billed charges,,,707.4,90,,percent of total billed charges,,,707.4,90,,percent of total billed charges,,,644.52,82,,percent of total billed charges,,,707.4,90,,percent of total billed charges,,,668.1,85,,percent of total billed charges,,196.5,746.7,
FF NK HD FT GEN LYR 20.1 TO 30 CM,20500868,CDM,12046,CPT,450,RC,outpatient,,856,856,,726.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214,22,,percent of total billed charges,,,,,,,,,770.4,90,,percent of total billed charges,,,708.77,82.8,,percent of total billed charges,,,727.6,85,,percent of total billed charges,,,,,,,,,753.28,88,,percent of total billed charges,,,,,,,,,653.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214,22,,percent of total billed charges,,,778.96,91,,percent of total billed charges,,,813.2,95,,percent of total billed charges,,,710.48,83,,percent of total billed charges,,,710.48,83,,percent of total billed charges,,,,,,,,,,,,,,,710.48,83,,percent of total billed charges,,,813.2,95,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,701.92,82,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,727.6,85,,percent of total billed charges,,214,813.2,
FF NK HD FT GEN LYR 7.6 TO 12.5 CM,20500869,CDM,12044,CPT,450,RC,outpatient,,714,714,,606.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.5,22,,percent of total billed charges,,,,,,,,,642.6,90,,percent of total billed charges,,,591.19,82.8,,percent of total billed charges,,,606.9,85,,percent of total billed charges,,,,,,,,,628.32,88,,percent of total billed charges,,,,,,,,,545.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.5,22,,percent of total billed charges,,,649.74,91,,percent of total billed charges,,,678.3,95,,percent of total billed charges,,,592.62,83,,percent of total billed charges,,,592.62,83,,percent of total billed charges,,,,,,,,,,,,,,,592.62,83,,percent of total billed charges,,,678.3,95,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,585.48,82,,percent of total billed charges,,,642.6,90,,percent of total billed charges,,,606.9,85,,percent of total billed charges,,178.5,678.3,
FF NK HND FT GEN LYR > 30 CM,20500870,CDM,12047,CPT,450,RC,outpatient,,1914,1914,,1624.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,478.5,22,,percent of total billed charges,,,,,,,,,1722.6,90,,percent of total billed charges,,,1584.79,82.8,,percent of total billed charges,,,1626.9,85,,percent of total billed charges,,,,,,,,,1684.32,88,,percent of total billed charges,,,,,,,,,1462.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,478.5,22,,percent of total billed charges,,,1741.74,91,,percent of total billed charges,,,1818.3,95,,percent of total billed charges,,,1588.62,83,,percent of total billed charges,,,1588.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1588.62,83,,percent of total billed charges,,,1818.3,95,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1569.48,82,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1626.9,85,,percent of total billed charges,,478.5,1818.3,
FF NK HND FT GEN LYR 0 TO 2.5 CM,20500871,CDM,12041,CPT,450,RC,outpatient,,580,580,,492.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,145,22,,percent of total billed charges,,,,,,,,,522,90,,percent of total billed charges,,,480.24,82.8,,percent of total billed charges,,,493,85,,percent of total billed charges,,,,,,,,,510.4,88,,percent of total billed charges,,,,,,,,,443.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,145,22,,percent of total billed charges,,,527.8,91,,percent of total billed charges,,,551,95,,percent of total billed charges,,,481.4,83,,percent of total billed charges,,,481.4,83,,percent of total billed charges,,,,,,,,,,,,,,,481.4,83,,percent of total billed charges,,,551,95,,percent of total billed charges,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,475.6,82,,percent of total billed charges,,,522,90,,percent of total billed charges,,,493,85,,percent of total billed charges,,145,551,
FF NK HND FT GEN LYR 2.6 TO 7.5 CM,20500872,CDM,12042,CPT,450,RC,outpatient,,1530,1530,,1298.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,382.5,22,,percent of total billed charges,,,,,,,,,1377,90,,percent of total billed charges,,,1266.84,82.8,,percent of total billed charges,,,1300.5,85,,percent of total billed charges,,,,,,,,,1346.4,88,,percent of total billed charges,,,,,,,,,1168.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,382.5,22,,percent of total billed charges,,,1392.3,91,,percent of total billed charges,,,1453.5,95,,percent of total billed charges,,,1269.9,83,,percent of total billed charges,,,1269.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1269.9,83,,percent of total billed charges,,,1453.5,95,,percent of total billed charges,,,1377,90,,percent of total billed charges,,,1377,90,,percent of total billed charges,,,1254.6,82,,percent of total billed charges,,,1377,90,,percent of total billed charges,,,1300.5,85,,percent of total billed charges,,382.5,1453.5,
FF PERITONEAL LAVAGE DIAG,20500873,CDM,49082,CPT,450,RC,outpatient,,1170,1170,,993.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,292.5,22,,percent of total billed charges,,,,,,,,,1053,90,,percent of total billed charges,,,968.76,82.8,,percent of total billed charges,,,994.5,85,,percent of total billed charges,,,,,,,,,1029.6,88,,percent of total billed charges,,,,,,,,,893.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,292.5,22,,percent of total billed charges,,,1064.7,91,,percent of total billed charges,,,1111.5,95,,percent of total billed charges,,,971.1,83,,percent of total billed charges,,,971.1,83,,percent of total billed charges,,,,,,,,,,,,,,,971.1,83,,percent of total billed charges,,,1111.5,95,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,959.4,82,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,994.5,85,,percent of total billed charges,,292.5,1111.5,
FF REMOVAL OF FB EAR,20500874,CDM,69200,CPT,450,RC,outpatient,,635,635,,539.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,158.75,22,,percent of total billed charges,,,,,,,,,571.5,90,,percent of total billed charges,,,525.78,82.8,,percent of total billed charges,,,539.75,85,,percent of total billed charges,,,,,,,,,558.8,88,,percent of total billed charges,,,,,,,,,485.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,158.75,22,,percent of total billed charges,,,577.85,91,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,,,,,,,,,,,,,527.05,83,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,520.7,82,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,539.75,85,,percent of total billed charges,,158.75,603.25,
FF REMOVAL OF FB INTRANASAL,20500875,CDM,30300,CPT,450,RC,outpatient,,635,635,,539.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,158.75,22,,percent of total billed charges,,,,,,,,,571.5,90,,percent of total billed charges,,,525.78,82.8,,percent of total billed charges,,,539.75,85,,percent of total billed charges,,,,,,,,,558.8,88,,percent of total billed charges,,,,,,,,,485.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,158.75,22,,percent of total billed charges,,,577.85,91,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,,,,,,,,,,,,,527.05,83,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,520.7,82,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,539.75,85,,percent of total billed charges,,158.75,603.25,
FF REMOVAL OF FB PHARYNX,20500876,CDM,42809,CPT,450,RC,outpatient,,635,635,,539.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,158.75,22,,percent of total billed charges,,,,,,,,,571.5,90,,percent of total billed charges,,,525.78,82.8,,percent of total billed charges,,,539.75,85,,percent of total billed charges,,,,,,,,,558.8,88,,percent of total billed charges,,,,,,,,,485.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,158.75,22,,percent of total billed charges,,,577.85,91,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,,,,,,,,,,,,,527.05,83,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,520.7,82,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,539.75,85,,percent of total billed charges,,158.75,603.25,
FF REMOVAL OF FB/CONJUNCTIVA,20500879,CDM,65205,CPT,450,RC,outpatient,,945,945,,802.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,236.25,22,,percent of total billed charges,,,,,,,,,850.5,90,,percent of total billed charges,,,782.46,82.8,,percent of total billed charges,,,803.25,85,,percent of total billed charges,,,,,,,,,831.6,88,,percent of total billed charges,,,,,,,,,721.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,236.25,22,,percent of total billed charges,,,859.95,91,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,,,,,,,,,,,,,784.35,83,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,774.9,82,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,803.25,85,,percent of total billed charges,,236.25,897.75,
FF REMOVAL OF FB/CORNEA,20500880,CDM,65220,CPT,450,RC,outpatient,,945,945,,802.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,236.25,22,,percent of total billed charges,,,,,,,,,850.5,90,,percent of total billed charges,,,782.46,82.8,,percent of total billed charges,,,803.25,85,,percent of total billed charges,,,,,,,,,831.6,88,,percent of total billed charges,,,,,,,,,721.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,236.25,22,,percent of total billed charges,,,859.95,91,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,,,,,,,,,,,,,784.35,83,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,774.9,82,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,803.25,85,,percent of total billed charges,,236.25,897.75,
FF REMOVAL OF FB/EMBED/CONJ,20500881,CDM,65210,CPT,450,RC,outpatient,,467,467,,396.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.75,22,,percent of total billed charges,,,,,,,,,420.3,90,,percent of total billed charges,,,386.68,82.8,,percent of total billed charges,,,396.95,85,,percent of total billed charges,,,,,,,,,410.96,88,,percent of total billed charges,,,,,,,,,356.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.75,22,,percent of total billed charges,,,424.97,91,,percent of total billed charges,,,443.65,95,,percent of total billed charges,,,387.61,83,,percent of total billed charges,,,387.61,83,,percent of total billed charges,,,,,,,,,,,,,,,387.61,83,,percent of total billed charges,,,443.65,95,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,382.94,82,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,396.95,85,,percent of total billed charges,,116.75,443.65,
FF SCALP TRK EXT LYR 2.6 TO 7.5 CM,20500882,CDM,12032,CPT,450,RC,outpatient,,2514,2514,,2134.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,628.5,22,,percent of total billed charges,,,,,,,,,2262.6,90,,percent of total billed charges,,,2081.59,82.8,,percent of total billed charges,,,2136.9,85,,percent of total billed charges,,,,,,,,,2212.32,88,,percent of total billed charges,,,,,,,,,1920.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,628.5,22,,percent of total billed charges,,,2287.74,91,,percent of total billed charges,,,2388.3,95,,percent of total billed charges,,,2086.62,83,,percent of total billed charges,,,2086.62,83,,percent of total billed charges,,,,,,,,,,,,,,,2086.62,83,,percent of total billed charges,,,2388.3,95,,percent of total billed charges,,,2262.6,90,,percent of total billed charges,,,2262.6,90,,percent of total billed charges,,,2061.48,82,,percent of total billed charges,,,2262.6,90,,percent of total billed charges,,,2136.9,85,,percent of total billed charges,,628.5,2388.3,
FF SCALP TRK EXT LYR 0 TO 2.5 CM,20500883,CDM,12031,CPT,450,RC,outpatient,,1731,1731,,1469.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,432.75,22,,percent of total billed charges,,,,,,,,,1557.9,90,,percent of total billed charges,,,1433.27,82.8,,percent of total billed charges,,,1471.35,85,,percent of total billed charges,,,,,,,,,1523.28,88,,percent of total billed charges,,,,,,,,,1322.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,432.75,22,,percent of total billed charges,,,1575.21,91,,percent of total billed charges,,,1644.45,95,,percent of total billed charges,,,1436.73,83,,percent of total billed charges,,,1436.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1436.73,83,,percent of total billed charges,,,1644.45,95,,percent of total billed charges,,,1557.9,90,,percent of total billed charges,,,1557.9,90,,percent of total billed charges,,,1419.42,82,,percent of total billed charges,,,1557.9,90,,percent of total billed charges,,,1471.35,85,,percent of total billed charges,,432.75,1644.45,
FF SCALP TRK EXT LYR > 30 CM,20500884,CDM,12037,CPT,450,RC,outpatient,,1914,1914,,1624.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,478.5,22,,percent of total billed charges,,,,,,,,,1722.6,90,,percent of total billed charges,,,1584.79,82.8,,percent of total billed charges,,,1626.9,85,,percent of total billed charges,,,,,,,,,1684.32,88,,percent of total billed charges,,,,,,,,,1462.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,478.5,22,,percent of total billed charges,,,1741.74,91,,percent of total billed charges,,,1818.3,95,,percent of total billed charges,,,1588.62,83,,percent of total billed charges,,,1588.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1588.62,83,,percent of total billed charges,,,1818.3,95,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1569.48,82,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1626.9,85,,percent of total billed charges,,478.5,1818.3,
FF SCALP TRK EXT LYR 12.6 TO 20 CM,20500885,CDM,12035,CPT,450,RC,outpatient,,2144,2144,,1820.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,536,22,,percent of total billed charges,,,,,,,,,1929.6,90,,percent of total billed charges,,,1775.23,82.8,,percent of total billed charges,,,1822.4,85,,percent of total billed charges,,,,,,,,,1886.72,88,,percent of total billed charges,,,,,,,,,1638.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,536,22,,percent of total billed charges,,,1951.04,91,,percent of total billed charges,,,2036.8,95,,percent of total billed charges,,,1779.52,83,,percent of total billed charges,,,1779.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1779.52,83,,percent of total billed charges,,,2036.8,95,,percent of total billed charges,,,1929.6,90,,percent of total billed charges,,,1929.6,90,,percent of total billed charges,,,1758.08,82,,percent of total billed charges,,,1929.6,90,,percent of total billed charges,,,1822.4,85,,percent of total billed charges,,536,2036.8,
FF SCALP TRK EXT LYR 20.1 TO 30 CM,20500886,CDM,12036,CPT,450,RC,outpatient,,856,856,,726.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214,22,,percent of total billed charges,,,,,,,,,770.4,90,,percent of total billed charges,,,708.77,82.8,,percent of total billed charges,,,727.6,85,,percent of total billed charges,,,,,,,,,753.28,88,,percent of total billed charges,,,,,,,,,653.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214,22,,percent of total billed charges,,,778.96,91,,percent of total billed charges,,,813.2,95,,percent of total billed charges,,,710.48,83,,percent of total billed charges,,,710.48,83,,percent of total billed charges,,,,,,,,,,,,,,,710.48,83,,percent of total billed charges,,,813.2,95,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,701.92,82,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,727.6,85,,percent of total billed charges,,214,813.2,
FF SCALP TRK EXT LYR 7.6 TO 12.5 CM,20500887,CDM,12034,CPT,450,RC,outpatient,,2147,2147,,1822.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,536.75,22,,percent of total billed charges,,,,,,,,,1932.3,90,,percent of total billed charges,,,1777.72,82.8,,percent of total billed charges,,,1824.95,85,,percent of total billed charges,,,,,,,,,1889.36,88,,percent of total billed charges,,,,,,,,,1640.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,536.75,22,,percent of total billed charges,,,1953.77,91,,percent of total billed charges,,,2039.65,95,,percent of total billed charges,,,1782.01,83,,percent of total billed charges,,,1782.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1782.01,83,,percent of total billed charges,,,2039.65,95,,percent of total billed charges,,,1932.3,90,,percent of total billed charges,,,1932.3,90,,percent of total billed charges,,,1760.54,82,,percent of total billed charges,,,1932.3,90,,percent of total billed charges,,,1824.95,85,,percent of total billed charges,,536.75,2039.65,
FF SHLD RELOCAT W MANIPULATION WO ANTH,20500888,CDM,23650,CPT,450,RC,outpatient,,1707,1707,,1449.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,426.75,22,,percent of total billed charges,,,,,,,,,1536.3,90,,percent of total billed charges,,,1413.4,82.8,,percent of total billed charges,,,1450.95,85,,percent of total billed charges,,,,,,,,,1502.16,88,,percent of total billed charges,,,,,,,,,1304.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,426.75,22,,percent of total billed charges,,,1553.37,91,,percent of total billed charges,,,1621.65,95,,percent of total billed charges,,,1416.81,83,,percent of total billed charges,,,1416.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1416.81,83,,percent of total billed charges,,,1621.65,95,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1399.74,82,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1450.95,85,,percent of total billed charges,,426.75,1621.65,
FF SPLINT FINGER,20500889,CDM,29130,CPT,450,RC,outpatient,,575,575,,488.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,143.75,22,,percent of total billed charges,,,,,,,,,517.5,90,,percent of total billed charges,,,476.1,82.8,,percent of total billed charges,,,488.75,85,,percent of total billed charges,,,,,,,,,506,88,,percent of total billed charges,,,,,,,,,439.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,143.75,22,,percent of total billed charges,,,523.25,91,,percent of total billed charges,,,546.25,95,,percent of total billed charges,,,477.25,83,,percent of total billed charges,,,477.25,83,,percent of total billed charges,,,,,,,,,,,,,,,477.25,83,,percent of total billed charges,,,546.25,95,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,471.5,82,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,488.75,85,,percent of total billed charges,,143.75,546.25,
FF SPLINT LONG ARM,20500890,CDM,29105,CPT,450,RC,outpatient,,1208,1208,,1025.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,302,22,,percent of total billed charges,,,,,,,,,1087.2,90,,percent of total billed charges,,,1000.22,82.8,,percent of total billed charges,,,1026.8,85,,percent of total billed charges,,,,,,,,,1063.04,88,,percent of total billed charges,,,,,,,,,922.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,302,22,,percent of total billed charges,,,1099.28,91,,percent of total billed charges,,,1147.6,95,,percent of total billed charges,,,1002.64,83,,percent of total billed charges,,,1002.64,83,,percent of total billed charges,,,,,,,,,,,,,,,1002.64,83,,percent of total billed charges,,,1147.6,95,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,990.56,82,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,1026.8,85,,percent of total billed charges,,302,1147.6,
FF SPLINT LONG LEG,20500891,CDM,29505,CPT,450,RC,outpatient,,1208,1208,,1025.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,302,22,,percent of total billed charges,,,,,,,,,1087.2,90,,percent of total billed charges,,,1000.22,82.8,,percent of total billed charges,,,1026.8,85,,percent of total billed charges,,,,,,,,,1063.04,88,,percent of total billed charges,,,,,,,,,922.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,302,22,,percent of total billed charges,,,1099.28,91,,percent of total billed charges,,,1147.6,95,,percent of total billed charges,,,1002.64,83,,percent of total billed charges,,,1002.64,83,,percent of total billed charges,,,,,,,,,,,,,,,1002.64,83,,percent of total billed charges,,,1147.6,95,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,990.56,82,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,1026.8,85,,percent of total billed charges,,302,1147.6,
FF SPLINT SHORT LEG,20500892,CDM,29515,CPT,450,RC,outpatient,,1004,1004,,852.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,251,22,,percent of total billed charges,,,,,,,,,903.6,90,,percent of total billed charges,,,831.31,82.8,,percent of total billed charges,,,853.4,85,,percent of total billed charges,,,,,,,,,883.52,88,,percent of total billed charges,,,,,,,,,767.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,251,22,,percent of total billed charges,,,913.64,91,,percent of total billed charges,,,953.8,95,,percent of total billed charges,,,833.32,83,,percent of total billed charges,,,833.32,83,,percent of total billed charges,,,,,,,,,,,,,,,833.32,83,,percent of total billed charges,,,953.8,95,,percent of total billed charges,,,903.6,90,,percent of total billed charges,,,903.6,90,,percent of total billed charges,,,823.28,82,,percent of total billed charges,,,903.6,90,,percent of total billed charges,,,853.4,85,,percent of total billed charges,,251,953.8,
FF LAC REP S N T H F EX 0 TO 2.5 CM,20500893,CDM,12001,CPT,450,RC,outpatient,,1094,1094,,928.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,273.5,22,,percent of total billed charges,,,,,,,,,984.6,90,,percent of total billed charges,,,905.83,82.8,,percent of total billed charges,,,929.9,85,,percent of total billed charges,,,,,,,,,962.72,88,,percent of total billed charges,,,,,,,,,835.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,273.5,22,,percent of total billed charges,,,995.54,91,,percent of total billed charges,,,1039.3,95,,percent of total billed charges,,,908.02,83,,percent of total billed charges,,,908.02,83,,percent of total billed charges,,,,,,,,,,,,,,,908.02,83,,percent of total billed charges,,,1039.3,95,,percent of total billed charges,,,984.6,90,,percent of total billed charges,,,984.6,90,,percent of total billed charges,,,897.08,82,,percent of total billed charges,,,984.6,90,,percent of total billed charges,,,929.9,85,,percent of total billed charges,,273.5,1039.3,
FF LAC REP N T H F EX 2.6 TO 7.5 CM,20500894,CDM,12002,CPT,450,RC,outpatient,,1243,1243,,1055.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,310.75,22,,percent of total billed charges,,,,,,,,,1118.7,90,,percent of total billed charges,,,1029.2,82.8,,percent of total billed charges,,,1056.55,85,,percent of total billed charges,,,,,,,,,1093.84,88,,percent of total billed charges,,,,,,,,,949.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,310.75,22,,percent of total billed charges,,,1131.13,91,,percent of total billed charges,,,1180.85,95,,percent of total billed charges,,,1031.69,83,,percent of total billed charges,,,1031.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1031.69,83,,percent of total billed charges,,,1180.85,95,,percent of total billed charges,,,1118.7,90,,percent of total billed charges,,,1118.7,90,,percent of total billed charges,,,1019.26,82,,percent of total billed charges,,,1118.7,90,,percent of total billed charges,,,1056.55,85,,percent of total billed charges,,310.75,1180.85,
FF LAC REPS N T H F EX 20.1 TO 30.0 CM,20500895,CDM,12006,CPT,450,RC,outpatient,,1932,1932,,1640.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483,22,,percent of total billed charges,,,,,,,,,1738.8,90,,percent of total billed charges,,,1599.7,82.8,,percent of total billed charges,,,1642.2,85,,percent of total billed charges,,,,,,,,,1700.16,88,,percent of total billed charges,,,,,,,,,1476.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483,22,,percent of total billed charges,,,1758.12,91,,percent of total billed charges,,,1835.4,95,,percent of total billed charges,,,1603.56,83,,percent of total billed charges,,,1603.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1603.56,83,,percent of total billed charges,,,1835.4,95,,percent of total billed charges,,,1738.8,90,,percent of total billed charges,,,1738.8,90,,percent of total billed charges,,,1584.24,82,,percent of total billed charges,,,1738.8,90,,percent of total billed charges,,,1642.2,85,,percent of total billed charges,,483,1835.4,
FF LAC REP S N T H F EX 7.6 TO 12.5 CM,20500896,CDM,12004,CPT,450,RC,outpatient,,1511,1511,,1282.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,377.75,22,,percent of total billed charges,,,,,,,,,1359.9,90,,percent of total billed charges,,,1251.11,82.8,,percent of total billed charges,,,1284.35,85,,percent of total billed charges,,,,,,,,,1329.68,88,,percent of total billed charges,,,,,,,,,1154.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,377.75,22,,percent of total billed charges,,,1375.01,91,,percent of total billed charges,,,1435.45,95,,percent of total billed charges,,,1254.13,83,,percent of total billed charges,,,1254.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1254.13,83,,percent of total billed charges,,,1435.45,95,,percent of total billed charges,,,1359.9,90,,percent of total billed charges,,,1359.9,90,,percent of total billed charges,,,1239.02,82,,percent of total billed charges,,,1359.9,90,,percent of total billed charges,,,1284.35,85,,percent of total billed charges,,377.75,1435.45,
FF LAC REPSCLP NK TRK EXT > 30 CM,20500897,CDM,12007,CPT,450,RC,outpatient,,2345,2345,,1990.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,586.25,22,,percent of total billed charges,,,,,,,,,2110.5,90,,percent of total billed charges,,,1941.66,82.8,,percent of total billed charges,,,1993.25,85,,percent of total billed charges,,,,,,,,,2063.6,88,,percent of total billed charges,,,,,,,,,1791.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,586.25,22,,percent of total billed charges,,,2133.95,91,,percent of total billed charges,,,2227.75,95,,percent of total billed charges,,,1946.35,83,,percent of total billed charges,,,1946.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1946.35,83,,percent of total billed charges,,,2227.75,95,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,1922.9,82,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,1993.25,85,,percent of total billed charges,,586.25,2227.75,
FF LAC REP SNTHF EX 12.6 TO 20.0 CM,20500898,CDM,12005,CPT,450,RC,outpatient,,1836,1836,,1558.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,459,22,,percent of total billed charges,,,,,,,,,1652.4,90,,percent of total billed charges,,,1520.21,82.8,,percent of total billed charges,,,1560.6,85,,percent of total billed charges,,,,,,,,,1615.68,88,,percent of total billed charges,,,,,,,,,1402.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,459,22,,percent of total billed charges,,,1670.76,91,,percent of total billed charges,,,1744.2,95,,percent of total billed charges,,,1523.88,83,,percent of total billed charges,,,1523.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1523.88,83,,percent of total billed charges,,,1744.2,95,,percent of total billed charges,,,1652.4,90,,percent of total billed charges,,,1652.4,90,,percent of total billed charges,,,1505.52,82,,percent of total billed charges,,,1652.4,90,,percent of total billed charges,,,1560.6,85,,percent of total billed charges,,459,1744.2,
FF LAC REP TRUNK COMPLEX 1.1 TO 2.5 CM,20500899,CDM,13100,CPT,450,RC,outpatient,,1914,1914,,1624.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,478.5,22,,percent of total billed charges,,,,,,,,,1722.6,90,,percent of total billed charges,,,1584.79,82.8,,percent of total billed charges,,,1626.9,85,,percent of total billed charges,,,,,,,,,1684.32,88,,percent of total billed charges,,,,,,,,,1462.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,478.5,22,,percent of total billed charges,,,1741.74,91,,percent of total billed charges,,,1818.3,95,,percent of total billed charges,,,1588.62,83,,percent of total billed charges,,,1588.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1588.62,83,,percent of total billed charges,,,1818.3,95,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1569.48,82,,percent of total billed charges,,,1722.6,90,,percent of total billed charges,,,1626.9,85,,percent of total billed charges,,478.5,1818.3,
FF LAC REP COMP -F N G H F 1.1 TO 2.5 CM,20500900,CDM,13131,CPT,450,RC,outpatient,,2196,2196,,1864.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,549,22,,percent of total billed charges,,,,,,,,,1976.4,90,,percent of total billed charges,,,1818.29,82.8,,percent of total billed charges,,,1866.6,85,,percent of total billed charges,,,,,,,,,1932.48,88,,percent of total billed charges,,,,,,,,,1677.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,549,22,,percent of total billed charges,,,1998.36,91,,percent of total billed charges,,,2086.2,95,,percent of total billed charges,,,1822.68,83,,percent of total billed charges,,,1822.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1822.68,83,,percent of total billed charges,,,2086.2,95,,percent of total billed charges,,,1976.4,90,,percent of total billed charges,,,1976.4,90,,percent of total billed charges,,,1800.72,82,,percent of total billed charges,,,1976.4,90,,percent of total billed charges,,,1866.6,85,,percent of total billed charges,,549,2086.2,
FF LAC REPR FACE 12.6 TO 20.0 CM,20500901,CDM,12016,CPT,450,RC,outpatient,,2001,2001,,1698.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,500.25,22,,percent of total billed charges,,,,,,,,,1800.9,90,,percent of total billed charges,,,1656.83,82.8,,percent of total billed charges,,,1700.85,85,,percent of total billed charges,,,,,,,,,1760.88,88,,percent of total billed charges,,,,,,,,,1528.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,500.25,22,,percent of total billed charges,,,1820.91,91,,percent of total billed charges,,,1900.95,95,,percent of total billed charges,,,1660.83,83,,percent of total billed charges,,,1660.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1660.83,83,,percent of total billed charges,,,1900.95,95,,percent of total billed charges,,,1800.9,90,,percent of total billed charges,,,1800.9,90,,percent of total billed charges,,,1640.82,82,,percent of total billed charges,,,1800.9,90,,percent of total billed charges,,,1700.85,85,,percent of total billed charges,,500.25,1900.95,
FF LAC REP FACE 2.6 TO 5.0 CM,20500902,CDM,12013,CPT,450,RC,outpatient,,1243,1243,,1055.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,310.75,22,,percent of total billed charges,,,,,,,,,1118.7,90,,percent of total billed charges,,,1029.2,82.8,,percent of total billed charges,,,1056.55,85,,percent of total billed charges,,,,,,,,,1093.84,88,,percent of total billed charges,,,,,,,,,949.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,310.75,22,,percent of total billed charges,,,1131.13,91,,percent of total billed charges,,,1180.85,95,,percent of total billed charges,,,1031.69,83,,percent of total billed charges,,,1031.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1031.69,83,,percent of total billed charges,,,1180.85,95,,percent of total billed charges,,,1118.7,90,,percent of total billed charges,,,1118.7,90,,percent of total billed charges,,,1019.26,82,,percent of total billed charges,,,1118.7,90,,percent of total billed charges,,,1056.55,85,,percent of total billed charges,,310.75,1180.85,
FF LAC REPR FACE 20.1 TO 30.0 CM,20500903,CDM,12017,CPT,450,RC,outpatient,,922,922,,782.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,230.5,22,,percent of total billed charges,,,,,,,,,829.8,90,,percent of total billed charges,,,763.42,82.8,,percent of total billed charges,,,783.7,85,,percent of total billed charges,,,,,,,,,811.36,88,,percent of total billed charges,,,,,,,,,704.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,230.5,22,,percent of total billed charges,,,839.02,91,,percent of total billed charges,,,875.9,95,,percent of total billed charges,,,765.26,83,,percent of total billed charges,,,765.26,83,,percent of total billed charges,,,,,,,,,,,,,,,765.26,83,,percent of total billed charges,,,875.9,95,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,756.04,82,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,783.7,85,,percent of total billed charges,,230.5,875.9,
FF LAC REPR FACE 30.1 CM,20500904,CDM,12018,CPT,450,RC,outpatient,,995,995,,844.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,248.75,22,,percent of total billed charges,,,,,,,,,895.5,90,,percent of total billed charges,,,823.86,82.8,,percent of total billed charges,,,845.75,85,,percent of total billed charges,,,,,,,,,875.6,88,,percent of total billed charges,,,,,,,,,760.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,248.75,22,,percent of total billed charges,,,905.45,91,,percent of total billed charges,,,945.25,95,,percent of total billed charges,,,825.85,83,,percent of total billed charges,,,825.85,83,,percent of total billed charges,,,,,,,,,,,,,,,825.85,83,,percent of total billed charges,,,945.25,95,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,815.9,82,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,845.75,85,,percent of total billed charges,,248.75,945.25,
FF LAC REP FACE 5.1 TO 7.5 CM,20500905,CDM,12014,CPT,450,RC,outpatient,,1392,1392,,1181.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,348,22,,percent of total billed charges,,,,,,,,,1252.8,90,,percent of total billed charges,,,1152.58,82.8,,percent of total billed charges,,,1183.2,85,,percent of total billed charges,,,,,,,,,1224.96,88,,percent of total billed charges,,,,,,,,,1063.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,348,22,,percent of total billed charges,,,1266.72,91,,percent of total billed charges,,,1322.4,95,,percent of total billed charges,,,1155.36,83,,percent of total billed charges,,,1155.36,83,,percent of total billed charges,,,,,,,,,,,,,,,1155.36,83,,percent of total billed charges,,,1322.4,95,,percent of total billed charges,,,1252.8,90,,percent of total billed charges,,,1252.8,90,,percent of total billed charges,,,1141.44,82,,percent of total billed charges,,,1252.8,90,,percent of total billed charges,,,1183.2,85,,percent of total billed charges,,348,1322.4,
FF LAC REP FACE 7.6 TO 12.5 CM,20500906,CDM,12015,CPT,450,RC,outpatient,,1588,1588,,1348.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,397,22,,percent of total billed charges,,,,,,,,,1429.2,90,,percent of total billed charges,,,1314.86,82.8,,percent of total billed charges,,,1349.8,85,,percent of total billed charges,,,,,,,,,1397.44,88,,percent of total billed charges,,,,,,,,,1213.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,397,22,,percent of total billed charges,,,1445.08,91,,percent of total billed charges,,,1508.6,95,,percent of total billed charges,,,1318.04,83,,percent of total billed charges,,,1318.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1318.04,83,,percent of total billed charges,,,1508.6,95,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1302.16,82,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1349.8,85,,percent of total billed charges,,397,1508.6,
FF LAC REPR FACE 0 TO 2.5 CM,20500907,CDM,12011,CPT,450,RC,outpatient,,1094,1094,,928.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,273.5,22,,percent of total billed charges,,,,,,,,,984.6,90,,percent of total billed charges,,,905.83,82.8,,percent of total billed charges,,,929.9,85,,percent of total billed charges,,,,,,,,,962.72,88,,percent of total billed charges,,,,,,,,,835.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,273.5,22,,percent of total billed charges,,,995.54,91,,percent of total billed charges,,,1039.3,95,,percent of total billed charges,,,908.02,83,,percent of total billed charges,,,908.02,83,,percent of total billed charges,,,,,,,,,,,,,,,908.02,83,,percent of total billed charges,,,1039.3,95,,percent of total billed charges,,,984.6,90,,percent of total billed charges,,,984.6,90,,percent of total billed charges,,,897.08,82,,percent of total billed charges,,,984.6,90,,percent of total billed charges,,,929.9,85,,percent of total billed charges,,273.5,1039.3,
FF LAC REPAIR 2.5 CM MOUTH/TONGUE,20500908,CDM,41250,CPT,450,RC,outpatient,,768,768,,652.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192,22,,percent of total billed charges,,,,,,,,,691.2,90,,percent of total billed charges,,,635.9,82.8,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,,,,,,,,675.84,88,,percent of total billed charges,,,,,,,,,586.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192,22,,percent of total billed charges,,,698.88,91,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,,,,,,,,,,,,,637.44,83,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,629.76,82,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,192,729.6,
FF TEMPOROMANDIBULAR DISLOCATION,20500909,CDM,21480,CPT,450,RC,outpatient,,768,768,,652.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192,22,,percent of total billed charges,,,,,,,,,691.2,90,,percent of total billed charges,,,635.9,82.8,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,,,,,,,,675.84,88,,percent of total billed charges,,,,,,,,,586.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192,22,,percent of total billed charges,,,698.88,91,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,,,,,,,,,,,,,637.44,83,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,629.76,82,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,192,729.6,
FF PLACEMENT NEEDLE INTRAOSSEOUS,20500913,CDM,36680,CPT,450,RC,outpatient,,1310,1310,,1112.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,327.5,22,,percent of total billed charges,,,,,,,,,1179,90,,percent of total billed charges,,,1084.68,82.8,,percent of total billed charges,,,1113.5,85,,percent of total billed charges,,,,,,,,,1152.8,88,,percent of total billed charges,,,,,,,,,1000.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,327.5,22,,percent of total billed charges,,,1192.1,91,,percent of total billed charges,,,1244.5,95,,percent of total billed charges,,,1087.3,83,,percent of total billed charges,,,1087.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1087.3,83,,percent of total billed charges,,,1244.5,95,,percent of total billed charges,,,1179,90,,percent of total billed charges,,,1179,90,,percent of total billed charges,,,1074.2,82,,percent of total billed charges,,,1179,90,,percent of total billed charges,,,1113.5,85,,percent of total billed charges,,327.5,1244.5,
FF GASTRO INTUB W/ASP,20500914,CDM,43753,CPT,450,RC,outpatient,,533,533,,452.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,133.25,22,,percent of total billed charges,,,,,,,,,479.7,90,,percent of total billed charges,,,441.32,82.8,,percent of total billed charges,,,453.05,85,,percent of total billed charges,,,,,,,,,469.04,88,,percent of total billed charges,,,,,,,,,407.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,133.25,22,,percent of total billed charges,,,485.03,91,,percent of total billed charges,,,506.35,95,,percent of total billed charges,,,442.39,83,,percent of total billed charges,,,442.39,83,,percent of total billed charges,,,,,,,,,,,,,,,442.39,83,,percent of total billed charges,,,506.35,95,,percent of total billed charges,,,479.7,90,,percent of total billed charges,,,479.7,90,,percent of total billed charges,,,437.06,82,,percent of total billed charges,,,479.7,90,,percent of total billed charges,,,453.05,85,,percent of total billed charges,,133.25,506.35,
FF I&D SKIN SIMPLE,20500915,CDM,10060,CPT,450,RC,outpatient,,1601,1601,,1359.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,400.25,22,,percent of total billed charges,,,,,,,,,1440.9,90,,percent of total billed charges,,,1325.63,82.8,,percent of total billed charges,,,1360.85,85,,percent of total billed charges,,,,,,,,,1408.88,88,,percent of total billed charges,,,,,,,,,1223.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,400.25,22,,percent of total billed charges,,,1456.91,91,,percent of total billed charges,,,1520.95,95,,percent of total billed charges,,,1328.83,83,,percent of total billed charges,,,1328.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1328.83,83,,percent of total billed charges,,,1520.95,95,,percent of total billed charges,,,1440.9,90,,percent of total billed charges,,,1440.9,90,,percent of total billed charges,,,1312.82,82,,percent of total billed charges,,,1440.9,90,,percent of total billed charges,,,1360.85,85,,percent of total billed charges,,400.25,1520.95,
FF CLOSED REDUCT OF TIBIA DISLO WO ANEST,20500916,CDM,27830,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
FF CLOSED REDUCT OF ELBOW DISLO WO ANEST,20500917,CDM,24600,CPT,450,RC,outpatient,,1422,1422,,1207.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,355.5,22,,percent of total billed charges,,,,,,,,,1279.8,90,,percent of total billed charges,,,1177.42,82.8,,percent of total billed charges,,,1208.7,85,,percent of total billed charges,,,,,,,,,1251.36,88,,percent of total billed charges,,,,,,,,,1086.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,355.5,22,,percent of total billed charges,,,1294.02,91,,percent of total billed charges,,,1350.9,95,,percent of total billed charges,,,1180.26,83,,percent of total billed charges,,,1180.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1180.26,83,,percent of total billed charges,,,1350.9,95,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1166.04,82,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1208.7,85,,percent of total billed charges,,355.5,1350.9,
FF CLOSED REDUCT OF ELBOW DISLO W/ ANEST,20500918,CDM,24605,CPT,450,RC,outpatient,,4961,4961,,4211.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1240.25,22,,percent of total billed charges,,,,,,,,,4464.9,90,,percent of total billed charges,,,4107.71,82.8,,percent of total billed charges,,,4216.85,85,,percent of total billed charges,,,,,,,,,4365.68,88,,percent of total billed charges,,,,,,,,,3790.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1240.25,22,,percent of total billed charges,,,4514.51,91,,percent of total billed charges,,,4712.95,95,,percent of total billed charges,,,4117.63,83,,percent of total billed charges,,,4117.63,83,,percent of total billed charges,,,,,,,,,,,,,,,4117.63,83,,percent of total billed charges,,,4712.95,95,,percent of total billed charges,,,4464.9,90,,percent of total billed charges,,,4464.9,90,,percent of total billed charges,,,4068.02,82,,percent of total billed charges,,,4464.9,90,,percent of total billed charges,,,4216.85,85,,percent of total billed charges,,1240.25,4712.95,
FF SPLINT SHORT ARM,20500919,CDM,29125,CPT,450,RC,outpatient,,1208,1208,,1025.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,302,22,,percent of total billed charges,,,,,,,,,1087.2,90,,percent of total billed charges,,,1000.22,82.8,,percent of total billed charges,,,1026.8,85,,percent of total billed charges,,,,,,,,,1063.04,88,,percent of total billed charges,,,,,,,,,922.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,302,22,,percent of total billed charges,,,1099.28,91,,percent of total billed charges,,,1147.6,95,,percent of total billed charges,,,1002.64,83,,percent of total billed charges,,,1002.64,83,,percent of total billed charges,,,,,,,,,,,,,,,1002.64,83,,percent of total billed charges,,,1147.6,95,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,990.56,82,,percent of total billed charges,,,1087.2,90,,percent of total billed charges,,,1026.8,85,,percent of total billed charges,,302,1147.6,
FF CLOSED REDUCT THUMB DISLO WO ANEST,20500920,CDM,26641,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
FF CLD REDUCT METACARPOPHALANGEAL WO ANE,20500921,CDM,26700,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
FF CLOSED REDUCTION OF DISLOCATED TOE,20500922,CDM,28660,CPT,450,RC,outpatient,,1422,1422,,1207.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,355.5,22,,percent of total billed charges,,,,,,,,,1279.8,90,,percent of total billed charges,,,1177.42,82.8,,percent of total billed charges,,,1208.7,85,,percent of total billed charges,,,,,,,,,1251.36,88,,percent of total billed charges,,,,,,,,,1086.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,355.5,22,,percent of total billed charges,,,1294.02,91,,percent of total billed charges,,,1350.9,95,,percent of total billed charges,,,1180.26,83,,percent of total billed charges,,,1180.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1180.26,83,,percent of total billed charges,,,1350.9,95,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1166.04,82,,percent of total billed charges,,,1279.8,90,,percent of total billed charges,,,1208.7,85,,percent of total billed charges,,355.5,1350.9,
FF CLOSED TX RADIAL SHAFT FRACTURE,20500923,CDM,25505,CPT,450,RC,outpatient,,2751,2751,,2335.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,687.75,22,,percent of total billed charges,,,,,,,,,2475.9,90,,percent of total billed charges,,,2277.83,82.8,,percent of total billed charges,,,2338.35,85,,percent of total billed charges,,,,,,,,,2420.88,88,,percent of total billed charges,,,,,,,,,2101.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,687.75,22,,percent of total billed charges,,,2503.41,91,,percent of total billed charges,,,2613.45,95,,percent of total billed charges,,,2283.33,83,,percent of total billed charges,,,2283.33,83,,percent of total billed charges,,,,,,,,,,,,,,,2283.33,83,,percent of total billed charges,,,2613.45,95,,percent of total billed charges,,,2475.9,90,,percent of total billed charges,,,2475.9,90,,percent of total billed charges,,,2255.82,82,,percent of total billed charges,,,2475.9,90,,percent of total billed charges,,,2338.35,85,,percent of total billed charges,,687.75,2613.45,
FF REMOVL OF FORN BDY SUBCUT TISSUE SMPL,20500925,CDM,10120,CPT,450,RC,outpatient,,2043,2043,,1734.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,510.75,22,,percent of total billed charges,,,,,,,,,1838.7,90,,percent of total billed charges,,,1691.6,82.8,,percent of total billed charges,,,1736.55,85,,percent of total billed charges,,,,,,,,,1797.84,88,,percent of total billed charges,,,,,,,,,1560.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,510.75,22,,percent of total billed charges,,,1859.13,91,,percent of total billed charges,,,1940.85,95,,percent of total billed charges,,,1695.69,83,,percent of total billed charges,,,1695.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1695.69,83,,percent of total billed charges,,,1940.85,95,,percent of total billed charges,,,1838.7,90,,percent of total billed charges,,,1838.7,90,,percent of total billed charges,,,1675.26,82,,percent of total billed charges,,,1838.7,90,,percent of total billed charges,,,1736.55,85,,percent of total billed charges,,510.75,1940.85,
"FF REMOVAL OF EMBEDDED FB, EYELID",20500926,CDM,67938,CPT,450,RC,outpatient,,467,467,,396.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.75,22,,percent of total billed charges,,,,,,,,,420.3,90,,percent of total billed charges,,,386.68,82.8,,percent of total billed charges,,,396.95,85,,percent of total billed charges,,,,,,,,,410.96,88,,percent of total billed charges,,,,,,,,,356.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.75,22,,percent of total billed charges,,,424.97,91,,percent of total billed charges,,,443.65,95,,percent of total billed charges,,,387.61,83,,percent of total billed charges,,,387.61,83,,percent of total billed charges,,,,,,,,,,,,,,,387.61,83,,percent of total billed charges,,,443.65,95,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,382.94,82,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,396.95,85,,percent of total billed charges,,116.75,443.65,
"FF REPAIR, EXTENSOR TENDON, FINGER",20500927,CDM,26418,CPT,450,RC,outpatient,,5568,5568,,4727.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1392,22,,percent of total billed charges,,,,,,,,,5011.2,90,,percent of total billed charges,,,4610.3,82.8,,percent of total billed charges,,,4732.8,85,,percent of total billed charges,,,,,,,,,4899.84,88,,percent of total billed charges,,,,,,,,,4253.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1392,22,,percent of total billed charges,,,5066.88,91,,percent of total billed charges,,,5289.6,95,,percent of total billed charges,,,4621.44,83,,percent of total billed charges,,,4621.44,83,,percent of total billed charges,,,,,,,,,,,,,,,4621.44,83,,percent of total billed charges,,,5289.6,95,,percent of total billed charges,,,5011.2,90,,percent of total billed charges,,,5011.2,90,,percent of total billed charges,,,4565.76,82,,percent of total billed charges,,,5011.2,90,,percent of total billed charges,,,4732.8,85,,percent of total billed charges,,1392,5289.6,
"FF UNLISTED PROCEDURE, HANDS OR FINGERS",20500928,CDM,26989,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
FF AVULSION OF NAIL PLATE,20500929,CDM,11730,CPT,450,RC,outpatient,,912,912,,774.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,228,22,,percent of total billed charges,,,,,,,,,820.8,90,,percent of total billed charges,,,755.14,82.8,,percent of total billed charges,,,775.2,85,,percent of total billed charges,,,,,,,,,802.56,88,,percent of total billed charges,,,,,,,,,696.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,228,22,,percent of total billed charges,,,829.92,91,,percent of total billed charges,,,866.4,95,,percent of total billed charges,,,756.96,83,,percent of total billed charges,,,756.96,83,,percent of total billed charges,,,,,,,,,,,,,,,756.96,83,,percent of total billed charges,,,866.4,95,,percent of total billed charges,,,820.8,90,,percent of total billed charges,,,820.8,90,,percent of total billed charges,,,747.84,82,,percent of total billed charges,,,820.8,90,,percent of total billed charges,,,775.2,85,,percent of total billed charges,,228,866.4,
FF SU-F N G H F COMP 2.6-7.5 CM,20500930,CDM,13132,CPT,450,RC,outpatient,,2414,2414,,2049.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,603.5,22,,percent of total billed charges,,,,,,,,,2172.6,90,,percent of total billed charges,,,1998.79,82.8,,percent of total billed charges,,,2051.9,85,,percent of total billed charges,,,,,,,,,2124.32,88,,percent of total billed charges,,,,,,,,,1844.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,603.5,22,,percent of total billed charges,,,2196.74,91,,percent of total billed charges,,,2293.3,95,,percent of total billed charges,,,2003.62,83,,percent of total billed charges,,,2003.62,83,,percent of total billed charges,,,,,,,,,,,,,,,2003.62,83,,percent of total billed charges,,,2293.3,95,,percent of total billed charges,,,2172.6,90,,percent of total billed charges,,,2172.6,90,,percent of total billed charges,,,1979.48,82,,percent of total billed charges,,,2172.6,90,,percent of total billed charges,,,2051.9,85,,percent of total billed charges,,603.5,2293.3,
FF REPAIR OF NAIL BED,20500931,CDM,11760,CPT,450,RC,outpatient,,1219,1219,,1034.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,304.75,22,,percent of total billed charges,,,,,,,,,1097.1,90,,percent of total billed charges,,,1009.33,82.8,,percent of total billed charges,,,1036.15,85,,percent of total billed charges,,,,,,,,,1072.72,88,,percent of total billed charges,,,,,,,,,931.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,304.75,22,,percent of total billed charges,,,1109.29,91,,percent of total billed charges,,,1158.05,95,,percent of total billed charges,,,1011.77,83,,percent of total billed charges,,,1011.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1011.77,83,,percent of total billed charges,,,1158.05,95,,percent of total billed charges,,,1097.1,90,,percent of total billed charges,,,1097.1,90,,percent of total billed charges,,,999.58,82,,percent of total billed charges,,,1097.1,90,,percent of total billed charges,,,1036.15,85,,percent of total billed charges,,304.75,1158.05,
FF DRAINAGE OF HEMATOMA,20500933,CDM,10140,CPT,450,RC,outpatient,,4020,4020,,3412.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1005,22,,percent of total billed charges,,,,,,,,,3618,90,,percent of total billed charges,,,3328.56,82.8,,percent of total billed charges,,,3417,85,,percent of total billed charges,,,,,,,,,3537.6,88,,percent of total billed charges,,,,,,,,,3071.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1005,22,,percent of total billed charges,,,3658.2,91,,percent of total billed charges,,,3819,95,,percent of total billed charges,,,3336.6,83,,percent of total billed charges,,,3336.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3336.6,83,,percent of total billed charges,,,3819,95,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3296.4,82,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3417,85,,percent of total billed charges,,1005,3819,
FF SU-S A L COMP 1.1-2.5 CM,20500935,CDM,13120,CPT,450,RC,outpatient,,1801,1801,,1529.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,450.25,22,,percent of total billed charges,,,,,,,,,1620.9,90,,percent of total billed charges,,,1491.23,82.8,,percent of total billed charges,,,1530.85,85,,percent of total billed charges,,,,,,,,,1584.88,88,,percent of total billed charges,,,,,,,,,1375.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,450.25,22,,percent of total billed charges,,,1638.91,91,,percent of total billed charges,,,1710.95,95,,percent of total billed charges,,,1494.83,83,,percent of total billed charges,,,1494.83,83,,percent of total billed charges,,,,,,,,,,,,,,,1494.83,83,,percent of total billed charges,,,1710.95,95,,percent of total billed charges,,,1620.9,90,,percent of total billed charges,,,1620.9,90,,percent of total billed charges,,,1476.82,82,,percent of total billed charges,,,1620.9,90,,percent of total billed charges,,,1530.85,85,,percent of total billed charges,,450.25,1710.95,
FF SU-S A L COMP 2.6-7.5 CM,20500936,CDM,13121,CPT,450,RC,outpatient,,2279,2279,,1934.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,569.75,22,,percent of total billed charges,,,,,,,,,2051.1,90,,percent of total billed charges,,,1887.01,82.8,,percent of total billed charges,,,1937.15,85,,percent of total billed charges,,,,,,,,,2005.52,88,,percent of total billed charges,,,,,,,,,1741.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,569.75,22,,percent of total billed charges,,,2073.89,91,,percent of total billed charges,,,2165.05,95,,percent of total billed charges,,,1891.57,83,,percent of total billed charges,,,1891.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1891.57,83,,percent of total billed charges,,,2165.05,95,,percent of total billed charges,,,2051.1,90,,percent of total billed charges,,,2051.1,90,,percent of total billed charges,,,1868.78,82,,percent of total billed charges,,,2051.1,90,,percent of total billed charges,,,1937.15,85,,percent of total billed charges,,569.75,2165.05,
"FF EXPLORATION PENETRATING WOUND, NECK",20500937,CDM,20100,CPT,450,RC,outpatient,,5947,5947,,5049,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1486.75,22,,percent of total billed charges,,,,,,,,,5352.3,90,,percent of total billed charges,,,4924.12,82.8,,percent of total billed charges,,,5054.95,85,,percent of total billed charges,,,,,,,,,5233.36,88,,percent of total billed charges,,,,,,,,,4543.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1486.75,22,,percent of total billed charges,,,5411.77,91,,percent of total billed charges,,,5649.65,95,,percent of total billed charges,,,4936.01,83,,percent of total billed charges,,,4936.01,83,,percent of total billed charges,,,,,,,,,,,,,,,4936.01,83,,percent of total billed charges,,,5649.65,95,,percent of total billed charges,,,5352.3,90,,percent of total billed charges,,,5352.3,90,,percent of total billed charges,,,4876.54,82,,percent of total billed charges,,,5352.3,90,,percent of total billed charges,,,5054.95,85,,percent of total billed charges,,1486.75,5649.65,
"FF EXPLOR PENETRATING WOUND, EXTREMITY",20500938,CDM,20103,CPT,450,RC,outpatient,,6322,6322,,5367.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1580.5,22,,percent of total billed charges,,,,,,,,,5689.8,90,,percent of total billed charges,,,5234.62,82.8,,percent of total billed charges,,,5373.7,85,,percent of total billed charges,,,,,,,,,5563.36,88,,percent of total billed charges,,,,,,,,,4830.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1580.5,22,,percent of total billed charges,,,5753.02,91,,percent of total billed charges,,,6005.9,95,,percent of total billed charges,,,5247.26,83,,percent of total billed charges,,,5247.26,83,,percent of total billed charges,,,,,,,,,,,,,,,5247.26,83,,percent of total billed charges,,,6005.9,95,,percent of total billed charges,,,5689.8,90,,percent of total billed charges,,,5689.8,90,,percent of total billed charges,,,5184.04,82,,percent of total billed charges,,,5689.8,90,,percent of total billed charges,,,5373.7,85,,percent of total billed charges,,1580.5,6005.9,
FF TRIGGER POINT INJ 1 OR 2 MUSCLE GRP,20500939,CDM,20552,CPT,450,RC,outpatient,,1943,1943,,1649.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,485.75,22,,percent of total billed charges,,,,,,,,,1748.7,90,,percent of total billed charges,,,1608.8,82.8,,percent of total billed charges,,,1651.55,85,,percent of total billed charges,,,,,,,,,1709.84,88,,percent of total billed charges,,,,,,,,,1484.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,485.75,22,,percent of total billed charges,,,1768.13,91,,percent of total billed charges,,,1845.85,95,,percent of total billed charges,,,1612.69,83,,percent of total billed charges,,,1612.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1612.69,83,,percent of total billed charges,,,1845.85,95,,percent of total billed charges,,,1748.7,90,,percent of total billed charges,,,1748.7,90,,percent of total billed charges,,,1593.26,82,,percent of total billed charges,,,1748.7,90,,percent of total billed charges,,,1651.55,85,,percent of total billed charges,,485.75,1845.85,
FF TRIGGER PNT INJ 3 OR MORE MUSCLE GRP,20500940,CDM,20553,CPT,450,RC,outpatient,,936,936,,794.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,234,22,,percent of total billed charges,,,,,,,,,842.4,90,,percent of total billed charges,,,775.01,82.8,,percent of total billed charges,,,795.6,85,,percent of total billed charges,,,,,,,,,823.68,88,,percent of total billed charges,,,,,,,,,715.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,234,22,,percent of total billed charges,,,851.76,91,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,,,,,,,,,,,,,776.88,83,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,767.52,82,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,795.6,85,,percent of total billed charges,,234,889.2,
FF CLSD TX PROX HUMERAL FX W/MANIPULATIO,20500941,CDM,23605,CPT,450,RC,outpatient,,4766,4766,,4046.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1191.5,22,,percent of total billed charges,,,,,,,,,4289.4,90,,percent of total billed charges,,,3946.25,82.8,,percent of total billed charges,,,4051.1,85,,percent of total billed charges,,,,,,,,,4194.08,88,,percent of total billed charges,,,,,,,,,3641.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1191.5,22,,percent of total billed charges,,,4337.06,91,,percent of total billed charges,,,4527.7,95,,percent of total billed charges,,,3955.78,83,,percent of total billed charges,,,3955.78,83,,percent of total billed charges,,,,,,,,,,,,,,,3955.78,83,,percent of total billed charges,,,4527.7,95,,percent of total billed charges,,,4289.4,90,,percent of total billed charges,,,4289.4,90,,percent of total billed charges,,,3908.12,82,,percent of total billed charges,,,4289.4,90,,percent of total billed charges,,,4051.1,85,,percent of total billed charges,,1191.5,4527.7,
FF RPR/ADV OF TENDON IN FINGER,20500942,CDM,26370,CPT,450,RC,outpatient,,8940,8940,,7590.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2235,22,,percent of total billed charges,,,,,,,,,8046,90,,percent of total billed charges,,,7402.32,82.8,,percent of total billed charges,,,7599,85,,percent of total billed charges,,,,,,,,,7867.2,88,,percent of total billed charges,,,,,,,,,6830.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2235,22,,percent of total billed charges,,,8135.4,91,,percent of total billed charges,,,8493,95,,percent of total billed charges,,,7420.2,83,,percent of total billed charges,,,7420.2,83,,percent of total billed charges,,,,,,,,,,,,,,,7420.2,83,,percent of total billed charges,,,8493,95,,percent of total billed charges,,,8046,90,,percent of total billed charges,,,8046,90,,percent of total billed charges,,,7330.8,82,,percent of total billed charges,,,8046,90,,percent of total billed charges,,,7599,85,,percent of total billed charges,,2235,8493,
FF CLSD TX INTERPHALANGEAL JOINT DISL,20500943,CDM,26770,CPT,450,RC,outpatient,,1707,1707,,1449.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,426.75,22,,percent of total billed charges,,,,,,,,,1536.3,90,,percent of total billed charges,,,1413.4,82.8,,percent of total billed charges,,,1450.95,85,,percent of total billed charges,,,,,,,,,1502.16,88,,percent of total billed charges,,,,,,,,,1304.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,426.75,22,,percent of total billed charges,,,1553.37,91,,percent of total billed charges,,,1621.65,95,,percent of total billed charges,,,1416.81,83,,percent of total billed charges,,,1416.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1416.81,83,,percent of total billed charges,,,1621.65,95,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1399.74,82,,percent of total billed charges,,,1536.3,90,,percent of total billed charges,,,1450.95,85,,percent of total billed charges,,426.75,1621.65,
FF KNEE DISLOCATION W/O ANESTHESIA,20500944,CDM,27550,CPT,450,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
FF CLOSED REDUCTION PATELLA W/O ANESTH,20500945,CDM,27560,CPT,450,RC,outpatient,,1120,1120,,950.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,280,22,,percent of total billed charges,,,,,,,,,1008,90,,percent of total billed charges,,,927.36,82.8,,percent of total billed charges,,,952,85,,percent of total billed charges,,,,,,,,,985.6,88,,percent of total billed charges,,,,,,,,,855.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,280,22,,percent of total billed charges,,,1019.2,91,,percent of total billed charges,,,1064,95,,percent of total billed charges,,,929.6,83,,percent of total billed charges,,,929.6,83,,percent of total billed charges,,,,,,,,,,,,,,,929.6,83,,percent of total billed charges,,,1064,95,,percent of total billed charges,,,1008,90,,percent of total billed charges,,,1008,90,,percent of total billed charges,,,918.4,82,,percent of total billed charges,,,1008,90,,percent of total billed charges,,,952,85,,percent of total billed charges,,280,1064,
"FF REMOVAL OF FB, SUBQ, FOOT",20500946,CDM,28190,CPT,450,RC,outpatient,,1499,1499,,1272.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,374.75,22,,percent of total billed charges,,,,,,,,,1349.1,90,,percent of total billed charges,,,1241.17,82.8,,percent of total billed charges,,,1274.15,85,,percent of total billed charges,,,,,,,,,1319.12,88,,percent of total billed charges,,,,,,,,,1145.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,374.75,22,,percent of total billed charges,,,1364.09,91,,percent of total billed charges,,,1424.05,95,,percent of total billed charges,,,1244.17,83,,percent of total billed charges,,,1244.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1244.17,83,,percent of total billed charges,,,1424.05,95,,percent of total billed charges,,,1349.1,90,,percent of total billed charges,,,1349.1,90,,percent of total billed charges,,,1229.18,82,,percent of total billed charges,,,1349.1,90,,percent of total billed charges,,,1274.15,85,,percent of total billed charges,,374.75,1424.05,
FF ARTERIAL PUNCTURE DIAGNOSTIC,20500947,CDM,36600,CPT,450,RC,outpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.5,22,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,170.57,82.8,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.5,22,,percent of total billed charges,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,51.5,195.7,
FF INCISION OF THROMBOSED HEMORRHOID,20500948,CDM,46083,CPT,450,RC,outpatient,,1274,1274,,1081.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,318.5,22,,percent of total billed charges,,,,,,,,,1146.6,90,,percent of total billed charges,,,1054.87,82.8,,percent of total billed charges,,,1082.9,85,,percent of total billed charges,,,,,,,,,1121.12,88,,percent of total billed charges,,,,,,,,,973.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,318.5,22,,percent of total billed charges,,,1159.34,91,,percent of total billed charges,,,1210.3,95,,percent of total billed charges,,,1057.42,83,,percent of total billed charges,,,1057.42,83,,percent of total billed charges,,,,,,,,,,,,,,,1057.42,83,,percent of total billed charges,,,1210.3,95,,percent of total billed charges,,,1146.6,90,,percent of total billed charges,,,1146.6,90,,percent of total billed charges,,,1044.68,82,,percent of total billed charges,,,1146.6,90,,percent of total billed charges,,,1082.9,85,,percent of total billed charges,,318.5,1210.3,
FF OB DELIVERY BY ED STAFF,20500949,CDM,59409,CPT,450,RC,outpatient,,7348,7348,,6238.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1837,22,,percent of total billed charges,,,,,,,,,6613.2,90,,percent of total billed charges,,,6084.14,82.8,,percent of total billed charges,,,6245.8,85,,percent of total billed charges,,,,,,,,,6466.24,88,,percent of total billed charges,,,,,,,,,5613.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1837,22,,percent of total billed charges,,,6686.68,91,,percent of total billed charges,,,6980.6,95,,percent of total billed charges,,,6098.84,83,,percent of total billed charges,,,6098.84,83,,percent of total billed charges,,,,,,,,,,,,,,,6098.84,83,,percent of total billed charges,,,6980.6,95,,percent of total billed charges,,,6613.2,90,,percent of total billed charges,,,6613.2,90,,percent of total billed charges,,,6025.36,82,,percent of total billed charges,,,6613.2,90,,percent of total billed charges,,,6245.8,85,,percent of total billed charges,,1837,6980.6,
"FF BLEPHAROTOMY, ABSCESS DR, EYELID",20500950,CDM,67700,CPT,450,RC,outpatient,,953,953,,809.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,238.25,22,,percent of total billed charges,,,,,,,,,857.7,90,,percent of total billed charges,,,789.08,82.8,,percent of total billed charges,,,810.05,85,,percent of total billed charges,,,,,,,,,838.64,88,,percent of total billed charges,,,,,,,,,728.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,238.25,22,,percent of total billed charges,,,867.23,91,,percent of total billed charges,,,905.35,95,,percent of total billed charges,,,790.99,83,,percent of total billed charges,,,790.99,83,,percent of total billed charges,,,,,,,,,,,,,,,790.99,83,,percent of total billed charges,,,905.35,95,,percent of total billed charges,,,857.7,90,,percent of total billed charges,,,857.7,90,,percent of total billed charges,,,781.46,82,,percent of total billed charges,,,857.7,90,,percent of total billed charges,,,810.05,85,,percent of total billed charges,,238.25,905.35,
FF TEMPORARY EXTERNAL PACING,20500951,CDM,92953,CPT,450,RC,outpatient,,905,905,,768.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,226.25,22,,percent of total billed charges,,,,,,,,,814.5,90,,percent of total billed charges,,,749.34,82.8,,percent of total billed charges,,,769.25,85,,percent of total billed charges,,,,,,,,,796.4,88,,percent of total billed charges,,,,,,,,,691.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,226.25,22,,percent of total billed charges,,,823.55,91,,percent of total billed charges,,,859.75,95,,percent of total billed charges,,,751.15,83,,percent of total billed charges,,,751.15,83,,percent of total billed charges,,,,,,,,,,,,,,,751.15,83,,percent of total billed charges,,,859.75,95,,percent of total billed charges,,,814.5,90,,percent of total billed charges,,,814.5,90,,percent of total billed charges,,,742.1,82,,percent of total billed charges,,,814.5,90,,percent of total billed charges,,,769.25,85,,percent of total billed charges,,226.25,859.75,
FF TUBE THORACOSTOMY,20500960,CDM,32551,CPT,450,RC,outpatient,,3503,3503,,2974.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,875.75,22,,percent of total billed charges,,,,,,,,,3152.7,90,,percent of total billed charges,,,2900.48,82.8,,percent of total billed charges,,,2977.55,85,,percent of total billed charges,,,,,,,,,3082.64,88,,percent of total billed charges,,,,,,,,,2676.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,875.75,22,,percent of total billed charges,,,3187.73,91,,percent of total billed charges,,,3327.85,95,,percent of total billed charges,,,2907.49,83,,percent of total billed charges,,,2907.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2907.49,83,,percent of total billed charges,,,3327.85,95,,percent of total billed charges,,,3152.7,90,,percent of total billed charges,,,3152.7,90,,percent of total billed charges,,,2872.46,82,,percent of total billed charges,,,3152.7,90,,percent of total billed charges,,,2977.55,85,,percent of total billed charges,,875.75,3327.85,
FF UNLISTED PROCEDURE RECTUM,20500961,CDM,45999,CPT,450,RC,outpatient,,4905,4905,,4164.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1226.25,22,,percent of total billed charges,,,,,,,,,4414.5,90,,percent of total billed charges,,,4061.34,82.8,,percent of total billed charges,,,4169.25,85,,percent of total billed charges,,,,,,,,,4316.4,88,,percent of total billed charges,,,,,,,,,3747.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1226.25,22,,percent of total billed charges,,,4463.55,91,,percent of total billed charges,,,4659.75,95,,percent of total billed charges,,,4071.15,83,,percent of total billed charges,,,4071.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4071.15,83,,percent of total billed charges,,,4659.75,95,,percent of total billed charges,,,4414.5,90,,percent of total billed charges,,,4414.5,90,,percent of total billed charges,,,4022.1,82,,percent of total billed charges,,,4414.5,90,,percent of total billed charges,,,4169.25,85,,percent of total billed charges,,1226.25,4659.75,
FF CLOSED TREAT RADIAL ULNAR W MANIPULAT,20500962,CDM,25565,CPT,450,RC,outpatient,,2535,2535,,2152.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,633.75,22,,percent of total billed charges,,,,,,,,,2281.5,90,,percent of total billed charges,,,2098.98,82.8,,percent of total billed charges,,,2154.75,85,,percent of total billed charges,,,,,,,,,2230.8,88,,percent of total billed charges,,,,,,,,,1936.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,633.75,22,,percent of total billed charges,,,2306.85,91,,percent of total billed charges,,,2408.25,95,,percent of total billed charges,,,2104.05,83,,percent of total billed charges,,,2104.05,83,,percent of total billed charges,,,,,,,,,,,,,,,2104.05,83,,percent of total billed charges,,,2408.25,95,,percent of total billed charges,,,2281.5,90,,percent of total billed charges,,,2281.5,90,,percent of total billed charges,,,2078.7,82,,percent of total billed charges,,,2281.5,90,,percent of total billed charges,,,2154.75,85,,percent of total billed charges,,633.75,2408.25,
FF EXPLOR PENETRATING WOUND ABD/BACK,20500970,CDM,20102,CPT,450,RC,outpatient,,7487,7487,,6356.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1871.75,22,,percent of total billed charges,,,,,,,,,6738.3,90,,percent of total billed charges,,,6199.24,82.8,,percent of total billed charges,,,6363.95,85,,percent of total billed charges,,,,,,,,,6588.56,88,,percent of total billed charges,,,,,,,,,5720.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1871.75,22,,percent of total billed charges,,,6813.17,91,,percent of total billed charges,,,7112.65,95,,percent of total billed charges,,,6214.21,83,,percent of total billed charges,,,6214.21,83,,percent of total billed charges,,,,,,,,,,,,,,,6214.21,83,,percent of total billed charges,,,7112.65,95,,percent of total billed charges,,,6738.3,90,,percent of total billed charges,,,6738.3,90,,percent of total billed charges,,,6139.34,82,,percent of total billed charges,,,6738.3,90,,percent of total billed charges,,,6363.95,85,,percent of total billed charges,,1871.75,7112.65,
FF CLD TREAT METACARP FRACT SG W/ MANIP,20500972,CDM,26605,CPT,450,RC,outpatient,,1686,1686,,1431.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,421.5,22,,percent of total billed charges,,,,,,,,,1517.4,90,,percent of total billed charges,,,1396.01,82.8,,percent of total billed charges,,,1433.1,85,,percent of total billed charges,,,,,,,,,1483.68,88,,percent of total billed charges,,,,,,,,,1288.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,421.5,22,,percent of total billed charges,,,1534.26,91,,percent of total billed charges,,,1601.7,95,,percent of total billed charges,,,1399.38,83,,percent of total billed charges,,,1399.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1399.38,83,,percent of total billed charges,,,1601.7,95,,percent of total billed charges,,,1517.4,90,,percent of total billed charges,,,1517.4,90,,percent of total billed charges,,,1382.52,82,,percent of total billed charges,,,1517.4,90,,percent of total billed charges,,,1433.1,85,,percent of total billed charges,,421.5,1601.7,
FF CLOSED SHLD RELOCAT W/SEDATIO,20500975,CDM,23655,CPT,450,RC,outpatient,,4297,4297,,3648.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1074.25,22,,percent of total billed charges,,,,,,,,,3867.3,90,,percent of total billed charges,,,3557.92,82.8,,percent of total billed charges,,,3652.45,85,,percent of total billed charges,,,,,,,,,3781.36,88,,percent of total billed charges,,,,,,,,,3282.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1074.25,22,,percent of total billed charges,,,3910.27,91,,percent of total billed charges,,,4082.15,95,,percent of total billed charges,,,3566.51,83,,percent of total billed charges,,,3566.51,83,,percent of total billed charges,,,,,,,,,,,,,,,3566.51,83,,percent of total billed charges,,,4082.15,95,,percent of total billed charges,,,3867.3,90,,percent of total billed charges,,,3867.3,90,,percent of total billed charges,,,3523.54,82,,percent of total billed charges,,,3867.3,90,,percent of total billed charges,,,3652.45,85,,percent of total billed charges,,1074.25,4082.15,
FF I&D PERINEAL ABSCESS,20500976,CDM,56405,CPT,450,RC,outpatient,,3960,3960,,3362.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,990,22,,percent of total billed charges,,,,,,,,,3564,90,,percent of total billed charges,,,3278.88,82.8,,percent of total billed charges,,,3366,85,,percent of total billed charges,,,,,,,,,3484.8,88,,percent of total billed charges,,,,,,,,,3025.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,990,22,,percent of total billed charges,,,3603.6,91,,percent of total billed charges,,,3762,95,,percent of total billed charges,,,3286.8,83,,percent of total billed charges,,,3286.8,83,,percent of total billed charges,,,,,,,,,,,,,,,3286.8,83,,percent of total billed charges,,,3762,95,,percent of total billed charges,,,3564,90,,percent of total billed charges,,,3564,90,,percent of total billed charges,,,3247.2,82,,percent of total billed charges,,,3564,90,,percent of total billed charges,,,3366,85,,percent of total billed charges,,990,3762,
FF INJECTION BURSA INTERMEDIATE,20500978,CDM,20605,CPT,450,RC,outpatient,,710,710,,602.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,177.5,22,,percent of total billed charges,,,,,,,,,639,90,,percent of total billed charges,,,587.88,82.8,,percent of total billed charges,,,603.5,85,,percent of total billed charges,,,,,,,,,624.8,88,,percent of total billed charges,,,,,,,,,542.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,177.5,22,,percent of total billed charges,,,646.1,91,,percent of total billed charges,,,674.5,95,,percent of total billed charges,,,589.3,83,,percent of total billed charges,,,589.3,83,,percent of total billed charges,,,,,,,,,,,,,,,589.3,83,,percent of total billed charges,,,674.5,95,,percent of total billed charges,,,639,90,,percent of total billed charges,,,639,90,,percent of total billed charges,,,582.2,82,,percent of total billed charges,,,639,90,,percent of total billed charges,,,603.5,85,,percent of total billed charges,,177.5,674.5,
FF BURSA INTERMEDIATE,20500979,CDM,20605,CPT,450,RC,outpatient,,710,710,,602.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,177.5,22,,percent of total billed charges,,,,,,,,,639,90,,percent of total billed charges,,,587.88,82.8,,percent of total billed charges,,,603.5,85,,percent of total billed charges,,,,,,,,,624.8,88,,percent of total billed charges,,,,,,,,,542.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,177.5,22,,percent of total billed charges,,,646.1,91,,percent of total billed charges,,,674.5,95,,percent of total billed charges,,,589.3,83,,percent of total billed charges,,,589.3,83,,percent of total billed charges,,,,,,,,,,,,,,,589.3,83,,percent of total billed charges,,,674.5,95,,percent of total billed charges,,,639,90,,percent of total billed charges,,,639,90,,percent of total billed charges,,,582.2,82,,percent of total billed charges,,,639,90,,percent of total billed charges,,,603.5,85,,percent of total billed charges,,177.5,674.5,
FF BURSA INTERMEDIATE,20500980,CDM,20605,CPT,450,RC,outpatient,,710,710,,602.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,177.5,22,,percent of total billed charges,,,,,,,,,639,90,,percent of total billed charges,,,587.88,82.8,,percent of total billed charges,,,603.5,85,,percent of total billed charges,,,,,,,,,624.8,88,,percent of total billed charges,,,,,,,,,542.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,177.5,22,,percent of total billed charges,,,646.1,91,,percent of total billed charges,,,674.5,95,,percent of total billed charges,,,589.3,83,,percent of total billed charges,,,589.3,83,,percent of total billed charges,,,,,,,,,,,,,,,589.3,83,,percent of total billed charges,,,674.5,95,,percent of total billed charges,,,639,90,,percent of total billed charges,,,639,90,,percent of total billed charges,,,582.2,82,,percent of total billed charges,,,639,90,,percent of total billed charges,,,603.5,85,,percent of total billed charges,,177.5,674.5,
FF PUNCTURE ASPIRATION OF ABCESS CYST BU,20500985,CDM,10160,CPT,450,RC,outpatient,,597,597,,506.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149.25,22,,percent of total billed charges,,,,,,,,,537.3,90,,percent of total billed charges,,,494.32,82.8,,percent of total billed charges,,,507.45,85,,percent of total billed charges,,,,,,,,,525.36,88,,percent of total billed charges,,,,,,,,,456.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149.25,22,,percent of total billed charges,,,543.27,91,,percent of total billed charges,,,567.15,95,,percent of total billed charges,,,495.51,83,,percent of total billed charges,,,495.51,83,,percent of total billed charges,,,,,,,,,,,,,,,495.51,83,,percent of total billed charges,,,567.15,95,,percent of total billed charges,,,537.3,90,,percent of total billed charges,,,537.3,90,,percent of total billed charges,,,489.54,82,,percent of total billed charges,,,537.3,90,,percent of total billed charges,,,507.45,85,,percent of total billed charges,,149.25,567.15,
FF CLOSED TREAT ANKLE FX W ANESTHESIA,20500990,CDM,27810,CPT,450,RC,outpatient,,2853,2853,,2422.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,713.25,22,,percent of total billed charges,,,,,,,,,2567.7,90,,percent of total billed charges,,,2362.28,82.8,,percent of total billed charges,,,2425.05,85,,percent of total billed charges,,,,,,,,,2510.64,88,,percent of total billed charges,,,,,,,,,2179.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,713.25,22,,percent of total billed charges,,,2596.23,91,,percent of total billed charges,,,2710.35,95,,percent of total billed charges,,,2367.99,83,,percent of total billed charges,,,2367.99,83,,percent of total billed charges,,,,,,,,,,,,,,,2367.99,83,,percent of total billed charges,,,2710.35,95,,percent of total billed charges,,,2567.7,90,,percent of total billed charges,,,2567.7,90,,percent of total billed charges,,,2339.46,82,,percent of total billed charges,,,2567.7,90,,percent of total billed charges,,,2425.05,85,,percent of total billed charges,,713.25,2710.35,
FF CLOSED REDUCTION OF GREAT TOE,20501000,CDM,28495,CPT,450,RC,outpatient,,852,852,,723.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,213,22,,percent of total billed charges,,,,,,,,,766.8,90,,percent of total billed charges,,,705.46,82.8,,percent of total billed charges,,,724.2,85,,percent of total billed charges,,,,,,,,,749.76,88,,percent of total billed charges,,,,,,,,,650.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,213,22,,percent of total billed charges,,,775.32,91,,percent of total billed charges,,,809.4,95,,percent of total billed charges,,,707.16,83,,percent of total billed charges,,,707.16,83,,percent of total billed charges,,,,,,,,,,,,,,,707.16,83,,percent of total billed charges,,,809.4,95,,percent of total billed charges,,,766.8,90,,percent of total billed charges,,,766.8,90,,percent of total billed charges,,,698.64,82,,percent of total billed charges,,,766.8,90,,percent of total billed charges,,,724.2,85,,percent of total billed charges,,213,809.4,
FF TREATMENT ANKLE FRACTURE,20501001,CDM,28435,CPT,450,RC,outpatient,,3510,3510,,2979.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,877.5,22,,percent of total billed charges,,,,,,,,,3159,90,,percent of total billed charges,,,2906.28,82.8,,percent of total billed charges,,,2983.5,85,,percent of total billed charges,,,,,,,,,3088.8,88,,percent of total billed charges,,,,,,,,,2681.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,877.5,22,,percent of total billed charges,,,3194.1,91,,percent of total billed charges,,,3334.5,95,,percent of total billed charges,,,2913.3,83,,percent of total billed charges,,,2913.3,83,,percent of total billed charges,,,,,,,,,,,,,,,2913.3,83,,percent of total billed charges,,,3334.5,95,,percent of total billed charges,,,3159,90,,percent of total billed charges,,,3159,90,,percent of total billed charges,,,2878.2,82,,percent of total billed charges,,,3159,90,,percent of total billed charges,,,2983.5,85,,percent of total billed charges,,877.5,3334.5,
FF CLOSED TREAT FRACTURE ULNA,20501002,CDM,25535,CPT,450,RC,outpatient,,3704,3704,,3144.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,926,22,,percent of total billed charges,,,,,,,,,3333.6,90,,percent of total billed charges,,,3066.91,82.8,,percent of total billed charges,,,3148.4,85,,percent of total billed charges,,,,,,,,,3259.52,88,,percent of total billed charges,,,,,,,,,2829.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,926,22,,percent of total billed charges,,,3370.64,91,,percent of total billed charges,,,3518.8,95,,percent of total billed charges,,,3074.32,83,,percent of total billed charges,,,3074.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3074.32,83,,percent of total billed charges,,,3518.8,95,,percent of total billed charges,,,3333.6,90,,percent of total billed charges,,,3333.6,90,,percent of total billed charges,,,3037.28,82,,percent of total billed charges,,,3333.6,90,,percent of total billed charges,,,3148.4,85,,percent of total billed charges,,926,3518.8,
FF CLOSED REDUCTION FINGER WO ANEST,20501003,CDM,26775,CPT,450,RC,outpatient,,2422,2422,,2056.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,605.5,22,,percent of total billed charges,,,,,,,,,2179.8,90,,percent of total billed charges,,,2005.42,82.8,,percent of total billed charges,,,2058.7,85,,percent of total billed charges,,,,,,,,,2131.36,88,,percent of total billed charges,,,,,,,,,1850.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,605.5,22,,percent of total billed charges,,,2204.02,91,,percent of total billed charges,,,2300.9,95,,percent of total billed charges,,,2010.26,83,,percent of total billed charges,,,2010.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2010.26,83,,percent of total billed charges,,,2300.9,95,,percent of total billed charges,,,2179.8,90,,percent of total billed charges,,,2179.8,90,,percent of total billed charges,,,1986.04,82,,percent of total billed charges,,,2179.8,90,,percent of total billed charges,,,2058.7,85,,percent of total billed charges,,605.5,2300.9,
FF REMOVAL IMPACTED EAR WAX UNI,20501004,CDM,69209,CPT,450,RC,outpatient,,233,233,,197.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,58.25,22,,percent of total billed charges,,,,,,,,,209.7,90,,percent of total billed charges,,,192.92,82.8,,percent of total billed charges,,,198.05,85,,percent of total billed charges,,,,,,,,,205.04,88,,percent of total billed charges,,,,,,,,,178.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,58.25,22,,percent of total billed charges,,,212.03,91,,percent of total billed charges,,,221.35,95,,percent of total billed charges,,,193.39,83,,percent of total billed charges,,,193.39,83,,percent of total billed charges,,,,,,,,,,,,,,,193.39,83,,percent of total billed charges,,,221.35,95,,percent of total billed charges,,,209.7,90,,percent of total billed charges,,,209.7,90,,percent of total billed charges,,,191.06,82,,percent of total billed charges,,,209.7,90,,percent of total billed charges,,,198.05,85,,percent of total billed charges,,58.25,221.35,
FF TREAT FINGER FRACTURE EACH,20501005,CDM,26755,CPT,450,RC,outpatient,,1161,1161,,985.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,290.25,22,,percent of total billed charges,,,,,,,,,1044.9,90,,percent of total billed charges,,,961.31,82.8,,percent of total billed charges,,,986.85,85,,percent of total billed charges,,,,,,,,,1021.68,88,,percent of total billed charges,,,,,,,,,887,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,290.25,22,,percent of total billed charges,,,1056.51,91,,percent of total billed charges,,,1102.95,95,,percent of total billed charges,,,963.63,83,,percent of total billed charges,,,963.63,83,,percent of total billed charges,,,,,,,,,,,,,,,963.63,83,,percent of total billed charges,,,1102.95,95,,percent of total billed charges,,,1044.9,90,,percent of total billed charges,,,1044.9,90,,percent of total billed charges,,,952.02,82,,percent of total billed charges,,,1044.9,90,,percent of total billed charges,,,986.85,85,,percent of total billed charges,,290.25,1102.95,
FF CLOSED REDUCT OF KNEE CAP DISL W/ANES,20501006,CDM,27562,CPT,450,RC,outpatient,,2209,2209,,1875.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,552.25,22,,percent of total billed charges,,,,,,,,,1988.1,90,,percent of total billed charges,,,1829.05,82.8,,percent of total billed charges,,,1877.65,85,,percent of total billed charges,,,,,,,,,1943.92,88,,percent of total billed charges,,,,,,,,,1687.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,552.25,22,,percent of total billed charges,,,2010.19,91,,percent of total billed charges,,,2098.55,95,,percent of total billed charges,,,1833.47,83,,percent of total billed charges,,,1833.47,83,,percent of total billed charges,,,,,,,,,,,,,,,1833.47,83,,percent of total billed charges,,,2098.55,95,,percent of total billed charges,,,1988.1,90,,percent of total billed charges,,,1988.1,90,,percent of total billed charges,,,1811.38,82,,percent of total billed charges,,,1988.1,90,,percent of total billed charges,,,1877.65,85,,percent of total billed charges,,552.25,2098.55,
FF TX SUPERFICIAL WOUND DEHISCENCE,20501007,CDM,12020,CPT,450,RC,outpatient,,5853,5853,,4969.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1463.25,22,,percent of total billed charges,,,,,,,,,5267.7,90,,percent of total billed charges,,,4846.28,82.8,,percent of total billed charges,,,4975.05,85,,percent of total billed charges,,,,,,,,,5150.64,88,,percent of total billed charges,,,,,,,,,4471.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1463.25,22,,percent of total billed charges,,,5326.23,91,,percent of total billed charges,,,5560.35,95,,percent of total billed charges,,,4857.99,83,,percent of total billed charges,,,4857.99,83,,percent of total billed charges,,,,,,,,,,,,,,,4857.99,83,,percent of total billed charges,,,5560.35,95,,percent of total billed charges,,,5267.7,90,,percent of total billed charges,,,5267.7,90,,percent of total billed charges,,,4799.46,82,,percent of total billed charges,,,5267.7,90,,percent of total billed charges,,,4975.05,85,,percent of total billed charges,,1463.25,5560.35,
FF CLOSED TREATMENT KNEE DISLOCA W ANETH,20501008,CDM,27552,CPT,450,RC,outpatient,,7165,7165,,6083.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1791.25,22,,percent of total billed charges,,,,,,,,,6448.5,90,,percent of total billed charges,,,5932.62,82.8,,percent of total billed charges,,,6090.25,85,,percent of total billed charges,,,,,,,,,6305.2,88,,percent of total billed charges,,,,,,,,,5474.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1791.25,22,,percent of total billed charges,,,6520.15,91,,percent of total billed charges,,,6806.75,95,,percent of total billed charges,,,5946.95,83,,percent of total billed charges,,,5946.95,83,,percent of total billed charges,,,,,,,,,,,,,,,5946.95,83,,percent of total billed charges,,,6806.75,95,,percent of total billed charges,,,6448.5,90,,percent of total billed charges,,,6448.5,90,,percent of total billed charges,,,5875.3,82,,percent of total billed charges,,,6448.5,90,,percent of total billed charges,,,6090.25,85,,percent of total billed charges,,1791.25,6806.75,
FF CLOSED TRTMT LOWER LEG FRACTURE W ANE,20501009,CDM,27825,CPT,450,RC,outpatient,,6022,6022,,5112.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1505.5,22,,percent of total billed charges,,,,,,,,,5419.8,90,,percent of total billed charges,,,4986.22,82.8,,percent of total billed charges,,,5118.7,85,,percent of total billed charges,,,,,,,,,5299.36,88,,percent of total billed charges,,,,,,,,,4600.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1505.5,22,,percent of total billed charges,,,5480.02,91,,percent of total billed charges,,,5720.9,95,,percent of total billed charges,,,4998.26,83,,percent of total billed charges,,,4998.26,83,,percent of total billed charges,,,,,,,,,,,,,,,4998.26,83,,percent of total billed charges,,,5720.9,95,,percent of total billed charges,,,5419.8,90,,percent of total billed charges,,,5419.8,90,,percent of total billed charges,,,4938.04,82,,percent of total billed charges,,,5419.8,90,,percent of total billed charges,,,5118.7,85,,percent of total billed charges,,1505.5,5720.9,
FF CLSD TX HUMERAL FX W/MANIPULATIO,20501010,CDM,24505,CPT,450,RC,outpatient,,2357,2357,,2001.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,589.25,22,,percent of total billed charges,,,,,,,,,2121.3,90,,percent of total billed charges,,,1951.6,82.8,,percent of total billed charges,,,2003.45,85,,percent of total billed charges,,,,,,,,,2074.16,88,,percent of total billed charges,,,,,,,,,1800.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,589.25,22,,percent of total billed charges,,,2144.87,91,,percent of total billed charges,,,2239.15,95,,percent of total billed charges,,,1956.31,83,,percent of total billed charges,,,1956.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1956.31,83,,percent of total billed charges,,,2239.15,95,,percent of total billed charges,,,2121.3,90,,percent of total billed charges,,,2121.3,90,,percent of total billed charges,,,1932.74,82,,percent of total billed charges,,,2121.3,90,,percent of total billed charges,,,2003.45,85,,percent of total billed charges,,589.25,2239.15,
FF CLOSED TREATMENT OF TIBIA FRACTURE,20501011,CDM,27752,CPT,450,RC,outpatient,,4234,4234,,3594.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1058.5,22,,percent of total billed charges,,,,,,,,,3810.6,90,,percent of total billed charges,,,3505.75,82.8,,percent of total billed charges,,,3598.9,85,,percent of total billed charges,,,,,,,,,3725.92,88,,percent of total billed charges,,,,,,,,,3234.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1058.5,22,,percent of total billed charges,,,3852.94,91,,percent of total billed charges,,,4022.3,95,,percent of total billed charges,,,3514.22,83,,percent of total billed charges,,,3514.22,83,,percent of total billed charges,,,,,,,,,,,,,,,3514.22,83,,percent of total billed charges,,,4022.3,95,,percent of total billed charges,,,3810.6,90,,percent of total billed charges,,,3810.6,90,,percent of total billed charges,,,3471.88,82,,percent of total billed charges,,,3810.6,90,,percent of total billed charges,,,3598.9,85,,percent of total billed charges,,1058.5,4022.3,
FF SPON CLOSED TRMT HIP DISLTN W ANES,20501012,CDM,27257,CPT,450,RC,outpatient,,3860,3860,,3277.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,965,22,,percent of total billed charges,,,,,,,,,3474,90,,percent of total billed charges,,,3196.08,82.8,,percent of total billed charges,,,3281,85,,percent of total billed charges,,,,,,,,,3396.8,88,,percent of total billed charges,,,,,,,,,2949.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,965,22,,percent of total billed charges,,,3512.6,91,,percent of total billed charges,,,3667,95,,percent of total billed charges,,,3203.8,83,,percent of total billed charges,,,3203.8,83,,percent of total billed charges,,,,,,,,,,,,,,,3203.8,83,,percent of total billed charges,,,3667,95,,percent of total billed charges,,,3474,90,,percent of total billed charges,,,3474,90,,percent of total billed charges,,,3165.2,82,,percent of total billed charges,,,3474,90,,percent of total billed charges,,,3281,85,,percent of total billed charges,,965,3667,
FF CLOSED RED POST HIP ARTH W/O ANETH,20501013,CDM,27265,CPT,450,RC,outpatient,,1514,1514,,1285.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,378.5,22,,percent of total billed charges,,,,,,,,,1362.6,90,,percent of total billed charges,,,1253.59,82.8,,percent of total billed charges,,,1286.9,85,,percent of total billed charges,,,,,,,,,1332.32,88,,percent of total billed charges,,,,,,,,,1156.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,378.5,22,,percent of total billed charges,,,1377.74,91,,percent of total billed charges,,,1438.3,95,,percent of total billed charges,,,1256.62,83,,percent of total billed charges,,,1256.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1256.62,83,,percent of total billed charges,,,1438.3,95,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1241.48,82,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1286.9,85,,percent of total billed charges,,378.5,1438.3,
FF EXC B9 LESION MRGN XCP SK TG 2.1-3.0,20501014,CDM,11403,CPT,450,RC,outpatient,,2901,2901,,2462.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,725.25,22,,percent of total billed charges,,,,,,,,,2610.9,90,,percent of total billed charges,,,2402.03,82.8,,percent of total billed charges,,,2465.85,85,,percent of total billed charges,,,,,,,,,2552.88,88,,percent of total billed charges,,,,,,,,,2216.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,725.25,22,,percent of total billed charges,,,2639.91,91,,percent of total billed charges,,,2755.95,95,,percent of total billed charges,,,2407.83,83,,percent of total billed charges,,,2407.83,83,,percent of total billed charges,,,,,,,,,,,,,,,2407.83,83,,percent of total billed charges,,,2755.95,95,,percent of total billed charges,,,2610.9,90,,percent of total billed charges,,,2610.9,90,,percent of total billed charges,,,2378.82,82,,percent of total billed charges,,,2610.9,90,,percent of total billed charges,,,2465.85,85,,percent of total billed charges,,725.25,2755.95,
FF EXC B9 LESION MRGN XCP SK TG 0.5 CM/<,20501015,CDM,11400,CPT,450,RC,outpatient,,1207,1207,,1024.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,301.75,22,,percent of total billed charges,,,,,,,,,1086.3,90,,percent of total billed charges,,,999.4,82.8,,percent of total billed charges,,,1025.95,85,,percent of total billed charges,,,,,,,,,1062.16,88,,percent of total billed charges,,,,,,,,,922.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,301.75,22,,percent of total billed charges,,,1098.37,91,,percent of total billed charges,,,1146.65,95,,percent of total billed charges,,,1001.81,83,,percent of total billed charges,,,1001.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1001.81,83,,percent of total billed charges,,,1146.65,95,,percent of total billed charges,,,1086.3,90,,percent of total billed charges,,,1086.3,90,,percent of total billed charges,,,989.74,82,,percent of total billed charges,,,1086.3,90,,percent of total billed charges,,,1025.95,85,,percent of total billed charges,,301.75,1146.65,
FF TELEHEALTH FACILITY FEE,20502000,CDM,Q3014,HCPCS,780,RC,outpatient,,58,58,,49.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.5,22,,percent of total billed charges,,,,,,,,,52.2,90,,percent of total billed charges,,,48.02,82.8,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,,,,,,,,51.04,88,,percent of total billed charges,,25,,,,fee schedule,,,44.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,25,,,,fee schedule,,,14.5,22,,percent of total billed charges,,,52.78,91,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,,,,,,,,,,,,,48.14,83,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,47.56,82,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,14.5,55.1,
FF TELEHEALTH CONSULT UP TO 30 MINUTES,20502001,CDM,G0425,HCPCS,780,RC,outpatient,,350,350,,297.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.5,22,,percent of total billed charges,,,,,,,,,315,90,,percent of total billed charges,,,289.8,82.8,,percent of total billed charges,,,297.5,85,,percent of total billed charges,,,,,,,,,308,88,,percent of total billed charges,,,,,,,,,267.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.5,22,,percent of total billed charges,,,318.5,91,,percent of total billed charges,,,332.5,95,,percent of total billed charges,,,290.5,83,,percent of total billed charges,,,290.5,83,,percent of total billed charges,,,,,,,,,,,,,,,290.5,83,,percent of total billed charges,,,332.5,95,,percent of total billed charges,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,287,82,,percent of total billed charges,,,315,90,,percent of total billed charges,,,297.5,85,,percent of total billed charges,,87.5,332.5,
FF TELEHEALTH CONSULT UP TO 50 MINUTES,20502002,CDM,G0426,HCPCS,780,RC,outpatient,,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116,22,,percent of total billed charges,,,,,,,,,417.6,90,,percent of total billed charges,,,384.19,82.8,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116,22,,percent of total billed charges,,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,116,440.8,
FF TELEHEALTH CONSULT UP TO 70 MINUTES,20502003,CDM,G0427,HCPCS,780,RC,outpatient,,601,601,,510.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.25,22,,percent of total billed charges,,,,,,,,,540.9,90,,percent of total billed charges,,,497.63,82.8,,percent of total billed charges,,,510.85,85,,percent of total billed charges,,,,,,,,,528.88,88,,percent of total billed charges,,,,,,,,,459.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.25,22,,percent of total billed charges,,,546.91,91,,percent of total billed charges,,,570.95,95,,percent of total billed charges,,,498.83,83,,percent of total billed charges,,,498.83,83,,percent of total billed charges,,,,,,,,,,,,,,,498.83,83,,percent of total billed charges,,,570.95,95,,percent of total billed charges,,,540.9,90,,percent of total billed charges,,,540.9,90,,percent of total billed charges,,,492.82,82,,percent of total billed charges,,,540.9,90,,percent of total billed charges,,,510.85,85,,percent of total billed charges,,150.25,570.95,
OP BLOOD ADMINISTRATION SERVICE,20600100,CDM,36430,CPT,391,RC,outpatient,,1766,1766,,1499.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,441.5,22,,percent of total billed charges,,,,,,,,,1589.4,90,,percent of total billed charges,,,1462.25,82.8,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,,,,,,,,1554.08,88,,percent of total billed charges,,,,,,,,,1349.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,441.5,22,,percent of total billed charges,,,1607.06,91,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.78,83,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1448.12,82,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,441.5,1677.7,
OP BLOOD ADMIN UP TO 4 HOURS(V-11-20),20600101,CDM,36430,CPT,391,RC,outpatient,,2764,2764,,2346.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,691,22,,percent of total billed charges,,,,,,,,,2487.6,90,,percent of total billed charges,,,2288.59,82.8,,percent of total billed charges,,,2349.4,85,,percent of total billed charges,,,,,,,,,2432.32,88,,percent of total billed charges,,,,,,,,,2111.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,691,22,,percent of total billed charges,,,2515.24,91,,percent of total billed charges,,,2625.8,95,,percent of total billed charges,,,2294.12,83,,percent of total billed charges,,,2294.12,83,,percent of total billed charges,,,,,,,,,,,,,,,2294.12,83,,percent of total billed charges,,,2625.8,95,,percent of total billed charges,,,2487.6,90,,percent of total billed charges,,,2487.6,90,,percent of total billed charges,,,2266.48,82,,percent of total billed charges,,,2487.6,90,,percent of total billed charges,,,2349.4,85,,percent of total billed charges,,691,2625.8,
OP BLOOD ADMIN UP TO 6 HOURS(V-11-20),20600102,CDM,36430,CPT,391,RC,outpatient,,3322,3322,,2820.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,830.5,22,,percent of total billed charges,,,,,,,,,2989.8,90,,percent of total billed charges,,,2750.62,82.8,,percent of total billed charges,,,2823.7,85,,percent of total billed charges,,,,,,,,,2923.36,88,,percent of total billed charges,,,,,,,,,2538.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,830.5,22,,percent of total billed charges,,,3023.02,91,,percent of total billed charges,,,3155.9,95,,percent of total billed charges,,,2757.26,83,,percent of total billed charges,,,2757.26,83,,percent of total billed charges,,,,,,,,,,,,,,,2757.26,83,,percent of total billed charges,,,3155.9,95,,percent of total billed charges,,,2989.8,90,,percent of total billed charges,,,2989.8,90,,percent of total billed charges,,,2724.04,82,,percent of total billed charges,,,2989.8,90,,percent of total billed charges,,,2823.7,85,,percent of total billed charges,,830.5,3155.9,
OP BLOOD ADMIN OVER 6 HOURS(V-11-20),20600103,CDM,36430,CPT,391,RC,outpatient,,3770,3770,,3200.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,942.5,22,,percent of total billed charges,,,,,,,,,3393,90,,percent of total billed charges,,,3121.56,82.8,,percent of total billed charges,,,3204.5,85,,percent of total billed charges,,,,,,,,,3317.6,88,,percent of total billed charges,,,,,,,,,2880.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,942.5,22,,percent of total billed charges,,,3430.7,91,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,,,,,,,,,,,,,3129.1,83,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3091.4,82,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3204.5,85,,percent of total billed charges,,942.5,3581.5,
OP FOLEY INSERTION/CHANGE,20600130,CDM,51702,CPT,761,RC,outpatient,,433,433,,367.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.25,22,,percent of total billed charges,,,,,,,,,389.7,90,,percent of total billed charges,,,358.52,82.8,,percent of total billed charges,,,368.05,85,,percent of total billed charges,,,,,,,,,381.04,88,,percent of total billed charges,,,,,,,,,330.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108.25,22,,percent of total billed charges,,,394.03,91,,percent of total billed charges,,,411.35,95,,percent of total billed charges,,,359.39,83,,percent of total billed charges,,,359.39,83,,percent of total billed charges,,,,,,,,,,,,,,,359.39,83,,percent of total billed charges,,,411.35,95,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,355.06,82,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,368.05,85,,percent of total billed charges,,108.25,411.35,
OP IM/SQ INJECTIONS,20600140,CDM,96372,CPT,761,RC,outpatient,XU,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.75,22,,percent of total billed charges,,,,,,,,,449.1,90,,percent of total billed charges,,,413.17,82.8,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.75,22,,percent of total billed charges,,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,124.75,474.05,
"OP IV PUSH MEDICATION, INITIAL",20600150,CDM,96374,CPT,761,RC,outpatient,XU,523,523,,444.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.75,22,,percent of total billed charges,,,,,,,,,470.7,90,,percent of total billed charges,,,433.04,82.8,,percent of total billed charges,,,444.55,85,,percent of total billed charges,,,,,,,,,460.24,88,,percent of total billed charges,,,,,,,,,399.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.75,22,,percent of total billed charges,,,475.93,91,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,,,,,,,,,,,,,434.09,83,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,428.86,82,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,444.55,85,,percent of total billed charges,,130.75,496.85,
"OP IV PUSH MEDICATION, SEQUENTIAL",20600152,CDM,96375,CPT,761,RC,outpatient,XU,330,330,,280.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.5,22,,percent of total billed charges,,,,,,,,,297,90,,percent of total billed charges,,,273.24,82.8,,percent of total billed charges,,,280.5,85,,percent of total billed charges,,,,,,,,,290.4,88,,percent of total billed charges,,,,,,,,,252.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82.5,22,,percent of total billed charges,,,300.3,91,,percent of total billed charges,,,313.5,95,,percent of total billed charges,,,273.9,83,,percent of total billed charges,,,273.9,83,,percent of total billed charges,,,,,,,,,,,,,,,273.9,83,,percent of total billed charges,,,313.5,95,,percent of total billed charges,,,297,90,,percent of total billed charges,,,297,90,,percent of total billed charges,,,270.6,82,,percent of total billed charges,,,297,90,,percent of total billed charges,,,280.5,85,,percent of total billed charges,,82.5,313.5,
"OP IV INFUSION, HYDRATION, UP TO 1 HOUR",20600160,CDM,96360,CPT,761,RC,outpatient,XU,1000,1000,,849,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,250,22,,percent of total billed charges,,,,,,,,,900,90,,percent of total billed charges,,,828,82.8,,percent of total billed charges,,,850,85,,percent of total billed charges,,,,,,,,,880,88,,percent of total billed charges,,,,,,,,,764,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,250,22,,percent of total billed charges,,,910,91,,percent of total billed charges,,,950,95,,percent of total billed charges,,,830,83,,percent of total billed charges,,,830,83,,percent of total billed charges,,,,,,,,,,,,,,,830,83,,percent of total billed charges,,,950,95,,percent of total billed charges,,,900,90,,percent of total billed charges,,,900,90,,percent of total billed charges,,,820,82,,percent of total billed charges,,,900,90,,percent of total billed charges,,,850,85,,percent of total billed charges,,250,950,
"OP IV INFUSION, HYDRATION, ADDT'L HOUR",20600161,CDM,96361,CPT,761,RC,outpatient,XU,302,302,,256.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.5,22,,percent of total billed charges,,,,,,,,,271.8,90,,percent of total billed charges,,,250.06,82.8,,percent of total billed charges,,,256.7,85,,percent of total billed charges,,,,,,,,,265.76,88,,percent of total billed charges,,,,,,,,,230.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.5,22,,percent of total billed charges,,,274.82,91,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,,,,,,,,,,,,,250.66,83,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,247.64,82,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,256.7,85,,percent of total billed charges,,75.5,286.9,
"OP IV INFUSION, THERAPEUTIC, UP TO 1 HR",20600162,CDM,96365,CPT,761,RC,outpatient,XU,1000,1000,,849,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,250,22,,percent of total billed charges,,,,,,,,,900,90,,percent of total billed charges,,,828,82.8,,percent of total billed charges,,,850,85,,percent of total billed charges,,,,,,,,,880,88,,percent of total billed charges,,,,,,,,,764,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,250,22,,percent of total billed charges,,,910,91,,percent of total billed charges,,,950,95,,percent of total billed charges,,,830,83,,percent of total billed charges,,,830,83,,percent of total billed charges,,,,,,,,,,,,,,,830,83,,percent of total billed charges,,,950,95,,percent of total billed charges,,,900,90,,percent of total billed charges,,,900,90,,percent of total billed charges,,,820,82,,percent of total billed charges,,,900,90,,percent of total billed charges,,,850,85,,percent of total billed charges,,250,950,
"OP IV INFUSION, THERAPEUTIC, ADDT'L HOUR",20600163,CDM,96366,CPT,761,RC,outpatient,XU,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
"OP IVP, SINGLE OR INITIAL",20600164,CDM,96374,CPT,761,RC,outpatient,XU,523,523,,444.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.75,22,,percent of total billed charges,,,,,,,,,470.7,90,,percent of total billed charges,,,433.04,82.8,,percent of total billed charges,,,444.55,85,,percent of total billed charges,,,,,,,,,460.24,88,,percent of total billed charges,,,,,,,,,399.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.75,22,,percent of total billed charges,,,475.93,91,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,,,,,,,,,,,,,434.09,83,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,428.86,82,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,444.55,85,,percent of total billed charges,,130.75,496.85,
OP IM/SQ ANTIBIOTIC INJECTION,20600165,CDM,96372,CPT,761,RC,outpatient,XU,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.75,22,,percent of total billed charges,,,,,,,,,449.1,90,,percent of total billed charges,,,413.17,82.8,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.75,22,,percent of total billed charges,,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,124.75,474.05,
95886 NEEDLE EMG EA EXT W/PARASPINL AREA,14500000,CDM,95886,CPT,922,RC,outpatient,TC,947,947,,804,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,236.75,22,,percent of total billed charges,,,,,,,,,852.3,90,,percent of total billed charges,,,784.12,82.8,,percent of total billed charges,,,804.95,85,,percent of total billed charges,,,,,,,,,833.36,88,,percent of total billed charges,,,,,,,,,723.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,236.75,22,,percent of total billed charges,,,861.77,91,,percent of total billed charges,,,899.65,95,,percent of total billed charges,,,786.01,83,,percent of total billed charges,,,786.01,83,,percent of total billed charges,,,,,,,,,,,,,,,786.01,83,,percent of total billed charges,,,899.65,95,,percent of total billed charges,,,852.3,90,,percent of total billed charges,,,852.3,90,,percent of total billed charges,,,776.54,82,,percent of total billed charges,,,852.3,90,,percent of total billed charges,,,804.95,85,,percent of total billed charges,,236.75,899.65,
95885 NEEDLE EMG EA EXTY W/PARASPINL LIM,14500001,CDM,95885,CPT,922,RC,outpatient,TC,722,722,,612.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.5,22,,percent of total billed charges,,,,,,,,,649.8,90,,percent of total billed charges,,,597.82,82.8,,percent of total billed charges,,,613.7,85,,percent of total billed charges,,,,,,,,,635.36,88,,percent of total billed charges,,,,,,,,,551.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.5,22,,percent of total billed charges,,,657.02,91,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,,,,,,,,,,,,,599.26,83,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,592.04,82,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,613.7,85,,percent of total billed charges,,180.5,685.9,
95887 NEEDLE EMG NONEXT MSCLES W/NE COND,14500002,CDM,95887,CPT,922,RC,outpatient,TC,804,804,,682.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,201,22,,percent of total billed charges,,,,,,,,,723.6,90,,percent of total billed charges,,,665.71,82.8,,percent of total billed charges,,,683.4,85,,percent of total billed charges,,,,,,,,,707.52,88,,percent of total billed charges,,,,,,,,,614.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,201,22,,percent of total billed charges,,,731.64,91,,percent of total billed charges,,,763.8,95,,percent of total billed charges,,,667.32,83,,percent of total billed charges,,,667.32,83,,percent of total billed charges,,,,,,,,,,,,,,,667.32,83,,percent of total billed charges,,,763.8,95,,percent of total billed charges,,,723.6,90,,percent of total billed charges,,,723.6,90,,percent of total billed charges,,,659.28,82,,percent of total billed charges,,,723.6,90,,percent of total billed charges,,,683.4,85,,percent of total billed charges,,201,763.8,
95874 NEEDLE EMG GUID W/CHEMODENERVATION,14500003,CDM,95874,CPT,922,RC,outpatient,TC,548,548,,465.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,137,22,,percent of total billed charges,,,,,,,,,493.2,90,,percent of total billed charges,,,453.74,82.8,,percent of total billed charges,,,465.8,85,,percent of total billed charges,,,,,,,,,482.24,88,,percent of total billed charges,,,,,,,,,418.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,137,22,,percent of total billed charges,,,498.68,91,,percent of total billed charges,,,520.6,95,,percent of total billed charges,,,454.84,83,,percent of total billed charges,,,454.84,83,,percent of total billed charges,,,,,,,,,,,,,,,454.84,83,,percent of total billed charges,,,520.6,95,,percent of total billed charges,,,493.2,90,,percent of total billed charges,,,493.2,90,,percent of total billed charges,,,449.36,82,,percent of total billed charges,,,493.2,90,,percent of total billed charges,,,465.8,85,,percent of total billed charges,,137,520.6,
95868 NEEDLE ELECTROMYOGRAPHY CRAIN NRV,14500004,CDM,95868,CPT,922,RC,outpatient,TC,1495,1495,,1269.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,373.75,22,,percent of total billed charges,,,,,,,,,1345.5,90,,percent of total billed charges,,,1237.86,82.8,,percent of total billed charges,,,1270.75,85,,percent of total billed charges,,,,,,,,,1315.6,88,,percent of total billed charges,,,,,,,,,1142.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,373.75,22,,percent of total billed charges,,,1360.45,91,,percent of total billed charges,,,1420.25,95,,percent of total billed charges,,,1240.85,83,,percent of total billed charges,,,1240.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1240.85,83,,percent of total billed charges,,,1420.25,95,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1225.9,82,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1270.75,85,,percent of total billed charges,,373.75,1420.25,
95869 NEEDLE EMG THRC PARI MS EXC T1/T12,14500005,CDM,95869,CPT,922,RC,outpatient,TC,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208,22,,percent of total billed charges,,,,,,,,,748.8,90,,percent of total billed charges,,,688.9,82.8,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208,22,,percent of total billed charges,,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,208,790.4,
95870 NEEDLE EMG LMTD STD MUSC 1 XTR/NON,14500006,CDM,95870,CPT,922,RC,outpatient,TC,784,784,,665.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,196,22,,percent of total billed charges,,,,,,,,,705.6,90,,percent of total billed charges,,,649.15,82.8,,percent of total billed charges,,,666.4,85,,percent of total billed charges,,,,,,,,,689.92,88,,percent of total billed charges,,,,,,,,,598.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,196,22,,percent of total billed charges,,,713.44,91,,percent of total billed charges,,,744.8,95,,percent of total billed charges,,,650.72,83,,percent of total billed charges,,,650.72,83,,percent of total billed charges,,,,,,,,,,,,,,,650.72,83,,percent of total billed charges,,,744.8,95,,percent of total billed charges,,,705.6,90,,percent of total billed charges,,,705.6,90,,percent of total billed charges,,,642.88,82,,percent of total billed charges,,,705.6,90,,percent of total billed charges,,,666.4,85,,percent of total billed charges,,196,744.8,
95867 NEEDLE ELECTRY CRAINIAL NRV MUS,14500007,CDM,95867,CPT,922,RC,outpatient,TC,1304,1304,,1107.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,326,22,,percent of total billed charges,,,,,,,,,1173.6,90,,percent of total billed charges,,,1079.71,82.8,,percent of total billed charges,,,1108.4,85,,percent of total billed charges,,,,,,,,,1147.52,88,,percent of total billed charges,,,,,,,,,996.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,326,22,,percent of total billed charges,,,1186.64,91,,percent of total billed charges,,,1238.8,95,,percent of total billed charges,,,1082.32,83,,percent of total billed charges,,,1082.32,83,,percent of total billed charges,,,,,,,,,,,,,,,1082.32,83,,percent of total billed charges,,,1238.8,95,,percent of total billed charges,,,1173.6,90,,percent of total billed charges,,,1173.6,90,,percent of total billed charges,,,1069.28,82,,percent of total billed charges,,,1173.6,90,,percent of total billed charges,,,1108.4,85,,percent of total billed charges,,326,1238.8,
95861 NEEDLE EMG 2 XTR W/WO RELAD PARASL,14500008,CDM,95861,CPT,922,RC,outpatient,TC,1587,1587,,1347.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,396.75,22,,percent of total billed charges,,,,,,,,,1428.3,90,,percent of total billed charges,,,1314.04,82.8,,percent of total billed charges,,,1348.95,85,,percent of total billed charges,,,,,,,,,1396.56,88,,percent of total billed charges,,,,,,,,,1212.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,396.75,22,,percent of total billed charges,,,1444.17,91,,percent of total billed charges,,,1507.65,95,,percent of total billed charges,,,1317.21,83,,percent of total billed charges,,,1317.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1317.21,83,,percent of total billed charges,,,1507.65,95,,percent of total billed charges,,,1428.3,90,,percent of total billed charges,,,1428.3,90,,percent of total billed charges,,,1301.34,82,,percent of total billed charges,,,1428.3,90,,percent of total billed charges,,,1348.95,85,,percent of total billed charges,,396.75,1507.65,
95863 NEEDLE EMG 3 XTR W/WO RELATED PARL,14500009,CDM,95863,CPT,922,RC,outpatient,TC,1849,1849,,1569.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,462.25,22,,percent of total billed charges,,,,,,,,,1664.1,90,,percent of total billed charges,,,1530.97,82.8,,percent of total billed charges,,,1571.65,85,,percent of total billed charges,,,,,,,,,1627.12,88,,percent of total billed charges,,,,,,,,,1412.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,462.25,22,,percent of total billed charges,,,1682.59,91,,percent of total billed charges,,,1756.55,95,,percent of total billed charges,,,1534.67,83,,percent of total billed charges,,,1534.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1534.67,83,,percent of total billed charges,,,1756.55,95,,percent of total billed charges,,,1664.1,90,,percent of total billed charges,,,1664.1,90,,percent of total billed charges,,,1516.18,82,,percent of total billed charges,,,1664.1,90,,percent of total billed charges,,,1571.65,85,,percent of total billed charges,,462.25,1756.55,
95864 NEEDLE EMG 4 XTR W/WO RELATED PARL,14500010,CDM,95864,CPT,922,RC,outpatient,TC,2176,2176,,1847.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,544,22,,percent of total billed charges,,,,,,,,,1958.4,90,,percent of total billed charges,,,1801.73,82.8,,percent of total billed charges,,,1849.6,85,,percent of total billed charges,,,,,,,,,1914.88,88,,percent of total billed charges,,,,,,,,,1662.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,544,22,,percent of total billed charges,,,1980.16,91,,percent of total billed charges,,,2067.2,95,,percent of total billed charges,,,1806.08,83,,percent of total billed charges,,,1806.08,83,,percent of total billed charges,,,,,,,,,,,,,,,1806.08,83,,percent of total billed charges,,,2067.2,95,,percent of total billed charges,,,1958.4,90,,percent of total billed charges,,,1958.4,90,,percent of total billed charges,,,1784.32,82,,percent of total billed charges,,,1958.4,90,,percent of total billed charges,,,1849.6,85,,percent of total billed charges,,544,2067.2,
95860 NEEDLE EMG 1 XTR W/WO RELATED PARL,14500011,CDM,95860,CPT,922,RC,outpatient,TC,1052,1052,,893.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,263,22,,percent of total billed charges,,,,,,,,,946.8,90,,percent of total billed charges,,,871.06,82.8,,percent of total billed charges,,,894.2,85,,percent of total billed charges,,,,,,,,,925.76,88,,percent of total billed charges,,,,,,,,,803.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,263,22,,percent of total billed charges,,,957.32,91,,percent of total billed charges,,,999.4,95,,percent of total billed charges,,,873.16,83,,percent of total billed charges,,,873.16,83,,percent of total billed charges,,,,,,,,,,,,,,,873.16,83,,percent of total billed charges,,,999.4,95,,percent of total billed charges,,,946.8,90,,percent of total billed charges,,,946.8,90,,percent of total billed charges,,,862.64,82,,percent of total billed charges,,,946.8,90,,percent of total billed charges,,,894.2,85,,percent of total billed charges,,263,999.4,
95907 NERVE CONDUCTN STUDIES 1-2 STUDIES,14500012,CDM,95907,CPT,922,RC,outpatient,TC,1025,1025,,870.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,256.25,22,,percent of total billed charges,,,,,,,,,922.5,90,,percent of total billed charges,,,848.7,82.8,,percent of total billed charges,,,871.25,85,,percent of total billed charges,,,,,,,,,902,88,,percent of total billed charges,,,,,,,,,783.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,256.25,22,,percent of total billed charges,,,932.75,91,,percent of total billed charges,,,973.75,95,,percent of total billed charges,,,850.75,83,,percent of total billed charges,,,850.75,83,,percent of total billed charges,,,,,,,,,,,,,,,850.75,83,,percent of total billed charges,,,973.75,95,,percent of total billed charges,,,922.5,90,,percent of total billed charges,,,922.5,90,,percent of total billed charges,,,840.5,82,,percent of total billed charges,,,922.5,90,,percent of total billed charges,,,871.25,85,,percent of total billed charges,,256.25,973.75,
95908 NERVE CONDUCTN STUDIES 3-4 STUDIES,14500013,CDM,95908,CPT,922,RC,outpatient,TC,1643,1643,,1394.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,410.75,22,,percent of total billed charges,,,,,,,,,1478.7,90,,percent of total billed charges,,,1360.4,82.8,,percent of total billed charges,,,1396.55,85,,percent of total billed charges,,,,,,,,,1445.84,88,,percent of total billed charges,,,,,,,,,1255.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,410.75,22,,percent of total billed charges,,,1495.13,91,,percent of total billed charges,,,1560.85,95,,percent of total billed charges,,,1363.69,83,,percent of total billed charges,,,1363.69,83,,percent of total billed charges,,,,,,,,,,,,,,,1363.69,83,,percent of total billed charges,,,1560.85,95,,percent of total billed charges,,,1478.7,90,,percent of total billed charges,,,1478.7,90,,percent of total billed charges,,,1347.26,82,,percent of total billed charges,,,1478.7,90,,percent of total billed charges,,,1396.55,85,,percent of total billed charges,,410.75,1560.85,
95909 NERVE CONDUCTN STUDIES 5-6 STUDIES,14500014,CDM,95909,CPT,922,RC,outpatient,TC,2514,2514,,2134.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,628.5,22,,percent of total billed charges,,,,,,,,,2262.6,90,,percent of total billed charges,,,2081.59,82.8,,percent of total billed charges,,,2136.9,85,,percent of total billed charges,,,,,,,,,2212.32,88,,percent of total billed charges,,,,,,,,,1920.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,628.5,22,,percent of total billed charges,,,2287.74,91,,percent of total billed charges,,,2388.3,95,,percent of total billed charges,,,2086.62,83,,percent of total billed charges,,,2086.62,83,,percent of total billed charges,,,,,,,,,,,,,,,2086.62,83,,percent of total billed charges,,,2388.3,95,,percent of total billed charges,,,2262.6,90,,percent of total billed charges,,,2262.6,90,,percent of total billed charges,,,2061.48,82,,percent of total billed charges,,,2262.6,90,,percent of total billed charges,,,2136.9,85,,percent of total billed charges,,628.5,2388.3,
95910 NERVE CONDUCTN STUDIES 7-8 STUDIES,14500015,CDM,95910,CPT,922,RC,outpatient,TC,3263,3263,,2770.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,815.75,22,,percent of total billed charges,,,,,,,,,2936.7,90,,percent of total billed charges,,,2701.76,82.8,,percent of total billed charges,,,2773.55,85,,percent of total billed charges,,,,,,,,,2871.44,88,,percent of total billed charges,,,,,,,,,2492.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,815.75,22,,percent of total billed charges,,,2969.33,91,,percent of total billed charges,,,3099.85,95,,percent of total billed charges,,,2708.29,83,,percent of total billed charges,,,2708.29,83,,percent of total billed charges,,,,,,,,,,,,,,,2708.29,83,,percent of total billed charges,,,3099.85,95,,percent of total billed charges,,,2936.7,90,,percent of total billed charges,,,2936.7,90,,percent of total billed charges,,,2675.66,82,,percent of total billed charges,,,2936.7,90,,percent of total billed charges,,,2773.55,85,,percent of total billed charges,,815.75,3099.85,
95911 NERVE CONDUCTN STUDIES 9-10 STUDIE,14500016,CDM,95911,CPT,922,RC,outpatient,TC,4202,4202,,3567.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1050.5,22,,percent of total billed charges,,,,,,,,,3781.8,90,,percent of total billed charges,,,3479.26,82.8,,percent of total billed charges,,,3571.7,85,,percent of total billed charges,,,,,,,,,3697.76,88,,percent of total billed charges,,,,,,,,,3210.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1050.5,22,,percent of total billed charges,,,3823.82,91,,percent of total billed charges,,,3991.9,95,,percent of total billed charges,,,3487.66,83,,percent of total billed charges,,,3487.66,83,,percent of total billed charges,,,,,,,,,,,,,,,3487.66,83,,percent of total billed charges,,,3991.9,95,,percent of total billed charges,,,3781.8,90,,percent of total billed charges,,,3781.8,90,,percent of total billed charges,,,3445.64,82,,percent of total billed charges,,,3781.8,90,,percent of total billed charges,,,3571.7,85,,percent of total billed charges,,1050.5,3991.9,
95912 NERVE CONDUCTN STUDIES 11-12 STUDI,14500017,CDM,95912,CPT,922,RC,outpatient,TC,4613,4613,,3916.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1153.25,22,,percent of total billed charges,,,,,,,,,4151.7,90,,percent of total billed charges,,,3819.56,82.8,,percent of total billed charges,,,3921.05,85,,percent of total billed charges,,,,,,,,,4059.44,88,,percent of total billed charges,,,,,,,,,3524.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1153.25,22,,percent of total billed charges,,,4197.83,91,,percent of total billed charges,,,4382.35,95,,percent of total billed charges,,,3828.79,83,,percent of total billed charges,,,3828.79,83,,percent of total billed charges,,,,,,,,,,,,,,,3828.79,83,,percent of total billed charges,,,4382.35,95,,percent of total billed charges,,,4151.7,90,,percent of total billed charges,,,4151.7,90,,percent of total billed charges,,,3782.66,82,,percent of total billed charges,,,4151.7,90,,percent of total billed charges,,,3921.05,85,,percent of total billed charges,,1153.25,4382.35,
95913 NERVE CONDUCTN STUDIES 13/> STUDIE,14500018,CDM,95913,CPT,922,RC,outpatient,TC,5980,5980,,5077.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1495,22,,percent of total billed charges,,,,,,,,,5382,90,,percent of total billed charges,,,4951.44,82.8,,percent of total billed charges,,,5083,85,,percent of total billed charges,,,,,,,,,5262.4,88,,percent of total billed charges,,,,,,,,,4568.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1495,22,,percent of total billed charges,,,5441.8,91,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4963.4,83,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,4903.6,82,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5083,85,,percent of total billed charges,,1495,5681,
95937 NEUROMUSCULAR JUNCTION TEST,14500019,CDM,95937,CPT,922,RC,outpatient,TC,1019,1019,,865.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,254.75,22,,percent of total billed charges,,,,,,,,,917.1,90,,percent of total billed charges,,,843.73,82.8,,percent of total billed charges,,,866.15,85,,percent of total billed charges,,,,,,,,,896.72,88,,percent of total billed charges,,,,,,,,,778.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,254.75,22,,percent of total billed charges,,,927.29,91,,percent of total billed charges,,,968.05,95,,percent of total billed charges,,,845.77,83,,percent of total billed charges,,,845.77,83,,percent of total billed charges,,,,,,,,,,,,,,,845.77,83,,percent of total billed charges,,,968.05,95,,percent of total billed charges,,,917.1,90,,percent of total billed charges,,,917.1,90,,percent of total billed charges,,,835.58,82,,percent of total billed charges,,,917.1,90,,percent of total billed charges,,,866.15,85,,percent of total billed charges,,254.75,968.05,
64612 CHEMODN MUSC INNERVATED FACIAL NRV,14500020,CDM,64612,CPT,361,RC,outpatient,TC,1019,1019,,865.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,254.75,22,,percent of total billed charges,,,,,,,,,917.1,90,,percent of total billed charges,,,843.73,82.8,,percent of total billed charges,,,866.15,85,,percent of total billed charges,,,,,,,,,896.72,88,,percent of total billed charges,,,,,,,,,778.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,254.75,22,,percent of total billed charges,,,927.29,91,,percent of total billed charges,,,968.05,95,,percent of total billed charges,,,845.77,83,,percent of total billed charges,,,845.77,83,,percent of total billed charges,,,,,,,,,,,,,,,845.77,83,,percent of total billed charges,,,968.05,95,,percent of total billed charges,,,917.1,90,,percent of total billed charges,,,917.1,90,,percent of total billed charges,,,835.58,82,,percent of total billed charges,,,917.1,90,,percent of total billed charges,,,866.15,85,,percent of total billed charges,,254.75,968.05,
64615 CHEMODNRVTJ MUSC MIGRAINE,14500021,CDM,64615,CPT,361,RC,outpatient,TC,1365,1365,,1158.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,341.25,22,,percent of total billed charges,,,,,,,,,1228.5,90,,percent of total billed charges,,,1130.22,82.8,,percent of total billed charges,,,1160.25,85,,percent of total billed charges,,,,,,,,,1201.2,88,,percent of total billed charges,,,,,,,,,1042.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,341.25,22,,percent of total billed charges,,,1242.15,91,,percent of total billed charges,,,1296.75,95,,percent of total billed charges,,,1132.95,83,,percent of total billed charges,,,1132.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1132.95,83,,percent of total billed charges,,,1296.75,95,,percent of total billed charges,,,1228.5,90,,percent of total billed charges,,,1228.5,90,,percent of total billed charges,,,1119.3,82,,percent of total billed charges,,,1228.5,90,,percent of total billed charges,,,1160.25,85,,percent of total billed charges,,341.25,1296.75,
64616 CHEMODNRVTJ MUSC NECK DYSTON,14500022,CDM,64616,CPT,361,RC,outpatient,TC,1836,1836,,1558.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,459,22,,percent of total billed charges,,,,,,,,,1652.4,90,,percent of total billed charges,,,1520.21,82.8,,percent of total billed charges,,,1560.6,85,,percent of total billed charges,,,,,,,,,1615.68,88,,percent of total billed charges,,,,,,,,,1402.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,459,22,,percent of total billed charges,,,1670.76,91,,percent of total billed charges,,,1744.2,95,,percent of total billed charges,,,1523.88,83,,percent of total billed charges,,,1523.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1523.88,83,,percent of total billed charges,,,1744.2,95,,percent of total billed charges,,,1652.4,90,,percent of total billed charges,,,1652.4,90,,percent of total billed charges,,,1505.52,82,,percent of total billed charges,,,1652.4,90,,percent of total billed charges,,,1560.6,85,,percent of total billed charges,,459,1744.2,
HEMODYNAMIC PROFILE,1190134,CDM,,,480,RC,outpatient,,509,509,,432.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.25,22,,percent of total billed charges,,,,,,,,,458.1,90,,percent of total billed charges,,,421.45,82.8,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,,,,,,,,447.92,88,,percent of total billed charges,,,,,,,,,388.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.25,22,,percent of total billed charges,,,463.19,91,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,,,,,,,,,,,,,422.47,83,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,417.38,82,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,127.25,483.55,
X INSERT TUNNELED CV CATH,26200041,CDM,36561,CPT,360,RC,outpatient,TC,10275,10275,,8723.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2568.75,22,,percent of total billed charges,,,,,,,,,9247.5,90,,percent of total billed charges,,,8507.7,82.8,,percent of total billed charges,,,8733.75,85,,percent of total billed charges,,,,,,,,,9042,88,,percent of total billed charges,,,,,,,,,7850.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2568.75,22,,percent of total billed charges,,,9350.25,91,,percent of total billed charges,,,9761.25,95,,percent of total billed charges,,,8528.25,83,,percent of total billed charges,,,8528.25,83,,percent of total billed charges,,,,,,,,,,,,,,,8528.25,83,,percent of total billed charges,,,9761.25,95,,percent of total billed charges,,,9247.5,90,,percent of total billed charges,,,9247.5,90,,percent of total billed charges,,,8425.5,82,,percent of total billed charges,,,9247.5,90,,percent of total billed charges,,,8733.75,85,,percent of total billed charges,,2568.75,9761.25,
X IR PLMT BILIARY DRAINAGE CATH,26200042,CDM,47533,CPT,360,RC,outpatient,,10388,10388,,8819.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2597,22,,percent of total billed charges,,,,,,,,,9349.2,90,,percent of total billed charges,,,8601.26,82.8,,percent of total billed charges,,,8829.8,85,,percent of total billed charges,,,,,,,,,9141.44,88,,percent of total billed charges,,,,,,,,,7936.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2597,22,,percent of total billed charges,,,9453.08,91,,percent of total billed charges,,,9868.6,95,,percent of total billed charges,,,8622.04,83,,percent of total billed charges,,,8622.04,83,,percent of total billed charges,,,,,,,,,,,,,,,8622.04,83,,percent of total billed charges,,,9868.6,95,,percent of total billed charges,,,9349.2,90,,percent of total billed charges,,,9349.2,90,,percent of total billed charges,,,8518.16,82,,percent of total billed charges,,,9349.2,90,,percent of total billed charges,,,8829.8,85,,percent of total billed charges,,2597,9868.6,
X IR EXCHANGE BILIARY DRAINAGE CATH,26200043,CDM,47536,CPT,360,RC,outpatient,,9064,9064,,7695.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2266,22,,percent of total billed charges,,,,,,,,,8157.6,90,,percent of total billed charges,,,7504.99,82.8,,percent of total billed charges,,,7704.4,85,,percent of total billed charges,,,,,,,,,7976.32,88,,percent of total billed charges,,,,,,,,,6924.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2266,22,,percent of total billed charges,,,8248.24,91,,percent of total billed charges,,,8610.8,95,,percent of total billed charges,,,7523.12,83,,percent of total billed charges,,,7523.12,83,,percent of total billed charges,,,,,,,,,,,,,,,7523.12,83,,percent of total billed charges,,,8610.8,95,,percent of total billed charges,,,8157.6,90,,percent of total billed charges,,,8157.6,90,,percent of total billed charges,,,7432.48,82,,percent of total billed charges,,,8157.6,90,,percent of total billed charges,,,7704.4,85,,percent of total billed charges,,2266,8610.8,
X IR PLMT NEPHROSTOMY CATH,26200044,CDM,50432,CPT,360,RC,outpatient,,8823,8823,,7490.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2205.75,22,,percent of total billed charges,,,,,,,,,7940.7,90,,percent of total billed charges,,,7305.44,82.8,,percent of total billed charges,,,7499.55,85,,percent of total billed charges,,,,,,,,,7764.24,88,,percent of total billed charges,,,,,,,,,6740.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2205.75,22,,percent of total billed charges,,,8028.93,91,,percent of total billed charges,,,8381.85,95,,percent of total billed charges,,,7323.09,83,,percent of total billed charges,,,7323.09,83,,percent of total billed charges,,,,,,,,,,,,,,,7323.09,83,,percent of total billed charges,,,8381.85,95,,percent of total billed charges,,,7940.7,90,,percent of total billed charges,,,7940.7,90,,percent of total billed charges,,,7234.86,82,,percent of total billed charges,,,7940.7,90,,percent of total billed charges,,,7499.55,85,,percent of total billed charges,,2205.75,8381.85,
X IR EXCHANGE NEPHROSTOMY CATH,26200045,CDM,50435,CPT,360,RC,outpatient,,6264,6264,,5318.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1566,22,,percent of total billed charges,,,,,,,,,5637.6,90,,percent of total billed charges,,,5186.59,82.8,,percent of total billed charges,,,5324.4,85,,percent of total billed charges,,,,,,,,,5512.32,88,,percent of total billed charges,,,,,,,,,4785.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1566,22,,percent of total billed charges,,,5700.24,91,,percent of total billed charges,,,5950.8,95,,percent of total billed charges,,,5199.12,83,,percent of total billed charges,,,5199.12,83,,percent of total billed charges,,,,,,,,,,,,,,,5199.12,83,,percent of total billed charges,,,5950.8,95,,percent of total billed charges,,,5637.6,90,,percent of total billed charges,,,5637.6,90,,percent of total billed charges,,,5136.48,82,,percent of total billed charges,,,5637.6,90,,percent of total billed charges,,,5324.4,85,,percent of total billed charges,,1566,5950.8,
X IR SCLEROTHERAPY FLUID COLLECTION W/IM,26200046,CDM,49185,CPT,360,RC,outpatient,,4039,4039,,3429.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1009.75,22,,percent of total billed charges,,,,,,,,,3635.1,90,,percent of total billed charges,,,3344.29,82.8,,percent of total billed charges,,,3433.15,85,,percent of total billed charges,,,,,,,,,3554.32,88,,percent of total billed charges,,,,,,,,,3085.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1009.75,22,,percent of total billed charges,,,3675.49,91,,percent of total billed charges,,,3837.05,95,,percent of total billed charges,,,3352.37,83,,percent of total billed charges,,,3352.37,83,,percent of total billed charges,,,,,,,,,,,,,,,3352.37,83,,percent of total billed charges,,,3837.05,95,,percent of total billed charges,,,3635.1,90,,percent of total billed charges,,,3635.1,90,,percent of total billed charges,,,3311.98,82,,percent of total billed charges,,,3635.1,90,,percent of total billed charges,,,3433.15,85,,percent of total billed charges,,1009.75,3837.05,
X IR ARTERIAL THROMBOLYSIS DAY 1,26200047,CDM,37211,CPT,360,RC,outpatient,,15326,15326,,13011.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3831.5,22,,percent of total billed charges,,,,,,,,,13793.4,90,,percent of total billed charges,,,12689.93,82.8,,percent of total billed charges,,,13027.1,85,,percent of total billed charges,,,,,,,,,13486.88,88,,percent of total billed charges,,,,,,,,,11709.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3831.5,22,,percent of total billed charges,,,13946.66,91,,percent of total billed charges,,,14559.7,95,,percent of total billed charges,,,12720.58,83,,percent of total billed charges,,,12720.58,83,,percent of total billed charges,,,,,,,,,,,,,,,12720.58,83,,percent of total billed charges,,,14559.7,95,,percent of total billed charges,,,13793.4,90,,percent of total billed charges,,,13793.4,90,,percent of total billed charges,,,12567.32,82,,percent of total billed charges,,,13793.4,90,,percent of total billed charges,,,13027.1,85,,percent of total billed charges,,3831.5,14559.7,
X IR ARTERIAL THROMBOLYSIS DAY 2,26200048,CDM,37213,CPT,360,RC,outpatient,,11714,11714,,9945.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2928.5,22,,percent of total billed charges,,,,,,,,,10542.6,90,,percent of total billed charges,,,9699.19,82.8,,percent of total billed charges,,,9956.9,85,,percent of total billed charges,,,,,,,,,10308.32,88,,percent of total billed charges,,,,,,,,,8949.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2928.5,22,,percent of total billed charges,,,10659.74,91,,percent of total billed charges,,,11128.3,95,,percent of total billed charges,,,9722.62,83,,percent of total billed charges,,,9722.62,83,,percent of total billed charges,,,,,,,,,,,,,,,9722.62,83,,percent of total billed charges,,,11128.3,95,,percent of total billed charges,,,10542.6,90,,percent of total billed charges,,,10542.6,90,,percent of total billed charges,,,9605.48,82,,percent of total billed charges,,,10542.6,90,,percent of total billed charges,,,9956.9,85,,percent of total billed charges,,2928.5,11128.3,
X IR ARTERIAL THROMBOLYSIS DAY 3/CATH RE,26200049,CDM,37214,CPT,360,RC,outpatient,,11714,11714,,9945.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2928.5,22,,percent of total billed charges,,,,,,,,,10542.6,90,,percent of total billed charges,,,9699.19,82.8,,percent of total billed charges,,,9956.9,85,,percent of total billed charges,,,,,,,,,10308.32,88,,percent of total billed charges,,,,,,,,,8949.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2928.5,22,,percent of total billed charges,,,10659.74,91,,percent of total billed charges,,,11128.3,95,,percent of total billed charges,,,9722.62,83,,percent of total billed charges,,,9722.62,83,,percent of total billed charges,,,,,,,,,,,,,,,9722.62,83,,percent of total billed charges,,,11128.3,95,,percent of total billed charges,,,10542.6,90,,percent of total billed charges,,,10542.6,90,,percent of total billed charges,,,9605.48,82,,percent of total billed charges,,,10542.6,90,,percent of total billed charges,,,9956.9,85,,percent of total billed charges,,2928.5,11128.3,
X IR ANTEGRADE NEPHROSTOGRAM/URTEROGRAM,26200050,CDM,50431,CPT,360,RC,outpatient,,3675,3675,,3120.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,918.75,22,,percent of total billed charges,,,,,,,,,3307.5,90,,percent of total billed charges,,,3042.9,82.8,,percent of total billed charges,,,3123.75,85,,percent of total billed charges,,,,,,,,,3234,88,,percent of total billed charges,,,,,,,,,2807.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,918.75,22,,percent of total billed charges,,,3344.25,91,,percent of total billed charges,,,3491.25,95,,percent of total billed charges,,,3050.25,83,,percent of total billed charges,,,3050.25,83,,percent of total billed charges,,,,,,,,,,,,,,,3050.25,83,,percent of total billed charges,,,3491.25,95,,percent of total billed charges,,,3307.5,90,,percent of total billed charges,,,3307.5,90,,percent of total billed charges,,,3013.5,82,,percent of total billed charges,,,3307.5,90,,percent of total billed charges,,,3123.75,85,,percent of total billed charges,,918.75,3491.25,
X IR GASTRO/JEJUMOSTOMY TUBE PLACEMENT,26200051,CDM,49441,CPT,360,RC,outpatient,,6665,6665,,5658.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1666.25,22,,percent of total billed charges,,,,,,,,,5998.5,90,,percent of total billed charges,,,5518.62,82.8,,percent of total billed charges,,,5665.25,85,,percent of total billed charges,,,,,,,,,5865.2,88,,percent of total billed charges,,,,,,,,,5092.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1666.25,22,,percent of total billed charges,,,6065.15,91,,percent of total billed charges,,,6331.75,95,,percent of total billed charges,,,5531.95,83,,percent of total billed charges,,,5531.95,83,,percent of total billed charges,,,,,,,,,,,,,,,5531.95,83,,percent of total billed charges,,,6331.75,95,,percent of total billed charges,,,5998.5,90,,percent of total billed charges,,,5998.5,90,,percent of total billed charges,,,5465.3,82,,percent of total billed charges,,,5998.5,90,,percent of total billed charges,,,5665.25,85,,percent of total billed charges,,1666.25,6331.75,
X IR GASTRO/JEJUMOSTOMY TUBE REPLACEMENT,26200052,CDM,49452,CPT,360,RC,outpatient,,3065,3065,,2602.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,766.25,22,,percent of total billed charges,,,,,,,,,2758.5,90,,percent of total billed charges,,,2537.82,82.8,,percent of total billed charges,,,2605.25,85,,percent of total billed charges,,,,,,,,,2697.2,88,,percent of total billed charges,,,,,,,,,2341.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,766.25,22,,percent of total billed charges,,,2789.15,91,,percent of total billed charges,,,2911.75,95,,percent of total billed charges,,,2543.95,83,,percent of total billed charges,,,2543.95,83,,percent of total billed charges,,,,,,,,,,,,,,,2543.95,83,,percent of total billed charges,,,2911.75,95,,percent of total billed charges,,,2758.5,90,,percent of total billed charges,,,2758.5,90,,percent of total billed charges,,,2513.3,82,,percent of total billed charges,,,2758.5,90,,percent of total billed charges,,,2605.25,85,,percent of total billed charges,,766.25,2911.75,
X IR FOREIGN BODY REMOVAL,26200053,CDM,20520,CPT,360,RC,outpatient,,6500,6500,,5518.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625,22,,percent of total billed charges,,,,,,,,,5850,90,,percent of total billed charges,,,5382,82.8,,percent of total billed charges,,,5525,85,,percent of total billed charges,,,,,,,,,5720,88,,percent of total billed charges,,,,,,,,,4966,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625,22,,percent of total billed charges,,,5915,91,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,5395,83,,percent of total billed charges,,,,,,,,,,,,,,,5395,83,,percent of total billed charges,,,6175,95,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5330,82,,percent of total billed charges,,,5850,90,,percent of total billed charges,,,5525,85,,percent of total billed charges,,1625,6175,
X IR NEPHROURETERAL STENT PLACEMENT,26200054,CDM,50433,CPT,360,RC,outpatient,TC,10115,10115,,8587.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2528.75,22,,percent of total billed charges,,,,,,,,,9103.5,90,,percent of total billed charges,,,8375.22,82.8,,percent of total billed charges,,,8597.75,85,,percent of total billed charges,,,,,,,,,8901.2,88,,percent of total billed charges,,,,,,,,,7727.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2528.75,22,,percent of total billed charges,,,9204.65,91,,percent of total billed charges,,,9609.25,95,,percent of total billed charges,,,8395.45,83,,percent of total billed charges,,,8395.45,83,,percent of total billed charges,,,,,,,,,,,,,,,8395.45,83,,percent of total billed charges,,,9609.25,95,,percent of total billed charges,,,9103.5,90,,percent of total billed charges,,,9103.5,90,,percent of total billed charges,,,8294.3,82,,percent of total billed charges,,,9103.5,90,,percent of total billed charges,,,8597.75,85,,percent of total billed charges,,2528.75,9609.25,
X IR CHANGE OF PERC DRAIN CATH,26200055,CDM,75984,CPT,360,RC,outpatient,TC,3030,3030,,2572.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,757.5,22,,percent of total billed charges,,,,,,,,,2727,90,,percent of total billed charges,,,2508.84,82.8,,percent of total billed charges,,,2575.5,85,,percent of total billed charges,,,,,,,,,2666.4,88,,percent of total billed charges,,,,,,,,,2314.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,757.5,22,,percent of total billed charges,,,2757.3,91,,percent of total billed charges,,,2878.5,95,,percent of total billed charges,,,2514.9,83,,percent of total billed charges,,,2514.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2514.9,83,,percent of total billed charges,,,2878.5,95,,percent of total billed charges,,,2727,90,,percent of total billed charges,,,2727,90,,percent of total billed charges,,,2484.6,82,,percent of total billed charges,,,2727,90,,percent of total billed charges,,,2575.5,85,,percent of total billed charges,,757.5,2878.5,
X IR GUIDE PERC DRAIN W/CATH,26200056,CDM,75989,CPT,360,RC,outpatient,TC,3634,3634,,3085.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,908.5,22,,percent of total billed charges,,,,,,,,,3270.6,90,,percent of total billed charges,,,3008.95,82.8,,percent of total billed charges,,,3088.9,85,,percent of total billed charges,,,,,,,,,3197.92,88,,percent of total billed charges,,,,,,,,,2776.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,908.5,22,,percent of total billed charges,,,3306.94,91,,percent of total billed charges,,,3452.3,95,,percent of total billed charges,,,3016.22,83,,percent of total billed charges,,,3016.22,83,,percent of total billed charges,,,,,,,,,,,,,,,3016.22,83,,percent of total billed charges,,,3452.3,95,,percent of total billed charges,,,3270.6,90,,percent of total billed charges,,,3270.6,90,,percent of total billed charges,,,2979.88,82,,percent of total billed charges,,,3270.6,90,,percent of total billed charges,,,3088.9,85,,percent of total billed charges,,908.5,3452.3,
X IR GUIDED FLUID COLLECTION/DRAINAGE,26200057,CDM,10030,CPT,360,RC,outpatient,TC,4094,4094,,3475.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1023.5,22,,percent of total billed charges,,,,,,,,,3684.6,90,,percent of total billed charges,,,3389.83,82.8,,percent of total billed charges,,,3479.9,85,,percent of total billed charges,,,,,,,,,3602.72,88,,percent of total billed charges,,,,,,,,,3127.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1023.5,22,,percent of total billed charges,,,3725.54,91,,percent of total billed charges,,,3889.3,95,,percent of total billed charges,,,3398.02,83,,percent of total billed charges,,,3398.02,83,,percent of total billed charges,,,,,,,,,,,,,,,3398.02,83,,percent of total billed charges,,,3889.3,95,,percent of total billed charges,,,3684.6,90,,percent of total billed charges,,,3684.6,90,,percent of total billed charges,,,3357.08,82,,percent of total billed charges,,,3684.6,90,,percent of total billed charges,,,3479.9,85,,percent of total billed charges,,1023.5,3889.3,
X IR ARTERIAL MECH THROMB PRIM,26200058,CDM,37184,CPT,360,RC,outpatient,TC,18625,18625,,15812.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4656.25,22,,percent of total billed charges,,,,,,,,,16762.5,90,,percent of total billed charges,,,15421.5,82.8,,percent of total billed charges,,,15831.25,85,,percent of total billed charges,,,,,,,,,16390,88,,percent of total billed charges,,,,,,,,,14229.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4656.25,22,,percent of total billed charges,,,16948.75,91,,percent of total billed charges,,,17693.75,95,,percent of total billed charges,,,15458.75,83,,percent of total billed charges,,,15458.75,83,,percent of total billed charges,,,,,,,,,,,,,,,15458.75,83,,percent of total billed charges,,,17693.75,95,,percent of total billed charges,,,16762.5,90,,percent of total billed charges,,,16762.5,90,,percent of total billed charges,,,15272.5,82,,percent of total billed charges,,,16762.5,90,,percent of total billed charges,,,15831.25,85,,percent of total billed charges,,4656.25,17693.75,
X IR ARTERIAL MECH THROMB SEC,26200059,CDM,37185,CPT,360,RC,outpatient,TC,9347,9347,,7935.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2336.75,22,,percent of total billed charges,,,,,,,,,8412.3,90,,percent of total billed charges,,,7739.32,82.8,,percent of total billed charges,,,7944.95,85,,percent of total billed charges,,,,,,,,,8225.36,88,,percent of total billed charges,,,,,,,,,7141.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2336.75,22,,percent of total billed charges,,,8505.77,91,,percent of total billed charges,,,8879.65,95,,percent of total billed charges,,,7758.01,83,,percent of total billed charges,,,7758.01,83,,percent of total billed charges,,,,,,,,,,,,,,,7758.01,83,,percent of total billed charges,,,8879.65,95,,percent of total billed charges,,,8412.3,90,,percent of total billed charges,,,8412.3,90,,percent of total billed charges,,,7664.54,82,,percent of total billed charges,,,8412.3,90,,percent of total billed charges,,,7944.95,85,,percent of total billed charges,,2336.75,8879.65,
X IR VENOUS MECH THROMB PRIM,26200060,CDM,37187,CPT,360,RC,outpatient,TC,15076,15076,,12799.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3769,22,,percent of total billed charges,,,,,,,,,13568.4,90,,percent of total billed charges,,,12482.93,82.8,,percent of total billed charges,,,12814.6,85,,percent of total billed charges,,,,,,,,,13266.88,88,,percent of total billed charges,,,,,,,,,11518.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3769,22,,percent of total billed charges,,,13719.16,91,,percent of total billed charges,,,14322.2,95,,percent of total billed charges,,,12513.08,83,,percent of total billed charges,,,12513.08,83,,percent of total billed charges,,,,,,,,,,,,,,,12513.08,83,,percent of total billed charges,,,14322.2,95,,percent of total billed charges,,,13568.4,90,,percent of total billed charges,,,13568.4,90,,percent of total billed charges,,,12362.32,82,,percent of total billed charges,,,13568.4,90,,percent of total billed charges,,,12814.6,85,,percent of total billed charges,,3769,14322.2,
X IR VENOUS MECH THROMB SEC,26200061,CDM,37188,CPT,360,RC,outpatient,TC,9381,9381,,7964.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2345.25,22,,percent of total billed charges,,,,,,,,,8442.9,90,,percent of total billed charges,,,7767.47,82.8,,percent of total billed charges,,,7973.85,85,,percent of total billed charges,,,,,,,,,8255.28,88,,percent of total billed charges,,,,,,,,,7167.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2345.25,22,,percent of total billed charges,,,8536.71,91,,percent of total billed charges,,,8911.95,95,,percent of total billed charges,,,7786.23,83,,percent of total billed charges,,,7786.23,83,,percent of total billed charges,,,,,,,,,,,,,,,7786.23,83,,percent of total billed charges,,,8911.95,95,,percent of total billed charges,,,8442.9,90,,percent of total billed charges,,,8442.9,90,,percent of total billed charges,,,7692.42,82,,percent of total billed charges,,,8442.9,90,,percent of total billed charges,,,7973.85,85,,percent of total billed charges,,2345.25,8911.95,
X IR GENICULAR NERVE BLOCK,26200062,CDM,64454,CPT,360,RC,outpatient,TC,4303,4303,,3653.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1075.75,22,,percent of total billed charges,,,,,,,,,3872.7,90,,percent of total billed charges,,,3562.88,82.8,,percent of total billed charges,,,3657.55,85,,percent of total billed charges,,,,,,,,,3786.64,88,,percent of total billed charges,,,,,,,,,3287.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1075.75,22,,percent of total billed charges,,,3915.73,91,,percent of total billed charges,,,4087.85,95,,percent of total billed charges,,,3571.49,83,,percent of total billed charges,,,3571.49,83,,percent of total billed charges,,,,,,,,,,,,,,,3571.49,83,,percent of total billed charges,,,4087.85,95,,percent of total billed charges,,,3872.7,90,,percent of total billed charges,,,3872.7,90,,percent of total billed charges,,,3528.46,82,,percent of total billed charges,,,3872.7,90,,percent of total billed charges,,,3657.55,85,,percent of total billed charges,,1075.75,4087.85,
X IR PLACEMENT OF INTRAVASCULAR STENT,26200063,CDM,37238,CPT,360,RC,outpatient,TC,35329,35329,,29994.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8832.25,22,,percent of total billed charges,,,,,,,,,31796.1,90,,percent of total billed charges,,,29252.41,82.8,,percent of total billed charges,,,30029.65,85,,percent of total billed charges,,,,,,,,,31089.52,88,,percent of total billed charges,,,,,,,,,26991.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8832.25,22,,percent of total billed charges,,,32149.39,91,,percent of total billed charges,,,33562.55,95,,percent of total billed charges,,,29323.07,83,,percent of total billed charges,,,29323.07,83,,percent of total billed charges,,,,,,,,,,,,,,,29323.07,83,,percent of total billed charges,,,33562.55,95,,percent of total billed charges,,,31796.1,90,,percent of total billed charges,,,31796.1,90,,percent of total billed charges,,,28969.78,82,,percent of total billed charges,,,31796.1,90,,percent of total billed charges,,,30029.65,85,,percent of total billed charges,,8832.25,33562.55,
X IR INTRO CATHETER SUP/INF VENA CAVA,26200064,CDM,36010,CPT,360,RC,outpatient,TC,5448,5448,,4625.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1362,22,,percent of total billed charges,,,,,,,,,4903.2,90,,percent of total billed charges,,,4510.94,82.8,,percent of total billed charges,,,4630.8,85,,percent of total billed charges,,,,,,,,,4794.24,88,,percent of total billed charges,,,,,,,,,4162.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1362,22,,percent of total billed charges,,,4957.68,91,,percent of total billed charges,,,5175.6,95,,percent of total billed charges,,,4521.84,83,,percent of total billed charges,,,4521.84,83,,percent of total billed charges,,,,,,,,,,,,,,,4521.84,83,,percent of total billed charges,,,5175.6,95,,percent of total billed charges,,,4903.2,90,,percent of total billed charges,,,4903.2,90,,percent of total billed charges,,,4467.36,82,,percent of total billed charges,,,4903.2,90,,percent of total billed charges,,,4630.8,85,,percent of total billed charges,,1362,5175.6,
X VASCULAR EMBOLIZATION/OCCLUSION,26200065,CDM,37241,CPT,360,RC,outpatient,,33480,33480,,28424.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8370,22,,percent of total billed charges,,,,,,,,,30132,90,,percent of total billed charges,,,27721.44,82.8,,percent of total billed charges,,,28458,85,,percent of total billed charges,,,,,,,,,29462.4,88,,percent of total billed charges,,,,,,,,,25578.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8370,22,,percent of total billed charges,,,30466.8,91,,percent of total billed charges,,,31806,95,,percent of total billed charges,,,27788.4,83,,percent of total billed charges,,,27788.4,83,,percent of total billed charges,,,,,,,,,,,,,,,27788.4,83,,percent of total billed charges,,,31806,95,,percent of total billed charges,,,30132,90,,percent of total billed charges,,,30132,90,,percent of total billed charges,,,27453.6,82,,percent of total billed charges,,,30132,90,,percent of total billed charges,,,28458,85,,percent of total billed charges,,8370,31806,
X IR ARTERIAL CATH PLACEMENT,26200066,CDM,36247,CPT,360,RC,outpatient,TC,9082,9082,,7710.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2270.5,22,,percent of total billed charges,,,,,,,,,8173.8,90,,percent of total billed charges,,,7519.9,82.8,,percent of total billed charges,,,7719.7,85,,percent of total billed charges,,,,,,,,,7992.16,88,,percent of total billed charges,,,,,,,,,6938.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2270.5,22,,percent of total billed charges,,,8264.62,91,,percent of total billed charges,,,8627.9,95,,percent of total billed charges,,,7538.06,83,,percent of total billed charges,,,7538.06,83,,percent of total billed charges,,,,,,,,,,,,,,,7538.06,83,,percent of total billed charges,,,8627.9,95,,percent of total billed charges,,,8173.8,90,,percent of total billed charges,,,8173.8,90,,percent of total billed charges,,,7447.24,82,,percent of total billed charges,,,8173.8,90,,percent of total billed charges,,,7719.7,85,,percent of total billed charges,,2270.5,8627.9,
X IR ARTERIAL CATH PLACEMENT ADDITIONAL,26200067,CDM,36248,CPT,360,RC,outpatient,TC,5764,5764,,4893.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1441,22,,percent of total billed charges,,,,,,,,,5187.6,90,,percent of total billed charges,,,4772.59,82.8,,percent of total billed charges,,,4899.4,85,,percent of total billed charges,,,,,,,,,5072.32,88,,percent of total billed charges,,,,,,,,,4403.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1441,22,,percent of total billed charges,,,5245.24,91,,percent of total billed charges,,,5475.8,95,,percent of total billed charges,,,4784.12,83,,percent of total billed charges,,,4784.12,83,,percent of total billed charges,,,,,,,,,,,,,,,4784.12,83,,percent of total billed charges,,,5475.8,95,,percent of total billed charges,,,5187.6,90,,percent of total billed charges,,,5187.6,90,,percent of total billed charges,,,4726.48,82,,percent of total billed charges,,,5187.6,90,,percent of total billed charges,,,4899.4,85,,percent of total billed charges,,1441,5475.8,
X REPAIR OF CENTRAL VENOUS CATH,26200068,CDM,,,360,RC,outpatient,,9185,9185,,7798.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2296.25,22,,percent of total billed charges,,,,,,,,,8266.5,90,,percent of total billed charges,,,7605.18,82.8,,percent of total billed charges,,,7807.25,85,,percent of total billed charges,,,,,,,,,8082.8,88,,percent of total billed charges,,,,,,,,,7017.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2296.25,22,,percent of total billed charges,,,8358.35,91,,percent of total billed charges,,,8725.75,95,,percent of total billed charges,,,7623.55,83,,percent of total billed charges,,,7623.55,83,,percent of total billed charges,,,,,,,,,,,,,,,7623.55,83,,percent of total billed charges,,,8725.75,95,,percent of total billed charges,,,8266.5,90,,percent of total billed charges,,,8266.5,90,,percent of total billed charges,,,7531.7,82,,percent of total billed charges,,,8266.5,90,,percent of total billed charges,,,7807.25,85,,percent of total billed charges,,2296.25,8725.75,
X IR REMOVAL OF NEPHROSTOMY CATH,26200069,CDM,50389,CPT,360,RC,outpatient,TC,4319,4319,,3666.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1079.75,22,,percent of total billed charges,,,,,,,,,3887.1,90,,percent of total billed charges,,,3576.13,82.8,,percent of total billed charges,,,3671.15,85,,percent of total billed charges,,,,,,,,,3800.72,88,,percent of total billed charges,,,,,,,,,3299.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1079.75,22,,percent of total billed charges,,,3930.29,91,,percent of total billed charges,,,4103.05,95,,percent of total billed charges,,,3584.77,83,,percent of total billed charges,,,3584.77,83,,percent of total billed charges,,,,,,,,,,,,,,,3584.77,83,,percent of total billed charges,,,4103.05,95,,percent of total billed charges,,,3887.1,90,,percent of total billed charges,,,3887.1,90,,percent of total billed charges,,,3541.58,82,,percent of total billed charges,,,3887.1,90,,percent of total billed charges,,,3671.15,85,,percent of total billed charges,,1079.75,4103.05,
X IR RF ABLATION OF GENICULAR NERVES,26200070,CDM,64624,CPT,360,RC,outpatient,TC,8249,8249,,7003.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2062.25,22,,percent of total billed charges,,,,,,,,,7424.1,90,,percent of total billed charges,,,6830.17,82.8,,percent of total billed charges,,,7011.65,85,,percent of total billed charges,,,,,,,,,7259.12,88,,percent of total billed charges,,,,,,,,,6302.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2062.25,22,,percent of total billed charges,,,7506.59,91,,percent of total billed charges,,,7836.55,95,,percent of total billed charges,,,6846.67,83,,percent of total billed charges,,,6846.67,83,,percent of total billed charges,,,,,,,,,,,,,,,6846.67,83,,percent of total billed charges,,,7836.55,95,,percent of total billed charges,,,7424.1,90,,percent of total billed charges,,,7424.1,90,,percent of total billed charges,,,6764.18,82,,percent of total billed charges,,,7424.1,90,,percent of total billed charges,,,7011.65,85,,percent of total billed charges,,2062.25,7836.55,
X IR INSERTION OF SUPRAPUBIC CATH,26200071,CDM,51102,CPT,360,RC,outpatient,TC,9836,9836,,8350.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2459,22,,percent of total billed charges,,,,,,,,,8852.4,90,,percent of total billed charges,,,8144.21,82.8,,percent of total billed charges,,,8360.6,85,,percent of total billed charges,,,,,,,,,8655.68,88,,percent of total billed charges,,,,,,,,,7514.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2459,22,,percent of total billed charges,,,8950.76,91,,percent of total billed charges,,,9344.2,95,,percent of total billed charges,,,8163.88,83,,percent of total billed charges,,,8163.88,83,,percent of total billed charges,,,,,,,,,,,,,,,8163.88,83,,percent of total billed charges,,,9344.2,95,,percent of total billed charges,,,8852.4,90,,percent of total billed charges,,,8852.4,90,,percent of total billed charges,,,8065.52,82,,percent of total billed charges,,,8852.4,90,,percent of total billed charges,,,8360.6,85,,percent of total billed charges,,2459,9344.2,
X IR ANGIOGRAPHY PELVIC,26200072,CDM,75736,CPT,360,RC,outpatient,TC,9665,9665,,8205.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2416.25,22,,percent of total billed charges,,,,,,,,,8698.5,90,,percent of total billed charges,,,8002.62,82.8,,percent of total billed charges,,,8215.25,85,,percent of total billed charges,,,,,,,,,8505.2,88,,percent of total billed charges,,,,,,,,,7384.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2416.25,22,,percent of total billed charges,,,8795.15,91,,percent of total billed charges,,,9181.75,95,,percent of total billed charges,,,8021.95,83,,percent of total billed charges,,,8021.95,83,,percent of total billed charges,,,,,,,,,,,,,,,8021.95,83,,percent of total billed charges,,,9181.75,95,,percent of total billed charges,,,8698.5,90,,percent of total billed charges,,,8698.5,90,,percent of total billed charges,,,7925.3,82,,percent of total billed charges,,,8698.5,90,,percent of total billed charges,,,8215.25,85,,percent of total billed charges,,2416.25,9181.75,
X IR SUPRAPUBIC CATH EXCHANGE,26200073,CDM,51705,CPT,360,RC,outpatient,TC,2929,2929,,2486.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,732.25,22,,percent of total billed charges,,,,,,,,,2636.1,90,,percent of total billed charges,,,2425.21,82.8,,percent of total billed charges,,,2489.65,85,,percent of total billed charges,,,,,,,,,2577.52,88,,percent of total billed charges,,,,,,,,,2237.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,732.25,22,,percent of total billed charges,,,2665.39,91,,percent of total billed charges,,,2782.55,95,,percent of total billed charges,,,2431.07,83,,percent of total billed charges,,,2431.07,83,,percent of total billed charges,,,,,,,,,,,,,,,2431.07,83,,percent of total billed charges,,,2782.55,95,,percent of total billed charges,,,2636.1,90,,percent of total billed charges,,,2636.1,90,,percent of total billed charges,,,2401.78,82,,percent of total billed charges,,,2636.1,90,,percent of total billed charges,,,2489.65,85,,percent of total billed charges,,732.25,2782.55,
X IR FEM/POPL REVASC W/STENT,26200074,CDM,37226,CPT,360,RC,outpatient,TC,42470,42470,,36057.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10617.5,22,,percent of total billed charges,,,,,,,,,38223,90,,percent of total billed charges,,,35165.16,82.8,,percent of total billed charges,,,36099.5,85,,percent of total billed charges,,,,,,,,,37373.6,88,,percent of total billed charges,,,,,,,,,32447.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10617.5,22,,percent of total billed charges,,,38647.7,91,,percent of total billed charges,,,40346.5,95,,percent of total billed charges,,,35250.1,83,,percent of total billed charges,,,35250.1,83,,percent of total billed charges,,,,,,,,,,,,,,,35250.1,83,,percent of total billed charges,,,40346.5,95,,percent of total billed charges,,,38223,90,,percent of total billed charges,,,38223,90,,percent of total billed charges,,,34825.4,82,,percent of total billed charges,,,38223,90,,percent of total billed charges,,,36099.5,85,,percent of total billed charges,,10617.5,40346.5,
X IR REVASC W/ATHERECTOMY INCL ANGIOPLAS,26200075,CDM,37225,CPT,360,RC,outpatient,TC,42769,42769,,36310.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10692.25,22,,percent of total billed charges,,,,,,,,,38492.1,90,,percent of total billed charges,,,35412.73,82.8,,percent of total billed charges,,,36353.65,85,,percent of total billed charges,,,,,,,,,37636.72,88,,percent of total billed charges,,,,,,,,,32675.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10692.25,22,,percent of total billed charges,,,38919.79,91,,percent of total billed charges,,,40630.55,95,,percent of total billed charges,,,35498.27,83,,percent of total billed charges,,,35498.27,83,,percent of total billed charges,,,,,,,,,,,,,,,35498.27,83,,percent of total billed charges,,,40630.55,95,,percent of total billed charges,,,38492.1,90,,percent of total billed charges,,,38492.1,90,,percent of total billed charges,,,35070.58,82,,percent of total billed charges,,,38492.1,90,,percent of total billed charges,,,36353.65,85,,percent of total billed charges,,10692.25,40630.55,
X IR GASTROSTOMY TUBE PLACEMENT,26200076,CDM,49440,CPT,360,RC,outpatient,TC,6214,6214,,5275.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1553.5,22,,percent of total billed charges,,,,,,,,,5592.6,90,,percent of total billed charges,,,5145.19,82.8,,percent of total billed charges,,,5281.9,85,,percent of total billed charges,,,,,,,,,5468.32,88,,percent of total billed charges,,,,,,,,,4747.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1553.5,22,,percent of total billed charges,,,5654.74,91,,percent of total billed charges,,,5903.3,95,,percent of total billed charges,,,5157.62,83,,percent of total billed charges,,,5157.62,83,,percent of total billed charges,,,,,,,,,,,,,,,5157.62,83,,percent of total billed charges,,,5903.3,95,,percent of total billed charges,,,5592.6,90,,percent of total billed charges,,,5592.6,90,,percent of total billed charges,,,5095.48,82,,percent of total billed charges,,,5592.6,90,,percent of total billed charges,,,5281.9,85,,percent of total billed charges,,1553.5,5903.3,
X IR GASTROSTOMY TUBE REPLACEMENT,26200077,CDM,49450,CPT,360,RC,outpatient,TC,4018,4018,,3411.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1004.5,22,,percent of total billed charges,,,,,,,,,3616.2,90,,percent of total billed charges,,,3326.9,82.8,,percent of total billed charges,,,3415.3,85,,percent of total billed charges,,,,,,,,,3535.84,88,,percent of total billed charges,,,,,,,,,3069.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1004.5,22,,percent of total billed charges,,,3656.38,91,,percent of total billed charges,,,3817.1,95,,percent of total billed charges,,,3334.94,83,,percent of total billed charges,,,3334.94,83,,percent of total billed charges,,,,,,,,,,,,,,,3334.94,83,,percent of total billed charges,,,3817.1,95,,percent of total billed charges,,,3616.2,90,,percent of total billed charges,,,3616.2,90,,percent of total billed charges,,,3294.76,82,,percent of total billed charges,,,3616.2,90,,percent of total billed charges,,,3415.3,85,,percent of total billed charges,,1004.5,3817.1,
X IR INSERTION OF CATH PLACEMENT,26200078,CDM,36245,CPT,360,RC,outpatient,TC,8265,8265,,7016.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2066.25,22,,percent of total billed charges,,,,,,,,,7438.5,90,,percent of total billed charges,,,6843.42,82.8,,percent of total billed charges,,,7025.25,85,,percent of total billed charges,,,,,,,,,7273.2,88,,percent of total billed charges,,,,,,,,,6314.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2066.25,22,,percent of total billed charges,,,7521.15,91,,percent of total billed charges,,,7851.75,95,,percent of total billed charges,,,6859.95,83,,percent of total billed charges,,,6859.95,83,,percent of total billed charges,,,,,,,,,,,,,,,6859.95,83,,percent of total billed charges,,,7851.75,95,,percent of total billed charges,,,7438.5,90,,percent of total billed charges,,,7438.5,90,,percent of total billed charges,,,6777.3,82,,percent of total billed charges,,,7438.5,90,,percent of total billed charges,,,7025.25,85,,percent of total billed charges,,2066.25,7851.75,
X IR INJ OF SCLEROSANT SINGLE VEIN,26200079,CDM,36470,CPT,360,RC,outpatient,TC,3680,3680,,3124.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,920,22,,percent of total billed charges,,,,,,,,,3312,90,,percent of total billed charges,,,3047.04,82.8,,percent of total billed charges,,,3128,85,,percent of total billed charges,,,,,,,,,3238.4,88,,percent of total billed charges,,,,,,,,,2811.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,920,22,,percent of total billed charges,,,3348.8,91,,percent of total billed charges,,,3496,95,,percent of total billed charges,,,3054.4,83,,percent of total billed charges,,,3054.4,83,,percent of total billed charges,,,,,,,,,,,,,,,3054.4,83,,percent of total billed charges,,,3496,95,,percent of total billed charges,,,3312,90,,percent of total billed charges,,,3312,90,,percent of total billed charges,,,3017.6,82,,percent of total billed charges,,,3312,90,,percent of total billed charges,,,3128,85,,percent of total billed charges,,920,3496,
X IR INJ OF SCLEROSANT MULTIPLE VEIN,26200080,CDM,36471,CPT,360,RC,outpatient,TC,1835,1835,,1557.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,458.75,22,,percent of total billed charges,,,,,,,,,1651.5,90,,percent of total billed charges,,,1519.38,82.8,,percent of total billed charges,,,1559.75,85,,percent of total billed charges,,,,,,,,,1614.8,88,,percent of total billed charges,,,,,,,,,1401.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,458.75,22,,percent of total billed charges,,,1669.85,91,,percent of total billed charges,,,1743.25,95,,percent of total billed charges,,,1523.05,83,,percent of total billed charges,,,1523.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1523.05,83,,percent of total billed charges,,,1743.25,95,,percent of total billed charges,,,1651.5,90,,percent of total billed charges,,,1651.5,90,,percent of total billed charges,,,1504.7,82,,percent of total billed charges,,,1651.5,90,,percent of total billed charges,,,1559.75,85,,percent of total billed charges,,458.75,1743.25,
X IR VASCULAR EMBOLIZATION/OCCLUSION ART,26200081,CDM,37243,CPT,360,RC,outpatient,TC,33632,33632,,28553.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8408,22,,percent of total billed charges,,,,,,,,,30268.8,90,,percent of total billed charges,,,27847.3,82.8,,percent of total billed charges,,,28587.2,85,,percent of total billed charges,,,,,,,,,29596.16,88,,percent of total billed charges,,,,,,,,,25694.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8408,22,,percent of total billed charges,,,30605.12,91,,percent of total billed charges,,,31950.4,95,,percent of total billed charges,,,27914.56,83,,percent of total billed charges,,,27914.56,83,,percent of total billed charges,,,,,,,,,,,,,,,27914.56,83,,percent of total billed charges,,,31950.4,95,,percent of total billed charges,,,30268.8,90,,percent of total billed charges,,,30268.8,90,,percent of total billed charges,,,27578.24,82,,percent of total billed charges,,,30268.8,90,,percent of total billed charges,,,28587.2,85,,percent of total billed charges,,8408,31950.4,
X IR TRANSCATHETER EMBOLIZATION,26200082,CDM,75894,CPT,360,RC,outpatient,TC,9745,9745,,8273.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2436.25,22,,percent of total billed charges,,,,,,,,,8770.5,90,,percent of total billed charges,,,8068.86,82.8,,percent of total billed charges,,,8283.25,85,,percent of total billed charges,,,,,,,,,8575.6,88,,percent of total billed charges,,,,,,,,,7445.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2436.25,22,,percent of total billed charges,,,8867.95,91,,percent of total billed charges,,,9257.75,95,,percent of total billed charges,,,8088.35,83,,percent of total billed charges,,,8088.35,83,,percent of total billed charges,,,,,,,,,,,,,,,8088.35,83,,percent of total billed charges,,,9257.75,95,,percent of total billed charges,,,8770.5,90,,percent of total billed charges,,,8770.5,90,,percent of total billed charges,,,7990.9,82,,percent of total billed charges,,,8770.5,90,,percent of total billed charges,,,8283.25,85,,percent of total billed charges,,2436.25,9257.75,
X IR ANGIOGRAPHY THROUGH EXISTING CATH,26200083,CDM,75898,CPT,360,RC,outpatient,TC,4102,4102,,3482.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1025.5,22,,percent of total billed charges,,,,,,,,,3691.8,90,,percent of total billed charges,,,3396.46,82.8,,percent of total billed charges,,,3486.7,85,,percent of total billed charges,,,,,,,,,3609.76,88,,percent of total billed charges,,,,,,,,,3133.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1025.5,22,,percent of total billed charges,,,3732.82,91,,percent of total billed charges,,,3896.9,95,,percent of total billed charges,,,3404.66,83,,percent of total billed charges,,,3404.66,83,,percent of total billed charges,,,,,,,,,,,,,,,3404.66,83,,percent of total billed charges,,,3896.9,95,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3363.64,82,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3486.7,85,,percent of total billed charges,,1025.5,3896.9,
X IR TRANSCATHETER BIOPSY,26200084,CDM,37200,CPT,360,RC,outpatient,TC,8126,8126,,6898.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.5,22,,percent of total billed charges,,,,,,,,,7313.4,90,,percent of total billed charges,,,6728.33,82.8,,percent of total billed charges,,,6907.1,85,,percent of total billed charges,,,,,,,,,7150.88,88,,percent of total billed charges,,,,,,,,,6208.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.5,22,,percent of total billed charges,,,7394.66,91,,percent of total billed charges,,,7719.7,95,,percent of total billed charges,,,6744.58,83,,percent of total billed charges,,,6744.58,83,,percent of total billed charges,,,,,,,,,,,,,,,6744.58,83,,percent of total billed charges,,,7719.7,95,,percent of total billed charges,,,7313.4,90,,percent of total billed charges,,,7313.4,90,,percent of total billed charges,,,6663.32,82,,percent of total billed charges,,,7313.4,90,,percent of total billed charges,,,6907.1,85,,percent of total billed charges,,2031.5,7719.7,
X IR LIVER NEEDLE BIOPSY,26200085,CDM,47000,CPT,360,RC,outpatient,TC,4409,4409,,3743.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1102.25,22,,percent of total billed charges,,,,,,,,,3968.1,90,,percent of total billed charges,,,3650.65,82.8,,percent of total billed charges,,,3747.65,85,,percent of total billed charges,,,,,,,,,3879.92,88,,percent of total billed charges,,,,,,,,,3368.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1102.25,22,,percent of total billed charges,,,4012.19,91,,percent of total billed charges,,,4188.55,95,,percent of total billed charges,,,3659.47,83,,percent of total billed charges,,,3659.47,83,,percent of total billed charges,,,,,,,,,,,,,,,3659.47,83,,percent of total billed charges,,,4188.55,95,,percent of total billed charges,,,3968.1,90,,percent of total billed charges,,,3968.1,90,,percent of total billed charges,,,3615.38,82,,percent of total billed charges,,,3968.1,90,,percent of total billed charges,,,3747.65,85,,percent of total billed charges,,1102.25,4188.55,
.XXXXXIDH2,2520019,CDM,81121,CPT,300,RC,outpatient,,457,457,,387.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,114.25,22,,percent of total billed charges,,,,,,,,,411.3,90,,percent of total billed charges,,,378.4,82.8,,percent of total billed charges,,,388.45,85,,percent of total billed charges,,,,,,,,,402.16,88,,percent of total billed charges,,,,,,,,,349.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,114.25,22,,percent of total billed charges,,,415.87,91,,percent of total billed charges,,,434.15,95,,percent of total billed charges,,,379.31,83,,percent of total billed charges,,,379.31,83,,percent of total billed charges,,,,,,,,,,,,,,,379.31,83,,percent of total billed charges,,,434.15,95,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,374.74,82,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,388.45,85,,percent of total billed charges,,114.25,434.15,
URIC ACID SYNOVAL FLUID,2520245,CDM,84560,CPT,300,RC,outpatient,,119,119,,101.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.75,22,,percent of total billed charges,,,,,,,,,107.1,90,,percent of total billed charges,,,98.53,82.8,,percent of total billed charges,,,101.15,85,,percent of total billed charges,,,,,,,,,104.72,88,,percent of total billed charges,,,,,,,,,90.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.75,22,,percent of total billed charges,,,108.29,91,,percent of total billed charges,,,113.05,95,,percent of total billed charges,,,98.77,83,,percent of total billed charges,,,98.77,83,,percent of total billed charges,,,,,,,,,,,,,,,98.77,83,,percent of total billed charges,,,113.05,95,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,97.58,82,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,101.15,85,,percent of total billed charges,,29.75,113.05,
BONE MARROW ENGRAFTMENT,2520678,CDM,81267,CPT,300,RC,outpatient,,1307,1307,,1109.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,326.75,22,,percent of total billed charges,,,,,,,,,1176.3,90,,percent of total billed charges,,,1082.2,82.8,,percent of total billed charges,,,1110.95,85,,percent of total billed charges,,,,,,,,,1150.16,88,,percent of total billed charges,,,,,,,,,998.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,326.75,22,,percent of total billed charges,,,1189.37,91,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1084.81,83,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1071.74,82,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1110.95,85,,percent of total billed charges,,326.75,1241.65,
DRUG SCREEN  GAH PRE-EMP(LABCORP),2522653,CDM,80307,CPT,300,RC,outpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.25,22,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,63.76,82.8,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.25,22,,percent of total billed charges,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,19.25,73.15,
* DEXTROMETER USAGE (V0904)(NC),23300475,CDM,,,270,RC,outpatient,,38,38,,32.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.5,22,,percent of total billed charges,,,,,,,,,34.2,90,,percent of total billed charges,,,31.46,82.8,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,,,,,,,,33.44,88,,percent of total billed charges,,,,,,,,,29.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.5,22,,percent of total billed charges,,,34.58,91,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,,,,,,,,,,,,,31.54,83,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,31.16,82,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,9.5,36.1,
X RHC SCREENING PAP SMEAR,25100000,CDM,Q0091,HCPCS,311,RC,outpatient,,140,140,,118.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35,22,,percent of total billed charges,,,,,,,,,126,90,,percent of total billed charges,,,115.92,82.8,,percent of total billed charges,,,119,85,,percent of total billed charges,,,,,,,,,123.2,88,,percent of total billed charges,,,,,,,,,106.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35,22,,percent of total billed charges,,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,133,95,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,114.8,82,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,35,133,
X RHC VENIPUNCTURE BLOOD COLLECTION,25200001,CDM,36415,CPT,300,RC,outpatient,,39,39,,33.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.75,22,,percent of total billed charges,,,,,,,,,35.1,90,,percent of total billed charges,,,32.29,82.8,,percent of total billed charges,,,33.15,85,,percent of total billed charges,,,,,,,,,34.32,88,,percent of total billed charges,,,,,,,,,29.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.75,22,,percent of total billed charges,,,35.49,91,,percent of total billed charges,,,37.05,95,,percent of total billed charges,,,32.37,83,,percent of total billed charges,,,32.37,83,,percent of total billed charges,,,,,,,,,,,,,,,32.37,83,,percent of total billed charges,,,37.05,95,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,31.98,82,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,33.15,85,,percent of total billed charges,,9.75,37.05,
X RHC URINE DIPSTICK ONLY,25200002,CDM,81003,CPT,300,RC,outpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.75,22,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,42.23,82.8,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.75,22,,percent of total billed charges,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,12.75,48.45,
"X RHC OCCULT BLOOD SCREEN, FECES 1-3",25200003,CDM,82270,CPT,300,RC,outpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6,22,,percent of total billed charges,,,,,,,,,21.6,90,,percent of total billed charges,,,19.87,82.8,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6,22,,percent of total billed charges,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,6,22.8,
X RHC OCCULT BLOOD SCREEN FIT OFFICE,25200004,CDM,82272,CPT,300,RC,outpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6,22,,percent of total billed charges,,,,,,,,,21.6,90,,percent of total billed charges,,,19.87,82.8,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6,22,,percent of total billed charges,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,6,22.8,
X RHC GLUCOSE (PCX),25200005,CDM,82948,CPT,300,RC,outpatient,,33,33,,28.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.25,22,,percent of total billed charges,,,,,,,,,29.7,90,,percent of total billed charges,,,27.32,82.8,,percent of total billed charges,,,28.05,85,,percent of total billed charges,,,,,,,,,29.04,88,,percent of total billed charges,,,,,,,,,25.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.25,22,,percent of total billed charges,,,30.03,91,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,,,,,,,,,,,,,27.39,83,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,27.06,82,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,28.05,85,,percent of total billed charges,,8.25,31.35,
X RHC HEMOGLOBIN A1c,25200006,CDM,83036,CPT,300,RC,outpatient,,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.75,22,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,121.72,82.8,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.75,22,,percent of total billed charges,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,36.75,139.65,
X RHC PROTHROMBIN TIME,25200007,CDM,85610,CPT,300,RC,outpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.25,22,,percent of total billed charges,,,,,,,,,72.9,90,,percent of total billed charges,,,67.07,82.8,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.25,22,,percent of total billed charges,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,20.25,76.95,
"X RHC STREP SCREEN, RAPID",25200008,CDM,87880,CPT,300,RC,outpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.5,22,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,64.58,82.8,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.5,22,,percent of total billed charges,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,19.5,74.1,
X RHC MICROALBUMIN,25200009,CDM,82044,CPT,300,RC,outpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.75,22,,percent of total billed charges,,,,,,,,,78.3,90,,percent of total billed charges,,,72.04,82.8,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.75,22,,percent of total billed charges,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,21.75,82.65,
X RHC CAPILLARY PUNCTURE BLOOD COLLECT,25200010,CDM,36416,CPT,300,RC,outpatient,,44,44,,37.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11,22,,percent of total billed charges,,,,,,,,,39.6,90,,percent of total billed charges,,,36.43,82.8,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,,,,,,,,38.72,88,,percent of total billed charges,,,,,,,,,33.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11,22,,percent of total billed charges,,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,36.08,82,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,11,41.8,
ENTEROVIRUS RNA QL PCR,25200016,CDM,87498,CPT,300,RC,outpatient,,415,415,,352.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,103.75,22,,percent of total billed charges,,,,,,,,,373.5,90,,percent of total billed charges,,,343.62,82.8,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,,,,,,,,365.2,88,,percent of total billed charges,,,,,,,,,317.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,103.75,22,,percent of total billed charges,,,377.65,91,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,,,,,,,,,,,,,344.45,83,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,340.3,82,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,103.75,394.25,
TROPONIN-I,25200017,CDM,84484,CPT,300,RC,outpatient,,379,379,,321.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94.75,22,,percent of total billed charges,,,,,,,,,341.1,90,,percent of total billed charges,,,313.81,82.8,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,,,,,,,,333.52,88,,percent of total billed charges,,,,,,,,,289.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94.75,22,,percent of total billed charges,,,344.89,91,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,,,,,,,,,,,,,314.57,83,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,310.78,82,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,94.75,360.05,
ENDOMYSIAL ANTIBODY SCREEN,25200018,CDM,86255,CPT,300,RC,outpatient,,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116,22,,percent of total billed charges,,,,,,,,,417.6,90,,percent of total billed charges,,,384.19,82.8,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116,22,,percent of total billed charges,,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,116,440.8,
MERCURY URINE,25200021,CDM,83825,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
ALBUMIN,25200022,CDM,82040,CPT,300,RC,outpatient,,99,99,,84.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.75,22,,percent of total billed charges,,,,,,,,,89.1,90,,percent of total billed charges,,,81.97,82.8,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,,,,,,,,87.12,88,,percent of total billed charges,,,,,,,,,75.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.75,22,,percent of total billed charges,,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,,,,,,,,,,,,,82.17,83,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,81.18,82,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,24.75,94.05,
C-PEPTIDE,25200023,CDM,84681,CPT,300,RC,outpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94,22,,percent of total billed charges,,,,,,,,,338.4,90,,percent of total billed charges,,,311.33,82.8,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94,22,,percent of total billed charges,,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,94,357.2,
"HIV-1 RNA PCR, QN",25200024,CDM,87536,CPT,300,RC,outpatient,,677,677,,574.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,169.25,22,,percent of total billed charges,,,,,,,,,609.3,90,,percent of total billed charges,,,560.56,82.8,,percent of total billed charges,,,575.45,85,,percent of total billed charges,,,,,,,,,595.76,88,,percent of total billed charges,,,,,,,,,517.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,169.25,22,,percent of total billed charges,,,616.07,91,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,561.91,83,,percent of total billed charges,,,,,,,,,,,,,,,561.91,83,,percent of total billed charges,,,643.15,95,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,555.14,82,,percent of total billed charges,,,609.3,90,,percent of total billed charges,,,575.45,85,,percent of total billed charges,,169.25,643.15,
AMIODARONE,25200025,CDM,80151,CPT,300,RC,outpatient,,224,224,,190.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56,22,,percent of total billed charges,,,,,,,,,201.6,90,,percent of total billed charges,,,185.47,82.8,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,,,,,,,,197.12,88,,percent of total billed charges,,,,,,,,,171.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56,22,,percent of total billed charges,,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,183.68,82,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,56,212.8,
BETA 2 GLYCOPROTEIN 1 AB (IgG),25200026,CDM,86146,CPT,300,RC,outpatient,,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.5,22,,percent of total billed charges,,,,,,,,,117,90,,percent of total billed charges,,,107.64,82.8,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.5,22,,percent of total billed charges,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,32.5,123.5,
BETA 2 MICROGLOBULIN,25200027,CDM,82232,CPT,300,RC,outpatient,,291,291,,247.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.75,22,,percent of total billed charges,,,,,,,,,261.9,90,,percent of total billed charges,,,240.95,82.8,,percent of total billed charges,,,247.35,85,,percent of total billed charges,,,,,,,,,256.08,88,,percent of total billed charges,,,,,,,,,222.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.75,22,,percent of total billed charges,,,264.81,91,,percent of total billed charges,,,276.45,95,,percent of total billed charges,,,241.53,83,,percent of total billed charges,,,241.53,83,,percent of total billed charges,,,,,,,,,,,,,,,241.53,83,,percent of total billed charges,,,276.45,95,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,238.62,82,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,247.35,85,,percent of total billed charges,,72.75,276.45,
TESTOSTERONE FREE (INCLUDES TOTAL),25200028,CDM,84402,CPT,300,RC,outpatient,,460,460,,390.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115,22,,percent of total billed charges,,,,,,,,,414,90,,percent of total billed charges,,,380.88,82.8,,percent of total billed charges,,,391,85,,percent of total billed charges,,,,,,,,,404.8,88,,percent of total billed charges,,,,,,,,,351.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115,22,,percent of total billed charges,,,418.6,91,,percent of total billed charges,,,437,95,,percent of total billed charges,,,381.8,83,,percent of total billed charges,,,381.8,83,,percent of total billed charges,,,,,,,,,,,,,,,381.8,83,,percent of total billed charges,,,437,95,,percent of total billed charges,,,414,90,,percent of total billed charges,,,414,90,,percent of total billed charges,,,377.2,82,,percent of total billed charges,,,414,90,,percent of total billed charges,,,391,85,,percent of total billed charges,,115,437,
FETAL HEMOGLOGIN,25200029,CDM,83021,CPT,300,RC,outpatient,,82,82,,69.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.5,22,,percent of total billed charges,,,,,,,,,73.8,90,,percent of total billed charges,,,67.9,82.8,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,,,,,,,,72.16,88,,percent of total billed charges,,,,,,,,,62.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.5,22,,percent of total billed charges,,,74.62,91,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,,,,,,,,,,,,,68.06,83,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,67.24,82,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,20.5,77.9,
ALKALINE PHOSPHATASE,25200030,CDM,84075,CPT,300,RC,outpatient,,116,116,,98.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29,22,,percent of total billed charges,,,,,,,,,104.4,90,,percent of total billed charges,,,96.05,82.8,,percent of total billed charges,,,98.6,85,,percent of total billed charges,,,,,,,,,102.08,88,,percent of total billed charges,,,,,,,,,88.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29,22,,percent of total billed charges,,,105.56,91,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,,,,,,,,,,,,,96.28,83,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,95.12,82,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,98.6,85,,percent of total billed charges,,29,110.2,
0SERTRALINE (ZOLOFT),25200031,CDM,80299,CPT,300,RC,outpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75,22,,percent of total billed charges,,,,,,,,,270,90,,percent of total billed charges,,,248.4,82.8,,percent of total billed charges,,,255,85,,percent of total billed charges,,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75,22,,percent of total billed charges,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,75,285,
BB THAW FRESH FROZEN PLASMA,25200032,CDM,86927,CPT,300,RC,outpatient,,265,265,,224.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.25,22,,percent of total billed charges,,,,,,,,,238.5,90,,percent of total billed charges,,,219.42,82.8,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,,,,,,,,233.2,88,,percent of total billed charges,,,,,,,,,202.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.25,22,,percent of total billed charges,,,241.15,91,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,,,,,,,,,,,,,219.95,83,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,217.3,82,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,66.25,251.75,
LEUKOCYTE ALKALINE PHOSPHATASE,25200033,CDM,85540,CPT,300,RC,outpatient,,161,161,,136.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.25,22,,percent of total billed charges,,,,,,,,,144.9,90,,percent of total billed charges,,,133.31,82.8,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,,,,,,,,141.68,88,,percent of total billed charges,,,,,,,,,123,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.25,22,,percent of total billed charges,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,132.02,82,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,40.25,152.95,
FACTOR V (LEIDEN),25200034,CDM,81241,CPT,300,RC,outpatient,,731,731,,620.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,182.75,22,,percent of total billed charges,,,,,,,,,657.9,90,,percent of total billed charges,,,605.27,82.8,,percent of total billed charges,,,621.35,85,,percent of total billed charges,,,,,,,,,643.28,88,,percent of total billed charges,,,,,,,,,558.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,182.75,22,,percent of total billed charges,,,665.21,91,,percent of total billed charges,,,694.45,95,,percent of total billed charges,,,606.73,83,,percent of total billed charges,,,606.73,83,,percent of total billed charges,,,,,,,,,,,,,,,606.73,83,,percent of total billed charges,,,694.45,95,,percent of total billed charges,,,657.9,90,,percent of total billed charges,,,657.9,90,,percent of total billed charges,,,599.42,82,,percent of total billed charges,,,657.9,90,,percent of total billed charges,,,621.35,85,,percent of total billed charges,,182.75,694.45,
COPPER URINE (24-HOUR),25200035,CDM,82525,CPT,300,RC,outpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.5,22,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,170.57,82.8,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.5,22,,percent of total billed charges,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,51.5,195.7,
.DRUG SCREEN BLOOD,25200036,CDM,80307,CPT,300,RC,outpatient,,44,44,,37.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11,22,,percent of total billed charges,,,,,,,,,39.6,90,,percent of total billed charges,,,36.43,82.8,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,,,,,,,,38.72,88,,percent of total billed charges,,,,,,,,,33.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11,22,,percent of total billed charges,,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,36.08,82,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,11,41.8,
MUMPS ANTIBODY (IgG),25200037,CDM,86735,CPT,300,RC,outpatient,,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.5,22,,percent of total billed charges,,,,,,,,,117,90,,percent of total billed charges,,,107.64,82.8,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.5,22,,percent of total billed charges,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,32.5,123.5,
MUMPS ANTIBODY (IgM),25200038,CDM,86735,CPT,300,RC,outpatient,,164,164,,139.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41,22,,percent of total billed charges,,,,,,,,,147.6,90,,percent of total billed charges,,,135.79,82.8,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,,,,,,,,144.32,88,,percent of total billed charges,,,,,,,,,125.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41,22,,percent of total billed charges,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,134.48,82,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,41,155.8,
GLOMERULAR BASEMENT MEMBRANE AB,25200039,CDM,83520,CPT,300,RC,outpatient,,565,565,,479.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141.25,22,,percent of total billed charges,,,,,,,,,508.5,90,,percent of total billed charges,,,467.82,82.8,,percent of total billed charges,,,480.25,85,,percent of total billed charges,,,,,,,,,497.2,88,,percent of total billed charges,,,,,,,,,431.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141.25,22,,percent of total billed charges,,,514.15,91,,percent of total billed charges,,,536.75,95,,percent of total billed charges,,,468.95,83,,percent of total billed charges,,,468.95,83,,percent of total billed charges,,,,,,,,,,,,,,,468.95,83,,percent of total billed charges,,,536.75,95,,percent of total billed charges,,,508.5,90,,percent of total billed charges,,,508.5,90,,percent of total billed charges,,,463.3,82,,percent of total billed charges,,,508.5,90,,percent of total billed charges,,,480.25,85,,percent of total billed charges,,141.25,536.75,
BK VIRUS DNA QN PCR,25200040,CDM,87799,CPT,300,RC,outpatient,,811,811,,688.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,202.75,22,,percent of total billed charges,,,,,,,,,729.9,90,,percent of total billed charges,,,671.51,82.8,,percent of total billed charges,,,689.35,85,,percent of total billed charges,,,,,,,,,713.68,88,,percent of total billed charges,,,,,,,,,619.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,202.75,22,,percent of total billed charges,,,738.01,91,,percent of total billed charges,,,770.45,95,,percent of total billed charges,,,673.13,83,,percent of total billed charges,,,673.13,83,,percent of total billed charges,,,,,,,,,,,,,,,673.13,83,,percent of total billed charges,,,770.45,95,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,665.02,82,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,689.35,85,,percent of total billed charges,,202.75,770.45,
.GTT - 2 HOUR,25200041,CDM,82951,CPT,300,RC,outpatient,,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.75,22,,percent of total billed charges,,,,,,,,,207.9,90,,percent of total billed charges,,,191.27,82.8,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.75,22,,percent of total billed charges,,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,57.75,219.45,
.GTT - 4 HOUR,25200042,CDM,82951,CPT,300,RC,outpatient,,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.5,22,,percent of total billed charges,,,,,,,,,196.2,90,,percent of total billed charges,,,180.5,82.8,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,,,,,,,,191.84,88,,percent of total billed charges,,,,,,,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.5,22,,percent of total billed charges,,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,54.5,207.1,
.CBC W/MANUAL DIFF,25200043,CDM,85027,CPT,300,RC,outpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
GALACTOSE-1-PHOSPHATE LEVEL,25200044,CDM,82775,CPT,300,RC,outpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.25,22,,percent of total billed charges,,,,,,,,,188.1,90,,percent of total billed charges,,,173.05,82.8,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.25,22,,percent of total billed charges,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,52.25,198.55,
HERPES SIM 2 IGG AB,25200045,CDM,86696,CPT,300,RC,outpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.75,22,,percent of total billed charges,,,,,,,,,143.1,90,,percent of total billed charges,,,131.65,82.8,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.75,22,,percent of total billed charges,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,39.75,151.05,
FETAL FIBRONECTIN,25200046,CDM,82731,CPT,300,RC,outpatient,,713,713,,605.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.25,22,,percent of total billed charges,,,,,,,,,641.7,90,,percent of total billed charges,,,590.36,82.8,,percent of total billed charges,,,606.05,85,,percent of total billed charges,,,,,,,,,627.44,88,,percent of total billed charges,,,,,,,,,544.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.25,22,,percent of total billed charges,,,648.83,91,,percent of total billed charges,,,677.35,95,,percent of total billed charges,,,591.79,83,,percent of total billed charges,,,591.79,83,,percent of total billed charges,,,,,,,,,,,,,,,591.79,83,,percent of total billed charges,,,677.35,95,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,584.66,82,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,606.05,85,,percent of total billed charges,,178.25,677.35,
BNP,25200047,CDM,83880,CPT,300,RC,outpatient,,561,561,,476.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,140.25,22,,percent of total billed charges,,,,,,,,,504.9,90,,percent of total billed charges,,,464.51,82.8,,percent of total billed charges,,,476.85,85,,percent of total billed charges,,,,,,,,,493.68,88,,percent of total billed charges,,,,,,,,,428.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,140.25,22,,percent of total billed charges,,,510.51,91,,percent of total billed charges,,,532.95,95,,percent of total billed charges,,,465.63,83,,percent of total billed charges,,,465.63,83,,percent of total billed charges,,,,,,,,,,,,,,,465.63,83,,percent of total billed charges,,,532.95,95,,percent of total billed charges,,,504.9,90,,percent of total billed charges,,,504.9,90,,percent of total billed charges,,,460.02,82,,percent of total billed charges,,,504.9,90,,percent of total billed charges,,,476.85,85,,percent of total billed charges,,140.25,532.95,
AMYLASE SERUM,25200048,CDM,82150,CPT,300,RC,outpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.75,22,,percent of total billed charges,,,,,,,,,143.1,90,,percent of total billed charges,,,131.65,82.8,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.75,22,,percent of total billed charges,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,39.75,151.05,
TETRACYCLINE,25200050,CDM,80299,CPT,300,RC,outpatient,,358,358,,303.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.5,22,,percent of total billed charges,,,,,,,,,322.2,90,,percent of total billed charges,,,296.42,82.8,,percent of total billed charges,,,304.3,85,,percent of total billed charges,,,,,,,,,315.04,88,,percent of total billed charges,,,,,,,,,273.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.5,22,,percent of total billed charges,,,325.78,91,,percent of total billed charges,,,340.1,95,,percent of total billed charges,,,297.14,83,,percent of total billed charges,,,297.14,83,,percent of total billed charges,,,,,,,,,,,,,,,297.14,83,,percent of total billed charges,,,340.1,95,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,293.56,82,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,304.3,85,,percent of total billed charges,,89.5,340.1,
..HERPES SIM 1&2 IGM AB,25200051,CDM,86695,CPT,300,RC,outpatient,,175,175,,148.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.75,22,,percent of total billed charges,,,,,,,,,157.5,90,,percent of total billed charges,,,144.9,82.8,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,,,,,,,,154,88,,percent of total billed charges,,,,,,,,,133.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.75,22,,percent of total billed charges,,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,,,,,,,,,,,,,145.25,83,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,143.5,82,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,43.75,166.25,
CYCLIC CITRULLINATED PEPTIDE  AB(IGG/IGA,25200052,CDM,86200,CPT,300,RC,outpatient,,381,381,,323.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,95.25,22,,percent of total billed charges,,,,,,,,,342.9,90,,percent of total billed charges,,,315.47,82.8,,percent of total billed charges,,,323.85,85,,percent of total billed charges,,,,,,,,,335.28,88,,percent of total billed charges,,,,,,,,,291.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,95.25,22,,percent of total billed charges,,,346.71,91,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,,,,,,,,,,,,,316.23,83,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,312.42,82,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,323.85,85,,percent of total billed charges,,95.25,361.95,
CYSTIC FIBROSIS CARRIER SCREEN,25200053,CDM,81220,CPT,300,RC,outpatient,,827,827,,702.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.75,22,,percent of total billed charges,,,,,,,,,744.3,90,,percent of total billed charges,,,684.76,82.8,,percent of total billed charges,,,702.95,85,,percent of total billed charges,,,,,,,,,727.76,88,,percent of total billed charges,,,,,,,,,631.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.75,22,,percent of total billed charges,,,752.57,91,,percent of total billed charges,,,785.65,95,,percent of total billed charges,,,686.41,83,,percent of total billed charges,,,686.41,83,,percent of total billed charges,,,,,,,,,,,,,,,686.41,83,,percent of total billed charges,,,785.65,95,,percent of total billed charges,,,744.3,90,,percent of total billed charges,,,744.3,90,,percent of total billed charges,,,678.14,82,,percent of total billed charges,,,744.3,90,,percent of total billed charges,,,702.95,85,,percent of total billed charges,,206.75,785.65,
CYTOCHROME P450 2D6 GENOTYPING,25200054,CDM,81226,CPT,300,RC,outpatient,,1572,1572,,1334.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,393,22,,percent of total billed charges,,,,,,,,,1414.8,90,,percent of total billed charges,,,1301.62,82.8,,percent of total billed charges,,,1336.2,85,,percent of total billed charges,,,,,,,,,1383.36,88,,percent of total billed charges,,,,,,,,,1201.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,393,22,,percent of total billed charges,,,1430.52,91,,percent of total billed charges,,,1493.4,95,,percent of total billed charges,,,1304.76,83,,percent of total billed charges,,,1304.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1304.76,83,,percent of total billed charges,,,1493.4,95,,percent of total billed charges,,,1414.8,90,,percent of total billed charges,,,1414.8,90,,percent of total billed charges,,,1289.04,82,,percent of total billed charges,,,1414.8,90,,percent of total billed charges,,,1336.2,85,,percent of total billed charges,,393,1493.4,
ANTIBIOTIC SENSITIVITY PANEL,25200055,CDM,87186,CPT,300,RC,outpatient,,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38,22,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,125.86,82.8,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38,22,,percent of total billed charges,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,38,144.4,
BETA 2 MICROGLOBULIN URINE,25200056,CDM,82232,CPT,300,RC,outpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.75,22,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,45.54,82.8,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.75,22,,percent of total billed charges,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,13.75,52.25,
ORGANISM I.D. AEROBIC,25200057,CDM,87077,CPT,300,RC,outpatient,,174,174,,147.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.5,22,,percent of total billed charges,,,,,,,,,156.6,90,,percent of total billed charges,,,144.07,82.8,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,,,,,,,,153.12,88,,percent of total billed charges,,,,,,,,,132.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.5,22,,percent of total billed charges,,,158.34,91,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,,,,,,,,,,,,,144.42,83,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,142.68,82,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,43.5,165.3,
ORGANISM I.D. ANAEROBIC,25200058,CDM,87076,CPT,300,RC,outpatient,,127,127,,107.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.75,22,,percent of total billed charges,,,,,,,,,114.3,90,,percent of total billed charges,,,105.16,82.8,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,,,,,,,,111.76,88,,percent of total billed charges,,,,,,,,,97.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.75,22,,percent of total billed charges,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,,,,,,,,,,,,,105.41,83,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,104.14,82,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,31.75,120.65,
TRYPSIN,25200059,CDM,83519,CPT,300,RC,outpatient,,149,149,,126.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.25,22,,percent of total billed charges,,,,,,,,,134.1,90,,percent of total billed charges,,,123.37,82.8,,percent of total billed charges,,,126.65,85,,percent of total billed charges,,,,,,,,,131.12,88,,percent of total billed charges,,,,,,,,,113.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.25,22,,percent of total billed charges,,,135.59,91,,percent of total billed charges,,,141.55,95,,percent of total billed charges,,,123.67,83,,percent of total billed charges,,,123.67,83,,percent of total billed charges,,,,,,,,,,,,,,,123.67,83,,percent of total billed charges,,,141.55,95,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,122.18,82,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,126.65,85,,percent of total billed charges,,37.25,141.55,
10-HYDROXYCARBEZEPINE,25200060,CDM,80183,CPT,300,RC,outpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.5,22,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,170.57,82.8,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.5,22,,percent of total billed charges,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,51.5,195.7,
DRUG SCREEN OPIATE SERUM,25200061,CDM,80361,CPT,300,RC,outpatient,,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.5,22,,percent of total billed charges,,,,,,,,,307.8,90,,percent of total billed charges,,,283.18,82.8,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.5,22,,percent of total billed charges,,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,85.5,324.9,
.DRUG SCREEN OPIATE URINE,25200062,CDM,83925,CPT,300,RC,outpatient,,340,340,,288.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85,22,,percent of total billed charges,,,,,,,,,306,90,,percent of total billed charges,,,281.52,82.8,,percent of total billed charges,,,289,85,,percent of total billed charges,,,,,,,,,299.2,88,,percent of total billed charges,,,,,,,,,259.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85,22,,percent of total billed charges,,,309.4,91,,percent of total billed charges,,,323,95,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,,,,,,,,,,,,,282.2,83,,percent of total billed charges,,,323,95,,percent of total billed charges,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,278.8,82,,percent of total billed charges,,,306,90,,percent of total billed charges,,,289,85,,percent of total billed charges,,85,323,
BB ANTIBODY SCREEN,25200063,CDM,86850,CPT,300,RC,outpatient,,270,270,,229.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.5,22,,percent of total billed charges,,,,,,,,,243,90,,percent of total billed charges,,,223.56,82.8,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,,,,,,,,237.6,88,,percent of total billed charges,,,,,,,,,206.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.5,22,,percent of total billed charges,,,245.7,91,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,,,,,,,,,,,,,224.1,83,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,243,90,,percent of total billed charges,,,243,90,,percent of total billed charges,,,221.4,82,,percent of total billed charges,,,243,90,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,67.5,256.5,
MYASTHENIA GRAVIS PANEL,25200064,CDM,83519,CPT,300,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
SULFONYLUREA SCREEN QT,25200066,CDM,80377,CPT,300,RC,outpatient,,498,498,,422.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.5,22,,percent of total billed charges,,,,,,,,,448.2,90,,percent of total billed charges,,,412.34,82.8,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,,,,,,,,438.24,88,,percent of total billed charges,,,,,,,,,380.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.5,22,,percent of total billed charges,,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,,,,,,,,,,,,,413.34,83,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,408.36,82,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,124.5,473.1,
SULFATIDE IGG,25200067,CDM,83520,CPT,300,RC,outpatient,,666,666,,565.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.5,22,,percent of total billed charges,,,,,,,,,599.4,90,,percent of total billed charges,,,551.45,82.8,,percent of total billed charges,,,566.1,85,,percent of total billed charges,,,,,,,,,586.08,88,,percent of total billed charges,,,,,,,,,508.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.5,22,,percent of total billed charges,,,606.06,91,,percent of total billed charges,,,632.7,95,,percent of total billed charges,,,552.78,83,,percent of total billed charges,,,552.78,83,,percent of total billed charges,,,,,,,,,,,,,,,552.78,83,,percent of total billed charges,,,632.7,95,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,546.12,82,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,566.1,85,,percent of total billed charges,,166.5,632.7,
MYELIN GLYCOPROTEIN ANTIBODY,25200068,CDM,84182,CPT,300,RC,outpatient,,480,480,,407.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,120,22,,percent of total billed charges,,,,,,,,,432,90,,percent of total billed charges,,,397.44,82.8,,percent of total billed charges,,,408,85,,percent of total billed charges,,,,,,,,,422.4,88,,percent of total billed charges,,,,,,,,,366.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,120,22,,percent of total billed charges,,,436.8,91,,percent of total billed charges,,,456,95,,percent of total billed charges,,,398.4,83,,percent of total billed charges,,,398.4,83,,percent of total billed charges,,,,,,,,,,,,,,,398.4,83,,percent of total billed charges,,,456,95,,percent of total billed charges,,,432,90,,percent of total billed charges,,,432,90,,percent of total billed charges,,,393.6,82,,percent of total billed charges,,,432,90,,percent of total billed charges,,,408,85,,percent of total billed charges,,120,456,
.GANGLIOSIDE ANTIBODIES (IGG & IGM),25200069,CDM,83516,CPT,300,RC,outpatient,,244,244,,207.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61,22,,percent of total billed charges,,,,,,,,,219.6,90,,percent of total billed charges,,,202.03,82.8,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,,,,,,,,214.72,88,,percent of total billed charges,,,,,,,,,186.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61,22,,percent of total billed charges,,,222.04,91,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,,,,,,,,,,,,,202.52,83,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,200.08,82,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,61,231.8,
SULFOGLUCURONYL PARAGLOBOSIDE (SPGP),25200070,CDM,83520,CPT,300,RC,outpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.75,22,,percent of total billed charges,,,,,,,,,312.3,90,,percent of total billed charges,,,287.32,82.8,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.75,22,,percent of total billed charges,,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,86.75,329.65,
ASO TITER,25200071,CDM,86060,CPT,300,RC,outpatient,,171,171,,145.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.75,22,,percent of total billed charges,,,,,,,,,153.9,90,,percent of total billed charges,,,141.59,82.8,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,,,,,,,,150.48,88,,percent of total billed charges,,,,,,,,,130.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.75,22,,percent of total billed charges,,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,,,,,,,,,,,,,141.93,83,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,140.22,82,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,42.75,162.45,
EBV VCA (IGG) ANTIBODY,25200072,CDM,86665,CPT,300,RC,outpatient,,328,328,,278.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82,22,,percent of total billed charges,,,,,,,,,295.2,90,,percent of total billed charges,,,271.58,82.8,,percent of total billed charges,,,278.8,85,,percent of total billed charges,,,,,,,,,288.64,88,,percent of total billed charges,,,,,,,,,250.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82,22,,percent of total billed charges,,,298.48,91,,percent of total billed charges,,,311.6,95,,percent of total billed charges,,,272.24,83,,percent of total billed charges,,,272.24,83,,percent of total billed charges,,,,,,,,,,,,,,,272.24,83,,percent of total billed charges,,,311.6,95,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,268.96,82,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,278.8,85,,percent of total billed charges,,82,311.6,
SULFATIDE IGM,25200073,CDM,83520,CPT,300,RC,outpatient,,666,666,,565.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.5,22,,percent of total billed charges,,,,,,,,,599.4,90,,percent of total billed charges,,,551.45,82.8,,percent of total billed charges,,,566.1,85,,percent of total billed charges,,,,,,,,,586.08,88,,percent of total billed charges,,,,,,,,,508.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.5,22,,percent of total billed charges,,,606.06,91,,percent of total billed charges,,,632.7,95,,percent of total billed charges,,,552.78,83,,percent of total billed charges,,,552.78,83,,percent of total billed charges,,,,,,,,,,,,,,,552.78,83,,percent of total billed charges,,,632.7,95,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,546.12,82,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,566.1,85,,percent of total billed charges,,166.5,632.7,
MYELIN BASIC PROTEIN,25200074,CDM,83873,CPT,300,RC,outpatient,,264,264,,224.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66,22,,percent of total billed charges,,,,,,,,,237.6,90,,percent of total billed charges,,,218.59,82.8,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,,,,,,,,232.32,88,,percent of total billed charges,,,,,,,,,201.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66,22,,percent of total billed charges,,,240.24,91,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,,,,,,,,,,,,,219.12,83,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,216.48,82,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,66,250.8,
IGF-1,25200075,CDM,84305,CPT,300,RC,outpatient,,398,398,,337.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,99.5,22,,percent of total billed charges,,,,,,,,,358.2,90,,percent of total billed charges,,,329.54,82.8,,percent of total billed charges,,,338.3,85,,percent of total billed charges,,,,,,,,,350.24,88,,percent of total billed charges,,,,,,,,,304.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,99.5,22,,percent of total billed charges,,,362.18,91,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,,,,,,,,,,,,,330.34,83,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,326.36,82,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,338.3,85,,percent of total billed charges,,99.5,378.1,
..B CELLS TOTAL COUNT,25200076,CDM,86355,CPT,310,RC,outpatient,,681,681,,578.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,170.25,22,,percent of total billed charges,,,,,,,,,612.9,90,,percent of total billed charges,,,563.87,82.8,,percent of total billed charges,,,578.85,85,,percent of total billed charges,,,,,,,,,599.28,88,,percent of total billed charges,,,,,,,,,520.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,170.25,22,,percent of total billed charges,,,619.71,91,,percent of total billed charges,,,646.95,95,,percent of total billed charges,,,565.23,83,,percent of total billed charges,,,565.23,83,,percent of total billed charges,,,,,,,,,,,,,,,565.23,83,,percent of total billed charges,,,646.95,95,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,558.42,82,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,578.85,85,,percent of total billed charges,,170.25,646.95,
STRONGYLOIDES ANTIBODY,25200077,CDM,86682,CPT,300,RC,outpatient,,343,343,,291.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.75,22,,percent of total billed charges,,,,,,,,,308.7,90,,percent of total billed charges,,,284,82.8,,percent of total billed charges,,,291.55,85,,percent of total billed charges,,,,,,,,,301.84,88,,percent of total billed charges,,,,,,,,,262.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.75,22,,percent of total billed charges,,,312.13,91,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,,,,,,,,,,,,,284.69,83,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,281.26,82,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,291.55,85,,percent of total billed charges,,85.75,325.85,
.CARDIOLIPIN ANTIBODY (IGA),25200078,CDM,86147,CPT,300,RC,outpatient,,384,384,,326.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96,22,,percent of total billed charges,,,,,,,,,345.6,90,,percent of total billed charges,,,317.95,82.8,,percent of total billed charges,,,326.4,85,,percent of total billed charges,,,,,,,,,337.92,88,,percent of total billed charges,,,,,,,,,293.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96,22,,percent of total billed charges,,,349.44,91,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,,,,,,,,,,,,,318.72,83,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,314.88,82,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,326.4,85,,percent of total billed charges,,96,364.8,
.CARDIOLIPIN ANTIBODY (IgG),25200079,CDM,86147,CPT,300,RC,outpatient,,384,384,,326.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96,22,,percent of total billed charges,,,,,,,,,345.6,90,,percent of total billed charges,,,317.95,82.8,,percent of total billed charges,,,326.4,85,,percent of total billed charges,,,,,,,,,337.92,88,,percent of total billed charges,,,,,,,,,293.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96,22,,percent of total billed charges,,,349.44,91,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,,,,,,,,,,,,,318.72,83,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,314.88,82,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,326.4,85,,percent of total billed charges,,96,364.8,
.CARDIOLIPIN ANTIBODY (IgM),25200080,CDM,86147,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
.PHOSPHATIDYLSERINE AB IGM,25200081,CDM,86148,CPT,300,RC,outpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
.PHOSPHATIDYLSERINE AB IGA,25200082,CDM,86148,CPT,300,RC,outpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
.PHOSPHATIDYLSERINE AB IGG,25200083,CDM,86148,CPT,300,RC,outpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
.BETA-2 GLYCOPROTEIN IGA,25200084,CDM,86146,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
.BETA-2 GLYCOPROTEIN IGM,25200085,CDM,86146,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
.BETA-2 GLYCOPROTEIN IGG,25200086,CDM,86146,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
IGF BINDING PROTEIN,25200088,CDM,83519,CPT,300,RC,outpatient,,127,127,,107.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.75,22,,percent of total billed charges,,,,,,,,,114.3,90,,percent of total billed charges,,,105.16,82.8,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,,,,,,,,111.76,88,,percent of total billed charges,,,,,,,,,97.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.75,22,,percent of total billed charges,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,,,,,,,,,,,,,105.41,83,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,104.14,82,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,31.75,120.65,
STREP A SCREEN (NAAT),25200089,CDM,87561,CPT,300,RC,outpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.75,22,,percent of total billed charges,,,,,,,,,312.3,90,,percent of total billed charges,,,287.32,82.8,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.75,22,,percent of total billed charges,,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,86.75,329.65,
.STREP PNEUMO AB (14 SEROTYPES),25200090,CDM,86317,CPT,300,RC,outpatient,,34,34,,28.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.5,22,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,28.15,82.8,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,,,,,,,,29.92,88,,percent of total billed charges,,,,,,,,,25.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.5,22,,percent of total billed charges,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,,,,,,,,,,,,,28.22,83,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,27.88,82,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,8.5,32.3,
.CARDIOLIPIN ANTIBODY (IgA),25200091,CDM,86147,CPT,300,RC,outpatient,,86,86,,73.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.5,22,,percent of total billed charges,,,,,,,,,77.4,90,,percent of total billed charges,,,71.21,82.8,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,,,,,,,,75.68,88,,percent of total billed charges,,,,,,,,,65.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.5,22,,percent of total billed charges,,,78.26,91,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,,,,,,,,,,,,,71.38,83,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,70.52,82,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,21.5,81.7,
"DRUG OF ABUSE (10)SCREEN, SERUM",25200092,CDM,80307,CPT,300,RC,outpatient,,431,431,,365.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.75,22,,percent of total billed charges,,,,,,,,,387.9,90,,percent of total billed charges,,,356.87,82.8,,percent of total billed charges,,,366.35,85,,percent of total billed charges,,,,,,,,,379.28,88,,percent of total billed charges,,,,,,,,,329.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.75,22,,percent of total billed charges,,,392.21,91,,percent of total billed charges,,,409.45,95,,percent of total billed charges,,,357.73,83,,percent of total billed charges,,,357.73,83,,percent of total billed charges,,,,,,,,,,,,,,,357.73,83,,percent of total billed charges,,,409.45,95,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,353.42,82,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,366.35,85,,percent of total billed charges,,107.75,409.45,
#NAME?,25200093,CDM,87150,CPT,300,RC,outpatient,,589,589,,500.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,147.25,22,,percent of total billed charges,,,,,,,,,530.1,90,,percent of total billed charges,,,487.69,82.8,,percent of total billed charges,,,500.65,85,,percent of total billed charges,,,,,,,,,518.32,88,,percent of total billed charges,,,,,,,,,450,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,147.25,22,,percent of total billed charges,,,535.99,91,,percent of total billed charges,,,559.55,95,,percent of total billed charges,,,488.87,83,,percent of total billed charges,,,488.87,83,,percent of total billed charges,,,,,,,,,,,,,,,488.87,83,,percent of total billed charges,,,559.55,95,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,482.98,82,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,500.65,85,,percent of total billed charges,,147.25,559.55,
FACTOR V (LEIDEN)RFLX R2,25200094,CDM,81241,CPT,300,RC,outpatient,,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.75,22,,percent of total billed charges,,,,,,,,,542.7,90,,percent of total billed charges,,,499.28,82.8,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.75,22,,percent of total billed charges,,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,150.75,572.85,
IGF-BP3,25200095,CDM,83519,CPT,300,RC,outpatient,,243,243,,206.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60.75,22,,percent of total billed charges,,,,,,,,,218.7,90,,percent of total billed charges,,,201.2,82.8,,percent of total billed charges,,,206.55,85,,percent of total billed charges,,,,,,,,,213.84,88,,percent of total billed charges,,,,,,,,,185.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60.75,22,,percent of total billed charges,,,221.13,91,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,,,,,,,,,,,,,201.69,83,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,199.26,82,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,206.55,85,,percent of total billed charges,,60.75,230.85,
EOSINOPHIL URINE,25200096,CDM,87205,CPT,300,RC,outpatient,,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38,22,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,125.86,82.8,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38,22,,percent of total billed charges,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,38,144.4,
BILIRUBIN DIRECT,25200097,CDM,82248,CPT,300,RC,outpatient,,100,100,,84.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25,22,,percent of total billed charges,,,,,,,,,90,90,,percent of total billed charges,,,82.8,82.8,,percent of total billed charges,,,85,85,,percent of total billed charges,,,,,,,,,88,88,,percent of total billed charges,,,,,,,,,76.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25,22,,percent of total billed charges,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,83,83,,percent of total billed charges,,,,,,,,,,,,,,,83,83,,percent of total billed charges,,,95,95,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,82,82,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,25,95,
...ADALIMUMAB +AB,25200099,CDM,80299,CPT,300,RC,outpatient,,426,426,,361.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,106.5,22,,percent of total billed charges,,,,,,,,,383.4,90,,percent of total billed charges,,,352.73,82.8,,percent of total billed charges,,,362.1,85,,percent of total billed charges,,,,,,,,,374.88,88,,percent of total billed charges,,,,,,,,,325.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,106.5,22,,percent of total billed charges,,,387.66,91,,percent of total billed charges,,,404.7,95,,percent of total billed charges,,,353.58,83,,percent of total billed charges,,,353.58,83,,percent of total billed charges,,,,,,,,,,,,,,,353.58,83,,percent of total billed charges,,,404.7,95,,percent of total billed charges,,,383.4,90,,percent of total billed charges,,,383.4,90,,percent of total billed charges,,,349.32,82,,percent of total billed charges,,,383.4,90,,percent of total billed charges,,,362.1,85,,percent of total billed charges,,106.5,404.7,
CHEMILUMINESCENT ASSAY,25200100,CDM,82397,CPT,300,RC,outpatient,,315,315,,267.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.75,22,,percent of total billed charges,,,,,,,,,283.5,90,,percent of total billed charges,,,260.82,82.8,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,,,,,,,,277.2,88,,percent of total billed charges,,,,,,,,,240.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.75,22,,percent of total billed charges,,,286.65,91,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,,,,,,,,,,,,,261.45,83,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,258.3,82,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,78.75,299.25,
BK VIRUS URINE,25200101,CDM,87799,CPT,300,RC,outpatient,,492,492,,417.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123,22,,percent of total billed charges,,,,,,,,,442.8,90,,percent of total billed charges,,,407.38,82.8,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,,,,,,,,432.96,88,,percent of total billed charges,,,,,,,,,375.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123,22,,percent of total billed charges,,,447.72,91,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,,,,,,,,,,,,,408.36,83,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,403.44,82,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,123,467.4,
RAPAMUNE,25200102,CDM,80195,CPT,300,RC,outpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.25,22,,percent of total billed charges,,,,,,,,,72.9,90,,percent of total billed charges,,,67.07,82.8,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.25,22,,percent of total billed charges,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,20.25,76.95,
INTERLUKIN 6,25200103,CDM,83520,CPT,300,RC,outpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
CORTISOL SALIVARY,25200104,CDM,82533,CPT,300,RC,outpatient,,75,75,,63.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.75,22,,percent of total billed charges,,,,,,,,,67.5,90,,percent of total billed charges,,,62.1,82.8,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,,,,,,,,66,88,,percent of total billed charges,,,,,,,,,57.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.75,22,,percent of total billed charges,,,68.25,91,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,,,,,,,,,,,,,62.25,83,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,61.5,82,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,18.75,71.25,
BILIRUBIN TOTAL,25200105,CDM,82247,CPT,300,RC,outpatient,,101,101,,85.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.25,22,,percent of total billed charges,,,,,,,,,90.9,90,,percent of total billed charges,,,83.63,82.8,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,,,,,,,,88.88,88,,percent of total billed charges,,,,,,,,,77.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.25,22,,percent of total billed charges,,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,82.82,82,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,25.25,95.95,
TROPONIN-T (SEND OUT),25200108,CDM,84484,CPT,300,RC,outpatient,,318,318,,269.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.5,22,,percent of total billed charges,,,,,,,,,286.2,90,,percent of total billed charges,,,263.3,82.8,,percent of total billed charges,,,270.3,85,,percent of total billed charges,,,,,,,,,279.84,88,,percent of total billed charges,,,,,,,,,242.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.5,22,,percent of total billed charges,,,289.38,91,,percent of total billed charges,,,302.1,95,,percent of total billed charges,,,263.94,83,,percent of total billed charges,,,263.94,83,,percent of total billed charges,,,,,,,,,,,,,,,263.94,83,,percent of total billed charges,,,302.1,95,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,260.76,82,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,270.3,85,,percent of total billed charges,,79.5,302.1,
PRO-BNP,25200109,CDM,83880,CPT,300,RC,outpatient,,510,510,,432.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.5,22,,percent of total billed charges,,,,,,,,,459,90,,percent of total billed charges,,,422.28,82.8,,percent of total billed charges,,,433.5,85,,percent of total billed charges,,,,,,,,,448.8,88,,percent of total billed charges,,,,,,,,,389.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.5,22,,percent of total billed charges,,,464.1,91,,percent of total billed charges,,,484.5,95,,percent of total billed charges,,,423.3,83,,percent of total billed charges,,,423.3,83,,percent of total billed charges,,,,,,,,,,,,,,,423.3,83,,percent of total billed charges,,,484.5,95,,percent of total billed charges,,,459,90,,percent of total billed charges,,,459,90,,percent of total billed charges,,,418.2,82,,percent of total billed charges,,,459,90,,percent of total billed charges,,,433.5,85,,percent of total billed charges,,127.5,484.5,
INTERLUKIN 2,25200110,CDM,83520,CPT,300,RC,outpatient,,267,267,,226.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.75,22,,percent of total billed charges,,,,,,,,,240.3,90,,percent of total billed charges,,,221.08,82.8,,percent of total billed charges,,,226.95,85,,percent of total billed charges,,,,,,,,,234.96,88,,percent of total billed charges,,,,,,,,,203.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.75,22,,percent of total billed charges,,,242.97,91,,percent of total billed charges,,,253.65,95,,percent of total billed charges,,,221.61,83,,percent of total billed charges,,,221.61,83,,percent of total billed charges,,,,,,,,,,,,,,,221.61,83,,percent of total billed charges,,,253.65,95,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,218.94,82,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,226.95,85,,percent of total billed charges,,66.75,253.65,
"DRUG SCREEN, CORD BLOOD",25200112,CDM,80307,CPT,300,RC,outpatient,,381,381,,323.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,95.25,22,,percent of total billed charges,,,,,,,,,342.9,90,,percent of total billed charges,,,315.47,82.8,,percent of total billed charges,,,323.85,85,,percent of total billed charges,,,,,,,,,335.28,88,,percent of total billed charges,,,,,,,,,291.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,95.25,22,,percent of total billed charges,,,346.71,91,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,,,,,,,,,,,,,316.23,83,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,312.42,82,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,323.85,85,,percent of total billed charges,,95.25,361.95,
BB BLOOD TYPING ABO,25200113,CDM,86900,CPT,300,RC,outpatient,,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.75,22,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,121.72,82.8,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.75,22,,percent of total billed charges,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,36.75,139.65,
GLIADIN ANTIBODY IGA,25200115,CDM,83516,CPT,300,RC,outpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.75,22,,percent of total billed charges,,,,,,,,,204.3,90,,percent of total billed charges,,,187.96,82.8,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.75,22,,percent of total billed charges,,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,56.75,215.65,
GLIADIN ANTIBODY IGG,25200116,CDM,83516,CPT,300,RC,outpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.75,22,,percent of total billed charges,,,,,,,,,182.7,90,,percent of total billed charges,,,168.08,82.8,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.75,22,,percent of total billed charges,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,50.75,192.85,
GLUTEN SENSITIVITY SCREEN,25200117,CDM,83516,CPT,300,RC,outpatient,,536,536,,455.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,134,22,,percent of total billed charges,,,,,,,,,482.4,90,,percent of total billed charges,,,443.81,82.8,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,,,,,,,,471.68,88,,percent of total billed charges,,,,,,,,,409.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,134,22,,percent of total billed charges,,,487.76,91,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,,,,,,,,,,,,,444.88,83,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,439.52,82,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,134,509.2,
.IDH1,25200118,CDM,81120,CPT,300,RC,outpatient,,475,475,,403.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,118.75,22,,percent of total billed charges,,,,,,,,,427.5,90,,percent of total billed charges,,,393.3,82.8,,percent of total billed charges,,,403.75,85,,percent of total billed charges,,,,,,,,,418,88,,percent of total billed charges,,,,,,,,,362.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,118.75,22,,percent of total billed charges,,,432.25,91,,percent of total billed charges,,,451.25,95,,percent of total billed charges,,,394.25,83,,percent of total billed charges,,,394.25,83,,percent of total billed charges,,,,,,,,,,,,,,,394.25,83,,percent of total billed charges,,,451.25,95,,percent of total billed charges,,,427.5,90,,percent of total billed charges,,,427.5,90,,percent of total billed charges,,,389.5,82,,percent of total billed charges,,,427.5,90,,percent of total billed charges,,,403.75,85,,percent of total billed charges,,118.75,451.25,
.IDH2,25200119,CDM,81121,CPT,300,RC,outpatient,,475,475,,403.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,118.75,22,,percent of total billed charges,,,,,,,,,427.5,90,,percent of total billed charges,,,393.3,82.8,,percent of total billed charges,,,403.75,85,,percent of total billed charges,,,,,,,,,418,88,,percent of total billed charges,,,,,,,,,362.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,118.75,22,,percent of total billed charges,,,432.25,91,,percent of total billed charges,,,451.25,95,,percent of total billed charges,,,394.25,83,,percent of total billed charges,,,394.25,83,,percent of total billed charges,,,,,,,,,,,,,,,394.25,83,,percent of total billed charges,,,451.25,95,,percent of total billed charges,,,427.5,90,,percent of total billed charges,,,427.5,90,,percent of total billed charges,,,389.5,82,,percent of total billed charges,,,427.5,90,,percent of total billed charges,,,403.75,85,,percent of total billed charges,,118.75,451.25,
AMINO ACID ANALYSIS (CSF),25200120,CDM,82139,CPT,300,RC,outpatient,,485,485,,411.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,121.25,22,,percent of total billed charges,,,,,,,,,436.5,90,,percent of total billed charges,,,401.58,82.8,,percent of total billed charges,,,412.25,85,,percent of total billed charges,,,,,,,,,426.8,88,,percent of total billed charges,,,,,,,,,370.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,121.25,22,,percent of total billed charges,,,441.35,91,,percent of total billed charges,,,460.75,95,,percent of total billed charges,,,402.55,83,,percent of total billed charges,,,402.55,83,,percent of total billed charges,,,,,,,,,,,,,,,402.55,83,,percent of total billed charges,,,460.75,95,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,397.7,82,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,412.25,85,,percent of total billed charges,,121.25,460.75,
.MICROALBUMIN URINE (24-HOUR),25200121,CDM,82043,CPT,300,RC,outpatient,,131,131,,111.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.75,22,,percent of total billed charges,,,,,,,,,117.9,90,,percent of total billed charges,,,108.47,82.8,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,,,,,,,,115.28,88,,percent of total billed charges,,,,,,,,,100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.75,22,,percent of total billed charges,,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,,,,,,,,,,,,,108.73,83,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,107.42,82,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,32.75,124.45,
MICROALBUMIN URINE (RANDOM),25200122,CDM,82043,CPT,300,RC,outpatient,,131,131,,111.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.75,22,,percent of total billed charges,,,,,,,,,117.9,90,,percent of total billed charges,,,108.47,82.8,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,,,,,,,,115.28,88,,percent of total billed charges,,,,,,,,,100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.75,22,,percent of total billed charges,,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,,,,,,,,,,,,,108.73,83,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,107.42,82,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,32.75,124.45,
.gASCA (IBD PROFILE),25200123,CDM,83516,CPT,300,RC,outpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,38.5,146.3,
.ACCA (IBD PROFILE),25200124,CDM,83516,CPT,300,RC,outpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,38.5,146.3,
.ALCA (IBD PROFILE),25200125,CDM,83516,CPT,300,RC,outpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,38.5,146.3,
.AMCA (IBD PROFILE),25200126,CDM,86255,CPT,300,RC,outpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,38.5,146.3,
.ATYPICAL PANCA (IBD PROFILE),25200127,CDM,86671,CPT,300,RC,outpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,38.5,146.3,
TESTOSTERONE FREE (NO TOTAL),25200129,CDM,84402,CPT,300,RC,outpatient,,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92,22,,percent of total billed charges,,,,,,,,,331.2,90,,percent of total billed charges,,,304.7,82.8,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92,22,,percent of total billed charges,,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,92,349.6,
DRUG SCREEN BLOOD,25200131,CDM,80307,CPT,300,RC,outpatient,,44,44,,37.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11,22,,percent of total billed charges,,,,,,,,,39.6,90,,percent of total billed charges,,,36.43,82.8,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,,,,,,,,38.72,88,,percent of total billed charges,,,,,,,,,33.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11,22,,percent of total billed charges,,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,36.08,82,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,11,41.8,
GANGLIOSIDE ANTIBODIES (IGG & IGM),25200132,CDM,83516,CPT,300,RC,outpatient,,244,244,,207.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61,22,,percent of total billed charges,,,,,,,,,219.6,90,,percent of total billed charges,,,202.03,82.8,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,,,,,,,,214.72,88,,percent of total billed charges,,,,,,,,,186.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61,22,,percent of total billed charges,,,222.04,91,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,,,,,,,,,,,,,202.52,83,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,200.08,82,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,61,231.8,
STREP PNEUMO AB (14 SEROTYPES),25200133,CDM,86317,CPT,300,RC,outpatient,,34,34,,28.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.5,22,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,28.15,82.8,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,,,,,,,,29.92,88,,percent of total billed charges,,,,,,,,,25.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.5,22,,percent of total billed charges,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,,,,,,,,,,,,,28.22,83,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,27.88,82,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,8.5,32.3,
MICROALBUMIN URINE (24-HOUR),25200134,CDM,82043,CPT,300,RC,outpatient,TC,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27,22,,percent of total billed charges,,,,,,,,,97.2,90,,percent of total billed charges,,,89.42,82.8,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27,22,,percent of total billed charges,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,27,102.6,
CHLORIDE SERUM,25200135,CDM,82435,CPT,300,RC,outpatient,TC,86,86,,73.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.5,22,,percent of total billed charges,,,,,,,,,77.4,90,,percent of total billed charges,,,71.21,82.8,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,,,,,,,,75.68,88,,percent of total billed charges,,,,,,,,,65.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.5,22,,percent of total billed charges,,,78.26,91,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,,,,,,,,,,,,,71.38,83,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,70.52,82,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,21.5,81.7,
HERPES SIM 1&2 PCR,25200137,CDM,87529,CPT,300,RC,outpatient,,524,524,,444.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131,22,,percent of total billed charges,,,,,,,,,471.6,90,,percent of total billed charges,,,433.87,82.8,,percent of total billed charges,,,445.4,85,,percent of total billed charges,,,,,,,,,461.12,88,,percent of total billed charges,,,,,,,,,400.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131,22,,percent of total billed charges,,,476.84,91,,percent of total billed charges,,,497.8,95,,percent of total billed charges,,,434.92,83,,percent of total billed charges,,,434.92,83,,percent of total billed charges,,,,,,,,,,,,,,,434.92,83,,percent of total billed charges,,,497.8,95,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,429.68,82,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,445.4,85,,percent of total billed charges,,131,497.8,
OLIGOCLONAL BANDS CSF & SERUM,25200138,CDM,83916,CPT,300,RC,outpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.75,22,,percent of total billed charges,,,,,,,,,189.9,90,,percent of total billed charges,,,174.71,82.8,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.75,22,,percent of total billed charges,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,52.75,200.45,
BB SERUM ALBUMIN 100 ML 25%,25200139,CDM,P9047,HCPCS,390,RC,outpatient,,755,755,,641,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,188.75,22,,percent of total billed charges,,,,,,,,,679.5,90,,percent of total billed charges,,,625.14,82.8,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,,,,,,,,664.4,88,,percent of total billed charges,,,,,,,,,576.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,188.75,22,,percent of total billed charges,,,687.05,91,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,,,,,,,,,,,,,626.65,83,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,619.1,82,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,188.75,717.25,
"PHOSPHATIDYLSERINE (IGM,IGG,IGA)",25200140,CDM,86148,CPT,300,RC,outpatient,,282,282,,239.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.5,22,,percent of total billed charges,,,,,,,,,253.8,90,,percent of total billed charges,,,233.5,82.8,,percent of total billed charges,,,239.7,85,,percent of total billed charges,,,,,,,,,248.16,88,,percent of total billed charges,,,,,,,,,215.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70.5,22,,percent of total billed charges,,,256.62,91,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,,,,,,,,,,,,,234.06,83,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,231.24,82,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,239.7,85,,percent of total billed charges,,70.5,267.9,
RICKETTSIA ANTIBODY PANEL,25200141,CDM,86757,CPT,300,RC,outpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.5,22,,percent of total billed charges,,,,,,,,,91.8,90,,percent of total billed charges,,,84.46,82.8,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.5,22,,percent of total billed charges,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,25.5,96.9,
EPIDERMAL ANTIBODY,25200142,CDM,86255,CPT,300,RC,outpatient,,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.75,22,,percent of total billed charges,,,,,,,,,449.1,90,,percent of total billed charges,,,413.17,82.8,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.75,22,,percent of total billed charges,,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,124.75,474.05,
"CANDIDA ANTIBODIES(IGG,IGM,IGA)",25200143,CDM,86628,CPT,300,RC,outpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.75,22,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,45.54,82.8,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.75,22,,percent of total billed charges,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,13.75,52.25,
"EHELICHIA CHEFFENS (IGG,IGM)",25200144,CDM,86666,CPT,300,RC,outpatient,,224,224,,190.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56,22,,percent of total billed charges,,,,,,,,,201.6,90,,percent of total billed charges,,,185.47,82.8,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,,,,,,,,197.12,88,,percent of total billed charges,,,,,,,,,171.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56,22,,percent of total billed charges,,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,183.68,82,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,56,212.8,
EHELICHIA PCR,25200145,CDM,87798,CPT,300,RC,outpatient,,401,401,,340.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100.25,22,,percent of total billed charges,,,,,,,,,360.9,90,,percent of total billed charges,,,332.03,82.8,,percent of total billed charges,,,340.85,85,,percent of total billed charges,,,,,,,,,352.88,88,,percent of total billed charges,,,,,,,,,306.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100.25,22,,percent of total billed charges,,,364.91,91,,percent of total billed charges,,,380.95,95,,percent of total billed charges,,,332.83,83,,percent of total billed charges,,,332.83,83,,percent of total billed charges,,,,,,,,,,,,,,,332.83,83,,percent of total billed charges,,,380.95,95,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,328.82,82,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,340.85,85,,percent of total billed charges,,100.25,380.95,
HER 2 NEU BY FISH,25200146,CDM,88374,CPT,310,RC,outpatient,,515,515,,437.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,128.75,22,,percent of total billed charges,,,,,,,,,463.5,90,,percent of total billed charges,,,426.42,82.8,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,,,,,,,,453.2,88,,percent of total billed charges,,,,,,,,,393.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,128.75,22,,percent of total billed charges,,,468.65,91,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,,,,,,,,,,,,,427.45,83,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,422.3,82,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,128.75,489.25,
BUN,25200147,CDM,84520,CPT,300,RC,outpatient,,97,97,,82.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.25,22,,percent of total billed charges,,,,,,,,,87.3,90,,percent of total billed charges,,,80.32,82.8,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,,,,,,,,85.36,88,,percent of total billed charges,,,,,,,,,74.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.25,22,,percent of total billed charges,,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,,,,,,,,,,,,,80.51,83,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,79.54,82,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,24.25,92.15,
HISTOPLASMA ANTIBODY COMP FIXATION,25200148,CDM,86698,CPT,300,RC,outpatient,,187,187,,158.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.75,22,,percent of total billed charges,,,,,,,,,168.3,90,,percent of total billed charges,,,154.84,82.8,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,,,,,,,,164.56,88,,percent of total billed charges,,,,,,,,,142.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.75,22,,percent of total billed charges,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,153.34,82,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,46.75,177.65,
TRYPTASE,25200149,CDM,83520,CPT,300,RC,outpatient,,186,186,,157.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.5,22,,percent of total billed charges,,,,,,,,,167.4,90,,percent of total billed charges,,,154.01,82.8,,percent of total billed charges,,,158.1,85,,percent of total billed charges,,,,,,,,,163.68,88,,percent of total billed charges,,,,,,,,,142.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.5,22,,percent of total billed charges,,,169.26,91,,percent of total billed charges,,,176.7,95,,percent of total billed charges,,,154.38,83,,percent of total billed charges,,,154.38,83,,percent of total billed charges,,,,,,,,,,,,,,,154.38,83,,percent of total billed charges,,,176.7,95,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,152.52,82,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,158.1,85,,percent of total billed charges,,46.5,176.7,
"DRUG SCREEN, CORD TISSUE",25200150,CDM,80307,CPT,300,RC,outpatient,,504,504,,427.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126,22,,percent of total billed charges,,,,,,,,,453.6,90,,percent of total billed charges,,,417.31,82.8,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,,,,,,,,443.52,88,,percent of total billed charges,,,,,,,,,385.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126,22,,percent of total billed charges,,,458.64,91,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,,,,,,,,,,,,,418.32,83,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,413.28,82,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,126,478.8,
.HSV 1 NAA (APTIMA),25200151,CDM,87529,CPT,300,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
.HSV 2 NAA (APTIMA),25200152,CDM,87529,CPT,300,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
CALCIUM  SERUM,25200154,CDM,82310,CPT,300,RC,outpatient,,151,151,,128.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.75,22,,percent of total billed charges,,,,,,,,,135.9,90,,percent of total billed charges,,,125.03,82.8,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,,,,,,,,132.88,88,,percent of total billed charges,,,,,,,,,115.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.75,22,,percent of total billed charges,,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,,,,,,,,,,,,,125.33,83,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,123.82,82,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,37.75,143.45,
..HERPES SIM 2 IGM AB(BILL ONLY),25200155,CDM,86696,CPT,300,RC,outpatient,,92,92,,78.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23,22,,percent of total billed charges,,,,,,,,,82.8,90,,percent of total billed charges,,,76.18,82.8,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,,,,,,,,80.96,88,,percent of total billed charges,,,,,,,,,70.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23,22,,percent of total billed charges,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,,,,,,,,,,,,,76.36,83,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,75.44,82,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,23,87.4,
"DRUG OF ABUSE (10)SCREEN, WB",25200156,CDM,80307,CPT,300,RC,outpatient,,437,437,,371.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.25,22,,percent of total billed charges,,,,,,,,,393.3,90,,percent of total billed charges,,,361.84,82.8,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,,,,,,,,384.56,88,,percent of total billed charges,,,,,,,,,333.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.25,22,,percent of total billed charges,,,397.67,91,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,,,,,,,,,,,,,362.71,83,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,358.34,82,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,109.25,415.15,
ALBUMIN (body fluid),25200157,CDM,82042,CPT,300,RC,outpatient,,7,7,,5.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.75,22,,percent of total billed charges,,,,,,,,,6.3,90,,percent of total billed charges,,,5.8,82.8,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,,,,,,,,6.16,88,,percent of total billed charges,,,,,,,,,5.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.75,22,,percent of total billed charges,,,6.37,91,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,,,,,,,,,,,,,5.81,83,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.74,82,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,1.75,6.65,
RABIES NEUT AB,25200158,CDM,86382,CPT,300,RC,outpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.25,22,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,63.76,82.8,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.25,22,,percent of total billed charges,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,19.25,73.15,
EVEROLIMUS WHOLD BLOOD,25200159,CDM,80169,CPT,300,RC,outpatient,,363,363,,308.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90.75,22,,percent of total billed charges,,,,,,,,,326.7,90,,percent of total billed charges,,,300.56,82.8,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,,,,,,,,319.44,88,,percent of total billed charges,,,,,,,,,277.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90.75,22,,percent of total billed charges,,,330.33,91,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,,,,,,,,,,,,,301.29,83,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,297.66,82,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,90.75,344.85,
BETA 2 TRANSFERIN,25200160,CDM,86335,CPT,300,RC,outpatient,,435,435,,369.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.75,22,,percent of total billed charges,,,,,,,,,391.5,90,,percent of total billed charges,,,360.18,82.8,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,,,,,,,,382.8,88,,percent of total billed charges,,,,,,,,,332.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108.75,22,,percent of total billed charges,,,395.85,91,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,,,,,,,,,,,,,361.05,83,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,356.7,82,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,108.75,413.25,
INFLIXIMAB  AB,25200161,CDM,80230,CPT,300,RC,outpatient,,279,279,,236.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.75,22,,percent of total billed charges,,,,,,,,,251.1,90,,percent of total billed charges,,,231.01,82.8,,percent of total billed charges,,,237.15,85,,percent of total billed charges,,,,,,,,,245.52,88,,percent of total billed charges,,,,,,,,,213.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.75,22,,percent of total billed charges,,,253.89,91,,percent of total billed charges,,,265.05,95,,percent of total billed charges,,,231.57,83,,percent of total billed charges,,,231.57,83,,percent of total billed charges,,,,,,,,,,,,,,,231.57,83,,percent of total billed charges,,,265.05,95,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,228.78,82,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,237.15,85,,percent of total billed charges,,69.75,265.05,
TIBC,25200162,CDM,83550,CPT,300,RC,outpatient,,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.25,22,,percent of total billed charges,,,,,,,,,137.7,90,,percent of total billed charges,,,126.68,82.8,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.25,22,,percent of total billed charges,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,38.25,145.35,
BETA 2 GLYCOPROTEIN 1 AB (IgA),25200163,CDM,86146,CPT,300,RC,outpatient,,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.5,22,,percent of total billed charges,,,,,,,,,117,90,,percent of total billed charges,,,107.64,82.8,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.5,22,,percent of total billed charges,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,32.5,123.5,
BETA 2 GLYCOPROTEIN 1 AB (IgM),25200164,CDM,86146,CPT,300,RC,outpatient,,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.5,22,,percent of total billed charges,,,,,,,,,117,90,,percent of total billed charges,,,107.64,82.8,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.5,22,,percent of total billed charges,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,32.5,123.5,
.BULLOUS PEMPHIGOID 180 IGG,25200166,CDM,83516,CPT,300,RC,outpatient,,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
.BULLOUS PEMPHIGOID 230 IGG,25200167,CDM,83516,CPT,300,RC,outpatient,,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
BETA-D GLUCAN,25200168,CDM,87449,CPT,300,RC,outpatient,,541,541,,459.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,135.25,22,,percent of total billed charges,,,,,,,,,486.9,90,,percent of total billed charges,,,447.95,82.8,,percent of total billed charges,,,459.85,85,,percent of total billed charges,,,,,,,,,476.08,88,,percent of total billed charges,,,,,,,,,413.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,135.25,22,,percent of total billed charges,,,492.31,91,,percent of total billed charges,,,513.95,95,,percent of total billed charges,,,449.03,83,,percent of total billed charges,,,449.03,83,,percent of total billed charges,,,,,,,,,,,,,,,449.03,83,,percent of total billed charges,,,513.95,95,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,443.62,82,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,459.85,85,,percent of total billed charges,,135.25,513.95,
CULTURE SPUTUM,25200170,CDM,87070,CPT,300,RC,outpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.25,22,,percent of total billed charges,,,,,,,,,188.1,90,,percent of total billed charges,,,173.05,82.8,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.25,22,,percent of total billed charges,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,52.25,198.55,
PROBE STAIN ADDITIONAL,25200171,CDM,88377,CPT,310,RC,outpatient,,810,810,,687.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,202.5,22,,percent of total billed charges,,,,,,,,,729,90,,percent of total billed charges,,,670.68,82.8,,percent of total billed charges,,,688.5,85,,percent of total billed charges,,,,,,,,,712.8,88,,percent of total billed charges,,,,,,,,,618.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,202.5,22,,percent of total billed charges,,,737.1,91,,percent of total billed charges,,,769.5,95,,percent of total billed charges,,,672.3,83,,percent of total billed charges,,,672.3,83,,percent of total billed charges,,,,,,,,,,,,,,,672.3,83,,percent of total billed charges,,,769.5,95,,percent of total billed charges,,,729,90,,percent of total billed charges,,,729,90,,percent of total billed charges,,,664.2,82,,percent of total billed charges,,,729,90,,percent of total billed charges,,,688.5,85,,percent of total billed charges,,202.5,769.5,
MULTIPLEX STAIN,25200172,CDM,88374,CPT,310,RC,outpatient,,1260,1260,,1069.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,315,22,,percent of total billed charges,,,,,,,,,1134,90,,percent of total billed charges,,,1043.28,82.8,,percent of total billed charges,,,1071,85,,percent of total billed charges,,,,,,,,,1108.8,88,,percent of total billed charges,,,,,,,,,962.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,315,22,,percent of total billed charges,,,1146.6,91,,percent of total billed charges,,,1197,95,,percent of total billed charges,,,1045.8,83,,percent of total billed charges,,,1045.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1045.8,83,,percent of total billed charges,,,1197,95,,percent of total billed charges,,,1134,90,,percent of total billed charges,,,1134,90,,percent of total billed charges,,,1033.2,82,,percent of total billed charges,,,1134,90,,percent of total billed charges,,,1071,85,,percent of total billed charges,,315,1197,
MORPHOMETRIC ANALYSIS 88367,25200173,CDM,88367,CPT,310,RC,outpatient,,504,504,,427.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126,22,,percent of total billed charges,,,,,,,,,453.6,90,,percent of total billed charges,,,417.31,82.8,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,,,,,,,,443.52,88,,percent of total billed charges,,,,,,,,,385.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126,22,,percent of total billed charges,,,458.64,91,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,,,,,,,,,,,,,418.32,83,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,413.28,82,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,126,478.8,
TARGET GENOMIC SEQUENCE,25200174,CDM,81455,CPT,310,RC,outpatient,,1890,1890,,1604.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,472.5,22,,percent of total billed charges,,,,,,,,,1701,90,,percent of total billed charges,,,1564.92,82.8,,percent of total billed charges,,,1606.5,85,,percent of total billed charges,,,,,,,,,1663.2,88,,percent of total billed charges,,,,,,,,,1443.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,472.5,22,,percent of total billed charges,,,1719.9,91,,percent of total billed charges,,,1795.5,95,,percent of total billed charges,,,1568.7,83,,percent of total billed charges,,,1568.7,83,,percent of total billed charges,,,,,,,,,,,,,,,1568.7,83,,percent of total billed charges,,,1795.5,95,,percent of total billed charges,,,1701,90,,percent of total billed charges,,,1701,90,,percent of total billed charges,,,1549.8,82,,percent of total billed charges,,,1701,90,,percent of total billed charges,,,1606.5,85,,percent of total billed charges,,472.5,1795.5,
UIBC,25200175,CDM,83550,CPT,300,RC,outpatient,,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.25,22,,percent of total billed charges,,,,,,,,,137.7,90,,percent of total billed charges,,,126.68,82.8,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.25,22,,percent of total billed charges,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,38.25,145.35,
MYELOID-NGS,25200176,CDM,81450,CPT,300,RC,outpatient,,4410,4410,,3744.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1102.5,22,,percent of total billed charges,,,,,,,,,3969,90,,percent of total billed charges,,,3651.48,82.8,,percent of total billed charges,,,3748.5,85,,percent of total billed charges,,,,,,,,,3880.8,88,,percent of total billed charges,,,,,,,,,3369.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1102.5,22,,percent of total billed charges,,,4013.1,91,,percent of total billed charges,,,4189.5,95,,percent of total billed charges,,,3660.3,83,,percent of total billed charges,,,3660.3,83,,percent of total billed charges,,,,,,,,,,,,,,,3660.3,83,,percent of total billed charges,,,4189.5,95,,percent of total billed charges,,,3969,90,,percent of total billed charges,,,3969,90,,percent of total billed charges,,,3616.2,82,,percent of total billed charges,,,3969,90,,percent of total billed charges,,,3748.5,85,,percent of total billed charges,,1102.5,4189.5,
DRAGU CBC W/AUTO DIFF,25200189,CDM,85025,CPT,300,RC,outpatient,,207,207,,175.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.75,22,,percent of total billed charges,,,,,,,,,186.3,90,,percent of total billed charges,,,171.4,82.8,,percent of total billed charges,,,175.95,85,,percent of total billed charges,,,,,,,,,182.16,88,,percent of total billed charges,,,,,,,,,158.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.75,22,,percent of total billed charges,,,188.37,91,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,,,,,,,,,,,,,171.81,83,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,169.74,82,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,175.95,85,,percent of total billed charges,,51.75,196.65,
CBC W/AUTO DIFF,25200190,CDM,85025,CPT,300,RC,outpatient,,207,207,,175.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.75,22,,percent of total billed charges,,,,,,,,,186.3,90,,percent of total billed charges,,,171.4,82.8,,percent of total billed charges,,,175.95,85,,percent of total billed charges,,,,,,,,,182.16,88,,percent of total billed charges,,,,,,,,,158.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.75,22,,percent of total billed charges,,,188.37,91,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,,,,,,,,,,,,,171.81,83,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,169.74,82,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,175.95,85,,percent of total billed charges,,51.75,196.65,
ANTI-SA AB IgG,25200194,CDM,83516,CPT,300,RC,outpatient,,381,381,,323.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,95.25,22,,percent of total billed charges,,,,,,,,,342.9,90,,percent of total billed charges,,,315.47,82.8,,percent of total billed charges,,,323.85,85,,percent of total billed charges,,,,,,,,,335.28,88,,percent of total billed charges,,,,,,,,,291.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,95.25,22,,percent of total billed charges,,,346.71,91,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,,,,,,,,,,,,,316.23,83,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,312.42,82,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,323.85,85,,percent of total billed charges,,95.25,361.95,
HCG QUANTITATIVE,25200196,CDM,84702,CPT,300,RC,outpatient,,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.5,22,,percent of total billed charges,,,,,,,,,239.4,90,,percent of total billed charges,,,220.25,82.8,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.5,22,,percent of total billed charges,,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,66.5,252.7,
COMP METABOLIC PANEL,25200204,CDM,80053,CPT,300,RC,outpatient,,337,337,,286.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.25,22,,percent of total billed charges,,,,,,,,,303.3,90,,percent of total billed charges,,,279.04,82.8,,percent of total billed charges,,,286.45,85,,percent of total billed charges,,,,,,,,,296.56,88,,percent of total billed charges,,,,,,,,,257.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.25,22,,percent of total billed charges,,,306.67,91,,percent of total billed charges,,,320.15,95,,percent of total billed charges,,,279.71,83,,percent of total billed charges,,,279.71,83,,percent of total billed charges,,,,,,,,,,,,,,,279.71,83,,percent of total billed charges,,,320.15,95,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,276.34,82,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,286.45,85,,percent of total billed charges,,84.25,320.15,
.CHLORIDE SERUM,25200212,CDM,82435,CPT,300,RC,outpatient,,100,100,,84.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25,22,,percent of total billed charges,,,,,,,,,90,90,,percent of total billed charges,,,82.8,82.8,,percent of total billed charges,,,85,85,,percent of total billed charges,,,,,,,,,88,88,,percent of total billed charges,,,,,,,,,76.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25,22,,percent of total billed charges,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,83,83,,percent of total billed charges,,,,,,,,,,,,,,,83,83,,percent of total billed charges,,,95,95,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,82,82,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,25,95,
14.3.3 PROTEIN ETA,25200214,CDM,83520,CPT,300,RC,outpatient,,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.75,22,,percent of total billed charges,,,,,,,,,207.9,90,,percent of total billed charges,,,191.27,82.8,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.75,22,,percent of total billed charges,,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,57.75,219.45,
LDL CHOLESTEROL(MEASURED),25200215,CDM,83721,CPT,300,RC,outpatient,,197,197,,167.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.25,22,,percent of total billed charges,,,,,,,,,177.3,90,,percent of total billed charges,,,163.12,82.8,,percent of total billed charges,,,167.45,85,,percent of total billed charges,,,,,,,,,173.36,88,,percent of total billed charges,,,,,,,,,150.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.25,22,,percent of total billed charges,,,179.27,91,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,,,,,,,,,,,,,163.51,83,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,161.54,82,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,167.45,85,,percent of total billed charges,,49.25,187.15,
LDL-P,25200216,CDM,83704,CPT,300,RC,outpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36,22,,percent of total billed charges,,,,,,,,,129.6,90,,percent of total billed charges,,,119.23,82.8,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36,22,,percent of total billed charges,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,36,136.8,
CHOLESTEROL,25200220,CDM,82465,CPT,300,RC,outpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.5,22,,percent of total billed charges,,,,,,,,,91.8,90,,percent of total billed charges,,,84.46,82.8,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.5,22,,percent of total billed charges,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,25.5,96.9,
LDL CHOLESTEROL,25200221,CDM,83721,CPT,300,RC,outpatient,,171,171,,145.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.75,22,,percent of total billed charges,,,,,,,,,153.9,90,,percent of total billed charges,,,141.59,82.8,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,,,,,,,,150.48,88,,percent of total billed charges,,,,,,,,,130.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.75,22,,percent of total billed charges,,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,,,,,,,,,,,,,141.93,83,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,140.22,82,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,42.75,162.45,
.CHOLESTEROL FLUID,25200222,CDM,84311,CPT,300,RC,outpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.25,22,,percent of total billed charges,,,,,,,,,202.5,90,,percent of total billed charges,,,186.3,82.8,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.25,22,,percent of total billed charges,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,56.25,213.75,
MICROALBUMIN URINE(W/O CREAT),25200223,CDM,82043,CPT,300,RC,outpatient,,131,131,,111.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.75,22,,percent of total billed charges,,,,,,,,,117.9,90,,percent of total billed charges,,,108.47,82.8,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,,,,,,,,115.28,88,,percent of total billed charges,,,,,,,,,100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.75,22,,percent of total billed charges,,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,,,,,,,,,,,,,108.73,83,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,107.42,82,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,32.75,124.45,
CHOLESTEROL fluid,25200224,CDM,82465,CPT,300,RC,outpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,38.5,146.3,
NUCLEIC ACID REVERSE TRANSCRIPTION,25200226,CDM,83902,CPT,300,RC,outpatient,,340,340,,288.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85,22,,percent of total billed charges,,,,,,,,,306,90,,percent of total billed charges,,,281.52,82.8,,percent of total billed charges,,,289,85,,percent of total billed charges,,,,,,,,,299.2,88,,percent of total billed charges,,,,,,,,,259.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85,22,,percent of total billed charges,,,309.4,91,,percent of total billed charges,,,323,95,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,,,,,,,,,,,,,282.2,83,,percent of total billed charges,,,323,95,,percent of total billed charges,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,278.8,82,,percent of total billed charges,,,306,90,,percent of total billed charges,,,289,85,,percent of total billed charges,,85,323,
SPECIMEN COLLECTION & HANDLING CHARGE,25200238,CDM,36415,CPT,300,RC,outpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.75,22,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,48.85,82.8,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,,,,,,,,51.92,88,,percent of total billed charges,,,,,,,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.75,22,,percent of total billed charges,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,14.75,56.05,
CRYOGLOBULIN,25200239,CDM,82595,CPT,300,RC,outpatient,,158,158,,134.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.5,22,,percent of total billed charges,,,,,,,,,142.2,90,,percent of total billed charges,,,130.82,82.8,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,,,,,,,,139.04,88,,percent of total billed charges,,,,,,,,,120.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.5,22,,percent of total billed charges,,,143.78,91,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,,,,,,,,,,,,,131.14,83,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,129.56,82,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,39.5,150.1,
CARBON DIOXIDE,25200246,CDM,82374,CPT,300,RC,outpatient,,139,139,,118.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.75,22,,percent of total billed charges,,,,,,,,,125.1,90,,percent of total billed charges,,,115.09,82.8,,percent of total billed charges,,,118.15,85,,percent of total billed charges,,,,,,,,,122.32,88,,percent of total billed charges,,,,,,,,,106.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.75,22,,percent of total billed charges,,,126.49,91,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,,,,,,,,,,,,,115.37,83,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,113.98,82,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,118.15,85,,percent of total billed charges,,34.75,132.05,
BB CROSSMATCH ANTIGLOBULIN,25200250,CDM,86922,CPT,300,RC,outpatient,,385,385,,326.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.25,22,,percent of total billed charges,,,,,,,,,346.5,90,,percent of total billed charges,,,318.78,82.8,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,,,,,,,,338.8,88,,percent of total billed charges,,,,,,,,,294.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.25,22,,percent of total billed charges,,,350.35,91,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,,,,,,,,,,,,,319.55,83,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,315.7,82,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,96.25,365.75,
BB CROSSMATCH IMMEDIATE SPIN,25200251,CDM,86920,CPT,300,RC,outpatient,,278,278,,236.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.5,22,,percent of total billed charges,,,,,,,,,250.2,90,,percent of total billed charges,,,230.18,82.8,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,,,,,,,,244.64,88,,percent of total billed charges,,,,,,,,,212.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.5,22,,percent of total billed charges,,,252.98,91,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,,,,,,,,,,,,,230.74,83,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,227.96,82,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,69.5,264.1,
COLD HEMAGGLUTININS,25200253,CDM,86157,CPT,300,RC,outpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,38.5,146.3,
GENTAMICIN TROUGH,25200256,CDM,80170,CPT,300,RC,outpatient,,355,355,,301.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.75,22,,percent of total billed charges,,,,,,,,,319.5,90,,percent of total billed charges,,,293.94,82.8,,percent of total billed charges,,,301.75,85,,percent of total billed charges,,,,,,,,,312.4,88,,percent of total billed charges,,,,,,,,,271.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.75,22,,percent of total billed charges,,,323.05,91,,percent of total billed charges,,,337.25,95,,percent of total billed charges,,,294.65,83,,percent of total billed charges,,,294.65,83,,percent of total billed charges,,,,,,,,,,,,,,,294.65,83,,percent of total billed charges,,,337.25,95,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,291.1,82,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,301.75,85,,percent of total billed charges,,88.75,337.25,
VANCOMYCIN TROUGH,25200257,CDM,80202,CPT,300,RC,outpatient,,380,380,,322.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,95,22,,percent of total billed charges,,,,,,,,,342,90,,percent of total billed charges,,,314.64,82.8,,percent of total billed charges,,,323,85,,percent of total billed charges,,,,,,,,,334.4,88,,percent of total billed charges,,,,,,,,,290.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,95,22,,percent of total billed charges,,,345.8,91,,percent of total billed charges,,,361,95,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,,,,,,,,,,,,,315.4,83,,percent of total billed charges,,,361,95,,percent of total billed charges,,,342,90,,percent of total billed charges,,,342,90,,percent of total billed charges,,,311.6,82,,percent of total billed charges,,,342,90,,percent of total billed charges,,,323,85,,percent of total billed charges,,95,361,
BB COOMBS DIRECT,25200261,CDM,86880,CPT,300,RC,outpatient,,140,140,,118.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35,22,,percent of total billed charges,,,,,,,,,126,90,,percent of total billed charges,,,115.92,82.8,,percent of total billed charges,,,119,85,,percent of total billed charges,,,,,,,,,123.2,88,,percent of total billed charges,,,,,,,,,106.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35,22,,percent of total billed charges,,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,133,95,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,114.8,82,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,35,133,
LABCORP DIRECT COOMBS,25200262,CDM,86880,CPT,300,RC,outpatient,,140,140,,118.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35,22,,percent of total billed charges,,,,,,,,,126,90,,percent of total billed charges,,,115.92,82.8,,percent of total billed charges,,,119,85,,percent of total billed charges,,,,,,,,,123.2,88,,percent of total billed charges,,,,,,,,,106.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35,22,,percent of total billed charges,,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,133,95,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,114.8,82,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,35,133,
BB COOMBS INDIRECT,25200279,CDM,86885,CPT,300,RC,outpatient,,163,163,,138.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.75,22,,percent of total billed charges,,,,,,,,,146.7,90,,percent of total billed charges,,,134.96,82.8,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,,,,,,,,143.44,88,,percent of total billed charges,,,,,,,,,124.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.75,22,,percent of total billed charges,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,,,,,,,,,,,,,135.29,83,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,133.66,82,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,40.75,154.85,
CHLORDIAZEPOXIDE,25200286,CDM,80346,CPT,300,RC,outpatient,,280,280,,237.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70,22,,percent of total billed charges,,,,,,,,,252,90,,percent of total billed charges,,,231.84,82.8,,percent of total billed charges,,,238,85,,percent of total billed charges,,,,,,,,,246.4,88,,percent of total billed charges,,,,,,,,,213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70,22,,percent of total billed charges,,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,,,,,,,,,,,,,232.4,83,,percent of total billed charges,,,266,95,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,229.6,82,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,70,266,
LIDOCAINE,25200287,CDM,80176,CPT,300,RC,outpatient,,252,252,,213.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63,22,,percent of total billed charges,,,,,,,,,226.8,90,,percent of total billed charges,,,208.66,82.8,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,,,,,,,,221.76,88,,percent of total billed charges,,,,,,,,,192.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63,22,,percent of total billed charges,,,229.32,91,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,,,,,,,,,,,,,209.16,83,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,206.64,82,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,63,239.4,
LISTERIA ANTIBODIES,25200288,CDM,86609,CPT,300,RC,outpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.25,22,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,63.76,82.8,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.25,22,,percent of total billed charges,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,19.25,73.15,
FUROSEMIDE,25200290,CDM,80375,CPT,300,RC,outpatient,,246,246,,208.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.5,22,,percent of total billed charges,,,,,,,,,221.4,90,,percent of total billed charges,,,203.69,82.8,,percent of total billed charges,,,209.1,85,,percent of total billed charges,,,,,,,,,216.48,88,,percent of total billed charges,,,,,,,,,187.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.5,22,,percent of total billed charges,,,223.86,91,,percent of total billed charges,,,233.7,95,,percent of total billed charges,,,204.18,83,,percent of total billed charges,,,204.18,83,,percent of total billed charges,,,,,,,,,,,,,,,204.18,83,,percent of total billed charges,,,233.7,95,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,201.72,82,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,209.1,85,,percent of total billed charges,,61.5,233.7,
PSA SCREEN,25200294,CDM,G0103,HCPCS,300,RC,outpatient,,295,295,,250.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.75,22,,percent of total billed charges,,,,,,,,,265.5,90,,percent of total billed charges,,,244.26,82.8,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,,,,,,,,259.6,88,,percent of total billed charges,,17.6,,,,fee schedule,,,225.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,17.6,,,,fee schedule,,,73.75,22,,percent of total billed charges,,,268.45,91,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,,,,,,,,,,,,,244.85,83,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,241.9,82,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,17.6,280.25,
PSA TOTAL,25200295,CDM,84153,CPT,300,RC,outpatient,,316,316,,268.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79,22,,percent of total billed charges,,,,,,,,,284.4,90,,percent of total billed charges,,,261.65,82.8,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,,,,,,,,278.08,88,,percent of total billed charges,,,,,,,,,241.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79,22,,percent of total billed charges,,,287.56,91,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,,,,,,,,,,,,,262.28,83,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,259.12,82,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,79,300.2,
PROZAC (FLUOXETINE),25200296,CDM,80299,CPT,300,RC,outpatient,,316,316,,268.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79,22,,percent of total billed charges,,,,,,,,,284.4,90,,percent of total billed charges,,,261.65,82.8,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,,,,,,,,278.08,88,,percent of total billed charges,,,,,,,,,241.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79,22,,percent of total billed charges,,,287.56,91,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,,,,,,,,,,,,,262.28,83,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,259.12,82,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,79,300.2,
FELBAMATE,25200298,CDM,80167,CPT,300,RC,outpatient,,171,171,,145.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.75,22,,percent of total billed charges,,,,,,,,,153.9,90,,percent of total billed charges,,,141.59,82.8,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,,,,,,,,150.48,88,,percent of total billed charges,,,,,,,,,130.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.75,22,,percent of total billed charges,,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,,,,,,,,,,,,,141.93,83,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,140.22,82,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,42.75,162.45,
PYRUVIC ACID,25200299,CDM,84210,CPT,300,RC,outpatient,,129,129,,109.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.25,22,,percent of total billed charges,,,,,,,,,116.1,90,,percent of total billed charges,,,106.81,82.8,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,,,,,,,,113.52,88,,percent of total billed charges,,,,,,,,,98.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.25,22,,percent of total billed charges,,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,105.78,82,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,32.25,122.55,
PSA FREE,25200301,CDM,84154,CPT,300,RC,outpatient,,378,378,,320.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94.5,22,,percent of total billed charges,,,,,,,,,340.2,90,,percent of total billed charges,,,312.98,82.8,,percent of total billed charges,,,321.3,85,,percent of total billed charges,,,,,,,,,332.64,88,,percent of total billed charges,,,,,,,,,288.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94.5,22,,percent of total billed charges,,,343.98,91,,percent of total billed charges,,,359.1,95,,percent of total billed charges,,,313.74,83,,percent of total billed charges,,,313.74,83,,percent of total billed charges,,,,,,,,,,,,,,,313.74,83,,percent of total billed charges,,,359.1,95,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,309.96,82,,percent of total billed charges,,,340.2,90,,percent of total billed charges,,,321.3,85,,percent of total billed charges,,94.5,359.1,
PSA ULTRASENSITIVE,25200302,CDM,84153,CPT,300,RC,outpatient,,275,275,,233.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.75,22,,percent of total billed charges,,,,,,,,,247.5,90,,percent of total billed charges,,,227.7,82.8,,percent of total billed charges,,,233.75,85,,percent of total billed charges,,,,,,,,,242,88,,percent of total billed charges,,,,,,,,,210.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.75,22,,percent of total billed charges,,,250.25,91,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,,,,,,,,,,,,,228.25,83,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,225.5,82,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,233.75,85,,percent of total billed charges,,68.75,261.25,
LIPID PANEL,25200303,CDM,80061,CPT,300,RC,outpatient,,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
FLT3,25200304,CDM,81245,CPT,300,RC,outpatient,,626,626,,531.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,156.5,22,,percent of total billed charges,,,,,,,,,563.4,90,,percent of total billed charges,,,518.33,82.8,,percent of total billed charges,,,532.1,85,,percent of total billed charges,,,,,,,,,550.88,88,,percent of total billed charges,,,,,,,,,478.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,156.5,22,,percent of total billed charges,,,569.66,91,,percent of total billed charges,,,594.7,95,,percent of total billed charges,,,519.58,83,,percent of total billed charges,,,519.58,83,,percent of total billed charges,,,,,,,,,,,,,,,519.58,83,,percent of total billed charges,,,594.7,95,,percent of total billed charges,,,563.4,90,,percent of total billed charges,,,563.4,90,,percent of total billed charges,,,513.32,82,,percent of total billed charges,,,563.4,90,,percent of total billed charges,,,532.1,85,,percent of total billed charges,,156.5,594.7,
CREATININE SERUM,25200311,CDM,82565,CPT,300,RC,outpatient,,118,118,,100.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.5,22,,percent of total billed charges,,,,,,,,,106.2,90,,percent of total billed charges,,,97.7,82.8,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,,,,,,,,103.84,88,,percent of total billed charges,,,,,,,,,90.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.5,22,,percent of total billed charges,,,107.38,91,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,,,,,,,,,,,,,97.94,83,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,96.76,82,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,29.5,112.1,
GFR,25200312,CDM,82565,CPT,300,RC,outpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.25,22,,percent of total billed charges,,,,,,,,,98.1,90,,percent of total billed charges,,,90.25,82.8,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.25,22,,percent of total billed charges,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,27.25,103.55,
CREATININE CLEARANCE,25200329,CDM,82575,CPT,300,RC,outpatient,,222,222,,188.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.5,22,,percent of total billed charges,,,,,,,,,199.8,90,,percent of total billed charges,,,183.82,82.8,,percent of total billed charges,,,188.7,85,,percent of total billed charges,,,,,,,,,195.36,88,,percent of total billed charges,,,,,,,,,169.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.5,22,,percent of total billed charges,,,202.02,91,,percent of total billed charges,,,210.9,95,,percent of total billed charges,,,184.26,83,,percent of total billed charges,,,184.26,83,,percent of total billed charges,,,,,,,,,,,,,,,184.26,83,,percent of total billed charges,,,210.9,95,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,182.04,82,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,188.7,85,,percent of total billed charges,,55.5,210.9,
INVASIVE TROPHOBLAST ANTIGEN,25200339,CDM,82397,CPT,300,RC,outpatient,,567,567,,481.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141.75,22,,percent of total billed charges,,,,,,,,,510.3,90,,percent of total billed charges,,,469.48,82.8,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,,,,,,,,498.96,88,,percent of total billed charges,,,,,,,,,433.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141.75,22,,percent of total billed charges,,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,,,,,,,,,,,,,470.61,83,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,464.94,82,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,141.75,538.65,
MATERNAL SCREEN SPINA BIFIDA,25200340,CDM,82105,CPT,300,RC,outpatient,,30.5,30.5,,25.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.63,22,,percent of total billed charges,,,,,,,,,27.45,90,,percent of total billed charges,,,25.25,82.8,,percent of total billed charges,,,25.93,85,,percent of total billed charges,,,,,,,,,26.84,88,,percent of total billed charges,,,,,,,,,23.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.63,22,,percent of total billed charges,,,27.76,91,,percent of total billed charges,,,28.98,95,,percent of total billed charges,,,25.32,83,,percent of total billed charges,,,25.32,83,,percent of total billed charges,,,,,,,,,,,,,,,25.32,83,,percent of total billed charges,,,28.98,95,,percent of total billed charges,,,27.45,90,,percent of total billed charges,,,27.45,90,,percent of total billed charges,,,25.01,82,,percent of total billed charges,,,27.45,90,,percent of total billed charges,,,25.93,85,,percent of total billed charges,,7.63,28.98,
GIARDIA ANTIBODY,25200344,CDM,86674,CPT,300,RC,outpatient,,196,196,,166.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49,22,,percent of total billed charges,,,,,,,,,176.4,90,,percent of total billed charges,,,162.29,82.8,,percent of total billed charges,,,166.6,85,,percent of total billed charges,,,,,,,,,172.48,88,,percent of total billed charges,,,,,,,,,149.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49,22,,percent of total billed charges,,,178.36,91,,percent of total billed charges,,,186.2,95,,percent of total billed charges,,,162.68,83,,percent of total billed charges,,,162.68,83,,percent of total billed charges,,,,,,,,,,,,,,,162.68,83,,percent of total billed charges,,,186.2,95,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,160.72,82,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,166.6,85,,percent of total billed charges,,49,186.2,
C-REACTIVE PROTEIN,25200345,CDM,86140,CPT,300,RC,outpatient,,135,135,,114.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.75,22,,percent of total billed charges,,,,,,,,,121.5,90,,percent of total billed charges,,,111.78,82.8,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,,,,,,,,118.8,88,,percent of total billed charges,,,,,,,,,103.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.75,22,,percent of total billed charges,,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,,,,,,,,,,,,,112.05,83,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,110.7,82,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,33.75,128.25,
GIARDIA ANTIGEN STOOL,25200346,CDM,87269,CPT,300,RC,outpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45,22,,percent of total billed charges,,,,,,,,,162,90,,percent of total billed charges,,,149.04,82.8,,percent of total billed charges,,,153,85,,percent of total billed charges,,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45,22,,percent of total billed charges,,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,45,171,
CORTISOL FREE URINE (24-HOUR),25200347,CDM,82530,CPT,300,RC,outpatient,,345,345,,292.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.25,22,,percent of total billed charges,,,,,,,,,310.5,90,,percent of total billed charges,,,285.66,82.8,,percent of total billed charges,,,293.25,85,,percent of total billed charges,,,,,,,,,303.6,88,,percent of total billed charges,,,,,,,,,263.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.25,22,,percent of total billed charges,,,313.95,91,,percent of total billed charges,,,327.75,95,,percent of total billed charges,,,286.35,83,,percent of total billed charges,,,286.35,83,,percent of total billed charges,,,,,,,,,,,,,,,286.35,83,,percent of total billed charges,,,327.75,95,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,282.9,82,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,293.25,85,,percent of total billed charges,,86.25,327.75,
CEFACLOR,25200348,CDM,86003,CPT,300,RC,outpatient,,91,91,,77.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.75,22,,percent of total billed charges,,,,,,,,,81.9,90,,percent of total billed charges,,,75.35,82.8,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,,,,,,,,80.08,88,,percent of total billed charges,,,,,,,,,69.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.75,22,,percent of total billed charges,,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,,,,,,,,,,,,,75.53,83,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,74.62,82,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,22.75,86.45,
"CORTISOL FREE, SERUM",25200350,CDM,82533,CPT,300,RC,outpatient,,347,347,,294.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.75,22,,percent of total billed charges,,,,,,,,,312.3,90,,percent of total billed charges,,,287.32,82.8,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,,,,,,,,305.36,88,,percent of total billed charges,,,,,,,,,265.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.75,22,,percent of total billed charges,,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,,,,,,,,,,,,,288.01,83,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,284.54,82,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,86.75,329.65,
CULTURE URINE,25200352,CDM,87086,CPT,300,RC,outpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.75,22,,percent of total billed charges,,,,,,,,,189.9,90,,percent of total billed charges,,,174.71,82.8,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.75,22,,percent of total billed charges,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,52.75,200.45,
RITICULIN AB EVALUATION,25200353,CDM,86255,CPT,300,RC,outpatient,,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93,22,,percent of total billed charges,,,,,,,,,334.8,90,,percent of total billed charges,,,308.02,82.8,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93,22,,percent of total billed charges,,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,93,353.4,
CELIAC  HLA DQ,25200357,CDM,81377,CPT,300,RC,outpatient,,790.75,790.75,,671.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,197.69,22,,percent of total billed charges,,,,,,,,,711.68,90,,percent of total billed charges,,,654.74,82.8,,percent of total billed charges,,,672.14,85,,percent of total billed charges,,,,,,,,,695.86,88,,percent of total billed charges,,,,,,,,,604.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,197.69,22,,percent of total billed charges,,,719.58,91,,percent of total billed charges,,,751.21,95,,percent of total billed charges,,,656.32,83,,percent of total billed charges,,,656.32,83,,percent of total billed charges,,,,,,,,,,,,,,,656.32,83,,percent of total billed charges,,,751.21,95,,percent of total billed charges,,,711.68,90,,percent of total billed charges,,,711.68,90,,percent of total billed charges,,,648.42,82,,percent of total billed charges,,,711.68,90,,percent of total billed charges,,,672.14,85,,percent of total billed charges,,197.69,751.21,
D-DIMER,25200360,CDM,85379,CPT,300,RC,outpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.75,22,,percent of total billed charges,,,,,,,,,189.9,90,,percent of total billed charges,,,174.71,82.8,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.75,22,,percent of total billed charges,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,52.75,200.45,
CULTURE GENITAL,25200377,CDM,87070,CPT,300,RC,outpatient,,253,253,,214.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.25,22,,percent of total billed charges,,,,,,,,,227.7,90,,percent of total billed charges,,,209.48,82.8,,percent of total billed charges,,,215.05,85,,percent of total billed charges,,,,,,,,,222.64,88,,percent of total billed charges,,,,,,,,,193.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.25,22,,percent of total billed charges,,,230.23,91,,percent of total billed charges,,,240.35,95,,percent of total billed charges,,,209.99,83,,percent of total billed charges,,,209.99,83,,percent of total billed charges,,,,,,,,,,,,,,,209.99,83,,percent of total billed charges,,,240.35,95,,percent of total billed charges,,,227.7,90,,percent of total billed charges,,,227.7,90,,percent of total billed charges,,,207.46,82,,percent of total billed charges,,,227.7,90,,percent of total billed charges,,,215.05,85,,percent of total billed charges,,63.25,240.35,
CULTURE AEROBIC,25200378,CDM,87070,CPT,300,RC,outpatient,TC,224,224,,190.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56,22,,percent of total billed charges,,,,,,,,,201.6,90,,percent of total billed charges,,,185.47,82.8,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,,,,,,,,197.12,88,,percent of total billed charges,,,,,,,,,171.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56,22,,percent of total billed charges,,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,183.68,82,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,56,212.8,
CULTURE MRSA SCREEN,25200381,CDM,87081,CPT,300,RC,outpatient,,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38,22,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,125.86,82.8,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38,22,,percent of total billed charges,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,38,144.4,
CULTURE VRE SCREEN,25200385,CDM,87081,CPT,300,RC,outpatient,,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38,22,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,125.86,82.8,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38,22,,percent of total billed charges,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,38,144.4,
PROGESTERONE,25200386,CDM,84144,CPT,300,RC,outpatient,,403,403,,342.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100.75,22,,percent of total billed charges,,,,,,,,,362.7,90,,percent of total billed charges,,,333.68,82.8,,percent of total billed charges,,,342.55,85,,percent of total billed charges,,,,,,,,,354.64,88,,percent of total billed charges,,,,,,,,,307.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100.75,22,,percent of total billed charges,,,366.73,91,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,,,,,,,,,,,,,334.49,83,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,330.46,82,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,342.55,85,,percent of total billed charges,,100.75,382.85,
17-OH PROGESTERONE/CREAT RATIO,25200387,CDM,82570,CPT,300,RC,outpatient,,403,403,,342.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100.75,22,,percent of total billed charges,,,,,,,,,362.7,90,,percent of total billed charges,,,333.68,82.8,,percent of total billed charges,,,342.55,85,,percent of total billed charges,,,,,,,,,354.64,88,,percent of total billed charges,,,,,,,,,307.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100.75,22,,percent of total billed charges,,,366.73,91,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,,,,,,,,,,,,,334.49,83,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,330.46,82,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,342.55,85,,percent of total billed charges,,100.75,382.85,
.CULTURE  AEROBIC (TISSUE),25200388,CDM,87070,CPT,300,RC,outpatient,,224,224,,190.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56,22,,percent of total billed charges,,,,,,,,,201.6,90,,percent of total billed charges,,,185.47,82.8,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,,,,,,,,197.12,88,,percent of total billed charges,,,,,,,,,171.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56,22,,percent of total billed charges,,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,183.68,82,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,56,212.8,
CULTURE AEROBIC(FLUID),25200389,CDM,87070,CPT,300,RC,outpatient,,249,249,,211.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.25,22,,percent of total billed charges,,,,,,,,,224.1,90,,percent of total billed charges,,,206.17,82.8,,percent of total billed charges,,,211.65,85,,percent of total billed charges,,,,,,,,,219.12,88,,percent of total billed charges,,,,,,,,,190.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.25,22,,percent of total billed charges,,,226.59,91,,percent of total billed charges,,,236.55,95,,percent of total billed charges,,,206.67,83,,percent of total billed charges,,,206.67,83,,percent of total billed charges,,,,,,,,,,,,,,,206.67,83,,percent of total billed charges,,,236.55,95,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,204.18,82,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,211.65,85,,percent of total billed charges,,62.25,236.55,
. MRSA NAA,25200390,CDM,87641,CPT,300,RC,outpatient,,183,183,,155.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.75,22,,percent of total billed charges,,,,,,,,,164.7,90,,percent of total billed charges,,,151.52,82.8,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,,,,,,,,161.04,88,,percent of total billed charges,,,,,,,,,139.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.75,22,,percent of total billed charges,,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,,,,,,,,,,,,,151.89,83,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,150.06,82,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,45.75,173.85,
".DIFFERENTIAL, MANUAL",25200394,CDM,85007,CPT,300,RC,outpatient,,86,86,,73.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.5,22,,percent of total billed charges,,,,,,,,,77.4,90,,percent of total billed charges,,,71.21,82.8,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,,,,,,,,75.68,88,,percent of total billed charges,,,,,,,,,65.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.5,22,,percent of total billed charges,,,78.26,91,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,,,,,,,,,,,,,71.38,83,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,70.52,82,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,21.5,81.7,
DIGOXIN,25200402,CDM,80162,CPT,300,RC,outpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75,22,,percent of total billed charges,,,,,,,,,270,90,,percent of total billed charges,,,248.4,82.8,,percent of total billed charges,,,255,85,,percent of total billed charges,,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75,22,,percent of total billed charges,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,75,285,
PHENYTOIN,25200410,CDM,80185,CPT,300,RC,outpatient,,277,277,,235.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.25,22,,percent of total billed charges,,,,,,,,,249.3,90,,percent of total billed charges,,,229.36,82.8,,percent of total billed charges,,,235.45,85,,percent of total billed charges,,,,,,,,,243.76,88,,percent of total billed charges,,,,,,,,,211.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.25,22,,percent of total billed charges,,,252.07,91,,percent of total billed charges,,,263.15,95,,percent of total billed charges,,,229.91,83,,percent of total billed charges,,,229.91,83,,percent of total billed charges,,,,,,,,,,,,,,,229.91,83,,percent of total billed charges,,,263.15,95,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,227.14,82,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,235.45,85,,percent of total billed charges,,69.25,263.15,
PHENYTOIN FREE,25200420,CDM,80186,CPT,300,RC,outpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.75,22,,percent of total billed charges,,,,,,,,,189.9,90,,percent of total billed charges,,,174.71,82.8,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.75,22,,percent of total billed charges,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,52.75,200.45,
PROTEIN TOTAL URINE (24-HOUR),25200428,CDM,84156,CPT,300,RC,outpatient,,182,182,,154.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.5,22,,percent of total billed charges,,,,,,,,,163.8,90,,percent of total billed charges,,,150.7,82.8,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,,,,,,,,160.16,88,,percent of total billed charges,,,,,,,,,139.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.5,22,,percent of total billed charges,,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,149.24,82,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,45.5,172.9,
ACTH,25200436,CDM,82024,CPT,300,RC,outpatient,,758,758,,643.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,189.5,22,,percent of total billed charges,,,,,,,,,682.2,90,,percent of total billed charges,,,627.62,82.8,,percent of total billed charges,,,644.3,85,,percent of total billed charges,,,,,,,,,667.04,88,,percent of total billed charges,,,,,,,,,579.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,189.5,22,,percent of total billed charges,,,689.78,91,,percent of total billed charges,,,720.1,95,,percent of total billed charges,,,629.14,83,,percent of total billed charges,,,629.14,83,,percent of total billed charges,,,,,,,,,,,,,,,629.14,83,,percent of total billed charges,,,720.1,95,,percent of total billed charges,,,682.2,90,,percent of total billed charges,,,682.2,90,,percent of total billed charges,,,621.56,82,,percent of total billed charges,,,682.2,90,,percent of total billed charges,,,644.3,85,,percent of total billed charges,,189.5,720.1,
VENIPUNCTURE BLOOD COLLECTION,25200444,CDM,36415,CPT,300,RC,outpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.75,22,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,45.54,82.8,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.75,22,,percent of total billed charges,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,13.75,52.25,
CAPILLARY PUNCTURE BLOOD COLLECTION,25200446,CDM,36416,CPT,300,RC,outpatient,,66,66,,56.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.5,22,,percent of total billed charges,,,,,,,,,59.4,90,,percent of total billed charges,,,54.65,82.8,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,,,,,,,,58.08,88,,percent of total billed charges,,,,,,,,,50.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.5,22,,percent of total billed charges,,,60.06,91,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,,,,,,,,,,,,,54.78,83,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,54.12,82,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,16.5,62.7,
FIBRINOGEN,25200450,CDM,85385,CPT,300,RC,outpatient,,504,504,,427.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126,22,,percent of total billed charges,,,,,,,,,453.6,90,,percent of total billed charges,,,417.31,82.8,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,,,,,,,,443.52,88,,percent of total billed charges,,,,,,,,,385.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126,22,,percent of total billed charges,,,458.64,91,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,,,,,,,,,,,,,418.32,83,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,413.28,82,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,126,478.8,
FIBRINOGEN (ACTIVITY),25200451,CDM,85384,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
.FUNGUS CULTURE WITH STAIN,25200452,CDM,87102,CPT,300,RC,outpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.25,22,,percent of total billed charges,,,,,,,,,267.3,90,,percent of total billed charges,,,245.92,82.8,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.25,22,,percent of total billed charges,,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,74.25,282.15,
FUNGUS CULTURE WITH STAIN,25200453,CDM,87102,CPT,300,RC,outpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.25,22,,percent of total billed charges,,,,,,,,,267.3,90,,percent of total billed charges,,,245.92,82.8,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.25,22,,percent of total billed charges,,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,74.25,282.15,
FUNGAL STAIN,25200454,CDM,87206,CPT,300,RC,outpatient,,29,29,,24.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.25,22,,percent of total billed charges,,,,,,,,,26.1,90,,percent of total billed charges,,,24.01,82.8,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,,,,,,,,25.52,88,,percent of total billed charges,,,,,,,,,22.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.25,22,,percent of total billed charges,,,26.39,91,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,,,,,,,,,,,,,24.07,83,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,23.78,82,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,7.25,27.55,
DRAGU FIBRINOGEN (ANTIGEN),25200455,CDM,85385,CPT,300,RC,outpatient,,504,504,,427.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126,22,,percent of total billed charges,,,,,,,,,453.6,90,,percent of total billed charges,,,417.31,82.8,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,,,,,,,,443.52,88,,percent of total billed charges,,,,,,,,,385.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126,22,,percent of total billed charges,,,458.64,91,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,,,,,,,,,,,,,418.32,83,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,413.28,82,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,126,478.8,
GENTAMICIN PEAK,25200469,CDM,80170,CPT,300,RC,outpatient,,355,355,,301.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.75,22,,percent of total billed charges,,,,,,,,,319.5,90,,percent of total billed charges,,,293.94,82.8,,percent of total billed charges,,,301.75,85,,percent of total billed charges,,,,,,,,,312.4,88,,percent of total billed charges,,,,,,,,,271.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.75,22,,percent of total billed charges,,,323.05,91,,percent of total billed charges,,,337.25,95,,percent of total billed charges,,,294.65,83,,percent of total billed charges,,,294.65,83,,percent of total billed charges,,,,,,,,,,,,,,,294.65,83,,percent of total billed charges,,,337.25,95,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,291.1,82,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,301.75,85,,percent of total billed charges,,88.75,337.25,
GENTAMICIN RANDOM,25200470,CDM,80170,CPT,300,RC,outpatient,,355,355,,301.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.75,22,,percent of total billed charges,,,,,,,,,319.5,90,,percent of total billed charges,,,293.94,82.8,,percent of total billed charges,,,301.75,85,,percent of total billed charges,,,,,,,,,312.4,88,,percent of total billed charges,,,,,,,,,271.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.75,22,,percent of total billed charges,,,323.05,91,,percent of total billed charges,,,337.25,95,,percent of total billed charges,,,294.65,83,,percent of total billed charges,,,294.65,83,,percent of total billed charges,,,,,,,,,,,,,,,294.65,83,,percent of total billed charges,,,337.25,95,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,291.1,82,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,301.75,85,,percent of total billed charges,,88.75,337.25,
GGT,25200477,CDM,82977,CPT,300,RC,outpatient,,196,196,,166.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49,22,,percent of total billed charges,,,,,,,,,176.4,90,,percent of total billed charges,,,162.29,82.8,,percent of total billed charges,,,166.6,85,,percent of total billed charges,,,,,,,,,172.48,88,,percent of total billed charges,,,,,,,,,149.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49,22,,percent of total billed charges,,,178.36,91,,percent of total billed charges,,,186.2,95,,percent of total billed charges,,,162.68,83,,percent of total billed charges,,,162.68,83,,percent of total billed charges,,,,,,,,,,,,,,,162.68,83,,percent of total billed charges,,,186.2,95,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,160.72,82,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,166.6,85,,percent of total billed charges,,49,186.2,
GEL SEPERATION,25200479,CDM,83894,CPT,300,RC,outpatient,,135,135,,114.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.75,22,,percent of total billed charges,,,,,,,,,121.5,90,,percent of total billed charges,,,111.78,82.8,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,,,,,,,,118.8,88,,percent of total billed charges,,,,,,,,,103.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.75,22,,percent of total billed charges,,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,,,,,,,,,,,,,112.05,83,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,110.7,82,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,33.75,128.25,
GLUCOSE SERUM,25200485,CDM,82947,CPT,300,RC,outpatient,,111,111,,94.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.75,22,,percent of total billed charges,,,,,,,,,99.9,90,,percent of total billed charges,,,91.91,82.8,,percent of total billed charges,,,94.35,85,,percent of total billed charges,,,,,,,,,97.68,88,,percent of total billed charges,,,,,,,,,84.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.75,22,,percent of total billed charges,,,101.01,91,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,,,,,,,,,,,,,92.13,83,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,91.02,82,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,94.35,85,,percent of total billed charges,,27.75,105.45,
GLUCOSE 1 HOUR PP,25200486,CDM,82950,CPT,300,RC,outpatient,,167,167,,141.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.75,22,,percent of total billed charges,,,,,,,,,150.3,90,,percent of total billed charges,,,138.28,82.8,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,,,,,,,,146.96,88,,percent of total billed charges,,,,,,,,,127.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.75,22,,percent of total billed charges,,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,,,,,,,,,,,,,138.61,83,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,136.94,82,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,41.75,158.65,
.GTT-ADDED SPECIMEN,25200487,CDM,82952,CPT,300,RC,outpatient,,72,72,,61.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18,22,,percent of total billed charges,,,,,,,,,64.8,90,,percent of total billed charges,,,59.62,82.8,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,,,,,,,,63.36,88,,percent of total billed charges,,,,,,,,,55.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18,22,,percent of total billed charges,,,65.52,91,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,,,,,,,,,,,,,59.76,83,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,59.04,82,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,18,68.4,
"GLUCOSE, CSF/BODY FL",25200488,CDM,82945,CPT,300,RC,outpatient,,122,122,,103.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.5,22,,percent of total billed charges,,,,,,,,,109.8,90,,percent of total billed charges,,,101.02,82.8,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,,,,,,,,107.36,88,,percent of total billed charges,,,,,,,,,93.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.5,22,,percent of total billed charges,,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,100.04,82,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,30.5,115.9,
GLUCOSE (POC),25200490,CDM,82948,CPT,300,RC,outpatient,,33,33,,28.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.25,22,,percent of total billed charges,,,,,,,,,29.7,90,,percent of total billed charges,,,27.32,82.8,,percent of total billed charges,,,28.05,85,,percent of total billed charges,,,,,,,,,29.04,88,,percent of total billed charges,,,,,,,,,25.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.25,22,,percent of total billed charges,,,30.03,91,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,,,,,,,,,,,,,27.39,83,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,27.06,82,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,28.05,85,,percent of total billed charges,,8.25,31.35,
.GTT - 3 HOUR,25200493,CDM,82951,CPT,300,RC,outpatient,,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.75,22,,percent of total billed charges,,,,,,,,,207.9,90,,percent of total billed charges,,,191.27,82.8,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.75,22,,percent of total billed charges,,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,57.75,219.45,
GRAM STAIN (BLOOD CULTURE),25200518,CDM,87205,CPT,300,RC,outpatient,TC,82,82,,69.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.5,22,,percent of total billed charges,,,,,,,,,73.8,90,,percent of total billed charges,,,67.9,82.8,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,,,,,,,,72.16,88,,percent of total billed charges,,,,,,,,,62.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.5,22,,percent of total billed charges,,,74.62,91,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,,,,,,,,,,,,,68.06,83,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,67.24,82,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,20.5,77.9,
GRAM STAIN (NOT SPUTUM),25200519,CDM,87205,CPT,300,RC,outpatient,,98,98,,83.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.5,22,,percent of total billed charges,,,,,,,,,88.2,90,,percent of total billed charges,,,81.14,82.8,,percent of total billed charges,,,83.3,85,,percent of total billed charges,,,,,,,,,86.24,88,,percent of total billed charges,,,,,,,,,74.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.5,22,,percent of total billed charges,,,89.18,91,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,,,,,,,,,,,,,81.34,83,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,80.36,82,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,83.3,85,,percent of total billed charges,,24.5,93.1,
GRAM STAIN (SPUTUM),25200520,CDM,87205,CPT,300,RC,outpatient,,98,98,,83.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.5,22,,percent of total billed charges,,,,,,,,,88.2,90,,percent of total billed charges,,,81.14,82.8,,percent of total billed charges,,,83.3,85,,percent of total billed charges,,,,,,,,,86.24,88,,percent of total billed charges,,,,,,,,,74.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.5,22,,percent of total billed charges,,,89.18,91,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,,,,,,,,,,,,,81.34,83,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,80.36,82,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,83.3,85,,percent of total billed charges,,24.5,93.1,
....HERPES SIM1&2 IGM AB,25200525,CDM,86694,CPT,300,RC,outpatient,,32,32,,27.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8,22,,percent of total billed charges,,,,,,,,,28.8,90,,percent of total billed charges,,,26.5,82.8,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,,,,,,,,28.16,88,,percent of total billed charges,,,,,,,,,24.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8,22,,percent of total billed charges,,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,,,,,,,,,,,,,26.56,83,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,26.24,82,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,8,30.4,
"HEPATITIS C, RNA, QN",25200526,CDM,87522,CPT,300,RC,outpatient,,1103,1103,,936.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,275.75,22,,percent of total billed charges,,,,,,,,,992.7,90,,percent of total billed charges,,,913.28,82.8,,percent of total billed charges,,,937.55,85,,percent of total billed charges,,,,,,,,,970.64,88,,percent of total billed charges,,,,,,,,,842.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,275.75,22,,percent of total billed charges,,,1003.73,91,,percent of total billed charges,,,1047.85,95,,percent of total billed charges,,,915.49,83,,percent of total billed charges,,,915.49,83,,percent of total billed charges,,,,,,,,,,,,,,,915.49,83,,percent of total billed charges,,,1047.85,95,,percent of total billed charges,,,992.7,90,,percent of total billed charges,,,992.7,90,,percent of total billed charges,,,904.46,82,,percent of total billed charges,,,992.7,90,,percent of total billed charges,,,937.55,85,,percent of total billed charges,,275.75,1047.85,
HDL CHOLESTEROL,25200527,CDM,83718,CPT,300,RC,outpatient,,201,201,,170.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.25,22,,percent of total billed charges,,,,,,,,,180.9,90,,percent of total billed charges,,,166.43,82.8,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,,,,,,,,176.88,88,,percent of total billed charges,,,,,,,,,153.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.25,22,,percent of total billed charges,,,182.91,91,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,,,,,,,,,,,,,166.83,83,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,164.82,82,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,50.25,190.95,
HERPES SIM VIRUS CULTURE,25200529,CDM,87255,CPT,300,RC,outpatient,,509,509,,432.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.25,22,,percent of total billed charges,,,,,,,,,458.1,90,,percent of total billed charges,,,421.45,82.8,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,,,,,,,,447.92,88,,percent of total billed charges,,,,,,,,,388.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.25,22,,percent of total billed charges,,,463.19,91,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,,,,,,,,,,,,,422.47,83,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,417.38,82,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,127.25,483.55,
".HIV-1 RNA QL, PCR",25200530,CDM,87535,CPT,300,RC,outpatient,,762,762,,646.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,190.5,22,,percent of total billed charges,,,,,,,,,685.8,90,,percent of total billed charges,,,630.94,82.8,,percent of total billed charges,,,647.7,85,,percent of total billed charges,,,,,,,,,670.56,88,,percent of total billed charges,,,,,,,,,582.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,190.5,22,,percent of total billed charges,,,693.42,91,,percent of total billed charges,,,723.9,95,,percent of total billed charges,,,632.46,83,,percent of total billed charges,,,632.46,83,,percent of total billed charges,,,,,,,,,,,,,,,632.46,83,,percent of total billed charges,,,723.9,95,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,624.84,82,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,647.7,85,,percent of total billed charges,,190.5,723.9,
.HERPES SIMPLEX 1&2 PCR,25200531,CDM,87529,CPT,300,RC,outpatient,,524,524,,444.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131,22,,percent of total billed charges,,,,,,,,,471.6,90,,percent of total billed charges,,,433.87,82.8,,percent of total billed charges,,,445.4,85,,percent of total billed charges,,,,,,,,,461.12,88,,percent of total billed charges,,,,,,,,,400.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131,22,,percent of total billed charges,,,476.84,91,,percent of total billed charges,,,497.8,95,,percent of total billed charges,,,434.92,83,,percent of total billed charges,,,434.92,83,,percent of total billed charges,,,,,,,,,,,,,,,434.92,83,,percent of total billed charges,,,497.8,95,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,429.68,82,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,445.4,85,,percent of total billed charges,,131,497.8,
HIV AB REFLEX TO WESTERN BLOTT,25200532,CDM,86703,CPT,300,RC,outpatient,,418,418,,354.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.5,22,,percent of total billed charges,,,,,,,,,376.2,90,,percent of total billed charges,,,346.1,82.8,,percent of total billed charges,,,355.3,85,,percent of total billed charges,,,,,,,,,367.84,88,,percent of total billed charges,,,,,,,,,319.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.5,22,,percent of total billed charges,,,380.38,91,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,,,,,,,,,,,,,346.94,83,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,342.76,82,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,355.3,85,,percent of total billed charges,,104.5,397.1,
HIV GENOTYPE,25200533,CDM,87536,CPT,300,RC,outpatient,,658,658,,558.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,164.5,22,,percent of total billed charges,,,,,,,,,592.2,90,,percent of total billed charges,,,544.82,82.8,,percent of total billed charges,,,559.3,85,,percent of total billed charges,,,,,,,,,579.04,88,,percent of total billed charges,,,,,,,,,502.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,164.5,22,,percent of total billed charges,,,598.78,91,,percent of total billed charges,,,625.1,95,,percent of total billed charges,,,546.14,83,,percent of total billed charges,,,546.14,83,,percent of total billed charges,,,,,,,,,,,,,,,546.14,83,,percent of total billed charges,,,625.1,95,,percent of total billed charges,,,592.2,90,,percent of total billed charges,,,592.2,90,,percent of total billed charges,,,539.56,82,,percent of total billed charges,,,592.2,90,,percent of total billed charges,,,559.3,85,,percent of total billed charges,,164.5,625.1,
"HEPATITIS C, RNA, DIAGNOSIS",25200534,CDM,87522,CPT,300,RC,outpatient,,539,539,,457.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,134.75,22,,percent of total billed charges,,,,,,,,,485.1,90,,percent of total billed charges,,,446.29,82.8,,percent of total billed charges,,,458.15,85,,percent of total billed charges,,,,,,,,,474.32,88,,percent of total billed charges,,,,,,,,,411.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,134.75,22,,percent of total billed charges,,,490.49,91,,percent of total billed charges,,,512.05,95,,percent of total billed charges,,,447.37,83,,percent of total billed charges,,,447.37,83,,percent of total billed charges,,,,,,,,,,,,,,,447.37,83,,percent of total billed charges,,,512.05,95,,percent of total billed charges,,,485.1,90,,percent of total billed charges,,,485.1,90,,percent of total billed charges,,,441.98,82,,percent of total billed charges,,,485.1,90,,percent of total billed charges,,,458.15,85,,percent of total billed charges,,134.75,512.05,
HEMATOCRIT,25200535,CDM,85014,CPT,300,RC,outpatient,,70,70,,59.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.5,22,,percent of total billed charges,,,,,,,,,63,90,,percent of total billed charges,,,57.96,82.8,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,,,,,,,,61.6,88,,percent of total billed charges,,,,,,,,,53.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.5,22,,percent of total billed charges,,,63.7,91,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,,,,,,,,,,,,,58.1,83,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,57.4,82,,percent of total billed charges,,,63,90,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,17.5,66.5,
.HIV-2,25200536,CDM,86702,CPT,300,RC,outpatient,,538,538,,456.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,134.5,22,,percent of total billed charges,,,,,,,,,484.2,90,,percent of total billed charges,,,445.46,82.8,,percent of total billed charges,,,457.3,85,,percent of total billed charges,,,,,,,,,473.44,88,,percent of total billed charges,,,,,,,,,411.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,134.5,22,,percent of total billed charges,,,489.58,91,,percent of total billed charges,,,511.1,95,,percent of total billed charges,,,446.54,83,,percent of total billed charges,,,446.54,83,,percent of total billed charges,,,,,,,,,,,,,,,446.54,83,,percent of total billed charges,,,511.1,95,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,441.16,82,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,457.3,85,,percent of total billed charges,,134.5,511.1,
.HIV-1 ANTIBODY CONFIRMATION,25200537,CDM,86689,CPT,300,RC,outpatient,,552,552,,468.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,138,22,,percent of total billed charges,,,,,,,,,496.8,90,,percent of total billed charges,,,457.06,82.8,,percent of total billed charges,,,469.2,85,,percent of total billed charges,,,,,,,,,485.76,88,,percent of total billed charges,,,,,,,,,421.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,138,22,,percent of total billed charges,,,502.32,91,,percent of total billed charges,,,524.4,95,,percent of total billed charges,,,458.16,83,,percent of total billed charges,,,458.16,83,,percent of total billed charges,,,,,,,,,,,,,,,458.16,83,,percent of total billed charges,,,524.4,95,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,452.64,82,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,469.2,85,,percent of total billed charges,,138,524.4,
.HIV P24 ANTIGEN,25200538,CDM,87390,CPT,300,RC,outpatient,,275,275,,233.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.75,22,,percent of total billed charges,,,,,,,,,247.5,90,,percent of total billed charges,,,227.7,82.8,,percent of total billed charges,,,233.75,85,,percent of total billed charges,,,,,,,,,242,88,,percent of total billed charges,,,,,,,,,210.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.75,22,,percent of total billed charges,,,250.25,91,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,,,,,,,,,,,,,228.25,83,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,225.5,82,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,233.75,85,,percent of total billed charges,,68.75,261.25,
HU AUTOANTIBODY,25200539,CDM,86255,CPT,300,RC,outpatient,,501,501,,425.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125.25,22,,percent of total billed charges,,,,,,,,,450.9,90,,percent of total billed charges,,,414.83,82.8,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,,,,,,,,440.88,88,,percent of total billed charges,,,,,,,,,382.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125.25,22,,percent of total billed charges,,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,,,,,,,,,,,,,415.83,83,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,410.82,82,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,125.25,475.95,
"HEPATITIS C VIRAL LOAD, QN",25200540,CDM,87522,CPT,300,RC,outpatient,,1013,1013,,860.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,253.25,22,,percent of total billed charges,,,,,,,,,911.7,90,,percent of total billed charges,,,838.76,82.8,,percent of total billed charges,,,861.05,85,,percent of total billed charges,,,,,,,,,891.44,88,,percent of total billed charges,,,,,,,,,773.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,253.25,22,,percent of total billed charges,,,921.83,91,,percent of total billed charges,,,962.35,95,,percent of total billed charges,,,840.79,83,,percent of total billed charges,,,840.79,83,,percent of total billed charges,,,,,,,,,,,,,,,840.79,83,,percent of total billed charges,,,962.35,95,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,830.66,82,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,861.05,85,,percent of total billed charges,,253.25,962.35,
"HEPATITIS C RNA, GENOTYPE",25200541,CDM,87902,CPT,300,RC,outpatient,,3855,3855,,3272.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,963.75,22,,percent of total billed charges,,,,,,,,,3469.5,90,,percent of total billed charges,,,3191.94,82.8,,percent of total billed charges,,,3276.75,85,,percent of total billed charges,,,,,,,,,3392.4,88,,percent of total billed charges,,,,,,,,,2945.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,963.75,22,,percent of total billed charges,,,3508.05,91,,percent of total billed charges,,,3662.25,95,,percent of total billed charges,,,3199.65,83,,percent of total billed charges,,,3199.65,83,,percent of total billed charges,,,,,,,,,,,,,,,3199.65,83,,percent of total billed charges,,,3662.25,95,,percent of total billed charges,,,3469.5,90,,percent of total billed charges,,,3469.5,90,,percent of total billed charges,,,3161.1,82,,percent of total billed charges,,,3469.5,90,,percent of total billed charges,,,3276.75,85,,percent of total billed charges,,963.75,3662.25,
HEPATITIS A IGM ANTIBODY,25200542,CDM,86709,CPT,300,RC,outpatient,,261,261,,221.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.25,22,,percent of total billed charges,,,,,,,,,234.9,90,,percent of total billed charges,,,216.11,82.8,,percent of total billed charges,,,221.85,85,,percent of total billed charges,,,,,,,,,229.68,88,,percent of total billed charges,,,,,,,,,199.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.25,22,,percent of total billed charges,,,237.51,91,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,,,,,,,,,,,,,216.63,83,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,214.02,82,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,221.85,85,,percent of total billed charges,,65.25,247.95,
HEMOGLOBIN,25200543,CDM,85018,CPT,300,RC,outpatient,,71,71,,60.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.75,22,,percent of total billed charges,,,,,,,,,63.9,90,,percent of total billed charges,,,58.79,82.8,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,,,,,,,,62.48,88,,percent of total billed charges,,,,,,,,,54.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.75,22,,percent of total billed charges,,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,,,,,,,,,,,,,58.93,83,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,58.22,82,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,17.75,67.45,
INSULIN FREE (INCLUDES TOTAL),25200545,CDM,83527,CPT,300,RC,outpatient,,196,196,,166.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49,22,,percent of total billed charges,,,,,,,,,176.4,90,,percent of total billed charges,,,162.29,82.8,,percent of total billed charges,,,166.6,85,,percent of total billed charges,,,,,,,,,172.48,88,,percent of total billed charges,,,,,,,,,149.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49,22,,percent of total billed charges,,,178.36,91,,percent of total billed charges,,,186.2,95,,percent of total billed charges,,,162.68,83,,percent of total billed charges,,,162.68,83,,percent of total billed charges,,,,,,,,,,,,,,,162.68,83,,percent of total billed charges,,,186.2,95,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,160.72,82,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,166.6,85,,percent of total billed charges,,49,186.2,
INSULIN ANTIBODY,25200546,CDM,86337,CPT,300,RC,outpatient,,453,453,,384.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,113.25,22,,percent of total billed charges,,,,,,,,,407.7,90,,percent of total billed charges,,,375.08,82.8,,percent of total billed charges,,,385.05,85,,percent of total billed charges,,,,,,,,,398.64,88,,percent of total billed charges,,,,,,,,,346.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,113.25,22,,percent of total billed charges,,,412.23,91,,percent of total billed charges,,,430.35,95,,percent of total billed charges,,,375.99,83,,percent of total billed charges,,,375.99,83,,percent of total billed charges,,,,,,,,,,,,,,,375.99,83,,percent of total billed charges,,,430.35,95,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,371.46,82,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,385.05,85,,percent of total billed charges,,113.25,430.35,
ISLET CELL ANTIBODY,25200547,CDM,86341,CPT,300,RC,outpatient,,226,226,,191.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.5,22,,percent of total billed charges,,,,,,,,,203.4,90,,percent of total billed charges,,,187.13,82.8,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,,,,,,,,198.88,88,,percent of total billed charges,,,,,,,,,172.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.5,22,,percent of total billed charges,,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,,,,,,,,,,,,,187.58,83,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,185.32,82,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,56.5,214.7,
"HYDROXYPROLINE TOTAL, URINE (24-HOUR)",25200548,CDM,83505,CPT,300,RC,outpatient,,520,520,,441.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130,22,,percent of total billed charges,,,,,,,,,468,90,,percent of total billed charges,,,430.56,82.8,,percent of total billed charges,,,442,85,,percent of total billed charges,,,,,,,,,457.6,88,,percent of total billed charges,,,,,,,,,397.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130,22,,percent of total billed charges,,,473.2,91,,percent of total billed charges,,,494,95,,percent of total billed charges,,,431.6,83,,percent of total billed charges,,,431.6,83,,percent of total billed charges,,,,,,,,,,,,,,,431.6,83,,percent of total billed charges,,,494,95,,percent of total billed charges,,,468,90,,percent of total billed charges,,,468,90,,percent of total billed charges,,,426.4,82,,percent of total billed charges,,,468,90,,percent of total billed charges,,,442,85,,percent of total billed charges,,130,494,
HUNTINGTON DISEASE ANALYSIS,25200549,CDM,81271,CPT,300,RC,outpatient,,511,511,,433.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.75,22,,percent of total billed charges,,,,,,,,,459.9,90,,percent of total billed charges,,,423.11,82.8,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,,,,,,,,449.68,88,,percent of total billed charges,,,,,,,,,390.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.75,22,,percent of total billed charges,,,465.01,91,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,,,,,,,,,,,,,424.13,83,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,419.02,82,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,127.75,485.45,
CULTURE THROAT,25200550,CDM,87081,CPT,300,RC,outpatient,,171,171,,145.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.75,22,,percent of total billed charges,,,,,,,,,153.9,90,,percent of total billed charges,,,141.59,82.8,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,,,,,,,,150.48,88,,percent of total billed charges,,,,,,,,,130.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.75,22,,percent of total billed charges,,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,,,,,,,,,,,,,141.93,83,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,140.22,82,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,42.75,162.45,
X RHC HEMOGLOBIN,25200551,CDM,85018,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
HEPARIN INDUCED PLT AB,25200552,CDM,86022,CPT,300,RC,outpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.75,22,,percent of total billed charges,,,,,,,,,236.7,90,,percent of total billed charges,,,217.76,82.8,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.75,22,,percent of total billed charges,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,65.75,249.85,
CULTURE NEG STREP SCR CONFIRMATION,25200553,CDM,87081,CPT,300,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
"HEPATITIS C RNA, QT rfx geno",25200555,CDM,87522,CPT,300,RC,outpatient,,936,936,,794.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,234,22,,percent of total billed charges,,,,,,,,,842.4,90,,percent of total billed charges,,,775.01,82.8,,percent of total billed charges,,,795.6,85,,percent of total billed charges,,,,,,,,,823.68,88,,percent of total billed charges,,,,,,,,,715.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,234,22,,percent of total billed charges,,,851.76,91,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,,,,,,,,,,,,,776.88,83,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,767.52,82,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,795.6,85,,percent of total billed charges,,234,889.2,
.SEROTONIN RELEASE ASSAY,25200556,CDM,86022,CPT,300,RC,outpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.75,22,,percent of total billed charges,,,,,,,,,236.7,90,,percent of total billed charges,,,217.76,82.8,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.75,22,,percent of total billed charges,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,65.75,249.85,
HEPARIN ANTI XA (LMWH),25200557,CDM,85520,CPT,300,RC,outpatient,,282,282,,239.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.5,22,,percent of total billed charges,,,,,,,,,253.8,90,,percent of total billed charges,,,233.5,82.8,,percent of total billed charges,,,239.7,85,,percent of total billed charges,,,,,,,,,248.16,88,,percent of total billed charges,,,,,,,,,215.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70.5,22,,percent of total billed charges,,,256.62,91,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,,,,,,,,,,,,,234.06,83,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,231.24,82,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,239.7,85,,percent of total billed charges,,70.5,267.9,
ISOHEMAGGLUTIN TITER,25200558,CDM,86940,CPT,300,RC,outpatient,,397,397,,337.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,99.25,22,,percent of total billed charges,,,,,,,,,357.3,90,,percent of total billed charges,,,328.72,82.8,,percent of total billed charges,,,337.45,85,,percent of total billed charges,,,,,,,,,349.36,88,,percent of total billed charges,,,,,,,,,303.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,99.25,22,,percent of total billed charges,,,361.27,91,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,,,,,,,,,,,,,329.51,83,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,325.54,82,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,337.45,85,,percent of total billed charges,,99.25,377.15,
"HEPATITIS C RNA, QUAL NAA",25200559,CDM,87521,CPT,300,RC,outpatient,,803,803,,681.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,200.75,22,,percent of total billed charges,,,,,,,,,722.7,90,,percent of total billed charges,,,664.88,82.8,,percent of total billed charges,,,682.55,85,,percent of total billed charges,,,,,,,,,706.64,88,,percent of total billed charges,,,,,,,,,613.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,200.75,22,,percent of total billed charges,,,730.73,91,,percent of total billed charges,,,762.85,95,,percent of total billed charges,,,666.49,83,,percent of total billed charges,,,666.49,83,,percent of total billed charges,,,,,,,,,,,,,,,666.49,83,,percent of total billed charges,,,762.85,95,,percent of total billed charges,,,722.7,90,,percent of total billed charges,,,722.7,90,,percent of total billed charges,,,658.46,82,,percent of total billed charges,,,722.7,90,,percent of total billed charges,,,682.55,85,,percent of total billed charges,,200.75,762.85,
GLUTAMIC ACID DECARBOXYLASE (CSF),25200560,CDM,86341,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
GLUTAMIC ACID (GAD65),25200561,CDM,86341,CPT,300,RC,outpatient,,568,568,,482.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,142,22,,percent of total billed charges,,,,,,,,,511.2,90,,percent of total billed charges,,,470.3,82.8,,percent of total billed charges,,,482.8,85,,percent of total billed charges,,,,,,,,,499.84,88,,percent of total billed charges,,,,,,,,,433.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,142,22,,percent of total billed charges,,,516.88,91,,percent of total billed charges,,,539.6,95,,percent of total billed charges,,,471.44,83,,percent of total billed charges,,,471.44,83,,percent of total billed charges,,,,,,,,,,,,,,,471.44,83,,percent of total billed charges,,,539.6,95,,percent of total billed charges,,,511.2,90,,percent of total billed charges,,,511.2,90,,percent of total billed charges,,,465.76,82,,percent of total billed charges,,,511.2,90,,percent of total billed charges,,,482.8,85,,percent of total billed charges,,142,539.6,
EBV CHRONIC/ACTIVE INFECTION,25200562,CDM,86663,CPT,300,RC,outpatient,,611,611,,518.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,152.75,22,,percent of total billed charges,,,,,,,,,549.9,90,,percent of total billed charges,,,505.91,82.8,,percent of total billed charges,,,519.35,85,,percent of total billed charges,,,,,,,,,537.68,88,,percent of total billed charges,,,,,,,,,466.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,152.75,22,,percent of total billed charges,,,556.01,91,,percent of total billed charges,,,580.45,95,,percent of total billed charges,,,507.13,83,,percent of total billed charges,,,507.13,83,,percent of total billed charges,,,,,,,,,,,,,,,507.13,83,,percent of total billed charges,,,580.45,95,,percent of total billed charges,,,549.9,90,,percent of total billed charges,,,549.9,90,,percent of total billed charges,,,501.02,82,,percent of total billed charges,,,549.9,90,,percent of total billed charges,,,519.35,85,,percent of total billed charges,,152.75,580.45,
HUMAN HERPES VIRUS 6 PCR,25200563,CDM,87532,CPT,300,RC,outpatient,,674,674,,572.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,168.5,22,,percent of total billed charges,,,,,,,,,606.6,90,,percent of total billed charges,,,558.07,82.8,,percent of total billed charges,,,572.9,85,,percent of total billed charges,,,,,,,,,593.12,88,,percent of total billed charges,,,,,,,,,514.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,168.5,22,,percent of total billed charges,,,613.34,91,,percent of total billed charges,,,640.3,95,,percent of total billed charges,,,559.42,83,,percent of total billed charges,,,559.42,83,,percent of total billed charges,,,,,,,,,,,,,,,559.42,83,,percent of total billed charges,,,640.3,95,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,552.68,82,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,572.9,85,,percent of total billed charges,,168.5,640.3,
HUMAN HERPES VIRUS 6 IGG AB,25200564,CDM,86790,CPT,300,RC,outpatient,,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92,22,,percent of total billed charges,,,,,,,,,331.2,90,,percent of total billed charges,,,304.7,82.8,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92,22,,percent of total billed charges,,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,92,349.6,
ITRACONAZOLE,25200565,CDM,80189,CPT,300,RC,outpatient,,744,744,,631.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,186,22,,percent of total billed charges,,,,,,,,,669.6,90,,percent of total billed charges,,,616.03,82.8,,percent of total billed charges,,,632.4,85,,percent of total billed charges,,,,,,,,,654.72,88,,percent of total billed charges,,,,,,,,,568.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,186,22,,percent of total billed charges,,,677.04,91,,percent of total billed charges,,,706.8,95,,percent of total billed charges,,,617.52,83,,percent of total billed charges,,,617.52,83,,percent of total billed charges,,,,,,,,,,,,,,,617.52,83,,percent of total billed charges,,,706.8,95,,percent of total billed charges,,,669.6,90,,percent of total billed charges,,,669.6,90,,percent of total billed charges,,,610.08,82,,percent of total billed charges,,,669.6,90,,percent of total billed charges,,,632.4,85,,percent of total billed charges,,186,706.8,
HYPERTROPHIC CARDIOMYOPATHY(HCM),25200567,CDM,81405,CPT,300,RC,outpatient,,613,613,,520.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153.25,22,,percent of total billed charges,,,,,,,,,551.7,90,,percent of total billed charges,,,507.56,82.8,,percent of total billed charges,,,521.05,85,,percent of total billed charges,,,,,,,,,539.44,88,,percent of total billed charges,,,,,,,,,468.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153.25,22,,percent of total billed charges,,,557.83,91,,percent of total billed charges,,,582.35,95,,percent of total billed charges,,,508.79,83,,percent of total billed charges,,,508.79,83,,percent of total billed charges,,,,,,,,,,,,,,,508.79,83,,percent of total billed charges,,,582.35,95,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,502.66,82,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,521.05,85,,percent of total billed charges,,153.25,582.35,
KOH PREP,25200568,CDM,87220,CPT,300,RC,outpatient,,131,131,,111.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.75,22,,percent of total billed charges,,,,,,,,,117.9,90,,percent of total billed charges,,,108.47,82.8,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,,,,,,,,115.28,88,,percent of total billed charges,,,,,,,,,100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.75,22,,percent of total billed charges,,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,,,,,,,,,,,,,108.73,83,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,107.42,82,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,32.75,124.45,
WET PREP /w KOH,25200569,CDM,87210,CPT,300,RC,outpatient,,131,131,,111.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.75,22,,percent of total billed charges,,,,,,,,,117.9,90,,percent of total billed charges,,,108.47,82.8,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,,,,,,,,115.28,88,,percent of total billed charges,,,,,,,,,100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.75,22,,percent of total billed charges,,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,,,,,,,,,,,,,108.73,83,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,107.42,82,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,32.75,124.45,
BUPROPION,25200570,CDM,80299,CPT,300,RC,outpatient,,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62,22,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,205.34,82.8,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62,22,,percent of total billed charges,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,62,235.6,
VON WILLEBRAND FACTOR ANTIGEN,25200571,CDM,85245,CPT,300,RC,outpatient,,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.5,22,,percent of total billed charges,,,,,,,,,239.4,90,,percent of total billed charges,,,220.25,82.8,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.5,22,,percent of total billed charges,,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,66.5,252.7,
VON WILLEBRAND FACTOR ACTIVITY,25200573,CDM,85246,CPT,300,RC,outpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,105,22,,percent of total billed charges,,,,,,,,,378,90,,percent of total billed charges,,,347.76,82.8,,percent of total billed charges,,,357,85,,percent of total billed charges,,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,105,22,,percent of total billed charges,,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,105,399,
EBV EA (EARLY ANTIGEN  AB),25200574,CDM,86663,CPT,300,RC,outpatient,,117,117,,99.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.25,22,,percent of total billed charges,,,,,,,,,105.3,90,,percent of total billed charges,,,96.88,82.8,,percent of total billed charges,,,99.45,85,,percent of total billed charges,,,,,,,,,102.96,88,,percent of total billed charges,,,,,,,,,89.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.25,22,,percent of total billed charges,,,106.47,91,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,,,,,,,,,,,,,97.11,83,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,95.94,82,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,99.45,85,,percent of total billed charges,,29.25,111.15,
ARIXTRA,25200575,CDM,85520,CPT,300,RC,outpatient,,308,308,,261.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77,22,,percent of total billed charges,,,,,,,,,277.2,90,,percent of total billed charges,,,255.02,82.8,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,,,,,,,,271.04,88,,percent of total billed charges,,,,,,,,,235.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77,22,,percent of total billed charges,,,280.28,91,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,,,,,,,,,,,,,255.64,83,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,252.56,82,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,77,292.6,
..HEPATITIS C DRUG RESISTANCE,25200576,CDM,87900,CPT,300,RC,outpatient,,444,444,,376.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,111,22,,percent of total billed charges,,,,,,,,,399.6,90,,percent of total billed charges,,,367.63,82.8,,percent of total billed charges,,,377.4,85,,percent of total billed charges,,,,,,,,,390.72,88,,percent of total billed charges,,,,,,,,,339.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,111,22,,percent of total billed charges,,,404.04,91,,percent of total billed charges,,,421.8,95,,percent of total billed charges,,,368.52,83,,percent of total billed charges,,,368.52,83,,percent of total billed charges,,,,,,,,,,,,,,,368.52,83,,percent of total billed charges,,,421.8,95,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,364.08,82,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,377.4,85,,percent of total billed charges,,111,421.8,
..HEPATITIS C VIRUS,25200577,CDM,87902,CPT,300,RC,outpatient,,1329,1329,,1128.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,332.25,22,,percent of total billed charges,,,,,,,,,1196.1,90,,percent of total billed charges,,,1100.41,82.8,,percent of total billed charges,,,1129.65,85,,percent of total billed charges,,,,,,,,,1169.52,88,,percent of total billed charges,,,,,,,,,1015.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,332.25,22,,percent of total billed charges,,,1209.39,91,,percent of total billed charges,,,1262.55,95,,percent of total billed charges,,,1103.07,83,,percent of total billed charges,,,1103.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1103.07,83,,percent of total billed charges,,,1262.55,95,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1089.78,82,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1129.65,85,,percent of total billed charges,,332.25,1262.55,
"HEPATITIS C, RNA, NAA, QUAL",25200580,CDM,87521,CPT,300,RC,outpatient,,219,219,,185.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.75,22,,percent of total billed charges,,,,,,,,,197.1,90,,percent of total billed charges,,,181.33,82.8,,percent of total billed charges,,,186.15,85,,percent of total billed charges,,,,,,,,,192.72,88,,percent of total billed charges,,,,,,,,,167.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.75,22,,percent of total billed charges,,,199.29,91,,percent of total billed charges,,,208.05,95,,percent of total billed charges,,,181.77,83,,percent of total billed charges,,,181.77,83,,percent of total billed charges,,,,,,,,,,,,,,,181.77,83,,percent of total billed charges,,,208.05,95,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,179.58,82,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,186.15,85,,percent of total billed charges,,54.75,208.05,
IA2 AUTOANTIBODY,25200581,CDM,86337,CPT,300,RC,outpatient,,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43,22,,percent of total billed charges,,,,,,,,,154.8,90,,percent of total billed charges,,,142.42,82.8,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43,22,,percent of total billed charges,,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,43,163.4,
HEPATITIS C GT1aNS5A,25200582,CDM,87522,CPT,300,RC,outpatient,,1013,1013,,860.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,253.25,22,,percent of total billed charges,,,,,,,,,911.7,90,,percent of total billed charges,,,838.76,82.8,,percent of total billed charges,,,861.05,85,,percent of total billed charges,,,,,,,,,891.44,88,,percent of total billed charges,,,,,,,,,773.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,253.25,22,,percent of total billed charges,,,921.83,91,,percent of total billed charges,,,962.35,95,,percent of total billed charges,,,840.79,83,,percent of total billed charges,,,840.79,83,,percent of total billed charges,,,,,,,,,,,,,,,840.79,83,,percent of total billed charges,,,962.35,95,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,830.66,82,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,861.05,85,,percent of total billed charges,,253.25,962.35,
FUNGAL EXAM THROAT,25200583,CDM,87210,CPT,300,RC,outpatient,,131,131,,111.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.75,22,,percent of total billed charges,,,,,,,,,117.9,90,,percent of total billed charges,,,108.47,82.8,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,,,,,,,,115.28,88,,percent of total billed charges,,,,,,,,,100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.75,22,,percent of total billed charges,,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,,,,,,,,,,,,,108.73,83,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,107.42,82,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,32.75,124.45,
LDH,25200584,CDM,83615,CPT,300,RC,outpatient,,165,165,,140.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.25,22,,percent of total billed charges,,,,,,,,,148.5,90,,percent of total billed charges,,,136.62,82.8,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,,,,,,,,145.2,88,,percent of total billed charges,,,,,,,,,126.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.25,22,,percent of total billed charges,,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,135.3,82,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,41.25,156.75,
HUMAN EPIDIDYMIS PROTEIN 4,25200585,CDM,86305,CPT,300,RC,outpatient,,648,648,,550.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,162,22,,percent of total billed charges,,,,,,,,,583.2,90,,percent of total billed charges,,,536.54,82.8,,percent of total billed charges,,,550.8,85,,percent of total billed charges,,,,,,,,,570.24,88,,percent of total billed charges,,,,,,,,,495.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,162,22,,percent of total billed charges,,,589.68,91,,percent of total billed charges,,,615.6,95,,percent of total billed charges,,,537.84,83,,percent of total billed charges,,,537.84,83,,percent of total billed charges,,,,,,,,,,,,,,,537.84,83,,percent of total billed charges,,,615.6,95,,percent of total billed charges,,,583.2,90,,percent of total billed charges,,,583.2,90,,percent of total billed charges,,,531.36,82,,percent of total billed charges,,,583.2,90,,percent of total billed charges,,,550.8,85,,percent of total billed charges,,162,615.6,
CULTURE STOOL,25200592,CDM,87045,CPT,300,RC,outpatient,,95,95,,80.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.75,22,,percent of total billed charges,,,,,,,,,85.5,90,,percent of total billed charges,,,78.66,82.8,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,,,,,,,,83.6,88,,percent of total billed charges,,,,,,,,,72.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.75,22,,percent of total billed charges,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,,,,,,,,,,,,,78.85,83,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,77.9,82,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,23.75,90.25,
LABCORP GI,25200593,CDM,87507,CPT,300,RC,outpatient,,813,813,,690.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,203.25,22,,percent of total billed charges,,,,,,,,,731.7,90,,percent of total billed charges,,,673.16,82.8,,percent of total billed charges,,,691.05,85,,percent of total billed charges,,,,,,,,,715.44,88,,percent of total billed charges,,,,,,,,,621.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,203.25,22,,percent of total billed charges,,,739.83,91,,percent of total billed charges,,,772.35,95,,percent of total billed charges,,,674.79,83,,percent of total billed charges,,,674.79,83,,percent of total billed charges,,,,,,,,,,,,,,,674.79,83,,percent of total billed charges,,,772.35,95,,percent of total billed charges,,,731.7,90,,percent of total billed charges,,,731.7,90,,percent of total billed charges,,,666.66,82,,percent of total billed charges,,,731.7,90,,percent of total billed charges,,,691.05,85,,percent of total billed charges,,203.25,772.35,
LITHIUM,25200600,CDM,80178,CPT,300,RC,outpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45,22,,percent of total billed charges,,,,,,,,,162,90,,percent of total billed charges,,,149.04,82.8,,percent of total billed charges,,,153,85,,percent of total billed charges,,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45,22,,percent of total billed charges,,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,45,171,
"MYCOPLASMA PNEUMONIAE ANTIBODY, IGG",25200601,CDM,86738,CPT,300,RC,outpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.5,22,,percent of total billed charges,,,,,,,,,178.2,90,,percent of total billed charges,,,163.94,82.8,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.5,22,,percent of total billed charges,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,49.5,188.1,
"MYCOPLASMA PNEUMONIAE ANTIBODY, IGM",25200602,CDM,86738,CPT,300,RC,outpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.5,22,,percent of total billed charges,,,,,,,,,178.2,90,,percent of total billed charges,,,163.94,82.8,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.5,22,,percent of total billed charges,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,49.5,188.1,
MALARIA BLOOD PARASITES,25200603,CDM,87207,CPT,300,RC,outpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.25,22,,percent of total billed charges,,,,,,,,,98.1,90,,percent of total billed charges,,,90.25,82.8,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.25,22,,percent of total billed charges,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,27.25,103.55,
LEGIONELLA ANTIGEN URINE,25200604,CDM,87449,CPT,300,RC,outpatient,,291,291,,247.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.75,22,,percent of total billed charges,,,,,,,,,261.9,90,,percent of total billed charges,,,240.95,82.8,,percent of total billed charges,,,247.35,85,,percent of total billed charges,,,,,,,,,256.08,88,,percent of total billed charges,,,,,,,,,222.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.75,22,,percent of total billed charges,,,264.81,91,,percent of total billed charges,,,276.45,95,,percent of total billed charges,,,241.53,83,,percent of total billed charges,,,241.53,83,,percent of total billed charges,,,,,,,,,,,,,,,241.53,83,,percent of total billed charges,,,276.45,95,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,238.62,82,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,247.35,85,,percent of total billed charges,,72.75,276.45,
LIPOPROTEIN A,25200605,CDM,83695,CPT,300,RC,outpatient,,182,182,,154.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.5,22,,percent of total billed charges,,,,,,,,,163.8,90,,percent of total billed charges,,,150.7,82.8,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,,,,,,,,160.16,88,,percent of total billed charges,,,,,,,,,139.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.5,22,,percent of total billed charges,,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,149.24,82,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,45.5,172.9,
LEPTIN,25200606,CDM,82397,CPT,300,RC,outpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.75,22,,percent of total billed charges,,,,,,,,,189.9,90,,percent of total billed charges,,,174.71,82.8,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.75,22,,percent of total billed charges,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,52.75,200.45,
LP-PLA2,25200607,CDM,83698,CPT,300,RC,outpatient,,264,264,,224.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66,22,,percent of total billed charges,,,,,,,,,237.6,90,,percent of total billed charges,,,218.59,82.8,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,,,,,,,,232.32,88,,percent of total billed charges,,,,,,,,,201.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66,22,,percent of total billed charges,,,240.24,91,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,,,,,,,,,,,,,219.12,83,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,216.48,82,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,66,250.8,
LIPOPROTEIN PHENOTYPING,25200608,CDM,83700,CPT,300,RC,outpatient,,278,278,,236.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.5,22,,percent of total billed charges,,,,,,,,,250.2,90,,percent of total billed charges,,,230.18,82.8,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,,,,,,,,244.64,88,,percent of total billed charges,,,,,,,,,212.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.5,22,,percent of total billed charges,,,252.98,91,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,,,,,,,,,,,,,230.74,83,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,227.96,82,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,69.5,264.1,
HEMOSIDERIN QUAL UNINE,25200617,CDM,83070,CPT,300,RC,outpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.75,22,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,45.54,82.8,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.75,22,,percent of total billed charges,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,13.75,52.25,
HEPATIC FUNCTION PANEL,25200618,CDM,80076,CPT,300,RC,outpatient,,269,269,,228.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.25,22,,percent of total billed charges,,,,,,,,,242.1,90,,percent of total billed charges,,,222.73,82.8,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,,,,,,,,236.72,88,,percent of total billed charges,,,,,,,,,205.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.25,22,,percent of total billed charges,,,244.79,91,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,,,,,,,,,,,,,223.27,83,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,220.58,82,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,67.25,255.55,
SS-A (RO) AB IGG,25200621,CDM,86235,CPT,300,RC,outpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.25,22,,percent of total billed charges,,,,,,,,,195.3,90,,percent of total billed charges,,,179.68,82.8,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.25,22,,percent of total billed charges,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,54.25,206.15,
SS-B (LA) AB IGG,25200622,CDM,86235,CPT,300,RC,outpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.25,22,,percent of total billed charges,,,,,,,,,195.3,90,,percent of total billed charges,,,179.68,82.8,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.25,22,,percent of total billed charges,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,54.25,206.15,
SCL-70 ANTIBODIES,25200623,CDM,86235,CPT,300,RC,outpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.25,22,,percent of total billed charges,,,,,,,,,195.3,90,,percent of total billed charges,,,179.68,82.8,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.25,22,,percent of total billed charges,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,54.25,206.15,
CYTOMEGALOVIRUS QT PCR,25200624,CDM,87497,CPT,300,RC,outpatient,,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.25,22,,percent of total billed charges,,,,,,,,,422.1,90,,percent of total billed charges,,,388.33,82.8,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.25,22,,percent of total billed charges,,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,117.25,445.55,
MAGNESIUM,25200626,CDM,83735,CPT,300,RC,outpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.25,22,,percent of total billed charges,,,,,,,,,195.3,90,,percent of total billed charges,,,179.68,82.8,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.25,22,,percent of total billed charges,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,54.25,206.15,
CYTOMEGALOVIRUS DNA QT PCR,25200627,CDM,87497,CPT,300,RC,outpatient,,643,643,,545.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,160.75,22,,percent of total billed charges,,,,,,,,,578.7,90,,percent of total billed charges,,,532.4,82.8,,percent of total billed charges,,,546.55,85,,percent of total billed charges,,,,,,,,,565.84,88,,percent of total billed charges,,,,,,,,,491.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,160.75,22,,percent of total billed charges,,,585.13,91,,percent of total billed charges,,,610.85,95,,percent of total billed charges,,,533.69,83,,percent of total billed charges,,,533.69,83,,percent of total billed charges,,,,,,,,,,,,,,,533.69,83,,percent of total billed charges,,,610.85,95,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,527.26,82,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,546.55,85,,percent of total billed charges,,160.75,610.85,
MYCOPHENALATE / MYCOPHENOLIC ACID,25200628,CDM,80180,CPT,300,RC,outpatient,,290,290,,246.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.5,22,,percent of total billed charges,,,,,,,,,261,90,,percent of total billed charges,,,240.12,82.8,,percent of total billed charges,,,246.5,85,,percent of total billed charges,,,,,,,,,255.2,88,,percent of total billed charges,,,,,,,,,221.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.5,22,,percent of total billed charges,,,263.9,91,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,,,,,,,,,,,,,240.7,83,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,261,90,,percent of total billed charges,,,261,90,,percent of total billed charges,,,237.8,82,,percent of total billed charges,,,261,90,,percent of total billed charges,,,246.5,85,,percent of total billed charges,,72.5,275.5,
METANEPHRINES PLASMA FREE,25200629,CDM,83835,CPT,300,RC,outpatient,,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.75,22,,percent of total billed charges,,,,,,,,,542.7,90,,percent of total billed charges,,,499.28,82.8,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.75,22,,percent of total billed charges,,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,150.75,572.85,
MYOCARDIAL ANTIBODY,25200630,CDM,86255,CPT,300,RC,outpatient,,275,275,,233.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.75,22,,percent of total billed charges,,,,,,,,,247.5,90,,percent of total billed charges,,,227.7,82.8,,percent of total billed charges,,,233.75,85,,percent of total billed charges,,,,,,,,,242,88,,percent of total billed charges,,,,,,,,,210.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.75,22,,percent of total billed charges,,,250.25,91,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,,,,,,,,,,,,,228.25,83,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,225.5,82,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,233.75,85,,percent of total billed charges,,68.75,261.25,
VASOACTIVE INTESTINAL POLYPEPTIDE (VIP),25200631,CDM,84586,CPT,300,RC,outpatient,,578,578,,490.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,144.5,22,,percent of total billed charges,,,,,,,,,520.2,90,,percent of total billed charges,,,478.58,82.8,,percent of total billed charges,,,491.3,85,,percent of total billed charges,,,,,,,,,508.64,88,,percent of total billed charges,,,,,,,,,441.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,144.5,22,,percent of total billed charges,,,525.98,91,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,,,,,,,,,,,,,479.74,83,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,473.96,82,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,491.3,85,,percent of total billed charges,,144.5,549.1,
AMNISURE (ROM) TEST,25200632,CDM,84112,CPT,300,RC,outpatient,,192,192,,163.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48,22,,percent of total billed charges,,,,,,,,,172.8,90,,percent of total billed charges,,,158.98,82.8,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,,,,,,,,168.96,88,,percent of total billed charges,,,,,,,,,146.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48,22,,percent of total billed charges,,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,,,,,,,,,,,,,159.36,83,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,157.44,82,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,48,182.4,
METHAMPHETAMINES D&L,25200633,CDM,80324,CPT,300,RC,outpatient,,204.75,204.75,,173.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.19,22,,percent of total billed charges,,,,,,,,,184.28,90,,percent of total billed charges,,,169.53,82.8,,percent of total billed charges,,,174.04,85,,percent of total billed charges,,,,,,,,,180.18,88,,percent of total billed charges,,,,,,,,,156.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.19,22,,percent of total billed charges,,,186.32,91,,percent of total billed charges,,,194.51,95,,percent of total billed charges,,,169.94,83,,percent of total billed charges,,,169.94,83,,percent of total billed charges,,,,,,,,,,,,,,,169.94,83,,percent of total billed charges,,,194.51,95,,percent of total billed charges,,,184.28,90,,percent of total billed charges,,,184.28,90,,percent of total billed charges,,,167.9,82,,percent of total billed charges,,,184.28,90,,percent of total billed charges,,,174.04,85,,percent of total billed charges,,51.19,194.51,
MONO TEST,25200634,CDM,86308,CPT,300,RC,outpatient,,133,133,,112.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.25,22,,percent of total billed charges,,,,,,,,,119.7,90,,percent of total billed charges,,,110.12,82.8,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,,,,,,,,117.04,88,,percent of total billed charges,,,,,,,,,101.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.25,22,,percent of total billed charges,,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,,,,,,,,,,,,,110.39,83,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,109.06,82,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,33.25,126.35,
THIORIDAZINE,25200635,CDM,G6057,HCPCS,300,RC,outpatient,,316,316,,268.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79,22,,percent of total billed charges,,,,,,,,,284.4,90,,percent of total billed charges,,,261.65,82.8,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,,,,,,,,278.08,88,,percent of total billed charges,,,,,,,,,241.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79,22,,percent of total billed charges,,,287.56,91,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,,,,,,,,,,,,,262.28,83,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,259.12,82,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,79,300.2,
.SM ANTIBODIES(SMITH),25200636,CDM,86235,CPT,300,RC,outpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.25,22,,percent of total billed charges,,,,,,,,,195.3,90,,percent of total billed charges,,,179.68,82.8,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.25,22,,percent of total billed charges,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,54.25,206.15,
"CATECHOLAMINES, RANDOM URINE",25200637,CDM,82384,CPT,300,RC,outpatient,,485,485,,411.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,121.25,22,,percent of total billed charges,,,,,,,,,436.5,90,,percent of total billed charges,,,401.58,82.8,,percent of total billed charges,,,412.25,85,,percent of total billed charges,,,,,,,,,426.8,88,,percent of total billed charges,,,,,,,,,370.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,121.25,22,,percent of total billed charges,,,441.35,91,,percent of total billed charges,,,460.75,95,,percent of total billed charges,,,402.55,83,,percent of total billed charges,,,402.55,83,,percent of total billed charges,,,,,,,,,,,,,,,402.55,83,,percent of total billed charges,,,460.75,95,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,397.7,82,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,412.25,85,,percent of total billed charges,,121.25,460.75,
RIBOSOMAL P ANTIBODY,25200638,CDM,83516,CPT,300,RC,outpatient,,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.5,22,,percent of total billed charges,,,,,,,,,275.4,90,,percent of total billed charges,,,253.37,82.8,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.5,22,,percent of total billed charges,,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,76.5,290.7,
CATECHOLAMINES PLASMA,25200639,CDM,82384,CPT,300,RC,outpatient,,366,366,,310.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.5,22,,percent of total billed charges,,,,,,,,,329.4,90,,percent of total billed charges,,,303.05,82.8,,percent of total billed charges,,,311.1,85,,percent of total billed charges,,,,,,,,,322.08,88,,percent of total billed charges,,,,,,,,,279.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.5,22,,percent of total billed charges,,,333.06,91,,percent of total billed charges,,,347.7,95,,percent of total billed charges,,,303.78,83,,percent of total billed charges,,,303.78,83,,percent of total billed charges,,,,,,,,,,,,,,,303.78,83,,percent of total billed charges,,,347.7,95,,percent of total billed charges,,,329.4,90,,percent of total billed charges,,,329.4,90,,percent of total billed charges,,,300.12,82,,percent of total billed charges,,,329.4,90,,percent of total billed charges,,,311.1,85,,percent of total billed charges,,91.5,347.7,
MERCURY BLOOD,25200640,CDM,83825,CPT,300,RC,outpatient,,315,315,,267.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.75,22,,percent of total billed charges,,,,,,,,,283.5,90,,percent of total billed charges,,,260.82,82.8,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,,,,,,,,277.2,88,,percent of total billed charges,,,,,,,,,240.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.75,22,,percent of total billed charges,,,286.65,91,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,,,,,,,,,,,,,261.45,83,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,258.3,82,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,78.75,299.25,
STRIATED MUSCLE AB,25200641,CDM,86255,CPT,300,RC,outpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.75,22,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,68.72,82.8,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.75,22,,percent of total billed charges,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,20.75,78.85,
SCL-70 AB W/CONFIRM,25200642,CDM,86235,CPT,300,RC,outpatient,,341,341,,289.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.25,22,,percent of total billed charges,,,,,,,,,306.9,90,,percent of total billed charges,,,282.35,82.8,,percent of total billed charges,,,289.85,85,,percent of total billed charges,,,,,,,,,300.08,88,,percent of total billed charges,,,,,,,,,260.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.25,22,,percent of total billed charges,,,310.31,91,,percent of total billed charges,,,323.95,95,,percent of total billed charges,,,283.03,83,,percent of total billed charges,,,283.03,83,,percent of total billed charges,,,,,,,,,,,,,,,283.03,83,,percent of total billed charges,,,323.95,95,,percent of total billed charges,,,306.9,90,,percent of total billed charges,,,306.9,90,,percent of total billed charges,,,279.62,82,,percent of total billed charges,,,306.9,90,,percent of total billed charges,,,289.85,85,,percent of total billed charges,,85.25,323.95,
"OCCULT BLOOD, GASTRIC FLUID",25200643,CDM,82271,CPT,300,RC,outpatient,,63,63,,53.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.75,22,,percent of total billed charges,,,,,,,,,56.7,90,,percent of total billed charges,,,52.16,82.8,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,,,,,,,,55.44,88,,percent of total billed charges,,,,,,,,,48.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.75,22,,percent of total billed charges,,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,,,,,,,,,,,,,52.29,83,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,51.66,82,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,15.75,59.85,
.OCCULT BLOOD SCREEN FECES 1-3,25200644,CDM,82270,CPT,300,RC,outpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.75,22,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,48.85,82.8,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,,,,,,,,51.92,88,,percent of total billed charges,,,,,,,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.75,22,,percent of total billed charges,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,14.75,56.05,
LYSOZYME SERUM,25200645,CDM,85549,CPT,300,RC,outpatient,,99,99,,84.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.75,22,,percent of total billed charges,,,,,,,,,89.1,90,,percent of total billed charges,,,81.97,82.8,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,,,,,,,,87.12,88,,percent of total billed charges,,,,,,,,,75.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.75,22,,percent of total billed charges,,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,,,,,,,,,,,,,82.17,83,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,81.18,82,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,24.75,94.05,
SMOOTH MUSCLE ANTIBODY (IgG),25200646,CDM,86255,CPT,300,RC,outpatient,,179,179,,151.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.75,22,,percent of total billed charges,,,,,,,,,161.1,90,,percent of total billed charges,,,148.21,82.8,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,,,,,,,,157.52,88,,percent of total billed charges,,,,,,,,,136.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.75,22,,percent of total billed charges,,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,146.78,82,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,44.75,170.05,
JCV AB RFX INHIBITION,25200647,CDM,86711,CPT,300,RC,outpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.75,22,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,68.72,82.8,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.75,22,,percent of total billed charges,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,20.75,78.85,
VASOACTIVE INTESTINAL POLYPEPTIDE,25200648,CDM,84586,CPT,300,RC,outpatient,,201,201,,170.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.25,22,,percent of total billed charges,,,,,,,,,180.9,90,,percent of total billed charges,,,166.43,82.8,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,,,,,,,,176.88,88,,percent of total billed charges,,,,,,,,,153.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.25,22,,percent of total billed charges,,,182.91,91,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,,,,,,,,,,,,,166.83,83,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,164.82,82,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,50.25,190.95,
PANCREATIC POLYPEPTIDE,25200649,CDM,84586,CPT,300,RC,outpatient,,310,310,,263.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.5,22,,percent of total billed charges,,,,,,,,,279,90,,percent of total billed charges,,,256.68,82.8,,percent of total billed charges,,,263.5,85,,percent of total billed charges,,,,,,,,,272.8,88,,percent of total billed charges,,,,,,,,,236.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.5,22,,percent of total billed charges,,,282.1,91,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,,,,,,,,,,,,,257.3,83,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,279,90,,percent of total billed charges,,,279,90,,percent of total billed charges,,,254.2,82,,percent of total billed charges,,,279,90,,percent of total billed charges,,,263.5,85,,percent of total billed charges,,77.5,294.5,
THIOPURINE METABOLITES,25200650,CDM,80299,CPT,300,RC,outpatient,,768,768,,652.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192,22,,percent of total billed charges,,,,,,,,,691.2,90,,percent of total billed charges,,,635.9,82.8,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,,,,,,,,675.84,88,,percent of total billed charges,,,,,,,,,586.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192,22,,percent of total billed charges,,,698.88,91,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,,,,,,,,,,,,,637.44,83,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,629.76,82,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,192,729.6,
THIOPURINE ACTIVITY,25200651,CDM,83789,CPT,300,RC,outpatient,,517,517,,438.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,129.25,22,,percent of total billed charges,,,,,,,,,465.3,90,,percent of total billed charges,,,428.08,82.8,,percent of total billed charges,,,439.45,85,,percent of total billed charges,,,,,,,,,454.96,88,,percent of total billed charges,,,,,,,,,394.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,129.25,22,,percent of total billed charges,,,470.47,91,,percent of total billed charges,,,491.15,95,,percent of total billed charges,,,429.11,83,,percent of total billed charges,,,429.11,83,,percent of total billed charges,,,,,,,,,,,,,,,429.11,83,,percent of total billed charges,,,491.15,95,,percent of total billed charges,,,465.3,90,,percent of total billed charges,,,465.3,90,,percent of total billed charges,,,423.94,82,,percent of total billed charges,,,465.3,90,,percent of total billed charges,,,439.45,85,,percent of total billed charges,,129.25,491.15,
JO-1 ANTIBODY,25200652,CDM,86235,CPT,300,RC,outpatient,,39,39,,33.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.75,22,,percent of total billed charges,,,,,,,,,35.1,90,,percent of total billed charges,,,32.29,82.8,,percent of total billed charges,,,33.15,85,,percent of total billed charges,,,,,,,,,34.32,88,,percent of total billed charges,,,,,,,,,29.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.75,22,,percent of total billed charges,,,35.49,91,,percent of total billed charges,,,37.05,95,,percent of total billed charges,,,32.37,83,,percent of total billed charges,,,32.37,83,,percent of total billed charges,,,,,,,,,,,,,,,32.37,83,,percent of total billed charges,,,37.05,95,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,31.98,82,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,33.15,85,,percent of total billed charges,,9.75,37.05,
THIOPURINE METHYLTRANSFERASE GENO,25200653,CDM,81335,CPT,300,RC,outpatient,,579,579,,491.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,144.75,22,,percent of total billed charges,,,,,,,,,521.1,90,,percent of total billed charges,,,479.41,82.8,,percent of total billed charges,,,492.15,85,,percent of total billed charges,,,,,,,,,509.52,88,,percent of total billed charges,,,,,,,,,442.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,144.75,22,,percent of total billed charges,,,526.89,91,,percent of total billed charges,,,550.05,95,,percent of total billed charges,,,480.57,83,,percent of total billed charges,,,480.57,83,,percent of total billed charges,,,,,,,,,,,,,,,480.57,83,,percent of total billed charges,,,550.05,95,,percent of total billed charges,,,521.1,90,,percent of total billed charges,,,521.1,90,,percent of total billed charges,,,474.78,82,,percent of total billed charges,,,521.1,90,,percent of total billed charges,,,492.15,85,,percent of total billed charges,,144.75,550.05,
OCCULT BLOOD SCREEN FECES FIT 1-3,25200655,CDM,82274,CPT,300,RC,outpatient,,92,92,,78.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23,22,,percent of total billed charges,,,,,,,,,82.8,90,,percent of total billed charges,,,76.18,82.8,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,,,,,,,,80.96,88,,percent of total billed charges,,,,,,,,,70.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23,22,,percent of total billed charges,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,,,,,,,,,,,,,76.36,83,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,75.44,82,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,23,87.4,
"OCCULT BLOOD DIAGNOSTIC, FIT",25200656,CDM,82274,CPT,300,RC,outpatient,,321,321,,272.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.25,22,,percent of total billed charges,,,,,,,,,288.9,90,,percent of total billed charges,,,265.79,82.8,,percent of total billed charges,,,272.85,85,,percent of total billed charges,,,,,,,,,282.48,88,,percent of total billed charges,,,,,,,,,245.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.25,22,,percent of total billed charges,,,292.11,91,,percent of total billed charges,,,304.95,95,,percent of total billed charges,,,266.43,83,,percent of total billed charges,,,266.43,83,,percent of total billed charges,,,,,,,,,,,,,,,266.43,83,,percent of total billed charges,,,304.95,95,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,263.22,82,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,272.85,85,,percent of total billed charges,,80.25,304.95,
OX CARBAZEPINE,25200660,CDM,80183,CPT,300,RC,outpatient,,387,387,,328.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.75,22,,percent of total billed charges,,,,,,,,,348.3,90,,percent of total billed charges,,,320.44,82.8,,percent of total billed charges,,,328.95,85,,percent of total billed charges,,,,,,,,,340.56,88,,percent of total billed charges,,,,,,,,,295.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.75,22,,percent of total billed charges,,,352.17,91,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,,,,,,,,,,,,,321.21,83,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,317.34,82,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,328.95,85,,percent of total billed charges,,96.75,367.65,
.OLIGOCLONAL BANDS CSF & SERUM,25200661,CDM,83916,CPT,300,RC,outpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.75,22,,percent of total billed charges,,,,,,,,,189.9,90,,percent of total billed charges,,,174.71,82.8,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.75,22,,percent of total billed charges,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,52.75,200.45,
OXYCODONE URINE CONFIRM,25200663,CDM,80365,CPT,300,RC,outpatient,,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.25,22,,percent of total billed charges,,,,,,,,,155.7,90,,percent of total billed charges,,,143.24,82.8,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.25,22,,percent of total billed charges,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,43.25,164.35,
ANTI-RNA POLYMERASE III,25200667,CDM,86235,CPT,300,RC,outpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.25,22,,percent of total billed charges,,,,,,,,,195.3,90,,percent of total billed charges,,,179.68,82.8,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.25,22,,percent of total billed charges,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,54.25,206.15,
ANTI-HMGCR,25200668,CDM,83516,CPT,300,RC,outpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.25,22,,percent of total billed charges,,,,,,,,,195.3,90,,percent of total billed charges,,,179.68,82.8,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.25,22,,percent of total billed charges,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,54.25,206.15,
VMA URINE (24-HOUR),25200675,CDM,84585,CPT,300,RC,outpatient,,278,278,,236.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.5,22,,percent of total billed charges,,,,,,,,,250.2,90,,percent of total billed charges,,,230.18,82.8,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,,,,,,,,244.64,88,,percent of total billed charges,,,,,,,,,212.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.5,22,,percent of total billed charges,,,252.98,91,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,,,,,,,,,,,,,230.74,83,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,227.96,82,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,69.5,264.1,
PH BODY FLUIDS,25200682,CDM,83986,CPT,300,RC,outpatient,,79,79,,67.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.75,22,,percent of total billed charges,,,,,,,,,71.1,90,,percent of total billed charges,,,65.41,82.8,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,,,,,,,,69.52,88,,percent of total billed charges,,,,,,,,,60.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.75,22,,percent of total billed charges,,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,,,,,,,,,,,,,65.57,83,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,64.78,82,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,19.75,75.05,
PHOSPHORUS SERUM,25200683,CDM,84100,CPT,300,RC,outpatient,,116,116,,98.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29,22,,percent of total billed charges,,,,,,,,,104.4,90,,percent of total billed charges,,,96.05,82.8,,percent of total billed charges,,,98.6,85,,percent of total billed charges,,,,,,,,,102.08,88,,percent of total billed charges,,,,,,,,,88.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29,22,,percent of total billed charges,,,105.56,91,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,,,,,,,,,,,,,96.28,83,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,95.12,82,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,98.6,85,,percent of total billed charges,,29,110.2,
PHOSPHORUS URINE,25200684,CDM,84105,CPT,300,RC,outpatient,,79,79,,67.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.75,22,,percent of total billed charges,,,,,,,,,71.1,90,,percent of total billed charges,,,65.41,82.8,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,,,,,,,,69.52,88,,percent of total billed charges,,,,,,,,,60.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.75,22,,percent of total billed charges,,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,,,,,,,,,,,,,65.57,83,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,64.78,82,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,19.75,75.05,
WBC FLUID,25200685,CDM,,,300,RC,outpatient,,6,6,,5.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.5,22,,percent of total billed charges,,,,,,,,,5.4,90,,percent of total billed charges,,,4.97,82.8,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,,,,,,,,5.28,88,,percent of total billed charges,,,,,,,,,4.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.5,22,,percent of total billed charges,,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4.98,83,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,4.92,82,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,1.5,5.7,
".PHOSPHATIDYLSERINE (IGM,IGG,IGA)",25200686,CDM,86148,CPT,300,RC,outpatient,,282,282,,239.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.5,22,,percent of total billed charges,,,,,,,,,253.8,90,,percent of total billed charges,,,233.5,82.8,,percent of total billed charges,,,239.7,85,,percent of total billed charges,,,,,,,,,248.16,88,,percent of total billed charges,,,,,,,,,215.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70.5,22,,percent of total billed charges,,,256.62,91,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,,,,,,,,,,,,,234.06,83,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,231.24,82,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,239.7,85,,percent of total billed charges,,70.5,267.9,
PHOSPHOLIPIDS,25200687,CDM,84311,CPT,300,RC,outpatient,,192,192,,163.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48,22,,percent of total billed charges,,,,,,,,,172.8,90,,percent of total billed charges,,,158.98,82.8,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,,,,,,,,168.96,88,,percent of total billed charges,,,,,,,,,146.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48,22,,percent of total billed charges,,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,,,,,,,,,,,,,159.36,83,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,157.44,82,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,48,182.4,
PENICILLIN V IGE,25200688,CDM,86003,CPT,300,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
PENICILLIN G,25200689,CDM,86003,CPT,300,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
PH STOOL,25200690,CDM,83986,CPT,300,RC,outpatient,,63,63,,53.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.75,22,,percent of total billed charges,,,,,,,,,56.7,90,,percent of total billed charges,,,52.16,82.8,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,,,,,,,,55.44,88,,percent of total billed charges,,,,,,,,,48.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.75,22,,percent of total billed charges,,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,,,,,,,,,,,,,52.29,83,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,51.66,82,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,15.75,59.85,
PINWORM EXAM,25200691,CDM,87172,CPT,300,RC,outpatient,,99,99,,84.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.75,22,,percent of total billed charges,,,,,,,,,89.1,90,,percent of total billed charges,,,81.97,82.8,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,,,,,,,,87.12,88,,percent of total billed charges,,,,,,,,,75.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.75,22,,percent of total billed charges,,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,,,,,,,,,,,,,82.17,83,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,81.18,82,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,24.75,94.05,
ELECTROLYTES STOOL,25200692,CDM,84302,CPT,300,RC,outpatient,,117,117,,99.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.25,22,,percent of total billed charges,,,,,,,,,105.3,90,,percent of total billed charges,,,96.88,82.8,,percent of total billed charges,,,99.45,85,,percent of total billed charges,,,,,,,,,102.96,88,,percent of total billed charges,,,,,,,,,89.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.25,22,,percent of total billed charges,,,106.47,91,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,,,,,,,,,,,,,97.11,83,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,95.94,82,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,99.45,85,,percent of total billed charges,,29.25,111.15,
.POTASSIUM  STOOL,25200693,CDM,84999,CPT,300,RC,outpatient,,117,117,,99.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.25,22,,percent of total billed charges,,,,,,,,,105.3,90,,percent of total billed charges,,,96.88,82.8,,percent of total billed charges,,,99.45,85,,percent of total billed charges,,,,,,,,,102.96,88,,percent of total billed charges,,,,,,,,,89.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.25,22,,percent of total billed charges,,,106.47,91,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,,,,,,,,,,,,,97.11,83,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,95.94,82,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,99.45,85,,percent of total billed charges,,29.25,111.15,
.CHLORIDE STOOL,25200694,CDM,82438,CPT,300,RC,outpatient,,117,117,,99.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.25,22,,percent of total billed charges,,,,,,,,,105.3,90,,percent of total billed charges,,,96.88,82.8,,percent of total billed charges,,,99.45,85,,percent of total billed charges,,,,,,,,,102.96,88,,percent of total billed charges,,,,,,,,,89.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.25,22,,percent of total billed charges,,,106.47,91,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,,,,,,,,,,,,,97.11,83,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,95.94,82,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,99.45,85,,percent of total billed charges,,29.25,111.15,
PENICILLIN V COO2 IGE,25200695,CDM,86003,CPT,300,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
PLATELET COUNT,25200709,CDM,85049,CPT,300,RC,outpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.75,22,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,85.28,82.8,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.75,22,,percent of total billed charges,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,25.75,97.85,
PLASMA HEMOGLOBIN,25200710,CDM,83051,CPT,300,RC,outpatient,,99,99,,84.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.75,22,,percent of total billed charges,,,,,,,,,89.1,90,,percent of total billed charges,,,81.97,82.8,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,,,,,,,,87.12,88,,percent of total billed charges,,,,,,,,,75.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.75,22,,percent of total billed charges,,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,,,,,,,,,,,,,82.17,83,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,81.18,82,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,24.75,94.05,
PLATELET FUNCTION TEST,25200711,CDM,85576,CPT,300,RC,outpatient,,164,164,,139.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41,22,,percent of total billed charges,,,,,,,,,147.6,90,,percent of total billed charges,,,135.79,82.8,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,,,,,,,,144.32,88,,percent of total billed charges,,,,,,,,,125.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41,22,,percent of total billed charges,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,134.48,82,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,41,155.8,
POTASSIUM SERUM,25200725,CDM,84132,CPT,300,RC,outpatient,,100,100,,84.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25,22,,percent of total billed charges,,,,,,,,,90,90,,percent of total billed charges,,,82.8,82.8,,percent of total billed charges,,,85,85,,percent of total billed charges,,,,,,,,,88,88,,percent of total billed charges,,,,,,,,,76.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25,22,,percent of total billed charges,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,83,83,,percent of total billed charges,,,,,,,,,,,,,,,83,83,,percent of total billed charges,,,95,95,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,82,82,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,25,95,
.URINE DIPSTICK ONLY,25200730,CDM,81003,CPT,300,RC,outpatient,,95,95,,80.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.75,22,,percent of total billed charges,,,,,,,,,85.5,90,,percent of total billed charges,,,78.66,82.8,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,,,,,,,,83.6,88,,percent of total billed charges,,,,,,,,,72.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.75,22,,percent of total billed charges,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,,,,,,,,,,,,,78.85,83,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,77.9,82,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,23.75,90.25,
"X RHC HCG, URINE PREGNANCY TEST",25200731,CDM,81025,CPT,300,RC,outpatient,,168,168,,142.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42,22,,percent of total billed charges,,,,,,,,,151.2,90,,percent of total billed charges,,,139.1,82.8,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,,,,,,,,147.84,88,,percent of total billed charges,,,,,,,,,128.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42,22,,percent of total billed charges,,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,,,,,,,,,,,,,139.44,83,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,137.76,82,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,42,159.6,
HCG URINE PREGNANCY TEST,25200733,CDM,81025,CPT,300,RC,outpatient,,190,190,,161.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.5,22,,percent of total billed charges,,,,,,,,,171,90,,percent of total billed charges,,,157.32,82.8,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,,,,,,,,167.2,88,,percent of total billed charges,,,,,,,,,145.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.5,22,,percent of total billed charges,,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,,,,,,,,,,,,,157.7,83,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,155.8,82,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,47.5,180.5,
PREGNENOLONE,25200735,CDM,84140,CPT,300,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
.PRENATAL PROFILE (QUEST),25200741,CDM,80055,CPT,300,RC,outpatient,,400,400,,339.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100,22,,percent of total billed charges,,,,,,,,,360,90,,percent of total billed charges,,,331.2,82.8,,percent of total billed charges,,,340,85,,percent of total billed charges,,,,,,,,,352,88,,percent of total billed charges,,,,,,,,,305.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100,22,,percent of total billed charges,,,364,91,,percent of total billed charges,,,380,95,,percent of total billed charges,,,332,83,,percent of total billed charges,,,332,83,,percent of total billed charges,,,,,,,,,,,,,,,332,83,,percent of total billed charges,,,380,95,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,328,82,,percent of total billed charges,,,360,90,,percent of total billed charges,,,340,85,,percent of total billed charges,,100,380,
.PRENATAL PROFILE,25200742,CDM,80055,CPT,300,RC,outpatient,,400,400,,339.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100,22,,percent of total billed charges,,,,,,,,,360,90,,percent of total billed charges,,,331.2,82.8,,percent of total billed charges,,,340,85,,percent of total billed charges,,,,,,,,,352,88,,percent of total billed charges,,,,,,,,,305.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100,22,,percent of total billed charges,,,364,91,,percent of total billed charges,,,380,95,,percent of total billed charges,,,332,83,,percent of total billed charges,,,332,83,,percent of total billed charges,,,,,,,,,,,,,,,332,83,,percent of total billed charges,,,380,95,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,328,82,,percent of total billed charges,,,360,90,,percent of total billed charges,,,340,85,,percent of total billed charges,,100,380,
PROTEIN TOTAL SERUM,25200758,CDM,84155,CPT,300,RC,outpatient,,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
PROTHROMBIN TIME w/INR,25200766,CDM,85610,CPT,300,RC,outpatient,,174,174,,147.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.5,22,,percent of total billed charges,,,,,,,,,156.6,90,,percent of total billed charges,,,144.07,82.8,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,,,,,,,,153.12,88,,percent of total billed charges,,,,,,,,,132.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.5,22,,percent of total billed charges,,,158.34,91,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,,,,,,,,,,,,,144.42,83,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,142.68,82,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,43.5,165.3,
DRAGU PT w/INR,25200767,CDM,85610,CPT,300,RC,outpatient,,174,174,,147.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.5,22,,percent of total billed charges,,,,,,,,,156.6,90,,percent of total billed charges,,,144.07,82.8,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,,,,,,,,153.12,88,,percent of total billed charges,,,,,,,,,132.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.5,22,,percent of total billed charges,,,158.34,91,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,,,,,,,,,,,,,144.42,83,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,142.68,82,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,43.5,165.3,
PARTIAL THROMBOPLASTIN TIME (PTT),25200774,CDM,85730,CPT,300,RC,outpatient,,187,187,,158.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.75,22,,percent of total billed charges,,,,,,,,,168.3,90,,percent of total billed charges,,,154.84,82.8,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,,,,,,,,164.56,88,,percent of total billed charges,,,,,,,,,142.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.75,22,,percent of total billed charges,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,153.34,82,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,46.75,177.65,
TISSUE THROMBOPLASTIN INHIBITION,25200775,CDM,85705,CPT,300,RC,outpatient,,272,272,,230.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68,22,,percent of total billed charges,,,,,,,,,244.8,90,,percent of total billed charges,,,225.22,82.8,,percent of total billed charges,,,231.2,85,,percent of total billed charges,,,,,,,,,239.36,88,,percent of total billed charges,,,,,,,,,207.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68,22,,percent of total billed charges,,,247.52,91,,percent of total billed charges,,,258.4,95,,percent of total billed charges,,,225.76,83,,percent of total billed charges,,,225.76,83,,percent of total billed charges,,,,,,,,,,,,,,,225.76,83,,percent of total billed charges,,,258.4,95,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,223.04,82,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,231.2,85,,percent of total billed charges,,68,258.4,
REPTILASE,25200776,CDM,85635,CPT,300,RC,outpatient,,244,244,,207.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61,22,,percent of total billed charges,,,,,,,,,219.6,90,,percent of total billed charges,,,202.03,82.8,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,,,,,,,,214.72,88,,percent of total billed charges,,,,,,,,,186.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61,22,,percent of total billed charges,,,222.04,91,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,,,,,,,,,,,,,202.52,83,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,200.08,82,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,61,231.8,
DRAGU PTT,25200777,CDM,85730,CPT,300,RC,outpatient,,187,187,,158.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.75,22,,percent of total billed charges,,,,,,,,,168.3,90,,percent of total billed charges,,,154.84,82.8,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,,,,,,,,164.56,88,,percent of total billed charges,,,,,,,,,142.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.75,22,,percent of total billed charges,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,153.34,82,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,46.75,177.65,
QUINIDINE,25200782,CDM,80194,CPT,300,RC,outpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.75,22,,percent of total billed charges,,,,,,,,,236.7,90,,percent of total billed charges,,,217.76,82.8,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.75,22,,percent of total billed charges,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,65.75,249.85,
QUETIAPINE (SEROQUEL),25200783,CDM,80299,CPT,300,RC,outpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.25,22,,percent of total billed charges,,,,,,,,,414.9,90,,percent of total billed charges,,,381.71,82.8,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.25,22,,percent of total billed charges,,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,115.25,437.95,
SERTRALINE & DESMETHYLSERTRALINE,25200784,CDM,80332,CPT,300,RC,outpatient,,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.5,22,,percent of total billed charges,,,,,,,,,196.2,90,,percent of total billed charges,,,180.5,82.8,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,,,,,,,,191.84,88,,percent of total billed charges,,,,,,,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.5,22,,percent of total billed charges,,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,54.5,207.1,
.....QUANTIFERON TB GOLD (LAB INCUBATED),25200785,CDM,86480,CPT,300,RC,outpatient,,424,424,,359.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,106,22,,percent of total billed charges,,,,,,,,,381.6,90,,percent of total billed charges,,,351.07,82.8,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,,,,,,,,373.12,88,,percent of total billed charges,,,,,,,,,323.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,106,22,,percent of total billed charges,,,385.84,91,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,,,,,,,,,,,,,351.92,83,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,347.68,82,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,106,402.8,
..QUANTIFERON TB  +(LAB INCUBATED),25200786,CDM,86480,CPT,300,RC,outpatient,,424,424,,359.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,106,22,,percent of total billed charges,,,,,,,,,381.6,90,,percent of total billed charges,,,351.07,82.8,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,,,,,,,,373.12,88,,percent of total billed charges,,,,,,,,,323.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,106,22,,percent of total billed charges,,,385.84,91,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,,,,,,,,,,,,,351.92,83,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,347.68,82,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,106,402.8,
QUANTIFERON TB GOLD +  (LABCORP INCUB),25200787,CDM,86480,CPT,300,RC,outpatient,,424,424,,359.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,106,22,,percent of total billed charges,,,,,,,,,381.6,90,,percent of total billed charges,,,351.07,82.8,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,,,,,,,,373.12,88,,percent of total billed charges,,,,,,,,,323.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,106,22,,percent of total billed charges,,,385.84,91,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,,,,,,,,,,,,,351.92,83,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,347.68,82,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,106,402.8,
Q FEVER ANTIBODIES,25200788,CDM,86638,CPT,300,RC,outpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.75,22,,percent of total billed charges,,,,,,,,,236.7,90,,percent of total billed charges,,,217.76,82.8,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.75,22,,percent of total billed charges,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,65.75,249.85,
PNEUMOCYSTIS CARINNI STAIN,25200789,CDM,86638,CPT,300,RC,outpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.75,22,,percent of total billed charges,,,,,,,,,236.7,90,,percent of total billed charges,,,217.76,82.8,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.75,22,,percent of total billed charges,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,65.75,249.85,
RHEUMATOID FACTOR,25200790,CDM,86430,CPT,300,RC,outpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.25,22,,percent of total billed charges,,,,,,,,,94.5,90,,percent of total billed charges,,,86.94,82.8,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.25,22,,percent of total billed charges,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,26.25,99.75,
RHEUMATOID FACTOR (IGA),25200791,CDM,86431,CPT,300,RC,outpatient,,95,95,,80.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.75,22,,percent of total billed charges,,,,,,,,,85.5,90,,percent of total billed charges,,,78.66,82.8,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,,,,,,,,83.6,88,,percent of total billed charges,,,,,,,,,72.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.75,22,,percent of total billed charges,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,,,,,,,,,,,,,78.85,83,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,77.9,82,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,23.75,90.25,
RHEUMATOID FACTOR (IGG),25200792,CDM,86431,CPT,300,RC,outpatient,,95,95,,80.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.75,22,,percent of total billed charges,,,,,,,,,85.5,90,,percent of total billed charges,,,78.66,82.8,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,,,,,,,,83.6,88,,percent of total billed charges,,,,,,,,,72.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.75,22,,percent of total billed charges,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,,,,,,,,,,,,,78.85,83,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,77.9,82,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,23.75,90.25,
RHEUMATOID FACTOR  FLUID,25200795,CDM,86430,CPT,300,RC,outpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27,22,,percent of total billed charges,,,,,,,,,97.2,90,,percent of total billed charges,,,89.42,82.8,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27,22,,percent of total billed charges,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,27,102.6,
RED BLOOD CELL COUNT,25200808,CDM,85041,CPT,300,RC,outpatient,,54,54,,45.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.5,22,,percent of total billed charges,,,,,,,,,48.6,90,,percent of total billed charges,,,44.71,82.8,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,,,,,,,,47.52,88,,percent of total billed charges,,,,,,,,,41.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.5,22,,percent of total billed charges,,,49.14,91,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,,,,,,,,,,,,,44.82,83,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,44.28,82,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,13.5,51.3,
RESPIRATORY PANEL(BIOFIRE),25200809,CDM,0202U,CPT,300,RC,outpatient,,1085,1085,,921.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,271.25,22,,percent of total billed charges,,,,,,,,,976.5,90,,percent of total billed charges,,,898.38,82.8,,percent of total billed charges,,,922.25,85,,percent of total billed charges,,,,,,,,,954.8,88,,percent of total billed charges,,,,,,,,,828.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,271.25,22,,percent of total billed charges,,,987.35,91,,percent of total billed charges,,,1030.75,95,,percent of total billed charges,,,900.55,83,,percent of total billed charges,,,900.55,83,,percent of total billed charges,,,,,,,,,,,,,,,900.55,83,,percent of total billed charges,,,1030.75,95,,percent of total billed charges,,,976.5,90,,percent of total billed charges,,,976.5,90,,percent of total billed charges,,,889.7,82,,percent of total billed charges,,,976.5,90,,percent of total billed charges,,,922.25,85,,percent of total billed charges,,271.25,1030.75,
#NAME?,25200810,CDM,87798,CPT,300,RC,outpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.75,22,,percent of total billed charges,,,,,,,,,78.3,90,,percent of total billed charges,,,72.04,82.8,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.75,22,,percent of total billed charges,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,21.75,82.65,
#NAME?,25200811,CDM,87486,CPT,300,RC,outpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.75,22,,percent of total billed charges,,,,,,,,,78.3,90,,percent of total billed charges,,,72.04,82.8,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.75,22,,percent of total billed charges,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,21.75,82.65,
#NAME?,25200812,CDM,87581,CPT,300,RC,outpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.75,22,,percent of total billed charges,,,,,,,,,78.3,90,,percent of total billed charges,,,72.04,82.8,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.75,22,,percent of total billed charges,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,21.75,82.65,
TEACHER (BIOFIRE),25200813,CDM,0202U,CPT,300,RC,outpatient,,1589,1589,,1349.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,397.25,22,,percent of total billed charges,,,,,,,,,1430.1,90,,percent of total billed charges,,,1315.69,82.8,,percent of total billed charges,,,1350.65,85,,percent of total billed charges,,,,,,,,,1398.32,88,,percent of total billed charges,,,,,,,,,1214,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,397.25,22,,percent of total billed charges,,,1445.99,91,,percent of total billed charges,,,1509.55,95,,percent of total billed charges,,,1318.87,83,,percent of total billed charges,,,1318.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1318.87,83,,percent of total billed charges,,,1509.55,95,,percent of total billed charges,,,1430.1,90,,percent of total billed charges,,,1430.1,90,,percent of total billed charges,,,1302.98,82,,percent of total billed charges,,,1430.1,90,,percent of total billed charges,,,1350.65,85,,percent of total billed charges,,397.25,1509.55,
"COMPLEMENT, TOTAL (CH-50)",25200815,CDM,86162,CPT,300,RC,outpatient,,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.5,22,,percent of total billed charges,,,,,,,,,275.4,90,,percent of total billed charges,,,253.37,82.8,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.5,22,,percent of total billed charges,,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,76.5,290.7,
COMPLEMENT (C1),25200816,CDM,86160,CPT,300,RC,outpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.5,22,,percent of total billed charges,,,,,,,,,365.4,90,,percent of total billed charges,,,336.17,82.8,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.5,22,,percent of total billed charges,,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,101.5,385.7,
#NAME?,25200817,CDM,87798,CPT,300,RC,outpatient,,60,60,,50.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15,22,,percent of total billed charges,,,,,,,,,54,90,,percent of total billed charges,,,49.68,82.8,,percent of total billed charges,,,51,85,,percent of total billed charges,,,,,,,,,52.8,88,,percent of total billed charges,,,,,,,,,45.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15,22,,percent of total billed charges,,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,,,,,,,,,,,,,49.8,83,,percent of total billed charges,,,57,95,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,49.2,82,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,15,57,
FECAL ELASTASE,25200820,CDM,82656,CPT,300,RC,outpatient,,511,511,,433.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.75,22,,percent of total billed charges,,,,,,,,,459.9,90,,percent of total billed charges,,,423.11,82.8,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,,,,,,,,449.68,88,,percent of total billed charges,,,,,,,,,390.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.75,22,,percent of total billed charges,,,465.01,91,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,,,,,,,,,,,,,424.13,83,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,419.02,82,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,127.75,485.45,
FECAL CHYMOTRYPSIN,25200821,CDM,84490,CPT,300,RC,outpatient,,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.25,22,,percent of total billed charges,,,,,,,,,137.7,90,,percent of total billed charges,,,126.68,82.8,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.25,22,,percent of total billed charges,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,38.25,145.35,
FECAL FAT QUANT,25200824,CDM,82710,CPT,300,RC,outpatient,,244,244,,207.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61,22,,percent of total billed charges,,,,,,,,,219.6,90,,percent of total billed charges,,,202.03,82.8,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,,,,,,,,214.72,88,,percent of total billed charges,,,,,,,,,186.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61,22,,percent of total billed charges,,,222.04,91,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,,,,,,,,,,,,,202.52,83,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,200.08,82,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,61,231.8,
FECAL FAT QUAL,25200825,CDM,82705,CPT,300,RC,outpatient,,244,244,,207.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61,22,,percent of total billed charges,,,,,,,,,219.6,90,,percent of total billed charges,,,202.03,82.8,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,,,,,,,,214.72,88,,percent of total billed charges,,,,,,,,,186.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61,22,,percent of total billed charges,,,222.04,91,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,,,,,,,,,,,,,202.52,83,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,200.08,82,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,61,231.8,
RETICULOCYTE COUNT,25200832,CDM,85045,CPT,300,RC,outpatient,,128,128,,108.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32,22,,percent of total billed charges,,,,,,,,,115.2,90,,percent of total billed charges,,,105.98,82.8,,percent of total billed charges,,,108.8,85,,percent of total billed charges,,,,,,,,,112.64,88,,percent of total billed charges,,,,,,,,,97.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32,22,,percent of total billed charges,,,116.48,91,,percent of total billed charges,,,121.6,95,,percent of total billed charges,,,106.24,83,,percent of total billed charges,,,106.24,83,,percent of total billed charges,,,,,,,,,,,,,,,106.24,83,,percent of total billed charges,,,121.6,95,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,104.96,82,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,108.8,85,,percent of total billed charges,,32,121.6,
.RICKETTSIA ANTIBODY PANEL,25200833,CDM,86757,CPT,300,RC,outpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.5,22,,percent of total billed charges,,,,,,,,,91.8,90,,percent of total billed charges,,,84.46,82.8,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.5,22,,percent of total billed charges,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,25.5,96.9,
LIPASE,25200840,CDM,83690,CPT,300,RC,outpatient,,186,186,,157.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.5,22,,percent of total billed charges,,,,,,,,,167.4,90,,percent of total billed charges,,,154.01,82.8,,percent of total billed charges,,,158.1,85,,percent of total billed charges,,,,,,,,,163.68,88,,percent of total billed charges,,,,,,,,,142.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.5,22,,percent of total billed charges,,,169.26,91,,percent of total billed charges,,,176.7,95,,percent of total billed charges,,,154.38,83,,percent of total billed charges,,,154.38,83,,percent of total billed charges,,,,,,,,,,,,,,,154.38,83,,percent of total billed charges,,,176.7,95,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,152.52,82,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,158.1,85,,percent of total billed charges,,46.5,176.7,
RHOGAM (INJECTION ONLY),25200857,CDM,J2790,HCPCS,636,RC,outpatient,,795,795,,674.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,198.75,22,,percent of total billed charges,,,,,,,,,715.5,90,,percent of total billed charges,,,658.26,82.8,,percent of total billed charges,,,675.75,85,,percent of total billed charges,,,,,,,,,699.6,88,,percent of total billed charges,,80.41,,,,fee schedule,,,607.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,80.41,,,,fee schedule,,,198.75,22,,percent of total billed charges,,,723.45,91,,percent of total billed charges,,,755.25,95,,percent of total billed charges,,,659.85,83,,percent of total billed charges,,,659.85,83,,percent of total billed charges,,,,,,,,,,,,,,,659.85,83,,percent of total billed charges,,,755.25,95,,percent of total billed charges,,,715.5,90,,percent of total billed charges,,,715.5,90,,percent of total billed charges,,,651.9,82,,percent of total billed charges,,,715.5,90,,percent of total billed charges,,,675.75,85,,percent of total billed charges,,80.41,755.25,
RPR REFLEX TO TREP. PALLIDUM,25200864,CDM,86592,CPT,300,RC,outpatient,,135,135,,114.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.75,22,,percent of total billed charges,,,,,,,,,121.5,90,,percent of total billed charges,,,111.78,82.8,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,,,,,,,,118.8,88,,percent of total billed charges,,,,,,,,,103.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.75,22,,percent of total billed charges,,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,,,,,,,,,,,,,112.05,83,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,110.7,82,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,33.75,128.25,
RPR,25200865,CDM,86592,CPT,300,RC,outpatient,,135,135,,114.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.75,22,,percent of total billed charges,,,,,,,,,121.5,90,,percent of total billed charges,,,111.78,82.8,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,,,,,,,,118.8,88,,percent of total billed charges,,,,,,,,,103.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.75,22,,percent of total billed charges,,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,,,,,,,,,,,,,112.05,83,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,110.7,82,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,33.75,128.25,
RISPERDAL,25200866,CDM,80299,CPT,300,RC,outpatient,,538,538,,456.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,134.5,22,,percent of total billed charges,,,,,,,,,484.2,90,,percent of total billed charges,,,445.46,82.8,,percent of total billed charges,,,457.3,85,,percent of total billed charges,,,,,,,,,473.44,88,,percent of total billed charges,,,,,,,,,411.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,134.5,22,,percent of total billed charges,,,489.58,91,,percent of total billed charges,,,511.1,95,,percent of total billed charges,,,446.54,83,,percent of total billed charges,,,446.54,83,,percent of total billed charges,,,,,,,,,,,,,,,446.54,83,,percent of total billed charges,,,511.1,95,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,441.16,82,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,457.3,85,,percent of total billed charges,,134.5,511.1,
TREPONEMA PALLIDUM AB,25200868,CDM,86780,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
TREPONEMA PALLIDUM CASCADE,25200869,CDM,86780,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
RUBELLA ANTIBODY (IgG),25200873,CDM,86762,CPT,300,RC,outpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.75,22,,percent of total billed charges,,,,,,,,,143.1,90,,percent of total billed charges,,,131.65,82.8,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.75,22,,percent of total billed charges,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,39.75,151.05,
REDUCING SUBSTANCES STOOL,25200874,CDM,84376,CPT,300,RC,outpatient,,82,82,,69.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.5,22,,percent of total billed charges,,,,,,,,,73.8,90,,percent of total billed charges,,,67.9,82.8,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,,,,,,,,72.16,88,,percent of total billed charges,,,,,,,,,62.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.5,22,,percent of total billed charges,,,74.62,91,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,,,,,,,,,,,,,68.06,83,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,67.24,82,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,20.5,77.9,
MTHFR,25200875,CDM,81291,CPT,300,RC,outpatient,,632,632,,536.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,158,22,,percent of total billed charges,,,,,,,,,568.8,90,,percent of total billed charges,,,523.3,82.8,,percent of total billed charges,,,537.2,85,,percent of total billed charges,,,,,,,,,556.16,88,,percent of total billed charges,,,,,,,,,482.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,158,22,,percent of total billed charges,,,575.12,91,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,,,,,,,,,,,,,524.56,83,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,518.24,82,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,537.2,85,,percent of total billed charges,,158,600.4,
RUBELLA ANTIBODY IgM,25200876,CDM,86762,CPT,300,RC,outpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.75,22,,percent of total billed charges,,,,,,,,,143.1,90,,percent of total billed charges,,,131.65,82.8,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.75,22,,percent of total billed charges,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,39.75,151.05,
SED RATE,25200881,CDM,85652,CPT,300,RC,outpatient,,127,127,,107.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.75,22,,percent of total billed charges,,,,,,,,,114.3,90,,percent of total billed charges,,,105.16,82.8,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,,,,,,,,111.76,88,,percent of total billed charges,,,,,,,,,97.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.75,22,,percent of total billed charges,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,,,,,,,,,,,,,105.41,83,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,104.14,82,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,31.75,120.65,
SCLERODERMA ANTIBODIES (SCL-70),25200882,CDM,86235,CPT,300,RC,outpatient,,319,319,,270.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.75,22,,percent of total billed charges,,,,,,,,,287.1,90,,percent of total billed charges,,,264.13,82.8,,percent of total billed charges,,,271.15,85,,percent of total billed charges,,,,,,,,,280.72,88,,percent of total billed charges,,,,,,,,,243.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.75,22,,percent of total billed charges,,,290.29,91,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,,,,,,,,,,,,,264.77,83,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,261.58,82,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,271.15,85,,percent of total billed charges,,79.75,303.05,
SCABIES ID,25200883,CDM,87169,CPT,300,RC,outpatient,,97,97,,82.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.25,22,,percent of total billed charges,,,,,,,,,87.3,90,,percent of total billed charges,,,80.32,82.8,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,,,,,,,,85.36,88,,percent of total billed charges,,,,,,,,,74.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.25,22,,percent of total billed charges,,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,,,,,,,,,,,,,80.51,83,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,79.54,82,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,24.25,92.15,
".CULTURE, CHLAMYDIA",25200899,CDM,87110,CPT,300,RC,outpatient,,301,301,,255.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.25,22,,percent of total billed charges,,,,,,,,,270.9,90,,percent of total billed charges,,,249.23,82.8,,percent of total billed charges,,,255.85,85,,percent of total billed charges,,,,,,,,,264.88,88,,percent of total billed charges,,,,,,,,,229.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.25,22,,percent of total billed charges,,,273.91,91,,percent of total billed charges,,,285.95,95,,percent of total billed charges,,,249.83,83,,percent of total billed charges,,,249.83,83,,percent of total billed charges,,,,,,,,,,,,,,,249.83,83,,percent of total billed charges,,,285.95,95,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,246.82,82,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,255.85,85,,percent of total billed charges,,75.25,285.95,
"..  CULTURE, CHLAMYDIA",25200900,CDM,87110,CPT,300,RC,outpatient,,311,311,,264.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.75,22,,percent of total billed charges,,,,,,,,,279.9,90,,percent of total billed charges,,,257.51,82.8,,percent of total billed charges,,,264.35,85,,percent of total billed charges,,,,,,,,,273.68,88,,percent of total billed charges,,,,,,,,,237.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.75,22,,percent of total billed charges,,,283.01,91,,percent of total billed charges,,,295.45,95,,percent of total billed charges,,,258.13,83,,percent of total billed charges,,,258.13,83,,percent of total billed charges,,,,,,,,,,,,,,,258.13,83,,percent of total billed charges,,,295.45,95,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,255.02,82,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,264.35,85,,percent of total billed charges,,77.75,295.45,
CULTURE CHLAMYDIA,25200901,CDM,87110,CPT,300,RC,outpatient,,311,311,,264.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.75,22,,percent of total billed charges,,,,,,,,,279.9,90,,percent of total billed charges,,,257.51,82.8,,percent of total billed charges,,,264.35,85,,percent of total billed charges,,,,,,,,,273.68,88,,percent of total billed charges,,,,,,,,,237.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.75,22,,percent of total billed charges,,,283.01,91,,percent of total billed charges,,,295.45,95,,percent of total billed charges,,,258.13,83,,percent of total billed charges,,,258.13,83,,percent of total billed charges,,,,,,,,,,,,,,,258.13,83,,percent of total billed charges,,,295.45,95,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,255.02,82,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,264.35,85,,percent of total billed charges,,77.75,295.45,
AST,25200907,CDM,84450,CPT,300,RC,outpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40,22,,percent of total billed charges,,,,,,,,,144,90,,percent of total billed charges,,,132.48,82.8,,percent of total billed charges,,,136,85,,percent of total billed charges,,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40,22,,percent of total billed charges,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,40,152,
CALPROTECTIN STOOL,25200909,CDM,83993,CPT,300,RC,outpatient,,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.25,22,,percent of total billed charges,,,,,,,,,321.3,90,,percent of total billed charges,,,295.6,82.8,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.25,22,,percent of total billed charges,,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,89.25,339.15,
CALRETICULIN (CLAR) MUTATION,25200910,CDM,81219,CPT,300,RC,outpatient,,732,732,,621.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,183,22,,percent of total billed charges,,,,,,,,,658.8,90,,percent of total billed charges,,,606.1,82.8,,percent of total billed charges,,,622.2,85,,percent of total billed charges,,,,,,,,,644.16,88,,percent of total billed charges,,,,,,,,,559.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,183,22,,percent of total billed charges,,,666.12,91,,percent of total billed charges,,,695.4,95,,percent of total billed charges,,,607.56,83,,percent of total billed charges,,,607.56,83,,percent of total billed charges,,,,,,,,,,,,,,,607.56,83,,percent of total billed charges,,,695.4,95,,percent of total billed charges,,,658.8,90,,percent of total billed charges,,,658.8,90,,percent of total billed charges,,,600.24,82,,percent of total billed charges,,,658.8,90,,percent of total billed charges,,,622.2,85,,percent of total billed charges,,183,695.4,
ALT,25200915,CDM,84460,CPT,300,RC,outpatient,,162,162,,137.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.5,22,,percent of total billed charges,,,,,,,,,145.8,90,,percent of total billed charges,,,134.14,82.8,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,,,,,,,,142.56,88,,percent of total billed charges,,,,,,,,,123.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.5,22,,percent of total billed charges,,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,,,,,,,,,,,,,134.46,83,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,132.84,82,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,40.5,153.9,
"CELL COUNT w/diff, CSF",25200923,CDM,89051,CPT,300,RC,outpatient,,148,148,,125.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37,22,,percent of total billed charges,,,,,,,,,133.2,90,,percent of total billed charges,,,122.54,82.8,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,,,,,,,,130.24,88,,percent of total billed charges,,,,,,,,,113.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37,22,,percent of total billed charges,,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,,,,,,,,,,,,,122.84,83,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,121.36,82,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,37,140.6,
SERZONE (NEFAZODONE),25200924,CDM,80299,CPT,300,RC,outpatient,,495,495,,420.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.75,22,,percent of total billed charges,,,,,,,,,445.5,90,,percent of total billed charges,,,409.86,82.8,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,,,,,,,,435.6,88,,percent of total billed charges,,,,,,,,,378.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.75,22,,percent of total billed charges,,,450.45,91,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,,,,,,,,,,,,,410.85,83,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,405.9,82,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,123.75,470.25,
"SODIUM, SERUM",25200931,CDM,84295,CPT,300,RC,outpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.75,22,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,85.28,82.8,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.75,22,,percent of total billed charges,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,25.75,97.85,
SELENIUM,25200933,CDM,84255,CPT,300,RC,outpatient,,385,385,,326.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.25,22,,percent of total billed charges,,,,,,,,,346.5,90,,percent of total billed charges,,,318.78,82.8,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,,,,,,,,338.8,88,,percent of total billed charges,,,,,,,,,294.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.25,22,,percent of total billed charges,,,350.35,91,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,,,,,,,,,,,,,319.55,83,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,315.7,82,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,96.25,365.75,
SELENIUM (URINE),25200934,CDM,84255,CPT,300,RC,outpatient,,385,385,,326.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.25,22,,percent of total billed charges,,,,,,,,,346.5,90,,percent of total billed charges,,,318.78,82.8,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,,,,,,,,338.8,88,,percent of total billed charges,,,,,,,,,294.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.25,22,,percent of total billed charges,,,350.35,91,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,,,,,,,,,,,,,319.55,83,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,315.7,82,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,96.25,365.75,
SHELL VIAL DFA,25200935,CDM,87254,CPT,300,RC,outpatient,,99,99,,84.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.75,22,,percent of total billed charges,,,,,,,,,89.1,90,,percent of total billed charges,,,81.97,82.8,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,,,,,,,,87.12,88,,percent of total billed charges,,,,,,,,,75.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.75,22,,percent of total billed charges,,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,,,,,,,,,,,,,82.17,83,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,81.18,82,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,24.75,94.05,
SEX HORMONE BINDING GLOBULIN,25200940,CDM,84270,CPT,300,RC,outpatient,,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.75,22,,percent of total billed charges,,,,,,,,,351.9,90,,percent of total billed charges,,,323.75,82.8,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.75,22,,percent of total billed charges,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,97.75,371.45,
.FAI,25200942,CDM,84270,CPT,300,RC,outpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.75,22,,percent of total billed charges,,,,,,,,,204.3,90,,percent of total billed charges,,,187.96,82.8,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.75,22,,percent of total billed charges,,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,56.75,215.65,
.FAI 2,25200943,CDM,84403,CPT,300,RC,outpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.75,22,,percent of total billed charges,,,,,,,,,204.3,90,,percent of total billed charges,,,187.96,82.8,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.75,22,,percent of total billed charges,,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,56.75,215.65,
SOLUBLE TRANSFERRIN RECPTOR,25200950,CDM,84238,CPT,300,RC,outpatient,,578,578,,490.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,144.5,22,,percent of total billed charges,,,,,,,,,520.2,90,,percent of total billed charges,,,478.58,82.8,,percent of total billed charges,,,491.3,85,,percent of total billed charges,,,,,,,,,508.64,88,,percent of total billed charges,,,,,,,,,441.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,144.5,22,,percent of total billed charges,,,525.98,91,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,,,,,,,,,,,,,479.74,83,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,473.96,82,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,491.3,85,,percent of total billed charges,,144.5,549.1,
SOLUBLE LIVER AG,25200951,CDM,83516,CPT,300,RC,outpatient,,471,471,,399.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.75,22,,percent of total billed charges,,,,,,,,,423.9,90,,percent of total billed charges,,,389.99,82.8,,percent of total billed charges,,,400.35,85,,percent of total billed charges,,,,,,,,,414.48,88,,percent of total billed charges,,,,,,,,,359.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.75,22,,percent of total billed charges,,,428.61,91,,percent of total billed charges,,,447.45,95,,percent of total billed charges,,,390.93,83,,percent of total billed charges,,,390.93,83,,percent of total billed charges,,,,,,,,,,,,,,,390.93,83,,percent of total billed charges,,,447.45,95,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,386.22,82,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,400.35,85,,percent of total billed charges,,117.75,447.45,
"SPERM COUNT, POST VAS",25200956,CDM,89321,CPT,300,RC,outpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
T-3 REVERSE,25200963,CDM,84482,CPT,300,RC,outpatient,,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.5,22,,percent of total billed charges,,,,,,,,,275.4,90,,percent of total billed charges,,,253.37,82.8,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.5,22,,percent of total billed charges,,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,76.5,290.7,
T-3 TOTAL,25200964,CDM,84480,CPT,300,RC,outpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.25,22,,percent of total billed charges,,,,,,,,,267.3,90,,percent of total billed charges,,,245.92,82.8,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.25,22,,percent of total billed charges,,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,74.25,282.15,
"T-4, TOTAL",25200972,CDM,84436,CPT,300,RC,outpatient,,190,190,,161.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.5,22,,percent of total billed charges,,,,,,,,,171,90,,percent of total billed charges,,,157.32,82.8,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,,,,,,,,167.2,88,,percent of total billed charges,,,,,,,,,145.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.5,22,,percent of total billed charges,,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,,,,,,,,,,,,,157.7,83,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,155.8,82,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,47.5,180.5,
THEOPHYLLINE,25200980,CDM,80198,CPT,300,RC,outpatient,,254,254,,215.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.5,22,,percent of total billed charges,,,,,,,,,228.6,90,,percent of total billed charges,,,210.31,82.8,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,,,,,,,,223.52,88,,percent of total billed charges,,,,,,,,,194.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.5,22,,percent of total billed charges,,,231.14,91,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,,,,,,,,,,,,,210.82,83,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,208.28,82,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,63.5,241.3,
CBC w/o DIFF,25200992,CDM,85027,CPT,300,RC,outpatient,,161,161,,136.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.25,22,,percent of total billed charges,,,,,,,,,144.9,90,,percent of total billed charges,,,133.31,82.8,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,,,,,,,,141.68,88,,percent of total billed charges,,,,,,,,,123,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.25,22,,percent of total billed charges,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,132.02,82,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,40.25,152.95,
".PAP SMEAR, CONVENTIONAL (88147)",25200999,CDM,88147,CPT,311,RC,outpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.75,22,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,85.28,82.8,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.75,22,,percent of total billed charges,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,25.75,97.85,
HEPATITIS B CORE  TOTAL  AB,25201004,CDM,86704,CPT,300,RC,outpatient,,244,244,,207.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61,22,,percent of total billed charges,,,,,,,,,219.6,90,,percent of total billed charges,,,202.03,82.8,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,,,,,,,,214.72,88,,percent of total billed charges,,,,,,,,,186.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61,22,,percent of total billed charges,,,222.04,91,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,,,,,,,,,,,,,202.52,83,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,200.08,82,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,61,231.8,
"COLLAGEN X-LINKED N-TELOPEPTIDE, URINE",25201005,CDM,82523,CPT,300,RC,outpatient,,339,339,,287.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.75,22,,percent of total billed charges,,,,,,,,,305.1,90,,percent of total billed charges,,,280.69,82.8,,percent of total billed charges,,,288.15,85,,percent of total billed charges,,,,,,,,,298.32,88,,percent of total billed charges,,,,,,,,,259,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.75,22,,percent of total billed charges,,,308.49,91,,percent of total billed charges,,,322.05,95,,percent of total billed charges,,,281.37,83,,percent of total billed charges,,,281.37,83,,percent of total billed charges,,,,,,,,,,,,,,,281.37,83,,percent of total billed charges,,,322.05,95,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,277.98,82,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,288.15,85,,percent of total billed charges,,84.75,322.05,
"HEPATITIS B VIRAL DNA, PCR",25201006,CDM,87517,CPT,300,RC,outpatient,,643,643,,545.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,160.75,22,,percent of total billed charges,,,,,,,,,578.7,90,,percent of total billed charges,,,532.4,82.8,,percent of total billed charges,,,546.55,85,,percent of total billed charges,,,,,,,,,565.84,88,,percent of total billed charges,,,,,,,,,491.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,160.75,22,,percent of total billed charges,,,585.13,91,,percent of total billed charges,,,610.85,95,,percent of total billed charges,,,533.69,83,,percent of total billed charges,,,533.69,83,,percent of total billed charges,,,,,,,,,,,,,,,533.69,83,,percent of total billed charges,,,610.85,95,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,527.26,82,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,546.55,85,,percent of total billed charges,,160.75,610.85,
"COLLAGEN X-LINKED N-TELOPEPTIDE, SERUM",25201007,CDM,82523,CPT,300,RC,outpatient,,288,288,,244.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72,22,,percent of total billed charges,,,,,,,,,259.2,90,,percent of total billed charges,,,238.46,82.8,,percent of total billed charges,,,244.8,85,,percent of total billed charges,,,,,,,,,253.44,88,,percent of total billed charges,,,,,,,,,220.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72,22,,percent of total billed charges,,,262.08,91,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,,,,,,,,,,,,,239.04,83,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,236.16,82,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,244.8,85,,percent of total billed charges,,72,273.6,
"HEPATITIS B CORE AB, IGM",25201010,CDM,86705,CPT,300,RC,outpatient,,101,101,,85.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.25,22,,percent of total billed charges,,,,,,,,,90.9,90,,percent of total billed charges,,,83.63,82.8,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,,,,,,,,88.88,88,,percent of total billed charges,,,,,,,,,77.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.25,22,,percent of total billed charges,,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,82.82,82,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,25.25,95.95,
LC-1,25201011,CDM,86705,CPT,300,RC,outpatient,,317,317,,269.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.25,22,,percent of total billed charges,,,,,,,,,285.3,90,,percent of total billed charges,,,262.48,82.8,,percent of total billed charges,,,269.45,85,,percent of total billed charges,,,,,,,,,278.96,88,,percent of total billed charges,,,,,,,,,242.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.25,22,,percent of total billed charges,,,288.47,91,,percent of total billed charges,,,301.15,95,,percent of total billed charges,,,263.11,83,,percent of total billed charges,,,263.11,83,,percent of total billed charges,,,,,,,,,,,,,,,263.11,83,,percent of total billed charges,,,301.15,95,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,259.94,82,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,269.45,85,,percent of total billed charges,,79.25,301.15,
"HEPATITIS E  AB, IGM/IGG",25201012,CDM,86790,CPT,300,RC,outpatient,,490,490,,416.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.5,22,,percent of total billed charges,,,,,,,,,441,90,,percent of total billed charges,,,405.72,82.8,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,,,,,,,,431.2,88,,percent of total billed charges,,,,,,,,,374.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.5,22,,percent of total billed charges,,,445.9,91,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,,,,,,,,,,,,,406.7,83,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,401.8,82,,percent of total billed charges,,,441,90,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,122.5,465.5,
VENLAFAXINE (EFIXER),25201013,CDM,80299,CPT,300,RC,outpatient,,616,616,,522.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154,22,,percent of total billed charges,,,,,,,,,554.4,90,,percent of total billed charges,,,510.05,82.8,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,,,,,,,,542.08,88,,percent of total billed charges,,,,,,,,,470.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154,22,,percent of total billed charges,,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,,,,,,,,,,,,,511.28,83,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,505.12,82,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,154,585.2,
TRIGLYCERIDES,25201020,CDM,84478,CPT,300,RC,outpatient,,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38,22,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,125.86,82.8,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38,22,,percent of total billed charges,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,38,144.4,
TRIGLYCERIDES FLUID,25201021,CDM,84478,CPT,300,RC,outpatient,,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.5,22,,percent of total billed charges,,,,,,,,,117,90,,percent of total billed charges,,,107.64,82.8,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.5,22,,percent of total billed charges,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,32.5,123.5,
URIC ACID SERUM,25201038,CDM,84550,CPT,300,RC,outpatient,,119,119,,101.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.75,22,,percent of total billed charges,,,,,,,,,107.1,90,,percent of total billed charges,,,98.53,82.8,,percent of total billed charges,,,101.15,85,,percent of total billed charges,,,,,,,,,104.72,88,,percent of total billed charges,,,,,,,,,90.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.75,22,,percent of total billed charges,,,108.29,91,,percent of total billed charges,,,113.05,95,,percent of total billed charges,,,98.77,83,,percent of total billed charges,,,98.77,83,,percent of total billed charges,,,,,,,,,,,,,,,98.77,83,,percent of total billed charges,,,113.05,95,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,97.58,82,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,101.15,85,,percent of total billed charges,,29.75,113.05,
.SYNOVIAL ALPHA DEFENSINS,25201041,CDM,83516,CPT,300,RC,outpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.5,22,,percent of total billed charges,,,,,,,,,365.4,90,,percent of total billed charges,,,336.17,82.8,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.5,22,,percent of total billed charges,,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,101.5,385.7,
.SYNOVIAL CRP,25201042,CDM,86140,CPT,300,RC,outpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
.SYNOVIAL HEMOGLOBIN,25201043,CDM,84311,CPT,300,RC,outpatient,,56,56,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14,22,,percent of total billed charges,,,,,,,,,50.4,90,,percent of total billed charges,,,46.37,82.8,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,,,,,,,,49.28,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14,22,,percent of total billed charges,,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,45.92,82,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,14,53.2,
URINALYSIS w/MICROSCOPIC,25201046,CDM,81001,CPT,300,RC,outpatient,,162,162,,137.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.5,22,,percent of total billed charges,,,,,,,,,145.8,90,,percent of total billed charges,,,134.14,82.8,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,,,,,,,,142.56,88,,percent of total billed charges,,,,,,,,,123.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.5,22,,percent of total billed charges,,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,,,,,,,,,,,,,134.46,83,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,132.84,82,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,40.5,153.9,
SYNOVIAL FLUID DIPSTICK,25201047,CDM,81003,CPT,300,RC,outpatient,,97,97,,82.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.25,22,,percent of total billed charges,,,,,,,,,87.3,90,,percent of total billed charges,,,80.32,82.8,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,,,,,,,,85.36,88,,percent of total billed charges,,,,,,,,,74.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.25,22,,percent of total billed charges,,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,,,,,,,,,,,,,80.51,83,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,79.54,82,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,24.25,92.15,
DIPSTICK UA MANUAL READ ONLY,25201048,CDM,81002,CPT,300,RC,outpatient,TC,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.5,22,,percent of total billed charges,,,,,,,,,45,90,,percent of total billed charges,,,41.4,82.8,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.5,22,,percent of total billed charges,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,12.5,47.5,
URINALYSIS W/O MICROSCOPIC,25201050,CDM,81003,CPT,300,RC,outpatient,,127,127,,107.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.75,22,,percent of total billed charges,,,,,,,,,114.3,90,,percent of total billed charges,,,105.16,82.8,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,,,,,,,,111.76,88,,percent of total billed charges,,,,,,,,,97.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.75,22,,percent of total billed charges,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,,,,,,,,,,,,,105.41,83,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,104.14,82,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,31.75,120.65,
WHITE BLOOD CELL COUNT (WBC),25201053,CDM,85048,CPT,300,RC,outpatient,,65,65,,55.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.25,22,,percent of total billed charges,,,,,,,,,58.5,90,,percent of total billed charges,,,53.82,82.8,,percent of total billed charges,,,55.25,85,,percent of total billed charges,,,,,,,,,57.2,88,,percent of total billed charges,,,,,,,,,49.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.25,22,,percent of total billed charges,,,59.15,91,,percent of total billed charges,,,61.75,95,,percent of total billed charges,,,53.95,83,,percent of total billed charges,,,53.95,83,,percent of total billed charges,,,,,,,,,,,,,,,53.95,83,,percent of total billed charges,,,61.75,95,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,53.3,82,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,55.25,85,,percent of total billed charges,,16.25,61.75,
METANEPHRINES URINE RANDOM,25201060,CDM,83835,CPT,300,RC,outpatient,,541,541,,459.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,135.25,22,,percent of total billed charges,,,,,,,,,486.9,90,,percent of total billed charges,,,447.95,82.8,,percent of total billed charges,,,459.85,85,,percent of total billed charges,,,,,,,,,476.08,88,,percent of total billed charges,,,,,,,,,413.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,135.25,22,,percent of total billed charges,,,492.31,91,,percent of total billed charges,,,513.95,95,,percent of total billed charges,,,449.03,83,,percent of total billed charges,,,449.03,83,,percent of total billed charges,,,,,,,,,,,,,,,449.03,83,,percent of total billed charges,,,513.95,95,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,443.62,82,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,459.85,85,,percent of total billed charges,,135.25,513.95,
METANEPHRINES URINE (24-HOUR),25201061,CDM,83835,CPT,300,RC,outpatient,,379,379,,321.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94.75,22,,percent of total billed charges,,,,,,,,,341.1,90,,percent of total billed charges,,,313.81,82.8,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,,,,,,,,333.52,88,,percent of total billed charges,,,,,,,,,289.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94.75,22,,percent of total billed charges,,,344.89,91,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,,,,,,,,,,,,,314.57,83,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,310.78,82,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,94.75,360.05,
IONIZED CALCIUM,25201079,CDM,82330,CPT,300,RC,outpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.5,22,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,170.57,82.8,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.5,22,,percent of total billed charges,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,51.5,195.7,
MDMA URINE CONFIRMATION,25201080,CDM,80307,CPT,300,RC,outpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.75,22,,percent of total billed charges,,,,,,,,,204.3,90,,percent of total billed charges,,,187.96,82.8,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.75,22,,percent of total billed charges,,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,56.75,215.65,
MAGNESIUM RBC,25201085,CDM,83735,CPT,300,RC,outpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.75,22,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,85.28,82.8,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.75,22,,percent of total billed charges,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,25.75,97.85,
MANGANESE,25201086,CDM,83785,CPT,300,RC,outpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.75,22,,percent of total billed charges,,,,,,,,,204.3,90,,percent of total billed charges,,,187.96,82.8,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.75,22,,percent of total billed charges,,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,56.75,215.65,
ESTROGEN,25201087,CDM,82672,CPT,300,RC,outpatient,,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.5,22,,percent of total billed charges,,,,,,,,,351,90,,percent of total billed charges,,,322.92,82.8,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.5,22,,percent of total billed charges,,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,97.5,370.5,
ESTRADIOL (PEDIATRICS) ULT SENS,25201094,CDM,82670,CPT,300,RC,outpatient,,578,578,,490.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,144.5,22,,percent of total billed charges,,,,,,,,,520.2,90,,percent of total billed charges,,,478.58,82.8,,percent of total billed charges,,,491.3,85,,percent of total billed charges,,,,,,,,,508.64,88,,percent of total billed charges,,,,,,,,,441.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,144.5,22,,percent of total billed charges,,,525.98,91,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,,,,,,,,,,,,,479.74,83,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,473.96,82,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,491.3,85,,percent of total billed charges,,144.5,549.1,
ESTRADIOL,25201095,CDM,82670,CPT,300,RC,outpatient,,360,360,,305.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90,22,,percent of total billed charges,,,,,,,,,324,90,,percent of total billed charges,,,298.08,82.8,,percent of total billed charges,,,306,85,,percent of total billed charges,,,,,,,,,316.8,88,,percent of total billed charges,,,,,,,,,275.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90,22,,percent of total billed charges,,,327.6,91,,percent of total billed charges,,,342,95,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,,,,,,,,,,,,,298.8,83,,percent of total billed charges,,,342,95,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,295.2,82,,percent of total billed charges,,,324,90,,percent of total billed charges,,,306,85,,percent of total billed charges,,90,342,
LAMOTRIGINE,25201096,CDM,80175,CPT,300,RC,outpatient,,530,530,,449.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.5,22,,percent of total billed charges,,,,,,,,,477,90,,percent of total billed charges,,,438.84,82.8,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,,,,,,,,466.4,88,,percent of total billed charges,,,,,,,,,404.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.5,22,,percent of total billed charges,,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,,,,,,,,,,,,,439.9,83,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,434.6,82,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,132.5,503.5,
BRIVARACETAM,25201097,CDM,80375,CPT,300,RC,outpatient,,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.5,22,,percent of total billed charges,,,,,,,,,214.2,90,,percent of total billed charges,,,197.06,82.8,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.5,22,,percent of total billed charges,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,59.5,226.1,
LACOSAMIDE (VIMPAT),25201098,CDM,80235,CPT,300,RC,outpatient,,243,243,,206.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60.75,22,,percent of total billed charges,,,,,,,,,218.7,90,,percent of total billed charges,,,201.2,82.8,,percent of total billed charges,,,206.55,85,,percent of total billed charges,,,,,,,,,213.84,88,,percent of total billed charges,,,,,,,,,185.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60.75,22,,percent of total billed charges,,,221.13,91,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,,,,,,,,,,,,,201.69,83,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,199.26,82,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,206.55,85,,percent of total billed charges,,60.75,230.85,
LACTOFERRIN FECAL QT,25201099,CDM,83631,CPT,300,RC,outpatient,,277,277,,235.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.25,22,,percent of total billed charges,,,,,,,,,249.3,90,,percent of total billed charges,,,229.36,82.8,,percent of total billed charges,,,235.45,85,,percent of total billed charges,,,,,,,,,243.76,88,,percent of total billed charges,,,,,,,,,211.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.25,22,,percent of total billed charges,,,252.07,91,,percent of total billed charges,,,263.15,95,,percent of total billed charges,,,229.91,83,,percent of total billed charges,,,229.91,83,,percent of total billed charges,,,,,,,,,,,,,,,229.91,83,,percent of total billed charges,,,263.15,95,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,227.14,82,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,235.45,85,,percent of total billed charges,,69.25,263.15,
DNASE-B ANTIBODY,25201100,CDM,86215,CPT,300,RC,outpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.5,22,,percent of total billed charges,,,,,,,,,178.2,90,,percent of total billed charges,,,163.94,82.8,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.5,22,,percent of total billed charges,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,49.5,188.1,
CATECHOLAMINES URINE (24-HOUR),25201103,CDM,82384,CPT,300,RC,outpatient,,458,458,,388.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,114.5,22,,percent of total billed charges,,,,,,,,,412.2,90,,percent of total billed charges,,,379.22,82.8,,percent of total billed charges,,,389.3,85,,percent of total billed charges,,,,,,,,,403.04,88,,percent of total billed charges,,,,,,,,,349.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,114.5,22,,percent of total billed charges,,,416.78,91,,percent of total billed charges,,,435.1,95,,percent of total billed charges,,,380.14,83,,percent of total billed charges,,,380.14,83,,percent of total billed charges,,,,,,,,,,,,,,,380.14,83,,percent of total billed charges,,,435.1,95,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,375.56,82,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,389.3,85,,percent of total billed charges,,114.5,435.1,
BLASTOMYCES ANTIBODY,25201110,CDM,86612,CPT,300,RC,outpatient,,63,63,,53.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.75,22,,percent of total billed charges,,,,,,,,,56.7,90,,percent of total billed charges,,,52.16,82.8,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,,,,,,,,55.44,88,,percent of total billed charges,,,,,,,,,48.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.75,22,,percent of total billed charges,,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,,,,,,,,,,,,,52.29,83,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,51.66,82,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,15.75,59.85,
BLASTOMYCES AG (URINE),25201111,CDM,86612,CPT,300,RC,outpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
ASPERGILLUS ANTIBODY,25201120,CDM,86606,CPT,300,RC,outpatient,,34,34,,28.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.5,22,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,28.15,82.8,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,,,,,,,,29.92,88,,percent of total billed charges,,,,,,,,,25.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.5,22,,percent of total billed charges,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,,,,,,,,,,,,,28.22,83,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,27.88,82,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,8.5,32.3,
HYPERSENS PNEUMONITIS,25201122,CDM,86331,CPT,300,RC,outpatient,,140,140,,118.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35,22,,percent of total billed charges,,,,,,,,,126,90,,percent of total billed charges,,,115.92,82.8,,percent of total billed charges,,,119,85,,percent of total billed charges,,,,,,,,,123.2,88,,percent of total billed charges,,,,,,,,,106.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35,22,,percent of total billed charges,,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,133,95,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,114.8,82,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,35,133,
ASPERGILLUS ANTIGEN,25201123,CDM,87305,CPT,300,RC,outpatient,,335,335,,284.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.75,22,,percent of total billed charges,,,,,,,,,301.5,90,,percent of total billed charges,,,277.38,82.8,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,,,,,,,,294.8,88,,percent of total billed charges,,,,,,,,,255.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.75,22,,percent of total billed charges,,,304.85,91,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,,,,,,,,,,,,,278.05,83,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,274.7,82,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,83.75,318.25,
5-HIAA 24-HOUR URINE,25201129,CDM,83497,CPT,300,RC,outpatient,,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.75,22,,percent of total billed charges,,,,,,,,,215.1,90,,percent of total billed charges,,,197.89,82.8,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.75,22,,percent of total billed charges,,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,59.75,227.05,
"5-HIAA, RANDOM URINE",25201130,CDM,83497,CPT,300,RC,outpatient,,265,265,,224.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.25,22,,percent of total billed charges,,,,,,,,,238.5,90,,percent of total billed charges,,,219.42,82.8,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,,,,,,,,233.2,88,,percent of total billed charges,,,,,,,,,202.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.25,22,,percent of total billed charges,,,241.15,91,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,,,,,,,,,,,,,219.95,83,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,217.3,82,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,66.25,251.75,
PHOSPHOLIPASE A2 RECEPTOR IGG,25201132,CDM,83516,CPT,300,RC,outpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75,22,,percent of total billed charges,,,,,,,,,270,90,,percent of total billed charges,,,248.4,82.8,,percent of total billed charges,,,255,85,,percent of total billed charges,,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75,22,,percent of total billed charges,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,75,285,
.EPIDERMAL ANTIBODY,25201136,CDM,86255,CPT,300,RC,outpatient,,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.75,22,,percent of total billed charges,,,,,,,,,449.1,90,,percent of total billed charges,,,413.17,82.8,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.75,22,,percent of total billed charges,,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,124.75,474.05,
ERYTHROPOIETIN,25201137,CDM,82668,CPT,300,RC,outpatient,,436,436,,370.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109,22,,percent of total billed charges,,,,,,,,,392.4,90,,percent of total billed charges,,,361.01,82.8,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,,,,,,,,383.68,88,,percent of total billed charges,,,,,,,,,333.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109,22,,percent of total billed charges,,,396.76,91,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,,,,,,,,,,,,,361.88,83,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,357.52,82,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,109,414.2,
BB PLATELET PHERESIS,25201145,CDM,P9035,HCPCS,390,RC,outpatient,,3193,3193,,2710.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,798.25,22,,percent of total billed charges,,,,,,,,,2873.7,90,,percent of total billed charges,,,2643.8,82.8,,percent of total billed charges,,,2714.05,85,,percent of total billed charges,,,,,,,,,2809.84,88,,percent of total billed charges,,,,,,,,,2439.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,798.25,22,,percent of total billed charges,,,2905.63,91,,percent of total billed charges,,,3033.35,95,,percent of total billed charges,,,2650.19,83,,percent of total billed charges,,,2650.19,83,,percent of total billed charges,,,,,,,,,,,,,,,2650.19,83,,percent of total billed charges,,,3033.35,95,,percent of total billed charges,,,2873.7,90,,percent of total billed charges,,,2873.7,90,,percent of total billed charges,,,2618.26,82,,percent of total billed charges,,,2873.7,90,,percent of total billed charges,,,2714.05,85,,percent of total billed charges,,798.25,3033.35,
"CHLAMYDIA, DNA (SWAB)",25201160,CDM,87491,CPT,300,RC,outpatient,,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.75,22,,percent of total billed charges,,,,,,,,,351.9,90,,percent of total billed charges,,,323.75,82.8,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.75,22,,percent of total billed charges,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,97.75,371.45,
".CANDIDA ANTIBODIES(IGG,IGM,IGA)",25201161,CDM,86628,CPT,300,RC,outpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.75,22,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,45.54,82.8,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.75,22,,percent of total billed charges,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,13.75,52.25,
CANDIDA  ANTIBODIES QUAL.,25201162,CDM,86628,CPT,300,RC,outpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.5,22,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,64.58,82.8,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.5,22,,percent of total billed charges,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,19.5,74.1,
TICLID LEVEL (TICLOPIDINE),25201179,CDM,80299,CPT,300,RC,outpatient,,508,508,,431.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127,22,,percent of total billed charges,,,,,,,,,457.2,90,,percent of total billed charges,,,420.62,82.8,,percent of total billed charges,,,431.8,85,,percent of total billed charges,,,,,,,,,447.04,88,,percent of total billed charges,,,,,,,,,388.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127,22,,percent of total billed charges,,,462.28,91,,percent of total billed charges,,,482.6,95,,percent of total billed charges,,,421.64,83,,percent of total billed charges,,,421.64,83,,percent of total billed charges,,,,,,,,,,,,,,,421.64,83,,percent of total billed charges,,,482.6,95,,percent of total billed charges,,,457.2,90,,percent of total billed charges,,,457.2,90,,percent of total billed charges,,,416.56,82,,percent of total billed charges,,,457.2,90,,percent of total billed charges,,,431.8,85,,percent of total billed charges,,127,482.6,
VANCOMYCIN RANDOM,25201201,CDM,80202,CPT,300,RC,outpatient,,380,380,,322.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,95,22,,percent of total billed charges,,,,,,,,,342,90,,percent of total billed charges,,,314.64,82.8,,percent of total billed charges,,,323,85,,percent of total billed charges,,,,,,,,,334.4,88,,percent of total billed charges,,,,,,,,,290.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,95,22,,percent of total billed charges,,,345.8,91,,percent of total billed charges,,,361,95,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,,,,,,,,,,,,,315.4,83,,percent of total billed charges,,,361,95,,percent of total billed charges,,,342,90,,percent of total billed charges,,,342,90,,percent of total billed charges,,,311.6,82,,percent of total billed charges,,,342,90,,percent of total billed charges,,,323,85,,percent of total billed charges,,95,361,
VANCOMYCIN PEAK,25201202,CDM,80202,CPT,300,RC,outpatient,,380,380,,322.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,95,22,,percent of total billed charges,,,,,,,,,342,90,,percent of total billed charges,,,314.64,82.8,,percent of total billed charges,,,323,85,,percent of total billed charges,,,,,,,,,334.4,88,,percent of total billed charges,,,,,,,,,290.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,95,22,,percent of total billed charges,,,345.8,91,,percent of total billed charges,,,361,95,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,,,,,,,,,,,,,315.4,83,,percent of total billed charges,,,361,95,,percent of total billed charges,,,342,90,,percent of total billed charges,,,342,90,,percent of total billed charges,,,311.6,82,,percent of total billed charges,,,342,90,,percent of total billed charges,,,323,85,,percent of total billed charges,,95,361,
LYME DISEASE AB/REFLEX,25201210,CDM,86618,CPT,300,RC,outpatient,,345,345,,292.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.25,22,,percent of total billed charges,,,,,,,,,310.5,90,,percent of total billed charges,,,285.66,82.8,,percent of total billed charges,,,293.25,85,,percent of total billed charges,,,,,,,,,303.6,88,,percent of total billed charges,,,,,,,,,263.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.25,22,,percent of total billed charges,,,313.95,91,,percent of total billed charges,,,327.75,95,,percent of total billed charges,,,286.35,83,,percent of total billed charges,,,286.35,83,,percent of total billed charges,,,,,,,,,,,,,,,286.35,83,,percent of total billed charges,,,327.75,95,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,282.9,82,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,293.25,85,,percent of total billed charges,,86.25,327.75,
LYME DISEASE DNA QUAL PCR,25201215,CDM,87801,CPT,300,RC,outpatient,,1053,1053,,894,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,263.25,22,,percent of total billed charges,,,,,,,,,947.7,90,,percent of total billed charges,,,871.88,82.8,,percent of total billed charges,,,895.05,85,,percent of total billed charges,,,,,,,,,926.64,88,,percent of total billed charges,,,,,,,,,804.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,263.25,22,,percent of total billed charges,,,958.23,91,,percent of total billed charges,,,1000.35,95,,percent of total billed charges,,,873.99,83,,percent of total billed charges,,,873.99,83,,percent of total billed charges,,,,,,,,,,,,,,,873.99,83,,percent of total billed charges,,,1000.35,95,,percent of total billed charges,,,947.7,90,,percent of total billed charges,,,947.7,90,,percent of total billed charges,,,863.46,82,,percent of total billed charges,,,947.7,90,,percent of total billed charges,,,895.05,85,,percent of total billed charges,,263.25,1000.35,
".EHELICHIA CHEFFENS (IGG,IGM)",25201220,CDM,86666,CPT,300,RC,outpatient,,224,224,,190.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56,22,,percent of total billed charges,,,,,,,,,201.6,90,,percent of total billed charges,,,185.47,82.8,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,,,,,,,,197.12,88,,percent of total billed charges,,,,,,,,,171.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56,22,,percent of total billed charges,,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,183.68,82,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,56,212.8,
.EHELICHIA PCR,25201221,CDM,87798,CPT,300,RC,outpatient,,401,401,,340.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100.25,22,,percent of total billed charges,,,,,,,,,360.9,90,,percent of total billed charges,,,332.03,82.8,,percent of total billed charges,,,340.85,85,,percent of total billed charges,,,,,,,,,352.88,88,,percent of total billed charges,,,,,,,,,306.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100.25,22,,percent of total billed charges,,,364.91,91,,percent of total billed charges,,,380.95,95,,percent of total billed charges,,,332.83,83,,percent of total billed charges,,,332.83,83,,percent of total billed charges,,,,,,,,,,,,,,,332.83,83,,percent of total billed charges,,,380.95,95,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,328.82,82,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,340.85,85,,percent of total billed charges,,100.25,380.95,
CALCIUM URINE (24-HOUR),25201236,CDM,82340,CPT,300,RC,outpatient,,158,158,,134.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.5,22,,percent of total billed charges,,,,,,,,,142.2,90,,percent of total billed charges,,,130.82,82.8,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,,,,,,,,139.04,88,,percent of total billed charges,,,,,,,,,120.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.5,22,,percent of total billed charges,,,143.78,91,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,,,,,,,,,,,,,131.14,83,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,129.56,82,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,39.5,150.1,
CALCIUM URINE (RANDOM),25201237,CDM,82310,CPT,300,RC,outpatient,,158,158,,134.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.5,22,,percent of total billed charges,,,,,,,,,142.2,90,,percent of total billed charges,,,130.82,82.8,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,,,,,,,,139.04,88,,percent of total billed charges,,,,,,,,,120.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.5,22,,percent of total billed charges,,,143.78,91,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,,,,,,,,,,,,,131.14,83,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,129.56,82,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,39.5,150.1,
URIC ACID URINE (24-HOUR),25201244,CDM,84560,CPT,300,RC,outpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31,22,,percent of total billed charges,,,,,,,,,111.6,90,,percent of total billed charges,,,102.67,82.8,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31,22,,percent of total billed charges,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,31,117.8,
UREA URINE (24-HOUR),25201245,CDM,84540,CPT,300,RC,outpatient,,113,113,,95.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.25,22,,percent of total billed charges,,,,,,,,,101.7,90,,percent of total billed charges,,,93.56,82.8,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,,,,,,,,99.44,88,,percent of total billed charges,,,,,,,,,86.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.25,22,,percent of total billed charges,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,92.66,82,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,28.25,107.35,
URIC ACID URINE RANDOM,25201246,CDM,84560,CPT,300,RC,outpatient,,95,95,,80.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.75,22,,percent of total billed charges,,,,,,,,,85.5,90,,percent of total billed charges,,,78.66,82.8,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,,,,,,,,83.6,88,,percent of total billed charges,,,,,,,,,72.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.75,22,,percent of total billed charges,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,,,,,,,,,,,,,78.85,83,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,77.9,82,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,23.75,90.25,
LEAD BLOOD(CAPILLARY SAMPLE),25201251,CDM,83655,CPT,300,RC,outpatient,,202,202,,171.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.5,22,,percent of total billed charges,,,,,,,,,181.8,90,,percent of total billed charges,,,167.26,82.8,,percent of total billed charges,,,171.7,85,,percent of total billed charges,,,,,,,,,177.76,88,,percent of total billed charges,,,,,,,,,154.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.5,22,,percent of total billed charges,,,183.82,91,,percent of total billed charges,,,191.9,95,,percent of total billed charges,,,167.66,83,,percent of total billed charges,,,167.66,83,,percent of total billed charges,,,,,,,,,,,,,,,167.66,83,,percent of total billed charges,,,191.9,95,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,165.64,82,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,171.7,85,,percent of total billed charges,,50.5,191.9,
LEAD URINE,25201252,CDM,83655,CPT,300,RC,outpatient,,155,155,,131.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.75,22,,percent of total billed charges,,,,,,,,,139.5,90,,percent of total billed charges,,,128.34,82.8,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,,,,,,,,136.4,88,,percent of total billed charges,,,,,,,,,118.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.75,22,,percent of total billed charges,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,127.1,82,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,38.75,147.25,
LEAD BLOOD (WHOLE BLOOD),25201253,CDM,83655,CPT,300,RC,outpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
SILVER SERUM/PLASMA,25201254,CDM,83018,CPT,300,RC,outpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
ACETAMINOPHEN,25201269,CDM,80143,CPT,300,RC,outpatient,,383,383,,325.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,95.75,22,,percent of total billed charges,,,,,,,,,344.7,90,,percent of total billed charges,,,317.12,82.8,,percent of total billed charges,,,325.55,85,,percent of total billed charges,,,,,,,,,337.04,88,,percent of total billed charges,,,,,,,,,292.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,95.75,22,,percent of total billed charges,,,348.53,91,,percent of total billed charges,,,363.85,95,,percent of total billed charges,,,317.89,83,,percent of total billed charges,,,317.89,83,,percent of total billed charges,,,,,,,,,,,,,,,317.89,83,,percent of total billed charges,,,363.85,95,,percent of total billed charges,,,344.7,90,,percent of total billed charges,,,344.7,90,,percent of total billed charges,,,314.06,82,,percent of total billed charges,,,344.7,90,,percent of total billed charges,,,325.55,85,,percent of total billed charges,,95.75,363.85,
CA 125,25201277,CDM,86304,CPT,300,RC,outpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94,22,,percent of total billed charges,,,,,,,,,338.4,90,,percent of total billed charges,,,311.33,82.8,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94,22,,percent of total billed charges,,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,94,357.2,
ALKALINE PHOSPHATASE ISOENZYMES,25201285,CDM,84080,CPT,300,RC,outpatient,,288,288,,244.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72,22,,percent of total billed charges,,,,,,,,,259.2,90,,percent of total billed charges,,,238.46,82.8,,percent of total billed charges,,,244.8,85,,percent of total billed charges,,,,,,,,,253.44,88,,percent of total billed charges,,,,,,,,,220.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72,22,,percent of total billed charges,,,262.08,91,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,,,,,,,,,,,,,239.04,83,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,236.16,82,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,244.8,85,,percent of total billed charges,,72,273.6,
ALKALINE PHOSPHATASE BONE SP,25201286,CDM,84075,CPT,300,RC,outpatient,,95,95,,80.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.75,22,,percent of total billed charges,,,,,,,,,85.5,90,,percent of total billed charges,,,78.66,82.8,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,,,,,,,,83.6,88,,percent of total billed charges,,,,,,,,,72.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.75,22,,percent of total billed charges,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,,,,,,,,,,,,,78.85,83,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,77.9,82,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,23.75,90.25,
SURG  INSITU HYBRIDIZATION(INIT),25201290,CDM,88365,CPT,310,RC,outpatient,,161,161,,136.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.25,22,,percent of total billed charges,,,,,,,,,144.9,90,,percent of total billed charges,,,133.31,82.8,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,,,,,,,,141.68,88,,percent of total billed charges,,,,,,,,,123,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.25,22,,percent of total billed charges,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,132.02,82,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,40.25,152.95,
SURG  INSITU HYBRIDIZATION(ADDITIONAL),25201291,CDM,88364,CPT,310,RC,outpatient,,161,161,,136.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.25,22,,percent of total billed charges,,,,,,,,,144.9,90,,percent of total billed charges,,,133.31,82.8,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,,,,,,,,141.68,88,,percent of total billed charges,,,,,,,,,123,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.25,22,,percent of total billed charges,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,132.02,82,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,40.25,152.95,
PROBE STAIN (KAPA/LAMDA),25201292,CDM,88365,CPT,310,RC,outpatient,,316,316,,268.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79,22,,percent of total billed charges,,,,,,,,,284.4,90,,percent of total billed charges,,,261.65,82.8,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,,,,,,,,278.08,88,,percent of total billed charges,,,,,,,,,241.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79,22,,percent of total billed charges,,,287.56,91,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,,,,,,,,,,,,,262.28,83,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,259.12,82,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,79,300.2,
ER/PR IMMUNOHISTOCHEM PARAFFIN,25201293,CDM,88360,CPT,310,RC,outpatient,,498,498,,422.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.5,22,,percent of total billed charges,,,,,,,,,448.2,90,,percent of total billed charges,,,412.34,82.8,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,,,,,,,,438.24,88,,percent of total billed charges,,,,,,,,,380.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.5,22,,percent of total billed charges,,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,,,,,,,,,,,,,413.34,83,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,408.36,82,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,124.5,473.1,
.HER 2 NEU BY FISH,25201294,CDM,88374,CPT,310,RC,outpatient,,515,515,,437.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,128.75,22,,percent of total billed charges,,,,,,,,,463.5,90,,percent of total billed charges,,,426.42,82.8,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,,,,,,,,453.2,88,,percent of total billed charges,,,,,,,,,393.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,128.75,22,,percent of total billed charges,,,468.65,91,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,,,,,,,,,,,,,427.45,83,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,422.3,82,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,128.75,489.25,
SURG PATH-TISSUE INSITU HYBRIDIZATION,25201295,CDM,88275,CPT,310,RC,outpatient,,467,467,,396.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.75,22,,percent of total billed charges,,,,,,,,,420.3,90,,percent of total billed charges,,,386.68,82.8,,percent of total billed charges,,,396.95,85,,percent of total billed charges,,,,,,,,,410.96,88,,percent of total billed charges,,,,,,,,,356.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.75,22,,percent of total billed charges,,,424.97,91,,percent of total billed charges,,,443.65,95,,percent of total billed charges,,,387.61,83,,percent of total billed charges,,,387.61,83,,percent of total billed charges,,,,,,,,,,,,,,,387.61,83,,percent of total billed charges,,,443.65,95,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,382.94,82,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,396.95,85,,percent of total billed charges,,116.75,443.65,
MORPHOMETRIC ANALYSIS 88361,25201296,CDM,88361,CPT,310,RC,outpatient,,491,491,,416.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.75,22,,percent of total billed charges,,,,,,,,,441.9,90,,percent of total billed charges,,,406.55,82.8,,percent of total billed charges,,,417.35,85,,percent of total billed charges,,,,,,,,,432.08,88,,percent of total billed charges,,,,,,,,,375.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.75,22,,percent of total billed charges,,,446.81,91,,percent of total billed charges,,,466.45,95,,percent of total billed charges,,,407.53,83,,percent of total billed charges,,,407.53,83,,percent of total billed charges,,,,,,,,,,,,,,,407.53,83,,percent of total billed charges,,,466.45,95,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,402.62,82,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,417.35,85,,percent of total billed charges,,122.75,466.45,
PROBE STAIN,25201297,CDM,88364,CPT,310,RC,outpatient,,526,526,,446.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.5,22,,percent of total billed charges,,,,,,,,,473.4,90,,percent of total billed charges,,,435.53,82.8,,percent of total billed charges,,,447.1,85,,percent of total billed charges,,,,,,,,,462.88,88,,percent of total billed charges,,,,,,,,,401.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131.5,22,,percent of total billed charges,,,478.66,91,,percent of total billed charges,,,499.7,95,,percent of total billed charges,,,436.58,83,,percent of total billed charges,,,436.58,83,,percent of total billed charges,,,,,,,,,,,,,,,436.58,83,,percent of total billed charges,,,499.7,95,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,431.32,82,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,447.1,85,,percent of total billed charges,,131.5,499.7,
MORPHOMETRIC STAIN,25201298,CDM,88377,CPT,310,RC,outpatient,,319,319,,270.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.75,22,,percent of total billed charges,,,,,,,,,287.1,90,,percent of total billed charges,,,264.13,82.8,,percent of total billed charges,,,271.15,85,,percent of total billed charges,,,,,,,,,280.72,88,,percent of total billed charges,,,,,,,,,243.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.75,22,,percent of total billed charges,,,290.29,91,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,,,,,,,,,,,,,264.77,83,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,261.58,82,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,271.15,85,,percent of total billed charges,,79.75,303.05,
"OXALATE, URINE (24-HOUR)",25201301,CDM,83945,CPT,300,RC,outpatient,,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
OSTEOCALCIN,25201302,CDM,83937,CPT,300,RC,outpatient,,498,498,,422.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.5,22,,percent of total billed charges,,,,,,,,,448.2,90,,percent of total billed charges,,,412.34,82.8,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,,,,,,,,438.24,88,,percent of total billed charges,,,,,,,,,380.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.5,22,,percent of total billed charges,,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,,,,,,,,,,,,,413.34,83,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,408.36,82,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,124.5,473.1,
OPIATES CONFIRMATION URINE,25201303,CDM,80361,CPT,300,RC,outpatient,,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.25,22,,percent of total billed charges,,,,,,,,,137.7,90,,percent of total billed charges,,,126.68,82.8,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.25,22,,percent of total billed charges,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,38.25,145.35,
AMPHETAMINES/METHAMPH URINE (CONFIRM),25201304,CDM,80324,CPT,300,RC,outpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31,22,,percent of total billed charges,,,,,,,,,111.6,90,,percent of total billed charges,,,102.67,82.8,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31,22,,percent of total billed charges,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,31,117.8,
TRICYCLIC ANTIDEPRESANT URINE (CONFIRM),25201305,CDM,80337,CPT,300,RC,outpatient,,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.25,22,,percent of total billed charges,,,,,,,,,155.7,90,,percent of total billed charges,,,143.24,82.8,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.25,22,,percent of total billed charges,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,43.25,164.35,
BENZODIAZEPINE URINE (CONFIRM),25201306,CDM,80346,CPT,300,RC,outpatient,,359,359,,304.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.75,22,,percent of total billed charges,,,,,,,,,323.1,90,,percent of total billed charges,,,297.25,82.8,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,,,,,,,,315.92,88,,percent of total billed charges,,,,,,,,,274.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.75,22,,percent of total billed charges,,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,,,,,,,,,,,,,297.97,83,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,294.38,82,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,89.75,341.05,
OLANZAPINE (ZYPREXA),25201307,CDM,80342,CPT,300,RC,outpatient,,431,431,,365.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.75,22,,percent of total billed charges,,,,,,,,,387.9,90,,percent of total billed charges,,,356.87,82.8,,percent of total billed charges,,,366.35,85,,percent of total billed charges,,,,,,,,,379.28,88,,percent of total billed charges,,,,,,,,,329.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.75,22,,percent of total billed charges,,,392.21,91,,percent of total billed charges,,,409.45,95,,percent of total billed charges,,,357.73,83,,percent of total billed charges,,,357.73,83,,percent of total billed charges,,,,,,,,,,,,,,,357.73,83,,percent of total billed charges,,,409.45,95,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,353.42,82,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,366.35,85,,percent of total billed charges,,107.75,409.45,
AMPHETAMINES/METHAMPH BLOOD (CONFIRM),25201308,CDM,80324,CPT,300,RC,outpatient,,329,329,,279.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.25,22,,percent of total billed charges,,,,,,,,,296.1,90,,percent of total billed charges,,,272.41,82.8,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,,,,,,,,289.52,88,,percent of total billed charges,,,,,,,,,251.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82.25,22,,percent of total billed charges,,,299.39,91,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,,,,,,,,,,,,,273.07,83,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,269.78,82,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,82.25,312.55,
ZINC TRANSPORTER 8 (ZNT8),25201309,CDM,86341,CPT,300,RC,outpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94,22,,percent of total billed charges,,,,,,,,,338.4,90,,percent of total billed charges,,,311.33,82.8,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94,22,,percent of total billed charges,,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,94,357.2,
.ROMA (OVARIAN CANCER RISK),25201310,CDM,81500,CPT,300,RC,outpatient,,722,722,,612.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.5,22,,percent of total billed charges,,,,,,,,,649.8,90,,percent of total billed charges,,,597.82,82.8,,percent of total billed charges,,,613.7,85,,percent of total billed charges,,,,,,,,,635.36,88,,percent of total billed charges,,,,,,,,,551.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.5,22,,percent of total billed charges,,,657.02,91,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,,,,,,,,,,,,,599.26,83,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,592.04,82,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,613.7,85,,percent of total billed charges,,180.5,685.9,
FENTANYL CONFIRMATION URINE,25201311,CDM,80354,CPT,300,RC,outpatient,,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.25,22,,percent of total billed charges,,,,,,,,,137.7,90,,percent of total billed charges,,,126.68,82.8,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.25,22,,percent of total billed charges,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,38.25,145.35,
COCAINE CONFIRMATION URINE,25201312,CDM,80353,CPT,300,RC,outpatient,,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.25,22,,percent of total billed charges,,,,,,,,,137.7,90,,percent of total billed charges,,,126.68,82.8,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.25,22,,percent of total billed charges,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,38.25,145.35,
AMPHETAMINES SERUM,25201313,CDM,80324,CPT,300,RC,outpatient,,329,329,,279.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.25,22,,percent of total billed charges,,,,,,,,,296.1,90,,percent of total billed charges,,,272.41,82.8,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,,,,,,,,289.52,88,,percent of total billed charges,,,,,,,,,251.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82.25,22,,percent of total billed charges,,,299.39,91,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,,,,,,,,,,,,,273.07,83,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,269.78,82,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,82.25,312.55,
BENZENE PROFILE,25201314,CDM,84600,CPT,300,RC,outpatient,,260,260,,220.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65,22,,percent of total billed charges,,,,,,,,,234,90,,percent of total billed charges,,,215.28,82.8,,percent of total billed charges,,,221,85,,percent of total billed charges,,,,,,,,,228.8,88,,percent of total billed charges,,,,,,,,,198.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65,22,,percent of total billed charges,,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,,,,,,,,,,,,,215.8,83,,percent of total billed charges,,,247,95,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,213.2,82,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,65,247,
METHYLPHENIDATE & METABOLITE,25201315,CDM,80360,CPT,300,RC,outpatient,,219,219,,185.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.75,22,,percent of total billed charges,,,,,,,,,197.1,90,,percent of total billed charges,,,181.33,82.8,,percent of total billed charges,,,186.15,85,,percent of total billed charges,,,,,,,,,192.72,88,,percent of total billed charges,,,,,,,,,167.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.75,22,,percent of total billed charges,,,199.29,91,,percent of total billed charges,,,208.05,95,,percent of total billed charges,,,181.77,83,,percent of total billed charges,,,181.77,83,,percent of total billed charges,,,,,,,,,,,,,,,181.77,83,,percent of total billed charges,,,208.05,95,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,179.58,82,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,186.15,85,,percent of total billed charges,,54.75,208.05,
METHYLHISTAMINE,25201316,CDM,82542,CPT,300,RC,outpatient,,471,471,,399.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.75,22,,percent of total billed charges,,,,,,,,,423.9,90,,percent of total billed charges,,,389.99,82.8,,percent of total billed charges,,,400.35,85,,percent of total billed charges,,,,,,,,,414.48,88,,percent of total billed charges,,,,,,,,,359.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.75,22,,percent of total billed charges,,,428.61,91,,percent of total billed charges,,,447.45,95,,percent of total billed charges,,,390.93,83,,percent of total billed charges,,,390.93,83,,percent of total billed charges,,,,,,,,,,,,,,,390.93,83,,percent of total billed charges,,,447.45,95,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,386.22,82,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,400.35,85,,percent of total billed charges,,117.75,447.45,
BENZODIAZEPINE & METABOLITE,25201317,CDM,80346,CPT,300,RC,outpatient,,417,417,,354.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.25,22,,percent of total billed charges,,,,,,,,,375.3,90,,percent of total billed charges,,,345.28,82.8,,percent of total billed charges,,,354.45,85,,percent of total billed charges,,,,,,,,,366.96,88,,percent of total billed charges,,,,,,,,,318.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.25,22,,percent of total billed charges,,,379.47,91,,percent of total billed charges,,,396.15,95,,percent of total billed charges,,,346.11,83,,percent of total billed charges,,,346.11,83,,percent of total billed charges,,,,,,,,,,,,,,,346.11,83,,percent of total billed charges,,,396.15,95,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,341.94,82,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,354.45,85,,percent of total billed charges,,104.25,396.15,
HEPATITIS B SURFACE AB  QUANT,25201318,CDM,86317,CPT,300,RC,outpatient,,210,210,,178.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.5,22,,percent of total billed charges,,,,,,,,,189,90,,percent of total billed charges,,,173.88,82.8,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,,,,,,,,184.8,88,,percent of total billed charges,,,,,,,,,160.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.5,22,,percent of total billed charges,,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,,,,,,,,,,,,,174.3,83,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,172.2,82,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,52.5,199.5,
HEPATITIS B SURFACE ANTIBODY,25201319,CDM,86706,CPT,300,RC,outpatient,,210,210,,178.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.5,22,,percent of total billed charges,,,,,,,,,189,90,,percent of total billed charges,,,173.88,82.8,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,,,,,,,,184.8,88,,percent of total billed charges,,,,,,,,,160.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.5,22,,percent of total billed charges,,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,,,,,,,,,,,,,174.3,83,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,172.2,82,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,52.5,199.5,
HEPATITIS B SCREEN (NON PREGNANT),25201320,CDM,G0499,HCPCS,300,RC,outpatient,,529,529,,449.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.25,22,,percent of total billed charges,,,,,,,,,476.1,90,,percent of total billed charges,,,438.01,82.8,,percent of total billed charges,,,449.65,85,,percent of total billed charges,,,,,,,,,465.52,88,,percent of total billed charges,,,,,,,,,404.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.25,22,,percent of total billed charges,,,481.39,91,,percent of total billed charges,,,502.55,95,,percent of total billed charges,,,439.07,83,,percent of total billed charges,,,439.07,83,,percent of total billed charges,,,,,,,,,,,,,,,439.07,83,,percent of total billed charges,,,502.55,95,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,433.78,82,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,449.65,85,,percent of total billed charges,,132.25,502.55,
BARBITURATE CONFIRMATION URINE,25201324,CDM,80345,CPT,300,RC,outpatient,,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.25,22,,percent of total billed charges,,,,,,,,,40.5,90,,percent of total billed charges,,,37.26,82.8,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.25,22,,percent of total billed charges,,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,11.25,42.75,
PROSTATIC ACID PHOSPHATASE,25201327,CDM,84066,CPT,300,RC,outpatient,,166,166,,140.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.5,22,,percent of total billed charges,,,,,,,,,149.4,90,,percent of total billed charges,,,137.45,82.8,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,,,,,,,,146.08,88,,percent of total billed charges,,,,,,,,,126.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.5,22,,percent of total billed charges,,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,,,,,,,,,,,,,137.78,83,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,136.12,82,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,41.5,157.7,
LDH CSF,25201343,CDM,83615,CPT,300,RC,outpatient,,166,166,,140.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.5,22,,percent of total billed charges,,,,,,,,,149.4,90,,percent of total billed charges,,,137.45,82.8,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,,,,,,,,146.08,88,,percent of total billed charges,,,,,,,,,126.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.5,22,,percent of total billed charges,,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,,,,,,,,,,,,,137.78,83,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,136.12,82,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,41.5,157.7,
CITRIC ACID URINE (24-HOUR),25201351,CDM,82507,CPT,300,RC,outpatient,,280,280,,237.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70,22,,percent of total billed charges,,,,,,,,,252,90,,percent of total billed charges,,,231.84,82.8,,percent of total billed charges,,,238,85,,percent of total billed charges,,,,,,,,,246.4,88,,percent of total billed charges,,,,,,,,,213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70,22,,percent of total billed charges,,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,,,,,,,,,,,,,232.4,83,,percent of total billed charges,,,266,95,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,229.6,82,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,70,266,
CITRIC ACID URINE (RANDOM),25201352,CDM,82507,CPT,300,RC,outpatient,,280,280,,237.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70,22,,percent of total billed charges,,,,,,,,,252,90,,percent of total billed charges,,,231.84,82.8,,percent of total billed charges,,,238,85,,percent of total billed charges,,,,,,,,,246.4,88,,percent of total billed charges,,,,,,,,,213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70,22,,percent of total billed charges,,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,,,,,,,,,,,,,232.4,83,,percent of total billed charges,,,266,95,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,229.6,82,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,70,266,
HEPATITIS BE ANTIGEN,25201368,CDM,87350,CPT,300,RC,outpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.75,22,,percent of total billed charges,,,,,,,,,182.7,90,,percent of total billed charges,,,168.08,82.8,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.75,22,,percent of total billed charges,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,50.75,192.85,
HISTOPLASMA ANTIBODY TOTAL,25201383,CDM,86698,CPT,300,RC,outpatient,,189,189,,160.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.25,22,,percent of total billed charges,,,,,,,,,170.1,90,,percent of total billed charges,,,156.49,82.8,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,,,,,,,,166.32,88,,percent of total billed charges,,,,,,,,,144.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.25,22,,percent of total billed charges,,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,,,,,,,,,,,,,156.87,83,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,154.98,82,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,47.25,179.55,
.HISTOPLASMA ANTIBODY COMP FIXATION,25201384,CDM,86698,CPT,300,RC,outpatient,,187,187,,158.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.75,22,,percent of total billed charges,,,,,,,,,168.3,90,,percent of total billed charges,,,154.84,82.8,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,,,,,,,,164.56,88,,percent of total billed charges,,,,,,,,,142.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.75,22,,percent of total billed charges,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,153.34,82,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,46.75,177.65,
HISTOPLASMA AG SERUM,25201385,CDM,87385,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
HISTOPLASMA AG URINE,25201386,CDM,87385,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
HISTOPLASMA AG AB (H & M),25201387,CDM,86698,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
IMIPRAMINE,25201392,CDM,G6030,HCPCS,300,RC,outpatient,,210,210,,178.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.5,22,,percent of total billed charges,,,,,,,,,189,90,,percent of total billed charges,,,173.88,82.8,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,,,,,,,,184.8,88,,percent of total billed charges,,,,,,,,,160.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.5,22,,percent of total billed charges,,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,,,,,,,,,,,,,174.3,83,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,172.2,82,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,52.5,199.5,
VECTRA,25201399,CDM,81490,CPT,300,RC,outpatient,,1869,1869,,1586.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,467.25,22,,percent of total billed charges,,,,,,,,,1682.1,90,,percent of total billed charges,,,1547.53,82.8,,percent of total billed charges,,,1588.65,85,,percent of total billed charges,,,,,,,,,1644.72,88,,percent of total billed charges,,,,,,,,,1427.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,467.25,22,,percent of total billed charges,,,1700.79,91,,percent of total billed charges,,,1775.55,95,,percent of total billed charges,,,1551.27,83,,percent of total billed charges,,,1551.27,83,,percent of total billed charges,,,,,,,,,,,,,,,1551.27,83,,percent of total billed charges,,,1775.55,95,,percent of total billed charges,,,1682.1,90,,percent of total billed charges,,,1682.1,90,,percent of total billed charges,,,1532.58,82,,percent of total billed charges,,,1682.1,90,,percent of total billed charges,,,1588.65,85,,percent of total billed charges,,467.25,1775.55,
VARICELLA-ZOSTER ANTIBODY (IgG),25201400,CDM,86787,CPT,300,RC,outpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27,22,,percent of total billed charges,,,,,,,,,97.2,90,,percent of total billed charges,,,89.42,82.8,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27,22,,percent of total billed charges,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,27,102.6,
"VARICELLA-ZOSTER ANTIBODY, IGM",25201401,CDM,86787,CPT,300,RC,outpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.25,22,,percent of total billed charges,,,,,,,,,98.1,90,,percent of total billed charges,,,90.25,82.8,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.25,22,,percent of total billed charges,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,27.25,103.55,
"ZIKA VIRUS, IGM",25201402,CDM,86790,CPT,300,RC,outpatient,,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43,22,,percent of total billed charges,,,,,,,,,154.8,90,,percent of total billed charges,,,142.42,82.8,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43,22,,percent of total billed charges,,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,43,163.4,
"ZIKA VIRUS, COMP PROFILE",25201403,CDM,87798,CPT,300,RC,outpatient,,515,515,,437.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,128.75,22,,percent of total billed charges,,,,,,,,,463.5,90,,percent of total billed charges,,,426.42,82.8,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,,,,,,,,453.2,88,,percent of total billed charges,,,,,,,,,393.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,128.75,22,,percent of total billed charges,,,468.65,91,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,,,,,,,,,,,,,427.45,83,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,422.3,82,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,128.75,489.25,
OSMOLALITY URINE,25201418,CDM,83935,CPT,300,RC,outpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31,22,,percent of total billed charges,,,,,,,,,111.6,90,,percent of total billed charges,,,102.67,82.8,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31,22,,percent of total billed charges,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,31,117.8,
OSMOLALITY STOOL,25201419,CDM,84999,CPT,300,RC,outpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31,22,,percent of total billed charges,,,,,,,,,111.6,90,,percent of total billed charges,,,102.67,82.8,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31,22,,percent of total billed charges,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,31,117.8,
SEROTONIN SERUM,25201426,CDM,84260,CPT,300,RC,outpatient,,319,319,,270.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.75,22,,percent of total billed charges,,,,,,,,,287.1,90,,percent of total billed charges,,,264.13,82.8,,percent of total billed charges,,,271.15,85,,percent of total billed charges,,,,,,,,,280.72,88,,percent of total billed charges,,,,,,,,,243.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.75,22,,percent of total billed charges,,,290.29,91,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,,,,,,,,,,,,,264.77,83,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,261.58,82,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,271.15,85,,percent of total billed charges,,79.75,303.05,
SEROTONIN WHOLE BLOOD,25201427,CDM,84260,CPT,300,RC,outpatient,,664,664,,563.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166,22,,percent of total billed charges,,,,,,,,,597.6,90,,percent of total billed charges,,,549.79,82.8,,percent of total billed charges,,,564.4,85,,percent of total billed charges,,,,,,,,,584.32,88,,percent of total billed charges,,,,,,,,,507.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166,22,,percent of total billed charges,,,604.24,91,,percent of total billed charges,,,630.8,95,,percent of total billed charges,,,551.12,83,,percent of total billed charges,,,551.12,83,,percent of total billed charges,,,,,,,,,,,,,,,551.12,83,,percent of total billed charges,,,630.8,95,,percent of total billed charges,,,597.6,90,,percent of total billed charges,,,597.6,90,,percent of total billed charges,,,544.48,82,,percent of total billed charges,,,597.6,90,,percent of total billed charges,,,564.4,85,,percent of total billed charges,,166,630.8,
ANTITHROMBIN III ANTIGEN,25201434,CDM,85300,CPT,300,RC,outpatient,,382,382,,324.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,95.5,22,,percent of total billed charges,,,,,,,,,343.8,90,,percent of total billed charges,,,316.3,82.8,,percent of total billed charges,,,324.7,85,,percent of total billed charges,,,,,,,,,336.16,88,,percent of total billed charges,,,,,,,,,291.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,95.5,22,,percent of total billed charges,,,347.62,91,,percent of total billed charges,,,362.9,95,,percent of total billed charges,,,317.06,83,,percent of total billed charges,,,317.06,83,,percent of total billed charges,,,,,,,,,,,,,,,317.06,83,,percent of total billed charges,,,362.9,95,,percent of total billed charges,,,343.8,90,,percent of total billed charges,,,343.8,90,,percent of total billed charges,,,313.24,82,,percent of total billed charges,,,343.8,90,,percent of total billed charges,,,324.7,85,,percent of total billed charges,,95.5,362.9,
ANTITHROMBIN III ACTIVITY,25201435,CDM,85300,CPT,300,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
ANTI-TH/TO AB (RDL),25201436,CDM,83516,CPT,300,RC,outpatient,,164,164,,139.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41,22,,percent of total billed charges,,,,,,,,,147.6,90,,percent of total billed charges,,,135.79,82.8,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,,,,,,,,144.32,88,,percent of total billed charges,,,,,,,,,125.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41,22,,percent of total billed charges,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,134.48,82,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,41,155.8,
T-3 UPTAKE,25201442,CDM,84479,CPT,300,RC,outpatient,,171,171,,145.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.75,22,,percent of total billed charges,,,,,,,,,153.9,90,,percent of total billed charges,,,141.59,82.8,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,,,,,,,,150.48,88,,percent of total billed charges,,,,,,,,,130.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.75,22,,percent of total billed charges,,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,,,,,,,,,,,,,141.93,83,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,140.22,82,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,42.75,162.45,
THYROGLOBULIN+TGAB,25201458,CDM,86800,CPT,300,RC,outpatient,,175,175,,148.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.75,22,,percent of total billed charges,,,,,,,,,157.5,90,,percent of total billed charges,,,144.9,82.8,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,,,,,,,,154,88,,percent of total billed charges,,,,,,,,,133.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.75,22,,percent of total billed charges,,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,,,,,,,,,,,,,145.25,83,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,143.5,82,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,43.75,166.25,
THYROGLOBULIN ANTIBODIES,25201459,CDM,86800,CPT,300,RC,outpatient,,260,260,,220.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65,22,,percent of total billed charges,,,,,,,,,234,90,,percent of total billed charges,,,215.28,82.8,,percent of total billed charges,,,221,85,,percent of total billed charges,,,,,,,,,228.8,88,,percent of total billed charges,,,,,,,,,198.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65,22,,percent of total billed charges,,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,,,,,,,,,,,,,215.8,83,,percent of total billed charges,,,247,95,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,213.2,82,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,65,247,
.THYROGLOBULIN (TG RIA),25201461,CDM,84432,CPT,300,RC,outpatient,,260,260,,220.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65,22,,percent of total billed charges,,,,,,,,,234,90,,percent of total billed charges,,,215.28,82.8,,percent of total billed charges,,,221,85,,percent of total billed charges,,,,,,,,,228.8,88,,percent of total billed charges,,,,,,,,,198.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65,22,,percent of total billed charges,,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,,,,,,,,,,,,,215.8,83,,percent of total billed charges,,,247,95,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,213.2,82,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,65,247,
THYROGLOBULIN AB IMA/MS,25201462,CDM,86800,CPT,300,RC,outpatient,,260,260,,220.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65,22,,percent of total billed charges,,,,,,,,,234,90,,percent of total billed charges,,,215.28,82.8,,percent of total billed charges,,,221,85,,percent of total billed charges,,,,,,,,,228.8,88,,percent of total billed charges,,,,,,,,,198.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65,22,,percent of total billed charges,,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,,,,,,,,,,,,,215.8,83,,percent of total billed charges,,,247,95,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,213.2,82,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,65,247,
TOBRAMYCIN RANDOM,25201463,CDM,80200,CPT,300,RC,outpatient,,320,320,,271.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80,22,,percent of total billed charges,,,,,,,,,288,90,,percent of total billed charges,,,264.96,82.8,,percent of total billed charges,,,272,85,,percent of total billed charges,,,,,,,,,281.6,88,,percent of total billed charges,,,,,,,,,244.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80,22,,percent of total billed charges,,,291.2,91,,percent of total billed charges,,,304,95,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,,,,,,,,,,,,,265.6,83,,percent of total billed charges,,,304,95,,percent of total billed charges,,,288,90,,percent of total billed charges,,,288,90,,percent of total billed charges,,,262.4,82,,percent of total billed charges,,,288,90,,percent of total billed charges,,,272,85,,percent of total billed charges,,80,304,
TOBRAMYCIN PEAK,25201467,CDM,80200,CPT,300,RC,outpatient,,320,320,,271.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80,22,,percent of total billed charges,,,,,,,,,288,90,,percent of total billed charges,,,264.96,82.8,,percent of total billed charges,,,272,85,,percent of total billed charges,,,,,,,,,281.6,88,,percent of total billed charges,,,,,,,,,244.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80,22,,percent of total billed charges,,,291.2,91,,percent of total billed charges,,,304,95,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,,,,,,,,,,,,,265.6,83,,percent of total billed charges,,,304,95,,percent of total billed charges,,,288,90,,percent of total billed charges,,,288,90,,percent of total billed charges,,,262.4,82,,percent of total billed charges,,,288,90,,percent of total billed charges,,,272,85,,percent of total billed charges,,80,304,
INHIBIN-A,25201468,CDM,86336,CPT,300,RC,outpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.5,22,,percent of total billed charges,,,,,,,,,289.8,90,,percent of total billed charges,,,266.62,82.8,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.5,22,,percent of total billed charges,,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,80.5,305.9,
TOBRAMYCIN TROUGH,25201469,CDM,80200,CPT,300,RC,outpatient,,320,320,,271.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80,22,,percent of total billed charges,,,,,,,,,288,90,,percent of total billed charges,,,264.96,82.8,,percent of total billed charges,,,272,85,,percent of total billed charges,,,,,,,,,281.6,88,,percent of total billed charges,,,,,,,,,244.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80,22,,percent of total billed charges,,,291.2,91,,percent of total billed charges,,,304,95,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,,,,,,,,,,,,,265.6,83,,percent of total billed charges,,,304,95,,percent of total billed charges,,,288,90,,percent of total billed charges,,,288,90,,percent of total billed charges,,,262.4,82,,percent of total billed charges,,,288,90,,percent of total billed charges,,,272,85,,percent of total billed charges,,80,304,
TOPIRAMATE,25201470,CDM,80201,CPT,300,RC,outpatient,,290,290,,246.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.5,22,,percent of total billed charges,,,,,,,,,261,90,,percent of total billed charges,,,240.12,82.8,,percent of total billed charges,,,246.5,85,,percent of total billed charges,,,,,,,,,255.2,88,,percent of total billed charges,,,,,,,,,221.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.5,22,,percent of total billed charges,,,263.9,91,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,,,,,,,,,,,,,240.7,83,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,261,90,,percent of total billed charges,,,261,90,,percent of total billed charges,,,237.8,82,,percent of total billed charges,,,261,90,,percent of total billed charges,,,246.5,85,,percent of total billed charges,,72.5,275.5,
INHIBIN-B,25201471,CDM,83520,CPT,300,RC,outpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.5,22,,percent of total billed charges,,,,,,,,,289.8,90,,percent of total billed charges,,,266.62,82.8,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.5,22,,percent of total billed charges,,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,80.5,305.9,
TOXOPLASMA ANTIBODY (IgG),25201484,CDM,86777,CPT,300,RC,outpatient,,216,216,,183.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54,22,,percent of total billed charges,,,,,,,,,194.4,90,,percent of total billed charges,,,178.85,82.8,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,,,,,,,,190.08,88,,percent of total billed charges,,,,,,,,,165.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54,22,,percent of total billed charges,,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,177.12,82,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,54,205.2,
TOXOPLASMA ANTIBODY (IgM),25201485,CDM,86778,CPT,300,RC,outpatient,,216,216,,183.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54,22,,percent of total billed charges,,,,,,,,,194.4,90,,percent of total billed charges,,,178.85,82.8,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,,,,,,,,190.08,88,,percent of total billed charges,,,,,,,,,165.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54,22,,percent of total billed charges,,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,177.12,82,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,54,205.2,
.WEST NILE AB SERUM (IGM),25201490,CDM,86788,CPT,300,RC,outpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31,22,,percent of total billed charges,,,,,,,,,111.6,90,,percent of total billed charges,,,102.67,82.8,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31,22,,percent of total billed charges,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,31,117.8,
"WEST NILE AB CSF (IGG,IGM)",25201492,CDM,86789,CPT,300,RC,outpatient,,216,216,,183.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54,22,,percent of total billed charges,,,,,,,,,194.4,90,,percent of total billed charges,,,178.85,82.8,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,,,,,,,,190.08,88,,percent of total billed charges,,,,,,,,,165.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54,22,,percent of total billed charges,,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,177.12,82,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,54,205.2,
.WEST NILE AB CSF (IGM),25201493,CDM,86788,CPT,300,RC,outpatient,,252,252,,213.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63,22,,percent of total billed charges,,,,,,,,,226.8,90,,percent of total billed charges,,,208.66,82.8,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,,,,,,,,221.76,88,,percent of total billed charges,,,,,,,,,192.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63,22,,percent of total billed charges,,,229.32,91,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,,,,,,,,,,,,,209.16,83,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,206.64,82,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,63,239.4,
SURG PATH-TISSUE IHC (ERA),25201501,CDM,88360,CPT,310,RC,outpatient,TC,470,470,,399.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.5,22,,percent of total billed charges,,,,,,,,,423,90,,percent of total billed charges,,,389.16,82.8,,percent of total billed charges,,,399.5,85,,percent of total billed charges,,,,,,,,,413.6,88,,percent of total billed charges,,,,,,,,,359.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.5,22,,percent of total billed charges,,,427.7,91,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,,,,,,,,,,,,,390.1,83,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,423,90,,percent of total billed charges,,,423,90,,percent of total billed charges,,,385.4,82,,percent of total billed charges,,,423,90,,percent of total billed charges,,,399.5,85,,percent of total billed charges,,117.5,446.5,
SPECIAL STAIN: HISTOLOGY,25201502,CDM,88314,CPT,300,RC,outpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
INTERNAL TUMOR  IHC,25201503,CDM,88360,CPT,300,RC,outpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.75,22,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,68.72,82.8,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.75,22,,percent of total billed charges,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,20.75,78.85,
CONCENTRATION TECHNIQUE,25201504,CDM,88108,CPT,300,RC,outpatient,,53,53,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.25,22,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,43.88,82.8,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,,,,,,,,46.64,88,,percent of total billed charges,,,,,,,,,40.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.25,22,,percent of total billed charges,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,,,,,,,,,,,,,43.99,83,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,43.46,82,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,13.25,50.35,
TISSUE (IGA)TRANSGLUTAMINASE AB,25201508,CDM,83516,CPT,300,RC,outpatient,,379,379,,321.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94.75,22,,percent of total billed charges,,,,,,,,,341.1,90,,percent of total billed charges,,,313.81,82.8,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,,,,,,,,333.52,88,,percent of total billed charges,,,,,,,,,289.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94.75,22,,percent of total billed charges,,,344.89,91,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,,,,,,,,,,,,,314.57,83,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,310.78,82,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,94.75,360.05,
TRANSFERRIN,25201509,CDM,84466,CPT,300,RC,outpatient,,192,192,,163.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48,22,,percent of total billed charges,,,,,,,,,172.8,90,,percent of total billed charges,,,158.98,82.8,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,,,,,,,,168.96,88,,percent of total billed charges,,,,,,,,,146.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48,22,,percent of total billed charges,,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,,,,,,,,,,,,,159.36,83,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,157.44,82,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,48,182.4,
TISSUE GRINDING,25201510,CDM,87176,CPT,300,RC,outpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.75,22,,percent of total billed charges,,,,,,,,,78.3,90,,percent of total billed charges,,,72.04,82.8,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.75,22,,percent of total billed charges,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,21.75,82.65,
TISSUE(IGG) TRANSGLUTAMINASE AB,25201511,CDM,83516,CPT,300,RC,outpatient,,379,379,,321.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94.75,22,,percent of total billed charges,,,,,,,,,341.1,90,,percent of total billed charges,,,313.81,82.8,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,,,,,,,,333.52,88,,percent of total billed charges,,,,,,,,,289.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94.75,22,,percent of total billed charges,,,344.89,91,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,,,,,,,,,,,,,314.57,83,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,310.78,82,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,94.75,360.05,
ALDOLASE,25201517,CDM,82085,CPT,300,RC,outpatient,,189,189,,160.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.25,22,,percent of total billed charges,,,,,,,,,170.1,90,,percent of total billed charges,,,156.49,82.8,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,,,,,,,,166.32,88,,percent of total billed charges,,,,,,,,,144.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.25,22,,percent of total billed charges,,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,,,,,,,,,,,,,156.87,83,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,154.98,82,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,47.25,179.55,
ADENOSINE DEAMINASE,25201520,CDM,84311,CPT,300,RC,outpatient,,620,620,,526.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,155,22,,percent of total billed charges,,,,,,,,,558,90,,percent of total billed charges,,,513.36,82.8,,percent of total billed charges,,,527,85,,percent of total billed charges,,,,,,,,,545.6,88,,percent of total billed charges,,,,,,,,,473.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,155,22,,percent of total billed charges,,,564.2,91,,percent of total billed charges,,,589,95,,percent of total billed charges,,,514.6,83,,percent of total billed charges,,,514.6,83,,percent of total billed charges,,,,,,,,,,,,,,,514.6,83,,percent of total billed charges,,,589,95,,percent of total billed charges,,,558,90,,percent of total billed charges,,,558,90,,percent of total billed charges,,,508.4,82,,percent of total billed charges,,,558,90,,percent of total billed charges,,,527,85,,percent of total billed charges,,155,589,
ANAPLASMA PHAGOCYTOPHILUM,25201521,CDM,87797,CPT,300,RC,outpatient,,315,315,,267.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.75,22,,percent of total billed charges,,,,,,,,,283.5,90,,percent of total billed charges,,,260.82,82.8,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,,,,,,,,277.2,88,,percent of total billed charges,,,,,,,,,240.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.75,22,,percent of total billed charges,,,286.65,91,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,,,,,,,,,,,,,261.45,83,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,258.3,82,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,78.75,299.25,
ADENOVIRUS DNA (LAVAGE),25201522,CDM,87799,CPT,300,RC,outpatient,,564,564,,478.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141,22,,percent of total billed charges,,,,,,,,,507.6,90,,percent of total billed charges,,,466.99,82.8,,percent of total billed charges,,,479.4,85,,percent of total billed charges,,,,,,,,,496.32,88,,percent of total billed charges,,,,,,,,,430.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141,22,,percent of total billed charges,,,513.24,91,,percent of total billed charges,,,535.8,95,,percent of total billed charges,,,468.12,83,,percent of total billed charges,,,468.12,83,,percent of total billed charges,,,,,,,,,,,,,,,468.12,83,,percent of total billed charges,,,535.8,95,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,462.48,82,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,479.4,85,,percent of total billed charges,,141,535.8,
EHRLICHIA PROFILE,25201523,CDM,87798,CPT,300,RC,outpatient,,315,315,,267.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.75,22,,percent of total billed charges,,,,,,,,,283.5,90,,percent of total billed charges,,,260.82,82.8,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,,,,,,,,277.2,88,,percent of total billed charges,,,,,,,,,240.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.75,22,,percent of total billed charges,,,286.65,91,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,,,,,,,,,,,,,261.45,83,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,258.3,82,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,78.75,299.25,
ALPHA-1-ANTITRYPSIN GENOTYPE,25201532,CDM,81332,CPT,300,RC,outpatient,,432,432,,366.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108,22,,percent of total billed charges,,,,,,,,,388.8,90,,percent of total billed charges,,,357.7,82.8,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,,,,,,,,380.16,88,,percent of total billed charges,,,,,,,,,330.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108,22,,percent of total billed charges,,,393.12,91,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,,,,,,,,,,,,,358.56,83,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,354.24,82,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,108,410.4,
ALPHA-1-ANTITRYPSIN,25201533,CDM,82103,CPT,300,RC,outpatient,,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
ALPHA-1-ANTITRYPSIN PHENOTYPE,25201534,CDM,82104,CPT,300,RC,outpatient,,489,489,,415.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.25,22,,percent of total billed charges,,,,,,,,,440.1,90,,percent of total billed charges,,,404.89,82.8,,percent of total billed charges,,,415.65,85,,percent of total billed charges,,,,,,,,,430.32,88,,percent of total billed charges,,,,,,,,,373.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.25,22,,percent of total billed charges,,,444.99,91,,percent of total billed charges,,,464.55,95,,percent of total billed charges,,,405.87,83,,percent of total billed charges,,,405.87,83,,percent of total billed charges,,,,,,,,,,,,,,,405.87,83,,percent of total billed charges,,,464.55,95,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,400.98,82,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,415.65,85,,percent of total billed charges,,122.25,464.55,
ALPHA-1-ANTITRYPSIN (QUANT/MUTATION,25201535,CDM,82103,CPT,300,RC,outpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.75,22,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,48.85,82.8,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,,,,,,,,51.92,88,,percent of total billed charges,,,,,,,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.75,22,,percent of total billed charges,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,14.75,56.05,
DRVVT,25201558,CDM,85613,CPT,300,RC,outpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.25,22,,percent of total billed charges,,,,,,,,,130.5,90,,percent of total billed charges,,,120.06,82.8,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.25,22,,percent of total billed charges,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,36.25,137.75,
DOXEPIN,25201559,CDM,80335,CPT,300,RC,outpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.25,22,,percent of total billed charges,,,,,,,,,130.5,90,,percent of total billed charges,,,120.06,82.8,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.25,22,,percent of total billed charges,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,36.25,137.75,
AMMONIA,25201574,CDM,82140,CPT,300,RC,outpatient,,308,308,,261.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77,22,,percent of total billed charges,,,,,,,,,277.2,90,,percent of total billed charges,,,255.02,82.8,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,,,,,,,,271.04,88,,percent of total billed charges,,,,,,,,,235.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77,22,,percent of total billed charges,,,280.28,91,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,,,,,,,,,,,,,255.64,83,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,252.56,82,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,77,292.6,
AMOXAPINE,25201575,CDM,80299,CPT,300,RC,outpatient,,552,552,,468.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,138,22,,percent of total billed charges,,,,,,,,,496.8,90,,percent of total billed charges,,,457.06,82.8,,percent of total billed charges,,,469.2,85,,percent of total billed charges,,,,,,,,,485.76,88,,percent of total billed charges,,,,,,,,,421.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,138,22,,percent of total billed charges,,,502.32,91,,percent of total billed charges,,,524.4,95,,percent of total billed charges,,,458.16,83,,percent of total billed charges,,,458.16,83,,percent of total billed charges,,,,,,,,,,,,,,,458.16,83,,percent of total billed charges,,,524.4,95,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,452.64,82,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,469.2,85,,percent of total billed charges,,138,524.4,
PORPHOBILINOGEN URINE (24-HOUR),25201582,CDM,84110,CPT,300,RC,outpatient,,118,118,,100.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.5,22,,percent of total billed charges,,,,,,,,,106.2,90,,percent of total billed charges,,,97.7,82.8,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,,,,,,,,103.84,88,,percent of total billed charges,,,,,,,,,90.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.5,22,,percent of total billed charges,,,107.38,91,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,,,,,,,,,,,,,97.94,83,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,96.76,82,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,29.5,112.1,
PLASMINOGEN ACTIVATOR INHIBITOR-1,25201585,CDM,85415,CPT,300,RC,outpatient,,501,501,,425.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125.25,22,,percent of total billed charges,,,,,,,,,450.9,90,,percent of total billed charges,,,414.83,82.8,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,,,,,,,,440.88,88,,percent of total billed charges,,,,,,,,,382.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125.25,22,,percent of total billed charges,,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,,,,,,,,,,,,,415.83,83,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,410.82,82,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,125.25,475.95,
MITOCHONDRIAL ANTIBODY,25201590,CDM,86255,CPT,300,RC,outpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
THYROID PEROXIDASE ANTIBODIES,25201608,CDM,86376,CPT,300,RC,outpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.75,22,,percent of total billed charges,,,,,,,,,236.7,90,,percent of total billed charges,,,217.76,82.8,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.75,22,,percent of total billed charges,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,65.75,249.85,
THYROID STIMULATING IMMUNOGLOBIN,25201609,CDM,84445,CPT,300,RC,outpatient,,762,762,,646.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,190.5,22,,percent of total billed charges,,,,,,,,,685.8,90,,percent of total billed charges,,,630.94,82.8,,percent of total billed charges,,,647.7,85,,percent of total billed charges,,,,,,,,,670.56,88,,percent of total billed charges,,,,,,,,,582.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,190.5,22,,percent of total billed charges,,,693.42,91,,percent of total billed charges,,,723.9,95,,percent of total billed charges,,,632.46,83,,percent of total billed charges,,,632.46,83,,percent of total billed charges,,,,,,,,,,,,,,,632.46,83,,percent of total billed charges,,,723.9,95,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,624.84,82,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,647.7,85,,percent of total billed charges,,190.5,723.9,
THYROID CASCADE,25201610,CDM,84443,CPT,300,RC,outpatient,,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62,22,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,205.34,82.8,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62,22,,percent of total billed charges,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,62,235.6,
.METAL-LTT PANEL 2,25201611,CDM,86353,CPT,300,RC,outpatient,,112,112,,95.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28,22,,percent of total billed charges,,,,,,,,,100.8,90,,percent of total billed charges,,,92.74,82.8,,percent of total billed charges,,,95.2,85,,percent of total billed charges,,,,,,,,,98.56,88,,percent of total billed charges,,,,,,,,,85.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28,22,,percent of total billed charges,,,101.92,91,,percent of total billed charges,,,106.4,95,,percent of total billed charges,,,92.96,83,,percent of total billed charges,,,92.96,83,,percent of total billed charges,,,,,,,,,,,,,,,92.96,83,,percent of total billed charges,,,106.4,95,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,91.84,82,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,95.2,85,,percent of total billed charges,,28,106.4,
.METAL-LTT PANEL 2,25201612,CDM,86353,CPT,300,RC,outpatient,,112,112,,95.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28,22,,percent of total billed charges,,,,,,,,,100.8,90,,percent of total billed charges,,,92.74,82.8,,percent of total billed charges,,,95.2,85,,percent of total billed charges,,,,,,,,,98.56,88,,percent of total billed charges,,,,,,,,,85.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28,22,,percent of total billed charges,,,101.92,91,,percent of total billed charges,,,106.4,95,,percent of total billed charges,,,92.96,83,,percent of total billed charges,,,92.96,83,,percent of total billed charges,,,,,,,,,,,,,,,92.96,83,,percent of total billed charges,,,106.4,95,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,91.84,82,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,95.2,85,,percent of total billed charges,,28,106.4,
MICROSPORIDIA,25201613,CDM,87207,CPT,300,RC,outpatient,,129,129,,109.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.25,22,,percent of total billed charges,,,,,,,,,116.1,90,,percent of total billed charges,,,106.81,82.8,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,,,,,,,,113.52,88,,percent of total billed charges,,,,,,,,,98.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.25,22,,percent of total billed charges,,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,105.78,82,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,32.25,122.55,
IMMUNOGLOBULIN G,25201616,CDM,82784,CPT,300,RC,outpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.25,22,,percent of total billed charges,,,,,,,,,188.1,90,,percent of total billed charges,,,173.05,82.8,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.25,22,,percent of total billed charges,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,52.25,198.55,
.IGG-1 (PART OF PANEL),25201617,CDM,82787,CPT,300,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
.IGG-2 (PART OF PANEL),25201618,CDM,82787,CPT,300,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
.IGG-3 (PART OF PANEL),25201619,CDM,82787,CPT,300,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
.IGG-4 (PART OF PANEL),25201620,CDM,82787,CPT,300,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
LACTIC ACID,25201624,CDM,83605,CPT,300,RC,outpatient,,293,293,,248.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.25,22,,percent of total billed charges,,,,,,,,,263.7,90,,percent of total billed charges,,,242.6,82.8,,percent of total billed charges,,,249.05,85,,percent of total billed charges,,,,,,,,,257.84,88,,percent of total billed charges,,,,,,,,,223.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.25,22,,percent of total billed charges,,,266.63,91,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,,,,,,,,,,,,,243.19,83,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,240.26,82,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,249.05,85,,percent of total billed charges,,73.25,278.35,
"HEPATITIS A ANTIBODY, TOTAL(RFLX IGM)",25201639,CDM,86708,CPT,300,RC,outpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.25,22,,percent of total billed charges,,,,,,,,,267.3,90,,percent of total billed charges,,,245.92,82.8,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.25,22,,percent of total billed charges,,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,74.25,282.15,
"HEPATITIS A ANTIBODY, TOTAL",25201640,CDM,86708,CPT,300,RC,outpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.25,22,,percent of total billed charges,,,,,,,,,267.3,90,,percent of total billed charges,,,245.92,82.8,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.25,22,,percent of total billed charges,,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,74.25,282.15,
GLUCOSE-6-PHOSPHATE DEHYDROGENASE,25201657,CDM,82955,CPT,300,RC,outpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45,22,,percent of total billed charges,,,,,,,,,162,90,,percent of total billed charges,,,149.04,82.8,,percent of total billed charges,,,153,85,,percent of total billed charges,,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45,22,,percent of total billed charges,,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,45,171,
GLUTATHIONE,25201658,CDM,82978,CPT,300,RC,outpatient,,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.5,22,,percent of total billed charges,,,,,,,,,214.2,90,,percent of total billed charges,,,197.06,82.8,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.5,22,,percent of total billed charges,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,59.5,226.1,
GLUCAGON PLASMA,25201659,CDM,82943,CPT,300,RC,outpatient,,418,418,,354.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.5,22,,percent of total billed charges,,,,,,,,,376.2,90,,percent of total billed charges,,,346.1,82.8,,percent of total billed charges,,,355.3,85,,percent of total billed charges,,,,,,,,,367.84,88,,percent of total billed charges,,,,,,,,,319.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.5,22,,percent of total billed charges,,,380.38,91,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,,,,,,,,,,,,,346.94,83,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,342.76,82,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,355.3,85,,percent of total billed charges,,104.5,397.1,
GASTROINTESTINAL PANEL(BIOFIRE),25201660,CDM,87507,CPT,300,RC,outpatient,,827,827,,702.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,206.75,22,,percent of total billed charges,,,,,,,,,744.3,90,,percent of total billed charges,,,684.76,82.8,,percent of total billed charges,,,702.95,85,,percent of total billed charges,,,,,,,,,727.76,88,,percent of total billed charges,,,,,,,,,631.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,206.75,22,,percent of total billed charges,,,752.57,91,,percent of total billed charges,,,785.65,95,,percent of total billed charges,,,686.41,83,,percent of total billed charges,,,686.41,83,,percent of total billed charges,,,,,,,,,,,,,,,686.41,83,,percent of total billed charges,,,785.65,95,,percent of total billed charges,,,744.3,90,,percent of total billed charges,,,744.3,90,,percent of total billed charges,,,678.14,82,,percent of total billed charges,,,744.3,90,,percent of total billed charges,,,702.95,85,,percent of total billed charges,,206.75,785.65,
FORMALDEHYDE,25201661,CDM,86003,CPT,300,RC,outpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45,22,,percent of total billed charges,,,,,,,,,162,90,,percent of total billed charges,,,149.04,82.8,,percent of total billed charges,,,153,85,,percent of total billed charges,,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45,22,,percent of total billed charges,,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,45,171,
GASTRIN,25201665,CDM,82941,CPT,300,RC,outpatient,,224,224,,190.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56,22,,percent of total billed charges,,,,,,,,,201.6,90,,percent of total billed charges,,,185.47,82.8,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,,,,,,,,197.12,88,,percent of total billed charges,,,,,,,,,171.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56,22,,percent of total billed charges,,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,183.68,82,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,56,212.8,
FTA-ABS,25201681,CDM,86780,CPT,300,RC,outpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.5,22,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,170.57,82.8,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.5,22,,percent of total billed charges,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,51.5,195.7,
"ESTRIOL, SERUM",25201707,CDM,82677,CPT,300,RC,outpatient,,224,224,,190.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56,22,,percent of total billed charges,,,,,,,,,201.6,90,,percent of total billed charges,,,185.47,82.8,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,,,,,,,,197.12,88,,percent of total billed charges,,,,,,,,,171.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56,22,,percent of total billed charges,,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,183.68,82,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,56,212.8,
AMYLASE URINE (24-HOUR),25201715,CDM,82150,CPT,300,RC,outpatient,,166,166,,140.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.5,22,,percent of total billed charges,,,,,,,,,149.4,90,,percent of total billed charges,,,137.45,82.8,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,,,,,,,,146.08,88,,percent of total billed charges,,,,,,,,,126.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.5,22,,percent of total billed charges,,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,,,,,,,,,,,,,137.78,83,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,136.12,82,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,41.5,157.7,
AMYLASE FLUID,25201716,CDM,82150,CPT,300,RC,outpatient,,190,190,,161.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.5,22,,percent of total billed charges,,,,,,,,,171,90,,percent of total billed charges,,,157.32,82.8,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,,,,,,,,167.2,88,,percent of total billed charges,,,,,,,,,145.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.5,22,,percent of total billed charges,,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,,,,,,,,,,,,,157.7,83,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,155.8,82,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,47.5,180.5,
AMITRIPTYLINE,25201723,CDM,80335,CPT,300,RC,outpatient,,261,261,,221.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.25,22,,percent of total billed charges,,,,,,,,,234.9,90,,percent of total billed charges,,,216.11,82.8,,percent of total billed charges,,,221.85,85,,percent of total billed charges,,,,,,,,,229.68,88,,percent of total billed charges,,,,,,,,,199.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.25,22,,percent of total billed charges,,,237.51,91,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,,,,,,,,,,,,,216.63,83,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,214.02,82,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,221.85,85,,percent of total billed charges,,65.25,247.95,
ALUMUNUM,25201745,CDM,82108,CPT,300,RC,outpatient,,401,401,,340.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100.25,22,,percent of total billed charges,,,,,,,,,360.9,90,,percent of total billed charges,,,332.03,82.8,,percent of total billed charges,,,340.85,85,,percent of total billed charges,,,,,,,,,352.88,88,,percent of total billed charges,,,,,,,,,306.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100.25,22,,percent of total billed charges,,,364.91,91,,percent of total billed charges,,,380.95,95,,percent of total billed charges,,,332.83,83,,percent of total billed charges,,,332.83,83,,percent of total billed charges,,,,,,,,,,,,,,,332.83,83,,percent of total billed charges,,,380.95,95,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,328.82,82,,percent of total billed charges,,,360.9,90,,percent of total billed charges,,,340.85,85,,percent of total billed charges,,100.25,380.95,
AMIKACIN PEAK SERUM,25201749,CDM,80150,CPT,300,RC,outpatient,,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62,22,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,205.34,82.8,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62,22,,percent of total billed charges,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,62,235.6,
ADENOSINE DEAMINASE (FLUID),25201760,CDM,84311,CPT,300,RC,outpatient,,257,257,,218.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.25,22,,percent of total billed charges,,,,,,,,,231.3,90,,percent of total billed charges,,,212.8,82.8,,percent of total billed charges,,,218.45,85,,percent of total billed charges,,,,,,,,,226.16,88,,percent of total billed charges,,,,,,,,,196.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.25,22,,percent of total billed charges,,,233.87,91,,percent of total billed charges,,,244.15,95,,percent of total billed charges,,,213.31,83,,percent of total billed charges,,,213.31,83,,percent of total billed charges,,,,,,,,,,,,,,,213.31,83,,percent of total billed charges,,,244.15,95,,percent of total billed charges,,,231.3,90,,percent of total billed charges,,,231.3,90,,percent of total billed charges,,,210.74,82,,percent of total billed charges,,,231.3,90,,percent of total billed charges,,,218.45,85,,percent of total billed charges,,64.25,244.15,
ALDOSTERONE SERUM,25201764,CDM,82088,CPT,300,RC,outpatient,,613,613,,520.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153.25,22,,percent of total billed charges,,,,,,,,,551.7,90,,percent of total billed charges,,,507.56,82.8,,percent of total billed charges,,,521.05,85,,percent of total billed charges,,,,,,,,,539.44,88,,percent of total billed charges,,,,,,,,,468.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153.25,22,,percent of total billed charges,,,557.83,91,,percent of total billed charges,,,582.35,95,,percent of total billed charges,,,508.79,83,,percent of total billed charges,,,508.79,83,,percent of total billed charges,,,,,,,,,,,,,,,508.79,83,,percent of total billed charges,,,582.35,95,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,502.66,82,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,521.05,85,,percent of total billed charges,,153.25,582.35,
ALDOSTERONE URINE (24-HOUR),25201765,CDM,82088,CPT,300,RC,outpatient,,531,531,,450.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.75,22,,percent of total billed charges,,,,,,,,,477.9,90,,percent of total billed charges,,,439.67,82.8,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,,,,,,,,467.28,88,,percent of total billed charges,,,,,,,,,405.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.75,22,,percent of total billed charges,,,483.21,91,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,,,,,,,,,,,,,440.73,83,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,435.42,82,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,132.75,504.45,
ADALIMUMAB & ANTIBODY,25201766,CDM,80299,CPT,300,RC,outpatient,,308,308,,261.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77,22,,percent of total billed charges,,,,,,,,,277.2,90,,percent of total billed charges,,,255.02,82.8,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,,,,,,,,271.04,88,,percent of total billed charges,,,,,,,,,235.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77,22,,percent of total billed charges,,,280.28,91,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,,,,,,,,,,,,,255.64,83,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,252.56,82,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,77,292.6,
.ADALIMUMAB  ANTIBODY,25201767,CDM,82397,CPT,300,RC,outpatient,,308,308,,261.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77,22,,percent of total billed charges,,,,,,,,,277.2,90,,percent of total billed charges,,,255.02,82.8,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,,,,,,,,271.04,88,,percent of total billed charges,,,,,,,,,235.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77,22,,percent of total billed charges,,,280.28,91,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,,,,,,,,,,,,,255.64,83,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,252.56,82,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,77,292.6,
SURG PATH LEVEL 4,25201772,CDM,88305,CPT,310,RC,outpatient,TC,613,613,,520.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153.25,22,,percent of total billed charges,,,,,,,,,551.7,90,,percent of total billed charges,,,507.56,82.8,,percent of total billed charges,,,521.05,85,,percent of total billed charges,,,,,,,,,539.44,88,,percent of total billed charges,,,,,,,,,468.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153.25,22,,percent of total billed charges,,,557.83,91,,percent of total billed charges,,,582.35,95,,percent of total billed charges,,,508.79,83,,percent of total billed charges,,,508.79,83,,percent of total billed charges,,,,,,,,,,,,,,,508.79,83,,percent of total billed charges,,,582.35,95,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,502.66,82,,percent of total billed charges,,,551.7,90,,percent of total billed charges,,,521.05,85,,percent of total billed charges,,153.25,582.35,
SURG PATH LEVEL 3,25201798,CDM,88304,CPT,310,RC,outpatient,TC,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.5,22,,percent of total billed charges,,,,,,,,,289.8,90,,percent of total billed charges,,,266.62,82.8,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.5,22,,percent of total billed charges,,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,80.5,305.9,
.CYTOLOGY NON-GYN,25201806,CDM,88160,CPT,310,RC,outpatient,,400,400,,339.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100,22,,percent of total billed charges,,,,,,,,,360,90,,percent of total billed charges,,,331.2,82.8,,percent of total billed charges,,,340,85,,percent of total billed charges,,,,,,,,,352,88,,percent of total billed charges,,,,,,,,,305.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100,22,,percent of total billed charges,,,364,91,,percent of total billed charges,,,380,95,,percent of total billed charges,,,332,83,,percent of total billed charges,,,332,83,,percent of total billed charges,,,,,,,,,,,,,,,332,83,,percent of total billed charges,,,380,95,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,328,82,,percent of total billed charges,,,360,90,,percent of total billed charges,,,340,85,,percent of total billed charges,,100,380,
CYTOLOGY FINE NEEDLE ASPIRATION,25201807,CDM,88173,CPT,310,RC,outpatient,,498,498,,422.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.5,22,,percent of total billed charges,,,,,,,,,448.2,90,,percent of total billed charges,,,412.34,82.8,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,,,,,,,,438.24,88,,percent of total billed charges,,,,,,,,,380.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.5,22,,percent of total billed charges,,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,,,,,,,,,,,,,413.34,83,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,408.36,82,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,124.5,473.1,
CYTOSPIN FLOW,25201808,CDM,88108,CPT,310,RC,outpatient,,35,35,,29.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.75,22,,percent of total billed charges,,,,,,,,,31.5,90,,percent of total billed charges,,,28.98,82.8,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,,,,,,,,30.8,88,,percent of total billed charges,,,,,,,,,26.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.75,22,,percent of total billed charges,,,31.85,91,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,,,,,,,,,,,,,29.05,83,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,28.7,82,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,8.75,33.25,
CYTOLOGY BODY FLUID NON-GYN,25201809,CDM,88108,CPT,310,RC,outpatient,TC,255,255,,216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.75,22,,percent of total billed charges,,,,,,,,,229.5,90,,percent of total billed charges,,,211.14,82.8,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,,,,,,,,224.4,88,,percent of total billed charges,,,,,,,,,194.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.75,22,,percent of total billed charges,,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,209.1,82,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,63.75,242.25,
CYTOLOGY BREAST DISCHARGE,25201810,CDM,88161,CPT,310,RC,outpatient,,365,365,,309.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.25,22,,percent of total billed charges,,,,,,,,,328.5,90,,percent of total billed charges,,,302.22,82.8,,percent of total billed charges,,,310.25,85,,percent of total billed charges,,,,,,,,,321.2,88,,percent of total billed charges,,,,,,,,,278.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.25,22,,percent of total billed charges,,,332.15,91,,percent of total billed charges,,,346.75,95,,percent of total billed charges,,,302.95,83,,percent of total billed charges,,,302.95,83,,percent of total billed charges,,,,,,,,,,,,,,,302.95,83,,percent of total billed charges,,,346.75,95,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,299.3,82,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,310.25,85,,percent of total billed charges,,91.25,346.75,
CYTOLOGY MISC BODY FLUID,25201811,CDM,88112,CPT,310,RC,outpatient,TC,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.5,22,,percent of total billed charges,,,,,,,,,394.2,90,,percent of total billed charges,,,362.66,82.8,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.5,22,,percent of total billed charges,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,109.5,416.1,
SURG PATH LEVEL 1,25201814,CDM,88300,CPT,310,RC,outpatient,TC,113,113,,95.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.25,22,,percent of total billed charges,,,,,,,,,101.7,90,,percent of total billed charges,,,93.56,82.8,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,,,,,,,,99.44,88,,percent of total billed charges,,,,,,,,,86.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.25,22,,percent of total billed charges,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,92.66,82,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,28.25,107.35,
CALCIUM SENSING RECEPTOR GENE,25201845,CDM,81405,CPT,300,RC,outpatient,,4169,4169,,3539.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1042.25,22,,percent of total billed charges,,,,,,,,,3752.1,90,,percent of total billed charges,,,3451.93,82.8,,percent of total billed charges,,,3543.65,85,,percent of total billed charges,,,,,,,,,3668.72,88,,percent of total billed charges,,,,,,,,,3185.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1042.25,22,,percent of total billed charges,,,3793.79,91,,percent of total billed charges,,,3960.55,95,,percent of total billed charges,,,3460.27,83,,percent of total billed charges,,,3460.27,83,,percent of total billed charges,,,,,,,,,,,,,,,3460.27,83,,percent of total billed charges,,,3960.55,95,,percent of total billed charges,,,3752.1,90,,percent of total billed charges,,,3752.1,90,,percent of total billed charges,,,3418.58,82,,percent of total billed charges,,,3752.1,90,,percent of total billed charges,,,3543.65,85,,percent of total billed charges,,1042.25,3960.55,
PROCALCITONIN,25201847,CDM,84145,CPT,300,RC,outpatient,,418,418,,354.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.5,22,,percent of total billed charges,,,,,,,,,376.2,90,,percent of total billed charges,,,346.1,82.8,,percent of total billed charges,,,355.3,85,,percent of total billed charges,,,,,,,,,367.84,88,,percent of total billed charges,,,,,,,,,319.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.5,22,,percent of total billed charges,,,380.38,91,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,,,,,,,,,,,,,346.94,83,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,342.76,82,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,355.3,85,,percent of total billed charges,,104.5,397.1,
CALCITONIN,25201848,CDM,82308,CPT,300,RC,outpatient,,418,418,,354.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.5,22,,percent of total billed charges,,,,,,,,,376.2,90,,percent of total billed charges,,,346.1,82.8,,percent of total billed charges,,,355.3,85,,percent of total billed charges,,,,,,,,,367.84,88,,percent of total billed charges,,,,,,,,,319.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.5,22,,percent of total billed charges,,,380.38,91,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,,,,,,,,,,,,,346.94,83,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,342.76,82,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,355.3,85,,percent of total billed charges,,104.5,397.1,
"CADMIUM, BLOOD",25201849,CDM,82300,CPT,300,RC,outpatient,,280,280,,237.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70,22,,percent of total billed charges,,,,,,,,,252,90,,percent of total billed charges,,,231.84,82.8,,percent of total billed charges,,,238,85,,percent of total billed charges,,,,,,,,,246.4,88,,percent of total billed charges,,,,,,,,,213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70,22,,percent of total billed charges,,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,,,,,,,,,,,,,232.4,83,,percent of total billed charges,,,266,95,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,229.6,82,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,70,266,
CADMIUM URINE,25201850,CDM,82300,CPT,300,RC,outpatient,,119,119,,101.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.75,22,,percent of total billed charges,,,,,,,,,107.1,90,,percent of total billed charges,,,98.53,82.8,,percent of total billed charges,,,101.15,85,,percent of total billed charges,,,,,,,,,104.72,88,,percent of total billed charges,,,,,,,,,90.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.75,22,,percent of total billed charges,,,108.29,91,,percent of total billed charges,,,113.05,95,,percent of total billed charges,,,98.77,83,,percent of total billed charges,,,98.77,83,,percent of total billed charges,,,,,,,,,,,,,,,98.77,83,,percent of total billed charges,,,113.05,95,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,97.58,82,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,101.15,85,,percent of total billed charges,,29.75,113.05,
CAROTENE,25201855,CDM,82380,CPT,300,RC,outpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31,22,,percent of total billed charges,,,,,,,,,111.6,90,,percent of total billed charges,,,102.67,82.8,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31,22,,percent of total billed charges,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,31,117.8,
CERULOPLASMIN,25201863,CDM,82390,CPT,300,RC,outpatient,,161,161,,136.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.25,22,,percent of total billed charges,,,,,,,,,144.9,90,,percent of total billed charges,,,133.31,82.8,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,,,,,,,,141.68,88,,percent of total billed charges,,,,,,,,,123,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.25,22,,percent of total billed charges,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,132.02,82,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,40.25,152.95,
CD4 CELLS ABSOLUTE COUNT,25201864,CDM,86361,CPT,300,RC,outpatient,,681,681,,578.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,170.25,22,,percent of total billed charges,,,,,,,,,612.9,90,,percent of total billed charges,,,563.87,82.8,,percent of total billed charges,,,578.85,85,,percent of total billed charges,,,,,,,,,599.28,88,,percent of total billed charges,,,,,,,,,520.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,170.25,22,,percent of total billed charges,,,619.71,91,,percent of total billed charges,,,646.95,95,,percent of total billed charges,,,565.23,83,,percent of total billed charges,,,565.23,83,,percent of total billed charges,,,,,,,,,,,,,,,565.23,83,,percent of total billed charges,,,646.95,95,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,558.42,82,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,578.85,85,,percent of total billed charges,,170.25,646.95,
CD4/CD8 RATIO PROFILE,25201865,CDM,86360,CPT,300,RC,outpatient,,286,286,,242.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.5,22,,percent of total billed charges,,,,,,,,,257.4,90,,percent of total billed charges,,,236.81,82.8,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,,,,,,,,251.68,88,,percent of total billed charges,,,,,,,,,218.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.5,22,,percent of total billed charges,,,260.26,91,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,,,,,,,,,,,,,237.38,83,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,234.52,82,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,71.5,271.7,
CARBON DISULFIDE,25201866,CDM,82374,CPT,300,RC,outpatient,,710,710,,602.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,177.5,22,,percent of total billed charges,,,,,,,,,639,90,,percent of total billed charges,,,587.88,82.8,,percent of total billed charges,,,603.5,85,,percent of total billed charges,,,,,,,,,624.8,88,,percent of total billed charges,,,,,,,,,542.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,177.5,22,,percent of total billed charges,,,646.1,91,,percent of total billed charges,,,674.5,95,,percent of total billed charges,,,589.3,83,,percent of total billed charges,,,589.3,83,,percent of total billed charges,,,,,,,,,,,,,,,589.3,83,,percent of total billed charges,,,674.5,95,,percent of total billed charges,,,639,90,,percent of total billed charges,,,639,90,,percent of total billed charges,,,582.2,82,,percent of total billed charges,,,639,90,,percent of total billed charges,,,603.5,85,,percent of total billed charges,,177.5,674.5,
CD33/CD66b CELLS,25201867,CDM,81268,CPT,300,RC,outpatient,,308,308,,261.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77,22,,percent of total billed charges,,,,,,,,,277.2,90,,percent of total billed charges,,,255.02,82.8,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,,,,,,,,271.04,88,,percent of total billed charges,,,,,,,,,235.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77,22,,percent of total billed charges,,,280.28,91,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,255.64,83,,percent of total billed charges,,,,,,,,,,,,,,,255.64,83,,percent of total billed charges,,,292.6,95,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,252.56,82,,percent of total billed charges,,,277.2,90,,percent of total billed charges,,,261.8,85,,percent of total billed charges,,77,292.6,
CARBOHYDRATE-DEFICIENT TRANSFERIN,25201868,CDM,82373,CPT,300,RC,outpatient,,273,273,,231.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.25,22,,percent of total billed charges,,,,,,,,,245.7,90,,percent of total billed charges,,,226.04,82.8,,percent of total billed charges,,,232.05,85,,percent of total billed charges,,,,,,,,,240.24,88,,percent of total billed charges,,,,,,,,,208.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.25,22,,percent of total billed charges,,,248.43,91,,percent of total billed charges,,,259.35,95,,percent of total billed charges,,,226.59,83,,percent of total billed charges,,,226.59,83,,percent of total billed charges,,,,,,,,,,,,,,,226.59,83,,percent of total billed charges,,,259.35,95,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,223.86,82,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,232.05,85,,percent of total billed charges,,68.25,259.35,
NEISSERIA GC DNA (SWAB),25201872,CDM,87591,CPT,300,RC,outpatient,,272,272,,230.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68,22,,percent of total billed charges,,,,,,,,,244.8,90,,percent of total billed charges,,,225.22,82.8,,percent of total billed charges,,,231.2,85,,percent of total billed charges,,,,,,,,,239.36,88,,percent of total billed charges,,,,,,,,,207.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68,22,,percent of total billed charges,,,247.52,91,,percent of total billed charges,,,258.4,95,,percent of total billed charges,,,225.76,83,,percent of total billed charges,,,225.76,83,,percent of total billed charges,,,,,,,,,,,,,,,225.76,83,,percent of total billed charges,,,258.4,95,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,223.04,82,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,231.2,85,,percent of total billed charges,,68,258.4,
"CHLAMYDIA, DNA (URINE)",25201873,CDM,87491,CPT,300,RC,outpatient,,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.75,22,,percent of total billed charges,,,,,,,,,351.9,90,,percent of total billed charges,,,323.75,82.8,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.75,22,,percent of total billed charges,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,97.75,371.45,
NEISSERIA GC DNA (URINE),25201874,CDM,87591,CPT,300,RC,outpatient,,272,272,,230.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68,22,,percent of total billed charges,,,,,,,,,244.8,90,,percent of total billed charges,,,225.22,82.8,,percent of total billed charges,,,231.2,85,,percent of total billed charges,,,,,,,,,239.36,88,,percent of total billed charges,,,,,,,,,207.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68,22,,percent of total billed charges,,,247.52,91,,percent of total billed charges,,,258.4,95,,percent of total billed charges,,,225.76,83,,percent of total billed charges,,,225.76,83,,percent of total billed charges,,,,,,,,,,,,,,,225.76,83,,percent of total billed charges,,,258.4,95,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,223.04,82,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,231.2,85,,percent of total billed charges,,68,258.4,
NEISSERIA GC ANTIBODIES (SERUM),25201875,CDM,86609,CPT,300,RC,outpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.5,22,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,38.09,82.8,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.5,22,,percent of total billed charges,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,11.5,43.7,
CYTOMEGALOVIRUS PCR (QUALITATIVE),25201885,CDM,87496,CPT,300,RC,outpatient,,385,385,,326.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.25,22,,percent of total billed charges,,,,,,,,,346.5,90,,percent of total billed charges,,,318.78,82.8,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,,,,,,,,338.8,88,,percent of total billed charges,,,,,,,,,294.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.25,22,,percent of total billed charges,,,350.35,91,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,,,,,,,,,,,,,319.55,83,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,315.7,82,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,96.25,365.75,
CYTOMEGALOVIRUS PCR (LAVAGE),25201886,CDM,87497,CPT,300,RC,outpatient,,564,564,,478.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141,22,,percent of total billed charges,,,,,,,,,507.6,90,,percent of total billed charges,,,466.99,82.8,,percent of total billed charges,,,479.4,85,,percent of total billed charges,,,,,,,,,496.32,88,,percent of total billed charges,,,,,,,,,430.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141,22,,percent of total billed charges,,,513.24,91,,percent of total billed charges,,,535.8,95,,percent of total billed charges,,,468.12,83,,percent of total billed charges,,,468.12,83,,percent of total billed charges,,,,,,,,,,,,,,,468.12,83,,percent of total billed charges,,,535.8,95,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,462.48,82,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,479.4,85,,percent of total billed charges,,141,535.8,
CYTOMEGALOVIRUS AB(IGM),25201889,CDM,86645,CPT,300,RC,outpatient,,190,190,,161.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.5,22,,percent of total billed charges,,,,,,,,,171,90,,percent of total billed charges,,,157.32,82.8,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,,,,,,,,167.2,88,,percent of total billed charges,,,,,,,,,145.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.5,22,,percent of total billed charges,,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,,,,,,,,,,,,,157.7,83,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,155.8,82,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,47.5,180.5,
COMPLEMENT (C3),25201897,CDM,86160,CPT,300,RC,outpatient,,216,216,,183.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54,22,,percent of total billed charges,,,,,,,,,194.4,90,,percent of total billed charges,,,178.85,82.8,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,,,,,,,,190.08,88,,percent of total billed charges,,,,,,,,,165.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54,22,,percent of total billed charges,,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,177.12,82,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,54,205.2,
COMPLEMENT (C4),25201905,CDM,86160,CPT,300,RC,outpatient,,216,216,,183.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54,22,,percent of total billed charges,,,,,,,,,194.4,90,,percent of total billed charges,,,178.85,82.8,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,,,,,,,,190.08,88,,percent of total billed charges,,,,,,,,,165.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54,22,,percent of total billed charges,,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,177.12,82,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,54,205.2,
C4 BINDING PROTEIN,25201906,CDM,83520,CPT,300,RC,outpatient,,216,216,,183.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54,22,,percent of total billed charges,,,,,,,,,194.4,90,,percent of total billed charges,,,178.85,82.8,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,,,,,,,,190.08,88,,percent of total billed charges,,,,,,,,,165.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54,22,,percent of total billed charges,,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,177.12,82,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,54,205.2,
BONE DECALCIFICATION,25201914,CDM,88311,CPT,310,RC,outpatient,,166,166,,140.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.5,22,,percent of total billed charges,,,,,,,,,149.4,90,,percent of total billed charges,,,137.45,82.8,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,,,,,,,,146.08,88,,percent of total billed charges,,,,,,,,,126.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.5,22,,percent of total billed charges,,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,,,,,,,,,,,,,137.78,83,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,136.12,82,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,41.5,157.7,
BETA HYDROXYBUTYRATE,25201916,CDM,82010,CPT,300,RC,outpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.5,22,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,170.57,82.8,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.5,22,,percent of total billed charges,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,51.5,195.7,
ARSENIC,25201939,CDM,82175,CPT,300,RC,outpatient,,286,286,,242.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.5,22,,percent of total billed charges,,,,,,,,,257.4,90,,percent of total billed charges,,,236.81,82.8,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,,,,,,,,251.68,88,,percent of total billed charges,,,,,,,,,218.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.5,22,,percent of total billed charges,,,260.26,91,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,,,,,,,,,,,,,237.38,83,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,234.52,82,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,71.5,271.7,
ARSENIC URINE,25201940,CDM,82175,CPT,300,RC,outpatient,,44,44,,37.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11,22,,percent of total billed charges,,,,,,,,,39.6,90,,percent of total billed charges,,,36.43,82.8,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,,,,,,,,38.72,88,,percent of total billed charges,,,,,,,,,33.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11,22,,percent of total billed charges,,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,36.08,82,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,11,41.8,
ARSENIC HAIR,25201941,CDM,82175,CPT,300,RC,outpatient,,585,585,,496.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,146.25,22,,percent of total billed charges,,,,,,,,,526.5,90,,percent of total billed charges,,,484.38,82.8,,percent of total billed charges,,,497.25,85,,percent of total billed charges,,,,,,,,,514.8,88,,percent of total billed charges,,,,,,,,,446.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,146.25,22,,percent of total billed charges,,,532.35,91,,percent of total billed charges,,,555.75,95,,percent of total billed charges,,,485.55,83,,percent of total billed charges,,,485.55,83,,percent of total billed charges,,,,,,,,,,,,,,,485.55,83,,percent of total billed charges,,,555.75,95,,percent of total billed charges,,,526.5,90,,percent of total billed charges,,,526.5,90,,percent of total billed charges,,,479.7,82,,percent of total billed charges,,,526.5,90,,percent of total billed charges,,,497.25,85,,percent of total billed charges,,146.25,555.75,
MERCURY HAIR,25201942,CDM,83825,CPT,300,RC,outpatient,,733,733,,622.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,183.25,22,,percent of total billed charges,,,,,,,,,659.7,90,,percent of total billed charges,,,606.92,82.8,,percent of total billed charges,,,623.05,85,,percent of total billed charges,,,,,,,,,645.04,88,,percent of total billed charges,,,,,,,,,560.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,183.25,22,,percent of total billed charges,,,667.03,91,,percent of total billed charges,,,696.35,95,,percent of total billed charges,,,608.39,83,,percent of total billed charges,,,608.39,83,,percent of total billed charges,,,,,,,,,,,,,,,608.39,83,,percent of total billed charges,,,696.35,95,,percent of total billed charges,,,659.7,90,,percent of total billed charges,,,659.7,90,,percent of total billed charges,,,601.06,82,,percent of total billed charges,,,659.7,90,,percent of total billed charges,,,623.05,85,,percent of total billed charges,,183.25,696.35,
VITAMIN C,25201947,CDM,82180,CPT,300,RC,outpatient,,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.5,22,,percent of total billed charges,,,,,,,,,239.4,90,,percent of total billed charges,,,220.25,82.8,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.5,22,,percent of total billed charges,,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,66.5,252.7,
AZATHIOPRINE,25201950,CDM,80375,CPT,300,RC,outpatient,,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43,22,,percent of total billed charges,,,,,,,,,154.8,90,,percent of total billed charges,,,142.42,82.8,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43,22,,percent of total billed charges,,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,43,163.4,
BUPRENORPHINE,25201952,CDM,80348,CPT,300,RC,outpatient,,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43,22,,percent of total billed charges,,,,,,,,,154.8,90,,percent of total billed charges,,,142.42,82.8,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43,22,,percent of total billed charges,,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,43,163.4,
XANAX,25201953,CDM,80168,CPT,300,RC,outpatient,,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43,22,,percent of total billed charges,,,,,,,,,154.8,90,,percent of total billed charges,,,142.42,82.8,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43,22,,percent of total billed charges,,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,43,163.4,
ETHOSUXIMIDE,25201954,CDM,80168,CPT,300,RC,outpatient,,166,166,,140.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.5,22,,percent of total billed charges,,,,,,,,,149.4,90,,percent of total billed charges,,,137.45,82.8,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,,,,,,,,146.08,88,,percent of total billed charges,,,,,,,,,126.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.5,22,,percent of total billed charges,,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,,,,,,,,,,,,,137.78,83,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,136.12,82,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,41.5,157.7,
ZONISAMIDE,25201955,CDM,80203,CPT,300,RC,outpatient,,207,207,,175.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.75,22,,percent of total billed charges,,,,,,,,,186.3,90,,percent of total billed charges,,,171.4,82.8,,percent of total billed charges,,,175.95,85,,percent of total billed charges,,,,,,,,,182.16,88,,percent of total billed charges,,,,,,,,,158.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.75,22,,percent of total billed charges,,,188.37,91,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,,,,,,,,,,,,,171.81,83,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,169.74,82,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,175.95,85,,percent of total billed charges,,51.75,196.65,
BUPRENORPHINE URINE CONFIRMATION,25201956,CDM,80348,CPT,300,RC,outpatient,,252,252,,213.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63,22,,percent of total billed charges,,,,,,,,,226.8,90,,percent of total billed charges,,,208.66,82.8,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,,,,,,,,221.76,88,,percent of total billed charges,,,,,,,,,192.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63,22,,percent of total billed charges,,,229.32,91,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,,,,,,,,,,,,,209.16,83,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,206.64,82,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,63,239.4,
FENTANYL URINE,25201957,CDM,80307,CPT,300,RC,outpatient,,252,252,,213.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63,22,,percent of total billed charges,,,,,,,,,226.8,90,,percent of total billed charges,,,208.66,82.8,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,,,,,,,,221.76,88,,percent of total billed charges,,,,,,,,,192.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63,22,,percent of total billed charges,,,229.32,91,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,,,,,,,,,,,,,209.16,83,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,206.64,82,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,63,239.4,
..BUPRENORPHINE CHARGE ONLY,25201958,CDM,G0480,HCPCS,300,RC,outpatient,,252,252,,213.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63,22,,percent of total billed charges,,,,,,,,,226.8,90,,percent of total billed charges,,,208.66,82.8,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,,,,,,,,221.76,88,,percent of total billed charges,,47.96,,,,fee schedule,,,192.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,47.96,,,,fee schedule,,,63,22,,percent of total billed charges,,,229.32,91,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,,,,,,,,,,,,,209.16,83,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,206.64,82,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,47.96,239.4,
ZINC SERUM,25201962,CDM,84630,CPT,300,RC,outpatient,,204,204,,173.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51,22,,percent of total billed charges,,,,,,,,,183.6,90,,percent of total billed charges,,,168.91,82.8,,percent of total billed charges,,,173.4,85,,percent of total billed charges,,,,,,,,,179.52,88,,percent of total billed charges,,,,,,,,,155.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51,22,,percent of total billed charges,,,185.64,91,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,,,,,,,,,,,,,169.32,83,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,167.28,82,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,173.4,85,,percent of total billed charges,,51,193.8,
BB ADSORPTION OF SERUM EACH CELL,25201969,CDM,86978,CPT,300,RC,outpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.75,22,,percent of total billed charges,,,,,,,,,189.9,90,,percent of total billed charges,,,174.71,82.8,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.75,22,,percent of total billed charges,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,52.75,200.45,
BB ANTIBODY IDENTIFICATION,25201970,CDM,86870,CPT,300,RC,outpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94,22,,percent of total billed charges,,,,,,,,,338.4,90,,percent of total billed charges,,,311.33,82.8,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94,22,,percent of total billed charges,,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,94,357.2,
BB ANTIGEN TESTING OF DONOR BLOOD,25201971,CDM,86902,CPT,300,RC,outpatient,,197,197,,167.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.25,22,,percent of total billed charges,,,,,,,,,177.3,90,,percent of total billed charges,,,163.12,82.8,,percent of total billed charges,,,167.45,85,,percent of total billed charges,,,,,,,,,173.36,88,,percent of total billed charges,,,,,,,,,150.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.25,22,,percent of total billed charges,,,179.27,91,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,,,,,,,,,,,,,163.51,83,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,161.54,82,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,167.45,85,,percent of total billed charges,,49.25,187.15,
BB AG SCREEN W/PT SERUM PER UNIT,25201972,CDM,86904,CPT,300,RC,outpatient,,197,197,,167.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.25,22,,percent of total billed charges,,,,,,,,,177.3,90,,percent of total billed charges,,,163.12,82.8,,percent of total billed charges,,,167.45,85,,percent of total billed charges,,,,,,,,,173.36,88,,percent of total billed charges,,,,,,,,,150.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.25,22,,percent of total billed charges,,,179.27,91,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,,,,,,,,,,,,,163.51,83,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,161.54,82,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,167.45,85,,percent of total billed charges,,49.25,187.15,
BB RBC AG NOT ABO OR D,25201973,CDM,86905,CPT,300,RC,outpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
BB RBC AG SCREEN SPECIFIC ORDER 1-10,25201974,CDM,86902,CPT,300,RC,outpatient,,197,197,,167.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.25,22,,percent of total billed charges,,,,,,,,,177.3,90,,percent of total billed charges,,,163.12,82.8,,percent of total billed charges,,,167.45,85,,percent of total billed charges,,,,,,,,,173.36,88,,percent of total billed charges,,,,,,,,,150.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.25,22,,percent of total billed charges,,,179.27,91,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,,,,,,,,,,,,,163.51,83,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,161.54,82,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,167.45,85,,percent of total billed charges,,49.25,187.15,
BB RH PHENOTYPING,25201975,CDM,86906,CPT,300,RC,outpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
BB RX RBC W/CHEMICALS,25201976,CDM,86970,CPT,300,RC,outpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
BB ANTIGEN TYPING K (KELL),25201977,CDM,86870,CPT,300,RC,outpatient,,166,166,,140.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.5,22,,percent of total billed charges,,,,,,,,,149.4,90,,percent of total billed charges,,,137.45,82.8,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,,,,,,,,146.08,88,,percent of total billed charges,,,,,,,,,126.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.5,22,,percent of total billed charges,,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,,,,,,,,,,,,,137.78,83,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,136.12,82,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,41.5,157.7,
BB ANTIGEN TYPING E (BIG E LITTLE E),25201978,CDM,,,300,RC,outpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40,22,,percent of total billed charges,,,,,,,,,144,90,,percent of total billed charges,,,132.48,82.8,,percent of total billed charges,,,136,85,,percent of total billed charges,,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40,22,,percent of total billed charges,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,40,152,
.BB ANTIGEN TYPING E,25201979,CDM,86905,CPT,300,RC,outpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40,22,,percent of total billed charges,,,,,,,,,144,90,,percent of total billed charges,,,132.48,82.8,,percent of total billed charges,,,136,85,,percent of total billed charges,,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40,22,,percent of total billed charges,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,40,152,
BORDETELLA PERTUSSIS CULTURE,25201992,CDM,87081,CPT,300,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
BORDETELLA PERTUSSIS PCR,25201993,CDM,87798,CPT,300,RC,outpatient,,874,874,,742.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.5,22,,percent of total billed charges,,,,,,,,,786.6,90,,percent of total billed charges,,,723.67,82.8,,percent of total billed charges,,,742.9,85,,percent of total billed charges,,,,,,,,,769.12,88,,percent of total billed charges,,,,,,,,,667.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.5,22,,percent of total billed charges,,,795.34,91,,percent of total billed charges,,,830.3,95,,percent of total billed charges,,,725.42,83,,percent of total billed charges,,,725.42,83,,percent of total billed charges,,,,,,,,,,,,,,,725.42,83,,percent of total billed charges,,,830.3,95,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,716.68,82,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,742.9,85,,percent of total billed charges,,218.5,830.3,
BORDETELLA PERTUSSIS ANTIBODIES,25201994,CDM,86615,CPT,300,RC,outpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.5,22,,percent of total billed charges,,,,,,,,,178.2,90,,percent of total billed charges,,,163.94,82.8,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.5,22,,percent of total billed charges,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,49.5,188.1,
"BRUCELLA ANTIBODIES (IgG, IgM)",25201996,CDM,86622,CPT,300,RC,outpatient,,97,97,,82.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.25,22,,percent of total billed charges,,,,,,,,,87.3,90,,percent of total billed charges,,,80.32,82.8,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,,,,,,,,85.36,88,,percent of total billed charges,,,,,,,,,74.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.25,22,,percent of total billed charges,,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,,,,,,,,,,,,,80.51,83,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,79.54,82,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,24.25,92.15,
CARBAMAZEPINE TOTAL,25202028,CDM,80156,CPT,300,RC,outpatient,,230,230,,195.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.5,22,,percent of total billed charges,,,,,,,,,207,90,,percent of total billed charges,,,190.44,82.8,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,,,,,,,,202.4,88,,percent of total billed charges,,,,,,,,,175.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.5,22,,percent of total billed charges,,,209.3,91,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,,,,,,,,,,,,,190.9,83,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,188.6,82,,percent of total billed charges,,,207,90,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,57.5,218.5,
CARBAMAZEPINE FREE,25202029,CDM,80157,CPT,300,RC,outpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.75,22,,percent of total billed charges,,,,,,,,,182.7,90,,percent of total billed charges,,,168.08,82.8,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.75,22,,percent of total billed charges,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,50.75,192.85,
CLOSTRIDIUM DIFFICILE TOXINS A & B & AG,25202036,CDM,87324,CPT,300,RC,outpatient,,439,439,,372.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.75,22,,percent of total billed charges,,,,,,,,,395.1,90,,percent of total billed charges,,,363.49,82.8,,percent of total billed charges,,,373.15,85,,percent of total billed charges,,,,,,,,,386.32,88,,percent of total billed charges,,,,,,,,,335.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.75,22,,percent of total billed charges,,,399.49,91,,percent of total billed charges,,,417.05,95,,percent of total billed charges,,,364.37,83,,percent of total billed charges,,,364.37,83,,percent of total billed charges,,,,,,,,,,,,,,,364.37,83,,percent of total billed charges,,,417.05,95,,percent of total billed charges,,,395.1,90,,percent of total billed charges,,,395.1,90,,percent of total billed charges,,,359.98,82,,percent of total billed charges,,,395.1,90,,percent of total billed charges,,,373.15,85,,percent of total billed charges,,109.75,417.05,
.CULTURE CLOSTRIDIUM DIFFICILE,25202037,CDM,87081,CPT,300,RC,outpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
CLOSTRIDUM DIFFICILE PCR,25202038,CDM,87493,CPT,300,RC,outpatient,,537,537,,455.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,134.25,22,,percent of total billed charges,,,,,,,,,483.3,90,,percent of total billed charges,,,444.64,82.8,,percent of total billed charges,,,456.45,85,,percent of total billed charges,,,,,,,,,472.56,88,,percent of total billed charges,,,,,,,,,410.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,134.25,22,,percent of total billed charges,,,488.67,91,,percent of total billed charges,,,510.15,95,,percent of total billed charges,,,445.71,83,,percent of total billed charges,,,445.71,83,,percent of total billed charges,,,,,,,,,,,,,,,445.71,83,,percent of total billed charges,,,510.15,95,,percent of total billed charges,,,483.3,90,,percent of total billed charges,,,483.3,90,,percent of total billed charges,,,440.34,82,,percent of total billed charges,,,483.3,90,,percent of total billed charges,,,456.45,85,,percent of total billed charges,,134.25,510.15,
"COPPER, BLOOD",25202044,CDM,82525,CPT,300,RC,outpatient,,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.5,22,,percent of total billed charges,,,,,,,,,351,90,,percent of total billed charges,,,322.92,82.8,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.5,22,,percent of total billed charges,,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,97.5,370.5,
NICKEL PLASMA,25202046,CDM,83885,CPT,300,RC,outpatient,,288,288,,244.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72,22,,percent of total billed charges,,,,,,,,,259.2,90,,percent of total billed charges,,,238.46,82.8,,percent of total billed charges,,,244.8,85,,percent of total billed charges,,,,,,,,,253.44,88,,percent of total billed charges,,,,,,,,,220.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72,22,,percent of total billed charges,,,262.08,91,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,,,,,,,,,,,,,239.04,83,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,236.16,82,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,244.8,85,,percent of total billed charges,,72,273.6,
CULTURE ANAEROBIC,25202051,CDM,87075,CPT,300,RC,outpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.5,22,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,170.57,82.8,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.5,22,,percent of total billed charges,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,51.5,195.7,
CULTURE GROUP B STREP,25202052,CDM,87081,CPT,300,RC,outpatient,,165,165,,140.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.25,22,,percent of total billed charges,,,,,,,,,148.5,90,,percent of total billed charges,,,136.62,82.8,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,,,,,,,,145.2,88,,percent of total billed charges,,,,,,,,,126.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.25,22,,percent of total billed charges,,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,135.3,82,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,41.25,156.75,
CULTURE FUNGUS (OTHER),25202069,CDM,87102,CPT,300,RC,outpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.25,22,,percent of total billed charges,,,,,,,,,267.3,90,,percent of total billed charges,,,245.92,82.8,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.25,22,,percent of total billed charges,,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,74.25,282.15,
CULTURE FUNGUS (BLOOD),25202070,CDM,87101,CPT,300,RC,outpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.25,22,,percent of total billed charges,,,,,,,,,267.3,90,,percent of total billed charges,,,245.92,82.8,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.25,22,,percent of total billed charges,,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,74.25,282.15,
"CULTURE FUNGUS (HAIR, SKIN, NAILS)",25202071,CDM,87101,CPT,300,RC,outpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.25,22,,percent of total billed charges,,,,,,,,,267.3,90,,percent of total billed charges,,,245.92,82.8,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.25,22,,percent of total billed charges,,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,74.25,282.15,
CULT FUNGUS W/RAPID ID,25202072,CDM,87101,CPT,300,RC,outpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.25,22,,percent of total billed charges,,,,,,,,,188.1,90,,percent of total billed charges,,,173.05,82.8,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.25,22,,percent of total billed charges,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,52.25,198.55,
CYANIDE BLOOD,25202077,CDM,82600,CPT,300,RC,outpatient,,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
CYCLOSPORA SMEAR STOOL,25202080,CDM,87015,CPT,300,RC,outpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.25,22,,percent of total billed charges,,,,,,,,,130.5,90,,percent of total billed charges,,,120.06,82.8,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.25,22,,percent of total billed charges,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,36.25,137.75,
CYCLOSPORINE A,25202085,CDM,80158,CPT,300,RC,outpatient,,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
CYSTATIN C,25202086,CDM,82610,CPT,300,RC,outpatient,,482,482,,409.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,120.5,22,,percent of total billed charges,,,,,,,,,433.8,90,,percent of total billed charges,,,399.1,82.8,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,,,,,,,,424.16,88,,percent of total billed charges,,,,,,,,,368.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,120.5,22,,percent of total billed charges,,,438.62,91,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,,,,,,,,,,,,,400.06,83,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,395.24,82,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,120.5,457.9,
DHEA-SULFATE,25202093,CDM,82627,CPT,300,RC,outpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.5,22,,percent of total billed charges,,,,,,,,,365.4,90,,percent of total billed charges,,,336.17,82.8,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.5,22,,percent of total billed charges,,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,101.5,385.7,
DEXAMETHASONE SUPPRESSION,25202094,CDM,82533,CPT,300,RC,outpatient,,293,293,,248.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.25,22,,percent of total billed charges,,,,,,,,,263.7,90,,percent of total billed charges,,,242.6,82.8,,percent of total billed charges,,,249.05,85,,percent of total billed charges,,,,,,,,,257.84,88,,percent of total billed charges,,,,,,,,,223.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.25,22,,percent of total billed charges,,,266.63,91,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,,,,,,,,,,,,,243.19,83,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,240.26,82,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,249.05,85,,percent of total billed charges,,73.25,278.35,
AMINOLEVULINIC ACID,25202095,CDM,82135,CPT,300,RC,outpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.25,22,,percent of total billed charges,,,,,,,,,188.1,90,,percent of total billed charges,,,173.05,82.8,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.25,22,,percent of total billed charges,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,52.25,198.55,
DEXAMETHASONE,25202096,CDM,80375,CPT,300,RC,outpatient,,221,221,,187.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.25,22,,percent of total billed charges,,,,,,,,,198.9,90,,percent of total billed charges,,,182.99,82.8,,percent of total billed charges,,,187.85,85,,percent of total billed charges,,,,,,,,,194.48,88,,percent of total billed charges,,,,,,,,,168.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.25,22,,percent of total billed charges,,,201.11,91,,percent of total billed charges,,,209.95,95,,percent of total billed charges,,,183.43,83,,percent of total billed charges,,,183.43,83,,percent of total billed charges,,,,,,,,,,,,,,,183.43,83,,percent of total billed charges,,,209.95,95,,percent of total billed charges,,,198.9,90,,percent of total billed charges,,,198.9,90,,percent of total billed charges,,,181.22,82,,percent of total billed charges,,,198.9,90,,percent of total billed charges,,,187.85,85,,percent of total billed charges,,55.25,209.95,
DHEA,25202097,CDM,82627,CPT,300,RC,outpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.5,22,,percent of total billed charges,,,,,,,,,365.4,90,,percent of total billed charges,,,336.17,82.8,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.5,22,,percent of total billed charges,,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,101.5,385.7,
CREATININE URINE,25202119,CDM,82570,CPT,300,RC,outpatient,,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.25,22,,percent of total billed charges,,,,,,,,,137.7,90,,percent of total billed charges,,,126.68,82.8,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.25,22,,percent of total billed charges,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,38.25,145.35,
COXSACKIE A ANTIBODIES,25202120,CDM,86658,CPT,300,RC,outpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.25,22,,percent of total billed charges,,,,,,,,,94.5,90,,percent of total billed charges,,,86.94,82.8,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.25,22,,percent of total billed charges,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,26.25,99.75,
COXSACKIE B ANTIBODIES,25202121,CDM,86658,CPT,300,RC,outpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.25,22,,percent of total billed charges,,,,,,,,,94.5,90,,percent of total billed charges,,,86.94,82.8,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.25,22,,percent of total billed charges,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,26.25,99.75,
MEASLES ANTIBODY (IgG),25202127,CDM,86765,CPT,300,RC,outpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.25,22,,percent of total billed charges,,,,,,,,,188.1,90,,percent of total billed charges,,,173.05,82.8,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.25,22,,percent of total billed charges,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,52.25,198.55,
MEASLES ANTIBODY (IgM),25202128,CDM,86765,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
PARVOVIRUS DNA PCR (HIGH RISK),25202130,CDM,87798,CPT,300,RC,outpatient,,711,711,,603.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,177.75,22,,percent of total billed charges,,,,,,,,,639.9,90,,percent of total billed charges,,,588.71,82.8,,percent of total billed charges,,,604.35,85,,percent of total billed charges,,,,,,,,,625.68,88,,percent of total billed charges,,,,,,,,,543.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,177.75,22,,percent of total billed charges,,,647.01,91,,percent of total billed charges,,,675.45,95,,percent of total billed charges,,,590.13,83,,percent of total billed charges,,,590.13,83,,percent of total billed charges,,,,,,,,,,,,,,,590.13,83,,percent of total billed charges,,,675.45,95,,percent of total billed charges,,,639.9,90,,percent of total billed charges,,,639.9,90,,percent of total billed charges,,,583.02,82,,percent of total billed charges,,,639.9,90,,percent of total billed charges,,,604.35,85,,percent of total billed charges,,177.75,675.45,
PARVOVIRUS B19 IgM ANTIBODY,25202133,CDM,86747,CPT,300,RC,outpatient,,226,226,,191.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.5,22,,percent of total billed charges,,,,,,,,,203.4,90,,percent of total billed charges,,,187.13,82.8,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,,,,,,,,198.88,88,,percent of total billed charges,,,,,,,,,172.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.5,22,,percent of total billed charges,,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,,,,,,,,,,,,,187.58,83,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,185.32,82,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,56.5,214.7,
PARVOVIRUS B19  IgG ANTIBODY,25202134,CDM,86747,CPT,300,RC,outpatient,,226,226,,191.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.5,22,,percent of total billed charges,,,,,,,,,203.4,90,,percent of total billed charges,,,187.13,82.8,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,,,,,,,,198.88,88,,percent of total billed charges,,,,,,,,,172.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.5,22,,percent of total billed charges,,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,,,,,,,,,,,,,187.58,83,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,185.32,82,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,56.5,214.7,
PARATHYROID HORMONE,25202135,CDM,83970,CPT,300,RC,outpatient,,741,741,,629.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,185.25,22,,percent of total billed charges,,,,,,,,,666.9,90,,percent of total billed charges,,,613.55,82.8,,percent of total billed charges,,,629.85,85,,percent of total billed charges,,,,,,,,,652.08,88,,percent of total billed charges,,,,,,,,,566.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,185.25,22,,percent of total billed charges,,,674.31,91,,percent of total billed charges,,,703.95,95,,percent of total billed charges,,,615.03,83,,percent of total billed charges,,,615.03,83,,percent of total billed charges,,,,,,,,,,,,,,,615.03,83,,percent of total billed charges,,,703.95,95,,percent of total billed charges,,,666.9,90,,percent of total billed charges,,,666.9,90,,percent of total billed charges,,,607.62,82,,percent of total billed charges,,,666.9,90,,percent of total billed charges,,,629.85,85,,percent of total billed charges,,185.25,703.95,
PTH RELATED PEPTIDE,25202136,CDM,83519,CPT,300,RC,outpatient,,113,113,,95.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.25,22,,percent of total billed charges,,,,,,,,,101.7,90,,percent of total billed charges,,,93.56,82.8,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,,,,,,,,99.44,88,,percent of total billed charges,,,,,,,,,86.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.25,22,,percent of total billed charges,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,92.66,82,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,28.25,107.35,
GONADOTROPIN RELEASING HORMONE,25202137,CDM,83727,CPT,300,RC,outpatient,,529,529,,449.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.25,22,,percent of total billed charges,,,,,,,,,476.1,90,,percent of total billed charges,,,438.01,82.8,,percent of total billed charges,,,449.65,85,,percent of total billed charges,,,,,,,,,465.52,88,,percent of total billed charges,,,,,,,,,404.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.25,22,,percent of total billed charges,,,481.39,91,,percent of total billed charges,,,502.55,95,,percent of total billed charges,,,439.07,83,,percent of total billed charges,,,439.07,83,,percent of total billed charges,,,,,,,,,,,,,,,439.07,83,,percent of total billed charges,,,502.55,95,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,433.78,82,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,449.65,85,,percent of total billed charges,,132.25,502.55,
HISTAMINE DETERMINATION PLASMA,25202138,CDM,83088,CPT,300,RC,outpatient,,524,524,,444.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131,22,,percent of total billed charges,,,,,,,,,471.6,90,,percent of total billed charges,,,433.87,82.8,,percent of total billed charges,,,445.4,85,,percent of total billed charges,,,,,,,,,461.12,88,,percent of total billed charges,,,,,,,,,400.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,131,22,,percent of total billed charges,,,476.84,91,,percent of total billed charges,,,497.8,95,,percent of total billed charges,,,434.92,83,,percent of total billed charges,,,434.92,83,,percent of total billed charges,,,,,,,,,,,,,,,434.92,83,,percent of total billed charges,,,497.8,95,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,429.68,82,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,445.4,85,,percent of total billed charges,,131,497.8,
HISTONE AB,25202139,CDM,86235,CPT,300,RC,outpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.5,22,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,38.09,82.8,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.5,22,,percent of total billed charges,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,11.5,43.7,
CK ISOENZYMES,25202143,CDM,82552,CPT,300,RC,outpatient,,344,344,,292.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86,22,,percent of total billed charges,,,,,,,,,309.6,90,,percent of total billed charges,,,284.83,82.8,,percent of total billed charges,,,292.4,85,,percent of total billed charges,,,,,,,,,302.72,88,,percent of total billed charges,,,,,,,,,262.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86,22,,percent of total billed charges,,,313.04,91,,percent of total billed charges,,,326.8,95,,percent of total billed charges,,,285.52,83,,percent of total billed charges,,,285.52,83,,percent of total billed charges,,,,,,,,,,,,,,,285.52,83,,percent of total billed charges,,,326.8,95,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,282.08,82,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,292.4,85,,percent of total billed charges,,86,326.8,
LDH ISOENZYMES,25202150,CDM,83625,CPT,300,RC,outpatient,,360,360,,305.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90,22,,percent of total billed charges,,,,,,,,,324,90,,percent of total billed charges,,,298.08,82.8,,percent of total billed charges,,,306,85,,percent of total billed charges,,,,,,,,,316.8,88,,percent of total billed charges,,,,,,,,,275.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90,22,,percent of total billed charges,,,327.6,91,,percent of total billed charges,,,342,95,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,,,,,,,,,,,,,298.8,83,,percent of total billed charges,,,342,95,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,295.2,82,,percent of total billed charges,,,324,90,,percent of total billed charges,,,306,85,,percent of total billed charges,,90,342,
CLORAZEPATE,25202168,CDM,80346,CPT,300,RC,outpatient,,280,280,,237.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70,22,,percent of total billed charges,,,,,,,,,252,90,,percent of total billed charges,,,231.84,82.8,,percent of total billed charges,,,238,85,,percent of total billed charges,,,,,,,,,246.4,88,,percent of total billed charges,,,,,,,,,213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70,22,,percent of total billed charges,,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,,,,,,,,,,,,,232.4,83,,percent of total billed charges,,,266,95,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,229.6,82,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,70,266,
CLONAZEPAM,25202169,CDM,80346,CPT,300,RC,outpatient,,280,280,,237.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70,22,,percent of total billed charges,,,,,,,,,252,90,,percent of total billed charges,,,231.84,82.8,,percent of total billed charges,,,238,85,,percent of total billed charges,,,,,,,,,246.4,88,,percent of total billed charges,,,,,,,,,213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70,22,,percent of total billed charges,,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,,,,,,,,,,,,,232.4,83,,percent of total billed charges,,,266,95,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,229.6,82,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,70,266,
THYROXINE BINDING GLOBULIN (TBG),25202176,CDM,84442,CPT,300,RC,outpatient,,290,290,,246.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.5,22,,percent of total billed charges,,,,,,,,,261,90,,percent of total billed charges,,,240.12,82.8,,percent of total billed charges,,,246.5,85,,percent of total billed charges,,,,,,,,,255.2,88,,percent of total billed charges,,,,,,,,,221.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.5,22,,percent of total billed charges,,,263.9,91,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,,,,,,,,,,,,,240.7,83,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,261,90,,percent of total billed charges,,,261,90,,percent of total billed charges,,,237.8,82,,percent of total billed charges,,,261,90,,percent of total billed charges,,,246.5,85,,percent of total billed charges,,72.5,275.5,
BONE MARROW PARTICLE SECTION,25202218,CDM,88305,CPT,310,RC,outpatient,,498,498,,422.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.5,22,,percent of total billed charges,,,,,,,,,448.2,90,,percent of total billed charges,,,412.34,82.8,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,,,,,,,,438.24,88,,percent of total billed charges,,,,,,,,,380.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.5,22,,percent of total billed charges,,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,,,,,,,,,,,,,413.34,83,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,408.36,82,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,124.5,473.1,
BONE MARROW IRON STAIN,25202226,CDM,88313,CPT,310,RC,outpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,44,167.2,
BONE MARROW INTERPRETATION,25202234,CDM,85097,CPT,310,RC,outpatient,,543,543,,461.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,135.75,22,,percent of total billed charges,,,,,,,,,488.7,90,,percent of total billed charges,,,449.6,82.8,,percent of total billed charges,,,461.55,85,,percent of total billed charges,,,,,,,,,477.84,88,,percent of total billed charges,,,,,,,,,414.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,135.75,22,,percent of total billed charges,,,494.13,91,,percent of total billed charges,,,515.85,95,,percent of total billed charges,,,450.69,83,,percent of total billed charges,,,450.69,83,,percent of total billed charges,,,,,,,,,,,,,,,450.69,83,,percent of total billed charges,,,515.85,95,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,445.26,82,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,461.55,85,,percent of total billed charges,,135.75,515.85,
PROTEIN ELECTRO CSF,25202242,CDM,84166,CPT,300,RC,outpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.75,22,,percent of total billed charges,,,,,,,,,204.3,90,,percent of total billed charges,,,187.96,82.8,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.75,22,,percent of total billed charges,,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,56.75,215.65,
PROTEIN ELECTRO BODY FLUID,25202244,CDM,84166,CPT,300,RC,outpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.75,22,,percent of total billed charges,,,,,,,,,204.3,90,,percent of total billed charges,,,187.96,82.8,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.75,22,,percent of total billed charges,,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,56.75,215.65,
BONE MARROW PERIPHERAL SMEAR,25202259,CDM,85060,CPT,300,RC,outpatient,,440,440,,373.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110,22,,percent of total billed charges,,,,,,,,,396,90,,percent of total billed charges,,,364.32,82.8,,percent of total billed charges,,,374,85,,percent of total billed charges,,,,,,,,,387.2,88,,percent of total billed charges,,,,,,,,,336.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110,22,,percent of total billed charges,,,400.4,91,,percent of total billed charges,,,418,95,,percent of total billed charges,,,365.2,83,,percent of total billed charges,,,365.2,83,,percent of total billed charges,,,,,,,,,,,,,,,365.2,83,,percent of total billed charges,,,418,95,,percent of total billed charges,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,360.8,82,,percent of total billed charges,,,396,90,,percent of total billed charges,,,374,85,,percent of total billed charges,,110,418,
BONE MARROW TREPHINE BIOPSY,25202260,CDM,88305,CPT,310,RC,outpatient,,498,498,,422.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.5,22,,percent of total billed charges,,,,,,,,,448.2,90,,percent of total billed charges,,,412.34,82.8,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,,,,,,,,438.24,88,,percent of total billed charges,,,,,,,,,380.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.5,22,,percent of total billed charges,,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,,,,,,,,,,,,,413.34,83,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,408.36,82,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,124.5,473.1,
BONE MARROW PROCESSING/STAINING,25202261,CDM,85999,CPT,310,RC,outpatient,,471,471,,399.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.75,22,,percent of total billed charges,,,,,,,,,423.9,90,,percent of total billed charges,,,389.99,82.8,,percent of total billed charges,,,400.35,85,,percent of total billed charges,,,,,,,,,414.48,88,,percent of total billed charges,,,,,,,,,359.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.75,22,,percent of total billed charges,,,428.61,91,,percent of total billed charges,,,447.45,95,,percent of total billed charges,,,390.93,83,,percent of total billed charges,,,390.93,83,,percent of total billed charges,,,,,,,,,,,,,,,390.93,83,,percent of total billed charges,,,447.45,95,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,386.22,82,,percent of total billed charges,,,423.9,90,,percent of total billed charges,,,400.35,85,,percent of total billed charges,,117.75,447.45,
ZINC PROTOPORPHYRIN FEP/ZPP,25202267,CDM,84202,CPT,300,RC,outpatient,,122,122,,103.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.5,22,,percent of total billed charges,,,,,,,,,109.8,90,,percent of total billed charges,,,101.02,82.8,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,,,,,,,,107.36,88,,percent of total billed charges,,,,,,,,,93.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.5,22,,percent of total billed charges,,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,100.04,82,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,30.5,115.9,
OSMITIC FRAGILITY,25202268,CDM,85555,CPT,300,RC,outpatient,,602,602,,511.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.5,22,,percent of total billed charges,,,,,,,,,541.8,90,,percent of total billed charges,,,498.46,82.8,,percent of total billed charges,,,511.7,85,,percent of total billed charges,,,,,,,,,529.76,88,,percent of total billed charges,,,,,,,,,459.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.5,22,,percent of total billed charges,,,547.82,91,,percent of total billed charges,,,571.9,95,,percent of total billed charges,,,499.66,83,,percent of total billed charges,,,499.66,83,,percent of total billed charges,,,,,,,,,,,,,,,499.66,83,,percent of total billed charges,,,571.9,95,,percent of total billed charges,,,541.8,90,,percent of total billed charges,,,541.8,90,,percent of total billed charges,,,493.64,82,,percent of total billed charges,,,541.8,90,,percent of total billed charges,,,511.7,85,,percent of total billed charges,,150.5,571.9,
HEXAGONAL PHOSPHOLIPID,25202270,CDM,85598,CPT,300,RC,outpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,38.5,146.3,
PLASMA FRACTION SUBSITUTION EACH,25202271,CDM,85732,CPT,300,RC,outpatient,,122,122,,103.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.5,22,,percent of total billed charges,,,,,,,,,109.8,90,,percent of total billed charges,,,101.02,82.8,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,,,,,,,,107.36,88,,percent of total billed charges,,,,,,,,,93.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.5,22,,percent of total billed charges,,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,100.04,82,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,30.5,115.9,
RENIN,25202275,CDM,84244,CPT,300,RC,outpatient,,433,433,,367.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.25,22,,percent of total billed charges,,,,,,,,,389.7,90,,percent of total billed charges,,,358.52,82.8,,percent of total billed charges,,,368.05,85,,percent of total billed charges,,,,,,,,,381.04,88,,percent of total billed charges,,,,,,,,,330.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108.25,22,,percent of total billed charges,,,394.03,91,,percent of total billed charges,,,411.35,95,,percent of total billed charges,,,359.39,83,,percent of total billed charges,,,359.39,83,,percent of total billed charges,,,,,,,,,,,,,,,359.39,83,,percent of total billed charges,,,411.35,95,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,355.06,82,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,368.05,85,,percent of total billed charges,,108.25,411.35,
RENAL FUNCTION PANEL,25202276,CDM,80069,CPT,300,RC,outpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.75,22,,percent of total billed charges,,,,,,,,,236.7,90,,percent of total billed charges,,,217.76,82.8,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.75,22,,percent of total billed charges,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,65.75,249.85,
RAPAMUNE (RAPAMYCIN),25202277,CDM,80195,CPT,300,RC,outpatient,,501,501,,425.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125.25,22,,percent of total billed charges,,,,,,,,,450.9,90,,percent of total billed charges,,,414.83,82.8,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,,,,,,,,440.88,88,,percent of total billed charges,,,,,,,,,382.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125.25,22,,percent of total billed charges,,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,,,,,,,,,,,,,415.83,83,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,410.82,82,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,125.25,475.95,
SALICYLATES,25202283,CDM,80179,CPT,300,RC,outpatient,,226,226,,191.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.5,22,,percent of total billed charges,,,,,,,,,203.4,90,,percent of total billed charges,,,187.13,82.8,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,,,,,,,,198.88,88,,percent of total billed charges,,,,,,,,,172.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.5,22,,percent of total billed charges,,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,,,,,,,,,,,,,187.58,83,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,185.32,82,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,56.5,214.7,
SICKLE CELL SCREEN,25202291,CDM,85660,CPT,300,RC,outpatient,,91,91,,77.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.75,22,,percent of total billed charges,,,,,,,,,81.9,90,,percent of total billed charges,,,75.35,82.8,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,,,,,,,,80.08,88,,percent of total billed charges,,,,,,,,,69.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.75,22,,percent of total billed charges,,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,,,,,,,,,,,,,75.53,83,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,74.62,82,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,22.75,86.45,
JAK2 MUTATION PLASMA,25202301,CDM,81270,CPT,300,RC,outpatient,,1272,1272,,1079.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,318,22,,percent of total billed charges,,,,,,,,,1144.8,90,,percent of total billed charges,,,1053.22,82.8,,percent of total billed charges,,,1081.2,85,,percent of total billed charges,,,,,,,,,1119.36,88,,percent of total billed charges,,,,,,,,,971.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,318,22,,percent of total billed charges,,,1157.52,91,,percent of total billed charges,,,1208.4,95,,percent of total billed charges,,,1055.76,83,,percent of total billed charges,,,1055.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1055.76,83,,percent of total billed charges,,,1208.4,95,,percent of total billed charges,,,1144.8,90,,percent of total billed charges,,,1144.8,90,,percent of total billed charges,,,1043.04,82,,percent of total billed charges,,,1144.8,90,,percent of total billed charges,,,1081.2,85,,percent of total billed charges,,318,1208.4,
JC VIRUS,25202302,CDM,87798,CPT,300,RC,outpatient,,599,599,,508.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,149.75,22,,percent of total billed charges,,,,,,,,,539.1,90,,percent of total billed charges,,,495.97,82.8,,percent of total billed charges,,,509.15,85,,percent of total billed charges,,,,,,,,,527.12,88,,percent of total billed charges,,,,,,,,,457.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,149.75,22,,percent of total billed charges,,,545.09,91,,percent of total billed charges,,,569.05,95,,percent of total billed charges,,,497.17,83,,percent of total billed charges,,,497.17,83,,percent of total billed charges,,,,,,,,,,,,,,,497.17,83,,percent of total billed charges,,,569.05,95,,percent of total billed charges,,,539.1,90,,percent of total billed charges,,,539.1,90,,percent of total billed charges,,,491.18,82,,percent of total billed charges,,,539.1,90,,percent of total billed charges,,,509.15,85,,percent of total billed charges,,149.75,569.05,
JAK2  v617f MUTATION /rflx exon 12-15,25202303,CDM,81270,CPT,300,RC,outpatient,,521,521,,442.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.25,22,,percent of total billed charges,,,,,,,,,468.9,90,,percent of total billed charges,,,431.39,82.8,,percent of total billed charges,,,442.85,85,,percent of total billed charges,,,,,,,,,458.48,88,,percent of total billed charges,,,,,,,,,398.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.25,22,,percent of total billed charges,,,474.11,91,,percent of total billed charges,,,494.95,95,,percent of total billed charges,,,432.43,83,,percent of total billed charges,,,432.43,83,,percent of total billed charges,,,,,,,,,,,,,,,432.43,83,,percent of total billed charges,,,494.95,95,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,427.22,82,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,442.85,85,,percent of total billed charges,,130.25,494.95,
..JAK2 EXON 12-15,25202304,CDM,81270,CPT,300,RC,outpatient,,546,546,,463.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,136.5,22,,percent of total billed charges,,,,,,,,,491.4,90,,percent of total billed charges,,,452.09,82.8,,percent of total billed charges,,,464.1,85,,percent of total billed charges,,,,,,,,,480.48,88,,percent of total billed charges,,,,,,,,,417.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,136.5,22,,percent of total billed charges,,,496.86,91,,percent of total billed charges,,,518.7,95,,percent of total billed charges,,,453.18,83,,percent of total billed charges,,,453.18,83,,percent of total billed charges,,,,,,,,,,,,,,,453.18,83,,percent of total billed charges,,,518.7,95,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,447.72,82,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,464.1,85,,percent of total billed charges,,136.5,518.7,
STOOL WBC STAIN,25202309,CDM,89055,CPT,300,RC,outpatient,,106,106,,89.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.5,22,,percent of total billed charges,,,,,,,,,95.4,90,,percent of total billed charges,,,87.77,82.8,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,,,,,,,,93.28,88,,percent of total billed charges,,,,,,,,,80.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.5,22,,percent of total billed charges,,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,,,,,,,,,,,,,87.98,83,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,86.92,82,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,26.5,100.7,
GROWTH HORMONE,25202317,CDM,83003,CPT,300,RC,outpatient,,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93,22,,percent of total billed charges,,,,,,,,,334.8,90,,percent of total billed charges,,,308.02,82.8,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93,22,,percent of total billed charges,,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,93,353.4,
FRUCTOSAMINE,25202325,CDM,82985,CPT,300,RC,outpatient,,226,226,,191.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.5,22,,percent of total billed charges,,,,,,,,,203.4,90,,percent of total billed charges,,,187.13,82.8,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,,,,,,,,198.88,88,,percent of total billed charges,,,,,,,,,172.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.5,22,,percent of total billed charges,,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,,,,,,,,,,,,,187.58,83,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,185.32,82,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,56.5,214.7,
..FRAGILE X,25202326,CDM,81243,CPT,300,RC,outpatient,,594,594,,504.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,148.5,22,,percent of total billed charges,,,,,,,,,534.6,90,,percent of total billed charges,,,491.83,82.8,,percent of total billed charges,,,504.9,85,,percent of total billed charges,,,,,,,,,522.72,88,,percent of total billed charges,,,,,,,,,453.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,148.5,22,,percent of total billed charges,,,540.54,91,,percent of total billed charges,,,564.3,95,,percent of total billed charges,,,493.02,83,,percent of total billed charges,,,493.02,83,,percent of total billed charges,,,,,,,,,,,,,,,493.02,83,,percent of total billed charges,,,564.3,95,,percent of total billed charges,,,534.6,90,,percent of total billed charges,,,534.6,90,,percent of total billed charges,,,487.08,82,,percent of total billed charges,,,534.6,90,,percent of total billed charges,,,504.9,85,,percent of total billed charges,,148.5,564.3,
INTRINSIC FACTOR ANTIBODY,25202332,CDM,86340,CPT,300,RC,outpatient,,226,226,,191.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.5,22,,percent of total billed charges,,,,,,,,,203.4,90,,percent of total billed charges,,,187.13,82.8,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,,,,,,,,198.88,88,,percent of total billed charges,,,,,,,,,172.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.5,22,,percent of total billed charges,,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,,,,,,,,,,,,,187.58,83,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,185.32,82,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,56.5,214.7,
INSULIN TOTAL,25202333,CDM,83525,CPT,300,RC,outpatient,,295,295,,250.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.75,22,,percent of total billed charges,,,,,,,,,265.5,90,,percent of total billed charges,,,244.26,82.8,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,,,,,,,,259.6,88,,percent of total billed charges,,,,,,,,,225.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.75,22,,percent of total billed charges,,,268.45,91,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,,,,,,,,,,,,,244.85,83,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,241.9,82,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,73.75,280.25,
INSULIN TOTAL (3 SPECIMENS),25202334,CDM,83525,CPT,300,RC,outpatient,,101,101,,85.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.25,22,,percent of total billed charges,,,,,,,,,90.9,90,,percent of total billed charges,,,83.63,82.8,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,,,,,,,,88.88,88,,percent of total billed charges,,,,,,,,,77.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.25,22,,percent of total billed charges,,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,82.82,82,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,25.25,95.95,
PROINSULIN,25202335,CDM,84206,CPT,300,RC,outpatient,,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.25,22,,percent of total billed charges,,,,,,,,,321.3,90,,percent of total billed charges,,,295.6,82.8,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.25,22,,percent of total billed charges,,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,89.25,339.15,
KETONE SERUM,25202341,CDM,82009,CPT,300,RC,outpatient,,149,149,,126.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.25,22,,percent of total billed charges,,,,,,,,,134.1,90,,percent of total billed charges,,,123.37,82.8,,percent of total billed charges,,,126.65,85,,percent of total billed charges,,,,,,,,,131.12,88,,percent of total billed charges,,,,,,,,,113.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.25,22,,percent of total billed charges,,,135.59,91,,percent of total billed charges,,,141.55,95,,percent of total billed charges,,,123.67,83,,percent of total billed charges,,,123.67,83,,percent of total billed charges,,,,,,,,,,,,,,,123.67,83,,percent of total billed charges,,,141.55,95,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,122.18,82,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,126.65,85,,percent of total billed charges,,37.25,141.55,
KEPPRA,25202342,CDM,80177,CPT,300,RC,outpatient,,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.25,22,,percent of total billed charges,,,,,,,,,321.3,90,,percent of total billed charges,,,295.6,82.8,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.25,22,,percent of total billed charges,,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,89.25,339.15,
BB ANTIBODY ELUTION,25202375,CDM,86860,CPT,300,RC,outpatient,,179,179,,151.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.75,22,,percent of total billed charges,,,,,,,,,161.1,90,,percent of total billed charges,,,148.21,82.8,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,,,,,,,,157.52,88,,percent of total billed charges,,,,,,,,,136.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.75,22,,percent of total billed charges,,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,146.78,82,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,44.75,170.05,
T-4 FREE,25202382,CDM,84439,CPT,300,RC,outpatient,,255,255,,216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.75,22,,percent of total billed charges,,,,,,,,,229.5,90,,percent of total billed charges,,,211.14,82.8,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,,,,,,,,224.4,88,,percent of total billed charges,,,,,,,,,194.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.75,22,,percent of total billed charges,,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,209.1,82,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,63.75,242.25,
T-3 FREE,25202383,CDM,84481,CPT,300,RC,outpatient,,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
VASOPRESSIN,25202408,CDM,84588,CPT,300,RC,outpatient,,550,550,,466.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,137.5,22,,percent of total billed charges,,,,,,,,,495,90,,percent of total billed charges,,,455.4,82.8,,percent of total billed charges,,,467.5,85,,percent of total billed charges,,,,,,,,,484,88,,percent of total billed charges,,,,,,,,,420.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,137.5,22,,percent of total billed charges,,,500.5,91,,percent of total billed charges,,,522.5,95,,percent of total billed charges,,,456.5,83,,percent of total billed charges,,,456.5,83,,percent of total billed charges,,,,,,,,,,,,,,,456.5,83,,percent of total billed charges,,,522.5,95,,percent of total billed charges,,,495,90,,percent of total billed charges,,,495,90,,percent of total billed charges,,,451,82,,percent of total billed charges,,,495,90,,percent of total billed charges,,,467.5,85,,percent of total billed charges,,137.5,522.5,
APOLIPOPROTEIN A1,25202409,CDM,82172,CPT,300,RC,outpatient,,264,264,,224.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66,22,,percent of total billed charges,,,,,,,,,237.6,90,,percent of total billed charges,,,218.59,82.8,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,,,,,,,,232.32,88,,percent of total billed charges,,,,,,,,,201.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66,22,,percent of total billed charges,,,240.24,91,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,,,,,,,,,,,,,219.12,83,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,216.48,82,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,66,250.8,
APOLIPOPROTEIN B,25202410,CDM,82172,CPT,300,RC,outpatient,,182,182,,154.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.5,22,,percent of total billed charges,,,,,,,,,163.8,90,,percent of total billed charges,,,150.7,82.8,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,,,,,,,,160.16,88,,percent of total billed charges,,,,,,,,,139.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.5,22,,percent of total billed charges,,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,149.24,82,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,45.5,172.9,
ACTIVATED PROTEIN C RESISTANCE,25202411,CDM,85307,CPT,300,RC,outpatient,,520,520,,441.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130,22,,percent of total billed charges,,,,,,,,,468,90,,percent of total billed charges,,,430.56,82.8,,percent of total billed charges,,,442,85,,percent of total billed charges,,,,,,,,,457.6,88,,percent of total billed charges,,,,,,,,,397.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130,22,,percent of total billed charges,,,473.2,91,,percent of total billed charges,,,494,95,,percent of total billed charges,,,431.6,83,,percent of total billed charges,,,431.6,83,,percent of total billed charges,,,,,,,,,,,,,,,431.6,83,,percent of total billed charges,,,494,95,,percent of total billed charges,,,468,90,,percent of total billed charges,,,468,90,,percent of total billed charges,,,426.4,82,,percent of total billed charges,,,468,90,,percent of total billed charges,,,442,85,,percent of total billed charges,,130,494,
CALIFORNIA ENCEPHALITIS,25202412,CDM,86651,CPT,300,RC,outpatient,,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.25,22,,percent of total billed charges,,,,,,,,,155.7,90,,percent of total billed charges,,,143.24,82.8,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.25,22,,percent of total billed charges,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,43.25,164.35,
EASTERN EQUINE ENCEPHALITIS,25202413,CDM,86652,CPT,300,RC,outpatient,,354,354,,300.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.5,22,,percent of total billed charges,,,,,,,,,318.6,90,,percent of total billed charges,,,293.11,82.8,,percent of total billed charges,,,300.9,85,,percent of total billed charges,,,,,,,,,311.52,88,,percent of total billed charges,,,,,,,,,270.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.5,22,,percent of total billed charges,,,322.14,91,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,,,,,,,,,,,,,293.82,83,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,290.28,82,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,300.9,85,,percent of total billed charges,,88.5,336.3,
WESTERN EQUINE ENCEPHALITIS,25202414,CDM,86654,CPT,300,RC,outpatient,,135,135,,114.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.75,22,,percent of total billed charges,,,,,,,,,121.5,90,,percent of total billed charges,,,111.78,82.8,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,,,,,,,,118.8,88,,percent of total billed charges,,,,,,,,,103.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.75,22,,percent of total billed charges,,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,,,,,,,,,,,,,112.05,83,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,110.7,82,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,33.75,128.25,
EASTERN EQUINE ENCEP (CSF),25202416,CDM,86652,CPT,300,RC,outpatient,,354,354,,300.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.5,22,,percent of total billed charges,,,,,,,,,318.6,90,,percent of total billed charges,,,293.11,82.8,,percent of total billed charges,,,300.9,85,,percent of total billed charges,,,,,,,,,311.52,88,,percent of total billed charges,,,,,,,,,270.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.5,22,,percent of total billed charges,,,322.14,91,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,,,,,,,,,,,,,293.82,83,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,290.28,82,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,300.9,85,,percent of total billed charges,,88.5,336.3,
APOE,25202417,CDM,81479,CPT,300,RC,outpatient,,718,718,,609.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,179.5,22,,percent of total billed charges,,,,,,,,,646.2,90,,percent of total billed charges,,,594.5,82.8,,percent of total billed charges,,,610.3,85,,percent of total billed charges,,,,,,,,,631.84,88,,percent of total billed charges,,,,,,,,,548.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,179.5,22,,percent of total billed charges,,,653.38,91,,percent of total billed charges,,,682.1,95,,percent of total billed charges,,,595.94,83,,percent of total billed charges,,,595.94,83,,percent of total billed charges,,,,,,,,,,,,,,,595.94,83,,percent of total billed charges,,,682.1,95,,percent of total billed charges,,,646.2,90,,percent of total billed charges,,,646.2,90,,percent of total billed charges,,,588.76,82,,percent of total billed charges,,,646.2,90,,percent of total billed charges,,,610.3,85,,percent of total billed charges,,179.5,682.1,
ANTI-MULLERIAN HORMONE,25202420,CDM,82397,CPT,300,RC,outpatient,,273,273,,231.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.25,22,,percent of total billed charges,,,,,,,,,245.7,90,,percent of total billed charges,,,226.04,82.8,,percent of total billed charges,,,232.05,85,,percent of total billed charges,,,,,,,,,240.24,88,,percent of total billed charges,,,,,,,,,208.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.25,22,,percent of total billed charges,,,248.43,91,,percent of total billed charges,,,259.35,95,,percent of total billed charges,,,226.59,83,,percent of total billed charges,,,226.59,83,,percent of total billed charges,,,,,,,,,,,,,,,226.59,83,,percent of total billed charges,,,259.35,95,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,223.86,82,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,232.05,85,,percent of total billed charges,,68.25,259.35,
ANTIPARIETAL CELL AB,25202421,CDM,83516,CPT,300,RC,outpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6,22,,percent of total billed charges,,,,,,,,,21.6,90,,percent of total billed charges,,,19.87,82.8,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6,22,,percent of total billed charges,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,6,22.8,
VORICONAZOLE,25202422,CDM,80285,CPT,300,RC,outpatient,,564,564,,478.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141,22,,percent of total billed charges,,,,,,,,,507.6,90,,percent of total billed charges,,,466.99,82.8,,percent of total billed charges,,,479.4,85,,percent of total billed charges,,,,,,,,,496.32,88,,percent of total billed charges,,,,,,,,,430.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141,22,,percent of total billed charges,,,513.24,91,,percent of total billed charges,,,535.8,95,,percent of total billed charges,,,468.12,83,,percent of total billed charges,,,468.12,83,,percent of total billed charges,,,,,,,,,,,,,,,468.12,83,,percent of total billed charges,,,535.8,95,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,462.48,82,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,479.4,85,,percent of total billed charges,,141,535.8,
ANTI-USTEKINUMAB AB,25202423,CDM,80299,CPT,300,RC,outpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6,22,,percent of total billed charges,,,,,,,,,21.6,90,,percent of total billed charges,,,19.87,82.8,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6,22,,percent of total billed charges,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,6,22.8,
DNA (SS) ANTIBODIES (IgG),25202430,CDM,86226,CPT,300,RC,outpatient,,72,72,,61.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18,22,,percent of total billed charges,,,,,,,,,64.8,90,,percent of total billed charges,,,59.62,82.8,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,,,,,,,,63.36,88,,percent of total billed charges,,,,,,,,,55.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18,22,,percent of total billed charges,,,65.52,91,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,,,,,,,,,,,,,59.76,83,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,59.04,82,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,18,68.4,
DNA (DS) ANTIBODIES,25202432,CDM,86225,CPT,300,RC,outpatient,,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62,22,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,205.34,82.8,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62,22,,percent of total billed charges,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,62,235.6,
DNA (DS) AB CRITHIDIA LUCILIAE,25202433,CDM,86225,CPT,300,RC,outpatient,,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62,22,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,205.34,82.8,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62,22,,percent of total billed charges,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,62,235.6,
.DNA PROBE FISH,25202435,CDM,88271,CPT,300,RC,outpatient,,186,186,,157.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.5,22,,percent of total billed charges,,,,,,,,,167.4,90,,percent of total billed charges,,,154.01,82.8,,percent of total billed charges,,,158.1,85,,percent of total billed charges,,,,,,,,,163.68,88,,percent of total billed charges,,,,,,,,,142.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.5,22,,percent of total billed charges,,,169.26,91,,percent of total billed charges,,,176.7,95,,percent of total billed charges,,,154.38,83,,percent of total billed charges,,,154.38,83,,percent of total billed charges,,,,,,,,,,,,,,,154.38,83,,percent of total billed charges,,,176.7,95,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,152.52,82,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,158.1,85,,percent of total billed charges,,46.5,176.7,
.CELLULAR ENHANCEMENT,25202436,CDM,88112,CPT,300,RC,outpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.25,22,,percent of total billed charges,,,,,,,,,72.9,90,,percent of total billed charges,,,67.07,82.8,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.25,22,,percent of total billed charges,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,20.25,76.95,
.INTERPHASE HYBRIDIZATION 100-300 CELLS,25202440,CDM,88275,CPT,300,RC,outpatient,,413,413,,350.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,103.25,22,,percent of total billed charges,,,,,,,,,371.7,90,,percent of total billed charges,,,341.96,82.8,,percent of total billed charges,,,351.05,85,,percent of total billed charges,,,,,,,,,363.44,88,,percent of total billed charges,,,,,,,,,315.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,103.25,22,,percent of total billed charges,,,375.83,91,,percent of total billed charges,,,392.35,95,,percent of total billed charges,,,342.79,83,,percent of total billed charges,,,342.79,83,,percent of total billed charges,,,,,,,,,,,,,,,342.79,83,,percent of total billed charges,,,392.35,95,,percent of total billed charges,,,371.7,90,,percent of total billed charges,,,371.7,90,,percent of total billed charges,,,338.66,82,,percent of total billed charges,,,371.7,90,,percent of total billed charges,,,351.05,85,,percent of total billed charges,,103.25,392.35,
FISH BLADDER CANCER,25202446,CDM,88120,CPT,300,RC,outpatient,,1710,1710,,1451.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,427.5,22,,percent of total billed charges,,,,,,,,,1539,90,,percent of total billed charges,,,1415.88,82.8,,percent of total billed charges,,,1453.5,85,,percent of total billed charges,,,,,,,,,1504.8,88,,percent of total billed charges,,,,,,,,,1306.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,427.5,22,,percent of total billed charges,,,1556.1,91,,percent of total billed charges,,,1624.5,95,,percent of total billed charges,,,1419.3,83,,percent of total billed charges,,,1419.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1419.3,83,,percent of total billed charges,,,1624.5,95,,percent of total billed charges,,,1539,90,,percent of total billed charges,,,1539,90,,percent of total billed charges,,,1402.2,82,,percent of total billed charges,,,1539,90,,percent of total billed charges,,,1453.5,85,,percent of total billed charges,,427.5,1624.5,
FISH T315I BCR/ABL,25202447,CDM,81170,CPT,300,RC,outpatient,,988,988,,838.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,247,22,,percent of total billed charges,,,,,,,,,889.2,90,,percent of total billed charges,,,818.06,82.8,,percent of total billed charges,,,839.8,85,,percent of total billed charges,,,,,,,,,869.44,88,,percent of total billed charges,,,,,,,,,754.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,247,22,,percent of total billed charges,,,899.08,91,,percent of total billed charges,,,938.6,95,,percent of total billed charges,,,820.04,83,,percent of total billed charges,,,820.04,83,,percent of total billed charges,,,,,,,,,,,,,,,820.04,83,,percent of total billed charges,,,938.6,95,,percent of total billed charges,,,889.2,90,,percent of total billed charges,,,889.2,90,,percent of total billed charges,,,810.16,82,,percent of total billed charges,,,889.2,90,,percent of total billed charges,,,839.8,85,,percent of total billed charges,,247,938.6,
CONCENTRATION INFECT AGENT,25202450,CDM,87015,CPT,300,RC,outpatient,,168,168,,142.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42,22,,percent of total billed charges,,,,,,,,,151.2,90,,percent of total billed charges,,,139.1,82.8,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,,,,,,,,147.84,88,,percent of total billed charges,,,,,,,,,128.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42,22,,percent of total billed charges,,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,,,,,,,,,,,,,139.44,83,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,137.76,82,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,42,159.6,
COCCIDIOIDES ANTIBODY PANEL (ARUP),25202455,CDM,86635,CPT,300,RC,outpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.5,22,,percent of total billed charges,,,,,,,,,91.8,90,,percent of total billed charges,,,84.46,82.8,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.5,22,,percent of total billed charges,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,25.5,96.9,
...COCCIDIOIDES ANTIBODY,25202457,CDM,86635,CPT,300,RC,outpatient,,99,99,,84.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.75,22,,percent of total billed charges,,,,,,,,,89.1,90,,percent of total billed charges,,,81.97,82.8,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,,,,,,,,87.12,88,,percent of total billed charges,,,,,,,,,75.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.75,22,,percent of total billed charges,,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,,,,,,,,,,,,,82.17,83,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,81.18,82,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,24.75,94.05,
CRYPTOCOCCUS ANTIGEN (CSF),25202464,CDM,87899,CPT,300,RC,outpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
CRYPTOCOCCUS ANTIGEN (SERUM),25202465,CDM,87899,CPT,300,RC,outpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
CRYPTOCOCCUS ANTIBODIES,25202466,CDM,86641,CPT,300,RC,outpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
EBV VCA (IGM) ANTIBODY,25202499,CDM,86665,CPT,300,RC,outpatient,,328,328,,278.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82,22,,percent of total billed charges,,,,,,,,,295.2,90,,percent of total billed charges,,,271.58,82.8,,percent of total billed charges,,,278.8,85,,percent of total billed charges,,,,,,,,,288.64,88,,percent of total billed charges,,,,,,,,,250.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82,22,,percent of total billed charges,,,298.48,91,,percent of total billed charges,,,311.6,95,,percent of total billed charges,,,272.24,83,,percent of total billed charges,,,272.24,83,,percent of total billed charges,,,,,,,,,,,,,,,272.24,83,,percent of total billed charges,,,311.6,95,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,268.96,82,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,278.8,85,,percent of total billed charges,,82,311.6,
ALCOHOL BLOOD,25202507,CDM,82077,CPT,300,RC,outpatient,,324,324,,275.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,81,22,,percent of total billed charges,,,,,,,,,291.6,90,,percent of total billed charges,,,268.27,82.8,,percent of total billed charges,,,275.4,85,,percent of total billed charges,,,,,,,,,285.12,88,,percent of total billed charges,,,,,,,,,247.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,81,22,,percent of total billed charges,,,294.84,91,,percent of total billed charges,,,307.8,95,,percent of total billed charges,,,268.92,83,,percent of total billed charges,,,268.92,83,,percent of total billed charges,,,,,,,,,,,,,,,268.92,83,,percent of total billed charges,,,307.8,95,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,265.68,82,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,275.4,85,,percent of total billed charges,,81,307.8,
"ALCOHOL, ETHANOL, URINE",25202508,CDM,80307,CPT,300,RC,outpatient,,35,35,,29.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.75,22,,percent of total billed charges,,,,,,,,,31.5,90,,percent of total billed charges,,,28.98,82.8,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,,,,,,,,30.8,88,,percent of total billed charges,,,,,,,,,26.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.75,22,,percent of total billed charges,,,31.85,91,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,,,,,,,,,,,,,29.05,83,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,28.7,82,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,8.75,33.25,
ETHYL GLUCURONIDE (ETG),25202509,CDM,80307,CPT,300,RC,outpatient,,66,66,,56.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.5,22,,percent of total billed charges,,,,,,,,,59.4,90,,percent of total billed charges,,,54.65,82.8,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,,,,,,,,58.08,88,,percent of total billed charges,,,,,,,,,50.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.5,22,,percent of total billed charges,,,60.06,91,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,,,,,,,,,,,,,54.78,83,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,54.12,82,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,16.5,62.7,
ETHYENE L GLYCOL (SERUM/PLASMA),25202510,CDM,82693,CPT,300,RC,outpatient,,38,38,,32.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.5,22,,percent of total billed charges,,,,,,,,,34.2,90,,percent of total billed charges,,,31.46,82.8,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,,,,,,,,33.44,88,,percent of total billed charges,,,,,,,,,29.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.5,22,,percent of total billed charges,,,34.58,91,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,,,,,,,,,,,,,31.54,83,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,31.16,82,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,9.5,36.1,
ANA W /9MARKERS,25202511,CDM,86225,CPT,300,RC,outpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
ANA REFLEX 9MARKERS,25202513,CDM,86038,CPT,300,RC,outpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
.ANA TITER & PATTERN,25202514,CDM,86039,CPT,300,RC,outpatient,,201,201,,170.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.25,22,,percent of total billed charges,,,,,,,,,180.9,90,,percent of total billed charges,,,166.43,82.8,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,,,,,,,,176.88,88,,percent of total billed charges,,,,,,,,,153.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.25,22,,percent of total billed charges,,,182.91,91,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,,,,,,,,,,,,,166.83,83,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,164.82,82,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,50.25,190.95,
ANTINUCLEAR ANTIBODY SCREEN,25202515,CDM,86038,CPT,300,RC,outpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
CLOMIPRAMINE,25202516,CDM,80299,CPT,300,RC,outpatient,,443,443,,376.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.75,22,,percent of total billed charges,,,,,,,,,398.7,90,,percent of total billed charges,,,366.8,82.8,,percent of total billed charges,,,376.55,85,,percent of total billed charges,,,,,,,,,389.84,88,,percent of total billed charges,,,,,,,,,338.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.75,22,,percent of total billed charges,,,403.13,91,,percent of total billed charges,,,420.85,95,,percent of total billed charges,,,367.69,83,,percent of total billed charges,,,367.69,83,,percent of total billed charges,,,,,,,,,,,,,,,367.69,83,,percent of total billed charges,,,420.85,95,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,363.26,82,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,376.55,85,,percent of total billed charges,,110.75,420.85,
..ANTI,25202517,CDM,86038,CPT,300,RC,outpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
ANA REFLX DNA/RNP/SM/SSA&B,25202520,CDM,86038,CPT,300,RC,outpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
...ANA W/,25202521,CDM,86038,CPT,300,RC,outpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
CONNECTIVE TISSUE CASCADE,25202523,CDM,86038,CPT,300,RC,outpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
CENTROMERE AB,25202525,CDM,86256,CPT,300,RC,outpatient,,71,71,,60.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.75,22,,percent of total billed charges,,,,,,,,,63.9,90,,percent of total billed charges,,,58.79,82.8,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,,,,,,,,62.48,88,,percent of total billed charges,,,,,,,,,54.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.75,22,,percent of total billed charges,,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,,,,,,,,,,,,,58.93,83,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,58.22,82,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,17.75,67.45,
ANGIOTENSIN II,25202527,CDM,82163,CPT,300,RC,outpatient,,223,223,,189.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.75,22,,percent of total billed charges,,,,,,,,,200.7,90,,percent of total billed charges,,,184.64,82.8,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,,,,,,,,196.24,88,,percent of total billed charges,,,,,,,,,170.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.75,22,,percent of total billed charges,,,202.93,91,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,,,,,,,,,,,,,185.09,83,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,182.86,82,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,55.75,211.85,
VITAMIN B12,25202531,CDM,82607,CPT,300,RC,outpatient,,292,292,,247.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73,22,,percent of total billed charges,,,,,,,,,262.8,90,,percent of total billed charges,,,241.78,82.8,,percent of total billed charges,,,248.2,85,,percent of total billed charges,,,,,,,,,256.96,88,,percent of total billed charges,,,,,,,,,223.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73,22,,percent of total billed charges,,,265.72,91,,percent of total billed charges,,,277.4,95,,percent of total billed charges,,,242.36,83,,percent of total billed charges,,,242.36,83,,percent of total billed charges,,,,,,,,,,,,,,,242.36,83,,percent of total billed charges,,,277.4,95,,percent of total billed charges,,,262.8,90,,percent of total billed charges,,,262.8,90,,percent of total billed charges,,,239.44,82,,percent of total billed charges,,,262.8,90,,percent of total billed charges,,,248.2,85,,percent of total billed charges,,73,277.4,
VITAMIN B12 BINDING CAPACITY,25202532,CDM,82608,CPT,300,RC,outpatient,,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62,22,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,205.34,82.8,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62,22,,percent of total billed charges,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,62,235.6,
CHOLINESTERASE SERUM,25202556,CDM,82480,CPT,300,RC,outpatient,,168,168,,142.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42,22,,percent of total billed charges,,,,,,,,,151.2,90,,percent of total billed charges,,,139.1,82.8,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,,,,,,,,147.84,88,,percent of total billed charges,,,,,,,,,128.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42,22,,percent of total billed charges,,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,,,,,,,,,,,,,139.44,83,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,137.76,82,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,42,159.6,
NMR LIPOPROFILE,25202560,CDM,83704,CPT,300,RC,outpatient,,329,329,,279.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.25,22,,percent of total billed charges,,,,,,,,,296.1,90,,percent of total billed charges,,,272.41,82.8,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,,,,,,,,289.52,88,,percent of total billed charges,,,,,,,,,251.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82.25,22,,percent of total billed charges,,,299.39,91,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,,,,,,,,,,,,,273.07,83,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,269.78,82,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,82.25,312.55,
CEA,25202564,CDM,82378,CPT,300,RC,outpatient,,395,395,,335.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.75,22,,percent of total billed charges,,,,,,,,,355.5,90,,percent of total billed charges,,,327.06,82.8,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,,,,,,,,347.6,88,,percent of total billed charges,,,,,,,,,301.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.75,22,,percent of total billed charges,,,359.45,91,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,,,,,,,,,,,,,327.85,83,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,323.9,82,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,98.75,375.25,
CEA (BODY FLUID),25202565,CDM,82378,CPT,300,RC,outpatient,,34,34,,28.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.5,22,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,28.15,82.8,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,,,,,,,,29.92,88,,percent of total billed charges,,,,,,,,,25.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.5,22,,percent of total billed charges,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,,,,,,,,,,,,,28.22,83,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,27.88,82,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,8.5,32.3,
CK TOTAL,25202572,CDM,82550,CPT,300,RC,outpatient,,155,155,,131.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.75,22,,percent of total billed charges,,,,,,,,,139.5,90,,percent of total billed charges,,,128.34,82.8,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,,,,,,,,136.4,88,,percent of total billed charges,,,,,,,,,118.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.75,22,,percent of total billed charges,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,127.1,82,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,38.75,147.25,
CK-MB,25202580,CDM,82553,CPT,300,RC,outpatient,,264,264,,224.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66,22,,percent of total billed charges,,,,,,,,,237.6,90,,percent of total billed charges,,,218.59,82.8,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,,,,,,,,232.32,88,,percent of total billed charges,,,,,,,,,201.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66,22,,percent of total billed charges,,,240.24,91,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,,,,,,,,,,,,,219.12,83,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,216.48,82,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,66,250.8,
CORTISOL STIMULATION,25202595,CDM,82533,CPT,300,RC,outpatient,,531,531,,450.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.75,22,,percent of total billed charges,,,,,,,,,477.9,90,,percent of total billed charges,,,439.67,82.8,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,,,,,,,,467.28,88,,percent of total billed charges,,,,,,,,,405.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.75,22,,percent of total billed charges,,,483.21,91,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,,,,,,,,,,,,,440.73,83,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,435.42,82,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,132.75,504.45,
CORTISOL TOTAL SERUM,25202598,CDM,82533,CPT,300,RC,outpatient,,293,293,,248.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.25,22,,percent of total billed charges,,,,,,,,,263.7,90,,percent of total billed charges,,,242.6,82.8,,percent of total billed charges,,,249.05,85,,percent of total billed charges,,,,,,,,,257.84,88,,percent of total billed charges,,,,,,,,,223.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.25,22,,percent of total billed charges,,,266.63,91,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,,,,,,,,,,,,,243.19,83,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,240.26,82,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,249.05,85,,percent of total billed charges,,73.25,278.35,
CORTISOL TOTAL (A.M. & P.M.),25202599,CDM,82533,CPT,300,RC,outpatient,,293,293,,248.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.25,22,,percent of total billed charges,,,,,,,,,263.7,90,,percent of total billed charges,,,242.6,82.8,,percent of total billed charges,,,249.05,85,,percent of total billed charges,,,,,,,,,257.84,88,,percent of total billed charges,,,,,,,,,223.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.25,22,,percent of total billed charges,,,266.63,91,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,,,,,,,,,,,,,243.19,83,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,240.26,82,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,249.05,85,,percent of total billed charges,,73.25,278.35,
ANTI-68 KD ANTIBODIES WESTERN BLOT,25202600,CDM,84181,CPT,300,RC,outpatient,,370,370,,314.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.5,22,,percent of total billed charges,,,,,,,,,333,90,,percent of total billed charges,,,306.36,82.8,,percent of total billed charges,,,314.5,85,,percent of total billed charges,,,,,,,,,325.6,88,,percent of total billed charges,,,,,,,,,282.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.5,22,,percent of total billed charges,,,336.7,91,,percent of total billed charges,,,351.5,95,,percent of total billed charges,,,307.1,83,,percent of total billed charges,,,307.1,83,,percent of total billed charges,,,,,,,,,,,,,,,307.1,83,,percent of total billed charges,,,351.5,95,,percent of total billed charges,,,333,90,,percent of total billed charges,,,333,90,,percent of total billed charges,,,303.4,82,,percent of total billed charges,,,333,90,,percent of total billed charges,,,314.5,85,,percent of total billed charges,,92.5,351.5,
HLA-B27 ANTIGEN,25202606,CDM,81374,CPT,300,RC,outpatient,,504,504,,427.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126,22,,percent of total billed charges,,,,,,,,,453.6,90,,percent of total billed charges,,,417.31,82.8,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,,,,,,,,443.52,88,,percent of total billed charges,,,,,,,,,385.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126,22,,percent of total billed charges,,,458.64,91,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,,,,,,,,,,,,,418.32,83,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,413.28,82,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,126,478.8,
HLA-B58,25202607,CDM,81381,CPT,300,RC,outpatient,,504,504,,427.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126,22,,percent of total billed charges,,,,,,,,,453.6,90,,percent of total billed charges,,,417.31,82.8,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,,,,,,,,443.52,88,,percent of total billed charges,,,,,,,,,385.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126,22,,percent of total billed charges,,,458.64,91,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,,,,,,,,,,,,,418.32,83,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,413.28,82,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,126,478.8,
"HLA CLASS I A,B,C DNA TYPING",25202610,CDM,81372,CPT,300,RC,outpatient,,545,545,,462.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,136.25,22,,percent of total billed charges,,,,,,,,,490.5,90,,percent of total billed charges,,,451.26,82.8,,percent of total billed charges,,,463.25,85,,percent of total billed charges,,,,,,,,,479.6,88,,percent of total billed charges,,,,,,,,,416.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,136.25,22,,percent of total billed charges,,,495.95,91,,percent of total billed charges,,,517.75,95,,percent of total billed charges,,,452.35,83,,percent of total billed charges,,,452.35,83,,percent of total billed charges,,,,,,,,,,,,,,,452.35,83,,percent of total billed charges,,,517.75,95,,percent of total billed charges,,,490.5,90,,percent of total billed charges,,,490.5,90,,percent of total billed charges,,,446.9,82,,percent of total billed charges,,,490.5,90,,percent of total billed charges,,,463.25,85,,percent of total billed charges,,136.25,517.75,
"HLA DRB1,3,4,5, DQB1 (IR)",25202612,CDM,81375,CPT,300,RC,outpatient,,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
EBV NUCLEAR ANTIGEN ANTIBODY,25202614,CDM,86664,CPT,300,RC,outpatient,,275,275,,233.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.75,22,,percent of total billed charges,,,,,,,,,247.5,90,,percent of total billed charges,,,227.7,82.8,,percent of total billed charges,,,233.75,85,,percent of total billed charges,,,,,,,,,242,88,,percent of total billed charges,,,,,,,,,210.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.75,22,,percent of total billed charges,,,250.25,91,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,,,,,,,,,,,,,228.25,83,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,225.5,82,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,233.75,85,,percent of total billed charges,,68.75,261.25,
EPSTEIN BARR QT DNA PCR,25202615,CDM,87799,CPT,300,RC,outpatient,,770,770,,653.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.5,22,,percent of total billed charges,,,,,,,,,693,90,,percent of total billed charges,,,637.56,82.8,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,,,,,,,,677.6,88,,percent of total billed charges,,,,,,,,,588.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.5,22,,percent of total billed charges,,,700.7,91,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,639.1,83,,percent of total billed charges,,,,,,,,,,,,,,,639.1,83,,percent of total billed charges,,,731.5,95,,percent of total billed charges,,,693,90,,percent of total billed charges,,,693,90,,percent of total billed charges,,,631.4,82,,percent of total billed charges,,,693,90,,percent of total billed charges,,,654.5,85,,percent of total billed charges,,192.5,731.5,
FERRITIN,25202622,CDM,82728,CPT,300,RC,outpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
FOLATE  SERUM,25202630,CDM,82746,CPT,300,RC,outpatient,,256,256,,217.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64,22,,percent of total billed charges,,,,,,,,,230.4,90,,percent of total billed charges,,,211.97,82.8,,percent of total billed charges,,,217.6,85,,percent of total billed charges,,,,,,,,,225.28,88,,percent of total billed charges,,,,,,,,,195.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64,22,,percent of total billed charges,,,232.96,91,,percent of total billed charges,,,243.2,95,,percent of total billed charges,,,212.48,83,,percent of total billed charges,,,212.48,83,,percent of total billed charges,,,,,,,,,,,,,,,212.48,83,,percent of total billed charges,,,243.2,95,,percent of total billed charges,,,230.4,90,,percent of total billed charges,,,230.4,90,,percent of total billed charges,,,209.92,82,,percent of total billed charges,,,230.4,90,,percent of total billed charges,,,217.6,85,,percent of total billed charges,,64,243.2,
FOLATE RBC,25202631,CDM,82747,CPT,300,RC,outpatient,,261,261,,221.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.25,22,,percent of total billed charges,,,,,,,,,234.9,90,,percent of total billed charges,,,216.11,82.8,,percent of total billed charges,,,221.85,85,,percent of total billed charges,,,,,,,,,229.68,88,,percent of total billed charges,,,,,,,,,199.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.25,22,,percent of total billed charges,,,237.51,91,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,,,,,,,,,,,,,216.63,83,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,214.02,82,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,221.85,85,,percent of total billed charges,,65.25,247.95,
CANNABINOID METABOLITE SYNTHETIC,25202645,CDM,80307,CPT,300,RC,outpatient,,310,310,,263.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.5,22,,percent of total billed charges,,,,,,,,,279,90,,percent of total billed charges,,,256.68,82.8,,percent of total billed charges,,,263.5,85,,percent of total billed charges,,,,,,,,,272.8,88,,percent of total billed charges,,,,,,,,,236.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.5,22,,percent of total billed charges,,,282.1,91,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,,,,,,,,,,,,,257.3,83,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,279,90,,percent of total billed charges,,,279,90,,percent of total billed charges,,,254.2,82,,percent of total billed charges,,,279,90,,percent of total billed charges,,,263.5,85,,percent of total billed charges,,77.5,294.5,
CANNABINOID MET SYNTHETIC BLOOD,25202646,CDM,80352,CPT,300,RC,outpatient,,261,261,,221.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.25,22,,percent of total billed charges,,,,,,,,,234.9,90,,percent of total billed charges,,,216.11,82.8,,percent of total billed charges,,,221.85,85,,percent of total billed charges,,,,,,,,,229.68,88,,percent of total billed charges,,,,,,,,,199.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.25,22,,percent of total billed charges,,,237.51,91,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,,,,,,,,,,,,,216.63,83,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,214.02,82,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,221.85,85,,percent of total billed charges,,65.25,247.95,
KLEIHAUER-BETKE,25202647,CDM,85460,CPT,300,RC,outpatient,,310,310,,263.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.5,22,,percent of total billed charges,,,,,,,,,279,90,,percent of total billed charges,,,256.68,82.8,,percent of total billed charges,,,263.5,85,,percent of total billed charges,,,,,,,,,272.8,88,,percent of total billed charges,,,,,,,,,236.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.5,22,,percent of total billed charges,,,282.1,91,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,,,,,,,,,,,,,257.3,83,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,279,90,,percent of total billed charges,,,279,90,,percent of total billed charges,,,254.2,82,,percent of total billed charges,,,279,90,,percent of total billed charges,,,263.5,85,,percent of total billed charges,,77.5,294.5,
DRUG SCREEN CLINICAL RAPID,25202648,CDM,80306,CPT,300,RC,outpatient,,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.75,22,,percent of total billed charges,,,,,,,,,215.1,90,,percent of total billed charges,,,197.89,82.8,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.75,22,,percent of total billed charges,,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,59.75,227.05,
DRUG SCREEN MECONIUM,25202649,CDM,80307,CPT,300,RC,outpatient,,190,190,,161.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.5,22,,percent of total billed charges,,,,,,,,,171,90,,percent of total billed charges,,,157.32,82.8,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,,,,,,,,167.2,88,,percent of total billed charges,,,,,,,,,145.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.5,22,,percent of total billed charges,,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,,,,,,,,,,,,,157.7,83,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,155.8,82,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,47.5,180.5,
..DRUG SCREEN PRE-EMPLOYMENT,25202650,CDM,80307,CPT,300,RC,outpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.25,22,,percent of total billed charges,,,,,,,,,98.1,90,,percent of total billed charges,,,90.25,82.8,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.25,22,,percent of total billed charges,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,27.25,103.55,
DRUG SCREEN PRE-EMP(LABCORP),25202651,CDM,80307,CPT,300,RC,outpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.25,22,,percent of total billed charges,,,,,,,,,98.1,90,,percent of total billed charges,,,90.25,82.8,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.25,22,,percent of total billed charges,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,27.25,103.55,
DRUG OF ABUSE (10)SCRN(LABCORP),25202652,CDM,80307,CPT,300,RC,outpatient,,122,122,,103.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.5,22,,percent of total billed charges,,,,,,,,,109.8,90,,percent of total billed charges,,,101.02,82.8,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,,,,,,,,107.36,88,,percent of total billed charges,,,,,,,,,93.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.5,22,,percent of total billed charges,,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,100.04,82,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,30.5,115.9,
DRUG OF ABUSE (14)SCRN(LABCORP),25202653,CDM,80307,CPT,300,RC,outpatient,,122,122,,103.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.5,22,,percent of total billed charges,,,,,,,,,109.8,90,,percent of total billed charges,,,101.02,82.8,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,,,,,,,,107.36,88,,percent of total billed charges,,,,,,,,,93.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.5,22,,percent of total billed charges,,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,100.04,82,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,30.5,115.9,
..DRUG SCREEN POST ACCIDENT,25202660,CDM,80307,CPT,300,RC,outpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.25,22,,percent of total billed charges,,,,,,,,,98.1,90,,percent of total billed charges,,,90.25,82.8,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.25,22,,percent of total billed charges,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,27.25,103.55,
DISOPYRAMIDE,25202663,CDM,80299,CPT,300,RC,outpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.5,22,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,170.57,82.8,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.5,22,,percent of total billed charges,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,51.5,195.7,
.DIPHTHERIA ANTITOXOID AB,25202666,CDM,86648,CPT,300,RC,outpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31,22,,percent of total billed charges,,,,,,,,,111.6,90,,percent of total billed charges,,,102.67,82.8,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31,22,,percent of total billed charges,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,31,117.8,
.TETANUS  AB,25202667,CDM,86774,CPT,300,RC,outpatient,,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31,22,,percent of total billed charges,,,,,,,,,111.6,90,,percent of total billed charges,,,102.67,82.8,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31,22,,percent of total billed charges,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,31,117.8,
NUCLEIC ACID ISOLATION/EXTRACTION,25202669,CDM,83891,CPT,300,RC,outpatient,,189,189,,160.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.25,22,,percent of total billed charges,,,,,,,,,170.1,90,,percent of total billed charges,,,156.49,82.8,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,,,,,,,,166.32,88,,percent of total billed charges,,,,,,,,,144.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.25,22,,percent of total billed charges,,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,,,,,,,,,,,,,156.87,83,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,154.98,82,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,47.25,179.55,
NUCLEIC ACID AMPLIFICATION 1 SEQ,25202670,CDM,83898,CPT,300,RC,outpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.75,22,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,48.85,82.8,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,,,,,,,,51.92,88,,percent of total billed charges,,,,,,,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.75,22,,percent of total billed charges,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,14.75,56.05,
NUCLEIC ACID AMPLIFICATION 1&2 SEQ,25202671,CDM,83900,CPT,300,RC,outpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.25,22,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,63.76,82.8,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.25,22,,percent of total billed charges,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,19.25,73.15,
NUCLEIC ACID AMPLIFICATION ADD SEQ,25202672,CDM,83901,CPT,300,RC,outpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.5,22,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,64.58,82.8,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.5,22,,percent of total billed charges,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,19.5,74.1,
NUCLEIC ACID MUTATION ID,25202673,CDM,83914,CPT,300,RC,outpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.25,22,,percent of total billed charges,,,,,,,,,94.5,90,,percent of total billed charges,,,86.94,82.8,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.25,22,,percent of total billed charges,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,26.25,99.75,
NUCLEIC ACID SEPERATION & ID,25202674,CDM,83909,CPT,300,RC,outpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.5,22,,percent of total billed charges,,,,,,,,,91.8,90,,percent of total billed charges,,,84.46,82.8,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.5,22,,percent of total billed charges,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,25.5,96.9,
NUCLEIC ACID INTERPRETATION,25202675,CDM,83912,CPT,300,RC,outpatient,,149,149,,126.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.25,22,,percent of total billed charges,,,,,,,,,134.1,90,,percent of total billed charges,,,123.37,82.8,,percent of total billed charges,,,126.65,85,,percent of total billed charges,,,,,,,,,131.12,88,,percent of total billed charges,,,,,,,,,113.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.25,22,,percent of total billed charges,,,135.59,91,,percent of total billed charges,,,141.55,95,,percent of total billed charges,,,123.67,83,,percent of total billed charges,,,123.67,83,,percent of total billed charges,,,,,,,,,,,,,,,123.67,83,,percent of total billed charges,,,141.55,95,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,122.18,82,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,126.65,85,,percent of total billed charges,,37.25,141.55,
"NUCLEIC ACID PROBE, each",25202676,CDM,83896,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
NUCLEIC ACID ENZYME DIGESTION,25202677,CDM,83892,CPT,300,RC,outpatient,,122,122,,103.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.5,22,,percent of total billed charges,,,,,,,,,109.8,90,,percent of total billed charges,,,101.02,82.8,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,,,,,,,,107.36,88,,percent of total billed charges,,,,,,,,,93.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.5,22,,percent of total billed charges,,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,100.04,82,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,30.5,115.9,
5-NUCLEOTIDASE,25202680,CDM,83915,CPT,300,RC,outpatient,,161,161,,136.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.25,22,,percent of total billed charges,,,,,,,,,144.9,90,,percent of total billed charges,,,133.31,82.8,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,,,,,,,,141.68,88,,percent of total billed charges,,,,,,,,,123,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.25,22,,percent of total billed charges,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,132.02,82,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,40.25,152.95,
21 HYDROXYLASE,25202685,CDM,83519,CPT,300,RC,outpatient,,1588,1588,,1348.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,397,22,,percent of total billed charges,,,,,,,,,1429.2,90,,percent of total billed charges,,,1314.86,82.8,,percent of total billed charges,,,1349.8,85,,percent of total billed charges,,,,,,,,,1397.44,88,,percent of total billed charges,,,,,,,,,1213.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,397,22,,percent of total billed charges,,,1445.08,91,,percent of total billed charges,,,1508.6,95,,percent of total billed charges,,,1318.04,83,,percent of total billed charges,,,1318.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1318.04,83,,percent of total billed charges,,,1508.6,95,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1302.16,82,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1349.8,85,,percent of total billed charges,,397,1508.6,
IRON TOTAL,25202689,CDM,83540,CPT,300,RC,outpatient,,185,185,,157.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.25,22,,percent of total billed charges,,,,,,,,,166.5,90,,percent of total billed charges,,,153.18,82.8,,percent of total billed charges,,,157.25,85,,percent of total billed charges,,,,,,,,,162.8,88,,percent of total billed charges,,,,,,,,,141.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.25,22,,percent of total billed charges,,,168.35,91,,percent of total billed charges,,,175.75,95,,percent of total billed charges,,,153.55,83,,percent of total billed charges,,,153.55,83,,percent of total billed charges,,,,,,,,,,,,,,,153.55,83,,percent of total billed charges,,,175.75,95,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,151.7,82,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,157.25,85,,percent of total billed charges,,46.25,175.75,
OVA & PARASITES,25202705,CDM,87177,CPT,300,RC,outpatient,,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.5,22,,percent of total billed charges,,,,,,,,,117,90,,percent of total billed charges,,,107.64,82.8,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.5,22,,percent of total billed charges,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,32.5,123.5,
CRYPTOSPORIDIUM ANTIGEN STOOL,25202713,CDM,87272,CPT,300,RC,outpatient,,190,190,,161.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.5,22,,percent of total billed charges,,,,,,,,,171,90,,percent of total billed charges,,,157.32,82.8,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,,,,,,,,167.2,88,,percent of total billed charges,,,,,,,,,145.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.5,22,,percent of total billed charges,,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,,,,,,,,,,,,,157.7,83,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,155.8,82,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,47.5,180.5,
PROLACTIN,25202721,CDM,84146,CPT,300,RC,outpatient,,335,335,,284.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.75,22,,percent of total billed charges,,,,,,,,,301.5,90,,percent of total billed charges,,,277.38,82.8,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,,,,,,,,294.8,88,,percent of total billed charges,,,,,,,,,255.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.75,22,,percent of total billed charges,,,304.85,91,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,,,,,,,,,,,,,278.05,83,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,274.7,82,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,83.75,318.25,
"PROLACTIN, FREE",25202722,CDM,84146,CPT,300,RC,outpatient,,129,129,,109.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.25,22,,percent of total billed charges,,,,,,,,,116.1,90,,percent of total billed charges,,,106.81,82.8,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,,,,,,,,113.52,88,,percent of total billed charges,,,,,,,,,98.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.25,22,,percent of total billed charges,,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,105.78,82,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,32.25,122.55,
ANDROSTENEDIONE,25202739,CDM,82157,CPT,300,RC,outpatient,,360,360,,305.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90,22,,percent of total billed charges,,,,,,,,,324,90,,percent of total billed charges,,,298.08,82.8,,percent of total billed charges,,,306,85,,percent of total billed charges,,,,,,,,,316.8,88,,percent of total billed charges,,,,,,,,,275.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90,22,,percent of total billed charges,,,327.6,91,,percent of total billed charges,,,342,95,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,,,,,,,,,,,,,298.8,83,,percent of total billed charges,,,342,95,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,295.2,82,,percent of total billed charges,,,324,90,,percent of total billed charges,,,306,85,,percent of total billed charges,,90,342,
FSH,25202747,CDM,83001,CPT,300,RC,outpatient,,377,377,,320.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94.25,22,,percent of total billed charges,,,,,,,,,339.3,90,,percent of total billed charges,,,312.16,82.8,,percent of total billed charges,,,320.45,85,,percent of total billed charges,,,,,,,,,331.76,88,,percent of total billed charges,,,,,,,,,288.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94.25,22,,percent of total billed charges,,,343.07,91,,percent of total billed charges,,,358.15,95,,percent of total billed charges,,,312.91,83,,percent of total billed charges,,,312.91,83,,percent of total billed charges,,,,,,,,,,,,,,,312.91,83,,percent of total billed charges,,,358.15,95,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,309.14,82,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,320.45,85,,percent of total billed charges,,94.25,358.15,
FSH (PEDIATRICS  ULT SENS),25202748,CDM,83001,CPT,300,RC,outpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.25,22,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,63.76,82.8,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.25,22,,percent of total billed charges,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,19.25,73.15,
VOLTAGE-GATED CA AB,25202760,CDM,86596,CPT,300,RC,outpatient,,208,208,,176.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52,22,,percent of total billed charges,,,,,,,,,187.2,90,,percent of total billed charges,,,172.22,82.8,,percent of total billed charges,,,176.8,85,,percent of total billed charges,,,,,,,,,183.04,88,,percent of total billed charges,,,,,,,,,158.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52,22,,percent of total billed charges,,,189.28,91,,percent of total billed charges,,,197.6,95,,percent of total billed charges,,,172.64,83,,percent of total billed charges,,,172.64,83,,percent of total billed charges,,,,,,,,,,,,,,,172.64,83,,percent of total billed charges,,,197.6,95,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,170.56,82,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,176.8,85,,percent of total billed charges,,52,197.6,
ACETYLCHOLINE RECEPTOR BIND AB,25202762,CDM,83519,CPT,300,RC,outpatient,,531,531,,450.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.75,22,,percent of total billed charges,,,,,,,,,477.9,90,,percent of total billed charges,,,439.67,82.8,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,,,,,,,,467.28,88,,percent of total billed charges,,,,,,,,,405.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.75,22,,percent of total billed charges,,,483.21,91,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,,,,,,,,,,,,,440.73,83,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,435.42,82,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,132.75,504.45,
ACETYLCHOLINE RECEPTOR MOD AB,25202763,CDM,83519,CPT,300,RC,outpatient,,655,655,,556.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,163.75,22,,percent of total billed charges,,,,,,,,,589.5,90,,percent of total billed charges,,,542.34,82.8,,percent of total billed charges,,,556.75,85,,percent of total billed charges,,,,,,,,,576.4,88,,percent of total billed charges,,,,,,,,,500.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,163.75,22,,percent of total billed charges,,,596.05,91,,percent of total billed charges,,,622.25,95,,percent of total billed charges,,,543.65,83,,percent of total billed charges,,,543.65,83,,percent of total billed charges,,,,,,,,,,,,,,,543.65,83,,percent of total billed charges,,,622.25,95,,percent of total billed charges,,,589.5,90,,percent of total billed charges,,,589.5,90,,percent of total billed charges,,,537.1,82,,percent of total billed charges,,,589.5,90,,percent of total billed charges,,,556.75,85,,percent of total billed charges,,163.75,622.25,
ACETYLCHOLINE RECEPTOR BLOCK AB,25202764,CDM,83519,CPT,300,RC,outpatient,,639,639,,542.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,159.75,22,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,529.09,82.8,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,,,,,,,,562.32,88,,percent of total billed charges,,,,,,,,,488.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,159.75,22,,percent of total billed charges,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,523.98,82,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,159.75,607.05,
ACYLCARNITINE PLASMA,25202765,CDM,82017,CPT,300,RC,outpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.25,22,,percent of total billed charges,,,,,,,,,414.9,90,,percent of total billed charges,,,381.71,82.8,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.25,22,,percent of total billed charges,,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,115.25,437.95,
TSH,25202770,CDM,84443,CPT,300,RC,outpatient,,321,321,,272.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.25,22,,percent of total billed charges,,,,,,,,,288.9,90,,percent of total billed charges,,,265.79,82.8,,percent of total billed charges,,,272.85,85,,percent of total billed charges,,,,,,,,,282.48,88,,percent of total billed charges,,,,,,,,,245.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.25,22,,percent of total billed charges,,,292.11,91,,percent of total billed charges,,,304.95,95,,percent of total billed charges,,,266.43,83,,percent of total billed charges,,,266.43,83,,percent of total billed charges,,,,,,,,,,,,,,,266.43,83,,percent of total billed charges,,,304.95,95,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,263.22,82,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,272.85,85,,percent of total billed charges,,80.25,304.95,
AMINO ACID ANALYSIS(URINE),25202772,CDM,82139,CPT,300,RC,outpatient,,858,858,,728.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,214.5,22,,percent of total billed charges,,,,,,,,,772.2,90,,percent of total billed charges,,,710.42,82.8,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,,,,,,,,755.04,88,,percent of total billed charges,,,,,,,,,655.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,214.5,22,,percent of total billed charges,,,780.78,91,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,712.14,83,,percent of total billed charges,,,,,,,,,,,,,,,712.14,83,,percent of total billed charges,,,815.1,95,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,703.56,82,,percent of total billed charges,,,772.2,90,,percent of total billed charges,,,729.3,85,,percent of total billed charges,,214.5,815.1,
AMINO ACID PLASMA,25202775,CDM,82139,CPT,300,RC,outpatient,,398,398,,337.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,99.5,22,,percent of total billed charges,,,,,,,,,358.2,90,,percent of total billed charges,,,329.54,82.8,,percent of total billed charges,,,338.3,85,,percent of total billed charges,,,,,,,,,350.24,88,,percent of total billed charges,,,,,,,,,304.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,99.5,22,,percent of total billed charges,,,362.18,91,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,,,,,,,,,,,,,330.34,83,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,326.36,82,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,338.3,85,,percent of total billed charges,,99.5,378.1,
CARNITINE,25202780,CDM,82379,CPT,300,RC,outpatient,,470,470,,399.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.5,22,,percent of total billed charges,,,,,,,,,423,90,,percent of total billed charges,,,389.16,82.8,,percent of total billed charges,,,399.5,85,,percent of total billed charges,,,,,,,,,413.6,88,,percent of total billed charges,,,,,,,,,359.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.5,22,,percent of total billed charges,,,427.7,91,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,,,,,,,,,,,,,390.1,83,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,423,90,,percent of total billed charges,,,423,90,,percent of total billed charges,,,385.4,82,,percent of total billed charges,,,423,90,,percent of total billed charges,,,399.5,85,,percent of total billed charges,,117.5,446.5,
ORGANIC ACID URINE QT,25202785,CDM,83918,CPT,300,RC,outpatient,,458,458,,388.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,114.5,22,,percent of total billed charges,,,,,,,,,412.2,90,,percent of total billed charges,,,379.22,82.8,,percent of total billed charges,,,389.3,85,,percent of total billed charges,,,,,,,,,403.04,88,,percent of total billed charges,,,,,,,,,349.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,114.5,22,,percent of total billed charges,,,416.78,91,,percent of total billed charges,,,435.1,95,,percent of total billed charges,,,380.14,83,,percent of total billed charges,,,380.14,83,,percent of total billed charges,,,,,,,,,,,,,,,380.14,83,,percent of total billed charges,,,435.1,95,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,375.56,82,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,389.3,85,,percent of total billed charges,,114.5,435.1,
BILE ACIDS FRACTIONATED,25202786,CDM,82239,CPT,300,RC,outpatient,,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92,22,,percent of total billed charges,,,,,,,,,331.2,90,,percent of total billed charges,,,304.7,82.8,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92,22,,percent of total billed charges,,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,92,349.6,
BILE ACIDS TOTAL,25202787,CDM,82239,CPT,300,RC,outpatient,,26,26,,22.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.5,22,,percent of total billed charges,,,,,,,,,23.4,90,,percent of total billed charges,,,21.53,82.8,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,,,,,,,,22.88,88,,percent of total billed charges,,,,,,,,,19.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.5,22,,percent of total billed charges,,,23.66,91,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,,,,,,,,,,,,,21.58,83,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,21.32,82,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,6.5,24.7,
TESTOSTERONE TOTAL (MALE),25202788,CDM,84403,CPT,300,RC,outpatient,,387,387,,328.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.75,22,,percent of total billed charges,,,,,,,,,348.3,90,,percent of total billed charges,,,320.44,82.8,,percent of total billed charges,,,328.95,85,,percent of total billed charges,,,,,,,,,340.56,88,,percent of total billed charges,,,,,,,,,295.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.75,22,,percent of total billed charges,,,352.17,91,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,,,,,,,,,,,,,321.21,83,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,317.34,82,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,328.95,85,,percent of total billed charges,,96.75,367.65,
TESTOSTERONE TOTAL (FEMALE/PED),25202789,CDM,84403,CPT,300,RC,outpatient,,387,387,,328.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.75,22,,percent of total billed charges,,,,,,,,,348.3,90,,percent of total billed charges,,,320.44,82.8,,percent of total billed charges,,,328.95,85,,percent of total billed charges,,,,,,,,,340.56,88,,percent of total billed charges,,,,,,,,,295.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.75,22,,percent of total billed charges,,,352.17,91,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,,,,,,,,,,,,,321.21,83,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,317.34,82,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,328.95,85,,percent of total billed charges,,96.75,367.65,
.TESTOSTERONE FREE (TOTAL NOT INC),25202791,CDM,84403,CPT,300,RC,outpatient,,42,42,,35.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.5,22,,percent of total billed charges,,,,,,,,,37.8,90,,percent of total billed charges,,,34.78,82.8,,percent of total billed charges,,,35.7,85,,percent of total billed charges,,,,,,,,,36.96,88,,percent of total billed charges,,,,,,,,,32.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.5,22,,percent of total billed charges,,,38.22,91,,percent of total billed charges,,,39.9,95,,percent of total billed charges,,,34.86,83,,percent of total billed charges,,,34.86,83,,percent of total billed charges,,,,,,,,,,,,,,,34.86,83,,percent of total billed charges,,,39.9,95,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,34.44,82,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,35.7,85,,percent of total billed charges,,10.5,39.9,
THIOCYANATE,25202796,CDM,84430,CPT,300,RC,outpatient,,339,339,,287.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.75,22,,percent of total billed charges,,,,,,,,,305.1,90,,percent of total billed charges,,,280.69,82.8,,percent of total billed charges,,,288.15,85,,percent of total billed charges,,,,,,,,,298.32,88,,percent of total billed charges,,,,,,,,,259,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.75,22,,percent of total billed charges,,,308.49,91,,percent of total billed charges,,,322.05,95,,percent of total billed charges,,,281.37,83,,percent of total billed charges,,,281.37,83,,percent of total billed charges,,,,,,,,,,,,,,,281.37,83,,percent of total billed charges,,,322.05,95,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,277.98,82,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,288.15,85,,percent of total billed charges,,84.75,322.05,
VALPROIC ACID,25202820,CDM,80164,CPT,300,RC,outpatient,,364,364,,309.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91,22,,percent of total billed charges,,,,,,,,,327.6,90,,percent of total billed charges,,,301.39,82.8,,percent of total billed charges,,,309.4,85,,percent of total billed charges,,,,,,,,,320.32,88,,percent of total billed charges,,,,,,,,,278.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91,22,,percent of total billed charges,,,331.24,91,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,,,,,,,,,,,,,302.12,83,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,298.48,82,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,309.4,85,,percent of total billed charges,,91,345.8,
"VALPROIC ACID, FREE",25202821,CDM,80165,CPT,300,RC,outpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.75,22,,percent of total billed charges,,,,,,,,,182.7,90,,percent of total billed charges,,,168.08,82.8,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.75,22,,percent of total billed charges,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,50.75,192.85,
VDRL CSF,25202838,CDM,86592,CPT,300,RC,outpatient,,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33,22,,percent of total billed charges,,,,,,,,,118.8,90,,percent of total billed charges,,,109.3,82.8,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33,22,,percent of total billed charges,,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,33,125.4,
"VITAMIN D 1, 25-DIHYDROXY",25202846,CDM,82652,CPT,300,RC,outpatient,,668,668,,567.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,167,22,,percent of total billed charges,,,,,,,,,601.2,90,,percent of total billed charges,,,553.1,82.8,,percent of total billed charges,,,567.8,85,,percent of total billed charges,,,,,,,,,587.84,88,,percent of total billed charges,,,,,,,,,510.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,167,22,,percent of total billed charges,,,607.88,91,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,,,,,,,,,,,,,554.44,83,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,547.76,82,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,567.8,85,,percent of total billed charges,,167,634.6,
VITAMIN D 25-HYDROXY,25202853,CDM,82306,CPT,300,RC,outpatient,,443,443,,376.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.75,22,,percent of total billed charges,,,,,,,,,398.7,90,,percent of total billed charges,,,366.8,82.8,,percent of total billed charges,,,376.55,85,,percent of total billed charges,,,,,,,,,389.84,88,,percent of total billed charges,,,,,,,,,338.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.75,22,,percent of total billed charges,,,403.13,91,,percent of total billed charges,,,420.85,95,,percent of total billed charges,,,367.69,83,,percent of total billed charges,,,367.69,83,,percent of total billed charges,,,,,,,,,,,,,,,367.69,83,,percent of total billed charges,,,420.85,95,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,363.26,82,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,376.55,85,,percent of total billed charges,,110.75,420.85,
"CHLAMYDIA AB PANEL (IgG, IgM)",25202861,CDM,86631,CPT,300,RC,outpatient,,294,294,,249.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.5,22,,percent of total billed charges,,,,,,,,,264.6,90,,percent of total billed charges,,,243.43,82.8,,percent of total billed charges,,,249.9,85,,percent of total billed charges,,,,,,,,,258.72,88,,percent of total billed charges,,,,,,,,,224.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.5,22,,percent of total billed charges,,,267.54,91,,percent of total billed charges,,,279.3,95,,percent of total billed charges,,,244.02,83,,percent of total billed charges,,,244.02,83,,percent of total billed charges,,,,,,,,,,,,,,,244.02,83,,percent of total billed charges,,,279.3,95,,percent of total billed charges,,,264.6,90,,percent of total billed charges,,,264.6,90,,percent of total billed charges,,,241.08,82,,percent of total billed charges,,,264.6,90,,percent of total billed charges,,,249.9,85,,percent of total billed charges,,73.5,279.3,
"CHLAMYDIA AB PANEL (IGG,IGM,IGA)",25202862,CDM,86631,CPT,300,RC,outpatient,,230,230,,195.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.5,22,,percent of total billed charges,,,,,,,,,207,90,,percent of total billed charges,,,190.44,82.8,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,,,,,,,,202.4,88,,percent of total billed charges,,,,,,,,,175.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.5,22,,percent of total billed charges,,,209.3,91,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,,,,,,,,,,,,,190.9,83,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,188.6,82,,percent of total billed charges,,,207,90,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,57.5,218.5,
X RHC INFLUENZA A,25202871,CDM,87804,CPT,300,RC,outpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45,22,,percent of total billed charges,,,,,,,,,162,90,,percent of total billed charges,,,149.04,82.8,,percent of total billed charges,,,153,85,,percent of total billed charges,,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45,22,,percent of total billed charges,,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,45,171,
INFLUENZA A (RAPID),25202879,CDM,87400,CPT,300,RC,outpatient,,216,216,,183.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54,22,,percent of total billed charges,,,,,,,,,194.4,90,,percent of total billed charges,,,178.85,82.8,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,,,,,,,,190.08,88,,percent of total billed charges,,,,,,,,,165.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54,22,,percent of total billed charges,,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,177.12,82,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,54,205.2,
INFLUENZA B (RAPID),25202880,CDM,87400,CPT,300,RC,outpatient,,244,244,,207.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61,22,,percent of total billed charges,,,,,,,,,219.6,90,,percent of total billed charges,,,202.03,82.8,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,,,,,,,,214.72,88,,percent of total billed charges,,,,,,,,,186.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61,22,,percent of total billed charges,,,222.04,91,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,,,,,,,,,,,,,202.52,83,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,200.08,82,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,61,231.8,
RSV TEST,25202881,CDM,87420,CPT,300,RC,outpatient,,264,264,,224.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66,22,,percent of total billed charges,,,,,,,,,237.6,90,,percent of total billed charges,,,218.59,82.8,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,,,,,,,,232.32,88,,percent of total billed charges,,,,,,,,,201.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66,22,,percent of total billed charges,,,240.24,91,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,219.12,83,,percent of total billed charges,,,,,,,,,,,,,,,219.12,83,,percent of total billed charges,,,250.8,95,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,216.48,82,,percent of total billed charges,,,237.6,90,,percent of total billed charges,,,224.4,85,,percent of total billed charges,,66,250.8,
INFLUENZA A&B ANTIBODIES,25202882,CDM,86710,CPT,300,RC,outpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.75,22,,percent of total billed charges,,,,,,,,,182.7,90,,percent of total billed charges,,,168.08,82.8,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.75,22,,percent of total billed charges,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,50.75,192.85,
FACTOR V HR2 ALLELE DNA,25202883,CDM,81400,CPT,300,RC,outpatient,,904,904,,767.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,226,22,,percent of total billed charges,,,,,,,,,813.6,90,,percent of total billed charges,,,748.51,82.8,,percent of total billed charges,,,768.4,85,,percent of total billed charges,,,,,,,,,795.52,88,,percent of total billed charges,,,,,,,,,690.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,226,22,,percent of total billed charges,,,822.64,91,,percent of total billed charges,,,858.8,95,,percent of total billed charges,,,750.32,83,,percent of total billed charges,,,750.32,83,,percent of total billed charges,,,,,,,,,,,,,,,750.32,83,,percent of total billed charges,,,858.8,95,,percent of total billed charges,,,813.6,90,,percent of total billed charges,,,813.6,90,,percent of total billed charges,,,741.28,82,,percent of total billed charges,,,813.6,90,,percent of total billed charges,,,768.4,85,,percent of total billed charges,,226,858.8,
INFLUENZA H1N1,25202885,CDM,87798,CPT,300,RC,outpatient,,701,701,,595.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175.25,22,,percent of total billed charges,,,,,,,,,630.9,90,,percent of total billed charges,,,580.43,82.8,,percent of total billed charges,,,595.85,85,,percent of total billed charges,,,,,,,,,616.88,88,,percent of total billed charges,,,,,,,,,535.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175.25,22,,percent of total billed charges,,,637.91,91,,percent of total billed charges,,,665.95,95,,percent of total billed charges,,,581.83,83,,percent of total billed charges,,,581.83,83,,percent of total billed charges,,,,,,,,,,,,,,,581.83,83,,percent of total billed charges,,,665.95,95,,percent of total billed charges,,,630.9,90,,percent of total billed charges,,,630.9,90,,percent of total billed charges,,,574.82,82,,percent of total billed charges,,,630.9,90,,percent of total billed charges,,,595.85,85,,percent of total billed charges,,175.25,665.95,
2019 NOVEL CORONAVIRUS,25202886,CDM,87635,CPT,300,RC,outpatient,,254,254,,215.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.5,22,,percent of total billed charges,,,,,,,,,228.6,90,,percent of total billed charges,,,210.31,82.8,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,,,,,,,,223.52,88,,percent of total billed charges,,,,,,,,,194.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.5,22,,percent of total billed charges,,,231.14,91,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,,,,,,,,,,,,,210.82,83,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,208.28,82,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,63.5,241.3,
MYOGLOBIN URINE,25202887,CDM,83874,CPT,300,RC,outpatient,,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.75,22,,percent of total billed charges,,,,,,,,,207.9,90,,percent of total billed charges,,,191.27,82.8,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.75,22,,percent of total billed charges,,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,57.75,219.45,
MYOGLOBIN SERUM,25202888,CDM,83874,CPT,300,RC,outpatient,,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.25,22,,percent of total billed charges,,,,,,,,,260.1,90,,percent of total billed charges,,,239.29,82.8,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.25,22,,percent of total billed charges,,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,72.25,274.55,
SARS CORONAVIRUS AB ( IgG) NUCLEOCAPSID,25202889,CDM,86769,CPT,300,RC,outpatient,,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
SARS CORONAVIRUS IGM,25202891,CDM,86769,CPT,300,RC,outpatient,,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
COVID (RAPID),25202892,CDM,87426,CPT,300,RC,outpatient,QW,254,254,,215.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.5,22,,percent of total billed charges,,,,,,,,,228.6,90,,percent of total billed charges,,,210.31,82.8,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,,,,,,,,223.52,88,,percent of total billed charges,,,,,,,,,194.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.5,22,,percent of total billed charges,,,231.14,91,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,,,,,,,,,,,,,210.82,83,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,208.28,82,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,63.5,241.3,
SARS CORONAVIRUS AB ( IgA),25202895,CDM,86769,CPT,300,RC,outpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.25,22,,percent of total billed charges,,,,,,,,,72.9,90,,percent of total billed charges,,,67.07,82.8,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.25,22,,percent of total billed charges,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,20.25,76.95,
SARS CO2 SEMIQT TOTAL AB,25202900,CDM,86769,CPT,300,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
PROTEIN-S ANTIGEN,25202903,CDM,85305,CPT,300,RC,outpatient,,329,329,,279.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.25,22,,percent of total billed charges,,,,,,,,,296.1,90,,percent of total billed charges,,,272.41,82.8,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,,,,,,,,289.52,88,,percent of total billed charges,,,,,,,,,251.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82.25,22,,percent of total billed charges,,,299.39,91,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,,,,,,,,,,,,,273.07,83,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,269.78,82,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,82.25,312.55,
PROTEIN-S ACTIVITY (FUNCTIONAL),25202904,CDM,85306,CPT,300,RC,outpatient,,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
PROTEIN-S PANEL,25202905,CDM,85306,CPT,300,RC,outpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.5,22,,percent of total billed charges,,,,,,,,,178.2,90,,percent of total billed charges,,,163.94,82.8,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.5,22,,percent of total billed charges,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,49.5,188.1,
PROTEIN-S F VII AG RATIO,25202906,CDM,85305,CPT,300,RC,outpatient,,312,312,,264.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78,22,,percent of total billed charges,,,,,,,,,280.8,90,,percent of total billed charges,,,258.34,82.8,,percent of total billed charges,,,265.2,85,,percent of total billed charges,,,,,,,,,274.56,88,,percent of total billed charges,,,,,,,,,238.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78,22,,percent of total billed charges,,,283.92,91,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,,,,,,,,,,,,,258.96,83,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,255.84,82,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,265.2,85,,percent of total billed charges,,78,296.4,
PROTEIN-S F VII ANTIGEN,25202907,CDM,85302,CPT,300,RC,outpatient,,312,312,,264.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78,22,,percent of total billed charges,,,,,,,,,280.8,90,,percent of total billed charges,,,258.34,82.8,,percent of total billed charges,,,265.2,85,,percent of total billed charges,,,,,,,,,274.56,88,,percent of total billed charges,,,,,,,,,238.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78,22,,percent of total billed charges,,,283.92,91,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,,,,,,,,,,,,,258.96,83,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,255.84,82,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,265.2,85,,percent of total billed charges,,78,296.4,
"PROTEIN, TOTAL CSF/BODY FLUID",25202910,CDM,84157,CPT,300,RC,outpatient,,193,193,,163.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.25,22,,percent of total billed charges,,,,,,,,,173.7,90,,percent of total billed charges,,,159.8,82.8,,percent of total billed charges,,,164.05,85,,percent of total billed charges,,,,,,,,,169.84,88,,percent of total billed charges,,,,,,,,,147.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.25,22,,percent of total billed charges,,,175.63,91,,percent of total billed charges,,,183.35,95,,percent of total billed charges,,,160.19,83,,percent of total billed charges,,,160.19,83,,percent of total billed charges,,,,,,,,,,,,,,,160.19,83,,percent of total billed charges,,,183.35,95,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,158.26,82,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,164.05,85,,percent of total billed charges,,48.25,183.35,
PROTEIN-C ACTIVITY (FUNCTIONAL),25202911,CDM,85303,CPT,300,RC,outpatient,,393,393,,333.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.25,22,,percent of total billed charges,,,,,,,,,353.7,90,,percent of total billed charges,,,325.4,82.8,,percent of total billed charges,,,334.05,85,,percent of total billed charges,,,,,,,,,345.84,88,,percent of total billed charges,,,,,,,,,300.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.25,22,,percent of total billed charges,,,357.63,91,,percent of total billed charges,,,373.35,95,,percent of total billed charges,,,326.19,83,,percent of total billed charges,,,326.19,83,,percent of total billed charges,,,,,,,,,,,,,,,326.19,83,,percent of total billed charges,,,373.35,95,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,322.26,82,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,334.05,85,,percent of total billed charges,,98.25,373.35,
PROTEIN-C ACTIVITY & ANTIGEN,25202912,CDM,85302,CPT,300,RC,outpatient,,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.25,22,,percent of total billed charges,,,,,,,,,137.7,90,,percent of total billed charges,,,126.68,82.8,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.25,22,,percent of total billed charges,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,38.25,145.35,
PROTEIN-C ANTIGEN,25202914,CDM,85302,CPT,300,RC,outpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.75,22,,percent of total billed charges,,,,,,,,,182.7,90,,percent of total billed charges,,,168.08,82.8,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.75,22,,percent of total billed charges,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,50.75,192.85,
"PROTEIN TOTAL, URINE (RANDOM)W/ CREAT",25202915,CDM,84157,CPT,300,RC,outpatient,,193,193,,163.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.25,22,,percent of total billed charges,,,,,,,,,173.7,90,,percent of total billed charges,,,159.8,82.8,,percent of total billed charges,,,164.05,85,,percent of total billed charges,,,,,,,,,169.84,88,,percent of total billed charges,,,,,,,,,147.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.25,22,,percent of total billed charges,,,175.63,91,,percent of total billed charges,,,183.35,95,,percent of total billed charges,,,160.19,83,,percent of total billed charges,,,160.19,83,,percent of total billed charges,,,,,,,,,,,,,,,160.19,83,,percent of total billed charges,,,183.35,95,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,158.26,82,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,164.05,85,,percent of total billed charges,,48.25,183.35,
PHENOBARBITAL,25202929,CDM,80184,CPT,300,RC,outpatient,,317,317,,269.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.25,22,,percent of total billed charges,,,,,,,,,285.3,90,,percent of total billed charges,,,262.48,82.8,,percent of total billed charges,,,269.45,85,,percent of total billed charges,,,,,,,,,278.96,88,,percent of total billed charges,,,,,,,,,242.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.25,22,,percent of total billed charges,,,288.47,91,,percent of total billed charges,,,301.15,95,,percent of total billed charges,,,263.11,83,,percent of total billed charges,,,263.11,83,,percent of total billed charges,,,,,,,,,,,,,,,263.11,83,,percent of total billed charges,,,301.15,95,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,259.94,82,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,269.45,85,,percent of total billed charges,,79.25,301.15,
BACTERIAL ANTIGENS,25202945,CDM,86403,CPT,300,RC,outpatient,,27,27,,22.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.75,22,,percent of total billed charges,,,,,,,,,24.3,90,,percent of total billed charges,,,22.36,82.8,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,,,,,,,,23.76,88,,percent of total billed charges,,,,,,,,,20.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.75,22,,percent of total billed charges,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,,,,,,,,,,,,,22.41,83,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.14,82,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,6.75,25.65,
SURG PATH LEVEL 6,25202952,CDM,88309,CPT,310,RC,outpatient,TC,2054,2054,,1743.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,513.5,22,,percent of total billed charges,,,,,,,,,1848.6,90,,percent of total billed charges,,,1700.71,82.8,,percent of total billed charges,,,1745.9,85,,percent of total billed charges,,,,,,,,,1807.52,88,,percent of total billed charges,,,,,,,,,1569.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,513.5,22,,percent of total billed charges,,,1869.14,91,,percent of total billed charges,,,1951.3,95,,percent of total billed charges,,,1704.82,83,,percent of total billed charges,,,1704.82,83,,percent of total billed charges,,,,,,,,,,,,,,,1704.82,83,,percent of total billed charges,,,1951.3,95,,percent of total billed charges,,,1848.6,90,,percent of total billed charges,,,1848.6,90,,percent of total billed charges,,,1684.28,82,,percent of total billed charges,,,1848.6,90,,percent of total billed charges,,,1745.9,85,,percent of total billed charges,,513.5,1951.3,
SURG PATH LEVEL 5,25202960,CDM,88307,CPT,310,RC,outpatient,TC,792,792,,672.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,198,22,,percent of total billed charges,,,,,,,,,712.8,90,,percent of total billed charges,,,655.78,82.8,,percent of total billed charges,,,673.2,85,,percent of total billed charges,,,,,,,,,696.96,88,,percent of total billed charges,,,,,,,,,605.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,198,22,,percent of total billed charges,,,720.72,91,,percent of total billed charges,,,752.4,95,,percent of total billed charges,,,657.36,83,,percent of total billed charges,,,657.36,83,,percent of total billed charges,,,,,,,,,,,,,,,657.36,83,,percent of total billed charges,,,752.4,95,,percent of total billed charges,,,712.8,90,,percent of total billed charges,,,712.8,90,,percent of total billed charges,,,649.44,82,,percent of total billed charges,,,712.8,90,,percent of total billed charges,,,673.2,85,,percent of total billed charges,,198,752.4,
SURG PATH-FROZEN SECTION,25202978,CDM,88331,CPT,310,RC,outpatient,,435,435,,369.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.75,22,,percent of total billed charges,,,,,,,,,391.5,90,,percent of total billed charges,,,360.18,82.8,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,,,,,,,,382.8,88,,percent of total billed charges,,,,,,,,,332.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108.75,22,,percent of total billed charges,,,395.85,91,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,,,,,,,,,,,,,361.05,83,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,356.7,82,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,108.75,413.25,
SURG PATH LEVEL 2,25202986,CDM,88302,CPT,310,RC,outpatient,TC,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.5,22,,percent of total billed charges,,,,,,,,,275.4,90,,percent of total billed charges,,,253.37,82.8,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.5,22,,percent of total billed charges,,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,76.5,290.7,
.PAP SMEAR SCREEN (G0143),25202990,CDM,G0143,HCPCS,311,RC,outpatient,,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,3.45,,,,fee schedule,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.45,,,,fee schedule,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,3.45,287.85,
.PAP SMEAR (P3000),25202991,CDM,P3000,HCPCS,311,RC,outpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.75,22,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,48.85,82.8,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,,,,,,,,51.92,88,,percent of total billed charges,,3.55,,,,fee schedule,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.55,,,,fee schedule,,,14.75,22,,percent of total billed charges,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,3.55,56.05,
.PAP SMEAR SCREEN (G0145),25202992,CDM,G0145,HCPCS,311,RC,outpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.5,22,,percent of total billed charges,,,,,,,,,113.4,90,,percent of total billed charges,,,104.33,82.8,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,,,,,,,,110.88,88,,percent of total billed charges,,3.45,,,,fee schedule,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.45,,,,fee schedule,,,31.5,22,,percent of total billed charges,,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,3.45,119.7,
.PAP SMEAR THIN LAYER PREP (88143),25202993,CDM,88143,CPT,311,RC,outpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.5,22,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,170.57,82.8,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.5,22,,percent of total billed charges,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,51.5,195.7,
.PAP SMEAR CONVENTIONAL (88164),25202994,CDM,88164,CPT,311,RC,outpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.75,22,,percent of total billed charges,,,,,,,,,143.1,90,,percent of total billed charges,,,131.65,82.8,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.75,22,,percent of total billed charges,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,39.75,151.05,
.PAP SMEAR THIN LAYER PREP (88174),25202995,CDM,88174,CPT,311,RC,outpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.5,22,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,170.57,82.8,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.5,22,,percent of total billed charges,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,51.5,195.7,
.PAP SMEAR THIN LAYER PREP (88175),25202996,CDM,88175,CPT,311,RC,outpatient,,397,397,,337.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,99.25,22,,percent of total billed charges,,,,,,,,,357.3,90,,percent of total billed charges,,,328.72,82.8,,percent of total billed charges,,,337.45,85,,percent of total billed charges,,,,,,,,,349.36,88,,percent of total billed charges,,,,,,,,,303.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,99.25,22,,percent of total billed charges,,,361.27,91,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,,,,,,,,,,,,,329.51,83,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,325.54,82,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,337.45,85,,percent of total billed charges,,99.25,377.15,
.PAP SMEAR SCREEN (G0144),25202998,CDM,G0144,HCPCS,311,RC,outpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.5,22,,percent of total billed charges,,,,,,,,,113.4,90,,percent of total billed charges,,,104.33,82.8,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,,,,,,,,110.88,88,,percent of total billed charges,,3.45,,,,fee schedule,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.45,,,,fee schedule,,,31.5,22,,percent of total billed charges,,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,3.45,119.7,
.PAP SMEAR THIN LAYER PREP (88142),25202999,CDM,88142,CPT,311,RC,outpatient,,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
THYROTROPIN-BINDING INHIB IMMUNOGLOBULIN,25203001,CDM,83519,CPT,300,RC,outpatient,,316,316,,268.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79,22,,percent of total billed charges,,,,,,,,,284.4,90,,percent of total billed charges,,,261.65,82.8,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,,,,,,,,278.08,88,,percent of total billed charges,,,,,,,,,241.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79,22,,percent of total billed charges,,,287.56,91,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,,,,,,,,,,,,,262.28,83,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,259.12,82,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,79,300.2,
T-CELL PROFILE ( HELPER/SUPPRESSOR),25203002,CDM,86359,CPT,310,RC,outpatient,,681,681,,578.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,170.25,22,,percent of total billed charges,,,,,,,,,612.9,90,,percent of total billed charges,,,563.87,82.8,,percent of total billed charges,,,578.85,85,,percent of total billed charges,,,,,,,,,599.28,88,,percent of total billed charges,,,,,,,,,520.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,170.25,22,,percent of total billed charges,,,619.71,91,,percent of total billed charges,,,646.95,95,,percent of total billed charges,,,565.23,83,,percent of total billed charges,,,565.23,83,,percent of total billed charges,,,,,,,,,,,,,,,565.23,83,,percent of total billed charges,,,646.95,95,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,558.42,82,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,578.85,85,,percent of total billed charges,,170.25,646.95,
V1212THYROTROPIN RELEASING HORMONE,25203003,CDM,83519,CPT,300,RC,outpatient,,641,641,,544.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,160.25,22,,percent of total billed charges,,,,,,,,,576.9,90,,percent of total billed charges,,,530.75,82.8,,percent of total billed charges,,,544.85,85,,percent of total billed charges,,,,,,,,,564.08,88,,percent of total billed charges,,,,,,,,,489.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,160.25,22,,percent of total billed charges,,,583.31,91,,percent of total billed charges,,,608.95,95,,percent of total billed charges,,,532.03,83,,percent of total billed charges,,,532.03,83,,percent of total billed charges,,,,,,,,,,,,,,,532.03,83,,percent of total billed charges,,,608.95,95,,percent of total billed charges,,,576.9,90,,percent of total billed charges,,,576.9,90,,percent of total billed charges,,,525.62,82,,percent of total billed charges,,,576.9,90,,percent of total billed charges,,,544.85,85,,percent of total billed charges,,160.25,608.95,
.PAP SMEAR CONVENTIONAL (88148),25203004,CDM,88148,CPT,311,RC,outpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.75,22,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,85.28,82.8,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.75,22,,percent of total billed charges,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,25.75,97.85,
.PAP SMEAR SCREEN (G0148),25203006,CDM,G0148,HCPCS,311,RC,outpatient,,59,59,,50.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.75,22,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,48.85,82.8,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,,,,,,,,51.92,88,,percent of total billed charges,,3.45,,,,fee schedule,,,45.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.45,,,,fee schedule,,,14.75,22,,percent of total billed charges,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,48.38,82,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,3.45,56.05,
.PAP SMEAR PATH REVIEW(88141),25203008,CDM,88141,CPT,311,RC,outpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.75,22,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,68.72,82.8,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.75,22,,percent of total billed charges,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,20.75,78.85,
T-CELL RECEPTOR B-CHAIN,25203009,CDM,81340,CPT,310,RC,outpatient,,996,996,,845.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,249,22,,percent of total billed charges,,,,,,,,,896.4,90,,percent of total billed charges,,,824.69,82.8,,percent of total billed charges,,,846.6,85,,percent of total billed charges,,,,,,,,,876.48,88,,percent of total billed charges,,,,,,,,,760.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,249,22,,percent of total billed charges,,,906.36,91,,percent of total billed charges,,,946.2,95,,percent of total billed charges,,,826.68,83,,percent of total billed charges,,,826.68,83,,percent of total billed charges,,,,,,,,,,,,,,,826.68,83,,percent of total billed charges,,,946.2,95,,percent of total billed charges,,,896.4,90,,percent of total billed charges,,,896.4,90,,percent of total billed charges,,,816.72,82,,percent of total billed charges,,,896.4,90,,percent of total billed charges,,,846.6,85,,percent of total billed charges,,249,946.2,
T-CELL RECEPTOR Y-CHAIN,25203010,CDM,81342,CPT,310,RC,outpatient,,492,492,,417.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123,22,,percent of total billed charges,,,,,,,,,442.8,90,,percent of total billed charges,,,407.38,82.8,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,,,,,,,,432.96,88,,percent of total billed charges,,,,,,,,,375.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123,22,,percent of total billed charges,,,447.72,91,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,,,,,,,,,,,,,408.36,83,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,403.44,82,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,123,467.4,
NEURON-SPECIFIC ENOLASE,25203011,CDM,86316,CPT,310,RC,outpatient,,79,79,,67.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.75,22,,percent of total billed charges,,,,,,,,,71.1,90,,percent of total billed charges,,,65.41,82.8,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,,,,,,,,69.52,88,,percent of total billed charges,,,,,,,,,60.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.75,22,,percent of total billed charges,,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,,,,,,,,,,,,,65.57,83,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,64.78,82,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,19.75,75.05,
PML-RARA TRANSCRIPT,25203012,CDM,81315,CPT,310,RC,outpatient,,809,809,,686.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,202.25,22,,percent of total billed charges,,,,,,,,,728.1,90,,percent of total billed charges,,,669.85,82.8,,percent of total billed charges,,,687.65,85,,percent of total billed charges,,,,,,,,,711.92,88,,percent of total billed charges,,,,,,,,,618.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,202.25,22,,percent of total billed charges,,,736.19,91,,percent of total billed charges,,,768.55,95,,percent of total billed charges,,,671.47,83,,percent of total billed charges,,,671.47,83,,percent of total billed charges,,,,,,,,,,,,,,,671.47,83,,percent of total billed charges,,,768.55,95,,percent of total billed charges,,,728.1,90,,percent of total billed charges,,,728.1,90,,percent of total billed charges,,,663.38,82,,percent of total billed charges,,,728.1,90,,percent of total billed charges,,,687.65,85,,percent of total billed charges,,202.25,768.55,
JAK2 MUTATION W/REFLEX CALR&12-15,25203013,CDM,81270,CPT,300,RC,outpatient,,420,420,,356.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,105,22,,percent of total billed charges,,,,,,,,,378,90,,percent of total billed charges,,,347.76,82.8,,percent of total billed charges,,,357,85,,percent of total billed charges,,,,,,,,,369.6,88,,percent of total billed charges,,,,,,,,,320.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,105,22,,percent of total billed charges,,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,,,,,,,,,,,,,348.6,83,,percent of total billed charges,,,399,95,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,344.4,82,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,105,399,
..JAK2 12-15MUTATION,25203014,CDM,81279,CPT,300,RC,outpatient,,945,945,,802.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,236.25,22,,percent of total billed charges,,,,,,,,,850.5,90,,percent of total billed charges,,,782.46,82.8,,percent of total billed charges,,,803.25,85,,percent of total billed charges,,,,,,,,,831.6,88,,percent of total billed charges,,,,,,,,,721.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,236.25,22,,percent of total billed charges,,,859.95,91,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,,,,,,,,,,,,,784.35,83,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,774.9,82,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,803.25,85,,percent of total billed charges,,236.25,897.75,
..CALRETICULIN MUTATION,25203015,CDM,81219,CPT,300,RC,outpatient,,945,945,,802.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,236.25,22,,percent of total billed charges,,,,,,,,,850.5,90,,percent of total billed charges,,,782.46,82.8,,percent of total billed charges,,,803.25,85,,percent of total billed charges,,,,,,,,,831.6,88,,percent of total billed charges,,,,,,,,,721.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,236.25,22,,percent of total billed charges,,,859.95,91,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,,,,,,,,,,,,,784.35,83,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,774.9,82,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,803.25,85,,percent of total billed charges,,236.25,897.75,
CULTURE BLOOD,25203034,CDM,87040,CPT,300,RC,outpatient,,299,299,,253.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.75,22,,percent of total billed charges,,,,,,,,,269.1,90,,percent of total billed charges,,,247.57,82.8,,percent of total billed charges,,,254.15,85,,percent of total billed charges,,,,,,,,,263.12,88,,percent of total billed charges,,,,,,,,,228.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.75,22,,percent of total billed charges,,,272.09,91,,percent of total billed charges,,,284.05,95,,percent of total billed charges,,,248.17,83,,percent of total billed charges,,,248.17,83,,percent of total billed charges,,,,,,,,,,,,,,,248.17,83,,percent of total billed charges,,,284.05,95,,percent of total billed charges,,,269.1,90,,percent of total billed charges,,,269.1,90,,percent of total billed charges,,,245.18,82,,percent of total billed charges,,,269.1,90,,percent of total billed charges,,,254.15,85,,percent of total billed charges,,74.75,284.05,
HEPATITIS B SURFACE ANTIGEN,25203042,CDM,87340,CPT,300,RC,outpatient,,200,200,,169.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50,22,,percent of total billed charges,,,,,,,,,180,90,,percent of total billed charges,,,165.6,82.8,,percent of total billed charges,,,170,85,,percent of total billed charges,,,,,,,,,176,88,,percent of total billed charges,,,,,,,,,152.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50,22,,percent of total billed charges,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,166,83,,percent of total billed charges,,,,,,,,,,,,,,,166,83,,percent of total billed charges,,,190,95,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,164,82,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,50,190,
PREALBUMIN,25203059,CDM,84134,CPT,300,RC,outpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.75,22,,percent of total billed charges,,,,,,,,,236.7,90,,percent of total billed charges,,,217.76,82.8,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.75,22,,percent of total billed charges,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,65.75,249.85,
"H. PYLORI ANTIGEN, STOOL",25203070,CDM,87338,CPT,300,RC,outpatient,,453,453,,384.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,113.25,22,,percent of total billed charges,,,,,,,,,407.7,90,,percent of total billed charges,,,375.08,82.8,,percent of total billed charges,,,385.05,85,,percent of total billed charges,,,,,,,,,398.64,88,,percent of total billed charges,,,,,,,,,346.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,113.25,22,,percent of total billed charges,,,412.23,91,,percent of total billed charges,,,430.35,95,,percent of total billed charges,,,375.99,83,,percent of total billed charges,,,375.99,83,,percent of total billed charges,,,,,,,,,,,,,,,375.99,83,,percent of total billed charges,,,430.35,95,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,371.46,82,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,385.05,85,,percent of total billed charges,,113.25,430.35,
DISACCHARIDASES,25203071,CDM,82657,CPT,300,RC,outpatient,,562,562,,477.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,140.5,22,,percent of total billed charges,,,,,,,,,505.8,90,,percent of total billed charges,,,465.34,82.8,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,,,,,,,,494.56,88,,percent of total billed charges,,,,,,,,,429.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,140.5,22,,percent of total billed charges,,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,,,,,,,,,,,,,466.46,83,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,460.84,82,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,140.5,533.9,
IGE LATEX,25203074,CDM,86003,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
IMMUNOGLOBULIN E,25203075,CDM,82785,CPT,300,RC,outpatient,,246,246,,208.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.5,22,,percent of total billed charges,,,,,,,,,221.4,90,,percent of total billed charges,,,203.69,82.8,,percent of total billed charges,,,209.1,85,,percent of total billed charges,,,,,,,,,216.48,88,,percent of total billed charges,,,,,,,,,187.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.5,22,,percent of total billed charges,,,223.86,91,,percent of total billed charges,,,233.7,95,,percent of total billed charges,,,204.18,83,,percent of total billed charges,,,204.18,83,,percent of total billed charges,,,,,,,,,,,,,,,204.18,83,,percent of total billed charges,,,233.7,95,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,201.72,82,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,209.1,85,,percent of total billed charges,,61.5,233.7,
PROCAINAMIDE,25203083,CDM,80192,CPT,300,RC,outpatient,,330,330,,280.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.5,22,,percent of total billed charges,,,,,,,,,297,90,,percent of total billed charges,,,273.24,82.8,,percent of total billed charges,,,280.5,85,,percent of total billed charges,,,,,,,,,290.4,88,,percent of total billed charges,,,,,,,,,252.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82.5,22,,percent of total billed charges,,,300.3,91,,percent of total billed charges,,,313.5,95,,percent of total billed charges,,,273.9,83,,percent of total billed charges,,,273.9,83,,percent of total billed charges,,,,,,,,,,,,,,,273.9,83,,percent of total billed charges,,,313.5,95,,percent of total billed charges,,,297,90,,percent of total billed charges,,,297,90,,percent of total billed charges,,,270.6,82,,percent of total billed charges,,,297,90,,percent of total billed charges,,,280.5,85,,percent of total billed charges,,82.5,313.5,
TACROLIMUS,25203084,CDM,80197,CPT,300,RC,outpatient,,398,398,,337.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,99.5,22,,percent of total billed charges,,,,,,,,,358.2,90,,percent of total billed charges,,,329.54,82.8,,percent of total billed charges,,,338.3,85,,percent of total billed charges,,,,,,,,,350.24,88,,percent of total billed charges,,,,,,,,,304.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,99.5,22,,percent of total billed charges,,,362.18,91,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,,,,,,,,,,,,,330.34,83,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,326.36,82,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,338.3,85,,percent of total billed charges,,99.5,378.1,
PROTRIPTYLINE,25203085,CDM,80299,CPT,300,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
TUMOR NECROSIS FACTOR ALPHA,25203086,CDM,83520,CPT,300,RC,outpatient,,398,398,,337.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,99.5,22,,percent of total billed charges,,,,,,,,,358.2,90,,percent of total billed charges,,,329.54,82.8,,percent of total billed charges,,,338.3,85,,percent of total billed charges,,,,,,,,,350.24,88,,percent of total billed charges,,,,,,,,,304.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,99.5,22,,percent of total billed charges,,,362.18,91,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,,,,,,,,,,,,,330.34,83,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,326.36,82,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,338.3,85,,percent of total billed charges,,99.5,378.1,
TITANIUM,25203088,CDM,83018,CPT,300,RC,outpatient,,397,397,,337.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,99.25,22,,percent of total billed charges,,,,,,,,,357.3,90,,percent of total billed charges,,,328.72,82.8,,percent of total billed charges,,,337.45,85,,percent of total billed charges,,,,,,,,,349.36,88,,percent of total billed charges,,,,,,,,,303.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,99.25,22,,percent of total billed charges,,,361.27,91,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,,,,,,,,,,,,,329.51,83,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,325.54,82,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,337.45,85,,percent of total billed charges,,99.25,377.15,
ALLERGEN EVALUATION EACH,25203091,CDM,86003,CPT,300,RC,outpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21,22,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,69.55,82.8,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,,,,,,,,73.92,88,,percent of total billed charges,,,,,,,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21,22,,percent of total billed charges,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,21,79.8,
.ALLERGEN  MOLD,25203092,CDM,86003,CPT,300,RC,outpatient,,17,17,,14.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.25,22,,percent of total billed charges,,,,,,,,,15.3,90,,percent of total billed charges,,,14.08,82.8,,percent of total billed charges,,,14.45,85,,percent of total billed charges,,,,,,,,,14.96,88,,percent of total billed charges,,,,,,,,,12.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.25,22,,percent of total billed charges,,,15.47,91,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,,,,,,,,,,,,,14.11,83,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,13.94,82,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,14.45,85,,percent of total billed charges,,4.25,16.15,
ALLERGEN  MILK,25203093,CDM,86003,CPT,300,RC,outpatient,,54,54,,45.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.5,22,,percent of total billed charges,,,,,,,,,48.6,90,,percent of total billed charges,,,44.71,82.8,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,,,,,,,,47.52,88,,percent of total billed charges,,,,,,,,,41.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.5,22,,percent of total billed charges,,,49.14,91,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,,,,,,,,,,,,,44.82,83,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,44.28,82,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,13.5,51.3,
ALLERGEN  FRUIT,25203094,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  GRAPE,25203097,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  BLUEBERRY,25203098,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  BIRCH,25203099,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  HAZELNUT,25203101,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  WATERMELLON,25203102,CDM,86003,CPT,300,RC,outpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.5,22,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,64.58,82.8,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.5,22,,percent of total billed charges,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,19.5,74.1,
ALLERGEN  PUMPKIN,25203103,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  FOOD BERRIES,25203104,CDM,86003,CPT,300,RC,outpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.75,22,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,45.54,82.8,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.75,22,,percent of total billed charges,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,13.75,52.25,
ALLERGEN NUTS (7) PANEL,25203106,CDM,86003,CPT,300,RC,outpatient,,101,101,,85.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.25,22,,percent of total billed charges,,,,,,,,,90.9,90,,percent of total billed charges,,,83.63,82.8,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,,,,,,,,88.88,88,,percent of total billed charges,,,,,,,,,77.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.25,22,,percent of total billed charges,,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,82.82,82,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,25.25,95.95,
ALLERGY SPICE (7) PANEL,25203107,CDM,86003,CPT,300,RC,outpatient,,91,91,,77.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.75,22,,percent of total billed charges,,,,,,,,,81.9,90,,percent of total billed charges,,,75.35,82.8,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,,,,,,,,80.08,88,,percent of total billed charges,,,,,,,,,69.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.75,22,,percent of total billed charges,,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,,,,,,,,,,,,,75.53,83,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,74.62,82,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,22.75,86.45,
HIV 1&2 (RAPID) ANTIBODY,25203108,CDM,86703,CPT,300,RC,outpatient,,237,237,,201.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.25,22,,percent of total billed charges,,,,,,,,,213.3,90,,percent of total billed charges,,,196.24,82.8,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,,,,,,,,208.56,88,,percent of total billed charges,,,,,,,,,181.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.25,22,,percent of total billed charges,,,215.67,91,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,,,,,,,,,,,,,196.71,83,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,194.34,82,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,59.25,225.15,
HIV 1&2 ANTIBODY SCREEN,25203109,CDM,87389,CPT,300,RC,outpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
HIV 1/0/2 AB/AG W/p24 PANEL,25203111,CDM,87389,CPT,300,RC,outpatient,,278,278,,236.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.5,22,,percent of total billed charges,,,,,,,,,250.2,90,,percent of total billed charges,,,230.18,82.8,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,,,,,,,,244.64,88,,percent of total billed charges,,,,,,,,,212.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.5,22,,percent of total billed charges,,,252.98,91,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,,,,,,,,,,,,,230.74,83,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,227.96,82,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,69.5,264.1,
ALLERGEN  GRAIN,25203112,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  CORN,25203113,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN FOOD BASIC,25203114,CDM,86003,CPT,300,RC,outpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.5,22,,percent of total billed charges,,,,,,,,,45,90,,percent of total billed charges,,,41.4,82.8,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.5,22,,percent of total billed charges,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,12.5,47.5,
...ALL,25203115,CDM,86003,CPT,300,RC,outpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3,22,,percent of total billed charges,,,,,,,,,10.8,90,,percent of total billed charges,,,9.94,82.8,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3,22,,percent of total billed charges,,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,3,11.4,
...AL,25203116,CDM,86003,CPT,300,RC,outpatient,,53,53,,45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.25,22,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,43.88,82.8,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,,,,,,,,46.64,88,,percent of total billed charges,,,,,,,,,40.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.25,22,,percent of total billed charges,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,,,,,,,,,,,,,43.99,83,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,43.46,82,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,13.25,50.35,
17-HYDROXYCORTICOSTEROIDS 24-HR URINE,25203117,CDM,83491,CPT,300,RC,outpatient,,575,575,,488.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,143.75,22,,percent of total billed charges,,,,,,,,,517.5,90,,percent of total billed charges,,,476.1,82.8,,percent of total billed charges,,,488.75,85,,percent of total billed charges,,,,,,,,,506,88,,percent of total billed charges,,,,,,,,,439.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,143.75,22,,percent of total billed charges,,,523.25,91,,percent of total billed charges,,,546.25,95,,percent of total billed charges,,,477.25,83,,percent of total billed charges,,,477.25,83,,percent of total billed charges,,,,,,,,,,,,,,,477.25,83,,percent of total billed charges,,,546.25,95,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,471.5,82,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,488.75,85,,percent of total billed charges,,143.75,546.25,
...AL,25203118,CDM,86003,CPT,300,RC,outpatient,,7,7,,5.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.75,22,,percent of total billed charges,,,,,,,,,6.3,90,,percent of total billed charges,,,5.8,82.8,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,,,,,,,,6.16,88,,percent of total billed charges,,,,,,,,,5.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.75,22,,percent of total billed charges,,,6.37,91,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,,,,,,,,,,,,,5.81,83,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.74,82,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,1.75,6.65,
ALLERGEN PROFILE PLUS PEDIATRIC,25203119,CDM,82785,CPT,300,RC,outpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21,22,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,69.55,82.8,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,,,,,,,,73.92,88,,percent of total billed charges,,,,,,,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21,22,,percent of total billed charges,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,21,79.8,
ALLERGEN MEAT,25203120,CDM,86003,CPT,300,RC,outpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.5,22,,percent of total billed charges,,,,,,,,,45,90,,percent of total billed charges,,,41.4,82.8,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.5,22,,percent of total billed charges,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,12.5,47.5,
.ALLERGY FOOD CHICKEN,25203121,CDM,86003,CPT,300,RC,outpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.5,22,,percent of total billed charges,,,,,,,,,45,90,,percent of total billed charges,,,41.4,82.8,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.5,22,,percent of total billed charges,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,12.5,47.5,
.ALLERGY FOOD PORK,25203122,CDM,86003,CPT,300,RC,outpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.5,22,,percent of total billed charges,,,,,,,,,45,90,,percent of total billed charges,,,41.4,82.8,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.5,22,,percent of total billed charges,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,12.5,47.5,
ALLERGEN  HICKORY NUT,25203123,CDM,86003,CPT,300,RC,outpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3,22,,percent of total billed charges,,,,,,,,,10.8,90,,percent of total billed charges,,,9.94,82.8,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3,22,,percent of total billed charges,,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,3,11.4,
"17-KETOSTEROIDS, 24-HOUR URINE",25203125,CDM,83586,CPT,300,RC,outpatient,,224,224,,190.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56,22,,percent of total billed charges,,,,,,,,,201.6,90,,percent of total billed charges,,,185.47,82.8,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,,,,,,,,197.12,88,,percent of total billed charges,,,,,,,,,171.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56,22,,percent of total billed charges,,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,183.68,82,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,56,212.8,
ALLERGEN  APRICOT,25203126,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  PISTACHIO,25203127,CDM,86003,CPT,300,RC,outpatient,,11,11,,9.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.75,22,,percent of total billed charges,,,,,,,,,9.9,90,,percent of total billed charges,,,9.11,82.8,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,,,,,,,,9.68,88,,percent of total billed charges,,,,,,,,,8.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.75,22,,percent of total billed charges,,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,,,,,,,,,,,,,9.13,83,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.02,82,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,2.75,10.45,
..ALLERGEN  ARA H1,25203128,CDM,86008,CPT,300,RC,outpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.25,22,,percent of total billed charges,,,,,,,,,62.1,90,,percent of total billed charges,,,57.13,82.8,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.25,22,,percent of total billed charges,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,17.25,65.55,
..ALLERGEN  ARA H2,25203129,CDM,86008,CPT,300,RC,outpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.25,22,,percent of total billed charges,,,,,,,,,62.1,90,,percent of total billed charges,,,57.13,82.8,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.25,22,,percent of total billed charges,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,17.25,65.55,
..ALLERGEN  ARA H4,25203130,CDM,86008,CPT,300,RC,outpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.25,22,,percent of total billed charges,,,,,,,,,62.1,90,,percent of total billed charges,,,57.13,82.8,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.25,22,,percent of total billed charges,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,17.25,65.55,
..ALLERGEN  ARA H8,25203131,CDM,86008,CPT,300,RC,outpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.25,22,,percent of total billed charges,,,,,,,,,62.1,90,,percent of total billed charges,,,57.13,82.8,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.25,22,,percent of total billed charges,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,17.25,65.55,
..ALLERGEN  ARA H9,25203132,CDM,86008,CPT,300,RC,outpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.25,22,,percent of total billed charges,,,,,,,,,62.1,90,,percent of total billed charges,,,57.13,82.8,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.25,22,,percent of total billed charges,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,17.25,65.55,
LEGIONELLA ANTIBODIES,25203133,CDM,86713,CPT,300,RC,outpatient,,230,230,,195.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.5,22,,percent of total billed charges,,,,,,,,,207,90,,percent of total billed charges,,,190.44,82.8,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,,,,,,,,202.4,88,,percent of total billed charges,,,,,,,,,175.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.5,22,,percent of total billed charges,,,209.3,91,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,,,,,,,,,,,,,190.9,83,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,188.6,82,,percent of total billed charges,,,207,90,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,57.5,218.5,
ALLERGEN  SCALLOP,25203136,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  SESAME SEED,25203137,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  SHRIMP,25203138,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  WALNUT,25203139,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
LIVER KIDNEY MICROSOMAL ANTIBODY,25203140,CDM,86376,CPT,300,RC,outpatient,,276,276,,234.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69,22,,percent of total billed charges,,,,,,,,,248.4,90,,percent of total billed charges,,,228.53,82.8,,percent of total billed charges,,,234.6,85,,percent of total billed charges,,,,,,,,,242.88,88,,percent of total billed charges,,,,,,,,,210.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69,22,,percent of total billed charges,,,251.16,91,,percent of total billed charges,,,262.2,95,,percent of total billed charges,,,229.08,83,,percent of total billed charges,,,229.08,83,,percent of total billed charges,,,,,,,,,,,,,,,229.08,83,,percent of total billed charges,,,262.2,95,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,226.32,82,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,234.6,85,,percent of total billed charges,,69,262.2,
ALLERGEN  CODFISH,25203141,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  CLAM,25203142,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
"HEPATITIS PANEL, ACUTE",25203143,CDM,80074,CPT,300,RC,outpatient,,713,713,,605.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.25,22,,percent of total billed charges,,,,,,,,,641.7,90,,percent of total billed charges,,,590.36,82.8,,percent of total billed charges,,,606.05,85,,percent of total billed charges,,,,,,,,,627.44,88,,percent of total billed charges,,,,,,,,,544.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.25,22,,percent of total billed charges,,,648.83,91,,percent of total billed charges,,,677.35,95,,percent of total billed charges,,,591.79,83,,percent of total billed charges,,,591.79,83,,percent of total billed charges,,,,,,,,,,,,,,,591.79,83,,percent of total billed charges,,,677.35,95,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,584.66,82,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,606.05,85,,percent of total billed charges,,178.25,677.35,
ALLERGEN  SWORDFISH,25203146,CDM,86003,CPT,300,RC,outpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.75,22,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,42.23,82.8,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.75,22,,percent of total billed charges,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,12.75,48.45,
ALLERGEN  CATFISH,25203147,CDM,86003,CPT,300,RC,outpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.75,22,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,42.23,82.8,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.75,22,,percent of total billed charges,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,12.75,48.45,
ALLERGEN  WHITEFISH,25203148,CDM,86003,CPT,300,RC,outpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.75,22,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,42.23,82.8,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.75,22,,percent of total billed charges,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,12.75,48.45,
LEM D-3,25203153,CDM,81479,CPT,300,RC,outpatient,,2100,2100,,1782.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,525,22,,percent of total billed charges,,,,,,,,,1890,90,,percent of total billed charges,,,1738.8,82.8,,percent of total billed charges,,,1785,85,,percent of total billed charges,,,,,,,,,1848,88,,percent of total billed charges,,,,,,,,,1604.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,525,22,,percent of total billed charges,,,1911,91,,percent of total billed charges,,,1995,95,,percent of total billed charges,,,1743,83,,percent of total billed charges,,,1743,83,,percent of total billed charges,,,,,,,,,,,,,,,1743,83,,percent of total billed charges,,,1995,95,,percent of total billed charges,,,1890,90,,percent of total billed charges,,,1890,90,,percent of total billed charges,,,1722,82,,percent of total billed charges,,,1890,90,,percent of total billed charges,,,1785,85,,percent of total billed charges,,525,1995,
BRBPS,25203154,CDM,87801,CPT,300,RC,outpatient,,840,840,,713.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210,22,,percent of total billed charges,,,,,,,,,756,90,,percent of total billed charges,,,695.52,82.8,,percent of total billed charges,,,714,85,,percent of total billed charges,,,,,,,,,739.2,88,,percent of total billed charges,,,,,,,,,641.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210,22,,percent of total billed charges,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,,,,,,,,,,,,,697.2,83,,percent of total billed charges,,,798,95,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,688.8,82,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,210,798,
ALLERGEN  CHEESE,25203155,CDM,86003,CPT,300,RC,outpatient,,37,37,,31.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.25,22,,percent of total billed charges,,,,,,,,,33.3,90,,percent of total billed charges,,,30.64,82.8,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,,,,,,,,32.56,88,,percent of total billed charges,,,,,,,,,28.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.25,22,,percent of total billed charges,,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,30.34,82,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,9.25,35.15,
HIV 1&2 QUALITATIVE,25203156,CDM,87535,CPT,300,RC,outpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
SURG PATH-ELECTRON MICROSCOPY,25203158,CDM,88348,CPT,310,RC,outpatient,,4667,4667,,3962.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1166.75,22,,percent of total billed charges,,,,,,,,,4200.3,90,,percent of total billed charges,,,3864.28,82.8,,percent of total billed charges,,,3966.95,85,,percent of total billed charges,,,,,,,,,4106.96,88,,percent of total billed charges,,,,,,,,,3565.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1166.75,22,,percent of total billed charges,,,4246.97,91,,percent of total billed charges,,,4433.65,95,,percent of total billed charges,,,3873.61,83,,percent of total billed charges,,,3873.61,83,,percent of total billed charges,,,,,,,,,,,,,,,3873.61,83,,percent of total billed charges,,,4433.65,95,,percent of total billed charges,,,4200.3,90,,percent of total billed charges,,,4200.3,90,,percent of total billed charges,,,3826.94,82,,percent of total billed charges,,,4200.3,90,,percent of total billed charges,,,3966.95,85,,percent of total billed charges,,1166.75,4433.65,
LH,25203166,CDM,83002,CPT,300,RC,outpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94,22,,percent of total billed charges,,,,,,,,,338.4,90,,percent of total billed charges,,,311.33,82.8,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94,22,,percent of total billed charges,,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,94,357.2,
LH PEDIATRICS,25203167,CDM,83002,CPT,300,RC,outpatient,,29,29,,24.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.25,22,,percent of total billed charges,,,,,,,,,26.1,90,,percent of total billed charges,,,24.01,82.8,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,,,,,,,,25.52,88,,percent of total billed charges,,,,,,,,,22.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.25,22,,percent of total billed charges,,,26.39,91,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,,,,,,,,,,,,,24.07,83,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,23.78,82,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,7.25,27.55,
CULTURE MYCOBACTERIA,25203182,CDM,87116,CPT,300,RC,outpatient,,201,201,,170.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.25,22,,percent of total billed charges,,,,,,,,,180.9,90,,percent of total billed charges,,,166.43,82.8,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,,,,,,,,176.88,88,,percent of total billed charges,,,,,,,,,153.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.25,22,,percent of total billed charges,,,182.91,91,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,,,,,,,,,,,,,166.83,83,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,164.82,82,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,50.25,190.95,
SPECIAL STAIN: GROUP I,25203190,CDM,88312,CPT,310,RC,outpatient,,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.5,22,,percent of total billed charges,,,,,,,,,275.4,90,,percent of total billed charges,,,253.37,82.8,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.5,22,,percent of total billed charges,,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,76.5,290.7,
PORPHYRINS PLASMA,25203207,CDM,82492,CPT,300,RC,outpatient,,617,617,,523.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154.25,22,,percent of total billed charges,,,,,,,,,555.3,90,,percent of total billed charges,,,510.88,82.8,,percent of total billed charges,,,524.45,85,,percent of total billed charges,,,,,,,,,542.96,88,,percent of total billed charges,,,,,,,,,471.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154.25,22,,percent of total billed charges,,,561.47,91,,percent of total billed charges,,,586.15,95,,percent of total billed charges,,,512.11,83,,percent of total billed charges,,,512.11,83,,percent of total billed charges,,,,,,,,,,,,,,,512.11,83,,percent of total billed charges,,,586.15,95,,percent of total billed charges,,,555.3,90,,percent of total billed charges,,,555.3,90,,percent of total billed charges,,,505.94,82,,percent of total billed charges,,,555.3,90,,percent of total billed charges,,,524.45,85,,percent of total billed charges,,154.25,586.15,
PORPHYRINS URINE (24-HOUR),25203208,CDM,84120,CPT,300,RC,outpatient,,252,252,,213.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63,22,,percent of total billed charges,,,,,,,,,226.8,90,,percent of total billed charges,,,208.66,82.8,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,,,,,,,,221.76,88,,percent of total billed charges,,,,,,,,,192.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63,22,,percent of total billed charges,,,229.32,91,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,,,,,,,,,,,,,209.16,83,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,206.64,82,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,63,239.4,
PORPHOBILINOGEN URINE (RANDOM),25203209,CDM,84110,CPT,300,RC,outpatient,,23,23,,19.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.75,22,,percent of total billed charges,,,,,,,,,20.7,90,,percent of total billed charges,,,19.04,82.8,,percent of total billed charges,,,19.55,85,,percent of total billed charges,,,,,,,,,20.24,88,,percent of total billed charges,,,,,,,,,17.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.75,22,,percent of total billed charges,,,20.93,91,,percent of total billed charges,,,21.85,95,,percent of total billed charges,,,19.09,83,,percent of total billed charges,,,19.09,83,,percent of total billed charges,,,,,,,,,,,,,,,19.09,83,,percent of total billed charges,,,21.85,95,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,18.86,82,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,19.55,85,,percent of total billed charges,,5.75,21.85,
PROTEIN ELECTRO W/ INTERP (SERUM),25203215,CDM,84165,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
PROTEIN ELECTRO SERUM,25203216,CDM,84165,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
PROSTAGLANDIN F2A,25203218,CDM,84150,CPT,300,RC,outpatient,,434,434,,368.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.5,22,,percent of total billed charges,,,,,,,,,390.6,90,,percent of total billed charges,,,359.35,82.8,,percent of total billed charges,,,368.9,85,,percent of total billed charges,,,,,,,,,381.92,88,,percent of total billed charges,,,,,,,,,331.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108.5,22,,percent of total billed charges,,,394.94,91,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,,,,,,,,,,,,,360.22,83,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,355.88,82,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,368.9,85,,percent of total billed charges,,108.5,412.3,
SPECIAL STAIN: GROUP II,25203224,CDM,88313,CPT,310,RC,outpatient,,315,315,,267.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.75,22,,percent of total billed charges,,,,,,,,,283.5,90,,percent of total billed charges,,,260.82,82.8,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,,,,,,,,277.2,88,,percent of total billed charges,,,,,,,,,240.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.75,22,,percent of total billed charges,,,286.65,91,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,,,,,,,,,,,,,261.45,83,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,258.3,82,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,78.75,299.25,
PROTEIN ELECTROPH RFLEX IFE (RND URINE ),25203230,CDM,84166,CPT,300,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
PROTEIN ELECTRO 24 HOUR URINE,25203232,CDM,84166,CPT,300,RC,outpatient,,189,189,,160.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.25,22,,percent of total billed charges,,,,,,,,,170.1,90,,percent of total billed charges,,,156.49,82.8,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,,,,,,,,166.32,88,,percent of total billed charges,,,,,,,,,144.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.25,22,,percent of total billed charges,,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,,,,,,,,,,,,,156.87,83,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,154.98,82,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,47.25,179.55,
PROTEIN ELECTRO (URINE RANDOM),25203233,CDM,84166,CPT,300,RC,outpatient,,320,320,,271.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80,22,,percent of total billed charges,,,,,,,,,288,90,,percent of total billed charges,,,264.96,82.8,,percent of total billed charges,,,272,85,,percent of total billed charges,,,,,,,,,281.6,88,,percent of total billed charges,,,,,,,,,244.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80,22,,percent of total billed charges,,,291.2,91,,percent of total billed charges,,,304,95,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,,,,,,,,,,,,,265.6,83,,percent of total billed charges,,,304,95,,percent of total billed charges,,,288,90,,percent of total billed charges,,,288,90,,percent of total billed charges,,,262.4,82,,percent of total billed charges,,,288,90,,percent of total billed charges,,,272,85,,percent of total billed charges,,80,304,
CLONIDINE URINE,25203234,CDM,80375,CPT,300,RC,outpatient,,320.06,320.06,,271.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.02,22,,percent of total billed charges,,,,,,,,,288.05,90,,percent of total billed charges,,,265.01,82.8,,percent of total billed charges,,,272.05,85,,percent of total billed charges,,,,,,,,,281.65,88,,percent of total billed charges,,,,,,,,,244.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.02,22,,percent of total billed charges,,,291.25,91,,percent of total billed charges,,,304.06,95,,percent of total billed charges,,,265.65,83,,percent of total billed charges,,,265.65,83,,percent of total billed charges,,,,,,,,,,,,,,,265.65,83,,percent of total billed charges,,,304.06,95,,percent of total billed charges,,,288.05,90,,percent of total billed charges,,,288.05,90,,percent of total billed charges,,,262.45,82,,percent of total billed charges,,,288.05,90,,percent of total billed charges,,,272.05,85,,percent of total billed charges,,80.02,304.06,
ROCKY MT SPOTTED FEVER AB IGG,25203240,CDM,86757,CPT,300,RC,outpatient,,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93,22,,percent of total billed charges,,,,,,,,,334.8,90,,percent of total billed charges,,,308.02,82.8,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93,22,,percent of total billed charges,,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,93,353.4,
ROMA (OVARIAN MALIGNANCY),25203241,CDM,81500,CPT,300,RC,outpatient,,909,909,,771.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.25,22,,percent of total billed charges,,,,,,,,,818.1,90,,percent of total billed charges,,,752.65,82.8,,percent of total billed charges,,,772.65,85,,percent of total billed charges,,,,,,,,,799.92,88,,percent of total billed charges,,,,,,,,,694.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.25,22,,percent of total billed charges,,,827.19,91,,percent of total billed charges,,,863.55,95,,percent of total billed charges,,,754.47,83,,percent of total billed charges,,,754.47,83,,percent of total billed charges,,,,,,,,,,,,,,,754.47,83,,percent of total billed charges,,,863.55,95,,percent of total billed charges,,,818.1,90,,percent of total billed charges,,,818.1,90,,percent of total billed charges,,,745.38,82,,percent of total billed charges,,,818.1,90,,percent of total billed charges,,,772.65,85,,percent of total billed charges,,227.25,863.55,
ROCKY MT SPOTTED FEVER AB IGM,25203242,CDM,86757,CPT,300,RC,outpatient,,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93,22,,percent of total billed charges,,,,,,,,,334.8,90,,percent of total billed charges,,,308.02,82.8,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93,22,,percent of total billed charges,,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,93,353.4,
IMMUNOCYTOCHEMISTRY (INITIAL STAIN),25203257,CDM,88342,CPT,310,RC,outpatient,TC,498,498,,422.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.5,22,,percent of total billed charges,,,,,,,,,448.2,90,,percent of total billed charges,,,412.34,82.8,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,,,,,,,,438.24,88,,percent of total billed charges,,,,,,,,,380.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.5,22,,percent of total billed charges,,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,,,,,,,,,,,,,413.34,83,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,408.36,82,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,124.5,473.1,
IMMUNOCYTOCHEMISTRY (ADDITIONAL STAIN),25203258,CDM,88341,CPT,310,RC,outpatient,TC,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.75,22,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,121.72,82.8,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.75,22,,percent of total billed charges,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,36.75,139.65,
MULTIPLEX AB STAIN,25203259,CDM,88344,CPT,310,RC,outpatient,TC,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.75,22,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,121.72,82.8,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.75,22,,percent of total billed charges,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,36.75,139.65,
TOUCH PREP CYTO EXAM,25203260,CDM,88333,CPT,310,RC,outpatient,,850,850,,721.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,212.5,22,,percent of total billed charges,,,,,,,,,765,90,,percent of total billed charges,,,703.8,82.8,,percent of total billed charges,,,722.5,85,,percent of total billed charges,,,,,,,,,748,88,,percent of total billed charges,,,,,,,,,649.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,212.5,22,,percent of total billed charges,,,773.5,91,,percent of total billed charges,,,807.5,95,,percent of total billed charges,,,705.5,83,,percent of total billed charges,,,705.5,83,,percent of total billed charges,,,,,,,,,,,,,,,705.5,83,,percent of total billed charges,,,807.5,95,,percent of total billed charges,,,765,90,,percent of total billed charges,,,765,90,,percent of total billed charges,,,697,82,,percent of total billed charges,,,765,90,,percent of total billed charges,,,722.5,85,,percent of total billed charges,,212.5,807.5,
SURG PATH-IMMUNOFLUORESCENT STUDY,25203265,CDM,88346,CPT,310,RC,outpatient,,1557,1557,,1321.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,389.25,22,,percent of total billed charges,,,,,,,,,1401.3,90,,percent of total billed charges,,,1289.2,82.8,,percent of total billed charges,,,1323.45,85,,percent of total billed charges,,,,,,,,,1370.16,88,,percent of total billed charges,,,,,,,,,1189.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,389.25,22,,percent of total billed charges,,,1416.87,91,,percent of total billed charges,,,1479.15,95,,percent of total billed charges,,,1292.31,83,,percent of total billed charges,,,1292.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1292.31,83,,percent of total billed charges,,,1479.15,95,,percent of total billed charges,,,1401.3,90,,percent of total billed charges,,,1401.3,90,,percent of total billed charges,,,1276.74,82,,percent of total billed charges,,,1401.3,90,,percent of total billed charges,,,1323.45,85,,percent of total billed charges,,389.25,1479.15,
SURG PATH-CONSULT W/RECORDS,25203280,CDM,88325,CPT,310,RC,outpatient,,530,530,,449.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.5,22,,percent of total billed charges,,,,,,,,,477,90,,percent of total billed charges,,,438.84,82.8,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,,,,,,,,466.4,88,,percent of total billed charges,,,,,,,,,404.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.5,22,,percent of total billed charges,,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,,,,,,,,,,,,,439.9,83,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,434.6,82,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,132.5,503.5,
SURG PATH-CONSULTATION,25203281,CDM,88323,CPT,310,RC,outpatient,,927,927,,787.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,231.75,22,,percent of total billed charges,,,,,,,,,834.3,90,,percent of total billed charges,,,767.56,82.8,,percent of total billed charges,,,787.95,85,,percent of total billed charges,,,,,,,,,815.76,88,,percent of total billed charges,,,,,,,,,708.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,231.75,22,,percent of total billed charges,,,843.57,91,,percent of total billed charges,,,880.65,95,,percent of total billed charges,,,769.41,83,,percent of total billed charges,,,769.41,83,,percent of total billed charges,,,,,,,,,,,,,,,769.41,83,,percent of total billed charges,,,880.65,95,,percent of total billed charges,,,834.3,90,,percent of total billed charges,,,834.3,90,,percent of total billed charges,,,760.14,82,,percent of total billed charges,,,834.3,90,,percent of total billed charges,,,787.95,85,,percent of total billed charges,,231.75,880.65,
NUCLEIC ACID MUTATION ID BY SEQUENCING,25203299,CDM,83904,CPT,300,RC,outpatient,,340,340,,288.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85,22,,percent of total billed charges,,,,,,,,,306,90,,percent of total billed charges,,,281.52,82.8,,percent of total billed charges,,,289,85,,percent of total billed charges,,,,,,,,,299.2,88,,percent of total billed charges,,,,,,,,,259.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85,22,,percent of total billed charges,,,309.4,91,,percent of total billed charges,,,323,95,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,,,,,,,,,,,,,282.2,83,,percent of total billed charges,,,323,95,,percent of total billed charges,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,278.8,82,,percent of total billed charges,,,306,90,,percent of total billed charges,,,289,85,,percent of total billed charges,,85,323,
NIACIN LEVEL,25203331,CDM,84591,CPT,300,RC,outpatient,,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.5,22,,percent of total billed charges,,,,,,,,,275.4,90,,percent of total billed charges,,,253.37,82.8,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.5,22,,percent of total billed charges,,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,76.5,290.7,
...NICOTINE SCREEN,25203340,CDM,83887,CPT,300,RC,outpatient,,370,370,,314.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.5,22,,percent of total billed charges,,,,,,,,,333,90,,percent of total billed charges,,,306.36,82.8,,percent of total billed charges,,,314.5,85,,percent of total billed charges,,,,,,,,,325.6,88,,percent of total billed charges,,,,,,,,,282.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.5,22,,percent of total billed charges,,,336.7,91,,percent of total billed charges,,,351.5,95,,percent of total billed charges,,,307.1,83,,percent of total billed charges,,,307.1,83,,percent of total billed charges,,,,,,,,,,,,,,,307.1,83,,percent of total billed charges,,,351.5,95,,percent of total billed charges,,,333,90,,percent of total billed charges,,,333,90,,percent of total billed charges,,,303.4,82,,percent of total billed charges,,,333,90,,percent of total billed charges,,,314.5,85,,percent of total billed charges,,92.5,351.5,
DNA GENE MUTATION MYBPC3,25203354,CDM,81403,CPT,300,RC,outpatient,,491,491,,416.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.75,22,,percent of total billed charges,,,,,,,,,441.9,90,,percent of total billed charges,,,406.55,82.8,,percent of total billed charges,,,417.35,85,,percent of total billed charges,,,,,,,,,432.08,88,,percent of total billed charges,,,,,,,,,375.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.75,22,,percent of total billed charges,,,446.81,91,,percent of total billed charges,,,466.45,95,,percent of total billed charges,,,407.53,83,,percent of total billed charges,,,407.53,83,,percent of total billed charges,,,,,,,,,,,,,,,407.53,83,,percent of total billed charges,,,466.45,95,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,402.62,82,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,417.35,85,,percent of total billed charges,,122.75,466.45,
ANGELMAN PRADER-WILLI DNA,25203355,CDM,81331,CPT,300,RC,outpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.25,22,,percent of total billed charges,,,,,,,,,414.9,90,,percent of total billed charges,,,381.71,82.8,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.25,22,,percent of total billed charges,,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,115.25,437.95,
SACCHAROMYCES CEREVISIAE AB IgA,25203358,CDM,86671,CPT,300,RC,outpatient,,302,302,,256.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.5,22,,percent of total billed charges,,,,,,,,,271.8,90,,percent of total billed charges,,,250.06,82.8,,percent of total billed charges,,,256.7,85,,percent of total billed charges,,,,,,,,,265.76,88,,percent of total billed charges,,,,,,,,,230.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.5,22,,percent of total billed charges,,,274.82,91,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,,,,,,,,,,,,,250.66,83,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,247.64,82,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,256.7,85,,percent of total billed charges,,75.5,286.9,
SACCHAROMYCES CEREVISIAE AB IgG,25203359,CDM,86671,CPT,300,RC,outpatient,,302,302,,256.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.5,22,,percent of total billed charges,,,,,,,,,271.8,90,,percent of total billed charges,,,250.06,82.8,,percent of total billed charges,,,256.7,85,,percent of total billed charges,,,,,,,,,265.76,88,,percent of total billed charges,,,,,,,,,230.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.5,22,,percent of total billed charges,,,274.82,91,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,,,,,,,,,,,,,250.66,83,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,247.64,82,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,256.7,85,,percent of total billed charges,,75.5,286.9,
WARFARIN SERUM,25203360,CDM,86021,CPT,300,RC,outpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.75,22,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,42.23,82.8,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.75,22,,percent of total billed charges,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,12.75,48.45,
..TRISOMY21/MONOSOMY X,25203361,CDM,81420,CPT,300,RC,outpatient,,984,984,,835.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,246,22,,percent of total billed charges,,,,,,,,,885.6,90,,percent of total billed charges,,,814.75,82.8,,percent of total billed charges,,,836.4,85,,percent of total billed charges,,,,,,,,,865.92,88,,percent of total billed charges,,,,,,,,,751.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,246,22,,percent of total billed charges,,,895.44,91,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,,,,,,,,,,,,,816.72,83,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,806.88,82,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,836.4,85,,percent of total billed charges,,246,934.8,
..FETAL CHROMOSOMAL MICRODELETION,25203362,CDM,81422,CPT,300,RC,outpatient,,984,984,,835.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,246,22,,percent of total billed charges,,,,,,,,,885.6,90,,percent of total billed charges,,,814.75,82.8,,percent of total billed charges,,,836.4,85,,percent of total billed charges,,,,,,,,,865.92,88,,percent of total billed charges,,,,,,,,,751.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,246,22,,percent of total billed charges,,,895.44,91,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,,,,,,,,,,,,,816.72,83,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,806.88,82,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,836.4,85,,percent of total billed charges,,246,934.8,
..MOLECULAR PATH UNLISTED,25203363,CDM,81479,CPT,300,RC,outpatient,,984,984,,835.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,246,22,,percent of total billed charges,,,,,,,,,885.6,90,,percent of total billed charges,,,814.75,82.8,,percent of total billed charges,,,836.4,85,,percent of total billed charges,,,,,,,,,865.92,88,,percent of total billed charges,,,,,,,,,751.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,246,22,,percent of total billed charges,,,895.44,91,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,,,,,,,,,,,,,816.72,83,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,806.88,82,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,836.4,85,,percent of total billed charges,,246,934.8,
HERPES SIM 1 IGG AB,25203364,CDM,86695,CPT,300,RC,outpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.75,22,,percent of total billed charges,,,,,,,,,143.1,90,,percent of total billed charges,,,131.65,82.8,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.75,22,,percent of total billed charges,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,39.75,151.05,
MATERNIT21 PLUS CORE W/ GENDER,25203366,CDM,81420,CPT,300,RC,outpatient,,1136,1136,,964.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284,22,,percent of total billed charges,,,,,,,,,1022.4,90,,percent of total billed charges,,,940.61,82.8,,percent of total billed charges,,,965.6,85,,percent of total billed charges,,,,,,,,,999.68,88,,percent of total billed charges,,,,,,,,,867.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284,22,,percent of total billed charges,,,1033.76,91,,percent of total billed charges,,,1079.2,95,,percent of total billed charges,,,942.88,83,,percent of total billed charges,,,942.88,83,,percent of total billed charges,,,,,,,,,,,,,,,942.88,83,,percent of total billed charges,,,1079.2,95,,percent of total billed charges,,,1022.4,90,,percent of total billed charges,,,1022.4,90,,percent of total billed charges,,,931.52,82,,percent of total billed charges,,,1022.4,90,,percent of total billed charges,,,965.6,85,,percent of total billed charges,,284,1079.2,
.HERPES SIM  2(LAVAGE),25203368,CDM,87530,CPT,300,RC,outpatient,,281,281,,238.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.25,22,,percent of total billed charges,,,,,,,,,252.9,90,,percent of total billed charges,,,232.67,82.8,,percent of total billed charges,,,238.85,85,,percent of total billed charges,,,,,,,,,247.28,88,,percent of total billed charges,,,,,,,,,214.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70.25,22,,percent of total billed charges,,,255.71,91,,percent of total billed charges,,,266.95,95,,percent of total billed charges,,,233.23,83,,percent of total billed charges,,,233.23,83,,percent of total billed charges,,,,,,,,,,,,,,,233.23,83,,percent of total billed charges,,,266.95,95,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,230.42,82,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,238.85,85,,percent of total billed charges,,70.25,266.95,
.HERPES SIM 1 (LAVAGE),25203369,CDM,87530,CPT,300,RC,outpatient,,281,281,,238.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.25,22,,percent of total billed charges,,,,,,,,,252.9,90,,percent of total billed charges,,,232.67,82.8,,percent of total billed charges,,,238.85,85,,percent of total billed charges,,,,,,,,,247.28,88,,percent of total billed charges,,,,,,,,,214.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70.25,22,,percent of total billed charges,,,255.71,91,,percent of total billed charges,,,266.95,95,,percent of total billed charges,,,233.23,83,,percent of total billed charges,,,233.23,83,,percent of total billed charges,,,,,,,,,,,,,,,233.23,83,,percent of total billed charges,,,266.95,95,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,230.42,82,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,238.85,85,,percent of total billed charges,,70.25,266.95,
FBN1 MARFAN SYNDROME,25203370,CDM,81408,CPT,300,RC,outpatient,,3400,3400,,2886.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,850,22,,percent of total billed charges,,,,,,,,,3060,90,,percent of total billed charges,,,2815.2,82.8,,percent of total billed charges,,,2890,85,,percent of total billed charges,,,,,,,,,2992,88,,percent of total billed charges,,,,,,,,,2597.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,850,22,,percent of total billed charges,,,3094,91,,percent of total billed charges,,,3230,95,,percent of total billed charges,,,2822,83,,percent of total billed charges,,,2822,83,,percent of total billed charges,,,,,,,,,,,,,,,2822,83,,percent of total billed charges,,,3230,95,,percent of total billed charges,,,3060,90,,percent of total billed charges,,,3060,90,,percent of total billed charges,,,2788,82,,percent of total billed charges,,,3060,90,,percent of total billed charges,,,2890,85,,percent of total billed charges,,850,3230,
H. PYLORI ANTIBODIES (IGA),25203371,CDM,86677,CPT,300,RC,outpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.25,22,,percent of total billed charges,,,,,,,,,195.3,90,,percent of total billed charges,,,179.68,82.8,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.25,22,,percent of total billed charges,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,54.25,206.15,
"H. PYLORI ANTIBODIES (IGA,IGM,IGG)",25203372,CDM,86677,CPT,300,RC,outpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.25,22,,percent of total billed charges,,,,,,,,,195.3,90,,percent of total billed charges,,,179.68,82.8,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.25,22,,percent of total billed charges,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,54.25,206.15,
H. PYLORI ANTIBODIES (IGM),25203373,CDM,86677,CPT,300,RC,outpatient,,217,217,,184.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.25,22,,percent of total billed charges,,,,,,,,,195.3,90,,percent of total billed charges,,,179.68,82.8,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,,,,,,,,190.96,88,,percent of total billed charges,,,,,,,,,165.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.25,22,,percent of total billed charges,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,177.94,82,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,54.25,206.15,
H. PYLORI BREATH TEST,25203374,CDM,83013,CPT,300,RC,outpatient,,713,713,,605.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.25,22,,percent of total billed charges,,,,,,,,,641.7,90,,percent of total billed charges,,,590.36,82.8,,percent of total billed charges,,,606.05,85,,percent of total billed charges,,,,,,,,,627.44,88,,percent of total billed charges,,,,,,,,,544.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.25,22,,percent of total billed charges,,,648.83,91,,percent of total billed charges,,,677.35,95,,percent of total billed charges,,,591.79,83,,percent of total billed charges,,,591.79,83,,percent of total billed charges,,,,,,,,,,,,,,,591.79,83,,percent of total billed charges,,,677.35,95,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,584.66,82,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,606.05,85,,percent of total billed charges,,178.25,677.35,
MATERNIT21 PLUS CORE NO GENDER,25203375,CDM,81420,CPT,300,RC,outpatient,,1136,1136,,964.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284,22,,percent of total billed charges,,,,,,,,,1022.4,90,,percent of total billed charges,,,940.61,82.8,,percent of total billed charges,,,965.6,85,,percent of total billed charges,,,,,,,,,999.68,88,,percent of total billed charges,,,,,,,,,867.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284,22,,percent of total billed charges,,,1033.76,91,,percent of total billed charges,,,1079.2,95,,percent of total billed charges,,,942.88,83,,percent of total billed charges,,,942.88,83,,percent of total billed charges,,,,,,,,,,,,,,,942.88,83,,percent of total billed charges,,,1079.2,95,,percent of total billed charges,,,1022.4,90,,percent of total billed charges,,,1022.4,90,,percent of total billed charges,,,931.52,82,,percent of total billed charges,,,1022.4,90,,percent of total billed charges,,,965.6,85,,percent of total billed charges,,284,1079.2,
SM and SM/RNP ANTIBODIES,25203380,CDM,86235,CPT,300,RC,outpatient,,319,319,,270.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.75,22,,percent of total billed charges,,,,,,,,,287.1,90,,percent of total billed charges,,,264.13,82.8,,percent of total billed charges,,,271.15,85,,percent of total billed charges,,,,,,,,,280.72,88,,percent of total billed charges,,,,,,,,,243.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.75,22,,percent of total billed charges,,,290.29,91,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,,,,,,,,,,,,,264.77,83,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,261.58,82,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,271.15,85,,percent of total billed charges,,79.75,303.05,
SMITH ANTIBODIES,25203381,CDM,86235,CPT,300,RC,outpatient,,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38,22,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,125.86,82.8,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38,22,,percent of total billed charges,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,38,144.4,
RNP AB & SMITH ANTIBODIES,25203382,CDM,86235,CPT,300,RC,outpatient,,37,37,,31.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.25,22,,percent of total billed charges,,,,,,,,,33.3,90,,percent of total billed charges,,,30.64,82.8,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,,,,,,,,32.56,88,,percent of total billed charges,,,,,,,,,28.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.25,22,,percent of total billed charges,,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,30.34,82,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,9.25,35.15,
MPO AB,25203384,CDM,83516,CPT,300,RC,outpatient,,37,37,,31.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.25,22,,percent of total billed charges,,,,,,,,,33.3,90,,percent of total billed charges,,,30.64,82.8,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,,,,,,,,32.56,88,,percent of total billed charges,,,,,,,,,28.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.25,22,,percent of total billed charges,,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,30.34,82,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,9.25,35.15,
PR3 AB,25203385,CDM,83516,CPT,300,RC,outpatient,,37,37,,31.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.25,22,,percent of total billed charges,,,,,,,,,33.3,90,,percent of total billed charges,,,30.64,82.8,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,,,,,,,,32.56,88,,percent of total billed charges,,,,,,,,,28.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.25,22,,percent of total billed charges,,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,30.34,82,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,9.25,35.15,
BASEMENT MEMBRANE AB,25203386,CDM,83516,CPT,300,RC,outpatient,,63,63,,53.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.75,22,,percent of total billed charges,,,,,,,,,56.7,90,,percent of total billed charges,,,52.16,82.8,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,,,,,,,,55.44,88,,percent of total billed charges,,,,,,,,,48.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.75,22,,percent of total billed charges,,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,,,,,,,,,,,,,52.29,83,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,51.66,82,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,15.75,59.85,
RNP AB,25203387,CDM,86235,CPT,300,RC,outpatient,,37,37,,31.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.25,22,,percent of total billed charges,,,,,,,,,33.3,90,,percent of total billed charges,,,30.64,82.8,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,,,,,,,,32.56,88,,percent of total billed charges,,,,,,,,,28.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.25,22,,percent of total billed charges,,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,30.34,82,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,9.25,35.15,
FACTOR X,25203398,CDM,85260,CPT,300,RC,outpatient,,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.25,22,,percent of total billed charges,,,,,,,,,260.1,90,,percent of total billed charges,,,239.29,82.8,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.25,22,,percent of total billed charges,,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,72.25,274.55,
FACTOR VII,25203405,CDM,85230,CPT,300,RC,outpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36,22,,percent of total billed charges,,,,,,,,,129.6,90,,percent of total billed charges,,,119.23,82.8,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36,22,,percent of total billed charges,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,36,136.8,
FACTOR VIII,25203406,CDM,85240,CPT,300,RC,outpatient,,352,352,,298.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88,22,,percent of total billed charges,,,,,,,,,316.8,90,,percent of total billed charges,,,291.46,82.8,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,,,,,,,,309.76,88,,percent of total billed charges,,,,,,,,,268.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88,22,,percent of total billed charges,,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,,,,,,,,,,,,,292.16,83,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,288.64,82,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,88,334.4,
FACTOR II,25203407,CDM,85210,CPT,300,RC,outpatient,,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.25,22,,percent of total billed charges,,,,,,,,,260.1,90,,percent of total billed charges,,,239.29,82.8,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.25,22,,percent of total billed charges,,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,72.25,274.55,
FACTOR IX,25203408,CDM,85250,CPT,300,RC,outpatient,,286,286,,242.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.5,22,,percent of total billed charges,,,,,,,,,257.4,90,,percent of total billed charges,,,236.81,82.8,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,,,,,,,,251.68,88,,percent of total billed charges,,,,,,,,,218.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.5,22,,percent of total billed charges,,,260.26,91,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,,,,,,,,,,,,,237.38,83,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,234.52,82,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,71.5,271.7,
FACTOR XI,25203409,CDM,85270,CPT,300,RC,outpatient,,267,267,,226.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.75,22,,percent of total billed charges,,,,,,,,,240.3,90,,percent of total billed charges,,,221.08,82.8,,percent of total billed charges,,,226.95,85,,percent of total billed charges,,,,,,,,,234.96,88,,percent of total billed charges,,,,,,,,,203.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.75,22,,percent of total billed charges,,,242.97,91,,percent of total billed charges,,,253.65,95,,percent of total billed charges,,,221.61,83,,percent of total billed charges,,,221.61,83,,percent of total billed charges,,,,,,,,,,,,,,,221.61,83,,percent of total billed charges,,,253.65,95,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,218.94,82,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,226.95,85,,percent of total billed charges,,66.75,253.65,
FACTOR XII,25203410,CDM,85280,CPT,300,RC,outpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.5,22,,percent of total billed charges,,,,,,,,,91.8,90,,percent of total billed charges,,,84.46,82.8,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.5,22,,percent of total billed charges,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,25.5,96.9,
FACTOR II DNA ANALYSIS,25203411,CDM,81240,CPT,300,RC,outpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.75,22,,percent of total billed charges,,,,,,,,,182.7,90,,percent of total billed charges,,,168.08,82.8,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.75,22,,percent of total billed charges,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,50.75,192.85,
FACTOR V,25203414,CDM,85220,CPT,300,RC,outpatient,,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.25,22,,percent of total billed charges,,,,,,,,,260.1,90,,percent of total billed charges,,,239.29,82.8,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.25,22,,percent of total billed charges,,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,72.25,274.55,
HYDROXYPROGESTERONE 17-ALPHA,25203422,CDM,83498,CPT,300,RC,outpatient,,407,407,,345.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.75,22,,percent of total billed charges,,,,,,,,,366.3,90,,percent of total billed charges,,,337,82.8,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,,,,,,,,358.16,88,,percent of total billed charges,,,,,,,,,310.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.75,22,,percent of total billed charges,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,,,,,,,,,,,,,337.81,83,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,333.74,82,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,101.75,386.65,
17 HYDROXYPREGNENOLONE,25203423,CDM,84143,CPT,300,RC,outpatient,,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.5,22,,percent of total billed charges,,,,,,,,,214.2,90,,percent of total billed charges,,,197.06,82.8,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.5,22,,percent of total billed charges,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,59.5,226.1,
17 HYDROXYPROGESTERONE,25203424,CDM,83498,CPT,300,RC,outpatient,,407,407,,345.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.75,22,,percent of total billed charges,,,,,,,,,366.3,90,,percent of total billed charges,,,337,82.8,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,,,,,,,,358.16,88,,percent of total billed charges,,,,,,,,,310.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.75,22,,percent of total billed charges,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,,,,,,,,,,,,,337.81,83,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,333.74,82,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,101.75,386.65,
17 HYDROXYPROGESTERONE URINE,25203425,CDM,83498,CPT,300,RC,outpatient,,530,530,,449.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.5,22,,percent of total billed charges,,,,,,,,,477,90,,percent of total billed charges,,,438.84,82.8,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,,,,,,,,466.4,88,,percent of total billed charges,,,,,,,,,404.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.5,22,,percent of total billed charges,,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,,,,,,,,,,,,,439.9,83,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,434.6,82,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,132.5,503.5,
HEPATITIS C ANTIBODY,25203430,CDM,86803,CPT,300,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
HEPATITIS C  AB W/ REFLEX TO QNT,25203432,CDM,86803,CPT,300,RC,outpatient,,280,280,,237.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70,22,,percent of total billed charges,,,,,,,,,252,90,,percent of total billed charges,,,231.84,82.8,,percent of total billed charges,,,238,85,,percent of total billed charges,,,,,,,,,246.4,88,,percent of total billed charges,,,,,,,,,213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70,22,,percent of total billed charges,,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,,,,,,,,,,,,,232.4,83,,percent of total billed charges,,,266,95,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,229.6,82,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,70,266,
HEPATITIS C AB HIGH RISK/OTHER,25203433,CDM,G0472,HCPCS,300,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,16.85,,,,fee schedule,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,16.85,,,,fee schedule,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,16.85,245.1,
VITAMIN A,25203596,CDM,84590,CPT,300,RC,outpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.25,22,,percent of total billed charges,,,,,,,,,188.1,90,,percent of total billed charges,,,173.05,82.8,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.25,22,,percent of total billed charges,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,52.25,198.55,
VITAMIN K PLASMA,25203598,CDM,84597,CPT,300,RC,outpatient,,254,254,,215.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.5,22,,percent of total billed charges,,,,,,,,,228.6,90,,percent of total billed charges,,,210.31,82.8,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,,,,,,,,223.52,88,,percent of total billed charges,,,,,,,,,194.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.5,22,,percent of total billed charges,,,231.14,91,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,,,,,,,,,,,,,210.82,83,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,208.28,82,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,63.5,241.3,
VITAMIN E (TOCOPHEROL),25203604,CDM,84446,CPT,300,RC,outpatient,,255,255,,216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.75,22,,percent of total billed charges,,,,,,,,,229.5,90,,percent of total billed charges,,,211.14,82.8,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,,,,,,,,224.4,88,,percent of total billed charges,,,,,,,,,194.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.75,22,,percent of total billed charges,,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,209.1,82,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,63.75,242.25,
IMMUNOFIXATION SERUM(INC SPE),25203611,CDM,86334,CPT,300,RC,outpatient,,403,403,,342.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100.75,22,,percent of total billed charges,,,,,,,,,362.7,90,,percent of total billed charges,,,333.68,82.8,,percent of total billed charges,,,342.55,85,,percent of total billed charges,,,,,,,,,354.64,88,,percent of total billed charges,,,,,,,,,307.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100.75,22,,percent of total billed charges,,,366.73,91,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,,,,,,,,,,,,,334.49,83,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,330.46,82,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,342.55,85,,percent of total billed charges,,100.75,382.85,
IFE AND PE CSF,25203612,CDM,86335,CPT,300,RC,outpatient,,358,358,,303.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.5,22,,percent of total billed charges,,,,,,,,,322.2,90,,percent of total billed charges,,,296.42,82.8,,percent of total billed charges,,,304.3,85,,percent of total billed charges,,,,,,,,,315.04,88,,percent of total billed charges,,,,,,,,,273.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.5,22,,percent of total billed charges,,,325.78,91,,percent of total billed charges,,,340.1,95,,percent of total billed charges,,,297.14,83,,percent of total billed charges,,,297.14,83,,percent of total billed charges,,,,,,,,,,,,,,,297.14,83,,percent of total billed charges,,,340.1,95,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,293.56,82,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,304.3,85,,percent of total billed charges,,89.5,340.1,
IMMUNOFIXATION URINE (RANDOM /24-HOUR),25203613,CDM,86335,CPT,300,RC,outpatient,,530,530,,449.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.5,22,,percent of total billed charges,,,,,,,,,477,90,,percent of total billed charges,,,438.84,82.8,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,,,,,,,,466.4,88,,percent of total billed charges,,,,,,,,,404.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.5,22,,percent of total billed charges,,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,,,,,,,,,,,,,439.9,83,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,434.6,82,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,132.5,503.5,
FREE & LIGHT CHAINS URINE (RANDOM),25203614,CDM,86335,CPT,300,RC,outpatient,,530,530,,449.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.5,22,,percent of total billed charges,,,,,,,,,477,90,,percent of total billed charges,,,438.84,82.8,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,,,,,,,,466.4,88,,percent of total billed charges,,,,,,,,,404.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.5,22,,percent of total billed charges,,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,,,,,,,,,,,,,439.9,83,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,434.6,82,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,132.5,503.5,
KAPPA/LAMBDA LIGHT CHAINS SERUM,25203615,CDM,83883,CPT,300,RC,outpatient,,437,437,,371.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.25,22,,percent of total billed charges,,,,,,,,,393.3,90,,percent of total billed charges,,,361.84,82.8,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,,,,,,,,384.56,88,,percent of total billed charges,,,,,,,,,333.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.25,22,,percent of total billed charges,,,397.67,91,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,,,,,,,,,,,,,362.71,83,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,358.34,82,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,109.25,415.15,
..KAPPA/LAMBDA LIGHT CHAINS SERUM,25203616,CDM,83883,CPT,300,RC,outpatient,,437,437,,371.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.25,22,,percent of total billed charges,,,,,,,,,393.3,90,,percent of total billed charges,,,361.84,82.8,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,,,,,,,,384.56,88,,percent of total billed charges,,,,,,,,,333.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.25,22,,percent of total billed charges,,,397.67,91,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,,,,,,,,,,,,,362.71,83,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,358.34,82,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,109.25,415.15,
C-R PROTEIN  (HS)(CARDIO),25203620,CDM,86141,CPT,300,RC,outpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75,22,,percent of total billed charges,,,,,,,,,270,90,,percent of total billed charges,,,248.4,82.8,,percent of total billed charges,,,255,85,,percent of total billed charges,,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75,22,,percent of total billed charges,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,75,285,
IMMUNOGLOBULIN M,25203638,CDM,82784,CPT,300,RC,outpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.25,22,,percent of total billed charges,,,,,,,,,188.1,90,,percent of total billed charges,,,173.05,82.8,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.25,22,,percent of total billed charges,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,52.25,198.55,
IMMUNOGLOBULIN A,25203646,CDM,82784,CPT,300,RC,outpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.25,22,,percent of total billed charges,,,,,,,,,188.1,90,,percent of total billed charges,,,173.05,82.8,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.25,22,,percent of total billed charges,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,52.25,198.55,
IODINE URINE (RANDOM),25203647,CDM,83789,CPT,300,RC,outpatient,,183,183,,155.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.75,22,,percent of total billed charges,,,,,,,,,164.7,90,,percent of total billed charges,,,151.52,82.8,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,,,,,,,,161.04,88,,percent of total billed charges,,,,,,,,,139.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.75,22,,percent of total billed charges,,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,,,,,,,,,,,,,151.89,83,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,150.06,82,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,45.75,173.85,
IODINE 24 HR URINE,25203648,CDM,83789,CPT,300,RC,outpatient,,269,269,,228.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.25,22,,percent of total billed charges,,,,,,,,,242.1,90,,percent of total billed charges,,,222.73,82.8,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,,,,,,,,236.72,88,,percent of total billed charges,,,,,,,,,205.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.25,22,,percent of total billed charges,,,244.79,91,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,,,,,,,,,,,,,223.27,83,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,220.58,82,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,67.25,255.55,
IODINE SERUM,25203649,CDM,83789,CPT,300,RC,outpatient,,114,114,,96.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.5,22,,percent of total billed charges,,,,,,,,,102.6,90,,percent of total billed charges,,,94.39,82.8,,percent of total billed charges,,,96.9,85,,percent of total billed charges,,,,,,,,,100.32,88,,percent of total billed charges,,,,,,,,,87.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.5,22,,percent of total billed charges,,,103.74,91,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,,,,,,,,,,,,,94.62,83,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,93.48,82,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,96.9,85,,percent of total billed charges,,28.5,108.3,
IMMUNOGLOBULIN D,25203650,CDM,82784,CPT,300,RC,outpatient,,166,166,,140.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.5,22,,percent of total billed charges,,,,,,,,,149.4,90,,percent of total billed charges,,,137.45,82.8,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,,,,,,,,146.08,88,,percent of total billed charges,,,,,,,,,126.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.5,22,,percent of total billed charges,,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,,,,,,,,,,,,,137.78,83,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,136.12,82,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,41.5,157.7,
ALPHA-FETOPROTEIN (TUMOR MARKER),25203652,CDM,82105,CPT,300,RC,outpatient,,313,313,,265.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.25,22,,percent of total billed charges,,,,,,,,,281.7,90,,percent of total billed charges,,,259.16,82.8,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,,,,,,,,275.44,88,,percent of total billed charges,,,,,,,,,239.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.25,22,,percent of total billed charges,,,284.83,91,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,,,,,,,,,,,,,259.79,83,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,256.66,82,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,78.25,297.35,
ALPHA-FETOPROTEIN (PREGNANCY),25203653,CDM,82105,CPT,300,RC,outpatient,,313,313,,265.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.25,22,,percent of total billed charges,,,,,,,,,281.7,90,,percent of total billed charges,,,259.16,82.8,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,,,,,,,,275.44,88,,percent of total billed charges,,,,,,,,,239.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.25,22,,percent of total billed charges,,,284.83,91,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,,,,,,,,,,,,,259.79,83,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,256.66,82,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,78.25,297.35,
ALPHA-FETOPROTEIN - L3,25203654,CDM,82107,CPT,300,RC,outpatient,,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.5,22,,percent of total billed charges,,,,,,,,,307.8,90,,percent of total billed charges,,,283.18,82.8,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.5,22,,percent of total billed charges,,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,85.5,324.9,
HCG SERUM PREGNANCY TEST,25203661,CDM,84703,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
CARBOXYHEMOGLOBIN,25203679,CDM,82375,CPT,300,RC,outpatient,TC,282,282,,239.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.5,22,,percent of total billed charges,,,,,,,,,253.8,90,,percent of total billed charges,,,233.5,82.8,,percent of total billed charges,,,239.7,85,,percent of total billed charges,,,,,,,,,248.16,88,,percent of total billed charges,,,,,,,,,215.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70.5,22,,percent of total billed charges,,,256.62,91,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,,,,,,,,,,,,,234.06,83,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,231.24,82,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,239.7,85,,percent of total billed charges,,70.5,267.9,
PROTHROMBIN GENE MUTATION,25203680,CDM,81240,CPT,300,RC,outpatient,,731,731,,620.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,182.75,22,,percent of total billed charges,,,,,,,,,657.9,90,,percent of total billed charges,,,605.27,82.8,,percent of total billed charges,,,621.35,85,,percent of total billed charges,,,,,,,,,643.28,88,,percent of total billed charges,,,,,,,,,558.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,182.75,22,,percent of total billed charges,,,665.21,91,,percent of total billed charges,,,694.45,95,,percent of total billed charges,,,606.73,83,,percent of total billed charges,,,606.73,83,,percent of total billed charges,,,,,,,,,,,,,,,606.73,83,,percent of total billed charges,,,694.45,95,,percent of total billed charges,,,657.9,90,,percent of total billed charges,,,657.9,90,,percent of total billed charges,,,599.42,82,,percent of total billed charges,,,657.9,90,,percent of total billed charges,,,621.35,85,,percent of total billed charges,,182.75,694.45,
HOMOCYSTEINE NUTRITIONAL,25203688,CDM,83090,CPT,300,RC,outpatient,,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.75,22,,percent of total billed charges,,,,,,,,,542.7,90,,percent of total billed charges,,,499.28,82.8,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.75,22,,percent of total billed charges,,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,150.75,572.85,
METHYLMALONIC ACID,25203689,CDM,83921,CPT,300,RC,outpatient,,544,544,,461.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,136,22,,percent of total billed charges,,,,,,,,,489.6,90,,percent of total billed charges,,,450.43,82.8,,percent of total billed charges,,,462.4,85,,percent of total billed charges,,,,,,,,,478.72,88,,percent of total billed charges,,,,,,,,,415.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,136,22,,percent of total billed charges,,,495.04,91,,percent of total billed charges,,,516.8,95,,percent of total billed charges,,,451.52,83,,percent of total billed charges,,,451.52,83,,percent of total billed charges,,,,,,,,,,,,,,,451.52,83,,percent of total billed charges,,,516.8,95,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,446.08,82,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,462.4,85,,percent of total billed charges,,136,516.8,
MTHFR METYLENETETRAHYDROFOLATE,25203691,CDM,83891,CPT,300,RC,outpatient,,305,305,,258.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.25,22,,percent of total billed charges,,,,,,,,,274.5,90,,percent of total billed charges,,,252.54,82.8,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,,,,,,,,268.4,88,,percent of total billed charges,,,,,,,,,233.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.25,22,,percent of total billed charges,,,277.55,91,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,,,,,,,,,,,,,253.15,83,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,250.1,82,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,76.25,289.75,
HOMOCYSTEINE CARDIOVASCULAR,25203692,CDM,83090,CPT,300,RC,outpatient,,360,360,,305.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90,22,,percent of total billed charges,,,,,,,,,324,90,,percent of total billed charges,,,298.08,82.8,,percent of total billed charges,,,306,85,,percent of total billed charges,,,,,,,,,316.8,88,,percent of total billed charges,,,,,,,,,275.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90,22,,percent of total billed charges,,,327.6,91,,percent of total billed charges,,,342,95,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,,,,,,,,,,,,,298.8,83,,percent of total billed charges,,,342,95,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,295.2,82,,percent of total billed charges,,,324,90,,percent of total billed charges,,,306,85,,percent of total billed charges,,90,342,
METHYLMALONIC ACID URINE,25203693,CDM,83921,CPT,300,RC,outpatient,,544,544,,461.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,136,22,,percent of total billed charges,,,,,,,,,489.6,90,,percent of total billed charges,,,450.43,82.8,,percent of total billed charges,,,462.4,85,,percent of total billed charges,,,,,,,,,478.72,88,,percent of total billed charges,,,,,,,,,415.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,136,22,,percent of total billed charges,,,495.04,91,,percent of total billed charges,,,516.8,95,,percent of total billed charges,,,451.52,83,,percent of total billed charges,,,451.52,83,,percent of total billed charges,,,,,,,,,,,,,,,451.52,83,,percent of total billed charges,,,516.8,95,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,446.08,82,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,462.4,85,,percent of total billed charges,,136,516.8,
ESTRONE,25203703,CDM,82679,CPT,300,RC,outpatient,,313,313,,265.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.25,22,,percent of total billed charges,,,,,,,,,281.7,90,,percent of total billed charges,,,259.16,82.8,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,,,,,,,,275.44,88,,percent of total billed charges,,,,,,,,,239.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.25,22,,percent of total billed charges,,,284.83,91,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,,,,,,,,,,,,,259.79,83,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,256.66,82,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,78.25,297.35,
PRIMIDONE,25203711,CDM,80188,CPT,300,RC,outpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
GABAPENTIN PLASMA,25203737,CDM,80171,CPT,300,RC,outpatient,,509,509,,432.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.25,22,,percent of total billed charges,,,,,,,,,458.1,90,,percent of total billed charges,,,421.45,82.8,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,,,,,,,,447.92,88,,percent of total billed charges,,,,,,,,,388.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.25,22,,percent of total billed charges,,,463.19,91,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,,,,,,,,,,,,,422.47,83,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,417.38,82,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,127.25,483.55,
NARCOLEPSY EVALUATION,25203738,CDM,80171,CPT,300,RC,outpatient,,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.75,22,,percent of total billed charges,,,,,,,,,215.1,90,,percent of total billed charges,,,197.89,82.8,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.75,22,,percent of total billed charges,,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,59.75,227.05,
MYELODYSPLASTIC SYNDROME(FISH ),25203739,CDM,88120,CPT,300,RC,outpatient,,1400,1400,,1188.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,350,22,,percent of total billed charges,,,,,,,,,1260,90,,percent of total billed charges,,,1159.2,82.8,,percent of total billed charges,,,1190,85,,percent of total billed charges,,,,,,,,,1232,88,,percent of total billed charges,,,,,,,,,1069.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,350,22,,percent of total billed charges,,,1274,91,,percent of total billed charges,,,1330,95,,percent of total billed charges,,,1162,83,,percent of total billed charges,,,1162,83,,percent of total billed charges,,,,,,,,,,,,,,,1162,83,,percent of total billed charges,,,1330,95,,percent of total billed charges,,,1260,90,,percent of total billed charges,,,1260,90,,percent of total billed charges,,,1148,82,,percent of total billed charges,,,1260,90,,percent of total billed charges,,,1190,85,,percent of total billed charges,,350,1330,
NMO ANTIBODY (IgG),25203740,CDM,86255,CPT,300,RC,outpatient,,910,910,,772.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,227.5,22,,percent of total billed charges,,,,,,,,,819,90,,percent of total billed charges,,,753.48,82.8,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,,,,,,,,800.8,88,,percent of total billed charges,,,,,,,,,695.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,227.5,22,,percent of total billed charges,,,828.1,91,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,755.3,83,,percent of total billed charges,,,,,,,,,,,,,,,755.3,83,,percent of total billed charges,,,864.5,95,,percent of total billed charges,,,819,90,,percent of total billed charges,,,819,90,,percent of total billed charges,,,746.2,82,,percent of total billed charges,,,819,90,,percent of total billed charges,,,773.5,85,,percent of total billed charges,,227.5,864.5,
NICOTINE  & METABOLITE(URINE),25203741,CDM,80323,CPT,300,RC,outpatient,,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93,22,,percent of total billed charges,,,,,,,,,334.8,90,,percent of total billed charges,,,308.02,82.8,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93,22,,percent of total billed charges,,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,93,353.4,
NICOTINE &  METABOLITE (serum),25203742,CDM,80323,CPT,300,RC,outpatient,,351,351,,298,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.75,22,,percent of total billed charges,,,,,,,,,315.9,90,,percent of total billed charges,,,290.63,82.8,,percent of total billed charges,,,298.35,85,,percent of total billed charges,,,,,,,,,308.88,88,,percent of total billed charges,,,,,,,,,268.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.75,22,,percent of total billed charges,,,319.41,91,,percent of total billed charges,,,333.45,95,,percent of total billed charges,,,291.33,83,,percent of total billed charges,,,291.33,83,,percent of total billed charges,,,,,,,,,,,,,,,291.33,83,,percent of total billed charges,,,333.45,95,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,287.82,82,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,298.35,85,,percent of total billed charges,,87.75,333.45,
ELECTROLYTE PANEL,25203745,CDM,80051,CPT,300,RC,outpatient,,221,221,,187.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.25,22,,percent of total billed charges,,,,,,,,,198.9,90,,percent of total billed charges,,,182.99,82.8,,percent of total billed charges,,,187.85,85,,percent of total billed charges,,,,,,,,,194.48,88,,percent of total billed charges,,,,,,,,,168.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.25,22,,percent of total billed charges,,,201.11,91,,percent of total billed charges,,,209.95,95,,percent of total billed charges,,,183.43,83,,percent of total billed charges,,,183.43,83,,percent of total billed charges,,,,,,,,,,,,,,,183.43,83,,percent of total billed charges,,,209.95,95,,percent of total billed charges,,,198.9,90,,percent of total billed charges,,,198.9,90,,percent of total billed charges,,,181.22,82,,percent of total billed charges,,,198.9,90,,percent of total billed charges,,,187.85,85,,percent of total billed charges,,55.25,209.95,
VOLUME MEASUREMENT,25203752,CDM,81050,CPT,300,RC,outpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.75,22,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,45.54,82.8,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.75,22,,percent of total billed charges,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,13.75,52.25,
"CELL COUNT w/diff, BODY FLUID",25203760,CDM,89051,CPT,300,RC,outpatient,,148,148,,125.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37,22,,percent of total billed charges,,,,,,,,,133.2,90,,percent of total billed charges,,,122.54,82.8,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,,,,,,,,130.24,88,,percent of total billed charges,,,,,,,,,113.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37,22,,percent of total billed charges,,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,,,,,,,,,,,,,122.84,83,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,121.36,82,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,37,140.6,
HEPATITIS BE ANTIBODY,25203778,CDM,86707,CPT,300,RC,outpatient,,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43,22,,percent of total billed charges,,,,,,,,,154.8,90,,percent of total billed charges,,,142.42,82.8,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43,22,,percent of total billed charges,,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,43,163.4,
ACID FAST STAIN,25203786,CDM,87206,CPT,300,RC,outpatient,,170,170,,144.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.5,22,,percent of total billed charges,,,,,,,,,153,90,,percent of total billed charges,,,140.76,82.8,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,,,,,,,,149.6,88,,percent of total billed charges,,,,,,,,,129.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.5,22,,percent of total billed charges,,,154.7,91,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,,,,,,,,,,,,,141.1,83,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,139.4,82,,percent of total billed charges,,,153,90,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,42.5,161.5,
POTASSIUM URINE,25203794,CDM,84133,CPT,300,RC,outpatient,,160,160,,135.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40,22,,percent of total billed charges,,,,,,,,,144,90,,percent of total billed charges,,,132.48,82.8,,percent of total billed charges,,,136,85,,percent of total billed charges,,,,,,,,,140.8,88,,percent of total billed charges,,,,,,,,,122.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40,22,,percent of total billed charges,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,,152,95,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,131.2,82,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,40,152,
POTASSIUM URINE 24HR,25203795,CDM,84133,CPT,300,RC,outpatient,TC,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
"SODIUM, URINE",25203802,CDM,84300,CPT,300,RC,outpatient,,175,175,,148.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.75,22,,percent of total billed charges,,,,,,,,,157.5,90,,percent of total billed charges,,,144.9,82.8,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,,,,,,,,154,88,,percent of total billed charges,,,,,,,,,133.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.75,22,,percent of total billed charges,,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,,,,,,,,,,,,,145.25,83,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,143.5,82,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,43.75,166.25,
"CHLORIDE, URINE",25203810,CDM,82436,CPT,300,RC,outpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.25,22,,percent of total billed charges,,,,,,,,,130.5,90,,percent of total billed charges,,,120.06,82.8,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.25,22,,percent of total billed charges,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,36.25,137.75,
"CHLORIDE, URINE (24HR)",25203811,CDM,82436,CPT,300,RC,outpatient,TC,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.5,22,,percent of total billed charges,,,,,,,,,117,90,,percent of total billed charges,,,107.64,82.8,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.5,22,,percent of total billed charges,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,32.5,123.5,
"VISCOSITY, SERUM",25203835,CDM,85810,CPT,300,RC,outpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.75,22,,percent of total billed charges,,,,,,,,,182.7,90,,percent of total billed charges,,,168.08,82.8,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.75,22,,percent of total billed charges,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,50.75,192.85,
CULTURE CSF,25203844,CDM,87070,CPT,300,RC,outpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.25,22,,percent of total billed charges,,,,,,,,,130.5,90,,percent of total billed charges,,,120.06,82.8,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.25,22,,percent of total billed charges,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,36.25,137.75,
"LDH, BODY FLUID",25203851,CDM,83615,CPT,300,RC,outpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
BB BLOOD TYPING RH,25203869,CDM,86901,CPT,300,RC,outpatient,,151,151,,128.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.75,22,,percent of total billed charges,,,,,,,,,135.9,90,,percent of total billed charges,,,125.03,82.8,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,,,,,,,,132.88,88,,percent of total billed charges,,,,,,,,,115.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.75,22,,percent of total billed charges,,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,,,,,,,,,,,,,125.33,83,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,123.82,82,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,37.75,143.45,
BASIC MET PANEL,25203885,CDM,80048,CPT,300,RC,outpatient,,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.25,22,,percent of total billed charges,,,,,,,,,260.1,90,,percent of total billed charges,,,239.29,82.8,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.25,22,,percent of total billed charges,,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,72.25,274.55,
ISTAT CHEM PANEL,25203886,CDM,80047,CPT,300,RC,outpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.75,22,,percent of total billed charges,,,,,,,,,236.7,90,,percent of total billed charges,,,217.76,82.8,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.75,22,,percent of total billed charges,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,65.75,249.85,
BARTONELLA SPECIES ANTIBODY,25203893,CDM,86611,CPT,300,RC,outpatient,,60,60,,50.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15,22,,percent of total billed charges,,,,,,,,,54,90,,percent of total billed charges,,,49.68,82.8,,percent of total billed charges,,,51,85,,percent of total billed charges,,,,,,,,,52.8,88,,percent of total billed charges,,,,,,,,,45.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15,22,,percent of total billed charges,,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,,,,,,,,,,,,,49.8,83,,percent of total billed charges,,,57,95,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,49.2,82,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,15,57,
BARTONELLA HENSELAE AB (IGG/IGM),25203894,CDM,86611,CPT,300,RC,outpatient,,183,183,,155.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.75,22,,percent of total billed charges,,,,,,,,,164.7,90,,percent of total billed charges,,,151.52,82.8,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,,,,,,,,161.04,88,,percent of total billed charges,,,,,,,,,139.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.75,22,,percent of total billed charges,,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,,,,,,,,,,,,,151.89,83,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,150.06,82,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,45.75,173.85,
BABESIA MICROTI AB (IGG/IGM),25203895,CDM,86753,CPT,300,RC,outpatient,,318,318,,269.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.5,22,,percent of total billed charges,,,,,,,,,286.2,90,,percent of total billed charges,,,263.3,82.8,,percent of total billed charges,,,270.3,85,,percent of total billed charges,,,,,,,,,279.84,88,,percent of total billed charges,,,,,,,,,242.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.5,22,,percent of total billed charges,,,289.38,91,,percent of total billed charges,,,302.1,95,,percent of total billed charges,,,263.94,83,,percent of total billed charges,,,263.94,83,,percent of total billed charges,,,,,,,,,,,,,,,263.94,83,,percent of total billed charges,,,302.1,95,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,260.76,82,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,270.3,85,,percent of total billed charges,,79.5,302.1,
BABESIA MICROTI  PCR,25203896,CDM,87798,CPT,300,RC,outpatient,,862,862,,731.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,215.5,22,,percent of total billed charges,,,,,,,,,775.8,90,,percent of total billed charges,,,713.74,82.8,,percent of total billed charges,,,732.7,85,,percent of total billed charges,,,,,,,,,758.56,88,,percent of total billed charges,,,,,,,,,658.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,215.5,22,,percent of total billed charges,,,784.42,91,,percent of total billed charges,,,818.9,95,,percent of total billed charges,,,715.46,83,,percent of total billed charges,,,715.46,83,,percent of total billed charges,,,,,,,,,,,,,,,715.46,83,,percent of total billed charges,,,818.9,95,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,706.84,82,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,732.7,85,,percent of total billed charges,,215.5,818.9,
CA 15-3,25203901,CDM,86300,CPT,300,RC,outpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94,22,,percent of total billed charges,,,,,,,,,338.4,90,,percent of total billed charges,,,311.33,82.8,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94,22,,percent of total billed charges,,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,94,357.2,
CA 19-9,25203902,CDM,86301,CPT,300,RC,outpatient,,313,313,,265.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.25,22,,percent of total billed charges,,,,,,,,,281.7,90,,percent of total billed charges,,,259.16,82.8,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,,,,,,,,275.44,88,,percent of total billed charges,,,,,,,,,239.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.25,22,,percent of total billed charges,,,284.83,91,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,,,,,,,,,,,,,259.79,83,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,256.66,82,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,78.25,297.35,
CA 27.29,25203903,CDM,86300,CPT,300,RC,outpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94,22,,percent of total billed charges,,,,,,,,,338.4,90,,percent of total billed charges,,,311.33,82.8,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94,22,,percent of total billed charges,,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,94,357.2,
CULTURE STOOL CAMPYLOBACTER,25203904,CDM,87046,CPT,300,RC,outpatient,,143,143,,121.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.75,22,,percent of total billed charges,,,,,,,,,128.7,90,,percent of total billed charges,,,118.4,82.8,,percent of total billed charges,,,121.55,85,,percent of total billed charges,,,,,,,,,125.84,88,,percent of total billed charges,,,,,,,,,109.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.75,22,,percent of total billed charges,,,130.13,91,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,,,,,,,,,,,,,118.69,83,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,117.26,82,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,121.55,85,,percent of total billed charges,,35.75,135.85,
TRICHROME STAIN,25203907,CDM,87209,CPT,300,RC,outpatient,,268,268,,227.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67,22,,percent of total billed charges,,,,,,,,,241.2,90,,percent of total billed charges,,,221.9,82.8,,percent of total billed charges,,,227.8,85,,percent of total billed charges,,,,,,,,,235.84,88,,percent of total billed charges,,,,,,,,,204.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67,22,,percent of total billed charges,,,243.88,91,,percent of total billed charges,,,254.6,95,,percent of total billed charges,,,222.44,83,,percent of total billed charges,,,222.44,83,,percent of total billed charges,,,,,,,,,,,,,,,222.44,83,,percent of total billed charges,,,254.6,95,,percent of total billed charges,,,241.2,90,,percent of total billed charges,,,241.2,90,,percent of total billed charges,,,219.76,82,,percent of total billed charges,,,241.2,90,,percent of total billed charges,,,227.8,85,,percent of total billed charges,,67,254.6,
E COLI SHIGA TOXIN EIA,25203908,CDM,87427,CPT,300,RC,outpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45,22,,percent of total billed charges,,,,,,,,,162,90,,percent of total billed charges,,,149.04,82.8,,percent of total billed charges,,,153,85,,percent of total billed charges,,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45,22,,percent of total billed charges,,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,45,171,
CULTURE YERSINIA,25203910,CDM,87046,CPT,300,RC,outpatient,,165,165,,140.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.25,22,,percent of total billed charges,,,,,,,,,148.5,90,,percent of total billed charges,,,136.62,82.8,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,,,,,,,,145.2,88,,percent of total billed charges,,,,,,,,,126.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.25,22,,percent of total billed charges,,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,135.3,82,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,41.25,156.75,
CULTURE VIBRIO,25203915,CDM,87046,CPT,300,RC,outpatient,,168,168,,142.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42,22,,percent of total billed charges,,,,,,,,,151.2,90,,percent of total billed charges,,,139.1,82.8,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,,,,,,,,147.84,88,,percent of total billed charges,,,,,,,,,128.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42,22,,percent of total billed charges,,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,,,,,,,,,,,,,139.44,83,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,137.76,82,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,42,159.6,
HPV DNA HIGH RISK,25203920,CDM,87624,CPT,300,RC,outpatient,,590,590,,500.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,147.5,22,,percent of total billed charges,,,,,,,,,531,90,,percent of total billed charges,,,488.52,82.8,,percent of total billed charges,,,501.5,85,,percent of total billed charges,,,,,,,,,519.2,88,,percent of total billed charges,,,,,,,,,450.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,147.5,22,,percent of total billed charges,,,536.9,91,,percent of total billed charges,,,560.5,95,,percent of total billed charges,,,489.7,83,,percent of total billed charges,,,489.7,83,,percent of total billed charges,,,,,,,,,,,,,,,489.7,83,,percent of total billed charges,,,560.5,95,,percent of total billed charges,,,531,90,,percent of total billed charges,,,531,90,,percent of total billed charges,,,483.8,82,,percent of total billed charges,,,531,90,,percent of total billed charges,,,501.5,85,,percent of total billed charges,,147.5,560.5,
"HPV DNA genotypr 16,18/45",25203921,CDM,87625,CPT,300,RC,outpatient,,340,340,,288.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85,22,,percent of total billed charges,,,,,,,,,306,90,,percent of total billed charges,,,281.52,82.8,,percent of total billed charges,,,289,85,,percent of total billed charges,,,,,,,,,299.2,88,,percent of total billed charges,,,,,,,,,259.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85,22,,percent of total billed charges,,,309.4,91,,percent of total billed charges,,,323,95,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,,,,,,,,,,,,,282.2,83,,percent of total billed charges,,,323,95,,percent of total billed charges,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,278.8,82,,percent of total billed charges,,,306,90,,percent of total billed charges,,,289,85,,percent of total billed charges,,85,323,
"HPV DNA genotypr (APTIMA) 16,18/45",25203922,CDM,87624,CPT,300,RC,outpatient,,340,340,,288.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85,22,,percent of total billed charges,,,,,,,,,306,90,,percent of total billed charges,,,281.52,82.8,,percent of total billed charges,,,289,85,,percent of total billed charges,,,,,,,,,299.2,88,,percent of total billed charges,,,,,,,,,259.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85,22,,percent of total billed charges,,,309.4,91,,percent of total billed charges,,,323,95,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,,,,,,,,,,,,,282.2,83,,percent of total billed charges,,,323,95,,percent of total billed charges,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,278.8,82,,percent of total billed charges,,,306,90,,percent of total billed charges,,,289,85,,percent of total billed charges,,85,323,
.GTT - 5 HOUR,25203927,CDM,82951,CPT,300,RC,outpatient,,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.75,22,,percent of total billed charges,,,,,,,,,207.9,90,,percent of total billed charges,,,191.27,82.8,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.75,22,,percent of total billed charges,,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,57.75,219.45,
PARIETAL CELL ANTIBODY,25203936,CDM,86255,CPT,300,RC,outpatient,,168,168,,142.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42,22,,percent of total billed charges,,,,,,,,,151.2,90,,percent of total billed charges,,,139.1,82.8,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,,,,,,,,147.84,88,,percent of total billed charges,,,,,,,,,128.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42,22,,percent of total billed charges,,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,,,,,,,,,,,,,139.44,83,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,137.76,82,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,42,159.6,
HEMOGLOBIN ELECTROPHORESIS W/REFLEX,25203943,CDM,83020,CPT,300,RC,outpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,38.5,146.3,
HEMOGLOBIN F,25203944,CDM,83021,CPT,300,RC,outpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,44,167.2,
ROTAVIRUS,25203950,CDM,87425,CPT,300,RC,outpatient,,254,254,,215.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.5,22,,percent of total billed charges,,,,,,,,,228.6,90,,percent of total billed charges,,,210.31,82.8,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,,,,,,,,223.52,88,,percent of total billed charges,,,,,,,,,194.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.5,22,,percent of total billed charges,,,231.14,91,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,,,,,,,,,,,,,210.82,83,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,208.28,82,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,63.5,241.3,
ROHYPHNOL / FLUNITRAZEPAM,25203951,CDM,80346,CPT,300,RC,outpatient,,789,789,,669.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,197.25,22,,percent of total billed charges,,,,,,,,,710.1,90,,percent of total billed charges,,,653.29,82.8,,percent of total billed charges,,,670.65,85,,percent of total billed charges,,,,,,,,,694.32,88,,percent of total billed charges,,,,,,,,,602.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,197.25,22,,percent of total billed charges,,,717.99,91,,percent of total billed charges,,,749.55,95,,percent of total billed charges,,,654.87,83,,percent of total billed charges,,,654.87,83,,percent of total billed charges,,,,,,,,,,,,,,,654.87,83,,percent of total billed charges,,,749.55,95,,percent of total billed charges,,,710.1,90,,percent of total billed charges,,,710.1,90,,percent of total billed charges,,,646.98,82,,percent of total billed charges,,,710.1,90,,percent of total billed charges,,,670.65,85,,percent of total billed charges,,197.25,749.55,
ADENOVIRUS TYPE 40/41,25203952,CDM,87425,CPT,300,RC,outpatient,,64.84,64.84,,55.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.21,22,,percent of total billed charges,,,,,,,,,58.36,90,,percent of total billed charges,,,53.69,82.8,,percent of total billed charges,,,55.11,85,,percent of total billed charges,,,,,,,,,57.06,88,,percent of total billed charges,,,,,,,,,49.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.21,22,,percent of total billed charges,,,59,91,,percent of total billed charges,,,61.6,95,,percent of total billed charges,,,53.82,83,,percent of total billed charges,,,53.82,83,,percent of total billed charges,,,,,,,,,,,,,,,53.82,83,,percent of total billed charges,,,61.6,95,,percent of total billed charges,,,58.36,90,,percent of total billed charges,,,58.36,90,,percent of total billed charges,,,53.17,82,,percent of total billed charges,,,58.36,90,,percent of total billed charges,,,55.11,85,,percent of total billed charges,,16.21,61.6,
..ROTAVIRUS CHARGE ONLY,25203954,CDM,87425,CPT,300,RC,outpatient,,47.93,47.93,,40.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.98,22,,percent of total billed charges,,,,,,,,,43.14,90,,percent of total billed charges,,,39.69,82.8,,percent of total billed charges,,,40.74,85,,percent of total billed charges,,,,,,,,,42.18,88,,percent of total billed charges,,,,,,,,,36.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.98,22,,percent of total billed charges,,,43.62,91,,percent of total billed charges,,,45.53,95,,percent of total billed charges,,,39.78,83,,percent of total billed charges,,,39.78,83,,percent of total billed charges,,,,,,,,,,,,,,,39.78,83,,percent of total billed charges,,,45.53,95,,percent of total billed charges,,,43.14,90,,percent of total billed charges,,,43.14,90,,percent of total billed charges,,,39.3,82,,percent of total billed charges,,,43.14,90,,percent of total billed charges,,,40.74,85,,percent of total billed charges,,11.98,45.53,
HEMOCHROMATOSIS DNA,25203955,CDM,81256,CPT,300,RC,outpatient,,755,755,,641,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,188.75,22,,percent of total billed charges,,,,,,,,,679.5,90,,percent of total billed charges,,,625.14,82.8,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,,,,,,,,664.4,88,,percent of total billed charges,,,,,,,,,576.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,188.75,22,,percent of total billed charges,,,687.05,91,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,,,,,,,,,,,,,626.65,83,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,619.1,82,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,188.75,717.25,
RETICULIN AB IGA,25203960,CDM,86255,CPT,300,RC,outpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
..RETICULIN AB IGG,25203961,CDM,86255,CPT,300,RC,outpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
.RETICULIN AB IGA TITER,25203962,CDM,86255,CPT,300,RC,outpatient,,140,140,,118.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35,22,,percent of total billed charges,,,,,,,,,126,90,,percent of total billed charges,,,115.92,82.8,,percent of total billed charges,,,119,85,,percent of total billed charges,,,,,,,,,123.2,88,,percent of total billed charges,,,,,,,,,106.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35,22,,percent of total billed charges,,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,133,95,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,114.8,82,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,35,133,
CYTOMEGALOVIRUS AB (IGG),25203968,CDM,86644,CPT,300,RC,outpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.75,22,,percent of total billed charges,,,,,,,,,143.1,90,,percent of total billed charges,,,131.65,82.8,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.75,22,,percent of total billed charges,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,39.75,151.05,
CLOTEST,25203976,CDM,87070,CPT,300,RC,outpatient,,255,255,,216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.75,22,,percent of total billed charges,,,,,,,,,229.5,90,,percent of total billed charges,,,211.14,82.8,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,,,,,,,,224.4,88,,percent of total billed charges,,,,,,,,,194.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.75,22,,percent of total billed charges,,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,209.1,82,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,63.75,242.25,
PTH ANTIBODY,25203980,CDM,83519,CPT,300,RC,outpatient,,387,387,,328.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.75,22,,percent of total billed charges,,,,,,,,,348.3,90,,percent of total billed charges,,,320.44,82.8,,percent of total billed charges,,,328.95,85,,percent of total billed charges,,,,,,,,,340.56,88,,percent of total billed charges,,,,,,,,,295.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.75,22,,percent of total billed charges,,,352.17,91,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,,,,,,,,,,,,,321.21,83,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,317.34,82,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,328.95,85,,percent of total billed charges,,96.75,367.65,
PTH RELATED PROTEIN,25203981,CDM,83519,CPT,300,RC,outpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.25,22,,percent of total billed charges,,,,,,,,,267.3,90,,percent of total billed charges,,,245.92,82.8,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.25,22,,percent of total billed charges,,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,74.25,282.15,
PARASITE ID,25203982,CDM,87169,CPT,300,RC,outpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.5,22,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,38.09,82.8,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.5,22,,percent of total billed charges,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,11.5,43.7,
PCP URINE/W CONFIRM,25203983,CDM,80307,CPT,300,RC,outpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.25,22,,percent of total billed charges,,,,,,,,,62.1,90,,percent of total billed charges,,,57.13,82.8,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.25,22,,percent of total billed charges,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,17.25,65.55,
PAXIL,25203984,CDM,80332,CPT,300,RC,outpatient,,495,495,,420.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.75,22,,percent of total billed charges,,,,,,,,,445.5,90,,percent of total billed charges,,,409.86,82.8,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,,,,,,,,435.6,88,,percent of total billed charges,,,,,,,,,378.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.75,22,,percent of total billed charges,,,450.45,91,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,,,,,,,,,,,,,410.85,83,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,405.9,82,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,123.75,470.25,
PARASITE ID (arthopod),25203985,CDM,87168,CPT,300,RC,outpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.5,22,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,38.09,82.8,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.5,22,,percent of total billed charges,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,11.5,43.7,
PORPHYRINS STOOL,25203992,CDM,84126,CPT,300,RC,outpatient,,902,902,,765.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,225.5,22,,percent of total billed charges,,,,,,,,,811.8,90,,percent of total billed charges,,,746.86,82.8,,percent of total billed charges,,,766.7,85,,percent of total billed charges,,,,,,,,,793.76,88,,percent of total billed charges,,,,,,,,,689.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,225.5,22,,percent of total billed charges,,,820.82,91,,percent of total billed charges,,,856.9,95,,percent of total billed charges,,,748.66,83,,percent of total billed charges,,,748.66,83,,percent of total billed charges,,,,,,,,,,,,,,,748.66,83,,percent of total billed charges,,,856.9,95,,percent of total billed charges,,,811.8,90,,percent of total billed charges,,,811.8,90,,percent of total billed charges,,,739.64,82,,percent of total billed charges,,,811.8,90,,percent of total billed charges,,,766.7,85,,percent of total billed charges,,225.5,856.9,
VITAMIN B-2,25204008,CDM,84252,CPT,300,RC,outpatient,,531,531,,450.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.75,22,,percent of total billed charges,,,,,,,,,477.9,90,,percent of total billed charges,,,439.67,82.8,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,,,,,,,,467.28,88,,percent of total billed charges,,,,,,,,,405.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.75,22,,percent of total billed charges,,,483.21,91,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,,,,,,,,,,,,,440.73,83,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,435.42,82,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,132.75,504.45,
VITAMIN B-3,25204009,CDM,84591,CPT,300,RC,outpatient,,506,506,,429.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126.5,22,,percent of total billed charges,,,,,,,,,455.4,90,,percent of total billed charges,,,418.97,82.8,,percent of total billed charges,,,430.1,85,,percent of total billed charges,,,,,,,,,445.28,88,,percent of total billed charges,,,,,,,,,386.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126.5,22,,percent of total billed charges,,,460.46,91,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,,,,,,,,,,,,,419.98,83,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,414.92,82,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,430.1,85,,percent of total billed charges,,126.5,480.7,
VITAMIN B-6,25204016,CDM,84207,CPT,300,RC,outpatient,,507,507,,430.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126.75,22,,percent of total billed charges,,,,,,,,,456.3,90,,percent of total billed charges,,,419.8,82.8,,percent of total billed charges,,,430.95,85,,percent of total billed charges,,,,,,,,,446.16,88,,percent of total billed charges,,,,,,,,,387.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126.75,22,,percent of total billed charges,,,461.37,91,,percent of total billed charges,,,481.65,95,,percent of total billed charges,,,420.81,83,,percent of total billed charges,,,420.81,83,,percent of total billed charges,,,,,,,,,,,,,,,420.81,83,,percent of total billed charges,,,481.65,95,,percent of total billed charges,,,456.3,90,,percent of total billed charges,,,456.3,90,,percent of total billed charges,,,415.74,82,,percent of total billed charges,,,456.3,90,,percent of total billed charges,,,430.95,85,,percent of total billed charges,,126.75,481.65,
VITAMIN B-7,25204017,CDM,84591,CPT,300,RC,outpatient,,377,377,,320.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94.25,22,,percent of total billed charges,,,,,,,,,339.3,90,,percent of total billed charges,,,312.16,82.8,,percent of total billed charges,,,320.45,85,,percent of total billed charges,,,,,,,,,331.76,88,,percent of total billed charges,,,,,,,,,288.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94.25,22,,percent of total billed charges,,,343.07,91,,percent of total billed charges,,,358.15,95,,percent of total billed charges,,,312.91,83,,percent of total billed charges,,,312.91,83,,percent of total billed charges,,,,,,,,,,,,,,,312.91,83,,percent of total billed charges,,,358.15,95,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,309.14,82,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,320.45,85,,percent of total billed charges,,94.25,358.15,
PANCREATIC ELASTASE,25204020,CDM,82656,CPT,300,RC,outpatient,,687,687,,583.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,171.75,22,,percent of total billed charges,,,,,,,,,618.3,90,,percent of total billed charges,,,568.84,82.8,,percent of total billed charges,,,583.95,85,,percent of total billed charges,,,,,,,,,604.56,88,,percent of total billed charges,,,,,,,,,524.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,171.75,22,,percent of total billed charges,,,625.17,91,,percent of total billed charges,,,652.65,95,,percent of total billed charges,,,570.21,83,,percent of total billed charges,,,570.21,83,,percent of total billed charges,,,,,,,,,,,,,,,570.21,83,,percent of total billed charges,,,652.65,95,,percent of total billed charges,,,618.3,90,,percent of total billed charges,,,618.3,90,,percent of total billed charges,,,563.34,82,,percent of total billed charges,,,618.3,90,,percent of total billed charges,,,583.95,85,,percent of total billed charges,,171.75,652.65,
PANORAMA PRENATAL,25204021,CDM,81599,CPT,300,RC,outpatient,,2048,2048,,1738.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,512,22,,percent of total billed charges,,,,,,,,,1843.2,90,,percent of total billed charges,,,1695.74,82.8,,percent of total billed charges,,,1740.8,85,,percent of total billed charges,,,,,,,,,1802.24,88,,percent of total billed charges,,,,,,,,,1564.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,512,22,,percent of total billed charges,,,1863.68,91,,percent of total billed charges,,,1945.6,95,,percent of total billed charges,,,1699.84,83,,percent of total billed charges,,,1699.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1699.84,83,,percent of total billed charges,,,1945.6,95,,percent of total billed charges,,,1843.2,90,,percent of total billed charges,,,1843.2,90,,percent of total billed charges,,,1679.36,82,,percent of total billed charges,,,1843.2,90,,percent of total billed charges,,,1740.8,85,,percent of total billed charges,,512,1945.6,
FLOW CYTOMETRY EACH ADDED MARKER,25204024,CDM,88185,CPT,310,RC,outpatient,,278,278,,236.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.5,22,,percent of total billed charges,,,,,,,,,250.2,90,,percent of total billed charges,,,230.18,82.8,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,,,,,,,,244.64,88,,percent of total billed charges,,,,,,,,,212.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.5,22,,percent of total billed charges,,,252.98,91,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,,,,,,,,,,,,,230.74,83,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,227.96,82,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,69.5,264.1,
FLOW CYTOMETRY 1ST MARKER,25204025,CDM,88184,CPT,310,RC,outpatient,,695,695,,590.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,173.75,22,,percent of total billed charges,,,,,,,,,625.5,90,,percent of total billed charges,,,575.46,82.8,,percent of total billed charges,,,590.75,85,,percent of total billed charges,,,,,,,,,611.6,88,,percent of total billed charges,,,,,,,,,530.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,173.75,22,,percent of total billed charges,,,632.45,91,,percent of total billed charges,,,660.25,95,,percent of total billed charges,,,576.85,83,,percent of total billed charges,,,576.85,83,,percent of total billed charges,,,,,,,,,,,,,,,576.85,83,,percent of total billed charges,,,660.25,95,,percent of total billed charges,,,625.5,90,,percent of total billed charges,,,625.5,90,,percent of total billed charges,,,569.9,82,,percent of total billed charges,,,625.5,90,,percent of total billed charges,,,590.75,85,,percent of total billed charges,,173.75,660.25,
FLOW CYTOMETRY INTERP 16 MARKERS,25204026,CDM,88189,CPT,310,RC,outpatient,,837,837,,710.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,209.25,22,,percent of total billed charges,,,,,,,,,753.3,90,,percent of total billed charges,,,693.04,82.8,,percent of total billed charges,,,711.45,85,,percent of total billed charges,,,,,,,,,736.56,88,,percent of total billed charges,,,,,,,,,639.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,209.25,22,,percent of total billed charges,,,761.67,91,,percent of total billed charges,,,795.15,95,,percent of total billed charges,,,694.71,83,,percent of total billed charges,,,694.71,83,,percent of total billed charges,,,,,,,,,,,,,,,694.71,83,,percent of total billed charges,,,795.15,95,,percent of total billed charges,,,753.3,90,,percent of total billed charges,,,753.3,90,,percent of total billed charges,,,686.34,82,,percent of total billed charges,,,753.3,90,,percent of total billed charges,,,711.45,85,,percent of total billed charges,,209.25,795.15,
FLOW CYTOMETRY PNH,25204028,CDM,88184,CPT,310,RC,outpatient,,312,312,,264.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78,22,,percent of total billed charges,,,,,,,,,280.8,90,,percent of total billed charges,,,258.34,82.8,,percent of total billed charges,,,265.2,85,,percent of total billed charges,,,,,,,,,274.56,88,,percent of total billed charges,,,,,,,,,238.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78,22,,percent of total billed charges,,,283.92,91,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,,,,,,,,,,,,,258.96,83,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,255.84,82,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,265.2,85,,percent of total billed charges,,78,296.4,
CHRONIC LYMPH LEUKEMIA FISH,25204029,CDM,,,310,RC,outpatient,,1500,1500,,1273.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375,22,,percent of total billed charges,,,,,,,,,1350,90,,percent of total billed charges,,,1242,82.8,,percent of total billed charges,,,1275,85,,percent of total billed charges,,,,,,,,,1320,88,,percent of total billed charges,,,,,,,,,1146,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,375,22,,percent of total billed charges,,,1365,91,,percent of total billed charges,,,1425,95,,percent of total billed charges,,,1245,83,,percent of total billed charges,,,1245,83,,percent of total billed charges,,,,,,,,,,,,,,,1245,83,,percent of total billed charges,,,1425,95,,percent of total billed charges,,,1350,90,,percent of total billed charges,,,1350,90,,percent of total billed charges,,,1230,82,,percent of total billed charges,,,1350,90,,percent of total billed charges,,,1275,85,,percent of total billed charges,,375,1425,
STONE ANALYSIS,25204099,CDM,82365,CPT,300,RC,outpatient,,192,192,,163.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48,22,,percent of total billed charges,,,,,,,,,172.8,90,,percent of total billed charges,,,158.98,82.8,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,,,,,,,,168.96,88,,percent of total billed charges,,,,,,,,,146.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48,22,,percent of total billed charges,,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,,,,,,,,,,,,,159.36,83,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,157.44,82,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,48,182.4,
HAPTOGLOBIN,25204107,CDM,83010,CPT,300,RC,outpatient,,288,288,,244.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72,22,,percent of total billed charges,,,,,,,,,259.2,90,,percent of total billed charges,,,238.46,82.8,,percent of total billed charges,,,244.8,85,,percent of total billed charges,,,,,,,,,253.44,88,,percent of total billed charges,,,,,,,,,220.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72,22,,percent of total billed charges,,,262.08,91,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,,,,,,,,,,,,,239.04,83,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,236.16,82,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,244.8,85,,percent of total billed charges,,72,273.6,
HARMONY PRENATAL,25204108,CDM,81507,CPT,300,RC,outpatient,,1311,1311,,1113.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,327.75,22,,percent of total billed charges,,,,,,,,,1179.9,90,,percent of total billed charges,,,1085.51,82.8,,percent of total billed charges,,,1114.35,85,,percent of total billed charges,,,,,,,,,1153.68,88,,percent of total billed charges,,,,,,,,,1001.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,327.75,22,,percent of total billed charges,,,1193.01,91,,percent of total billed charges,,,1245.45,95,,percent of total billed charges,,,1088.13,83,,percent of total billed charges,,,1088.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1088.13,83,,percent of total billed charges,,,1245.45,95,,percent of total billed charges,,,1179.9,90,,percent of total billed charges,,,1179.9,90,,percent of total billed charges,,,1075.02,82,,percent of total billed charges,,,1179.9,90,,percent of total billed charges,,,1114.35,85,,percent of total billed charges,,327.75,1245.45,
HEROIN SERUM,25204109,CDM,80356,CPT,310,RC,outpatient,,453,453,,384.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,113.25,22,,percent of total billed charges,,,,,,,,,407.7,90,,percent of total billed charges,,,375.08,82.8,,percent of total billed charges,,,385.05,85,,percent of total billed charges,,,,,,,,,398.64,88,,percent of total billed charges,,,,,,,,,346.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,113.25,22,,percent of total billed charges,,,412.23,91,,percent of total billed charges,,,430.35,95,,percent of total billed charges,,,375.99,83,,percent of total billed charges,,,375.99,83,,percent of total billed charges,,,,,,,,,,,,,,,375.99,83,,percent of total billed charges,,,430.35,95,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,371.46,82,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,385.05,85,,percent of total billed charges,,113.25,430.35,
FENTANYL & METABOLITE SERUM,25204110,CDM,80354,CPT,310,RC,outpatient,,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.75,22,,percent of total billed charges,,,,,,,,,207.9,90,,percent of total billed charges,,,191.27,82.8,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.75,22,,percent of total billed charges,,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,57.75,219.45,
TRAMADOL SERUM,25204111,CDM,80373,CPT,310,RC,outpatient,,189,189,,160.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.25,22,,percent of total billed charges,,,,,,,,,170.1,90,,percent of total billed charges,,,156.49,82.8,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,,,,,,,,166.32,88,,percent of total billed charges,,,,,,,,,144.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.25,22,,percent of total billed charges,,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,,,,,,,,,,,,,156.87,83,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,154.98,82,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,47.25,179.55,
TRAMADOL URINE,25204112,CDM,80299,CPT,310,RC,outpatient,,189,189,,160.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.25,22,,percent of total billed charges,,,,,,,,,170.1,90,,percent of total billed charges,,,156.49,82.8,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,,,,,,,,166.32,88,,percent of total billed charges,,,,,,,,,144.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.25,22,,percent of total billed charges,,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,,,,,,,,,,,,,156.87,83,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,154.98,82,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,47.25,179.55,
VITAMIN B-1,25204115,CDM,84425,CPT,300,RC,outpatient,,384,384,,326.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96,22,,percent of total billed charges,,,,,,,,,345.6,90,,percent of total billed charges,,,317.95,82.8,,percent of total billed charges,,,326.4,85,,percent of total billed charges,,,,,,,,,337.92,88,,percent of total billed charges,,,,,,,,,293.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96,22,,percent of total billed charges,,,349.44,91,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,,,,,,,,,,,,,318.72,83,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,314.88,82,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,326.4,85,,percent of total billed charges,,96,364.8,
CRYSTALS SYNOVIAL FLUID,25204123,CDM,89060,CPT,300,RC,outpatient,,113,113,,95.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.25,22,,percent of total billed charges,,,,,,,,,101.7,90,,percent of total billed charges,,,93.56,82.8,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,,,,,,,,99.44,88,,percent of total billed charges,,,,,,,,,86.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.25,22,,percent of total billed charges,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,92.66,82,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,28.25,107.35,
THROMBIN TIME,25204149,CDM,85670,CPT,300,RC,outpatient,,82,82,,69.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.5,22,,percent of total billed charges,,,,,,,,,73.8,90,,percent of total billed charges,,,67.9,82.8,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,,,,,,,,72.16,88,,percent of total billed charges,,,,,,,,,62.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.5,22,,percent of total billed charges,,,74.62,91,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,,,,,,,,,,,,,68.06,83,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,67.24,82,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,20.5,77.9,
.PHOSPHO NEUTRALIZATION PLT,25204150,CDM,85597,CPT,300,RC,outpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.25,22,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,63.76,82.8,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.25,22,,percent of total billed charges,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,19.25,73.15,
.CHROMIUM,25204200,CDM,82495,CPT,310,RC,outpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.75,22,,percent of total billed charges,,,,,,,,,182.7,90,,percent of total billed charges,,,168.08,82.8,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.75,22,,percent of total billed charges,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,50.75,192.85,
CHROMIUM PLASMA,25204201,CDM,82495,CPT,310,RC,outpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.75,22,,percent of total billed charges,,,,,,,,,204.3,90,,percent of total billed charges,,,187.96,82.8,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.75,22,,percent of total billed charges,,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,56.75,215.65,
ST. LOUIS ENCEPHALITIS(IgM),25204206,CDM,86653,CPT,300,RC,outpatient,,301,301,,255.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.25,22,,percent of total billed charges,,,,,,,,,270.9,90,,percent of total billed charges,,,249.23,82.8,,percent of total billed charges,,,255.85,85,,percent of total billed charges,,,,,,,,,264.88,88,,percent of total billed charges,,,,,,,,,229.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.25,22,,percent of total billed charges,,,273.91,91,,percent of total billed charges,,,285.95,95,,percent of total billed charges,,,249.83,83,,percent of total billed charges,,,249.83,83,,percent of total billed charges,,,,,,,,,,,,,,,249.83,83,,percent of total billed charges,,,285.95,95,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,246.82,82,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,255.85,85,,percent of total billed charges,,75.25,285.95,
ST. LOUIS ENCEPHALITIS(IgG),25204207,CDM,86653,CPT,300,RC,outpatient,,301,301,,255.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.25,22,,percent of total billed charges,,,,,,,,,270.9,90,,percent of total billed charges,,,249.23,82.8,,percent of total billed charges,,,255.85,85,,percent of total billed charges,,,,,,,,,264.88,88,,percent of total billed charges,,,,,,,,,229.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.25,22,,percent of total billed charges,,,273.91,91,,percent of total billed charges,,,285.95,95,,percent of total billed charges,,,249.83,83,,percent of total billed charges,,,249.83,83,,percent of total billed charges,,,,,,,,,,,,,,,249.83,83,,percent of total billed charges,,,285.95,95,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,246.82,82,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,255.85,85,,percent of total billed charges,,75.25,285.95,
COBALT PLASMA,25204210,CDM,83018,CPT,310,RC,outpatient,,397,397,,337.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,99.25,22,,percent of total billed charges,,,,,,,,,357.3,90,,percent of total billed charges,,,328.72,82.8,,percent of total billed charges,,,337.45,85,,percent of total billed charges,,,,,,,,,349.36,88,,percent of total billed charges,,,,,,,,,303.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,99.25,22,,percent of total billed charges,,,361.27,91,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,,,,,,,,,,,,,329.51,83,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,325.54,82,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,337.45,85,,percent of total billed charges,,99.25,377.15,
COBALT URINE,25204211,CDM,83018,CPT,300,RC,outpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.5,22,,percent of total billed charges,,,,,,,,,113.4,90,,percent of total billed charges,,,104.33,82.8,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,,,,,,,,110.88,88,,percent of total billed charges,,,,,,,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.5,22,,percent of total billed charges,,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,31.5,119.7,
"THALLIUM, URINE",25204212,CDM,83018,CPT,300,RC,outpatient,,135,135,,114.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.75,22,,percent of total billed charges,,,,,,,,,121.5,90,,percent of total billed charges,,,111.78,82.8,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,,,,,,,,118.8,88,,percent of total billed charges,,,,,,,,,103.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.75,22,,percent of total billed charges,,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,,,,,,,,,,,,,112.05,83,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,110.7,82,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,33.75,128.25,
COENZYME Q10,25204213,CDM,82491,CPT,310,RC,outpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.75,22,,percent of total billed charges,,,,,,,,,182.7,90,,percent of total billed charges,,,168.08,82.8,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.75,22,,percent of total billed charges,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,50.75,192.85,
CULTURE VIRAL/TISSUE BX/FLUID,25204214,CDM,87252,CPT,300,RC,outpatient,,349,349,,296.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.25,22,,percent of total billed charges,,,,,,,,,314.1,90,,percent of total billed charges,,,288.97,82.8,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,,,,,,,,307.12,88,,percent of total billed charges,,,,,,,,,266.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.25,22,,percent of total billed charges,,,317.59,91,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,,,,,,,,,,,,,289.67,83,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,286.18,82,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,87.25,331.55,
CULTURE VIRAL/HERPES/VARICELLA,25204215,CDM,87254,CPT,300,RC,outpatient,,293,293,,248.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.25,22,,percent of total billed charges,,,,,,,,,263.7,90,,percent of total billed charges,,,242.6,82.8,,percent of total billed charges,,,249.05,85,,percent of total billed charges,,,,,,,,,257.84,88,,percent of total billed charges,,,,,,,,,223.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.25,22,,percent of total billed charges,,,266.63,91,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,243.19,83,,percent of total billed charges,,,,,,,,,,,,,,,243.19,83,,percent of total billed charges,,,278.35,95,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,240.26,82,,percent of total billed charges,,,263.7,90,,percent of total billed charges,,,249.05,85,,percent of total billed charges,,73.25,278.35,
ADDITIONAL HIGH RESOLUTION STUDY,25204216,CDM,88289,CPT,300,RC,outpatient,,453,453,,384.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,113.25,22,,percent of total billed charges,,,,,,,,,407.7,90,,percent of total billed charges,,,375.08,82.8,,percent of total billed charges,,,385.05,85,,percent of total billed charges,,,,,,,,,398.64,88,,percent of total billed charges,,,,,,,,,346.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,113.25,22,,percent of total billed charges,,,412.23,91,,percent of total billed charges,,,430.35,95,,percent of total billed charges,,,375.99,83,,percent of total billed charges,,,375.99,83,,percent of total billed charges,,,,,,,,,,,,,,,375.99,83,,percent of total billed charges,,,430.35,95,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,371.46,82,,percent of total billed charges,,,407.7,90,,percent of total billed charges,,,385.05,85,,percent of total billed charges,,113.25,430.35,
CHROMOSOMAL MICRO ARRAY,25204219,CDM,81229,CPT,300,RC,outpatient,,2564,2564,,2176.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,641,22,,percent of total billed charges,,,,,,,,,2307.6,90,,percent of total billed charges,,,2122.99,82.8,,percent of total billed charges,,,2179.4,85,,percent of total billed charges,,,,,,,,,2256.32,88,,percent of total billed charges,,,,,,,,,1958.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,641,22,,percent of total billed charges,,,2333.24,91,,percent of total billed charges,,,2435.8,95,,percent of total billed charges,,,2128.12,83,,percent of total billed charges,,,2128.12,83,,percent of total billed charges,,,,,,,,,,,,,,,2128.12,83,,percent of total billed charges,,,2435.8,95,,percent of total billed charges,,,2307.6,90,,percent of total billed charges,,,2307.6,90,,percent of total billed charges,,,2102.48,82,,percent of total billed charges,,,2307.6,90,,percent of total billed charges,,,2179.4,85,,percent of total billed charges,,641,2435.8,
CHROMOGRANIN-A,25204220,CDM,86316,CPT,300,RC,outpatient,,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94,22,,percent of total billed charges,,,,,,,,,338.4,90,,percent of total billed charges,,,311.33,82.8,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94,22,,percent of total billed charges,,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,94,357.2,
CHROMATIN AB,25204221,CDM,86235,CPT,300,RC,outpatient,,328,328,,278.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82,22,,percent of total billed charges,,,,,,,,,295.2,90,,percent of total billed charges,,,271.58,82.8,,percent of total billed charges,,,278.8,85,,percent of total billed charges,,,,,,,,,288.64,88,,percent of total billed charges,,,,,,,,,250.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82,22,,percent of total billed charges,,,298.48,91,,percent of total billed charges,,,311.6,95,,percent of total billed charges,,,272.24,83,,percent of total billed charges,,,272.24,83,,percent of total billed charges,,,,,,,,,,,,,,,272.24,83,,percent of total billed charges,,,311.6,95,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,268.96,82,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,278.8,85,,percent of total billed charges,,82,311.6,
COBALT BODY FLUID,25204222,CDM,83018,CPT,310,RC,outpatient,,397,397,,337.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,99.25,22,,percent of total billed charges,,,,,,,,,357.3,90,,percent of total billed charges,,,328.72,82.8,,percent of total billed charges,,,337.45,85,,percent of total billed charges,,,,,,,,,349.36,88,,percent of total billed charges,,,,,,,,,303.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,99.25,22,,percent of total billed charges,,,361.27,91,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,,,,,,,,,,,,,329.51,83,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,325.54,82,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,337.45,85,,percent of total billed charges,,99.25,377.15,
CHROMOSOME STUDIES BLOOD,25204223,CDM,88230,CPT,310,RC,outpatient,,4328,4328,,3674.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1082,22,,percent of total billed charges,,,,,,,,,3895.2,90,,percent of total billed charges,,,3583.58,82.8,,percent of total billed charges,,,3678.8,85,,percent of total billed charges,,,,,,,,,3808.64,88,,percent of total billed charges,,,,,,,,,3306.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1082,22,,percent of total billed charges,,,3938.48,91,,percent of total billed charges,,,4111.6,95,,percent of total billed charges,,,3592.24,83,,percent of total billed charges,,,3592.24,83,,percent of total billed charges,,,,,,,,,,,,,,,3592.24,83,,percent of total billed charges,,,4111.6,95,,percent of total billed charges,,,3895.2,90,,percent of total billed charges,,,3895.2,90,,percent of total billed charges,,,3548.96,82,,percent of total billed charges,,,3895.2,90,,percent of total billed charges,,,3678.8,85,,percent of total billed charges,,1082,4111.6,
CHROMOSOME STUDIES TISSUE,25204224,CDM,88262,CPT,310,RC,outpatient,,1174,1174,,996.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,293.5,22,,percent of total billed charges,,,,,,,,,1056.6,90,,percent of total billed charges,,,972.07,82.8,,percent of total billed charges,,,997.9,85,,percent of total billed charges,,,,,,,,,1033.12,88,,percent of total billed charges,,,,,,,,,896.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,293.5,22,,percent of total billed charges,,,1068.34,91,,percent of total billed charges,,,1115.3,95,,percent of total billed charges,,,974.42,83,,percent of total billed charges,,,974.42,83,,percent of total billed charges,,,,,,,,,,,,,,,974.42,83,,percent of total billed charges,,,1115.3,95,,percent of total billed charges,,,1056.6,90,,percent of total billed charges,,,1056.6,90,,percent of total billed charges,,,962.68,82,,percent of total billed charges,,,1056.6,90,,percent of total billed charges,,,997.9,85,,percent of total billed charges,,293.5,1115.3,
SURG PATH CHROMOSOME KARYOTYPE 25 CELLS,25204225,CDM,88264,CPT,310,RC,outpatient,,1839,1839,,1561.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,459.75,22,,percent of total billed charges,,,,,,,,,1655.1,90,,percent of total billed charges,,,1522.69,82.8,,percent of total billed charges,,,1563.15,85,,percent of total billed charges,,,,,,,,,1618.32,88,,percent of total billed charges,,,,,,,,,1405,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,459.75,22,,percent of total billed charges,,,1673.49,91,,percent of total billed charges,,,1747.05,95,,percent of total billed charges,,,1526.37,83,,percent of total billed charges,,,1526.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1526.37,83,,percent of total billed charges,,,1747.05,95,,percent of total billed charges,,,1655.1,90,,percent of total billed charges,,,1655.1,90,,percent of total billed charges,,,1507.98,82,,percent of total billed charges,,,1655.1,90,,percent of total billed charges,,,1563.15,85,,percent of total billed charges,,459.75,1747.05,
SURG PATH CHROMOSOME KARYOTYPE ADD CELLS,25204227,CDM,88280,CPT,310,RC,outpatient,,380,380,,322.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,95,22,,percent of total billed charges,,,,,,,,,342,90,,percent of total billed charges,,,314.64,82.8,,percent of total billed charges,,,323,85,,percent of total billed charges,,,,,,,,,334.4,88,,percent of total billed charges,,,,,,,,,290.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,95,22,,percent of total billed charges,,,345.8,91,,percent of total billed charges,,,361,95,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,,,,,,,,,,,,,315.4,83,,percent of total billed charges,,,361,95,,percent of total billed charges,,,342,90,,percent of total billed charges,,,342,90,,percent of total billed charges,,,311.6,82,,percent of total billed charges,,,342,90,,percent of total billed charges,,,323,85,,percent of total billed charges,,95,361,
CYTOGENITICS SOLID TUMOR,25204228,CDM,88239,CPT,310,RC,outpatient,,424,424,,359.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,106,22,,percent of total billed charges,,,,,,,,,381.6,90,,percent of total billed charges,,,351.07,82.8,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,,,,,,,,373.12,88,,percent of total billed charges,,,,,,,,,323.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,106,22,,percent of total billed charges,,,385.84,91,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,,,,,,,,,,,,,351.92,83,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,347.68,82,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,106,402.8,
COUNT CELLS KARYOTYPES/BANDING,25204229,CDM,88262,CPT,300,RC,outpatient,,1360,1360,,1154.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,340,22,,percent of total billed charges,,,,,,,,,1224,90,,percent of total billed charges,,,1126.08,82.8,,percent of total billed charges,,,1156,85,,percent of total billed charges,,,,,,,,,1196.8,88,,percent of total billed charges,,,,,,,,,1039.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,340,22,,percent of total billed charges,,,1237.6,91,,percent of total billed charges,,,1292,95,,percent of total billed charges,,,1128.8,83,,percent of total billed charges,,,1128.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1128.8,83,,percent of total billed charges,,,1292,95,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1115.2,82,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1156,85,,percent of total billed charges,,340,1292,
TRAZODONE,25204230,CDM,80338,CPT,300,RC,outpatient,,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62,22,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,205.34,82.8,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62,22,,percent of total billed charges,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,62,235.6,
CHROMOSOME CORD/PLACENTA,25204231,CDM,81230,CPT,310,RC,outpatient,,1890,1890,,1604.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,472.5,22,,percent of total billed charges,,,,,,,,,1701,90,,percent of total billed charges,,,1564.92,82.8,,percent of total billed charges,,,1606.5,85,,percent of total billed charges,,,,,,,,,1663.2,88,,percent of total billed charges,,,,,,,,,1443.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,472.5,22,,percent of total billed charges,,,1719.9,91,,percent of total billed charges,,,1795.5,95,,percent of total billed charges,,,1568.7,83,,percent of total billed charges,,,1568.7,83,,percent of total billed charges,,,,,,,,,,,,,,,1568.7,83,,percent of total billed charges,,,1795.5,95,,percent of total billed charges,,,1701,90,,percent of total billed charges,,,1701,90,,percent of total billed charges,,,1549.8,82,,percent of total billed charges,,,1701,90,,percent of total billed charges,,,1606.5,85,,percent of total billed charges,,472.5,1795.5,
BONE MARROW CULTURE,25204232,CDM,88237,CPT,310,RC,outpatient,,1791,1791,,1520.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,447.75,22,,percent of total billed charges,,,,,,,,,1611.9,90,,percent of total billed charges,,,1482.95,82.8,,percent of total billed charges,,,1522.35,85,,percent of total billed charges,,,,,,,,,1576.08,88,,percent of total billed charges,,,,,,,,,1368.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,447.75,22,,percent of total billed charges,,,1629.81,91,,percent of total billed charges,,,1701.45,95,,percent of total billed charges,,,1486.53,83,,percent of total billed charges,,,1486.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1486.53,83,,percent of total billed charges,,,1701.45,95,,percent of total billed charges,,,1611.9,90,,percent of total billed charges,,,1611.9,90,,percent of total billed charges,,,1468.62,82,,percent of total billed charges,,,1611.9,90,,percent of total billed charges,,,1522.35,85,,percent of total billed charges,,447.75,1701.45,
TRICH VAG BY NAA,25204233,CDM,87661,CPT,300,RC,outpatient,,276,276,,234.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69,22,,percent of total billed charges,,,,,,,,,248.4,90,,percent of total billed charges,,,228.53,82.8,,percent of total billed charges,,,234.6,85,,percent of total billed charges,,,,,,,,,242.88,88,,percent of total billed charges,,,,,,,,,210.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69,22,,percent of total billed charges,,,251.16,91,,percent of total billed charges,,,262.2,95,,percent of total billed charges,,,229.08,83,,percent of total billed charges,,,229.08,83,,percent of total billed charges,,,,,,,,,,,,,,,229.08,83,,percent of total billed charges,,,262.2,95,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,226.32,82,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,234.6,85,,percent of total billed charges,,69,262.2,
DOWN SYNDROME CHROM MICRO ARRAY,25204235,CDM,81229,CPT,300,RC,outpatient,,3354,3354,,2847.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,838.5,22,,percent of total billed charges,,,,,,,,,3018.6,90,,percent of total billed charges,,,2777.11,82.8,,percent of total billed charges,,,2850.9,85,,percent of total billed charges,,,,,,,,,2951.52,88,,percent of total billed charges,,,,,,,,,2562.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,838.5,22,,percent of total billed charges,,,3052.14,91,,percent of total billed charges,,,3186.3,95,,percent of total billed charges,,,2783.82,83,,percent of total billed charges,,,2783.82,83,,percent of total billed charges,,,,,,,,,,,,,,,2783.82,83,,percent of total billed charges,,,3186.3,95,,percent of total billed charges,,,3018.6,90,,percent of total billed charges,,,3018.6,90,,percent of total billed charges,,,2750.28,82,,percent of total billed charges,,,3018.6,90,,percent of total billed charges,,,2850.9,85,,percent of total billed charges,,838.5,3186.3,
CULTURE VIRAL MUMPS,25204236,CDM,87254,CPT,300,RC,outpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.25,22,,percent of total billed charges,,,,,,,,,267.3,90,,percent of total billed charges,,,245.92,82.8,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.25,22,,percent of total billed charges,,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,74.25,282.15,
CHROMIUM BODY FLUID,25204237,CDM,82495,CPT,310,RC,outpatient,,441,441,,374.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.25,22,,percent of total billed charges,,,,,,,,,396.9,90,,percent of total billed charges,,,365.15,82.8,,percent of total billed charges,,,374.85,85,,percent of total billed charges,,,,,,,,,388.08,88,,percent of total billed charges,,,,,,,,,336.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.25,22,,percent of total billed charges,,,401.31,91,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,,,,,,,,,,,,,366.03,83,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,361.62,82,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,374.85,85,,percent of total billed charges,,110.25,418.95,
FRAGILE X & SOUTHERN BLOT,25204238,CDM,81243,CPT,300,RC,outpatient,,634,634,,538.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,158.5,22,,percent of total billed charges,,,,,,,,,570.6,90,,percent of total billed charges,,,524.95,82.8,,percent of total billed charges,,,538.9,85,,percent of total billed charges,,,,,,,,,557.92,88,,percent of total billed charges,,,,,,,,,484.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,158.5,22,,percent of total billed charges,,,576.94,91,,percent of total billed charges,,,602.3,95,,percent of total billed charges,,,526.22,83,,percent of total billed charges,,,526.22,83,,percent of total billed charges,,,,,,,,,,,,,,,526.22,83,,percent of total billed charges,,,602.3,95,,percent of total billed charges,,,570.6,90,,percent of total billed charges,,,570.6,90,,percent of total billed charges,,,519.88,82,,percent of total billed charges,,,570.6,90,,percent of total billed charges,,,538.9,85,,percent of total billed charges,,158.5,602.3,
CHROMOSOME WB/ REFLEX Y DELETION,25204241,CDM,88230,CPT,310,RC,outpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75,22,,percent of total billed charges,,,,,,,,,270,90,,percent of total billed charges,,,248.4,82.8,,percent of total billed charges,,,255,85,,percent of total billed charges,,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75,22,,percent of total billed charges,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,75,285,
PATH SMEAR REVIEW,25204491,CDM,85060,CPT,300,RC,outpatient,,440,440,,373.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110,22,,percent of total billed charges,,,,,,,,,396,90,,percent of total billed charges,,,364.32,82.8,,percent of total billed charges,,,374,85,,percent of total billed charges,,,,,,,,,387.2,88,,percent of total billed charges,,,,,,,,,336.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110,22,,percent of total billed charges,,,400.4,91,,percent of total billed charges,,,418,95,,percent of total billed charges,,,365.2,83,,percent of total billed charges,,,365.2,83,,percent of total billed charges,,,,,,,,,,,,,,,365.2,83,,percent of total billed charges,,,418,95,,percent of total billed charges,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,360.8,82,,percent of total billed charges,,,396,90,,percent of total billed charges,,,374,85,,percent of total billed charges,,110,418,
MYELOPEROXIDASE,25204500,CDM,83876,CPT,300,RC,outpatient,,265,265,,224.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.25,22,,percent of total billed charges,,,,,,,,,238.5,90,,percent of total billed charges,,,219.42,82.8,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,,,,,,,,233.2,88,,percent of total billed charges,,,,,,,,,202.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.25,22,,percent of total billed charges,,,241.15,91,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,,,,,,,,,,,,,219.95,83,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,217.3,82,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,66.25,251.75,
OXLDL/ADIPONECTIN,25204501,CDM,83516,CPT,300,RC,outpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.75,22,,percent of total billed charges,,,,,,,,,204.3,90,,percent of total billed charges,,,187.96,82.8,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.75,22,,percent of total billed charges,,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,56.75,215.65,
OMEGACHECK (OMEGA 3 & 6),25204502,CDM,82542,CPT,300,RC,outpatient,,111,111,,94.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.75,22,,percent of total billed charges,,,,,,,,,99.9,90,,percent of total billed charges,,,91.91,82.8,,percent of total billed charges,,,94.35,85,,percent of total billed charges,,,,,,,,,97.68,88,,percent of total billed charges,,,,,,,,,84.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.75,22,,percent of total billed charges,,,101.01,91,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,,,,,,,,,,,,,92.13,83,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,91.02,82,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,94.35,85,,percent of total billed charges,,27.75,105.45,
.NMR NO LIPIDS,25204503,CDM,83704,CPT,300,RC,outpatient,,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.25,22,,percent of total billed charges,,,,,,,,,260.1,90,,percent of total billed charges,,,239.29,82.8,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.25,22,,percent of total billed charges,,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,72.25,274.55,
..F-2 ISOPROSTANE,25204505,CDM,83789,CPT,300,RC,outpatient,,517,517,,438.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,129.25,22,,percent of total billed charges,,,,,,,,,465.3,90,,percent of total billed charges,,,428.08,82.8,,percent of total billed charges,,,439.45,85,,percent of total billed charges,,,,,,,,,454.96,88,,percent of total billed charges,,,,,,,,,394.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,129.25,22,,percent of total billed charges,,,470.47,91,,percent of total billed charges,,,491.15,95,,percent of total billed charges,,,429.11,83,,percent of total billed charges,,,429.11,83,,percent of total billed charges,,,,,,,,,,,,,,,429.11,83,,percent of total billed charges,,,491.15,95,,percent of total billed charges,,,465.3,90,,percent of total billed charges,,,465.3,90,,percent of total billed charges,,,423.94,82,,percent of total billed charges,,,465.3,90,,percent of total billed charges,,,439.45,85,,percent of total billed charges,,129.25,491.15,
MYELOPROLIFERATIVE (MPN/CML) FISH,25204506,CDM,88271,CPT,300,RC,outpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
CANNABINOIDS SERUM W/CONFIRM,25210009,CDM,80307,CPT,310,RC,outpatient,,269,269,,228.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.25,22,,percent of total billed charges,,,,,,,,,242.1,90,,percent of total billed charges,,,222.73,82.8,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,,,,,,,,236.72,88,,percent of total billed charges,,,,,,,,,205.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.25,22,,percent of total billed charges,,,244.79,91,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,,,,,,,,,,,,,223.27,83,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,220.58,82,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,67.25,255.55,
.PAP SMEAR (DR INTERP),25210016,CDM,,,310,RC,outpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.5,22,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,64.58,82.8,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.5,22,,percent of total billed charges,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,19.5,74.1,
THC CONFIRM URINE,25210018,CDM,82542,CPT,310,RC,outpatient,,269,269,,228.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.25,22,,percent of total billed charges,,,,,,,,,242.1,90,,percent of total billed charges,,,222.73,82.8,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,,,,,,,,236.72,88,,percent of total billed charges,,,,,,,,,205.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.25,22,,percent of total billed charges,,,244.79,91,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,,,,,,,,,,,,,223.27,83,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,220.58,82,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,67.25,255.55,
.AMPLIFIED PROBE EACH ORGANISM,25210020,CDM,87798,CPT,300,RC,outpatient,,151,151,,128.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.75,22,,percent of total billed charges,,,,,,,,,135.9,90,,percent of total billed charges,,,125.03,82.8,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,,,,,,,,132.88,88,,percent of total billed charges,,,,,,,,,115.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.75,22,,percent of total billed charges,,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,,,,,,,,,,,,,125.33,83,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,123.82,82,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,37.75,143.45,
.CANDIDA  AMP  PROBE EACH ORGANISM,25210021,CDM,87481,CPT,300,RC,outpatient,,151,151,,128.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.75,22,,percent of total billed charges,,,,,,,,,135.9,90,,percent of total billed charges,,,125.03,82.8,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,,,,,,,,132.88,88,,percent of total billed charges,,,,,,,,,115.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.75,22,,percent of total billed charges,,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,,,,,,,,,,,,,125.33,83,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,123.82,82,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,37.75,143.45,
.TRICH VAG  AMP  PROBE EACH ORGANISM,25210022,CDM,87661,CPT,300,RC,outpatient,,151,151,,128.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.75,22,,percent of total billed charges,,,,,,,,,135.9,90,,percent of total billed charges,,,125.03,82.8,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,,,,,,,,132.88,88,,percent of total billed charges,,,,,,,,,115.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.75,22,,percent of total billed charges,,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,,,,,,,,,,,,,125.33,83,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,123.82,82,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,37.75,143.45,
METHADONE CONFIRM URINE,25210026,CDM,80358,CPT,310,RC,outpatient,,269,269,,228.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.25,22,,percent of total billed charges,,,,,,,,,242.1,90,,percent of total billed charges,,,222.73,82.8,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,,,,,,,,236.72,88,,percent of total billed charges,,,,,,,,,205.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.25,22,,percent of total billed charges,,,244.79,91,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,,,,,,,,,,,,,223.27,83,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,220.58,82,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,67.25,255.55,
.LYME  ANTIBODY/RFX WESTERN BLOTT,25210029,CDM,86618,CPT,300,RC,outpatient,,27,27,,22.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.75,22,,percent of total billed charges,,,,,,,,,24.3,90,,percent of total billed charges,,,22.36,82.8,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,,,,,,,,23.76,88,,percent of total billed charges,,,,,,,,,20.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.75,22,,percent of total billed charges,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,,,,,,,,,,,,,22.41,83,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.14,82,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,6.75,25.65,
EHRLICHIA DETECTION PCR,25210030,CDM,87798,CPT,300,RC,outpatient,,247,247,,209.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.75,22,,percent of total billed charges,,,,,,,,,222.3,90,,percent of total billed charges,,,204.52,82.8,,percent of total billed charges,,,209.95,85,,percent of total billed charges,,,,,,,,,217.36,88,,percent of total billed charges,,,,,,,,,188.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.75,22,,percent of total billed charges,,,224.77,91,,percent of total billed charges,,,234.65,95,,percent of total billed charges,,,205.01,83,,percent of total billed charges,,,205.01,83,,percent of total billed charges,,,,,,,,,,,,,,,205.01,83,,percent of total billed charges,,,234.65,95,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,202.54,82,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,209.95,85,,percent of total billed charges,,61.75,234.65,
SCHISTOSOMAL  AB,25210031,CDM,86682,CPT,300,RC,outpatient,,337,337,,286.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.25,22,,percent of total billed charges,,,,,,,,,303.3,90,,percent of total billed charges,,,279.04,82.8,,percent of total billed charges,,,286.45,85,,percent of total billed charges,,,,,,,,,296.56,88,,percent of total billed charges,,,,,,,,,257.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.25,22,,percent of total billed charges,,,306.67,91,,percent of total billed charges,,,320.15,95,,percent of total billed charges,,,279.71,83,,percent of total billed charges,,,279.71,83,,percent of total billed charges,,,,,,,,,,,,,,,279.71,83,,percent of total billed charges,,,320.15,95,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,276.34,82,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,286.45,85,,percent of total billed charges,,84.25,320.15,
LYME  ANTIBODY/ CSF WESTERN BLOTT,25210033,CDM,86617,CPT,300,RC,outpatient,,516,516,,438.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,129,22,,percent of total billed charges,,,,,,,,,464.4,90,,percent of total billed charges,,,427.25,82.8,,percent of total billed charges,,,438.6,85,,percent of total billed charges,,,,,,,,,454.08,88,,percent of total billed charges,,,,,,,,,394.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,129,22,,percent of total billed charges,,,469.56,91,,percent of total billed charges,,,490.2,95,,percent of total billed charges,,,428.28,83,,percent of total billed charges,,,428.28,83,,percent of total billed charges,,,,,,,,,,,,,,,428.28,83,,percent of total billed charges,,,490.2,95,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,423.12,82,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,438.6,85,,percent of total billed charges,,129,490.2,
LYME  ANTIBODY/RFX,25210038,CDM,86618,CPT,300,RC,outpatient,,27,27,,22.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.75,22,,percent of total billed charges,,,,,,,,,24.3,90,,percent of total billed charges,,,22.36,82.8,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,,,,,,,,23.76,88,,percent of total billed charges,,,,,,,,,20.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.75,22,,percent of total billed charges,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,,,,,,,,,,,,,22.41,83,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.14,82,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,6.75,25.65,
ACETYLMORPHINE URINE,25210039,CDM,80356,CPT,310,RC,outpatient,,151,151,,128.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.75,22,,percent of total billed charges,,,,,,,,,135.9,90,,percent of total billed charges,,,125.03,82.8,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,,,,,,,,132.88,88,,percent of total billed charges,,,,,,,,,115.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.75,22,,percent of total billed charges,,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,,,,,,,,,,,,,125.33,83,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,123.82,82,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,37.75,143.45,
VAGINITIS PLUS CANDIDAX6,25210042,CDM,,,300,RC,outpatient,,300,300,,254.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75,22,,percent of total billed charges,,,,,,,,,270,90,,percent of total billed charges,,,248.4,82.8,,percent of total billed charges,,,255,85,,percent of total billed charges,,,,,,,,,264,88,,percent of total billed charges,,,,,,,,,229.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75,22,,percent of total billed charges,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,,,,,,,,,,,,,,249,83,,percent of total billed charges,,,285,95,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,246,82,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,75,285,
CREATININE 24-HOUR URINE,25210100,CDM,82570,CPT,300,RC,outpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.25,22,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,77,82.8,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.25,22,,percent of total billed charges,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,23.25,88.35,
MAGNESIUM URINE (24-HOUR),25210110,CDM,83735,CPT,300,RC,outpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.75,22,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,85.28,82.8,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.75,22,,percent of total billed charges,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,25.75,97.85,
PHOSPHORUS URINE (24-HOUR),25210120,CDM,84105,CPT,300,RC,outpatient,,28,28,,23.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7,22,,percent of total billed charges,,,,,,,,,25.2,90,,percent of total billed charges,,,23.18,82.8,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,,,,,,,,24.64,88,,percent of total billed charges,,,,,,,,,21.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7,22,,percent of total billed charges,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,,,,,,,,,,,,,23.24,83,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,22.96,82,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,7,26.6,
SODIUM URINE (24-HOUR),25210130,CDM,84300,CPT,300,RC,outpatient,,120,120,,101.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30,22,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,99.36,82.8,,percent of total billed charges,,,102,85,,percent of total billed charges,,,,,,,,,105.6,88,,percent of total billed charges,,,,,,,,,91.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30,22,,percent of total billed charges,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,114,95,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,98.4,82,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,30,114,
HERPES 6 (HHV-6),25210131,CDM,86790,CPT,300,RC,outpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.25,22,,percent of total billed charges,,,,,,,,,72.9,90,,percent of total billed charges,,,67.07,82.8,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.25,22,,percent of total billed charges,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,20.25,76.95,
HERPES 6 (HHV-6) QT,25210132,CDM,87533,CPT,300,RC,outpatient,,478,478,,405.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.5,22,,percent of total billed charges,,,,,,,,,430.2,90,,percent of total billed charges,,,395.78,82.8,,percent of total billed charges,,,406.3,85,,percent of total billed charges,,,,,,,,,420.64,88,,percent of total billed charges,,,,,,,,,365.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.5,22,,percent of total billed charges,,,434.98,91,,percent of total billed charges,,,454.1,95,,percent of total billed charges,,,396.74,83,,percent of total billed charges,,,396.74,83,,percent of total billed charges,,,,,,,,,,,,,,,396.74,83,,percent of total billed charges,,,454.1,95,,percent of total billed charges,,,430.2,90,,percent of total billed charges,,,430.2,90,,percent of total billed charges,,,391.96,82,,percent of total billed charges,,,430.2,90,,percent of total billed charges,,,406.3,85,,percent of total billed charges,,119.5,454.1,
HERPES 6 IGM (HHV-6),25210133,CDM,86790,CPT,300,RC,outpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.25,22,,percent of total billed charges,,,,,,,,,72.9,90,,percent of total billed charges,,,67.07,82.8,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.25,22,,percent of total billed charges,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,20.25,76.95,
DIHYDROTESTOSTERONE,25210140,CDM,82642,CPT,300,RC,outpatient,,101,101,,85.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.25,22,,percent of total billed charges,,,,,,,,,90.9,90,,percent of total billed charges,,,83.63,82.8,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,,,,,,,,88.88,88,,percent of total billed charges,,,,,,,,,77.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.25,22,,percent of total billed charges,,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,82.82,82,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,25.25,95.95,
MLH1 MUTATION,25210150,CDM,81294,CPT,300,RC,outpatient,,2520,2520,,2139.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,630,22,,percent of total billed charges,,,,,,,,,2268,90,,percent of total billed charges,,,2086.56,82.8,,percent of total billed charges,,,2142,85,,percent of total billed charges,,,,,,,,,2217.6,88,,percent of total billed charges,,,,,,,,,1925.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,630,22,,percent of total billed charges,,,2293.2,91,,percent of total billed charges,,,2394,95,,percent of total billed charges,,,2091.6,83,,percent of total billed charges,,,2091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,2091.6,83,,percent of total billed charges,,,2394,95,,percent of total billed charges,,,2268,90,,percent of total billed charges,,,2268,90,,percent of total billed charges,,,2066.4,82,,percent of total billed charges,,,2268,90,,percent of total billed charges,,,2142,85,,percent of total billed charges,,630,2394,
MSH2 MUTATION,25210155,CDM,81295,CPT,300,RC,outpatient,,2520,2520,,2139.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,630,22,,percent of total billed charges,,,,,,,,,2268,90,,percent of total billed charges,,,2086.56,82.8,,percent of total billed charges,,,2142,85,,percent of total billed charges,,,,,,,,,2217.6,88,,percent of total billed charges,,,,,,,,,1925.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,630,22,,percent of total billed charges,,,2293.2,91,,percent of total billed charges,,,2394,95,,percent of total billed charges,,,2091.6,83,,percent of total billed charges,,,2091.6,83,,percent of total billed charges,,,,,,,,,,,,,,,2091.6,83,,percent of total billed charges,,,2394,95,,percent of total billed charges,,,2268,90,,percent of total billed charges,,,2268,90,,percent of total billed charges,,,2066.4,82,,percent of total billed charges,,,2268,90,,percent of total billed charges,,,2142,85,,percent of total billed charges,,630,2394,
FAMILIAL ADENOMATOUS POLYPOSIS,25210160,CDM,81201,CPT,300,RC,outpatient,,2083,2083,,1768.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,520.75,22,,percent of total billed charges,,,,,,,,,1874.7,90,,percent of total billed charges,,,1724.72,82.8,,percent of total billed charges,,,1770.55,85,,percent of total billed charges,,,,,,,,,1833.04,88,,percent of total billed charges,,,,,,,,,1591.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,520.75,22,,percent of total billed charges,,,1895.53,91,,percent of total billed charges,,,1978.85,95,,percent of total billed charges,,,1728.89,83,,percent of total billed charges,,,1728.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1728.89,83,,percent of total billed charges,,,1978.85,95,,percent of total billed charges,,,1874.7,90,,percent of total billed charges,,,1874.7,90,,percent of total billed charges,,,1708.06,82,,percent of total billed charges,,,1874.7,90,,percent of total billed charges,,,1770.55,85,,percent of total billed charges,,520.75,1978.85,
MSH6 MUTATION,25210165,CDM,81298,CPT,300,RC,outpatient,,3111,3111,,2641.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,777.75,22,,percent of total billed charges,,,,,,,,,2799.9,90,,percent of total billed charges,,,2575.91,82.8,,percent of total billed charges,,,2644.35,85,,percent of total billed charges,,,,,,,,,2737.68,88,,percent of total billed charges,,,,,,,,,2376.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,777.75,22,,percent of total billed charges,,,2831.01,91,,percent of total billed charges,,,2955.45,95,,percent of total billed charges,,,2582.13,83,,percent of total billed charges,,,2582.13,83,,percent of total billed charges,,,,,,,,,,,,,,,2582.13,83,,percent of total billed charges,,,2955.45,95,,percent of total billed charges,,,2799.9,90,,percent of total billed charges,,,2799.9,90,,percent of total billed charges,,,2551.02,82,,percent of total billed charges,,,2799.9,90,,percent of total billed charges,,,2644.35,85,,percent of total billed charges,,777.75,2955.45,
MUSK AB,25210167,CDM,83519,CPT,300,RC,outpatient,,2105,2105,,1787.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,526.25,22,,percent of total billed charges,,,,,,,,,1894.5,90,,percent of total billed charges,,,1742.94,82.8,,percent of total billed charges,,,1789.25,85,,percent of total billed charges,,,,,,,,,1852.4,88,,percent of total billed charges,,,,,,,,,1608.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,526.25,22,,percent of total billed charges,,,1915.55,91,,percent of total billed charges,,,1999.75,95,,percent of total billed charges,,,1747.15,83,,percent of total billed charges,,,1747.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1747.15,83,,percent of total billed charges,,,1999.75,95,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1726.1,82,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1789.25,85,,percent of total billed charges,,526.25,1999.75,
MPL MUTATION,25210168,CDM,81338,CPT,300,RC,outpatient,,882,882,,748.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,220.5,22,,percent of total billed charges,,,,,,,,,793.8,90,,percent of total billed charges,,,730.3,82.8,,percent of total billed charges,,,749.7,85,,percent of total billed charges,,,,,,,,,776.16,88,,percent of total billed charges,,,,,,,,,673.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,220.5,22,,percent of total billed charges,,,802.62,91,,percent of total billed charges,,,837.9,95,,percent of total billed charges,,,732.06,83,,percent of total billed charges,,,732.06,83,,percent of total billed charges,,,,,,,,,,,,,,,732.06,83,,percent of total billed charges,,,837.9,95,,percent of total billed charges,,,793.8,90,,percent of total billed charges,,,793.8,90,,percent of total billed charges,,,723.24,82,,percent of total billed charges,,,793.8,90,,percent of total billed charges,,,749.7,85,,percent of total billed charges,,220.5,837.9,
BRACASSURE COMP,25213000,CDM,81162,CPT,300,RC,outpatient,,3681,3681,,3125.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,920.25,22,,percent of total billed charges,,,,,,,,,3312.9,90,,percent of total billed charges,,,3047.87,82.8,,percent of total billed charges,,,3128.85,85,,percent of total billed charges,,,,,,,,,3239.28,88,,percent of total billed charges,,,,,,,,,2812.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,920.25,22,,percent of total billed charges,,,3349.71,91,,percent of total billed charges,,,3496.95,95,,percent of total billed charges,,,3055.23,83,,percent of total billed charges,,,3055.23,83,,percent of total billed charges,,,,,,,,,,,,,,,3055.23,83,,percent of total billed charges,,,3496.95,95,,percent of total billed charges,,,3312.9,90,,percent of total billed charges,,,3312.9,90,,percent of total billed charges,,,3018.42,82,,percent of total billed charges,,,3312.9,90,,percent of total billed charges,,,3128.85,85,,percent of total billed charges,,920.25,3496.95,
BRAF  GENE ANALYSIS,25213001,CDM,81210,CPT,310,RC,outpatient,,620,620,,526.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,155,22,,percent of total billed charges,,,,,,,,,558,90,,percent of total billed charges,,,513.36,82.8,,percent of total billed charges,,,527,85,,percent of total billed charges,,,,,,,,,545.6,88,,percent of total billed charges,,,,,,,,,473.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,155,22,,percent of total billed charges,,,564.2,91,,percent of total billed charges,,,589,95,,percent of total billed charges,,,514.6,83,,percent of total billed charges,,,514.6,83,,percent of total billed charges,,,,,,,,,,,,,,,514.6,83,,percent of total billed charges,,,589,95,,percent of total billed charges,,,558,90,,percent of total billed charges,,,558,90,,percent of total billed charges,,,508.4,82,,percent of total billed charges,,,558,90,,percent of total billed charges,,,527,85,,percent of total billed charges,,155,589,
. ONKOSIGHT  KIT GENE ANALYSIS,25213002,CDM,81402,CPT,310,RC,outpatient,,284,284,,241.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71,22,,percent of total billed charges,,,,,,,,,255.6,90,,percent of total billed charges,,,235.15,82.8,,percent of total billed charges,,,241.4,85,,percent of total billed charges,,,,,,,,,249.92,88,,percent of total billed charges,,,,,,,,,216.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71,22,,percent of total billed charges,,,258.44,91,,percent of total billed charges,,,269.8,95,,percent of total billed charges,,,235.72,83,,percent of total billed charges,,,235.72,83,,percent of total billed charges,,,,,,,,,,,,,,,235.72,83,,percent of total billed charges,,,269.8,95,,percent of total billed charges,,,255.6,90,,percent of total billed charges,,,255.6,90,,percent of total billed charges,,,232.88,82,,percent of total billed charges,,,255.6,90,,percent of total billed charges,,,241.4,85,,percent of total billed charges,,71,269.8,
.NRAS ONKOSIGHT MOLECULAR PATH5,25213003,CDM,81404,CPT,310,RC,outpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.5,22,,percent of total billed charges,,,,,,,,,289.8,90,,percent of total billed charges,,,266.62,82.8,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.5,22,,percent of total billed charges,,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,80.5,305.9,
.MICRODISSECTION MANUAL,25213004,CDM,88381,CPT,310,RC,outpatient,,170,170,,144.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.5,22,,percent of total billed charges,,,,,,,,,153,90,,percent of total billed charges,,,140.76,82.8,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,,,,,,,,149.6,88,,percent of total billed charges,,,,,,,,,129.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.5,22,,percent of total billed charges,,,154.7,91,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,,,,,,,,,,,,,141.1,83,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,139.4,82,,percent of total billed charges,,,153,90,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,42.5,161.5,
.MSI ANALYSIS,25213005,CDM,81301,CPT,310,RC,outpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.5,22,,percent of total billed charges,,,,,,,,,289.8,90,,percent of total billed charges,,,266.62,82.8,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.5,22,,percent of total billed charges,,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,80.5,305.9,
BRACASSURE BRCA2,25213006,CDM,81217,CPT,300,RC,outpatient,,1314,1314,,1115.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,328.5,22,,percent of total billed charges,,,,,,,,,1182.6,90,,percent of total billed charges,,,1087.99,82.8,,percent of total billed charges,,,1116.9,85,,percent of total billed charges,,,,,,,,,1156.32,88,,percent of total billed charges,,,,,,,,,1003.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,328.5,22,,percent of total billed charges,,,1195.74,91,,percent of total billed charges,,,1248.3,95,,percent of total billed charges,,,1090.62,83,,percent of total billed charges,,,1090.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1090.62,83,,percent of total billed charges,,,1248.3,95,,percent of total billed charges,,,1182.6,90,,percent of total billed charges,,,1182.6,90,,percent of total billed charges,,,1077.48,82,,percent of total billed charges,,,1182.6,90,,percent of total billed charges,,,1116.9,85,,percent of total billed charges,,328.5,1248.3,
.COMPLIANCE DRUG ANALYSIS,25213010,CDM,,,300,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
.HARMONY PRENATAL,25213020,CDM,,,300,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
.HARMONY W/XY,25213030,CDM,,,300,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
.HARMONY W/Y,25213040,CDM,,,300,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
.INHERITEST CARRIER,25213050,CDM,,,300,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
.INTEGRATED 1,25213060,CDM,,,300,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
.INTEGRATED 2,25213070,CDM,,,300,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
.SEQUENTIAL 1,25213090,CDM,,,300,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
.SEQUENTIAL 2,25213100,CDM,,,300,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
.INHERITEST SELECT CARRIER,25213110,CDM,,,300,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
.HLA CLASS 1 PLT AB,25213448,CDM,86022,CPT,300,RC,outpatient,,305,305,,258.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.25,22,,percent of total billed charges,,,,,,,,,274.5,90,,percent of total billed charges,,,252.54,82.8,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,,,,,,,,268.4,88,,percent of total billed charges,,,,,,,,,233.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.25,22,,percent of total billed charges,,,277.55,91,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,,,,,,,,,,,,,253.15,83,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,250.1,82,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,76.25,289.75,
.IIb/IIIa  PLT AB,25213449,CDM,86022,CPT,300,RC,outpatient,,305,305,,258.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.25,22,,percent of total billed charges,,,,,,,,,274.5,90,,percent of total billed charges,,,252.54,82.8,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,,,,,,,,268.4,88,,percent of total billed charges,,,,,,,,,233.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.25,22,,percent of total billed charges,,,277.55,91,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,,,,,,,,,,,,,253.15,83,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,250.1,82,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,76.25,289.75,
.Ib/IX  PLT AB,25213450,CDM,86022,CPT,300,RC,outpatient,,305,305,,258.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.25,22,,percent of total billed charges,,,,,,,,,274.5,90,,percent of total billed charges,,,252.54,82.8,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,,,,,,,,268.4,88,,percent of total billed charges,,,,,,,,,233.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.25,22,,percent of total billed charges,,,277.55,91,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,,,,,,,,,,,,,253.15,83,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,250.1,82,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,76.25,289.75,
.Ib/IX  PLT AB,25213451,CDM,86022,CPT,300,RC,outpatient,,305,305,,258.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.25,22,,percent of total billed charges,,,,,,,,,274.5,90,,percent of total billed charges,,,252.54,82.8,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,,,,,,,,268.4,88,,percent of total billed charges,,,,,,,,,233.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.25,22,,percent of total billed charges,,,277.55,91,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,,,,,,,,,,,,,253.15,83,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,250.1,82,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,76.25,289.75,
 .DELETE,25214008,CDM,80048,CPT,300,RC,outpatient,,106,106,,89.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.5,22,,percent of total billed charges,,,,,,,,,95.4,90,,percent of total billed charges,,,87.77,82.8,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,,,,,,,,93.28,88,,percent of total billed charges,,,,,,,,,80.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.5,22,,percent of total billed charges,,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,,,,,,,,,,,,,87.98,83,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,86.92,82,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,26.5,100.7,
RL CBC W/AUTO DIFF,25214009,CDM,85025,CPT,300,RC,outpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.25,22,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,77,82.8,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.25,22,,percent of total billed charges,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,23.25,88.35,
RL COMP METABOLIC PANEL,25214010,CDM,80053,CPT,300,RC,outpatient,,180,180,,152.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45,22,,percent of total billed charges,,,,,,,,,162,90,,percent of total billed charges,,,149.04,82.8,,percent of total billed charges,,,153,85,,percent of total billed charges,,,,,,,,,158.4,88,,percent of total billed charges,,,,,,,,,137.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45,22,,percent of total billed charges,,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,,,,,,,,,,,,,149.4,83,,percent of total billed charges,,,171,95,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,147.6,82,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,45,171,
RL CULTURE URINE,25214011,CDM,87086,CPT,300,RC,outpatient,,99,99,,84.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.75,22,,percent of total billed charges,,,,,,,,,89.1,90,,percent of total billed charges,,,81.97,82.8,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,,,,,,,,87.12,88,,percent of total billed charges,,,,,,,,,75.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.75,22,,percent of total billed charges,,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,,,,,,,,,,,,,82.17,83,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,81.18,82,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,24.75,94.05,
RL HEMOGLOBIN A1c,25214012,CDM,83036,CPT,300,RC,outpatient,,125,125,,106.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.25,22,,percent of total billed charges,,,,,,,,,112.5,90,,percent of total billed charges,,,103.5,82.8,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,,,,,,,,110,88,,percent of total billed charges,,,,,,,,,95.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.25,22,,percent of total billed charges,,,113.75,91,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,,,,,,,,,,,,,103.75,83,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,102.5,82,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,31.25,118.75,
.DELETE IRON TOTAL,25214013,CDM,83540,CPT,300,RC,outpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.25,22,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,63.76,82.8,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.25,22,,percent of total billed charges,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,19.25,73.15,
RL LIPID PANEL,25214014,CDM,80061,CPT,300,RC,outpatient,,158,158,,134.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.5,22,,percent of total billed charges,,,,,,,,,142.2,90,,percent of total billed charges,,,130.82,82.8,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,,,,,,,,139.04,88,,percent of total billed charges,,,,,,,,,120.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.5,22,,percent of total billed charges,,,143.78,91,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,,,,,,,,,,,,,131.14,83,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,129.56,82,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,39.5,150.1,
.RL PARTIAL THROMBOPLASTIN TIME (PTT),25214015,CDM,85730,CPT,300,RC,outpatient,,163,163,,138.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.75,22,,percent of total billed charges,,,,,,,,,146.7,90,,percent of total billed charges,,,134.96,82.8,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,,,,,,,,143.44,88,,percent of total billed charges,,,,,,,,,124.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.75,22,,percent of total billed charges,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,,,,,,,,,,,,,135.29,83,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,133.66,82,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,40.75,154.85,
RL PROTHROMBIN TIME w/INR,25214016,CDM,85610,CPT,300,RC,outpatient,,75,75,,63.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.75,22,,percent of total billed charges,,,,,,,,,67.5,90,,percent of total billed charges,,,62.1,82.8,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,,,,,,,,66,88,,percent of total billed charges,,,,,,,,,57.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.75,22,,percent of total billed charges,,,68.25,91,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,,,,,,,,,,,,,62.25,83,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,61.5,82,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,18.75,71.25,
RL TSH,25214017,CDM,84443,CPT,300,RC,outpatient,,165,165,,140.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.25,22,,percent of total billed charges,,,,,,,,,148.5,90,,percent of total billed charges,,,136.62,82.8,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,,,,,,,,145.2,88,,percent of total billed charges,,,,,,,,,126.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.25,22,,percent of total billed charges,,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,135.3,82,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,41.25,156.75,
RL CULTURE THROAT,25214018,CDM,87081,CPT,300,RC,outpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.25,22,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,63.76,82.8,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.25,22,,percent of total billed charges,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,19.25,73.15,
RL GGT,25214019,CDM,82977,CPT,300,RC,outpatient,,101,101,,85.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.25,22,,percent of total billed charges,,,,,,,,,90.9,90,,percent of total billed charges,,,83.63,82.8,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,,,,,,,,88.88,88,,percent of total billed charges,,,,,,,,,77.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.25,22,,percent of total billed charges,,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,82.82,82,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,25.25,95.95,
RL BASIC MET PANEL,25214020,CDM,80048,CPT,300,RC,outpatient,,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33,22,,percent of total billed charges,,,,,,,,,118.8,90,,percent of total billed charges,,,109.3,82.8,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33,22,,percent of total billed charges,,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,33,125.4,
ALLERGEN  CRAB,25214021,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  LOBSTER,25214022,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  CHOCOLATE,25214023,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN PTERONYSSINUS,25215000,CDM,86003,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
ALLERGEN D FARINAE,25215001,CDM,86003,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
ALLERGEN CAT DANDER,25215002,CDM,86003,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
ALLERGEN DOG DANDER,25215003,CDM,86003,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
ALLERGEN BLUEGRASS KENTUCKY,25215004,CDM,86003,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
ALLERGEN  ALTERARIA,25215005,CDM,86003,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
ALLERGEN OAK WHITE,25215006,CDM,86003,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
ALLERGEN ELM AMERICAN,25215007,CDM,86003,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
ALLERGEN RAGWEED,25215008,CDM,86003,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
ALLERGEN PLANTAIN,25215009,CDM,86003,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
ALLERGEN BERMUDA GRASS,25215010,CDM,86003,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
ALLERGEN HONEYBEE,25215011,CDM,86003,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
ALLERGEN WASP PAPER,25215012,CDM,86003,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
ALLERGEN TIMOTHY GRASS,25215013,CDM,86003,CPT,300,RC,outpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21,22,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,69.55,82.8,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,,,,,,,,73.92,88,,percent of total billed charges,,,,,,,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21,22,,percent of total billed charges,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,21,79.8,
ALLERGEN RYE GRASS,25215014,CDM,86003,CPT,300,RC,outpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21,22,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,69.55,82.8,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,,,,,,,,73.92,88,,percent of total billed charges,,,,,,,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21,22,,percent of total billed charges,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,21,79.8,
ALLERGEN MUCOR RACEMOSUS,25215015,CDM,86003,CPT,300,RC,outpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21,22,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,69.55,82.8,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,,,,,,,,73.92,88,,percent of total billed charges,,,,,,,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21,22,,percent of total billed charges,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,21,79.8,
ALLERGEN JOHNSON GRASS,25215016,CDM,86003,CPT,300,RC,outpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21,22,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,69.55,82.8,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,,,,,,,,73.92,88,,percent of total billed charges,,,,,,,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21,22,,percent of total billed charges,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,21,79.8,
ALLERGEN BAHIA GRASS,25215017,CDM,86003,CPT,300,RC,outpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21,22,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,69.55,82.8,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,,,,,,,,73.92,88,,percent of total billed charges,,,,,,,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21,22,,percent of total billed charges,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,21,79.8,
ALLERGEN CLADOSPORIUM HERBARUM,25215018,CDM,86003,CPT,300,RC,outpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21,22,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,69.55,82.8,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,,,,,,,,73.92,88,,percent of total billed charges,,,,,,,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21,22,,percent of total billed charges,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,21,79.8,
.CHLAMYDIA (LIQUID PAP),25220001,CDM,87491,CPT,300,RC,outpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.5,22,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,38.09,82.8,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.5,22,,percent of total billed charges,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,11.5,43.7,
.NEISSERIA (LIQUID PAP),25220002,CDM,87591,CPT,300,RC,outpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.5,22,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,38.09,82.8,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.5,22,,percent of total billed charges,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,11.5,43.7,
.TRICH (LIQUID PAP),25220003,CDM,87661,CPT,300,RC,outpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.5,22,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,38.09,82.8,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.5,22,,percent of total billed charges,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,11.5,43.7,
ALLERGEN  WHEAT,25220005,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  PINEAPPLE,25220006,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  ALMOND,25220007,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  TILAPIA,25220008,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  EGG WHITE,25220009,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  EGG YOLK,25220010,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  CASHEWS,25220011,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  PEANUT,25220012,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  ANIMAL,25220013,CDM,86005,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  EGG WHOLE,25220014,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  GOAT MILK,25220015,CDM,86003,CPT,300,RC,outpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3,22,,percent of total billed charges,,,,,,,,,10.8,90,,percent of total billed charges,,,9.94,82.8,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3,22,,percent of total billed charges,,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,3,11.4,
ALLERGEN  SWISS CHEESE,25220016,CDM,86003,CPT,300,RC,outpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3,22,,percent of total billed charges,,,,,,,,,10.8,90,,percent of total billed charges,,,9.94,82.8,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3,22,,percent of total billed charges,,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,3,11.4,
ALLERGEN  APPLE,25240000,CDM,86003,CPT,300,RC,outpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3,22,,percent of total billed charges,,,,,,,,,10.8,90,,percent of total billed charges,,,9.94,82.8,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3,22,,percent of total billed charges,,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,3,11.4,
ALLERGEN  AVOCADO,25240001,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  BANANA,25240002,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  BARLEY,25240003,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  BRAZIL NUT,25240004,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  BROCCOLI,25240005,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  BRUSSEL SPROUTS,25240006,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  CABBAGE,25240007,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  CARROT,25240008,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  CAULIFLOWER,25240009,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  COCONUT,25240010,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  MILK,25240011,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  CUCUMBER,25240012,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  GARLIC,25240013,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  LEMON,25240014,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  MUSHROOM,25240015,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  MUSTARD,25240016,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  OAT,25240017,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  ORANGE,25240018,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  PEACH,25240019,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  PEAR,25240020,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  POTATOE WHITE,25240021,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  RICE,25240022,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  RYE,25240023,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  SOYBEAN,25240024,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  SPINACH,25240025,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  STRAWBERRY,25240026,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  TOMATO,25240027,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  WHITE BEAN,25240028,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  SOLE,25240029,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  GREEN PEA,25240030,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  CHICKEN,25240031,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  MELON,25240040,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN FOOD  VEGETABLE II,25240042,CDM,,,300,RC,outpatient,,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92,22,,percent of total billed charges,,,,,,,,,331.2,90,,percent of total billed charges,,,304.7,82.8,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92,22,,percent of total billed charges,,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,92,349.6,
ALLERGEN  GREEN BEAN,25240043,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  ONION,25240044,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN GRAPEFRUIT,25240045,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  LIME,25240046,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  TANGERINE,25240047,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  TURKEY,25240048,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  ALFALFA,25240049,CDM,86003,CPT,300,RC,outpatient,,21,21,,17.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.25,22,,percent of total billed charges,,,,,,,,,18.9,90,,percent of total billed charges,,,17.39,82.8,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,,,,,,,,18.48,88,,percent of total billed charges,,,,,,,,,16.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.25,22,,percent of total billed charges,,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.22,82,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,5.25,19.95,
ALLERGEN  RABBIT,25240050,CDM,86003,CPT,300,RC,outpatient,,11,11,,9.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.75,22,,percent of total billed charges,,,,,,,,,9.9,90,,percent of total billed charges,,,9.11,82.8,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,,,,,,,,9.68,88,,percent of total billed charges,,,,,,,,,8.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.75,22,,percent of total billed charges,,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,,,,,,,,,,,,,9.13,83,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.02,82,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,2.75,10.45,
ALLERGEN  MOUSE URINE,25240051,CDM,86003,CPT,300,RC,outpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3,22,,percent of total billed charges,,,,,,,,,10.8,90,,percent of total billed charges,,,9.94,82.8,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3,22,,percent of total billed charges,,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,3,11.4,
ALLERGEN DUST MITE,25240052,CDM,86003,CPT,300,RC,outpatient,,7,7,,5.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.75,22,,percent of total billed charges,,,,,,,,,6.3,90,,percent of total billed charges,,,5.8,82.8,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,,,,,,,,6.16,88,,percent of total billed charges,,,,,,,,,5.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.75,22,,percent of total billed charges,,,6.37,91,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,,,,,,,,,,,,,5.81,83,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.74,82,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,1.75,6.65,
ALLERGEN  SHEEP SORREL,25240054,CDM,86003,CPT,300,RC,outpatient,,7,7,,5.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.75,22,,percent of total billed charges,,,,,,,,,6.3,90,,percent of total billed charges,,,5.8,82.8,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,,,,,,,,6.16,88,,percent of total billed charges,,,,,,,,,5.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.75,22,,percent of total billed charges,,,6.37,91,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,,,,,,,,,,,,,5.81,83,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.74,82,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,1.75,6.65,
ALLERGEN  NETTLE,25240055,CDM,86003,CPT,300,RC,outpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3,22,,percent of total billed charges,,,,,,,,,10.8,90,,percent of total billed charges,,,9.94,82.8,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3,22,,percent of total billed charges,,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,3,11.4,
ALLERGEN  SILVER BIRCH,25240056,CDM,86003,CPT,300,RC,outpatient,,7,7,,5.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.75,22,,percent of total billed charges,,,,,,,,,6.3,90,,percent of total billed charges,,,5.8,82.8,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,,,,,,,,6.16,88,,percent of total billed charges,,,,,,,,,5.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.75,22,,percent of total billed charges,,,6.37,91,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,,,,,,,,,,,,,5.81,83,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.74,82,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,1.75,6.65,
ALLERGEN PORK,25240057,CDM,86003,CPT,300,RC,outpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3,22,,percent of total billed charges,,,,,,,,,10.8,90,,percent of total billed charges,,,9.94,82.8,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3,22,,percent of total billed charges,,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,3,11.4,
ALLERGEN MOSQUITO WHOLE BODY,25240058,CDM,86003,CPT,300,RC,outpatient,,47,47,,39.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.75,22,,percent of total billed charges,,,,,,,,,42.3,90,,percent of total billed charges,,,38.92,82.8,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,,,,,,,,41.36,88,,percent of total billed charges,,,,,,,,,35.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.75,22,,percent of total billed charges,,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,,,,,,,,,,,,,39.01,83,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,38.54,82,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,11.75,44.65,
.ALLERGEN PROFILE LATEX PLUS,25240060,CDM,86003,CPT,300,RC,outpatient,,47,47,,39.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.75,22,,percent of total billed charges,,,,,,,,,42.3,90,,percent of total billed charges,,,38.92,82.8,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,,,,,,,,41.36,88,,percent of total billed charges,,,,,,,,,35.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.75,22,,percent of total billed charges,,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,,,,,,,,,,,,,39.01,83,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,38.54,82,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,11.75,44.65,
ALLERGEN  MACADAMIA NUT,25240062,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  PECAN,25240063,CDM,86003,CPT,300,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
ALLERGEN  CELERY,25240065,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  LETTUCE,25240066,CDM,86003,CPT,300,RC,outpatient,,62,62,,52.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.5,22,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,51.34,82.8,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,,,,,,,,54.56,88,,percent of total billed charges,,,,,,,,,47.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.5,22,,percent of total billed charges,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,50.84,82,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,15.5,58.9,
ALLERGEN  EPICOCCUM PURPUR,25240067,CDM,86003,CPT,300,RC,outpatient,,21,21,,17.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.25,22,,percent of total billed charges,,,,,,,,,18.9,90,,percent of total billed charges,,,17.39,82.8,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,,,,,,,,18.48,88,,percent of total billed charges,,,,,,,,,16.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.25,22,,percent of total billed charges,,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.22,82,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,5.25,19.95,
ALLERGEN  RAT URINE,25240068,CDM,86003,CPT,300,RC,outpatient,,21,21,,17.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.25,22,,percent of total billed charges,,,,,,,,,18.9,90,,percent of total billed charges,,,17.39,82.8,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,,,,,,,,18.48,88,,percent of total billed charges,,,,,,,,,16.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.25,22,,percent of total billed charges,,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.22,82,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,5.25,19.95,
ALLERGEN  ORCHARD GRASS,25240069,CDM,86003,CPT,300,RC,outpatient,,21,21,,17.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.25,22,,percent of total billed charges,,,,,,,,,18.9,90,,percent of total billed charges,,,17.39,82.8,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,,,,,,,,18.48,88,,percent of total billed charges,,,,,,,,,16.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.25,22,,percent of total billed charges,,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.22,82,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,5.25,19.95,
PTT LA (SEND OUT),25250000,CDM,85730,CPT,300,RC,outpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27,22,,percent of total billed charges,,,,,,,,,97.2,90,,percent of total billed charges,,,89.42,82.8,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27,22,,percent of total billed charges,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,27,102.6,
C1 INHIBITOR FUNCTIONAL,25250002,CDM,86160,CPT,300,RC,outpatient,,72,72,,61.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18,22,,percent of total billed charges,,,,,,,,,64.8,90,,percent of total billed charges,,,59.62,82.8,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,,,,,,,,63.36,88,,percent of total billed charges,,,,,,,,,55.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18,22,,percent of total billed charges,,,65.52,91,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,,,,,,,,,,,,,59.76,83,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,59.04,82,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,18,68.4,
C1 INHIBITOR PROTEIN TOTAL,25250004,CDM,86161,CPT,300,RC,outpatient,,44,44,,37.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11,22,,percent of total billed charges,,,,,,,,,39.6,90,,percent of total billed charges,,,36.43,82.8,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,,,,,,,,38.72,88,,percent of total billed charges,,,,,,,,,33.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11,22,,percent of total billed charges,,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,36.08,82,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,11,41.8,
VARICELLA-ZOSTER PCR,25250005,CDM,87798,CPT,300,RC,outpatient,,485,485,,411.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,121.25,22,,percent of total billed charges,,,,,,,,,436.5,90,,percent of total billed charges,,,401.58,82.8,,percent of total billed charges,,,412.25,85,,percent of total billed charges,,,,,,,,,426.8,88,,percent of total billed charges,,,,,,,,,370.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,121.25,22,,percent of total billed charges,,,441.35,91,,percent of total billed charges,,,460.75,95,,percent of total billed charges,,,402.55,83,,percent of total billed charges,,,402.55,83,,percent of total billed charges,,,,,,,,,,,,,,,402.55,83,,percent of total billed charges,,,460.75,95,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,397.7,82,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,412.25,85,,percent of total billed charges,,121.25,460.75,
.PATHOLOGIST CONSULATION,25250008,CDM,80503,CPT,300,RC,outpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.25,22,,percent of total billed charges,,,,,,,,,94.5,90,,percent of total billed charges,,,86.94,82.8,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.25,22,,percent of total billed charges,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,26.25,99.75,
FACTOR XIII,25250009,CDM,85291,CPT,300,RC,outpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.5,22,,percent of total billed charges,,,,,,,,,91.8,90,,percent of total billed charges,,,84.46,82.8,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.5,22,,percent of total billed charges,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,25.5,96.9,
.PATHOLOGIST CONSULATION (MODERATE,25250010,CDM,80504,CPT,300,RC,outpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.25,22,,percent of total billed charges,,,,,,,,,94.5,90,,percent of total billed charges,,,86.94,82.8,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.25,22,,percent of total billed charges,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,26.25,99.75,
.PATHOLOGIST CONSULATION(HIGH),25250011,CDM,80505,CPT,300,RC,outpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.25,22,,percent of total billed charges,,,,,,,,,94.5,90,,percent of total billed charges,,,86.94,82.8,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.25,22,,percent of total billed charges,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,26.25,99.75,
.PATHOLOGIST CONSULATION(PROLONG),25250012,CDM,80506,CPT,300,RC,outpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.25,22,,percent of total billed charges,,,,,,,,,94.5,90,,percent of total billed charges,,,86.94,82.8,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.25,22,,percent of total billed charges,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,26.25,99.75,
REFERED SLIDE CONSULT,25250015,CDM,88321,CPT,300,RC,outpatient,,316,316,,268.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79,22,,percent of total billed charges,,,,,,,,,284.4,90,,percent of total billed charges,,,261.65,82.8,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,,,,,,,,278.08,88,,percent of total billed charges,,,,,,,,,241.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79,22,,percent of total billed charges,,,287.56,91,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,,,,,,,,,,,,,262.28,83,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,259.12,82,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,79,300.2,
MONKEYPOX DNA  PCR,25250017,CDM,87798,CPT,300,RC,outpatient,,158,158,,134.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.5,22,,percent of total billed charges,,,,,,,,,142.2,90,,percent of total billed charges,,,130.82,82.8,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,,,,,,,,139.04,88,,percent of total billed charges,,,,,,,,,120.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.5,22,,percent of total billed charges,,,143.78,91,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,,,,,,,,,,,,,131.14,83,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,129.56,82,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,39.5,150.1,
POLIOVIRUS 1  ANTIBODY,25250020,CDM,86658,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
POLIOVIRUS 2  ANTIBODY,25250021,CDM,86382,CPT,300,RC,outpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.5,22,,percent of total billed charges,,,,,,,,,91.8,90,,percent of total billed charges,,,84.46,82.8,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.5,22,,percent of total billed charges,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,25.5,96.9,
POLIOVIRUS 3  ANTIBODY,25250022,CDM,86658,CPT,300,RC,outpatient,,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
FET,25250026,CDM,,,310,RC,outpatient,,672.48,672.48,,570.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,168.12,22,,percent of total billed charges,,,,,,,,,605.23,90,,percent of total billed charges,,,556.81,82.8,,percent of total billed charges,,,571.61,85,,percent of total billed charges,,,,,,,,,591.78,88,,percent of total billed charges,,,,,,,,,513.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,168.12,22,,percent of total billed charges,,,611.96,91,,percent of total billed charges,,,638.86,95,,percent of total billed charges,,,558.16,83,,percent of total billed charges,,,558.16,83,,percent of total billed charges,,,,,,,,,,,,,,,558.16,83,,percent of total billed charges,,,638.86,95,,percent of total billed charges,,,605.23,90,,percent of total billed charges,,,605.23,90,,percent of total billed charges,,,551.43,82,,percent of total billed charges,,,605.23,90,,percent of total billed charges,,,571.61,85,,percent of total billed charges,,168.12,638.86,
__2 HR GLUCOSE,25250032,CDM,82951,CPT,300,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
__3 HR GLUCOSE,25250033,CDM,82952,CPT,300,RC,outpatient,,85,85,,72.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.25,22,,percent of total billed charges,,,,,,,,,76.5,90,,percent of total billed charges,,,70.38,82.8,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,,,,,,,,74.8,88,,percent of total billed charges,,,,,,,,,64.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.25,22,,percent of total billed charges,,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,,,,,,,,,,,,,70.55,83,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,69.7,82,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,21.25,80.75,
__4 HR GLUCOSE,25250034,CDM,82952,CPT,300,RC,outpatient,,85,85,,72.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.25,22,,percent of total billed charges,,,,,,,,,76.5,90,,percent of total billed charges,,,70.38,82.8,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,,,,,,,,74.8,88,,percent of total billed charges,,,,,,,,,64.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.25,22,,percent of total billed charges,,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,,,,,,,,,,,,,70.55,83,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,69.7,82,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,21.25,80.75,
__5 HR GLUCOSE,25250035,CDM,82952,CPT,300,RC,outpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.75,22,,percent of total billed charges,,,,,,,,,78.3,90,,percent of total billed charges,,,72.04,82.8,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.75,22,,percent of total billed charges,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,21.75,82.65,
..ANALGESICS >6,25250040,CDM,80331,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..ANTIDEPRESSANTS >6,25250041,CDM,80334,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..ANTIDEPRESSANTS  >6,25250042,CDM,80337,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..ANTIDEPRESSANTS  NOS,25250043,CDM,80338,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..ANTIEPILEPTICS >7,25250044,CDM,80341,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..ANTIPSYCHOYICS >7,25250045,CDM,80344,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..BENZODIAZEPINES 1-12,25250046,CDM,80346,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..BUPRENOPHINE,25250047,CDM,80348,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..COCAINE,25250048,CDM,80353,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..FENTANYL,25250049,CDM,80354,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..GABAPENTIN,25250050,CDM,80355,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..KETAMINE,25250051,CDM,80357,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..METHADONE,25250052,CDM,80358,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..MDMA,25250053,CDM,80359,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..METHYPHENIDATE,25250054,CDM,80360,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..OPIATES,25250055,CDM,80361,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..OPIOIDS >5,25250056,CDM,80364,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..OXYCODONE,25250057,CDM,80365,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..PREGABALIN,25250058,CDM,80366,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..PROPOXYPHENE,25250059,CDM,80367,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..SEDATIVE HYPNOTICS,25250060,CDM,80368,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..SKELETAL RELAXANTS >3,25250061,CDM,80370,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..STIMULANTS SYNTHETIC,25250062,CDM,80371,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..TAPENTADOL,25250063,CDM,80372,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..TRAMADOL,25250064,CDM,80372,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..DRUGS NOS X7,25250065,CDM,80377,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..PHENCYCLIDINE,25250066,CDM,83992,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..DRUGS NOS,25250067,CDM,80307,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
..AMPHETAMINES 5 OR MORE,25250068,CDM,80326,CPT,300,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
ALLERGEN  HAMSTER EPITHELIUM,25250314,CDM,86003,CPT,300,RC,outpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3,22,,percent of total billed charges,,,,,,,,,10.8,90,,percent of total billed charges,,,9.94,82.8,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3,22,,percent of total billed charges,,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,3,11.4,
ANA IFA W/ REFLEX,25252518,CDM,86038,CPT,300,RC,outpatient,,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
aPTT MIXING STUDIES,25252519,CDM,85730,CPT,300,RC,outpatient,,421,421,,357.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,105.25,22,,percent of total billed charges,,,,,,,,,378.9,90,,percent of total billed charges,,,348.59,82.8,,percent of total billed charges,,,357.85,85,,percent of total billed charges,,,,,,,,,370.48,88,,percent of total billed charges,,,,,,,,,321.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,105.25,22,,percent of total billed charges,,,383.11,91,,percent of total billed charges,,,399.95,95,,percent of total billed charges,,,349.43,83,,percent of total billed charges,,,349.43,83,,percent of total billed charges,,,,,,,,,,,,,,,349.43,83,,percent of total billed charges,,,399.95,95,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,345.22,82,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,357.85,85,,percent of total billed charges,,105.25,399.95,
aPT MIXING STUDIES,25252520,CDM,85610,CPT,300,RC,outpatient,,179,179,,151.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.75,22,,percent of total billed charges,,,,,,,,,161.1,90,,percent of total billed charges,,,148.21,82.8,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,,,,,,,,157.52,88,,percent of total billed charges,,,,,,,,,136.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.75,22,,percent of total billed charges,,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,146.78,82,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,44.75,170.05,
HEPARIN-DEP PLATELET AB,25252521,CDM,82542,CPT,300,RC,outpatient,,668,668,,567.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,167,22,,percent of total billed charges,,,,,,,,,601.2,90,,percent of total billed charges,,,553.1,82.8,,percent of total billed charges,,,567.8,85,,percent of total billed charges,,,,,,,,,587.84,88,,percent of total billed charges,,,,,,,,,510.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,167,22,,percent of total billed charges,,,607.88,91,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,,,,,,,,,,,,,554.44,83,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,547.76,82,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,567.8,85,,percent of total billed charges,,167,634.6,
IFE & PROTEIN ELECTROPHORESIS(24HR),25252522,CDM,84156,CPT,300,RC,outpatient,,79,79,,67.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.75,22,,percent of total billed charges,,,,,,,,,71.1,90,,percent of total billed charges,,,65.41,82.8,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,,,,,,,,69.52,88,,percent of total billed charges,,,,,,,,,60.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.75,22,,percent of total billed charges,,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,,,,,,,,,,,,,65.57,83,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,64.78,82,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,19.75,75.05,
SERIAL CBC W/AUTO DIFF,25260000,CDM,85025,CPT,300,RC,outpatient,,207,207,,175.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.75,22,,percent of total billed charges,,,,,,,,,186.3,90,,percent of total billed charges,,,171.4,82.8,,percent of total billed charges,,,175.95,85,,percent of total billed charges,,,,,,,,,182.16,88,,percent of total billed charges,,,,,,,,,158.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.75,22,,percent of total billed charges,,,188.37,91,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,,,,,,,,,,,,,171.81,83,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,169.74,82,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,175.95,85,,percent of total billed charges,,51.75,196.65,
SERIAL COMP METABOLIC PANEL,25260001,CDM,80053,CPT,300,RC,outpatient,,337,337,,286.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.25,22,,percent of total billed charges,,,,,,,,,303.3,90,,percent of total billed charges,,,279.04,82.8,,percent of total billed charges,,,286.45,85,,percent of total billed charges,,,,,,,,,296.56,88,,percent of total billed charges,,,,,,,,,257.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.25,22,,percent of total billed charges,,,306.67,91,,percent of total billed charges,,,320.15,95,,percent of total billed charges,,,279.71,83,,percent of total billed charges,,,279.71,83,,percent of total billed charges,,,,,,,,,,,,,,,279.71,83,,percent of total billed charges,,,320.15,95,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,276.34,82,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,286.45,85,,percent of total billed charges,,84.25,320.15,
SERIAL LDH,25260002,CDM,83615,CPT,300,RC,outpatient,,165,165,,140.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.25,22,,percent of total billed charges,,,,,,,,,148.5,90,,percent of total billed charges,,,136.62,82.8,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,,,,,,,,145.2,88,,percent of total billed charges,,,,,,,,,126.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.25,22,,percent of total billed charges,,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,135.3,82,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,41.25,156.75,
SERIAL TROPONIN-I,25260003,CDM,84484,CPT,300,RC,outpatient,,379,379,,321.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94.75,22,,percent of total billed charges,,,,,,,,,341.1,90,,percent of total billed charges,,,313.81,82.8,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,,,,,,,,333.52,88,,percent of total billed charges,,,,,,,,,289.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94.75,22,,percent of total billed charges,,,344.89,91,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,,,,,,,,,,,,,314.57,83,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,310.78,82,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,94.75,360.05,
SERIAL PROTHROMBIN TIME w/INR,25260005,CDM,85610,CPT,300,RC,outpatient,,174,174,,147.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.5,22,,percent of total billed charges,,,,,,,,,156.6,90,,percent of total billed charges,,,144.07,82.8,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,,,,,,,,153.12,88,,percent of total billed charges,,,,,,,,,132.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.5,22,,percent of total billed charges,,,158.34,91,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,,,,,,,,,,,,,144.42,83,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,142.68,82,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,43.5,165.3,
SERIAL PARTIAL THROMBOPLASTIN TIME (PTT),25260006,CDM,85730,CPT,300,RC,outpatient,,187,187,,158.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.75,22,,percent of total billed charges,,,,,,,,,168.3,90,,percent of total billed charges,,,154.84,82.8,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,,,,,,,,164.56,88,,percent of total billed charges,,,,,,,,,142.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.75,22,,percent of total billed charges,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,153.34,82,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,46.75,177.65,
SERIAL D-DIMER,25260008,CDM,85379,CPT,300,RC,outpatient,,211,211,,179.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.75,22,,percent of total billed charges,,,,,,,,,189.9,90,,percent of total billed charges,,,174.71,82.8,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,,,,,,,,185.68,88,,percent of total billed charges,,,,,,,,,161.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.75,22,,percent of total billed charges,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,173.02,82,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,52.75,200.45,
SERIAL FIBRINOGEN (ANTIGEN),25260009,CDM,85385,CPT,300,RC,outpatient,,504,504,,427.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126,22,,percent of total billed charges,,,,,,,,,453.6,90,,percent of total billed charges,,,417.31,82.8,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,,,,,,,,443.52,88,,percent of total billed charges,,,,,,,,,385.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126,22,,percent of total billed charges,,,458.64,91,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,418.32,83,,percent of total billed charges,,,,,,,,,,,,,,,418.32,83,,percent of total billed charges,,,478.8,95,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,413.28,82,,percent of total billed charges,,,453.6,90,,percent of total billed charges,,,428.4,85,,percent of total billed charges,,126,478.8,
SERIAL FERRITIN,25260010,CDM,82728,CPT,300,RC,outpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
SERIAL ALT,25260011,CDM,84460,CPT,300,RC,outpatient,,162,162,,137.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.5,22,,percent of total billed charges,,,,,,,,,145.8,90,,percent of total billed charges,,,134.14,82.8,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,,,,,,,,142.56,88,,percent of total billed charges,,,,,,,,,123.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.5,22,,percent of total billed charges,,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,,,,,,,,,,,,,134.46,83,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,132.84,82,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,40.5,153.9,
SERIAL CK TOTAL,25260012,CDM,82550,CPT,300,RC,outpatient,,155,155,,131.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.75,22,,percent of total billed charges,,,,,,,,,139.5,90,,percent of total billed charges,,,128.34,82.8,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,,,,,,,,136.4,88,,percent of total billed charges,,,,,,,,,118.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.75,22,,percent of total billed charges,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,127.1,82,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,38.75,147.25,
SERIAL C-REACTIVE PROTEIN,25260013,CDM,86140,CPT,300,RC,outpatient,,135,135,,114.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.75,22,,percent of total billed charges,,,,,,,,,121.5,90,,percent of total billed charges,,,111.78,82.8,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,,,,,,,,118.8,88,,percent of total billed charges,,,,,,,,,103.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.75,22,,percent of total billed charges,,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,,,,,,,,,,,,,112.05,83,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,110.7,82,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,33.75,128.25,
CYSTIC FIBROSIS GENE SEQ,25279400,CDM,81223,CPT,300,RC,outpatient,,1785,1785,,1515.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,446.25,22,,percent of total billed charges,,,,,,,,,1606.5,90,,percent of total billed charges,,,1477.98,82.8,,percent of total billed charges,,,1517.25,85,,percent of total billed charges,,,,,,,,,1570.8,88,,percent of total billed charges,,,,,,,,,1363.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,446.25,22,,percent of total billed charges,,,1624.35,91,,percent of total billed charges,,,1695.75,95,,percent of total billed charges,,,1481.55,83,,percent of total billed charges,,,1481.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1481.55,83,,percent of total billed charges,,,1695.75,95,,percent of total billed charges,,,1606.5,90,,percent of total billed charges,,,1606.5,90,,percent of total billed charges,,,1463.7,82,,percent of total billed charges,,,1606.5,90,,percent of total billed charges,,,1517.25,85,,percent of total billed charges,,446.25,1695.75,
PANCREATITIS 3 GENE PROFILE,25279401,CDM,81223,CPT,300,RC,outpatient,,1785,1785,,1515.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,446.25,22,,percent of total billed charges,,,,,,,,,1606.5,90,,percent of total billed charges,,,1477.98,82.8,,percent of total billed charges,,,1517.25,85,,percent of total billed charges,,,,,,,,,1570.8,88,,percent of total billed charges,,,,,,,,,1363.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,446.25,22,,percent of total billed charges,,,1624.35,91,,percent of total billed charges,,,1695.75,95,,percent of total billed charges,,,1481.55,83,,percent of total billed charges,,,1481.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1481.55,83,,percent of total billed charges,,,1695.75,95,,percent of total billed charges,,,1606.5,90,,percent of total billed charges,,,1606.5,90,,percent of total billed charges,,,1463.7,82,,percent of total billed charges,,,1606.5,90,,percent of total billed charges,,,1517.25,85,,percent of total billed charges,,446.25,1695.75,
.PL-7 AB,25300001,CDM,86235,CPT,300,RC,outpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.25,22,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,77,82.8,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.25,22,,percent of total billed charges,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,23.25,88.35,
.PL-12 AB,25300002,CDM,86235,CPT,300,RC,outpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.25,22,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,77,82.8,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.25,22,,percent of total billed charges,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,23.25,88.35,
.EJ AB,25300003,CDM,86235,CPT,300,RC,outpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.25,22,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,77,82.8,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.25,22,,percent of total billed charges,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,23.25,88.35,
.OJ AB,25300004,CDM,86235,CPT,300,RC,outpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.25,22,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,77,82.8,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.25,22,,percent of total billed charges,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,23.25,88.35,
.RO-52 AB,25300005,CDM,86235,CPT,300,RC,outpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.25,22,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,77,82.8,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.25,22,,percent of total billed charges,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,23.25,88.35,
.SCL-100 AB,25300006,CDM,86235,CPT,300,RC,outpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.25,22,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,77,82.8,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.25,22,,percent of total billed charges,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,23.25,88.35,
.KU AB,25300007,CDM,86235,CPT,300,RC,outpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.25,22,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,77,82.8,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.25,22,,percent of total billed charges,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,23.25,88.35,
.SIGNAL RECOG PARTICLE,25300008,CDM,86235,CPT,300,RC,outpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.25,22,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,77,82.8,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.25,22,,percent of total billed charges,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,23.25,88.35,
.MI-2 AB,25300009,CDM,86235,CPT,300,RC,outpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.25,22,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,77,82.8,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.25,22,,percent of total billed charges,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,23.25,88.35,
FL C-REACTIVE PROTEIN,25400000,CDM,86140,CPT,300,RC,outpatient,TC,67,67,,56.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.75,22,,percent of total billed charges,,,,,,,,,60.3,90,,percent of total billed charges,,,55.48,82.8,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,,,,,,,,58.96,88,,percent of total billed charges,,,,,,,,,51.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.75,22,,percent of total billed charges,,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,,,,,,,,,,,,,55.61,83,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,54.94,82,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,16.75,63.65,
FL MAGNESIUM,25400001,CDM,83735,CPT,300,RC,outpatient,TC,85,85,,72.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.25,22,,percent of total billed charges,,,,,,,,,76.5,90,,percent of total billed charges,,,70.38,82.8,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,,,,,,,,74.8,88,,percent of total billed charges,,,,,,,,,64.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.25,22,,percent of total billed charges,,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,,,,,,,,,,,,,70.55,83,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,69.7,82,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,21.25,80.75,
FL IRON TOTAL,25400002,CDM,83540,CPT,300,RC,outpatient,TC,76,76,,64.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19,22,,percent of total billed charges,,,,,,,,,68.4,90,,percent of total billed charges,,,62.93,82.8,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,,,,,,,,66.88,88,,percent of total billed charges,,,,,,,,,58.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19,22,,percent of total billed charges,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,,,,,,,,,,,,,63.08,83,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,62.32,82,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,19,72.2,
FL LDH,25400003,CDM,83615,CPT,300,RC,outpatient,TC,72,72,,61.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18,22,,percent of total billed charges,,,,,,,,,64.8,90,,percent of total billed charges,,,59.62,82.8,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,,,,,,,,63.36,88,,percent of total billed charges,,,,,,,,,55.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18,22,,percent of total billed charges,,,65.52,91,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,,,,,,,,,,,,,59.76,83,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,59.04,82,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,18,68.4,
FL URIC ACID SERUM,25400004,CDM,84550,CPT,300,RC,outpatient,TC,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12,22,,percent of total billed charges,,,,,,,,,43.2,90,,percent of total billed charges,,,39.74,82.8,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12,22,,percent of total billed charges,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,12,45.6,
FL PHOSPHORUS SERUM,25400005,CDM,84100,CPT,300,RC,outpatient,TC,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.25,22,,percent of total billed charges,,,,,,,,,40.5,90,,percent of total billed charges,,,37.26,82.8,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.25,22,,percent of total billed charges,,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,11.25,42.75,
FL VITAMIN B12,25400006,CDM,82607,CPT,300,RC,outpatient,TC,122,122,,103.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.5,22,,percent of total billed charges,,,,,,,,,109.8,90,,percent of total billed charges,,,101.02,82.8,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,,,,,,,,107.36,88,,percent of total billed charges,,,,,,,,,93.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.5,22,,percent of total billed charges,,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,100.04,82,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,30.5,115.9,
FL HOMOCYSTEINE CARDIOVASCULAR,25400007,CDM,83090,CPT,300,RC,outpatient,TC,182,182,,154.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.5,22,,percent of total billed charges,,,,,,,,,163.8,90,,percent of total billed charges,,,150.7,82.8,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,,,,,,,,160.16,88,,percent of total billed charges,,,,,,,,,139.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.5,22,,percent of total billed charges,,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,149.24,82,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,45.5,172.9,
FL APOLIPOPROTEIN B,25400008,CDM,82172,CPT,300,RC,outpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27,22,,percent of total billed charges,,,,,,,,,97.2,90,,percent of total billed charges,,,89.42,82.8,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27,22,,percent of total billed charges,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,27,102.6,
FL  LIPOPROTEIN A,25400009,CDM,83695,CPT,300,RC,outpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27,22,,percent of total billed charges,,,,,,,,,97.2,90,,percent of total billed charges,,,89.42,82.8,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27,22,,percent of total billed charges,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,27,102.6,
FL VITAMIN D 25-HYDROXY,25400010,CDM,82306,CPT,300,RC,outpatient,,126,126,,106.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.5,22,,percent of total billed charges,,,,,,,,,113.4,90,,percent of total billed charges,,,104.33,82.8,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,,,,,,,,110.88,88,,percent of total billed charges,,,,,,,,,96.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.5,22,,percent of total billed charges,,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,103.32,82,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,31.5,119.7,
FL DHEA-SULFATE,25400011,CDM,82627,CPT,300,RC,outpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.25,22,,percent of total billed charges,,,,,,,,,108.9,90,,percent of total billed charges,,,100.19,82.8,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.25,22,,percent of total billed charges,,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,30.25,114.95,
COCCIDIOIDES IMMITIS,25502455,CDM,86635,CPT,300,RC,outpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.5,22,,percent of total billed charges,,,,,,,,,91.8,90,,percent of total billed charges,,,84.46,82.8,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.5,22,,percent of total billed charges,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,25.5,96.9,
BCR/ABL GENE REARRANGEMENT QT PCR,25799999,CDM,81206,CPT,300,RC,outpatient,,698,698,,592.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,174.5,22,,percent of total billed charges,,,,,,,,,628.2,90,,percent of total billed charges,,,577.94,82.8,,percent of total billed charges,,,593.3,85,,percent of total billed charges,,,,,,,,,614.24,88,,percent of total billed charges,,,,,,,,,533.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,174.5,22,,percent of total billed charges,,,635.18,91,,percent of total billed charges,,,663.1,95,,percent of total billed charges,,,579.34,83,,percent of total billed charges,,,579.34,83,,percent of total billed charges,,,,,,,,,,,,,,,579.34,83,,percent of total billed charges,,,663.1,95,,percent of total billed charges,,,628.2,90,,percent of total billed charges,,,628.2,90,,percent of total billed charges,,,572.36,82,,percent of total billed charges,,,628.2,90,,percent of total billed charges,,,593.3,85,,percent of total billed charges,,174.5,663.1,
.NUCLEIC ACID ISOLATION/EXTRACTION,25800000,CDM,83891,CPT,300,RC,outpatient,,189,189,,160.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.25,22,,percent of total billed charges,,,,,,,,,170.1,90,,percent of total billed charges,,,156.49,82.8,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,,,,,,,,166.32,88,,percent of total billed charges,,,,,,,,,144.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.25,22,,percent of total billed charges,,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,,,,,,,,,,,,,156.87,83,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,154.98,82,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,47.25,179.55,
".NUCLEIC ACID PROBE, each",25800001,CDM,83896,CPT,300,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
.NUCLEIC ACID AMPLIFICATION 1 SEQ,25800002,CDM,83898,CPT,300,RC,outpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6,22,,percent of total billed charges,,,,,,,,,21.6,90,,percent of total billed charges,,,19.87,82.8,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6,22,,percent of total billed charges,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,6,22.8,
.NUCLEIC ACID AMPLIFICATION 1&2 SEQ,25800003,CDM,83900,CPT,300,RC,outpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.25,22,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,63.76,82.8,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.25,22,,percent of total billed charges,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,19.25,73.15,
.NUCLEIC ACID AMPLIFICATION ADD SEQ,25800004,CDM,83901,CPT,300,RC,outpatient,,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.5,22,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,64.58,82.8,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.5,22,,percent of total billed charges,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,19.5,74.1,
.NUCLEIC ACID REVERSE TRANSCRIPTION,25800005,CDM,83902,CPT,300,RC,outpatient,,42,42,,35.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.5,22,,percent of total billed charges,,,,,,,,,37.8,90,,percent of total billed charges,,,34.78,82.8,,percent of total billed charges,,,35.7,85,,percent of total billed charges,,,,,,,,,36.96,88,,percent of total billed charges,,,,,,,,,32.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.5,22,,percent of total billed charges,,,38.22,91,,percent of total billed charges,,,39.9,95,,percent of total billed charges,,,34.86,83,,percent of total billed charges,,,34.86,83,,percent of total billed charges,,,,,,,,,,,,,,,34.86,83,,percent of total billed charges,,,39.9,95,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,34.44,82,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,35.7,85,,percent of total billed charges,,10.5,39.9,
.NUCLEIC ACID INTERPRETATION,25800006,CDM,83912,CPT,300,RC,outpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.5,22,,percent of total billed charges,,,,,,,,,45,90,,percent of total billed charges,,,41.4,82.8,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.5,22,,percent of total billed charges,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,12.5,47.5,
NOROVIRUS,25920592,CDM,87798,CPT,300,RC,outpatient,,246,246,,208.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.5,22,,percent of total billed charges,,,,,,,,,221.4,90,,percent of total billed charges,,,203.69,82.8,,percent of total billed charges,,,209.1,85,,percent of total billed charges,,,,,,,,,216.48,88,,percent of total billed charges,,,,,,,,,187.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.5,22,,percent of total billed charges,,,223.86,91,,percent of total billed charges,,,233.7,95,,percent of total billed charges,,,204.18,83,,percent of total billed charges,,,204.18,83,,percent of total billed charges,,,,,,,,,,,,,,,204.18,83,,percent of total billed charges,,,233.7,95,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,201.72,82,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,209.1,85,,percent of total billed charges,,61.5,233.7,
TH (DO NOT ORDER),25999964,CDM,,,300,RC,outpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
HEMOGLOBIN A1c,25999965,CDM,83036,CPT,300,RC,outpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
ANGIOTENSIN-1-CONVERTING ENZYME,25999966,CDM,82164,CPT,300,RC,outpatient,,223,223,,189.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.75,22,,percent of total billed charges,,,,,,,,,200.7,90,,percent of total billed charges,,,184.64,82.8,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,,,,,,,,196.24,88,,percent of total billed charges,,,,,,,,,170.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.75,22,,percent of total billed charges,,,202.93,91,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,,,,,,,,,,,,,185.09,83,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,182.86,82,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,55.75,211.85,
9P21 GENOTYPE,25999973,CDM,81479,CPT,300,RC,outpatient,,764,764,,648.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,191,22,,percent of total billed charges,,,,,,,,,687.6,90,,percent of total billed charges,,,632.59,82.8,,percent of total billed charges,,,649.4,85,,percent of total billed charges,,,,,,,,,672.32,88,,percent of total billed charges,,,,,,,,,583.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,191,22,,percent of total billed charges,,,695.24,91,,percent of total billed charges,,,725.8,95,,percent of total billed charges,,,634.12,83,,percent of total billed charges,,,634.12,83,,percent of total billed charges,,,,,,,,,,,,,,,634.12,83,,percent of total billed charges,,,725.8,95,,percent of total billed charges,,,687.6,90,,percent of total billed charges,,,687.6,90,,percent of total billed charges,,,626.48,82,,percent of total billed charges,,,687.6,90,,percent of total billed charges,,,649.4,85,,percent of total billed charges,,191,725.8,
KIF6 GENOTYPE,25999974,CDM,81479,CPT,300,RC,outpatient,,495,495,,420.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.75,22,,percent of total billed charges,,,,,,,,,445.5,90,,percent of total billed charges,,,409.86,82.8,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,,,,,,,,435.6,88,,percent of total billed charges,,,,,,,,,378.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.75,22,,percent of total billed charges,,,450.45,91,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,,,,,,,,,,,,,410.85,83,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,405.9,82,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,123.75,470.25,
ISTAT CHEM PANEL XRAY,26100005,CDM,82565,CPT,300,RC,outpatient,,97,97,,82.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.25,22,,percent of total billed charges,,,,,,,,,87.3,90,,percent of total billed charges,,,80.32,82.8,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,,,,,,,,85.36,88,,percent of total billed charges,,,,,,,,,74.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.25,22,,percent of total billed charges,,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,,,,,,,,,,,,,80.51,83,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,79.54,82,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,24.25,92.15,
ISTAT CREATININE XRAY,26100006,CDM,82565,CPT,300,RC,outpatient,,118,118,,100.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.5,22,,percent of total billed charges,,,,,,,,,106.2,90,,percent of total billed charges,,,97.7,82.8,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,,,,,,,,103.84,88,,percent of total billed charges,,,,,,,,,90.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.5,22,,percent of total billed charges,,,107.38,91,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,,,,,,,,,,,,,97.94,83,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,96.76,82,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,29.5,112.1,
OT MOD 59 MANUAL THERAPY ANNEX,5900500,CDM,97140,CPT,430,RC,outpatient,GO,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
OT MOD 59 THERAPUTIC ACTIVITY ANNEX,5900501,CDM,97530,CPT,430,RC,outpatient,GO,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
OT MOD 59 THERAPUTIC EXER 15 MIN ANNEX,5900502,CDM,97110,CPT,430,RC,outpatient,GO,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
OT FUNCTIONAL THERAPEUTIC ACTIVITY ANNEX,5900606,CDM,97530,CPT,430,RC,outpatient,GO,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
OT SEF CARE/ MANG. TRNG. EA 15 MIN ANNEX,5900607,CDM,97535,CPT,430,RC,outpatient,GO,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62,22,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,205.34,82.8,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62,22,,percent of total billed charges,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,62,235.6,
OT COMM/W RE-INTEG. TRNG. EA 15MIN ANNEX,5900608,CDM,97537,CPT,430,RC,outpatient,GO,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38,22,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,125.86,82.8,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38,22,,percent of total billed charges,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,38,144.4,
OT W/C MGT/PROPULSON TMG 15 MIN ANNEX,5900620,CDM,97542,CPT,430,RC,outpatient,GO,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
OT DEV COG SK(ATTNPROB SOLV/EA15MN ANNEX,5900714,CDM,97129,CPT,430,RC,outpatient,GO,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
OT MANUAL THERAPY TQS EA 15 MIN ANNEX,5900720,CDM,97140,CPT,430,RC,outpatient,GO,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
OT THERA EX FOR STRENGTH EA 15 MIN ANNEX,5900738,CDM,97110,CPT,430,RC,outpatient,GO,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
"OT NEUR-MUSC RE-ED,BAL/PR/PST 15M ANNEX",5900739,CDM,97112,CPT,430,RC,outpatient,GO,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.5,22,,percent of total billed charges,,,,,,,,,214.2,90,,percent of total billed charges,,,197.06,82.8,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.5,22,,percent of total billed charges,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,59.5,226.1,
"OT ORT MGMT&TRNG, UE&LE, EA 15 MIN ANNEX",5900803,CDM,97760,CPT,430,RC,outpatient,GO,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
"OT ORO MGMT, UE&LE, EA 15 MIN MODF ANNEX",5900804,CDM,97760,CPT,430,RC,outpatient,GO,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
OT MOD 59 RE-EVALUATION ANNEX(V10-19),5900990,CDM,97004,CPT,430,RC,outpatient,GO,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.75,22,,percent of total billed charges,,,,,,,,,351.9,90,,percent of total billed charges,,,323.75,82.8,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.75,22,,percent of total billed charges,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,97.75,371.45,
OT RE-EVALUATION ANNEX(V10-19),5900993,CDM,97004,CPT,430,RC,outpatient,GO,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.75,22,,percent of total billed charges,,,,,,,,,351.9,90,,percent of total billed charges,,,323.75,82.8,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.75,22,,percent of total billed charges,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,97.75,371.45,
OT OCCUPATIONAL THER EVAL ANNEX(V10-19),5901041,CDM,97003,CPT,434,RC,outpatient,GO,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153,22,,percent of total billed charges,,,,,,,,,550.8,90,,percent of total billed charges,,,506.74,82.8,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153,22,,percent of total billed charges,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,153,581.4,
OT OCCPNAL THER EVAL W THCAP A(V10-19),5902000,CDM,97003,CPT,434,RC,outpatient,KX,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153,22,,percent of total billed charges,,,,,,,,,550.8,90,,percent of total billed charges,,,506.74,82.8,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153,22,,percent of total billed charges,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,153,581.4,
OT RE-EVALUATION W THCAP ANNEX(V10-19),5902001,CDM,97004,CPT,434,RC,outpatient,KX,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.75,22,,percent of total billed charges,,,,,,,,,351.9,90,,percent of total billed charges,,,323.75,82.8,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.75,22,,percent of total billed charges,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,97.75,371.45,
OT HOT/COLD PACK W THCAP ANNEX,5902002,CDM,97010,CPT,430,RC,outpatient,KX,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.75,22,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,121.72,82.8,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.75,22,,percent of total billed charges,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,36.75,139.65,
OT ELEL STIMTION UNATTDED W THCAP ANNEX,5902003,CDM,97014,CPT,430,RC,outpatient,KX,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,44,167.2,
OT VASOPNEUMATIC DEVICE W THCAP ANNEX,5902004,CDM,97016,CPT,430,RC,outpatient,KX,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33,22,,percent of total billed charges,,,,,,,,,118.8,90,,percent of total billed charges,,,109.3,82.8,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33,22,,percent of total billed charges,,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,33,125.4,
OT PARAFFIN BATH I W THCAP ANNEX,5902005,CDM,97018,CPT,430,RC,outpatient,KX,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
OT WHIPOOL SUPERD/UNATTDED W THCAP ANNEX,5902006,CDM,97022,CPT,430,RC,outpatient,KX,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.5,22,,percent of total billed charges,,,,,,,,,239.4,90,,percent of total billed charges,,,220.25,82.8,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.5,22,,percent of total billed charges,,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,66.5,252.7,
OT EL STIN ATTED EA 15 MIN W THCAP ANNEX,5902007,CDM,97032,CPT,430,RC,outpatient,KX,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,38.5,146.3,
OT IONTOPHORESIS 15 MIN W THCAP ANNEX,5902008,CDM,97033,CPT,430,RC,outpatient,KX,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.75,22,,percent of total billed charges,,,,,,,,,207.9,90,,percent of total billed charges,,,191.27,82.8,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.75,22,,percent of total billed charges,,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,57.75,219.45,
OT ULTRSD/PHONOP EA 15 MIN W THCAP ANNEX,5902009,CDM,97035,CPT,430,RC,outpatient,KX,91,91,,77.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.75,22,,percent of total billed charges,,,,,,,,,81.9,90,,percent of total billed charges,,,75.35,82.8,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,,,,,,,,80.08,88,,percent of total billed charges,,,,,,,,,69.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.75,22,,percent of total billed charges,,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,,,,,,,,,,,,,75.53,83,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,74.62,82,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,22.75,86.45,
OT THRA EX FOR STRTH EA 15 W THCAP ANNEX,5902010,CDM,97110,CPT,430,RC,outpatient,KX,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
"OT NR-MSC RE-ED,BL/PT 15M W THCAP  ANNEX",5902011,CDM,97112,CPT,430,RC,outpatient,KX,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.5,22,,percent of total billed charges,,,,,,,,,214.2,90,,percent of total billed charges,,,197.06,82.8,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.5,22,,percent of total billed charges,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,59.5,226.1,
OT MANL THY TQS EA 15 MIN W THCAP ANNEX,5902012,CDM,97140,CPT,430,RC,outpatient,KX,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
OT FUNT THERTIC ACTIVITY W THCAP ANNEX,5902013,CDM,97530,CPT,430,RC,outpatient,KX,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
"OT DE CO SK(ATN,M S/EA15MN W THCAP ANNEX",5902014,CDM,97129,CPT,430,RC,outpatient,KX,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
"OT SY INTEGN TQS, EA 15 MS W THCAP ANNEX",5902015,CDM,97533,CPT,430,RC,outpatient,KX,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43,22,,percent of total billed charges,,,,,,,,,154.8,90,,percent of total billed charges,,,142.42,82.8,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43,22,,percent of total billed charges,,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,43,163.4,
OT SEF CE/HE MA. TG. EA 15 W THCAP ANNEX,5902016,CDM,97535,CPT,430,RC,outpatient,KX,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62,22,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,205.34,82.8,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62,22,,percent of total billed charges,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,62,235.6,
OT CO/WO RE-ING. TRG. EA 15W THCAP ANNEX,5902017,CDM,97537,CPT,430,RC,outpatient,KX,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38,22,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,125.86,82.8,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38,22,,percent of total billed charges,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,38,144.4,
OT W/C MGT/PRN TMG 15 MIN W THCAP ANNEX,5902018,CDM,97542,CPT,430,RC,outpatient,KX,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
OT WORK HAR/COND INIT 2 HR W THCAP ANNEX,5902019,CDM,97545,CPT,430,RC,outpatient,KX,562,562,,477.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,140.5,22,,percent of total billed charges,,,,,,,,,505.8,90,,percent of total billed charges,,,465.34,82.8,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,,,,,,,,494.56,88,,percent of total billed charges,,,,,,,,,429.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,140.5,22,,percent of total billed charges,,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,,,,,,,,,,,,,466.46,83,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,460.84,82,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,140.5,533.9,
OT WORK HARDEG/CON ADD HR W THCAP ANNEX,5902020,CDM,97546,CPT,430,RC,outpatient,KX,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.25,22,,percent of total billed charges,,,,,,,,,260.1,90,,percent of total billed charges,,,239.29,82.8,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.25,22,,percent of total billed charges,,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,72.25,274.55,
OT PY PEF TT/ME(FXN CAP)15 W THCAP ANNEX,5902021,CDM,97750,CPT,430,RC,outpatient,KX,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.75,22,,percent of total billed charges,,,,,,,,,215.1,90,,percent of total billed charges,,,197.89,82.8,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.75,22,,percent of total billed charges,,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,59.75,227.05,
"OT O MGT&TG, UE&LE,EA 15  W THCAP ANNEX",5902022,CDM,97760,CPT,430,RC,outpatient,KX,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
OT CK O ORT/PR ES PT 15 MN W THCAP ANNEX,5902023,CDM,97763,CPT,430,RC,outpatient,KX,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.5,22,,percent of total billed charges,,,,,,,,,307.8,90,,percent of total billed charges,,,283.18,82.8,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.5,22,,percent of total billed charges,,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,85.5,324.9,
OT ETL STIMN MEDICARE W THCAP ANNEX,5902024,CDM,G0283,HCPCS,430,RC,outpatient,KX,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.25,22,,percent of total billed charges,,,,,,,,,72.9,90,,percent of total billed charges,,,67.07,82.8,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.25,22,,percent of total billed charges,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,20.25,76.95,
OT THERA EX FOR STH EA 15 MIN ANNEX THER,5902034,CDM,97110,CPT,430,RC,outpatient,CO,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
OT FUNCTIONAL TH ACTIVITY ANNEX THERAPY,5902036,CDM,97530,CPT,430,RC,outpatient,CO,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
OT MAN THERAPY TQS EA 15 MIN ANNEX THERA,5902037,CDM,97140,CPT,430,RC,outpatient,CO,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
ANNEX FF ADMINISTRATION PNU VACCINE,32000001,CDM,G0009,HCPCS,771,RC,outpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.75,22,,percent of total billed charges,,,,,,,,,143.1,90,,percent of total billed charges,,,131.65,82.8,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.75,22,,percent of total billed charges,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,39.75,151.05,
ANNEX PNEUMOCOCC 23(PNEUMOVAX),32050001,CDM,90732,CPT,636,RC,outpatient,,1478,1478,,1254.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,369.5,22,,percent of total billed charges,,,,,,,,,1330.2,90,,percent of total billed charges,,,1223.78,82.8,,percent of total billed charges,,,1256.3,85,,percent of total billed charges,,,,,,,,,1300.64,88,,percent of total billed charges,,,,,,,,,1129.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,369.5,22,,percent of total billed charges,,,1344.98,91,,percent of total billed charges,,,1404.1,95,,percent of total billed charges,,,1226.74,83,,percent of total billed charges,,,1226.74,83,,percent of total billed charges,,,,,,,,,,,,,,,1226.74,83,,percent of total billed charges,,,1404.1,95,,percent of total billed charges,,,1330.2,90,,percent of total billed charges,,,1330.2,90,,percent of total billed charges,,,1211.96,82,,percent of total billed charges,,,1330.2,90,,percent of total billed charges,,,1256.3,85,,percent of total billed charges,,369.5,1404.1,
OT OCC THER EVAL LOW ANNEX,35200300,CDM,97165,CPT,434,RC,outpatient,GO,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153,22,,percent of total billed charges,,,,,,,,,550.8,90,,percent of total billed charges,,,506.74,82.8,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153,22,,percent of total billed charges,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,153,581.4,
OT OCCP THER EVAL LOW COMP W THCAP ANNEX,35200301,CDM,97165,CPT,434,RC,outpatient,KX,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153,22,,percent of total billed charges,,,,,,,,,550.8,90,,percent of total billed charges,,,506.74,82.8,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153,22,,percent of total billed charges,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,153,581.4,
OT OCC THER EVAL MOD ANNEX,35200305,CDM,97166,CPT,434,RC,outpatient,GO,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153,22,,percent of total billed charges,,,,,,,,,550.8,90,,percent of total billed charges,,,506.74,82.8,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153,22,,percent of total billed charges,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,153,581.4,
OT OCCP THER EVAL MOD COMP W THCAP ANNEX,35200306,CDM,97166,CPT,434,RC,outpatient,KX,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153,22,,percent of total billed charges,,,,,,,,,550.8,90,,percent of total billed charges,,,506.74,82.8,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153,22,,percent of total billed charges,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,153,581.4,
OT OCC THER EVAL HIGH COMPL  ANNEX,35200310,CDM,97167,CPT,434,RC,outpatient,GO,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153,22,,percent of total billed charges,,,,,,,,,550.8,90,,percent of total billed charges,,,506.74,82.8,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153,22,,percent of total billed charges,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,153,581.4,
OT OCC THER EVAL HIGH COMP W THCAP ANNEX,35200311,CDM,97167,CPT,434,RC,outpatient,KX,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153,22,,percent of total billed charges,,,,,,,,,550.8,90,,percent of total billed charges,,,506.74,82.8,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153,22,,percent of total billed charges,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,153,581.4,
OT MOD 59 RE-EVAL EST PLAN CARE ANNEX,35200315,CDM,97168,CPT,430,RC,outpatient,GO,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.75,22,,percent of total billed charges,,,,,,,,,351.9,90,,percent of total billed charges,,,323.75,82.8,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.75,22,,percent of total billed charges,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,97.75,371.45,
OT RE-EVAL EST PLAN CARE ANNEX,35200316,CDM,97168,CPT,430,RC,outpatient,GO,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.75,22,,percent of total billed charges,,,,,,,,,351.9,90,,percent of total billed charges,,,323.75,82.8,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.75,22,,percent of total billed charges,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,97.75,371.45,
OT RE-EVAL EST PLAN CARE W THCAP ANNEX,35200317,CDM,97168,CPT,434,RC,outpatient,KX,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.75,22,,percent of total billed charges,,,,,,,,,351.9,90,,percent of total billed charges,,,323.75,82.8,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.75,22,,percent of total billed charges,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,97.75,371.45,
ADMINISTRATION FLU VACCINE,890055,CDM,G0008,HCPCS,771,RC,outpatient,,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.5,22,,percent of total billed charges,,,,,,,,,117,90,,percent of total billed charges,,,107.64,82.8,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.5,22,,percent of total billed charges,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,32.5,123.5,
ADMINISTRATION PNEUMOCOCCAL VACCINE,890056,CDM,G0009,HCPCS,771,RC,outpatient,,130,130,,110.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.5,22,,percent of total billed charges,,,,,,,,,117,90,,percent of total billed charges,,,107.64,82.8,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,,,,,,,,114.4,88,,percent of total billed charges,,,,,,,,,99.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.5,22,,percent of total billed charges,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,,,,,,,,,,,,,107.9,83,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,106.6,82,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,32.5,123.5,
BEDSIDE PROCDURE-MS,890061,CDM,,,360,RC,outpatient,,1736,1736,,1473.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,434,22,,percent of total billed charges,,,,,,,,,1562.4,90,,percent of total billed charges,,,1437.41,82.8,,percent of total billed charges,,,1475.6,85,,percent of total billed charges,,,,,,,,,1527.68,88,,percent of total billed charges,,,,,,,,,1326.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,434,22,,percent of total billed charges,,,1579.76,91,,percent of total billed charges,,,1649.2,95,,percent of total billed charges,,,1440.88,83,,percent of total billed charges,,,1440.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1440.88,83,,percent of total billed charges,,,1649.2,95,,percent of total billed charges,,,1562.4,90,,percent of total billed charges,,,1562.4,90,,percent of total billed charges,,,1423.52,82,,percent of total billed charges,,,1562.4,90,,percent of total billed charges,,,1475.6,85,,percent of total billed charges,,434,1649.2,
NURSING CARE OBSERV FIRST HOUR,890068,CDM,G0378,HCPCS,762,RC,outpatient,,1135,1135,,963.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,283.75,22,,percent of total billed charges,,,,,,,,,1021.5,90,,percent of total billed charges,,,939.78,82.8,,percent of total billed charges,,,964.75,85,,percent of total billed charges,,,,,,,,,998.8,88,,percent of total billed charges,,,,,,,,,867.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,283.75,22,,percent of total billed charges,,,1032.85,91,,percent of total billed charges,,,1078.25,95,,percent of total billed charges,,,942.05,83,,percent of total billed charges,,,942.05,83,,percent of total billed charges,,,,,,,,,,,,,,,942.05,83,,percent of total billed charges,,,1078.25,95,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,930.7,82,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,964.75,85,,percent of total billed charges,,283.75,1078.25,
BLOOD ADMINISTRATION SERVICE,890070,CDM,36430,CPT,391,RC,outpatient,,1766,1766,,1499.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,441.5,22,,percent of total billed charges,,,,,,,,,1589.4,90,,percent of total billed charges,,,1462.25,82.8,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,,,,,,,,1554.08,88,,percent of total billed charges,,,,,,,,,1349.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,441.5,22,,percent of total billed charges,,,1607.06,91,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.78,83,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1448.12,82,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,441.5,1677.7,
BLOOD ADMIN UP TO 4 HOURS(V-11-20),890071,CDM,36430,CPT,391,RC,outpatient,,1372,1372,,1164.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,343,22,,percent of total billed charges,,,,,,,,,1234.8,90,,percent of total billed charges,,,1136.02,82.8,,percent of total billed charges,,,1166.2,85,,percent of total billed charges,,,,,,,,,1207.36,88,,percent of total billed charges,,,,,,,,,1048.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,343,22,,percent of total billed charges,,,1248.52,91,,percent of total billed charges,,,1303.4,95,,percent of total billed charges,,,1138.76,83,,percent of total billed charges,,,1138.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.76,83,,percent of total billed charges,,,1303.4,95,,percent of total billed charges,,,1234.8,90,,percent of total billed charges,,,1234.8,90,,percent of total billed charges,,,1125.04,82,,percent of total billed charges,,,1234.8,90,,percent of total billed charges,,,1166.2,85,,percent of total billed charges,,343,1303.4,
BLOOD ADMIN UP TO 6 HOURS(V-11-20),890072,CDM,36430,CPT,391,RC,outpatient,,1709,1709,,1450.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,427.25,22,,percent of total billed charges,,,,,,,,,1538.1,90,,percent of total billed charges,,,1415.05,82.8,,percent of total billed charges,,,1452.65,85,,percent of total billed charges,,,,,,,,,1503.92,88,,percent of total billed charges,,,,,,,,,1305.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,427.25,22,,percent of total billed charges,,,1555.19,91,,percent of total billed charges,,,1623.55,95,,percent of total billed charges,,,1418.47,83,,percent of total billed charges,,,1418.47,83,,percent of total billed charges,,,,,,,,,,,,,,,1418.47,83,,percent of total billed charges,,,1623.55,95,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1401.38,82,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1452.65,85,,percent of total billed charges,,427.25,1623.55,
BLOOD ADMIN OVER 6 HOURS(V-11-20),890073,CDM,36430,CPT,391,RC,outpatient,,2137,2137,,1814.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,534.25,22,,percent of total billed charges,,,,,,,,,1923.3,90,,percent of total billed charges,,,1769.44,82.8,,percent of total billed charges,,,1816.45,85,,percent of total billed charges,,,,,,,,,1880.56,88,,percent of total billed charges,,,,,,,,,1632.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,534.25,22,,percent of total billed charges,,,1944.67,91,,percent of total billed charges,,,2030.15,95,,percent of total billed charges,,,1773.71,83,,percent of total billed charges,,,1773.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1773.71,83,,percent of total billed charges,,,2030.15,95,,percent of total billed charges,,,1923.3,90,,percent of total billed charges,,,1923.3,90,,percent of total billed charges,,,1752.34,82,,percent of total billed charges,,,1923.3,90,,percent of total billed charges,,,1816.45,85,,percent of total billed charges,,534.25,2030.15,
NURSING CARE OBSERV ADDTL HOUR,890076,CDM,G0378,HCPCS,762,RC,outpatient,,178,178,,151.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.5,22,,percent of total billed charges,,,,,,,,,160.2,90,,percent of total billed charges,,,147.38,82.8,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,,,,,,,,156.64,88,,percent of total billed charges,,,,,,,,,135.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.5,22,,percent of total billed charges,,,161.98,91,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,,,,,,,,,,,,,147.74,83,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,145.96,82,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,44.5,169.1,
TELEMETRY OBSERVATION FIRST HOUR,890077,CDM,G0378,HCPCS,762,RC,outpatient,,1553,1553,,1318.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,388.25,22,,percent of total billed charges,,,,,,,,,1397.7,90,,percent of total billed charges,,,1285.88,82.8,,percent of total billed charges,,,1320.05,85,,percent of total billed charges,,,,,,,,,1366.64,88,,percent of total billed charges,,,,,,,,,1186.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,388.25,22,,percent of total billed charges,,,1413.23,91,,percent of total billed charges,,,1475.35,95,,percent of total billed charges,,,1288.99,83,,percent of total billed charges,,,1288.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1288.99,83,,percent of total billed charges,,,1475.35,95,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1273.46,82,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1320.05,85,,percent of total billed charges,,388.25,1475.35,
TELEMETRY OBSERVATION ADDTL HOUR,890078,CDM,G0378,HCPCS,762,RC,outpatient,,184,184,,156.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46,22,,percent of total billed charges,,,,,,,,,165.6,90,,percent of total billed charges,,,152.35,82.8,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,,,,,,,,161.92,88,,percent of total billed charges,,,,,,,,,140.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46,22,,percent of total billed charges,,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,,,,,,,,,,,,,152.72,83,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,150.88,82,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,46,174.8,
EXTENDED RECOVERY 1ST HOUR,890080,CDM,,,710,RC,outpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.25,22,,percent of total billed charges,,,,,,,,,188.1,90,,percent of total billed charges,,,173.05,82.8,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.25,22,,percent of total billed charges,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,52.25,198.55,
EXTENDED RECOVERY EACH ADDTL HOUR,890082,CDM,,,710,RC,outpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.25,22,,percent of total billed charges,,,,,,,,,98.1,90,,percent of total billed charges,,,90.25,82.8,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.25,22,,percent of total billed charges,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,27.25,103.55,
"IV INFUSION, HYDRATION, UP TO 1 HOUR",890100,CDM,96360,CPT,260,RC,outpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208,22,,percent of total billed charges,,,,,,,,,748.8,90,,percent of total billed charges,,,688.9,82.8,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208,22,,percent of total billed charges,,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,208,790.4,
"IV INFUSION, HYDRATION, ADDTL HOUR",890101,CDM,96361,CPT,260,RC,outpatient,XU,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
"IV INFUSION, THERAPEUTIC, UP TO 1 HOUR",890102,CDM,96365,CPT,260,RC,outpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208,22,,percent of total billed charges,,,,,,,,,748.8,90,,percent of total billed charges,,,688.9,82.8,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208,22,,percent of total billed charges,,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,208,790.4,
"IV INFUSION, THERAPEUTIC, ADDTL HOUR",890103,CDM,96366,CPT,260,RC,outpatient,XU,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.75,22,,percent of total billed charges,,,,,,,,,225.9,90,,percent of total billed charges,,,207.83,82.8,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.75,22,,percent of total billed charges,,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,62.75,238.45,
CONCURRENT ADDT'L MEDICATED SOLUTION,890104,CDM,96368,CPT,260,RC,outpatient,XU,522,522,,443.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.5,22,,percent of total billed charges,,,,,,,,,469.8,90,,percent of total billed charges,,,432.22,82.8,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,,,,,,,,459.36,88,,percent of total billed charges,,,,,,,,,398.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.5,22,,percent of total billed charges,,,475.02,91,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,,,,,,,,,,,,,433.26,83,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,428.04,82,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,130.5,495.9,
IM/SQ INJECTION,890105,CDM,96372,CPT,260,RC,outpatient,XU,352,352,,298.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88,22,,percent of total billed charges,,,,,,,,,316.8,90,,percent of total billed charges,,,291.46,82.8,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,,,,,,,,309.76,88,,percent of total billed charges,,,,,,,,,268.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88,22,,percent of total billed charges,,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,,,,,,,,,,,,,292.16,83,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,288.64,82,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,88,334.4,
"IVP, SINGLE OR INITIAL",890106,CDM,96374,CPT,260,RC,outpatient,XU,436,436,,370.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109,22,,percent of total billed charges,,,,,,,,,392.4,90,,percent of total billed charges,,,361.01,82.8,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,,,,,,,,383.68,88,,percent of total billed charges,,,,,,,,,333.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109,22,,percent of total billed charges,,,396.76,91,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,,,,,,,,,,,,,361.88,83,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,357.52,82,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,109,414.2,
"IVP, EACH ADDTL OF NEW SUBSTANCE/DRUG",890107,CDM,96375,CPT,260,RC,outpatient,XU,359,359,,304.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.75,22,,percent of total billed charges,,,,,,,,,323.1,90,,percent of total billed charges,,,297.25,82.8,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,,,,,,,,315.92,88,,percent of total billed charges,,,,,,,,,274.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.75,22,,percent of total billed charges,,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,,,,,,,,,,,,,297.97,83,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,294.38,82,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,89.75,341.05,
"IVP, EACH ADDTL SEQUENTIAL INTRA PUSH",890111,CDM,96376,CPT,260,RC,outpatient,XU,274,274,,232.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.5,22,,percent of total billed charges,,,,,,,,,246.6,90,,percent of total billed charges,,,226.87,82.8,,percent of total billed charges,,,232.9,85,,percent of total billed charges,,,,,,,,,241.12,88,,percent of total billed charges,,,,,,,,,209.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.5,22,,percent of total billed charges,,,249.34,91,,percent of total billed charges,,,260.3,95,,percent of total billed charges,,,227.42,83,,percent of total billed charges,,,227.42,83,,percent of total billed charges,,,,,,,,,,,,,,,227.42,83,,percent of total billed charges,,,260.3,95,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,224.68,82,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,232.9,85,,percent of total billed charges,,68.5,260.3,
COMPLEX UROFLOWMETRY,890115,CDM,51741,CPT,762,RC,outpatient,,1662,1662,,1411.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,415.5,22,,percent of total billed charges,,,,,,,,,1495.8,90,,percent of total billed charges,,,1376.14,82.8,,percent of total billed charges,,,1412.7,85,,percent of total billed charges,,,,,,,,,1462.56,88,,percent of total billed charges,,,,,,,,,1269.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,415.5,22,,percent of total billed charges,,,1512.42,91,,percent of total billed charges,,,1578.9,95,,percent of total billed charges,,,1379.46,83,,percent of total billed charges,,,1379.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1379.46,83,,percent of total billed charges,,,1578.9,95,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1362.84,82,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1412.7,85,,percent of total billed charges,,415.5,1578.9,
MINOR SURGERY CASE,891234,CDM,,,361,RC,outpatient,,16223,16223,,13773.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4055.75,22,,percent of total billed charges,,,,,,,,,14600.7,90,,percent of total billed charges,,,13432.64,82.8,,percent of total billed charges,,,13789.55,85,,percent of total billed charges,,,,,,,,,14276.24,88,,percent of total billed charges,,,,,,,,,12394.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4055.75,22,,percent of total billed charges,,,14762.93,91,,percent of total billed charges,,,15411.85,95,,percent of total billed charges,,,13465.09,83,,percent of total billed charges,,,13465.09,83,,percent of total billed charges,,,,,,,,,,,,,,,13465.09,83,,percent of total billed charges,,,15411.85,95,,percent of total billed charges,,,14600.7,90,,percent of total billed charges,,,14600.7,90,,percent of total billed charges,,,13302.86,82,,percent of total billed charges,,,14600.7,90,,percent of total billed charges,,,13789.55,85,,percent of total billed charges,,4055.75,15411.85,
MINOR SURGERY WOUND CARE,891235,CDM,,,361,RC,outpatient,,2434,2434,,2066.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,608.5,22,,percent of total billed charges,,,,,,,,,2190.6,90,,percent of total billed charges,,,2015.35,82.8,,percent of total billed charges,,,2068.9,85,,percent of total billed charges,,,,,,,,,2141.92,88,,percent of total billed charges,,,,,,,,,1859.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,608.5,22,,percent of total billed charges,,,2214.94,91,,percent of total billed charges,,,2312.3,95,,percent of total billed charges,,,2020.22,83,,percent of total billed charges,,,2020.22,83,,percent of total billed charges,,,,,,,,,,,,,,,2020.22,83,,percent of total billed charges,,,2312.3,95,,percent of total billed charges,,,2190.6,90,,percent of total billed charges,,,2190.6,90,,percent of total billed charges,,,1995.88,82,,percent of total billed charges,,,2190.6,90,,percent of total billed charges,,,2068.9,85,,percent of total billed charges,,608.5,2312.3,
CARDIOVERSION EXTERNAL,899000,CDM,92960,CPT,761,RC,outpatient,,1444,1444,,1225.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,361,22,,percent of total billed charges,,,,,,,,,1299.6,90,,percent of total billed charges,,,1195.63,82.8,,percent of total billed charges,,,1227.4,85,,percent of total billed charges,,,,,,,,,1270.72,88,,percent of total billed charges,,,,,,,,,1103.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,361,22,,percent of total billed charges,,,1314.04,91,,percent of total billed charges,,,1371.8,95,,percent of total billed charges,,,1198.52,83,,percent of total billed charges,,,1198.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1198.52,83,,percent of total billed charges,,,1371.8,95,,percent of total billed charges,,,1299.6,90,,percent of total billed charges,,,1299.6,90,,percent of total billed charges,,,1184.08,82,,percent of total billed charges,,,1299.6,90,,percent of total billed charges,,,1227.4,85,,percent of total billed charges,,361,1371.8,
MM BRSTNDLLOC/PLC(SINGLE),30000996,CDM,19281,CPT,401,RC,outpatient,TC,929,929,,788.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,232.25,22,,percent of total billed charges,,,,,,,,,836.1,90,,percent of total billed charges,,,769.21,82.8,,percent of total billed charges,,,789.65,85,,percent of total billed charges,,,,,,,,,817.52,88,,percent of total billed charges,,,,,,,,,709.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,232.25,22,,percent of total billed charges,,,845.39,91,,percent of total billed charges,,,882.55,95,,percent of total billed charges,,,771.07,83,,percent of total billed charges,,,771.07,83,,percent of total billed charges,,,,,,,,,,,,,,,771.07,83,,percent of total billed charges,,,882.55,95,,percent of total billed charges,,,836.1,90,,percent of total billed charges,,,836.1,90,,percent of total billed charges,,,761.78,82,,percent of total billed charges,,,836.1,90,,percent of total billed charges,,,789.65,85,,percent of total billed charges,,232.25,882.55,
MM BRSTNDLLOC/PLC(2+),30000997,CDM,19282,CPT,401,RC,outpatient,TC,851,851,,722.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,212.75,22,,percent of total billed charges,,,,,,,,,765.9,90,,percent of total billed charges,,,704.63,82.8,,percent of total billed charges,,,723.35,85,,percent of total billed charges,,,,,,,,,748.88,88,,percent of total billed charges,,,,,,,,,650.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,212.75,22,,percent of total billed charges,,,774.41,91,,percent of total billed charges,,,808.45,95,,percent of total billed charges,,,706.33,83,,percent of total billed charges,,,706.33,83,,percent of total billed charges,,,,,,,,,,,,,,,706.33,83,,percent of total billed charges,,,808.45,95,,percent of total billed charges,,,765.9,90,,percent of total billed charges,,,765.9,90,,percent of total billed charges,,,697.82,82,,percent of total billed charges,,,765.9,90,,percent of total billed charges,,,723.35,85,,percent of total billed charges,,212.75,808.45,
MM BRST STRTCTC 1ST LESION,30000998,CDM,19081,CPT,401,RC,outpatient,TC,6087,6087,,5167.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1521.75,22,,percent of total billed charges,,,,,,,,,5478.3,90,,percent of total billed charges,,,5040.04,82.8,,percent of total billed charges,,,5173.95,85,,percent of total billed charges,,,,,,,,,5356.56,88,,percent of total billed charges,,,,,,,,,4650.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1521.75,22,,percent of total billed charges,,,5539.17,91,,percent of total billed charges,,,5782.65,95,,percent of total billed charges,,,5052.21,83,,percent of total billed charges,,,5052.21,83,,percent of total billed charges,,,,,,,,,,,,,,,5052.21,83,,percent of total billed charges,,,5782.65,95,,percent of total billed charges,,,5478.3,90,,percent of total billed charges,,,5478.3,90,,percent of total billed charges,,,4991.34,82,,percent of total billed charges,,,5478.3,90,,percent of total billed charges,,,5173.95,85,,percent of total billed charges,,1521.75,5782.65,
MM BRST STRTCTC ADD LESION,30000999,CDM,19082,CPT,401,RC,outpatient,TC,4927,4927,,4183.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1231.75,22,,percent of total billed charges,,,,,,,,,4434.3,90,,percent of total billed charges,,,4079.56,82.8,,percent of total billed charges,,,4187.95,85,,percent of total billed charges,,,,,,,,,4335.76,88,,percent of total billed charges,,,,,,,,,3764.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1231.75,22,,percent of total billed charges,,,4483.57,91,,percent of total billed charges,,,4680.65,95,,percent of total billed charges,,,4089.41,83,,percent of total billed charges,,,4089.41,83,,percent of total billed charges,,,,,,,,,,,,,,,4089.41,83,,percent of total billed charges,,,4680.65,95,,percent of total billed charges,,,4434.3,90,,percent of total billed charges,,,4434.3,90,,percent of total billed charges,,,4040.14,82,,percent of total billed charges,,,4434.3,90,,percent of total billed charges,,,4187.95,85,,percent of total billed charges,,1231.75,4680.65,
X SURGICAL SPECIMEN,30101162,CDM,76098,CPT,400,RC,outpatient,TC,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,231.25,22,,percent of total billed charges,,,,,,,,,832.5,90,,percent of total billed charges,,,765.9,82.8,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,231.25,22,,percent of total billed charges,,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,231.25,878.75,
UL SURGICAL SPECIMEN,30101163,CDM,76098,CPT,400,RC,outpatient,TC,936,936,,794.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,234,22,,percent of total billed charges,,,,,,,,,842.4,90,,percent of total billed charges,,,775.01,82.8,,percent of total billed charges,,,795.6,85,,percent of total billed charges,,,,,,,,,823.68,88,,percent of total billed charges,,,,,,,,,715.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,234,22,,percent of total billed charges,,,851.76,91,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,,,,,,,,,,,,,776.88,83,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,767.52,82,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,795.6,85,,percent of total billed charges,,234,889.2,
MM SURGICAL SPECIMEN DIGITAL,30101164,CDM,76098,CPT,400,RC,outpatient,TC,608,608,,516.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,152,22,,percent of total billed charges,,,,,,,,,547.2,90,,percent of total billed charges,,,503.42,82.8,,percent of total billed charges,,,516.8,85,,percent of total billed charges,,,,,,,,,535.04,88,,percent of total billed charges,,,,,,,,,464.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,152,22,,percent of total billed charges,,,553.28,91,,percent of total billed charges,,,577.6,95,,percent of total billed charges,,,504.64,83,,percent of total billed charges,,,504.64,83,,percent of total billed charges,,,,,,,,,,,,,,,504.64,83,,percent of total billed charges,,,577.6,95,,percent of total billed charges,,,547.2,90,,percent of total billed charges,,,547.2,90,,percent of total billed charges,,,498.56,82,,percent of total billed charges,,,547.2,90,,percent of total billed charges,,,516.8,85,,percent of total billed charges,,152,577.6,
MM DUCTOGRAM SGL RT,30101165,CDM,77053,CPT,320,RC,outpatient,RT,2105,2105,,1787.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,526.25,22,,percent of total billed charges,,,,,,,,,1894.5,90,,percent of total billed charges,,,1742.94,82.8,,percent of total billed charges,,,1789.25,85,,percent of total billed charges,,,,,,,,,1852.4,88,,percent of total billed charges,,,,,,,,,1608.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,526.25,22,,percent of total billed charges,,,1915.55,91,,percent of total billed charges,,,1999.75,95,,percent of total billed charges,,,1747.15,83,,percent of total billed charges,,,1747.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1747.15,83,,percent of total billed charges,,,1999.75,95,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1726.1,82,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1789.25,85,,percent of total billed charges,,526.25,1999.75,
MM DUCTOGRAM SGL LT,30101166,CDM,77053,CPT,320,RC,outpatient,LT,2105,2105,,1787.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,526.25,22,,percent of total billed charges,,,,,,,,,1894.5,90,,percent of total billed charges,,,1742.94,82.8,,percent of total billed charges,,,1789.25,85,,percent of total billed charges,,,,,,,,,1852.4,88,,percent of total billed charges,,,,,,,,,1608.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,526.25,22,,percent of total billed charges,,,1915.55,91,,percent of total billed charges,,,1999.75,95,,percent of total billed charges,,,1747.15,83,,percent of total billed charges,,,1747.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1747.15,83,,percent of total billed charges,,,1999.75,95,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1726.1,82,,percent of total billed charges,,,1894.5,90,,percent of total billed charges,,,1789.25,85,,percent of total billed charges,,526.25,1999.75,
ASOCIATED DUCTOGRAM INJECTION PROCEDURE,30101167,CDM,19030,CPT,320,RC,outpatient,,959,959,,814.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,239.75,22,,percent of total billed charges,,,,,,,,,863.1,90,,percent of total billed charges,,,794.05,82.8,,percent of total billed charges,,,815.15,85,,percent of total billed charges,,,,,,,,,843.92,88,,percent of total billed charges,,,,,,,,,732.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,239.75,22,,percent of total billed charges,,,872.69,91,,percent of total billed charges,,,911.05,95,,percent of total billed charges,,,795.97,83,,percent of total billed charges,,,795.97,83,,percent of total billed charges,,,,,,,,,,,,,,,795.97,83,,percent of total billed charges,,,911.05,95,,percent of total billed charges,,,863.1,90,,percent of total billed charges,,,863.1,90,,percent of total billed charges,,,786.38,82,,percent of total billed charges,,,863.1,90,,percent of total billed charges,,,815.15,85,,percent of total billed charges,,239.75,911.05,
MM DUCTOGRAM 2+ RT,30101169,CDM,77054,CPT,320,RC,outpatient,RT,3010,3010,,2555.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,752.5,22,,percent of total billed charges,,,,,,,,,2709,90,,percent of total billed charges,,,2492.28,82.8,,percent of total billed charges,,,2558.5,85,,percent of total billed charges,,,,,,,,,2648.8,88,,percent of total billed charges,,,,,,,,,2299.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,752.5,22,,percent of total billed charges,,,2739.1,91,,percent of total billed charges,,,2859.5,95,,percent of total billed charges,,,2498.3,83,,percent of total billed charges,,,2498.3,83,,percent of total billed charges,,,,,,,,,,,,,,,2498.3,83,,percent of total billed charges,,,2859.5,95,,percent of total billed charges,,,2709,90,,percent of total billed charges,,,2709,90,,percent of total billed charges,,,2468.2,82,,percent of total billed charges,,,2709,90,,percent of total billed charges,,,2558.5,85,,percent of total billed charges,,752.5,2859.5,
* MA SCREEN BIL (V306),30101535,CDM,76092,CPT,403,RC,outpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,38.5,146.3,
* DNU MA BREAST NDL LOCAL & PLC (SINGLE),30101550,CDM,19290,CPT,769,RC,outpatient,TC,995,995,,844.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,248.75,22,,percent of total billed charges,,,,,,,,,895.5,90,,percent of total billed charges,,,823.86,82.8,,percent of total billed charges,,,845.75,85,,percent of total billed charges,,,,,,,,,875.6,88,,percent of total billed charges,,,,,,,,,760.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,248.75,22,,percent of total billed charges,,,905.45,91,,percent of total billed charges,,,945.25,95,,percent of total billed charges,,,825.85,83,,percent of total billed charges,,,825.85,83,,percent of total billed charges,,,,,,,,,,,,,,,825.85,83,,percent of total billed charges,,,945.25,95,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,815.9,82,,percent of total billed charges,,,895.5,90,,percent of total billed charges,,,845.75,85,,percent of total billed charges,,248.75,945.25,
*DNU MA BREAST NDL LOCAL & PLC (MULT 2+),30101568,CDM,19291,CPT,769,RC,outpatient,TC,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43,22,,percent of total billed charges,,,,,,,,,154.8,90,,percent of total billed charges,,,142.42,82.8,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43,22,,percent of total billed charges,,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,43,163.4,
* DNU MA BREAST LOC GUIDE DIGITAL(V0107),30103994,CDM,76096,CPT,320,RC,outpatient,,865,865,,734.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,216.25,22,,percent of total billed charges,,,,,,,,,778.5,90,,percent of total billed charges,,,716.22,82.8,,percent of total billed charges,,,735.25,85,,percent of total billed charges,,,,,,,,,761.2,88,,percent of total billed charges,,,,,,,,,660.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,216.25,22,,percent of total billed charges,,,787.15,91,,percent of total billed charges,,,821.75,95,,percent of total billed charges,,,717.95,83,,percent of total billed charges,,,717.95,83,,percent of total billed charges,,,,,,,,,,,,,,,717.95,83,,percent of total billed charges,,,821.75,95,,percent of total billed charges,,,778.5,90,,percent of total billed charges,,,778.5,90,,percent of total billed charges,,,709.3,82,,percent of total billed charges,,,778.5,90,,percent of total billed charges,,,735.25,85,,percent of total billed charges,,216.25,821.75,
ASSOC 19281 BREAST LOCAL MAMMO SINGLE,30103995,CDM,19281,CPT,401,RC,outpatient,TC,1298,1298,,1102,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,324.5,22,,percent of total billed charges,,,,,,,,,1168.2,90,,percent of total billed charges,,,1074.74,82.8,,percent of total billed charges,,,1103.3,85,,percent of total billed charges,,,,,,,,,1142.24,88,,percent of total billed charges,,,,,,,,,991.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,324.5,22,,percent of total billed charges,,,1181.18,91,,percent of total billed charges,,,1233.1,95,,percent of total billed charges,,,1077.34,83,,percent of total billed charges,,,1077.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1077.34,83,,percent of total billed charges,,,1233.1,95,,percent of total billed charges,,,1168.2,90,,percent of total billed charges,,,1168.2,90,,percent of total billed charges,,,1064.36,82,,percent of total billed charges,,,1168.2,90,,percent of total billed charges,,,1103.3,85,,percent of total billed charges,,324.5,1233.1,
ASSOC 19282 BREAST LOCAL MAMMO MULTI,30103996,CDM,19282,CPT,401,RC,outpatient,TC,1588,1588,,1348.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,397,22,,percent of total billed charges,,,,,,,,,1429.2,90,,percent of total billed charges,,,1314.86,82.8,,percent of total billed charges,,,1349.8,85,,percent of total billed charges,,,,,,,,,1397.44,88,,percent of total billed charges,,,,,,,,,1213.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,397,22,,percent of total billed charges,,,1445.08,91,,percent of total billed charges,,,1508.6,95,,percent of total billed charges,,,1318.04,83,,percent of total billed charges,,,1318.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1318.04,83,,percent of total billed charges,,,1508.6,95,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1302.16,82,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1349.8,85,,percent of total billed charges,,397,1508.6,
* MA DIAG BIL (V306),30104000,CDM,76091,CPT,401,RC,outpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.75,22,,percent of total billed charges,,,,,,,,,204.3,90,,percent of total billed charges,,,187.96,82.8,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.75,22,,percent of total billed charges,,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,56.75,215.65,
* MA SCREEN RT (V306),30104018,CDM,76092,CPT,403,RC,outpatient,52,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31,22,,percent of total billed charges,,,,,,,,,111.6,90,,percent of total billed charges,,,102.67,82.8,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31,22,,percent of total billed charges,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,31,117.8,
* MA SCREEN LT (V306),30104019,CDM,76092,CPT,403,RC,outpatient,52,124,124,,105.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31,22,,percent of total billed charges,,,,,,,,,111.6,90,,percent of total billed charges,,,102.67,82.8,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,,,,,,,,109.12,88,,percent of total billed charges,,,,,,,,,94.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31,22,,percent of total billed charges,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,101.68,82,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,31,117.8,
* MA DIAG LT (V306),30104020,CDM,76090,CPT,401,RC,outpatient,,188,188,,159.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47,22,,percent of total billed charges,,,,,,,,,169.2,90,,percent of total billed charges,,,155.66,82.8,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,,,,,,,,165.44,88,,percent of total billed charges,,,,,,,,,143.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47,22,,percent of total billed charges,,,171.08,91,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,,,,,,,,,,,,,156.04,83,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,154.16,82,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,47,178.6,
* MA DIAG RT (V306),30104021,CDM,76090,CPT,401,RC,outpatient,,188,188,,159.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47,22,,percent of total billed charges,,,,,,,,,169.2,90,,percent of total billed charges,,,155.66,82.8,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,,,,,,,,165.44,88,,percent of total billed charges,,,,,,,,,143.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47,22,,percent of total billed charges,,,171.08,91,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,,,,,,,,,,,,,156.04,83,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,154.16,82,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,47,178.6,
MM DX MAMMO BIL INCL CAD,30104022,CDM,77066,CPT,401,RC,outpatient,TC,1463,1463,,1242.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,365.75,22,,percent of total billed charges,,,,,,,,,1316.7,90,,percent of total billed charges,,,1211.36,82.8,,percent of total billed charges,,,1243.55,85,,percent of total billed charges,,,,,,,,,1287.44,88,,percent of total billed charges,,,,,,,,,1117.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,365.75,22,,percent of total billed charges,,,1331.33,91,,percent of total billed charges,,,1389.85,95,,percent of total billed charges,,,1214.29,83,,percent of total billed charges,,,1214.29,83,,percent of total billed charges,,,,,,,,,,,,,,,1214.29,83,,percent of total billed charges,,,1389.85,95,,percent of total billed charges,,,1316.7,90,,percent of total billed charges,,,1316.7,90,,percent of total billed charges,,,1199.66,82,,percent of total billed charges,,,1316.7,90,,percent of total billed charges,,,1243.55,85,,percent of total billed charges,,365.75,1389.85,
MM DX MAMMO LEFT INCL CAD,30104023,CDM,77065,CPT,401,RC,outpatient,TC,1179,1179,,1000.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,294.75,22,,percent of total billed charges,,,,,,,,,1061.1,90,,percent of total billed charges,,,976.21,82.8,,percent of total billed charges,,,1002.15,85,,percent of total billed charges,,,,,,,,,1037.52,88,,percent of total billed charges,,,,,,,,,900.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,294.75,22,,percent of total billed charges,,,1072.89,91,,percent of total billed charges,,,1120.05,95,,percent of total billed charges,,,978.57,83,,percent of total billed charges,,,978.57,83,,percent of total billed charges,,,,,,,,,,,,,,,978.57,83,,percent of total billed charges,,,1120.05,95,,percent of total billed charges,,,1061.1,90,,percent of total billed charges,,,1061.1,90,,percent of total billed charges,,,966.78,82,,percent of total billed charges,,,1061.1,90,,percent of total billed charges,,,1002.15,85,,percent of total billed charges,,294.75,1120.05,
MM DX MAMMO RIGHT DIGITAL INCL CAD,30104024,CDM,77065,CPT,401,RC,outpatient,TC,1179,1179,,1000.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,294.75,22,,percent of total billed charges,,,,,,,,,1061.1,90,,percent of total billed charges,,,976.21,82.8,,percent of total billed charges,,,1002.15,85,,percent of total billed charges,,,,,,,,,1037.52,88,,percent of total billed charges,,,,,,,,,900.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,294.75,22,,percent of total billed charges,,,1072.89,91,,percent of total billed charges,,,1120.05,95,,percent of total billed charges,,,978.57,83,,percent of total billed charges,,,978.57,83,,percent of total billed charges,,,,,,,,,,,,,,,978.57,83,,percent of total billed charges,,,1120.05,95,,percent of total billed charges,,,1061.1,90,,percent of total billed charges,,,1061.1,90,,percent of total billed charges,,,966.78,82,,percent of total billed charges,,,1061.1,90,,percent of total billed charges,,,1002.15,85,,percent of total billed charges,,294.75,1120.05,
MM SCR MAMMO BIL INCL CAD,30104025,CDM,77067,CPT,403,RC,outpatient,TC,1251,1251,,1062.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,312.75,22,,percent of total billed charges,,,,,,,,,1125.9,90,,percent of total billed charges,,,1035.83,82.8,,percent of total billed charges,,,1063.35,85,,percent of total billed charges,,,,,,,,,1100.88,88,,percent of total billed charges,,,,,,,,,955.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,312.75,22,,percent of total billed charges,,,1138.41,91,,percent of total billed charges,,,1188.45,95,,percent of total billed charges,,,1038.33,83,,percent of total billed charges,,,1038.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1038.33,83,,percent of total billed charges,,,1188.45,95,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1025.82,82,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1063.35,85,,percent of total billed charges,,312.75,1188.45,
MM SCR MAMMO LEFT INCL CAD,30104026,CDM,77067,CPT,403,RC,outpatient,TC,1251,1251,,1062.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,312.75,22,,percent of total billed charges,,,,,,,,,1125.9,90,,percent of total billed charges,,,1035.83,82.8,,percent of total billed charges,,,1063.35,85,,percent of total billed charges,,,,,,,,,1100.88,88,,percent of total billed charges,,,,,,,,,955.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,312.75,22,,percent of total billed charges,,,1138.41,91,,percent of total billed charges,,,1188.45,95,,percent of total billed charges,,,1038.33,83,,percent of total billed charges,,,1038.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1038.33,83,,percent of total billed charges,,,1188.45,95,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1025.82,82,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1063.35,85,,percent of total billed charges,,312.75,1188.45,
MM SCR MAMMO RIGHT INCL CAD,30104027,CDM,77067,CPT,403,RC,outpatient,TC,1251,1251,,1062.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,312.75,22,,percent of total billed charges,,,,,,,,,1125.9,90,,percent of total billed charges,,,1035.83,82.8,,percent of total billed charges,,,1063.35,85,,percent of total billed charges,,,,,,,,,1100.88,88,,percent of total billed charges,,,,,,,,,955.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,312.75,22,,percent of total billed charges,,,1138.41,91,,percent of total billed charges,,,1188.45,95,,percent of total billed charges,,,1038.33,83,,percent of total billed charges,,,1038.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1038.33,83,,percent of total billed charges,,,1188.45,95,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1025.82,82,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1063.35,85,,percent of total billed charges,,312.75,1188.45,
* MA SCREEN CAD ( V0107),30104028,CDM,77052,CPT,403,RC,outpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.75,22,,percent of total billed charges,,,,,,,,,78.3,90,,percent of total billed charges,,,72.04,82.8,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.75,22,,percent of total billed charges,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,21.75,82.65,
*   MA DIAG ICAD(V0107),30104029,CDM,77051,CPT,401,RC,outpatient,,87,87,,73.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.75,22,,percent of total billed charges,,,,,,,,,78.3,90,,percent of total billed charges,,,72.04,82.8,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,,,,,,,,76.56,88,,percent of total billed charges,,,,,,,,,66.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.75,22,,percent of total billed charges,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,71.34,82,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,21.75,82.65,
MM SCREEN ICAD(V 01-18),30104030,CDM,77067,CPT,403,RC,outpatient,TC,114,114,,96.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.5,22,,percent of total billed charges,,,,,,,,,102.6,90,,percent of total billed charges,,,94.39,82.8,,percent of total billed charges,,,96.9,85,,percent of total billed charges,,,,,,,,,100.32,88,,percent of total billed charges,,,,,,,,,87.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.5,22,,percent of total billed charges,,,103.74,91,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,,,,,,,,,,,,,94.62,83,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,93.48,82,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,96.9,85,,percent of total billed charges,,28.5,108.3,
MM DIAG ICAD(V 01-18),30104031,CDM,77065,CPT,401,RC,outpatient,TC,90,90,,76.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.5,22,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,74.52,82.8,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,,,,,,,,79.2,88,,percent of total billed charges,,,,,,,,,68.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.5,22,,percent of total billed charges,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,73.8,82,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,22.5,85.5,
MM POST BX DIAG MAMMO LEFT,30104032,CDM,77065,CPT,401,RC,outpatient,LT,624,624,,529.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,156,22,,percent of total billed charges,,,,,,,,,561.6,90,,percent of total billed charges,,,516.67,82.8,,percent of total billed charges,,,530.4,85,,percent of total billed charges,,,,,,,,,549.12,88,,percent of total billed charges,,,,,,,,,476.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,156,22,,percent of total billed charges,,,567.84,91,,percent of total billed charges,,,592.8,95,,percent of total billed charges,,,517.92,83,,percent of total billed charges,,,517.92,83,,percent of total billed charges,,,,,,,,,,,,,,,517.92,83,,percent of total billed charges,,,592.8,95,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,511.68,82,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,530.4,85,,percent of total billed charges,,156,592.8,
MM POST BX DIAG MAMMO RIGHT,30104033,CDM,77065,CPT,401,RC,outpatient,RT,624,624,,529.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,156,22,,percent of total billed charges,,,,,,,,,561.6,90,,percent of total billed charges,,,516.67,82.8,,percent of total billed charges,,,530.4,85,,percent of total billed charges,,,,,,,,,549.12,88,,percent of total billed charges,,,,,,,,,476.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,156,22,,percent of total billed charges,,,567.84,91,,percent of total billed charges,,,592.8,95,,percent of total billed charges,,,517.92,83,,percent of total billed charges,,,517.92,83,,percent of total billed charges,,,,,,,,,,,,,,,517.92,83,,percent of total billed charges,,,592.8,95,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,511.68,82,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,530.4,85,,percent of total billed charges,,156,592.8,
DNU,3100058,CDM,73223,CPT,610,RC,outpatient,,4543,4543,,3857.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1135.75,22,,percent of total billed charges,,,,,,,,,4088.7,90,,percent of total billed charges,,,3761.6,82.8,,percent of total billed charges,,,3861.55,85,,percent of total billed charges,,,,,,,,,3997.84,88,,percent of total billed charges,,,,,,,,,3470.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1135.75,22,,percent of total billed charges,,,4134.13,91,,percent of total billed charges,,,4315.85,95,,percent of total billed charges,,,3770.69,83,,percent of total billed charges,,,3770.69,83,,percent of total billed charges,,,,,,,,,,,,,,,3770.69,83,,percent of total billed charges,,,4315.85,95,,percent of total billed charges,,,4088.7,90,,percent of total billed charges,,,4088.7,90,,percent of total billed charges,,,3725.26,82,,percent of total billed charges,,,4088.7,90,,percent of total billed charges,,,3861.55,85,,percent of total billed charges,,1135.75,4315.85,
MR 3D RENDERING,31100000,CDM,76376,CPT,610,RC,outpatient,TC,1723,1723,,1462.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,430.75,22,,percent of total billed charges,,,,,,,,,1550.7,90,,percent of total billed charges,,,1426.64,82.8,,percent of total billed charges,,,1464.55,85,,percent of total billed charges,,,,,,,,,1516.24,88,,percent of total billed charges,,,,,,,,,1316.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,430.75,22,,percent of total billed charges,,,1567.93,91,,percent of total billed charges,,,1636.85,95,,percent of total billed charges,,,1430.09,83,,percent of total billed charges,,,1430.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1430.09,83,,percent of total billed charges,,,1636.85,95,,percent of total billed charges,,,1550.7,90,,percent of total billed charges,,,1550.7,90,,percent of total billed charges,,,1412.86,82,,percent of total billed charges,,,1550.7,90,,percent of total billed charges,,,1464.55,85,,percent of total billed charges,,430.75,1636.85,
MR NDL PLACE/BX OR ASP,31100003,CDM,77021,CPT,610,RC,outpatient,TC,3962,3962,,3363.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,990.5,22,,percent of total billed charges,,,,,,,,,3565.8,90,,percent of total billed charges,,,3280.54,82.8,,percent of total billed charges,,,3367.7,85,,percent of total billed charges,,,,,,,,,3486.56,88,,percent of total billed charges,,,,,,,,,3026.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,990.5,22,,percent of total billed charges,,,3605.42,91,,percent of total billed charges,,,3763.9,95,,percent of total billed charges,,,3288.46,83,,percent of total billed charges,,,3288.46,83,,percent of total billed charges,,,,,,,,,,,,,,,3288.46,83,,percent of total billed charges,,,3763.9,95,,percent of total billed charges,,,3565.8,90,,percent of total billed charges,,,3565.8,90,,percent of total billed charges,,,3248.84,82,,percent of total billed charges,,,3565.8,90,,percent of total billed charges,,,3367.7,85,,percent of total billed charges,,990.5,3763.9,
MRA HEAD W/O+REPROC,31100010,CDM,70544,CPT,611,RC,outpatient,TC,4911,4911,,4169.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1227.75,22,,percent of total billed charges,,,,,,,,,4419.9,90,,percent of total billed charges,,,4066.31,82.8,,percent of total billed charges,,,4174.35,85,,percent of total billed charges,,,,,,,,,4321.68,88,,percent of total billed charges,,,,,,,,,3752,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1227.75,22,,percent of total billed charges,,,4469.01,91,,percent of total billed charges,,,4665.45,95,,percent of total billed charges,,,4076.13,83,,percent of total billed charges,,,4076.13,83,,percent of total billed charges,,,,,,,,,,,,,,,4076.13,83,,percent of total billed charges,,,4665.45,95,,percent of total billed charges,,,4419.9,90,,percent of total billed charges,,,4419.9,90,,percent of total billed charges,,,4027.02,82,,percent of total billed charges,,,4419.9,90,,percent of total billed charges,,,4174.35,85,,percent of total billed charges,,1227.75,4665.45,
MRA HEAD W + WO REPROC,31100011,CDM,70546,CPT,611,RC,outpatient,,5987,5987,,5082.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1496.75,22,,percent of total billed charges,,,,,,,,,5388.3,90,,percent of total billed charges,,,4957.24,82.8,,percent of total billed charges,,,5088.95,85,,percent of total billed charges,,,,,,,,,5268.56,88,,percent of total billed charges,,,,,,,,,4574.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1496.75,22,,percent of total billed charges,,,5448.17,91,,percent of total billed charges,,,5687.65,95,,percent of total billed charges,,,4969.21,83,,percent of total billed charges,,,4969.21,83,,percent of total billed charges,,,,,,,,,,,,,,,4969.21,83,,percent of total billed charges,,,5687.65,95,,percent of total billed charges,,,5388.3,90,,percent of total billed charges,,,5388.3,90,,percent of total billed charges,,,4909.34,82,,percent of total billed charges,,,5388.3,90,,percent of total billed charges,,,5088.95,85,,percent of total billed charges,,1496.75,5687.65,
MRA NECK W +REPROC,31100015,CDM,70548,CPT,610,RC,outpatient,,5292,5292,,4492.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1323,22,,percent of total billed charges,,,,,,,,,4762.8,90,,percent of total billed charges,,,4381.78,82.8,,percent of total billed charges,,,4498.2,85,,percent of total billed charges,,,,,,,,,4656.96,88,,percent of total billed charges,,,,,,,,,4043.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1323,22,,percent of total billed charges,,,4815.72,91,,percent of total billed charges,,,5027.4,95,,percent of total billed charges,,,4392.36,83,,percent of total billed charges,,,4392.36,83,,percent of total billed charges,,,,,,,,,,,,,,,4392.36,83,,percent of total billed charges,,,5027.4,95,,percent of total billed charges,,,4762.8,90,,percent of total billed charges,,,4762.8,90,,percent of total billed charges,,,4339.44,82,,percent of total billed charges,,,4762.8,90,,percent of total billed charges,,,4498.2,85,,percent of total billed charges,,1323,5027.4,
MRA NECK W/WO + REPROC,31100016,CDM,70549,CPT,610,RC,outpatient,,6502,6502,,5520.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625.5,22,,percent of total billed charges,,,,,,,,,5851.8,90,,percent of total billed charges,,,5383.66,82.8,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,,,,,,,,5721.76,88,,percent of total billed charges,,,,,,,,,4967.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625.5,22,,percent of total billed charges,,,5916.82,91,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,,,,,,,,,,,,,5396.66,83,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5331.64,82,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,1625.5,6176.9,
MR BRAIN W/O,31100020,CDM,70551,CPT,611,RC,outpatient,TC,5262,5262,,4467.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1315.5,22,,percent of total billed charges,,,,,,,,,4735.8,90,,percent of total billed charges,,,4356.94,82.8,,percent of total billed charges,,,4472.7,85,,percent of total billed charges,,,,,,,,,4630.56,88,,percent of total billed charges,,,,,,,,,4020.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1315.5,22,,percent of total billed charges,,,4788.42,91,,percent of total billed charges,,,4998.9,95,,percent of total billed charges,,,4367.46,83,,percent of total billed charges,,,4367.46,83,,percent of total billed charges,,,,,,,,,,,,,,,4367.46,83,,percent of total billed charges,,,4998.9,95,,percent of total billed charges,,,4735.8,90,,percent of total billed charges,,,4735.8,90,,percent of total billed charges,,,4314.84,82,,percent of total billed charges,,,4735.8,90,,percent of total billed charges,,,4472.7,85,,percent of total billed charges,,1315.5,4998.9,
MR NECK W/O,31100025,CDM,70540,CPT,610,RC,outpatient,TC,5048,5048,,4285.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1262,22,,percent of total billed charges,,,,,,,,,4543.2,90,,percent of total billed charges,,,4179.74,82.8,,percent of total billed charges,,,4290.8,85,,percent of total billed charges,,,,,,,,,4442.24,88,,percent of total billed charges,,,,,,,,,3856.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1262,22,,percent of total billed charges,,,4593.68,91,,percent of total billed charges,,,4795.6,95,,percent of total billed charges,,,4189.84,83,,percent of total billed charges,,,4189.84,83,,percent of total billed charges,,,,,,,,,,,,,,,4189.84,83,,percent of total billed charges,,,4795.6,95,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4139.36,82,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4290.8,85,,percent of total billed charges,,1262,4795.6,
MR NECK W/,31100026,CDM,70542,CPT,610,RC,outpatient,,5671,5671,,4814.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1417.75,22,,percent of total billed charges,,,,,,,,,5103.9,90,,percent of total billed charges,,,4695.59,82.8,,percent of total billed charges,,,4820.35,85,,percent of total billed charges,,,,,,,,,4990.48,88,,percent of total billed charges,,,,,,,,,4332.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1417.75,22,,percent of total billed charges,,,5160.61,91,,percent of total billed charges,,,5387.45,95,,percent of total billed charges,,,4706.93,83,,percent of total billed charges,,,4706.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4706.93,83,,percent of total billed charges,,,5387.45,95,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,4650.22,82,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,4820.35,85,,percent of total billed charges,,1417.75,5387.45,
MR NECK W/WO,31100027,CDM,70543,CPT,610,RC,outpatient,TC,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1925.5,22,,percent of total billed charges,,,,,,,,,6931.8,90,,percent of total billed charges,,,6377.26,82.8,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1925.5,22,,percent of total billed charges,,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,1925.5,7316.9,
MR ORBIT W/,31100028,CDM,70542,CPT,610,RC,outpatient,,5190,5190,,4406.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1297.5,22,,percent of total billed charges,,,,,,,,,4671,90,,percent of total billed charges,,,4297.32,82.8,,percent of total billed charges,,,4411.5,85,,percent of total billed charges,,,,,,,,,4567.2,88,,percent of total billed charges,,,,,,,,,3965.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1297.5,22,,percent of total billed charges,,,4722.9,91,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,,,,,,,,,,,,,4307.7,83,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4255.8,82,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4411.5,85,,percent of total billed charges,,1297.5,4930.5,
MR ORBIT W/WO,31100029,CDM,70543,CPT,610,RC,outpatient,TC,5952,5952,,5053.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1488,22,,percent of total billed charges,,,,,,,,,5356.8,90,,percent of total billed charges,,,4928.26,82.8,,percent of total billed charges,,,5059.2,85,,percent of total billed charges,,,,,,,,,5237.76,88,,percent of total billed charges,,,,,,,,,4547.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1488,22,,percent of total billed charges,,,5416.32,91,,percent of total billed charges,,,5654.4,95,,percent of total billed charges,,,4940.16,83,,percent of total billed charges,,,4940.16,83,,percent of total billed charges,,,,,,,,,,,,,,,4940.16,83,,percent of total billed charges,,,5654.4,95,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,4880.64,82,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,5059.2,85,,percent of total billed charges,,1488,5654.4,
MR ORBIT W/O,31100030,CDM,70540,CPT,610,RC,outpatient,TC,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1134,22,,percent of total billed charges,,,,,,,,,4082.4,90,,percent of total billed charges,,,3755.81,82.8,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1134,22,,percent of total billed charges,,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,1134,4309.2,
MR FACE W/O,31100035,CDM,70540,CPT,610,RC,outpatient,TC,5048,5048,,4285.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1262,22,,percent of total billed charges,,,,,,,,,4543.2,90,,percent of total billed charges,,,4179.74,82.8,,percent of total billed charges,,,4290.8,85,,percent of total billed charges,,,,,,,,,4442.24,88,,percent of total billed charges,,,,,,,,,3856.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1262,22,,percent of total billed charges,,,4593.68,91,,percent of total billed charges,,,4795.6,95,,percent of total billed charges,,,4189.84,83,,percent of total billed charges,,,4189.84,83,,percent of total billed charges,,,,,,,,,,,,,,,4189.84,83,,percent of total billed charges,,,4795.6,95,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4139.36,82,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4290.8,85,,percent of total billed charges,,1262,4795.6,
MR FACE W/,31100036,CDM,70542,CPT,610,RC,outpatient,,5671,5671,,4814.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1417.75,22,,percent of total billed charges,,,,,,,,,5103.9,90,,percent of total billed charges,,,4695.59,82.8,,percent of total billed charges,,,4820.35,85,,percent of total billed charges,,,,,,,,,4990.48,88,,percent of total billed charges,,,,,,,,,4332.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1417.75,22,,percent of total billed charges,,,5160.61,91,,percent of total billed charges,,,5387.45,95,,percent of total billed charges,,,4706.93,83,,percent of total billed charges,,,4706.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4706.93,83,,percent of total billed charges,,,5387.45,95,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,4650.22,82,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,4820.35,85,,percent of total billed charges,,1417.75,5387.45,
MR FACE W/WO,31100037,CDM,70543,CPT,610,RC,outpatient,TC,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1925.5,22,,percent of total billed charges,,,,,,,,,6931.8,90,,percent of total billed charges,,,6377.26,82.8,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1925.5,22,,percent of total billed charges,,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,1925.5,7316.9,
MRA NECK WO + REPROC,31100040,CDM,70547,CPT,610,RC,outpatient,TC,4808,4808,,4081.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1202,22,,percent of total billed charges,,,,,,,,,4327.2,90,,percent of total billed charges,,,3981.02,82.8,,percent of total billed charges,,,4086.8,85,,percent of total billed charges,,,,,,,,,4231.04,88,,percent of total billed charges,,,,,,,,,3673.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1202,22,,percent of total billed charges,,,4375.28,91,,percent of total billed charges,,,4567.6,95,,percent of total billed charges,,,3990.64,83,,percent of total billed charges,,,3990.64,83,,percent of total billed charges,,,,,,,,,,,,,,,3990.64,83,,percent of total billed charges,,,4567.6,95,,percent of total billed charges,,,4327.2,90,,percent of total billed charges,,,4327.2,90,,percent of total billed charges,,,3942.56,82,,percent of total billed charges,,,4327.2,90,,percent of total billed charges,,,4086.8,85,,percent of total billed charges,,1202,4567.6,
MRA HEAD W + REPROC,31100045,CDM,70545,CPT,611,RC,outpatient,,5443,5443,,4621.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1360.75,22,,percent of total billed charges,,,,,,,,,4898.7,90,,percent of total billed charges,,,4506.8,82.8,,percent of total billed charges,,,4626.55,85,,percent of total billed charges,,,,,,,,,4789.84,88,,percent of total billed charges,,,,,,,,,4158.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1360.75,22,,percent of total billed charges,,,4953.13,91,,percent of total billed charges,,,5170.85,95,,percent of total billed charges,,,4517.69,83,,percent of total billed charges,,,4517.69,83,,percent of total billed charges,,,,,,,,,,,,,,,4517.69,83,,percent of total billed charges,,,5170.85,95,,percent of total billed charges,,,4898.7,90,,percent of total billed charges,,,4898.7,90,,percent of total billed charges,,,4463.26,82,,percent of total billed charges,,,4898.7,90,,percent of total billed charges,,,4626.55,85,,percent of total billed charges,,1360.75,5170.85,
MRV HEAD W + REPROC,31100046,CDM,70545,CPT,611,RC,outpatient,TC,5443,5443,,4621.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1360.75,22,,percent of total billed charges,,,,,,,,,4898.7,90,,percent of total billed charges,,,4506.8,82.8,,percent of total billed charges,,,4626.55,85,,percent of total billed charges,,,,,,,,,4789.84,88,,percent of total billed charges,,,,,,,,,4158.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1360.75,22,,percent of total billed charges,,,4953.13,91,,percent of total billed charges,,,5170.85,95,,percent of total billed charges,,,4517.69,83,,percent of total billed charges,,,4517.69,83,,percent of total billed charges,,,,,,,,,,,,,,,4517.69,83,,percent of total billed charges,,,5170.85,95,,percent of total billed charges,,,4898.7,90,,percent of total billed charges,,,4898.7,90,,percent of total billed charges,,,4463.26,82,,percent of total billed charges,,,4898.7,90,,percent of total billed charges,,,4626.55,85,,percent of total billed charges,,1360.75,5170.85,
MRV HEAD W + WO REPROC,31100047,CDM,70546,CPT,611,RC,outpatient,TC,5987,5987,,5082.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1496.75,22,,percent of total billed charges,,,,,,,,,5388.3,90,,percent of total billed charges,,,4957.24,82.8,,percent of total billed charges,,,5088.95,85,,percent of total billed charges,,,,,,,,,5268.56,88,,percent of total billed charges,,,,,,,,,4574.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1496.75,22,,percent of total billed charges,,,5448.17,91,,percent of total billed charges,,,5687.65,95,,percent of total billed charges,,,4969.21,83,,percent of total billed charges,,,4969.21,83,,percent of total billed charges,,,,,,,,,,,,,,,4969.21,83,,percent of total billed charges,,,5687.65,95,,percent of total billed charges,,,5388.3,90,,percent of total billed charges,,,5388.3,90,,percent of total billed charges,,,4909.34,82,,percent of total billed charges,,,5388.3,90,,percent of total billed charges,,,5088.95,85,,percent of total billed charges,,1496.75,5687.65,
MR BRAIN W/WO,31100050,CDM,70553,CPT,611,RC,outpatient,TC,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1925.5,22,,percent of total billed charges,,,,,,,,,6931.8,90,,percent of total billed charges,,,6377.26,82.8,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1925.5,22,,percent of total billed charges,,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,1925.5,7316.9,
MR IAC AND BRAIN W/,31100051,CDM,70542,CPT,610,RC,outpatient,TC,5671,5671,,4814.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1417.75,22,,percent of total billed charges,,,,,,,,,5103.9,90,,percent of total billed charges,,,4695.59,82.8,,percent of total billed charges,,,4820.35,85,,percent of total billed charges,,,,,,,,,4990.48,88,,percent of total billed charges,,,,,,,,,4332.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1417.75,22,,percent of total billed charges,,,5160.61,91,,percent of total billed charges,,,5387.45,95,,percent of total billed charges,,,4706.93,83,,percent of total billed charges,,,4706.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4706.93,83,,percent of total billed charges,,,5387.45,95,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,4650.22,82,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,4820.35,85,,percent of total billed charges,,1417.75,5387.45,
MR IAC AND BRAIN W/WO,31100052,CDM,70553,CPT,610,RC,outpatient,TC,8704,8704,,7389.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2176,22,,percent of total billed charges,,,,,,,,,7833.6,90,,percent of total billed charges,,,7206.91,82.8,,percent of total billed charges,,,7398.4,85,,percent of total billed charges,,,,,,,,,7659.52,88,,percent of total billed charges,,,,,,,,,6649.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2176,22,,percent of total billed charges,,,7920.64,91,,percent of total billed charges,,,8268.8,95,,percent of total billed charges,,,7224.32,83,,percent of total billed charges,,,7224.32,83,,percent of total billed charges,,,,,,,,,,,,,,,7224.32,83,,percent of total billed charges,,,8268.8,95,,percent of total billed charges,,,7833.6,90,,percent of total billed charges,,,7833.6,90,,percent of total billed charges,,,7137.28,82,,percent of total billed charges,,,7833.6,90,,percent of total billed charges,,,7398.4,85,,percent of total billed charges,,2176,8268.8,
MR IAC AND BRAIN W/O,31100053,CDM,70540,CPT,610,RC,outpatient,TC,5048,5048,,4285.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1262,22,,percent of total billed charges,,,,,,,,,4543.2,90,,percent of total billed charges,,,4179.74,82.8,,percent of total billed charges,,,4290.8,85,,percent of total billed charges,,,,,,,,,4442.24,88,,percent of total billed charges,,,,,,,,,3856.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1262,22,,percent of total billed charges,,,4593.68,91,,percent of total billed charges,,,4795.6,95,,percent of total billed charges,,,4189.84,83,,percent of total billed charges,,,4189.84,83,,percent of total billed charges,,,,,,,,,,,,,,,4189.84,83,,percent of total billed charges,,,4795.6,95,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4139.36,82,,percent of total billed charges,,,4543.2,90,,percent of total billed charges,,,4290.8,85,,percent of total billed charges,,1262,4795.6,
MR IAC W/WO,31100054,CDM,70543,CPT,610,RC,outpatient,TC,6043,6043,,5130.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1510.75,22,,percent of total billed charges,,,,,,,,,5438.7,90,,percent of total billed charges,,,5003.6,82.8,,percent of total billed charges,,,5136.55,85,,percent of total billed charges,,,,,,,,,5317.84,88,,percent of total billed charges,,,,,,,,,4616.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1510.75,22,,percent of total billed charges,,,5499.13,91,,percent of total billed charges,,,5740.85,95,,percent of total billed charges,,,5015.69,83,,percent of total billed charges,,,5015.69,83,,percent of total billed charges,,,,,,,,,,,,,,,5015.69,83,,percent of total billed charges,,,5740.85,95,,percent of total billed charges,,,5438.7,90,,percent of total billed charges,,,5438.7,90,,percent of total billed charges,,,4955.26,82,,percent of total billed charges,,,5438.7,90,,percent of total billed charges,,,5136.55,85,,percent of total billed charges,,1510.75,5740.85,
MR CHEST W/O,31100055,CDM,71550,CPT,610,RC,outpatient,TC,5174,5174,,4392.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1293.5,22,,percent of total billed charges,,,,,,,,,4656.6,90,,percent of total billed charges,,,4284.07,82.8,,percent of total billed charges,,,4397.9,85,,percent of total billed charges,,,,,,,,,4553.12,88,,percent of total billed charges,,,,,,,,,3952.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1293.5,22,,percent of total billed charges,,,4708.34,91,,percent of total billed charges,,,4915.3,95,,percent of total billed charges,,,4294.42,83,,percent of total billed charges,,,4294.42,83,,percent of total billed charges,,,,,,,,,,,,,,,4294.42,83,,percent of total billed charges,,,4915.3,95,,percent of total billed charges,,,4656.6,90,,percent of total billed charges,,,4656.6,90,,percent of total billed charges,,,4242.68,82,,percent of total billed charges,,,4656.6,90,,percent of total billed charges,,,4397.9,85,,percent of total billed charges,,1293.5,4915.3,
MR CHEST W/WO,31100056,CDM,71552,CPT,610,RC,outpatient,TC,5844,5844,,4961.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1461,22,,percent of total billed charges,,,,,,,,,5259.6,90,,percent of total billed charges,,,4838.83,82.8,,percent of total billed charges,,,4967.4,85,,percent of total billed charges,,,,,,,,,5142.72,88,,percent of total billed charges,,,,,,,,,4464.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1461,22,,percent of total billed charges,,,5318.04,91,,percent of total billed charges,,,5551.8,95,,percent of total billed charges,,,4850.52,83,,percent of total billed charges,,,4850.52,83,,percent of total billed charges,,,,,,,,,,,,,,,4850.52,83,,percent of total billed charges,,,5551.8,95,,percent of total billed charges,,,5259.6,90,,percent of total billed charges,,,5259.6,90,,percent of total billed charges,,,4792.08,82,,percent of total billed charges,,,5259.6,90,,percent of total billed charges,,,4967.4,85,,percent of total billed charges,,1461,5551.8,
MR U EXT JOINT RIGHT W/WO (V 05-17),31100058,CDM,73223,CPT,610,RC,outpatient,RT,6144,6144,,5216.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1536,22,,percent of total billed charges,,,,,,,,,5529.6,90,,percent of total billed charges,,,5087.23,82.8,,percent of total billed charges,,,5222.4,85,,percent of total billed charges,,,,,,,,,5406.72,88,,percent of total billed charges,,,,,,,,,4694.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1536,22,,percent of total billed charges,,,5591.04,91,,percent of total billed charges,,,5836.8,95,,percent of total billed charges,,,5099.52,83,,percent of total billed charges,,,5099.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5099.52,83,,percent of total billed charges,,,5836.8,95,,percent of total billed charges,,,5529.6,90,,percent of total billed charges,,,5529.6,90,,percent of total billed charges,,,5038.08,82,,percent of total billed charges,,,5529.6,90,,percent of total billed charges,,,5222.4,85,,percent of total billed charges,,1536,5836.8,
MR UP EXT JOINT RIGHT  W/O (V 05-17),31100059,CDM,73221,CPT,610,RC,outpatient,RT,5331,5331,,4526.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1332.75,22,,percent of total billed charges,,,,,,,,,4797.9,90,,percent of total billed charges,,,4414.07,82.8,,percent of total billed charges,,,4531.35,85,,percent of total billed charges,,,,,,,,,4691.28,88,,percent of total billed charges,,,,,,,,,4072.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1332.75,22,,percent of total billed charges,,,4851.21,91,,percent of total billed charges,,,5064.45,95,,percent of total billed charges,,,4424.73,83,,percent of total billed charges,,,4424.73,83,,percent of total billed charges,,,,,,,,,,,,,,,4424.73,83,,percent of total billed charges,,,5064.45,95,,percent of total billed charges,,,4797.9,90,,percent of total billed charges,,,4797.9,90,,percent of total billed charges,,,4371.42,82,,percent of total billed charges,,,4797.9,90,,percent of total billed charges,,,4531.35,85,,percent of total billed charges,,1332.75,5064.45,
MR BRAIN W/,31100060,CDM,70552,CPT,611,RC,outpatient,TC,5903,5903,,5011.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1475.75,22,,percent of total billed charges,,,,,,,,,5312.7,90,,percent of total billed charges,,,4887.68,82.8,,percent of total billed charges,,,5017.55,85,,percent of total billed charges,,,,,,,,,5194.64,88,,percent of total billed charges,,,,,,,,,4509.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1475.75,22,,percent of total billed charges,,,5371.73,91,,percent of total billed charges,,,5607.85,95,,percent of total billed charges,,,4899.49,83,,percent of total billed charges,,,4899.49,83,,percent of total billed charges,,,,,,,,,,,,,,,4899.49,83,,percent of total billed charges,,,5607.85,95,,percent of total billed charges,,,5312.7,90,,percent of total billed charges,,,5312.7,90,,percent of total billed charges,,,4840.46,82,,percent of total billed charges,,,5312.7,90,,percent of total billed charges,,,5017.55,85,,percent of total billed charges,,1475.75,5607.85,
* MRA CHEST W/WO & REPROCESSING (V306),31100066,CDM,C8911,HCPCS,610,RC,outpatient,,3224,3224,,2737.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,806,22,,percent of total billed charges,,,,,,,,,2901.6,90,,percent of total billed charges,,,2669.47,82.8,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,,,,,,,,2837.12,88,,percent of total billed charges,,,,,,,,,2463.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,806,22,,percent of total billed charges,,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2675.92,83,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2643.68,82,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,806,3062.8,
MR ABDOMEN W/O,31100075,CDM,74181,CPT,610,RC,outpatient,TC,5200,5200,,4414.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1300,22,,percent of total billed charges,,,,,,,,,4680,90,,percent of total billed charges,,,4305.6,82.8,,percent of total billed charges,,,4420,85,,percent of total billed charges,,,,,,,,,4576,88,,percent of total billed charges,,,,,,,,,3972.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1300,22,,percent of total billed charges,,,4732,91,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,4316,83,,percent of total billed charges,,,,,,,,,,,,,,,4316,83,,percent of total billed charges,,,4940,95,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4264,82,,percent of total billed charges,,,4680,90,,percent of total billed charges,,,4420,85,,percent of total billed charges,,1300,4940,
MR ABDOMEN W/,31100076,CDM,74182,CPT,610,RC,outpatient,TC,5843,5843,,4960.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1460.75,22,,percent of total billed charges,,,,,,,,,5258.7,90,,percent of total billed charges,,,4838,82.8,,percent of total billed charges,,,4966.55,85,,percent of total billed charges,,,,,,,,,5141.84,88,,percent of total billed charges,,,,,,,,,4464.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1460.75,22,,percent of total billed charges,,,5317.13,91,,percent of total billed charges,,,5550.85,95,,percent of total billed charges,,,4849.69,83,,percent of total billed charges,,,4849.69,83,,percent of total billed charges,,,,,,,,,,,,,,,4849.69,83,,percent of total billed charges,,,5550.85,95,,percent of total billed charges,,,5258.7,90,,percent of total billed charges,,,5258.7,90,,percent of total billed charges,,,4791.26,82,,percent of total billed charges,,,5258.7,90,,percent of total billed charges,,,4966.55,85,,percent of total billed charges,,1460.75,5550.85,
MR ABDOMEN W/WO,31100077,CDM,74183,CPT,610,RC,outpatient,TC,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1925.5,22,,percent of total billed charges,,,,,,,,,6931.8,90,,percent of total billed charges,,,6377.26,82.8,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1925.5,22,,percent of total billed charges,,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,1925.5,7316.9,
MR MRCP,31100078,CDM,74181,CPT,610,RC,outpatient,TC,4941,4941,,4194.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1235.25,22,,percent of total billed charges,,,,,,,,,4446.9,90,,percent of total billed charges,,,4091.15,82.8,,percent of total billed charges,,,4199.85,85,,percent of total billed charges,,,,,,,,,4348.08,88,,percent of total billed charges,,,,,,,,,3774.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1235.25,22,,percent of total billed charges,,,4496.31,91,,percent of total billed charges,,,4693.95,95,,percent of total billed charges,,,4101.03,83,,percent of total billed charges,,,4101.03,83,,percent of total billed charges,,,,,,,,,,,,,,,4101.03,83,,percent of total billed charges,,,4693.95,95,,percent of total billed charges,,,4446.9,90,,percent of total billed charges,,,4446.9,90,,percent of total billed charges,,,4051.62,82,,percent of total billed charges,,,4446.9,90,,percent of total billed charges,,,4199.85,85,,percent of total billed charges,,1235.25,4693.95,
MRA LOWEXTBILW/ORW/O/REPR,31100079,CDM,73725,CPT,610,RC,outpatient,50,9072,9072,,7702.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2268,22,,percent of total billed charges,,,,,,,,,8164.8,90,,percent of total billed charges,,,7511.62,82.8,,percent of total billed charges,,,7711.2,85,,percent of total billed charges,,,,,,,,,7983.36,88,,percent of total billed charges,,,,,,,,,6931.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2268,22,,percent of total billed charges,,,8255.52,91,,percent of total billed charges,,,8618.4,95,,percent of total billed charges,,,7529.76,83,,percent of total billed charges,,,7529.76,83,,percent of total billed charges,,,,,,,,,,,,,,,7529.76,83,,percent of total billed charges,,,8618.4,95,,percent of total billed charges,,,8164.8,90,,percent of total billed charges,,,8164.8,90,,percent of total billed charges,,,7439.04,82,,percent of total billed charges,,,8164.8,90,,percent of total billed charges,,,7711.2,85,,percent of total billed charges,,2268,8618.4,
MRA LOWEXTLT WORWO/REPROC,31100080,CDM,73725,CPT,610,RC,outpatient,LT,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1134,22,,percent of total billed charges,,,,,,,,,4082.4,90,,percent of total billed charges,,,3755.81,82.8,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1134,22,,percent of total billed charges,,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,1134,4309.2,
MRA LOWEXTRT W/ORW/O/REPR,31100081,CDM,73725,CPT,610,RC,outpatient,RT,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1134,22,,percent of total billed charges,,,,,,,,,4082.4,90,,percent of total billed charges,,,3755.81,82.8,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1134,22,,percent of total billed charges,,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,1134,4309.2,
MRA UPPER EXT W/WO CONTRAST,31100082,CDM,73225,CPT,610,RC,outpatient,TC,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1134,22,,percent of total billed charges,,,,,,,,,4082.4,90,,percent of total billed charges,,,3755.81,82.8,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1134,22,,percent of total billed charges,,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,1134,4309.2,
MRA MRV ABD W/AND/OR W/OREPR,31100085,CDM,74185,CPT,610,RC,outpatient,TC,6250,6250,,5306.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1562.5,22,,percent of total billed charges,,,,,,,,,5625,90,,percent of total billed charges,,,5175,82.8,,percent of total billed charges,,,5312.5,85,,percent of total billed charges,,,,,,,,,5500,88,,percent of total billed charges,,,,,,,,,4775,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1562.5,22,,percent of total billed charges,,,5687.5,91,,percent of total billed charges,,,5937.5,95,,percent of total billed charges,,,5187.5,83,,percent of total billed charges,,,5187.5,83,,percent of total billed charges,,,,,,,,,,,,,,,5187.5,83,,percent of total billed charges,,,5937.5,95,,percent of total billed charges,,,5625,90,,percent of total billed charges,,,5625,90,,percent of total billed charges,,,5125,82,,percent of total billed charges,,,5625,90,,percent of total billed charges,,,5312.5,85,,percent of total billed charges,,1562.5,5937.5,
MRA ABD W/O & REPROC,31100090,CDM,74185,CPT,610,RC,outpatient,TC,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1134,22,,percent of total billed charges,,,,,,,,,4082.4,90,,percent of total billed charges,,,3755.81,82.8,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1134,22,,percent of total billed charges,,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,1134,4309.2,
* DNU MR BONE MARROW(V0107),31100095,CDM,76400,CPT,610,RC,outpatient,,4675,4675,,3969.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1168.75,22,,percent of total billed charges,,,,,,,,,4207.5,90,,percent of total billed charges,,,3870.9,82.8,,percent of total billed charges,,,3973.75,85,,percent of total billed charges,,,,,,,,,4114,88,,percent of total billed charges,,,,,,,,,3571.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1168.75,22,,percent of total billed charges,,,4254.25,91,,percent of total billed charges,,,4441.25,95,,percent of total billed charges,,,3880.25,83,,percent of total billed charges,,,3880.25,83,,percent of total billed charges,,,,,,,,,,,,,,,3880.25,83,,percent of total billed charges,,,4441.25,95,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,3833.5,82,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,3973.75,85,,percent of total billed charges,,1168.75,4441.25,
MR BONE MARROW,31100096,CDM,77084,CPT,610,RC,outpatient,TC,5190,5190,,4406.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1297.5,22,,percent of total billed charges,,,,,,,,,4671,90,,percent of total billed charges,,,4297.32,82.8,,percent of total billed charges,,,4411.5,85,,percent of total billed charges,,,,,,,,,4567.2,88,,percent of total billed charges,,,,,,,,,3965.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1297.5,22,,percent of total billed charges,,,4722.9,91,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,,,,,,,,,,,,,4307.7,83,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4255.8,82,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4411.5,85,,percent of total billed charges,,1297.5,4930.5,
MR SHOULDER BILAT W/O,31100099,CDM,73221,CPT,610,RC,outpatient,50,10170,10170,,8634.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2542.5,22,,percent of total billed charges,,,,,,,,,9153,90,,percent of total billed charges,,,8420.76,82.8,,percent of total billed charges,,,8644.5,85,,percent of total billed charges,,,,,,,,,8949.6,88,,percent of total billed charges,,,,,,,,,7769.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2542.5,22,,percent of total billed charges,,,9254.7,91,,percent of total billed charges,,,9661.5,95,,percent of total billed charges,,,8441.1,83,,percent of total billed charges,,,8441.1,83,,percent of total billed charges,,,,,,,,,,,,,,,8441.1,83,,percent of total billed charges,,,9661.5,95,,percent of total billed charges,,,9153,90,,percent of total billed charges,,,9153,90,,percent of total billed charges,,,8339.4,82,,percent of total billed charges,,,9153,90,,percent of total billed charges,,,8644.5,85,,percent of total billed charges,,2542.5,9661.5,
MRA LOW EXT LT W/ANDREPROC,31100105,CDM,73725,CPT,610,RC,outpatient,LT,5190,5190,,4406.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1297.5,22,,percent of total billed charges,,,,,,,,,4671,90,,percent of total billed charges,,,4297.32,82.8,,percent of total billed charges,,,4411.5,85,,percent of total billed charges,,,,,,,,,4567.2,88,,percent of total billed charges,,,,,,,,,3965.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1297.5,22,,percent of total billed charges,,,4722.9,91,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,,,,,,,,,,,,,4307.7,83,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4255.8,82,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4411.5,85,,percent of total billed charges,,1297.5,4930.5,
MRA LOW EXT RTW/ANDREPROC,31100106,CDM,73725,CPT,610,RC,outpatient,RT,5190,5190,,4406.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1297.5,22,,percent of total billed charges,,,,,,,,,4671,90,,percent of total billed charges,,,4297.32,82.8,,percent of total billed charges,,,4411.5,85,,percent of total billed charges,,,,,,,,,4567.2,88,,percent of total billed charges,,,,,,,,,3965.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1297.5,22,,percent of total billed charges,,,4722.9,91,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,,,,,,,,,,,,,4307.7,83,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4255.8,82,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4411.5,85,,percent of total billed charges,,1297.5,4930.5,
* MRA LOW EXT LT W/WO & REPROC (V306),31100107,CDM,C8914,HCPCS,610,RC,outpatient,,3224,3224,,2737.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,806,22,,percent of total billed charges,,,,,,,,,2901.6,90,,percent of total billed charges,,,2669.47,82.8,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,,,,,,,,2837.12,88,,percent of total billed charges,,,,,,,,,2463.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,806,22,,percent of total billed charges,,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2675.92,83,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2643.68,82,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,806,3062.8,
* MRA LOW EXTREM RT W/WO & REPROC (V306),31100108,CDM,C8914,HCPCS,610,RC,outpatient,,3224,3224,,2737.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,806,22,,percent of total billed charges,,,,,,,,,2901.6,90,,percent of total billed charges,,,2669.47,82.8,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,,,,,,,,2837.12,88,,percent of total billed charges,,,,,,,,,2463.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,806,22,,percent of total billed charges,,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2675.92,83,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2643.68,82,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,806,3062.8,
* DNU MR JT LOW LT WO (V606),31100110,CDM,73721,CPT,610,RC,outpatient,,2388,2388,,2027.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,597,22,,percent of total billed charges,,,,,,,,,2149.2,90,,percent of total billed charges,,,1977.26,82.8,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,,,,,,,,2101.44,88,,percent of total billed charges,,,,,,,,,1824.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,597,22,,percent of total billed charges,,,2173.08,91,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1982.04,83,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,1958.16,82,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,597,2268.6,
* DNU MR JT LOW RT WO (V606),31100111,CDM,73721,CPT,610,RC,outpatient,,2388,2388,,2027.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,597,22,,percent of total billed charges,,,,,,,,,2149.2,90,,percent of total billed charges,,,1977.26,82.8,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,,,,,,,,2101.44,88,,percent of total billed charges,,,,,,,,,1824.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,597,22,,percent of total billed charges,,,2173.08,91,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1982.04,83,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,1958.16,82,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,597,2268.6,
* MR JT LOW LT W (V606),31100112,CDM,73722,CPT,610,RC,outpatient,,2774,2774,,2355.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,693.5,22,,percent of total billed charges,,,,,,,,,2496.6,90,,percent of total billed charges,,,2296.87,82.8,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,,,,,,,,2441.12,88,,percent of total billed charges,,,,,,,,,2119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,693.5,22,,percent of total billed charges,,,2524.34,91,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2302.42,83,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2274.68,82,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,693.5,2635.3,
* MR JT LOW RT W (V06),31100113,CDM,73722,CPT,610,RC,outpatient,,2774,2774,,2355.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,693.5,22,,percent of total billed charges,,,,,,,,,2496.6,90,,percent of total billed charges,,,2296.87,82.8,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,,,,,,,,2441.12,88,,percent of total billed charges,,,,,,,,,2119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,693.5,22,,percent of total billed charges,,,2524.34,91,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2302.42,83,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2274.68,82,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,693.5,2635.3,
* DNU MR LOW EXT RT WO (V606),31100114,CDM,73718,CPT,610,RC,outpatient,,2388,2388,,2027.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,597,22,,percent of total billed charges,,,,,,,,,2149.2,90,,percent of total billed charges,,,1977.26,82.8,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,,,,,,,,2101.44,88,,percent of total billed charges,,,,,,,,,1824.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,597,22,,percent of total billed charges,,,2173.08,91,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1982.04,83,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,1958.16,82,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,597,2268.6,
* DNU MR LOW EXT LT WO (V606),31100115,CDM,73718,CPT,610,RC,outpatient,,2388,2388,,2027.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,597,22,,percent of total billed charges,,,,,,,,,2149.2,90,,percent of total billed charges,,,1977.26,82.8,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,,,,,,,,2101.44,88,,percent of total billed charges,,,,,,,,,1824.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,597,22,,percent of total billed charges,,,2173.08,91,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1982.04,83,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,1958.16,82,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,597,2268.6,
* MR LOW EXT LT W (V606),31100116,CDM,73719,CPT,610,RC,outpatient,,2774,2774,,2355.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,693.5,22,,percent of total billed charges,,,,,,,,,2496.6,90,,percent of total billed charges,,,2296.87,82.8,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,,,,,,,,2441.12,88,,percent of total billed charges,,,,,,,,,2119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,693.5,22,,percent of total billed charges,,,2524.34,91,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2302.42,83,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2274.68,82,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,693.5,2635.3,
* MR LOW EXT RT W (V606),31100117,CDM,73719,CPT,610,RC,outpatient,,2774,2774,,2355.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,693.5,22,,percent of total billed charges,,,,,,,,,2496.6,90,,percent of total billed charges,,,2296.87,82.8,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,,,,,,,,2441.12,88,,percent of total billed charges,,,,,,,,,2119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,693.5,22,,percent of total billed charges,,,2524.34,91,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2302.42,83,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2274.68,82,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,693.5,2635.3,
* DNU MR LOW EXT LT W/WO (V606),31100118,CDM,73720,CPT,610,RC,outpatient,,3224,3224,,2737.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,806,22,,percent of total billed charges,,,,,,,,,2901.6,90,,percent of total billed charges,,,2669.47,82.8,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,,,,,,,,2837.12,88,,percent of total billed charges,,,,,,,,,2463.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,806,22,,percent of total billed charges,,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2675.92,83,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2643.68,82,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,806,3062.8,
* DNU MR LOW EXT RT W/WO (V606),31100119,CDM,73720,CPT,610,RC,outpatient,,3224,3224,,2737.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,806,22,,percent of total billed charges,,,,,,,,,2901.6,90,,percent of total billed charges,,,2669.47,82.8,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,,,,,,,,2837.12,88,,percent of total billed charges,,,,,,,,,2463.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,806,22,,percent of total billed charges,,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2675.92,83,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2643.68,82,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,806,3062.8,
* MR UP EXT LT W (V606),31100122,CDM,73219,CPT,610,RC,outpatient,,2774,2774,,2355.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,693.5,22,,percent of total billed charges,,,,,,,,,2496.6,90,,percent of total billed charges,,,2296.87,82.8,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,,,,,,,,2441.12,88,,percent of total billed charges,,,,,,,,,2119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,693.5,22,,percent of total billed charges,,,2524.34,91,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2302.42,83,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2274.68,82,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,693.5,2635.3,
* MR UP EXT RT W (V606),31100123,CDM,73219,CPT,610,RC,outpatient,,2774,2774,,2355.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,693.5,22,,percent of total billed charges,,,,,,,,,2496.6,90,,percent of total billed charges,,,2296.87,82.8,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,,,,,,,,2441.12,88,,percent of total billed charges,,,,,,,,,2119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,693.5,22,,percent of total billed charges,,,2524.34,91,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2302.42,83,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2274.68,82,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,693.5,2635.3,
* DNU MR UP EXT LT W/WO (V606),31100124,CDM,73220,CPT,610,RC,outpatient,,3224,3224,,2737.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,806,22,,percent of total billed charges,,,,,,,,,2901.6,90,,percent of total billed charges,,,2669.47,82.8,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,,,,,,,,2837.12,88,,percent of total billed charges,,,,,,,,,2463.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,806,22,,percent of total billed charges,,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2675.92,83,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2643.68,82,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,806,3062.8,
* MR UP EXT LT WO (V606),31100125,CDM,73218,CPT,610,RC,outpatient,,2388,2388,,2027.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,597,22,,percent of total billed charges,,,,,,,,,2149.2,90,,percent of total billed charges,,,1977.26,82.8,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,,,,,,,,2101.44,88,,percent of total billed charges,,,,,,,,,1824.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,597,22,,percent of total billed charges,,,2173.08,91,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1982.04,83,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,1958.16,82,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,597,2268.6,
* DNU MR UP EXT RT W/WO (V606),31100126,CDM,73220,CPT,610,RC,outpatient,,3224,3224,,2737.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,806,22,,percent of total billed charges,,,,,,,,,2901.6,90,,percent of total billed charges,,,2669.47,82.8,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,,,,,,,,2837.12,88,,percent of total billed charges,,,,,,,,,2463.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,806,22,,percent of total billed charges,,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2675.92,83,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2643.68,82,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,806,3062.8,
* MR UP EXT RT WO (V606),31100127,CDM,73218,CPT,610,RC,outpatient,,2388,2388,,2027.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,597,22,,percent of total billed charges,,,,,,,,,2149.2,90,,percent of total billed charges,,,1977.26,82.8,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,,,,,,,,2101.44,88,,percent of total billed charges,,,,,,,,,1824.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,597,22,,percent of total billed charges,,,2173.08,91,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1982.04,83,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,1958.16,82,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,597,2268.6,
* DNU MR JT UP LT W (V806),31100134,CDM,73222,CPT,610,RC,outpatient,,4675,4675,,3969.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1168.75,22,,percent of total billed charges,,,,,,,,,4207.5,90,,percent of total billed charges,,,3870.9,82.8,,percent of total billed charges,,,3973.75,85,,percent of total billed charges,,,,,,,,,4114,88,,percent of total billed charges,,,,,,,,,3571.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1168.75,22,,percent of total billed charges,,,4254.25,91,,percent of total billed charges,,,4441.25,95,,percent of total billed charges,,,3880.25,83,,percent of total billed charges,,,3880.25,83,,percent of total billed charges,,,,,,,,,,,,,,,3880.25,83,,percent of total billed charges,,,4441.25,95,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,3833.5,82,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,3973.75,85,,percent of total billed charges,,1168.75,4441.25,
* DNU MR JT UP LT WO (V806),31100135,CDM,73221,CPT,610,RC,outpatient,,4020,4020,,3412.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1005,22,,percent of total billed charges,,,,,,,,,3618,90,,percent of total billed charges,,,3328.56,82.8,,percent of total billed charges,,,3417,85,,percent of total billed charges,,,,,,,,,3537.6,88,,percent of total billed charges,,,,,,,,,3071.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1005,22,,percent of total billed charges,,,3658.2,91,,percent of total billed charges,,,3819,95,,percent of total billed charges,,,3336.6,83,,percent of total billed charges,,,3336.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3336.6,83,,percent of total billed charges,,,3819,95,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3296.4,82,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3417,85,,percent of total billed charges,,1005,3819,
* DNU MR JT UP RT W (V806),31100136,CDM,73222,CPT,610,RC,outpatient,,4675,4675,,3969.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1168.75,22,,percent of total billed charges,,,,,,,,,4207.5,90,,percent of total billed charges,,,3870.9,82.8,,percent of total billed charges,,,3973.75,85,,percent of total billed charges,,,,,,,,,4114,88,,percent of total billed charges,,,,,,,,,3571.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1168.75,22,,percent of total billed charges,,,4254.25,91,,percent of total billed charges,,,4441.25,95,,percent of total billed charges,,,3880.25,83,,percent of total billed charges,,,3880.25,83,,percent of total billed charges,,,,,,,,,,,,,,,3880.25,83,,percent of total billed charges,,,4441.25,95,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,3833.5,82,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,3973.75,85,,percent of total billed charges,,1168.75,4441.25,
* DNU MR JT UP LT W/WO (V806),31100137,CDM,73223,CPT,610,RC,outpatient,,5435,5435,,4614.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1358.75,22,,percent of total billed charges,,,,,,,,,4891.5,90,,percent of total billed charges,,,4500.18,82.8,,percent of total billed charges,,,4619.75,85,,percent of total billed charges,,,,,,,,,4782.8,88,,percent of total billed charges,,,,,,,,,4152.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1358.75,22,,percent of total billed charges,,,4945.85,91,,percent of total billed charges,,,5163.25,95,,percent of total billed charges,,,4511.05,83,,percent of total billed charges,,,4511.05,83,,percent of total billed charges,,,,,,,,,,,,,,,4511.05,83,,percent of total billed charges,,,5163.25,95,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4456.7,82,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4619.75,85,,percent of total billed charges,,1358.75,5163.25,
* DNU MR JT UP RT W/WO,31100138,CDM,73223,CPT,610,RC,outpatient,,5435,5435,,4614.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1358.75,22,,percent of total billed charges,,,,,,,,,4891.5,90,,percent of total billed charges,,,4500.18,82.8,,percent of total billed charges,,,4619.75,85,,percent of total billed charges,,,,,,,,,4782.8,88,,percent of total billed charges,,,,,,,,,4152.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1358.75,22,,percent of total billed charges,,,4945.85,91,,percent of total billed charges,,,5163.25,95,,percent of total billed charges,,,4511.05,83,,percent of total billed charges,,,4511.05,83,,percent of total billed charges,,,,,,,,,,,,,,,4511.05,83,,percent of total billed charges,,,5163.25,95,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4456.7,82,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4619.75,85,,percent of total billed charges,,1358.75,5163.25,
* DNU MR JT UP RT WO,31100139,CDM,73221,CPT,610,RC,outpatient,,4020,4020,,3412.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1005,22,,percent of total billed charges,,,,,,,,,3618,90,,percent of total billed charges,,,3328.56,82.8,,percent of total billed charges,,,3417,85,,percent of total billed charges,,,,,,,,,3537.6,88,,percent of total billed charges,,,,,,,,,3071.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1005,22,,percent of total billed charges,,,3658.2,91,,percent of total billed charges,,,3819,95,,percent of total billed charges,,,3336.6,83,,percent of total billed charges,,,3336.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3336.6,83,,percent of total billed charges,,,3819,95,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3296.4,82,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3417,85,,percent of total billed charges,,1005,3819,
MRA PELV W/ ANDREPROC,31100140,CDM,72198,CPT,610,RC,outpatient,TC,5190,5190,,4406.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1297.5,22,,percent of total billed charges,,,,,,,,,4671,90,,percent of total billed charges,,,4297.32,82.8,,percent of total billed charges,,,4411.5,85,,percent of total billed charges,,,,,,,,,4567.2,88,,percent of total billed charges,,,,,,,,,3965.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1297.5,22,,percent of total billed charges,,,4722.9,91,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,4307.7,83,,percent of total billed charges,,,,,,,,,,,,,,,4307.7,83,,percent of total billed charges,,,4930.5,95,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4255.8,82,,percent of total billed charges,,,4671,90,,percent of total billed charges,,,4411.5,85,,percent of total billed charges,,1297.5,4930.5,
MRA PELV W/O AND REPROC,31100145,CDM,72198,CPT,610,RC,outpatient,TC,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1134,22,,percent of total billed charges,,,,,,,,,4082.4,90,,percent of total billed charges,,,3755.81,82.8,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1134,22,,percent of total billed charges,,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,1134,4309.2,
MRA PELV W/WO AND REPROC,31100146,CDM,72198,CPT,610,RC,outpatient,TC,5952,5952,,5053.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1488,22,,percent of total billed charges,,,,,,,,,5356.8,90,,percent of total billed charges,,,4928.26,82.8,,percent of total billed charges,,,5059.2,85,,percent of total billed charges,,,,,,,,,5237.76,88,,percent of total billed charges,,,,,,,,,4547.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1488,22,,percent of total billed charges,,,5416.32,91,,percent of total billed charges,,,5654.4,95,,percent of total billed charges,,,4940.16,83,,percent of total billed charges,,,4940.16,83,,percent of total billed charges,,,,,,,,,,,,,,,4940.16,83,,percent of total billed charges,,,5654.4,95,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,4880.64,82,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,5059.2,85,,percent of total billed charges,,1488,5654.4,
MR PELVIS W/O,31100150,CDM,72195,CPT,610,RC,outpatient,TC,5077,5077,,4310.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1269.25,22,,percent of total billed charges,,,,,,,,,4569.3,90,,percent of total billed charges,,,4203.76,82.8,,percent of total billed charges,,,4315.45,85,,percent of total billed charges,,,,,,,,,4467.76,88,,percent of total billed charges,,,,,,,,,3878.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1269.25,22,,percent of total billed charges,,,4620.07,91,,percent of total billed charges,,,4823.15,95,,percent of total billed charges,,,4213.91,83,,percent of total billed charges,,,4213.91,83,,percent of total billed charges,,,,,,,,,,,,,,,4213.91,83,,percent of total billed charges,,,4823.15,95,,percent of total billed charges,,,4569.3,90,,percent of total billed charges,,,4569.3,90,,percent of total billed charges,,,4163.14,82,,percent of total billed charges,,,4569.3,90,,percent of total billed charges,,,4315.45,85,,percent of total billed charges,,1269.25,4823.15,
MR PELVIS W/,31100151,CDM,72196,CPT,610,RC,outpatient,TC,5726,5726,,4861.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1431.5,22,,percent of total billed charges,,,,,,,,,5153.4,90,,percent of total billed charges,,,4741.13,82.8,,percent of total billed charges,,,4867.1,85,,percent of total billed charges,,,,,,,,,5038.88,88,,percent of total billed charges,,,,,,,,,4374.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1431.5,22,,percent of total billed charges,,,5210.66,91,,percent of total billed charges,,,5439.7,95,,percent of total billed charges,,,4752.58,83,,percent of total billed charges,,,4752.58,83,,percent of total billed charges,,,,,,,,,,,,,,,4752.58,83,,percent of total billed charges,,,5439.7,95,,percent of total billed charges,,,5153.4,90,,percent of total billed charges,,,5153.4,90,,percent of total billed charges,,,4695.32,82,,percent of total billed charges,,,5153.4,90,,percent of total billed charges,,,4867.1,85,,percent of total billed charges,,1431.5,5439.7,
MR PELVIS W/WO,31100152,CDM,72197,CPT,610,RC,outpatient,TC,6864,6864,,5827.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1716,22,,percent of total billed charges,,,,,,,,,6177.6,90,,percent of total billed charges,,,5683.39,82.8,,percent of total billed charges,,,5834.4,85,,percent of total billed charges,,,,,,,,,6040.32,88,,percent of total billed charges,,,,,,,,,5244.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1716,22,,percent of total billed charges,,,6246.24,91,,percent of total billed charges,,,6520.8,95,,percent of total billed charges,,,5697.12,83,,percent of total billed charges,,,5697.12,83,,percent of total billed charges,,,,,,,,,,,,,,,5697.12,83,,percent of total billed charges,,,6520.8,95,,percent of total billed charges,,,6177.6,90,,percent of total billed charges,,,6177.6,90,,percent of total billed charges,,,5628.48,82,,percent of total billed charges,,,6177.6,90,,percent of total billed charges,,,5834.4,85,,percent of total billed charges,,1716,6520.8,
MR C SPINE W/O,31100155,CDM,72141,CPT,612,RC,outpatient,TC,5602,5602,,4756.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1400.5,22,,percent of total billed charges,,,,,,,,,5041.8,90,,percent of total billed charges,,,4638.46,82.8,,percent of total billed charges,,,4761.7,85,,percent of total billed charges,,,,,,,,,4929.76,88,,percent of total billed charges,,,,,,,,,4279.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1400.5,22,,percent of total billed charges,,,5097.82,91,,percent of total billed charges,,,5321.9,95,,percent of total billed charges,,,4649.66,83,,percent of total billed charges,,,4649.66,83,,percent of total billed charges,,,,,,,,,,,,,,,4649.66,83,,percent of total billed charges,,,5321.9,95,,percent of total billed charges,,,5041.8,90,,percent of total billed charges,,,5041.8,90,,percent of total billed charges,,,4593.64,82,,percent of total billed charges,,,5041.8,90,,percent of total billed charges,,,4761.7,85,,percent of total billed charges,,1400.5,5321.9,
MR C SPINE W/,31100160,CDM,72142,CPT,612,RC,outpatient,TC,5802,5802,,4925.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1450.5,22,,percent of total billed charges,,,,,,,,,5221.8,90,,percent of total billed charges,,,4804.06,82.8,,percent of total billed charges,,,4931.7,85,,percent of total billed charges,,,,,,,,,5105.76,88,,percent of total billed charges,,,,,,,,,4432.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1450.5,22,,percent of total billed charges,,,5279.82,91,,percent of total billed charges,,,5511.9,95,,percent of total billed charges,,,4815.66,83,,percent of total billed charges,,,4815.66,83,,percent of total billed charges,,,,,,,,,,,,,,,4815.66,83,,percent of total billed charges,,,5511.9,95,,percent of total billed charges,,,5221.8,90,,percent of total billed charges,,,5221.8,90,,percent of total billed charges,,,4757.64,82,,percent of total billed charges,,,5221.8,90,,percent of total billed charges,,,4931.7,85,,percent of total billed charges,,1450.5,5511.9,
MR C SPINE W/WO,31100165,CDM,72156,CPT,612,RC,outpatient,TC,7434,7434,,6311.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1858.5,22,,percent of total billed charges,,,,,,,,,6690.6,90,,percent of total billed charges,,,6155.35,82.8,,percent of total billed charges,,,6318.9,85,,percent of total billed charges,,,,,,,,,6541.92,88,,percent of total billed charges,,,,,,,,,5679.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1858.5,22,,percent of total billed charges,,,6764.94,91,,percent of total billed charges,,,7062.3,95,,percent of total billed charges,,,6170.22,83,,percent of total billed charges,,,6170.22,83,,percent of total billed charges,,,,,,,,,,,,,,,6170.22,83,,percent of total billed charges,,,7062.3,95,,percent of total billed charges,,,6690.6,90,,percent of total billed charges,,,6690.6,90,,percent of total billed charges,,,6095.88,82,,percent of total billed charges,,,6690.6,90,,percent of total billed charges,,,6318.9,85,,percent of total billed charges,,1858.5,7062.3,
MRA C SPINE WO + REPROC,31100175,CDM,72159,CPT,612,RC,outpatient,,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1134,22,,percent of total billed charges,,,,,,,,,4082.4,90,,percent of total billed charges,,,3755.81,82.8,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1134,22,,percent of total billed charges,,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,1134,4309.2,
MR L SPINE W/,31100180,CDM,72149,CPT,612,RC,outpatient,TC,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1467.75,22,,percent of total billed charges,,,,,,,,,5283.9,90,,percent of total billed charges,,,4861.19,82.8,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1467.75,22,,percent of total billed charges,,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,1467.75,5577.45,
MR L SPINE W/O,31100185,CDM,72148,CPT,612,RC,outpatient,TC,5602,5602,,4756.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1400.5,22,,percent of total billed charges,,,,,,,,,5041.8,90,,percent of total billed charges,,,4638.46,82.8,,percent of total billed charges,,,4761.7,85,,percent of total billed charges,,,,,,,,,4929.76,88,,percent of total billed charges,,,,,,,,,4279.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1400.5,22,,percent of total billed charges,,,5097.82,91,,percent of total billed charges,,,5321.9,95,,percent of total billed charges,,,4649.66,83,,percent of total billed charges,,,4649.66,83,,percent of total billed charges,,,,,,,,,,,,,,,4649.66,83,,percent of total billed charges,,,5321.9,95,,percent of total billed charges,,,5041.8,90,,percent of total billed charges,,,5041.8,90,,percent of total billed charges,,,4593.64,82,,percent of total billed charges,,,5041.8,90,,percent of total billed charges,,,4761.7,85,,percent of total billed charges,,1400.5,5321.9,
MR L SPINE W/WO,31100190,CDM,72158,CPT,612,RC,outpatient,TC,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1925.5,22,,percent of total billed charges,,,,,,,,,6931.8,90,,percent of total billed charges,,,6377.26,82.8,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1925.5,22,,percent of total billed charges,,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,1925.5,7316.9,
MRA L SPINE WO + REPROC,31100200,CDM,72159,CPT,612,RC,outpatient,,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1134,22,,percent of total billed charges,,,,,,,,,4082.4,90,,percent of total billed charges,,,3755.81,82.8,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1134,22,,percent of total billed charges,,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,1134,4309.2,
MR T SPINE W/,31100205,CDM,72147,CPT,612,RC,outpatient,TC,5873,5873,,4986.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1468.25,22,,percent of total billed charges,,,,,,,,,5285.7,90,,percent of total billed charges,,,4862.84,82.8,,percent of total billed charges,,,4992.05,85,,percent of total billed charges,,,,,,,,,5168.24,88,,percent of total billed charges,,,,,,,,,4486.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1468.25,22,,percent of total billed charges,,,5344.43,91,,percent of total billed charges,,,5579.35,95,,percent of total billed charges,,,4874.59,83,,percent of total billed charges,,,4874.59,83,,percent of total billed charges,,,,,,,,,,,,,,,4874.59,83,,percent of total billed charges,,,5579.35,95,,percent of total billed charges,,,5285.7,90,,percent of total billed charges,,,5285.7,90,,percent of total billed charges,,,4815.86,82,,percent of total billed charges,,,5285.7,90,,percent of total billed charges,,,4992.05,85,,percent of total billed charges,,1468.25,5579.35,
MR T SPINE W/O,31100210,CDM,72146,CPT,612,RC,outpatient,TC,5370,5370,,4559.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1342.5,22,,percent of total billed charges,,,,,,,,,4833,90,,percent of total billed charges,,,4446.36,82.8,,percent of total billed charges,,,4564.5,85,,percent of total billed charges,,,,,,,,,4725.6,88,,percent of total billed charges,,,,,,,,,4102.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1342.5,22,,percent of total billed charges,,,4886.7,91,,percent of total billed charges,,,5101.5,95,,percent of total billed charges,,,4457.1,83,,percent of total billed charges,,,4457.1,83,,percent of total billed charges,,,,,,,,,,,,,,,4457.1,83,,percent of total billed charges,,,5101.5,95,,percent of total billed charges,,,4833,90,,percent of total billed charges,,,4833,90,,percent of total billed charges,,,4403.4,82,,percent of total billed charges,,,4833,90,,percent of total billed charges,,,4564.5,85,,percent of total billed charges,,1342.5,5101.5,
MR T SPINE W/WO,31100215,CDM,72157,CPT,612,RC,outpatient,TC,7294,7294,,6192.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1823.5,22,,percent of total billed charges,,,,,,,,,6564.6,90,,percent of total billed charges,,,6039.43,82.8,,percent of total billed charges,,,6199.9,85,,percent of total billed charges,,,,,,,,,6418.72,88,,percent of total billed charges,,,,,,,,,5572.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1823.5,22,,percent of total billed charges,,,6637.54,91,,percent of total billed charges,,,6929.3,95,,percent of total billed charges,,,6054.02,83,,percent of total billed charges,,,6054.02,83,,percent of total billed charges,,,,,,,,,,,,,,,6054.02,83,,percent of total billed charges,,,6929.3,95,,percent of total billed charges,,,6564.6,90,,percent of total billed charges,,,6564.6,90,,percent of total billed charges,,,5981.08,82,,percent of total billed charges,,,6564.6,90,,percent of total billed charges,,,6199.9,85,,percent of total billed charges,,1823.5,6929.3,
* MRA THORACIC W/WO& REPROCESSING (V306),31100221,CDM,C8911,HCPCS,610,RC,outpatient,,3224,3224,,2737.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,806,22,,percent of total billed charges,,,,,,,,,2901.6,90,,percent of total billed charges,,,2669.47,82.8,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,,,,,,,,2837.12,88,,percent of total billed charges,,,,,,,,,2463.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,806,22,,percent of total billed charges,,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2675.92,83,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2643.68,82,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,806,3062.8,
MR TMJ,31100250,CDM,70336,CPT,610,RC,outpatient,,5069,5069,,4303.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1267.25,22,,percent of total billed charges,,,,,,,,,4562.1,90,,percent of total billed charges,,,4197.13,82.8,,percent of total billed charges,,,4308.65,85,,percent of total billed charges,,,,,,,,,4460.72,88,,percent of total billed charges,,,,,,,,,3872.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1267.25,22,,percent of total billed charges,,,4612.79,91,,percent of total billed charges,,,4815.55,95,,percent of total billed charges,,,4207.27,83,,percent of total billed charges,,,4207.27,83,,percent of total billed charges,,,,,,,,,,,,,,,4207.27,83,,percent of total billed charges,,,4815.55,95,,percent of total billed charges,,,4562.1,90,,percent of total billed charges,,,4562.1,90,,percent of total billed charges,,,4156.58,82,,percent of total billed charges,,,4562.1,90,,percent of total billed charges,,,4308.65,85,,percent of total billed charges,,1267.25,4815.55,
* DNU MR BREAST RT W/WO(V0107),31100300,CDM,76093,CPT,610,RC,outpatient,,5435,5435,,4614.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1358.75,22,,percent of total billed charges,,,,,,,,,4891.5,90,,percent of total billed charges,,,4500.18,82.8,,percent of total billed charges,,,4619.75,85,,percent of total billed charges,,,,,,,,,4782.8,88,,percent of total billed charges,,,,,,,,,4152.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1358.75,22,,percent of total billed charges,,,4945.85,91,,percent of total billed charges,,,5163.25,95,,percent of total billed charges,,,4511.05,83,,percent of total billed charges,,,4511.05,83,,percent of total billed charges,,,,,,,,,,,,,,,4511.05,83,,percent of total billed charges,,,5163.25,95,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4456.7,82,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4619.75,85,,percent of total billed charges,,1358.75,5163.25,
MR BREAST RT W/WO,31100302,CDM,77046,CPT,610,RC,outpatient,RT,5952,5952,,5053.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1488,22,,percent of total billed charges,,,,,,,,,5356.8,90,,percent of total billed charges,,,4928.26,82.8,,percent of total billed charges,,,5059.2,85,,percent of total billed charges,,,,,,,,,5237.76,88,,percent of total billed charges,,,,,,,,,4547.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1488,22,,percent of total billed charges,,,5416.32,91,,percent of total billed charges,,,5654.4,95,,percent of total billed charges,,,4940.16,83,,percent of total billed charges,,,4940.16,83,,percent of total billed charges,,,,,,,,,,,,,,,4940.16,83,,percent of total billed charges,,,5654.4,95,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,4880.64,82,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,5059.2,85,,percent of total billed charges,,1488,5654.4,
* DNU MR BREAST LT W/WO(V0107),31100305,CDM,76093,CPT,610,RC,outpatient,,5435,5435,,4614.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1358.75,22,,percent of total billed charges,,,,,,,,,4891.5,90,,percent of total billed charges,,,4500.18,82.8,,percent of total billed charges,,,4619.75,85,,percent of total billed charges,,,,,,,,,4782.8,88,,percent of total billed charges,,,,,,,,,4152.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1358.75,22,,percent of total billed charges,,,4945.85,91,,percent of total billed charges,,,5163.25,95,,percent of total billed charges,,,4511.05,83,,percent of total billed charges,,,4511.05,83,,percent of total billed charges,,,,,,,,,,,,,,,4511.05,83,,percent of total billed charges,,,5163.25,95,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4456.7,82,,percent of total billed charges,,,4891.5,90,,percent of total billed charges,,,4619.75,85,,percent of total billed charges,,1358.75,5163.25,
MR BREAST LT W/WO,31100307,CDM,77046,CPT,610,RC,outpatient,LT,5952,5952,,5053.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1488,22,,percent of total billed charges,,,,,,,,,5356.8,90,,percent of total billed charges,,,4928.26,82.8,,percent of total billed charges,,,5059.2,85,,percent of total billed charges,,,,,,,,,5237.76,88,,percent of total billed charges,,,,,,,,,4547.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1488,22,,percent of total billed charges,,,5416.32,91,,percent of total billed charges,,,5654.4,95,,percent of total billed charges,,,4940.16,83,,percent of total billed charges,,,4940.16,83,,percent of total billed charges,,,,,,,,,,,,,,,4940.16,83,,percent of total billed charges,,,5654.4,95,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,4880.64,82,,percent of total billed charges,,,5356.8,90,,percent of total billed charges,,,5059.2,85,,percent of total billed charges,,1488,5654.4,
MR BREAST BIL W/WO,31100309,CDM,77047,CPT,610,RC,outpatient,TC,11904,11904,,10106.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2976,22,,percent of total billed charges,,,,,,,,,10713.6,90,,percent of total billed charges,,,9856.51,82.8,,percent of total billed charges,,,10118.4,85,,percent of total billed charges,,,,,,,,,10475.52,88,,percent of total billed charges,,,,,,,,,9094.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2976,22,,percent of total billed charges,,,10832.64,91,,percent of total billed charges,,,11308.8,95,,percent of total billed charges,,,9880.32,83,,percent of total billed charges,,,9880.32,83,,percent of total billed charges,,,,,,,,,,,,,,,9880.32,83,,percent of total billed charges,,,11308.8,95,,percent of total billed charges,,,10713.6,90,,percent of total billed charges,,,10713.6,90,,percent of total billed charges,,,9761.28,82,,percent of total billed charges,,,10713.6,90,,percent of total billed charges,,,10118.4,85,,percent of total billed charges,,2976,11308.8,
* DNU MR BREAST BIL W/WO(V0107),31100310,CDM,76094,CPT,610,RC,outpatient,,6901,6901,,5858.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1725.25,22,,percent of total billed charges,,,,,,,,,6210.9,90,,percent of total billed charges,,,5714.03,82.8,,percent of total billed charges,,,5865.85,85,,percent of total billed charges,,,,,,,,,6072.88,88,,percent of total billed charges,,,,,,,,,5272.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1725.25,22,,percent of total billed charges,,,6279.91,91,,percent of total billed charges,,,6555.95,95,,percent of total billed charges,,,5727.83,83,,percent of total billed charges,,,5727.83,83,,percent of total billed charges,,,,,,,,,,,,,,,5727.83,83,,percent of total billed charges,,,6555.95,95,,percent of total billed charges,,,6210.9,90,,percent of total billed charges,,,6210.9,90,,percent of total billed charges,,,5658.82,82,,percent of total billed charges,,,6210.9,90,,percent of total billed charges,,,5865.85,85,,percent of total billed charges,,1725.25,6555.95,
* MR BREAST BIL W (V306),31100311,CDM,C8906,HCPCS,610,RC,outpatient,,3006,3006,,2552.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,751.5,22,,percent of total billed charges,,,,,,,,,2705.4,90,,percent of total billed charges,,,2488.97,82.8,,percent of total billed charges,,,2555.1,85,,percent of total billed charges,,,,,,,,,2645.28,88,,percent of total billed charges,,,,,,,,,2296.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,751.5,22,,percent of total billed charges,,,2735.46,91,,percent of total billed charges,,,2855.7,95,,percent of total billed charges,,,2494.98,83,,percent of total billed charges,,,2494.98,83,,percent of total billed charges,,,,,,,,,,,,,,,2494.98,83,,percent of total billed charges,,,2855.7,95,,percent of total billed charges,,,2705.4,90,,percent of total billed charges,,,2705.4,90,,percent of total billed charges,,,2464.92,82,,percent of total billed charges,,,2705.4,90,,percent of total billed charges,,,2555.1,85,,percent of total billed charges,,751.5,2855.7,
* MR BREAST LT W (V306),31100312,CDM,C8903,HCPCS,610,RC,outpatient,,2774,2774,,2355.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,693.5,22,,percent of total billed charges,,,,,,,,,2496.6,90,,percent of total billed charges,,,2296.87,82.8,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,,,,,,,,2441.12,88,,percent of total billed charges,,,,,,,,,2119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,693.5,22,,percent of total billed charges,,,2524.34,91,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2302.42,83,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2274.68,82,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,693.5,2635.3,
* MR BREAST RT W (V306),31100313,CDM,C8903,HCPCS,610,RC,outpatient,,2774,2774,,2355.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,693.5,22,,percent of total billed charges,,,,,,,,,2496.6,90,,percent of total billed charges,,,2296.87,82.8,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,,,,,,,,2441.12,88,,percent of total billed charges,,,,,,,,,2119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,693.5,22,,percent of total billed charges,,,2524.34,91,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,2302.42,83,,percent of total billed charges,,,,,,,,,,,,,,,2302.42,83,,percent of total billed charges,,,2635.3,95,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2274.68,82,,percent of total billed charges,,,2496.6,90,,percent of total billed charges,,,2357.9,85,,percent of total billed charges,,693.5,2635.3,
* MR BREAST LT WO (V306),31100314,CDM,C8904,HCPCS,610,RC,outpatient,,2388,2388,,2027.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,597,22,,percent of total billed charges,,,,,,,,,2149.2,90,,percent of total billed charges,,,1977.26,82.8,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,,,,,,,,2101.44,88,,percent of total billed charges,,,,,,,,,1824.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,597,22,,percent of total billed charges,,,2173.08,91,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1982.04,83,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,1958.16,82,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,597,2268.6,
* MR BREAST RT WO (V306),31100315,CDM,C8904,HCPCS,610,RC,outpatient,,2388,2388,,2027.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,597,22,,percent of total billed charges,,,,,,,,,2149.2,90,,percent of total billed charges,,,1977.26,82.8,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,,,,,,,,2101.44,88,,percent of total billed charges,,,,,,,,,1824.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,597,22,,percent of total billed charges,,,2173.08,91,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,1982.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1982.04,83,,percent of total billed charges,,,2268.6,95,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,1958.16,82,,percent of total billed charges,,,2149.2,90,,percent of total billed charges,,,2029.8,85,,percent of total billed charges,,597,2268.6,
* MR BREAST BIL WO (V306),31100316,CDM,C8907,HCPCS,610,RC,outpatient,,2543,2543,,2159.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,635.75,22,,percent of total billed charges,,,,,,,,,2288.7,90,,percent of total billed charges,,,2105.6,82.8,,percent of total billed charges,,,2161.55,85,,percent of total billed charges,,,,,,,,,2237.84,88,,percent of total billed charges,,,,,,,,,1942.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,635.75,22,,percent of total billed charges,,,2314.13,91,,percent of total billed charges,,,2415.85,95,,percent of total billed charges,,,2110.69,83,,percent of total billed charges,,,2110.69,83,,percent of total billed charges,,,,,,,,,,,,,,,2110.69,83,,percent of total billed charges,,,2415.85,95,,percent of total billed charges,,,2288.7,90,,percent of total billed charges,,,2288.7,90,,percent of total billed charges,,,2085.26,82,,percent of total billed charges,,,2288.7,90,,percent of total billed charges,,,2161.55,85,,percent of total billed charges,,635.75,2415.85,
MR KNEE LT W,31101000,CDM,73722,CPT,610,RC,outpatient,,5471,5471,,4644.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1367.75,22,,percent of total billed charges,,,,,,,,,4923.9,90,,percent of total billed charges,,,4529.99,82.8,,percent of total billed charges,,,4650.35,85,,percent of total billed charges,,,,,,,,,4814.48,88,,percent of total billed charges,,,,,,,,,4179.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1367.75,22,,percent of total billed charges,,,4978.61,91,,percent of total billed charges,,,5197.45,95,,percent of total billed charges,,,4540.93,83,,percent of total billed charges,,,4540.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4540.93,83,,percent of total billed charges,,,5197.45,95,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4486.22,82,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4650.35,85,,percent of total billed charges,,1367.75,5197.45,
MR KNEE LEFT W/WO,31101001,CDM,73723,CPT,610,RC,outpatient,LT,6683,6683,,5673.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1670.75,22,,percent of total billed charges,,,,,,,,,6014.7,90,,percent of total billed charges,,,5533.52,82.8,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,,,,,,,,5881.04,88,,percent of total billed charges,,,,,,,,,5105.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1670.75,22,,percent of total billed charges,,,6081.53,91,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,,,,,,,,,,,,,5546.89,83,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5480.06,82,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,1670.75,6348.85,
MR KNEE LEFT W/O,31101002,CDM,73721,CPT,610,RC,outpatient,LT,5178,5178,,4396.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1294.5,22,,percent of total billed charges,,,,,,,,,4660.2,90,,percent of total billed charges,,,4287.38,82.8,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,,,,,,,,4556.64,88,,percent of total billed charges,,,,,,,,,3955.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1294.5,22,,percent of total billed charges,,,4711.98,91,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,,,,,,,,,,,,,4297.74,83,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4245.96,82,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,1294.5,4919.1,
MR KNEE RT W,31101003,CDM,73722,CPT,610,RC,outpatient,,5471,5471,,4644.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1367.75,22,,percent of total billed charges,,,,,,,,,4923.9,90,,percent of total billed charges,,,4529.99,82.8,,percent of total billed charges,,,4650.35,85,,percent of total billed charges,,,,,,,,,4814.48,88,,percent of total billed charges,,,,,,,,,4179.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1367.75,22,,percent of total billed charges,,,4978.61,91,,percent of total billed charges,,,5197.45,95,,percent of total billed charges,,,4540.93,83,,percent of total billed charges,,,4540.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4540.93,83,,percent of total billed charges,,,5197.45,95,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4486.22,82,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4650.35,85,,percent of total billed charges,,1367.75,5197.45,
MR KNEE RIGHT W/WO,31101004,CDM,73723,CPT,610,RC,outpatient,RT,6683,6683,,5673.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1670.75,22,,percent of total billed charges,,,,,,,,,6014.7,90,,percent of total billed charges,,,5533.52,82.8,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,,,,,,,,5881.04,88,,percent of total billed charges,,,,,,,,,5105.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1670.75,22,,percent of total billed charges,,,6081.53,91,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,,,,,,,,,,,,,5546.89,83,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5480.06,82,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,1670.75,6348.85,
MR KNEE RIGHT W/O,31101005,CDM,73721,CPT,610,RC,outpatient,RT,5178,5178,,4396.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1294.5,22,,percent of total billed charges,,,,,,,,,4660.2,90,,percent of total billed charges,,,4287.38,82.8,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,,,,,,,,4556.64,88,,percent of total billed charges,,,,,,,,,3955.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1294.5,22,,percent of total billed charges,,,4711.98,91,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,,,,,,,,,,,,,4297.74,83,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4245.96,82,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,1294.5,4919.1,
MR HIP LT W,31101006,CDM,73722,CPT,610,RC,outpatient,LT,6459,6459,,5483.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1614.75,22,,percent of total billed charges,,,,,,,,,5813.1,90,,percent of total billed charges,,,5348.05,82.8,,percent of total billed charges,,,5490.15,85,,percent of total billed charges,,,,,,,,,5683.92,88,,percent of total billed charges,,,,,,,,,4934.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1614.75,22,,percent of total billed charges,,,5877.69,91,,percent of total billed charges,,,6136.05,95,,percent of total billed charges,,,5360.97,83,,percent of total billed charges,,,5360.97,83,,percent of total billed charges,,,,,,,,,,,,,,,5360.97,83,,percent of total billed charges,,,6136.05,95,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5296.38,82,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5490.15,85,,percent of total billed charges,,1614.75,6136.05,
MR HIP LEFT W/WO,31101007,CDM,73723,CPT,610,RC,outpatient,LT,6683,6683,,5673.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1670.75,22,,percent of total billed charges,,,,,,,,,6014.7,90,,percent of total billed charges,,,5533.52,82.8,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,,,,,,,,5881.04,88,,percent of total billed charges,,,,,,,,,5105.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1670.75,22,,percent of total billed charges,,,6081.53,91,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,,,,,,,,,,,,,5546.89,83,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5480.06,82,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,1670.75,6348.85,
MR HIP LEFT W/O,31101008,CDM,73721,CPT,610,RC,outpatient,LT,5178,5178,,4396.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1294.5,22,,percent of total billed charges,,,,,,,,,4660.2,90,,percent of total billed charges,,,4287.38,82.8,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,,,,,,,,4556.64,88,,percent of total billed charges,,,,,,,,,3955.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1294.5,22,,percent of total billed charges,,,4711.98,91,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,,,,,,,,,,,,,4297.74,83,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4245.96,82,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,1294.5,4919.1,
MR HIP RT W,31101009,CDM,73722,CPT,610,RC,outpatient,TC,6459,6459,,5483.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1614.75,22,,percent of total billed charges,,,,,,,,,5813.1,90,,percent of total billed charges,,,5348.05,82.8,,percent of total billed charges,,,5490.15,85,,percent of total billed charges,,,,,,,,,5683.92,88,,percent of total billed charges,,,,,,,,,4934.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1614.75,22,,percent of total billed charges,,,5877.69,91,,percent of total billed charges,,,6136.05,95,,percent of total billed charges,,,5360.97,83,,percent of total billed charges,,,5360.97,83,,percent of total billed charges,,,,,,,,,,,,,,,5360.97,83,,percent of total billed charges,,,6136.05,95,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5296.38,82,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5490.15,85,,percent of total billed charges,,1614.75,6136.05,
MR HIP RIGHT W/WO,31101010,CDM,73723,CPT,610,RC,outpatient,RT,6683,6683,,5673.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1670.75,22,,percent of total billed charges,,,,,,,,,6014.7,90,,percent of total billed charges,,,5533.52,82.8,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,,,,,,,,5881.04,88,,percent of total billed charges,,,,,,,,,5105.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1670.75,22,,percent of total billed charges,,,6081.53,91,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,,,,,,,,,,,,,5546.89,83,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5480.06,82,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,1670.75,6348.85,
MR HIP RIGHT W/O,31101011,CDM,73721,CPT,610,RC,outpatient,RT,5178,5178,,4396.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1294.5,22,,percent of total billed charges,,,,,,,,,4660.2,90,,percent of total billed charges,,,4287.38,82.8,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,,,,,,,,4556.64,88,,percent of total billed charges,,,,,,,,,3955.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1294.5,22,,percent of total billed charges,,,4711.98,91,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,,,,,,,,,,,,,4297.74,83,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4245.96,82,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,1294.5,4919.1,
MR ANKLE LT W,31101012,CDM,73722,CPT,610,RC,outpatient,,5471,5471,,4644.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1367.75,22,,percent of total billed charges,,,,,,,,,4923.9,90,,percent of total billed charges,,,4529.99,82.8,,percent of total billed charges,,,4650.35,85,,percent of total billed charges,,,,,,,,,4814.48,88,,percent of total billed charges,,,,,,,,,4179.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1367.75,22,,percent of total billed charges,,,4978.61,91,,percent of total billed charges,,,5197.45,95,,percent of total billed charges,,,4540.93,83,,percent of total billed charges,,,4540.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4540.93,83,,percent of total billed charges,,,5197.45,95,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4486.22,82,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4650.35,85,,percent of total billed charges,,1367.75,5197.45,
MR ANKLE LEFT W/WO,31101013,CDM,73723,CPT,610,RC,outpatient,LT,6683,6683,,5673.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1670.75,22,,percent of total billed charges,,,,,,,,,6014.7,90,,percent of total billed charges,,,5533.52,82.8,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,,,,,,,,5881.04,88,,percent of total billed charges,,,,,,,,,5105.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1670.75,22,,percent of total billed charges,,,6081.53,91,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,,,,,,,,,,,,,5546.89,83,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5480.06,82,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,1670.75,6348.85,
MR ANKLE LEFT W/O,31101014,CDM,73721,CPT,610,RC,outpatient,LT,5178,5178,,4396.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1294.5,22,,percent of total billed charges,,,,,,,,,4660.2,90,,percent of total billed charges,,,4287.38,82.8,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,,,,,,,,4556.64,88,,percent of total billed charges,,,,,,,,,3955.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1294.5,22,,percent of total billed charges,,,4711.98,91,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,,,,,,,,,,,,,4297.74,83,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4245.96,82,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,1294.5,4919.1,
MR ANKLE RT W,31101015,CDM,73722,CPT,610,RC,outpatient,,5471,5471,,4644.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1367.75,22,,percent of total billed charges,,,,,,,,,4923.9,90,,percent of total billed charges,,,4529.99,82.8,,percent of total billed charges,,,4650.35,85,,percent of total billed charges,,,,,,,,,4814.48,88,,percent of total billed charges,,,,,,,,,4179.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1367.75,22,,percent of total billed charges,,,4978.61,91,,percent of total billed charges,,,5197.45,95,,percent of total billed charges,,,4540.93,83,,percent of total billed charges,,,4540.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4540.93,83,,percent of total billed charges,,,5197.45,95,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4486.22,82,,percent of total billed charges,,,4923.9,90,,percent of total billed charges,,,4650.35,85,,percent of total billed charges,,1367.75,5197.45,
MR ANKLE RIGHT W/WO,31101016,CDM,73723,CPT,610,RC,outpatient,RT,6683,6683,,5673.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1670.75,22,,percent of total billed charges,,,,,,,,,6014.7,90,,percent of total billed charges,,,5533.52,82.8,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,,,,,,,,5881.04,88,,percent of total billed charges,,,,,,,,,5105.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1670.75,22,,percent of total billed charges,,,6081.53,91,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,5546.89,83,,percent of total billed charges,,,,,,,,,,,,,,,5546.89,83,,percent of total billed charges,,,6348.85,95,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5480.06,82,,percent of total billed charges,,,6014.7,90,,percent of total billed charges,,,5680.55,85,,percent of total billed charges,,1670.75,6348.85,
MR ANKLE RIGHT W/O,31101017,CDM,73721,CPT,610,RC,outpatient,RT,5178,5178,,4396.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1294.5,22,,percent of total billed charges,,,,,,,,,4660.2,90,,percent of total billed charges,,,4287.38,82.8,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,,,,,,,,4556.64,88,,percent of total billed charges,,,,,,,,,3955.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1294.5,22,,percent of total billed charges,,,4711.98,91,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,4297.74,83,,percent of total billed charges,,,,,,,,,,,,,,,4297.74,83,,percent of total billed charges,,,4919.1,95,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4245.96,82,,percent of total billed charges,,,4660.2,90,,percent of total billed charges,,,4401.3,85,,percent of total billed charges,,1294.5,4919.1,
MR FEMUR LEFT W/,31101018,CDM,73719,CPT,610,RC,outpatient,LT,5797,5797,,4921.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1449.25,22,,percent of total billed charges,,,,,,,,,5217.3,90,,percent of total billed charges,,,4799.92,82.8,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,,,,,,,,5101.36,88,,percent of total billed charges,,,,,,,,,4428.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1449.25,22,,percent of total billed charges,,,5275.27,91,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4811.51,83,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4753.54,82,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,1449.25,5507.15,
MR FEMUR LEFT W/WO,31101019,CDM,73720,CPT,610,RC,outpatient,LT,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1925.5,22,,percent of total billed charges,,,,,,,,,6931.8,90,,percent of total billed charges,,,6377.26,82.8,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1925.5,22,,percent of total billed charges,,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,1925.5,7316.9,
MR FEMUR LEFT W/O,31101020,CDM,73718,CPT,610,RC,outpatient,LT,5066,5066,,4301.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1266.5,22,,percent of total billed charges,,,,,,,,,4559.4,90,,percent of total billed charges,,,4194.65,82.8,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,,,,,,,,4458.08,88,,percent of total billed charges,,,,,,,,,3870.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1266.5,22,,percent of total billed charges,,,4610.06,91,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,,,,,,,,,,,,,4204.78,83,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4154.12,82,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,1266.5,4812.7,
MR FEMUR RIGHT W/,31101021,CDM,73719,CPT,610,RC,outpatient,RT,5797,5797,,4921.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1449.25,22,,percent of total billed charges,,,,,,,,,5217.3,90,,percent of total billed charges,,,4799.92,82.8,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,,,,,,,,5101.36,88,,percent of total billed charges,,,,,,,,,4428.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1449.25,22,,percent of total billed charges,,,5275.27,91,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4811.51,83,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4753.54,82,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,1449.25,5507.15,
MR FEMUR RIGHT W/WO,31101022,CDM,73720,CPT,610,RC,outpatient,RT,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1925.5,22,,percent of total billed charges,,,,,,,,,6931.8,90,,percent of total billed charges,,,6377.26,82.8,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1925.5,22,,percent of total billed charges,,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,1925.5,7316.9,
MR FEMUR RIGHT W/O,31101023,CDM,73718,CPT,610,RC,outpatient,RT,5066,5066,,4301.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1266.5,22,,percent of total billed charges,,,,,,,,,4559.4,90,,percent of total billed charges,,,4194.65,82.8,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,,,,,,,,4458.08,88,,percent of total billed charges,,,,,,,,,3870.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1266.5,22,,percent of total billed charges,,,4610.06,91,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,,,,,,,,,,,,,4204.78,83,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4154.12,82,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,1266.5,4812.7,
MR LOW LEG LEFT W/,31101024,CDM,73719,CPT,610,RC,outpatient,LT,5797,5797,,4921.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1449.25,22,,percent of total billed charges,,,,,,,,,5217.3,90,,percent of total billed charges,,,4799.92,82.8,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,,,,,,,,5101.36,88,,percent of total billed charges,,,,,,,,,4428.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1449.25,22,,percent of total billed charges,,,5275.27,91,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4811.51,83,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4753.54,82,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,1449.25,5507.15,
MR LOW LEG LEFT W/WO,31101025,CDM,73720,CPT,610,RC,outpatient,LT,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1925.5,22,,percent of total billed charges,,,,,,,,,6931.8,90,,percent of total billed charges,,,6377.26,82.8,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1925.5,22,,percent of total billed charges,,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,1925.5,7316.9,
MR LOW LEG LEFT W/O,31101026,CDM,73718,CPT,610,RC,outpatient,LT,5066,5066,,4301.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1266.5,22,,percent of total billed charges,,,,,,,,,4559.4,90,,percent of total billed charges,,,4194.65,82.8,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,,,,,,,,4458.08,88,,percent of total billed charges,,,,,,,,,3870.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1266.5,22,,percent of total billed charges,,,4610.06,91,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,,,,,,,,,,,,,4204.78,83,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4154.12,82,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,1266.5,4812.7,
MR LOW LEG RIGHT W/,31101027,CDM,73719,CPT,610,RC,outpatient,RT,5797,5797,,4921.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1449.25,22,,percent of total billed charges,,,,,,,,,5217.3,90,,percent of total billed charges,,,4799.92,82.8,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,,,,,,,,5101.36,88,,percent of total billed charges,,,,,,,,,4428.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1449.25,22,,percent of total billed charges,,,5275.27,91,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4811.51,83,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4753.54,82,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,1449.25,5507.15,
MR LOW LEG RIGHT W/WO,31101028,CDM,73720,CPT,610,RC,outpatient,RT,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1925.5,22,,percent of total billed charges,,,,,,,,,6931.8,90,,percent of total billed charges,,,6377.26,82.8,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1925.5,22,,percent of total billed charges,,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,1925.5,7316.9,
MR LOW LEG RIGHT W/O,31101029,CDM,73718,CPT,610,RC,outpatient,RT,5066,5066,,4301.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1266.5,22,,percent of total billed charges,,,,,,,,,4559.4,90,,percent of total billed charges,,,4194.65,82.8,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,,,,,,,,4458.08,88,,percent of total billed charges,,,,,,,,,3870.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1266.5,22,,percent of total billed charges,,,4610.06,91,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,,,,,,,,,,,,,4204.78,83,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4154.12,82,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,1266.5,4812.7,
MR SHOULDER LEFT W/ (V 05-17),31101030,CDM,73222,CPT,610,RC,outpatient,LT,4675,4675,,3969.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1168.75,22,,percent of total billed charges,,,,,,,,,4207.5,90,,percent of total billed charges,,,3870.9,82.8,,percent of total billed charges,,,3973.75,85,,percent of total billed charges,,,,,,,,,4114,88,,percent of total billed charges,,,,,,,,,3571.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1168.75,22,,percent of total billed charges,,,4254.25,91,,percent of total billed charges,,,4441.25,95,,percent of total billed charges,,,3880.25,83,,percent of total billed charges,,,3880.25,83,,percent of total billed charges,,,,,,,,,,,,,,,3880.25,83,,percent of total billed charges,,,4441.25,95,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,3833.5,82,,percent of total billed charges,,,4207.5,90,,percent of total billed charges,,,3973.75,85,,percent of total billed charges,,1168.75,4441.25,
MR SHOULDER LEFT W/WO,31101031,CDM,73223,CPT,610,RC,outpatient,LT,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1925.5,22,,percent of total billed charges,,,,,,,,,6931.8,90,,percent of total billed charges,,,6377.26,82.8,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1925.5,22,,percent of total billed charges,,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,1925.5,7316.9,
MR SHOULDER LEFT W/O,31101032,CDM,73221,CPT,610,RC,outpatient,LT,5084,5084,,4316.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1271,22,,percent of total billed charges,,,,,,,,,4575.6,90,,percent of total billed charges,,,4209.55,82.8,,percent of total billed charges,,,4321.4,85,,percent of total billed charges,,,,,,,,,4473.92,88,,percent of total billed charges,,,,,,,,,3884.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1271,22,,percent of total billed charges,,,4626.44,91,,percent of total billed charges,,,4829.8,95,,percent of total billed charges,,,4219.72,83,,percent of total billed charges,,,4219.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4219.72,83,,percent of total billed charges,,,4829.8,95,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4168.88,82,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4321.4,85,,percent of total billed charges,,1271,4829.8,
MR SHOULDER RIGHT W/,31101033,CDM,73222,CPT,610,RC,outpatient,RT,6459,6459,,5483.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1614.75,22,,percent of total billed charges,,,,,,,,,5813.1,90,,percent of total billed charges,,,5348.05,82.8,,percent of total billed charges,,,5490.15,85,,percent of total billed charges,,,,,,,,,5683.92,88,,percent of total billed charges,,,,,,,,,4934.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1614.75,22,,percent of total billed charges,,,5877.69,91,,percent of total billed charges,,,6136.05,95,,percent of total billed charges,,,5360.97,83,,percent of total billed charges,,,5360.97,83,,percent of total billed charges,,,,,,,,,,,,,,,5360.97,83,,percent of total billed charges,,,6136.05,95,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5296.38,82,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5490.15,85,,percent of total billed charges,,1614.75,6136.05,
MR SHOULDER RIGHT W/WO,31101034,CDM,73223,CPT,610,RC,outpatient,RT,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1925.5,22,,percent of total billed charges,,,,,,,,,6931.8,90,,percent of total billed charges,,,6377.26,82.8,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1925.5,22,,percent of total billed charges,,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,1925.5,7316.9,
MR SHOULDER RIGHT W/O,31101035,CDM,73221,CPT,610,RC,outpatient,RT,5084,5084,,4316.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1271,22,,percent of total billed charges,,,,,,,,,4575.6,90,,percent of total billed charges,,,4209.55,82.8,,percent of total billed charges,,,4321.4,85,,percent of total billed charges,,,,,,,,,4473.92,88,,percent of total billed charges,,,,,,,,,3884.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1271,22,,percent of total billed charges,,,4626.44,91,,percent of total billed charges,,,4829.8,95,,percent of total billed charges,,,4219.72,83,,percent of total billed charges,,,4219.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4219.72,83,,percent of total billed charges,,,4829.8,95,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4168.88,82,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4321.4,85,,percent of total billed charges,,1271,4829.8,
MR ELBOW LEFT W/,31101036,CDM,73222,CPT,610,RC,outpatient,LT,5523,5523,,4689.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1380.75,22,,percent of total billed charges,,,,,,,,,4970.7,90,,percent of total billed charges,,,4573.04,82.8,,percent of total billed charges,,,4694.55,85,,percent of total billed charges,,,,,,,,,4860.24,88,,percent of total billed charges,,,,,,,,,4219.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1380.75,22,,percent of total billed charges,,,5025.93,91,,percent of total billed charges,,,5246.85,95,,percent of total billed charges,,,4584.09,83,,percent of total billed charges,,,4584.09,83,,percent of total billed charges,,,,,,,,,,,,,,,4584.09,83,,percent of total billed charges,,,5246.85,95,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4528.86,82,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4694.55,85,,percent of total billed charges,,1380.75,5246.85,
MR ELBOW LEFT W/WO,31101037,CDM,73223,CPT,610,RC,outpatient,LT,6613,6613,,5614.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1653.25,22,,percent of total billed charges,,,,,,,,,5951.7,90,,percent of total billed charges,,,5475.56,82.8,,percent of total billed charges,,,5621.05,85,,percent of total billed charges,,,,,,,,,5819.44,88,,percent of total billed charges,,,,,,,,,5052.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1653.25,22,,percent of total billed charges,,,6017.83,91,,percent of total billed charges,,,6282.35,95,,percent of total billed charges,,,5488.79,83,,percent of total billed charges,,,5488.79,83,,percent of total billed charges,,,,,,,,,,,,,,,5488.79,83,,percent of total billed charges,,,6282.35,95,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5422.66,82,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5621.05,85,,percent of total billed charges,,1653.25,6282.35,
MR ELBOW LEFT W/O,31101038,CDM,73221,CPT,610,RC,outpatient,LT,5083,5083,,4315.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1270.75,22,,percent of total billed charges,,,,,,,,,4574.7,90,,percent of total billed charges,,,4208.72,82.8,,percent of total billed charges,,,4320.55,85,,percent of total billed charges,,,,,,,,,4473.04,88,,percent of total billed charges,,,,,,,,,3883.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1270.75,22,,percent of total billed charges,,,4625.53,91,,percent of total billed charges,,,4828.85,95,,percent of total billed charges,,,4218.89,83,,percent of total billed charges,,,4218.89,83,,percent of total billed charges,,,,,,,,,,,,,,,4218.89,83,,percent of total billed charges,,,4828.85,95,,percent of total billed charges,,,4574.7,90,,percent of total billed charges,,,4574.7,90,,percent of total billed charges,,,4168.06,82,,percent of total billed charges,,,4574.7,90,,percent of total billed charges,,,4320.55,85,,percent of total billed charges,,1270.75,4828.85,
MR ELBOW RIGHT W/,31101039,CDM,73222,CPT,610,RC,outpatient,RT,5523,5523,,4689.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1380.75,22,,percent of total billed charges,,,,,,,,,4970.7,90,,percent of total billed charges,,,4573.04,82.8,,percent of total billed charges,,,4694.55,85,,percent of total billed charges,,,,,,,,,4860.24,88,,percent of total billed charges,,,,,,,,,4219.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1380.75,22,,percent of total billed charges,,,5025.93,91,,percent of total billed charges,,,5246.85,95,,percent of total billed charges,,,4584.09,83,,percent of total billed charges,,,4584.09,83,,percent of total billed charges,,,,,,,,,,,,,,,4584.09,83,,percent of total billed charges,,,5246.85,95,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4528.86,82,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4694.55,85,,percent of total billed charges,,1380.75,5246.85,
MR ELBOW RIGHT W/O,31101040,CDM,73221,CPT,610,RC,outpatient,RT,5083,5083,,4315.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1270.75,22,,percent of total billed charges,,,,,,,,,4574.7,90,,percent of total billed charges,,,4208.72,82.8,,percent of total billed charges,,,4320.55,85,,percent of total billed charges,,,,,,,,,4473.04,88,,percent of total billed charges,,,,,,,,,3883.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1270.75,22,,percent of total billed charges,,,4625.53,91,,percent of total billed charges,,,4828.85,95,,percent of total billed charges,,,4218.89,83,,percent of total billed charges,,,4218.89,83,,percent of total billed charges,,,,,,,,,,,,,,,4218.89,83,,percent of total billed charges,,,4828.85,95,,percent of total billed charges,,,4574.7,90,,percent of total billed charges,,,4574.7,90,,percent of total billed charges,,,4168.06,82,,percent of total billed charges,,,4574.7,90,,percent of total billed charges,,,4320.55,85,,percent of total billed charges,,1270.75,4828.85,
MR ELBOW RIGHT W/WO,31101041,CDM,73223,CPT,610,RC,outpatient,RT,6613,6613,,5614.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1653.25,22,,percent of total billed charges,,,,,,,,,5951.7,90,,percent of total billed charges,,,5475.56,82.8,,percent of total billed charges,,,5621.05,85,,percent of total billed charges,,,,,,,,,5819.44,88,,percent of total billed charges,,,,,,,,,5052.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1653.25,22,,percent of total billed charges,,,6017.83,91,,percent of total billed charges,,,6282.35,95,,percent of total billed charges,,,5488.79,83,,percent of total billed charges,,,5488.79,83,,percent of total billed charges,,,,,,,,,,,,,,,5488.79,83,,percent of total billed charges,,,6282.35,95,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5422.66,82,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5621.05,85,,percent of total billed charges,,1653.25,6282.35,
MR WRIST LEFT W/,31101042,CDM,73222,CPT,610,RC,outpatient,LT,5523,5523,,4689.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1380.75,22,,percent of total billed charges,,,,,,,,,4970.7,90,,percent of total billed charges,,,4573.04,82.8,,percent of total billed charges,,,4694.55,85,,percent of total billed charges,,,,,,,,,4860.24,88,,percent of total billed charges,,,,,,,,,4219.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1380.75,22,,percent of total billed charges,,,5025.93,91,,percent of total billed charges,,,5246.85,95,,percent of total billed charges,,,4584.09,83,,percent of total billed charges,,,4584.09,83,,percent of total billed charges,,,,,,,,,,,,,,,4584.09,83,,percent of total billed charges,,,5246.85,95,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4528.86,82,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4694.55,85,,percent of total billed charges,,1380.75,5246.85,
MR WRIST LEFT W/WO,31101043,CDM,73223,CPT,610,RC,outpatient,LT,6613,6613,,5614.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1653.25,22,,percent of total billed charges,,,,,,,,,5951.7,90,,percent of total billed charges,,,5475.56,82.8,,percent of total billed charges,,,5621.05,85,,percent of total billed charges,,,,,,,,,5819.44,88,,percent of total billed charges,,,,,,,,,5052.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1653.25,22,,percent of total billed charges,,,6017.83,91,,percent of total billed charges,,,6282.35,95,,percent of total billed charges,,,5488.79,83,,percent of total billed charges,,,5488.79,83,,percent of total billed charges,,,,,,,,,,,,,,,5488.79,83,,percent of total billed charges,,,6282.35,95,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5422.66,82,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5621.05,85,,percent of total billed charges,,1653.25,6282.35,
MR WRIST LEFT W/O,31101044,CDM,73221,CPT,610,RC,outpatient,LT,5084,5084,,4316.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1271,22,,percent of total billed charges,,,,,,,,,4575.6,90,,percent of total billed charges,,,4209.55,82.8,,percent of total billed charges,,,4321.4,85,,percent of total billed charges,,,,,,,,,4473.92,88,,percent of total billed charges,,,,,,,,,3884.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1271,22,,percent of total billed charges,,,4626.44,91,,percent of total billed charges,,,4829.8,95,,percent of total billed charges,,,4219.72,83,,percent of total billed charges,,,4219.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4219.72,83,,percent of total billed charges,,,4829.8,95,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4168.88,82,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4321.4,85,,percent of total billed charges,,1271,4829.8,
MR WRIST RIGHT W/,31101045,CDM,73222,CPT,610,RC,outpatient,RT,5523,5523,,4689.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1380.75,22,,percent of total billed charges,,,,,,,,,4970.7,90,,percent of total billed charges,,,4573.04,82.8,,percent of total billed charges,,,4694.55,85,,percent of total billed charges,,,,,,,,,4860.24,88,,percent of total billed charges,,,,,,,,,4219.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1380.75,22,,percent of total billed charges,,,5025.93,91,,percent of total billed charges,,,5246.85,95,,percent of total billed charges,,,4584.09,83,,percent of total billed charges,,,4584.09,83,,percent of total billed charges,,,,,,,,,,,,,,,4584.09,83,,percent of total billed charges,,,5246.85,95,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4528.86,82,,percent of total billed charges,,,4970.7,90,,percent of total billed charges,,,4694.55,85,,percent of total billed charges,,1380.75,5246.85,
MR WRIST RIGHT W/WO,31101046,CDM,73223,CPT,610,RC,outpatient,RT,6613,6613,,5614.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1653.25,22,,percent of total billed charges,,,,,,,,,5951.7,90,,percent of total billed charges,,,5475.56,82.8,,percent of total billed charges,,,5621.05,85,,percent of total billed charges,,,,,,,,,5819.44,88,,percent of total billed charges,,,,,,,,,5052.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1653.25,22,,percent of total billed charges,,,6017.83,91,,percent of total billed charges,,,6282.35,95,,percent of total billed charges,,,5488.79,83,,percent of total billed charges,,,5488.79,83,,percent of total billed charges,,,,,,,,,,,,,,,5488.79,83,,percent of total billed charges,,,6282.35,95,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5422.66,82,,percent of total billed charges,,,5951.7,90,,percent of total billed charges,,,5621.05,85,,percent of total billed charges,,1653.25,6282.35,
MR WRIST RIGHT W/O,31101047,CDM,73221,CPT,610,RC,outpatient,RT,5084,5084,,4316.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1271,22,,percent of total billed charges,,,,,,,,,4575.6,90,,percent of total billed charges,,,4209.55,82.8,,percent of total billed charges,,,4321.4,85,,percent of total billed charges,,,,,,,,,4473.92,88,,percent of total billed charges,,,,,,,,,3884.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1271,22,,percent of total billed charges,,,4626.44,91,,percent of total billed charges,,,4829.8,95,,percent of total billed charges,,,4219.72,83,,percent of total billed charges,,,4219.72,83,,percent of total billed charges,,,,,,,,,,,,,,,4219.72,83,,percent of total billed charges,,,4829.8,95,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4168.88,82,,percent of total billed charges,,,4575.6,90,,percent of total billed charges,,,4321.4,85,,percent of total billed charges,,1271,4829.8,
MR HUMERUS LT W,31101048,CDM,73219,CPT,610,RC,outpatient,,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1467.75,22,,percent of total billed charges,,,,,,,,,5283.9,90,,percent of total billed charges,,,4861.19,82.8,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1467.75,22,,percent of total billed charges,,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,1467.75,5577.45,
MR HUMERUS LEFT W/WO,31101049,CDM,73220,CPT,610,RC,outpatient,LT,6502,6502,,5520.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625.5,22,,percent of total billed charges,,,,,,,,,5851.8,90,,percent of total billed charges,,,5383.66,82.8,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,,,,,,,,5721.76,88,,percent of total billed charges,,,,,,,,,4967.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625.5,22,,percent of total billed charges,,,5916.82,91,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,,,,,,,,,,,,,5396.66,83,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5331.64,82,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,1625.5,6176.9,
MR HUMERUS LEFT W/O,31101050,CDM,73218,CPT,610,RC,outpatient,LT,4962,4962,,4212.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1240.5,22,,percent of total billed charges,,,,,,,,,4465.8,90,,percent of total billed charges,,,4108.54,82.8,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,,,,,,,,4366.56,88,,percent of total billed charges,,,,,,,,,3790.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1240.5,22,,percent of total billed charges,,,4515.42,91,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,,,,,,,,,,,,,4118.46,83,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4068.84,82,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,1240.5,4713.9,
MR HUMERUS RT W,31101051,CDM,73219,CPT,610,RC,outpatient,,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1467.75,22,,percent of total billed charges,,,,,,,,,5283.9,90,,percent of total billed charges,,,4861.19,82.8,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1467.75,22,,percent of total billed charges,,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,1467.75,5577.45,
MR HUMERUS RIGHT W/WO,31101052,CDM,73220,CPT,610,RC,outpatient,RT,6502,6502,,5520.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625.5,22,,percent of total billed charges,,,,,,,,,5851.8,90,,percent of total billed charges,,,5383.66,82.8,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,,,,,,,,5721.76,88,,percent of total billed charges,,,,,,,,,4967.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625.5,22,,percent of total billed charges,,,5916.82,91,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,,,,,,,,,,,,,5396.66,83,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5331.64,82,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,1625.5,6176.9,
MR HUMERUS RIGHT W/O,31101053,CDM,73218,CPT,610,RC,outpatient,RT,4962,4962,,4212.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1240.5,22,,percent of total billed charges,,,,,,,,,4465.8,90,,percent of total billed charges,,,4108.54,82.8,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,,,,,,,,4366.56,88,,percent of total billed charges,,,,,,,,,3790.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1240.5,22,,percent of total billed charges,,,4515.42,91,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,,,,,,,,,,,,,4118.46,83,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4068.84,82,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,1240.5,4713.9,
MR FOREARM LT W,31101054,CDM,73219,CPT,610,RC,outpatient,,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1467.75,22,,percent of total billed charges,,,,,,,,,5283.9,90,,percent of total billed charges,,,4861.19,82.8,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1467.75,22,,percent of total billed charges,,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,1467.75,5577.45,
MR FOREARM LEFT W/WO,31101055,CDM,73220,CPT,610,RC,outpatient,LT,6502,6502,,5520.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625.5,22,,percent of total billed charges,,,,,,,,,5851.8,90,,percent of total billed charges,,,5383.66,82.8,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,,,,,,,,5721.76,88,,percent of total billed charges,,,,,,,,,4967.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625.5,22,,percent of total billed charges,,,5916.82,91,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,,,,,,,,,,,,,5396.66,83,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5331.64,82,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,1625.5,6176.9,
MR FOREARM LEFT W/O,31101056,CDM,73218,CPT,610,RC,outpatient,LT,4962,4962,,4212.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1240.5,22,,percent of total billed charges,,,,,,,,,4465.8,90,,percent of total billed charges,,,4108.54,82.8,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,,,,,,,,4366.56,88,,percent of total billed charges,,,,,,,,,3790.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1240.5,22,,percent of total billed charges,,,4515.42,91,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,,,,,,,,,,,,,4118.46,83,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4068.84,82,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,1240.5,4713.9,
MR FOREARM RT W,31101057,CDM,73219,CPT,610,RC,outpatient,,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1467.75,22,,percent of total billed charges,,,,,,,,,5283.9,90,,percent of total billed charges,,,4861.19,82.8,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1467.75,22,,percent of total billed charges,,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,1467.75,5577.45,
MR FOREARM RIGHT W/WO,31101058,CDM,73220,CPT,610,RC,outpatient,RT,6502,6502,,5520.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625.5,22,,percent of total billed charges,,,,,,,,,5851.8,90,,percent of total billed charges,,,5383.66,82.8,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,,,,,,,,5721.76,88,,percent of total billed charges,,,,,,,,,4967.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625.5,22,,percent of total billed charges,,,5916.82,91,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,,,,,,,,,,,,,5396.66,83,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5331.64,82,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,1625.5,6176.9,
MR FOREARM RIGHT W/O,31101059,CDM,73218,CPT,610,RC,outpatient,RT,4962,4962,,4212.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1240.5,22,,percent of total billed charges,,,,,,,,,4465.8,90,,percent of total billed charges,,,4108.54,82.8,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,,,,,,,,4366.56,88,,percent of total billed charges,,,,,,,,,3790.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1240.5,22,,percent of total billed charges,,,4515.42,91,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,,,,,,,,,,,,,4118.46,83,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4068.84,82,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,1240.5,4713.9,
MR FOOT LEFT W/O,31101060,CDM,73718,CPT,610,RC,outpatient,LT,5066,5066,,4301.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1266.5,22,,percent of total billed charges,,,,,,,,,4559.4,90,,percent of total billed charges,,,4194.65,82.8,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,,,,,,,,4458.08,88,,percent of total billed charges,,,,,,,,,3870.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1266.5,22,,percent of total billed charges,,,4610.06,91,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,,,,,,,,,,,,,4204.78,83,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4154.12,82,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,1266.5,4812.7,
MR FOOT RIGHT W/O,31101061,CDM,73718,CPT,610,RC,outpatient,RT,5066,5066,,4301.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1266.5,22,,percent of total billed charges,,,,,,,,,4559.4,90,,percent of total billed charges,,,4194.65,82.8,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,,,,,,,,4458.08,88,,percent of total billed charges,,,,,,,,,3870.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1266.5,22,,percent of total billed charges,,,4610.06,91,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,4204.78,83,,percent of total billed charges,,,,,,,,,,,,,,,4204.78,83,,percent of total billed charges,,,4812.7,95,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4154.12,82,,percent of total billed charges,,,4559.4,90,,percent of total billed charges,,,4306.1,85,,percent of total billed charges,,1266.5,4812.7,
MR FOOT LEFT W/WO,31101062,CDM,73720,CPT,610,RC,outpatient,LT,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1925.5,22,,percent of total billed charges,,,,,,,,,6931.8,90,,percent of total billed charges,,,6377.26,82.8,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1925.5,22,,percent of total billed charges,,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,1925.5,7316.9,
MR FOOT LEFT W/,31101063,CDM,73719,CPT,610,RC,outpatient,LT,5797,5797,,4921.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1449.25,22,,percent of total billed charges,,,,,,,,,5217.3,90,,percent of total billed charges,,,4799.92,82.8,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,,,,,,,,5101.36,88,,percent of total billed charges,,,,,,,,,4428.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1449.25,22,,percent of total billed charges,,,5275.27,91,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4811.51,83,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4753.54,82,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,1449.25,5507.15,
MR FOOT RIGHT W/,31101064,CDM,73719,CPT,610,RC,outpatient,RT,5797,5797,,4921.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1449.25,22,,percent of total billed charges,,,,,,,,,5217.3,90,,percent of total billed charges,,,4799.92,82.8,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,,,,,,,,5101.36,88,,percent of total billed charges,,,,,,,,,4428.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1449.25,22,,percent of total billed charges,,,5275.27,91,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,4811.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4811.51,83,,percent of total billed charges,,,5507.15,95,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4753.54,82,,percent of total billed charges,,,5217.3,90,,percent of total billed charges,,,4927.45,85,,percent of total billed charges,,1449.25,5507.15,
MR FOOT RIGHT W/WO,31101065,CDM,73720,CPT,610,RC,outpatient,RT,7702,7702,,6539,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1925.5,22,,percent of total billed charges,,,,,,,,,6931.8,90,,percent of total billed charges,,,6377.26,82.8,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,,,,,,,,6777.76,88,,percent of total billed charges,,,,,,,,,5884.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1925.5,22,,percent of total billed charges,,,7008.82,91,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,6392.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6392.66,83,,percent of total billed charges,,,7316.9,95,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6315.64,82,,percent of total billed charges,,,6931.8,90,,percent of total billed charges,,,6546.7,85,,percent of total billed charges,,1925.5,7316.9,
MR HAND LEFT W/,31101066,CDM,73219,CPT,610,RC,outpatient,LT,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1467.75,22,,percent of total billed charges,,,,,,,,,5283.9,90,,percent of total billed charges,,,4861.19,82.8,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1467.75,22,,percent of total billed charges,,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,1467.75,5577.45,
MR HAND LEFT W/WO,31101067,CDM,73220,CPT,610,RC,outpatient,LT,6502,6502,,5520.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625.5,22,,percent of total billed charges,,,,,,,,,5851.8,90,,percent of total billed charges,,,5383.66,82.8,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,,,,,,,,5721.76,88,,percent of total billed charges,,,,,,,,,4967.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625.5,22,,percent of total billed charges,,,5916.82,91,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,,,,,,,,,,,,,5396.66,83,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5331.64,82,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,1625.5,6176.9,
MR HAND LEFT W/O,31101068,CDM,73218,CPT,610,RC,outpatient,LT,4962,4962,,4212.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1240.5,22,,percent of total billed charges,,,,,,,,,4465.8,90,,percent of total billed charges,,,4108.54,82.8,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,,,,,,,,4366.56,88,,percent of total billed charges,,,,,,,,,3790.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1240.5,22,,percent of total billed charges,,,4515.42,91,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,,,,,,,,,,,,,4118.46,83,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4068.84,82,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,1240.5,4713.9,
MR HAND RIGHT W/,31101069,CDM,73219,CPT,610,RC,outpatient,RT,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1467.75,22,,percent of total billed charges,,,,,,,,,5283.9,90,,percent of total billed charges,,,4861.19,82.8,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1467.75,22,,percent of total billed charges,,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,1467.75,5577.45,
MR HAND RIGHT W/WO,31101070,CDM,73220,CPT,610,RC,outpatient,RT,6502,6502,,5520.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1625.5,22,,percent of total billed charges,,,,,,,,,5851.8,90,,percent of total billed charges,,,5383.66,82.8,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,,,,,,,,5721.76,88,,percent of total billed charges,,,,,,,,,4967.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1625.5,22,,percent of total billed charges,,,5916.82,91,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,5396.66,83,,percent of total billed charges,,,,,,,,,,,,,,,5396.66,83,,percent of total billed charges,,,6176.9,95,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5331.64,82,,percent of total billed charges,,,5851.8,90,,percent of total billed charges,,,5526.7,85,,percent of total billed charges,,1625.5,6176.9,
MR HAND RIGHT W/O,31101071,CDM,73218,CPT,610,RC,outpatient,RT,4962,4962,,4212.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1240.5,22,,percent of total billed charges,,,,,,,,,4465.8,90,,percent of total billed charges,,,4108.54,82.8,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,,,,,,,,4366.56,88,,percent of total billed charges,,,,,,,,,3790.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1240.5,22,,percent of total billed charges,,,4515.42,91,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,4118.46,83,,percent of total billed charges,,,,,,,,,,,,,,,4118.46,83,,percent of total billed charges,,,4713.9,95,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4068.84,82,,percent of total billed charges,,,4465.8,90,,percent of total billed charges,,,4217.7,85,,percent of total billed charges,,1240.5,4713.9,
MR KNEE BILATERAL W/O,31101088,CDM,73721,CPT,610,RC,outpatient,50,9834,9834,,8349.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2458.5,22,,percent of total billed charges,,,,,,,,,8850.6,90,,percent of total billed charges,,,8142.55,82.8,,percent of total billed charges,,,8358.9,85,,percent of total billed charges,,,,,,,,,8653.92,88,,percent of total billed charges,,,,,,,,,7513.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2458.5,22,,percent of total billed charges,,,8948.94,91,,percent of total billed charges,,,9342.3,95,,percent of total billed charges,,,8162.22,83,,percent of total billed charges,,,8162.22,83,,percent of total billed charges,,,,,,,,,,,,,,,8162.22,83,,percent of total billed charges,,,9342.3,95,,percent of total billed charges,,,8850.6,90,,percent of total billed charges,,,8850.6,90,,percent of total billed charges,,,8063.88,82,,percent of total billed charges,,,8850.6,90,,percent of total billed charges,,,8358.9,85,,percent of total billed charges,,2458.5,9342.3,
MR FOOT BILAT W/O,31101161,CDM,73718,CPT,610,RC,outpatient,50,10135,10135,,8604.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2533.75,22,,percent of total billed charges,,,,,,,,,9121.5,90,,percent of total billed charges,,,8391.78,82.8,,percent of total billed charges,,,8614.75,85,,percent of total billed charges,,,,,,,,,8918.8,88,,percent of total billed charges,,,,,,,,,7743.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2533.75,22,,percent of total billed charges,,,9222.85,91,,percent of total billed charges,,,9628.25,95,,percent of total billed charges,,,8412.05,83,,percent of total billed charges,,,8412.05,83,,percent of total billed charges,,,,,,,,,,,,,,,8412.05,83,,percent of total billed charges,,,9628.25,95,,percent of total billed charges,,,9121.5,90,,percent of total billed charges,,,9121.5,90,,percent of total billed charges,,,8310.7,82,,percent of total billed charges,,,9121.5,90,,percent of total billed charges,,,8614.75,85,,percent of total billed charges,,2533.75,9628.25,
MR SHOULDER LEFT W/,31101899,CDM,73222,CPT,610,RC,outpatient,LT,6459,6459,,5483.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1614.75,22,,percent of total billed charges,,,,,,,,,5813.1,90,,percent of total billed charges,,,5348.05,82.8,,percent of total billed charges,,,5490.15,85,,percent of total billed charges,,,,,,,,,5683.92,88,,percent of total billed charges,,,,,,,,,4934.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1614.75,22,,percent of total billed charges,,,5877.69,91,,percent of total billed charges,,,6136.05,95,,percent of total billed charges,,,5360.97,83,,percent of total billed charges,,,5360.97,83,,percent of total billed charges,,,,,,,,,,,,,,,5360.97,83,,percent of total billed charges,,,6136.05,95,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5296.38,82,,percent of total billed charges,,,5813.1,90,,percent of total billed charges,,,5490.15,85,,percent of total billed charges,,1614.75,6136.05,
MR HIP BILATERAL W/O,31101900,CDM,73721,CPT,610,RC,outpatient,50,10353,10353,,8789.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2588.25,22,,percent of total billed charges,,,,,,,,,9317.7,90,,percent of total billed charges,,,8572.28,82.8,,percent of total billed charges,,,8800.05,85,,percent of total billed charges,,,,,,,,,9110.64,88,,percent of total billed charges,,,,,,,,,7909.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2588.25,22,,percent of total billed charges,,,9421.23,91,,percent of total billed charges,,,9835.35,95,,percent of total billed charges,,,8592.99,83,,percent of total billed charges,,,8592.99,83,,percent of total billed charges,,,,,,,,,,,,,,,8592.99,83,,percent of total billed charges,,,9835.35,95,,percent of total billed charges,,,9317.7,90,,percent of total billed charges,,,9317.7,90,,percent of total billed charges,,,8489.46,82,,percent of total billed charges,,,9317.7,90,,percent of total billed charges,,,8800.05,85,,percent of total billed charges,,2588.25,9835.35,
MR HIP BILATERAL W/WO,31101901,CDM,73723,CPT,610,RC,outpatient,50,13369,13369,,11350.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3342.25,22,,percent of total billed charges,,,,,,,,,12032.1,90,,percent of total billed charges,,,11069.53,82.8,,percent of total billed charges,,,11363.65,85,,percent of total billed charges,,,,,,,,,11764.72,88,,percent of total billed charges,,,,,,,,,10213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3342.25,22,,percent of total billed charges,,,12165.79,91,,percent of total billed charges,,,12700.55,95,,percent of total billed charges,,,11096.27,83,,percent of total billed charges,,,11096.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11096.27,83,,percent of total billed charges,,,12700.55,95,,percent of total billed charges,,,12032.1,90,,percent of total billed charges,,,12032.1,90,,percent of total billed charges,,,10962.58,82,,percent of total billed charges,,,12032.1,90,,percent of total billed charges,,,11363.65,85,,percent of total billed charges,,3342.25,12700.55,
MR ORTHO PELVIS W/O (V 05-17),31101999,CDM,73721,CPT,610,RC,outpatient,50,8556,8556,,7264.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2139,22,,percent of total billed charges,,,,,,,,,7700.4,90,,percent of total billed charges,,,7084.37,82.8,,percent of total billed charges,,,7272.6,85,,percent of total billed charges,,,,,,,,,7529.28,88,,percent of total billed charges,,,,,,,,,6536.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2139,22,,percent of total billed charges,,,7785.96,91,,percent of total billed charges,,,8128.2,95,,percent of total billed charges,,,7101.48,83,,percent of total billed charges,,,7101.48,83,,percent of total billed charges,,,,,,,,,,,,,,,7101.48,83,,percent of total billed charges,,,8128.2,95,,percent of total billed charges,,,7700.4,90,,percent of total billed charges,,,7700.4,90,,percent of total billed charges,,,7015.92,82,,percent of total billed charges,,,7700.4,90,,percent of total billed charges,,,7272.6,85,,percent of total billed charges,,2139,8128.2,
MRV HEAD W/O AND REPROC,31102009,CDM,70544,CPT,611,RC,outpatient,TC,4536,4536,,3851.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1134,22,,percent of total billed charges,,,,,,,,,4082.4,90,,percent of total billed charges,,,3755.81,82.8,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,,,,,,,,3991.68,88,,percent of total billed charges,,,,,,,,,3465.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1134,22,,percent of total billed charges,,,4127.76,91,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,3764.88,83,,percent of total billed charges,,,,,,,,,,,,,,,3764.88,83,,percent of total billed charges,,,4309.2,95,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3719.52,82,,percent of total billed charges,,,4082.4,90,,percent of total billed charges,,,3855.6,85,,percent of total billed charges,,1134,4309.2,
NM THYROID SCAN ONLY,28000001,CDM,78013,CPT,340,RC,outpatient,TC,1565,1565,,1328.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,391.25,22,,percent of total billed charges,,,,,,,,,1408.5,90,,percent of total billed charges,,,1295.82,82.8,,percent of total billed charges,,,1330.25,85,,percent of total billed charges,,,,,,,,,1377.2,88,,percent of total billed charges,,,,,,,,,1195.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,391.25,22,,percent of total billed charges,,,1424.15,91,,percent of total billed charges,,,1486.75,95,,percent of total billed charges,,,1298.95,83,,percent of total billed charges,,,1298.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1298.95,83,,percent of total billed charges,,,1486.75,95,,percent of total billed charges,,,1408.5,90,,percent of total billed charges,,,1408.5,90,,percent of total billed charges,,,1283.3,82,,percent of total billed charges,,,1408.5,90,,percent of total billed charges,,,1330.25,85,,percent of total billed charges,,391.25,1486.75,
NM HIDA,28101005,CDM,78226,CPT,340,RC,outpatient,TC,2834,2834,,2406.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,708.5,22,,percent of total billed charges,,,,,,,,,2550.6,90,,percent of total billed charges,,,2346.55,82.8,,percent of total billed charges,,,2408.9,85,,percent of total billed charges,,,,,,,,,2493.92,88,,percent of total billed charges,,,,,,,,,2165.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,708.5,22,,percent of total billed charges,,,2578.94,91,,percent of total billed charges,,,2692.3,95,,percent of total billed charges,,,2352.22,83,,percent of total billed charges,,,2352.22,83,,percent of total billed charges,,,,,,,,,,,,,,,2352.22,83,,percent of total billed charges,,,2692.3,95,,percent of total billed charges,,,2550.6,90,,percent of total billed charges,,,2550.6,90,,percent of total billed charges,,,2323.88,82,,percent of total billed charges,,,2550.6,90,,percent of total billed charges,,,2408.9,85,,percent of total billed charges,,708.5,2692.3,
NM BRAIN,28101014,CDM,78605,CPT,340,RC,outpatient,TC,1416,1416,,1202.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,354,22,,percent of total billed charges,,,,,,,,,1274.4,90,,percent of total billed charges,,,1172.45,82.8,,percent of total billed charges,,,1203.6,85,,percent of total billed charges,,,,,,,,,1246.08,88,,percent of total billed charges,,,,,,,,,1081.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,354,22,,percent of total billed charges,,,1288.56,91,,percent of total billed charges,,,1345.2,95,,percent of total billed charges,,,1175.28,83,,percent of total billed charges,,,1175.28,83,,percent of total billed charges,,,,,,,,,,,,,,,1175.28,83,,percent of total billed charges,,,1345.2,95,,percent of total billed charges,,,1274.4,90,,percent of total billed charges,,,1274.4,90,,percent of total billed charges,,,1161.12,82,,percent of total billed charges,,,1274.4,90,,percent of total billed charges,,,1203.6,85,,percent of total billed charges,,354,1345.2,
NM BRAIN W/FLOW STUDY,28101022,CDM,78606,CPT,340,RC,outpatient,TC,2364,2364,,2007.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,591,22,,percent of total billed charges,,,,,,,,,2127.6,90,,percent of total billed charges,,,1957.39,82.8,,percent of total billed charges,,,2009.4,85,,percent of total billed charges,,,,,,,,,2080.32,88,,percent of total billed charges,,,,,,,,,1806.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,591,22,,percent of total billed charges,,,2151.24,91,,percent of total billed charges,,,2245.8,95,,percent of total billed charges,,,1962.12,83,,percent of total billed charges,,,1962.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1962.12,83,,percent of total billed charges,,,2245.8,95,,percent of total billed charges,,,2127.6,90,,percent of total billed charges,,,2127.6,90,,percent of total billed charges,,,1938.48,82,,percent of total billed charges,,,2127.6,90,,percent of total billed charges,,,2009.4,85,,percent of total billed charges,,591,2245.8,
NM LIVERANDSPLEEN,28101030,CDM,78215,CPT,340,RC,outpatient,TC,2483,2483,,2108.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,620.75,22,,percent of total billed charges,,,,,,,,,2234.7,90,,percent of total billed charges,,,2055.92,82.8,,percent of total billed charges,,,2110.55,85,,percent of total billed charges,,,,,,,,,2185.04,88,,percent of total billed charges,,,,,,,,,1897.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,620.75,22,,percent of total billed charges,,,2259.53,91,,percent of total billed charges,,,2358.85,95,,percent of total billed charges,,,2060.89,83,,percent of total billed charges,,,2060.89,83,,percent of total billed charges,,,,,,,,,,,,,,,2060.89,83,,percent of total billed charges,,,2358.85,95,,percent of total billed charges,,,2234.7,90,,percent of total billed charges,,,2234.7,90,,percent of total billed charges,,,2036.06,82,,percent of total billed charges,,,2234.7,90,,percent of total billed charges,,,2110.55,85,,percent of total billed charges,,620.75,2358.85,
NM BREAST,28101038,CDM,78800,CPT,341,RC,outpatient,TC,1366,1366,,1159.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,341.5,22,,percent of total billed charges,,,,,,,,,1229.4,90,,percent of total billed charges,,,1131.05,82.8,,percent of total billed charges,,,1161.1,85,,percent of total billed charges,,,,,,,,,1202.08,88,,percent of total billed charges,,,,,,,,,1043.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,341.5,22,,percent of total billed charges,,,1243.06,91,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1133.78,83,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1120.12,82,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1161.1,85,,percent of total billed charges,,341.5,1297.7,
NM LUNG PERFUSION,28101055,CDM,78580,CPT,340,RC,outpatient,TC,1865,1865,,1583.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,466.25,22,,percent of total billed charges,,,,,,,,,1678.5,90,,percent of total billed charges,,,1544.22,82.8,,percent of total billed charges,,,1585.25,85,,percent of total billed charges,,,,,,,,,1641.2,88,,percent of total billed charges,,,,,,,,,1424.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,466.25,22,,percent of total billed charges,,,1697.15,91,,percent of total billed charges,,,1771.75,95,,percent of total billed charges,,,1547.95,83,,percent of total billed charges,,,1547.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1547.95,83,,percent of total billed charges,,,1771.75,95,,percent of total billed charges,,,1678.5,90,,percent of total billed charges,,,1678.5,90,,percent of total billed charges,,,1529.3,82,,percent of total billed charges,,,1678.5,90,,percent of total billed charges,,,1585.25,85,,percent of total billed charges,,466.25,1771.75,
NM LUNG VQ COMPLETE,28101060,CDM,78582,CPT,340,RC,outpatient,TC,2014,2014,,1709.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,503.5,22,,percent of total billed charges,,,,,,,,,1812.6,90,,percent of total billed charges,,,1667.59,82.8,,percent of total billed charges,,,1711.9,85,,percent of total billed charges,,,,,,,,,1772.32,88,,percent of total billed charges,,,,,,,,,1538.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,503.5,22,,percent of total billed charges,,,1832.74,91,,percent of total billed charges,,,1913.3,95,,percent of total billed charges,,,1671.62,83,,percent of total billed charges,,,1671.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1671.62,83,,percent of total billed charges,,,1913.3,95,,percent of total billed charges,,,1812.6,90,,percent of total billed charges,,,1812.6,90,,percent of total billed charges,,,1651.48,82,,percent of total billed charges,,,1812.6,90,,percent of total billed charges,,,1711.9,85,,percent of total billed charges,,503.5,1913.3,
NM LUNG VENTILATION,28101063,CDM,78597,CPT,340,RC,outpatient,TC,1865,1865,,1583.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,466.25,22,,percent of total billed charges,,,,,,,,,1678.5,90,,percent of total billed charges,,,1544.22,82.8,,percent of total billed charges,,,1585.25,85,,percent of total billed charges,,,,,,,,,1641.2,88,,percent of total billed charges,,,,,,,,,1424.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,466.25,22,,percent of total billed charges,,,1697.15,91,,percent of total billed charges,,,1771.75,95,,percent of total billed charges,,,1547.95,83,,percent of total billed charges,,,1547.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1547.95,83,,percent of total billed charges,,,1771.75,95,,percent of total billed charges,,,1678.5,90,,percent of total billed charges,,,1678.5,90,,percent of total billed charges,,,1529.3,82,,percent of total billed charges,,,1678.5,90,,percent of total billed charges,,,1585.25,85,,percent of total billed charges,,466.25,1771.75,
NM LUNG QUANTIFICATION,28101064,CDM,78598,CPT,340,RC,outpatient,TC,2365,2365,,2007.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,591.25,22,,percent of total billed charges,,,,,,,,,2128.5,90,,percent of total billed charges,,,1958.22,82.8,,percent of total billed charges,,,2010.25,85,,percent of total billed charges,,,,,,,,,2081.2,88,,percent of total billed charges,,,,,,,,,1806.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,591.25,22,,percent of total billed charges,,,2152.15,91,,percent of total billed charges,,,2246.75,95,,percent of total billed charges,,,1962.95,83,,percent of total billed charges,,,1962.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1962.95,83,,percent of total billed charges,,,2246.75,95,,percent of total billed charges,,,2128.5,90,,percent of total billed charges,,,2128.5,90,,percent of total billed charges,,,1939.3,82,,percent of total billed charges,,,2128.5,90,,percent of total billed charges,,,2010.25,85,,percent of total billed charges,,591.25,2246.75,
NM BONE SPECT,28101065,CDM,78803,CPT,340,RC,outpatient,TC,3218,3218,,2732.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,804.5,22,,percent of total billed charges,,,,,,,,,2896.2,90,,percent of total billed charges,,,2664.5,82.8,,percent of total billed charges,,,2735.3,85,,percent of total billed charges,,,,,,,,,2831.84,88,,percent of total billed charges,,,,,,,,,2458.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,804.5,22,,percent of total billed charges,,,2928.38,91,,percent of total billed charges,,,3057.1,95,,percent of total billed charges,,,2670.94,83,,percent of total billed charges,,,2670.94,83,,percent of total billed charges,,,,,,,,,,,,,,,2670.94,83,,percent of total billed charges,,,3057.1,95,,percent of total billed charges,,,2896.2,90,,percent of total billed charges,,,2896.2,90,,percent of total billed charges,,,2638.76,82,,percent of total billed charges,,,2896.2,90,,percent of total billed charges,,,2735.3,85,,percent of total billed charges,,804.5,3057.1,
NM LIVER SPECT,28101066,CDM,78803,CPT,340,RC,outpatient,TC,3047,3047,,2586.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,761.75,22,,percent of total billed charges,,,,,,,,,2742.3,90,,percent of total billed charges,,,2522.92,82.8,,percent of total billed charges,,,2589.95,85,,percent of total billed charges,,,,,,,,,2681.36,88,,percent of total billed charges,,,,,,,,,2327.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,761.75,22,,percent of total billed charges,,,2772.77,91,,percent of total billed charges,,,2894.65,95,,percent of total billed charges,,,2529.01,83,,percent of total billed charges,,,2529.01,83,,percent of total billed charges,,,,,,,,,,,,,,,2529.01,83,,percent of total billed charges,,,2894.65,95,,percent of total billed charges,,,2742.3,90,,percent of total billed charges,,,2742.3,90,,percent of total billed charges,,,2498.54,82,,percent of total billed charges,,,2742.3,90,,percent of total billed charges,,,2589.95,85,,percent of total billed charges,,761.75,2894.65,
NM BONE,28101089,CDM,78306,CPT,340,RC,outpatient,TC,3045,3045,,2585.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,761.25,22,,percent of total billed charges,,,,,,,,,2740.5,90,,percent of total billed charges,,,2521.26,82.8,,percent of total billed charges,,,2588.25,85,,percent of total billed charges,,,,,,,,,2679.6,88,,percent of total billed charges,,,,,,,,,2326.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,761.25,22,,percent of total billed charges,,,2770.95,91,,percent of total billed charges,,,2892.75,95,,percent of total billed charges,,,2527.35,83,,percent of total billed charges,,,2527.35,83,,percent of total billed charges,,,,,,,,,,,,,,,2527.35,83,,percent of total billed charges,,,2892.75,95,,percent of total billed charges,,,2740.5,90,,percent of total billed charges,,,2740.5,90,,percent of total billed charges,,,2496.9,82,,percent of total billed charges,,,2740.5,90,,percent of total billed charges,,,2588.25,85,,percent of total billed charges,,761.25,2892.75,
NM PARATHYROID,28101090,CDM,78070,CPT,340,RC,outpatient,TC,3680,3680,,3124.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,920,22,,percent of total billed charges,,,,,,,,,3312,90,,percent of total billed charges,,,3047.04,82.8,,percent of total billed charges,,,3128,85,,percent of total billed charges,,,,,,,,,3238.4,88,,percent of total billed charges,,,,,,,,,2811.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,920,22,,percent of total billed charges,,,3348.8,91,,percent of total billed charges,,,3496,95,,percent of total billed charges,,,3054.4,83,,percent of total billed charges,,,3054.4,83,,percent of total billed charges,,,,,,,,,,,,,,,3054.4,83,,percent of total billed charges,,,3496,95,,percent of total billed charges,,,3312,90,,percent of total billed charges,,,3312,90,,percent of total billed charges,,,3017.6,82,,percent of total billed charges,,,3312,90,,percent of total billed charges,,,3128,85,,percent of total billed charges,,920,3496,
NM INTEST/MECKELS,28101097,CDM,78290,CPT,340,RC,outpatient,TC,2365,2365,,2007.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,591.25,22,,percent of total billed charges,,,,,,,,,2128.5,90,,percent of total billed charges,,,1958.22,82.8,,percent of total billed charges,,,2010.25,85,,percent of total billed charges,,,,,,,,,2081.2,88,,percent of total billed charges,,,,,,,,,1806.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,591.25,22,,percent of total billed charges,,,2152.15,91,,percent of total billed charges,,,2246.75,95,,percent of total billed charges,,,1962.95,83,,percent of total billed charges,,,1962.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1962.95,83,,percent of total billed charges,,,2246.75,95,,percent of total billed charges,,,2128.5,90,,percent of total billed charges,,,2128.5,90,,percent of total billed charges,,,1939.3,82,,percent of total billed charges,,,2128.5,90,,percent of total billed charges,,,2010.25,85,,percent of total billed charges,,591.25,2246.75,
NM CISTERNOGRAM,28101100,CDM,78650,CPT,340,RC,outpatient,TC,2237,2237,,1899.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,559.25,22,,percent of total billed charges,,,,,,,,,2013.3,90,,percent of total billed charges,,,1852.24,82.8,,percent of total billed charges,,,1901.45,85,,percent of total billed charges,,,,,,,,,1968.56,88,,percent of total billed charges,,,,,,,,,1709.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,559.25,22,,percent of total billed charges,,,2035.67,91,,percent of total billed charges,,,2125.15,95,,percent of total billed charges,,,1856.71,83,,percent of total billed charges,,,1856.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1856.71,83,,percent of total billed charges,,,2125.15,95,,percent of total billed charges,,,2013.3,90,,percent of total billed charges,,,2013.3,90,,percent of total billed charges,,,1834.34,82,,percent of total billed charges,,,2013.3,90,,percent of total billed charges,,,1901.45,85,,percent of total billed charges,,559.25,2125.15,
NM CISTERNOGRAM FLUID SCAN,28101101,CDM,78630,CPT,340,RC,outpatient,TC,3336,3336,,2832.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,834,22,,percent of total billed charges,,,,,,,,,3002.4,90,,percent of total billed charges,,,2762.21,82.8,,percent of total billed charges,,,2835.6,85,,percent of total billed charges,,,,,,,,,2935.68,88,,percent of total billed charges,,,,,,,,,2548.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,834,22,,percent of total billed charges,,,3035.76,91,,percent of total billed charges,,,3169.2,95,,percent of total billed charges,,,2768.88,83,,percent of total billed charges,,,2768.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2768.88,83,,percent of total billed charges,,,3169.2,95,,percent of total billed charges,,,3002.4,90,,percent of total billed charges,,,3002.4,90,,percent of total billed charges,,,2735.52,82,,percent of total billed charges,,,3002.4,90,,percent of total billed charges,,,2835.6,85,,percent of total billed charges,,834,3169.2,
NM HIDA W/CCK CHALLENGE,28101105,CDM,78227,CPT,340,RC,outpatient,TC,3036,3036,,2577.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,759,22,,percent of total billed charges,,,,,,,,,2732.4,90,,percent of total billed charges,,,2513.81,82.8,,percent of total billed charges,,,2580.6,85,,percent of total billed charges,,,,,,,,,2671.68,88,,percent of total billed charges,,,,,,,,,2319.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,759,22,,percent of total billed charges,,,2762.76,91,,percent of total billed charges,,,2884.2,95,,percent of total billed charges,,,2519.88,83,,percent of total billed charges,,,2519.88,83,,percent of total billed charges,,,,,,,,,,,,,,,2519.88,83,,percent of total billed charges,,,2884.2,95,,percent of total billed charges,,,2732.4,90,,percent of total billed charges,,,2732.4,90,,percent of total billed charges,,,2489.52,82,,percent of total billed charges,,,2732.4,90,,percent of total billed charges,,,2580.6,85,,percent of total billed charges,,759,2884.2,
NM RENOGRAMW/CAPOTEN/LASIX,28101113,CDM,78708,CPT,340,RC,outpatient,TC,2843,2843,,2413.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,710.75,22,,percent of total billed charges,,,,,,,,,2558.7,90,,percent of total billed charges,,,2354,82.8,,percent of total billed charges,,,2416.55,85,,percent of total billed charges,,,,,,,,,2501.84,88,,percent of total billed charges,,,,,,,,,2172.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,710.75,22,,percent of total billed charges,,,2587.13,91,,percent of total billed charges,,,2700.85,95,,percent of total billed charges,,,2359.69,83,,percent of total billed charges,,,2359.69,83,,percent of total billed charges,,,,,,,,,,,,,,,2359.69,83,,percent of total billed charges,,,2700.85,95,,percent of total billed charges,,,2558.7,90,,percent of total billed charges,,,2558.7,90,,percent of total billed charges,,,2331.26,82,,percent of total billed charges,,,2558.7,90,,percent of total billed charges,,,2416.55,85,,percent of total billed charges,,710.75,2700.85,
NM MYOCRDIOSNGL(RSTORSTRS),28101139,CDM,78451,CPT,340,RC,outpatient,TC,5111,5111,,4339.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1277.75,22,,percent of total billed charges,,,,,,,,,4599.9,90,,percent of total billed charges,,,4231.91,82.8,,percent of total billed charges,,,4344.35,85,,percent of total billed charges,,,,,,,,,4497.68,88,,percent of total billed charges,,,,,,,,,3904.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1277.75,22,,percent of total billed charges,,,4651.01,91,,percent of total billed charges,,,4855.45,95,,percent of total billed charges,,,4242.13,83,,percent of total billed charges,,,4242.13,83,,percent of total billed charges,,,,,,,,,,,,,,,4242.13,83,,percent of total billed charges,,,4855.45,95,,percent of total billed charges,,,4599.9,90,,percent of total billed charges,,,4599.9,90,,percent of total billed charges,,,4191.02,82,,percent of total billed charges,,,4599.9,90,,percent of total billed charges,,,4344.35,85,,percent of total billed charges,,1277.75,4855.45,
NM MYOCRDIO STRS/RST,28101147,CDM,78452,CPT,340,RC,outpatient,TC,6939,6939,,5891.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1734.75,22,,percent of total billed charges,,,,,,,,,6245.1,90,,percent of total billed charges,,,5745.49,82.8,,percent of total billed charges,,,5898.15,85,,percent of total billed charges,,,,,,,,,6106.32,88,,percent of total billed charges,,,,,,,,,5301.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1734.75,22,,percent of total billed charges,,,6314.49,91,,percent of total billed charges,,,6592.05,95,,percent of total billed charges,,,5759.37,83,,percent of total billed charges,,,5759.37,83,,percent of total billed charges,,,,,,,,,,,,,,,5759.37,83,,percent of total billed charges,,,6592.05,95,,percent of total billed charges,,,6245.1,90,,percent of total billed charges,,,6245.1,90,,percent of total billed charges,,,5689.98,82,,percent of total billed charges,,,6245.1,90,,percent of total billed charges,,,5898.15,85,,percent of total billed charges,,1734.75,6592.05,
NM CARDIAC EJECT(DONOTUSE),28101153,CDM,78480,CPT,340,RC,outpatient,,1201,1201,,1019.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,300.25,22,,percent of total billed charges,,,,,,,,,1080.9,90,,percent of total billed charges,,,994.43,82.8,,percent of total billed charges,,,1020.85,85,,percent of total billed charges,,,,,,,,,1056.88,88,,percent of total billed charges,,,,,,,,,917.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,300.25,22,,percent of total billed charges,,,1092.91,91,,percent of total billed charges,,,1140.95,95,,percent of total billed charges,,,996.83,83,,percent of total billed charges,,,996.83,83,,percent of total billed charges,,,,,,,,,,,,,,,996.83,83,,percent of total billed charges,,,1140.95,95,,percent of total billed charges,,,1080.9,90,,percent of total billed charges,,,1080.9,90,,percent of total billed charges,,,984.82,82,,percent of total billed charges,,,1080.9,90,,percent of total billed charges,,,1020.85,85,,percent of total billed charges,,300.25,1140.95,
NM CARDIAC WALL(DONOTUSE),28101155,CDM,78478,CPT,340,RC,outpatient,,1201,1201,,1019.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,300.25,22,,percent of total billed charges,,,,,,,,,1080.9,90,,percent of total billed charges,,,994.43,82.8,,percent of total billed charges,,,1020.85,85,,percent of total billed charges,,,,,,,,,1056.88,88,,percent of total billed charges,,,,,,,,,917.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,300.25,22,,percent of total billed charges,,,1092.91,91,,percent of total billed charges,,,1140.95,95,,percent of total billed charges,,,996.83,83,,percent of total billed charges,,,996.83,83,,percent of total billed charges,,,,,,,,,,,,,,,996.83,83,,percent of total billed charges,,,1140.95,95,,percent of total billed charges,,,1080.9,90,,percent of total billed charges,,,1080.9,90,,percent of total billed charges,,,984.82,82,,percent of total billed charges,,,1080.9,90,,percent of total billed charges,,,1020.85,85,,percent of total billed charges,,300.25,1140.95,
NM MYOCARDIAL PERFUSION PLANAR MULT STDY,28101156,CDM,78454,CPT,340,RC,outpatient,TC,5960,5960,,5060.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1490,22,,percent of total billed charges,,,,,,,,,5364,90,,percent of total billed charges,,,4934.88,82.8,,percent of total billed charges,,,5066,85,,percent of total billed charges,,,,,,,,,5244.8,88,,percent of total billed charges,,,,,,,,,4553.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1490,22,,percent of total billed charges,,,5423.6,91,,percent of total billed charges,,,5662,95,,percent of total billed charges,,,4946.8,83,,percent of total billed charges,,,4946.8,83,,percent of total billed charges,,,,,,,,,,,,,,,4946.8,83,,percent of total billed charges,,,5662,95,,percent of total billed charges,,,5364,90,,percent of total billed charges,,,5364,90,,percent of total billed charges,,,4887.2,82,,percent of total billed charges,,,5364,90,,percent of total billed charges,,,5066,85,,percent of total billed charges,,1490,5662,
NM THYROID/UPTKANDSCAN,28101172,CDM,78014,CPT,340,RC,outpatient,TC,2486,2486,,2110.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,621.5,22,,percent of total billed charges,,,,,,,,,2237.4,90,,percent of total billed charges,,,2058.41,82.8,,percent of total billed charges,,,2113.1,85,,percent of total billed charges,,,,,,,,,2187.68,88,,percent of total billed charges,,,,,,,,,1899.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,621.5,22,,percent of total billed charges,,,2262.26,91,,percent of total billed charges,,,2361.7,95,,percent of total billed charges,,,2063.38,83,,percent of total billed charges,,,2063.38,83,,percent of total billed charges,,,,,,,,,,,,,,,2063.38,83,,percent of total billed charges,,,2361.7,95,,percent of total billed charges,,,2237.4,90,,percent of total billed charges,,,2237.4,90,,percent of total billed charges,,,2038.52,82,,percent of total billed charges,,,2237.4,90,,percent of total billed charges,,,2113.1,85,,percent of total billed charges,,621.5,2361.7,
NM THYROIDMETS/WHLBDY-I131,28101173,CDM,78018,CPT,340,RC,outpatient,TC,3168,3168,,2689.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,792,22,,percent of total billed charges,,,,,,,,,2851.2,90,,percent of total billed charges,,,2623.1,82.8,,percent of total billed charges,,,2692.8,85,,percent of total billed charges,,,,,,,,,2787.84,88,,percent of total billed charges,,,,,,,,,2420.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,792,22,,percent of total billed charges,,,2882.88,91,,percent of total billed charges,,,3009.6,95,,percent of total billed charges,,,2629.44,83,,percent of total billed charges,,,2629.44,83,,percent of total billed charges,,,,,,,,,,,,,,,2629.44,83,,percent of total billed charges,,,3009.6,95,,percent of total billed charges,,,2851.2,90,,percent of total billed charges,,,2851.2,90,,percent of total billed charges,,,2597.76,82,,percent of total billed charges,,,2851.2,90,,percent of total billed charges,,,2692.8,85,,percent of total billed charges,,792,3009.6,
NM TOMO SPECT INFARCT,28101194,CDM,0332T,CPT,340,RC,outpatient,TC,1744,1744,,1480.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,436,22,,percent of total billed charges,,,,,,,,,1569.6,90,,percent of total billed charges,,,1444.03,82.8,,percent of total billed charges,,,1482.4,85,,percent of total billed charges,,,,,,,,,1534.72,88,,percent of total billed charges,,,,,,,,,1332.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,436,22,,percent of total billed charges,,,1587.04,91,,percent of total billed charges,,,1656.8,95,,percent of total billed charges,,,1447.52,83,,percent of total billed charges,,,1447.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1447.52,83,,percent of total billed charges,,,1656.8,95,,percent of total billed charges,,,1569.6,90,,percent of total billed charges,,,1569.6,90,,percent of total billed charges,,,1430.08,82,,percent of total billed charges,,,1569.6,90,,percent of total billed charges,,,1482.4,85,,percent of total billed charges,,436,1656.8,
NM CARDIAC PLANAR,28101195,CDM,0331T,CPT,340,RC,outpatient,TC,2093,2093,,1776.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,523.25,22,,percent of total billed charges,,,,,,,,,1883.7,90,,percent of total billed charges,,,1733,82.8,,percent of total billed charges,,,1779.05,85,,percent of total billed charges,,,,,,,,,1841.84,88,,percent of total billed charges,,,,,,,,,1599.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,523.25,22,,percent of total billed charges,,,1904.63,91,,percent of total billed charges,,,1988.35,95,,percent of total billed charges,,,1737.19,83,,percent of total billed charges,,,1737.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1737.19,83,,percent of total billed charges,,,1988.35,95,,percent of total billed charges,,,1883.7,90,,percent of total billed charges,,,1883.7,90,,percent of total billed charges,,,1716.26,82,,percent of total billed charges,,,1883.7,90,,percent of total billed charges,,,1779.05,85,,percent of total billed charges,,523.25,1988.35,
NM ACUTE MI,28101196,CDM,78466,CPT,340,RC,outpatient,TC,2028,2028,,1721.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,507,22,,percent of total billed charges,,,,,,,,,1825.2,90,,percent of total billed charges,,,1679.18,82.8,,percent of total billed charges,,,1723.8,85,,percent of total billed charges,,,,,,,,,1784.64,88,,percent of total billed charges,,,,,,,,,1549.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,507,22,,percent of total billed charges,,,1845.48,91,,percent of total billed charges,,,1926.6,95,,percent of total billed charges,,,1683.24,83,,percent of total billed charges,,,1683.24,83,,percent of total billed charges,,,,,,,,,,,,,,,1683.24,83,,percent of total billed charges,,,1926.6,95,,percent of total billed charges,,,1825.2,90,,percent of total billed charges,,,1825.2,90,,percent of total billed charges,,,1662.96,82,,percent of total billed charges,,,1825.2,90,,percent of total billed charges,,,1723.8,85,,percent of total billed charges,,507,1926.6,
NM GALLIUM ABSCESS BODY,28101197,CDM,78300,CPT,340,RC,outpatient,TC,3948,3948,,3351.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,987,22,,percent of total billed charges,,,,,,,,,3553.2,90,,percent of total billed charges,,,3268.94,82.8,,percent of total billed charges,,,3355.8,85,,percent of total billed charges,,,,,,,,,3474.24,88,,percent of total billed charges,,,,,,,,,3016.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,987,22,,percent of total billed charges,,,3592.68,91,,percent of total billed charges,,,3750.6,95,,percent of total billed charges,,,3276.84,83,,percent of total billed charges,,,3276.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3276.84,83,,percent of total billed charges,,,3750.6,95,,percent of total billed charges,,,3553.2,90,,percent of total billed charges,,,3553.2,90,,percent of total billed charges,,,3237.36,82,,percent of total billed charges,,,3553.2,90,,percent of total billed charges,,,3355.8,85,,percent of total billed charges,,987,3750.6,
NM GALLIUM ABSCESS SPECT,28101198,CDM,78305,CPT,340,RC,outpatient,TC,3369,3369,,2860.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,842.25,22,,percent of total billed charges,,,,,,,,,3032.1,90,,percent of total billed charges,,,2789.53,82.8,,percent of total billed charges,,,2863.65,85,,percent of total billed charges,,,,,,,,,2964.72,88,,percent of total billed charges,,,,,,,,,2573.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,842.25,22,,percent of total billed charges,,,3065.79,91,,percent of total billed charges,,,3200.55,95,,percent of total billed charges,,,2796.27,83,,percent of total billed charges,,,2796.27,83,,percent of total billed charges,,,,,,,,,,,,,,,2796.27,83,,percent of total billed charges,,,3200.55,95,,percent of total billed charges,,,3032.1,90,,percent of total billed charges,,,3032.1,90,,percent of total billed charges,,,2762.58,82,,percent of total billed charges,,,3032.1,90,,percent of total billed charges,,,2863.65,85,,percent of total billed charges,,842.25,3200.55,
NM GALL TUMOR LOC BODY,28101200,CDM,78802,CPT,340,RC,outpatient,TC,3761,3761,,3193.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,940.25,22,,percent of total billed charges,,,,,,,,,3384.9,90,,percent of total billed charges,,,3114.11,82.8,,percent of total billed charges,,,3196.85,85,,percent of total billed charges,,,,,,,,,3309.68,88,,percent of total billed charges,,,,,,,,,2873.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,940.25,22,,percent of total billed charges,,,3422.51,91,,percent of total billed charges,,,3572.95,95,,percent of total billed charges,,,3121.63,83,,percent of total billed charges,,,3121.63,83,,percent of total billed charges,,,,,,,,,,,,,,,3121.63,83,,percent of total billed charges,,,3572.95,95,,percent of total billed charges,,,3384.9,90,,percent of total billed charges,,,3384.9,90,,percent of total billed charges,,,3084.02,82,,percent of total billed charges,,,3384.9,90,,percent of total billed charges,,,3196.85,85,,percent of total billed charges,,940.25,3572.95,
NM GALL TUMOR LOCATE LTD,28101201,CDM,78800,CPT,340,RC,outpatient,TC,1366,1366,,1159.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,341.5,22,,percent of total billed charges,,,,,,,,,1229.4,90,,percent of total billed charges,,,1131.05,82.8,,percent of total billed charges,,,1161.1,85,,percent of total billed charges,,,,,,,,,1202.08,88,,percent of total billed charges,,,,,,,,,1043.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,341.5,22,,percent of total billed charges,,,1243.06,91,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1133.78,83,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1120.12,82,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1161.1,85,,percent of total billed charges,,341.5,1297.7,
NM MYOCARDIAL PYP SCAN,28101202,CDM,78803,CPT,340,RC,outpatient,TC,4501,4501,,3821.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1125.25,22,,percent of total billed charges,,,,,,,,,4050.9,90,,percent of total billed charges,,,3726.83,82.8,,percent of total billed charges,,,3825.85,85,,percent of total billed charges,,,,,,,,,3960.88,88,,percent of total billed charges,,,,,,,,,3438.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1125.25,22,,percent of total billed charges,,,4095.91,91,,percent of total billed charges,,,4275.95,95,,percent of total billed charges,,,3735.83,83,,percent of total billed charges,,,3735.83,83,,percent of total billed charges,,,,,,,,,,,,,,,3735.83,83,,percent of total billed charges,,,4275.95,95,,percent of total billed charges,,,4050.9,90,,percent of total billed charges,,,4050.9,90,,percent of total billed charges,,,3690.82,82,,percent of total billed charges,,,4050.9,90,,percent of total billed charges,,,3825.85,85,,percent of total billed charges,,1125.25,4275.95,
NM TESTICULAR,28101204,CDM,78761,CPT,340,RC,outpatient,TC,1705,1705,,1447.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,426.25,22,,percent of total billed charges,,,,,,,,,1534.5,90,,percent of total billed charges,,,1411.74,82.8,,percent of total billed charges,,,1449.25,85,,percent of total billed charges,,,,,,,,,1500.4,88,,percent of total billed charges,,,,,,,,,1302.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,426.25,22,,percent of total billed charges,,,1551.55,91,,percent of total billed charges,,,1619.75,95,,percent of total billed charges,,,1415.15,83,,percent of total billed charges,,,1415.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1415.15,83,,percent of total billed charges,,,1619.75,95,,percent of total billed charges,,,1534.5,90,,percent of total billed charges,,,1534.5,90,,percent of total billed charges,,,1398.1,82,,percent of total billed charges,,,1534.5,90,,percent of total billed charges,,,1449.25,85,,percent of total billed charges,,426.25,1619.75,
NM BONE 3 PHASE,28101253,CDM,78315,CPT,340,RC,outpatient,TC,3212,3212,,2726.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,803,22,,percent of total billed charges,,,,,,,,,2890.8,90,,percent of total billed charges,,,2659.54,82.8,,percent of total billed charges,,,2730.2,85,,percent of total billed charges,,,,,,,,,2826.56,88,,percent of total billed charges,,,,,,,,,2453.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,803,22,,percent of total billed charges,,,2922.92,91,,percent of total billed charges,,,3051.4,95,,percent of total billed charges,,,2665.96,83,,percent of total billed charges,,,2665.96,83,,percent of total billed charges,,,,,,,,,,,,,,,2665.96,83,,percent of total billed charges,,,3051.4,95,,percent of total billed charges,,,2890.8,90,,percent of total billed charges,,,2890.8,90,,percent of total billed charges,,,2633.84,82,,percent of total billed charges,,,2890.8,90,,percent of total billed charges,,,2730.2,85,,percent of total billed charges,,803,3051.4,
NM BONE LTD,28103028,CDM,78300,CPT,340,RC,outpatient,TC,1315,1315,,1116.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,328.75,22,,percent of total billed charges,,,,,,,,,1183.5,90,,percent of total billed charges,,,1088.82,82.8,,percent of total billed charges,,,1117.75,85,,percent of total billed charges,,,,,,,,,1157.2,88,,percent of total billed charges,,,,,,,,,1004.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,328.75,22,,percent of total billed charges,,,1196.65,91,,percent of total billed charges,,,1249.25,95,,percent of total billed charges,,,1091.45,83,,percent of total billed charges,,,1091.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1091.45,83,,percent of total billed charges,,,1249.25,95,,percent of total billed charges,,,1183.5,90,,percent of total billed charges,,,1183.5,90,,percent of total billed charges,,,1078.3,82,,percent of total billed charges,,,1183.5,90,,percent of total billed charges,,,1117.75,85,,percent of total billed charges,,328.75,1249.25,
NM DOSE BONE/DOSE (<30 mCi),28103200,CDM,A9503,HCPCS,636,RC,outpatient,,351,351,,298,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.75,22,,percent of total billed charges,,,,,,,,,315.9,90,,percent of total billed charges,,,290.63,82.8,,percent of total billed charges,,,298.35,85,,percent of total billed charges,,,,,,,,,308.88,88,,percent of total billed charges,,,,,,,,,268.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.75,22,,percent of total billed charges,,,319.41,91,,percent of total billed charges,,,333.45,95,,percent of total billed charges,,,291.33,83,,percent of total billed charges,,,291.33,83,,percent of total billed charges,,,,,,,,,,,,,,,291.33,83,,percent of total billed charges,,,333.45,95,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,287.82,82,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,298.35,85,,percent of total billed charges,,87.75,333.45,
NM DOSE CCK,28103201,CDM,,,250,RC,outpatient,,223,223,,189.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.75,22,,percent of total billed charges,,,,,,,,,200.7,90,,percent of total billed charges,,,184.64,82.8,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,,,,,,,,196.24,88,,percent of total billed charges,,,,,,,,,170.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.75,22,,percent of total billed charges,,,202.93,91,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,,,,,,,,,,,,,185.09,83,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,182.86,82,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,55.75,211.85,
* NM DOSE DTPA (PER mCi)(V1205),28103202,CDM,A9515,HCPCS,636,RC,outpatient,,30,30,,25.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.5,22,,percent of total billed charges,,,,,,,,,27,90,,percent of total billed charges,,,24.84,82.8,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,,,,,,,,26.4,88,,percent of total billed charges,,,,,,,,,22.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.5,22,,percent of total billed charges,,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,24.9,83,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,24.6,82,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,7.5,28.5,
NM DOSE CERETEC/DOSE (<25mCi),28103205,CDM,A9521,HCPCS,343,RC,outpatient,,12487,12487,,10601.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3121.75,22,,percent of total billed charges,,,,,,,,,11238.3,90,,percent of total billed charges,,,10339.24,82.8,,percent of total billed charges,,,10613.95,85,,percent of total billed charges,,,,,,,,,10988.56,88,,percent of total billed charges,,,,,,,,,9540.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3121.75,22,,percent of total billed charges,,,11363.17,91,,percent of total billed charges,,,11862.65,95,,percent of total billed charges,,,10364.21,83,,percent of total billed charges,,,10364.21,83,,percent of total billed charges,,,,,,,,,,,,,,,10364.21,83,,percent of total billed charges,,,11862.65,95,,percent of total billed charges,,,11238.3,90,,percent of total billed charges,,,11238.3,90,,percent of total billed charges,,,10239.34,82,,percent of total billed charges,,,11238.3,90,,percent of total billed charges,,,10613.95,85,,percent of total billed charges,,3121.75,11862.65,
NM DOSE SESTAMIBI/DOSE (<40mCi),28103210,CDM,A9500,HCPCS,636,RC,outpatient,,983,983,,834.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,245.75,22,,percent of total billed charges,,,,,,,,,884.7,90,,percent of total billed charges,,,813.92,82.8,,percent of total billed charges,,,835.55,85,,percent of total billed charges,,,,,,,,,865.04,88,,percent of total billed charges,,,,,,,,,751.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,245.75,22,,percent of total billed charges,,,894.53,91,,percent of total billed charges,,,933.85,95,,percent of total billed charges,,,815.89,83,,percent of total billed charges,,,815.89,83,,percent of total billed charges,,,,,,,,,,,,,,,815.89,83,,percent of total billed charges,,,933.85,95,,percent of total billed charges,,,884.7,90,,percent of total billed charges,,,884.7,90,,percent of total billed charges,,,806.06,82,,percent of total billed charges,,,884.7,90,,percent of total billed charges,,,835.55,85,,percent of total billed charges,,245.75,933.85,
NM LYMPHOSCINTOGRAPHY (SENT NODE),28103211,CDM,78195,CPT,341,RC,outpatient,TC,2784,2784,,2363.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,696,22,,percent of total billed charges,,,,,,,,,2505.6,90,,percent of total billed charges,,,2305.15,82.8,,percent of total billed charges,,,2366.4,85,,percent of total billed charges,,,,,,,,,2449.92,88,,percent of total billed charges,,,,,,,,,2126.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,696,22,,percent of total billed charges,,,2533.44,91,,percent of total billed charges,,,2644.8,95,,percent of total billed charges,,,2310.72,83,,percent of total billed charges,,,2310.72,83,,percent of total billed charges,,,,,,,,,,,,,,,2310.72,83,,percent of total billed charges,,,2644.8,95,,percent of total billed charges,,,2505.6,90,,percent of total billed charges,,,2505.6,90,,percent of total billed charges,,,2282.88,82,,percent of total billed charges,,,2505.6,90,,percent of total billed charges,,,2366.4,85,,percent of total billed charges,,696,2644.8,
NM GATED HEART (MUGA),28103212,CDM,78472,CPT,341,RC,outpatient,TC,2933,2933,,2490.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,733.25,22,,percent of total billed charges,,,,,,,,,2639.7,90,,percent of total billed charges,,,2428.52,82.8,,percent of total billed charges,,,2493.05,85,,percent of total billed charges,,,,,,,,,2581.04,88,,percent of total billed charges,,,,,,,,,2240.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,733.25,22,,percent of total billed charges,,,2669.03,91,,percent of total billed charges,,,2786.35,95,,percent of total billed charges,,,2434.39,83,,percent of total billed charges,,,2434.39,83,,percent of total billed charges,,,,,,,,,,,,,,,2434.39,83,,percent of total billed charges,,,2786.35,95,,percent of total billed charges,,,2639.7,90,,percent of total billed charges,,,2639.7,90,,percent of total billed charges,,,2405.06,82,,percent of total billed charges,,,2639.7,90,,percent of total billed charges,,,2493.05,85,,percent of total billed charges,,733.25,2786.35,
NM DOSE DTPA/DOSE (<25mCi),28103213,CDM,A9539,HCPCS,636,RC,outpatient,,435,435,,369.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.75,22,,percent of total billed charges,,,,,,,,,391.5,90,,percent of total billed charges,,,360.18,82.8,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,,,,,,,,382.8,88,,percent of total billed charges,,,,,,,,,332.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108.75,22,,percent of total billed charges,,,395.85,91,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,,,,,,,,,,,,,361.05,83,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,356.7,82,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,108.75,413.25,
NM DOSE GALLIUM/mCi,28103214,CDM,A9556,HCPCS,343,RC,outpatient,,334,334,,283.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.5,22,,percent of total billed charges,,,,,,,,,300.6,90,,percent of total billed charges,,,276.55,82.8,,percent of total billed charges,,,283.9,85,,percent of total billed charges,,,,,,,,,293.92,88,,percent of total billed charges,,,,,,,,,255.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.5,22,,percent of total billed charges,,,303.94,91,,percent of total billed charges,,,317.3,95,,percent of total billed charges,,,277.22,83,,percent of total billed charges,,,277.22,83,,percent of total billed charges,,,,,,,,,,,,,,,277.22,83,,percent of total billed charges,,,317.3,95,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,273.88,82,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,283.9,85,,percent of total billed charges,,83.5,317.3,
NM DOSE CHOLETEC/DOSE (<15mCi),28103215,CDM,A9537,HCPCS,636,RC,outpatient,,384,384,,326.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96,22,,percent of total billed charges,,,,,,,,,345.6,90,,percent of total billed charges,,,317.95,82.8,,percent of total billed charges,,,326.4,85,,percent of total billed charges,,,,,,,,,337.92,88,,percent of total billed charges,,,,,,,,,293.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96,22,,percent of total billed charges,,,349.44,91,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,,,,,,,,,,,,,318.72,83,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,314.88,82,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,326.4,85,,percent of total billed charges,,96,364.8,
NM DOSE INDIUM/.5mCi,28103216,CDM,A9547,HCPCS,343,RC,outpatient,,9946,9946,,8444.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2486.5,22,,percent of total billed charges,,,,,,,,,8951.4,90,,percent of total billed charges,,,8235.29,82.8,,percent of total billed charges,,,8454.1,85,,percent of total billed charges,,,,,,,,,8752.48,88,,percent of total billed charges,,,,,,,,,7598.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2486.5,22,,percent of total billed charges,,,9050.86,91,,percent of total billed charges,,,9448.7,95,,percent of total billed charges,,,8255.18,83,,percent of total billed charges,,,8255.18,83,,percent of total billed charges,,,,,,,,,,,,,,,8255.18,83,,percent of total billed charges,,,9448.7,95,,percent of total billed charges,,,8951.4,90,,percent of total billed charges,,,8951.4,90,,percent of total billed charges,,,8155.72,82,,percent of total billed charges,,,8951.4,90,,percent of total billed charges,,,8454.1,85,,percent of total billed charges,,2486.5,9448.7,
NM DOSE MAA/DOSE (<10 mCi),28103217,CDM,A9540,HCPCS,343,RC,outpatient,,282,282,,239.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.5,22,,percent of total billed charges,,,,,,,,,253.8,90,,percent of total billed charges,,,233.5,82.8,,percent of total billed charges,,,239.7,85,,percent of total billed charges,,,,,,,,,248.16,88,,percent of total billed charges,,,,,,,,,215.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70.5,22,,percent of total billed charges,,,256.62,91,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,,,,,,,,,,,,,234.06,83,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,231.24,82,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,239.7,85,,percent of total billed charges,,70.5,267.9,
NM GI BLEED,28103218,CDM,78278,CPT,340,RC,outpatient,TC,2549,2549,,2164.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,637.25,22,,percent of total billed charges,,,,,,,,,2294.1,90,,percent of total billed charges,,,2110.57,82.8,,percent of total billed charges,,,2166.65,85,,percent of total billed charges,,,,,,,,,2243.12,88,,percent of total billed charges,,,,,,,,,1947.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,637.25,22,,percent of total billed charges,,,2319.59,91,,percent of total billed charges,,,2421.55,95,,percent of total billed charges,,,2115.67,83,,percent of total billed charges,,,2115.67,83,,percent of total billed charges,,,,,,,,,,,,,,,2115.67,83,,percent of total billed charges,,,2421.55,95,,percent of total billed charges,,,2294.1,90,,percent of total billed charges,,,2294.1,90,,percent of total billed charges,,,2090.18,82,,percent of total billed charges,,,2294.1,90,,percent of total billed charges,,,2166.65,85,,percent of total billed charges,,637.25,2421.55,
NM DOSE TECHNITIUM/mCi,28103219,CDM,A9512,HCPCS,343,RC,outpatient,,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.5,22,,percent of total billed charges,,,,,,,,,239.4,90,,percent of total billed charges,,,220.25,82.8,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.5,22,,percent of total billed charges,,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,66.5,252.7,
NM DOSE TECHNETIUM TC-99 PYROPH (25mCi),28103220,CDM,A9538,HCPCS,636,RC,outpatient,,435,435,,369.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.75,22,,percent of total billed charges,,,,,,,,,391.5,90,,percent of total billed charges,,,360.18,82.8,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,,,,,,,,382.8,88,,percent of total billed charges,,,,,,,,,332.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108.75,22,,percent of total billed charges,,,395.85,91,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,,,,,,,,,,,,,361.05,83,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,356.7,82,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,108.75,413.25,
NM DOSE IODINE I123/100 uCi,28103221,CDM,A9516,HCPCS,636,RC,outpatient,,415,415,,352.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,103.75,22,,percent of total billed charges,,,,,,,,,373.5,90,,percent of total billed charges,,,343.62,82.8,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,,,,,,,,365.2,88,,percent of total billed charges,,,,,,,,,317.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,103.75,22,,percent of total billed charges,,,377.65,91,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,,,,,,,,,,,,,344.45,83,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,340.3,82,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,103.75,394.25,
NM DOSE CARDIOLITE/DOSE (<40mCi),28103223,CDM,A9500,HCPCS,636,RC,outpatient,,1032,1032,,876.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,258,22,,percent of total billed charges,,,,,,,,,928.8,90,,percent of total billed charges,,,854.5,82.8,,percent of total billed charges,,,877.2,85,,percent of total billed charges,,,,,,,,,908.16,88,,percent of total billed charges,,,,,,,,,788.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,258,22,,percent of total billed charges,,,939.12,91,,percent of total billed charges,,,980.4,95,,percent of total billed charges,,,856.56,83,,percent of total billed charges,,,856.56,83,,percent of total billed charges,,,,,,,,,,,,,,,856.56,83,,percent of total billed charges,,,980.4,95,,percent of total billed charges,,,928.8,90,,percent of total billed charges,,,928.8,90,,percent of total billed charges,,,846.24,82,,percent of total billed charges,,,928.8,90,,percent of total billed charges,,,877.2,85,,percent of total billed charges,,258,980.4,
NM DOSE THALLIUM/mCi,28103224,CDM,A9505,HCPCS,636,RC,outpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.25,22,,percent of total billed charges,,,,,,,,,267.3,90,,percent of total billed charges,,,245.92,82.8,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.25,22,,percent of total billed charges,,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,74.25,282.15,
NM DOSE IODINE I131/0.5 mCi,28103225,CDM,A9508,HCPCS,636,RC,outpatient,,1229,1229,,1043.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,307.25,22,,percent of total billed charges,,,,,,,,,1106.1,90,,percent of total billed charges,,,1017.61,82.8,,percent of total billed charges,,,1044.65,85,,percent of total billed charges,,,,,,,,,1081.52,88,,percent of total billed charges,,,,,,,,,938.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,307.25,22,,percent of total billed charges,,,1118.39,91,,percent of total billed charges,,,1167.55,95,,percent of total billed charges,,,1020.07,83,,percent of total billed charges,,,1020.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1020.07,83,,percent of total billed charges,,,1167.55,95,,percent of total billed charges,,,1106.1,90,,percent of total billed charges,,,1106.1,90,,percent of total billed charges,,,1007.78,82,,percent of total billed charges,,,1106.1,90,,percent of total billed charges,,,1044.65,85,,percent of total billed charges,,307.25,1167.55,
NM RENAL W/FLOW,28103226,CDM,78707,CPT,340,RC,outpatient,TC,2821,2821,,2395.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,705.25,22,,percent of total billed charges,,,,,,,,,2538.9,90,,percent of total billed charges,,,2335.79,82.8,,percent of total billed charges,,,2397.85,85,,percent of total billed charges,,,,,,,,,2482.48,88,,percent of total billed charges,,,,,,,,,2155.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,705.25,22,,percent of total billed charges,,,2567.11,91,,percent of total billed charges,,,2679.95,95,,percent of total billed charges,,,2341.43,83,,percent of total billed charges,,,2341.43,83,,percent of total billed charges,,,,,,,,,,,,,,,2341.43,83,,percent of total billed charges,,,2679.95,95,,percent of total billed charges,,,2538.9,90,,percent of total billed charges,,,2538.9,90,,percent of total billed charges,,,2313.22,82,,percent of total billed charges,,,2538.9,90,,percent of total billed charges,,,2397.85,85,,percent of total billed charges,,705.25,2679.95,
NM DOSE MAG 3/DOSE (<15mCi),28103227,CDM,A9562,HCPCS,636,RC,outpatient,,1198,1198,,1017.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,299.5,22,,percent of total billed charges,,,,,,,,,1078.2,90,,percent of total billed charges,,,991.94,82.8,,percent of total billed charges,,,1018.3,85,,percent of total billed charges,,,,,,,,,1054.24,88,,percent of total billed charges,,,,,,,,,915.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,299.5,22,,percent of total billed charges,,,1090.18,91,,percent of total billed charges,,,1138.1,95,,percent of total billed charges,,,994.34,83,,percent of total billed charges,,,994.34,83,,percent of total billed charges,,,,,,,,,,,,,,,994.34,83,,percent of total billed charges,,,1138.1,95,,percent of total billed charges,,,1078.2,90,,percent of total billed charges,,,1078.2,90,,percent of total billed charges,,,982.36,82,,percent of total billed charges,,,1078.2,90,,percent of total billed charges,,,1018.3,85,,percent of total billed charges,,299.5,1138.1,
NM DOSE SULFUR COLLOID/DOSE (<20mCi),28103228,CDM,A9541,HCPCS,343,RC,outpatient,,623,623,,528.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,155.75,22,,percent of total billed charges,,,,,,,,,560.7,90,,percent of total billed charges,,,515.84,82.8,,percent of total billed charges,,,529.55,85,,percent of total billed charges,,,,,,,,,548.24,88,,percent of total billed charges,,,,,,,,,475.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,155.75,22,,percent of total billed charges,,,566.93,91,,percent of total billed charges,,,591.85,95,,percent of total billed charges,,,517.09,83,,percent of total billed charges,,,517.09,83,,percent of total billed charges,,,,,,,,,,,,,,,517.09,83,,percent of total billed charges,,,591.85,95,,percent of total billed charges,,,560.7,90,,percent of total billed charges,,,560.7,90,,percent of total billed charges,,,510.86,82,,percent of total billed charges,,,560.7,90,,percent of total billed charges,,,529.55,85,,percent of total billed charges,,155.75,591.85,
NM DOSE ULTRA TAG/DOSE (<30mCi),28103229,CDM,A9560,HCPCS,343,RC,outpatient,,769,769,,652.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.25,22,,percent of total billed charges,,,,,,,,,692.1,90,,percent of total billed charges,,,636.73,82.8,,percent of total billed charges,,,653.65,85,,percent of total billed charges,,,,,,,,,676.72,88,,percent of total billed charges,,,,,,,,,587.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.25,22,,percent of total billed charges,,,699.79,91,,percent of total billed charges,,,730.55,95,,percent of total billed charges,,,638.27,83,,percent of total billed charges,,,638.27,83,,percent of total billed charges,,,,,,,,,,,,,,,638.27,83,,percent of total billed charges,,,730.55,95,,percent of total billed charges,,,692.1,90,,percent of total billed charges,,,692.1,90,,percent of total billed charges,,,630.58,82,,percent of total billed charges,,,692.1,90,,percent of total billed charges,,,653.65,85,,percent of total billed charges,,192.25,730.55,
NM DOSE THALLIUM/mCi,28103230,CDM,A9505,HCPCS,636,RC,outpatient,,1487,1487,,1262.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,371.75,22,,percent of total billed charges,,,,,,,,,1338.3,90,,percent of total billed charges,,,1231.24,82.8,,percent of total billed charges,,,1263.95,85,,percent of total billed charges,,,,,,,,,1308.56,88,,percent of total billed charges,,,,,,,,,1136.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,371.75,22,,percent of total billed charges,,,1353.17,91,,percent of total billed charges,,,1412.65,95,,percent of total billed charges,,,1234.21,83,,percent of total billed charges,,,1234.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1234.21,83,,percent of total billed charges,,,1412.65,95,,percent of total billed charges,,,1338.3,90,,percent of total billed charges,,,1338.3,90,,percent of total billed charges,,,1219.34,82,,percent of total billed charges,,,1338.3,90,,percent of total billed charges,,,1263.95,85,,percent of total billed charges,,371.75,1412.65,
NM WHITE BLOOD CELL TAGGED,28103250,CDM,78300,CPT,340,RC,outpatient,TC,4849,4849,,4116.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1212.25,22,,percent of total billed charges,,,,,,,,,4364.1,90,,percent of total billed charges,,,4014.97,82.8,,percent of total billed charges,,,4121.65,85,,percent of total billed charges,,,,,,,,,4267.12,88,,percent of total billed charges,,,,,,,,,3704.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1212.25,22,,percent of total billed charges,,,4412.59,91,,percent of total billed charges,,,4606.55,95,,percent of total billed charges,,,4024.67,83,,percent of total billed charges,,,4024.67,83,,percent of total billed charges,,,,,,,,,,,,,,,4024.67,83,,percent of total billed charges,,,4606.55,95,,percent of total billed charges,,,4364.1,90,,percent of total billed charges,,,4364.1,90,,percent of total billed charges,,,3976.18,82,,percent of total billed charges,,,4364.1,90,,percent of total billed charges,,,4121.65,85,,percent of total billed charges,,1212.25,4606.55,
NM GASTRIC EMPTYING,28103260,CDM,78264,CPT,340,RC,outpatient,TC,2756,2756,,2339.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,689,22,,percent of total billed charges,,,,,,,,,2480.4,90,,percent of total billed charges,,,2281.97,82.8,,percent of total billed charges,,,2342.6,85,,percent of total billed charges,,,,,,,,,2425.28,88,,percent of total billed charges,,,,,,,,,2105.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,689,22,,percent of total billed charges,,,2507.96,91,,percent of total billed charges,,,2618.2,95,,percent of total billed charges,,,2287.48,83,,percent of total billed charges,,,2287.48,83,,percent of total billed charges,,,,,,,,,,,,,,,2287.48,83,,percent of total billed charges,,,2618.2,95,,percent of total billed charges,,,2480.4,90,,percent of total billed charges,,,2480.4,90,,percent of total billed charges,,,2259.92,82,,percent of total billed charges,,,2480.4,90,,percent of total billed charges,,,2342.6,85,,percent of total billed charges,,689,2618.2,
NM DOSE IN-111 PENTETATE PER.5MC,28103290,CDM,A9548,HCPCS,343,RC,outpatient,,1851,1851,,1571.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,462.75,22,,percent of total billed charges,,,,,,,,,1665.9,90,,percent of total billed charges,,,1532.63,82.8,,percent of total billed charges,,,1573.35,85,,percent of total billed charges,,,,,,,,,1628.88,88,,percent of total billed charges,,,,,,,,,1414.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,462.75,22,,percent of total billed charges,,,1684.41,91,,percent of total billed charges,,,1758.45,95,,percent of total billed charges,,,1536.33,83,,percent of total billed charges,,,1536.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1536.33,83,,percent of total billed charges,,,1758.45,95,,percent of total billed charges,,,1665.9,90,,percent of total billed charges,,,1665.9,90,,percent of total billed charges,,,1517.82,82,,percent of total billed charges,,,1665.9,90,,percent of total billed charges,,,1573.35,85,,percent of total billed charges,,462.75,1758.45,
NM TUMOR LOCAL BODY2OR>DAY,28444220,CDM,78804,CPT,340,RC,outpatient,TC,3260,3260,,2767.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,815,22,,percent of total billed charges,,,,,,,,,2934,90,,percent of total billed charges,,,2699.28,82.8,,percent of total billed charges,,,2771,85,,percent of total billed charges,,,,,,,,,2868.8,88,,percent of total billed charges,,,,,,,,,2490.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,815,22,,percent of total billed charges,,,2966.6,91,,percent of total billed charges,,,3097,95,,percent of total billed charges,,,2705.8,83,,percent of total billed charges,,,2705.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2705.8,83,,percent of total billed charges,,,3097,95,,percent of total billed charges,,,2934,90,,percent of total billed charges,,,2934,90,,percent of total billed charges,,,2673.2,82,,percent of total billed charges,,,2934,90,,percent of total billed charges,,,2771,85,,percent of total billed charges,,815,3097,
NM OCTREOSCAN 2 OR>DAY,28544220,CDM,78804,CPT,340,RC,outpatient,TC,9219,9219,,7826.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2304.75,22,,percent of total billed charges,,,,,,,,,8297.1,90,,percent of total billed charges,,,7633.33,82.8,,percent of total billed charges,,,7836.15,85,,percent of total billed charges,,,,,,,,,8112.72,88,,percent of total billed charges,,,,,,,,,7043.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2304.75,22,,percent of total billed charges,,,8389.29,91,,percent of total billed charges,,,8758.05,95,,percent of total billed charges,,,7651.77,83,,percent of total billed charges,,,7651.77,83,,percent of total billed charges,,,,,,,,,,,,,,,7651.77,83,,percent of total billed charges,,,8758.05,95,,percent of total billed charges,,,8297.1,90,,percent of total billed charges,,,8297.1,90,,percent of total billed charges,,,7559.58,82,,percent of total billed charges,,,8297.1,90,,percent of total billed charges,,,7836.15,85,,percent of total billed charges,,2304.75,8758.05,
BEDSIDE PROCDURE-OB,830082,CDM,,,360,RC,outpatient,,536,536,,455.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,134,22,,percent of total billed charges,,,,,,,,,482.4,90,,percent of total billed charges,,,443.81,82.8,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,,,,,,,,471.68,88,,percent of total billed charges,,,,,,,,,409.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,134,22,,percent of total billed charges,,,487.76,91,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,,,,,,,,,,,,,444.88,83,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,439.52,82,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,134,509.2,
LABOR PER HOUR,831000,CDM,,,721,RC,outpatient,,788,788,,669.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,197,22,,percent of total billed charges,,,,,,,,,709.2,90,,percent of total billed charges,,,652.46,82.8,,percent of total billed charges,,,669.8,85,,percent of total billed charges,,,,,,,,,693.44,88,,percent of total billed charges,,,,,,,,,602.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,197,22,,percent of total billed charges,,,717.08,91,,percent of total billed charges,,,748.6,95,,percent of total billed charges,,,654.04,83,,percent of total billed charges,,,654.04,83,,percent of total billed charges,,,,,,,,,,,,,,,654.04,83,,percent of total billed charges,,,748.6,95,,percent of total billed charges,,,709.2,90,,percent of total billed charges,,,709.2,90,,percent of total billed charges,,,646.16,82,,percent of total billed charges,,,709.2,90,,percent of total billed charges,,,669.8,85,,percent of total billed charges,,197,748.6,
NURSING CARE OBSERVATION FIRST HOUR,832003,CDM,G0378,HCPCS,762,RC,outpatient,,1475,1475,,1252.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,368.75,22,,percent of total billed charges,,,,,,,,,1327.5,90,,percent of total billed charges,,,1221.3,82.8,,percent of total billed charges,,,1253.75,85,,percent of total billed charges,,,,,,,,,1298,88,,percent of total billed charges,,,,,,,,,1126.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,368.75,22,,percent of total billed charges,,,1342.25,91,,percent of total billed charges,,,1401.25,95,,percent of total billed charges,,,1224.25,83,,percent of total billed charges,,,1224.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1224.25,83,,percent of total billed charges,,,1401.25,95,,percent of total billed charges,,,1327.5,90,,percent of total billed charges,,,1327.5,90,,percent of total billed charges,,,1209.5,82,,percent of total billed charges,,,1327.5,90,,percent of total billed charges,,,1253.75,85,,percent of total billed charges,,368.75,1401.25,
NURSING CARE OBSERVATION EACH ADDTL,832011,CDM,G0378,HCPCS,762,RC,outpatient,,178,178,,151.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.5,22,,percent of total billed charges,,,,,,,,,160.2,90,,percent of total billed charges,,,147.38,82.8,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,,,,,,,,156.64,88,,percent of total billed charges,,,,,,,,,135.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.5,22,,percent of total billed charges,,,161.98,91,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,,,,,,,,,,,,,147.74,83,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,145.96,82,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,44.5,169.1,
EXTENDED RECOVERY 1ST HOUR,832015,CDM,,,710,RC,outpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.25,22,,percent of total billed charges,,,,,,,,,188.1,90,,percent of total billed charges,,,173.05,82.8,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.25,22,,percent of total billed charges,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,52.25,198.55,
EXTENDED RECOVERY EACH ADDTL HOUR,832017,CDM,,,710,RC,outpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.25,22,,percent of total billed charges,,,,,,,,,98.1,90,,percent of total billed charges,,,90.25,82.8,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.25,22,,percent of total billed charges,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,27.25,103.55,
PKU,832030,CDM,84030,CPT,300,RC,outpatient,,295,295,,250.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.75,22,,percent of total billed charges,,,,,,,,,265.5,90,,percent of total billed charges,,,244.26,82.8,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,,,,,,,,259.6,88,,percent of total billed charges,,,,,,,,,225.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.75,22,,percent of total billed charges,,,268.45,91,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,,,,,,,,,,,,,244.85,83,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,241.9,82,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,73.75,280.25,
"CIRCUMCISION, EXCEPT NEWBORN",832031,CDM,54150,CPT,360,RC,outpatient,,1021,1021,,866.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,255.25,22,,percent of total billed charges,,,,,,,,,918.9,90,,percent of total billed charges,,,845.39,82.8,,percent of total billed charges,,,867.85,85,,percent of total billed charges,,,,,,,,,898.48,88,,percent of total billed charges,,,,,,,,,780.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,255.25,22,,percent of total billed charges,,,929.11,91,,percent of total billed charges,,,969.95,95,,percent of total billed charges,,,847.43,83,,percent of total billed charges,,,847.43,83,,percent of total billed charges,,,,,,,,,,,,,,,847.43,83,,percent of total billed charges,,,969.95,95,,percent of total billed charges,,,918.9,90,,percent of total billed charges,,,918.9,90,,percent of total billed charges,,,837.22,82,,percent of total billed charges,,,918.9,90,,percent of total billed charges,,,867.85,85,,percent of total billed charges,,255.25,969.95,
"BILIRUBIN, TOTAL, TRANSCUTANEOUS",832032,CDM,88720,CPT,300,RC,outpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27,22,,percent of total billed charges,,,,,,,,,97.2,90,,percent of total billed charges,,,89.42,82.8,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27,22,,percent of total billed charges,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,27,102.6,
BLOOD ADMINISTRATION SERVICE,832035,CDM,36430,CPT,391,RC,outpatient,,1766,1766,,1499.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,441.5,22,,percent of total billed charges,,,,,,,,,1589.4,90,,percent of total billed charges,,,1462.25,82.8,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,,,,,,,,1554.08,88,,percent of total billed charges,,,,,,,,,1349.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,441.5,22,,percent of total billed charges,,,1607.06,91,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.78,83,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1448.12,82,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,441.5,1677.7,
BLOOD ADIN UP TO 4 HOURS(V-11-20),832036,CDM,36430,CPT,391,RC,outpatient,,1372,1372,,1164.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,343,22,,percent of total billed charges,,,,,,,,,1234.8,90,,percent of total billed charges,,,1136.02,82.8,,percent of total billed charges,,,1166.2,85,,percent of total billed charges,,,,,,,,,1207.36,88,,percent of total billed charges,,,,,,,,,1048.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,343,22,,percent of total billed charges,,,1248.52,91,,percent of total billed charges,,,1303.4,95,,percent of total billed charges,,,1138.76,83,,percent of total billed charges,,,1138.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1138.76,83,,percent of total billed charges,,,1303.4,95,,percent of total billed charges,,,1234.8,90,,percent of total billed charges,,,1234.8,90,,percent of total billed charges,,,1125.04,82,,percent of total billed charges,,,1234.8,90,,percent of total billed charges,,,1166.2,85,,percent of total billed charges,,343,1303.4,
BLOOD ADMIN UP TO 6 HOURS(V-11-20),832037,CDM,36430,CPT,391,RC,outpatient,,1709,1709,,1450.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,427.25,22,,percent of total billed charges,,,,,,,,,1538.1,90,,percent of total billed charges,,,1415.05,82.8,,percent of total billed charges,,,1452.65,85,,percent of total billed charges,,,,,,,,,1503.92,88,,percent of total billed charges,,,,,,,,,1305.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,427.25,22,,percent of total billed charges,,,1555.19,91,,percent of total billed charges,,,1623.55,95,,percent of total billed charges,,,1418.47,83,,percent of total billed charges,,,1418.47,83,,percent of total billed charges,,,,,,,,,,,,,,,1418.47,83,,percent of total billed charges,,,1623.55,95,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1401.38,82,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1452.65,85,,percent of total billed charges,,427.25,1623.55,
BLOOD ADMIN OVER 6 HOURS(V-11-20),832038,CDM,36430,CPT,391,RC,outpatient,,2137,2137,,1814.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,534.25,22,,percent of total billed charges,,,,,,,,,1923.3,90,,percent of total billed charges,,,1769.44,82.8,,percent of total billed charges,,,1816.45,85,,percent of total billed charges,,,,,,,,,1880.56,88,,percent of total billed charges,,,,,,,,,1632.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,534.25,22,,percent of total billed charges,,,1944.67,91,,percent of total billed charges,,,2030.15,95,,percent of total billed charges,,,1773.71,83,,percent of total billed charges,,,1773.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1773.71,83,,percent of total billed charges,,,2030.15,95,,percent of total billed charges,,,1923.3,90,,percent of total billed charges,,,1923.3,90,,percent of total billed charges,,,1752.34,82,,percent of total billed charges,,,1923.3,90,,percent of total billed charges,,,1816.45,85,,percent of total billed charges,,534.25,2030.15,
"SUBCUTANEOUS INF,INITIAL, UP TO 1 HOUR",832048,CDM,96369,CPT,260,RC,outpatient,,672,672,,570.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,168,22,,percent of total billed charges,,,,,,,,,604.8,90,,percent of total billed charges,,,556.42,82.8,,percent of total billed charges,,,571.2,85,,percent of total billed charges,,,,,,,,,591.36,88,,percent of total billed charges,,,,,,,,,513.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,168,22,,percent of total billed charges,,,611.52,91,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,,,,,,,,,,,,,557.76,83,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,551.04,82,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,571.2,85,,percent of total billed charges,,168,638.4,
"IV INFUSION, HYDRATION, UP TO 1 HOUR",832050,CDM,96360,CPT,260,RC,outpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208,22,,percent of total billed charges,,,,,,,,,748.8,90,,percent of total billed charges,,,688.9,82.8,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208,22,,percent of total billed charges,,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,208,790.4,
"IV INFUSION, HYDRATION, EA ADDTL HOUR",832051,CDM,96361,CPT,260,RC,outpatient,XU,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.75,22,,percent of total billed charges,,,,,,,,,225.9,90,,percent of total billed charges,,,207.83,82.8,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.75,22,,percent of total billed charges,,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,62.75,238.45,
"IV INFUSION, THERAPEUTIC, UP TO 1 HOUR",832052,CDM,96365,CPT,260,RC,outpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208,22,,percent of total billed charges,,,,,,,,,748.8,90,,percent of total billed charges,,,688.9,82.8,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208,22,,percent of total billed charges,,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,208,790.4,
"IV INFUSION, THERAPEUTIC, EA ADDTL HOUR",832053,CDM,96366,CPT,260,RC,outpatient,XU,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.75,22,,percent of total billed charges,,,,,,,,,225.9,90,,percent of total billed charges,,,207.83,82.8,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.75,22,,percent of total billed charges,,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,62.75,238.45,
CONCURRENT ADDTL MEDICATED SOLUTION,832054,CDM,96368,CPT,260,RC,outpatient,XU,522,522,,443.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.5,22,,percent of total billed charges,,,,,,,,,469.8,90,,percent of total billed charges,,,432.22,82.8,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,,,,,,,,459.36,88,,percent of total billed charges,,,,,,,,,398.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.5,22,,percent of total billed charges,,,475.02,91,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,,,,,,,,,,,,,433.26,83,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,428.04,82,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,130.5,495.9,
IM/SQ INJECTION,832055,CDM,96372,CPT,260,RC,outpatient,XU,352,352,,298.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88,22,,percent of total billed charges,,,,,,,,,316.8,90,,percent of total billed charges,,,291.46,82.8,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,,,,,,,,309.76,88,,percent of total billed charges,,,,,,,,,268.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88,22,,percent of total billed charges,,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,,,,,,,,,,,,,292.16,83,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,288.64,82,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,88,334.4,
"IVP, SINGLE OR INITIAL",832056,CDM,96374,CPT,260,RC,outpatient,XU,436,436,,370.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109,22,,percent of total billed charges,,,,,,,,,392.4,90,,percent of total billed charges,,,361.01,82.8,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,,,,,,,,383.68,88,,percent of total billed charges,,,,,,,,,333.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109,22,,percent of total billed charges,,,396.76,91,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,,,,,,,,,,,,,361.88,83,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,357.52,82,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,109,414.2,
"IVP, EA ADDTL OF NEW SUBSTANCE/DRUG",832057,CDM,96375,CPT,260,RC,outpatient,XU,359,359,,304.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.75,22,,percent of total billed charges,,,,,,,,,323.1,90,,percent of total billed charges,,,297.25,82.8,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,,,,,,,,315.92,88,,percent of total billed charges,,,,,,,,,274.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.75,22,,percent of total billed charges,,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,,,,,,,,,,,,,297.97,83,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,294.38,82,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,89.75,341.05,
IM INJECTION - ANTIBIOTIC,832058,CDM,96372,CPT,260,RC,outpatient,XU,319,319,,270.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.75,22,,percent of total billed charges,,,,,,,,,287.1,90,,percent of total billed charges,,,264.13,82.8,,percent of total billed charges,,,271.15,85,,percent of total billed charges,,,,,,,,,280.72,88,,percent of total billed charges,,,,,,,,,243.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.75,22,,percent of total billed charges,,,290.29,91,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,264.77,83,,percent of total billed charges,,,,,,,,,,,,,,,264.77,83,,percent of total billed charges,,,303.05,95,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,261.58,82,,percent of total billed charges,,,287.1,90,,percent of total billed charges,,,271.15,85,,percent of total billed charges,,79.75,303.05,
"IV INFUSION, ADDT'L SEQUENTIAL INF",832059,CDM,96367,CPT,260,RC,outpatient,,501,501,,425.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125.25,22,,percent of total billed charges,,,,,,,,,450.9,90,,percent of total billed charges,,,414.83,82.8,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,,,,,,,,440.88,88,,percent of total billed charges,,,,,,,,,382.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125.25,22,,percent of total billed charges,,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,,,,,,,,,,,,,415.83,83,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,410.82,82,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,125.25,475.95,
"IVP, EA ADDTL SEQUENTIAL INTRA PUSH",832060,CDM,96376,CPT,260,RC,outpatient,XU,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
FETAL NON STRESS MONITORING,832100,CDM,59025,CPT,920,RC,outpatient,,759,759,,644.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,189.75,22,,percent of total billed charges,,,,,,,,,683.1,90,,percent of total billed charges,,,628.45,82.8,,percent of total billed charges,,,645.15,85,,percent of total billed charges,,,,,,,,,667.92,88,,percent of total billed charges,,,,,,,,,579.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,189.75,22,,percent of total billed charges,,,690.69,91,,percent of total billed charges,,,721.05,95,,percent of total billed charges,,,629.97,83,,percent of total billed charges,,,629.97,83,,percent of total billed charges,,,,,,,,,,,,,,,629.97,83,,percent of total billed charges,,,721.05,95,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,622.38,82,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,645.15,85,,percent of total billed charges,,189.75,721.05,
INSERT DRUG IMPLANT DEVICE,832200,CDM,11981,CPT,360,RC,outpatient,,3854,3854,,3272.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,963.5,22,,percent of total billed charges,,,,,,,,,3468.6,90,,percent of total billed charges,,,3191.11,82.8,,percent of total billed charges,,,3275.9,85,,percent of total billed charges,,,,,,,,,3391.52,88,,percent of total billed charges,,,,,,,,,2944.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,963.5,22,,percent of total billed charges,,,3507.14,91,,percent of total billed charges,,,3661.3,95,,percent of total billed charges,,,3198.82,83,,percent of total billed charges,,,3198.82,83,,percent of total billed charges,,,,,,,,,,,,,,,3198.82,83,,percent of total billed charges,,,3661.3,95,,percent of total billed charges,,,3468.6,90,,percent of total billed charges,,,3468.6,90,,percent of total billed charges,,,3160.28,82,,percent of total billed charges,,,3468.6,90,,percent of total billed charges,,,3275.9,85,,percent of total billed charges,,963.5,3661.3,
CODE BLUE NURSERY,932060,CDM,92950,CPT,480,RC,outpatient,,2261,2261,,1919.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,565.25,22,,percent of total billed charges,,,,,,,,,2034.9,90,,percent of total billed charges,,,1872.11,82.8,,percent of total billed charges,,,1921.85,85,,percent of total billed charges,,,,,,,,,1989.68,88,,percent of total billed charges,,,,,,,,,1727.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,565.25,22,,percent of total billed charges,,,2057.51,91,,percent of total billed charges,,,2147.95,95,,percent of total billed charges,,,1876.63,83,,percent of total billed charges,,,1876.63,83,,percent of total billed charges,,,,,,,,,,,,,,,1876.63,83,,percent of total billed charges,,,2147.95,95,,percent of total billed charges,,,2034.9,90,,percent of total billed charges,,,2034.9,90,,percent of total billed charges,,,1854.02,82,,percent of total billed charges,,,2034.9,90,,percent of total billed charges,,,1921.85,85,,percent of total billed charges,,565.25,2147.95,
TYPMANOMETRY,932500,CDM,92551,CPT,471,RC,outpatient,,133,133,,112.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.25,22,,percent of total billed charges,,,,,,,,,119.7,90,,percent of total billed charges,,,110.12,82.8,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,,,,,,,,117.04,88,,percent of total billed charges,,,,,,,,,101.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.25,22,,percent of total billed charges,,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,,,,,,,,,,,,,110.39,83,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,109.06,82,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,33.25,126.35,
CIRCUMCISION,932508,CDM,54150,CPT,723,RC,outpatient,,912,912,,774.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,228,22,,percent of total billed charges,,,,,,,,,820.8,90,,percent of total billed charges,,,755.14,82.8,,percent of total billed charges,,,775.2,85,,percent of total billed charges,,,,,,,,,802.56,88,,percent of total billed charges,,,,,,,,,696.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,228,22,,percent of total billed charges,,,829.92,91,,percent of total billed charges,,,866.4,95,,percent of total billed charges,,,756.96,83,,percent of total billed charges,,,756.96,83,,percent of total billed charges,,,,,,,,,,,,,,,756.96,83,,percent of total billed charges,,,866.4,95,,percent of total billed charges,,,820.8,90,,percent of total billed charges,,,820.8,90,,percent of total billed charges,,,747.84,82,,percent of total billed charges,,,820.8,90,,percent of total billed charges,,,775.2,85,,percent of total billed charges,,228,866.4,
* DELIVERY CARE (V1004),1730015,CDM,,,722,RC,outpatient,,920,920,,781.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,230,22,,percent of total billed charges,,,,,,,,,828,90,,percent of total billed charges,,,761.76,82.8,,percent of total billed charges,,,782,85,,percent of total billed charges,,,,,,,,,809.6,88,,percent of total billed charges,,,,,,,,,702.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,230,22,,percent of total billed charges,,,837.2,91,,percent of total billed charges,,,874,95,,percent of total billed charges,,,763.6,83,,percent of total billed charges,,,763.6,83,,percent of total billed charges,,,,,,,,,,,,,,,763.6,83,,percent of total billed charges,,,874,95,,percent of total billed charges,,,828,90,,percent of total billed charges,,,828,90,,percent of total billed charges,,,754.4,82,,percent of total billed charges,,,828,90,,percent of total billed charges,,,782,85,,percent of total billed charges,,230,874,
FETAL MONITOR W INTERPRETATION,1731021,CDM,59050,CPT,920,RC,outpatient,,768,768,,652.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192,22,,percent of total billed charges,,,,,,,,,691.2,90,,percent of total billed charges,,,635.9,82.8,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,,,,,,,,675.84,88,,percent of total billed charges,,,,,,,,,586.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192,22,,percent of total billed charges,,,698.88,91,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,,,,,,,,,,,,,637.44,83,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,629.76,82,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,192,729.6,
FETAL MONITOR INTERNAL,2331047,CDM,59050,CPT,920,RC,outpatient,,768,768,,652.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192,22,,percent of total billed charges,,,,,,,,,691.2,90,,percent of total billed charges,,,635.9,82.8,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,,,,,,,,675.84,88,,percent of total billed charges,,,,,,,,,586.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192,22,,percent of total billed charges,,,698.88,91,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,637.44,83,,percent of total billed charges,,,,,,,,,,,,,,,637.44,83,,percent of total billed charges,,,729.6,95,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,629.76,82,,percent of total billed charges,,,691.2,90,,percent of total billed charges,,,652.8,85,,percent of total billed charges,,192,729.6,
FETAL CONTRACT STRESS TEST,2332524,CDM,59020,CPT,920,RC,outpatient,,983,983,,834.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,245.75,22,,percent of total billed charges,,,,,,,,,884.7,90,,percent of total billed charges,,,813.92,82.8,,percent of total billed charges,,,835.55,85,,percent of total billed charges,,,,,,,,,865.04,88,,percent of total billed charges,,,,,,,,,751.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,245.75,22,,percent of total billed charges,,,894.53,91,,percent of total billed charges,,,933.85,95,,percent of total billed charges,,,815.89,83,,percent of total billed charges,,,815.89,83,,percent of total billed charges,,,,,,,,,,,,,,,815.89,83,,percent of total billed charges,,,933.85,95,,percent of total billed charges,,,884.7,90,,percent of total billed charges,,,884.7,90,,percent of total billed charges,,,806.06,82,,percent of total billed charges,,,884.7,90,,percent of total billed charges,,,835.55,85,,percent of total billed charges,,245.75,933.85,
* SCALP ELECTRODE (V0904),23301431,CDM,93012,CPT,732,RC,outpatient,,29,29,,24.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.25,22,,percent of total billed charges,,,,,,,,,26.1,90,,percent of total billed charges,,,24.01,82.8,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,,,,,,,,25.52,88,,percent of total billed charges,,,,,,,,,22.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.25,22,,percent of total billed charges,,,26.39,91,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,,,,,,,,,,,,,24.07,83,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,23.78,82,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,7.25,27.55,
OT THERA EX FOR STRENGTH EA 15 MIN ANNEX,5902025,CDM,97110,CPT,430,RC,outpatient,KX,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
"OT NER-MC RE-ED,BAL/CRD/PRR/PT 15M ANNEX",5902026,CDM,97112,CPT,430,RC,outpatient,KX,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.5,22,,percent of total billed charges,,,,,,,,,214.2,90,,percent of total billed charges,,,197.06,82.8,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.5,22,,percent of total billed charges,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,59.5,226.1,
OT FUNCTIONAL THERAPEUTIC ACTIVITY ANNEX,5902027,CDM,97530,CPT,430,RC,outpatient,KX,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
"OT DEV CG SKL(AN,MEM,PB SOV/EA15MN ANNEX",5902028,CDM,97129,CPT,430,RC,outpatient,KX,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
OT SELF CE/HE MAN. TRNG. EA 15 MIN ANNEX,5902029,CDM,97535,CPT,430,RC,outpatient,KX,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62,22,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,205.34,82.8,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62,22,,percent of total billed charges,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,62,235.6,
OT COM/WK RE-INTEG. TRNG. EA 15MIN ANNEX,5902030,CDM,97537,CPT,430,RC,outpatient,KX,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38,22,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,125.86,82.8,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38,22,,percent of total billed charges,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,38,144.4,
OT W/C MGT/PROPULSON TMG 15 MIN ANNEX,5902031,CDM,97542,CPT,430,RC,outpatient,KX,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
"OT ORIC MGT&TRNG, UE&LE, EA 15 MIN ANNEX",5902032,CDM,97760,CPT,430,RC,outpatient,KX,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
"OT NER-MC RE-ED,BAL/CRD/PRR/PT 15M ANN T",5902035,CDM,97112,CPT,430,RC,outpatient,CO,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.5,22,,percent of total billed charges,,,,,,,,,214.2,90,,percent of total billed charges,,,197.06,82.8,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.5,22,,percent of total billed charges,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,59.5,226.1,
OT OCCUP THER EVAL LOW COMPLEX,35200302,CDM,97165,CPT,434,RC,outpatient,GO,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153,22,,percent of total billed charges,,,,,,,,,550.8,90,,percent of total billed charges,,,506.74,82.8,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153,22,,percent of total billed charges,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,153,581.4,
OT OCCU THER IPA EVAL LOW COMPLEX,35200303,CDM,97165,CPT,434,RC,outpatient,GO,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.25,22,,percent of total billed charges,,,,,,,,,137.7,90,,percent of total billed charges,,,126.68,82.8,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.25,22,,percent of total billed charges,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,38.25,145.35,
OT OCC THER EVAL LOW COMPLEX  W THCAP,35200304,CDM,97165,CPT,434,RC,outpatient,KX,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153,22,,percent of total billed charges,,,,,,,,,550.8,90,,percent of total billed charges,,,506.74,82.8,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153,22,,percent of total billed charges,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,153,581.4,
OT OCCUP THER EVAL MOD COMPLEX,35200307,CDM,97166,CPT,434,RC,outpatient,GO,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153,22,,percent of total billed charges,,,,,,,,,550.8,90,,percent of total billed charges,,,506.74,82.8,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153,22,,percent of total billed charges,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,153,581.4,
OT OCCU THER IPA EVAL MOD COMPLEX,35200308,CDM,97166,CPT,434,RC,outpatient,GO,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.25,22,,percent of total billed charges,,,,,,,,,137.7,90,,percent of total billed charges,,,126.68,82.8,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.25,22,,percent of total billed charges,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,38.25,145.35,
OT OCC THER EVAL MOD COMPLEX  W THCAP,35200309,CDM,97166,CPT,434,RC,outpatient,KX,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153,22,,percent of total billed charges,,,,,,,,,550.8,90,,percent of total billed charges,,,506.74,82.8,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153,22,,percent of total billed charges,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,153,581.4,
OT OCCUP THER EVAL HIGH COMPLEX,35200312,CDM,97167,CPT,434,RC,outpatient,GO,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153,22,,percent of total billed charges,,,,,,,,,550.8,90,,percent of total billed charges,,,506.74,82.8,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153,22,,percent of total billed charges,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,153,581.4,
OT OCCU THER IPA EVAL HIG COMPLEX,35200313,CDM,97167,CPT,434,RC,outpatient,GO,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.25,22,,percent of total billed charges,,,,,,,,,137.7,90,,percent of total billed charges,,,126.68,82.8,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.25,22,,percent of total billed charges,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,38.25,145.35,
OT OCC THER EVAL HIGH COMPLEX  W THCAP,35200314,CDM,97167,CPT,434,RC,outpatient,KX,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153,22,,percent of total billed charges,,,,,,,,,550.8,90,,percent of total billed charges,,,506.74,82.8,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153,22,,percent of total billed charges,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,153,581.4,
OT MOD 59 RE-EVAL EST PLAN CARE,35200318,CDM,97168,CPT,434,RC,outpatient,GO,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.75,22,,percent of total billed charges,,,,,,,,,351.9,90,,percent of total billed charges,,,323.75,82.8,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.75,22,,percent of total billed charges,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,97.75,371.45,
OT RE-EVALUATION EST PLAN CARE,35200319,CDM,97168,CPT,434,RC,outpatient,GO,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.75,22,,percent of total billed charges,,,,,,,,,351.9,90,,percent of total billed charges,,,323.75,82.8,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.75,22,,percent of total billed charges,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,97.75,371.45,
OT RE-EVAL EST PLAN CARE  W THCAP,35200320,CDM,97168,CPT,434,RC,outpatient,KX,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.75,22,,percent of total billed charges,,,,,,,,,351.9,90,,percent of total billed charges,,,323.75,82.8,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.75,22,,percent of total billed charges,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,97.75,371.45,
OT MOD 59 MANUAL THERAPY,35900500,CDM,97140,CPT,430,RC,outpatient,GO,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
OT MOD 59 THERAPUTIC ACTIVITY,35900501,CDM,97530,CPT,430,RC,outpatient,GO,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
OT MOD 59 THERAPUTIC EXERCISE 15 MIN,35900502,CDM,97110,CPT,430,RC,outpatient,GO,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
OT SUPPLY - DYNAMIC FINGER SPLINT,35900600,CDM,,,270,RC,outpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.5,22,,percent of total billed charges,,,,,,,,,289.8,90,,percent of total billed charges,,,266.62,82.8,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.5,22,,percent of total billed charges,,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,80.5,305.9,
OT SUPPLY - LONG LEG SPLINT,35900601,CDM,,,270,RC,outpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.5,22,,percent of total billed charges,,,,,,,,,289.8,90,,percent of total billed charges,,,266.62,82.8,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.5,22,,percent of total billed charges,,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,80.5,305.9,
OT FUNCTIONAL THERAPEUTIC ACTIVITY,35900606,CDM,97530,CPT,430,RC,outpatient,GO,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
OT SELF CARE/HOME MANG. TRNG. EA 15 MIN,35900607,CDM,97535,CPT,430,RC,outpatient,GO,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62,22,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,205.34,82.8,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62,22,,percent of total billed charges,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,62,235.6,
OT COMM/WORK RE-INTEG. TRNG. EA 15MIN,35900608,CDM,97537,CPT,430,RC,outpatient,GO,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38,22,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,125.86,82.8,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38,22,,percent of total billed charges,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,38,144.4,
OT SUPPLY - LONG ARM SPLINT,35900609,CDM,,,270,RC,outpatient,,480,480,,407.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,120,22,,percent of total billed charges,,,,,,,,,432,90,,percent of total billed charges,,,397.44,82.8,,percent of total billed charges,,,408,85,,percent of total billed charges,,,,,,,,,422.4,88,,percent of total billed charges,,,,,,,,,366.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,120,22,,percent of total billed charges,,,436.8,91,,percent of total billed charges,,,456,95,,percent of total billed charges,,,398.4,83,,percent of total billed charges,,,398.4,83,,percent of total billed charges,,,,,,,,,,,,,,,398.4,83,,percent of total billed charges,,,456,95,,percent of total billed charges,,,432,90,,percent of total billed charges,,,432,90,,percent of total billed charges,,,393.6,82,,percent of total billed charges,,,432,90,,percent of total billed charges,,,408,85,,percent of total billed charges,,120,456,
"OT SUPPLY - SHORT ARM SPLINT, STATIC",35900610,CDM,,,270,RC,outpatient,,354,354,,300.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.5,22,,percent of total billed charges,,,,,,,,,318.6,90,,percent of total billed charges,,,293.11,82.8,,percent of total billed charges,,,300.9,85,,percent of total billed charges,,,,,,,,,311.52,88,,percent of total billed charges,,,,,,,,,270.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.5,22,,percent of total billed charges,,,322.14,91,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,,,,,,,,,,,,,293.82,83,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,290.28,82,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,300.9,85,,percent of total billed charges,,88.5,336.3,
OT SUPPLY - DYNAMIC SHORT ARM SPLINT,35900611,CDM,,,270,RC,outpatient,,398,398,,337.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,99.5,22,,percent of total billed charges,,,,,,,,,358.2,90,,percent of total billed charges,,,329.54,82.8,,percent of total billed charges,,,338.3,85,,percent of total billed charges,,,,,,,,,350.24,88,,percent of total billed charges,,,,,,,,,304.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,99.5,22,,percent of total billed charges,,,362.18,91,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,,,,,,,,,,,,,330.34,83,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,326.36,82,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,338.3,85,,percent of total billed charges,,99.5,378.1,
OT SUPPLY - STATIC FINGER SPLINT,35900612,CDM,,,270,RC,outpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.5,22,,percent of total billed charges,,,,,,,,,289.8,90,,percent of total billed charges,,,266.62,82.8,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.5,22,,percent of total billed charges,,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,80.5,305.9,
OT SHOULDER STRAPPING,35900615,CDM,29240,CPT,430,RC,outpatient,GO,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.5,22,,percent of total billed charges,,,,,,,,,196.2,90,,percent of total billed charges,,,180.5,82.8,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,,,,,,,,191.84,88,,percent of total billed charges,,,,,,,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.5,22,,percent of total billed charges,,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,54.5,207.1,
OT W/C MGT/PROPULSON TMG 15 MIN,35900620,CDM,97542,CPT,430,RC,outpatient,GO,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
OT WORK HARDENING/CONDITIONING INIT 2 HR,35900621,CDM,97545,CPT,430,RC,outpatient,GO,562,562,,477.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,140.5,22,,percent of total billed charges,,,,,,,,,505.8,90,,percent of total billed charges,,,465.34,82.8,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,,,,,,,,494.56,88,,percent of total billed charges,,,,,,,,,429.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,140.5,22,,percent of total billed charges,,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,,,,,,,,,,,,,466.46,83,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,460.84,82,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,140.5,533.9,
OT WORK HARDENING/CONDITIONING ADDTL HR,35900622,CDM,97546,CPT,430,RC,outpatient,GO,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.25,22,,percent of total billed charges,,,,,,,,,260.1,90,,percent of total billed charges,,,239.29,82.8,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.25,22,,percent of total billed charges,,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,72.25,274.55,
OT CK OUT ORTHO/PROSTH USE EST PT 15 MIN,35900623,CDM,97763,CPT,430,RC,outpatient,GO,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.5,22,,percent of total billed charges,,,,,,,,,307.8,90,,percent of total billed charges,,,283.18,82.8,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.5,22,,percent of total billed charges,,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,85.5,324.9,
OT PHY PERF TEST/MEASURE(FXNAL CAP)15MIN,35900624,CDM,97750,CPT,430,RC,outpatient,GO,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.75,22,,percent of total billed charges,,,,,,,,,215.1,90,,percent of total billed charges,,,197.89,82.8,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.75,22,,percent of total billed charges,,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,59.75,227.05,
"OT SUPPLY - SHORT LEG SPLINT, CALF-FOOT",35900625,CDM,,,270,RC,outpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.5,22,,percent of total billed charges,,,,,,,,,289.8,90,,percent of total billed charges,,,266.62,82.8,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.5,22,,percent of total billed charges,,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,80.5,305.9,
OT WHIRLPOOL SUPERVISED/UNATTENDED,35900650,CDM,97022,CPT,430,RC,outpatient,GO,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.5,22,,percent of total billed charges,,,,,,,,,239.4,90,,percent of total billed charges,,,220.25,82.8,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.5,22,,percent of total billed charges,,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,66.5,252.7,
OT ULTRASOUND/PHONOP EA 15 MIN,35900670,CDM,97035,CPT,430,RC,outpatient,GO,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
OT PARAFFIN BATH I,35900688,CDM,97018,CPT,430,RC,outpatient,GO,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
OT VASOPNEUMATIC DEVICE,35900692,CDM,97016,CPT,430,RC,outpatient,GO,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33,22,,percent of total billed charges,,,,,,,,,118.8,90,,percent of total billed charges,,,109.3,82.8,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33,22,,percent of total billed charges,,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,33,125.4,
"OT ELEC STIMULATION ATTENDED, EA 15 MIN",35900713,CDM,97032,CPT,430,RC,outpatient,GO,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,38.5,146.3,
"OT DEV COG SKL(ATTN,MEM,PROB SOLV/EA15MN",35900714,CDM,97129,CPT,430,RC,outpatient,GO,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
"OT SENSORY INTEGRATION TQS, EA 15 MINS",35900715,CDM,97533,CPT,430,RC,outpatient,GO,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43,22,,percent of total billed charges,,,,,,,,,154.8,90,,percent of total billed charges,,,142.42,82.8,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43,22,,percent of total billed charges,,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,43,163.4,
OT GROUP,35900718,CDM,97150,CPT,430,RC,outpatient,GO,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27,22,,percent of total billed charges,,,,,,,,,97.2,90,,percent of total billed charges,,,89.42,82.8,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27,22,,percent of total billed charges,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,27,102.6,
OT MANUAL THERAPY TQS EA 15 MIN,35900720,CDM,97140,CPT,430,RC,outpatient,GO,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
OT UNLISTED MODALITY EA 15 MIN,35900722,CDM,97139,CPT,430,RC,outpatient,GO,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
OT THERA EX FOR STRENGTH EA 15 MIN,35900738,CDM,97110,CPT,430,RC,outpatient,GO,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
"OT NEUR-MUSC RE-ED,BAL/CRD/PRPR/PST 15M",35900739,CDM,97112,CPT,430,RC,outpatient,GO,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.5,22,,percent of total billed charges,,,,,,,,,214.2,90,,percent of total billed charges,,,197.06,82.8,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.5,22,,percent of total billed charges,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,59.5,226.1,
"OT THER EX EA 15 MIN, IPA PT U6",35900740,CDM,97110,CPT,430,RC,outpatient,GO,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
OT SELECTIVE DEBRIDEMENT >20 SQ CM,35900741,CDM,97598,CPT,430,RC,outpatient,GO,501,501,,425.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125.25,22,,percent of total billed charges,,,,,,,,,450.9,90,,percent of total billed charges,,,414.83,82.8,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,,,,,,,,440.88,88,,percent of total billed charges,,,,,,,,,382.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125.25,22,,percent of total billed charges,,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,,,,,,,,,,,,,415.83,83,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,410.82,82,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,125.25,475.95,
OT SELECTIVE DEBRIDEMENT 20 SQCM OR LESS,35900742,CDM,97597,CPT,430,RC,outpatient,GO,400,400,,339.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100,22,,percent of total billed charges,,,,,,,,,360,90,,percent of total billed charges,,,331.2,82.8,,percent of total billed charges,,,340,85,,percent of total billed charges,,,,,,,,,352,88,,percent of total billed charges,,,,,,,,,305.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100,22,,percent of total billed charges,,,364,91,,percent of total billed charges,,,380,95,,percent of total billed charges,,,332,83,,percent of total billed charges,,,332,83,,percent of total billed charges,,,,,,,,,,,,,,,332,83,,percent of total billed charges,,,380,95,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,328,82,,percent of total billed charges,,,360,90,,percent of total billed charges,,,340,85,,percent of total billed charges,,100,380,
OT IONTOPHORESIS 15 MIN,35900746,CDM,97033,CPT,430,RC,outpatient,GO,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.75,22,,percent of total billed charges,,,,,,,,,207.9,90,,percent of total billed charges,,,191.27,82.8,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.75,22,,percent of total billed charges,,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,57.75,219.45,
OT ELECTRICAL STIMULATION UNATTENDED,35900779,CDM,97014,CPT,430,RC,outpatient,GO,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,44,167.2,
OT ELECTRICAL STIMULATION MEDICARE,35900780,CDM,G0283,HCPCS,430,RC,outpatient,GO,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.75,22,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,121.72,82.8,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.75,22,,percent of total billed charges,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,36.75,139.65,
"OT ORTHOTIC MGMT&TRNG, UE&LE, EA 15 MIN",35900803,CDM,97760,CPT,430,RC,outpatient,GO,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
"OT ORTHO MGMTTRNG, UE&LE, EA 15 MIN MODF",35900804,CDM,97760,CPT,430,RC,outpatient,GO,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
OT THERAPUTTY,35900837,CDM,,,270,RC,outpatient,,30,30,,25.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.5,22,,percent of total billed charges,,,,,,,,,27,90,,percent of total billed charges,,,24.84,82.8,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,,,,,,,,26.4,88,,percent of total billed charges,,,,,,,,,22.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.5,22,,percent of total billed charges,,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,24.9,83,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,24.6,82,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,7.5,28.5,
*OT THERABAND PER YARD(V0708),35900845,CDM,,,270,RC,outpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6,22,,percent of total billed charges,,,,,,,,,21.6,90,,percent of total billed charges,,,19.87,82.8,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6,22,,percent of total billed charges,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,6,22.8,
OT MEPIFORM - PER SHEET,35900854,CDM,,,270,RC,outpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27,22,,percent of total billed charges,,,,,,,,,97.2,90,,percent of total billed charges,,,89.42,82.8,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27,22,,percent of total billed charges,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,27,102.6,
OT OVERDOOR PULLEYS,35900902,CDM,,,270,RC,outpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.25,22,,percent of total billed charges,,,,,,,,,62.1,90,,percent of total billed charges,,,57.13,82.8,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.25,22,,percent of total billed charges,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,17.25,65.55,
OT HAND HELPER,35900969,CDM,,,270,RC,outpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.25,22,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,63.76,82.8,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.25,22,,percent of total billed charges,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,19.25,73.15,
OT MOD 59 RE-EVALUATION(V10-19),35900990,CDM,97004,CPT,434,RC,outpatient,GO,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.75,22,,percent of total billed charges,,,,,,,,,351.9,90,,percent of total billed charges,,,323.75,82.8,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.75,22,,percent of total billed charges,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,97.75,371.45,
OT RE-EVALUATION(V10-19),35900993,CDM,97004,CPT,434,RC,outpatient,GO,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.75,22,,percent of total billed charges,,,,,,,,,351.9,90,,percent of total billed charges,,,323.75,82.8,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.75,22,,percent of total billed charges,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,97.75,371.45,
OT OCCUPATIONAL THER EVAL(V10-19),35901041,CDM,,,434,RC,outpatient,,612,612,,519.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153,22,,percent of total billed charges,,,,,,,,,550.8,90,,percent of total billed charges,,,506.74,82.8,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,,,,,,,,538.56,88,,percent of total billed charges,,,,,,,,,467.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153,22,,percent of total billed charges,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,501.84,82,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,153,581.4,
OT OCCU THER IPA EVAL 15 MIN(V10-19),35901042,CDM,97003,CPT,434,RC,outpatient,GO,153,153,,129.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.25,22,,percent of total billed charges,,,,,,,,,137.7,90,,percent of total billed charges,,,126.68,82.8,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,,,,,,,,134.64,88,,percent of total billed charges,,,,,,,,,116.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.25,22,,percent of total billed charges,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,125.46,82,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,38.25,145.35,
OT OCC SAFETY & HEALTH CONSULT 1HR,35901265,CDM,,,430,RC,outpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.5,22,,percent of total billed charges,,,,,,,,,289.8,90,,percent of total billed charges,,,266.62,82.8,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.5,22,,percent of total billed charges,,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,80.5,305.9,
"OT ERGONOMIC ASSESSMENT & REPORT,EA HOUR",35901268,CDM,,,430,RC,outpatient,,322,322,,273.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.5,22,,percent of total billed charges,,,,,,,,,289.8,90,,percent of total billed charges,,,266.62,82.8,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,,,,,,,,283.36,88,,percent of total billed charges,,,,,,,,,246.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.5,22,,percent of total billed charges,,,293.02,91,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,267.26,83,,percent of total billed charges,,,,,,,,,,,,,,,267.26,83,,percent of total billed charges,,,305.9,95,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,264.04,82,,percent of total billed charges,,,289.8,90,,percent of total billed charges,,,273.7,85,,percent of total billed charges,,80.5,305.9,
OT ELBOW WRIST STRAPPING W THCAP,35901305,CDM,29260,CPT,430,RC,outpatient,KX,410,410,,348.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,102.5,22,,percent of total billed charges,,,,,,,,,369,90,,percent of total billed charges,,,339.48,82.8,,percent of total billed charges,,,348.5,85,,percent of total billed charges,,,,,,,,,360.8,88,,percent of total billed charges,,,,,,,,,313.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,102.5,22,,percent of total billed charges,,,373.1,91,,percent of total billed charges,,,389.5,95,,percent of total billed charges,,,340.3,83,,percent of total billed charges,,,340.3,83,,percent of total billed charges,,,,,,,,,,,,,,,340.3,83,,percent of total billed charges,,,389.5,95,,percent of total billed charges,,,369,90,,percent of total billed charges,,,369,90,,percent of total billed charges,,,336.2,82,,percent of total billed charges,,,369,90,,percent of total billed charges,,,348.5,85,,percent of total billed charges,,102.5,389.5,
OT HAND FINGER STRAPPING W THCAP,35901306,CDM,29280,CPT,430,RC,outpatient,KX,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92,22,,percent of total billed charges,,,,,,,,,331.2,90,,percent of total billed charges,,,304.7,82.8,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92,22,,percent of total billed charges,,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,92,349.6,
OT HIP STRAPPING W THCAP,35901307,CDM,29520,CPT,430,RC,outpatient,KX,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
OT KNEE STRAPPING W THCAP,35901308,CDM,29530,CPT,430,RC,outpatient,KX,432,432,,366.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108,22,,percent of total billed charges,,,,,,,,,388.8,90,,percent of total billed charges,,,357.7,82.8,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,,,,,,,,380.16,88,,percent of total billed charges,,,,,,,,,330.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108,22,,percent of total billed charges,,,393.12,91,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,,,,,,,,,,,,,358.56,83,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,354.24,82,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,108,410.4,
OT ANKLE STRAPPING W THCAP,35901309,CDM,29540,CPT,430,RC,outpatient,KX,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.25,22,,percent of total billed charges,,,,,,,,,155.7,90,,percent of total billed charges,,,143.24,82.8,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.25,22,,percent of total billed charges,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,43.25,164.35,
OT SHOULDER STRAPPING W THCAP,35901310,CDM,29240,CPT,430,RC,outpatient,KX,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.5,22,,percent of total billed charges,,,,,,,,,196.2,90,,percent of total billed charges,,,180.5,82.8,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,,,,,,,,191.84,88,,percent of total billed charges,,,,,,,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.5,22,,percent of total billed charges,,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,54.5,207.1,
OT ELECTRICAL STIMTION UNATTDED W THCAP,35901314,CDM,97014,CPT,430,RC,outpatient,KX,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,44,167.2,
OT VASOPNEUMATIC DEVICE W THCAP,35901315,CDM,97016,CPT,430,RC,outpatient,KX,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33,22,,percent of total billed charges,,,,,,,,,118.8,90,,percent of total billed charges,,,109.3,82.8,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33,22,,percent of total billed charges,,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,33,125.4,
OT PARAFFIN BATH I W THCAP,35901316,CDM,97018,CPT,430,RC,outpatient,KX,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
OT WHIRLPOOL SUPERD/UNATTDED W THCAP,35901317,CDM,97022,CPT,430,RC,outpatient,KX,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.5,22,,percent of total billed charges,,,,,,,,,239.4,90,,percent of total billed charges,,,220.25,82.8,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.5,22,,percent of total billed charges,,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,66.5,252.7,
"OT ELE STIMN ATTENDED, EA 15 MIN W THCAP",35901318,CDM,97032,CPT,430,RC,outpatient,KX,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,38.5,146.3,
OT IONTOPHORESIS 15 MIN W THCAP,35901319,CDM,97033,CPT,430,RC,outpatient,KX,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.75,22,,percent of total billed charges,,,,,,,,,207.9,90,,percent of total billed charges,,,191.27,82.8,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.75,22,,percent of total billed charges,,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,57.75,219.45,
OT ULTRASD/PHONOP EA 15 MIN W THCAP,35901320,CDM,97035,CPT,430,RC,outpatient,KX,91,91,,77.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.75,22,,percent of total billed charges,,,,,,,,,81.9,90,,percent of total billed charges,,,75.35,82.8,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,,,,,,,,80.08,88,,percent of total billed charges,,,,,,,,,69.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.75,22,,percent of total billed charges,,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,,,,,,,,,,,,,75.53,83,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,74.62,82,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,22.75,86.45,
OT THERA EX FOR STRTH EA 15 MIN W THCAP,35901321,CDM,97110,CPT,430,RC,outpatient,KX,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
"OT NER-MSC RE-ED,BL/CR/R/PT 15M W THCAP",35901322,CDM,97112,CPT,430,RC,outpatient,KX,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.5,22,,percent of total billed charges,,,,,,,,,214.2,90,,percent of total billed charges,,,197.06,82.8,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.5,22,,percent of total billed charges,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,59.5,226.1,
OT MANUAL THERAPY TQS EA 15 MIN W THCAP,35901323,CDM,97140,CPT,430,RC,outpatient,KX,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
OT FUNCTIONAL THERTIC ACTIVITY W THCAP,35901324,CDM,97530,CPT,430,RC,outpatient,KX,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
"OT DEV CO SK(ATN,MEM SOLV/EA15MN W THCAP",35901325,CDM,97129,CPT,430,RC,outpatient,KX,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
"OT SENSRY INTEGN TQS, EA 15 MINS W THCAP",35901326,CDM,97533,CPT,430,RC,outpatient,KX,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43,22,,percent of total billed charges,,,,,,,,,154.8,90,,percent of total billed charges,,,142.42,82.8,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43,22,,percent of total billed charges,,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,43,163.4,
OT SEF CE/HOME MA. TG. EA 15 MIN W THCAP,35901327,CDM,97535,CPT,430,RC,outpatient,KX,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62,22,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,205.34,82.8,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62,22,,percent of total billed charges,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,62,235.6,
OT COM/WOK RE-ING. TRG. EA 15MIN W THCAP,35901328,CDM,97537,CPT,430,RC,outpatient,KX,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38,22,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,125.86,82.8,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38,22,,percent of total billed charges,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,38,144.4,
OT W/C MGT/PROPULSON TMG 15 MIN W THCAP,35901329,CDM,97542,CPT,430,RC,outpatient,KX,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
OT WORK HARING/CONDING INIT 2 HR W THCAP,35901330,CDM,97545,CPT,430,RC,outpatient,KX,562,562,,477.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,140.5,22,,percent of total billed charges,,,,,,,,,505.8,90,,percent of total billed charges,,,465.34,82.8,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,,,,,,,,494.56,88,,percent of total billed charges,,,,,,,,,429.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,140.5,22,,percent of total billed charges,,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,,,,,,,,,,,,,466.46,83,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,460.84,82,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,140.5,533.9,
OT WORK HARDEG/CONDNG ADDTL HR W THCAP,35901331,CDM,97546,CPT,430,RC,outpatient,KX,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.25,22,,percent of total billed charges,,,,,,,,,260.1,90,,percent of total billed charges,,,239.29,82.8,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.25,22,,percent of total billed charges,,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,72.25,274.55,
OT PHY PEF TEST/ME(FXN CAP)15MIN W THCAP,35901332,CDM,97750,CPT,430,RC,outpatient,KX,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.75,22,,percent of total billed charges,,,,,,,,,215.1,90,,percent of total billed charges,,,197.89,82.8,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.75,22,,percent of total billed charges,,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,59.75,227.05,
"OT ORTHO MGT&TG, UE&LE,EA 15 MIN W THCAP",35901333,CDM,97760,CPT,430,RC,outpatient,KX,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
OT CK O ORT/PRO USE ES PT 15 MIN W THCAP,35901334,CDM,97763,CPT,430,RC,outpatient,KX,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.5,22,,percent of total billed charges,,,,,,,,,307.8,90,,percent of total billed charges,,,283.18,82.8,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.5,22,,percent of total billed charges,,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,85.5,324.9,
OT ELECTRICAL STIMN MEDICARE W THCAP,35901335,CDM,G0283,HCPCS,430,RC,outpatient,KX,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.25,22,,percent of total billed charges,,,,,,,,,72.9,90,,percent of total billed charges,,,67.07,82.8,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.25,22,,percent of total billed charges,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,20.25,76.95,
OT THERA EX FOR STRENGTH EA 15 MIN THERA,35901400,CDM,97110,CPT,430,RC,outpatient,CO,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
"OT NEUR-MUSC RE-ED,BAL/CRD/PRPR/PST 15M",35901401,CDM,97112,CPT,430,RC,outpatient,CO,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.5,22,,percent of total billed charges,,,,,,,,,214.2,90,,percent of total billed charges,,,197.06,82.8,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.5,22,,percent of total billed charges,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,59.5,226.1,
OT FUNCTIONAL THERAPEUTIC ACTIVITY THERA,35901402,CDM,97530,CPT,430,RC,outpatient,CO,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
OT MANUAL TH TQS EA 15 MIN THERAPY  ASSI,35901403,CDM,97140,CPT,430,RC,outpatient,CO,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
OT SELF CARE/HOME MANG. TRNG. EA 15 MIN,35901404,CDM,97535,CPT,430,RC,outpatient,CO,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62,22,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,205.34,82.8,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62,22,,percent of total billed charges,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,62,235.6,
OT ELBOW WRIST STRAPPING,35910000,CDM,29260,CPT,430,RC,outpatient,GO,410,410,,348.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,102.5,22,,percent of total billed charges,,,,,,,,,369,90,,percent of total billed charges,,,339.48,82.8,,percent of total billed charges,,,348.5,85,,percent of total billed charges,,,,,,,,,360.8,88,,percent of total billed charges,,,,,,,,,313.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,102.5,22,,percent of total billed charges,,,373.1,91,,percent of total billed charges,,,389.5,95,,percent of total billed charges,,,340.3,83,,percent of total billed charges,,,340.3,83,,percent of total billed charges,,,,,,,,,,,,,,,340.3,83,,percent of total billed charges,,,389.5,95,,percent of total billed charges,,,369,90,,percent of total billed charges,,,369,90,,percent of total billed charges,,,336.2,82,,percent of total billed charges,,,369,90,,percent of total billed charges,,,348.5,85,,percent of total billed charges,,102.5,389.5,
OT HAND FINGER STRAPPING,35910001,CDM,29280,CPT,430,RC,outpatient,GO,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92,22,,percent of total billed charges,,,,,,,,,331.2,90,,percent of total billed charges,,,304.7,82.8,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92,22,,percent of total billed charges,,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,92,349.6,
OT HIP STRAPPING,35910002,CDM,29520,CPT,430,RC,outpatient,GO,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
OT KNEE STRAPPING,35910003,CDM,29530,CPT,430,RC,outpatient,GO,432,432,,366.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108,22,,percent of total billed charges,,,,,,,,,388.8,90,,percent of total billed charges,,,357.7,82.8,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,,,,,,,,380.16,88,,percent of total billed charges,,,,,,,,,330.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108,22,,percent of total billed charges,,,393.12,91,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,,,,,,,,,,,,,358.56,83,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,354.24,82,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,108,410.4,
OT ANKLE STRAPPING,35910004,CDM,29540,CPT,430,RC,outpatient,GO,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.25,22,,percent of total billed charges,,,,,,,,,155.7,90,,percent of total billed charges,,,143.24,82.8,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.25,22,,percent of total billed charges,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,43.25,164.35,
OT SHOULDER STRAPPING,35910006,CDM,29240,CPT,430,RC,outpatient,GO,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.5,22,,percent of total billed charges,,,,,,,,,196.2,90,,percent of total billed charges,,,180.5,82.8,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,,,,,,,,191.84,88,,percent of total billed charges,,,,,,,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.5,22,,percent of total billed charges,,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,54.5,207.1,
OT UNLIST MODALITY SPEC TYPE&TIME CONSTA,35910007,CDM,97039,CPT,430,RC,outpatient,GO,167,167,,141.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.75,22,,percent of total billed charges,,,,,,,,,150.3,90,,percent of total billed charges,,,138.28,82.8,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,,,,,,,,146.96,88,,percent of total billed charges,,,,,,,,,127.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.75,22,,percent of total billed charges,,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,,,,,,,,,,,,,138.61,83,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,136.94,82,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,41.75,158.65,
OFFICE OUTPT EST 15 MIN,65000,CDM,99213,CPT,510,RC,outpatient,,90,90,,76.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.5,22,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,74.52,82.8,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,,,,,,,,79.2,88,,percent of total billed charges,,,,,,,,,68.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.5,22,,percent of total billed charges,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,73.8,82,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,22.5,85.5,
ARTHROCENTESIS ASPIR/INJ MAJORJT/BUR,65001,CDM,20610,CPT,510,RC,outpatient,,58,58,,49.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.5,22,,percent of total billed charges,,,,,,,,,52.2,90,,percent of total billed charges,,,48.02,82.8,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,,,,,,,,51.04,88,,percent of total billed charges,,,,,,,,,44.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.5,22,,percent of total billed charges,,,52.78,91,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,,,,,,,,,,,,,48.14,83,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,47.56,82,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,14.5,55.1,
METHYLPREDNISOLONE 40 MG INJ,65002,CDM,J1030,HCPCS,636,RC,outpatient,,89,89,,75.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.25,22,,percent of total billed charges,,,,,,,,,80.1,90,,percent of total billed charges,,,73.69,82.8,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,,,,,,,,78.32,88,,percent of total billed charges,,29.81,,,,fee schedule,,,68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,29.81,,,,fee schedule,,,22.25,22,,percent of total billed charges,,,80.99,91,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,,,,,,,,,,,,,73.87,83,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,72.98,82,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,22.25,84.55,
SYNVISC INJ PER DOSE,65003,CDM,J7325,HCPCS,636,RC,outpatient,,3263,3263,,2770.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,815.75,22,,percent of total billed charges,,,,,,,,,2936.7,90,,percent of total billed charges,,,2701.76,82.8,,percent of total billed charges,,,2773.55,85,,percent of total billed charges,,,,,,,,,2871.44,88,,percent of total billed charges,,973.06,,,,fee schedule,,,2492.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,973.06,,,,fee schedule,,,815.75,22,,percent of total billed charges,,,2969.33,91,,percent of total billed charges,,,3099.85,95,,percent of total billed charges,,,2708.29,83,,percent of total billed charges,,,2708.29,83,,percent of total billed charges,,,,,,,,,,,,,,,2708.29,83,,percent of total billed charges,,,3099.85,95,,percent of total billed charges,,,2936.7,90,,percent of total billed charges,,,2936.7,90,,percent of total billed charges,,,2675.66,82,,percent of total billed charges,,,2936.7,90,,percent of total billed charges,,,2773.55,85,,percent of total billed charges,,815.75,3099.85,
OFFICE OUTPT EST 10 MIN,65004,CDM,99212,CPT,510,RC,outpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.75,22,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,68.72,82.8,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.75,22,,percent of total billed charges,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,20.75,78.85,
OFFICE OUTPT EST 25 MIN,65005,CDM,99214,CPT,510,RC,outpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.25,22,,percent of total billed charges,,,,,,,,,108.9,90,,percent of total billed charges,,,100.19,82.8,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.25,22,,percent of total billed charges,,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,30.25,114.95,
APPLICATION OF LONG ARM CAST,65006,CDM,29065,CPT,510,RC,outpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.75,22,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,68.72,82.8,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.75,22,,percent of total billed charges,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,20.75,78.85,
OFFICE OUTPT NEW 30 MIN,65007,CDM,99203,CPT,510,RC,outpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.25,22,,percent of total billed charges,,,,,,,,,130.5,90,,percent of total billed charges,,,120.06,82.8,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.25,22,,percent of total billed charges,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,36.25,137.75,
EUFLEXXA INJ PER DOSE,65008,CDM,J7323,HCPCS,636,RC,outpatient,,861,861,,730.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,215.25,22,,percent of total billed charges,,,,,,,,,774.9,90,,percent of total billed charges,,,712.91,82.8,,percent of total billed charges,,,731.85,85,,percent of total billed charges,,,,,,,,,757.68,88,,percent of total billed charges,,261.77,,,,fee schedule,,,657.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,261.77,,,,fee schedule,,,215.25,22,,percent of total billed charges,,,783.51,91,,percent of total billed charges,,,817.95,95,,percent of total billed charges,,,714.63,83,,percent of total billed charges,,,714.63,83,,percent of total billed charges,,,,,,,,,,,,,,,714.63,83,,percent of total billed charges,,,817.95,95,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,706.02,82,,percent of total billed charges,,,774.9,90,,percent of total billed charges,,,731.85,85,,percent of total billed charges,,215.25,817.95,
INJECTION THERAPEUTIC CARPAL TUNNEL,65009,CDM,20526,CPT,510,RC,outpatient,,71,71,,60.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.75,22,,percent of total billed charges,,,,,,,,,63.9,90,,percent of total billed charges,,,58.79,82.8,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,,,,,,,,62.48,88,,percent of total billed charges,,,,,,,,,54.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.75,22,,percent of total billed charges,,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,,,,,,,,,,,,,58.93,83,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,58.22,82,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,17.75,67.45,
OFFICE OUTPT EST 40-54 MIN,65010,CDM,99215,CPT,510,RC,outpatient,,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
OFFICE OUTPT NEW 45 MIN,65011,CDM,99204,CPT,510,RC,outpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.5,22,,percent of total billed charges,,,,,,,,,178.2,90,,percent of total billed charges,,,163.94,82.8,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.5,22,,percent of total billed charges,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,49.5,188.1,
ARTHROCENTESIS ASPIR/INJ INTERM JT/BUR,65012,CDM,20605,CPT,510,RC,outpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.5,22,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,38.09,82.8,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.5,22,,percent of total billed charges,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,11.5,43.7,
TRIAMCINOLONE ACETONIDE INJ 10MG,65013,CDM,J3301,HCPCS,636,RC,outpatient,,247,247,,209.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.75,22,,percent of total billed charges,,,,,,,,,222.3,90,,percent of total billed charges,,,204.52,82.8,,percent of total billed charges,,,209.95,85,,percent of total billed charges,,,,,,,,,217.36,88,,percent of total billed charges,,17.47,,,,fee schedule,,,188.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,17.47,,,,fee schedule,,,61.75,22,,percent of total billed charges,,,224.77,91,,percent of total billed charges,,,234.65,95,,percent of total billed charges,,,205.01,83,,percent of total billed charges,,,205.01,83,,percent of total billed charges,,,,,,,,,,,,,,,205.01,83,,percent of total billed charges,,,234.65,95,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,202.54,82,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,209.95,85,,percent of total billed charges,,17.47,234.65,
ARTHROCENTESIS ASPIR/INJ SMALL JT/BUR,65014,CDM,20600,CPT,510,RC,outpatient,,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.25,22,,percent of total billed charges,,,,,,,,,40.5,90,,percent of total billed charges,,,37.26,82.8,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.25,22,,percent of total billed charges,,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,11.25,42.75,
INJECTION 1 TENDON SHEATH/LIG FLUORO GU,65015,CDM,20550,CPT,510,RC,outpatient,,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12,22,,percent of total billed charges,,,,,,,,,43.2,90,,percent of total billed charges,,,39.74,82.8,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12,22,,percent of total billed charges,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,12,45.6,
APPLY FOREARM SPLINT,65016,CDM,29125,CPT,510,RC,outpatient,,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12,22,,percent of total billed charges,,,,,,,,,43.2,90,,percent of total billed charges,,,39.74,82.8,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12,22,,percent of total billed charges,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,12,45.6,
APPLY HAND/WRIST CAST,65017,CDM,29085,CPT,510,RC,outpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.25,22,,percent of total billed charges,,,,,,,,,72.9,90,,percent of total billed charges,,,67.07,82.8,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.25,22,,percent of total billed charges,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,20.25,76.95,
APPLY SHORT LEG CAST,65018,CDM,29405,CPT,510,RC,outpatient,,72,72,,61.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18,22,,percent of total billed charges,,,,,,,,,64.8,90,,percent of total billed charges,,,59.62,82.8,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,,,,,,,,63.36,88,,percent of total billed charges,,,,,,,,,55.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18,22,,percent of total billed charges,,,65.52,91,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,,,,,,,,,,,,,59.76,83,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,59.04,82,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,18,68.4,
TREAT METACARPAL FRACTURE,65019,CDM,26605,CPT,510,RC,outpatient,,365,365,,309.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.25,22,,percent of total billed charges,,,,,,,,,328.5,90,,percent of total billed charges,,,302.22,82.8,,percent of total billed charges,,,310.25,85,,percent of total billed charges,,,,,,,,,321.2,88,,percent of total billed charges,,,,,,,,,278.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.25,22,,percent of total billed charges,,,332.15,91,,percent of total billed charges,,,346.75,95,,percent of total billed charges,,,302.95,83,,percent of total billed charges,,,302.95,83,,percent of total billed charges,,,,,,,,,,,,,,,302.95,83,,percent of total billed charges,,,346.75,95,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,299.3,82,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,310.25,85,,percent of total billed charges,,91.25,346.75,
TREATMENT OF ANKLE FRACTURE W/MANP,65020,CDM,27788,CPT,510,RC,outpatient,,477,477,,404.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.25,22,,percent of total billed charges,,,,,,,,,429.3,90,,percent of total billed charges,,,394.96,82.8,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,,,,,,,,419.76,88,,percent of total billed charges,,,,,,,,,364.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.25,22,,percent of total billed charges,,,434.07,91,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,,,,,,,,,,,,,395.91,83,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,391.14,82,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,119.25,453.15,
TREAT METACARPAL FRACTURE WITHOUT MANIP,65021,CDM,26600,CPT,510,RC,outpatient,,348,348,,295.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87,22,,percent of total billed charges,,,,,,,,,313.2,90,,percent of total billed charges,,,288.14,82.8,,percent of total billed charges,,,295.8,85,,percent of total billed charges,,,,,,,,,306.24,88,,percent of total billed charges,,,,,,,,,265.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87,22,,percent of total billed charges,,,316.68,91,,percent of total billed charges,,,330.6,95,,percent of total billed charges,,,288.84,83,,percent of total billed charges,,,288.84,83,,percent of total billed charges,,,,,,,,,,,,,,,288.84,83,,percent of total billed charges,,,330.6,95,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,285.36,82,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,295.8,85,,percent of total billed charges,,87,330.6,
TREAT FRACTURE OF RADIUS,65022,CDM,25505,CPT,510,RC,outpatient,,568,568,,482.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,142,22,,percent of total billed charges,,,,,,,,,511.2,90,,percent of total billed charges,,,470.3,82.8,,percent of total billed charges,,,482.8,85,,percent of total billed charges,,,,,,,,,499.84,88,,percent of total billed charges,,,,,,,,,433.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,142,22,,percent of total billed charges,,,516.88,91,,percent of total billed charges,,,539.6,95,,percent of total billed charges,,,471.44,83,,percent of total billed charges,,,471.44,83,,percent of total billed charges,,,,,,,,,,,,,,,471.44,83,,percent of total billed charges,,,539.6,95,,percent of total billed charges,,,511.2,90,,percent of total billed charges,,,511.2,90,,percent of total billed charges,,,465.76,82,,percent of total billed charges,,,511.2,90,,percent of total billed charges,,,482.8,85,,percent of total billed charges,,142,539.6,
NEG PRESS WNDTX</=50 SQ CM,65023,CDM,97607,CPT,510,RC,outpatient,,29,29,,24.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.25,22,,percent of total billed charges,,,,,,,,,26.1,90,,percent of total billed charges,,,24.01,82.8,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,,,,,,,,25.52,88,,percent of total billed charges,,,,,,,,,22.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.25,22,,percent of total billed charges,,,26.39,91,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,,,,,,,,,,,,,24.07,83,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,23.78,82,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,7.25,27.55,
INJECTION SINGLE TENDON ORIGIN/INSERTION,65024,CDM,20551,CPT,510,RC,outpatient,,49,49,,41.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.25,22,,percent of total billed charges,,,,,,,,,44.1,90,,percent of total billed charges,,,40.57,82.8,,percent of total billed charges,,,41.65,85,,percent of total billed charges,,,,,,,,,43.12,88,,percent of total billed charges,,,,,,,,,37.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.25,22,,percent of total billed charges,,,44.59,91,,percent of total billed charges,,,46.55,95,,percent of total billed charges,,,40.67,83,,percent of total billed charges,,,40.67,83,,percent of total billed charges,,,,,,,,,,,,,,,40.67,83,,percent of total billed charges,,,46.55,95,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,40.18,82,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,41.65,85,,percent of total billed charges,,12.25,46.55,
APPLICATION LOWER LEG SPLINT,65025,CDM,29515,CPT,510,RC,outpatient,,61,61,,51.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.25,22,,percent of total billed charges,,,,,,,,,54.9,90,,percent of total billed charges,,,50.51,82.8,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,,,,,,,,53.68,88,,percent of total billed charges,,,,,,,,,46.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.25,22,,percent of total billed charges,,,55.51,91,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,,,,,,,,,,,,,50.63,83,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,50.02,82,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,15.25,57.95,
APPLICATION OF FOREARM CAST,65026,CDM,29075,CPT,510,RC,outpatient,,76,76,,64.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19,22,,percent of total billed charges,,,,,,,,,68.4,90,,percent of total billed charges,,,62.93,82.8,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,,,,,,,,66.88,88,,percent of total billed charges,,,,,,,,,58.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19,22,,percent of total billed charges,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,,,,,,,,,,,,,63.08,83,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,62.32,82,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,19,72.2,
APPLICATION OF LONG LEG CAST WALKING,65027,CDM,29355,CPT,510,RC,outpatient,,133,133,,112.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.25,22,,percent of total billed charges,,,,,,,,,119.7,90,,percent of total billed charges,,,110.12,82.8,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,,,,,,,,117.04,88,,percent of total billed charges,,,,,,,,,101.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.25,22,,percent of total billed charges,,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,,,,,,,,,,,,,110.39,83,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,109.06,82,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,33.25,126.35,
GEL-ONE,65028,CDM,J7326,HCPCS,636,RC,outpatient,,3626,3626,,3078.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,906.5,22,,percent of total billed charges,,,,,,,,,3263.4,90,,percent of total billed charges,,,3002.33,82.8,,percent of total billed charges,,,3082.1,85,,percent of total billed charges,,,,,,,,,3190.88,88,,percent of total billed charges,,984.46,,,,fee schedule,,,2770.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,984.46,,,,fee schedule,,,906.5,22,,percent of total billed charges,,,3299.66,91,,percent of total billed charges,,,3444.7,95,,percent of total billed charges,,,3009.58,83,,percent of total billed charges,,,3009.58,83,,percent of total billed charges,,,,,,,,,,,,,,,3009.58,83,,percent of total billed charges,,,3444.7,95,,percent of total billed charges,,,3263.4,90,,percent of total billed charges,,,3263.4,90,,percent of total billed charges,,,2973.32,82,,percent of total billed charges,,,3263.4,90,,percent of total billed charges,,,3082.1,85,,percent of total billed charges,,906.5,3444.7,
APPLICATION OF LONG LEG CAST,65029,CDM,29345,CPT,510,RC,outpatient,,123,123,,104.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.75,22,,percent of total billed charges,,,,,,,,,110.7,90,,percent of total billed charges,,,101.84,82.8,,percent of total billed charges,,,104.55,85,,percent of total billed charges,,,,,,,,,108.24,88,,percent of total billed charges,,,,,,,,,93.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.75,22,,percent of total billed charges,,,111.93,91,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,,,,,,,,,,,,,102.09,83,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,100.86,82,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,104.55,85,,percent of total billed charges,,30.75,116.85,
OFFICE OUTPT NEW 15-29 MIN,65030,CDM,99202,CPT,510,RC,outpatient,,107,107,,90.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.75,22,,percent of total billed charges,,,,,,,,,96.3,90,,percent of total billed charges,,,88.6,82.8,,percent of total billed charges,,,90.95,85,,percent of total billed charges,,,,,,,,,94.16,88,,percent of total billed charges,,,,,,,,,81.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.75,22,,percent of total billed charges,,,97.37,91,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,,,,,,,,,,,,,88.81,83,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,87.74,82,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,90.95,85,,percent of total billed charges,,26.75,101.65,
APPLY LONG ARM SPLINT,65031,CDM,29105,CPT,510,RC,outpatient,,54,54,,45.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.5,22,,percent of total billed charges,,,,,,,,,48.6,90,,percent of total billed charges,,,44.71,82.8,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,,,,,,,,47.52,88,,percent of total billed charges,,,,,,,,,41.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.5,22,,percent of total billed charges,,,49.14,91,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,,,,,,,,,,,,,44.82,83,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,44.28,82,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,13.5,51.3,
TREAT FRACTURE RADIUS/ULNA,65032,CDM,25600,CPT,510,RC,outpatient,,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.75,22,,percent of total billed charges,,,,,,,,,351.9,90,,percent of total billed charges,,,323.75,82.8,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.75,22,,percent of total billed charges,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,97.75,371.45,
TREATMENT OF ANKLE FRACTURE,65034,CDM,28430,CPT,510,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
TREATMENT CLAVICLE FRACTURE,65035,CDM,23500,CPT,510,RC,outpatient,,278,278,,236.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.5,22,,percent of total billed charges,,,,,,,,,250.2,90,,percent of total billed charges,,,230.18,82.8,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,,,,,,,,244.64,88,,percent of total billed charges,,,,,,,,,212.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.5,22,,percent of total billed charges,,,252.98,91,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,230.74,83,,percent of total billed charges,,,,,,,,,,,,,,,230.74,83,,percent of total billed charges,,,264.1,95,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,227.96,82,,percent of total billed charges,,,250.2,90,,percent of total billed charges,,,236.3,85,,percent of total billed charges,,69.5,264.1,
METHYPREDNISOLONE 20 MG INJ,65036,CDM,J1020,HCPCS,636,RC,outpatient,,84,84,,71.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21,22,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,69.55,82.8,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,,,,,,,,73.92,88,,percent of total billed charges,,11.93,,,,fee schedule,,,64.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11.93,,,,fee schedule,,,21,22,,percent of total billed charges,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,68.88,82,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,11.93,79.8,
TREAT HUMERUS FRACTURE,65037,CDM,23600,CPT,510,RC,outpatient,,386,386,,327.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.5,22,,percent of total billed charges,,,,,,,,,347.4,90,,percent of total billed charges,,,319.61,82.8,,percent of total billed charges,,,328.1,85,,percent of total billed charges,,,,,,,,,339.68,88,,percent of total billed charges,,,,,,,,,294.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.5,22,,percent of total billed charges,,,351.26,91,,percent of total billed charges,,,366.7,95,,percent of total billed charges,,,320.38,83,,percent of total billed charges,,,320.38,83,,percent of total billed charges,,,,,,,,,,,,,,,320.38,83,,percent of total billed charges,,,366.7,95,,percent of total billed charges,,,347.4,90,,percent of total billed charges,,,347.4,90,,percent of total billed charges,,,316.52,82,,percent of total billed charges,,,347.4,90,,percent of total billed charges,,,328.1,85,,percent of total billed charges,,96.5,366.7,
TREAT HUMERUS FRACTURE W/O MANIP,65038,CDM,24500,CPT,510,RC,outpatient,,408,408,,346.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,102,22,,percent of total billed charges,,,,,,,,,367.2,90,,percent of total billed charges,,,337.82,82.8,,percent of total billed charges,,,346.8,85,,percent of total billed charges,,,,,,,,,359.04,88,,percent of total billed charges,,,,,,,,,311.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,102,22,,percent of total billed charges,,,371.28,91,,percent of total billed charges,,,387.6,95,,percent of total billed charges,,,338.64,83,,percent of total billed charges,,,338.64,83,,percent of total billed charges,,,,,,,,,,,,,,,338.64,83,,percent of total billed charges,,,387.6,95,,percent of total billed charges,,,367.2,90,,percent of total billed charges,,,367.2,90,,percent of total billed charges,,,334.56,82,,percent of total billed charges,,,367.2,90,,percent of total billed charges,,,346.8,85,,percent of total billed charges,,102,387.6,
INJECTION SINGLE/MLT TRIGGER POINT 1/2 M,65039,CDM,20552,CPT,510,RC,outpatient,,47,47,,39.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.75,22,,percent of total billed charges,,,,,,,,,42.3,90,,percent of total billed charges,,,38.92,82.8,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,,,,,,,,41.36,88,,percent of total billed charges,,,,,,,,,35.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.75,22,,percent of total billed charges,,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,,,,,,,,,,,,,39.01,83,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,38.54,82,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,11.75,44.65,
TREAT KNEE FRACTURE,65041,CDM,27530,CPT,510,RC,outpatient,,352,352,,298.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88,22,,percent of total billed charges,,,,,,,,,316.8,90,,percent of total billed charges,,,291.46,82.8,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,,,,,,,,309.76,88,,percent of total billed charges,,,,,,,,,268.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88,22,,percent of total billed charges,,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,,,,,,,,,,,,,292.16,83,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,288.64,82,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,88,334.4,
APPLICATION OF FINGER SPLINT,65042,CDM,29130,CPT,510,RC,outpatient,,36,36,,30.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9,22,,percent of total billed charges,,,,,,,,,32.4,90,,percent of total billed charges,,,29.81,82.8,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,,,,,,,,31.68,88,,percent of total billed charges,,,,,,,,,27.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9,22,,percent of total billed charges,,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,,,,,,,,,,,,,29.88,83,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,29.52,82,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,9,34.2,
TREATMENT FRACTURE OF ULNA,65043,CDM,25530,CPT,510,RC,outpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.25,22,,percent of total billed charges,,,,,,,,,267.3,90,,percent of total billed charges,,,245.92,82.8,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.25,22,,percent of total billed charges,,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,74.25,282.15,
APPLY LONG LEG SPLINT,65044,CDM,29505,CPT,510,RC,outpatient,,64,64,,54.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16,22,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,52.99,82.8,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,,,,,,,,56.32,88,,percent of total billed charges,,,,,,,,,48.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16,22,,percent of total billed charges,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,,,,,,,,,,,,,53.12,83,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,52.48,82,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,16,60.8,
METHYLPREDNISOLONE 80 MG INJ,65045,CDM,J1040,HCPCS,636,RC,outpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,23.18,,,,fee schedule,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,23.18,,,,fee schedule,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,23.18,167.2,
APPLY SHORT LEG CAST,65046,CDM,29425,CPT,510,RC,outpatient,,67,67,,56.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.75,22,,percent of total billed charges,,,,,,,,,60.3,90,,percent of total billed charges,,,55.48,82.8,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,,,,,,,,58.96,88,,percent of total billed charges,,,,,,,,,51.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.75,22,,percent of total billed charges,,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,,,,,,,,,,,,,55.61,83,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,54.94,82,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,16.75,63.65,
INJ DUPUYTRENCORD W/ENZYME,65047,CDM,20527,CPT,510,RC,outpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.25,22,,percent of total billed charges,,,,,,,,,72.9,90,,percent of total billed charges,,,67.07,82.8,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.25,22,,percent of total billed charges,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,20.25,76.95,
DRAIN/INJ JOINT/BURSA W/US,65048,CDM,20611,CPT,510,RC,outpatient,,75,75,,63.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.75,22,,percent of total billed charges,,,,,,,,,67.5,90,,percent of total billed charges,,,62.1,82.8,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,,,,,,,,66,88,,percent of total billed charges,,,,,,,,,57.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.75,22,,percent of total billed charges,,,68.25,91,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,,,,,,,,,,,,,62.25,83,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,61.5,82,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,18.75,71.25,
TREATMENT FRACTURE RADIUS/ULNA,65049,CDM,25560,CPT,510,RC,outpatient,,316,316,,268.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79,22,,percent of total billed charges,,,,,,,,,284.4,90,,percent of total billed charges,,,261.65,82.8,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,,,,,,,,278.08,88,,percent of total billed charges,,,,,,,,,241.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79,22,,percent of total billed charges,,,287.56,91,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,,,,,,,,,,,,,262.28,83,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,259.12,82,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,79,300.2,
SIMPLE REPAIR SCALP/NECK/AX/TRUNK 2.5/<,65050,CDM,12001,CPT,510,RC,outpatient,,56,56,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14,22,,percent of total billed charges,,,,,,,,,50.4,90,,percent of total billed charges,,,46.37,82.8,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,,,,,,,,49.28,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14,22,,percent of total billed charges,,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,45.92,82,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,14,53.2,
DX BONE MARROW BIOPSIES,65051,CDM,38221,CPT,510,RC,outpatient,,85,85,,72.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.25,22,,percent of total billed charges,,,,,,,,,76.5,90,,percent of total billed charges,,,70.38,82.8,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,,,,,,,,74.8,88,,percent of total billed charges,,,,,,,,,64.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.25,22,,percent of total billed charges,,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,,,,,,,,,,,,,70.55,83,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,69.7,82,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,21.25,80.75,
"DRAINAGE OF SKIN ABSCESS, SINGLE OR SIMP",65052,CDM,10060,CPT,510,RC,outpatient,,125,125,,106.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.25,22,,percent of total billed charges,,,,,,,,,112.5,90,,percent of total billed charges,,,103.5,82.8,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,,,,,,,,110,88,,percent of total billed charges,,,,,,,,,95.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.25,22,,percent of total billed charges,,,113.75,91,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,,,,,,,,,,,,,103.75,83,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,102.5,82,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,31.25,118.75,
CLTX POST ANKLE FX,65053,CDM,27767,CPT,510,RC,outpatient,,412,412,,349.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,103,22,,percent of total billed charges,,,,,,,,,370.8,90,,percent of total billed charges,,,341.14,82.8,,percent of total billed charges,,,350.2,85,,percent of total billed charges,,,,,,,,,362.56,88,,percent of total billed charges,,,,,,,,,314.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,103,22,,percent of total billed charges,,,374.92,91,,percent of total billed charges,,,391.4,95,,percent of total billed charges,,,341.96,83,,percent of total billed charges,,,341.96,83,,percent of total billed charges,,,,,,,,,,,,,,,341.96,83,,percent of total billed charges,,,391.4,95,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,337.84,82,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,350.2,85,,percent of total billed charges,,103,391.4,
OFFICE OUTPT NEW/EST 40MIN,65054,CDM,99243,CPT,510,RC,outpatient,,93,93,,78.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.25,22,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,77,82.8,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,,,,,,,,81.84,88,,percent of total billed charges,,,,,,,,,71.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.25,22,,percent of total billed charges,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,76.26,82,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,23.25,88.35,
CASTING SUPPLIES,65055,CDM,Q4010,HCPCS,270,RC,outpatient,,73,73,,61.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.25,22,,percent of total billed charges,,,,,,,,,65.7,90,,percent of total billed charges,,,60.44,82.8,,percent of total billed charges,,,62.05,85,,percent of total billed charges,,,,,,,,,64.24,88,,percent of total billed charges,,,,,,,,,55.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.25,22,,percent of total billed charges,,,66.43,91,,percent of total billed charges,,,69.35,95,,percent of total billed charges,,,60.59,83,,percent of total billed charges,,,60.59,83,,percent of total billed charges,,,,,,,,,,,,,,,60.59,83,,percent of total billed charges,,,69.35,95,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,59.86,82,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,62.05,85,,percent of total billed charges,,18.25,69.35,
CASTING SUPPLIES,65056,CDM,Q4013,HCPCS,270,RC,outpatient,,79,79,,67.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.75,22,,percent of total billed charges,,,,,,,,,71.1,90,,percent of total billed charges,,,65.41,82.8,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,,,,,,,,69.52,88,,percent of total billed charges,,,,,,,,,60.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.75,22,,percent of total billed charges,,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,,,,,,,,,,,,,65.57,83,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,64.78,82,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,19.75,75.05,
CLTX THUMB DISLOCATION,65057,CDM,26641,CPT,510,RC,outpatient,,865,865,,734.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,216.25,22,,percent of total billed charges,,,,,,,,,778.5,90,,percent of total billed charges,,,716.22,82.8,,percent of total billed charges,,,735.25,85,,percent of total billed charges,,,,,,,,,761.2,88,,percent of total billed charges,,,,,,,,,660.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,216.25,22,,percent of total billed charges,,,787.15,91,,percent of total billed charges,,,821.75,95,,percent of total billed charges,,,717.95,83,,percent of total billed charges,,,717.95,83,,percent of total billed charges,,,,,,,,,,,,,,,717.95,83,,percent of total billed charges,,,821.75,95,,percent of total billed charges,,,778.5,90,,percent of total billed charges,,,778.5,90,,percent of total billed charges,,,709.3,82,,percent of total billed charges,,,778.5,90,,percent of total billed charges,,,735.25,85,,percent of total billed charges,,216.25,821.75,
CASTING SUPPLIES,65058,CDM,Q4018,HCPCS,270,RC,outpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.25,22,,percent of total billed charges,,,,,,,,,62.1,90,,percent of total billed charges,,,57.13,82.8,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.25,22,,percent of total billed charges,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,17.25,65.55,
TREATMENT SUPERFICIAL WOUND,65059,CDM,12020,CPT,510,RC,outpatient,,309,309,,262.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.25,22,,percent of total billed charges,,,,,,,,,278.1,90,,percent of total billed charges,,,255.85,82.8,,percent of total billed charges,,,262.65,85,,percent of total billed charges,,,,,,,,,271.92,88,,percent of total billed charges,,,,,,,,,236.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.25,22,,percent of total billed charges,,,281.19,91,,percent of total billed charges,,,293.55,95,,percent of total billed charges,,,256.47,83,,percent of total billed charges,,,256.47,83,,percent of total billed charges,,,,,,,,,,,,,,,256.47,83,,percent of total billed charges,,,293.55,95,,percent of total billed charges,,,278.1,90,,percent of total billed charges,,,278.1,90,,percent of total billed charges,,,253.38,82,,percent of total billed charges,,,278.1,90,,percent of total billed charges,,,262.65,85,,percent of total billed charges,,77.25,293.55,
CLOSED TREATMENT FINGER FRACTURE,65060,CDM,26725,CPT,510,RC,outpatient,,567,567,,481.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141.75,22,,percent of total billed charges,,,,,,,,,510.3,90,,percent of total billed charges,,,469.48,82.8,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,,,,,,,,498.96,88,,percent of total billed charges,,,,,,,,,433.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141.75,22,,percent of total billed charges,,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,,,,,,,,,,,,,470.61,83,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,464.94,82,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,141.75,538.65,
CLOSED TREATMENT TOE FRACTURE,65061,CDM,28510,CPT,510,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
DRAINAGE OF HEMATOMA SEROMA/FLUID COL,65062,CDM,10140,CPT,510,RC,outpatient,,226,226,,191.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.5,22,,percent of total billed charges,,,,,,,,,203.4,90,,percent of total billed charges,,,187.13,82.8,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,,,,,,,,198.88,88,,percent of total billed charges,,,,,,,,,172.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.5,22,,percent of total billed charges,,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,,,,,,,,,,,,,187.58,83,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,185.32,82,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,56.5,214.7,
CASTING SUPPLIES,65063,CDM,Q4021,HCPCS,270,RC,outpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.5,22,,percent of total billed charges,,,,,,,,,45,90,,percent of total billed charges,,,41.4,82.8,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.5,22,,percent of total billed charges,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,12.5,47.5,
CLOSED TREATMENT GREATER ROCHANTERIC FX,65064,CDM,27246,CPT,510,RC,outpatient,,747,747,,634.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,186.75,22,,percent of total billed charges,,,,,,,,,672.3,90,,percent of total billed charges,,,618.52,82.8,,percent of total billed charges,,,634.95,85,,percent of total billed charges,,,,,,,,,657.36,88,,percent of total billed charges,,,,,,,,,570.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,186.75,22,,percent of total billed charges,,,679.77,91,,percent of total billed charges,,,709.65,95,,percent of total billed charges,,,620.01,83,,percent of total billed charges,,,620.01,83,,percent of total billed charges,,,,,,,,,,,,,,,620.01,83,,percent of total billed charges,,,709.65,95,,percent of total billed charges,,,672.3,90,,percent of total billed charges,,,672.3,90,,percent of total billed charges,,,612.54,82,,percent of total billed charges,,,672.3,90,,percent of total billed charges,,,634.95,85,,percent of total billed charges,,186.75,709.65,
CLOSED TREATMENT FINGER DISLOCATION,65065,CDM,26770,CPT,510,RC,outpatient,,155,155,,131.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.75,22,,percent of total billed charges,,,,,,,,,139.5,90,,percent of total billed charges,,,128.34,82.8,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,,,,,,,,136.4,88,,percent of total billed charges,,,,,,,,,118.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.75,22,,percent of total billed charges,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,127.1,82,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,38.75,147.25,
CLOSED TREATMENT FINGER FRACTURE,65066,CDM,26720,CPT,510,RC,outpatient,,578,578,,490.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,144.5,22,,percent of total billed charges,,,,,,,,,520.2,90,,percent of total billed charges,,,478.58,82.8,,percent of total billed charges,,,491.3,85,,percent of total billed charges,,,,,,,,,508.64,88,,percent of total billed charges,,,,,,,,,441.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,144.5,22,,percent of total billed charges,,,525.98,91,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,,,,,,,,,,,,,479.74,83,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,473.96,82,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,491.3,85,,percent of total billed charges,,144.5,549.1,
CASTING SUPPLIES,65067,CDM,Q4006,HCPCS,270,RC,outpatient,,88,88,,74.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22,22,,percent of total billed charges,,,,,,,,,79.2,90,,percent of total billed charges,,,72.86,82.8,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,,,,,,,,77.44,88,,percent of total billed charges,,,,,,,,,67.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22,22,,percent of total billed charges,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,,,,,,,,,,,,,73.04,83,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,72.16,82,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,22,83.6,
CLTX CARPAL SCAPHOID FX,65068,CDM,25622,CPT,510,RC,outpatient,,747,747,,634.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,186.75,22,,percent of total billed charges,,,,,,,,,672.3,90,,percent of total billed charges,,,618.52,82.8,,percent of total billed charges,,,634.95,85,,percent of total billed charges,,,,,,,,,657.36,88,,percent of total billed charges,,,,,,,,,570.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,186.75,22,,percent of total billed charges,,,679.77,91,,percent of total billed charges,,,709.65,95,,percent of total billed charges,,,620.01,83,,percent of total billed charges,,,620.01,83,,percent of total billed charges,,,,,,,,,,,,,,,620.01,83,,percent of total billed charges,,,709.65,95,,percent of total billed charges,,,672.3,90,,percent of total billed charges,,,672.3,90,,percent of total billed charges,,,612.54,82,,percent of total billed charges,,,672.3,90,,percent of total billed charges,,,634.95,85,,percent of total billed charges,,186.75,709.65,
INJ HYALURONAN/DERIVATIVE,65069,CDM,J7318,HCPCS,510,RC,outpatient,,2534,2534,,2151.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,633.5,22,,percent of total billed charges,,,,,,,,,2280.6,90,,percent of total billed charges,,,2098.15,82.8,,percent of total billed charges,,,2153.9,85,,percent of total billed charges,,,,,,,,,2229.92,88,,percent of total billed charges,,1111.92,,,,fee schedule,,,1935.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1111.92,,,,fee schedule,,,633.5,22,,percent of total billed charges,,,2305.94,91,,percent of total billed charges,,,2407.3,95,,percent of total billed charges,,,2103.22,83,,percent of total billed charges,,,2103.22,83,,percent of total billed charges,,,,,,,,,,,,,,,2103.22,83,,percent of total billed charges,,,2407.3,95,,percent of total billed charges,,,2280.6,90,,percent of total billed charges,,,2280.6,90,,percent of total billed charges,,,2077.88,82,,percent of total billed charges,,,2280.6,90,,percent of total billed charges,,,2153.9,85,,percent of total billed charges,,633.5,2407.3,
CASTING SUPPLIES,65070,CDM,Q4014,HCPCS,270,RC,outpatient,,74,74,,62.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.5,22,,percent of total billed charges,,,,,,,,,66.6,90,,percent of total billed charges,,,61.27,82.8,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,,,,,,,,65.12,88,,percent of total billed charges,,,,,,,,,56.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.5,22,,percent of total billed charges,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,,,,,,,,,,,,,61.42,83,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,60.68,82,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,18.5,70.3,
CLOSED TREATMENT PATELLAR FRACTURE,65071,CDM,27520,CPT,510,RC,outpatient,,191,191,,162.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.75,22,,percent of total billed charges,,,,,,,,,171.9,90,,percent of total billed charges,,,158.15,82.8,,percent of total billed charges,,,162.35,85,,percent of total billed charges,,,,,,,,,168.08,88,,percent of total billed charges,,,,,,,,,145.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.75,22,,percent of total billed charges,,,173.81,91,,percent of total billed charges,,,181.45,95,,percent of total billed charges,,,158.53,83,,percent of total billed charges,,,158.53,83,,percent of total billed charges,,,,,,,,,,,,,,,158.53,83,,percent of total billed charges,,,181.45,95,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,156.62,82,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,162.35,85,,percent of total billed charges,,47.75,181.45,
OFFICE OUTPT NEW 60 MIN,65072,CDM,99205,CPT,510,RC,outpatient,,237,237,,201.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.25,22,,percent of total billed charges,,,,,,,,,213.3,90,,percent of total billed charges,,,196.24,82.8,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,,,,,,,,208.56,88,,percent of total billed charges,,,,,,,,,181.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.25,22,,percent of total billed charges,,,215.67,91,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,,,,,,,,,,,,,196.71,83,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,194.34,82,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,59.25,225.15,
CASTING SUPPLIES,65073,CDM,Q4038,HCPCS,270,RC,outpatient,,50,50,,42.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.5,22,,percent of total billed charges,,,,,,,,,45,90,,percent of total billed charges,,,41.4,82.8,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,,,,,,,,44,88,,percent of total billed charges,,,,,,,,,38.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.5,22,,percent of total billed charges,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,41,82,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,12.5,47.5,
CLOSED TREATMENT OF ANKLE FRACTURE,65074,CDM,27808,CPT,510,RC,outpatient,,920,920,,781.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,230,22,,percent of total billed charges,,,,,,,,,828,90,,percent of total billed charges,,,761.76,82.8,,percent of total billed charges,,,782,85,,percent of total billed charges,,,,,,,,,809.6,88,,percent of total billed charges,,,,,,,,,702.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,230,22,,percent of total billed charges,,,837.2,91,,percent of total billed charges,,,874,95,,percent of total billed charges,,,763.6,83,,percent of total billed charges,,,763.6,83,,percent of total billed charges,,,,,,,,,,,,,,,763.6,83,,percent of total billed charges,,,874,95,,percent of total billed charges,,,828,90,,percent of total billed charges,,,828,90,,percent of total billed charges,,,754.4,82,,percent of total billed charges,,,828,90,,percent of total billed charges,,,782,85,,percent of total billed charges,,230,874,
OFFICE OUTPT NEW 45 MIN,93000,CDM,99204,CPT,510,RC,outpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.5,22,,percent of total billed charges,,,,,,,,,178.2,90,,percent of total billed charges,,,163.94,82.8,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.5,22,,percent of total billed charges,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,49.5,188.1,
OFFICE OUTPT EST 25 MIN,93001,CDM,99214,CPT,510,RC,outpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.25,22,,percent of total billed charges,,,,,,,,,108.9,90,,percent of total billed charges,,,100.19,82.8,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.25,22,,percent of total billed charges,,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,30.25,114.95,
OFFICE OUTPT NEW 30 MIN,93002,CDM,99203,CPT,510,RC,outpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.25,22,,percent of total billed charges,,,,,,,,,130.5,90,,percent of total billed charges,,,120.06,82.8,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.25,22,,percent of total billed charges,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,36.25,137.75,
"DRAINAGE OF SKIN ABSCESS, SINGLE/SIMPLE",93003,CDM,10060,CPT,510,RC,outpatient,,125,125,,106.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.25,22,,percent of total billed charges,,,,,,,,,112.5,90,,percent of total billed charges,,,103.5,82.8,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,,,,,,,,110,88,,percent of total billed charges,,,,,,,,,95.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.25,22,,percent of total billed charges,,,113.75,91,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,,,,,,,,,,,,,103.75,83,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,102.5,82,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,31.25,118.75,
OFFICE OUTPT EST 15 MIN,93004,CDM,99213,CPT,510,RC,outpatient,,90,90,,76.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.5,22,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,74.52,82.8,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,,,,,,,,79.2,88,,percent of total billed charges,,,,,,,,,68.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.5,22,,percent of total billed charges,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,73.8,82,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,22.5,85.5,
OFFICE OUTPT EST 40-54 MIN,93005,CDM,99215,CPT,510,RC,outpatient,,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
TRIM NAIL(S),93006,CDM,11719,CPT,510,RC,outpatient,,9,9,,7.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.25,22,,percent of total billed charges,,,,,,,,,8.1,90,,percent of total billed charges,,,7.45,82.8,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,,,,,,,,7.92,88,,percent of total billed charges,,,,,,,,,6.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.25,22,,percent of total billed charges,,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.38,82,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,2.25,8.55,
EXC B9 LES MRGN XCP SK TG T/A/L 2.1-3.0,93007,CDM,11403,CPT,510,RC,outpatient,,179,179,,151.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.75,22,,percent of total billed charges,,,,,,,,,161.1,90,,percent of total billed charges,,,148.21,82.8,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,,,,,,,,157.52,88,,percent of total billed charges,,,,,,,,,136.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.75,22,,percent of total billed charges,,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,146.78,82,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,44.75,170.05,
DESTRUCTION PREMALIGNANT LESION 1ST,93008,CDM,17000,CPT,510,RC,outpatient,,64,64,,54.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16,22,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,52.99,82.8,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,,,,,,,,56.32,88,,percent of total billed charges,,,,,,,,,48.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16,22,,percent of total billed charges,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,,,,,,,,,,,,,53.12,83,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,52.48,82,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,16,60.8,
BIOPSY OF VULVA/PERINEUM,93009,CDM,56605,CPT,510,RC,outpatient,,74,74,,62.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.5,22,,percent of total billed charges,,,,,,,,,66.6,90,,percent of total billed charges,,,61.27,82.8,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,,,,,,,,65.12,88,,percent of total billed charges,,,,,,,,,56.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.5,22,,percent of total billed charges,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,,,,,,,,,,,,,61.42,83,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,60.68,82,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,18.5,70.3,
AVULSION NAIL PLATE PARTIAL/COMPLETE 1,93010,CDM,11730,CPT,510,RC,outpatient,,67,67,,56.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.75,22,,percent of total billed charges,,,,,,,,,60.3,90,,percent of total billed charges,,,55.48,82.8,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,,,,,,,,58.96,88,,percent of total billed charges,,,,,,,,,51.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.75,22,,percent of total billed charges,,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,,,,,,,,,,,,,55.61,83,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,54.94,82,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,16.75,63.65,
EXC TR-EXT B9+MARG 1.1-2 CM,93011,CDM,11402,CPT,510,RC,outpatient,,140,140,,118.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35,22,,percent of total billed charges,,,,,,,,,126,90,,percent of total billed charges,,,115.92,82.8,,percent of total billed charges,,,119,85,,percent of total billed charges,,,,,,,,,123.2,88,,percent of total billed charges,,,,,,,,,106.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35,22,,percent of total billed charges,,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,133,95,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,114.8,82,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,35,133,
OFFICE OUTPT EST 10 MIN,93012,CDM,99212,CPT,510,RC,outpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.75,22,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,68.72,82.8,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.75,22,,percent of total billed charges,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,20.75,78.85,
EXC B9 LES MRGN XCP SK TG S/N/H 1.1-2.0,93013,CDM,11422,CPT,510,RC,outpatient,,164,164,,139.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41,22,,percent of total billed charges,,,,,,,,,147.6,90,,percent of total billed charges,,,135.79,82.8,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,,,,,,,,144.32,88,,percent of total billed charges,,,,,,,,,125.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41,22,,percent of total billed charges,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,134.48,82,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,41,155.8,
EXC B9 LES MRGN XCP SK TG S/N/H 2.1-3 CM,93014,CDM,11423,CPT,510,RC,outpatient,,188,188,,159.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47,22,,percent of total billed charges,,,,,,,,,169.2,90,,percent of total billed charges,,,155.66,82.8,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,,,,,,,,165.44,88,,percent of total billed charges,,,,,,,,,143.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47,22,,percent of total billed charges,,,171.08,91,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,,,,,,,,,,,,,156.04,83,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,154.16,82,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,47,178.6,
"EXCISION OF NAIL FOLD, TOE",93015,CDM,11765,CPT,510,RC,outpatient,,111,111,,94.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.75,22,,percent of total billed charges,,,,,,,,,99.9,90,,percent of total billed charges,,,91.91,82.8,,percent of total billed charges,,,94.35,85,,percent of total billed charges,,,,,,,,,97.68,88,,percent of total billed charges,,,,,,,,,84.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.75,22,,percent of total billed charges,,,101.01,91,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,,,,,,,,,,,,,92.13,83,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,91.02,82,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,94.35,85,,percent of total billed charges,,27.75,105.45,
EXC H-F-NK-SP B9+ MARG 3.1-4,93016,CDM,11424,CPT,510,RC,outpatient,,216,216,,183.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54,22,,percent of total billed charges,,,,,,,,,194.4,90,,percent of total billed charges,,,178.85,82.8,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,,,,,,,,190.08,88,,percent of total billed charges,,,,,,,,,165.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54,22,,percent of total billed charges,,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,177.12,82,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,54,205.2,
EXC B9 LES MRGN XCP SK TG T/A/L 0.6-1.0,93017,CDM,11401,CPT,510,RC,outpatient,,127,127,,107.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.75,22,,percent of total billed charges,,,,,,,,,114.3,90,,percent of total billed charges,,,105.16,82.8,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,,,,,,,,111.76,88,,percent of total billed charges,,,,,,,,,97.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.75,22,,percent of total billed charges,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,,,,,,,,,,,,,105.41,83,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,104.14,82,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,31.75,120.65,
SIMPLE REPAIR SCALP/NECK/AX/TRUNK 2.5CM<,93018,CDM,12001,CPT,510,RC,outpatient,,56,56,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14,22,,percent of total billed charges,,,,,,,,,50.4,90,,percent of total billed charges,,,46.37,82.8,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,,,,,,,,49.28,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14,22,,percent of total billed charges,,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,45.92,82,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,14,53.2,
PROCTOSIGMOIDOSCOPY DX,93019,CDM,45300,CPT,510,RC,outpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.75,22,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,85.28,82.8,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.75,22,,percent of total billed charges,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,25.75,97.85,
EXC TR-EXT MAL+MARG >4CM,93020,CDM,11606,CPT,510,RC,outpatient,,412,412,,349.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,103,22,,percent of total billed charges,,,,,,,,,370.8,90,,percent of total billed charges,,,341.14,82.8,,percent of total billed charges,,,350.2,85,,percent of total billed charges,,,,,,,,,362.56,88,,percent of total billed charges,,,,,,,,,314.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,103,22,,percent of total billed charges,,,374.92,91,,percent of total billed charges,,,391.4,95,,percent of total billed charges,,,341.96,83,,percent of total billed charges,,,341.96,83,,percent of total billed charges,,,,,,,,,,,,,,,341.96,83,,percent of total billed charges,,,391.4,95,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,337.84,82,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,350.2,85,,percent of total billed charges,,103,391.4,
GI TRACT IMG INTRALUMINAL,93021,CDM,91110,CPT,510,RC,outpatient,,1030,1030,,874.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,257.5,22,,percent of total billed charges,,,,,,,,,927,90,,percent of total billed charges,,,852.84,82.8,,percent of total billed charges,,,875.5,85,,percent of total billed charges,,,,,,,,,906.4,88,,percent of total billed charges,,,,,,,,,786.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,257.5,22,,percent of total billed charges,,,937.3,91,,percent of total billed charges,,,978.5,95,,percent of total billed charges,,,854.9,83,,percent of total billed charges,,,854.9,83,,percent of total billed charges,,,,,,,,,,,,,,,854.9,83,,percent of total billed charges,,,978.5,95,,percent of total billed charges,,,927,90,,percent of total billed charges,,,927,90,,percent of total billed charges,,,844.6,82,,percent of total billed charges,,,927,90,,percent of total billed charges,,,875.5,85,,percent of total billed charges,,257.5,978.5,
SUPPLY MISC,99013,CDM,,,,,outpatient,,20,20,,16.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5,22,,percent of total billed charges,,,,,,,,,18,90,,percent of total billed charges,,,16.56,82.8,,percent of total billed charges,,,17,85,,percent of total billed charges,,,,,,,,,17.6,88,,percent of total billed charges,,,,,,,,,15.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5,22,,percent of total billed charges,,,18.2,91,,percent of total billed charges,,,19,95,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,,,,,,,,,,,,,16.6,83,,percent of total billed charges,,,19,95,,percent of total billed charges,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,16.4,82,,percent of total billed charges,,,18,90,,percent of total billed charges,,,17,85,,percent of total billed charges,,5,19,
OFFICE OUTPT EST 15MIN,105000,CDM,99213,CPT,510,RC,outpatient,,90,90,,76.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.5,22,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,74.52,82.8,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,,,,,,,,79.2,88,,percent of total billed charges,,,,,,,,,68.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.5,22,,percent of total billed charges,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,73.8,82,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,22.5,85.5,
OFFICE OUTPT EST 25 MIN,105001,CDM,99214,CPT,510,RC,outpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.25,22,,percent of total billed charges,,,,,,,,,108.9,90,,percent of total billed charges,,,100.19,82.8,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.25,22,,percent of total billed charges,,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,30.25,114.95,
OFFICE OUTPT NEW 45 MIN,105002,CDM,99204,CPT,510,RC,outpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.5,22,,percent of total billed charges,,,,,,,,,178.2,90,,percent of total billed charges,,,163.94,82.8,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.5,22,,percent of total billed charges,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,49.5,188.1,
OFFICE OUTPT EST 10 MIN,105003,CDM,99212,CPT,510,RC,outpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.75,22,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,68.72,82.8,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.75,22,,percent of total billed charges,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,20.75,78.85,
OFFICE OUTPT NEW 30 MIN,105004,CDM,99203,CPT,510,RC,outpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.25,22,,percent of total billed charges,,,,,,,,,130.5,90,,percent of total billed charges,,,120.06,82.8,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.25,22,,percent of total billed charges,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,36.25,137.75,
ECG ROUTINE ECG W/LEAST 12 LDS 1/R ONLY,105005,CDM,93010,CPT,510,RC,outpatient,,10,10,,8.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.5,22,,percent of total billed charges,,,,,,,,,9,90,,percent of total billed charges,,,8.28,82.8,,percent of total billed charges,,,8.5,85,,percent of total billed charges,,,,,,,,,8.8,88,,percent of total billed charges,,,,,,,,,7.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.5,22,,percent of total billed charges,,,9.1,91,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,,,,,,,,,,,,,8.3,83,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,9,90,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.2,82,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.5,85,,percent of total billed charges,,2.5,9.5,
CARDIOVASCULAR STRESS TEST,105006,CDM,93016,CPT,510,RC,outpatient,,27,27,,22.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.75,22,,percent of total billed charges,,,,,,,,,24.3,90,,percent of total billed charges,,,22.36,82.8,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,,,,,,,,23.76,88,,percent of total billed charges,,,,,,,,,20.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.75,22,,percent of total billed charges,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,,,,,,,,,,,,,22.41,83,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.14,82,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,6.75,25.65,
CARDIOVASCULAR STRESS TEST INTERPRET,105007,CDM,93018,CPT,510,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
OFFICE OUTPT EST,105008,CDM,99215,CPT,510,RC,outpatient,,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
OFFICE OUTPT NEW 60 MIN,105009,CDM,99205,CPT,510,RC,outpatient,,237,237,,201.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.25,22,,percent of total billed charges,,,,,,,,,213.3,90,,percent of total billed charges,,,196.24,82.8,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,,,,,,,,208.56,88,,percent of total billed charges,,,,,,,,,181.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.25,22,,percent of total billed charges,,,215.67,91,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,,,,,,,,,,,,,196.71,83,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,194.34,82,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,59.25,225.15,
ELETROCARDIOGRAM TRACING,105010,CDM,93005,CPT,510,RC,outpatient,,123,123,,104.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.75,22,,percent of total billed charges,,,,,,,,,110.7,90,,percent of total billed charges,,,101.84,82.8,,percent of total billed charges,,,104.55,85,,percent of total billed charges,,,,,,,,,108.24,88,,percent of total billed charges,,,,,,,,,93.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.75,22,,percent of total billed charges,,,111.93,91,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,,,,,,,,,,,,,102.09,83,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,100.86,82,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,104.55,85,,percent of total billed charges,,30.75,116.85,
TTE W/DOPPLER COMPLETE,105011,CDM,93306,CPT,510,RC,outpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.75,22,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,85.28,82.8,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.75,22,,percent of total billed charges,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,25.75,97.85,
NJX SCLRSNT 1 INCMPTNT VEIN,105012,CDM,36470,CPT,510,RC,outpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.75,22,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,85.28,82.8,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.75,22,,percent of total billed charges,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,25.75,97.85,
NJX SCLRSNT MLT INCMPTNT VEIN,105013,CDM,36471,CPT,510,RC,outpatient,,129,129,,109.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.25,22,,percent of total billed charges,,,,,,,,,116.1,90,,percent of total billed charges,,,106.81,82.8,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,,,,,,,,113.52,88,,percent of total billed charges,,,,,,,,,98.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.25,22,,percent of total billed charges,,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,105.78,82,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,32.25,122.55,
OFFICE OUTPT VISIT NEW,105014,CDM,99202,CPT,510,RC,outpatient,,107,107,,90.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.75,22,,percent of total billed charges,,,,,,,,,96.3,90,,percent of total billed charges,,,88.6,82.8,,percent of total billed charges,,,90.95,85,,percent of total billed charges,,,,,,,,,94.16,88,,percent of total billed charges,,,,,,,,,81.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.75,22,,percent of total billed charges,,,97.37,91,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,,,,,,,,,,,,,88.81,83,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,87.74,82,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,90.95,85,,percent of total billed charges,,26.75,101.65,
CARDIOVASCULAR STRESS TEST,105015,CDM,93017,CPT,510,RC,outpatient,,115,115,,97.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.75,22,,percent of total billed charges,,,,,,,,,103.5,90,,percent of total billed charges,,,95.22,82.8,,percent of total billed charges,,,97.75,85,,percent of total billed charges,,,,,,,,,101.2,88,,percent of total billed charges,,,,,,,,,87.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.75,22,,percent of total billed charges,,,104.65,91,,percent of total billed charges,,,109.25,95,,percent of total billed charges,,,95.45,83,,percent of total billed charges,,,95.45,83,,percent of total billed charges,,,,,,,,,,,,,,,95.45,83,,percent of total billed charges,,,109.25,95,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,94.3,82,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,97.75,85,,percent of total billed charges,,28.75,109.25,
TTE W/DOPPLER COMPLETE,105016,CDM,93306,CPT,510,RC,outpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.75,22,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,85.28,82.8,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.75,22,,percent of total billed charges,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,25.75,97.85,
INSERT TEMP BLADDER CATH,141000,CDM,51702,CPT,510,RC,outpatient,,31,31,,26.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.75,22,,percent of total billed charges,,,,,,,,,27.9,90,,percent of total billed charges,,,25.67,82.8,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,,,,,,,,27.28,88,,percent of total billed charges,,,,,,,,,23.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.75,22,,percent of total billed charges,,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,,,,,,,,,,,,,25.73,83,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,25.42,82,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,7.75,29.45,
OFFICE OUTPT NEW 45 MIN,141001,CDM,99204,CPT,510,RC,outpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.5,22,,percent of total billed charges,,,,,,,,,178.2,90,,percent of total billed charges,,,163.94,82.8,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.5,22,,percent of total billed charges,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,49.5,188.1,
OFFICE OUTPT NEW 30 MIN,141002,CDM,99203,CPT,510,RC,outpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.25,22,,percent of total billed charges,,,,,,,,,130.5,90,,percent of total billed charges,,,120.06,82.8,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.25,22,,percent of total billed charges,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,36.25,137.75,
OFFICE OUTPT EST 25 MIN,141003,CDM,99214,CPT,510,RC,outpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.25,22,,percent of total billed charges,,,,,,,,,108.9,90,,percent of total billed charges,,,100.19,82.8,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.25,22,,percent of total billed charges,,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,30.25,114.95,
"OFFICE/OUTPATIENT VISIT, NEW",141004,CDM,99202,CPT,510,RC,outpatient,,107,107,,90.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.75,22,,percent of total billed charges,,,,,,,,,96.3,90,,percent of total billed charges,,,88.6,82.8,,percent of total billed charges,,,90.95,85,,percent of total billed charges,,,,,,,,,94.16,88,,percent of total billed charges,,,,,,,,,81.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.75,22,,percent of total billed charges,,,97.37,91,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,,,,,,,,,,,,,88.81,83,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,87.74,82,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,90.95,85,,percent of total billed charges,,26.75,101.65,
OFFICE OUTPT EST 10 MIN,141005,CDM,99212,CPT,510,RC,outpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.75,22,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,68.72,82.8,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.75,22,,percent of total billed charges,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,20.75,78.85,
OFFICE OUTPT EST 15 MIN,141006,CDM,99213,CPT,510,RC,outpatient,,90,90,,76.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.5,22,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,74.52,82.8,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,,,,,,,,79.2,88,,percent of total billed charges,,,,,,,,,68.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.5,22,,percent of total billed charges,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,73.8,82,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,22.5,85.5,
CYSTOSCOPY,141007,CDM,52000,CPT,510,RC,outpatient,,100,100,,84.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25,22,,percent of total billed charges,,,,,,,,,90,90,,percent of total billed charges,,,82.8,82.8,,percent of total billed charges,,,85,85,,percent of total billed charges,,,,,,,,,88,88,,percent of total billed charges,,,,,,,,,76.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25,22,,percent of total billed charges,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,83,83,,percent of total billed charges,,,,,,,,,,,,,,,83,83,,percent of total billed charges,,,95,95,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,82,82,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,25,95,
BIOPSY OF PROSTATE,141008,CDM,55700,CPT,510,RC,outpatient,,162,162,,137.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.5,22,,percent of total billed charges,,,,,,,,,145.8,90,,percent of total billed charges,,,134.14,82.8,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,,,,,,,,142.56,88,,percent of total billed charges,,,,,,,,,123.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.5,22,,percent of total billed charges,,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,,,,,,,,,,,,,134.46,83,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,132.84,82,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,40.5,153.9,
GARAMYCIN GENTAMICIN INJ,141009,CDM,J1580,HCPCS,636,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,21.3,,,,fee schedule,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21.3,,,,fee schedule,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,21.3,
VOIDING PRESSURE STUDIES/ANY TECH,141010,CDM,51728,CPT,510,RC,outpatient,,129,129,,109.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.25,22,,percent of total billed charges,,,,,,,,,116.1,90,,percent of total billed charges,,,106.81,82.8,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,,,,,,,,113.52,88,,percent of total billed charges,,,,,,,,,98.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.25,22,,percent of total billed charges,,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,105.78,82,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,32.25,122.55,
ANAL/URINARY MUSCLE STUDY,141011,CDM,51784,CPT,510,RC,outpatient,,66,66,,56.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.5,22,,percent of total billed charges,,,,,,,,,59.4,90,,percent of total billed charges,,,54.65,82.8,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,,,,,,,,58.08,88,,percent of total billed charges,,,,,,,,,50.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.5,22,,percent of total billed charges,,,60.06,91,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,,,,,,,,,,,,,54.78,83,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,54.12,82,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,16.5,62.7,
INTRAABDOMINAL PRESSURE TEST,141012,CDM,51797,CPT,510,RC,outpatient,,49,49,,41.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.25,22,,percent of total billed charges,,,,,,,,,44.1,90,,percent of total billed charges,,,40.57,82.8,,percent of total billed charges,,,41.65,85,,percent of total billed charges,,,,,,,,,43.12,88,,percent of total billed charges,,,,,,,,,37.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.25,22,,percent of total billed charges,,,44.59,91,,percent of total billed charges,,,46.55,95,,percent of total billed charges,,,40.67,83,,percent of total billed charges,,,40.67,83,,percent of total billed charges,,,,,,,,,,,,,,,40.67,83,,percent of total billed charges,,,46.55,95,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,40.18,82,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,41.65,85,,percent of total billed charges,,12.25,46.55,
US URINE CAPACITY MEASURE,141013,CDM,51798,CPT,510,RC,outpatient,,26,26,,22.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.5,22,,percent of total billed charges,,,,,,,,,23.4,90,,percent of total billed charges,,,21.53,82.8,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,,,,,,,,22.88,88,,percent of total billed charges,,,,,,,,,19.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.5,22,,percent of total billed charges,,,23.66,91,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,,,,,,,,,,,,,21.58,83,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,21.32,82,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,6.5,24.7,
INSERT BLADDER CATHETER,141014,CDM,51701,CPT,510,RC,outpatient,,144,144,,122.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36,22,,percent of total billed charges,,,,,,,,,129.6,90,,percent of total billed charges,,,119.23,82.8,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,,,,,,,,126.72,88,,percent of total billed charges,,,,,,,,,110.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36,22,,percent of total billed charges,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,118.08,82,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,36,136.8,
URINALYSIS DIPSTICK,141015,CDM,81003,CPT,300,RC,outpatient,,47,47,,39.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.75,22,,percent of total billed charges,,,,,,,,,42.3,90,,percent of total billed charges,,,38.92,82.8,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,,,,,,,,41.36,88,,percent of total billed charges,,,,,,,,,35.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.75,22,,percent of total billed charges,,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,,,,,,,,,,,,,39.01,83,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,38.54,82,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,11.75,44.65,
ELECTRO-UROFLOW FIRST,141016,CDM,51741,CPT,510,RC,outpatient,,136,136,,115.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34,22,,percent of total billed charges,,,,,,,,,122.4,90,,percent of total billed charges,,,112.61,82.8,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,,,,,,,,119.68,88,,percent of total billed charges,,,,,,,,,103.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34,22,,percent of total billed charges,,,123.76,91,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,,,,,,,,,,,,,112.88,83,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,111.52,82,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,34,129.2,
COMPLEX CYSTOMETROGRAM,141017,CDM,51726,CPT,510,RC,outpatient,,515,515,,437.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,128.75,22,,percent of total billed charges,,,,,,,,,463.5,90,,percent of total billed charges,,,426.42,82.8,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,,,,,,,,453.2,88,,percent of total billed charges,,,,,,,,,393.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,128.75,22,,percent of total billed charges,,,468.65,91,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,,,,,,,,,,,,,427.45,83,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,422.3,82,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,128.75,489.25,
CYSTOSCOPY CHEMODENERVATION,141018,CDM,52287,CPT,510,RC,outpatient,,610,610,,517.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,152.5,22,,percent of total billed charges,,,,,,,,,549,90,,percent of total billed charges,,,505.08,82.8,,percent of total billed charges,,,518.5,85,,percent of total billed charges,,,,,,,,,536.8,88,,percent of total billed charges,,,,,,,,,466.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,152.5,22,,percent of total billed charges,,,555.1,91,,percent of total billed charges,,,579.5,95,,percent of total billed charges,,,506.3,83,,percent of total billed charges,,,506.3,83,,percent of total billed charges,,,,,,,,,,,,,,,506.3,83,,percent of total billed charges,,,579.5,95,,percent of total billed charges,,,549,90,,percent of total billed charges,,,549,90,,percent of total billed charges,,,500.2,82,,percent of total billed charges,,,549,90,,percent of total billed charges,,,518.5,85,,percent of total billed charges,,152.5,579.5,
OFFICE OUTPT NEW 60 MIN,141019,CDM,99205,CPT,510,RC,outpatient,,237,237,,201.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.25,22,,percent of total billed charges,,,,,,,,,213.3,90,,percent of total billed charges,,,196.24,82.8,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,,,,,,,,208.56,88,,percent of total billed charges,,,,,,,,,181.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.25,22,,percent of total billed charges,,,215.67,91,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,,,,,,,,,,,,,196.71,83,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,194.34,82,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,59.25,225.15,
INJECTION OF CORPORA CAVERNOSA,141020,CDM,54235,CPT,510,RC,outpatient,,148,148,,125.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37,22,,percent of total billed charges,,,,,,,,,133.2,90,,percent of total billed charges,,,122.54,82.8,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,,,,,,,,130.24,88,,percent of total billed charges,,,,,,,,,113.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37,22,,percent of total billed charges,,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,,,,,,,,,,,,,122.84,83,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,121.36,82,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,37,140.6,
US TRANSRECTAL,141021,CDM,76872,CPT,510,RC,outpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.5,22,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,170.57,82.8,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.5,22,,percent of total billed charges,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,51.5,195.7,
US GUIDANCE NEEDLE PLACEMENT,141022,CDM,76942,CPT,510,RC,outpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.5,22,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,170.57,82.8,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.5,22,,percent of total billed charges,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,51.5,195.7,
REMOVAL OF INDWELLING URETERAL STENT,141023,CDM,52310,CPT,510,RC,outpatient,,683,683,,579.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,170.75,22,,percent of total billed charges,,,,,,,,,614.7,90,,percent of total billed charges,,,565.52,82.8,,percent of total billed charges,,,580.55,85,,percent of total billed charges,,,,,,,,,601.04,88,,percent of total billed charges,,,,,,,,,521.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,170.75,22,,percent of total billed charges,,,621.53,91,,percent of total billed charges,,,648.85,95,,percent of total billed charges,,,566.89,83,,percent of total billed charges,,,566.89,83,,percent of total billed charges,,,,,,,,,,,,,,,566.89,83,,percent of total billed charges,,,648.85,95,,percent of total billed charges,,,614.7,90,,percent of total billed charges,,,614.7,90,,percent of total billed charges,,,560.06,82,,percent of total billed charges,,,614.7,90,,percent of total billed charges,,,580.55,85,,percent of total billed charges,,170.75,648.85,
FITTING/INSERTION OF PESSARY SUPPORT,141024,CDM,57160,CPT,510,RC,outpatient,,155,155,,131.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.75,22,,percent of total billed charges,,,,,,,,,139.5,90,,percent of total billed charges,,,128.34,82.8,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,,,,,,,,136.4,88,,percent of total billed charges,,,,,,,,,118.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.75,22,,percent of total billed charges,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,127.1,82,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,38.75,147.25,
INJECTION ANESTHETIC AGENT/STEROID,141025,CDM,64450,CPT,510,RC,outpatient,,222,222,,188.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.5,22,,percent of total billed charges,,,,,,,,,199.8,90,,percent of total billed charges,,,183.82,82.8,,percent of total billed charges,,,188.7,85,,percent of total billed charges,,,,,,,,,195.36,88,,percent of total billed charges,,,,,,,,,169.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.5,22,,percent of total billed charges,,,202.02,91,,percent of total billed charges,,,210.9,95,,percent of total billed charges,,,184.26,83,,percent of total billed charges,,,184.26,83,,percent of total billed charges,,,,,,,,,,,,,,,184.26,83,,percent of total billed charges,,,210.9,95,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,182.04,82,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,188.7,85,,percent of total billed charges,,55.5,210.9,
NEUROELTRD STIM POST TIBIAL,141026,CDM,64566,CPT,510,RC,outpatient,,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.5,22,,percent of total billed charges,,,,,,,,,275.4,90,,percent of total billed charges,,,253.37,82.8,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.5,22,,percent of total billed charges,,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,76.5,290.7,
ONABOTULINUMTOXINA INJ,141922,CDM,J0585,HCPCS,636,RC,outpatient,,16,16,,13.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4,22,,percent of total billed charges,,,,,,,,,14.4,90,,percent of total billed charges,,,13.25,82.8,,percent of total billed charges,,,13.6,85,,percent of total billed charges,,,,,,,,,14.08,88,,percent of total billed charges,,2491.6,,,,fee schedule,,,12.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2491.6,,,,fee schedule,,,4,22,,percent of total billed charges,,,14.56,91,,percent of total billed charges,,,15.2,95,,percent of total billed charges,,,13.28,83,,percent of total billed charges,,,13.28,83,,percent of total billed charges,,,,,,,,,,,,,,,13.28,83,,percent of total billed charges,,,15.2,95,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,13.12,82,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,13.6,85,,percent of total billed charges,,4,2491.6,
OFFICE OUTPT EST 15MIN,142000,CDM,99213,CPT,510,RC,outpatient,,90,90,,76.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.5,22,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,74.52,82.8,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,,,,,,,,79.2,88,,percent of total billed charges,,,,,,,,,68.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.5,22,,percent of total billed charges,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,73.8,82,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,22.5,85.5,
OFFICE OUTPT NEW 45 MIN,142001,CDM,99204,CPT,510,RC,outpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.5,22,,percent of total billed charges,,,,,,,,,178.2,90,,percent of total billed charges,,,163.94,82.8,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.5,22,,percent of total billed charges,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,49.5,188.1,
EAR MICROSCOPY EXAMINATION,142002,CDM,92504,CPT,510,RC,outpatient,,11,11,,9.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.75,22,,percent of total billed charges,,,,,,,,,9.9,90,,percent of total billed charges,,,9.11,82.8,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,,,,,,,,9.68,88,,percent of total billed charges,,,,,,,,,8.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.75,22,,percent of total billed charges,,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,,,,,,,,,,,,,9.13,83,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.02,82,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,2.75,10.45,
TYMPANOMETRY,142003,CDM,92567,CPT,510,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
"NASAL ENDOSCOPY, DX",142004,CDM,31231,CPT,510,RC,outpatient,,79,79,,67.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.75,22,,percent of total billed charges,,,,,,,,,71.1,90,,percent of total billed charges,,,65.41,82.8,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,,,,,,,,69.52,88,,percent of total billed charges,,,,,,,,,60.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.75,22,,percent of total billed charges,,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,,,,,,,,,,,,,65.57,83,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,64.78,82,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,19.75,75.05,
DIAGNOSTIC LARYNGOSCOPY,142005,CDM,31575,CPT,510,RC,outpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.25,22,,percent of total billed charges,,,,,,,,,72.9,90,,percent of total billed charges,,,67.07,82.8,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.25,22,,percent of total billed charges,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,20.25,76.95,
OFFICE OUTPT NEW 30 MIN,142006,CDM,99203,CPT,510,RC,outpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.25,22,,percent of total billed charges,,,,,,,,,130.5,90,,percent of total billed charges,,,120.06,82.8,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.25,22,,percent of total billed charges,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,36.25,137.75,
OFFICE OUTPT EST 25 MIN,142007,CDM,99214,CPT,510,RC,outpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.25,22,,percent of total billed charges,,,,,,,,,108.9,90,,percent of total billed charges,,,100.19,82.8,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.25,22,,percent of total billed charges,,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,30.25,114.95,
CREATE EARDRUM OPENING,142008,CDM,69433,CPT,510,RC,outpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.75,22,,percent of total billed charges,,,,,,,,,143.1,90,,percent of total billed charges,,,131.65,82.8,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.75,22,,percent of total billed charges,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,39.75,151.05,
NASOPHARYNGOSCOPY,142009,CDM,92511,CPT,510,RC,outpatient,,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.25,22,,percent of total billed charges,,,,,,,,,40.5,90,,percent of total billed charges,,,37.26,82.8,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.25,22,,percent of total billed charges,,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,11.25,42.75,
"OFFICE/OUTPATIENT VISIT, NEW",142010,CDM,99202,CPT,510,RC,outpatient,,107,107,,90.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.75,22,,percent of total billed charges,,,,,,,,,96.3,90,,percent of total billed charges,,,88.6,82.8,,percent of total billed charges,,,90.95,85,,percent of total billed charges,,,,,,,,,94.16,88,,percent of total billed charges,,,,,,,,,81.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.75,22,,percent of total billed charges,,,97.37,91,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,,,,,,,,,,,,,88.81,83,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,87.74,82,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,90.95,85,,percent of total billed charges,,26.75,101.65,
"EXCISION LESION, MOUTH ROOF",142011,CDM,42104,CPT,510,RC,outpatient,,164,164,,139.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41,22,,percent of total billed charges,,,,,,,,,147.6,90,,percent of total billed charges,,,135.79,82.8,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,,,,,,,,144.32,88,,percent of total billed charges,,,,,,,,,125.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41,22,,percent of total billed charges,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,134.48,82,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,41,155.8,
OFFICE OUTPT EST 10 MIN,142012,CDM,99212,CPT,510,RC,outpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.75,22,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,68.72,82.8,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.75,22,,percent of total billed charges,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,20.75,78.85,
RMVL FB XTRNL AUD CANAL W/O ANES,142013,CDM,69200,CPT,510,RC,outpatient,,58,58,,49.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.5,22,,percent of total billed charges,,,,,,,,,52.2,90,,percent of total billed charges,,,48.02,82.8,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,,,,,,,,51.04,88,,percent of total billed charges,,,,,,,,,44.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.5,22,,percent of total billed charges,,,52.78,91,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,,,,,,,,,,,,,48.14,83,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,47.56,82,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,14.5,55.1,
CONTROL OF NOSEBLEED SIMPLE,142014,CDM,30901,CPT,510,RC,outpatient,,71,71,,60.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.75,22,,percent of total billed charges,,,,,,,,,63.9,90,,percent of total billed charges,,,58.79,82.8,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,,,,,,,,62.48,88,,percent of total billed charges,,,,,,,,,54.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.75,22,,percent of total billed charges,,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,,,,,,,,,,,,,58.93,83,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,58.22,82,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,17.75,67.45,
BIOPSY OF TONGUE,142015,CDM,41100,CPT,510,RC,outpatient,,131,131,,111.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.75,22,,percent of total billed charges,,,,,,,,,117.9,90,,percent of total billed charges,,,108.47,82.8,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,,,,,,,,115.28,88,,percent of total billed charges,,,,,,,,,100.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.75,22,,percent of total billed charges,,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,,,,,,,,,,,,,108.73,83,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,107.42,82,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,32.75,124.45,
RMVL IMPACT CERUMEN BY INST SPX 1/2 EARS,142016,CDM,69210,CPT,510,RC,outpatient,,41,41,,34.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.25,22,,percent of total billed charges,,,,,,,,,36.9,90,,percent of total billed charges,,,33.95,82.8,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,,,,,,,,36.08,88,,percent of total billed charges,,,,,,,,,31.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.25,22,,percent of total billed charges,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,,,,,,,,,,,,,34.03,83,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,33.62,82,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,10.25,38.95,
CANALITH REPOSITIONING PROC,142017,CDM,95992,CPT,510,RC,outpatient,,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.25,22,,percent of total billed charges,,,,,,,,,40.5,90,,percent of total billed charges,,,37.26,82.8,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.25,22,,percent of total billed charges,,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,11.25,42.75,
INTRANASAL BIOPSY,142018,CDM,30100,CPT,510,RC,outpatient,,81,81,,68.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.25,22,,percent of total billed charges,,,,,,,,,72.9,90,,percent of total billed charges,,,67.07,82.8,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,,,,,,,,71.28,88,,percent of total billed charges,,,,,,,,,61.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.25,22,,percent of total billed charges,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,66.42,82,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,20.25,76.95,
CLEAN OUT MASTOID CAVITY,142019,CDM,69220,CPT,510,RC,outpatient,,63,63,,53.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.75,22,,percent of total billed charges,,,,,,,,,56.7,90,,percent of total billed charges,,,52.16,82.8,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,,,,,,,,55.44,88,,percent of total billed charges,,,,,,,,,48.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.75,22,,percent of total billed charges,,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,,,,,,,,,,,,,52.29,83,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,51.66,82,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,15.75,59.85,
CONTROL OF NOSEBLEED COMPLEX,142020,CDM,30903,CPT,510,RC,outpatient,,98,98,,83.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.5,22,,percent of total billed charges,,,,,,,,,88.2,90,,percent of total billed charges,,,81.14,82.8,,percent of total billed charges,,,83.3,85,,percent of total billed charges,,,,,,,,,86.24,88,,percent of total billed charges,,,,,,,,,74.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.5,22,,percent of total billed charges,,,89.18,91,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,,,,,,,,,,,,,81.34,83,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,80.36,82,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,83.3,85,,percent of total billed charges,,24.5,93.1,
INJECTION TREATMENT OF NOSE,142021,CDM,30200,CPT,510,RC,outpatient,,71,71,,60.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.75,22,,percent of total billed charges,,,,,,,,,63.9,90,,percent of total billed charges,,,58.79,82.8,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,,,,,,,,62.48,88,,percent of total billed charges,,,,,,,,,54.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.75,22,,percent of total billed charges,,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,,,,,,,,,,,,,58.93,83,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,58.22,82,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,17.75,67.45,
BIOPSY OF LIP,142022,CDM,40490,CPT,510,RC,outpatient,,85,85,,72.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.25,22,,percent of total billed charges,,,,,,,,,76.5,90,,percent of total billed charges,,,70.38,82.8,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,,,,,,,,74.8,88,,percent of total billed charges,,,,,,,,,64.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.25,22,,percent of total billed charges,,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,,,,,,,,,,,,,70.55,83,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,69.7,82,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,21.25,80.75,
SHAVING SKIN LES 1 F/E/E/N/L/M DI 0.5 CM,142023,CDM,11310,CPT,510,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
REPAIR INTER F/E/E/N/L/M/MUC 2.5 CM<,142024,CDM,12051,CPT,510,RC,outpatient,,205,205,,174.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.25,22,,percent of total billed charges,,,,,,,,,184.5,90,,percent of total billed charges,,,169.74,82.8,,percent of total billed charges,,,174.25,85,,percent of total billed charges,,,,,,,,,180.4,88,,percent of total billed charges,,,,,,,,,156.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.25,22,,percent of total billed charges,,,186.55,91,,percent of total billed charges,,,194.75,95,,percent of total billed charges,,,170.15,83,,percent of total billed charges,,,170.15,83,,percent of total billed charges,,,,,,,,,,,,,,,170.15,83,,percent of total billed charges,,,194.75,95,,percent of total billed charges,,,184.5,90,,percent of total billed charges,,,184.5,90,,percent of total billed charges,,,168.1,82,,percent of total billed charges,,,184.5,90,,percent of total billed charges,,,174.25,85,,percent of total billed charges,,51.25,194.75,
EXC B9 LES MARGN F/E/E/N/L/M 0.6-1.0 CM,142025,CDM,11441,CPT,510,RC,outpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.75,22,,percent of total billed charges,,,,,,,,,143.1,90,,percent of total billed charges,,,131.65,82.8,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.75,22,,percent of total billed charges,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,39.75,151.05,
BIOPSY OF MOUTH LESION,142026,CDM,40808,CPT,510,RC,outpatient,,105,105,,89.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.25,22,,percent of total billed charges,,,,,,,,,94.5,90,,percent of total billed charges,,,86.94,82.8,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,,,,,,,,92.4,88,,percent of total billed charges,,,,,,,,,80.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.25,22,,percent of total billed charges,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,86.1,82,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,26.25,99.75,
EXC FACE-MM MALIG+MARG 1.1-2,142027,CDM,11642,CPT,510,RC,outpatient,,220,220,,186.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55,22,,percent of total billed charges,,,,,,,,,198,90,,percent of total billed charges,,,182.16,82.8,,percent of total billed charges,,,187,85,,percent of total billed charges,,,,,,,,,193.6,88,,percent of total billed charges,,,,,,,,,168.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55,22,,percent of total billed charges,,,200.2,91,,percent of total billed charges,,,209,95,,percent of total billed charges,,,182.6,83,,percent of total billed charges,,,182.6,83,,percent of total billed charges,,,,,,,,,,,,,,,182.6,83,,percent of total billed charges,,,209,95,,percent of total billed charges,,,198,90,,percent of total billed charges,,,198,90,,percent of total billed charges,,,180.4,82,,percent of total billed charges,,,198,90,,percent of total billed charges,,,187,85,,percent of total billed charges,,55,209,
DRAINAGE OF TONSIL ABSCESS,142028,CDM,42700,CPT,510,RC,outpatient,,164,164,,139.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41,22,,percent of total billed charges,,,,,,,,,147.6,90,,percent of total billed charges,,,135.79,82.8,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,,,,,,,,144.32,88,,percent of total billed charges,,,,,,,,,125.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41,22,,percent of total billed charges,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,134.48,82,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,41,155.8,
EXC B9 LES MARGN F/E/E/N/L/M 0.5CM/<,142029,CDM,11440,CPT,510,RC,outpatient,,125,125,,106.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.25,22,,percent of total billed charges,,,,,,,,,112.5,90,,percent of total billed charges,,,103.5,82.8,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,,,,,,,,110,88,,percent of total billed charges,,,,,,,,,95.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.25,22,,percent of total billed charges,,,113.75,91,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,,,,,,,,,,,,,103.75,83,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,102.5,82,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,31.25,118.75,
REPAIR COMPL F/C/C/M/N/AX/G 1.1- 2.5 CM,142030,CDM,13131,CPT,510,RC,outpatient,,297,297,,252.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.25,22,,percent of total billed charges,,,,,,,,,267.3,90,,percent of total billed charges,,,245.92,82.8,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,,,,,,,,261.36,88,,percent of total billed charges,,,,,,,,,226.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.25,22,,percent of total billed charges,,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,243.54,82,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,74.25,282.15,
EXC B9 LES MARG XCP F/E/E/N/L/M 1.1-2.0C,142031,CDM,11442,CPT,510,RC,outpatient,,175,175,,148.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.75,22,,percent of total billed charges,,,,,,,,,157.5,90,,percent of total billed charges,,,144.9,82.8,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,,,,,,,,154,88,,percent of total billed charges,,,,,,,,,133.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.75,22,,percent of total billed charges,,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,,,,,,,,,,,,,145.25,83,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,143.5,82,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,43.75,166.25,
REPAIR INTER F/E/E/N/L/M/MUC 2.6-5.0 CM,142032,CDM,12052,CPT,510,RC,outpatient,,243,243,,206.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60.75,22,,percent of total billed charges,,,,,,,,,218.7,90,,percent of total billed charges,,,201.2,82.8,,percent of total billed charges,,,206.55,85,,percent of total billed charges,,,,,,,,,213.84,88,,percent of total billed charges,,,,,,,,,185.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60.75,22,,percent of total billed charges,,,221.13,91,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,,,,,,,,,,,,,201.69,83,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,199.26,82,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,206.55,85,,percent of total billed charges,,60.75,230.85,
DESTRUCTION PREMALIGNANT LESION 2-14 EA,142033,CDM,17003,CPT,510,RC,outpatient,,2,2,,1.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.5,22,,percent of total billed charges,,,,,,,,,1.8,90,,percent of total billed charges,,,1.66,82.8,,percent of total billed charges,,,1.7,85,,percent of total billed charges,,,,,,,,,1.76,88,,percent of total billed charges,,,,,,,,,1.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.5,22,,percent of total billed charges,,,1.82,91,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,,,,,,,,,,,,,1.66,83,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.64,82,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.7,85,,percent of total billed charges,,0.5,1.9,
ESOPHAGOSCOPY FLEXIBLE,142034,CDM,43197,CPT,510,RC,outpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.75,22,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,85.28,82.8,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.75,22,,percent of total billed charges,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,25.75,97.85,
CLEAN OUT MASTOID CAVITY,142035,CDM,69222,CPT,510,RC,outpatient,,164,164,,139.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41,22,,percent of total billed charges,,,,,,,,,147.6,90,,percent of total billed charges,,,135.79,82.8,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,,,,,,,,144.32,88,,percent of total billed charges,,,,,,,,,125.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41,22,,percent of total billed charges,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,134.48,82,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,41,155.8,
DRAINED TONGUE ABSCESS,142036,CDM,41000,CPT,510,RC,outpatient,,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33,22,,percent of total billed charges,,,,,,,,,118.8,90,,percent of total billed charges,,,109.3,82.8,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33,22,,percent of total billed charges,,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,33,125.4,
ELECTRO-UROFLOWMETRY FIRST,142037,CDM,51741,CPT,510,RC,outpatient,,52,52,,44.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13,22,,percent of total billed charges,,,,,,,,,46.8,90,,percent of total billed charges,,,43.06,82.8,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,,,,,,,,45.76,88,,percent of total billed charges,,,,,,,,,39.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13,22,,percent of total billed charges,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,42.64,82,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,13,49.4,
COMPREHENSIVE HEARING TEST,142038,CDM,92557,CPT,510,RC,outpatient,,52,52,,44.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13,22,,percent of total billed charges,,,,,,,,,46.8,90,,percent of total billed charges,,,43.06,82.8,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,,,,,,,,45.76,88,,percent of total billed charges,,,,,,,,,39.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13,22,,percent of total billed charges,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,42.64,82,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,13,49.4,
EVOKED AUDITORY TST COMPLETE,142039,CDM,92588,CPT,510,RC,outpatient,,52,52,,44.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13,22,,percent of total billed charges,,,,,,,,,46.8,90,,percent of total billed charges,,,43.06,82.8,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,,,,,,,,45.76,88,,percent of total billed charges,,,,,,,,,39.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13,22,,percent of total billed charges,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,42.64,82,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,13,49.4,
NASAL/SINUS ENDOSCOPY,142040,CDM,31237,CPT,510,RC,outpatient,,878,878,,745.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,219.5,22,,percent of total billed charges,,,,,,,,,790.2,90,,percent of total billed charges,,,726.98,82.8,,percent of total billed charges,,,746.3,85,,percent of total billed charges,,,,,,,,,772.64,88,,percent of total billed charges,,,,,,,,,670.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,219.5,22,,percent of total billed charges,,,798.98,91,,percent of total billed charges,,,834.1,95,,percent of total billed charges,,,728.74,83,,percent of total billed charges,,,728.74,83,,percent of total billed charges,,,,,,,,,,,,,,,728.74,83,,percent of total billed charges,,,834.1,95,,percent of total billed charges,,,790.2,90,,percent of total billed charges,,,790.2,90,,percent of total billed charges,,,719.96,82,,percent of total billed charges,,,790.2,90,,percent of total billed charges,,,746.3,85,,percent of total billed charges,,219.5,834.1,
LABYRINTHOTOMY TRANSCANAL,142041,CDM,69801,CPT,510,RC,outpatient,,1030,1030,,874.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,257.5,22,,percent of total billed charges,,,,,,,,,927,90,,percent of total billed charges,,,852.84,82.8,,percent of total billed charges,,,875.5,85,,percent of total billed charges,,,,,,,,,906.4,88,,percent of total billed charges,,,,,,,,,786.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,257.5,22,,percent of total billed charges,,,937.3,91,,percent of total billed charges,,,978.5,95,,percent of total billed charges,,,854.9,83,,percent of total billed charges,,,854.9,83,,percent of total billed charges,,,,,,,,,,,,,,,854.9,83,,percent of total billed charges,,,978.5,95,,percent of total billed charges,,,927,90,,percent of total billed charges,,,927,90,,percent of total billed charges,,,844.6,82,,percent of total billed charges,,,927,90,,percent of total billed charges,,,875.5,85,,percent of total billed charges,,257.5,978.5,
INCISION OF EARDRUM,142042,CDM,69420,CPT,510,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,,,,,,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,64.5,245.1,
BIOPSY PALATE UVULA,142043,CDM,42100,CPT,510,RC,outpatient,,309,309,,262.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.25,22,,percent of total billed charges,,,,,,,,,278.1,90,,percent of total billed charges,,,255.85,82.8,,percent of total billed charges,,,262.65,85,,percent of total billed charges,,,,,,,,,271.92,88,,percent of total billed charges,,,,,,,,,236.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.25,22,,percent of total billed charges,,,281.19,91,,percent of total billed charges,,,293.55,95,,percent of total billed charges,,,256.47,83,,percent of total billed charges,,,256.47,83,,percent of total billed charges,,,,,,,,,,,,,,,256.47,83,,percent of total billed charges,,,293.55,95,,percent of total billed charges,,,278.1,90,,percent of total billed charges,,,278.1,90,,percent of total billed charges,,,253.38,82,,percent of total billed charges,,,278.1,90,,percent of total billed charges,,,262.65,85,,percent of total billed charges,,77.25,293.55,
NASAL/SINUS ENDOSCOPY W/CONTROL HEMORRHA,142044,CDM,31238,CPT,510,RC,outpatient,,515,515,,437.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,128.75,22,,percent of total billed charges,,,,,,,,,463.5,90,,percent of total billed charges,,,426.42,82.8,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,,,,,,,,453.2,88,,percent of total billed charges,,,,,,,,,393.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,128.75,22,,percent of total billed charges,,,468.65,91,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,,,,,,,,,,,,,427.45,83,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,422.3,82,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,128.75,489.25,
NASAL/SINUS ENDOSCOPY,142045,CDM,31238,CPT,510,RC,outpatient,,528,528,,448.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132,22,,percent of total billed charges,,,,,,,,,475.2,90,,percent of total billed charges,,,437.18,82.8,,percent of total billed charges,,,448.8,85,,percent of total billed charges,,,,,,,,,464.64,88,,percent of total billed charges,,,,,,,,,403.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132,22,,percent of total billed charges,,,480.48,91,,percent of total billed charges,,,501.6,95,,percent of total billed charges,,,438.24,83,,percent of total billed charges,,,438.24,83,,percent of total billed charges,,,,,,,,,,,,,,,438.24,83,,percent of total billed charges,,,501.6,95,,percent of total billed charges,,,475.2,90,,percent of total billed charges,,,475.2,90,,percent of total billed charges,,,432.96,82,,percent of total billed charges,,,475.2,90,,percent of total billed charges,,,448.8,85,,percent of total billed charges,,132,501.6,
SHAVE SKIN LESION 0.6-1.0CM,142046,CDM,11311,CPT,510,RC,outpatient,,155,155,,131.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.75,22,,percent of total billed charges,,,,,,,,,139.5,90,,percent of total billed charges,,,128.34,82.8,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,,,,,,,,136.4,88,,percent of total billed charges,,,,,,,,,118.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.75,22,,percent of total billed charges,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,127.1,82,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,38.75,147.25,
VISUALIZATION OF WINDPIPE,142047,CDM,31615,CPT,510,RC,outpatient,,487,487,,413.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,121.75,22,,percent of total billed charges,,,,,,,,,438.3,90,,percent of total billed charges,,,403.24,82.8,,percent of total billed charges,,,413.95,85,,percent of total billed charges,,,,,,,,,428.56,88,,percent of total billed charges,,,,,,,,,372.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,121.75,22,,percent of total billed charges,,,443.17,91,,percent of total billed charges,,,462.65,95,,percent of total billed charges,,,404.21,83,,percent of total billed charges,,,404.21,83,,percent of total billed charges,,,,,,,,,,,,,,,404.21,83,,percent of total billed charges,,,462.65,95,,percent of total billed charges,,,438.3,90,,percent of total billed charges,,,438.3,90,,percent of total billed charges,,,399.34,82,,percent of total billed charges,,,438.3,90,,percent of total billed charges,,,413.95,85,,percent of total billed charges,,121.75,462.65,
OFFICE OUTPT NEW 60 MIN,142048,CDM,99205,CPT,510,RC,outpatient,,237,237,,201.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.25,22,,percent of total billed charges,,,,,,,,,213.3,90,,percent of total billed charges,,,196.24,82.8,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,,,,,,,,208.56,88,,percent of total billed charges,,,,,,,,,181.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.25,22,,percent of total billed charges,,,215.67,91,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,,,,,,,,,,,,,196.71,83,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,194.34,82,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,59.25,225.15,
THERAPEUTIC PROPH/DX INJECTION SUBQ/IM,144000,CDM,96372,CPT,510,RC,outpatient,XU,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.25,22,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,63.76,82.8,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.25,22,,percent of total billed charges,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,19.25,73.15,
THER PROPH/DX NJX EA SEQL IV PUSH SBST,144001,CDM,96375,CPT,510,RC,outpatient,,77,77,,65.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.25,22,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,63.76,82.8,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,,,,,,,,67.76,88,,percent of total billed charges,,,,,,,,,58.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.25,22,,percent of total billed charges,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,63.14,82,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,19.25,73.15,
OFFICE OUTPT NEW 30 MIN,144002,CDM,99203,CPT,510,RC,outpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.25,22,,percent of total billed charges,,,,,,,,,130.5,90,,percent of total billed charges,,,120.06,82.8,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.25,22,,percent of total billed charges,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,36.25,137.75,
OFFICE OUTPT NEW 45 MIN,144003,CDM,99204,CPT,510,RC,outpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.5,22,,percent of total billed charges,,,,,,,,,178.2,90,,percent of total billed charges,,,163.94,82.8,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.5,22,,percent of total billed charges,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,49.5,188.1,
OFFICE OUTPT NEW 60 MIN,144004,CDM,99205,CPT,510,RC,outpatient,,165,165,,140.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.25,22,,percent of total billed charges,,,,,,,,,148.5,90,,percent of total billed charges,,,136.62,82.8,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,,,,,,,,145.2,88,,percent of total billed charges,,,,,,,,,126.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.25,22,,percent of total billed charges,,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,135.3,82,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,41.25,156.75,
OFFICE OUTPT EST 10 MIN,144005,CDM,99212,CPT,510,RC,outpatient,,83,83,,70.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.75,22,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,68.72,82.8,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,,,,,,,,73.04,88,,percent of total billed charges,,,,,,,,,63.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.75,22,,percent of total billed charges,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,68.06,82,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,20.75,78.85,
OFFICE OUTPT EST 15 MIN,144006,CDM,99213,CPT,510,RC,outpatient,,90,90,,76.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.5,22,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,74.52,82.8,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,,,,,,,,79.2,88,,percent of total billed charges,,,,,,,,,68.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.5,22,,percent of total billed charges,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,73.8,82,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,22.5,85.5,
OFFICE OUTPT EST 25 MIN,144007,CDM,99214,CPT,510,RC,outpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.25,22,,percent of total billed charges,,,,,,,,,108.9,90,,percent of total billed charges,,,100.19,82.8,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.25,22,,percent of total billed charges,,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,30.25,114.95,
OFFICE OUTPT VISIT EST,144008,CDM,99215,CPT,510,RC,outpatient,,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
OFFICE CONSULT 60 MIN,144009,CDM,99244,CPT,510,RC,outpatient,,129,129,,109.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.25,22,,percent of total billed charges,,,,,,,,,116.1,90,,percent of total billed charges,,,106.81,82.8,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,,,,,,,,113.52,88,,percent of total billed charges,,,,,,,,,98.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.25,22,,percent of total billed charges,,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,105.78,82,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,32.25,122.55,
METHYLPREDNISOLONE INJECTION,144010,CDM,J2930,HCPCS,510,RC,outpatient,,177,177,,150.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.25,22,,percent of total billed charges,,,,,,,,,159.3,90,,percent of total billed charges,,,146.56,82.8,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,,,,,,,,155.76,88,,percent of total billed charges,,172.26,,,,fee schedule,,,135.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,172.26,,,,fee schedule,,,44.25,22,,percent of total billed charges,,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,,,,,,,,,,,,,146.91,83,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,145.14,82,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,44.25,172.26,
PROLONGD SERV W/O CONTACT 1ST HOUR,145000,CDM,99358,CPT,510,RC,outpatient,,249,249,,211.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.25,22,,percent of total billed charges,,,,,,,,,224.1,90,,percent of total billed charges,,,206.17,82.8,,percent of total billed charges,,,211.65,85,,percent of total billed charges,,,,,,,,,219.12,88,,percent of total billed charges,,,,,,,,,190.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.25,22,,percent of total billed charges,,,226.59,91,,percent of total billed charges,,,236.55,95,,percent of total billed charges,,,206.67,83,,percent of total billed charges,,,206.67,83,,percent of total billed charges,,,,,,,,,,,,,,,206.67,83,,percent of total billed charges,,,236.55,95,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,204.18,82,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,211.65,85,,percent of total billed charges,,62.25,236.55,
OFFICE OUTPT NEW 30 MIN,145001,CDM,99203,CPT,510,RC,outpatient,,145,145,,123.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.25,22,,percent of total billed charges,,,,,,,,,130.5,90,,percent of total billed charges,,,120.06,82.8,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,,,,,,,,127.6,88,,percent of total billed charges,,,,,,,,,110.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.25,22,,percent of total billed charges,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,,,,,,,,,,,,,120.35,83,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,118.9,82,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,36.25,137.75,
OFFICE OUTPT EST 15MIN,145002,CDM,99213,CPT,510,RC,outpatient,,90,90,,76.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.5,22,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,74.52,82.8,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,,,,,,,,79.2,88,,percent of total billed charges,,,,,,,,,68.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.5,22,,percent of total billed charges,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,73.8,82,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,22.5,85.5,
ARTHROCENTESIS ASPIR/INJ SMALL JT/BUR,146000,CDM,20600,CPT,510,RC,outpatient,,45,45,,38.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.25,22,,percent of total billed charges,,,,,,,,,40.5,90,,percent of total billed charges,,,37.26,82.8,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,,,,,,,,39.6,88,,percent of total billed charges,,,,,,,,,34.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.25,22,,percent of total billed charges,,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,36.9,82,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,11.25,42.75,
ARTHROCENTESIS ASPIR/INJ INTERM JT/BUR,146001,CDM,20605,CPT,510,RC,outpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.5,22,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,38.09,82.8,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.5,22,,percent of total billed charges,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,11.5,43.7,
ARTHROCENTESIS ASPIR/INJ MAJORJT/BUR,146002,CDM,20610,CPT,510,RC,outpatient,,58,58,,49.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.5,22,,percent of total billed charges,,,,,,,,,52.2,90,,percent of total billed charges,,,48.02,82.8,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,,,,,,,,51.04,88,,percent of total billed charges,,,,,,,,,44.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.5,22,,percent of total billed charges,,,52.78,91,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,,,,,,,,,,,,,48.14,83,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,47.56,82,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,14.5,55.1,
DRAIN/INJ JOINT/BURSA W/US,146003,CDM,20611,CPT,510,RC,outpatient,,75,75,,63.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.75,22,,percent of total billed charges,,,,,,,,,67.5,90,,percent of total billed charges,,,62.1,82.8,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,,,,,,,,66,88,,percent of total billed charges,,,,,,,,,57.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.75,22,,percent of total billed charges,,,68.25,91,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,,,,,,,,,,,,,62.25,83,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,61.5,82,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,18.75,71.25,
ASPIRATION/INJECTION GANGLION CYST ANY L,146004,CDM,20612,CPT,510,RC,outpatient,,155,155,,131.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.75,22,,percent of total billed charges,,,,,,,,,139.5,90,,percent of total billed charges,,,128.34,82.8,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,,,,,,,,136.4,88,,percent of total billed charges,,,,,,,,,118.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.75,22,,percent of total billed charges,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,127.1,82,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,38.75,147.25,
OFFICE OUTPT NEW 45 MIN,146005,CDM,99204,CPT,510,RC,outpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.5,22,,percent of total billed charges,,,,,,,,,178.2,90,,percent of total billed charges,,,163.94,82.8,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.5,22,,percent of total billed charges,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,49.5,188.1,
OFFICE OUTPT EST 25 MIN,146006,CDM,99214,CPT,510,RC,outpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.25,22,,percent of total billed charges,,,,,,,,,108.9,90,,percent of total billed charges,,,100.19,82.8,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.25,22,,percent of total billed charges,,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,30.25,114.95,
OFFICE OUTPT NEW 60 MIN,146007,CDM,99205,CPT,510,RC,outpatient,,165,165,,140.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.25,22,,percent of total billed charges,,,,,,,,,148.5,90,,percent of total billed charges,,,136.62,82.8,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,,,,,,,,145.2,88,,percent of total billed charges,,,,,,,,,126.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.25,22,,percent of total billed charges,,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,135.3,82,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,41.25,156.75,
OFFICE OUTPT EST 25 MIN,151000,CDM,99214,CPT,510,RC,outpatient,,121,121,,102.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.25,22,,percent of total billed charges,,,,,,,,,108.9,90,,percent of total billed charges,,,100.19,82.8,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,,,,,,,,106.48,88,,percent of total billed charges,,,,,,,,,92.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.25,22,,percent of total billed charges,,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,99.22,82,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,30.25,114.95,
OFFICE OUTPT NEW 45 MIN,151001,CDM,99204,CPT,510,RC,outpatient,,198,198,,168.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.5,22,,percent of total billed charges,,,,,,,,,178.2,90,,percent of total billed charges,,,163.94,82.8,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,,,,,,,,174.24,88,,percent of total billed charges,,,,,,,,,151.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.5,22,,percent of total billed charges,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,162.36,82,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,49.5,188.1,
OFFICE OUTPT NEW 60 MIN,151002,CDM,99205,CPT,510,RC,outpatient,,165,165,,140.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.25,22,,percent of total billed charges,,,,,,,,,148.5,90,,percent of total billed charges,,,136.62,82.8,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,,,,,,,,145.2,88,,percent of total billed charges,,,,,,,,,126.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.25,22,,percent of total billed charges,,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,135.3,82,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,41.25,156.75,
"IV CHEMO INFUSION UP TO 1 HR, SGL/INIT",4540121,CDM,96413,CPT,335,RC,outpatient,,1975,1975,,1676.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,493.75,22,,percent of total billed charges,,,,,,,,,1777.5,90,,percent of total billed charges,,,1635.3,82.8,,percent of total billed charges,,,1678.75,85,,percent of total billed charges,,,,,,,,,1738,88,,percent of total billed charges,,,,,,,,,1508.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,493.75,22,,percent of total billed charges,,,1797.25,91,,percent of total billed charges,,,1876.25,95,,percent of total billed charges,,,1639.25,83,,percent of total billed charges,,,1639.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1639.25,83,,percent of total billed charges,,,1876.25,95,,percent of total billed charges,,,1777.5,90,,percent of total billed charges,,,1777.5,90,,percent of total billed charges,,,1619.5,82,,percent of total billed charges,,,1777.5,90,,percent of total billed charges,,,1678.75,85,,percent of total billed charges,,493.75,1876.25,
"IV CHEMO INFUSION, EA ADDTL HR, TO 8 HR",4540122,CDM,96415,CPT,335,RC,outpatient,,335,335,,284.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.75,22,,percent of total billed charges,,,,,,,,,301.5,90,,percent of total billed charges,,,277.38,82.8,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,,,,,,,,294.8,88,,percent of total billed charges,,,,,,,,,255.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.75,22,,percent of total billed charges,,,304.85,91,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,,,,,,,,,,,,,278.05,83,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,274.7,82,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,83.75,318.25,
CHEMO PROLONG INFUSE W/PUMP,4540125,CDM,96416,CPT,335,RC,outpatient,,1896,1896,,1609.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,474,22,,percent of total billed charges,,,,,,,,,1706.4,90,,percent of total billed charges,,,1569.89,82.8,,percent of total billed charges,,,1611.6,85,,percent of total billed charges,,,,,,,,,1668.48,88,,percent of total billed charges,,,,,,,,,1448.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,474,22,,percent of total billed charges,,,1725.36,91,,percent of total billed charges,,,1801.2,95,,percent of total billed charges,,,1573.68,83,,percent of total billed charges,,,1573.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1573.68,83,,percent of total billed charges,,,1801.2,95,,percent of total billed charges,,,1706.4,90,,percent of total billed charges,,,1706.4,90,,percent of total billed charges,,,1554.72,82,,percent of total billed charges,,,1706.4,90,,percent of total billed charges,,,1611.6,85,,percent of total billed charges,,474,1801.2,
"CHEMO ADMIN IV PUSH ONLY, SINGLE OR INIT",4540154,CDM,96409,CPT,335,RC,outpatient,,713,713,,605.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.25,22,,percent of total billed charges,,,,,,,,,641.7,90,,percent of total billed charges,,,590.36,82.8,,percent of total billed charges,,,606.05,85,,percent of total billed charges,,,,,,,,,627.44,88,,percent of total billed charges,,,,,,,,,544.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.25,22,,percent of total billed charges,,,648.83,91,,percent of total billed charges,,,677.35,95,,percent of total billed charges,,,591.79,83,,percent of total billed charges,,,591.79,83,,percent of total billed charges,,,,,,,,,,,,,,,591.79,83,,percent of total billed charges,,,677.35,95,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,584.66,82,,percent of total billed charges,,,641.7,90,,percent of total billed charges,,,606.05,85,,percent of total billed charges,,178.25,677.35,
"CHEMO - IV PUSH, EA ADDTL SUBSTANCE/DRUG",4540160,CDM,96411,CPT,335,RC,outpatient,,643,643,,545.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,160.75,22,,percent of total billed charges,,,,,,,,,578.7,90,,percent of total billed charges,,,532.4,82.8,,percent of total billed charges,,,546.55,85,,percent of total billed charges,,,,,,,,,565.84,88,,percent of total billed charges,,,,,,,,,491.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,160.75,22,,percent of total billed charges,,,585.13,91,,percent of total billed charges,,,610.85,95,,percent of total billed charges,,,533.69,83,,percent of total billed charges,,,533.69,83,,percent of total billed charges,,,,,,,,,,,,,,,533.69,83,,percent of total billed charges,,,610.85,95,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,527.26,82,,percent of total billed charges,,,578.7,90,,percent of total billed charges,,,546.55,85,,percent of total billed charges,,160.75,610.85,
"CHEMO - INFUSION OF DIF DRUG, UP TO 1 HR",4540165,CDM,96417,CPT,335,RC,outpatient,,536,536,,455.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,134,22,,percent of total billed charges,,,,,,,,,482.4,90,,percent of total billed charges,,,443.81,82.8,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,,,,,,,,471.68,88,,percent of total billed charges,,,,,,,,,409.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,134,22,,percent of total billed charges,,,487.76,91,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,,,,,,,,,,,,,444.88,83,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,439.52,82,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,134,509.2,
"CHEMO - SQ,IM (NONHORMONAL,ANTINEOPLAST)",4540170,CDM,96401,CPT,331,RC,outpatient,,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.75,22,,percent of total billed charges,,,,,,,,,449.1,90,,percent of total billed charges,,,413.17,82.8,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.75,22,,percent of total billed charges,,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,124.75,474.05,
"CHEMO - SQ,IM (HORMONAL,ANTINEOPLASTIC)",4540171,CDM,96402,CPT,331,RC,outpatient,,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.75,22,,percent of total billed charges,,,,,,,,,449.1,90,,percent of total billed charges,,,413.17,82.8,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.75,22,,percent of total billed charges,,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,124.75,474.05,
CS WITH BIOPSY OF CERVIX ONLY,4540186,CDM,57455,CPT,510,RC,outpatient,,979,979,,831.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,244.75,22,,percent of total billed charges,,,,,,,,,881.1,90,,percent of total billed charges,,,810.61,82.8,,percent of total billed charges,,,832.15,85,,percent of total billed charges,,,,,,,,,861.52,88,,percent of total billed charges,,,,,,,,,747.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,244.75,22,,percent of total billed charges,,,890.89,91,,percent of total billed charges,,,930.05,95,,percent of total billed charges,,,812.57,83,,percent of total billed charges,,,812.57,83,,percent of total billed charges,,,,,,,,,,,,,,,812.57,83,,percent of total billed charges,,,930.05,95,,percent of total billed charges,,,881.1,90,,percent of total billed charges,,,881.1,90,,percent of total billed charges,,,802.78,82,,percent of total billed charges,,,881.1,90,,percent of total billed charges,,,832.15,85,,percent of total billed charges,,244.75,930.05,
CS WITH BIOPSY ENDO CURETTAGE ONLY,4540187,CDM,57456,CPT,510,RC,outpatient,,672,672,,570.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,168,22,,percent of total billed charges,,,,,,,,,604.8,90,,percent of total billed charges,,,556.42,82.8,,percent of total billed charges,,,571.2,85,,percent of total billed charges,,,,,,,,,591.36,88,,percent of total billed charges,,,,,,,,,513.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,168,22,,percent of total billed charges,,,611.52,91,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,,,,,,,,,,,,,557.76,83,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,551.04,82,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,571.2,85,,percent of total billed charges,,168,638.4,
CS WITH BIOPSY OF CERVIX & ENDO CURETTAG,4540188,CDM,57454,CPT,510,RC,outpatient,,1054,1054,,894.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,263.5,22,,percent of total billed charges,,,,,,,,,948.6,90,,percent of total billed charges,,,872.71,82.8,,percent of total billed charges,,,895.9,85,,percent of total billed charges,,,,,,,,,927.52,88,,percent of total billed charges,,,,,,,,,805.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,263.5,22,,percent of total billed charges,,,959.14,91,,percent of total billed charges,,,1001.3,95,,percent of total billed charges,,,874.82,83,,percent of total billed charges,,,874.82,83,,percent of total billed charges,,,,,,,,,,,,,,,874.82,83,,percent of total billed charges,,,1001.3,95,,percent of total billed charges,,,948.6,90,,percent of total billed charges,,,948.6,90,,percent of total billed charges,,,864.28,82,,percent of total billed charges,,,948.6,90,,percent of total billed charges,,,895.9,85,,percent of total billed charges,,263.5,1001.3,
LEEP,4540195,CDM,57460,CPT,510,RC,outpatient,,3962,3962,,3363.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,990.5,22,,percent of total billed charges,,,,,,,,,3565.8,90,,percent of total billed charges,,,3280.54,82.8,,percent of total billed charges,,,3367.7,85,,percent of total billed charges,,,,,,,,,3486.56,88,,percent of total billed charges,,,,,,,,,3026.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,990.5,22,,percent of total billed charges,,,3605.42,91,,percent of total billed charges,,,3763.9,95,,percent of total billed charges,,,3288.46,83,,percent of total billed charges,,,3288.46,83,,percent of total billed charges,,,,,,,,,,,,,,,3288.46,83,,percent of total billed charges,,,3763.9,95,,percent of total billed charges,,,3565.8,90,,percent of total billed charges,,,3565.8,90,,percent of total billed charges,,,3248.84,82,,percent of total billed charges,,,3565.8,90,,percent of total billed charges,,,3367.7,85,,percent of total billed charges,,990.5,3763.9,
COLPOSCOPY,4540196,CDM,57452,CPT,510,RC,outpatient,,890,890,,755.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,222.5,22,,percent of total billed charges,,,,,,,,,801,90,,percent of total billed charges,,,736.92,82.8,,percent of total billed charges,,,756.5,85,,percent of total billed charges,,,,,,,,,783.2,88,,percent of total billed charges,,,,,,,,,679.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,222.5,22,,percent of total billed charges,,,809.9,91,,percent of total billed charges,,,845.5,95,,percent of total billed charges,,,738.7,83,,percent of total billed charges,,,738.7,83,,percent of total billed charges,,,,,,,,,,,,,,,738.7,83,,percent of total billed charges,,,845.5,95,,percent of total billed charges,,,801,90,,percent of total billed charges,,,801,90,,percent of total billed charges,,,729.8,82,,percent of total billed charges,,,801,90,,percent of total billed charges,,,756.5,85,,percent of total billed charges,,222.5,845.5,
PHLEBOTOMY THERAPEUTIC SEPERATE PROCEDUR,4540199,CDM,99195,CPT,940,RC,outpatient,,336,336,,285.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84,22,,percent of total billed charges,,,,,,,,,302.4,90,,percent of total billed charges,,,278.21,82.8,,percent of total billed charges,,,285.6,85,,percent of total billed charges,,,,,,,,,295.68,88,,percent of total billed charges,,,,,,,,,256.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84,22,,percent of total billed charges,,,305.76,91,,percent of total billed charges,,,319.2,95,,percent of total billed charges,,,278.88,83,,percent of total billed charges,,,278.88,83,,percent of total billed charges,,,,,,,,,,,,,,,278.88,83,,percent of total billed charges,,,319.2,95,,percent of total billed charges,,,302.4,90,,percent of total billed charges,,,302.4,90,,percent of total billed charges,,,275.52,82,,percent of total billed charges,,,302.4,90,,percent of total billed charges,,,285.6,85,,percent of total billed charges,,84,319.2,
BLOOD ADMINISTRATION SERVICE,4540200,CDM,36430,CPT,391,RC,outpatient,,1766,1766,,1499.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,441.5,22,,percent of total billed charges,,,,,,,,,1589.4,90,,percent of total billed charges,,,1462.25,82.8,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,,,,,,,,1554.08,88,,percent of total billed charges,,,,,,,,,1349.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,441.5,22,,percent of total billed charges,,,1607.06,91,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.78,83,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1448.12,82,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,441.5,1677.7,
BLOOD ADMIN UP TO 4 HOURS(V11-20),4540201,CDM,36430,CPT,391,RC,outpatient,,2303,2303,,1955.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,575.75,22,,percent of total billed charges,,,,,,,,,2072.7,90,,percent of total billed charges,,,1906.88,82.8,,percent of total billed charges,,,1957.55,85,,percent of total billed charges,,,,,,,,,2026.64,88,,percent of total billed charges,,,,,,,,,1759.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,575.75,22,,percent of total billed charges,,,2095.73,91,,percent of total billed charges,,,2187.85,95,,percent of total billed charges,,,1911.49,83,,percent of total billed charges,,,1911.49,83,,percent of total billed charges,,,,,,,,,,,,,,,1911.49,83,,percent of total billed charges,,,2187.85,95,,percent of total billed charges,,,2072.7,90,,percent of total billed charges,,,2072.7,90,,percent of total billed charges,,,1888.46,82,,percent of total billed charges,,,2072.7,90,,percent of total billed charges,,,1957.55,85,,percent of total billed charges,,575.75,2187.85,
BLOOD ADMIN UP TO 6 HOURS(V-11-20),4540202,CDM,36430,CPT,391,RC,outpatient,,2769,2769,,2350.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,692.25,22,,percent of total billed charges,,,,,,,,,2492.1,90,,percent of total billed charges,,,2292.73,82.8,,percent of total billed charges,,,2353.65,85,,percent of total billed charges,,,,,,,,,2436.72,88,,percent of total billed charges,,,,,,,,,2115.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,692.25,22,,percent of total billed charges,,,2519.79,91,,percent of total billed charges,,,2630.55,95,,percent of total billed charges,,,2298.27,83,,percent of total billed charges,,,2298.27,83,,percent of total billed charges,,,,,,,,,,,,,,,2298.27,83,,percent of total billed charges,,,2630.55,95,,percent of total billed charges,,,2492.1,90,,percent of total billed charges,,,2492.1,90,,percent of total billed charges,,,2270.58,82,,percent of total billed charges,,,2492.1,90,,percent of total billed charges,,,2353.65,85,,percent of total billed charges,,692.25,2630.55,
BLOOD ADMIN OVER 6 HOURS(V-11-20),4540203,CDM,36430,CPT,391,RC,outpatient,,3080,3080,,2614.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,770,22,,percent of total billed charges,,,,,,,,,2772,90,,percent of total billed charges,,,2550.24,82.8,,percent of total billed charges,,,2618,85,,percent of total billed charges,,,,,,,,,2710.4,88,,percent of total billed charges,,,,,,,,,2353.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,770,22,,percent of total billed charges,,,2802.8,91,,percent of total billed charges,,,2926,95,,percent of total billed charges,,,2556.4,83,,percent of total billed charges,,,2556.4,83,,percent of total billed charges,,,,,,,,,,,,,,,2556.4,83,,percent of total billed charges,,,2926,95,,percent of total billed charges,,,2772,90,,percent of total billed charges,,,2772,90,,percent of total billed charges,,,2525.6,82,,percent of total billed charges,,,2772,90,,percent of total billed charges,,,2618,85,,percent of total billed charges,,770,2926,
COMPLEX UROFLOWMETRY,4540205,CDM,51741,CPT,510,RC,outpatient,,1662,1662,,1411.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,415.5,22,,percent of total billed charges,,,,,,,,,1495.8,90,,percent of total billed charges,,,1376.14,82.8,,percent of total billed charges,,,1412.7,85,,percent of total billed charges,,,,,,,,,1462.56,88,,percent of total billed charges,,,,,,,,,1269.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,415.5,22,,percent of total billed charges,,,1512.42,91,,percent of total billed charges,,,1578.9,95,,percent of total billed charges,,,1379.46,83,,percent of total billed charges,,,1379.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1379.46,83,,percent of total billed charges,,,1578.9,95,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1362.84,82,,percent of total billed charges,,,1495.8,90,,percent of total billed charges,,,1412.7,85,,percent of total billed charges,,415.5,1578.9,
MEASUR POST VOID URINE US PFA,4540206,CDM,51798,CPT,510,RC,outpatient,TC,335,335,,284.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.75,22,,percent of total billed charges,,,,,,,,,301.5,90,,percent of total billed charges,,,277.38,82.8,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,,,,,,,,294.8,88,,percent of total billed charges,,,,,,,,,255.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.75,22,,percent of total billed charges,,,304.85,91,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,,,,,,,,,,,,,278.05,83,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,274.7,82,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,83.75,318.25,
BLOOD DRAW FROM IVAD,4540207,CDM,36591,CPT,510,RC,outpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.25,22,,percent of total billed charges,,,,,,,,,202.5,90,,percent of total billed charges,,,186.3,82.8,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.25,22,,percent of total billed charges,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,56.25,213.75,
"BLOOD DRAW FROM CVAD, PICC, PERIPH IV",4540208,CDM,36592,CPT,510,RC,outpatient,,206,206,,174.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.5,22,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,170.57,82.8,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,,,,,,,,181.28,88,,percent of total billed charges,,,,,,,,,157.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.5,22,,percent of total billed charges,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,168.92,82,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,51.5,195.7,
*DECLOTTING THROMB AGENT VASCULAR(V0108),4540210,CDM,36550,CPT,360,RC,outpatient,,340,340,,288.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85,22,,percent of total billed charges,,,,,,,,,306,90,,percent of total billed charges,,,281.52,82.8,,percent of total billed charges,,,289,85,,percent of total billed charges,,,,,,,,,299.2,88,,percent of total billed charges,,,,,,,,,259.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85,22,,percent of total billed charges,,,309.4,91,,percent of total billed charges,,,323,95,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,,,,,,,,,,,,,282.2,83,,percent of total billed charges,,,323,95,,percent of total billed charges,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,278.8,82,,percent of total billed charges,,,306,90,,percent of total billed charges,,,289,85,,percent of total billed charges,,85,323,
DECLOTTING THROMB AGENT VASCULAR,4540211,CDM,36593,CPT,510,RC,outpatient,,1013,1013,,860.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,253.25,22,,percent of total billed charges,,,,,,,,,911.7,90,,percent of total billed charges,,,838.76,82.8,,percent of total billed charges,,,861.05,85,,percent of total billed charges,,,,,,,,,891.44,88,,percent of total billed charges,,,,,,,,,773.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,253.25,22,,percent of total billed charges,,,921.83,91,,percent of total billed charges,,,962.35,95,,percent of total billed charges,,,840.79,83,,percent of total billed charges,,,840.79,83,,percent of total billed charges,,,,,,,,,,,,,,,840.79,83,,percent of total billed charges,,,962.35,95,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,830.66,82,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,861.05,85,,percent of total billed charges,,253.25,962.35,
IM/SQ INJECTION,4540215,CDM,96372,CPT,940,RC,outpatient,XU,416,416,,353.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104,22,,percent of total billed charges,,,,,,,,,374.4,90,,percent of total billed charges,,,344.45,82.8,,percent of total billed charges,,,353.6,85,,percent of total billed charges,,,,,,,,,366.08,88,,percent of total billed charges,,,,,,,,,317.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104,22,,percent of total billed charges,,,378.56,91,,percent of total billed charges,,,395.2,95,,percent of total billed charges,,,345.28,83,,percent of total billed charges,,,345.28,83,,percent of total billed charges,,,,,,,,,,,,,,,345.28,83,,percent of total billed charges,,,395.2,95,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,341.12,82,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,353.6,85,,percent of total billed charges,,104,395.2,
IV PUSH - SINGLE OR INITIAL,4540217,CDM,96374,CPT,510,RC,outpatient,XU,436,436,,370.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109,22,,percent of total billed charges,,,,,,,,,392.4,90,,percent of total billed charges,,,361.01,82.8,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,,,,,,,,383.68,88,,percent of total billed charges,,,,,,,,,333.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109,22,,percent of total billed charges,,,396.76,91,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,,,,,,,,,,,,,361.88,83,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,357.52,82,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,109,414.2,
IV PUSH - EA ADDTL SEQUENTIAL IVP,4540218,CDM,96375,CPT,510,RC,outpatient,XU,359,359,,304.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.75,22,,percent of total billed charges,,,,,,,,,323.1,90,,percent of total billed charges,,,297.25,82.8,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,,,,,,,,315.92,88,,percent of total billed charges,,,,,,,,,274.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.75,22,,percent of total billed charges,,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,,,,,,,,,,,,,297.97,83,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,294.38,82,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,89.75,341.05,
"IV HYDRATION, INITIAL, FIRST HOUR",4540219,CDM,96360,CPT,510,RC,outpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208,22,,percent of total billed charges,,,,,,,,,748.8,90,,percent of total billed charges,,,688.9,82.8,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208,22,,percent of total billed charges,,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,208,790.4,
"IV HYDRATION EACH HR, UP TO 8 HRS",4540220,CDM,96361,CPT,510,RC,outpatient,XU,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.75,22,,percent of total billed charges,,,,,,,,,225.9,90,,percent of total billed charges,,,207.83,82.8,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.75,22,,percent of total billed charges,,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,62.75,238.45,
IV INFUSION UP TO 1 HR,4540222,CDM,96365,CPT,510,RC,outpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208,22,,percent of total billed charges,,,,,,,,,748.8,90,,percent of total billed charges,,,688.9,82.8,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208,22,,percent of total billed charges,,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,208,790.4,
IV INFUSION ADD (2ND) HR OR 2ND SAME DAY,4540225,CDM,96366,CPT,510,RC,outpatient,XU,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.75,22,,percent of total billed charges,,,,,,,,,225.9,90,,percent of total billed charges,,,207.83,82.8,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.75,22,,percent of total billed charges,,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,62.75,238.45,
IV INFUSION 3RD HOUR OR 3RD PER DAY,4540226,CDM,96366,CPT,510,RC,outpatient,XU,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
"IV INFUSION OF DIF DRUG, UP TO 1 HR",4540227,CDM,96367,CPT,510,RC,outpatient,,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.75,22,,percent of total billed charges,,,,,,,,,449.1,90,,percent of total billed charges,,,413.17,82.8,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.75,22,,percent of total billed charges,,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,124.75,474.05,
IV INFUSION - CONCURRENT INFUSION,4540229,CDM,96368,CPT,510,RC,outpatient,XU,522,522,,443.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.5,22,,percent of total billed charges,,,,,,,,,469.8,90,,percent of total billed charges,,,432.22,82.8,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,,,,,,,,459.36,88,,percent of total billed charges,,,,,,,,,398.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.5,22,,percent of total billed charges,,,475.02,91,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,,,,,,,,,,,,,433.26,83,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,428.04,82,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,130.5,495.9,
INJECTION EA ADDTL SEQ IVP OF SAME SUBST,4540233,CDM,96376,CPT,510,RC,outpatient,XU,310,310,,263.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.5,22,,percent of total billed charges,,,,,,,,,279,90,,percent of total billed charges,,,256.68,82.8,,percent of total billed charges,,,263.5,85,,percent of total billed charges,,,,,,,,,272.8,88,,percent of total billed charges,,,,,,,,,236.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.5,22,,percent of total billed charges,,,282.1,91,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,,,,,,,,,,,,,257.3,83,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,279,90,,percent of total billed charges,,,279,90,,percent of total billed charges,,,254.2,82,,percent of total billed charges,,,279,90,,percent of total billed charges,,,263.5,85,,percent of total billed charges,,77.5,294.5,
IRRIGATION OF IV AD FOR DRUG DELIVERY,4540240,CDM,96523,CPT,510,RC,outpatient,,536,536,,455.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,134,22,,percent of total billed charges,,,,,,,,,482.4,90,,percent of total billed charges,,,443.81,82.8,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,,,,,,,,471.68,88,,percent of total billed charges,,,,,,,,,409.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,134,22,,percent of total billed charges,,,487.76,91,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,,,,,,,,,,,,,444.88,83,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,439.52,82,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,134,509.2,
BONE MARROW ASPIRATION & BIOPSY,4540301,CDM,G0364,HCPCS,510,RC,outpatient,,762,762,,646.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,190.5,22,,percent of total billed charges,,,,,,,,,685.8,90,,percent of total billed charges,,,630.94,82.8,,percent of total billed charges,,,647.7,85,,percent of total billed charges,,,,,,,,,670.56,88,,percent of total billed charges,,,,,,,,,582.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,190.5,22,,percent of total billed charges,,,693.42,91,,percent of total billed charges,,,723.9,95,,percent of total billed charges,,,632.46,83,,percent of total billed charges,,,632.46,83,,percent of total billed charges,,,,,,,,,,,,,,,632.46,83,,percent of total billed charges,,,723.9,95,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,624.84,82,,percent of total billed charges,,,685.8,90,,percent of total billed charges,,,647.7,85,,percent of total billed charges,,190.5,723.9,
BONE MARROW ASPIRATION,4540302,CDM,38221,CPT,510,RC,outpatient,,1523,1523,,1293.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,380.75,22,,percent of total billed charges,,,,,,,,,1370.7,90,,percent of total billed charges,,,1261.04,82.8,,percent of total billed charges,,,1294.55,85,,percent of total billed charges,,,,,,,,,1340.24,88,,percent of total billed charges,,,,,,,,,1163.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,380.75,22,,percent of total billed charges,,,1385.93,91,,percent of total billed charges,,,1446.85,95,,percent of total billed charges,,,1264.09,83,,percent of total billed charges,,,1264.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1264.09,83,,percent of total billed charges,,,1446.85,95,,percent of total billed charges,,,1370.7,90,,percent of total billed charges,,,1370.7,90,,percent of total billed charges,,,1248.86,82,,percent of total billed charges,,,1370.7,90,,percent of total billed charges,,,1294.55,85,,percent of total billed charges,,380.75,1446.85,
APPLICATION OF ON-BODY INJECTOR,4540303,CDM,96377,CPT,940,RC,outpatient,,512,512,,434.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,128,22,,percent of total billed charges,,,,,,,,,460.8,90,,percent of total billed charges,,,423.94,82.8,,percent of total billed charges,,,435.2,85,,percent of total billed charges,,,,,,,,,450.56,88,,percent of total billed charges,,,,,,,,,391.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,128,22,,percent of total billed charges,,,465.92,91,,percent of total billed charges,,,486.4,95,,percent of total billed charges,,,424.96,83,,percent of total billed charges,,,424.96,83,,percent of total billed charges,,,,,,,,,,,,,,,424.96,83,,percent of total billed charges,,,486.4,95,,percent of total billed charges,,,460.8,90,,percent of total billed charges,,,460.8,90,,percent of total billed charges,,,419.84,82,,percent of total billed charges,,,460.8,90,,percent of total billed charges,,,435.2,85,,percent of total billed charges,,128,486.4,
LUMBAR PUNCTURE,4540350,CDM,62270,CPT,510,RC,outpatient,,1500,1500,,1273.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375,22,,percent of total billed charges,,,,,,,,,1350,90,,percent of total billed charges,,,1242,82.8,,percent of total billed charges,,,1275,85,,percent of total billed charges,,,,,,,,,1320,88,,percent of total billed charges,,,,,,,,,1146,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,375,22,,percent of total billed charges,,,1365,91,,percent of total billed charges,,,1425,95,,percent of total billed charges,,,1245,83,,percent of total billed charges,,,1245,83,,percent of total billed charges,,,,,,,,,,,,,,,1245,83,,percent of total billed charges,,,1425,95,,percent of total billed charges,,,1350,90,,percent of total billed charges,,,1350,90,,percent of total billed charges,,,1230,82,,percent of total billed charges,,,1350,90,,percent of total billed charges,,,1275,85,,percent of total billed charges,,375,1425,
DRUG SCREENING COLLECTION,4540355,CDM,,,300,RC,outpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.75,22,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,42.23,82.8,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.75,22,,percent of total billed charges,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,12.75,48.45,
BLADDER IRRIGATION SIMPLE LAVAGE,4540360,CDM,51700,CPT,510,RC,outpatient,,715,715,,607.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.75,22,,percent of total billed charges,,,,,,,,,643.5,90,,percent of total billed charges,,,592.02,82.8,,percent of total billed charges,,,607.75,85,,percent of total billed charges,,,,,,,,,629.2,88,,percent of total billed charges,,,,,,,,,546.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.75,22,,percent of total billed charges,,,650.65,91,,percent of total billed charges,,,679.25,95,,percent of total billed charges,,,593.45,83,,percent of total billed charges,,,593.45,83,,percent of total billed charges,,,,,,,,,,,,,,,593.45,83,,percent of total billed charges,,,679.25,95,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,586.3,82,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,607.75,85,,percent of total billed charges,,178.75,679.25,
INSERT NON INDWELLING BLAD CATH,4540361,CDM,51701,CPT,510,RC,outpatient,,359,359,,304.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.75,22,,percent of total billed charges,,,,,,,,,323.1,90,,percent of total billed charges,,,297.25,82.8,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,,,,,,,,315.92,88,,percent of total billed charges,,,,,,,,,274.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.75,22,,percent of total billed charges,,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,,,,,,,,,,,,,297.97,83,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,294.38,82,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,89.75,341.05,
INSERT TEMPORARY INDWEELING CATH,4540362,CDM,51702,CPT,510,RC,outpatient,,548,548,,465.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,137,22,,percent of total billed charges,,,,,,,,,493.2,90,,percent of total billed charges,,,453.74,82.8,,percent of total billed charges,,,465.8,85,,percent of total billed charges,,,,,,,,,482.24,88,,percent of total billed charges,,,,,,,,,418.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,137,22,,percent of total billed charges,,,498.68,91,,percent of total billed charges,,,520.6,95,,percent of total billed charges,,,454.84,83,,percent of total billed charges,,,454.84,83,,percent of total billed charges,,,,,,,,,,,,,,,454.84,83,,percent of total billed charges,,,520.6,95,,percent of total billed charges,,,493.2,90,,percent of total billed charges,,,493.2,90,,percent of total billed charges,,,449.36,82,,percent of total billed charges,,,493.2,90,,percent of total billed charges,,,465.8,85,,percent of total billed charges,,137,520.6,
OPC PREOP E/M EXAM,4540500,CDM,G0463,HCPCS,510,RC,outpatient,,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.5,22,,percent of total billed charges,,,,,,,,,307.8,90,,percent of total billed charges,,,283.18,82.8,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.5,22,,percent of total billed charges,,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,85.5,324.9,
TREATMENT ROOM - OPC,4540601,CDM,G0463,HCPCS,510,RC,outpatient,,536,536,,455.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,134,22,,percent of total billed charges,,,,,,,,,482.4,90,,percent of total billed charges,,,443.81,82.8,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,,,,,,,,471.68,88,,percent of total billed charges,,,,,,,,,409.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,134,22,,percent of total billed charges,,,487.76,91,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,,,,,,,,,,,,,444.88,83,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,439.52,82,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,134,509.2,
EXTERNAL ELECTROCARDIOGRAPHIC 7-15 DAYS,4540650,CDM,93248,CPT,510,RC,outpatient,,174,174,,147.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.5,22,,percent of total billed charges,,,,,,,,,156.6,90,,percent of total billed charges,,,144.07,82.8,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,,,,,,,,153.12,88,,percent of total billed charges,,,,,,,,,132.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.5,22,,percent of total billed charges,,,158.34,91,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,,,,,,,,,,,,,144.42,83,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,142.68,82,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,43.5,165.3,
FF OPC MONITOR PRESSURE COMPART SYNDROME,4540700,CDM,20950,CPT,510,RC,outpatient,,874,874,,742.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.5,22,,percent of total billed charges,,,,,,,,,786.6,90,,percent of total billed charges,,,723.67,82.8,,percent of total billed charges,,,742.9,85,,percent of total billed charges,,,,,,,,,769.12,88,,percent of total billed charges,,,,,,,,,667.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.5,22,,percent of total billed charges,,,795.34,91,,percent of total billed charges,,,830.3,95,,percent of total billed charges,,,725.42,83,,percent of total billed charges,,,725.42,83,,percent of total billed charges,,,,,,,,,,,,,,,725.42,83,,percent of total billed charges,,,830.3,95,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,716.68,82,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,742.9,85,,percent of total billed charges,,218.5,830.3,
BLADDER INSTILLATION OF ANTICARCINOGENIC,4540900,CDM,51720,CPT,510,RC,outpatient,,2395,2395,,2033.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,598.75,22,,percent of total billed charges,,,,,,,,,2155.5,90,,percent of total billed charges,,,1983.06,82.8,,percent of total billed charges,,,2035.75,85,,percent of total billed charges,,,,,,,,,2107.6,88,,percent of total billed charges,,,,,,,,,1829.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,598.75,22,,percent of total billed charges,,,2179.45,91,,percent of total billed charges,,,2275.25,95,,percent of total billed charges,,,1987.85,83,,percent of total billed charges,,,1987.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1987.85,83,,percent of total billed charges,,,2275.25,95,,percent of total billed charges,,,2155.5,90,,percent of total billed charges,,,2155.5,90,,percent of total billed charges,,,1963.9,82,,percent of total billed charges,,,2155.5,90,,percent of total billed charges,,,2035.75,85,,percent of total billed charges,,598.75,2275.25,
CHANGE OF G-TUBE,4540905,CDM,43762,CPT,510,RC,outpatient,,1234,1234,,1047.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,308.5,22,,percent of total billed charges,,,,,,,,,1110.6,90,,percent of total billed charges,,,1021.75,82.8,,percent of total billed charges,,,1048.9,85,,percent of total billed charges,,,,,,,,,1085.92,88,,percent of total billed charges,,,,,,,,,942.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,308.5,22,,percent of total billed charges,,,1122.94,91,,percent of total billed charges,,,1172.3,95,,percent of total billed charges,,,1024.22,83,,percent of total billed charges,,,1024.22,83,,percent of total billed charges,,,,,,,,,,,,,,,1024.22,83,,percent of total billed charges,,,1172.3,95,,percent of total billed charges,,,1110.6,90,,percent of total billed charges,,,1110.6,90,,percent of total billed charges,,,1011.88,82,,percent of total billed charges,,,1110.6,90,,percent of total billed charges,,,1048.9,85,,percent of total billed charges,,308.5,1172.3,
NERVE CONDUCTION EA NERVE W/O WAVE,4595900,CDM,95900,CPT,922,RC,outpatient,TC,385,385,,326.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.25,22,,percent of total billed charges,,,,,,,,,346.5,90,,percent of total billed charges,,,318.78,82.8,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,,,,,,,,338.8,88,,percent of total billed charges,,,,,,,,,294.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.25,22,,percent of total billed charges,,,350.35,91,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,,,,,,,,,,,,,319.55,83,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,315.7,82,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,96.25,365.75,
NERVE CONDUCTION EA NERVE WITH WAVE,4595903,CDM,95903,CPT,922,RC,outpatient,TC,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.5,22,,percent of total billed charges,,,,,,,,,394.2,90,,percent of total billed charges,,,362.66,82.8,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.5,22,,percent of total billed charges,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,109.5,416.1,
NERVE CONDUCTION AMPL EA NERVE SENSORY,4595904,CDM,95904,CPT,922,RC,outpatient,TC,343,343,,291.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.75,22,,percent of total billed charges,,,,,,,,,308.7,90,,percent of total billed charges,,,284,82.8,,percent of total billed charges,,,291.55,85,,percent of total billed charges,,,,,,,,,301.84,88,,percent of total billed charges,,,,,,,,,262.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.75,22,,percent of total billed charges,,,312.13,91,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,,,,,,,,,,,,,284.69,83,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,281.26,82,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,291.55,85,,percent of total billed charges,,85.75,325.85,
H REFLEX STUDY GASTRO SOLEUS MUSCLE,4595934,CDM,95934,CPT,510,RC,outpatient,,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.5,22,,percent of total billed charges,,,,,,,,,394.2,90,,percent of total billed charges,,,362.66,82.8,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.5,22,,percent of total billed charges,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,109.5,416.1,
ER/OR OXYGEN (CHG. FOR O2),13800169,CDM,,,270,RC,outpatient,,183,183,,155.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.75,22,,percent of total billed charges,,,,,,,,,164.7,90,,percent of total billed charges,,,151.52,82.8,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,,,,,,,,161.04,88,,percent of total billed charges,,,,,,,,,139.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.75,22,,percent of total billed charges,,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,,,,,,,,,,,,,151.89,83,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,150.06,82,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,45.75,173.85,
OXYGEN PER HOUR,13800177,CDM,,,270,RC,outpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27,22,,percent of total billed charges,,,,,,,,,97.2,90,,percent of total billed charges,,,89.42,82.8,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27,22,,percent of total billed charges,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,27,102.6,
RECOVERY ROOM 1ST HR,19604009,CDM,,,710,RC,outpatient,,1987,1987,,1686.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,496.75,22,,percent of total billed charges,,,,,,,,,1788.3,90,,percent of total billed charges,,,1645.24,82.8,,percent of total billed charges,,,1688.95,85,,percent of total billed charges,,,,,,,,,1748.56,88,,percent of total billed charges,,,,,,,,,1518.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,496.75,22,,percent of total billed charges,,,1808.17,91,,percent of total billed charges,,,1887.65,95,,percent of total billed charges,,,1649.21,83,,percent of total billed charges,,,1649.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1649.21,83,,percent of total billed charges,,,1887.65,95,,percent of total billed charges,,,1788.3,90,,percent of total billed charges,,,1788.3,90,,percent of total billed charges,,,1629.34,82,,percent of total billed charges,,,1788.3,90,,percent of total billed charges,,,1688.95,85,,percent of total billed charges,,496.75,1887.65,
PACU RECOVERY ROOM 1ST HR,19604010,CDM,,,710,RC,outpatient,,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.25,22,,percent of total billed charges,,,,,,,,,155.7,90,,percent of total billed charges,,,143.24,82.8,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.25,22,,percent of total billed charges,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,43.25,164.35,
PACU ADDTL RECOVERY ROOM,19604011,CDM,,,710,RC,outpatient,,88,88,,74.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22,22,,percent of total billed charges,,,,,,,,,79.2,90,,percent of total billed charges,,,72.86,82.8,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,,,,,,,,77.44,88,,percent of total billed charges,,,,,,,,,67.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22,22,,percent of total billed charges,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,,,,,,,,,,,,,73.04,83,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,72.16,82,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,22,83.6,
RECOVERY ROOM ADDT 15 MIN,19604025,CDM,,,710,RC,outpatient,,395,395,,335.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.75,22,,percent of total billed charges,,,,,,,,,355.5,90,,percent of total billed charges,,,327.06,82.8,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,,,,,,,,347.6,88,,percent of total billed charges,,,,,,,,,301.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.75,22,,percent of total billed charges,,,359.45,91,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,,,,,,,,,,,,,327.85,83,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,323.9,82,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,98.75,375.25,
BONE MARROW BIOPSY,19604100,CDM,,,360,RC,outpatient,,2889,2889,,2452.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,722.25,22,,percent of total billed charges,,,,,,,,,2600.1,90,,percent of total billed charges,,,2392.09,82.8,,percent of total billed charges,,,2455.65,85,,percent of total billed charges,,,,,,,,,2542.32,88,,percent of total billed charges,,,,,,,,,2207.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,722.25,22,,percent of total billed charges,,,2628.99,91,,percent of total billed charges,,,2744.55,95,,percent of total billed charges,,,2397.87,83,,percent of total billed charges,,,2397.87,83,,percent of total billed charges,,,,,,,,,,,,,,,2397.87,83,,percent of total billed charges,,,2744.55,95,,percent of total billed charges,,,2600.1,90,,percent of total billed charges,,,2600.1,90,,percent of total billed charges,,,2368.98,82,,percent of total billed charges,,,2600.1,90,,percent of total billed charges,,,2455.65,85,,percent of total billed charges,,722.25,2744.55,
BONE MARROW ASPIRATION,19604110,CDM,38220,CPT,310,RC,outpatient,,4643,4643,,3941.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1160.75,22,,percent of total billed charges,,,,,,,,,4178.7,90,,percent of total billed charges,,,3844.4,82.8,,percent of total billed charges,,,3946.55,85,,percent of total billed charges,,,,,,,,,4085.84,88,,percent of total billed charges,,,,,,,,,3547.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1160.75,22,,percent of total billed charges,,,4225.13,91,,percent of total billed charges,,,4410.85,95,,percent of total billed charges,,,3853.69,83,,percent of total billed charges,,,3853.69,83,,percent of total billed charges,,,,,,,,,,,,,,,3853.69,83,,percent of total billed charges,,,4410.85,95,,percent of total billed charges,,,4178.7,90,,percent of total billed charges,,,4178.7,90,,percent of total billed charges,,,3807.26,82,,percent of total billed charges,,,4178.7,90,,percent of total billed charges,,,3946.55,85,,percent of total billed charges,,1160.75,4410.85,
NM PET LTD OF CHEST HEAD/NECK,28101300,CDM,78811,CPT,340,RC,outpatient,TC,7195,7195,,6108.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1798.75,22,,percent of total billed charges,,,,,,,,,6475.5,90,,percent of total billed charges,,,5957.46,82.8,,percent of total billed charges,,,6115.75,85,,percent of total billed charges,,,,,,,,,6331.6,88,,percent of total billed charges,,,,,,,,,5496.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1798.75,22,,percent of total billed charges,,,6547.45,91,,percent of total billed charges,,,6835.25,95,,percent of total billed charges,,,5971.85,83,,percent of total billed charges,,,5971.85,83,,percent of total billed charges,,,,,,,,,,,,,,,5971.85,83,,percent of total billed charges,,,6835.25,95,,percent of total billed charges,,,6475.5,90,,percent of total billed charges,,,6475.5,90,,percent of total billed charges,,,5899.9,82,,percent of total billed charges,,,6475.5,90,,percent of total billed charges,,,6115.75,85,,percent of total billed charges,,1798.75,6835.25,
NM PET SKULL BASE TO MID THIGH,28101301,CDM,78812,CPT,340,RC,outpatient,TC,8805,8805,,7475.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2201.25,22,,percent of total billed charges,,,,,,,,,7924.5,90,,percent of total billed charges,,,7290.54,82.8,,percent of total billed charges,,,7484.25,85,,percent of total billed charges,,,,,,,,,7748.4,88,,percent of total billed charges,,,,,,,,,6727.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2201.25,22,,percent of total billed charges,,,8012.55,91,,percent of total billed charges,,,8364.75,95,,percent of total billed charges,,,7308.15,83,,percent of total billed charges,,,7308.15,83,,percent of total billed charges,,,,,,,,,,,,,,,7308.15,83,,percent of total billed charges,,,8364.75,95,,percent of total billed charges,,,7924.5,90,,percent of total billed charges,,,7924.5,90,,percent of total billed charges,,,7220.1,82,,percent of total billed charges,,,7924.5,90,,percent of total billed charges,,,7484.25,85,,percent of total billed charges,,2201.25,8364.75,
NM PET WHOLE BODY,28101302,CDM,78813,CPT,340,RC,outpatient,TC,8794,8794,,7466.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2198.5,22,,percent of total billed charges,,,,,,,,,7914.6,90,,percent of total billed charges,,,7281.43,82.8,,percent of total billed charges,,,7474.9,85,,percent of total billed charges,,,,,,,,,7738.72,88,,percent of total billed charges,,,,,,,,,6718.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2198.5,22,,percent of total billed charges,,,8002.54,91,,percent of total billed charges,,,8354.3,95,,percent of total billed charges,,,7299.02,83,,percent of total billed charges,,,7299.02,83,,percent of total billed charges,,,,,,,,,,,,,,,7299.02,83,,percent of total billed charges,,,8354.3,95,,percent of total billed charges,,,7914.6,90,,percent of total billed charges,,,7914.6,90,,percent of total billed charges,,,7211.08,82,,percent of total billed charges,,,7914.6,90,,percent of total billed charges,,,7474.9,85,,percent of total billed charges,,2198.5,8354.3,
NM PET CT FOR ATT LTD,28101303,CDM,78814,CPT,340,RC,outpatient,TC,8482,8482,,7201.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2120.5,22,,percent of total billed charges,,,,,,,,,7633.8,90,,percent of total billed charges,,,7023.1,82.8,,percent of total billed charges,,,7209.7,85,,percent of total billed charges,,,,,,,,,7464.16,88,,percent of total billed charges,,,,,,,,,6480.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2120.5,22,,percent of total billed charges,,,7718.62,91,,percent of total billed charges,,,8057.9,95,,percent of total billed charges,,,7040.06,83,,percent of total billed charges,,,7040.06,83,,percent of total billed charges,,,,,,,,,,,,,,,7040.06,83,,percent of total billed charges,,,8057.9,95,,percent of total billed charges,,,7633.8,90,,percent of total billed charges,,,7633.8,90,,percent of total billed charges,,,6955.24,82,,percent of total billed charges,,,7633.8,90,,percent of total billed charges,,,7209.7,85,,percent of total billed charges,,2120.5,8057.9,
NM PET CT ATT SKULL BASE MID TH,28101304,CDM,78815,CPT,340,RC,outpatient,TC,9386,9386,,7968.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2346.5,22,,percent of total billed charges,,,,,,,,,8447.4,90,,percent of total billed charges,,,7771.61,82.8,,percent of total billed charges,,,7978.1,85,,percent of total billed charges,,,,,,,,,8259.68,88,,percent of total billed charges,,,,,,,,,7170.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2346.5,22,,percent of total billed charges,,,8541.26,91,,percent of total billed charges,,,8916.7,95,,percent of total billed charges,,,7790.38,83,,percent of total billed charges,,,7790.38,83,,percent of total billed charges,,,,,,,,,,,,,,,7790.38,83,,percent of total billed charges,,,8916.7,95,,percent of total billed charges,,,8447.4,90,,percent of total billed charges,,,8447.4,90,,percent of total billed charges,,,7696.52,82,,percent of total billed charges,,,8447.4,90,,percent of total billed charges,,,7978.1,85,,percent of total billed charges,,2346.5,8916.7,
NM PET CT ATT WHOLE BODY,28101305,CDM,78816,CPT,340,RC,outpatient,TC,9527,9527,,8088.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2381.75,22,,percent of total billed charges,,,,,,,,,8574.3,90,,percent of total billed charges,,,7888.36,82.8,,percent of total billed charges,,,8097.95,85,,percent of total billed charges,,,,,,,,,8383.76,88,,percent of total billed charges,,,,,,,,,7278.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2381.75,22,,percent of total billed charges,,,8669.57,91,,percent of total billed charges,,,9050.65,95,,percent of total billed charges,,,7907.41,83,,percent of total billed charges,,,7907.41,83,,percent of total billed charges,,,,,,,,,,,,,,,7907.41,83,,percent of total billed charges,,,9050.65,95,,percent of total billed charges,,,8574.3,90,,percent of total billed charges,,,8574.3,90,,percent of total billed charges,,,7812.14,82,,percent of total billed charges,,,8574.3,90,,percent of total billed charges,,,8097.95,85,,percent of total billed charges,,2381.75,9050.65,
NM PET CT PROSTATE SKULL TO THIGH,28101500,CDM,78815,CPT,340,RC,outpatient,TC,9386,9386,,7968.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2346.5,22,,percent of total billed charges,,,,,,,,,8447.4,90,,percent of total billed charges,,,7771.61,82.8,,percent of total billed charges,,,7978.1,85,,percent of total billed charges,,,,,,,,,8259.68,88,,percent of total billed charges,,,,,,,,,7170.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2346.5,22,,percent of total billed charges,,,8541.26,91,,percent of total billed charges,,,8916.7,95,,percent of total billed charges,,,7790.38,83,,percent of total billed charges,,,7790.38,83,,percent of total billed charges,,,,,,,,,,,,,,,7790.38,83,,percent of total billed charges,,,8916.7,95,,percent of total billed charges,,,8447.4,90,,percent of total billed charges,,,8447.4,90,,percent of total billed charges,,,7696.52,82,,percent of total billed charges,,,8447.4,90,,percent of total billed charges,,,7978.1,85,,percent of total billed charges,,2346.5,8916.7,
NM PET CT PROSTATE WHOLE BODY,28101501,CDM,78816,CPT,340,RC,outpatient,TC,9527,9527,,8088.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2381.75,22,,percent of total billed charges,,,,,,,,,8574.3,90,,percent of total billed charges,,,7888.36,82.8,,percent of total billed charges,,,8097.95,85,,percent of total billed charges,,,,,,,,,8383.76,88,,percent of total billed charges,,,,,,,,,7278.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2381.75,22,,percent of total billed charges,,,8669.57,91,,percent of total billed charges,,,9050.65,95,,percent of total billed charges,,,7907.41,83,,percent of total billed charges,,,7907.41,83,,percent of total billed charges,,,,,,,,,,,,,,,7907.41,83,,percent of total billed charges,,,9050.65,95,,percent of total billed charges,,,8574.3,90,,percent of total billed charges,,,8574.3,90,,percent of total billed charges,,,7812.14,82,,percent of total billed charges,,,8574.3,90,,percent of total billed charges,,,8097.95,85,,percent of total billed charges,,2381.75,9050.65,
NM DOSE PET/DOSE (<45 mCi),28103291,CDM,A9552,HCPCS,636,RC,outpatient,,1793,1793,,1522.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,448.25,22,,percent of total billed charges,,,,,,,,,1613.7,90,,percent of total billed charges,,,1484.6,82.8,,percent of total billed charges,,,1524.05,85,,percent of total billed charges,,,,,,,,,1577.84,88,,percent of total billed charges,,,,,,,,,1369.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,448.25,22,,percent of total billed charges,,,1631.63,91,,percent of total billed charges,,,1703.35,95,,percent of total billed charges,,,1488.19,83,,percent of total billed charges,,,1488.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1488.19,83,,percent of total billed charges,,,1703.35,95,,percent of total billed charges,,,1613.7,90,,percent of total billed charges,,,1613.7,90,,percent of total billed charges,,,1470.26,82,,percent of total billed charges,,,1613.7,90,,percent of total billed charges,,,1524.05,85,,percent of total billed charges,,448.25,1703.35,
NM DOSE PIFLUFOLASTAT F-18 DIAGNOSTIC,28103292,CDM,A9595,HCPCS,636,RC,outpatient,,4928,4928,,4183.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1232,22,,percent of total billed charges,,,,,,,,,4435.2,90,,percent of total billed charges,,,4080.38,82.8,,percent of total billed charges,,,4188.8,85,,percent of total billed charges,,,,,,,,,4336.64,88,,percent of total billed charges,,,,,,,,,3764.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1232,22,,percent of total billed charges,,,4484.48,91,,percent of total billed charges,,,4681.6,95,,percent of total billed charges,,,4090.24,83,,percent of total billed charges,,,4090.24,83,,percent of total billed charges,,,,,,,,,,,,,,,4090.24,83,,percent of total billed charges,,,4681.6,95,,percent of total billed charges,,,4435.2,90,,percent of total billed charges,,,4435.2,90,,percent of total billed charges,,,4040.96,82,,percent of total billed charges,,,4435.2,90,,percent of total billed charges,,,4188.8,85,,percent of total billed charges,,1232,4681.6,
AMERICAINE OTIC DROPS 15ML,3200847,CDM,,,250,RC,outpatient,,64,64,,54.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16,22,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,52.99,82.8,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,,,,,,,,56.32,88,,percent of total billed charges,,,,,,,,,48.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16,22,,percent of total billed charges,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,,,,,,,,,,,,,53.12,83,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,52.48,82,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,16,60.8,
P-EPHED/FEXO(ALLEGRA D 12HR)TAB:120-60MG,32000007,CDM,,,250,RC,outpatient,,25.38,25.38,,21.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.35,22,,percent of total billed charges,,,,,,,,,22.84,90,,percent of total billed charges,,,21.01,82.8,,percent of total billed charges,,,21.57,85,,percent of total billed charges,,,,,,,,,22.33,88,,percent of total billed charges,,,,,,,,,19.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.35,22,,percent of total billed charges,,,23.1,91,,percent of total billed charges,,,24.11,95,,percent of total billed charges,,,21.07,83,,percent of total billed charges,,,21.07,83,,percent of total billed charges,,,,,,,,,,,,,,,21.07,83,,percent of total billed charges,,,24.11,95,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,20.81,82,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,21.57,85,,percent of total billed charges,,6.35,24.11,
METIPRANO(OPTIPRANOLOL)DROP:0.3% 10ML,32000008,CDM,,,250,RC,outpatient,,588.41,588.41,,499.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,147.1,22,,percent of total billed charges,,,,,,,,,529.57,90,,percent of total billed charges,,,487.2,82.8,,percent of total billed charges,,,500.15,85,,percent of total billed charges,,,,,,,,,517.8,88,,percent of total billed charges,,,,,,,,,449.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,147.1,22,,percent of total billed charges,,,535.45,91,,percent of total billed charges,,,558.99,95,,percent of total billed charges,,,488.38,83,,percent of total billed charges,,,488.38,83,,percent of total billed charges,,,,,,,,,,,,,,,488.38,83,,percent of total billed charges,,,558.99,95,,percent of total billed charges,,,529.57,90,,percent of total billed charges,,,529.57,90,,percent of total billed charges,,,482.5,82,,percent of total billed charges,,,529.57,90,,percent of total billed charges,,,500.15,85,,percent of total billed charges,,147.1,558.99,
OLANZAPINE (Zyprexia) TAB : 5MG,32000009,CDM,,,250,RC,outpatient,,203.8,203.8,,173.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.95,22,,percent of total billed charges,,,,,,,,,183.42,90,,percent of total billed charges,,,168.75,82.8,,percent of total billed charges,,,173.23,85,,percent of total billed charges,,,,,,,,,179.34,88,,percent of total billed charges,,,,,,,,,155.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.95,22,,percent of total billed charges,,,185.46,91,,percent of total billed charges,,,193.61,95,,percent of total billed charges,,,169.15,83,,percent of total billed charges,,,169.15,83,,percent of total billed charges,,,,,,,,,,,,,,,169.15,83,,percent of total billed charges,,,193.61,95,,percent of total billed charges,,,183.42,90,,percent of total billed charges,,,183.42,90,,percent of total billed charges,,,167.12,82,,percent of total billed charges,,,183.42,90,,percent of total billed charges,,,173.23,85,,percent of total billed charges,,50.95,193.61,
NATEGLINIDE (STARLIX) TAB : 60MG,32000010,CDM,,,250,RC,outpatient,,59.95,59.95,,50.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.99,22,,percent of total billed charges,,,,,,,,,53.96,90,,percent of total billed charges,,,49.64,82.8,,percent of total billed charges,,,50.96,85,,percent of total billed charges,,,,,,,,,52.76,88,,percent of total billed charges,,,,,,,,,45.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.99,22,,percent of total billed charges,,,54.55,91,,percent of total billed charges,,,56.95,95,,percent of total billed charges,,,49.76,83,,percent of total billed charges,,,49.76,83,,percent of total billed charges,,,,,,,,,,,,,,,49.76,83,,percent of total billed charges,,,56.95,95,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,49.16,82,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,50.96,85,,percent of total billed charges,,14.99,56.95,
ESOMEPRAZOLE (NEXIUM) CAP:40MG,32000012,CDM,,,250,RC,outpatient,,131.48,131.48,,111.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.87,22,,percent of total billed charges,,,,,,,,,118.33,90,,percent of total billed charges,,,108.87,82.8,,percent of total billed charges,,,111.76,85,,percent of total billed charges,,,,,,,,,115.7,88,,percent of total billed charges,,,,,,,,,100.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.87,22,,percent of total billed charges,,,119.65,91,,percent of total billed charges,,,124.91,95,,percent of total billed charges,,,109.13,83,,percent of total billed charges,,,109.13,83,,percent of total billed charges,,,,,,,,,,,,,,,109.13,83,,percent of total billed charges,,,124.91,95,,percent of total billed charges,,,118.33,90,,percent of total billed charges,,,118.33,90,,percent of total billed charges,,,107.81,82,,percent of total billed charges,,,118.33,90,,percent of total billed charges,,,111.76,85,,percent of total billed charges,,32.87,124.91,
ACARBOSE(PRECOSE)TAB:25MG,32000013,CDM,,,250,RC,outpatient,,13.48,13.48,,11.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.37,22,,percent of total billed charges,,,,,,,,,12.13,90,,percent of total billed charges,,,11.16,82.8,,percent of total billed charges,,,11.46,85,,percent of total billed charges,,,,,,,,,11.86,88,,percent of total billed charges,,,,,,,,,10.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.37,22,,percent of total billed charges,,,12.27,91,,percent of total billed charges,,,12.81,95,,percent of total billed charges,,,11.19,83,,percent of total billed charges,,,11.19,83,,percent of total billed charges,,,,,,,,,,,,,,,11.19,83,,percent of total billed charges,,,12.81,95,,percent of total billed charges,,,12.13,90,,percent of total billed charges,,,12.13,90,,percent of total billed charges,,,11.05,82,,percent of total billed charges,,,12.13,90,,percent of total billed charges,,,11.46,85,,percent of total billed charges,,3.37,12.81,
DEXTRAN 70/HYPROMELL (BION TEAR)DROP  EA,32000014,CDM,,,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
ABBOKINASE  **J3365**,32000017,CDM,J3365,HCPCS,636,RC,outpatient,,740,740,,628.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,185,22,,percent of total billed charges,,,,,,,,,666,90,,percent of total billed charges,,,612.72,82.8,,percent of total billed charges,,,629,85,,percent of total billed charges,,,,,,,,,651.2,88,,percent of total billed charges,,,,,,,,,565.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,185,22,,percent of total billed charges,,,673.4,91,,percent of total billed charges,,,703,95,,percent of total billed charges,,,614.2,83,,percent of total billed charges,,,614.2,83,,percent of total billed charges,,,,,,,,,,,,,,,614.2,83,,percent of total billed charges,,,703,95,,percent of total billed charges,,,666,90,,percent of total billed charges,,,666,90,,percent of total billed charges,,,606.8,82,,percent of total billed charges,,,666,90,,percent of total billed charges,,,629,85,,percent of total billed charges,,185,703,
LIDOCAINE 5% PATCH (LIDODERM),32000018,CDM,,,250,RC,outpatient,,118.75,118.75,,100.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.69,22,,percent of total billed charges,,,,,,,,,106.88,90,,percent of total billed charges,,,98.33,82.8,,percent of total billed charges,,,100.94,85,,percent of total billed charges,,,,,,,,,104.5,88,,percent of total billed charges,,,,,,,,,90.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.69,22,,percent of total billed charges,,,108.06,91,,percent of total billed charges,,,112.81,95,,percent of total billed charges,,,98.56,83,,percent of total billed charges,,,98.56,83,,percent of total billed charges,,,,,,,,,,,,,,,98.56,83,,percent of total billed charges,,,112.81,95,,percent of total billed charges,,,106.88,90,,percent of total billed charges,,,106.88,90,,percent of total billed charges,,,97.38,82,,percent of total billed charges,,,106.88,90,,percent of total billed charges,,,100.94,85,,percent of total billed charges,,29.69,112.81,
CHOLESTY/ASPART(QUESTRAN)POW(CAN-239.4G),32000019,CDM,,,250,RC,outpatient,,899.67,899.67,,763.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,224.92,22,,percent of total billed charges,,,,,,,,,809.7,90,,percent of total billed charges,,,744.93,82.8,,percent of total billed charges,,,764.72,85,,percent of total billed charges,,,,,,,,,791.71,88,,percent of total billed charges,,,,,,,,,687.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,224.92,22,,percent of total billed charges,,,818.7,91,,percent of total billed charges,,,854.69,95,,percent of total billed charges,,,746.73,83,,percent of total billed charges,,,746.73,83,,percent of total billed charges,,,,,,,,,,,,,,,746.73,83,,percent of total billed charges,,,854.69,95,,percent of total billed charges,,,809.7,90,,percent of total billed charges,,,809.7,90,,percent of total billed charges,,,737.73,82,,percent of total billed charges,,,809.7,90,,percent of total billed charges,,,764.72,85,,percent of total billed charges,,224.92,854.69,
ACYCLOVIR(ZOVIRAX):1000MG/20ML  (J/5MG),32000020,CDM,J0133,HCPCS,636,RC,outpatient,,84.31,84.31,,71.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.08,22,,percent of total billed charges,,,,,,,,,75.88,90,,percent of total billed charges,,,69.81,82.8,,percent of total billed charges,,,71.66,85,,percent of total billed charges,,,,,,,,,74.19,88,,percent of total billed charges,,31.5,,,,fee schedule,,,64.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,31.5,,,,fee schedule,,,21.08,22,,percent of total billed charges,,,76.72,91,,percent of total billed charges,,,80.09,95,,percent of total billed charges,,,69.98,83,,percent of total billed charges,,,69.98,83,,percent of total billed charges,,,,,,,,,,,,,,,69.98,83,,percent of total billed charges,,,80.09,95,,percent of total billed charges,,,75.88,90,,percent of total billed charges,,,75.88,90,,percent of total billed charges,,,69.13,82,,percent of total billed charges,,,75.88,90,,percent of total billed charges,,,71.66,85,,percent of total billed charges,,21.08,80.09,
ZAFIRLUKAST(ACCOLATE)TAB:20MG,32000021,CDM,J8499,HCPCS,250,RC,outpatient,,37.42,37.42,,31.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.36,22,,percent of total billed charges,,,,,,,,,33.68,90,,percent of total billed charges,,,30.98,82.8,,percent of total billed charges,,,31.81,85,,percent of total billed charges,,,,,,,,,32.93,88,,percent of total billed charges,,,,,,,,,28.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.36,22,,percent of total billed charges,,,34.05,91,,percent of total billed charges,,,35.55,95,,percent of total billed charges,,,31.06,83,,percent of total billed charges,,,31.06,83,,percent of total billed charges,,,,,,,,,,,,,,,31.06,83,,percent of total billed charges,,,35.55,95,,percent of total billed charges,,,33.68,90,,percent of total billed charges,,,33.68,90,,percent of total billed charges,,,30.68,82,,percent of total billed charges,,,33.68,90,,percent of total billed charges,,,31.81,85,,percent of total billed charges,,9.36,35.55,
HYPROMELLOSE(GENTEAL) DROP :0.3% 15ML,32000023,CDM,,,250,RC,outpatient,,112.13,112.13,,95.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.03,22,,percent of total billed charges,,,,,,,,,100.92,90,,percent of total billed charges,,,92.84,82.8,,percent of total billed charges,,,95.31,85,,percent of total billed charges,,,,,,,,,98.67,88,,percent of total billed charges,,,,,,,,,85.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.03,22,,percent of total billed charges,,,102.04,91,,percent of total billed charges,,,106.52,95,,percent of total billed charges,,,93.07,83,,percent of total billed charges,,,93.07,83,,percent of total billed charges,,,,,,,,,,,,,,,93.07,83,,percent of total billed charges,,,106.52,95,,percent of total billed charges,,,100.92,90,,percent of total billed charges,,,100.92,90,,percent of total billed charges,,,91.95,82,,percent of total billed charges,,,100.92,90,,percent of total billed charges,,,95.31,85,,percent of total billed charges,,28.03,106.52,
METOPROLOL (TOPROL XL) TAB : 100MG,32000024,CDM,,,250,RC,outpatient,,29.98,29.98,,25.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.5,22,,percent of total billed charges,,,,,,,,,26.98,90,,percent of total billed charges,,,24.82,82.8,,percent of total billed charges,,,25.48,85,,percent of total billed charges,,,,,,,,,26.38,88,,percent of total billed charges,,,,,,,,,22.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.5,22,,percent of total billed charges,,,27.28,91,,percent of total billed charges,,,28.48,95,,percent of total billed charges,,,24.88,83,,percent of total billed charges,,,24.88,83,,percent of total billed charges,,,,,,,,,,,,,,,24.88,83,,percent of total billed charges,,,28.48,95,,percent of total billed charges,,,26.98,90,,percent of total billed charges,,,26.98,90,,percent of total billed charges,,,24.58,82,,percent of total billed charges,,,26.98,90,,percent of total billed charges,,,25.48,85,,percent of total billed charges,,7.5,28.48,
AMIKACIN POWDER:5GM NOT STERILE,32000030,CDM,,,250,RC,outpatient,,588.72,588.72,,499.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,147.18,22,,percent of total billed charges,,,,,,,,,529.85,90,,percent of total billed charges,,,487.46,82.8,,percent of total billed charges,,,500.41,85,,percent of total billed charges,,,,,,,,,518.07,88,,percent of total billed charges,,,,,,,,,449.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,147.18,22,,percent of total billed charges,,,535.74,91,,percent of total billed charges,,,559.28,95,,percent of total billed charges,,,488.64,83,,percent of total billed charges,,,488.64,83,,percent of total billed charges,,,,,,,,,,,,,,,488.64,83,,percent of total billed charges,,,559.28,95,,percent of total billed charges,,,529.85,90,,percent of total billed charges,,,529.85,90,,percent of total billed charges,,,482.75,82,,percent of total billed charges,,,529.85,90,,percent of total billed charges,,,500.41,85,,percent of total billed charges,,147.18,559.28,
ONDANSETRON(ZOFRAN):4MG/2ML,32000031,CDM,J2405,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,1.38,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.38,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,1.38,60.99,
CLOTRI/BETA(LOTRISONE)CRM:15GM,32000032,CDM,J3490,HCPCS,250,RC,outpatient,,352.78,352.78,,299.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.2,22,,percent of total billed charges,,,,,,,,,317.5,90,,percent of total billed charges,,,292.1,82.8,,percent of total billed charges,,,299.86,85,,percent of total billed charges,,,,,,,,,310.45,88,,percent of total billed charges,,,,,,,,,269.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.2,22,,percent of total billed charges,,,321.03,91,,percent of total billed charges,,,335.14,95,,percent of total billed charges,,,292.81,83,,percent of total billed charges,,,292.81,83,,percent of total billed charges,,,,,,,,,,,,,,,292.81,83,,percent of total billed charges,,,335.14,95,,percent of total billed charges,,,317.5,90,,percent of total billed charges,,,317.5,90,,percent of total billed charges,,,289.28,82,,percent of total billed charges,,,317.5,90,,percent of total billed charges,,,299.86,85,,percent of total billed charges,,88.2,335.14,
PRAMIPEXOLE DI(MIRAPEX)TAB:0.25MG,32000033,CDM,,,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
RACEPINEPHRINE(S-2)VIAL 2.25%:UD-0.5ML*,32000034,CDM,J3490,HCPCS,250,RC,outpatient,,24.8,24.8,,21.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.2,22,,percent of total billed charges,,,,,,,,,22.32,90,,percent of total billed charges,,,20.53,82.8,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,,,,,,,,21.82,88,,percent of total billed charges,,,,,,,,,18.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.2,22,,percent of total billed charges,,,22.57,91,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,,,,,,,,,,,,,20.58,83,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,20.34,82,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,6.2,23.56,
SODIUM HYPOCHLO(DAKINS)LIQ 0.5%:480ML,32000035,CDM,J3490,HCPCS,250,RC,outpatient,,193.02,193.02,,163.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.26,22,,percent of total billed charges,,,,,,,,,173.72,90,,percent of total billed charges,,,159.82,82.8,,percent of total billed charges,,,164.07,85,,percent of total billed charges,,,,,,,,,169.86,88,,percent of total billed charges,,,,,,,,,147.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.26,22,,percent of total billed charges,,,175.65,91,,percent of total billed charges,,,183.37,95,,percent of total billed charges,,,160.21,83,,percent of total billed charges,,,160.21,83,,percent of total billed charges,,,,,,,,,,,,,,,160.21,83,,percent of total billed charges,,,183.37,95,,percent of total billed charges,,,173.72,90,,percent of total billed charges,,,173.72,90,,percent of total billed charges,,,158.28,82,,percent of total billed charges,,,173.72,90,,percent of total billed charges,,,164.07,85,,percent of total billed charges,,48.26,183.37,
CAPTOPRIL(CAPOTEN)TAB:12.5MG,32000036,CDM,J8499,HCPCS,250,RC,outpatient,,19.77,19.77,,16.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.94,22,,percent of total billed charges,,,,,,,,,17.79,90,,percent of total billed charges,,,16.37,82.8,,percent of total billed charges,,,16.8,85,,percent of total billed charges,,,,,,,,,17.4,88,,percent of total billed charges,,,,,,,,,15.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.94,22,,percent of total billed charges,,,17.99,91,,percent of total billed charges,,,18.78,95,,percent of total billed charges,,,16.41,83,,percent of total billed charges,,,16.41,83,,percent of total billed charges,,,,,,,,,,,,,,,16.41,83,,percent of total billed charges,,,18.78,95,,percent of total billed charges,,,17.79,90,,percent of total billed charges,,,17.79,90,,percent of total billed charges,,,16.21,82,,percent of total billed charges,,,17.79,90,,percent of total billed charges,,,16.8,85,,percent of total billed charges,,4.94,18.78,
PIOGLITAZONE HCL (ACTOS) TAB : 30MG,32000037,CDM,,,250,RC,outpatient,,329.57,329.57,,279.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.39,22,,percent of total billed charges,,,,,,,,,296.61,90,,percent of total billed charges,,,272.88,82.8,,percent of total billed charges,,,280.13,85,,percent of total billed charges,,,,,,,,,290.02,88,,percent of total billed charges,,,,,,,,,251.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82.39,22,,percent of total billed charges,,,299.91,91,,percent of total billed charges,,,313.09,95,,percent of total billed charges,,,273.54,83,,percent of total billed charges,,,273.54,83,,percent of total billed charges,,,,,,,,,,,,,,,273.54,83,,percent of total billed charges,,,313.09,95,,percent of total billed charges,,,296.61,90,,percent of total billed charges,,,296.61,90,,percent of total billed charges,,,270.25,82,,percent of total billed charges,,,296.61,90,,percent of total billed charges,,,280.13,85,,percent of total billed charges,,82.39,313.09,
MESALAMINE (CANASA) SUPP : 500MG,32000038,CDM,,,250,RC,outpatient,,72.16,72.16,,61.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.04,22,,percent of total billed charges,,,,,,,,,64.94,90,,percent of total billed charges,,,59.75,82.8,,percent of total billed charges,,,61.34,85,,percent of total billed charges,,,,,,,,,63.5,88,,percent of total billed charges,,,,,,,,,55.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.04,22,,percent of total billed charges,,,65.67,91,,percent of total billed charges,,,68.55,95,,percent of total billed charges,,,59.89,83,,percent of total billed charges,,,59.89,83,,percent of total billed charges,,,,,,,,,,,,,,,59.89,83,,percent of total billed charges,,,68.55,95,,percent of total billed charges,,,64.94,90,,percent of total billed charges,,,64.94,90,,percent of total billed charges,,,59.17,82,,percent of total billed charges,,,64.94,90,,percent of total billed charges,,,61.34,85,,percent of total billed charges,,18.04,68.55,
ACYCLOVIR(ZOVIRAX)ORAL:200MG/5ML (473ML),32000039,CDM,,,250,RC,outpatient,,2711.39,2711.39,,2301.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,677.85,22,,percent of total billed charges,,,,,,,,,2440.25,90,,percent of total billed charges,,,2245.03,82.8,,percent of total billed charges,,,2304.68,85,,percent of total billed charges,,,,,,,,,2386.02,88,,percent of total billed charges,,,,,,,,,2071.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,677.85,22,,percent of total billed charges,,,2467.36,91,,percent of total billed charges,,,2575.82,95,,percent of total billed charges,,,2250.45,83,,percent of total billed charges,,,2250.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2250.45,83,,percent of total billed charges,,,2575.82,95,,percent of total billed charges,,,2440.25,90,,percent of total billed charges,,,2440.25,90,,percent of total billed charges,,,2223.34,82,,percent of total billed charges,,,2440.25,90,,percent of total billed charges,,,2304.68,85,,percent of total billed charges,,677.85,2575.82,
RIVASTIGMINE (EXELON) CAP : 4.5MG,32000040,CDM,,,250,RC,outpatient,,78.98,78.98,,67.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.75,22,,percent of total billed charges,,,,,,,,,71.08,90,,percent of total billed charges,,,65.4,82.8,,percent of total billed charges,,,67.13,85,,percent of total billed charges,,,,,,,,,69.5,88,,percent of total billed charges,,,,,,,,,60.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.75,22,,percent of total billed charges,,,71.87,91,,percent of total billed charges,,,75.03,95,,percent of total billed charges,,,65.55,83,,percent of total billed charges,,,65.55,83,,percent of total billed charges,,,,,,,,,,,,,,,65.55,83,,percent of total billed charges,,,75.03,95,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,64.76,82,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,67.13,85,,percent of total billed charges,,19.75,75.03,
celeCOXIB(celeBREX)CAP:100MG,32000042,CDM,J8499,HCPCS,250,RC,outpatient,,14.05,14.05,,11.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.51,22,,percent of total billed charges,,,,,,,,,12.65,90,,percent of total billed charges,,,11.63,82.8,,percent of total billed charges,,,11.94,85,,percent of total billed charges,,,,,,,,,12.36,88,,percent of total billed charges,,,,,,,,,10.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.51,22,,percent of total billed charges,,,12.79,91,,percent of total billed charges,,,13.35,95,,percent of total billed charges,,,11.66,83,,percent of total billed charges,,,11.66,83,,percent of total billed charges,,,,,,,,,,,,,,,11.66,83,,percent of total billed charges,,,13.35,95,,percent of total billed charges,,,12.65,90,,percent of total billed charges,,,12.65,90,,percent of total billed charges,,,11.52,82,,percent of total billed charges,,,12.65,90,,percent of total billed charges,,,11.94,85,,percent of total billed charges,,3.51,13.35,
CITALOPRAM(celeXA)TAB :20MG,32000043,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ESTRADIOL(CLIMARA)PATCH:0.05MG/24HR,32000045,CDM,J3490,HCPCS,250,RC,outpatient,,242.66,242.66,,206.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60.67,22,,percent of total billed charges,,,,,,,,,218.39,90,,percent of total billed charges,,,200.92,82.8,,percent of total billed charges,,,206.26,85,,percent of total billed charges,,,,,,,,,213.54,88,,percent of total billed charges,,,,,,,,,185.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60.67,22,,percent of total billed charges,,,220.82,91,,percent of total billed charges,,,230.53,95,,percent of total billed charges,,,201.41,83,,percent of total billed charges,,,201.41,83,,percent of total billed charges,,,,,,,,,,,,,,,201.41,83,,percent of total billed charges,,,230.53,95,,percent of total billed charges,,,218.39,90,,percent of total billed charges,,,218.39,90,,percent of total billed charges,,,198.98,82,,percent of total billed charges,,,218.39,90,,percent of total billed charges,,,206.26,85,,percent of total billed charges,,60.67,230.53,
CEFDINIR(OMNICEF)CAP:300MG,32000047,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
NITROglycerin(NITRO-BID)OINT 2%:UD,32000048,CDM,J3490,HCPCS,250,RC,outpatient,,37.26,37.26,,31.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.32,22,,percent of total billed charges,,,,,,,,,33.53,90,,percent of total billed charges,,,30.85,82.8,,percent of total billed charges,,,31.67,85,,percent of total billed charges,,,,,,,,,32.79,88,,percent of total billed charges,,,,,,,,,28.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.32,22,,percent of total billed charges,,,33.91,91,,percent of total billed charges,,,35.4,95,,percent of total billed charges,,,30.93,83,,percent of total billed charges,,,30.93,83,,percent of total billed charges,,,,,,,,,,,,,,,30.93,83,,percent of total billed charges,,,35.4,95,,percent of total billed charges,,,33.53,90,,percent of total billed charges,,,33.53,90,,percent of total billed charges,,,30.55,82,,percent of total billed charges,,,33.53,90,,percent of total billed charges,,,31.67,85,,percent of total billed charges,,9.32,35.4,
GUAIFN/CODEINE(ROBITUSSIN AC) SYRP: 60ML,32000049,CDM,,,250,RC,outpatient,,7.5,7.5,,6.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.88,22,,percent of total billed charges,,,,,,,,,6.75,90,,percent of total billed charges,,,6.21,82.8,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,,,,,,,,6.6,88,,percent of total billed charges,,,,,,,,,5.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.88,22,,percent of total billed charges,,,6.83,91,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,,,,,,,,,,,,,6.23,83,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.15,82,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,1.88,7.13,
GUAIFENE(ROBITUSSIN)SYRP: 100MG/5ML 90ML,32000050,CDM,,,250,RC,outpatient,,7.75,7.75,,6.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.94,22,,percent of total billed charges,,,,,,,,,6.98,90,,percent of total billed charges,,,6.42,82.8,,percent of total billed charges,,,6.59,85,,percent of total billed charges,,,,,,,,,6.82,88,,percent of total billed charges,,,,,,,,,5.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.94,22,,percent of total billed charges,,,7.05,91,,percent of total billed charges,,,7.36,95,,percent of total billed charges,,,6.43,83,,percent of total billed charges,,,6.43,83,,percent of total billed charges,,,,,,,,,,,,,,,6.43,83,,percent of total billed charges,,,7.36,95,,percent of total billed charges,,,6.98,90,,percent of total billed charges,,,6.98,90,,percent of total billed charges,,,6.36,82,,percent of total billed charges,,,6.98,90,,percent of total billed charges,,,6.59,85,,percent of total billed charges,,1.94,7.36,
LACTULOSE (CONSTULOSE) SOL : 10G/15ML,32000051,CDM,,,250,RC,outpatient,,17.92,17.92,,15.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.48,22,,percent of total billed charges,,,,,,,,,16.13,90,,percent of total billed charges,,,14.84,82.8,,percent of total billed charges,,,15.23,85,,percent of total billed charges,,,,,,,,,15.77,88,,percent of total billed charges,,,,,,,,,13.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.48,22,,percent of total billed charges,,,16.31,91,,percent of total billed charges,,,17.02,95,,percent of total billed charges,,,14.87,83,,percent of total billed charges,,,14.87,83,,percent of total billed charges,,,,,,,,,,,,,,,14.87,83,,percent of total billed charges,,,17.02,95,,percent of total billed charges,,,16.13,90,,percent of total billed charges,,,16.13,90,,percent of total billed charges,,,14.69,82,,percent of total billed charges,,,16.13,90,,percent of total billed charges,,,15.23,85,,percent of total billed charges,,4.48,17.02,
PRALIDOXIME CHLORIDE(PROTOPAM)VIAL:1GM,32000052,CDM,J2730,HCPCS,636,RC,outpatient,,1246.69,1246.69,,1058.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,311.67,22,,percent of total billed charges,,,,,,,,,1122.02,90,,percent of total billed charges,,,1032.26,82.8,,percent of total billed charges,,,1059.69,85,,percent of total billed charges,,,,,,,,,1097.09,88,,percent of total billed charges,,165.77,,,,fee schedule,,,952.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,165.77,,,,fee schedule,,,311.67,22,,percent of total billed charges,,,1134.49,91,,percent of total billed charges,,,1184.36,95,,percent of total billed charges,,,1034.75,83,,percent of total billed charges,,,1034.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1034.75,83,,percent of total billed charges,,,1184.36,95,,percent of total billed charges,,,1122.02,90,,percent of total billed charges,,,1122.02,90,,percent of total billed charges,,,1022.29,82,,percent of total billed charges,,,1122.02,90,,percent of total billed charges,,,1059.69,85,,percent of total billed charges,,165.77,1184.36,
HYDROcod/APAP(LORCET):(2.5-167/5) 118ML,32000053,CDM,,,250,RC,outpatient,,103.25,103.25,,87.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.81,22,,percent of total billed charges,,,,,,,,,92.93,90,,percent of total billed charges,,,85.49,82.8,,percent of total billed charges,,,87.76,85,,percent of total billed charges,,,,,,,,,90.86,88,,percent of total billed charges,,,,,,,,,78.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.81,22,,percent of total billed charges,,,93.96,91,,percent of total billed charges,,,98.09,95,,percent of total billed charges,,,85.7,83,,percent of total billed charges,,,85.7,83,,percent of total billed charges,,,,,,,,,,,,,,,85.7,83,,percent of total billed charges,,,98.09,95,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,84.67,82,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,87.76,85,,percent of total billed charges,,25.81,98.09,
IV D51/2NS 1000ML/KCL30MEQ  (PREMIX),32000054,CDM,J3480,HCPCS,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,3.22,,,,fee schedule,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,3.22,181.67,
VALDECOXIB (BEXTRA) TAB : 10MG,32000055,CDM,,,250,RC,outpatient,,46.79,46.79,,39.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.7,22,,percent of total billed charges,,,,,,,,,42.11,90,,percent of total billed charges,,,38.74,82.8,,percent of total billed charges,,,39.77,85,,percent of total billed charges,,,,,,,,,41.18,88,,percent of total billed charges,,,,,,,,,35.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.7,22,,percent of total billed charges,,,42.58,91,,percent of total billed charges,,,44.45,95,,percent of total billed charges,,,38.84,83,,percent of total billed charges,,,38.84,83,,percent of total billed charges,,,,,,,,,,,,,,,38.84,83,,percent of total billed charges,,,44.45,95,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,38.37,82,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,39.77,85,,percent of total billed charges,,11.7,44.45,
WARFARIN(COUMADIN)TAB: 4MG,32000056,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CYANOCBLMN/FA/PYRX(FOLTEX)TAB:2-2.5-25MG,32000057,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FE FUM/VIT C/B12(FEOGEN FOR)CAP:460-60MG,32000058,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
VALPROATE(DEPAKENE)SYRP:250MG/5ML(480ML),32000059,CDM,J8499,HCPCS,250,RC,outpatient,,689.43,689.43,,585.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,172.36,22,,percent of total billed charges,,,,,,,,,620.49,90,,percent of total billed charges,,,570.85,82.8,,percent of total billed charges,,,586.02,85,,percent of total billed charges,,,,,,,,,606.7,88,,percent of total billed charges,,,,,,,,,526.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,172.36,22,,percent of total billed charges,,,627.38,91,,percent of total billed charges,,,654.96,95,,percent of total billed charges,,,572.23,83,,percent of total billed charges,,,572.23,83,,percent of total billed charges,,,,,,,,,,,,,,,572.23,83,,percent of total billed charges,,,654.96,95,,percent of total billed charges,,,620.49,90,,percent of total billed charges,,,620.49,90,,percent of total billed charges,,,565.33,82,,percent of total billed charges,,,620.49,90,,percent of total billed charges,,,586.02,85,,percent of total billed charges,,172.36,654.96,
HYDROCODONE/ACETA SOL :2.5-167/5ml 30ML,32000060,CDM,,,250,RC,outpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6,22,,percent of total billed charges,,,,,,,,,21.6,90,,percent of total billed charges,,,19.87,82.8,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6,22,,percent of total billed charges,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,6,22.8,
VERAPAMIL HCL (COVERA-HS) TAB : 180MG,32000061,CDM,,,250,RC,outpatient,,35.68,35.68,,30.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.92,22,,percent of total billed charges,,,,,,,,,32.11,90,,percent of total billed charges,,,29.54,82.8,,percent of total billed charges,,,30.33,85,,percent of total billed charges,,,,,,,,,31.4,88,,percent of total billed charges,,,,,,,,,27.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.92,22,,percent of total billed charges,,,32.47,91,,percent of total billed charges,,,33.9,95,,percent of total billed charges,,,29.61,83,,percent of total billed charges,,,29.61,83,,percent of total billed charges,,,,,,,,,,,,,,,29.61,83,,percent of total billed charges,,,33.9,95,,percent of total billed charges,,,32.11,90,,percent of total billed charges,,,32.11,90,,percent of total billed charges,,,29.26,82,,percent of total billed charges,,,32.11,90,,percent of total billed charges,,,30.33,85,,percent of total billed charges,,8.92,33.9,
HYDROCODONE/ACETA SOL :2.5-167/5 60ML,32000062,CDM,,,250,RC,outpatient,,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12,22,,percent of total billed charges,,,,,,,,,43.2,90,,percent of total billed charges,,,39.74,82.8,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12,22,,percent of total billed charges,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,12,45.6,
ESCITALOPRAM(LEXAPRO)TAB:10MG,32000064,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DYPHYLLINE (DILOR) TAB : 200MG,32000065,CDM,,,250,RC,outpatient,,13.48,13.48,,11.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.37,22,,percent of total billed charges,,,,,,,,,12.13,90,,percent of total billed charges,,,11.16,82.8,,percent of total billed charges,,,11.46,85,,percent of total billed charges,,,,,,,,,11.86,88,,percent of total billed charges,,,,,,,,,10.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.37,22,,percent of total billed charges,,,12.27,91,,percent of total billed charges,,,12.81,95,,percent of total billed charges,,,11.19,83,,percent of total billed charges,,,11.19,83,,percent of total billed charges,,,,,,,,,,,,,,,11.19,83,,percent of total billed charges,,,12.81,95,,percent of total billed charges,,,12.13,90,,percent of total billed charges,,,12.13,90,,percent of total billed charges,,,11.05,82,,percent of total billed charges,,,12.13,90,,percent of total billed charges,,,11.46,85,,percent of total billed charges,,3.37,12.81,
VERAPAMIL HCL (COVERA-HS) TAB : 240MG,32000066,CDM,,,250,RC,outpatient,,13,13,,11.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.25,22,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,10.76,82.8,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,,,,,,,,11.44,88,,percent of total billed charges,,,,,,,,,9.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.25,22,,percent of total billed charges,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,10.66,82,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.25,12.35,
IV D5LR+KCL 20MEQ 1000ML    (ADMIX),32000067,CDM,,,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
CALCIUM CARBONATE/VIT D2 TAB : 500MG-125,32000068,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
AZITHROMYCIN(ZITHROMA)SUS 100MG/5ML 15ML,32000069,CDM,J8499,HCPCS,250,RC,outpatient,,175.98,175.98,,149.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.38,90,,percent of total billed charges,,,145.71,82.8,,percent of total billed charges,,,149.58,85,,percent of total billed charges,,,,,,,,,154.86,88,,percent of total billed charges,,,,,,,,,134.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.14,91,,percent of total billed charges,,,167.18,95,,percent of total billed charges,,,146.06,83,,percent of total billed charges,,,146.06,83,,percent of total billed charges,,,,,,,,,,,,,,,146.06,83,,percent of total billed charges,,,167.18,95,,percent of total billed charges,,,158.38,90,,percent of total billed charges,,,158.38,90,,percent of total billed charges,,,144.3,82,,percent of total billed charges,,,158.38,90,,percent of total billed charges,,,149.58,85,,percent of total billed charges,,44,167.18,
MORPHINE SULF CPJ SYR:4MG/ML,32000070,CDM,,,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,,,,,,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,16.88,64.15,
AMYLA/LIPAS/PROT(LIPRAM)CAP:33.2-10-38,32000071,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
buPROPion(Wellbutrin SR)TAB:100MG,32000072,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
TOLTERODINE(DETROL LA)CAP:2MG,32000073,CDM,J8499,HCPCS,250,RC,outpatient,,137.91,137.91,,117.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.48,22,,percent of total billed charges,,,,,,,,,124.12,90,,percent of total billed charges,,,114.19,82.8,,percent of total billed charges,,,117.22,85,,percent of total billed charges,,,,,,,,,121.36,88,,percent of total billed charges,,,,,,,,,105.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.48,22,,percent of total billed charges,,,125.5,91,,percent of total billed charges,,,131.01,95,,percent of total billed charges,,,114.47,83,,percent of total billed charges,,,114.47,83,,percent of total billed charges,,,,,,,,,,,,,,,114.47,83,,percent of total billed charges,,,131.01,95,,percent of total billed charges,,,124.12,90,,percent of total billed charges,,,124.12,90,,percent of total billed charges,,,113.09,82,,percent of total billed charges,,,124.12,90,,percent of total billed charges,,,117.22,85,,percent of total billed charges,,34.48,131.01,
WATER FOR INJECTION 10ML,32000074,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
METAXALONE (SKELAXIN) TAB : 400MG,32000075,CDM,,,250,RC,outpatient,,20.94,20.94,,17.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.24,22,,percent of total billed charges,,,,,,,,,18.85,90,,percent of total billed charges,,,17.34,82.8,,percent of total billed charges,,,17.8,85,,percent of total billed charges,,,,,,,,,18.43,88,,percent of total billed charges,,,,,,,,,16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.24,22,,percent of total billed charges,,,19.06,91,,percent of total billed charges,,,19.89,95,,percent of total billed charges,,,17.38,83,,percent of total billed charges,,,17.38,83,,percent of total billed charges,,,,,,,,,,,,,,,17.38,83,,percent of total billed charges,,,19.89,95,,percent of total billed charges,,,18.85,90,,percent of total billed charges,,,18.85,90,,percent of total billed charges,,,17.17,82,,percent of total billed charges,,,18.85,90,,percent of total billed charges,,,17.8,85,,percent of total billed charges,,5.24,19.89,
DICLOFENAC SODIUM TAB : 50MG,32000076,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CIPROFLOXACIN(CIPRO)SUS:250MG/5ML(100ML),32000077,CDM,J8499,HCPCS,250,RC,outpatient,,1267.93,1267.93,,1076.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,316.98,22,,percent of total billed charges,,,,,,,,,1141.14,90,,percent of total billed charges,,,1049.85,82.8,,percent of total billed charges,,,1077.74,85,,percent of total billed charges,,,,,,,,,1115.78,88,,percent of total billed charges,,,,,,,,,968.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,316.98,22,,percent of total billed charges,,,1153.82,91,,percent of total billed charges,,,1204.53,95,,percent of total billed charges,,,1052.38,83,,percent of total billed charges,,,1052.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1052.38,83,,percent of total billed charges,,,1204.53,95,,percent of total billed charges,,,1141.14,90,,percent of total billed charges,,,1141.14,90,,percent of total billed charges,,,1039.7,82,,percent of total billed charges,,,1141.14,90,,percent of total billed charges,,,1077.74,85,,percent of total billed charges,,316.98,1204.53,
HEPAT A (HAVRIX)VL:1440 UNITS/ML,32000078,CDM,,,250,RC,outpatient,,792.69,792.69,,672.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,198.17,22,,percent of total billed charges,,,,,,,,,713.42,90,,percent of total billed charges,,,656.35,82.8,,percent of total billed charges,,,673.79,85,,percent of total billed charges,,,,,,,,,697.57,88,,percent of total billed charges,,,,,,,,,605.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,198.17,22,,percent of total billed charges,,,721.35,91,,percent of total billed charges,,,753.06,95,,percent of total billed charges,,,657.93,83,,percent of total billed charges,,,657.93,83,,percent of total billed charges,,,,,,,,,,,,,,,657.93,83,,percent of total billed charges,,,753.06,95,,percent of total billed charges,,,713.42,90,,percent of total billed charges,,,713.42,90,,percent of total billed charges,,,650.01,82,,percent of total billed charges,,,713.42,90,,percent of total billed charges,,,673.79,85,,percent of total billed charges,,198.17,753.06,
POLIOMYELITIS VAC KILLED(IPOL)VIAL:5ML,32000079,CDM,,,250,RC,outpatient,,2777.43,2777.43,,2358.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,694.36,22,,percent of total billed charges,,,,,,,,,2499.69,90,,percent of total billed charges,,,2299.71,82.8,,percent of total billed charges,,,2360.82,85,,percent of total billed charges,,,,,,,,,2444.14,88,,percent of total billed charges,,,,,,,,,2121.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,694.36,22,,percent of total billed charges,,,2527.46,91,,percent of total billed charges,,,2638.56,95,,percent of total billed charges,,,2305.27,83,,percent of total billed charges,,,2305.27,83,,percent of total billed charges,,,,,,,,,,,,,,,2305.27,83,,percent of total billed charges,,,2638.56,95,,percent of total billed charges,,,2499.69,90,,percent of total billed charges,,,2499.69,90,,percent of total billed charges,,,2277.49,82,,percent of total billed charges,,,2499.69,90,,percent of total billed charges,,,2360.82,85,,percent of total billed charges,,694.36,2638.56,
MENINGOC VAC A/C/Y W135 (MENOMUNE) VIAL,32000080,CDM,,,250,RC,outpatient,,1727.58,1727.58,,1466.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,431.9,22,,percent of total billed charges,,,,,,,,,1554.82,90,,percent of total billed charges,,,1430.44,82.8,,percent of total billed charges,,,1468.44,85,,percent of total billed charges,,,,,,,,,1520.27,88,,percent of total billed charges,,,,,,,,,1319.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,431.9,22,,percent of total billed charges,,,1572.1,91,,percent of total billed charges,,,1641.2,95,,percent of total billed charges,,,1433.89,83,,percent of total billed charges,,,1433.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1433.89,83,,percent of total billed charges,,,1641.2,95,,percent of total billed charges,,,1554.82,90,,percent of total billed charges,,,1554.82,90,,percent of total billed charges,,,1416.62,82,,percent of total billed charges,,,1554.82,90,,percent of total billed charges,,,1468.44,85,,percent of total billed charges,,431.9,1641.2,
PNEUMOCOC 13VAL(PREVNAR)SYR:0.5ML,32000082,CDM,90670,CPT,636,RC,outpatient,,3072.9,3072.9,,2608.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,768.23,22,,percent of total billed charges,,,,,,,,,2765.61,90,,percent of total billed charges,,,2544.36,82.8,,percent of total billed charges,,,2611.97,85,,percent of total billed charges,,,,,,,,,2704.15,88,,percent of total billed charges,,,,,,,,,2347.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,768.23,22,,percent of total billed charges,,,2796.34,91,,percent of total billed charges,,,2919.26,95,,percent of total billed charges,,,2550.51,83,,percent of total billed charges,,,2550.51,83,,percent of total billed charges,,,,,,,,,,,,,,,2550.51,83,,percent of total billed charges,,,2919.26,95,,percent of total billed charges,,,2765.61,90,,percent of total billed charges,,,2765.61,90,,percent of total billed charges,,,2519.78,82,,percent of total billed charges,,,2765.61,90,,percent of total billed charges,,,2611.97,85,,percent of total billed charges,,768.23,2919.26,
carBAMazepine(TEGretol XR)TAB:200MG,32000083,CDM,J8499,HCPCS,250,RC,outpatient,,47.22,47.22,,40.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.81,22,,percent of total billed charges,,,,,,,,,42.5,90,,percent of total billed charges,,,39.1,82.8,,percent of total billed charges,,,40.14,85,,percent of total billed charges,,,,,,,,,41.55,88,,percent of total billed charges,,,,,,,,,36.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.81,22,,percent of total billed charges,,,42.97,91,,percent of total billed charges,,,44.86,95,,percent of total billed charges,,,39.19,83,,percent of total billed charges,,,39.19,83,,percent of total billed charges,,,,,,,,,,,,,,,39.19,83,,percent of total billed charges,,,44.86,95,,percent of total billed charges,,,42.5,90,,percent of total billed charges,,,42.5,90,,percent of total billed charges,,,38.72,82,,percent of total billed charges,,,42.5,90,,percent of total billed charges,,,40.14,85,,percent of total billed charges,,11.81,44.86,
VALACYCLOVIR HCL (VALTREX) TAB : 500MG,32000084,CDM,J8499,HCPCS,250,RC,outpatient,,39.38,39.38,,33.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.85,22,,percent of total billed charges,,,,,,,,,35.44,90,,percent of total billed charges,,,32.61,82.8,,percent of total billed charges,,,33.47,85,,percent of total billed charges,,,,,,,,,34.65,88,,percent of total billed charges,,,,,,,,,30.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.85,22,,percent of total billed charges,,,35.84,91,,percent of total billed charges,,,37.41,95,,percent of total billed charges,,,32.69,83,,percent of total billed charges,,,32.69,83,,percent of total billed charges,,,,,,,,,,,,,,,32.69,83,,percent of total billed charges,,,37.41,95,,percent of total billed charges,,,35.44,90,,percent of total billed charges,,,35.44,90,,percent of total billed charges,,,32.29,82,,percent of total billed charges,,,35.44,90,,percent of total billed charges,,,33.47,85,,percent of total billed charges,,9.85,37.41,
TETANUS & DIPHT(DT)TOX VIAL:5ML,32000087,CDM,,,250,RC,outpatient,,175.09,175.09,,148.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.77,22,,percent of total billed charges,,,,,,,,,157.58,90,,percent of total billed charges,,,144.97,82.8,,percent of total billed charges,,,148.83,85,,percent of total billed charges,,,,,,,,,154.08,88,,percent of total billed charges,,,,,,,,,133.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.77,22,,percent of total billed charges,,,159.33,91,,percent of total billed charges,,,166.34,95,,percent of total billed charges,,,145.32,83,,percent of total billed charges,,,145.32,83,,percent of total billed charges,,,,,,,,,,,,,,,145.32,83,,percent of total billed charges,,,166.34,95,,percent of total billed charges,,,157.58,90,,percent of total billed charges,,,157.58,90,,percent of total billed charges,,,143.57,82,,percent of total billed charges,,,157.58,90,,percent of total billed charges,,,148.83,85,,percent of total billed charges,,43.77,166.34,
STARCH(ANUSOL)SUPP 51%:,32000088,CDM,,,250,RC,outpatient,,14.22,14.22,,12.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.56,22,,percent of total billed charges,,,,,,,,,12.8,90,,percent of total billed charges,,,11.77,82.8,,percent of total billed charges,,,12.09,85,,percent of total billed charges,,,,,,,,,12.51,88,,percent of total billed charges,,,,,,,,,10.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.56,22,,percent of total billed charges,,,12.94,91,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,,,,,,,,,,,,,11.8,83,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,11.66,82,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.09,85,,percent of total billed charges,,3.56,13.51,
LOVASTATIN(MEVACOR)TAB:10MG,32000089,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
HYDROCODONE/ACET SOL : 2.5-167/5ml 15ML,32000090,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
VALPROATE(DEPAKOTE)-VIAL:500MG/5ML,32000092,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
IRBESARTAN/HYDRO(AVALIDE)TAB:300-12.5MG,32000093,CDM,,,250,RC,outpatient,,51.39,51.39,,43.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.85,22,,percent of total billed charges,,,,,,,,,46.25,90,,percent of total billed charges,,,42.55,82.8,,percent of total billed charges,,,43.68,85,,percent of total billed charges,,,,,,,,,45.22,88,,percent of total billed charges,,,,,,,,,39.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.85,22,,percent of total billed charges,,,46.76,91,,percent of total billed charges,,,48.82,95,,percent of total billed charges,,,42.65,83,,percent of total billed charges,,,42.65,83,,percent of total billed charges,,,,,,,,,,,,,,,42.65,83,,percent of total billed charges,,,48.82,95,,percent of total billed charges,,,46.25,90,,percent of total billed charges,,,46.25,90,,percent of total billed charges,,,42.14,82,,percent of total billed charges,,,46.25,90,,percent of total billed charges,,,43.68,85,,percent of total billed charges,,12.85,48.82,
levETIRAcetam(KEPPRA)TAB:500MG,32000094,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
SODIUM CHLORIDE (MURO-128) DROP 2% 15ML,32000095,CDM,,,250,RC,outpatient,,252.81,252.81,,214.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.2,22,,percent of total billed charges,,,,,,,,,227.53,90,,percent of total billed charges,,,209.33,82.8,,percent of total billed charges,,,214.89,85,,percent of total billed charges,,,,,,,,,222.47,88,,percent of total billed charges,,,,,,,,,193.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.2,22,,percent of total billed charges,,,230.06,91,,percent of total billed charges,,,240.17,95,,percent of total billed charges,,,209.83,83,,percent of total billed charges,,,209.83,83,,percent of total billed charges,,,,,,,,,,,,,,,209.83,83,,percent of total billed charges,,,240.17,95,,percent of total billed charges,,,227.53,90,,percent of total billed charges,,,227.53,90,,percent of total billed charges,,,207.3,82,,percent of total billed charges,,,227.53,90,,percent of total billed charges,,,214.89,85,,percent of total billed charges,,63.2,240.17,
celeCOXIB(celeBREX)CAP:200MG,32000096,CDM,J8499,HCPCS,250,RC,outpatient,,19.44,19.44,,16.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.86,22,,percent of total billed charges,,,,,,,,,17.5,90,,percent of total billed charges,,,16.1,82.8,,percent of total billed charges,,,16.52,85,,percent of total billed charges,,,,,,,,,17.11,88,,percent of total billed charges,,,,,,,,,14.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.86,22,,percent of total billed charges,,,17.69,91,,percent of total billed charges,,,18.47,95,,percent of total billed charges,,,16.14,83,,percent of total billed charges,,,16.14,83,,percent of total billed charges,,,,,,,,,,,,,,,16.14,83,,percent of total billed charges,,,18.47,95,,percent of total billed charges,,,17.5,90,,percent of total billed charges,,,17.5,90,,percent of total billed charges,,,15.94,82,,percent of total billed charges,,,17.5,90,,percent of total billed charges,,,16.52,85,,percent of total billed charges,,4.86,18.47,
AZITHROMYCIN(ZITHROMA)SUS:200MG/5ML 30ML,32000097,CDM,,,250,RC,outpatient,,116.89,116.89,,99.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.22,22,,percent of total billed charges,,,,,,,,,105.2,90,,percent of total billed charges,,,96.78,82.8,,percent of total billed charges,,,99.36,85,,percent of total billed charges,,,,,,,,,102.86,88,,percent of total billed charges,,,,,,,,,89.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.22,22,,percent of total billed charges,,,106.37,91,,percent of total billed charges,,,111.05,95,,percent of total billed charges,,,97.02,83,,percent of total billed charges,,,97.02,83,,percent of total billed charges,,,,,,,,,,,,,,,97.02,83,,percent of total billed charges,,,111.05,95,,percent of total billed charges,,,105.2,90,,percent of total billed charges,,,105.2,90,,percent of total billed charges,,,95.85,82,,percent of total billed charges,,,105.2,90,,percent of total billed charges,,,99.36,85,,percent of total billed charges,,29.22,111.05,
CLOMIPRAMINE (ANAFRANIL) CAP : 25MG,32000098,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
metFORMIN(GLUCOPHAGE XR)TAB:500MG,32000103,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FOSINOPRIL(MONOPRIL)TAB:40MG,32000104,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
INDOCYANINE GREEN VIAL : 25MG,32000105,CDM,,,250,RC,outpatient,,1607.83,1607.83,,1365.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,401.96,22,,percent of total billed charges,,,,,,,,,1447.05,90,,percent of total billed charges,,,1331.28,82.8,,percent of total billed charges,,,1366.66,85,,percent of total billed charges,,,,,,,,,1414.89,88,,percent of total billed charges,,,,,,,,,1228.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,401.96,22,,percent of total billed charges,,,1463.13,91,,percent of total billed charges,,,1527.44,95,,percent of total billed charges,,,1334.5,83,,percent of total billed charges,,,1334.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1334.5,83,,percent of total billed charges,,,1527.44,95,,percent of total billed charges,,,1447.05,90,,percent of total billed charges,,,1447.05,90,,percent of total billed charges,,,1318.42,82,,percent of total billed charges,,,1447.05,90,,percent of total billed charges,,,1366.66,85,,percent of total billed charges,,401.96,1527.44,
AMPHOTRB(ABELCET):100MG/20ML  (J/10MG),32000107,CDM,J0287,HCPCS,636,RC,outpatient,,2610.72,2610.72,,2216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,652.68,22,,percent of total billed charges,,,,,,,,,2349.65,90,,percent of total billed charges,,,2161.68,82.8,,percent of total billed charges,,,2219.11,85,,percent of total billed charges,,,,,,,,,2297.43,88,,percent of total billed charges,,773.25,,,,fee schedule,,,1994.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,773.25,,,,fee schedule,,,652.68,22,,percent of total billed charges,,,2375.76,91,,percent of total billed charges,,,2480.18,95,,percent of total billed charges,,,2166.9,83,,percent of total billed charges,,,2166.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2166.9,83,,percent of total billed charges,,,2480.18,95,,percent of total billed charges,,,2349.65,90,,percent of total billed charges,,,2349.65,90,,percent of total billed charges,,,2140.79,82,,percent of total billed charges,,,2349.65,90,,percent of total billed charges,,,2219.11,85,,percent of total billed charges,,652.68,2480.18,
SALMETEROL (SEREVENT) DISC 50MCG 60'S,32000108,CDM,,,250,RC,outpatient,,144.33,144.33,,122.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.08,22,,percent of total billed charges,,,,,,,,,129.9,90,,percent of total billed charges,,,119.51,82.8,,percent of total billed charges,,,122.68,85,,percent of total billed charges,,,,,,,,,127.01,88,,percent of total billed charges,,,,,,,,,110.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.08,22,,percent of total billed charges,,,131.34,91,,percent of total billed charges,,,137.11,95,,percent of total billed charges,,,119.79,83,,percent of total billed charges,,,119.79,83,,percent of total billed charges,,,,,,,,,,,,,,,119.79,83,,percent of total billed charges,,,137.11,95,,percent of total billed charges,,,129.9,90,,percent of total billed charges,,,129.9,90,,percent of total billed charges,,,118.35,82,,percent of total billed charges,,,129.9,90,,percent of total billed charges,,,122.68,85,,percent of total billed charges,,36.08,137.11,
MINERAL OIL (FLEET MINERAL OIL) 480ML,32000109,CDM,,,250,RC,outpatient,,48.69,48.69,,41.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.17,22,,percent of total billed charges,,,,,,,,,43.82,90,,percent of total billed charges,,,40.32,82.8,,percent of total billed charges,,,41.39,85,,percent of total billed charges,,,,,,,,,42.85,88,,percent of total billed charges,,,,,,,,,37.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.17,22,,percent of total billed charges,,,44.31,91,,percent of total billed charges,,,46.26,95,,percent of total billed charges,,,40.41,83,,percent of total billed charges,,,40.41,83,,percent of total billed charges,,,,,,,,,,,,,,,40.41,83,,percent of total billed charges,,,46.26,95,,percent of total billed charges,,,43.82,90,,percent of total billed charges,,,43.82,90,,percent of total billed charges,,,39.93,82,,percent of total billed charges,,,43.82,90,,percent of total billed charges,,,41.39,85,,percent of total billed charges,,12.17,46.26,
ALENDRONATE (FOSAMAX) TAB : 10MG,32000111,CDM,,,250,RC,outpatient,,46.31,46.31,,39.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.58,22,,percent of total billed charges,,,,,,,,,41.68,90,,percent of total billed charges,,,38.34,82.8,,percent of total billed charges,,,39.36,85,,percent of total billed charges,,,,,,,,,40.75,88,,percent of total billed charges,,,,,,,,,35.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.58,22,,percent of total billed charges,,,42.14,91,,percent of total billed charges,,,43.99,95,,percent of total billed charges,,,38.44,83,,percent of total billed charges,,,38.44,83,,percent of total billed charges,,,,,,,,,,,,,,,38.44,83,,percent of total billed charges,,,43.99,95,,percent of total billed charges,,,41.68,90,,percent of total billed charges,,,41.68,90,,percent of total billed charges,,,37.97,82,,percent of total billed charges,,,41.68,90,,percent of total billed charges,,,39.36,85,,percent of total billed charges,,11.58,43.99,
ALENDRONATE (FOSAMAX) TAB : 5MG,32000112,CDM,,,250,RC,outpatient,,46.31,46.31,,39.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.58,22,,percent of total billed charges,,,,,,,,,41.68,90,,percent of total billed charges,,,38.34,82.8,,percent of total billed charges,,,39.36,85,,percent of total billed charges,,,,,,,,,40.75,88,,percent of total billed charges,,,,,,,,,35.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.58,22,,percent of total billed charges,,,42.14,91,,percent of total billed charges,,,43.99,95,,percent of total billed charges,,,38.44,83,,percent of total billed charges,,,38.44,83,,percent of total billed charges,,,,,,,,,,,,,,,38.44,83,,percent of total billed charges,,,43.99,95,,percent of total billed charges,,,41.68,90,,percent of total billed charges,,,41.68,90,,percent of total billed charges,,,37.97,82,,percent of total billed charges,,,41.68,90,,percent of total billed charges,,,39.36,85,,percent of total billed charges,,11.58,43.99,
ENALAPRIL/HCTZ (VASERETIC) TAB:10-25MG,32000113,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
TESTOSTERONE CYPION VL:200MG/ML (J/200),32000114,CDM,J1080,HCPCS,636,RC,outpatient,,349.71,349.71,,296.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.43,22,,percent of total billed charges,,,,,,,,,314.74,90,,percent of total billed charges,,,289.56,82.8,,percent of total billed charges,,,297.25,85,,percent of total billed charges,,,,,,,,,307.74,88,,percent of total billed charges,,,,,,,,,267.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.43,22,,percent of total billed charges,,,318.24,91,,percent of total billed charges,,,332.22,95,,percent of total billed charges,,,290.26,83,,percent of total billed charges,,,290.26,83,,percent of total billed charges,,,,,,,,,,,,,,,290.26,83,,percent of total billed charges,,,332.22,95,,percent of total billed charges,,,314.74,90,,percent of total billed charges,,,314.74,90,,percent of total billed charges,,,286.76,82,,percent of total billed charges,,,314.74,90,,percent of total billed charges,,,297.25,85,,percent of total billed charges,,87.43,332.22,
BUPIVACAINE 0.5% PF INJ SOL 30ML,32000115,CDM,J3490,HCPCS,250,RC,outpatient,,131.86,131.86,,111.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.97,22,,percent of total billed charges,,,,,,,,,118.67,90,,percent of total billed charges,,,109.18,82.8,,percent of total billed charges,,,112.08,85,,percent of total billed charges,,,,,,,,,116.04,88,,percent of total billed charges,,,,,,,,,100.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.97,22,,percent of total billed charges,,,119.99,91,,percent of total billed charges,,,125.27,95,,percent of total billed charges,,,109.44,83,,percent of total billed charges,,,109.44,83,,percent of total billed charges,,,,,,,,,,,,,,,109.44,83,,percent of total billed charges,,,125.27,95,,percent of total billed charges,,,118.67,90,,percent of total billed charges,,,118.67,90,,percent of total billed charges,,,108.13,82,,percent of total billed charges,,,118.67,90,,percent of total billed charges,,,112.08,85,,percent of total billed charges,,32.97,125.27,
RISEDRONATE(ACTONEL)TAB:35MG,32000117,CDM,,,250,RC,outpatient,,459.31,459.31,,389.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,114.83,22,,percent of total billed charges,,,,,,,,,413.38,90,,percent of total billed charges,,,380.31,82.8,,percent of total billed charges,,,390.41,85,,percent of total billed charges,,,,,,,,,404.19,88,,percent of total billed charges,,,,,,,,,350.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,114.83,22,,percent of total billed charges,,,417.97,91,,percent of total billed charges,,,436.34,95,,percent of total billed charges,,,381.23,83,,percent of total billed charges,,,381.23,83,,percent of total billed charges,,,,,,,,,,,,,,,381.23,83,,percent of total billed charges,,,436.34,95,,percent of total billed charges,,,413.38,90,,percent of total billed charges,,,413.38,90,,percent of total billed charges,,,376.63,82,,percent of total billed charges,,,413.38,90,,percent of total billed charges,,,390.41,85,,percent of total billed charges,,114.83,436.34,
ERYTHROMYCIN BASE(E-MYCIN)TAB:500MG,32000118,CDM,,,250,RC,outpatient,,291.35,291.35,,247.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.84,22,,percent of total billed charges,,,,,,,,,262.22,90,,percent of total billed charges,,,241.24,82.8,,percent of total billed charges,,,247.65,85,,percent of total billed charges,,,,,,,,,256.39,88,,percent of total billed charges,,,,,,,,,222.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.84,22,,percent of total billed charges,,,265.13,91,,percent of total billed charges,,,276.78,95,,percent of total billed charges,,,241.82,83,,percent of total billed charges,,,241.82,83,,percent of total billed charges,,,,,,,,,,,,,,,241.82,83,,percent of total billed charges,,,276.78,95,,percent of total billed charges,,,262.22,90,,percent of total billed charges,,,262.22,90,,percent of total billed charges,,,238.91,82,,percent of total billed charges,,,262.22,90,,percent of total billed charges,,,247.65,85,,percent of total billed charges,,72.84,276.78,
COD/APAP/CAF/BU(FIORCET+C)CAP:30-325-50,32000120,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
metFORMIN(GLUCOPHAGE)TAB:850MG,32000121,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
POTCL/POT BICARB/CIT(KLYTE CL) TAB:25MEQ,32000122,CDM,,,250,RC,outpatient,,19.03,19.03,,16.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.76,22,,percent of total billed charges,,,,,,,,,17.13,90,,percent of total billed charges,,,15.76,82.8,,percent of total billed charges,,,16.18,85,,percent of total billed charges,,,,,,,,,16.75,88,,percent of total billed charges,,,,,,,,,14.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.76,22,,percent of total billed charges,,,17.32,91,,percent of total billed charges,,,18.08,95,,percent of total billed charges,,,15.79,83,,percent of total billed charges,,,15.79,83,,percent of total billed charges,,,,,,,,,,,,,,,15.79,83,,percent of total billed charges,,,18.08,95,,percent of total billed charges,,,17.13,90,,percent of total billed charges,,,17.13,90,,percent of total billed charges,,,15.6,82,,percent of total billed charges,,,17.13,90,,percent of total billed charges,,,16.18,85,,percent of total billed charges,,4.76,18.08,
GATIFLOXACIN(ZYMAR)DROP 0.3%:5ML,32000123,CDM,,,250,RC,outpatient,,1024.26,1024.26,,869.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,256.07,22,,percent of total billed charges,,,,,,,,,921.83,90,,percent of total billed charges,,,848.09,82.8,,percent of total billed charges,,,870.62,85,,percent of total billed charges,,,,,,,,,901.35,88,,percent of total billed charges,,,,,,,,,782.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,256.07,22,,percent of total billed charges,,,932.08,91,,percent of total billed charges,,,973.05,95,,percent of total billed charges,,,850.14,83,,percent of total billed charges,,,850.14,83,,percent of total billed charges,,,,,,,,,,,,,,,850.14,83,,percent of total billed charges,,,973.05,95,,percent of total billed charges,,,921.83,90,,percent of total billed charges,,,921.83,90,,percent of total billed charges,,,839.89,82,,percent of total billed charges,,,921.83,90,,percent of total billed charges,,,870.62,85,,percent of total billed charges,,256.07,973.05,
OCTREOTIDE(SandoSTIN)VIAL:0.05MG/ML,32000124,CDM,J2354,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,22.34,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,22.34,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
VERAPAMIL HCL (VERELAN PM) CAP : 240MG,32000125,CDM,,,250,RC,outpatient,,21.09,21.09,,17.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.27,22,,percent of total billed charges,,,,,,,,,18.98,90,,percent of total billed charges,,,17.46,82.8,,percent of total billed charges,,,17.93,85,,percent of total billed charges,,,,,,,,,18.56,88,,percent of total billed charges,,,,,,,,,16.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.27,22,,percent of total billed charges,,,19.19,91,,percent of total billed charges,,,20.04,95,,percent of total billed charges,,,17.5,83,,percent of total billed charges,,,17.5,83,,percent of total billed charges,,,,,,,,,,,,,,,17.5,83,,percent of total billed charges,,,20.04,95,,percent of total billed charges,,,18.98,90,,percent of total billed charges,,,18.98,90,,percent of total billed charges,,,17.29,82,,percent of total billed charges,,,18.98,90,,percent of total billed charges,,,17.93,85,,percent of total billed charges,,5.27,20.04,
guaiFENesin(MUCINEX)TAB:600MG,32000126,CDM,J8499,HCPCS,250,RC,outpatient,,15.2,15.2,,12.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.8,22,,percent of total billed charges,,,,,,,,,13.68,90,,percent of total billed charges,,,12.59,82.8,,percent of total billed charges,,,12.92,85,,percent of total billed charges,,,,,,,,,13.38,88,,percent of total billed charges,,,,,,,,,11.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.8,22,,percent of total billed charges,,,13.83,91,,percent of total billed charges,,,14.44,95,,percent of total billed charges,,,12.62,83,,percent of total billed charges,,,12.62,83,,percent of total billed charges,,,,,,,,,,,,,,,12.62,83,,percent of total billed charges,,,14.44,95,,percent of total billed charges,,,13.68,90,,percent of total billed charges,,,13.68,90,,percent of total billed charges,,,12.46,82,,percent of total billed charges,,,13.68,90,,percent of total billed charges,,,12.92,85,,percent of total billed charges,,3.8,14.44,
FLUCONAZOLE(DIFLUCAN)TAB:150MG,32000127,CDM,J8499,HCPCS,250,RC,outpatient,,23.69,23.69,,20.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.92,22,,percent of total billed charges,,,,,,,,,21.32,90,,percent of total billed charges,,,19.62,82.8,,percent of total billed charges,,,20.14,85,,percent of total billed charges,,,,,,,,,20.85,88,,percent of total billed charges,,,,,,,,,18.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.92,22,,percent of total billed charges,,,21.56,91,,percent of total billed charges,,,22.51,95,,percent of total billed charges,,,19.66,83,,percent of total billed charges,,,19.66,83,,percent of total billed charges,,,,,,,,,,,,,,,19.66,83,,percent of total billed charges,,,22.51,95,,percent of total billed charges,,,21.32,90,,percent of total billed charges,,,21.32,90,,percent of total billed charges,,,19.43,82,,percent of total billed charges,,,21.32,90,,percent of total billed charges,,,20.14,85,,percent of total billed charges,,5.92,22.51,
NIACINAMIDE TAB:500MG,32000128,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
EZETIMIBE(ZETIA)TAB:10MG,32000129,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FENOFIBRATE MICRONIZED (TRICOR)TAB:160MG,32000130,CDM,,,250,RC,outpatient,,46.95,46.95,,39.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.74,22,,percent of total billed charges,,,,,,,,,42.26,90,,percent of total billed charges,,,38.87,82.8,,percent of total billed charges,,,39.91,85,,percent of total billed charges,,,,,,,,,41.32,88,,percent of total billed charges,,,,,,,,,35.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.74,22,,percent of total billed charges,,,42.72,91,,percent of total billed charges,,,44.6,95,,percent of total billed charges,,,38.97,83,,percent of total billed charges,,,38.97,83,,percent of total billed charges,,,,,,,,,,,,,,,38.97,83,,percent of total billed charges,,,44.6,95,,percent of total billed charges,,,42.26,90,,percent of total billed charges,,,42.26,90,,percent of total billed charges,,,38.5,82,,percent of total billed charges,,,42.26,90,,percent of total billed charges,,,39.91,85,,percent of total billed charges,,11.74,44.6,
guaiFENesin(ORGANIDIN)TAB:200MG,32000131,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PARoxetine(PAXIL CR)TAB:37.5MG,32000132,CDM,,,250,RC,outpatient,,63.28,63.28,,53.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.82,22,,percent of total billed charges,,,,,,,,,56.95,90,,percent of total billed charges,,,52.4,82.8,,percent of total billed charges,,,53.79,85,,percent of total billed charges,,,,,,,,,55.69,88,,percent of total billed charges,,,,,,,,,48.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.82,22,,percent of total billed charges,,,57.58,91,,percent of total billed charges,,,60.12,95,,percent of total billed charges,,,52.52,83,,percent of total billed charges,,,52.52,83,,percent of total billed charges,,,,,,,,,,,,,,,52.52,83,,percent of total billed charges,,,60.12,95,,percent of total billed charges,,,56.95,90,,percent of total billed charges,,,56.95,90,,percent of total billed charges,,,51.89,82,,percent of total billed charges,,,56.95,90,,percent of total billed charges,,,53.79,85,,percent of total billed charges,,15.82,60.12,
PERINDOPRIL ERBUMINE(ACEON)TAB:8MG,32000133,CDM,,,250,RC,outpatient,,49.48,49.48,,42.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.37,22,,percent of total billed charges,,,,,,,,,44.53,90,,percent of total billed charges,,,40.97,82.8,,percent of total billed charges,,,42.06,85,,percent of total billed charges,,,,,,,,,43.54,88,,percent of total billed charges,,,,,,,,,37.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.37,22,,percent of total billed charges,,,45.03,91,,percent of total billed charges,,,47.01,95,,percent of total billed charges,,,41.07,83,,percent of total billed charges,,,41.07,83,,percent of total billed charges,,,,,,,,,,,,,,,41.07,83,,percent of total billed charges,,,47.01,95,,percent of total billed charges,,,44.53,90,,percent of total billed charges,,,44.53,90,,percent of total billed charges,,,40.57,82,,percent of total billed charges,,,44.53,90,,percent of total billed charges,,,42.06,85,,percent of total billed charges,,12.37,47.01,
ADENOCARD SYR : 3MG/ML *,32000134,CDM,,,250,RC,outpatient,,964.45,964.45,,818.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,241.11,22,,percent of total billed charges,,,,,,,,,868.01,90,,percent of total billed charges,,,798.56,82.8,,percent of total billed charges,,,819.78,85,,percent of total billed charges,,,,,,,,,848.72,88,,percent of total billed charges,,,,,,,,,736.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,241.11,22,,percent of total billed charges,,,877.65,91,,percent of total billed charges,,,916.23,95,,percent of total billed charges,,,800.49,83,,percent of total billed charges,,,800.49,83,,percent of total billed charges,,,,,,,,,,,,,,,800.49,83,,percent of total billed charges,,,916.23,95,,percent of total billed charges,,,868.01,90,,percent of total billed charges,,,868.01,90,,percent of total billed charges,,,790.85,82,,percent of total billed charges,,,868.01,90,,percent of total billed charges,,,819.78,85,,percent of total billed charges,,241.11,916.23,
EMOLLIENT (VANICREAM) CREAM,32000135,CDM,,,250,RC,outpatient,,67.56,67.56,,57.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.89,22,,percent of total billed charges,,,,,,,,,60.8,90,,percent of total billed charges,,,55.94,82.8,,percent of total billed charges,,,57.43,85,,percent of total billed charges,,,,,,,,,59.45,88,,percent of total billed charges,,,,,,,,,51.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.89,22,,percent of total billed charges,,,61.48,91,,percent of total billed charges,,,64.18,95,,percent of total billed charges,,,56.07,83,,percent of total billed charges,,,56.07,83,,percent of total billed charges,,,,,,,,,,,,,,,56.07,83,,percent of total billed charges,,,64.18,95,,percent of total billed charges,,,60.8,90,,percent of total billed charges,,,60.8,90,,percent of total billed charges,,,55.4,82,,percent of total billed charges,,,60.8,90,,percent of total billed charges,,,57.43,85,,percent of total billed charges,,16.89,64.18,
OCTREOTIDE(SandoSTIN LAR) KIT:30MG   J/1,32000136,CDM,J2353,HCPCS,636,RC,outpatient,,22063.9,22063.9,,18732.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5515.98,22,,percent of total billed charges,,,,,,,,,19857.51,90,,percent of total billed charges,,,18268.91,82.8,,percent of total billed charges,,,18754.32,85,,percent of total billed charges,,,,,,,,,19416.23,88,,percent of total billed charges,,8278.44,,,,fee schedule,,,16856.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8278.44,,,,fee schedule,,,5515.98,22,,percent of total billed charges,,,20078.15,91,,percent of total billed charges,,,20960.71,95,,percent of total billed charges,,,18313.04,83,,percent of total billed charges,,,18313.04,83,,percent of total billed charges,,,,,,,,,,,,,,,18313.04,83,,percent of total billed charges,,,20960.71,95,,percent of total billed charges,,,19857.51,90,,percent of total billed charges,,,19857.51,90,,percent of total billed charges,,,18092.4,82,,percent of total billed charges,,,19857.51,90,,percent of total billed charges,,,18754.32,85,,percent of total billed charges,,5515.98,20960.71,
PARoxetine(PAXIL CR)TAB:12.5MG,32000137,CDM,,,250,RC,outpatient,,58.84,58.84,,49.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.71,22,,percent of total billed charges,,,,,,,,,52.96,90,,percent of total billed charges,,,48.72,82.8,,percent of total billed charges,,,50.01,85,,percent of total billed charges,,,,,,,,,51.78,88,,percent of total billed charges,,,,,,,,,44.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.71,22,,percent of total billed charges,,,53.54,91,,percent of total billed charges,,,55.9,95,,percent of total billed charges,,,48.84,83,,percent of total billed charges,,,48.84,83,,percent of total billed charges,,,,,,,,,,,,,,,48.84,83,,percent of total billed charges,,,55.9,95,,percent of total billed charges,,,52.96,90,,percent of total billed charges,,,52.96,90,,percent of total billed charges,,,48.25,82,,percent of total billed charges,,,52.96,90,,percent of total billed charges,,,50.01,85,,percent of total billed charges,,14.71,55.9,
CLOBETASOL(TEMOVATE)CREAM 0.05%:15GM,32000138,CDM,J3490,HCPCS,250,RC,outpatient,,54.25,54.25,,46.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.56,22,,percent of total billed charges,,,,,,,,,48.83,90,,percent of total billed charges,,,44.92,82.8,,percent of total billed charges,,,46.11,85,,percent of total billed charges,,,,,,,,,47.74,88,,percent of total billed charges,,,,,,,,,41.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.56,22,,percent of total billed charges,,,49.37,91,,percent of total billed charges,,,51.54,95,,percent of total billed charges,,,45.03,83,,percent of total billed charges,,,45.03,83,,percent of total billed charges,,,,,,,,,,,,,,,45.03,83,,percent of total billed charges,,,51.54,95,,percent of total billed charges,,,48.83,90,,percent of total billed charges,,,48.83,90,,percent of total billed charges,,,44.49,82,,percent of total billed charges,,,48.83,90,,percent of total billed charges,,,46.11,85,,percent of total billed charges,,13.56,51.54,
FLUTICASON/SALMET(ADVAIR DISK):250-50MCG,32000139,CDM,,,250,RC,outpatient,,424,424,,359.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,106,22,,percent of total billed charges,,,,,,,,,381.6,90,,percent of total billed charges,,,351.07,82.8,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,,,,,,,,373.12,88,,percent of total billed charges,,,,,,,,,323.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,106,22,,percent of total billed charges,,,385.84,91,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,,,,,,,,,,,,,351.92,83,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,347.68,82,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,106,402.8,
PALIVIZUMAB (SYNAGIS) VIAL : 50MG 1ML,32000140,CDM,,,250,RC,outpatient,,4962.74,4962.74,,4213.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1240.69,22,,percent of total billed charges,,,,,,,,,4466.47,90,,percent of total billed charges,,,4109.15,82.8,,percent of total billed charges,,,4218.33,85,,percent of total billed charges,,,,,,,,,4367.21,88,,percent of total billed charges,,,,,,,,,3791.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1240.69,22,,percent of total billed charges,,,4516.09,91,,percent of total billed charges,,,4714.6,95,,percent of total billed charges,,,4119.07,83,,percent of total billed charges,,,4119.07,83,,percent of total billed charges,,,,,,,,,,,,,,,4119.07,83,,percent of total billed charges,,,4714.6,95,,percent of total billed charges,,,4466.47,90,,percent of total billed charges,,,4466.47,90,,percent of total billed charges,,,4069.45,82,,percent of total billed charges,,,4466.47,90,,percent of total billed charges,,,4218.33,85,,percent of total billed charges,,1240.69,4714.6,
PALIVIZUMAB (SYNAGIS) VIAL : 100MG 1ML,32000142,CDM,,,250,RC,outpatient,,5760.86,5760.86,,4890.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1440.22,22,,percent of total billed charges,,,,,,,,,5184.77,90,,percent of total billed charges,,,4769.99,82.8,,percent of total billed charges,,,4896.73,85,,percent of total billed charges,,,,,,,,,5069.56,88,,percent of total billed charges,,,,,,,,,4401.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1440.22,22,,percent of total billed charges,,,5242.38,91,,percent of total billed charges,,,5472.82,95,,percent of total billed charges,,,4781.51,83,,percent of total billed charges,,,4781.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4781.51,83,,percent of total billed charges,,,5472.82,95,,percent of total billed charges,,,5184.77,90,,percent of total billed charges,,,5184.77,90,,percent of total billed charges,,,4723.91,82,,percent of total billed charges,,,5184.77,90,,percent of total billed charges,,,4896.73,85,,percent of total billed charges,,1440.22,5472.82,
INTERFE ALFA-2B(INTRON)MDV:6MMU/ML,32000143,CDM,J9214,HCPCS,636,RC,outpatient,,519.89,519.89,,441.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,129.97,22,,percent of total billed charges,,,,,,,,,467.9,90,,percent of total billed charges,,,430.47,82.8,,percent of total billed charges,,,441.91,85,,percent of total billed charges,,,,,,,,,457.5,88,,percent of total billed charges,,2443.05,,,,fee schedule,,,397.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2443.05,,,,fee schedule,,,129.97,22,,percent of total billed charges,,,473.1,91,,percent of total billed charges,,,493.9,95,,percent of total billed charges,,,431.51,83,,percent of total billed charges,,,431.51,83,,percent of total billed charges,,,,,,,,,,,,,,,431.51,83,,percent of total billed charges,,,493.9,95,,percent of total billed charges,,,467.9,90,,percent of total billed charges,,,467.9,90,,percent of total billed charges,,,426.31,82,,percent of total billed charges,,,467.9,90,,percent of total billed charges,,,441.91,85,,percent of total billed charges,,129.97,2443.05,
CALCITONIN(MIACALCIN):400UNITS/2ML,32000144,CDM,J0630,HCPCS,250,RC,outpatient,,14488.42,14488.42,,12300.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3622.11,22,,percent of total billed charges,,,,,,,,,13039.58,90,,percent of total billed charges,,,11996.41,82.8,,percent of total billed charges,,,12315.16,85,,percent of total billed charges,,,,,,,,,12749.81,88,,percent of total billed charges,,3554.67,,,,fee schedule,,,11069.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3554.67,,,,fee schedule,,,3622.11,22,,percent of total billed charges,,,13184.46,91,,percent of total billed charges,,,13764,95,,percent of total billed charges,,,12025.39,83,,percent of total billed charges,,,12025.39,83,,percent of total billed charges,,,,,,,,,,,,,,,12025.39,83,,percent of total billed charges,,,13764,95,,percent of total billed charges,,,13039.58,90,,percent of total billed charges,,,13039.58,90,,percent of total billed charges,,,11880.5,82,,percent of total billed charges,,,13039.58,90,,percent of total billed charges,,,12315.16,85,,percent of total billed charges,,3554.67,13764,
OXALIPLATIN(ELOXATIN):100MG  (J/0.5MG),32000145,CDM,J9263,HCPCS,636,RC,outpatient,,4073.58,4073.58,,3458.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1018.4,22,,percent of total billed charges,,,,,,,,,3666.22,90,,percent of total billed charges,,,3372.92,82.8,,percent of total billed charges,,,3462.54,85,,percent of total billed charges,,,,,,,,,3584.75,88,,percent of total billed charges,,38.5,,,,fee schedule,,,3112.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,38.5,,,,fee schedule,,,1018.4,22,,percent of total billed charges,,,3706.96,91,,percent of total billed charges,,,3869.9,95,,percent of total billed charges,,,3381.07,83,,percent of total billed charges,,,3381.07,83,,percent of total billed charges,,,,,,,,,,,,,,,3381.07,83,,percent of total billed charges,,,3869.9,95,,percent of total billed charges,,,3666.22,90,,percent of total billed charges,,,3666.22,90,,percent of total billed charges,,,3340.34,82,,percent of total billed charges,,,3666.22,90,,percent of total billed charges,,,3462.54,85,,percent of total billed charges,,38.5,3869.9,
POTASSIUM CHL LIQ 40MEQ/30ML  UD,32000146,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
TESTOSTRN ENTH VIAL:1000MG/5ML,32000147,CDM,,,250,RC,outpatient,,1168.07,1168.07,,991.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,292.02,22,,percent of total billed charges,,,,,,,,,1051.26,90,,percent of total billed charges,,,967.16,82.8,,percent of total billed charges,,,992.86,85,,percent of total billed charges,,,,,,,,,1027.9,88,,percent of total billed charges,,,,,,,,,892.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,292.02,22,,percent of total billed charges,,,1062.94,91,,percent of total billed charges,,,1109.67,95,,percent of total billed charges,,,969.5,83,,percent of total billed charges,,,969.5,83,,percent of total billed charges,,,,,,,,,,,,,,,969.5,83,,percent of total billed charges,,,1109.67,95,,percent of total billed charges,,,1051.26,90,,percent of total billed charges,,,1051.26,90,,percent of total billed charges,,,957.82,82,,percent of total billed charges,,,1051.26,90,,percent of total billed charges,,,992.86,85,,percent of total billed charges,,292.02,1109.67,
OXCARBAZEPINE (TRILEPTAL) TAB : 150MG,32000148,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
OXCARBAZEPINE (TRILEPTAL) TAB : 600MG,32000149,CDM,,,250,RC,outpatient,,75.81,75.81,,64.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.95,22,,percent of total billed charges,,,,,,,,,68.23,90,,percent of total billed charges,,,62.77,82.8,,percent of total billed charges,,,64.44,85,,percent of total billed charges,,,,,,,,,66.71,88,,percent of total billed charges,,,,,,,,,57.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.95,22,,percent of total billed charges,,,68.99,91,,percent of total billed charges,,,72.02,95,,percent of total billed charges,,,62.92,83,,percent of total billed charges,,,62.92,83,,percent of total billed charges,,,,,,,,,,,,,,,62.92,83,,percent of total billed charges,,,72.02,95,,percent of total billed charges,,,68.23,90,,percent of total billed charges,,,68.23,90,,percent of total billed charges,,,62.16,82,,percent of total billed charges,,,68.23,90,,percent of total billed charges,,,64.44,85,,percent of total billed charges,,18.95,72.02,
IBUTILIDE(CORVERT):1MG/10ML,32000150,CDM,J1742,HCPCS,636,RC,outpatient,,882,882,,748.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,220.5,22,,percent of total billed charges,,,,,,,,,793.8,90,,percent of total billed charges,,,730.3,82.8,,percent of total billed charges,,,749.7,85,,percent of total billed charges,,,,,,,,,776.16,88,,percent of total billed charges,,492.2,,,,fee schedule,,,673.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,492.2,,,,fee schedule,,,220.5,22,,percent of total billed charges,,,802.62,91,,percent of total billed charges,,,837.9,95,,percent of total billed charges,,,732.06,83,,percent of total billed charges,,,732.06,83,,percent of total billed charges,,,,,,,,,,,,,,,732.06,83,,percent of total billed charges,,,837.9,95,,percent of total billed charges,,,793.8,90,,percent of total billed charges,,,793.8,90,,percent of total billed charges,,,723.24,82,,percent of total billed charges,,,793.8,90,,percent of total billed charges,,,749.7,85,,percent of total billed charges,,220.5,837.9,
ISOSORBIDE MONONITRATE(IMDUR) TAB : 30MG,32000151,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
OSELTAM(TAMIFLU)SUSP:12MG/ML(75ML)SNS,32000152,CDM,,,250,RC,outpatient,,711.32,711.32,,603.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,177.83,22,,percent of total billed charges,,,,,,,,,640.19,90,,percent of total billed charges,,,588.97,82.8,,percent of total billed charges,,,604.62,85,,percent of total billed charges,,,,,,,,,625.96,88,,percent of total billed charges,,,,,,,,,543.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,177.83,22,,percent of total billed charges,,,647.3,91,,percent of total billed charges,,,675.75,95,,percent of total billed charges,,,590.4,83,,percent of total billed charges,,,590.4,83,,percent of total billed charges,,,,,,,,,,,,,,,590.4,83,,percent of total billed charges,,,675.75,95,,percent of total billed charges,,,640.19,90,,percent of total billed charges,,,640.19,90,,percent of total billed charges,,,583.28,82,,percent of total billed charges,,,640.19,90,,percent of total billed charges,,,604.62,85,,percent of total billed charges,,177.83,675.75,
OXALIPLATIN(ELOXATIN):50MG/10ML,32000153,CDM,J9263,HCPCS,636,RC,outpatient,,155.39,155.39,,131.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.85,22,,percent of total billed charges,,,,,,,,,139.85,90,,percent of total billed charges,,,128.66,82.8,,percent of total billed charges,,,132.08,85,,percent of total billed charges,,,,,,,,,136.74,88,,percent of total billed charges,,38.5,,,,fee schedule,,,118.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,38.5,,,,fee schedule,,,38.85,22,,percent of total billed charges,,,141.4,91,,percent of total billed charges,,,147.62,95,,percent of total billed charges,,,128.97,83,,percent of total billed charges,,,128.97,83,,percent of total billed charges,,,,,,,,,,,,,,,128.97,83,,percent of total billed charges,,,147.62,95,,percent of total billed charges,,,139.85,90,,percent of total billed charges,,,139.85,90,,percent of total billed charges,,,127.42,82,,percent of total billed charges,,,139.85,90,,percent of total billed charges,,,132.08,85,,percent of total billed charges,,38.5,147.62,
PROPAFENONE(RYTHMOL)TAB:150MG,32000154,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
POTASSIUM CHLORIDE LIQ:20MEQ/15ML CUP PX,32000155,CDM,J8499,HCPCS,250,RC,outpatient,,113.56,113.56,,96.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.39,22,,percent of total billed charges,,,,,,,,,102.2,90,,percent of total billed charges,,,94.03,82.8,,percent of total billed charges,,,96.53,85,,percent of total billed charges,,,,,,,,,99.93,88,,percent of total billed charges,,,,,,,,,86.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.39,22,,percent of total billed charges,,,103.34,91,,percent of total billed charges,,,107.88,95,,percent of total billed charges,,,94.25,83,,percent of total billed charges,,,94.25,83,,percent of total billed charges,,,,,,,,,,,,,,,94.25,83,,percent of total billed charges,,,107.88,95,,percent of total billed charges,,,102.2,90,,percent of total billed charges,,,102.2,90,,percent of total billed charges,,,93.12,82,,percent of total billed charges,,,102.2,90,,percent of total billed charges,,,96.53,85,,percent of total billed charges,,28.39,107.88,
SUMAtriptan(IMITREX)TAB:25MG,32000156,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
prednisoLONE(PEDIAPRED):5MG/5ML(5ML),32000157,CDM,J7599,HCPCS,250,RC,outpatient,,53.27,53.27,,45.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.32,22,,percent of total billed charges,,,,,,,,,47.94,90,,percent of total billed charges,,,44.11,82.8,,percent of total billed charges,,,45.28,85,,percent of total billed charges,,,,,,,,,46.88,88,,percent of total billed charges,,,,,,,,,40.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.32,22,,percent of total billed charges,,,48.48,91,,percent of total billed charges,,,50.61,95,,percent of total billed charges,,,44.21,83,,percent of total billed charges,,,44.21,83,,percent of total billed charges,,,,,,,,,,,,,,,44.21,83,,percent of total billed charges,,,50.61,95,,percent of total billed charges,,,47.94,90,,percent of total billed charges,,,47.94,90,,percent of total billed charges,,,43.68,82,,percent of total billed charges,,,47.94,90,,percent of total billed charges,,,45.28,85,,percent of total billed charges,,13.32,50.61,
PYRIDOSTIGMINE(REGONL)AMP:10MG/2ML,32000158,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
DACARBAZINE(DTIC)200MG VIAL,32000159,CDM,J9130,HCPCS,636,RC,outpatient,,176.2,176.2,,149.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.05,22,,percent of total billed charges,,,,,,,,,158.58,90,,percent of total billed charges,,,145.89,82.8,,percent of total billed charges,,,149.77,85,,percent of total billed charges,,,,,,,,,155.06,88,,percent of total billed charges,,40.8,,,,fee schedule,,,134.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,40.8,,,,fee schedule,,,44.05,22,,percent of total billed charges,,,160.34,91,,percent of total billed charges,,,167.39,95,,percent of total billed charges,,,146.25,83,,percent of total billed charges,,,146.25,83,,percent of total billed charges,,,,,,,,,,,,,,,146.25,83,,percent of total billed charges,,,167.39,95,,percent of total billed charges,,,158.58,90,,percent of total billed charges,,,158.58,90,,percent of total billed charges,,,144.48,82,,percent of total billed charges,,,158.58,90,,percent of total billed charges,,,149.77,85,,percent of total billed charges,,40.8,167.39,
DACARBAZINE(DTIC)VIAL:100MG,32000160,CDM,J9130,HCPCS,636,RC,outpatient,,157.33,157.33,,133.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.33,22,,percent of total billed charges,,,,,,,,,141.6,90,,percent of total billed charges,,,130.27,82.8,,percent of total billed charges,,,133.73,85,,percent of total billed charges,,,,,,,,,138.45,88,,percent of total billed charges,,40.8,,,,fee schedule,,,120.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,40.8,,,,fee schedule,,,39.33,22,,percent of total billed charges,,,143.17,91,,percent of total billed charges,,,149.46,95,,percent of total billed charges,,,130.58,83,,percent of total billed charges,,,130.58,83,,percent of total billed charges,,,,,,,,,,,,,,,130.58,83,,percent of total billed charges,,,149.46,95,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,129.01,82,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,133.73,85,,percent of total billed charges,,39.33,149.46,
FLURBIPROFEN(ANSAID)TAB:100MG,32000162,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
TRYPS/BAL/PERU/CST OIL(XENADRM)OINT:60GM,32000163,CDM,,,250,RC,outpatient,,729.4,729.4,,619.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,182.35,22,,percent of total billed charges,,,,,,,,,656.46,90,,percent of total billed charges,,,603.94,82.8,,percent of total billed charges,,,619.99,85,,percent of total billed charges,,,,,,,,,641.87,88,,percent of total billed charges,,,,,,,,,557.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,182.35,22,,percent of total billed charges,,,663.75,91,,percent of total billed charges,,,692.93,95,,percent of total billed charges,,,605.4,83,,percent of total billed charges,,,605.4,83,,percent of total billed charges,,,,,,,,,,,,,,,605.4,83,,percent of total billed charges,,,692.93,95,,percent of total billed charges,,,656.46,90,,percent of total billed charges,,,656.46,90,,percent of total billed charges,,,598.11,82,,percent of total billed charges,,,656.46,90,,percent of total billed charges,,,619.99,85,,percent of total billed charges,,182.35,692.93,
ORLISTAT (XENICAL) CAP : 120MG,32000164,CDM,,,250,RC,outpatient,,79.78,79.78,,67.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.95,22,,percent of total billed charges,,,,,,,,,71.8,90,,percent of total billed charges,,,66.06,82.8,,percent of total billed charges,,,67.81,85,,percent of total billed charges,,,,,,,,,70.21,88,,percent of total billed charges,,,,,,,,,60.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.95,22,,percent of total billed charges,,,72.6,91,,percent of total billed charges,,,75.79,95,,percent of total billed charges,,,66.22,83,,percent of total billed charges,,,66.22,83,,percent of total billed charges,,,,,,,,,,,,,,,66.22,83,,percent of total billed charges,,,75.79,95,,percent of total billed charges,,,71.8,90,,percent of total billed charges,,,71.8,90,,percent of total billed charges,,,65.42,82,,percent of total billed charges,,,71.8,90,,percent of total billed charges,,,67.81,85,,percent of total billed charges,,19.95,75.79,
MICONAZOLE NIT(DESENEX) AER : 2% 85GM,32000165,CDM,,,250,RC,outpatient,,67.72,67.72,,57.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.93,22,,percent of total billed charges,,,,,,,,,60.95,90,,percent of total billed charges,,,56.07,82.8,,percent of total billed charges,,,57.56,85,,percent of total billed charges,,,,,,,,,59.59,88,,percent of total billed charges,,,,,,,,,51.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.93,22,,percent of total billed charges,,,61.63,91,,percent of total billed charges,,,64.33,95,,percent of total billed charges,,,56.21,83,,percent of total billed charges,,,56.21,83,,percent of total billed charges,,,,,,,,,,,,,,,56.21,83,,percent of total billed charges,,,64.33,95,,percent of total billed charges,,,60.95,90,,percent of total billed charges,,,60.95,90,,percent of total billed charges,,,55.53,82,,percent of total billed charges,,,60.95,90,,percent of total billed charges,,,57.56,85,,percent of total billed charges,,16.93,64.33,
LEVOBUNOLOL (BETAGAN) DROP : 0.50%  10ML,32000166,CDM,,,250,RC,outpatient,,582.86,582.86,,494.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,145.72,22,,percent of total billed charges,,,,,,,,,524.57,90,,percent of total billed charges,,,482.61,82.8,,percent of total billed charges,,,495.43,85,,percent of total billed charges,,,,,,,,,512.92,88,,percent of total billed charges,,,,,,,,,445.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,145.72,22,,percent of total billed charges,,,530.4,91,,percent of total billed charges,,,553.72,95,,percent of total billed charges,,,483.77,83,,percent of total billed charges,,,483.77,83,,percent of total billed charges,,,,,,,,,,,,,,,483.77,83,,percent of total billed charges,,,553.72,95,,percent of total billed charges,,,524.57,90,,percent of total billed charges,,,524.57,90,,percent of total billed charges,,,477.95,82,,percent of total billed charges,,,524.57,90,,percent of total billed charges,,,495.43,85,,percent of total billed charges,,145.72,553.72,
BENAZEPR/HCT(LOTENSIN) HCT TAB:20-12.5MG,32000167,CDM,,,250,RC,outpatient,,14.91,14.91,,12.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.73,22,,percent of total billed charges,,,,,,,,,13.42,90,,percent of total billed charges,,,12.35,82.8,,percent of total billed charges,,,12.67,85,,percent of total billed charges,,,,,,,,,13.12,88,,percent of total billed charges,,,,,,,,,11.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.73,22,,percent of total billed charges,,,13.57,91,,percent of total billed charges,,,14.16,95,,percent of total billed charges,,,12.38,83,,percent of total billed charges,,,12.38,83,,percent of total billed charges,,,,,,,,,,,,,,,12.38,83,,percent of total billed charges,,,14.16,95,,percent of total billed charges,,,13.42,90,,percent of total billed charges,,,13.42,90,,percent of total billed charges,,,12.23,82,,percent of total billed charges,,,13.42,90,,percent of total billed charges,,,12.67,85,,percent of total billed charges,,3.73,14.16,
NAFTIFINE(NAFTIN)CREAM 1%:15GM,32000168,CDM,,,250,RC,outpatient,,593.96,593.96,,504.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,148.49,22,,percent of total billed charges,,,,,,,,,534.56,90,,percent of total billed charges,,,491.8,82.8,,percent of total billed charges,,,504.87,85,,percent of total billed charges,,,,,,,,,522.68,88,,percent of total billed charges,,,,,,,,,453.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,148.49,22,,percent of total billed charges,,,540.5,91,,percent of total billed charges,,,564.26,95,,percent of total billed charges,,,492.99,83,,percent of total billed charges,,,492.99,83,,percent of total billed charges,,,,,,,,,,,,,,,492.99,83,,percent of total billed charges,,,564.26,95,,percent of total billed charges,,,534.56,90,,percent of total billed charges,,,534.56,90,,percent of total billed charges,,,487.05,82,,percent of total billed charges,,,534.56,90,,percent of total billed charges,,,504.87,85,,percent of total billed charges,,148.49,564.26,
NAFTIFINE(NAFTIN)CREAM 1%:60GM,32000169,CDM,,,250,RC,outpatient,,1790.21,1790.21,,1519.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,447.55,22,,percent of total billed charges,,,,,,,,,1611.19,90,,percent of total billed charges,,,1482.29,82.8,,percent of total billed charges,,,1521.68,85,,percent of total billed charges,,,,,,,,,1575.38,88,,percent of total billed charges,,,,,,,,,1367.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,447.55,22,,percent of total billed charges,,,1629.09,91,,percent of total billed charges,,,1700.7,95,,percent of total billed charges,,,1485.87,83,,percent of total billed charges,,,1485.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1485.87,83,,percent of total billed charges,,,1700.7,95,,percent of total billed charges,,,1611.19,90,,percent of total billed charges,,,1611.19,90,,percent of total billed charges,,,1467.97,82,,percent of total billed charges,,,1611.19,90,,percent of total billed charges,,,1521.68,85,,percent of total billed charges,,447.55,1700.7,
BENAZEPRIL-HCTZ(LOTENSIN-HCT)TAB 20/25MG,32000170,CDM,,,250,RC,outpatient,,5,5,,4.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.25,22,,percent of total billed charges,,,,,,,,,4.5,90,,percent of total billed charges,,,4.14,82.8,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,,,,,,,,4.4,88,,percent of total billed charges,,,,,,,,,3.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.25,22,,percent of total billed charges,,,4.55,91,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4.15,83,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.1,82,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,1.25,4.75,
ENOXAPARIN(LOVENOX):120MG/0.8ML,32000171,CDM,J1650,HCPCS,250,RC,outpatient,,174.18,174.18,,147.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.55,22,,percent of total billed charges,,,,,,,,,156.76,90,,percent of total billed charges,,,144.22,82.8,,percent of total billed charges,,,148.05,85,,percent of total billed charges,,,,,,,,,153.28,88,,percent of total billed charges,,15.16,,,,fee schedule,,,133.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.16,,,,fee schedule,,,43.55,22,,percent of total billed charges,,,158.5,91,,percent of total billed charges,,,165.47,95,,percent of total billed charges,,,144.57,83,,percent of total billed charges,,,144.57,83,,percent of total billed charges,,,,,,,,,,,,,,,144.57,83,,percent of total billed charges,,,165.47,95,,percent of total billed charges,,,156.76,90,,percent of total billed charges,,,156.76,90,,percent of total billed charges,,,142.83,82,,percent of total billed charges,,,156.76,90,,percent of total billed charges,,,148.05,85,,percent of total billed charges,,15.16,165.47,
OMEPRAZOLE(priLOSEC)CAP:20MG,32000172,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
POLYETH GLYCL3350(MIRALAX)PAC:17GUD,32000173,CDM,J8499,HCPCS,250,RC,outpatient,,27.45,27.45,,23.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.86,22,,percent of total billed charges,,,,,,,,,24.71,90,,percent of total billed charges,,,22.73,82.8,,percent of total billed charges,,,23.33,85,,percent of total billed charges,,,,,,,,,24.16,88,,percent of total billed charges,,,,,,,,,20.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.86,22,,percent of total billed charges,,,24.98,91,,percent of total billed charges,,,26.08,95,,percent of total billed charges,,,22.78,83,,percent of total billed charges,,,22.78,83,,percent of total billed charges,,,,,,,,,,,,,,,22.78,83,,percent of total billed charges,,,26.08,95,,percent of total billed charges,,,24.71,90,,percent of total billed charges,,,24.71,90,,percent of total billed charges,,,22.51,82,,percent of total billed charges,,,24.71,90,,percent of total billed charges,,,23.33,85,,percent of total billed charges,,6.86,26.08,
LIDOCAINE(XYLOCAINE)JELLY 2%: 5ML,32000174,CDM,J3490,HCPCS,250,RC,outpatient,,116.83,116.83,,99.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.21,22,,percent of total billed charges,,,,,,,,,105.15,90,,percent of total billed charges,,,96.74,82.8,,percent of total billed charges,,,99.31,85,,percent of total billed charges,,,,,,,,,102.81,88,,percent of total billed charges,,,,,,,,,89.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.21,22,,percent of total billed charges,,,106.32,91,,percent of total billed charges,,,110.99,95,,percent of total billed charges,,,96.97,83,,percent of total billed charges,,,96.97,83,,percent of total billed charges,,,,,,,,,,,,,,,96.97,83,,percent of total billed charges,,,110.99,95,,percent of total billed charges,,,105.15,90,,percent of total billed charges,,,105.15,90,,percent of total billed charges,,,95.8,82,,percent of total billed charges,,,105.15,90,,percent of total billed charges,,,99.31,85,,percent of total billed charges,,29.21,110.99,
PRAMIPEXOLE DI-HCL (MIRAPEX) TAB : 1MG,32000175,CDM,,,250,RC,outpatient,,36.16,36.16,,30.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.04,22,,percent of total billed charges,,,,,,,,,32.54,90,,percent of total billed charges,,,29.94,82.8,,percent of total billed charges,,,30.74,85,,percent of total billed charges,,,,,,,,,31.82,88,,percent of total billed charges,,,,,,,,,27.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.04,22,,percent of total billed charges,,,32.91,91,,percent of total billed charges,,,34.35,95,,percent of total billed charges,,,30.01,83,,percent of total billed charges,,,30.01,83,,percent of total billed charges,,,,,,,,,,,,,,,30.01,83,,percent of total billed charges,,,34.35,95,,percent of total billed charges,,,32.54,90,,percent of total billed charges,,,32.54,90,,percent of total billed charges,,,29.65,82,,percent of total billed charges,,,32.54,90,,percent of total billed charges,,,30.74,85,,percent of total billed charges,,9.04,34.35,
CHARCOAL/SORBTL(ACTIDOSE)ORAL:25G/120ML,32000176,CDM,J3490,HCPCS,250,RC,outpatient,,349.4,349.4,,296.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.35,22,,percent of total billed charges,,,,,,,,,314.46,90,,percent of total billed charges,,,289.3,82.8,,percent of total billed charges,,,296.99,85,,percent of total billed charges,,,,,,,,,307.47,88,,percent of total billed charges,,,,,,,,,266.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.35,22,,percent of total billed charges,,,317.95,91,,percent of total billed charges,,,331.93,95,,percent of total billed charges,,,290,83,,percent of total billed charges,,,290,83,,percent of total billed charges,,,,,,,,,,,,,,,290,83,,percent of total billed charges,,,331.93,95,,percent of total billed charges,,,314.46,90,,percent of total billed charges,,,314.46,90,,percent of total billed charges,,,286.51,82,,percent of total billed charges,,,314.46,90,,percent of total billed charges,,,296.99,85,,percent of total billed charges,,87.35,331.93,
DEXAMETHASONE(DECADRON): 4MG/ML 1ML,32000177,CDM,,,250,RC,outpatient,,85.33,85.33,,72.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.33,22,,percent of total billed charges,,,,,,,,,76.8,90,,percent of total billed charges,,,70.65,82.8,,percent of total billed charges,,,72.53,85,,percent of total billed charges,,,,,,,,,75.09,88,,percent of total billed charges,,,,,,,,,65.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.33,22,,percent of total billed charges,,,77.65,91,,percent of total billed charges,,,81.06,95,,percent of total billed charges,,,70.82,83,,percent of total billed charges,,,70.82,83,,percent of total billed charges,,,,,,,,,,,,,,,70.82,83,,percent of total billed charges,,,81.06,95,,percent of total billed charges,,,76.8,90,,percent of total billed charges,,,76.8,90,,percent of total billed charges,,,69.97,82,,percent of total billed charges,,,76.8,90,,percent of total billed charges,,,72.53,85,,percent of total billed charges,,21.33,81.06,
MULTIVITS STRESS FORMULA (STRESS600)TAB,32000178,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PODOFILOX SOL : 0.50% 3.5ML,32000179,CDM,,,250,RC,outpatient,,552.72,552.72,,469.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,138.18,22,,percent of total billed charges,,,,,,,,,497.45,90,,percent of total billed charges,,,457.65,82.8,,percent of total billed charges,,,469.81,85,,percent of total billed charges,,,,,,,,,486.39,88,,percent of total billed charges,,,,,,,,,422.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,138.18,22,,percent of total billed charges,,,502.98,91,,percent of total billed charges,,,525.08,95,,percent of total billed charges,,,458.76,83,,percent of total billed charges,,,458.76,83,,percent of total billed charges,,,,,,,,,,,,,,,458.76,83,,percent of total billed charges,,,525.08,95,,percent of total billed charges,,,497.45,90,,percent of total billed charges,,,497.45,90,,percent of total billed charges,,,453.23,82,,percent of total billed charges,,,497.45,90,,percent of total billed charges,,,469.81,85,,percent of total billed charges,,138.18,525.08,
metoPROLOL SUCC(TOPROL XL)TAB:25MG,32000180,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DICLOFENAC (VOLTARAN) TAB : 50MG,32000182,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ESTRADIOL(CLIMARA)PATCH:0.1MG/24HR,32000184,CDM,,,250,RC,outpatient,,309.11,309.11,,262.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.28,22,,percent of total billed charges,,,,,,,,,278.2,90,,percent of total billed charges,,,255.94,82.8,,percent of total billed charges,,,262.74,85,,percent of total billed charges,,,,,,,,,272.02,88,,percent of total billed charges,,,,,,,,,236.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.28,22,,percent of total billed charges,,,281.29,91,,percent of total billed charges,,,293.65,95,,percent of total billed charges,,,256.56,83,,percent of total billed charges,,,256.56,83,,percent of total billed charges,,,,,,,,,,,,,,,256.56,83,,percent of total billed charges,,,293.65,95,,percent of total billed charges,,,278.2,90,,percent of total billed charges,,,278.2,90,,percent of total billed charges,,,253.47,82,,percent of total billed charges,,,278.2,90,,percent of total billed charges,,,262.74,85,,percent of total billed charges,,77.28,293.65,
IBUPROFEN(MOTRIN)ORAL 100MG/5ML 480ML,32000185,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
IBUPROFEN(MOTRIN)ORAL:100MG/5ML (120ML),32000186,CDM,J8499,HCPCS,250,RC,outpatient,UD,45.43,45.43,,38.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.36,22,,percent of total billed charges,,,,,,,,,40.89,90,,percent of total billed charges,,,37.62,82.8,,percent of total billed charges,,,38.62,85,,percent of total billed charges,,,,,,,,,39.98,88,,percent of total billed charges,,,,,,,,,34.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.36,22,,percent of total billed charges,,,41.34,91,,percent of total billed charges,,,43.16,95,,percent of total billed charges,,,37.71,83,,percent of total billed charges,,,37.71,83,,percent of total billed charges,,,,,,,,,,,,,,,37.71,83,,percent of total billed charges,,,43.16,95,,percent of total billed charges,,,40.89,90,,percent of total billed charges,,,40.89,90,,percent of total billed charges,,,37.25,82,,percent of total billed charges,,,40.89,90,,percent of total billed charges,,,38.62,85,,percent of total billed charges,,11.36,43.16,
CEFDINIR (OMNICEF) SUS : 125MG/5ML 60ml,32000187,CDM,,,250,RC,outpatient,,725.36,725.36,,615.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,181.34,22,,percent of total billed charges,,,,,,,,,652.82,90,,percent of total billed charges,,,600.6,82.8,,percent of total billed charges,,,616.56,85,,percent of total billed charges,,,,,,,,,638.32,88,,percent of total billed charges,,,,,,,,,554.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,181.34,22,,percent of total billed charges,,,660.08,91,,percent of total billed charges,,,689.09,95,,percent of total billed charges,,,602.05,83,,percent of total billed charges,,,602.05,83,,percent of total billed charges,,,,,,,,,,,,,,,602.05,83,,percent of total billed charges,,,689.09,95,,percent of total billed charges,,,652.82,90,,percent of total billed charges,,,652.82,90,,percent of total billed charges,,,594.8,82,,percent of total billed charges,,,652.82,90,,percent of total billed charges,,,616.56,85,,percent of total billed charges,,181.34,689.09,
CEFDINIR(OMNICEF)SUS:125MG/5ML(100ML),32000188,CDM,J8499,HCPCS,250,RC,outpatient,,843.55,843.55,,716.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210.89,22,,percent of total billed charges,,,,,,,,,759.2,90,,percent of total billed charges,,,698.46,82.8,,percent of total billed charges,,,717.02,85,,percent of total billed charges,,,,,,,,,742.32,88,,percent of total billed charges,,,,,,,,,644.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210.89,22,,percent of total billed charges,,,767.63,91,,percent of total billed charges,,,801.37,95,,percent of total billed charges,,,700.15,83,,percent of total billed charges,,,700.15,83,,percent of total billed charges,,,,,,,,,,,,,,,700.15,83,,percent of total billed charges,,,801.37,95,,percent of total billed charges,,,759.2,90,,percent of total billed charges,,,759.2,90,,percent of total billed charges,,,691.71,82,,percent of total billed charges,,,759.2,90,,percent of total billed charges,,,717.02,85,,percent of total billed charges,,210.89,801.37,
CICLOPIROX(LOPROX)CREAM 0.77%:15GM,32000189,CDM,,,250,RC,outpatient,,129.5,129.5,,109.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.38,22,,percent of total billed charges,,,,,,,,,116.55,90,,percent of total billed charges,,,107.23,82.8,,percent of total billed charges,,,110.08,85,,percent of total billed charges,,,,,,,,,113.96,88,,percent of total billed charges,,,,,,,,,98.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.38,22,,percent of total billed charges,,,117.85,91,,percent of total billed charges,,,123.03,95,,percent of total billed charges,,,107.49,83,,percent of total billed charges,,,107.49,83,,percent of total billed charges,,,,,,,,,,,,,,,107.49,83,,percent of total billed charges,,,123.03,95,,percent of total billed charges,,,116.55,90,,percent of total billed charges,,,116.55,90,,percent of total billed charges,,,106.19,82,,percent of total billed charges,,,116.55,90,,percent of total billed charges,,,110.08,85,,percent of total billed charges,,32.38,123.03,
BACTERIOSTATIC NS VIAL:0.9% 30ML,32000190,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
MORPHINE SULF VIAL:10MG/ML,32000191,CDM,,,250,RC,outpatient,,106.58,106.58,,90.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.65,22,,percent of total billed charges,,,,,,,,,95.92,90,,percent of total billed charges,,,88.25,82.8,,percent of total billed charges,,,90.59,85,,percent of total billed charges,,,,,,,,,93.79,88,,percent of total billed charges,,,,,,,,,81.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.65,22,,percent of total billed charges,,,96.99,91,,percent of total billed charges,,,101.25,95,,percent of total billed charges,,,88.46,83,,percent of total billed charges,,,88.46,83,,percent of total billed charges,,,,,,,,,,,,,,,88.46,83,,percent of total billed charges,,,101.25,95,,percent of total billed charges,,,95.92,90,,percent of total billed charges,,,95.92,90,,percent of total billed charges,,,87.4,82,,percent of total billed charges,,,95.92,90,,percent of total billed charges,,,90.59,85,,percent of total billed charges,,26.65,101.25,
FORMOTEROL (FORADIL) CAP : 12MCG  60'S,32000192,CDM,,,250,RC,outpatient,,847.12,847.12,,719.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,211.78,22,,percent of total billed charges,,,,,,,,,762.41,90,,percent of total billed charges,,,701.42,82.8,,percent of total billed charges,,,720.05,85,,percent of total billed charges,,,,,,,,,745.47,88,,percent of total billed charges,,,,,,,,,647.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,211.78,22,,percent of total billed charges,,,770.88,91,,percent of total billed charges,,,804.76,95,,percent of total billed charges,,,703.11,83,,percent of total billed charges,,,703.11,83,,percent of total billed charges,,,,,,,,,,,,,,,703.11,83,,percent of total billed charges,,,804.76,95,,percent of total billed charges,,,762.41,90,,percent of total billed charges,,,762.41,90,,percent of total billed charges,,,694.64,82,,percent of total billed charges,,,762.41,90,,percent of total billed charges,,,720.05,85,,percent of total billed charges,,211.78,804.76,
CIPROF/DXMTH(CIPRODEX)DRP:0.3-0.1% 7.5ML,32000193,CDM,J3490,HCPCS,250,RC,outpatient,UD,1942.45,1942.45,,1649.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,485.61,22,,percent of total billed charges,,,,,,,,,1748.21,90,,percent of total billed charges,,,1608.35,82.8,,percent of total billed charges,,,1651.08,85,,percent of total billed charges,,,,,,,,,1709.36,88,,percent of total billed charges,,,,,,,,,1484.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,485.61,22,,percent of total billed charges,,,1767.63,91,,percent of total billed charges,,,1845.33,95,,percent of total billed charges,,,1612.23,83,,percent of total billed charges,,,1612.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1612.23,83,,percent of total billed charges,,,1845.33,95,,percent of total billed charges,,,1748.21,90,,percent of total billed charges,,,1748.21,90,,percent of total billed charges,,,1592.81,82,,percent of total billed charges,,,1748.21,90,,percent of total billed charges,,,1651.08,85,,percent of total billed charges,,485.61,1845.33,
MEMANTINE(NAMENDA)TAB:5 MG,32000194,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
MONSEL'S SOLUTION BOTTLE:8ML UD,32000195,CDM,J3490,HCPCS,250,RC,outpatient,,272.71,272.71,,231.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.18,22,,percent of total billed charges,,,,,,,,,245.44,90,,percent of total billed charges,,,225.8,82.8,,percent of total billed charges,,,231.8,85,,percent of total billed charges,,,,,,,,,239.98,88,,percent of total billed charges,,,,,,,,,208.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.18,22,,percent of total billed charges,,,248.17,91,,percent of total billed charges,,,259.07,95,,percent of total billed charges,,,226.35,83,,percent of total billed charges,,,226.35,83,,percent of total billed charges,,,,,,,,,,,,,,,226.35,83,,percent of total billed charges,,,259.07,95,,percent of total billed charges,,,245.44,90,,percent of total billed charges,,,245.44,90,,percent of total billed charges,,,223.62,82,,percent of total billed charges,,,245.44,90,,percent of total billed charges,,,231.8,85,,percent of total billed charges,,68.18,259.07,
MORPHINE SULF VIAL:25MG/ML (20ML),32000196,CDM,,,250,RC,outpatient,,73.27,73.27,,62.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.32,22,,percent of total billed charges,,,,,,,,,65.94,90,,percent of total billed charges,,,60.67,82.8,,percent of total billed charges,,,62.28,85,,percent of total billed charges,,,,,,,,,64.48,88,,percent of total billed charges,,,,,,,,,55.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.32,22,,percent of total billed charges,,,66.68,91,,percent of total billed charges,,,69.61,95,,percent of total billed charges,,,60.81,83,,percent of total billed charges,,,60.81,83,,percent of total billed charges,,,,,,,,,,,,,,,60.81,83,,percent of total billed charges,,,69.61,95,,percent of total billed charges,,,65.94,90,,percent of total billed charges,,,65.94,90,,percent of total billed charges,,,60.08,82,,percent of total billed charges,,,65.94,90,,percent of total billed charges,,,62.28,85,,percent of total billed charges,,18.32,69.61,
HYDROcod/APAP(NORCO)TAB 10/325MG:,32000197,CDM,,,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
CLOTRIMAZOLE(GYNE-LOTRIMIN 3)TAB:200MG,32000198,CDM,,,250,RC,outpatient,,41.55,41.55,,35.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.39,22,,percent of total billed charges,,,,,,,,,37.4,90,,percent of total billed charges,,,34.4,82.8,,percent of total billed charges,,,35.32,85,,percent of total billed charges,,,,,,,,,36.56,88,,percent of total billed charges,,,,,,,,,31.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.39,22,,percent of total billed charges,,,37.81,91,,percent of total billed charges,,,39.47,95,,percent of total billed charges,,,34.49,83,,percent of total billed charges,,,34.49,83,,percent of total billed charges,,,,,,,,,,,,,,,34.49,83,,percent of total billed charges,,,39.47,95,,percent of total billed charges,,,37.4,90,,percent of total billed charges,,,37.4,90,,percent of total billed charges,,,34.07,82,,percent of total billed charges,,,37.4,90,,percent of total billed charges,,,35.32,85,,percent of total billed charges,,10.39,39.47,
TRAMADOL/ACETAMN(ULTRACET)TAB:37.5-325MG,32000199,CDM,,,250,RC,outpatient,,24.9,24.9,,21.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.23,22,,percent of total billed charges,,,,,,,,,22.41,90,,percent of total billed charges,,,20.62,82.8,,percent of total billed charges,,,21.17,85,,percent of total billed charges,,,,,,,,,21.91,88,,percent of total billed charges,,,,,,,,,19.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.23,22,,percent of total billed charges,,,22.66,91,,percent of total billed charges,,,23.66,95,,percent of total billed charges,,,20.67,83,,percent of total billed charges,,,20.67,83,,percent of total billed charges,,,,,,,,,,,,,,,20.67,83,,percent of total billed charges,,,23.66,95,,percent of total billed charges,,,22.41,90,,percent of total billed charges,,,22.41,90,,percent of total billed charges,,,20.42,82,,percent of total billed charges,,,22.41,90,,percent of total billed charges,,,21.17,85,,percent of total billed charges,,6.23,23.66,
teraZOSIN (HYTRIN) CAPS :10MG,32000200,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
NAPROXEN (NAPROSYN) TAB : 375MG,32000201,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
LIDOCAINE(LMX 4)CREAM 4%:30GM,32000202,CDM,J3490,HCPCS,250,RC,outpatient,,532.9,532.9,,452.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,133.23,22,,percent of total billed charges,,,,,,,,,479.61,90,,percent of total billed charges,,,441.24,82.8,,percent of total billed charges,,,452.97,85,,percent of total billed charges,,,,,,,,,468.95,88,,percent of total billed charges,,,,,,,,,407.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,133.23,22,,percent of total billed charges,,,484.94,91,,percent of total billed charges,,,506.26,95,,percent of total billed charges,,,442.31,83,,percent of total billed charges,,,442.31,83,,percent of total billed charges,,,,,,,,,,,,,,,442.31,83,,percent of total billed charges,,,506.26,95,,percent of total billed charges,,,479.61,90,,percent of total billed charges,,,479.61,90,,percent of total billed charges,,,436.98,82,,percent of total billed charges,,,479.61,90,,percent of total billed charges,,,452.97,85,,percent of total billed charges,,133.23,506.26,
HC/PRAMOX(PRAMOSONE)OINT1%-1%:28.4GM,32000203,CDM,,,250,RC,outpatient,,2075.54,2075.54,,1762.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,518.89,22,,percent of total billed charges,,,,,,,,,1867.99,90,,percent of total billed charges,,,1718.55,82.8,,percent of total billed charges,,,1764.21,85,,percent of total billed charges,,,,,,,,,1826.48,88,,percent of total billed charges,,,,,,,,,1585.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,518.89,22,,percent of total billed charges,,,1888.74,91,,percent of total billed charges,,,1971.76,95,,percent of total billed charges,,,1722.7,83,,percent of total billed charges,,,1722.7,83,,percent of total billed charges,,,,,,,,,,,,,,,1722.7,83,,percent of total billed charges,,,1971.76,95,,percent of total billed charges,,,1867.99,90,,percent of total billed charges,,,1867.99,90,,percent of total billed charges,,,1701.94,82,,percent of total billed charges,,,1867.99,90,,percent of total billed charges,,,1764.21,85,,percent of total billed charges,,518.89,1971.76,
ONDANSETRON HCL (ZOFRAN) TAB : 24MG,32000204,CDM,,,250,RC,outpatient,,1343.46,1343.46,,1140.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,335.87,22,,percent of total billed charges,,,,,,,,,1209.11,90,,percent of total billed charges,,,1112.38,82.8,,percent of total billed charges,,,1141.94,85,,percent of total billed charges,,,,,,,,,1182.24,88,,percent of total billed charges,,,,,,,,,1026.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,335.87,22,,percent of total billed charges,,,1222.55,91,,percent of total billed charges,,,1276.29,95,,percent of total billed charges,,,1115.07,83,,percent of total billed charges,,,1115.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1115.07,83,,percent of total billed charges,,,1276.29,95,,percent of total billed charges,,,1209.11,90,,percent of total billed charges,,,1209.11,90,,percent of total billed charges,,,1101.64,82,,percent of total billed charges,,,1209.11,90,,percent of total billed charges,,,1141.94,85,,percent of total billed charges,,335.87,1276.29,
ONDANSETRON(ZOFRAN)TAB:4MG,32000205,CDM,,,250,RC,outpatient,,17.45,17.45,,14.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.36,22,,percent of total billed charges,,,,,,,,,15.71,90,,percent of total billed charges,,,14.45,82.8,,percent of total billed charges,,,14.83,85,,percent of total billed charges,,,,,,,,,15.36,88,,percent of total billed charges,,,,,,,,,13.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.36,22,,percent of total billed charges,,,15.88,91,,percent of total billed charges,,,16.58,95,,percent of total billed charges,,,14.48,83,,percent of total billed charges,,,14.48,83,,percent of total billed charges,,,,,,,,,,,,,,,14.48,83,,percent of total billed charges,,,16.58,95,,percent of total billed charges,,,15.71,90,,percent of total billed charges,,,15.71,90,,percent of total billed charges,,,14.31,82,,percent of total billed charges,,,15.71,90,,percent of total billed charges,,,14.83,85,,percent of total billed charges,,4.36,16.58,
MOMETASONE(ELOCON)CREAM 0.1%:15GM,32000207,CDM,,,250,RC,outpatient,,789.04,789.04,,669.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,197.26,22,,percent of total billed charges,,,,,,,,,710.14,90,,percent of total billed charges,,,653.33,82.8,,percent of total billed charges,,,670.68,85,,percent of total billed charges,,,,,,,,,694.36,88,,percent of total billed charges,,,,,,,,,602.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,197.26,22,,percent of total billed charges,,,718.03,91,,percent of total billed charges,,,749.59,95,,percent of total billed charges,,,654.9,83,,percent of total billed charges,,,654.9,83,,percent of total billed charges,,,,,,,,,,,,,,,654.9,83,,percent of total billed charges,,,749.59,95,,percent of total billed charges,,,710.14,90,,percent of total billed charges,,,710.14,90,,percent of total billed charges,,,647.01,82,,percent of total billed charges,,,710.14,90,,percent of total billed charges,,,670.68,85,,percent of total billed charges,,197.26,749.59,
MEMANTINE HCL (NAMENDA) TAB : 10MG,32000208,CDM,,,250,RC,outpatient,,123.39,123.39,,104.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.85,22,,percent of total billed charges,,,,,,,,,111.05,90,,percent of total billed charges,,,102.17,82.8,,percent of total billed charges,,,104.88,85,,percent of total billed charges,,,,,,,,,108.58,88,,percent of total billed charges,,,,,,,,,94.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.85,22,,percent of total billed charges,,,112.28,91,,percent of total billed charges,,,117.22,95,,percent of total billed charges,,,102.41,83,,percent of total billed charges,,,102.41,83,,percent of total billed charges,,,,,,,,,,,,,,,102.41,83,,percent of total billed charges,,,117.22,95,,percent of total billed charges,,,111.05,90,,percent of total billed charges,,,111.05,90,,percent of total billed charges,,,101.18,82,,percent of total billed charges,,,111.05,90,,percent of total billed charges,,,104.88,85,,percent of total billed charges,,30.85,117.22,
VALDECOXIB (BEXTRA) TAB : 20MG,32000209,CDM,,,250,RC,outpatient,,46.79,46.79,,39.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.7,22,,percent of total billed charges,,,,,,,,,42.11,90,,percent of total billed charges,,,38.74,82.8,,percent of total billed charges,,,39.77,85,,percent of total billed charges,,,,,,,,,41.18,88,,percent of total billed charges,,,,,,,,,35.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.7,22,,percent of total billed charges,,,42.58,91,,percent of total billed charges,,,44.45,95,,percent of total billed charges,,,38.84,83,,percent of total billed charges,,,38.84,83,,percent of total billed charges,,,,,,,,,,,,,,,38.84,83,,percent of total billed charges,,,44.45,95,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,38.37,82,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,39.77,85,,percent of total billed charges,,11.7,44.45,
BALSALAZIDE DISODIUM (COLAZAL) CAP:750MG,32000210,CDM,,,250,RC,outpatient,,92.78,92.78,,78.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.2,22,,percent of total billed charges,,,,,,,,,83.5,90,,percent of total billed charges,,,76.82,82.8,,percent of total billed charges,,,78.86,85,,percent of total billed charges,,,,,,,,,81.65,88,,percent of total billed charges,,,,,,,,,70.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.2,22,,percent of total billed charges,,,84.43,91,,percent of total billed charges,,,88.14,95,,percent of total billed charges,,,77.01,83,,percent of total billed charges,,,77.01,83,,percent of total billed charges,,,,,,,,,,,,,,,77.01,83,,percent of total billed charges,,,88.14,95,,percent of total billed charges,,,83.5,90,,percent of total billed charges,,,83.5,90,,percent of total billed charges,,,76.08,82,,percent of total billed charges,,,83.5,90,,percent of total billed charges,,,78.86,85,,percent of total billed charges,,23.2,88.14,
MORPHINE(ASTRAMORPH)INJ:10MG/10ML,32000212,CDM,J2274,HCPCS,250,RC,outpatient,,114.05,114.05,,96.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.51,22,,percent of total billed charges,,,,,,,,,102.65,90,,percent of total billed charges,,,94.43,82.8,,percent of total billed charges,,,96.94,85,,percent of total billed charges,,,,,,,,,100.36,88,,percent of total billed charges,,11.83,,,,fee schedule,,,87.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11.83,,,,fee schedule,,,28.51,22,,percent of total billed charges,,,103.79,91,,percent of total billed charges,,,108.35,95,,percent of total billed charges,,,94.66,83,,percent of total billed charges,,,94.66,83,,percent of total billed charges,,,,,,,,,,,,,,,94.66,83,,percent of total billed charges,,,108.35,95,,percent of total billed charges,,,102.65,90,,percent of total billed charges,,,102.65,90,,percent of total billed charges,,,93.52,82,,percent of total billed charges,,,102.65,90,,percent of total billed charges,,,96.94,85,,percent of total billed charges,,11.83,108.35,
FENOFIBRATE MICRONIZED (TRICOR) TAB:54MG,32000214,CDM,,,250,RC,outpatient,,15.7,15.7,,13.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.93,22,,percent of total billed charges,,,,,,,,,14.13,90,,percent of total billed charges,,,13,82.8,,percent of total billed charges,,,13.35,85,,percent of total billed charges,,,,,,,,,13.82,88,,percent of total billed charges,,,,,,,,,11.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.93,22,,percent of total billed charges,,,14.29,91,,percent of total billed charges,,,14.92,95,,percent of total billed charges,,,13.03,83,,percent of total billed charges,,,13.03,83,,percent of total billed charges,,,,,,,,,,,,,,,13.03,83,,percent of total billed charges,,,14.92,95,,percent of total billed charges,,,14.13,90,,percent of total billed charges,,,14.13,90,,percent of total billed charges,,,12.87,82,,percent of total billed charges,,,14.13,90,,percent of total billed charges,,,13.35,85,,percent of total billed charges,,3.93,14.92,
LEVOTHYROXINE SOD (LEVOTHROID)TAB:175MCG,32000215,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PARoxetine(PAXIL)TAB:10MG,32000216,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
AMINOPHYLLINE 200MG TABS,32000217,CDM,,,250,RC,outpatient,,1.1,1.1,,0.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.28,22,,percent of total billed charges,,,,,,,,,0.99,90,,percent of total billed charges,,,0.91,82.8,,percent of total billed charges,,,0.94,85,,percent of total billed charges,,,,,,,,,0.97,88,,percent of total billed charges,,,,,,,,,0.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.28,22,,percent of total billed charges,,,1,91,,percent of total billed charges,,,1.05,95,,percent of total billed charges,,,0.91,83,,percent of total billed charges,,,0.91,83,,percent of total billed charges,,,,,,,,,,,,,,,0.91,83,,percent of total billed charges,,,1.05,95,,percent of total billed charges,,,0.99,90,,percent of total billed charges,,,0.99,90,,percent of total billed charges,,,0.9,82,,percent of total billed charges,,,0.99,90,,percent of total billed charges,,,0.94,85,,percent of total billed charges,,0.28,1.05,
HEXACHLOROPH(PHISOHEX) LIQ 3%:473ML,32000218,CDM,,,250,RC,outpatient,,720.38,720.38,,611.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.1,22,,percent of total billed charges,,,,,,,,,648.34,90,,percent of total billed charges,,,596.47,82.8,,percent of total billed charges,,,612.32,85,,percent of total billed charges,,,,,,,,,633.93,88,,percent of total billed charges,,,,,,,,,550.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.1,22,,percent of total billed charges,,,655.55,91,,percent of total billed charges,,,684.36,95,,percent of total billed charges,,,597.92,83,,percent of total billed charges,,,597.92,83,,percent of total billed charges,,,,,,,,,,,,,,,597.92,83,,percent of total billed charges,,,684.36,95,,percent of total billed charges,,,648.34,90,,percent of total billed charges,,,648.34,90,,percent of total billed charges,,,590.71,82,,percent of total billed charges,,,648.34,90,,percent of total billed charges,,,612.32,85,,percent of total billed charges,,180.1,684.36,
DIVALPROEX (DEPAKOTE DR) TAB : 500MG,32000219,CDM,,,250,RC,outpatient,,69.78,69.78,,59.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.45,22,,percent of total billed charges,,,,,,,,,62.8,90,,percent of total billed charges,,,57.78,82.8,,percent of total billed charges,,,59.31,85,,percent of total billed charges,,,,,,,,,61.41,88,,percent of total billed charges,,,,,,,,,53.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.45,22,,percent of total billed charges,,,63.5,91,,percent of total billed charges,,,66.29,95,,percent of total billed charges,,,57.92,83,,percent of total billed charges,,,57.92,83,,percent of total billed charges,,,,,,,,,,,,,,,57.92,83,,percent of total billed charges,,,66.29,95,,percent of total billed charges,,,62.8,90,,percent of total billed charges,,,62.8,90,,percent of total billed charges,,,57.22,82,,percent of total billed charges,,,62.8,90,,percent of total billed charges,,,59.31,85,,percent of total billed charges,,17.45,66.29,
CALCIUM ACETATE (PHOSLO) TAB : 667MG,32000220,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PERGOLIDE (PERMAX) TAB : 0.25MG,32000221,CDM,,,250,RC,outpatient,,23.31,23.31,,19.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.83,22,,percent of total billed charges,,,,,,,,,20.98,90,,percent of total billed charges,,,19.3,82.8,,percent of total billed charges,,,19.81,85,,percent of total billed charges,,,,,,,,,20.51,88,,percent of total billed charges,,,,,,,,,17.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.83,22,,percent of total billed charges,,,21.21,91,,percent of total billed charges,,,22.14,95,,percent of total billed charges,,,19.35,83,,percent of total billed charges,,,19.35,83,,percent of total billed charges,,,,,,,,,,,,,,,19.35,83,,percent of total billed charges,,,22.14,95,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,19.11,82,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,19.81,85,,percent of total billed charges,,5.83,22.14,
CLORAZEPATE (TRANXENE) TAB : 7.5MG,32000222,CDM,,,250,RC,outpatient,,21.73,21.73,,18.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.43,22,,percent of total billed charges,,,,,,,,,19.56,90,,percent of total billed charges,,,17.99,82.8,,percent of total billed charges,,,18.47,85,,percent of total billed charges,,,,,,,,,19.12,88,,percent of total billed charges,,,,,,,,,16.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.43,22,,percent of total billed charges,,,19.77,91,,percent of total billed charges,,,20.64,95,,percent of total billed charges,,,18.04,83,,percent of total billed charges,,,18.04,83,,percent of total billed charges,,,,,,,,,,,,,,,18.04,83,,percent of total billed charges,,,20.64,95,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,17.82,82,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,18.47,85,,percent of total billed charges,,5.43,20.64,
OXYBUTYNIN (DITROPAN XL) TAB : 10MG,32000223,CDM,,,250,RC,outpatient,,57.25,57.25,,48.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.31,22,,percent of total billed charges,,,,,,,,,51.53,90,,percent of total billed charges,,,47.4,82.8,,percent of total billed charges,,,48.66,85,,percent of total billed charges,,,,,,,,,50.38,88,,percent of total billed charges,,,,,,,,,43.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.31,22,,percent of total billed charges,,,52.1,91,,percent of total billed charges,,,54.39,95,,percent of total billed charges,,,47.52,83,,percent of total billed charges,,,47.52,83,,percent of total billed charges,,,,,,,,,,,,,,,47.52,83,,percent of total billed charges,,,54.39,95,,percent of total billed charges,,,51.53,90,,percent of total billed charges,,,51.53,90,,percent of total billed charges,,,46.95,82,,percent of total billed charges,,,51.53,90,,percent of total billed charges,,,48.66,85,,percent of total billed charges,,14.31,54.39,
TRAVOPROST(TRAVATAN)DROP:2.5ML,32000224,CDM,J3490,HCPCS,250,RC,outpatient,,1903.64,1903.64,,1616.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,475.91,22,,percent of total billed charges,,,,,,,,,1713.28,90,,percent of total billed charges,,,1576.21,82.8,,percent of total billed charges,,,1618.09,85,,percent of total billed charges,,,,,,,,,1675.2,88,,percent of total billed charges,,,,,,,,,1454.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,475.91,22,,percent of total billed charges,,,1732.31,91,,percent of total billed charges,,,1808.46,95,,percent of total billed charges,,,1580.02,83,,percent of total billed charges,,,1580.02,83,,percent of total billed charges,,,,,,,,,,,,,,,1580.02,83,,percent of total billed charges,,,1808.46,95,,percent of total billed charges,,,1713.28,90,,percent of total billed charges,,,1713.28,90,,percent of total billed charges,,,1560.98,82,,percent of total billed charges,,,1713.28,90,,percent of total billed charges,,,1618.09,85,,percent of total billed charges,,475.91,1808.46,
PRIMIDONE(MYSOLINE)TAB:50MG,32000225,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
BISMUT SUBS(PEPTOBISMOL)262MG/15ML:118ML,32000226,CDM,J8499,HCPCS,250,RC,outpatient,,44.77,44.77,,38.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.19,22,,percent of total billed charges,,,,,,,,,40.29,90,,percent of total billed charges,,,37.07,82.8,,percent of total billed charges,,,38.05,85,,percent of total billed charges,,,,,,,,,39.4,88,,percent of total billed charges,,,,,,,,,34.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.19,22,,percent of total billed charges,,,40.74,91,,percent of total billed charges,,,42.53,95,,percent of total billed charges,,,37.16,83,,percent of total billed charges,,,37.16,83,,percent of total billed charges,,,,,,,,,,,,,,,37.16,83,,percent of total billed charges,,,42.53,95,,percent of total billed charges,,,40.29,90,,percent of total billed charges,,,40.29,90,,percent of total billed charges,,,36.71,82,,percent of total billed charges,,,40.29,90,,percent of total billed charges,,,38.05,85,,percent of total billed charges,,11.19,42.53,
MODAFINIL (PROVIGIL) TAB : 100MG,32000228,CDM,,,250,RC,outpatient,,407.13,407.13,,345.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.78,22,,percent of total billed charges,,,,,,,,,366.42,90,,percent of total billed charges,,,337.1,82.8,,percent of total billed charges,,,346.06,85,,percent of total billed charges,,,,,,,,,358.27,88,,percent of total billed charges,,,,,,,,,311.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.78,22,,percent of total billed charges,,,370.49,91,,percent of total billed charges,,,386.77,95,,percent of total billed charges,,,337.92,83,,percent of total billed charges,,,337.92,83,,percent of total billed charges,,,,,,,,,,,,,,,337.92,83,,percent of total billed charges,,,386.77,95,,percent of total billed charges,,,366.42,90,,percent of total billed charges,,,366.42,90,,percent of total billed charges,,,333.85,82,,percent of total billed charges,,,366.42,90,,percent of total billed charges,,,346.06,85,,percent of total billed charges,,101.78,386.77,
SERTRALINE HCL (ZOLOFT) TAB : 25MG,32000229,CDM,,,250,RC,outpatient,,40.13,40.13,,34.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.03,22,,percent of total billed charges,,,,,,,,,36.12,90,,percent of total billed charges,,,33.23,82.8,,percent of total billed charges,,,34.11,85,,percent of total billed charges,,,,,,,,,35.31,88,,percent of total billed charges,,,,,,,,,30.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.03,22,,percent of total billed charges,,,36.52,91,,percent of total billed charges,,,38.12,95,,percent of total billed charges,,,33.31,83,,percent of total billed charges,,,33.31,83,,percent of total billed charges,,,,,,,,,,,,,,,33.31,83,,percent of total billed charges,,,38.12,95,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,32.91,82,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,34.11,85,,percent of total billed charges,,10.03,38.12,
CAL 600MG/VIT D 200MG TAB,32000230,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
URSODIOL (ACTIGALL) CAP : 300MG,32000232,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
RIVASTIGMINE (EXELON) CAP : 3MG,32000233,CDM,,,250,RC,outpatient,,78.98,78.98,,67.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.75,22,,percent of total billed charges,,,,,,,,,71.08,90,,percent of total billed charges,,,65.4,82.8,,percent of total billed charges,,,67.13,85,,percent of total billed charges,,,,,,,,,69.5,88,,percent of total billed charges,,,,,,,,,60.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.75,22,,percent of total billed charges,,,71.87,91,,percent of total billed charges,,,75.03,95,,percent of total billed charges,,,65.55,83,,percent of total billed charges,,,65.55,83,,percent of total billed charges,,,,,,,,,,,,,,,65.55,83,,percent of total billed charges,,,75.03,95,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,64.76,82,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,67.13,85,,percent of total billed charges,,19.75,75.03,
MELOXICAM(MOBIC)TAB:7.5MG,32000234,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
TIOTROPIUM(SPIRIVA)CAP:18MCG (5'S),32000235,CDM,J3490,HCPCS,250,RC,outpatient,,715.8,715.8,,607.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.95,22,,percent of total billed charges,,,,,,,,,644.22,90,,percent of total billed charges,,,592.68,82.8,,percent of total billed charges,,,608.43,85,,percent of total billed charges,,,,,,,,,629.9,88,,percent of total billed charges,,,,,,,,,546.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.95,22,,percent of total billed charges,,,651.38,91,,percent of total billed charges,,,680.01,95,,percent of total billed charges,,,594.11,83,,percent of total billed charges,,,594.11,83,,percent of total billed charges,,,,,,,,,,,,,,,594.11,83,,percent of total billed charges,,,680.01,95,,percent of total billed charges,,,644.22,90,,percent of total billed charges,,,644.22,90,,percent of total billed charges,,,586.96,82,,percent of total billed charges,,,644.22,90,,percent of total billed charges,,,608.43,85,,percent of total billed charges,,178.95,680.01,
ACARBOSE (PRECOSE) TAB : 50MG,32000236,CDM,,,250,RC,outpatient,,14.43,14.43,,12.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.61,22,,percent of total billed charges,,,,,,,,,12.99,90,,percent of total billed charges,,,11.95,82.8,,percent of total billed charges,,,12.27,85,,percent of total billed charges,,,,,,,,,12.7,88,,percent of total billed charges,,,,,,,,,11.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.61,22,,percent of total billed charges,,,13.13,91,,percent of total billed charges,,,13.71,95,,percent of total billed charges,,,11.98,83,,percent of total billed charges,,,11.98,83,,percent of total billed charges,,,,,,,,,,,,,,,11.98,83,,percent of total billed charges,,,13.71,95,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,11.83,82,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,12.27,85,,percent of total billed charges,,3.61,13.71,
ROPINIROLE HCL (REQUIP) TAB : 0.5MG,32000237,CDM,,,250,RC,outpatient,,93.57,93.57,,79.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.39,22,,percent of total billed charges,,,,,,,,,84.21,90,,percent of total billed charges,,,77.48,82.8,,percent of total billed charges,,,79.53,85,,percent of total billed charges,,,,,,,,,82.34,88,,percent of total billed charges,,,,,,,,,71.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.39,22,,percent of total billed charges,,,85.15,91,,percent of total billed charges,,,88.89,95,,percent of total billed charges,,,77.66,83,,percent of total billed charges,,,77.66,83,,percent of total billed charges,,,,,,,,,,,,,,,77.66,83,,percent of total billed charges,,,88.89,95,,percent of total billed charges,,,84.21,90,,percent of total billed charges,,,84.21,90,,percent of total billed charges,,,76.73,82,,percent of total billed charges,,,84.21,90,,percent of total billed charges,,,79.53,85,,percent of total billed charges,,23.39,88.89,
ROPINIROLE HCL (REQUIP) TAB : 2MG,32000238,CDM,,,250,RC,outpatient,,93.57,93.57,,79.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.39,22,,percent of total billed charges,,,,,,,,,84.21,90,,percent of total billed charges,,,77.48,82.8,,percent of total billed charges,,,79.53,85,,percent of total billed charges,,,,,,,,,82.34,88,,percent of total billed charges,,,,,,,,,71.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.39,22,,percent of total billed charges,,,85.15,91,,percent of total billed charges,,,88.89,95,,percent of total billed charges,,,77.66,83,,percent of total billed charges,,,77.66,83,,percent of total billed charges,,,,,,,,,,,,,,,77.66,83,,percent of total billed charges,,,88.89,95,,percent of total billed charges,,,84.21,90,,percent of total billed charges,,,84.21,90,,percent of total billed charges,,,76.73,82,,percent of total billed charges,,,84.21,90,,percent of total billed charges,,,79.53,85,,percent of total billed charges,,23.39,88.89,
BIMATOPROST(LUMIGAN)DROP 0.03%:2.5ML,32000239,CDM,,,250,RC,outpatient,,1368.6,1368.6,,1161.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,342.15,22,,percent of total billed charges,,,,,,,,,1231.74,90,,percent of total billed charges,,,1133.2,82.8,,percent of total billed charges,,,1163.31,85,,percent of total billed charges,,,,,,,,,1204.37,88,,percent of total billed charges,,,,,,,,,1045.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,342.15,22,,percent of total billed charges,,,1245.43,91,,percent of total billed charges,,,1300.17,95,,percent of total billed charges,,,1135.94,83,,percent of total billed charges,,,1135.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1135.94,83,,percent of total billed charges,,,1300.17,95,,percent of total billed charges,,,1231.74,90,,percent of total billed charges,,,1231.74,90,,percent of total billed charges,,,1122.25,82,,percent of total billed charges,,,1231.74,90,,percent of total billed charges,,,1163.31,85,,percent of total billed charges,,342.15,1300.17,
ROSUVASTATIN(CRESTOR)TAB:10MG,32000240,CDM,,,250,RC,outpatient,,17.97,17.97,,15.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.49,22,,percent of total billed charges,,,,,,,,,16.17,90,,percent of total billed charges,,,14.88,82.8,,percent of total billed charges,,,15.27,85,,percent of total billed charges,,,,,,,,,15.81,88,,percent of total billed charges,,,,,,,,,13.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.49,22,,percent of total billed charges,,,16.35,91,,percent of total billed charges,,,17.07,95,,percent of total billed charges,,,14.92,83,,percent of total billed charges,,,14.92,83,,percent of total billed charges,,,,,,,,,,,,,,,14.92,83,,percent of total billed charges,,,17.07,95,,percent of total billed charges,,,16.17,90,,percent of total billed charges,,,16.17,90,,percent of total billed charges,,,14.74,82,,percent of total billed charges,,,16.17,90,,percent of total billed charges,,,15.27,85,,percent of total billed charges,,4.49,17.07,
PRIMIDONE (MYSOLINE) TAB : 250MG,32000241,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ROPINIROLE HCL (REQUIP) TAB : 3MG,32000242,CDM,,,250,RC,outpatient,,97.06,97.06,,82.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.27,22,,percent of total billed charges,,,,,,,,,87.35,90,,percent of total billed charges,,,80.37,82.8,,percent of total billed charges,,,82.5,85,,percent of total billed charges,,,,,,,,,85.41,88,,percent of total billed charges,,,,,,,,,74.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.27,22,,percent of total billed charges,,,88.32,91,,percent of total billed charges,,,92.21,95,,percent of total billed charges,,,80.56,83,,percent of total billed charges,,,80.56,83,,percent of total billed charges,,,,,,,,,,,,,,,80.56,83,,percent of total billed charges,,,92.21,95,,percent of total billed charges,,,87.35,90,,percent of total billed charges,,,87.35,90,,percent of total billed charges,,,79.59,82,,percent of total billed charges,,,87.35,90,,percent of total billed charges,,,82.5,85,,percent of total billed charges,,24.27,92.21,
ZIDOVUDINE(RETROVIR)SYRP:10MG/ML (30ML),32000243,CDM,,,250,RC,outpatient,,98.49,98.49,,83.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.62,22,,percent of total billed charges,,,,,,,,,88.64,90,,percent of total billed charges,,,81.55,82.8,,percent of total billed charges,,,83.72,85,,percent of total billed charges,,,,,,,,,86.67,88,,percent of total billed charges,,,,,,,,,75.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.62,22,,percent of total billed charges,,,89.63,91,,percent of total billed charges,,,93.57,95,,percent of total billed charges,,,81.75,83,,percent of total billed charges,,,81.75,83,,percent of total billed charges,,,,,,,,,,,,,,,81.75,83,,percent of total billed charges,,,93.57,95,,percent of total billed charges,,,88.64,90,,percent of total billed charges,,,88.64,90,,percent of total billed charges,,,80.76,82,,percent of total billed charges,,,88.64,90,,percent of total billed charges,,,83.72,85,,percent of total billed charges,,24.62,93.57,
ZIDOVUDINE(RETROVIR IV)VIAL:200MG/20ML,32000244,CDM,J3485,HCPCS,250,RC,outpatient,,475.17,475.17,,403.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,118.79,22,,percent of total billed charges,,,,,,,,,427.65,90,,percent of total billed charges,,,393.44,82.8,,percent of total billed charges,,,403.89,85,,percent of total billed charges,,,,,,,,,418.15,88,,percent of total billed charges,,30.22,,,,fee schedule,,,363.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,30.22,,,,fee schedule,,,118.79,22,,percent of total billed charges,,,432.4,91,,percent of total billed charges,,,451.41,95,,percent of total billed charges,,,394.39,83,,percent of total billed charges,,,394.39,83,,percent of total billed charges,,,,,,,,,,,,,,,394.39,83,,percent of total billed charges,,,451.41,95,,percent of total billed charges,,,427.65,90,,percent of total billed charges,,,427.65,90,,percent of total billed charges,,,389.64,82,,percent of total billed charges,,,427.65,90,,percent of total billed charges,,,403.89,85,,percent of total billed charges,,30.22,451.41,
oxyCODONE/ACETAMN(PERCOCET) 5MG-325MG:,32000245,CDM,,,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
DINOPROSTONE(PROSTIN E2)SUPP:20MG,32000246,CDM,,,250,RC,outpatient,,10485.76,10485.76,,8902.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2621.44,22,,percent of total billed charges,,,,,,,,,9437.18,90,,percent of total billed charges,,,8682.21,82.8,,percent of total billed charges,,,8912.9,85,,percent of total billed charges,,,,,,,,,9227.47,88,,percent of total billed charges,,,,,,,,,8011.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2621.44,22,,percent of total billed charges,,,9542.04,91,,percent of total billed charges,,,9961.47,95,,percent of total billed charges,,,8703.18,83,,percent of total billed charges,,,8703.18,83,,percent of total billed charges,,,,,,,,,,,,,,,8703.18,83,,percent of total billed charges,,,9961.47,95,,percent of total billed charges,,,9437.18,90,,percent of total billed charges,,,9437.18,90,,percent of total billed charges,,,8598.32,82,,percent of total billed charges,,,9437.18,90,,percent of total billed charges,,,8912.9,85,,percent of total billed charges,,2621.44,9961.47,
VITAMIN B COMP W-C TAB,32000248,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
LANSOPRAZOLE (PREVACID) SOLU-TAB : 30MG,32000249,CDM,,,250,RC,outpatient,,59.95,59.95,,50.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.99,22,,percent of total billed charges,,,,,,,,,53.96,90,,percent of total billed charges,,,49.64,82.8,,percent of total billed charges,,,50.96,85,,percent of total billed charges,,,,,,,,,52.76,88,,percent of total billed charges,,,,,,,,,45.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.99,22,,percent of total billed charges,,,54.55,91,,percent of total billed charges,,,56.95,95,,percent of total billed charges,,,49.76,83,,percent of total billed charges,,,49.76,83,,percent of total billed charges,,,,,,,,,,,,,,,49.76,83,,percent of total billed charges,,,56.95,95,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,49.16,82,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,50.96,85,,percent of total billed charges,,14.99,56.95,
OLMESARTAN(BENICAR)TAB:40MG,32000250,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
RISPERIDONE (RISPERDAL) TAB : 1MG,32000251,CDM,,,250,RC,outpatient,,81.52,81.52,,69.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.38,22,,percent of total billed charges,,,,,,,,,73.37,90,,percent of total billed charges,,,67.5,82.8,,percent of total billed charges,,,69.29,85,,percent of total billed charges,,,,,,,,,71.74,88,,percent of total billed charges,,,,,,,,,62.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.38,22,,percent of total billed charges,,,74.18,91,,percent of total billed charges,,,77.44,95,,percent of total billed charges,,,67.66,83,,percent of total billed charges,,,67.66,83,,percent of total billed charges,,,,,,,,,,,,,,,67.66,83,,percent of total billed charges,,,77.44,95,,percent of total billed charges,,,73.37,90,,percent of total billed charges,,,73.37,90,,percent of total billed charges,,,66.85,82,,percent of total billed charges,,,73.37,90,,percent of total billed charges,,,69.29,85,,percent of total billed charges,,20.38,77.44,
SODIUM CHLORIDE FOR INHAL VL0.9%:5ML(RT),32000252,CDM,,,250,RC,outpatient,,7.5,7.5,,6.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.88,22,,percent of total billed charges,,,,,,,,,6.75,90,,percent of total billed charges,,,6.21,82.8,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,,,,,,,,6.6,88,,percent of total billed charges,,,,,,,,,5.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.88,22,,percent of total billed charges,,,6.83,91,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,,,,,,,,,,,,,6.23,83,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.15,82,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,1.88,7.13,
LOVASTATIN (MEVACOR) TAB : 40MG,32000253,CDM,,,250,RC,outpatient,,19.51,19.51,,16.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.88,22,,percent of total billed charges,,,,,,,,,17.56,90,,percent of total billed charges,,,16.15,82.8,,percent of total billed charges,,,16.58,85,,percent of total billed charges,,,,,,,,,17.17,88,,percent of total billed charges,,,,,,,,,14.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.88,22,,percent of total billed charges,,,17.75,91,,percent of total billed charges,,,18.53,95,,percent of total billed charges,,,16.19,83,,percent of total billed charges,,,16.19,83,,percent of total billed charges,,,,,,,,,,,,,,,16.19,83,,percent of total billed charges,,,18.53,95,,percent of total billed charges,,,17.56,90,,percent of total billed charges,,,17.56,90,,percent of total billed charges,,,16,82,,percent of total billed charges,,,17.56,90,,percent of total billed charges,,,16.58,85,,percent of total billed charges,,4.88,18.53,
TOPIRAMATE(TOPAMAX)TAB:25MG,32000254,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DICLOFENAC (VOLTARAN) TAB : 100MG,32000257,CDM,,,250,RC,outpatient,,37.43,37.43,,31.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.36,22,,percent of total billed charges,,,,,,,,,33.69,90,,percent of total billed charges,,,30.99,82.8,,percent of total billed charges,,,31.82,85,,percent of total billed charges,,,,,,,,,32.94,88,,percent of total billed charges,,,,,,,,,28.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.36,22,,percent of total billed charges,,,34.06,91,,percent of total billed charges,,,35.56,95,,percent of total billed charges,,,31.07,83,,percent of total billed charges,,,31.07,83,,percent of total billed charges,,,,,,,,,,,,,,,31.07,83,,percent of total billed charges,,,35.56,95,,percent of total billed charges,,,33.69,90,,percent of total billed charges,,,33.69,90,,percent of total billed charges,,,30.69,82,,percent of total billed charges,,,33.69,90,,percent of total billed charges,,,31.82,85,,percent of total billed charges,,9.36,35.56,
METHYLCELLULOSE(CITRUCEL)PAC U/D:,32000258,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
HYDROcod/APAP (NORCO)TAB 7.5-325MG:,32000259,CDM,,,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
RIVASTIGMINE (EXELON) CAP : 6MG,32000260,CDM,,,250,RC,outpatient,,78.98,78.98,,67.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.75,22,,percent of total billed charges,,,,,,,,,71.08,90,,percent of total billed charges,,,65.4,82.8,,percent of total billed charges,,,67.13,85,,percent of total billed charges,,,,,,,,,69.5,88,,percent of total billed charges,,,,,,,,,60.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.75,22,,percent of total billed charges,,,71.87,91,,percent of total billed charges,,,75.03,95,,percent of total billed charges,,,65.55,83,,percent of total billed charges,,,65.55,83,,percent of total billed charges,,,,,,,,,,,,,,,65.55,83,,percent of total billed charges,,,75.03,95,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,64.76,82,,percent of total billed charges,,,71.08,90,,percent of total billed charges,,,67.13,85,,percent of total billed charges,,19.75,75.03,
ALENDRONATE (FOSAMAX) SOL:70MG/75ML,32000262,CDM,,,250,RC,outpatient,,393.33,393.33,,333.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.33,22,,percent of total billed charges,,,,,,,,,354,90,,percent of total billed charges,,,325.68,82.8,,percent of total billed charges,,,334.33,85,,percent of total billed charges,,,,,,,,,346.13,88,,percent of total billed charges,,,,,,,,,300.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.33,22,,percent of total billed charges,,,357.93,91,,percent of total billed charges,,,373.66,95,,percent of total billed charges,,,326.46,83,,percent of total billed charges,,,326.46,83,,percent of total billed charges,,,,,,,,,,,,,,,326.46,83,,percent of total billed charges,,,373.66,95,,percent of total billed charges,,,354,90,,percent of total billed charges,,,354,90,,percent of total billed charges,,,322.53,82,,percent of total billed charges,,,354,90,,percent of total billed charges,,,334.33,85,,percent of total billed charges,,98.33,373.66,
TROSPIUM(SANCTURA)TAB:20MG,32000263,CDM,,,250,RC,outpatient,,40.6,40.6,,34.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.15,22,,percent of total billed charges,,,,,,,,,36.54,90,,percent of total billed charges,,,33.62,82.8,,percent of total billed charges,,,34.51,85,,percent of total billed charges,,,,,,,,,35.73,88,,percent of total billed charges,,,,,,,,,31.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.15,22,,percent of total billed charges,,,36.95,91,,percent of total billed charges,,,38.57,95,,percent of total billed charges,,,33.7,83,,percent of total billed charges,,,33.7,83,,percent of total billed charges,,,,,,,,,,,,,,,33.7,83,,percent of total billed charges,,,38.57,95,,percent of total billed charges,,,36.54,90,,percent of total billed charges,,,36.54,90,,percent of total billed charges,,,33.29,82,,percent of total billed charges,,,36.54,90,,percent of total billed charges,,,34.51,85,,percent of total billed charges,,10.15,38.57,
ACYCLOVIR(ZOVIRAX):500MG/10ML,32000264,CDM,J0133,HCPCS,636,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,31.5,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,31.5,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
OXICONAZOLE (OXISTAT) CREAM : 1%  30 GM,32000265,CDM,,,250,RC,outpatient,,725.36,725.36,,615.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,181.34,22,,percent of total billed charges,,,,,,,,,652.82,90,,percent of total billed charges,,,600.6,82.8,,percent of total billed charges,,,616.56,85,,percent of total billed charges,,,,,,,,,638.32,88,,percent of total billed charges,,,,,,,,,554.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,181.34,22,,percent of total billed charges,,,660.08,91,,percent of total billed charges,,,689.09,95,,percent of total billed charges,,,602.05,83,,percent of total billed charges,,,602.05,83,,percent of total billed charges,,,,,,,,,,,,,,,602.05,83,,percent of total billed charges,,,689.09,95,,percent of total billed charges,,,652.82,90,,percent of total billed charges,,,652.82,90,,percent of total billed charges,,,594.8,82,,percent of total billed charges,,,652.82,90,,percent of total billed charges,,,616.56,85,,percent of total billed charges,,181.34,689.09,
FLUTICA/SALMET(ADVAIR DISK):500-50MCG,32000267,CDM,J7699,HCPCS,250,RC,outpatient,,567.49,567.49,,481.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141.87,22,,percent of total billed charges,,,,,,,,,510.74,90,,percent of total billed charges,,,469.88,82.8,,percent of total billed charges,,,482.37,85,,percent of total billed charges,,,,,,,,,499.39,88,,percent of total billed charges,,,,,,,,,433.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141.87,22,,percent of total billed charges,,,516.42,91,,percent of total billed charges,,,539.12,95,,percent of total billed charges,,,471.02,83,,percent of total billed charges,,,471.02,83,,percent of total billed charges,,,,,,,,,,,,,,,471.02,83,,percent of total billed charges,,,539.12,95,,percent of total billed charges,,,510.74,90,,percent of total billed charges,,,510.74,90,,percent of total billed charges,,,465.34,82,,percent of total billed charges,,,510.74,90,,percent of total billed charges,,,482.37,85,,percent of total billed charges,,141.87,539.12,
tiZANidine(ZANAFLEX)TAB:2MG,32000268,CDM,,,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
IV LR 1000ML+PITOCIN:20UNITS (COMPD),32000269,CDM,,,258,RC,outpatient,,261.16,261.16,,221.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.29,22,,percent of total billed charges,,,,,,,,,235.04,90,,percent of total billed charges,,,216.24,82.8,,percent of total billed charges,,,221.99,85,,percent of total billed charges,,,,,,,,,229.82,88,,percent of total billed charges,,,,,,,,,199.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.29,22,,percent of total billed charges,,,237.66,91,,percent of total billed charges,,,248.1,95,,percent of total billed charges,,,216.76,83,,percent of total billed charges,,,216.76,83,,percent of total billed charges,,,,,,,,,,,,,,,216.76,83,,percent of total billed charges,,,248.1,95,,percent of total billed charges,,,235.04,90,,percent of total billed charges,,,235.04,90,,percent of total billed charges,,,214.15,82,,percent of total billed charges,,,235.04,90,,percent of total billed charges,,,221.99,85,,percent of total billed charges,,65.29,248.1,
EUCERIN (HYDROCERIN) CREAM:120ML,32000270,CDM,J3490,HCPCS,250,RC,outpatient,,49.35,49.35,,41.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.34,22,,percent of total billed charges,,,,,,,,,44.42,90,,percent of total billed charges,,,40.86,82.8,,percent of total billed charges,,,41.95,85,,percent of total billed charges,,,,,,,,,43.43,88,,percent of total billed charges,,,,,,,,,37.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.34,22,,percent of total billed charges,,,44.91,91,,percent of total billed charges,,,46.88,95,,percent of total billed charges,,,40.96,83,,percent of total billed charges,,,40.96,83,,percent of total billed charges,,,,,,,,,,,,,,,40.96,83,,percent of total billed charges,,,46.88,95,,percent of total billed charges,,,44.42,90,,percent of total billed charges,,,44.42,90,,percent of total billed charges,,,40.47,82,,percent of total billed charges,,,44.42,90,,percent of total billed charges,,,41.95,85,,percent of total billed charges,,12.34,46.88,
HYDROcod/APAP(NORCO)TAB 5-325MG:,32000271,CDM,,,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
ALTEPLACE(CATHFLO)VIAL:2MG,32000272,CDM,J2997,HCPCS,636,RC,outpatient,,2300.48,2300.48,,1953.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,575.12,22,,percent of total billed charges,,,,,,,,,2070.43,90,,percent of total billed charges,,,1904.8,82.8,,percent of total billed charges,,,1955.41,85,,percent of total billed charges,,,,,,,,,2024.42,88,,percent of total billed charges,,176.06,,,,fee schedule,,,1757.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,176.06,,,,fee schedule,,,575.12,22,,percent of total billed charges,,,2093.44,91,,percent of total billed charges,,,2185.46,95,,percent of total billed charges,,,1909.4,83,,percent of total billed charges,,,1909.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1909.4,83,,percent of total billed charges,,,2185.46,95,,percent of total billed charges,,,2070.43,90,,percent of total billed charges,,,2070.43,90,,percent of total billed charges,,,1886.39,82,,percent of total billed charges,,,2070.43,90,,percent of total billed charges,,,1955.41,85,,percent of total billed charges,,176.06,2185.46,
metoPROLOL TART(LOPRESSOR)TAB:25MG,32000273,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ATORVASTATIN CALCIUM(LIPITOR) TAB 80 MG:,32000274,CDM,,,250,RC,outpatient,,273.9,273.9,,232.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.48,22,,percent of total billed charges,,,,,,,,,246.51,90,,percent of total billed charges,,,226.79,82.8,,percent of total billed charges,,,232.82,85,,percent of total billed charges,,,,,,,,,241.03,88,,percent of total billed charges,,,,,,,,,209.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.48,22,,percent of total billed charges,,,249.25,91,,percent of total billed charges,,,260.21,95,,percent of total billed charges,,,227.34,83,,percent of total billed charges,,,227.34,83,,percent of total billed charges,,,,,,,,,,,,,,,227.34,83,,percent of total billed charges,,,260.21,95,,percent of total billed charges,,,246.51,90,,percent of total billed charges,,,246.51,90,,percent of total billed charges,,,224.6,82,,percent of total billed charges,,,246.51,90,,percent of total billed charges,,,232.82,85,,percent of total billed charges,,68.48,260.21,
ZALEPLON (SONATA) CAP : 10MG,32000275,CDM,,,250,RC,outpatient,,179.22,179.22,,152.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.81,22,,percent of total billed charges,,,,,,,,,161.3,90,,percent of total billed charges,,,148.39,82.8,,percent of total billed charges,,,152.34,85,,percent of total billed charges,,,,,,,,,157.71,88,,percent of total billed charges,,,,,,,,,136.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.81,22,,percent of total billed charges,,,163.09,91,,percent of total billed charges,,,170.26,95,,percent of total billed charges,,,148.75,83,,percent of total billed charges,,,148.75,83,,percent of total billed charges,,,,,,,,,,,,,,,148.75,83,,percent of total billed charges,,,170.26,95,,percent of total billed charges,,,161.3,90,,percent of total billed charges,,,161.3,90,,percent of total billed charges,,,146.96,82,,percent of total billed charges,,,161.3,90,,percent of total billed charges,,,152.34,85,,percent of total billed charges,,44.81,170.26,
PILOCARPINE HCL TAB : 5MG,32000277,CDM,,,250,RC,outpatient,,20.3,20.3,,17.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.08,22,,percent of total billed charges,,,,,,,,,18.27,90,,percent of total billed charges,,,16.81,82.8,,percent of total billed charges,,,17.26,85,,percent of total billed charges,,,,,,,,,17.86,88,,percent of total billed charges,,,,,,,,,15.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.08,22,,percent of total billed charges,,,18.47,91,,percent of total billed charges,,,19.29,95,,percent of total billed charges,,,16.85,83,,percent of total billed charges,,,16.85,83,,percent of total billed charges,,,,,,,,,,,,,,,16.85,83,,percent of total billed charges,,,19.29,95,,percent of total billed charges,,,18.27,90,,percent of total billed charges,,,18.27,90,,percent of total billed charges,,,16.65,82,,percent of total billed charges,,,18.27,90,,percent of total billed charges,,,17.26,85,,percent of total billed charges,,5.08,19.29,
DULoxetine(CYMBALTA)CAP:30MG,32000278,CDM,J8499,HCPCS,250,RC,outpatient,,17.65,17.65,,14.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.41,22,,percent of total billed charges,,,,,,,,,15.89,90,,percent of total billed charges,,,14.61,82.8,,percent of total billed charges,,,15,85,,percent of total billed charges,,,,,,,,,15.53,88,,percent of total billed charges,,,,,,,,,13.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.41,22,,percent of total billed charges,,,16.06,91,,percent of total billed charges,,,16.77,95,,percent of total billed charges,,,14.65,83,,percent of total billed charges,,,14.65,83,,percent of total billed charges,,,,,,,,,,,,,,,14.65,83,,percent of total billed charges,,,16.77,95,,percent of total billed charges,,,15.89,90,,percent of total billed charges,,,15.89,90,,percent of total billed charges,,,14.47,82,,percent of total billed charges,,,15.89,90,,percent of total billed charges,,,15,85,,percent of total billed charges,,4.41,16.77,
DULoxetine(CYMBALTA)CAP:20MG,32000279,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ZOLEDRONIC(ZOMETA)VIAL: 4MG/5ML,32000280,CDM,J3489,HCPCS,636,RC,outpatient,,135.3,135.3,,114.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.83,22,,percent of total billed charges,,,,,,,,,121.77,90,,percent of total billed charges,,,112.03,82.8,,percent of total billed charges,,,115.01,85,,percent of total billed charges,,,,,,,,,119.06,88,,percent of total billed charges,,41.84,,,,fee schedule,,,103.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,41.84,,,,fee schedule,,,33.83,22,,percent of total billed charges,,,123.12,91,,percent of total billed charges,,,128.54,95,,percent of total billed charges,,,112.3,83,,percent of total billed charges,,,112.3,83,,percent of total billed charges,,,,,,,,,,,,,,,112.3,83,,percent of total billed charges,,,128.54,95,,percent of total billed charges,,,121.77,90,,percent of total billed charges,,,121.77,90,,percent of total billed charges,,,110.95,82,,percent of total billed charges,,,121.77,90,,percent of total billed charges,,,115.01,85,,percent of total billed charges,,33.83,128.54,
DICLOFENAC(VOLTARAN) DR TAB:75MG,32000281,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LEVOBUNOLOL (BETAGAN) DROP : 0.5%   5 ML,32000282,CDM,,,250,RC,outpatient,,31.24,31.24,,26.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.81,22,,percent of total billed charges,,,,,,,,,28.12,90,,percent of total billed charges,,,25.87,82.8,,percent of total billed charges,,,26.55,85,,percent of total billed charges,,,,,,,,,27.49,88,,percent of total billed charges,,,,,,,,,23.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.81,22,,percent of total billed charges,,,28.43,91,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,,,,,,,,,,,,,25.93,83,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,25.62,82,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,26.55,85,,percent of total billed charges,,7.81,29.68,
FLUTICASONE(FLOVENT HFA)AER:110MCG  12GM,32000283,CDM,,,250,RC,outpatient,,435,435,,369.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.75,22,,percent of total billed charges,,,,,,,,,391.5,90,,percent of total billed charges,,,360.18,82.8,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,,,,,,,,382.8,88,,percent of total billed charges,,,,,,,,,332.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108.75,22,,percent of total billed charges,,,395.85,91,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,,,,,,,,,,,,,361.05,83,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,356.7,82,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,108.75,413.25,
CYANOCOBALAMIN(VITAMIN B-12)TAB:100MCG,32000284,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LOVASTATIN(ALTOPREV)TAB:40MG,32000285,CDM,,,250,RC,outpatient,,425.52,425.52,,361.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,106.38,22,,percent of total billed charges,,,,,,,,,382.97,90,,percent of total billed charges,,,352.33,82.8,,percent of total billed charges,,,361.69,85,,percent of total billed charges,,,,,,,,,374.46,88,,percent of total billed charges,,,,,,,,,325.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,106.38,22,,percent of total billed charges,,,387.22,91,,percent of total billed charges,,,404.24,95,,percent of total billed charges,,,353.18,83,,percent of total billed charges,,,353.18,83,,percent of total billed charges,,,,,,,,,,,,,,,353.18,83,,percent of total billed charges,,,404.24,95,,percent of total billed charges,,,382.97,90,,percent of total billed charges,,,382.97,90,,percent of total billed charges,,,348.93,82,,percent of total billed charges,,,382.97,90,,percent of total billed charges,,,361.69,85,,percent of total billed charges,,106.38,404.24,
AZITHROMYCIN(ZITHROMA)SUS:200MG/5ML 22.5,32000286,CDM,,,250,RC,outpatient,,435.67,435.67,,369.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.92,22,,percent of total billed charges,,,,,,,,,392.1,90,,percent of total billed charges,,,360.73,82.8,,percent of total billed charges,,,370.32,85,,percent of total billed charges,,,,,,,,,383.39,88,,percent of total billed charges,,,,,,,,,332.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108.92,22,,percent of total billed charges,,,396.46,91,,percent of total billed charges,,,413.89,95,,percent of total billed charges,,,361.61,83,,percent of total billed charges,,,361.61,83,,percent of total billed charges,,,,,,,,,,,,,,,361.61,83,,percent of total billed charges,,,413.89,95,,percent of total billed charges,,,392.1,90,,percent of total billed charges,,,392.1,90,,percent of total billed charges,,,357.25,82,,percent of total billed charges,,,392.1,90,,percent of total billed charges,,,370.32,85,,percent of total billed charges,,108.92,413.89,
MENING VAC W135(MENACTRA)VIAL:4MCG/0.5ML,32000287,CDM,,,250,RC,outpatient,,1891.28,1891.28,,1605.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,472.82,22,,percent of total billed charges,,,,,,,,,1702.15,90,,percent of total billed charges,,,1565.98,82.8,,percent of total billed charges,,,1607.59,85,,percent of total billed charges,,,,,,,,,1664.33,88,,percent of total billed charges,,,,,,,,,1444.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,472.82,22,,percent of total billed charges,,,1721.06,91,,percent of total billed charges,,,1796.72,95,,percent of total billed charges,,,1569.76,83,,percent of total billed charges,,,1569.76,83,,percent of total billed charges,,,,,,,,,,,,,,,1569.76,83,,percent of total billed charges,,,1796.72,95,,percent of total billed charges,,,1702.15,90,,percent of total billed charges,,,1702.15,90,,percent of total billed charges,,,1550.85,82,,percent of total billed charges,,,1702.15,90,,percent of total billed charges,,,1607.59,85,,percent of total billed charges,,472.82,1796.72,
CAFFEINE(NO DOZ)TAB:200MG,32000288,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
HYDROcod/APAP(NORCO)TAB:5MG-325MG (1x10),32000290,CDM,,,250,RC,outpatient,,67.72,67.72,,57.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.93,22,,percent of total billed charges,,,,,,,,,60.95,90,,percent of total billed charges,,,56.07,82.8,,percent of total billed charges,,,57.56,85,,percent of total billed charges,,,,,,,,,59.59,88,,percent of total billed charges,,,,,,,,,51.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.93,22,,percent of total billed charges,,,61.63,91,,percent of total billed charges,,,64.33,95,,percent of total billed charges,,,56.21,83,,percent of total billed charges,,,56.21,83,,percent of total billed charges,,,,,,,,,,,,,,,56.21,83,,percent of total billed charges,,,64.33,95,,percent of total billed charges,,,60.95,90,,percent of total billed charges,,,60.95,90,,percent of total billed charges,,,55.53,82,,percent of total billed charges,,,60.95,90,,percent of total billed charges,,,57.56,85,,percent of total billed charges,,16.93,64.33,
LEVALBUTEROL HCL (XOPENEX)SOL:1.25MG/3ML,32000292,CDM,,,250,RC,outpatient,,130.84,130.84,,111.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.71,22,,percent of total billed charges,,,,,,,,,117.76,90,,percent of total billed charges,,,108.34,82.8,,percent of total billed charges,,,111.21,85,,percent of total billed charges,,,,,,,,,115.14,88,,percent of total billed charges,,,,,,,,,99.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.71,22,,percent of total billed charges,,,119.06,91,,percent of total billed charges,,,124.3,95,,percent of total billed charges,,,108.6,83,,percent of total billed charges,,,108.6,83,,percent of total billed charges,,,,,,,,,,,,,,,108.6,83,,percent of total billed charges,,,124.3,95,,percent of total billed charges,,,117.76,90,,percent of total billed charges,,,117.76,90,,percent of total billed charges,,,107.29,82,,percent of total billed charges,,,117.76,90,,percent of total billed charges,,,111.21,85,,percent of total billed charges,,32.71,124.3,
BUTORPHANOL(STADOL) VIAL : 2MG/ML   2ML,32000293,CDM,,,250,RC,outpatient,,109.91,109.91,,93.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.48,22,,percent of total billed charges,,,,,,,,,98.92,90,,percent of total billed charges,,,91.01,82.8,,percent of total billed charges,,,93.42,85,,percent of total billed charges,,,,,,,,,96.72,88,,percent of total billed charges,,,,,,,,,83.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.48,22,,percent of total billed charges,,,100.02,91,,percent of total billed charges,,,104.41,95,,percent of total billed charges,,,91.23,83,,percent of total billed charges,,,91.23,83,,percent of total billed charges,,,,,,,,,,,,,,,91.23,83,,percent of total billed charges,,,104.41,95,,percent of total billed charges,,,98.92,90,,percent of total billed charges,,,98.92,90,,percent of total billed charges,,,90.13,82,,percent of total billed charges,,,98.92,90,,percent of total billed charges,,,93.42,85,,percent of total billed charges,,27.48,104.41,
DEMECLOCYCLINE(DECL0MYCIN)TAB:150MG,32000294,CDM,,,250,RC,outpatient,,67.25,67.25,,57.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.81,22,,percent of total billed charges,,,,,,,,,60.53,90,,percent of total billed charges,,,55.68,82.8,,percent of total billed charges,,,57.16,85,,percent of total billed charges,,,,,,,,,59.18,88,,percent of total billed charges,,,,,,,,,51.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.81,22,,percent of total billed charges,,,61.2,91,,percent of total billed charges,,,63.89,95,,percent of total billed charges,,,55.82,83,,percent of total billed charges,,,55.82,83,,percent of total billed charges,,,,,,,,,,,,,,,55.82,83,,percent of total billed charges,,,63.89,95,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,55.15,82,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,57.16,85,,percent of total billed charges,,16.81,63.89,
BENZALKONIUM CH (MYCOCIDE NS) LIQ  30ML,32000295,CDM,,,250,RC,outpatient,,157.33,157.33,,133.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.33,22,,percent of total billed charges,,,,,,,,,141.6,90,,percent of total billed charges,,,130.27,82.8,,percent of total billed charges,,,133.73,85,,percent of total billed charges,,,,,,,,,138.45,88,,percent of total billed charges,,,,,,,,,120.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.33,22,,percent of total billed charges,,,143.17,91,,percent of total billed charges,,,149.46,95,,percent of total billed charges,,,130.58,83,,percent of total billed charges,,,130.58,83,,percent of total billed charges,,,,,,,,,,,,,,,130.58,83,,percent of total billed charges,,,149.46,95,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,129.01,82,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,133.73,85,,percent of total billed charges,,39.33,149.46,
CETIRIZINE(ZyrTEC)TAB:10MG,32000296,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
TIMOLOL SOL-GEL(TIMOPTIC XE):0.50% 2.5ML,32000297,CDM,,,250,RC,outpatient,,341.31,341.31,,289.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.33,22,,percent of total billed charges,,,,,,,,,307.18,90,,percent of total billed charges,,,282.6,82.8,,percent of total billed charges,,,290.11,85,,percent of total billed charges,,,,,,,,,300.35,88,,percent of total billed charges,,,,,,,,,260.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.33,22,,percent of total billed charges,,,310.59,91,,percent of total billed charges,,,324.24,95,,percent of total billed charges,,,283.29,83,,percent of total billed charges,,,283.29,83,,percent of total billed charges,,,,,,,,,,,,,,,283.29,83,,percent of total billed charges,,,324.24,95,,percent of total billed charges,,,307.18,90,,percent of total billed charges,,,307.18,90,,percent of total billed charges,,,279.87,82,,percent of total billed charges,,,307.18,90,,percent of total billed charges,,,290.11,85,,percent of total billed charges,,85.33,324.24,
NALOXONE(NARCAN)SYR:2MG/2ML,32000298,CDM,J2310,HCPCS,250,RC,outpatient,,502.29,502.29,,426.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125.57,22,,percent of total billed charges,,,,,,,,,452.06,90,,percent of total billed charges,,,415.9,82.8,,percent of total billed charges,,,426.95,85,,percent of total billed charges,,,,,,,,,442.02,88,,percent of total billed charges,,19.95,,,,fee schedule,,,383.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.95,,,,fee schedule,,,125.57,22,,percent of total billed charges,,,457.08,91,,percent of total billed charges,,,477.18,95,,percent of total billed charges,,,416.9,83,,percent of total billed charges,,,416.9,83,,percent of total billed charges,,,,,,,,,,,,,,,416.9,83,,percent of total billed charges,,,477.18,95,,percent of total billed charges,,,452.06,90,,percent of total billed charges,,,452.06,90,,percent of total billed charges,,,411.88,82,,percent of total billed charges,,,452.06,90,,percent of total billed charges,,,426.95,85,,percent of total billed charges,,19.95,477.18,
PANTOPRAZOLE(PROTONIX)VIAL:40MG,32000299,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
MORPHINE SULF CPJ SYR:2MG/ML,32000300,CDM,,,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,,,,,,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,16.88,64.15,
NALOXONE(NARCAN)AMP:0.4MG/ML,32000301,CDM,J2310,HCPCS,250,RC,outpatient,,74.35,74.35,,63.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.59,22,,percent of total billed charges,,,,,,,,,66.92,90,,percent of total billed charges,,,61.56,82.8,,percent of total billed charges,,,63.2,85,,percent of total billed charges,,,,,,,,,65.43,88,,percent of total billed charges,,19.95,,,,fee schedule,,,56.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.95,,,,fee schedule,,,18.59,22,,percent of total billed charges,,,67.66,91,,percent of total billed charges,,,70.63,95,,percent of total billed charges,,,61.71,83,,percent of total billed charges,,,61.71,83,,percent of total billed charges,,,,,,,,,,,,,,,61.71,83,,percent of total billed charges,,,70.63,95,,percent of total billed charges,,,66.92,90,,percent of total billed charges,,,66.92,90,,percent of total billed charges,,,60.97,82,,percent of total billed charges,,,66.92,90,,percent of total billed charges,,,63.2,85,,percent of total billed charges,,18.59,70.63,
IBUPROFEN ORAL UD:100MG/5ML,32000302,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ACETAMINOPHEN ELIX : 130MG/5ML  (12.5ML),32000303,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
APAP/CODEINE ELIX 300MG-30MG/12.5ML UD,32000304,CDM,J8499,HCPCS,250,RC,outpatient,,41.18,41.18,,34.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.3,22,,percent of total billed charges,,,,,,,,,37.06,90,,percent of total billed charges,,,34.1,82.8,,percent of total billed charges,,,35,85,,percent of total billed charges,,,,,,,,,36.24,88,,percent of total billed charges,,,,,,,,,31.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.3,22,,percent of total billed charges,,,37.47,91,,percent of total billed charges,,,39.12,95,,percent of total billed charges,,,34.18,83,,percent of total billed charges,,,34.18,83,,percent of total billed charges,,,,,,,,,,,,,,,34.18,83,,percent of total billed charges,,,39.12,95,,percent of total billed charges,,,37.06,90,,percent of total billed charges,,,37.06,90,,percent of total billed charges,,,33.77,82,,percent of total billed charges,,,37.06,90,,percent of total billed charges,,,35,85,,percent of total billed charges,,10.3,39.12,
DOLASETRON MESYLATE (ANZEMET)TAB : 100MG,32000305,CDM,,,250,RC,outpatient,,1347.76,1347.76,,1144.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,336.94,22,,percent of total billed charges,,,,,,,,,1212.98,90,,percent of total billed charges,,,1115.95,82.8,,percent of total billed charges,,,1145.6,85,,percent of total billed charges,,,,,,,,,1186.03,88,,percent of total billed charges,,,,,,,,,1029.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,336.94,22,,percent of total billed charges,,,1226.46,91,,percent of total billed charges,,,1280.37,95,,percent of total billed charges,,,1118.64,83,,percent of total billed charges,,,1118.64,83,,percent of total billed charges,,,,,,,,,,,,,,,1118.64,83,,percent of total billed charges,,,1280.37,95,,percent of total billed charges,,,1212.98,90,,percent of total billed charges,,,1212.98,90,,percent of total billed charges,,,1105.16,82,,percent of total billed charges,,,1212.98,90,,percent of total billed charges,,,1145.6,85,,percent of total billed charges,,336.94,1280.37,
PHENYTOIN(DILANTIN)VIAL:100MG/2ML,32000306,CDM,J1165,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,15.86,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.86,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
BECLOMETH DIPROP(QVAR) AER:40MCG(8.7GM),32000308,CDM,,,250,RC,outpatient,,2234.13,2234.13,,1896.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,558.53,22,,percent of total billed charges,,,,,,,,,2010.72,90,,percent of total billed charges,,,1849.86,82.8,,percent of total billed charges,,,1899.01,85,,percent of total billed charges,,,,,,,,,1966.03,88,,percent of total billed charges,,,,,,,,,1706.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,558.53,22,,percent of total billed charges,,,2033.06,91,,percent of total billed charges,,,2122.42,95,,percent of total billed charges,,,1854.33,83,,percent of total billed charges,,,1854.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1854.33,83,,percent of total billed charges,,,2122.42,95,,percent of total billed charges,,,2010.72,90,,percent of total billed charges,,,2010.72,90,,percent of total billed charges,,,1831.99,82,,percent of total billed charges,,,2010.72,90,,percent of total billed charges,,,1899.01,85,,percent of total billed charges,,558.53,2122.42,
LIOTHYRONINE SODIUM(CYTOMEL) TAB : 25MCG,32000309,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
IRINOTECAN(CAMPTOSAR)VIAL:100MG/5ML,32000310,CDM,J9206,HCPCS,636,RC,outpatient,,332.58,332.58,,282.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.15,22,,percent of total billed charges,,,,,,,,,299.32,90,,percent of total billed charges,,,275.38,82.8,,percent of total billed charges,,,282.69,85,,percent of total billed charges,,,,,,,,,292.67,88,,percent of total billed charges,,114.58,,,,fee schedule,,,254.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,114.58,,,,fee schedule,,,83.15,22,,percent of total billed charges,,,302.65,91,,percent of total billed charges,,,315.95,95,,percent of total billed charges,,,276.04,83,,percent of total billed charges,,,276.04,83,,percent of total billed charges,,,,,,,,,,,,,,,276.04,83,,percent of total billed charges,,,315.95,95,,percent of total billed charges,,,299.32,90,,percent of total billed charges,,,299.32,90,,percent of total billed charges,,,272.72,82,,percent of total billed charges,,,299.32,90,,percent of total billed charges,,,282.69,85,,percent of total billed charges,,83.15,315.95,
PHENYTOIN(DILANTIN)VIAL:250MG/5ML,32000311,CDM,J1165,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,15.86,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.86,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,15.86,60.99,
BISOPROLOL(ZEBETA)TAB:5MG,32000313,CDM,,,250,RC,outpatient,,15.07,15.07,,12.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.77,22,,percent of total billed charges,,,,,,,,,13.56,90,,percent of total billed charges,,,12.48,82.8,,percent of total billed charges,,,12.81,85,,percent of total billed charges,,,,,,,,,13.26,88,,percent of total billed charges,,,,,,,,,11.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.77,22,,percent of total billed charges,,,13.71,91,,percent of total billed charges,,,14.32,95,,percent of total billed charges,,,12.51,83,,percent of total billed charges,,,12.51,83,,percent of total billed charges,,,,,,,,,,,,,,,12.51,83,,percent of total billed charges,,,14.32,95,,percent of total billed charges,,,13.56,90,,percent of total billed charges,,,13.56,90,,percent of total billed charges,,,12.36,82,,percent of total billed charges,,,13.56,90,,percent of total billed charges,,,12.81,85,,percent of total billed charges,,3.77,14.32,
DANAZOL (DANOCRINE) CAP : 200MG,32000314,CDM,,,250,RC,outpatient,,63.6,63.6,,54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.9,22,,percent of total billed charges,,,,,,,,,57.24,90,,percent of total billed charges,,,52.66,82.8,,percent of total billed charges,,,54.06,85,,percent of total billed charges,,,,,,,,,55.97,88,,percent of total billed charges,,,,,,,,,48.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.9,22,,percent of total billed charges,,,57.88,91,,percent of total billed charges,,,60.42,95,,percent of total billed charges,,,52.79,83,,percent of total billed charges,,,52.79,83,,percent of total billed charges,,,,,,,,,,,,,,,52.79,83,,percent of total billed charges,,,60.42,95,,percent of total billed charges,,,57.24,90,,percent of total billed charges,,,57.24,90,,percent of total billed charges,,,52.15,82,,percent of total billed charges,,,57.24,90,,percent of total billed charges,,,54.06,85,,percent of total billed charges,,15.9,60.42,
MIGLITOL (GLYSET) TAB : 50MG,32000315,CDM,,,250,RC,outpatient,,50.28,50.28,,42.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.57,22,,percent of total billed charges,,,,,,,,,45.25,90,,percent of total billed charges,,,41.63,82.8,,percent of total billed charges,,,42.74,85,,percent of total billed charges,,,,,,,,,44.25,88,,percent of total billed charges,,,,,,,,,38.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.57,22,,percent of total billed charges,,,45.75,91,,percent of total billed charges,,,47.77,95,,percent of total billed charges,,,41.73,83,,percent of total billed charges,,,41.73,83,,percent of total billed charges,,,,,,,,,,,,,,,41.73,83,,percent of total billed charges,,,47.77,95,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,41.23,82,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,42.74,85,,percent of total billed charges,,12.57,47.77,
NALBUPHINE(NUBAIN)AMP:20MG/ML,32000316,CDM,J2300,HCPCS,250,RC,outpatient,,98.17,98.17,,83.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.54,22,,percent of total billed charges,,,,,,,,,88.35,90,,percent of total billed charges,,,81.28,82.8,,percent of total billed charges,,,83.44,85,,percent of total billed charges,,,,,,,,,86.39,88,,percent of total billed charges,,6.28,,,,fee schedule,,,75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6.28,,,,fee schedule,,,24.54,22,,percent of total billed charges,,,89.33,91,,percent of total billed charges,,,93.26,95,,percent of total billed charges,,,81.48,83,,percent of total billed charges,,,81.48,83,,percent of total billed charges,,,,,,,,,,,,,,,81.48,83,,percent of total billed charges,,,93.26,95,,percent of total billed charges,,,88.35,90,,percent of total billed charges,,,88.35,90,,percent of total billed charges,,,80.5,82,,percent of total billed charges,,,88.35,90,,percent of total billed charges,,,83.44,85,,percent of total billed charges,,6.28,93.26,
BACITRACIN/POLYM B(POLYSPORIN)OINT:30GM,32000317,CDM,J3490,HCPCS,250,RC,outpatient,,119.12,119.12,,101.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.78,22,,percent of total billed charges,,,,,,,,,107.21,90,,percent of total billed charges,,,98.63,82.8,,percent of total billed charges,,,101.25,85,,percent of total billed charges,,,,,,,,,104.83,88,,percent of total billed charges,,,,,,,,,91.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.78,22,,percent of total billed charges,,,108.4,91,,percent of total billed charges,,,113.16,95,,percent of total billed charges,,,98.87,83,,percent of total billed charges,,,98.87,83,,percent of total billed charges,,,,,,,,,,,,,,,98.87,83,,percent of total billed charges,,,113.16,95,,percent of total billed charges,,,107.21,90,,percent of total billed charges,,,107.21,90,,percent of total billed charges,,,97.68,82,,percent of total billed charges,,,107.21,90,,percent of total billed charges,,,101.25,85,,percent of total billed charges,,29.78,113.16,
ENOXAPARIN(LOVENOX): 60MG/0.6ML,32000318,CDM,J1650,HCPCS,250,RC,outpatient,,92.48,92.48,,78.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.12,22,,percent of total billed charges,,,,,,,,,83.23,90,,percent of total billed charges,,,76.57,82.8,,percent of total billed charges,,,78.61,85,,percent of total billed charges,,,,,,,,,81.38,88,,percent of total billed charges,,15.16,,,,fee schedule,,,70.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.16,,,,fee schedule,,,23.12,22,,percent of total billed charges,,,84.16,91,,percent of total billed charges,,,87.86,95,,percent of total billed charges,,,76.76,83,,percent of total billed charges,,,76.76,83,,percent of total billed charges,,,,,,,,,,,,,,,76.76,83,,percent of total billed charges,,,87.86,95,,percent of total billed charges,,,83.23,90,,percent of total billed charges,,,83.23,90,,percent of total billed charges,,,75.83,82,,percent of total billed charges,,,83.23,90,,percent of total billed charges,,,78.61,85,,percent of total billed charges,,15.16,87.86,
DIPHENHYDRAM(BENADRYL)VIAL:50MG/ML(10ML),32000319,CDM,,,250,RC,outpatient,,191.59,191.59,,162.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.9,22,,percent of total billed charges,,,,,,,,,172.43,90,,percent of total billed charges,,,158.64,82.8,,percent of total billed charges,,,162.85,85,,percent of total billed charges,,,,,,,,,168.6,88,,percent of total billed charges,,,,,,,,,146.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.9,22,,percent of total billed charges,,,174.35,91,,percent of total billed charges,,,182.01,95,,percent of total billed charges,,,159.02,83,,percent of total billed charges,,,159.02,83,,percent of total billed charges,,,,,,,,,,,,,,,159.02,83,,percent of total billed charges,,,182.01,95,,percent of total billed charges,,,172.43,90,,percent of total billed charges,,,172.43,90,,percent of total billed charges,,,157.1,82,,percent of total billed charges,,,172.43,90,,percent of total billed charges,,,162.85,85,,percent of total billed charges,,47.9,182.01,
DICYCLOMINE(BENTYL)CAP:10MG,32000323,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ENOXAPARIN(LOVENOX): 80MG/0.8ML,32000326,CDM,J1650,HCPCS,250,RC,outpatient,,123.37,123.37,,104.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.84,22,,percent of total billed charges,,,,,,,,,111.03,90,,percent of total billed charges,,,102.15,82.8,,percent of total billed charges,,,104.86,85,,percent of total billed charges,,,,,,,,,108.57,88,,percent of total billed charges,,15.16,,,,fee schedule,,,94.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.16,,,,fee schedule,,,30.84,22,,percent of total billed charges,,,112.27,91,,percent of total billed charges,,,117.2,95,,percent of total billed charges,,,102.4,83,,percent of total billed charges,,,102.4,83,,percent of total billed charges,,,,,,,,,,,,,,,102.4,83,,percent of total billed charges,,,117.2,95,,percent of total billed charges,,,111.03,90,,percent of total billed charges,,,111.03,90,,percent of total billed charges,,,101.16,82,,percent of total billed charges,,,111.03,90,,percent of total billed charges,,,104.86,85,,percent of total billed charges,,15.16,117.2,
ENOXAPARIN(LOVENOX):100MG/ML,32000327,CDM,J1650,HCPCS,250,RC,outpatient,,154.09,154.09,,130.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.52,22,,percent of total billed charges,,,,,,,,,138.68,90,,percent of total billed charges,,,127.59,82.8,,percent of total billed charges,,,130.98,85,,percent of total billed charges,,,,,,,,,135.6,88,,percent of total billed charges,,15.16,,,,fee schedule,,,117.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.16,,,,fee schedule,,,38.52,22,,percent of total billed charges,,,140.22,91,,percent of total billed charges,,,146.39,95,,percent of total billed charges,,,127.89,83,,percent of total billed charges,,,127.89,83,,percent of total billed charges,,,,,,,,,,,,,,,127.89,83,,percent of total billed charges,,,146.39,95,,percent of total billed charges,,,138.68,90,,percent of total billed charges,,,138.68,90,,percent of total billed charges,,,126.35,82,,percent of total billed charges,,,138.68,90,,percent of total billed charges,,,130.98,85,,percent of total billed charges,,15.16,146.39,
METHYLPHENIDATE(RITALIN SR)TAB : 20MG,32000328,CDM,,,250,RC,outpatient,,30.13,30.13,,25.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.53,22,,percent of total billed charges,,,,,,,,,27.12,90,,percent of total billed charges,,,24.95,82.8,,percent of total billed charges,,,25.61,85,,percent of total billed charges,,,,,,,,,26.51,88,,percent of total billed charges,,,,,,,,,23.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.53,22,,percent of total billed charges,,,27.42,91,,percent of total billed charges,,,28.62,95,,percent of total billed charges,,,25.01,83,,percent of total billed charges,,,25.01,83,,percent of total billed charges,,,,,,,,,,,,,,,25.01,83,,percent of total billed charges,,,28.62,95,,percent of total billed charges,,,27.12,90,,percent of total billed charges,,,27.12,90,,percent of total billed charges,,,24.71,82,,percent of total billed charges,,,27.12,90,,percent of total billed charges,,,25.61,85,,percent of total billed charges,,7.53,28.62,
ALENDRONATE(FOSAMAX)TAB:70MG,32000329,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CONTAINER EMPTY BOTTLE :500ML,32000330,CDM,J3490,HCPCS,250,RC,outpatient,,195.4,195.4,,165.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.85,22,,percent of total billed charges,,,,,,,,,175.86,90,,percent of total billed charges,,,161.79,82.8,,percent of total billed charges,,,166.09,85,,percent of total billed charges,,,,,,,,,171.95,88,,percent of total billed charges,,,,,,,,,149.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.85,22,,percent of total billed charges,,,177.81,91,,percent of total billed charges,,,185.63,95,,percent of total billed charges,,,162.18,83,,percent of total billed charges,,,162.18,83,,percent of total billed charges,,,,,,,,,,,,,,,162.18,83,,percent of total billed charges,,,185.63,95,,percent of total billed charges,,,175.86,90,,percent of total billed charges,,,175.86,90,,percent of total billed charges,,,160.23,82,,percent of total billed charges,,,175.86,90,,percent of total billed charges,,,166.09,85,,percent of total billed charges,,48.85,185.63,
RIVASTIGMINE(EXELON)CAP:1.5MG,32000331,CDM,J8499,HCPCS,250,RC,outpatient,,43.46,43.46,,36.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.87,22,,percent of total billed charges,,,,,,,,,39.11,90,,percent of total billed charges,,,35.98,82.8,,percent of total billed charges,,,36.94,85,,percent of total billed charges,,,,,,,,,38.24,88,,percent of total billed charges,,,,,,,,,33.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.87,22,,percent of total billed charges,,,39.55,91,,percent of total billed charges,,,41.29,95,,percent of total billed charges,,,36.07,83,,percent of total billed charges,,,36.07,83,,percent of total billed charges,,,,,,,,,,,,,,,36.07,83,,percent of total billed charges,,,41.29,95,,percent of total billed charges,,,39.11,90,,percent of total billed charges,,,39.11,90,,percent of total billed charges,,,35.64,82,,percent of total billed charges,,,39.11,90,,percent of total billed charges,,,36.94,85,,percent of total billed charges,,10.87,41.29,
VENLAFAXINE(EFFEXOR XR)CAP:37.5MG,32000332,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
risperiDONE(risperDAL)TAB:0.25MG,32000333,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
HC PRAMOXINE(PROCTOFOAM) FOAM 1%:10GM,32000334,CDM,J3490,HCPCS,250,RC,outpatient,,2248.31,2248.31,,1908.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,562.08,22,,percent of total billed charges,,,,,,,,,2023.48,90,,percent of total billed charges,,,1861.6,82.8,,percent of total billed charges,,,1911.06,85,,percent of total billed charges,,,,,,,,,1978.51,88,,percent of total billed charges,,,,,,,,,1717.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,562.08,22,,percent of total billed charges,,,2045.96,91,,percent of total billed charges,,,2135.89,95,,percent of total billed charges,,,1866.1,83,,percent of total billed charges,,,1866.1,83,,percent of total billed charges,,,,,,,,,,,,,,,1866.1,83,,percent of total billed charges,,,2135.89,95,,percent of total billed charges,,,2023.48,90,,percent of total billed charges,,,2023.48,90,,percent of total billed charges,,,1843.61,82,,percent of total billed charges,,,2023.48,90,,percent of total billed charges,,,1911.06,85,,percent of total billed charges,,562.08,2135.89,
PHENYL(PHNERGANVC)SYR:5-6.25MG/5ML(60ML),32000337,CDM,,,250,RC,outpatient,,58.68,58.68,,49.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.67,22,,percent of total billed charges,,,,,,,,,52.81,90,,percent of total billed charges,,,48.59,82.8,,percent of total billed charges,,,49.88,85,,percent of total billed charges,,,,,,,,,51.64,88,,percent of total billed charges,,,,,,,,,44.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.67,22,,percent of total billed charges,,,53.4,91,,percent of total billed charges,,,55.75,95,,percent of total billed charges,,,48.7,83,,percent of total billed charges,,,48.7,83,,percent of total billed charges,,,,,,,,,,,,,,,48.7,83,,percent of total billed charges,,,55.75,95,,percent of total billed charges,,,52.81,90,,percent of total billed charges,,,52.81,90,,percent of total billed charges,,,48.12,82,,percent of total billed charges,,,52.81,90,,percent of total billed charges,,,49.88,85,,percent of total billed charges,,14.67,55.75,
ZINC (DERMAGRAN MOISTURIZR) SPR 118ML,32000339,CDM,,,250,RC,outpatient,,113.56,113.56,,96.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.39,22,,percent of total billed charges,,,,,,,,,102.2,90,,percent of total billed charges,,,94.03,82.8,,percent of total billed charges,,,96.53,85,,percent of total billed charges,,,,,,,,,99.93,88,,percent of total billed charges,,,,,,,,,86.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.39,22,,percent of total billed charges,,,103.34,91,,percent of total billed charges,,,107.88,95,,percent of total billed charges,,,94.25,83,,percent of total billed charges,,,94.25,83,,percent of total billed charges,,,,,,,,,,,,,,,94.25,83,,percent of total billed charges,,,107.88,95,,percent of total billed charges,,,102.2,90,,percent of total billed charges,,,102.2,90,,percent of total billed charges,,,93.12,82,,percent of total billed charges,,,102.2,90,,percent of total billed charges,,,96.53,85,,percent of total billed charges,,28.39,107.88,
glipiZIDE(GLUCOTROL XL)TAB:2.5 MG,32000340,CDM,J8499,HCPCS,250,RC,outpatient,,17.81,17.81,,15.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.45,22,,percent of total billed charges,,,,,,,,,16.03,90,,percent of total billed charges,,,14.75,82.8,,percent of total billed charges,,,15.14,85,,percent of total billed charges,,,,,,,,,15.67,88,,percent of total billed charges,,,,,,,,,13.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.45,22,,percent of total billed charges,,,16.21,91,,percent of total billed charges,,,16.92,95,,percent of total billed charges,,,14.78,83,,percent of total billed charges,,,14.78,83,,percent of total billed charges,,,,,,,,,,,,,,,14.78,83,,percent of total billed charges,,,16.92,95,,percent of total billed charges,,,16.03,90,,percent of total billed charges,,,16.03,90,,percent of total billed charges,,,14.6,82,,percent of total billed charges,,,16.03,90,,percent of total billed charges,,,15.14,85,,percent of total billed charges,,4.45,16.92,
ceFAClor(CECLOR)CAP:250MG (1X6),32000341,CDM,,,250,RC,outpatient,,165.9,165.9,,140.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.48,22,,percent of total billed charges,,,,,,,,,149.31,90,,percent of total billed charges,,,137.37,82.8,,percent of total billed charges,,,141.02,85,,percent of total billed charges,,,,,,,,,145.99,88,,percent of total billed charges,,,,,,,,,126.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.48,22,,percent of total billed charges,,,150.97,91,,percent of total billed charges,,,157.61,95,,percent of total billed charges,,,137.7,83,,percent of total billed charges,,,137.7,83,,percent of total billed charges,,,,,,,,,,,,,,,137.7,83,,percent of total billed charges,,,157.61,95,,percent of total billed charges,,,149.31,90,,percent of total billed charges,,,149.31,90,,percent of total billed charges,,,136.04,82,,percent of total billed charges,,,149.31,90,,percent of total billed charges,,,141.02,85,,percent of total billed charges,,41.48,157.61,
BENAZEPRIL (LOTENSIN) TAB : 40MG,32000342,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ALBUT/IPRAT(DUONEB)SOL:2.5-0.5 (3ML),32000343,CDM,J7620,HCPCS,250,RC,outpatient,,24.8,24.8,,21.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.2,22,,percent of total billed charges,,,,,,,,,22.32,90,,percent of total billed charges,,,20.53,82.8,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,,,,,,,,21.82,88,,percent of total billed charges,,0.13,,,,fee schedule,,,18.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.13,,,,fee schedule,,,6.2,22,,percent of total billed charges,,,22.57,91,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,,,,,,,,,,,,,20.58,83,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,20.34,82,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,0.13,23.56,
CANDESARTAN (ATACAND) TAB : 4MG,32000344,CDM,,,250,RC,outpatient,,59.16,59.16,,50.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.79,22,,percent of total billed charges,,,,,,,,,53.24,90,,percent of total billed charges,,,48.98,82.8,,percent of total billed charges,,,50.29,85,,percent of total billed charges,,,,,,,,,52.06,88,,percent of total billed charges,,,,,,,,,45.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.79,22,,percent of total billed charges,,,53.84,91,,percent of total billed charges,,,56.2,95,,percent of total billed charges,,,49.1,83,,percent of total billed charges,,,49.1,83,,percent of total billed charges,,,,,,,,,,,,,,,49.1,83,,percent of total billed charges,,,56.2,95,,percent of total billed charges,,,53.24,90,,percent of total billed charges,,,53.24,90,,percent of total billed charges,,,48.51,82,,percent of total billed charges,,,53.24,90,,percent of total billed charges,,,50.29,85,,percent of total billed charges,,14.79,56.2,
FEXOFENADINE HCL (ALLEGRA) TAB : 180MG,32000345,CDM,,,250,RC,outpatient,,16.97,16.97,,14.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.24,22,,percent of total billed charges,,,,,,,,,15.27,90,,percent of total billed charges,,,14.05,82.8,,percent of total billed charges,,,14.42,85,,percent of total billed charges,,,,,,,,,14.93,88,,percent of total billed charges,,,,,,,,,12.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.24,22,,percent of total billed charges,,,15.44,91,,percent of total billed charges,,,16.12,95,,percent of total billed charges,,,14.09,83,,percent of total billed charges,,,14.09,83,,percent of total billed charges,,,,,,,,,,,,,,,14.09,83,,percent of total billed charges,,,16.12,95,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,13.92,82,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,14.42,85,,percent of total billed charges,,4.24,16.12,
nitroPRUSSID(nitroPRESS)VIAL:25MG/ML 2ML,32000346,CDM,,,250,RC,outpatient,,127.36,127.36,,108.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.84,22,,percent of total billed charges,,,,,,,,,114.62,90,,percent of total billed charges,,,105.45,82.8,,percent of total billed charges,,,108.26,85,,percent of total billed charges,,,,,,,,,112.08,88,,percent of total billed charges,,,,,,,,,97.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.84,22,,percent of total billed charges,,,115.9,91,,percent of total billed charges,,,120.99,95,,percent of total billed charges,,,105.71,83,,percent of total billed charges,,,105.71,83,,percent of total billed charges,,,,,,,,,,,,,,,105.71,83,,percent of total billed charges,,,120.99,95,,percent of total billed charges,,,114.62,90,,percent of total billed charges,,,114.62,90,,percent of total billed charges,,,104.44,82,,percent of total billed charges,,,114.62,90,,percent of total billed charges,,,108.26,85,,percent of total billed charges,,31.84,120.99,
PRAMIPEXOLE DI-HCL (MIRAPEX) TAB:0.125MG,32000347,CDM,,,250,RC,outpatient,,24.74,24.74,,21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.19,22,,percent of total billed charges,,,,,,,,,22.27,90,,percent of total billed charges,,,20.48,82.8,,percent of total billed charges,,,21.03,85,,percent of total billed charges,,,,,,,,,21.77,88,,percent of total billed charges,,,,,,,,,18.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.19,22,,percent of total billed charges,,,22.51,91,,percent of total billed charges,,,23.5,95,,percent of total billed charges,,,20.53,83,,percent of total billed charges,,,20.53,83,,percent of total billed charges,,,,,,,,,,,,,,,20.53,83,,percent of total billed charges,,,23.5,95,,percent of total billed charges,,,22.27,90,,percent of total billed charges,,,22.27,90,,percent of total billed charges,,,20.29,82,,percent of total billed charges,,,22.27,90,,percent of total billed charges,,,21.03,85,,percent of total billed charges,,6.19,23.5,
PAPAI/UREA(ACCUZYME)OINT:30GM,32000350,CDM,,,250,RC,outpatient,,680.24,680.24,,577.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,170.06,22,,percent of total billed charges,,,,,,,,,612.22,90,,percent of total billed charges,,,563.24,82.8,,percent of total billed charges,,,578.2,85,,percent of total billed charges,,,,,,,,,598.61,88,,percent of total billed charges,,,,,,,,,519.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,170.06,22,,percent of total billed charges,,,619.02,91,,percent of total billed charges,,,646.23,95,,percent of total billed charges,,,564.6,83,,percent of total billed charges,,,564.6,83,,percent of total billed charges,,,,,,,,,,,,,,,564.6,83,,percent of total billed charges,,,646.23,95,,percent of total billed charges,,,612.22,90,,percent of total billed charges,,,612.22,90,,percent of total billed charges,,,557.8,82,,percent of total billed charges,,,612.22,90,,percent of total billed charges,,,578.2,85,,percent of total billed charges,,170.06,646.23,
"LIDOCAINE W/EPI 1:100,000 VIAL 1%:20ML",32000351,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
BUPIVACAINE(MARCAINE)VL 0.5%:10ML,32000352,CDM,J3490,HCPCS,250,RC,outpatient,,95.43,95.43,,81.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.86,22,,percent of total billed charges,,,,,,,,,85.89,90,,percent of total billed charges,,,79.02,82.8,,percent of total billed charges,,,81.12,85,,percent of total billed charges,,,,,,,,,83.98,88,,percent of total billed charges,,,,,,,,,72.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.86,22,,percent of total billed charges,,,86.84,91,,percent of total billed charges,,,90.66,95,,percent of total billed charges,,,79.21,83,,percent of total billed charges,,,79.21,83,,percent of total billed charges,,,,,,,,,,,,,,,79.21,83,,percent of total billed charges,,,90.66,95,,percent of total billed charges,,,85.89,90,,percent of total billed charges,,,85.89,90,,percent of total billed charges,,,78.25,82,,percent of total billed charges,,,85.89,90,,percent of total billed charges,,,81.12,85,,percent of total billed charges,,23.86,90.66,
INSUL GLA(LANTUS)VL:100UNITS/ML(10ML),32000353,CDM,J1815,HCPCS,250,RC,outpatient,,1459.32,1459.32,,1238.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,364.83,22,,percent of total billed charges,,,,,,,,,1313.39,90,,percent of total billed charges,,,1208.32,82.8,,percent of total billed charges,,,1240.42,85,,percent of total billed charges,,,,,,,,,1284.2,88,,percent of total billed charges,,,,,,,,,1114.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,364.83,22,,percent of total billed charges,,,1327.98,91,,percent of total billed charges,,,1386.35,95,,percent of total billed charges,,,1211.24,83,,percent of total billed charges,,,1211.24,83,,percent of total billed charges,,,,,,,,,,,,,,,1211.24,83,,percent of total billed charges,,,1386.35,95,,percent of total billed charges,,,1313.39,90,,percent of total billed charges,,,1313.39,90,,percent of total billed charges,,,1196.64,82,,percent of total billed charges,,,1313.39,90,,percent of total billed charges,,,1240.42,85,,percent of total billed charges,,364.83,1386.35,
inFLIXimab(REMICADE)VIAL 100MG,32000354,CDM,J1745,HCPCS,636,RC,outpatient,,5432.49,5432.49,,4612.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1358.12,22,,percent of total billed charges,,,,,,,,,4889.24,90,,percent of total billed charges,,,4498.1,82.8,,percent of total billed charges,,,4617.62,85,,percent of total billed charges,,,,,,,,,4780.59,88,,percent of total billed charges,,4377.75,,,,fee schedule,,,4150.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,4377.75,,,,fee schedule,,,1358.12,22,,percent of total billed charges,,,4943.57,91,,percent of total billed charges,,,5160.87,95,,percent of total billed charges,,,4508.97,83,,percent of total billed charges,,,4508.97,83,,percent of total billed charges,,,,,,,,,,,,,,,4508.97,83,,percent of total billed charges,,,5160.87,95,,percent of total billed charges,,,4889.24,90,,percent of total billed charges,,,4889.24,90,,percent of total billed charges,,,4454.64,82,,percent of total billed charges,,,4889.24,90,,percent of total billed charges,,,4617.62,85,,percent of total billed charges,,1358.12,5160.87,
"LIDOCAINE W/EPI 1:100,000 VIAL 2%:20ML",32000356,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
ZIPRASIDONE (GEODON) CAP : 20 MG,32000357,CDM,,,250,RC,outpatient,,350.51,350.51,,297.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.63,22,,percent of total billed charges,,,,,,,,,315.46,90,,percent of total billed charges,,,290.22,82.8,,percent of total billed charges,,,297.93,85,,percent of total billed charges,,,,,,,,,308.45,88,,percent of total billed charges,,,,,,,,,267.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.63,22,,percent of total billed charges,,,318.96,91,,percent of total billed charges,,,332.98,95,,percent of total billed charges,,,290.92,83,,percent of total billed charges,,,290.92,83,,percent of total billed charges,,,,,,,,,,,,,,,290.92,83,,percent of total billed charges,,,332.98,95,,percent of total billed charges,,,315.46,90,,percent of total billed charges,,,315.46,90,,percent of total billed charges,,,287.42,82,,percent of total billed charges,,,315.46,90,,percent of total billed charges,,,297.93,85,,percent of total billed charges,,87.63,332.98,
HYDROCORTISONE (PROCTOZONE) CREAM:2.50%,32000358,CDM,,,250,RC,outpatient,,331,331,,281.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.75,22,,percent of total billed charges,,,,,,,,,297.9,90,,percent of total billed charges,,,274.07,82.8,,percent of total billed charges,,,281.35,85,,percent of total billed charges,,,,,,,,,291.28,88,,percent of total billed charges,,,,,,,,,252.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82.75,22,,percent of total billed charges,,,301.21,91,,percent of total billed charges,,,314.45,95,,percent of total billed charges,,,274.73,83,,percent of total billed charges,,,274.73,83,,percent of total billed charges,,,,,,,,,,,,,,,274.73,83,,percent of total billed charges,,,314.45,95,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,271.42,82,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,281.35,85,,percent of total billed charges,,82.75,314.45,
INSUL LISP(HumaLOG MIX)75-25UNT/ML:10ML,32000359,CDM,,,250,RC,outpatient,,392.25,392.25,,333.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.06,22,,percent of total billed charges,,,,,,,,,353.03,90,,percent of total billed charges,,,324.78,82.8,,percent of total billed charges,,,333.41,85,,percent of total billed charges,,,,,,,,,345.18,88,,percent of total billed charges,,,,,,,,,299.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.06,22,,percent of total billed charges,,,356.95,91,,percent of total billed charges,,,372.64,95,,percent of total billed charges,,,325.57,83,,percent of total billed charges,,,325.57,83,,percent of total billed charges,,,,,,,,,,,,,,,325.57,83,,percent of total billed charges,,,372.64,95,,percent of total billed charges,,,353.03,90,,percent of total billed charges,,,353.03,90,,percent of total billed charges,,,321.65,82,,percent of total billed charges,,,353.03,90,,percent of total billed charges,,,333.41,85,,percent of total billed charges,,98.06,372.64,
QUEtiapine(SEROquel)TAB:100MG,32000360,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
teraZOSIN(HYTRIN)CAP:5MG,32000361,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
OLOPATADINE(PATANOL)DROP 0.1%:5ML,32000362,CDM,,,250,RC,outpatient,,2233.62,2233.62,,1896.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,558.41,22,,percent of total billed charges,,,,,,,,,2010.26,90,,percent of total billed charges,,,1849.44,82.8,,percent of total billed charges,,,1898.58,85,,percent of total billed charges,,,,,,,,,1965.59,88,,percent of total billed charges,,,,,,,,,1706.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,558.41,22,,percent of total billed charges,,,2032.59,91,,percent of total billed charges,,,2121.94,95,,percent of total billed charges,,,1853.9,83,,percent of total billed charges,,,1853.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1853.9,83,,percent of total billed charges,,,2121.94,95,,percent of total billed charges,,,2010.26,90,,percent of total billed charges,,,2010.26,90,,percent of total billed charges,,,1831.57,82,,percent of total billed charges,,,2010.26,90,,percent of total billed charges,,,1898.58,85,,percent of total billed charges,,558.41,2121.94,
MIRTAZAPINE(REMERON)SOL-TAB:30MG,32000364,CDM,,,250,RC,outpatient,,72.96,72.96,,61.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.24,22,,percent of total billed charges,,,,,,,,,65.66,90,,percent of total billed charges,,,60.41,82.8,,percent of total billed charges,,,62.02,85,,percent of total billed charges,,,,,,,,,64.2,88,,percent of total billed charges,,,,,,,,,55.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.24,22,,percent of total billed charges,,,66.39,91,,percent of total billed charges,,,69.31,95,,percent of total billed charges,,,60.56,83,,percent of total billed charges,,,60.56,83,,percent of total billed charges,,,,,,,,,,,,,,,60.56,83,,percent of total billed charges,,,69.31,95,,percent of total billed charges,,,65.66,90,,percent of total billed charges,,,65.66,90,,percent of total billed charges,,,59.83,82,,percent of total billed charges,,,65.66,90,,percent of total billed charges,,,62.02,85,,percent of total billed charges,,18.24,69.31,
BRINZOLAMIDE(AZOPT)DROP 1%:5ML,32000365,CDM,,,250,RC,outpatient,,558.75,558.75,,474.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,139.69,22,,percent of total billed charges,,,,,,,,,502.88,90,,percent of total billed charges,,,462.65,82.8,,percent of total billed charges,,,474.94,85,,percent of total billed charges,,,,,,,,,491.7,88,,percent of total billed charges,,,,,,,,,426.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,139.69,22,,percent of total billed charges,,,508.46,91,,percent of total billed charges,,,530.81,95,,percent of total billed charges,,,463.76,83,,percent of total billed charges,,,463.76,83,,percent of total billed charges,,,,,,,,,,,,,,,463.76,83,,percent of total billed charges,,,530.81,95,,percent of total billed charges,,,502.88,90,,percent of total billed charges,,,502.88,90,,percent of total billed charges,,,458.18,82,,percent of total billed charges,,,502.88,90,,percent of total billed charges,,,474.94,85,,percent of total billed charges,,139.69,530.81,
FLUTICA/SALMET(ADVAIR DISK):250-50MCG,32000367,CDM,J7699,HCPCS,250,RC,outpatient,,1666.47,1666.47,,1414.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,416.62,22,,percent of total billed charges,,,,,,,,,1499.82,90,,percent of total billed charges,,,1379.84,82.8,,percent of total billed charges,,,1416.5,85,,percent of total billed charges,,,,,,,,,1466.49,88,,percent of total billed charges,,,,,,,,,1273.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,416.62,22,,percent of total billed charges,,,1516.49,91,,percent of total billed charges,,,1583.15,95,,percent of total billed charges,,,1383.17,83,,percent of total billed charges,,,1383.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1383.17,83,,percent of total billed charges,,,1583.15,95,,percent of total billed charges,,,1499.82,90,,percent of total billed charges,,,1499.82,90,,percent of total billed charges,,,1366.51,82,,percent of total billed charges,,,1499.82,90,,percent of total billed charges,,,1416.5,85,,percent of total billed charges,,416.62,1583.15,
MAALOX QUICK DISSOLVE TAB:600MG,32000368,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
BUDESONIDE(PULMICORT) UD:0.5MG/2ML (NEB),32000369,CDM,,,250,RC,outpatient,,56.78,56.78,,48.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.2,22,,percent of total billed charges,,,,,,,,,51.1,90,,percent of total billed charges,,,47.01,82.8,,percent of total billed charges,,,48.26,85,,percent of total billed charges,,,,,,,,,49.97,88,,percent of total billed charges,,,,,,,,,43.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.2,22,,percent of total billed charges,,,51.67,91,,percent of total billed charges,,,53.94,95,,percent of total billed charges,,,47.13,83,,percent of total billed charges,,,47.13,83,,percent of total billed charges,,,,,,,,,,,,,,,47.13,83,,percent of total billed charges,,,53.94,95,,percent of total billed charges,,,51.1,90,,percent of total billed charges,,,51.1,90,,percent of total billed charges,,,46.56,82,,percent of total billed charges,,,51.1,90,,percent of total billed charges,,,48.26,85,,percent of total billed charges,,14.2,53.94,
CISplatin MDV :50MG/50ML   (J/10MG),32000370,CDM,J9060,HCPCS,636,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,47.9,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,47.9,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
MANNITOL VIAL 25%:50 ML,32000371,CDM,J2150,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,34.78,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,34.78,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
IPRATR(ATROVENT)NASAL SPR:21MCG  14GM,32000373,CDM,,,250,RC,outpatient,,1936.84,1936.84,,1644.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,484.21,22,,percent of total billed charges,,,,,,,,,1743.16,90,,percent of total billed charges,,,1603.7,82.8,,percent of total billed charges,,,1646.31,85,,percent of total billed charges,,,,,,,,,1704.42,88,,percent of total billed charges,,,,,,,,,1479.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,484.21,22,,percent of total billed charges,,,1762.52,91,,percent of total billed charges,,,1840,95,,percent of total billed charges,,,1607.58,83,,percent of total billed charges,,,1607.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1607.58,83,,percent of total billed charges,,,1840,95,,percent of total billed charges,,,1743.16,90,,percent of total billed charges,,,1743.16,90,,percent of total billed charges,,,1588.21,82,,percent of total billed charges,,,1743.16,90,,percent of total billed charges,,,1646.31,85,,percent of total billed charges,,484.21,1840,
BECLOMETH DIP (VANCERIL) AER:42MCG  17GM,32000374,CDM,,,250,RC,outpatient,,665.01,665.01,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.51,90,,percent of total billed charges,,,550.63,82.8,,percent of total billed charges,,,565.26,85,,percent of total billed charges,,,,,,,,,585.21,88,,percent of total billed charges,,,,,,,,,508.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.16,91,,percent of total billed charges,,,631.76,95,,percent of total billed charges,,,551.96,83,,percent of total billed charges,,,551.96,83,,percent of total billed charges,,,,,,,,,,,,,,,551.96,83,,percent of total billed charges,,,631.76,95,,percent of total billed charges,,,598.51,90,,percent of total billed charges,,,598.51,90,,percent of total billed charges,,,545.31,82,,percent of total billed charges,,,598.51,90,,percent of total billed charges,,,565.26,85,,percent of total billed charges,,166.25,631.76,
AMPHET ASP/D(ADEDERALL)TAB:10MG,32000375,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
LIDOCAINE HCL 1% VIAL:(10MG/ML) (20ML),32000376,CDM,J2001,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
FLUTICA/SALMET(ADVAIR DISK):100-50,32000377,CDM,,,250,RC,outpatient,,353.2,353.2,,299.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.3,22,,percent of total billed charges,,,,,,,,,317.88,90,,percent of total billed charges,,,292.45,82.8,,percent of total billed charges,,,300.22,85,,percent of total billed charges,,,,,,,,,310.82,88,,percent of total billed charges,,,,,,,,,269.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.3,22,,percent of total billed charges,,,321.41,91,,percent of total billed charges,,,335.54,95,,percent of total billed charges,,,293.16,83,,percent of total billed charges,,,293.16,83,,percent of total billed charges,,,,,,,,,,,,,,,293.16,83,,percent of total billed charges,,,335.54,95,,percent of total billed charges,,,317.88,90,,percent of total billed charges,,,317.88,90,,percent of total billed charges,,,289.62,82,,percent of total billed charges,,,317.88,90,,percent of total billed charges,,,300.22,85,,percent of total billed charges,,88.3,335.54,
GALANTAMINE(RAZADYNE)TAB:4MG,32000378,CDM,,,250,RC,outpatient,,88.82,88.82,,75.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.21,22,,percent of total billed charges,,,,,,,,,79.94,90,,percent of total billed charges,,,73.54,82.8,,percent of total billed charges,,,75.5,85,,percent of total billed charges,,,,,,,,,78.16,88,,percent of total billed charges,,,,,,,,,67.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.21,22,,percent of total billed charges,,,80.83,91,,percent of total billed charges,,,84.38,95,,percent of total billed charges,,,73.72,83,,percent of total billed charges,,,73.72,83,,percent of total billed charges,,,,,,,,,,,,,,,73.72,83,,percent of total billed charges,,,84.38,95,,percent of total billed charges,,,79.94,90,,percent of total billed charges,,,79.94,90,,percent of total billed charges,,,72.83,82,,percent of total billed charges,,,79.94,90,,percent of total billed charges,,,75.5,85,,percent of total billed charges,,22.21,84.38,
HYDROXYUREA (HYDREA) CAPS: 500MG,32000379,CDM,,,250,RC,outpatient,,22.68,22.68,,19.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.67,22,,percent of total billed charges,,,,,,,,,20.41,90,,percent of total billed charges,,,18.78,82.8,,percent of total billed charges,,,19.28,85,,percent of total billed charges,,,,,,,,,19.96,88,,percent of total billed charges,,,,,,,,,17.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.67,22,,percent of total billed charges,,,20.64,91,,percent of total billed charges,,,21.55,95,,percent of total billed charges,,,18.82,83,,percent of total billed charges,,,18.82,83,,percent of total billed charges,,,,,,,,,,,,,,,18.82,83,,percent of total billed charges,,,21.55,95,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,18.6,82,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,19.28,85,,percent of total billed charges,,5.67,21.55,
VALSRTN/HCTZ (DIOVAN) TAB : 80-12.5MG,32000380,CDM,,,250,RC,outpatient,,58.21,58.21,,49.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.55,22,,percent of total billed charges,,,,,,,,,52.39,90,,percent of total billed charges,,,48.2,82.8,,percent of total billed charges,,,49.48,85,,percent of total billed charges,,,,,,,,,51.22,88,,percent of total billed charges,,,,,,,,,44.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.55,22,,percent of total billed charges,,,52.97,91,,percent of total billed charges,,,55.3,95,,percent of total billed charges,,,48.31,83,,percent of total billed charges,,,48.31,83,,percent of total billed charges,,,,,,,,,,,,,,,48.31,83,,percent of total billed charges,,,55.3,95,,percent of total billed charges,,,52.39,90,,percent of total billed charges,,,52.39,90,,percent of total billed charges,,,47.73,82,,percent of total billed charges,,,52.39,90,,percent of total billed charges,,,49.48,85,,percent of total billed charges,,14.55,55.3,
LIDOCAINE HCL 2% VIAL:(20MG/ML) (20ML),32000381,CDM,J2001,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
CLINDAMYCIN (CLEOCIN)CREAM : 2%    40GM,32000382,CDM,,,250,RC,outpatient,,2728.72,2728.72,,2316.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,682.18,22,,percent of total billed charges,,,,,,,,,2455.85,90,,percent of total billed charges,,,2259.38,82.8,,percent of total billed charges,,,2319.41,85,,percent of total billed charges,,,,,,,,,2401.27,88,,percent of total billed charges,,,,,,,,,2084.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,682.18,22,,percent of total billed charges,,,2483.14,91,,percent of total billed charges,,,2592.28,95,,percent of total billed charges,,,2264.84,83,,percent of total billed charges,,,2264.84,83,,percent of total billed charges,,,,,,,,,,,,,,,2264.84,83,,percent of total billed charges,,,2592.28,95,,percent of total billed charges,,,2455.85,90,,percent of total billed charges,,,2455.85,90,,percent of total billed charges,,,2237.55,82,,percent of total billed charges,,,2455.85,90,,percent of total billed charges,,,2319.41,85,,percent of total billed charges,,682.18,2592.28,
MAGNESI HYDR(M.O.M.)ORAL:400MG/5ML 480ML,32000383,CDM,,,250,RC,outpatient,,56.62,56.62,,48.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.16,22,,percent of total billed charges,,,,,,,,,50.96,90,,percent of total billed charges,,,46.88,82.8,,percent of total billed charges,,,48.13,85,,percent of total billed charges,,,,,,,,,49.83,88,,percent of total billed charges,,,,,,,,,43.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.16,22,,percent of total billed charges,,,51.52,91,,percent of total billed charges,,,53.79,95,,percent of total billed charges,,,46.99,83,,percent of total billed charges,,,46.99,83,,percent of total billed charges,,,,,,,,,,,,,,,46.99,83,,percent of total billed charges,,,53.79,95,,percent of total billed charges,,,50.96,90,,percent of total billed charges,,,50.96,90,,percent of total billed charges,,,46.43,82,,percent of total billed charges,,,50.96,90,,percent of total billed charges,,,48.13,85,,percent of total billed charges,,14.16,53.79,
GELATIN  ABSORBABL(GELFOAM)SPONGE:12-7MM,32000384,CDM,,,250,RC,outpatient,,49.75,49.75,,42.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.44,22,,percent of total billed charges,,,,,,,,,44.78,90,,percent of total billed charges,,,41.19,82.8,,percent of total billed charges,,,42.29,85,,percent of total billed charges,,,,,,,,,43.78,88,,percent of total billed charges,,,,,,,,,38.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.44,22,,percent of total billed charges,,,45.27,91,,percent of total billed charges,,,47.26,95,,percent of total billed charges,,,41.29,83,,percent of total billed charges,,,41.29,83,,percent of total billed charges,,,,,,,,,,,,,,,41.29,83,,percent of total billed charges,,,47.26,95,,percent of total billed charges,,,44.78,90,,percent of total billed charges,,,44.78,90,,percent of total billed charges,,,40.8,82,,percent of total billed charges,,,44.78,90,,percent of total billed charges,,,42.29,85,,percent of total billed charges,,12.44,47.26,
prednisoLONE(PRELONE)SYRP:15MG/5ML(30ML),32000385,CDM,J7599,HCPCS,250,RC,outpatient,,45.75,45.75,,38.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.44,22,,percent of total billed charges,,,,,,,,,41.18,90,,percent of total billed charges,,,37.88,82.8,,percent of total billed charges,,,38.89,85,,percent of total billed charges,,,,,,,,,40.26,88,,percent of total billed charges,,,,,,,,,34.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.44,22,,percent of total billed charges,,,41.63,91,,percent of total billed charges,,,43.46,95,,percent of total billed charges,,,37.97,83,,percent of total billed charges,,,37.97,83,,percent of total billed charges,,,,,,,,,,,,,,,37.97,83,,percent of total billed charges,,,43.46,95,,percent of total billed charges,,,41.18,90,,percent of total billed charges,,,41.18,90,,percent of total billed charges,,,37.52,82,,percent of total billed charges,,,41.18,90,,percent of total billed charges,,,38.89,85,,percent of total billed charges,,11.44,43.46,
LIDOCAINE VIAL1%--OB:(10MG/ML) TEAR 30ML,32000386,CDM,J2001,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
RACEPINEPHRINE HCL (S-2) VIAL : 2.25%,32000387,CDM,,,250,RC,outpatient,,27.28,27.28,,23.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.82,22,,percent of total billed charges,,,,,,,,,24.55,90,,percent of total billed charges,,,22.59,82.8,,percent of total billed charges,,,23.19,85,,percent of total billed charges,,,,,,,,,24.01,88,,percent of total billed charges,,,,,,,,,20.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.82,22,,percent of total billed charges,,,24.82,91,,percent of total billed charges,,,25.92,95,,percent of total billed charges,,,22.64,83,,percent of total billed charges,,,22.64,83,,percent of total billed charges,,,,,,,,,,,,,,,22.64,83,,percent of total billed charges,,,25.92,95,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,22.37,82,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,23.19,85,,percent of total billed charges,,6.82,25.92,
guaiFENesin(MUCINEX DM)TAB:600-30MG,32000389,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
VANCOMYCIN-VIAL:500MG,32000391,CDM,J3370,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,19.39,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.39,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
COLLOIDAL OATMEAL (AVEENO BATH) PAC,32000392,CDM,,,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
THYMOL/MENTHOL (ABSORBINE JR) LIN 120ML,32000393,CDM,,,250,RC,outpatient,,82.47,82.47,,70.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.62,22,,percent of total billed charges,,,,,,,,,74.22,90,,percent of total billed charges,,,68.29,82.8,,percent of total billed charges,,,70.1,85,,percent of total billed charges,,,,,,,,,72.57,88,,percent of total billed charges,,,,,,,,,63.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.62,22,,percent of total billed charges,,,75.05,91,,percent of total billed charges,,,78.35,95,,percent of total billed charges,,,68.45,83,,percent of total billed charges,,,68.45,83,,percent of total billed charges,,,,,,,,,,,,,,,68.45,83,,percent of total billed charges,,,78.35,95,,percent of total billed charges,,,74.22,90,,percent of total billed charges,,,74.22,90,,percent of total billed charges,,,67.63,82,,percent of total billed charges,,,74.22,90,,percent of total billed charges,,,70.1,85,,percent of total billed charges,,20.62,78.35,
PRAMOX HCL/CAMPH/OATMEAL(AVEENO)LOT:120M,32000394,CDM,,,250,RC,outpatient,,66.29,66.29,,56.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.57,22,,percent of total billed charges,,,,,,,,,59.66,90,,percent of total billed charges,,,54.89,82.8,,percent of total billed charges,,,56.35,85,,percent of total billed charges,,,,,,,,,58.34,88,,percent of total billed charges,,,,,,,,,50.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.57,22,,percent of total billed charges,,,60.32,91,,percent of total billed charges,,,62.98,95,,percent of total billed charges,,,55.02,83,,percent of total billed charges,,,55.02,83,,percent of total billed charges,,,,,,,,,,,,,,,55.02,83,,percent of total billed charges,,,62.98,95,,percent of total billed charges,,,59.66,90,,percent of total billed charges,,,59.66,90,,percent of total billed charges,,,54.36,82,,percent of total billed charges,,,59.66,90,,percent of total billed charges,,,56.35,85,,percent of total billed charges,,16.57,62.98,
TEMAZEPAM (RESTORIL) CAP : 7.5MG,32000395,CDM,,,250,RC,outpatient,,41.71,41.71,,35.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.43,22,,percent of total billed charges,,,,,,,,,37.54,90,,percent of total billed charges,,,34.54,82.8,,percent of total billed charges,,,35.45,85,,percent of total billed charges,,,,,,,,,36.7,88,,percent of total billed charges,,,,,,,,,31.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.43,22,,percent of total billed charges,,,37.96,91,,percent of total billed charges,,,39.62,95,,percent of total billed charges,,,34.62,83,,percent of total billed charges,,,34.62,83,,percent of total billed charges,,,,,,,,,,,,,,,34.62,83,,percent of total billed charges,,,39.62,95,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,34.2,82,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,35.45,85,,percent of total billed charges,,10.43,39.62,
ACETAMINOPHEN(TYLENOL)EL:650MG/20ML *M&S,32000396,CDM,,,250,RC,outpatient,,22.2,22.2,,18.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.55,22,,percent of total billed charges,,,,,,,,,19.98,90,,percent of total billed charges,,,18.38,82.8,,percent of total billed charges,,,18.87,85,,percent of total billed charges,,,,,,,,,19.54,88,,percent of total billed charges,,,,,,,,,16.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.55,22,,percent of total billed charges,,,20.2,91,,percent of total billed charges,,,21.09,95,,percent of total billed charges,,,18.43,83,,percent of total billed charges,,,18.43,83,,percent of total billed charges,,,,,,,,,,,,,,,18.43,83,,percent of total billed charges,,,21.09,95,,percent of total billed charges,,,19.98,90,,percent of total billed charges,,,19.98,90,,percent of total billed charges,,,18.2,82,,percent of total billed charges,,,19.98,90,,percent of total billed charges,,,18.87,85,,percent of total billed charges,,5.55,21.09,
CARMUSTINE (BICNU) VIAL : 100MG,32000397,CDM,,,250,RC,outpatient,,2418.93,2418.93,,2053.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,604.73,22,,percent of total billed charges,,,,,,,,,2177.04,90,,percent of total billed charges,,,2002.87,82.8,,percent of total billed charges,,,2056.09,85,,percent of total billed charges,,,,,,,,,2128.66,88,,percent of total billed charges,,,,,,,,,1848.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,604.73,22,,percent of total billed charges,,,2201.23,91,,percent of total billed charges,,,2297.98,95,,percent of total billed charges,,,2007.71,83,,percent of total billed charges,,,2007.71,83,,percent of total billed charges,,,,,,,,,,,,,,,2007.71,83,,percent of total billed charges,,,2297.98,95,,percent of total billed charges,,,2177.04,90,,percent of total billed charges,,,2177.04,90,,percent of total billed charges,,,1983.52,82,,percent of total billed charges,,,2177.04,90,,percent of total billed charges,,,2056.09,85,,percent of total billed charges,,604.73,2297.98,
FLUTAMIDE(EULEXIN)CAP:125MG,32000398,CDM,,,250,RC,outpatient,,26.17,26.17,,22.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.54,22,,percent of total billed charges,,,,,,,,,23.55,90,,percent of total billed charges,,,21.67,82.8,,percent of total billed charges,,,22.24,85,,percent of total billed charges,,,,,,,,,23.03,88,,percent of total billed charges,,,,,,,,,19.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.54,22,,percent of total billed charges,,,23.81,91,,percent of total billed charges,,,24.86,95,,percent of total billed charges,,,21.72,83,,percent of total billed charges,,,21.72,83,,percent of total billed charges,,,,,,,,,,,,,,,21.72,83,,percent of total billed charges,,,24.86,95,,percent of total billed charges,,,23.55,90,,percent of total billed charges,,,23.55,90,,percent of total billed charges,,,21.46,82,,percent of total billed charges,,,23.55,90,,percent of total billed charges,,,22.24,85,,percent of total billed charges,,6.54,24.86,
TOLTERODINE (DETROL LA) CAP : 4MG,32000399,CDM,,,250,RC,outpatient,,204.59,204.59,,173.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.15,22,,percent of total billed charges,,,,,,,,,184.13,90,,percent of total billed charges,,,169.4,82.8,,percent of total billed charges,,,173.9,85,,percent of total billed charges,,,,,,,,,180.04,88,,percent of total billed charges,,,,,,,,,156.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.15,22,,percent of total billed charges,,,186.18,91,,percent of total billed charges,,,194.36,95,,percent of total billed charges,,,169.81,83,,percent of total billed charges,,,169.81,83,,percent of total billed charges,,,,,,,,,,,,,,,169.81,83,,percent of total billed charges,,,194.36,95,,percent of total billed charges,,,184.13,90,,percent of total billed charges,,,184.13,90,,percent of total billed charges,,,167.76,82,,percent of total billed charges,,,184.13,90,,percent of total billed charges,,,173.9,85,,percent of total billed charges,,51.15,194.36,
RISPERIDONE (RISPERDAL) TAB : 0.5MG,32000400,CDM,,,250,RC,outpatient,,76.76,76.76,,65.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.19,22,,percent of total billed charges,,,,,,,,,69.08,90,,percent of total billed charges,,,63.56,82.8,,percent of total billed charges,,,65.25,85,,percent of total billed charges,,,,,,,,,67.55,88,,percent of total billed charges,,,,,,,,,58.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.19,22,,percent of total billed charges,,,69.85,91,,percent of total billed charges,,,72.92,95,,percent of total billed charges,,,63.71,83,,percent of total billed charges,,,63.71,83,,percent of total billed charges,,,,,,,,,,,,,,,63.71,83,,percent of total billed charges,,,72.92,95,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,62.94,82,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,65.25,85,,percent of total billed charges,,19.19,72.92,
FLUCONAZOLE SUS(DIFLUCAN):10MG/ML (35ML),32000401,CDM,,,250,RC,outpatient,,269.78,269.78,,229.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.45,22,,percent of total billed charges,,,,,,,,,242.8,90,,percent of total billed charges,,,223.38,82.8,,percent of total billed charges,,,229.31,85,,percent of total billed charges,,,,,,,,,237.41,88,,percent of total billed charges,,,,,,,,,206.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.45,22,,percent of total billed charges,,,245.5,91,,percent of total billed charges,,,256.29,95,,percent of total billed charges,,,223.92,83,,percent of total billed charges,,,223.92,83,,percent of total billed charges,,,,,,,,,,,,,,,223.92,83,,percent of total billed charges,,,256.29,95,,percent of total billed charges,,,242.8,90,,percent of total billed charges,,,242.8,90,,percent of total billed charges,,,221.22,82,,percent of total billed charges,,,242.8,90,,percent of total billed charges,,,229.31,85,,percent of total billed charges,,67.45,256.29,
TRANDOLAPRIL(MAVIK)TAB:1MG,32000402,CDM,,,250,RC,outpatient,,18.4,18.4,,15.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.6,22,,percent of total billed charges,,,,,,,,,16.56,90,,percent of total billed charges,,,15.24,82.8,,percent of total billed charges,,,15.64,85,,percent of total billed charges,,,,,,,,,16.19,88,,percent of total billed charges,,,,,,,,,14.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.6,22,,percent of total billed charges,,,16.74,91,,percent of total billed charges,,,17.48,95,,percent of total billed charges,,,15.27,83,,percent of total billed charges,,,15.27,83,,percent of total billed charges,,,,,,,,,,,,,,,15.27,83,,percent of total billed charges,,,17.48,95,,percent of total billed charges,,,16.56,90,,percent of total billed charges,,,16.56,90,,percent of total billed charges,,,15.09,82,,percent of total billed charges,,,16.56,90,,percent of total billed charges,,,15.64,85,,percent of total billed charges,,4.6,17.48,
BRIMONIDINE TARTR DROP:0.15% 15ML,32000404,CDM,,,250,RC,outpatient,,199,199,,168.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.75,22,,percent of total billed charges,,,,,,,,,179.1,90,,percent of total billed charges,,,164.77,82.8,,percent of total billed charges,,,169.15,85,,percent of total billed charges,,,,,,,,,175.12,88,,percent of total billed charges,,,,,,,,,152.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.75,22,,percent of total billed charges,,,181.09,91,,percent of total billed charges,,,189.05,95,,percent of total billed charges,,,165.17,83,,percent of total billed charges,,,165.17,83,,percent of total billed charges,,,,,,,,,,,,,,,165.17,83,,percent of total billed charges,,,189.05,95,,percent of total billed charges,,,179.1,90,,percent of total billed charges,,,179.1,90,,percent of total billed charges,,,163.18,82,,percent of total billed charges,,,179.1,90,,percent of total billed charges,,,169.15,85,,percent of total billed charges,,49.75,189.05,
KETOROLAC(ACULAR)DROP 0.5%:5ML,32000405,CDM,,,250,RC,outpatient,,303.08,303.08,,257.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.77,22,,percent of total billed charges,,,,,,,,,272.77,90,,percent of total billed charges,,,250.95,82.8,,percent of total billed charges,,,257.62,85,,percent of total billed charges,,,,,,,,,266.71,88,,percent of total billed charges,,,,,,,,,231.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.77,22,,percent of total billed charges,,,275.8,91,,percent of total billed charges,,,287.93,95,,percent of total billed charges,,,251.56,83,,percent of total billed charges,,,251.56,83,,percent of total billed charges,,,,,,,,,,,,,,,251.56,83,,percent of total billed charges,,,287.93,95,,percent of total billed charges,,,272.77,90,,percent of total billed charges,,,272.77,90,,percent of total billed charges,,,248.53,82,,percent of total billed charges,,,272.77,90,,percent of total billed charges,,,257.62,85,,percent of total billed charges,,75.77,287.93,
TIMOLOL/DORZOL(COSOPT)DROP 0.5%-2%:10ML,32000406,CDM,,,250,RC,outpatient,,333.06,333.06,,282.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.27,22,,percent of total billed charges,,,,,,,,,299.75,90,,percent of total billed charges,,,275.77,82.8,,percent of total billed charges,,,283.1,85,,percent of total billed charges,,,,,,,,,293.09,88,,percent of total billed charges,,,,,,,,,254.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.27,22,,percent of total billed charges,,,303.08,91,,percent of total billed charges,,,316.41,95,,percent of total billed charges,,,276.44,83,,percent of total billed charges,,,276.44,83,,percent of total billed charges,,,,,,,,,,,,,,,276.44,83,,percent of total billed charges,,,316.41,95,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,273.11,82,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,283.1,85,,percent of total billed charges,,83.27,316.41,
FENOFIBRATE MICRONIZED (TRICOR) TAB:48MG,32000407,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
SALMETEROL(SEREVENT)DISC:50MCG (28'S),32000408,CDM,J3490,HCPCS,250,RC,outpatient,,1865.5,1865.5,,1583.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,466.38,22,,percent of total billed charges,,,,,,,,,1678.95,90,,percent of total billed charges,,,1544.63,82.8,,percent of total billed charges,,,1585.68,85,,percent of total billed charges,,,,,,,,,1641.64,88,,percent of total billed charges,,,,,,,,,1425.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,466.38,22,,percent of total billed charges,,,1697.61,91,,percent of total billed charges,,,1772.23,95,,percent of total billed charges,,,1548.37,83,,percent of total billed charges,,,1548.37,83,,percent of total billed charges,,,,,,,,,,,,,,,1548.37,83,,percent of total billed charges,,,1772.23,95,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1529.71,82,,percent of total billed charges,,,1678.95,90,,percent of total billed charges,,,1585.68,85,,percent of total billed charges,,466.38,1772.23,
PIPERACIL/TAZO(ZOSYN)PIGGY:3.375G/50ML,32000409,CDM,,,250,RC,outpatient,,308.32,308.32,,261.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.08,22,,percent of total billed charges,,,,,,,,,277.49,90,,percent of total billed charges,,,255.29,82.8,,percent of total billed charges,,,262.07,85,,percent of total billed charges,,,,,,,,,271.32,88,,percent of total billed charges,,,,,,,,,235.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.08,22,,percent of total billed charges,,,280.57,91,,percent of total billed charges,,,292.9,95,,percent of total billed charges,,,255.91,83,,percent of total billed charges,,,255.91,83,,percent of total billed charges,,,,,,,,,,,,,,,255.91,83,,percent of total billed charges,,,292.9,95,,percent of total billed charges,,,277.49,90,,percent of total billed charges,,,277.49,90,,percent of total billed charges,,,252.82,82,,percent of total billed charges,,,277.49,90,,percent of total billed charges,,,262.07,85,,percent of total billed charges,,77.08,292.9,
ESZOPICLONE (LUNESTA) TAB : 2MG,32000410,CDM,,,250,RC,outpatient,,261.06,261.06,,221.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.27,22,,percent of total billed charges,,,,,,,,,234.95,90,,percent of total billed charges,,,216.16,82.8,,percent of total billed charges,,,221.9,85,,percent of total billed charges,,,,,,,,,229.73,88,,percent of total billed charges,,,,,,,,,199.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.27,22,,percent of total billed charges,,,237.56,91,,percent of total billed charges,,,248.01,95,,percent of total billed charges,,,216.68,83,,percent of total billed charges,,,216.68,83,,percent of total billed charges,,,,,,,,,,,,,,,216.68,83,,percent of total billed charges,,,248.01,95,,percent of total billed charges,,,234.95,90,,percent of total billed charges,,,234.95,90,,percent of total billed charges,,,214.07,82,,percent of total billed charges,,,234.95,90,,percent of total billed charges,,,221.9,85,,percent of total billed charges,,65.27,248.01,
NORMAL SALINE 0.9%-VIAL:50ML,32000451,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
ceFEPime(MAXIPIME)VIAL:2GM,32000452,CDM,J0692,HCPCS,250,RC,outpatient,,154.41,154.41,,131.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.6,22,,percent of total billed charges,,,,,,,,,138.97,90,,percent of total billed charges,,,127.85,82.8,,percent of total billed charges,,,131.25,85,,percent of total billed charges,,,,,,,,,135.88,88,,percent of total billed charges,,6.96,,,,fee schedule,,,117.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6.96,,,,fee schedule,,,38.6,22,,percent of total billed charges,,,140.51,91,,percent of total billed charges,,,146.69,95,,percent of total billed charges,,,128.16,83,,percent of total billed charges,,,128.16,83,,percent of total billed charges,,,,,,,,,,,,,,,128.16,83,,percent of total billed charges,,,146.69,95,,percent of total billed charges,,,138.97,90,,percent of total billed charges,,,138.97,90,,percent of total billed charges,,,126.62,82,,percent of total billed charges,,,138.97,90,,percent of total billed charges,,,131.25,85,,percent of total billed charges,,6.96,146.69,
ceFEPime(MAXIPIME)VIAL:1GM,32000453,CDM,J0692,HCPCS,250,RC,outpatient,,91.01,91.01,,77.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.75,22,,percent of total billed charges,,,,,,,,,81.91,90,,percent of total billed charges,,,75.36,82.8,,percent of total billed charges,,,77.36,85,,percent of total billed charges,,,,,,,,,80.09,88,,percent of total billed charges,,6.96,,,,fee schedule,,,69.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6.96,,,,fee schedule,,,22.75,22,,percent of total billed charges,,,82.82,91,,percent of total billed charges,,,86.46,95,,percent of total billed charges,,,75.54,83,,percent of total billed charges,,,75.54,83,,percent of total billed charges,,,,,,,,,,,,,,,75.54,83,,percent of total billed charges,,,86.46,95,,percent of total billed charges,,,81.91,90,,percent of total billed charges,,,81.91,90,,percent of total billed charges,,,74.63,82,,percent of total billed charges,,,81.91,90,,percent of total billed charges,,,77.36,85,,percent of total billed charges,,6.96,86.46,
ARIPiprazole(ABILIFY)TAB:5MG,32000454,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DIVaLproex(DEPAkote *er* )TAB:250MG,32000456,CDM,J8499,HCPCS,250,RC,outpatient,,20.26,20.26,,17.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.07,22,,percent of total billed charges,,,,,,,,,18.23,90,,percent of total billed charges,,,16.78,82.8,,percent of total billed charges,,,17.22,85,,percent of total billed charges,,,,,,,,,17.83,88,,percent of total billed charges,,,,,,,,,15.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.07,22,,percent of total billed charges,,,18.44,91,,percent of total billed charges,,,19.25,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.25,95,,percent of total billed charges,,,18.23,90,,percent of total billed charges,,,18.23,90,,percent of total billed charges,,,16.61,82,,percent of total billed charges,,,18.23,90,,percent of total billed charges,,,17.22,85,,percent of total billed charges,,5.07,19.25,
ZALEPLON (SONATA) CAP : 5MG,32000457,CDM,,,250,RC,outpatient,,50.12,50.12,,42.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.53,22,,percent of total billed charges,,,,,,,,,45.11,90,,percent of total billed charges,,,41.5,82.8,,percent of total billed charges,,,42.6,85,,percent of total billed charges,,,,,,,,,44.11,88,,percent of total billed charges,,,,,,,,,38.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.53,22,,percent of total billed charges,,,45.61,91,,percent of total billed charges,,,47.61,95,,percent of total billed charges,,,41.6,83,,percent of total billed charges,,,41.6,83,,percent of total billed charges,,,,,,,,,,,,,,,41.6,83,,percent of total billed charges,,,47.61,95,,percent of total billed charges,,,45.11,90,,percent of total billed charges,,,45.11,90,,percent of total billed charges,,,41.1,82,,percent of total billed charges,,,45.11,90,,percent of total billed charges,,,42.6,85,,percent of total billed charges,,12.53,47.61,
HYDROCHLOROTHIAZIDE(HCTZ) CAP:12.5MG,32000458,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CAMPATH SDPF: 30MG/ML  J/10MG,32000459,CDM,J9010,HCPCS,636,RC,outpatient,,4517.39,4517.39,,3835.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1129.35,22,,percent of total billed charges,,,,,,,,,4065.65,90,,percent of total billed charges,,,3740.4,82.8,,percent of total billed charges,,,3839.78,85,,percent of total billed charges,,,,,,,,,3975.3,88,,percent of total billed charges,,,,,,,,,3451.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1129.35,22,,percent of total billed charges,,,4110.82,91,,percent of total billed charges,,,4291.52,95,,percent of total billed charges,,,3749.43,83,,percent of total billed charges,,,3749.43,83,,percent of total billed charges,,,,,,,,,,,,,,,3749.43,83,,percent of total billed charges,,,4291.52,95,,percent of total billed charges,,,4065.65,90,,percent of total billed charges,,,4065.65,90,,percent of total billed charges,,,3704.26,82,,percent of total billed charges,,,4065.65,90,,percent of total billed charges,,,3839.78,85,,percent of total billed charges,,1129.35,4291.52,
DORNASE(PULMOZYME):1MG/ML  U/D,32000460,CDM,,,250,RC,outpatient,,1621.8,1621.8,,1376.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,405.45,22,,percent of total billed charges,,,,,,,,,1459.62,90,,percent of total billed charges,,,1342.85,82.8,,percent of total billed charges,,,1378.53,85,,percent of total billed charges,,,,,,,,,1427.18,88,,percent of total billed charges,,,,,,,,,1239.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,405.45,22,,percent of total billed charges,,,1475.84,91,,percent of total billed charges,,,1540.71,95,,percent of total billed charges,,,1346.09,83,,percent of total billed charges,,,1346.09,83,,percent of total billed charges,,,,,,,,,,,,,,,1346.09,83,,percent of total billed charges,,,1540.71,95,,percent of total billed charges,,,1459.62,90,,percent of total billed charges,,,1459.62,90,,percent of total billed charges,,,1329.88,82,,percent of total billed charges,,,1459.62,90,,percent of total billed charges,,,1378.53,85,,percent of total billed charges,,405.45,1540.71,
CARBAXEFED DM(RONDEC DM)DRPS:30ML,32000461,CDM,,,250,RC,outpatient,,99.76,99.76,,84.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.94,22,,percent of total billed charges,,,,,,,,,89.78,90,,percent of total billed charges,,,82.6,82.8,,percent of total billed charges,,,84.8,85,,percent of total billed charges,,,,,,,,,87.79,88,,percent of total billed charges,,,,,,,,,76.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.94,22,,percent of total billed charges,,,90.78,91,,percent of total billed charges,,,94.77,95,,percent of total billed charges,,,82.8,83,,percent of total billed charges,,,82.8,83,,percent of total billed charges,,,,,,,,,,,,,,,82.8,83,,percent of total billed charges,,,94.77,95,,percent of total billed charges,,,89.78,90,,percent of total billed charges,,,89.78,90,,percent of total billed charges,,,81.8,82,,percent of total billed charges,,,89.78,90,,percent of total billed charges,,,84.8,85,,percent of total billed charges,,24.94,94.77,
LEVONORGESTREL(PLAN B),32000462,CDM,J8499,HCPCS,250,RC,outpatient,,541.14,541.14,,459.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,135.29,22,,percent of total billed charges,,,,,,,,,487.03,90,,percent of total billed charges,,,448.06,82.8,,percent of total billed charges,,,459.97,85,,percent of total billed charges,,,,,,,,,476.2,88,,percent of total billed charges,,,,,,,,,413.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,135.29,22,,percent of total billed charges,,,492.44,91,,percent of total billed charges,,,514.08,95,,percent of total billed charges,,,449.15,83,,percent of total billed charges,,,449.15,83,,percent of total billed charges,,,,,,,,,,,,,,,449.15,83,,percent of total billed charges,,,514.08,95,,percent of total billed charges,,,487.03,90,,percent of total billed charges,,,487.03,90,,percent of total billed charges,,,443.73,82,,percent of total billed charges,,,487.03,90,,percent of total billed charges,,,459.97,85,,percent of total billed charges,,135.29,514.08,
CHOLESTYRAMINE (QUESTRAN LIGHT) U/D PKG,32000463,CDM,,,250,RC,outpatient,,23.31,23.31,,19.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.83,22,,percent of total billed charges,,,,,,,,,20.98,90,,percent of total billed charges,,,19.3,82.8,,percent of total billed charges,,,19.81,85,,percent of total billed charges,,,,,,,,,20.51,88,,percent of total billed charges,,,,,,,,,17.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.83,22,,percent of total billed charges,,,21.21,91,,percent of total billed charges,,,22.14,95,,percent of total billed charges,,,19.35,83,,percent of total billed charges,,,19.35,83,,percent of total billed charges,,,,,,,,,,,,,,,19.35,83,,percent of total billed charges,,,22.14,95,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,19.11,82,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,19.81,85,,percent of total billed charges,,5.83,22.14,
EXENATIDE (BYETTA)PPN 10MCG/0.04ML SYR,32000464,CDM,,,250,RC,outpatient,,1850.79,1850.79,,1571.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,462.7,22,,percent of total billed charges,,,,,,,,,1665.71,90,,percent of total billed charges,,,1532.45,82.8,,percent of total billed charges,,,1573.17,85,,percent of total billed charges,,,,,,,,,1628.7,88,,percent of total billed charges,,,,,,,,,1414,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,462.7,22,,percent of total billed charges,,,1684.22,91,,percent of total billed charges,,,1758.25,95,,percent of total billed charges,,,1536.16,83,,percent of total billed charges,,,1536.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1536.16,83,,percent of total billed charges,,,1758.25,95,,percent of total billed charges,,,1665.71,90,,percent of total billed charges,,,1665.71,90,,percent of total billed charges,,,1517.65,82,,percent of total billed charges,,,1665.71,90,,percent of total billed charges,,,1573.17,85,,percent of total billed charges,,462.7,1758.25,
BD ULTRA-FINE III SHORT PEN NEEDLES(BOX),32000465,CDM,,,250,RC,outpatient,,467.55,467.55,,396.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.89,22,,percent of total billed charges,,,,,,,,,420.8,90,,percent of total billed charges,,,387.13,82.8,,percent of total billed charges,,,397.42,85,,percent of total billed charges,,,,,,,,,411.44,88,,percent of total billed charges,,,,,,,,,357.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.89,22,,percent of total billed charges,,,425.47,91,,percent of total billed charges,,,444.17,95,,percent of total billed charges,,,388.07,83,,percent of total billed charges,,,388.07,83,,percent of total billed charges,,,,,,,,,,,,,,,388.07,83,,percent of total billed charges,,,444.17,95,,percent of total billed charges,,,420.8,90,,percent of total billed charges,,,420.8,90,,percent of total billed charges,,,383.39,82,,percent of total billed charges,,,420.8,90,,percent of total billed charges,,,397.42,85,,percent of total billed charges,,116.89,444.17,
MORPHINE SULF VIAL PCA:30MG/30ML,32000466,CDM,J2270,HCPCS,250,RC,outpatient,,136.93,136.93,,116.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.23,22,,percent of total billed charges,,,,,,,,,123.24,90,,percent of total billed charges,,,113.38,82.8,,percent of total billed charges,,,116.39,85,,percent of total billed charges,,,,,,,,,120.5,88,,percent of total billed charges,,5.94,,,,fee schedule,,,104.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.94,,,,fee schedule,,,34.23,22,,percent of total billed charges,,,124.61,91,,percent of total billed charges,,,130.08,95,,percent of total billed charges,,,113.65,83,,percent of total billed charges,,,113.65,83,,percent of total billed charges,,,,,,,,,,,,,,,113.65,83,,percent of total billed charges,,,130.08,95,,percent of total billed charges,,,123.24,90,,percent of total billed charges,,,123.24,90,,percent of total billed charges,,,112.28,82,,percent of total billed charges,,,123.24,90,,percent of total billed charges,,,116.39,85,,percent of total billed charges,,5.94,130.08,
*DOCETAXEL (TaxoTERE) 20MG/0.5ML:(V1011),32000467,CDM,J9171,HCPCS,636,RC,outpatient,,3165.53,3165.53,,2687.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,791.38,22,,percent of total billed charges,,,,,,,,,2848.98,90,,percent of total billed charges,,,2621.06,82.8,,percent of total billed charges,,,2690.7,85,,percent of total billed charges,,,,,,,,,2785.67,88,,percent of total billed charges,,121.68,,,,fee schedule,,,2418.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,791.38,22,,percent of total billed charges,,,2880.63,91,,percent of total billed charges,,,3007.25,95,,percent of total billed charges,,,2627.39,83,,percent of total billed charges,,,2627.39,83,,percent of total billed charges,,,,,,,,,,,,,,,2627.39,83,,percent of total billed charges,,,3007.25,95,,percent of total billed charges,,,2848.98,90,,percent of total billed charges,,,2848.98,90,,percent of total billed charges,,,2595.73,82,,percent of total billed charges,,,2848.98,90,,percent of total billed charges,,,2690.7,85,,percent of total billed charges,,121.68,3007.25,
CYCLOPHOSPHAMIDE(CYTOXAN)VIAL:500MG,32000468,CDM,J9070,HCPCS,636,RC,outpatient,,1503.02,1503.02,,1276.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,375.76,22,,percent of total billed charges,,,,,,,,,1352.72,90,,percent of total billed charges,,,1244.5,82.8,,percent of total billed charges,,,1277.57,85,,percent of total billed charges,,,,,,,,,1322.66,88,,percent of total billed charges,,1315.38,,,,fee schedule,,,1148.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1315.38,,,,fee schedule,,,375.76,22,,percent of total billed charges,,,1367.75,91,,percent of total billed charges,,,1427.87,95,,percent of total billed charges,,,1247.51,83,,percent of total billed charges,,,1247.51,83,,percent of total billed charges,,,,,,,,,,,,,,,1247.51,83,,percent of total billed charges,,,1427.87,95,,percent of total billed charges,,,1352.72,90,,percent of total billed charges,,,1352.72,90,,percent of total billed charges,,,1232.48,82,,percent of total billed charges,,,1352.72,90,,percent of total billed charges,,,1277.57,85,,percent of total billed charges,,375.76,1427.87,
MORPHINE SULFATE,32000471,CDM,,,250,RC,outpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.42,22,,percent of total billed charges,,,,,,,,,59.09,90,,percent of total billed charges,,,54.37,82.8,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,,,,,,,,57.78,88,,percent of total billed charges,,,,,,,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.42,22,,percent of total billed charges,,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,16.42,62.38,
SOLIFENACIN(VESICARE)TAB:5MG,32000472,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
oxyCODONE(oxyCONTIN) ER TAB:10MG,32000473,CDM,,,250,RC,outpatient,,67.97,67.97,,57.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.99,22,,percent of total billed charges,,,,,,,,,61.17,90,,percent of total billed charges,,,56.28,82.8,,percent of total billed charges,,,57.77,85,,percent of total billed charges,,,,,,,,,59.81,88,,percent of total billed charges,,,,,,,,,51.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.99,22,,percent of total billed charges,,,61.85,91,,percent of total billed charges,,,64.57,95,,percent of total billed charges,,,56.42,83,,percent of total billed charges,,,56.42,83,,percent of total billed charges,,,,,,,,,,,,,,,56.42,83,,percent of total billed charges,,,64.57,95,,percent of total billed charges,,,61.17,90,,percent of total billed charges,,,61.17,90,,percent of total billed charges,,,55.74,82,,percent of total billed charges,,,61.17,90,,percent of total billed charges,,,57.77,85,,percent of total billed charges,,16.99,64.57,
CALFACTANT(INFASURF)SDV:210MG/6ML,32000474,CDM,,,250,RC,outpatient,,4458.9,4458.9,,3785.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1114.73,22,,percent of total billed charges,,,,,,,,,4013.01,90,,percent of total billed charges,,,3691.97,82.8,,percent of total billed charges,,,3790.07,85,,percent of total billed charges,,,,,,,,,3923.83,88,,percent of total billed charges,,,,,,,,,3406.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1114.73,22,,percent of total billed charges,,,4057.6,91,,percent of total billed charges,,,4235.96,95,,percent of total billed charges,,,3700.89,83,,percent of total billed charges,,,3700.89,83,,percent of total billed charges,,,,,,,,,,,,,,,3700.89,83,,percent of total billed charges,,,4235.96,95,,percent of total billed charges,,,4013.01,90,,percent of total billed charges,,,4013.01,90,,percent of total billed charges,,,3656.3,82,,percent of total billed charges,,,4013.01,90,,percent of total billed charges,,,3790.07,85,,percent of total billed charges,,1114.73,4235.96,
lamoTRIgine(LaMICtal)TAB:100MG,32000475,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
MEPERIDINE (DEMEROL) PCA:300MG/30ML,32000476,CDM,,,250,RC,outpatient,,125.93,125.93,,106.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.48,22,,percent of total billed charges,,,,,,,,,113.34,90,,percent of total billed charges,,,104.27,82.8,,percent of total billed charges,,,107.04,85,,percent of total billed charges,,,,,,,,,110.82,88,,percent of total billed charges,,,,,,,,,96.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.48,22,,percent of total billed charges,,,114.6,91,,percent of total billed charges,,,119.63,95,,percent of total billed charges,,,104.52,83,,percent of total billed charges,,,104.52,83,,percent of total billed charges,,,,,,,,,,,,,,,104.52,83,,percent of total billed charges,,,119.63,95,,percent of total billed charges,,,113.34,90,,percent of total billed charges,,,113.34,90,,percent of total billed charges,,,103.26,82,,percent of total billed charges,,,113.34,90,,percent of total billed charges,,,107.04,85,,percent of total billed charges,,31.48,119.63,
DUTASTERIDE(AVODART)GELCAP:0.5 MG,32000477,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ESZOPICLONE (LUNESTA) TAB : 1 MG,32000478,CDM,,,250,RC,outpatient,,771.11,771.11,,654.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.78,22,,percent of total billed charges,,,,,,,,,694,90,,percent of total billed charges,,,638.48,82.8,,percent of total billed charges,,,655.44,85,,percent of total billed charges,,,,,,,,,678.58,88,,percent of total billed charges,,,,,,,,,589.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.78,22,,percent of total billed charges,,,701.71,91,,percent of total billed charges,,,732.55,95,,percent of total billed charges,,,640.02,83,,percent of total billed charges,,,640.02,83,,percent of total billed charges,,,,,,,,,,,,,,,640.02,83,,percent of total billed charges,,,732.55,95,,percent of total billed charges,,,694,90,,percent of total billed charges,,,694,90,,percent of total billed charges,,,632.31,82,,percent of total billed charges,,,694,90,,percent of total billed charges,,,655.44,85,,percent of total billed charges,,192.78,732.55,
APAP/DICH/ISOMETH(MIDRIN)CAP:,32000479,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
EPOETIN(PROCRIT)MDV:20000UNITS/ML-J/1000,32000480,CDM,J0885,HCPCS,636,RC,outpatient,,243.96,243.96,,207.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60.99,22,,percent of total billed charges,,,,,,,,,219.56,90,,percent of total billed charges,,,202,82.8,,percent of total billed charges,,,207.37,85,,percent of total billed charges,,,,,,,,,214.68,88,,percent of total billed charges,,669.6,,,,fee schedule,,,186.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,669.6,,,,fee schedule,,,60.99,22,,percent of total billed charges,,,222,91,,percent of total billed charges,,,231.76,95,,percent of total billed charges,,,202.49,83,,percent of total billed charges,,,202.49,83,,percent of total billed charges,,,,,,,,,,,,,,,202.49,83,,percent of total billed charges,,,231.76,95,,percent of total billed charges,,,219.56,90,,percent of total billed charges,,,219.56,90,,percent of total billed charges,,,200.05,82,,percent of total billed charges,,,219.56,90,,percent of total billed charges,,,207.37,85,,percent of total billed charges,,60.99,669.6,
SODIUM CHLORIDE(AYR GEL NSL W/ALOE):,32000481,CDM,J3490,HCPCS,250,RC,outpatient,,48.2,48.2,,40.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.05,22,,percent of total billed charges,,,,,,,,,43.38,90,,percent of total billed charges,,,39.91,82.8,,percent of total billed charges,,,40.97,85,,percent of total billed charges,,,,,,,,,42.42,88,,percent of total billed charges,,,,,,,,,36.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.05,22,,percent of total billed charges,,,43.86,91,,percent of total billed charges,,,45.79,95,,percent of total billed charges,,,40.01,83,,percent of total billed charges,,,40.01,83,,percent of total billed charges,,,,,,,,,,,,,,,40.01,83,,percent of total billed charges,,,45.79,95,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,39.52,82,,percent of total billed charges,,,43.38,90,,percent of total billed charges,,,40.97,85,,percent of total billed charges,,12.05,45.79,
ETOMIDATE(AMIDATE)VIAL:20MG/10ML,32000482,CDM,J3490,HCPCS,250,RC,outpatient,,75.33,75.33,,63.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.83,22,,percent of total billed charges,,,,,,,,,67.8,90,,percent of total billed charges,,,62.37,82.8,,percent of total billed charges,,,64.03,85,,percent of total billed charges,,,,,,,,,66.29,88,,percent of total billed charges,,,,,,,,,57.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.83,22,,percent of total billed charges,,,68.55,91,,percent of total billed charges,,,71.56,95,,percent of total billed charges,,,62.52,83,,percent of total billed charges,,,62.52,83,,percent of total billed charges,,,,,,,,,,,,,,,62.52,83,,percent of total billed charges,,,71.56,95,,percent of total billed charges,,,67.8,90,,percent of total billed charges,,,67.8,90,,percent of total billed charges,,,61.77,82,,percent of total billed charges,,,67.8,90,,percent of total billed charges,,,64.03,85,,percent of total billed charges,,18.83,71.56,
DARIFENACIN(ENABLEX ER)TAB:7.5MG,32000483,CDM,J8499,HCPCS,250,RC,outpatient,,35.84,35.84,,30.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.96,22,,percent of total billed charges,,,,,,,,,32.26,90,,percent of total billed charges,,,29.68,82.8,,percent of total billed charges,,,30.46,85,,percent of total billed charges,,,,,,,,,31.54,88,,percent of total billed charges,,,,,,,,,27.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.96,22,,percent of total billed charges,,,32.61,91,,percent of total billed charges,,,34.05,95,,percent of total billed charges,,,29.75,83,,percent of total billed charges,,,29.75,83,,percent of total billed charges,,,,,,,,,,,,,,,29.75,83,,percent of total billed charges,,,34.05,95,,percent of total billed charges,,,32.26,90,,percent of total billed charges,,,32.26,90,,percent of total billed charges,,,29.39,82,,percent of total billed charges,,,32.26,90,,percent of total billed charges,,,30.46,85,,percent of total billed charges,,8.96,34.05,
ONDANSETRON(ZOFRAN)MDV:40MG/20ML(J/1MG),32000487,CDM,J2405,HCPCS,636,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,1.38,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.38,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,1.38,60.99,
riTUXimab(RITUXAN):100MG/10ML,32000489,CDM,J9312,HCPCS,636,RC,outpatient,,7438.21,7438.21,,6315.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1859.55,22,,percent of total billed charges,,,,,,,,,6694.39,90,,percent of total billed charges,,,6158.84,82.8,,percent of total billed charges,,,6322.48,85,,percent of total billed charges,,,,,,,,,6545.62,88,,percent of total billed charges,,10692.63,,,,fee schedule,,,5682.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,10692.63,,,,fee schedule,,,1859.55,22,,percent of total billed charges,,,6768.77,91,,percent of total billed charges,,,7066.3,95,,percent of total billed charges,,,6173.71,83,,percent of total billed charges,,,6173.71,83,,percent of total billed charges,,,,,,,,,,,,,,,6173.71,83,,percent of total billed charges,,,7066.3,95,,percent of total billed charges,,,6694.39,90,,percent of total billed charges,,,6694.39,90,,percent of total billed charges,,,6099.33,82,,percent of total billed charges,,,6694.39,90,,percent of total billed charges,,,6322.48,85,,percent of total billed charges,,1859.55,10692.63,
NIACIN(NIASPAN)TAB:500MG,32000490,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
VANCOMYCIN-VIAL:1GM,32000491,CDM,J3370,HCPCS,250,RC,outpatient,,332.85,332.85,,282.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.21,22,,percent of total billed charges,,,,,,,,,299.57,90,,percent of total billed charges,,,275.6,82.8,,percent of total billed charges,,,282.92,85,,percent of total billed charges,,,,,,,,,292.91,88,,percent of total billed charges,,19.39,,,,fee schedule,,,254.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.39,,,,fee schedule,,,83.21,22,,percent of total billed charges,,,302.89,91,,percent of total billed charges,,,316.21,95,,percent of total billed charges,,,276.27,83,,percent of total billed charges,,,276.27,83,,percent of total billed charges,,,,,,,,,,,,,,,276.27,83,,percent of total billed charges,,,316.21,95,,percent of total billed charges,,,299.57,90,,percent of total billed charges,,,299.57,90,,percent of total billed charges,,,272.94,82,,percent of total billed charges,,,299.57,90,,percent of total billed charges,,,282.92,85,,percent of total billed charges,,19.39,316.21,
EXENTIDE (BYETTA) SYRINGE 5MCG/0.02:,32000492,CDM,,,250,RC,outpatient,,3063.79,3063.79,,2601.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,765.95,22,,percent of total billed charges,,,,,,,,,2757.41,90,,percent of total billed charges,,,2536.82,82.8,,percent of total billed charges,,,2604.22,85,,percent of total billed charges,,,,,,,,,2696.14,88,,percent of total billed charges,,,,,,,,,2340.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,765.95,22,,percent of total billed charges,,,2788.05,91,,percent of total billed charges,,,2910.6,95,,percent of total billed charges,,,2542.95,83,,percent of total billed charges,,,2542.95,83,,percent of total billed charges,,,,,,,,,,,,,,,2542.95,83,,percent of total billed charges,,,2910.6,95,,percent of total billed charges,,,2757.41,90,,percent of total billed charges,,,2757.41,90,,percent of total billed charges,,,2512.31,82,,percent of total billed charges,,,2757.41,90,,percent of total billed charges,,,2604.22,85,,percent of total billed charges,,765.95,2910.6,
TERBINAFINE(LamISIL)TAB:250MG,32000494,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CROMOLYN(INTAL)MDI:8.1GM,32000495,CDM,,,250,RC,outpatient,,959.48,959.48,,814.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,239.87,22,,percent of total billed charges,,,,,,,,,863.53,90,,percent of total billed charges,,,794.45,82.8,,percent of total billed charges,,,815.56,85,,percent of total billed charges,,,,,,,,,844.34,88,,percent of total billed charges,,,,,,,,,733.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,239.87,22,,percent of total billed charges,,,873.13,91,,percent of total billed charges,,,911.51,95,,percent of total billed charges,,,796.37,83,,percent of total billed charges,,,796.37,83,,percent of total billed charges,,,,,,,,,,,,,,,796.37,83,,percent of total billed charges,,,911.51,95,,percent of total billed charges,,,863.53,90,,percent of total billed charges,,,863.53,90,,percent of total billed charges,,,786.77,82,,percent of total billed charges,,,863.53,90,,percent of total billed charges,,,815.56,85,,percent of total billed charges,,239.87,911.51,
IV DOPAmine/D5W 200MG 250ML  (PREMIX-PD),32000496,CDM,,,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
EPLERENONE(INSPRA)TAB:25 MG,32000498,CDM,,,250,RC,outpatient,,51.86,51.86,,44.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.97,22,,percent of total billed charges,,,,,,,,,46.67,90,,percent of total billed charges,,,42.94,82.8,,percent of total billed charges,,,44.08,85,,percent of total billed charges,,,,,,,,,45.64,88,,percent of total billed charges,,,,,,,,,39.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.97,22,,percent of total billed charges,,,47.19,91,,percent of total billed charges,,,49.27,95,,percent of total billed charges,,,43.04,83,,percent of total billed charges,,,43.04,83,,percent of total billed charges,,,,,,,,,,,,,,,43.04,83,,percent of total billed charges,,,49.27,95,,percent of total billed charges,,,46.67,90,,percent of total billed charges,,,46.67,90,,percent of total billed charges,,,42.53,82,,percent of total billed charges,,,46.67,90,,percent of total billed charges,,,44.08,85,,percent of total billed charges,,12.97,49.27,
MIDODRINE TAB:5MG,32000499,CDM,,,250,RC,outpatient,,20.46,20.46,,17.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.12,22,,percent of total billed charges,,,,,,,,,18.41,90,,percent of total billed charges,,,16.94,82.8,,percent of total billed charges,,,17.39,85,,percent of total billed charges,,,,,,,,,18,88,,percent of total billed charges,,,,,,,,,15.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.12,22,,percent of total billed charges,,,18.62,91,,percent of total billed charges,,,19.44,95,,percent of total billed charges,,,16.98,83,,percent of total billed charges,,,16.98,83,,percent of total billed charges,,,,,,,,,,,,,,,16.98,83,,percent of total billed charges,,,19.44,95,,percent of total billed charges,,,18.41,90,,percent of total billed charges,,,18.41,90,,percent of total billed charges,,,16.78,82,,percent of total billed charges,,,18.41,90,,percent of total billed charges,,,17.39,85,,percent of total billed charges,,5.12,19.44,
NICOTINE(NICORETTE)GUM:2MG,32000500,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ABATACEPT (ORENCIA) 250 MG VIAL,32000502,CDM,J0129,HCPCS,636,RC,outpatient,,6151.86,6151.86,,5222.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1537.97,22,,percent of total billed charges,,,,,,,,,5536.67,90,,percent of total billed charges,,,5093.74,82.8,,percent of total billed charges,,,5229.08,85,,percent of total billed charges,,,,,,,,,5413.64,88,,percent of total billed charges,,4324.6,,,,fee schedule,,,4700.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,4324.6,,,,fee schedule,,,1537.97,22,,percent of total billed charges,,,5598.19,91,,percent of total billed charges,,,5844.27,95,,percent of total billed charges,,,5106.04,83,,percent of total billed charges,,,5106.04,83,,percent of total billed charges,,,,,,,,,,,,,,,5106.04,83,,percent of total billed charges,,,5844.27,95,,percent of total billed charges,,,5536.67,90,,percent of total billed charges,,,5536.67,90,,percent of total billed charges,,,5044.53,82,,percent of total billed charges,,,5536.67,90,,percent of total billed charges,,,5229.08,85,,percent of total billed charges,,1537.97,5844.27,
PEGFILGRASTIM(NEULASTA)SYR 6MG/0.6ML,32000503,CDM,J2506,HCPCS,636,RC,outpatient,,20954.21,20954.21,,17790.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5238.55,22,,percent of total billed charges,,,,,,,,,18858.79,90,,percent of total billed charges,,,17350.09,82.8,,percent of total billed charges,,,17811.08,85,,percent of total billed charges,,,,,,,,,18439.7,88,,percent of total billed charges,,1576.97,,,,fee schedule,,,16009.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1576.97,,,,fee schedule,,,5238.55,22,,percent of total billed charges,,,19068.33,91,,percent of total billed charges,,,19906.5,95,,percent of total billed charges,,,17391.99,83,,percent of total billed charges,,,17391.99,83,,percent of total billed charges,,,,,,,,,,,,,,,17391.99,83,,percent of total billed charges,,,19906.5,95,,percent of total billed charges,,,18858.79,90,,percent of total billed charges,,,18858.79,90,,percent of total billed charges,,,17182.45,82,,percent of total billed charges,,,18858.79,90,,percent of total billed charges,,,17811.08,85,,percent of total billed charges,,1576.97,19906.5,
DICLOFEN/MISOPROS(ARTHROTEC)TAB:75MG,32000504,CDM,,,250,RC,outpatient,,59.16,59.16,,50.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.79,22,,percent of total billed charges,,,,,,,,,53.24,90,,percent of total billed charges,,,48.98,82.8,,percent of total billed charges,,,50.29,85,,percent of total billed charges,,,,,,,,,52.06,88,,percent of total billed charges,,,,,,,,,45.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.79,22,,percent of total billed charges,,,53.84,91,,percent of total billed charges,,,56.2,95,,percent of total billed charges,,,49.1,83,,percent of total billed charges,,,49.1,83,,percent of total billed charges,,,,,,,,,,,,,,,49.1,83,,percent of total billed charges,,,56.2,95,,percent of total billed charges,,,53.24,90,,percent of total billed charges,,,53.24,90,,percent of total billed charges,,,48.51,82,,percent of total billed charges,,,53.24,90,,percent of total billed charges,,,50.29,85,,percent of total billed charges,,14.79,56.2,
TOPIRAMATE(TOPAMAX)TAB:100MG,32000505,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
VORICONAZOLE (VFEND) TABS : 200 MG,32000506,CDM,,,250,RC,outpatient,,61.38,61.38,,52.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.35,22,,percent of total billed charges,,,,,,,,,55.24,90,,percent of total billed charges,,,50.82,82.8,,percent of total billed charges,,,52.17,85,,percent of total billed charges,,,,,,,,,54.01,88,,percent of total billed charges,,,,,,,,,46.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.35,22,,percent of total billed charges,,,55.86,91,,percent of total billed charges,,,58.31,95,,percent of total billed charges,,,50.95,83,,percent of total billed charges,,,50.95,83,,percent of total billed charges,,,,,,,,,,,,,,,50.95,83,,percent of total billed charges,,,58.31,95,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,50.33,82,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,52.17,85,,percent of total billed charges,,15.35,58.31,
TEGASEROD (ZELNORM) TAB : 6 MG,32000507,CDM,,,250,RC,outpatient,,49.32,49.32,,41.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.33,22,,percent of total billed charges,,,,,,,,,44.39,90,,percent of total billed charges,,,40.84,82.8,,percent of total billed charges,,,41.92,85,,percent of total billed charges,,,,,,,,,43.4,88,,percent of total billed charges,,,,,,,,,37.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.33,22,,percent of total billed charges,,,44.88,91,,percent of total billed charges,,,46.85,95,,percent of total billed charges,,,40.94,83,,percent of total billed charges,,,40.94,83,,percent of total billed charges,,,,,,,,,,,,,,,40.94,83,,percent of total billed charges,,,46.85,95,,percent of total billed charges,,,44.39,90,,percent of total billed charges,,,44.39,90,,percent of total billed charges,,,40.44,82,,percent of total billed charges,,,44.39,90,,percent of total billed charges,,,41.92,85,,percent of total billed charges,,12.33,46.85,
CEFTAROLINE (TEFLARO)-VIAL:600MG  J/10MG,32000509,CDM,J0712,HCPCS,250,RC,outpatient,,2989.06,2989.06,,2537.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,747.27,22,,percent of total billed charges,,,,,,,,,2690.15,90,,percent of total billed charges,,,2474.94,82.8,,percent of total billed charges,,,2540.7,85,,percent of total billed charges,,,,,,,,,2630.37,88,,percent of total billed charges,,224.52,,,,fee schedule,,,2283.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,224.52,,,,fee schedule,,,747.27,22,,percent of total billed charges,,,2720.04,91,,percent of total billed charges,,,2839.61,95,,percent of total billed charges,,,2480.92,83,,percent of total billed charges,,,2480.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2480.92,83,,percent of total billed charges,,,2839.61,95,,percent of total billed charges,,,2690.15,90,,percent of total billed charges,,,2690.15,90,,percent of total billed charges,,,2451.03,82,,percent of total billed charges,,,2690.15,90,,percent of total billed charges,,,2540.7,85,,percent of total billed charges,,224.52,2839.61,
LUBIPROSTONE (AMITIZA) CAP 24 MCG :,32000510,CDM,,,250,RC,outpatient,,48.06,48.06,,40.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.02,22,,percent of total billed charges,,,,,,,,,43.25,90,,percent of total billed charges,,,39.79,82.8,,percent of total billed charges,,,40.85,85,,percent of total billed charges,,,,,,,,,42.29,88,,percent of total billed charges,,,,,,,,,36.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.02,22,,percent of total billed charges,,,43.73,91,,percent of total billed charges,,,45.66,95,,percent of total billed charges,,,39.89,83,,percent of total billed charges,,,39.89,83,,percent of total billed charges,,,,,,,,,,,,,,,39.89,83,,percent of total billed charges,,,45.66,95,,percent of total billed charges,,,43.25,90,,percent of total billed charges,,,43.25,90,,percent of total billed charges,,,39.41,82,,percent of total billed charges,,,43.25,90,,percent of total billed charges,,,40.85,85,,percent of total billed charges,,12.02,45.66,
CONTAINER EMPTY LIFECARE FLEX BAG:250ML,32000511,CDM,J3490,HCPCS,250,RC,outpatient,,46.79,46.79,,39.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.7,22,,percent of total billed charges,,,,,,,,,42.11,90,,percent of total billed charges,,,38.74,82.8,,percent of total billed charges,,,39.77,85,,percent of total billed charges,,,,,,,,,41.18,88,,percent of total billed charges,,,,,,,,,35.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.7,22,,percent of total billed charges,,,42.58,91,,percent of total billed charges,,,44.45,95,,percent of total billed charges,,,38.84,83,,percent of total billed charges,,,38.84,83,,percent of total billed charges,,,,,,,,,,,,,,,38.84,83,,percent of total billed charges,,,44.45,95,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,38.37,82,,percent of total billed charges,,,42.11,90,,percent of total billed charges,,,39.77,85,,percent of total billed charges,,11.7,44.45,
LEVOFLOX(LEVAQUIN)-IVPB:750MG/D5W150ML,32000512,CDM,J1956,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,3.21,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.21,,,,fee schedule,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.21,187.11,
DIPT/TETANUS/PERT(ACELL)TET:0.5ML,32000513,CDM,,,250,RC,outpatient,,400.62,400.62,,340.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100.16,22,,percent of total billed charges,,,,,,,,,360.56,90,,percent of total billed charges,,,331.71,82.8,,percent of total billed charges,,,340.53,85,,percent of total billed charges,,,,,,,,,352.55,88,,percent of total billed charges,,,,,,,,,306.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100.16,22,,percent of total billed charges,,,364.56,91,,percent of total billed charges,,,380.59,95,,percent of total billed charges,,,332.51,83,,percent of total billed charges,,,332.51,83,,percent of total billed charges,,,,,,,,,,,,,,,332.51,83,,percent of total billed charges,,,380.59,95,,percent of total billed charges,,,360.56,90,,percent of total billed charges,,,360.56,90,,percent of total billed charges,,,328.51,82,,percent of total billed charges,,,360.56,90,,percent of total billed charges,,,340.53,85,,percent of total billed charges,,100.16,380.59,
GELATIN SPONGE (GELFOAM):SZ 100,32000514,CDM,J3490,HCPCS,250,RC,outpatient,,663.4,663.4,,563.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,165.85,22,,percent of total billed charges,,,,,,,,,597.06,90,,percent of total billed charges,,,549.3,82.8,,percent of total billed charges,,,563.89,85,,percent of total billed charges,,,,,,,,,583.79,88,,percent of total billed charges,,,,,,,,,506.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,165.85,22,,percent of total billed charges,,,603.69,91,,percent of total billed charges,,,630.23,95,,percent of total billed charges,,,550.62,83,,percent of total billed charges,,,550.62,83,,percent of total billed charges,,,,,,,,,,,,,,,550.62,83,,percent of total billed charges,,,630.23,95,,percent of total billed charges,,,597.06,90,,percent of total billed charges,,,597.06,90,,percent of total billed charges,,,543.99,82,,percent of total billed charges,,,597.06,90,,percent of total billed charges,,,563.89,85,,percent of total billed charges,,165.85,630.23,
TROLAMINE SALICYLATE(ASPERCREME) 10%:,32000515,CDM,,,250,RC,outpatient,,23.63,23.63,,20.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.91,22,,percent of total billed charges,,,,,,,,,21.27,90,,percent of total billed charges,,,19.57,82.8,,percent of total billed charges,,,20.09,85,,percent of total billed charges,,,,,,,,,20.79,88,,percent of total billed charges,,,,,,,,,18.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.91,22,,percent of total billed charges,,,21.5,91,,percent of total billed charges,,,22.45,95,,percent of total billed charges,,,19.61,83,,percent of total billed charges,,,19.61,83,,percent of total billed charges,,,,,,,,,,,,,,,19.61,83,,percent of total billed charges,,,22.45,95,,percent of total billed charges,,,21.27,90,,percent of total billed charges,,,21.27,90,,percent of total billed charges,,,19.38,82,,percent of total billed charges,,,21.27,90,,percent of total billed charges,,,20.09,85,,percent of total billed charges,,5.91,22.45,
METHOCARBAMOL(ROBAXIN)TABS:750MG,32000516,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FERROUS FUMARATE(FERRO-SEQUELS)CAPS:,32000517,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
FENOFIBRATE(TRICOR)TABS:145 MG,32000519,CDM,J8499,HCPCS,250,RC,outpatient,,45.1,45.1,,38.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.28,22,,percent of total billed charges,,,,,,,,,40.59,90,,percent of total billed charges,,,37.34,82.8,,percent of total billed charges,,,38.34,85,,percent of total billed charges,,,,,,,,,39.69,88,,percent of total billed charges,,,,,,,,,34.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.28,22,,percent of total billed charges,,,41.04,91,,percent of total billed charges,,,42.85,95,,percent of total billed charges,,,37.43,83,,percent of total billed charges,,,37.43,83,,percent of total billed charges,,,,,,,,,,,,,,,37.43,83,,percent of total billed charges,,,42.85,95,,percent of total billed charges,,,40.59,90,,percent of total billed charges,,,40.59,90,,percent of total billed charges,,,36.98,82,,percent of total billed charges,,,40.59,90,,percent of total billed charges,,,38.34,85,,percent of total billed charges,,11.28,42.85,
insul ASPART(novoLOG)VIAL 70/30:,32000520,CDM,J1815,HCPCS,250,RC,outpatient,,2311.91,2311.91,,1962.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,577.98,22,,percent of total billed charges,,,,,,,,,2080.72,90,,percent of total billed charges,,,1914.26,82.8,,percent of total billed charges,,,1965.12,85,,percent of total billed charges,,,,,,,,,2034.48,88,,percent of total billed charges,,,,,,,,,1766.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,577.98,22,,percent of total billed charges,,,2103.84,91,,percent of total billed charges,,,2196.31,95,,percent of total billed charges,,,1918.89,83,,percent of total billed charges,,,1918.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1918.89,83,,percent of total billed charges,,,2196.31,95,,percent of total billed charges,,,2080.72,90,,percent of total billed charges,,,2080.72,90,,percent of total billed charges,,,1895.77,82,,percent of total billed charges,,,2080.72,90,,percent of total billed charges,,,1965.12,85,,percent of total billed charges,,577.98,2196.31,
HEPATITIS B(NABI-HB)I.G. VIAL:5ML,32000521,CDM,90371,CPT,250,RC,outpatient,,5453.4,5453.4,,4629.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1363.35,22,,percent of total billed charges,,,,,,,,,4908.06,90,,percent of total billed charges,,,4515.42,82.8,,percent of total billed charges,,,4635.39,85,,percent of total billed charges,,,,,,,,,4798.99,88,,percent of total billed charges,,,,,,,,,4166.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1363.35,22,,percent of total billed charges,,,4962.59,91,,percent of total billed charges,,,5180.73,95,,percent of total billed charges,,,4526.32,83,,percent of total billed charges,,,4526.32,83,,percent of total billed charges,,,,,,,,,,,,,,,4526.32,83,,percent of total billed charges,,,5180.73,95,,percent of total billed charges,,,4908.06,90,,percent of total billed charges,,,4908.06,90,,percent of total billed charges,,,4471.79,82,,percent of total billed charges,,,4908.06,90,,percent of total billed charges,,,4635.39,85,,percent of total billed charges,,1363.35,5180.73,
HEPATITIS B(NABI-NB)I.G. VIAL:1 ML,32000522,CDM,90371,CPT,250,RC,outpatient,,2286.41,2286.41,,1941.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,571.6,22,,percent of total billed charges,,,,,,,,,2057.77,90,,percent of total billed charges,,,1893.15,82.8,,percent of total billed charges,,,1943.45,85,,percent of total billed charges,,,,,,,,,2012.04,88,,percent of total billed charges,,,,,,,,,1746.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,571.6,22,,percent of total billed charges,,,2080.63,91,,percent of total billed charges,,,2172.09,95,,percent of total billed charges,,,1897.72,83,,percent of total billed charges,,,1897.72,83,,percent of total billed charges,,,,,,,,,,,,,,,1897.72,83,,percent of total billed charges,,,2172.09,95,,percent of total billed charges,,,2057.77,90,,percent of total billed charges,,,2057.77,90,,percent of total billed charges,,,1874.86,82,,percent of total billed charges,,,2057.77,90,,percent of total billed charges,,,1943.45,85,,percent of total billed charges,,571.6,2172.09,
SEVELAMER (RENAGEL) TABS 800 MG:,32000523,CDM,,,250,RC,outpatient,,123.87,123.87,,105.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.97,22,,percent of total billed charges,,,,,,,,,111.48,90,,percent of total billed charges,,,102.56,82.8,,percent of total billed charges,,,105.29,85,,percent of total billed charges,,,,,,,,,109.01,88,,percent of total billed charges,,,,,,,,,94.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.97,22,,percent of total billed charges,,,112.72,91,,percent of total billed charges,,,117.68,95,,percent of total billed charges,,,102.81,83,,percent of total billed charges,,,102.81,83,,percent of total billed charges,,,,,,,,,,,,,,,102.81,83,,percent of total billed charges,,,117.68,95,,percent of total billed charges,,,111.48,90,,percent of total billed charges,,,111.48,90,,percent of total billed charges,,,101.57,82,,percent of total billed charges,,,111.48,90,,percent of total billed charges,,,105.29,85,,percent of total billed charges,,30.97,117.68,
LIDOCAINE 4% PF INJ SOL AMP:5ML,32000524,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
ephinePHRINE PF(NO SULFITES) 1:1000:,32000525,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
SODIUM CHLORIDE FTV  LF SDPF 14.6%:20ML,32000526,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
ALFUZOSIN (UROXATRAL) ER TABS 10MG:,32000527,CDM,,,250,RC,outpatient,,205.23,205.23,,174.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.31,22,,percent of total billed charges,,,,,,,,,184.71,90,,percent of total billed charges,,,169.93,82.8,,percent of total billed charges,,,174.45,85,,percent of total billed charges,,,,,,,,,180.6,88,,percent of total billed charges,,,,,,,,,156.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.31,22,,percent of total billed charges,,,186.76,91,,percent of total billed charges,,,194.97,95,,percent of total billed charges,,,170.34,83,,percent of total billed charges,,,170.34,83,,percent of total billed charges,,,,,,,,,,,,,,,170.34,83,,percent of total billed charges,,,194.97,95,,percent of total billed charges,,,184.71,90,,percent of total billed charges,,,184.71,90,,percent of total billed charges,,,168.29,82,,percent of total billed charges,,,184.71,90,,percent of total billed charges,,,174.45,85,,percent of total billed charges,,51.31,194.97,
LEUPROLIDE(LUPRON)SYR30MG:PER7.5MG-MEN,32000528,CDM,J9217,HCPCS,636,RC,outpatient,,32653.22,32653.22,,27722.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8163.31,22,,percent of total billed charges,,,,,,,,,29387.9,90,,percent of total billed charges,,,27036.87,82.8,,percent of total billed charges,,,27755.24,85,,percent of total billed charges,,,,,,,,,28734.83,88,,percent of total billed charges,,998.81,,,,fee schedule,,,24947.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,998.81,,,,fee schedule,,,8163.31,22,,percent of total billed charges,,,29714.43,91,,percent of total billed charges,,,31020.56,95,,percent of total billed charges,,,27102.17,83,,percent of total billed charges,,,27102.17,83,,percent of total billed charges,,,,,,,,,,,,,,,27102.17,83,,percent of total billed charges,,,31020.56,95,,percent of total billed charges,,,29387.9,90,,percent of total billed charges,,,29387.9,90,,percent of total billed charges,,,26775.64,82,,percent of total billed charges,,,29387.9,90,,percent of total billed charges,,,27755.24,85,,percent of total billed charges,,998.81,31020.56,
UREA (AQUAPHIL/CARBAMIDE) OINT 20%:,32000529,CDM,,,250,RC,outpatient,,89.93,89.93,,76.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.48,22,,percent of total billed charges,,,,,,,,,80.94,90,,percent of total billed charges,,,74.46,82.8,,percent of total billed charges,,,76.44,85,,percent of total billed charges,,,,,,,,,79.14,88,,percent of total billed charges,,,,,,,,,68.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.48,22,,percent of total billed charges,,,81.84,91,,percent of total billed charges,,,85.43,95,,percent of total billed charges,,,74.64,83,,percent of total billed charges,,,74.64,83,,percent of total billed charges,,,,,,,,,,,,,,,74.64,83,,percent of total billed charges,,,85.43,95,,percent of total billed charges,,,80.94,90,,percent of total billed charges,,,80.94,90,,percent of total billed charges,,,73.74,82,,percent of total billed charges,,,80.94,90,,percent of total billed charges,,,76.44,85,,percent of total billed charges,,22.48,85.43,
IRINOTECAN(CAMPTOSAR):40MG/2ML,32000530,CDM,J9206,HCPCS,636,RC,outpatient,,218.47,218.47,,185.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.62,22,,percent of total billed charges,,,,,,,,,196.62,90,,percent of total billed charges,,,180.89,82.8,,percent of total billed charges,,,185.7,85,,percent of total billed charges,,,,,,,,,192.25,88,,percent of total billed charges,,114.58,,,,fee schedule,,,166.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,114.58,,,,fee schedule,,,54.62,22,,percent of total billed charges,,,198.81,91,,percent of total billed charges,,,207.55,95,,percent of total billed charges,,,181.33,83,,percent of total billed charges,,,181.33,83,,percent of total billed charges,,,,,,,,,,,,,,,181.33,83,,percent of total billed charges,,,207.55,95,,percent of total billed charges,,,196.62,90,,percent of total billed charges,,,196.62,90,,percent of total billed charges,,,179.15,82,,percent of total billed charges,,,196.62,90,,percent of total billed charges,,,185.7,85,,percent of total billed charges,,54.62,207.55,
AMPHOTER B LIP(AMBISOME):50MG   J/10MG,32000533,CDM,J0289,HCPCS,636,RC,outpatient,,2054.36,2054.36,,1744.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,513.59,22,,percent of total billed charges,,,,,,,,,1848.92,90,,percent of total billed charges,,,1701.01,82.8,,percent of total billed charges,,,1746.21,85,,percent of total billed charges,,,,,,,,,1807.84,88,,percent of total billed charges,,1942.8,,,,fee schedule,,,1569.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1942.8,,,,fee schedule,,,513.59,22,,percent of total billed charges,,,1869.47,91,,percent of total billed charges,,,1951.64,95,,percent of total billed charges,,,1705.12,83,,percent of total billed charges,,,1705.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1705.12,83,,percent of total billed charges,,,1951.64,95,,percent of total billed charges,,,1848.92,90,,percent of total billed charges,,,1848.92,90,,percent of total billed charges,,,1684.58,82,,percent of total billed charges,,,1848.92,90,,percent of total billed charges,,,1746.21,85,,percent of total billed charges,,513.59,1951.64,
FORMOTEROL(FORADIL) 12 MCG:12'S,32000534,CDM,,,250,RC,outpatient,,847.12,847.12,,719.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,211.78,22,,percent of total billed charges,,,,,,,,,762.41,90,,percent of total billed charges,,,701.42,82.8,,percent of total billed charges,,,720.05,85,,percent of total billed charges,,,,,,,,,745.47,88,,percent of total billed charges,,,,,,,,,647.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,211.78,22,,percent of total billed charges,,,770.88,91,,percent of total billed charges,,,804.76,95,,percent of total billed charges,,,703.11,83,,percent of total billed charges,,,703.11,83,,percent of total billed charges,,,,,,,,,,,,,,,703.11,83,,percent of total billed charges,,,804.76,95,,percent of total billed charges,,,762.41,90,,percent of total billed charges,,,762.41,90,,percent of total billed charges,,,694.64,82,,percent of total billed charges,,,762.41,90,,percent of total billed charges,,,720.05,85,,percent of total billed charges,,211.78,804.76,
VINblastine(VELBAN)1MG/ML:J/1MG,32000535,CDM,J9360,HCPCS,636,RC,outpatient,,69.94,69.94,,59.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.49,22,,percent of total billed charges,,,,,,,,,62.95,90,,percent of total billed charges,,,57.91,82.8,,percent of total billed charges,,,59.45,85,,percent of total billed charges,,,,,,,,,61.55,88,,percent of total billed charges,,179.86,,,,fee schedule,,,53.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,179.86,,,,fee schedule,,,17.49,22,,percent of total billed charges,,,63.65,91,,percent of total billed charges,,,66.44,95,,percent of total billed charges,,,58.05,83,,percent of total billed charges,,,58.05,83,,percent of total billed charges,,,,,,,,,,,,,,,58.05,83,,percent of total billed charges,,,66.44,95,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,57.35,82,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,59.45,85,,percent of total billed charges,,17.49,179.86,
QUINAPRIL(ACCUPRIL)TAB:10MG,32000536,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
METOPROTERENOL(ALUPENT)MDI:14GM,32000537,CDM,,,250,RC,outpatient,,624.88,624.88,,530.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,156.22,22,,percent of total billed charges,,,,,,,,,562.39,90,,percent of total billed charges,,,517.4,82.8,,percent of total billed charges,,,531.15,85,,percent of total billed charges,,,,,,,,,549.89,88,,percent of total billed charges,,,,,,,,,477.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,156.22,22,,percent of total billed charges,,,568.64,91,,percent of total billed charges,,,593.64,95,,percent of total billed charges,,,518.65,83,,percent of total billed charges,,,518.65,83,,percent of total billed charges,,,,,,,,,,,,,,,518.65,83,,percent of total billed charges,,,593.64,95,,percent of total billed charges,,,562.39,90,,percent of total billed charges,,,562.39,90,,percent of total billed charges,,,512.4,82,,percent of total billed charges,,,562.39,90,,percent of total billed charges,,,531.15,85,,percent of total billed charges,,156.22,593.64,
TRYPAN BLUE(VISION BLUE):0.5ML,32000538,CDM,,,250,RC,outpatient,,1014.33,1014.33,,861.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,253.58,22,,percent of total billed charges,,,,,,,,,912.9,90,,percent of total billed charges,,,839.87,82.8,,percent of total billed charges,,,862.18,85,,percent of total billed charges,,,,,,,,,892.61,88,,percent of total billed charges,,,,,,,,,774.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,253.58,22,,percent of total billed charges,,,923.04,91,,percent of total billed charges,,,963.61,95,,percent of total billed charges,,,841.89,83,,percent of total billed charges,,,841.89,83,,percent of total billed charges,,,,,,,,,,,,,,,841.89,83,,percent of total billed charges,,,963.61,95,,percent of total billed charges,,,912.9,90,,percent of total billed charges,,,912.9,90,,percent of total billed charges,,,831.75,82,,percent of total billed charges,,,912.9,90,,percent of total billed charges,,,862.18,85,,percent of total billed charges,,253.58,963.61,
IRON SUCROSE(VENOFER):100MG/5ML,32000539,CDM,J1756,HCPCS,636,RC,outpatient,,608.34,608.34,,516.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,152.09,22,,percent of total billed charges,,,,,,,,,547.51,90,,percent of total billed charges,,,503.71,82.8,,percent of total billed charges,,,517.09,85,,percent of total billed charges,,,,,,,,,535.34,88,,percent of total billed charges,,102,,,,fee schedule,,,464.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,102,,,,fee schedule,,,152.09,22,,percent of total billed charges,,,553.59,91,,percent of total billed charges,,,577.92,95,,percent of total billed charges,,,504.92,83,,percent of total billed charges,,,504.92,83,,percent of total billed charges,,,,,,,,,,,,,,,504.92,83,,percent of total billed charges,,,577.92,95,,percent of total billed charges,,,547.51,90,,percent of total billed charges,,,547.51,90,,percent of total billed charges,,,498.84,82,,percent of total billed charges,,,547.51,90,,percent of total billed charges,,,517.09,85,,percent of total billed charges,,102,577.92,
INSUL ASPART(NovoLOG)100UNITS/ML:(10ML),32000540,CDM,J1815,HCPCS,250,RC,outpatient,,684.9,684.9,,581.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,171.23,22,,percent of total billed charges,,,,,,,,,616.41,90,,percent of total billed charges,,,567.1,82.8,,percent of total billed charges,,,582.17,85,,percent of total billed charges,,,,,,,,,602.71,88,,percent of total billed charges,,,,,,,,,523.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,171.23,22,,percent of total billed charges,,,623.26,91,,percent of total billed charges,,,650.66,95,,percent of total billed charges,,,568.47,83,,percent of total billed charges,,,568.47,83,,percent of total billed charges,,,,,,,,,,,,,,,568.47,83,,percent of total billed charges,,,650.66,95,,percent of total billed charges,,,616.41,90,,percent of total billed charges,,,616.41,90,,percent of total billed charges,,,561.62,82,,percent of total billed charges,,,616.41,90,,percent of total billed charges,,,582.17,85,,percent of total billed charges,,171.23,650.66,
QUINAPRIL HCL (ACCUPRIL) TAB : 20MG,32000541,CDM,,,250,RC,outpatient,,81.04,81.04,,68.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.26,22,,percent of total billed charges,,,,,,,,,72.94,90,,percent of total billed charges,,,67.1,82.8,,percent of total billed charges,,,68.88,85,,percent of total billed charges,,,,,,,,,71.32,88,,percent of total billed charges,,,,,,,,,61.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.26,22,,percent of total billed charges,,,73.75,91,,percent of total billed charges,,,76.99,95,,percent of total billed charges,,,67.26,83,,percent of total billed charges,,,67.26,83,,percent of total billed charges,,,,,,,,,,,,,,,67.26,83,,percent of total billed charges,,,76.99,95,,percent of total billed charges,,,72.94,90,,percent of total billed charges,,,72.94,90,,percent of total billed charges,,,66.45,82,,percent of total billed charges,,,72.94,90,,percent of total billed charges,,,68.88,85,,percent of total billed charges,,20.26,76.99,
ZANFEL CREAM:,32000542,CDM,J3490,HCPCS,250,RC,outpatient,,366.37,366.37,,311.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.59,22,,percent of total billed charges,,,,,,,,,329.73,90,,percent of total billed charges,,,303.35,82.8,,percent of total billed charges,,,311.41,85,,percent of total billed charges,,,,,,,,,322.41,88,,percent of total billed charges,,,,,,,,,279.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.59,22,,percent of total billed charges,,,333.4,91,,percent of total billed charges,,,348.05,95,,percent of total billed charges,,,304.09,83,,percent of total billed charges,,,304.09,83,,percent of total billed charges,,,,,,,,,,,,,,,304.09,83,,percent of total billed charges,,,348.05,95,,percent of total billed charges,,,329.73,90,,percent of total billed charges,,,329.73,90,,percent of total billed charges,,,300.42,82,,percent of total billed charges,,,329.73,90,,percent of total billed charges,,,311.41,85,,percent of total billed charges,,91.59,348.05,
NATEGLINIDE(STARLIX)TABS:120MG,32000543,CDM,J8499,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
ZOLMITRIPTAN (ZOMIG) ODT TABS 5 MG:,32000544,CDM,,,250,RC,outpatient,,440.75,440.75,,374.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.19,22,,percent of total billed charges,,,,,,,,,396.68,90,,percent of total billed charges,,,364.94,82.8,,percent of total billed charges,,,374.64,85,,percent of total billed charges,,,,,,,,,387.86,88,,percent of total billed charges,,,,,,,,,336.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.19,22,,percent of total billed charges,,,401.08,91,,percent of total billed charges,,,418.71,95,,percent of total billed charges,,,365.82,83,,percent of total billed charges,,,365.82,83,,percent of total billed charges,,,,,,,,,,,,,,,365.82,83,,percent of total billed charges,,,418.71,95,,percent of total billed charges,,,396.68,90,,percent of total billed charges,,,396.68,90,,percent of total billed charges,,,361.42,82,,percent of total billed charges,,,396.68,90,,percent of total billed charges,,,374.64,85,,percent of total billed charges,,110.19,418.71,
TRANDOLAPRIL(MAVIK) TABS 4MG:,32000545,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
QUINAPRIL HCL (ACCUPRIL) TAB : 5MG,32000546,CDM,,,250,RC,outpatient,,8.25,8.25,,7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.06,22,,percent of total billed charges,,,,,,,,,7.43,90,,percent of total billed charges,,,6.83,82.8,,percent of total billed charges,,,7.01,85,,percent of total billed charges,,,,,,,,,7.26,88,,percent of total billed charges,,,,,,,,,6.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.06,22,,percent of total billed charges,,,7.51,91,,percent of total billed charges,,,7.84,95,,percent of total billed charges,,,6.85,83,,percent of total billed charges,,,6.85,83,,percent of total billed charges,,,,,,,,,,,,,,,6.85,83,,percent of total billed charges,,,7.84,95,,percent of total billed charges,,,7.43,90,,percent of total billed charges,,,7.43,90,,percent of total billed charges,,,6.77,82,,percent of total billed charges,,,7.43,90,,percent of total billed charges,,,7.01,85,,percent of total billed charges,,2.06,7.84,
ACEBUTOLOL(SECTRAL)CAP:200MG,32000548,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
BEVACIZUMAB(AVASTIN):100MG/4ML,32000549,CDM,J9035,HCPCS,636,RC,outpatient,,6125.3,6125.3,,5200.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1531.33,22,,percent of total billed charges,,,,,,,,,5512.77,90,,percent of total billed charges,,,5071.75,82.8,,percent of total billed charges,,,5206.51,85,,percent of total billed charges,,,,,,,,,5390.26,88,,percent of total billed charges,,13247.18,,,,fee schedule,,,4679.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13247.18,,,,fee schedule,,,1531.33,22,,percent of total billed charges,,,5574.02,91,,percent of total billed charges,,,5819.04,95,,percent of total billed charges,,,5084,83,,percent of total billed charges,,,5084,83,,percent of total billed charges,,,,,,,,,,,,,,,5084,83,,percent of total billed charges,,,5819.04,95,,percent of total billed charges,,,5512.77,90,,percent of total billed charges,,,5512.77,90,,percent of total billed charges,,,5022.75,82,,percent of total billed charges,,,5512.77,90,,percent of total billed charges,,,5206.51,85,,percent of total billed charges,,1531.33,13247.18,
FULVESTRANT(FASLODEX)SYN: 250MG/5ML,32000550,CDM,J9395,HCPCS,636,RC,outpatient,,1199.93,1199.93,,1018.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,299.98,22,,percent of total billed charges,,,,,,,,,1079.94,90,,percent of total billed charges,,,993.54,82.8,,percent of total billed charges,,,1019.94,85,,percent of total billed charges,,,,,,,,,1055.94,88,,percent of total billed charges,,220.96,,,,fee schedule,,,916.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,220.96,,,,fee schedule,,,299.98,22,,percent of total billed charges,,,1091.94,91,,percent of total billed charges,,,1139.93,95,,percent of total billed charges,,,995.94,83,,percent of total billed charges,,,995.94,83,,percent of total billed charges,,,,,,,,,,,,,,,995.94,83,,percent of total billed charges,,,1139.93,95,,percent of total billed charges,,,1079.94,90,,percent of total billed charges,,,1079.94,90,,percent of total billed charges,,,983.94,82,,percent of total billed charges,,,1079.94,90,,percent of total billed charges,,,1019.94,85,,percent of total billed charges,,220.96,1139.93,
MORPHINE(DURAMORPH)AMP:10MG/10ML,32000552,CDM,J2274,HCPCS,250,RC,outpatient,,126.56,126.56,,107.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.64,22,,percent of total billed charges,,,,,,,,,113.9,90,,percent of total billed charges,,,104.79,82.8,,percent of total billed charges,,,107.58,85,,percent of total billed charges,,,,,,,,,111.37,88,,percent of total billed charges,,11.83,,,,fee schedule,,,96.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11.83,,,,fee schedule,,,31.64,22,,percent of total billed charges,,,115.17,91,,percent of total billed charges,,,120.23,95,,percent of total billed charges,,,105.04,83,,percent of total billed charges,,,105.04,83,,percent of total billed charges,,,,,,,,,,,,,,,105.04,83,,percent of total billed charges,,,120.23,95,,percent of total billed charges,,,113.9,90,,percent of total billed charges,,,113.9,90,,percent of total billed charges,,,103.78,82,,percent of total billed charges,,,113.9,90,,percent of total billed charges,,,107.58,85,,percent of total billed charges,,11.83,120.23,
PAPAIN/UREA (ACCUZYME) OINT 10% (6GM):,32000553,CDM,,,250,RC,outpatient,,182.71,182.71,,155.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.68,22,,percent of total billed charges,,,,,,,,,164.44,90,,percent of total billed charges,,,151.28,82.8,,percent of total billed charges,,,155.3,85,,percent of total billed charges,,,,,,,,,160.78,88,,percent of total billed charges,,,,,,,,,139.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.68,22,,percent of total billed charges,,,166.27,91,,percent of total billed charges,,,173.57,95,,percent of total billed charges,,,151.65,83,,percent of total billed charges,,,151.65,83,,percent of total billed charges,,,,,,,,,,,,,,,151.65,83,,percent of total billed charges,,,173.57,95,,percent of total billed charges,,,164.44,90,,percent of total billed charges,,,164.44,90,,percent of total billed charges,,,149.82,82,,percent of total billed charges,,,164.44,90,,percent of total billed charges,,,155.3,85,,percent of total billed charges,,45.68,173.57,
carBAMazepine(CARBATROL)ER CAPS:100MG,32000554,CDM,,,250,RC,outpatient,,29.5,29.5,,25.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.38,22,,percent of total billed charges,,,,,,,,,26.55,90,,percent of total billed charges,,,24.43,82.8,,percent of total billed charges,,,25.08,85,,percent of total billed charges,,,,,,,,,25.96,88,,percent of total billed charges,,,,,,,,,22.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.38,22,,percent of total billed charges,,,26.85,91,,percent of total billed charges,,,28.03,95,,percent of total billed charges,,,24.49,83,,percent of total billed charges,,,24.49,83,,percent of total billed charges,,,,,,,,,,,,,,,24.49,83,,percent of total billed charges,,,28.03,95,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,24.19,82,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,25.08,85,,percent of total billed charges,,7.38,28.03,
TRIAMCINOLONE(KENALOG) 0.1% CRM:454GM,32000555,CDM,,,250,RC,outpatient,,171.29,171.29,,145.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.82,22,,percent of total billed charges,,,,,,,,,154.16,90,,percent of total billed charges,,,141.83,82.8,,percent of total billed charges,,,145.6,85,,percent of total billed charges,,,,,,,,,150.74,88,,percent of total billed charges,,,,,,,,,130.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.82,22,,percent of total billed charges,,,155.87,91,,percent of total billed charges,,,162.73,95,,percent of total billed charges,,,142.17,83,,percent of total billed charges,,,142.17,83,,percent of total billed charges,,,,,,,,,,,,,,,142.17,83,,percent of total billed charges,,,162.73,95,,percent of total billed charges,,,154.16,90,,percent of total billed charges,,,154.16,90,,percent of total billed charges,,,140.46,82,,percent of total billed charges,,,154.16,90,,percent of total billed charges,,,145.6,85,,percent of total billed charges,,42.82,162.73,
ACETAMINOPHEN ELIX : 160MG/5ML 480ML,32000557,CDM,,,250,RC,outpatient,,49.64,49.64,,42.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.41,22,,percent of total billed charges,,,,,,,,,44.68,90,,percent of total billed charges,,,41.1,82.8,,percent of total billed charges,,,42.19,85,,percent of total billed charges,,,,,,,,,43.68,88,,percent of total billed charges,,,,,,,,,37.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.41,22,,percent of total billed charges,,,45.17,91,,percent of total billed charges,,,47.16,95,,percent of total billed charges,,,41.2,83,,percent of total billed charges,,,41.2,83,,percent of total billed charges,,,,,,,,,,,,,,,41.2,83,,percent of total billed charges,,,47.16,95,,percent of total billed charges,,,44.68,90,,percent of total billed charges,,,44.68,90,,percent of total billed charges,,,40.7,82,,percent of total billed charges,,,44.68,90,,percent of total billed charges,,,42.19,85,,percent of total billed charges,,12.41,47.16,
PREGABALIN(LYRICA)CAPS:50MG,32000558,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
POTASSIUM CITRATE 10 MEQ TABS:,32000559,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
SILDENAFIL CITRATE  TABS 5 MG:,32000560,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ACETAMINOPHEN,32000561,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
LEUCOVORIN CALCIUM VIAL:200MG,32000562,CDM,J0640,HCPCS,636,RC,outpatient,,186.11,186.11,,158.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.53,22,,percent of total billed charges,,,,,,,,,167.5,90,,percent of total billed charges,,,154.1,82.8,,percent of total billed charges,,,158.19,85,,percent of total billed charges,,,,,,,,,163.78,88,,percent of total billed charges,,100.5,,,,fee schedule,,,142.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,100.5,,,,fee schedule,,,46.53,22,,percent of total billed charges,,,169.36,91,,percent of total billed charges,,,176.8,95,,percent of total billed charges,,,154.47,83,,percent of total billed charges,,,154.47,83,,percent of total billed charges,,,,,,,,,,,,,,,154.47,83,,percent of total billed charges,,,176.8,95,,percent of total billed charges,,,167.5,90,,percent of total billed charges,,,167.5,90,,percent of total billed charges,,,152.61,82,,percent of total billed charges,,,167.5,90,,percent of total billed charges,,,158.19,85,,percent of total billed charges,,46.53,176.8,
PALONOSETRON(ALOXI)VL:0.25MG/5ML,32000563,CDM,J2469,HCPCS,636,RC,outpatient,,218.79,218.79,,185.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.7,22,,percent of total billed charges,,,,,,,,,196.91,90,,percent of total billed charges,,,181.16,82.8,,percent of total billed charges,,,185.97,85,,percent of total billed charges,,,,,,,,,192.54,88,,percent of total billed charges,,11.5,,,,fee schedule,,,167.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11.5,,,,fee schedule,,,54.7,22,,percent of total billed charges,,,199.1,91,,percent of total billed charges,,,207.85,95,,percent of total billed charges,,,181.6,83,,percent of total billed charges,,,181.6,83,,percent of total billed charges,,,,,,,,,,,,,,,181.6,83,,percent of total billed charges,,,207.85,95,,percent of total billed charges,,,196.91,90,,percent of total billed charges,,,196.91,90,,percent of total billed charges,,,179.41,82,,percent of total billed charges,,,196.91,90,,percent of total billed charges,,,185.97,85,,percent of total billed charges,,11.5,207.85,
PREGABALIN(LYRICA)CAPS:25MG,32000564,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
PCA EMPTY SYRINGE 30 ML:,32000565,CDM,,,250,RC,outpatient,,0.16,0.16,,0.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.04,22,,percent of total billed charges,,,,,,,,,0.14,90,,percent of total billed charges,,,0.13,82.8,,percent of total billed charges,,,0.14,85,,percent of total billed charges,,,,,,,,,0.14,88,,percent of total billed charges,,,,,,,,,0.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.04,22,,percent of total billed charges,,,0.15,91,,percent of total billed charges,,,0.15,95,,percent of total billed charges,,,0.13,83,,percent of total billed charges,,,0.13,83,,percent of total billed charges,,,,,,,,,,,,,,,0.13,83,,percent of total billed charges,,,0.15,95,,percent of total billed charges,,,0.14,90,,percent of total billed charges,,,0.14,90,,percent of total billed charges,,,0.13,82,,percent of total billed charges,,,0.14,90,,percent of total billed charges,,,0.14,85,,percent of total billed charges,,0.04,0.15,
ACET(TYLENOL) ORAL : 160MG/5ML 118ML,32000567,CDM,,,250,RC,outpatient,,38.06,38.06,,32.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.52,22,,percent of total billed charges,,,,,,,,,34.25,90,,percent of total billed charges,,,31.51,82.8,,percent of total billed charges,,,32.35,85,,percent of total billed charges,,,,,,,,,33.49,88,,percent of total billed charges,,,,,,,,,29.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.52,22,,percent of total billed charges,,,34.63,91,,percent of total billed charges,,,36.16,95,,percent of total billed charges,,,31.59,83,,percent of total billed charges,,,31.59,83,,percent of total billed charges,,,,,,,,,,,,,,,31.59,83,,percent of total billed charges,,,36.16,95,,percent of total billed charges,,,34.25,90,,percent of total billed charges,,,34.25,90,,percent of total billed charges,,,31.21,82,,percent of total billed charges,,,34.25,90,,percent of total billed charges,,,32.35,85,,percent of total billed charges,,9.52,36.16,
ACETAMINOPHEN ELIX : 160MG/5ML 60ML,32000568,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ACETAMINOPHEN ELIX : 160MG/5ML 30ML,32000569,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ACETAMINOPHEN ELIX:480MG/15ML UD-ED,32000570,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ACETAMINOPHEN/COD(TYLENOL#3)TAB:30-300MG,32000571,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
ACETAMINOPHEN/DPHYDRM(MAPAP)TAB:500-25MG,32000572,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ACET/DIPHEN (TYLENOL PM) CAP: 500-25 MG,32000573,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
COD/APAP(TYLENOL+COD)TAB:30-300MG(1X10),32000574,CDM,J8499,HCPCS,250,RC,outpatient,,21.57,21.57,,18.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.39,22,,percent of total billed charges,,,,,,,,,19.41,90,,percent of total billed charges,,,17.86,82.8,,percent of total billed charges,,,18.33,85,,percent of total billed charges,,,,,,,,,18.98,88,,percent of total billed charges,,,,,,,,,16.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.39,22,,percent of total billed charges,,,19.63,91,,percent of total billed charges,,,20.49,95,,percent of total billed charges,,,17.9,83,,percent of total billed charges,,,17.9,83,,percent of total billed charges,,,,,,,,,,,,,,,17.9,83,,percent of total billed charges,,,20.49,95,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,17.69,82,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,18.33,85,,percent of total billed charges,,5.39,20.49,
ACETIC ACID/HYDROCORT(ACETASOL)DROP:2-1%,32000576,CDM,,,250,RC,outpatient,,2835.3,2835.3,,2407.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,708.83,22,,percent of total billed charges,,,,,,,,,2551.77,90,,percent of total billed charges,,,2347.63,82.8,,percent of total billed charges,,,2410.01,85,,percent of total billed charges,,,,,,,,,2495.06,88,,percent of total billed charges,,,,,,,,,2166.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,708.83,22,,percent of total billed charges,,,2580.12,91,,percent of total billed charges,,,2693.54,95,,percent of total billed charges,,,2353.3,83,,percent of total billed charges,,,2353.3,83,,percent of total billed charges,,,,,,,,,,,,,,,2353.3,83,,percent of total billed charges,,,2693.54,95,,percent of total billed charges,,,2551.77,90,,percent of total billed charges,,,2551.77,90,,percent of total billed charges,,,2324.95,82,,percent of total billed charges,,,2551.77,90,,percent of total billed charges,,,2410.01,85,,percent of total billed charges,,708.83,2693.54,
oxyCODONE IR TABS:5MG,32000578,CDM,,,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
INFLUENZA VACCINE 2008-2009 SYR 0.5ML:,32000579,CDM,90658,CPT,636,RC,outpatient,,226.32,226.32,,192.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.58,22,,percent of total billed charges,,,,,,,,,203.69,90,,percent of total billed charges,,,187.39,82.8,,percent of total billed charges,,,192.37,85,,percent of total billed charges,,,,,,,,,199.16,88,,percent of total billed charges,,,,,,,,,172.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.58,22,,percent of total billed charges,,,205.95,91,,percent of total billed charges,,,215,95,,percent of total billed charges,,,187.85,83,,percent of total billed charges,,,187.85,83,,percent of total billed charges,,,,,,,,,,,,,,,187.85,83,,percent of total billed charges,,,215,95,,percent of total billed charges,,,203.69,90,,percent of total billed charges,,,203.69,90,,percent of total billed charges,,,185.58,82,,percent of total billed charges,,,203.69,90,,percent of total billed charges,,,192.37,85,,percent of total billed charges,,56.58,215,
METAXALONE(SKELAXIN)TAB:800 MG,32000580,CDM,J8499,HCPCS,250,RC,outpatient,,170.18,170.18,,144.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.55,22,,percent of total billed charges,,,,,,,,,153.16,90,,percent of total billed charges,,,140.91,82.8,,percent of total billed charges,,,144.65,85,,percent of total billed charges,,,,,,,,,149.76,88,,percent of total billed charges,,,,,,,,,130.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.55,22,,percent of total billed charges,,,154.86,91,,percent of total billed charges,,,161.67,95,,percent of total billed charges,,,141.25,83,,percent of total billed charges,,,141.25,83,,percent of total billed charges,,,,,,,,,,,,,,,141.25,83,,percent of total billed charges,,,161.67,95,,percent of total billed charges,,,153.16,90,,percent of total billed charges,,,153.16,90,,percent of total billed charges,,,139.55,82,,percent of total billed charges,,,153.16,90,,percent of total billed charges,,,144.65,85,,percent of total billed charges,,42.55,161.67,
DEXTROMETHORPHAN(DELSYM):30MG/5ML U/D,32000582,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
HYDROmorphone (DILAUDID) 4MG TABS:,32000583,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
CLINDAMYCIN(CLEOCIN)LIQ 75MG/5ML: 100 ML,32000584,CDM,,,250,RC,outpatient,,510.37,510.37,,433.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.59,22,,percent of total billed charges,,,,,,,,,459.33,90,,percent of total billed charges,,,422.59,82.8,,percent of total billed charges,,,433.81,85,,percent of total billed charges,,,,,,,,,449.13,88,,percent of total billed charges,,,,,,,,,389.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.59,22,,percent of total billed charges,,,464.44,91,,percent of total billed charges,,,484.85,95,,percent of total billed charges,,,423.61,83,,percent of total billed charges,,,423.61,83,,percent of total billed charges,,,,,,,,,,,,,,,423.61,83,,percent of total billed charges,,,484.85,95,,percent of total billed charges,,,459.33,90,,percent of total billed charges,,,459.33,90,,percent of total billed charges,,,418.5,82,,percent of total billed charges,,,459.33,90,,percent of total billed charges,,,433.81,85,,percent of total billed charges,,127.59,484.85,
MORPHINE SULFATE TAB : 100MG (10X10MG),32000587,CDM,,,250,RC,outpatient,,30,30,,25.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.5,22,,percent of total billed charges,,,,,,,,,27,90,,percent of total billed charges,,,24.84,82.8,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,,,,,,,,26.4,88,,percent of total billed charges,,,,,,,,,22.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.5,22,,percent of total billed charges,,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,24.9,83,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,24.6,82,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,7.5,28.5,
TRASTUZUMAB(HERCEPTIN)MDV:440MG-J/10MG,32000588,CDM,J9355,HCPCS,636,RC,outpatient,,1464.42,1464.42,,1243.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,366.11,22,,percent of total billed charges,,,,,,,,,1317.98,90,,percent of total billed charges,,,1212.54,82.8,,percent of total billed charges,,,1244.76,85,,percent of total billed charges,,,,,,,,,1288.69,88,,percent of total billed charges,,8440.1,,,,fee schedule,,,1118.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8440.1,,,,fee schedule,,,366.11,22,,percent of total billed charges,,,1332.62,91,,percent of total billed charges,,,1391.2,95,,percent of total billed charges,,,1215.47,83,,percent of total billed charges,,,1215.47,83,,percent of total billed charges,,,,,,,,,,,,,,,1215.47,83,,percent of total billed charges,,,1391.2,95,,percent of total billed charges,,,1317.98,90,,percent of total billed charges,,,1317.98,90,,percent of total billed charges,,,1200.82,82,,percent of total billed charges,,,1317.98,90,,percent of total billed charges,,,1244.76,85,,percent of total billed charges,,366.11,8440.1,
KETOCONAZOLE(NIZORAL)TABS 200MG:,32000590,CDM,J8499,HCPCS,250,RC,outpatient,,30.77,30.77,,26.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.69,22,,percent of total billed charges,,,,,,,,,27.69,90,,percent of total billed charges,,,25.48,82.8,,percent of total billed charges,,,26.15,85,,percent of total billed charges,,,,,,,,,27.08,88,,percent of total billed charges,,,,,,,,,23.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.69,22,,percent of total billed charges,,,28,91,,percent of total billed charges,,,29.23,95,,percent of total billed charges,,,25.54,83,,percent of total billed charges,,,25.54,83,,percent of total billed charges,,,,,,,,,,,,,,,25.54,83,,percent of total billed charges,,,29.23,95,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,25.23,82,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,26.15,85,,percent of total billed charges,,7.69,29.23,
LIDOCAINE + EPI MPF 2%:20 ML-- ANES**,32000593,CDM,J3490,HCPCS,250,RC,outpatient,,64.71,64.71,,54.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.18,22,,percent of total billed charges,,,,,,,,,58.24,90,,percent of total billed charges,,,53.58,82.8,,percent of total billed charges,,,55,85,,percent of total billed charges,,,,,,,,,56.94,88,,percent of total billed charges,,,,,,,,,49.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.18,22,,percent of total billed charges,,,58.89,91,,percent of total billed charges,,,61.47,95,,percent of total billed charges,,,53.71,83,,percent of total billed charges,,,53.71,83,,percent of total billed charges,,,,,,,,,,,,,,,53.71,83,,percent of total billed charges,,,61.47,95,,percent of total billed charges,,,58.24,90,,percent of total billed charges,,,58.24,90,,percent of total billed charges,,,53.06,82,,percent of total billed charges,,,58.24,90,,percent of total billed charges,,,55,85,,percent of total billed charges,,16.18,61.47,
CALCITRIOL(ROCALTROL)CAPS:0.25MCG,32000594,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ALISKIREN (TEKTURNA)TABS 150 MG:,32000595,CDM,,,250,RC,outpatient,,91.67,91.67,,77.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.92,22,,percent of total billed charges,,,,,,,,,82.5,90,,percent of total billed charges,,,75.9,82.8,,percent of total billed charges,,,77.92,85,,percent of total billed charges,,,,,,,,,80.67,88,,percent of total billed charges,,,,,,,,,70.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.92,22,,percent of total billed charges,,,83.42,91,,percent of total billed charges,,,87.09,95,,percent of total billed charges,,,76.09,83,,percent of total billed charges,,,76.09,83,,percent of total billed charges,,,,,,,,,,,,,,,76.09,83,,percent of total billed charges,,,87.09,95,,percent of total billed charges,,,82.5,90,,percent of total billed charges,,,82.5,90,,percent of total billed charges,,,75.17,82,,percent of total billed charges,,,82.5,90,,percent of total billed charges,,,77.92,85,,percent of total billed charges,,22.92,87.09,
INSUL ASPART(NovoLOG FLEXPEN)300UNIT/3ML,32000597,CDM,J1815,HCPCS,250,RC,outpatient,,794.97,794.97,,674.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,198.74,22,,percent of total billed charges,,,,,,,,,715.47,90,,percent of total billed charges,,,658.24,82.8,,percent of total billed charges,,,675.72,85,,percent of total billed charges,,,,,,,,,699.57,88,,percent of total billed charges,,,,,,,,,607.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,198.74,22,,percent of total billed charges,,,723.42,91,,percent of total billed charges,,,755.22,95,,percent of total billed charges,,,659.83,83,,percent of total billed charges,,,659.83,83,,percent of total billed charges,,,,,,,,,,,,,,,659.83,83,,percent of total billed charges,,,755.22,95,,percent of total billed charges,,,715.47,90,,percent of total billed charges,,,715.47,90,,percent of total billed charges,,,651.88,82,,percent of total billed charges,,,715.47,90,,percent of total billed charges,,,675.72,85,,percent of total billed charges,,198.74,755.22,
MICONAZOLE(FUNGOID) TR 2% 30ML:,32000598,CDM,,,250,RC,outpatient,,288.33,288.33,,244.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.08,22,,percent of total billed charges,,,,,,,,,259.5,90,,percent of total billed charges,,,238.74,82.8,,percent of total billed charges,,,245.08,85,,percent of total billed charges,,,,,,,,,253.73,88,,percent of total billed charges,,,,,,,,,220.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.08,22,,percent of total billed charges,,,262.38,91,,percent of total billed charges,,,273.91,95,,percent of total billed charges,,,239.31,83,,percent of total billed charges,,,239.31,83,,percent of total billed charges,,,,,,,,,,,,,,,239.31,83,,percent of total billed charges,,,273.91,95,,percent of total billed charges,,,259.5,90,,percent of total billed charges,,,259.5,90,,percent of total billed charges,,,236.43,82,,percent of total billed charges,,,259.5,90,,percent of total billed charges,,,245.08,85,,percent of total billed charges,,72.08,273.91,
ALTEPLASE(ACTIVASE):100MG,32000602,CDM,J2997,HCPCS,636,RC,outpatient,,40957.96,40957.96,,34773.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10239.49,22,,percent of total billed charges,,,,,,,,,36862.16,90,,percent of total billed charges,,,33913.19,82.8,,percent of total billed charges,,,34814.27,85,,percent of total billed charges,,,,,,,,,36043,88,,percent of total billed charges,,176.06,,,,fee schedule,,,31291.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,176.06,,,,fee schedule,,,10239.49,22,,percent of total billed charges,,,37271.74,91,,percent of total billed charges,,,38910.06,95,,percent of total billed charges,,,33995.11,83,,percent of total billed charges,,,33995.11,83,,percent of total billed charges,,,,,,,,,,,,,,,33995.11,83,,percent of total billed charges,,,38910.06,95,,percent of total billed charges,,,36862.16,90,,percent of total billed charges,,,36862.16,90,,percent of total billed charges,,,33585.53,82,,percent of total billed charges,,,36862.16,90,,percent of total billed charges,,,34814.27,85,,percent of total billed charges,,176.06,38910.06,
PIOGLITAZONE(ACTOS)TAB:15MG,32000603,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
RISEDRONATE(ACTONEL)TAB: 5MG,32000604,CDM,J8499,HCPCS,250,RC,outpatient,,40.44,40.44,,34.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.11,22,,percent of total billed charges,,,,,,,,,36.4,90,,percent of total billed charges,,,33.48,82.8,,percent of total billed charges,,,34.37,85,,percent of total billed charges,,,,,,,,,35.59,88,,percent of total billed charges,,,,,,,,,30.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.11,22,,percent of total billed charges,,,36.8,91,,percent of total billed charges,,,38.42,95,,percent of total billed charges,,,33.57,83,,percent of total billed charges,,,33.57,83,,percent of total billed charges,,,,,,,,,,,,,,,33.57,83,,percent of total billed charges,,,38.42,95,,percent of total billed charges,,,36.4,90,,percent of total billed charges,,,36.4,90,,percent of total billed charges,,,33.16,82,,percent of total billed charges,,,36.4,90,,percent of total billed charges,,,34.37,85,,percent of total billed charges,,10.11,38.42,
PEN G POTAS(PFIZERPEN)VIAL: 24 MIL UNITS,32000605,CDM,,,250,RC,outpatient,,611.4,611.4,,519.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,152.85,22,,percent of total billed charges,,,,,,,,,550.26,90,,percent of total billed charges,,,506.24,82.8,,percent of total billed charges,,,519.69,85,,percent of total billed charges,,,,,,,,,538.03,88,,percent of total billed charges,,,,,,,,,467.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,152.85,22,,percent of total billed charges,,,556.37,91,,percent of total billed charges,,,580.83,95,,percent of total billed charges,,,507.46,83,,percent of total billed charges,,,507.46,83,,percent of total billed charges,,,,,,,,,,,,,,,507.46,83,,percent of total billed charges,,,580.83,95,,percent of total billed charges,,,550.26,90,,percent of total billed charges,,,550.26,90,,percent of total billed charges,,,501.35,82,,percent of total billed charges,,,550.26,90,,percent of total billed charges,,,519.69,85,,percent of total billed charges,,152.85,580.83,
KETOROLAC TROMETHAMINE(ACULAR)DROP:0.50%,32000606,CDM,,,250,RC,outpatient,,2116.94,2116.94,,1797.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,529.24,22,,percent of total billed charges,,,,,,,,,1905.25,90,,percent of total billed charges,,,1752.83,82.8,,percent of total billed charges,,,1799.4,85,,percent of total billed charges,,,,,,,,,1862.91,88,,percent of total billed charges,,,,,,,,,1617.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,529.24,22,,percent of total billed charges,,,1926.42,91,,percent of total billed charges,,,2011.09,95,,percent of total billed charges,,,1757.06,83,,percent of total billed charges,,,1757.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1757.06,83,,percent of total billed charges,,,2011.09,95,,percent of total billed charges,,,1905.25,90,,percent of total billed charges,,,1905.25,90,,percent of total billed charges,,,1735.89,82,,percent of total billed charges,,,1905.25,90,,percent of total billed charges,,,1799.4,85,,percent of total billed charges,,529.24,2011.09,
PENICILLIN G POTAS VIAL:1 MIL UNITS,32000607,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
POLYETHYLENE GLYCOL(MIRALAX)PWD:119GM,32000609,CDM,J8499,HCPCS,250,RC,outpatient,,116.34,116.34,,98.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.09,22,,percent of total billed charges,,,,,,,,,104.71,90,,percent of total billed charges,,,96.33,82.8,,percent of total billed charges,,,98.89,85,,percent of total billed charges,,,,,,,,,102.38,88,,percent of total billed charges,,,,,,,,,88.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.09,22,,percent of total billed charges,,,105.87,91,,percent of total billed charges,,,110.52,95,,percent of total billed charges,,,96.56,83,,percent of total billed charges,,,96.56,83,,percent of total billed charges,,,,,,,,,,,,,,,96.56,83,,percent of total billed charges,,,110.52,95,,percent of total billed charges,,,104.71,90,,percent of total billed charges,,,104.71,90,,percent of total billed charges,,,95.4,82,,percent of total billed charges,,,104.71,90,,percent of total billed charges,,,98.89,85,,percent of total billed charges,,29.09,110.52,
RABIES VACCINE(RABAVERT):2.5UNITS,32000610,CDM,90675,CPT,250,RC,outpatient,,2955.83,2955.83,,2509.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,738.96,22,,percent of total billed charges,,,,,,,,,2660.25,90,,percent of total billed charges,,,2447.43,82.8,,percent of total billed charges,,,2512.46,85,,percent of total billed charges,,,,,,,,,2601.13,88,,percent of total billed charges,,,,,,,,,2258.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,738.96,22,,percent of total billed charges,,,2689.81,91,,percent of total billed charges,,,2808.04,95,,percent of total billed charges,,,2453.34,83,,percent of total billed charges,,,2453.34,83,,percent of total billed charges,,,,,,,,,,,,,,,2453.34,83,,percent of total billed charges,,,2808.04,95,,percent of total billed charges,,,2660.25,90,,percent of total billed charges,,,2660.25,90,,percent of total billed charges,,,2423.78,82,,percent of total billed charges,,,2660.25,90,,percent of total billed charges,,,2512.46,85,,percent of total billed charges,,738.96,2808.04,
NIFEdipine(PROCARDIA)CAP:10MG,32000611,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
RABIES I.G.(HyperRAB):300IntUnits/2ML,32000612,CDM,90375,CPT,250,RC,outpatient,,4943.85,4943.85,,4197.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1235.96,22,,percent of total billed charges,,,,,,,,,4449.47,90,,percent of total billed charges,,,4093.51,82.8,,percent of total billed charges,,,4202.27,85,,percent of total billed charges,,,,,,,,,4350.59,88,,percent of total billed charges,,,,,,,,,3777.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1235.96,22,,percent of total billed charges,,,4498.9,91,,percent of total billed charges,,,4696.66,95,,percent of total billed charges,,,4103.4,83,,percent of total billed charges,,,4103.4,83,,percent of total billed charges,,,,,,,,,,,,,,,4103.4,83,,percent of total billed charges,,,4696.66,95,,percent of total billed charges,,,4449.47,90,,percent of total billed charges,,,4449.47,90,,percent of total billed charges,,,4053.96,82,,percent of total billed charges,,,4449.47,90,,percent of total billed charges,,,4202.27,85,,percent of total billed charges,,1235.96,4696.66,
WARFARIN(COUMADIN)TAB: 6MG,32000613,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
guaiFENesin/COD (ROBITUSS AC)5ML UD PX,32000614,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
MIDAZOLAM(VERSED)VIAL:2MG/2ML,32000615,CDM,J2250,HCPCS,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,7.08,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.08,,,,fee schedule,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,7.08,64.15,
METHYLENE BLUE 1% AMP:1ML,32000617,CDM,J3490,HCPCS,250,RC,outpatient,,298.01,298.01,,253.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.5,22,,percent of total billed charges,,,,,,,,,268.21,90,,percent of total billed charges,,,246.75,82.8,,percent of total billed charges,,,253.31,85,,percent of total billed charges,,,,,,,,,262.25,88,,percent of total billed charges,,,,,,,,,227.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.5,22,,percent of total billed charges,,,271.19,91,,percent of total billed charges,,,283.11,95,,percent of total billed charges,,,247.35,83,,percent of total billed charges,,,247.35,83,,percent of total billed charges,,,,,,,,,,,,,,,247.35,83,,percent of total billed charges,,,283.11,95,,percent of total billed charges,,,268.21,90,,percent of total billed charges,,,268.21,90,,percent of total billed charges,,,244.37,82,,percent of total billed charges,,,268.21,90,,percent of total billed charges,,,253.31,85,,percent of total billed charges,,74.5,283.11,
DEFEROXAMINE (DESFERAL) 2GM: PER 500MG,32000618,CDM,J0895,HCPCS,636,RC,outpatient,,1778.52,1778.52,,1509.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,444.63,22,,percent of total billed charges,,,,,,,,,1600.67,90,,percent of total billed charges,,,1472.61,82.8,,percent of total billed charges,,,1511.74,85,,percent of total billed charges,,,,,,,,,1565.1,88,,percent of total billed charges,,31.71,,,,fee schedule,,,1358.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,31.71,,,,fee schedule,,,444.63,22,,percent of total billed charges,,,1618.45,91,,percent of total billed charges,,,1689.59,95,,percent of total billed charges,,,1476.17,83,,percent of total billed charges,,,1476.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1476.17,83,,percent of total billed charges,,,1689.59,95,,percent of total billed charges,,,1600.67,90,,percent of total billed charges,,,1600.67,90,,percent of total billed charges,,,1458.39,82,,percent of total billed charges,,,1600.67,90,,percent of total billed charges,,,1511.74,85,,percent of total billed charges,,31.71,1689.59,
PROMETRIUM CAPS 100 MG,32000619,CDM,,,250,RC,outpatient,,55.99,55.99,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14,22,,percent of total billed charges,,,,,,,,,50.39,90,,percent of total billed charges,,,46.36,82.8,,percent of total billed charges,,,47.59,85,,percent of total billed charges,,,,,,,,,49.27,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14,22,,percent of total billed charges,,,50.95,91,,percent of total billed charges,,,53.19,95,,percent of total billed charges,,,46.47,83,,percent of total billed charges,,,46.47,83,,percent of total billed charges,,,,,,,,,,,,,,,46.47,83,,percent of total billed charges,,,53.19,95,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,45.91,82,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,47.59,85,,percent of total billed charges,,14,53.19,
risperiDONE(risperDAL)TAB:2MG,32000620,CDM,J8499,HCPCS,250,RC,outpatient,,20.19,20.19,,17.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.05,22,,percent of total billed charges,,,,,,,,,18.17,90,,percent of total billed charges,,,16.72,82.8,,percent of total billed charges,,,17.16,85,,percent of total billed charges,,,,,,,,,17.77,88,,percent of total billed charges,,,,,,,,,15.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.05,22,,percent of total billed charges,,,18.37,91,,percent of total billed charges,,,19.18,95,,percent of total billed charges,,,16.76,83,,percent of total billed charges,,,16.76,83,,percent of total billed charges,,,,,,,,,,,,,,,16.76,83,,percent of total billed charges,,,19.18,95,,percent of total billed charges,,,18.17,90,,percent of total billed charges,,,18.17,90,,percent of total billed charges,,,16.56,82,,percent of total billed charges,,,18.17,90,,percent of total billed charges,,,17.16,85,,percent of total billed charges,,5.05,19.18,
ADALAT CC,32000621,CDM,,,250,RC,outpatient,,21.73,21.73,,18.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.43,22,,percent of total billed charges,,,,,,,,,19.56,90,,percent of total billed charges,,,17.99,82.8,,percent of total billed charges,,,18.47,85,,percent of total billed charges,,,,,,,,,19.12,88,,percent of total billed charges,,,,,,,,,16.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.43,22,,percent of total billed charges,,,19.77,91,,percent of total billed charges,,,20.64,95,,percent of total billed charges,,,18.04,83,,percent of total billed charges,,,18.04,83,,percent of total billed charges,,,,,,,,,,,,,,,18.04,83,,percent of total billed charges,,,20.64,95,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,17.82,82,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,18.47,85,,percent of total billed charges,,5.43,20.64,
ZOLEDRONIC(RECLAST):5MG/100ML,32000622,CDM,J3489,HCPCS,636,RC,outpatient,,930.46,930.46,,789.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,232.62,22,,percent of total billed charges,,,,,,,,,837.41,90,,percent of total billed charges,,,770.42,82.8,,percent of total billed charges,,,790.89,85,,percent of total billed charges,,,,,,,,,818.8,88,,percent of total billed charges,,41.84,,,,fee schedule,,,710.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,41.84,,,,fee schedule,,,232.62,22,,percent of total billed charges,,,846.72,91,,percent of total billed charges,,,883.94,95,,percent of total billed charges,,,772.28,83,,percent of total billed charges,,,772.28,83,,percent of total billed charges,,,,,,,,,,,,,,,772.28,83,,percent of total billed charges,,,883.94,95,,percent of total billed charges,,,837.41,90,,percent of total billed charges,,,837.41,90,,percent of total billed charges,,,762.98,82,,percent of total billed charges,,,837.41,90,,percent of total billed charges,,,790.89,85,,percent of total billed charges,,41.84,883.94,
BUPIVACAINE(SENSORCAINE-MPF)0.75%:30ML,32000624,CDM,,,250,RC,outpatient,,90.88,90.88,,77.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.72,22,,percent of total billed charges,,,,,,,,,81.79,90,,percent of total billed charges,,,75.25,82.8,,percent of total billed charges,,,77.25,85,,percent of total billed charges,,,,,,,,,79.97,88,,percent of total billed charges,,,,,,,,,69.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.72,22,,percent of total billed charges,,,82.7,91,,percent of total billed charges,,,86.34,95,,percent of total billed charges,,,75.43,83,,percent of total billed charges,,,75.43,83,,percent of total billed charges,,,,,,,,,,,,,,,75.43,83,,percent of total billed charges,,,86.34,95,,percent of total billed charges,,,81.79,90,,percent of total billed charges,,,81.79,90,,percent of total billed charges,,,74.52,82,,percent of total billed charges,,,81.79,90,,percent of total billed charges,,,77.25,85,,percent of total billed charges,,22.72,86.34,
DARBEPOETIN(ARANESP)SYR:200MCG/0.4ML,32000625,CDM,J0881,HCPCS,636,RC,outpatient,,7314.3,7314.3,,6209.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1828.58,22,,percent of total billed charges,,,,,,,,,6582.87,90,,percent of total billed charges,,,6056.24,82.8,,percent of total billed charges,,,6217.16,85,,percent of total billed charges,,,,,,,,,6436.58,88,,percent of total billed charges,,1579.5,,,,fee schedule,,,5588.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1579.5,,,,fee schedule,,,1828.58,22,,percent of total billed charges,,,6656.01,91,,percent of total billed charges,,,6948.59,95,,percent of total billed charges,,,6070.87,83,,percent of total billed charges,,,6070.87,83,,percent of total billed charges,,,,,,,,,,,,,,,6070.87,83,,percent of total billed charges,,,6948.59,95,,percent of total billed charges,,,6582.87,90,,percent of total billed charges,,,6582.87,90,,percent of total billed charges,,,5997.73,82,,percent of total billed charges,,,6582.87,90,,percent of total billed charges,,,6217.16,85,,percent of total billed charges,,1579.5,6948.59,
HEParin LOCK CPJT:100UNITS/ML,32000627,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
ROPIVACAINE(NAROPIN)BTL 0.2%:200ML,32000628,CDM,J2795,HCPCS,250,RC,outpatient,,1163.81,1163.81,,988.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,290.95,22,,percent of total billed charges,,,,,,,,,1047.43,90,,percent of total billed charges,,,963.63,82.8,,percent of total billed charges,,,989.24,85,,percent of total billed charges,,,,,,,,,1024.15,88,,percent of total billed charges,,13.8,,,,fee schedule,,,889.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.8,,,,fee schedule,,,290.95,22,,percent of total billed charges,,,1059.07,91,,percent of total billed charges,,,1105.62,95,,percent of total billed charges,,,965.96,83,,percent of total billed charges,,,965.96,83,,percent of total billed charges,,,,,,,,,,,,,,,965.96,83,,percent of total billed charges,,,1105.62,95,,percent of total billed charges,,,1047.43,90,,percent of total billed charges,,,1047.43,90,,percent of total billed charges,,,954.32,82,,percent of total billed charges,,,1047.43,90,,percent of total billed charges,,,989.24,85,,percent of total billed charges,,13.8,1105.62,
HEP B IG (HYPERHEP B) SYR 0.5 ML:NEONATE,32000629,CDM,90371,CPT,250,RC,outpatient,,1089.58,1089.58,,925.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,272.4,22,,percent of total billed charges,,,,,,,,,980.62,90,,percent of total billed charges,,,902.17,82.8,,percent of total billed charges,,,926.14,85,,percent of total billed charges,,,,,,,,,958.83,88,,percent of total billed charges,,,,,,,,,832.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,272.4,22,,percent of total billed charges,,,991.52,91,,percent of total billed charges,,,1035.1,95,,percent of total billed charges,,,904.35,83,,percent of total billed charges,,,904.35,83,,percent of total billed charges,,,,,,,,,,,,,,,904.35,83,,percent of total billed charges,,,1035.1,95,,percent of total billed charges,,,980.62,90,,percent of total billed charges,,,980.62,90,,percent of total billed charges,,,893.46,82,,percent of total billed charges,,,980.62,90,,percent of total billed charges,,,926.14,85,,percent of total billed charges,,272.4,1035.1,
LINEZOLID(ZYVOX) TABS 600 MG:,32000630,CDM,,,250,RC,outpatient,,38.89,38.89,,33.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.72,22,,percent of total billed charges,,,,,,,,,35,90,,percent of total billed charges,,,32.2,82.8,,percent of total billed charges,,,33.06,85,,percent of total billed charges,,,,,,,,,34.22,88,,percent of total billed charges,,,,,,,,,29.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.72,22,,percent of total billed charges,,,35.39,91,,percent of total billed charges,,,36.95,95,,percent of total billed charges,,,32.28,83,,percent of total billed charges,,,32.28,83,,percent of total billed charges,,,,,,,,,,,,,,,32.28,83,,percent of total billed charges,,,36.95,95,,percent of total billed charges,,,35,90,,percent of total billed charges,,,35,90,,percent of total billed charges,,,31.89,82,,percent of total billed charges,,,35,90,,percent of total billed charges,,,33.06,85,,percent of total billed charges,,9.72,36.95,
FOMEPIZOLE (ANTIZOL):1.5GM/1.5ML -J/15MG,32000632,CDM,J1451,HCPCS,250,RC,outpatient,,6197.99,6197.99,,5262.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1549.5,22,,percent of total billed charges,,,,,,,,,5578.19,90,,percent of total billed charges,,,5131.94,82.8,,percent of total billed charges,,,5268.29,85,,percent of total billed charges,,,,,,,,,5454.23,88,,percent of total billed charges,,813.45,,,,fee schedule,,,4735.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,813.45,,,,fee schedule,,,1549.5,22,,percent of total billed charges,,,5640.17,91,,percent of total billed charges,,,5888.09,95,,percent of total billed charges,,,5144.33,83,,percent of total billed charges,,,5144.33,83,,percent of total billed charges,,,,,,,,,,,,,,,5144.33,83,,percent of total billed charges,,,5888.09,95,,percent of total billed charges,,,5578.19,90,,percent of total billed charges,,,5578.19,90,,percent of total billed charges,,,5082.35,82,,percent of total billed charges,,,5578.19,90,,percent of total billed charges,,,5268.29,85,,percent of total billed charges,,813.45,5888.09,
oxyCODONE/ACETAMN(PERCOCET) 10/325MG:,32000633,CDM,,,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
HYDROmorphone (DILAUDID)TABS:2MG,32000634,CDM,,,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
HYDROmorphone (DILAUDID) SYR:2MG/ML,32000635,CDM,J1170,HCPCS,250,RC,outpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.42,22,,percent of total billed charges,,,,,,,,,59.09,90,,percent of total billed charges,,,54.37,82.8,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,,,,,,,,57.78,88,,percent of total billed charges,,3.47,,,,fee schedule,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.47,,,,fee schedule,,,16.42,22,,percent of total billed charges,,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,3.47,62.38,
ADENOSINE(ADENOCARD)VL:6MG/2ML,32000636,CDM,J0153,HCPCS,636,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,52.44,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,52.44,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
ETODOLAC(LODINE)TAB:500MG,32000637,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
DARBEPOETIN(ARANESP):500MCG SYR  J/1MCG,32000638,CDM,J0881,HCPCS,636,RC,outpatient,,18285.75,18285.75,,15524.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4571.44,22,,percent of total billed charges,,,,,,,,,16457.18,90,,percent of total billed charges,,,15140.6,82.8,,percent of total billed charges,,,15542.89,85,,percent of total billed charges,,,,,,,,,16091.46,88,,percent of total billed charges,,1579.5,,,,fee schedule,,,13970.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1579.5,,,,fee schedule,,,4571.44,22,,percent of total billed charges,,,16640.03,91,,percent of total billed charges,,,17371.46,95,,percent of total billed charges,,,15177.17,83,,percent of total billed charges,,,15177.17,83,,percent of total billed charges,,,,,,,,,,,,,,,15177.17,83,,percent of total billed charges,,,17371.46,95,,percent of total billed charges,,,16457.18,90,,percent of total billed charges,,,16457.18,90,,percent of total billed charges,,,14994.32,82,,percent of total billed charges,,,16457.18,90,,percent of total billed charges,,,15542.89,85,,percent of total billed charges,,1579.5,17371.46,
levETIRAcetam(KEPPRA)VIAL:500MG/5ML,32000639,CDM,J1953,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,15,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,15,60.99,
"POLYMYXIN B 500,000 UNITS/VIAL:",32000640,CDM,,,250,RC,outpatient,,187.31,187.31,,159.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.83,22,,percent of total billed charges,,,,,,,,,168.58,90,,percent of total billed charges,,,155.09,82.8,,percent of total billed charges,,,159.21,85,,percent of total billed charges,,,,,,,,,164.83,88,,percent of total billed charges,,,,,,,,,143.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.83,22,,percent of total billed charges,,,170.45,91,,percent of total billed charges,,,177.94,95,,percent of total billed charges,,,155.47,83,,percent of total billed charges,,,155.47,83,,percent of total billed charges,,,,,,,,,,,,,,,155.47,83,,percent of total billed charges,,,177.94,95,,percent of total billed charges,,,168.58,90,,percent of total billed charges,,,168.58,90,,percent of total billed charges,,,153.59,82,,percent of total billed charges,,,168.58,90,,percent of total billed charges,,,159.21,85,,percent of total billed charges,,46.83,177.94,
SPIRONOLACTONE(ALDACTONE)TAB:100MG,32000642,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
MITOMYCIN IV VIAL: 5 MG,32000643,CDM,J9280,HCPCS,636,RC,outpatient,,1869.38,1869.38,,1587.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,467.35,22,,percent of total billed charges,,,,,,,,,1682.44,90,,percent of total billed charges,,,1547.85,82.8,,percent of total billed charges,,,1588.97,85,,percent of total billed charges,,,,,,,,,1645.05,88,,percent of total billed charges,,542.94,,,,fee schedule,,,1428.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,542.94,,,,fee schedule,,,467.35,22,,percent of total billed charges,,,1701.14,91,,percent of total billed charges,,,1775.91,95,,percent of total billed charges,,,1551.59,83,,percent of total billed charges,,,1551.59,83,,percent of total billed charges,,,,,,,,,,,,,,,1551.59,83,,percent of total billed charges,,,1775.91,95,,percent of total billed charges,,,1682.44,90,,percent of total billed charges,,,1682.44,90,,percent of total billed charges,,,1532.89,82,,percent of total billed charges,,,1682.44,90,,percent of total billed charges,,,1588.97,85,,percent of total billed charges,,467.35,1775.91,
CASPOFUNGIN(CANCISAS)VL 50MG:J/5MG,32000644,CDM,J0637,HCPCS,636,RC,outpatient,,562.4,562.4,,477.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,140.6,22,,percent of total billed charges,,,,,,,,,506.16,90,,percent of total billed charges,,,465.67,82.8,,percent of total billed charges,,,478.04,85,,percent of total billed charges,,,,,,,,,494.91,88,,percent of total billed charges,,117.87,,,,fee schedule,,,429.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,117.87,,,,fee schedule,,,140.6,22,,percent of total billed charges,,,511.78,91,,percent of total billed charges,,,534.28,95,,percent of total billed charges,,,466.79,83,,percent of total billed charges,,,466.79,83,,percent of total billed charges,,,,,,,,,,,,,,,466.79,83,,percent of total billed charges,,,534.28,95,,percent of total billed charges,,,506.16,90,,percent of total billed charges,,,506.16,90,,percent of total billed charges,,,461.17,82,,percent of total billed charges,,,506.16,90,,percent of total billed charges,,,478.04,85,,percent of total billed charges,,117.87,534.28,
ERTAPENEM(INVanz)VIAL:1GM,32000645,CDM,J1335,HCPCS,250,RC,outpatient,,583.83,583.83,,495.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,145.96,22,,percent of total billed charges,,,,,,,,,525.45,90,,percent of total billed charges,,,483.41,82.8,,percent of total billed charges,,,496.26,85,,percent of total billed charges,,,,,,,,,513.77,88,,percent of total billed charges,,30.48,,,,fee schedule,,,446.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,30.48,,,,fee schedule,,,145.96,22,,percent of total billed charges,,,531.29,91,,percent of total billed charges,,,554.64,95,,percent of total billed charges,,,484.58,83,,percent of total billed charges,,,484.58,83,,percent of total billed charges,,,,,,,,,,,,,,,484.58,83,,percent of total billed charges,,,554.64,95,,percent of total billed charges,,,525.45,90,,percent of total billed charges,,,525.45,90,,percent of total billed charges,,,478.74,82,,percent of total billed charges,,,525.45,90,,percent of total billed charges,,,496.26,85,,percent of total billed charges,,30.48,554.64,
EPINEPHrine NASAL(ADREN SOL):30MG/30ML,32000646,CDM,,,250,RC,outpatient,,2897.53,2897.53,,2460,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,724.38,22,,percent of total billed charges,,,,,,,,,2607.78,90,,percent of total billed charges,,,2399.15,82.8,,percent of total billed charges,,,2462.9,85,,percent of total billed charges,,,,,,,,,2549.83,88,,percent of total billed charges,,,,,,,,,2213.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,724.38,22,,percent of total billed charges,,,2636.75,91,,percent of total billed charges,,,2752.65,95,,percent of total billed charges,,,2404.95,83,,percent of total billed charges,,,2404.95,83,,percent of total billed charges,,,,,,,,,,,,,,,2404.95,83,,percent of total billed charges,,,2752.65,95,,percent of total billed charges,,,2607.78,90,,percent of total billed charges,,,2607.78,90,,percent of total billed charges,,,2375.97,82,,percent of total billed charges,,,2607.78,90,,percent of total billed charges,,,2462.9,85,,percent of total billed charges,,724.38,2752.65,
DESOGESTREL-ETHINYL ESTRADIO(APRI) TABS:,32000647,CDM,,,250,RC,outpatient,,178.58,178.58,,151.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.65,22,,percent of total billed charges,,,,,,,,,160.72,90,,percent of total billed charges,,,147.86,82.8,,percent of total billed charges,,,151.79,85,,percent of total billed charges,,,,,,,,,157.15,88,,percent of total billed charges,,,,,,,,,136.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.65,22,,percent of total billed charges,,,162.51,91,,percent of total billed charges,,,169.65,95,,percent of total billed charges,,,148.22,83,,percent of total billed charges,,,148.22,83,,percent of total billed charges,,,,,,,,,,,,,,,148.22,83,,percent of total billed charges,,,169.65,95,,percent of total billed charges,,,160.72,90,,percent of total billed charges,,,160.72,90,,percent of total billed charges,,,146.44,82,,percent of total billed charges,,,160.72,90,,percent of total billed charges,,,151.79,85,,percent of total billed charges,,44.65,169.65,
MORPHINE SULF TAB IR:15MG,32000648,CDM,,,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
MORPHINE (ORAL)SOL UD:10MG/5ML,32000649,CDM,,,250,RC,outpatient,,20.1,20.1,,17.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.03,22,,percent of total billed charges,,,,,,,,,18.09,90,,percent of total billed charges,,,16.64,82.8,,percent of total billed charges,,,17.09,85,,percent of total billed charges,,,,,,,,,17.69,88,,percent of total billed charges,,,,,,,,,15.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.03,22,,percent of total billed charges,,,18.29,91,,percent of total billed charges,,,19.1,95,,percent of total billed charges,,,16.68,83,,percent of total billed charges,,,16.68,83,,percent of total billed charges,,,,,,,,,,,,,,,16.68,83,,percent of total billed charges,,,19.1,95,,percent of total billed charges,,,18.09,90,,percent of total billed charges,,,18.09,90,,percent of total billed charges,,,16.48,82,,percent of total billed charges,,,18.09,90,,percent of total billed charges,,,17.09,85,,percent of total billed charges,,5.03,19.1,
THROMBIN/GELATIN FOAM HEMOSTAT:,32000650,CDM,,,250,RC,outpatient,,755.6,755.6,,641.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,188.9,22,,percent of total billed charges,,,,,,,,,680.04,90,,percent of total billed charges,,,625.64,82.8,,percent of total billed charges,,,642.26,85,,percent of total billed charges,,,,,,,,,664.93,88,,percent of total billed charges,,,,,,,,,577.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,188.9,22,,percent of total billed charges,,,687.6,91,,percent of total billed charges,,,717.82,95,,percent of total billed charges,,,627.15,83,,percent of total billed charges,,,627.15,83,,percent of total billed charges,,,,,,,,,,,,,,,627.15,83,,percent of total billed charges,,,717.82,95,,percent of total billed charges,,,680.04,90,,percent of total billed charges,,,680.04,90,,percent of total billed charges,,,619.59,82,,percent of total billed charges,,,680.04,90,,percent of total billed charges,,,642.26,85,,percent of total billed charges,,188.9,717.82,
EPINEPHrine VIAL:30MG/30ML,32000651,CDM,J0171,HCPCS,250,RC,outpatient,,1953.99,1953.99,,1658.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,488.5,22,,percent of total billed charges,,,,,,,,,1758.59,90,,percent of total billed charges,,,1617.9,82.8,,percent of total billed charges,,,1660.89,85,,percent of total billed charges,,,,,,,,,1719.51,88,,percent of total billed charges,,7.28,,,,fee schedule,,,1492.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.28,,,,fee schedule,,,488.5,22,,percent of total billed charges,,,1778.13,91,,percent of total billed charges,,,1856.29,95,,percent of total billed charges,,,1621.81,83,,percent of total billed charges,,,1621.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1621.81,83,,percent of total billed charges,,,1856.29,95,,percent of total billed charges,,,1758.59,90,,percent of total billed charges,,,1758.59,90,,percent of total billed charges,,,1602.27,82,,percent of total billed charges,,,1758.59,90,,percent of total billed charges,,,1660.89,85,,percent of total billed charges,,7.28,1856.29,
LACTOBACILLUS RHAMNOSUS(CULTURELLE) CAP,32000652,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
BUDESONIDE (ENTOCORT) CAPS 3 MG:,32000653,CDM,,,250,RC,outpatient,,34.75,34.75,,29.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.69,22,,percent of total billed charges,,,,,,,,,31.28,90,,percent of total billed charges,,,28.77,82.8,,percent of total billed charges,,,29.54,85,,percent of total billed charges,,,,,,,,,30.58,88,,percent of total billed charges,,,,,,,,,26.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.69,22,,percent of total billed charges,,,31.62,91,,percent of total billed charges,,,33.01,95,,percent of total billed charges,,,28.84,83,,percent of total billed charges,,,28.84,83,,percent of total billed charges,,,,,,,,,,,,,,,28.84,83,,percent of total billed charges,,,33.01,95,,percent of total billed charges,,,31.28,90,,percent of total billed charges,,,31.28,90,,percent of total billed charges,,,28.5,82,,percent of total billed charges,,,31.28,90,,percent of total billed charges,,,29.54,85,,percent of total billed charges,,8.69,33.01,
RABIES I.G.(HYPERRAB S/D)VIAL:10ML,32000654,CDM,90375,CPT,250,RC,outpatient,,15839.1,15839.1,,13447.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3959.78,22,,percent of total billed charges,,,,,,,,,14255.19,90,,percent of total billed charges,,,13114.77,82.8,,percent of total billed charges,,,13463.24,85,,percent of total billed charges,,,,,,,,,13938.41,88,,percent of total billed charges,,,,,,,,,12101.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3959.78,22,,percent of total billed charges,,,14413.58,91,,percent of total billed charges,,,15047.15,95,,percent of total billed charges,,,13146.45,83,,percent of total billed charges,,,13146.45,83,,percent of total billed charges,,,,,,,,,,,,,,,13146.45,83,,percent of total billed charges,,,15047.15,95,,percent of total billed charges,,,14255.19,90,,percent of total billed charges,,,14255.19,90,,percent of total billed charges,,,12988.06,82,,percent of total billed charges,,,14255.19,90,,percent of total billed charges,,,13463.24,85,,percent of total billed charges,,3959.78,15047.15,
ALBUTEROL(VENTOLIN)HFA M.D.I.: (6.7GM),32000655,CDM,J7620,HCPCS,250,RC,outpatient,,389.87,389.87,,331,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.47,22,,percent of total billed charges,,,,,,,,,350.88,90,,percent of total billed charges,,,322.81,82.8,,percent of total billed charges,,,331.39,85,,percent of total billed charges,,,,,,,,,343.09,88,,percent of total billed charges,,0.13,,,,fee schedule,,,297.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.13,,,,fee schedule,,,97.47,22,,percent of total billed charges,,,354.78,91,,percent of total billed charges,,,370.38,95,,percent of total billed charges,,,323.59,83,,percent of total billed charges,,,323.59,83,,percent of total billed charges,,,,,,,,,,,,,,,323.59,83,,percent of total billed charges,,,370.38,95,,percent of total billed charges,,,350.88,90,,percent of total billed charges,,,350.88,90,,percent of total billed charges,,,319.69,82,,percent of total billed charges,,,350.88,90,,percent of total billed charges,,,331.39,85,,percent of total billed charges,,0.13,370.38,
TEMSIROLIMUS(TORISEL)25MG/ML:J/1MG,32000657,CDM,J9330,HCPCS,636,RC,outpatient,,1003.83,1003.83,,852.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,250.96,22,,percent of total billed charges,,,,,,,,,903.45,90,,percent of total billed charges,,,831.17,82.8,,percent of total billed charges,,,853.26,85,,percent of total billed charges,,,,,,,,,883.37,88,,percent of total billed charges,,797,,,,fee schedule,,,766.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,797,,,,fee schedule,,,250.96,22,,percent of total billed charges,,,913.49,91,,percent of total billed charges,,,953.64,95,,percent of total billed charges,,,833.18,83,,percent of total billed charges,,,833.18,83,,percent of total billed charges,,,,,,,,,,,,,,,833.18,83,,percent of total billed charges,,,953.64,95,,percent of total billed charges,,,903.45,90,,percent of total billed charges,,,903.45,90,,percent of total billed charges,,,823.14,82,,percent of total billed charges,,,903.45,90,,percent of total billed charges,,,853.26,85,,percent of total billed charges,,250.96,953.64,
FLUTICA/SALMET(ADVAIR DISK):100-50,32000658,CDM,J7699,HCPCS,250,RC,outpatient,,1341.1,1341.1,,1138.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,335.28,22,,percent of total billed charges,,,,,,,,,1206.99,90,,percent of total billed charges,,,1110.43,82.8,,percent of total billed charges,,,1139.94,85,,percent of total billed charges,,,,,,,,,1180.17,88,,percent of total billed charges,,,,,,,,,1024.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,335.28,22,,percent of total billed charges,,,1220.4,91,,percent of total billed charges,,,1274.05,95,,percent of total billed charges,,,1113.11,83,,percent of total billed charges,,,1113.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1113.11,83,,percent of total billed charges,,,1274.05,95,,percent of total billed charges,,,1206.99,90,,percent of total billed charges,,,1206.99,90,,percent of total billed charges,,,1099.7,82,,percent of total billed charges,,,1206.99,90,,percent of total billed charges,,,1139.94,85,,percent of total billed charges,,335.28,1274.05,
Warfarin(COUMadin)Tab:  0.5MG,32000659,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DOXORUBICIN(ADRIAMYCIN):10MG/5ML,32000661,CDM,J9000,HCPCS,636,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,43.69,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,43.69,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
ALVIMOPAN(ENTEREG)CAP:12MG,32000663,CDM,J8499,HCPCS,250,RC,outpatient,,2642.47,2642.47,,2243.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,660.62,22,,percent of total billed charges,,,,,,,,,2378.22,90,,percent of total billed charges,,,2187.97,82.8,,percent of total billed charges,,,2246.1,85,,percent of total billed charges,,,,,,,,,2325.37,88,,percent of total billed charges,,,,,,,,,2018.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,660.62,22,,percent of total billed charges,,,2404.65,91,,percent of total billed charges,,,2510.35,95,,percent of total billed charges,,,2193.25,83,,percent of total billed charges,,,2193.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2193.25,83,,percent of total billed charges,,,2510.35,95,,percent of total billed charges,,,2378.22,90,,percent of total billed charges,,,2378.22,90,,percent of total billed charges,,,2166.83,82,,percent of total billed charges,,,2378.22,90,,percent of total billed charges,,,2246.1,85,,percent of total billed charges,,660.62,2510.35,
SPOT (DIAGNOSTIC AGENT),32000664,CDM,,,250,RC,outpatient,,341.51,341.51,,289.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.38,22,,percent of total billed charges,,,,,,,,,307.36,90,,percent of total billed charges,,,282.77,82.8,,percent of total billed charges,,,290.28,85,,percent of total billed charges,,,,,,,,,300.53,88,,percent of total billed charges,,,,,,,,,260.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.38,22,,percent of total billed charges,,,310.77,91,,percent of total billed charges,,,324.43,95,,percent of total billed charges,,,283.45,83,,percent of total billed charges,,,283.45,83,,percent of total billed charges,,,,,,,,,,,,,,,283.45,83,,percent of total billed charges,,,324.43,95,,percent of total billed charges,,,307.36,90,,percent of total billed charges,,,307.36,90,,percent of total billed charges,,,280.04,82,,percent of total billed charges,,,307.36,90,,percent of total billed charges,,,290.28,85,,percent of total billed charges,,85.38,324.43,
INTERFERON BETA 1A SYR:30MCG,32000665,CDM,,,250,RC,outpatient,,27504.22,27504.22,,23351.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6876.06,22,,percent of total billed charges,,,,,,,,,24753.8,90,,percent of total billed charges,,,22773.49,82.8,,percent of total billed charges,,,23378.59,85,,percent of total billed charges,,,,,,,,,24203.71,88,,percent of total billed charges,,,,,,,,,21013.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6876.06,22,,percent of total billed charges,,,25028.84,91,,percent of total billed charges,,,26129.01,95,,percent of total billed charges,,,22828.5,83,,percent of total billed charges,,,22828.5,83,,percent of total billed charges,,,,,,,,,,,,,,,22828.5,83,,percent of total billed charges,,,26129.01,95,,percent of total billed charges,,,24753.8,90,,percent of total billed charges,,,24753.8,90,,percent of total billed charges,,,22553.46,82,,percent of total billed charges,,,24753.8,90,,percent of total billed charges,,,23378.59,85,,percent of total billed charges,,6876.06,26129.01,
PEMEtrexed(ALIMTA)VIAL:100MG,32000667,CDM,J9305,HCPCS,636,RC,outpatient,,5928.85,5928.85,,5033.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1482.21,22,,percent of total billed charges,,,,,,,,,5335.97,90,,percent of total billed charges,,,4909.09,82.8,,percent of total billed charges,,,5039.52,85,,percent of total billed charges,,,,,,,,,5217.39,88,,percent of total billed charges,,6016.12,,,,fee schedule,,,4529.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6016.12,,,,fee schedule,,,1482.21,22,,percent of total billed charges,,,5395.25,91,,percent of total billed charges,,,5632.41,95,,percent of total billed charges,,,4920.95,83,,percent of total billed charges,,,4920.95,83,,percent of total billed charges,,,,,,,,,,,,,,,4920.95,83,,percent of total billed charges,,,5632.41,95,,percent of total billed charges,,,5335.97,90,,percent of total billed charges,,,5335.97,90,,percent of total billed charges,,,4861.66,82,,percent of total billed charges,,,5335.97,90,,percent of total billed charges,,,5039.52,85,,percent of total billed charges,,1482.21,6016.12,
PEMEtrexed (ALIMTA)VIAL:500MG,32000668,CDM,J9305,HCPCS,636,RC,outpatient,,15503.29,15503.29,,13162.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3875.82,22,,percent of total billed charges,,,,,,,,,13952.96,90,,percent of total billed charges,,,12836.72,82.8,,percent of total billed charges,,,13177.8,85,,percent of total billed charges,,,,,,,,,13642.9,88,,percent of total billed charges,,6016.12,,,,fee schedule,,,11844.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6016.12,,,,fee schedule,,,3875.82,22,,percent of total billed charges,,,14107.99,91,,percent of total billed charges,,,14728.13,95,,percent of total billed charges,,,12867.73,83,,percent of total billed charges,,,12867.73,83,,percent of total billed charges,,,,,,,,,,,,,,,12867.73,83,,percent of total billed charges,,,14728.13,95,,percent of total billed charges,,,13952.96,90,,percent of total billed charges,,,13952.96,90,,percent of total billed charges,,,12712.7,82,,percent of total billed charges,,,13952.96,90,,percent of total billed charges,,,13177.8,85,,percent of total billed charges,,3875.82,14728.13,
CODEINE TAB:30 MG,32000669,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
CLOBETASOL (OLUX-E) FOAM 0.05% :,32000670,CDM,,,250,RC,outpatient,,3321.29,3321.29,,2819.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,830.32,22,,percent of total billed charges,,,,,,,,,2989.16,90,,percent of total billed charges,,,2750.03,82.8,,percent of total billed charges,,,2823.1,85,,percent of total billed charges,,,,,,,,,2922.74,88,,percent of total billed charges,,,,,,,,,2537.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,830.32,22,,percent of total billed charges,,,3022.37,91,,percent of total billed charges,,,3155.23,95,,percent of total billed charges,,,2756.67,83,,percent of total billed charges,,,2756.67,83,,percent of total billed charges,,,,,,,,,,,,,,,2756.67,83,,percent of total billed charges,,,3155.23,95,,percent of total billed charges,,,2989.16,90,,percent of total billed charges,,,2989.16,90,,percent of total billed charges,,,2723.46,82,,percent of total billed charges,,,2989.16,90,,percent of total billed charges,,,2823.1,85,,percent of total billed charges,,830.32,3155.23,
FLUOROURACIL(5-FU)VL:500MG/10ML,32000671,CDM,J9190,HCPCS,636,RC,outpatient,,273.37,273.37,,232.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.34,22,,percent of total billed charges,,,,,,,,,246.03,90,,percent of total billed charges,,,226.35,82.8,,percent of total billed charges,,,232.36,85,,percent of total billed charges,,,,,,,,,240.57,88,,percent of total billed charges,,47.2,,,,fee schedule,,,208.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,47.2,,,,fee schedule,,,68.34,22,,percent of total billed charges,,,248.77,91,,percent of total billed charges,,,259.7,95,,percent of total billed charges,,,226.9,83,,percent of total billed charges,,,226.9,83,,percent of total billed charges,,,,,,,,,,,,,,,226.9,83,,percent of total billed charges,,,259.7,95,,percent of total billed charges,,,246.03,90,,percent of total billed charges,,,246.03,90,,percent of total billed charges,,,224.16,82,,percent of total billed charges,,,246.03,90,,percent of total billed charges,,,232.36,85,,percent of total billed charges,,47.2,259.7,
hepARIN LOCK FLUSH SYR 10UNITS/ML -(5ML),32000673,CDM,J1642,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
hepARIN LOCK FLUSH SYR 100UNITS/ML-(5ML),32000674,CDM,J1642,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
OSELTAMIVIR(TAMIFLU)CAP:75MG (#10),32000675,CDM,,,250,RC,outpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.63,22,,percent of total billed charges,,,,,,,,,182.28,90,,percent of total billed charges,,,167.69,82.8,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.63,22,,percent of total billed charges,,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,50.63,192.4,
OSELTAM(TAMIFLU)SUSP:12MG/ML (SD) SNS,32000678,CDM,,,250,RC,outpatient,,142.26,142.26,,120.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.57,22,,percent of total billed charges,,,,,,,,,128.03,90,,percent of total billed charges,,,117.79,82.8,,percent of total billed charges,,,120.92,85,,percent of total billed charges,,,,,,,,,125.19,88,,percent of total billed charges,,,,,,,,,108.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.57,22,,percent of total billed charges,,,129.46,91,,percent of total billed charges,,,135.15,95,,percent of total billed charges,,,118.08,83,,percent of total billed charges,,,118.08,83,,percent of total billed charges,,,,,,,,,,,,,,,118.08,83,,percent of total billed charges,,,135.15,95,,percent of total billed charges,,,128.03,90,,percent of total billed charges,,,128.03,90,,percent of total billed charges,,,116.65,82,,percent of total billed charges,,,128.03,90,,percent of total billed charges,,,120.92,85,,percent of total billed charges,,35.57,135.15,
OSELTAMIVIR(TAMIFLU)CAP:30MG,32000679,CDM,J8499,HCPCS,250,RC,outpatient,,20.42,20.42,,17.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.11,22,,percent of total billed charges,,,,,,,,,18.38,90,,percent of total billed charges,,,16.91,82.8,,percent of total billed charges,,,17.36,85,,percent of total billed charges,,,,,,,,,17.97,88,,percent of total billed charges,,,,,,,,,15.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.11,22,,percent of total billed charges,,,18.58,91,,percent of total billed charges,,,19.4,95,,percent of total billed charges,,,16.95,83,,percent of total billed charges,,,16.95,83,,percent of total billed charges,,,,,,,,,,,,,,,16.95,83,,percent of total billed charges,,,19.4,95,,percent of total billed charges,,,18.38,90,,percent of total billed charges,,,18.38,90,,percent of total billed charges,,,16.74,82,,percent of total billed charges,,,18.38,90,,percent of total billed charges,,,17.36,85,,percent of total billed charges,,5.11,19.4,
PROPAFENONE(RYTHMOL)SR CAPS:225 MG,32000680,CDM,,,250,RC,outpatient,,89.29,89.29,,75.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.32,22,,percent of total billed charges,,,,,,,,,80.36,90,,percent of total billed charges,,,73.93,82.8,,percent of total billed charges,,,75.9,85,,percent of total billed charges,,,,,,,,,78.58,88,,percent of total billed charges,,,,,,,,,68.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.32,22,,percent of total billed charges,,,81.25,91,,percent of total billed charges,,,84.83,95,,percent of total billed charges,,,74.11,83,,percent of total billed charges,,,74.11,83,,percent of total billed charges,,,,,,,,,,,,,,,74.11,83,,percent of total billed charges,,,84.83,95,,percent of total billed charges,,,80.36,90,,percent of total billed charges,,,80.36,90,,percent of total billed charges,,,73.22,82,,percent of total billed charges,,,80.36,90,,percent of total billed charges,,,75.9,85,,percent of total billed charges,,22.32,84.83,
DIPHENHYDR(BENADRYL)EL:25MG/10ML,32000682,CDM,J8499,HCPCS,250,RC,outpatient,,26.14,26.14,,22.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.54,22,,percent of total billed charges,,,,,,,,,23.53,90,,percent of total billed charges,,,21.64,82.8,,percent of total billed charges,,,22.22,85,,percent of total billed charges,,,,,,,,,23,88,,percent of total billed charges,,,,,,,,,19.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.54,22,,percent of total billed charges,,,23.79,91,,percent of total billed charges,,,24.83,95,,percent of total billed charges,,,21.7,83,,percent of total billed charges,,,21.7,83,,percent of total billed charges,,,,,,,,,,,,,,,21.7,83,,percent of total billed charges,,,24.83,95,,percent of total billed charges,,,23.53,90,,percent of total billed charges,,,23.53,90,,percent of total billed charges,,,21.43,82,,percent of total billed charges,,,23.53,90,,percent of total billed charges,,,22.22,85,,percent of total billed charges,,6.54,24.83,
DARBEPOTN(ARANESP)SY:300MCG/0.6ML J/1MCG,32000683,CDM,J0881,HCPCS,636,RC,outpatient,,10971.45,10971.45,,9314.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2742.86,22,,percent of total billed charges,,,,,,,,,9874.31,90,,percent of total billed charges,,,9084.36,82.8,,percent of total billed charges,,,9325.73,85,,percent of total billed charges,,,,,,,,,9654.88,88,,percent of total billed charges,,1579.5,,,,fee schedule,,,8382.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1579.5,,,,fee schedule,,,2742.86,22,,percent of total billed charges,,,9984.02,91,,percent of total billed charges,,,10422.88,95,,percent of total billed charges,,,9106.3,83,,percent of total billed charges,,,9106.3,83,,percent of total billed charges,,,,,,,,,,,,,,,9106.3,83,,percent of total billed charges,,,10422.88,95,,percent of total billed charges,,,9874.31,90,,percent of total billed charges,,,9874.31,90,,percent of total billed charges,,,8996.59,82,,percent of total billed charges,,,9874.31,90,,percent of total billed charges,,,9325.73,85,,percent of total billed charges,,1579.5,10422.88,
ESMOLOL(BREVIBLOC)VL:100MG/10ML,32000684,CDM,J3490,HCPCS,250,RC,outpatient,,198.2,198.2,,168.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.55,22,,percent of total billed charges,,,,,,,,,178.38,90,,percent of total billed charges,,,164.11,82.8,,percent of total billed charges,,,168.47,85,,percent of total billed charges,,,,,,,,,174.42,88,,percent of total billed charges,,,,,,,,,151.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.55,22,,percent of total billed charges,,,180.36,91,,percent of total billed charges,,,188.29,95,,percent of total billed charges,,,164.51,83,,percent of total billed charges,,,164.51,83,,percent of total billed charges,,,,,,,,,,,,,,,164.51,83,,percent of total billed charges,,,188.29,95,,percent of total billed charges,,,178.38,90,,percent of total billed charges,,,178.38,90,,percent of total billed charges,,,162.52,82,,percent of total billed charges,,,178.38,90,,percent of total billed charges,,,168.47,85,,percent of total billed charges,,49.55,188.29,
IV DOPamine 400MG/D5W250ML   (PREMIX),32000685,CDM,J1265,HCPCS,250,RC,outpatient,,219.28,219.28,,186.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.82,22,,percent of total billed charges,,,,,,,,,197.35,90,,percent of total billed charges,,,181.56,82.8,,percent of total billed charges,,,186.39,85,,percent of total billed charges,,,,,,,,,192.97,88,,percent of total billed charges,,7.14,,,,fee schedule,,,167.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.14,,,,fee schedule,,,54.82,22,,percent of total billed charges,,,199.54,91,,percent of total billed charges,,,208.32,95,,percent of total billed charges,,,182,83,,percent of total billed charges,,,182,83,,percent of total billed charges,,,,,,,,,,,,,,,182,83,,percent of total billed charges,,,208.32,95,,percent of total billed charges,,,197.35,90,,percent of total billed charges,,,197.35,90,,percent of total billed charges,,,179.81,82,,percent of total billed charges,,,197.35,90,,percent of total billed charges,,,186.39,85,,percent of total billed charges,,7.14,208.32,
GENTAMICIN-VIAL PEDS:20MG/2ML,32000687,CDM,J1580,HCPCS,250,RC,outpatient,,79.41,79.41,,67.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.85,22,,percent of total billed charges,,,,,,,,,71.47,90,,percent of total billed charges,,,65.75,82.8,,percent of total billed charges,,,67.5,85,,percent of total billed charges,,,,,,,,,69.88,88,,percent of total billed charges,,21.3,,,,fee schedule,,,60.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21.3,,,,fee schedule,,,19.85,22,,percent of total billed charges,,,72.26,91,,percent of total billed charges,,,75.44,95,,percent of total billed charges,,,65.91,83,,percent of total billed charges,,,65.91,83,,percent of total billed charges,,,,,,,,,,,,,,,65.91,83,,percent of total billed charges,,,75.44,95,,percent of total billed charges,,,71.47,90,,percent of total billed charges,,,71.47,90,,percent of total billed charges,,,65.12,82,,percent of total billed charges,,,71.47,90,,percent of total billed charges,,,67.5,85,,percent of total billed charges,,19.85,75.44,
PHENOBARBITAL SODIUM VIAL:60MG/ML,32000688,CDM,,,250,RC,outpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.42,22,,percent of total billed charges,,,,,,,,,59.09,90,,percent of total billed charges,,,54.37,82.8,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,,,,,,,,57.78,88,,percent of total billed charges,,,,,,,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.42,22,,percent of total billed charges,,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,16.42,62.38,
DEXPANTHENOL VIAL 500MG/2ML:,32000690,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
FOSAPREPITANT (EMEND)115MG/10ML:,32000691,CDM,J1453,HCPCS,636,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,21,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
PROPOFOL DRIP(DIPRIVAN)IVPB:1000MG/100ML,32000692,CDM,J2704,HCPCS,250,RC,outpatient,,506.87,506.87,,430.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126.72,22,,percent of total billed charges,,,,,,,,,456.18,90,,percent of total billed charges,,,419.69,82.8,,percent of total billed charges,,,430.84,85,,percent of total billed charges,,,,,,,,,446.05,88,,percent of total billed charges,,14.4,,,,fee schedule,,,387.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.4,,,,fee schedule,,,126.72,22,,percent of total billed charges,,,461.25,91,,percent of total billed charges,,,481.53,95,,percent of total billed charges,,,420.7,83,,percent of total billed charges,,,420.7,83,,percent of total billed charges,,,,,,,,,,,,,,,420.7,83,,percent of total billed charges,,,481.53,95,,percent of total billed charges,,,456.18,90,,percent of total billed charges,,,456.18,90,,percent of total billed charges,,,415.63,82,,percent of total billed charges,,,456.18,90,,percent of total billed charges,,,430.84,85,,percent of total billed charges,,14.4,481.53,
DICLOFENAC(VOLTAREN)TOPICAL GEL 1%:,32000693,CDM,J3490,HCPCS,250,RC,outpatient,,762.32,762.32,,647.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,190.58,22,,percent of total billed charges,,,,,,,,,686.09,90,,percent of total billed charges,,,631.2,82.8,,percent of total billed charges,,,647.97,85,,percent of total billed charges,,,,,,,,,670.84,88,,percent of total billed charges,,,,,,,,,582.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,190.58,22,,percent of total billed charges,,,693.71,91,,percent of total billed charges,,,724.2,95,,percent of total billed charges,,,632.73,83,,percent of total billed charges,,,632.73,83,,percent of total billed charges,,,,,,,,,,,,,,,632.73,83,,percent of total billed charges,,,724.2,95,,percent of total billed charges,,,686.09,90,,percent of total billed charges,,,686.09,90,,percent of total billed charges,,,625.1,82,,percent of total billed charges,,,686.09,90,,percent of total billed charges,,,647.97,85,,percent of total billed charges,,190.58,724.2,
BUPIVACAINE(MARCAINE)SPINAL:7.5MG/ML,32000694,CDM,J3490,HCPCS,250,RC,outpatient,,65.03,65.03,,55.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.26,22,,percent of total billed charges,,,,,,,,,58.53,90,,percent of total billed charges,,,53.84,82.8,,percent of total billed charges,,,55.28,85,,percent of total billed charges,,,,,,,,,57.23,88,,percent of total billed charges,,,,,,,,,49.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.26,22,,percent of total billed charges,,,59.18,91,,percent of total billed charges,,,61.78,95,,percent of total billed charges,,,53.97,83,,percent of total billed charges,,,53.97,83,,percent of total billed charges,,,,,,,,,,,,,,,53.97,83,,percent of total billed charges,,,61.78,95,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,53.32,82,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,55.28,85,,percent of total billed charges,,16.26,61.78,
fentaNYL PATCH(DURAGESIC): 12MCG/HR,32000695,CDM,,,250,RC,outpatient,,141.99,141.99,,120.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.5,22,,percent of total billed charges,,,,,,,,,127.79,90,,percent of total billed charges,,,117.57,82.8,,percent of total billed charges,,,120.69,85,,percent of total billed charges,,,,,,,,,124.95,88,,percent of total billed charges,,,,,,,,,108.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.5,22,,percent of total billed charges,,,129.21,91,,percent of total billed charges,,,134.89,95,,percent of total billed charges,,,117.85,83,,percent of total billed charges,,,117.85,83,,percent of total billed charges,,,,,,,,,,,,,,,117.85,83,,percent of total billed charges,,,134.89,95,,percent of total billed charges,,,127.79,90,,percent of total billed charges,,,127.79,90,,percent of total billed charges,,,116.43,82,,percent of total billed charges,,,127.79,90,,percent of total billed charges,,,120.69,85,,percent of total billed charges,,35.5,134.89,
ASPIRIN/DIPYRIDAMOLE(AGGRNX)CPM:25-200MG,32000697,CDM,J8499,HCPCS,250,RC,outpatient,,92.31,92.31,,78.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.08,22,,percent of total billed charges,,,,,,,,,83.08,90,,percent of total billed charges,,,76.43,82.8,,percent of total billed charges,,,78.46,85,,percent of total billed charges,,,,,,,,,81.23,88,,percent of total billed charges,,,,,,,,,70.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.08,22,,percent of total billed charges,,,84,91,,percent of total billed charges,,,87.69,95,,percent of total billed charges,,,76.62,83,,percent of total billed charges,,,76.62,83,,percent of total billed charges,,,,,,,,,,,,,,,76.62,83,,percent of total billed charges,,,87.69,95,,percent of total billed charges,,,83.08,90,,percent of total billed charges,,,83.08,90,,percent of total billed charges,,,75.69,82,,percent of total billed charges,,,83.08,90,,percent of total billed charges,,,78.46,85,,percent of total billed charges,,23.08,87.69,
PENICILLIN G POTAS VIAL:5 MIL UNITS,32000698,CDM,J2540,HCPCS,250,RC,outpatient,,123.2,123.2,,104.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.8,22,,percent of total billed charges,,,,,,,,,110.88,90,,percent of total billed charges,,,102.01,82.8,,percent of total billed charges,,,104.72,85,,percent of total billed charges,,,,,,,,,108.42,88,,percent of total billed charges,,7.79,,,,fee schedule,,,94.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.79,,,,fee schedule,,,30.8,22,,percent of total billed charges,,,112.11,91,,percent of total billed charges,,,117.04,95,,percent of total billed charges,,,102.26,83,,percent of total billed charges,,,102.26,83,,percent of total billed charges,,,,,,,,,,,,,,,102.26,83,,percent of total billed charges,,,117.04,95,,percent of total billed charges,,,110.88,90,,percent of total billed charges,,,110.88,90,,percent of total billed charges,,,101.02,82,,percent of total billed charges,,,110.88,90,,percent of total billed charges,,,104.72,85,,percent of total billed charges,,7.79,117.04,
CETUXIMAB(ERBITUX)200MG/100ML:J /10MG,32000699,CDM,J9055,HCPCS,636,RC,outpatient,,6552.68,6552.68,,5563.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1638.17,22,,percent of total billed charges,,,,,,,,,5897.41,90,,percent of total billed charges,,,5425.62,82.8,,percent of total billed charges,,,5569.78,85,,percent of total billed charges,,,,,,,,,5766.36,88,,percent of total billed charges,,10363.95,,,,fee schedule,,,5006.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,10363.95,,,,fee schedule,,,1638.17,22,,percent of total billed charges,,,5962.94,91,,percent of total billed charges,,,6225.05,95,,percent of total billed charges,,,5438.72,83,,percent of total billed charges,,,5438.72,83,,percent of total billed charges,,,,,,,,,,,,,,,5438.72,83,,percent of total billed charges,,,6225.05,95,,percent of total billed charges,,,5897.41,90,,percent of total billed charges,,,5897.41,90,,percent of total billed charges,,,5373.2,82,,percent of total billed charges,,,5897.41,90,,percent of total billed charges,,,5569.78,85,,percent of total billed charges,,1638.17,10363.95,
CETUXIMA(ERBITUX)-IVPB:100MG/50ML,32000700,CDM,J9055,HCPCS,636,RC,outpatient,,5329.55,5329.55,,4524.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1332.39,22,,percent of total billed charges,,,,,,,,,4796.6,90,,percent of total billed charges,,,4412.87,82.8,,percent of total billed charges,,,4530.12,85,,percent of total billed charges,,,,,,,,,4690,88,,percent of total billed charges,,10363.95,,,,fee schedule,,,4071.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,10363.95,,,,fee schedule,,,1332.39,22,,percent of total billed charges,,,4849.89,91,,percent of total billed charges,,,5063.07,95,,percent of total billed charges,,,4423.53,83,,percent of total billed charges,,,4423.53,83,,percent of total billed charges,,,,,,,,,,,,,,,4423.53,83,,percent of total billed charges,,,5063.07,95,,percent of total billed charges,,,4796.6,90,,percent of total billed charges,,,4796.6,90,,percent of total billed charges,,,4370.23,82,,percent of total billed charges,,,4796.6,90,,percent of total billed charges,,,4530.12,85,,percent of total billed charges,,1332.39,10363.95,
FLUNISOLIDE(AEROBID)AER:250MCG,32000701,CDM,,,250,RC,outpatient,,379.75,379.75,,322.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94.94,22,,percent of total billed charges,,,,,,,,,341.78,90,,percent of total billed charges,,,314.43,82.8,,percent of total billed charges,,,322.79,85,,percent of total billed charges,,,,,,,,,334.18,88,,percent of total billed charges,,,,,,,,,290.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94.94,22,,percent of total billed charges,,,345.57,91,,percent of total billed charges,,,360.76,95,,percent of total billed charges,,,315.19,83,,percent of total billed charges,,,315.19,83,,percent of total billed charges,,,,,,,,,,,,,,,315.19,83,,percent of total billed charges,,,360.76,95,,percent of total billed charges,,,341.78,90,,percent of total billed charges,,,341.78,90,,percent of total billed charges,,,311.4,82,,percent of total billed charges,,,341.78,90,,percent of total billed charges,,,322.79,85,,percent of total billed charges,,94.94,360.76,
EMPTY EVACUATED CONTAINER:1000 ML,32000702,CDM,J3490,HCPCS,258,RC,outpatient,,400.82,400.82,,340.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100.21,22,,percent of total billed charges,,,,,,,,,360.74,90,,percent of total billed charges,,,331.88,82.8,,percent of total billed charges,,,340.7,85,,percent of total billed charges,,,,,,,,,352.72,88,,percent of total billed charges,,,,,,,,,306.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100.21,22,,percent of total billed charges,,,364.75,91,,percent of total billed charges,,,380.78,95,,percent of total billed charges,,,332.68,83,,percent of total billed charges,,,332.68,83,,percent of total billed charges,,,,,,,,,,,,,,,332.68,83,,percent of total billed charges,,,380.78,95,,percent of total billed charges,,,360.74,90,,percent of total billed charges,,,360.74,90,,percent of total billed charges,,,328.67,82,,percent of total billed charges,,,360.74,90,,percent of total billed charges,,,340.7,85,,percent of total billed charges,,100.21,380.78,
PACLITAXEL PROTIEN-BOUND(ABRAXANE):100MG,32000703,CDM,J9264,HCPCS,636,RC,outpatient,,6285.2,6285.2,,5336.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1571.3,22,,percent of total billed charges,,,,,,,,,5656.68,90,,percent of total billed charges,,,5204.15,82.8,,percent of total billed charges,,,5342.42,85,,percent of total billed charges,,,,,,,,,5530.98,88,,percent of total billed charges,,7314,,,,fee schedule,,,4801.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7314,,,,fee schedule,,,1571.3,22,,percent of total billed charges,,,5719.53,91,,percent of total billed charges,,,5970.94,95,,percent of total billed charges,,,5216.72,83,,percent of total billed charges,,,5216.72,83,,percent of total billed charges,,,,,,,,,,,,,,,5216.72,83,,percent of total billed charges,,,5970.94,95,,percent of total billed charges,,,5656.68,90,,percent of total billed charges,,,5656.68,90,,percent of total billed charges,,,5153.86,82,,percent of total billed charges,,,5656.68,90,,percent of total billed charges,,,5342.42,85,,percent of total billed charges,,1571.3,7314,
CHOLECALCI(VITAMIN D)TAB:1000UNIT(25MCG),32000704,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
REGADENO(LEXISCAN):0.4MG/5ML,32000705,CDM,J2785,HCPCS,636,RC,outpatient,,1186.54,1186.54,,1007.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,296.64,22,,percent of total billed charges,,,,,,,,,1067.89,90,,percent of total billed charges,,,982.46,82.8,,percent of total billed charges,,,1008.56,85,,percent of total billed charges,,,,,,,,,1044.16,88,,percent of total billed charges,,245.38,,,,fee schedule,,,906.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,245.38,,,,fee schedule,,,296.64,22,,percent of total billed charges,,,1079.75,91,,percent of total billed charges,,,1127.21,95,,percent of total billed charges,,,984.83,83,,percent of total billed charges,,,984.83,83,,percent of total billed charges,,,,,,,,,,,,,,,984.83,83,,percent of total billed charges,,,1127.21,95,,percent of total billed charges,,,1067.89,90,,percent of total billed charges,,,1067.89,90,,percent of total billed charges,,,972.96,82,,percent of total billed charges,,,1067.89,90,,percent of total billed charges,,,1008.56,85,,percent of total billed charges,,245.38,1127.21,
ALBUMIN (HUMAN) ALBUTEIN 100ML 25%,32000707,CDM,,,250,RC,outpatient,,236.5,236.5,,200.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.13,22,,percent of total billed charges,,,,,,,,,212.85,90,,percent of total billed charges,,,195.82,82.8,,percent of total billed charges,,,201.03,85,,percent of total billed charges,,,,,,,,,208.12,88,,percent of total billed charges,,,,,,,,,180.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.13,22,,percent of total billed charges,,,215.22,91,,percent of total billed charges,,,224.68,95,,percent of total billed charges,,,196.3,83,,percent of total billed charges,,,196.3,83,,percent of total billed charges,,,,,,,,,,,,,,,196.3,83,,percent of total billed charges,,,224.68,95,,percent of total billed charges,,,212.85,90,,percent of total billed charges,,,212.85,90,,percent of total billed charges,,,193.93,82,,percent of total billed charges,,,212.85,90,,percent of total billed charges,,,201.03,85,,percent of total billed charges,,59.13,224.68,
INFLUENZA VACCINE(2009-2010)SYR:0.5ML,32000709,CDM,90658,CPT,636,RC,outpatient,,165.9,165.9,,140.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.48,22,,percent of total billed charges,,,,,,,,,149.31,90,,percent of total billed charges,,,137.37,82.8,,percent of total billed charges,,,141.02,85,,percent of total billed charges,,,,,,,,,145.99,88,,percent of total billed charges,,,,,,,,,126.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.48,22,,percent of total billed charges,,,150.97,91,,percent of total billed charges,,,157.61,95,,percent of total billed charges,,,137.7,83,,percent of total billed charges,,,137.7,83,,percent of total billed charges,,,,,,,,,,,,,,,137.7,83,,percent of total billed charges,,,157.61,95,,percent of total billed charges,,,149.31,90,,percent of total billed charges,,,149.31,90,,percent of total billed charges,,,136.04,82,,percent of total billed charges,,,149.31,90,,percent of total billed charges,,,141.02,85,,percent of total billed charges,,41.48,157.61,
ALBUTEROL 0.5% 0.5ML,32000710,CDM,,,250,RC,outpatient,,24.11,24.11,,20.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.03,22,,percent of total billed charges,,,,,,,,,21.7,90,,percent of total billed charges,,,19.96,82.8,,percent of total billed charges,,,20.49,85,,percent of total billed charges,,,,,,,,,21.22,88,,percent of total billed charges,,,,,,,,,18.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.03,22,,percent of total billed charges,,,21.94,91,,percent of total billed charges,,,22.9,95,,percent of total billed charges,,,20.01,83,,percent of total billed charges,,,20.01,83,,percent of total billed charges,,,,,,,,,,,,,,,20.01,83,,percent of total billed charges,,,22.9,95,,percent of total billed charges,,,21.7,90,,percent of total billed charges,,,21.7,90,,percent of total billed charges,,,19.77,82,,percent of total billed charges,,,21.7,90,,percent of total billed charges,,,20.49,85,,percent of total billed charges,,6.03,22.9,
ALBUTEROL (VENTOLIN) TAB : 2MG,32000711,CDM,,,250,RC,outpatient,,2.5,2.5,,2.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.63,22,,percent of total billed charges,,,,,,,,,2.25,90,,percent of total billed charges,,,2.07,82.8,,percent of total billed charges,,,2.13,85,,percent of total billed charges,,,,,,,,,2.2,88,,percent of total billed charges,,,,,,,,,1.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.63,22,,percent of total billed charges,,,2.28,91,,percent of total billed charges,,,2.38,95,,percent of total billed charges,,,2.08,83,,percent of total billed charges,,,2.08,83,,percent of total billed charges,,,,,,,,,,,,,,,2.08,83,,percent of total billed charges,,,2.38,95,,percent of total billed charges,,,2.25,90,,percent of total billed charges,,,2.25,90,,percent of total billed charges,,,2.05,82,,percent of total billed charges,,,2.25,90,,percent of total billed charges,,,2.13,85,,percent of total billed charges,,0.63,2.38,
PROPARACAINE(ALCAINE)DROP 0.5%:15ML,32000713,CDM,J3490,HCPCS,250,RC,outpatient,,572.06,572.06,,485.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,143.02,22,,percent of total billed charges,,,,,,,,,514.85,90,,percent of total billed charges,,,473.67,82.8,,percent of total billed charges,,,486.25,85,,percent of total billed charges,,,,,,,,,503.41,88,,percent of total billed charges,,,,,,,,,437.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,143.02,22,,percent of total billed charges,,,520.57,91,,percent of total billed charges,,,543.46,95,,percent of total billed charges,,,474.81,83,,percent of total billed charges,,,474.81,83,,percent of total billed charges,,,,,,,,,,,,,,,474.81,83,,percent of total billed charges,,,543.46,95,,percent of total billed charges,,,514.85,90,,percent of total billed charges,,,514.85,90,,percent of total billed charges,,,469.09,82,,percent of total billed charges,,,514.85,90,,percent of total billed charges,,,486.25,85,,percent of total billed charges,,143.02,543.46,
ALBUTEROL SULFATE SOL:5MG/ML,32000714,CDM,,,250,RC,outpatient,,7.5,7.5,,6.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.88,22,,percent of total billed charges,,,,,,,,,6.75,90,,percent of total billed charges,,,6.21,82.8,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,,,,,,,,6.6,88,,percent of total billed charges,,,,,,,,,5.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.88,22,,percent of total billed charges,,,6.83,91,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,,,,,,,,,,,,,6.23,83,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.15,82,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,1.88,7.13,
TIOTROPIUM BR (SPIRIVA) CAP : 18MCG 30'S,32000715,CDM,,,250,RC,outpatient,,779.04,779.04,,661.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,194.76,22,,percent of total billed charges,,,,,,,,,701.14,90,,percent of total billed charges,,,645.05,82.8,,percent of total billed charges,,,662.18,85,,percent of total billed charges,,,,,,,,,685.56,88,,percent of total billed charges,,,,,,,,,595.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,194.76,22,,percent of total billed charges,,,708.93,91,,percent of total billed charges,,,740.09,95,,percent of total billed charges,,,646.6,83,,percent of total billed charges,,,646.6,83,,percent of total billed charges,,,,,,,,,,,,,,,646.6,83,,percent of total billed charges,,,740.09,95,,percent of total billed charges,,,701.14,90,,percent of total billed charges,,,701.14,90,,percent of total billed charges,,,638.81,82,,percent of total billed charges,,,701.14,90,,percent of total billed charges,,,662.18,85,,percent of total billed charges,,194.76,740.09,
THYROTROPIN(THYROGEN):0.9MG/ML  J/0.9,32000717,CDM,J3240,HCPCS,636,RC,outpatient,,7025.8,7025.8,,5964.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1756.45,22,,percent of total billed charges,,,,,,,,,6323.22,90,,percent of total billed charges,,,5817.36,82.8,,percent of total billed charges,,,5971.93,85,,percent of total billed charges,,,,,,,,,6182.7,88,,percent of total billed charges,,1926.71,,,,fee schedule,,,5367.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1926.71,,,,fee schedule,,,1756.45,22,,percent of total billed charges,,,6393.48,91,,percent of total billed charges,,,6674.51,95,,percent of total billed charges,,,5831.41,83,,percent of total billed charges,,,5831.41,83,,percent of total billed charges,,,,,,,,,,,,,,,5831.41,83,,percent of total billed charges,,,6674.51,95,,percent of total billed charges,,,6323.22,90,,percent of total billed charges,,,6323.22,90,,percent of total billed charges,,,5761.16,82,,percent of total billed charges,,,6323.22,90,,percent of total billed charges,,,5971.93,85,,percent of total billed charges,,1756.45,6674.51,
LIDOCAINE(LIDODERM)PATCH 5%,32000718,CDM,J3490,HCPCS,250,RC,outpatient,,27.94,27.94,,23.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.99,22,,percent of total billed charges,,,,,,,,,25.15,90,,percent of total billed charges,,,23.13,82.8,,percent of total billed charges,,,23.75,85,,percent of total billed charges,,,,,,,,,24.59,88,,percent of total billed charges,,,,,,,,,21.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.99,22,,percent of total billed charges,,,25.43,91,,percent of total billed charges,,,26.54,95,,percent of total billed charges,,,23.19,83,,percent of total billed charges,,,23.19,83,,percent of total billed charges,,,,,,,,,,,,,,,23.19,83,,percent of total billed charges,,,26.54,95,,percent of total billed charges,,,25.15,90,,percent of total billed charges,,,25.15,90,,percent of total billed charges,,,22.91,82,,percent of total billed charges,,,25.15,90,,percent of total billed charges,,,23.75,85,,percent of total billed charges,,6.99,26.54,
COLESTIPOL(COLESTID)TABS:1GM,32000719,CDM,,,250,RC,outpatient,,35.21,35.21,,29.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.8,22,,percent of total billed charges,,,,,,,,,31.69,90,,percent of total billed charges,,,29.15,82.8,,percent of total billed charges,,,29.93,85,,percent of total billed charges,,,,,,,,,30.98,88,,percent of total billed charges,,,,,,,,,26.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.8,22,,percent of total billed charges,,,32.04,91,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,,,,,,,,,,,,,29.22,83,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,28.87,82,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,29.93,85,,percent of total billed charges,,8.8,33.45,
AZITHROMYCIN(ZITHROMAX) 200MG/5ML-15ML,32000720,CDM,J8499,HCPCS,250,RC,outpatient,UD,121.73,121.73,,103.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.43,22,,percent of total billed charges,,,,,,,,,109.56,90,,percent of total billed charges,,,100.79,82.8,,percent of total billed charges,,,103.47,85,,percent of total billed charges,,,,,,,,,107.12,88,,percent of total billed charges,,,,,,,,,93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.43,22,,percent of total billed charges,,,110.77,91,,percent of total billed charges,,,115.64,95,,percent of total billed charges,,,101.04,83,,percent of total billed charges,,,101.04,83,,percent of total billed charges,,,,,,,,,,,,,,,101.04,83,,percent of total billed charges,,,115.64,95,,percent of total billed charges,,,109.56,90,,percent of total billed charges,,,109.56,90,,percent of total billed charges,,,99.82,82,,percent of total billed charges,,,109.56,90,,percent of total billed charges,,,103.47,85,,percent of total billed charges,,30.43,115.64,
NS(NORMAL SALINE)10ML PFS:,32000722,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
INFLUENZA A(H1N1)2009 SYR:(0.5 ML),32000723,CDM,90470,CPT,250,RC,outpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,203.31,22,,percent of total billed charges,,,,,,,,,731.93,90,,percent of total billed charges,,,673.37,82.8,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,203.31,22,,percent of total billed charges,,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,203.31,772.59,
CIPROFLOX(CIPRO)-IVPB:400MG/200ML PREMIX,32000724,CDM,J0744,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,2.57,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.57,,,,fee schedule,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,2.57,187.11,
THROMBIN-GEL 40:,32000725,CDM,J3490,HCPCS,250,RC,outpatient,,755.6,755.6,,641.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,188.9,22,,percent of total billed charges,,,,,,,,,680.04,90,,percent of total billed charges,,,625.64,82.8,,percent of total billed charges,,,642.26,85,,percent of total billed charges,,,,,,,,,664.93,88,,percent of total billed charges,,,,,,,,,577.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,188.9,22,,percent of total billed charges,,,687.6,91,,percent of total billed charges,,,717.82,95,,percent of total billed charges,,,627.15,83,,percent of total billed charges,,,627.15,83,,percent of total billed charges,,,,,,,,,,,,,,,627.15,83,,percent of total billed charges,,,717.82,95,,percent of total billed charges,,,680.04,90,,percent of total billed charges,,,680.04,90,,percent of total billed charges,,,619.59,82,,percent of total billed charges,,,680.04,90,,percent of total billed charges,,,642.26,85,,percent of total billed charges,,188.9,717.82,
ALFENTANIL(ALFENTA) AMP : 500MCG/ML 1 ML,32000731,CDM,,,250,RC,outpatient,,71.53,71.53,,60.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.88,22,,percent of total billed charges,,,,,,,,,64.38,90,,percent of total billed charges,,,59.23,82.8,,percent of total billed charges,,,60.8,85,,percent of total billed charges,,,,,,,,,62.95,88,,percent of total billed charges,,,,,,,,,54.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.88,22,,percent of total billed charges,,,65.09,91,,percent of total billed charges,,,67.95,95,,percent of total billed charges,,,59.37,83,,percent of total billed charges,,,59.37,83,,percent of total billed charges,,,,,,,,,,,,,,,59.37,83,,percent of total billed charges,,,67.95,95,,percent of total billed charges,,,64.38,90,,percent of total billed charges,,,64.38,90,,percent of total billed charges,,,58.65,82,,percent of total billed charges,,,64.38,90,,percent of total billed charges,,,60.8,85,,percent of total billed charges,,17.88,67.95,
CYCLOPENTOLATE(CYCLOGEL) 1%:15ML,32000732,CDM,,,250,RC,outpatient,,321.96,321.96,,273.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.49,22,,percent of total billed charges,,,,,,,,,289.76,90,,percent of total billed charges,,,266.58,82.8,,percent of total billed charges,,,273.67,85,,percent of total billed charges,,,,,,,,,283.32,88,,percent of total billed charges,,,,,,,,,245.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.49,22,,percent of total billed charges,,,292.98,91,,percent of total billed charges,,,305.86,95,,percent of total billed charges,,,267.23,83,,percent of total billed charges,,,267.23,83,,percent of total billed charges,,,,,,,,,,,,,,,267.23,83,,percent of total billed charges,,,305.86,95,,percent of total billed charges,,,289.76,90,,percent of total billed charges,,,289.76,90,,percent of total billed charges,,,264.01,82,,percent of total billed charges,,,289.76,90,,percent of total billed charges,,,273.67,85,,percent of total billed charges,,80.49,305.86,
ACETYLCYSTEINE(ACETADOTE):6000MG/30ML,32000733,CDM,J0132,HCPCS,250,RC,outpatient,,2653.06,2653.06,,2252.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,663.27,22,,percent of total billed charges,,,,,,,,,2387.75,90,,percent of total billed charges,,,2196.73,82.8,,percent of total billed charges,,,2255.1,85,,percent of total billed charges,,,,,,,,,2334.69,88,,percent of total billed charges,,140.2,,,,fee schedule,,,2026.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,140.2,,,,fee schedule,,,663.27,22,,percent of total billed charges,,,2414.28,91,,percent of total billed charges,,,2520.41,95,,percent of total billed charges,,,2202.04,83,,percent of total billed charges,,,2202.04,83,,percent of total billed charges,,,,,,,,,,,,,,,2202.04,83,,percent of total billed charges,,,2520.41,95,,percent of total billed charges,,,2387.75,90,,percent of total billed charges,,,2387.75,90,,percent of total billed charges,,,2175.51,82,,percent of total billed charges,,,2387.75,90,,percent of total billed charges,,,2255.1,85,,percent of total billed charges,,140.2,2520.41,
RANITIDINE(ZANTAC)-IVPB:50MG/NS50ML,32000734,CDM,,,258,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
MELPHALAN (ALKERAN) TAB : 2MG,32000736,CDM,,,250,RC,outpatient,,118.16,118.16,,100.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.54,22,,percent of total billed charges,,,,,,,,,106.34,90,,percent of total billed charges,,,97.84,82.8,,percent of total billed charges,,,100.44,85,,percent of total billed charges,,,,,,,,,103.98,88,,percent of total billed charges,,,,,,,,,90.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.54,22,,percent of total billed charges,,,107.53,91,,percent of total billed charges,,,112.25,95,,percent of total billed charges,,,98.07,83,,percent of total billed charges,,,98.07,83,,percent of total billed charges,,,,,,,,,,,,,,,98.07,83,,percent of total billed charges,,,112.25,95,,percent of total billed charges,,,106.34,90,,percent of total billed charges,,,106.34,90,,percent of total billed charges,,,96.89,82,,percent of total billed charges,,,106.34,90,,percent of total billed charges,,,100.44,85,,percent of total billed charges,,29.54,112.25,
GAMMAGLOB(GAMMAGARD)20GM/200ML:J 500MG,32000737,CDM,J1569,HCPCS,636,RC,outpatient,,1053.29,1053.29,,894.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,263.32,22,,percent of total billed charges,,,,,,,,,947.96,90,,percent of total billed charges,,,872.12,82.8,,percent of total billed charges,,,895.3,85,,percent of total billed charges,,,,,,,,,926.9,88,,percent of total billed charges,,11307.25,,,,fee schedule,,,804.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11307.25,,,,fee schedule,,,263.32,22,,percent of total billed charges,,,958.49,91,,percent of total billed charges,,,1000.63,95,,percent of total billed charges,,,874.23,83,,percent of total billed charges,,,874.23,83,,percent of total billed charges,,,,,,,,,,,,,,,874.23,83,,percent of total billed charges,,,1000.63,95,,percent of total billed charges,,,947.96,90,,percent of total billed charges,,,947.96,90,,percent of total billed charges,,,863.7,82,,percent of total billed charges,,,947.96,90,,percent of total billed charges,,,895.3,85,,percent of total billed charges,,263.32,11307.25,
GAMMAGLOB(GAMMAGARD):20GM/200ML-J 500MG,32000738,CDM,J1569,HCPCS,636,RC,outpatient,,9433.46,9433.46,,8009.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2358.37,22,,percent of total billed charges,,,,,,,,,8490.11,90,,percent of total billed charges,,,7810.9,82.8,,percent of total billed charges,,,8018.44,85,,percent of total billed charges,,,,,,,,,8301.44,88,,percent of total billed charges,,11307.25,,,,fee schedule,,,7207.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11307.25,,,,fee schedule,,,2358.37,22,,percent of total billed charges,,,8584.45,91,,percent of total billed charges,,,8961.79,95,,percent of total billed charges,,,7829.77,83,,percent of total billed charges,,,7829.77,83,,percent of total billed charges,,,,,,,,,,,,,,,7829.77,83,,percent of total billed charges,,,8961.79,95,,percent of total billed charges,,,8490.11,90,,percent of total billed charges,,,8490.11,90,,percent of total billed charges,,,7735.44,82,,percent of total billed charges,,,8490.11,90,,percent of total billed charges,,,8018.44,85,,percent of total billed charges,,2358.37,11307.25,
PAMIDRONATE(AREDIA) 30MG/10ML,32000739,CDM,J2430,HCPCS,636,RC,outpatient,,188.07,188.07,,159.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.02,22,,percent of total billed charges,,,,,,,,,169.26,90,,percent of total billed charges,,,155.72,82.8,,percent of total billed charges,,,159.86,85,,percent of total billed charges,,,,,,,,,165.5,88,,percent of total billed charges,,32.94,,,,fee schedule,,,143.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,32.94,,,,fee schedule,,,47.02,22,,percent of total billed charges,,,171.14,91,,percent of total billed charges,,,178.67,95,,percent of total billed charges,,,156.1,83,,percent of total billed charges,,,156.1,83,,percent of total billed charges,,,,,,,,,,,,,,,156.1,83,,percent of total billed charges,,,178.67,95,,percent of total billed charges,,,169.26,90,,percent of total billed charges,,,169.26,90,,percent of total billed charges,,,154.22,82,,percent of total billed charges,,,169.26,90,,percent of total billed charges,,,159.86,85,,percent of total billed charges,,32.94,178.67,
BROMFENAC(XIBROM)0.09% OPTH SOLUTION,32000740,CDM,J3490,HCPCS,250,RC,outpatient,,2174.86,2174.86,,1846.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,543.72,22,,percent of total billed charges,,,,,,,,,1957.37,90,,percent of total billed charges,,,1800.78,82.8,,percent of total billed charges,,,1848.63,85,,percent of total billed charges,,,,,,,,,1913.88,88,,percent of total billed charges,,,,,,,,,1661.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,543.72,22,,percent of total billed charges,,,1979.12,91,,percent of total billed charges,,,2066.12,95,,percent of total billed charges,,,1805.13,83,,percent of total billed charges,,,1805.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1805.13,83,,percent of total billed charges,,,2066.12,95,,percent of total billed charges,,,1957.37,90,,percent of total billed charges,,,1957.37,90,,percent of total billed charges,,,1783.39,82,,percent of total billed charges,,,1957.37,90,,percent of total billed charges,,,1848.63,85,,percent of total billed charges,,543.72,2066.12,
ALLBEE W/C,32000741,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
BESIFLOXACIN(BESIVANCE)OPTH 0.6%:5ML,32000742,CDM,J3490,HCPCS,250,RC,outpatient,,2624.97,2624.97,,2228.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,656.24,22,,percent of total billed charges,,,,,,,,,2362.47,90,,percent of total billed charges,,,2173.48,82.8,,percent of total billed charges,,,2231.22,85,,percent of total billed charges,,,,,,,,,2309.97,88,,percent of total billed charges,,,,,,,,,2005.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,656.24,22,,percent of total billed charges,,,2388.72,91,,percent of total billed charges,,,2493.72,95,,percent of total billed charges,,,2178.73,83,,percent of total billed charges,,,2178.73,83,,percent of total billed charges,,,,,,,,,,,,,,,2178.73,83,,percent of total billed charges,,,2493.72,95,,percent of total billed charges,,,2362.47,90,,percent of total billed charges,,,2362.47,90,,percent of total billed charges,,,2152.48,82,,percent of total billed charges,,,2362.47,90,,percent of total billed charges,,,2231.22,85,,percent of total billed charges,,656.24,2493.72,
PHYTONADIONE(VIT-K)NEONATAL SY:1MG/0.5ML,32000743,CDM,J3430,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,82.65,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,82.65,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,82.65,
DOCEtaxel(TaxoTERE)20MG/0.5ML:J/1MG,32000744,CDM,J9171,HCPCS,636,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,121.68,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,121.68,
D.P.T. (Tdap) (ADACEL) SYR 0.5ML,32000745,CDM,90715,CPT,250,RC,outpatient,,749.84,749.84,,636.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,187.46,22,,percent of total billed charges,,,,,,,,,674.86,90,,percent of total billed charges,,,620.87,82.8,,percent of total billed charges,,,637.36,85,,percent of total billed charges,,,,,,,,,659.86,88,,percent of total billed charges,,,,,,,,,572.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,187.46,22,,percent of total billed charges,,,682.35,91,,percent of total billed charges,,,712.35,95,,percent of total billed charges,,,622.37,83,,percent of total billed charges,,,622.37,83,,percent of total billed charges,,,,,,,,,,,,,,,622.37,83,,percent of total billed charges,,,712.35,95,,percent of total billed charges,,,674.86,90,,percent of total billed charges,,,674.86,90,,percent of total billed charges,,,614.87,82,,percent of total billed charges,,,674.86,90,,percent of total billed charges,,,637.36,85,,percent of total billed charges,,187.46,712.35,
FEXOFENADINE(ALLEGRA)TAB:60MG,32000746,CDM,,,250,RC,outpatient,,21.57,21.57,,18.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.39,22,,percent of total billed charges,,,,,,,,,19.41,90,,percent of total billed charges,,,17.86,82.8,,percent of total billed charges,,,18.33,85,,percent of total billed charges,,,,,,,,,18.98,88,,percent of total billed charges,,,,,,,,,16.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.39,22,,percent of total billed charges,,,19.63,91,,percent of total billed charges,,,20.49,95,,percent of total billed charges,,,17.9,83,,percent of total billed charges,,,17.9,83,,percent of total billed charges,,,,,,,,,,,,,,,17.9,83,,percent of total billed charges,,,20.49,95,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,17.69,82,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,18.33,85,,percent of total billed charges,,5.39,20.49,
FONDAPARINUX(ARIXTRA)2.5MG/0.5ML:J/0.5MG,32000747,CDM,J1652,HCPCS,636,RC,outpatient,,749.82,749.82,,636.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,187.46,22,,percent of total billed charges,,,,,,,,,674.84,90,,percent of total billed charges,,,620.85,82.8,,percent of total billed charges,,,637.35,85,,percent of total billed charges,,,,,,,,,659.84,88,,percent of total billed charges,,24.32,,,,fee schedule,,,572.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,24.32,,,,fee schedule,,,187.46,22,,percent of total billed charges,,,682.34,91,,percent of total billed charges,,,712.33,95,,percent of total billed charges,,,622.35,83,,percent of total billed charges,,,622.35,83,,percent of total billed charges,,,,,,,,,,,,,,,622.35,83,,percent of total billed charges,,,712.33,95,,percent of total billed charges,,,674.84,90,,percent of total billed charges,,,674.84,90,,percent of total billed charges,,,614.85,82,,percent of total billed charges,,,674.84,90,,percent of total billed charges,,,637.35,85,,percent of total billed charges,,24.32,712.33,
NEBIVOLOL (BYSTOLIC) TABS 5MG:,32000748,CDM,,,250,RC,outpatient,,47.42,47.42,,40.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.86,22,,percent of total billed charges,,,,,,,,,42.68,90,,percent of total billed charges,,,39.26,82.8,,percent of total billed charges,,,40.31,85,,percent of total billed charges,,,,,,,,,41.73,88,,percent of total billed charges,,,,,,,,,36.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.86,22,,percent of total billed charges,,,43.15,91,,percent of total billed charges,,,45.05,95,,percent of total billed charges,,,39.36,83,,percent of total billed charges,,,39.36,83,,percent of total billed charges,,,,,,,,,,,,,,,39.36,83,,percent of total billed charges,,,45.05,95,,percent of total billed charges,,,42.68,90,,percent of total billed charges,,,42.68,90,,percent of total billed charges,,,38.88,82,,percent of total billed charges,,,42.68,90,,percent of total billed charges,,,40.31,85,,percent of total billed charges,,11.86,45.05,
METHYLNALTREXONE(RELISTOR):12MG/0.6ML,32000749,CDM,J2212,HCPCS,250,RC,outpatient,,2077.38,2077.38,,1763.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,519.35,22,,percent of total billed charges,,,,,,,,,1869.64,90,,percent of total billed charges,,,1720.07,82.8,,percent of total billed charges,,,1765.77,85,,percent of total billed charges,,,,,,,,,1828.09,88,,percent of total billed charges,,115.08,,,,fee schedule,,,1587.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,115.08,,,,fee schedule,,,519.35,22,,percent of total billed charges,,,1890.42,91,,percent of total billed charges,,,1973.51,95,,percent of total billed charges,,,1724.23,83,,percent of total billed charges,,,1724.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1724.23,83,,percent of total billed charges,,,1973.51,95,,percent of total billed charges,,,1869.64,90,,percent of total billed charges,,,1869.64,90,,percent of total billed charges,,,1703.45,82,,percent of total billed charges,,,1869.64,90,,percent of total billed charges,,,1765.77,85,,percent of total billed charges,,115.08,1973.51,
MOXIFLOXACIN (AVELOX) TAB 400MG:,32000750,CDM,,,250,RC,outpatient,,507.04,507.04,,430.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126.76,22,,percent of total billed charges,,,,,,,,,456.34,90,,percent of total billed charges,,,419.83,82.8,,percent of total billed charges,,,430.98,85,,percent of total billed charges,,,,,,,,,446.2,88,,percent of total billed charges,,,,,,,,,387.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126.76,22,,percent of total billed charges,,,461.41,91,,percent of total billed charges,,,481.69,95,,percent of total billed charges,,,420.84,83,,percent of total billed charges,,,420.84,83,,percent of total billed charges,,,,,,,,,,,,,,,420.84,83,,percent of total billed charges,,,481.69,95,,percent of total billed charges,,,456.34,90,,percent of total billed charges,,,456.34,90,,percent of total billed charges,,,415.77,82,,percent of total billed charges,,,456.34,90,,percent of total billed charges,,,430.98,85,,percent of total billed charges,,126.76,481.69,
ALLOPURINOL(ZYLOPRIM)TAB:100MG,32000751,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ALLOPURINOL (ZYLOPRIM) TAB : 300MG,32000752,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ESTRADIOL (VIVELLE-DOT) PAT : 0.1MG/24HR,32000753,CDM,,,250,RC,outpatient,,52.25,52.25,,44.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.06,22,,percent of total billed charges,,,,,,,,,47.03,90,,percent of total billed charges,,,43.26,82.8,,percent of total billed charges,,,44.41,85,,percent of total billed charges,,,,,,,,,45.98,88,,percent of total billed charges,,,,,,,,,39.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.06,22,,percent of total billed charges,,,47.55,91,,percent of total billed charges,,,49.64,95,,percent of total billed charges,,,43.37,83,,percent of total billed charges,,,43.37,83,,percent of total billed charges,,,,,,,,,,,,,,,43.37,83,,percent of total billed charges,,,49.64,95,,percent of total billed charges,,,47.03,90,,percent of total billed charges,,,47.03,90,,percent of total billed charges,,,42.85,82,,percent of total billed charges,,,47.03,90,,percent of total billed charges,,,44.41,85,,percent of total billed charges,,13.06,49.64,
BRIMONIDINE(ALPHAGAN-P)DROP 0.2%:5ML,32000757,CDM,J3490,HCPCS,250,RC,outpatient,,78.92,78.92,,67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.73,22,,percent of total billed charges,,,,,,,,,71.03,90,,percent of total billed charges,,,65.35,82.8,,percent of total billed charges,,,67.08,85,,percent of total billed charges,,,,,,,,,69.45,88,,percent of total billed charges,,,,,,,,,60.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.73,22,,percent of total billed charges,,,71.82,91,,percent of total billed charges,,,74.97,95,,percent of total billed charges,,,65.5,83,,percent of total billed charges,,,65.5,83,,percent of total billed charges,,,,,,,,,,,,,,,65.5,83,,percent of total billed charges,,,74.97,95,,percent of total billed charges,,,71.03,90,,percent of total billed charges,,,71.03,90,,percent of total billed charges,,,64.71,82,,percent of total billed charges,,,71.03,90,,percent of total billed charges,,,67.08,85,,percent of total billed charges,,19.73,74.97,
ALPRAZolam(XANAX)TAB:0.25MG,32000761,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
ALPRAZolam(XANAX)TAB:0.5MG,32000766,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
RAMIPRIL(ALTACE)CAP:2.5MG,32000776,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
TOBRAMYCIN POWDER:1.2GM/50ML,32000780,CDM,J3260,HCPCS,250,RC,outpatient,,898.91,898.91,,763.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,224.73,22,,percent of total billed charges,,,,,,,,,809.02,90,,percent of total billed charges,,,744.3,82.8,,percent of total billed charges,,,764.07,85,,percent of total billed charges,,,,,,,,,791.04,88,,percent of total billed charges,,20.81,,,,fee schedule,,,686.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,20.81,,,,fee schedule,,,224.73,22,,percent of total billed charges,,,818.01,91,,percent of total billed charges,,,853.96,95,,percent of total billed charges,,,746.1,83,,percent of total billed charges,,,746.1,83,,percent of total billed charges,,,,,,,,,,,,,,,746.1,83,,percent of total billed charges,,,853.96,95,,percent of total billed charges,,,809.02,90,,percent of total billed charges,,,809.02,90,,percent of total billed charges,,,737.11,82,,percent of total billed charges,,,809.02,90,,percent of total billed charges,,,764.07,85,,percent of total billed charges,,20.81,853.96,
RAMIPRIL (ALTACE) CAP : 5MG,32000781,CDM,,,250,RC,outpatient,,34.26,34.26,,29.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.57,22,,percent of total billed charges,,,,,,,,,30.83,90,,percent of total billed charges,,,28.37,82.8,,percent of total billed charges,,,29.12,85,,percent of total billed charges,,,,,,,,,30.15,88,,percent of total billed charges,,,,,,,,,26.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.57,22,,percent of total billed charges,,,31.18,91,,percent of total billed charges,,,32.55,95,,percent of total billed charges,,,28.44,83,,percent of total billed charges,,,28.44,83,,percent of total billed charges,,,,,,,,,,,,,,,28.44,83,,percent of total billed charges,,,32.55,95,,percent of total billed charges,,,30.83,90,,percent of total billed charges,,,30.83,90,,percent of total billed charges,,,28.09,82,,percent of total billed charges,,,30.83,90,,percent of total billed charges,,,29.12,85,,percent of total billed charges,,8.57,32.55,
DAPTOmycin(CUBICIN):500MG--J/1MG,32000782,CDM,J0878,HCPCS,636,RC,outpatient,,388.73,388.73,,330.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.18,22,,percent of total billed charges,,,,,,,,,349.86,90,,percent of total billed charges,,,321.87,82.8,,percent of total billed charges,,,330.42,85,,percent of total billed charges,,,,,,,,,342.08,88,,percent of total billed charges,,33,,,,fee schedule,,,296.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,33,,,,fee schedule,,,97.18,22,,percent of total billed charges,,,353.74,91,,percent of total billed charges,,,369.29,95,,percent of total billed charges,,,322.65,83,,percent of total billed charges,,,322.65,83,,percent of total billed charges,,,,,,,,,,,,,,,322.65,83,,percent of total billed charges,,,369.29,95,,percent of total billed charges,,,349.86,90,,percent of total billed charges,,,349.86,90,,percent of total billed charges,,,318.76,82,,percent of total billed charges,,,349.86,90,,percent of total billed charges,,,330.42,85,,percent of total billed charges,,33,369.29,
"THROMBIN,TOPICAL VIAL:20,000 UNITS",32000787,CDM,J3490,HCPCS,250,RC,outpatient,,2836.09,2836.09,,2407.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,709.02,22,,percent of total billed charges,,,,,,,,,2552.48,90,,percent of total billed charges,,,2348.28,82.8,,percent of total billed charges,,,2410.68,85,,percent of total billed charges,,,,,,,,,2495.76,88,,percent of total billed charges,,,,,,,,,2166.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,709.02,22,,percent of total billed charges,,,2580.84,91,,percent of total billed charges,,,2694.29,95,,percent of total billed charges,,,2353.95,83,,percent of total billed charges,,,2353.95,83,,percent of total billed charges,,,,,,,,,,,,,,,2353.95,83,,percent of total billed charges,,,2694.29,95,,percent of total billed charges,,,2552.48,90,,percent of total billed charges,,,2552.48,90,,percent of total billed charges,,,2325.59,82,,percent of total billed charges,,,2552.48,90,,percent of total billed charges,,,2410.68,85,,percent of total billed charges,,709.02,2694.29,
FERUMOXYTOL(FERAHEME):510MG/17ML,32000788,CDM,,,250,RC,outpatient,,6802.11,6802.11,,5774.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1700.53,22,,percent of total billed charges,,,,,,,,,6121.9,90,,percent of total billed charges,,,5632.15,82.8,,percent of total billed charges,,,5781.79,85,,percent of total billed charges,,,,,,,,,5985.86,88,,percent of total billed charges,,,,,,,,,5196.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1700.53,22,,percent of total billed charges,,,6189.92,91,,percent of total billed charges,,,6462,95,,percent of total billed charges,,,5645.75,83,,percent of total billed charges,,,5645.75,83,,percent of total billed charges,,,,,,,,,,,,,,,5645.75,83,,percent of total billed charges,,,6462,95,,percent of total billed charges,,,6121.9,90,,percent of total billed charges,,,6121.9,90,,percent of total billed charges,,,5577.73,82,,percent of total billed charges,,,6121.9,90,,percent of total billed charges,,,5781.79,85,,percent of total billed charges,,1700.53,6462,
LINEZOLID(ZYVOX)-IVPB:600MG/300ML,32000789,CDM,J2020,HCPCS,250,RC,outpatient,,792.84,792.84,,673.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,198.21,22,,percent of total billed charges,,,,,,,,,713.56,90,,percent of total billed charges,,,656.47,82.8,,percent of total billed charges,,,673.91,85,,percent of total billed charges,,,,,,,,,697.7,88,,percent of total billed charges,,12.56,,,,fee schedule,,,605.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,12.56,,,,fee schedule,,,198.21,22,,percent of total billed charges,,,721.48,91,,percent of total billed charges,,,753.2,95,,percent of total billed charges,,,658.06,83,,percent of total billed charges,,,658.06,83,,percent of total billed charges,,,,,,,,,,,,,,,658.06,83,,percent of total billed charges,,,753.2,95,,percent of total billed charges,,,713.56,90,,percent of total billed charges,,,713.56,90,,percent of total billed charges,,,650.13,82,,percent of total billed charges,,,713.56,90,,percent of total billed charges,,,673.91,85,,percent of total billed charges,,12.56,753.2,
HYDROmorphone (DILAUDID) SYR:1MG/ML,32000790,CDM,J1170,HCPCS,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,3.47,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.47,,,,fee schedule,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,3.47,64.15,
INFLUENZA VACCINE(2010-2011)SYR:0.5ML,32000792,CDM,Q2034,HCPCS,636,RC,outpatient,,194.13,194.13,,164.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.53,22,,percent of total billed charges,,,,,,,,,174.72,90,,percent of total billed charges,,,160.74,82.8,,percent of total billed charges,,,165.01,85,,percent of total billed charges,,,,,,,,,170.83,88,,percent of total billed charges,,,,,,,,,148.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.53,22,,percent of total billed charges,,,176.66,91,,percent of total billed charges,,,184.42,95,,percent of total billed charges,,,161.13,83,,percent of total billed charges,,,161.13,83,,percent of total billed charges,,,,,,,,,,,,,,,161.13,83,,percent of total billed charges,,,184.42,95,,percent of total billed charges,,,174.72,90,,percent of total billed charges,,,174.72,90,,percent of total billed charges,,,159.19,82,,percent of total billed charges,,,174.72,90,,percent of total billed charges,,,165.01,85,,percent of total billed charges,,48.53,184.42,
FENOFIBRATE(TRICOR)CAP:200MG,32000793,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ERLOTINIB(TARCEVA)TAB:100MG,32000794,CDM,,,250,RC,outpatient,,1914.33,1914.33,,1625.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,478.58,22,,percent of total billed charges,,,,,,,,,1722.9,90,,percent of total billed charges,,,1585.07,82.8,,percent of total billed charges,,,1627.18,85,,percent of total billed charges,,,,,,,,,1684.61,88,,percent of total billed charges,,,,,,,,,1462.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,478.58,22,,percent of total billed charges,,,1742.04,91,,percent of total billed charges,,,1818.61,95,,percent of total billed charges,,,1588.89,83,,percent of total billed charges,,,1588.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1588.89,83,,percent of total billed charges,,,1818.61,95,,percent of total billed charges,,,1722.9,90,,percent of total billed charges,,,1722.9,90,,percent of total billed charges,,,1569.75,82,,percent of total billed charges,,,1722.9,90,,percent of total billed charges,,,1627.18,85,,percent of total billed charges,,478.58,1818.61,
ERLOTINIB(TARCEVA)TAB:150MG,32000795,CDM,,,250,RC,outpatient,,2165.26,2165.26,,1838.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,541.32,22,,percent of total billed charges,,,,,,,,,1948.73,90,,percent of total billed charges,,,1792.84,82.8,,percent of total billed charges,,,1840.47,85,,percent of total billed charges,,,,,,,,,1905.43,88,,percent of total billed charges,,,,,,,,,1654.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,541.32,22,,percent of total billed charges,,,1970.39,91,,percent of total billed charges,,,2057,95,,percent of total billed charges,,,1797.17,83,,percent of total billed charges,,,1797.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1797.17,83,,percent of total billed charges,,,2057,95,,percent of total billed charges,,,1948.73,90,,percent of total billed charges,,,1948.73,90,,percent of total billed charges,,,1775.51,82,,percent of total billed charges,,,1948.73,90,,percent of total billed charges,,,1840.47,85,,percent of total billed charges,,541.32,2057,
DENOSUMAB (PROLIA) 60 mg,32000797,CDM,J0897,HCPCS,636,RC,outpatient,,6874.88,6874.88,,5836.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1718.72,22,,percent of total billed charges,,,,,,,,,6187.39,90,,percent of total billed charges,,,5692.4,82.8,,percent of total billed charges,,,5843.65,85,,percent of total billed charges,,,,,,,,,6049.89,88,,percent of total billed charges,,2701.2,,,,fee schedule,,,5252.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2701.2,,,,fee schedule,,,1718.72,22,,percent of total billed charges,,,6256.14,91,,percent of total billed charges,,,6531.14,95,,percent of total billed charges,,,5706.15,83,,percent of total billed charges,,,5706.15,83,,percent of total billed charges,,,,,,,,,,,,,,,5706.15,83,,percent of total billed charges,,,6531.14,95,,percent of total billed charges,,,6187.39,90,,percent of total billed charges,,,6187.39,90,,percent of total billed charges,,,5637.4,82,,percent of total billed charges,,,6187.39,90,,percent of total billed charges,,,5843.65,85,,percent of total billed charges,,1718.72,6531.14,
CABAZITAXEL(JEVTANA)60MG/1.5ML:J/1MG,32000798,CDM,J9043,HCPCS,636,RC,outpatient,,2851.97,2851.97,,2421.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,712.99,22,,percent of total billed charges,,,,,,,,,2566.77,90,,percent of total billed charges,,,2361.43,82.8,,percent of total billed charges,,,2424.17,85,,percent of total billed charges,,,,,,,,,2509.73,88,,percent of total billed charges,,11739.18,,,,fee schedule,,,2178.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11739.18,,,,fee schedule,,,712.99,22,,percent of total billed charges,,,2595.29,91,,percent of total billed charges,,,2709.37,95,,percent of total billed charges,,,2367.14,83,,percent of total billed charges,,,2367.14,83,,percent of total billed charges,,,,,,,,,,,,,,,2367.14,83,,percent of total billed charges,,,2709.37,95,,percent of total billed charges,,,2566.77,90,,percent of total billed charges,,,2566.77,90,,percent of total billed charges,,,2338.62,82,,percent of total billed charges,,,2566.77,90,,percent of total billed charges,,,2424.17,85,,percent of total billed charges,,712.99,11739.18,
BOTOX THERAPEUTIC 100 UNITS: J/UNIT,32000799,CDM,J0585,HCPCS,636,RC,outpatient,,4780.69,4780.69,,4058.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1195.17,22,,percent of total billed charges,,,,,,,,,4302.62,90,,percent of total billed charges,,,3958.41,82.8,,percent of total billed charges,,,4063.59,85,,percent of total billed charges,,,,,,,,,4207.01,88,,percent of total billed charges,,2491.6,,,,fee schedule,,,3652.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2491.6,,,,fee schedule,,,1195.17,22,,percent of total billed charges,,,4350.43,91,,percent of total billed charges,,,4541.66,95,,percent of total billed charges,,,3967.97,83,,percent of total billed charges,,,3967.97,83,,percent of total billed charges,,,,,,,,,,,,,,,3967.97,83,,percent of total billed charges,,,4541.66,95,,percent of total billed charges,,,4302.62,90,,percent of total billed charges,,,4302.62,90,,percent of total billed charges,,,3920.17,82,,percent of total billed charges,,,4302.62,90,,percent of total billed charges,,,4063.59,85,,percent of total billed charges,,1195.17,4541.66,
BCG LIVE (TICE) VIAL:50 MG,32000800,CDM,J9031,HCPCS,636,RC,outpatient,,2215.85,2215.85,,1881.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,553.96,22,,percent of total billed charges,,,,,,,,,1994.27,90,,percent of total billed charges,,,1834.72,82.8,,percent of total billed charges,,,1883.47,85,,percent of total billed charges,,,,,,,,,1949.95,88,,percent of total billed charges,,,,,,,,,1692.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,553.96,22,,percent of total billed charges,,,2016.42,91,,percent of total billed charges,,,2105.06,95,,percent of total billed charges,,,1839.16,83,,percent of total billed charges,,,1839.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1839.16,83,,percent of total billed charges,,,2105.06,95,,percent of total billed charges,,,1994.27,90,,percent of total billed charges,,,1994.27,90,,percent of total billed charges,,,1817,82,,percent of total billed charges,,,1994.27,90,,percent of total billed charges,,,1883.47,85,,percent of total billed charges,,553.96,2105.06,
HISTRELIN ACET(VANTAS)IMPLANT:50MG,32000802,CDM,J9225,HCPCS,636,RC,outpatient,,23028.98,23028.98,,19551.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5757.25,22,,percent of total billed charges,,,,,,,,,20726.08,90,,percent of total billed charges,,,19068,82.8,,percent of total billed charges,,,19574.63,85,,percent of total billed charges,,,,,,,,,20265.5,88,,percent of total billed charges,,5166.29,,,,fee schedule,,,17594.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5166.29,,,,fee schedule,,,5757.25,22,,percent of total billed charges,,,20956.37,91,,percent of total billed charges,,,21877.53,95,,percent of total billed charges,,,19114.05,83,,percent of total billed charges,,,19114.05,83,,percent of total billed charges,,,,,,,,,,,,,,,19114.05,83,,percent of total billed charges,,,21877.53,95,,percent of total billed charges,,,20726.08,90,,percent of total billed charges,,,20726.08,90,,percent of total billed charges,,,18883.76,82,,percent of total billed charges,,,20726.08,90,,percent of total billed charges,,,19574.63,85,,percent of total billed charges,,5166.29,21877.53,
INTERFERON alpha2b:50MMU(Units)   J/1MMU,32000803,CDM,J9214,HCPCS,636,RC,outpatient,,399.67,399.67,,339.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,99.92,22,,percent of total billed charges,,,,,,,,,359.7,90,,percent of total billed charges,,,330.93,82.8,,percent of total billed charges,,,339.72,85,,percent of total billed charges,,,,,,,,,351.71,88,,percent of total billed charges,,2443.05,,,,fee schedule,,,305.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2443.05,,,,fee schedule,,,99.92,22,,percent of total billed charges,,,363.7,91,,percent of total billed charges,,,379.69,95,,percent of total billed charges,,,331.73,83,,percent of total billed charges,,,331.73,83,,percent of total billed charges,,,,,,,,,,,,,,,331.73,83,,percent of total billed charges,,,379.69,95,,percent of total billed charges,,,359.7,90,,percent of total billed charges,,,359.7,90,,percent of total billed charges,,,327.73,82,,percent of total billed charges,,,359.7,90,,percent of total billed charges,,,339.72,85,,percent of total billed charges,,99.92,2443.05,
TIGECYCLINE(TIGACIL)VL:50MG          J/1,32000804,CDM,J3243,HCPCS,250,RC,outpatient,,2219.62,2219.62,,1884.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,554.91,22,,percent of total billed charges,,,,,,,,,1997.66,90,,percent of total billed charges,,,1837.85,82.8,,percent of total billed charges,,,1886.68,85,,percent of total billed charges,,,,,,,,,1953.27,88,,percent of total billed charges,,91.1,,,,fee schedule,,,1695.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,91.1,,,,fee schedule,,,554.91,22,,percent of total billed charges,,,2019.85,91,,percent of total billed charges,,,2108.64,95,,percent of total billed charges,,,1842.28,83,,percent of total billed charges,,,1842.28,83,,percent of total billed charges,,,,,,,,,,,,,,,1842.28,83,,percent of total billed charges,,,2108.64,95,,percent of total billed charges,,,1997.66,90,,percent of total billed charges,,,1997.66,90,,percent of total billed charges,,,1820.09,82,,percent of total billed charges,,,1997.66,90,,percent of total billed charges,,,1886.68,85,,percent of total billed charges,,91.1,2108.64,
BCG(THERACYCS) LIVE VIAL:81MG,32000805,CDM,J9031,HCPCS,636,RC,outpatient,,2408.31,2408.31,,2044.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,602.08,22,,percent of total billed charges,,,,,,,,,2167.48,90,,percent of total billed charges,,,1994.08,82.8,,percent of total billed charges,,,2047.06,85,,percent of total billed charges,,,,,,,,,2119.31,88,,percent of total billed charges,,,,,,,,,1839.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,602.08,22,,percent of total billed charges,,,2191.56,91,,percent of total billed charges,,,2287.89,95,,percent of total billed charges,,,1998.9,83,,percent of total billed charges,,,1998.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1998.9,83,,percent of total billed charges,,,2287.89,95,,percent of total billed charges,,,2167.48,90,,percent of total billed charges,,,2167.48,90,,percent of total billed charges,,,1974.81,82,,percent of total billed charges,,,2167.48,90,,percent of total billed charges,,,2047.06,85,,percent of total billed charges,,602.08,2287.89,
BELLADONNA ALK W/ PB(DONNATAL) ELIXR:5ML,32000807,CDM,,,250,RC,outpatient,,149.72,149.72,,127.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.43,22,,percent of total billed charges,,,,,,,,,134.75,90,,percent of total billed charges,,,123.97,82.8,,percent of total billed charges,,,127.26,85,,percent of total billed charges,,,,,,,,,131.75,88,,percent of total billed charges,,,,,,,,,114.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.43,22,,percent of total billed charges,,,136.25,91,,percent of total billed charges,,,142.23,95,,percent of total billed charges,,,124.27,83,,percent of total billed charges,,,124.27,83,,percent of total billed charges,,,,,,,,,,,,,,,124.27,83,,percent of total billed charges,,,142.23,95,,percent of total billed charges,,,134.75,90,,percent of total billed charges,,,134.75,90,,percent of total billed charges,,,122.77,82,,percent of total billed charges,,,134.75,90,,percent of total billed charges,,,127.26,85,,percent of total billed charges,,37.43,142.23,
PHENobarbital SODIUM VIAL:65MG/ML,32000808,CDM,J2560,HCPCS,250,RC,outpatient,,289.76,289.76,,246.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.44,22,,percent of total billed charges,,,,,,,,,260.78,90,,percent of total billed charges,,,239.92,82.8,,percent of total billed charges,,,246.3,85,,percent of total billed charges,,,,,,,,,254.99,88,,percent of total billed charges,,224.63,,,,fee schedule,,,221.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,224.63,,,,fee schedule,,,72.44,22,,percent of total billed charges,,,263.68,91,,percent of total billed charges,,,275.27,95,,percent of total billed charges,,,240.5,83,,percent of total billed charges,,,240.5,83,,percent of total billed charges,,,,,,,,,,,,,,,240.5,83,,percent of total billed charges,,,275.27,95,,percent of total billed charges,,,260.78,90,,percent of total billed charges,,,260.78,90,,percent of total billed charges,,,237.6,82,,percent of total billed charges,,,260.78,90,,percent of total billed charges,,,246.3,85,,percent of total billed charges,,72.44,275.27,
TRANEXAMIC(CYKLOKAPRON)VIAL:1000MG/10ML,32000809,CDM,J3490,HCPCS,250,RC,outpatient,,64.22,64.22,,54.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.06,22,,percent of total billed charges,,,,,,,,,57.8,90,,percent of total billed charges,,,53.17,82.8,,percent of total billed charges,,,54.59,85,,percent of total billed charges,,,,,,,,,56.51,88,,percent of total billed charges,,,,,,,,,49.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.06,22,,percent of total billed charges,,,58.44,91,,percent of total billed charges,,,61.01,95,,percent of total billed charges,,,53.3,83,,percent of total billed charges,,,53.3,83,,percent of total billed charges,,,,,,,,,,,,,,,53.3,83,,percent of total billed charges,,,61.01,95,,percent of total billed charges,,,57.8,90,,percent of total billed charges,,,57.8,90,,percent of total billed charges,,,52.66,82,,percent of total billed charges,,,57.8,90,,percent of total billed charges,,,54.59,85,,percent of total billed charges,,16.06,61.01,
TESTOSTERONE(ANDROGEL) 1%:,32000810,CDM,,,250,RC,outpatient,,355.42,355.42,,301.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.86,22,,percent of total billed charges,,,,,,,,,319.88,90,,percent of total billed charges,,,294.29,82.8,,percent of total billed charges,,,302.11,85,,percent of total billed charges,,,,,,,,,312.77,88,,percent of total billed charges,,,,,,,,,271.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.86,22,,percent of total billed charges,,,323.43,91,,percent of total billed charges,,,337.65,95,,percent of total billed charges,,,295,83,,percent of total billed charges,,,295,83,,percent of total billed charges,,,,,,,,,,,,,,,295,83,,percent of total billed charges,,,337.65,95,,percent of total billed charges,,,319.88,90,,percent of total billed charges,,,319.88,90,,percent of total billed charges,,,291.44,82,,percent of total billed charges,,,319.88,90,,percent of total billed charges,,,302.11,85,,percent of total billed charges,,88.86,337.65,
POTASSIUM CHLORIDE VIAL:40MEQ/20ML,32000811,CDM,J3480,HCPCS,250,RC,outpatient,,77.12,77.12,,65.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.28,22,,percent of total billed charges,,,,,,,,,69.41,90,,percent of total billed charges,,,63.86,82.8,,percent of total billed charges,,,65.55,85,,percent of total billed charges,,,,,,,,,67.87,88,,percent of total billed charges,,3.22,,,,fee schedule,,,58.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,19.28,22,,percent of total billed charges,,,70.18,91,,percent of total billed charges,,,73.26,95,,percent of total billed charges,,,64.01,83,,percent of total billed charges,,,64.01,83,,percent of total billed charges,,,,,,,,,,,,,,,64.01,83,,percent of total billed charges,,,73.26,95,,percent of total billed charges,,,69.41,90,,percent of total billed charges,,,69.41,90,,percent of total billed charges,,,63.24,82,,percent of total billed charges,,,69.41,90,,percent of total billed charges,,,65.55,85,,percent of total billed charges,,3.22,73.26,
sitaGLIPtin(JANUVIA) TAB:100MG,32000812,CDM,,,250,RC,outpatient,,275.81,275.81,,234.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.95,22,,percent of total billed charges,,,,,,,,,248.23,90,,percent of total billed charges,,,228.37,82.8,,percent of total billed charges,,,234.44,85,,percent of total billed charges,,,,,,,,,242.71,88,,percent of total billed charges,,,,,,,,,210.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.95,22,,percent of total billed charges,,,250.99,91,,percent of total billed charges,,,262.02,95,,percent of total billed charges,,,228.92,83,,percent of total billed charges,,,228.92,83,,percent of total billed charges,,,,,,,,,,,,,,,228.92,83,,percent of total billed charges,,,262.02,95,,percent of total billed charges,,,248.23,90,,percent of total billed charges,,,248.23,90,,percent of total billed charges,,,226.16,82,,percent of total billed charges,,,248.23,90,,percent of total billed charges,,,234.44,85,,percent of total billed charges,,68.95,262.02,
OLOPATADINE(PATANASE):665MCG (30.5GM),32000813,CDM,,,250,RC,outpatient,,2225.21,2225.21,,1889.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,556.3,22,,percent of total billed charges,,,,,,,,,2002.69,90,,percent of total billed charges,,,1842.47,82.8,,percent of total billed charges,,,1891.43,85,,percent of total billed charges,,,,,,,,,1958.18,88,,percent of total billed charges,,,,,,,,,1700.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,556.3,22,,percent of total billed charges,,,2024.94,91,,percent of total billed charges,,,2113.95,95,,percent of total billed charges,,,1846.92,83,,percent of total billed charges,,,1846.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1846.92,83,,percent of total billed charges,,,2113.95,95,,percent of total billed charges,,,2002.69,90,,percent of total billed charges,,,2002.69,90,,percent of total billed charges,,,1824.67,82,,percent of total billed charges,,,2002.69,90,,percent of total billed charges,,,1891.43,85,,percent of total billed charges,,556.3,2113.95,
GLYCOPYRROL(ROBINUL)VIAL:0.2MG/1ML,32000814,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
IV DEXTRAN/D5W40(LMD 10%/5%DEXT) 500ML,32000815,CDM,,,250,RC,outpatient,,443.92,443.92,,376.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.98,22,,percent of total billed charges,,,,,,,,,399.53,90,,percent of total billed charges,,,367.57,82.8,,percent of total billed charges,,,377.33,85,,percent of total billed charges,,,,,,,,,390.65,88,,percent of total billed charges,,,,,,,,,339.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.98,22,,percent of total billed charges,,,403.97,91,,percent of total billed charges,,,421.72,95,,percent of total billed charges,,,368.45,83,,percent of total billed charges,,,368.45,83,,percent of total billed charges,,,,,,,,,,,,,,,368.45,83,,percent of total billed charges,,,421.72,95,,percent of total billed charges,,,399.53,90,,percent of total billed charges,,,399.53,90,,percent of total billed charges,,,364.01,82,,percent of total billed charges,,,399.53,90,,percent of total billed charges,,,377.33,85,,percent of total billed charges,,110.98,421.72,
hydrOXYzine(VISTARIL)VIAL(*IM*):50MG/ML,32000816,CDM,J3410,HCPCS,250,RC,outpatient,,293.3,293.3,,249.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.33,22,,percent of total billed charges,,,,,,,,,263.97,90,,percent of total billed charges,,,242.85,82.8,,percent of total billed charges,,,249.31,85,,percent of total billed charges,,,,,,,,,258.1,88,,percent of total billed charges,,45.34,,,,fee schedule,,,224.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,45.34,,,,fee schedule,,,73.33,22,,percent of total billed charges,,,266.9,91,,percent of total billed charges,,,278.64,95,,percent of total billed charges,,,243.44,83,,percent of total billed charges,,,243.44,83,,percent of total billed charges,,,,,,,,,,,,,,,243.44,83,,percent of total billed charges,,,278.64,95,,percent of total billed charges,,,263.97,90,,percent of total billed charges,,,263.97,90,,percent of total billed charges,,,240.51,82,,percent of total billed charges,,,263.97,90,,percent of total billed charges,,,249.31,85,,percent of total billed charges,,45.34,278.64,
SUFentanil(SUFENTA) AMP:100MCG/2ML,32000817,CDM,,,250,RC,outpatient,,83.26,83.26,,70.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.82,22,,percent of total billed charges,,,,,,,,,74.93,90,,percent of total billed charges,,,68.94,82.8,,percent of total billed charges,,,70.77,85,,percent of total billed charges,,,,,,,,,73.27,88,,percent of total billed charges,,,,,,,,,63.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.82,22,,percent of total billed charges,,,75.77,91,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,,,,,,,,,,,,,69.11,83,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,68.27,82,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,70.77,85,,percent of total billed charges,,20.82,79.1,
ONDANSETRON(ZOFRAN)ODT TAB:4MG,32000818,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
VITAMIN B-COMPLEX 100 VIAL:30ML,32000819,CDM,J3490,HCPCS,250,RC,outpatient,,102.46,102.46,,86.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.62,22,,percent of total billed charges,,,,,,,,,92.21,90,,percent of total billed charges,,,84.84,82.8,,percent of total billed charges,,,87.09,85,,percent of total billed charges,,,,,,,,,90.16,88,,percent of total billed charges,,,,,,,,,78.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.62,22,,percent of total billed charges,,,93.24,91,,percent of total billed charges,,,97.34,95,,percent of total billed charges,,,85.04,83,,percent of total billed charges,,,85.04,83,,percent of total billed charges,,,,,,,,,,,,,,,85.04,83,,percent of total billed charges,,,97.34,95,,percent of total billed charges,,,92.21,90,,percent of total billed charges,,,92.21,90,,percent of total billed charges,,,84.02,82,,percent of total billed charges,,,92.21,90,,percent of total billed charges,,,87.09,85,,percent of total billed charges,,25.62,97.34,
SODIUM CHLORIDE 0.9% IRRIG (BAG) 1000ML:,32000820,CDM,,,258,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
AMANTADINE(SYMMETREL)SYRP:50MG/5ML(60ML),32000821,CDM,J8499,HCPCS,250,RC,outpatient,,13.96,13.96,,11.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.49,22,,percent of total billed charges,,,,,,,,,12.56,90,,percent of total billed charges,,,11.56,82.8,,percent of total billed charges,,,11.87,85,,percent of total billed charges,,,,,,,,,12.28,88,,percent of total billed charges,,,,,,,,,10.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.49,22,,percent of total billed charges,,,12.7,91,,percent of total billed charges,,,13.26,95,,percent of total billed charges,,,11.59,83,,percent of total billed charges,,,11.59,83,,percent of total billed charges,,,,,,,,,,,,,,,11.59,83,,percent of total billed charges,,,13.26,95,,percent of total billed charges,,,12.56,90,,percent of total billed charges,,,12.56,90,,percent of total billed charges,,,11.45,82,,percent of total billed charges,,,12.56,90,,percent of total billed charges,,,11.87,85,,percent of total billed charges,,3.49,13.26,
MEROPENEM(MERREM)VIAL:1000MG,32000822,CDM,J2185,HCPCS,250,RC,outpatient,,74.35,74.35,,63.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.59,22,,percent of total billed charges,,,,,,,,,66.92,90,,percent of total billed charges,,,61.56,82.8,,percent of total billed charges,,,63.2,85,,percent of total billed charges,,,,,,,,,65.43,88,,percent of total billed charges,,14.5,,,,fee schedule,,,56.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.5,,,,fee schedule,,,18.59,22,,percent of total billed charges,,,67.66,91,,percent of total billed charges,,,70.63,95,,percent of total billed charges,,,61.71,83,,percent of total billed charges,,,61.71,83,,percent of total billed charges,,,,,,,,,,,,,,,61.71,83,,percent of total billed charges,,,70.63,95,,percent of total billed charges,,,66.92,90,,percent of total billed charges,,,66.92,90,,percent of total billed charges,,,60.97,82,,percent of total billed charges,,,66.92,90,,percent of total billed charges,,,63.2,85,,percent of total billed charges,,14.5,70.63,
BLEOMYCIN VIAL: 30 UNITS,32000823,CDM,J9040,HCPCS,636,RC,outpatient,,1033.4,1033.4,,877.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,258.35,22,,percent of total billed charges,,,,,,,,,930.06,90,,percent of total billed charges,,,855.66,82.8,,percent of total billed charges,,,878.39,85,,percent of total billed charges,,,,,,,,,909.39,88,,percent of total billed charges,,97.2,,,,fee schedule,,,789.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,97.2,,,,fee schedule,,,258.35,22,,percent of total billed charges,,,940.39,91,,percent of total billed charges,,,981.73,95,,percent of total billed charges,,,857.72,83,,percent of total billed charges,,,857.72,83,,percent of total billed charges,,,,,,,,,,,,,,,857.72,83,,percent of total billed charges,,,981.73,95,,percent of total billed charges,,,930.06,90,,percent of total billed charges,,,930.06,90,,percent of total billed charges,,,847.39,82,,percent of total billed charges,,,930.06,90,,percent of total billed charges,,,878.39,85,,percent of total billed charges,,97.2,981.73,
CHLOROPROCAI(NESACAINE)VL:30MG/ML (20ML),32000824,CDM,,,250,RC,outpatient,,372.71,372.71,,316.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.18,22,,percent of total billed charges,,,,,,,,,335.44,90,,percent of total billed charges,,,308.6,82.8,,percent of total billed charges,,,316.8,85,,percent of total billed charges,,,,,,,,,327.98,88,,percent of total billed charges,,,,,,,,,284.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.18,22,,percent of total billed charges,,,339.17,91,,percent of total billed charges,,,354.07,95,,percent of total billed charges,,,309.35,83,,percent of total billed charges,,,309.35,83,,percent of total billed charges,,,,,,,,,,,,,,,309.35,83,,percent of total billed charges,,,354.07,95,,percent of total billed charges,,,335.44,90,,percent of total billed charges,,,335.44,90,,percent of total billed charges,,,305.62,82,,percent of total billed charges,,,335.44,90,,percent of total billed charges,,,316.8,85,,percent of total billed charges,,93.18,354.07,
NEBIVOLOL(BYSTOLIC)TAB:2.5MG,32000825,CDM,J8499,HCPCS,250,RC,outpatient,,93.46,93.46,,79.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.37,22,,percent of total billed charges,,,,,,,,,84.11,90,,percent of total billed charges,,,77.38,82.8,,percent of total billed charges,,,79.44,85,,percent of total billed charges,,,,,,,,,82.24,88,,percent of total billed charges,,,,,,,,,71.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.37,22,,percent of total billed charges,,,85.05,91,,percent of total billed charges,,,88.79,95,,percent of total billed charges,,,77.57,83,,percent of total billed charges,,,77.57,83,,percent of total billed charges,,,,,,,,,,,,,,,77.57,83,,percent of total billed charges,,,88.79,95,,percent of total billed charges,,,84.11,90,,percent of total billed charges,,,84.11,90,,percent of total billed charges,,,76.64,82,,percent of total billed charges,,,84.11,90,,percent of total billed charges,,,79.44,85,,percent of total billed charges,,23.37,88.79,
AMANTADINE(SYMETREL) SYRP:50MG/5ML 480ML,32000826,CDM,,,250,RC,outpatient,,109.43,109.43,,92.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.36,22,,percent of total billed charges,,,,,,,,,98.49,90,,percent of total billed charges,,,90.61,82.8,,percent of total billed charges,,,93.02,85,,percent of total billed charges,,,,,,,,,96.3,88,,percent of total billed charges,,,,,,,,,83.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.36,22,,percent of total billed charges,,,99.58,91,,percent of total billed charges,,,103.96,95,,percent of total billed charges,,,90.83,83,,percent of total billed charges,,,90.83,83,,percent of total billed charges,,,,,,,,,,,,,,,90.83,83,,percent of total billed charges,,,103.96,95,,percent of total billed charges,,,98.49,90,,percent of total billed charges,,,98.49,90,,percent of total billed charges,,,89.73,82,,percent of total billed charges,,,98.49,90,,percent of total billed charges,,,93.02,85,,percent of total billed charges,,27.36,103.96,
FOSAPREPITANT (EMEND)VIAL:150MG,32000827,CDM,J1453,HCPCS,636,RC,outpatient,,273.65,273.65,,232.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.41,22,,percent of total billed charges,,,,,,,,,246.29,90,,percent of total billed charges,,,226.58,82.8,,percent of total billed charges,,,232.6,85,,percent of total billed charges,,,,,,,,,240.81,88,,percent of total billed charges,,21,,,,fee schedule,,,209.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21,,,,fee schedule,,,68.41,22,,percent of total billed charges,,,249.02,91,,percent of total billed charges,,,259.97,95,,percent of total billed charges,,,227.13,83,,percent of total billed charges,,,227.13,83,,percent of total billed charges,,,,,,,,,,,,,,,227.13,83,,percent of total billed charges,,,259.97,95,,percent of total billed charges,,,246.29,90,,percent of total billed charges,,,246.29,90,,percent of total billed charges,,,224.39,82,,percent of total billed charges,,,246.29,90,,percent of total billed charges,,,232.6,85,,percent of total billed charges,,21,259.97,
SODIUM BICARB SYR 4.2%:5MEQ/10ML(INFANT),32000828,CDM,J3490,HCPCS,250,RC,outpatient,,188.73,188.73,,160.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.18,22,,percent of total billed charges,,,,,,,,,169.86,90,,percent of total billed charges,,,156.27,82.8,,percent of total billed charges,,,160.42,85,,percent of total billed charges,,,,,,,,,166.08,88,,percent of total billed charges,,,,,,,,,144.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.18,22,,percent of total billed charges,,,171.74,91,,percent of total billed charges,,,179.29,95,,percent of total billed charges,,,156.65,83,,percent of total billed charges,,,156.65,83,,percent of total billed charges,,,,,,,,,,,,,,,156.65,83,,percent of total billed charges,,,179.29,95,,percent of total billed charges,,,169.86,90,,percent of total billed charges,,,169.86,90,,percent of total billed charges,,,154.76,82,,percent of total billed charges,,,169.86,90,,percent of total billed charges,,,160.42,85,,percent of total billed charges,,47.18,179.29,
chlorproMAZINE(THORAZINE)AMP:50MG/2ML,32000829,CDM,J3230,HCPCS,250,RC,outpatient,,551.29,551.29,,468.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,137.82,22,,percent of total billed charges,,,,,,,,,496.16,90,,percent of total billed charges,,,456.47,82.8,,percent of total billed charges,,,468.6,85,,percent of total billed charges,,,,,,,,,485.14,88,,percent of total billed charges,,272.04,,,,fee schedule,,,421.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,272.04,,,,fee schedule,,,137.82,22,,percent of total billed charges,,,501.67,91,,percent of total billed charges,,,523.73,95,,percent of total billed charges,,,457.57,83,,percent of total billed charges,,,457.57,83,,percent of total billed charges,,,,,,,,,,,,,,,457.57,83,,percent of total billed charges,,,523.73,95,,percent of total billed charges,,,496.16,90,,percent of total billed charges,,,496.16,90,,percent of total billed charges,,,452.06,82,,percent of total billed charges,,,496.16,90,,percent of total billed charges,,,468.6,85,,percent of total billed charges,,137.82,523.73,
DESVENLAFAXINE SUCC(PRISTIQ)TAB:50MG,32000830,CDM,,,250,RC,outpatient,,236,236,,200.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59,22,,percent of total billed charges,,,,,,,,,212.4,90,,percent of total billed charges,,,195.41,82.8,,percent of total billed charges,,,200.6,85,,percent of total billed charges,,,,,,,,,207.68,88,,percent of total billed charges,,,,,,,,,180.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59,22,,percent of total billed charges,,,214.76,91,,percent of total billed charges,,,224.2,95,,percent of total billed charges,,,195.88,83,,percent of total billed charges,,,195.88,83,,percent of total billed charges,,,,,,,,,,,,,,,195.88,83,,percent of total billed charges,,,224.2,95,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,193.52,82,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,200.6,85,,percent of total billed charges,,59,224.2,
AMANTADINE(SYMMETREL) SYRP:50MG/5ML 90ML,32000831,CDM,,,250,RC,outpatient,,20.78,20.78,,17.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.2,22,,percent of total billed charges,,,,,,,,,18.7,90,,percent of total billed charges,,,17.21,82.8,,percent of total billed charges,,,17.66,85,,percent of total billed charges,,,,,,,,,18.29,88,,percent of total billed charges,,,,,,,,,15.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.2,22,,percent of total billed charges,,,18.91,91,,percent of total billed charges,,,19.74,95,,percent of total billed charges,,,17.25,83,,percent of total billed charges,,,17.25,83,,percent of total billed charges,,,,,,,,,,,,,,,17.25,83,,percent of total billed charges,,,19.74,95,,percent of total billed charges,,,18.7,90,,percent of total billed charges,,,18.7,90,,percent of total billed charges,,,17.04,82,,percent of total billed charges,,,18.7,90,,percent of total billed charges,,,17.66,85,,percent of total billed charges,,5.2,19.74,
MAGIC MOUTH WASH 1(Lido Malx Bndrl):90ml,32000832,CDM,,,250,RC,outpatient,,108.17,108.17,,91.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.04,22,,percent of total billed charges,,,,,,,,,97.35,90,,percent of total billed charges,,,89.56,82.8,,percent of total billed charges,,,91.94,85,,percent of total billed charges,,,,,,,,,95.19,88,,percent of total billed charges,,,,,,,,,82.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.04,22,,percent of total billed charges,,,98.43,91,,percent of total billed charges,,,102.76,95,,percent of total billed charges,,,89.78,83,,percent of total billed charges,,,89.78,83,,percent of total billed charges,,,,,,,,,,,,,,,89.78,83,,percent of total billed charges,,,102.76,95,,percent of total billed charges,,,97.35,90,,percent of total billed charges,,,97.35,90,,percent of total billed charges,,,88.7,82,,percent of total billed charges,,,97.35,90,,percent of total billed charges,,,91.94,85,,percent of total billed charges,,27.04,102.76,
ARFORMOTEROL(BROVANA)INH:15MCG/2ML,32000833,CDM,,,250,RC,outpatient,,312.44,312.44,,265.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.11,22,,percent of total billed charges,,,,,,,,,281.2,90,,percent of total billed charges,,,258.7,82.8,,percent of total billed charges,,,265.57,85,,percent of total billed charges,,,,,,,,,274.95,88,,percent of total billed charges,,,,,,,,,238.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.11,22,,percent of total billed charges,,,284.32,91,,percent of total billed charges,,,296.82,95,,percent of total billed charges,,,259.33,83,,percent of total billed charges,,,259.33,83,,percent of total billed charges,,,,,,,,,,,,,,,259.33,83,,percent of total billed charges,,,296.82,95,,percent of total billed charges,,,281.2,90,,percent of total billed charges,,,281.2,90,,percent of total billed charges,,,256.2,82,,percent of total billed charges,,,281.2,90,,percent of total billed charges,,,265.57,85,,percent of total billed charges,,78.11,296.82,
RIFAMPIN VIAL:600MG,32000834,CDM,J3490,HCPCS,250,RC,outpatient,,1206.91,1206.91,,1024.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,301.73,22,,percent of total billed charges,,,,,,,,,1086.22,90,,percent of total billed charges,,,999.32,82.8,,percent of total billed charges,,,1025.87,85,,percent of total billed charges,,,,,,,,,1062.08,88,,percent of total billed charges,,,,,,,,,922.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,301.73,22,,percent of total billed charges,,,1098.29,91,,percent of total billed charges,,,1146.56,95,,percent of total billed charges,,,1001.74,83,,percent of total billed charges,,,1001.74,83,,percent of total billed charges,,,,,,,,,,,,,,,1001.74,83,,percent of total billed charges,,,1146.56,95,,percent of total billed charges,,,1086.22,90,,percent of total billed charges,,,1086.22,90,,percent of total billed charges,,,989.67,82,,percent of total billed charges,,,1086.22,90,,percent of total billed charges,,,1025.87,85,,percent of total billed charges,,301.73,1146.56,
DABIGATRAN(PRADAXA) CAPS:75MG,32000835,CDM,J8499,HCPCS,250,RC,outpatient,,120.92,120.92,,102.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.23,22,,percent of total billed charges,,,,,,,,,108.83,90,,percent of total billed charges,,,100.12,82.8,,percent of total billed charges,,,102.78,85,,percent of total billed charges,,,,,,,,,106.41,88,,percent of total billed charges,,,,,,,,,92.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.23,22,,percent of total billed charges,,,110.04,91,,percent of total billed charges,,,114.87,95,,percent of total billed charges,,,100.36,83,,percent of total billed charges,,,100.36,83,,percent of total billed charges,,,,,,,,,,,,,,,100.36,83,,percent of total billed charges,,,114.87,95,,percent of total billed charges,,,108.83,90,,percent of total billed charges,,,108.83,90,,percent of total billed charges,,,99.15,82,,percent of total billed charges,,,108.83,90,,percent of total billed charges,,,102.78,85,,percent of total billed charges,,30.23,114.87,
AMANTADINE(SYMMETREL)CAP:100MG,32000836,CDM,J8499,HCPCS,250,RC,outpatient,,14.71,14.71,,12.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.68,22,,percent of total billed charges,,,,,,,,,13.24,90,,percent of total billed charges,,,12.18,82.8,,percent of total billed charges,,,12.5,85,,percent of total billed charges,,,,,,,,,12.94,88,,percent of total billed charges,,,,,,,,,11.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.68,22,,percent of total billed charges,,,13.39,91,,percent of total billed charges,,,13.97,95,,percent of total billed charges,,,12.21,83,,percent of total billed charges,,,12.21,83,,percent of total billed charges,,,,,,,,,,,,,,,12.21,83,,percent of total billed charges,,,13.97,95,,percent of total billed charges,,,13.24,90,,percent of total billed charges,,,13.24,90,,percent of total billed charges,,,12.06,82,,percent of total billed charges,,,13.24,90,,percent of total billed charges,,,12.5,85,,percent of total billed charges,,3.68,13.97,
GLIMEPIRIDE (AMARYL) TAB : 2MG,32000837,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ACETAMINOPHEN-IVPB:1000MG/100ML,32000838,CDM,J0131,HCPCS,250,RC,outpatient,,168.96,168.96,,143.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.24,22,,percent of total billed charges,,,,,,,,,152.06,90,,percent of total billed charges,,,139.9,82.8,,percent of total billed charges,,,143.62,85,,percent of total billed charges,,,,,,,,,148.68,88,,percent of total billed charges,,5.83,,,,fee schedule,,,129.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.83,,,,fee schedule,,,42.24,22,,percent of total billed charges,,,153.75,91,,percent of total billed charges,,,160.51,95,,percent of total billed charges,,,140.24,83,,percent of total billed charges,,,140.24,83,,percent of total billed charges,,,,,,,,,,,,,,,140.24,83,,percent of total billed charges,,,160.51,95,,percent of total billed charges,,,152.06,90,,percent of total billed charges,,,152.06,90,,percent of total billed charges,,,138.55,82,,percent of total billed charges,,,152.06,90,,percent of total billed charges,,,143.62,85,,percent of total billed charges,,5.83,160.51,
ZOLPIDEM(AMBIEN)TAB:5MG,32000841,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
ZOLPIDEM (AMBIEN) TAB : 10MG,32000842,CDM,,,250,RC,outpatient,,71.85,71.85,,61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.96,22,,percent of total billed charges,,,,,,,,,64.67,90,,percent of total billed charges,,,59.49,82.8,,percent of total billed charges,,,61.07,85,,percent of total billed charges,,,,,,,,,63.23,88,,percent of total billed charges,,,,,,,,,54.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.96,22,,percent of total billed charges,,,65.38,91,,percent of total billed charges,,,68.26,95,,percent of total billed charges,,,59.64,83,,percent of total billed charges,,,59.64,83,,percent of total billed charges,,,,,,,,,,,,,,,59.64,83,,percent of total billed charges,,,68.26,95,,percent of total billed charges,,,64.67,90,,percent of total billed charges,,,64.67,90,,percent of total billed charges,,,58.92,82,,percent of total billed charges,,,64.67,90,,percent of total billed charges,,,61.07,85,,percent of total billed charges,,17.96,68.26,
GLIMEPIRIDE(AMARYL)TAB:4MG,32000843,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
AMINOPHYLLINE VIAL:500MG/20ML,32000871,CDM,J0280,HCPCS,250,RC,outpatient,,128.78,128.78,,109.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.2,22,,percent of total billed charges,,,,,,,,,115.9,90,,percent of total billed charges,,,106.63,82.8,,percent of total billed charges,,,109.46,85,,percent of total billed charges,,,,,,,,,113.33,88,,percent of total billed charges,,34.11,,,,fee schedule,,,98.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,34.11,,,,fee schedule,,,32.2,22,,percent of total billed charges,,,117.19,91,,percent of total billed charges,,,122.34,95,,percent of total billed charges,,,106.89,83,,percent of total billed charges,,,106.89,83,,percent of total billed charges,,,,,,,,,,,,,,,106.89,83,,percent of total billed charges,,,122.34,95,,percent of total billed charges,,,115.9,90,,percent of total billed charges,,,115.9,90,,percent of total billed charges,,,105.6,82,,percent of total billed charges,,,115.9,90,,percent of total billed charges,,,109.46,85,,percent of total billed charges,,32.2,122.34,
AMINOCAPROIC ACID(amicar)5000MG/20ML,32000876,CDM,J3490,HCPCS,250,RC,outpatient,,108.48,108.48,,92.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.12,22,,percent of total billed charges,,,,,,,,,97.63,90,,percent of total billed charges,,,89.82,82.8,,percent of total billed charges,,,92.21,85,,percent of total billed charges,,,,,,,,,95.46,88,,percent of total billed charges,,,,,,,,,82.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.12,22,,percent of total billed charges,,,98.72,91,,percent of total billed charges,,,103.06,95,,percent of total billed charges,,,90.04,83,,percent of total billed charges,,,90.04,83,,percent of total billed charges,,,,,,,,,,,,,,,90.04,83,,percent of total billed charges,,,103.06,95,,percent of total billed charges,,,97.63,90,,percent of total billed charges,,,97.63,90,,percent of total billed charges,,,88.95,82,,percent of total billed charges,,,97.63,90,,percent of total billed charges,,,92.21,85,,percent of total billed charges,,27.12,103.06,
AMITRIPTYLINE(ELAVIL)TAB:25MG,32000881,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
AMITRIPTYLINE(ELAVIL)TAB:10MG,32000886,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
AMITRIP HCL/CHLORDIAZEPOXDE TAB:12.5-5MG,32000911,CDM,,,250,RC,outpatient,,17.29,17.29,,14.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.32,22,,percent of total billed charges,,,,,,,,,15.56,90,,percent of total billed charges,,,14.32,82.8,,percent of total billed charges,,,14.7,85,,percent of total billed charges,,,,,,,,,15.22,88,,percent of total billed charges,,,,,,,,,13.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.32,22,,percent of total billed charges,,,15.73,91,,percent of total billed charges,,,16.43,95,,percent of total billed charges,,,14.35,83,,percent of total billed charges,,,14.35,83,,percent of total billed charges,,,,,,,,,,,,,,,14.35,83,,percent of total billed charges,,,16.43,95,,percent of total billed charges,,,15.56,90,,percent of total billed charges,,,15.56,90,,percent of total billed charges,,,14.18,82,,percent of total billed charges,,,15.56,90,,percent of total billed charges,,,14.7,85,,percent of total billed charges,,4.32,16.43,
AMMONIA(AMMONIA AROMATIC)AMP:,32000916,CDM,J3490,HCPCS,250,RC,outpatient,,54.58,54.58,,46.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.65,22,,percent of total billed charges,,,,,,,,,49.12,90,,percent of total billed charges,,,45.19,82.8,,percent of total billed charges,,,46.39,85,,percent of total billed charges,,,,,,,,,48.03,88,,percent of total billed charges,,,,,,,,,41.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.65,22,,percent of total billed charges,,,49.67,91,,percent of total billed charges,,,51.85,95,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,,,,,,,,,,,,,,45.3,83,,percent of total billed charges,,,51.85,95,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,44.76,82,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,46.39,85,,percent of total billed charges,,13.65,51.85,
AMOXAPINE (ASENDIN) TAB :  25MG,32000921,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
POTASSIUM CHLORIDE VIAL:20MEQ/10ML,32000926,CDM,J3480,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,3.22,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,3.22,60.99,
POTASS CHLOR -IVPB : 20MEQ/100 ML,32000927,CDM,J3480,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,3.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.22,187.11,
METHYL SALIC/MENTHL(ANALGESIC) OINT 30GM,32000936,CDM,,,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
PHYSOSTIGMINE(ANTILIRIUM)AMP:2MG/2ML,32000961,CDM,J3490,HCPCS,250,RC,outpatient,,1125.73,1125.73,,955.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,281.43,22,,percent of total billed charges,,,,,,,,,1013.16,90,,percent of total billed charges,,,932.1,82.8,,percent of total billed charges,,,956.87,85,,percent of total billed charges,,,,,,,,,990.64,88,,percent of total billed charges,,,,,,,,,860.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,281.43,22,,percent of total billed charges,,,1024.41,91,,percent of total billed charges,,,1069.44,95,,percent of total billed charges,,,934.36,83,,percent of total billed charges,,,934.36,83,,percent of total billed charges,,,,,,,,,,,,,,,934.36,83,,percent of total billed charges,,,1069.44,95,,percent of total billed charges,,,1013.16,90,,percent of total billed charges,,,1013.16,90,,percent of total billed charges,,,923.1,82,,percent of total billed charges,,,1013.16,90,,percent of total billed charges,,,956.87,85,,percent of total billed charges,,281.43,1069.44,
ANTIVENIN CROTALID(EQUINE)(POLYVALNT):,32000966,CDM,,,250,RC,outpatient,,4624.83,4624.83,,3926.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1156.21,22,,percent of total billed charges,,,,,,,,,4162.35,90,,percent of total billed charges,,,3829.36,82.8,,percent of total billed charges,,,3931.11,85,,percent of total billed charges,,,,,,,,,4069.85,88,,percent of total billed charges,,,,,,,,,3533.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1156.21,22,,percent of total billed charges,,,4208.6,91,,percent of total billed charges,,,4393.59,95,,percent of total billed charges,,,3838.61,83,,percent of total billed charges,,,3838.61,83,,percent of total billed charges,,,,,,,,,,,,,,,3838.61,83,,percent of total billed charges,,,4393.59,95,,percent of total billed charges,,,4162.35,90,,percent of total billed charges,,,4162.35,90,,percent of total billed charges,,,3792.36,82,,percent of total billed charges,,,4162.35,90,,percent of total billed charges,,,3931.11,85,,percent of total billed charges,,1156.21,4393.59,
BDON ALK/PB(DONNATAL)EL :16.2MG/5ML 60ML,32000971,CDM,,,250,RC,outpatient,,1522.08,1522.08,,1292.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,380.52,22,,percent of total billed charges,,,,,,,,,1369.87,90,,percent of total billed charges,,,1260.28,82.8,,percent of total billed charges,,,1293.77,85,,percent of total billed charges,,,,,,,,,1339.43,88,,percent of total billed charges,,,,,,,,,1162.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,380.52,22,,percent of total billed charges,,,1385.09,91,,percent of total billed charges,,,1445.98,95,,percent of total billed charges,,,1263.33,83,,percent of total billed charges,,,1263.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1263.33,83,,percent of total billed charges,,,1445.98,95,,percent of total billed charges,,,1369.87,90,,percent of total billed charges,,,1369.87,90,,percent of total billed charges,,,1248.11,82,,percent of total billed charges,,,1369.87,90,,percent of total billed charges,,,1293.77,85,,percent of total billed charges,,380.52,1445.98,
BDON ALK/PB(DONNATAL) EL:16.2MG/5ML 90ML,32000976,CDM,,,250,RC,outpatient,,2283.05,2283.05,,1938.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,570.76,22,,percent of total billed charges,,,,,,,,,2054.75,90,,percent of total billed charges,,,1890.37,82.8,,percent of total billed charges,,,1940.59,85,,percent of total billed charges,,,,,,,,,2009.08,88,,percent of total billed charges,,,,,,,,,1744.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,570.76,22,,percent of total billed charges,,,2077.58,91,,percent of total billed charges,,,2168.9,95,,percent of total billed charges,,,1894.93,83,,percent of total billed charges,,,1894.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1894.93,83,,percent of total billed charges,,,2168.9,95,,percent of total billed charges,,,2054.75,90,,percent of total billed charges,,,2054.75,90,,percent of total billed charges,,,1872.1,82,,percent of total billed charges,,,2054.75,90,,percent of total billed charges,,,1940.59,85,,percent of total billed charges,,570.76,2168.9,
HYDROCORTISONE(ANUSOL-HC)CREAM 2.5%:30GM,32000986,CDM,,,250,RC,outpatient,,331,331,,281.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.75,22,,percent of total billed charges,,,,,,,,,297.9,90,,percent of total billed charges,,,274.07,82.8,,percent of total billed charges,,,281.35,85,,percent of total billed charges,,,,,,,,,291.28,88,,percent of total billed charges,,,,,,,,,252.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,82.75,22,,percent of total billed charges,,,301.21,91,,percent of total billed charges,,,314.45,95,,percent of total billed charges,,,274.73,83,,percent of total billed charges,,,274.73,83,,percent of total billed charges,,,,,,,,,,,,,,,274.73,83,,percent of total billed charges,,,314.45,95,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,271.42,82,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,281.35,85,,percent of total billed charges,,82.75,314.45,
HYDROCORTiSONE(ANUCORT HC)SUPP:25MG,32000992,CDM,J3490,HCPCS,250,RC,outpatient,,38.07,38.07,,32.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.52,22,,percent of total billed charges,,,,,,,,,34.26,90,,percent of total billed charges,,,31.52,82.8,,percent of total billed charges,,,32.36,85,,percent of total billed charges,,,,,,,,,33.5,88,,percent of total billed charges,,,,,,,,,29.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.52,22,,percent of total billed charges,,,34.64,91,,percent of total billed charges,,,36.17,95,,percent of total billed charges,,,31.6,83,,percent of total billed charges,,,31.6,83,,percent of total billed charges,,,,,,,,,,,,,,,31.6,83,,percent of total billed charges,,,36.17,95,,percent of total billed charges,,,34.26,90,,percent of total billed charges,,,34.26,90,,percent of total billed charges,,,31.22,82,,percent of total billed charges,,,34.26,90,,percent of total billed charges,,,32.36,85,,percent of total billed charges,,9.52,36.17,
PRAM HCL/BALS/ZNOX/BENZL(ANUSOL)OINT 30G,32000996,CDM,,,250,RC,outpatient,,50.28,50.28,,42.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.57,22,,percent of total billed charges,,,,,,,,,45.25,90,,percent of total billed charges,,,41.63,82.8,,percent of total billed charges,,,42.74,85,,percent of total billed charges,,,,,,,,,44.25,88,,percent of total billed charges,,,,,,,,,38.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.57,22,,percent of total billed charges,,,45.75,91,,percent of total billed charges,,,47.77,95,,percent of total billed charges,,,41.73,83,,percent of total billed charges,,,41.73,83,,percent of total billed charges,,,,,,,,,,,,,,,41.73,83,,percent of total billed charges,,,47.77,95,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,41.23,82,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,42.74,85,,percent of total billed charges,,12.57,47.77,
PRAMOX/M.0./ZNX(ANUSOL)OINT:1%-12.5%30GM,32001001,CDM,,,250,RC,outpatient,,54.88,54.88,,46.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.72,22,,percent of total billed charges,,,,,,,,,49.39,90,,percent of total billed charges,,,45.44,82.8,,percent of total billed charges,,,46.65,85,,percent of total billed charges,,,,,,,,,48.29,88,,percent of total billed charges,,,,,,,,,41.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.72,22,,percent of total billed charges,,,49.94,91,,percent of total billed charges,,,52.14,95,,percent of total billed charges,,,45.55,83,,percent of total billed charges,,,45.55,83,,percent of total billed charges,,,,,,,,,,,,,,,45.55,83,,percent of total billed charges,,,52.14,95,,percent of total billed charges,,,49.39,90,,percent of total billed charges,,,49.39,90,,percent of total billed charges,,,45,82,,percent of total billed charges,,,49.39,90,,percent of total billed charges,,,46.65,85,,percent of total billed charges,,13.72,52.14,
DOLASETRON MESYLATE(ANZEMET)VIAL:20MG/ML,32001002,CDM,J1260,HCPCS,636,RC,outpatient,,312.76,312.76,,265.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.19,22,,percent of total billed charges,,,,,,,,,281.48,90,,percent of total billed charges,,,258.97,82.8,,percent of total billed charges,,,265.85,85,,percent of total billed charges,,,,,,,,,275.23,88,,percent of total billed charges,,,,,,,,,238.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.19,22,,percent of total billed charges,,,284.61,91,,percent of total billed charges,,,297.12,95,,percent of total billed charges,,,259.59,83,,percent of total billed charges,,,259.59,83,,percent of total billed charges,,,,,,,,,,,,,,,259.59,83,,percent of total billed charges,,,297.12,95,,percent of total billed charges,,,281.48,90,,percent of total billed charges,,,281.48,90,,percent of total billed charges,,,256.46,82,,percent of total billed charges,,,281.48,90,,percent of total billed charges,,,265.85,85,,percent of total billed charges,,78.19,297.12,
TUBERCULIN(TB)VIAL:5 T UNITS/0.1ML,32001006,CDM,J3490,HCPCS,250,RC,outpatient,,147.39,147.39,,125.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.85,22,,percent of total billed charges,,,,,,,,,132.65,90,,percent of total billed charges,,,122.04,82.8,,percent of total billed charges,,,125.28,85,,percent of total billed charges,,,,,,,,,129.7,88,,percent of total billed charges,,,,,,,,,112.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.85,22,,percent of total billed charges,,,134.12,91,,percent of total billed charges,,,140.02,95,,percent of total billed charges,,,122.33,83,,percent of total billed charges,,,122.33,83,,percent of total billed charges,,,,,,,,,,,,,,,122.33,83,,percent of total billed charges,,,140.02,95,,percent of total billed charges,,,132.65,90,,percent of total billed charges,,,132.65,90,,percent of total billed charges,,,120.86,82,,percent of total billed charges,,,132.65,90,,percent of total billed charges,,,125.28,85,,percent of total billed charges,,36.85,140.02,
TUBERCULIN(TB)VIAL:5 TEST UNITS/0.1ML,32001011,CDM,,,250,RC,outpatient,,141.25,141.25,,119.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.31,22,,percent of total billed charges,,,,,,,,,127.13,90,,percent of total billed charges,,,116.96,82.8,,percent of total billed charges,,,120.06,85,,percent of total billed charges,,,,,,,,,124.3,88,,percent of total billed charges,,,,,,,,,107.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.31,22,,percent of total billed charges,,,128.54,91,,percent of total billed charges,,,134.19,95,,percent of total billed charges,,,117.24,83,,percent of total billed charges,,,117.24,83,,percent of total billed charges,,,,,,,,,,,,,,,117.24,83,,percent of total billed charges,,,134.19,95,,percent of total billed charges,,,127.13,90,,percent of total billed charges,,,127.13,90,,percent of total billed charges,,,115.83,82,,percent of total billed charges,,,127.13,90,,percent of total billed charges,,,120.06,85,,percent of total billed charges,,35.31,134.19,
METARAMINOL (ARAMINE)VIAL:10MG/ML  10ML,32001026,CDM,,,250,RC,outpatient,,177.95,177.95,,151.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.49,22,,percent of total billed charges,,,,,,,,,160.16,90,,percent of total billed charges,,,147.34,82.8,,percent of total billed charges,,,151.26,85,,percent of total billed charges,,,,,,,,,156.6,88,,percent of total billed charges,,,,,,,,,135.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.49,22,,percent of total billed charges,,,161.93,91,,percent of total billed charges,,,169.05,95,,percent of total billed charges,,,147.7,83,,percent of total billed charges,,,147.7,83,,percent of total billed charges,,,,,,,,,,,,,,,147.7,83,,percent of total billed charges,,,169.05,95,,percent of total billed charges,,,160.16,90,,percent of total billed charges,,,160.16,90,,percent of total billed charges,,,145.92,82,,percent of total billed charges,,,160.16,90,,percent of total billed charges,,,151.26,85,,percent of total billed charges,,44.49,169.05,
PAMIDRONATE (AREDIA):90MG  (J PER 30MG),32001031,CDM,J2430,HCPCS,636,RC,outpatient,,527.34,527.34,,447.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.84,22,,percent of total billed charges,,,,,,,,,474.61,90,,percent of total billed charges,,,436.64,82.8,,percent of total billed charges,,,448.24,85,,percent of total billed charges,,,,,,,,,464.06,88,,percent of total billed charges,,32.94,,,,fee schedule,,,402.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,32.94,,,,fee schedule,,,131.84,22,,percent of total billed charges,,,479.88,91,,percent of total billed charges,,,500.97,95,,percent of total billed charges,,,437.69,83,,percent of total billed charges,,,437.69,83,,percent of total billed charges,,,,,,,,,,,,,,,437.69,83,,percent of total billed charges,,,500.97,95,,percent of total billed charges,,,474.61,90,,percent of total billed charges,,,474.61,90,,percent of total billed charges,,,432.42,82,,percent of total billed charges,,,474.61,90,,percent of total billed charges,,,448.24,85,,percent of total billed charges,,32.94,500.97,
DONEPEZIL(ARICEPT)TAB:5MG,32001037,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DONEPEZIL (ARICEPT) TAB : 10MG,32001038,CDM,,,250,RC,outpatient,,255.66,255.66,,217.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.92,22,,percent of total billed charges,,,,,,,,,230.09,90,,percent of total billed charges,,,211.69,82.8,,percent of total billed charges,,,217.31,85,,percent of total billed charges,,,,,,,,,224.98,88,,percent of total billed charges,,,,,,,,,195.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.92,22,,percent of total billed charges,,,232.65,91,,percent of total billed charges,,,242.88,95,,percent of total billed charges,,,212.2,83,,percent of total billed charges,,,212.2,83,,percent of total billed charges,,,,,,,,,,,,,,,212.2,83,,percent of total billed charges,,,242.88,95,,percent of total billed charges,,,230.09,90,,percent of total billed charges,,,230.09,90,,percent of total billed charges,,,209.64,82,,percent of total billed charges,,,230.09,90,,percent of total billed charges,,,217.31,85,,percent of total billed charges,,63.92,242.88,
THYROID TAB : 30MG,32001051,CDM,,,250,RC,outpatient,,13.8,13.8,,11.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.45,22,,percent of total billed charges,,,,,,,,,12.42,90,,percent of total billed charges,,,11.43,82.8,,percent of total billed charges,,,11.73,85,,percent of total billed charges,,,,,,,,,12.14,88,,percent of total billed charges,,,,,,,,,10.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.45,22,,percent of total billed charges,,,12.56,91,,percent of total billed charges,,,13.11,95,,percent of total billed charges,,,11.45,83,,percent of total billed charges,,,11.45,83,,percent of total billed charges,,,,,,,,,,,,,,,11.45,83,,percent of total billed charges,,,13.11,95,,percent of total billed charges,,,12.42,90,,percent of total billed charges,,,12.42,90,,percent of total billed charges,,,11.32,82,,percent of total billed charges,,,12.42,90,,percent of total billed charges,,,11.73,85,,percent of total billed charges,,3.45,13.11,
THYROID TAB:60MG,32001061,CDM,J8499,HCPCS,250,RC,outpatient,,15.52,15.52,,13.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.88,22,,percent of total billed charges,,,,,,,,,13.97,90,,percent of total billed charges,,,12.85,82.8,,percent of total billed charges,,,13.19,85,,percent of total billed charges,,,,,,,,,13.66,88,,percent of total billed charges,,,,,,,,,11.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.88,22,,percent of total billed charges,,,14.12,91,,percent of total billed charges,,,14.74,95,,percent of total billed charges,,,12.88,83,,percent of total billed charges,,,12.88,83,,percent of total billed charges,,,,,,,,,,,,,,,12.88,83,,percent of total billed charges,,,14.74,95,,percent of total billed charges,,,13.97,90,,percent of total billed charges,,,13.97,90,,percent of total billed charges,,,12.73,82,,percent of total billed charges,,,13.97,90,,percent of total billed charges,,,13.19,85,,percent of total billed charges,,3.88,14.74,
ASCORBIC ACID(VITAMIN C)TAB:500MG,32001071,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
MESALAMINE(ASACOL)TAB:400MG,32001075,CDM,,,250,RC,outpatient,,35.05,35.05,,29.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.76,22,,percent of total billed charges,,,,,,,,,31.55,90,,percent of total billed charges,,,29.02,82.8,,percent of total billed charges,,,29.79,85,,percent of total billed charges,,,,,,,,,30.84,88,,percent of total billed charges,,,,,,,,,26.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.76,22,,percent of total billed charges,,,31.9,91,,percent of total billed charges,,,33.3,95,,percent of total billed charges,,,29.09,83,,percent of total billed charges,,,29.09,83,,percent of total billed charges,,,,,,,,,,,,,,,29.09,83,,percent of total billed charges,,,33.3,95,,percent of total billed charges,,,31.55,90,,percent of total billed charges,,,31.55,90,,percent of total billed charges,,,28.74,82,,percent of total billed charges,,,31.55,90,,percent of total billed charges,,,29.79,85,,percent of total billed charges,,8.76,33.3,
ASA/CAL CRB/AL HYDRX(ASCRIPTIN)TAB:325MG,32001076,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ASPIRIN SUPP : 300MG,32001106,CDM,J3490,HCPCS,250,RC,outpatient,,21.24,21.24,,18.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.31,22,,percent of total billed charges,,,,,,,,,19.12,90,,percent of total billed charges,,,17.59,82.8,,percent of total billed charges,,,18.05,85,,percent of total billed charges,,,,,,,,,18.69,88,,percent of total billed charges,,,,,,,,,16.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.31,22,,percent of total billed charges,,,19.33,91,,percent of total billed charges,,,20.18,95,,percent of total billed charges,,,17.63,83,,percent of total billed charges,,,17.63,83,,percent of total billed charges,,,,,,,,,,,,,,,17.63,83,,percent of total billed charges,,,20.18,95,,percent of total billed charges,,,19.12,90,,percent of total billed charges,,,19.12,90,,percent of total billed charges,,,17.42,82,,percent of total billed charges,,,19.12,90,,percent of total billed charges,,,18.05,85,,percent of total billed charges,,5.31,20.18,
ASPIRIN SUPP:600MG,32001131,CDM,J3490,HCPCS,250,RC,outpatient,,21.25,21.25,,18.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.31,22,,percent of total billed charges,,,,,,,,,19.13,90,,percent of total billed charges,,,17.6,82.8,,percent of total billed charges,,,18.06,85,,percent of total billed charges,,,,,,,,,18.7,88,,percent of total billed charges,,,,,,,,,16.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.31,22,,percent of total billed charges,,,19.34,91,,percent of total billed charges,,,20.19,95,,percent of total billed charges,,,17.64,83,,percent of total billed charges,,,17.64,83,,percent of total billed charges,,,,,,,,,,,,,,,17.64,83,,percent of total billed charges,,,20.19,95,,percent of total billed charges,,,19.13,90,,percent of total billed charges,,,19.13,90,,percent of total billed charges,,,17.43,82,,percent of total billed charges,,,19.13,90,,percent of total billed charges,,,18.06,85,,percent of total billed charges,,5.31,20.19,
ASPIRIN,32001136,CDM,,,250,RC,outpatient,,22063.9,22063.9,,18732.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5515.98,22,,percent of total billed charges,,,,,,,,,19857.51,90,,percent of total billed charges,,,18268.91,82.8,,percent of total billed charges,,,18754.32,85,,percent of total billed charges,,,,,,,,,19416.23,88,,percent of total billed charges,,,,,,,,,16856.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5515.98,22,,percent of total billed charges,,,20078.15,91,,percent of total billed charges,,,20960.71,95,,percent of total billed charges,,,18313.04,83,,percent of total billed charges,,,18313.04,83,,percent of total billed charges,,,,,,,,,,,,,,,18313.04,83,,percent of total billed charges,,,20960.71,95,,percent of total billed charges,,,19857.51,90,,percent of total billed charges,,,19857.51,90,,percent of total billed charges,,,18092.4,82,,percent of total billed charges,,,19857.51,90,,percent of total billed charges,,,18754.32,85,,percent of total billed charges,,5515.98,20960.71,
AZELASTINE(ASTELIN)SPR:137MCG (30ML),32001137,CDM,J3490,HCPCS,250,RC,outpatient,,199.2,199.2,,169.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.8,22,,percent of total billed charges,,,,,,,,,179.28,90,,percent of total billed charges,,,164.94,82.8,,percent of total billed charges,,,169.32,85,,percent of total billed charges,,,,,,,,,175.3,88,,percent of total billed charges,,,,,,,,,152.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.8,22,,percent of total billed charges,,,181.27,91,,percent of total billed charges,,,189.24,95,,percent of total billed charges,,,165.34,83,,percent of total billed charges,,,165.34,83,,percent of total billed charges,,,,,,,,,,,,,,,165.34,83,,percent of total billed charges,,,189.24,95,,percent of total billed charges,,,179.28,90,,percent of total billed charges,,,179.28,90,,percent of total billed charges,,,163.34,82,,percent of total billed charges,,,179.28,90,,percent of total billed charges,,,169.32,85,,percent of total billed charges,,49.8,189.24,
CANDESARTAN(ATACAND)TAB:16MG,32001138,CDM,J8499,HCPCS,250,RC,outpatient,,23.86,23.86,,20.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.97,22,,percent of total billed charges,,,,,,,,,21.47,90,,percent of total billed charges,,,19.76,82.8,,percent of total billed charges,,,20.28,85,,percent of total billed charges,,,,,,,,,21,88,,percent of total billed charges,,,,,,,,,18.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.97,22,,percent of total billed charges,,,21.71,91,,percent of total billed charges,,,22.67,95,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,,,,,,,,,,,,,,19.8,83,,percent of total billed charges,,,22.67,95,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,19.57,82,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,20.28,85,,percent of total billed charges,,5.97,22.67,
ATENOLOL(TENORMIN)TAB:50MG,32001151,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ATENOLOL(TENORMIN)TAB:25MG,32001156,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LORazepam(ATIVAN)INJ:2MG/ML,32001161,CDM,J2060,HCPCS,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,1.91,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.91,,,,fee schedule,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,1.91,64.15,
IPRATRO(ATROVENT)NASAL SPR:42MCG (15ML),32001162,CDM,,,250,RC,outpatient,,182,182,,154.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.5,22,,percent of total billed charges,,,,,,,,,163.8,90,,percent of total billed charges,,,150.7,82.8,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,,,,,,,,160.16,88,,percent of total billed charges,,,,,,,,,139.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.5,22,,percent of total billed charges,,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,149.24,82,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,45.5,172.9,
IPRATRO(ATROVENT)MDI AER:17MCG (12.9GM),32001166,CDM,J7644,HCPCS,250,RC,outpatient,,3469.91,3469.91,,2945.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,867.48,22,,percent of total billed charges,,,,,,,,,3122.92,90,,percent of total billed charges,,,2873.09,82.8,,percent of total billed charges,,,2949.42,85,,percent of total billed charges,,,,,,,,,3053.52,88,,percent of total billed charges,,0.21,,,,fee schedule,,,2651.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.21,,,,fee schedule,,,867.48,22,,percent of total billed charges,,,3157.62,91,,percent of total billed charges,,,3296.41,95,,percent of total billed charges,,,2880.03,83,,percent of total billed charges,,,2880.03,83,,percent of total billed charges,,,,,,,,,,,,,,,2880.03,83,,percent of total billed charges,,,3296.41,95,,percent of total billed charges,,,3122.92,90,,percent of total billed charges,,,3122.92,90,,percent of total billed charges,,,2845.33,82,,percent of total billed charges,,,3122.92,90,,percent of total billed charges,,,2949.42,85,,percent of total billed charges,,0.21,3296.41,
IPRATROPIUM(ATROVENT)SOL:0.5MG/2.5ML U/D,32001171,CDM,J7644,HCPCS,250,RC,outpatient,,24.8,24.8,,21.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.2,22,,percent of total billed charges,,,,,,,,,22.32,90,,percent of total billed charges,,,20.53,82.8,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,,,,,,,,21.82,88,,percent of total billed charges,,0.21,,,,fee schedule,,,18.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.21,,,,fee schedule,,,6.2,22,,percent of total billed charges,,,22.57,91,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,,,,,,,,,,,,,20.58,83,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,20.34,82,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,0.21,23.56,
ATROPINE AMP:0.4MG/0.5ML,32001181,CDM,J0461,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,42.6,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,42.6,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
ATROPINE SYR:1MG/10ML,32001185,CDM,J0461,HCPCS,250,RC,outpatient,,160.95,160.95,,136.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.24,22,,percent of total billed charges,,,,,,,,,144.86,90,,percent of total billed charges,,,133.27,82.8,,percent of total billed charges,,,136.81,85,,percent of total billed charges,,,,,,,,,141.64,88,,percent of total billed charges,,42.6,,,,fee schedule,,,122.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,42.6,,,,fee schedule,,,40.24,22,,percent of total billed charges,,,146.46,91,,percent of total billed charges,,,152.9,95,,percent of total billed charges,,,133.59,83,,percent of total billed charges,,,133.59,83,,percent of total billed charges,,,,,,,,,,,,,,,133.59,83,,percent of total billed charges,,,152.9,95,,percent of total billed charges,,,144.86,90,,percent of total billed charges,,,144.86,90,,percent of total billed charges,,,131.98,82,,percent of total billed charges,,,144.86,90,,percent of total billed charges,,,136.81,85,,percent of total billed charges,,40.24,152.9,
ATROPINE VIAL:0.4MG/ML (1ml),32001191,CDM,J0461,HCPCS,250,RC,outpatient,,66.83,66.83,,56.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.71,22,,percent of total billed charges,,,,,,,,,60.15,90,,percent of total billed charges,,,55.34,82.8,,percent of total billed charges,,,56.81,85,,percent of total billed charges,,,,,,,,,58.81,88,,percent of total billed charges,,42.6,,,,fee schedule,,,51.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,42.6,,,,fee schedule,,,16.71,22,,percent of total billed charges,,,60.82,91,,percent of total billed charges,,,63.49,95,,percent of total billed charges,,,55.47,83,,percent of total billed charges,,,55.47,83,,percent of total billed charges,,,,,,,,,,,,,,,55.47,83,,percent of total billed charges,,,63.49,95,,percent of total billed charges,,,60.15,90,,percent of total billed charges,,,60.15,90,,percent of total billed charges,,,54.8,82,,percent of total billed charges,,,60.15,90,,percent of total billed charges,,,56.81,85,,percent of total billed charges,,16.71,63.49,
MEASLES VACCINE LIVE ATTENUATD VIAL:,32001196,CDM,90705,CPT,636,RC,outpatient,,265.02,265.02,,225,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.26,22,,percent of total billed charges,,,,,,,,,238.52,90,,percent of total billed charges,,,219.44,82.8,,percent of total billed charges,,,225.27,85,,percent of total billed charges,,,,,,,,,233.22,88,,percent of total billed charges,,,,,,,,,202.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.26,22,,percent of total billed charges,,,241.17,91,,percent of total billed charges,,,251.77,95,,percent of total billed charges,,,219.97,83,,percent of total billed charges,,,219.97,83,,percent of total billed charges,,,,,,,,,,,,,,,219.97,83,,percent of total billed charges,,,251.77,95,,percent of total billed charges,,,238.52,90,,percent of total billed charges,,,238.52,90,,percent of total billed charges,,,217.32,82,,percent of total billed charges,,,238.52,90,,percent of total billed charges,,,225.27,85,,percent of total billed charges,,66.26,251.77,
AMOX/CLAV(AUGMENTIN)TAB:250-125MG,32001201,CDM,,,250,RC,outpatient,,56.14,56.14,,47.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.04,22,,percent of total billed charges,,,,,,,,,50.53,90,,percent of total billed charges,,,46.48,82.8,,percent of total billed charges,,,47.72,85,,percent of total billed charges,,,,,,,,,49.4,88,,percent of total billed charges,,,,,,,,,42.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.04,22,,percent of total billed charges,,,51.09,91,,percent of total billed charges,,,53.33,95,,percent of total billed charges,,,46.6,83,,percent of total billed charges,,,46.6,83,,percent of total billed charges,,,,,,,,,,,,,,,46.6,83,,percent of total billed charges,,,53.33,95,,percent of total billed charges,,,50.53,90,,percent of total billed charges,,,50.53,90,,percent of total billed charges,,,46.03,82,,percent of total billed charges,,,50.53,90,,percent of total billed charges,,,47.72,85,,percent of total billed charges,,14.04,53.33,
AMOX/CLAV(AUGMENTIN)TAB 500-125MG,32001206,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
AMOX/CLAV(AUGMENTIN)TAB 500-125MG (1x6),32001207,CDM,,,250,RC,outpatient,,22.39,22.39,,19.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.6,22,,percent of total billed charges,,,,,,,,,20.15,90,,percent of total billed charges,,,18.54,82.8,,percent of total billed charges,,,19.03,85,,percent of total billed charges,,,,,,,,,19.7,88,,percent of total billed charges,,,,,,,,,17.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.6,22,,percent of total billed charges,,,20.37,91,,percent of total billed charges,,,21.27,95,,percent of total billed charges,,,18.58,83,,percent of total billed charges,,,18.58,83,,percent of total billed charges,,,,,,,,,,,,,,,18.58,83,,percent of total billed charges,,,21.27,95,,percent of total billed charges,,,20.15,90,,percent of total billed charges,,,20.15,90,,percent of total billed charges,,,18.36,82,,percent of total billed charges,,,20.15,90,,percent of total billed charges,,,19.03,85,,percent of total billed charges,,5.6,21.27,
AMOX/CLAV(AUGMENTIN)SUS 400-57/5 (100ML),32001210,CDM,J8499,HCPCS,250,RC,outpatient,,105.56,105.56,,89.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.39,22,,percent of total billed charges,,,,,,,,,95,90,,percent of total billed charges,,,87.4,82.8,,percent of total billed charges,,,89.73,85,,percent of total billed charges,,,,,,,,,92.89,88,,percent of total billed charges,,,,,,,,,80.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.39,22,,percent of total billed charges,,,96.06,91,,percent of total billed charges,,,100.28,95,,percent of total billed charges,,,87.61,83,,percent of total billed charges,,,87.61,83,,percent of total billed charges,,,,,,,,,,,,,,,87.61,83,,percent of total billed charges,,,100.28,95,,percent of total billed charges,,,95,90,,percent of total billed charges,,,95,90,,percent of total billed charges,,,86.56,82,,percent of total billed charges,,,95,90,,percent of total billed charges,,,89.73,85,,percent of total billed charges,,26.39,100.28,
AMOX/CLAV(AUGMENTN)SUS 250-62.5/5(75ML),32001211,CDM,J8499,HCPCS,250,RC,outpatient,,714.84,714.84,,606.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.71,22,,percent of total billed charges,,,,,,,,,643.36,90,,percent of total billed charges,,,591.89,82.8,,percent of total billed charges,,,607.61,85,,percent of total billed charges,,,,,,,,,629.06,88,,percent of total billed charges,,,,,,,,,546.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.71,22,,percent of total billed charges,,,650.5,91,,percent of total billed charges,,,679.1,95,,percent of total billed charges,,,593.32,83,,percent of total billed charges,,,593.32,83,,percent of total billed charges,,,,,,,,,,,,,,,593.32,83,,percent of total billed charges,,,679.1,95,,percent of total billed charges,,,643.36,90,,percent of total billed charges,,,643.36,90,,percent of total billed charges,,,586.17,82,,percent of total billed charges,,,643.36,90,,percent of total billed charges,,,607.61,85,,percent of total billed charges,,178.71,679.1,
AMOX/CLAV(AUGMENTIN)SUSP 125-31.25(75ML),32001216,CDM,J8499,HCPCS,250,RC,outpatient,,17.16,17.16,,14.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.29,22,,percent of total billed charges,,,,,,,,,15.44,90,,percent of total billed charges,,,14.21,82.8,,percent of total billed charges,,,14.59,85,,percent of total billed charges,,,,,,,,,15.1,88,,percent of total billed charges,,,,,,,,,13.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.29,22,,percent of total billed charges,,,15.62,91,,percent of total billed charges,,,16.3,95,,percent of total billed charges,,,14.24,83,,percent of total billed charges,,,14.24,83,,percent of total billed charges,,,,,,,,,,,,,,,14.24,83,,percent of total billed charges,,,16.3,95,,percent of total billed charges,,,15.44,90,,percent of total billed charges,,,15.44,90,,percent of total billed charges,,,14.07,82,,percent of total billed charges,,,15.44,90,,percent of total billed charges,,,14.59,85,,percent of total billed charges,,4.29,16.3,
AMOX/CLAV(AUGMENTIN)TAB 875-125MG,32001221,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
AMOX/CLAV(AUGMENTIN)TAB 875-125MG (1x6),32001222,CDM,J8499,HCPCS,250,RC,outpatient,,23.86,23.86,,20.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.97,22,,percent of total billed charges,,,,,,,,,21.47,90,,percent of total billed charges,,,19.76,82.8,,percent of total billed charges,,,20.28,85,,percent of total billed charges,,,,,,,,,21,88,,percent of total billed charges,,,,,,,,,18.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.97,22,,percent of total billed charges,,,21.71,91,,percent of total billed charges,,,22.67,95,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,,,,,,,,,,,,,,19.8,83,,percent of total billed charges,,,22.67,95,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,19.57,82,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,20.28,85,,percent of total billed charges,,5.97,22.67,
ANTIPYRINE/BENZ/GLYC(AURALGAN) DROP:10ML,32001226,CDM,J3490,HCPCS,250,RC,outpatient,,164.87,164.87,,139.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.22,22,,percent of total billed charges,,,,,,,,,148.38,90,,percent of total billed charges,,,136.51,82.8,,percent of total billed charges,,,140.14,85,,percent of total billed charges,,,,,,,,,145.09,88,,percent of total billed charges,,,,,,,,,125.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.22,22,,percent of total billed charges,,,150.03,91,,percent of total billed charges,,,156.63,95,,percent of total billed charges,,,136.84,83,,percent of total billed charges,,,136.84,83,,percent of total billed charges,,,,,,,,,,,,,,,136.84,83,,percent of total billed charges,,,156.63,95,,percent of total billed charges,,,148.38,90,,percent of total billed charges,,,148.38,90,,percent of total billed charges,,,135.19,82,,percent of total billed charges,,,148.38,90,,percent of total billed charges,,,140.14,85,,percent of total billed charges,,41.22,156.63,
IRBESARTAN(avaPRO)TAB:150MG,32001227,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ROSIGLITAZONE(AVANdia)TAB:4MG,32001228,CDM,,,250,RC,outpatient,,65.03,65.03,,55.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.26,22,,percent of total billed charges,,,,,,,,,58.53,90,,percent of total billed charges,,,53.84,82.8,,percent of total billed charges,,,55.28,85,,percent of total billed charges,,,,,,,,,57.23,88,,percent of total billed charges,,,,,,,,,49.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.26,22,,percent of total billed charges,,,59.18,91,,percent of total billed charges,,,61.78,95,,percent of total billed charges,,,53.97,83,,percent of total billed charges,,,53.97,83,,percent of total billed charges,,,,,,,,,,,,,,,53.97,83,,percent of total billed charges,,,61.78,95,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,53.32,82,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,55.28,85,,percent of total billed charges,,16.26,61.78,
ROSIGLITAZONE MALEATE(AVAndia) TAB : 2MG,32001229,CDM,,,250,RC,outpatient,,43.77,43.77,,37.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.94,22,,percent of total billed charges,,,,,,,,,39.39,90,,percent of total billed charges,,,36.24,82.8,,percent of total billed charges,,,37.2,85,,percent of total billed charges,,,,,,,,,38.52,88,,percent of total billed charges,,,,,,,,,33.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.94,22,,percent of total billed charges,,,39.83,91,,percent of total billed charges,,,41.58,95,,percent of total billed charges,,,36.33,83,,percent of total billed charges,,,36.33,83,,percent of total billed charges,,,,,,,,,,,,,,,36.33,83,,percent of total billed charges,,,41.58,95,,percent of total billed charges,,,39.39,90,,percent of total billed charges,,,39.39,90,,percent of total billed charges,,,35.89,82,,percent of total billed charges,,,39.39,90,,percent of total billed charges,,,37.2,85,,percent of total billed charges,,10.94,41.58,
MICROFIB COLLAGEN(AVITENE)SHEET:70X35MM,32001241,CDM,,,250,RC,outpatient,,2681.28,2681.28,,2276.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,670.32,22,,percent of total billed charges,,,,,,,,,2413.15,90,,percent of total billed charges,,,2220.1,82.8,,percent of total billed charges,,,2279.09,85,,percent of total billed charges,,,,,,,,,2359.53,88,,percent of total billed charges,,,,,,,,,2048.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,670.32,22,,percent of total billed charges,,,2439.96,91,,percent of total billed charges,,,2547.22,95,,percent of total billed charges,,,2225.46,83,,percent of total billed charges,,,2225.46,83,,percent of total billed charges,,,,,,,,,,,,,,,2225.46,83,,percent of total billed charges,,,2547.22,95,,percent of total billed charges,,,2413.15,90,,percent of total billed charges,,,2413.15,90,,percent of total billed charges,,,2198.65,82,,percent of total billed charges,,,2413.15,90,,percent of total billed charges,,,2279.09,85,,percent of total billed charges,,670.32,2547.22,
NIZATIDINE (AXID) CAP : 150MG,32001246,CDM,,,250,RC,outpatient,,27.44,27.44,,23.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.86,22,,percent of total billed charges,,,,,,,,,24.7,90,,percent of total billed charges,,,22.72,82.8,,percent of total billed charges,,,23.32,85,,percent of total billed charges,,,,,,,,,24.15,88,,percent of total billed charges,,,,,,,,,20.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.86,22,,percent of total billed charges,,,24.97,91,,percent of total billed charges,,,26.07,95,,percent of total billed charges,,,22.78,83,,percent of total billed charges,,,22.78,83,,percent of total billed charges,,,,,,,,,,,,,,,22.78,83,,percent of total billed charges,,,26.07,95,,percent of total billed charges,,,24.7,90,,percent of total billed charges,,,24.7,90,,percent of total billed charges,,,22.5,82,,percent of total billed charges,,,24.7,90,,percent of total billed charges,,,23.32,85,,percent of total billed charges,,6.86,26.07,
AZTREONAM (AZACTAM) VIAL : 500MG,32001251,CDM,,,250,RC,outpatient,,211.26,211.26,,179.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.82,22,,percent of total billed charges,,,,,,,,,190.13,90,,percent of total billed charges,,,174.92,82.8,,percent of total billed charges,,,179.57,85,,percent of total billed charges,,,,,,,,,185.91,88,,percent of total billed charges,,,,,,,,,161.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.82,22,,percent of total billed charges,,,192.25,91,,percent of total billed charges,,,200.7,95,,percent of total billed charges,,,175.35,83,,percent of total billed charges,,,175.35,83,,percent of total billed charges,,,,,,,,,,,,,,,175.35,83,,percent of total billed charges,,,200.7,95,,percent of total billed charges,,,190.13,90,,percent of total billed charges,,,190.13,90,,percent of total billed charges,,,173.23,82,,percent of total billed charges,,,190.13,90,,percent of total billed charges,,,179.57,85,,percent of total billed charges,,52.82,200.7,
AZTREONAM (AZACTAM) VIAL : 2G,32001256,CDM,J3490,HCPCS,250,RC,outpatient,,821.96,821.96,,697.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,205.49,22,,percent of total billed charges,,,,,,,,,739.76,90,,percent of total billed charges,,,680.58,82.8,,percent of total billed charges,,,698.67,85,,percent of total billed charges,,,,,,,,,723.32,88,,percent of total billed charges,,,,,,,,,627.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,205.49,22,,percent of total billed charges,,,747.98,91,,percent of total billed charges,,,780.86,95,,percent of total billed charges,,,682.23,83,,percent of total billed charges,,,682.23,83,,percent of total billed charges,,,,,,,,,,,,,,,682.23,83,,percent of total billed charges,,,780.86,95,,percent of total billed charges,,,739.76,90,,percent of total billed charges,,,739.76,90,,percent of total billed charges,,,674.01,82,,percent of total billed charges,,,739.76,90,,percent of total billed charges,,,698.67,85,,percent of total billed charges,,205.49,780.86,
AZTREONAM(AZACTAM)VIAL:1GM,32001261,CDM,J3490,HCPCS,250,RC,outpatient,,485.13,485.13,,411.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,121.28,22,,percent of total billed charges,,,,,,,,,436.62,90,,percent of total billed charges,,,401.69,82.8,,percent of total billed charges,,,412.36,85,,percent of total billed charges,,,,,,,,,426.91,88,,percent of total billed charges,,,,,,,,,370.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,121.28,22,,percent of total billed charges,,,441.47,91,,percent of total billed charges,,,460.87,95,,percent of total billed charges,,,402.66,83,,percent of total billed charges,,,402.66,83,,percent of total billed charges,,,,,,,,,,,,,,,402.66,83,,percent of total billed charges,,,460.87,95,,percent of total billed charges,,,436.62,90,,percent of total billed charges,,,436.62,90,,percent of total billed charges,,,397.81,82,,percent of total billed charges,,,436.62,90,,percent of total billed charges,,,412.36,85,,percent of total billed charges,,121.28,460.87,
TRIAMCINOLONE(AZMACORT)AER:100MCG 20GM,32001266,CDM,,,250,RC,outpatient,,1928.24,1928.24,,1637.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,482.06,22,,percent of total billed charges,,,,,,,,,1735.42,90,,percent of total billed charges,,,1596.58,82.8,,percent of total billed charges,,,1639,85,,percent of total billed charges,,,,,,,,,1696.85,88,,percent of total billed charges,,,,,,,,,1473.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,482.06,22,,percent of total billed charges,,,1754.7,91,,percent of total billed charges,,,1831.83,95,,percent of total billed charges,,,1600.44,83,,percent of total billed charges,,,1600.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1600.44,83,,percent of total billed charges,,,1831.83,95,,percent of total billed charges,,,1735.42,90,,percent of total billed charges,,,1735.42,90,,percent of total billed charges,,,1581.16,82,,percent of total billed charges,,,1735.42,90,,percent of total billed charges,,,1639,85,,percent of total billed charges,,482.06,1831.83,
sulfaSALAzine(AZULFIDINE)TAB:500MG,32001271,CDM,J8499,HCPCS,250,RC,outpatient,,34.31,34.31,,29.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.58,22,,percent of total billed charges,,,,,,,,,30.88,90,,percent of total billed charges,,,28.41,82.8,,percent of total billed charges,,,29.16,85,,percent of total billed charges,,,,,,,,,30.19,88,,percent of total billed charges,,,,,,,,,26.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.58,22,,percent of total billed charges,,,31.22,91,,percent of total billed charges,,,32.59,95,,percent of total billed charges,,,28.48,83,,percent of total billed charges,,,28.48,83,,percent of total billed charges,,,,,,,,,,,,,,,28.48,83,,percent of total billed charges,,,32.59,95,,percent of total billed charges,,,30.88,90,,percent of total billed charges,,,30.88,90,,percent of total billed charges,,,28.13,82,,percent of total billed charges,,,30.88,90,,percent of total billed charges,,,29.16,85,,percent of total billed charges,,8.58,32.59,
OPIUM/BELLA(B&O16-A)SUPP:30-16.2MG,32001276,CDM,,,250,RC,outpatient,,347.55,347.55,,295.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.89,22,,percent of total billed charges,,,,,,,,,312.8,90,,percent of total billed charges,,,287.77,82.8,,percent of total billed charges,,,295.42,85,,percent of total billed charges,,,,,,,,,305.84,88,,percent of total billed charges,,,,,,,,,265.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.89,22,,percent of total billed charges,,,316.27,91,,percent of total billed charges,,,330.17,95,,percent of total billed charges,,,288.47,83,,percent of total billed charges,,,288.47,83,,percent of total billed charges,,,,,,,,,,,,,,,288.47,83,,percent of total billed charges,,,330.17,95,,percent of total billed charges,,,312.8,90,,percent of total billed charges,,,312.8,90,,percent of total billed charges,,,284.99,82,,percent of total billed charges,,,312.8,90,,percent of total billed charges,,,295.42,85,,percent of total billed charges,,86.89,330.17,
BACITRACIN OPTH OINT:500UNIT/GM (3.5GM),32001291,CDM,J3490,HCPCS,250,RC,outpatient,,1391.34,1391.34,,1181.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,347.84,22,,percent of total billed charges,,,,,,,,,1252.21,90,,percent of total billed charges,,,1152.03,82.8,,percent of total billed charges,,,1182.64,85,,percent of total billed charges,,,,,,,,,1224.38,88,,percent of total billed charges,,,,,,,,,1062.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,347.84,22,,percent of total billed charges,,,1266.12,91,,percent of total billed charges,,,1321.77,95,,percent of total billed charges,,,1154.81,83,,percent of total billed charges,,,1154.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1154.81,83,,percent of total billed charges,,,1321.77,95,,percent of total billed charges,,,1252.21,90,,percent of total billed charges,,,1252.21,90,,percent of total billed charges,,,1140.9,82,,percent of total billed charges,,,1252.21,90,,percent of total billed charges,,,1182.64,85,,percent of total billed charges,,347.84,1321.77,
NEO/BACI/POLYM(TRPL ABX)OPHTH OINT:3.5GM,32001296,CDM,,,250,RC,outpatient,,55.99,55.99,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14,22,,percent of total billed charges,,,,,,,,,50.39,90,,percent of total billed charges,,,46.36,82.8,,percent of total billed charges,,,47.59,85,,percent of total billed charges,,,,,,,,,49.27,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14,22,,percent of total billed charges,,,50.95,91,,percent of total billed charges,,,53.19,95,,percent of total billed charges,,,46.47,83,,percent of total billed charges,,,46.47,83,,percent of total billed charges,,,,,,,,,,,,,,,46.47,83,,percent of total billed charges,,,53.19,95,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,45.91,82,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,47.59,85,,percent of total billed charges,,14,53.19,
BACITRACIN ZINC PAC:500UNIT/GM UD,32001301,CDM,J3490,HCPCS,250,RC,outpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.07,22,,percent of total billed charges,,,,,,,,,18.24,90,,percent of total billed charges,,,16.78,82.8,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.07,22,,percent of total billed charges,,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,5.07,19.26,
BACITRACIN ZINC OINT:500:GM(30GM),32001306,CDM,J3490,HCPCS,250,RC,outpatient,,23.04,23.04,,19.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.76,22,,percent of total billed charges,,,,,,,,,20.74,90,,percent of total billed charges,,,19.08,82.8,,percent of total billed charges,,,19.58,85,,percent of total billed charges,,,,,,,,,20.28,88,,percent of total billed charges,,,,,,,,,17.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.76,22,,percent of total billed charges,,,20.97,91,,percent of total billed charges,,,21.89,95,,percent of total billed charges,,,19.12,83,,percent of total billed charges,,,19.12,83,,percent of total billed charges,,,,,,,,,,,,,,,19.12,83,,percent of total billed charges,,,21.89,95,,percent of total billed charges,,,20.74,90,,percent of total billed charges,,,20.74,90,,percent of total billed charges,,,18.89,82,,percent of total billed charges,,,20.74,90,,percent of total billed charges,,,19.58,85,,percent of total billed charges,,5.76,21.89,
NEO/BACI/POLYB(NEOSPORIN)ABX OINT:30GM,32001311,CDM,J3490,HCPCS,250,RC,outpatient,,36.44,36.44,,30.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.11,22,,percent of total billed charges,,,,,,,,,32.8,90,,percent of total billed charges,,,30.17,82.8,,percent of total billed charges,,,30.97,85,,percent of total billed charges,,,,,,,,,32.07,88,,percent of total billed charges,,,,,,,,,27.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.11,22,,percent of total billed charges,,,33.16,91,,percent of total billed charges,,,34.62,95,,percent of total billed charges,,,30.25,83,,percent of total billed charges,,,30.25,83,,percent of total billed charges,,,,,,,,,,,,,,,30.25,83,,percent of total billed charges,,,34.62,95,,percent of total billed charges,,,32.8,90,,percent of total billed charges,,,32.8,90,,percent of total billed charges,,,29.88,82,,percent of total billed charges,,,32.8,90,,percent of total billed charges,,,30.97,85,,percent of total billed charges,,9.11,34.62,
BACITRACIN VIAL:50000UNIT,32001316,CDM,J3490,HCPCS,250,RC,outpatient,,77.45,77.45,,65.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.36,22,,percent of total billed charges,,,,,,,,,69.71,90,,percent of total billed charges,,,64.13,82.8,,percent of total billed charges,,,65.83,85,,percent of total billed charges,,,,,,,,,68.16,88,,percent of total billed charges,,,,,,,,,59.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.36,22,,percent of total billed charges,,,70.48,91,,percent of total billed charges,,,73.58,95,,percent of total billed charges,,,64.28,83,,percent of total billed charges,,,64.28,83,,percent of total billed charges,,,,,,,,,,,,,,,64.28,83,,percent of total billed charges,,,73.58,95,,percent of total billed charges,,,69.71,90,,percent of total billed charges,,,69.71,90,,percent of total billed charges,,,63.51,82,,percent of total billed charges,,,69.71,90,,percent of total billed charges,,,65.83,85,,percent of total billed charges,,19.36,73.58,
BACLOFEN(LIORESAL)TAB:10MG,32001321,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
BACLOFEN (LIORESAL) TAB: 20MG,32001326,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
BAYCOL 0.3MG,32001327,CDM,,,250,RC,outpatient,,5.75,5.75,,4.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.44,22,,percent of total billed charges,,,,,,,,,5.18,90,,percent of total billed charges,,,4.76,82.8,,percent of total billed charges,,,4.89,85,,percent of total billed charges,,,,,,,,,5.06,88,,percent of total billed charges,,,,,,,,,4.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.44,22,,percent of total billed charges,,,5.23,91,,percent of total billed charges,,,5.46,95,,percent of total billed charges,,,4.77,83,,percent of total billed charges,,,4.77,83,,percent of total billed charges,,,,,,,,,,,,,,,4.77,83,,percent of total billed charges,,,5.46,95,,percent of total billed charges,,,5.18,90,,percent of total billed charges,,,5.18,90,,percent of total billed charges,,,4.72,82,,percent of total billed charges,,,5.18,90,,percent of total billed charges,,,4.89,85,,percent of total billed charges,,1.44,5.46,
MUPIROCIN(BACTROBAN)OINT 2%:22GM,32001331,CDM,J3490,HCPCS,250,RC,outpatient,,68.63,68.63,,58.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.16,22,,percent of total billed charges,,,,,,,,,61.77,90,,percent of total billed charges,,,56.83,82.8,,percent of total billed charges,,,58.34,85,,percent of total billed charges,,,,,,,,,60.39,88,,percent of total billed charges,,,,,,,,,52.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.16,22,,percent of total billed charges,,,62.45,91,,percent of total billed charges,,,65.2,95,,percent of total billed charges,,,56.96,83,,percent of total billed charges,,,56.96,83,,percent of total billed charges,,,,,,,,,,,,,,,56.96,83,,percent of total billed charges,,,65.2,95,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,56.28,82,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,58.34,85,,percent of total billed charges,,17.16,65.2,
MUPIROCIN(BACTROBANS)CREAM 2%:15GM,32001332,CDM,J3490,HCPCS,250,RC,outpatient,,2850.21,2850.21,,2419.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,712.55,22,,percent of total billed charges,,,,,,,,,2565.19,90,,percent of total billed charges,,,2359.97,82.8,,percent of total billed charges,,,2422.68,85,,percent of total billed charges,,,,,,,,,2508.18,88,,percent of total billed charges,,,,,,,,,2177.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,712.55,22,,percent of total billed charges,,,2593.69,91,,percent of total billed charges,,,2707.7,95,,percent of total billed charges,,,2365.67,83,,percent of total billed charges,,,2365.67,83,,percent of total billed charges,,,,,,,,,,,,,,,2365.67,83,,percent of total billed charges,,,2707.7,95,,percent of total billed charges,,,2565.19,90,,percent of total billed charges,,,2565.19,90,,percent of total billed charges,,,2337.17,82,,percent of total billed charges,,,2565.19,90,,percent of total billed charges,,,2422.68,85,,percent of total billed charges,,712.55,2707.7,
OXYQ/PETRO/WHT/LAN(BAGBALM)OINT 0.3%:,32001336,CDM,,,250,RC,outpatient,,18.25,18.25,,15.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.56,22,,percent of total billed charges,,,,,,,,,16.43,90,,percent of total billed charges,,,15.11,82.8,,percent of total billed charges,,,15.51,85,,percent of total billed charges,,,,,,,,,16.06,88,,percent of total billed charges,,,,,,,,,13.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.56,22,,percent of total billed charges,,,16.61,91,,percent of total billed charges,,,17.34,95,,percent of total billed charges,,,15.15,83,,percent of total billed charges,,,15.15,83,,percent of total billed charges,,,,,,,,,,,,,,,15.15,83,,percent of total billed charges,,,17.34,95,,percent of total billed charges,,,16.43,90,,percent of total billed charges,,,16.43,90,,percent of total billed charges,,,14.97,82,,percent of total billed charges,,,16.43,90,,percent of total billed charges,,,15.51,85,,percent of total billed charges,,4.56,17.34,
DIMERCAPROL (BAL IN OIL) AMP : 100MG/ML,32001341,CDM,J0470,HCPCS,636,RC,outpatient,,1243.07,1243.07,,1055.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,310.77,22,,percent of total billed charges,,,,,,,,,1118.76,90,,percent of total billed charges,,,1029.26,82.8,,percent of total billed charges,,,1056.61,85,,percent of total billed charges,,,,,,,,,1093.9,88,,percent of total billed charges,,323.65,,,,fee schedule,,,949.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,323.65,,,,fee schedule,,,310.77,22,,percent of total billed charges,,,1131.19,91,,percent of total billed charges,,,1180.92,95,,percent of total billed charges,,,1031.75,83,,percent of total billed charges,,,1031.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1031.75,83,,percent of total billed charges,,,1180.92,95,,percent of total billed charges,,,1118.76,90,,percent of total billed charges,,,1118.76,90,,percent of total billed charges,,,1019.32,82,,percent of total billed charges,,,1118.76,90,,percent of total billed charges,,,1056.61,85,,percent of total billed charges,,310.77,1180.92,
BECLOMETHASONE DIPROP(VANCERIL)AER:42MCG,32001361,CDM,,,250,RC,outpatient,,665.01,665.01,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.51,90,,percent of total billed charges,,,550.63,82.8,,percent of total billed charges,,,565.26,85,,percent of total billed charges,,,,,,,,,585.21,88,,percent of total billed charges,,,,,,,,,508.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.16,91,,percent of total billed charges,,,631.76,95,,percent of total billed charges,,,551.96,83,,percent of total billed charges,,,551.96,83,,percent of total billed charges,,,,,,,,,,,,,,,551.96,83,,percent of total billed charges,,,631.76,95,,percent of total billed charges,,,598.51,90,,percent of total billed charges,,,598.51,90,,percent of total billed charges,,,545.31,82,,percent of total billed charges,,,598.51,90,,percent of total billed charges,,,565.26,85,,percent of total billed charges,,166.25,631.76,
BECLOMETHASONE(BECONASE) SPR:42MCG  25GM,32001376,CDM,,,250,RC,outpatient,,343.25,343.25,,291.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.81,22,,percent of total billed charges,,,,,,,,,308.93,90,,percent of total billed charges,,,284.21,82.8,,percent of total billed charges,,,291.76,85,,percent of total billed charges,,,,,,,,,302.06,88,,percent of total billed charges,,,,,,,,,262.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.81,22,,percent of total billed charges,,,312.36,91,,percent of total billed charges,,,326.09,95,,percent of total billed charges,,,284.9,83,,percent of total billed charges,,,284.9,83,,percent of total billed charges,,,,,,,,,,,,,,,284.9,83,,percent of total billed charges,,,326.09,95,,percent of total billed charges,,,308.93,90,,percent of total billed charges,,,308.93,90,,percent of total billed charges,,,281.47,82,,percent of total billed charges,,,308.93,90,,percent of total billed charges,,,291.76,85,,percent of total billed charges,,85.81,326.09,
DIPHENHYDRAM(BENADRYL)CREAM 1%:30GM,32001386,CDM,J3490,HCPCS,250,RC,outpatient,,40.6,40.6,,34.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.15,22,,percent of total billed charges,,,,,,,,,36.54,90,,percent of total billed charges,,,33.62,82.8,,percent of total billed charges,,,34.51,85,,percent of total billed charges,,,,,,,,,35.73,88,,percent of total billed charges,,,,,,,,,31.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.15,22,,percent of total billed charges,,,36.95,91,,percent of total billed charges,,,38.57,95,,percent of total billed charges,,,33.7,83,,percent of total billed charges,,,33.7,83,,percent of total billed charges,,,,,,,,,,,,,,,33.7,83,,percent of total billed charges,,,38.57,95,,percent of total billed charges,,,36.54,90,,percent of total billed charges,,,36.54,90,,percent of total billed charges,,,33.29,82,,percent of total billed charges,,,36.54,90,,percent of total billed charges,,,34.51,85,,percent of total billed charges,,10.15,38.57,
DICYCLOMINE(BENTYL)TAB:20MG,32001396,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
BENZTROPINE(COGENTIN)TAB:1MG,32001401,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
BENZONATATE(TESSALON)CAP:100MG,32001411,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
BETADINE 5%,32001415,CDM,,,250,RC,outpatient,,36,36,,30.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9,22,,percent of total billed charges,,,,,,,,,32.4,90,,percent of total billed charges,,,29.81,82.8,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,,,,,,,,31.68,88,,percent of total billed charges,,,,,,,,,27.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9,22,,percent of total billed charges,,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,,,,,,,,,,,,,29.88,83,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,29.52,82,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,9,34.2,
POVIDONE-IODINE (BETADINE) OINT 10% 30GM,32001416,CDM,,,250,RC,outpatient,,24.27,24.27,,20.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.07,22,,percent of total billed charges,,,,,,,,,21.84,90,,percent of total billed charges,,,20.1,82.8,,percent of total billed charges,,,20.63,85,,percent of total billed charges,,,,,,,,,21.36,88,,percent of total billed charges,,,,,,,,,18.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.07,22,,percent of total billed charges,,,22.09,91,,percent of total billed charges,,,23.06,95,,percent of total billed charges,,,20.14,83,,percent of total billed charges,,,20.14,83,,percent of total billed charges,,,,,,,,,,,,,,,20.14,83,,percent of total billed charges,,,23.06,95,,percent of total billed charges,,,21.84,90,,percent of total billed charges,,,21.84,90,,percent of total billed charges,,,19.9,82,,percent of total billed charges,,,21.84,90,,percent of total billed charges,,,20.63,85,,percent of total billed charges,,6.07,23.06,
POVIDONE-IODINE (BETADINE) SWAB : 10%,32001421,CDM,,,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
BETAMETHASONE(VALISONE) OINT : 0.1% 45GM,32001426,CDM,,,250,RC,outpatient,,358.28,358.28,,304.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.57,22,,percent of total billed charges,,,,,,,,,322.45,90,,percent of total billed charges,,,296.66,82.8,,percent of total billed charges,,,304.54,85,,percent of total billed charges,,,,,,,,,315.29,88,,percent of total billed charges,,,,,,,,,273.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.57,22,,percent of total billed charges,,,326.03,91,,percent of total billed charges,,,340.37,95,,percent of total billed charges,,,297.37,83,,percent of total billed charges,,,297.37,83,,percent of total billed charges,,,,,,,,,,,,,,,297.37,83,,percent of total billed charges,,,340.37,95,,percent of total billed charges,,,322.45,90,,percent of total billed charges,,,322.45,90,,percent of total billed charges,,,293.79,82,,percent of total billed charges,,,322.45,90,,percent of total billed charges,,,304.54,85,,percent of total billed charges,,89.57,340.37,
BETAMETHASONE(VALISONE) CM : 0.1%  45GM,32001431,CDM,,,250,RC,outpatient,,394.6,394.6,,335.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.65,22,,percent of total billed charges,,,,,,,,,355.14,90,,percent of total billed charges,,,326.73,82.8,,percent of total billed charges,,,335.41,85,,percent of total billed charges,,,,,,,,,347.25,88,,percent of total billed charges,,,,,,,,,301.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.65,22,,percent of total billed charges,,,359.09,91,,percent of total billed charges,,,374.87,95,,percent of total billed charges,,,327.52,83,,percent of total billed charges,,,327.52,83,,percent of total billed charges,,,,,,,,,,,,,,,327.52,83,,percent of total billed charges,,,374.87,95,,percent of total billed charges,,,355.14,90,,percent of total billed charges,,,355.14,90,,percent of total billed charges,,,323.57,82,,percent of total billed charges,,,355.14,90,,percent of total billed charges,,,335.41,85,,percent of total billed charges,,98.65,374.87,
BETAMETHASONE(VALISONE) CM 0.1%:15GM,32001436,CDM,J3490,HCPCS,250,RC,outpatient,,221.88,221.88,,188.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.47,22,,percent of total billed charges,,,,,,,,,199.69,90,,percent of total billed charges,,,183.72,82.8,,percent of total billed charges,,,188.6,85,,percent of total billed charges,,,,,,,,,195.25,88,,percent of total billed charges,,,,,,,,,169.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.47,22,,percent of total billed charges,,,201.91,91,,percent of total billed charges,,,210.79,95,,percent of total billed charges,,,184.16,83,,percent of total billed charges,,,184.16,83,,percent of total billed charges,,,,,,,,,,,,,,,184.16,83,,percent of total billed charges,,,210.79,95,,percent of total billed charges,,,199.69,90,,percent of total billed charges,,,199.69,90,,percent of total billed charges,,,181.94,82,,percent of total billed charges,,,199.69,90,,percent of total billed charges,,,188.6,85,,percent of total billed charges,,55.47,210.79,
BETAMETHASONE(VALISONE) OINT:0.1% 15GM,32001441,CDM,,,250,RC,outpatient,,152.41,152.41,,129.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.1,22,,percent of total billed charges,,,,,,,,,137.17,90,,percent of total billed charges,,,126.2,82.8,,percent of total billed charges,,,129.55,85,,percent of total billed charges,,,,,,,,,134.12,88,,percent of total billed charges,,,,,,,,,116.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.1,22,,percent of total billed charges,,,138.69,91,,percent of total billed charges,,,144.79,95,,percent of total billed charges,,,126.5,83,,percent of total billed charges,,,126.5,83,,percent of total billed charges,,,,,,,,,,,,,,,126.5,83,,percent of total billed charges,,,144.79,95,,percent of total billed charges,,,137.17,90,,percent of total billed charges,,,137.17,90,,percent of total billed charges,,,124.98,82,,percent of total billed charges,,,137.17,90,,percent of total billed charges,,,129.55,85,,percent of total billed charges,,38.1,144.79,
BETAMETHASONE (VALISONE) LOT : 0.1% 60ML,32001446,CDM,,,250,RC,outpatient,,846.72,846.72,,718.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,211.68,22,,percent of total billed charges,,,,,,,,,762.05,90,,percent of total billed charges,,,701.08,82.8,,percent of total billed charges,,,719.71,85,,percent of total billed charges,,,,,,,,,745.11,88,,percent of total billed charges,,,,,,,,,646.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,211.68,22,,percent of total billed charges,,,770.52,91,,percent of total billed charges,,,804.38,95,,percent of total billed charges,,,702.78,83,,percent of total billed charges,,,702.78,83,,percent of total billed charges,,,,,,,,,,,,,,,702.78,83,,percent of total billed charges,,,804.38,95,,percent of total billed charges,,,762.05,90,,percent of total billed charges,,,762.05,90,,percent of total billed charges,,,694.31,82,,percent of total billed charges,,,762.05,90,,percent of total billed charges,,,719.71,85,,percent of total billed charges,,211.68,804.38,
SOTALOL(BETAPACE)TAB:80MG,32001451,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
POVIDONE-IODINE(BETADINE)SOL 5%:30ML,32001457,CDM,J3490,HCPCS,250,RC,outpatient,,232.35,232.35,,197.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,58.09,22,,percent of total billed charges,,,,,,,,,209.12,90,,percent of total billed charges,,,192.39,82.8,,percent of total billed charges,,,197.5,85,,percent of total billed charges,,,,,,,,,204.47,88,,percent of total billed charges,,,,,,,,,177.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,58.09,22,,percent of total billed charges,,,211.44,91,,percent of total billed charges,,,220.73,95,,percent of total billed charges,,,192.85,83,,percent of total billed charges,,,192.85,83,,percent of total billed charges,,,,,,,,,,,,,,,192.85,83,,percent of total billed charges,,,220.73,95,,percent of total billed charges,,,209.12,90,,percent of total billed charges,,,209.12,90,,percent of total billed charges,,,190.53,82,,percent of total billed charges,,,209.12,90,,percent of total billed charges,,,197.5,85,,percent of total billed charges,,58.09,220.73,
BETAMETHASONE DIPROPIONATE CR 0.05%:15GM,32001458,CDM,J3490,HCPCS,250,RC,outpatient,,380.32,380.32,,322.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,95.08,22,,percent of total billed charges,,,,,,,,,342.29,90,,percent of total billed charges,,,314.9,82.8,,percent of total billed charges,,,323.27,85,,percent of total billed charges,,,,,,,,,334.68,88,,percent of total billed charges,,,,,,,,,290.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,95.08,22,,percent of total billed charges,,,346.09,91,,percent of total billed charges,,,361.3,95,,percent of total billed charges,,,315.67,83,,percent of total billed charges,,,315.67,83,,percent of total billed charges,,,,,,,,,,,,,,,315.67,83,,percent of total billed charges,,,361.3,95,,percent of total billed charges,,,342.29,90,,percent of total billed charges,,,342.29,90,,percent of total billed charges,,,311.86,82,,percent of total billed charges,,,342.29,90,,percent of total billed charges,,,323.27,85,,percent of total billed charges,,95.08,361.3,
BETAMETHASONE DIPROP LOT: 0.05%   60ML,32001461,CDM,,,250,RC,outpatient,,473.1,473.1,,401.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,118.28,22,,percent of total billed charges,,,,,,,,,425.79,90,,percent of total billed charges,,,391.73,82.8,,percent of total billed charges,,,402.14,85,,percent of total billed charges,,,,,,,,,416.33,88,,percent of total billed charges,,,,,,,,,361.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,118.28,22,,percent of total billed charges,,,430.52,91,,percent of total billed charges,,,449.45,95,,percent of total billed charges,,,392.67,83,,percent of total billed charges,,,392.67,83,,percent of total billed charges,,,,,,,,,,,,,,,392.67,83,,percent of total billed charges,,,449.45,95,,percent of total billed charges,,,425.79,90,,percent of total billed charges,,,425.79,90,,percent of total billed charges,,,387.94,82,,percent of total billed charges,,,425.79,90,,percent of total billed charges,,,402.14,85,,percent of total billed charges,,118.28,449.45,
BETHANECHOL (URECHOLINE) TAB : 5MG,32001462,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
BETHANECHOL(URECHOLINE)TAB:10MG,32001466,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
BETHANECHOL(URECHOLINE)TAB:25MG,32001471,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
BETAXOLOL (BETOPTIC) DROP : 0.5%  10ML,32001476,CDM,,,250,RC,outpatient,,1337.68,1337.68,,1135.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,334.42,22,,percent of total billed charges,,,,,,,,,1203.91,90,,percent of total billed charges,,,1107.6,82.8,,percent of total billed charges,,,1137.03,85,,percent of total billed charges,,,,,,,,,1177.16,88,,percent of total billed charges,,,,,,,,,1021.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,334.42,22,,percent of total billed charges,,,1217.29,91,,percent of total billed charges,,,1270.8,95,,percent of total billed charges,,,1110.27,83,,percent of total billed charges,,,1110.27,83,,percent of total billed charges,,,,,,,,,,,,,,,1110.27,83,,percent of total billed charges,,,1270.8,95,,percent of total billed charges,,,1203.91,90,,percent of total billed charges,,,1203.91,90,,percent of total billed charges,,,1096.9,82,,percent of total billed charges,,,1203.91,90,,percent of total billed charges,,,1137.03,85,,percent of total billed charges,,334.42,1270.8,
BETAXOLOL(BETOPTIC S)DROP 0.25%:5ML,32001481,CDM,,,250,RC,outpatient,,679.44,679.44,,576.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,169.86,22,,percent of total billed charges,,,,,,,,,611.5,90,,percent of total billed charges,,,562.58,82.8,,percent of total billed charges,,,577.52,85,,percent of total billed charges,,,,,,,,,597.91,88,,percent of total billed charges,,,,,,,,,519.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,169.86,22,,percent of total billed charges,,,618.29,91,,percent of total billed charges,,,645.47,95,,percent of total billed charges,,,563.94,83,,percent of total billed charges,,,563.94,83,,percent of total billed charges,,,,,,,,,,,,,,,563.94,83,,percent of total billed charges,,,645.47,95,,percent of total billed charges,,,611.5,90,,percent of total billed charges,,,611.5,90,,percent of total billed charges,,,557.14,82,,percent of total billed charges,,,611.5,90,,percent of total billed charges,,,577.52,85,,percent of total billed charges,,169.86,645.47,
BIAXIN 125 MG/5ML 50ML,32001490,CDM,,,250,RC,outpatient,,59.5,59.5,,50.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.88,22,,percent of total billed charges,,,,,,,,,53.55,90,,percent of total billed charges,,,49.27,82.8,,percent of total billed charges,,,50.58,85,,percent of total billed charges,,,,,,,,,52.36,88,,percent of total billed charges,,,,,,,,,45.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.88,22,,percent of total billed charges,,,54.15,91,,percent of total billed charges,,,56.53,95,,percent of total billed charges,,,49.39,83,,percent of total billed charges,,,49.39,83,,percent of total billed charges,,,,,,,,,,,,,,,49.39,83,,percent of total billed charges,,,56.53,95,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,48.79,82,,percent of total billed charges,,,53.55,90,,percent of total billed charges,,,50.58,85,,percent of total billed charges,,14.88,56.53,
CLARITHROMY(BIAXIN) SUS: 125MG/5ML 100ML,32001491,CDM,,,250,RC,outpatient,,488.33,488.33,,414.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.08,22,,percent of total billed charges,,,,,,,,,439.5,90,,percent of total billed charges,,,404.34,82.8,,percent of total billed charges,,,415.08,85,,percent of total billed charges,,,,,,,,,429.73,88,,percent of total billed charges,,,,,,,,,373.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.08,22,,percent of total billed charges,,,444.38,91,,percent of total billed charges,,,463.91,95,,percent of total billed charges,,,405.31,83,,percent of total billed charges,,,405.31,83,,percent of total billed charges,,,,,,,,,,,,,,,405.31,83,,percent of total billed charges,,,463.91,95,,percent of total billed charges,,,439.5,90,,percent of total billed charges,,,439.5,90,,percent of total billed charges,,,400.43,82,,percent of total billed charges,,,439.5,90,,percent of total billed charges,,,415.08,85,,percent of total billed charges,,122.08,463.91,
CLARITHROMYCIN(BIAXIN)TAB:500MG,32001496,CDM,J8499,HCPCS,250,RC,outpatient,,36.76,36.76,,31.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.19,22,,percent of total billed charges,,,,,,,,,33.08,90,,percent of total billed charges,,,30.44,82.8,,percent of total billed charges,,,31.25,85,,percent of total billed charges,,,,,,,,,32.35,88,,percent of total billed charges,,,,,,,,,28.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.19,22,,percent of total billed charges,,,33.45,91,,percent of total billed charges,,,34.92,95,,percent of total billed charges,,,30.51,83,,percent of total billed charges,,,30.51,83,,percent of total billed charges,,,,,,,,,,,,,,,30.51,83,,percent of total billed charges,,,34.92,95,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,30.14,82,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,31.25,85,,percent of total billed charges,,9.19,34.92,
CLARITHROMYCIN(BIAXIN) TAB: 500MG (1X4),32001497,CDM,,,250,RC,outpatient,,142.9,142.9,,121.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.73,22,,percent of total billed charges,,,,,,,,,128.61,90,,percent of total billed charges,,,118.32,82.8,,percent of total billed charges,,,121.47,85,,percent of total billed charges,,,,,,,,,125.75,88,,percent of total billed charges,,,,,,,,,109.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.73,22,,percent of total billed charges,,,130.04,91,,percent of total billed charges,,,135.76,95,,percent of total billed charges,,,118.61,83,,percent of total billed charges,,,118.61,83,,percent of total billed charges,,,,,,,,,,,,,,,118.61,83,,percent of total billed charges,,,135.76,95,,percent of total billed charges,,,128.61,90,,percent of total billed charges,,,128.61,90,,percent of total billed charges,,,117.18,82,,percent of total billed charges,,,128.61,90,,percent of total billed charges,,,121.47,85,,percent of total billed charges,,35.73,135.76,
CLARITHROMY(BIAXIN) SUS :250MG/5ML 100ML,32001501,CDM,,,250,RC,outpatient,,788.66,788.66,,669.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,197.17,22,,percent of total billed charges,,,,,,,,,709.79,90,,percent of total billed charges,,,653.01,82.8,,percent of total billed charges,,,670.36,85,,percent of total billed charges,,,,,,,,,694.02,88,,percent of total billed charges,,,,,,,,,602.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,197.17,22,,percent of total billed charges,,,717.68,91,,percent of total billed charges,,,749.23,95,,percent of total billed charges,,,654.59,83,,percent of total billed charges,,,654.59,83,,percent of total billed charges,,,,,,,,,,,,,,,654.59,83,,percent of total billed charges,,,749.23,95,,percent of total billed charges,,,709.79,90,,percent of total billed charges,,,709.79,90,,percent of total billed charges,,,646.7,82,,percent of total billed charges,,,709.79,90,,percent of total billed charges,,,670.36,85,,percent of total billed charges,,197.17,749.23,
CLARITHROMYCIN (BIAXIN) TAB : 250MG,32001506,CDM,,,250,RC,outpatient,,98.01,98.01,,83.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.5,22,,percent of total billed charges,,,,,,,,,88.21,90,,percent of total billed charges,,,81.15,82.8,,percent of total billed charges,,,83.31,85,,percent of total billed charges,,,,,,,,,86.25,88,,percent of total billed charges,,,,,,,,,74.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.5,22,,percent of total billed charges,,,89.19,91,,percent of total billed charges,,,93.11,95,,percent of total billed charges,,,81.35,83,,percent of total billed charges,,,81.35,83,,percent of total billed charges,,,,,,,,,,,,,,,81.35,83,,percent of total billed charges,,,93.11,95,,percent of total billed charges,,,88.21,90,,percent of total billed charges,,,88.21,90,,percent of total billed charges,,,80.37,82,,percent of total billed charges,,,88.21,90,,percent of total billed charges,,,83.31,85,,percent of total billed charges,,24.5,93.11,
CITR ACID/NS CITRA(BICITRA):UD,32001512,CDM,J8499,HCPCS,250,RC,outpatient,,52.12,52.12,,44.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.03,22,,percent of total billed charges,,,,,,,,,46.91,90,,percent of total billed charges,,,43.16,82.8,,percent of total billed charges,,,44.3,85,,percent of total billed charges,,,,,,,,,45.87,88,,percent of total billed charges,,,,,,,,,39.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.03,22,,percent of total billed charges,,,47.43,91,,percent of total billed charges,,,49.51,95,,percent of total billed charges,,,43.26,83,,percent of total billed charges,,,43.26,83,,percent of total billed charges,,,,,,,,,,,,,,,43.26,83,,percent of total billed charges,,,49.51,95,,percent of total billed charges,,,46.91,90,,percent of total billed charges,,,46.91,90,,percent of total billed charges,,,42.74,82,,percent of total billed charges,,,46.91,90,,percent of total billed charges,,,44.3,85,,percent of total billed charges,,13.03,49.51,
PEN GBENZ/PROC(BICILLN CR)SYR:1.2MMU/2ML,32001526,CDM,,,250,RC,outpatient,,1936.7,1936.7,,1644.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,484.18,22,,percent of total billed charges,,,,,,,,,1743.03,90,,percent of total billed charges,,,1603.59,82.8,,percent of total billed charges,,,1646.2,85,,percent of total billed charges,,,,,,,,,1704.3,88,,percent of total billed charges,,,,,,,,,1479.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,484.18,22,,percent of total billed charges,,,1762.4,91,,percent of total billed charges,,,1839.87,95,,percent of total billed charges,,,1607.46,83,,percent of total billed charges,,,1607.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1607.46,83,,percent of total billed charges,,,1839.87,95,,percent of total billed charges,,,1743.03,90,,percent of total billed charges,,,1743.03,90,,percent of total billed charges,,,1588.09,82,,percent of total billed charges,,,1743.03,90,,percent of total billed charges,,,1646.2,85,,percent of total billed charges,,484.18,1839.87,
PEN G BEN(BICILLIN LA)SYR:1.2MIL UNITS,32001531,CDM,J0570,HCPCS,250,RC,outpatient,,2981.27,2981.27,,2531.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,745.32,22,,percent of total billed charges,,,,,,,,,2683.14,90,,percent of total billed charges,,,2468.49,82.8,,percent of total billed charges,,,2534.08,85,,percent of total billed charges,,,,,,,,,2623.52,88,,percent of total billed charges,,,,,,,,,2277.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,745.32,22,,percent of total billed charges,,,2712.96,91,,percent of total billed charges,,,2832.21,95,,percent of total billed charges,,,2474.45,83,,percent of total billed charges,,,2474.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2474.45,83,,percent of total billed charges,,,2832.21,95,,percent of total billed charges,,,2683.14,90,,percent of total billed charges,,,2683.14,90,,percent of total billed charges,,,2444.64,82,,percent of total billed charges,,,2683.14,90,,percent of total billed charges,,,2534.08,85,,percent of total billed charges,,745.32,2832.21,
BISACODYL(DULCOLAX)TAB:5MG,32001541,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
BISACODYL(DULCOLAX)SUPP:10MG,32001546,CDM,J3490,HCPCS,250,RC,outpatient,,14.64,14.64,,12.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.66,22,,percent of total billed charges,,,,,,,,,13.18,90,,percent of total billed charges,,,12.12,82.8,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,,,,,,,,12.88,88,,percent of total billed charges,,,,,,,,,11.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.66,22,,percent of total billed charges,,,13.32,91,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,,,,,,,,,,,,,12.15,83,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12,82,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,3.66,13.91,
BLEOMYCIN SULFATE VIAL : 15 UNIT   1ML,32001551,CDM,J9040,HCPCS,636,RC,outpatient,,334.49,334.49,,283.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.62,22,,percent of total billed charges,,,,,,,,,301.04,90,,percent of total billed charges,,,276.96,82.8,,percent of total billed charges,,,284.32,85,,percent of total billed charges,,,,,,,,,294.35,88,,percent of total billed charges,,97.2,,,,fee schedule,,,255.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,97.2,,,,fee schedule,,,83.62,22,,percent of total billed charges,,,304.39,91,,percent of total billed charges,,,317.77,95,,percent of total billed charges,,,277.63,83,,percent of total billed charges,,,277.63,83,,percent of total billed charges,,,,,,,,,,,,,,,277.63,83,,percent of total billed charges,,,317.77,95,,percent of total billed charges,,,301.04,90,,percent of total billed charges,,,301.04,90,,percent of total billed charges,,,274.28,82,,percent of total billed charges,,,301.04,90,,percent of total billed charges,,,284.32,85,,percent of total billed charges,,83.62,317.77,
SULFACET/PRED(BLEPHAMIDE)OINT:10-0.2%3.5,32001556,CDM,,,250,RC,outpatient,,2003.1,2003.1,,1700.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,500.78,22,,percent of total billed charges,,,,,,,,,1802.79,90,,percent of total billed charges,,,1658.57,82.8,,percent of total billed charges,,,1702.64,85,,percent of total billed charges,,,,,,,,,1762.73,88,,percent of total billed charges,,,,,,,,,1530.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,500.78,22,,percent of total billed charges,,,1822.82,91,,percent of total billed charges,,,1902.95,95,,percent of total billed charges,,,1662.57,83,,percent of total billed charges,,,1662.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1662.57,83,,percent of total billed charges,,,1902.95,95,,percent of total billed charges,,,1802.79,90,,percent of total billed charges,,,1802.79,90,,percent of total billed charges,,,1642.54,82,,percent of total billed charges,,,1802.79,90,,percent of total billed charges,,,1702.64,85,,percent of total billed charges,,500.78,1902.95,
SULFACETAMIDE/PREDNS(BLEPHAMD)DROP:5ML,32001557,CDM,J3490,HCPCS,250,RC,outpatient,,2330.93,2330.93,,1978.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,582.73,22,,percent of total billed charges,,,,,,,,,2097.84,90,,percent of total billed charges,,,1930.01,82.8,,percent of total billed charges,,,1981.29,85,,percent of total billed charges,,,,,,,,,2051.22,88,,percent of total billed charges,,,,,,,,,1780.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,582.73,22,,percent of total billed charges,,,2121.15,91,,percent of total billed charges,,,2214.38,95,,percent of total billed charges,,,1934.67,83,,percent of total billed charges,,,1934.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1934.67,83,,percent of total billed charges,,,2214.38,95,,percent of total billed charges,,,2097.84,90,,percent of total billed charges,,,2097.84,90,,percent of total billed charges,,,1911.36,82,,percent of total billed charges,,,2097.84,90,,percent of total billed charges,,,1981.29,85,,percent of total billed charges,,582.73,2214.38,
SULFACETAMIDE(BLEPH 10)DROP 10%:15ML,32001566,CDM,J3490,HCPCS,250,RC,outpatient,,610.95,610.95,,518.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,152.74,22,,percent of total billed charges,,,,,,,,,549.86,90,,percent of total billed charges,,,505.87,82.8,,percent of total billed charges,,,519.31,85,,percent of total billed charges,,,,,,,,,537.64,88,,percent of total billed charges,,,,,,,,,466.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,152.74,22,,percent of total billed charges,,,555.96,91,,percent of total billed charges,,,580.4,95,,percent of total billed charges,,,507.09,83,,percent of total billed charges,,,507.09,83,,percent of total billed charges,,,,,,,,,,,,,,,507.09,83,,percent of total billed charges,,,580.4,95,,percent of total billed charges,,,549.86,90,,percent of total billed charges,,,549.86,90,,percent of total billed charges,,,500.98,82,,percent of total billed charges,,,549.86,90,,percent of total billed charges,,,519.31,85,,percent of total billed charges,,152.74,580.4,
DOMEBORO PKG,32001572,CDM,,,636,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
TERBUTALINE(BRETHINE)VIAL:1MG/ML,32001576,CDM,J3105,HCPCS,250,RC,outpatient,,300.17,300.17,,254.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.04,22,,percent of total billed charges,,,,,,,,,270.15,90,,percent of total billed charges,,,248.54,82.8,,percent of total billed charges,,,255.14,85,,percent of total billed charges,,,,,,,,,264.15,88,,percent of total billed charges,,12.77,,,,fee schedule,,,229.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,12.77,,,,fee schedule,,,75.04,22,,percent of total billed charges,,,273.15,91,,percent of total billed charges,,,285.16,95,,percent of total billed charges,,,249.14,83,,percent of total billed charges,,,249.14,83,,percent of total billed charges,,,,,,,,,,,,,,,249.14,83,,percent of total billed charges,,,285.16,95,,percent of total billed charges,,,270.15,90,,percent of total billed charges,,,270.15,90,,percent of total billed charges,,,246.14,82,,percent of total billed charges,,,270.15,90,,percent of total billed charges,,,255.14,85,,percent of total billed charges,,12.77,285.16,
TERBUTALINE(BRETHINE)TAB:5MG,32001586,CDM,,,250,RC,outpatient,,84.06,84.06,,71.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.02,22,,percent of total billed charges,,,,,,,,,75.65,90,,percent of total billed charges,,,69.6,82.8,,percent of total billed charges,,,71.45,85,,percent of total billed charges,,,,,,,,,73.97,88,,percent of total billed charges,,,,,,,,,64.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.02,22,,percent of total billed charges,,,76.49,91,,percent of total billed charges,,,79.86,95,,percent of total billed charges,,,69.77,83,,percent of total billed charges,,,69.77,83,,percent of total billed charges,,,,,,,,,,,,,,,69.77,83,,percent of total billed charges,,,79.86,95,,percent of total billed charges,,,75.65,90,,percent of total billed charges,,,75.65,90,,percent of total billed charges,,,68.93,82,,percent of total billed charges,,,75.65,90,,percent of total billed charges,,,71.45,85,,percent of total billed charges,,21.02,79.86,
TERBUTALINE (BRETHINE) TAB : 2.5MG,32001591,CDM,J8499,HCPCS,250,RC,outpatient,,64.38,64.38,,54.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.1,22,,percent of total billed charges,,,,,,,,,57.94,90,,percent of total billed charges,,,53.31,82.8,,percent of total billed charges,,,54.72,85,,percent of total billed charges,,,,,,,,,56.65,88,,percent of total billed charges,,,,,,,,,49.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.1,22,,percent of total billed charges,,,58.59,91,,percent of total billed charges,,,61.16,95,,percent of total billed charges,,,53.44,83,,percent of total billed charges,,,53.44,83,,percent of total billed charges,,,,,,,,,,,,,,,53.44,83,,percent of total billed charges,,,61.16,95,,percent of total billed charges,,,57.94,90,,percent of total billed charges,,,57.94,90,,percent of total billed charges,,,52.79,82,,percent of total billed charges,,,57.94,90,,percent of total billed charges,,,54.72,85,,percent of total billed charges,,16.1,61.16,
BRETYLIUM TOSYLATE VIAL : 50MG/ML 10ML,32001596,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
GUAIFENESIN/COD (BRONTEX) TAB : 300-10MG,32001636,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
BALANCED SALT IRRIG SOL COMBS(BSS):15ML,32001651,CDM,J3490,HCPCS,250,RC,outpatient,,181.21,181.21,,153.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.3,22,,percent of total billed charges,,,,,,,,,163.09,90,,percent of total billed charges,,,150.04,82.8,,percent of total billed charges,,,154.03,85,,percent of total billed charges,,,,,,,,,159.46,88,,percent of total billed charges,,,,,,,,,138.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.3,22,,percent of total billed charges,,,164.9,91,,percent of total billed charges,,,172.15,95,,percent of total billed charges,,,150.4,83,,percent of total billed charges,,,150.4,83,,percent of total billed charges,,,,,,,,,,,,,,,150.4,83,,percent of total billed charges,,,172.15,95,,percent of total billed charges,,,163.09,90,,percent of total billed charges,,,163.09,90,,percent of total billed charges,,,148.59,82,,percent of total billed charges,,,163.09,90,,percent of total billed charges,,,154.03,85,,percent of total billed charges,,45.3,172.15,
BUMETANIDE (BUMEX) TAB : 0.5MG,32001661,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
BUMETANIDE(BUMEX)TAB:1MG,32001666,CDM,J8499,HCPCS,250,RC,outpatient,,15.69,15.69,,13.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.92,22,,percent of total billed charges,,,,,,,,,14.12,90,,percent of total billed charges,,,12.99,82.8,,percent of total billed charges,,,13.34,85,,percent of total billed charges,,,,,,,,,13.81,88,,percent of total billed charges,,,,,,,,,11.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.92,22,,percent of total billed charges,,,14.28,91,,percent of total billed charges,,,14.91,95,,percent of total billed charges,,,13.02,83,,percent of total billed charges,,,13.02,83,,percent of total billed charges,,,,,,,,,,,,,,,13.02,83,,percent of total billed charges,,,14.91,95,,percent of total billed charges,,,14.12,90,,percent of total billed charges,,,14.12,90,,percent of total billed charges,,,12.87,82,,percent of total billed charges,,,14.12,90,,percent of total billed charges,,,13.34,85,,percent of total billed charges,,3.92,14.91,
BUMETANIDE (BUMEX) TAB : 2MG,32001667,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
BUMETANIDE (BUMEX) VIAL : 0.25MG/ML  2ML,32001671,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
BUMETANIDE(BUMEX)VIAL:2.5MG/10ML,32001676,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
BUMETANIDE(BUMEX)VIAL:1MG/4ML,32001681,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
BUPRENEX,32001686,CDM,,,250,RC,outpatient,,245.04,245.04,,208.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.26,22,,percent of total billed charges,,,,,,,,,220.54,90,,percent of total billed charges,,,202.89,82.8,,percent of total billed charges,,,208.28,85,,percent of total billed charges,,,,,,,,,215.64,88,,percent of total billed charges,,,,,,,,,187.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.26,22,,percent of total billed charges,,,222.99,91,,percent of total billed charges,,,232.79,95,,percent of total billed charges,,,203.38,83,,percent of total billed charges,,,203.38,83,,percent of total billed charges,,,,,,,,,,,,,,,203.38,83,,percent of total billed charges,,,232.79,95,,percent of total billed charges,,,220.54,90,,percent of total billed charges,,,220.54,90,,percent of total billed charges,,,200.93,82,,percent of total billed charges,,,220.54,90,,percent of total billed charges,,,208.28,85,,percent of total billed charges,,61.26,232.79,
busPIRone(BUSPAR)TAB:5MG,32001691,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
BUSPIRONE (BUSPAR) TAB : 10MG,32001696,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CAFFEINE/SODIUM BENZOATE 0.5GM/2ML,32001702,CDM,,,250,RC,outpatient,,68,68,,57.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17,22,,percent of total billed charges,,,,,,,,,61.2,90,,percent of total billed charges,,,56.3,82.8,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,,,,,,,,59.84,88,,percent of total billed charges,,,,,,,,,51.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17,22,,percent of total billed charges,,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,,,,,,,,,,,,,56.44,83,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,55.76,82,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,17,64.6,
EDETATE CALC DISOD(EDTA)AMP:200MG/ML-5ML,32001706,CDM,J0600,HCPCS,636,RC,outpatient,,1091.87,1091.87,,927,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,272.97,22,,percent of total billed charges,,,,,,,,,982.68,90,,percent of total billed charges,,,904.07,82.8,,percent of total billed charges,,,928.09,85,,percent of total billed charges,,,,,,,,,960.85,88,,percent of total billed charges,,11417.19,,,,fee schedule,,,834.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11417.19,,,,fee schedule,,,272.97,22,,percent of total billed charges,,,993.6,91,,percent of total billed charges,,,1037.28,95,,percent of total billed charges,,,906.25,83,,percent of total billed charges,,,906.25,83,,percent of total billed charges,,,,,,,,,,,,,,,906.25,83,,percent of total billed charges,,,1037.28,95,,percent of total billed charges,,,982.68,90,,percent of total billed charges,,,982.68,90,,percent of total billed charges,,,895.33,82,,percent of total billed charges,,,982.68,90,,percent of total billed charges,,,928.09,85,,percent of total billed charges,,272.97,11417.19,
ERGOTAMINE TART/CAF(MIGERGOT)SUP:2-100MG,32001711,CDM,,,250,RC,outpatient,,2180.24,2180.24,,1851.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,545.06,22,,percent of total billed charges,,,,,,,,,1962.22,90,,percent of total billed charges,,,1805.24,82.8,,percent of total billed charges,,,1853.2,85,,percent of total billed charges,,,,,,,,,1918.61,88,,percent of total billed charges,,,,,,,,,1665.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,545.06,22,,percent of total billed charges,,,1984.02,91,,percent of total billed charges,,,2071.23,95,,percent of total billed charges,,,1809.6,83,,percent of total billed charges,,,1809.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1809.6,83,,percent of total billed charges,,,2071.23,95,,percent of total billed charges,,,1962.22,90,,percent of total billed charges,,,1962.22,90,,percent of total billed charges,,,1787.8,82,,percent of total billed charges,,,1962.22,90,,percent of total billed charges,,,1853.2,85,,percent of total billed charges,,545.06,2071.23,
CALCIUM CARBONATE TAB:600MG  PX,32001712,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CALCIUM GLUCONATE VL:1GM/10ML(100MG/ML),32001716,CDM,J0610,HCPCS,250,RC,outpatient,,182.19,182.19,,154.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.55,22,,percent of total billed charges,,,,,,,,,163.97,90,,percent of total billed charges,,,150.85,82.8,,percent of total billed charges,,,154.86,85,,percent of total billed charges,,,,,,,,,160.33,88,,percent of total billed charges,,13.37,,,,fee schedule,,,139.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.37,,,,fee schedule,,,45.55,22,,percent of total billed charges,,,165.79,91,,percent of total billed charges,,,173.08,95,,percent of total billed charges,,,151.22,83,,percent of total billed charges,,,151.22,83,,percent of total billed charges,,,,,,,,,,,,,,,151.22,83,,percent of total billed charges,,,173.08,95,,percent of total billed charges,,,163.97,90,,percent of total billed charges,,,163.97,90,,percent of total billed charges,,,149.4,82,,percent of total billed charges,,,163.97,90,,percent of total billed charges,,,154.86,85,,percent of total billed charges,,13.37,173.08,
PRAMOXINE/CALAM(CALADRYL)LOT:1-8% 180ML,32001726,CDM,,,250,RC,outpatient,,64.87,64.87,,55.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.22,22,,percent of total billed charges,,,,,,,,,58.38,90,,percent of total billed charges,,,53.71,82.8,,percent of total billed charges,,,55.14,85,,percent of total billed charges,,,,,,,,,57.09,88,,percent of total billed charges,,,,,,,,,49.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.22,22,,percent of total billed charges,,,59.03,91,,percent of total billed charges,,,61.63,95,,percent of total billed charges,,,53.84,83,,percent of total billed charges,,,53.84,83,,percent of total billed charges,,,,,,,,,,,,,,,53.84,83,,percent of total billed charges,,,61.63,95,,percent of total billed charges,,,58.38,90,,percent of total billed charges,,,58.38,90,,percent of total billed charges,,,53.19,82,,percent of total billed charges,,,58.38,90,,percent of total billed charges,,,55.14,85,,percent of total billed charges,,16.22,61.63,
VERAPAMIL(CALAN SR)TAB:180MG,32001731,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
VERAPAMIL (CALAN SR) TAB : 240 MG,32001736,CDM,,,250,RC,outpatient,,27.76,27.76,,23.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.94,22,,percent of total billed charges,,,,,,,,,24.98,90,,percent of total billed charges,,,22.99,82.8,,percent of total billed charges,,,23.6,85,,percent of total billed charges,,,,,,,,,24.43,88,,percent of total billed charges,,,,,,,,,21.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.94,22,,percent of total billed charges,,,25.26,91,,percent of total billed charges,,,26.37,95,,percent of total billed charges,,,23.04,83,,percent of total billed charges,,,23.04,83,,percent of total billed charges,,,,,,,,,,,,,,,23.04,83,,percent of total billed charges,,,26.37,95,,percent of total billed charges,,,24.98,90,,percent of total billed charges,,,24.98,90,,percent of total billed charges,,,22.76,82,,percent of total billed charges,,,24.98,90,,percent of total billed charges,,,23.6,85,,percent of total billed charges,,6.94,26.37,
CALAMINE LOT:180ML,32001741,CDM,J3490,HCPCS,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
CALCIUM /VIT D:600MG/400 I.U.,32001746,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CALCIUM CARB ORAL SUSP : 500MG/5ML 500ML,32001747,CDM,,,250,RC,outpatient,,139.09,139.09,,118.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.77,22,,percent of total billed charges,,,,,,,,,125.18,90,,percent of total billed charges,,,115.17,82.8,,percent of total billed charges,,,118.23,85,,percent of total billed charges,,,,,,,,,122.4,88,,percent of total billed charges,,,,,,,,,106.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.77,22,,percent of total billed charges,,,126.57,91,,percent of total billed charges,,,132.14,95,,percent of total billed charges,,,115.44,83,,percent of total billed charges,,,115.44,83,,percent of total billed charges,,,,,,,,,,,,,,,115.44,83,,percent of total billed charges,,,132.14,95,,percent of total billed charges,,,125.18,90,,percent of total billed charges,,,125.18,90,,percent of total billed charges,,,114.05,82,,percent of total billed charges,,,125.18,90,,percent of total billed charges,,,118.23,85,,percent of total billed charges,,34.77,132.14,
CALCIUM CHLOR SYR:10ML=1GM(100MG/ML),32001751,CDM,J3490,HCPCS,250,RC,outpatient,,161.93,161.93,,137.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.48,22,,percent of total billed charges,,,,,,,,,145.74,90,,percent of total billed charges,,,134.08,82.8,,percent of total billed charges,,,137.64,85,,percent of total billed charges,,,,,,,,,142.5,88,,percent of total billed charges,,,,,,,,,123.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.48,22,,percent of total billed charges,,,147.36,91,,percent of total billed charges,,,153.83,95,,percent of total billed charges,,,134.4,83,,percent of total billed charges,,,134.4,83,,percent of total billed charges,,,,,,,,,,,,,,,134.4,83,,percent of total billed charges,,,153.83,95,,percent of total billed charges,,,145.74,90,,percent of total billed charges,,,145.74,90,,percent of total billed charges,,,132.78,82,,percent of total billed charges,,,145.74,90,,percent of total billed charges,,,137.64,85,,percent of total billed charges,,40.48,153.83,
CAMPTOSAR 20MG,32001753,CDM,J9206,HCPCS,636,RC,outpatient,,149.5,149.5,,126.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.38,22,,percent of total billed charges,,,,,,,,,134.55,90,,percent of total billed charges,,,123.79,82.8,,percent of total billed charges,,,127.08,85,,percent of total billed charges,,,,,,,,,131.56,88,,percent of total billed charges,,114.58,,,,fee schedule,,,114.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,114.58,,,,fee schedule,,,37.38,22,,percent of total billed charges,,,136.05,91,,percent of total billed charges,,,142.03,95,,percent of total billed charges,,,124.09,83,,percent of total billed charges,,,124.09,83,,percent of total billed charges,,,,,,,,,,,,,,,124.09,83,,percent of total billed charges,,,142.03,95,,percent of total billed charges,,,134.55,90,,percent of total billed charges,,,134.55,90,,percent of total billed charges,,,122.59,82,,percent of total billed charges,,,134.55,90,,percent of total billed charges,,,127.08,85,,percent of total billed charges,,37.38,142.03,
MOLD EXTRACTS (CANDIN) ALL,32001756,CDM,,,250,RC,outpatient,,1185.41,1185.41,,1006.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,296.35,22,,percent of total billed charges,,,,,,,,,1066.87,90,,percent of total billed charges,,,981.52,82.8,,percent of total billed charges,,,1007.6,85,,percent of total billed charges,,,,,,,,,1043.16,88,,percent of total billed charges,,,,,,,,,905.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,296.35,22,,percent of total billed charges,,,1078.72,91,,percent of total billed charges,,,1126.14,95,,percent of total billed charges,,,983.89,83,,percent of total billed charges,,,983.89,83,,percent of total billed charges,,,,,,,,,,,,,,,983.89,83,,percent of total billed charges,,,1126.14,95,,percent of total billed charges,,,1066.87,90,,percent of total billed charges,,,1066.87,90,,percent of total billed charges,,,972.04,82,,percent of total billed charges,,,1066.87,90,,percent of total billed charges,,,1007.6,85,,percent of total billed charges,,296.35,1126.14,
CAPTOPRIL (CAPOTEN) TAB : 25MG,32001771,CDM,,,250,RC,outpatient,,22.36,22.36,,18.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.59,22,,percent of total billed charges,,,,,,,,,20.12,90,,percent of total billed charges,,,18.51,82.8,,percent of total billed charges,,,19.01,85,,percent of total billed charges,,,,,,,,,19.68,88,,percent of total billed charges,,,,,,,,,17.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.59,22,,percent of total billed charges,,,20.35,91,,percent of total billed charges,,,21.24,95,,percent of total billed charges,,,18.56,83,,percent of total billed charges,,,18.56,83,,percent of total billed charges,,,,,,,,,,,,,,,18.56,83,,percent of total billed charges,,,21.24,95,,percent of total billed charges,,,20.12,90,,percent of total billed charges,,,20.12,90,,percent of total billed charges,,,18.34,82,,percent of total billed charges,,,20.12,90,,percent of total billed charges,,,19.01,85,,percent of total billed charges,,5.59,21.24,
CAPTOPRIL(CAPOTEN)TAB:50MG,32001776,CDM,J8499,HCPCS,250,RC,outpatient,,14.59,14.59,,12.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.65,22,,percent of total billed charges,,,,,,,,,13.13,90,,percent of total billed charges,,,12.08,82.8,,percent of total billed charges,,,12.4,85,,percent of total billed charges,,,,,,,,,12.84,88,,percent of total billed charges,,,,,,,,,11.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.65,22,,percent of total billed charges,,,13.28,91,,percent of total billed charges,,,13.86,95,,percent of total billed charges,,,12.11,83,,percent of total billed charges,,,12.11,83,,percent of total billed charges,,,,,,,,,,,,,,,12.11,83,,percent of total billed charges,,,13.86,95,,percent of total billed charges,,,13.13,90,,percent of total billed charges,,,13.13,90,,percent of total billed charges,,,11.96,82,,percent of total billed charges,,,13.13,90,,percent of total billed charges,,,12.4,85,,percent of total billed charges,,3.65,13.86,
CAPSAICIN (ZOSTRIX) CREAM :0.025% 60GM,32001786,CDM,J3490,HCPCS,250,RC,outpatient,,94.68,94.68,,80.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.67,22,,percent of total billed charges,,,,,,,,,85.21,90,,percent of total billed charges,,,78.4,82.8,,percent of total billed charges,,,80.48,85,,percent of total billed charges,,,,,,,,,83.32,88,,percent of total billed charges,,,,,,,,,72.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.67,22,,percent of total billed charges,,,86.16,91,,percent of total billed charges,,,89.95,95,,percent of total billed charges,,,78.58,83,,percent of total billed charges,,,78.58,83,,percent of total billed charges,,,,,,,,,,,,,,,78.58,83,,percent of total billed charges,,,89.95,95,,percent of total billed charges,,,85.21,90,,percent of total billed charges,,,85.21,90,,percent of total billed charges,,,77.64,82,,percent of total billed charges,,,85.21,90,,percent of total billed charges,,,80.48,85,,percent of total billed charges,,23.67,89.95,
CAPSAICIN(ZOSTRIX)CREAM 0.08%:60GM,32001787,CDM,,,250,RC,outpatient,,144.64,144.64,,122.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.16,22,,percent of total billed charges,,,,,,,,,130.18,90,,percent of total billed charges,,,119.76,82.8,,percent of total billed charges,,,122.94,85,,percent of total billed charges,,,,,,,,,127.28,88,,percent of total billed charges,,,,,,,,,110.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.16,22,,percent of total billed charges,,,131.62,91,,percent of total billed charges,,,137.41,95,,percent of total billed charges,,,120.05,83,,percent of total billed charges,,,120.05,83,,percent of total billed charges,,,,,,,,,,,,,,,120.05,83,,percent of total billed charges,,,137.41,95,,percent of total billed charges,,,130.18,90,,percent of total billed charges,,,130.18,90,,percent of total billed charges,,,118.6,82,,percent of total billed charges,,,130.18,90,,percent of total billed charges,,,122.94,85,,percent of total billed charges,,36.16,137.41,
SUCRALFATE (CARAFATE)ORAL: 1G/10ML 90ML,32001791,CDM,,,250,RC,outpatient,,64.75,64.75,,54.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.19,22,,percent of total billed charges,,,,,,,,,58.28,90,,percent of total billed charges,,,53.61,82.8,,percent of total billed charges,,,55.04,85,,percent of total billed charges,,,,,,,,,56.98,88,,percent of total billed charges,,,,,,,,,49.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.19,22,,percent of total billed charges,,,58.92,91,,percent of total billed charges,,,61.51,95,,percent of total billed charges,,,53.74,83,,percent of total billed charges,,,53.74,83,,percent of total billed charges,,,,,,,,,,,,,,,53.74,83,,percent of total billed charges,,,61.51,95,,percent of total billed charges,,,58.28,90,,percent of total billed charges,,,58.28,90,,percent of total billed charges,,,53.1,82,,percent of total billed charges,,,58.28,90,,percent of total billed charges,,,55.04,85,,percent of total billed charges,,16.19,61.51,
SUCRALFATE(CARAFATE)TAB:1GM,32001796,CDM,J8499,HCPCS,250,RC,outpatient,,75.49,75.49,,64.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.87,22,,percent of total billed charges,,,,,,,,,67.94,90,,percent of total billed charges,,,62.51,82.8,,percent of total billed charges,,,64.17,85,,percent of total billed charges,,,,,,,,,66.43,88,,percent of total billed charges,,,,,,,,,57.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.87,22,,percent of total billed charges,,,68.7,91,,percent of total billed charges,,,71.72,95,,percent of total billed charges,,,62.66,83,,percent of total billed charges,,,62.66,83,,percent of total billed charges,,,,,,,,,,,,,,,62.66,83,,percent of total billed charges,,,71.72,95,,percent of total billed charges,,,67.94,90,,percent of total billed charges,,,67.94,90,,percent of total billed charges,,,61.9,82,,percent of total billed charges,,,67.94,90,,percent of total billed charges,,,64.17,85,,percent of total billed charges,,18.87,71.72,
SUCRALFATE(CARAFATE):1GM/10ML (UD),32001799,CDM,J8499,HCPCS,250,RC,outpatient,,151.31,151.31,,128.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.83,22,,percent of total billed charges,,,,,,,,,136.18,90,,percent of total billed charges,,,125.28,82.8,,percent of total billed charges,,,128.61,85,,percent of total billed charges,,,,,,,,,133.15,88,,percent of total billed charges,,,,,,,,,115.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.83,22,,percent of total billed charges,,,137.69,91,,percent of total billed charges,,,143.74,95,,percent of total billed charges,,,125.59,83,,percent of total billed charges,,,125.59,83,,percent of total billed charges,,,,,,,,,,,,,,,125.59,83,,percent of total billed charges,,,143.74,95,,percent of total billed charges,,,136.18,90,,percent of total billed charges,,,136.18,90,,percent of total billed charges,,,124.07,82,,percent of total billed charges,,,136.18,90,,percent of total billed charges,,,128.61,85,,percent of total billed charges,,37.83,143.74,
SUCRALFATE (CARAFATE) ORAL:1G/10ML 414ML,32001801,CDM,,,250,RC,outpatient,,230.5,230.5,,195.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.63,22,,percent of total billed charges,,,,,,,,,207.45,90,,percent of total billed charges,,,190.85,82.8,,percent of total billed charges,,,195.93,85,,percent of total billed charges,,,,,,,,,202.84,88,,percent of total billed charges,,,,,,,,,176.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.63,22,,percent of total billed charges,,,209.76,91,,percent of total billed charges,,,218.98,95,,percent of total billed charges,,,191.32,83,,percent of total billed charges,,,191.32,83,,percent of total billed charges,,,,,,,,,,,,,,,191.32,83,,percent of total billed charges,,,218.98,95,,percent of total billed charges,,,207.45,90,,percent of total billed charges,,,207.45,90,,percent of total billed charges,,,189.01,82,,percent of total billed charges,,,207.45,90,,percent of total billed charges,,,195.93,85,,percent of total billed charges,,57.63,218.98,
SUCRALFATE (CARAFATE) ORAL:1G/10ML 60ML,32001811,CDM,,,250,RC,outpatient,,43.25,43.25,,36.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.81,22,,percent of total billed charges,,,,,,,,,38.93,90,,percent of total billed charges,,,35.81,82.8,,percent of total billed charges,,,36.76,85,,percent of total billed charges,,,,,,,,,38.06,88,,percent of total billed charges,,,,,,,,,33.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.81,22,,percent of total billed charges,,,39.36,91,,percent of total billed charges,,,41.09,95,,percent of total billed charges,,,35.9,83,,percent of total billed charges,,,35.9,83,,percent of total billed charges,,,,,,,,,,,,,,,35.9,83,,percent of total billed charges,,,41.09,95,,percent of total billed charges,,,38.93,90,,percent of total billed charges,,,38.93,90,,percent of total billed charges,,,35.47,82,,percent of total billed charges,,,38.93,90,,percent of total billed charges,,,36.76,85,,percent of total billed charges,,10.81,41.09,
CARBIDOPA/LEVODOPA TAB : 25MG-250MG,32001816,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
carBAMazepine(TEGretol)TAB:200MG,32001821,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CARB/LEVO(sineMET)TAB:25MG-100MG,32001826,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CARBIDOPA/LEVODOPA CR TAB : 25MG-100MG,32001827,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CARB/LEVO(sineMET)TAB:10MG-100MG,32001831,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
doxaZOSIN MESYLATE (CARDURA) TAB : 1MG,32001836,CDM,,,250,RC,outpatient,,42.5,42.5,,36.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.63,22,,percent of total billed charges,,,,,,,,,38.25,90,,percent of total billed charges,,,35.19,82.8,,percent of total billed charges,,,36.13,85,,percent of total billed charges,,,,,,,,,37.4,88,,percent of total billed charges,,,,,,,,,32.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.63,22,,percent of total billed charges,,,38.68,91,,percent of total billed charges,,,40.38,95,,percent of total billed charges,,,35.28,83,,percent of total billed charges,,,35.28,83,,percent of total billed charges,,,,,,,,,,,,,,,35.28,83,,percent of total billed charges,,,40.38,95,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,34.85,82,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,36.13,85,,percent of total billed charges,,10.63,40.38,
DILTIAZEM(CARDIZEM)VL:25MG/5ML,32001841,CDM,J3490,HCPCS,250,RC,outpatient,,65.03,65.03,,55.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.26,22,,percent of total billed charges,,,,,,,,,58.53,90,,percent of total billed charges,,,53.84,82.8,,percent of total billed charges,,,55.28,85,,percent of total billed charges,,,,,,,,,57.23,88,,percent of total billed charges,,,,,,,,,49.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.26,22,,percent of total billed charges,,,59.18,91,,percent of total billed charges,,,61.78,95,,percent of total billed charges,,,53.97,83,,percent of total billed charges,,,53.97,83,,percent of total billed charges,,,,,,,,,,,,,,,53.97,83,,percent of total billed charges,,,61.78,95,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,53.32,82,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,55.28,85,,percent of total billed charges,,16.26,61.78,
DILTIAZEM(CARDIZEM CD)CAP:120MG,32001851,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DILTIAZEM(CARDIZEM CD)CAP:180MG,32001856,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DILTIAZEM(CARDIZEM CD)CAP:240MG,32001861,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
NICARDIPINE (CARDENE) CAP : 20MG,32001871,CDM,,,250,RC,outpatient,,29.66,29.66,,25.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.42,22,,percent of total billed charges,,,,,,,,,26.69,90,,percent of total billed charges,,,24.56,82.8,,percent of total billed charges,,,25.21,85,,percent of total billed charges,,,,,,,,,26.1,88,,percent of total billed charges,,,,,,,,,22.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.42,22,,percent of total billed charges,,,26.99,91,,percent of total billed charges,,,28.18,95,,percent of total billed charges,,,24.62,83,,percent of total billed charges,,,24.62,83,,percent of total billed charges,,,,,,,,,,,,,,,24.62,83,,percent of total billed charges,,,28.18,95,,percent of total billed charges,,,26.69,90,,percent of total billed charges,,,26.69,90,,percent of total billed charges,,,24.32,82,,percent of total billed charges,,,26.69,90,,percent of total billed charges,,,25.21,85,,percent of total billed charges,,7.42,28.18,
NICARDIPINE (CARDENE) CAP : 30MG,32001876,CDM,,,250,RC,outpatient,,42.5,42.5,,36.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.63,22,,percent of total billed charges,,,,,,,,,38.25,90,,percent of total billed charges,,,35.19,82.8,,percent of total billed charges,,,36.13,85,,percent of total billed charges,,,,,,,,,37.4,88,,percent of total billed charges,,,,,,,,,32.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.63,22,,percent of total billed charges,,,38.68,91,,percent of total billed charges,,,40.38,95,,percent of total billed charges,,,35.28,83,,percent of total billed charges,,,35.28,83,,percent of total billed charges,,,,,,,,,,,,,,,35.28,83,,percent of total billed charges,,,40.38,95,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,34.85,82,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,36.13,85,,percent of total billed charges,,10.63,40.38,
DILTIAZEM(CARDIZEM)VL:50MG/10ML,32001881,CDM,J3490,HCPCS,250,RC,outpatient,,118.63,118.63,,100.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.66,22,,percent of total billed charges,,,,,,,,,106.77,90,,percent of total billed charges,,,98.23,82.8,,percent of total billed charges,,,100.84,85,,percent of total billed charges,,,,,,,,,104.39,88,,percent of total billed charges,,,,,,,,,90.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.66,22,,percent of total billed charges,,,107.95,91,,percent of total billed charges,,,112.7,95,,percent of total billed charges,,,98.46,83,,percent of total billed charges,,,98.46,83,,percent of total billed charges,,,,,,,,,,,,,,,98.46,83,,percent of total billed charges,,,112.7,95,,percent of total billed charges,,,106.77,90,,percent of total billed charges,,,106.77,90,,percent of total billed charges,,,97.28,82,,percent of total billed charges,,,106.77,90,,percent of total billed charges,,,100.84,85,,percent of total billed charges,,29.66,112.7,
doxaZOSIN(CARDURA)TAB:2MG,32001885,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DILTIAZEM HCL (CARDIZEM CD) CAP : 300MG,32001896,CDM,,,250,RC,outpatient,,45.36,45.36,,38.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.34,22,,percent of total billed charges,,,,,,,,,40.82,90,,percent of total billed charges,,,37.56,82.8,,percent of total billed charges,,,38.56,85,,percent of total billed charges,,,,,,,,,39.92,88,,percent of total billed charges,,,,,,,,,34.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.34,22,,percent of total billed charges,,,41.28,91,,percent of total billed charges,,,43.09,95,,percent of total billed charges,,,37.65,83,,percent of total billed charges,,,37.65,83,,percent of total billed charges,,,,,,,,,,,,,,,37.65,83,,percent of total billed charges,,,43.09,95,,percent of total billed charges,,,40.82,90,,percent of total billed charges,,,40.82,90,,percent of total billed charges,,,37.2,82,,percent of total billed charges,,,40.82,90,,percent of total billed charges,,,38.56,85,,percent of total billed charges,,11.34,43.09,
DILTIAZEM HCL SR CAP : 90MG,32001901,CDM,,,250,RC,outpatient,,51.07,51.07,,43.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.77,22,,percent of total billed charges,,,,,,,,,45.96,90,,percent of total billed charges,,,42.29,82.8,,percent of total billed charges,,,43.41,85,,percent of total billed charges,,,,,,,,,44.94,88,,percent of total billed charges,,,,,,,,,39.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.77,22,,percent of total billed charges,,,46.47,91,,percent of total billed charges,,,48.52,95,,percent of total billed charges,,,42.39,83,,percent of total billed charges,,,42.39,83,,percent of total billed charges,,,,,,,,,,,,,,,42.39,83,,percent of total billed charges,,,48.52,95,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,41.88,82,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,43.41,85,,percent of total billed charges,,12.77,48.52,
CARISOPRODOL(SOMA)TAB:350MG,32001906,CDM,J8499,HCPCS,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
CARISOPRODOL/ASPIRIN TAB : 200-325MG,32001911,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
BICALUTAMIDE(CASODEX)TAB:50MG,32001928,CDM,,,250,RC,outpatient,,274.7,274.7,,233.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.68,22,,percent of total billed charges,,,,,,,,,247.23,90,,percent of total billed charges,,,227.45,82.8,,percent of total billed charges,,,233.5,85,,percent of total billed charges,,,,,,,,,241.74,88,,percent of total billed charges,,,,,,,,,209.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.68,22,,percent of total billed charges,,,249.98,91,,percent of total billed charges,,,260.97,95,,percent of total billed charges,,,228,83,,percent of total billed charges,,,228,83,,percent of total billed charges,,,,,,,,,,,,,,,228,83,,percent of total billed charges,,,260.97,95,,percent of total billed charges,,,247.23,90,,percent of total billed charges,,,247.23,90,,percent of total billed charges,,,225.25,82,,percent of total billed charges,,,247.23,90,,percent of total billed charges,,,233.5,85,,percent of total billed charges,,68.68,260.97,
CASTOR OIL 180 ML,32001936,CDM,J3490,HCPCS,250,RC,outpatient,,30.93,30.93,,26.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.73,22,,percent of total billed charges,,,,,,,,,27.84,90,,percent of total billed charges,,,25.61,82.8,,percent of total billed charges,,,26.29,85,,percent of total billed charges,,,,,,,,,27.22,88,,percent of total billed charges,,,,,,,,,23.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.73,22,,percent of total billed charges,,,28.15,91,,percent of total billed charges,,,29.38,95,,percent of total billed charges,,,25.67,83,,percent of total billed charges,,,25.67,83,,percent of total billed charges,,,,,,,,,,,,,,,25.67,83,,percent of total billed charges,,,29.38,95,,percent of total billed charges,,,27.84,90,,percent of total billed charges,,,27.84,90,,percent of total billed charges,,,25.36,82,,percent of total billed charges,,,27.84,90,,percent of total billed charges,,,26.29,85,,percent of total billed charges,,7.73,29.38,
cloNIDine(CATAPRES-TTS 1)PAT:0.1MG/24HR,32001941,CDM,J3490,HCPCS,250,RC,outpatient,,161.28,161.28,,136.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.32,22,,percent of total billed charges,,,,,,,,,145.15,90,,percent of total billed charges,,,133.54,82.8,,percent of total billed charges,,,137.09,85,,percent of total billed charges,,,,,,,,,141.93,88,,percent of total billed charges,,,,,,,,,123.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.32,22,,percent of total billed charges,,,146.76,91,,percent of total billed charges,,,153.22,95,,percent of total billed charges,,,133.86,83,,percent of total billed charges,,,133.86,83,,percent of total billed charges,,,,,,,,,,,,,,,133.86,83,,percent of total billed charges,,,153.22,95,,percent of total billed charges,,,145.15,90,,percent of total billed charges,,,145.15,90,,percent of total billed charges,,,132.25,82,,percent of total billed charges,,,145.15,90,,percent of total billed charges,,,137.09,85,,percent of total billed charges,,40.32,153.22,
CLONIDINE (CATAPRES-TTS 2)PAT:0.2MG/24HR,32001946,CDM,,,250,RC,outpatient,,544.32,544.32,,462.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,136.08,22,,percent of total billed charges,,,,,,,,,489.89,90,,percent of total billed charges,,,450.7,82.8,,percent of total billed charges,,,462.67,85,,percent of total billed charges,,,,,,,,,479,88,,percent of total billed charges,,,,,,,,,415.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,136.08,22,,percent of total billed charges,,,495.33,91,,percent of total billed charges,,,517.1,95,,percent of total billed charges,,,451.79,83,,percent of total billed charges,,,451.79,83,,percent of total billed charges,,,,,,,,,,,,,,,451.79,83,,percent of total billed charges,,,517.1,95,,percent of total billed charges,,,489.89,90,,percent of total billed charges,,,489.89,90,,percent of total billed charges,,,446.34,82,,percent of total billed charges,,,489.89,90,,percent of total billed charges,,,462.67,85,,percent of total billed charges,,136.08,517.1,
CLONIDINE (CATAPRES-TTS 3)PAT:0.3MG/24HR,32001951,CDM,,,250,RC,outpatient,,2391.78,2391.78,,2030.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,597.95,22,,percent of total billed charges,,,,,,,,,2152.6,90,,percent of total billed charges,,,1980.39,82.8,,percent of total billed charges,,,2033.01,85,,percent of total billed charges,,,,,,,,,2104.77,88,,percent of total billed charges,,,,,,,,,1827.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,597.95,22,,percent of total billed charges,,,2176.52,91,,percent of total billed charges,,,2272.19,95,,percent of total billed charges,,,1985.18,83,,percent of total billed charges,,,1985.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1985.18,83,,percent of total billed charges,,,2272.19,95,,percent of total billed charges,,,2152.6,90,,percent of total billed charges,,,2152.6,90,,percent of total billed charges,,,1961.26,82,,percent of total billed charges,,,2152.6,90,,percent of total billed charges,,,2033.01,85,,percent of total billed charges,,597.95,2272.19,
DICLOFENAC POTASSIUM (CATAFLAM) TAB 50MG,32001961,CDM,,,250,RC,outpatient,,17.45,17.45,,14.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.36,22,,percent of total billed charges,,,,,,,,,15.71,90,,percent of total billed charges,,,14.45,82.8,,percent of total billed charges,,,14.83,85,,percent of total billed charges,,,,,,,,,15.36,88,,percent of total billed charges,,,,,,,,,13.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.36,22,,percent of total billed charges,,,15.88,91,,percent of total billed charges,,,16.58,95,,percent of total billed charges,,,14.48,83,,percent of total billed charges,,,14.48,83,,percent of total billed charges,,,,,,,,,,,,,,,14.48,83,,percent of total billed charges,,,16.58,95,,percent of total billed charges,,,15.71,90,,percent of total billed charges,,,15.71,90,,percent of total billed charges,,,14.31,82,,percent of total billed charges,,,15.71,90,,percent of total billed charges,,,14.83,85,,percent of total billed charges,,4.36,16.58,
ceFAClor(CECLOR)SUSP:125MG/5ML (75ML),32001976,CDM,,,250,RC,outpatient,,82.47,82.47,,70.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.62,22,,percent of total billed charges,,,,,,,,,74.22,90,,percent of total billed charges,,,68.29,82.8,,percent of total billed charges,,,70.1,85,,percent of total billed charges,,,,,,,,,72.57,88,,percent of total billed charges,,,,,,,,,63.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.62,22,,percent of total billed charges,,,75.05,91,,percent of total billed charges,,,78.35,95,,percent of total billed charges,,,68.45,83,,percent of total billed charges,,,68.45,83,,percent of total billed charges,,,,,,,,,,,,,,,68.45,83,,percent of total billed charges,,,78.35,95,,percent of total billed charges,,,74.22,90,,percent of total billed charges,,,74.22,90,,percent of total billed charges,,,67.63,82,,percent of total billed charges,,,74.22,90,,percent of total billed charges,,,70.1,85,,percent of total billed charges,,20.62,78.35,
ceFAClor(CECLOR)CAP:250MG,32001981,CDM,J8499,HCPCS,250,RC,outpatient,,27.6,27.6,,23.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.9,22,,percent of total billed charges,,,,,,,,,24.84,90,,percent of total billed charges,,,22.85,82.8,,percent of total billed charges,,,23.46,85,,percent of total billed charges,,,,,,,,,24.29,88,,percent of total billed charges,,,,,,,,,21.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.9,22,,percent of total billed charges,,,25.12,91,,percent of total billed charges,,,26.22,95,,percent of total billed charges,,,22.91,83,,percent of total billed charges,,,22.91,83,,percent of total billed charges,,,,,,,,,,,,,,,22.91,83,,percent of total billed charges,,,26.22,95,,percent of total billed charges,,,24.84,90,,percent of total billed charges,,,24.84,90,,percent of total billed charges,,,22.63,82,,percent of total billed charges,,,24.84,90,,percent of total billed charges,,,23.46,85,,percent of total billed charges,,6.9,26.22,
ceFAClor(CECLOR)SUSP:250MG/5ML (75ML),32001986,CDM,,,250,RC,outpatient,,170.65,170.65,,144.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.66,22,,percent of total billed charges,,,,,,,,,153.59,90,,percent of total billed charges,,,141.3,82.8,,percent of total billed charges,,,145.05,85,,percent of total billed charges,,,,,,,,,150.17,88,,percent of total billed charges,,,,,,,,,130.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.66,22,,percent of total billed charges,,,155.29,91,,percent of total billed charges,,,162.12,95,,percent of total billed charges,,,141.64,83,,percent of total billed charges,,,141.64,83,,percent of total billed charges,,,,,,,,,,,,,,,141.64,83,,percent of total billed charges,,,162.12,95,,percent of total billed charges,,,153.59,90,,percent of total billed charges,,,153.59,90,,percent of total billed charges,,,139.93,82,,percent of total billed charges,,,153.59,90,,percent of total billed charges,,,145.05,85,,percent of total billed charges,,42.66,162.12,
CEFADROXIL(DURICEF)CAP:500MG,32001987,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
cefUROXime(CEFTIN) SUS:125MG/5ML 100ML,32002006,CDM,,,250,RC,outpatient,,232.82,232.82,,197.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,58.21,22,,percent of total billed charges,,,,,,,,,209.54,90,,percent of total billed charges,,,192.77,82.8,,percent of total billed charges,,,197.9,85,,percent of total billed charges,,,,,,,,,204.88,88,,percent of total billed charges,,,,,,,,,177.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,58.21,22,,percent of total billed charges,,,211.87,91,,percent of total billed charges,,,221.18,95,,percent of total billed charges,,,193.24,83,,percent of total billed charges,,,193.24,83,,percent of total billed charges,,,,,,,,,,,,,,,193.24,83,,percent of total billed charges,,,221.18,95,,percent of total billed charges,,,209.54,90,,percent of total billed charges,,,209.54,90,,percent of total billed charges,,,190.91,82,,percent of total billed charges,,,209.54,90,,percent of total billed charges,,,197.9,85,,percent of total billed charges,,58.21,221.18,
cefUROXime(CEFTIN)TAB:250MG,32002011,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CEFPROZIL (CEFZIL) SUS : 125MG/5ML  50ML,32002016,CDM,,,250,RC,outpatient,,311.97,311.97,,264.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.99,22,,percent of total billed charges,,,,,,,,,280.77,90,,percent of total billed charges,,,258.31,82.8,,percent of total billed charges,,,265.17,85,,percent of total billed charges,,,,,,,,,274.53,88,,percent of total billed charges,,,,,,,,,238.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.99,22,,percent of total billed charges,,,283.89,91,,percent of total billed charges,,,296.37,95,,percent of total billed charges,,,258.94,83,,percent of total billed charges,,,258.94,83,,percent of total billed charges,,,,,,,,,,,,,,,258.94,83,,percent of total billed charges,,,296.37,95,,percent of total billed charges,,,280.77,90,,percent of total billed charges,,,280.77,90,,percent of total billed charges,,,255.82,82,,percent of total billed charges,,,280.77,90,,percent of total billed charges,,,265.17,85,,percent of total billed charges,,77.99,296.37,
CEFPROZIL(CEFZIL)TAB:250MG,32002021,CDM,J8499,HCPCS,250,RC,outpatient,,52.34,52.34,,44.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.09,22,,percent of total billed charges,,,,,,,,,47.11,90,,percent of total billed charges,,,43.34,82.8,,percent of total billed charges,,,44.49,85,,percent of total billed charges,,,,,,,,,46.06,88,,percent of total billed charges,,,,,,,,,39.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.09,22,,percent of total billed charges,,,47.63,91,,percent of total billed charges,,,49.72,95,,percent of total billed charges,,,43.44,83,,percent of total billed charges,,,43.44,83,,percent of total billed charges,,,,,,,,,,,,,,,43.44,83,,percent of total billed charges,,,49.72,95,,percent of total billed charges,,,47.11,90,,percent of total billed charges,,,47.11,90,,percent of total billed charges,,,42.92,82,,percent of total billed charges,,,47.11,90,,percent of total billed charges,,,44.49,85,,percent of total billed charges,,13.09,49.72,
CEFPROZIL (CEFZIL) TAB : 500MG,32002022,CDM,,,250,RC,outpatient,,132.11,132.11,,112.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.03,22,,percent of total billed charges,,,,,,,,,118.9,90,,percent of total billed charges,,,109.39,82.8,,percent of total billed charges,,,112.29,85,,percent of total billed charges,,,,,,,,,116.26,88,,percent of total billed charges,,,,,,,,,100.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.03,22,,percent of total billed charges,,,120.22,91,,percent of total billed charges,,,125.5,95,,percent of total billed charges,,,109.65,83,,percent of total billed charges,,,109.65,83,,percent of total billed charges,,,,,,,,,,,,,,,109.65,83,,percent of total billed charges,,,125.5,95,,percent of total billed charges,,,118.9,90,,percent of total billed charges,,,118.9,90,,percent of total billed charges,,,108.33,82,,percent of total billed charges,,,118.9,90,,percent of total billed charges,,,112.29,85,,percent of total billed charges,,33.03,125.5,
CEFPROZIL(CEFZIL)SUS:250MG/5ML (50ML),32002026,CDM,,,250,RC,outpatient,,393.96,393.96,,334.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.49,22,,percent of total billed charges,,,,,,,,,354.56,90,,percent of total billed charges,,,326.2,82.8,,percent of total billed charges,,,334.87,85,,percent of total billed charges,,,,,,,,,346.68,88,,percent of total billed charges,,,,,,,,,300.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.49,22,,percent of total billed charges,,,358.5,91,,percent of total billed charges,,,374.26,95,,percent of total billed charges,,,326.99,83,,percent of total billed charges,,,326.99,83,,percent of total billed charges,,,,,,,,,,,,,,,326.99,83,,percent of total billed charges,,,374.26,95,,percent of total billed charges,,,354.56,90,,percent of total billed charges,,,354.56,90,,percent of total billed charges,,,323.05,82,,percent of total billed charges,,,354.56,90,,percent of total billed charges,,,334.87,85,,percent of total billed charges,,98.49,374.26,
BETAMET/NAPH(CELESTONE)VIAL:6MG/ML (5ML),32002031,CDM,J0702,HCPCS,250,RC,outpatient,,591.51,591.51,,502.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,147.88,22,,percent of total billed charges,,,,,,,,,532.36,90,,percent of total billed charges,,,489.77,82.8,,percent of total billed charges,,,502.78,85,,percent of total billed charges,,,,,,,,,520.53,88,,percent of total billed charges,,34.08,,,,fee schedule,,,451.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,34.08,,,,fee schedule,,,147.88,22,,percent of total billed charges,,,538.27,91,,percent of total billed charges,,,561.93,95,,percent of total billed charges,,,490.95,83,,percent of total billed charges,,,490.95,83,,percent of total billed charges,,,,,,,,,,,,,,,490.95,83,,percent of total billed charges,,,561.93,95,,percent of total billed charges,,,532.36,90,,percent of total billed charges,,,532.36,90,,percent of total billed charges,,,485.04,82,,percent of total billed charges,,,532.36,90,,percent of total billed charges,,,502.78,85,,percent of total billed charges,,34.08,561.93,
BETAMETHASO (CELESTONE)VIAL:6MG/ML 2.5ML,32002036,CDM,,,250,RC,outpatient,,567.15,567.15,,481.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141.79,22,,percent of total billed charges,,,,,,,,,510.44,90,,percent of total billed charges,,,469.6,82.8,,percent of total billed charges,,,482.08,85,,percent of total billed charges,,,,,,,,,499.09,88,,percent of total billed charges,,,,,,,,,433.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141.79,22,,percent of total billed charges,,,516.11,91,,percent of total billed charges,,,538.79,95,,percent of total billed charges,,,470.73,83,,percent of total billed charges,,,470.73,83,,percent of total billed charges,,,,,,,,,,,,,,,470.73,83,,percent of total billed charges,,,538.79,95,,percent of total billed charges,,,510.44,90,,percent of total billed charges,,,510.44,90,,percent of total billed charges,,,465.06,82,,percent of total billed charges,,,510.44,90,,percent of total billed charges,,,482.08,85,,percent of total billed charges,,141.79,538.79,
CARBOXYMETHYLCELL(CELLUVISC)DROP 1%:,32002037,CDM,,,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
METHSUXIMIDE (CELONTIN) CAP : 150MG,32002041,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
BENZOCAINE/MENTH(CHLORASEPTIC)LOZ:6/10MG,32002066,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
cePHALexin(KEFLEX)CAP:250MG,32002071,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
cephaLEXIN (KEFLEX) CAP : 250MG   1X8,32002072,CDM,,,250,RC,outpatient,,33.62,33.62,,28.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.41,22,,percent of total billed charges,,,,,,,,,30.26,90,,percent of total billed charges,,,27.84,82.8,,percent of total billed charges,,,28.58,85,,percent of total billed charges,,,,,,,,,29.59,88,,percent of total billed charges,,,,,,,,,25.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.41,22,,percent of total billed charges,,,30.59,91,,percent of total billed charges,,,31.94,95,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,,,,,,,,,,,,,,27.9,83,,percent of total billed charges,,,31.94,95,,percent of total billed charges,,,30.26,90,,percent of total billed charges,,,30.26,90,,percent of total billed charges,,,27.57,82,,percent of total billed charges,,,30.26,90,,percent of total billed charges,,,28.58,85,,percent of total billed charges,,8.41,31.94,
cePHALexin(KEFLEX):125MG/5ML (100ML),32002076,CDM,J8499,HCPCS,250,RC,outpatient,,407.36,407.36,,345.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.84,22,,percent of total billed charges,,,,,,,,,366.62,90,,percent of total billed charges,,,337.29,82.8,,percent of total billed charges,,,346.26,85,,percent of total billed charges,,,,,,,,,358.48,88,,percent of total billed charges,,,,,,,,,311.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.84,22,,percent of total billed charges,,,370.7,91,,percent of total billed charges,,,386.99,95,,percent of total billed charges,,,338.11,83,,percent of total billed charges,,,338.11,83,,percent of total billed charges,,,,,,,,,,,,,,,338.11,83,,percent of total billed charges,,,386.99,95,,percent of total billed charges,,,366.62,90,,percent of total billed charges,,,366.62,90,,percent of total billed charges,,,334.04,82,,percent of total billed charges,,,366.62,90,,percent of total billed charges,,,346.26,85,,percent of total billed charges,,101.84,386.99,
cePHALexin(KEFLEX)CAP:500MG,32002091,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
cephaLEXIN (KEFLEX) CAP : 500MG  1X8,32002092,CDM,,,250,RC,outpatient,,33.31,33.31,,28.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.33,22,,percent of total billed charges,,,,,,,,,29.98,90,,percent of total billed charges,,,27.58,82.8,,percent of total billed charges,,,28.31,85,,percent of total billed charges,,,,,,,,,29.31,88,,percent of total billed charges,,,,,,,,,25.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.33,22,,percent of total billed charges,,,30.31,91,,percent of total billed charges,,,31.64,95,,percent of total billed charges,,,27.65,83,,percent of total billed charges,,,27.65,83,,percent of total billed charges,,,,,,,,,,,,,,,27.65,83,,percent of total billed charges,,,31.64,95,,percent of total billed charges,,,29.98,90,,percent of total billed charges,,,29.98,90,,percent of total billed charges,,,27.31,82,,percent of total billed charges,,,29.98,90,,percent of total billed charges,,,28.31,85,,percent of total billed charges,,8.33,31.64,
cePHALexin(KEFLEX):250MG/5ML (100ML),32002106,CDM,J8499,HCPCS,250,RC,outpatient,,203.11,203.11,,172.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.78,22,,percent of total billed charges,,,,,,,,,182.8,90,,percent of total billed charges,,,168.18,82.8,,percent of total billed charges,,,172.64,85,,percent of total billed charges,,,,,,,,,178.74,88,,percent of total billed charges,,,,,,,,,155.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.78,22,,percent of total billed charges,,,184.83,91,,percent of total billed charges,,,192.95,95,,percent of total billed charges,,,168.58,83,,percent of total billed charges,,,168.58,83,,percent of total billed charges,,,,,,,,,,,,,,,168.58,83,,percent of total billed charges,,,192.95,95,,percent of total billed charges,,,182.8,90,,percent of total billed charges,,,182.8,90,,percent of total billed charges,,,166.55,82,,percent of total billed charges,,,182.8,90,,percent of total billed charges,,,172.64,85,,percent of total billed charges,,50.78,192.95,
TRIETHANOLAMINE (CERUMENEX)DROP:10% 6ML,32002111,CDM,,,250,RC,outpatient,,384.92,384.92,,326.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.23,22,,percent of total billed charges,,,,,,,,,346.43,90,,percent of total billed charges,,,318.71,82.8,,percent of total billed charges,,,327.18,85,,percent of total billed charges,,,,,,,,,338.73,88,,percent of total billed charges,,,,,,,,,294.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.23,22,,percent of total billed charges,,,350.28,91,,percent of total billed charges,,,365.67,95,,percent of total billed charges,,,319.48,83,,percent of total billed charges,,,319.48,83,,percent of total billed charges,,,,,,,,,,,,,,,319.48,83,,percent of total billed charges,,,365.67,95,,percent of total billed charges,,,346.43,90,,percent of total billed charges,,,346.43,90,,percent of total billed charges,,,315.63,82,,percent of total billed charges,,,346.43,90,,percent of total billed charges,,,327.18,85,,percent of total billed charges,,96.23,365.67,
DINOPROSTONE(CERVIDIL)SUPP:10MG,32002112,CDM,J3490,HCPCS,250,RC,outpatient,,3741.88,3741.88,,3176.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,935.47,22,,percent of total billed charges,,,,,,,,,3367.69,90,,percent of total billed charges,,,3098.28,82.8,,percent of total billed charges,,,3180.6,85,,percent of total billed charges,,,,,,,,,3292.85,88,,percent of total billed charges,,,,,,,,,2858.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,935.47,22,,percent of total billed charges,,,3405.11,91,,percent of total billed charges,,,3554.79,95,,percent of total billed charges,,,3105.76,83,,percent of total billed charges,,,3105.76,83,,percent of total billed charges,,,,,,,,,,,,,,,3105.76,83,,percent of total billed charges,,,3554.79,95,,percent of total billed charges,,,3367.69,90,,percent of total billed charges,,,3367.69,90,,percent of total billed charges,,,3068.34,82,,percent of total billed charges,,,3367.69,90,,percent of total billed charges,,,3180.6,85,,percent of total billed charges,,935.47,3554.79,
SULFAC/PREDN(CETAPRED)OINT:10-.25% 3.5GM,32002116,CDM,,,250,RC,outpatient,,390.47,390.47,,331.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.62,22,,percent of total billed charges,,,,,,,,,351.42,90,,percent of total billed charges,,,323.31,82.8,,percent of total billed charges,,,331.9,85,,percent of total billed charges,,,,,,,,,343.61,88,,percent of total billed charges,,,,,,,,,298.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.62,22,,percent of total billed charges,,,355.33,91,,percent of total billed charges,,,370.95,95,,percent of total billed charges,,,324.09,83,,percent of total billed charges,,,324.09,83,,percent of total billed charges,,,,,,,,,,,,,,,324.09,83,,percent of total billed charges,,,370.95,95,,percent of total billed charges,,,351.42,90,,percent of total billed charges,,,351.42,90,,percent of total billed charges,,,320.19,82,,percent of total billed charges,,,351.42,90,,percent of total billed charges,,,331.9,85,,percent of total billed charges,,97.62,370.95,
CETACAINE SPRAY FOR EGD ONLY,32002121,CDM,,,250,RC,outpatient,,20.33,20.33,,17.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.08,22,,percent of total billed charges,,,,,,,,,18.3,90,,percent of total billed charges,,,16.83,82.8,,percent of total billed charges,,,17.28,85,,percent of total billed charges,,,,,,,,,17.89,88,,percent of total billed charges,,,,,,,,,15.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.08,22,,percent of total billed charges,,,18.5,91,,percent of total billed charges,,,19.31,95,,percent of total billed charges,,,16.87,83,,percent of total billed charges,,,16.87,83,,percent of total billed charges,,,,,,,,,,,,,,,16.87,83,,percent of total billed charges,,,19.31,95,,percent of total billed charges,,,18.3,90,,percent of total billed charges,,,18.3,90,,percent of total billed charges,,,16.67,82,,percent of total billed charges,,,18.3,90,,percent of total billed charges,,,17.28,85,,percent of total billed charges,,5.08,19.31,
TETRA/BENZ/BUT(CETACAINE)SPR:56ML,32002126,CDM,,,250,RC,outpatient,,779.36,779.36,,661.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,194.84,22,,percent of total billed charges,,,,,,,,,701.42,90,,percent of total billed charges,,,645.31,82.8,,percent of total billed charges,,,662.46,85,,percent of total billed charges,,,,,,,,,685.84,88,,percent of total billed charges,,,,,,,,,595.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,194.84,22,,percent of total billed charges,,,709.22,91,,percent of total billed charges,,,740.39,95,,percent of total billed charges,,,646.87,83,,percent of total billed charges,,,646.87,83,,percent of total billed charges,,,,,,,,,,,,,,,646.87,83,,percent of total billed charges,,,740.39,95,,percent of total billed charges,,,701.42,90,,percent of total billed charges,,,701.42,90,,percent of total billed charges,,,639.08,82,,percent of total billed charges,,,701.42,90,,percent of total billed charges,,,662.46,85,,percent of total billed charges,,194.84,740.39,
TETRA/BENZ/BUT(CETACAINE)SPR:56GM,32002131,CDM,J3490,HCPCS,250,RC,outpatient,,78.43,78.43,,66.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.61,22,,percent of total billed charges,,,,,,,,,70.59,90,,percent of total billed charges,,,64.94,82.8,,percent of total billed charges,,,66.67,85,,percent of total billed charges,,,,,,,,,69.02,88,,percent of total billed charges,,,,,,,,,59.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.61,22,,percent of total billed charges,,,71.37,91,,percent of total billed charges,,,74.51,95,,percent of total billed charges,,,65.1,83,,percent of total billed charges,,,65.1,83,,percent of total billed charges,,,,,,,,,,,,,,,65.1,83,,percent of total billed charges,,,74.51,95,,percent of total billed charges,,,70.59,90,,percent of total billed charges,,,70.59,90,,percent of total billed charges,,,64.31,82,,percent of total billed charges,,,70.59,90,,percent of total billed charges,,,66.67,85,,percent of total billed charges,,19.61,74.51,
SULFACETAMIDE(BLEPH-10) OINT : 10% 3.5GM,32002136,CDM,,,250,RC,outpatient,,31.56,31.56,,26.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.89,22,,percent of total billed charges,,,,,,,,,28.4,90,,percent of total billed charges,,,26.13,82.8,,percent of total billed charges,,,26.83,85,,percent of total billed charges,,,,,,,,,27.77,88,,percent of total billed charges,,,,,,,,,24.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.89,22,,percent of total billed charges,,,28.72,91,,percent of total billed charges,,,29.98,95,,percent of total billed charges,,,26.19,83,,percent of total billed charges,,,26.19,83,,percent of total billed charges,,,,,,,,,,,,,,,26.19,83,,percent of total billed charges,,,29.98,95,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,25.88,82,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,26.83,85,,percent of total billed charges,,7.89,29.98,
PADIMATE O (CHAPSTICK) STICK,32002146,CDM,,,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
CHERRY FLAVOR SYRP   480 ML,32002156,CDM,,,250,RC,outpatient,,191.43,191.43,,162.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.86,22,,percent of total billed charges,,,,,,,,,172.29,90,,percent of total billed charges,,,158.5,82.8,,percent of total billed charges,,,162.72,85,,percent of total billed charges,,,,,,,,,168.46,88,,percent of total billed charges,,,,,,,,,146.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.86,22,,percent of total billed charges,,,174.2,91,,percent of total billed charges,,,181.86,95,,percent of total billed charges,,,158.89,83,,percent of total billed charges,,,158.89,83,,percent of total billed charges,,,,,,,,,,,,,,,158.89,83,,percent of total billed charges,,,181.86,95,,percent of total billed charges,,,172.29,90,,percent of total billed charges,,,172.29,90,,percent of total billed charges,,,156.97,82,,percent of total billed charges,,,172.29,90,,percent of total billed charges,,,162.72,85,,percent of total billed charges,,47.86,181.86,
CALCIUM CARB(TUMS)TAB:500 MG,32002171,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PERIOGARD ORAL SOLN. 480ML,32002177,CDM,,,250,RC,outpatient,,22.5,22.5,,19.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.63,22,,percent of total billed charges,,,,,,,,,20.25,90,,percent of total billed charges,,,18.63,82.8,,percent of total billed charges,,,19.13,85,,percent of total billed charges,,,,,,,,,19.8,88,,percent of total billed charges,,,,,,,,,17.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.63,22,,percent of total billed charges,,,20.48,91,,percent of total billed charges,,,21.38,95,,percent of total billed charges,,,18.68,83,,percent of total billed charges,,,18.68,83,,percent of total billed charges,,,,,,,,,,,,,,,18.68,83,,percent of total billed charges,,,21.38,95,,percent of total billed charges,,,20.25,90,,percent of total billed charges,,,20.25,90,,percent of total billed charges,,,18.45,82,,percent of total billed charges,,,20.25,90,,percent of total billed charges,,,19.13,85,,percent of total billed charges,,5.63,21.38,
CHLORDIAZEPOXIDE (LIBRIUM) CAP : 10MG,32002186,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
chlordiazePOXIDE(LIBRIUM)CAP:5MG,32002191,CDM,J8499,HCPCS,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
CHLORZOXAZONE(PARAFON FORTE) TAB : 500MG,32002196,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CHLORPROMAZINE (THORAZINE) TAB : 50MG,32002227,CDM,,,250,RC,outpatient,,107.69,107.69,,91.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.92,22,,percent of total billed charges,,,,,,,,,96.92,90,,percent of total billed charges,,,89.17,82.8,,percent of total billed charges,,,91.54,85,,percent of total billed charges,,,,,,,,,94.77,88,,percent of total billed charges,,,,,,,,,82.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.92,22,,percent of total billed charges,,,98,91,,percent of total billed charges,,,102.31,95,,percent of total billed charges,,,89.38,83,,percent of total billed charges,,,89.38,83,,percent of total billed charges,,,,,,,,,,,,,,,89.38,83,,percent of total billed charges,,,102.31,95,,percent of total billed charges,,,96.92,90,,percent of total billed charges,,,96.92,90,,percent of total billed charges,,,88.31,82,,percent of total billed charges,,,96.92,90,,percent of total billed charges,,,91.54,85,,percent of total billed charges,,26.92,102.31,
CHLORPROPAMIDE (DIABINESE) : 100MG,32002236,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CHLORPROPAMIDE (DIABINESE) TAB : 250MG,32002246,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CHLORAL HYDRATE SYRP:500MG/5ML (5ML),32002251,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
PHENOL/NA (CHLORASEPTIC) SPRAY:180ML,32002261,CDM,J3490,HCPCS,250,RC,outpatient,,33.33,33.33,,28.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.33,22,,percent of total billed charges,,,,,,,,,30,90,,percent of total billed charges,,,27.6,82.8,,percent of total billed charges,,,28.33,85,,percent of total billed charges,,,,,,,,,29.33,88,,percent of total billed charges,,,,,,,,,25.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.33,22,,percent of total billed charges,,,30.33,91,,percent of total billed charges,,,31.66,95,,percent of total billed charges,,,27.66,83,,percent of total billed charges,,,27.66,83,,percent of total billed charges,,,,,,,,,,,,,,,27.66,83,,percent of total billed charges,,,31.66,95,,percent of total billed charges,,,30,90,,percent of total billed charges,,,30,90,,percent of total billed charges,,,27.33,82,,percent of total billed charges,,,30,90,,percent of total billed charges,,,28.33,85,,percent of total billed charges,,8.33,31.66,
chlorproMAZINE(THORAZINE)AMP:25MG/ML,32002271,CDM,J3230,HCPCS,250,RC,outpatient,,436.77,436.77,,370.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.19,22,,percent of total billed charges,,,,,,,,,393.09,90,,percent of total billed charges,,,361.65,82.8,,percent of total billed charges,,,371.25,85,,percent of total billed charges,,,,,,,,,384.36,88,,percent of total billed charges,,272.04,,,,fee schedule,,,333.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,272.04,,,,fee schedule,,,109.19,22,,percent of total billed charges,,,397.46,91,,percent of total billed charges,,,414.93,95,,percent of total billed charges,,,362.52,83,,percent of total billed charges,,,362.52,83,,percent of total billed charges,,,,,,,,,,,,,,,362.52,83,,percent of total billed charges,,,414.93,95,,percent of total billed charges,,,393.09,90,,percent of total billed charges,,,393.09,90,,percent of total billed charges,,,358.15,82,,percent of total billed charges,,,393.09,90,,percent of total billed charges,,,371.25,85,,percent of total billed charges,,109.19,414.93,
PHENOL/NA(CHLORASEPTIC)LOZ:,32002276,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
chlordiazePOXIDE(LIBRIUM)CAP:25MG,32002281,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
CHLORPHENIRAMINE(CHLORTRIMETON)TAB:4MG,32002296,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PSEUDOEPHED/CHLOR(NOVOFED)CAP:120-8MG,32002302,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
chlorproMAZINE(THORAZINE)TAB:25MG,32002316,CDM,J8499,HCPCS,250,RC,outpatient,UD,44.88,44.88,,38.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.22,22,,percent of total billed charges,,,,,,,,,40.39,90,,percent of total billed charges,,,37.16,82.8,,percent of total billed charges,,,38.15,85,,percent of total billed charges,,,,,,,,,39.49,88,,percent of total billed charges,,,,,,,,,34.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.22,22,,percent of total billed charges,,,40.84,91,,percent of total billed charges,,,42.64,95,,percent of total billed charges,,,37.25,83,,percent of total billed charges,,,37.25,83,,percent of total billed charges,,,,,,,,,,,,,,,37.25,83,,percent of total billed charges,,,42.64,95,,percent of total billed charges,,,40.39,90,,percent of total billed charges,,,40.39,90,,percent of total billed charges,,,36.8,82,,percent of total billed charges,,,40.39,90,,percent of total billed charges,,,38.15,85,,percent of total billed charges,,11.22,42.64,
CHLORAL HYDRATE SYRP : 500MG/5ML,32002322,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
CHLORAL HYDRATE SYRP:500MG/5ML  (90ML),32002323,CDM,,,250,RC,outpatient,,21.73,21.73,,18.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.43,22,,percent of total billed charges,,,,,,,,,19.56,90,,percent of total billed charges,,,17.99,82.8,,percent of total billed charges,,,18.47,85,,percent of total billed charges,,,,,,,,,19.12,88,,percent of total billed charges,,,,,,,,,16.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.43,22,,percent of total billed charges,,,19.77,91,,percent of total billed charges,,,20.64,95,,percent of total billed charges,,,18.04,83,,percent of total billed charges,,,18.04,83,,percent of total billed charges,,,,,,,,,,,,,,,18.04,83,,percent of total billed charges,,,20.64,95,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,17.82,82,,percent of total billed charges,,,19.56,90,,percent of total billed charges,,,18.47,85,,percent of total billed charges,,5.43,20.64,
CHROMIUM PICOLINATE 200MCG,32002324,CDM,,,250,RC,outpatient,,0.5,0.5,,0.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.13,22,,percent of total billed charges,,,,,,,,,0.45,90,,percent of total billed charges,,,0.41,82.8,,percent of total billed charges,,,0.43,85,,percent of total billed charges,,,,,,,,,0.44,88,,percent of total billed charges,,,,,,,,,0.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.13,22,,percent of total billed charges,,,0.46,91,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,,,,,,,,,,,,,0.42,83,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.41,82,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.43,85,,percent of total billed charges,,0.13,0.48,
CIPROFLOXACIN(CILOXAN)DROP 0.3%:2.5ML,32002327,CDM,J3490,HCPCS,250,RC,outpatient,,98.53,98.53,,83.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.63,22,,percent of total billed charges,,,,,,,,,88.68,90,,percent of total billed charges,,,81.58,82.8,,percent of total billed charges,,,83.75,85,,percent of total billed charges,,,,,,,,,86.71,88,,percent of total billed charges,,,,,,,,,75.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.63,22,,percent of total billed charges,,,89.66,91,,percent of total billed charges,,,93.6,95,,percent of total billed charges,,,81.78,83,,percent of total billed charges,,,81.78,83,,percent of total billed charges,,,,,,,,,,,,,,,81.78,83,,percent of total billed charges,,,93.6,95,,percent of total billed charges,,,88.68,90,,percent of total billed charges,,,88.68,90,,percent of total billed charges,,,80.79,82,,percent of total billed charges,,,88.68,90,,percent of total billed charges,,,83.75,85,,percent of total billed charges,,24.63,93.6,
CIMETIDINE (TAGAMET) TAB : 300MG,32002331,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CIMETIDINE SOLUTION 300MG/5ML  60ML,32002337,CDM,,,250,RC,outpatient,,58.5,58.5,,49.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.63,22,,percent of total billed charges,,,,,,,,,52.65,90,,percent of total billed charges,,,48.44,82.8,,percent of total billed charges,,,49.73,85,,percent of total billed charges,,,,,,,,,51.48,88,,percent of total billed charges,,,,,,,,,44.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.63,22,,percent of total billed charges,,,53.24,91,,percent of total billed charges,,,55.58,95,,percent of total billed charges,,,48.56,83,,percent of total billed charges,,,48.56,83,,percent of total billed charges,,,,,,,,,,,,,,,48.56,83,,percent of total billed charges,,,55.58,95,,percent of total billed charges,,,52.65,90,,percent of total billed charges,,,52.65,90,,percent of total billed charges,,,47.97,82,,percent of total billed charges,,,52.65,90,,percent of total billed charges,,,49.73,85,,percent of total billed charges,,14.63,55.58,
CIMETIDINE(TAGAMET)TAB:400MG,32002341,CDM,J8499,HCPCS,250,RC,outpatient,,13.56,13.56,,11.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.23,82.8,,percent of total billed charges,,,11.53,85,,percent of total billed charges,,,,,,,,,11.93,88,,percent of total billed charges,,,,,,,,,10.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.34,91,,percent of total billed charges,,,12.88,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.88,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.12,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.53,85,,percent of total billed charges,,3.39,12.88,
CIPROFLOXACIN(CIPRO)/D5W PIG:400MG/0.2L,32002361,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
CIPROFLOXACIN (CIPRO) VL:400MG/40ML,32002366,CDM,J0744,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,2.57,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.57,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,2.57,59.21,
CIPROFLOXACIN (CIPRO)VIAL : 200MG/20ML,32002371,CDM,,,250,RC,outpatient,,66.61,66.61,,56.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.65,22,,percent of total billed charges,,,,,,,,,59.95,90,,percent of total billed charges,,,55.15,82.8,,percent of total billed charges,,,56.62,85,,percent of total billed charges,,,,,,,,,58.62,88,,percent of total billed charges,,,,,,,,,50.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.65,22,,percent of total billed charges,,,60.62,91,,percent of total billed charges,,,63.28,95,,percent of total billed charges,,,55.29,83,,percent of total billed charges,,,55.29,83,,percent of total billed charges,,,,,,,,,,,,,,,55.29,83,,percent of total billed charges,,,63.28,95,,percent of total billed charges,,,59.95,90,,percent of total billed charges,,,59.95,90,,percent of total billed charges,,,54.62,82,,percent of total billed charges,,,59.95,90,,percent of total billed charges,,,56.62,85,,percent of total billed charges,,16.65,63.28,
CIPROFLOXACIN(CIPRO)TAB:250MG,32002376,CDM,J8499,HCPCS,250,RC,outpatient,,61.6,61.6,,52.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.4,22,,percent of total billed charges,,,,,,,,,55.44,90,,percent of total billed charges,,,51,82.8,,percent of total billed charges,,,52.36,85,,percent of total billed charges,,,,,,,,,54.21,88,,percent of total billed charges,,,,,,,,,47.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.4,22,,percent of total billed charges,,,56.06,91,,percent of total billed charges,,,58.52,95,,percent of total billed charges,,,51.13,83,,percent of total billed charges,,,51.13,83,,percent of total billed charges,,,,,,,,,,,,,,,51.13,83,,percent of total billed charges,,,58.52,95,,percent of total billed charges,,,55.44,90,,percent of total billed charges,,,55.44,90,,percent of total billed charges,,,50.51,82,,percent of total billed charges,,,55.44,90,,percent of total billed charges,,,52.36,85,,percent of total billed charges,,15.4,58.52,
CIPROFLOXACIN (CIPRO) TAB: 250MG (1X4),32002377,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CIPROFLOXACIN (CIPRO) TAB : 500MG,32002381,CDM,,,250,RC,outpatient,,416.32,416.32,,353.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.08,22,,percent of total billed charges,,,,,,,,,374.69,90,,percent of total billed charges,,,344.71,82.8,,percent of total billed charges,,,353.87,85,,percent of total billed charges,,,,,,,,,366.36,88,,percent of total billed charges,,,,,,,,,318.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.08,22,,percent of total billed charges,,,378.85,91,,percent of total billed charges,,,395.5,95,,percent of total billed charges,,,345.55,83,,percent of total billed charges,,,345.55,83,,percent of total billed charges,,,,,,,,,,,,,,,345.55,83,,percent of total billed charges,,,395.5,95,,percent of total billed charges,,,374.69,90,,percent of total billed charges,,,374.69,90,,percent of total billed charges,,,341.38,82,,percent of total billed charges,,,374.69,90,,percent of total billed charges,,,353.87,85,,percent of total billed charges,,104.08,395.5,
CIPROFLOXACIN (CIPRO) TAB: 500 MG (1x4),32002382,CDM,,,250,RC,outpatient,,1411.2,1411.2,,1198.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,352.8,22,,percent of total billed charges,,,,,,,,,1270.08,90,,percent of total billed charges,,,1168.47,82.8,,percent of total billed charges,,,1199.52,85,,percent of total billed charges,,,,,,,,,1241.86,88,,percent of total billed charges,,,,,,,,,1078.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,352.8,22,,percent of total billed charges,,,1284.19,91,,percent of total billed charges,,,1340.64,95,,percent of total billed charges,,,1171.3,83,,percent of total billed charges,,,1171.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1171.3,83,,percent of total billed charges,,,1340.64,95,,percent of total billed charges,,,1270.08,90,,percent of total billed charges,,,1270.08,90,,percent of total billed charges,,,1157.18,82,,percent of total billed charges,,,1270.08,90,,percent of total billed charges,,,1199.52,85,,percent of total billed charges,,352.8,1340.64,
CIPROFLOXACIN (CIPRO) TAB : 750MG,32002386,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
METHYLCELLULOSE (CITRUCEL) POW   CAN,32002390,CDM,,,250,RC,outpatient,,97.7,97.7,,82.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.43,22,,percent of total billed charges,,,,,,,,,87.93,90,,percent of total billed charges,,,80.9,82.8,,percent of total billed charges,,,83.05,85,,percent of total billed charges,,,,,,,,,85.98,88,,percent of total billed charges,,,,,,,,,74.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.43,22,,percent of total billed charges,,,88.91,91,,percent of total billed charges,,,92.82,95,,percent of total billed charges,,,81.09,83,,percent of total billed charges,,,81.09,83,,percent of total billed charges,,,,,,,,,,,,,,,81.09,83,,percent of total billed charges,,,92.82,95,,percent of total billed charges,,,87.93,90,,percent of total billed charges,,,87.93,90,,percent of total billed charges,,,80.11,82,,percent of total billed charges,,,87.93,90,,percent of total billed charges,,,83.05,85,,percent of total billed charges,,24.43,92.82,
MAG CITRATE(CITROMA)SOL:300ML,32002391,CDM,J8499,HCPCS,250,RC,outpatient,,36.76,36.76,,31.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.19,22,,percent of total billed charges,,,,,,,,,33.08,90,,percent of total billed charges,,,30.44,82.8,,percent of total billed charges,,,31.25,85,,percent of total billed charges,,,,,,,,,32.35,88,,percent of total billed charges,,,,,,,,,28.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.19,22,,percent of total billed charges,,,33.45,91,,percent of total billed charges,,,34.92,95,,percent of total billed charges,,,30.51,83,,percent of total billed charges,,,30.51,83,,percent of total billed charges,,,,,,,,,,,,,,,30.51,83,,percent of total billed charges,,,34.92,95,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,30.14,82,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,31.25,85,,percent of total billed charges,,9.19,34.92,
CITRUCEL,32002396,CDM,,,250,RC,outpatient,,125.45,125.45,,106.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.36,22,,percent of total billed charges,,,,,,,,,112.91,90,,percent of total billed charges,,,103.87,82.8,,percent of total billed charges,,,106.63,85,,percent of total billed charges,,,,,,,,,110.4,88,,percent of total billed charges,,,,,,,,,95.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.36,22,,percent of total billed charges,,,114.16,91,,percent of total billed charges,,,119.18,95,,percent of total billed charges,,,104.12,83,,percent of total billed charges,,,104.12,83,,percent of total billed charges,,,,,,,,,,,,,,,104.12,83,,percent of total billed charges,,,119.18,95,,percent of total billed charges,,,112.91,90,,percent of total billed charges,,,112.91,90,,percent of total billed charges,,,102.87,82,,percent of total billed charges,,,112.91,90,,percent of total billed charges,,,106.63,85,,percent of total billed charges,,31.36,119.18,
cefoTAXIME (CLAFORAN) VIAL : 500MG,32002401,CDM,J0698,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,5.72,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.72,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,5.72,59.21,
cefoTAXIME (CLAFORAN) VIAL : 2GM,32002406,CDM,,,250,RC,outpatient,,83.26,83.26,,70.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.82,22,,percent of total billed charges,,,,,,,,,74.93,90,,percent of total billed charges,,,68.94,82.8,,percent of total billed charges,,,70.77,85,,percent of total billed charges,,,,,,,,,73.27,88,,percent of total billed charges,,,,,,,,,63.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.82,22,,percent of total billed charges,,,75.77,91,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,,,,,,,,,,,,,69.11,83,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,68.27,82,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,70.77,85,,percent of total billed charges,,20.82,79.1,
ceFOTaxime(CLAFORAN)VIAL:1GM,32002411,CDM,J0698,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,5.72,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.72,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,5.72,59.21,
P-EPHED/LORA(CLARITIN D 12HR)TAB:,32002421,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
LORATADIN(CLARITIN)TAB:10MG,32002426,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CLEMASTINE (TAVIST-1) TAB : 1.34MG,32002431,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CLEMASTINE (TAVIST) TAB : 2.68MG,32002436,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CLINDAMYCIN(CLEOCIN)VIAL:300MG/2ML,32002441,CDM,,,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
CLINDAMYCIN(CLEOCIN)VIAL:600MG/4ML,32002446,CDM,,,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
CLIDINIUM/CHLORDIAZ(LIBRAX)CAP:2.5-5MG,32002456,CDM,J8499,HCPCS,250,RC,outpatient,,71.37,71.37,,60.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.84,22,,percent of total billed charges,,,,,,,,,64.23,90,,percent of total billed charges,,,59.09,82.8,,percent of total billed charges,,,60.66,85,,percent of total billed charges,,,,,,,,,62.81,88,,percent of total billed charges,,,,,,,,,54.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.84,22,,percent of total billed charges,,,64.95,91,,percent of total billed charges,,,67.8,95,,percent of total billed charges,,,59.24,83,,percent of total billed charges,,,59.24,83,,percent of total billed charges,,,,,,,,,,,,,,,59.24,83,,percent of total billed charges,,,67.8,95,,percent of total billed charges,,,64.23,90,,percent of total billed charges,,,64.23,90,,percent of total billed charges,,,58.52,82,,percent of total billed charges,,,64.23,90,,percent of total billed charges,,,60.66,85,,percent of total billed charges,,17.84,67.8,
CLINDAMYCIN(CLEOCIN)CAP:150MG,32002461,CDM,,,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
clonazePAM(KlonoPIN)TAB:0.5MG,32002466,CDM,,,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
CLOMIPRAMINE (ANAFRANIL) CAP : 50MG,32002467,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CLONIDINE (CATAPRES) TAB : 0.3MG,32002471,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
cloNIDine(CATAPRES)TAB:0.1MG,32002476,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CLORAZEPATE (TRANXENE) TAB : 3.75MG,32002481,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
CLOTRIMAZOLE(LOTRIMIN VAG) CRM : 1% 45GM,32002486,CDM,,,250,RC,outpatient,,39.33,39.33,,33.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.83,22,,percent of total billed charges,,,,,,,,,35.4,90,,percent of total billed charges,,,32.57,82.8,,percent of total billed charges,,,33.43,85,,percent of total billed charges,,,,,,,,,34.61,88,,percent of total billed charges,,,,,,,,,30.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.83,22,,percent of total billed charges,,,35.79,91,,percent of total billed charges,,,37.36,95,,percent of total billed charges,,,32.64,83,,percent of total billed charges,,,32.64,83,,percent of total billed charges,,,,,,,,,,,,,,,32.64,83,,percent of total billed charges,,,37.36,95,,percent of total billed charges,,,35.4,90,,percent of total billed charges,,,35.4,90,,percent of total billed charges,,,32.25,82,,percent of total billed charges,,,35.4,90,,percent of total billed charges,,,33.43,85,,percent of total billed charges,,9.83,37.36,
COCAINE HCL SOL 4%:4ML,32002496,CDM,,,250,RC,outpatient,,2934.5,2934.5,,2491.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,733.63,22,,percent of total billed charges,,,,,,,,,2641.05,90,,percent of total billed charges,,,2429.77,82.8,,percent of total billed charges,,,2494.33,85,,percent of total billed charges,,,,,,,,,2582.36,88,,percent of total billed charges,,,,,,,,,2241.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,733.63,22,,percent of total billed charges,,,2670.4,91,,percent of total billed charges,,,2787.78,95,,percent of total billed charges,,,2435.64,83,,percent of total billed charges,,,2435.64,83,,percent of total billed charges,,,,,,,,,,,,,,,2435.64,83,,percent of total billed charges,,,2787.78,95,,percent of total billed charges,,,2641.05,90,,percent of total billed charges,,,2641.05,90,,percent of total billed charges,,,2406.29,82,,percent of total billed charges,,,2641.05,90,,percent of total billed charges,,,2494.33,85,,percent of total billed charges,,733.63,2787.78,
CODEINE SULF TAB : 15MG,32002516,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
BENZTROPINE MESYLAT(COGENTIN)AMP:2MG/2ML,32002526,CDM,J0515,HCPCS,250,RC,outpatient,,747.8,747.8,,634.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,186.95,22,,percent of total billed charges,,,,,,,,,673.02,90,,percent of total billed charges,,,619.18,82.8,,percent of total billed charges,,,635.63,85,,percent of total billed charges,,,,,,,,,658.06,88,,percent of total billed charges,,87.59,,,,fee schedule,,,571.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,87.59,,,,fee schedule,,,186.95,22,,percent of total billed charges,,,680.5,91,,percent of total billed charges,,,710.41,95,,percent of total billed charges,,,620.67,83,,percent of total billed charges,,,620.67,83,,percent of total billed charges,,,,,,,,,,,,,,,620.67,83,,percent of total billed charges,,,710.41,95,,percent of total billed charges,,,673.02,90,,percent of total billed charges,,,673.02,90,,percent of total billed charges,,,613.2,82,,percent of total billed charges,,,673.02,90,,percent of total billed charges,,,635.63,85,,percent of total billed charges,,87.59,710.41,
TACRINE HCL (COGNEX) CAP : 20MG,32002531,CDM,,,250,RC,outpatient,,17.6,17.6,,14.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.4,22,,percent of total billed charges,,,,,,,,,15.84,90,,percent of total billed charges,,,14.57,82.8,,percent of total billed charges,,,14.96,85,,percent of total billed charges,,,,,,,,,15.49,88,,percent of total billed charges,,,,,,,,,13.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.4,22,,percent of total billed charges,,,16.02,91,,percent of total billed charges,,,16.72,95,,percent of total billed charges,,,14.61,83,,percent of total billed charges,,,14.61,83,,percent of total billed charges,,,,,,,,,,,,,,,14.61,83,,percent of total billed charges,,,16.72,95,,percent of total billed charges,,,15.84,90,,percent of total billed charges,,,15.84,90,,percent of total billed charges,,,14.43,82,,percent of total billed charges,,,15.84,90,,percent of total billed charges,,,14.96,85,,percent of total billed charges,,4.4,16.72,
TACRINE HCL (COGNEX) CAP : 10MG,32002536,CDM,,,250,RC,outpatient,,38.86,38.86,,32.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.72,22,,percent of total billed charges,,,,,,,,,34.97,90,,percent of total billed charges,,,32.18,82.8,,percent of total billed charges,,,33.03,85,,percent of total billed charges,,,,,,,,,34.2,88,,percent of total billed charges,,,,,,,,,29.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.72,22,,percent of total billed charges,,,35.36,91,,percent of total billed charges,,,36.92,95,,percent of total billed charges,,,32.25,83,,percent of total billed charges,,,32.25,83,,percent of total billed charges,,,,,,,,,,,,,,,32.25,83,,percent of total billed charges,,,36.92,95,,percent of total billed charges,,,34.97,90,,percent of total billed charges,,,34.97,90,,percent of total billed charges,,,31.87,82,,percent of total billed charges,,,34.97,90,,percent of total billed charges,,,33.03,85,,percent of total billed charges,,9.72,36.92,
TACRINE HCL (COGNEX) CAP : 40MG,32002537,CDM,,,250,RC,outpatient,,38.86,38.86,,32.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.72,22,,percent of total billed charges,,,,,,,,,34.97,90,,percent of total billed charges,,,32.18,82.8,,percent of total billed charges,,,33.03,85,,percent of total billed charges,,,,,,,,,34.2,88,,percent of total billed charges,,,,,,,,,29.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.72,22,,percent of total billed charges,,,35.36,91,,percent of total billed charges,,,36.92,95,,percent of total billed charges,,,32.25,83,,percent of total billed charges,,,32.25,83,,percent of total billed charges,,,,,,,,,,,,,,,32.25,83,,percent of total billed charges,,,36.92,95,,percent of total billed charges,,,34.97,90,,percent of total billed charges,,,34.97,90,,percent of total billed charges,,,31.87,82,,percent of total billed charges,,,34.97,90,,percent of total billed charges,,,33.03,85,,percent of total billed charges,,9.72,36.92,
COLCHICINE TAB:0.6MG,32002541,CDM,J8499,HCPCS,250,RC,outpatient,,63.56,63.56,,53.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.89,22,,percent of total billed charges,,,,,,,,,57.2,90,,percent of total billed charges,,,52.63,82.8,,percent of total billed charges,,,54.03,85,,percent of total billed charges,,,,,,,,,55.93,88,,percent of total billed charges,,,,,,,,,48.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.89,22,,percent of total billed charges,,,57.84,91,,percent of total billed charges,,,60.38,95,,percent of total billed charges,,,52.75,83,,percent of total billed charges,,,52.75,83,,percent of total billed charges,,,,,,,,,,,,,,,52.75,83,,percent of total billed charges,,,60.38,95,,percent of total billed charges,,,57.2,90,,percent of total billed charges,,,57.2,90,,percent of total billed charges,,,52.12,82,,percent of total billed charges,,,57.2,90,,percent of total billed charges,,,54.03,85,,percent of total billed charges,,15.89,60.38,
ALBUTEROL/IPRA(COMBIVENT)AER/MDI:,32002545,CDM,,,250,RC,outpatient,,3052.63,3052.63,,2591.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,763.16,22,,percent of total billed charges,,,,,,,,,2747.37,90,,percent of total billed charges,,,2527.58,82.8,,percent of total billed charges,,,2594.74,85,,percent of total billed charges,,,,,,,,,2686.31,88,,percent of total billed charges,,,,,,,,,2332.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,763.16,22,,percent of total billed charges,,,2777.89,91,,percent of total billed charges,,,2900,95,,percent of total billed charges,,,2533.68,83,,percent of total billed charges,,,2533.68,83,,percent of total billed charges,,,,,,,,,,,,,,,2533.68,83,,percent of total billed charges,,,2900,95,,percent of total billed charges,,,2747.37,90,,percent of total billed charges,,,2747.37,90,,percent of total billed charges,,,2503.16,82,,percent of total billed charges,,,2747.37,90,,percent of total billed charges,,,2594.74,85,,percent of total billed charges,,763.16,2900,
PROCHLORPERAZINE(COMPAZINE)SUPP:2.5MG,32002546,CDM,,,250,RC,outpatient,,37.27,37.27,,31.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.32,22,,percent of total billed charges,,,,,,,,,33.54,90,,percent of total billed charges,,,30.86,82.8,,percent of total billed charges,,,31.68,85,,percent of total billed charges,,,,,,,,,32.8,88,,percent of total billed charges,,,,,,,,,28.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.32,22,,percent of total billed charges,,,33.92,91,,percent of total billed charges,,,35.41,95,,percent of total billed charges,,,30.93,83,,percent of total billed charges,,,30.93,83,,percent of total billed charges,,,,,,,,,,,,,,,30.93,83,,percent of total billed charges,,,35.41,95,,percent of total billed charges,,,33.54,90,,percent of total billed charges,,,33.54,90,,percent of total billed charges,,,30.56,82,,percent of total billed charges,,,33.54,90,,percent of total billed charges,,,31.68,85,,percent of total billed charges,,9.32,35.41,
PROCHLORPERZ(COMPAZINE)SYP:5MG/5ML 118ML,32002551,CDM,,,250,RC,outpatient,,339.72,339.72,,288.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.93,22,,percent of total billed charges,,,,,,,,,305.75,90,,percent of total billed charges,,,281.29,82.8,,percent of total billed charges,,,288.76,85,,percent of total billed charges,,,,,,,,,298.95,88,,percent of total billed charges,,,,,,,,,259.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.93,22,,percent of total billed charges,,,309.15,91,,percent of total billed charges,,,322.73,95,,percent of total billed charges,,,281.97,83,,percent of total billed charges,,,281.97,83,,percent of total billed charges,,,,,,,,,,,,,,,281.97,83,,percent of total billed charges,,,322.73,95,,percent of total billed charges,,,305.75,90,,percent of total billed charges,,,305.75,90,,percent of total billed charges,,,278.57,82,,percent of total billed charges,,,305.75,90,,percent of total billed charges,,,288.76,85,,percent of total billed charges,,84.93,322.73,
PROCHLORPERAZINE MALEATE(COMPAZ)SUPP:5MG,32002556,CDM,,,250,RC,outpatient,,41.39,41.39,,35.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.35,22,,percent of total billed charges,,,,,,,,,37.25,90,,percent of total billed charges,,,34.27,82.8,,percent of total billed charges,,,35.18,85,,percent of total billed charges,,,,,,,,,36.42,88,,percent of total billed charges,,,,,,,,,31.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.35,22,,percent of total billed charges,,,37.66,91,,percent of total billed charges,,,39.32,95,,percent of total billed charges,,,34.35,83,,percent of total billed charges,,,34.35,83,,percent of total billed charges,,,,,,,,,,,,,,,34.35,83,,percent of total billed charges,,,39.32,95,,percent of total billed charges,,,37.25,90,,percent of total billed charges,,,37.25,90,,percent of total billed charges,,,33.94,82,,percent of total billed charges,,,37.25,90,,percent of total billed charges,,,35.18,85,,percent of total billed charges,,10.35,39.32,
PROCHLORPER(COMPAZINE)  SYP:5MG/5ML 60ML,32002561,CDM,,,250,RC,outpatient,,172.72,172.72,,146.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.18,22,,percent of total billed charges,,,,,,,,,155.45,90,,percent of total billed charges,,,143.01,82.8,,percent of total billed charges,,,146.81,85,,percent of total billed charges,,,,,,,,,151.99,88,,percent of total billed charges,,,,,,,,,131.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.18,22,,percent of total billed charges,,,157.18,91,,percent of total billed charges,,,164.08,95,,percent of total billed charges,,,143.36,83,,percent of total billed charges,,,143.36,83,,percent of total billed charges,,,,,,,,,,,,,,,143.36,83,,percent of total billed charges,,,164.08,95,,percent of total billed charges,,,155.45,90,,percent of total billed charges,,,155.45,90,,percent of total billed charges,,,141.63,82,,percent of total billed charges,,,155.45,90,,percent of total billed charges,,,146.81,85,,percent of total billed charges,,43.18,164.08,
PROCHLORPERZN(COMPAZINE)SYP:5MG/5ML 90ML,32002566,CDM,,,250,RC,outpatient,,259.15,259.15,,220.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.79,22,,percent of total billed charges,,,,,,,,,233.24,90,,percent of total billed charges,,,214.58,82.8,,percent of total billed charges,,,220.28,85,,percent of total billed charges,,,,,,,,,228.05,88,,percent of total billed charges,,,,,,,,,197.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.79,22,,percent of total billed charges,,,235.83,91,,percent of total billed charges,,,246.19,95,,percent of total billed charges,,,215.09,83,,percent of total billed charges,,,215.09,83,,percent of total billed charges,,,,,,,,,,,,,,,215.09,83,,percent of total billed charges,,,246.19,95,,percent of total billed charges,,,233.24,90,,percent of total billed charges,,,233.24,90,,percent of total billed charges,,,212.5,82,,percent of total billed charges,,,233.24,90,,percent of total billed charges,,,220.28,85,,percent of total billed charges,,64.79,246.19,
PROCHLORPERAZINE(COMPAZINE)TAB:5MG,32002571,CDM,Q0164,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,0.52,,,,fee schedule,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.52,,,,fee schedule,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,0.52,12.87,
ENTACAPONE(COMTAN)TAB:200MG,32002572,CDM,,,250,RC,outpatient,,128.47,128.47,,109.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.12,22,,percent of total billed charges,,,,,,,,,115.62,90,,percent of total billed charges,,,106.37,82.8,,percent of total billed charges,,,109.2,85,,percent of total billed charges,,,,,,,,,113.05,88,,percent of total billed charges,,,,,,,,,98.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.12,22,,percent of total billed charges,,,116.91,91,,percent of total billed charges,,,122.05,95,,percent of total billed charges,,,106.63,83,,percent of total billed charges,,,106.63,83,,percent of total billed charges,,,,,,,,,,,,,,,106.63,83,,percent of total billed charges,,,122.05,95,,percent of total billed charges,,,115.62,90,,percent of total billed charges,,,115.62,90,,percent of total billed charges,,,105.35,82,,percent of total billed charges,,,115.62,90,,percent of total billed charges,,,109.2,85,,percent of total billed charges,,32.12,122.05,
LACTULOSE (CONSTULOSE) SOL : 10G/15ML,32002576,CDM,,,250,RC,outpatient,,70.74,70.74,,60.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.69,22,,percent of total billed charges,,,,,,,,,63.67,90,,percent of total billed charges,,,58.57,82.8,,percent of total billed charges,,,60.13,85,,percent of total billed charges,,,,,,,,,62.25,88,,percent of total billed charges,,,,,,,,,54.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.69,22,,percent of total billed charges,,,64.37,91,,percent of total billed charges,,,67.2,95,,percent of total billed charges,,,58.71,83,,percent of total billed charges,,,58.71,83,,percent of total billed charges,,,,,,,,,,,,,,,58.71,83,,percent of total billed charges,,,67.2,95,,percent of total billed charges,,,63.67,90,,percent of total billed charges,,,63.67,90,,percent of total billed charges,,,58.01,82,,percent of total billed charges,,,63.67,90,,percent of total billed charges,,,60.13,85,,percent of total billed charges,,17.69,67.2,
LACTULOSE (CONSTULOSE) SOL : 10G/15ML,32002581,CDM,,,250,RC,outpatient,,26.8,26.8,,22.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.7,22,,percent of total billed charges,,,,,,,,,24.12,90,,percent of total billed charges,,,22.19,82.8,,percent of total billed charges,,,22.78,85,,percent of total billed charges,,,,,,,,,23.58,88,,percent of total billed charges,,,,,,,,,20.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.7,22,,percent of total billed charges,,,24.39,91,,percent of total billed charges,,,25.46,95,,percent of total billed charges,,,22.24,83,,percent of total billed charges,,,22.24,83,,percent of total billed charges,,,,,,,,,,,,,,,22.24,83,,percent of total billed charges,,,25.46,95,,percent of total billed charges,,,24.12,90,,percent of total billed charges,,,24.12,90,,percent of total billed charges,,,21.98,82,,percent of total billed charges,,,24.12,90,,percent of total billed charges,,,22.78,85,,percent of total billed charges,,6.7,25.46,
LACTULOSE(CHRONULAC):20GM/30ML U/D,32002582,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
AMIODARONE(CORDARONE)TAB:200MG,32002601,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
AMIODARONE(CORDARONE)VIAL:150MG/3ML,32002602,CDM,J0282,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,7.62,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.62,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,7.62,60.99,
CARVEDILOL(COREG)TAB: 3.125MG,32002612,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CARVEDILOL(COREG)TAB:12.5MG,32002613,CDM,,,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CARVEDILOL (COREG) TAB : 6.25MG,32002614,CDM,,,250,RC,outpatient,,94.68,94.68,,80.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.67,22,,percent of total billed charges,,,,,,,,,85.21,90,,percent of total billed charges,,,78.4,82.8,,percent of total billed charges,,,80.48,85,,percent of total billed charges,,,,,,,,,83.32,88,,percent of total billed charges,,,,,,,,,72.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.67,22,,percent of total billed charges,,,86.16,91,,percent of total billed charges,,,89.95,95,,percent of total billed charges,,,78.58,83,,percent of total billed charges,,,78.58,83,,percent of total billed charges,,,,,,,,,,,,,,,78.58,83,,percent of total billed charges,,,89.95,95,,percent of total billed charges,,,85.21,90,,percent of total billed charges,,,85.21,90,,percent of total billed charges,,,77.64,82,,percent of total billed charges,,,85.21,90,,percent of total billed charges,,,80.48,85,,percent of total billed charges,,23.67,89.95,
CORTISONE ACETATE TAB:25MG,32002616,CDM,J8499,HCPCS,250,RC,outpatient,,41.55,41.55,,35.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.39,22,,percent of total billed charges,,,,,,,,,37.4,90,,percent of total billed charges,,,34.4,82.8,,percent of total billed charges,,,35.32,85,,percent of total billed charges,,,,,,,,,36.56,88,,percent of total billed charges,,,,,,,,,31.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.39,22,,percent of total billed charges,,,37.81,91,,percent of total billed charges,,,39.47,95,,percent of total billed charges,,,34.49,83,,percent of total billed charges,,,34.49,83,,percent of total billed charges,,,,,,,,,,,,,,,34.49,83,,percent of total billed charges,,,39.47,95,,percent of total billed charges,,,37.4,90,,percent of total billed charges,,,37.4,90,,percent of total billed charges,,,34.07,82,,percent of total billed charges,,,37.4,90,,percent of total billed charges,,,35.32,85,,percent of total billed charges,,10.39,39.47,
NEOMYCIN/POLYMIXIN/HYDROCORTISONE,32002622,CDM,,,250,RC,outpatient,,89,89,,75.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.25,22,,percent of total billed charges,,,,,,,,,80.1,90,,percent of total billed charges,,,73.69,82.8,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,,,,,,,,78.32,88,,percent of total billed charges,,,,,,,,,68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.25,22,,percent of total billed charges,,,80.99,91,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,,,,,,,,,,,,,73.87,83,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,72.98,82,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,22.25,84.55,
COSYNTROPIN(CORTROSYN)VIAL:0.25MG,32002626,CDM,J0834,HCPCS,636,RC,outpatient,,375.41,375.41,,318.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.85,22,,percent of total billed charges,,,,,,,,,337.87,90,,percent of total billed charges,,,310.84,82.8,,percent of total billed charges,,,319.1,85,,percent of total billed charges,,,,,,,,,330.36,88,,percent of total billed charges,,93.17,,,,fee schedule,,,286.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,93.17,,,,fee schedule,,,93.85,22,,percent of total billed charges,,,341.62,91,,percent of total billed charges,,,356.64,95,,percent of total billed charges,,,311.59,83,,percent of total billed charges,,,311.59,83,,percent of total billed charges,,,,,,,,,,,,,,,311.59,83,,percent of total billed charges,,,356.64,95,,percent of total billed charges,,,337.87,90,,percent of total billed charges,,,337.87,90,,percent of total billed charges,,,307.84,82,,percent of total billed charges,,,337.87,90,,percent of total billed charges,,,319.1,85,,percent of total billed charges,,93.17,356.64,
MENTHOL(ROBITUSSIN)LOZ:10MG,32002627,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
WARFARIN(CoumADIN)TAB: 1MG,32002631,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
WARFARIN(COUMadin)TAB: 2MG,32002636,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
WARFARIN(COUMadin)TAB: 3MG,32002637,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
WARFARIN(COUMadin)TAB: 5MG,32002641,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
WARFARIN(CouMADIN)TAB:10MG,32002646,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
WARFARIN(couMADIN)TAB:   2.5MG,32002651,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
WARFARIN(couMADIN)TAB: 7.5MG,32002656,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LOSARTAN(COZAAR)TAB:25MG,32002661,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LOSARTAN POTASSIUM (COZAAR) TAB : 50MG,32002666,CDM,,,250,RC,outpatient,,40.13,40.13,,34.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.03,22,,percent of total billed charges,,,,,,,,,36.12,90,,percent of total billed charges,,,33.23,82.8,,percent of total billed charges,,,34.11,85,,percent of total billed charges,,,,,,,,,35.31,88,,percent of total billed charges,,,,,,,,,30.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.03,22,,percent of total billed charges,,,36.52,91,,percent of total billed charges,,,38.12,95,,percent of total billed charges,,,33.31,83,,percent of total billed charges,,,33.31,83,,percent of total billed charges,,,,,,,,,,,,,,,33.31,83,,percent of total billed charges,,,38.12,95,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,32.91,82,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,34.11,85,,percent of total billed charges,,10.03,38.12,
CROMOLYN (INTAL) DROP : 4% (EYES)  10ML,32002706,CDM,,,250,RC,outpatient,,54.56,54.56,,46.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.64,22,,percent of total billed charges,,,,,,,,,49.1,90,,percent of total billed charges,,,45.18,82.8,,percent of total billed charges,,,46.38,85,,percent of total billed charges,,,,,,,,,48.01,88,,percent of total billed charges,,,,,,,,,41.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.64,22,,percent of total billed charges,,,49.65,91,,percent of total billed charges,,,51.83,95,,percent of total billed charges,,,45.28,83,,percent of total billed charges,,,45.28,83,,percent of total billed charges,,,,,,,,,,,,,,,45.28,83,,percent of total billed charges,,,51.83,95,,percent of total billed charges,,,49.1,90,,percent of total billed charges,,,49.1,90,,percent of total billed charges,,,44.74,82,,percent of total billed charges,,,49.1,90,,percent of total billed charges,,,46.38,85,,percent of total billed charges,,13.64,51.83,
CROMOLYN NA (INTAL) AMP:20MG/2ML U/D,32002711,CDM,J7631,HCPCS,250,RC,outpatient,,90.56,90.56,,76.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.64,22,,percent of total billed charges,,,,,,,,,81.5,90,,percent of total billed charges,,,74.98,82.8,,percent of total billed charges,,,76.98,85,,percent of total billed charges,,,,,,,,,79.69,88,,percent of total billed charges,,1.49,,,,fee schedule,,,69.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.49,,,,fee schedule,,,22.64,22,,percent of total billed charges,,,82.41,91,,percent of total billed charges,,,86.03,95,,percent of total billed charges,,,75.16,83,,percent of total billed charges,,,75.16,83,,percent of total billed charges,,,,,,,,,,,,,,,75.16,83,,percent of total billed charges,,,86.03,95,,percent of total billed charges,,,81.5,90,,percent of total billed charges,,,81.5,90,,percent of total billed charges,,,74.26,82,,percent of total billed charges,,,81.5,90,,percent of total billed charges,,,76.98,85,,percent of total billed charges,,1.49,86.03,
SODTHIO/SOD NIT/AMY NIT(CYANIDE ANTIDT):,32002726,CDM,,,250,RC,outpatient,,2826.54,2826.54,,2399.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,706.64,22,,percent of total billed charges,,,,,,,,,2543.89,90,,percent of total billed charges,,,2340.38,82.8,,percent of total billed charges,,,2402.56,85,,percent of total billed charges,,,,,,,,,2487.36,88,,percent of total billed charges,,,,,,,,,2159.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,706.64,22,,percent of total billed charges,,,2572.15,91,,percent of total billed charges,,,2685.21,95,,percent of total billed charges,,,2346.03,83,,percent of total billed charges,,,2346.03,83,,percent of total billed charges,,,,,,,,,,,,,,,2346.03,83,,percent of total billed charges,,,2685.21,95,,percent of total billed charges,,,2543.89,90,,percent of total billed charges,,,2543.89,90,,percent of total billed charges,,,2317.76,82,,percent of total billed charges,,,2543.89,90,,percent of total billed charges,,,2402.56,85,,percent of total billed charges,,706.64,2685.21,
CYANOCOBALAMINE (VITAMIN B12) VL:1000MCG,32002731,CDM,J3420,HCPCS,636,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,1.95,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.95,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,1.95,60.99,
CYCLOPENTOLATE(CYCLOGYL)DROP 1%:15ML,32002736,CDM,J3490,HCPCS,250,RC,outpatient,,68.2,68.2,,57.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.05,22,,percent of total billed charges,,,,,,,,,61.38,90,,percent of total billed charges,,,56.47,82.8,,percent of total billed charges,,,57.97,85,,percent of total billed charges,,,,,,,,,60.02,88,,percent of total billed charges,,,,,,,,,52.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.05,22,,percent of total billed charges,,,62.06,91,,percent of total billed charges,,,64.79,95,,percent of total billed charges,,,56.61,83,,percent of total billed charges,,,56.61,83,,percent of total billed charges,,,,,,,,,,,,,,,56.61,83,,percent of total billed charges,,,64.79,95,,percent of total billed charges,,,61.38,90,,percent of total billed charges,,,61.38,90,,percent of total billed charges,,,55.92,82,,percent of total billed charges,,,61.38,90,,percent of total billed charges,,,57.97,85,,percent of total billed charges,,17.05,64.79,
CYCLOPENTOLATE (CYCLOGYL) DROP:1%   5ML,32002741,CDM,,,250,RC,outpatient,,777.46,777.46,,660.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,194.37,22,,percent of total billed charges,,,,,,,,,699.71,90,,percent of total billed charges,,,643.74,82.8,,percent of total billed charges,,,660.84,85,,percent of total billed charges,,,,,,,,,684.16,88,,percent of total billed charges,,,,,,,,,593.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,194.37,22,,percent of total billed charges,,,707.49,91,,percent of total billed charges,,,738.59,95,,percent of total billed charges,,,645.29,83,,percent of total billed charges,,,645.29,83,,percent of total billed charges,,,,,,,,,,,,,,,645.29,83,,percent of total billed charges,,,738.59,95,,percent of total billed charges,,,699.71,90,,percent of total billed charges,,,699.71,90,,percent of total billed charges,,,637.52,82,,percent of total billed charges,,,699.71,90,,percent of total billed charges,,,660.84,85,,percent of total billed charges,,194.37,738.59,
CYCLOBENZAPRINE(FLEXERIL)TAB:10MG,32002746,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
medroxyPRO(PROVERA)TAB:2.5MG,32002747,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CYCLOBENZAPRINE(FLEXERIL) TAB:10MG (1x6),32002748,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PHENYL/CYCL(CYCLOMYDRYL)DROP 1%-0.2%:2ML,32002751,CDM,,,250,RC,outpatient,,479.61,479.61,,407.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.9,22,,percent of total billed charges,,,,,,,,,431.65,90,,percent of total billed charges,,,397.12,82.8,,percent of total billed charges,,,407.67,85,,percent of total billed charges,,,,,,,,,422.06,88,,percent of total billed charges,,,,,,,,,366.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.9,22,,percent of total billed charges,,,436.45,91,,percent of total billed charges,,,455.63,95,,percent of total billed charges,,,398.08,83,,percent of total billed charges,,,398.08,83,,percent of total billed charges,,,,,,,,,,,,,,,398.08,83,,percent of total billed charges,,,455.63,95,,percent of total billed charges,,,431.65,90,,percent of total billed charges,,,431.65,90,,percent of total billed charges,,,393.28,82,,percent of total billed charges,,,431.65,90,,percent of total billed charges,,,407.67,85,,percent of total billed charges,,119.9,455.63,
CYPROHEPTADINE(PERIACTIN)TAB:4MG,32002756,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CYCLOPHOSPHAMIDE (CYTOXAN) TAB : 50MG,32002761,CDM,,,250,RC,outpatient,,68.2,68.2,,57.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.05,22,,percent of total billed charges,,,,,,,,,61.38,90,,percent of total billed charges,,,56.47,82.8,,percent of total billed charges,,,57.97,85,,percent of total billed charges,,,,,,,,,60.02,88,,percent of total billed charges,,,,,,,,,52.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.05,22,,percent of total billed charges,,,62.06,91,,percent of total billed charges,,,64.79,95,,percent of total billed charges,,,56.61,83,,percent of total billed charges,,,56.61,83,,percent of total billed charges,,,,,,,,,,,,,,,56.61,83,,percent of total billed charges,,,64.79,95,,percent of total billed charges,,,61.38,90,,percent of total billed charges,,,61.38,90,,percent of total billed charges,,,55.92,82,,percent of total billed charges,,,61.38,90,,percent of total billed charges,,,57.97,85,,percent of total billed charges,,17.05,64.79,
MISOPROSTOL (CYTOTEC) TAB : 200MCG,32002766,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CYCLOPHOSPHAMIDE(CYTOXAN)VIAL:1GM,32002771,CDM,J9070,HCPCS,636,RC,outpatient,,3191.78,3191.78,,2709.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,797.95,22,,percent of total billed charges,,,,,,,,,2872.6,90,,percent of total billed charges,,,2642.79,82.8,,percent of total billed charges,,,2713.01,85,,percent of total billed charges,,,,,,,,,2808.77,88,,percent of total billed charges,,1315.38,,,,fee schedule,,,2438.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1315.38,,,,fee schedule,,,797.95,22,,percent of total billed charges,,,2904.52,91,,percent of total billed charges,,,3032.19,95,,percent of total billed charges,,,2649.18,83,,percent of total billed charges,,,2649.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2649.18,83,,percent of total billed charges,,,3032.19,95,,percent of total billed charges,,,2872.6,90,,percent of total billed charges,,,2872.6,90,,percent of total billed charges,,,2617.26,82,,percent of total billed charges,,,2872.6,90,,percent of total billed charges,,,2713.01,85,,percent of total billed charges,,797.95,3032.19,
MISOPROSTOL(CYTOTEC)TAB:100MCG,32002776,CDM,J8499,HCPCS,250,RC,outpatient,,70.1,70.1,,59.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.53,22,,percent of total billed charges,,,,,,,,,63.09,90,,percent of total billed charges,,,58.04,82.8,,percent of total billed charges,,,59.59,85,,percent of total billed charges,,,,,,,,,61.69,88,,percent of total billed charges,,,,,,,,,53.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.53,22,,percent of total billed charges,,,63.79,91,,percent of total billed charges,,,66.6,95,,percent of total billed charges,,,58.18,83,,percent of total billed charges,,,58.18,83,,percent of total billed charges,,,,,,,,,,,,,,,58.18,83,,percent of total billed charges,,,66.6,95,,percent of total billed charges,,,63.09,90,,percent of total billed charges,,,63.09,90,,percent of total billed charges,,,57.48,82,,percent of total billed charges,,,63.09,90,,percent of total billed charges,,,59.59,85,,percent of total billed charges,,17.53,66.6,
MULTIVITAMINS LIQ  240 ML,32002778,CDM,,,250,RC,outpatient,,64.39,64.39,,54.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.1,22,,percent of total billed charges,,,,,,,,,57.95,90,,percent of total billed charges,,,53.31,82.8,,percent of total billed charges,,,54.73,85,,percent of total billed charges,,,,,,,,,56.66,88,,percent of total billed charges,,,,,,,,,49.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.1,22,,percent of total billed charges,,,58.59,91,,percent of total billed charges,,,61.17,95,,percent of total billed charges,,,53.44,83,,percent of total billed charges,,,53.44,83,,percent of total billed charges,,,,,,,,,,,,,,,53.44,83,,percent of total billed charges,,,61.17,95,,percent of total billed charges,,,57.95,90,,percent of total billed charges,,,57.95,90,,percent of total billed charges,,,52.8,82,,percent of total billed charges,,,57.95,90,,percent of total billed charges,,,54.73,85,,percent of total billed charges,,16.1,61.17,
DANTROLENE(DANTRIUM IV)VIAL:20MG,32002786,CDM,J3490,HCPCS,250,RC,outpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,203.31,22,,percent of total billed charges,,,,,,,,,731.93,90,,percent of total billed charges,,,673.37,82.8,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,203.31,22,,percent of total billed charges,,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,203.31,772.59,
PROPOXY/APAP(DN-100)TAB:100-650MG(1x8),32002790,CDM,,,250,RC,outpatient,,23.47,23.47,,19.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.87,22,,percent of total billed charges,,,,,,,,,21.12,90,,percent of total billed charges,,,19.43,82.8,,percent of total billed charges,,,19.95,85,,percent of total billed charges,,,,,,,,,20.65,88,,percent of total billed charges,,,,,,,,,17.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.87,22,,percent of total billed charges,,,21.36,91,,percent of total billed charges,,,22.3,95,,percent of total billed charges,,,19.48,83,,percent of total billed charges,,,19.48,83,,percent of total billed charges,,,,,,,,,,,,,,,19.48,83,,percent of total billed charges,,,22.3,95,,percent of total billed charges,,,21.12,90,,percent of total billed charges,,,21.12,90,,percent of total billed charges,,,19.25,82,,percent of total billed charges,,,21.12,90,,percent of total billed charges,,,19.95,85,,percent of total billed charges,,5.87,22.3,
PROPOXY/APAP(DARVOCET N)TAB:100-650MG,32002792,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
PROPOXYPHENE(DARVON)CAP:65MG,32002796,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
PENCICLOVIR(DENAVIR)CREAM 1%:1.5GM,32002802,CDM,,,250,RC,outpatient,,1356.1,1356.1,,1151.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,339.03,22,,percent of total billed charges,,,,,,,,,1220.49,90,,percent of total billed charges,,,1122.85,82.8,,percent of total billed charges,,,1152.69,85,,percent of total billed charges,,,,,,,,,1193.37,88,,percent of total billed charges,,,,,,,,,1036.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,339.03,22,,percent of total billed charges,,,1234.05,91,,percent of total billed charges,,,1288.3,95,,percent of total billed charges,,,1125.56,83,,percent of total billed charges,,,1125.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1125.56,83,,percent of total billed charges,,,1288.3,95,,percent of total billed charges,,,1220.49,90,,percent of total billed charges,,,1220.49,90,,percent of total billed charges,,,1112,82,,percent of total billed charges,,,1220.49,90,,percent of total billed charges,,,1152.69,85,,percent of total billed charges,,339.03,1288.3,
SODIUM HYPOCHLOR DAKINS)LIQ:0.25%480ML,32002803,CDM,,,250,RC,outpatient,,157.33,157.33,,133.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.33,22,,percent of total billed charges,,,,,,,,,141.6,90,,percent of total billed charges,,,130.27,82.8,,percent of total billed charges,,,133.73,85,,percent of total billed charges,,,,,,,,,138.45,88,,percent of total billed charges,,,,,,,,,120.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.33,22,,percent of total billed charges,,,143.17,91,,percent of total billed charges,,,149.46,95,,percent of total billed charges,,,130.58,83,,percent of total billed charges,,,130.58,83,,percent of total billed charges,,,,,,,,,,,,,,,130.58,83,,percent of total billed charges,,,149.46,95,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,129.01,82,,percent of total billed charges,,,141.6,90,,percent of total billed charges,,,133.73,85,,percent of total billed charges,,39.33,149.46,
OXAPROZIN(DAYPRO)TAB:600MG,32002806,CDM,,,250,RC,outpatient,,47.58,47.58,,40.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.9,22,,percent of total billed charges,,,,,,,,,42.82,90,,percent of total billed charges,,,39.4,82.8,,percent of total billed charges,,,40.44,85,,percent of total billed charges,,,,,,,,,41.87,88,,percent of total billed charges,,,,,,,,,36.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.9,22,,percent of total billed charges,,,43.3,91,,percent of total billed charges,,,45.2,95,,percent of total billed charges,,,39.49,83,,percent of total billed charges,,,39.49,83,,percent of total billed charges,,,,,,,,,,,,,,,39.49,83,,percent of total billed charges,,,45.2,95,,percent of total billed charges,,,42.82,90,,percent of total billed charges,,,42.82,90,,percent of total billed charges,,,39.02,82,,percent of total billed charges,,,42.82,90,,percent of total billed charges,,,40.44,85,,percent of total billed charges,,11.9,45.2,
DESMOPRESSIN ACETATE(DDAVP)INJ:4MCG/ML,32002807,CDM,J2597,HCPCS,250,RC,outpatient,,503.6,503.6,,427.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125.9,22,,percent of total billed charges,,,,,,,,,453.24,90,,percent of total billed charges,,,416.98,82.8,,percent of total billed charges,,,428.06,85,,percent of total billed charges,,,,,,,,,443.17,88,,percent of total billed charges,,30.44,,,,fee schedule,,,384.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,30.44,,,,fee schedule,,,125.9,22,,percent of total billed charges,,,458.28,91,,percent of total billed charges,,,478.42,95,,percent of total billed charges,,,417.99,83,,percent of total billed charges,,,417.99,83,,percent of total billed charges,,,,,,,,,,,,,,,417.99,83,,percent of total billed charges,,,478.42,95,,percent of total billed charges,,,453.24,90,,percent of total billed charges,,,453.24,90,,percent of total billed charges,,,412.95,82,,percent of total billed charges,,,453.24,90,,percent of total billed charges,,,428.06,85,,percent of total billed charges,,30.44,478.42,
PSEUDOEPHED(SUDAFED)SYRP:30MG/5ML(118ML),32002831,CDM,J8499,HCPCS,250,RC,outpatient,,32.51,32.51,,27.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.13,22,,percent of total billed charges,,,,,,,,,29.26,90,,percent of total billed charges,,,26.92,82.8,,percent of total billed charges,,,27.63,85,,percent of total billed charges,,,,,,,,,28.61,88,,percent of total billed charges,,,,,,,,,24.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.13,22,,percent of total billed charges,,,29.58,91,,percent of total billed charges,,,30.88,95,,percent of total billed charges,,,26.98,83,,percent of total billed charges,,,26.98,83,,percent of total billed charges,,,,,,,,,,,,,,,26.98,83,,percent of total billed charges,,,30.88,95,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,26.66,82,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,27.63,85,,percent of total billed charges,,8.13,30.88,
DEMECLOCYCLIN (DECLOMYCIN)TAB:300MG,32002842,CDM,,,250,RC,outpatient,,191.11,191.11,,162.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.78,22,,percent of total billed charges,,,,,,,,,172,90,,percent of total billed charges,,,158.24,82.8,,percent of total billed charges,,,162.44,85,,percent of total billed charges,,,,,,,,,168.18,88,,percent of total billed charges,,,,,,,,,146.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.78,22,,percent of total billed charges,,,173.91,91,,percent of total billed charges,,,181.55,95,,percent of total billed charges,,,158.62,83,,percent of total billed charges,,,158.62,83,,percent of total billed charges,,,,,,,,,,,,,,,158.62,83,,percent of total billed charges,,,181.55,95,,percent of total billed charges,,,172,90,,percent of total billed charges,,,172,90,,percent of total billed charges,,,156.71,82,,percent of total billed charges,,,172,90,,percent of total billed charges,,,162.44,85,,percent of total billed charges,,47.78,181.55,
DEXTROM POLIS(DELSYM)SUS:30MG/5ML(120ML),32002861,CDM,,,250,RC,outpatient,,100.87,100.87,,85.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.22,22,,percent of total billed charges,,,,,,,,,90.78,90,,percent of total billed charges,,,83.52,82.8,,percent of total billed charges,,,85.74,85,,percent of total billed charges,,,,,,,,,88.77,88,,percent of total billed charges,,,,,,,,,77.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.22,22,,percent of total billed charges,,,91.79,91,,percent of total billed charges,,,95.83,95,,percent of total billed charges,,,83.72,83,,percent of total billed charges,,,83.72,83,,percent of total billed charges,,,,,,,,,,,,,,,83.72,83,,percent of total billed charges,,,95.83,95,,percent of total billed charges,,,90.78,90,,percent of total billed charges,,,90.78,90,,percent of total billed charges,,,82.71,82,,percent of total billed charges,,,90.78,90,,percent of total billed charges,,,85.74,85,,percent of total billed charges,,25.22,95.83,
TORSEMIDE (DEMEDEX) TAB : 20MG,32002862,CDM,,,250,RC,outpatient,,18.71,18.71,,15.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.68,22,,percent of total billed charges,,,,,,,,,16.84,90,,percent of total billed charges,,,15.49,82.8,,percent of total billed charges,,,15.9,85,,percent of total billed charges,,,,,,,,,16.46,88,,percent of total billed charges,,,,,,,,,14.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.68,22,,percent of total billed charges,,,17.03,91,,percent of total billed charges,,,17.77,95,,percent of total billed charges,,,15.53,83,,percent of total billed charges,,,15.53,83,,percent of total billed charges,,,,,,,,,,,,,,,15.53,83,,percent of total billed charges,,,17.77,95,,percent of total billed charges,,,16.84,90,,percent of total billed charges,,,16.84,90,,percent of total billed charges,,,15.34,82,,percent of total billed charges,,,16.84,90,,percent of total billed charges,,,15.9,85,,percent of total billed charges,,4.68,17.77,
TORSEMIDE(DEMADEX)TAB:10MG,32002863,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DIVaLproex(DEPAkote DR)TAB:250MG,32002896,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DIVALPROEX (DEPAKOTE DR) TAB : 125MG,32002897,CDM,,,250,RC,outpatient,,15.86,15.86,,13.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.97,22,,percent of total billed charges,,,,,,,,,14.27,90,,percent of total billed charges,,,13.13,82.8,,percent of total billed charges,,,13.48,85,,percent of total billed charges,,,,,,,,,13.96,88,,percent of total billed charges,,,,,,,,,12.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.97,22,,percent of total billed charges,,,14.43,91,,percent of total billed charges,,,15.07,95,,percent of total billed charges,,,13.16,83,,percent of total billed charges,,,13.16,83,,percent of total billed charges,,,,,,,,,,,,,,,13.16,83,,percent of total billed charges,,,15.07,95,,percent of total billed charges,,,14.27,90,,percent of total billed charges,,,14.27,90,,percent of total billed charges,,,13.01,82,,percent of total billed charges,,,14.27,90,,percent of total billed charges,,,13.48,85,,percent of total billed charges,,3.97,15.07,
medroxyPRO(DEPOPROVERA)*IM*VIAL:150MG/ML,32002906,CDM,J1050,HCPCS,250,RC,outpatient,,352.62,352.62,,299.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.16,22,,percent of total billed charges,,,,,,,,,317.36,90,,percent of total billed charges,,,291.97,82.8,,percent of total billed charges,,,299.73,85,,percent of total billed charges,,,,,,,,,310.31,88,,percent of total billed charges,,165.1,,,,fee schedule,,,269.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,165.1,,,,fee schedule,,,88.16,22,,percent of total billed charges,,,320.88,91,,percent of total billed charges,,,334.99,95,,percent of total billed charges,,,292.67,83,,percent of total billed charges,,,292.67,83,,percent of total billed charges,,,,,,,,,,,,,,,292.67,83,,percent of total billed charges,,,334.99,95,,percent of total billed charges,,,317.36,90,,percent of total billed charges,,,317.36,90,,percent of total billed charges,,,289.15,82,,percent of total billed charges,,,317.36,90,,percent of total billed charges,,,299.73,85,,percent of total billed charges,,88.16,334.99,
methylPRED(DEPO-MEDROL)*IM* VIAL:40MG/ML,32002911,CDM,J1030,HCPCS,250,RC,outpatient,,151.15,151.15,,128.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.79,22,,percent of total billed charges,,,,,,,,,136.04,90,,percent of total billed charges,,,125.15,82.8,,percent of total billed charges,,,128.48,85,,percent of total billed charges,,,,,,,,,133.01,88,,percent of total billed charges,,29.81,,,,fee schedule,,,115.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,29.81,,,,fee schedule,,,37.79,22,,percent of total billed charges,,,137.55,91,,percent of total billed charges,,,143.59,95,,percent of total billed charges,,,125.45,83,,percent of total billed charges,,,125.45,83,,percent of total billed charges,,,,,,,,,,,,,,,125.45,83,,percent of total billed charges,,,143.59,95,,percent of total billed charges,,,136.04,90,,percent of total billed charges,,,136.04,90,,percent of total billed charges,,,123.94,82,,percent of total billed charges,,,136.04,90,,percent of total billed charges,,,128.48,85,,percent of total billed charges,,29.81,143.59,
BENZOCAI/LANOLIN(DERMOPLAST)AER20%:85G,32002916,CDM,J3490,HCPCS,250,RC,outpatient,,83.5,83.5,,70.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.88,22,,percent of total billed charges,,,,,,,,,75.15,90,,percent of total billed charges,,,69.14,82.8,,percent of total billed charges,,,70.98,85,,percent of total billed charges,,,,,,,,,73.48,88,,percent of total billed charges,,,,,,,,,63.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.88,22,,percent of total billed charges,,,75.99,91,,percent of total billed charges,,,79.33,95,,percent of total billed charges,,,69.31,83,,percent of total billed charges,,,69.31,83,,percent of total billed charges,,,,,,,,,,,,,,,69.31,83,,percent of total billed charges,,,79.33,95,,percent of total billed charges,,,75.15,90,,percent of total billed charges,,,75.15,90,,percent of total billed charges,,,68.47,82,,percent of total billed charges,,,75.15,90,,percent of total billed charges,,,70.98,85,,percent of total billed charges,,20.88,79.33,
DEFEROXAMINE MESYLT (DESFERAL)VIAL:500MG,32002921,CDM,J0895,HCPCS,636,RC,outpatient,,195.99,195.99,,166.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49,22,,percent of total billed charges,,,,,,,,,176.39,90,,percent of total billed charges,,,162.28,82.8,,percent of total billed charges,,,166.59,85,,percent of total billed charges,,,,,,,,,172.47,88,,percent of total billed charges,,31.71,,,,fee schedule,,,149.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,31.71,,,,fee schedule,,,49,22,,percent of total billed charges,,,178.35,91,,percent of total billed charges,,,186.19,95,,percent of total billed charges,,,162.67,83,,percent of total billed charges,,,162.67,83,,percent of total billed charges,,,,,,,,,,,,,,,162.67,83,,percent of total billed charges,,,186.19,95,,percent of total billed charges,,,176.39,90,,percent of total billed charges,,,176.39,90,,percent of total billed charges,,,160.71,82,,percent of total billed charges,,,176.39,90,,percent of total billed charges,,,166.59,85,,percent of total billed charges,,31.71,186.19,
DESIPRAMINE(NORPRAMINE)TAB:50MG,32002926,CDM,,,250,RC,outpatient,,45.68,45.68,,38.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.42,22,,percent of total billed charges,,,,,,,,,41.11,90,,percent of total billed charges,,,37.82,82.8,,percent of total billed charges,,,38.83,85,,percent of total billed charges,,,,,,,,,40.2,88,,percent of total billed charges,,,,,,,,,34.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.42,22,,percent of total billed charges,,,41.57,91,,percent of total billed charges,,,43.4,95,,percent of total billed charges,,,37.91,83,,percent of total billed charges,,,37.91,83,,percent of total billed charges,,,,,,,,,,,,,,,37.91,83,,percent of total billed charges,,,43.4,95,,percent of total billed charges,,,41.11,90,,percent of total billed charges,,,41.11,90,,percent of total billed charges,,,37.46,82,,percent of total billed charges,,,41.11,90,,percent of total billed charges,,,38.83,85,,percent of total billed charges,,11.42,43.4,
DESONIDE 0.05%,32002947,CDM,,,250,RC,outpatient,,37,37,,31.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.25,22,,percent of total billed charges,,,,,,,,,33.3,90,,percent of total billed charges,,,30.64,82.8,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,,,,,,,,32.56,88,,percent of total billed charges,,,,,,,,,28.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.25,22,,percent of total billed charges,,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,30.34,82,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,9.25,35.15,
DESMOPRESSIN ACETATE(DDAVP)SPR:0.1MG/ML,32002948,CDM,,,250,RC,outpatient,,2780.2,2780.2,,2360.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,695.05,22,,percent of total billed charges,,,,,,,,,2502.18,90,,percent of total billed charges,,,2302.01,82.8,,percent of total billed charges,,,2363.17,85,,percent of total billed charges,,,,,,,,,2446.58,88,,percent of total billed charges,,,,,,,,,2124.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,695.05,22,,percent of total billed charges,,,2529.98,91,,percent of total billed charges,,,2641.19,95,,percent of total billed charges,,,2307.57,83,,percent of total billed charges,,,2307.57,83,,percent of total billed charges,,,,,,,,,,,,,,,2307.57,83,,percent of total billed charges,,,2641.19,95,,percent of total billed charges,,,2502.18,90,,percent of total billed charges,,,2502.18,90,,percent of total billed charges,,,2279.76,82,,percent of total billed charges,,,2502.18,90,,percent of total billed charges,,,2363.17,85,,percent of total billed charges,,695.05,2641.19,
DESOXIMETASONE CREAM (TOPICORT) : 0.25%,32002956,CDM,,,250,RC,outpatient,,683.72,683.72,,580.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,170.93,22,,percent of total billed charges,,,,,,,,,615.35,90,,percent of total billed charges,,,566.12,82.8,,percent of total billed charges,,,581.16,85,,percent of total billed charges,,,,,,,,,601.67,88,,percent of total billed charges,,,,,,,,,522.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,170.93,22,,percent of total billed charges,,,622.19,91,,percent of total billed charges,,,649.53,95,,percent of total billed charges,,,567.49,83,,percent of total billed charges,,,567.49,83,,percent of total billed charges,,,,,,,,,,,,,,,567.49,83,,percent of total billed charges,,,649.53,95,,percent of total billed charges,,,615.35,90,,percent of total billed charges,,,615.35,90,,percent of total billed charges,,,560.65,82,,percent of total billed charges,,,615.35,90,,percent of total billed charges,,,581.16,85,,percent of total billed charges,,170.93,649.53,
TOLTERODINE TARTRATE (DETROL) TAB : 1MG,32002957,CDM,,,250,RC,outpatient,,100.55,100.55,,85.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.14,22,,percent of total billed charges,,,,,,,,,90.5,90,,percent of total billed charges,,,83.26,82.8,,percent of total billed charges,,,85.47,85,,percent of total billed charges,,,,,,,,,88.48,88,,percent of total billed charges,,,,,,,,,76.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.14,22,,percent of total billed charges,,,91.5,91,,percent of total billed charges,,,95.52,95,,percent of total billed charges,,,83.46,83,,percent of total billed charges,,,83.46,83,,percent of total billed charges,,,,,,,,,,,,,,,83.46,83,,percent of total billed charges,,,95.52,95,,percent of total billed charges,,,90.5,90,,percent of total billed charges,,,90.5,90,,percent of total billed charges,,,82.45,82,,percent of total billed charges,,,90.5,90,,percent of total billed charges,,,85.47,85,,percent of total billed charges,,25.14,95.52,
TOLTERODINE (DETROL) TAB : 2MG,32002958,CDM,,,250,RC,outpatient,,103.25,103.25,,87.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.81,22,,percent of total billed charges,,,,,,,,,92.93,90,,percent of total billed charges,,,85.49,82.8,,percent of total billed charges,,,87.76,85,,percent of total billed charges,,,,,,,,,90.86,88,,percent of total billed charges,,,,,,,,,78.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.81,22,,percent of total billed charges,,,93.96,91,,percent of total billed charges,,,98.09,95,,percent of total billed charges,,,85.7,83,,percent of total billed charges,,,85.7,83,,percent of total billed charges,,,,,,,,,,,,,,,85.7,83,,percent of total billed charges,,,98.09,95,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,84.67,82,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,87.76,85,,percent of total billed charges,,25.81,98.09,
DEXAMETHASONE(DECADRON)TAB:4MG,32002961,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DEXAMETHASONE TAB (DECADRON): 0.5MG,32002966,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
DEXAMETHASONE VIAL **PF**:10MG/ML,32002972,CDM,J1100,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,5,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,5,60.99,
DEXAMETHASONE(DECADRON)VIAL:4MG/ML  **,32002981,CDM,J1100,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,5,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,5,60.99,
DEXAMETHASONE (DECADRON) TAB : 0.75MG,32002986,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
DEXAMETHASONE (DECADRON) TAB : 2MG,32002993,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
DEXEDRINE 5MG TABLETS,32002997,CDM,,,250,RC,outpatient,,1,1,,0.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.25,22,,percent of total billed charges,,,,,,,,,0.9,90,,percent of total billed charges,,,0.83,82.8,,percent of total billed charges,,,0.85,85,,percent of total billed charges,,,,,,,,,0.88,88,,percent of total billed charges,,,,,,,,,0.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.25,22,,percent of total billed charges,,,0.91,91,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,,,,,,,,,,,,,0.83,83,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.82,82,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.85,85,,percent of total billed charges,,0.25,0.95,
DEXTROSE 50%-WATER SYR:50ML,32003001,CDM,J3490,HCPCS,250,RC,outpatient,,225.33,225.33,,191.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.33,22,,percent of total billed charges,,,,,,,,,202.8,90,,percent of total billed charges,,,186.57,82.8,,percent of total billed charges,,,191.53,85,,percent of total billed charges,,,,,,,,,198.29,88,,percent of total billed charges,,,,,,,,,172.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.33,22,,percent of total billed charges,,,205.05,91,,percent of total billed charges,,,214.06,95,,percent of total billed charges,,,187.02,83,,percent of total billed charges,,,187.02,83,,percent of total billed charges,,,,,,,,,,,,,,,187.02,83,,percent of total billed charges,,,214.06,95,,percent of total billed charges,,,202.8,90,,percent of total billed charges,,,202.8,90,,percent of total billed charges,,,184.77,82,,percent of total billed charges,,,202.8,90,,percent of total billed charges,,,191.53,85,,percent of total billed charges,,56.33,214.06,
DIHYDROERGOTAMINE(DHE)AMP:1MG/ML,32003006,CDM,J1110,HCPCS,636,RC,outpatient,,939.04,939.04,,797.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,234.76,22,,percent of total billed charges,,,,,,,,,845.14,90,,percent of total billed charges,,,777.53,82.8,,percent of total billed charges,,,798.18,85,,percent of total billed charges,,,,,,,,,826.36,88,,percent of total billed charges,,174.3,,,,fee schedule,,,717.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,174.3,,,,fee schedule,,,234.76,22,,percent of total billed charges,,,854.53,91,,percent of total billed charges,,,892.09,95,,percent of total billed charges,,,779.4,83,,percent of total billed charges,,,779.4,83,,percent of total billed charges,,,,,,,,,,,,,,,779.4,83,,percent of total billed charges,,,892.09,95,,percent of total billed charges,,,845.14,90,,percent of total billed charges,,,845.14,90,,percent of total billed charges,,,770.01,82,,percent of total billed charges,,,845.14,90,,percent of total billed charges,,,798.18,85,,percent of total billed charges,,174.3,892.09,
ACETAZOLAMIDE (DIAMOX) TAB : 250MG,32003021,CDM,J8499,HCPCS,250,RC,outpatient,,18.3,18.3,,15.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.58,22,,percent of total billed charges,,,,,,,,,16.47,90,,percent of total billed charges,,,15.15,82.8,,percent of total billed charges,,,15.56,85,,percent of total billed charges,,,,,,,,,16.1,88,,percent of total billed charges,,,,,,,,,13.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.58,22,,percent of total billed charges,,,16.65,91,,percent of total billed charges,,,17.39,95,,percent of total billed charges,,,15.19,83,,percent of total billed charges,,,15.19,83,,percent of total billed charges,,,,,,,,,,,,,,,15.19,83,,percent of total billed charges,,,17.39,95,,percent of total billed charges,,,16.47,90,,percent of total billed charges,,,16.47,90,,percent of total billed charges,,,15.01,82,,percent of total billed charges,,,16.47,90,,percent of total billed charges,,,15.56,85,,percent of total billed charges,,4.58,17.39,
acetaZOLAMIDE(DIAMOX SEQUEL)ER CAP:500MG,32003022,CDM,J8499,HCPCS,250,RC,outpatient,,70.26,70.26,,59.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.57,22,,percent of total billed charges,,,,,,,,,63.23,90,,percent of total billed charges,,,58.18,82.8,,percent of total billed charges,,,59.72,85,,percent of total billed charges,,,,,,,,,61.83,88,,percent of total billed charges,,,,,,,,,53.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.57,22,,percent of total billed charges,,,63.94,91,,percent of total billed charges,,,66.75,95,,percent of total billed charges,,,58.32,83,,percent of total billed charges,,,58.32,83,,percent of total billed charges,,,,,,,,,,,,,,,58.32,83,,percent of total billed charges,,,66.75,95,,percent of total billed charges,,,63.23,90,,percent of total billed charges,,,63.23,90,,percent of total billed charges,,,57.61,82,,percent of total billed charges,,,63.23,90,,percent of total billed charges,,,59.72,85,,percent of total billed charges,,17.57,66.75,
acetaZOLAMIDE(DIAMOX)VIAL:500MG,32003026,CDM,J1120,HCPCS,250,RC,outpatient,,222.39,222.39,,188.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.6,22,,percent of total billed charges,,,,,,,,,200.15,90,,percent of total billed charges,,,184.14,82.8,,percent of total billed charges,,,189.03,85,,percent of total billed charges,,,,,,,,,195.7,88,,percent of total billed charges,,22.49,,,,fee schedule,,,169.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,22.49,,,,fee schedule,,,55.6,22,,percent of total billed charges,,,202.37,91,,percent of total billed charges,,,211.27,95,,percent of total billed charges,,,184.58,83,,percent of total billed charges,,,184.58,83,,percent of total billed charges,,,,,,,,,,,,,,,184.58,83,,percent of total billed charges,,,211.27,95,,percent of total billed charges,,,200.15,90,,percent of total billed charges,,,200.15,90,,percent of total billed charges,,,182.36,82,,percent of total billed charges,,,200.15,90,,percent of total billed charges,,,189.03,85,,percent of total billed charges,,22.49,211.27,
COD LIVR/ZNOX(DIAPER RSH)OINT 40%:120GM,32003031,CDM,,,250,RC,outpatient,,31.56,31.56,,26.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.89,22,,percent of total billed charges,,,,,,,,,28.4,90,,percent of total billed charges,,,26.13,82.8,,percent of total billed charges,,,26.83,85,,percent of total billed charges,,,,,,,,,27.77,88,,percent of total billed charges,,,,,,,,,24.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.89,22,,percent of total billed charges,,,28.72,91,,percent of total billed charges,,,29.98,95,,percent of total billed charges,,,26.19,83,,percent of total billed charges,,,26.19,83,,percent of total billed charges,,,,,,,,,,,,,,,26.19,83,,percent of total billed charges,,,29.98,95,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,25.88,82,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,26.83,85,,percent of total billed charges,,7.89,29.98,
DIAZEPAM(VALIUM)SYR:10MG/2ML,32003036,CDM,J3360,HCPCS,250,RC,outpatient,,433.5,433.5,,368.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.38,22,,percent of total billed charges,,,,,,,,,390.15,90,,percent of total billed charges,,,358.94,82.8,,percent of total billed charges,,,368.48,85,,percent of total billed charges,,,,,,,,,381.48,88,,percent of total billed charges,,26.31,,,,fee schedule,,,331.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,26.31,,,,fee schedule,,,108.38,22,,percent of total billed charges,,,394.49,91,,percent of total billed charges,,,411.83,95,,percent of total billed charges,,,359.81,83,,percent of total billed charges,,,359.81,83,,percent of total billed charges,,,,,,,,,,,,,,,359.81,83,,percent of total billed charges,,,411.83,95,,percent of total billed charges,,,390.15,90,,percent of total billed charges,,,390.15,90,,percent of total billed charges,,,355.47,82,,percent of total billed charges,,,390.15,90,,percent of total billed charges,,,368.48,85,,percent of total billed charges,,26.31,411.83,
DIAZEPAM(VALIUM)TAB:2MG,32003041,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
DIAZEPAM(VALIUM)TAB:5MG,32003046,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
DIBUCAINE (NUPERCAINAL) OINT : 1% 30 GM,32003056,CDM,,,250,RC,outpatient,,51.07,51.07,,43.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.77,22,,percent of total billed charges,,,,,,,,,45.96,90,,percent of total billed charges,,,42.29,82.8,,percent of total billed charges,,,43.41,85,,percent of total billed charges,,,,,,,,,44.94,88,,percent of total billed charges,,,,,,,,,39.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.77,22,,percent of total billed charges,,,46.47,91,,percent of total billed charges,,,48.52,95,,percent of total billed charges,,,42.39,83,,percent of total billed charges,,,42.39,83,,percent of total billed charges,,,,,,,,,,,,,,,42.39,83,,percent of total billed charges,,,48.52,95,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,41.88,82,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,43.41,85,,percent of total billed charges,,12.77,48.52,
DICLOXACILLIN(DYNAPEN)CAP:250MG,32003061,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
DICYCLOMINE(BENTYL)AMP:20MG/2ML,32003066,CDM,J0500,HCPCS,250,RC,outpatient,,622.23,622.23,,528.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,155.56,22,,percent of total billed charges,,,,,,,,,560.01,90,,percent of total billed charges,,,515.21,82.8,,percent of total billed charges,,,528.9,85,,percent of total billed charges,,,,,,,,,547.56,88,,percent of total billed charges,,25.64,,,,fee schedule,,,475.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,25.64,,,,fee schedule,,,155.56,22,,percent of total billed charges,,,566.23,91,,percent of total billed charges,,,591.12,95,,percent of total billed charges,,,516.45,83,,percent of total billed charges,,,516.45,83,,percent of total billed charges,,,,,,,,,,,,,,,516.45,83,,percent of total billed charges,,,591.12,95,,percent of total billed charges,,,560.01,90,,percent of total billed charges,,,560.01,90,,percent of total billed charges,,,510.23,82,,percent of total billed charges,,,560.01,90,,percent of total billed charges,,,528.9,85,,percent of total billed charges,,25.64,591.12,
ETIDRONATE DISODIUM (DIDRONEL) TAB:200MG,32003071,CDM,,,250,RC,outpatient,,56.46,56.46,,47.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.12,22,,percent of total billed charges,,,,,,,,,50.81,90,,percent of total billed charges,,,46.75,82.8,,percent of total billed charges,,,47.99,85,,percent of total billed charges,,,,,,,,,49.68,88,,percent of total billed charges,,,,,,,,,43.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.12,22,,percent of total billed charges,,,51.38,91,,percent of total billed charges,,,53.64,95,,percent of total billed charges,,,46.86,83,,percent of total billed charges,,,46.86,83,,percent of total billed charges,,,,,,,,,,,,,,,46.86,83,,percent of total billed charges,,,53.64,95,,percent of total billed charges,,,50.81,90,,percent of total billed charges,,,50.81,90,,percent of total billed charges,,,46.3,82,,percent of total billed charges,,,50.81,90,,percent of total billed charges,,,47.99,85,,percent of total billed charges,,14.12,53.64,
DIETHYLSTILBESTROL (DES),32003076,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
FLUCONAZOLE(DIFLUCAN)TAB:100MG,32003081,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DIFLUNISAL(DOLOBID)TAB:500MG,32003086,CDM,J8499,HCPCS,250,RC,outpatient,,14.27,14.27,,12.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.57,22,,percent of total billed charges,,,,,,,,,12.84,90,,percent of total billed charges,,,11.82,82.8,,percent of total billed charges,,,12.13,85,,percent of total billed charges,,,,,,,,,12.56,88,,percent of total billed charges,,,,,,,,,10.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.57,22,,percent of total billed charges,,,12.99,91,,percent of total billed charges,,,13.56,95,,percent of total billed charges,,,11.84,83,,percent of total billed charges,,,11.84,83,,percent of total billed charges,,,,,,,,,,,,,,,11.84,83,,percent of total billed charges,,,13.56,95,,percent of total billed charges,,,12.84,90,,percent of total billed charges,,,12.84,90,,percent of total billed charges,,,11.7,82,,percent of total billed charges,,,12.84,90,,percent of total billed charges,,,12.13,85,,percent of total billed charges,,3.57,13.56,
DIGOXIN IMMUNE FAB(DIGIFAB)VIAL:40MG,32003091,CDM,J1162,HCPCS,636,RC,outpatient,,18397.26,18397.26,,15619.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4599.32,22,,percent of total billed charges,,,,,,,,,16557.53,90,,percent of total billed charges,,,15232.93,82.8,,percent of total billed charges,,,15637.67,85,,percent of total billed charges,,,,,,,,,16189.59,88,,percent of total billed charges,,85881.64,,,,fee schedule,,,14055.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,85881.64,,,,fee schedule,,,4599.32,22,,percent of total billed charges,,,16741.51,91,,percent of total billed charges,,,17477.4,95,,percent of total billed charges,,,15269.73,83,,percent of total billed charges,,,15269.73,83,,percent of total billed charges,,,,,,,,,,,,,,,15269.73,83,,percent of total billed charges,,,17477.4,95,,percent of total billed charges,,,16557.53,90,,percent of total billed charges,,,16557.53,90,,percent of total billed charges,,,15085.75,82,,percent of total billed charges,,,16557.53,90,,percent of total billed charges,,,15637.67,85,,percent of total billed charges,,4599.32,85881.64,
DIGOXIN ELIX(LANOXIN):50MCG/ML (60ML),32003096,CDM,J8499,HCPCS,250,RC,outpatient,,1688.62,1688.62,,1433.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,422.16,22,,percent of total billed charges,,,,,,,,,1519.76,90,,percent of total billed charges,,,1398.18,82.8,,percent of total billed charges,,,1435.33,85,,percent of total billed charges,,,,,,,,,1485.99,88,,percent of total billed charges,,,,,,,,,1290.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,422.16,22,,percent of total billed charges,,,1536.64,91,,percent of total billed charges,,,1604.19,95,,percent of total billed charges,,,1401.55,83,,percent of total billed charges,,,1401.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1401.55,83,,percent of total billed charges,,,1604.19,95,,percent of total billed charges,,,1519.76,90,,percent of total billed charges,,,1519.76,90,,percent of total billed charges,,,1384.67,82,,percent of total billed charges,,,1519.76,90,,percent of total billed charges,,,1435.33,85,,percent of total billed charges,,422.16,1604.19,
guaiFENesin/PEPH(ROBTUSSN DAC)SYRP:120ML,32003101,CDM,,,250,RC,outpatient,,25.5,25.5,,21.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.38,22,,percent of total billed charges,,,,,,,,,22.95,90,,percent of total billed charges,,,21.11,82.8,,percent of total billed charges,,,21.68,85,,percent of total billed charges,,,,,,,,,22.44,88,,percent of total billed charges,,,,,,,,,19.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.38,22,,percent of total billed charges,,,23.21,91,,percent of total billed charges,,,24.23,95,,percent of total billed charges,,,21.17,83,,percent of total billed charges,,,21.17,83,,percent of total billed charges,,,,,,,,,,,,,,,21.17,83,,percent of total billed charges,,,24.23,95,,percent of total billed charges,,,22.95,90,,percent of total billed charges,,,22.95,90,,percent of total billed charges,,,20.91,82,,percent of total billed charges,,,22.95,90,,percent of total billed charges,,,21.68,85,,percent of total billed charges,,6.38,24.23,
GUAIFN/PEPH(ROBITUSSIN DAC) SYRP:  90ML,32003106,CDM,,,250,RC,outpatient,,666.12,666.12,,565.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.53,22,,percent of total billed charges,,,,,,,,,599.51,90,,percent of total billed charges,,,551.55,82.8,,percent of total billed charges,,,566.2,85,,percent of total billed charges,,,,,,,,,586.19,88,,percent of total billed charges,,,,,,,,,508.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.53,22,,percent of total billed charges,,,606.17,91,,percent of total billed charges,,,632.81,95,,percent of total billed charges,,,552.88,83,,percent of total billed charges,,,552.88,83,,percent of total billed charges,,,,,,,,,,,,,,,552.88,83,,percent of total billed charges,,,632.81,95,,percent of total billed charges,,,599.51,90,,percent of total billed charges,,,599.51,90,,percent of total billed charges,,,546.22,82,,percent of total billed charges,,,599.51,90,,percent of total billed charges,,,566.2,85,,percent of total billed charges,,166.53,632.81,
GUAIFN/PEPH(ROBITUSSIN DAC) SYRP:   60ML,32003111,CDM,,,250,RC,outpatient,,12.75,12.75,,10.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.19,22,,percent of total billed charges,,,,,,,,,11.48,90,,percent of total billed charges,,,10.56,82.8,,percent of total billed charges,,,10.84,85,,percent of total billed charges,,,,,,,,,11.22,88,,percent of total billed charges,,,,,,,,,9.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.19,22,,percent of total billed charges,,,11.6,91,,percent of total billed charges,,,12.11,95,,percent of total billed charges,,,10.58,83,,percent of total billed charges,,,10.58,83,,percent of total billed charges,,,,,,,,,,,,,,,10.58,83,,percent of total billed charges,,,12.11,95,,percent of total billed charges,,,11.48,90,,percent of total billed charges,,,11.48,90,,percent of total billed charges,,,10.46,82,,percent of total billed charges,,,11.48,90,,percent of total billed charges,,,10.84,85,,percent of total billed charges,,3.19,12.11,
PHENYTOIN(DILANTIN)ORAL : 125MG/5ML 60ML,32003116,CDM,,,250,RC,outpatient,,46,46,,39.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.5,22,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,38.09,82.8,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,,,,,,,,40.48,88,,percent of total billed charges,,,,,,,,,35.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.5,22,,percent of total billed charges,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,37.72,82,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,11.5,43.7,
PHENYTOIN(DILANTIN)ORAL:125MG/5ML(237ML),32003121,CDM,J8499,HCPCS,250,RC,outpatient,,454.23,454.23,,385.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,113.56,22,,percent of total billed charges,,,,,,,,,408.81,90,,percent of total billed charges,,,376.1,82.8,,percent of total billed charges,,,386.1,85,,percent of total billed charges,,,,,,,,,399.72,88,,percent of total billed charges,,,,,,,,,347.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,113.56,22,,percent of total billed charges,,,413.35,91,,percent of total billed charges,,,431.52,95,,percent of total billed charges,,,377.01,83,,percent of total billed charges,,,377.01,83,,percent of total billed charges,,,,,,,,,,,,,,,377.01,83,,percent of total billed charges,,,431.52,95,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,372.47,82,,percent of total billed charges,,,408.81,90,,percent of total billed charges,,,386.1,85,,percent of total billed charges,,113.56,431.52,
PHENYTOIN(DILANTIN) ER CAP:100MG,32003126,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
VALSARTN/HCTZ (DIOVAN)TAB: 160-12.5MG,32003152,CDM,,,250,RC,outpatient,,63.28,63.28,,53.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.82,22,,percent of total billed charges,,,,,,,,,56.95,90,,percent of total billed charges,,,52.4,82.8,,percent of total billed charges,,,53.79,85,,percent of total billed charges,,,,,,,,,55.69,88,,percent of total billed charges,,,,,,,,,48.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.82,22,,percent of total billed charges,,,57.58,91,,percent of total billed charges,,,60.12,95,,percent of total billed charges,,,52.52,83,,percent of total billed charges,,,52.52,83,,percent of total billed charges,,,,,,,,,,,,,,,52.52,83,,percent of total billed charges,,,60.12,95,,percent of total billed charges,,,56.95,90,,percent of total billed charges,,,56.95,90,,percent of total billed charges,,,51.89,82,,percent of total billed charges,,,56.95,90,,percent of total billed charges,,,53.79,85,,percent of total billed charges,,15.82,60.12,
PHENYTOIN(DILANTIN) IR CHEW TAB:50MG,32003156,CDM,J8499,HCPCS,250,RC,outpatient,,16.97,16.97,,14.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.24,22,,percent of total billed charges,,,,,,,,,15.27,90,,percent of total billed charges,,,14.05,82.8,,percent of total billed charges,,,14.42,85,,percent of total billed charges,,,,,,,,,14.93,88,,percent of total billed charges,,,,,,,,,12.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.24,22,,percent of total billed charges,,,15.44,91,,percent of total billed charges,,,16.12,95,,percent of total billed charges,,,14.09,83,,percent of total billed charges,,,14.09,83,,percent of total billed charges,,,,,,,,,,,,,,,14.09,83,,percent of total billed charges,,,16.12,95,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,13.92,82,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,14.42,85,,percent of total billed charges,,4.24,16.12,
DILTIAZEM HCL SR CAP : 60MG,32003166,CDM,,,250,RC,outpatient,,43.14,43.14,,36.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.79,22,,percent of total billed charges,,,,,,,,,38.83,90,,percent of total billed charges,,,35.72,82.8,,percent of total billed charges,,,36.67,85,,percent of total billed charges,,,,,,,,,37.96,88,,percent of total billed charges,,,,,,,,,32.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.79,22,,percent of total billed charges,,,39.26,91,,percent of total billed charges,,,40.98,95,,percent of total billed charges,,,35.81,83,,percent of total billed charges,,,35.81,83,,percent of total billed charges,,,,,,,,,,,,,,,35.81,83,,percent of total billed charges,,,40.98,95,,percent of total billed charges,,,38.83,90,,percent of total billed charges,,,38.83,90,,percent of total billed charges,,,35.37,82,,percent of total billed charges,,,38.83,90,,percent of total billed charges,,,36.67,85,,percent of total billed charges,,10.79,40.98,
DILTIAZEM(CARDIZEM)TAB:30MG,32003171,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DILTIAZEM (CARDIZEM) TAB : 60MG,32003176,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PPA HCL/BROMPHENIR(DIMETAPP)ELIX:118ML,32003186,CDM,,,250,RC,outpatient,,14.27,14.27,,12.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.57,22,,percent of total billed charges,,,,,,,,,12.84,90,,percent of total billed charges,,,11.82,82.8,,percent of total billed charges,,,12.13,85,,percent of total billed charges,,,,,,,,,12.56,88,,percent of total billed charges,,,,,,,,,10.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.57,22,,percent of total billed charges,,,12.99,91,,percent of total billed charges,,,13.56,95,,percent of total billed charges,,,11.84,83,,percent of total billed charges,,,11.84,83,,percent of total billed charges,,,,,,,,,,,,,,,11.84,83,,percent of total billed charges,,,13.56,95,,percent of total billed charges,,,12.84,90,,percent of total billed charges,,,12.84,90,,percent of total billed charges,,,11.7,82,,percent of total billed charges,,,12.84,90,,percent of total billed charges,,,12.13,85,,percent of total billed charges,,3.57,13.56,
PPA HCL/BROMPHENIRAMIN(DIMETAPP)ELIX60ML,32003191,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PPA HCL/BROMPHENIRA(DIMETAPP) ELIX 90ML,32003196,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CASANTHRAN/DOCU(DIOCTO-C)SYRP:30-60MG/15,32003201,CDM,,,250,RC,outpatient,,53.29,53.29,,45.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.32,22,,percent of total billed charges,,,,,,,,,47.96,90,,percent of total billed charges,,,44.12,82.8,,percent of total billed charges,,,45.3,85,,percent of total billed charges,,,,,,,,,46.9,88,,percent of total billed charges,,,,,,,,,40.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.32,22,,percent of total billed charges,,,48.49,91,,percent of total billed charges,,,50.63,95,,percent of total billed charges,,,44.23,83,,percent of total billed charges,,,44.23,83,,percent of total billed charges,,,,,,,,,,,,,,,44.23,83,,percent of total billed charges,,,50.63,95,,percent of total billed charges,,,47.96,90,,percent of total billed charges,,,47.96,90,,percent of total billed charges,,,43.7,82,,percent of total billed charges,,,47.96,90,,percent of total billed charges,,,45.3,85,,percent of total billed charges,,13.32,50.63,
CASANTHRAN/DOCU(DIOCTO-C)SYRP:30-60MG/15,32003206,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CASANTHRAN/DOCU(DIOCTO-C)SYRP:30-60MG/15,32003211,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
DOCUSATE (COLACE) SYRP : 60MG/15ML 480ML,32003216,CDM,,,250,RC,outpatient,,240.91,240.91,,204.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60.23,22,,percent of total billed charges,,,,,,,,,216.82,90,,percent of total billed charges,,,199.47,82.8,,percent of total billed charges,,,204.77,85,,percent of total billed charges,,,,,,,,,212,88,,percent of total billed charges,,,,,,,,,184.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60.23,22,,percent of total billed charges,,,219.23,91,,percent of total billed charges,,,228.86,95,,percent of total billed charges,,,199.96,83,,percent of total billed charges,,,199.96,83,,percent of total billed charges,,,,,,,,,,,,,,,199.96,83,,percent of total billed charges,,,228.86,95,,percent of total billed charges,,,216.82,90,,percent of total billed charges,,,216.82,90,,percent of total billed charges,,,197.55,82,,percent of total billed charges,,,216.82,90,,percent of total billed charges,,,204.77,85,,percent of total billed charges,,60.23,228.86,
DOCUSATE (COLACE) SYRP : 60MG/15ML 90ML,32003221,CDM,,,250,RC,outpatient,,45.84,45.84,,38.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.46,22,,percent of total billed charges,,,,,,,,,41.26,90,,percent of total billed charges,,,37.96,82.8,,percent of total billed charges,,,38.96,85,,percent of total billed charges,,,,,,,,,40.34,88,,percent of total billed charges,,,,,,,,,35.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.46,22,,percent of total billed charges,,,41.71,91,,percent of total billed charges,,,43.55,95,,percent of total billed charges,,,38.05,83,,percent of total billed charges,,,38.05,83,,percent of total billed charges,,,,,,,,,,,,,,,38.05,83,,percent of total billed charges,,,43.55,95,,percent of total billed charges,,,41.26,90,,percent of total billed charges,,,41.26,90,,percent of total billed charges,,,37.59,82,,percent of total billed charges,,,41.26,90,,percent of total billed charges,,,38.96,85,,percent of total billed charges,,11.46,43.55,
DOCUSATE(COLACE)SYRP:60MG/15ML (60ML),32003226,CDM,J8499,HCPCS,250,RC,outpatient,,31.54,31.54,,26.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.89,22,,percent of total billed charges,,,,,,,,,28.39,90,,percent of total billed charges,,,26.12,82.8,,percent of total billed charges,,,26.81,85,,percent of total billed charges,,,,,,,,,27.76,88,,percent of total billed charges,,,,,,,,,24.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.89,22,,percent of total billed charges,,,28.7,91,,percent of total billed charges,,,29.96,95,,percent of total billed charges,,,26.18,83,,percent of total billed charges,,,26.18,83,,percent of total billed charges,,,,,,,,,,,,,,,26.18,83,,percent of total billed charges,,,29.96,95,,percent of total billed charges,,,28.39,90,,percent of total billed charges,,,28.39,90,,percent of total billed charges,,,25.86,82,,percent of total billed charges,,,28.39,90,,percent of total billed charges,,,26.81,85,,percent of total billed charges,,7.89,29.96,
VALSARTAN(DIOVAN)TAB:80MG,32003227,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
diphenhydrAMINE(BENADRYL)CAP:25MG,32003231,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DIPHENHYD (BENADRYL) TAB: 25MG (1x10),32003232,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
OLSALAZINE SODIUM (DIPENTUM) CAP : 250MG,32003236,CDM,,,250,RC,outpatient,,29.18,29.18,,24.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.3,22,,percent of total billed charges,,,,,,,,,26.26,90,,percent of total billed charges,,,24.16,82.8,,percent of total billed charges,,,24.8,85,,percent of total billed charges,,,,,,,,,25.68,88,,percent of total billed charges,,,,,,,,,22.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.3,22,,percent of total billed charges,,,26.55,91,,percent of total billed charges,,,27.72,95,,percent of total billed charges,,,24.22,83,,percent of total billed charges,,,24.22,83,,percent of total billed charges,,,,,,,,,,,,,,,24.22,83,,percent of total billed charges,,,27.72,95,,percent of total billed charges,,,26.26,90,,percent of total billed charges,,,26.26,90,,percent of total billed charges,,,23.93,82,,percent of total billed charges,,,26.26,90,,percent of total billed charges,,,24.8,85,,percent of total billed charges,,7.3,27.72,
DIPHENOXY/ATROP(LOMOTIL)TAB:2.5-.025MG,32003241,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
DIPHENHYDRAMINE (BENADRYL) CAP : 50MG,32003251,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
TETANUS DIPHTHERA TOXOID PED SYR:5-10LFU,32003261,CDM,90723,CPT,636,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
TETANUS DIPHTH VIAL:6-2LFU MDV 0.5ML,32003262,CDM,,,250,RC,outpatient,,124.75,124.75,,105.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.19,22,,percent of total billed charges,,,,,,,,,112.28,90,,percent of total billed charges,,,103.29,82.8,,percent of total billed charges,,,106.04,85,,percent of total billed charges,,,,,,,,,109.78,88,,percent of total billed charges,,,,,,,,,95.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.19,22,,percent of total billed charges,,,113.52,91,,percent of total billed charges,,,118.51,95,,percent of total billed charges,,,103.54,83,,percent of total billed charges,,,103.54,83,,percent of total billed charges,,,,,,,,,,,,,,,103.54,83,,percent of total billed charges,,,118.51,95,,percent of total billed charges,,,112.28,90,,percent of total billed charges,,,112.28,90,,percent of total billed charges,,,102.3,82,,percent of total billed charges,,,112.28,90,,percent of total billed charges,,,106.04,85,,percent of total billed charges,,31.19,118.51,
DIPHENOX/ATR(LOMOTIL)LIQ:2.5MG/5ML(60ML),32003266,CDM,J8499,HCPCS,250,RC,outpatient,,846.59,846.59,,718.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,211.65,22,,percent of total billed charges,,,,,,,,,761.93,90,,percent of total billed charges,,,700.98,82.8,,percent of total billed charges,,,719.6,85,,percent of total billed charges,,,,,,,,,745,88,,percent of total billed charges,,,,,,,,,646.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,211.65,22,,percent of total billed charges,,,770.4,91,,percent of total billed charges,,,804.26,95,,percent of total billed charges,,,702.67,83,,percent of total billed charges,,,702.67,83,,percent of total billed charges,,,,,,,,,,,,,,,702.67,83,,percent of total billed charges,,,804.26,95,,percent of total billed charges,,,761.93,90,,percent of total billed charges,,,761.93,90,,percent of total billed charges,,,694.2,82,,percent of total billed charges,,,761.93,90,,percent of total billed charges,,,719.6,85,,percent of total billed charges,,211.65,804.26,
DIPHENHYDR(BENADRYL)VL PX:50MG/ML,32003271,CDM,J1200,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,2.34,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.34,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,2.34,60.99,
TETANUS DIPHTHERIA PED VIAL:,32003276,CDM,90702,CPT,250,RC,outpatient,,1411.2,1411.2,,1198.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,352.8,22,,percent of total billed charges,,,,,,,,,1270.08,90,,percent of total billed charges,,,1168.47,82.8,,percent of total billed charges,,,1199.52,85,,percent of total billed charges,,,,,,,,,1241.86,88,,percent of total billed charges,,,,,,,,,1078.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,352.8,22,,percent of total billed charges,,,1284.19,91,,percent of total billed charges,,,1340.64,95,,percent of total billed charges,,,1171.3,83,,percent of total billed charges,,,1171.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1171.3,83,,percent of total billed charges,,,1340.64,95,,percent of total billed charges,,,1270.08,90,,percent of total billed charges,,,1270.08,90,,percent of total billed charges,,,1157.18,82,,percent of total billed charges,,,1270.08,90,,percent of total billed charges,,,1199.52,85,,percent of total billed charges,,352.8,1340.64,
DIPHENHYD(BENADRYL)LIQ:12.5MG/5ML(120ML),32003281,CDM,,,250,RC,outpatient,,35.21,35.21,,29.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.8,22,,percent of total billed charges,,,,,,,,,31.69,90,,percent of total billed charges,,,29.15,82.8,,percent of total billed charges,,,29.93,85,,percent of total billed charges,,,,,,,,,30.98,88,,percent of total billed charges,,,,,,,,,26.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.8,22,,percent of total billed charges,,,32.04,91,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,,,,,,,,,,,,,29.22,83,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,28.87,82,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,29.93,85,,percent of total billed charges,,8.8,33.45,
DIPIVEFRIN (PROPINE) DROP : 0.1% 5 ML,32003286,CDM,,,250,RC,outpatient,,49.96,49.96,,42.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.49,22,,percent of total billed charges,,,,,,,,,44.96,90,,percent of total billed charges,,,41.37,82.8,,percent of total billed charges,,,42.47,85,,percent of total billed charges,,,,,,,,,43.96,88,,percent of total billed charges,,,,,,,,,38.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.49,22,,percent of total billed charges,,,45.46,91,,percent of total billed charges,,,47.46,95,,percent of total billed charges,,,41.47,83,,percent of total billed charges,,,41.47,83,,percent of total billed charges,,,,,,,,,,,,,,,41.47,83,,percent of total billed charges,,,47.46,95,,percent of total billed charges,,,44.96,90,,percent of total billed charges,,,44.96,90,,percent of total billed charges,,,40.97,82,,percent of total billed charges,,,44.96,90,,percent of total billed charges,,,42.47,85,,percent of total billed charges,,12.49,47.46,
PROPOFOL(DIPRIVAN)VL:200MG/20ML  BRAND,32003296,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
BETAMETHASONE DIPROP GEL 0.05%:15ML,32003301,CDM,J3490,HCPCS,250,RC,outpatient,,380.32,380.32,,322.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,95.08,22,,percent of total billed charges,,,,,,,,,342.29,90,,percent of total billed charges,,,314.9,82.8,,percent of total billed charges,,,323.27,85,,percent of total billed charges,,,,,,,,,334.68,88,,percent of total billed charges,,,,,,,,,290.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,95.08,22,,percent of total billed charges,,,346.09,91,,percent of total billed charges,,,361.3,95,,percent of total billed charges,,,315.67,83,,percent of total billed charges,,,315.67,83,,percent of total billed charges,,,,,,,,,,,,,,,315.67,83,,percent of total billed charges,,,361.3,95,,percent of total billed charges,,,342.29,90,,percent of total billed charges,,,342.29,90,,percent of total billed charges,,,311.86,82,,percent of total billed charges,,,342.29,90,,percent of total billed charges,,,323.27,85,,percent of total billed charges,,95.08,361.3,
DIPYRIDAMOLE(PERSANTINE)TAB:25MG,32003306,CDM,J8499,HCPCS,636,RC,outpatient,,24.67,24.67,,20.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.17,22,,percent of total billed charges,,,,,,,,,22.2,90,,percent of total billed charges,,,20.43,82.8,,percent of total billed charges,,,20.97,85,,percent of total billed charges,,,,,,,,,21.71,88,,percent of total billed charges,,,,,,,,,18.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.17,22,,percent of total billed charges,,,22.45,91,,percent of total billed charges,,,23.44,95,,percent of total billed charges,,,20.48,83,,percent of total billed charges,,,20.48,83,,percent of total billed charges,,,,,,,,,,,,,,,20.48,83,,percent of total billed charges,,,23.44,95,,percent of total billed charges,,,22.2,90,,percent of total billed charges,,,22.2,90,,percent of total billed charges,,,20.23,82,,percent of total billed charges,,,22.2,90,,percent of total billed charges,,,20.97,85,,percent of total billed charges,,6.17,23.44,
DIPYRIDAMOLE TAB (PERSANTINE) : 50MG,32003311,CDM,,,636,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
DIPYRIDAMOLE TAB (PERSANTINE) : 75MG,32003316,CDM,,,636,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
DISOPYRAMIDE PHOSP(NORPACE)CAP : 100MG,32003321,CDM,,,250,RC,outpatient,,33.15,33.15,,28.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.29,22,,percent of total billed charges,,,,,,,,,29.84,90,,percent of total billed charges,,,27.45,82.8,,percent of total billed charges,,,28.18,85,,percent of total billed charges,,,,,,,,,29.17,88,,percent of total billed charges,,,,,,,,,25.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.29,22,,percent of total billed charges,,,30.17,91,,percent of total billed charges,,,31.49,95,,percent of total billed charges,,,27.51,83,,percent of total billed charges,,,27.51,83,,percent of total billed charges,,,,,,,,,,,,,,,27.51,83,,percent of total billed charges,,,31.49,95,,percent of total billed charges,,,29.84,90,,percent of total billed charges,,,29.84,90,,percent of total billed charges,,,27.18,82,,percent of total billed charges,,,29.84,90,,percent of total billed charges,,,28.18,85,,percent of total billed charges,,8.29,31.49,
OXYBUTYNIN(DITROPAN XL)TAB:5MG,32003327,CDM,J8499,HCPCS,250,RC,outpatient,,37.42,37.42,,31.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.36,22,,percent of total billed charges,,,,,,,,,33.68,90,,percent of total billed charges,,,30.98,82.8,,percent of total billed charges,,,31.81,85,,percent of total billed charges,,,,,,,,,32.93,88,,percent of total billed charges,,,,,,,,,28.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.36,22,,percent of total billed charges,,,34.05,91,,percent of total billed charges,,,35.55,95,,percent of total billed charges,,,31.06,83,,percent of total billed charges,,,31.06,83,,percent of total billed charges,,,,,,,,,,,,,,,31.06,83,,percent of total billed charges,,,35.55,95,,percent of total billed charges,,,33.68,90,,percent of total billed charges,,,33.68,90,,percent of total billed charges,,,30.68,82,,percent of total billed charges,,,33.68,90,,percent of total billed charges,,,31.81,85,,percent of total billed charges,,9.36,35.55,
OXYBUTYNIN CHLORIDE (DITROPAN XL) :15MG,32003328,CDM,,,250,RC,outpatient,,58.68,58.68,,49.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.67,22,,percent of total billed charges,,,,,,,,,52.81,90,,percent of total billed charges,,,48.59,82.8,,percent of total billed charges,,,49.88,85,,percent of total billed charges,,,,,,,,,51.64,88,,percent of total billed charges,,,,,,,,,44.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.67,22,,percent of total billed charges,,,53.4,91,,percent of total billed charges,,,55.75,95,,percent of total billed charges,,,48.7,83,,percent of total billed charges,,,48.7,83,,percent of total billed charges,,,,,,,,,,,,,,,48.7,83,,percent of total billed charges,,,55.75,95,,percent of total billed charges,,,52.81,90,,percent of total billed charges,,,52.81,90,,percent of total billed charges,,,48.12,82,,percent of total billed charges,,,52.81,90,,percent of total billed charges,,,49.88,85,,percent of total billed charges,,14.67,55.75,
METOLAZONE(ZAROXOLYN)TAB:5MG,32003331,CDM,J8499,HCPCS,250,RC,outpatient,,43.95,43.95,,37.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.99,22,,percent of total billed charges,,,,,,,,,39.56,90,,percent of total billed charges,,,36.39,82.8,,percent of total billed charges,,,37.36,85,,percent of total billed charges,,,,,,,,,38.68,88,,percent of total billed charges,,,,,,,,,33.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.99,22,,percent of total billed charges,,,39.99,91,,percent of total billed charges,,,41.75,95,,percent of total billed charges,,,36.48,83,,percent of total billed charges,,,36.48,83,,percent of total billed charges,,,,,,,,,,,,,,,36.48,83,,percent of total billed charges,,,41.75,95,,percent of total billed charges,,,39.56,90,,percent of total billed charges,,,39.56,90,,percent of total billed charges,,,36.04,82,,percent of total billed charges,,,39.56,90,,percent of total billed charges,,,37.36,85,,percent of total billed charges,,10.99,41.75,
METOLAZONE (ZAROXOLYN) TAB : 2.5MG,32003336,CDM,,,250,RC,outpatient,,25.22,25.22,,21.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.31,22,,percent of total billed charges,,,,,,,,,22.7,90,,percent of total billed charges,,,20.88,82.8,,percent of total billed charges,,,21.44,85,,percent of total billed charges,,,,,,,,,22.19,88,,percent of total billed charges,,,,,,,,,19.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.31,22,,percent of total billed charges,,,22.95,91,,percent of total billed charges,,,23.96,95,,percent of total billed charges,,,20.93,83,,percent of total billed charges,,,20.93,83,,percent of total billed charges,,,,,,,,,,,,,,,20.93,83,,percent of total billed charges,,,23.96,95,,percent of total billed charges,,,22.7,90,,percent of total billed charges,,,22.7,90,,percent of total billed charges,,,20.68,82,,percent of total billed charges,,,22.7,90,,percent of total billed charges,,,21.44,85,,percent of total billed charges,,6.31,23.96,
DOBUTamine IV:250MG/20ML,32003351,CDM,J1250,HCPCS,250,RC,outpatient,,88.34,88.34,,75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.09,22,,percent of total billed charges,,,,,,,,,79.51,90,,percent of total billed charges,,,73.15,82.8,,percent of total billed charges,,,75.09,85,,percent of total billed charges,,,,,,,,,77.74,88,,percent of total billed charges,,13.07,,,,fee schedule,,,67.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.07,,,,fee schedule,,,22.09,22,,percent of total billed charges,,,80.39,91,,percent of total billed charges,,,83.92,95,,percent of total billed charges,,,73.32,83,,percent of total billed charges,,,73.32,83,,percent of total billed charges,,,,,,,,,,,,,,,73.32,83,,percent of total billed charges,,,83.92,95,,percent of total billed charges,,,79.51,90,,percent of total billed charges,,,79.51,90,,percent of total billed charges,,,72.44,82,,percent of total billed charges,,,79.51,90,,percent of total billed charges,,,75.09,85,,percent of total billed charges,,13.07,83.92,
Docusate CALCIUM(SURFAK)CAP:240MG,32003356,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CASANTHRANOL/DOCUSATE SODM CAP:30-100MG,32003361,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
Docusate SODIUM(COLACE)CAP:100MG,32003366,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
BELLADONN ALKA/PB (DONNATAL) TAB: 16.2MG,32003381,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
DOPamine VIAL:200MG/5ML,32003406,CDM,J1265,HCPCS,636,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,7.14,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.14,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,7.14,59.21,
doXEPIN (sineQUAN) CAP : 50MG,32003416,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
DOXEpin(SINEquan)CAP:25MG,32003421,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
doXEPIN (sineQUAN) CAP : 10MG,32003426,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
DOXEPIN HCL CAP : 75MG,32003431,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
DOXYCYCLINE(VIBRAMYCIN)VIAL:100MG,32003441,CDM,J3490,HCPCS,250,RC,outpatient,,336.11,336.11,,285.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.03,22,,percent of total billed charges,,,,,,,,,302.5,90,,percent of total billed charges,,,278.3,82.8,,percent of total billed charges,,,285.69,85,,percent of total billed charges,,,,,,,,,295.78,88,,percent of total billed charges,,,,,,,,,256.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.03,22,,percent of total billed charges,,,305.86,91,,percent of total billed charges,,,319.3,95,,percent of total billed charges,,,278.97,83,,percent of total billed charges,,,278.97,83,,percent of total billed charges,,,,,,,,,,,,,,,278.97,83,,percent of total billed charges,,,319.3,95,,percent of total billed charges,,,302.5,90,,percent of total billed charges,,,302.5,90,,percent of total billed charges,,,275.61,82,,percent of total billed charges,,,302.5,90,,percent of total billed charges,,,285.69,85,,percent of total billed charges,,84.03,319.3,
DOXYCYCLINE(VBM)CAP:100MG,32003446,CDM,J8499,HCPCS,250,RC,outpatient,,20.92,20.92,,17.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.23,22,,percent of total billed charges,,,,,,,,,18.83,90,,percent of total billed charges,,,17.32,82.8,,percent of total billed charges,,,17.78,85,,percent of total billed charges,,,,,,,,,18.41,88,,percent of total billed charges,,,,,,,,,15.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.23,22,,percent of total billed charges,,,19.04,91,,percent of total billed charges,,,19.87,95,,percent of total billed charges,,,17.36,83,,percent of total billed charges,,,17.36,83,,percent of total billed charges,,,,,,,,,,,,,,,17.36,83,,percent of total billed charges,,,19.87,95,,percent of total billed charges,,,18.83,90,,percent of total billed charges,,,18.83,90,,percent of total billed charges,,,17.15,82,,percent of total billed charges,,,18.83,90,,percent of total billed charges,,,17.78,85,,percent of total billed charges,,5.23,19.87,
DOXYCYCLINE(VBM)TAB:100MG(1x4),32003447,CDM,,,250,RC,outpatient,,26.96,26.96,,22.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.74,22,,percent of total billed charges,,,,,,,,,24.26,90,,percent of total billed charges,,,22.32,82.8,,percent of total billed charges,,,22.92,85,,percent of total billed charges,,,,,,,,,23.72,88,,percent of total billed charges,,,,,,,,,20.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.74,22,,percent of total billed charges,,,24.53,91,,percent of total billed charges,,,25.61,95,,percent of total billed charges,,,22.38,83,,percent of total billed charges,,,22.38,83,,percent of total billed charges,,,,,,,,,,,,,,,22.38,83,,percent of total billed charges,,,25.61,95,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,22.11,82,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,22.92,85,,percent of total billed charges,,6.74,25.61,
IV HETASTARCH/NS(hesPAN) 500ML,32003451,CDM,J3490,HCPCS,250,RC,outpatient,,232.82,232.82,,197.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,58.21,22,,percent of total billed charges,,,,,,,,,209.54,90,,percent of total billed charges,,,192.77,82.8,,percent of total billed charges,,,197.9,85,,percent of total billed charges,,,,,,,,,204.88,88,,percent of total billed charges,,,,,,,,,177.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,58.21,22,,percent of total billed charges,,,211.87,91,,percent of total billed charges,,,221.18,95,,percent of total billed charges,,,193.24,83,,percent of total billed charges,,,193.24,83,,percent of total billed charges,,,,,,,,,,,,,,,193.24,83,,percent of total billed charges,,,221.18,95,,percent of total billed charges,,,209.54,90,,percent of total billed charges,,,209.54,90,,percent of total billed charges,,,190.91,82,,percent of total billed charges,,,209.54,90,,percent of total billed charges,,,197.9,85,,percent of total billed charges,,58.21,221.18,
fentaNYL PATCH(DURAGESIC): 25MCG/HR,32003476,CDM,,,250,RC,outpatient,,54.74,54.74,,46.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.69,22,,percent of total billed charges,,,,,,,,,49.27,90,,percent of total billed charges,,,45.32,82.8,,percent of total billed charges,,,46.53,85,,percent of total billed charges,,,,,,,,,48.17,88,,percent of total billed charges,,,,,,,,,41.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.69,22,,percent of total billed charges,,,49.81,91,,percent of total billed charges,,,52,95,,percent of total billed charges,,,45.43,83,,percent of total billed charges,,,45.43,83,,percent of total billed charges,,,,,,,,,,,,,,,45.43,83,,percent of total billed charges,,,52,95,,percent of total billed charges,,,49.27,90,,percent of total billed charges,,,49.27,90,,percent of total billed charges,,,44.89,82,,percent of total billed charges,,,49.27,90,,percent of total billed charges,,,46.53,85,,percent of total billed charges,,13.69,52,
fentaNYL PATCH(DURAGESIC):100MCG/HR,32003481,CDM,,,250,RC,outpatient,,154.58,154.58,,131.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.65,22,,percent of total billed charges,,,,,,,,,139.12,90,,percent of total billed charges,,,127.99,82.8,,percent of total billed charges,,,131.39,85,,percent of total billed charges,,,,,,,,,136.03,88,,percent of total billed charges,,,,,,,,,118.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.65,22,,percent of total billed charges,,,140.67,91,,percent of total billed charges,,,146.85,95,,percent of total billed charges,,,128.3,83,,percent of total billed charges,,,128.3,83,,percent of total billed charges,,,,,,,,,,,,,,,128.3,83,,percent of total billed charges,,,146.85,95,,percent of total billed charges,,,139.12,90,,percent of total billed charges,,,139.12,90,,percent of total billed charges,,,126.76,82,,percent of total billed charges,,,139.12,90,,percent of total billed charges,,,131.39,85,,percent of total billed charges,,38.65,146.85,
fentaNYL PATCH(DURAGESIC):  50MCG/HR,32003486,CDM,,,250,RC,outpatient,,72.06,72.06,,61.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.02,22,,percent of total billed charges,,,,,,,,,64.85,90,,percent of total billed charges,,,59.67,82.8,,percent of total billed charges,,,61.25,85,,percent of total billed charges,,,,,,,,,63.41,88,,percent of total billed charges,,,,,,,,,55.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.02,22,,percent of total billed charges,,,65.57,91,,percent of total billed charges,,,68.46,95,,percent of total billed charges,,,59.81,83,,percent of total billed charges,,,59.81,83,,percent of total billed charges,,,,,,,,,,,,,,,59.81,83,,percent of total billed charges,,,68.46,95,,percent of total billed charges,,,64.85,90,,percent of total billed charges,,,64.85,90,,percent of total billed charges,,,59.09,82,,percent of total billed charges,,,64.85,90,,percent of total billed charges,,,61.25,85,,percent of total billed charges,,18.02,68.46,
GUAIFENE/P-EPHED(MUCINEX D)TB:1200-120MG,32003491,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
fentaNYL PATCH(DURAGESIC): 75MCG/HR,32003496,CDM,,,250,RC,outpatient,,111.6,111.6,,94.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.9,22,,percent of total billed charges,,,,,,,,,100.44,90,,percent of total billed charges,,,92.4,82.8,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,,,,,,,,98.21,88,,percent of total billed charges,,,,,,,,,85.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.9,22,,percent of total billed charges,,,101.56,91,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,,,,,,,,,,,,,92.63,83,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,91.51,82,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,27.9,106.02,
CEFADROXIL(DURICEF)SUS:250MG/5ML(100ML),32003497,CDM,,,250,RC,outpatient,,489.12,489.12,,415.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.28,22,,percent of total billed charges,,,,,,,,,440.21,90,,percent of total billed charges,,,404.99,82.8,,percent of total billed charges,,,415.75,85,,percent of total billed charges,,,,,,,,,430.43,88,,percent of total billed charges,,,,,,,,,373.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.28,22,,percent of total billed charges,,,445.1,91,,percent of total billed charges,,,464.66,95,,percent of total billed charges,,,405.97,83,,percent of total billed charges,,,405.97,83,,percent of total billed charges,,,,,,,,,,,,,,,405.97,83,,percent of total billed charges,,,464.66,95,,percent of total billed charges,,,440.21,90,,percent of total billed charges,,,440.21,90,,percent of total billed charges,,,401.08,82,,percent of total billed charges,,,440.21,90,,percent of total billed charges,,,415.75,85,,percent of total billed charges,,122.28,464.66,
TRIAMTERENE/HCTZ(DYAZIDE)CAP:37.5-25MG,32003501,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DYNAPEN SUSPENSION 100 ML 62.5 ML\5ML,32003507,CDM,,,250,RC,outpatient,,32,32,,27.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8,22,,percent of total billed charges,,,,,,,,,28.8,90,,percent of total billed charges,,,26.5,82.8,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,,,,,,,,28.16,88,,percent of total billed charges,,,,,,,,,24.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8,22,,percent of total billed charges,,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,,,,,,,,,,,,,26.56,83,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,26.24,82,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,8,30.4,
ISRADIPINE (DYNACIRC) CAP : 2.5MG,32003516,CDM,,,250,RC,outpatient,,20.3,20.3,,17.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.08,22,,percent of total billed charges,,,,,,,,,18.27,90,,percent of total billed charges,,,16.81,82.8,,percent of total billed charges,,,17.26,85,,percent of total billed charges,,,,,,,,,17.86,88,,percent of total billed charges,,,,,,,,,15.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.08,22,,percent of total billed charges,,,18.47,91,,percent of total billed charges,,,19.29,95,,percent of total billed charges,,,16.85,83,,percent of total billed charges,,,16.85,83,,percent of total billed charges,,,,,,,,,,,,,,,16.85,83,,percent of total billed charges,,,19.29,95,,percent of total billed charges,,,18.27,90,,percent of total billed charges,,,18.27,90,,percent of total billed charges,,,16.65,82,,percent of total billed charges,,,18.27,90,,percent of total billed charges,,,17.26,85,,percent of total billed charges,,5.08,19.29,
ISRADIPINE (DYNACIRC) CAP : 5MG,32003521,CDM,,,250,RC,outpatient,,29.66,29.66,,25.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.42,22,,percent of total billed charges,,,,,,,,,26.69,90,,percent of total billed charges,,,24.56,82.8,,percent of total billed charges,,,25.21,85,,percent of total billed charges,,,,,,,,,26.1,88,,percent of total billed charges,,,,,,,,,22.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.42,22,,percent of total billed charges,,,26.99,91,,percent of total billed charges,,,28.18,95,,percent of total billed charges,,,24.62,83,,percent of total billed charges,,,24.62,83,,percent of total billed charges,,,,,,,,,,,,,,,24.62,83,,percent of total billed charges,,,28.18,95,,percent of total billed charges,,,26.69,90,,percent of total billed charges,,,26.69,90,,percent of total billed charges,,,24.32,82,,percent of total billed charges,,,26.69,90,,percent of total billed charges,,,25.21,85,,percent of total billed charges,,7.42,28.18,
CARBAMIDE PEROX (DEBROX EAR)DROPS 6.50%:,32003531,CDM,J3490,HCPCS,250,RC,outpatient,,24.02,24.02,,20.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.01,22,,percent of total billed charges,,,,,,,,,21.62,90,,percent of total billed charges,,,19.89,82.8,,percent of total billed charges,,,20.42,85,,percent of total billed charges,,,,,,,,,21.14,88,,percent of total billed charges,,,,,,,,,18.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.01,22,,percent of total billed charges,,,21.86,91,,percent of total billed charges,,,22.82,95,,percent of total billed charges,,,19.94,83,,percent of total billed charges,,,19.94,83,,percent of total billed charges,,,,,,,,,,,,,,,19.94,83,,percent of total billed charges,,,22.82,95,,percent of total billed charges,,,21.62,90,,percent of total billed charges,,,21.62,90,,percent of total billed charges,,,19.7,82,,percent of total billed charges,,,21.62,90,,percent of total billed charges,,,20.42,85,,percent of total billed charges,,6.01,22.82,
PREDNISOLONE (PRED-FORTE) DROP : 1% 5ML,32003532,CDM,,,250,RC,outpatient,,66.75,66.75,,56.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.69,22,,percent of total billed charges,,,,,,,,,60.08,90,,percent of total billed charges,,,55.27,82.8,,percent of total billed charges,,,56.74,85,,percent of total billed charges,,,,,,,,,58.74,88,,percent of total billed charges,,,,,,,,,51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.69,22,,percent of total billed charges,,,60.74,91,,percent of total billed charges,,,63.41,95,,percent of total billed charges,,,55.4,83,,percent of total billed charges,,,55.4,83,,percent of total billed charges,,,,,,,,,,,,,,,55.4,83,,percent of total billed charges,,,63.41,95,,percent of total billed charges,,,60.08,90,,percent of total billed charges,,,60.08,90,,percent of total billed charges,,,54.74,82,,percent of total billed charges,,,60.08,90,,percent of total billed charges,,,56.74,85,,percent of total billed charges,,16.69,63.41,
prednisoLONE(PRED-FORTE)DROP 1%:5ML,32003536,CDM,J7599,HCPCS,250,RC,outpatient,,600.78,600.78,,510.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.2,22,,percent of total billed charges,,,,,,,,,540.7,90,,percent of total billed charges,,,497.45,82.8,,percent of total billed charges,,,510.66,85,,percent of total billed charges,,,,,,,,,528.69,88,,percent of total billed charges,,,,,,,,,459,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.2,22,,percent of total billed charges,,,546.71,91,,percent of total billed charges,,,570.74,95,,percent of total billed charges,,,498.65,83,,percent of total billed charges,,,498.65,83,,percent of total billed charges,,,,,,,,,,,,,,,498.65,83,,percent of total billed charges,,,570.74,95,,percent of total billed charges,,,540.7,90,,percent of total billed charges,,,540.7,90,,percent of total billed charges,,,492.64,82,,percent of total billed charges,,,540.7,90,,percent of total billed charges,,,510.66,85,,percent of total billed charges,,150.2,570.74,
ETHACRYNIC ACID(EDECRINTAB:25MG,32003541,CDM,,,250,RC,outpatient,,39.49,39.49,,33.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.87,22,,percent of total billed charges,,,,,,,,,35.54,90,,percent of total billed charges,,,32.7,82.8,,percent of total billed charges,,,33.57,85,,percent of total billed charges,,,,,,,,,34.75,88,,percent of total billed charges,,,,,,,,,30.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.87,22,,percent of total billed charges,,,35.94,91,,percent of total billed charges,,,37.52,95,,percent of total billed charges,,,32.78,83,,percent of total billed charges,,,32.78,83,,percent of total billed charges,,,,,,,,,,,,,,,32.78,83,,percent of total billed charges,,,37.52,95,,percent of total billed charges,,,35.54,90,,percent of total billed charges,,,35.54,90,,percent of total billed charges,,,32.38,82,,percent of total billed charges,,,35.54,90,,percent of total billed charges,,,33.57,85,,percent of total billed charges,,9.87,37.52,
ERYTHROMYCIN ETHYLSU (EES)ORAL:200MG/5ML,32003551,CDM,,,250,RC,outpatient,,66.77,66.77,,56.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.69,22,,percent of total billed charges,,,,,,,,,60.09,90,,percent of total billed charges,,,55.29,82.8,,percent of total billed charges,,,56.75,85,,percent of total billed charges,,,,,,,,,58.76,88,,percent of total billed charges,,,,,,,,,51.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.69,22,,percent of total billed charges,,,60.76,91,,percent of total billed charges,,,63.43,95,,percent of total billed charges,,,55.42,83,,percent of total billed charges,,,55.42,83,,percent of total billed charges,,,,,,,,,,,,,,,55.42,83,,percent of total billed charges,,,63.43,95,,percent of total billed charges,,,60.09,90,,percent of total billed charges,,,60.09,90,,percent of total billed charges,,,54.75,82,,percent of total billed charges,,,60.09,90,,percent of total billed charges,,,56.75,85,,percent of total billed charges,,16.69,63.43,
ERYTHROMYCIN ETHYLSU (EES)TAB : 400MG,32003556,CDM,,,250,RC,outpatient,,34.89,34.89,,29.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.72,22,,percent of total billed charges,,,,,,,,,31.4,90,,percent of total billed charges,,,28.89,82.8,,percent of total billed charges,,,29.66,85,,percent of total billed charges,,,,,,,,,30.7,88,,percent of total billed charges,,,,,,,,,26.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.72,22,,percent of total billed charges,,,31.75,91,,percent of total billed charges,,,33.15,95,,percent of total billed charges,,,28.96,83,,percent of total billed charges,,,28.96,83,,percent of total billed charges,,,,,,,,,,,,,,,28.96,83,,percent of total billed charges,,,33.15,95,,percent of total billed charges,,,31.4,90,,percent of total billed charges,,,31.4,90,,percent of total billed charges,,,28.61,82,,percent of total billed charges,,,31.4,90,,percent of total billed charges,,,29.66,85,,percent of total billed charges,,8.72,33.15,
VENLAFAXINE(EFFEXOR)TAB:37.5MG,32003561,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
EFFEXOR XR 37.5MG,32003562,CDM,,,250,RC,outpatient,,7.5,7.5,,6.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.88,22,,percent of total billed charges,,,,,,,,,6.75,90,,percent of total billed charges,,,6.21,82.8,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,,,,,,,,6.6,88,,percent of total billed charges,,,,,,,,,5.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.88,22,,percent of total billed charges,,,6.83,91,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,,,,,,,,,,,,,6.23,83,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.15,82,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,1.88,7.13,
VENLAFAXINE HCL (EFFEXOR XR) CAP : 75MG,32003563,CDM,,,250,RC,outpatient,,234.41,234.41,,199.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,58.6,22,,percent of total billed charges,,,,,,,,,210.97,90,,percent of total billed charges,,,194.09,82.8,,percent of total billed charges,,,199.25,85,,percent of total billed charges,,,,,,,,,206.28,88,,percent of total billed charges,,,,,,,,,179.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,58.6,22,,percent of total billed charges,,,213.31,91,,percent of total billed charges,,,222.69,95,,percent of total billed charges,,,194.56,83,,percent of total billed charges,,,194.56,83,,percent of total billed charges,,,,,,,,,,,,,,,194.56,83,,percent of total billed charges,,,222.69,95,,percent of total billed charges,,,210.97,90,,percent of total billed charges,,,210.97,90,,percent of total billed charges,,,192.22,82,,percent of total billed charges,,,210.97,90,,percent of total billed charges,,,199.25,85,,percent of total billed charges,,58.6,222.69,
VENLAFAXINE (EFFEXOR XR) CAP : 150MG,32003564,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DENTURE CLEANSER (EFFERDENT) TAB,32003566,CDM,,,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
POVIDONE-IODINE (BETADINE) PAC : 10% PKG,32003576,CDM,,,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
FLUOROURACIL(EFUDEX)CREAM 5%:40GM,32003581,CDM,,,250,RC,outpatient,,1308.79,1308.79,,1111.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,327.2,22,,percent of total billed charges,,,,,,,,,1177.91,90,,percent of total billed charges,,,1083.68,82.8,,percent of total billed charges,,,1112.47,85,,percent of total billed charges,,,,,,,,,1151.74,88,,percent of total billed charges,,,,,,,,,999.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,327.2,22,,percent of total billed charges,,,1191,91,,percent of total billed charges,,,1243.35,95,,percent of total billed charges,,,1086.3,83,,percent of total billed charges,,,1086.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1086.3,83,,percent of total billed charges,,,1243.35,95,,percent of total billed charges,,,1177.91,90,,percent of total billed charges,,,1177.91,90,,percent of total billed charges,,,1073.21,82,,percent of total billed charges,,,1177.91,90,,percent of total billed charges,,,1112.47,85,,percent of total billed charges,,327.2,1243.35,
PERMETHRIN(ELIMITE)CREAM 5%:60GM,32003611,CDM,J3490,HCPCS,250,RC,outpatient,,367,367,,311.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91.75,22,,percent of total billed charges,,,,,,,,,330.3,90,,percent of total billed charges,,,303.88,82.8,,percent of total billed charges,,,311.95,85,,percent of total billed charges,,,,,,,,,322.96,88,,percent of total billed charges,,,,,,,,,280.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91.75,22,,percent of total billed charges,,,333.97,91,,percent of total billed charges,,,348.65,95,,percent of total billed charges,,,304.61,83,,percent of total billed charges,,,304.61,83,,percent of total billed charges,,,,,,,,,,,,,,,304.61,83,,percent of total billed charges,,,348.65,95,,percent of total billed charges,,,330.3,90,,percent of total billed charges,,,330.3,90,,percent of total billed charges,,,300.94,82,,percent of total billed charges,,,330.3,90,,percent of total billed charges,,,311.95,85,,percent of total billed charges,,91.75,348.65,
MOMETASONE (ELOCON) LOT : 0.1%   30ML,32003616,CDM,,,250,RC,outpatient,,838.25,838.25,,711.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,209.56,22,,percent of total billed charges,,,,,,,,,754.43,90,,percent of total billed charges,,,694.07,82.8,,percent of total billed charges,,,712.51,85,,percent of total billed charges,,,,,,,,,737.66,88,,percent of total billed charges,,,,,,,,,640.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,209.56,22,,percent of total billed charges,,,762.81,91,,percent of total billed charges,,,796.34,95,,percent of total billed charges,,,695.75,83,,percent of total billed charges,,,695.75,83,,percent of total billed charges,,,,,,,,,,,,,,,695.75,83,,percent of total billed charges,,,796.34,95,,percent of total billed charges,,,754.43,90,,percent of total billed charges,,,754.43,90,,percent of total billed charges,,,687.37,82,,percent of total billed charges,,,754.43,90,,percent of total billed charges,,,712.51,85,,percent of total billed charges,,209.56,796.34,
MOMETASONE (ELOCON) OINT : 0.1%  45GM,32003621,CDM,,,250,RC,outpatient,,1505.01,1505.01,,1277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,376.25,22,,percent of total billed charges,,,,,,,,,1354.51,90,,percent of total billed charges,,,1246.15,82.8,,percent of total billed charges,,,1279.26,85,,percent of total billed charges,,,,,,,,,1324.41,88,,percent of total billed charges,,,,,,,,,1149.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,376.25,22,,percent of total billed charges,,,1369.56,91,,percent of total billed charges,,,1429.76,95,,percent of total billed charges,,,1249.16,83,,percent of total billed charges,,,1249.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1249.16,83,,percent of total billed charges,,,1429.76,95,,percent of total billed charges,,,1354.51,90,,percent of total billed charges,,,1354.51,90,,percent of total billed charges,,,1234.11,82,,percent of total billed charges,,,1354.51,90,,percent of total billed charges,,,1279.26,85,,percent of total billed charges,,376.25,1429.76,
LIDOCAI/PRILOCA(EMLA)CR 2.5%-2.5%:5GM,32003622,CDM,J3490,HCPCS,250,RC,outpatient,,138.4,138.4,,117.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.6,22,,percent of total billed charges,,,,,,,,,124.56,90,,percent of total billed charges,,,114.6,82.8,,percent of total billed charges,,,117.64,85,,percent of total billed charges,,,,,,,,,121.79,88,,percent of total billed charges,,,,,,,,,105.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.6,22,,percent of total billed charges,,,125.94,91,,percent of total billed charges,,,131.48,95,,percent of total billed charges,,,114.87,83,,percent of total billed charges,,,114.87,83,,percent of total billed charges,,,,,,,,,,,,,,,114.87,83,,percent of total billed charges,,,131.48,95,,percent of total billed charges,,,124.56,90,,percent of total billed charges,,,124.56,90,,percent of total billed charges,,,113.49,82,,percent of total billed charges,,,124.56,90,,percent of total billed charges,,,117.64,85,,percent of total billed charges,,34.6,131.48,
PHOS AC DIL/DEXT/FRUCT(KALMZ) SOL  125ML,32003626,CDM,,,250,RC,outpatient,,41.71,41.71,,35.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.43,22,,percent of total billed charges,,,,,,,,,37.54,90,,percent of total billed charges,,,34.54,82.8,,percent of total billed charges,,,35.45,85,,percent of total billed charges,,,,,,,,,36.7,88,,percent of total billed charges,,,,,,,,,31.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.43,22,,percent of total billed charges,,,37.96,91,,percent of total billed charges,,,39.62,95,,percent of total billed charges,,,34.62,83,,percent of total billed charges,,,34.62,83,,percent of total billed charges,,,,,,,,,,,,,,,34.62,83,,percent of total billed charges,,,39.62,95,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,34.2,82,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,35.45,85,,percent of total billed charges,,10.43,39.62,
ENGERIX-B 20MCG (ADULT),32003632,CDM,,,250,RC,outpatient,,706.81,706.81,,600.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,176.7,22,,percent of total billed charges,,,,,,,,,636.13,90,,percent of total billed charges,,,585.24,82.8,,percent of total billed charges,,,600.79,85,,percent of total billed charges,,,,,,,,,621.99,88,,percent of total billed charges,,,,,,,,,540,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,176.7,22,,percent of total billed charges,,,643.2,91,,percent of total billed charges,,,671.47,95,,percent of total billed charges,,,586.65,83,,percent of total billed charges,,,586.65,83,,percent of total billed charges,,,,,,,,,,,,,,,586.65,83,,percent of total billed charges,,,671.47,95,,percent of total billed charges,,,636.13,90,,percent of total billed charges,,,636.13,90,,percent of total billed charges,,,579.58,82,,percent of total billed charges,,,636.13,90,,percent of total billed charges,,,600.79,85,,percent of total billed charges,,176.7,671.47,
EDROPHONIUM CHLORIDE (ENLON)VIAL:10MG/ML,32003656,CDM,,,250,RC,outpatient,,143.22,143.22,,121.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.81,22,,percent of total billed charges,,,,,,,,,128.9,90,,percent of total billed charges,,,118.59,82.8,,percent of total billed charges,,,121.74,85,,percent of total billed charges,,,,,,,,,126.03,88,,percent of total billed charges,,,,,,,,,109.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.81,22,,percent of total billed charges,,,130.33,91,,percent of total billed charges,,,136.06,95,,percent of total billed charges,,,118.87,83,,percent of total billed charges,,,118.87,83,,percent of total billed charges,,,,,,,,,,,,,,,118.87,83,,percent of total billed charges,,,136.06,95,,percent of total billed charges,,,128.9,90,,percent of total billed charges,,,128.9,90,,percent of total billed charges,,,117.44,82,,percent of total billed charges,,,128.9,90,,percent of total billed charges,,,121.74,85,,percent of total billed charges,,35.81,136.06,
ENLON PLUS 15ML,32003657,CDM,,,250,RC,outpatient,,56,56,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14,22,,percent of total billed charges,,,,,,,,,50.4,90,,percent of total billed charges,,,46.37,82.8,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,,,,,,,,49.28,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14,22,,percent of total billed charges,,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,45.92,82,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,14,53.2,
ePHEDrine SULFATE VIAL:50MG/ML **,32003666,CDM,J3490,HCPCS,250,RC,outpatient,,264.22,264.22,,224.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.06,22,,percent of total billed charges,,,,,,,,,237.8,90,,percent of total billed charges,,,218.77,82.8,,percent of total billed charges,,,224.59,85,,percent of total billed charges,,,,,,,,,232.51,88,,percent of total billed charges,,,,,,,,,201.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.06,22,,percent of total billed charges,,,240.44,91,,percent of total billed charges,,,251.01,95,,percent of total billed charges,,,219.3,83,,percent of total billed charges,,,219.3,83,,percent of total billed charges,,,,,,,,,,,,,,,219.3,83,,percent of total billed charges,,,251.01,95,,percent of total billed charges,,,237.8,90,,percent of total billed charges,,,237.8,90,,percent of total billed charges,,,216.66,82,,percent of total billed charges,,,237.8,90,,percent of total billed charges,,,224.59,85,,percent of total billed charges,,66.06,251.01,
EPINEPHRINE SYR (TUBEX) : 1MG/ML,32003671,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
EPINEPHrine AMP:1MG/ML,32003676,CDM,J0171,HCPCS,250,RC,outpatient,,168.96,168.96,,143.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.24,22,,percent of total billed charges,,,,,,,,,152.06,90,,percent of total billed charges,,,139.9,82.8,,percent of total billed charges,,,143.62,85,,percent of total billed charges,,,,,,,,,148.68,88,,percent of total billed charges,,7.28,,,,fee schedule,,,129.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.28,,,,fee schedule,,,42.24,22,,percent of total billed charges,,,153.75,91,,percent of total billed charges,,,160.51,95,,percent of total billed charges,,,140.24,83,,percent of total billed charges,,,140.24,83,,percent of total billed charges,,,,,,,,,,,,,,,140.24,83,,percent of total billed charges,,,160.51,95,,percent of total billed charges,,,152.06,90,,percent of total billed charges,,,152.06,90,,percent of total billed charges,,,138.55,82,,percent of total billed charges,,,152.06,90,,percent of total billed charges,,,143.62,85,,percent of total billed charges,,7.28,160.51,
EPINEPHrine SYR:0.1MG/ML ** 10ML,32003681,CDM,J0171,HCPCS,250,RC,outpatient,,126.96,126.96,,107.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.74,22,,percent of total billed charges,,,,,,,,,114.26,90,,percent of total billed charges,,,105.12,82.8,,percent of total billed charges,,,107.92,85,,percent of total billed charges,,,,,,,,,111.72,88,,percent of total billed charges,,7.28,,,,fee schedule,,,97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.28,,,,fee schedule,,,31.74,22,,percent of total billed charges,,,115.53,91,,percent of total billed charges,,,120.61,95,,percent of total billed charges,,,105.38,83,,percent of total billed charges,,,105.38,83,,percent of total billed charges,,,,,,,,,,,,,,,105.38,83,,percent of total billed charges,,,120.61,95,,percent of total billed charges,,,114.26,90,,percent of total billed charges,,,114.26,90,,percent of total billed charges,,,104.11,82,,percent of total billed charges,,,114.26,90,,percent of total billed charges,,,107.92,85,,percent of total billed charges,,7.28,120.61,
EPINEPHrine(EPIPEN)PEN:0.3MG/0.3ML,32003686,CDM,J0171,HCPCS,250,RC,outpatient,,2027.28,2027.28,,1721.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,506.82,22,,percent of total billed charges,,,,,,,,,1824.55,90,,percent of total billed charges,,,1678.59,82.8,,percent of total billed charges,,,1723.19,85,,percent of total billed charges,,,,,,,,,1784.01,88,,percent of total billed charges,,7.28,,,,fee schedule,,,1548.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.28,,,,fee schedule,,,506.82,22,,percent of total billed charges,,,1844.82,91,,percent of total billed charges,,,1925.92,95,,percent of total billed charges,,,1682.64,83,,percent of total billed charges,,,1682.64,83,,percent of total billed charges,,,,,,,,,,,,,,,1682.64,83,,percent of total billed charges,,,1925.92,95,,percent of total billed charges,,,1824.55,90,,percent of total billed charges,,,1824.55,90,,percent of total billed charges,,,1662.37,82,,percent of total billed charges,,,1824.55,90,,percent of total billed charges,,,1723.19,85,,percent of total billed charges,,7.28,1925.92,
EPINEPHrine(EPIPEN JR)PEN:0.15MG/0.3ML,32003687,CDM,J0171,HCPCS,250,RC,outpatient,,2007.91,2007.91,,1704.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,501.98,22,,percent of total billed charges,,,,,,,,,1807.12,90,,percent of total billed charges,,,1662.55,82.8,,percent of total billed charges,,,1706.72,85,,percent of total billed charges,,,,,,,,,1766.96,88,,percent of total billed charges,,7.28,,,,fee schedule,,,1534.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.28,,,,fee schedule,,,501.98,22,,percent of total billed charges,,,1827.2,91,,percent of total billed charges,,,1907.51,95,,percent of total billed charges,,,1666.57,83,,percent of total billed charges,,,1666.57,83,,percent of total billed charges,,,,,,,,,,,,,,,1666.57,83,,percent of total billed charges,,,1907.51,95,,percent of total billed charges,,,1807.12,90,,percent of total billed charges,,,1807.12,90,,percent of total billed charges,,,1646.49,82,,percent of total billed charges,,,1807.12,90,,percent of total billed charges,,,1706.72,85,,percent of total billed charges,,7.28,1907.51,
MAG SULF-(EPSON SALT)GRAN:30GM,32003701,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
MAG SULF-(EPSON SALT)GRAN:90GM,32003706,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
MAG SULF-(EPSOM SALT)CRYSTALS:120GM,32003707,CDM,,,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
MAG SULF-(EPSOM SALT)GRAN:454GM,32003711,CDM,,,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
ERYTHROMYCIN LACTOBIONATE VIAL : 1G,32003736,CDM,,,250,RC,outpatient,,300.55,300.55,,255.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.14,22,,percent of total billed charges,,,,,,,,,270.5,90,,percent of total billed charges,,,248.86,82.8,,percent of total billed charges,,,255.47,85,,percent of total billed charges,,,,,,,,,264.48,88,,percent of total billed charges,,,,,,,,,229.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.14,22,,percent of total billed charges,,,273.5,91,,percent of total billed charges,,,285.52,95,,percent of total billed charges,,,249.46,83,,percent of total billed charges,,,249.46,83,,percent of total billed charges,,,,,,,,,,,,,,,249.46,83,,percent of total billed charges,,,285.52,95,,percent of total billed charges,,,270.5,90,,percent of total billed charges,,,270.5,90,,percent of total billed charges,,,246.45,82,,percent of total billed charges,,,270.5,90,,percent of total billed charges,,,255.47,85,,percent of total billed charges,,75.14,285.52,
ERYTHROMYCIN BASE/ETHOL(ERYDERM)SOL 2%:,32003737,CDM,,,250,RC,outpatient,,244.09,244.09,,207.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.02,22,,percent of total billed charges,,,,,,,,,219.68,90,,percent of total billed charges,,,202.11,82.8,,percent of total billed charges,,,207.48,85,,percent of total billed charges,,,,,,,,,214.8,88,,percent of total billed charges,,,,,,,,,186.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.02,22,,percent of total billed charges,,,222.12,91,,percent of total billed charges,,,231.89,95,,percent of total billed charges,,,202.59,83,,percent of total billed charges,,,202.59,83,,percent of total billed charges,,,,,,,,,,,,,,,202.59,83,,percent of total billed charges,,,231.89,95,,percent of total billed charges,,,219.68,90,,percent of total billed charges,,,219.68,90,,percent of total billed charges,,,200.15,82,,percent of total billed charges,,,219.68,90,,percent of total billed charges,,,207.48,85,,percent of total billed charges,,61.02,231.89,
ERYTHROMYCIN BASE OINT:5MG/G OPHTH **,32003741,CDM,J3490,HCPCS,250,RC,outpatient,,121.41,121.41,,103.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.35,22,,percent of total billed charges,,,,,,,,,109.27,90,,percent of total billed charges,,,100.53,82.8,,percent of total billed charges,,,103.2,85,,percent of total billed charges,,,,,,,,,106.84,88,,percent of total billed charges,,,,,,,,,92.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.35,22,,percent of total billed charges,,,110.48,91,,percent of total billed charges,,,115.34,95,,percent of total billed charges,,,100.77,83,,percent of total billed charges,,,100.77,83,,percent of total billed charges,,,,,,,,,,,,,,,100.77,83,,percent of total billed charges,,,115.34,95,,percent of total billed charges,,,109.27,90,,percent of total billed charges,,,109.27,90,,percent of total billed charges,,,99.56,82,,percent of total billed charges,,,109.27,90,,percent of total billed charges,,,103.2,85,,percent of total billed charges,,30.35,115.34,
ERYTHROMYCIN BASE (E-MYCIN) TAB : 250MG,32003746,CDM,,,250,RC,outpatient,,36.32,36.32,,30.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.08,22,,percent of total billed charges,,,,,,,,,32.69,90,,percent of total billed charges,,,30.07,82.8,,percent of total billed charges,,,30.87,85,,percent of total billed charges,,,,,,,,,31.96,88,,percent of total billed charges,,,,,,,,,27.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.08,22,,percent of total billed charges,,,33.05,91,,percent of total billed charges,,,34.5,95,,percent of total billed charges,,,30.15,83,,percent of total billed charges,,,30.15,83,,percent of total billed charges,,,,,,,,,,,,,,,30.15,83,,percent of total billed charges,,,34.5,95,,percent of total billed charges,,,32.69,90,,percent of total billed charges,,,32.69,90,,percent of total billed charges,,,29.78,82,,percent of total billed charges,,,32.69,90,,percent of total billed charges,,,30.87,85,,percent of total billed charges,,9.08,34.5,
ERYTHROMYCIN STEARATE TAB:500MG,32003751,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ERYTHROMYCIN LACTOBIONAT VIAL:500MG,32003756,CDM,J1364,HCPCS,250,RC,outpatient,,1154.36,1154.36,,980.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,288.59,22,,percent of total billed charges,,,,,,,,,1038.92,90,,percent of total billed charges,,,955.81,82.8,,percent of total billed charges,,,981.21,85,,percent of total billed charges,,,,,,,,,1015.84,88,,percent of total billed charges,,165.79,,,,fee schedule,,,881.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,165.79,,,,fee schedule,,,288.59,22,,percent of total billed charges,,,1050.47,91,,percent of total billed charges,,,1096.64,95,,percent of total billed charges,,,958.12,83,,percent of total billed charges,,,958.12,83,,percent of total billed charges,,,,,,,,,,,,,,,958.12,83,,percent of total billed charges,,,1096.64,95,,percent of total billed charges,,,1038.92,90,,percent of total billed charges,,,1038.92,90,,percent of total billed charges,,,946.58,82,,percent of total billed charges,,,1038.92,90,,percent of total billed charges,,,981.21,85,,percent of total billed charges,,165.79,1096.64,
ESTRADIOL TAB : 2MG,32003761,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ESTRADIOL TAB : 0.5MG,32003762,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ESTRADIOL TAB : 1MG,32003763,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ESTRADERM 0.1 PATCH,32003767,CDM,,,250,RC,outpatient,,9.5,9.5,,8.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.38,22,,percent of total billed charges,,,,,,,,,8.55,90,,percent of total billed charges,,,7.87,82.8,,percent of total billed charges,,,8.08,85,,percent of total billed charges,,,,,,,,,8.36,88,,percent of total billed charges,,,,,,,,,7.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.38,22,,percent of total billed charges,,,8.65,91,,percent of total billed charges,,,9.03,95,,percent of total billed charges,,,7.89,83,,percent of total billed charges,,,7.89,83,,percent of total billed charges,,,,,,,,,,,,,,,7.89,83,,percent of total billed charges,,,9.03,95,,percent of total billed charges,,,8.55,90,,percent of total billed charges,,,8.55,90,,percent of total billed charges,,,7.79,82,,percent of total billed charges,,,8.55,90,,percent of total billed charges,,,8.08,85,,percent of total billed charges,,2.38,9.03,
ME-TEST/ESTROGEN (SYNTEST)TAB:2.5-1.25MG,32003768,CDM,,,250,RC,outpatient,,22.52,22.52,,19.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.63,22,,percent of total billed charges,,,,,,,,,20.27,90,,percent of total billed charges,,,18.65,82.8,,percent of total billed charges,,,19.14,85,,percent of total billed charges,,,,,,,,,19.82,88,,percent of total billed charges,,,,,,,,,17.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.63,22,,percent of total billed charges,,,20.49,91,,percent of total billed charges,,,21.39,95,,percent of total billed charges,,,18.69,83,,percent of total billed charges,,,18.69,83,,percent of total billed charges,,,,,,,,,,,,,,,18.69,83,,percent of total billed charges,,,21.39,95,,percent of total billed charges,,,20.27,90,,percent of total billed charges,,,20.27,90,,percent of total billed charges,,,18.47,82,,percent of total billed charges,,,20.27,90,,percent of total billed charges,,,19.14,85,,percent of total billed charges,,5.63,21.39,
MORICIZINE HCL (ETHMOZINE) TAB : 200MG,32003776,CDM,,,250,RC,outpatient,,17.76,17.76,,15.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.44,22,,percent of total billed charges,,,,,,,,,15.98,90,,percent of total billed charges,,,14.71,82.8,,percent of total billed charges,,,15.1,85,,percent of total billed charges,,,,,,,,,15.63,88,,percent of total billed charges,,,,,,,,,13.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.44,22,,percent of total billed charges,,,16.16,91,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,,,,,,,,,,,,,14.74,83,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,14.56,82,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.1,85,,percent of total billed charges,,4.44,16.87,
ETHYL CHLORIDE SPR,32003786,CDM,,,250,RC,outpatient,,503.4,503.4,,427.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125.85,22,,percent of total billed charges,,,,,,,,,453.06,90,,percent of total billed charges,,,416.82,82.8,,percent of total billed charges,,,427.89,85,,percent of total billed charges,,,,,,,,,442.99,88,,percent of total billed charges,,,,,,,,,384.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125.85,22,,percent of total billed charges,,,458.09,91,,percent of total billed charges,,,478.23,95,,percent of total billed charges,,,417.82,83,,percent of total billed charges,,,417.82,83,,percent of total billed charges,,,,,,,,,,,,,,,417.82,83,,percent of total billed charges,,,478.23,95,,percent of total billed charges,,,453.06,90,,percent of total billed charges,,,453.06,90,,percent of total billed charges,,,412.79,82,,percent of total billed charges,,,453.06,90,,percent of total billed charges,,,427.89,85,,percent of total billed charges,,125.85,478.23,
EUCERIN CREAM:120GM,32003796,CDM,,,250,RC,outpatient,,111.6,111.6,,94.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.9,22,,percent of total billed charges,,,,,,,,,100.44,90,,percent of total billed charges,,,92.4,82.8,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,,,,,,,,98.21,88,,percent of total billed charges,,,,,,,,,85.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.9,22,,percent of total billed charges,,,101.56,91,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,92.63,83,,percent of total billed charges,,,,,,,,,,,,,,,92.63,83,,percent of total billed charges,,,106.02,95,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,91.51,82,,percent of total billed charges,,,100.44,90,,percent of total billed charges,,,94.86,85,,percent of total billed charges,,27.9,106.02,
MIN OIL/PET WHT(EUCERIN) CREAM  454 GM,32003801,CDM,,,250,RC,outpatient,,178.58,178.58,,151.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.65,22,,percent of total billed charges,,,,,,,,,160.72,90,,percent of total billed charges,,,147.86,82.8,,percent of total billed charges,,,151.79,85,,percent of total billed charges,,,,,,,,,157.15,88,,percent of total billed charges,,,,,,,,,136.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.65,22,,percent of total billed charges,,,162.51,91,,percent of total billed charges,,,169.65,95,,percent of total billed charges,,,148.22,83,,percent of total billed charges,,,148.22,83,,percent of total billed charges,,,,,,,,,,,,,,,148.22,83,,percent of total billed charges,,,169.65,95,,percent of total billed charges,,,160.72,90,,percent of total billed charges,,,160.72,90,,percent of total billed charges,,,146.44,82,,percent of total billed charges,,,160.72,90,,percent of total billed charges,,,151.79,85,,percent of total billed charges,,44.65,169.65,
MO/UREA/PEG'S/H20(EUCERIN PLUS) 360ML,32003802,CDM,,,250,RC,outpatient,,126.4,126.4,,107.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.6,22,,percent of total billed charges,,,,,,,,,113.76,90,,percent of total billed charges,,,104.66,82.8,,percent of total billed charges,,,107.44,85,,percent of total billed charges,,,,,,,,,111.23,88,,percent of total billed charges,,,,,,,,,96.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.6,22,,percent of total billed charges,,,115.02,91,,percent of total billed charges,,,120.08,95,,percent of total billed charges,,,104.91,83,,percent of total billed charges,,,104.91,83,,percent of total billed charges,,,,,,,,,,,,,,,104.91,83,,percent of total billed charges,,,120.08,95,,percent of total billed charges,,,113.76,90,,percent of total billed charges,,,113.76,90,,percent of total billed charges,,,103.65,82,,percent of total billed charges,,,113.76,90,,percent of total billed charges,,,107.44,85,,percent of total billed charges,,31.6,120.08,
M.O./UREA/PEGS/H20(EUCERIN PLUS)CRM 120G,32003803,CDM,,,250,RC,outpatient,,87.39,87.39,,74.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.85,22,,percent of total billed charges,,,,,,,,,78.65,90,,percent of total billed charges,,,72.36,82.8,,percent of total billed charges,,,74.28,85,,percent of total billed charges,,,,,,,,,76.9,88,,percent of total billed charges,,,,,,,,,66.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.85,22,,percent of total billed charges,,,79.52,91,,percent of total billed charges,,,83.02,95,,percent of total billed charges,,,72.53,83,,percent of total billed charges,,,72.53,83,,percent of total billed charges,,,,,,,,,,,,,,,72.53,83,,percent of total billed charges,,,83.02,95,,percent of total billed charges,,,78.65,90,,percent of total billed charges,,,78.65,90,,percent of total billed charges,,,71.66,82,,percent of total billed charges,,,78.65,90,,percent of total billed charges,,,74.28,85,,percent of total billed charges,,21.85,83.02,
FLUTAMIDE (EULEXIN) CAP : 125MG,32003816,CDM,,,250,RC,outpatient,,36.32,36.32,,30.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.08,22,,percent of total billed charges,,,,,,,,,32.69,90,,percent of total billed charges,,,30.07,82.8,,percent of total billed charges,,,30.87,85,,percent of total billed charges,,,,,,,,,31.96,88,,percent of total billed charges,,,,,,,,,27.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.08,22,,percent of total billed charges,,,33.05,91,,percent of total billed charges,,,34.5,95,,percent of total billed charges,,,30.15,83,,percent of total billed charges,,,30.15,83,,percent of total billed charges,,,,,,,,,,,,,,,30.15,83,,percent of total billed charges,,,34.5,95,,percent of total billed charges,,,32.69,90,,percent of total billed charges,,,32.69,90,,percent of total billed charges,,,29.78,82,,percent of total billed charges,,,32.69,90,,percent of total billed charges,,,30.87,85,,percent of total billed charges,,9.08,34.5,
CROTAMITON (EURAX) LOT : 10%       60ML,32003821,CDM,,,250,RC,outpatient,,231.4,231.4,,196.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.85,22,,percent of total billed charges,,,,,,,,,208.26,90,,percent of total billed charges,,,191.6,82.8,,percent of total billed charges,,,196.69,85,,percent of total billed charges,,,,,,,,,203.63,88,,percent of total billed charges,,,,,,,,,176.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.85,22,,percent of total billed charges,,,210.57,91,,percent of total billed charges,,,219.83,95,,percent of total billed charges,,,192.06,83,,percent of total billed charges,,,192.06,83,,percent of total billed charges,,,,,,,,,,,,,,,192.06,83,,percent of total billed charges,,,219.83,95,,percent of total billed charges,,,208.26,90,,percent of total billed charges,,,208.26,90,,percent of total billed charges,,,189.75,82,,percent of total billed charges,,,208.26,90,,percent of total billed charges,,,196.69,85,,percent of total billed charges,,57.85,219.83,
PHENOLPHTHALEIN (EVACUGEN) TAB : 97.2MG,32003826,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
RALOXIFENE(EVISTA)TAB:60MG,32003827,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
APAP/ASA/CAFFEINE TAB: 250/250/65MG,32003831,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PHENOLPHTHALEIN (EX-LAX) TAB : 90MG,32003836,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PURIFIED WATER (EYE-STREAM) IRRIG:30ML,32003871,CDM,J3490,HCPCS,250,RC,outpatient,,342.81,342.81,,291.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.7,22,,percent of total billed charges,,,,,,,,,308.53,90,,percent of total billed charges,,,283.85,82.8,,percent of total billed charges,,,291.39,85,,percent of total billed charges,,,,,,,,,301.67,88,,percent of total billed charges,,,,,,,,,261.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.7,22,,percent of total billed charges,,,311.96,91,,percent of total billed charges,,,325.67,95,,percent of total billed charges,,,284.53,83,,percent of total billed charges,,,284.53,83,,percent of total billed charges,,,,,,,,,,,,,,,284.53,83,,percent of total billed charges,,,325.67,95,,percent of total billed charges,,,308.53,90,,percent of total billed charges,,,308.53,90,,percent of total billed charges,,,281.1,82,,percent of total billed charges,,,308.53,90,,percent of total billed charges,,,291.39,85,,percent of total billed charges,,85.7,325.67,
FAMCICLOVIR(FAMVIR)TAB:500MG,32003881,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FAMCICLOVIR (FAMVIR) TAB 500 MG (1 x 4),32003882,CDM,,,250,RC,outpatient,,31.24,31.24,,26.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.81,22,,percent of total billed charges,,,,,,,,,28.12,90,,percent of total billed charges,,,25.87,82.8,,percent of total billed charges,,,26.55,85,,percent of total billed charges,,,,,,,,,27.49,88,,percent of total billed charges,,,,,,,,,23.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.81,22,,percent of total billed charges,,,28.43,91,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,,,,,,,,,,,,,25.93,83,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,25.62,82,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,26.55,85,,percent of total billed charges,,7.81,29.68,
FENOPROFEN CAL (NALFON)TAB : 600MG,32003891,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
FERRIC SUBSULFATE SOL 500ML,32003901,CDM,,,250,RC,outpatient,,226,226,,191.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.5,22,,percent of total billed charges,,,,,,,,,203.4,90,,percent of total billed charges,,,187.13,82.8,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,,,,,,,,198.88,88,,percent of total billed charges,,,,,,,,,172.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.5,22,,percent of total billed charges,,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,,,,,,,,,,,,,187.58,83,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,185.32,82,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,56.5,214.7,
FERRIC SUBSULFATE SOL 60ML,32003906,CDM,,,250,RC,outpatient,,27.12,27.12,,23.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.78,22,,percent of total billed charges,,,,,,,,,24.41,90,,percent of total billed charges,,,22.46,82.8,,percent of total billed charges,,,23.05,85,,percent of total billed charges,,,,,,,,,23.87,88,,percent of total billed charges,,,,,,,,,20.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.78,22,,percent of total billed charges,,,24.68,91,,percent of total billed charges,,,25.76,95,,percent of total billed charges,,,22.51,83,,percent of total billed charges,,,22.51,83,,percent of total billed charges,,,,,,,,,,,,,,,22.51,83,,percent of total billed charges,,,25.76,95,,percent of total billed charges,,,24.41,90,,percent of total billed charges,,,24.41,90,,percent of total billed charges,,,22.24,82,,percent of total billed charges,,,24.41,90,,percent of total billed charges,,,23.05,85,,percent of total billed charges,,6.78,25.76,
FERROUS SULFATE ELIX : 220MG/5ML 480ML,32003921,CDM,,,250,RC,outpatient,,57.25,57.25,,48.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.31,22,,percent of total billed charges,,,,,,,,,51.53,90,,percent of total billed charges,,,47.4,82.8,,percent of total billed charges,,,48.66,85,,percent of total billed charges,,,,,,,,,50.38,88,,percent of total billed charges,,,,,,,,,43.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.31,22,,percent of total billed charges,,,52.1,91,,percent of total billed charges,,,54.39,95,,percent of total billed charges,,,47.52,83,,percent of total billed charges,,,47.52,83,,percent of total billed charges,,,,,,,,,,,,,,,47.52,83,,percent of total billed charges,,,54.39,95,,percent of total billed charges,,,51.53,90,,percent of total billed charges,,,51.53,90,,percent of total billed charges,,,46.95,82,,percent of total billed charges,,,51.53,90,,percent of total billed charges,,,48.66,85,,percent of total billed charges,,14.31,54.39,
FERROUS SULFATE ELIX:220MG/5ML (60ML),32003926,CDM,J8499,HCPCS,250,RC,outpatient,,14.54,14.54,,12.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.64,22,,percent of total billed charges,,,,,,,,,13.09,90,,percent of total billed charges,,,12.04,82.8,,percent of total billed charges,,,12.36,85,,percent of total billed charges,,,,,,,,,12.8,88,,percent of total billed charges,,,,,,,,,11.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.64,22,,percent of total billed charges,,,13.23,91,,percent of total billed charges,,,13.81,95,,percent of total billed charges,,,12.07,83,,percent of total billed charges,,,12.07,83,,percent of total billed charges,,,,,,,,,,,,,,,12.07,83,,percent of total billed charges,,,13.81,95,,percent of total billed charges,,,13.09,90,,percent of total billed charges,,,13.09,90,,percent of total billed charges,,,11.92,82,,percent of total billed charges,,,13.09,90,,percent of total billed charges,,,12.36,85,,percent of total billed charges,,3.64,13.81,
FERROUS SULFATE TAB:325(65)MG,32003931,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
IRON POLYSACCHRD CMPLX(FERREX)CAP:150MG,32003932,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FE PS CMPLX/CYA(FERREX FORTE)CAP:,32003933,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ACETAMINOPHEN(TYLENOL)SUPP:120MG,32003946,CDM,J3490,HCPCS,250,RC,outpatient,,14.64,14.64,,12.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.66,22,,percent of total billed charges,,,,,,,,,13.18,90,,percent of total billed charges,,,12.12,82.8,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,,,,,,,,12.88,88,,percent of total billed charges,,,,,,,,,11.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.66,22,,percent of total billed charges,,,13.32,91,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,,,,,,,,,,,,,12.15,83,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12,82,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,3.66,13.91,
ACETAMINOPHEN(TYLENOL)SUPP:325MG,32003951,CDM,J3490,HCPCS,250,RC,outpatient,,14.64,14.64,,12.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.66,22,,percent of total billed charges,,,,,,,,,13.18,90,,percent of total billed charges,,,12.12,82.8,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,,,,,,,,12.88,88,,percent of total billed charges,,,,,,,,,11.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.66,22,,percent of total billed charges,,,13.32,91,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,,,,,,,,,,,,,12.15,83,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12,82,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,3.66,13.91,
ACETAMINOPHEN(TYLENOL)SUPP:650MG,32003956,CDM,J3490,HCPCS,250,RC,outpatient,,14.64,14.64,,12.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.66,22,,percent of total billed charges,,,,,,,,,13.18,90,,percent of total billed charges,,,12.12,82.8,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,,,,,,,,12.88,88,,percent of total billed charges,,,,,,,,,11.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.66,22,,percent of total billed charges,,,13.32,91,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,,,,,,,,,,,,,12.15,83,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12,82,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,3.66,13.91,
VAPONEFRIN,32003961,CDM,,,250,RC,outpatient,,9,9,,7.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.25,22,,percent of total billed charges,,,,,,,,,8.1,90,,percent of total billed charges,,,7.45,82.8,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,,,,,,,,7.92,88,,percent of total billed charges,,,,,,,,,6.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.25,22,,percent of total billed charges,,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.38,82,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,2.25,8.55,
CALC POLYCARBOPHIL(FIBERCON)TAB:625MG,32003966,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ASPIR/CAFF/BUTAL(FIORINAL) CAP:325-40-50,32003971,CDM,J8499,HCPCS,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
COD/ASA/CAF/BU(FIORINAL+C) CAP:30-325-50,32003976,CDM,,,250,RC,outpatient,,38.06,38.06,,32.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.52,22,,percent of total billed charges,,,,,,,,,34.25,90,,percent of total billed charges,,,31.51,82.8,,percent of total billed charges,,,32.35,85,,percent of total billed charges,,,,,,,,,33.49,88,,percent of total billed charges,,,,,,,,,29.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.52,22,,percent of total billed charges,,,34.63,91,,percent of total billed charges,,,36.16,95,,percent of total billed charges,,,31.59,83,,percent of total billed charges,,,31.59,83,,percent of total billed charges,,,,,,,,,,,,,,,31.59,83,,percent of total billed charges,,,36.16,95,,percent of total billed charges,,,34.25,90,,percent of total billed charges,,,34.25,90,,percent of total billed charges,,,31.21,82,,percent of total billed charges,,,34.25,90,,percent of total billed charges,,,32.35,85,,percent of total billed charges,,9.52,36.16,
APAP/CAF/BUTALB(FIORICET)TAB:300-40-50MG,32003981,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
BISACODYL/NAPH MB-DB(FLEET PREP KIT #1),32003986,CDM,,,250,RC,outpatient,,72.64,72.64,,61.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.16,22,,percent of total billed charges,,,,,,,,,65.38,90,,percent of total billed charges,,,60.15,82.8,,percent of total billed charges,,,61.74,85,,percent of total billed charges,,,,,,,,,63.92,88,,percent of total billed charges,,,,,,,,,55.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.16,22,,percent of total billed charges,,,66.1,91,,percent of total billed charges,,,69.01,95,,percent of total billed charges,,,60.29,83,,percent of total billed charges,,,60.29,83,,percent of total billed charges,,,,,,,,,,,,,,,60.29,83,,percent of total billed charges,,,69.01,95,,percent of total billed charges,,,65.38,90,,percent of total billed charges,,,65.38,90,,percent of total billed charges,,,59.56,82,,percent of total billed charges,,,65.38,90,,percent of total billed charges,,,61.74,85,,percent of total billed charges,,18.16,69.01,
NA PHOS(FLEET ENEMA):133 ML**,32003991,CDM,J3490,HCPCS,250,RC,outpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.07,22,,percent of total billed charges,,,,,,,,,18.24,90,,percent of total billed charges,,,16.78,82.8,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.07,22,,percent of total billed charges,,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,5.07,19.26,
MINERAL OIL(FLEET M.O. ENEMA):135ML,32003996,CDM,J3490,HCPCS,250,RC,outpatient,,30.07,30.07,,25.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.52,22,,percent of total billed charges,,,,,,,,,27.06,90,,percent of total billed charges,,,24.9,82.8,,percent of total billed charges,,,25.56,85,,percent of total billed charges,,,,,,,,,26.46,88,,percent of total billed charges,,,,,,,,,22.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.52,22,,percent of total billed charges,,,27.36,91,,percent of total billed charges,,,28.57,95,,percent of total billed charges,,,24.96,83,,percent of total billed charges,,,24.96,83,,percent of total billed charges,,,,,,,,,,,,,,,24.96,83,,percent of total billed charges,,,28.57,95,,percent of total billed charges,,,27.06,90,,percent of total billed charges,,,27.06,90,,percent of total billed charges,,,24.66,82,,percent of total billed charges,,,27.06,90,,percent of total billed charges,,,25.56,85,,percent of total billed charges,,7.52,28.57,
TAMSULOSIN(FLOMAX)CAP:0.4MG,32003997,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FLUTICASONE(FLONASE)SPR:50MCG (16ML),32004000,CDM,J3490,HCPCS,250,RC,outpatient,,54.41,54.41,,46.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.6,22,,percent of total billed charges,,,,,,,,,48.97,90,,percent of total billed charges,,,45.05,82.8,,percent of total billed charges,,,46.25,85,,percent of total billed charges,,,,,,,,,47.88,88,,percent of total billed charges,,,,,,,,,41.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.6,22,,percent of total billed charges,,,49.51,91,,percent of total billed charges,,,51.69,95,,percent of total billed charges,,,45.16,83,,percent of total billed charges,,,45.16,83,,percent of total billed charges,,,,,,,,,,,,,,,45.16,83,,percent of total billed charges,,,51.69,95,,percent of total billed charges,,,48.97,90,,percent of total billed charges,,,48.97,90,,percent of total billed charges,,,44.62,82,,percent of total billed charges,,,48.97,90,,percent of total billed charges,,,46.25,85,,percent of total billed charges,,13.6,51.69,
FLUDROCORTISONE(FLORINEF)TAB:0.1MG,32004001,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FLOIVENT 13G,32004007,CDM,,,250,RC,outpatient,,749.82,749.82,,636.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,187.46,22,,percent of total billed charges,,,,,,,,,674.84,90,,percent of total billed charges,,,620.85,82.8,,percent of total billed charges,,,637.35,85,,percent of total billed charges,,,,,,,,,659.84,88,,percent of total billed charges,,,,,,,,,572.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,187.46,22,,percent of total billed charges,,,682.34,91,,percent of total billed charges,,,712.33,95,,percent of total billed charges,,,622.35,83,,percent of total billed charges,,,622.35,83,,percent of total billed charges,,,,,,,,,,,,,,,622.35,83,,percent of total billed charges,,,712.33,95,,percent of total billed charges,,,674.84,90,,percent of total billed charges,,,674.84,90,,percent of total billed charges,,,614.85,82,,percent of total billed charges,,,674.84,90,,percent of total billed charges,,,637.35,85,,percent of total billed charges,,187.46,712.33,
FLUTICASONE(FLOVENT)MDI:220MCG,32004008,CDM,J7699,HCPCS,250,RC,outpatient,,3296.64,3296.64,,2798.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,824.16,22,,percent of total billed charges,,,,,,,,,2966.98,90,,percent of total billed charges,,,2729.62,82.8,,percent of total billed charges,,,2802.14,85,,percent of total billed charges,,,,,,,,,2901.04,88,,percent of total billed charges,,,,,,,,,2518.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,824.16,22,,percent of total billed charges,,,2999.94,91,,percent of total billed charges,,,3131.81,95,,percent of total billed charges,,,2736.21,83,,percent of total billed charges,,,2736.21,83,,percent of total billed charges,,,,,,,,,,,,,,,2736.21,83,,percent of total billed charges,,,3131.81,95,,percent of total billed charges,,,2966.98,90,,percent of total billed charges,,,2966.98,90,,percent of total billed charges,,,2703.24,82,,percent of total billed charges,,,2966.98,90,,percent of total billed charges,,,2802.14,85,,percent of total billed charges,,824.16,3131.81,
FLUTICASONE(FLOVENT)MDI:44MCG (7.9GM),32004009,CDM,,,250,RC,outpatient,,2802.37,2802.37,,2379.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,700.59,22,,percent of total billed charges,,,,,,,,,2522.13,90,,percent of total billed charges,,,2320.36,82.8,,percent of total billed charges,,,2382.01,85,,percent of total billed charges,,,,,,,,,2466.09,88,,percent of total billed charges,,,,,,,,,2141.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,700.59,22,,percent of total billed charges,,,2550.16,91,,percent of total billed charges,,,2662.25,95,,percent of total billed charges,,,2325.97,83,,percent of total billed charges,,,2325.97,83,,percent of total billed charges,,,,,,,,,,,,,,,2325.97,83,,percent of total billed charges,,,2662.25,95,,percent of total billed charges,,,2522.13,90,,percent of total billed charges,,,2522.13,90,,percent of total billed charges,,,2297.94,82,,percent of total billed charges,,,2522.13,90,,percent of total billed charges,,,2382.01,85,,percent of total billed charges,,700.59,2662.25,
FLOVENT 220MCG INAHALER (7.9G),32004010,CDM,,,250,RC,outpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.75,22,,percent of total billed charges,,,,,,,,,182.7,90,,percent of total billed charges,,,168.08,82.8,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.75,22,,percent of total billed charges,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,50.75,192.85,
FLUTICASONE(FLOVENT)MDI:110MCG (12G),32004012,CDM,J7699,HCPCS,250,RC,outpatient,,2122.36,2122.36,,1801.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,530.59,22,,percent of total billed charges,,,,,,,,,1910.12,90,,percent of total billed charges,,,1757.31,82.8,,percent of total billed charges,,,1804.01,85,,percent of total billed charges,,,,,,,,,1867.68,88,,percent of total billed charges,,,,,,,,,1621.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,530.59,22,,percent of total billed charges,,,1931.35,91,,percent of total billed charges,,,2016.24,95,,percent of total billed charges,,,1761.56,83,,percent of total billed charges,,,1761.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1761.56,83,,percent of total billed charges,,,2016.24,95,,percent of total billed charges,,,1910.12,90,,percent of total billed charges,,,1910.12,90,,percent of total billed charges,,,1740.34,82,,percent of total billed charges,,,1910.12,90,,percent of total billed charges,,,1804.01,85,,percent of total billed charges,,530.59,2016.24,
FLUSHIELD TUBEX,32004032,CDM,90657,CPT,636,RC,outpatient,,30,30,,25.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.5,22,,percent of total billed charges,,,,,,,,,27,90,,percent of total billed charges,,,24.84,82.8,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,,,,,,,,26.4,88,,percent of total billed charges,,,,,,,,,22.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.5,22,,percent of total billed charges,,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,24.9,83,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,24.6,82,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,7.5,28.5,
FLUDARABINE(FLUDARA)VIAL:50MG,32004036,CDM,J9185,HCPCS,636,RC,outpatient,,1333.52,1333.52,,1132.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,333.38,22,,percent of total billed charges,,,,,,,,,1200.17,90,,percent of total billed charges,,,1104.15,82.8,,percent of total billed charges,,,1133.49,85,,percent of total billed charges,,,,,,,,,1173.5,88,,percent of total billed charges,,184.43,,,,fee schedule,,,1018.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,184.43,,,,fee schedule,,,333.38,22,,percent of total billed charges,,,1213.5,91,,percent of total billed charges,,,1266.84,95,,percent of total billed charges,,,1106.82,83,,percent of total billed charges,,,1106.82,83,,percent of total billed charges,,,,,,,,,,,,,,,1106.82,83,,percent of total billed charges,,,1266.84,95,,percent of total billed charges,,,1200.17,90,,percent of total billed charges,,,1200.17,90,,percent of total billed charges,,,1093.49,82,,percent of total billed charges,,,1200.17,90,,percent of total billed charges,,,1133.49,85,,percent of total billed charges,,184.43,1266.84,
FLUORESCEIN(FLUOR-I)STRIP:9MG,32004051,CDM,J3490,HCPCS,250,RC,outpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.07,22,,percent of total billed charges,,,,,,,,,18.24,90,,percent of total billed charges,,,16.78,82.8,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.07,22,,percent of total billed charges,,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,5.07,19.26,
HALOTHANE (FLUOTHANE) LIQ    5ML,32004061,CDM,,,250,RC,outpatient,,370.81,370.81,,314.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.7,22,,percent of total billed charges,,,,,,,,,333.73,90,,percent of total billed charges,,,307.03,82.8,,percent of total billed charges,,,315.19,85,,percent of total billed charges,,,,,,,,,326.31,88,,percent of total billed charges,,,,,,,,,283.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.7,22,,percent of total billed charges,,,337.44,91,,percent of total billed charges,,,352.27,95,,percent of total billed charges,,,307.77,83,,percent of total billed charges,,,307.77,83,,percent of total billed charges,,,,,,,,,,,,,,,307.77,83,,percent of total billed charges,,,352.27,95,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,304.06,82,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,315.19,85,,percent of total billed charges,,92.7,352.27,
HALOTHANE (FLUOTHANE) LIQ  20 ML,32004066,CDM,,,250,RC,outpatient,,370.81,370.81,,314.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.7,22,,percent of total billed charges,,,,,,,,,333.73,90,,percent of total billed charges,,,307.03,82.8,,percent of total billed charges,,,315.19,85,,percent of total billed charges,,,,,,,,,326.31,88,,percent of total billed charges,,,,,,,,,283.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.7,22,,percent of total billed charges,,,337.44,91,,percent of total billed charges,,,352.27,95,,percent of total billed charges,,,307.77,83,,percent of total billed charges,,,307.77,83,,percent of total billed charges,,,,,,,,,,,,,,,307.77,83,,percent of total billed charges,,,352.27,95,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,304.06,82,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,315.19,85,,percent of total billed charges,,92.7,352.27,
FLURAZEPAM HCL CAP(DALMANE) : 15MG,32004081,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
FLURBIPROFEN(OCUFEN)EYE DROP 0.03%:2.5ML,32004091,CDM,J3490,HCPCS,250,RC,outpatient,,583.17,583.17,,495.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,145.79,22,,percent of total billed charges,,,,,,,,,524.85,90,,percent of total billed charges,,,482.86,82.8,,percent of total billed charges,,,495.69,85,,percent of total billed charges,,,,,,,,,513.19,88,,percent of total billed charges,,,,,,,,,445.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,145.79,22,,percent of total billed charges,,,530.68,91,,percent of total billed charges,,,554.01,95,,percent of total billed charges,,,484.03,83,,percent of total billed charges,,,484.03,83,,percent of total billed charges,,,,,,,,,,,,,,,484.03,83,,percent of total billed charges,,,554.01,95,,percent of total billed charges,,,524.85,90,,percent of total billed charges,,,524.85,90,,percent of total billed charges,,,478.2,82,,percent of total billed charges,,,524.85,90,,percent of total billed charges,,,495.69,85,,percent of total billed charges,,145.79,554.01,
FOLIC ACID TAB:1MG,32004111,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FOLIC ACID VIAL:5MG/ML  (10ML),32004116,CDM,J3490,HCPCS,250,RC,outpatient,,703.76,703.76,,597.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175.94,22,,percent of total billed charges,,,,,,,,,633.38,90,,percent of total billed charges,,,582.71,82.8,,percent of total billed charges,,,598.2,85,,percent of total billed charges,,,,,,,,,619.31,88,,percent of total billed charges,,,,,,,,,537.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175.94,22,,percent of total billed charges,,,640.42,91,,percent of total billed charges,,,668.57,95,,percent of total billed charges,,,584.12,83,,percent of total billed charges,,,584.12,83,,percent of total billed charges,,,,,,,,,,,,,,,584.12,83,,percent of total billed charges,,,668.57,95,,percent of total billed charges,,,633.38,90,,percent of total billed charges,,,633.38,90,,percent of total billed charges,,,577.08,82,,percent of total billed charges,,,633.38,90,,percent of total billed charges,,,598.2,85,,percent of total billed charges,,175.94,668.57,
ISOFLURANE (FORANE) LIQ   20 ML,32004126,CDM,,,250,RC,outpatient,,370.81,370.81,,314.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.7,22,,percent of total billed charges,,,,,,,,,333.73,90,,percent of total billed charges,,,307.03,82.8,,percent of total billed charges,,,315.19,85,,percent of total billed charges,,,,,,,,,326.31,88,,percent of total billed charges,,,,,,,,,283.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.7,22,,percent of total billed charges,,,337.44,91,,percent of total billed charges,,,352.27,95,,percent of total billed charges,,,307.77,83,,percent of total billed charges,,,307.77,83,,percent of total billed charges,,,,,,,,,,,,,,,307.77,83,,percent of total billed charges,,,352.27,95,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,304.06,82,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,315.19,85,,percent of total billed charges,,92.7,352.27,
CEFTAZIDIME (FORTAZ) VIAL:500MG,32004131,CDM,,,250,RC,outpatient,,98.65,98.65,,83.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.66,22,,percent of total billed charges,,,,,,,,,88.79,90,,percent of total billed charges,,,81.68,82.8,,percent of total billed charges,,,83.85,85,,percent of total billed charges,,,,,,,,,86.81,88,,percent of total billed charges,,,,,,,,,75.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.66,22,,percent of total billed charges,,,89.77,91,,percent of total billed charges,,,93.72,95,,percent of total billed charges,,,81.88,83,,percent of total billed charges,,,81.88,83,,percent of total billed charges,,,,,,,,,,,,,,,81.88,83,,percent of total billed charges,,,93.72,95,,percent of total billed charges,,,88.79,90,,percent of total billed charges,,,88.79,90,,percent of total billed charges,,,80.89,82,,percent of total billed charges,,,88.79,90,,percent of total billed charges,,,83.85,85,,percent of total billed charges,,24.66,93.72,
cefTAZIDIME (TAZICEF) VIAL: 1GM,32004136,CDM,J0713,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,7.75,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.75,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,7.75,59.21,
FRAGMIN 2500U SYRINGE,32004137,CDM,,,250,RC,outpatient,,51,51,,43.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.75,22,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,42.23,82.8,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,,,,,,,,44.88,88,,percent of total billed charges,,,,,,,,,38.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.75,22,,percent of total billed charges,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,41.82,82,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,12.75,48.45,
DALTEPARIN PORCNE(FRAGMIN)SYR:5000 U/0.2,32004138,CDM,,,250,RC,outpatient,,431.55,431.55,,366.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.89,22,,percent of total billed charges,,,,,,,,,388.4,90,,percent of total billed charges,,,357.32,82.8,,percent of total billed charges,,,366.82,85,,percent of total billed charges,,,,,,,,,379.76,88,,percent of total billed charges,,,,,,,,,329.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.89,22,,percent of total billed charges,,,392.71,91,,percent of total billed charges,,,409.97,95,,percent of total billed charges,,,358.19,83,,percent of total billed charges,,,358.19,83,,percent of total billed charges,,,,,,,,,,,,,,,358.19,83,,percent of total billed charges,,,409.97,95,,percent of total billed charges,,,388.4,90,,percent of total billed charges,,,388.4,90,,percent of total billed charges,,,353.87,82,,percent of total billed charges,,,388.4,90,,percent of total billed charges,,,366.82,85,,percent of total billed charges,,107.89,409.97,
FRAGMIN 10000U/ML (1ML),32004139,CDM,,,250,RC,outpatient,,162,162,,137.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.5,22,,percent of total billed charges,,,,,,,,,145.8,90,,percent of total billed charges,,,134.14,82.8,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,,,,,,,,142.56,88,,percent of total billed charges,,,,,,,,,123.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.5,22,,percent of total billed charges,,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,,,,,,,,,,,,,134.46,83,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,132.84,82,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,40.5,153.9,
FRAGMIN 9.5ML MD,32004142,CDM,,,250,RC,outpatient,,661.5,661.5,,561.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,165.38,22,,percent of total billed charges,,,,,,,,,595.35,90,,percent of total billed charges,,,547.72,82.8,,percent of total billed charges,,,562.28,85,,percent of total billed charges,,,,,,,,,582.12,88,,percent of total billed charges,,,,,,,,,505.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,165.38,22,,percent of total billed charges,,,601.97,91,,percent of total billed charges,,,628.43,95,,percent of total billed charges,,,549.05,83,,percent of total billed charges,,,549.05,83,,percent of total billed charges,,,,,,,,,,,,,,,549.05,83,,percent of total billed charges,,,628.43,95,,percent of total billed charges,,,595.35,90,,percent of total billed charges,,,595.35,90,,percent of total billed charges,,,542.43,82,,percent of total billed charges,,,595.35,90,,percent of total billed charges,,,562.28,85,,percent of total billed charges,,165.38,628.43,
GRISEOFULVIN ULTRAMICROSIZE TAB : 330MG,32004146,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
AMPHOTERICIN B(FUNGIZONE)VIAL:50MG,32004151,CDM,J0285,HCPCS,636,RC,outpatient,,727.66,727.66,,617.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,181.92,22,,percent of total billed charges,,,,,,,,,654.89,90,,percent of total billed charges,,,602.5,82.8,,percent of total billed charges,,,618.51,85,,percent of total billed charges,,,,,,,,,640.34,88,,percent of total billed charges,,118.01,,,,fee schedule,,,555.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,118.01,,,,fee schedule,,,181.92,22,,percent of total billed charges,,,662.17,91,,percent of total billed charges,,,691.28,95,,percent of total billed charges,,,603.96,83,,percent of total billed charges,,,603.96,83,,percent of total billed charges,,,,,,,,,,,,,,,603.96,83,,percent of total billed charges,,,691.28,95,,percent of total billed charges,,,654.89,90,,percent of total billed charges,,,654.89,90,,percent of total billed charges,,,596.68,82,,percent of total billed charges,,,654.89,90,,percent of total billed charges,,,618.51,85,,percent of total billed charges,,118.01,691.28,
FUROSEMIDE(LASIX)TAB:20MG,32004166,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FUROSEMIDE(LASIX)TAB:40MG,32004171,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FUROSEMIDE(LASIX)TAB:80MG,32004176,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FUROSEMIDE(LASIX)VL: 20MG/2ML,32004181,CDM,J1940,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,3.16,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.16,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,3.16,60.99,
FUROSEMIDE(LASIX)VL: 40MG/4ML,32004186,CDM,J1940,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,3.16,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.16,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,3.16,60.99,
FUROSEMIDE(LASIX)VL:100MG/10ML,32004191,CDM,J1940,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,3.16,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.16,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,3.16,60.99,
FUROSEMIDE(LASIX)ORAL SOL:10MG/ML (60ML),32004196,CDM,,,250,RC,outpatient,,85.96,85.96,,72.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.49,22,,percent of total billed charges,,,,,,,,,77.36,90,,percent of total billed charges,,,71.17,82.8,,percent of total billed charges,,,73.07,85,,percent of total billed charges,,,,,,,,,75.64,88,,percent of total billed charges,,,,,,,,,65.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.49,22,,percent of total billed charges,,,78.22,91,,percent of total billed charges,,,81.66,95,,percent of total billed charges,,,71.35,83,,percent of total billed charges,,,71.35,83,,percent of total billed charges,,,,,,,,,,,,,,,71.35,83,,percent of total billed charges,,,81.66,95,,percent of total billed charges,,,77.36,90,,percent of total billed charges,,,77.36,90,,percent of total billed charges,,,70.49,82,,percent of total billed charges,,,77.36,90,,percent of total billed charges,,,73.07,85,,percent of total billed charges,,21.49,81.66,
GELATIN  ABSORBABL(GELFOAM)SPONGE:12-7MM,32004206,CDM,J3490,HCPCS,250,RC,outpatient,,135.95,135.95,,115.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.99,22,,percent of total billed charges,,,,,,,,,122.36,90,,percent of total billed charges,,,112.57,82.8,,percent of total billed charges,,,115.56,85,,percent of total billed charges,,,,,,,,,119.64,88,,percent of total billed charges,,,,,,,,,103.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.99,22,,percent of total billed charges,,,123.71,91,,percent of total billed charges,,,129.15,95,,percent of total billed charges,,,112.84,83,,percent of total billed charges,,,112.84,83,,percent of total billed charges,,,,,,,,,,,,,,,112.84,83,,percent of total billed charges,,,129.15,95,,percent of total billed charges,,,122.36,90,,percent of total billed charges,,,122.36,90,,percent of total billed charges,,,111.48,82,,percent of total billed charges,,,122.36,90,,percent of total billed charges,,,115.56,85,,percent of total billed charges,,33.99,129.15,
GEMFIBROZIL(LOPID)TAB:600MG,32004211,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
GEMCITABINE(GEMZAR)VIAL:200MG,32004212,CDM,J9201,HCPCS,636,RC,outpatient,,155.39,155.39,,131.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.85,22,,percent of total billed charges,,,,,,,,,139.85,90,,percent of total billed charges,,,128.66,82.8,,percent of total billed charges,,,132.08,85,,percent of total billed charges,,,,,,,,,136.74,88,,percent of total billed charges,,55.14,,,,fee schedule,,,118.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,55.14,,,,fee schedule,,,38.85,22,,percent of total billed charges,,,141.4,91,,percent of total billed charges,,,147.62,95,,percent of total billed charges,,,128.97,83,,percent of total billed charges,,,128.97,83,,percent of total billed charges,,,,,,,,,,,,,,,128.97,83,,percent of total billed charges,,,147.62,95,,percent of total billed charges,,,139.85,90,,percent of total billed charges,,,139.85,90,,percent of total billed charges,,,127.42,82,,percent of total billed charges,,,139.85,90,,percent of total billed charges,,,132.08,85,,percent of total billed charges,,38.85,147.62,
GEMZAR 1 GM  **J9201X5**,32004213,CDM,J9201,HCPCS,636,RC,outpatient,,493,493,,418.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.25,22,,percent of total billed charges,,,,,,,,,443.7,90,,percent of total billed charges,,,408.2,82.8,,percent of total billed charges,,,419.05,85,,percent of total billed charges,,,,,,,,,433.84,88,,percent of total billed charges,,55.14,,,,fee schedule,,,376.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,55.14,,,,fee schedule,,,123.25,22,,percent of total billed charges,,,448.63,91,,percent of total billed charges,,,468.35,95,,percent of total billed charges,,,409.19,83,,percent of total billed charges,,,409.19,83,,percent of total billed charges,,,,,,,,,,,,,,,409.19,83,,percent of total billed charges,,,468.35,95,,percent of total billed charges,,,443.7,90,,percent of total billed charges,,,443.7,90,,percent of total billed charges,,,404.26,82,,percent of total billed charges,,,443.7,90,,percent of total billed charges,,,419.05,85,,percent of total billed charges,,55.14,468.35,
OXYMETAZOLINE(AFRIN)SPR 0.05%:15ML,32004216,CDM,J3490,HCPCS,250,RC,outpatient,,22.88,22.88,,19.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.72,22,,percent of total billed charges,,,,,,,,,20.59,90,,percent of total billed charges,,,18.94,82.8,,percent of total billed charges,,,19.45,85,,percent of total billed charges,,,,,,,,,20.13,88,,percent of total billed charges,,,,,,,,,17.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.72,22,,percent of total billed charges,,,20.82,91,,percent of total billed charges,,,21.74,95,,percent of total billed charges,,,18.99,83,,percent of total billed charges,,,18.99,83,,percent of total billed charges,,,,,,,,,,,,,,,18.99,83,,percent of total billed charges,,,21.74,95,,percent of total billed charges,,,20.59,90,,percent of total billed charges,,,20.59,90,,percent of total billed charges,,,18.76,82,,percent of total billed charges,,,20.59,90,,percent of total billed charges,,,19.45,85,,percent of total billed charges,,5.72,21.74,
MAGCAR/AL/ALG(GAVISCON)ORAL   360ML,32004221,CDM,,,250,RC,outpatient,,32.99,32.99,,28.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.25,22,,percent of total billed charges,,,,,,,,,29.69,90,,percent of total billed charges,,,27.32,82.8,,percent of total billed charges,,,28.04,85,,percent of total billed charges,,,,,,,,,29.03,88,,percent of total billed charges,,,,,,,,,25.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.25,22,,percent of total billed charges,,,30.02,91,,percent of total billed charges,,,31.34,95,,percent of total billed charges,,,27.38,83,,percent of total billed charges,,,27.38,83,,percent of total billed charges,,,,,,,,,,,,,,,27.38,83,,percent of total billed charges,,,31.34,95,,percent of total billed charges,,,29.69,90,,percent of total billed charges,,,29.69,90,,percent of total billed charges,,,27.05,82,,percent of total billed charges,,,29.69,90,,percent of total billed charges,,,28.04,85,,percent of total billed charges,,8.25,31.34,
ASPIRIN/ACET/CAFF(GENACED)TAB:250-250-65,32004226,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
SIMETHICONE(MYLICON)DROP:40MG/0.6ML 30ML,32004231,CDM,J8499,HCPCS,250,RC,outpatient,,29.74,29.74,,25.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.44,22,,percent of total billed charges,,,,,,,,,26.77,90,,percent of total billed charges,,,24.62,82.8,,percent of total billed charges,,,25.28,85,,percent of total billed charges,,,,,,,,,26.17,88,,percent of total billed charges,,,,,,,,,22.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.44,22,,percent of total billed charges,,,27.06,91,,percent of total billed charges,,,28.25,95,,percent of total billed charges,,,24.68,83,,percent of total billed charges,,,24.68,83,,percent of total billed charges,,,,,,,,,,,,,,,24.68,83,,percent of total billed charges,,,28.25,95,,percent of total billed charges,,,26.77,90,,percent of total billed charges,,,26.77,90,,percent of total billed charges,,,24.39,82,,percent of total billed charges,,,26.77,90,,percent of total billed charges,,,25.28,85,,percent of total billed charges,,7.44,28.25,
TRISIL/ALH/NAHCO3(GAVISCON) TAB: 20-80MG,32004236,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
GENTAMICIN(GENTAMICIN)DROP 0.3%:5ML,32004246,CDM,J3490,HCPCS,250,RC,outpatient,,84.48,84.48,,71.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.12,22,,percent of total billed charges,,,,,,,,,76.03,90,,percent of total billed charges,,,69.95,82.8,,percent of total billed charges,,,71.81,85,,percent of total billed charges,,,,,,,,,74.34,88,,percent of total billed charges,,,,,,,,,64.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.12,22,,percent of total billed charges,,,76.88,91,,percent of total billed charges,,,80.26,95,,percent of total billed charges,,,70.12,83,,percent of total billed charges,,,70.12,83,,percent of total billed charges,,,,,,,,,,,,,,,70.12,83,,percent of total billed charges,,,80.26,95,,percent of total billed charges,,,76.03,90,,percent of total billed charges,,,76.03,90,,percent of total billed charges,,,69.27,82,,percent of total billed charges,,,76.03,90,,percent of total billed charges,,,71.81,85,,percent of total billed charges,,21.12,80.26,
GENOPTIC 1ML,32004247,CDM,,,250,RC,outpatient,,12.5,12.5,,10.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.13,22,,percent of total billed charges,,,,,,,,,11.25,90,,percent of total billed charges,,,10.35,82.8,,percent of total billed charges,,,10.63,85,,percent of total billed charges,,,,,,,,,11,88,,percent of total billed charges,,,,,,,,,9.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.13,22,,percent of total billed charges,,,11.38,91,,percent of total billed charges,,,11.88,95,,percent of total billed charges,,,10.38,83,,percent of total billed charges,,,10.38,83,,percent of total billed charges,,,,,,,,,,,,,,,10.38,83,,percent of total billed charges,,,11.88,95,,percent of total billed charges,,,11.25,90,,percent of total billed charges,,,11.25,90,,percent of total billed charges,,,10.25,82,,percent of total billed charges,,,11.25,90,,percent of total billed charges,,,10.63,85,,percent of total billed charges,,3.13,11.88,
GENTAMICIN(GARAMYCIN)TOP CR 0.1%:15GM,32004251,CDM,J3490,HCPCS,250,RC,outpatient,,234.57,234.57,,199.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,58.64,22,,percent of total billed charges,,,,,,,,,211.11,90,,percent of total billed charges,,,194.22,82.8,,percent of total billed charges,,,199.38,85,,percent of total billed charges,,,,,,,,,206.42,88,,percent of total billed charges,,,,,,,,,179.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,58.64,22,,percent of total billed charges,,,213.46,91,,percent of total billed charges,,,222.84,95,,percent of total billed charges,,,194.69,83,,percent of total billed charges,,,194.69,83,,percent of total billed charges,,,,,,,,,,,,,,,194.69,83,,percent of total billed charges,,,222.84,95,,percent of total billed charges,,,211.11,90,,percent of total billed charges,,,211.11,90,,percent of total billed charges,,,192.35,82,,percent of total billed charges,,,211.11,90,,percent of total billed charges,,,199.38,85,,percent of total billed charges,,58.64,222.84,
GENTAMICIN(GARAMYCIN)TOP OINT 0.1%:30GM,32004256,CDM,J3490,HCPCS,250,RC,outpatient,,657.71,657.71,,558.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,164.43,22,,percent of total billed charges,,,,,,,,,591.94,90,,percent of total billed charges,,,544.58,82.8,,percent of total billed charges,,,559.05,85,,percent of total billed charges,,,,,,,,,578.78,88,,percent of total billed charges,,,,,,,,,502.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,164.43,22,,percent of total billed charges,,,598.52,91,,percent of total billed charges,,,624.82,95,,percent of total billed charges,,,545.9,83,,percent of total billed charges,,,545.9,83,,percent of total billed charges,,,,,,,,,,,,,,,545.9,83,,percent of total billed charges,,,624.82,95,,percent of total billed charges,,,591.94,90,,percent of total billed charges,,,591.94,90,,percent of total billed charges,,,539.32,82,,percent of total billed charges,,,591.94,90,,percent of total billed charges,,,559.05,85,,percent of total billed charges,,164.43,624.82,
GENTAMICIN(GENTAK)OPTH OINT 0.3%:3.5GM,32004271,CDM,J3490,HCPCS,250,RC,outpatient,,520.27,520.27,,441.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.07,22,,percent of total billed charges,,,,,,,,,468.24,90,,percent of total billed charges,,,430.78,82.8,,percent of total billed charges,,,442.23,85,,percent of total billed charges,,,,,,,,,457.84,88,,percent of total billed charges,,,,,,,,,397.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.07,22,,percent of total billed charges,,,473.45,91,,percent of total billed charges,,,494.26,95,,percent of total billed charges,,,431.82,83,,percent of total billed charges,,,431.82,83,,percent of total billed charges,,,,,,,,,,,,,,,431.82,83,,percent of total billed charges,,,494.26,95,,percent of total billed charges,,,468.24,90,,percent of total billed charges,,,468.24,90,,percent of total billed charges,,,426.62,82,,percent of total billed charges,,,468.24,90,,percent of total billed charges,,,442.23,85,,percent of total billed charges,,130.07,494.26,
GENTAMICIN-VIAL:80MG/2ML,32004276,CDM,J1580,HCPCS,250,RC,outpatient,,69.61,69.61,,59.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.4,22,,percent of total billed charges,,,,,,,,,62.65,90,,percent of total billed charges,,,57.64,82.8,,percent of total billed charges,,,59.17,85,,percent of total billed charges,,,,,,,,,61.26,88,,percent of total billed charges,,21.3,,,,fee schedule,,,53.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21.3,,,,fee schedule,,,17.4,22,,percent of total billed charges,,,63.35,91,,percent of total billed charges,,,66.13,95,,percent of total billed charges,,,57.78,83,,percent of total billed charges,,,57.78,83,,percent of total billed charges,,,,,,,,,,,,,,,57.78,83,,percent of total billed charges,,,66.13,95,,percent of total billed charges,,,62.65,90,,percent of total billed charges,,,62.65,90,,percent of total billed charges,,,57.08,82,,percent of total billed charges,,,62.65,90,,percent of total billed charges,,,59.17,85,,percent of total billed charges,,17.4,66.13,
GENTAMICIN 40MG/ML 20ML,32004277,CDM,,,250,RC,outpatient,,40.5,40.5,,34.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.13,22,,percent of total billed charges,,,,,,,,,36.45,90,,percent of total billed charges,,,33.53,82.8,,percent of total billed charges,,,34.43,85,,percent of total billed charges,,,,,,,,,35.64,88,,percent of total billed charges,,,,,,,,,30.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.13,22,,percent of total billed charges,,,36.86,91,,percent of total billed charges,,,38.48,95,,percent of total billed charges,,,33.62,83,,percent of total billed charges,,,33.62,83,,percent of total billed charges,,,,,,,,,,,,,,,33.62,83,,percent of total billed charges,,,38.48,95,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,33.21,82,,percent of total billed charges,,,36.45,90,,percent of total billed charges,,,34.43,85,,percent of total billed charges,,10.13,38.48,
G I  COCKTAIL  30ML,32004296,CDM,,,250,RC,outpatient,,27.45,27.45,,23.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.86,22,,percent of total billed charges,,,,,,,,,24.71,90,,percent of total billed charges,,,22.73,82.8,,percent of total billed charges,,,23.33,85,,percent of total billed charges,,,,,,,,,24.16,88,,percent of total billed charges,,,,,,,,,20.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.86,22,,percent of total billed charges,,,24.98,91,,percent of total billed charges,,,26.08,95,,percent of total billed charges,,,22.78,83,,percent of total billed charges,,,22.78,83,,percent of total billed charges,,,,,,,,,,,,,,,22.78,83,,percent of total billed charges,,,26.08,95,,percent of total billed charges,,,24.71,90,,percent of total billed charges,,,24.71,90,,percent of total billed charges,,,22.51,82,,percent of total billed charges,,,24.71,90,,percent of total billed charges,,,23.33,85,,percent of total billed charges,,6.86,26.08,
GINSENG,32004297,CDM,,,250,RC,outpatient,,0.5,0.5,,0.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.13,22,,percent of total billed charges,,,,,,,,,0.45,90,,percent of total billed charges,,,0.41,82.8,,percent of total billed charges,,,0.43,85,,percent of total billed charges,,,,,,,,,0.44,88,,percent of total billed charges,,,,,,,,,0.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.13,22,,percent of total billed charges,,,0.46,91,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,,,,,,,,,,,,,0.42,83,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.41,82,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.43,85,,percent of total billed charges,,0.13,0.48,
glipiZIDE(GLUCOTROL)TAB:5MG,32004301,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
gliPIZIDE (GLUCOTROL) TAB : 10MG,32004306,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
GLUCAGON HUMAN RECOMBINANT KIT : 1MG,32004311,CDM,J1610,HCPCS,636,RC,outpatient,,1517.28,1517.28,,1288.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,379.32,22,,percent of total billed charges,,,,,,,,,1365.55,90,,percent of total billed charges,,,1256.31,82.8,,percent of total billed charges,,,1289.69,85,,percent of total billed charges,,,,,,,,,1335.21,88,,percent of total billed charges,,340.66,,,,fee schedule,,,1159.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,340.66,,,,fee schedule,,,379.32,22,,percent of total billed charges,,,1380.72,91,,percent of total billed charges,,,1441.42,95,,percent of total billed charges,,,1259.34,83,,percent of total billed charges,,,1259.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1259.34,83,,percent of total billed charges,,,1441.42,95,,percent of total billed charges,,,1365.55,90,,percent of total billed charges,,,1365.55,90,,percent of total billed charges,,,1244.17,82,,percent of total billed charges,,,1365.55,90,,percent of total billed charges,,,1289.69,85,,percent of total billed charges,,340.66,1441.42,
metFORMIN(GLUCOPHAGE)TAB:500MG,32004316,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
glipiZIDE(GLUCOTROL XL)TAB:5MG,32004321,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
glipiZIDE(GLUCOTROL XL)TAB:10MG,32004322,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
GLUCOSAMINE CHONDRTN,32004323,CDM,,,250,RC,outpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.75,22,,percent of total billed charges,,,,,,,,,2.7,90,,percent of total billed charges,,,2.48,82.8,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.75,22,,percent of total billed charges,,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,0.75,2.85,
DEXTROSE(GLUCOSE)TAB:4GM,32004324,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
glyBURIDE (DIABETA) TAB : 1.25MG,32004326,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
glyBURIDE(DIABETA)TAB:2.5MG,32004331,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
glyBURIDE (DIABETA) TAB : 5MG,32004336,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
GLYCERIN(SANI-SUPP)SUPP:ADULT,32004341,CDM,J3490,HCPCS,250,RC,outpatient,,14.64,14.64,,12.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.66,22,,percent of total billed charges,,,,,,,,,13.18,90,,percent of total billed charges,,,12.12,82.8,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,,,,,,,,12.88,88,,percent of total billed charges,,,,,,,,,11.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.66,22,,percent of total billed charges,,,13.32,91,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,,,,,,,,,,,,,12.15,83,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12,82,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,3.66,13.91,
GLYCERIN(SANI-SUPP)SUPP:PEDIATRIC,32004346,CDM,J3490,HCPCS,250,RC,outpatient,,14.64,14.64,,12.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.66,22,,percent of total billed charges,,,,,,,,,13.18,90,,percent of total billed charges,,,12.12,82.8,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,,,,,,,,12.88,88,,percent of total billed charges,,,,,,,,,11.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.66,22,,percent of total billed charges,,,13.32,91,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,12.15,83,,percent of total billed charges,,,,,,,,,,,,,,,12.15,83,,percent of total billed charges,,,13.91,95,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12,82,,percent of total billed charges,,,13.18,90,,percent of total billed charges,,,12.44,85,,percent of total billed charges,,3.66,13.91,
GLYCERIN + ROSEWATER,32004347,CDM,,,250,RC,outpatient,,11.5,11.5,,9.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.88,22,,percent of total billed charges,,,,,,,,,10.35,90,,percent of total billed charges,,,9.52,82.8,,percent of total billed charges,,,9.78,85,,percent of total billed charges,,,,,,,,,10.12,88,,percent of total billed charges,,,,,,,,,8.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.88,22,,percent of total billed charges,,,10.47,91,,percent of total billed charges,,,10.93,95,,percent of total billed charges,,,9.55,83,,percent of total billed charges,,,9.55,83,,percent of total billed charges,,,,,,,,,,,,,,,9.55,83,,percent of total billed charges,,,10.93,95,,percent of total billed charges,,,10.35,90,,percent of total billed charges,,,10.35,90,,percent of total billed charges,,,9.43,82,,percent of total billed charges,,,10.35,90,,percent of total billed charges,,,9.78,85,,percent of total billed charges,,2.88,10.93,
GLYCERIN LIQ 120 ML,32004351,CDM,,,250,RC,outpatient,,39.49,39.49,,33.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.87,22,,percent of total billed charges,,,,,,,,,35.54,90,,percent of total billed charges,,,32.7,82.8,,percent of total billed charges,,,33.57,85,,percent of total billed charges,,,,,,,,,34.75,88,,percent of total billed charges,,,,,,,,,30.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.87,22,,percent of total billed charges,,,35.94,91,,percent of total billed charges,,,37.52,95,,percent of total billed charges,,,32.78,83,,percent of total billed charges,,,32.78,83,,percent of total billed charges,,,,,,,,,,,,,,,32.78,83,,percent of total billed charges,,,37.52,95,,percent of total billed charges,,,35.54,90,,percent of total billed charges,,,35.54,90,,percent of total billed charges,,,32.38,82,,percent of total billed charges,,,35.54,90,,percent of total billed charges,,,33.57,85,,percent of total billed charges,,9.87,37.52,
GLYCERIN LIQ:480 ML,32004356,CDM,J3490,HCPCS,250,RC,outpatient,,327.67,327.67,,278.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,81.92,22,,percent of total billed charges,,,,,,,,,294.9,90,,percent of total billed charges,,,271.31,82.8,,percent of total billed charges,,,278.52,85,,percent of total billed charges,,,,,,,,,288.35,88,,percent of total billed charges,,,,,,,,,250.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,81.92,22,,percent of total billed charges,,,298.18,91,,percent of total billed charges,,,311.29,95,,percent of total billed charges,,,271.97,83,,percent of total billed charges,,,271.97,83,,percent of total billed charges,,,,,,,,,,,,,,,271.97,83,,percent of total billed charges,,,311.29,95,,percent of total billed charges,,,294.9,90,,percent of total billed charges,,,294.9,90,,percent of total billed charges,,,268.69,82,,percent of total billed charges,,,294.9,90,,percent of total billed charges,,,278.52,85,,percent of total billed charges,,81.92,311.29,
MIGLITOL (GLYSET) TAB : 25MG,32004357,CDM,,,250,RC,outpatient,,45.68,45.68,,38.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.42,22,,percent of total billed charges,,,,,,,,,41.11,90,,percent of total billed charges,,,37.82,82.8,,percent of total billed charges,,,38.83,85,,percent of total billed charges,,,,,,,,,40.2,88,,percent of total billed charges,,,,,,,,,34.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.42,22,,percent of total billed charges,,,41.57,91,,percent of total billed charges,,,43.4,95,,percent of total billed charges,,,37.91,83,,percent of total billed charges,,,37.91,83,,percent of total billed charges,,,,,,,,,,,,,,,37.91,83,,percent of total billed charges,,,43.4,95,,percent of total billed charges,,,41.11,90,,percent of total billed charges,,,41.11,90,,percent of total billed charges,,,37.46,82,,percent of total billed charges,,,41.11,90,,percent of total billed charges,,,38.83,85,,percent of total billed charges,,11.42,43.4,
glyBURIDE (GLYNASE) TAB : 6MG,32004361,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
glyBURIDE(GLYNASE)TAB:3MG,32004366,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
SODI/NAHC03/KCL/PEGS(GOLYTELY)SOL:4000ML,32004376,CDM,J8499,HCPCS,250,RC,outpatient,,160.3,160.3,,136.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.08,22,,percent of total billed charges,,,,,,,,,144.27,90,,percent of total billed charges,,,132.73,82.8,,percent of total billed charges,,,136.26,85,,percent of total billed charges,,,,,,,,,141.06,88,,percent of total billed charges,,,,,,,,,122.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.08,22,,percent of total billed charges,,,145.87,91,,percent of total billed charges,,,152.29,95,,percent of total billed charges,,,133.05,83,,percent of total billed charges,,,133.05,83,,percent of total billed charges,,,,,,,,,,,,,,,133.05,83,,percent of total billed charges,,,152.29,95,,percent of total billed charges,,,144.27,90,,percent of total billed charges,,,144.27,90,,percent of total billed charges,,,131.45,82,,percent of total billed charges,,,144.27,90,,percent of total billed charges,,,136.26,85,,percent of total billed charges,,40.08,152.29,
TRYPS/BAL/CAST OIL(GRANULAX) SPRAY 56.7G,32004386,CDM,,,250,RC,outpatient,,67,67,,56.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.75,22,,percent of total billed charges,,,,,,,,,60.3,90,,percent of total billed charges,,,55.48,82.8,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,,,,,,,,58.96,88,,percent of total billed charges,,,,,,,,,51.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.75,22,,percent of total billed charges,,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,,,,,,,,,,,,,55.61,83,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,54.94,82,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,16.75,63.65,
GRAPESEED EXTRACT,32004387,CDM,,,250,RC,outpatient,,1,1,,0.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.25,22,,percent of total billed charges,,,,,,,,,0.9,90,,percent of total billed charges,,,0.83,82.8,,percent of total billed charges,,,0.85,85,,percent of total billed charges,,,,,,,,,0.88,88,,percent of total billed charges,,,,,,,,,0.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.25,22,,percent of total billed charges,,,0.91,91,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,,,,,,,,,,,,,0.83,83,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.82,82,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.85,85,,percent of total billed charges,,0.25,0.95,
GUAIFENESIN (PHENYLFENESIN) TAB:400-75MG,32004396,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
EUCALYPTUS/MENTHOL(HALLS)LOZ:,32004397,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
guaiFENesin/COD(ROBITUSSIN AC)SYR:120ML,32004406,CDM,J8499,HCPCS,250,RC,outpatient,,94.94,94.94,,80.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.74,22,,percent of total billed charges,,,,,,,,,85.45,90,,percent of total billed charges,,,78.61,82.8,,percent of total billed charges,,,80.7,85,,percent of total billed charges,,,,,,,,,83.55,88,,percent of total billed charges,,,,,,,,,72.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.74,22,,percent of total billed charges,,,86.4,91,,percent of total billed charges,,,90.19,95,,percent of total billed charges,,,78.8,83,,percent of total billed charges,,,78.8,83,,percent of total billed charges,,,,,,,,,,,,,,,78.8,83,,percent of total billed charges,,,90.19,95,,percent of total billed charges,,,85.45,90,,percent of total billed charges,,,85.45,90,,percent of total billed charges,,,77.85,82,,percent of total billed charges,,,85.45,90,,percent of total billed charges,,,80.7,85,,percent of total billed charges,,23.74,90.19,
GUAIFN/CODEINE(ROBITUSSIN AC) SYRP :90ML,32004411,CDM,,,250,RC,outpatient,,11.25,11.25,,9.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.81,22,,percent of total billed charges,,,,,,,,,10.13,90,,percent of total billed charges,,,9.32,82.8,,percent of total billed charges,,,9.56,85,,percent of total billed charges,,,,,,,,,9.9,88,,percent of total billed charges,,,,,,,,,8.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.81,22,,percent of total billed charges,,,10.24,91,,percent of total billed charges,,,10.69,95,,percent of total billed charges,,,9.34,83,,percent of total billed charges,,,9.34,83,,percent of total billed charges,,,,,,,,,,,,,,,9.34,83,,percent of total billed charges,,,10.69,95,,percent of total billed charges,,,10.13,90,,percent of total billed charges,,,10.13,90,,percent of total billed charges,,,9.23,82,,percent of total billed charges,,,10.13,90,,percent of total billed charges,,,9.56,85,,percent of total billed charges,,2.81,10.69,
HALOPERIDOL(HALDOL)VIAL:5MG/ML,32004421,CDM,J1630,HCPCS,636,RC,outpatient,,89.71,89.71,,76.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.43,22,,percent of total billed charges,,,,,,,,,80.74,90,,percent of total billed charges,,,74.28,82.8,,percent of total billed charges,,,76.25,85,,percent of total billed charges,,,,,,,,,78.94,88,,percent of total billed charges,,1.62,,,,fee schedule,,,68.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.62,,,,fee schedule,,,22.43,22,,percent of total billed charges,,,81.64,91,,percent of total billed charges,,,85.22,95,,percent of total billed charges,,,74.46,83,,percent of total billed charges,,,74.46,83,,percent of total billed charges,,,,,,,,,,,,,,,74.46,83,,percent of total billed charges,,,85.22,95,,percent of total billed charges,,,80.74,90,,percent of total billed charges,,,80.74,90,,percent of total billed charges,,,73.56,82,,percent of total billed charges,,,80.74,90,,percent of total billed charges,,,76.25,85,,percent of total billed charges,,1.62,85.22,
HALCINONIDE (HALOG) CREAM : 0.1%  15GM,32004426,CDM,,,250,RC,outpatient,,332.9,332.9,,282.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.23,22,,percent of total billed charges,,,,,,,,,299.61,90,,percent of total billed charges,,,275.64,82.8,,percent of total billed charges,,,282.97,85,,percent of total billed charges,,,,,,,,,292.95,88,,percent of total billed charges,,,,,,,,,254.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.23,22,,percent of total billed charges,,,302.94,91,,percent of total billed charges,,,316.26,95,,percent of total billed charges,,,276.31,83,,percent of total billed charges,,,276.31,83,,percent of total billed charges,,,,,,,,,,,,,,,276.31,83,,percent of total billed charges,,,316.26,95,,percent of total billed charges,,,299.61,90,,percent of total billed charges,,,299.61,90,,percent of total billed charges,,,272.98,82,,percent of total billed charges,,,299.61,90,,percent of total billed charges,,,282.97,85,,percent of total billed charges,,83.23,316.26,
HALOPERIDOL(HALDOL)TAB:0.5MG,32004436,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
HALOPERIDOL LACTATE ORAL : 2MG/ML 120ML,32004446,CDM,,,250,RC,outpatient,,322.59,322.59,,273.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.65,22,,percent of total billed charges,,,,,,,,,290.33,90,,percent of total billed charges,,,267.1,82.8,,percent of total billed charges,,,274.2,85,,percent of total billed charges,,,,,,,,,283.88,88,,percent of total billed charges,,,,,,,,,246.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.65,22,,percent of total billed charges,,,293.56,91,,percent of total billed charges,,,306.46,95,,percent of total billed charges,,,267.75,83,,percent of total billed charges,,,267.75,83,,percent of total billed charges,,,,,,,,,,,,,,,267.75,83,,percent of total billed charges,,,306.46,95,,percent of total billed charges,,,290.33,90,,percent of total billed charges,,,290.33,90,,percent of total billed charges,,,264.52,82,,percent of total billed charges,,,290.33,90,,percent of total billed charges,,,274.2,85,,percent of total billed charges,,80.65,306.46,
HALOPERIDOL (HALDOL) TAB : 5MG,32004456,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CARBOPROST TROMET(HEMABATE)AMP:250MCG/ML,32004467,CDM,J3490,HCPCS,250,RC,outpatient,,2777.81,2777.81,,2358.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,694.45,22,,percent of total billed charges,,,,,,,,,2500.03,90,,percent of total billed charges,,,2300.03,82.8,,percent of total billed charges,,,2361.14,85,,percent of total billed charges,,,,,,,,,2444.47,88,,percent of total billed charges,,,,,,,,,2122.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,694.45,22,,percent of total billed charges,,,2527.81,91,,percent of total billed charges,,,2638.92,95,,percent of total billed charges,,,2305.58,83,,percent of total billed charges,,,2305.58,83,,percent of total billed charges,,,,,,,,,,,,,,,2305.58,83,,percent of total billed charges,,,2638.92,95,,percent of total billed charges,,,2500.03,90,,percent of total billed charges,,,2500.03,90,,percent of total billed charges,,,2277.8,82,,percent of total billed charges,,,2500.03,90,,percent of total billed charges,,,2361.14,85,,percent of total billed charges,,694.45,2638.92,
"HEParin VIAL:5,000UNITS/ML",32004471,CDM,J1644,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
HEParin VIAL: 10000 UNITS/ML   1ML,32004476,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
HEPARIN VIAL : 100 U/ML,32004481,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
HEParin LOCK 10ML:100UNITS/ML,32004486,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
INSUL REG(HumuLIN) 50-50UNIT/ML:10ML,32004505,CDM,,,250,RC,outpatient,,169,169,,143.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.25,22,,percent of total billed charges,,,,,,,,,152.1,90,,percent of total billed charges,,,139.93,82.8,,percent of total billed charges,,,143.65,85,,percent of total billed charges,,,,,,,,,148.72,88,,percent of total billed charges,,,,,,,,,129.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.25,22,,percent of total billed charges,,,153.79,91,,percent of total billed charges,,,160.55,95,,percent of total billed charges,,,140.27,83,,percent of total billed charges,,,140.27,83,,percent of total billed charges,,,,,,,,,,,,,,,140.27,83,,percent of total billed charges,,,160.55,95,,percent of total billed charges,,,152.1,90,,percent of total billed charges,,,152.1,90,,percent of total billed charges,,,138.58,82,,percent of total billed charges,,,152.1,90,,percent of total billed charges,,,143.65,85,,percent of total billed charges,,42.25,160.55,
insul NPH(novoLIN N):100UNIT/ML  (10ML),32004506,CDM,J1815,HCPCS,250,RC,outpatient,,252.94,252.94,,214.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.24,22,,percent of total billed charges,,,,,,,,,227.65,90,,percent of total billed charges,,,209.43,82.8,,percent of total billed charges,,,215,85,,percent of total billed charges,,,,,,,,,222.59,88,,percent of total billed charges,,,,,,,,,193.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.24,22,,percent of total billed charges,,,230.18,91,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,,,,,,,,,,,,,209.94,83,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,207.41,82,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,215,85,,percent of total billed charges,,63.24,240.29,
INSUL ZN(NOVOLIN L):100 UNITS/ML 10ML,32004511,CDM,,,250,RC,outpatient,,460.73,460.73,,391.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.18,22,,percent of total billed charges,,,,,,,,,414.66,90,,percent of total billed charges,,,381.48,82.8,,percent of total billed charges,,,391.62,85,,percent of total billed charges,,,,,,,,,405.44,88,,percent of total billed charges,,,,,,,,,352,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.18,22,,percent of total billed charges,,,419.26,91,,percent of total billed charges,,,437.69,95,,percent of total billed charges,,,382.41,83,,percent of total billed charges,,,382.41,83,,percent of total billed charges,,,,,,,,,,,,,,,382.41,83,,percent of total billed charges,,,437.69,95,,percent of total billed charges,,,414.66,90,,percent of total billed charges,,,414.66,90,,percent of total billed charges,,,377.8,82,,percent of total billed charges,,,414.66,90,,percent of total billed charges,,,391.62,85,,percent of total billed charges,,115.18,437.69,
insul REG(novoLIN R):100UNITS/ML (10ML),32004516,CDM,J1815,HCPCS,250,RC,outpatient,,252.94,252.94,,214.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.24,22,,percent of total billed charges,,,,,,,,,227.65,90,,percent of total billed charges,,,209.43,82.8,,percent of total billed charges,,,215,85,,percent of total billed charges,,,,,,,,,222.59,88,,percent of total billed charges,,,,,,,,,193.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.24,22,,percent of total billed charges,,,230.18,91,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,,,,,,,,,,,,,209.94,83,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,207.41,82,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,215,85,,percent of total billed charges,,63.24,240.29,
insul REG(novoLIN R):100UNITS/ML  (1ML),32004521,CDM,,,250,RC,outpatient,,223.15,223.15,,189.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.79,22,,percent of total billed charges,,,,,,,,,200.84,90,,percent of total billed charges,,,184.77,82.8,,percent of total billed charges,,,189.68,85,,percent of total billed charges,,,,,,,,,196.37,88,,percent of total billed charges,,,,,,,,,170.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.79,22,,percent of total billed charges,,,203.07,91,,percent of total billed charges,,,211.99,95,,percent of total billed charges,,,185.21,83,,percent of total billed charges,,,185.21,83,,percent of total billed charges,,,,,,,,,,,,,,,185.21,83,,percent of total billed charges,,,211.99,95,,percent of total billed charges,,,200.84,90,,percent of total billed charges,,,200.84,90,,percent of total billed charges,,,182.98,82,,percent of total billed charges,,,200.84,90,,percent of total billed charges,,,189.68,85,,percent of total billed charges,,55.79,211.99,
INSUL ZN EXT(HumuLINU):100UNIT/ML (10ML),32004526,CDM,,,250,RC,outpatient,,460.73,460.73,,391.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.18,22,,percent of total billed charges,,,,,,,,,414.66,90,,percent of total billed charges,,,381.48,82.8,,percent of total billed charges,,,391.62,85,,percent of total billed charges,,,,,,,,,405.44,88,,percent of total billed charges,,,,,,,,,352,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.18,22,,percent of total billed charges,,,419.26,91,,percent of total billed charges,,,437.69,95,,percent of total billed charges,,,382.41,83,,percent of total billed charges,,,382.41,83,,percent of total billed charges,,,,,,,,,,,,,,,382.41,83,,percent of total billed charges,,,437.69,95,,percent of total billed charges,,,414.66,90,,percent of total billed charges,,,414.66,90,,percent of total billed charges,,,377.8,82,,percent of total billed charges,,,414.66,90,,percent of total billed charges,,,391.62,85,,percent of total billed charges,,115.18,437.69,
insul ASPART(novoLOG)VL100UNIT/ML:10ML,32004527,CDM,,,250,RC,outpatient,,2290.88,2290.88,,1944.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,572.72,22,,percent of total billed charges,,,,,,,,,2061.79,90,,percent of total billed charges,,,1896.85,82.8,,percent of total billed charges,,,1947.25,85,,percent of total billed charges,,,,,,,,,2015.97,88,,percent of total billed charges,,,,,,,,,1750.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,572.72,22,,percent of total billed charges,,,2084.7,91,,percent of total billed charges,,,2176.34,95,,percent of total billed charges,,,1901.43,83,,percent of total billed charges,,,1901.43,83,,percent of total billed charges,,,,,,,,,,,,,,,1901.43,83,,percent of total billed charges,,,2176.34,95,,percent of total billed charges,,,2061.79,90,,percent of total billed charges,,,2061.79,90,,percent of total billed charges,,,1878.52,82,,percent of total billed charges,,,2061.79,90,,percent of total billed charges,,,1947.25,85,,percent of total billed charges,,572.72,2176.34,
insul NPH/R(novoLIN 70/30) VIAL:10ML,32004531,CDM,J1815,HCPCS,250,RC,outpatient,,251.31,251.31,,213.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.83,22,,percent of total billed charges,,,,,,,,,226.18,90,,percent of total billed charges,,,208.08,82.8,,percent of total billed charges,,,213.61,85,,percent of total billed charges,,,,,,,,,221.15,88,,percent of total billed charges,,,,,,,,,192,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.83,22,,percent of total billed charges,,,228.69,91,,percent of total billed charges,,,238.74,95,,percent of total billed charges,,,208.59,83,,percent of total billed charges,,,208.59,83,,percent of total billed charges,,,,,,,,,,,,,,,208.59,83,,percent of total billed charges,,,238.74,95,,percent of total billed charges,,,226.18,90,,percent of total billed charges,,,226.18,90,,percent of total billed charges,,,206.07,82,,percent of total billed charges,,,226.18,90,,percent of total billed charges,,,213.61,85,,percent of total billed charges,,62.83,238.74,
BENZOCAINE(HURRICAINE)SPR  20%:1ML,32004536,CDM,J3490,HCPCS,250,RC,outpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.07,22,,percent of total billed charges,,,,,,,,,18.24,90,,percent of total billed charges,,,16.78,82.8,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.07,22,,percent of total billed charges,,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,5.07,19.26,
BENZOCAINE(HURRICAINE)SPR 20%:60ML,32004541,CDM,J3490,HCPCS,250,RC,outpatient,,533.83,533.83,,453.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,133.46,22,,percent of total billed charges,,,,,,,,,480.45,90,,percent of total billed charges,,,442.01,82.8,,percent of total billed charges,,,453.76,85,,percent of total billed charges,,,,,,,,,469.77,88,,percent of total billed charges,,,,,,,,,407.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,133.46,22,,percent of total billed charges,,,485.79,91,,percent of total billed charges,,,507.14,95,,percent of total billed charges,,,443.08,83,,percent of total billed charges,,,443.08,83,,percent of total billed charges,,,,,,,,,,,,,,,443.08,83,,percent of total billed charges,,,507.14,95,,percent of total billed charges,,,480.45,90,,percent of total billed charges,,,480.45,90,,percent of total billed charges,,,437.74,82,,percent of total billed charges,,,480.45,90,,percent of total billed charges,,,453.76,85,,percent of total billed charges,,133.46,507.14,
*TOPOTECAN(HYCAMTIN)VIAL:4MG(V1011),32004547,CDM,J9351,HCPCS,636,RC,outpatient,,5142.78,5142.78,,4366.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1285.7,22,,percent of total billed charges,,,,,,,,,4628.5,90,,percent of total billed charges,,,4258.22,82.8,,percent of total billed charges,,,4371.36,85,,percent of total billed charges,,,,,,,,,4525.65,88,,percent of total billed charges,,44.36,,,,fee schedule,,,3929.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,44.36,,,,fee schedule,,,1285.7,22,,percent of total billed charges,,,4679.93,91,,percent of total billed charges,,,4885.64,95,,percent of total billed charges,,,4268.51,83,,percent of total billed charges,,,4268.51,83,,percent of total billed charges,,,,,,,,,,,,,,,4268.51,83,,percent of total billed charges,,,4885.64,95,,percent of total billed charges,,,4628.5,90,,percent of total billed charges,,,4628.5,90,,percent of total billed charges,,,4217.08,82,,percent of total billed charges,,,4628.5,90,,percent of total billed charges,,,4371.36,85,,percent of total billed charges,,44.36,4885.64,
hydrALAZINE(APRESOLINE)VIAL:20MG/ML,32004556,CDM,J0360,HCPCS,250,RC,outpatient,,274.51,274.51,,233.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.63,22,,percent of total billed charges,,,,,,,,,247.06,90,,percent of total billed charges,,,227.29,82.8,,percent of total billed charges,,,233.33,85,,percent of total billed charges,,,,,,,,,241.57,88,,percent of total billed charges,,13.29,,,,fee schedule,,,209.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.29,,,,fee schedule,,,68.63,22,,percent of total billed charges,,,249.8,91,,percent of total billed charges,,,260.78,95,,percent of total billed charges,,,227.84,83,,percent of total billed charges,,,227.84,83,,percent of total billed charges,,,,,,,,,,,,,,,227.84,83,,percent of total billed charges,,,260.78,95,,percent of total billed charges,,,247.06,90,,percent of total billed charges,,,247.06,90,,percent of total billed charges,,,225.1,82,,percent of total billed charges,,,247.06,90,,percent of total billed charges,,,233.33,85,,percent of total billed charges,,13.29,260.78,
HYDROXYCHLOROQUINE(PLAQUENIL)TAB:200MG,32004557,CDM,J8499,HCPCS,250,RC,outpatient,,16.83,16.83,,14.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.21,22,,percent of total billed charges,,,,,,,,,15.15,90,,percent of total billed charges,,,13.94,82.8,,percent of total billed charges,,,14.31,85,,percent of total billed charges,,,,,,,,,14.81,88,,percent of total billed charges,,,,,,,,,12.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.21,22,,percent of total billed charges,,,15.32,91,,percent of total billed charges,,,15.99,95,,percent of total billed charges,,,13.97,83,,percent of total billed charges,,,13.97,83,,percent of total billed charges,,,,,,,,,,,,,,,13.97,83,,percent of total billed charges,,,15.99,95,,percent of total billed charges,,,15.15,90,,percent of total billed charges,,,15.15,90,,percent of total billed charges,,,13.8,82,,percent of total billed charges,,,15.15,90,,percent of total billed charges,,,14.31,85,,percent of total billed charges,,4.21,15.99,
hydroxyZINE (ATARAX) TAB : 10MG,32004561,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
hydrOXYzine(ATARAX)TAB:25MG,32004566,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
HYDERGINE LC,32004571,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
HYDROCORTISONE CREAM 0.5%:30GM,32004576,CDM,J3490,HCPCS,250,RC,outpatient,,44.41,44.41,,37.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.1,22,,percent of total billed charges,,,,,,,,,39.97,90,,percent of total billed charges,,,36.77,82.8,,percent of total billed charges,,,37.75,85,,percent of total billed charges,,,,,,,,,39.08,88,,percent of total billed charges,,,,,,,,,33.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.1,22,,percent of total billed charges,,,40.41,91,,percent of total billed charges,,,42.19,95,,percent of total billed charges,,,36.86,83,,percent of total billed charges,,,36.86,83,,percent of total billed charges,,,,,,,,,,,,,,,36.86,83,,percent of total billed charges,,,42.19,95,,percent of total billed charges,,,39.97,90,,percent of total billed charges,,,39.97,90,,percent of total billed charges,,,36.42,82,,percent of total billed charges,,,39.97,90,,percent of total billed charges,,,37.75,85,,percent of total billed charges,,11.1,42.19,
HYDROCORTISONE ACETATE POW:10GM,32004581,CDM,,,250,RC,outpatient,,341.31,341.31,,289.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.33,22,,percent of total billed charges,,,,,,,,,307.18,90,,percent of total billed charges,,,282.6,82.8,,percent of total billed charges,,,290.11,85,,percent of total billed charges,,,,,,,,,300.35,88,,percent of total billed charges,,,,,,,,,260.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.33,22,,percent of total billed charges,,,310.59,91,,percent of total billed charges,,,324.24,95,,percent of total billed charges,,,283.29,83,,percent of total billed charges,,,283.29,83,,percent of total billed charges,,,,,,,,,,,,,,,283.29,83,,percent of total billed charges,,,324.24,95,,percent of total billed charges,,,307.18,90,,percent of total billed charges,,,307.18,90,,percent of total billed charges,,,279.87,82,,percent of total billed charges,,,307.18,90,,percent of total billed charges,,,290.11,85,,percent of total billed charges,,85.33,324.24,
HYDROCORTISONE OINT : 1%     28.35GM,32004586,CDM,,,250,RC,outpatient,,99.92,99.92,,84.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.98,22,,percent of total billed charges,,,,,,,,,89.93,90,,percent of total billed charges,,,82.73,82.8,,percent of total billed charges,,,84.93,85,,percent of total billed charges,,,,,,,,,87.93,88,,percent of total billed charges,,,,,,,,,76.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.98,22,,percent of total billed charges,,,90.93,91,,percent of total billed charges,,,94.92,95,,percent of total billed charges,,,82.93,83,,percent of total billed charges,,,82.93,83,,percent of total billed charges,,,,,,,,,,,,,,,82.93,83,,percent of total billed charges,,,94.92,95,,percent of total billed charges,,,89.93,90,,percent of total billed charges,,,89.93,90,,percent of total billed charges,,,81.93,82,,percent of total billed charges,,,89.93,90,,percent of total billed charges,,,84.93,85,,percent of total billed charges,,24.98,94.92,
hydrALAZINE(APRESOLINE)TAB:10MG,32004591,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
HYDROCORTISONE CREAM 1%:30GM,32004596,CDM,J3490,HCPCS,250,RC,outpatient,,25.16,25.16,,21.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.29,22,,percent of total billed charges,,,,,,,,,22.64,90,,percent of total billed charges,,,20.83,82.8,,percent of total billed charges,,,21.39,85,,percent of total billed charges,,,,,,,,,22.14,88,,percent of total billed charges,,,,,,,,,19.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.29,22,,percent of total billed charges,,,22.9,91,,percent of total billed charges,,,23.9,95,,percent of total billed charges,,,20.88,83,,percent of total billed charges,,,20.88,83,,percent of total billed charges,,,,,,,,,,,,,,,20.88,83,,percent of total billed charges,,,23.9,95,,percent of total billed charges,,,22.64,90,,percent of total billed charges,,,22.64,90,,percent of total billed charges,,,20.63,82,,percent of total billed charges,,,22.64,90,,percent of total billed charges,,,21.39,85,,percent of total billed charges,,6.29,23.9,
HYDROGEN PEROXIDE SOL 3%:480 ML,32004601,CDM,J3490,HCPCS,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
HYDROXY (ATARAX)SYRP : 10MG/5ML 480ML,32004606,CDM,,,250,RC,outpatient,,531.94,531.94,,451.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.99,22,,percent of total billed charges,,,,,,,,,478.75,90,,percent of total billed charges,,,440.45,82.8,,percent of total billed charges,,,452.15,85,,percent of total billed charges,,,,,,,,,468.11,88,,percent of total billed charges,,,,,,,,,406.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.99,22,,percent of total billed charges,,,484.07,91,,percent of total billed charges,,,505.34,95,,percent of total billed charges,,,441.51,83,,percent of total billed charges,,,441.51,83,,percent of total billed charges,,,,,,,,,,,,,,,441.51,83,,percent of total billed charges,,,505.34,95,,percent of total billed charges,,,478.75,90,,percent of total billed charges,,,478.75,90,,percent of total billed charges,,,436.19,82,,percent of total billed charges,,,478.75,90,,percent of total billed charges,,,452.15,85,,percent of total billed charges,,132.99,505.34,
HYDROXY (ATARAX) SYRP: 10MG/5ML  60ML,32004611,CDM,,,250,RC,outpatient,,67.56,67.56,,57.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.89,22,,percent of total billed charges,,,,,,,,,60.8,90,,percent of total billed charges,,,55.94,82.8,,percent of total billed charges,,,57.43,85,,percent of total billed charges,,,,,,,,,59.45,88,,percent of total billed charges,,,,,,,,,51.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.89,22,,percent of total billed charges,,,61.48,91,,percent of total billed charges,,,64.18,95,,percent of total billed charges,,,56.07,83,,percent of total billed charges,,,56.07,83,,percent of total billed charges,,,,,,,,,,,,,,,56.07,83,,percent of total billed charges,,,64.18,95,,percent of total billed charges,,,60.8,90,,percent of total billed charges,,,60.8,90,,percent of total billed charges,,,55.4,82,,percent of total billed charges,,,60.8,90,,percent of total billed charges,,,57.43,85,,percent of total billed charges,,16.89,64.18,
hydrALAZINE(APRESOLINE)TAB:25MG,32004621,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
HYDROGEN PEROXIDE SOL 3%:480ML,32004626,CDM,,,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
DIPHENHYDR(BENDRYL)EL:12.5MG/5ML(60ML)PX,32004636,CDM,,,250,RC,outpatient,,35.21,35.21,,29.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.8,22,,percent of total billed charges,,,,,,,,,31.69,90,,percent of total billed charges,,,29.15,82.8,,percent of total billed charges,,,29.93,85,,percent of total billed charges,,,,,,,,,30.98,88,,percent of total billed charges,,,,,,,,,26.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.8,22,,percent of total billed charges,,,32.04,91,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,,,,,,,,,,,,,29.22,83,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,28.87,82,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,29.93,85,,percent of total billed charges,,8.8,33.45,
HYDROCORTISONE(CORT-ENEMA):100MG/60ML,32004641,CDM,J3490,HCPCS,250,RC,outpatient,,99.76,99.76,,84.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.94,22,,percent of total billed charges,,,,,,,,,89.78,90,,percent of total billed charges,,,82.6,82.8,,percent of total billed charges,,,84.8,85,,percent of total billed charges,,,,,,,,,87.79,88,,percent of total billed charges,,,,,,,,,76.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.94,22,,percent of total billed charges,,,90.78,91,,percent of total billed charges,,,94.77,95,,percent of total billed charges,,,82.8,83,,percent of total billed charges,,,82.8,83,,percent of total billed charges,,,,,,,,,,,,,,,82.8,83,,percent of total billed charges,,,94.77,95,,percent of total billed charges,,,89.78,90,,percent of total billed charges,,,89.78,90,,percent of total billed charges,,,81.8,82,,percent of total billed charges,,,89.78,90,,percent of total billed charges,,,84.8,85,,percent of total billed charges,,24.94,94.77,
HYDROmorphone 2mg tabHCL,32004651,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
DIPHENHYDRA(BENADRYL)LIQ:12.5MG/5ML 90ML,32004656,CDM,,,250,RC,outpatient,,8.5,8.5,,7.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.13,22,,percent of total billed charges,,,,,,,,,7.65,90,,percent of total billed charges,,,7.04,82.8,,percent of total billed charges,,,7.23,85,,percent of total billed charges,,,,,,,,,7.48,88,,percent of total billed charges,,,,,,,,,6.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.13,22,,percent of total billed charges,,,7.74,91,,percent of total billed charges,,,8.08,95,,percent of total billed charges,,,7.06,83,,percent of total billed charges,,,7.06,83,,percent of total billed charges,,,,,,,,,,,,,,,7.06,83,,percent of total billed charges,,,8.08,95,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,6.97,82,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,7.23,85,,percent of total billed charges,,2.13,8.08,
NEO/HC/POLY SUSP(CORTISPORIN EAR):10ML,32004661,CDM,J3490,HCPCS,250,RC,outpatient,,785.42,785.42,,666.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,196.36,22,,percent of total billed charges,,,,,,,,,706.88,90,,percent of total billed charges,,,650.33,82.8,,percent of total billed charges,,,667.61,85,,percent of total billed charges,,,,,,,,,691.17,88,,percent of total billed charges,,,,,,,,,600.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,196.36,22,,percent of total billed charges,,,714.73,91,,percent of total billed charges,,,746.15,95,,percent of total billed charges,,,651.9,83,,percent of total billed charges,,,651.9,83,,percent of total billed charges,,,,,,,,,,,,,,,651.9,83,,percent of total billed charges,,,746.15,95,,percent of total billed charges,,,706.88,90,,percent of total billed charges,,,706.88,90,,percent of total billed charges,,,644.04,82,,percent of total billed charges,,,706.88,90,,percent of total billed charges,,,667.61,85,,percent of total billed charges,,196.36,746.15,
HYDROCORTISONE LOT:2.50% 59ML,32004666,CDM,,,250,RC,outpatient,,491.34,491.34,,417.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.84,22,,percent of total billed charges,,,,,,,,,442.21,90,,percent of total billed charges,,,406.83,82.8,,percent of total billed charges,,,417.64,85,,percent of total billed charges,,,,,,,,,432.38,88,,percent of total billed charges,,,,,,,,,375.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.84,22,,percent of total billed charges,,,447.12,91,,percent of total billed charges,,,466.77,95,,percent of total billed charges,,,407.81,83,,percent of total billed charges,,,407.81,83,,percent of total billed charges,,,,,,,,,,,,,,,407.81,83,,percent of total billed charges,,,466.77,95,,percent of total billed charges,,,442.21,90,,percent of total billed charges,,,442.21,90,,percent of total billed charges,,,402.9,82,,percent of total billed charges,,,442.21,90,,percent of total billed charges,,,417.64,85,,percent of total billed charges,,122.84,466.77,
HYDROCORTISONE CREAM  2.50%:30GM,32004671,CDM,J3490,HCPCS,250,RC,outpatient,,32.51,32.51,,27.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.13,22,,percent of total billed charges,,,,,,,,,29.26,90,,percent of total billed charges,,,26.92,82.8,,percent of total billed charges,,,27.63,85,,percent of total billed charges,,,,,,,,,28.61,88,,percent of total billed charges,,,,,,,,,24.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.13,22,,percent of total billed charges,,,29.58,91,,percent of total billed charges,,,30.88,95,,percent of total billed charges,,,26.98,83,,percent of total billed charges,,,26.98,83,,percent of total billed charges,,,,,,,,,,,,,,,26.98,83,,percent of total billed charges,,,30.88,95,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,26.66,82,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,27.63,85,,percent of total billed charges,,8.13,30.88,
DIPHENHYD(BENADRYL)LIQ:12.5MG/5ML(120ML),32004681,CDM,J8499,HCPCS,250,RC,outpatient,,35.21,35.21,,29.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.8,22,,percent of total billed charges,,,,,,,,,31.69,90,,percent of total billed charges,,,29.15,82.8,,percent of total billed charges,,,29.93,85,,percent of total billed charges,,,,,,,,,30.98,88,,percent of total billed charges,,,,,,,,,26.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.8,22,,percent of total billed charges,,,32.04,91,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,,,,,,,,,,,,,29.22,83,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,28.87,82,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,29.93,85,,percent of total billed charges,,8.8,33.45,
HYDROmorphone (Diluadid) 2mg/ml syringe,32004686,CDM,,,250,RC,outpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.42,22,,percent of total billed charges,,,,,,,,,59.09,90,,percent of total billed charges,,,54.37,82.8,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,,,,,,,,57.78,88,,percent of total billed charges,,,,,,,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.42,22,,percent of total billed charges,,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,16.42,62.38,
HYDROmorphone (DILAUDID) SYR : 4MG/ML,32004687,CDM,,,250,RC,outpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.42,22,,percent of total billed charges,,,,,,,,,59.09,90,,percent of total billed charges,,,54.37,82.8,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,,,,,,,,57.78,88,,percent of total billed charges,,,,,,,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.42,22,,percent of total billed charges,,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,16.42,62.38,
HYOSCYAMINE (LEVSIN)SUB-LING TAB:0.125MG,32004706,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
DIATRIZOATE MEGLUMINE (HYPAQUE)BTL : 60%,32004716,CDM,,,250,RC,outpatient,,338.29,338.29,,287.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.57,22,,percent of total billed charges,,,,,,,,,304.46,90,,percent of total billed charges,,,280.1,82.8,,percent of total billed charges,,,287.55,85,,percent of total billed charges,,,,,,,,,297.7,88,,percent of total billed charges,,,,,,,,,258.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.57,22,,percent of total billed charges,,,307.84,91,,percent of total billed charges,,,321.38,95,,percent of total billed charges,,,280.78,83,,percent of total billed charges,,,280.78,83,,percent of total billed charges,,,,,,,,,,,,,,,280.78,83,,percent of total billed charges,,,321.38,95,,percent of total billed charges,,,304.46,90,,percent of total billed charges,,,304.46,90,,percent of total billed charges,,,277.4,82,,percent of total billed charges,,,304.46,90,,percent of total billed charges,,,287.55,85,,percent of total billed charges,,84.57,321.38,
DIATRIZOATE MEGLUMINE(HYPAQUE-CY)BTL:30%,32004721,CDM,,,250,RC,outpatient,,317.2,317.2,,269.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.3,22,,percent of total billed charges,,,,,,,,,285.48,90,,percent of total billed charges,,,262.64,82.8,,percent of total billed charges,,,269.62,85,,percent of total billed charges,,,,,,,,,279.14,88,,percent of total billed charges,,,,,,,,,242.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.3,22,,percent of total billed charges,,,288.65,91,,percent of total billed charges,,,301.34,95,,percent of total billed charges,,,263.28,83,,percent of total billed charges,,,263.28,83,,percent of total billed charges,,,,,,,,,,,,,,,263.28,83,,percent of total billed charges,,,301.34,95,,percent of total billed charges,,,285.48,90,,percent of total billed charges,,,285.48,90,,percent of total billed charges,,,260.1,82,,percent of total billed charges,,,285.48,90,,percent of total billed charges,,,269.62,85,,percent of total billed charges,,79.3,301.34,
DIATRIZOATE MEGLUMINE(HYPAQUE)VIAL : 60%,32004726,CDM,,,250,RC,outpatient,,105.94,105.94,,89.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.49,22,,percent of total billed charges,,,,,,,,,95.35,90,,percent of total billed charges,,,87.72,82.8,,percent of total billed charges,,,90.05,85,,percent of total billed charges,,,,,,,,,93.23,88,,percent of total billed charges,,,,,,,,,80.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.49,22,,percent of total billed charges,,,96.41,91,,percent of total billed charges,,,100.64,95,,percent of total billed charges,,,87.93,83,,percent of total billed charges,,,87.93,83,,percent of total billed charges,,,,,,,,,,,,,,,87.93,83,,percent of total billed charges,,,100.64,95,,percent of total billed charges,,,95.35,90,,percent of total billed charges,,,95.35,90,,percent of total billed charges,,,86.87,82,,percent of total billed charges,,,95.35,90,,percent of total billed charges,,,90.05,85,,percent of total billed charges,,26.49,100.64,
DIAZOXIDE(HYPERSTAT IV)AMP:300MG/20ML,32004736,CDM,J1730,HCPCS,636,RC,outpatient,,1521.95,1521.95,,1292.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,380.49,22,,percent of total billed charges,,,,,,,,,1369.76,90,,percent of total billed charges,,,1260.17,82.8,,percent of total billed charges,,,1293.66,85,,percent of total billed charges,,,,,,,,,1339.32,88,,percent of total billed charges,,,,,,,,,1162.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,380.49,22,,percent of total billed charges,,,1384.97,91,,percent of total billed charges,,,1445.85,95,,percent of total billed charges,,,1263.22,83,,percent of total billed charges,,,1263.22,83,,percent of total billed charges,,,,,,,,,,,,,,,1263.22,83,,percent of total billed charges,,,1445.85,95,,percent of total billed charges,,,1369.76,90,,percent of total billed charges,,,1369.76,90,,percent of total billed charges,,,1248,82,,percent of total billed charges,,,1369.76,90,,percent of total billed charges,,,1293.66,85,,percent of total billed charges,,380.49,1445.85,
ELECTROLYTE(TPN)SOLUTION VIAL:20ML,32004743,CDM,J3490,HCPCS,250,RC,outpatient,,113.73,113.73,,96.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.43,22,,percent of total billed charges,,,,,,,,,102.36,90,,percent of total billed charges,,,94.17,82.8,,percent of total billed charges,,,96.67,85,,percent of total billed charges,,,,,,,,,100.08,88,,percent of total billed charges,,,,,,,,,86.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.43,22,,percent of total billed charges,,,103.49,91,,percent of total billed charges,,,108.04,95,,percent of total billed charges,,,94.4,83,,percent of total billed charges,,,94.4,83,,percent of total billed charges,,,,,,,,,,,,,,,94.4,83,,percent of total billed charges,,,108.04,95,,percent of total billed charges,,,102.36,90,,percent of total billed charges,,,102.36,90,,percent of total billed charges,,,93.26,82,,percent of total billed charges,,,102.36,90,,percent of total billed charges,,,96.67,85,,percent of total billed charges,,28.43,108.04,
HYDROCORTISONE LOT : 1%    118 ML,32004746,CDM,,,250,RC,outpatient,,109.59,109.59,,93.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.4,22,,percent of total billed charges,,,,,,,,,98.63,90,,percent of total billed charges,,,90.74,82.8,,percent of total billed charges,,,93.15,85,,percent of total billed charges,,,,,,,,,96.44,88,,percent of total billed charges,,,,,,,,,83.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.4,22,,percent of total billed charges,,,99.73,91,,percent of total billed charges,,,104.11,95,,percent of total billed charges,,,90.96,83,,percent of total billed charges,,,90.96,83,,percent of total billed charges,,,,,,,,,,,,,,,90.96,83,,percent of total billed charges,,,104.11,95,,percent of total billed charges,,,98.63,90,,percent of total billed charges,,,98.63,90,,percent of total billed charges,,,89.86,82,,percent of total billed charges,,,98.63,90,,percent of total billed charges,,,93.15,85,,percent of total billed charges,,27.4,104.11,
teraZOSIN (HYTRIN) CAP : 2MG,32004751,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
teraZOSIN(HYTRIN)CAP:1MG,32004756,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LOSARTAN/HYDCHLTHZD(HYZAAR)TAB:50-12.5MG,32004761,CDM,,,250,RC,outpatient,,44.41,44.41,,37.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.1,22,,percent of total billed charges,,,,,,,,,39.97,90,,percent of total billed charges,,,36.77,82.8,,percent of total billed charges,,,37.75,85,,percent of total billed charges,,,,,,,,,39.08,88,,percent of total billed charges,,,,,,,,,33.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.1,22,,percent of total billed charges,,,40.41,91,,percent of total billed charges,,,42.19,95,,percent of total billed charges,,,36.86,83,,percent of total billed charges,,,36.86,83,,percent of total billed charges,,,,,,,,,,,,,,,36.86,83,,percent of total billed charges,,,42.19,95,,percent of total billed charges,,,39.97,90,,percent of total billed charges,,,39.97,90,,percent of total billed charges,,,36.42,82,,percent of total billed charges,,,39.97,90,,percent of total billed charges,,,37.75,85,,percent of total billed charges,,11.1,42.19,
IBUPROFEN(MOTRIN IB)TAB:200MG,32004771,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ISOSORBIDE MONONITRATE(IMDUR)TAB:60MG,32004811,CDM,J8499,HCPCS,250,RC,outpatient,UD,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
IMIPRAMINE (TOFRANIL) TAB : 10MG,32004816,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
IMIPRAMINE (TOFRANIL) TAB : 25MG,32004821,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
SUMAtriptan(IMITREX)VIAL:6MG/0.5ML,32004826,CDM,J3030,HCPCS,250,RC,outpatient,,83.66,83.66,,71.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.92,22,,percent of total billed charges,,,,,,,,,75.29,90,,percent of total billed charges,,,69.27,82.8,,percent of total billed charges,,,71.11,85,,percent of total billed charges,,,,,,,,,73.62,88,,percent of total billed charges,,7.64,,,,fee schedule,,,63.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.64,,,,fee schedule,,,20.92,22,,percent of total billed charges,,,76.13,91,,percent of total billed charges,,,79.48,95,,percent of total billed charges,,,69.44,83,,percent of total billed charges,,,69.44,83,,percent of total billed charges,,,,,,,,,,,,,,,69.44,83,,percent of total billed charges,,,79.48,95,,percent of total billed charges,,,75.29,90,,percent of total billed charges,,,75.29,90,,percent of total billed charges,,,68.6,82,,percent of total billed charges,,,75.29,90,,percent of total billed charges,,,71.11,85,,percent of total billed charges,,7.64,79.48,
azaTHIOprine(IMURAN)TAB:50MG,32004837,CDM,J7500,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
DROPERIDOL(INAPSINE):5MG/2ML,32004841,CDM,J1790,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,1.51,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.51,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,1.51,59.21,
PROPRANOLOL(INDERAL)AMP:1MG/ML,32004846,CDM,,,250,RC,outpatient,,99.92,99.92,,84.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.98,22,,percent of total billed charges,,,,,,,,,89.93,90,,percent of total billed charges,,,82.73,82.8,,percent of total billed charges,,,84.93,85,,percent of total billed charges,,,,,,,,,87.93,88,,percent of total billed charges,,,,,,,,,76.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.98,22,,percent of total billed charges,,,90.93,91,,percent of total billed charges,,,94.92,95,,percent of total billed charges,,,82.93,83,,percent of total billed charges,,,82.93,83,,percent of total billed charges,,,,,,,,,,,,,,,82.93,83,,percent of total billed charges,,,94.92,95,,percent of total billed charges,,,89.93,90,,percent of total billed charges,,,89.93,90,,percent of total billed charges,,,81.93,82,,percent of total billed charges,,,89.93,90,,percent of total billed charges,,,84.93,85,,percent of total billed charges,,24.98,94.92,
PROPRANOLOL (INDERAL LA) CAP : 160MG,32004851,CDM,,,250,RC,outpatient,,27.44,27.44,,23.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.86,22,,percent of total billed charges,,,,,,,,,24.7,90,,percent of total billed charges,,,22.72,82.8,,percent of total billed charges,,,23.32,85,,percent of total billed charges,,,,,,,,,24.15,88,,percent of total billed charges,,,,,,,,,20.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.86,22,,percent of total billed charges,,,24.97,91,,percent of total billed charges,,,26.07,95,,percent of total billed charges,,,22.78,83,,percent of total billed charges,,,22.78,83,,percent of total billed charges,,,,,,,,,,,,,,,22.78,83,,percent of total billed charges,,,26.07,95,,percent of total billed charges,,,24.7,90,,percent of total billed charges,,,24.7,90,,percent of total billed charges,,,22.5,82,,percent of total billed charges,,,24.7,90,,percent of total billed charges,,,23.32,85,,percent of total billed charges,,6.86,26.07,
PROPRANOLOL(INDERAL LA)CAP:80MG,32004856,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PROPRANOLOL HCL (INDERAL LA) CAP : 120MG,32004861,CDM,,,250,RC,outpatient,,74.38,74.38,,63.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.6,22,,percent of total billed charges,,,,,,,,,66.94,90,,percent of total billed charges,,,61.59,82.8,,percent of total billed charges,,,63.22,85,,percent of total billed charges,,,,,,,,,65.45,88,,percent of total billed charges,,,,,,,,,56.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.6,22,,percent of total billed charges,,,67.69,91,,percent of total billed charges,,,70.66,95,,percent of total billed charges,,,61.74,83,,percent of total billed charges,,,61.74,83,,percent of total billed charges,,,,,,,,,,,,,,,61.74,83,,percent of total billed charges,,,70.66,95,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,60.99,82,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,63.22,85,,percent of total billed charges,,18.6,70.66,
INDIGOTINDISLFNT(INDGO CARM) 0.8%:5ML,32004866,CDM,J3490,HCPCS,250,RC,outpatient,,2233.78,2233.78,,1896.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,558.45,22,,percent of total billed charges,,,,,,,,,2010.4,90,,percent of total billed charges,,,1849.57,82.8,,percent of total billed charges,,,1898.71,85,,percent of total billed charges,,,,,,,,,1965.73,88,,percent of total billed charges,,,,,,,,,1706.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,558.45,22,,percent of total billed charges,,,2032.74,91,,percent of total billed charges,,,2122.09,95,,percent of total billed charges,,,1854.04,83,,percent of total billed charges,,,1854.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1854.04,83,,percent of total billed charges,,,2122.09,95,,percent of total billed charges,,,2010.4,90,,percent of total billed charges,,,2010.4,90,,percent of total billed charges,,,1831.7,82,,percent of total billed charges,,,2010.4,90,,percent of total billed charges,,,1898.71,85,,percent of total billed charges,,558.45,2122.09,
INDOMETHACIN (INDOCIN) CAP : 50MG,32004871,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
INDOMETHACIN(INDOCIN)CAP:25MG,32004876,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
INDOMETHACIN (INDOCIN SR) CAP : 75MG,32004886,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
IRON DEXTRAN(INFED)100MG/2ML:Z-TRAC,32004896,CDM,J1750,HCPCS,636,RC,outpatient,,496.74,496.74,,421.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.19,22,,percent of total billed charges,,,,,,,,,447.07,90,,percent of total billed charges,,,411.3,82.8,,percent of total billed charges,,,422.23,85,,percent of total billed charges,,,,,,,,,437.13,88,,percent of total billed charges,,826.25,,,,fee schedule,,,379.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,826.25,,,,fee schedule,,,124.19,22,,percent of total billed charges,,,452.03,91,,percent of total billed charges,,,471.9,95,,percent of total billed charges,,,412.29,83,,percent of total billed charges,,,412.29,83,,percent of total billed charges,,,,,,,,,,,,,,,412.29,83,,percent of total billed charges,,,471.9,95,,percent of total billed charges,,,447.07,90,,percent of total billed charges,,,447.07,90,,percent of total billed charges,,,407.33,82,,percent of total billed charges,,,447.07,90,,percent of total billed charges,,,422.23,85,,percent of total billed charges,,124.19,826.25,
INFLUENZA(FLUZONE):45MCG/0.5ML(S.D.)0607,32004897,CDM,90658,CPT,636,RC,outpatient,,186.51,186.51,,158.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.63,22,,percent of total billed charges,,,,,,,,,167.86,90,,percent of total billed charges,,,154.43,82.8,,percent of total billed charges,,,158.53,85,,percent of total billed charges,,,,,,,,,164.13,88,,percent of total billed charges,,,,,,,,,142.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.63,22,,percent of total billed charges,,,169.72,91,,percent of total billed charges,,,177.18,95,,percent of total billed charges,,,154.8,83,,percent of total billed charges,,,154.8,83,,percent of total billed charges,,,,,,,,,,,,,,,154.8,83,,percent of total billed charges,,,177.18,95,,percent of total billed charges,,,167.86,90,,percent of total billed charges,,,167.86,90,,percent of total billed charges,,,152.94,82,,percent of total billed charges,,,167.86,90,,percent of total billed charges,,,158.53,85,,percent of total billed charges,,46.63,177.18,
INFLUENZA VIRUS VACCINE VIAL 98/99,32004898,CDM,,,250,RC,outpatient,,111.5,111.5,,94.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.88,22,,percent of total billed charges,,,,,,,,,100.35,90,,percent of total billed charges,,,92.32,82.8,,percent of total billed charges,,,94.78,85,,percent of total billed charges,,,,,,,,,98.12,88,,percent of total billed charges,,,,,,,,,85.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.88,22,,percent of total billed charges,,,101.47,91,,percent of total billed charges,,,105.93,95,,percent of total billed charges,,,92.55,83,,percent of total billed charges,,,92.55,83,,percent of total billed charges,,,,,,,,,,,,,,,92.55,83,,percent of total billed charges,,,105.93,95,,percent of total billed charges,,,100.35,90,,percent of total billed charges,,,100.35,90,,percent of total billed charges,,,91.43,82,,percent of total billed charges,,,100.35,90,,percent of total billed charges,,,94.78,85,,percent of total billed charges,,27.88,105.93,
EPTIFIB(INTEGRILIN):20MG/10ML,32004952,CDM,J1327,HCPCS,636,RC,outpatient,,2116.8,2116.8,,1797.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,529.2,22,,percent of total billed charges,,,,,,,,,1905.12,90,,percent of total billed charges,,,1752.71,82.8,,percent of total billed charges,,,1799.28,85,,percent of total billed charges,,,,,,,,,1862.78,88,,percent of total billed charges,,198,,,,fee schedule,,,1617.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,198,,,,fee schedule,,,529.2,22,,percent of total billed charges,,,1926.29,91,,percent of total billed charges,,,2010.96,95,,percent of total billed charges,,,1756.94,83,,percent of total billed charges,,,1756.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1756.94,83,,percent of total billed charges,,,2010.96,95,,percent of total billed charges,,,1905.12,90,,percent of total billed charges,,,1905.12,90,,percent of total billed charges,,,1735.78,82,,percent of total billed charges,,,1905.12,90,,percent of total billed charges,,,1799.28,85,,percent of total billed charges,,198,2010.96,
EPTIFIB(INTEGRILIN):75MG/100ML,32004953,CDM,J1327,HCPCS,636,RC,outpatient,,4181.55,4181.55,,3550.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1045.39,22,,percent of total billed charges,,,,,,,,,3763.4,90,,percent of total billed charges,,,3462.32,82.8,,percent of total billed charges,,,3554.32,85,,percent of total billed charges,,,,,,,,,3679.76,88,,percent of total billed charges,,198,,,,fee schedule,,,3194.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,198,,,,fee schedule,,,1045.39,22,,percent of total billed charges,,,3805.21,91,,percent of total billed charges,,,3972.47,95,,percent of total billed charges,,,3470.69,83,,percent of total billed charges,,,3470.69,83,,percent of total billed charges,,,,,,,,,,,,,,,3470.69,83,,percent of total billed charges,,,3972.47,95,,percent of total billed charges,,,3763.4,90,,percent of total billed charges,,,3763.4,90,,percent of total billed charges,,,3428.87,82,,percent of total billed charges,,,3763.4,90,,percent of total billed charges,,,3554.32,85,,percent of total billed charges,,198,3972.47,
CLIOQUINOL/HYDROCORT(VIOFORM) CRM : 3-1%,32004976,CDM,,,250,RC,outpatient,,205.7,205.7,,174.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.43,22,,percent of total billed charges,,,,,,,,,185.13,90,,percent of total billed charges,,,170.32,82.8,,percent of total billed charges,,,174.85,85,,percent of total billed charges,,,,,,,,,181.02,88,,percent of total billed charges,,,,,,,,,157.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.43,22,,percent of total billed charges,,,187.19,91,,percent of total billed charges,,,195.42,95,,percent of total billed charges,,,170.73,83,,percent of total billed charges,,,170.73,83,,percent of total billed charges,,,,,,,,,,,,,,,170.73,83,,percent of total billed charges,,,195.42,95,,percent of total billed charges,,,185.13,90,,percent of total billed charges,,,185.13,90,,percent of total billed charges,,,168.67,82,,percent of total billed charges,,,185.13,90,,percent of total billed charges,,,174.85,85,,percent of total billed charges,,51.43,195.42,
APRACLONIDINE(IOPIDINE)DROP 1%:0.2ML,32005012,CDM,,,250,RC,outpatient,,461.68,461.68,,391.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.42,22,,percent of total billed charges,,,,,,,,,415.51,90,,percent of total billed charges,,,382.27,82.8,,percent of total billed charges,,,392.43,85,,percent of total billed charges,,,,,,,,,406.28,88,,percent of total billed charges,,,,,,,,,352.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.42,22,,percent of total billed charges,,,420.13,91,,percent of total billed charges,,,438.6,95,,percent of total billed charges,,,383.19,83,,percent of total billed charges,,,383.19,83,,percent of total billed charges,,,,,,,,,,,,,,,383.19,83,,percent of total billed charges,,,438.6,95,,percent of total billed charges,,,415.51,90,,percent of total billed charges,,,415.51,90,,percent of total billed charges,,,378.58,82,,percent of total billed charges,,,415.51,90,,percent of total billed charges,,,392.43,85,,percent of total billed charges,,115.42,438.6,
IPECAC SYRP 30 ML,32005016,CDM,,,250,RC,outpatient,,72.48,72.48,,61.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.12,22,,percent of total billed charges,,,,,,,,,65.23,90,,percent of total billed charges,,,60.01,82.8,,percent of total billed charges,,,61.61,85,,percent of total billed charges,,,,,,,,,63.78,88,,percent of total billed charges,,,,,,,,,55.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.12,22,,percent of total billed charges,,,65.96,91,,percent of total billed charges,,,68.86,95,,percent of total billed charges,,,60.16,83,,percent of total billed charges,,,60.16,83,,percent of total billed charges,,,,,,,,,,,,,,,60.16,83,,percent of total billed charges,,,68.86,95,,percent of total billed charges,,,65.23,90,,percent of total billed charges,,,65.23,90,,percent of total billed charges,,,59.43,82,,percent of total billed charges,,,65.23,90,,percent of total billed charges,,,61.61,85,,percent of total billed charges,,18.12,68.86,
ISOSORBIDE (ISMO) TAB : 20MG,32005026,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ISOPROPYL ALCOHOL SOL 70%:480ML,32005041,CDM,J3490,HCPCS,250,RC,outpatient,,202.13,202.13,,171.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.53,22,,percent of total billed charges,,,,,,,,,181.92,90,,percent of total billed charges,,,167.36,82.8,,percent of total billed charges,,,171.81,85,,percent of total billed charges,,,,,,,,,177.87,88,,percent of total billed charges,,,,,,,,,154.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.53,22,,percent of total billed charges,,,183.94,91,,percent of total billed charges,,,192.02,95,,percent of total billed charges,,,167.77,83,,percent of total billed charges,,,167.77,83,,percent of total billed charges,,,,,,,,,,,,,,,167.77,83,,percent of total billed charges,,,192.02,95,,percent of total billed charges,,,181.92,90,,percent of total billed charges,,,181.92,90,,percent of total billed charges,,,165.75,82,,percent of total billed charges,,,181.92,90,,percent of total billed charges,,,171.81,85,,percent of total billed charges,,50.53,192.02,
ISOPROPYL ALCOHOL SOL : 70%    3840 ML,32005042,CDM,,,250,RC,outpatient,,417.59,417.59,,354.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.4,22,,percent of total billed charges,,,,,,,,,375.83,90,,percent of total billed charges,,,345.76,82.8,,percent of total billed charges,,,354.95,85,,percent of total billed charges,,,,,,,,,367.48,88,,percent of total billed charges,,,,,,,,,319.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.4,22,,percent of total billed charges,,,380.01,91,,percent of total billed charges,,,396.71,95,,percent of total billed charges,,,346.6,83,,percent of total billed charges,,,346.6,83,,percent of total billed charges,,,,,,,,,,,,,,,346.6,83,,percent of total billed charges,,,396.71,95,,percent of total billed charges,,,375.83,90,,percent of total billed charges,,,375.83,90,,percent of total billed charges,,,342.42,82,,percent of total billed charges,,,375.83,90,,percent of total billed charges,,,354.95,85,,percent of total billed charges,,104.4,396.71,
ATROPINE SULFATE DROP : 1% 5ML,32005046,CDM,,,250,RC,outpatient,,259.79,259.79,,220.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.95,22,,percent of total billed charges,,,,,,,,,233.81,90,,percent of total billed charges,,,215.11,82.8,,percent of total billed charges,,,220.82,85,,percent of total billed charges,,,,,,,,,228.62,88,,percent of total billed charges,,,,,,,,,198.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.95,22,,percent of total billed charges,,,236.41,91,,percent of total billed charges,,,246.8,95,,percent of total billed charges,,,215.63,83,,percent of total billed charges,,,215.63,83,,percent of total billed charges,,,,,,,,,,,,,,,215.63,83,,percent of total billed charges,,,246.8,95,,percent of total billed charges,,,233.81,90,,percent of total billed charges,,,233.81,90,,percent of total billed charges,,,213.03,82,,percent of total billed charges,,,233.81,90,,percent of total billed charges,,,220.82,85,,percent of total billed charges,,64.95,246.8,
PILOCARPINE HCL DROP : 0.50% 15ML,32005051,CDM,,,250,RC,outpatient,,51.54,51.54,,43.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.89,22,,percent of total billed charges,,,,,,,,,46.39,90,,percent of total billed charges,,,42.68,82.8,,percent of total billed charges,,,43.81,85,,percent of total billed charges,,,,,,,,,45.36,88,,percent of total billed charges,,,,,,,,,39.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.89,22,,percent of total billed charges,,,46.9,91,,percent of total billed charges,,,48.96,95,,percent of total billed charges,,,42.78,83,,percent of total billed charges,,,42.78,83,,percent of total billed charges,,,,,,,,,,,,,,,42.78,83,,percent of total billed charges,,,48.96,95,,percent of total billed charges,,,46.39,90,,percent of total billed charges,,,46.39,90,,percent of total billed charges,,,42.26,82,,percent of total billed charges,,,46.39,90,,percent of total billed charges,,,43.81,85,,percent of total billed charges,,12.89,48.96,
ISOPROTERENOL HCL AMP:0.2MG/ML (5ML),32005061,CDM,,,250,RC,outpatient,,73.59,73.59,,62.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.4,22,,percent of total billed charges,,,,,,,,,66.23,90,,percent of total billed charges,,,60.93,82.8,,percent of total billed charges,,,62.55,85,,percent of total billed charges,,,,,,,,,64.76,88,,percent of total billed charges,,,,,,,,,56.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.4,22,,percent of total billed charges,,,66.97,91,,percent of total billed charges,,,69.91,95,,percent of total billed charges,,,61.08,83,,percent of total billed charges,,,61.08,83,,percent of total billed charges,,,,,,,,,,,,,,,61.08,83,,percent of total billed charges,,,69.91,95,,percent of total billed charges,,,66.23,90,,percent of total billed charges,,,66.23,90,,percent of total billed charges,,,60.34,82,,percent of total billed charges,,,66.23,90,,percent of total billed charges,,,62.55,85,,percent of total billed charges,,18.4,69.91,
PILOCARPINE DROP 1%:15ML,32005066,CDM,,,250,RC,outpatient,,1112.7,1112.7,,944.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,278.18,22,,percent of total billed charges,,,,,,,,,1001.43,90,,percent of total billed charges,,,921.32,82.8,,percent of total billed charges,,,945.8,85,,percent of total billed charges,,,,,,,,,979.18,88,,percent of total billed charges,,,,,,,,,850.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,278.18,22,,percent of total billed charges,,,1012.56,91,,percent of total billed charges,,,1057.07,95,,percent of total billed charges,,,923.54,83,,percent of total billed charges,,,923.54,83,,percent of total billed charges,,,,,,,,,,,,,,,923.54,83,,percent of total billed charges,,,1057.07,95,,percent of total billed charges,,,1001.43,90,,percent of total billed charges,,,1001.43,90,,percent of total billed charges,,,912.41,82,,percent of total billed charges,,,1001.43,90,,percent of total billed charges,,,945.8,85,,percent of total billed charges,,278.18,1057.07,
PILOCARPINE DROP 1%:2ML,32005067,CDM,,,250,RC,outpatient,,79.93,79.93,,67.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.98,22,,percent of total billed charges,,,,,,,,,71.94,90,,percent of total billed charges,,,66.18,82.8,,percent of total billed charges,,,67.94,85,,percent of total billed charges,,,,,,,,,70.34,88,,percent of total billed charges,,,,,,,,,61.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.98,22,,percent of total billed charges,,,72.74,91,,percent of total billed charges,,,75.93,95,,percent of total billed charges,,,66.34,83,,percent of total billed charges,,,66.34,83,,percent of total billed charges,,,,,,,,,,,,,,,66.34,83,,percent of total billed charges,,,75.93,95,,percent of total billed charges,,,71.94,90,,percent of total billed charges,,,71.94,90,,percent of total billed charges,,,65.54,82,,percent of total billed charges,,,71.94,90,,percent of total billed charges,,,67.94,85,,percent of total billed charges,,19.98,75.93,
PILOCARPINE DROP 2%:15ML,32005071,CDM,J3490,HCPCS,250,RC,outpatient,,713.22,713.22,,605.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.31,22,,percent of total billed charges,,,,,,,,,641.9,90,,percent of total billed charges,,,590.55,82.8,,percent of total billed charges,,,606.24,85,,percent of total billed charges,,,,,,,,,627.63,88,,percent of total billed charges,,,,,,,,,544.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.31,22,,percent of total billed charges,,,649.03,91,,percent of total billed charges,,,677.56,95,,percent of total billed charges,,,591.97,83,,percent of total billed charges,,,591.97,83,,percent of total billed charges,,,,,,,,,,,,,,,591.97,83,,percent of total billed charges,,,677.56,95,,percent of total billed charges,,,641.9,90,,percent of total billed charges,,,641.9,90,,percent of total billed charges,,,584.84,82,,percent of total billed charges,,,641.9,90,,percent of total billed charges,,,606.24,85,,percent of total billed charges,,178.31,677.56,
PILOCARPINE DROP 4%:15ML,32005076,CDM,J3490,HCPCS,250,RC,outpatient,,1193.2,1193.2,,1013.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,298.3,22,,percent of total billed charges,,,,,,,,,1073.88,90,,percent of total billed charges,,,987.97,82.8,,percent of total billed charges,,,1014.22,85,,percent of total billed charges,,,,,,,,,1050.02,88,,percent of total billed charges,,,,,,,,,911.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,298.3,22,,percent of total billed charges,,,1085.81,91,,percent of total billed charges,,,1133.54,95,,percent of total billed charges,,,990.36,83,,percent of total billed charges,,,990.36,83,,percent of total billed charges,,,,,,,,,,,,,,,990.36,83,,percent of total billed charges,,,1133.54,95,,percent of total billed charges,,,1073.88,90,,percent of total billed charges,,,1073.88,90,,percent of total billed charges,,,978.42,82,,percent of total billed charges,,,1073.88,90,,percent of total billed charges,,,1014.22,85,,percent of total billed charges,,298.3,1133.54,
HOMATROPINE HBR DROP 5%:5ML,32005077,CDM,J3490,HCPCS,250,RC,outpatient,,288.81,288.81,,245.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.2,22,,percent of total billed charges,,,,,,,,,259.93,90,,percent of total billed charges,,,239.13,82.8,,percent of total billed charges,,,245.49,85,,percent of total billed charges,,,,,,,,,254.15,88,,percent of total billed charges,,,,,,,,,220.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.2,22,,percent of total billed charges,,,262.82,91,,percent of total billed charges,,,274.37,95,,percent of total billed charges,,,239.71,83,,percent of total billed charges,,,239.71,83,,percent of total billed charges,,,,,,,,,,,,,,,239.71,83,,percent of total billed charges,,,274.37,95,,percent of total billed charges,,,259.93,90,,percent of total billed charges,,,259.93,90,,percent of total billed charges,,,236.82,82,,percent of total billed charges,,,259.93,90,,percent of total billed charges,,,245.49,85,,percent of total billed charges,,72.2,274.37,
SCOPOLAMINE (HYOSCINE) DROP: 0.25%   5ML,32005081,CDM,,,250,RC,outpatient,,579.52,579.52,,492.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,144.88,22,,percent of total billed charges,,,,,,,,,521.57,90,,percent of total billed charges,,,479.84,82.8,,percent of total billed charges,,,492.59,85,,percent of total billed charges,,,,,,,,,509.98,88,,percent of total billed charges,,,,,,,,,442.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,144.88,22,,percent of total billed charges,,,527.36,91,,percent of total billed charges,,,550.54,95,,percent of total billed charges,,,481,83,,percent of total billed charges,,,481,83,,percent of total billed charges,,,,,,,,,,,,,,,481,83,,percent of total billed charges,,,550.54,95,,percent of total billed charges,,,521.57,90,,percent of total billed charges,,,521.57,90,,percent of total billed charges,,,475.21,82,,percent of total billed charges,,,521.57,90,,percent of total billed charges,,,492.59,85,,percent of total billed charges,,144.88,550.54,
ISOSORBIDE DINITRATE (ISORDIL)TAB:10MG,32005086,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ISOSORBIDE (ISORDIL) TAB : 20MG,32005091,CDM,,,250,RC,outpatient,,15.86,15.86,,13.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.97,22,,percent of total billed charges,,,,,,,,,14.27,90,,percent of total billed charges,,,13.13,82.8,,percent of total billed charges,,,13.48,85,,percent of total billed charges,,,,,,,,,13.96,88,,percent of total billed charges,,,,,,,,,12.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.97,22,,percent of total billed charges,,,14.43,91,,percent of total billed charges,,,15.07,95,,percent of total billed charges,,,13.16,83,,percent of total billed charges,,,13.16,83,,percent of total billed charges,,,,,,,,,,,,,,,13.16,83,,percent of total billed charges,,,15.07,95,,percent of total billed charges,,,14.27,90,,percent of total billed charges,,,14.27,90,,percent of total billed charges,,,13.01,82,,percent of total billed charges,,,14.27,90,,percent of total billed charges,,,13.48,85,,percent of total billed charges,,3.97,15.07,
ISOXSUPRINE (VASODILAN) TAB : 10MG,32005096,CDM,,,250,RC,outpatient,,14.43,14.43,,12.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.61,22,,percent of total billed charges,,,,,,,,,12.99,90,,percent of total billed charges,,,11.95,82.8,,percent of total billed charges,,,12.27,85,,percent of total billed charges,,,,,,,,,12.7,88,,percent of total billed charges,,,,,,,,,11.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.61,22,,percent of total billed charges,,,13.13,91,,percent of total billed charges,,,13.71,95,,percent of total billed charges,,,11.98,83,,percent of total billed charges,,,11.98,83,,percent of total billed charges,,,,,,,,,,,,,,,11.98,83,,percent of total billed charges,,,13.71,95,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,11.83,82,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,12.27,85,,percent of total billed charges,,3.61,13.71,
ISOXSUPRINE(VASODILAN)TAB:20MG,32005101,CDM,,,250,RC,outpatient,,23.31,23.31,,19.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.83,22,,percent of total billed charges,,,,,,,,,20.98,90,,percent of total billed charges,,,19.3,82.8,,percent of total billed charges,,,19.81,85,,percent of total billed charges,,,,,,,,,20.51,88,,percent of total billed charges,,,,,,,,,17.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.83,22,,percent of total billed charges,,,21.21,91,,percent of total billed charges,,,22.14,95,,percent of total billed charges,,,19.35,83,,percent of total billed charges,,,19.35,83,,percent of total billed charges,,,,,,,,,,,,,,,19.35,83,,percent of total billed charges,,,22.14,95,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,19.11,82,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,19.81,85,,percent of total billed charges,,5.83,22.14,
ISOPROTERENOL HCL AMP:1MG/5ML,32005106,CDM,J3490,HCPCS,250,RC,outpatient,,684.63,684.63,,581.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,171.16,22,,percent of total billed charges,,,,,,,,,616.17,90,,percent of total billed charges,,,566.87,82.8,,percent of total billed charges,,,581.94,85,,percent of total billed charges,,,,,,,,,602.47,88,,percent of total billed charges,,,,,,,,,523.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,171.16,22,,percent of total billed charges,,,623.01,91,,percent of total billed charges,,,650.4,95,,percent of total billed charges,,,568.24,83,,percent of total billed charges,,,568.24,83,,percent of total billed charges,,,,,,,,,,,,,,,568.24,83,,percent of total billed charges,,,650.4,95,,percent of total billed charges,,,616.17,90,,percent of total billed charges,,,616.17,90,,percent of total billed charges,,,561.4,82,,percent of total billed charges,,,616.17,90,,percent of total billed charges,,,581.94,85,,percent of total billed charges,,171.16,650.4,
FLUCONAZOLE(DIFLUCAN)-IVPB:200MG/100ML,32005121,CDM,J1450,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,10.46,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,10.46,,,,fee schedule,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,10.46,187.11,
POTASSIUM CHLORIDE(K-DUR)TAB:20MEQ,32005126,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
Potassium Chloride(K-DUR) ER TABS:10 meq,32005131,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
POTASSIUM BICARB/CIT (KLORCON) TAB:25MEQ,32005136,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
POTASSIUM CHLORIDE LIQ 20MEQ/15ML 500ML,32005151,CDM,,,250,RC,outpatient,,701.33,701.33,,595.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,175.33,22,,percent of total billed charges,,,,,,,,,631.2,90,,percent of total billed charges,,,580.7,82.8,,percent of total billed charges,,,596.13,85,,percent of total billed charges,,,,,,,,,617.17,88,,percent of total billed charges,,,,,,,,,535.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,175.33,22,,percent of total billed charges,,,638.21,91,,percent of total billed charges,,,666.26,95,,percent of total billed charges,,,582.1,83,,percent of total billed charges,,,582.1,83,,percent of total billed charges,,,,,,,,,,,,,,,582.1,83,,percent of total billed charges,,,666.26,95,,percent of total billed charges,,,631.2,90,,percent of total billed charges,,,631.2,90,,percent of total billed charges,,,575.09,82,,percent of total billed charges,,,631.2,90,,percent of total billed charges,,,596.13,85,,percent of total billed charges,,175.33,666.26,
POTASSIUM CHLORIDE LIQ:20MEQ/15ML 60ML,32005152,CDM,,,250,RC,outpatient,,88.97,88.97,,75.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.24,22,,percent of total billed charges,,,,,,,,,80.07,90,,percent of total billed charges,,,73.67,82.8,,percent of total billed charges,,,75.62,85,,percent of total billed charges,,,,,,,,,78.29,88,,percent of total billed charges,,,,,,,,,67.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.24,22,,percent of total billed charges,,,80.96,91,,percent of total billed charges,,,84.52,95,,percent of total billed charges,,,73.85,83,,percent of total billed charges,,,73.85,83,,percent of total billed charges,,,,,,,,,,,,,,,73.85,83,,percent of total billed charges,,,84.52,95,,percent of total billed charges,,,80.07,90,,percent of total billed charges,,,80.07,90,,percent of total billed charges,,,72.96,82,,percent of total billed charges,,,80.07,90,,percent of total billed charges,,,75.62,85,,percent of total billed charges,,22.24,84.52,
POTASSIUM CHLORIDE LIQ:20MEQ/15ML 90ML,32005153,CDM,,,250,RC,outpatient,,133.38,133.38,,113.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.35,22,,percent of total billed charges,,,,,,,,,120.04,90,,percent of total billed charges,,,110.44,82.8,,percent of total billed charges,,,113.37,85,,percent of total billed charges,,,,,,,,,117.37,88,,percent of total billed charges,,,,,,,,,101.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.35,22,,percent of total billed charges,,,121.38,91,,percent of total billed charges,,,126.71,95,,percent of total billed charges,,,110.71,83,,percent of total billed charges,,,110.71,83,,percent of total billed charges,,,,,,,,,,,,,,,110.71,83,,percent of total billed charges,,,126.71,95,,percent of total billed charges,,,120.04,90,,percent of total billed charges,,,120.04,90,,percent of total billed charges,,,109.37,82,,percent of total billed charges,,,120.04,90,,percent of total billed charges,,,113.37,85,,percent of total billed charges,,33.35,126.71,
ATTAPULGITE (KAOPEK)ORAL:600MG/15ML 60ML,32005156,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ATTAPULGITE (KAOPEK)ORAL:600MG/15ML 90ML,32005161,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ATTAPULGITE(KAOPEK)ORAL:600MG/15ML 240ML,32005166,CDM,,,250,RC,outpatient,,34.42,34.42,,29.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.61,22,,percent of total billed charges,,,,,,,,,30.98,90,,percent of total billed charges,,,28.5,82.8,,percent of total billed charges,,,29.26,85,,percent of total billed charges,,,,,,,,,30.29,88,,percent of total billed charges,,,,,,,,,26.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.61,22,,percent of total billed charges,,,31.32,91,,percent of total billed charges,,,32.7,95,,percent of total billed charges,,,28.57,83,,percent of total billed charges,,,28.57,83,,percent of total billed charges,,,,,,,,,,,,,,,28.57,83,,percent of total billed charges,,,32.7,95,,percent of total billed charges,,,30.98,90,,percent of total billed charges,,,30.98,90,,percent of total billed charges,,,28.22,82,,percent of total billed charges,,,30.98,90,,percent of total billed charges,,,29.26,85,,percent of total billed charges,,8.61,32.7,
KETAMINE(KETALAR) VIAL:500MG/10ML,32005201,CDM,J3490,HCPCS,250,RC,outpatient,,90.24,90.24,,76.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.56,22,,percent of total billed charges,,,,,,,,,81.22,90,,percent of total billed charges,,,74.72,82.8,,percent of total billed charges,,,76.7,85,,percent of total billed charges,,,,,,,,,79.41,88,,percent of total billed charges,,,,,,,,,68.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.56,22,,percent of total billed charges,,,82.12,91,,percent of total billed charges,,,85.73,95,,percent of total billed charges,,,74.9,83,,percent of total billed charges,,,74.9,83,,percent of total billed charges,,,,,,,,,,,,,,,74.9,83,,percent of total billed charges,,,85.73,95,,percent of total billed charges,,,81.22,90,,percent of total billed charges,,,81.22,90,,percent of total billed charges,,,74,82,,percent of total billed charges,,,81.22,90,,percent of total billed charges,,,76.7,85,,percent of total billed charges,,22.56,85.73,
KETOPROFEN (ORUDIS) CAP : 50MG,32005206,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
KETOPROFEN (ORUDIS) CAP : 75MG,32005216,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
KETOROLAC(TORADOL)VL:60MG/2ML,32005217,CDM,J1885,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,2.54,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.54,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,2.54,60.99,
KETOROLAC(TORADOL)VL:30MG/ML,32005218,CDM,J1885,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,2.54,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.54,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,2.54,60.99,
SINCALIDE (KINEVAC) :__MCG/SW 5ML  (PD),32005221,CDM,J2805,HCPCS,250,RC,outpatient,,1726.68,1726.68,,1465.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,431.67,22,,percent of total billed charges,,,,,,,,,1554.01,90,,percent of total billed charges,,,1429.69,82.8,,percent of total billed charges,,,1467.68,85,,percent of total billed charges,,,,,,,,,1519.48,88,,percent of total billed charges,,,,,,,,,1319.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,431.67,22,,percent of total billed charges,,,1571.28,91,,percent of total billed charges,,,1640.35,95,,percent of total billed charges,,,1433.14,83,,percent of total billed charges,,,1433.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1433.14,83,,percent of total billed charges,,,1640.35,95,,percent of total billed charges,,,1554.01,90,,percent of total billed charges,,,1554.01,90,,percent of total billed charges,,,1415.88,82,,percent of total billed charges,,,1554.01,90,,percent of total billed charges,,,1467.68,85,,percent of total billed charges,,431.67,1640.35,
POTASSIUM PHOS MONO(K-PHOS)TAB:500MG,32005226,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
POTASSIUM BICARB/CIT/CA(K-LYTE)TAB:50MEQ,32005231,CDM,,,250,RC,outpatient,,35.68,35.68,,30.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.92,22,,percent of total billed charges,,,,,,,,,32.11,90,,percent of total billed charges,,,29.54,82.8,,percent of total billed charges,,,30.33,85,,percent of total billed charges,,,,,,,,,31.4,88,,percent of total billed charges,,,,,,,,,27.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.92,22,,percent of total billed charges,,,32.47,91,,percent of total billed charges,,,33.9,95,,percent of total billed charges,,,29.61,83,,percent of total billed charges,,,29.61,83,,percent of total billed charges,,,,,,,,,,,,,,,29.61,83,,percent of total billed charges,,,33.9,95,,percent of total billed charges,,,32.11,90,,percent of total billed charges,,,32.11,90,,percent of total billed charges,,,29.26,82,,percent of total billed charges,,,32.11,90,,percent of total billed charges,,,30.33,85,,percent of total billed charges,,8.92,33.9,
AMMONIUM (LAC-HYDRIN) LOTION: 2%   225ML,32005237,CDM,,,250,RC,outpatient,,73.75,73.75,,62.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.44,22,,percent of total billed charges,,,,,,,,,66.38,90,,percent of total billed charges,,,61.07,82.8,,percent of total billed charges,,,62.69,85,,percent of total billed charges,,,,,,,,,64.9,88,,percent of total billed charges,,,,,,,,,56.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.44,22,,percent of total billed charges,,,67.11,91,,percent of total billed charges,,,70.06,95,,percent of total billed charges,,,61.21,83,,percent of total billed charges,,,61.21,83,,percent of total billed charges,,,,,,,,,,,,,,,61.21,83,,percent of total billed charges,,,70.06,95,,percent of total billed charges,,,66.38,90,,percent of total billed charges,,,66.38,90,,percent of total billed charges,,,60.48,82,,percent of total billed charges,,,66.38,90,,percent of total billed charges,,,62.69,85,,percent of total billed charges,,18.44,70.06,
LANOLIN/MO/PETRO WHT(LACRILUBE)OINT  7GM,32005241,CDM,,,250,RC,outpatient,,281.67,281.67,,239.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.42,22,,percent of total billed charges,,,,,,,,,253.5,90,,percent of total billed charges,,,233.22,82.8,,percent of total billed charges,,,239.42,85,,percent of total billed charges,,,,,,,,,247.87,88,,percent of total billed charges,,,,,,,,,215.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70.42,22,,percent of total billed charges,,,256.32,91,,percent of total billed charges,,,267.59,95,,percent of total billed charges,,,233.79,83,,percent of total billed charges,,,233.79,83,,percent of total billed charges,,,,,,,,,,,,,,,233.79,83,,percent of total billed charges,,,267.59,95,,percent of total billed charges,,,253.5,90,,percent of total billed charges,,,253.5,90,,percent of total billed charges,,,230.97,82,,percent of total billed charges,,,253.5,90,,percent of total billed charges,,,239.42,85,,percent of total billed charges,,70.42,267.59,
LANOLIN/MIN OIL/PETRO WHT(LACRILUBE)PAC,32005246,CDM,,,250,RC,outpatient,,26.96,26.96,,22.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.74,22,,percent of total billed charges,,,,,,,,,24.26,90,,percent of total billed charges,,,22.32,82.8,,percent of total billed charges,,,22.92,85,,percent of total billed charges,,,,,,,,,23.72,88,,percent of total billed charges,,,,,,,,,20.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.74,22,,percent of total billed charges,,,24.53,91,,percent of total billed charges,,,25.61,95,,percent of total billed charges,,,22.38,83,,percent of total billed charges,,,22.38,83,,percent of total billed charges,,,,,,,,,,,,,,,22.38,83,,percent of total billed charges,,,25.61,95,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,22.11,82,,percent of total billed charges,,,24.26,90,,percent of total billed charges,,,22.92,85,,percent of total billed charges,,6.74,25.61,
MILK DIGESTANT TABS,32005247,CDM,,,250,RC,outpatient,,32,32,,27.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8,22,,percent of total billed charges,,,,,,,,,28.8,90,,percent of total billed charges,,,26.5,82.8,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,,,,,,,,28.16,88,,percent of total billed charges,,,,,,,,,24.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8,22,,percent of total billed charges,,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,,,,,,,,,,,,,26.56,83,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,26.24,82,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,8,30.4,
LACTOBACILLUS ACIDOPHILUS (LACTINEX)TAB,32005264,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ACIDOPHILUS/BULGARICUS(FLORANEX)TAB:,32005265,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
BCAINE/ALOE/BENZ(LANACANE)CM:6%-0.2%60GM,32005267,CDM,,,250,RC,outpatient,,78.51,78.51,,66.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.63,22,,percent of total billed charges,,,,,,,,,70.66,90,,percent of total billed charges,,,65.01,82.8,,percent of total billed charges,,,66.73,85,,percent of total billed charges,,,,,,,,,69.09,88,,percent of total billed charges,,,,,,,,,59.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.63,22,,percent of total billed charges,,,71.44,91,,percent of total billed charges,,,74.58,95,,percent of total billed charges,,,65.16,83,,percent of total billed charges,,,65.16,83,,percent of total billed charges,,,,,,,,,,,,,,,65.16,83,,percent of total billed charges,,,74.58,95,,percent of total billed charges,,,70.66,90,,percent of total billed charges,,,70.66,90,,percent of total billed charges,,,64.38,82,,percent of total billed charges,,,70.66,90,,percent of total billed charges,,,66.73,85,,percent of total billed charges,,19.63,74.58,
TERBINAFINE HCL(LAMISIL AT)CREAM:1% 2GM,32005268,CDM,,,250,RC,outpatient,,55.5,55.5,,47.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.88,22,,percent of total billed charges,,,,,,,,,49.95,90,,percent of total billed charges,,,45.95,82.8,,percent of total billed charges,,,47.18,85,,percent of total billed charges,,,,,,,,,48.84,88,,percent of total billed charges,,,,,,,,,42.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.88,22,,percent of total billed charges,,,50.51,91,,percent of total billed charges,,,52.73,95,,percent of total billed charges,,,46.07,83,,percent of total billed charges,,,46.07,83,,percent of total billed charges,,,,,,,,,,,,,,,46.07,83,,percent of total billed charges,,,52.73,95,,percent of total billed charges,,,49.95,90,,percent of total billed charges,,,49.95,90,,percent of total billed charges,,,45.51,82,,percent of total billed charges,,,49.95,90,,percent of total billed charges,,,47.18,85,,percent of total billed charges,,13.88,52.73,
TERBINAFINE(LamISIL AT)CREAM:24GM,32005269,CDM,J3490,HCPCS,250,RC,outpatient,,173.37,173.37,,147.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.34,22,,percent of total billed charges,,,,,,,,,156.03,90,,percent of total billed charges,,,143.55,82.8,,percent of total billed charges,,,147.36,85,,percent of total billed charges,,,,,,,,,152.57,88,,percent of total billed charges,,,,,,,,,132.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.34,22,,percent of total billed charges,,,157.77,91,,percent of total billed charges,,,164.7,95,,percent of total billed charges,,,143.9,83,,percent of total billed charges,,,143.9,83,,percent of total billed charges,,,,,,,,,,,,,,,143.9,83,,percent of total billed charges,,,164.7,95,,percent of total billed charges,,,156.03,90,,percent of total billed charges,,,156.03,90,,percent of total billed charges,,,142.16,82,,percent of total billed charges,,,156.03,90,,percent of total billed charges,,,147.36,85,,percent of total billed charges,,43.34,164.7,
TERBINAFINE HCL(LAMISIL AT)SPR:1%30GM,32005270,CDM,,,250,RC,outpatient,,113.08,113.08,,96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.27,22,,percent of total billed charges,,,,,,,,,101.77,90,,percent of total billed charges,,,93.63,82.8,,percent of total billed charges,,,96.12,85,,percent of total billed charges,,,,,,,,,99.51,88,,percent of total billed charges,,,,,,,,,86.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.27,22,,percent of total billed charges,,,102.9,91,,percent of total billed charges,,,107.43,95,,percent of total billed charges,,,93.86,83,,percent of total billed charges,,,93.86,83,,percent of total billed charges,,,,,,,,,,,,,,,93.86,83,,percent of total billed charges,,,107.43,95,,percent of total billed charges,,,101.77,90,,percent of total billed charges,,,101.77,90,,percent of total billed charges,,,92.73,82,,percent of total billed charges,,,101.77,90,,percent of total billed charges,,,96.12,85,,percent of total billed charges,,28.27,107.43,
DIGOXIN(LANOXIN)TAB:125MCG(0.125MG) YEL,32005281,CDM,J8499,HCPCS,250,RC,outpatient,,14.38,14.38,,12.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.6,22,,percent of total billed charges,,,,,,,,,12.94,90,,percent of total billed charges,,,11.91,82.8,,percent of total billed charges,,,12.22,85,,percent of total billed charges,,,,,,,,,12.65,88,,percent of total billed charges,,,,,,,,,10.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.6,22,,percent of total billed charges,,,13.09,91,,percent of total billed charges,,,13.66,95,,percent of total billed charges,,,11.94,83,,percent of total billed charges,,,11.94,83,,percent of total billed charges,,,,,,,,,,,,,,,11.94,83,,percent of total billed charges,,,13.66,95,,percent of total billed charges,,,12.94,90,,percent of total billed charges,,,12.94,90,,percent of total billed charges,,,11.79,82,,percent of total billed charges,,,12.94,90,,percent of total billed charges,,,12.22,85,,percent of total billed charges,,3.6,13.66,
LANOLIN OINT 1oz,32005286,CDM,J3490,HCPCS,250,RC,outpatient,,121.08,121.08,,102.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.27,22,,percent of total billed charges,,,,,,,,,108.97,90,,percent of total billed charges,,,100.25,82.8,,percent of total billed charges,,,102.92,85,,percent of total billed charges,,,,,,,,,106.55,88,,percent of total billed charges,,,,,,,,,92.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.27,22,,percent of total billed charges,,,110.18,91,,percent of total billed charges,,,115.03,95,,percent of total billed charges,,,100.5,83,,percent of total billed charges,,,100.5,83,,percent of total billed charges,,,,,,,,,,,,,,,100.5,83,,percent of total billed charges,,,115.03,95,,percent of total billed charges,,,108.97,90,,percent of total billed charges,,,108.97,90,,percent of total billed charges,,,99.29,82,,percent of total billed charges,,,108.97,90,,percent of total billed charges,,,102.92,85,,percent of total billed charges,,30.27,115.03,
DIGOXIN (LANOXIN) TAB : 250MCG,32005291,CDM,,,250,RC,outpatient,,15.23,15.23,,12.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.81,22,,percent of total billed charges,,,,,,,,,13.71,90,,percent of total billed charges,,,12.61,82.8,,percent of total billed charges,,,12.95,85,,percent of total billed charges,,,,,,,,,13.4,88,,percent of total billed charges,,,,,,,,,11.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.81,22,,percent of total billed charges,,,13.86,91,,percent of total billed charges,,,14.47,95,,percent of total billed charges,,,12.64,83,,percent of total billed charges,,,12.64,83,,percent of total billed charges,,,,,,,,,,,,,,,12.64,83,,percent of total billed charges,,,14.47,95,,percent of total billed charges,,,13.71,90,,percent of total billed charges,,,13.71,90,,percent of total billed charges,,,12.49,82,,percent of total billed charges,,,13.71,90,,percent of total billed charges,,,12.95,85,,percent of total billed charges,,3.81,14.47,
DIGOXIN(LANOXIN)AMP:500MCG/2ML,32005296,CDM,J1160,HCPCS,250,RC,outpatient,,115.2,115.2,,97.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.8,22,,percent of total billed charges,,,,,,,,,103.68,90,,percent of total billed charges,,,95.39,82.8,,percent of total billed charges,,,97.92,85,,percent of total billed charges,,,,,,,,,101.38,88,,percent of total billed charges,,41.16,,,,fee schedule,,,88.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,41.16,,,,fee schedule,,,28.8,22,,percent of total billed charges,,,104.83,91,,percent of total billed charges,,,109.44,95,,percent of total billed charges,,,95.62,83,,percent of total billed charges,,,95.62,83,,percent of total billed charges,,,,,,,,,,,,,,,95.62,83,,percent of total billed charges,,,109.44,95,,percent of total billed charges,,,103.68,90,,percent of total billed charges,,,103.68,90,,percent of total billed charges,,,94.46,82,,percent of total billed charges,,,103.68,90,,percent of total billed charges,,,97.92,85,,percent of total billed charges,,28.8,109.44,
FLUVASTATIN SODIUM (LESCOL) CAP : 20MG,32005306,CDM,,,250,RC,outpatient,,85.01,85.01,,72.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.25,22,,percent of total billed charges,,,,,,,,,76.51,90,,percent of total billed charges,,,70.39,82.8,,percent of total billed charges,,,72.26,85,,percent of total billed charges,,,,,,,,,74.81,88,,percent of total billed charges,,,,,,,,,64.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.25,22,,percent of total billed charges,,,77.36,91,,percent of total billed charges,,,80.76,95,,percent of total billed charges,,,70.56,83,,percent of total billed charges,,,70.56,83,,percent of total billed charges,,,,,,,,,,,,,,,70.56,83,,percent of total billed charges,,,80.76,95,,percent of total billed charges,,,76.51,90,,percent of total billed charges,,,76.51,90,,percent of total billed charges,,,69.71,82,,percent of total billed charges,,,76.51,90,,percent of total billed charges,,,72.26,85,,percent of total billed charges,,21.25,80.76,
FLUVASTATIN SODIUM (LESCOL) CAP : 40MG,32005311,CDM,,,250,RC,outpatient,,84.85,84.85,,72.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.21,22,,percent of total billed charges,,,,,,,,,76.37,90,,percent of total billed charges,,,70.26,82.8,,percent of total billed charges,,,72.12,85,,percent of total billed charges,,,,,,,,,74.67,88,,percent of total billed charges,,,,,,,,,64.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.21,22,,percent of total billed charges,,,77.21,91,,percent of total billed charges,,,80.61,95,,percent of total billed charges,,,70.43,83,,percent of total billed charges,,,70.43,83,,percent of total billed charges,,,,,,,,,,,,,,,70.43,83,,percent of total billed charges,,,80.61,95,,percent of total billed charges,,,76.37,90,,percent of total billed charges,,,76.37,90,,percent of total billed charges,,,69.58,82,,percent of total billed charges,,,76.37,90,,percent of total billed charges,,,72.12,85,,percent of total billed charges,,21.21,80.61,
LEUCOVORIN 200MG,32005315,CDM,,,250,RC,outpatient,,234,234,,198.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,58.5,22,,percent of total billed charges,,,,,,,,,210.6,90,,percent of total billed charges,,,193.75,82.8,,percent of total billed charges,,,198.9,85,,percent of total billed charges,,,,,,,,,205.92,88,,percent of total billed charges,,,,,,,,,178.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,58.5,22,,percent of total billed charges,,,212.94,91,,percent of total billed charges,,,222.3,95,,percent of total billed charges,,,194.22,83,,percent of total billed charges,,,194.22,83,,percent of total billed charges,,,,,,,,,,,,,,,194.22,83,,percent of total billed charges,,,222.3,95,,percent of total billed charges,,,210.6,90,,percent of total billed charges,,,210.6,90,,percent of total billed charges,,,191.88,82,,percent of total billed charges,,,210.6,90,,percent of total billed charges,,,198.9,85,,percent of total billed charges,,58.5,222.3,
LEUCOVORIN CALCIUM VIAL:350MG,32005327,CDM,J0640,HCPCS,636,RC,outpatient,,267,267,,226.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.75,22,,percent of total billed charges,,,,,,,,,240.3,90,,percent of total billed charges,,,221.08,82.8,,percent of total billed charges,,,226.95,85,,percent of total billed charges,,,,,,,,,234.96,88,,percent of total billed charges,,100.5,,,,fee schedule,,,203.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,100.5,,,,fee schedule,,,66.75,22,,percent of total billed charges,,,242.97,91,,percent of total billed charges,,,253.65,95,,percent of total billed charges,,,221.61,83,,percent of total billed charges,,,221.61,83,,percent of total billed charges,,,,,,,,,,,,,,,221.61,83,,percent of total billed charges,,,253.65,95,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,218.94,82,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,226.95,85,,percent of total billed charges,,66.75,253.65,
LEVOFLOXACIN (LEVAQUIN) TAB : 250MG 1X2,32005330,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
HYOSCYAMINE ER (LEVSINEX ER) TAB:0.375MG,32005332,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LEVOFLOXACIN(LEVAQUIN)TAB:250MG,32005333,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LEVOFLOXACIN(LEVAQUIN)TAB:500MG,32005334,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LEVOFLOX(LEVAQUIN)-IVPB:250MG/D5W50ML,32005335,CDM,J1956,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,3.21,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.21,,,,fee schedule,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.21,187.11,
LEVOTHYROXINE (SYNTHROID)TAB: 125 MCG,32005336,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
LEVOFLOXA/DEX5%(LEVAQUIN)PIG:500MG/100ML,32005337,CDM,J1956,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,3.21,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.21,,,,fee schedule,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.21,187.11,
LEVOBUNOLOL(BETAGAN)DROP 0.5%:5ML,32005339,CDM,J3490,HCPCS,250,RC,outpatient,,70.74,70.74,,60.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.69,22,,percent of total billed charges,,,,,,,,,63.67,90,,percent of total billed charges,,,58.57,82.8,,percent of total billed charges,,,60.13,85,,percent of total billed charges,,,,,,,,,62.25,88,,percent of total billed charges,,,,,,,,,54.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.69,22,,percent of total billed charges,,,64.37,91,,percent of total billed charges,,,67.2,95,,percent of total billed charges,,,58.71,83,,percent of total billed charges,,,58.71,83,,percent of total billed charges,,,,,,,,,,,,,,,58.71,83,,percent of total billed charges,,,67.2,95,,percent of total billed charges,,,63.67,90,,percent of total billed charges,,,63.67,90,,percent of total billed charges,,,58.01,82,,percent of total billed charges,,,63.67,90,,percent of total billed charges,,,60.13,85,,percent of total billed charges,,17.69,67.2,
LEVOFLOXACIN (LEVAQUIN) TAB :500MG (1X2),32005340,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
LEVOTHYROXINE(SYNTHROID)TAB:100MCG,32005346,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LEVOTHYROXINE (SYNTHROID)     TAB:150MCG,32005351,CDM,,,250,RC,outpatient,,22.68,22.68,,19.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.67,22,,percent of total billed charges,,,,,,,,,20.41,90,,percent of total billed charges,,,18.78,82.8,,percent of total billed charges,,,19.28,85,,percent of total billed charges,,,,,,,,,19.96,88,,percent of total billed charges,,,,,,,,,17.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.67,22,,percent of total billed charges,,,20.64,91,,percent of total billed charges,,,21.55,95,,percent of total billed charges,,,18.82,83,,percent of total billed charges,,,18.82,83,,percent of total billed charges,,,,,,,,,,,,,,,18.82,83,,percent of total billed charges,,,21.55,95,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,18.6,82,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,19.28,85,,percent of total billed charges,,5.67,21.55,
LEVOTHYROXINE(SYNTHROID)TAB:25MCG,32005356,CDM,,,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LEVOTHYROXINE(SYNTHROID)TAB:50MCG,32005361,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LEVOTHYROXINE(LEVOTHROID)TAB:88MCG,32005362,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LEVOTHYROXINE(LEVOTHROID)TAB:112 MCG,32005366,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LEVOTHYROXINE(SYNTHROID)TAB:75MCG,32005371,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LEVOXYL .075MG TAB,32005372,CDM,,,250,RC,outpatient,,1,1,,0.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.25,22,,percent of total billed charges,,,,,,,,,0.9,90,,percent of total billed charges,,,0.83,82.8,,percent of total billed charges,,,0.85,85,,percent of total billed charges,,,,,,,,,0.88,88,,percent of total billed charges,,,,,,,,,0.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.25,22,,percent of total billed charges,,,0.91,91,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,,,,,,,,,,,,,0.83,83,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.82,82,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.85,85,,percent of total billed charges,,0.25,0.95,
LEVOXYL .025MG TAB,32005373,CDM,,,250,RC,outpatient,,1,1,,0.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.25,22,,percent of total billed charges,,,,,,,,,0.9,90,,percent of total billed charges,,,0.83,82.8,,percent of total billed charges,,,0.85,85,,percent of total billed charges,,,,,,,,,0.88,88,,percent of total billed charges,,,,,,,,,0.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.25,22,,percent of total billed charges,,,0.91,91,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,,,,,,,,,,,,,0.83,83,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.82,82,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.85,85,,percent of total billed charges,,0.25,0.95,
LEVOTHYROXINE(SYNTHROID)INJ:200MCG,32005374,CDM,,,250,RC,outpatient,,706.72,706.72,,600.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,176.68,22,,percent of total billed charges,,,,,,,,,636.05,90,,percent of total billed charges,,,585.16,82.8,,percent of total billed charges,,,600.71,85,,percent of total billed charges,,,,,,,,,621.91,88,,percent of total billed charges,,,,,,,,,539.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,176.68,22,,percent of total billed charges,,,643.12,91,,percent of total billed charges,,,671.38,95,,percent of total billed charges,,,586.58,83,,percent of total billed charges,,,586.58,83,,percent of total billed charges,,,,,,,,,,,,,,,586.58,83,,percent of total billed charges,,,671.38,95,,percent of total billed charges,,,636.05,90,,percent of total billed charges,,,636.05,90,,percent of total billed charges,,,579.51,82,,percent of total billed charges,,,636.05,90,,percent of total billed charges,,,600.71,85,,percent of total billed charges,,176.68,671.38,
LEVOTHYROXINE (SYNTHROID)VIAL: 500 MCG,32005376,CDM,,,250,RC,outpatient,,333.06,333.06,,282.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.27,22,,percent of total billed charges,,,,,,,,,299.75,90,,percent of total billed charges,,,275.77,82.8,,percent of total billed charges,,,283.1,85,,percent of total billed charges,,,,,,,,,293.09,88,,percent of total billed charges,,,,,,,,,254.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.27,22,,percent of total billed charges,,,303.08,91,,percent of total billed charges,,,316.41,95,,percent of total billed charges,,,276.44,83,,percent of total billed charges,,,276.44,83,,percent of total billed charges,,,,,,,,,,,,,,,276.44,83,,percent of total billed charges,,,316.41,95,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,273.11,82,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,283.1,85,,percent of total billed charges,,83.27,316.41,
LIDOCAINE HCL AMP PF 1%:20MG/2ML,32005382,CDM,J2001,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
BUFFERED LIDOCAINE,32005383,CDM,,,250,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
LIDOCAINE OINT 5%:35.44GM,32005386,CDM,J3490,HCPCS,250,RC,outpatient,,346.24,346.24,,293.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.56,22,,percent of total billed charges,,,,,,,,,311.62,90,,percent of total billed charges,,,286.69,82.8,,percent of total billed charges,,,294.3,85,,percent of total billed charges,,,,,,,,,304.69,88,,percent of total billed charges,,,,,,,,,264.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.56,22,,percent of total billed charges,,,315.08,91,,percent of total billed charges,,,328.93,95,,percent of total billed charges,,,287.38,83,,percent of total billed charges,,,287.38,83,,percent of total billed charges,,,,,,,,,,,,,,,287.38,83,,percent of total billed charges,,,328.93,95,,percent of total billed charges,,,311.62,90,,percent of total billed charges,,,311.62,90,,percent of total billed charges,,,283.92,82,,percent of total billed charges,,,311.62,90,,percent of total billed charges,,,294.3,85,,percent of total billed charges,,86.56,328.93,
LIDOCAINE(UROJECT)JEL 2%:11ML,32005391,CDM,J2001,HCPCS,250,RC,outpatient,,80.23,80.23,,68.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.06,22,,percent of total billed charges,,,,,,,,,72.21,90,,percent of total billed charges,,,66.43,82.8,,percent of total billed charges,,,68.2,85,,percent of total billed charges,,,,,,,,,70.6,88,,percent of total billed charges,,0.75,,,,fee schedule,,,61.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,20.06,22,,percent of total billed charges,,,73.01,91,,percent of total billed charges,,,76.22,95,,percent of total billed charges,,,66.59,83,,percent of total billed charges,,,66.59,83,,percent of total billed charges,,,,,,,,,,,,,,,66.59,83,,percent of total billed charges,,,76.22,95,,percent of total billed charges,,,72.21,90,,percent of total billed charges,,,72.21,90,,percent of total billed charges,,,65.79,82,,percent of total billed charges,,,72.21,90,,percent of total billed charges,,,68.2,85,,percent of total billed charges,,0.75,76.22,
LIDOCAINE(XYLOCAINE)TOP SOL 4%:50ML,32005396,CDM,J3490,HCPCS,250,RC,outpatient,,651.97,651.97,,553.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,162.99,22,,percent of total billed charges,,,,,,,,,586.77,90,,percent of total billed charges,,,539.83,82.8,,percent of total billed charges,,,554.17,85,,percent of total billed charges,,,,,,,,,573.73,88,,percent of total billed charges,,,,,,,,,498.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,162.99,22,,percent of total billed charges,,,593.29,91,,percent of total billed charges,,,619.37,95,,percent of total billed charges,,,541.14,83,,percent of total billed charges,,,541.14,83,,percent of total billed charges,,,,,,,,,,,,,,,541.14,83,,percent of total billed charges,,,619.37,95,,percent of total billed charges,,,586.77,90,,percent of total billed charges,,,586.77,90,,percent of total billed charges,,,534.62,82,,percent of total billed charges,,,586.77,90,,percent of total billed charges,,,554.17,85,,percent of total billed charges,,162.99,619.37,
LIDOCAINE(XYLOCAIN SYR):100MG/5ML,32005401,CDM,J2001,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
LIDOCAINE VISCOUS(XYLOCAINE) 2%:15ML U/D,32005411,CDM,J8499,HCPCS,250,RC,outpatient,,64.38,64.38,,54.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.1,22,,percent of total billed charges,,,,,,,,,57.94,90,,percent of total billed charges,,,53.31,82.8,,percent of total billed charges,,,54.72,85,,percent of total billed charges,,,,,,,,,56.65,88,,percent of total billed charges,,,,,,,,,49.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.1,22,,percent of total billed charges,,,58.59,91,,percent of total billed charges,,,61.16,95,,percent of total billed charges,,,53.44,83,,percent of total billed charges,,,53.44,83,,percent of total billed charges,,,,,,,,,,,,,,,53.44,83,,percent of total billed charges,,,61.16,95,,percent of total billed charges,,,57.94,90,,percent of total billed charges,,,57.94,90,,percent of total billed charges,,,52.79,82,,percent of total billed charges,,,57.94,90,,percent of total billed charges,,,54.72,85,,percent of total billed charges,,16.1,61.16,
LIDOCAINE VISCOUS 2% SOL:100ML,32005412,CDM,J8499,HCPCS,250,RC,outpatient,,188.56,188.56,,160.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.14,22,,percent of total billed charges,,,,,,,,,169.7,90,,percent of total billed charges,,,156.13,82.8,,percent of total billed charges,,,160.28,85,,percent of total billed charges,,,,,,,,,165.93,88,,percent of total billed charges,,,,,,,,,144.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.14,22,,percent of total billed charges,,,171.59,91,,percent of total billed charges,,,179.13,95,,percent of total billed charges,,,156.5,83,,percent of total billed charges,,,156.5,83,,percent of total billed charges,,,,,,,,,,,,,,,156.5,83,,percent of total billed charges,,,179.13,95,,percent of total billed charges,,,169.7,90,,percent of total billed charges,,,169.7,90,,percent of total billed charges,,,154.62,82,,percent of total billed charges,,,169.7,90,,percent of total billed charges,,,160.28,85,,percent of total billed charges,,47.14,179.13,
IV NITROglycerin BTL 25MG/250ML (PREMIX),32005413,CDM,J3490,HCPCS,250,RC,outpatient,,316.67,316.67,,268.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.17,22,,percent of total billed charges,,,,,,,,,285,90,,percent of total billed charges,,,262.2,82.8,,percent of total billed charges,,,269.17,85,,percent of total billed charges,,,,,,,,,278.67,88,,percent of total billed charges,,,,,,,,,241.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.17,22,,percent of total billed charges,,,288.17,91,,percent of total billed charges,,,300.84,95,,percent of total billed charges,,,262.84,83,,percent of total billed charges,,,262.84,83,,percent of total billed charges,,,,,,,,,,,,,,,262.84,83,,percent of total billed charges,,,300.84,95,,percent of total billed charges,,,285,90,,percent of total billed charges,,,285,90,,percent of total billed charges,,,259.67,82,,percent of total billed charges,,,285,90,,percent of total billed charges,,,269.17,85,,percent of total billed charges,,79.17,300.84,
LINDANE LOT (KWELL) : 1%  60ML,32005426,CDM,,,250,RC,outpatient,,1470.34,1470.34,,1248.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,367.59,22,,percent of total billed charges,,,,,,,,,1323.31,90,,percent of total billed charges,,,1217.44,82.8,,percent of total billed charges,,,1249.79,85,,percent of total billed charges,,,,,,,,,1293.9,88,,percent of total billed charges,,,,,,,,,1123.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,367.59,22,,percent of total billed charges,,,1338.01,91,,percent of total billed charges,,,1396.82,95,,percent of total billed charges,,,1220.38,83,,percent of total billed charges,,,1220.38,83,,percent of total billed charges,,,,,,,,,,,,,,,1220.38,83,,percent of total billed charges,,,1396.82,95,,percent of total billed charges,,,1323.31,90,,percent of total billed charges,,,1323.31,90,,percent of total billed charges,,,1205.68,82,,percent of total billed charges,,,1323.31,90,,percent of total billed charges,,,1249.79,85,,percent of total billed charges,,367.59,1396.82,
LINDANE SHAM (KWELL) 1%:60ML,32005431,CDM,,,250,RC,outpatient,,1498.83,1498.83,,1272.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,374.71,22,,percent of total billed charges,,,,,,,,,1348.95,90,,percent of total billed charges,,,1241.03,82.8,,percent of total billed charges,,,1274.01,85,,percent of total billed charges,,,,,,,,,1318.97,88,,percent of total billed charges,,,,,,,,,1145.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,374.71,22,,percent of total billed charges,,,1363.94,91,,percent of total billed charges,,,1423.89,95,,percent of total billed charges,,,1244.03,83,,percent of total billed charges,,,1244.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1244.03,83,,percent of total billed charges,,,1423.89,95,,percent of total billed charges,,,1348.95,90,,percent of total billed charges,,,1348.95,90,,percent of total billed charges,,,1229.04,82,,percent of total billed charges,,,1348.95,90,,percent of total billed charges,,,1274.01,85,,percent of total billed charges,,374.71,1423.89,
ATORVASTATIN(LIPITOR)TAB:10MG,32005432,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ATORVASTATIN (LIPITOR) TAB : 20MG,32005433,CDM,,,250,RC,outpatient,,287.7,287.7,,244.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.93,22,,percent of total billed charges,,,,,,,,,258.93,90,,percent of total billed charges,,,238.22,82.8,,percent of total billed charges,,,244.55,85,,percent of total billed charges,,,,,,,,,253.18,88,,percent of total billed charges,,,,,,,,,219.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.93,22,,percent of total billed charges,,,261.81,91,,percent of total billed charges,,,273.32,95,,percent of total billed charges,,,238.79,83,,percent of total billed charges,,,238.79,83,,percent of total billed charges,,,,,,,,,,,,,,,238.79,83,,percent of total billed charges,,,273.32,95,,percent of total billed charges,,,258.93,90,,percent of total billed charges,,,258.93,90,,percent of total billed charges,,,235.91,82,,percent of total billed charges,,,258.93,90,,percent of total billed charges,,,244.55,85,,percent of total billed charges,,71.93,273.32,
POLYVIN ALC (ARTIF TEARS)DROP 1.40%:15ML,32005436,CDM,J3490,HCPCS,250,RC,outpatient,,107.84,107.84,,91.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.96,22,,percent of total billed charges,,,,,,,,,97.06,90,,percent of total billed charges,,,89.29,82.8,,percent of total billed charges,,,91.66,85,,percent of total billed charges,,,,,,,,,94.9,88,,percent of total billed charges,,,,,,,,,82.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.96,22,,percent of total billed charges,,,98.13,91,,percent of total billed charges,,,102.45,95,,percent of total billed charges,,,89.51,83,,percent of total billed charges,,,89.51,83,,percent of total billed charges,,,,,,,,,,,,,,,89.51,83,,percent of total billed charges,,,102.45,95,,percent of total billed charges,,,97.06,90,,percent of total billed charges,,,97.06,90,,percent of total billed charges,,,88.43,82,,percent of total billed charges,,,97.06,90,,percent of total billed charges,,,91.66,85,,percent of total billed charges,,26.96,102.45,
ACTIVATED CHARCL(ACTIDOSE)ORAL:25G/120ML,32005441,CDM,J8499,HCPCS,250,RC,outpatient,,150,150,,127.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.5,22,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,124.2,82.8,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,,,,,,,,132,88,,percent of total billed charges,,,,,,,,,114.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.5,22,,percent of total billed charges,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,,,,,,,,,,,,,124.5,83,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,123,82,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,37.5,142.5,
LIQUI-CHAR 50GM,32005442,CDM,,,250,RC,outpatient,,35,35,,29.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.75,22,,percent of total billed charges,,,,,,,,,31.5,90,,percent of total billed charges,,,28.98,82.8,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,,,,,,,,30.8,88,,percent of total billed charges,,,,,,,,,26.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.75,22,,percent of total billed charges,,,31.85,91,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,,,,,,,,,,,,,29.05,83,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,28.7,82,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,8.75,33.25,
LISTERINE 250ML,32005447,CDM,,,250,RC,outpatient,,10,10,,8.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.5,22,,percent of total billed charges,,,,,,,,,9,90,,percent of total billed charges,,,8.28,82.8,,percent of total billed charges,,,8.5,85,,percent of total billed charges,,,,,,,,,8.8,88,,percent of total billed charges,,,,,,,,,7.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.5,22,,percent of total billed charges,,,9.1,91,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,,,,,,,,,,,,,8.3,83,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,9,90,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.2,82,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.5,85,,percent of total billed charges,,2.5,9.5,
LITHIUM CARBONATE CAP:300MG,32005451,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LITHIUM CARBONATE CAP : 150MG,32005452,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
LITHIUM CARBONATE (LITHOBID)TAB:300MG,32005456,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ETODOLAC(LODINE)CAP:300MG,32005461,CDM,,,250,RC,outpatient,,13.64,13.64,,11.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.41,22,,percent of total billed charges,,,,,,,,,12.28,90,,percent of total billed charges,,,11.29,82.8,,percent of total billed charges,,,11.59,85,,percent of total billed charges,,,,,,,,,12,88,,percent of total billed charges,,,,,,,,,10.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.41,22,,percent of total billed charges,,,12.41,91,,percent of total billed charges,,,12.96,95,,percent of total billed charges,,,11.32,83,,percent of total billed charges,,,11.32,83,,percent of total billed charges,,,,,,,,,,,,,,,11.32,83,,percent of total billed charges,,,12.96,95,,percent of total billed charges,,,12.28,90,,percent of total billed charges,,,12.28,90,,percent of total billed charges,,,11.18,82,,percent of total billed charges,,,12.28,90,,percent of total billed charges,,,11.59,85,,percent of total billed charges,,3.41,12.96,
ETODOLAC TAB (LODINE) : 400MG,32005471,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
LODINE XL 400MG,32005472,CDM,,,250,RC,outpatient,,4,4,,3.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1,22,,percent of total billed charges,,,,,,,,,3.6,90,,percent of total billed charges,,,3.31,82.8,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,,,,,,,,3.52,88,,percent of total billed charges,,,,,,,,,3.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1,22,,percent of total billed charges,,,3.64,91,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,,,,,,,,,,,,,3.32,83,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.28,82,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,1,3.8,
LONOX,32005475,CDM,,,250,RC,outpatient,,2,2,,1.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.5,22,,percent of total billed charges,,,,,,,,,1.8,90,,percent of total billed charges,,,1.66,82.8,,percent of total billed charges,,,1.7,85,,percent of total billed charges,,,,,,,,,1.76,88,,percent of total billed charges,,,,,,,,,1.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.5,22,,percent of total billed charges,,,1.82,91,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,,,,,,,,,,,,,1.66,83,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.64,82,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.7,85,,percent of total billed charges,,0.5,1.9,
LOPERAMIDE (IMODIUM) LIQ: 1MG/5ML 10 ML,32005481,CDM,,,250,RC,outpatient,,25.38,25.38,,21.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.35,22,,percent of total billed charges,,,,,,,,,22.84,90,,percent of total billed charges,,,21.01,82.8,,percent of total billed charges,,,21.57,85,,percent of total billed charges,,,,,,,,,22.33,88,,percent of total billed charges,,,,,,,,,19.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.35,22,,percent of total billed charges,,,23.1,91,,percent of total billed charges,,,24.11,95,,percent of total billed charges,,,21.07,83,,percent of total billed charges,,,21.07,83,,percent of total billed charges,,,,,,,,,,,,,,,21.07,83,,percent of total billed charges,,,24.11,95,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,20.81,82,,percent of total billed charges,,,22.84,90,,percent of total billed charges,,,21.57,85,,percent of total billed charges,,6.35,24.11,
LOPERAMIDE 1MG/5ML SOLUTION 120CC,32005482,CDM,,,250,RC,outpatient,,20.25,20.25,,17.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.06,22,,percent of total billed charges,,,,,,,,,18.23,90,,percent of total billed charges,,,16.77,82.8,,percent of total billed charges,,,17.21,85,,percent of total billed charges,,,,,,,,,17.82,88,,percent of total billed charges,,,,,,,,,15.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.06,22,,percent of total billed charges,,,18.43,91,,percent of total billed charges,,,19.24,95,,percent of total billed charges,,,16.81,83,,percent of total billed charges,,,16.81,83,,percent of total billed charges,,,,,,,,,,,,,,,16.81,83,,percent of total billed charges,,,19.24,95,,percent of total billed charges,,,18.23,90,,percent of total billed charges,,,18.23,90,,percent of total billed charges,,,16.61,82,,percent of total billed charges,,,18.23,90,,percent of total billed charges,,,17.21,85,,percent of total billed charges,,5.06,19.24,
LOPERAMIDE(IMODIUM)CAP:2MG,32005486,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LOPERAMIDE HCL (IMODIUM) 120ML,32005491,CDM,,,250,RC,outpatient,,28.5,28.5,,24.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.13,22,,percent of total billed charges,,,,,,,,,25.65,90,,percent of total billed charges,,,23.6,82.8,,percent of total billed charges,,,24.23,85,,percent of total billed charges,,,,,,,,,25.08,88,,percent of total billed charges,,,,,,,,,21.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.13,22,,percent of total billed charges,,,25.94,91,,percent of total billed charges,,,27.08,95,,percent of total billed charges,,,23.66,83,,percent of total billed charges,,,23.66,83,,percent of total billed charges,,,,,,,,,,,,,,,23.66,83,,percent of total billed charges,,,27.08,95,,percent of total billed charges,,,25.65,90,,percent of total billed charges,,,25.65,90,,percent of total billed charges,,,23.37,82,,percent of total billed charges,,,25.65,90,,percent of total billed charges,,,24.23,85,,percent of total billed charges,,7.13,27.08,
LOPERAMIDE(IMODIUM)LIQ:1MG/5ML(120ML),32005496,CDM,J8499,HCPCS,250,RC,outpatient,,28.5,28.5,,24.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.13,22,,percent of total billed charges,,,,,,,,,25.65,90,,percent of total billed charges,,,23.6,82.8,,percent of total billed charges,,,24.23,85,,percent of total billed charges,,,,,,,,,25.08,88,,percent of total billed charges,,,,,,,,,21.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.13,22,,percent of total billed charges,,,25.94,91,,percent of total billed charges,,,27.08,95,,percent of total billed charges,,,23.66,83,,percent of total billed charges,,,23.66,83,,percent of total billed charges,,,,,,,,,,,,,,,23.66,83,,percent of total billed charges,,,27.08,95,,percent of total billed charges,,,25.65,90,,percent of total billed charges,,,25.65,90,,percent of total billed charges,,,23.37,82,,percent of total billed charges,,,25.65,90,,percent of total billed charges,,,24.23,85,,percent of total billed charges,,7.13,27.08,
LORazepam(ATIVAN)TAB:0.5MG,32005511,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
LORAZEPAM (ATIVAN) TAB : 2MG,32005516,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
LORazepam(ATIVAN)TAB:1MG,32005526,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
HYDROCOD/ACET(VICOD ES)TAB :7.5-750MG,32005532,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
HYDROCOD/ACETA (LORCET) TAB:10-650MG,32005536,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
VICODIN TAB:5-500MG ***SUB TO NORCO,32005551,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
HYDROcod/APAP(VICODIN)TAB:5-500MG (1X10),32005552,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
BENAZEPRIL (LOTENSIN) TAB : 5MG,32005556,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
BENAZEPRIL(LOTENSIN)TAB:10MG,32005561,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
AMLODIPINE/BENZAPRIL(LOTREL) CAP:5-10MG,32005562,CDM,,,250,RC,outpatient,,40.13,40.13,,34.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.03,22,,percent of total billed charges,,,,,,,,,36.12,90,,percent of total billed charges,,,33.23,82.8,,percent of total billed charges,,,34.11,85,,percent of total billed charges,,,,,,,,,35.31,88,,percent of total billed charges,,,,,,,,,30.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.03,22,,percent of total billed charges,,,36.52,91,,percent of total billed charges,,,38.12,95,,percent of total billed charges,,,33.31,83,,percent of total billed charges,,,33.31,83,,percent of total billed charges,,,,,,,,,,,,,,,33.31,83,,percent of total billed charges,,,38.12,95,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,32.91,82,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,34.11,85,,percent of total billed charges,,10.03,38.12,
AMLODIPINE/BENAZEPRIL(LOTREL) CAP:5-20MG,32005563,CDM,,,250,RC,outpatient,,42.35,42.35,,35.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.59,22,,percent of total billed charges,,,,,,,,,38.12,90,,percent of total billed charges,,,35.07,82.8,,percent of total billed charges,,,36,85,,percent of total billed charges,,,,,,,,,37.27,88,,percent of total billed charges,,,,,,,,,32.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.59,22,,percent of total billed charges,,,38.54,91,,percent of total billed charges,,,40.23,95,,percent of total billed charges,,,35.15,83,,percent of total billed charges,,,35.15,83,,percent of total billed charges,,,,,,,,,,,,,,,35.15,83,,percent of total billed charges,,,40.23,95,,percent of total billed charges,,,38.12,90,,percent of total billed charges,,,38.12,90,,percent of total billed charges,,,34.73,82,,percent of total billed charges,,,38.12,90,,percent of total billed charges,,,36,85,,percent of total billed charges,,10.59,40.23,
LOTRISONE:15GM,32005566,CDM,,,250,RC,outpatient,,342.42,342.42,,290.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.61,22,,percent of total billed charges,,,,,,,,,308.18,90,,percent of total billed charges,,,283.52,82.8,,percent of total billed charges,,,291.06,85,,percent of total billed charges,,,,,,,,,301.33,88,,percent of total billed charges,,,,,,,,,261.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.61,22,,percent of total billed charges,,,311.6,91,,percent of total billed charges,,,325.3,95,,percent of total billed charges,,,284.21,83,,percent of total billed charges,,,284.21,83,,percent of total billed charges,,,,,,,,,,,,,,,284.21,83,,percent of total billed charges,,,325.3,95,,percent of total billed charges,,,308.18,90,,percent of total billed charges,,,308.18,90,,percent of total billed charges,,,280.78,82,,percent of total billed charges,,,308.18,90,,percent of total billed charges,,,291.06,85,,percent of total billed charges,,85.61,325.3,
LOTRISONE CREAM 45GM,32005567,CDM,,,250,RC,outpatient,,143,143,,121.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.75,22,,percent of total billed charges,,,,,,,,,128.7,90,,percent of total billed charges,,,118.4,82.8,,percent of total billed charges,,,121.55,85,,percent of total billed charges,,,,,,,,,125.84,88,,percent of total billed charges,,,,,,,,,109.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.75,22,,percent of total billed charges,,,130.13,91,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,,,,,,,,,,,,,118.69,83,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,117.26,82,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,121.55,85,,percent of total billed charges,,35.75,135.85,
ENOXAPARIN(LOVENOX): 30MG/0.3ML,32005571,CDM,J1650,HCPCS,250,RC,outpatient,,73.37,73.37,,62.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.34,22,,percent of total billed charges,,,,,,,,,66.03,90,,percent of total billed charges,,,60.75,82.8,,percent of total billed charges,,,62.36,85,,percent of total billed charges,,,,,,,,,64.57,88,,percent of total billed charges,,15.16,,,,fee schedule,,,56.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.16,,,,fee schedule,,,18.34,22,,percent of total billed charges,,,66.77,91,,percent of total billed charges,,,69.7,95,,percent of total billed charges,,,60.9,83,,percent of total billed charges,,,60.9,83,,percent of total billed charges,,,,,,,,,,,,,,,60.9,83,,percent of total billed charges,,,69.7,95,,percent of total billed charges,,,66.03,90,,percent of total billed charges,,,66.03,90,,percent of total billed charges,,,60.16,82,,percent of total billed charges,,,66.03,90,,percent of total billed charges,,,62.36,85,,percent of total billed charges,,15.16,69.7,
LOVENOX 40MG/.4ML SYRINGES,32005572,CDM,,,250,RC,outpatient,,62.81,62.81,,53.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.7,22,,percent of total billed charges,,,,,,,,,56.53,90,,percent of total billed charges,,,52.01,82.8,,percent of total billed charges,,,53.39,85,,percent of total billed charges,,,,,,,,,55.27,88,,percent of total billed charges,,,,,,,,,47.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.7,22,,percent of total billed charges,,,57.16,91,,percent of total billed charges,,,59.67,95,,percent of total billed charges,,,52.13,83,,percent of total billed charges,,,52.13,83,,percent of total billed charges,,,,,,,,,,,,,,,52.13,83,,percent of total billed charges,,,59.67,95,,percent of total billed charges,,,56.53,90,,percent of total billed charges,,,56.53,90,,percent of total billed charges,,,51.5,82,,percent of total billed charges,,,56.53,90,,percent of total billed charges,,,53.39,85,,percent of total billed charges,,15.7,59.67,
ENOXAPARIN(LOVENOX): 40MG/0.4ML,32005573,CDM,J1650,HCPCS,636,RC,outpatient,,65.52,65.52,,55.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.38,22,,percent of total billed charges,,,,,,,,,58.97,90,,percent of total billed charges,,,54.25,82.8,,percent of total billed charges,,,55.69,85,,percent of total billed charges,,,,,,,,,57.66,88,,percent of total billed charges,,15.16,,,,fee schedule,,,50.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.16,,,,fee schedule,,,16.38,22,,percent of total billed charges,,,59.62,91,,percent of total billed charges,,,62.24,95,,percent of total billed charges,,,54.38,83,,percent of total billed charges,,,54.38,83,,percent of total billed charges,,,,,,,,,,,,,,,54.38,83,,percent of total billed charges,,,62.24,95,,percent of total billed charges,,,58.97,90,,percent of total billed charges,,,58.97,90,,percent of total billed charges,,,53.73,82,,percent of total billed charges,,,58.97,90,,percent of total billed charges,,,55.69,85,,percent of total billed charges,,15.16,62.24,
INDAPAMIDE (LOZOL) TAB : 2.5MG,32005576,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
LEUPROLIDE ACETATE (LUPRON DEPOT) 7.5MG,32005587,CDM,J9217,HCPCS,636,RC,outpatient,,8125.74,8125.74,,6898.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.44,22,,percent of total billed charges,,,,,,,,,7313.17,90,,percent of total billed charges,,,6728.11,82.8,,percent of total billed charges,,,6906.88,85,,percent of total billed charges,,,,,,,,,7150.65,88,,percent of total billed charges,,998.81,,,,fee schedule,,,6208.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,998.81,,,,fee schedule,,,2031.44,22,,percent of total billed charges,,,7394.42,91,,percent of total billed charges,,,7719.45,95,,percent of total billed charges,,,6744.36,83,,percent of total billed charges,,,6744.36,83,,percent of total billed charges,,,,,,,,,,,,,,,6744.36,83,,percent of total billed charges,,,7719.45,95,,percent of total billed charges,,,7313.17,90,,percent of total billed charges,,,7313.17,90,,percent of total billed charges,,,6663.11,82,,percent of total billed charges,,,7313.17,90,,percent of total billed charges,,,6906.88,85,,percent of total billed charges,,998.81,7719.45,
*DEPO LUPRON 4 MONTH(V1014),32005592,CDM,J9217,HCPCS,636,RC,outpatient,,3144,3144,,2669.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,786,22,,percent of total billed charges,,,,,,,,,2829.6,90,,percent of total billed charges,,,2603.23,82.8,,percent of total billed charges,,,2672.4,85,,percent of total billed charges,,,,,,,,,2766.72,88,,percent of total billed charges,,998.81,,,,fee schedule,,,2402.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,998.81,,,,fee schedule,,,786,22,,percent of total billed charges,,,2861.04,91,,percent of total billed charges,,,2986.8,95,,percent of total billed charges,,,2609.52,83,,percent of total billed charges,,,2609.52,83,,percent of total billed charges,,,,,,,,,,,,,,,2609.52,83,,percent of total billed charges,,,2986.8,95,,percent of total billed charges,,,2829.6,90,,percent of total billed charges,,,2829.6,90,,percent of total billed charges,,,2578.08,82,,percent of total billed charges,,,2829.6,90,,percent of total billed charges,,,2672.4,85,,percent of total billed charges,,786,2986.8,
MAG+ALOH+SIMETH(MYLANTA):30ML,32005597,CDM,J8499,HCPCS,250,RC,outpatient,,54.58,54.58,,46.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.65,22,,percent of total billed charges,,,,,,,,,49.12,90,,percent of total billed charges,,,45.19,82.8,,percent of total billed charges,,,46.39,85,,percent of total billed charges,,,,,,,,,48.03,88,,percent of total billed charges,,,,,,,,,41.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.65,22,,percent of total billed charges,,,49.67,91,,percent of total billed charges,,,51.85,95,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,,,,,,,,,,,,,,45.3,83,,percent of total billed charges,,,51.85,95,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,44.76,82,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,46.39,85,,percent of total billed charges,,13.65,51.85,
MAG HYDRO(ALAMAG):200-225/5 (12OZ),32005601,CDM,,,250,RC,outpatient,,14.75,14.75,,12.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.69,22,,percent of total billed charges,,,,,,,,,13.28,90,,percent of total billed charges,,,12.21,82.8,,percent of total billed charges,,,12.54,85,,percent of total billed charges,,,,,,,,,12.98,88,,percent of total billed charges,,,,,,,,,11.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.69,22,,percent of total billed charges,,,13.42,91,,percent of total billed charges,,,14.01,95,,percent of total billed charges,,,12.24,83,,percent of total billed charges,,,12.24,83,,percent of total billed charges,,,,,,,,,,,,,,,12.24,83,,percent of total billed charges,,,14.01,95,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,12.1,82,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,12.54,85,,percent of total billed charges,,3.69,14.01,
MAG/AL/SIM(MAALOX+)ORAL:200-200-20 148ML,32005606,CDM,,,250,RC,outpatient,,32.35,32.35,,27.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.09,22,,percent of total billed charges,,,,,,,,,29.12,90,,percent of total billed charges,,,26.79,82.8,,percent of total billed charges,,,27.5,85,,percent of total billed charges,,,,,,,,,28.47,88,,percent of total billed charges,,,,,,,,,24.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.09,22,,percent of total billed charges,,,29.44,91,,percent of total billed charges,,,30.73,95,,percent of total billed charges,,,26.85,83,,percent of total billed charges,,,26.85,83,,percent of total billed charges,,,,,,,,,,,,,,,26.85,83,,percent of total billed charges,,,30.73,95,,percent of total billed charges,,,29.12,90,,percent of total billed charges,,,29.12,90,,percent of total billed charges,,,26.53,82,,percent of total billed charges,,,29.12,90,,percent of total billed charges,,,27.5,85,,percent of total billed charges,,8.09,30.73,
MAG/AL/SIM(MAALOX+)ORAL:200-225-25 148ML,32005611,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
MAALOX EXTRA STRENGTH PLUS 148CC,32005612,CDM,,,250,RC,outpatient,,3.25,3.25,,2.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.81,22,,percent of total billed charges,,,,,,,,,2.93,90,,percent of total billed charges,,,2.69,82.8,,percent of total billed charges,,,2.76,85,,percent of total billed charges,,,,,,,,,2.86,88,,percent of total billed charges,,,,,,,,,2.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.81,22,,percent of total billed charges,,,2.96,91,,percent of total billed charges,,,3.09,95,,percent of total billed charges,,,2.7,83,,percent of total billed charges,,,2.7,83,,percent of total billed charges,,,,,,,,,,,,,,,2.7,83,,percent of total billed charges,,,3.09,95,,percent of total billed charges,,,2.93,90,,percent of total billed charges,,,2.93,90,,percent of total billed charges,,,2.67,82,,percent of total billed charges,,,2.93,90,,percent of total billed charges,,,2.76,85,,percent of total billed charges,,0.81,3.09,
NITROFURANTOIN(MACROBID)CAP:100MG,32005616,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
MAG OXIDE TAB:400MG,32005621,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
MAGNESIUM SULF VIAL : 4MEQ/ML (1GM) 2ML,32005626,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
MAG SULF-VIAL:5GM/10ML,32005631,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
MAG SULF-VIAL:1GM/2ML,32005636,CDM,J3475,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,15.22,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.22,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,15.22,60.99,
METHENAMINE MANDELATE TAB : 1G,32005651,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
MAPROTILINE (LUDIOMIL) TAB : 25MG,32005661,CDM,,,250,RC,outpatient,,15.38,15.38,,13.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.85,22,,percent of total billed charges,,,,,,,,,13.84,90,,percent of total billed charges,,,12.73,82.8,,percent of total billed charges,,,13.07,85,,percent of total billed charges,,,,,,,,,13.53,88,,percent of total billed charges,,,,,,,,,11.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.85,22,,percent of total billed charges,,,14,91,,percent of total billed charges,,,14.61,95,,percent of total billed charges,,,12.77,83,,percent of total billed charges,,,12.77,83,,percent of total billed charges,,,,,,,,,,,,,,,12.77,83,,percent of total billed charges,,,14.61,95,,percent of total billed charges,,,13.84,90,,percent of total billed charges,,,13.84,90,,percent of total billed charges,,,12.61,82,,percent of total billed charges,,,13.84,90,,percent of total billed charges,,,13.07,85,,percent of total billed charges,,3.85,14.61,
MAPROTILINE (LUDIOMIL) TAB : 50MG,32005666,CDM,,,250,RC,outpatient,,22.68,22.68,,19.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.67,22,,percent of total billed charges,,,,,,,,,20.41,90,,percent of total billed charges,,,18.78,82.8,,percent of total billed charges,,,19.28,85,,percent of total billed charges,,,,,,,,,19.96,88,,percent of total billed charges,,,,,,,,,17.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.67,22,,percent of total billed charges,,,20.64,91,,percent of total billed charges,,,21.55,95,,percent of total billed charges,,,18.82,83,,percent of total billed charges,,,18.82,83,,percent of total billed charges,,,,,,,,,,,,,,,18.82,83,,percent of total billed charges,,,21.55,95,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,18.6,82,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,19.28,85,,percent of total billed charges,,5.67,21.55,
MAPROTILINE (LUDIOMIL) TAB : 75MG,32005671,CDM,,,250,RC,outpatient,,31.24,31.24,,26.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.81,22,,percent of total billed charges,,,,,,,,,28.12,90,,percent of total billed charges,,,25.87,82.8,,percent of total billed charges,,,26.55,85,,percent of total billed charges,,,,,,,,,27.49,88,,percent of total billed charges,,,,,,,,,23.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.81,22,,percent of total billed charges,,,28.43,91,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,,,,,,,,,,,,,25.93,83,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,25.62,82,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,26.55,85,,percent of total billed charges,,7.81,29.68,
RIZATRIPTAN(MAXALT)TAB:10MG,32005682,CDM,J8499,HCPCS,250,RC,outpatient,,370.49,370.49,,314.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.62,22,,percent of total billed charges,,,,,,,,,333.44,90,,percent of total billed charges,,,306.77,82.8,,percent of total billed charges,,,314.92,85,,percent of total billed charges,,,,,,,,,326.03,88,,percent of total billed charges,,,,,,,,,283.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.62,22,,percent of total billed charges,,,337.15,91,,percent of total billed charges,,,351.97,95,,percent of total billed charges,,,307.51,83,,percent of total billed charges,,,307.51,83,,percent of total billed charges,,,,,,,,,,,,,,,307.51,83,,percent of total billed charges,,,351.97,95,,percent of total billed charges,,,333.44,90,,percent of total billed charges,,,333.44,90,,percent of total billed charges,,,303.8,82,,percent of total billed charges,,,333.44,90,,percent of total billed charges,,,314.92,85,,percent of total billed charges,,92.62,351.97,
NEO/POLY/DEX(MAXITROL)DROP 0.1%:5ML,32005686,CDM,J3490,HCPCS,250,RC,outpatient,,222.36,222.36,,188.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.59,22,,percent of total billed charges,,,,,,,,,200.12,90,,percent of total billed charges,,,184.11,82.8,,percent of total billed charges,,,189.01,85,,percent of total billed charges,,,,,,,,,195.68,88,,percent of total billed charges,,,,,,,,,169.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.59,22,,percent of total billed charges,,,202.35,91,,percent of total billed charges,,,211.24,95,,percent of total billed charges,,,184.56,83,,percent of total billed charges,,,184.56,83,,percent of total billed charges,,,,,,,,,,,,,,,184.56,83,,percent of total billed charges,,,211.24,95,,percent of total billed charges,,,200.12,90,,percent of total billed charges,,,200.12,90,,percent of total billed charges,,,182.34,82,,percent of total billed charges,,,200.12,90,,percent of total billed charges,,,189.01,85,,percent of total billed charges,,55.59,211.24,
DEXAMETHASONE(MAXIDEX)EYE DROP 0.1%:5ML,32005691,CDM,J3490,HCPCS,250,RC,outpatient,,706.21,706.21,,599.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,176.55,22,,percent of total billed charges,,,,,,,,,635.59,90,,percent of total billed charges,,,584.74,82.8,,percent of total billed charges,,,600.28,85,,percent of total billed charges,,,,,,,,,621.46,88,,percent of total billed charges,,,,,,,,,539.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,176.55,22,,percent of total billed charges,,,642.65,91,,percent of total billed charges,,,670.9,95,,percent of total billed charges,,,586.15,83,,percent of total billed charges,,,586.15,83,,percent of total billed charges,,,,,,,,,,,,,,,586.15,83,,percent of total billed charges,,,670.9,95,,percent of total billed charges,,,635.59,90,,percent of total billed charges,,,635.59,90,,percent of total billed charges,,,579.09,82,,percent of total billed charges,,,635.59,90,,percent of total billed charges,,,600.28,85,,percent of total billed charges,,176.55,670.9,
NEO/POLY/DEX OPHTH OINT:3.5GM,32005701,CDM,,,250,RC,outpatient,,299.75,299.75,,254.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.94,22,,percent of total billed charges,,,,,,,,,269.78,90,,percent of total billed charges,,,248.19,82.8,,percent of total billed charges,,,254.79,85,,percent of total billed charges,,,,,,,,,263.78,88,,percent of total billed charges,,,,,,,,,229.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.94,22,,percent of total billed charges,,,272.77,91,,percent of total billed charges,,,284.76,95,,percent of total billed charges,,,248.79,83,,percent of total billed charges,,,248.79,83,,percent of total billed charges,,,,,,,,,,,,,,,248.79,83,,percent of total billed charges,,,284.76,95,,percent of total billed charges,,,269.78,90,,percent of total billed charges,,,269.78,90,,percent of total billed charges,,,245.8,82,,percent of total billed charges,,,269.78,90,,percent of total billed charges,,,254.79,85,,percent of total billed charges,,74.94,284.76,
TRIAMTERENE/HCTZ(MAXZIDE) TAB : 37-26MG,32005706,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
FLUMAZENIL(ROMAZICON)VL:0.5MG/5ML,32005711,CDM,J3490,HCPCS,250,RC,outpatient,,111.44,111.44,,94.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.86,22,,percent of total billed charges,,,,,,,,,100.3,90,,percent of total billed charges,,,92.27,82.8,,percent of total billed charges,,,94.72,85,,percent of total billed charges,,,,,,,,,98.07,88,,percent of total billed charges,,,,,,,,,85.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.86,22,,percent of total billed charges,,,101.41,91,,percent of total billed charges,,,105.87,95,,percent of total billed charges,,,92.5,83,,percent of total billed charges,,,92.5,83,,percent of total billed charges,,,,,,,,,,,,,,,92.5,83,,percent of total billed charges,,,105.87,95,,percent of total billed charges,,,100.3,90,,percent of total billed charges,,,100.3,90,,percent of total billed charges,,,91.38,82,,percent of total billed charges,,,100.3,90,,percent of total billed charges,,,94.72,85,,percent of total billed charges,,27.86,105.87,
FREAMINE III KIT:8.50%,32005726,CDM,,,250,RC,outpatient,,252.75,252.75,,214.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.19,22,,percent of total billed charges,,,,,,,,,227.48,90,,percent of total billed charges,,,209.28,82.8,,percent of total billed charges,,,214.84,85,,percent of total billed charges,,,,,,,,,222.42,88,,percent of total billed charges,,,,,,,,,193.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.19,22,,percent of total billed charges,,,230,91,,percent of total billed charges,,,240.11,95,,percent of total billed charges,,,209.78,83,,percent of total billed charges,,,209.78,83,,percent of total billed charges,,,,,,,,,,,,,,,209.78,83,,percent of total billed charges,,,240.11,95,,percent of total billed charges,,,227.48,90,,percent of total billed charges,,,227.48,90,,percent of total billed charges,,,207.26,82,,percent of total billed charges,,,227.48,90,,percent of total billed charges,,,214.84,85,,percent of total billed charges,,63.19,240.11,
metroNID(FLAGYL)-IVPB:500MG/NS100ML,32005851,CDM,J3490,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
MECLIZINE (ANTIVERT) TAB : 12.5MG,32005921,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
MECLIZINE(ANTIVERT)TAB:25MG,32005926,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
MECLOFENAMATE (PONSTEL) CAP : 50MG,32005931,CDM,,,250,RC,outpatient,,55.51,55.51,,47.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.88,22,,percent of total billed charges,,,,,,,,,49.96,90,,percent of total billed charges,,,45.96,82.8,,percent of total billed charges,,,47.18,85,,percent of total billed charges,,,,,,,,,48.85,88,,percent of total billed charges,,,,,,,,,42.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.88,22,,percent of total billed charges,,,50.51,91,,percent of total billed charges,,,52.73,95,,percent of total billed charges,,,46.07,83,,percent of total billed charges,,,46.07,83,,percent of total billed charges,,,,,,,,,,,,,,,46.07,83,,percent of total billed charges,,,52.73,95,,percent of total billed charges,,,49.96,90,,percent of total billed charges,,,49.96,90,,percent of total billed charges,,,45.52,82,,percent of total billed charges,,,49.96,90,,percent of total billed charges,,,47.18,85,,percent of total billed charges,,13.88,52.73,
methylPRED(MEDROL)DOSEPAK:4MG (21TABS)ED,32005941,CDM,J8499,HCPCS,250,RC,outpatient,,81.86,81.86,,69.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.47,22,,percent of total billed charges,,,,,,,,,73.67,90,,percent of total billed charges,,,67.78,82.8,,percent of total billed charges,,,69.58,85,,percent of total billed charges,,,,,,,,,72.04,88,,percent of total billed charges,,,,,,,,,62.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.47,22,,percent of total billed charges,,,74.49,91,,percent of total billed charges,,,77.77,95,,percent of total billed charges,,,67.94,83,,percent of total billed charges,,,67.94,83,,percent of total billed charges,,,,,,,,,,,,,,,67.94,83,,percent of total billed charges,,,77.77,95,,percent of total billed charges,,,73.67,90,,percent of total billed charges,,,73.67,90,,percent of total billed charges,,,67.13,82,,percent of total billed charges,,,73.67,90,,percent of total billed charges,,,69.58,85,,percent of total billed charges,,20.47,77.77,
MEDROXYPROGESTERONE (PROVERA) TAB : 10MG,32005951,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ceFOXitin(MEFOXIN)-VIAL:1GM,32005961,CDM,J0694,HCPCS,250,RC,outpatient,,133.5,133.5,,113.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.38,22,,percent of total billed charges,,,,,,,,,120.15,90,,percent of total billed charges,,,110.54,82.8,,percent of total billed charges,,,113.48,85,,percent of total billed charges,,,,,,,,,117.48,88,,percent of total billed charges,,15.93,,,,fee schedule,,,101.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.93,,,,fee schedule,,,33.38,22,,percent of total billed charges,,,121.49,91,,percent of total billed charges,,,126.83,95,,percent of total billed charges,,,110.81,83,,percent of total billed charges,,,110.81,83,,percent of total billed charges,,,,,,,,,,,,,,,110.81,83,,percent of total billed charges,,,126.83,95,,percent of total billed charges,,,120.15,90,,percent of total billed charges,,,120.15,90,,percent of total billed charges,,,109.47,82,,percent of total billed charges,,,120.15,90,,percent of total billed charges,,,113.48,85,,percent of total billed charges,,15.93,126.83,
ceFOXitin(MEFOXIN)-VIAL:2GM,32005966,CDM,J0694,HCPCS,250,RC,outpatient,,103.76,103.76,,88.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.94,22,,percent of total billed charges,,,,,,,,,93.38,90,,percent of total billed charges,,,85.91,82.8,,percent of total billed charges,,,88.2,85,,percent of total billed charges,,,,,,,,,91.31,88,,percent of total billed charges,,15.93,,,,fee schedule,,,79.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.93,,,,fee schedule,,,25.94,22,,percent of total billed charges,,,94.42,91,,percent of total billed charges,,,98.57,95,,percent of total billed charges,,,86.12,83,,percent of total billed charges,,,86.12,83,,percent of total billed charges,,,,,,,,,,,,,,,86.12,83,,percent of total billed charges,,,98.57,95,,percent of total billed charges,,,93.38,90,,percent of total billed charges,,,93.38,90,,percent of total billed charges,,,85.08,82,,percent of total billed charges,,,93.38,90,,percent of total billed charges,,,88.2,85,,percent of total billed charges,,15.93,98.57,
MEGESTROL(MEGACE)TAB:40MG,32005971,CDM,J8999,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
MEGESTROL(MEGACE)ORAL:400MG/10ML (240ML),32005972,CDM,J8999,HCPCS,250,RC,outpatient,,499.59,499.59,,424.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.9,22,,percent of total billed charges,,,,,,,,,449.63,90,,percent of total billed charges,,,413.66,82.8,,percent of total billed charges,,,424.65,85,,percent of total billed charges,,,,,,,,,439.64,88,,percent of total billed charges,,,,,,,,,381.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.9,22,,percent of total billed charges,,,454.63,91,,percent of total billed charges,,,474.61,95,,percent of total billed charges,,,414.66,83,,percent of total billed charges,,,414.66,83,,percent of total billed charges,,,,,,,,,,,,,,,414.66,83,,percent of total billed charges,,,474.61,95,,percent of total billed charges,,,449.63,90,,percent of total billed charges,,,449.63,90,,percent of total billed charges,,,409.66,82,,percent of total billed charges,,,449.63,90,,percent of total billed charges,,,424.65,85,,percent of total billed charges,,124.9,474.61,
MENTHOLATUM OINT,32005987,CDM,,,250,RC,outpatient,,7.5,7.5,,6.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.88,22,,percent of total billed charges,,,,,,,,,6.75,90,,percent of total billed charges,,,6.21,82.8,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,,,,,,,,6.6,88,,percent of total billed charges,,,,,,,,,5.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.88,22,,percent of total billed charges,,,6.83,91,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,,,,,,,,,,,,,6.23,83,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.15,82,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,1.88,7.13,
ESTROGENS ESTERIFIED (MENEST) TAB:1.25MG,32005988,CDM,,,250,RC,outpatient,,58.21,58.21,,49.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.55,22,,percent of total billed charges,,,,,,,,,52.39,90,,percent of total billed charges,,,48.2,82.8,,percent of total billed charges,,,49.48,85,,percent of total billed charges,,,,,,,,,51.22,88,,percent of total billed charges,,,,,,,,,44.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.55,22,,percent of total billed charges,,,52.97,91,,percent of total billed charges,,,55.3,95,,percent of total billed charges,,,48.31,83,,percent of total billed charges,,,48.31,83,,percent of total billed charges,,,,,,,,,,,,,,,48.31,83,,percent of total billed charges,,,55.3,95,,percent of total billed charges,,,52.39,90,,percent of total billed charges,,,52.39,90,,percent of total billed charges,,,47.73,82,,percent of total billed charges,,,52.39,90,,percent of total billed charges,,,49.48,85,,percent of total billed charges,,14.55,55.3,
PHYTONADIONE(MEPHYTON)TAB:5MG,32005991,CDM,J8499,HCPCS,250,RC,outpatient,,657.19,657.19,,557.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,164.3,22,,percent of total billed charges,,,,,,,,,591.47,90,,percent of total billed charges,,,544.15,82.8,,percent of total billed charges,,,558.61,85,,percent of total billed charges,,,,,,,,,578.33,88,,percent of total billed charges,,,,,,,,,502.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,164.3,22,,percent of total billed charges,,,598.04,91,,percent of total billed charges,,,624.33,95,,percent of total billed charges,,,545.47,83,,percent of total billed charges,,,545.47,83,,percent of total billed charges,,,,,,,,,,,,,,,545.47,83,,percent of total billed charges,,,624.33,95,,percent of total billed charges,,,591.47,90,,percent of total billed charges,,,591.47,90,,percent of total billed charges,,,538.9,82,,percent of total billed charges,,,591.47,90,,percent of total billed charges,,,558.61,85,,percent of total billed charges,,164.3,624.33,
MEPERIDINE (DEMEROL) AMP:25MG/0.5ML,32005992,CDM,J2180,HCPCS,250,RC,outpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.42,22,,percent of total billed charges,,,,,,,,,59.09,90,,percent of total billed charges,,,54.37,82.8,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,,,,,,,,57.78,88,,percent of total billed charges,,,,,,,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.42,22,,percent of total billed charges,,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,16.42,62.38,
MEPERIDINE (DEMEROL) AMP:50MG/ML,32005993,CDM,J2180,HCPCS,250,RC,outpatient,,68.63,68.63,,58.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.16,22,,percent of total billed charges,,,,,,,,,61.77,90,,percent of total billed charges,,,56.83,82.8,,percent of total billed charges,,,58.34,85,,percent of total billed charges,,,,,,,,,60.39,88,,percent of total billed charges,,,,,,,,,52.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.16,22,,percent of total billed charges,,,62.45,91,,percent of total billed charges,,,65.2,95,,percent of total billed charges,,,56.96,83,,percent of total billed charges,,,56.96,83,,percent of total billed charges,,,,,,,,,,,,,,,56.96,83,,percent of total billed charges,,,65.2,95,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,56.28,82,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,58.34,85,,percent of total billed charges,,17.16,65.2,
MEPERIDINE (DEMEROL) SYR:50MG/ML,32005994,CDM,,,250,RC,outpatient,,102.93,102.93,,87.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.73,22,,percent of total billed charges,,,,,,,,,92.64,90,,percent of total billed charges,,,85.23,82.8,,percent of total billed charges,,,87.49,85,,percent of total billed charges,,,,,,,,,90.58,88,,percent of total billed charges,,,,,,,,,78.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.73,22,,percent of total billed charges,,,93.67,91,,percent of total billed charges,,,97.78,95,,percent of total billed charges,,,85.43,83,,percent of total billed charges,,,85.43,83,,percent of total billed charges,,,,,,,,,,,,,,,85.43,83,,percent of total billed charges,,,97.78,95,,percent of total billed charges,,,92.64,90,,percent of total billed charges,,,92.64,90,,percent of total billed charges,,,84.4,82,,percent of total billed charges,,,92.64,90,,percent of total billed charges,,,87.49,85,,percent of total billed charges,,25.73,97.78,
MEPERIDINE (DEMEROL) AMP:75MG/1.5ML,32005995,CDM,,,250,RC,outpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.42,22,,percent of total billed charges,,,,,,,,,59.09,90,,percent of total billed charges,,,54.37,82.8,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,,,,,,,,57.78,88,,percent of total billed charges,,,,,,,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.42,22,,percent of total billed charges,,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,16.42,62.38,
MEPERIDINE (DEMEROL) AMP:100MG/ML,32005998,CDM,J2180,HCPCS,250,RC,outpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.42,22,,percent of total billed charges,,,,,,,,,59.09,90,,percent of total billed charges,,,54.37,82.8,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,,,,,,,,57.78,88,,percent of total billed charges,,,,,,,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.42,22,,percent of total billed charges,,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,16.42,62.38,
MEPROBAMATE(EQUANIL)TAB:400MG,32006001,CDM,,,250,RC,outpatient,,24.42,24.42,,20.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.11,22,,percent of total billed charges,,,,,,,,,21.98,90,,percent of total billed charges,,,20.22,82.8,,percent of total billed charges,,,20.76,85,,percent of total billed charges,,,,,,,,,21.49,88,,percent of total billed charges,,,,,,,,,18.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.11,22,,percent of total billed charges,,,22.22,91,,percent of total billed charges,,,23.2,95,,percent of total billed charges,,,20.27,83,,percent of total billed charges,,,20.27,83,,percent of total billed charges,,,,,,,,,,,,,,,20.27,83,,percent of total billed charges,,,23.2,95,,percent of total billed charges,,,21.98,90,,percent of total billed charges,,,21.98,90,,percent of total billed charges,,,20.02,82,,percent of total billed charges,,,21.98,90,,percent of total billed charges,,,20.76,85,,percent of total billed charges,,6.11,23.2,
RUBELLA VACCINE(MERUVAX II)VIAL:0.5ML,32006016,CDM,90706,CPT,250,RC,outpatient,,306.42,306.42,,260.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.61,22,,percent of total billed charges,,,,,,,,,275.78,90,,percent of total billed charges,,,253.72,82.8,,percent of total billed charges,,,260.46,85,,percent of total billed charges,,,,,,,,,269.65,88,,percent of total billed charges,,,,,,,,,234.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.61,22,,percent of total billed charges,,,278.84,91,,percent of total billed charges,,,291.1,95,,percent of total billed charges,,,254.33,83,,percent of total billed charges,,,254.33,83,,percent of total billed charges,,,,,,,,,,,,,,,254.33,83,,percent of total billed charges,,,291.1,95,,percent of total billed charges,,,275.78,90,,percent of total billed charges,,,275.78,90,,percent of total billed charges,,,251.26,82,,percent of total billed charges,,,275.78,90,,percent of total billed charges,,,260.46,85,,percent of total billed charges,,76.61,291.1,
METAPROT(ALUPENT) SYRP: 10MG/5ML   60ML,32006021,CDM,,,250,RC,outpatient,,55.83,55.83,,47.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.96,22,,percent of total billed charges,,,,,,,,,50.25,90,,percent of total billed charges,,,46.23,82.8,,percent of total billed charges,,,47.46,85,,percent of total billed charges,,,,,,,,,49.13,88,,percent of total billed charges,,,,,,,,,42.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.96,22,,percent of total billed charges,,,50.81,91,,percent of total billed charges,,,53.04,95,,percent of total billed charges,,,46.34,83,,percent of total billed charges,,,46.34,83,,percent of total billed charges,,,,,,,,,,,,,,,46.34,83,,percent of total billed charges,,,53.04,95,,percent of total billed charges,,,50.25,90,,percent of total billed charges,,,50.25,90,,percent of total billed charges,,,45.78,82,,percent of total billed charges,,,50.25,90,,percent of total billed charges,,,47.46,85,,percent of total billed charges,,13.96,53.04,
METAPROTER (ALUPENT)SYRP:10MG/5ML   90ML,32006026,CDM,,,250,RC,outpatient,,83.74,83.74,,71.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.94,22,,percent of total billed charges,,,,,,,,,75.37,90,,percent of total billed charges,,,69.34,82.8,,percent of total billed charges,,,71.18,85,,percent of total billed charges,,,,,,,,,73.69,88,,percent of total billed charges,,,,,,,,,63.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.94,22,,percent of total billed charges,,,76.2,91,,percent of total billed charges,,,79.55,95,,percent of total billed charges,,,69.5,83,,percent of total billed charges,,,69.5,83,,percent of total billed charges,,,,,,,,,,,,,,,69.5,83,,percent of total billed charges,,,79.55,95,,percent of total billed charges,,,75.37,90,,percent of total billed charges,,,75.37,90,,percent of total billed charges,,,68.67,82,,percent of total billed charges,,,75.37,90,,percent of total billed charges,,,71.18,85,,percent of total billed charges,,20.94,79.55,
PSYLLIUM SEED(METAMUCIL)PAC U/D:,32006031,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
METAPROTEREN(ALUPENT)SYRP:10MG/5ML 480ML,32006041,CDM,,,250,RC,outpatient,,440.43,440.43,,373.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.11,22,,percent of total billed charges,,,,,,,,,396.39,90,,percent of total billed charges,,,364.68,82.8,,percent of total billed charges,,,374.37,85,,percent of total billed charges,,,,,,,,,387.58,88,,percent of total billed charges,,,,,,,,,336.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.11,22,,percent of total billed charges,,,400.79,91,,percent of total billed charges,,,418.41,95,,percent of total billed charges,,,365.56,83,,percent of total billed charges,,,365.56,83,,percent of total billed charges,,,,,,,,,,,,,,,365.56,83,,percent of total billed charges,,,418.41,95,,percent of total billed charges,,,396.39,90,,percent of total billed charges,,,396.39,90,,percent of total billed charges,,,361.15,82,,percent of total billed charges,,,396.39,90,,percent of total billed charges,,,374.37,85,,percent of total billed charges,,110.11,418.41,
METAPROTERENOL (ALUPENT) TAB : 10MG,32006046,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PSYLLIUM SEED/DEXTROSE(METAMUCIL)POW368,32006051,CDM,,,250,RC,outpatient,,113.4,113.4,,96.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.35,22,,percent of total billed charges,,,,,,,,,102.06,90,,percent of total billed charges,,,93.9,82.8,,percent of total billed charges,,,96.39,85,,percent of total billed charges,,,,,,,,,99.79,88,,percent of total billed charges,,,,,,,,,86.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.35,22,,percent of total billed charges,,,103.19,91,,percent of total billed charges,,,107.73,95,,percent of total billed charges,,,94.12,83,,percent of total billed charges,,,94.12,83,,percent of total billed charges,,,,,,,,,,,,,,,94.12,83,,percent of total billed charges,,,107.73,95,,percent of total billed charges,,,102.06,90,,percent of total billed charges,,,102.06,90,,percent of total billed charges,,,92.99,82,,percent of total billed charges,,,102.06,90,,percent of total billed charges,,,96.39,85,,percent of total billed charges,,28.35,107.73,
METHYLERGO(METHERGINE)AMP:0.2MG/ML,32006056,CDM,J2210,HCPCS,250,RC,outpatient,,328.76,328.76,,279.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,82.19,22,,percent of total billed charges,,,,,,,,,295.88,90,,percent of total billed charges,,,272.21,82.8,,percent of total billed charges,,,279.45,85,,percent of total billed charges,,,,,,,,,289.31,88,,percent of total billed charges,,20.4,,,,fee schedule,,,251.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,20.4,,,,fee schedule,,,82.19,22,,percent of total billed charges,,,299.17,91,,percent of total billed charges,,,312.32,95,,percent of total billed charges,,,272.87,83,,percent of total billed charges,,,272.87,83,,percent of total billed charges,,,,,,,,,,,,,,,272.87,83,,percent of total billed charges,,,312.32,95,,percent of total billed charges,,,295.88,90,,percent of total billed charges,,,295.88,90,,percent of total billed charges,,,269.58,82,,percent of total billed charges,,,295.88,90,,percent of total billed charges,,,279.45,85,,percent of total billed charges,,20.4,312.32,
METHYLERGONOVIN(METHERGINE)TAB:0.2MG,32006061,CDM,J8499,HCPCS,250,RC,outpatient,,464.22,464.22,,394.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.06,22,,percent of total billed charges,,,,,,,,,417.8,90,,percent of total billed charges,,,384.37,82.8,,percent of total billed charges,,,394.59,85,,percent of total billed charges,,,,,,,,,408.51,88,,percent of total billed charges,,,,,,,,,354.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.06,22,,percent of total billed charges,,,422.44,91,,percent of total billed charges,,,441.01,95,,percent of total billed charges,,,385.3,83,,percent of total billed charges,,,385.3,83,,percent of total billed charges,,,,,,,,,,,,,,,385.3,83,,percent of total billed charges,,,441.01,95,,percent of total billed charges,,,417.8,90,,percent of total billed charges,,,417.8,90,,percent of total billed charges,,,380.66,82,,percent of total billed charges,,,417.8,90,,percent of total billed charges,,,394.59,85,,percent of total billed charges,,116.06,441.01,
METHYLENE BLUE VIAL 1%:10ML,32006066,CDM,,,250,RC,outpatient,,156.54,156.54,,132.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.14,22,,percent of total billed charges,,,,,,,,,140.89,90,,percent of total billed charges,,,129.62,82.8,,percent of total billed charges,,,133.06,85,,percent of total billed charges,,,,,,,,,137.76,88,,percent of total billed charges,,,,,,,,,119.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.14,22,,percent of total billed charges,,,142.45,91,,percent of total billed charges,,,148.71,95,,percent of total billed charges,,,129.93,83,,percent of total billed charges,,,129.93,83,,percent of total billed charges,,,,,,,,,,,,,,,129.93,83,,percent of total billed charges,,,148.71,95,,percent of total billed charges,,,140.89,90,,percent of total billed charges,,,140.89,90,,percent of total billed charges,,,128.36,82,,percent of total billed charges,,,140.89,90,,percent of total billed charges,,,133.06,85,,percent of total billed charges,,39.14,148.71,
METHOCARBAMOL (ROBAXIN) :500MG,32006076,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
METHOTREXATE SODIUM TAB : 2.5MG,32006081,CDM,J8610,HCPCS,250,RC,outpatient,,42.16,42.16,,35.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.54,22,,percent of total billed charges,,,,,,,,,37.94,90,,percent of total billed charges,,,34.91,82.8,,percent of total billed charges,,,35.84,85,,percent of total billed charges,,,,,,,,,37.1,88,,percent of total billed charges,,4.84,,,,fee schedule,,,32.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,4.84,,,,fee schedule,,,10.54,22,,percent of total billed charges,,,38.37,91,,percent of total billed charges,,,40.05,95,,percent of total billed charges,,,34.99,83,,percent of total billed charges,,,34.99,83,,percent of total billed charges,,,,,,,,,,,,,,,34.99,83,,percent of total billed charges,,,40.05,95,,percent of total billed charges,,,37.94,90,,percent of total billed charges,,,37.94,90,,percent of total billed charges,,,34.57,82,,percent of total billed charges,,,37.94,90,,percent of total billed charges,,,35.84,85,,percent of total billed charges,,4.84,40.05,
METHOTREXATE:50MG/2ML  (J/5MG),32006091,CDM,J9250,HCPCS,636,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,6.29,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6.29,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,6.29,59.21,
METHYLDOPATE(ALDOMET):250MG/5ML  (J/5),32006106,CDM,J0210,HCPCS,636,RC,outpatient,,666.12,666.12,,565.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.53,22,,percent of total billed charges,,,,,,,,,599.51,90,,percent of total billed charges,,,551.55,82.8,,percent of total billed charges,,,566.2,85,,percent of total billed charges,,,,,,,,,586.19,88,,percent of total billed charges,,,,,,,,,508.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.53,22,,percent of total billed charges,,,606.17,91,,percent of total billed charges,,,632.81,95,,percent of total billed charges,,,552.88,83,,percent of total billed charges,,,552.88,83,,percent of total billed charges,,,,,,,,,,,,,,,552.88,83,,percent of total billed charges,,,632.81,95,,percent of total billed charges,,,599.51,90,,percent of total billed charges,,,599.51,90,,percent of total billed charges,,,546.22,82,,percent of total billed charges,,,599.51,90,,percent of total billed charges,,,566.2,85,,percent of total billed charges,,166.53,632.81,
METHYLDOPA (ALDOMET) TAB : 500MG,32006121,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
METHYLDOPA(ALDOMET)TAB:250MG,32006126,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
metoPROLOL(LOPRESSOR)VIAL:5MG/5ML,32006131,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
METOCLOP(REGLAN)-TAB:10MG,32006136,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
METOCLOP(REGLAN)-TAB:5MG,32006141,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
metoPROLOL TART(LOPRESSOR)TAB:50MG,32006146,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
METOCLOP(REGLAN) SOL : 5MG/5ML  500ML,32006151,CDM,,,250,RC,outpatient,,491.18,491.18,,417.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.8,22,,percent of total billed charges,,,,,,,,,442.06,90,,percent of total billed charges,,,406.7,82.8,,percent of total billed charges,,,417.5,85,,percent of total billed charges,,,,,,,,,432.24,88,,percent of total billed charges,,,,,,,,,375.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.8,22,,percent of total billed charges,,,446.97,91,,percent of total billed charges,,,466.62,95,,percent of total billed charges,,,407.68,83,,percent of total billed charges,,,407.68,83,,percent of total billed charges,,,,,,,,,,,,,,,407.68,83,,percent of total billed charges,,,466.62,95,,percent of total billed charges,,,442.06,90,,percent of total billed charges,,,442.06,90,,percent of total billed charges,,,402.77,82,,percent of total billed charges,,,442.06,90,,percent of total billed charges,,,417.5,85,,percent of total billed charges,,122.8,466.62,
METOCLOP(REGLAN)-SOL:5MG/5ML(60ML),32006156,CDM,J8499,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
METOCLOPRAMIDE(REGLAN) S0L: 5MG/5ML 90ML,32006161,CDM,,,250,RC,outpatient,,93.42,93.42,,79.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.36,22,,percent of total billed charges,,,,,,,,,84.08,90,,percent of total billed charges,,,77.35,82.8,,percent of total billed charges,,,79.41,85,,percent of total billed charges,,,,,,,,,82.21,88,,percent of total billed charges,,,,,,,,,71.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.36,22,,percent of total billed charges,,,85.01,91,,percent of total billed charges,,,88.75,95,,percent of total billed charges,,,77.54,83,,percent of total billed charges,,,77.54,83,,percent of total billed charges,,,,,,,,,,,,,,,77.54,83,,percent of total billed charges,,,88.75,95,,percent of total billed charges,,,84.08,90,,percent of total billed charges,,,84.08,90,,percent of total billed charges,,,76.6,82,,percent of total billed charges,,,84.08,90,,percent of total billed charges,,,79.41,85,,percent of total billed charges,,23.36,88.75,
METOCLOP(REGLAN)-VIAL:10MG/2ML,32006162,CDM,J2765,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,26.5,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,26.5,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
metroNIDAZOLE(FLAGYL)TAB:250MG,32006166,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
metroNID(FLAGYL)TAB:500MG,32006171,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
metroNID(METROGEL)GEL(TOP)0.75%:28.4GM,32006176,CDM,,,250,RC,outpatient,,522.9,522.9,,443.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.73,22,,percent of total billed charges,,,,,,,,,470.61,90,,percent of total billed charges,,,432.96,82.8,,percent of total billed charges,,,444.47,85,,percent of total billed charges,,,,,,,,,460.15,88,,percent of total billed charges,,,,,,,,,399.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.73,22,,percent of total billed charges,,,475.84,91,,percent of total billed charges,,,496.76,95,,percent of total billed charges,,,434.01,83,,percent of total billed charges,,,434.01,83,,percent of total billed charges,,,,,,,,,,,,,,,434.01,83,,percent of total billed charges,,,496.76,95,,percent of total billed charges,,,470.61,90,,percent of total billed charges,,,470.61,90,,percent of total billed charges,,,428.78,82,,percent of total billed charges,,,470.61,90,,percent of total billed charges,,,444.47,85,,percent of total billed charges,,130.73,496.76,
metroNIDAZOLE VAG GEL 0.75%:70GM,32006177,CDM,J3490,HCPCS,250,RC,outpatient,,796.86,796.86,,676.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,199.22,22,,percent of total billed charges,,,,,,,,,717.17,90,,percent of total billed charges,,,659.8,82.8,,percent of total billed charges,,,677.33,85,,percent of total billed charges,,,,,,,,,701.24,88,,percent of total billed charges,,,,,,,,,608.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,199.22,22,,percent of total billed charges,,,725.14,91,,percent of total billed charges,,,757.02,95,,percent of total billed charges,,,661.39,83,,percent of total billed charges,,,661.39,83,,percent of total billed charges,,,,,,,,,,,,,,,661.39,83,,percent of total billed charges,,,757.02,95,,percent of total billed charges,,,717.17,90,,percent of total billed charges,,,717.17,90,,percent of total billed charges,,,653.43,82,,percent of total billed charges,,,717.17,90,,percent of total billed charges,,,677.33,85,,percent of total billed charges,,199.22,757.02,
metroNID(METROGEL)GEL 0.75%:45GM,32006178,CDM,,,250,RC,outpatient,,1928.77,1928.77,,1637.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,482.19,22,,percent of total billed charges,,,,,,,,,1735.89,90,,percent of total billed charges,,,1597.02,82.8,,percent of total billed charges,,,1639.45,85,,percent of total billed charges,,,,,,,,,1697.32,88,,percent of total billed charges,,,,,,,,,1473.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,482.19,22,,percent of total billed charges,,,1755.18,91,,percent of total billed charges,,,1832.33,95,,percent of total billed charges,,,1600.88,83,,percent of total billed charges,,,1600.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1600.88,83,,percent of total billed charges,,,1832.33,95,,percent of total billed charges,,,1735.89,90,,percent of total billed charges,,,1735.89,90,,percent of total billed charges,,,1581.59,82,,percent of total billed charges,,,1735.89,90,,percent of total billed charges,,,1639.45,85,,percent of total billed charges,,482.19,1832.33,
LOVASTATIN (MEVACOR) TAB : 20MG,32006181,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CALCITONIN(FORTICAL)NASAL:200UNITS,32006281,CDM,J3490,HCPCS,250,RC,outpatient,,255.07,255.07,,216.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.77,22,,percent of total billed charges,,,,,,,,,229.56,90,,percent of total billed charges,,,211.2,82.8,,percent of total billed charges,,,216.81,85,,percent of total billed charges,,,,,,,,,224.46,88,,percent of total billed charges,,,,,,,,,194.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.77,22,,percent of total billed charges,,,232.11,91,,percent of total billed charges,,,242.32,95,,percent of total billed charges,,,211.71,83,,percent of total billed charges,,,211.71,83,,percent of total billed charges,,,,,,,,,,,,,,,211.71,83,,percent of total billed charges,,,242.32,95,,percent of total billed charges,,,229.56,90,,percent of total billed charges,,,229.56,90,,percent of total billed charges,,,209.16,82,,percent of total billed charges,,,229.56,90,,percent of total billed charges,,,216.81,85,,percent of total billed charges,,63.77,242.32,
MICONAZOLE(MICATIN)CREAM 2%:30GM,32006286,CDM,,,250,RC,outpatient,,23.63,23.63,,20.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.91,22,,percent of total billed charges,,,,,,,,,21.27,90,,percent of total billed charges,,,19.57,82.8,,percent of total billed charges,,,20.09,85,,percent of total billed charges,,,,,,,,,20.79,88,,percent of total billed charges,,,,,,,,,18.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.91,22,,percent of total billed charges,,,21.5,91,,percent of total billed charges,,,22.45,95,,percent of total billed charges,,,19.61,83,,percent of total billed charges,,,19.61,83,,percent of total billed charges,,,,,,,,,,,,,,,19.61,83,,percent of total billed charges,,,22.45,95,,percent of total billed charges,,,21.27,90,,percent of total billed charges,,,21.27,90,,percent of total billed charges,,,19.38,82,,percent of total billed charges,,,21.27,90,,percent of total billed charges,,,20.09,85,,percent of total billed charges,,5.91,22.45,
MICONAZOLE (MICATIN) CREAM :2%   45GM,32006291,CDM,,,250,RC,outpatient,,133.22,133.22,,113.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.31,22,,percent of total billed charges,,,,,,,,,119.9,90,,percent of total billed charges,,,110.31,82.8,,percent of total billed charges,,,113.24,85,,percent of total billed charges,,,,,,,,,117.23,88,,percent of total billed charges,,,,,,,,,101.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.31,22,,percent of total billed charges,,,121.23,91,,percent of total billed charges,,,126.56,95,,percent of total billed charges,,,110.57,83,,percent of total billed charges,,,110.57,83,,percent of total billed charges,,,,,,,,,,,,,,,110.57,83,,percent of total billed charges,,,126.56,95,,percent of total billed charges,,,119.9,90,,percent of total billed charges,,,119.9,90,,percent of total billed charges,,,109.24,82,,percent of total billed charges,,,119.9,90,,percent of total billed charges,,,113.24,85,,percent of total billed charges,,33.31,126.56,
MIDAZOLAM(VERSED)VIAL:10MG/10ML,32006297,CDM,J2250,HCPCS,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,7.08,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.08,,,,fee schedule,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,7.08,64.15,
POTASSIUM CHLORIDE(MICRO K)CAP ER:10MEQ,32006301,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LACTASE/RENNET(MILK DIGESTANT)TAB:25-2MG,32006312,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
MINERAL OIL:60ML,32006326,CDM,J3490,HCPCS,250,RC,outpatient,,30.77,30.77,,26.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.69,22,,percent of total billed charges,,,,,,,,,27.69,90,,percent of total billed charges,,,25.48,82.8,,percent of total billed charges,,,26.15,85,,percent of total billed charges,,,,,,,,,27.08,88,,percent of total billed charges,,,,,,,,,23.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.69,22,,percent of total billed charges,,,28,91,,percent of total billed charges,,,29.23,95,,percent of total billed charges,,,25.54,83,,percent of total billed charges,,,25.54,83,,percent of total billed charges,,,,,,,,,,,,,,,25.54,83,,percent of total billed charges,,,29.23,95,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,25.23,82,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,26.15,85,,percent of total billed charges,,7.69,29.23,
MINERAL OIL(MURI-LUBE) VIAL STERILE 10ML,32006331,CDM,J3490,HCPCS,250,RC,outpatient,,253.6,253.6,,215.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.4,22,,percent of total billed charges,,,,,,,,,228.24,90,,percent of total billed charges,,,209.98,82.8,,percent of total billed charges,,,215.56,85,,percent of total billed charges,,,,,,,,,223.17,88,,percent of total billed charges,,,,,,,,,193.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.4,22,,percent of total billed charges,,,230.78,91,,percent of total billed charges,,,240.92,95,,percent of total billed charges,,,210.49,83,,percent of total billed charges,,,210.49,83,,percent of total billed charges,,,,,,,,,,,,,,,210.49,83,,percent of total billed charges,,,240.92,95,,percent of total billed charges,,,228.24,90,,percent of total billed charges,,,228.24,90,,percent of total billed charges,,,207.95,82,,percent of total billed charges,,,228.24,90,,percent of total billed charges,,,215.56,85,,percent of total billed charges,,63.4,240.92,
MINTRAN PATCH 0.1MG/HR,32006332,CDM,,,250,RC,outpatient,,5.5,5.5,,4.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.38,22,,percent of total billed charges,,,,,,,,,4.95,90,,percent of total billed charges,,,4.55,82.8,,percent of total billed charges,,,4.68,85,,percent of total billed charges,,,,,,,,,4.84,88,,percent of total billed charges,,,,,,,,,4.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.38,22,,percent of total billed charges,,,5.01,91,,percent of total billed charges,,,5.23,95,,percent of total billed charges,,,4.57,83,,percent of total billed charges,,,4.57,83,,percent of total billed charges,,,,,,,,,,,,,,,4.57,83,,percent of total billed charges,,,5.23,95,,percent of total billed charges,,,4.95,90,,percent of total billed charges,,,4.95,90,,percent of total billed charges,,,4.51,82,,percent of total billed charges,,,4.95,90,,percent of total billed charges,,,4.68,85,,percent of total billed charges,,1.38,5.23,
MINOCYCLINE (MINOCIN) CAP : 100MG,32006336,CDM,J8499,HCPCS,250,RC,outpatient,,15.52,15.52,,13.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.88,22,,percent of total billed charges,,,,,,,,,13.97,90,,percent of total billed charges,,,12.85,82.8,,percent of total billed charges,,,13.19,85,,percent of total billed charges,,,,,,,,,13.66,88,,percent of total billed charges,,,,,,,,,11.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.88,22,,percent of total billed charges,,,14.12,91,,percent of total billed charges,,,14.74,95,,percent of total billed charges,,,12.88,83,,percent of total billed charges,,,12.88,83,,percent of total billed charges,,,,,,,,,,,,,,,12.88,83,,percent of total billed charges,,,14.74,95,,percent of total billed charges,,,13.97,90,,percent of total billed charges,,,13.97,90,,percent of total billed charges,,,12.73,82,,percent of total billed charges,,,13.97,90,,percent of total billed charges,,,13.19,85,,percent of total billed charges,,3.88,14.74,
MINOCYCLINE (MINOCIN) HCL CAP : 50MG,32006341,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ACETYLCHOLINE(MIOCHOL-E)KIT 1%:,32006351,CDM,J3490,HCPCS,250,RC,outpatient,,1638.79,1638.79,,1391.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,409.7,22,,percent of total billed charges,,,,,,,,,1474.91,90,,percent of total billed charges,,,1356.92,82.8,,percent of total billed charges,,,1392.97,85,,percent of total billed charges,,,,,,,,,1442.14,88,,percent of total billed charges,,,,,,,,,1252.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,409.7,22,,percent of total billed charges,,,1491.3,91,,percent of total billed charges,,,1556.85,95,,percent of total billed charges,,,1360.2,83,,percent of total billed charges,,,1360.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1360.2,83,,percent of total billed charges,,,1556.85,95,,percent of total billed charges,,,1474.91,90,,percent of total billed charges,,,1474.91,90,,percent of total billed charges,,,1343.81,82,,percent of total billed charges,,,1474.91,90,,percent of total billed charges,,,1392.97,85,,percent of total billed charges,,409.7,1556.85,
PRAMIPEXOLE DI-HCL (MIRAPEX) TAB : 0.5MG,32006352,CDM,,,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
MIVACURIUM (MIVACRON)VIAL:2MG/ML (10ML),32006411,CDM,,,250,RC,outpatient,,429.49,429.49,,364.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.37,22,,percent of total billed charges,,,,,,,,,386.54,90,,percent of total billed charges,,,355.62,82.8,,percent of total billed charges,,,365.07,85,,percent of total billed charges,,,,,,,,,377.95,88,,percent of total billed charges,,,,,,,,,328.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.37,22,,percent of total billed charges,,,390.84,91,,percent of total billed charges,,,408.02,95,,percent of total billed charges,,,356.48,83,,percent of total billed charges,,,356.48,83,,percent of total billed charges,,,,,,,,,,,,,,,356.48,83,,percent of total billed charges,,,408.02,95,,percent of total billed charges,,,386.54,90,,percent of total billed charges,,,386.54,90,,percent of total billed charges,,,352.18,82,,percent of total billed charges,,,386.54,90,,percent of total billed charges,,,365.07,85,,percent of total billed charges,,107.37,408.02,
MEASLES MUMPS&RUBELLA (MMR-II) VACCINE:,32006416,CDM,90707,CPT,250,RC,outpatient,,1250.17,1250.17,,1061.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,312.54,22,,percent of total billed charges,,,,,,,,,1125.15,90,,percent of total billed charges,,,1035.14,82.8,,percent of total billed charges,,,1062.64,85,,percent of total billed charges,,,,,,,,,1100.15,88,,percent of total billed charges,,,,,,,,,955.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,312.54,22,,percent of total billed charges,,,1137.65,91,,percent of total billed charges,,,1187.66,95,,percent of total billed charges,,,1037.64,83,,percent of total billed charges,,,1037.64,83,,percent of total billed charges,,,,,,,,,,,,,,,1037.64,83,,percent of total billed charges,,,1187.66,95,,percent of total billed charges,,,1125.15,90,,percent of total billed charges,,,1125.15,90,,percent of total billed charges,,,1025.14,82,,percent of total billed charges,,,1125.15,90,,percent of total billed charges,,,1062.64,85,,percent of total billed charges,,312.54,1187.66,
PHILLIPS CHEWABLE TABS,32006425,CDM,,,250,RC,outpatient,,16,16,,13.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4,22,,percent of total billed charges,,,,,,,,,14.4,90,,percent of total billed charges,,,13.25,82.8,,percent of total billed charges,,,13.6,85,,percent of total billed charges,,,,,,,,,14.08,88,,percent of total billed charges,,,,,,,,,12.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4,22,,percent of total billed charges,,,14.56,91,,percent of total billed charges,,,15.2,95,,percent of total billed charges,,,13.28,83,,percent of total billed charges,,,13.28,83,,percent of total billed charges,,,,,,,,,,,,,,,13.28,83,,percent of total billed charges,,,15.2,95,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,13.12,82,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,13.6,85,,percent of total billed charges,,4,15.2,
MILK MAG(CONC)ORAL U/D:2400MG/10ML,32006426,CDM,J8499,HCPCS,250,RC,outpatient,,42.16,42.16,,35.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.54,22,,percent of total billed charges,,,,,,,,,37.94,90,,percent of total billed charges,,,34.91,82.8,,percent of total billed charges,,,35.84,85,,percent of total billed charges,,,,,,,,,37.1,88,,percent of total billed charges,,,,,,,,,32.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.54,22,,percent of total billed charges,,,38.37,91,,percent of total billed charges,,,40.05,95,,percent of total billed charges,,,34.99,83,,percent of total billed charges,,,34.99,83,,percent of total billed charges,,,,,,,,,,,,,,,34.99,83,,percent of total billed charges,,,40.05,95,,percent of total billed charges,,,37.94,90,,percent of total billed charges,,,37.94,90,,percent of total billed charges,,,34.57,82,,percent of total billed charges,,,37.94,90,,percent of total billed charges,,,35.84,85,,percent of total billed charges,,10.54,40.05,
CLOTRIMAZOLE(MYCELEX)TROCHE:10MG,32006427,CDM,J8499,HCPCS,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
MAGNE HYDRX(MLK MAG)ORAL:800MG/5ML 400ML,32006436,CDM,,,250,RC,outpatient,,120.54,120.54,,102.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.14,22,,percent of total billed charges,,,,,,,,,108.49,90,,percent of total billed charges,,,99.81,82.8,,percent of total billed charges,,,102.46,85,,percent of total billed charges,,,,,,,,,106.08,88,,percent of total billed charges,,,,,,,,,92.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.14,22,,percent of total billed charges,,,109.69,91,,percent of total billed charges,,,114.51,95,,percent of total billed charges,,,100.05,83,,percent of total billed charges,,,100.05,83,,percent of total billed charges,,,,,,,,,,,,,,,100.05,83,,percent of total billed charges,,,114.51,95,,percent of total billed charges,,,108.49,90,,percent of total billed charges,,,108.49,90,,percent of total billed charges,,,98.84,82,,percent of total billed charges,,,108.49,90,,percent of total billed charges,,,102.46,85,,percent of total billed charges,,30.14,114.51,
POLYETHYLENE GLYC(MIRALAX)POW:100% 255GM,32006442,CDM,,,250,RC,outpatient,,240.6,240.6,,204.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60.15,22,,percent of total billed charges,,,,,,,,,216.54,90,,percent of total billed charges,,,199.22,82.8,,percent of total billed charges,,,204.51,85,,percent of total billed charges,,,,,,,,,211.73,88,,percent of total billed charges,,,,,,,,,183.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60.15,22,,percent of total billed charges,,,218.95,91,,percent of total billed charges,,,228.57,95,,percent of total billed charges,,,199.7,83,,percent of total billed charges,,,199.7,83,,percent of total billed charges,,,,,,,,,,,,,,,199.7,83,,percent of total billed charges,,,228.57,95,,percent of total billed charges,,,216.54,90,,percent of total billed charges,,,216.54,90,,percent of total billed charges,,,197.29,82,,percent of total billed charges,,,216.54,90,,percent of total billed charges,,,204.51,85,,percent of total billed charges,,60.15,228.57,
MICONAZOLE(MONISTAT-3)CREAM 4%:25GM,32006447,CDM,,,250,RC,outpatient,,183.66,183.66,,155.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.92,22,,percent of total billed charges,,,,,,,,,165.29,90,,percent of total billed charges,,,152.07,82.8,,percent of total billed charges,,,156.11,85,,percent of total billed charges,,,,,,,,,161.62,88,,percent of total billed charges,,,,,,,,,140.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.92,22,,percent of total billed charges,,,167.13,91,,percent of total billed charges,,,174.48,95,,percent of total billed charges,,,152.44,83,,percent of total billed charges,,,152.44,83,,percent of total billed charges,,,,,,,,,,,,,,,152.44,83,,percent of total billed charges,,,174.48,95,,percent of total billed charges,,,165.29,90,,percent of total billed charges,,,165.29,90,,percent of total billed charges,,,150.6,82,,percent of total billed charges,,,165.29,90,,percent of total billed charges,,,156.11,85,,percent of total billed charges,,45.92,174.48,
MICONAZOLE(MONISTAT-3)VAG SUPP:3'S,32006448,CDM,,,250,RC,outpatient,,576.99,576.99,,489.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,144.25,22,,percent of total billed charges,,,,,,,,,519.29,90,,percent of total billed charges,,,477.75,82.8,,percent of total billed charges,,,490.44,85,,percent of total billed charges,,,,,,,,,507.75,88,,percent of total billed charges,,,,,,,,,440.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,144.25,22,,percent of total billed charges,,,525.06,91,,percent of total billed charges,,,548.14,95,,percent of total billed charges,,,478.9,83,,percent of total billed charges,,,478.9,83,,percent of total billed charges,,,,,,,,,,,,,,,478.9,83,,percent of total billed charges,,,548.14,95,,percent of total billed charges,,,519.29,90,,percent of total billed charges,,,519.29,90,,percent of total billed charges,,,473.13,82,,percent of total billed charges,,,519.29,90,,percent of total billed charges,,,490.44,85,,percent of total billed charges,,144.25,548.14,
FOSINOPRIL(MONOPRIL)TAB:10MG,32006451,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
FOSINOPRIL (MONOPRIL) TAB : 20MG,32006452,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
FOSFOMYCIN(MONUROL)PAC:3GM,32006453,CDM,J8499,HCPCS,250,RC,outpatient,,1306.5,1306.5,,1109.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,326.63,22,,percent of total billed charges,,,,,,,,,1175.85,90,,percent of total billed charges,,,1081.78,82.8,,percent of total billed charges,,,1110.53,85,,percent of total billed charges,,,,,,,,,1149.72,88,,percent of total billed charges,,,,,,,,,998.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,326.63,22,,percent of total billed charges,,,1188.92,91,,percent of total billed charges,,,1241.18,95,,percent of total billed charges,,,1084.4,83,,percent of total billed charges,,,1084.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1084.4,83,,percent of total billed charges,,,1241.18,95,,percent of total billed charges,,,1175.85,90,,percent of total billed charges,,,1175.85,90,,percent of total billed charges,,,1071.33,82,,percent of total billed charges,,,1175.85,90,,percent of total billed charges,,,1110.53,85,,percent of total billed charges,,326.63,1241.18,
MORPHINE SULF(ORAL)SOL:20MG/5ML (60ML),32006466,CDM,,,250,RC,outpatient,,66.29,66.29,,56.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.57,22,,percent of total billed charges,,,,,,,,,59.66,90,,percent of total billed charges,,,54.89,82.8,,percent of total billed charges,,,56.35,85,,percent of total billed charges,,,,,,,,,58.34,88,,percent of total billed charges,,,,,,,,,50.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.57,22,,percent of total billed charges,,,60.32,91,,percent of total billed charges,,,62.98,95,,percent of total billed charges,,,55.02,83,,percent of total billed charges,,,55.02,83,,percent of total billed charges,,,,,,,,,,,,,,,55.02,83,,percent of total billed charges,,,62.98,95,,percent of total billed charges,,,59.66,90,,percent of total billed charges,,,59.66,90,,percent of total billed charges,,,54.36,82,,percent of total billed charges,,,59.66,90,,percent of total billed charges,,,56.35,85,,percent of total billed charges,,16.57,62.98,
MORPHINE SULF CPJ SYR:10MG/ML,32006471,CDM,J2270,HCPCS,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,5.94,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.94,,,,fee schedule,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,5.94,64.15,
MORPHINE SULF VIAL:10MG/ML,32006476,CDM,,,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,,,,,,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,16.88,64.15,
MORPHINE SULFATE TAB : 10MG,32006481,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
MORPHINE SULF TAB IR:30MG,32006482,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
MORPHINE SULF(ORAMORPH)ER TAB:30MG,32006483,CDM,,,250,RC,outpatient,,21.25,21.25,,18.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.31,22,,percent of total billed charges,,,,,,,,,19.13,90,,percent of total billed charges,,,17.6,82.8,,percent of total billed charges,,,18.06,85,,percent of total billed charges,,,,,,,,,18.7,88,,percent of total billed charges,,,,,,,,,16.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.31,22,,percent of total billed charges,,,19.34,91,,percent of total billed charges,,,20.19,95,,percent of total billed charges,,,17.64,83,,percent of total billed charges,,,17.64,83,,percent of total billed charges,,,,,,,,,,,,,,,17.64,83,,percent of total billed charges,,,20.19,95,,percent of total billed charges,,,19.13,90,,percent of total billed charges,,,19.13,90,,percent of total billed charges,,,17.43,82,,percent of total billed charges,,,19.13,90,,percent of total billed charges,,,18.06,85,,percent of total billed charges,,5.31,20.19,
MORPHINE SULF(ORAMORPH)ER TAB:60MG,32006484,CDM,,,250,RC,outpatient,,61.06,61.06,,51.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.27,22,,percent of total billed charges,,,,,,,,,54.95,90,,percent of total billed charges,,,50.56,82.8,,percent of total billed charges,,,51.9,85,,percent of total billed charges,,,,,,,,,53.73,88,,percent of total billed charges,,,,,,,,,46.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.27,22,,percent of total billed charges,,,55.56,91,,percent of total billed charges,,,58.01,95,,percent of total billed charges,,,50.68,83,,percent of total billed charges,,,50.68,83,,percent of total billed charges,,,,,,,,,,,,,,,50.68,83,,percent of total billed charges,,,58.01,95,,percent of total billed charges,,,54.95,90,,percent of total billed charges,,,54.95,90,,percent of total billed charges,,,50.07,82,,percent of total billed charges,,,54.95,90,,percent of total billed charges,,,51.9,85,,percent of total billed charges,,15.27,58.01,
IBUPROFEN (MOTRIN) TAB:800MG,32006496,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
IBUPROFEN(MOTRIN)ORAL : 100MG/5ML 5ML,32006501,CDM,,,250,RC,outpatient,,2.5,2.5,,2.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.63,22,,percent of total billed charges,,,,,,,,,2.25,90,,percent of total billed charges,,,2.07,82.8,,percent of total billed charges,,,2.13,85,,percent of total billed charges,,,,,,,,,2.2,88,,percent of total billed charges,,,,,,,,,1.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.63,22,,percent of total billed charges,,,2.28,91,,percent of total billed charges,,,2.38,95,,percent of total billed charges,,,2.08,83,,percent of total billed charges,,,2.08,83,,percent of total billed charges,,,,,,,,,,,,,,,2.08,83,,percent of total billed charges,,,2.38,95,,percent of total billed charges,,,2.25,90,,percent of total billed charges,,,2.25,90,,percent of total billed charges,,,2.05,82,,percent of total billed charges,,,2.25,90,,percent of total billed charges,,,2.13,85,,percent of total billed charges,,0.63,2.38,
MOTRIN SUSPENSION 473ML,32006502,CDM,,,250,RC,outpatient,,74,74,,62.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.5,22,,percent of total billed charges,,,,,,,,,66.6,90,,percent of total billed charges,,,61.27,82.8,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,,,,,,,,65.12,88,,percent of total billed charges,,,,,,,,,56.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.5,22,,percent of total billed charges,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,,,,,,,,,,,,,61.42,83,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,60.68,82,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,18.5,70.3,
IBUPROFEN (MOTRIN) TAB:400MG,32006506,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
IBUPROFEN (MOTRIN) TAB : 400MG  1X8,32006507,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
IBUPROFEN (MOTRIN) TAB : 600MG  1X8,32006508,CDM,,,250,RC,outpatient,,23.31,23.31,,19.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.83,22,,percent of total billed charges,,,,,,,,,20.98,90,,percent of total billed charges,,,19.3,82.8,,percent of total billed charges,,,19.81,85,,percent of total billed charges,,,,,,,,,20.51,88,,percent of total billed charges,,,,,,,,,17.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.83,22,,percent of total billed charges,,,21.21,91,,percent of total billed charges,,,22.14,95,,percent of total billed charges,,,19.35,83,,percent of total billed charges,,,19.35,83,,percent of total billed charges,,,,,,,,,,,,,,,19.35,83,,percent of total billed charges,,,22.14,95,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,19.11,82,,percent of total billed charges,,,20.98,90,,percent of total billed charges,,,19.81,85,,percent of total billed charges,,5.83,22.14,
IBUPROFEN (MOTRIN) TAB : 800MG  1X8,32006509,CDM,,,250,RC,outpatient,,19.35,19.35,,16.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.84,22,,percent of total billed charges,,,,,,,,,17.42,90,,percent of total billed charges,,,16.02,82.8,,percent of total billed charges,,,16.45,85,,percent of total billed charges,,,,,,,,,17.03,88,,percent of total billed charges,,,,,,,,,14.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.84,22,,percent of total billed charges,,,17.61,91,,percent of total billed charges,,,18.38,95,,percent of total billed charges,,,16.06,83,,percent of total billed charges,,,16.06,83,,percent of total billed charges,,,,,,,,,,,,,,,16.06,83,,percent of total billed charges,,,18.38,95,,percent of total billed charges,,,17.42,90,,percent of total billed charges,,,17.42,90,,percent of total billed charges,,,15.87,82,,percent of total billed charges,,,17.42,90,,percent of total billed charges,,,16.45,85,,percent of total billed charges,,4.84,18.38,
IBUPROFEN (MOTRIN) TAB:600MG,32006511,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
MORPHINE SULF(ORAMORPH)ER TAB:15MG,32006521,CDM,,,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
ZN/CU/PHYD/MANG(MULTITRACE-4)VIAL:10ML,32006526,CDM,,,250,RC,outpatient,,410.14,410.14,,348.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,102.54,22,,percent of total billed charges,,,,,,,,,369.13,90,,percent of total billed charges,,,339.6,82.8,,percent of total billed charges,,,348.62,85,,percent of total billed charges,,,,,,,,,360.92,88,,percent of total billed charges,,,,,,,,,313.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,102.54,22,,percent of total billed charges,,,373.23,91,,percent of total billed charges,,,389.63,95,,percent of total billed charges,,,340.42,83,,percent of total billed charges,,,340.42,83,,percent of total billed charges,,,,,,,,,,,,,,,340.42,83,,percent of total billed charges,,,389.63,95,,percent of total billed charges,,,369.13,90,,percent of total billed charges,,,369.13,90,,percent of total billed charges,,,336.31,82,,percent of total billed charges,,,369.13,90,,percent of total billed charges,,,348.62,85,,percent of total billed charges,,102.54,389.63,
ACETYL(MUCOMYST)VIAL 20%:200MG/ML(30ML),32006531,CDM,J7608,HCPCS,250,RC,outpatient,,436.11,436.11,,370.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.03,22,,percent of total billed charges,,,,,,,,,392.5,90,,percent of total billed charges,,,361.1,82.8,,percent of total billed charges,,,370.69,85,,percent of total billed charges,,,,,,,,,383.78,88,,percent of total billed charges,,14.79,,,,fee schedule,,,333.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.79,,,,fee schedule,,,109.03,22,,percent of total billed charges,,,396.86,91,,percent of total billed charges,,,414.3,95,,percent of total billed charges,,,361.97,83,,percent of total billed charges,,,361.97,83,,percent of total billed charges,,,,,,,,,,,,,,,361.97,83,,percent of total billed charges,,,414.3,95,,percent of total billed charges,,,392.5,90,,percent of total billed charges,,,392.5,90,,percent of total billed charges,,,357.61,82,,percent of total billed charges,,,392.5,90,,percent of total billed charges,,,370.69,85,,percent of total billed charges,,14.79,414.3,
ACETYL(MUCOMYST)VIAL 20%:200MG/ML(4ML),32006536,CDM,J7608,HCPCS,250,RC,outpatient,,86.77,86.77,,73.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.69,22,,percent of total billed charges,,,,,,,,,78.09,90,,percent of total billed charges,,,71.85,82.8,,percent of total billed charges,,,73.75,85,,percent of total billed charges,,,,,,,,,76.36,88,,percent of total billed charges,,14.79,,,,fee schedule,,,66.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.79,,,,fee schedule,,,21.69,22,,percent of total billed charges,,,78.96,91,,percent of total billed charges,,,82.43,95,,percent of total billed charges,,,72.02,83,,percent of total billed charges,,,72.02,83,,percent of total billed charges,,,,,,,,,,,,,,,72.02,83,,percent of total billed charges,,,82.43,95,,percent of total billed charges,,,78.09,90,,percent of total billed charges,,,78.09,90,,percent of total billed charges,,,71.15,82,,percent of total billed charges,,,78.09,90,,percent of total billed charges,,,73.75,85,,percent of total billed charges,,14.79,82.43,
ACETYL(MUCOMYST)VIAL:100MG/ML 10% 4ML,32006541,CDM,,,250,RC,outpatient,,86.44,86.44,,73.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.61,22,,percent of total billed charges,,,,,,,,,77.8,90,,percent of total billed charges,,,71.57,82.8,,percent of total billed charges,,,73.47,85,,percent of total billed charges,,,,,,,,,76.07,88,,percent of total billed charges,,,,,,,,,66.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.61,22,,percent of total billed charges,,,78.66,91,,percent of total billed charges,,,82.12,95,,percent of total billed charges,,,71.75,83,,percent of total billed charges,,,71.75,83,,percent of total billed charges,,,,,,,,,,,,,,,71.75,83,,percent of total billed charges,,,82.12,95,,percent of total billed charges,,,77.8,90,,percent of total billed charges,,,77.8,90,,percent of total billed charges,,,70.88,82,,percent of total billed charges,,,77.8,90,,percent of total billed charges,,,73.47,85,,percent of total billed charges,,21.61,82.12,
MULTIDEX POWDER BOX (5X25GM PKTS),32006542,CDM,,,250,RC,outpatient,,75.5,75.5,,64.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.88,22,,percent of total billed charges,,,,,,,,,67.95,90,,percent of total billed charges,,,62.51,82.8,,percent of total billed charges,,,64.18,85,,percent of total billed charges,,,,,,,,,66.44,88,,percent of total billed charges,,,,,,,,,57.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.88,22,,percent of total billed charges,,,68.71,91,,percent of total billed charges,,,71.73,95,,percent of total billed charges,,,62.67,83,,percent of total billed charges,,,62.67,83,,percent of total billed charges,,,,,,,,,,,,,,,62.67,83,,percent of total billed charges,,,71.73,95,,percent of total billed charges,,,67.95,90,,percent of total billed charges,,,67.95,90,,percent of total billed charges,,,61.91,82,,percent of total billed charges,,,67.95,90,,percent of total billed charges,,,64.18,85,,percent of total billed charges,,18.88,71.73,
ZINC SULF/CUSO4 P-HYD/MANG/CR VIAL : PED,32006546,CDM,,,250,RC,outpatient,,170.02,170.02,,144.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.51,22,,percent of total billed charges,,,,,,,,,153.02,90,,percent of total billed charges,,,140.78,82.8,,percent of total billed charges,,,144.52,85,,percent of total billed charges,,,,,,,,,149.62,88,,percent of total billed charges,,,,,,,,,129.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.51,22,,percent of total billed charges,,,154.72,91,,percent of total billed charges,,,161.52,95,,percent of total billed charges,,,141.12,83,,percent of total billed charges,,,141.12,83,,percent of total billed charges,,,,,,,,,,,,,,,141.12,83,,percent of total billed charges,,,161.52,95,,percent of total billed charges,,,153.02,90,,percent of total billed charges,,,153.02,90,,percent of total billed charges,,,139.42,82,,percent of total billed charges,,,153.02,90,,percent of total billed charges,,,144.52,85,,percent of total billed charges,,42.51,161.52,
MUMPS VACCINE LIVE VIAL,32006556,CDM,90704,CPT,636,RC,outpatient,,357.96,357.96,,303.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.49,22,,percent of total billed charges,,,,,,,,,322.16,90,,percent of total billed charges,,,296.39,82.8,,percent of total billed charges,,,304.27,85,,percent of total billed charges,,,,,,,,,315,88,,percent of total billed charges,,,,,,,,,273.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.49,22,,percent of total billed charges,,,325.74,91,,percent of total billed charges,,,340.06,95,,percent of total billed charges,,,297.11,83,,percent of total billed charges,,,297.11,83,,percent of total billed charges,,,,,,,,,,,,,,,297.11,83,,percent of total billed charges,,,340.06,95,,percent of total billed charges,,,322.16,90,,percent of total billed charges,,,322.16,90,,percent of total billed charges,,,293.53,82,,percent of total billed charges,,,322.16,90,,percent of total billed charges,,,304.27,85,,percent of total billed charges,,89.49,340.06,
MURINE TEARS 15ML,32006557,CDM,,,250,RC,outpatient,,15,15,,12.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.75,22,,percent of total billed charges,,,,,,,,,13.5,90,,percent of total billed charges,,,12.42,82.8,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,,,,,,,,13.2,88,,percent of total billed charges,,,,,,,,,11.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.75,22,,percent of total billed charges,,,13.65,91,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,,,,,,,,,,,,,12.45,83,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.3,82,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,3.75,14.25,
VENLAFAXINE HCL (EFFEXOR) TAB : 100MG,32006565,CDM,,,250,RC,outpatient,,29.02,29.02,,24.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.26,22,,percent of total billed charges,,,,,,,,,26.12,90,,percent of total billed charges,,,24.03,82.8,,percent of total billed charges,,,24.67,85,,percent of total billed charges,,,,,,,,,25.54,88,,percent of total billed charges,,,,,,,,,22.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.26,22,,percent of total billed charges,,,26.41,91,,percent of total billed charges,,,27.57,95,,percent of total billed charges,,,24.09,83,,percent of total billed charges,,,24.09,83,,percent of total billed charges,,,,,,,,,,,,,,,24.09,83,,percent of total billed charges,,,27.57,95,,percent of total billed charges,,,26.12,90,,percent of total billed charges,,,26.12,90,,percent of total billed charges,,,23.8,82,,percent of total billed charges,,,26.12,90,,percent of total billed charges,,,24.67,85,,percent of total billed charges,,7.26,27.57,
MVI(ADULT) W/VIT K VIAL:10ML,32006566,CDM,J3490,HCPCS,250,RC,outpatient,,186.28,186.28,,158.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.57,22,,percent of total billed charges,,,,,,,,,167.65,90,,percent of total billed charges,,,154.24,82.8,,percent of total billed charges,,,158.34,85,,percent of total billed charges,,,,,,,,,163.93,88,,percent of total billed charges,,,,,,,,,142.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.57,22,,percent of total billed charges,,,169.51,91,,percent of total billed charges,,,176.97,95,,percent of total billed charges,,,154.61,83,,percent of total billed charges,,,154.61,83,,percent of total billed charges,,,,,,,,,,,,,,,154.61,83,,percent of total billed charges,,,176.97,95,,percent of total billed charges,,,167.65,90,,percent of total billed charges,,,167.65,90,,percent of total billed charges,,,152.75,82,,percent of total billed charges,,,167.65,90,,percent of total billed charges,,,158.34,85,,percent of total billed charges,,46.57,176.97,
CLOTRIMAZOLE (LOTRIMIN) SOL : 1%  10 ML,32006571,CDM,,,250,RC,outpatient,,601.09,601.09,,510.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.27,22,,percent of total billed charges,,,,,,,,,540.98,90,,percent of total billed charges,,,497.7,82.8,,percent of total billed charges,,,510.93,85,,percent of total billed charges,,,,,,,,,528.96,88,,percent of total billed charges,,,,,,,,,459.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.27,22,,percent of total billed charges,,,546.99,91,,percent of total billed charges,,,571.04,95,,percent of total billed charges,,,498.9,83,,percent of total billed charges,,,498.9,83,,percent of total billed charges,,,,,,,,,,,,,,,498.9,83,,percent of total billed charges,,,571.04,95,,percent of total billed charges,,,540.98,90,,percent of total billed charges,,,540.98,90,,percent of total billed charges,,,492.89,82,,percent of total billed charges,,,540.98,90,,percent of total billed charges,,,510.93,85,,percent of total billed charges,,150.27,571.04,
CLOTRIMAZOLE(LOTRIMIN)CREAM 1%:15 GM,32006576,CDM,J3490,HCPCS,250,RC,outpatient,,21.08,21.08,,17.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.27,22,,percent of total billed charges,,,,,,,,,18.97,90,,percent of total billed charges,,,17.45,82.8,,percent of total billed charges,,,17.92,85,,percent of total billed charges,,,,,,,,,18.55,88,,percent of total billed charges,,,,,,,,,16.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.27,22,,percent of total billed charges,,,19.18,91,,percent of total billed charges,,,20.03,95,,percent of total billed charges,,,17.5,83,,percent of total billed charges,,,17.5,83,,percent of total billed charges,,,,,,,,,,,,,,,17.5,83,,percent of total billed charges,,,20.03,95,,percent of total billed charges,,,18.97,90,,percent of total billed charges,,,18.97,90,,percent of total billed charges,,,17.29,82,,percent of total billed charges,,,18.97,90,,percent of total billed charges,,,17.92,85,,percent of total billed charges,,5.27,20.03,
NYSTATIN POWDER: 1500MU/15GM,32006581,CDM,J3490,HCPCS,250,RC,outpatient,,58.5,58.5,,49.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.63,22,,percent of total billed charges,,,,,,,,,52.65,90,,percent of total billed charges,,,48.44,82.8,,percent of total billed charges,,,49.73,85,,percent of total billed charges,,,,,,,,,51.48,88,,percent of total billed charges,,,,,,,,,44.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.63,22,,percent of total billed charges,,,53.24,91,,percent of total billed charges,,,55.58,95,,percent of total billed charges,,,48.56,83,,percent of total billed charges,,,48.56,83,,percent of total billed charges,,,,,,,,,,,,,,,48.56,83,,percent of total billed charges,,,55.58,95,,percent of total billed charges,,,52.65,90,,percent of total billed charges,,,52.65,90,,percent of total billed charges,,,47.97,82,,percent of total billed charges,,,52.65,90,,percent of total billed charges,,,49.73,85,,percent of total billed charges,,14.63,55.58,
TROPICAMIDE(MYDRIACYL)DROP 1%:2ML,32006582,CDM,J3490,HCPCS,250,RC,outpatient,,152.18,152.18,,129.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.05,22,,percent of total billed charges,,,,,,,,,136.96,90,,percent of total billed charges,,,126.01,82.8,,percent of total billed charges,,,129.35,85,,percent of total billed charges,,,,,,,,,133.92,88,,percent of total billed charges,,,,,,,,,116.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.05,22,,percent of total billed charges,,,138.48,91,,percent of total billed charges,,,144.57,95,,percent of total billed charges,,,126.31,83,,percent of total billed charges,,,126.31,83,,percent of total billed charges,,,,,,,,,,,,,,,126.31,83,,percent of total billed charges,,,144.57,95,,percent of total billed charges,,,136.96,90,,percent of total billed charges,,,136.96,90,,percent of total billed charges,,,124.79,82,,percent of total billed charges,,,136.96,90,,percent of total billed charges,,,129.35,85,,percent of total billed charges,,38.05,144.57,
PHENYLEPH(NEO-SYNPHR)DROP 2.5%(EYE):15ML,32006583,CDM,J3490,HCPCS,250,RC,outpatient,,1216.81,1216.81,,1033.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,304.2,22,,percent of total billed charges,,,,,,,,,1095.13,90,,percent of total billed charges,,,1007.52,82.8,,percent of total billed charges,,,1034.29,85,,percent of total billed charges,,,,,,,,,1070.79,88,,percent of total billed charges,,,,,,,,,929.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,304.2,22,,percent of total billed charges,,,1107.3,91,,percent of total billed charges,,,1155.97,95,,percent of total billed charges,,,1009.95,83,,percent of total billed charges,,,1009.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1009.95,83,,percent of total billed charges,,,1155.97,95,,percent of total billed charges,,,1095.13,90,,percent of total billed charges,,,1095.13,90,,percent of total billed charges,,,997.78,82,,percent of total billed charges,,,1095.13,90,,percent of total billed charges,,,1034.29,85,,percent of total billed charges,,304.2,1155.97,
IOHEXOL (MYELO-KIT) KIT : 180MG/ML,32006586,CDM,,,250,RC,outpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,203.31,22,,percent of total billed charges,,,,,,,,,731.93,90,,percent of total billed charges,,,673.37,82.8,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,203.31,22,,percent of total billed charges,,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,203.31,772.59,
TROLAMINE SALICYL(MYOFLEX) CREAM   90GM,32006621,CDM,,,250,RC,outpatient,,22.52,22.52,,19.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.63,22,,percent of total billed charges,,,,,,,,,20.27,90,,percent of total billed charges,,,18.65,82.8,,percent of total billed charges,,,19.14,85,,percent of total billed charges,,,,,,,,,19.82,88,,percent of total billed charges,,,,,,,,,17.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.63,22,,percent of total billed charges,,,20.49,91,,percent of total billed charges,,,21.39,95,,percent of total billed charges,,,18.69,83,,percent of total billed charges,,,18.69,83,,percent of total billed charges,,,,,,,,,,,,,,,18.69,83,,percent of total billed charges,,,21.39,95,,percent of total billed charges,,,20.27,90,,percent of total billed charges,,,20.27,90,,percent of total billed charges,,,18.47,82,,percent of total billed charges,,,20.27,90,,percent of total billed charges,,,19.14,85,,percent of total billed charges,,5.63,21.39,
NADOLOL(CORGARD)TAB:40MG,32006626,CDM,J8499,HCPCS,250,RC,outpatient,,54.74,54.74,,46.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.69,22,,percent of total billed charges,,,,,,,,,49.27,90,,percent of total billed charges,,,45.32,82.8,,percent of total billed charges,,,46.53,85,,percent of total billed charges,,,,,,,,,48.17,88,,percent of total billed charges,,,,,,,,,41.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.69,22,,percent of total billed charges,,,49.81,91,,percent of total billed charges,,,52,95,,percent of total billed charges,,,45.43,83,,percent of total billed charges,,,45.43,83,,percent of total billed charges,,,,,,,,,,,,,,,45.43,83,,percent of total billed charges,,,52,95,,percent of total billed charges,,,49.27,90,,percent of total billed charges,,,49.27,90,,percent of total billed charges,,,44.89,82,,percent of total billed charges,,,49.27,90,,percent of total billed charges,,,46.53,85,,percent of total billed charges,,13.69,52,
NAFCILLIN-VIAL:1GM,32006631,CDM,J3490,HCPCS,250,RC,outpatient,,84.69,84.69,,71.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.17,22,,percent of total billed charges,,,,,,,,,76.22,90,,percent of total billed charges,,,70.12,82.8,,percent of total billed charges,,,71.99,85,,percent of total billed charges,,,,,,,,,74.53,88,,percent of total billed charges,,,,,,,,,64.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.17,22,,percent of total billed charges,,,77.07,91,,percent of total billed charges,,,80.46,95,,percent of total billed charges,,,70.29,83,,percent of total billed charges,,,70.29,83,,percent of total billed charges,,,,,,,,,,,,,,,70.29,83,,percent of total billed charges,,,80.46,95,,percent of total billed charges,,,76.22,90,,percent of total billed charges,,,76.22,90,,percent of total billed charges,,,69.45,82,,percent of total billed charges,,,76.22,90,,percent of total billed charges,,,71.99,85,,percent of total billed charges,,21.17,80.46,
NAFCILLIN-VIAL:2GM,32006636,CDM,J3490,HCPCS,250,RC,outpatient,,604.74,604.74,,513.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,151.19,22,,percent of total billed charges,,,,,,,,,544.27,90,,percent of total billed charges,,,500.72,82.8,,percent of total billed charges,,,514.03,85,,percent of total billed charges,,,,,,,,,532.17,88,,percent of total billed charges,,,,,,,,,462.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,151.19,22,,percent of total billed charges,,,550.31,91,,percent of total billed charges,,,574.5,95,,percent of total billed charges,,,501.93,83,,percent of total billed charges,,,501.93,83,,percent of total billed charges,,,,,,,,,,,,,,,501.93,83,,percent of total billed charges,,,574.5,95,,percent of total billed charges,,,544.27,90,,percent of total billed charges,,,544.27,90,,percent of total billed charges,,,495.89,82,,percent of total billed charges,,,544.27,90,,percent of total billed charges,,,514.03,85,,percent of total billed charges,,151.19,574.5,
NALGEST (NALDECON),32006640,CDM,,,250,RC,outpatient,,0.5,0.5,,0.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.13,22,,percent of total billed charges,,,,,,,,,0.45,90,,percent of total billed charges,,,0.41,82.8,,percent of total billed charges,,,0.43,85,,percent of total billed charges,,,,,,,,,0.44,88,,percent of total billed charges,,,,,,,,,0.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.13,22,,percent of total billed charges,,,0.46,91,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,,,,,,,,,,,,,0.42,83,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.41,82,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.43,85,,percent of total billed charges,,0.13,0.48,
NAPHAZOLINE HCL (NAPHCON)DROP 0.01% 15ML,32006671,CDM,,,250,RC,outpatient,,312.28,312.28,,265.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.07,22,,percent of total billed charges,,,,,,,,,281.05,90,,percent of total billed charges,,,258.57,82.8,,percent of total billed charges,,,265.44,85,,percent of total billed charges,,,,,,,,,274.81,88,,percent of total billed charges,,,,,,,,,238.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.07,22,,percent of total billed charges,,,284.17,91,,percent of total billed charges,,,296.67,95,,percent of total billed charges,,,259.19,83,,percent of total billed charges,,,259.19,83,,percent of total billed charges,,,,,,,,,,,,,,,259.19,83,,percent of total billed charges,,,296.67,95,,percent of total billed charges,,,281.05,90,,percent of total billed charges,,,281.05,90,,percent of total billed charges,,,256.07,82,,percent of total billed charges,,,281.05,90,,percent of total billed charges,,,265.44,85,,percent of total billed charges,,78.07,296.67,
NAPH/PHE(VISINE-A)DROP:0.025-0.3%15ML,32006676,CDM,,,250,RC,outpatient,,68.83,68.83,,58.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.21,22,,percent of total billed charges,,,,,,,,,61.95,90,,percent of total billed charges,,,56.99,82.8,,percent of total billed charges,,,58.51,85,,percent of total billed charges,,,,,,,,,60.57,88,,percent of total billed charges,,,,,,,,,52.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.21,22,,percent of total billed charges,,,62.64,91,,percent of total billed charges,,,65.39,95,,percent of total billed charges,,,57.13,83,,percent of total billed charges,,,57.13,83,,percent of total billed charges,,,,,,,,,,,,,,,57.13,83,,percent of total billed charges,,,65.39,95,,percent of total billed charges,,,61.95,90,,percent of total billed charges,,,61.95,90,,percent of total billed charges,,,56.44,82,,percent of total billed charges,,,61.95,90,,percent of total billed charges,,,58.51,85,,percent of total billed charges,,17.21,65.39,
NAPROXEN (NAPROSYN) TAB : 250MG,32006681,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
NAPROXEN(NAPROSYN)TAB:500MG,32006687,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ROPIVACAINE(NAROPIN) 0.2%:100ML,32006695,CDM,J2795,HCPCS,250,RC,outpatient,,686.93,686.93,,583.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,171.73,22,,percent of total billed charges,,,,,,,,,618.24,90,,percent of total billed charges,,,568.78,82.8,,percent of total billed charges,,,583.89,85,,percent of total billed charges,,,,,,,,,604.5,88,,percent of total billed charges,,13.8,,,,fee schedule,,,524.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.8,,,,fee schedule,,,171.73,22,,percent of total billed charges,,,625.11,91,,percent of total billed charges,,,652.58,95,,percent of total billed charges,,,570.15,83,,percent of total billed charges,,,570.15,83,,percent of total billed charges,,,,,,,,,,,,,,,570.15,83,,percent of total billed charges,,,652.58,95,,percent of total billed charges,,,618.24,90,,percent of total billed charges,,,618.24,90,,percent of total billed charges,,,563.28,82,,percent of total billed charges,,,618.24,90,,percent of total billed charges,,,583.89,85,,percent of total billed charges,,13.8,652.58,
NALOXONE(NARCAN)SYR:2MG/2ML,32006696,CDM,,,250,RC,outpatient,,481.51,481.51,,408.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,120.38,22,,percent of total billed charges,,,,,,,,,433.36,90,,percent of total billed charges,,,398.69,82.8,,percent of total billed charges,,,409.28,85,,percent of total billed charges,,,,,,,,,423.73,88,,percent of total billed charges,,,,,,,,,367.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,120.38,22,,percent of total billed charges,,,438.17,91,,percent of total billed charges,,,457.43,95,,percent of total billed charges,,,399.65,83,,percent of total billed charges,,,399.65,83,,percent of total billed charges,,,,,,,,,,,,,,,399.65,83,,percent of total billed charges,,,457.43,95,,percent of total billed charges,,,433.36,90,,percent of total billed charges,,,433.36,90,,percent of total billed charges,,,394.84,82,,percent of total billed charges,,,433.36,90,,percent of total billed charges,,,409.28,85,,percent of total billed charges,,120.38,457.43,
ROPIVACAINE 0.5%:150MG/30ML,32006697,CDM,J2795,HCPCS,250,RC,outpatient,,96.57,96.57,,81.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.14,22,,percent of total billed charges,,,,,,,,,86.91,90,,percent of total billed charges,,,79.96,82.8,,percent of total billed charges,,,82.08,85,,percent of total billed charges,,,,,,,,,84.98,88,,percent of total billed charges,,13.8,,,,fee schedule,,,73.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.8,,,,fee schedule,,,24.14,22,,percent of total billed charges,,,87.88,91,,percent of total billed charges,,,91.74,95,,percent of total billed charges,,,80.15,83,,percent of total billed charges,,,80.15,83,,percent of total billed charges,,,,,,,,,,,,,,,80.15,83,,percent of total billed charges,,,91.74,95,,percent of total billed charges,,,86.91,90,,percent of total billed charges,,,86.91,90,,percent of total billed charges,,,79.19,82,,percent of total billed charges,,,86.91,90,,percent of total billed charges,,,82.08,85,,percent of total billed charges,,13.8,91.74,
FLUNISOLIDE(NASALIDE)0.025%:NASAL SPRY,32006701,CDM,,,250,RC,outpatient,,681.35,681.35,,578.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,170.34,22,,percent of total billed charges,,,,,,,,,613.22,90,,percent of total billed charges,,,564.16,82.8,,percent of total billed charges,,,579.15,85,,percent of total billed charges,,,,,,,,,599.59,88,,percent of total billed charges,,,,,,,,,520.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,170.34,22,,percent of total billed charges,,,620.03,91,,percent of total billed charges,,,647.28,95,,percent of total billed charges,,,565.52,83,,percent of total billed charges,,,565.52,83,,percent of total billed charges,,,,,,,,,,,,,,,565.52,83,,percent of total billed charges,,,647.28,95,,percent of total billed charges,,,613.22,90,,percent of total billed charges,,,613.22,90,,percent of total billed charges,,,558.71,82,,percent of total billed charges,,,613.22,90,,percent of total billed charges,,,579.15,85,,percent of total billed charges,,170.34,647.28,
TRIAMCINOLONE (NASACORT) AER: 55MCG 10GM,32006706,CDM,,,250,RC,outpatient,,675.63,675.63,,573.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,168.91,22,,percent of total billed charges,,,,,,,,,608.07,90,,percent of total billed charges,,,559.42,82.8,,percent of total billed charges,,,574.29,85,,percent of total billed charges,,,,,,,,,594.55,88,,percent of total billed charges,,,,,,,,,516.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,168.91,22,,percent of total billed charges,,,614.82,91,,percent of total billed charges,,,641.85,95,,percent of total billed charges,,,560.77,83,,percent of total billed charges,,,560.77,83,,percent of total billed charges,,,,,,,,,,,,,,,560.77,83,,percent of total billed charges,,,641.85,95,,percent of total billed charges,,,608.07,90,,percent of total billed charges,,,608.07,90,,percent of total billed charges,,,554.02,82,,percent of total billed charges,,,608.07,90,,percent of total billed charges,,,574.29,85,,percent of total billed charges,,168.91,641.85,
SODIUM CHLORIDE NASAL(OCEAN)SPR:45ML,32006716,CDM,J3490,HCPCS,250,RC,outpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.07,22,,percent of total billed charges,,,,,,,,,18.24,90,,percent of total billed charges,,,16.78,82.8,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.07,22,,percent of total billed charges,,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,5.07,19.26,
VINORELBI(NAVELBINE)50MG/5ML:(J/10MG),32006722,CDM,J9390,HCPCS,636,RC,outpatient,,333.06,333.06,,282.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.27,22,,percent of total billed charges,,,,,,,,,299.75,90,,percent of total billed charges,,,275.77,82.8,,percent of total billed charges,,,283.1,85,,percent of total billed charges,,,,,,,,,293.09,88,,percent of total billed charges,,74.17,,,,fee schedule,,,254.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,74.17,,,,fee schedule,,,83.27,22,,percent of total billed charges,,,303.08,91,,percent of total billed charges,,,316.41,95,,percent of total billed charges,,,276.44,83,,percent of total billed charges,,,276.44,83,,percent of total billed charges,,,,,,,,,,,,,,,276.44,83,,percent of total billed charges,,,316.41,95,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,273.11,82,,percent of total billed charges,,,299.75,90,,percent of total billed charges,,,283.1,85,,percent of total billed charges,,74.17,316.41,
PHENYLEPH(NEO-SYNEPHRINE)DROP 0.25%:15ML,32006746,CDM,,,250,RC,outpatient,,47.74,47.74,,40.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.94,22,,percent of total billed charges,,,,,,,,,42.97,90,,percent of total billed charges,,,39.53,82.8,,percent of total billed charges,,,40.58,85,,percent of total billed charges,,,,,,,,,42.01,88,,percent of total billed charges,,,,,,,,,36.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.94,22,,percent of total billed charges,,,43.44,91,,percent of total billed charges,,,45.35,95,,percent of total billed charges,,,39.62,83,,percent of total billed charges,,,39.62,83,,percent of total billed charges,,,,,,,,,,,,,,,39.62,83,,percent of total billed charges,,,45.35,95,,percent of total billed charges,,,42.97,90,,percent of total billed charges,,,42.97,90,,percent of total billed charges,,,39.15,82,,percent of total billed charges,,,42.97,90,,percent of total billed charges,,,40.58,85,,percent of total billed charges,,11.94,45.35,
PHENYLEPH(NEO-SYNEPHRINE)SPR 0.25%:15ML,32006747,CDM,,,250,RC,outpatient,,52.81,52.81,,44.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.2,22,,percent of total billed charges,,,,,,,,,47.53,90,,percent of total billed charges,,,43.73,82.8,,percent of total billed charges,,,44.89,85,,percent of total billed charges,,,,,,,,,46.47,88,,percent of total billed charges,,,,,,,,,40.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.2,22,,percent of total billed charges,,,48.06,91,,percent of total billed charges,,,50.17,95,,percent of total billed charges,,,43.83,83,,percent of total billed charges,,,43.83,83,,percent of total billed charges,,,,,,,,,,,,,,,43.83,83,,percent of total billed charges,,,50.17,95,,percent of total billed charges,,,47.53,90,,percent of total billed charges,,,47.53,90,,percent of total billed charges,,,43.3,82,,percent of total billed charges,,,47.53,90,,percent of total billed charges,,,44.89,85,,percent of total billed charges,,13.2,50.17,
PHENYLEPH(NEO-SYNEPHRINE)SPR 1%:15ML,32006751,CDM,J3490,HCPCS,250,RC,outpatient,,66.67,66.67,,56.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.67,22,,percent of total billed charges,,,,,,,,,60,90,,percent of total billed charges,,,55.2,82.8,,percent of total billed charges,,,56.67,85,,percent of total billed charges,,,,,,,,,58.67,88,,percent of total billed charges,,,,,,,,,50.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.67,22,,percent of total billed charges,,,60.67,91,,percent of total billed charges,,,63.34,95,,percent of total billed charges,,,55.34,83,,percent of total billed charges,,,55.34,83,,percent of total billed charges,,,,,,,,,,,,,,,55.34,83,,percent of total billed charges,,,63.34,95,,percent of total billed charges,,,60,90,,percent of total billed charges,,,60,90,,percent of total billed charges,,,54.67,82,,percent of total billed charges,,,60,90,,percent of total billed charges,,,56.67,85,,percent of total billed charges,,16.67,63.34,
NEOMYCIN SULFATE TAB:500MG,32006771,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
NEOMYCIN/POLYMYXIN B\DEXAMETN 5ML SUS,32006772,CDM,,,250,RC,outpatient,,9.5,9.5,,8.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.38,22,,percent of total billed charges,,,,,,,,,8.55,90,,percent of total billed charges,,,7.87,82.8,,percent of total billed charges,,,8.08,85,,percent of total billed charges,,,,,,,,,8.36,88,,percent of total billed charges,,,,,,,,,7.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.38,22,,percent of total billed charges,,,8.65,91,,percent of total billed charges,,,9.03,95,,percent of total billed charges,,,7.89,83,,percent of total billed charges,,,7.89,83,,percent of total billed charges,,,,,,,,,,,,,,,7.89,83,,percent of total billed charges,,,9.03,95,,percent of total billed charges,,,8.55,90,,percent of total billed charges,,,8.55,90,,percent of total billed charges,,,7.79,82,,percent of total billed charges,,,8.55,90,,percent of total billed charges,,,8.08,85,,percent of total billed charges,,2.38,9.03,
NEOMY/POLYMYXB SOL(CORTISPORIN OTIC)10ML,32006776,CDM,,,250,RC,outpatient,,762.72,762.72,,647.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,190.68,22,,percent of total billed charges,,,,,,,,,686.45,90,,percent of total billed charges,,,631.53,82.8,,percent of total billed charges,,,648.31,85,,percent of total billed charges,,,,,,,,,671.19,88,,percent of total billed charges,,,,,,,,,582.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,190.68,22,,percent of total billed charges,,,694.08,91,,percent of total billed charges,,,724.58,95,,percent of total billed charges,,,633.06,83,,percent of total billed charges,,,633.06,83,,percent of total billed charges,,,,,,,,,,,,,,,633.06,83,,percent of total billed charges,,,724.58,95,,percent of total billed charges,,,686.45,90,,percent of total billed charges,,,686.45,90,,percent of total billed charges,,,625.43,82,,percent of total billed charges,,,686.45,90,,percent of total billed charges,,,648.31,85,,percent of total billed charges,,190.68,724.58,
NEO/BACI ZN(CORTISPORIN EYE)OINT:3.5GM,32006786,CDM,,,250,RC,outpatient,,69.94,69.94,,59.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.49,22,,percent of total billed charges,,,,,,,,,62.95,90,,percent of total billed charges,,,57.91,82.8,,percent of total billed charges,,,59.45,85,,percent of total billed charges,,,,,,,,,61.55,88,,percent of total billed charges,,,,,,,,,53.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.49,22,,percent of total billed charges,,,63.65,91,,percent of total billed charges,,,66.44,95,,percent of total billed charges,,,58.05,83,,percent of total billed charges,,,58.05,83,,percent of total billed charges,,,,,,,,,,,,,,,58.05,83,,percent of total billed charges,,,66.44,95,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,57.35,82,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,59.45,85,,percent of total billed charges,,17.49,66.44,
NEOSPORIN PLUS CREAM 15GM,32006797,CDM,,,250,RC,outpatient,,14,14,,11.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.5,22,,percent of total billed charges,,,,,,,,,12.6,90,,percent of total billed charges,,,11.59,82.8,,percent of total billed charges,,,11.9,85,,percent of total billed charges,,,,,,,,,12.32,88,,percent of total billed charges,,,,,,,,,10.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.5,22,,percent of total billed charges,,,12.74,91,,percent of total billed charges,,,13.3,95,,percent of total billed charges,,,11.62,83,,percent of total billed charges,,,11.62,83,,percent of total billed charges,,,,,,,,,,,,,,,11.62,83,,percent of total billed charges,,,13.3,95,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,11.48,82,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,11.9,85,,percent of total billed charges,,3.5,13.3,
CHLOROPROCAI(NESACAINE)VL:20MG/ML (20ML),32006798,CDM,J2400,HCPCS,250,RC,outpatient,,346.07,346.07,,293.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.52,22,,percent of total billed charges,,,,,,,,,311.46,90,,percent of total billed charges,,,286.55,82.8,,percent of total billed charges,,,294.16,85,,percent of total billed charges,,,,,,,,,304.54,88,,percent of total billed charges,,,,,,,,,264.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.52,22,,percent of total billed charges,,,314.92,91,,percent of total billed charges,,,328.77,95,,percent of total billed charges,,,287.24,83,,percent of total billed charges,,,287.24,83,,percent of total billed charges,,,,,,,,,,,,,,,287.24,83,,percent of total billed charges,,,328.77,95,,percent of total billed charges,,,311.46,90,,percent of total billed charges,,,311.46,90,,percent of total billed charges,,,283.78,82,,percent of total billed charges,,,311.46,90,,percent of total billed charges,,,294.16,85,,percent of total billed charges,,86.52,328.77,
NEOSYNEPHRINE OPTH DROPS 10% 5ML,32006802,CDM,,,250,RC,outpatient,,77.5,77.5,,65.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.38,22,,percent of total billed charges,,,,,,,,,69.75,90,,percent of total billed charges,,,64.17,82.8,,percent of total billed charges,,,65.88,85,,percent of total billed charges,,,,,,,,,68.2,88,,percent of total billed charges,,,,,,,,,59.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.38,22,,percent of total billed charges,,,70.53,91,,percent of total billed charges,,,73.63,95,,percent of total billed charges,,,64.33,83,,percent of total billed charges,,,64.33,83,,percent of total billed charges,,,,,,,,,,,,,,,64.33,83,,percent of total billed charges,,,73.63,95,,percent of total billed charges,,,69.75,90,,percent of total billed charges,,,69.75,90,,percent of total billed charges,,,63.55,82,,percent of total billed charges,,,69.75,90,,percent of total billed charges,,,65.88,85,,percent of total billed charges,,19.38,73.63,
NEOSTIGMINE VIAL:10MG/10ML,32006803,CDM,J2710,HCPCS,250,RC,outpatient,,69.28,69.28,,58.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.32,22,,percent of total billed charges,,,,,,,,,62.35,90,,percent of total billed charges,,,57.36,82.8,,percent of total billed charges,,,58.89,85,,percent of total billed charges,,,,,,,,,60.97,88,,percent of total billed charges,,2.49,,,,fee schedule,,,52.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.49,,,,fee schedule,,,17.32,22,,percent of total billed charges,,,63.04,91,,percent of total billed charges,,,65.82,95,,percent of total billed charges,,,57.5,83,,percent of total billed charges,,,57.5,83,,percent of total billed charges,,,,,,,,,,,,,,,57.5,83,,percent of total billed charges,,,65.82,95,,percent of total billed charges,,,62.35,90,,percent of total billed charges,,,62.35,90,,percent of total billed charges,,,56.81,82,,percent of total billed charges,,,62.35,90,,percent of total billed charges,,,58.89,85,,percent of total billed charges,,2.49,65.82,
PHENYLEPH(NEO-SYNEPHRINE)DROP 1%:30ML,32006806,CDM,,,250,RC,outpatient,,32.04,32.04,,27.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.01,22,,percent of total billed charges,,,,,,,,,28.84,90,,percent of total billed charges,,,26.53,82.8,,percent of total billed charges,,,27.23,85,,percent of total billed charges,,,,,,,,,28.2,88,,percent of total billed charges,,,,,,,,,24.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.01,22,,percent of total billed charges,,,29.16,91,,percent of total billed charges,,,30.44,95,,percent of total billed charges,,,26.59,83,,percent of total billed charges,,,26.59,83,,percent of total billed charges,,,,,,,,,,,,,,,26.59,83,,percent of total billed charges,,,30.44,95,,percent of total billed charges,,,28.84,90,,percent of total billed charges,,,28.84,90,,percent of total billed charges,,,26.27,82,,percent of total billed charges,,,28.84,90,,percent of total billed charges,,,27.23,85,,percent of total billed charges,,8.01,30.44,
PHENYLEPH(NEO-SYNEPHRINE)SPR 0.5%:15ML,32006811,CDM,J3490,HCPCS,250,RC,outpatient,,59.48,59.48,,50.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.87,22,,percent of total billed charges,,,,,,,,,53.53,90,,percent of total billed charges,,,49.25,82.8,,percent of total billed charges,,,50.56,85,,percent of total billed charges,,,,,,,,,52.34,88,,percent of total billed charges,,,,,,,,,45.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.87,22,,percent of total billed charges,,,54.13,91,,percent of total billed charges,,,56.51,95,,percent of total billed charges,,,49.37,83,,percent of total billed charges,,,49.37,83,,percent of total billed charges,,,,,,,,,,,,,,,49.37,83,,percent of total billed charges,,,56.51,95,,percent of total billed charges,,,53.53,90,,percent of total billed charges,,,53.53,90,,percent of total billed charges,,,48.77,82,,percent of total billed charges,,,53.53,90,,percent of total billed charges,,,50.56,85,,percent of total billed charges,,14.87,56.51,
FILGRASTIM(NEUPOGEN):480MCG/1.6ML,32006816,CDM,J1442,HCPCS,636,RC,outpatient,,3853.25,3853.25,,3271.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,963.31,22,,percent of total billed charges,,,,,,,,,3467.93,90,,percent of total billed charges,,,3190.49,82.8,,percent of total billed charges,,,3275.26,85,,percent of total billed charges,,,,,,,,,3390.86,88,,percent of total billed charges,,947.52,,,,fee schedule,,,2943.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,947.52,,,,fee schedule,,,963.31,22,,percent of total billed charges,,,3506.46,91,,percent of total billed charges,,,3660.59,95,,percent of total billed charges,,,3198.2,83,,percent of total billed charges,,,3198.2,83,,percent of total billed charges,,,,,,,,,,,,,,,3198.2,83,,percent of total billed charges,,,3660.59,95,,percent of total billed charges,,,3467.93,90,,percent of total billed charges,,,3467.93,90,,percent of total billed charges,,,3159.67,82,,percent of total billed charges,,,3467.93,90,,percent of total billed charges,,,3275.26,85,,percent of total billed charges,,947.52,3660.59,
FILGRASTIM(NEUPOGEN)SYRINGE:300MCG/0.5ML,32006817,CDM,J1442,HCPCS,636,RC,outpatient,,2586.37,2586.37,,2195.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,646.59,22,,percent of total billed charges,,,,,,,,,2327.73,90,,percent of total billed charges,,,2141.51,82.8,,percent of total billed charges,,,2198.41,85,,percent of total billed charges,,,,,,,,,2276.01,88,,percent of total billed charges,,947.52,,,,fee schedule,,,1975.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,947.52,,,,fee schedule,,,646.59,22,,percent of total billed charges,,,2353.6,91,,percent of total billed charges,,,2457.05,95,,percent of total billed charges,,,2146.69,83,,percent of total billed charges,,,2146.69,83,,percent of total billed charges,,,,,,,,,,,,,,,2146.69,83,,percent of total billed charges,,,2457.05,95,,percent of total billed charges,,,2327.73,90,,percent of total billed charges,,,2327.73,90,,percent of total billed charges,,,2120.82,82,,percent of total billed charges,,,2327.73,90,,percent of total billed charges,,,2198.41,85,,percent of total billed charges,,646.59,2457.05,
GABAPENTIN(NEURONTIN)CAP:300MG,32006821,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
GABAPENTIN(NEURONTIN)CAP:100MG,32006822,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
GABAPENTIN (NEURONTIN) CAP : 400MG,32006823,CDM,,,250,RC,outpatient,,112.45,112.45,,95.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.11,22,,percent of total billed charges,,,,,,,,,101.21,90,,percent of total billed charges,,,93.11,82.8,,percent of total billed charges,,,95.58,85,,percent of total billed charges,,,,,,,,,98.96,88,,percent of total billed charges,,,,,,,,,85.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.11,22,,percent of total billed charges,,,102.33,91,,percent of total billed charges,,,106.83,95,,percent of total billed charges,,,93.33,83,,percent of total billed charges,,,93.33,83,,percent of total billed charges,,,,,,,,,,,,,,,93.33,83,,percent of total billed charges,,,106.83,95,,percent of total billed charges,,,101.21,90,,percent of total billed charges,,,101.21,90,,percent of total billed charges,,,92.21,82,,percent of total billed charges,,,101.21,90,,percent of total billed charges,,,95.58,85,,percent of total billed charges,,28.11,106.83,
SOD PHOS/K PHOS(NEUTRA PHOS K)PACKET,32006825,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
SODIUM BICARBANATE(NEUT)VIAL:5ML,32006826,CDM,J3490,HCPCS,250,RC,outpatient,,120.06,120.06,,101.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.02,22,,percent of total billed charges,,,,,,,,,108.05,90,,percent of total billed charges,,,99.41,82.8,,percent of total billed charges,,,102.05,85,,percent of total billed charges,,,,,,,,,105.65,88,,percent of total billed charges,,,,,,,,,91.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.02,22,,percent of total billed charges,,,109.25,91,,percent of total billed charges,,,114.06,95,,percent of total billed charges,,,99.65,83,,percent of total billed charges,,,99.65,83,,percent of total billed charges,,,,,,,,,,,,,,,99.65,83,,percent of total billed charges,,,114.06,95,,percent of total billed charges,,,108.05,90,,percent of total billed charges,,,108.05,90,,percent of total billed charges,,,98.45,82,,percent of total billed charges,,,108.05,90,,percent of total billed charges,,,102.05,85,,percent of total billed charges,,30.02,114.06,
NAPO4 MB-DB/K PH MBDB(NEUTRA PHOS)PKT:,32006827,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
NIACIN TAB : 50MG,32006831,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
NIACIN TAB : 100MG,32006836,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
NICOTINE PAT(NICODERM):7MG/24HR,32006850,CDM,J3490,HCPCS,250,RC,outpatient,,31.21,31.21,,26.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.8,22,,percent of total billed charges,,,,,,,,,28.09,90,,percent of total billed charges,,,25.84,82.8,,percent of total billed charges,,,26.53,85,,percent of total billed charges,,,,,,,,,27.46,88,,percent of total billed charges,,,,,,,,,23.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.8,22,,percent of total billed charges,,,28.4,91,,percent of total billed charges,,,29.65,95,,percent of total billed charges,,,25.9,83,,percent of total billed charges,,,25.9,83,,percent of total billed charges,,,,,,,,,,,,,,,25.9,83,,percent of total billed charges,,,29.65,95,,percent of total billed charges,,,28.09,90,,percent of total billed charges,,,28.09,90,,percent of total billed charges,,,25.59,82,,percent of total billed charges,,,28.09,90,,percent of total billed charges,,,26.53,85,,percent of total billed charges,,7.8,29.65,
NICOTINE PAT(NICODERM):14MG/24HR,32006851,CDM,J3490,HCPCS,250,RC,outpatient,,30.72,30.72,,26.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.68,22,,percent of total billed charges,,,,,,,,,27.65,90,,percent of total billed charges,,,25.44,82.8,,percent of total billed charges,,,26.11,85,,percent of total billed charges,,,,,,,,,27.03,88,,percent of total billed charges,,,,,,,,,23.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.68,22,,percent of total billed charges,,,27.96,91,,percent of total billed charges,,,29.18,95,,percent of total billed charges,,,25.5,83,,percent of total billed charges,,,25.5,83,,percent of total billed charges,,,,,,,,,,,,,,,25.5,83,,percent of total billed charges,,,29.18,95,,percent of total billed charges,,,27.65,90,,percent of total billed charges,,,27.65,90,,percent of total billed charges,,,25.19,82,,percent of total billed charges,,,27.65,90,,percent of total billed charges,,,26.11,85,,percent of total billed charges,,7.68,29.18,
NICOTINE PAT(NICODERM):21MG/24HR,32006861,CDM,J3490,HCPCS,250,RC,outpatient,,26.31,26.31,,22.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.58,22,,percent of total billed charges,,,,,,,,,23.68,90,,percent of total billed charges,,,21.78,82.8,,percent of total billed charges,,,22.36,85,,percent of total billed charges,,,,,,,,,23.15,88,,percent of total billed charges,,,,,,,,,20.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.58,22,,percent of total billed charges,,,23.94,91,,percent of total billed charges,,,24.99,95,,percent of total billed charges,,,21.84,83,,percent of total billed charges,,,21.84,83,,percent of total billed charges,,,,,,,,,,,,,,,21.84,83,,percent of total billed charges,,,24.99,95,,percent of total billed charges,,,23.68,90,,percent of total billed charges,,,23.68,90,,percent of total billed charges,,,21.57,82,,percent of total billed charges,,,23.68,90,,percent of total billed charges,,,22.36,85,,percent of total billed charges,,6.58,24.99,
nitroPRUSSID(nitroPRESS)VIAL:50MG/2ML,32006881,CDM,J3490,HCPCS,250,RC,outpatient,,254.55,254.55,,216.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.64,22,,percent of total billed charges,,,,,,,,,229.1,90,,percent of total billed charges,,,210.77,82.8,,percent of total billed charges,,,216.37,85,,percent of total billed charges,,,,,,,,,224,88,,percent of total billed charges,,,,,,,,,194.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.64,22,,percent of total billed charges,,,231.64,91,,percent of total billed charges,,,241.82,95,,percent of total billed charges,,,211.28,83,,percent of total billed charges,,,211.28,83,,percent of total billed charges,,,,,,,,,,,,,,,211.28,83,,percent of total billed charges,,,241.82,95,,percent of total billed charges,,,229.1,90,,percent of total billed charges,,,229.1,90,,percent of total billed charges,,,208.73,82,,percent of total billed charges,,,229.1,90,,percent of total billed charges,,,216.37,85,,percent of total billed charges,,63.64,241.82,
NITROglycerin PAT(NITRO-DUR):0.4MG/HR,32006887,CDM,J3490,HCPCS,250,RC,outpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.07,22,,percent of total billed charges,,,,,,,,,18.24,90,,percent of total billed charges,,,16.78,82.8,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.07,22,,percent of total billed charges,,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,5.07,19.26,
NitroGLYCERIN (NITRO-DUR) PAT : 0.3MG/HR,32006897,CDM,,,250,RC,outpatient,,92.62,92.62,,78.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.16,22,,percent of total billed charges,,,,,,,,,83.36,90,,percent of total billed charges,,,76.69,82.8,,percent of total billed charges,,,78.73,85,,percent of total billed charges,,,,,,,,,81.51,88,,percent of total billed charges,,,,,,,,,70.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.16,22,,percent of total billed charges,,,84.28,91,,percent of total billed charges,,,87.99,95,,percent of total billed charges,,,76.87,83,,percent of total billed charges,,,76.87,83,,percent of total billed charges,,,,,,,,,,,,,,,76.87,83,,percent of total billed charges,,,87.99,95,,percent of total billed charges,,,83.36,90,,percent of total billed charges,,,83.36,90,,percent of total billed charges,,,75.95,82,,percent of total billed charges,,,83.36,90,,percent of total billed charges,,,78.73,85,,percent of total billed charges,,23.16,87.99,
NitroGLYCERIN (NITRO-DUR) PAT : 0.8MG/HR,32006901,CDM,,,250,RC,outpatient,,100.39,100.39,,85.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.1,22,,percent of total billed charges,,,,,,,,,90.35,90,,percent of total billed charges,,,83.12,82.8,,percent of total billed charges,,,85.33,85,,percent of total billed charges,,,,,,,,,88.34,88,,percent of total billed charges,,,,,,,,,76.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.1,22,,percent of total billed charges,,,91.35,91,,percent of total billed charges,,,95.37,95,,percent of total billed charges,,,83.32,83,,percent of total billed charges,,,83.32,83,,percent of total billed charges,,,,,,,,,,,,,,,83.32,83,,percent of total billed charges,,,95.37,95,,percent of total billed charges,,,90.35,90,,percent of total billed charges,,,90.35,90,,percent of total billed charges,,,82.32,82,,percent of total billed charges,,,90.35,90,,percent of total billed charges,,,85.33,85,,percent of total billed charges,,25.1,95.37,
NitroGLYCERIN (NITRO-BID)CAP : 6.5MG,32006906,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
NitroGLYCERIN PAT (NITRO-DUR) : 0.6MG/HR,32006912,CDM,,,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
NITROFURANTOIN MACRO(MACRODANTI)CAP:50MG,32006916,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
NITROglycerin PAT(NITRO-DUR):0.2MG/HR,32006922,CDM,J3490,HCPCS,250,RC,outpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.07,22,,percent of total billed charges,,,,,,,,,18.24,90,,percent of total billed charges,,,16.78,82.8,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.07,22,,percent of total billed charges,,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,5.07,19.26,
NITROglycerin PAT(NITRO-DUR):0.1MG/HR,32006923,CDM,J3490,HCPCS,250,RC,outpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.07,22,,percent of total billed charges,,,,,,,,,18.24,90,,percent of total billed charges,,,16.78,82.8,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.07,22,,percent of total billed charges,,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,5.07,19.26,
NitroGLYCERIN (NITRO-BID) OINT : 2% 30GM,32006926,CDM,,,250,RC,outpatient,,553.36,553.36,,469.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,138.34,22,,percent of total billed charges,,,,,,,,,498.02,90,,percent of total billed charges,,,458.18,82.8,,percent of total billed charges,,,470.36,85,,percent of total billed charges,,,,,,,,,486.96,88,,percent of total billed charges,,,,,,,,,422.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,138.34,22,,percent of total billed charges,,,503.56,91,,percent of total billed charges,,,525.69,95,,percent of total billed charges,,,459.29,83,,percent of total billed charges,,,459.29,83,,percent of total billed charges,,,,,,,,,,,,,,,459.29,83,,percent of total billed charges,,,525.69,95,,percent of total billed charges,,,498.02,90,,percent of total billed charges,,,498.02,90,,percent of total billed charges,,,453.76,82,,percent of total billed charges,,,498.02,90,,percent of total billed charges,,,470.36,85,,percent of total billed charges,,138.34,525.69,
NITROFURANTOIN (MACRODANTIN) CAP : 100MG,32006931,CDM,,,250,RC,outpatient,,15.38,15.38,,13.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.85,22,,percent of total billed charges,,,,,,,,,13.84,90,,percent of total billed charges,,,12.73,82.8,,percent of total billed charges,,,13.07,85,,percent of total billed charges,,,,,,,,,13.53,88,,percent of total billed charges,,,,,,,,,11.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.85,22,,percent of total billed charges,,,14,91,,percent of total billed charges,,,14.61,95,,percent of total billed charges,,,12.77,83,,percent of total billed charges,,,12.77,83,,percent of total billed charges,,,,,,,,,,,,,,,12.77,83,,percent of total billed charges,,,14.61,95,,percent of total billed charges,,,13.84,90,,percent of total billed charges,,,13.84,90,,percent of total billed charges,,,12.61,82,,percent of total billed charges,,,13.84,90,,percent of total billed charges,,,13.07,85,,percent of total billed charges,,3.85,14.61,
NITROglycerin(NITROSTAT)TAB:0.4MG(25)PX,32006941,CDM,J8499,HCPCS,250,RC,outpatient,,429.91,429.91,,364.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.48,22,,percent of total billed charges,,,,,,,,,386.92,90,,percent of total billed charges,,,355.97,82.8,,percent of total billed charges,,,365.42,85,,percent of total billed charges,,,,,,,,,378.32,88,,percent of total billed charges,,,,,,,,,328.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.48,22,,percent of total billed charges,,,391.22,91,,percent of total billed charges,,,408.41,95,,percent of total billed charges,,,356.83,83,,percent of total billed charges,,,356.83,83,,percent of total billed charges,,,,,,,,,,,,,,,356.83,83,,percent of total billed charges,,,408.41,95,,percent of total billed charges,,,386.92,90,,percent of total billed charges,,,386.92,90,,percent of total billed charges,,,352.53,82,,percent of total billed charges,,,386.92,90,,percent of total billed charges,,,365.42,85,,percent of total billed charges,,107.48,408.41,
NITROglycerin VIAL:5MG/ML (10ML),32006946,CDM,J3490,HCPCS,250,RC,outpatient,,202.13,202.13,,171.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.53,22,,percent of total billed charges,,,,,,,,,181.92,90,,percent of total billed charges,,,167.36,82.8,,percent of total billed charges,,,171.81,85,,percent of total billed charges,,,,,,,,,177.87,88,,percent of total billed charges,,,,,,,,,154.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.53,22,,percent of total billed charges,,,183.94,91,,percent of total billed charges,,,192.02,95,,percent of total billed charges,,,167.77,83,,percent of total billed charges,,,167.77,83,,percent of total billed charges,,,,,,,,,,,,,,,167.77,83,,percent of total billed charges,,,192.02,95,,percent of total billed charges,,,181.92,90,,percent of total billed charges,,,181.92,90,,percent of total billed charges,,,165.75,82,,percent of total billed charges,,,181.92,90,,percent of total billed charges,,,171.81,85,,percent of total billed charges,,50.53,192.02,
NitroGLYCERIN (NITRO-BID) CAP : 2.5MG,32006951,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
NITROGLYCERIN TAB (SL): 0.3MG,32006956,CDM,,,250,RC,outpatient,,208.08,208.08,,176.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.02,22,,percent of total billed charges,,,,,,,,,187.27,90,,percent of total billed charges,,,172.29,82.8,,percent of total billed charges,,,176.87,85,,percent of total billed charges,,,,,,,,,183.11,88,,percent of total billed charges,,,,,,,,,158.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.02,22,,percent of total billed charges,,,189.35,91,,percent of total billed charges,,,197.68,95,,percent of total billed charges,,,172.71,83,,percent of total billed charges,,,172.71,83,,percent of total billed charges,,,,,,,,,,,,,,,172.71,83,,percent of total billed charges,,,197.68,95,,percent of total billed charges,,,187.27,90,,percent of total billed charges,,,187.27,90,,percent of total billed charges,,,170.63,82,,percent of total billed charges,,,187.27,90,,percent of total billed charges,,,176.87,85,,percent of total billed charges,,52.02,197.68,
NITROGLYCERIN 0.6MG 100'S,32006961,CDM,,,250,RC,outpatient,,208.08,208.08,,176.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.02,22,,percent of total billed charges,,,,,,,,,187.27,90,,percent of total billed charges,,,172.29,82.8,,percent of total billed charges,,,176.87,85,,percent of total billed charges,,,,,,,,,183.11,88,,percent of total billed charges,,,,,,,,,158.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.02,22,,percent of total billed charges,,,189.35,91,,percent of total billed charges,,,197.68,95,,percent of total billed charges,,,172.71,83,,percent of total billed charges,,,172.71,83,,percent of total billed charges,,,,,,,,,,,,,,,172.71,83,,percent of total billed charges,,,197.68,95,,percent of total billed charges,,,187.27,90,,percent of total billed charges,,,187.27,90,,percent of total billed charges,,,170.63,82,,percent of total billed charges,,,187.27,90,,percent of total billed charges,,,176.87,85,,percent of total billed charges,,52.02,197.68,
NitroGLYCERIN (NITROLINGUAL) AER : 0.4MG,32006962,CDM,,,250,RC,outpatient,,416.01,416.01,,353.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104,22,,percent of total billed charges,,,,,,,,,374.41,90,,percent of total billed charges,,,344.46,82.8,,percent of total billed charges,,,353.61,85,,percent of total billed charges,,,,,,,,,366.09,88,,percent of total billed charges,,,,,,,,,317.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104,22,,percent of total billed charges,,,378.57,91,,percent of total billed charges,,,395.21,95,,percent of total billed charges,,,345.29,83,,percent of total billed charges,,,345.29,83,,percent of total billed charges,,,,,,,,,,,,,,,345.29,83,,percent of total billed charges,,,395.21,95,,percent of total billed charges,,,374.41,90,,percent of total billed charges,,,374.41,90,,percent of total billed charges,,,341.13,82,,percent of total billed charges,,,374.41,90,,percent of total billed charges,,,353.61,85,,percent of total billed charges,,104,395.21,
KETOCONAZOLE(NIZORAL)CREAM 2%:15GM,32006966,CDM,J3490,HCPCS,250,RC,outpatient,,126.96,126.96,,107.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.74,22,,percent of total billed charges,,,,,,,,,114.26,90,,percent of total billed charges,,,105.12,82.8,,percent of total billed charges,,,107.92,85,,percent of total billed charges,,,,,,,,,111.72,88,,percent of total billed charges,,,,,,,,,97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.74,22,,percent of total billed charges,,,115.53,91,,percent of total billed charges,,,120.61,95,,percent of total billed charges,,,105.38,83,,percent of total billed charges,,,105.38,83,,percent of total billed charges,,,,,,,,,,,,,,,105.38,83,,percent of total billed charges,,,120.61,95,,percent of total billed charges,,,114.26,90,,percent of total billed charges,,,114.26,90,,percent of total billed charges,,,104.11,82,,percent of total billed charges,,,114.26,90,,percent of total billed charges,,,107.92,85,,percent of total billed charges,,31.74,120.61,
KETOCONAZOLE(NIZORAL)SHAMP 2%:120ML,32006971,CDM,,,250,RC,outpatient,,137.35,137.35,,116.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.34,22,,percent of total billed charges,,,,,,,,,123.62,90,,percent of total billed charges,,,113.73,82.8,,percent of total billed charges,,,116.75,85,,percent of total billed charges,,,,,,,,,120.87,88,,percent of total billed charges,,,,,,,,,104.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.34,22,,percent of total billed charges,,,124.99,91,,percent of total billed charges,,,130.48,95,,percent of total billed charges,,,114,83,,percent of total billed charges,,,114,83,,percent of total billed charges,,,,,,,,,,,,,,,114,83,,percent of total billed charges,,,130.48,95,,percent of total billed charges,,,123.62,90,,percent of total billed charges,,,123.62,90,,percent of total billed charges,,,112.63,82,,percent of total billed charges,,,123.62,90,,percent of total billed charges,,,116.75,85,,percent of total billed charges,,34.34,130.48,
TAMOXIFEN(NOLVADEX)TAB:10MG,32006976,CDM,,,250,RC,outpatient,,31.4,31.4,,26.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.85,22,,percent of total billed charges,,,,,,,,,28.26,90,,percent of total billed charges,,,26,82.8,,percent of total billed charges,,,26.69,85,,percent of total billed charges,,,,,,,,,27.63,88,,percent of total billed charges,,,,,,,,,23.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.85,22,,percent of total billed charges,,,28.57,91,,percent of total billed charges,,,29.83,95,,percent of total billed charges,,,26.06,83,,percent of total billed charges,,,26.06,83,,percent of total billed charges,,,,,,,,,,,,,,,26.06,83,,percent of total billed charges,,,29.83,95,,percent of total billed charges,,,28.26,90,,percent of total billed charges,,,28.26,90,,percent of total billed charges,,,25.75,82,,percent of total billed charges,,,28.26,90,,percent of total billed charges,,,26.69,85,,percent of total billed charges,,7.85,29.83,
VECURONIUM(NORCURON)VIAL:10MG,32006981,CDM,J3490,HCPCS,250,RC,outpatient,,108.82,108.82,,92.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.21,22,,percent of total billed charges,,,,,,,,,97.94,90,,percent of total billed charges,,,90.1,82.8,,percent of total billed charges,,,92.5,85,,percent of total billed charges,,,,,,,,,95.76,88,,percent of total billed charges,,,,,,,,,83.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.21,22,,percent of total billed charges,,,99.03,91,,percent of total billed charges,,,103.38,95,,percent of total billed charges,,,90.32,83,,percent of total billed charges,,,90.32,83,,percent of total billed charges,,,,,,,,,,,,,,,90.32,83,,percent of total billed charges,,,103.38,95,,percent of total billed charges,,,97.94,90,,percent of total billed charges,,,97.94,90,,percent of total billed charges,,,89.23,82,,percent of total billed charges,,,97.94,90,,percent of total billed charges,,,92.5,85,,percent of total billed charges,,27.21,103.38,
NOREPINEPHRIN(LEVOPHED)AMP:4MG/4ML,32006986,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
NORFLOXACIN (NOROXIN) TAB : 400MG,32006996,CDM,,,250,RC,outpatient,,67.25,67.25,,57.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.81,22,,percent of total billed charges,,,,,,,,,60.53,90,,percent of total billed charges,,,55.68,82.8,,percent of total billed charges,,,57.16,85,,percent of total billed charges,,,,,,,,,59.18,88,,percent of total billed charges,,,,,,,,,51.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.81,22,,percent of total billed charges,,,61.2,91,,percent of total billed charges,,,63.89,95,,percent of total billed charges,,,55.82,83,,percent of total billed charges,,,55.82,83,,percent of total billed charges,,,,,,,,,,,,,,,55.82,83,,percent of total billed charges,,,63.89,95,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,55.15,82,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,57.16,85,,percent of total billed charges,,16.81,63.89,
DISOPYRAMIDE(NORPACE)CAP:150MG,32007006,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
NORTRIPTYLINE(PAMELOR)CAP:10MG,32007011,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
NORTRIPTYLINE (PAMELOR) CAP : 25MG,32007016,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
NORTRIPTYLINE (PAMELOR) CAP : 50MG,32007021,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
amLODIPine(NORVASC)TAB:5MG,32007026,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
AMLODIPINE (NORVASC) TAB : 2.5MG,32007027,CDM,,,250,RC,outpatient,,119.74,119.74,,101.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.94,22,,percent of total billed charges,,,,,,,,,107.77,90,,percent of total billed charges,,,99.14,82.8,,percent of total billed charges,,,101.78,85,,percent of total billed charges,,,,,,,,,105.37,88,,percent of total billed charges,,,,,,,,,91.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.94,22,,percent of total billed charges,,,108.96,91,,percent of total billed charges,,,113.75,95,,percent of total billed charges,,,99.38,83,,percent of total billed charges,,,99.38,83,,percent of total billed charges,,,,,,,,,,,,,,,99.38,83,,percent of total billed charges,,,113.75,95,,percent of total billed charges,,,107.77,90,,percent of total billed charges,,,107.77,90,,percent of total billed charges,,,98.19,82,,percent of total billed charges,,,107.77,90,,percent of total billed charges,,,101.78,85,,percent of total billed charges,,29.94,113.75,
AMLODIPINE (NORVASC) TAB : 10MG,32007028,CDM,,,250,RC,outpatient,,164.15,164.15,,139.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.04,22,,percent of total billed charges,,,,,,,,,147.74,90,,percent of total billed charges,,,135.92,82.8,,percent of total billed charges,,,139.53,85,,percent of total billed charges,,,,,,,,,144.45,88,,percent of total billed charges,,,,,,,,,125.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.04,22,,percent of total billed charges,,,149.38,91,,percent of total billed charges,,,155.94,95,,percent of total billed charges,,,136.24,83,,percent of total billed charges,,,136.24,83,,percent of total billed charges,,,,,,,,,,,,,,,136.24,83,,percent of total billed charges,,,155.94,95,,percent of total billed charges,,,147.74,90,,percent of total billed charges,,,147.74,90,,percent of total billed charges,,,134.6,82,,percent of total billed charges,,,147.74,90,,percent of total billed charges,,,139.53,85,,percent of total billed charges,,41.04,155.94,
MITOX(NOVANTRONE):20MG/10ML (J/5MG),32007031,CDM,J9293,HCPCS,636,RC,outpatient,,2399.04,2399.04,,2036.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,599.76,22,,percent of total billed charges,,,,,,,,,2159.14,90,,percent of total billed charges,,,1986.41,82.8,,percent of total billed charges,,,2039.18,85,,percent of total billed charges,,,,,,,,,2111.16,88,,percent of total billed charges,,320.03,,,,fee schedule,,,1832.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,320.03,,,,fee schedule,,,599.76,22,,percent of total billed charges,,,2183.13,91,,percent of total billed charges,,,2279.09,95,,percent of total billed charges,,,1991.2,83,,percent of total billed charges,,,1991.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1991.2,83,,percent of total billed charges,,,2279.09,95,,percent of total billed charges,,,2159.14,90,,percent of total billed charges,,,2159.14,90,,percent of total billed charges,,,1967.21,82,,percent of total billed charges,,,2159.14,90,,percent of total billed charges,,,2039.18,85,,percent of total billed charges,,320.03,2279.09,
NALBUPHINE(NUBAIN)AMP:10MG/ML,32007032,CDM,J2300,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,6.28,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6.28,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,6.28,60.99,
NUBAIN 10MG/ML 1ML,32007033,CDM,,,250,RC,outpatient,,6,6,,5.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.5,22,,percent of total billed charges,,,,,,,,,5.4,90,,percent of total billed charges,,,4.97,82.8,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,,,,,,,,5.28,88,,percent of total billed charges,,,,,,,,,4.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.5,22,,percent of total billed charges,,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,,,,,,,,,,,,,4.98,83,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,4.92,82,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,1.5,5.7,
MUMPS SKIN TEST ANTIGEN (MSTA) VIAL,32007036,CDM,,,250,RC,outpatient,,1608.1,1608.1,,1365.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,402.03,22,,percent of total billed charges,,,,,,,,,1447.29,90,,percent of total billed charges,,,1331.51,82.8,,percent of total billed charges,,,1366.89,85,,percent of total billed charges,,,,,,,,,1415.13,88,,percent of total billed charges,,,,,,,,,1228.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,402.03,22,,percent of total billed charges,,,1463.37,91,,percent of total billed charges,,,1527.7,95,,percent of total billed charges,,,1334.72,83,,percent of total billed charges,,,1334.72,83,,percent of total billed charges,,,,,,,,,,,,,,,1334.72,83,,percent of total billed charges,,,1527.7,95,,percent of total billed charges,,,1447.29,90,,percent of total billed charges,,,1447.29,90,,percent of total billed charges,,,1318.64,82,,percent of total billed charges,,,1447.29,90,,percent of total billed charges,,,1366.89,85,,percent of total billed charges,,402.03,1527.7,
NUBAIN 20MG/ML,32007040,CDM,,,250,RC,outpatient,,5,5,,4.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.25,22,,percent of total billed charges,,,,,,,,,4.5,90,,percent of total billed charges,,,4.14,82.8,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,,,,,,,,4.4,88,,percent of total billed charges,,,,,,,,,3.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.25,22,,percent of total billed charges,,,4.55,91,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4.15,83,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.1,82,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,1.25,4.75,
NYSTATIN CREAM : 100000 U/G 15GM,32007046,CDM,,,250,RC,outpatient,,59.95,59.95,,50.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.99,22,,percent of total billed charges,,,,,,,,,53.96,90,,percent of total billed charges,,,49.64,82.8,,percent of total billed charges,,,50.96,85,,percent of total billed charges,,,,,,,,,52.76,88,,percent of total billed charges,,,,,,,,,45.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.99,22,,percent of total billed charges,,,54.55,91,,percent of total billed charges,,,56.95,95,,percent of total billed charges,,,49.76,83,,percent of total billed charges,,,49.76,83,,percent of total billed charges,,,,,,,,,,,,,,,49.76,83,,percent of total billed charges,,,56.95,95,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,49.16,82,,percent of total billed charges,,,53.96,90,,percent of total billed charges,,,50.96,85,,percent of total billed charges,,14.99,56.95,
NYSTATIN CREAM:30GM,32007061,CDM,J3490,HCPCS,250,RC,outpatient,,99.02,99.02,,84.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.76,22,,percent of total billed charges,,,,,,,,,89.12,90,,percent of total billed charges,,,81.99,82.8,,percent of total billed charges,,,84.17,85,,percent of total billed charges,,,,,,,,,87.14,88,,percent of total billed charges,,,,,,,,,75.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.76,22,,percent of total billed charges,,,90.11,91,,percent of total billed charges,,,94.07,95,,percent of total billed charges,,,82.19,83,,percent of total billed charges,,,82.19,83,,percent of total billed charges,,,,,,,,,,,,,,,82.19,83,,percent of total billed charges,,,94.07,95,,percent of total billed charges,,,89.12,90,,percent of total billed charges,,,89.12,90,,percent of total billed charges,,,81.2,82,,percent of total billed charges,,,89.12,90,,percent of total billed charges,,,84.17,85,,percent of total billed charges,,24.76,94.07,
NYSTATIN ORAL: 100MU/ML 60ML,32007071,CDM,J8499,HCPCS,250,RC,outpatient,,116.57,116.57,,98.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.14,22,,percent of total billed charges,,,,,,,,,104.91,90,,percent of total billed charges,,,96.52,82.8,,percent of total billed charges,,,99.08,85,,percent of total billed charges,,,,,,,,,102.58,88,,percent of total billed charges,,,,,,,,,89.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.14,22,,percent of total billed charges,,,106.08,91,,percent of total billed charges,,,110.74,95,,percent of total billed charges,,,96.75,83,,percent of total billed charges,,,96.75,83,,percent of total billed charges,,,,,,,,,,,,,,,96.75,83,,percent of total billed charges,,,110.74,95,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,95.59,82,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,99.08,85,,percent of total billed charges,,29.14,110.74,
NYSTATIN/TRIA(MYCOLOG)CREAM:30GM,32007076,CDM,,,250,RC,outpatient,,1350.72,1350.72,,1146.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,337.68,22,,percent of total billed charges,,,,,,,,,1215.65,90,,percent of total billed charges,,,1118.4,82.8,,percent of total billed charges,,,1148.11,85,,percent of total billed charges,,,,,,,,,1188.63,88,,percent of total billed charges,,,,,,,,,1031.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,337.68,22,,percent of total billed charges,,,1229.16,91,,percent of total billed charges,,,1283.18,95,,percent of total billed charges,,,1121.1,83,,percent of total billed charges,,,1121.1,83,,percent of total billed charges,,,,,,,,,,,,,,,1121.1,83,,percent of total billed charges,,,1283.18,95,,percent of total billed charges,,,1215.65,90,,percent of total billed charges,,,1215.65,90,,percent of total billed charges,,,1107.59,82,,percent of total billed charges,,,1215.65,90,,percent of total billed charges,,,1148.11,85,,percent of total billed charges,,337.68,1283.18,
NEO/POLY/GRAM(POLYMYCIN)DROP:10ML,32007081,CDM,,,250,RC,outpatient,,705.73,705.73,,599.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,176.43,22,,percent of total billed charges,,,,,,,,,635.16,90,,percent of total billed charges,,,584.34,82.8,,percent of total billed charges,,,599.87,85,,percent of total billed charges,,,,,,,,,621.04,88,,percent of total billed charges,,,,,,,,,539.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,176.43,22,,percent of total billed charges,,,642.21,91,,percent of total billed charges,,,670.44,95,,percent of total billed charges,,,585.76,83,,percent of total billed charges,,,585.76,83,,percent of total billed charges,,,,,,,,,,,,,,,585.76,83,,percent of total billed charges,,,670.44,95,,percent of total billed charges,,,635.16,90,,percent of total billed charges,,,635.16,90,,percent of total billed charges,,,578.7,82,,percent of total billed charges,,,635.16,90,,percent of total billed charges,,,599.87,85,,percent of total billed charges,,176.43,670.44,
OFLOXACIN (OCUFLOX) EYE DROP : 0.3% 10ML,32007083,CDM,,,250,RC,outpatient,,554.25,554.25,,470.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,138.56,22,,percent of total billed charges,,,,,,,,,498.83,90,,percent of total billed charges,,,458.92,82.8,,percent of total billed charges,,,471.11,85,,percent of total billed charges,,,,,,,,,487.74,88,,percent of total billed charges,,,,,,,,,423.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,138.56,22,,percent of total billed charges,,,504.37,91,,percent of total billed charges,,,526.54,95,,percent of total billed charges,,,460.03,83,,percent of total billed charges,,,460.03,83,,percent of total billed charges,,,,,,,,,,,,,,,460.03,83,,percent of total billed charges,,,526.54,95,,percent of total billed charges,,,498.83,90,,percent of total billed charges,,,498.83,90,,percent of total billed charges,,,454.49,82,,percent of total billed charges,,,498.83,90,,percent of total billed charges,,,471.11,85,,percent of total billed charges,,138.56,526.54,
BETA-CAROTENE(A) WC & E/MIN(OCUVITE)CAP:,32007086,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CLOVE OIL  3.7 ML,32007091,CDM,J3490,HCPCS,250,RC,outpatient,,80.57,80.57,,68.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.14,22,,percent of total billed charges,,,,,,,,,72.51,90,,percent of total billed charges,,,66.71,82.8,,percent of total billed charges,,,68.48,85,,percent of total billed charges,,,,,,,,,70.9,88,,percent of total billed charges,,,,,,,,,61.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.14,22,,percent of total billed charges,,,73.32,91,,percent of total billed charges,,,76.54,95,,percent of total billed charges,,,66.87,83,,percent of total billed charges,,,66.87,83,,percent of total billed charges,,,,,,,,,,,,,,,66.87,83,,percent of total billed charges,,,76.54,95,,percent of total billed charges,,,72.51,90,,percent of total billed charges,,,72.51,90,,percent of total billed charges,,,66.07,82,,percent of total billed charges,,,72.51,90,,percent of total billed charges,,,68.48,85,,percent of total billed charges,,20.14,76.54,
OLIVE OIL  30ML,32007096,CDM,,,250,RC,outpatient,,96.43,96.43,,81.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.11,22,,percent of total billed charges,,,,,,,,,86.79,90,,percent of total billed charges,,,79.84,82.8,,percent of total billed charges,,,81.97,85,,percent of total billed charges,,,,,,,,,84.86,88,,percent of total billed charges,,,,,,,,,73.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.11,22,,percent of total billed charges,,,87.75,91,,percent of total billed charges,,,91.61,95,,percent of total billed charges,,,80.04,83,,percent of total billed charges,,,80.04,83,,percent of total billed charges,,,,,,,,,,,,,,,80.04,83,,percent of total billed charges,,,91.61,95,,percent of total billed charges,,,86.79,90,,percent of total billed charges,,,86.79,90,,percent of total billed charges,,,79.07,82,,percent of total billed charges,,,86.79,90,,percent of total billed charges,,,81.97,85,,percent of total billed charges,,24.11,91.61,
IOHEXOL (OMNIPAQUE) BTL : 300MG/ML,32007101,CDM,,,250,RC,outpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,203.31,22,,percent of total billed charges,,,,,,,,,731.93,90,,percent of total billed charges,,,673.37,82.8,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,203.31,22,,percent of total billed charges,,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,203.31,772.59,
OPIUM/BELLADONNA ALKALOID SUPP : 60-15MG,32007111,CDM,,,250,RC,outpatient,,38.38,38.38,,32.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.6,22,,percent of total billed charges,,,,,,,,,34.54,90,,percent of total billed charges,,,31.78,82.8,,percent of total billed charges,,,32.62,85,,percent of total billed charges,,,,,,,,,33.77,88,,percent of total billed charges,,,,,,,,,29.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.6,22,,percent of total billed charges,,,34.93,91,,percent of total billed charges,,,36.46,95,,percent of total billed charges,,,31.86,83,,percent of total billed charges,,,31.86,83,,percent of total billed charges,,,,,,,,,,,,,,,31.86,83,,percent of total billed charges,,,36.46,95,,percent of total billed charges,,,34.54,90,,percent of total billed charges,,,34.54,90,,percent of total billed charges,,,31.47,82,,percent of total billed charges,,,34.54,90,,percent of total billed charges,,,32.62,85,,percent of total billed charges,,9.6,36.46,
IPODATE (ORAGRAFIN) CAP : 500MG    6'S,32007116,CDM,,,250,RC,outpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.63,22,,percent of total billed charges,,,,,,,,,182.28,90,,percent of total billed charges,,,167.69,82.8,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.63,22,,percent of total billed charges,,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,50.63,192.4,
IPODATE SODIUM (ORAGRAFIN) CAP : 500MG,32007121,CDM,,,250,RC,outpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.63,22,,percent of total billed charges,,,,,,,,,182.28,90,,percent of total billed charges,,,167.69,82.8,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.63,22,,percent of total billed charges,,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,50.63,192.4,
BENZOCAINE (ORAJEL) GEL : 10% 10ML,32007126,CDM,,,250,RC,outpatient,,57.89,57.89,,49.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.47,22,,percent of total billed charges,,,,,,,,,52.1,90,,percent of total billed charges,,,47.93,82.8,,percent of total billed charges,,,49.21,85,,percent of total billed charges,,,,,,,,,50.94,88,,percent of total billed charges,,,,,,,,,44.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.47,22,,percent of total billed charges,,,52.68,91,,percent of total billed charges,,,55,95,,percent of total billed charges,,,48.05,83,,percent of total billed charges,,,48.05,83,,percent of total billed charges,,,,,,,,,,,,,,,48.05,83,,percent of total billed charges,,,55,95,,percent of total billed charges,,,52.1,90,,percent of total billed charges,,,52.1,90,,percent of total billed charges,,,47.47,82,,percent of total billed charges,,,52.1,90,,percent of total billed charges,,,49.21,85,,percent of total billed charges,,14.47,55,
MORPHINE SULF(ORAMORPH)ER TAB:100MG,32007127,CDM,,,250,RC,outpatient,,61.22,61.22,,51.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.31,22,,percent of total billed charges,,,,,,,,,55.1,90,,percent of total billed charges,,,50.69,82.8,,percent of total billed charges,,,52.04,85,,percent of total billed charges,,,,,,,,,53.87,88,,percent of total billed charges,,,,,,,,,46.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.31,22,,percent of total billed charges,,,55.71,91,,percent of total billed charges,,,58.16,95,,percent of total billed charges,,,50.81,83,,percent of total billed charges,,,50.81,83,,percent of total billed charges,,,,,,,,,,,,,,,50.81,83,,percent of total billed charges,,,58.16,95,,percent of total billed charges,,,55.1,90,,percent of total billed charges,,,55.1,90,,percent of total billed charges,,,50.2,82,,percent of total billed charges,,,55.1,90,,percent of total billed charges,,,52.04,85,,percent of total billed charges,,15.31,58.16,
HYDROCHLOROTHIAZIDE TAB:25MG,32007131,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
POLIOMYELITIS VACCINE(ORIMUNE DISPET)PIP,32007166,CDM,90712,CPT,636,RC,outpatient,,275.01,275.01,,233.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.75,22,,percent of total billed charges,,,,,,,,,247.51,90,,percent of total billed charges,,,227.71,82.8,,percent of total billed charges,,,233.76,85,,percent of total billed charges,,,,,,,,,242.01,88,,percent of total billed charges,,,,,,,,,210.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.75,22,,percent of total billed charges,,,250.26,91,,percent of total billed charges,,,261.26,95,,percent of total billed charges,,,228.26,83,,percent of total billed charges,,,228.26,83,,percent of total billed charges,,,,,,,,,,,,,,,228.26,83,,percent of total billed charges,,,261.26,95,,percent of total billed charges,,,247.51,90,,percent of total billed charges,,,247.51,90,,percent of total billed charges,,,225.51,82,,percent of total billed charges,,,247.51,90,,percent of total billed charges,,,233.76,85,,percent of total billed charges,,68.75,261.26,
DIENESTROL CREAM : 0.01% CREAM 78 GM,32007171,CDM,,,250,RC,outpatient,,406.17,406.17,,344.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.54,22,,percent of total billed charges,,,,,,,,,365.55,90,,percent of total billed charges,,,336.31,82.8,,percent of total billed charges,,,345.24,85,,percent of total billed charges,,,,,,,,,357.43,88,,percent of total billed charges,,,,,,,,,310.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.54,22,,percent of total billed charges,,,369.61,91,,percent of total billed charges,,,385.86,95,,percent of total billed charges,,,337.12,83,,percent of total billed charges,,,337.12,83,,percent of total billed charges,,,,,,,,,,,,,,,337.12,83,,percent of total billed charges,,,385.86,95,,percent of total billed charges,,,365.55,90,,percent of total billed charges,,,365.55,90,,percent of total billed charges,,,333.06,82,,percent of total billed charges,,,365.55,90,,percent of total billed charges,,,345.24,85,,percent of total billed charges,,101.54,385.86,
OTOGESIC (AMERICAINE),32007172,CDM,,,250,RC,outpatient,,20,20,,16.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5,22,,percent of total billed charges,,,,,,,,,18,90,,percent of total billed charges,,,16.56,82.8,,percent of total billed charges,,,17,85,,percent of total billed charges,,,,,,,,,17.6,88,,percent of total billed charges,,,,,,,,,15.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5,22,,percent of total billed charges,,,18.2,91,,percent of total billed charges,,,19,95,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,,,,,,,,,,,,,16.6,83,,percent of total billed charges,,,19,95,,percent of total billed charges,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,16.4,82,,percent of total billed charges,,,18,90,,percent of total billed charges,,,17,85,,percent of total billed charges,,5,19,
OXAZEPAM (SERAX) CAP : 15MG,32007186,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
OXAZEPAM (SERAX) CAP : 30MG,32007191,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
OXAZEPAM(SERAX)CAP:10MG,32007196,CDM,J8499,HCPCS,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
OXISTAT CREAM,32007197,CDM,,,250,RC,outpatient,,80.5,80.5,,68.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.13,22,,percent of total billed charges,,,,,,,,,72.45,90,,percent of total billed charges,,,66.65,82.8,,percent of total billed charges,,,68.43,85,,percent of total billed charges,,,,,,,,,70.84,88,,percent of total billed charges,,,,,,,,,61.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.13,22,,percent of total billed charges,,,73.26,91,,percent of total billed charges,,,76.48,95,,percent of total billed charges,,,66.82,83,,percent of total billed charges,,,66.82,83,,percent of total billed charges,,,,,,,,,,,,,,,66.82,83,,percent of total billed charges,,,76.48,95,,percent of total billed charges,,,72.45,90,,percent of total billed charges,,,72.45,90,,percent of total billed charges,,,66.01,82,,percent of total billed charges,,,72.45,90,,percent of total billed charges,,,68.43,85,,percent of total billed charges,,20.13,76.48,
OXISTAT 1% CM,32007198,CDM,,,250,RC,outpatient,,39,39,,33.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.75,22,,percent of total billed charges,,,,,,,,,35.1,90,,percent of total billed charges,,,32.29,82.8,,percent of total billed charges,,,33.15,85,,percent of total billed charges,,,,,,,,,34.32,88,,percent of total billed charges,,,,,,,,,29.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.75,22,,percent of total billed charges,,,35.49,91,,percent of total billed charges,,,37.05,95,,percent of total billed charges,,,32.37,83,,percent of total billed charges,,,32.37,83,,percent of total billed charges,,,,,,,,,,,,,,,32.37,83,,percent of total billed charges,,,37.05,95,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,31.98,82,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,33.15,85,,percent of total billed charges,,9.75,37.05,
OXYTOCIN(PITOCIN)VIAL:10UNIT/ML,32007199,CDM,J2590,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,2.57,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.57,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,2.57,60.99,
oxyCODONE (oxyCONTIN) ER TAB:20MG,32007200,CDM,,,250,RC,outpatient,,104.99,104.99,,89.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.25,22,,percent of total billed charges,,,,,,,,,94.49,90,,percent of total billed charges,,,86.93,82.8,,percent of total billed charges,,,89.24,85,,percent of total billed charges,,,,,,,,,92.39,88,,percent of total billed charges,,,,,,,,,80.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.25,22,,percent of total billed charges,,,95.54,91,,percent of total billed charges,,,99.74,95,,percent of total billed charges,,,87.14,83,,percent of total billed charges,,,87.14,83,,percent of total billed charges,,,,,,,,,,,,,,,87.14,83,,percent of total billed charges,,,99.74,95,,percent of total billed charges,,,94.49,90,,percent of total billed charges,,,94.49,90,,percent of total billed charges,,,86.09,82,,percent of total billed charges,,,94.49,90,,percent of total billed charges,,,89.24,85,,percent of total billed charges,,26.25,99.74,
OXYBUTYNIN(DITROPAN)TAB:5MG,32007201,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
OXYCODONE (OXYCONTIN CR) TAB : 80MG,32007202,CDM,,,250,RC,outpatient,,150.83,150.83,,128.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.71,22,,percent of total billed charges,,,,,,,,,135.75,90,,percent of total billed charges,,,124.89,82.8,,percent of total billed charges,,,128.21,85,,percent of total billed charges,,,,,,,,,132.73,88,,percent of total billed charges,,,,,,,,,115.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.71,22,,percent of total billed charges,,,137.26,91,,percent of total billed charges,,,143.29,95,,percent of total billed charges,,,125.19,83,,percent of total billed charges,,,125.19,83,,percent of total billed charges,,,,,,,,,,,,,,,125.19,83,,percent of total billed charges,,,143.29,95,,percent of total billed charges,,,135.75,90,,percent of total billed charges,,,135.75,90,,percent of total billed charges,,,123.68,82,,percent of total billed charges,,,135.75,90,,percent of total billed charges,,,128.21,85,,percent of total billed charges,,37.71,143.29,
OYSTER SHELL(OSCAL)TAB:1.25GM (500MG),32007207,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CALCIUM CARB(OSCAL+D) TAB : 250MG-125,32007211,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PANCREATIC ENZYME(PANCRELIPASE DR) CAPS:,32007216,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PANCURONIUM(PAVULON)VIAL:10MG/10ML,32007221,CDM,,,250,RC,outpatient,,90.72,90.72,,77.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.68,22,,percent of total billed charges,,,,,,,,,81.65,90,,percent of total billed charges,,,75.12,82.8,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,,,,,,,,79.83,88,,percent of total billed charges,,,,,,,,,69.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.68,22,,percent of total billed charges,,,82.56,91,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,,,,,,,,,,,,,,75.3,83,,percent of total billed charges,,,86.18,95,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,74.39,82,,percent of total billed charges,,,81.65,90,,percent of total billed charges,,,77.11,85,,percent of total billed charges,,22.68,86.18,
PAPAVERINE (PAVABID) CAP : 150MG,32007226,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
CARBOplatin(PARAPLATIN)MDV:50MG/5ML J/50,32007241,CDM,J9045,HCPCS,636,RC,outpatient,,137.35,137.35,,116.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.34,22,,percent of total billed charges,,,,,,,,,123.62,90,,percent of total billed charges,,,113.73,82.8,,percent of total billed charges,,,116.75,85,,percent of total billed charges,,,,,,,,,120.87,88,,percent of total billed charges,,48.01,,,,fee schedule,,,104.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,48.01,,,,fee schedule,,,34.34,22,,percent of total billed charges,,,124.99,91,,percent of total billed charges,,,130.48,95,,percent of total billed charges,,,114,83,,percent of total billed charges,,,114,83,,percent of total billed charges,,,,,,,,,,,,,,,114,83,,percent of total billed charges,,,130.48,95,,percent of total billed charges,,,123.62,90,,percent of total billed charges,,,123.62,90,,percent of total billed charges,,,112.63,82,,percent of total billed charges,,,123.62,90,,percent of total billed charges,,,116.75,85,,percent of total billed charges,,34.34,130.48,
PAROXETINE HCL (PAXIL) TAB : 20MG,32007261,CDM,,,250,RC,outpatient,,52.34,52.34,,44.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.09,22,,percent of total billed charges,,,,,,,,,47.11,90,,percent of total billed charges,,,43.34,82.8,,percent of total billed charges,,,44.49,85,,percent of total billed charges,,,,,,,,,46.06,88,,percent of total billed charges,,,,,,,,,39.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.09,22,,percent of total billed charges,,,47.63,91,,percent of total billed charges,,,49.72,95,,percent of total billed charges,,,43.44,83,,percent of total billed charges,,,43.44,83,,percent of total billed charges,,,,,,,,,,,,,,,43.44,83,,percent of total billed charges,,,49.72,95,,percent of total billed charges,,,47.11,90,,percent of total billed charges,,,47.11,90,,percent of total billed charges,,,42.92,82,,percent of total billed charges,,,47.11,90,,percent of total billed charges,,,44.49,85,,percent of total billed charges,,13.09,49.72,
ERYTHROMYCIN BASE(ERY-TAB)TAB:333MG,32007271,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PREDNISOLONE(PEDIAPRED)SOL 5MG/5ML 120ML,32007281,CDM,,,250,RC,outpatient,,1051.81,1051.81,,892.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,262.95,22,,percent of total billed charges,,,,,,,,,946.63,90,,percent of total billed charges,,,870.9,82.8,,percent of total billed charges,,,894.04,85,,percent of total billed charges,,,,,,,,,925.59,88,,percent of total billed charges,,,,,,,,,803.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,262.95,22,,percent of total billed charges,,,957.15,91,,percent of total billed charges,,,999.22,95,,percent of total billed charges,,,873,83,,percent of total billed charges,,,873,83,,percent of total billed charges,,,,,,,,,,,,,,,873,83,,percent of total billed charges,,,999.22,95,,percent of total billed charges,,,946.63,90,,percent of total billed charges,,,946.63,90,,percent of total billed charges,,,862.48,82,,percent of total billed charges,,,946.63,90,,percent of total billed charges,,,894.04,85,,percent of total billed charges,,262.95,999.22,
predNISOLONE (PEDIAPRED) 5MG/5ML 60ML,32007282,CDM,,,250,RC,outpatient,,620.6,620.6,,526.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,155.15,22,,percent of total billed charges,,,,,,,,,558.54,90,,percent of total billed charges,,,513.86,82.8,,percent of total billed charges,,,527.51,85,,percent of total billed charges,,,,,,,,,546.13,88,,percent of total billed charges,,,,,,,,,474.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,155.15,22,,percent of total billed charges,,,564.75,91,,percent of total billed charges,,,589.57,95,,percent of total billed charges,,,515.1,83,,percent of total billed charges,,,515.1,83,,percent of total billed charges,,,,,,,,,,,,,,,515.1,83,,percent of total billed charges,,,589.57,95,,percent of total billed charges,,,558.54,90,,percent of total billed charges,,,558.54,90,,percent of total billed charges,,,508.89,82,,percent of total billed charges,,,558.54,90,,percent of total billed charges,,,527.51,85,,percent of total billed charges,,155.15,589.57,
EES/SULF(PEDIAZOLE):200-600/5M  (100ML),32007286,CDM,,,250,RC,outpatient,,229.18,229.18,,194.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.3,22,,percent of total billed charges,,,,,,,,,206.26,90,,percent of total billed charges,,,189.76,82.8,,percent of total billed charges,,,194.8,85,,percent of total billed charges,,,,,,,,,201.68,88,,percent of total billed charges,,,,,,,,,175.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.3,22,,percent of total billed charges,,,208.55,91,,percent of total billed charges,,,217.72,95,,percent of total billed charges,,,190.22,83,,percent of total billed charges,,,190.22,83,,percent of total billed charges,,,,,,,,,,,,,,,190.22,83,,percent of total billed charges,,,217.72,95,,percent of total billed charges,,,206.26,90,,percent of total billed charges,,,206.26,90,,percent of total billed charges,,,187.93,82,,percent of total billed charges,,,206.26,90,,percent of total billed charges,,,194.8,85,,percent of total billed charges,,57.3,217.72,
PREDnisolone(PEDIAPRED) SOL 5MG/5ML 30ML,32007291,CDM,,,250,RC,outpatient,,310.22,310.22,,263.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.56,22,,percent of total billed charges,,,,,,,,,279.2,90,,percent of total billed charges,,,256.86,82.8,,percent of total billed charges,,,263.69,85,,percent of total billed charges,,,,,,,,,272.99,88,,percent of total billed charges,,,,,,,,,237.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.56,22,,percent of total billed charges,,,282.3,91,,percent of total billed charges,,,294.71,95,,percent of total billed charges,,,257.48,83,,percent of total billed charges,,,257.48,83,,percent of total billed charges,,,,,,,,,,,,,,,257.48,83,,percent of total billed charges,,,294.71,95,,percent of total billed charges,,,279.2,90,,percent of total billed charges,,,279.2,90,,percent of total billed charges,,,254.38,82,,percent of total billed charges,,,279.2,90,,percent of total billed charges,,,263.69,85,,percent of total billed charges,,77.56,294.71,
PEN G POTAS(PFIZERPEN) VIAL : 1 MIL UNIT,32007296,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
PEN G POTAS(PFIZERPEN) VIAL:  5 MIL UNIT,32007301,CDM,,,250,RC,outpatient,,118,118,,100.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.5,22,,percent of total billed charges,,,,,,,,,106.2,90,,percent of total billed charges,,,97.7,82.8,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,,,,,,,,103.84,88,,percent of total billed charges,,,,,,,,,90.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.5,22,,percent of total billed charges,,,107.38,91,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,,,,,,,,,,,,,97.94,83,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,96.76,82,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,29.5,112.1,
PENICILLIN G POTAS VIAL: 5 MIL UNITS,32007302,CDM,,,250,RC,outpatient,,152.89,152.89,,129.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.22,22,,percent of total billed charges,,,,,,,,,137.6,90,,percent of total billed charges,,,126.59,82.8,,percent of total billed charges,,,129.96,85,,percent of total billed charges,,,,,,,,,134.54,88,,percent of total billed charges,,,,,,,,,116.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.22,22,,percent of total billed charges,,,139.13,91,,percent of total billed charges,,,145.25,95,,percent of total billed charges,,,126.9,83,,percent of total billed charges,,,126.9,83,,percent of total billed charges,,,,,,,,,,,,,,,126.9,83,,percent of total billed charges,,,145.25,95,,percent of total billed charges,,,137.6,90,,percent of total billed charges,,,137.6,90,,percent of total billed charges,,,125.37,82,,percent of total billed charges,,,137.6,90,,percent of total billed charges,,,129.96,85,,percent of total billed charges,,38.22,145.25,
PEN G POTAS(PFIZERPEN) VIAL : 10MIL UNIT,32007306,CDM,,,250,RC,outpatient,,84.53,84.53,,71.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.13,22,,percent of total billed charges,,,,,,,,,76.08,90,,percent of total billed charges,,,69.99,82.8,,percent of total billed charges,,,71.85,85,,percent of total billed charges,,,,,,,,,74.39,88,,percent of total billed charges,,,,,,,,,64.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.13,22,,percent of total billed charges,,,76.92,91,,percent of total billed charges,,,80.3,95,,percent of total billed charges,,,70.16,83,,percent of total billed charges,,,70.16,83,,percent of total billed charges,,,,,,,,,,,,,,,70.16,83,,percent of total billed charges,,,80.3,95,,percent of total billed charges,,,76.08,90,,percent of total billed charges,,,76.08,90,,percent of total billed charges,,,69.31,82,,percent of total billed charges,,,76.08,90,,percent of total billed charges,,,71.85,85,,percent of total billed charges,,21.13,80.3,
PENICILLIN V POTASSIUM TAB:500MG,32007311,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PENICILLIN V POTASSIUM TAB:250MG,32007316,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
MESALAMINE (PENTASA) CAP : 250MG,32007321,CDM,,,250,RC,outpatient,,9,9,,7.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.25,22,,percent of total billed charges,,,,,,,,,8.1,90,,percent of total billed charges,,,7.45,82.8,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,,,,,,,,7.92,88,,percent of total billed charges,,,,,,,,,6.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.25,22,,percent of total billed charges,,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.38,82,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,2.25,8.55,
FAMOTIDINE(PEPCID)TAB:20MG,32007331,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FAMOTIDINE(PEPCID)VIAL:20MG/2ML,32007332,CDM,J3490,HCPCS,636,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
OXYCOD/ASPIR(PERCODAN) TAB:4.88-325MG,32007336,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
PERGOLIDE (PERMAX) TAB : 0.05MG,32007346,CDM,,,250,RC,outpatient,,13.96,13.96,,11.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.49,22,,percent of total billed charges,,,,,,,,,12.56,90,,percent of total billed charges,,,11.56,82.8,,percent of total billed charges,,,11.87,85,,percent of total billed charges,,,,,,,,,12.28,88,,percent of total billed charges,,,,,,,,,10.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.49,22,,percent of total billed charges,,,12.7,91,,percent of total billed charges,,,13.26,95,,percent of total billed charges,,,11.59,83,,percent of total billed charges,,,11.59,83,,percent of total billed charges,,,,,,,,,,,,,,,11.59,83,,percent of total billed charges,,,13.26,95,,percent of total billed charges,,,12.56,90,,percent of total billed charges,,,12.56,90,,percent of total billed charges,,,11.45,82,,percent of total billed charges,,,12.56,90,,percent of total billed charges,,,11.87,85,,percent of total billed charges,,3.49,13.26,
PERPHENAZINE (TRILIFON) TAB : 2MG,32007351,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
DIPYRIDAMOLE (PERSANTINE):10mg/2ml,32007352,CDM,J1245,HCPCS,636,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,22.18,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,22.18,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
PAPAIN/UREA/CHLRPH(PANAFL)OINT:30G,32007357,CDM,,,250,RC,outpatient,,986.5,986.5,,837.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,246.63,22,,percent of total billed charges,,,,,,,,,887.85,90,,percent of total billed charges,,,816.82,82.8,,percent of total billed charges,,,838.53,85,,percent of total billed charges,,,,,,,,,868.12,88,,percent of total billed charges,,,,,,,,,753.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,246.63,22,,percent of total billed charges,,,897.72,91,,percent of total billed charges,,,937.18,95,,percent of total billed charges,,,818.8,83,,percent of total billed charges,,,818.8,83,,percent of total billed charges,,,,,,,,,,,,,,,818.8,83,,percent of total billed charges,,,937.18,95,,percent of total billed charges,,,887.85,90,,percent of total billed charges,,,887.85,90,,percent of total billed charges,,,808.93,82,,percent of total billed charges,,,887.85,90,,percent of total billed charges,,,838.53,85,,percent of total billed charges,,246.63,937.18,
PETROLATUM WHITE(VASELINE)JEL:75GM,32007361,CDM,J3490,HCPCS,250,RC,outpatient,,26.64,26.64,,22.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.66,22,,percent of total billed charges,,,,,,,,,23.98,90,,percent of total billed charges,,,22.06,82.8,,percent of total billed charges,,,22.64,85,,percent of total billed charges,,,,,,,,,23.44,88,,percent of total billed charges,,,,,,,,,20.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.66,22,,percent of total billed charges,,,24.24,91,,percent of total billed charges,,,25.31,95,,percent of total billed charges,,,22.11,83,,percent of total billed charges,,,22.11,83,,percent of total billed charges,,,,,,,,,,,,,,,22.11,83,,percent of total billed charges,,,25.31,95,,percent of total billed charges,,,23.98,90,,percent of total billed charges,,,23.98,90,,percent of total billed charges,,,21.84,82,,percent of total billed charges,,,23.98,90,,percent of total billed charges,,,22.64,85,,percent of total billed charges,,6.66,25.31,
PETROLATUM WHITE(VASELINE)JEL:U/D,32007366,CDM,,,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
PHENobarbital SODIUM VIAL:130MG/ML,32007381,CDM,,,250,RC,outpatient,,878.3,878.3,,745.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,219.58,22,,percent of total billed charges,,,,,,,,,790.47,90,,percent of total billed charges,,,727.23,82.8,,percent of total billed charges,,,746.56,85,,percent of total billed charges,,,,,,,,,772.9,88,,percent of total billed charges,,,,,,,,,671.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,219.58,22,,percent of total billed charges,,,799.25,91,,percent of total billed charges,,,834.39,95,,percent of total billed charges,,,728.99,83,,percent of total billed charges,,,728.99,83,,percent of total billed charges,,,,,,,,,,,,,,,728.99,83,,percent of total billed charges,,,834.39,95,,percent of total billed charges,,,790.47,90,,percent of total billed charges,,,790.47,90,,percent of total billed charges,,,720.21,82,,percent of total billed charges,,,790.47,90,,percent of total billed charges,,,746.56,85,,percent of total billed charges,,219.58,834.39,
PHENAZOPYRIDINE(PYRIDIUM)TAB:100MG,32007386,CDM,J8499,HCPCS,250,RC,outpatient,,13.89,13.89,,11.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.47,22,,percent of total billed charges,,,,,,,,,12.5,90,,percent of total billed charges,,,11.5,82.8,,percent of total billed charges,,,11.81,85,,percent of total billed charges,,,,,,,,,12.22,88,,percent of total billed charges,,,,,,,,,10.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.47,22,,percent of total billed charges,,,12.64,91,,percent of total billed charges,,,13.2,95,,percent of total billed charges,,,11.53,83,,percent of total billed charges,,,11.53,83,,percent of total billed charges,,,,,,,,,,,,,,,11.53,83,,percent of total billed charges,,,13.2,95,,percent of total billed charges,,,12.5,90,,percent of total billed charges,,,12.5,90,,percent of total billed charges,,,11.39,82,,percent of total billed charges,,,12.5,90,,percent of total billed charges,,,11.81,85,,percent of total billed charges,,3.47,13.2,
PHENYLEPH(NEO-SYNPHRINE)VIAL:10MG/ML,32007391,CDM,J2370,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
PHENYLEPH(NEO-SYNPHRN)DROP 10%(EYE):5ML,32007396,CDM,J3490,HCPCS,250,RC,outpatient,,648.2,648.2,,550.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,162.05,22,,percent of total billed charges,,,,,,,,,583.38,90,,percent of total billed charges,,,536.71,82.8,,percent of total billed charges,,,550.97,85,,percent of total billed charges,,,,,,,,,570.42,88,,percent of total billed charges,,,,,,,,,495.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,162.05,22,,percent of total billed charges,,,589.86,91,,percent of total billed charges,,,615.79,95,,percent of total billed charges,,,538.01,83,,percent of total billed charges,,,538.01,83,,percent of total billed charges,,,,,,,,,,,,,,,538.01,83,,percent of total billed charges,,,615.79,95,,percent of total billed charges,,,583.38,90,,percent of total billed charges,,,583.38,90,,percent of total billed charges,,,531.52,82,,percent of total billed charges,,,583.38,90,,percent of total billed charges,,,550.97,85,,percent of total billed charges,,162.05,615.79,
PHENOL LIQ  500ML,32007401,CDM,,,250,RC,outpatient,,710.57,710.57,,603.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,177.64,22,,percent of total billed charges,,,,,,,,,639.51,90,,percent of total billed charges,,,588.35,82.8,,percent of total billed charges,,,603.98,85,,percent of total billed charges,,,,,,,,,625.3,88,,percent of total billed charges,,,,,,,,,542.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,177.64,22,,percent of total billed charges,,,646.62,91,,percent of total billed charges,,,675.04,95,,percent of total billed charges,,,589.77,83,,percent of total billed charges,,,589.77,83,,percent of total billed charges,,,,,,,,,,,,,,,589.77,83,,percent of total billed charges,,,675.04,95,,percent of total billed charges,,,639.51,90,,percent of total billed charges,,,639.51,90,,percent of total billed charges,,,582.67,82,,percent of total billed charges,,,639.51,90,,percent of total billed charges,,,603.98,85,,percent of total billed charges,,177.64,675.04,
PROMETHAZINE(PHENERGAN)SUPP:12.5MG,32007406,CDM,J3490,HCPCS,250,RC,outpatient,,167.16,167.16,,141.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.79,22,,percent of total billed charges,,,,,,,,,150.44,90,,percent of total billed charges,,,138.41,82.8,,percent of total billed charges,,,142.09,85,,percent of total billed charges,,,,,,,,,147.1,88,,percent of total billed charges,,,,,,,,,127.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.79,22,,percent of total billed charges,,,152.12,91,,percent of total billed charges,,,158.8,95,,percent of total billed charges,,,138.74,83,,percent of total billed charges,,,138.74,83,,percent of total billed charges,,,,,,,,,,,,,,,138.74,83,,percent of total billed charges,,,158.8,95,,percent of total billed charges,,,150.44,90,,percent of total billed charges,,,150.44,90,,percent of total billed charges,,,137.07,82,,percent of total billed charges,,,150.44,90,,percent of total billed charges,,,142.09,85,,percent of total billed charges,,41.79,158.8,
PHENOL LIQ  500ML,32007411,CDM,,,250,RC,outpatient,,50.28,50.28,,42.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.57,22,,percent of total billed charges,,,,,,,,,45.25,90,,percent of total billed charges,,,41.63,82.8,,percent of total billed charges,,,42.74,85,,percent of total billed charges,,,,,,,,,44.25,88,,percent of total billed charges,,,,,,,,,38.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.57,22,,percent of total billed charges,,,45.75,91,,percent of total billed charges,,,47.77,95,,percent of total billed charges,,,41.73,83,,percent of total billed charges,,,41.73,83,,percent of total billed charges,,,,,,,,,,,,,,,41.73,83,,percent of total billed charges,,,47.77,95,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,41.23,82,,percent of total billed charges,,,45.25,90,,percent of total billed charges,,,42.74,85,,percent of total billed charges,,12.57,47.77,
PROMETHAZINE(PHENERGAN)SUPP:25MG,32007431,CDM,J3490,HCPCS,250,RC,outpatient,,54.09,54.09,,45.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.52,22,,percent of total billed charges,,,,,,,,,48.68,90,,percent of total billed charges,,,44.79,82.8,,percent of total billed charges,,,45.98,85,,percent of total billed charges,,,,,,,,,47.6,88,,percent of total billed charges,,,,,,,,,41.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.52,22,,percent of total billed charges,,,49.22,91,,percent of total billed charges,,,51.39,95,,percent of total billed charges,,,44.89,83,,percent of total billed charges,,,44.89,83,,percent of total billed charges,,,,,,,,,,,,,,,44.89,83,,percent of total billed charges,,,51.39,95,,percent of total billed charges,,,48.68,90,,percent of total billed charges,,,48.68,90,,percent of total billed charges,,,44.35,82,,percent of total billed charges,,,48.68,90,,percent of total billed charges,,,45.98,85,,percent of total billed charges,,13.52,51.39,
PROMETHAZINE(PHENERGAN)TAB:25MG,32007432,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PROMETHAZINE(PHENERGAN)TAB:25MG (1x6),32007433,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PHENAZOPYRIDINE(PYRIDIUM) TAB : 200MG,32007436,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PHENAZOPYRIDI(PYRIDIUM) TAB :200MG (1X6),32007437,CDM,,,250,RC,outpatient,,16.49,16.49,,14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.12,22,,percent of total billed charges,,,,,,,,,14.84,90,,percent of total billed charges,,,13.65,82.8,,percent of total billed charges,,,14.02,85,,percent of total billed charges,,,,,,,,,14.51,88,,percent of total billed charges,,,,,,,,,12.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.12,22,,percent of total billed charges,,,15.01,91,,percent of total billed charges,,,15.67,95,,percent of total billed charges,,,13.69,83,,percent of total billed charges,,,13.69,83,,percent of total billed charges,,,,,,,,,,,,,,,13.69,83,,percent of total billed charges,,,15.67,95,,percent of total billed charges,,,14.84,90,,percent of total billed charges,,,14.84,90,,percent of total billed charges,,,13.52,82,,percent of total billed charges,,,14.84,90,,percent of total billed charges,,,14.02,85,,percent of total billed charges,,4.12,15.67,
PHISODERM LOTION 6 OZ,32007452,CDM,,,250,RC,outpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3,22,,percent of total billed charges,,,,,,,,,10.8,90,,percent of total billed charges,,,9.94,82.8,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3,22,,percent of total billed charges,,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,3,11.4,
PHOSPHO SODA(FLEET-ORAL):45ML,32007456,CDM,,,250,RC,outpatient,,43.3,43.3,,36.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.83,22,,percent of total billed charges,,,,,,,,,38.97,90,,percent of total billed charges,,,35.85,82.8,,percent of total billed charges,,,36.81,85,,percent of total billed charges,,,,,,,,,38.1,88,,percent of total billed charges,,,,,,,,,33.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.83,22,,percent of total billed charges,,,39.4,91,,percent of total billed charges,,,41.14,95,,percent of total billed charges,,,35.94,83,,percent of total billed charges,,,35.94,83,,percent of total billed charges,,,,,,,,,,,,,,,35.94,83,,percent of total billed charges,,,41.14,95,,percent of total billed charges,,,38.97,90,,percent of total billed charges,,,38.97,90,,percent of total billed charges,,,35.51,82,,percent of total billed charges,,,38.97,90,,percent of total billed charges,,,36.81,85,,percent of total billed charges,,10.83,41.14,
PHENobarbital TAB:15MG,32007466,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
PHENobarbital ELIX UD: 20MG/5ML,32007471,CDM,J8499,HCPCS,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
PHENobarbital ELIX:20MG/5ML 60ML,32007476,CDM,J8499,HCPCS,250,RC,outpatient,,89.77,89.77,,76.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.44,22,,percent of total billed charges,,,,,,,,,80.79,90,,percent of total billed charges,,,74.33,82.8,,percent of total billed charges,,,76.3,85,,percent of total billed charges,,,,,,,,,79,88,,percent of total billed charges,,,,,,,,,68.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.44,22,,percent of total billed charges,,,81.69,91,,percent of total billed charges,,,85.28,95,,percent of total billed charges,,,74.51,83,,percent of total billed charges,,,74.51,83,,percent of total billed charges,,,,,,,,,,,,,,,74.51,83,,percent of total billed charges,,,85.28,95,,percent of total billed charges,,,80.79,90,,percent of total billed charges,,,80.79,90,,percent of total billed charges,,,73.61,82,,percent of total billed charges,,,80.79,90,,percent of total billed charges,,,76.3,85,,percent of total billed charges,,22.44,85.28,
PHENobarbital ELIX:20MG/5ML 480ML,32007481,CDM,,,250,RC,outpatient,,134.65,134.65,,114.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.66,22,,percent of total billed charges,,,,,,,,,121.19,90,,percent of total billed charges,,,111.49,82.8,,percent of total billed charges,,,114.45,85,,percent of total billed charges,,,,,,,,,118.49,88,,percent of total billed charges,,,,,,,,,102.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.66,22,,percent of total billed charges,,,122.53,91,,percent of total billed charges,,,127.92,95,,percent of total billed charges,,,111.76,83,,percent of total billed charges,,,111.76,83,,percent of total billed charges,,,,,,,,,,,,,,,111.76,83,,percent of total billed charges,,,127.92,95,,percent of total billed charges,,,121.19,90,,percent of total billed charges,,,121.19,90,,percent of total billed charges,,,110.41,82,,percent of total billed charges,,,121.19,90,,percent of total billed charges,,,114.45,85,,percent of total billed charges,,33.66,127.92,
PHENOBARBITAL TAB : 60MG,32007486,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
PHENobarbital ELIX:20MG/5ML 480ML,32007491,CDM,,,250,RC,outpatient,,707.36,707.36,,600.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,176.84,22,,percent of total billed charges,,,,,,,,,636.62,90,,percent of total billed charges,,,585.69,82.8,,percent of total billed charges,,,601.26,85,,percent of total billed charges,,,,,,,,,622.48,88,,percent of total billed charges,,,,,,,,,540.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,176.84,22,,percent of total billed charges,,,643.7,91,,percent of total billed charges,,,671.99,95,,percent of total billed charges,,,587.11,83,,percent of total billed charges,,,587.11,83,,percent of total billed charges,,,,,,,,,,,,,,,587.11,83,,percent of total billed charges,,,671.99,95,,percent of total billed charges,,,636.62,90,,percent of total billed charges,,,636.62,90,,percent of total billed charges,,,580.04,82,,percent of total billed charges,,,636.62,90,,percent of total billed charges,,,601.26,85,,percent of total billed charges,,176.84,671.99,
PILOCARPINE DROP 2%:2ML,32007501,CDM,,,250,RC,outpatient,,79.93,79.93,,67.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.98,22,,percent of total billed charges,,,,,,,,,71.94,90,,percent of total billed charges,,,66.18,82.8,,percent of total billed charges,,,67.94,85,,percent of total billed charges,,,,,,,,,70.34,88,,percent of total billed charges,,,,,,,,,61.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.98,22,,percent of total billed charges,,,72.74,91,,percent of total billed charges,,,75.93,95,,percent of total billed charges,,,66.34,83,,percent of total billed charges,,,66.34,83,,percent of total billed charges,,,,,,,,,,,,,,,66.34,83,,percent of total billed charges,,,75.93,95,,percent of total billed charges,,,71.94,90,,percent of total billed charges,,,71.94,90,,percent of total billed charges,,,65.54,82,,percent of total billed charges,,,71.94,90,,percent of total billed charges,,,67.94,85,,percent of total billed charges,,19.98,75.93,
PILOCARPINE(PILOPINE HS)GEL 4%:4ML,32007506,CDM,,,250,RC,outpatient,,1287.69,1287.69,,1093.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,321.92,22,,percent of total billed charges,,,,,,,,,1158.92,90,,percent of total billed charges,,,1066.21,82.8,,percent of total billed charges,,,1094.54,85,,percent of total billed charges,,,,,,,,,1133.17,88,,percent of total billed charges,,,,,,,,,983.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,321.92,22,,percent of total billed charges,,,1171.8,91,,percent of total billed charges,,,1223.31,95,,percent of total billed charges,,,1068.78,83,,percent of total billed charges,,,1068.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1068.78,83,,percent of total billed charges,,,1223.31,95,,percent of total billed charges,,,1158.92,90,,percent of total billed charges,,,1158.92,90,,percent of total billed charges,,,1055.91,82,,percent of total billed charges,,,1158.92,90,,percent of total billed charges,,,1094.54,85,,percent of total billed charges,,321.92,1223.31,
CILOSTAZOL(PLETAL)TAB:100MG,32007517,CDM,J8499,HCPCS,250,RC,outpatient,UD,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PIROXICAM (FELDENE) CAP : 20MG,32007536,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PIROXICAM(FELDENE)CAP:10MG,32007541,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PITRESSIN,32007551,CDM,,,250,RC,outpatient,,616.16,616.16,,523.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154.04,22,,percent of total billed charges,,,,,,,,,554.54,90,,percent of total billed charges,,,510.18,82.8,,percent of total billed charges,,,523.74,85,,percent of total billed charges,,,,,,,,,542.22,88,,percent of total billed charges,,,,,,,,,470.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154.04,22,,percent of total billed charges,,,560.71,91,,percent of total billed charges,,,585.35,95,,percent of total billed charges,,,511.41,83,,percent of total billed charges,,,511.41,83,,percent of total billed charges,,,,,,,,,,,,,,,511.41,83,,percent of total billed charges,,,585.35,95,,percent of total billed charges,,,554.54,90,,percent of total billed charges,,,554.54,90,,percent of total billed charges,,,505.25,82,,percent of total billed charges,,,554.54,90,,percent of total billed charges,,,523.74,85,,percent of total billed charges,,154.04,585.35,
CLOPIDOGREL(PLAVIX)TAB:75MG,32007572,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FELODIPINE(PLENDIL) E.R. TAB:2.5MG,32007576,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FELODIPINE (PLENDIL) TAB : 5MG,32007581,CDM,,,250,RC,outpatient,,22.84,22.84,,19.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.71,22,,percent of total billed charges,,,,,,,,,20.56,90,,percent of total billed charges,,,18.91,82.8,,percent of total billed charges,,,19.41,85,,percent of total billed charges,,,,,,,,,20.1,88,,percent of total billed charges,,,,,,,,,17.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.71,22,,percent of total billed charges,,,20.78,91,,percent of total billed charges,,,21.7,95,,percent of total billed charges,,,18.96,83,,percent of total billed charges,,,18.96,83,,percent of total billed charges,,,,,,,,,,,,,,,18.96,83,,percent of total billed charges,,,21.7,95,,percent of total billed charges,,,20.56,90,,percent of total billed charges,,,20.56,90,,percent of total billed charges,,,18.73,82,,percent of total billed charges,,,20.56,90,,percent of total billed charges,,,19.41,85,,percent of total billed charges,,5.71,21.7,
PNEUMOCOCCAL(PNEUMOVAX)VIAL:25MCG/0.5ML,32007586,CDM,90732,CPT,636,RC,outpatient,,1675.89,1675.89,,1422.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,418.97,22,,percent of total billed charges,,,,,,,,,1508.3,90,,percent of total billed charges,,,1387.64,82.8,,percent of total billed charges,,,1424.51,85,,percent of total billed charges,,,,,,,,,1474.78,88,,percent of total billed charges,,,,,,,,,1280.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,418.97,22,,percent of total billed charges,,,1525.06,91,,percent of total billed charges,,,1592.1,95,,percent of total billed charges,,,1390.99,83,,percent of total billed charges,,,1390.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1390.99,83,,percent of total billed charges,,,1592.1,95,,percent of total billed charges,,,1508.3,90,,percent of total billed charges,,,1508.3,90,,percent of total billed charges,,,1374.23,82,,percent of total billed charges,,,1508.3,90,,percent of total billed charges,,,1424.51,85,,percent of total billed charges,,418.97,1592.1,
POLIOMYELITIS VAC KILLED(IPOL)SYR 0.5ML,32007587,CDM,90713,CPT,636,RC,outpatient,,422.03,422.03,,358.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,105.51,22,,percent of total billed charges,,,,,,,,,379.83,90,,percent of total billed charges,,,349.44,82.8,,percent of total billed charges,,,358.73,85,,percent of total billed charges,,,,,,,,,371.39,88,,percent of total billed charges,,,,,,,,,322.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,105.51,22,,percent of total billed charges,,,384.05,91,,percent of total billed charges,,,400.93,95,,percent of total billed charges,,,350.28,83,,percent of total billed charges,,,350.28,83,,percent of total billed charges,,,,,,,,,,,,,,,350.28,83,,percent of total billed charges,,,400.93,95,,percent of total billed charges,,,379.83,90,,percent of total billed charges,,,379.83,90,,percent of total billed charges,,,346.06,82,,percent of total billed charges,,,379.83,90,,percent of total billed charges,,,358.73,85,,percent of total billed charges,,105.51,400.93,
PNEUMOCOCC 23(PNEUMOVAX)VIAL:25MCG/0.5ML,32007588,CDM,90732,CPT,636,RC,outpatient,,136.5,136.5,,115.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.13,22,,percent of total billed charges,,,,,,,,,122.85,90,,percent of total billed charges,,,113.02,82.8,,percent of total billed charges,,,116.03,85,,percent of total billed charges,,,,,,,,,120.12,88,,percent of total billed charges,,,,,,,,,104.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.13,22,,percent of total billed charges,,,124.22,91,,percent of total billed charges,,,129.68,95,,percent of total billed charges,,,113.3,83,,percent of total billed charges,,,113.3,83,,percent of total billed charges,,,,,,,,,,,,,,,113.3,83,,percent of total billed charges,,,129.68,95,,percent of total billed charges,,,122.85,90,,percent of total billed charges,,,122.85,90,,percent of total billed charges,,,111.93,82,,percent of total billed charges,,,122.85,90,,percent of total billed charges,,,116.03,85,,percent of total billed charges,,34.13,129.68,
POTASSIUM ACETATE VIAL:40MEQ/20ML,32007591,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
PODOPHYLLUM RESIN(PODOCON-25)LIQ 25% 15M,32007606,CDM,,,250,RC,outpatient,,1382.98,1382.98,,1174.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,345.75,22,,percent of total billed charges,,,,,,,,,1244.68,90,,percent of total billed charges,,,1145.11,82.8,,percent of total billed charges,,,1175.53,85,,percent of total billed charges,,,,,,,,,1217.02,88,,percent of total billed charges,,,,,,,,,1056.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,345.75,22,,percent of total billed charges,,,1258.51,91,,percent of total billed charges,,,1313.83,95,,percent of total billed charges,,,1147.87,83,,percent of total billed charges,,,1147.87,83,,percent of total billed charges,,,,,,,,,,,,,,,1147.87,83,,percent of total billed charges,,,1313.83,95,,percent of total billed charges,,,1244.68,90,,percent of total billed charges,,,1244.68,90,,percent of total billed charges,,,1134.04,82,,percent of total billed charges,,,1244.68,90,,percent of total billed charges,,,1175.53,85,,percent of total billed charges,,345.75,1313.83,
MEPIVACAINE(POLOCAINE) 2% MPF:400MG/20ML,32007611,CDM,J0670,HCPCS,250,RC,outpatient,,125.49,125.49,,106.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.37,22,,percent of total billed charges,,,,,,,,,112.94,90,,percent of total billed charges,,,103.91,82.8,,percent of total billed charges,,,106.67,85,,percent of total billed charges,,,,,,,,,110.43,88,,percent of total billed charges,,,,,,,,,95.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.37,22,,percent of total billed charges,,,114.2,91,,percent of total billed charges,,,119.22,95,,percent of total billed charges,,,104.16,83,,percent of total billed charges,,,104.16,83,,percent of total billed charges,,,,,,,,,,,,,,,104.16,83,,percent of total billed charges,,,119.22,95,,percent of total billed charges,,,112.94,90,,percent of total billed charges,,,112.94,90,,percent of total billed charges,,,102.9,82,,percent of total billed charges,,,112.94,90,,percent of total billed charges,,,106.67,85,,percent of total billed charges,,31.37,119.22,
BACITRACIN/POLYM B(POLYSPORIN)PWD:10GM,32007616,CDM,,,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
AMPicillin-VIAL:500MG,32007626,CDM,J0290,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,3.05,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.05,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,3.05,60.99,
AMPicillin-VIAL:250MG,32007631,CDM,J0290,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,3.05,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.05,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,3.05,60.99,
AMPicillin-VIAL:1GM,32007641,CDM,J0290,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,3.05,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.05,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,3.05,60.99,
AMPicillin-VIAL:2GM,32007646,CDM,J0290,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,3.05,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.05,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,3.05,59.21,
TETRACAINE HCL (PONTOCAINE) SOL:2% 30ML,32007656,CDM,,,250,RC,outpatient,,190.48,190.48,,161.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.62,22,,percent of total billed charges,,,,,,,,,171.43,90,,percent of total billed charges,,,157.72,82.8,,percent of total billed charges,,,161.91,85,,percent of total billed charges,,,,,,,,,167.62,88,,percent of total billed charges,,,,,,,,,145.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.62,22,,percent of total billed charges,,,173.34,91,,percent of total billed charges,,,180.96,95,,percent of total billed charges,,,158.1,83,,percent of total billed charges,,,158.1,83,,percent of total billed charges,,,,,,,,,,,,,,,158.1,83,,percent of total billed charges,,,180.96,95,,percent of total billed charges,,,171.43,90,,percent of total billed charges,,,171.43,90,,percent of total billed charges,,,156.19,82,,percent of total billed charges,,,171.43,90,,percent of total billed charges,,,161.91,85,,percent of total billed charges,,47.62,180.96,
POTASSIUM CHLORIDE (KLOR-CON 8) TAB:8MEQ,32007660,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
POTAS PHOS(KP04)VIAL:45MMOL/15ML,32007661,CDM,J3490,HCPCS,250,RC,outpatient,,615.21,615.21,,522.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153.8,22,,percent of total billed charges,,,,,,,,,553.69,90,,percent of total billed charges,,,509.39,82.8,,percent of total billed charges,,,522.93,85,,percent of total billed charges,,,,,,,,,541.38,88,,percent of total billed charges,,,,,,,,,470.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153.8,22,,percent of total billed charges,,,559.84,91,,percent of total billed charges,,,584.45,95,,percent of total billed charges,,,510.62,83,,percent of total billed charges,,,510.62,83,,percent of total billed charges,,,,,,,,,,,,,,,510.62,83,,percent of total billed charges,,,584.45,95,,percent of total billed charges,,,553.69,90,,percent of total billed charges,,,553.69,90,,percent of total billed charges,,,504.47,82,,percent of total billed charges,,,553.69,90,,percent of total billed charges,,,522.93,85,,percent of total billed charges,,153.8,584.45,
PROMETHAZINE(PHENERGAN)SUPP:50MG,32007666,CDM,J3490,HCPCS,250,RC,outpatient,,378.9,378.9,,321.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94.73,22,,percent of total billed charges,,,,,,,,,341.01,90,,percent of total billed charges,,,313.73,82.8,,percent of total billed charges,,,322.07,85,,percent of total billed charges,,,,,,,,,333.43,88,,percent of total billed charges,,,,,,,,,289.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94.73,22,,percent of total billed charges,,,344.8,91,,percent of total billed charges,,,359.96,95,,percent of total billed charges,,,314.49,83,,percent of total billed charges,,,314.49,83,,percent of total billed charges,,,,,,,,,,,,,,,314.49,83,,percent of total billed charges,,,359.96,95,,percent of total billed charges,,,341.01,90,,percent of total billed charges,,,341.01,90,,percent of total billed charges,,,310.7,82,,percent of total billed charges,,,341.01,90,,percent of total billed charges,,,322.07,85,,percent of total billed charges,,94.73,359.96,
REPAGLINIDE(PRANDIN)TAB:0.5MG,32007672,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PRAVASTATIN(PRAVACHOL)TAB:20MG,32007676,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PRAZOSIN (MINIPRES) CAP : 5MG,32007681,CDM,,,250,RC,outpatient,,47.58,47.58,,40.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.9,22,,percent of total billed charges,,,,,,,,,42.82,90,,percent of total billed charges,,,39.4,82.8,,percent of total billed charges,,,40.44,85,,percent of total billed charges,,,,,,,,,41.87,88,,percent of total billed charges,,,,,,,,,36.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.9,22,,percent of total billed charges,,,43.3,91,,percent of total billed charges,,,45.2,95,,percent of total billed charges,,,39.49,83,,percent of total billed charges,,,39.49,83,,percent of total billed charges,,,,,,,,,,,,,,,39.49,83,,percent of total billed charges,,,45.2,95,,percent of total billed charges,,,42.82,90,,percent of total billed charges,,,42.82,90,,percent of total billed charges,,,39.02,82,,percent of total billed charges,,,42.82,90,,percent of total billed charges,,,40.44,85,,percent of total billed charges,,11.9,45.2,
PRAZOSIN (MINIPRES) CAP : 2MG,32007686,CDM,,,250,RC,outpatient,,28.07,28.07,,23.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.02,22,,percent of total billed charges,,,,,,,,,25.26,90,,percent of total billed charges,,,23.24,82.8,,percent of total billed charges,,,23.86,85,,percent of total billed charges,,,,,,,,,24.7,88,,percent of total billed charges,,,,,,,,,21.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.02,22,,percent of total billed charges,,,25.54,91,,percent of total billed charges,,,26.67,95,,percent of total billed charges,,,23.3,83,,percent of total billed charges,,,23.3,83,,percent of total billed charges,,,,,,,,,,,,,,,23.3,83,,percent of total billed charges,,,26.67,95,,percent of total billed charges,,,25.26,90,,percent of total billed charges,,,25.26,90,,percent of total billed charges,,,23.02,82,,percent of total billed charges,,,25.26,90,,percent of total billed charges,,,23.86,85,,percent of total billed charges,,7.02,26.67,
PRAZOSIN(MINIPRES)CAP:1MG,32007691,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PRED FORTE 1% 5ML,32007692,CDM,,,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PREDNISOLONE ACITATE 1% SOLN 5ML,32007693,CDM,,,250,RC,outpatient,,45.5,45.5,,38.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.38,22,,percent of total billed charges,,,,,,,,,40.95,90,,percent of total billed charges,,,37.67,82.8,,percent of total billed charges,,,38.68,85,,percent of total billed charges,,,,,,,,,40.04,88,,percent of total billed charges,,,,,,,,,34.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.38,22,,percent of total billed charges,,,41.41,91,,percent of total billed charges,,,43.23,95,,percent of total billed charges,,,37.77,83,,percent of total billed charges,,,37.77,83,,percent of total billed charges,,,,,,,,,,,,,,,37.77,83,,percent of total billed charges,,,43.23,95,,percent of total billed charges,,,40.95,90,,percent of total billed charges,,,40.95,90,,percent of total billed charges,,,37.31,82,,percent of total billed charges,,,40.95,90,,percent of total billed charges,,,38.68,85,,percent of total billed charges,,11.38,43.23,
predNISONE ORAL (INTOSOL): 5MG/ML 30ML,32007701,CDM,,,250,RC,outpatient,,1742.76,1742.76,,1479.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,435.69,22,,percent of total billed charges,,,,,,,,,1568.48,90,,percent of total billed charges,,,1443.01,82.8,,percent of total billed charges,,,1481.35,85,,percent of total billed charges,,,,,,,,,1533.63,88,,percent of total billed charges,,,,,,,,,1331.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,435.69,22,,percent of total billed charges,,,1585.91,91,,percent of total billed charges,,,1655.62,95,,percent of total billed charges,,,1446.49,83,,percent of total billed charges,,,1446.49,83,,percent of total billed charges,,,,,,,,,,,,,,,1446.49,83,,percent of total billed charges,,,1655.62,95,,percent of total billed charges,,,1568.48,90,,percent of total billed charges,,,1568.48,90,,percent of total billed charges,,,1429.06,82,,percent of total billed charges,,,1568.48,90,,percent of total billed charges,,,1481.35,85,,percent of total billed charges,,435.69,1655.62,
predniSONE TAB: 5MG,32007706,CDM,J7599,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
predniSONE TAB: 2.5MG,32007707,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
predniSONE TAB:10MG,32007711,CDM,J7599,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
predniSONE TAB:20MG,32007716,CDM,J7599,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
predNISONE TAB : 20MG (1X4),32007717,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
predNISONE TAB : 50MG,32007721,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PRELONE 240ML,32007722,CDM,,,250,RC,outpatient,,215,215,,182.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.75,22,,percent of total billed charges,,,,,,,,,193.5,90,,percent of total billed charges,,,178.02,82.8,,percent of total billed charges,,,182.75,85,,percent of total billed charges,,,,,,,,,189.2,88,,percent of total billed charges,,,,,,,,,164.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.75,22,,percent of total billed charges,,,195.65,91,,percent of total billed charges,,,204.25,95,,percent of total billed charges,,,178.45,83,,percent of total billed charges,,,178.45,83,,percent of total billed charges,,,,,,,,,,,,,,,178.45,83,,percent of total billed charges,,,204.25,95,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,176.3,82,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,182.75,85,,percent of total billed charges,,53.75,204.25,
predniSONE TAB: 1MG,32007723,CDM,J7599,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
predNISOLONE(PRELONE)SYRP : 15MG/5ML 5ML,32007724,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
predNISOLONE(PRELONE) SYRP:15MG/5ML 60ML,32007725,CDM,,,250,RC,outpatient,,46.95,46.95,,39.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.74,22,,percent of total billed charges,,,,,,,,,42.26,90,,percent of total billed charges,,,38.87,82.8,,percent of total billed charges,,,39.91,85,,percent of total billed charges,,,,,,,,,41.32,88,,percent of total billed charges,,,,,,,,,35.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.74,22,,percent of total billed charges,,,42.72,91,,percent of total billed charges,,,44.6,95,,percent of total billed charges,,,38.97,83,,percent of total billed charges,,,38.97,83,,percent of total billed charges,,,,,,,,,,,,,,,38.97,83,,percent of total billed charges,,,44.6,95,,percent of total billed charges,,,42.26,90,,percent of total billed charges,,,42.26,90,,percent of total billed charges,,,38.5,82,,percent of total billed charges,,,42.26,90,,percent of total billed charges,,,39.91,85,,percent of total billed charges,,11.74,44.6,
ESTROGENS CONJUGATED(PREMARIN)VIAL:25MG,32007726,CDM,J1410,HCPCS,636,RC,outpatient,,2512.86,2512.86,,2133.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,628.22,22,,percent of total billed charges,,,,,,,,,2261.57,90,,percent of total billed charges,,,2080.65,82.8,,percent of total billed charges,,,2135.93,85,,percent of total billed charges,,,,,,,,,2211.32,88,,percent of total billed charges,,355.49,,,,fee schedule,,,1919.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,355.49,,,,fee schedule,,,628.22,22,,percent of total billed charges,,,2286.7,91,,percent of total billed charges,,,2387.22,95,,percent of total billed charges,,,2085.67,83,,percent of total billed charges,,,2085.67,83,,percent of total billed charges,,,,,,,,,,,,,,,2085.67,83,,percent of total billed charges,,,2387.22,95,,percent of total billed charges,,,2261.57,90,,percent of total billed charges,,,2261.57,90,,percent of total billed charges,,,2060.55,82,,percent of total billed charges,,,2261.57,90,,percent of total billed charges,,,2135.93,85,,percent of total billed charges,,355.49,2387.22,
ESTROGENS CONJUGATED (PREMARIN)TAB:0.3MG,32007731,CDM,,,250,RC,outpatient,,17.13,17.13,,14.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.28,22,,percent of total billed charges,,,,,,,,,15.42,90,,percent of total billed charges,,,14.18,82.8,,percent of total billed charges,,,14.56,85,,percent of total billed charges,,,,,,,,,15.07,88,,percent of total billed charges,,,,,,,,,13.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.28,22,,percent of total billed charges,,,15.59,91,,percent of total billed charges,,,16.27,95,,percent of total billed charges,,,14.22,83,,percent of total billed charges,,,14.22,83,,percent of total billed charges,,,,,,,,,,,,,,,14.22,83,,percent of total billed charges,,,16.27,95,,percent of total billed charges,,,15.42,90,,percent of total billed charges,,,15.42,90,,percent of total billed charges,,,14.05,82,,percent of total billed charges,,,15.42,90,,percent of total billed charges,,,14.56,85,,percent of total billed charges,,4.28,16.27,
ESTROGEN CONJ(PREMARIN)CR:0.625MG/GM,32007736,CDM,,,250,RC,outpatient,,2665.42,2665.42,,2262.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,666.36,22,,percent of total billed charges,,,,,,,,,2398.88,90,,percent of total billed charges,,,2206.97,82.8,,percent of total billed charges,,,2265.61,85,,percent of total billed charges,,,,,,,,,2345.57,88,,percent of total billed charges,,,,,,,,,2036.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,666.36,22,,percent of total billed charges,,,2425.53,91,,percent of total billed charges,,,2532.15,95,,percent of total billed charges,,,2212.3,83,,percent of total billed charges,,,2212.3,83,,percent of total billed charges,,,,,,,,,,,,,,,2212.3,83,,percent of total billed charges,,,2532.15,95,,percent of total billed charges,,,2398.88,90,,percent of total billed charges,,,2398.88,90,,percent of total billed charges,,,2185.64,82,,percent of total billed charges,,,2398.88,90,,percent of total billed charges,,,2265.61,85,,percent of total billed charges,,666.36,2532.15,
ESTROGEN/M-PROGEST(PREMPRO)TAB:0.625-2.5,32007742,CDM,,,250,RC,outpatient,,42.19,42.19,,35.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.55,22,,percent of total billed charges,,,,,,,,,37.97,90,,percent of total billed charges,,,34.93,82.8,,percent of total billed charges,,,35.86,85,,percent of total billed charges,,,,,,,,,37.13,88,,percent of total billed charges,,,,,,,,,32.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.55,22,,percent of total billed charges,,,38.39,91,,percent of total billed charges,,,40.08,95,,percent of total billed charges,,,35.02,83,,percent of total billed charges,,,35.02,83,,percent of total billed charges,,,,,,,,,,,,,,,35.02,83,,percent of total billed charges,,,40.08,95,,percent of total billed charges,,,37.97,90,,percent of total billed charges,,,37.97,90,,percent of total billed charges,,,34.6,82,,percent of total billed charges,,,37.97,90,,percent of total billed charges,,,35.86,85,,percent of total billed charges,,10.55,40.08,
ESTROGEN/M-PROGEST(PREMPRO)TAB:0.625-5MG,32007743,CDM,,,250,RC,outpatient,,32.51,32.51,,27.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.13,22,,percent of total billed charges,,,,,,,,,29.26,90,,percent of total billed charges,,,26.92,82.8,,percent of total billed charges,,,27.63,85,,percent of total billed charges,,,,,,,,,28.61,88,,percent of total billed charges,,,,,,,,,24.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.13,22,,percent of total billed charges,,,29.58,91,,percent of total billed charges,,,30.88,95,,percent of total billed charges,,,26.98,83,,percent of total billed charges,,,26.98,83,,percent of total billed charges,,,,,,,,,,,,,,,26.98,83,,percent of total billed charges,,,30.88,95,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,26.66,82,,percent of total billed charges,,,29.26,90,,percent of total billed charges,,,27.63,85,,percent of total billed charges,,8.13,30.88,
ESTROGENS CONJUGATD(PREMARIN)TAB:0.625MG,32007746,CDM,J8499,HCPCS,250,RC,outpatient,,103.25,103.25,,87.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.81,22,,percent of total billed charges,,,,,,,,,92.93,90,,percent of total billed charges,,,85.49,82.8,,percent of total billed charges,,,87.76,85,,percent of total billed charges,,,,,,,,,90.86,88,,percent of total billed charges,,,,,,,,,78.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.81,22,,percent of total billed charges,,,93.96,91,,percent of total billed charges,,,98.09,95,,percent of total billed charges,,,85.7,83,,percent of total billed charges,,,85.7,83,,percent of total billed charges,,,,,,,,,,,,,,,85.7,83,,percent of total billed charges,,,98.09,95,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,84.67,82,,percent of total billed charges,,,92.93,90,,percent of total billed charges,,,87.76,85,,percent of total billed charges,,25.81,98.09,
ESTROGENS CONJUGATED(PREMARIN)TAB:1.25MG,32007747,CDM,,,250,RC,outpatient,,17.76,17.76,,15.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.44,22,,percent of total billed charges,,,,,,,,,15.98,90,,percent of total billed charges,,,14.71,82.8,,percent of total billed charges,,,15.1,85,,percent of total billed charges,,,,,,,,,15.63,88,,percent of total billed charges,,,,,,,,,13.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.44,22,,percent of total billed charges,,,16.16,91,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,,,,,,,,,,,,,14.74,83,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,14.56,82,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.1,85,,percent of total billed charges,,4.44,16.87,
VIT/FE FUMAR/FA(PRENATAL 1+1)TAB:,32007751,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
SHARK LIVER OIL/MERC(PREP-H) SALTS SUPP,32007756,CDM,,,250,RC,outpatient,,14.22,14.22,,12.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.56,22,,percent of total billed charges,,,,,,,,,12.8,90,,percent of total billed charges,,,11.77,82.8,,percent of total billed charges,,,12.09,85,,percent of total billed charges,,,,,,,,,12.51,88,,percent of total billed charges,,,,,,,,,10.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.56,22,,percent of total billed charges,,,12.94,91,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,,,,,,,,,,,,,11.8,83,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,11.66,82,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.09,85,,percent of total billed charges,,3.56,13.51,
PHENYLEPH/SHK(FORMULATION R)OINT:30GM,32007761,CDM,J3490,HCPCS,250,RC,outpatient,,116.83,116.83,,99.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.21,22,,percent of total billed charges,,,,,,,,,105.15,90,,percent of total billed charges,,,96.74,82.8,,percent of total billed charges,,,99.31,85,,percent of total billed charges,,,,,,,,,102.81,88,,percent of total billed charges,,,,,,,,,89.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.21,22,,percent of total billed charges,,,106.32,91,,percent of total billed charges,,,110.99,95,,percent of total billed charges,,,96.97,83,,percent of total billed charges,,,96.97,83,,percent of total billed charges,,,,,,,,,,,,,,,96.97,83,,percent of total billed charges,,,110.99,95,,percent of total billed charges,,,105.15,90,,percent of total billed charges,,,105.15,90,,percent of total billed charges,,,95.8,82,,percent of total billed charges,,,105.15,90,,percent of total billed charges,,,99.31,85,,percent of total billed charges,,29.21,110.99,
DINOPROSTONE(PREPIDIL)GEL:0.5MG/3GM,32007766,CDM,,,250,RC,outpatient,,4354.38,4354.38,,3696.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1088.6,22,,percent of total billed charges,,,,,,,,,3918.94,90,,percent of total billed charges,,,3605.43,82.8,,percent of total billed charges,,,3701.22,85,,percent of total billed charges,,,,,,,,,3831.85,88,,percent of total billed charges,,,,,,,,,3326.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1088.6,22,,percent of total billed charges,,,3962.49,91,,percent of total billed charges,,,4136.66,95,,percent of total billed charges,,,3614.14,83,,percent of total billed charges,,,3614.14,83,,percent of total billed charges,,,,,,,,,,,,,,,3614.14,83,,percent of total billed charges,,,4136.66,95,,percent of total billed charges,,,3918.94,90,,percent of total billed charges,,,3918.94,90,,percent of total billed charges,,,3570.59,82,,percent of total billed charges,,,3918.94,90,,percent of total billed charges,,,3701.22,85,,percent of total billed charges,,1088.6,4136.66,
LANSOPRAZOLE (PREVACID) CAP : 15MG,32007771,CDM,,,250,RC,outpatient,,83.26,83.26,,70.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.82,22,,percent of total billed charges,,,,,,,,,74.93,90,,percent of total billed charges,,,68.94,82.8,,percent of total billed charges,,,70.77,85,,percent of total billed charges,,,,,,,,,73.27,88,,percent of total billed charges,,,,,,,,,63.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.82,22,,percent of total billed charges,,,75.77,91,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,,,,,,,,,,,,,69.11,83,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,68.27,82,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,70.77,85,,percent of total billed charges,,20.82,79.1,
LANSOPRAZOLE (PREVACID) CAP : 30MG,32007772,CDM,,,250,RC,outpatient,,83.26,83.26,,70.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.82,22,,percent of total billed charges,,,,,,,,,74.93,90,,percent of total billed charges,,,68.94,82.8,,percent of total billed charges,,,70.77,85,,percent of total billed charges,,,,,,,,,73.27,88,,percent of total billed charges,,,,,,,,,63.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.82,22,,percent of total billed charges,,,75.77,91,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,,,,,,,,,,,,,69.11,83,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,68.27,82,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,70.77,85,,percent of total billed charges,,20.82,79.1,
OMEPRAZOLE(prilLOSEC)CAP:10MG,32007773,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
zz    OMEPRAZOLE (PRILOSEC) CAP : 20MG,32007776,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
OMEPRAZOLE (PRILOSEC) CAP : 40MG,32007777,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
OMEPRAZOLE (PRILOSEC) CAP : 20MG  (1x2),32007778,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
IMIPENEM/CILASTN SOD(PRIMAXIN)VIAL:500MG,32007786,CDM,J0743,HCPCS,250,RC,outpatient,,150.65,150.65,,127.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.66,22,,percent of total billed charges,,,,,,,,,135.59,90,,percent of total billed charges,,,124.74,82.8,,percent of total billed charges,,,128.05,85,,percent of total billed charges,,,,,,,,,132.57,88,,percent of total billed charges,,32.74,,,,fee schedule,,,115.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,32.74,,,,fee schedule,,,37.66,22,,percent of total billed charges,,,137.09,91,,percent of total billed charges,,,143.12,95,,percent of total billed charges,,,125.04,83,,percent of total billed charges,,,125.04,83,,percent of total billed charges,,,,,,,,,,,,,,,125.04,83,,percent of total billed charges,,,143.12,95,,percent of total billed charges,,,135.59,90,,percent of total billed charges,,,135.59,90,,percent of total billed charges,,,123.53,82,,percent of total billed charges,,,135.59,90,,percent of total billed charges,,,128.05,85,,percent of total billed charges,,32.74,143.12,
PRIMAXIN 250 MG IV,32007787,CDM,,,250,RC,outpatient,,44.5,44.5,,37.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.13,22,,percent of total billed charges,,,,,,,,,40.05,90,,percent of total billed charges,,,36.85,82.8,,percent of total billed charges,,,37.83,85,,percent of total billed charges,,,,,,,,,39.16,88,,percent of total billed charges,,,,,,,,,34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.13,22,,percent of total billed charges,,,40.5,91,,percent of total billed charges,,,42.28,95,,percent of total billed charges,,,36.94,83,,percent of total billed charges,,,36.94,83,,percent of total billed charges,,,,,,,,,,,,,,,36.94,83,,percent of total billed charges,,,42.28,95,,percent of total billed charges,,,40.05,90,,percent of total billed charges,,,40.05,90,,percent of total billed charges,,,36.49,82,,percent of total billed charges,,,40.05,90,,percent of total billed charges,,,37.83,85,,percent of total billed charges,,11.13,42.28,
AMPicillin(PRNCIPEN)SUS:125MG/5ML(100ML),32007791,CDM,,,250,RC,outpatient,,53.61,53.61,,45.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.4,22,,percent of total billed charges,,,,,,,,,48.25,90,,percent of total billed charges,,,44.39,82.8,,percent of total billed charges,,,45.57,85,,percent of total billed charges,,,,,,,,,47.18,88,,percent of total billed charges,,,,,,,,,40.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.4,22,,percent of total billed charges,,,48.79,91,,percent of total billed charges,,,50.93,95,,percent of total billed charges,,,44.5,83,,percent of total billed charges,,,44.5,83,,percent of total billed charges,,,,,,,,,,,,,,,44.5,83,,percent of total billed charges,,,50.93,95,,percent of total billed charges,,,48.25,90,,percent of total billed charges,,,48.25,90,,percent of total billed charges,,,43.96,82,,percent of total billed charges,,,48.25,90,,percent of total billed charges,,,45.57,85,,percent of total billed charges,,13.4,50.93,
LISINOPRIL(PRINIVIL)TAB:5MG,32007796,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
AMPicillin(PRNCIPEN)SUS:250MG/5ML(100ML),32007801,CDM,,,250,RC,outpatient,,179.85,179.85,,152.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.96,22,,percent of total billed charges,,,,,,,,,161.87,90,,percent of total billed charges,,,148.92,82.8,,percent of total billed charges,,,152.87,85,,percent of total billed charges,,,,,,,,,158.27,88,,percent of total billed charges,,,,,,,,,137.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.96,22,,percent of total billed charges,,,163.66,91,,percent of total billed charges,,,170.86,95,,percent of total billed charges,,,149.28,83,,percent of total billed charges,,,149.28,83,,percent of total billed charges,,,,,,,,,,,,,,,149.28,83,,percent of total billed charges,,,170.86,95,,percent of total billed charges,,,161.87,90,,percent of total billed charges,,,161.87,90,,percent of total billed charges,,,147.48,82,,percent of total billed charges,,,161.87,90,,percent of total billed charges,,,152.87,85,,percent of total billed charges,,44.96,170.86,
LISINOPRIL 10MG,32007806,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
AMPicillin(PRINCIPEN)CAP:250MG,32007811,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
AMPicillin (PRINCIPEN) CAP : 500MG,32007816,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
LISINOPRIL(PRINIVIL)TAB:20MG,32007821,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PROMETH(PHENERGAN)SYRP:6.25MG/5ML(120ML),32007826,CDM,J8499,HCPCS,250,RC,outpatient,,40.92,40.92,,34.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.23,22,,percent of total billed charges,,,,,,,,,36.83,90,,percent of total billed charges,,,33.88,82.8,,percent of total billed charges,,,34.78,85,,percent of total billed charges,,,,,,,,,36.01,88,,percent of total billed charges,,,,,,,,,31.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.23,22,,percent of total billed charges,,,37.24,91,,percent of total billed charges,,,38.87,95,,percent of total billed charges,,,33.96,83,,percent of total billed charges,,,33.96,83,,percent of total billed charges,,,,,,,,,,,,,,,33.96,83,,percent of total billed charges,,,38.87,95,,percent of total billed charges,,,36.83,90,,percent of total billed charges,,,36.83,90,,percent of total billed charges,,,33.55,82,,percent of total billed charges,,,36.83,90,,percent of total billed charges,,,34.78,85,,percent of total billed charges,,10.23,38.87,
PROMETH (PHENERGAN) SYRP:6.25MG/5ML 90ML,32007831,CDM,,,250,RC,outpatient,,31.24,31.24,,26.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.81,22,,percent of total billed charges,,,,,,,,,28.12,90,,percent of total billed charges,,,25.87,82.8,,percent of total billed charges,,,26.55,85,,percent of total billed charges,,,,,,,,,27.49,88,,percent of total billed charges,,,,,,,,,23.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.81,22,,percent of total billed charges,,,28.43,91,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,,,,,,,,,,,,,25.93,83,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,25.62,82,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,26.55,85,,percent of total billed charges,,7.81,29.68,
PROMETH(PHENERGAN) SYRP: 6.25MG/5ML 60ML,32007836,CDM,,,250,RC,outpatient,,20.78,20.78,,17.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.2,22,,percent of total billed charges,,,,,,,,,18.7,90,,percent of total billed charges,,,17.21,82.8,,percent of total billed charges,,,17.66,85,,percent of total billed charges,,,,,,,,,18.29,88,,percent of total billed charges,,,,,,,,,15.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.2,22,,percent of total billed charges,,,18.91,91,,percent of total billed charges,,,19.74,95,,percent of total billed charges,,,17.25,83,,percent of total billed charges,,,17.25,83,,percent of total billed charges,,,,,,,,,,,,,,,17.25,83,,percent of total billed charges,,,19.74,95,,percent of total billed charges,,,18.7,90,,percent of total billed charges,,,18.7,90,,percent of total billed charges,,,17.04,82,,percent of total billed charges,,,18.7,90,,percent of total billed charges,,,17.66,85,,percent of total billed charges,,5.2,19.74,
COD/PROMETH (PHENERGAN + COD) SYRP  90ML,32007846,CDM,,,250,RC,outpatient,,36.75,36.75,,31.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.19,22,,percent of total billed charges,,,,,,,,,33.08,90,,percent of total billed charges,,,30.43,82.8,,percent of total billed charges,,,31.24,85,,percent of total billed charges,,,,,,,,,32.34,88,,percent of total billed charges,,,,,,,,,28.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.19,22,,percent of total billed charges,,,33.44,91,,percent of total billed charges,,,34.91,95,,percent of total billed charges,,,30.5,83,,percent of total billed charges,,,30.5,83,,percent of total billed charges,,,,,,,,,,,,,,,30.5,83,,percent of total billed charges,,,34.91,95,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,30.14,82,,percent of total billed charges,,,33.08,90,,percent of total billed charges,,,31.24,85,,percent of total billed charges,,9.19,34.91,
COD/PROMETH (PHENERGAN + COD) SYRP 60ML,32007851,CDM,,,250,RC,outpatient,,24.5,24.5,,20.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.13,22,,percent of total billed charges,,,,,,,,,22.05,90,,percent of total billed charges,,,20.29,82.8,,percent of total billed charges,,,20.83,85,,percent of total billed charges,,,,,,,,,21.56,88,,percent of total billed charges,,,,,,,,,18.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.13,22,,percent of total billed charges,,,22.3,91,,percent of total billed charges,,,23.28,95,,percent of total billed charges,,,20.34,83,,percent of total billed charges,,,20.34,83,,percent of total billed charges,,,,,,,,,,,,,,,20.34,83,,percent of total billed charges,,,23.28,95,,percent of total billed charges,,,22.05,90,,percent of total billed charges,,,22.05,90,,percent of total billed charges,,,20.09,82,,percent of total billed charges,,,22.05,90,,percent of total billed charges,,,20.83,85,,percent of total billed charges,,6.13,23.28,
PROCAINAMIDE HCL VIAL : 500MG/ML 2ML,32007856,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
PROPRANOLOL(INDERAL)TAB:10MG,32007866,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PROBENECID(BENEMID)TAB:500MG,32007881,CDM,J8499,HCPCS,250,RC,outpatient,,48.69,48.69,,41.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.17,22,,percent of total billed charges,,,,,,,,,43.82,90,,percent of total billed charges,,,40.32,82.8,,percent of total billed charges,,,41.39,85,,percent of total billed charges,,,,,,,,,42.85,88,,percent of total billed charges,,,,,,,,,37.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.17,22,,percent of total billed charges,,,44.31,91,,percent of total billed charges,,,46.26,95,,percent of total billed charges,,,40.41,83,,percent of total billed charges,,,40.41,83,,percent of total billed charges,,,,,,,,,,,,,,,40.41,83,,percent of total billed charges,,,46.26,95,,percent of total billed charges,,,43.82,90,,percent of total billed charges,,,43.82,90,,percent of total billed charges,,,39.93,82,,percent of total billed charges,,,43.82,90,,percent of total billed charges,,,41.39,85,,percent of total billed charges,,12.17,46.26,
PROCHLORPERAZINE(COMPAZINE)SUPP:25MG,32007891,CDM,J3490,HCPCS,250,RC,outpatient,,99.51,99.51,,84.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.88,22,,percent of total billed charges,,,,,,,,,89.56,90,,percent of total billed charges,,,82.39,82.8,,percent of total billed charges,,,84.58,85,,percent of total billed charges,,,,,,,,,87.57,88,,percent of total billed charges,,,,,,,,,76.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.88,22,,percent of total billed charges,,,90.55,91,,percent of total billed charges,,,94.53,95,,percent of total billed charges,,,82.59,83,,percent of total billed charges,,,82.59,83,,percent of total billed charges,,,,,,,,,,,,,,,82.59,83,,percent of total billed charges,,,94.53,95,,percent of total billed charges,,,89.56,90,,percent of total billed charges,,,89.56,90,,percent of total billed charges,,,81.6,82,,percent of total billed charges,,,89.56,90,,percent of total billed charges,,,84.58,85,,percent of total billed charges,,24.88,94.53,
EPOETIN(PROCRIT):40000 UNITS/ML,32007895,CDM,J0885,HCPCS,636,RC,outpatient,,4501.61,4501.61,,3821.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1125.4,22,,percent of total billed charges,,,,,,,,,4051.45,90,,percent of total billed charges,,,3727.33,82.8,,percent of total billed charges,,,3826.37,85,,percent of total billed charges,,,,,,,,,3961.42,88,,percent of total billed charges,,669.6,,,,fee schedule,,,3439.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,669.6,,,,fee schedule,,,1125.4,22,,percent of total billed charges,,,4096.47,91,,percent of total billed charges,,,4276.53,95,,percent of total billed charges,,,3736.34,83,,percent of total billed charges,,,3736.34,83,,percent of total billed charges,,,,,,,,,,,,,,,3736.34,83,,percent of total billed charges,,,4276.53,95,,percent of total billed charges,,,4051.45,90,,percent of total billed charges,,,4051.45,90,,percent of total billed charges,,,3691.32,82,,percent of total billed charges,,,4051.45,90,,percent of total billed charges,,,3826.37,85,,percent of total billed charges,,669.6,4276.53,
EPOETIN(PROCRIT): 4000 UNITS/ML,32007896,CDM,J0885,HCPCS,636,RC,outpatient,,1508.51,1508.51,,1280.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,377.13,22,,percent of total billed charges,,,,,,,,,1357.66,90,,percent of total billed charges,,,1249.05,82.8,,percent of total billed charges,,,1282.23,85,,percent of total billed charges,,,,,,,,,1327.49,88,,percent of total billed charges,,669.6,,,,fee schedule,,,1152.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,669.6,,,,fee schedule,,,377.13,22,,percent of total billed charges,,,1372.74,91,,percent of total billed charges,,,1433.08,95,,percent of total billed charges,,,1252.06,83,,percent of total billed charges,,,1252.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1252.06,83,,percent of total billed charges,,,1433.08,95,,percent of total billed charges,,,1357.66,90,,percent of total billed charges,,,1357.66,90,,percent of total billed charges,,,1236.98,82,,percent of total billed charges,,,1357.66,90,,percent of total billed charges,,,1282.23,85,,percent of total billed charges,,377.13,1433.08,
"PROCRIT VIALS 10,000 U/ML",32007897,CDM,,,250,RC,outpatient,,178,178,,151.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.5,22,,percent of total billed charges,,,,,,,,,160.2,90,,percent of total billed charges,,,147.38,82.8,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,,,,,,,,156.64,88,,percent of total billed charges,,,,,,,,,135.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.5,22,,percent of total billed charges,,,161.98,91,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,,,,,,,,,,,,,147.74,83,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,145.96,82,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,44.5,169.1,
"PROCRIT 15,000U",32007898,CDM,,,250,RC,outpatient,,271.5,271.5,,230.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,67.88,22,,percent of total billed charges,,,,,,,,,244.35,90,,percent of total billed charges,,,224.8,82.8,,percent of total billed charges,,,230.78,85,,percent of total billed charges,,,,,,,,,238.92,88,,percent of total billed charges,,,,,,,,,207.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,67.88,22,,percent of total billed charges,,,247.07,91,,percent of total billed charges,,,257.93,95,,percent of total billed charges,,,225.35,83,,percent of total billed charges,,,225.35,83,,percent of total billed charges,,,,,,,,,,,,,,,225.35,83,,percent of total billed charges,,,257.93,95,,percent of total billed charges,,,244.35,90,,percent of total billed charges,,,244.35,90,,percent of total billed charges,,,222.63,82,,percent of total billed charges,,,244.35,90,,percent of total billed charges,,,230.78,85,,percent of total billed charges,,67.88,257.93,
PROCAINAMIDE (PROCAN SR) HCL TAB : 750MG,32007906,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PROCHLORPERAZINE(COMPAZINE)VIAL:10MG/2ML,32007916,CDM,J0780,HCPCS,250,RC,outpatient,,82.84,82.84,,70.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.71,22,,percent of total billed charges,,,,,,,,,74.56,90,,percent of total billed charges,,,68.59,82.8,,percent of total billed charges,,,70.41,85,,percent of total billed charges,,,,,,,,,72.9,88,,percent of total billed charges,,8.39,,,,fee schedule,,,63.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8.39,,,,fee schedule,,,20.71,22,,percent of total billed charges,,,75.38,91,,percent of total billed charges,,,78.7,95,,percent of total billed charges,,,68.76,83,,percent of total billed charges,,,68.76,83,,percent of total billed charges,,,,,,,,,,,,,,,68.76,83,,percent of total billed charges,,,78.7,95,,percent of total billed charges,,,74.56,90,,percent of total billed charges,,,74.56,90,,percent of total billed charges,,,67.93,82,,percent of total billed charges,,,74.56,90,,percent of total billed charges,,,70.41,85,,percent of total billed charges,,8.39,78.7,
NIFEdipine(PROCARDIA XL)TAB:30MG,32007922,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
NIFEDIPINE TAB (PROCARDIA XL) : 90MG,32007926,CDM,,,250,RC,outpatient,,39.97,39.97,,33.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.99,22,,percent of total billed charges,,,,,,,,,35.97,90,,percent of total billed charges,,,33.1,82.8,,percent of total billed charges,,,33.97,85,,percent of total billed charges,,,,,,,,,35.17,88,,percent of total billed charges,,,,,,,,,30.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.99,22,,percent of total billed charges,,,36.37,91,,percent of total billed charges,,,37.97,95,,percent of total billed charges,,,33.18,83,,percent of total billed charges,,,33.18,83,,percent of total billed charges,,,,,,,,,,,,,,,33.18,83,,percent of total billed charges,,,37.97,95,,percent of total billed charges,,,35.97,90,,percent of total billed charges,,,35.97,90,,percent of total billed charges,,,32.78,82,,percent of total billed charges,,,35.97,90,,percent of total billed charges,,,33.97,85,,percent of total billed charges,,9.99,37.97,
NIFEDIPINE (PROCARDIA XL) TAB : 60MG,32007931,CDM,,,250,RC,outpatient,,61.38,61.38,,52.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.35,22,,percent of total billed charges,,,,,,,,,55.24,90,,percent of total billed charges,,,50.82,82.8,,percent of total billed charges,,,52.17,85,,percent of total billed charges,,,,,,,,,54.01,88,,percent of total billed charges,,,,,,,,,46.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.35,22,,percent of total billed charges,,,55.86,91,,percent of total billed charges,,,58.31,95,,percent of total billed charges,,,50.95,83,,percent of total billed charges,,,50.95,83,,percent of total billed charges,,,,,,,,,,,,,,,50.95,83,,percent of total billed charges,,,58.31,95,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,50.33,82,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,52.17,85,,percent of total billed charges,,15.35,58.31,
PROCAINAMIDE VIAL:1000MG/10ML,32007936,CDM,,,250,RC,outpatient,,1225.06,1225.06,,1040.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,306.27,22,,percent of total billed charges,,,,,,,,,1102.55,90,,percent of total billed charges,,,1014.35,82.8,,percent of total billed charges,,,1041.3,85,,percent of total billed charges,,,,,,,,,1078.05,88,,percent of total billed charges,,,,,,,,,935.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,306.27,22,,percent of total billed charges,,,1114.8,91,,percent of total billed charges,,,1163.81,95,,percent of total billed charges,,,1016.8,83,,percent of total billed charges,,,1016.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1016.8,83,,percent of total billed charges,,,1163.81,95,,percent of total billed charges,,,1102.55,90,,percent of total billed charges,,,1102.55,90,,percent of total billed charges,,,1004.55,82,,percent of total billed charges,,,1102.55,90,,percent of total billed charges,,,1041.3,85,,percent of total billed charges,,306.27,1163.81,
PROGESTERONE VIAL : 50MG/ML  10ML,32007951,CDM,,,250,RC,outpatient,,516.24,516.24,,438.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,129.06,22,,percent of total billed charges,,,,,,,,,464.62,90,,percent of total billed charges,,,427.45,82.8,,percent of total billed charges,,,438.8,85,,percent of total billed charges,,,,,,,,,454.29,88,,percent of total billed charges,,,,,,,,,394.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,129.06,22,,percent of total billed charges,,,469.78,91,,percent of total billed charges,,,490.43,95,,percent of total billed charges,,,428.48,83,,percent of total billed charges,,,428.48,83,,percent of total billed charges,,,,,,,,,,,,,,,428.48,83,,percent of total billed charges,,,490.43,95,,percent of total billed charges,,,464.62,90,,percent of total billed charges,,,464.62,90,,percent of total billed charges,,,423.32,82,,percent of total billed charges,,,464.62,90,,percent of total billed charges,,,438.8,85,,percent of total billed charges,,129.06,490.43,
COD/PROMETH(PHENERGAN/COD)SYRP:120ML,32007975,CDM,J8499,HCPCS,250,RC,outpatient,,44.25,44.25,,37.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.06,22,,percent of total billed charges,,,,,,,,,39.83,90,,percent of total billed charges,,,36.64,82.8,,percent of total billed charges,,,37.61,85,,percent of total billed charges,,,,,,,,,38.94,88,,percent of total billed charges,,,,,,,,,33.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.06,22,,percent of total billed charges,,,40.27,91,,percent of total billed charges,,,42.04,95,,percent of total billed charges,,,36.73,83,,percent of total billed charges,,,36.73,83,,percent of total billed charges,,,,,,,,,,,,,,,36.73,83,,percent of total billed charges,,,42.04,95,,percent of total billed charges,,,39.83,90,,percent of total billed charges,,,39.83,90,,percent of total billed charges,,,36.29,82,,percent of total billed charges,,,39.83,90,,percent of total billed charges,,,37.61,85,,percent of total billed charges,,11.06,42.04,
PHENYLEPHRINE(PHENERGAN VC)SYRP:(120ML),32007981,CDM,,,250,RC,outpatient,,82.15,82.15,,69.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.54,22,,percent of total billed charges,,,,,,,,,73.94,90,,percent of total billed charges,,,68.02,82.8,,percent of total billed charges,,,69.83,85,,percent of total billed charges,,,,,,,,,72.29,88,,percent of total billed charges,,,,,,,,,62.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.54,22,,percent of total billed charges,,,74.76,91,,percent of total billed charges,,,78.04,95,,percent of total billed charges,,,68.18,83,,percent of total billed charges,,,68.18,83,,percent of total billed charges,,,,,,,,,,,,,,,68.18,83,,percent of total billed charges,,,78.04,95,,percent of total billed charges,,,73.94,90,,percent of total billed charges,,,73.94,90,,percent of total billed charges,,,67.36,82,,percent of total billed charges,,,73.94,90,,percent of total billed charges,,,69.83,85,,percent of total billed charges,,20.54,78.04,
PROMETHAZINE(PHENERGAN)VIAL:25MG/ML,32007991,CDM,J2550,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,2.94,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.94,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,2.94,60.99,
PROMETHAZINE(PHENERGAN)VIAL :50MG/ML 1ML,32008001,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
PROPRANOLOL (INDERAL) TAB : 20MG,32008006,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PROPRANOLOL (INDERAL) TAB : 40MG,32008011,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PROPRANOLOL(INDERAL)VIAL:1MG/ML,32008016,CDM,J1800,HCPCS,250,RC,outpatient,,167.48,167.48,,142.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.87,22,,percent of total billed charges,,,,,,,,,150.73,90,,percent of total billed charges,,,138.67,82.8,,percent of total billed charges,,,142.36,85,,percent of total billed charges,,,,,,,,,147.38,88,,percent of total billed charges,,19.8,,,,fee schedule,,,127.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.8,,,,fee schedule,,,41.87,22,,percent of total billed charges,,,152.41,91,,percent of total billed charges,,,159.11,95,,percent of total billed charges,,,139.01,83,,percent of total billed charges,,,139.01,83,,percent of total billed charges,,,,,,,,,,,,,,,139.01,83,,percent of total billed charges,,,159.11,95,,percent of total billed charges,,,150.73,90,,percent of total billed charges,,,150.73,90,,percent of total billed charges,,,137.33,82,,percent of total billed charges,,,150.73,90,,percent of total billed charges,,,142.36,85,,percent of total billed charges,,19.8,159.11,
PROPYLTHIOURACIL (PTU) TAB : 50MG,32008021,CDM,J8499,HCPCS,250,RC,outpatient,,35.78,35.78,,30.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.95,22,,percent of total billed charges,,,,,,,,,32.2,90,,percent of total billed charges,,,29.63,82.8,,percent of total billed charges,,,30.41,85,,percent of total billed charges,,,,,,,,,31.49,88,,percent of total billed charges,,,,,,,,,27.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.95,22,,percent of total billed charges,,,32.56,91,,percent of total billed charges,,,33.99,95,,percent of total billed charges,,,29.7,83,,percent of total billed charges,,,29.7,83,,percent of total billed charges,,,,,,,,,,,,,,,29.7,83,,percent of total billed charges,,,33.99,95,,percent of total billed charges,,,32.2,90,,percent of total billed charges,,,32.2,90,,percent of total billed charges,,,29.34,82,,percent of total billed charges,,,32.2,90,,percent of total billed charges,,,30.41,85,,percent of total billed charges,,8.95,33.99,
PROPULSID 20 MG,32008027,CDM,,,250,RC,outpatient,,6.5,6.5,,5.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.63,22,,percent of total billed charges,,,,,,,,,5.85,90,,percent of total billed charges,,,5.38,82.8,,percent of total billed charges,,,5.53,85,,percent of total billed charges,,,,,,,,,5.72,88,,percent of total billed charges,,,,,,,,,4.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.63,22,,percent of total billed charges,,,5.92,91,,percent of total billed charges,,,6.18,95,,percent of total billed charges,,,5.4,83,,percent of total billed charges,,,5.4,83,,percent of total billed charges,,,,,,,,,,,,,,,5.4,83,,percent of total billed charges,,,6.18,95,,percent of total billed charges,,,5.85,90,,percent of total billed charges,,,5.85,90,,percent of total billed charges,,,5.33,82,,percent of total billed charges,,,5.85,90,,percent of total billed charges,,,5.53,85,,percent of total billed charges,,1.63,6.18,
PROPRANOLOL(INDERAL LA)CAP:60MG,32008041,CDM,J8499,HCPCS,250,RC,outpatient,,31.54,31.54,,26.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.89,22,,percent of total billed charges,,,,,,,,,28.39,90,,percent of total billed charges,,,26.12,82.8,,percent of total billed charges,,,26.81,85,,percent of total billed charges,,,,,,,,,27.76,88,,percent of total billed charges,,,,,,,,,24.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.89,22,,percent of total billed charges,,,28.7,91,,percent of total billed charges,,,29.96,95,,percent of total billed charges,,,26.18,83,,percent of total billed charges,,,26.18,83,,percent of total billed charges,,,,,,,,,,,,,,,26.18,83,,percent of total billed charges,,,29.96,95,,percent of total billed charges,,,28.39,90,,percent of total billed charges,,,28.39,90,,percent of total billed charges,,,25.86,82,,percent of total billed charges,,,28.39,90,,percent of total billed charges,,,26.81,85,,percent of total billed charges,,7.89,29.96,
PROSTIGMIN 1:2000,32008042,CDM,,,250,RC,outpatient,,223.47,223.47,,189.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.87,22,,percent of total billed charges,,,,,,,,,201.12,90,,percent of total billed charges,,,185.03,82.8,,percent of total billed charges,,,189.95,85,,percent of total billed charges,,,,,,,,,196.65,88,,percent of total billed charges,,,,,,,,,170.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.87,22,,percent of total billed charges,,,203.36,91,,percent of total billed charges,,,212.3,95,,percent of total billed charges,,,185.48,83,,percent of total billed charges,,,185.48,83,,percent of total billed charges,,,,,,,,,,,,,,,185.48,83,,percent of total billed charges,,,212.3,95,,percent of total billed charges,,,201.12,90,,percent of total billed charges,,,201.12,90,,percent of total billed charges,,,183.25,82,,percent of total billed charges,,,201.12,90,,percent of total billed charges,,,189.95,85,,percent of total billed charges,,55.87,212.3,
PROPOFOL(DIPRIVAN)VIAL:200MG/20ML*,32008043,CDM,J2704,HCPCS,250,RC,outpatient,,101.31,101.31,,86.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.33,22,,percent of total billed charges,,,,,,,,,91.18,90,,percent of total billed charges,,,83.88,82.8,,percent of total billed charges,,,86.11,85,,percent of total billed charges,,,,,,,,,89.15,88,,percent of total billed charges,,14.4,,,,fee schedule,,,77.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.4,,,,fee schedule,,,25.33,22,,percent of total billed charges,,,92.19,91,,percent of total billed charges,,,96.24,95,,percent of total billed charges,,,84.09,83,,percent of total billed charges,,,84.09,83,,percent of total billed charges,,,,,,,,,,,,,,,84.09,83,,percent of total billed charges,,,96.24,95,,percent of total billed charges,,,91.18,90,,percent of total billed charges,,,91.18,90,,percent of total billed charges,,,83.07,82,,percent of total billed charges,,,91.18,90,,percent of total billed charges,,,86.11,85,,percent of total billed charges,,14.4,96.24,
ESTAZOLAM (PROSOM) TAB : 1MG,32008051,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
FINASTERIDE(PROSCAR)TAB:5MG,32008056,CDM,J8499,HCPCS,250,RC,outpatient,UD,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PROTAMINE SULF VIAL:250MG/25ML,32008066,CDM,J2720,HCPCS,250,RC,outpatient,,605.06,605.06,,513.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,151.27,22,,percent of total billed charges,,,,,,,,,544.55,90,,percent of total billed charges,,,500.99,82.8,,percent of total billed charges,,,514.3,85,,percent of total billed charges,,,,,,,,,532.45,88,,percent of total billed charges,,8.14,,,,fee schedule,,,462.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8.14,,,,fee schedule,,,151.27,22,,percent of total billed charges,,,550.6,91,,percent of total billed charges,,,574.81,95,,percent of total billed charges,,,502.2,83,,percent of total billed charges,,,502.2,83,,percent of total billed charges,,,,,,,,,,,,,,,502.2,83,,percent of total billed charges,,,574.81,95,,percent of total billed charges,,,544.55,90,,percent of total billed charges,,,544.55,90,,percent of total billed charges,,,496.15,82,,percent of total billed charges,,,544.55,90,,percent of total billed charges,,,514.3,85,,percent of total billed charges,,8.14,574.81,
PANTOPRAZOLE (PROTONIX) 40MG   (1X2),32008069,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PANTOPRAZOLE (PROTONIX) TAB: 40MG,32008070,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FLUoxetine(PROzac)CAP:20MG,32008076,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FLUoxetine(PROzac)TAB:10MG,32008081,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PSEUDOEPHED(SUDAFED)TAB:30MG,32008086,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
BUDESONIDE(PULMICORT)AER:200MCG  MDI,32008087,CDM,,,250,RC,outpatient,,2081.86,2081.86,,1767.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,520.47,22,,percent of total billed charges,,,,,,,,,1873.67,90,,percent of total billed charges,,,1723.78,82.8,,percent of total billed charges,,,1769.58,85,,percent of total billed charges,,,,,,,,,1832.04,88,,percent of total billed charges,,,,,,,,,1590.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,520.47,22,,percent of total billed charges,,,1894.49,91,,percent of total billed charges,,,1977.77,95,,percent of total billed charges,,,1727.94,83,,percent of total billed charges,,,1727.94,83,,percent of total billed charges,,,,,,,,,,,,,,,1727.94,83,,percent of total billed charges,,,1977.77,95,,percent of total billed charges,,,1873.67,90,,percent of total billed charges,,,1873.67,90,,percent of total billed charges,,,1707.13,82,,percent of total billed charges,,,1873.67,90,,percent of total billed charges,,,1769.58,85,,percent of total billed charges,,520.47,1977.77,
POLYVIN ALC(PURALUBE TEAR)DROP:1%   15ML,32008091,CDM,,,250,RC,outpatient,,31.56,31.56,,26.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.89,22,,percent of total billed charges,,,,,,,,,28.4,90,,percent of total billed charges,,,26.13,82.8,,percent of total billed charges,,,26.83,85,,percent of total billed charges,,,,,,,,,27.77,88,,percent of total billed charges,,,,,,,,,24.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.89,22,,percent of total billed charges,,,28.72,91,,percent of total billed charges,,,29.98,95,,percent of total billed charges,,,26.19,83,,percent of total billed charges,,,26.19,83,,percent of total billed charges,,,,,,,,,,,,,,,26.19,83,,percent of total billed charges,,,29.98,95,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,25.88,82,,percent of total billed charges,,,28.4,90,,percent of total billed charges,,,26.83,85,,percent of total billed charges,,7.89,29.98,
PYRIDOXINE(VIT-B6)VIAL:100MG/ML,32008096,CDM,J3415,HCPCS,250,RC,outpatient,,280.07,280.07,,237.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.02,22,,percent of total billed charges,,,,,,,,,252.06,90,,percent of total billed charges,,,231.9,82.8,,percent of total billed charges,,,238.06,85,,percent of total billed charges,,,,,,,,,246.46,88,,percent of total billed charges,,57.96,,,,fee schedule,,,213.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,57.96,,,,fee schedule,,,70.02,22,,percent of total billed charges,,,254.86,91,,percent of total billed charges,,,266.07,95,,percent of total billed charges,,,232.46,83,,percent of total billed charges,,,232.46,83,,percent of total billed charges,,,,,,,,,,,,,,,232.46,83,,percent of total billed charges,,,266.07,95,,percent of total billed charges,,,252.06,90,,percent of total billed charges,,,252.06,90,,percent of total billed charges,,,229.66,82,,percent of total billed charges,,,252.06,90,,percent of total billed charges,,,238.06,85,,percent of total billed charges,,57.96,266.07,
SUCCINYLCHOL(QUELICIN)VIAL:200MG/10ML,32008101,CDM,J0330,HCPCS,250,RC,outpatient,,91.34,91.34,,77.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.84,22,,percent of total billed charges,,,,,,,,,82.21,90,,percent of total billed charges,,,75.63,82.8,,percent of total billed charges,,,77.64,85,,percent of total billed charges,,,,,,,,,80.38,88,,percent of total billed charges,,,,,,,,,69.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.84,22,,percent of total billed charges,,,83.12,91,,percent of total billed charges,,,86.77,95,,percent of total billed charges,,,75.81,83,,percent of total billed charges,,,75.81,83,,percent of total billed charges,,,,,,,,,,,,,,,75.81,83,,percent of total billed charges,,,86.77,95,,percent of total billed charges,,,82.21,90,,percent of total billed charges,,,82.21,90,,percent of total billed charges,,,74.9,82,,percent of total billed charges,,,82.21,90,,percent of total billed charges,,,77.64,85,,percent of total billed charges,,22.84,86.77,
QUESTRAN LIGHT,32008106,CDM,,,250,RC,outpatient,,135.5,135.5,,115.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.88,22,,percent of total billed charges,,,,,,,,,121.95,90,,percent of total billed charges,,,112.19,82.8,,percent of total billed charges,,,115.18,85,,percent of total billed charges,,,,,,,,,119.24,88,,percent of total billed charges,,,,,,,,,103.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.88,22,,percent of total billed charges,,,123.31,91,,percent of total billed charges,,,128.73,95,,percent of total billed charges,,,112.47,83,,percent of total billed charges,,,112.47,83,,percent of total billed charges,,,,,,,,,,,,,,,112.47,83,,percent of total billed charges,,,128.73,95,,percent of total billed charges,,,121.95,90,,percent of total billed charges,,,121.95,90,,percent of total billed charges,,,111.11,82,,percent of total billed charges,,,121.95,90,,percent of total billed charges,,,115.18,85,,percent of total billed charges,,33.88,128.73,
QUESTRAN LIGHT CAN 210GM,32008107,CDM,,,250,RC,outpatient,,135.5,135.5,,115.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.88,22,,percent of total billed charges,,,,,,,,,121.95,90,,percent of total billed charges,,,112.19,82.8,,percent of total billed charges,,,115.18,85,,percent of total billed charges,,,,,,,,,119.24,88,,percent of total billed charges,,,,,,,,,103.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.88,22,,percent of total billed charges,,,123.31,91,,percent of total billed charges,,,128.73,95,,percent of total billed charges,,,112.47,83,,percent of total billed charges,,,112.47,83,,percent of total billed charges,,,,,,,,,,,,,,,112.47,83,,percent of total billed charges,,,128.73,95,,percent of total billed charges,,,121.95,90,,percent of total billed charges,,,121.95,90,,percent of total billed charges,,,111.11,82,,percent of total billed charges,,,121.95,90,,percent of total billed charges,,,115.18,85,,percent of total billed charges,,33.88,128.73,
CHOLESTYRAMINE/SUCROSE(QUESTRAN)PAC:4GM,32008111,CDM,J8499,HCPCS,250,RC,outpatient,,21.09,21.09,,17.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.27,22,,percent of total billed charges,,,,,,,,,18.98,90,,percent of total billed charges,,,17.46,82.8,,percent of total billed charges,,,17.93,85,,percent of total billed charges,,,,,,,,,18.56,88,,percent of total billed charges,,,,,,,,,16.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.27,22,,percent of total billed charges,,,19.19,91,,percent of total billed charges,,,20.04,95,,percent of total billed charges,,,17.5,83,,percent of total billed charges,,,17.5,83,,percent of total billed charges,,,,,,,,,,,,,,,17.5,83,,percent of total billed charges,,,20.04,95,,percent of total billed charges,,,18.98,90,,percent of total billed charges,,,18.98,90,,percent of total billed charges,,,17.29,82,,percent of total billed charges,,,18.98,90,,percent of total billed charges,,,17.93,85,,percent of total billed charges,,5.27,20.04,
quiNIDINE GLUCONATE TAB:324MG,32008116,CDM,,,250,RC,outpatient,,120.69,120.69,,102.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.17,22,,percent of total billed charges,,,,,,,,,108.62,90,,percent of total billed charges,,,99.93,82.8,,percent of total billed charges,,,102.59,85,,percent of total billed charges,,,,,,,,,106.21,88,,percent of total billed charges,,,,,,,,,92.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.17,22,,percent of total billed charges,,,109.83,91,,percent of total billed charges,,,114.66,95,,percent of total billed charges,,,100.17,83,,percent of total billed charges,,,100.17,83,,percent of total billed charges,,,,,,,,,,,,,,,100.17,83,,percent of total billed charges,,,114.66,95,,percent of total billed charges,,,108.62,90,,percent of total billed charges,,,108.62,90,,percent of total billed charges,,,98.97,82,,percent of total billed charges,,,108.62,90,,percent of total billed charges,,,102.59,85,,percent of total billed charges,,30.17,114.66,
quiNINE SULFATE TAB : 260,32008121,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
quiNIDINE SULFATE TAB:200MG,32008126,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
quiNINE SULFATE CAP : 200MG,32008136,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
RAPLON 100MG,32008140,CDM,,,250,RC,outpatient,,60,60,,50.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15,22,,percent of total billed charges,,,,,,,,,54,90,,percent of total billed charges,,,49.68,82.8,,percent of total billed charges,,,51,85,,percent of total billed charges,,,,,,,,,52.8,88,,percent of total billed charges,,,,,,,,,45.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15,22,,percent of total billed charges,,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,,,,,,,,,,,,,49.8,83,,percent of total billed charges,,,57,95,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,49.2,82,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,15,57,
quiNINE SULFATE CAP:325MG,32008141,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
R-TANNATE(RYNATAN)SUSO. 60ML,32008142,CDM,,,250,RC,outpatient,,6.5,6.5,,5.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.63,22,,percent of total billed charges,,,,,,,,,5.85,90,,percent of total billed charges,,,5.38,82.8,,percent of total billed charges,,,5.53,85,,percent of total billed charges,,,,,,,,,5.72,88,,percent of total billed charges,,,,,,,,,4.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.63,22,,percent of total billed charges,,,5.92,91,,percent of total billed charges,,,6.18,95,,percent of total billed charges,,,5.4,83,,percent of total billed charges,,,5.4,83,,percent of total billed charges,,,,,,,,,,,,,,,5.4,83,,percent of total billed charges,,,6.18,95,,percent of total billed charges,,,5.85,90,,percent of total billed charges,,,5.85,90,,percent of total billed charges,,,5.33,82,,percent of total billed charges,,,5.85,90,,percent of total billed charges,,,5.53,85,,percent of total billed charges,,1.63,6.18,
RECOMBIVAX HB,32008146,CDM,90746,CPT,636,RC,outpatient,,722.11,722.11,,613.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.53,22,,percent of total billed charges,,,,,,,,,649.9,90,,percent of total billed charges,,,597.91,82.8,,percent of total billed charges,,,613.79,85,,percent of total billed charges,,,,,,,,,635.46,88,,percent of total billed charges,,,,,,,,,551.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.53,22,,percent of total billed charges,,,657.12,91,,percent of total billed charges,,,686,95,,percent of total billed charges,,,599.35,83,,percent of total billed charges,,,599.35,83,,percent of total billed charges,,,,,,,,,,,,,,,599.35,83,,percent of total billed charges,,,686,95,,percent of total billed charges,,,649.9,90,,percent of total billed charges,,,649.9,90,,percent of total billed charges,,,592.13,82,,percent of total billed charges,,,649.9,90,,percent of total billed charges,,,613.79,85,,percent of total billed charges,,180.53,686,
HEP B(ENGERIX)VIAL:10MCG/0.5ML 0.5ML ped,32008147,CDM,90744,CPT,636,RC,outpatient,,445.26,445.26,,378.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,111.32,22,,percent of total billed charges,,,,,,,,,400.73,90,,percent of total billed charges,,,368.68,82.8,,percent of total billed charges,,,378.47,85,,percent of total billed charges,,,,,,,,,391.83,88,,percent of total billed charges,,,,,,,,,340.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,111.32,22,,percent of total billed charges,,,405.19,91,,percent of total billed charges,,,423,95,,percent of total billed charges,,,369.57,83,,percent of total billed charges,,,369.57,83,,percent of total billed charges,,,,,,,,,,,,,,,369.57,83,,percent of total billed charges,,,423,95,,percent of total billed charges,,,400.73,90,,percent of total billed charges,,,400.73,90,,percent of total billed charges,,,365.11,82,,percent of total billed charges,,,400.73,90,,percent of total billed charges,,,378.47,85,,percent of total billed charges,,111.32,423,
REFRESH PLUS 0.5% DROPS 50X0.4ML,32008157,CDM,,,250,RC,outpatient,,42.5,42.5,,36.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.63,22,,percent of total billed charges,,,,,,,,,38.25,90,,percent of total billed charges,,,35.19,82.8,,percent of total billed charges,,,36.13,85,,percent of total billed charges,,,,,,,,,37.4,88,,percent of total billed charges,,,,,,,,,32.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.63,22,,percent of total billed charges,,,38.68,91,,percent of total billed charges,,,40.38,95,,percent of total billed charges,,,35.28,83,,percent of total billed charges,,,35.28,83,,percent of total billed charges,,,,,,,,,,,,,,,35.28,83,,percent of total billed charges,,,40.38,95,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,34.85,82,,percent of total billed charges,,,38.25,90,,percent of total billed charges,,,36.13,85,,percent of total billed charges,,10.63,40.38,
CARBOXY CELL(REFRESH TEARS)DROP 0.5%:,32008158,CDM,J3490,HCPCS,250,RC,outpatient,,107.84,107.84,,91.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.96,22,,percent of total billed charges,,,,,,,,,97.06,90,,percent of total billed charges,,,89.29,82.8,,percent of total billed charges,,,91.66,85,,percent of total billed charges,,,,,,,,,94.9,88,,percent of total billed charges,,,,,,,,,82.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.96,22,,percent of total billed charges,,,98.13,91,,percent of total billed charges,,,102.45,95,,percent of total billed charges,,,89.51,83,,percent of total billed charges,,,89.51,83,,percent of total billed charges,,,,,,,,,,,,,,,89.51,83,,percent of total billed charges,,,102.45,95,,percent of total billed charges,,,97.06,90,,percent of total billed charges,,,97.06,90,,percent of total billed charges,,,88.43,82,,percent of total billed charges,,,97.06,90,,percent of total billed charges,,,91.66,85,,percent of total billed charges,,26.96,102.45,
PETRO WHT/MIN OIL/SODCHL(REFRESH PM)OINT,32008159,CDM,,,250,RC,outpatient,,142.9,142.9,,121.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.73,22,,percent of total billed charges,,,,,,,,,128.61,90,,percent of total billed charges,,,118.32,82.8,,percent of total billed charges,,,121.47,85,,percent of total billed charges,,,,,,,,,125.75,88,,percent of total billed charges,,,,,,,,,109.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.73,22,,percent of total billed charges,,,130.04,91,,percent of total billed charges,,,135.76,95,,percent of total billed charges,,,118.61,83,,percent of total billed charges,,,118.61,83,,percent of total billed charges,,,,,,,,,,,,,,,118.61,83,,percent of total billed charges,,,135.76,95,,percent of total billed charges,,,128.61,90,,percent of total billed charges,,,128.61,90,,percent of total billed charges,,,117.18,82,,percent of total billed charges,,,128.61,90,,percent of total billed charges,,,121.47,85,,percent of total billed charges,,35.73,135.76,
PHENTOLAMINE(REGITINE)VIAL:5MG,32008161,CDM,J2760,HCPCS,250,RC,outpatient,,3014.52,3014.52,,2559.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,753.63,22,,percent of total billed charges,,,,,,,,,2713.07,90,,percent of total billed charges,,,2496.02,82.8,,percent of total billed charges,,,2562.34,85,,percent of total billed charges,,,,,,,,,2652.78,88,,percent of total billed charges,,826.95,,,,fee schedule,,,2303.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,826.95,,,,fee schedule,,,753.63,22,,percent of total billed charges,,,2743.21,91,,percent of total billed charges,,,2863.79,95,,percent of total billed charges,,,2502.05,83,,percent of total billed charges,,,2502.05,83,,percent of total billed charges,,,,,,,,,,,,,,,2502.05,83,,percent of total billed charges,,,2863.79,95,,percent of total billed charges,,,2713.07,90,,percent of total billed charges,,,2713.07,90,,percent of total billed charges,,,2471.91,82,,percent of total billed charges,,,2713.07,90,,percent of total billed charges,,,2562.34,85,,percent of total billed charges,,753.63,2863.79,
BECAPLERMIN(REGRANEX)GEL 0.01%:15GM,32008167,CDM,,,250,RC,outpatient,,6233.35,6233.35,,5292.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1558.34,22,,percent of total billed charges,,,,,,,,,5610.02,90,,percent of total billed charges,,,5161.21,82.8,,percent of total billed charges,,,5298.35,85,,percent of total billed charges,,,,,,,,,5485.35,88,,percent of total billed charges,,,,,,,,,4762.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1558.34,22,,percent of total billed charges,,,5672.35,91,,percent of total billed charges,,,5921.68,95,,percent of total billed charges,,,5173.68,83,,percent of total billed charges,,,5173.68,83,,percent of total billed charges,,,,,,,,,,,,,,,5173.68,83,,percent of total billed charges,,,5921.68,95,,percent of total billed charges,,,5610.02,90,,percent of total billed charges,,,5610.02,90,,percent of total billed charges,,,5111.35,82,,percent of total billed charges,,,5610.02,90,,percent of total billed charges,,,5298.35,85,,percent of total billed charges,,1558.34,5921.68,
NABUMETONE(RELAFEN)TAB:500MG,32008171,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
MIRTAZAPINE (REMERON) TAB : 30MG,32008172,CDM,,,250,RC,outpatient,,91.67,91.67,,77.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.92,22,,percent of total billed charges,,,,,,,,,82.5,90,,percent of total billed charges,,,75.9,82.8,,percent of total billed charges,,,77.92,85,,percent of total billed charges,,,,,,,,,80.67,88,,percent of total billed charges,,,,,,,,,70.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.92,22,,percent of total billed charges,,,83.42,91,,percent of total billed charges,,,87.09,95,,percent of total billed charges,,,76.09,83,,percent of total billed charges,,,76.09,83,,percent of total billed charges,,,,,,,,,,,,,,,76.09,83,,percent of total billed charges,,,87.09,95,,percent of total billed charges,,,82.5,90,,percent of total billed charges,,,82.5,90,,percent of total billed charges,,,75.17,82,,percent of total billed charges,,,82.5,90,,percent of total billed charges,,,77.92,85,,percent of total billed charges,,22.92,87.09,
MIRTAZAPINE(REMERON)O.D.TAB:15MG,32008173,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
RELENZA,32008174,CDM,,,250,RC,outpatient,,133.25,133.25,,113.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.31,22,,percent of total billed charges,,,,,,,,,119.93,90,,percent of total billed charges,,,110.33,82.8,,percent of total billed charges,,,113.26,85,,percent of total billed charges,,,,,,,,,117.26,88,,percent of total billed charges,,,,,,,,,101.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.31,22,,percent of total billed charges,,,121.26,91,,percent of total billed charges,,,126.59,95,,percent of total billed charges,,,110.6,83,,percent of total billed charges,,,110.6,83,,percent of total billed charges,,,,,,,,,,,,,,,110.6,83,,percent of total billed charges,,,126.59,95,,percent of total billed charges,,,119.93,90,,percent of total billed charges,,,119.93,90,,percent of total billed charges,,,109.27,82,,percent of total billed charges,,,119.93,90,,percent of total billed charges,,,113.26,85,,percent of total billed charges,,33.31,126.59,
ZANAMIVIR(RELENZA)DISK:5MG,32008175,CDM,,,250,RC,outpatient,,370.81,370.81,,314.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.7,22,,percent of total billed charges,,,,,,,,,333.73,90,,percent of total billed charges,,,307.03,82.8,,percent of total billed charges,,,315.19,85,,percent of total billed charges,,,,,,,,,326.31,88,,percent of total billed charges,,,,,,,,,283.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.7,22,,percent of total billed charges,,,337.44,91,,percent of total billed charges,,,352.27,95,,percent of total billed charges,,,307.77,83,,percent of total billed charges,,,307.77,83,,percent of total billed charges,,,,,,,,,,,,,,,307.77,83,,percent of total billed charges,,,352.27,95,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,304.06,82,,percent of total billed charges,,,333.73,90,,percent of total billed charges,,,315.19,85,,percent of total billed charges,,92.7,352.27,
DIATRIZOATE MEGLUMINE(RENO-M-30)VIAL:30%,32008176,CDM,,,250,RC,outpatient,,222.67,222.67,,189.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.67,22,,percent of total billed charges,,,,,,,,,200.4,90,,percent of total billed charges,,,184.37,82.8,,percent of total billed charges,,,189.27,85,,percent of total billed charges,,,,,,,,,195.95,88,,percent of total billed charges,,,,,,,,,170.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.67,22,,percent of total billed charges,,,202.63,91,,percent of total billed charges,,,211.54,95,,percent of total billed charges,,,184.82,83,,percent of total billed charges,,,184.82,83,,percent of total billed charges,,,,,,,,,,,,,,,184.82,83,,percent of total billed charges,,,211.54,95,,percent of total billed charges,,,200.4,90,,percent of total billed charges,,,200.4,90,,percent of total billed charges,,,182.59,82,,percent of total billed charges,,,200.4,90,,percent of total billed charges,,,189.27,85,,percent of total billed charges,,55.67,211.54,
rOPINIRole HCL (REQUIP) TAB : 0.25MG,32008177,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
NABUMETONE (RELAFEN) TAB : 750MG,32008178,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
RETAVASE KIT,32008192,CDM,,,250,RC,outpatient,,3721.5,3721.5,,3159.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,930.38,22,,percent of total billed charges,,,,,,,,,3349.35,90,,percent of total billed charges,,,3081.4,82.8,,percent of total billed charges,,,3163.28,85,,percent of total billed charges,,,,,,,,,3274.92,88,,percent of total billed charges,,,,,,,,,2843.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,930.38,22,,percent of total billed charges,,,3386.57,91,,percent of total billed charges,,,3535.43,95,,percent of total billed charges,,,3088.85,83,,percent of total billed charges,,,3088.85,83,,percent of total billed charges,,,,,,,,,,,,,,,3088.85,83,,percent of total billed charges,,,3535.43,95,,percent of total billed charges,,,3349.35,90,,percent of total billed charges,,,3349.35,90,,percent of total billed charges,,,3051.63,82,,percent of total billed charges,,,3349.35,90,,percent of total billed charges,,,3163.28,85,,percent of total billed charges,,930.38,3535.43,
REZULIN 400MG TABLETS,32008197,CDM,,,250,RC,outpatient,,18,18,,15.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.5,22,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,14.9,82.8,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,,,,,,,,15.84,88,,percent of total billed charges,,,,,,,,,13.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.5,22,,percent of total billed charges,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,14.76,82,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,4.5,17.1,
PERMETHRIN(RID)SPR 0.5%:150ML,32008202,CDM,J3490,HCPCS,250,RC,outpatient,,71.05,71.05,,60.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.76,22,,percent of total billed charges,,,,,,,,,63.95,90,,percent of total billed charges,,,58.83,82.8,,percent of total billed charges,,,60.39,85,,percent of total billed charges,,,,,,,,,62.52,88,,percent of total billed charges,,,,,,,,,54.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.76,22,,percent of total billed charges,,,64.66,91,,percent of total billed charges,,,67.5,95,,percent of total billed charges,,,58.97,83,,percent of total billed charges,,,58.97,83,,percent of total billed charges,,,,,,,,,,,,,,,58.97,83,,percent of total billed charges,,,67.5,95,,percent of total billed charges,,,63.95,90,,percent of total billed charges,,,63.95,90,,percent of total billed charges,,,58.26,82,,percent of total billed charges,,,63.95,90,,percent of total billed charges,,,60.39,85,,percent of total billed charges,,17.76,67.5,
RIFAMPIN(RIFADIN)CAP:300MG,32008206,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DIMETHYL SULFOXIDE(RIMSO-50)SOL 50%:,32008216,CDM,,,250,RC,outpatient,,677.38,677.38,,575.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,169.35,22,,percent of total billed charges,,,,,,,,,609.64,90,,percent of total billed charges,,,560.87,82.8,,percent of total billed charges,,,575.77,85,,percent of total billed charges,,,,,,,,,596.09,88,,percent of total billed charges,,,,,,,,,517.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,169.35,22,,percent of total billed charges,,,616.42,91,,percent of total billed charges,,,643.51,95,,percent of total billed charges,,,562.23,83,,percent of total billed charges,,,562.23,83,,percent of total billed charges,,,,,,,,,,,,,,,562.23,83,,percent of total billed charges,,,643.51,95,,percent of total billed charges,,,609.64,90,,percent of total billed charges,,,609.64,90,,percent of total billed charges,,,555.45,82,,percent of total billed charges,,,609.64,90,,percent of total billed charges,,,575.77,85,,percent of total billed charges,,169.35,643.51,
METHYLPHENIDATE(RITALIN)TAB:5MG,32008271,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
METHYLPHENIDATE(RITALIN)TAB:10MG,32008272,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
GAVISCON:450MG/5ML (500ML),32008281,CDM,,,250,RC,outpatient,,127.2,127.2,,107.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.8,22,,percent of total billed charges,,,,,,,,,114.48,90,,percent of total billed charges,,,105.32,82.8,,percent of total billed charges,,,108.12,85,,percent of total billed charges,,,,,,,,,111.94,88,,percent of total billed charges,,,,,,,,,97.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.8,22,,percent of total billed charges,,,115.75,91,,percent of total billed charges,,,120.84,95,,percent of total billed charges,,,105.58,83,,percent of total billed charges,,,105.58,83,,percent of total billed charges,,,,,,,,,,,,,,,105.58,83,,percent of total billed charges,,,120.84,95,,percent of total billed charges,,,114.48,90,,percent of total billed charges,,,114.48,90,,percent of total billed charges,,,104.3,82,,percent of total billed charges,,,114.48,90,,percent of total billed charges,,,108.12,85,,percent of total billed charges,,31.8,120.84,
SODIUM POLYST SULF ORAL:15G/60ML (500ML),32008286,CDM,,,250,RC,outpatient,,661.52,661.52,,561.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,165.38,22,,percent of total billed charges,,,,,,,,,595.37,90,,percent of total billed charges,,,547.74,82.8,,percent of total billed charges,,,562.29,85,,percent of total billed charges,,,,,,,,,582.14,88,,percent of total billed charges,,,,,,,,,505.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,165.38,22,,percent of total billed charges,,,601.98,91,,percent of total billed charges,,,628.44,95,,percent of total billed charges,,,549.06,83,,percent of total billed charges,,,549.06,83,,percent of total billed charges,,,,,,,,,,,,,,,549.06,83,,percent of total billed charges,,,628.44,95,,percent of total billed charges,,,595.37,90,,percent of total billed charges,,,595.37,90,,percent of total billed charges,,,542.45,82,,percent of total billed charges,,,595.37,90,,percent of total billed charges,,,562.29,85,,percent of total billed charges,,165.38,628.44,
METHOCARB(ROBAXIN)VIAL:1000MG/10ML,32008291,CDM,,,250,RC,outpatient,,207.13,207.13,,175.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.78,22,,percent of total billed charges,,,,,,,,,186.42,90,,percent of total billed charges,,,171.5,82.8,,percent of total billed charges,,,176.06,85,,percent of total billed charges,,,,,,,,,182.27,88,,percent of total billed charges,,,,,,,,,158.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.78,22,,percent of total billed charges,,,188.49,91,,percent of total billed charges,,,196.77,95,,percent of total billed charges,,,171.92,83,,percent of total billed charges,,,171.92,83,,percent of total billed charges,,,,,,,,,,,,,,,171.92,83,,percent of total billed charges,,,196.77,95,,percent of total billed charges,,,186.42,90,,percent of total billed charges,,,186.42,90,,percent of total billed charges,,,169.85,82,,percent of total billed charges,,,186.42,90,,percent of total billed charges,,,176.06,85,,percent of total billed charges,,51.78,196.77,
guaiFENesin/D-METHORP(ROBAFEN-CF)SYR:4OZ,32008292,CDM,,,250,RC,outpatient,,24.58,24.58,,20.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.15,22,,percent of total billed charges,,,,,,,,,22.12,90,,percent of total billed charges,,,20.35,82.8,,percent of total billed charges,,,20.89,85,,percent of total billed charges,,,,,,,,,21.63,88,,percent of total billed charges,,,,,,,,,18.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.15,22,,percent of total billed charges,,,22.37,91,,percent of total billed charges,,,23.35,95,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,,,,,,,,,,,,,,20.4,83,,percent of total billed charges,,,23.35,95,,percent of total billed charges,,,22.12,90,,percent of total billed charges,,,22.12,90,,percent of total billed charges,,,20.16,82,,percent of total billed charges,,,22.12,90,,percent of total billed charges,,,20.89,85,,percent of total billed charges,,6.15,23.35,
GUAIFENE(ROBITUSSIN)SYRP :100MG/5ML 60ML,32008316,CDM,,,250,RC,outpatient,,5.25,5.25,,4.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.31,22,,percent of total billed charges,,,,,,,,,4.73,90,,percent of total billed charges,,,4.35,82.8,,percent of total billed charges,,,4.46,85,,percent of total billed charges,,,,,,,,,4.62,88,,percent of total billed charges,,,,,,,,,4.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.31,22,,percent of total billed charges,,,4.78,91,,percent of total billed charges,,,4.99,95,,percent of total billed charges,,,4.36,83,,percent of total billed charges,,,4.36,83,,percent of total billed charges,,,,,,,,,,,,,,,4.36,83,,percent of total billed charges,,,4.99,95,,percent of total billed charges,,,4.73,90,,percent of total billed charges,,,4.73,90,,percent of total billed charges,,,4.31,82,,percent of total billed charges,,,4.73,90,,percent of total billed charges,,,4.46,85,,percent of total billed charges,,1.31,4.99,
guaiFENesin(ROBTUS)SYRP:100MG/5ML(118ML),32008321,CDM,J8499,HCPCS,250,RC,outpatient,,30.39,30.39,,25.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.6,22,,percent of total billed charges,,,,,,,,,27.35,90,,percent of total billed charges,,,25.16,82.8,,percent of total billed charges,,,25.83,85,,percent of total billed charges,,,,,,,,,26.74,88,,percent of total billed charges,,,,,,,,,23.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.6,22,,percent of total billed charges,,,27.65,91,,percent of total billed charges,,,28.87,95,,percent of total billed charges,,,25.22,83,,percent of total billed charges,,,25.22,83,,percent of total billed charges,,,,,,,,,,,,,,,25.22,83,,percent of total billed charges,,,28.87,95,,percent of total billed charges,,,27.35,90,,percent of total billed charges,,,27.35,90,,percent of total billed charges,,,24.92,82,,percent of total billed charges,,,27.35,90,,percent of total billed charges,,,25.83,85,,percent of total billed charges,,7.6,28.87,
GLYCOPYRROL(ROBINUL)VIAL:1MG/5ML,32008331,CDM,J3490,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
GUAIF/PEPH(ROBITUSN PE)SRP:100-30MG/5,32008336,CDM,,,250,RC,outpatient,,61.22,61.22,,51.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.31,22,,percent of total billed charges,,,,,,,,,55.1,90,,percent of total billed charges,,,50.69,82.8,,percent of total billed charges,,,52.04,85,,percent of total billed charges,,,,,,,,,53.87,88,,percent of total billed charges,,,,,,,,,46.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.31,22,,percent of total billed charges,,,55.71,91,,percent of total billed charges,,,58.16,95,,percent of total billed charges,,,50.81,83,,percent of total billed charges,,,50.81,83,,percent of total billed charges,,,,,,,,,,,,,,,50.81,83,,percent of total billed charges,,,58.16,95,,percent of total billed charges,,,55.1,90,,percent of total billed charges,,,55.1,90,,percent of total billed charges,,,50.2,82,,percent of total billed charges,,,55.1,90,,percent of total billed charges,,,52.04,85,,percent of total billed charges,,15.31,58.16,
cefTRIAXone(ROCEPHIN)VIAL:1GM,32008346,CDM,J0696,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,8.06,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8.06,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,8.06,60.99,
guaiFENesin/DM(ROBITUSS DM)SYP:120ML,32008347,CDM,J8499,HCPCS,250,RC,outpatient,,30.07,30.07,,25.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.52,22,,percent of total billed charges,,,,,,,,,27.06,90,,percent of total billed charges,,,24.9,82.8,,percent of total billed charges,,,25.56,85,,percent of total billed charges,,,,,,,,,26.46,88,,percent of total billed charges,,,,,,,,,22.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.52,22,,percent of total billed charges,,,27.36,91,,percent of total billed charges,,,28.57,95,,percent of total billed charges,,,24.96,83,,percent of total billed charges,,,24.96,83,,percent of total billed charges,,,,,,,,,,,,,,,24.96,83,,percent of total billed charges,,,28.57,95,,percent of total billed charges,,,27.06,90,,percent of total billed charges,,,27.06,90,,percent of total billed charges,,,24.66,82,,percent of total billed charges,,,27.06,90,,percent of total billed charges,,,25.56,85,,percent of total billed charges,,7.52,28.57,
cefTRIAXone(ROCEPHIN)VIAL:500MG,32008351,CDM,J0696,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,8.06,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8.06,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,8.06,60.99,
cefTRIAXone(ROCEPHIN)VIAL:250MG,32008356,CDM,J0696,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,8.06,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8.06,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,8.06,60.99,
MESALAMINE (ROWASA) ENEMA : 4G/60ML,32008371,CDM,,,250,RC,outpatient,,127.99,127.99,,108.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32,22,,percent of total billed charges,,,,,,,,,115.19,90,,percent of total billed charges,,,105.98,82.8,,percent of total billed charges,,,108.79,85,,percent of total billed charges,,,,,,,,,112.63,88,,percent of total billed charges,,,,,,,,,97.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32,22,,percent of total billed charges,,,116.47,91,,percent of total billed charges,,,121.59,95,,percent of total billed charges,,,106.23,83,,percent of total billed charges,,,106.23,83,,percent of total billed charges,,,,,,,,,,,,,,,106.23,83,,percent of total billed charges,,,121.59,95,,percent of total billed charges,,,115.19,90,,percent of total billed charges,,,115.19,90,,percent of total billed charges,,,104.95,82,,percent of total billed charges,,,115.19,90,,percent of total billed charges,,,108.79,85,,percent of total billed charges,,32,121.59,
MORPHINE SULF(ROXANOL)SOL : 20MG/ML 30ML,32008376,CDM,,,250,RC,outpatient,,257.41,257.41,,218.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.35,22,,percent of total billed charges,,,,,,,,,231.67,90,,percent of total billed charges,,,213.14,82.8,,percent of total billed charges,,,218.8,85,,percent of total billed charges,,,,,,,,,226.52,88,,percent of total billed charges,,,,,,,,,196.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.35,22,,percent of total billed charges,,,234.24,91,,percent of total billed charges,,,244.54,95,,percent of total billed charges,,,213.65,83,,percent of total billed charges,,,213.65,83,,percent of total billed charges,,,,,,,,,,,,,,,213.65,83,,percent of total billed charges,,,244.54,95,,percent of total billed charges,,,231.67,90,,percent of total billed charges,,,231.67,90,,percent of total billed charges,,,211.08,82,,percent of total billed charges,,,231.67,90,,percent of total billed charges,,,218.8,85,,percent of total billed charges,,64.35,244.54,
SODIUM POLYST SULF ORAL:15G/60ML (120ML),32008381,CDM,,,250,RC,outpatient,,158.76,158.76,,134.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.69,22,,percent of total billed charges,,,,,,,,,142.88,90,,percent of total billed charges,,,131.45,82.8,,percent of total billed charges,,,134.95,85,,percent of total billed charges,,,,,,,,,139.71,88,,percent of total billed charges,,,,,,,,,121.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.69,22,,percent of total billed charges,,,144.47,91,,percent of total billed charges,,,150.82,95,,percent of total billed charges,,,131.77,83,,percent of total billed charges,,,131.77,83,,percent of total billed charges,,,,,,,,,,,,,,,131.77,83,,percent of total billed charges,,,150.82,95,,percent of total billed charges,,,142.88,90,,percent of total billed charges,,,142.88,90,,percent of total billed charges,,,130.18,82,,percent of total billed charges,,,142.88,90,,percent of total billed charges,,,134.95,85,,percent of total billed charges,,39.69,150.82,
SODIUM POLYST SULF ORAL:15G/60ML (60ML),32008386,CDM,,,250,RC,outpatient,,143.69,143.69,,121.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.92,22,,percent of total billed charges,,,,,,,,,129.32,90,,percent of total billed charges,,,118.98,82.8,,percent of total billed charges,,,122.14,85,,percent of total billed charges,,,,,,,,,126.45,88,,percent of total billed charges,,,,,,,,,109.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,35.92,22,,percent of total billed charges,,,130.76,91,,percent of total billed charges,,,136.51,95,,percent of total billed charges,,,119.26,83,,percent of total billed charges,,,119.26,83,,percent of total billed charges,,,,,,,,,,,,,,,119.26,83,,percent of total billed charges,,,136.51,95,,percent of total billed charges,,,129.32,90,,percent of total billed charges,,,129.32,90,,percent of total billed charges,,,117.83,82,,percent of total billed charges,,,129.32,90,,percent of total billed charges,,,122.14,85,,percent of total billed charges,,35.92,136.51,
FE FUMRT/VIT C/B12(FEROCON)CAP:110-0.5MG,32008391,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
RACEPINEPHRINE HCL (S-2) VIAL 2.25% 15ML,32008396,CDM,,,250,RC,outpatient,,27.28,27.28,,23.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.82,22,,percent of total billed charges,,,,,,,,,24.55,90,,percent of total billed charges,,,22.59,82.8,,percent of total billed charges,,,23.19,85,,percent of total billed charges,,,,,,,,,24.01,88,,percent of total billed charges,,,,,,,,,20.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.82,22,,percent of total billed charges,,,24.82,91,,percent of total billed charges,,,25.92,95,,percent of total billed charges,,,22.64,83,,percent of total billed charges,,,22.64,83,,percent of total billed charges,,,,,,,,,,,,,,,22.64,83,,percent of total billed charges,,,25.92,95,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,22.37,82,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,23.19,85,,percent of total billed charges,,6.82,25.92,
LYTES/CARBOXYMETH(SALIVART)AER:75ML,32008397,CDM,,,250,RC,outpatient,,117.36,117.36,,99.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.34,22,,percent of total billed charges,,,,,,,,,105.62,90,,percent of total billed charges,,,97.17,82.8,,percent of total billed charges,,,99.76,85,,percent of total billed charges,,,,,,,,,103.28,88,,percent of total billed charges,,,,,,,,,89.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.34,22,,percent of total billed charges,,,106.8,91,,percent of total billed charges,,,111.49,95,,percent of total billed charges,,,97.41,83,,percent of total billed charges,,,97.41,83,,percent of total billed charges,,,,,,,,,,,,,,,97.41,83,,percent of total billed charges,,,111.49,95,,percent of total billed charges,,,105.62,90,,percent of total billed charges,,,105.62,90,,percent of total billed charges,,,96.24,82,,percent of total billed charges,,,105.62,90,,percent of total billed charges,,,99.76,85,,percent of total billed charges,,29.34,111.49,
LYTES/CARBOXYMETH(SALIVA SUBST)SOL 120ML,32008398,CDM,,,250,RC,outpatient,,25.75,25.75,,21.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.44,22,,percent of total billed charges,,,,,,,,,23.18,90,,percent of total billed charges,,,21.32,82.8,,percent of total billed charges,,,21.89,85,,percent of total billed charges,,,,,,,,,22.66,88,,percent of total billed charges,,,,,,,,,19.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.44,22,,percent of total billed charges,,,23.43,91,,percent of total billed charges,,,24.46,95,,percent of total billed charges,,,21.37,83,,percent of total billed charges,,,21.37,83,,percent of total billed charges,,,,,,,,,,,,,,,21.37,83,,percent of total billed charges,,,24.46,95,,percent of total billed charges,,,23.18,90,,percent of total billed charges,,,23.18,90,,percent of total billed charges,,,21.12,82,,percent of total billed charges,,,23.18,90,,percent of total billed charges,,,21.89,85,,percent of total billed charges,,6.44,24.46,
SALSALATE (DISALCID) TAB: 750MG,32008401,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
SALSALATE (DISALCID) TAB: 500MG,32008406,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
COLLAGENASE(SANTYL)OINT 250UNIT/GM:15GM,32008412,CDM,J3490,HCPCS,250,RC,outpatient,,1953.42,1953.42,,1658.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,488.36,22,,percent of total billed charges,,,,,,,,,1758.08,90,,percent of total billed charges,,,1617.43,82.8,,percent of total billed charges,,,1660.41,85,,percent of total billed charges,,,,,,,,,1719.01,88,,percent of total billed charges,,,,,,,,,1492.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,488.36,22,,percent of total billed charges,,,1777.61,91,,percent of total billed charges,,,1855.75,95,,percent of total billed charges,,,1621.34,83,,percent of total billed charges,,,1621.34,83,,percent of total billed charges,,,,,,,,,,,,,,,1621.34,83,,percent of total billed charges,,,1855.75,95,,percent of total billed charges,,,1758.08,90,,percent of total billed charges,,,1758.08,90,,percent of total billed charges,,,1601.8,82,,percent of total billed charges,,,1758.08,90,,percent of total billed charges,,,1660.41,85,,percent of total billed charges,,488.36,1855.75,
SANDOSTATIN MDV,32008413,CDM,,,250,RC,outpatient,,188,188,,159.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47,22,,percent of total billed charges,,,,,,,,,169.2,90,,percent of total billed charges,,,155.66,82.8,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,,,,,,,,165.44,88,,percent of total billed charges,,,,,,,,,143.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47,22,,percent of total billed charges,,,171.08,91,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,,,,,,,,,,,,,156.04,83,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,154.16,82,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,47,178.6,
SECOBARBITAL SODIUM 100MG,32008432,CDM,,,250,RC,outpatient,,2.75,2.75,,2.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.69,22,,percent of total billed charges,,,,,,,,,2.48,90,,percent of total billed charges,,,2.28,82.8,,percent of total billed charges,,,2.34,85,,percent of total billed charges,,,,,,,,,2.42,88,,percent of total billed charges,,,,,,,,,2.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.69,22,,percent of total billed charges,,,2.5,91,,percent of total billed charges,,,2.61,95,,percent of total billed charges,,,2.28,83,,percent of total billed charges,,,2.28,83,,percent of total billed charges,,,,,,,,,,,,,,,2.28,83,,percent of total billed charges,,,2.61,95,,percent of total billed charges,,,2.48,90,,percent of total billed charges,,,2.48,90,,percent of total billed charges,,,2.26,82,,percent of total billed charges,,,2.48,90,,percent of total billed charges,,,2.34,85,,percent of total billed charges,,0.69,2.61,
ACEBUTOLOL (SECTRAL) CAP : 400 MG,32008436,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
SELENIUM SULFIDE SHAMP 2.50%:118ML,32008446,CDM,J3490,HCPCS,250,RC,outpatient,,164.79,164.79,,139.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.2,22,,percent of total billed charges,,,,,,,,,148.31,90,,percent of total billed charges,,,136.45,82.8,,percent of total billed charges,,,140.07,85,,percent of total billed charges,,,,,,,,,145.02,88,,percent of total billed charges,,,,,,,,,125.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.2,22,,percent of total billed charges,,,149.96,91,,percent of total billed charges,,,156.55,95,,percent of total billed charges,,,136.78,83,,percent of total billed charges,,,136.78,83,,percent of total billed charges,,,,,,,,,,,,,,,136.78,83,,percent of total billed charges,,,156.55,95,,percent of total billed charges,,,148.31,90,,percent of total billed charges,,,148.31,90,,percent of total billed charges,,,135.13,82,,percent of total billed charges,,,148.31,90,,percent of total billed charges,,,140.07,85,,percent of total billed charges,,41.2,156.55,
SELEGILINE (ELDEPRYL) TAB : 5MG,32008451,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
SENNOSIDES(SENOKOT)TAB:8.6 MG,32008456,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
SENNOSIDES/DOCU(SENOKOT-S)TAB:8.6-50MG,32008461,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
BUPIVACAINE(SENSORCAINE)7.5% MPF:10ML,32008462,CDM,J3490,HCPCS,250,RC,outpatient,,96.43,96.43,,81.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.11,22,,percent of total billed charges,,,,,,,,,86.79,90,,percent of total billed charges,,,79.84,82.8,,percent of total billed charges,,,81.97,85,,percent of total billed charges,,,,,,,,,84.86,88,,percent of total billed charges,,,,,,,,,73.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.11,22,,percent of total billed charges,,,87.75,91,,percent of total billed charges,,,91.61,95,,percent of total billed charges,,,80.04,83,,percent of total billed charges,,,80.04,83,,percent of total billed charges,,,,,,,,,,,,,,,80.04,83,,percent of total billed charges,,,91.61,95,,percent of total billed charges,,,86.79,90,,percent of total billed charges,,,86.79,90,,percent of total billed charges,,,79.07,82,,percent of total billed charges,,,86.79,90,,percent of total billed charges,,,81.97,85,,percent of total billed charges,,24.11,91.61,
SENSORCAINE 0.5% MDV : 50 ML,32008466,CDM,,,250,RC,outpatient,,155.43,155.43,,131.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.86,22,,percent of total billed charges,,,,,,,,,139.89,90,,percent of total billed charges,,,128.7,82.8,,percent of total billed charges,,,132.12,85,,percent of total billed charges,,,,,,,,,136.78,88,,percent of total billed charges,,,,,,,,,118.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.86,22,,percent of total billed charges,,,141.44,91,,percent of total billed charges,,,147.66,95,,percent of total billed charges,,,129.01,83,,percent of total billed charges,,,129.01,83,,percent of total billed charges,,,,,,,,,,,,,,,129.01,83,,percent of total billed charges,,,147.66,95,,percent of total billed charges,,,139.89,90,,percent of total billed charges,,,139.89,90,,percent of total billed charges,,,127.45,82,,percent of total billed charges,,,139.89,90,,percent of total billed charges,,,132.12,85,,percent of total billed charges,,38.86,147.66,
BUPI/EPINE(SENSORCAINE)0.5%:30ML,32008471,CDM,,,250,RC,outpatient,,189.22,189.22,,160.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.31,22,,percent of total billed charges,,,,,,,,,170.3,90,,percent of total billed charges,,,156.67,82.8,,percent of total billed charges,,,160.84,85,,percent of total billed charges,,,,,,,,,166.51,88,,percent of total billed charges,,,,,,,,,144.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.31,22,,percent of total billed charges,,,172.19,91,,percent of total billed charges,,,179.76,95,,percent of total billed charges,,,157.05,83,,percent of total billed charges,,,157.05,83,,percent of total billed charges,,,,,,,,,,,,,,,157.05,83,,percent of total billed charges,,,179.76,95,,percent of total billed charges,,,170.3,90,,percent of total billed charges,,,170.3,90,,percent of total billed charges,,,155.16,82,,percent of total billed charges,,,170.3,90,,percent of total billed charges,,,160.84,85,,percent of total billed charges,,47.31,179.76,
BUPIVICAINE/EPI(MARCAINE)VL 0.25%:30ML*,32008476,CDM,J3490,HCPCS,250,RC,outpatient,,162.91,162.91,,138.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.73,22,,percent of total billed charges,,,,,,,,,146.62,90,,percent of total billed charges,,,134.89,82.8,,percent of total billed charges,,,138.47,85,,percent of total billed charges,,,,,,,,,143.36,88,,percent of total billed charges,,,,,,,,,124.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.73,22,,percent of total billed charges,,,148.25,91,,percent of total billed charges,,,154.76,95,,percent of total billed charges,,,135.22,83,,percent of total billed charges,,,135.22,83,,percent of total billed charges,,,,,,,,,,,,,,,135.22,83,,percent of total billed charges,,,154.76,95,,percent of total billed charges,,,146.62,90,,percent of total billed charges,,,146.62,90,,percent of total billed charges,,,133.59,82,,percent of total billed charges,,,146.62,90,,percent of total billed charges,,,138.47,85,,percent of total billed charges,,40.73,154.76,
bupivacaine 0.25% PF Inj Sol 30ML,32008481,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
SENSORCAINE .25% 1-5 ML,32008482,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
BUPIVICAINE(SENSORCAINE)VL 0.25%:30ML,32008483,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
MESORIDAZINE BESYLATE (SERENTIL)TAB:10MG,32008491,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
MESORIDAZINE BESYLATE (SERENTIL)TAB:25MG,32008496,CDM,,,250,RC,outpatient,,16.18,16.18,,13.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.05,22,,percent of total billed charges,,,,,,,,,14.56,90,,percent of total billed charges,,,13.4,82.8,,percent of total billed charges,,,13.75,85,,percent of total billed charges,,,,,,,,,14.24,88,,percent of total billed charges,,,,,,,,,12.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.05,22,,percent of total billed charges,,,14.72,91,,percent of total billed charges,,,15.37,95,,percent of total billed charges,,,13.43,83,,percent of total billed charges,,,13.43,83,,percent of total billed charges,,,,,,,,,,,,,,,13.43,83,,percent of total billed charges,,,15.37,95,,percent of total billed charges,,,14.56,90,,percent of total billed charges,,,14.56,90,,percent of total billed charges,,,13.27,82,,percent of total billed charges,,,14.56,90,,percent of total billed charges,,,13.75,85,,percent of total billed charges,,4.05,15.37,
MESORIDAZINE(SERENTIL)ORAL:25MG/ML 118ML,32008501,CDM,,,250,RC,outpatient,,883.28,883.28,,749.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,220.82,22,,percent of total billed charges,,,,,,,,,794.95,90,,percent of total billed charges,,,731.36,82.8,,percent of total billed charges,,,750.79,85,,percent of total billed charges,,,,,,,,,777.29,88,,percent of total billed charges,,,,,,,,,674.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,220.82,22,,percent of total billed charges,,,803.78,91,,percent of total billed charges,,,839.12,95,,percent of total billed charges,,,733.12,83,,percent of total billed charges,,,733.12,83,,percent of total billed charges,,,,,,,,,,,,,,,733.12,83,,percent of total billed charges,,,839.12,95,,percent of total billed charges,,,794.95,90,,percent of total billed charges,,,794.95,90,,percent of total billed charges,,,724.29,82,,percent of total billed charges,,,794.95,90,,percent of total billed charges,,,750.79,85,,percent of total billed charges,,220.82,839.12,
RESERPINE TAB:0.25MG,32008506,CDM,,,250,RC,outpatient,,20.14,20.14,,17.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.04,22,,percent of total billed charges,,,,,,,,,18.13,90,,percent of total billed charges,,,16.68,82.8,,percent of total billed charges,,,17.12,85,,percent of total billed charges,,,,,,,,,17.72,88,,percent of total billed charges,,,,,,,,,15.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.04,22,,percent of total billed charges,,,18.33,91,,percent of total billed charges,,,19.13,95,,percent of total billed charges,,,16.72,83,,percent of total billed charges,,,16.72,83,,percent of total billed charges,,,,,,,,,,,,,,,16.72,83,,percent of total billed charges,,,19.13,95,,percent of total billed charges,,,18.13,90,,percent of total billed charges,,,18.13,90,,percent of total billed charges,,,16.51,82,,percent of total billed charges,,,18.13,90,,percent of total billed charges,,,17.12,85,,percent of total billed charges,,5.04,19.13,
SEREVENT 13GM,32008512,CDM,,,250,RC,outpatient,,17,17,,14.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.25,22,,percent of total billed charges,,,,,,,,,15.3,90,,percent of total billed charges,,,14.08,82.8,,percent of total billed charges,,,14.45,85,,percent of total billed charges,,,,,,,,,14.96,88,,percent of total billed charges,,,,,,,,,12.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.25,22,,percent of total billed charges,,,15.47,91,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,,,,,,,,,,,,,14.11,83,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,13.94,82,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,14.45,85,,percent of total billed charges,,4.25,16.15,
QUEtiapine(SEROquel)TAB:25MG,32008522,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
SILVER NITRATE STICK (1),32008531,CDM,J3490,HCPCS,250,RC,outpatient,,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.07,22,,percent of total billed charges,,,,,,,,,18.24,90,,percent of total billed charges,,,16.78,82.8,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.07,22,,percent of total billed charges,,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,5.07,19.26,
SIMETHICONE(MYLICON)TAB:80MG,32008536,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CARB/LEVO(sineMET CR)TAB:50MG-200MG,32008546,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
MONTELUKAST(SINGULAIR)TAB:10MG,32008552,CDM,J8499,HCPCS,250,RC,outpatient,,10,10,,8.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.5,22,,percent of total billed charges,,,,,,,,,9,90,,percent of total billed charges,,,8.28,82.8,,percent of total billed charges,,,8.5,85,,percent of total billed charges,,,,,,,,,8.8,88,,percent of total billed charges,,,,,,,,,7.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.5,22,,percent of total billed charges,,,9.1,91,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,,,,,,,,,,,,,8.3,83,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,9,90,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.2,82,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.5,85,,percent of total billed charges,,2.5,9.5,
FERROUS SULFATE(SLOW FE)TAB:160MG,32008556,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
SODIUM ACETATE VIAL:40MEQ/20ML,32008562,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
SODIUM BICARBONATE VIAL:50MEQ/50ML,32008566,CDM,J3490,HCPCS,250,RC,outpatient,UD,145.1,145.1,,123.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.28,22,,percent of total billed charges,,,,,,,,,130.59,90,,percent of total billed charges,,,120.14,82.8,,percent of total billed charges,,,123.34,85,,percent of total billed charges,,,,,,,,,127.69,88,,percent of total billed charges,,,,,,,,,110.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.28,22,,percent of total billed charges,,,132.04,91,,percent of total billed charges,,,137.85,95,,percent of total billed charges,,,120.43,83,,percent of total billed charges,,,120.43,83,,percent of total billed charges,,,,,,,,,,,,,,,120.43,83,,percent of total billed charges,,,137.85,95,,percent of total billed charges,,,130.59,90,,percent of total billed charges,,,130.59,90,,percent of total billed charges,,,118.98,82,,percent of total billed charges,,,130.59,90,,percent of total billed charges,,,123.34,85,,percent of total billed charges,,36.28,137.85,
NORMAL SALINE 0.9%-VIAL10ML,32008571,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
NORMAL SALINE 0.9% - VIAL: 20ML,32008576,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
SODIUM CHLORIDE FOR INHAL VL0.9%:3ML(RT),32008581,CDM,J3490,HCPCS,250,RC,outpatient,,24.8,24.8,,21.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.2,22,,percent of total billed charges,,,,,,,,,22.32,90,,percent of total billed charges,,,20.53,82.8,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,,,,,,,,21.82,88,,percent of total billed charges,,,,,,,,,18.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.2,22,,percent of total billed charges,,,22.57,91,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,,,,,,,,,,,,,20.58,83,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,20.34,82,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,6.2,23.56,
SODIUM CHLORIDE FOR INHAL VL0.9%:5ML IRR,32008582,CDM,,,250,RC,outpatient,,7.5,7.5,,6.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.88,22,,percent of total billed charges,,,,,,,,,6.75,90,,percent of total billed charges,,,6.21,82.8,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,,,,,,,,6.6,88,,percent of total billed charges,,,,,,,,,5.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.88,22,,percent of total billed charges,,,6.83,91,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,6.23,83,,percent of total billed charges,,,,,,,,,,,,,,,6.23,83,,percent of total billed charges,,,7.13,95,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.15,82,,percent of total billed charges,,,6.75,90,,percent of total billed charges,,,6.38,85,,percent of total billed charges,,1.88,7.13,
SODIUM CHLORIDE VIAL : 4MEQ/ML 30ML,32008591,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
SODIUM BICARBONATE SYR:10MEQ/10ML(PEDS),32008596,CDM,J3490,HCPCS,250,RC,outpatient,,247.39,247.39,,210.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,61.85,22,,percent of total billed charges,,,,,,,,,222.65,90,,percent of total billed charges,,,204.84,82.8,,percent of total billed charges,,,210.28,85,,percent of total billed charges,,,,,,,,,217.7,88,,percent of total billed charges,,,,,,,,,189.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,61.85,22,,percent of total billed charges,,,225.12,91,,percent of total billed charges,,,235.02,95,,percent of total billed charges,,,205.33,83,,percent of total billed charges,,,205.33,83,,percent of total billed charges,,,,,,,,,,,,,,,205.33,83,,percent of total billed charges,,,235.02,95,,percent of total billed charges,,,222.65,90,,percent of total billed charges,,,222.65,90,,percent of total billed charges,,,202.86,82,,percent of total billed charges,,,222.65,90,,percent of total billed charges,,,210.28,85,,percent of total billed charges,,61.85,235.02,
SODIUM BICARBONATE SYR:50MEQ/50ML,32008606,CDM,J3490,HCPCS,250,RC,outpatient,,227.13,227.13,,192.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.78,22,,percent of total billed charges,,,,,,,,,204.42,90,,percent of total billed charges,,,188.06,82.8,,percent of total billed charges,,,193.06,85,,percent of total billed charges,,,,,,,,,199.87,88,,percent of total billed charges,,,,,,,,,173.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.78,22,,percent of total billed charges,,,206.69,91,,percent of total billed charges,,,215.77,95,,percent of total billed charges,,,188.52,83,,percent of total billed charges,,,188.52,83,,percent of total billed charges,,,,,,,,,,,,,,,188.52,83,,percent of total billed charges,,,215.77,95,,percent of total billed charges,,,204.42,90,,percent of total billed charges,,,204.42,90,,percent of total billed charges,,,186.25,82,,percent of total billed charges,,,204.42,90,,percent of total billed charges,,,193.06,85,,percent of total billed charges,,56.78,215.77,
CITRIC ACID/SODIUM CITRATE 334-500MG 480,32008607,CDM,,,250,RC,outpatient,,50.59,50.59,,42.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.65,22,,percent of total billed charges,,,,,,,,,45.53,90,,percent of total billed charges,,,41.89,82.8,,percent of total billed charges,,,43,85,,percent of total billed charges,,,,,,,,,44.52,88,,percent of total billed charges,,,,,,,,,38.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.65,22,,percent of total billed charges,,,46.04,91,,percent of total billed charges,,,48.06,95,,percent of total billed charges,,,41.99,83,,percent of total billed charges,,,41.99,83,,percent of total billed charges,,,,,,,,,,,,,,,41.99,83,,percent of total billed charges,,,48.06,95,,percent of total billed charges,,,45.53,90,,percent of total billed charges,,,45.53,90,,percent of total billed charges,,,41.48,82,,percent of total billed charges,,,45.53,90,,percent of total billed charges,,,43,85,,percent of total billed charges,,12.65,48.06,
ETHACRYNATE SOD(EDECRIN)VL:50MG,32008611,CDM,,,250,RC,outpatient,,23694.26,23694.26,,20116.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5923.57,22,,percent of total billed charges,,,,,,,,,21324.83,90,,percent of total billed charges,,,19618.85,82.8,,percent of total billed charges,,,20140.12,85,,percent of total billed charges,,,,,,,,,20850.95,88,,percent of total billed charges,,,,,,,,,18102.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5923.57,22,,percent of total billed charges,,,21561.78,91,,percent of total billed charges,,,22509.55,95,,percent of total billed charges,,,19666.24,83,,percent of total billed charges,,,19666.24,83,,percent of total billed charges,,,,,,,,,,,,,,,19666.24,83,,percent of total billed charges,,,22509.55,95,,percent of total billed charges,,,21324.83,90,,percent of total billed charges,,,21324.83,90,,percent of total billed charges,,,19429.29,82,,percent of total billed charges,,,21324.83,90,,percent of total billed charges,,,20140.12,85,,percent of total billed charges,,5923.57,22509.55,
methylPRED(solu-MEDROL)VIAL:40MG/ML,32008612,CDM,J2920,HCPCS,250,RC,outpatient,,81.37,81.37,,69.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.34,22,,percent of total billed charges,,,,,,,,,73.23,90,,percent of total billed charges,,,67.37,82.8,,percent of total billed charges,,,69.16,85,,percent of total billed charges,,,,,,,,,71.61,88,,percent of total billed charges,,4.28,,,,fee schedule,,,62.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,4.28,,,,fee schedule,,,20.34,22,,percent of total billed charges,,,74.05,91,,percent of total billed charges,,,77.3,95,,percent of total billed charges,,,67.54,83,,percent of total billed charges,,,67.54,83,,percent of total billed charges,,,,,,,,,,,,,,,67.54,83,,percent of total billed charges,,,77.3,95,,percent of total billed charges,,,73.23,90,,percent of total billed charges,,,73.23,90,,percent of total billed charges,,,66.72,82,,percent of total billed charges,,,73.23,90,,percent of total billed charges,,,69.16,85,,percent of total billed charges,,4.28,77.3,
methylPRED(solu-MEDROL)VIAL:125MG/2ML,32008613,CDM,J2930,HCPCS,250,RC,outpatient,,129.58,129.58,,110.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.4,22,,percent of total billed charges,,,,,,,,,116.62,90,,percent of total billed charges,,,107.29,82.8,,percent of total billed charges,,,110.14,85,,percent of total billed charges,,,,,,,,,114.03,88,,percent of total billed charges,,172.26,,,,fee schedule,,,99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,172.26,,,,fee schedule,,,32.4,22,,percent of total billed charges,,,117.92,91,,percent of total billed charges,,,123.1,95,,percent of total billed charges,,,107.55,83,,percent of total billed charges,,,107.55,83,,percent of total billed charges,,,,,,,,,,,,,,,107.55,83,,percent of total billed charges,,,123.1,95,,percent of total billed charges,,,116.62,90,,percent of total billed charges,,,116.62,90,,percent of total billed charges,,,106.26,82,,percent of total billed charges,,,116.62,90,,percent of total billed charges,,,110.14,85,,percent of total billed charges,,32.4,172.26,
SOLU-MEDROL,32008616,CDM,,,250,RC,outpatient,,8.5,8.5,,7.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.13,22,,percent of total billed charges,,,,,,,,,7.65,90,,percent of total billed charges,,,7.04,82.8,,percent of total billed charges,,,7.23,85,,percent of total billed charges,,,,,,,,,7.48,88,,percent of total billed charges,,,,,,,,,6.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.13,22,,percent of total billed charges,,,7.74,91,,percent of total billed charges,,,8.08,95,,percent of total billed charges,,,7.06,83,,percent of total billed charges,,,7.06,83,,percent of total billed charges,,,,,,,,,,,,,,,7.06,83,,percent of total billed charges,,,8.08,95,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,6.97,82,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,7.23,85,,percent of total billed charges,,2.13,8.08,
METHYLPREDNISLNE (SOLU-MEDROL)VIAL:500MG,32008621,CDM,,,250,RC,outpatient,,404.27,404.27,,343.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.07,22,,percent of total billed charges,,,,,,,,,363.84,90,,percent of total billed charges,,,334.74,82.8,,percent of total billed charges,,,343.63,85,,percent of total billed charges,,,,,,,,,355.76,88,,percent of total billed charges,,,,,,,,,308.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.07,22,,percent of total billed charges,,,367.89,91,,percent of total billed charges,,,384.06,95,,percent of total billed charges,,,335.54,83,,percent of total billed charges,,,335.54,83,,percent of total billed charges,,,,,,,,,,,,,,,335.54,83,,percent of total billed charges,,,384.06,95,,percent of total billed charges,,,363.84,90,,percent of total billed charges,,,363.84,90,,percent of total billed charges,,,331.5,82,,percent of total billed charges,,,363.84,90,,percent of total billed charges,,,343.63,85,,percent of total billed charges,,101.07,384.06,
SOLU-MEDROL,32008626,CDM,,,250,RC,outpatient,,124.34,124.34,,105.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.09,22,,percent of total billed charges,,,,,,,,,111.91,90,,percent of total billed charges,,,102.95,82.8,,percent of total billed charges,,,105.69,85,,percent of total billed charges,,,,,,,,,109.42,88,,percent of total billed charges,,,,,,,,,95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.09,22,,percent of total billed charges,,,113.15,91,,percent of total billed charges,,,118.12,95,,percent of total billed charges,,,103.2,83,,percent of total billed charges,,,103.2,83,,percent of total billed charges,,,,,,,,,,,,,,,103.2,83,,percent of total billed charges,,,118.12,95,,percent of total billed charges,,,111.91,90,,percent of total billed charges,,,111.91,90,,percent of total billed charges,,,101.96,82,,percent of total billed charges,,,111.91,90,,percent of total billed charges,,,105.69,85,,percent of total billed charges,,31.09,118.12,
HYDROCORTISONE(SOLU-cortef)VL:250MG/2ML,32008631,CDM,J1720,HCPCS,250,RC,outpatient,,479.25,479.25,,406.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.81,22,,percent of total billed charges,,,,,,,,,431.33,90,,percent of total billed charges,,,396.82,82.8,,percent of total billed charges,,,407.36,85,,percent of total billed charges,,,,,,,,,421.74,88,,percent of total billed charges,,89.37,,,,fee schedule,,,366.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,89.37,,,,fee schedule,,,119.81,22,,percent of total billed charges,,,436.12,91,,percent of total billed charges,,,455.29,95,,percent of total billed charges,,,397.78,83,,percent of total billed charges,,,397.78,83,,percent of total billed charges,,,,,,,,,,,,,,,397.78,83,,percent of total billed charges,,,455.29,95,,percent of total billed charges,,,431.33,90,,percent of total billed charges,,,431.33,90,,percent of total billed charges,,,392.99,82,,percent of total billed charges,,,431.33,90,,percent of total billed charges,,,407.36,85,,percent of total billed charges,,89.37,455.29,
HYDROCORT(solu-CORTEF) VIAL:500MG/4ML,32008636,CDM,,,250,RC,outpatient,,264.23,264.23,,224.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.06,22,,percent of total billed charges,,,,,,,,,237.81,90,,percent of total billed charges,,,218.78,82.8,,percent of total billed charges,,,224.6,85,,percent of total billed charges,,,,,,,,,232.52,88,,percent of total billed charges,,,,,,,,,201.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.06,22,,percent of total billed charges,,,240.45,91,,percent of total billed charges,,,251.02,95,,percent of total billed charges,,,219.31,83,,percent of total billed charges,,,219.31,83,,percent of total billed charges,,,,,,,,,,,,,,,219.31,83,,percent of total billed charges,,,251.02,95,,percent of total billed charges,,,237.81,90,,percent of total billed charges,,,237.81,90,,percent of total billed charges,,,216.67,82,,percent of total billed charges,,,237.81,90,,percent of total billed charges,,,224.6,85,,percent of total billed charges,,66.06,251.02,
methylPRED(solu-MEDROL)VIAL:1000MG/16ML,32008641,CDM,J2930,HCPCS,250,RC,outpatient,,395.26,395.26,,335.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.82,22,,percent of total billed charges,,,,,,,,,355.73,90,,percent of total billed charges,,,327.28,82.8,,percent of total billed charges,,,335.97,85,,percent of total billed charges,,,,,,,,,347.83,88,,percent of total billed charges,,172.26,,,,fee schedule,,,301.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,172.26,,,,fee schedule,,,98.82,22,,percent of total billed charges,,,359.69,91,,percent of total billed charges,,,375.5,95,,percent of total billed charges,,,328.07,83,,percent of total billed charges,,,328.07,83,,percent of total billed charges,,,,,,,,,,,,,,,328.07,83,,percent of total billed charges,,,375.5,95,,percent of total billed charges,,,355.73,90,,percent of total billed charges,,,355.73,90,,percent of total billed charges,,,324.11,82,,percent of total billed charges,,,355.73,90,,percent of total billed charges,,,335.97,85,,percent of total billed charges,,98.82,375.5,
HYDROCORTISONE(SOLU-cortef)VL:100MG/2ML,32008646,CDM,J1720,HCPCS,250,RC,outpatient,,256.54,256.54,,217.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.14,22,,percent of total billed charges,,,,,,,,,230.89,90,,percent of total billed charges,,,212.42,82.8,,percent of total billed charges,,,218.06,85,,percent of total billed charges,,,,,,,,,225.76,88,,percent of total billed charges,,89.37,,,,fee schedule,,,196,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,89.37,,,,fee schedule,,,64.14,22,,percent of total billed charges,,,233.45,91,,percent of total billed charges,,,243.71,95,,percent of total billed charges,,,212.93,83,,percent of total billed charges,,,212.93,83,,percent of total billed charges,,,,,,,,,,,,,,,212.93,83,,percent of total billed charges,,,243.71,95,,percent of total billed charges,,,230.89,90,,percent of total billed charges,,,230.89,90,,percent of total billed charges,,,210.36,82,,percent of total billed charges,,,230.89,90,,percent of total billed charges,,,218.06,85,,percent of total billed charges,,64.14,243.71,
SODIUM PHOS VIAL:45MMOL/15ML,32008651,CDM,J3490,HCPCS,250,RC,outpatient,,252.65,252.65,,214.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.16,22,,percent of total billed charges,,,,,,,,,227.39,90,,percent of total billed charges,,,209.19,82.8,,percent of total billed charges,,,214.75,85,,percent of total billed charges,,,,,,,,,222.33,88,,percent of total billed charges,,,,,,,,,193.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.16,22,,percent of total billed charges,,,229.91,91,,percent of total billed charges,,,240.02,95,,percent of total billed charges,,,209.7,83,,percent of total billed charges,,,209.7,83,,percent of total billed charges,,,,,,,,,,,,,,,209.7,83,,percent of total billed charges,,,240.02,95,,percent of total billed charges,,,227.39,90,,percent of total billed charges,,,227.39,90,,percent of total billed charges,,,207.17,82,,percent of total billed charges,,,227.39,90,,percent of total billed charges,,,214.75,85,,percent of total billed charges,,63.16,240.02,
ISOSORBIDE (ISORDIL) TAB : 30MG,32008656,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ISOSORBIDE (ISORDIL) TAB : 40MG,32008661,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
SORBITOL SOLUTION SOL 70%: 30ML,32008671,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
SORBITOL SOLUTION SOL : 70% 473ML,32008676,CDM,,,250,RC,outpatient,,55.99,55.99,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14,22,,percent of total billed charges,,,,,,,,,50.39,90,,percent of total billed charges,,,46.36,82.8,,percent of total billed charges,,,47.59,85,,percent of total billed charges,,,,,,,,,49.27,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14,22,,percent of total billed charges,,,50.95,91,,percent of total billed charges,,,53.19,95,,percent of total billed charges,,,46.47,83,,percent of total billed charges,,,46.47,83,,percent of total billed charges,,,,,,,,,,,,,,,46.47,83,,percent of total billed charges,,,53.19,95,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,45.91,82,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,47.59,85,,percent of total billed charges,,14,53.19,
SORBITOL SOLUTION SOL 70%: 50ML,32008686,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
SORBITOL SOLUTION SOL 70%:100ML,32008691,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
SORBITOL SOLUTION SOL 70%:480ML,32008696,CDM,J8499,HCPCS,250,RC,outpatient,,55.99,55.99,,47.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14,22,,percent of total billed charges,,,,,,,,,50.39,90,,percent of total billed charges,,,46.36,82.8,,percent of total billed charges,,,47.59,85,,percent of total billed charges,,,,,,,,,49.27,88,,percent of total billed charges,,,,,,,,,42.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14,22,,percent of total billed charges,,,50.95,91,,percent of total billed charges,,,53.19,95,,percent of total billed charges,,,46.47,83,,percent of total billed charges,,,46.47,83,,percent of total billed charges,,,,,,,,,,,,,,,46.47,83,,percent of total billed charges,,,53.19,95,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,45.91,82,,percent of total billed charges,,,50.39,90,,percent of total billed charges,,,47.59,85,,percent of total billed charges,,14,53.19,
EDETATE DISODIUM(EDTA)AMP:200MG/ML,32008706,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
SPIRONOLACTONE(ALDACTONE)TAB: 25MG,32008731,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ITRACONAZOLE (SPORANOX) CAP : 100MG,32008732,CDM,,,250,RC,outpatient,,123.55,123.55,,104.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.89,22,,percent of total billed charges,,,,,,,,,111.2,90,,percent of total billed charges,,,102.3,82.8,,percent of total billed charges,,,105.02,85,,percent of total billed charges,,,,,,,,,108.72,88,,percent of total billed charges,,,,,,,,,94.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.89,22,,percent of total billed charges,,,112.43,91,,percent of total billed charges,,,117.37,95,,percent of total billed charges,,,102.55,83,,percent of total billed charges,,,102.55,83,,percent of total billed charges,,,,,,,,,,,,,,,102.55,83,,percent of total billed charges,,,117.37,95,,percent of total billed charges,,,111.2,90,,percent of total billed charges,,,111.2,90,,percent of total billed charges,,,101.31,82,,percent of total billed charges,,,111.2,90,,percent of total billed charges,,,105.02,85,,percent of total billed charges,,30.89,117.37,
SILVER SULFADIAZINE(SSD)CREAM 1%:400GM,32008740,CDM,J3490,HCPCS,250,RC,outpatient,,508.01,508.01,,431.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127,22,,percent of total billed charges,,,,,,,,,457.21,90,,percent of total billed charges,,,420.63,82.8,,percent of total billed charges,,,431.81,85,,percent of total billed charges,,,,,,,,,447.05,88,,percent of total billed charges,,,,,,,,,388.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127,22,,percent of total billed charges,,,462.29,91,,percent of total billed charges,,,482.61,95,,percent of total billed charges,,,421.65,83,,percent of total billed charges,,,421.65,83,,percent of total billed charges,,,,,,,,,,,,,,,421.65,83,,percent of total billed charges,,,482.61,95,,percent of total billed charges,,,457.21,90,,percent of total billed charges,,,457.21,90,,percent of total billed charges,,,416.57,82,,percent of total billed charges,,,457.21,90,,percent of total billed charges,,,431.81,85,,percent of total billed charges,,127,482.61,
POTASSIUM IODIDE(SSKI)SOL 1GM/ML:30ML,32008741,CDM,,,250,RC,outpatient,,64.25,64.25,,54.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.06,22,,percent of total billed charges,,,,,,,,,57.83,90,,percent of total billed charges,,,53.2,82.8,,percent of total billed charges,,,54.61,85,,percent of total billed charges,,,,,,,,,56.54,88,,percent of total billed charges,,,,,,,,,49.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.06,22,,percent of total billed charges,,,58.47,91,,percent of total billed charges,,,61.04,95,,percent of total billed charges,,,53.33,83,,percent of total billed charges,,,53.33,83,,percent of total billed charges,,,,,,,,,,,,,,,53.33,83,,percent of total billed charges,,,61.04,95,,percent of total billed charges,,,57.83,90,,percent of total billed charges,,,57.83,90,,percent of total billed charges,,,52.69,82,,percent of total billed charges,,,57.83,90,,percent of total billed charges,,,54.61,85,,percent of total billed charges,,16.06,61.04,
BUTORPHANOL(STADOL) :10MG/ML SPRAY 2.5ML,32008746,CDM,,,250,RC,outpatient,,66.14,66.14,,56.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.54,22,,percent of total billed charges,,,,,,,,,59.53,90,,percent of total billed charges,,,54.76,82.8,,percent of total billed charges,,,56.22,85,,percent of total billed charges,,,,,,,,,58.2,88,,percent of total billed charges,,,,,,,,,50.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.54,22,,percent of total billed charges,,,60.19,91,,percent of total billed charges,,,62.83,95,,percent of total billed charges,,,54.9,83,,percent of total billed charges,,,54.9,83,,percent of total billed charges,,,,,,,,,,,,,,,54.9,83,,percent of total billed charges,,,62.83,95,,percent of total billed charges,,,59.53,90,,percent of total billed charges,,,59.53,90,,percent of total billed charges,,,54.23,82,,percent of total billed charges,,,59.53,90,,percent of total billed charges,,,56.22,85,,percent of total billed charges,,16.54,62.83,
BUTORPHANOL(STADOL)VIAL:1MG/ML,32008751,CDM,J0595,HCPCS,250,RC,outpatient,,79.74,79.74,,67.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.94,22,,percent of total billed charges,,,,,,,,,71.77,90,,percent of total billed charges,,,66.02,82.8,,percent of total billed charges,,,67.78,85,,percent of total billed charges,,,,,,,,,70.17,88,,percent of total billed charges,,11.85,,,,fee schedule,,,60.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11.85,,,,fee schedule,,,19.94,22,,percent of total billed charges,,,72.56,91,,percent of total billed charges,,,75.75,95,,percent of total billed charges,,,66.18,83,,percent of total billed charges,,,66.18,83,,percent of total billed charges,,,,,,,,,,,,,,,66.18,83,,percent of total billed charges,,,75.75,95,,percent of total billed charges,,,71.77,90,,percent of total billed charges,,,71.77,90,,percent of total billed charges,,,65.39,82,,percent of total billed charges,,,71.77,90,,percent of total billed charges,,,67.78,85,,percent of total billed charges,,11.85,75.75,
STERILE WATER FOR INJECTION VIAL: 10ML,32008756,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
STERILE WATER FOR INJECTION VIAL: 20ML,32008761,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
STREPTO (STREPTASE) 1.5MMU :(J PER 1MMU),32008781,CDM,J2995,HCPCS,636,RC,outpatient,,1156.11,1156.11,,981.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,289.03,22,,percent of total billed charges,,,,,,,,,1040.5,90,,percent of total billed charges,,,957.26,82.8,,percent of total billed charges,,,982.69,85,,percent of total billed charges,,,,,,,,,1017.38,88,,percent of total billed charges,,,,,,,,,883.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,289.03,22,,percent of total billed charges,,,1052.06,91,,percent of total billed charges,,,1098.3,95,,percent of total billed charges,,,959.57,83,,percent of total billed charges,,,959.57,83,,percent of total billed charges,,,,,,,,,,,,,,,959.57,83,,percent of total billed charges,,,1098.3,95,,percent of total billed charges,,,1040.5,90,,percent of total billed charges,,,1040.5,90,,percent of total billed charges,,,948.01,82,,percent of total billed charges,,,1040.5,90,,percent of total billed charges,,,982.69,85,,percent of total billed charges,,289.03,1098.3,
POTASSIUM IODIDE/IODINE SOL 5% 473ML,32008786,CDM,,,250,RC,outpatient,,1008.54,1008.54,,856.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,252.14,22,,percent of total billed charges,,,,,,,,,907.69,90,,percent of total billed charges,,,835.07,82.8,,percent of total billed charges,,,857.26,85,,percent of total billed charges,,,,,,,,,887.52,88,,percent of total billed charges,,,,,,,,,770.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,252.14,22,,percent of total billed charges,,,917.77,91,,percent of total billed charges,,,958.11,95,,percent of total billed charges,,,837.09,83,,percent of total billed charges,,,837.09,83,,percent of total billed charges,,,,,,,,,,,,,,,837.09,83,,percent of total billed charges,,,958.11,95,,percent of total billed charges,,,907.69,90,,percent of total billed charges,,,907.69,90,,percent of total billed charges,,,827,82,,percent of total billed charges,,,907.69,90,,percent of total billed charges,,,857.26,85,,percent of total billed charges,,252.14,958.11,
POTASSIUM IODIDE/IODINE SOL 5%      60ML,32008791,CDM,,,250,RC,outpatient,,37.75,37.75,,32.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.44,22,,percent of total billed charges,,,,,,,,,33.98,90,,percent of total billed charges,,,31.26,82.8,,percent of total billed charges,,,32.09,85,,percent of total billed charges,,,,,,,,,33.22,88,,percent of total billed charges,,,,,,,,,28.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.44,22,,percent of total billed charges,,,34.35,91,,percent of total billed charges,,,35.86,95,,percent of total billed charges,,,31.33,83,,percent of total billed charges,,,31.33,83,,percent of total billed charges,,,,,,,,,,,,,,,31.33,83,,percent of total billed charges,,,35.86,95,,percent of total billed charges,,,33.98,90,,percent of total billed charges,,,33.98,90,,percent of total billed charges,,,30.96,82,,percent of total billed charges,,,33.98,90,,percent of total billed charges,,,32.09,85,,percent of total billed charges,,9.44,35.86,
fentaNYL(SUBLIMAZE)PF INJ:100MCG/2ML,32008796,CDM,J3010,HCPCS,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,1.79,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.79,,,,fee schedule,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,1.79,64.15,
HEXYLRESORCINOL (SUCRETS) LOZ,32008801,CDM,,,250,RC,outpatient,,33.62,33.62,,28.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.41,22,,percent of total billed charges,,,,,,,,,30.26,90,,percent of total billed charges,,,27.84,82.8,,percent of total billed charges,,,28.58,85,,percent of total billed charges,,,,,,,,,29.59,88,,percent of total billed charges,,,,,,,,,25.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.41,22,,percent of total billed charges,,,30.59,91,,percent of total billed charges,,,31.94,95,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,,,,,,,,,,,,,,27.9,83,,percent of total billed charges,,,31.94,95,,percent of total billed charges,,,30.26,90,,percent of total billed charges,,,30.26,90,,percent of total billed charges,,,27.57,82,,percent of total billed charges,,,30.26,90,,percent of total billed charges,,,28.58,85,,percent of total billed charges,,8.41,31.94,
SULF/TRIM(BACTRIM)SUS:200-40MG/5ML 100ML,32008806,CDM,J8499,HCPCS,250,RC,outpatient,UD,156.21,156.21,,132.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.05,22,,percent of total billed charges,,,,,,,,,140.59,90,,percent of total billed charges,,,129.34,82.8,,percent of total billed charges,,,132.78,85,,percent of total billed charges,,,,,,,,,137.46,88,,percent of total billed charges,,,,,,,,,119.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.05,22,,percent of total billed charges,,,142.15,91,,percent of total billed charges,,,148.4,95,,percent of total billed charges,,,129.65,83,,percent of total billed charges,,,129.65,83,,percent of total billed charges,,,,,,,,,,,,,,,129.65,83,,percent of total billed charges,,,148.4,95,,percent of total billed charges,,,140.59,90,,percent of total billed charges,,,140.59,90,,percent of total billed charges,,,128.09,82,,percent of total billed charges,,,140.59,90,,percent of total billed charges,,,132.78,85,,percent of total billed charges,,39.05,148.4,
SULF/TRIM (BACTRIM)ORAL:200-40MG/5 480ML,32008811,CDM,,,250,RC,outpatient,,802.64,802.64,,681.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,200.66,22,,percent of total billed charges,,,,,,,,,722.38,90,,percent of total billed charges,,,664.59,82.8,,percent of total billed charges,,,682.24,85,,percent of total billed charges,,,,,,,,,706.32,88,,percent of total billed charges,,,,,,,,,613.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,200.66,22,,percent of total billed charges,,,730.4,91,,percent of total billed charges,,,762.51,95,,percent of total billed charges,,,666.19,83,,percent of total billed charges,,,666.19,83,,percent of total billed charges,,,,,,,,,,,,,,,666.19,83,,percent of total billed charges,,,762.51,95,,percent of total billed charges,,,722.38,90,,percent of total billed charges,,,722.38,90,,percent of total billed charges,,,658.16,82,,percent of total billed charges,,,722.38,90,,percent of total billed charges,,,682.24,85,,percent of total billed charges,,200.66,762.51,
NISOLDIPINE (SULAR) TAB : 10MG,32008821,CDM,,,250,RC,outpatient,,17.76,17.76,,15.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.44,22,,percent of total billed charges,,,,,,,,,15.98,90,,percent of total billed charges,,,14.71,82.8,,percent of total billed charges,,,15.1,85,,percent of total billed charges,,,,,,,,,15.63,88,,percent of total billed charges,,,,,,,,,13.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.44,22,,percent of total billed charges,,,16.16,91,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,,,,,,,,,,,,,14.74,83,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,14.56,82,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.1,85,,percent of total billed charges,,4.44,16.87,
NISOLDIPINE(SULAR)TAB:20MG,32008822,CDM,,,250,RC,outpatient,,17.76,17.76,,15.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.44,22,,percent of total billed charges,,,,,,,,,15.98,90,,percent of total billed charges,,,14.71,82.8,,percent of total billed charges,,,15.1,85,,percent of total billed charges,,,,,,,,,15.63,88,,percent of total billed charges,,,,,,,,,13.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.44,22,,percent of total billed charges,,,16.16,91,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,,,,,,,,,,,,,14.74,83,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,14.56,82,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.1,85,,percent of total billed charges,,4.44,16.87,
SULF/TRIM(BACTRIM)VIAL:800-160MG/10ML,32008826,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
SULF/TRIM TAB(BACTRIM PLAIN) : 400-80MG,32008836,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
SULF/TRIM(BACTRIM DS)TAB:800-160MG,32008841,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
SULF/TRIM(BACTRIM DS)TAB:800-160MG(1X6),32008842,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
SULINDAC TAB (CLINORIL): 150MG,32008856,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
SULINDAC TAB (CLINORIL) : 200MG,32008861,CDM,,,250,RC,outpatient,,16.81,16.81,,14.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.2,22,,percent of total billed charges,,,,,,,,,15.13,90,,percent of total billed charges,,,13.92,82.8,,percent of total billed charges,,,14.29,85,,percent of total billed charges,,,,,,,,,14.79,88,,percent of total billed charges,,,,,,,,,12.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.2,22,,percent of total billed charges,,,15.3,91,,percent of total billed charges,,,15.97,95,,percent of total billed charges,,,13.95,83,,percent of total billed charges,,,13.95,83,,percent of total billed charges,,,,,,,,,,,,,,,13.95,83,,percent of total billed charges,,,15.97,95,,percent of total billed charges,,,15.13,90,,percent of total billed charges,,,15.13,90,,percent of total billed charges,,,13.78,82,,percent of total billed charges,,,15.13,90,,percent of total billed charges,,,14.29,85,,percent of total billed charges,,4.2,15.97,
CIMETIDINE(TAGAMET)VIAL:150MG/ML,32008936,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
CIMETIDINE(TAGAMET) LIQ :300MG/5ML 237ML,32008941,CDM,,,250,RC,outpatient,,233.14,233.14,,197.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,58.29,22,,percent of total billed charges,,,,,,,,,209.83,90,,percent of total billed charges,,,193.04,82.8,,percent of total billed charges,,,198.17,85,,percent of total billed charges,,,,,,,,,205.16,88,,percent of total billed charges,,,,,,,,,178.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,58.29,22,,percent of total billed charges,,,212.16,91,,percent of total billed charges,,,221.48,95,,percent of total billed charges,,,193.51,83,,percent of total billed charges,,,193.51,83,,percent of total billed charges,,,,,,,,,,,,,,,193.51,83,,percent of total billed charges,,,221.48,95,,percent of total billed charges,,,209.83,90,,percent of total billed charges,,,209.83,90,,percent of total billed charges,,,191.17,82,,percent of total billed charges,,,209.83,90,,percent of total billed charges,,,198.17,85,,percent of total billed charges,,58.29,221.48,
CIMETIDINE (TAGAMET) VIAL : 150MG/ML 8ML,32008951,CDM,,,250,RC,outpatient,,66.61,66.61,,56.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.65,22,,percent of total billed charges,,,,,,,,,59.95,90,,percent of total billed charges,,,55.15,82.8,,percent of total billed charges,,,56.62,85,,percent of total billed charges,,,,,,,,,58.62,88,,percent of total billed charges,,,,,,,,,50.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.65,22,,percent of total billed charges,,,60.62,91,,percent of total billed charges,,,63.28,95,,percent of total billed charges,,,55.29,83,,percent of total billed charges,,,55.29,83,,percent of total billed charges,,,,,,,,,,,,,,,55.29,83,,percent of total billed charges,,,63.28,95,,percent of total billed charges,,,59.95,90,,percent of total billed charges,,,59.95,90,,percent of total billed charges,,,54.62,82,,percent of total billed charges,,,59.95,90,,percent of total billed charges,,,56.62,85,,percent of total billed charges,,16.65,63.28,
FLECAINIDE ACETATE (TAMBACOR)TAB : 100MG,32008971,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
*TAXOTERE 20MG  **J9170**(V1011),32008972,CDM,J9171,HCPCS,636,RC,outpatient,,428,428,,363.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107,22,,percent of total billed charges,,,,,,,,,385.2,90,,percent of total billed charges,,,354.38,82.8,,percent of total billed charges,,,363.8,85,,percent of total billed charges,,,,,,,,,376.64,88,,percent of total billed charges,,121.68,,,,fee schedule,,,326.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,107,22,,percent of total billed charges,,,389.48,91,,percent of total billed charges,,,406.6,95,,percent of total billed charges,,,355.24,83,,percent of total billed charges,,,355.24,83,,percent of total billed charges,,,,,,,,,,,,,,,355.24,83,,percent of total billed charges,,,406.6,95,,percent of total billed charges,,,385.2,90,,percent of total billed charges,,,385.2,90,,percent of total billed charges,,,350.96,82,,percent of total billed charges,,,385.2,90,,percent of total billed charges,,,363.8,85,,percent of total billed charges,,107,406.6,
*DOCETAXEL (Taxotere) 80MG/2ML: (V1011),32008973,CDM,J9171,HCPCS,636,RC,outpatient,,3165.53,3165.53,,2687.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,791.38,22,,percent of total billed charges,,,,,,,,,2848.98,90,,percent of total billed charges,,,2621.06,82.8,,percent of total billed charges,,,2690.7,85,,percent of total billed charges,,,,,,,,,2785.67,88,,percent of total billed charges,,121.68,,,,fee schedule,,,2418.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,791.38,22,,percent of total billed charges,,,2880.63,91,,percent of total billed charges,,,3007.25,95,,percent of total billed charges,,,2627.39,83,,percent of total billed charges,,,2627.39,83,,percent of total billed charges,,,,,,,,,,,,,,,2627.39,83,,percent of total billed charges,,,3007.25,95,,percent of total billed charges,,,2848.98,90,,percent of total billed charges,,,2848.98,90,,percent of total billed charges,,,2595.73,82,,percent of total billed charges,,,2848.98,90,,percent of total billed charges,,,2690.7,85,,percent of total billed charges,,121.68,3007.25,
PACLitaxel(TAXol)MDV:100MG/16.7ML J/1,32008974,CDM,J9267,HCPCS,636,RC,outpatient,,1.9,1.9,,1.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.48,22,,percent of total billed charges,,,,,,,,,1.71,90,,percent of total billed charges,,,1.57,82.8,,percent of total billed charges,,,1.62,85,,percent of total billed charges,,,,,,,,,1.67,88,,percent of total billed charges,,61.04,,,,fee schedule,,,1.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,61.04,,,,fee schedule,,,0.48,22,,percent of total billed charges,,,1.73,91,,percent of total billed charges,,,1.81,95,,percent of total billed charges,,,1.58,83,,percent of total billed charges,,,1.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1.58,83,,percent of total billed charges,,,1.81,95,,percent of total billed charges,,,1.71,90,,percent of total billed charges,,,1.71,90,,percent of total billed charges,,,1.56,82,,percent of total billed charges,,,1.71,90,,percent of total billed charges,,,1.62,85,,percent of total billed charges,,0.48,61.04,
OSELTAMIVIR(TAMIFLU)CAP:75MG,32008975,CDM,J8499,HCPCS,250,RC,outpatient,,17.48,17.48,,14.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.37,22,,percent of total billed charges,,,,,,,,,15.73,90,,percent of total billed charges,,,14.47,82.8,,percent of total billed charges,,,14.86,85,,percent of total billed charges,,,,,,,,,15.38,88,,percent of total billed charges,,,,,,,,,13.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.37,22,,percent of total billed charges,,,15.91,91,,percent of total billed charges,,,16.61,95,,percent of total billed charges,,,14.51,83,,percent of total billed charges,,,14.51,83,,percent of total billed charges,,,,,,,,,,,,,,,14.51,83,,percent of total billed charges,,,16.61,95,,percent of total billed charges,,,15.73,90,,percent of total billed charges,,,15.73,90,,percent of total billed charges,,,14.33,82,,percent of total billed charges,,,15.73,90,,percent of total billed charges,,,14.86,85,,percent of total billed charges,,4.37,16.61,
METHIMAZOLE(TAPAZOLE)TAB:5MG,32008977,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
TRIMETHOBENZAMIDE (TIGAN) SUPP: 200MG-2%,32008996,CDM,,,250,RC,outpatient,,14.22,14.22,,12.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.56,22,,percent of total billed charges,,,,,,,,,12.8,90,,percent of total billed charges,,,11.77,82.8,,percent of total billed charges,,,12.09,85,,percent of total billed charges,,,,,,,,,12.51,88,,percent of total billed charges,,,,,,,,,10.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.56,22,,percent of total billed charges,,,12.94,91,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,,,,,,,,,,,,,11.8,83,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,11.66,82,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.09,85,,percent of total billed charges,,3.56,13.51,
TRIMETHOBENZAMIDE (TIGAN) SUPP: 100MG-2%,32009001,CDM,,,250,RC,outpatient,,14.22,14.22,,12.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.56,22,,percent of total billed charges,,,,,,,,,12.8,90,,percent of total billed charges,,,11.77,82.8,,percent of total billed charges,,,12.09,85,,percent of total billed charges,,,,,,,,,12.51,88,,percent of total billed charges,,,,,,,,,10.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.56,22,,percent of total billed charges,,,12.94,91,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,,,,,,,,,,,,,11.8,83,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,11.66,82,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.09,85,,percent of total billed charges,,3.56,13.51,
carBAMazepine(TEGretol)CHEW TAB:100MG,32009006,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
TELMISARTAN(MICARDIS)TAB:40MG,32009007,CDM,J8499,HCPCS,250,RC,outpatient,,23.86,23.86,,20.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.97,22,,percent of total billed charges,,,,,,,,,21.47,90,,percent of total billed charges,,,19.76,82.8,,percent of total billed charges,,,20.28,85,,percent of total billed charges,,,,,,,,,21,88,,percent of total billed charges,,,,,,,,,18.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.97,22,,percent of total billed charges,,,21.71,91,,percent of total billed charges,,,22.67,95,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,,,,,,,,,,,,,,19.8,83,,percent of total billed charges,,,22.67,95,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,19.57,82,,percent of total billed charges,,,21.47,90,,percent of total billed charges,,,20.28,85,,percent of total billed charges,,5.97,22.67,
carBAMazepine(TEGretol):100MG/5ML(450ML),32009010,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
TEMAZEPAM(RESTORIL)CAP:15MG,32009016,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
ATENOLOL(TENORMIN IV)AMP:5MG/10ML,32009027,CDM,,,250,RC,outpatient,,62.25,62.25,,52.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.56,22,,percent of total billed charges,,,,,,,,,56.03,90,,percent of total billed charges,,,51.54,82.8,,percent of total billed charges,,,52.91,85,,percent of total billed charges,,,,,,,,,54.78,88,,percent of total billed charges,,,,,,,,,47.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.56,22,,percent of total billed charges,,,56.65,91,,percent of total billed charges,,,59.14,95,,percent of total billed charges,,,51.67,83,,percent of total billed charges,,,51.67,83,,percent of total billed charges,,,,,,,,,,,,,,,51.67,83,,percent of total billed charges,,,59.14,95,,percent of total billed charges,,,56.03,90,,percent of total billed charges,,,56.03,90,,percent of total billed charges,,,51.05,82,,percent of total billed charges,,,56.03,90,,percent of total billed charges,,,52.91,85,,percent of total billed charges,,15.56,59.14,
TERCONAZOLE (TERAZOL 7) CREAM:0.40% 45GM,32009036,CDM,,,250,RC,outpatient,,732.57,732.57,,621.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,183.14,22,,percent of total billed charges,,,,,,,,,659.31,90,,percent of total billed charges,,,606.57,82.8,,percent of total billed charges,,,622.68,85,,percent of total billed charges,,,,,,,,,644.66,88,,percent of total billed charges,,,,,,,,,559.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,183.14,22,,percent of total billed charges,,,666.64,91,,percent of total billed charges,,,695.94,95,,percent of total billed charges,,,608.03,83,,percent of total billed charges,,,608.03,83,,percent of total billed charges,,,,,,,,,,,,,,,608.03,83,,percent of total billed charges,,,695.94,95,,percent of total billed charges,,,659.31,90,,percent of total billed charges,,,659.31,90,,percent of total billed charges,,,600.71,82,,percent of total billed charges,,,659.31,90,,percent of total billed charges,,,622.68,85,,percent of total billed charges,,183.14,695.94,
TERCONAZOLE(TERAZOL 3)CREAM:20GM,32009041,CDM,,,250,RC,outpatient,,653.27,653.27,,554.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,163.32,22,,percent of total billed charges,,,,,,,,,587.94,90,,percent of total billed charges,,,540.91,82.8,,percent of total billed charges,,,555.28,85,,percent of total billed charges,,,,,,,,,574.88,88,,percent of total billed charges,,,,,,,,,499.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,163.32,22,,percent of total billed charges,,,594.48,91,,percent of total billed charges,,,620.61,95,,percent of total billed charges,,,542.21,83,,percent of total billed charges,,,542.21,83,,percent of total billed charges,,,,,,,,,,,,,,,542.21,83,,percent of total billed charges,,,620.61,95,,percent of total billed charges,,,587.94,90,,percent of total billed charges,,,587.94,90,,percent of total billed charges,,,535.68,82,,percent of total billed charges,,,587.94,90,,percent of total billed charges,,,555.28,85,,percent of total billed charges,,163.32,620.61,
TERCONAZOLE(TERAZOL 3)SUPP:80MG EA,32009046,CDM,,,250,RC,outpatient,,345.43,345.43,,293.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.36,22,,percent of total billed charges,,,,,,,,,310.89,90,,percent of total billed charges,,,286.02,82.8,,percent of total billed charges,,,293.62,85,,percent of total billed charges,,,,,,,,,303.98,88,,percent of total billed charges,,,,,,,,,263.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.36,22,,percent of total billed charges,,,314.34,91,,percent of total billed charges,,,328.16,95,,percent of total billed charges,,,286.71,83,,percent of total billed charges,,,286.71,83,,percent of total billed charges,,,,,,,,,,,,,,,286.71,83,,percent of total billed charges,,,328.16,95,,percent of total billed charges,,,310.89,90,,percent of total billed charges,,,310.89,90,,percent of total billed charges,,,283.25,82,,percent of total billed charges,,,310.89,90,,percent of total billed charges,,,293.62,85,,percent of total billed charges,,86.36,328.16,
TERCONAZOLE(TERAZOL)SUPP:80MG,32009051,CDM,J3490,HCPCS,250,RC,outpatient,,345.43,345.43,,293.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86.36,22,,percent of total billed charges,,,,,,,,,310.89,90,,percent of total billed charges,,,286.02,82.8,,percent of total billed charges,,,293.62,85,,percent of total billed charges,,,,,,,,,303.98,88,,percent of total billed charges,,,,,,,,,263.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86.36,22,,percent of total billed charges,,,314.34,91,,percent of total billed charges,,,328.16,95,,percent of total billed charges,,,286.71,83,,percent of total billed charges,,,286.71,83,,percent of total billed charges,,,,,,,,,,,,,,,286.71,83,,percent of total billed charges,,,328.16,95,,percent of total billed charges,,,310.89,90,,percent of total billed charges,,,310.89,90,,percent of total billed charges,,,283.25,82,,percent of total billed charges,,,310.89,90,,percent of total billed charges,,,293.62,85,,percent of total billed charges,,86.36,328.16,
TETAN&DIPH(TENIVAC)SYR:0.5ML  PYX,32009076,CDM,90714,CPT,636,RC,outpatient,,484.84,484.84,,411.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,121.21,22,,percent of total billed charges,,,,,,,,,436.36,90,,percent of total billed charges,,,401.45,82.8,,percent of total billed charges,,,412.11,85,,percent of total billed charges,,,,,,,,,426.66,88,,percent of total billed charges,,,,,,,,,370.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,121.21,22,,percent of total billed charges,,,441.2,91,,percent of total billed charges,,,460.6,95,,percent of total billed charges,,,402.42,83,,percent of total billed charges,,,402.42,83,,percent of total billed charges,,,,,,,,,,,,,,,402.42,83,,percent of total billed charges,,,460.6,95,,percent of total billed charges,,,436.36,90,,percent of total billed charges,,,436.36,90,,percent of total billed charges,,,397.57,82,,percent of total billed charges,,,436.36,90,,percent of total billed charges,,,412.11,85,,percent of total billed charges,,121.21,460.6,
TETRACYCLINE CAP:500MG,32009086,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
TETRACAINE DROP 0.5%:4ML,32009091,CDM,J3490,HCPCS,250,RC,outpatient,,196.9,196.9,,167.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.23,22,,percent of total billed charges,,,,,,,,,177.21,90,,percent of total billed charges,,,163.03,82.8,,percent of total billed charges,,,167.37,85,,percent of total billed charges,,,,,,,,,173.27,88,,percent of total billed charges,,,,,,,,,150.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.23,22,,percent of total billed charges,,,179.18,91,,percent of total billed charges,,,187.06,95,,percent of total billed charges,,,163.43,83,,percent of total billed charges,,,163.43,83,,percent of total billed charges,,,,,,,,,,,,,,,163.43,83,,percent of total billed charges,,,187.06,95,,percent of total billed charges,,,177.21,90,,percent of total billed charges,,,177.21,90,,percent of total billed charges,,,161.46,82,,percent of total billed charges,,,177.21,90,,percent of total billed charges,,,167.37,85,,percent of total billed charges,,49.23,187.06,
TETRACYCLINE HCL CAP : 250MG,32009096,CDM,,,250,RC,outpatient,,2.1,2.1,,1.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.53,22,,percent of total billed charges,,,,,,,,,1.89,90,,percent of total billed charges,,,1.74,82.8,,percent of total billed charges,,,1.79,85,,percent of total billed charges,,,,,,,,,1.85,88,,percent of total billed charges,,,,,,,,,1.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.53,22,,percent of total billed charges,,,1.91,91,,percent of total billed charges,,,2,95,,percent of total billed charges,,,1.74,83,,percent of total billed charges,,,1.74,83,,percent of total billed charges,,,,,,,,,,,,,,,1.74,83,,percent of total billed charges,,,2,95,,percent of total billed charges,,,1.89,90,,percent of total billed charges,,,1.89,90,,percent of total billed charges,,,1.72,82,,percent of total billed charges,,,1.89,90,,percent of total billed charges,,,1.79,85,,percent of total billed charges,,0.53,2,
THEOPHYLLINE(THEO-DUR)TAB:100MG,32009116,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
THEOPHYLLINE (THEO-DUR) TAB : 300MG,32009121,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
THEOPHYLLINE ANHYDROU SOL:80MG/15ML 30ML,32009126,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
THEOPHYLLINE (THEO-DUR) TAB : 200MG,32009136,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
THEOPHYLLINE ANHYDROU SOL:80MG/15ML 90ML,32009146,CDM,,,250,RC,outpatient,,13.8,13.8,,11.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.45,22,,percent of total billed charges,,,,,,,,,12.42,90,,percent of total billed charges,,,11.43,82.8,,percent of total billed charges,,,11.73,85,,percent of total billed charges,,,,,,,,,12.14,88,,percent of total billed charges,,,,,,,,,10.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.45,22,,percent of total billed charges,,,12.56,91,,percent of total billed charges,,,13.11,95,,percent of total billed charges,,,11.45,83,,percent of total billed charges,,,11.45,83,,percent of total billed charges,,,,,,,,,,,,,,,11.45,83,,percent of total billed charges,,,13.11,95,,percent of total billed charges,,,12.42,90,,percent of total billed charges,,,12.42,90,,percent of total billed charges,,,11.32,82,,percent of total billed charges,,,12.42,90,,percent of total billed charges,,,11.73,85,,percent of total billed charges,,3.45,13.11,
THEOPHYLLINE ANHYDR SOL:80MG/15ML 500ML,32009161,CDM,,,250,RC,outpatient,,76.76,76.76,,65.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.19,22,,percent of total billed charges,,,,,,,,,69.08,90,,percent of total billed charges,,,63.56,82.8,,percent of total billed charges,,,65.25,85,,percent of total billed charges,,,,,,,,,67.55,88,,percent of total billed charges,,,,,,,,,58.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.19,22,,percent of total billed charges,,,69.85,91,,percent of total billed charges,,,72.92,95,,percent of total billed charges,,,63.71,83,,percent of total billed charges,,,63.71,83,,percent of total billed charges,,,,,,,,,,,,,,,63.71,83,,percent of total billed charges,,,72.92,95,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,62.94,82,,percent of total billed charges,,,69.08,90,,percent of total billed charges,,,65.25,85,,percent of total billed charges,,19.19,72.92,
MULTIVITAMINS THERA TAB:,32009186,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
SODIUM CHLORIDE(SALT)TAB:1GM,32009196,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
THERAVITE (MULTIVITAMIN) 120ML,32009201,CDM,,,250,RC,outpatient,,53.77,53.77,,45.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.44,22,,percent of total billed charges,,,,,,,,,48.39,90,,percent of total billed charges,,,44.52,82.8,,percent of total billed charges,,,45.7,85,,percent of total billed charges,,,,,,,,,47.32,88,,percent of total billed charges,,,,,,,,,41.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.44,22,,percent of total billed charges,,,48.93,91,,percent of total billed charges,,,51.08,95,,percent of total billed charges,,,44.63,83,,percent of total billed charges,,,44.63,83,,percent of total billed charges,,,,,,,,,,,,,,,44.63,83,,percent of total billed charges,,,51.08,95,,percent of total billed charges,,,48.39,90,,percent of total billed charges,,,48.39,90,,percent of total billed charges,,,44.09,82,,percent of total billed charges,,,48.39,90,,percent of total billed charges,,,45.7,85,,percent of total billed charges,,13.44,51.08,
SILVER SULFADIAZINE(SSD AF)CREAM 1%:50G,32009211,CDM,J3490,HCPCS,250,RC,outpatient,,114.05,114.05,,96.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.51,22,,percent of total billed charges,,,,,,,,,102.65,90,,percent of total billed charges,,,94.43,82.8,,percent of total billed charges,,,96.94,85,,percent of total billed charges,,,,,,,,,100.36,88,,percent of total billed charges,,,,,,,,,87.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.51,22,,percent of total billed charges,,,103.79,91,,percent of total billed charges,,,108.35,95,,percent of total billed charges,,,94.66,83,,percent of total billed charges,,,94.66,83,,percent of total billed charges,,,,,,,,,,,,,,,94.66,83,,percent of total billed charges,,,108.35,95,,percent of total billed charges,,,102.65,90,,percent of total billed charges,,,102.65,90,,percent of total billed charges,,,93.52,82,,percent of total billed charges,,,102.65,90,,percent of total billed charges,,,96.94,85,,percent of total billed charges,,28.51,108.35,
THIAMINE HCL VIAL:200MG/2ML,32009221,CDM,J3411,HCPCS,250,RC,outpatient,,80.56,80.56,,68.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.14,22,,percent of total billed charges,,,,,,,,,72.5,90,,percent of total billed charges,,,66.7,82.8,,percent of total billed charges,,,68.48,85,,percent of total billed charges,,,,,,,,,70.89,88,,percent of total billed charges,,2.88,,,,fee schedule,,,61.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.88,,,,fee schedule,,,20.14,22,,percent of total billed charges,,,73.31,91,,percent of total billed charges,,,76.53,95,,percent of total billed charges,,,66.86,83,,percent of total billed charges,,,66.86,83,,percent of total billed charges,,,,,,,,,,,,,,,66.86,83,,percent of total billed charges,,,76.53,95,,percent of total billed charges,,,72.5,90,,percent of total billed charges,,,72.5,90,,percent of total billed charges,,,66.06,82,,percent of total billed charges,,,72.5,90,,percent of total billed charges,,,68.48,85,,percent of total billed charges,,2.88,76.53,
THIORIDAZINE (MELLARIL) TAB : 25MG,32009231,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
THIORIDAZINE (MELLARIL) TAB : 10MG,32009236,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
THIOTHIXENE 1 MG CAPS,32009247,CDM,,,250,RC,outpatient,,1,1,,0.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.25,22,,percent of total billed charges,,,,,,,,,0.9,90,,percent of total billed charges,,,0.83,82.8,,percent of total billed charges,,,0.85,85,,percent of total billed charges,,,,,,,,,0.88,88,,percent of total billed charges,,,,,,,,,0.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.25,22,,percent of total billed charges,,,0.91,91,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,0.83,83,,percent of total billed charges,,,,,,,,,,,,,,,0.83,83,,percent of total billed charges,,,0.95,95,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.82,82,,percent of total billed charges,,,0.9,90,,percent of total billed charges,,,0.85,85,,percent of total billed charges,,0.25,0.95,
THROMBIN VIAL 50000 UNIT:,32009257,CDM,,,250,RC,outpatient,,2217.01,2217.01,,1882.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,554.25,22,,percent of total billed charges,,,,,,,,,1995.31,90,,percent of total billed charges,,,1835.68,82.8,,percent of total billed charges,,,1884.46,85,,percent of total billed charges,,,,,,,,,1950.97,88,,percent of total billed charges,,,,,,,,,1693.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,554.25,22,,percent of total billed charges,,,2017.48,91,,percent of total billed charges,,,2106.16,95,,percent of total billed charges,,,1840.12,83,,percent of total billed charges,,,1840.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1840.12,83,,percent of total billed charges,,,2106.16,95,,percent of total billed charges,,,1995.31,90,,percent of total billed charges,,,1995.31,90,,percent of total billed charges,,,1817.95,82,,percent of total billed charges,,,1995.31,90,,percent of total billed charges,,,1884.46,85,,percent of total billed charges,,554.25,2106.16,
LIOTRIX (THYROLAR-1) TAB : 60MG,32009261,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
TICLOPIDINE (TICLID) TAB : 250MG,32009271,CDM,,,250,RC,outpatient,,21.57,21.57,,18.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.39,22,,percent of total billed charges,,,,,,,,,19.41,90,,percent of total billed charges,,,17.86,82.8,,percent of total billed charges,,,18.33,85,,percent of total billed charges,,,,,,,,,18.98,88,,percent of total billed charges,,,,,,,,,16.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.39,22,,percent of total billed charges,,,19.63,91,,percent of total billed charges,,,20.49,95,,percent of total billed charges,,,17.9,83,,percent of total billed charges,,,17.9,83,,percent of total billed charges,,,,,,,,,,,,,,,17.9,83,,percent of total billed charges,,,20.49,95,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,17.69,82,,percent of total billed charges,,,19.41,90,,percent of total billed charges,,,18.33,85,,percent of total billed charges,,5.39,20.49,
NEDOCROMIL(TILADE)AER:1.75MG  (16.2GM),32009276,CDM,,,250,RC,outpatient,,1213.5,1213.5,,1030.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,303.38,22,,percent of total billed charges,,,,,,,,,1092.15,90,,percent of total billed charges,,,1004.78,82.8,,percent of total billed charges,,,1031.48,85,,percent of total billed charges,,,,,,,,,1067.88,88,,percent of total billed charges,,,,,,,,,927.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,303.38,22,,percent of total billed charges,,,1104.29,91,,percent of total billed charges,,,1152.83,95,,percent of total billed charges,,,1007.21,83,,percent of total billed charges,,,1007.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1007.21,83,,percent of total billed charges,,,1152.83,95,,percent of total billed charges,,,1092.15,90,,percent of total billed charges,,,1092.15,90,,percent of total billed charges,,,995.07,82,,percent of total billed charges,,,1092.15,90,,percent of total billed charges,,,1031.48,85,,percent of total billed charges,,303.38,1152.83,
TIMOLOL (BLOCADREN) TAB : 10MG,32009286,CDM,,,250,RC,outpatient,,22.68,22.68,,19.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.67,22,,percent of total billed charges,,,,,,,,,20.41,90,,percent of total billed charges,,,18.78,82.8,,percent of total billed charges,,,19.28,85,,percent of total billed charges,,,,,,,,,19.96,88,,percent of total billed charges,,,,,,,,,17.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.67,22,,percent of total billed charges,,,20.64,91,,percent of total billed charges,,,21.55,95,,percent of total billed charges,,,18.82,83,,percent of total billed charges,,,18.82,83,,percent of total billed charges,,,,,,,,,,,,,,,18.82,83,,percent of total billed charges,,,21.55,95,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,18.6,82,,percent of total billed charges,,,20.41,90,,percent of total billed charges,,,19.28,85,,percent of total billed charges,,5.67,21.55,
TIMOLOL(TIMOPTIC)DROP 0.25%:5ML,32009291,CDM,J3490,HCPCS,250,RC,outpatient,,50.43,50.43,,42.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.61,22,,percent of total billed charges,,,,,,,,,45.39,90,,percent of total billed charges,,,41.76,82.8,,percent of total billed charges,,,42.87,85,,percent of total billed charges,,,,,,,,,44.38,88,,percent of total billed charges,,,,,,,,,38.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.61,22,,percent of total billed charges,,,45.89,91,,percent of total billed charges,,,47.91,95,,percent of total billed charges,,,41.86,83,,percent of total billed charges,,,41.86,83,,percent of total billed charges,,,,,,,,,,,,,,,41.86,83,,percent of total billed charges,,,47.91,95,,percent of total billed charges,,,45.39,90,,percent of total billed charges,,,45.39,90,,percent of total billed charges,,,41.35,82,,percent of total billed charges,,,45.39,90,,percent of total billed charges,,,42.87,85,,percent of total billed charges,,12.61,47.91,
TIMOPTIC XE 0.25% 10ML,32009292,CDM,,,250,RC,outpatient,,37.5,37.5,,31.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.38,22,,percent of total billed charges,,,,,,,,,33.75,90,,percent of total billed charges,,,31.05,82.8,,percent of total billed charges,,,31.88,85,,percent of total billed charges,,,,,,,,,33,88,,percent of total billed charges,,,,,,,,,28.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.38,22,,percent of total billed charges,,,34.13,91,,percent of total billed charges,,,35.63,95,,percent of total billed charges,,,31.13,83,,percent of total billed charges,,,31.13,83,,percent of total billed charges,,,,,,,,,,,,,,,31.13,83,,percent of total billed charges,,,35.63,95,,percent of total billed charges,,,33.75,90,,percent of total billed charges,,,33.75,90,,percent of total billed charges,,,30.75,82,,percent of total billed charges,,,33.75,90,,percent of total billed charges,,,31.88,85,,percent of total billed charges,,9.38,35.63,
TIMOLOL(TIMOPTIC)DROP 0.5%:5ML,32009296,CDM,J3490,HCPCS,250,RC,outpatient,,165.52,165.52,,140.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.38,22,,percent of total billed charges,,,,,,,,,148.97,90,,percent of total billed charges,,,137.05,82.8,,percent of total billed charges,,,140.69,85,,percent of total billed charges,,,,,,,,,145.66,88,,percent of total billed charges,,,,,,,,,126.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.38,22,,percent of total billed charges,,,150.62,91,,percent of total billed charges,,,157.24,95,,percent of total billed charges,,,137.38,83,,percent of total billed charges,,,137.38,83,,percent of total billed charges,,,,,,,,,,,,,,,137.38,83,,percent of total billed charges,,,157.24,95,,percent of total billed charges,,,148.97,90,,percent of total billed charges,,,148.97,90,,percent of total billed charges,,,135.73,82,,percent of total billed charges,,,148.97,90,,percent of total billed charges,,,140.69,85,,percent of total billed charges,,41.38,157.24,
TINCTURE OF BENZOIN,32009302,CDM,,,250,RC,outpatient,,8.75,8.75,,7.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.19,22,,percent of total billed charges,,,,,,,,,7.88,90,,percent of total billed charges,,,7.25,82.8,,percent of total billed charges,,,7.44,85,,percent of total billed charges,,,,,,,,,7.7,88,,percent of total billed charges,,,,,,,,,6.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.19,22,,percent of total billed charges,,,7.96,91,,percent of total billed charges,,,8.31,95,,percent of total billed charges,,,7.26,83,,percent of total billed charges,,,7.26,83,,percent of total billed charges,,,,,,,,,,,,,,,7.26,83,,percent of total billed charges,,,8.31,95,,percent of total billed charges,,,7.88,90,,percent of total billed charges,,,7.88,90,,percent of total billed charges,,,7.18,82,,percent of total billed charges,,,7.88,90,,percent of total billed charges,,,7.44,85,,percent of total billed charges,,2.19,8.31,
TENECTEPLASE(TNKase)KIT:50MG,32009303,CDM,J3101,HCPCS,636,RC,outpatient,,29384.1,29384.1,,24947.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7346.03,22,,percent of total billed charges,,,,,,,,,26445.69,90,,percent of total billed charges,,,24330.03,82.8,,percent of total billed charges,,,24976.49,85,,percent of total billed charges,,,,,,,,,25858.01,88,,percent of total billed charges,,7193.6,,,,fee schedule,,,22449.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7193.6,,,,fee schedule,,,7346.03,22,,percent of total billed charges,,,26739.53,91,,percent of total billed charges,,,27914.9,95,,percent of total billed charges,,,24388.8,83,,percent of total billed charges,,,24388.8,83,,percent of total billed charges,,,,,,,,,,,,,,,24388.8,83,,percent of total billed charges,,,27914.9,95,,percent of total billed charges,,,26445.69,90,,percent of total billed charges,,,26445.69,90,,percent of total billed charges,,,24094.96,82,,percent of total billed charges,,,26445.69,90,,percent of total billed charges,,,24976.49,85,,percent of total billed charges,,7193.6,27914.9,
TOBRAMYCIN-VIAL:80MG/2ML,32009306,CDM,J3260,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,20.81,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,20.81,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
TOBRAMYCIN(TOBREX)OINT 0.3%:3.5GM,32009311,CDM,,,250,RC,outpatient,,3025.08,3025.08,,2568.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,756.27,22,,percent of total billed charges,,,,,,,,,2722.57,90,,percent of total billed charges,,,2504.77,82.8,,percent of total billed charges,,,2571.32,85,,percent of total billed charges,,,,,,,,,2662.07,88,,percent of total billed charges,,,,,,,,,2311.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,756.27,22,,percent of total billed charges,,,2752.82,91,,percent of total billed charges,,,2873.83,95,,percent of total billed charges,,,2510.82,83,,percent of total billed charges,,,2510.82,83,,percent of total billed charges,,,,,,,,,,,,,,,2510.82,83,,percent of total billed charges,,,2873.83,95,,percent of total billed charges,,,2722.57,90,,percent of total billed charges,,,2722.57,90,,percent of total billed charges,,,2480.57,82,,percent of total billed charges,,,2722.57,90,,percent of total billed charges,,,2571.32,85,,percent of total billed charges,,756.27,2873.83,
TOBRAMYCIN(TOBREX)DROP 0.3%:5ML,32009316,CDM,J3490,HCPCS,250,RC,outpatient,,123.04,123.04,,104.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.76,22,,percent of total billed charges,,,,,,,,,110.74,90,,percent of total billed charges,,,101.88,82.8,,percent of total billed charges,,,104.58,85,,percent of total billed charges,,,,,,,,,108.28,88,,percent of total billed charges,,,,,,,,,94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.76,22,,percent of total billed charges,,,111.97,91,,percent of total billed charges,,,116.89,95,,percent of total billed charges,,,102.12,83,,percent of total billed charges,,,102.12,83,,percent of total billed charges,,,,,,,,,,,,,,,102.12,83,,percent of total billed charges,,,116.89,95,,percent of total billed charges,,,110.74,90,,percent of total billed charges,,,110.74,90,,percent of total billed charges,,,100.89,82,,percent of total billed charges,,,110.74,90,,percent of total billed charges,,,104.58,85,,percent of total billed charges,,30.76,116.89,
TOBRA/DEX(TOBRADEX)DROP 0.3-0.1%:5ML,32009321,CDM,J3490,HCPCS,250,RC,outpatient,,1797.68,1797.68,,1526.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,449.42,22,,percent of total billed charges,,,,,,,,,1617.91,90,,percent of total billed charges,,,1488.48,82.8,,percent of total billed charges,,,1528.03,85,,percent of total billed charges,,,,,,,,,1581.96,88,,percent of total billed charges,,,,,,,,,1373.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,449.42,22,,percent of total billed charges,,,1635.89,91,,percent of total billed charges,,,1707.8,95,,percent of total billed charges,,,1492.07,83,,percent of total billed charges,,,1492.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1492.07,83,,percent of total billed charges,,,1707.8,95,,percent of total billed charges,,,1617.91,90,,percent of total billed charges,,,1617.91,90,,percent of total billed charges,,,1474.1,82,,percent of total billed charges,,,1617.91,90,,percent of total billed charges,,,1528.03,85,,percent of total billed charges,,449.42,1707.8,
TOBRA/DEX(TOBRADEX)OINT 0.3-0.1%:3.5GM,32009326,CDM,J3490,HCPCS,250,RC,outpatient,,3250.19,3250.19,,2759.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,812.55,22,,percent of total billed charges,,,,,,,,,2925.17,90,,percent of total billed charges,,,2691.16,82.8,,percent of total billed charges,,,2762.66,85,,percent of total billed charges,,,,,,,,,2860.17,88,,percent of total billed charges,,,,,,,,,2483.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,812.55,22,,percent of total billed charges,,,2957.67,91,,percent of total billed charges,,,3087.68,95,,percent of total billed charges,,,2697.66,83,,percent of total billed charges,,,2697.66,83,,percent of total billed charges,,,,,,,,,,,,,,,2697.66,83,,percent of total billed charges,,,3087.68,95,,percent of total billed charges,,,2925.17,90,,percent of total billed charges,,,2925.17,90,,percent of total billed charges,,,2665.16,82,,percent of total billed charges,,,2925.17,90,,percent of total billed charges,,,2762.66,85,,percent of total billed charges,,812.55,3087.68,
TOLAZAMIDE (TOLINASE) TAB : 100MG,32009336,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
TOLAZAMIDE (TOLINASE) TAB : 250MG,32009341,CDM,,,250,RC,outpatient,,30.77,30.77,,26.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.69,22,,percent of total billed charges,,,,,,,,,27.69,90,,percent of total billed charges,,,25.48,82.8,,percent of total billed charges,,,26.15,85,,percent of total billed charges,,,,,,,,,27.08,88,,percent of total billed charges,,,,,,,,,23.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.69,22,,percent of total billed charges,,,28,91,,percent of total billed charges,,,29.23,95,,percent of total billed charges,,,25.54,83,,percent of total billed charges,,,25.54,83,,percent of total billed charges,,,,,,,,,,,,,,,25.54,83,,percent of total billed charges,,,29.23,95,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,25.23,82,,percent of total billed charges,,,27.69,90,,percent of total billed charges,,,26.15,85,,percent of total billed charges,,7.69,29.23,
TOLBUTamide(ORINASE)TAB:500MG,32009346,CDM,,,250,RC,outpatient,,15.7,15.7,,13.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.93,22,,percent of total billed charges,,,,,,,,,14.13,90,,percent of total billed charges,,,13,82.8,,percent of total billed charges,,,13.35,85,,percent of total billed charges,,,,,,,,,13.82,88,,percent of total billed charges,,,,,,,,,11.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.93,22,,percent of total billed charges,,,14.29,91,,percent of total billed charges,,,14.92,95,,percent of total billed charges,,,13.03,83,,percent of total billed charges,,,13.03,83,,percent of total billed charges,,,,,,,,,,,,,,,13.03,83,,percent of total billed charges,,,14.92,95,,percent of total billed charges,,,14.13,90,,percent of total billed charges,,,14.13,90,,percent of total billed charges,,,12.87,82,,percent of total billed charges,,,14.13,90,,percent of total billed charges,,,13.35,85,,percent of total billed charges,,3.93,14.92,
DESOXIMETASONE OINT (TOPICORT) : 0.25%,32009371,CDM,,,250,RC,outpatient,,217.12,217.12,,184.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.28,22,,percent of total billed charges,,,,,,,,,195.41,90,,percent of total billed charges,,,179.78,82.8,,percent of total billed charges,,,184.55,85,,percent of total billed charges,,,,,,,,,191.07,88,,percent of total billed charges,,,,,,,,,165.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.28,22,,percent of total billed charges,,,197.58,91,,percent of total billed charges,,,206.26,95,,percent of total billed charges,,,180.21,83,,percent of total billed charges,,,180.21,83,,percent of total billed charges,,,,,,,,,,,,,,,180.21,83,,percent of total billed charges,,,206.26,95,,percent of total billed charges,,,195.41,90,,percent of total billed charges,,,195.41,90,,percent of total billed charges,,,178.04,82,,percent of total billed charges,,,195.41,90,,percent of total billed charges,,,184.55,85,,percent of total billed charges,,54.28,206.26,
DESOXIMETASONE GEL(TOPICORT)0.05%:,32009376,CDM,,,250,RC,outpatient,,781.74,781.74,,663.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195.44,22,,percent of total billed charges,,,,,,,,,703.57,90,,percent of total billed charges,,,647.28,82.8,,percent of total billed charges,,,664.48,85,,percent of total billed charges,,,,,,,,,687.93,88,,percent of total billed charges,,,,,,,,,597.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195.44,22,,percent of total billed charges,,,711.38,91,,percent of total billed charges,,,742.65,95,,percent of total billed charges,,,648.84,83,,percent of total billed charges,,,648.84,83,,percent of total billed charges,,,,,,,,,,,,,,,648.84,83,,percent of total billed charges,,,742.65,95,,percent of total billed charges,,,703.57,90,,percent of total billed charges,,,703.57,90,,percent of total billed charges,,,641.03,82,,percent of total billed charges,,,703.57,90,,percent of total billed charges,,,664.48,85,,percent of total billed charges,,195.44,742.65,
metoPROLOL SUCC(TOPROL XL)TAB:50MG,32009377,CDM,J8499,HCPCS,250,RC,outpatient,,15.36,15.36,,13.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.84,22,,percent of total billed charges,,,,,,,,,13.82,90,,percent of total billed charges,,,12.72,82.8,,percent of total billed charges,,,13.06,85,,percent of total billed charges,,,,,,,,,13.52,88,,percent of total billed charges,,,,,,,,,11.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.84,22,,percent of total billed charges,,,13.98,91,,percent of total billed charges,,,14.59,95,,percent of total billed charges,,,12.75,83,,percent of total billed charges,,,12.75,83,,percent of total billed charges,,,,,,,,,,,,,,,12.75,83,,percent of total billed charges,,,14.59,95,,percent of total billed charges,,,13.82,90,,percent of total billed charges,,,13.82,90,,percent of total billed charges,,,12.6,82,,percent of total billed charges,,,13.82,90,,percent of total billed charges,,,13.06,85,,percent of total billed charges,,3.84,14.59,
KETOROLAC(TORADOL)TAB:10MG,32009381,CDM,J8499,HCPCS,250,RC,outpatient,,14.54,14.54,,12.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.64,22,,percent of total billed charges,,,,,,,,,13.09,90,,percent of total billed charges,,,12.04,82.8,,percent of total billed charges,,,12.36,85,,percent of total billed charges,,,,,,,,,12.8,88,,percent of total billed charges,,,,,,,,,11.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.64,22,,percent of total billed charges,,,13.23,91,,percent of total billed charges,,,13.81,95,,percent of total billed charges,,,12.07,83,,percent of total billed charges,,,12.07,83,,percent of total billed charges,,,,,,,,,,,,,,,12.07,83,,percent of total billed charges,,,13.81,95,,percent of total billed charges,,,13.09,90,,percent of total billed charges,,,13.09,90,,percent of total billed charges,,,11.92,82,,percent of total billed charges,,,13.09,90,,percent of total billed charges,,,12.36,85,,percent of total billed charges,,3.64,13.81,
KETOROLAC (TORADOL) TAB: 10MG (1X10),32009382,CDM,,,250,RC,outpatient,,149.24,149.24,,126.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.31,22,,percent of total billed charges,,,,,,,,,134.32,90,,percent of total billed charges,,,123.57,82.8,,percent of total billed charges,,,126.85,85,,percent of total billed charges,,,,,,,,,131.33,88,,percent of total billed charges,,,,,,,,,114.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.31,22,,percent of total billed charges,,,135.81,91,,percent of total billed charges,,,141.78,95,,percent of total billed charges,,,123.87,83,,percent of total billed charges,,,123.87,83,,percent of total billed charges,,,,,,,,,,,,,,,123.87,83,,percent of total billed charges,,,141.78,95,,percent of total billed charges,,,134.32,90,,percent of total billed charges,,,134.32,90,,percent of total billed charges,,,122.38,82,,percent of total billed charges,,,134.32,90,,percent of total billed charges,,,126.85,85,,percent of total billed charges,,37.31,141.78,
KETOROLAC(TORADOL)VL:15MG/ML,32009386,CDM,J1885,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,2.54,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.54,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,2.54,60.99,
LABETALOL (TRANDATE) TAB : 200MG,32009421,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
LABETALOL(TRANDATE)TAB:100MG,32009426,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
SCOPOLAM(TRANSDERM SCOP)PAT 1MG/72HR:,32009431,CDM,J3490,HCPCS,250,RC,outpatient,,321.08,321.08,,272.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.27,22,,percent of total billed charges,,,,,,,,,288.97,90,,percent of total billed charges,,,265.85,82.8,,percent of total billed charges,,,272.92,85,,percent of total billed charges,,,,,,,,,282.55,88,,percent of total billed charges,,,,,,,,,245.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.27,22,,percent of total billed charges,,,292.18,91,,percent of total billed charges,,,305.03,95,,percent of total billed charges,,,266.5,83,,percent of total billed charges,,,266.5,83,,percent of total billed charges,,,,,,,,,,,,,,,266.5,83,,percent of total billed charges,,,305.03,95,,percent of total billed charges,,,288.97,90,,percent of total billed charges,,,288.97,90,,percent of total billed charges,,,263.29,82,,percent of total billed charges,,,288.97,90,,percent of total billed charges,,,272.92,85,,percent of total billed charges,,80.27,305.03,
LABETALOL(TRANDATE)VIAL:100MG/20ML,32009436,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
traZODone(DESERYL)TAB:50MG,32009441,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PENTOXIFYLLINE(TRENtal) ER TAB:400MG,32009446,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
TRIAMCINOLONE(KENALOG) 0.1% CRM:15GM,32009456,CDM,J3490,HCPCS,250,RC,outpatient,,29.74,29.74,,25.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.44,22,,percent of total billed charges,,,,,,,,,26.77,90,,percent of total billed charges,,,24.62,82.8,,percent of total billed charges,,,25.28,85,,percent of total billed charges,,,,,,,,,26.17,88,,percent of total billed charges,,,,,,,,,22.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.44,22,,percent of total billed charges,,,27.06,91,,percent of total billed charges,,,28.25,95,,percent of total billed charges,,,24.68,83,,percent of total billed charges,,,24.68,83,,percent of total billed charges,,,,,,,,,,,,,,,24.68,83,,percent of total billed charges,,,28.25,95,,percent of total billed charges,,,26.77,90,,percent of total billed charges,,,26.77,90,,percent of total billed charges,,,24.39,82,,percent of total billed charges,,,26.77,90,,percent of total billed charges,,,25.28,85,,percent of total billed charges,,7.44,28.25,
TRIAMCINOLONE 0.1% CREAM,32009457,CDM,,,250,RC,outpatient,,74.38,74.38,,63.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.6,22,,percent of total billed charges,,,,,,,,,66.94,90,,percent of total billed charges,,,61.59,82.8,,percent of total billed charges,,,63.22,85,,percent of total billed charges,,,,,,,,,65.45,88,,percent of total billed charges,,,,,,,,,56.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.6,22,,percent of total billed charges,,,67.69,91,,percent of total billed charges,,,70.66,95,,percent of total billed charges,,,61.74,83,,percent of total billed charges,,,61.74,83,,percent of total billed charges,,,,,,,,,,,,,,,61.74,83,,percent of total billed charges,,,70.66,95,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,60.99,82,,percent of total billed charges,,,66.94,90,,percent of total billed charges,,,63.22,85,,percent of total billed charges,,18.6,70.66,
TRIAMCINOLONE(KENALOG)PASTE 0.1%:5GM,32009461,CDM,J3490,HCPCS,250,RC,outpatient,,489.28,489.28,,415.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.32,22,,percent of total billed charges,,,,,,,,,440.35,90,,percent of total billed charges,,,405.12,82.8,,percent of total billed charges,,,415.89,85,,percent of total billed charges,,,,,,,,,430.57,88,,percent of total billed charges,,,,,,,,,373.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.32,22,,percent of total billed charges,,,445.24,91,,percent of total billed charges,,,464.82,95,,percent of total billed charges,,,406.1,83,,percent of total billed charges,,,406.1,83,,percent of total billed charges,,,,,,,,,,,,,,,406.1,83,,percent of total billed charges,,,464.82,95,,percent of total billed charges,,,440.35,90,,percent of total billed charges,,,440.35,90,,percent of total billed charges,,,401.21,82,,percent of total billed charges,,,440.35,90,,percent of total billed charges,,,415.89,85,,percent of total billed charges,,122.32,464.82,
TRIAMCINOLONE(KENALOG) VIAL:40MG/ML,32009481,CDM,J3301,HCPCS,250,RC,outpatient,,158.17,158.17,,134.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.54,22,,percent of total billed charges,,,,,,,,,142.35,90,,percent of total billed charges,,,130.96,82.8,,percent of total billed charges,,,134.44,85,,percent of total billed charges,,,,,,,,,139.19,88,,percent of total billed charges,,17.47,,,,fee schedule,,,120.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,17.47,,,,fee schedule,,,39.54,22,,percent of total billed charges,,,143.93,91,,percent of total billed charges,,,150.26,95,,percent of total billed charges,,,131.28,83,,percent of total billed charges,,,131.28,83,,percent of total billed charges,,,,,,,,,,,,,,,131.28,83,,percent of total billed charges,,,150.26,95,,percent of total billed charges,,,142.35,90,,percent of total billed charges,,,142.35,90,,percent of total billed charges,,,129.7,82,,percent of total billed charges,,,142.35,90,,percent of total billed charges,,,134.44,85,,percent of total billed charges,,17.47,150.26,
TRIAMCINOLONE(KENALOG)VIAL:50MG/5ML,32009482,CDM,J3301,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,17.47,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,17.47,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
TRIAMTERENE/HCTZ(MAXZIDE) TAB : 75-50MG,32009486,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
TRIAMTERENE/HCTZ(DYAZIDE)CAP:50MG-25MG,32009487,CDM,,,250,RC,outpatient,,27.6,27.6,,23.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.9,22,,percent of total billed charges,,,,,,,,,24.84,90,,percent of total billed charges,,,22.85,82.8,,percent of total billed charges,,,23.46,85,,percent of total billed charges,,,,,,,,,24.29,88,,percent of total billed charges,,,,,,,,,21.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.9,22,,percent of total billed charges,,,25.12,91,,percent of total billed charges,,,26.22,95,,percent of total billed charges,,,22.91,83,,percent of total billed charges,,,22.91,83,,percent of total billed charges,,,,,,,,,,,,,,,22.91,83,,percent of total billed charges,,,26.22,95,,percent of total billed charges,,,24.84,90,,percent of total billed charges,,,24.84,90,,percent of total billed charges,,,22.63,82,,percent of total billed charges,,,24.84,90,,percent of total billed charges,,,23.46,85,,percent of total billed charges,,6.9,26.22,
TRIAZOLAM TAB : 0.25MG,32009491,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
TRIFLURIDINE (VIROPTIC) DROP : 1% 7.5ML,32009522,CDM,,,250,RC,outpatient,,2141.13,2141.13,,1817.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,535.28,22,,percent of total billed charges,,,,,,,,,1927.02,90,,percent of total billed charges,,,1772.86,82.8,,percent of total billed charges,,,1819.96,85,,percent of total billed charges,,,,,,,,,1884.19,88,,percent of total billed charges,,,,,,,,,1635.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,535.28,22,,percent of total billed charges,,,1948.43,91,,percent of total billed charges,,,2034.07,95,,percent of total billed charges,,,1777.14,83,,percent of total billed charges,,,1777.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1777.14,83,,percent of total billed charges,,,2034.07,95,,percent of total billed charges,,,1927.02,90,,percent of total billed charges,,,1927.02,90,,percent of total billed charges,,,1755.73,82,,percent of total billed charges,,,1927.02,90,,percent of total billed charges,,,1819.96,85,,percent of total billed charges,,535.28,2034.07,
TRIHEXYPHENIDYL(ARTANE)TAB:2MG,32009526,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
TRIMETHOBENZAMIDE (TIGAN)    CAP : 250MG,32009531,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
AMOXicillin(AMOXIL)DROP:50MG/ML (15ML),32009536,CDM,J8499,HCPCS,250,RC,outpatient,,21.89,21.89,,18.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.47,22,,percent of total billed charges,,,,,,,,,19.7,90,,percent of total billed charges,,,18.12,82.8,,percent of total billed charges,,,18.61,85,,percent of total billed charges,,,,,,,,,19.26,88,,percent of total billed charges,,,,,,,,,16.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.47,22,,percent of total billed charges,,,19.92,91,,percent of total billed charges,,,20.8,95,,percent of total billed charges,,,18.17,83,,percent of total billed charges,,,18.17,83,,percent of total billed charges,,,,,,,,,,,,,,,18.17,83,,percent of total billed charges,,,20.8,95,,percent of total billed charges,,,19.7,90,,percent of total billed charges,,,19.7,90,,percent of total billed charges,,,17.95,82,,percent of total billed charges,,,19.7,90,,percent of total billed charges,,,18.61,85,,percent of total billed charges,,5.47,20.8,
AMOXicillin(AMOXIL)CAP:500MG,32009541,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
AMOXicillin(AMOXIL)CAP: 500MG (1X6),32009542,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
AMOXicillin(AMOXIL)SUS 125MG/5ML(100ML),32009546,CDM,J8499,HCPCS,250,RC,outpatient,,22.88,22.88,,19.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.72,22,,percent of total billed charges,,,,,,,,,20.59,90,,percent of total billed charges,,,18.94,82.8,,percent of total billed charges,,,19.45,85,,percent of total billed charges,,,,,,,,,20.13,88,,percent of total billed charges,,,,,,,,,17.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.72,22,,percent of total billed charges,,,20.82,91,,percent of total billed charges,,,21.74,95,,percent of total billed charges,,,18.99,83,,percent of total billed charges,,,18.99,83,,percent of total billed charges,,,,,,,,,,,,,,,18.99,83,,percent of total billed charges,,,21.74,95,,percent of total billed charges,,,20.59,90,,percent of total billed charges,,,20.59,90,,percent of total billed charges,,,18.76,82,,percent of total billed charges,,,20.59,90,,percent of total billed charges,,,19.45,85,,percent of total billed charges,,5.72,21.74,
AMOXicillin(AMOXIL)SUS 250MG/5ML(100ML),32009551,CDM,J8499,HCPCS,250,RC,outpatient,,29.25,29.25,,24.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.31,22,,percent of total billed charges,,,,,,,,,26.33,90,,percent of total billed charges,,,24.22,82.8,,percent of total billed charges,,,24.86,85,,percent of total billed charges,,,,,,,,,25.74,88,,percent of total billed charges,,,,,,,,,22.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.31,22,,percent of total billed charges,,,26.62,91,,percent of total billed charges,,,27.79,95,,percent of total billed charges,,,24.28,83,,percent of total billed charges,,,24.28,83,,percent of total billed charges,,,,,,,,,,,,,,,24.28,83,,percent of total billed charges,,,27.79,95,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,23.99,82,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,24.86,85,,percent of total billed charges,,7.31,27.79,
AMOXicillin(AMOXIL)CAP:250MG,32009556,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
AMOXicllin CAP:250MG (1X6),32009557,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
TRIMETHOBENZ(TIGAN) VIAL: 100MG/ML 20ML,32009561,CDM,,,250,RC,outpatient,,35,35,,29.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.75,22,,percent of total billed charges,,,,,,,,,31.5,90,,percent of total billed charges,,,28.98,82.8,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,,,,,,,,30.8,88,,percent of total billed charges,,,,,,,,,26.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.75,22,,percent of total billed charges,,,31.85,91,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,,,,,,,,,,,,,29.05,83,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,28.7,82,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,8.75,33.25,
TRIMETHOPRIM (TRIMPEX) TAB : 100MG,32009566,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
PSEUDOPHD SULF/AZAT(TRINALIN)TAB:120-1MG,32009567,CDM,,,250,RC,outpatient,,19.19,19.19,,16.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.8,22,,percent of total billed charges,,,,,,,,,17.27,90,,percent of total billed charges,,,15.89,82.8,,percent of total billed charges,,,16.31,85,,percent of total billed charges,,,,,,,,,16.89,88,,percent of total billed charges,,,,,,,,,14.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.8,22,,percent of total billed charges,,,17.46,91,,percent of total billed charges,,,18.23,95,,percent of total billed charges,,,15.93,83,,percent of total billed charges,,,15.93,83,,percent of total billed charges,,,,,,,,,,,,,,,15.93,83,,percent of total billed charges,,,18.23,95,,percent of total billed charges,,,17.27,90,,percent of total billed charges,,,17.27,90,,percent of total billed charges,,,15.74,82,,percent of total billed charges,,,17.27,90,,percent of total billed charges,,,16.31,85,,percent of total billed charges,,4.8,18.23,
NEO/BACI/POLYB(NEOSPORIN)ABX OINT:PKT,32009586,CDM,J3490,HCPCS,250,RC,outpatient,UD,20.27,20.27,,17.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.07,22,,percent of total billed charges,,,,,,,,,18.24,90,,percent of total billed charges,,,16.78,82.8,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,,,,,,,,17.84,88,,percent of total billed charges,,,,,,,,,15.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.07,22,,percent of total billed charges,,,18.45,91,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,16.82,83,,percent of total billed charges,,,,,,,,,,,,,,,16.82,83,,percent of total billed charges,,,19.26,95,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,16.62,82,,percent of total billed charges,,,18.24,90,,percent of total billed charges,,,17.23,85,,percent of total billed charges,,5.07,19.26,
TROVAN 100MG TABS,32009617,CDM,,,250,RC,outpatient,,23.5,23.5,,19.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.88,22,,percent of total billed charges,,,,,,,,,21.15,90,,percent of total billed charges,,,19.46,82.8,,percent of total billed charges,,,19.98,85,,percent of total billed charges,,,,,,,,,20.68,88,,percent of total billed charges,,,,,,,,,17.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.88,22,,percent of total billed charges,,,21.39,91,,percent of total billed charges,,,22.33,95,,percent of total billed charges,,,19.51,83,,percent of total billed charges,,,19.51,83,,percent of total billed charges,,,,,,,,,,,,,,,19.51,83,,percent of total billed charges,,,22.33,95,,percent of total billed charges,,,21.15,90,,percent of total billed charges,,,21.15,90,,percent of total billed charges,,,19.27,82,,percent of total billed charges,,,21.15,90,,percent of total billed charges,,,19.98,85,,percent of total billed charges,,5.88,22.33,
DORZOLAMIDE(TRUSOPT)DROP 2%:10ML,32009621,CDM,J3490,HCPCS,250,RC,outpatient,,466.92,466.92,,396.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.73,22,,percent of total billed charges,,,,,,,,,420.23,90,,percent of total billed charges,,,386.61,82.8,,percent of total billed charges,,,396.88,85,,percent of total billed charges,,,,,,,,,410.89,88,,percent of total billed charges,,,,,,,,,356.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.73,22,,percent of total billed charges,,,424.9,91,,percent of total billed charges,,,443.57,95,,percent of total billed charges,,,387.54,83,,percent of total billed charges,,,387.54,83,,percent of total billed charges,,,,,,,,,,,,,,,387.54,83,,percent of total billed charges,,,443.57,95,,percent of total billed charges,,,420.23,90,,percent of total billed charges,,,420.23,90,,percent of total billed charges,,,382.87,82,,percent of total billed charges,,,420.23,90,,percent of total billed charges,,,396.88,85,,percent of total billed charges,,116.73,443.57,
TUBOCURARINE(QUELICIN) VIAL: 3MG/ML 10ML,32009636,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
GLYCERIN/WITCH(TUCKS)HAZEL LEAF PAD'S:,32009641,CDM,J3490,HCPCS,250,RC,outpatient,,49.51,49.51,,42.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.38,22,,percent of total billed charges,,,,,,,,,44.56,90,,percent of total billed charges,,,40.99,82.8,,percent of total billed charges,,,42.08,85,,percent of total billed charges,,,,,,,,,43.57,88,,percent of total billed charges,,,,,,,,,37.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.38,22,,percent of total billed charges,,,45.05,91,,percent of total billed charges,,,47.03,95,,percent of total billed charges,,,41.09,83,,percent of total billed charges,,,41.09,83,,percent of total billed charges,,,,,,,,,,,,,,,41.09,83,,percent of total billed charges,,,47.03,95,,percent of total billed charges,,,44.56,90,,percent of total billed charges,,,44.56,90,,percent of total billed charges,,,40.6,82,,percent of total billed charges,,,44.56,90,,percent of total billed charges,,,42.08,85,,percent of total billed charges,,12.38,47.03,
ALLANTOIN/ONION/PEGS/WATER(MEDERMA)GEL:,32009642,CDM,,,250,RC,outpatient,,241.71,241.71,,205.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60.43,22,,percent of total billed charges,,,,,,,,,217.54,90,,percent of total billed charges,,,200.14,82.8,,percent of total billed charges,,,205.45,85,,percent of total billed charges,,,,,,,,,212.7,88,,percent of total billed charges,,,,,,,,,184.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60.43,22,,percent of total billed charges,,,219.96,91,,percent of total billed charges,,,229.62,95,,percent of total billed charges,,,200.62,83,,percent of total billed charges,,,200.62,83,,percent of total billed charges,,,,,,,,,,,,,,,200.62,83,,percent of total billed charges,,,229.62,95,,percent of total billed charges,,,217.54,90,,percent of total billed charges,,,217.54,90,,percent of total billed charges,,,198.2,82,,percent of total billed charges,,,217.54,90,,percent of total billed charges,,,205.45,85,,percent of total billed charges,,60.43,229.62,
HYDROCODONE/PHENYL (TUSSIONEX) ORAL 90ML,32009666,CDM,,,250,RC,outpatient,,124.66,124.66,,105.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.17,22,,percent of total billed charges,,,,,,,,,112.19,90,,percent of total billed charges,,,103.22,82.8,,percent of total billed charges,,,105.96,85,,percent of total billed charges,,,,,,,,,109.7,88,,percent of total billed charges,,,,,,,,,95.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.17,22,,percent of total billed charges,,,113.44,91,,percent of total billed charges,,,118.43,95,,percent of total billed charges,,,103.47,83,,percent of total billed charges,,,103.47,83,,percent of total billed charges,,,,,,,,,,,,,,,103.47,83,,percent of total billed charges,,,118.43,95,,percent of total billed charges,,,112.19,90,,percent of total billed charges,,,112.19,90,,percent of total billed charges,,,102.22,82,,percent of total billed charges,,,112.19,90,,percent of total billed charges,,,105.96,85,,percent of total billed charges,,31.17,118.43,
HYDROcod/PHENYL(TUSSIONEX)ORAL:5ML,32009671,CDM,,,250,RC,outpatient,,40.13,40.13,,34.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.03,22,,percent of total billed charges,,,,,,,,,36.12,90,,percent of total billed charges,,,33.23,82.8,,percent of total billed charges,,,34.11,85,,percent of total billed charges,,,,,,,,,35.31,88,,percent of total billed charges,,,,,,,,,30.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.03,22,,percent of total billed charges,,,36.52,91,,percent of total billed charges,,,38.12,95,,percent of total billed charges,,,33.31,83,,percent of total billed charges,,,33.31,83,,percent of total billed charges,,,,,,,,,,,,,,,33.31,83,,percent of total billed charges,,,38.12,95,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,32.91,82,,percent of total billed charges,,,36.12,90,,percent of total billed charges,,,34.11,85,,percent of total billed charges,,10.03,38.12,
HYDROCODONE/PHENYL (TUSSIONEX) ORAL 60ML,32009676,CDM,,,250,RC,outpatient,,83.11,83.11,,70.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.78,22,,percent of total billed charges,,,,,,,,,74.8,90,,percent of total billed charges,,,68.82,82.8,,percent of total billed charges,,,70.64,85,,percent of total billed charges,,,,,,,,,73.14,88,,percent of total billed charges,,,,,,,,,63.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.78,22,,percent of total billed charges,,,75.63,91,,percent of total billed charges,,,78.95,95,,percent of total billed charges,,,68.98,83,,percent of total billed charges,,,68.98,83,,percent of total billed charges,,,,,,,,,,,,,,,68.98,83,,percent of total billed charges,,,78.95,95,,percent of total billed charges,,,74.8,90,,percent of total billed charges,,,74.8,90,,percent of total billed charges,,,68.15,82,,percent of total billed charges,,,74.8,90,,percent of total billed charges,,,70.64,85,,percent of total billed charges,,20.78,78.95,
ACETAMINOPHEN (TYLENOL) TAB : 325MG #50,32009747,CDM,,,250,RC,outpatient,,33.31,33.31,,28.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.33,22,,percent of total billed charges,,,,,,,,,29.98,90,,percent of total billed charges,,,27.58,82.8,,percent of total billed charges,,,28.31,85,,percent of total billed charges,,,,,,,,,29.31,88,,percent of total billed charges,,,,,,,,,25.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.33,22,,percent of total billed charges,,,30.31,91,,percent of total billed charges,,,31.64,95,,percent of total billed charges,,,27.65,83,,percent of total billed charges,,,27.65,83,,percent of total billed charges,,,,,,,,,,,,,,,27.65,83,,percent of total billed charges,,,31.64,95,,percent of total billed charges,,,29.98,90,,percent of total billed charges,,,29.98,90,,percent of total billed charges,,,27.31,82,,percent of total billed charges,,,29.98,90,,percent of total billed charges,,,28.31,85,,percent of total billed charges,,8.33,31.64,
ACETAMINOPHEN(TYLENOL)TAB:80MG,32009751,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
COD/APAP(TYLENOL+COD):12-120MG/5 (60ML),32009756,CDM,J8499,HCPCS,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
COD/APAP(TYLENOL/COD): 12-120MG/5 90ML,32009761,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
TYLENOL ES 500MG GELCAPS,32009772,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
OXYCODONE/ACETAMIN (TYLOX) CAP : 5-500MG,32009781,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
ACETAMINOPHEN(TYLENOL)DRP:100MG/ML(15ML),32009786,CDM,J8499,HCPCS,250,RC,outpatient,,35.21,35.21,,29.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.8,22,,percent of total billed charges,,,,,,,,,31.69,90,,percent of total billed charges,,,29.15,82.8,,percent of total billed charges,,,29.93,85,,percent of total billed charges,,,,,,,,,30.98,88,,percent of total billed charges,,,,,,,,,26.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.8,22,,percent of total billed charges,,,32.04,91,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,29.22,83,,percent of total billed charges,,,,,,,,,,,,,,,29.22,83,,percent of total billed charges,,,33.45,95,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,28.87,82,,percent of total billed charges,,,31.69,90,,percent of total billed charges,,,29.93,85,,percent of total billed charges,,8.8,33.45,
traMADol(ULTRAM)TAB:50MG,32009791,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
AMPicil/SULB(UNASYN):1.5GM,32009796,CDM,J0295,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,5.26,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.26,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,5.26,60.99,
MOEXIPRIL HCL (UNIVASC) TAB : 7.5MG,32009797,CDM,,,250,RC,outpatient,,43.3,43.3,,36.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.83,22,,percent of total billed charges,,,,,,,,,38.97,90,,percent of total billed charges,,,35.85,82.8,,percent of total billed charges,,,36.81,85,,percent of total billed charges,,,,,,,,,38.1,88,,percent of total billed charges,,,,,,,,,33.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.83,22,,percent of total billed charges,,,39.4,91,,percent of total billed charges,,,41.14,95,,percent of total billed charges,,,35.94,83,,percent of total billed charges,,,35.94,83,,percent of total billed charges,,,,,,,,,,,,,,,35.94,83,,percent of total billed charges,,,41.14,95,,percent of total billed charges,,,38.97,90,,percent of total billed charges,,,38.97,90,,percent of total billed charges,,,35.51,82,,percent of total billed charges,,,38.97,90,,percent of total billed charges,,,36.81,85,,percent of total billed charges,,10.83,41.14,
MOEXIPRIL HCL (UNIVASC) TAB : 15MG,32009798,CDM,,,250,RC,outpatient,,45.36,45.36,,38.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.34,22,,percent of total billed charges,,,,,,,,,40.82,90,,percent of total billed charges,,,37.56,82.8,,percent of total billed charges,,,38.56,85,,percent of total billed charges,,,,,,,,,39.92,88,,percent of total billed charges,,,,,,,,,34.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.34,22,,percent of total billed charges,,,41.28,91,,percent of total billed charges,,,43.09,95,,percent of total billed charges,,,37.65,83,,percent of total billed charges,,,37.65,83,,percent of total billed charges,,,,,,,,,,,,,,,37.65,83,,percent of total billed charges,,,43.09,95,,percent of total billed charges,,,40.82,90,,percent of total billed charges,,,40.82,90,,percent of total billed charges,,,37.2,82,,percent of total billed charges,,,40.82,90,,percent of total billed charges,,,38.56,85,,percent of total billed charges,,11.34,43.09,
AMPicil/SULB(UNASYN):3GM,32009801,CDM,J0295,HCPCS,250,RC,outpatient,,140.2,140.2,,119.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,35.05,22,,percent of total billed charges,,,,,,,,,126.18,90,,percent of total billed charges,,,116.09,82.8,,percent of total billed charges,,,119.17,85,,percent of total billed charges,,,,,,,,,123.38,88,,percent of total billed charges,,5.26,,,,fee schedule,,,107.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.26,,,,fee schedule,,,35.05,22,,percent of total billed charges,,,127.58,91,,percent of total billed charges,,,133.19,95,,percent of total billed charges,,,116.37,83,,percent of total billed charges,,,116.37,83,,percent of total billed charges,,,,,,,,,,,,,,,116.37,83,,percent of total billed charges,,,133.19,95,,percent of total billed charges,,,126.18,90,,percent of total billed charges,,,126.18,90,,percent of total billed charges,,,114.96,82,,percent of total billed charges,,,126.18,90,,percent of total billed charges,,,119.17,85,,percent of total billed charges,,5.26,133.19,
flavoxATE(URISPAS)TAB:100MG,32009816,CDM,,,250,RC,outpatient,,18.4,18.4,,15.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.6,22,,percent of total billed charges,,,,,,,,,16.56,90,,percent of total billed charges,,,15.24,82.8,,percent of total billed charges,,,15.64,85,,percent of total billed charges,,,,,,,,,16.19,88,,percent of total billed charges,,,,,,,,,14.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.6,22,,percent of total billed charges,,,16.74,91,,percent of total billed charges,,,17.48,95,,percent of total billed charges,,,15.27,83,,percent of total billed charges,,,15.27,83,,percent of total billed charges,,,,,,,,,,,,,,,15.27,83,,percent of total billed charges,,,17.48,95,,percent of total billed charges,,,16.56,90,,percent of total billed charges,,,16.56,90,,percent of total billed charges,,,15.09,82,,percent of total billed charges,,,16.56,90,,percent of total billed charges,,,15.64,85,,percent of total billed charges,,4.6,17.48,
VANCOMYCIN-VIAL:500 MG **OPTH USE,32009818,CDM,J3370,HCPCS,250,RC,outpatient,,40.25,40.25,,34.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.06,22,,percent of total billed charges,,,,,,,,,36.23,90,,percent of total billed charges,,,33.33,82.8,,percent of total billed charges,,,34.21,85,,percent of total billed charges,,,,,,,,,35.42,88,,percent of total billed charges,,19.39,,,,fee schedule,,,30.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.39,,,,fee schedule,,,10.06,22,,percent of total billed charges,,,36.63,91,,percent of total billed charges,,,38.24,95,,percent of total billed charges,,,33.41,83,,percent of total billed charges,,,33.41,83,,percent of total billed charges,,,,,,,,,,,,,,,33.41,83,,percent of total billed charges,,,38.24,95,,percent of total billed charges,,,36.23,90,,percent of total billed charges,,,36.23,90,,percent of total billed charges,,,33.01,82,,percent of total billed charges,,,36.23,90,,percent of total billed charges,,,34.21,85,,percent of total billed charges,,10.06,38.24,
VALPROATE(DEPAKENE)SYRP:250MG/5ML (90ML),32009819,CDM,J8499,HCPCS,250,RC,outpatient,,1346.28,1346.28,,1142.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,336.57,22,,percent of total billed charges,,,,,,,,,1211.65,90,,percent of total billed charges,,,1114.72,82.8,,percent of total billed charges,,,1144.34,85,,percent of total billed charges,,,,,,,,,1184.73,88,,percent of total billed charges,,,,,,,,,1028.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,336.57,22,,percent of total billed charges,,,1225.11,91,,percent of total billed charges,,,1278.97,95,,percent of total billed charges,,,1117.41,83,,percent of total billed charges,,,1117.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1117.41,83,,percent of total billed charges,,,1278.97,95,,percent of total billed charges,,,1211.65,90,,percent of total billed charges,,,1211.65,90,,percent of total billed charges,,,1103.95,82,,percent of total billed charges,,,1211.65,90,,percent of total billed charges,,,1144.34,85,,percent of total billed charges,,336.57,1278.97,
VANCOMYCIN HCL VIAL : 500MG,32009821,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
VANCOMYCIN HCL (VANCOCIN) CAP 125MG,32009827,CDM,J8499,HCPCS,250,RC,outpatient,,18.79,18.79,,15.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.7,22,,percent of total billed charges,,,,,,,,,16.91,90,,percent of total billed charges,,,15.56,82.8,,percent of total billed charges,,,15.97,85,,percent of total billed charges,,,,,,,,,16.54,88,,percent of total billed charges,,,,,,,,,14.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.7,22,,percent of total billed charges,,,17.1,91,,percent of total billed charges,,,17.85,95,,percent of total billed charges,,,15.6,83,,percent of total billed charges,,,15.6,83,,percent of total billed charges,,,,,,,,,,,,,,,15.6,83,,percent of total billed charges,,,17.85,95,,percent of total billed charges,,,16.91,90,,percent of total billed charges,,,16.91,90,,percent of total billed charges,,,15.41,82,,percent of total billed charges,,,16.91,90,,percent of total billed charges,,,15.97,85,,percent of total billed charges,,4.7,17.85,
CEFPODOXIME(VANTIN) SUSP :50MG/5ML 100ML,32009841,CDM,,,250,RC,outpatient,,763.39,763.39,,648.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,190.85,22,,percent of total billed charges,,,,,,,,,687.05,90,,percent of total billed charges,,,632.09,82.8,,percent of total billed charges,,,648.88,85,,percent of total billed charges,,,,,,,,,671.78,88,,percent of total billed charges,,,,,,,,,583.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,190.85,22,,percent of total billed charges,,,694.68,91,,percent of total billed charges,,,725.22,95,,percent of total billed charges,,,633.61,83,,percent of total billed charges,,,633.61,83,,percent of total billed charges,,,,,,,,,,,,,,,633.61,83,,percent of total billed charges,,,725.22,95,,percent of total billed charges,,,687.05,90,,percent of total billed charges,,,687.05,90,,percent of total billed charges,,,625.98,82,,percent of total billed charges,,,687.05,90,,percent of total billed charges,,,648.88,85,,percent of total billed charges,,190.85,725.22,
VANTIN ORAL SUSP 50MG/5ML 50ML,32009842,CDM,,,250,RC,outpatient,,61.5,61.5,,52.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.38,22,,percent of total billed charges,,,,,,,,,55.35,90,,percent of total billed charges,,,50.92,82.8,,percent of total billed charges,,,52.28,85,,percent of total billed charges,,,,,,,,,54.12,88,,percent of total billed charges,,,,,,,,,46.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.38,22,,percent of total billed charges,,,55.97,91,,percent of total billed charges,,,58.43,95,,percent of total billed charges,,,51.05,83,,percent of total billed charges,,,51.05,83,,percent of total billed charges,,,,,,,,,,,,,,,51.05,83,,percent of total billed charges,,,58.43,95,,percent of total billed charges,,,55.35,90,,percent of total billed charges,,,55.35,90,,percent of total billed charges,,,50.43,82,,percent of total billed charges,,,55.35,90,,percent of total billed charges,,,52.28,85,,percent of total billed charges,,15.38,58.43,
CEFPODOXIME(VANTIN)TAB:200MG,32009846,CDM,,,250,RC,outpatient,,134.18,134.18,,113.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.55,22,,percent of total billed charges,,,,,,,,,120.76,90,,percent of total billed charges,,,111.1,82.8,,percent of total billed charges,,,114.05,85,,percent of total billed charges,,,,,,,,,118.08,88,,percent of total billed charges,,,,,,,,,102.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.55,22,,percent of total billed charges,,,122.1,91,,percent of total billed charges,,,127.47,95,,percent of total billed charges,,,111.37,83,,percent of total billed charges,,,111.37,83,,percent of total billed charges,,,,,,,,,,,,,,,111.37,83,,percent of total billed charges,,,127.47,95,,percent of total billed charges,,,120.76,90,,percent of total billed charges,,,120.76,90,,percent of total billed charges,,,110.03,82,,percent of total billed charges,,,120.76,90,,percent of total billed charges,,,114.05,85,,percent of total billed charges,,33.55,127.47,
VARICELLA LOSTER(V-ZIG),32009852,CDM,90396,CPT,636,RC,outpatient,,157,157,,133.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.25,22,,percent of total billed charges,,,,,,,,,141.3,90,,percent of total billed charges,,,130,82.8,,percent of total billed charges,,,133.45,85,,percent of total billed charges,,,,,,,,,138.16,88,,percent of total billed charges,,,,,,,,,119.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.25,22,,percent of total billed charges,,,142.87,91,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,,,,,,,,,,,,,130.31,83,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,128.74,82,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,133.45,85,,percent of total billed charges,,39.25,149.15,
VARICELLA(VARIVAX)VIRUS VACC VIAL 1ML,32009853,CDM,,,250,RC,outpatient,,1910.63,1910.63,,1622.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,477.66,22,,percent of total billed charges,,,,,,,,,1719.57,90,,percent of total billed charges,,,1582,82.8,,percent of total billed charges,,,1624.04,85,,percent of total billed charges,,,,,,,,,1681.35,88,,percent of total billed charges,,,,,,,,,1459.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,477.66,22,,percent of total billed charges,,,1738.67,91,,percent of total billed charges,,,1815.1,95,,percent of total billed charges,,,1585.82,83,,percent of total billed charges,,,1585.82,83,,percent of total billed charges,,,,,,,,,,,,,,,1585.82,83,,percent of total billed charges,,,1815.1,95,,percent of total billed charges,,,1719.57,90,,percent of total billed charges,,,1719.57,90,,percent of total billed charges,,,1566.72,82,,percent of total billed charges,,,1719.57,90,,percent of total billed charges,,,1624.04,85,,percent of total billed charges,,477.66,1815.1,
VAQTA ADULT 50U SDV,32009854,CDM,,,250,RC,outpatient,,193,193,,163.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.25,22,,percent of total billed charges,,,,,,,,,173.7,90,,percent of total billed charges,,,159.8,82.8,,percent of total billed charges,,,164.05,85,,percent of total billed charges,,,,,,,,,169.84,88,,percent of total billed charges,,,,,,,,,147.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.25,22,,percent of total billed charges,,,175.63,91,,percent of total billed charges,,,183.35,95,,percent of total billed charges,,,160.19,83,,percent of total billed charges,,,160.19,83,,percent of total billed charges,,,,,,,,,,,,,,,160.19,83,,percent of total billed charges,,,183.35,95,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,158.26,82,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,164.05,85,,percent of total billed charges,,48.25,183.35,
VASOPRESSIN(PITRESSIN)VL:20UNIT/ML,32009855,CDM,,,250,RC,outpatient,,616.16,616.16,,523.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154.04,22,,percent of total billed charges,,,,,,,,,554.54,90,,percent of total billed charges,,,510.18,82.8,,percent of total billed charges,,,523.74,85,,percent of total billed charges,,,,,,,,,542.22,88,,percent of total billed charges,,,,,,,,,470.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154.04,22,,percent of total billed charges,,,560.71,91,,percent of total billed charges,,,585.35,95,,percent of total billed charges,,,511.41,83,,percent of total billed charges,,,511.41,83,,percent of total billed charges,,,,,,,,,,,,,,,511.41,83,,percent of total billed charges,,,585.35,95,,percent of total billed charges,,,554.54,90,,percent of total billed charges,,,554.54,90,,percent of total billed charges,,,505.25,82,,percent of total billed charges,,,554.54,90,,percent of total billed charges,,,523.74,85,,percent of total billed charges,,154.04,585.35,
ENALAPRIL(VASOTEC)TAB:10MG,32009856,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ENALAPRIL (VASOTEC) TAB : 20MG,32009861,CDM,,,250,RC,outpatient,,15.23,15.23,,12.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.81,22,,percent of total billed charges,,,,,,,,,13.71,90,,percent of total billed charges,,,12.61,82.8,,percent of total billed charges,,,12.95,85,,percent of total billed charges,,,,,,,,,13.4,88,,percent of total billed charges,,,,,,,,,11.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.81,22,,percent of total billed charges,,,13.86,91,,percent of total billed charges,,,14.47,95,,percent of total billed charges,,,12.64,83,,percent of total billed charges,,,12.64,83,,percent of total billed charges,,,,,,,,,,,,,,,12.64,83,,percent of total billed charges,,,14.47,95,,percent of total billed charges,,,13.71,90,,percent of total billed charges,,,13.71,90,,percent of total billed charges,,,12.49,82,,percent of total billed charges,,,13.71,90,,percent of total billed charges,,,12.95,85,,percent of total billed charges,,3.81,14.47,
ENALAPRIL(VASOTEC)TAB:5MG,32009871,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ENALAPRIL(VASOTEC)TAB:2.5MG,32009876,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ENALAPRILAT(VASOTEC)VIAL:1.25MG/ML,32009886,CDM,J3490,HCPCS,250,RC,outpatient,,95.26,95.26,,80.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.82,22,,percent of total billed charges,,,,,,,,,85.73,90,,percent of total billed charges,,,78.88,82.8,,percent of total billed charges,,,80.97,85,,percent of total billed charges,,,,,,,,,83.83,88,,percent of total billed charges,,,,,,,,,72.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.82,22,,percent of total billed charges,,,86.69,91,,percent of total billed charges,,,90.5,95,,percent of total billed charges,,,79.07,83,,percent of total billed charges,,,79.07,83,,percent of total billed charges,,,,,,,,,,,,,,,79.07,83,,percent of total billed charges,,,90.5,95,,percent of total billed charges,,,85.73,90,,percent of total billed charges,,,85.73,90,,percent of total billed charges,,,78.11,82,,percent of total billed charges,,,85.73,90,,percent of total billed charges,,,80.97,85,,percent of total billed charges,,23.82,90.5,
PENNICILLIN V POT SUSP:125MG/5ML(100ML),32009891,CDM,J8499,HCPCS,250,RC,outpatient,,98.69,98.69,,83.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.67,22,,percent of total billed charges,,,,,,,,,88.82,90,,percent of total billed charges,,,81.72,82.8,,percent of total billed charges,,,83.89,85,,percent of total billed charges,,,,,,,,,86.85,88,,percent of total billed charges,,,,,,,,,75.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.67,22,,percent of total billed charges,,,89.81,91,,percent of total billed charges,,,93.76,95,,percent of total billed charges,,,81.91,83,,percent of total billed charges,,,81.91,83,,percent of total billed charges,,,,,,,,,,,,,,,81.91,83,,percent of total billed charges,,,93.76,95,,percent of total billed charges,,,88.82,90,,percent of total billed charges,,,88.82,90,,percent of total billed charges,,,80.93,82,,percent of total billed charges,,,88.82,90,,percent of total billed charges,,,83.89,85,,percent of total billed charges,,24.67,93.76,
ALBUTEROL MDI: 90MCG/ACT  6.7GM,32009916,CDM,J7620,HCPCS,250,RC,outpatient,,292.65,292.65,,248.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.16,22,,percent of total billed charges,,,,,,,,,263.39,90,,percent of total billed charges,,,242.31,82.8,,percent of total billed charges,,,248.75,85,,percent of total billed charges,,,,,,,,,257.53,88,,percent of total billed charges,,0.13,,,,fee schedule,,,223.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.13,,,,fee schedule,,,73.16,22,,percent of total billed charges,,,266.31,91,,percent of total billed charges,,,278.02,95,,percent of total billed charges,,,242.9,83,,percent of total billed charges,,,242.9,83,,percent of total billed charges,,,,,,,,,,,,,,,242.9,83,,percent of total billed charges,,,278.02,95,,percent of total billed charges,,,263.39,90,,percent of total billed charges,,,263.39,90,,percent of total billed charges,,,239.97,82,,percent of total billed charges,,,263.39,90,,percent of total billed charges,,,248.75,85,,percent of total billed charges,,0.13,278.02,
ALBUTEROL SULFATE SYRP : 2MG/5ML  473ML,32009921,CDM,,,250,RC,outpatient,,361.13,361.13,,306.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90.28,22,,percent of total billed charges,,,,,,,,,325.02,90,,percent of total billed charges,,,299.02,82.8,,percent of total billed charges,,,306.96,85,,percent of total billed charges,,,,,,,,,317.79,88,,percent of total billed charges,,,,,,,,,275.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90.28,22,,percent of total billed charges,,,328.63,91,,percent of total billed charges,,,343.07,95,,percent of total billed charges,,,299.74,83,,percent of total billed charges,,,299.74,83,,percent of total billed charges,,,,,,,,,,,,,,,299.74,83,,percent of total billed charges,,,343.07,95,,percent of total billed charges,,,325.02,90,,percent of total billed charges,,,325.02,90,,percent of total billed charges,,,296.13,82,,percent of total billed charges,,,325.02,90,,percent of total billed charges,,,306.96,85,,percent of total billed charges,,90.28,343.07,
ALBUTEROL SULFATE SYRP : 2MG/5ML  90 ML,32009926,CDM,,,250,RC,outpatient,,68.67,68.67,,58.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.17,22,,percent of total billed charges,,,,,,,,,61.8,90,,percent of total billed charges,,,56.86,82.8,,percent of total billed charges,,,58.37,85,,percent of total billed charges,,,,,,,,,60.43,88,,percent of total billed charges,,,,,,,,,52.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.17,22,,percent of total billed charges,,,62.49,91,,percent of total billed charges,,,65.24,95,,percent of total billed charges,,,57,83,,percent of total billed charges,,,57,83,,percent of total billed charges,,,,,,,,,,,,,,,57,83,,percent of total billed charges,,,65.24,95,,percent of total billed charges,,,61.8,90,,percent of total billed charges,,,61.8,90,,percent of total billed charges,,,56.31,82,,percent of total billed charges,,,61.8,90,,percent of total billed charges,,,58.37,85,,percent of total billed charges,,17.17,65.24,
ALBUTEROL SULFATE SYRP:2MG/5ML (60ML),32009931,CDM,J8499,HCPCS,250,RC,outpatient,,45.84,45.84,,38.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.46,22,,percent of total billed charges,,,,,,,,,41.26,90,,percent of total billed charges,,,37.96,82.8,,percent of total billed charges,,,38.96,85,,percent of total billed charges,,,,,,,,,40.34,88,,percent of total billed charges,,,,,,,,,35.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.46,22,,percent of total billed charges,,,41.71,91,,percent of total billed charges,,,43.55,95,,percent of total billed charges,,,38.05,83,,percent of total billed charges,,,38.05,83,,percent of total billed charges,,,,,,,,,,,,,,,38.05,83,,percent of total billed charges,,,43.55,95,,percent of total billed charges,,,41.26,90,,percent of total billed charges,,,41.26,90,,percent of total billed charges,,,37.59,82,,percent of total billed charges,,,41.26,90,,percent of total billed charges,,,38.96,85,,percent of total billed charges,,11.46,43.55,
ALBUTEROL AER : 90MCG   17GM M.D.I,32009936,CDM,,,250,RC,outpatient,,362.56,362.56,,307.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90.64,22,,percent of total billed charges,,,,,,,,,326.3,90,,percent of total billed charges,,,300.2,82.8,,percent of total billed charges,,,308.18,85,,percent of total billed charges,,,,,,,,,319.05,88,,percent of total billed charges,,,,,,,,,277,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90.64,22,,percent of total billed charges,,,329.93,91,,percent of total billed charges,,,344.43,95,,percent of total billed charges,,,300.92,83,,percent of total billed charges,,,300.92,83,,percent of total billed charges,,,,,,,,,,,,,,,300.92,83,,percent of total billed charges,,,344.43,95,,percent of total billed charges,,,326.3,90,,percent of total billed charges,,,326.3,90,,percent of total billed charges,,,297.3,82,,percent of total billed charges,,,326.3,90,,percent of total billed charges,,,308.18,85,,percent of total billed charges,,90.64,344.43,
ALBUTEROL (BULK) ***J7625***,32009939,CDM,,,636,RC,outpatient,,817.69,817.69,,694.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,204.42,22,,percent of total billed charges,,,,,,,,,735.92,90,,percent of total billed charges,,,677.05,82.8,,percent of total billed charges,,,695.04,85,,percent of total billed charges,,,,,,,,,719.57,88,,percent of total billed charges,,,,,,,,,624.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,204.42,22,,percent of total billed charges,,,744.1,91,,percent of total billed charges,,,776.81,95,,percent of total billed charges,,,678.68,83,,percent of total billed charges,,,678.68,83,,percent of total billed charges,,,,,,,,,,,,,,,678.68,83,,percent of total billed charges,,,776.81,95,,percent of total billed charges,,,735.92,90,,percent of total billed charges,,,735.92,90,,percent of total billed charges,,,670.51,82,,percent of total billed charges,,,735.92,90,,percent of total billed charges,,,695.04,85,,percent of total billed charges,,204.42,776.81,
ALBUTEROL SOL:0.83MG/ML  PYX UD,32009940,CDM,J7609,HCPCS,250,RC,outpatient,,24.8,24.8,,21.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.2,22,,percent of total billed charges,,,,,,,,,22.32,90,,percent of total billed charges,,,20.53,82.8,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,,,,,,,,21.82,88,,percent of total billed charges,,,,,,,,,18.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.2,22,,percent of total billed charges,,,22.57,91,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,,,,,,,,,,,,,20.58,83,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,20.34,82,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,6.2,23.56,
ALBUTEROL SULFATE SOL:5MG/ML (20ML),32009941,CDM,J7611,HCPCS,250,RC,outpatient,,801.31,801.31,,680.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,200.33,22,,percent of total billed charges,,,,,,,,,721.18,90,,percent of total billed charges,,,663.48,82.8,,percent of total billed charges,,,681.11,85,,percent of total billed charges,,,,,,,,,705.15,88,,percent of total billed charges,,1.33,,,,fee schedule,,,612.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.33,,,,fee schedule,,,200.33,22,,percent of total billed charges,,,729.19,91,,percent of total billed charges,,,761.24,95,,percent of total billed charges,,,665.09,83,,percent of total billed charges,,,665.09,83,,percent of total billed charges,,,,,,,,,,,,,,,665.09,83,,percent of total billed charges,,,761.24,95,,percent of total billed charges,,,721.18,90,,percent of total billed charges,,,721.18,90,,percent of total billed charges,,,657.07,82,,percent of total billed charges,,,721.18,90,,percent of total billed charges,,,681.11,85,,percent of total billed charges,,1.33,761.24,
VENTOLIN (ALBUTEROL),32009946,CDM,,,636,RC,outpatient,,10.5,10.5,,8.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.63,22,,percent of total billed charges,,,,,,,,,9.45,90,,percent of total billed charges,,,8.69,82.8,,percent of total billed charges,,,8.93,85,,percent of total billed charges,,,,,,,,,9.24,88,,percent of total billed charges,,,,,,,,,8.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.63,22,,percent of total billed charges,,,9.56,91,,percent of total billed charges,,,9.98,95,,percent of total billed charges,,,8.72,83,,percent of total billed charges,,,8.72,83,,percent of total billed charges,,,,,,,,,,,,,,,8.72,83,,percent of total billed charges,,,9.98,95,,percent of total billed charges,,,9.45,90,,percent of total billed charges,,,9.45,90,,percent of total billed charges,,,8.61,82,,percent of total billed charges,,,9.45,90,,percent of total billed charges,,,8.93,85,,percent of total billed charges,,2.63,9.98,
ETOPOSIDE(TOPOSAR)MDV:100MG/5ML(J/10MG),32009956,CDM,J9181,HCPCS,250,RC,outpatient,,19.03,19.03,,16.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.76,22,,percent of total billed charges,,,,,,,,,17.13,90,,percent of total billed charges,,,15.76,82.8,,percent of total billed charges,,,16.18,85,,percent of total billed charges,,,,,,,,,16.75,88,,percent of total billed charges,,21.03,,,,fee schedule,,,14.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21.03,,,,fee schedule,,,4.76,22,,percent of total billed charges,,,17.32,91,,percent of total billed charges,,,18.08,95,,percent of total billed charges,,,15.79,83,,percent of total billed charges,,,15.79,83,,percent of total billed charges,,,,,,,,,,,,,,,15.79,83,,percent of total billed charges,,,18.08,95,,percent of total billed charges,,,17.13,90,,percent of total billed charges,,,17.13,90,,percent of total billed charges,,,15.6,82,,percent of total billed charges,,,17.13,90,,percent of total billed charges,,,16.18,85,,percent of total billed charges,,4.76,21.03,
VERAPAMIL(CALAN)VIAL:5MG/2ML,32009961,CDM,J3490,HCPCS,250,RC,outpatient,,100.33,100.33,,85.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.08,22,,percent of total billed charges,,,,,,,,,90.3,90,,percent of total billed charges,,,83.07,82.8,,percent of total billed charges,,,85.28,85,,percent of total billed charges,,,,,,,,,88.29,88,,percent of total billed charges,,,,,,,,,76.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.08,22,,percent of total billed charges,,,91.3,91,,percent of total billed charges,,,95.31,95,,percent of total billed charges,,,83.27,83,,percent of total billed charges,,,83.27,83,,percent of total billed charges,,,,,,,,,,,,,,,83.27,83,,percent of total billed charges,,,95.31,95,,percent of total billed charges,,,90.3,90,,percent of total billed charges,,,90.3,90,,percent of total billed charges,,,82.27,82,,percent of total billed charges,,,90.3,90,,percent of total billed charges,,,85.28,85,,percent of total billed charges,,25.08,95.31,
VERAPAMIL(CALAN)VIAL:10MG/4ML,32009966,CDM,J3490,HCPCS,250,RC,outpatient,,533.05,533.05,,452.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,133.26,22,,percent of total billed charges,,,,,,,,,479.75,90,,percent of total billed charges,,,441.37,82.8,,percent of total billed charges,,,453.09,85,,percent of total billed charges,,,,,,,,,469.08,88,,percent of total billed charges,,,,,,,,,407.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,133.26,22,,percent of total billed charges,,,485.08,91,,percent of total billed charges,,,506.4,95,,percent of total billed charges,,,442.43,83,,percent of total billed charges,,,442.43,83,,percent of total billed charges,,,,,,,,,,,,,,,442.43,83,,percent of total billed charges,,,506.4,95,,percent of total billed charges,,,479.75,90,,percent of total billed charges,,,479.75,90,,percent of total billed charges,,,437.1,82,,percent of total billed charges,,,479.75,90,,percent of total billed charges,,,453.09,85,,percent of total billed charges,,133.26,506.4,
VERAPAMIL(CALAN SR)TAB:120MG,32009970,CDM,J8499,HCPCS,250,RC,outpatient,,19.93,19.93,,16.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.98,22,,percent of total billed charges,,,,,,,,,17.94,90,,percent of total billed charges,,,16.5,82.8,,percent of total billed charges,,,16.94,85,,percent of total billed charges,,,,,,,,,17.54,88,,percent of total billed charges,,,,,,,,,15.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.98,22,,percent of total billed charges,,,18.14,91,,percent of total billed charges,,,18.93,95,,percent of total billed charges,,,16.54,83,,percent of total billed charges,,,16.54,83,,percent of total billed charges,,,,,,,,,,,,,,,16.54,83,,percent of total billed charges,,,18.93,95,,percent of total billed charges,,,17.94,90,,percent of total billed charges,,,17.94,90,,percent of total billed charges,,,16.34,82,,percent of total billed charges,,,17.94,90,,percent of total billed charges,,,16.94,85,,percent of total billed charges,,4.98,18.93,
VERAPAMIL (CALAN) TAB : 120MG,32009971,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
VERAPAMIL(CALAN)TAB:80MG,32009976,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
VERAPAMIL HCL CAP : 240MG,32009986,CDM,,,250,RC,outpatient,,14.43,14.43,,12.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.61,22,,percent of total billed charges,,,,,,,,,12.99,90,,percent of total billed charges,,,11.95,82.8,,percent of total billed charges,,,12.27,85,,percent of total billed charges,,,,,,,,,12.7,88,,percent of total billed charges,,,,,,,,,11.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.61,22,,percent of total billed charges,,,13.13,91,,percent of total billed charges,,,13.71,95,,percent of total billed charges,,,11.98,83,,percent of total billed charges,,,11.98,83,,percent of total billed charges,,,,,,,,,,,,,,,11.98,83,,percent of total billed charges,,,13.71,95,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,11.83,82,,percent of total billed charges,,,12.99,90,,percent of total billed charges,,,12.27,85,,percent of total billed charges,,3.61,13.71,
MEBENDAZOLE (VERMOX) TAB : 100MG,32009991,CDM,,,250,RC,outpatient,,75.02,75.02,,63.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.76,22,,percent of total billed charges,,,,,,,,,67.52,90,,percent of total billed charges,,,62.12,82.8,,percent of total billed charges,,,63.77,85,,percent of total billed charges,,,,,,,,,66.02,88,,percent of total billed charges,,,,,,,,,57.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.76,22,,percent of total billed charges,,,68.27,91,,percent of total billed charges,,,71.27,95,,percent of total billed charges,,,62.27,83,,percent of total billed charges,,,62.27,83,,percent of total billed charges,,,,,,,,,,,,,,,62.27,83,,percent of total billed charges,,,71.27,95,,percent of total billed charges,,,67.52,90,,percent of total billed charges,,,67.52,90,,percent of total billed charges,,,61.52,82,,percent of total billed charges,,,67.52,90,,percent of total billed charges,,,63.77,85,,percent of total billed charges,,18.76,71.27,
MIDAZOLAM(VERSED)VIAL:10MG/2ML,32009996,CDM,J2250,HCPCS,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,7.08,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.08,,,,fee schedule,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,7.08,64.15,
ESTRADIOL(ESTRACE)VAG CR:0.1MG/GM,32010008,CDM,J3490,HCPCS,250,RC,outpatient,,407.83,407.83,,346.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.96,22,,percent of total billed charges,,,,,,,,,367.05,90,,percent of total billed charges,,,337.68,82.8,,percent of total billed charges,,,346.66,85,,percent of total billed charges,,,,,,,,,358.89,88,,percent of total billed charges,,,,,,,,,311.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.96,22,,percent of total billed charges,,,371.13,91,,percent of total billed charges,,,387.44,95,,percent of total billed charges,,,338.5,83,,percent of total billed charges,,,338.5,83,,percent of total billed charges,,,,,,,,,,,,,,,338.5,83,,percent of total billed charges,,,387.44,95,,percent of total billed charges,,,367.05,90,,percent of total billed charges,,,367.05,90,,percent of total billed charges,,,334.42,82,,percent of total billed charges,,,367.05,90,,percent of total billed charges,,,346.66,85,,percent of total billed charges,,101.96,387.44,
DILTIAZEM(CARDIZEM)VL:125MG/25ML,32010010,CDM,J3490,HCPCS,250,RC,outpatient,,173.37,173.37,,147.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.34,22,,percent of total billed charges,,,,,,,,,156.03,90,,percent of total billed charges,,,143.55,82.8,,percent of total billed charges,,,147.36,85,,percent of total billed charges,,,,,,,,,152.57,88,,percent of total billed charges,,,,,,,,,132.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.34,22,,percent of total billed charges,,,157.77,91,,percent of total billed charges,,,164.7,95,,percent of total billed charges,,,143.9,83,,percent of total billed charges,,,143.9,83,,percent of total billed charges,,,,,,,,,,,,,,,143.9,83,,percent of total billed charges,,,164.7,95,,percent of total billed charges,,,156.03,90,,percent of total billed charges,,,156.03,90,,percent of total billed charges,,,142.16,82,,percent of total billed charges,,,156.03,90,,percent of total billed charges,,,147.36,85,,percent of total billed charges,,43.34,164.7,
rOPINIRole HCL (REQUIP) TAB : 1 MG,32010013,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
RISPERIDONE(RISPERDAL CONSTA) VL:25MG,32010014,CDM,,,636,RC,outpatient,,4095.98,4095.98,,3477.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1024,22,,percent of total billed charges,,,,,,,,,3686.38,90,,percent of total billed charges,,,3391.47,82.8,,percent of total billed charges,,,3481.58,85,,percent of total billed charges,,,,,,,,,3604.46,88,,percent of total billed charges,,,,,,,,,3129.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1024,22,,percent of total billed charges,,,3727.34,91,,percent of total billed charges,,,3891.18,95,,percent of total billed charges,,,3399.66,83,,percent of total billed charges,,,3399.66,83,,percent of total billed charges,,,,,,,,,,,,,,,3399.66,83,,percent of total billed charges,,,3891.18,95,,percent of total billed charges,,,3686.38,90,,percent of total billed charges,,,3686.38,90,,percent of total billed charges,,,3358.7,82,,percent of total billed charges,,,3686.38,90,,percent of total billed charges,,,3481.58,85,,percent of total billed charges,,1024,3891.18,
EUCALYPT/MEN/CAMP/TURP(VICK VAPORUB)OINT,32010016,CDM,,,250,RC,outpatient,,63.6,63.6,,54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.9,22,,percent of total billed charges,,,,,,,,,57.24,90,,percent of total billed charges,,,52.66,82.8,,percent of total billed charges,,,54.06,85,,percent of total billed charges,,,,,,,,,55.97,88,,percent of total billed charges,,,,,,,,,48.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.9,22,,percent of total billed charges,,,57.88,91,,percent of total billed charges,,,60.42,95,,percent of total billed charges,,,52.79,83,,percent of total billed charges,,,52.79,83,,percent of total billed charges,,,,,,,,,,,,,,,52.79,83,,percent of total billed charges,,,60.42,95,,percent of total billed charges,,,57.24,90,,percent of total billed charges,,,57.24,90,,percent of total billed charges,,,52.15,82,,percent of total billed charges,,,57.24,90,,percent of total billed charges,,,54.06,85,,percent of total billed charges,,15.9,60.42,
VICKS 44 COUGH RELIEF 4OZ,32010017,CDM,,,250,RC,outpatient,,12.75,12.75,,10.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.19,22,,percent of total billed charges,,,,,,,,,11.48,90,,percent of total billed charges,,,10.56,82.8,,percent of total billed charges,,,10.84,85,,percent of total billed charges,,,,,,,,,11.22,88,,percent of total billed charges,,,,,,,,,9.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.19,22,,percent of total billed charges,,,11.6,91,,percent of total billed charges,,,12.11,95,,percent of total billed charges,,,10.58,83,,percent of total billed charges,,,10.58,83,,percent of total billed charges,,,,,,,,,,,,,,,10.58,83,,percent of total billed charges,,,12.11,95,,percent of total billed charges,,,11.48,90,,percent of total billed charges,,,11.48,90,,percent of total billed charges,,,10.46,82,,percent of total billed charges,,,11.48,90,,percent of total billed charges,,,10.84,85,,percent of total billed charges,,3.19,12.11,
MAG SULF-IVPB 4GM/SW100ML(PRE-MIX),32010024,CDM,J3475,HCPCS,258,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,15.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.22,,,,fee schedule,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,15.22,187.11,
MISOPROSTOL(CYTOTEC)TAB:25 MCG,32010025,CDM,J8499,HCPCS,250,RC,outpatient,,17.48,17.48,,14.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.37,22,,percent of total billed charges,,,,,,,,,15.73,90,,percent of total billed charges,,,14.47,82.8,,percent of total billed charges,,,14.86,85,,percent of total billed charges,,,,,,,,,15.38,88,,percent of total billed charges,,,,,,,,,13.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.37,22,,percent of total billed charges,,,15.91,91,,percent of total billed charges,,,16.61,95,,percent of total billed charges,,,14.51,83,,percent of total billed charges,,,14.51,83,,percent of total billed charges,,,,,,,,,,,,,,,14.51,83,,percent of total billed charges,,,16.61,95,,percent of total billed charges,,,15.73,90,,percent of total billed charges,,,15.73,90,,percent of total billed charges,,,14.33,82,,percent of total billed charges,,,15.73,90,,percent of total billed charges,,,14.86,85,,percent of total billed charges,,4.37,16.61,
FUROSEMIDE IV DRIP:100MG/NS50ML,32010033,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
MULTIVITAMINS LIQ 240 ML,32010036,CDM,,,250,RC,outpatient,,67.5,67.5,,57.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.75,90,,percent of total billed charges,,,55.89,82.8,,percent of total billed charges,,,57.38,85,,percent of total billed charges,,,,,,,,,59.4,88,,percent of total billed charges,,,,,,,,,51.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.88,22,,percent of total billed charges,,,61.43,91,,percent of total billed charges,,,64.13,95,,percent of total billed charges,,,56.03,83,,percent of total billed charges,,,56.03,83,,percent of total billed charges,,,,,,,,,,,,,,,56.03,83,,percent of total billed charges,,,64.13,95,,percent of total billed charges,,,60.75,90,,percent of total billed charges,,,60.75,90,,percent of total billed charges,,,55.35,82,,percent of total billed charges,,,60.75,90,,percent of total billed charges,,,57.38,85,,percent of total billed charges,,16.88,64.13,
NYSTATIN ORAL UD:500MU/5ML,32010037,CDM,J8499,HCPCS,250,RC,outpatient,,16.5,16.5,,14.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.13,22,,percent of total billed charges,,,,,,,,,14.85,90,,percent of total billed charges,,,13.66,82.8,,percent of total billed charges,,,14.03,85,,percent of total billed charges,,,,,,,,,14.52,88,,percent of total billed charges,,,,,,,,,12.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.13,22,,percent of total billed charges,,,15.02,91,,percent of total billed charges,,,15.68,95,,percent of total billed charges,,,13.7,83,,percent of total billed charges,,,13.7,83,,percent of total billed charges,,,,,,,,,,,,,,,13.7,83,,percent of total billed charges,,,15.68,95,,percent of total billed charges,,,14.85,90,,percent of total billed charges,,,14.85,90,,percent of total billed charges,,,13.53,82,,percent of total billed charges,,,14.85,90,,percent of total billed charges,,,14.03,85,,percent of total billed charges,,4.13,15.68,
SUFentanil(SUFENTA) FTV:50MCG/1ML,32010038,CDM,,,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,,,,,,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,16.88,64.15,
vinCRISTine SULFATE VIAL:1MG/ML,32010041,CDM,J9370,HCPCS,636,RC,outpatient,,90.2,90.2,,76.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.55,22,,percent of total billed charges,,,,,,,,,81.18,90,,percent of total billed charges,,,74.69,82.8,,percent of total billed charges,,,76.67,85,,percent of total billed charges,,,,,,,,,79.38,88,,percent of total billed charges,,19.52,,,,fee schedule,,,68.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.52,,,,fee schedule,,,22.55,22,,percent of total billed charges,,,82.08,91,,percent of total billed charges,,,85.69,95,,percent of total billed charges,,,74.87,83,,percent of total billed charges,,,74.87,83,,percent of total billed charges,,,,,,,,,,,,,,,74.87,83,,percent of total billed charges,,,85.69,95,,percent of total billed charges,,,81.18,90,,percent of total billed charges,,,81.18,90,,percent of total billed charges,,,73.96,82,,percent of total billed charges,,,81.18,90,,percent of total billed charges,,,76.67,85,,percent of total billed charges,,19.52,85.69,
sitaGLIPtin(JANUVIA) TAB:50MG,32010042,CDM,J8499,HCPCS,250,RC,outpatient,,293.63,293.63,,249.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.41,22,,percent of total billed charges,,,,,,,,,264.27,90,,percent of total billed charges,,,243.13,82.8,,percent of total billed charges,,,249.59,85,,percent of total billed charges,,,,,,,,,258.39,88,,percent of total billed charges,,,,,,,,,224.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.41,22,,percent of total billed charges,,,267.2,91,,percent of total billed charges,,,278.95,95,,percent of total billed charges,,,243.71,83,,percent of total billed charges,,,243.71,83,,percent of total billed charges,,,,,,,,,,,,,,,243.71,83,,percent of total billed charges,,,278.95,95,,percent of total billed charges,,,264.27,90,,percent of total billed charges,,,264.27,90,,percent of total billed charges,,,240.78,82,,percent of total billed charges,,,264.27,90,,percent of total billed charges,,,249.59,85,,percent of total billed charges,,73.41,278.95,
INFLUENZA VACCINE(2011-2012)SYR:0.5ML,32010044,CDM,90656,CPT,636,RC,outpatient,,205.7,205.7,,174.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.43,22,,percent of total billed charges,,,,,,,,,185.13,90,,percent of total billed charges,,,170.32,82.8,,percent of total billed charges,,,174.85,85,,percent of total billed charges,,,,,,,,,181.02,88,,percent of total billed charges,,,,,,,,,157.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.43,22,,percent of total billed charges,,,187.19,91,,percent of total billed charges,,,195.42,95,,percent of total billed charges,,,170.73,83,,percent of total billed charges,,,170.73,83,,percent of total billed charges,,,,,,,,,,,,,,,170.73,83,,percent of total billed charges,,,195.42,95,,percent of total billed charges,,,185.13,90,,percent of total billed charges,,,185.13,90,,percent of total billed charges,,,168.67,82,,percent of total billed charges,,,185.13,90,,percent of total billed charges,,,174.85,85,,percent of total billed charges,,51.43,195.42,
ROFECOXIB (VIOXX) TAB : 25MG,32010047,CDM,,,250,RC,outpatient,,42.03,42.03,,35.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.51,22,,percent of total billed charges,,,,,,,,,37.83,90,,percent of total billed charges,,,34.8,82.8,,percent of total billed charges,,,35.73,85,,percent of total billed charges,,,,,,,,,36.99,88,,percent of total billed charges,,,,,,,,,32.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.51,22,,percent of total billed charges,,,38.25,91,,percent of total billed charges,,,39.93,95,,percent of total billed charges,,,34.88,83,,percent of total billed charges,,,34.88,83,,percent of total billed charges,,,,,,,,,,,,,,,34.88,83,,percent of total billed charges,,,39.93,95,,percent of total billed charges,,,37.83,90,,percent of total billed charges,,,37.83,90,,percent of total billed charges,,,34.46,82,,percent of total billed charges,,,37.83,90,,percent of total billed charges,,,35.73,85,,percent of total billed charges,,10.51,39.93,
ROFECOXIB (VIOXX) TAB : 12.5MG,32010048,CDM,,,250,RC,outpatient,,42.03,42.03,,35.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.51,22,,percent of total billed charges,,,,,,,,,37.83,90,,percent of total billed charges,,,34.8,82.8,,percent of total billed charges,,,35.73,85,,percent of total billed charges,,,,,,,,,36.99,88,,percent of total billed charges,,,,,,,,,32.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.51,22,,percent of total billed charges,,,38.25,91,,percent of total billed charges,,,39.93,95,,percent of total billed charges,,,34.88,83,,percent of total billed charges,,,34.88,83,,percent of total billed charges,,,,,,,,,,,,,,,34.88,83,,percent of total billed charges,,,39.93,95,,percent of total billed charges,,,37.83,90,,percent of total billed charges,,,37.83,90,,percent of total billed charges,,,34.46,82,,percent of total billed charges,,,37.83,90,,percent of total billed charges,,,35.73,85,,percent of total billed charges,,10.51,39.93,
ROFECOXIB (VIOXX) TAB : 25MG,32010049,CDM,,,250,RC,outpatient,,84.22,84.22,,71.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.06,22,,percent of total billed charges,,,,,,,,,75.8,90,,percent of total billed charges,,,69.73,82.8,,percent of total billed charges,,,71.59,85,,percent of total billed charges,,,,,,,,,74.11,88,,percent of total billed charges,,,,,,,,,64.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.06,22,,percent of total billed charges,,,76.64,91,,percent of total billed charges,,,80.01,95,,percent of total billed charges,,,69.9,83,,percent of total billed charges,,,69.9,83,,percent of total billed charges,,,,,,,,,,,,,,,69.9,83,,percent of total billed charges,,,80.01,95,,percent of total billed charges,,,75.8,90,,percent of total billed charges,,,75.8,90,,percent of total billed charges,,,69.06,82,,percent of total billed charges,,,75.8,90,,percent of total billed charges,,,71.59,85,,percent of total billed charges,,21.06,80.01,
RIVAROXABAN(XARELTO) TABS:10MG,32010050,CDM,J8499,HCPCS,250,RC,outpatient,,218.3,218.3,,185.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.58,22,,percent of total billed charges,,,,,,,,,196.47,90,,percent of total billed charges,,,180.75,82.8,,percent of total billed charges,,,185.56,85,,percent of total billed charges,,,,,,,,,192.1,88,,percent of total billed charges,,,,,,,,,166.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.58,22,,percent of total billed charges,,,198.65,91,,percent of total billed charges,,,207.39,95,,percent of total billed charges,,,181.19,83,,percent of total billed charges,,,181.19,83,,percent of total billed charges,,,,,,,,,,,,,,,181.19,83,,percent of total billed charges,,,207.39,95,,percent of total billed charges,,,196.47,90,,percent of total billed charges,,,196.47,90,,percent of total billed charges,,,179.01,82,,percent of total billed charges,,,196.47,90,,percent of total billed charges,,,185.56,85,,percent of total billed charges,,54.58,207.39,
VIDARABINE (VIRA-A) OINT : 3% 3.5GM,32010051,CDM,,,250,RC,outpatient,,360.34,360.34,,305.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90.09,22,,percent of total billed charges,,,,,,,,,324.31,90,,percent of total billed charges,,,298.36,82.8,,percent of total billed charges,,,306.29,85,,percent of total billed charges,,,,,,,,,317.1,88,,percent of total billed charges,,,,,,,,,275.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90.09,22,,percent of total billed charges,,,327.91,91,,percent of total billed charges,,,342.32,95,,percent of total billed charges,,,299.08,83,,percent of total billed charges,,,299.08,83,,percent of total billed charges,,,,,,,,,,,,,,,299.08,83,,percent of total billed charges,,,342.32,95,,percent of total billed charges,,,324.31,90,,percent of total billed charges,,,324.31,90,,percent of total billed charges,,,295.48,82,,percent of total billed charges,,,324.31,90,,percent of total billed charges,,,306.29,85,,percent of total billed charges,,90.09,342.32,
LIDOCAINE HCL 2% VIAL:(20MG/ML) (5ML),32010052,CDM,J2001,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
fentaNYL(SUBLIMAZE)PF INJ:250MCG/5ML,32010053,CDM,J3010,HCPCS,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,1.79,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.79,,,,fee schedule,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,1.79,64.15,
methylPRED(DEPO-MEDROL)*IM* VIAL:80MG/ML,32010054,CDM,J1040,HCPCS,250,RC,outpatient,,280.07,280.07,,237.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.02,22,,percent of total billed charges,,,,,,,,,252.06,90,,percent of total billed charges,,,231.9,82.8,,percent of total billed charges,,,238.06,85,,percent of total billed charges,,,,,,,,,246.46,88,,percent of total billed charges,,23.18,,,,fee schedule,,,213.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,23.18,,,,fee schedule,,,70.02,22,,percent of total billed charges,,,254.86,91,,percent of total billed charges,,,266.07,95,,percent of total billed charges,,,232.46,83,,percent of total billed charges,,,232.46,83,,percent of total billed charges,,,,,,,,,,,,,,,232.46,83,,percent of total billed charges,,,266.07,95,,percent of total billed charges,,,252.06,90,,percent of total billed charges,,,252.06,90,,percent of total billed charges,,,229.66,82,,percent of total billed charges,,,252.06,90,,percent of total billed charges,,,238.06,85,,percent of total billed charges,,23.18,266.07,
CHONDRO SU/HYALUR(VISCOAT)SYR:40-30MG/ML,32010056,CDM,,,250,RC,outpatient,,303.08,303.08,,257.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.77,22,,percent of total billed charges,,,,,,,,,272.77,90,,percent of total billed charges,,,250.95,82.8,,percent of total billed charges,,,257.62,85,,percent of total billed charges,,,,,,,,,266.71,88,,percent of total billed charges,,,,,,,,,231.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.77,22,,percent of total billed charges,,,275.8,91,,percent of total billed charges,,,287.93,95,,percent of total billed charges,,,251.56,83,,percent of total billed charges,,,251.56,83,,percent of total billed charges,,,,,,,,,,,,,,,251.56,83,,percent of total billed charges,,,287.93,95,,percent of total billed charges,,,272.77,90,,percent of total billed charges,,,272.77,90,,percent of total billed charges,,,248.53,82,,percent of total billed charges,,,272.77,90,,percent of total billed charges,,,257.62,85,,percent of total billed charges,,75.77,287.93,
DIAZEPAM(VALIUM)VIAL:50MG/10ML,32010057,CDM,J3360,HCPCS,250,RC,outpatient,,654.58,654.58,,555.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,163.65,22,,percent of total billed charges,,,,,,,,,589.12,90,,percent of total billed charges,,,541.99,82.8,,percent of total billed charges,,,556.39,85,,percent of total billed charges,,,,,,,,,576.03,88,,percent of total billed charges,,26.31,,,,fee schedule,,,500.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,26.31,,,,fee schedule,,,163.65,22,,percent of total billed charges,,,595.67,91,,percent of total billed charges,,,621.85,95,,percent of total billed charges,,,543.3,83,,percent of total billed charges,,,543.3,83,,percent of total billed charges,,,,,,,,,,,,,,,543.3,83,,percent of total billed charges,,,621.85,95,,percent of total billed charges,,,589.12,90,,percent of total billed charges,,,589.12,90,,percent of total billed charges,,,536.76,82,,percent of total billed charges,,,589.12,90,,percent of total billed charges,,,556.39,85,,percent of total billed charges,,26.31,621.85,
FACTOR VIII (HUMATE-P):1 UNIT       J/1,32010060,CDM,J7187,HCPCS,636,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,12958.7,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,12958.7,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,12958.7,
MORPHINE SULF VIAL :50MG/ML  50ML,32010062,CDM,J2270,HCPCS,250,RC,outpatient,,450.27,450.27,,382.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,112.57,22,,percent of total billed charges,,,,,,,,,405.24,90,,percent of total billed charges,,,372.82,82.8,,percent of total billed charges,,,382.73,85,,percent of total billed charges,,,,,,,,,396.24,88,,percent of total billed charges,,5.94,,,,fee schedule,,,344.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.94,,,,fee schedule,,,112.57,22,,percent of total billed charges,,,409.75,91,,percent of total billed charges,,,427.76,95,,percent of total billed charges,,,373.72,83,,percent of total billed charges,,,373.72,83,,percent of total billed charges,,,,,,,,,,,,,,,373.72,83,,percent of total billed charges,,,427.76,95,,percent of total billed charges,,,405.24,90,,percent of total billed charges,,,405.24,90,,percent of total billed charges,,,369.22,82,,percent of total billed charges,,,405.24,90,,percent of total billed charges,,,382.73,85,,percent of total billed charges,,5.94,427.76,
HYDROmorphone (DILAUDID) VIAL:2MG/ML,32010068,CDM,J1170,HCPCS,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,3.47,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.47,,,,fee schedule,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,3.47,64.15,
ZOLEDRONIC(ZOMETA)BTL* 4MG/100ML:(J/1MG),32010070,CDM,J3489,HCPCS,636,RC,outpatient,,265.65,265.65,,225.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.41,22,,percent of total billed charges,,,,,,,,,239.09,90,,percent of total billed charges,,,219.96,82.8,,percent of total billed charges,,,225.8,85,,percent of total billed charges,,,,,,,,,233.77,88,,percent of total billed charges,,41.84,,,,fee schedule,,,202.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,41.84,,,,fee schedule,,,66.41,22,,percent of total billed charges,,,241.74,91,,percent of total billed charges,,,252.37,95,,percent of total billed charges,,,220.49,83,,percent of total billed charges,,,220.49,83,,percent of total billed charges,,,,,,,,,,,,,,,220.49,83,,percent of total billed charges,,,252.37,95,,percent of total billed charges,,,239.09,90,,percent of total billed charges,,,239.09,90,,percent of total billed charges,,,217.83,82,,percent of total billed charges,,,239.09,90,,percent of total billed charges,,,225.8,85,,percent of total billed charges,,41.84,252.37,
methaDONE HCL TABS:10MG,32010072,CDM,,,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
THIAMINE(VITAMIN B-1)TAB:100MG,32010076,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PYRIDOXINE(VITAMIN B-6)TAB:50MG,32010077,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CYANOCOBALAMIN(VITAMIN B-12)TAB:500MCG,32010078,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
VITAMIN B12 500MCG TAB,32010079,CDM,,,250,RC,outpatient,,0.5,0.5,,0.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.13,22,,percent of total billed charges,,,,,,,,,0.45,90,,percent of total billed charges,,,0.41,82.8,,percent of total billed charges,,,0.43,85,,percent of total billed charges,,,,,,,,,0.44,88,,percent of total billed charges,,,,,,,,,0.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.13,22,,percent of total billed charges,,,0.46,91,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,,,,,,,,,,,,,0.42,83,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.41,82,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.43,85,,percent of total billed charges,,0.13,0.48,
VITAMIN E CAP : 200 UNIT,32010081,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
LEVOTHYROXINE(SYNTHROID)*INJ*:100MCG,32010082,CDM,J3490,HCPCS,250,RC,outpatient,,1147.34,1147.34,,974.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,286.84,22,,percent of total billed charges,,,,,,,,,1032.61,90,,percent of total billed charges,,,950,82.8,,percent of total billed charges,,,975.24,85,,percent of total billed charges,,,,,,,,,1009.66,88,,percent of total billed charges,,,,,,,,,876.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,286.84,22,,percent of total billed charges,,,1044.08,91,,percent of total billed charges,,,1089.97,95,,percent of total billed charges,,,952.29,83,,percent of total billed charges,,,952.29,83,,percent of total billed charges,,,,,,,,,,,,,,,952.29,83,,percent of total billed charges,,,1089.97,95,,percent of total billed charges,,,1032.61,90,,percent of total billed charges,,,1032.61,90,,percent of total billed charges,,,940.82,82,,percent of total billed charges,,,1032.61,90,,percent of total billed charges,,,975.24,85,,percent of total billed charges,,286.84,1089.97,
VITAMIN E CAP : 1000 UNIT,32010087,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
VITAMIN E CAP:400 UNIT,32010088,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
VITAMINS A AND D OINT 60GM,32010091,CDM,,,250,RC,outpatient,,35.84,35.84,,30.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.96,22,,percent of total billed charges,,,,,,,,,32.26,90,,percent of total billed charges,,,29.68,82.8,,percent of total billed charges,,,30.46,85,,percent of total billed charges,,,,,,,,,31.54,88,,percent of total billed charges,,,,,,,,,27.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.96,22,,percent of total billed charges,,,32.61,91,,percent of total billed charges,,,34.05,95,,percent of total billed charges,,,29.75,83,,percent of total billed charges,,,29.75,83,,percent of total billed charges,,,,,,,,,,,,,,,29.75,83,,percent of total billed charges,,,34.05,95,,percent of total billed charges,,,32.26,90,,percent of total billed charges,,,32.26,90,,percent of total billed charges,,,29.39,82,,percent of total billed charges,,,32.26,90,,percent of total billed charges,,,30.46,85,,percent of total billed charges,,8.96,34.05,
VITAMINS A & D OINT:U/D,32010092,CDM,J3490,HCPCS,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
VITAMIN A & D OINTMENT - BOX OF PACKETS,32010093,CDM,,,250,RC,outpatient,,29.5,29.5,,25.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.38,22,,percent of total billed charges,,,,,,,,,26.55,90,,percent of total billed charges,,,24.43,82.8,,percent of total billed charges,,,25.08,85,,percent of total billed charges,,,,,,,,,25.96,88,,percent of total billed charges,,,,,,,,,22.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.38,22,,percent of total billed charges,,,26.85,91,,percent of total billed charges,,,28.03,95,,percent of total billed charges,,,24.49,83,,percent of total billed charges,,,24.49,83,,percent of total billed charges,,,,,,,,,,,,,,,24.49,83,,percent of total billed charges,,,28.03,95,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,24.19,82,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,25.08,85,,percent of total billed charges,,7.38,28.03,
VITAMIN A & D OINTMENT PACKET,32010094,CDM,,,250,RC,outpatient,,0.5,0.5,,0.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.13,22,,percent of total billed charges,,,,,,,,,0.45,90,,percent of total billed charges,,,0.41,82.8,,percent of total billed charges,,,0.43,85,,percent of total billed charges,,,,,,,,,0.44,88,,percent of total billed charges,,,,,,,,,0.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.13,22,,percent of total billed charges,,,0.46,91,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,0.42,83,,percent of total billed charges,,,,,,,,,,,,,,,0.42,83,,percent of total billed charges,,,0.48,95,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.41,82,,percent of total billed charges,,,0.45,90,,percent of total billed charges,,,0.43,85,,percent of total billed charges,,0.13,0.48,
"VITAMIN D 50,000 units",32010101,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
CHOLECALCIFEROL(VITAMIN D)TAB:400UNITS,32010102,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ONDANSETRON(ZOFRAN):4MG/2ML  SYR  J/1MG,32010103,CDM,J2405,HCPCS,636,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,1.38,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.38,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,1.38,59.21,
VITAMIN E CREAM 60GM,32010106,CDM,,,250,RC,outpatient,,31.24,31.24,,26.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.81,22,,percent of total billed charges,,,,,,,,,28.12,90,,percent of total billed charges,,,25.87,82.8,,percent of total billed charges,,,26.55,85,,percent of total billed charges,,,,,,,,,27.49,88,,percent of total billed charges,,,,,,,,,23.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.81,22,,percent of total billed charges,,,28.43,91,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,25.93,83,,percent of total billed charges,,,,,,,,,,,,,,,25.93,83,,percent of total billed charges,,,29.68,95,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,25.62,82,,percent of total billed charges,,,28.12,90,,percent of total billed charges,,,26.55,85,,percent of total billed charges,,7.81,29.68,
PRASUGREL(EFFIENT)TAB:10MG,32010109,CDM,,,250,RC,outpatient,,106.26,106.26,,90.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.57,22,,percent of total billed charges,,,,,,,,,95.63,90,,percent of total billed charges,,,87.98,82.8,,percent of total billed charges,,,90.32,85,,percent of total billed charges,,,,,,,,,93.51,88,,percent of total billed charges,,,,,,,,,81.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.57,22,,percent of total billed charges,,,96.7,91,,percent of total billed charges,,,100.95,95,,percent of total billed charges,,,88.2,83,,percent of total billed charges,,,88.2,83,,percent of total billed charges,,,,,,,,,,,,,,,88.2,83,,percent of total billed charges,,,100.95,95,,percent of total billed charges,,,95.63,90,,percent of total billed charges,,,95.63,90,,percent of total billed charges,,,87.13,82,,percent of total billed charges,,,95.63,90,,percent of total billed charges,,,90.32,85,,percent of total billed charges,,26.57,100.95,
PRASUGREL(EFFIENT)TAB:5MG,32010110,CDM,,,250,RC,outpatient,,106.26,106.26,,90.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.57,22,,percent of total billed charges,,,,,,,,,95.63,90,,percent of total billed charges,,,87.98,82.8,,percent of total billed charges,,,90.32,85,,percent of total billed charges,,,,,,,,,93.51,88,,percent of total billed charges,,,,,,,,,81.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.57,22,,percent of total billed charges,,,96.7,91,,percent of total billed charges,,,100.95,95,,percent of total billed charges,,,88.2,83,,percent of total billed charges,,,88.2,83,,percent of total billed charges,,,,,,,,,,,,,,,88.2,83,,percent of total billed charges,,,100.95,95,,percent of total billed charges,,,95.63,90,,percent of total billed charges,,,95.63,90,,percent of total billed charges,,,87.13,82,,percent of total billed charges,,,95.63,90,,percent of total billed charges,,,90.32,85,,percent of total billed charges,,26.57,100.95,
PHYTONADIONE(VIT-K)NEONATL AMP:1MG/0.5ML,32010111,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
POTASSIUM IODIDE(LUGOL'S)SOL 5%:14ML,32010113,CDM,J3490,HCPCS,250,RC,outpatient,,544.95,544.95,,462.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,136.24,22,,percent of total billed charges,,,,,,,,,490.46,90,,percent of total billed charges,,,451.22,82.8,,percent of total billed charges,,,463.21,85,,percent of total billed charges,,,,,,,,,479.56,88,,percent of total billed charges,,,,,,,,,416.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,136.24,22,,percent of total billed charges,,,495.9,91,,percent of total billed charges,,,517.7,95,,percent of total billed charges,,,452.31,83,,percent of total billed charges,,,452.31,83,,percent of total billed charges,,,,,,,,,,,,,,,452.31,83,,percent of total billed charges,,,517.7,95,,percent of total billed charges,,,490.46,90,,percent of total billed charges,,,490.46,90,,percent of total billed charges,,,446.86,82,,percent of total billed charges,,,490.46,90,,percent of total billed charges,,,463.21,85,,percent of total billed charges,,136.24,517.7,
PHYTONADIONE(VIT-K ADULT)AMP:10MG/ML,32010116,CDM,J3430,HCPCS,250,RC,outpatient,,764.71,764.71,,649.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,191.18,22,,percent of total billed charges,,,,,,,,,688.24,90,,percent of total billed charges,,,633.18,82.8,,percent of total billed charges,,,650,85,,percent of total billed charges,,,,,,,,,672.94,88,,percent of total billed charges,,82.65,,,,fee schedule,,,584.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,82.65,,,,fee schedule,,,191.18,22,,percent of total billed charges,,,695.89,91,,percent of total billed charges,,,726.47,95,,percent of total billed charges,,,634.71,83,,percent of total billed charges,,,634.71,83,,percent of total billed charges,,,,,,,,,,,,,,,634.71,83,,percent of total billed charges,,,726.47,95,,percent of total billed charges,,,688.24,90,,percent of total billed charges,,,688.24,90,,percent of total billed charges,,,627.06,82,,percent of total billed charges,,,688.24,90,,percent of total billed charges,,,650,85,,percent of total billed charges,,82.65,726.47,
ZN/CU/CR/MN/SE(MULTITRACE-5)VIAL:10ML,32010119,CDM,J3490,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
HALOPERIDOL DECANOATE(HALDOL)AMP:50MG/ML,32010120,CDM,J1631,HCPCS,636,RC,outpatient,,282.78,282.78,,240.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70.7,22,,percent of total billed charges,,,,,,,,,254.5,90,,percent of total billed charges,,,234.14,82.8,,percent of total billed charges,,,240.36,85,,percent of total billed charges,,,,,,,,,248.85,88,,percent of total billed charges,,46.67,,,,fee schedule,,,216.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,46.67,,,,fee schedule,,,70.7,22,,percent of total billed charges,,,257.33,91,,percent of total billed charges,,,268.64,95,,percent of total billed charges,,,234.71,83,,percent of total billed charges,,,234.71,83,,percent of total billed charges,,,,,,,,,,,,,,,234.71,83,,percent of total billed charges,,,268.64,95,,percent of total billed charges,,,254.5,90,,percent of total billed charges,,,254.5,90,,percent of total billed charges,,,231.88,82,,percent of total billed charges,,,254.5,90,,percent of total billed charges,,,240.36,85,,percent of total billed charges,,46.67,268.64,
PIPERONLY BUTOXID/PYRETHRM EXT(RID):60ML,32010123,CDM,,,250,RC,outpatient,,70.1,70.1,,59.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.53,22,,percent of total billed charges,,,,,,,,,63.09,90,,percent of total billed charges,,,58.04,82.8,,percent of total billed charges,,,59.59,85,,percent of total billed charges,,,,,,,,,61.69,88,,percent of total billed charges,,,,,,,,,53.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.53,22,,percent of total billed charges,,,63.79,91,,percent of total billed charges,,,66.6,95,,percent of total billed charges,,,58.18,83,,percent of total billed charges,,,58.18,83,,percent of total billed charges,,,,,,,,,,,,,,,58.18,83,,percent of total billed charges,,,66.6,95,,percent of total billed charges,,,63.09,90,,percent of total billed charges,,,63.09,90,,percent of total billed charges,,,57.48,82,,percent of total billed charges,,,63.09,90,,percent of total billed charges,,,59.59,85,,percent of total billed charges,,17.53,66.6,
MALATHION 0.5% LOTN (OVIDE):59ML,32010127,CDM,J3490,HCPCS,250,RC,outpatient,,2118.01,2118.01,,1798.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,529.5,22,,percent of total billed charges,,,,,,,,,1906.21,90,,percent of total billed charges,,,1753.71,82.8,,percent of total billed charges,,,1800.31,85,,percent of total billed charges,,,,,,,,,1863.85,88,,percent of total billed charges,,,,,,,,,1618.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,529.5,22,,percent of total billed charges,,,1927.39,91,,percent of total billed charges,,,2012.11,95,,percent of total billed charges,,,1757.95,83,,percent of total billed charges,,,1757.95,83,,percent of total billed charges,,,,,,,,,,,,,,,1757.95,83,,percent of total billed charges,,,2012.11,95,,percent of total billed charges,,,1906.21,90,,percent of total billed charges,,,1906.21,90,,percent of total billed charges,,,1736.77,82,,percent of total billed charges,,,1906.21,90,,percent of total billed charges,,,1800.31,85,,percent of total billed charges,,529.5,2012.11,
3% SODIUM CHLORID INHALATION SOL:4ML(RT),32010128,CDM,,,250,RC,outpatient,,24.8,24.8,,21.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.2,22,,percent of total billed charges,,,,,,,,,22.32,90,,percent of total billed charges,,,20.53,82.8,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,,,,,,,,21.82,88,,percent of total billed charges,,,,,,,,,18.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.2,22,,percent of total billed charges,,,22.57,91,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,20.58,83,,percent of total billed charges,,,,,,,,,,,,,,,20.58,83,,percent of total billed charges,,,23.56,95,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,20.34,82,,percent of total billed charges,,,22.32,90,,percent of total billed charges,,,21.08,85,,percent of total billed charges,,6.2,23.56,
DICLOFENAC (VOLTARAN) TAB : 25MG,32010136,CDM,,,250,RC,outpatient,,17.76,17.76,,15.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.44,22,,percent of total billed charges,,,,,,,,,15.98,90,,percent of total billed charges,,,14.71,82.8,,percent of total billed charges,,,15.1,85,,percent of total billed charges,,,,,,,,,15.63,88,,percent of total billed charges,,,,,,,,,13.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.44,22,,percent of total billed charges,,,16.16,91,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,14.74,83,,percent of total billed charges,,,,,,,,,,,,,,,14.74,83,,percent of total billed charges,,,16.87,95,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,14.56,82,,percent of total billed charges,,,15.98,90,,percent of total billed charges,,,15.1,85,,percent of total billed charges,,4.44,16.87,
STERILE WATER FOR INJECTION VIAL:100ML,32010146,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
buPROPion(Wellbutrin SR)TAB:150MG,32010165,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
BUPROPION (WELLBUTRIN) TAB : 100MG,32010166,CDM,,,250,RC,outpatient,,27.28,27.28,,23.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.82,22,,percent of total billed charges,,,,,,,,,24.55,90,,percent of total billed charges,,,22.59,82.8,,percent of total billed charges,,,23.19,85,,percent of total billed charges,,,,,,,,,24.01,88,,percent of total billed charges,,,,,,,,,20.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.82,22,,percent of total billed charges,,,24.82,91,,percent of total billed charges,,,25.92,95,,percent of total billed charges,,,22.64,83,,percent of total billed charges,,,22.64,83,,percent of total billed charges,,,,,,,,,,,,,,,22.64,83,,percent of total billed charges,,,25.92,95,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,22.37,82,,percent of total billed charges,,,24.55,90,,percent of total billed charges,,,23.19,85,,percent of total billed charges,,6.82,25.92,
BUPROPION (WELLBUTRIN) TAB : 75MG,32010171,CDM,,,250,RC,outpatient,,16.97,16.97,,14.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.24,22,,percent of total billed charges,,,,,,,,,15.27,90,,percent of total billed charges,,,14.05,82.8,,percent of total billed charges,,,14.42,85,,percent of total billed charges,,,,,,,,,14.93,88,,percent of total billed charges,,,,,,,,,12.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.24,22,,percent of total billed charges,,,15.44,91,,percent of total billed charges,,,16.12,95,,percent of total billed charges,,,14.09,83,,percent of total billed charges,,,14.09,83,,percent of total billed charges,,,,,,,,,,,,,,,14.09,83,,percent of total billed charges,,,16.12,95,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,13.92,82,,percent of total billed charges,,,15.27,90,,percent of total billed charges,,,14.42,85,,percent of total billed charges,,4.24,16.12,
BUDESON/FORMOT(SYMBICORT) 160/4.5  6GM:,32010193,CDM,J3490,HCPCS,250,RC,outpatient,,2533,2533,,2150.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,633.25,22,,percent of total billed charges,,,,,,,,,2279.7,90,,percent of total billed charges,,,2097.32,82.8,,percent of total billed charges,,,2153.05,85,,percent of total billed charges,,,,,,,,,2229.04,88,,percent of total billed charges,,,,,,,,,1935.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,633.25,22,,percent of total billed charges,,,2305.03,91,,percent of total billed charges,,,2406.35,95,,percent of total billed charges,,,2102.39,83,,percent of total billed charges,,,2102.39,83,,percent of total billed charges,,,,,,,,,,,,,,,2102.39,83,,percent of total billed charges,,,2406.35,95,,percent of total billed charges,,,2279.7,90,,percent of total billed charges,,,2279.7,90,,percent of total billed charges,,,2077.06,82,,percent of total billed charges,,,2279.7,90,,percent of total billed charges,,,2153.05,85,,percent of total billed charges,,633.25,2406.35,
BUDESONID/FORMTERL(SYMBICORT) 10.2GM:,32010194,CDM,,,250,RC,outpatient,,2856.56,2856.56,,2425.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,714.14,22,,percent of total billed charges,,,,,,,,,2570.9,90,,percent of total billed charges,,,2365.23,82.8,,percent of total billed charges,,,2428.08,85,,percent of total billed charges,,,,,,,,,2513.77,88,,percent of total billed charges,,,,,,,,,2182.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,714.14,22,,percent of total billed charges,,,2599.47,91,,percent of total billed charges,,,2713.73,95,,percent of total billed charges,,,2370.94,83,,percent of total billed charges,,,2370.94,83,,percent of total billed charges,,,,,,,,,,,,,,,2370.94,83,,percent of total billed charges,,,2713.73,95,,percent of total billed charges,,,2570.9,90,,percent of total billed charges,,,2570.9,90,,percent of total billed charges,,,2342.38,82,,percent of total billed charges,,,2570.9,90,,percent of total billed charges,,,2428.08,85,,percent of total billed charges,,714.14,2713.73,
PEN G PROC(WYCILLIN)SYR: 1.2MIL UNIT 2ML,32010196,CDM,,,250,RC,outpatient,,819.03,819.03,,695.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,204.76,22,,percent of total billed charges,,,,,,,,,737.13,90,,percent of total billed charges,,,678.16,82.8,,percent of total billed charges,,,696.18,85,,percent of total billed charges,,,,,,,,,720.75,88,,percent of total billed charges,,,,,,,,,625.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,204.76,22,,percent of total billed charges,,,745.32,91,,percent of total billed charges,,,778.08,95,,percent of total billed charges,,,679.79,83,,percent of total billed charges,,,679.79,83,,percent of total billed charges,,,,,,,,,,,,,,,679.79,83,,percent of total billed charges,,,778.08,95,,percent of total billed charges,,,737.13,90,,percent of total billed charges,,,737.13,90,,percent of total billed charges,,,671.6,82,,percent of total billed charges,,,737.13,90,,percent of total billed charges,,,696.18,85,,percent of total billed charges,,204.76,778.08,
"PENICILL G PROCAINE SYR:600,000 Unit 1ML",32010201,CDM,,,250,RC,outpatient,,174.62,174.62,,148.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.66,22,,percent of total billed charges,,,,,,,,,157.16,90,,percent of total billed charges,,,144.59,82.8,,percent of total billed charges,,,148.43,85,,percent of total billed charges,,,,,,,,,153.67,88,,percent of total billed charges,,,,,,,,,133.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.66,22,,percent of total billed charges,,,158.9,91,,percent of total billed charges,,,165.89,95,,percent of total billed charges,,,144.93,83,,percent of total billed charges,,,144.93,83,,percent of total billed charges,,,,,,,,,,,,,,,144.93,83,,percent of total billed charges,,,165.89,95,,percent of total billed charges,,,157.16,90,,percent of total billed charges,,,157.16,90,,percent of total billed charges,,,143.19,82,,percent of total billed charges,,,157.16,90,,percent of total billed charges,,,148.43,85,,percent of total billed charges,,43.66,165.89,
HYALURONIDASE(HYLENEX)VIAL:150U/ML,32010211,CDM,J3473,HCPCS,636,RC,outpatient,,798.71,798.71,,678.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,199.68,22,,percent of total billed charges,,,,,,,,,718.84,90,,percent of total billed charges,,,661.33,82.8,,percent of total billed charges,,,678.9,85,,percent of total billed charges,,,,,,,,,702.86,88,,percent of total billed charges,,108,,,,fee schedule,,,610.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,108,,,,fee schedule,,,199.68,22,,percent of total billed charges,,,726.83,91,,percent of total billed charges,,,758.77,95,,percent of total billed charges,,,662.93,83,,percent of total billed charges,,,662.93,83,,percent of total billed charges,,,,,,,,,,,,,,,662.93,83,,percent of total billed charges,,,758.77,95,,percent of total billed charges,,,718.84,90,,percent of total billed charges,,,718.84,90,,percent of total billed charges,,,654.94,82,,percent of total billed charges,,,718.84,90,,percent of total billed charges,,,678.9,85,,percent of total billed charges,,108,758.77,
LATANOPROST(XALATAN)DROP 0.005%:2.5ML,32010212,CDM,J3490,HCPCS,250,RC,outpatient,,95.43,95.43,,81.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.86,22,,percent of total billed charges,,,,,,,,,85.89,90,,percent of total billed charges,,,79.02,82.8,,percent of total billed charges,,,81.12,85,,percent of total billed charges,,,,,,,,,83.98,88,,percent of total billed charges,,,,,,,,,72.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.86,22,,percent of total billed charges,,,86.84,91,,percent of total billed charges,,,90.66,95,,percent of total billed charges,,,79.21,83,,percent of total billed charges,,,79.21,83,,percent of total billed charges,,,,,,,,,,,,,,,79.21,83,,percent of total billed charges,,,90.66,95,,percent of total billed charges,,,85.89,90,,percent of total billed charges,,,85.89,90,,percent of total billed charges,,,78.25,82,,percent of total billed charges,,,85.89,90,,percent of total billed charges,,,81.12,85,,percent of total billed charges,,23.86,90.66,
LIDOCAINE(XYLOCAINE)JEL 2%:30GM,32010216,CDM,J3490,HCPCS,250,RC,outpatient,,1468.59,1468.59,,1246.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,367.15,22,,percent of total billed charges,,,,,,,,,1321.73,90,,percent of total billed charges,,,1215.99,82.8,,percent of total billed charges,,,1248.3,85,,percent of total billed charges,,,,,,,,,1292.36,88,,percent of total billed charges,,,,,,,,,1122,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,367.15,22,,percent of total billed charges,,,1336.42,91,,percent of total billed charges,,,1395.16,95,,percent of total billed charges,,,1218.93,83,,percent of total billed charges,,,1218.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1218.93,83,,percent of total billed charges,,,1395.16,95,,percent of total billed charges,,,1321.73,90,,percent of total billed charges,,,1321.73,90,,percent of total billed charges,,,1204.24,82,,percent of total billed charges,,,1321.73,90,,percent of total billed charges,,,1248.3,85,,percent of total billed charges,,367.15,1395.16,
ATROPINE VIAL:0.4MG/ML (20 ML MDV),32010219,CDM,J0461,HCPCS,250,RC,outpatient,,154.74,154.74,,131.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.69,22,,percent of total billed charges,,,,,,,,,139.27,90,,percent of total billed charges,,,128.12,82.8,,percent of total billed charges,,,131.53,85,,percent of total billed charges,,,,,,,,,136.17,88,,percent of total billed charges,,42.6,,,,fee schedule,,,118.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,42.6,,,,fee schedule,,,38.69,22,,percent of total billed charges,,,140.81,91,,percent of total billed charges,,,147,95,,percent of total billed charges,,,128.43,83,,percent of total billed charges,,,128.43,83,,percent of total billed charges,,,,,,,,,,,,,,,128.43,83,,percent of total billed charges,,,147,95,,percent of total billed charges,,,139.27,90,,percent of total billed charges,,,139.27,90,,percent of total billed charges,,,126.89,82,,percent of total billed charges,,,139.27,90,,percent of total billed charges,,,131.53,85,,percent of total billed charges,,38.69,147,
LIDOCAINE(XYLOCAINE)AMP 1.5%:15MG/ML20ML,32010221,CDM,J2001,HCPCS,250,RC,outpatient,,155.27,155.27,,131.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.82,22,,percent of total billed charges,,,,,,,,,139.74,90,,percent of total billed charges,,,128.56,82.8,,percent of total billed charges,,,131.98,85,,percent of total billed charges,,,,,,,,,136.64,88,,percent of total billed charges,,0.75,,,,fee schedule,,,118.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,38.82,22,,percent of total billed charges,,,141.3,91,,percent of total billed charges,,,147.51,95,,percent of total billed charges,,,128.87,83,,percent of total billed charges,,,128.87,83,,percent of total billed charges,,,,,,,,,,,,,,,128.87,83,,percent of total billed charges,,,147.51,95,,percent of total billed charges,,,139.74,90,,percent of total billed charges,,,139.74,90,,percent of total billed charges,,,127.32,82,,percent of total billed charges,,,139.74,90,,percent of total billed charges,,,131.98,85,,percent of total billed charges,,0.75,147.51,
XYLOCAINE 1% 30ML,32010222,CDM,,,250,RC,outpatient,,32,32,,27.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8,22,,percent of total billed charges,,,,,,,,,28.8,90,,percent of total billed charges,,,26.5,82.8,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,,,,,,,,28.16,88,,percent of total billed charges,,,,,,,,,24.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8,22,,percent of total billed charges,,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,,,,,,,,,,,,,26.56,83,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,26.24,82,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,8,30.4,
LIDOCAINE(XYLOCAINE)VIAL 0.5%:50ML,32010226,CDM,J3490,HCPCS,250,RC,outpatient,,212.75,212.75,,180.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.19,22,,percent of total billed charges,,,,,,,,,191.48,90,,percent of total billed charges,,,176.16,82.8,,percent of total billed charges,,,180.84,85,,percent of total billed charges,,,,,,,,,187.22,88,,percent of total billed charges,,,,,,,,,162.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.19,22,,percent of total billed charges,,,193.6,91,,percent of total billed charges,,,202.11,95,,percent of total billed charges,,,176.58,83,,percent of total billed charges,,,176.58,83,,percent of total billed charges,,,,,,,,,,,,,,,176.58,83,,percent of total billed charges,,,202.11,95,,percent of total billed charges,,,191.48,90,,percent of total billed charges,,,191.48,90,,percent of total billed charges,,,174.46,82,,percent of total billed charges,,,191.48,90,,percent of total billed charges,,,180.84,85,,percent of total billed charges,,53.19,202.11,
LIDOCAINE HCL (XYLOCAINE) JEL : 2% 7.5GM,32010231,CDM,,,250,RC,outpatient,,433.3,433.3,,367.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108.33,22,,percent of total billed charges,,,,,,,,,389.97,90,,percent of total billed charges,,,358.77,82.8,,percent of total billed charges,,,368.31,85,,percent of total billed charges,,,,,,,,,381.3,88,,percent of total billed charges,,,,,,,,,331.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108.33,22,,percent of total billed charges,,,394.3,91,,percent of total billed charges,,,411.64,95,,percent of total billed charges,,,359.64,83,,percent of total billed charges,,,359.64,83,,percent of total billed charges,,,,,,,,,,,,,,,359.64,83,,percent of total billed charges,,,411.64,95,,percent of total billed charges,,,389.97,90,,percent of total billed charges,,,389.97,90,,percent of total billed charges,,,355.31,82,,percent of total billed charges,,,389.97,90,,percent of total billed charges,,,368.31,85,,percent of total billed charges,,108.33,411.64,
LIDOCAIN 5% W/DEXTROSE 7.5% 2ML F/SPINAL,32010236,CDM,,,250,RC,outpatient,,152.73,152.73,,129.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.18,22,,percent of total billed charges,,,,,,,,,137.46,90,,percent of total billed charges,,,126.46,82.8,,percent of total billed charges,,,129.82,85,,percent of total billed charges,,,,,,,,,134.4,88,,percent of total billed charges,,,,,,,,,116.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.18,22,,percent of total billed charges,,,138.98,91,,percent of total billed charges,,,145.09,95,,percent of total billed charges,,,126.77,83,,percent of total billed charges,,,126.77,83,,percent of total billed charges,,,,,,,,,,,,,,,126.77,83,,percent of total billed charges,,,145.09,95,,percent of total billed charges,,,137.46,90,,percent of total billed charges,,,137.46,90,,percent of total billed charges,,,125.24,82,,percent of total billed charges,,,137.46,90,,percent of total billed charges,,,129.82,85,,percent of total billed charges,,38.18,145.09,
SODIUM BICARBONATE TAB (10 GR):650 MG,32010253,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
RANITIDINE HCL TAB : 150MG,32010256,CDM,,,250,RC,outpatient,,8.5,8.5,,7.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.13,22,,percent of total billed charges,,,,,,,,,7.65,90,,percent of total billed charges,,,7.04,82.8,,percent of total billed charges,,,7.23,85,,percent of total billed charges,,,,,,,,,7.48,88,,percent of total billed charges,,,,,,,,,6.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.13,22,,percent of total billed charges,,,7.74,91,,percent of total billed charges,,,8.08,95,,percent of total billed charges,,,7.06,83,,percent of total billed charges,,,7.06,83,,percent of total billed charges,,,,,,,,,,,,,,,7.06,83,,percent of total billed charges,,,8.08,95,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,6.97,82,,percent of total billed charges,,,7.65,90,,percent of total billed charges,,,7.23,85,,percent of total billed charges,,2.13,8.08,
RANITIDINE(ZANTAC)VIAL:50MG/2ML,32010261,CDM,,,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
RANITIDINE (ZANTAC) SYRP 15MG/ML  480ML,32010266,CDM,,,250,RC,outpatient,,2634.32,2634.32,,2236.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,658.58,22,,percent of total billed charges,,,,,,,,,2370.89,90,,percent of total billed charges,,,2181.22,82.8,,percent of total billed charges,,,2239.17,85,,percent of total billed charges,,,,,,,,,2318.2,88,,percent of total billed charges,,,,,,,,,2012.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,658.58,22,,percent of total billed charges,,,2397.23,91,,percent of total billed charges,,,2502.6,95,,percent of total billed charges,,,2186.49,83,,percent of total billed charges,,,2186.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2186.49,83,,percent of total billed charges,,,2502.6,95,,percent of total billed charges,,,2370.89,90,,percent of total billed charges,,,2370.89,90,,percent of total billed charges,,,2160.14,82,,percent of total billed charges,,,2370.89,90,,percent of total billed charges,,,2239.17,85,,percent of total billed charges,,658.58,2502.6,
RANITIDINE (ZANTAC) TAB : 75MG,32010267,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
RANITIDINE(ZANTAC)TAB:150MG,32010271,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
RANITIDINE(ZANTAC)TAB:150MG(1x4),32010272,CDM,,,250,RC,outpatient,,23.95,23.95,,20.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.99,22,,percent of total billed charges,,,,,,,,,21.56,90,,percent of total billed charges,,,19.83,82.8,,percent of total billed charges,,,20.36,85,,percent of total billed charges,,,,,,,,,21.08,88,,percent of total billed charges,,,,,,,,,18.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.99,22,,percent of total billed charges,,,21.79,91,,percent of total billed charges,,,22.75,95,,percent of total billed charges,,,19.88,83,,percent of total billed charges,,,19.88,83,,percent of total billed charges,,,,,,,,,,,,,,,19.88,83,,percent of total billed charges,,,22.75,95,,percent of total billed charges,,,21.56,90,,percent of total billed charges,,,21.56,90,,percent of total billed charges,,,19.64,82,,percent of total billed charges,,,21.56,90,,percent of total billed charges,,,20.36,85,,percent of total billed charges,,5.99,22.75,
RANITIDINE (ZANTAC) SYRP : 15MG/ML  60ML,32010276,CDM,,,250,RC,outpatient,,713.38,713.38,,605.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.35,22,,percent of total billed charges,,,,,,,,,642.04,90,,percent of total billed charges,,,590.68,82.8,,percent of total billed charges,,,606.37,85,,percent of total billed charges,,,,,,,,,627.77,88,,percent of total billed charges,,,,,,,,,545.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.35,22,,percent of total billed charges,,,649.18,91,,percent of total billed charges,,,677.71,95,,percent of total billed charges,,,592.11,83,,percent of total billed charges,,,592.11,83,,percent of total billed charges,,,,,,,,,,,,,,,592.11,83,,percent of total billed charges,,,677.71,95,,percent of total billed charges,,,642.04,90,,percent of total billed charges,,,642.04,90,,percent of total billed charges,,,584.97,82,,percent of total billed charges,,,642.04,90,,percent of total billed charges,,,606.37,85,,percent of total billed charges,,178.35,677.71,
RANITIDINE (ZANTAC) SYRP: 15MG/ML  90ML,32010281,CDM,,,250,RC,outpatient,,906.93,906.93,,769.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,226.73,22,,percent of total billed charges,,,,,,,,,816.24,90,,percent of total billed charges,,,750.94,82.8,,percent of total billed charges,,,770.89,85,,percent of total billed charges,,,,,,,,,798.1,88,,percent of total billed charges,,,,,,,,,692.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,226.73,22,,percent of total billed charges,,,825.31,91,,percent of total billed charges,,,861.58,95,,percent of total billed charges,,,752.75,83,,percent of total billed charges,,,752.75,83,,percent of total billed charges,,,,,,,,,,,,,,,752.75,83,,percent of total billed charges,,,861.58,95,,percent of total billed charges,,,816.24,90,,percent of total billed charges,,,816.24,90,,percent of total billed charges,,,743.68,82,,percent of total billed charges,,,816.24,90,,percent of total billed charges,,,770.89,85,,percent of total billed charges,,226.73,861.58,
OMALIZUMAB(XOLAIR) VL:150MG,32010284,CDM,J2357,HCPCS,636,RC,outpatient,,5492.07,5492.07,,4662.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1373.02,22,,percent of total billed charges,,,,,,,,,4942.86,90,,percent of total billed charges,,,4547.43,82.8,,percent of total billed charges,,,4668.26,85,,percent of total billed charges,,,,,,,,,4833.02,88,,percent of total billed charges,,2898.9,,,,fee schedule,,,4195.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2898.9,,,,fee schedule,,,1373.02,22,,percent of total billed charges,,,4997.78,91,,percent of total billed charges,,,5217.47,95,,percent of total billed charges,,,4558.42,83,,percent of total billed charges,,,4558.42,83,,percent of total billed charges,,,,,,,,,,,,,,,4558.42,83,,percent of total billed charges,,,5217.47,95,,percent of total billed charges,,,4942.86,90,,percent of total billed charges,,,4942.86,90,,percent of total billed charges,,,4503.5,82,,percent of total billed charges,,,4942.86,90,,percent of total billed charges,,,4668.26,85,,percent of total billed charges,,1373.02,5217.47,
METOLAZONE (ZAROXOLYN) TAB : 10MG,32010296,CDM,,,250,RC,outpatient,,34.26,34.26,,29.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.57,22,,percent of total billed charges,,,,,,,,,30.83,90,,percent of total billed charges,,,28.37,82.8,,percent of total billed charges,,,29.12,85,,percent of total billed charges,,,,,,,,,30.15,88,,percent of total billed charges,,,,,,,,,26.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.57,22,,percent of total billed charges,,,31.18,91,,percent of total billed charges,,,32.55,95,,percent of total billed charges,,,28.44,83,,percent of total billed charges,,,28.44,83,,percent of total billed charges,,,,,,,,,,,,,,,28.44,83,,percent of total billed charges,,,32.55,95,,percent of total billed charges,,,30.83,90,,percent of total billed charges,,,30.83,90,,percent of total billed charges,,,28.09,82,,percent of total billed charges,,,30.83,90,,percent of total billed charges,,,29.12,85,,percent of total billed charges,,8.57,32.55,
ROCURONIUM(ZEMURON)VIAL:50MG/5ML,32010297,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
BISOPROL/HYDROCHLOR(ZIAC)TAB:10-6.25MG,32010301,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
INFLUENZA VACCINE(2012-2013)SYR:0.5ML,32010305,CDM,90656,CPT,636,RC,outpatient,,195.4,195.4,,165.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.85,22,,percent of total billed charges,,,,,,,,,175.86,90,,percent of total billed charges,,,161.79,82.8,,percent of total billed charges,,,166.09,85,,percent of total billed charges,,,,,,,,,171.95,88,,percent of total billed charges,,,,,,,,,149.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.85,22,,percent of total billed charges,,,177.81,91,,percent of total billed charges,,,185.63,95,,percent of total billed charges,,,162.18,83,,percent of total billed charges,,,162.18,83,,percent of total billed charges,,,,,,,,,,,,,,,162.18,83,,percent of total billed charges,,,185.63,95,,percent of total billed charges,,,175.86,90,,percent of total billed charges,,,175.86,90,,percent of total billed charges,,,160.23,82,,percent of total billed charges,,,175.86,90,,percent of total billed charges,,,166.09,85,,percent of total billed charges,,48.85,185.63,
BISOPROL/HYDROCHLOR(ZIAC) TAB:2.5-6.25MG,32010306,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
BISOPROL/HYDROCHLORO (ZIAC) TAB:5-6.25MG,32010311,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
cefUROXime(ZINACEF)VIAL:750MG,32010316,CDM,J0697,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,8.74,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8.74,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,8.74,59.21,
IBUP/HYDROCOD(VICOPROFEN)TAB:200-7.5MG,32010317,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
IBU/HYDCOD(VICOPROF)TAB:200-7.5MG(1X10),32010318,CDM,,,250,RC,outpatient,,48.85,48.85,,41.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.21,22,,percent of total billed charges,,,,,,,,,43.97,90,,percent of total billed charges,,,40.45,82.8,,percent of total billed charges,,,41.52,85,,percent of total billed charges,,,,,,,,,42.99,88,,percent of total billed charges,,,,,,,,,37.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.21,22,,percent of total billed charges,,,44.45,91,,percent of total billed charges,,,46.41,95,,percent of total billed charges,,,40.55,83,,percent of total billed charges,,,40.55,83,,percent of total billed charges,,,,,,,,,,,,,,,40.55,83,,percent of total billed charges,,,46.41,95,,percent of total billed charges,,,43.97,90,,percent of total billed charges,,,43.97,90,,percent of total billed charges,,,40.06,82,,percent of total billed charges,,,43.97,90,,percent of total billed charges,,,41.52,85,,percent of total billed charges,,12.21,46.41,
ceFUROXIME VIAL: 1.5GM,32010321,CDM,J0697,HCPCS,250,RC,outpatient,,88.4,88.4,,75.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.1,22,,percent of total billed charges,,,,,,,,,79.56,90,,percent of total billed charges,,,73.2,82.8,,percent of total billed charges,,,75.14,85,,percent of total billed charges,,,,,,,,,77.79,88,,percent of total billed charges,,8.74,,,,fee schedule,,,67.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8.74,,,,fee schedule,,,22.1,22,,percent of total billed charges,,,80.44,91,,percent of total billed charges,,,83.98,95,,percent of total billed charges,,,73.37,83,,percent of total billed charges,,,73.37,83,,percent of total billed charges,,,,,,,,,,,,,,,73.37,83,,percent of total billed charges,,,83.98,95,,percent of total billed charges,,,79.56,90,,percent of total billed charges,,,79.56,90,,percent of total billed charges,,,72.49,82,,percent of total billed charges,,,79.56,90,,percent of total billed charges,,,75.14,85,,percent of total billed charges,,8.74,83.98,
CALCIUM CITRATE /VIT D:315MG/250 I.U.,32010325,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ZINC SULFATE CAP : 220MG,32010331,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ZINC SULFATE CAP:220MG,32010332,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ZINC OXIDE OINT 20%:30GM,32010336,CDM,J3490,HCPCS,250,RC,outpatient,,36.11,36.11,,30.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.03,22,,percent of total billed charges,,,,,,,,,32.5,90,,percent of total billed charges,,,29.9,82.8,,percent of total billed charges,,,30.69,85,,percent of total billed charges,,,,,,,,,31.78,88,,percent of total billed charges,,,,,,,,,27.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.03,22,,percent of total billed charges,,,32.86,91,,percent of total billed charges,,,34.3,95,,percent of total billed charges,,,29.97,83,,percent of total billed charges,,,29.97,83,,percent of total billed charges,,,,,,,,,,,,,,,29.97,83,,percent of total billed charges,,,34.3,95,,percent of total billed charges,,,32.5,90,,percent of total billed charges,,,32.5,90,,percent of total billed charges,,,29.61,82,,percent of total billed charges,,,32.5,90,,percent of total billed charges,,,30.69,85,,percent of total billed charges,,9.03,34.3,
NAPROXEN(NAPROSYN EC)TAB:500MG,32010339,CDM,J8499,HCPCS,250,RC,outpatient,,14.75,14.75,,12.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.69,22,,percent of total billed charges,,,,,,,,,13.28,90,,percent of total billed charges,,,12.21,82.8,,percent of total billed charges,,,12.54,85,,percent of total billed charges,,,,,,,,,12.98,88,,percent of total billed charges,,,,,,,,,11.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.69,22,,percent of total billed charges,,,13.42,91,,percent of total billed charges,,,14.01,95,,percent of total billed charges,,,12.24,83,,percent of total billed charges,,,12.24,83,,percent of total billed charges,,,,,,,,,,,,,,,12.24,83,,percent of total billed charges,,,14.01,95,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,12.1,82,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,12.54,85,,percent of total billed charges,,3.69,14.01,
ZINC OXIDE OINT : 20% 454GM,32010341,CDM,,,250,RC,outpatient,,94.84,94.84,,80.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.71,22,,percent of total billed charges,,,,,,,,,85.36,90,,percent of total billed charges,,,78.53,82.8,,percent of total billed charges,,,80.61,85,,percent of total billed charges,,,,,,,,,83.46,88,,percent of total billed charges,,,,,,,,,72.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.71,22,,percent of total billed charges,,,86.3,91,,percent of total billed charges,,,90.1,95,,percent of total billed charges,,,78.72,83,,percent of total billed charges,,,78.72,83,,percent of total billed charges,,,,,,,,,,,,,,,78.72,83,,percent of total billed charges,,,90.1,95,,percent of total billed charges,,,85.36,90,,percent of total billed charges,,,85.36,90,,percent of total billed charges,,,77.77,82,,percent of total billed charges,,,85.36,90,,percent of total billed charges,,,80.61,85,,percent of total billed charges,,23.71,90.1,
AZITHROMYCIN(ZITHROMAX)TAB:250MG,32010346,CDM,J8499,HCPCS,250,RC,outpatient,,16.83,16.83,,14.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.21,22,,percent of total billed charges,,,,,,,,,15.15,90,,percent of total billed charges,,,13.94,82.8,,percent of total billed charges,,,14.31,85,,percent of total billed charges,,,,,,,,,14.81,88,,percent of total billed charges,,,,,,,,,12.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.21,22,,percent of total billed charges,,,15.32,91,,percent of total billed charges,,,15.99,95,,percent of total billed charges,,,13.97,83,,percent of total billed charges,,,13.97,83,,percent of total billed charges,,,,,,,,,,,,,,,13.97,83,,percent of total billed charges,,,15.99,95,,percent of total billed charges,,,15.15,90,,percent of total billed charges,,,15.15,90,,percent of total billed charges,,,13.8,82,,percent of total billed charges,,,15.15,90,,percent of total billed charges,,,14.31,85,,percent of total billed charges,,4.21,15.99,
AZITHROMYCIN (ZITHROMAX) VIAL : 500MG,32010347,CDM,J0456,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,3.12,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.12,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,3.12,60.99,
AZITHROMYCIN(ZITHROMAX)TAB:250MG (1X4),32010348,CDM,J8499,HCPCS,250,RC,outpatient,,40.76,40.76,,34.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.19,22,,percent of total billed charges,,,,,,,,,36.68,90,,percent of total billed charges,,,33.75,82.8,,percent of total billed charges,,,34.65,85,,percent of total billed charges,,,,,,,,,35.87,88,,percent of total billed charges,,,,,,,,,31.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.19,22,,percent of total billed charges,,,37.09,91,,percent of total billed charges,,,38.72,95,,percent of total billed charges,,,33.83,83,,percent of total billed charges,,,33.83,83,,percent of total billed charges,,,,,,,,,,,,,,,33.83,83,,percent of total billed charges,,,38.72,95,,percent of total billed charges,,,36.68,90,,percent of total billed charges,,,36.68,90,,percent of total billed charges,,,33.42,82,,percent of total billed charges,,,36.68,90,,percent of total billed charges,,,34.65,85,,percent of total billed charges,,10.19,38.72,
SIMVASTATIN(ZOCOR)TAB:10MG,32010351,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
SIMVASTATIN (ZOCOR) TAB : 20MG,32010352,CDM,,,250,RC,outpatient,,72.8,72.8,,61.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.2,22,,percent of total billed charges,,,,,,,,,65.52,90,,percent of total billed charges,,,60.28,82.8,,percent of total billed charges,,,61.88,85,,percent of total billed charges,,,,,,,,,64.06,88,,percent of total billed charges,,,,,,,,,55.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.2,22,,percent of total billed charges,,,66.25,91,,percent of total billed charges,,,69.16,95,,percent of total billed charges,,,60.42,83,,percent of total billed charges,,,60.42,83,,percent of total billed charges,,,,,,,,,,,,,,,60.42,83,,percent of total billed charges,,,69.16,95,,percent of total billed charges,,,65.52,90,,percent of total billed charges,,,65.52,90,,percent of total billed charges,,,59.7,82,,percent of total billed charges,,,65.52,90,,percent of total billed charges,,,61.88,85,,percent of total billed charges,,18.2,69.16,
SIMVASTATIN(ZOCOR)TAB:40MG,32010353,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ONDANSETRON HCL (ZOFRAN) TAB : 8MG,32010356,CDM,,,250,RC,outpatient,,614.26,614.26,,521.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153.57,22,,percent of total billed charges,,,,,,,,,552.83,90,,percent of total billed charges,,,508.61,82.8,,percent of total billed charges,,,522.12,85,,percent of total billed charges,,,,,,,,,540.55,88,,percent of total billed charges,,,,,,,,,469.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153.57,22,,percent of total billed charges,,,558.98,91,,percent of total billed charges,,,583.55,95,,percent of total billed charges,,,509.84,83,,percent of total billed charges,,,509.84,83,,percent of total billed charges,,,,,,,,,,,,,,,509.84,83,,percent of total billed charges,,,583.55,95,,percent of total billed charges,,,552.83,90,,percent of total billed charges,,,552.83,90,,percent of total billed charges,,,503.69,82,,percent of total billed charges,,,552.83,90,,percent of total billed charges,,,522.12,85,,percent of total billed charges,,153.57,583.55,
ACYCLOVIR(ZOVIRAX)OINT 5%:5GM,32010360,CDM,,,250,RC,outpatient,,2822.4,2822.4,,2396.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,705.6,22,,percent of total billed charges,,,,,,,,,2540.16,90,,percent of total billed charges,,,2336.95,82.8,,percent of total billed charges,,,2399.04,85,,percent of total billed charges,,,,,,,,,2483.71,88,,percent of total billed charges,,,,,,,,,2156.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,705.6,22,,percent of total billed charges,,,2568.38,91,,percent of total billed charges,,,2681.28,95,,percent of total billed charges,,,2342.59,83,,percent of total billed charges,,,2342.59,83,,percent of total billed charges,,,,,,,,,,,,,,,2342.59,83,,percent of total billed charges,,,2681.28,95,,percent of total billed charges,,,2540.16,90,,percent of total billed charges,,,2540.16,90,,percent of total billed charges,,,2314.37,82,,percent of total billed charges,,,2540.16,90,,percent of total billed charges,,,2399.04,85,,percent of total billed charges,,705.6,2681.28,
L-LYSINE TAB:500MG,32010363,CDM,,,250,RC,outpatient,,9,9,,7.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.25,22,,percent of total billed charges,,,,,,,,,8.1,90,,percent of total billed charges,,,7.45,82.8,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,,,,,,,,7.92,88,,percent of total billed charges,,,,,,,,,6.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.25,22,,percent of total billed charges,,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.38,82,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,2.25,8.55,
PENCICLOVIR(DENAVIR)CREAM 1%:5GM,32010364,CDM,,,250,RC,outpatient,,3292.9,3292.9,,2795.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,823.23,22,,percent of total billed charges,,,,,,,,,2963.61,90,,percent of total billed charges,,,2726.52,82.8,,percent of total billed charges,,,2798.97,85,,percent of total billed charges,,,,,,,,,2897.75,88,,percent of total billed charges,,,,,,,,,2515.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,823.23,22,,percent of total billed charges,,,2996.54,91,,percent of total billed charges,,,3128.26,95,,percent of total billed charges,,,2733.11,83,,percent of total billed charges,,,2733.11,83,,percent of total billed charges,,,,,,,,,,,,,,,2733.11,83,,percent of total billed charges,,,3128.26,95,,percent of total billed charges,,,2963.61,90,,percent of total billed charges,,,2963.61,90,,percent of total billed charges,,,2700.18,82,,percent of total billed charges,,,2963.61,90,,percent of total billed charges,,,2798.97,85,,percent of total billed charges,,823.23,3128.26,
ZOFRAN 32MG (16ML),32010377,CDM,,,250,RC,outpatient,,294.5,294.5,,250.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.63,22,,percent of total billed charges,,,,,,,,,265.05,90,,percent of total billed charges,,,243.85,82.8,,percent of total billed charges,,,250.33,85,,percent of total billed charges,,,,,,,,,259.16,88,,percent of total billed charges,,,,,,,,,225,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.63,22,,percent of total billed charges,,,268,91,,percent of total billed charges,,,279.78,95,,percent of total billed charges,,,244.44,83,,percent of total billed charges,,,244.44,83,,percent of total billed charges,,,,,,,,,,,,,,,244.44,83,,percent of total billed charges,,,279.78,95,,percent of total billed charges,,,265.05,90,,percent of total billed charges,,,265.05,90,,percent of total billed charges,,,241.49,82,,percent of total billed charges,,,265.05,90,,percent of total billed charges,,,250.33,85,,percent of total billed charges,,73.63,279.78,
MICONAZOLE NITRATE(BAZA)CM 2%:142GM,32010385,CDM,,,250,RC,outpatient,,168.27,168.27,,142.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,42.07,22,,percent of total billed charges,,,,,,,,,151.44,90,,percent of total billed charges,,,139.33,82.8,,percent of total billed charges,,,143.03,85,,percent of total billed charges,,,,,,,,,148.08,88,,percent of total billed charges,,,,,,,,,128.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,42.07,22,,percent of total billed charges,,,153.13,91,,percent of total billed charges,,,159.86,95,,percent of total billed charges,,,139.66,83,,percent of total billed charges,,,139.66,83,,percent of total billed charges,,,,,,,,,,,,,,,139.66,83,,percent of total billed charges,,,159.86,95,,percent of total billed charges,,,151.44,90,,percent of total billed charges,,,151.44,90,,percent of total billed charges,,,137.98,82,,percent of total billed charges,,,151.44,90,,percent of total billed charges,,,143.03,85,,percent of total billed charges,,42.07,159.86,
GOSERELIN ACETATE (ZOLADEX) IMP : 3.6MG,32010386,CDM,J9202,HCPCS,636,RC,outpatient,,4650.03,4650.03,,3947.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1162.51,22,,percent of total billed charges,,,,,,,,,4185.03,90,,percent of total billed charges,,,3850.22,82.8,,percent of total billed charges,,,3952.53,85,,percent of total billed charges,,,,,,,,,4092.03,88,,percent of total billed charges,,1718.15,,,,fee schedule,,,3552.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1718.15,,,,fee schedule,,,1162.51,22,,percent of total billed charges,,,4231.53,91,,percent of total billed charges,,,4417.53,95,,percent of total billed charges,,,3859.52,83,,percent of total billed charges,,,3859.52,83,,percent of total billed charges,,,,,,,,,,,,,,,3859.52,83,,percent of total billed charges,,,4417.53,95,,percent of total billed charges,,,4185.03,90,,percent of total billed charges,,,4185.03,90,,percent of total billed charges,,,3813.02,82,,percent of total billed charges,,,4185.03,90,,percent of total billed charges,,,3952.53,85,,percent of total billed charges,,1162.51,4417.53,
PIPERACILLIN/TAZO(ZOSYN)VIAL:2.25GM,32010392,CDM,J2543,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,5.92,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.92,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,5.92,60.99,
PIPERACILLIN/TAZO(ZOSYN)VIAL:4.5GM,32010393,CDM,J2543,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,5.92,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.92,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,5.92,60.99,
PIPERACILLIN/TAZO(ZOSYN)VIAL:3.375GM,32010394,CDM,J2543,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,5.92,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5.92,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,5.92,60.99,
ceFAZolin(ANCEF)VL:1GM,32010401,CDM,J0690,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,2.88,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.88,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,2.88,60.99,
SERTRALINE(ZOLOFT)TAB: 50MG,32010406,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
SERTRALINE(ZOLOFT)TAB:100MG,32010407,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
TRANEXAMIC ACID- IRR:2000 MG/NS100ML,32010408,CDM,,,258,RC,outpatient,,369.38,369.38,,313.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.35,22,,percent of total billed charges,,,,,,,,,332.44,90,,percent of total billed charges,,,305.85,82.8,,percent of total billed charges,,,313.97,85,,percent of total billed charges,,,,,,,,,325.05,88,,percent of total billed charges,,,,,,,,,282.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.35,22,,percent of total billed charges,,,336.14,91,,percent of total billed charges,,,350.91,95,,percent of total billed charges,,,306.59,83,,percent of total billed charges,,,306.59,83,,percent of total billed charges,,,,,,,,,,,,,,,306.59,83,,percent of total billed charges,,,350.91,95,,percent of total billed charges,,,332.44,90,,percent of total billed charges,,,332.44,90,,percent of total billed charges,,,302.89,82,,percent of total billed charges,,,332.44,90,,percent of total billed charges,,,313.97,85,,percent of total billed charges,,92.35,350.91,
ACYCLOVIR(ZOVIRAX)CAP:200MG,32010411,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ZOVIRAX 1G VLS (500MG DOSE),32010417,CDM,,,250,RC,outpatient,,923.87,923.87,,784.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,230.97,22,,percent of total billed charges,,,,,,,,,831.48,90,,percent of total billed charges,,,764.96,82.8,,percent of total billed charges,,,785.29,85,,percent of total billed charges,,,,,,,,,813.01,88,,percent of total billed charges,,,,,,,,,705.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,230.97,22,,percent of total billed charges,,,840.72,91,,percent of total billed charges,,,877.68,95,,percent of total billed charges,,,766.81,83,,percent of total billed charges,,,766.81,83,,percent of total billed charges,,,,,,,,,,,,,,,766.81,83,,percent of total billed charges,,,877.68,95,,percent of total billed charges,,,831.48,90,,percent of total billed charges,,,831.48,90,,percent of total billed charges,,,757.57,82,,percent of total billed charges,,,831.48,90,,percent of total billed charges,,,785.29,85,,percent of total billed charges,,230.97,877.68,
ACYCLOVIR(ZOVIRAX)OINT 5%:15GM,32010421,CDM,J3490,HCPCS,250,RC,outpatient,,1032.46,1032.46,,876.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,258.12,22,,percent of total billed charges,,,,,,,,,929.21,90,,percent of total billed charges,,,854.88,82.8,,percent of total billed charges,,,877.59,85,,percent of total billed charges,,,,,,,,,908.56,88,,percent of total billed charges,,,,,,,,,788.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,258.12,22,,percent of total billed charges,,,939.54,91,,percent of total billed charges,,,980.84,95,,percent of total billed charges,,,856.94,83,,percent of total billed charges,,,856.94,83,,percent of total billed charges,,,,,,,,,,,,,,,856.94,83,,percent of total billed charges,,,980.84,95,,percent of total billed charges,,,929.21,90,,percent of total billed charges,,,929.21,90,,percent of total billed charges,,,846.62,82,,percent of total billed charges,,,929.21,90,,percent of total billed charges,,,877.59,85,,percent of total billed charges,,258.12,980.84,
ACYCLOVIR(ZOVIRAX) OINT : 5%   2 GM,32010422,CDM,,,250,RC,outpatient,,353.2,353.2,,299.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.3,22,,percent of total billed charges,,,,,,,,,317.88,90,,percent of total billed charges,,,292.45,82.8,,percent of total billed charges,,,300.22,85,,percent of total billed charges,,,,,,,,,310.82,88,,percent of total billed charges,,,,,,,,,269.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.3,22,,percent of total billed charges,,,321.41,91,,percent of total billed charges,,,335.54,95,,percent of total billed charges,,,293.16,83,,percent of total billed charges,,,293.16,83,,percent of total billed charges,,,,,,,,,,,,,,,293.16,83,,percent of total billed charges,,,335.54,95,,percent of total billed charges,,,317.88,90,,percent of total billed charges,,,317.88,90,,percent of total billed charges,,,289.62,82,,percent of total billed charges,,,317.88,90,,percent of total billed charges,,,300.22,85,,percent of total billed charges,,88.3,335.54,
ACYCLOVIR (ZOVIRAX) TAB : 800MG,32010426,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
ZYPREXX 5MG TAB,32010427,CDM,,,250,RC,outpatient,,21,21,,17.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.25,22,,percent of total billed charges,,,,,,,,,18.9,90,,percent of total billed charges,,,17.39,82.8,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,,,,,,,,18.48,88,,percent of total billed charges,,,,,,,,,16.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.25,22,,percent of total billed charges,,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.22,82,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,5.25,19.95,
OLANZapine (Zyprexa) TAB : 10MG,32010428,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
OLANZapine(ZyPREXA)TAB:2.5MG,32010429,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
BUPIVACAINE LIPOSOME(Exparel)VL1.3%:20ML,32010484,CDM,C9290,HCPCS,250,RC,outpatient,,2806.84,2806.84,,2383.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,701.71,22,,percent of total billed charges,,,,,,,,,2526.16,90,,percent of total billed charges,,,2324.06,82.8,,percent of total billed charges,,,2385.81,85,,percent of total billed charges,,,,,,,,,2470.02,88,,percent of total billed charges,,,,,,,,,2144.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,701.71,22,,percent of total billed charges,,,2554.22,91,,percent of total billed charges,,,2666.5,95,,percent of total billed charges,,,2329.68,83,,percent of total billed charges,,,2329.68,83,,percent of total billed charges,,,,,,,,,,,,,,,2329.68,83,,percent of total billed charges,,,2666.5,95,,percent of total billed charges,,,2526.16,90,,percent of total billed charges,,,2526.16,90,,percent of total billed charges,,,2301.61,82,,percent of total billed charges,,,2526.16,90,,percent of total billed charges,,,2385.81,85,,percent of total billed charges,,701.71,2666.5,
GLYCERIN(PEDIA LAX) SUPP:PEDIATRIC,32010506,CDM,,,250,RC,outpatient,,14.22,14.22,,12.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.56,22,,percent of total billed charges,,,,,,,,,12.8,90,,percent of total billed charges,,,11.77,82.8,,percent of total billed charges,,,12.09,85,,percent of total billed charges,,,,,,,,,12.51,88,,percent of total billed charges,,,,,,,,,10.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.56,22,,percent of total billed charges,,,12.94,91,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,11.8,83,,percent of total billed charges,,,,,,,,,,,,,,,11.8,83,,percent of total billed charges,,,13.51,95,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,11.66,82,,percent of total billed charges,,,12.8,90,,percent of total billed charges,,,12.09,85,,percent of total billed charges,,3.56,13.51,
LEUPROLIDE(LUPRON DEPO)(3MONTHS) 22.5MG,32010523,CDM,J9217,HCPCS,636,RC,outpatient,,24301.94,24301.94,,20632.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6075.49,22,,percent of total billed charges,,,,,,,,,21871.75,90,,percent of total billed charges,,,20122.01,82.8,,percent of total billed charges,,,20656.65,85,,percent of total billed charges,,,,,,,,,21385.71,88,,percent of total billed charges,,998.81,,,,fee schedule,,,18566.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,998.81,,,,fee schedule,,,6075.49,22,,percent of total billed charges,,,22114.77,91,,percent of total billed charges,,,23086.84,95,,percent of total billed charges,,,20170.61,83,,percent of total billed charges,,,20170.61,83,,percent of total billed charges,,,,,,,,,,,,,,,20170.61,83,,percent of total billed charges,,,23086.84,95,,percent of total billed charges,,,21871.75,90,,percent of total billed charges,,,21871.75,90,,percent of total billed charges,,,19927.59,82,,percent of total billed charges,,,21871.75,90,,percent of total billed charges,,,20656.65,85,,percent of total billed charges,,998.81,23086.84,
AZACITIDINE (VIDAZA) VIAL:100MG,32010527,CDM,J9025,HCPCS,636,RC,outpatient,,510.46,510.46,,433.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.62,22,,percent of total billed charges,,,,,,,,,459.41,90,,percent of total billed charges,,,422.66,82.8,,percent of total billed charges,,,433.89,85,,percent of total billed charges,,,,,,,,,449.2,88,,percent of total billed charges,,100.6,,,,fee schedule,,,389.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,100.6,,,,fee schedule,,,127.62,22,,percent of total billed charges,,,464.52,91,,percent of total billed charges,,,484.94,95,,percent of total billed charges,,,423.68,83,,percent of total billed charges,,,423.68,83,,percent of total billed charges,,,,,,,,,,,,,,,423.68,83,,percent of total billed charges,,,484.94,95,,percent of total billed charges,,,459.41,90,,percent of total billed charges,,,459.41,90,,percent of total billed charges,,,418.58,82,,percent of total billed charges,,,459.41,90,,percent of total billed charges,,,433.89,85,,percent of total billed charges,,100.6,484.94,
CHLORHEXIDINE (PERIDEX ORAL) LIQD:473ML,32010567,CDM,J8499,HCPCS,250,RC,outpatient,,33.99,33.99,,28.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.5,22,,percent of total billed charges,,,,,,,,,30.59,90,,percent of total billed charges,,,28.14,82.8,,percent of total billed charges,,,28.89,85,,percent of total billed charges,,,,,,,,,29.91,88,,percent of total billed charges,,,,,,,,,25.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.5,22,,percent of total billed charges,,,30.93,91,,percent of total billed charges,,,32.29,95,,percent of total billed charges,,,28.21,83,,percent of total billed charges,,,28.21,83,,percent of total billed charges,,,,,,,,,,,,,,,28.21,83,,percent of total billed charges,,,32.29,95,,percent of total billed charges,,,30.59,90,,percent of total billed charges,,,30.59,90,,percent of total billed charges,,,27.87,82,,percent of total billed charges,,,30.59,90,,percent of total billed charges,,,28.89,85,,percent of total billed charges,,8.5,32.29,
IV DOBUTamine 250MG/D5W250ML   (PREMIX),32010680,CDM,J1250,HCPCS,250,RC,outpatient,,341.02,341.02,,289.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.26,22,,percent of total billed charges,,,,,,,,,306.92,90,,percent of total billed charges,,,282.36,82.8,,percent of total billed charges,,,289.87,85,,percent of total billed charges,,,,,,,,,300.1,88,,percent of total billed charges,,13.07,,,,fee schedule,,,260.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.07,,,,fee schedule,,,85.26,22,,percent of total billed charges,,,310.33,91,,percent of total billed charges,,,323.97,95,,percent of total billed charges,,,283.05,83,,percent of total billed charges,,,283.05,83,,percent of total billed charges,,,,,,,,,,,,,,,283.05,83,,percent of total billed charges,,,323.97,95,,percent of total billed charges,,,306.92,90,,percent of total billed charges,,,306.92,90,,percent of total billed charges,,,279.64,82,,percent of total billed charges,,,306.92,90,,percent of total billed charges,,,289.87,85,,percent of total billed charges,,13.07,323.97,
BUDESON/FORMOT(SYMBICORT) 80/4.5  6.9GM:,32010688,CDM,J3490,HCPCS,250,RC,outpatient,,2533.14,2533.14,,2150.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,633.29,22,,percent of total billed charges,,,,,,,,,2279.83,90,,percent of total billed charges,,,2097.44,82.8,,percent of total billed charges,,,2153.17,85,,percent of total billed charges,,,,,,,,,2229.16,88,,percent of total billed charges,,,,,,,,,1935.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,633.29,22,,percent of total billed charges,,,2305.16,91,,percent of total billed charges,,,2406.48,95,,percent of total billed charges,,,2102.51,83,,percent of total billed charges,,,2102.51,83,,percent of total billed charges,,,,,,,,,,,,,,,2102.51,83,,percent of total billed charges,,,2406.48,95,,percent of total billed charges,,,2279.83,90,,percent of total billed charges,,,2279.83,90,,percent of total billed charges,,,2077.17,82,,percent of total billed charges,,,2279.83,90,,percent of total billed charges,,,2153.17,85,,percent of total billed charges,,633.29,2406.48,
AMYL NITRITE(AROMATIC)AMP:,32010708,CDM,J3490,HCPCS,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
BORTEZOMIB (VELCADE) VIAL:3.5MG,32010725,CDM,J9044,HCPCS,636,RC,outpatient,,7616.7,7616.7,,6466.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1904.18,22,,percent of total billed charges,,,,,,,,,6855.03,90,,percent of total billed charges,,,6306.63,82.8,,percent of total billed charges,,,6474.2,85,,percent of total billed charges,,,,,,,,,6702.7,88,,percent of total billed charges,,,,,,,,,5819.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1904.18,22,,percent of total billed charges,,,6931.2,91,,percent of total billed charges,,,7235.87,95,,percent of total billed charges,,,6321.86,83,,percent of total billed charges,,,6321.86,83,,percent of total billed charges,,,,,,,,,,,,,,,6321.86,83,,percent of total billed charges,,,7235.87,95,,percent of total billed charges,,,6855.03,90,,percent of total billed charges,,,6855.03,90,,percent of total billed charges,,,6245.69,82,,percent of total billed charges,,,6855.03,90,,percent of total billed charges,,,6474.2,85,,percent of total billed charges,,1904.18,7235.87,
SCLEROSOL(STERILE TALC POWDER)4GM,32010792,CDM,,,250,RC,outpatient,,1721.66,1721.66,,1461.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,430.42,22,,percent of total billed charges,,,,,,,,,1549.49,90,,percent of total billed charges,,,1425.53,82.8,,percent of total billed charges,,,1463.41,85,,percent of total billed charges,,,,,,,,,1515.06,88,,percent of total billed charges,,,,,,,,,1315.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,430.42,22,,percent of total billed charges,,,1566.71,91,,percent of total billed charges,,,1635.58,95,,percent of total billed charges,,,1428.98,83,,percent of total billed charges,,,1428.98,83,,percent of total billed charges,,,,,,,,,,,,,,,1428.98,83,,percent of total billed charges,,,1635.58,95,,percent of total billed charges,,,1549.49,90,,percent of total billed charges,,,1549.49,90,,percent of total billed charges,,,1411.76,82,,percent of total billed charges,,,1549.49,90,,percent of total billed charges,,,1463.41,85,,percent of total billed charges,,430.42,1635.58,
ROFLUMILAST(DALIRESP)TAB:500MCG,32010822,CDM,J8499,HCPCS,250,RC,outpatient,,157.17,157.17,,133.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.29,22,,percent of total billed charges,,,,,,,,,141.45,90,,percent of total billed charges,,,130.14,82.8,,percent of total billed charges,,,133.59,85,,percent of total billed charges,,,,,,,,,138.31,88,,percent of total billed charges,,,,,,,,,120.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.29,22,,percent of total billed charges,,,143.02,91,,percent of total billed charges,,,149.31,95,,percent of total billed charges,,,130.45,83,,percent of total billed charges,,,130.45,83,,percent of total billed charges,,,,,,,,,,,,,,,130.45,83,,percent of total billed charges,,,149.31,95,,percent of total billed charges,,,141.45,90,,percent of total billed charges,,,141.45,90,,percent of total billed charges,,,128.88,82,,percent of total billed charges,,,141.45,90,,percent of total billed charges,,,133.59,85,,percent of total billed charges,,39.29,149.31,
INFLUENZA VACCINE(2013-2014)SYR:0.5ML,32010830,CDM,90656,CPT,636,RC,outpatient,,195.55,195.55,,166.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.89,22,,percent of total billed charges,,,,,,,,,176,90,,percent of total billed charges,,,161.92,82.8,,percent of total billed charges,,,166.22,85,,percent of total billed charges,,,,,,,,,172.08,88,,percent of total billed charges,,,,,,,,,149.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.89,22,,percent of total billed charges,,,177.95,91,,percent of total billed charges,,,185.77,95,,percent of total billed charges,,,162.31,83,,percent of total billed charges,,,162.31,83,,percent of total billed charges,,,,,,,,,,,,,,,162.31,83,,percent of total billed charges,,,185.77,95,,percent of total billed charges,,,176,90,,percent of total billed charges,,,176,90,,percent of total billed charges,,,160.35,82,,percent of total billed charges,,,176,90,,percent of total billed charges,,,166.22,85,,percent of total billed charges,,48.89,185.77,
ANASTROZOLE(ARIMIDEX)TAB:1MG,32010853,CDM,J8999,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
HIGH DOSE FLU VACCIN(2013-2014)SYR:0.5ML,32010865,CDM,90656,CPT,636,RC,outpatient,,454.39,454.39,,385.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,113.6,22,,percent of total billed charges,,,,,,,,,408.95,90,,percent of total billed charges,,,376.23,82.8,,percent of total billed charges,,,386.23,85,,percent of total billed charges,,,,,,,,,399.86,88,,percent of total billed charges,,,,,,,,,347.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,113.6,22,,percent of total billed charges,,,413.49,91,,percent of total billed charges,,,431.67,95,,percent of total billed charges,,,377.14,83,,percent of total billed charges,,,377.14,83,,percent of total billed charges,,,,,,,,,,,,,,,377.14,83,,percent of total billed charges,,,431.67,95,,percent of total billed charges,,,408.95,90,,percent of total billed charges,,,408.95,90,,percent of total billed charges,,,372.6,82,,percent of total billed charges,,,408.95,90,,percent of total billed charges,,,386.23,85,,percent of total billed charges,,113.6,431.67,
IMMUNE GLOBULIN(FLEBOGAMA)SDV:20GM/200ML,32010920,CDM,J1572,HCPCS,636,RC,outpatient,,9438.66,9438.66,,8013.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2359.67,22,,percent of total billed charges,,,,,,,,,8494.79,90,,percent of total billed charges,,,7815.21,82.8,,percent of total billed charges,,,8022.86,85,,percent of total billed charges,,,,,,,,,8306.02,88,,percent of total billed charges,,5980.5,,,,fee schedule,,,7211.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5980.5,,,,fee schedule,,,2359.67,22,,percent of total billed charges,,,8589.18,91,,percent of total billed charges,,,8966.73,95,,percent of total billed charges,,,7834.09,83,,percent of total billed charges,,,7834.09,83,,percent of total billed charges,,,,,,,,,,,,,,,7834.09,83,,percent of total billed charges,,,8966.73,95,,percent of total billed charges,,,8494.79,90,,percent of total billed charges,,,8494.79,90,,percent of total billed charges,,,7739.7,82,,percent of total billed charges,,,8494.79,90,,percent of total billed charges,,,8022.86,85,,percent of total billed charges,,2359.67,8966.73,
ATORVASTATIN(LIPITOR)TAB:40MG,32010935,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
cePHALexin(KEFLEX)CAP:500MG (1x6),32010936,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LABETALOL(TRANDATE)TAB:100MG (1x6),32010937,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
NIFEdipine(PROCARDIA)CAP:10MG (1x6),32010938,CDM,J8499,HCPCS,250,RC,outpatient,,37.27,37.27,,31.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.32,22,,percent of total billed charges,,,,,,,,,33.54,90,,percent of total billed charges,,,30.86,82.8,,percent of total billed charges,,,31.68,85,,percent of total billed charges,,,,,,,,,32.8,88,,percent of total billed charges,,,,,,,,,28.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.32,22,,percent of total billed charges,,,33.92,91,,percent of total billed charges,,,35.41,95,,percent of total billed charges,,,30.93,83,,percent of total billed charges,,,30.93,83,,percent of total billed charges,,,,,,,,,,,,,,,30.93,83,,percent of total billed charges,,,35.41,95,,percent of total billed charges,,,33.54,90,,percent of total billed charges,,,33.54,90,,percent of total billed charges,,,30.56,82,,percent of total billed charges,,,33.54,90,,percent of total billed charges,,,31.68,85,,percent of total billed charges,,9.32,35.41,
TRANEXAMIC ACID:1000 MG/NS100ML,32010951,CDM,,,258,RC,outpatient,,64.22,64.22,,54.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.06,22,,percent of total billed charges,,,,,,,,,57.8,90,,percent of total billed charges,,,53.17,82.8,,percent of total billed charges,,,54.59,85,,percent of total billed charges,,,,,,,,,56.51,88,,percent of total billed charges,,,,,,,,,49.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.06,22,,percent of total billed charges,,,58.44,91,,percent of total billed charges,,,61.01,95,,percent of total billed charges,,,53.3,83,,percent of total billed charges,,,53.3,83,,percent of total billed charges,,,,,,,,,,,,,,,53.3,83,,percent of total billed charges,,,61.01,95,,percent of total billed charges,,,57.8,90,,percent of total billed charges,,,57.8,90,,percent of total billed charges,,,52.66,82,,percent of total billed charges,,,57.8,90,,percent of total billed charges,,,54.59,85,,percent of total billed charges,,16.06,61.01,
GABAPENTIN(NEURONTIN)TAB:600MG,32010960,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
MICAFUNGIN SODIUM VL:100 MG,32010973,CDM,J2248,HCPCS,250,RC,outpatient,,1029.64,1029.64,,874.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,257.41,22,,percent of total billed charges,,,,,,,,,926.68,90,,percent of total billed charges,,,852.54,82.8,,percent of total billed charges,,,875.19,85,,percent of total billed charges,,,,,,,,,906.08,88,,percent of total billed charges,,118.05,,,,fee schedule,,,786.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,118.05,,,,fee schedule,,,257.41,22,,percent of total billed charges,,,936.97,91,,percent of total billed charges,,,978.16,95,,percent of total billed charges,,,854.6,83,,percent of total billed charges,,,854.6,83,,percent of total billed charges,,,,,,,,,,,,,,,854.6,83,,percent of total billed charges,,,978.16,95,,percent of total billed charges,,,926.68,90,,percent of total billed charges,,,926.68,90,,percent of total billed charges,,,844.3,82,,percent of total billed charges,,,926.68,90,,percent of total billed charges,,,875.19,85,,percent of total billed charges,,118.05,978.16,
COMBIVENT RESPIMAT,32010991,CDM,J3490,HCPCS,250,RC,outpatient,,3057.39,3057.39,,2595.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,764.35,22,,percent of total billed charges,,,,,,,,,2751.65,90,,percent of total billed charges,,,2531.52,82.8,,percent of total billed charges,,,2598.78,85,,percent of total billed charges,,,,,,,,,2690.5,88,,percent of total billed charges,,,,,,,,,2335.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,764.35,22,,percent of total billed charges,,,2782.22,91,,percent of total billed charges,,,2904.52,95,,percent of total billed charges,,,2537.63,83,,percent of total billed charges,,,2537.63,83,,percent of total billed charges,,,,,,,,,,,,,,,2537.63,83,,percent of total billed charges,,,2904.52,95,,percent of total billed charges,,,2751.65,90,,percent of total billed charges,,,2751.65,90,,percent of total billed charges,,,2507.06,82,,percent of total billed charges,,,2751.65,90,,percent of total billed charges,,,2598.78,85,,percent of total billed charges,,764.35,2904.52,
ZOMETA PREMIX-IVPB:4MG/100ML,32010995,CDM,J3489,HCPCS,636,RC,outpatient,,273.7,273.7,,232.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.43,22,,percent of total billed charges,,,,,,,,,246.33,90,,percent of total billed charges,,,226.62,82.8,,percent of total billed charges,,,232.65,85,,percent of total billed charges,,,,,,,,,240.86,88,,percent of total billed charges,,41.84,,,,fee schedule,,,209.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,41.84,,,,fee schedule,,,68.43,22,,percent of total billed charges,,,249.07,91,,percent of total billed charges,,,260.02,95,,percent of total billed charges,,,227.17,83,,percent of total billed charges,,,227.17,83,,percent of total billed charges,,,,,,,,,,,,,,,227.17,83,,percent of total billed charges,,,260.02,95,,percent of total billed charges,,,246.33,90,,percent of total billed charges,,,246.33,90,,percent of total billed charges,,,224.43,82,,percent of total billed charges,,,246.33,90,,percent of total billed charges,,,232.65,85,,percent of total billed charges,,41.84,260.02,
buPROPion XL(Wellbutrin XL)TAB:150MG,32011036,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
NEXTERONE(AMIODARONE)150MG/100ML(PREMIX),32011044,CDM,J0282,HCPCS,250,RC,outpatient,,586.28,586.28,,497.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,146.57,22,,percent of total billed charges,,,,,,,,,527.65,90,,percent of total billed charges,,,485.44,82.8,,percent of total billed charges,,,498.34,85,,percent of total billed charges,,,,,,,,,515.93,88,,percent of total billed charges,,7.62,,,,fee schedule,,,447.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.62,,,,fee schedule,,,146.57,22,,percent of total billed charges,,,533.51,91,,percent of total billed charges,,,556.97,95,,percent of total billed charges,,,486.61,83,,percent of total billed charges,,,486.61,83,,percent of total billed charges,,,,,,,,,,,,,,,486.61,83,,percent of total billed charges,,,556.97,95,,percent of total billed charges,,,527.65,90,,percent of total billed charges,,,527.65,90,,percent of total billed charges,,,480.75,82,,percent of total billed charges,,,527.65,90,,percent of total billed charges,,,498.34,85,,percent of total billed charges,,7.62,556.97,
NEXTERONE(AMIODARONE)360MG/200ML(PREMIX),32011045,CDM,J0282,HCPCS,250,RC,outpatient,,779.74,779.74,,662,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,194.94,22,,percent of total billed charges,,,,,,,,,701.77,90,,percent of total billed charges,,,645.62,82.8,,percent of total billed charges,,,662.78,85,,percent of total billed charges,,,,,,,,,686.17,88,,percent of total billed charges,,7.62,,,,fee schedule,,,595.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.62,,,,fee schedule,,,194.94,22,,percent of total billed charges,,,709.56,91,,percent of total billed charges,,,740.75,95,,percent of total billed charges,,,647.18,83,,percent of total billed charges,,,647.18,83,,percent of total billed charges,,,,,,,,,,,,,,,647.18,83,,percent of total billed charges,,,740.75,95,,percent of total billed charges,,,701.77,90,,percent of total billed charges,,,701.77,90,,percent of total billed charges,,,639.39,82,,percent of total billed charges,,,701.77,90,,percent of total billed charges,,,662.78,85,,percent of total billed charges,,7.62,740.75,
MAGNESIUM SULFATE-IVPB:2GM/50ML (PREMIX),32011049,CDM,J3475,HCPCS,258,RC,outpatient,,253.92,253.92,,215.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.48,22,,percent of total billed charges,,,,,,,,,228.53,90,,percent of total billed charges,,,210.25,82.8,,percent of total billed charges,,,215.83,85,,percent of total billed charges,,,,,,,,,223.45,88,,percent of total billed charges,,15.22,,,,fee schedule,,,193.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.22,,,,fee schedule,,,63.48,22,,percent of total billed charges,,,231.07,91,,percent of total billed charges,,,241.22,95,,percent of total billed charges,,,210.75,83,,percent of total billed charges,,,210.75,83,,percent of total billed charges,,,,,,,,,,,,,,,210.75,83,,percent of total billed charges,,,241.22,95,,percent of total billed charges,,,228.53,90,,percent of total billed charges,,,228.53,90,,percent of total billed charges,,,208.21,82,,percent of total billed charges,,,228.53,90,,percent of total billed charges,,,215.83,85,,percent of total billed charges,,15.22,241.22,
HYDROXYPROPL METHYL(GONAK)DROP 2.5% 15ML,32011072,CDM,,,250,RC,outpatient,,322.43,322.43,,273.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.61,22,,percent of total billed charges,,,,,,,,,290.19,90,,percent of total billed charges,,,266.97,82.8,,percent of total billed charges,,,274.07,85,,percent of total billed charges,,,,,,,,,283.74,88,,percent of total billed charges,,,,,,,,,246.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.61,22,,percent of total billed charges,,,293.41,91,,percent of total billed charges,,,306.31,95,,percent of total billed charges,,,267.62,83,,percent of total billed charges,,,267.62,83,,percent of total billed charges,,,,,,,,,,,,,,,267.62,83,,percent of total billed charges,,,306.31,95,,percent of total billed charges,,,290.19,90,,percent of total billed charges,,,290.19,90,,percent of total billed charges,,,264.39,82,,percent of total billed charges,,,290.19,90,,percent of total billed charges,,,274.07,85,,percent of total billed charges,,80.61,306.31,
IV LR 250ML,32011088,CDM,,,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
ORPHENADRINE(NORFLEX)VL:60MG/2ML,32011090,CDM,J2360,HCPCS,250,RC,outpatient,,260.79,260.79,,221.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.2,22,,percent of total billed charges,,,,,,,,,234.71,90,,percent of total billed charges,,,215.93,82.8,,percent of total billed charges,,,221.67,85,,percent of total billed charges,,,,,,,,,229.5,88,,percent of total billed charges,,4.07,,,,fee schedule,,,199.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,4.07,,,,fee schedule,,,65.2,22,,percent of total billed charges,,,237.32,91,,percent of total billed charges,,,247.75,95,,percent of total billed charges,,,216.46,83,,percent of total billed charges,,,216.46,83,,percent of total billed charges,,,,,,,,,,,,,,,216.46,83,,percent of total billed charges,,,247.75,95,,percent of total billed charges,,,234.71,90,,percent of total billed charges,,,234.71,90,,percent of total billed charges,,,213.85,82,,percent of total billed charges,,,234.71,90,,percent of total billed charges,,,221.67,85,,percent of total billed charges,,4.07,247.75,
FAMOTIDINE(PEPCID)IVPB:20MG/NS50ML,32011106,CDM,J3490,HCPCS,258,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
AMINOPHYLLINE VIAL:250MG/10ML,32011136,CDM,J0280,HCPCS,250,RC,outpatient,,208.24,208.24,,176.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.06,22,,percent of total billed charges,,,,,,,,,187.42,90,,percent of total billed charges,,,172.42,82.8,,percent of total billed charges,,,177,85,,percent of total billed charges,,,,,,,,,183.25,88,,percent of total billed charges,,34.11,,,,fee schedule,,,159.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,34.11,,,,fee schedule,,,52.06,22,,percent of total billed charges,,,189.5,91,,percent of total billed charges,,,197.83,95,,percent of total billed charges,,,172.84,83,,percent of total billed charges,,,172.84,83,,percent of total billed charges,,,,,,,,,,,,,,,172.84,83,,percent of total billed charges,,,197.83,95,,percent of total billed charges,,,187.42,90,,percent of total billed charges,,,187.42,90,,percent of total billed charges,,,170.76,82,,percent of total billed charges,,,187.42,90,,percent of total billed charges,,,177,85,,percent of total billed charges,,34.11,197.83,
IV DEXTROSE 10%-WATER SOL 500ML,32011267,CDM,J3490,HCPCS,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
SODIUM THIOSULFATE VIAL: 12.5GM/50ML,32011269,CDM,,,250,RC,outpatient,,1255.97,1255.97,,1066.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,313.99,22,,percent of total billed charges,,,,,,,,,1130.37,90,,percent of total billed charges,,,1039.94,82.8,,percent of total billed charges,,,1067.57,85,,percent of total billed charges,,,,,,,,,1105.25,88,,percent of total billed charges,,,,,,,,,959.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,313.99,22,,percent of total billed charges,,,1142.93,91,,percent of total billed charges,,,1193.17,95,,percent of total billed charges,,,1042.46,83,,percent of total billed charges,,,1042.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1042.46,83,,percent of total billed charges,,,1193.17,95,,percent of total billed charges,,,1130.37,90,,percent of total billed charges,,,1130.37,90,,percent of total billed charges,,,1029.9,82,,percent of total billed charges,,,1130.37,90,,percent of total billed charges,,,1067.57,85,,percent of total billed charges,,313.99,1193.17,
MEROPENEM(MERREM)VIAL IV:500MG,32011279,CDM,J2185,HCPCS,250,RC,outpatient,,96.59,96.59,,82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.15,22,,percent of total billed charges,,,,,,,,,86.93,90,,percent of total billed charges,,,79.98,82.8,,percent of total billed charges,,,82.1,85,,percent of total billed charges,,,,,,,,,85,88,,percent of total billed charges,,14.5,,,,fee schedule,,,73.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.5,,,,fee schedule,,,24.15,22,,percent of total billed charges,,,87.9,91,,percent of total billed charges,,,91.76,95,,percent of total billed charges,,,80.17,83,,percent of total billed charges,,,80.17,83,,percent of total billed charges,,,,,,,,,,,,,,,80.17,83,,percent of total billed charges,,,91.76,95,,percent of total billed charges,,,86.93,90,,percent of total billed charges,,,86.93,90,,percent of total billed charges,,,79.2,82,,percent of total billed charges,,,86.93,90,,percent of total billed charges,,,82.1,85,,percent of total billed charges,,14.5,91.76,
DECITABINE VIAL: 50MG,32011327,CDM,J0894,HCPCS,636,RC,outpatient,,6132.7,6132.7,,5206.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1533.18,22,,percent of total billed charges,,,,,,,,,5519.43,90,,percent of total billed charges,,,5077.88,82.8,,percent of total billed charges,,,5212.8,85,,percent of total billed charges,,,,,,,,,5396.78,88,,percent of total billed charges,,70.75,,,,fee schedule,,,4685.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,70.75,,,,fee schedule,,,1533.18,22,,percent of total billed charges,,,5580.76,91,,percent of total billed charges,,,5826.07,95,,percent of total billed charges,,,5090.14,83,,percent of total billed charges,,,5090.14,83,,percent of total billed charges,,,,,,,,,,,,,,,5090.14,83,,percent of total billed charges,,,5826.07,95,,percent of total billed charges,,,5519.43,90,,percent of total billed charges,,,5519.43,90,,percent of total billed charges,,,5028.81,82,,percent of total billed charges,,,5519.43,90,,percent of total billed charges,,,5212.8,85,,percent of total billed charges,,70.75,5826.07,
CHLORTHALIDONE TAB:25MG,32011342,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ROPIVACAINE 0.2%:20ML,32011394,CDM,J2795,HCPCS,250,RC,outpatient,,163.4,163.4,,138.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.85,22,,percent of total billed charges,,,,,,,,,147.06,90,,percent of total billed charges,,,135.3,82.8,,percent of total billed charges,,,138.89,85,,percent of total billed charges,,,,,,,,,143.79,88,,percent of total billed charges,,13.8,,,,fee schedule,,,124.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.8,,,,fee schedule,,,40.85,22,,percent of total billed charges,,,148.69,91,,percent of total billed charges,,,155.23,95,,percent of total billed charges,,,135.62,83,,percent of total billed charges,,,135.62,83,,percent of total billed charges,,,,,,,,,,,,,,,135.62,83,,percent of total billed charges,,,155.23,95,,percent of total billed charges,,,147.06,90,,percent of total billed charges,,,147.06,90,,percent of total billed charges,,,133.99,82,,percent of total billed charges,,,147.06,90,,percent of total billed charges,,,138.89,85,,percent of total billed charges,,13.8,155.23,
Dangles Cocktail W/O Ketorolac,32011422,CDM,,,258,RC,outpatient,,369.77,369.77,,313.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92.44,22,,percent of total billed charges,,,,,,,,,332.79,90,,percent of total billed charges,,,306.17,82.8,,percent of total billed charges,,,314.3,85,,percent of total billed charges,,,,,,,,,325.4,88,,percent of total billed charges,,,,,,,,,282.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92.44,22,,percent of total billed charges,,,336.49,91,,percent of total billed charges,,,351.28,95,,percent of total billed charges,,,306.91,83,,percent of total billed charges,,,306.91,83,,percent of total billed charges,,,,,,,,,,,,,,,306.91,83,,percent of total billed charges,,,351.28,95,,percent of total billed charges,,,332.79,90,,percent of total billed charges,,,332.79,90,,percent of total billed charges,,,303.21,82,,percent of total billed charges,,,332.79,90,,percent of total billed charges,,,314.3,85,,percent of total billed charges,,92.44,351.28,
CLINDAMYCIN(CLEOCIN)VIAL:900MG/6ML,32011435,CDM,,,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
ceFAZolin(ANCef):10gm bulk vial,32011444,CDM,J0690,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,2.88,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.88,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,2.88,59.21,
DOPamine VIAL:400MG/10ML,32011445,CDM,J1265,HCPCS,636,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,7.14,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.14,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,7.14,59.21,
DOPamine VIAL:400MG/5ML(2x conc),32011446,CDM,J1265,HCPCS,636,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,7.14,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.14,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,7.14,59.21,
ACTIVATED CHARCL(ADULT)ORAL:50G/240ML,32011447,CDM,,,250,RC,outpatient,,298.96,298.96,,253.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.74,22,,percent of total billed charges,,,,,,,,,269.06,90,,percent of total billed charges,,,247.54,82.8,,percent of total billed charges,,,254.12,85,,percent of total billed charges,,,,,,,,,263.08,88,,percent of total billed charges,,,,,,,,,228.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.74,22,,percent of total billed charges,,,272.05,91,,percent of total billed charges,,,284.01,95,,percent of total billed charges,,,248.14,83,,percent of total billed charges,,,248.14,83,,percent of total billed charges,,,,,,,,,,,,,,,248.14,83,,percent of total billed charges,,,284.01,95,,percent of total billed charges,,,269.06,90,,percent of total billed charges,,,269.06,90,,percent of total billed charges,,,245.15,82,,percent of total billed charges,,,269.06,90,,percent of total billed charges,,,254.12,85,,percent of total billed charges,,74.74,284.01,
SUFentanil(SUFENTA) FTV:100MCG/2ML,32011448,CDM,,,250,RC,outpatient,,83.26,83.26,,70.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.82,22,,percent of total billed charges,,,,,,,,,74.93,90,,percent of total billed charges,,,68.94,82.8,,percent of total billed charges,,,70.77,85,,percent of total billed charges,,,,,,,,,73.27,88,,percent of total billed charges,,,,,,,,,63.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20.82,22,,percent of total billed charges,,,75.77,91,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,69.11,83,,percent of total billed charges,,,,,,,,,,,,,,,69.11,83,,percent of total billed charges,,,79.1,95,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,68.27,82,,percent of total billed charges,,,74.93,90,,percent of total billed charges,,,70.77,85,,percent of total billed charges,,20.82,79.1,
HYDROmorphone (DILAUDID) VIAL:40MG/20ML,32011450,CDM,J1170,HCPCS,250,RC,outpatient,,396.02,396.02,,336.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,99.01,22,,percent of total billed charges,,,,,,,,,356.42,90,,percent of total billed charges,,,327.9,82.8,,percent of total billed charges,,,336.62,85,,percent of total billed charges,,,,,,,,,348.5,88,,percent of total billed charges,,3.47,,,,fee schedule,,,302.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.47,,,,fee schedule,,,99.01,22,,percent of total billed charges,,,360.38,91,,percent of total billed charges,,,376.22,95,,percent of total billed charges,,,328.7,83,,percent of total billed charges,,,328.7,83,,percent of total billed charges,,,,,,,,,,,,,,,328.7,83,,percent of total billed charges,,,376.22,95,,percent of total billed charges,,,356.42,90,,percent of total billed charges,,,356.42,90,,percent of total billed charges,,,324.74,82,,percent of total billed charges,,,356.42,90,,percent of total billed charges,,,336.62,85,,percent of total billed charges,,3.47,376.22,
LEUCOVORIN CALCIUM VIAL:50MG,32011474,CDM,J0640,HCPCS,636,RC,outpatient,,166.53,166.53,,141.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.63,22,,percent of total billed charges,,,,,,,,,149.88,90,,percent of total billed charges,,,137.89,82.8,,percent of total billed charges,,,141.55,85,,percent of total billed charges,,,,,,,,,146.55,88,,percent of total billed charges,,100.5,,,,fee schedule,,,127.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,100.5,,,,fee schedule,,,41.63,22,,percent of total billed charges,,,151.54,91,,percent of total billed charges,,,158.2,95,,percent of total billed charges,,,138.22,83,,percent of total billed charges,,,138.22,83,,percent of total billed charges,,,,,,,,,,,,,,,138.22,83,,percent of total billed charges,,,158.2,95,,percent of total billed charges,,,149.88,90,,percent of total billed charges,,,149.88,90,,percent of total billed charges,,,136.55,82,,percent of total billed charges,,,149.88,90,,percent of total billed charges,,,141.55,85,,percent of total billed charges,,41.63,158.2,
LIDOCAINE HCL 1% VIAL:(10MG/ML) (10ML),32011475,CDM,J2001,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
TRIAMCINOLONE(KENALOG) 0.1% CRM:80GM,32011477,CDM,,,250,RC,outpatient,,116.57,116.57,,98.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.14,22,,percent of total billed charges,,,,,,,,,104.91,90,,percent of total billed charges,,,96.52,82.8,,percent of total billed charges,,,99.08,85,,percent of total billed charges,,,,,,,,,102.58,88,,percent of total billed charges,,,,,,,,,89.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.14,22,,percent of total billed charges,,,106.08,91,,percent of total billed charges,,,110.74,95,,percent of total billed charges,,,96.75,83,,percent of total billed charges,,,96.75,83,,percent of total billed charges,,,,,,,,,,,,,,,96.75,83,,percent of total billed charges,,,110.74,95,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,95.59,82,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,99.08,85,,percent of total billed charges,,29.14,110.74,
EUCERIN LOT:480 GM,32011479,CDM,,,250,RC,outpatient,,39.89,39.89,,33.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.97,22,,percent of total billed charges,,,,,,,,,35.9,90,,percent of total billed charges,,,33.03,82.8,,percent of total billed charges,,,33.91,85,,percent of total billed charges,,,,,,,,,35.1,88,,percent of total billed charges,,,,,,,,,30.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.97,22,,percent of total billed charges,,,36.3,91,,percent of total billed charges,,,37.9,95,,percent of total billed charges,,,33.11,83,,percent of total billed charges,,,33.11,83,,percent of total billed charges,,,,,,,,,,,,,,,33.11,83,,percent of total billed charges,,,37.9,95,,percent of total billed charges,,,35.9,90,,percent of total billed charges,,,35.9,90,,percent of total billed charges,,,32.71,82,,percent of total billed charges,,,35.9,90,,percent of total billed charges,,,33.91,85,,percent of total billed charges,,9.97,37.9,
MEPIVACAINE 1% PF VL: 10MG/ML (30ML),32011480,CDM,J0670,HCPCS,250,RC,outpatient,,111.65,111.65,,94.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.91,22,,percent of total billed charges,,,,,,,,,100.49,90,,percent of total billed charges,,,92.45,82.8,,percent of total billed charges,,,94.9,85,,percent of total billed charges,,,,,,,,,98.25,88,,percent of total billed charges,,,,,,,,,85.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.91,22,,percent of total billed charges,,,101.6,91,,percent of total billed charges,,,106.07,95,,percent of total billed charges,,,92.67,83,,percent of total billed charges,,,92.67,83,,percent of total billed charges,,,,,,,,,,,,,,,92.67,83,,percent of total billed charges,,,106.07,95,,percent of total billed charges,,,100.49,90,,percent of total billed charges,,,100.49,90,,percent of total billed charges,,,91.55,82,,percent of total billed charges,,,100.49,90,,percent of total billed charges,,,94.9,85,,percent of total billed charges,,27.91,106.07,
METHIMAZOLE(TAPAZOLE)TAB:10MG,32011481,CDM,J8499,HCPCS,250,RC,outpatient,,9,9,,7.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.25,22,,percent of total billed charges,,,,,,,,,8.1,90,,percent of total billed charges,,,7.45,82.8,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,,,,,,,,7.92,88,,percent of total billed charges,,,,,,,,,6.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.25,22,,percent of total billed charges,,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.38,82,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,2.25,8.55,
methylPRED(solu-MEDROL)VIAL:500MG,32011482,CDM,J2930,HCPCS,250,RC,outpatient,,223.44,223.44,,189.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.86,22,,percent of total billed charges,,,,,,,,,201.1,90,,percent of total billed charges,,,185.01,82.8,,percent of total billed charges,,,189.92,85,,percent of total billed charges,,,,,,,,,196.63,88,,percent of total billed charges,,172.26,,,,fee schedule,,,170.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,172.26,,,,fee schedule,,,55.86,22,,percent of total billed charges,,,203.33,91,,percent of total billed charges,,,212.27,95,,percent of total billed charges,,,185.46,83,,percent of total billed charges,,,185.46,83,,percent of total billed charges,,,,,,,,,,,,,,,185.46,83,,percent of total billed charges,,,212.27,95,,percent of total billed charges,,,201.1,90,,percent of total billed charges,,,201.1,90,,percent of total billed charges,,,183.22,82,,percent of total billed charges,,,201.1,90,,percent of total billed charges,,,189.92,85,,percent of total billed charges,,55.86,212.27,
NAFCILLIN BULK VIAL: 10GM,32011483,CDM,J3490,HCPCS,250,RC,outpatient,,715.67,715.67,,607.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.92,22,,percent of total billed charges,,,,,,,,,644.1,90,,percent of total billed charges,,,592.57,82.8,,percent of total billed charges,,,608.32,85,,percent of total billed charges,,,,,,,,,629.79,88,,percent of total billed charges,,,,,,,,,546.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.92,22,,percent of total billed charges,,,651.26,91,,percent of total billed charges,,,679.89,95,,percent of total billed charges,,,594.01,83,,percent of total billed charges,,,594.01,83,,percent of total billed charges,,,,,,,,,,,,,,,594.01,83,,percent of total billed charges,,,679.89,95,,percent of total billed charges,,,644.1,90,,percent of total billed charges,,,644.1,90,,percent of total billed charges,,,586.85,82,,percent of total billed charges,,,644.1,90,,percent of total billed charges,,,608.32,85,,percent of total billed charges,,178.92,679.89,
RAMIPRIL(ALTACE)CAP:10MG,32011484,CDM,,,250,RC,outpatient,,17.16,17.16,,14.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.29,22,,percent of total billed charges,,,,,,,,,15.44,90,,percent of total billed charges,,,14.21,82.8,,percent of total billed charges,,,14.59,85,,percent of total billed charges,,,,,,,,,15.1,88,,percent of total billed charges,,,,,,,,,13.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.29,22,,percent of total billed charges,,,15.62,91,,percent of total billed charges,,,16.3,95,,percent of total billed charges,,,14.24,83,,percent of total billed charges,,,14.24,83,,percent of total billed charges,,,,,,,,,,,,,,,14.24,83,,percent of total billed charges,,,16.3,95,,percent of total billed charges,,,15.44,90,,percent of total billed charges,,,15.44,90,,percent of total billed charges,,,14.07,82,,percent of total billed charges,,,15.44,90,,percent of total billed charges,,,14.59,85,,percent of total billed charges,,4.29,16.3,
OFLOXACIN (OCUFLOX)DROP OPTH : 0.3% 5ML,32011485,CDM,,,250,RC,outpatient,,164.71,164.71,,139.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.18,22,,percent of total billed charges,,,,,,,,,148.24,90,,percent of total billed charges,,,136.38,82.8,,percent of total billed charges,,,140,85,,percent of total billed charges,,,,,,,,,144.94,88,,percent of total billed charges,,,,,,,,,125.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.18,22,,percent of total billed charges,,,149.89,91,,percent of total billed charges,,,156.47,95,,percent of total billed charges,,,136.71,83,,percent of total billed charges,,,136.71,83,,percent of total billed charges,,,,,,,,,,,,,,,136.71,83,,percent of total billed charges,,,156.47,95,,percent of total billed charges,,,148.24,90,,percent of total billed charges,,,148.24,90,,percent of total billed charges,,,135.06,82,,percent of total billed charges,,,148.24,90,,percent of total billed charges,,,140,85,,percent of total billed charges,,41.18,156.47,
PHENYLEPH(NEO-SYNPHRINE)VIAL:50MG/5ML,32011488,CDM,,,250,RC,outpatient,,114,114,,96.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.5,22,,percent of total billed charges,,,,,,,,,102.6,90,,percent of total billed charges,,,94.39,82.8,,percent of total billed charges,,,96.9,85,,percent of total billed charges,,,,,,,,,100.32,88,,percent of total billed charges,,,,,,,,,87.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.5,22,,percent of total billed charges,,,103.74,91,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,,,,,,,,,,,,,94.62,83,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,93.48,82,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,96.9,85,,percent of total billed charges,,28.5,108.3,
PIPERONLY BUTOXI/PYRETHRM EXT(RID):118ML,32011489,CDM,J3490,HCPCS,250,RC,outpatient,,72.22,72.22,,61.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.06,22,,percent of total billed charges,,,,,,,,,65,90,,percent of total billed charges,,,59.8,82.8,,percent of total billed charges,,,61.39,85,,percent of total billed charges,,,,,,,,,63.55,88,,percent of total billed charges,,,,,,,,,55.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.06,22,,percent of total billed charges,,,65.72,91,,percent of total billed charges,,,68.61,95,,percent of total billed charges,,,59.94,83,,percent of total billed charges,,,59.94,83,,percent of total billed charges,,,,,,,,,,,,,,,59.94,83,,percent of total billed charges,,,68.61,95,,percent of total billed charges,,,65,90,,percent of total billed charges,,,65,90,,percent of total billed charges,,,59.22,82,,percent of total billed charges,,,65,90,,percent of total billed charges,,,61.39,85,,percent of total billed charges,,18.06,68.61,
SILVER SULFADIAZINE(SSD AF)CREAM 1%:25G,32011490,CDM,J3490,HCPCS,250,RC,outpatient,,61.38,61.38,,52.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.35,22,,percent of total billed charges,,,,,,,,,55.24,90,,percent of total billed charges,,,50.82,82.8,,percent of total billed charges,,,52.17,85,,percent of total billed charges,,,,,,,,,54.01,88,,percent of total billed charges,,,,,,,,,46.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.35,22,,percent of total billed charges,,,55.86,91,,percent of total billed charges,,,58.31,95,,percent of total billed charges,,,50.95,83,,percent of total billed charges,,,50.95,83,,percent of total billed charges,,,,,,,,,,,,,,,50.95,83,,percent of total billed charges,,,58.31,95,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,50.33,82,,percent of total billed charges,,,55.24,90,,percent of total billed charges,,,52.17,85,,percent of total billed charges,,15.35,58.31,
GLYCERIN INFANT RECTAL ENEMA 4ML,32011491,CDM,J3490,HCPCS,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
HYDROCODONE/APAP SOL : 7.5-325MG/15ML UD,32011512,CDM,,,250,RC,outpatient,,75,75,,63.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.75,22,,percent of total billed charges,,,,,,,,,67.5,90,,percent of total billed charges,,,62.1,82.8,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,,,,,,,,66,88,,percent of total billed charges,,,,,,,,,57.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.75,22,,percent of total billed charges,,,68.25,91,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,,,,,,,,,,,,,62.25,83,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,61.5,82,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,18.75,71.25,
HYDROcod/APAP(Norco):7.5-325/15ML 118ML,32011513,CDM,,,250,RC,outpatient,,111.5,111.5,,94.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.88,22,,percent of total billed charges,,,,,,,,,100.35,90,,percent of total billed charges,,,92.32,82.8,,percent of total billed charges,,,94.78,85,,percent of total billed charges,,,,,,,,,98.12,88,,percent of total billed charges,,,,,,,,,85.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.88,22,,percent of total billed charges,,,101.47,91,,percent of total billed charges,,,105.93,95,,percent of total billed charges,,,92.55,83,,percent of total billed charges,,,92.55,83,,percent of total billed charges,,,,,,,,,,,,,,,92.55,83,,percent of total billed charges,,,105.93,95,,percent of total billed charges,,,100.35,90,,percent of total billed charges,,,100.35,90,,percent of total billed charges,,,91.43,82,,percent of total billed charges,,,100.35,90,,percent of total billed charges,,,94.78,85,,percent of total billed charges,,27.88,105.93,
ETANERCEPT (ENBREL)SYR: 50 mg/0.98ML,32011514,CDM,J1438,HCPCS,250,RC,outpatient,,7049.88,7049.88,,5985.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1762.47,22,,percent of total billed charges,,,,,,,,,6344.89,90,,percent of total billed charges,,,5837.3,82.8,,percent of total billed charges,,,5992.4,85,,percent of total billed charges,,,,,,,,,6203.89,88,,percent of total billed charges,,,,,,,,,5386.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1762.47,22,,percent of total billed charges,,,6415.39,91,,percent of total billed charges,,,6697.39,95,,percent of total billed charges,,,5851.4,83,,percent of total billed charges,,,5851.4,83,,percent of total billed charges,,,,,,,,,,,,,,,5851.4,83,,percent of total billed charges,,,6697.39,95,,percent of total billed charges,,,6344.89,90,,percent of total billed charges,,,6344.89,90,,percent of total billed charges,,,5780.9,82,,percent of total billed charges,,,6344.89,90,,percent of total billed charges,,,5992.4,85,,percent of total billed charges,,1762.47,6697.39,
PHENYTOIN ORAL SUSP U/D:100MG/4ML,32011590,CDM,J8499,HCPCS,250,RC,outpatient,,69.28,69.28,,58.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.32,22,,percent of total billed charges,,,,,,,,,62.35,90,,percent of total billed charges,,,57.36,82.8,,percent of total billed charges,,,58.89,85,,percent of total billed charges,,,,,,,,,60.97,88,,percent of total billed charges,,,,,,,,,52.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.32,22,,percent of total billed charges,,,63.04,91,,percent of total billed charges,,,65.82,95,,percent of total billed charges,,,57.5,83,,percent of total billed charges,,,57.5,83,,percent of total billed charges,,,,,,,,,,,,,,,57.5,83,,percent of total billed charges,,,65.82,95,,percent of total billed charges,,,62.35,90,,percent of total billed charges,,,62.35,90,,percent of total billed charges,,,56.81,82,,percent of total billed charges,,,62.35,90,,percent of total billed charges,,,58.89,85,,percent of total billed charges,,17.32,65.82,
VALPROIC ACID SYRUP U/D:250MG/5ML,32011630,CDM,J8499,HCPCS,250,RC,outpatient,,16.18,16.18,,13.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.05,22,,percent of total billed charges,,,,,,,,,14.56,90,,percent of total billed charges,,,13.4,82.8,,percent of total billed charges,,,13.75,85,,percent of total billed charges,,,,,,,,,14.24,88,,percent of total billed charges,,,,,,,,,12.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.05,22,,percent of total billed charges,,,14.72,91,,percent of total billed charges,,,15.37,95,,percent of total billed charges,,,13.43,83,,percent of total billed charges,,,13.43,83,,percent of total billed charges,,,,,,,,,,,,,,,13.43,83,,percent of total billed charges,,,15.37,95,,percent of total billed charges,,,14.56,90,,percent of total billed charges,,,14.56,90,,percent of total billed charges,,,13.27,82,,percent of total billed charges,,,14.56,90,,percent of total billed charges,,,13.75,85,,percent of total billed charges,,4.05,15.37,
GUAIFENESIN SYRUP UD:200MG/10ML,32011631,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
BUDESONIDE(PULMICORT):0.5MG/2MLNEB,32011638,CDM,J7626,HCPCS,250,RC,outpatient,,29.25,29.25,,24.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.31,22,,percent of total billed charges,,,,,,,,,26.33,90,,percent of total billed charges,,,24.22,82.8,,percent of total billed charges,,,24.86,85,,percent of total billed charges,,,,,,,,,25.74,88,,percent of total billed charges,,1.93,,,,fee schedule,,,22.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.93,,,,fee schedule,,,7.31,22,,percent of total billed charges,,,26.62,91,,percent of total billed charges,,,27.79,95,,percent of total billed charges,,,24.28,83,,percent of total billed charges,,,24.28,83,,percent of total billed charges,,,,,,,,,,,,,,,24.28,83,,percent of total billed charges,,,27.79,95,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,23.99,82,,percent of total billed charges,,,26.33,90,,percent of total billed charges,,,24.86,85,,percent of total billed charges,,1.93,27.79,
PROPOFOL(DIPRIVAN)VIAL:500MG/50ML,32011682,CDM,J2704,HCPCS,250,RC,outpatient,,80.23,80.23,,68.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20.06,22,,percent of total billed charges,,,,,,,,,72.21,90,,percent of total billed charges,,,66.43,82.8,,percent of total billed charges,,,68.2,85,,percent of total billed charges,,,,,,,,,70.6,88,,percent of total billed charges,,14.4,,,,fee schedule,,,61.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.4,,,,fee schedule,,,20.06,22,,percent of total billed charges,,,73.01,91,,percent of total billed charges,,,76.22,95,,percent of total billed charges,,,66.59,83,,percent of total billed charges,,,66.59,83,,percent of total billed charges,,,,,,,,,,,,,,,66.59,83,,percent of total billed charges,,,76.22,95,,percent of total billed charges,,,72.21,90,,percent of total billed charges,,,72.21,90,,percent of total billed charges,,,65.79,82,,percent of total billed charges,,,72.21,90,,percent of total billed charges,,,68.2,85,,percent of total billed charges,,14.4,76.22,
VANCOMYCIN-VIAL:10GM BULK,32011683,CDM,J3370,HCPCS,250,RC,outpatient,,3035.16,3035.16,,2576.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,758.79,22,,percent of total billed charges,,,,,,,,,2731.64,90,,percent of total billed charges,,,2513.11,82.8,,percent of total billed charges,,,2579.89,85,,percent of total billed charges,,,,,,,,,2670.94,88,,percent of total billed charges,,19.39,,,,fee schedule,,,2318.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.39,,,,fee schedule,,,758.79,22,,percent of total billed charges,,,2762,91,,percent of total billed charges,,,2883.4,95,,percent of total billed charges,,,2519.18,83,,percent of total billed charges,,,2519.18,83,,percent of total billed charges,,,,,,,,,,,,,,,2519.18,83,,percent of total billed charges,,,2883.4,95,,percent of total billed charges,,,2731.64,90,,percent of total billed charges,,,2731.64,90,,percent of total billed charges,,,2488.83,82,,percent of total billed charges,,,2731.64,90,,percent of total billed charges,,,2579.89,85,,percent of total billed charges,,19.39,2883.4,
SILVER SULFADIAZINE(SSD AF)CREAM 1%:20G,32011684,CDM,J3490,HCPCS,250,RC,outpatient,,139.71,139.71,,118.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.93,22,,percent of total billed charges,,,,,,,,,125.74,90,,percent of total billed charges,,,115.68,82.8,,percent of total billed charges,,,118.75,85,,percent of total billed charges,,,,,,,,,122.94,88,,percent of total billed charges,,,,,,,,,106.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.93,22,,percent of total billed charges,,,127.14,91,,percent of total billed charges,,,132.72,95,,percent of total billed charges,,,115.96,83,,percent of total billed charges,,,115.96,83,,percent of total billed charges,,,,,,,,,,,,,,,115.96,83,,percent of total billed charges,,,132.72,95,,percent of total billed charges,,,125.74,90,,percent of total billed charges,,,125.74,90,,percent of total billed charges,,,114.56,82,,percent of total billed charges,,,125.74,90,,percent of total billed charges,,,118.75,85,,percent of total billed charges,,34.93,132.72,
DEXAMETHASONE VIAL **NON PF** :10MG/ML,32011685,CDM,J1100,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,5,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,5,60.99,
ZN/CU/PHYD/MANG/SE(MULTITRACE-5)VIAL:1ML,32011686,CDM,J3490,HCPCS,250,RC,outpatient,,218.63,218.63,,185.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.66,22,,percent of total billed charges,,,,,,,,,196.77,90,,percent of total billed charges,,,181.03,82.8,,percent of total billed charges,,,185.84,85,,percent of total billed charges,,,,,,,,,192.39,88,,percent of total billed charges,,,,,,,,,167.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.66,22,,percent of total billed charges,,,198.95,91,,percent of total billed charges,,,207.7,95,,percent of total billed charges,,,181.46,83,,percent of total billed charges,,,181.46,83,,percent of total billed charges,,,,,,,,,,,,,,,181.46,83,,percent of total billed charges,,,207.7,95,,percent of total billed charges,,,196.77,90,,percent of total billed charges,,,196.77,90,,percent of total billed charges,,,179.28,82,,percent of total billed charges,,,196.77,90,,percent of total billed charges,,,185.84,85,,percent of total billed charges,,54.66,207.7,
MINERAL OIL:473ML,32011688,CDM,J3490,HCPCS,250,RC,outpatient,UD,29.5,29.5,,25.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.38,22,,percent of total billed charges,,,,,,,,,26.55,90,,percent of total billed charges,,,24.43,82.8,,percent of total billed charges,,,25.08,85,,percent of total billed charges,,,,,,,,,25.96,88,,percent of total billed charges,,,,,,,,,22.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.38,22,,percent of total billed charges,,,26.85,91,,percent of total billed charges,,,28.03,95,,percent of total billed charges,,,24.49,83,,percent of total billed charges,,,24.49,83,,percent of total billed charges,,,,,,,,,,,,,,,24.49,83,,percent of total billed charges,,,28.03,95,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,24.19,82,,percent of total billed charges,,,26.55,90,,percent of total billed charges,,,25.08,85,,percent of total billed charges,,7.38,28.03,
VasoSTRICT(VASOPRESSIN)VL:20UNIT/ML,32011689,CDM,J8499,HCPCS,250,RC,outpatient,,3039.96,3039.96,,2580.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,759.99,22,,percent of total billed charges,,,,,,,,,2735.96,90,,percent of total billed charges,,,2517.09,82.8,,percent of total billed charges,,,2583.97,85,,percent of total billed charges,,,,,,,,,2675.16,88,,percent of total billed charges,,,,,,,,,2322.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,759.99,22,,percent of total billed charges,,,2766.36,91,,percent of total billed charges,,,2887.96,95,,percent of total billed charges,,,2523.17,83,,percent of total billed charges,,,2523.17,83,,percent of total billed charges,,,,,,,,,,,,,,,2523.17,83,,percent of total billed charges,,,2887.96,95,,percent of total billed charges,,,2735.96,90,,percent of total billed charges,,,2735.96,90,,percent of total billed charges,,,2492.77,82,,percent of total billed charges,,,2735.96,90,,percent of total billed charges,,,2583.97,85,,percent of total billed charges,,759.99,2887.96,
NIVOLUMAB(OPDIVO)100MG/10ML,32011701,CDM,J9299,HCPCS,636,RC,outpatient,,12389.31,12389.31,,10518.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3097.33,22,,percent of total billed charges,,,,,,,,,11150.38,90,,percent of total billed charges,,,10258.35,82.8,,percent of total billed charges,,,10530.91,85,,percent of total billed charges,,,,,,,,,10902.59,88,,percent of total billed charges,,14182.56,,,,fee schedule,,,9465.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14182.56,,,,fee schedule,,,3097.33,22,,percent of total billed charges,,,11274.27,91,,percent of total billed charges,,,11769.84,95,,percent of total billed charges,,,10283.13,83,,percent of total billed charges,,,10283.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10283.13,83,,percent of total billed charges,,,11769.84,95,,percent of total billed charges,,,11150.38,90,,percent of total billed charges,,,11150.38,90,,percent of total billed charges,,,10159.23,82,,percent of total billed charges,,,11150.38,90,,percent of total billed charges,,,10530.91,85,,percent of total billed charges,,3097.33,14182.56,
CABERGOLINE TAB:0.5MG,32011716,CDM,,,250,RC,outpatient,,51.23,51.23,,43.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.81,22,,percent of total billed charges,,,,,,,,,46.11,90,,percent of total billed charges,,,42.42,82.8,,percent of total billed charges,,,43.55,85,,percent of total billed charges,,,,,,,,,45.08,88,,percent of total billed charges,,,,,,,,,39.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.81,22,,percent of total billed charges,,,46.62,91,,percent of total billed charges,,,48.67,95,,percent of total billed charges,,,42.52,83,,percent of total billed charges,,,42.52,83,,percent of total billed charges,,,,,,,,,,,,,,,42.52,83,,percent of total billed charges,,,48.67,95,,percent of total billed charges,,,46.11,90,,percent of total billed charges,,,46.11,90,,percent of total billed charges,,,42.01,82,,percent of total billed charges,,,46.11,90,,percent of total billed charges,,,43.55,85,,percent of total billed charges,,12.81,48.67,
DOCEtaxel(TaxoTERE)MDV 20MG/ML:J/1MG,32011718,CDM,J9171,HCPCS,636,RC,outpatient,,26.33,26.33,,22.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.58,22,,percent of total billed charges,,,,,,,,,23.7,90,,percent of total billed charges,,,21.8,82.8,,percent of total billed charges,,,22.38,85,,percent of total billed charges,,,,,,,,,23.17,88,,percent of total billed charges,,121.68,,,,fee schedule,,,20.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,6.58,22,,percent of total billed charges,,,23.96,91,,percent of total billed charges,,,25.01,95,,percent of total billed charges,,,21.85,83,,percent of total billed charges,,,21.85,83,,percent of total billed charges,,,,,,,,,,,,,,,21.85,83,,percent of total billed charges,,,25.01,95,,percent of total billed charges,,,23.7,90,,percent of total billed charges,,,23.7,90,,percent of total billed charges,,,21.59,82,,percent of total billed charges,,,23.7,90,,percent of total billed charges,,,22.38,85,,percent of total billed charges,,6.58,121.68,
DENOSUMAB (XGEVA): 120 mg,32011728,CDM,J0897,HCPCS,636,RC,outpatient,,12645.94,12645.94,,10736.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3161.49,22,,percent of total billed charges,,,,,,,,,11381.35,90,,percent of total billed charges,,,10470.84,82.8,,percent of total billed charges,,,10749.05,85,,percent of total billed charges,,,,,,,,,11128.43,88,,percent of total billed charges,,2701.2,,,,fee schedule,,,9661.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2701.2,,,,fee schedule,,,3161.49,22,,percent of total billed charges,,,11507.81,91,,percent of total billed charges,,,12013.64,95,,percent of total billed charges,,,10496.13,83,,percent of total billed charges,,,10496.13,83,,percent of total billed charges,,,,,,,,,,,,,,,10496.13,83,,percent of total billed charges,,,12013.64,95,,percent of total billed charges,,,11381.35,90,,percent of total billed charges,,,11381.35,90,,percent of total billed charges,,,10369.67,82,,percent of total billed charges,,,11381.35,90,,percent of total billed charges,,,10749.05,85,,percent of total billed charges,,2701.2,12013.64,
APIXABAN(ELIQUIS) TABS:2.5MG,32011733,CDM,J8499,HCPCS,250,RC,outpatient,,111.77,111.77,,94.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.94,22,,percent of total billed charges,,,,,,,,,100.59,90,,percent of total billed charges,,,92.55,82.8,,percent of total billed charges,,,95,85,,percent of total billed charges,,,,,,,,,98.36,88,,percent of total billed charges,,,,,,,,,85.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.94,22,,percent of total billed charges,,,101.71,91,,percent of total billed charges,,,106.18,95,,percent of total billed charges,,,92.77,83,,percent of total billed charges,,,92.77,83,,percent of total billed charges,,,,,,,,,,,,,,,92.77,83,,percent of total billed charges,,,106.18,95,,percent of total billed charges,,,100.59,90,,percent of total billed charges,,,100.59,90,,percent of total billed charges,,,91.65,82,,percent of total billed charges,,,100.59,90,,percent of total billed charges,,,95,85,,percent of total billed charges,,27.94,106.18,
HIV PEP KIT(ZIDOV EMTRICIT RALTEG)30 DAY,32011746,CDM,,,250,RC,outpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.63,22,,percent of total billed charges,,,,,,,,,182.28,90,,percent of total billed charges,,,167.69,82.8,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.63,22,,percent of total billed charges,,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,50.63,192.4,
HYDROGEN PEROXIDE SOL 3%:240 ML,32011769,CDM,J3490,HCPCS,250,RC,outpatient,,19.68,19.68,,16.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.92,22,,percent of total billed charges,,,,,,,,,17.71,90,,percent of total billed charges,,,16.3,82.8,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,,,,,,,,17.32,88,,percent of total billed charges,,,,,,,,,15.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.92,22,,percent of total billed charges,,,17.91,91,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,16.33,83,,percent of total billed charges,,,,,,,,,,,,,,,16.33,83,,percent of total billed charges,,,18.7,95,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.14,82,,percent of total billed charges,,,17.71,90,,percent of total billed charges,,,16.73,85,,percent of total billed charges,,4.92,18.7,
D5 0.225 NS 500ML,32011804,CDM,J3490,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
GEODON(ZIPRASIDONE)VIAL:20MG/ML,32011813,CDM,J3486,HCPCS,250,RC,outpatient,,771.46,771.46,,654.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.87,22,,percent of total billed charges,,,,,,,,,694.31,90,,percent of total billed charges,,,638.77,82.8,,percent of total billed charges,,,655.74,85,,percent of total billed charges,,,,,,,,,678.88,88,,percent of total billed charges,,,,,,,,,589.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.87,22,,percent of total billed charges,,,702.03,91,,percent of total billed charges,,,732.89,95,,percent of total billed charges,,,640.31,83,,percent of total billed charges,,,640.31,83,,percent of total billed charges,,,,,,,,,,,,,,,640.31,83,,percent of total billed charges,,,732.89,95,,percent of total billed charges,,,694.31,90,,percent of total billed charges,,,694.31,90,,percent of total billed charges,,,632.6,82,,percent of total billed charges,,,694.31,90,,percent of total billed charges,,,655.74,85,,percent of total billed charges,,192.87,732.89,
OXCARBAZEPINE (TRILEPTAL) TAB : 300MG,32011814,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
OXALIPLATIN(ELOXATIN):100MG/20ML,32011844,CDM,J9263,HCPCS,636,RC,outpatient,,302.45,302.45,,256.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.61,22,,percent of total billed charges,,,,,,,,,272.21,90,,percent of total billed charges,,,250.43,82.8,,percent of total billed charges,,,257.08,85,,percent of total billed charges,,,,,,,,,266.16,88,,percent of total billed charges,,38.5,,,,fee schedule,,,231.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,38.5,,,,fee schedule,,,75.61,22,,percent of total billed charges,,,275.23,91,,percent of total billed charges,,,287.33,95,,percent of total billed charges,,,251.03,83,,percent of total billed charges,,,251.03,83,,percent of total billed charges,,,,,,,,,,,,,,,251.03,83,,percent of total billed charges,,,287.33,95,,percent of total billed charges,,,272.21,90,,percent of total billed charges,,,272.21,90,,percent of total billed charges,,,248.01,82,,percent of total billed charges,,,272.21,90,,percent of total billed charges,,,257.08,85,,percent of total billed charges,,38.5,287.33,
LIDOCAINE HCL 2%PF VIAL:(10MG/ML) (10ML),32011845,CDM,J2001,HCPCS,250,RC,outpatient,,100.39,100.39,,85.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.1,22,,percent of total billed charges,,,,,,,,,90.35,90,,percent of total billed charges,,,83.12,82.8,,percent of total billed charges,,,85.33,85,,percent of total billed charges,,,,,,,,,88.34,88,,percent of total billed charges,,0.75,,,,fee schedule,,,76.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,25.1,22,,percent of total billed charges,,,91.35,91,,percent of total billed charges,,,95.37,95,,percent of total billed charges,,,83.32,83,,percent of total billed charges,,,83.32,83,,percent of total billed charges,,,,,,,,,,,,,,,83.32,83,,percent of total billed charges,,,95.37,95,,percent of total billed charges,,,90.35,90,,percent of total billed charges,,,90.35,90,,percent of total billed charges,,,82.32,82,,percent of total billed charges,,,90.35,90,,percent of total billed charges,,,85.33,85,,percent of total billed charges,,0.75,95.37,
GADOBENATE DIMEGLUMINE 529MG/ML:15ML,32011846,CDM,,,250,RC,outpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,203.31,22,,percent of total billed charges,,,,,,,,,731.93,90,,percent of total billed charges,,,673.37,82.8,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,203.31,22,,percent of total billed charges,,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,203.31,772.59,
GADOBENATE DIMEGLUMINE 529MG/ML:5ML,32011847,CDM,,,250,RC,outpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,203.31,22,,percent of total billed charges,,,,,,,,,731.93,90,,percent of total billed charges,,,673.37,82.8,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,203.31,22,,percent of total billed charges,,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,203.31,772.59,
IOPAMIDOL 76% SOL:125ML,32011851,CDM,Q9967,HCPCS,250,RC,outpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,203.31,22,,percent of total billed charges,,,,,,,,,731.93,90,,percent of total billed charges,,,673.37,82.8,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,203.31,22,,percent of total billed charges,,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,203.31,772.59,
BARIUM SULFATE 0.1% SUS:125ML,32011852,CDM,,,250,RC,outpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.63,22,,percent of total billed charges,,,,,,,,,182.28,90,,percent of total billed charges,,,167.69,82.8,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.63,22,,percent of total billed charges,,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,50.63,192.4,
BARIUM SULFATE 2.1% SUS:450ML,32011853,CDM,,,250,RC,outpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.63,22,,percent of total billed charges,,,,,,,,,182.28,90,,percent of total billed charges,,,167.69,82.8,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.63,22,,percent of total billed charges,,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,50.63,192.4,
BARIUM SULFATE 40% POW: 48GM,32011854,CDM,,,250,RC,outpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.63,22,,percent of total billed charges,,,,,,,,,182.28,90,,percent of total billed charges,,,167.69,82.8,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.63,22,,percent of total billed charges,,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,50.63,192.4,
BARIUM SULFATE 105% SUS,32011855,CDM,,,250,RC,outpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.63,22,,percent of total billed charges,,,,,,,,,182.28,90,,percent of total billed charges,,,167.69,82.8,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.63,22,,percent of total billed charges,,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,50.63,192.4,
BARIUM SULFATE 24% SUS: 600 ML,32011856,CDM,,,250,RC,outpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.63,22,,percent of total billed charges,,,,,,,,,182.28,90,,percent of total billed charges,,,167.69,82.8,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.63,22,,percent of total billed charges,,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,50.63,192.4,
BARIUM SULFATE 98% POW: 340 GM,32011857,CDM,,,250,RC,outpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.63,22,,percent of total billed charges,,,,,,,,,182.28,90,,percent of total billed charges,,,167.69,82.8,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.63,22,,percent of total billed charges,,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,50.63,192.4,
BARIUM SULFATE 96% POW: 176 GM,32011858,CDM,,,250,RC,outpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.63,22,,percent of total billed charges,,,,,,,,,182.28,90,,percent of total billed charges,,,167.69,82.8,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.63,22,,percent of total billed charges,,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,50.63,192.4,
CITRIC ACID/SIMETH/BICARB 4G U/D PKT,32011859,CDM,,,250,RC,outpatient,,202.53,202.53,,171.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.63,22,,percent of total billed charges,,,,,,,,,182.28,90,,percent of total billed charges,,,167.69,82.8,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,,,,,,,,178.23,88,,percent of total billed charges,,,,,,,,,154.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.63,22,,percent of total billed charges,,,184.3,91,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,168.1,83,,percent of total billed charges,,,,,,,,,,,,,,,168.1,83,,percent of total billed charges,,,192.4,95,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,166.07,82,,percent of total billed charges,,,182.28,90,,percent of total billed charges,,,172.15,85,,percent of total billed charges,,50.63,192.4,
DOCEtaxel(TaxoTERE)SDV: 80MG/4ML,32011866,CDM,J9171,HCPCS,636,RC,outpatient,,523.04,523.04,,444.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.76,22,,percent of total billed charges,,,,,,,,,470.74,90,,percent of total billed charges,,,433.08,82.8,,percent of total billed charges,,,444.58,85,,percent of total billed charges,,,,,,,,,460.28,88,,percent of total billed charges,,121.68,,,,fee schedule,,,399.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,130.76,22,,percent of total billed charges,,,475.97,91,,percent of total billed charges,,,496.89,95,,percent of total billed charges,,,434.12,83,,percent of total billed charges,,,434.12,83,,percent of total billed charges,,,,,,,,,,,,,,,434.12,83,,percent of total billed charges,,,496.89,95,,percent of total billed charges,,,470.74,90,,percent of total billed charges,,,470.74,90,,percent of total billed charges,,,428.89,82,,percent of total billed charges,,,470.74,90,,percent of total billed charges,,,444.58,85,,percent of total billed charges,,121.68,496.89,
IV MANNITOL SOL 20%:250 ML,32011867,CDM,,,250,RC,outpatient,,175,175,,148.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.75,22,,percent of total billed charges,,,,,,,,,157.5,90,,percent of total billed charges,,,144.9,82.8,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,,,,,,,,154,88,,percent of total billed charges,,,,,,,,,133.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.75,22,,percent of total billed charges,,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,,,,,,,,,,,,,145.25,83,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,143.5,82,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,43.75,166.25,
CYCLOPHOSPHAMIDE(CYTOXAN)VIAL:1GM,32011868,CDM,J9070,HCPCS,636,RC,outpatient,,549.38,549.38,,466.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,137.35,22,,percent of total billed charges,,,,,,,,,494.44,90,,percent of total billed charges,,,454.89,82.8,,percent of total billed charges,,,466.97,85,,percent of total billed charges,,,,,,,,,483.45,88,,percent of total billed charges,,1315.38,,,,fee schedule,,,419.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1315.38,,,,fee schedule,,,137.35,22,,percent of total billed charges,,,499.94,91,,percent of total billed charges,,,521.91,95,,percent of total billed charges,,,455.99,83,,percent of total billed charges,,,455.99,83,,percent of total billed charges,,,,,,,,,,,,,,,455.99,83,,percent of total billed charges,,,521.91,95,,percent of total billed charges,,,494.44,90,,percent of total billed charges,,,494.44,90,,percent of total billed charges,,,450.49,82,,percent of total billed charges,,,494.44,90,,percent of total billed charges,,,466.97,85,,percent of total billed charges,,137.35,1315.38,
IOPAMIDOL 41% SOL:20ML,32011869,CDM,Q9966,HCPCS,250,RC,outpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,203.31,22,,percent of total billed charges,,,,,,,,,731.93,90,,percent of total billed charges,,,673.37,82.8,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,203.31,22,,percent of total billed charges,,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,203.31,772.59,
ERIBULIN (HALAVEN) VIAL:1MG/2ML,32011870,CDM,J9179,HCPCS,636,RC,outpatient,,5896.8,5896.8,,5006.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1474.2,22,,percent of total billed charges,,,,,,,,,5307.12,90,,percent of total billed charges,,,4882.55,82.8,,percent of total billed charges,,,5012.28,85,,percent of total billed charges,,,,,,,,,5189.18,88,,percent of total billed charges,,3770.4,,,,fee schedule,,,4505.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3770.4,,,,fee schedule,,,1474.2,22,,percent of total billed charges,,,5366.09,91,,percent of total billed charges,,,5601.96,95,,percent of total billed charges,,,4894.34,83,,percent of total billed charges,,,4894.34,83,,percent of total billed charges,,,,,,,,,,,,,,,4894.34,83,,percent of total billed charges,,,5601.96,95,,percent of total billed charges,,,5307.12,90,,percent of total billed charges,,,5307.12,90,,percent of total billed charges,,,4835.38,82,,percent of total billed charges,,,5307.12,90,,percent of total billed charges,,,5012.28,85,,percent of total billed charges,,1474.2,5601.96,
diatrizoate meglumine 30% SOL:300ML,32011871,CDM,Q9958,HCPCS,250,RC,outpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,203.31,22,,percent of total billed charges,,,,,,,,,731.93,90,,percent of total billed charges,,,673.37,82.8,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,203.31,22,,percent of total billed charges,,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,203.31,772.59,
RIFAMPIN(RIFADIN)CAP:150MG,32011872,CDM,J8499,HCPCS,250,RC,outpatient,,23.2,23.2,,19.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.8,22,,percent of total billed charges,,,,,,,,,20.88,90,,percent of total billed charges,,,19.21,82.8,,percent of total billed charges,,,19.72,85,,percent of total billed charges,,,,,,,,,20.42,88,,percent of total billed charges,,,,,,,,,17.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.8,22,,percent of total billed charges,,,21.11,91,,percent of total billed charges,,,22.04,95,,percent of total billed charges,,,19.26,83,,percent of total billed charges,,,19.26,83,,percent of total billed charges,,,,,,,,,,,,,,,19.26,83,,percent of total billed charges,,,22.04,95,,percent of total billed charges,,,20.88,90,,percent of total billed charges,,,20.88,90,,percent of total billed charges,,,19.02,82,,percent of total billed charges,,,20.88,90,,percent of total billed charges,,,19.72,85,,percent of total billed charges,,5.8,22.04,
FLUOROURACIL(5-FU)VL:2500MG/50ML,32011873,CDM,J9190,HCPCS,636,RC,outpatient,,445.1,445.1,,377.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,111.28,22,,percent of total billed charges,,,,,,,,,400.59,90,,percent of total billed charges,,,368.54,82.8,,percent of total billed charges,,,378.34,85,,percent of total billed charges,,,,,,,,,391.69,88,,percent of total billed charges,,47.2,,,,fee schedule,,,340.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,47.2,,,,fee schedule,,,111.28,22,,percent of total billed charges,,,405.04,91,,percent of total billed charges,,,422.85,95,,percent of total billed charges,,,369.43,83,,percent of total billed charges,,,369.43,83,,percent of total billed charges,,,,,,,,,,,,,,,369.43,83,,percent of total billed charges,,,422.85,95,,percent of total billed charges,,,400.59,90,,percent of total billed charges,,,400.59,90,,percent of total billed charges,,,364.98,82,,percent of total billed charges,,,400.59,90,,percent of total billed charges,,,378.34,85,,percent of total billed charges,,47.2,422.85,
LEUCOVORIN CALCIUM VIAL:100MG,32011874,CDM,J0640,HCPCS,636,RC,outpatient,,161.44,161.44,,137.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.36,22,,percent of total billed charges,,,,,,,,,145.3,90,,percent of total billed charges,,,133.67,82.8,,percent of total billed charges,,,137.22,85,,percent of total billed charges,,,,,,,,,142.07,88,,percent of total billed charges,,100.5,,,,fee schedule,,,123.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,100.5,,,,fee schedule,,,40.36,22,,percent of total billed charges,,,146.91,91,,percent of total billed charges,,,153.37,95,,percent of total billed charges,,,134,83,,percent of total billed charges,,,134,83,,percent of total billed charges,,,,,,,,,,,,,,,134,83,,percent of total billed charges,,,153.37,95,,percent of total billed charges,,,145.3,90,,percent of total billed charges,,,145.3,90,,percent of total billed charges,,,132.38,82,,percent of total billed charges,,,145.3,90,,percent of total billed charges,,,137.22,85,,percent of total billed charges,,40.36,153.37,
HYDROmorphone (DILAUDID) SYR:0.5MG/0.5ML,32011875,CDM,J1170,HCPCS,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,3.47,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.47,,,,fee schedule,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,3.47,64.15,
INFLUENZA VACCINE(2015-2016)SYR:0.5ML,32011876,CDM,90656,CPT,636,RC,outpatient,,256.46,256.46,,217.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.12,22,,percent of total billed charges,,,,,,,,,230.81,90,,percent of total billed charges,,,212.35,82.8,,percent of total billed charges,,,217.99,85,,percent of total billed charges,,,,,,,,,225.68,88,,percent of total billed charges,,,,,,,,,195.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,64.12,22,,percent of total billed charges,,,233.38,91,,percent of total billed charges,,,243.64,95,,percent of total billed charges,,,212.86,83,,percent of total billed charges,,,212.86,83,,percent of total billed charges,,,,,,,,,,,,,,,212.86,83,,percent of total billed charges,,,243.64,95,,percent of total billed charges,,,230.81,90,,percent of total billed charges,,,230.81,90,,percent of total billed charges,,,210.3,82,,percent of total billed charges,,,230.81,90,,percent of total billed charges,,,217.99,85,,percent of total billed charges,,64.12,243.64,
HIGH DOSE FLU VACCIN(2015-2016)SYR:0.5ML,32011877,CDM,90656,CPT,636,RC,outpatient,,520.05,520.05,,441.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.01,22,,percent of total billed charges,,,,,,,,,468.05,90,,percent of total billed charges,,,430.6,82.8,,percent of total billed charges,,,442.04,85,,percent of total billed charges,,,,,,,,,457.64,88,,percent of total billed charges,,,,,,,,,397.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.01,22,,percent of total billed charges,,,473.25,91,,percent of total billed charges,,,494.05,95,,percent of total billed charges,,,431.64,83,,percent of total billed charges,,,431.64,83,,percent of total billed charges,,,,,,,,,,,,,,,431.64,83,,percent of total billed charges,,,494.05,95,,percent of total billed charges,,,468.05,90,,percent of total billed charges,,,468.05,90,,percent of total billed charges,,,426.44,82,,percent of total billed charges,,,468.05,90,,percent of total billed charges,,,442.04,85,,percent of total billed charges,,130.01,494.05,
SODIUM POLYST SULF ORAL UD:15G/60ML,32011878,CDM,J8499,HCPCS,250,RC,outpatient,,321.08,321.08,,272.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.27,22,,percent of total billed charges,,,,,,,,,288.97,90,,percent of total billed charges,,,265.85,82.8,,percent of total billed charges,,,272.92,85,,percent of total billed charges,,,,,,,,,282.55,88,,percent of total billed charges,,,,,,,,,245.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.27,22,,percent of total billed charges,,,292.18,91,,percent of total billed charges,,,305.03,95,,percent of total billed charges,,,266.5,83,,percent of total billed charges,,,266.5,83,,percent of total billed charges,,,,,,,,,,,,,,,266.5,83,,percent of total billed charges,,,305.03,95,,percent of total billed charges,,,288.97,90,,percent of total billed charges,,,288.97,90,,percent of total billed charges,,,263.29,82,,percent of total billed charges,,,288.97,90,,percent of total billed charges,,,272.92,85,,percent of total billed charges,,80.27,305.03,
LEUPROLIDE (LUPRON DEPO): 30MG/4MONTH,32011880,CDM,J9217,HCPCS,636,RC,outpatient,,34516.04,34516.04,,29304.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8629.01,22,,percent of total billed charges,,,,,,,,,31064.44,90,,percent of total billed charges,,,28579.28,82.8,,percent of total billed charges,,,29338.63,85,,percent of total billed charges,,,,,,,,,30374.12,88,,percent of total billed charges,,998.81,,,,fee schedule,,,26370.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,998.81,,,,fee schedule,,,8629.01,22,,percent of total billed charges,,,31409.6,91,,percent of total billed charges,,,32790.24,95,,percent of total billed charges,,,28648.31,83,,percent of total billed charges,,,28648.31,83,,percent of total billed charges,,,,,,,,,,,,,,,28648.31,83,,percent of total billed charges,,,32790.24,95,,percent of total billed charges,,,31064.44,90,,percent of total billed charges,,,31064.44,90,,percent of total billed charges,,,28303.15,82,,percent of total billed charges,,,31064.44,90,,percent of total billed charges,,,29338.63,85,,percent of total billed charges,,998.81,32790.24,
MORPHINE SULF(ORAL)SOL:10MG/5ML (100ML),32011881,CDM,,,250,RC,outpatient,,151.78,151.78,,128.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.95,22,,percent of total billed charges,,,,,,,,,136.6,90,,percent of total billed charges,,,125.67,82.8,,percent of total billed charges,,,129.01,85,,percent of total billed charges,,,,,,,,,133.57,88,,percent of total billed charges,,,,,,,,,115.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.95,22,,percent of total billed charges,,,138.12,91,,percent of total billed charges,,,144.19,95,,percent of total billed charges,,,125.98,83,,percent of total billed charges,,,125.98,83,,percent of total billed charges,,,,,,,,,,,,,,,125.98,83,,percent of total billed charges,,,144.19,95,,percent of total billed charges,,,136.6,90,,percent of total billed charges,,,136.6,90,,percent of total billed charges,,,124.46,82,,percent of total billed charges,,,136.6,90,,percent of total billed charges,,,129.01,85,,percent of total billed charges,,37.95,144.19,
KETAMINE(KETALAR) VIAL:1000MG/20ML,32011882,CDM,,,250,RC,outpatient,,320.53,320.53,,272.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,80.13,22,,percent of total billed charges,,,,,,,,,288.48,90,,percent of total billed charges,,,265.4,82.8,,percent of total billed charges,,,272.45,85,,percent of total billed charges,,,,,,,,,282.07,88,,percent of total billed charges,,,,,,,,,244.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,80.13,22,,percent of total billed charges,,,291.68,91,,percent of total billed charges,,,304.5,95,,percent of total billed charges,,,266.04,83,,percent of total billed charges,,,266.04,83,,percent of total billed charges,,,,,,,,,,,,,,,266.04,83,,percent of total billed charges,,,304.5,95,,percent of total billed charges,,,288.48,90,,percent of total billed charges,,,288.48,90,,percent of total billed charges,,,262.83,82,,percent of total billed charges,,,288.48,90,,percent of total billed charges,,,272.45,85,,percent of total billed charges,,80.13,304.5,
TRANEXEMIC ACID TAB:650MG,32011883,CDM,J8499,HCPCS,250,RC,outpatient,,31.21,31.21,,26.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.8,22,,percent of total billed charges,,,,,,,,,28.09,90,,percent of total billed charges,,,25.84,82.8,,percent of total billed charges,,,26.53,85,,percent of total billed charges,,,,,,,,,27.46,88,,percent of total billed charges,,,,,,,,,23.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.8,22,,percent of total billed charges,,,28.4,91,,percent of total billed charges,,,29.65,95,,percent of total billed charges,,,25.9,83,,percent of total billed charges,,,25.9,83,,percent of total billed charges,,,,,,,,,,,,,,,25.9,83,,percent of total billed charges,,,29.65,95,,percent of total billed charges,,,28.09,90,,percent of total billed charges,,,28.09,90,,percent of total billed charges,,,25.59,82,,percent of total billed charges,,,28.09,90,,percent of total billed charges,,,26.53,85,,percent of total billed charges,,7.8,29.65,
PROVOCHOLINE(METHACHOLINE): 100MG VIAL,32011884,CDM,J7674,HCPCS,250,RC,outpatient,,1133.5,1133.5,,962.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,283.38,22,,percent of total billed charges,,,,,,,,,1020.15,90,,percent of total billed charges,,,938.54,82.8,,percent of total billed charges,,,963.48,85,,percent of total billed charges,,,,,,,,,997.48,88,,percent of total billed charges,,162.5,,,,fee schedule,,,865.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,162.5,,,,fee schedule,,,283.38,22,,percent of total billed charges,,,1031.49,91,,percent of total billed charges,,,1076.83,95,,percent of total billed charges,,,940.81,83,,percent of total billed charges,,,940.81,83,,percent of total billed charges,,,,,,,,,,,,,,,940.81,83,,percent of total billed charges,,,1076.83,95,,percent of total billed charges,,,1020.15,90,,percent of total billed charges,,,1020.15,90,,percent of total billed charges,,,929.47,82,,percent of total billed charges,,,1020.15,90,,percent of total billed charges,,,963.48,85,,percent of total billed charges,,162.5,1076.83,
epiRUBICIN(ELLENCE):50MG/25ML,32011885,CDM,,,636,RC,outpatient,,769.84,769.84,,653.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,192.46,22,,percent of total billed charges,,,,,,,,,692.86,90,,percent of total billed charges,,,637.43,82.8,,percent of total billed charges,,,654.36,85,,percent of total billed charges,,,,,,,,,677.46,88,,percent of total billed charges,,,,,,,,,588.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,192.46,22,,percent of total billed charges,,,700.55,91,,percent of total billed charges,,,731.35,95,,percent of total billed charges,,,638.97,83,,percent of total billed charges,,,638.97,83,,percent of total billed charges,,,,,,,,,,,,,,,638.97,83,,percent of total billed charges,,,731.35,95,,percent of total billed charges,,,692.86,90,,percent of total billed charges,,,692.86,90,,percent of total billed charges,,,631.27,82,,percent of total billed charges,,,692.86,90,,percent of total billed charges,,,654.36,85,,percent of total billed charges,,192.46,731.35,
ACETAMINOPHEN INFANT GTT:160MG/5ML 30ML,32011887,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DOCEtaxel(TaxoTERE)SDV: *20MG/2ML*,32011888,CDM,J9171,HCPCS,636,RC,outpatient,,974.94,974.94,,827.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.74,22,,percent of total billed charges,,,,,,,,,877.45,90,,percent of total billed charges,,,807.25,82.8,,percent of total billed charges,,,828.7,85,,percent of total billed charges,,,,,,,,,857.95,88,,percent of total billed charges,,121.68,,,,fee schedule,,,744.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,243.74,22,,percent of total billed charges,,,887.2,91,,percent of total billed charges,,,926.19,95,,percent of total billed charges,,,809.2,83,,percent of total billed charges,,,809.2,83,,percent of total billed charges,,,,,,,,,,,,,,,809.2,83,,percent of total billed charges,,,926.19,95,,percent of total billed charges,,,877.45,90,,percent of total billed charges,,,877.45,90,,percent of total billed charges,,,799.45,82,,percent of total billed charges,,,877.45,90,,percent of total billed charges,,,828.7,85,,percent of total billed charges,,121.68,926.19,
DOCEtaxel(TaxoTERE)MDV: 80MG/4ML (J/1),32011889,CDM,J9171,HCPCS,636,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,121.68,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,121.68,
GEMCITABINE(GEMZAR)VIAL:1GM,32011892,CDM,J9201,HCPCS,636,RC,outpatient,,777.13,777.13,,659.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,194.28,22,,percent of total billed charges,,,,,,,,,699.42,90,,percent of total billed charges,,,643.46,82.8,,percent of total billed charges,,,660.56,85,,percent of total billed charges,,,,,,,,,683.87,88,,percent of total billed charges,,55.14,,,,fee schedule,,,593.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,55.14,,,,fee schedule,,,194.28,22,,percent of total billed charges,,,707.19,91,,percent of total billed charges,,,738.27,95,,percent of total billed charges,,,645.02,83,,percent of total billed charges,,,645.02,83,,percent of total billed charges,,,,,,,,,,,,,,,645.02,83,,percent of total billed charges,,,738.27,95,,percent of total billed charges,,,699.42,90,,percent of total billed charges,,,699.42,90,,percent of total billed charges,,,637.25,82,,percent of total billed charges,,,699.42,90,,percent of total billed charges,,,660.56,85,,percent of total billed charges,,55.14,738.27,
"THROMBIN,TOPICAL VIAL:5,000 UNITS",32011902,CDM,J3490,HCPCS,250,RC,outpatient,,719.13,719.13,,610.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,179.78,22,,percent of total billed charges,,,,,,,,,647.22,90,,percent of total billed charges,,,595.44,82.8,,percent of total billed charges,,,611.26,85,,percent of total billed charges,,,,,,,,,632.83,88,,percent of total billed charges,,,,,,,,,549.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,179.78,22,,percent of total billed charges,,,654.41,91,,percent of total billed charges,,,683.17,95,,percent of total billed charges,,,596.88,83,,percent of total billed charges,,,596.88,83,,percent of total billed charges,,,,,,,,,,,,,,,596.88,83,,percent of total billed charges,,,683.17,95,,percent of total billed charges,,,647.22,90,,percent of total billed charges,,,647.22,90,,percent of total billed charges,,,589.69,82,,percent of total billed charges,,,647.22,90,,percent of total billed charges,,,611.26,85,,percent of total billed charges,,179.78,683.17,
CARDENE IVPB:20MG/NS200ML(PREMIX),32011903,CDM,J3490,HCPCS,258,RC,outpatient,,1425.94,1425.94,,1210.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,356.49,22,,percent of total billed charges,,,,,,,,,1283.35,90,,percent of total billed charges,,,1180.68,82.8,,percent of total billed charges,,,1212.05,85,,percent of total billed charges,,,,,,,,,1254.83,88,,percent of total billed charges,,,,,,,,,1089.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,356.49,22,,percent of total billed charges,,,1297.61,91,,percent of total billed charges,,,1354.64,95,,percent of total billed charges,,,1183.53,83,,percent of total billed charges,,,1183.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1183.53,83,,percent of total billed charges,,,1354.64,95,,percent of total billed charges,,,1283.35,90,,percent of total billed charges,,,1283.35,90,,percent of total billed charges,,,1169.27,82,,percent of total billed charges,,,1283.35,90,,percent of total billed charges,,,1212.05,85,,percent of total billed charges,,356.49,1354.64,
TRAMADOL 50 MG TAB (1X8),32011906,CDM,J8499,HCPCS,250,RC,outpatient,,16.88,16.88,,14.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.22,22,,percent of total billed charges,,,,,,,,,15.19,90,,percent of total billed charges,,,13.98,82.8,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,,,,,,,,14.85,88,,percent of total billed charges,,,,,,,,,12.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.22,22,,percent of total billed charges,,,15.36,91,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,14.01,83,,percent of total billed charges,,,,,,,,,,,,,,,14.01,83,,percent of total billed charges,,,16.04,95,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,13.84,82,,percent of total billed charges,,,15.19,90,,percent of total billed charges,,,14.35,85,,percent of total billed charges,,4.22,16.04,
ONDANSETRON 4 MG ODT TAB (1X6),32011907,CDM,J8499,HCPCS,250,RC,outpatient,,19.44,19.44,,16.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.86,22,,percent of total billed charges,,,,,,,,,17.5,90,,percent of total billed charges,,,16.1,82.8,,percent of total billed charges,,,16.52,85,,percent of total billed charges,,,,,,,,,17.11,88,,percent of total billed charges,,,,,,,,,14.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.86,22,,percent of total billed charges,,,17.69,91,,percent of total billed charges,,,18.47,95,,percent of total billed charges,,,16.14,83,,percent of total billed charges,,,16.14,83,,percent of total billed charges,,,,,,,,,,,,,,,16.14,83,,percent of total billed charges,,,18.47,95,,percent of total billed charges,,,17.5,90,,percent of total billed charges,,,17.5,90,,percent of total billed charges,,,15.94,82,,percent of total billed charges,,,17.5,90,,percent of total billed charges,,,16.52,85,,percent of total billed charges,,4.86,18.47,
ENTYVIO (VEDOLIZUMAB) VIAL 300MG,32011914,CDM,J3380,HCPCS,636,RC,outpatient,,31788.14,31788.14,,26988.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7947.04,22,,percent of total billed charges,,,,,,,,,28609.33,90,,percent of total billed charges,,,26320.58,82.8,,percent of total billed charges,,,27019.92,85,,percent of total billed charges,,,,,,,,,27973.56,88,,percent of total billed charges,,6689.1,,,,fee schedule,,,24286.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6689.1,,,,fee schedule,,,7947.04,22,,percent of total billed charges,,,28927.21,91,,percent of total billed charges,,,30198.73,95,,percent of total billed charges,,,26384.16,83,,percent of total billed charges,,,26384.16,83,,percent of total billed charges,,,,,,,,,,,,,,,26384.16,83,,percent of total billed charges,,,30198.73,95,,percent of total billed charges,,,28609.33,90,,percent of total billed charges,,,28609.33,90,,percent of total billed charges,,,26066.27,82,,percent of total billed charges,,,28609.33,90,,percent of total billed charges,,,27019.92,85,,percent of total billed charges,,6689.1,30198.73,
IBANDRONATE (BONIVA) IV SYRINGE:3MG/3ML,32011997,CDM,J1740,HCPCS,636,RC,outpatient,,1764,1764,,1497.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,441,22,,percent of total billed charges,,,,,,,,,1587.6,90,,percent of total billed charges,,,1460.59,82.8,,percent of total billed charges,,,1499.4,85,,percent of total billed charges,,,,,,,,,1552.32,88,,percent of total billed charges,,77.54,,,,fee schedule,,,1347.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,77.54,,,,fee schedule,,,441,22,,percent of total billed charges,,,1605.24,91,,percent of total billed charges,,,1675.8,95,,percent of total billed charges,,,1464.12,83,,percent of total billed charges,,,1464.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1464.12,83,,percent of total billed charges,,,1675.8,95,,percent of total billed charges,,,1587.6,90,,percent of total billed charges,,,1587.6,90,,percent of total billed charges,,,1446.48,82,,percent of total billed charges,,,1587.6,90,,percent of total billed charges,,,1499.4,85,,percent of total billed charges,,77.54,1675.8,
MEGESTROL(MEGACE)ORAL UD:400MG/10ML,32012025,CDM,J8999,HCPCS,250,RC,outpatient,,36.11,36.11,,30.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.03,22,,percent of total billed charges,,,,,,,,,32.5,90,,percent of total billed charges,,,29.9,82.8,,percent of total billed charges,,,30.69,85,,percent of total billed charges,,,,,,,,,31.78,88,,percent of total billed charges,,,,,,,,,27.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.03,22,,percent of total billed charges,,,32.86,91,,percent of total billed charges,,,34.3,95,,percent of total billed charges,,,29.97,83,,percent of total billed charges,,,29.97,83,,percent of total billed charges,,,,,,,,,,,,,,,29.97,83,,percent of total billed charges,,,34.3,95,,percent of total billed charges,,,32.5,90,,percent of total billed charges,,,32.5,90,,percent of total billed charges,,,29.61,82,,percent of total billed charges,,,32.5,90,,percent of total billed charges,,,30.69,85,,percent of total billed charges,,9.03,34.3,
IV LR 1000ML+PITOCIN:20UNITS (QuVa 503B),32012205,CDM,,,258,RC,outpatient,,294.61,294.61,,250.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,73.65,22,,percent of total billed charges,,,,,,,,,265.15,90,,percent of total billed charges,,,243.94,82.8,,percent of total billed charges,,,250.42,85,,percent of total billed charges,,,,,,,,,259.26,88,,percent of total billed charges,,,,,,,,,225.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,73.65,22,,percent of total billed charges,,,268.1,91,,percent of total billed charges,,,279.88,95,,percent of total billed charges,,,244.53,83,,percent of total billed charges,,,244.53,83,,percent of total billed charges,,,,,,,,,,,,,,,244.53,83,,percent of total billed charges,,,279.88,95,,percent of total billed charges,,,265.15,90,,percent of total billed charges,,,265.15,90,,percent of total billed charges,,,241.58,82,,percent of total billed charges,,,265.15,90,,percent of total billed charges,,,250.42,85,,percent of total billed charges,,73.65,279.88,
USODEOXYCHOLIC ACID(URSODIOL)CAP:300MG,32012385,CDM,J8499,HCPCS,250,RC,outpatient,,29.98,29.98,,25.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.5,22,,percent of total billed charges,,,,,,,,,26.98,90,,percent of total billed charges,,,24.82,82.8,,percent of total billed charges,,,25.48,85,,percent of total billed charges,,,,,,,,,26.38,88,,percent of total billed charges,,,,,,,,,22.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.5,22,,percent of total billed charges,,,27.28,91,,percent of total billed charges,,,28.48,95,,percent of total billed charges,,,24.88,83,,percent of total billed charges,,,24.88,83,,percent of total billed charges,,,,,,,,,,,,,,,24.88,83,,percent of total billed charges,,,28.48,95,,percent of total billed charges,,,26.98,90,,percent of total billed charges,,,26.98,90,,percent of total billed charges,,,24.58,82,,percent of total billed charges,,,26.98,90,,percent of total billed charges,,,25.48,85,,percent of total billed charges,,7.5,28.48,
MELATONIN TAB: 3 MG,32012419,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DOCEtaxel(TaxoTERE)SDV: *20MG/ML*,32012439,CDM,J9171,HCPCS,636,RC,outpatient,,527.34,527.34,,447.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,131.84,22,,percent of total billed charges,,,,,,,,,474.61,90,,percent of total billed charges,,,436.64,82.8,,percent of total billed charges,,,448.24,85,,percent of total billed charges,,,,,,,,,464.06,88,,percent of total billed charges,,121.68,,,,fee schedule,,,402.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,131.84,22,,percent of total billed charges,,,479.88,91,,percent of total billed charges,,,500.97,95,,percent of total billed charges,,,437.69,83,,percent of total billed charges,,,437.69,83,,percent of total billed charges,,,,,,,,,,,,,,,437.69,83,,percent of total billed charges,,,500.97,95,,percent of total billed charges,,,474.61,90,,percent of total billed charges,,,474.61,90,,percent of total billed charges,,,432.42,82,,percent of total billed charges,,,474.61,90,,percent of total billed charges,,,448.24,85,,percent of total billed charges,,121.68,500.97,
INFLUENZA VAC QUAD(2016-2017)SYR:0.5ML,32012452,CDM,90686,CPT,636,RC,outpatient,,286.75,286.75,,243.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.69,22,,percent of total billed charges,,,,,,,,,258.08,90,,percent of total billed charges,,,237.43,82.8,,percent of total billed charges,,,243.74,85,,percent of total billed charges,,,,,,,,,252.34,88,,percent of total billed charges,,,,,,,,,219.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.69,22,,percent of total billed charges,,,260.94,91,,percent of total billed charges,,,272.41,95,,percent of total billed charges,,,238,83,,percent of total billed charges,,,238,83,,percent of total billed charges,,,,,,,,,,,,,,,238,83,,percent of total billed charges,,,272.41,95,,percent of total billed charges,,,258.08,90,,percent of total billed charges,,,258.08,90,,percent of total billed charges,,,235.14,82,,percent of total billed charges,,,258.08,90,,percent of total billed charges,,,243.74,85,,percent of total billed charges,,71.69,272.41,
HIGH DOSE INFLU VAC (2016-2017)SYR:0.5ML,32012453,CDM,90662,CPT,636,RC,outpatient,,613.62,613.62,,520.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153.41,22,,percent of total billed charges,,,,,,,,,552.26,90,,percent of total billed charges,,,508.08,82.8,,percent of total billed charges,,,521.58,85,,percent of total billed charges,,,,,,,,,539.99,88,,percent of total billed charges,,,,,,,,,468.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153.41,22,,percent of total billed charges,,,558.39,91,,percent of total billed charges,,,582.94,95,,percent of total billed charges,,,509.3,83,,percent of total billed charges,,,509.3,83,,percent of total billed charges,,,,,,,,,,,,,,,509.3,83,,percent of total billed charges,,,582.94,95,,percent of total billed charges,,,552.26,90,,percent of total billed charges,,,552.26,90,,percent of total billed charges,,,503.17,82,,percent of total billed charges,,,552.26,90,,percent of total billed charges,,,521.58,85,,percent of total billed charges,,153.41,582.94,
PAIN EASE TOP ANESTHETIC SPR:116ML,32012468,CDM,J3490,HCPCS,250,RC,outpatient,,477.86,477.86,,405.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.47,22,,percent of total billed charges,,,,,,,,,430.07,90,,percent of total billed charges,,,395.67,82.8,,percent of total billed charges,,,406.18,85,,percent of total billed charges,,,,,,,,,420.52,88,,percent of total billed charges,,,,,,,,,365.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.47,22,,percent of total billed charges,,,434.85,91,,percent of total billed charges,,,453.97,95,,percent of total billed charges,,,396.62,83,,percent of total billed charges,,,396.62,83,,percent of total billed charges,,,,,,,,,,,,,,,396.62,83,,percent of total billed charges,,,453.97,95,,percent of total billed charges,,,430.07,90,,percent of total billed charges,,,430.07,90,,percent of total billed charges,,,391.85,82,,percent of total billed charges,,,430.07,90,,percent of total billed charges,,,406.18,85,,percent of total billed charges,,119.47,453.97,
CABAZItaxel(JEVTANA)SDV:60MG/1.5ML,32012494,CDM,J9043,HCPCS,636,RC,outpatient,,65494.31,65494.31,,55604.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16373.58,22,,percent of total billed charges,,,,,,,,,58944.88,90,,percent of total billed charges,,,54229.29,82.8,,percent of total billed charges,,,55670.16,85,,percent of total billed charges,,,,,,,,,57634.99,88,,percent of total billed charges,,11739.18,,,,fee schedule,,,50037.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11739.18,,,,fee schedule,,,16373.58,22,,percent of total billed charges,,,59599.82,91,,percent of total billed charges,,,62219.59,95,,percent of total billed charges,,,54360.28,83,,percent of total billed charges,,,54360.28,83,,percent of total billed charges,,,,,,,,,,,,,,,54360.28,83,,percent of total billed charges,,,62219.59,95,,percent of total billed charges,,,58944.88,90,,percent of total billed charges,,,58944.88,90,,percent of total billed charges,,,53705.33,82,,percent of total billed charges,,,58944.88,90,,percent of total billed charges,,,55670.16,85,,percent of total billed charges,,11739.18,62219.59,
DOXOrubicin(ADRIAMYCIN):50MG/25ML,32012504,CDM,J9000,HCPCS,636,RC,outpatient,,316.83,316.83,,268.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.21,22,,percent of total billed charges,,,,,,,,,285.15,90,,percent of total billed charges,,,262.34,82.8,,percent of total billed charges,,,269.31,85,,percent of total billed charges,,,,,,,,,278.81,88,,percent of total billed charges,,43.69,,,,fee schedule,,,242.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,43.69,,,,fee schedule,,,79.21,22,,percent of total billed charges,,,288.32,91,,percent of total billed charges,,,300.99,95,,percent of total billed charges,,,262.97,83,,percent of total billed charges,,,262.97,83,,percent of total billed charges,,,,,,,,,,,,,,,262.97,83,,percent of total billed charges,,,300.99,95,,percent of total billed charges,,,285.15,90,,percent of total billed charges,,,285.15,90,,percent of total billed charges,,,259.8,82,,percent of total billed charges,,,285.15,90,,percent of total billed charges,,,269.31,85,,percent of total billed charges,,43.69,300.99,
DOXOrubicin(ADRIAMYCIN):20MG/10ML,32012505,CDM,J9000,HCPCS,636,RC,outpatient,,230.07,230.07,,195.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.52,22,,percent of total billed charges,,,,,,,,,207.06,90,,percent of total billed charges,,,190.5,82.8,,percent of total billed charges,,,195.56,85,,percent of total billed charges,,,,,,,,,202.46,88,,percent of total billed charges,,43.69,,,,fee schedule,,,175.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,43.69,,,,fee schedule,,,57.52,22,,percent of total billed charges,,,209.36,91,,percent of total billed charges,,,218.57,95,,percent of total billed charges,,,190.96,83,,percent of total billed charges,,,190.96,83,,percent of total billed charges,,,,,,,,,,,,,,,190.96,83,,percent of total billed charges,,,218.57,95,,percent of total billed charges,,,207.06,90,,percent of total billed charges,,,207.06,90,,percent of total billed charges,,,188.66,82,,percent of total billed charges,,,207.06,90,,percent of total billed charges,,,195.56,85,,percent of total billed charges,,43.69,218.57,
DESMOPRESSIN(DDVAP)NASAL:10MCG/0.1ML,32012535,CDM,J3490,HCPCS,250,RC,outpatient,,2120.16,2120.16,,1800.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,530.04,22,,percent of total billed charges,,,,,,,,,1908.14,90,,percent of total billed charges,,,1755.49,82.8,,percent of total billed charges,,,1802.14,85,,percent of total billed charges,,,,,,,,,1865.74,88,,percent of total billed charges,,,,,,,,,1619.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,530.04,22,,percent of total billed charges,,,1929.35,91,,percent of total billed charges,,,2014.15,95,,percent of total billed charges,,,1759.73,83,,percent of total billed charges,,,1759.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1759.73,83,,percent of total billed charges,,,2014.15,95,,percent of total billed charges,,,1908.14,90,,percent of total billed charges,,,1908.14,90,,percent of total billed charges,,,1738.53,82,,percent of total billed charges,,,1908.14,90,,percent of total billed charges,,,1802.14,85,,percent of total billed charges,,530.04,2014.15,
STIMATE (DDVAP)HIGHCONC NASAL:1.5MG/1ML,32012540,CDM,J3490,HCPCS,250,RC,outpatient,,5730.02,5730.02,,4864.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1432.51,22,,percent of total billed charges,,,,,,,,,5157.02,90,,percent of total billed charges,,,4744.46,82.8,,percent of total billed charges,,,4870.52,85,,percent of total billed charges,,,,,,,,,5042.42,88,,percent of total billed charges,,,,,,,,,4377.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1432.51,22,,percent of total billed charges,,,5214.32,91,,percent of total billed charges,,,5443.52,95,,percent of total billed charges,,,4755.92,83,,percent of total billed charges,,,4755.92,83,,percent of total billed charges,,,,,,,,,,,,,,,4755.92,83,,percent of total billed charges,,,5443.52,95,,percent of total billed charges,,,5157.02,90,,percent of total billed charges,,,5157.02,90,,percent of total billed charges,,,4698.62,82,,percent of total billed charges,,,5157.02,90,,percent of total billed charges,,,4870.52,85,,percent of total billed charges,,1432.51,5443.52,
FACTOR VIII (HUMATE-P): 2004 UNITS,32012541,CDM,J7187,HCPCS,636,RC,outpatient,,7575.12,7575.12,,6431.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1893.78,22,,percent of total billed charges,,,,,,,,,6817.61,90,,percent of total billed charges,,,6272.2,82.8,,percent of total billed charges,,,6438.85,85,,percent of total billed charges,,,,,,,,,6666.11,88,,percent of total billed charges,,12958.7,,,,fee schedule,,,5787.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,12958.7,,,,fee schedule,,,1893.78,22,,percent of total billed charges,,,6893.36,91,,percent of total billed charges,,,7196.36,95,,percent of total billed charges,,,6287.35,83,,percent of total billed charges,,,6287.35,83,,percent of total billed charges,,,,,,,,,,,,,,,6287.35,83,,percent of total billed charges,,,7196.36,95,,percent of total billed charges,,,6817.61,90,,percent of total billed charges,,,6817.61,90,,percent of total billed charges,,,6211.6,82,,percent of total billed charges,,,6817.61,90,,percent of total billed charges,,,6438.85,85,,percent of total billed charges,,1893.78,12958.7,
LIDOCAINE 4%CREAM:5GM,32012542,CDM,J3490,HCPCS,250,RC,outpatient,,54.58,54.58,,46.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.65,22,,percent of total billed charges,,,,,,,,,49.12,90,,percent of total billed charges,,,45.19,82.8,,percent of total billed charges,,,46.39,85,,percent of total billed charges,,,,,,,,,48.03,88,,percent of total billed charges,,,,,,,,,41.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.65,22,,percent of total billed charges,,,49.67,91,,percent of total billed charges,,,51.85,95,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,,,,,,,,,,,,,,45.3,83,,percent of total billed charges,,,51.85,95,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,44.76,82,,percent of total billed charges,,,49.12,90,,percent of total billed charges,,,46.39,85,,percent of total billed charges,,13.65,51.85,
CARBOplatin MDV:150MG/15ML   J/50,32012605,CDM,J9045,HCPCS,636,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,48.01,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,48.01,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
ORBACTIV(ORITAVANCIN) IV VIAL: 1200MG,32012618,CDM,J2407,HCPCS,250,RC,outpatient,,14233.5,14233.5,,12084.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3558.38,22,,percent of total billed charges,,,,,,,,,12810.15,90,,percent of total billed charges,,,11785.34,82.8,,percent of total billed charges,,,12098.48,85,,percent of total billed charges,,,,,,,,,12525.48,88,,percent of total billed charges,,3096.6,,,,fee schedule,,,10874.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3096.6,,,,fee schedule,,,3558.38,22,,percent of total billed charges,,,12952.49,91,,percent of total billed charges,,,13521.83,95,,percent of total billed charges,,,11813.81,83,,percent of total billed charges,,,11813.81,83,,percent of total billed charges,,,,,,,,,,,,,,,11813.81,83,,percent of total billed charges,,,13521.83,95,,percent of total billed charges,,,12810.15,90,,percent of total billed charges,,,12810.15,90,,percent of total billed charges,,,11671.47,82,,percent of total billed charges,,,12810.15,90,,percent of total billed charges,,,12098.48,85,,percent of total billed charges,,3096.6,13521.83,
ADALIMUMAB (HUMIRA) SYRINGE 40MG/0.8ML,32012642,CDM,J0135,HCPCS,636,RC,outpatient,,14099.8,14099.8,,11970.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3524.95,22,,percent of total billed charges,,,,,,,,,12689.82,90,,percent of total billed charges,,,11674.63,82.8,,percent of total billed charges,,,11984.83,85,,percent of total billed charges,,,,,,,,,12407.82,88,,percent of total billed charges,,,,,,,,,10772.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3524.95,22,,percent of total billed charges,,,12830.82,91,,percent of total billed charges,,,13394.81,95,,percent of total billed charges,,,11702.83,83,,percent of total billed charges,,,11702.83,83,,percent of total billed charges,,,,,,,,,,,,,,,11702.83,83,,percent of total billed charges,,,13394.81,95,,percent of total billed charges,,,12689.82,90,,percent of total billed charges,,,12689.82,90,,percent of total billed charges,,,11561.84,82,,percent of total billed charges,,,12689.82,90,,percent of total billed charges,,,11984.83,85,,percent of total billed charges,,3524.95,13394.81,
PROPRANOLOL(INDERAL)TAB:80MG,32012731,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
MIDAZOLAM(VERSED)VIAL:5MG/5ML,32012759,CDM,J2250,HCPCS,250,RC,outpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.42,22,,percent of total billed charges,,,,,,,,,59.09,90,,percent of total billed charges,,,54.37,82.8,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,,,,,,,,57.78,88,,percent of total billed charges,,7.08,,,,fee schedule,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.08,,,,fee schedule,,,16.42,22,,percent of total billed charges,,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,7.08,62.38,
MIDAZOLAM(VERSED)SYRINGE:10MG/2ML,32012760,CDM,J2250,HCPCS,250,RC,outpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.42,22,,percent of total billed charges,,,,,,,,,59.09,90,,percent of total billed charges,,,54.37,82.8,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,,,,,,,,57.78,88,,percent of total billed charges,,7.08,,,,fee schedule,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.08,,,,fee schedule,,,16.42,22,,percent of total billed charges,,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,7.08,62.38,
WATER FOR IRRIGATION STERILE SOL:1500ML,32012813,CDM,J3490,HCPCS,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
WATER FOR IRRIGATION STERILE SOL: 250ML,32012814,CDM,J3490,HCPCS,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
riTUXimab(RITUXAN)VIAL:500MG/50ML,32012919,CDM,J9312,HCPCS,636,RC,outpatient,,23305.95,23305.95,,19786.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5826.49,22,,percent of total billed charges,,,,,,,,,20975.36,90,,percent of total billed charges,,,19297.33,82.8,,percent of total billed charges,,,19810.06,85,,percent of total billed charges,,,,,,,,,20509.24,88,,percent of total billed charges,,10692.63,,,,fee schedule,,,17805.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,10692.63,,,,fee schedule,,,5826.49,22,,percent of total billed charges,,,21208.41,91,,percent of total billed charges,,,22140.65,95,,percent of total billed charges,,,19343.94,83,,percent of total billed charges,,,19343.94,83,,percent of total billed charges,,,,,,,,,,,,,,,19343.94,83,,percent of total billed charges,,,22140.65,95,,percent of total billed charges,,,20975.36,90,,percent of total billed charges,,,20975.36,90,,percent of total billed charges,,,19110.88,82,,percent of total billed charges,,,20975.36,90,,percent of total billed charges,,,19810.06,85,,percent of total billed charges,,5826.49,22140.65,
vinCRISTine SULFATE VIAL:2MG/2ML,32012920,CDM,J9370,HCPCS,636,RC,outpatient,,166.99,166.99,,141.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.75,22,,percent of total billed charges,,,,,,,,,150.29,90,,percent of total billed charges,,,138.27,82.8,,percent of total billed charges,,,141.94,85,,percent of total billed charges,,,,,,,,,146.95,88,,percent of total billed charges,,19.52,,,,fee schedule,,,127.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,19.52,,,,fee schedule,,,41.75,22,,percent of total billed charges,,,151.96,91,,percent of total billed charges,,,158.64,95,,percent of total billed charges,,,138.6,83,,percent of total billed charges,,,138.6,83,,percent of total billed charges,,,,,,,,,,,,,,,138.6,83,,percent of total billed charges,,,158.64,95,,percent of total billed charges,,,150.29,90,,percent of total billed charges,,,150.29,90,,percent of total billed charges,,,136.93,82,,percent of total billed charges,,,150.29,90,,percent of total billed charges,,,141.94,85,,percent of total billed charges,,19.52,158.64,
TUDORZA PRESSAIR AER:400/ACT,32012971,CDM,J3490,HCPCS,250,RC,outpatient,,1985.63,1985.63,,1685.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,496.41,22,,percent of total billed charges,,,,,,,,,1787.07,90,,percent of total billed charges,,,1644.1,82.8,,percent of total billed charges,,,1687.79,85,,percent of total billed charges,,,,,,,,,1747.35,88,,percent of total billed charges,,,,,,,,,1517.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,496.41,22,,percent of total billed charges,,,1806.92,91,,percent of total billed charges,,,1886.35,95,,percent of total billed charges,,,1648.07,83,,percent of total billed charges,,,1648.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1648.07,83,,percent of total billed charges,,,1886.35,95,,percent of total billed charges,,,1787.07,90,,percent of total billed charges,,,1787.07,90,,percent of total billed charges,,,1628.22,82,,percent of total billed charges,,,1787.07,90,,percent of total billed charges,,,1687.79,85,,percent of total billed charges,,496.41,1886.35,
IMMUNE GLOBULIN(FLEBOGAMMA)SDV:5GM/50ML,32013034,CDM,J1572,HCPCS,636,RC,outpatient,,3838.39,3838.39,,3258.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,959.6,22,,percent of total billed charges,,,,,,,,,3454.55,90,,percent of total billed charges,,,3178.19,82.8,,percent of total billed charges,,,3262.63,85,,percent of total billed charges,,,,,,,,,3377.78,88,,percent of total billed charges,,5980.5,,,,fee schedule,,,2932.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5980.5,,,,fee schedule,,,959.6,22,,percent of total billed charges,,,3492.93,91,,percent of total billed charges,,,3646.47,95,,percent of total billed charges,,,3185.86,83,,percent of total billed charges,,,3185.86,83,,percent of total billed charges,,,,,,,,,,,,,,,3185.86,83,,percent of total billed charges,,,3646.47,95,,percent of total billed charges,,,3454.55,90,,percent of total billed charges,,,3454.55,90,,percent of total billed charges,,,3147.48,82,,percent of total billed charges,,,3454.55,90,,percent of total billed charges,,,3262.63,85,,percent of total billed charges,,959.6,5980.5,
MEROPENEM(MERREM)VIAL IV:1GM,32013096,CDM,J2185,HCPCS,250,RC,outpatient,,88.82,88.82,,75.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.21,22,,percent of total billed charges,,,,,,,,,79.94,90,,percent of total billed charges,,,73.54,82.8,,percent of total billed charges,,,75.5,85,,percent of total billed charges,,,,,,,,,78.16,88,,percent of total billed charges,,14.5,,,,fee schedule,,,67.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.5,,,,fee schedule,,,22.21,22,,percent of total billed charges,,,80.83,91,,percent of total billed charges,,,84.38,95,,percent of total billed charges,,,73.72,83,,percent of total billed charges,,,73.72,83,,percent of total billed charges,,,,,,,,,,,,,,,73.72,83,,percent of total billed charges,,,84.38,95,,percent of total billed charges,,,79.94,90,,percent of total billed charges,,,79.94,90,,percent of total billed charges,,,72.83,82,,percent of total billed charges,,,79.94,90,,percent of total billed charges,,,75.5,85,,percent of total billed charges,,14.5,84.38,
PEGFILGRASTIM(NEULASTA) ONPRO 6MG/0.6ML,32013125,CDM,J2506,HCPCS,636,RC,outpatient,,19831.81,19831.81,,16837.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4957.95,22,,percent of total billed charges,,,,,,,,,17848.63,90,,percent of total billed charges,,,16420.74,82.8,,percent of total billed charges,,,16857.04,85,,percent of total billed charges,,,,,,,,,17451.99,88,,percent of total billed charges,,1576.97,,,,fee schedule,,,15151.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1576.97,,,,fee schedule,,,4957.95,22,,percent of total billed charges,,,18046.95,91,,percent of total billed charges,,,18840.22,95,,percent of total billed charges,,,16460.4,83,,percent of total billed charges,,,16460.4,83,,percent of total billed charges,,,,,,,,,,,,,,,16460.4,83,,percent of total billed charges,,,18840.22,95,,percent of total billed charges,,,17848.63,90,,percent of total billed charges,,,17848.63,90,,percent of total billed charges,,,16262.08,82,,percent of total billed charges,,,17848.63,90,,percent of total billed charges,,,16857.04,85,,percent of total billed charges,,1576.97,18840.22,
MAG SULF 50% IM SYRINGE:5GM/10ML,32013196,CDM,J3475,HCPCS,250,RC,outpatient,,275.96,275.96,,234.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.99,22,,percent of total billed charges,,,,,,,,,248.36,90,,percent of total billed charges,,,228.49,82.8,,percent of total billed charges,,,234.57,85,,percent of total billed charges,,,,,,,,,242.84,88,,percent of total billed charges,,15.22,,,,fee schedule,,,210.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.22,,,,fee schedule,,,68.99,22,,percent of total billed charges,,,251.12,91,,percent of total billed charges,,,262.16,95,,percent of total billed charges,,,229.05,83,,percent of total billed charges,,,229.05,83,,percent of total billed charges,,,,,,,,,,,,,,,229.05,83,,percent of total billed charges,,,262.16,95,,percent of total billed charges,,,248.36,90,,percent of total billed charges,,,248.36,90,,percent of total billed charges,,,226.29,82,,percent of total billed charges,,,248.36,90,,percent of total billed charges,,,234.57,85,,percent of total billed charges,,15.22,262.16,
OSELTAM(TAMIFLU)SUSP:6MG/ML (60ML),32013214,CDM,J8499,HCPCS,250,RC,outpatient,,477.78,477.78,,405.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.45,22,,percent of total billed charges,,,,,,,,,430,90,,percent of total billed charges,,,395.6,82.8,,percent of total billed charges,,,406.11,85,,percent of total billed charges,,,,,,,,,420.45,88,,percent of total billed charges,,,,,,,,,365.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.45,22,,percent of total billed charges,,,434.78,91,,percent of total billed charges,,,453.89,95,,percent of total billed charges,,,396.56,83,,percent of total billed charges,,,396.56,83,,percent of total billed charges,,,,,,,,,,,,,,,396.56,83,,percent of total billed charges,,,453.89,95,,percent of total billed charges,,,430,90,,percent of total billed charges,,,430,90,,percent of total billed charges,,,391.78,82,,percent of total billed charges,,,430,90,,percent of total billed charges,,,406.11,85,,percent of total billed charges,,119.45,453.89,
PROVAYBLUE (METHYLENE BLUE) 0.5%AMP:10ML,32013233,CDM,J3490,HCPCS,250,RC,outpatient,,1918.85,1918.85,,1629.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,479.71,22,,percent of total billed charges,,,,,,,,,1726.97,90,,percent of total billed charges,,,1588.81,82.8,,percent of total billed charges,,,1631.02,85,,percent of total billed charges,,,,,,,,,1688.59,88,,percent of total billed charges,,,,,,,,,1466,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,479.71,22,,percent of total billed charges,,,1746.15,91,,percent of total billed charges,,,1822.91,95,,percent of total billed charges,,,1592.65,83,,percent of total billed charges,,,1592.65,83,,percent of total billed charges,,,,,,,,,,,,,,,1592.65,83,,percent of total billed charges,,,1822.91,95,,percent of total billed charges,,,1726.97,90,,percent of total billed charges,,,1726.97,90,,percent of total billed charges,,,1573.46,82,,percent of total billed charges,,,1726.97,90,,percent of total billed charges,,,1631.02,85,,percent of total billed charges,,479.71,1822.91,
"LIDOCAINE W/EPI 1:100,000 VIAL 1%:30ML",32013245,CDM,J3490,HCPCS,250,RC,outpatient,,88.4,88.4,,75.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.1,22,,percent of total billed charges,,,,,,,,,79.56,90,,percent of total billed charges,,,73.2,82.8,,percent of total billed charges,,,75.14,85,,percent of total billed charges,,,,,,,,,77.79,88,,percent of total billed charges,,,,,,,,,67.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.1,22,,percent of total billed charges,,,80.44,91,,percent of total billed charges,,,83.98,95,,percent of total billed charges,,,73.37,83,,percent of total billed charges,,,73.37,83,,percent of total billed charges,,,,,,,,,,,,,,,73.37,83,,percent of total billed charges,,,83.98,95,,percent of total billed charges,,,79.56,90,,percent of total billed charges,,,79.56,90,,percent of total billed charges,,,72.49,82,,percent of total billed charges,,,79.56,90,,percent of total billed charges,,,75.14,85,,percent of total billed charges,,22.1,83.98,
PROMETHAZINE W/ CODEINE:6.5-10MG/5ML UD,32013283,CDM,Q0169,HCPCS,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,0.17,,,,fee schedule,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.17,,,,fee schedule,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,0.17,15.57,
CYRAMZA (RAMUCIRUMAB) VIAL 500MG,32013312,CDM,J9308,HCPCS,636,RC,outpatient,,29679.62,29679.62,,25198,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7419.91,22,,percent of total billed charges,,,,,,,,,26711.66,90,,percent of total billed charges,,,24574.73,82.8,,percent of total billed charges,,,25227.68,85,,percent of total billed charges,,,,,,,,,26118.07,88,,percent of total billed charges,,16405,,,,fee schedule,,,22675.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,16405,,,,fee schedule,,,7419.91,22,,percent of total billed charges,,,27008.45,91,,percent of total billed charges,,,28195.64,95,,percent of total billed charges,,,24634.08,83,,percent of total billed charges,,,24634.08,83,,percent of total billed charges,,,,,,,,,,,,,,,24634.08,83,,percent of total billed charges,,,28195.64,95,,percent of total billed charges,,,26711.66,90,,percent of total billed charges,,,26711.66,90,,percent of total billed charges,,,24337.29,82,,percent of total billed charges,,,26711.66,90,,percent of total billed charges,,,25227.68,85,,percent of total billed charges,,7419.91,28195.64,
KEYTRUDA (PEMBROLIZUMAB) VIAL: 100MG/4ML,32013340,CDM,J9271,HCPCS,636,RC,outpatient,,24745,24745,,21008.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6186.25,22,,percent of total billed charges,,,,,,,,,22270.5,90,,percent of total billed charges,,,20488.86,82.8,,percent of total billed charges,,,21033.25,85,,percent of total billed charges,,,,,,,,,21775.6,88,,percent of total billed charges,,21819.2,,,,fee schedule,,,18905.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21819.2,,,,fee schedule,,,6186.25,22,,percent of total billed charges,,,22517.95,91,,percent of total billed charges,,,23507.75,95,,percent of total billed charges,,,20538.35,83,,percent of total billed charges,,,20538.35,83,,percent of total billed charges,,,,,,,,,,,,,,,20538.35,83,,percent of total billed charges,,,23507.75,95,,percent of total billed charges,,,22270.5,90,,percent of total billed charges,,,22270.5,90,,percent of total billed charges,,,20290.9,82,,percent of total billed charges,,,22270.5,90,,percent of total billed charges,,,21033.25,85,,percent of total billed charges,,6186.25,23507.75,
"LIDOCAINE W/EPI 1:200,000 VIAL 1%:30ML",32013395,CDM,J3490,HCPCS,250,RC,outpatient,,172.87,172.87,,146.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.22,22,,percent of total billed charges,,,,,,,,,155.58,90,,percent of total billed charges,,,143.14,82.8,,percent of total billed charges,,,146.94,85,,percent of total billed charges,,,,,,,,,152.13,88,,percent of total billed charges,,,,,,,,,132.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.22,22,,percent of total billed charges,,,157.31,91,,percent of total billed charges,,,164.23,95,,percent of total billed charges,,,143.48,83,,percent of total billed charges,,,143.48,83,,percent of total billed charges,,,,,,,,,,,,,,,143.48,83,,percent of total billed charges,,,164.23,95,,percent of total billed charges,,,155.58,90,,percent of total billed charges,,,155.58,90,,percent of total billed charges,,,141.75,82,,percent of total billed charges,,,155.58,90,,percent of total billed charges,,,146.94,85,,percent of total billed charges,,43.22,164.23,
SACCHAROMYCES BOULA(FLORASTOR) CAP 250MG,32013435,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
METOCLOP(REGLAN)-SOL UD:10MG/10ML,32013436,CDM,J8499,HCPCS,250,RC,outpatient,,40.52,40.52,,34.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.13,22,,percent of total billed charges,,,,,,,,,36.47,90,,percent of total billed charges,,,33.55,82.8,,percent of total billed charges,,,34.44,85,,percent of total billed charges,,,,,,,,,35.66,88,,percent of total billed charges,,,,,,,,,30.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.13,22,,percent of total billed charges,,,36.87,91,,percent of total billed charges,,,38.49,95,,percent of total billed charges,,,33.63,83,,percent of total billed charges,,,33.63,83,,percent of total billed charges,,,,,,,,,,,,,,,33.63,83,,percent of total billed charges,,,38.49,95,,percent of total billed charges,,,36.47,90,,percent of total billed charges,,,36.47,90,,percent of total billed charges,,,33.23,82,,percent of total billed charges,,,36.47,90,,percent of total billed charges,,,34.44,85,,percent of total billed charges,,10.13,38.49,
methylPRED(MEDROL) TAB: 4 MG,32013442,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ROCURONIUM(ZEMURON)VIAL:100MG/10ML,32013540,CDM,J3490,HCPCS,250,RC,outpatient,,116.57,116.57,,98.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.14,22,,percent of total billed charges,,,,,,,,,104.91,90,,percent of total billed charges,,,96.52,82.8,,percent of total billed charges,,,99.08,85,,percent of total billed charges,,,,,,,,,102.58,88,,percent of total billed charges,,,,,,,,,89.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.14,22,,percent of total billed charges,,,106.08,91,,percent of total billed charges,,,110.74,95,,percent of total billed charges,,,96.75,83,,percent of total billed charges,,,96.75,83,,percent of total billed charges,,,,,,,,,,,,,,,96.75,83,,percent of total billed charges,,,110.74,95,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,95.59,82,,percent of total billed charges,,,104.91,90,,percent of total billed charges,,,99.08,85,,percent of total billed charges,,29.14,110.74,
INDOCYANIN GREEN(PINPOINT) VIAL,32013541,CDM,,,250,RC,outpatient,,813.25,813.25,,690.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,203.31,22,,percent of total billed charges,,,,,,,,,731.93,90,,percent of total billed charges,,,673.37,82.8,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,,,,,,,,715.66,88,,percent of total billed charges,,,,,,,,,621.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,203.31,22,,percent of total billed charges,,,740.06,91,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,675,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,,,,,,,,,,,,,,675,83,,percent of total billed charges,,,772.59,95,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,666.87,82,,percent of total billed charges,,,731.93,90,,percent of total billed charges,,,691.26,85,,percent of total billed charges,,203.31,772.59,
ETOPOSIDE(TOPOSAR)MDV:500MG/25ML(J/10MG),32013551,CDM,J9181,HCPCS,250,RC,outpatient,,12.69,12.69,,10.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.17,22,,percent of total billed charges,,,,,,,,,11.42,90,,percent of total billed charges,,,10.51,82.8,,percent of total billed charges,,,10.79,85,,percent of total billed charges,,,,,,,,,11.17,88,,percent of total billed charges,,21.03,,,,fee schedule,,,9.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21.03,,,,fee schedule,,,3.17,22,,percent of total billed charges,,,11.55,91,,percent of total billed charges,,,12.06,95,,percent of total billed charges,,,10.53,83,,percent of total billed charges,,,10.53,83,,percent of total billed charges,,,,,,,,,,,,,,,10.53,83,,percent of total billed charges,,,12.06,95,,percent of total billed charges,,,11.42,90,,percent of total billed charges,,,11.42,90,,percent of total billed charges,,,10.41,82,,percent of total billed charges,,,11.42,90,,percent of total billed charges,,,10.79,85,,percent of total billed charges,,3.17,21.03,
CISplatin MDV :100MG/100ML   (J/10MG),32013570,CDM,J9060,HCPCS,636,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,47.9,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,47.9,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
FILGRASTIM(NEUPOGEN)SYRINGE:480MCG/0.8ML,32013626,CDM,J1442,HCPCS,636,RC,outpatient,,3169.63,3169.63,,2691.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,792.41,22,,percent of total billed charges,,,,,,,,,2852.67,90,,percent of total billed charges,,,2624.45,82.8,,percent of total billed charges,,,2694.19,85,,percent of total billed charges,,,,,,,,,2789.27,88,,percent of total billed charges,,947.52,,,,fee schedule,,,2421.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,947.52,,,,fee schedule,,,792.41,22,,percent of total billed charges,,,2884.36,91,,percent of total billed charges,,,3011.15,95,,percent of total billed charges,,,2630.79,83,,percent of total billed charges,,,2630.79,83,,percent of total billed charges,,,,,,,,,,,,,,,2630.79,83,,percent of total billed charges,,,3011.15,95,,percent of total billed charges,,,2852.67,90,,percent of total billed charges,,,2852.67,90,,percent of total billed charges,,,2599.1,82,,percent of total billed charges,,,2852.67,90,,percent of total billed charges,,,2694.19,85,,percent of total billed charges,,792.41,3011.15,
FLUOROURACIL(5-FU)VL:5000MG/100ML,32013721,CDM,J9190,HCPCS,636,RC,outpatient,,999.11,999.11,,848.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,249.78,22,,percent of total billed charges,,,,,,,,,899.2,90,,percent of total billed charges,,,827.26,82.8,,percent of total billed charges,,,849.24,85,,percent of total billed charges,,,,,,,,,879.22,88,,percent of total billed charges,,47.2,,,,fee schedule,,,763.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,47.2,,,,fee schedule,,,249.78,22,,percent of total billed charges,,,909.19,91,,percent of total billed charges,,,949.15,95,,percent of total billed charges,,,829.26,83,,percent of total billed charges,,,829.26,83,,percent of total billed charges,,,,,,,,,,,,,,,829.26,83,,percent of total billed charges,,,949.15,95,,percent of total billed charges,,,899.2,90,,percent of total billed charges,,,899.2,90,,percent of total billed charges,,,819.27,82,,percent of total billed charges,,,899.2,90,,percent of total billed charges,,,849.24,85,,percent of total billed charges,,47.2,949.15,
VAGISIL CREAM 5-2%:28GM,32013808,CDM,J3490,HCPCS,250,RC,outpatient,UD,44.25,44.25,,37.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.06,22,,percent of total billed charges,,,,,,,,,39.83,90,,percent of total billed charges,,,36.64,82.8,,percent of total billed charges,,,37.61,85,,percent of total billed charges,,,,,,,,,38.94,88,,percent of total billed charges,,,,,,,,,33.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.06,22,,percent of total billed charges,,,40.27,91,,percent of total billed charges,,,42.04,95,,percent of total billed charges,,,36.73,83,,percent of total billed charges,,,36.73,83,,percent of total billed charges,,,,,,,,,,,,,,,36.73,83,,percent of total billed charges,,,42.04,95,,percent of total billed charges,,,39.83,90,,percent of total billed charges,,,39.83,90,,percent of total billed charges,,,36.29,82,,percent of total billed charges,,,39.83,90,,percent of total billed charges,,,37.61,85,,percent of total billed charges,,11.06,42.04,
HERCEPTIN (TRASTUZUMAB) VIAL 150MG,32013809,CDM,J9355,HCPCS,636,RC,outpatient,,7363.53,7363.53,,6251.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1840.88,22,,percent of total billed charges,,,,,,,,,6627.18,90,,percent of total billed charges,,,6097,82.8,,percent of total billed charges,,,6259,85,,percent of total billed charges,,,,,,,,,6479.91,88,,percent of total billed charges,,8440.1,,,,fee schedule,,,5625.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8440.1,,,,fee schedule,,,1840.88,22,,percent of total billed charges,,,6700.81,91,,percent of total billed charges,,,6995.35,95,,percent of total billed charges,,,6111.73,83,,percent of total billed charges,,,6111.73,83,,percent of total billed charges,,,,,,,,,,,,,,,6111.73,83,,percent of total billed charges,,,6995.35,95,,percent of total billed charges,,,6627.18,90,,percent of total billed charges,,,6627.18,90,,percent of total billed charges,,,6038.09,82,,percent of total billed charges,,,6627.18,90,,percent of total billed charges,,,6259,85,,percent of total billed charges,,1840.88,8440.1,
SUGAMMADEX(BRIDION) IV VIAL:200MG/2ML,32013907,CDM,J3490,HCPCS,250,RC,outpatient,,1652.08,1652.08,,1402.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,413.02,22,,percent of total billed charges,,,,,,,,,1486.87,90,,percent of total billed charges,,,1367.92,82.8,,percent of total billed charges,,,1404.27,85,,percent of total billed charges,,,,,,,,,1453.83,88,,percent of total billed charges,,,,,,,,,1262.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,413.02,22,,percent of total billed charges,,,1503.39,91,,percent of total billed charges,,,1569.48,95,,percent of total billed charges,,,1371.23,83,,percent of total billed charges,,,1371.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1371.23,83,,percent of total billed charges,,,1569.48,95,,percent of total billed charges,,,1486.87,90,,percent of total billed charges,,,1486.87,90,,percent of total billed charges,,,1354.71,82,,percent of total billed charges,,,1486.87,90,,percent of total billed charges,,,1404.27,85,,percent of total billed charges,,413.02,1569.48,
LEUPROLIDE (LUPRON DEPO): 45MG/6MONTH,32013918,CDM,J9217,HCPCS,636,RC,outpatient,,51774.75,51774.75,,43956.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12943.69,22,,percent of total billed charges,,,,,,,,,46597.28,90,,percent of total billed charges,,,42869.49,82.8,,percent of total billed charges,,,44008.54,85,,percent of total billed charges,,,,,,,,,45561.78,88,,percent of total billed charges,,998.81,,,,fee schedule,,,39555.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,998.81,,,,fee schedule,,,12943.69,22,,percent of total billed charges,,,47115.02,91,,percent of total billed charges,,,49186.01,95,,percent of total billed charges,,,42973.04,83,,percent of total billed charges,,,42973.04,83,,percent of total billed charges,,,,,,,,,,,,,,,42973.04,83,,percent of total billed charges,,,49186.01,95,,percent of total billed charges,,,46597.28,90,,percent of total billed charges,,,46597.28,90,,percent of total billed charges,,,42455.3,82,,percent of total billed charges,,,46597.28,90,,percent of total billed charges,,,44008.54,85,,percent of total billed charges,,998.81,49186.01,
POTAS PHOS(KP04)VIAL:15MMOL/5ML,32014021,CDM,J3490,HCPCS,250,RC,outpatient,,343.14,343.14,,291.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.79,22,,percent of total billed charges,,,,,,,,,308.83,90,,percent of total billed charges,,,284.12,82.8,,percent of total billed charges,,,291.67,85,,percent of total billed charges,,,,,,,,,301.96,88,,percent of total billed charges,,,,,,,,,262.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.79,22,,percent of total billed charges,,,312.26,91,,percent of total billed charges,,,325.98,95,,percent of total billed charges,,,284.81,83,,percent of total billed charges,,,284.81,83,,percent of total billed charges,,,,,,,,,,,,,,,284.81,83,,percent of total billed charges,,,325.98,95,,percent of total billed charges,,,308.83,90,,percent of total billed charges,,,308.83,90,,percent of total billed charges,,,281.37,82,,percent of total billed charges,,,308.83,90,,percent of total billed charges,,,291.67,85,,percent of total billed charges,,85.79,325.98,
FLUZONE QUAD(2017-2018)SYR:0.5ML,32014110,CDM,90686,CPT,636,RC,outpatient,,276.92,276.92,,235.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.23,22,,percent of total billed charges,,,,,,,,,249.23,90,,percent of total billed charges,,,229.29,82.8,,percent of total billed charges,,,235.38,85,,percent of total billed charges,,,,,,,,,243.69,88,,percent of total billed charges,,,,,,,,,211.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.23,22,,percent of total billed charges,,,252,91,,percent of total billed charges,,,263.07,95,,percent of total billed charges,,,229.84,83,,percent of total billed charges,,,229.84,83,,percent of total billed charges,,,,,,,,,,,,,,,229.84,83,,percent of total billed charges,,,263.07,95,,percent of total billed charges,,,249.23,90,,percent of total billed charges,,,249.23,90,,percent of total billed charges,,,227.07,82,,percent of total billed charges,,,249.23,90,,percent of total billed charges,,,235.38,85,,percent of total billed charges,,69.23,263.07,
FLUZONE HIGH DOSE (2017-2018)SYR:0.5ML,32014111,CDM,90662,CPT,636,RC,outpatient,,683.41,683.41,,580.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,170.85,22,,percent of total billed charges,,,,,,,,,615.07,90,,percent of total billed charges,,,565.86,82.8,,percent of total billed charges,,,580.9,85,,percent of total billed charges,,,,,,,,,601.4,88,,percent of total billed charges,,,,,,,,,522.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,170.85,22,,percent of total billed charges,,,621.9,91,,percent of total billed charges,,,649.24,95,,percent of total billed charges,,,567.23,83,,percent of total billed charges,,,567.23,83,,percent of total billed charges,,,,,,,,,,,,,,,567.23,83,,percent of total billed charges,,,649.24,95,,percent of total billed charges,,,615.07,90,,percent of total billed charges,,,615.07,90,,percent of total billed charges,,,560.4,82,,percent of total billed charges,,,615.07,90,,percent of total billed charges,,,580.9,85,,percent of total billed charges,,170.85,649.24,
GEMCITABINE(GEMZAR)VIAL:2GM,32014124,CDM,J9201,HCPCS,636,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,55.14,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,55.14,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
bupivacaine 0.25% PF Inj Sol 10ML,32014223,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
STERILE WATER FOR INJECTION VIAL:50ML,32014355,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
IMMUNE GLOBULIN(GAMUNEX-C)SDV:20GM/200ML,32014379,CDM,J1561,HCPCS,636,RC,outpatient,,8863.47,8863.47,,7525.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2215.87,22,,percent of total billed charges,,,,,,,,,7977.12,90,,percent of total billed charges,,,7338.95,82.8,,percent of total billed charges,,,7533.95,85,,percent of total billed charges,,,,,,,,,7799.85,88,,percent of total billed charges,,11167,,,,fee schedule,,,6771.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11167,,,,fee schedule,,,2215.87,22,,percent of total billed charges,,,8065.76,91,,percent of total billed charges,,,8420.3,95,,percent of total billed charges,,,7356.68,83,,percent of total billed charges,,,7356.68,83,,percent of total billed charges,,,,,,,,,,,,,,,7356.68,83,,percent of total billed charges,,,8420.3,95,,percent of total billed charges,,,7977.12,90,,percent of total billed charges,,,7977.12,90,,percent of total billed charges,,,7268.05,82,,percent of total billed charges,,,7977.12,90,,percent of total billed charges,,,7533.95,85,,percent of total billed charges,,2215.87,11167,
IMMUNE GLOBULIN(GAMUNEX-C)SDV:2.5GM/25ML,32014380,CDM,J1561,HCPCS,636,RC,outpatient,,3407.55,3407.55,,2893.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,851.89,22,,percent of total billed charges,,,,,,,,,3066.8,90,,percent of total billed charges,,,2821.45,82.8,,percent of total billed charges,,,2896.42,85,,percent of total billed charges,,,,,,,,,2998.64,88,,percent of total billed charges,,11167,,,,fee schedule,,,2603.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11167,,,,fee schedule,,,851.89,22,,percent of total billed charges,,,3100.87,91,,percent of total billed charges,,,3237.17,95,,percent of total billed charges,,,2828.27,83,,percent of total billed charges,,,2828.27,83,,percent of total billed charges,,,,,,,,,,,,,,,2828.27,83,,percent of total billed charges,,,3237.17,95,,percent of total billed charges,,,3066.8,90,,percent of total billed charges,,,3066.8,90,,percent of total billed charges,,,2794.19,82,,percent of total billed charges,,,3066.8,90,,percent of total billed charges,,,2896.42,85,,percent of total billed charges,,851.89,11167,
TECENTRIQ (ATEZOLIZUMAB)VIAL:1200MG/20ML,32014432,CDM,J9022,HCPCS,636,RC,outpatient,,41960.56,41960.56,,35624.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10490.14,22,,percent of total billed charges,,,,,,,,,37764.5,90,,percent of total billed charges,,,34743.34,82.8,,percent of total billed charges,,,35666.48,85,,percent of total billed charges,,,,,,,,,36925.29,88,,percent of total billed charges,,13787.09,,,,fee schedule,,,32057.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13787.09,,,,fee schedule,,,10490.14,22,,percent of total billed charges,,,38184.11,91,,percent of total billed charges,,,39862.53,95,,percent of total billed charges,,,34827.26,83,,percent of total billed charges,,,34827.26,83,,percent of total billed charges,,,,,,,,,,,,,,,34827.26,83,,percent of total billed charges,,,39862.53,95,,percent of total billed charges,,,37764.5,90,,percent of total billed charges,,,37764.5,90,,percent of total billed charges,,,34407.66,82,,percent of total billed charges,,,37764.5,90,,percent of total billed charges,,,35666.48,85,,percent of total billed charges,,10490.14,39862.53,
FERRIC CARBOX(INJECTAFER)VIAL:750MG/15ML,32014434,CDM,J1439,HCPCS,636,RC,outpatient,,7355.95,7355.95,,6245.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1838.99,22,,percent of total billed charges,,,,,,,,,6620.36,90,,percent of total billed charges,,,6090.73,82.8,,percent of total billed charges,,,6252.56,85,,percent of total billed charges,,,,,,,,,6473.24,88,,percent of total billed charges,,855.75,,,,fee schedule,,,5619.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,855.75,,,,fee schedule,,,1838.99,22,,percent of total billed charges,,,6693.91,91,,percent of total billed charges,,,6988.15,95,,percent of total billed charges,,,6105.44,83,,percent of total billed charges,,,6105.44,83,,percent of total billed charges,,,,,,,,,,,,,,,6105.44,83,,percent of total billed charges,,,6988.15,95,,percent of total billed charges,,,6620.36,90,,percent of total billed charges,,,6620.36,90,,percent of total billed charges,,,6031.88,82,,percent of total billed charges,,,6620.36,90,,percent of total billed charges,,,6252.56,85,,percent of total billed charges,,855.75,6988.15,
ACETAMINOPHEN SUSP UD: 160MG/5ML,32014437,CDM,J8499,HCPCS,250,RC,outpatient,,13.89,13.89,,11.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.47,22,,percent of total billed charges,,,,,,,,,12.5,90,,percent of total billed charges,,,11.5,82.8,,percent of total billed charges,,,11.81,85,,percent of total billed charges,,,,,,,,,12.22,88,,percent of total billed charges,,,,,,,,,10.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.47,22,,percent of total billed charges,,,12.64,91,,percent of total billed charges,,,13.2,95,,percent of total billed charges,,,11.53,83,,percent of total billed charges,,,11.53,83,,percent of total billed charges,,,,,,,,,,,,,,,11.53,83,,percent of total billed charges,,,13.2,95,,percent of total billed charges,,,12.5,90,,percent of total billed charges,,,12.5,90,,percent of total billed charges,,,11.39,82,,percent of total billed charges,,,12.5,90,,percent of total billed charges,,,11.81,85,,percent of total billed charges,,3.47,13.2,
GRANISETRON (KYTRIL):1MG/ML,32014533,CDM,J1626,HCPCS,636,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,7.72,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.72,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,7.72,60.99,
CARBOplatin MDV:450MG/45ML   J/50,32014547,CDM,J9045,HCPCS,636,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,48.01,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,48.01,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
DEMECLOCYCLINE TAB:150MG,32014736,CDM,J8499,HCPCS,250,RC,outpatient,,67.25,67.25,,57.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.81,22,,percent of total billed charges,,,,,,,,,60.53,90,,percent of total billed charges,,,55.68,82.8,,percent of total billed charges,,,57.16,85,,percent of total billed charges,,,,,,,,,59.18,88,,percent of total billed charges,,,,,,,,,51.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.81,22,,percent of total billed charges,,,61.2,91,,percent of total billed charges,,,63.89,95,,percent of total billed charges,,,55.82,83,,percent of total billed charges,,,55.82,83,,percent of total billed charges,,,,,,,,,,,,,,,55.82,83,,percent of total billed charges,,,63.89,95,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,55.15,82,,percent of total billed charges,,,60.53,90,,percent of total billed charges,,,57.16,85,,percent of total billed charges,,16.81,63.89,
PACLitaxel(TAXol)MDV:300MG/50ML (J/1mg),32014769,CDM,J9267,HCPCS,636,RC,outpatient,,2.01,2.01,,1.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.5,22,,percent of total billed charges,,,,,,,,,1.81,90,,percent of total billed charges,,,1.66,82.8,,percent of total billed charges,,,1.71,85,,percent of total billed charges,,,,,,,,,1.77,88,,percent of total billed charges,,61.04,,,,fee schedule,,,1.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,61.04,,,,fee schedule,,,0.5,22,,percent of total billed charges,,,1.83,91,,percent of total billed charges,,,1.91,95,,percent of total billed charges,,,1.67,83,,percent of total billed charges,,,1.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1.67,83,,percent of total billed charges,,,1.91,95,,percent of total billed charges,,,1.81,90,,percent of total billed charges,,,1.81,90,,percent of total billed charges,,,1.65,82,,percent of total billed charges,,,1.81,90,,percent of total billed charges,,,1.71,85,,percent of total billed charges,,0.5,61.04,
WATER FOR IRRIGATION STERILE SOL:500ML,32014841,CDM,J3490,HCPCS,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
FLUOROURACIL(5-FU)VL:1000MG/20ML,32014874,CDM,J9190,HCPCS,636,RC,outpatient,,100.71,100.71,,85.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.18,22,,percent of total billed charges,,,,,,,,,90.64,90,,percent of total billed charges,,,83.39,82.8,,percent of total billed charges,,,85.6,85,,percent of total billed charges,,,,,,,,,88.62,88,,percent of total billed charges,,47.2,,,,fee schedule,,,76.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,47.2,,,,fee schedule,,,25.18,22,,percent of total billed charges,,,91.65,91,,percent of total billed charges,,,95.67,95,,percent of total billed charges,,,83.59,83,,percent of total billed charges,,,83.59,83,,percent of total billed charges,,,,,,,,,,,,,,,83.59,83,,percent of total billed charges,,,95.67,95,,percent of total billed charges,,,90.64,90,,percent of total billed charges,,,90.64,90,,percent of total billed charges,,,82.58,82,,percent of total billed charges,,,90.64,90,,percent of total billed charges,,,85.6,85,,percent of total billed charges,,25.18,95.67,
PEN G POTAS(PFIZERPEN)VIAL: 20 MIL UNITS,32014903,CDM,J2540,HCPCS,250,RC,outpatient,,611.4,611.4,,519.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,152.85,22,,percent of total billed charges,,,,,,,,,550.26,90,,percent of total billed charges,,,506.24,82.8,,percent of total billed charges,,,519.69,85,,percent of total billed charges,,,,,,,,,538.03,88,,percent of total billed charges,,7.79,,,,fee schedule,,,467.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.79,,,,fee schedule,,,152.85,22,,percent of total billed charges,,,556.37,91,,percent of total billed charges,,,580.83,95,,percent of total billed charges,,,507.46,83,,percent of total billed charges,,,507.46,83,,percent of total billed charges,,,,,,,,,,,,,,,507.46,83,,percent of total billed charges,,,580.83,95,,percent of total billed charges,,,550.26,90,,percent of total billed charges,,,550.26,90,,percent of total billed charges,,,501.35,82,,percent of total billed charges,,,550.26,90,,percent of total billed charges,,,519.69,85,,percent of total billed charges,,7.79,580.83,
ALFENTanil(ALFENTA)PF AMP:1000MCG/2ML,32014955,CDM,J3490,HCPCS,250,RC,outpatient,,120.1,120.1,,101.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.03,22,,percent of total billed charges,,,,,,,,,108.09,90,,percent of total billed charges,,,99.44,82.8,,percent of total billed charges,,,102.09,85,,percent of total billed charges,,,,,,,,,105.69,88,,percent of total billed charges,,,,,,,,,91.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.03,22,,percent of total billed charges,,,109.29,91,,percent of total billed charges,,,114.1,95,,percent of total billed charges,,,99.68,83,,percent of total billed charges,,,99.68,83,,percent of total billed charges,,,,,,,,,,,,,,,99.68,83,,percent of total billed charges,,,114.1,95,,percent of total billed charges,,,108.09,90,,percent of total billed charges,,,108.09,90,,percent of total billed charges,,,98.48,82,,percent of total billed charges,,,108.09,90,,percent of total billed charges,,,102.09,85,,percent of total billed charges,,30.03,114.1,
TROPICAMIDE(MYDRIACYL)DROP 1%:15ML,32014956,CDM,J3490,HCPCS,250,RC,outpatient,,95.95,95.95,,81.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.99,22,,percent of total billed charges,,,,,,,,,86.36,90,,percent of total billed charges,,,79.45,82.8,,percent of total billed charges,,,81.56,85,,percent of total billed charges,,,,,,,,,84.44,88,,percent of total billed charges,,,,,,,,,73.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.99,22,,percent of total billed charges,,,87.31,91,,percent of total billed charges,,,91.15,95,,percent of total billed charges,,,79.64,83,,percent of total billed charges,,,79.64,83,,percent of total billed charges,,,,,,,,,,,,,,,79.64,83,,percent of total billed charges,,,91.15,95,,percent of total billed charges,,,86.36,90,,percent of total billed charges,,,86.36,90,,percent of total billed charges,,,78.68,82,,percent of total billed charges,,,86.36,90,,percent of total billed charges,,,81.56,85,,percent of total billed charges,,23.99,91.15,
fentaNYL PHARMACY ADMIX SYR:100MCG/2ML,32014964,CDM,J3010,HCPCS,250,RC,outpatient,,65.66,65.66,,55.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.42,22,,percent of total billed charges,,,,,,,,,59.09,90,,percent of total billed charges,,,54.37,82.8,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,,,,,,,,57.78,88,,percent of total billed charges,,1.79,,,,fee schedule,,,50.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1.79,,,,fee schedule,,,16.42,22,,percent of total billed charges,,,59.75,91,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,54.5,83,,percent of total billed charges,,,,,,,,,,,,,,,54.5,83,,percent of total billed charges,,,62.38,95,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,53.84,82,,percent of total billed charges,,,59.09,90,,percent of total billed charges,,,55.81,85,,percent of total billed charges,,1.79,62.38,
INSUL GLA(LANTUS) PEN:100UNITS/ML(3ML),32014965,CDM,J1815,HCPCS,250,RC,outpatient,,431.21,431.21,,366.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.8,22,,percent of total billed charges,,,,,,,,,388.09,90,,percent of total billed charges,,,357.04,82.8,,percent of total billed charges,,,366.53,85,,percent of total billed charges,,,,,,,,,379.46,88,,percent of total billed charges,,,,,,,,,329.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.8,22,,percent of total billed charges,,,392.4,91,,percent of total billed charges,,,409.65,95,,percent of total billed charges,,,357.9,83,,percent of total billed charges,,,357.9,83,,percent of total billed charges,,,,,,,,,,,,,,,357.9,83,,percent of total billed charges,,,409.65,95,,percent of total billed charges,,,388.09,90,,percent of total billed charges,,,388.09,90,,percent of total billed charges,,,353.59,82,,percent of total billed charges,,,388.09,90,,percent of total billed charges,,,366.53,85,,percent of total billed charges,,107.8,409.65,
ROPIVACAINE(NAROPIN)BAG 0.2%:200ML,32015031,CDM,J2795,HCPCS,250,RC,outpatient,,1122.56,1122.56,,953.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,280.64,22,,percent of total billed charges,,,,,,,,,1010.3,90,,percent of total billed charges,,,929.48,82.8,,percent of total billed charges,,,954.18,85,,percent of total billed charges,,,,,,,,,987.85,88,,percent of total billed charges,,13.8,,,,fee schedule,,,857.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.8,,,,fee schedule,,,280.64,22,,percent of total billed charges,,,1021.53,91,,percent of total billed charges,,,1066.43,95,,percent of total billed charges,,,931.72,83,,percent of total billed charges,,,931.72,83,,percent of total billed charges,,,,,,,,,,,,,,,931.72,83,,percent of total billed charges,,,1066.43,95,,percent of total billed charges,,,1010.3,90,,percent of total billed charges,,,1010.3,90,,percent of total billed charges,,,920.5,82,,percent of total billed charges,,,1010.3,90,,percent of total billed charges,,,954.18,85,,percent of total billed charges,,13.8,1066.43,
TETRACAINE SPINAL  AMP 1%: 2ML,32015056,CDM,J3490,HCPCS,250,RC,outpatient,,1070.52,1070.52,,908.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,267.63,22,,percent of total billed charges,,,,,,,,,963.47,90,,percent of total billed charges,,,886.39,82.8,,percent of total billed charges,,,909.94,85,,percent of total billed charges,,,,,,,,,942.06,88,,percent of total billed charges,,,,,,,,,817.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,267.63,22,,percent of total billed charges,,,974.17,91,,percent of total billed charges,,,1016.99,95,,percent of total billed charges,,,888.53,83,,percent of total billed charges,,,888.53,83,,percent of total billed charges,,,,,,,,,,,,,,,888.53,83,,percent of total billed charges,,,1016.99,95,,percent of total billed charges,,,963.47,90,,percent of total billed charges,,,963.47,90,,percent of total billed charges,,,877.83,82,,percent of total billed charges,,,963.47,90,,percent of total billed charges,,,909.94,85,,percent of total billed charges,,267.63,1016.99,
ROPIVACAINE(NAROPIN)AMP 0.5%:100MG/20ML,32015057,CDM,J2795,HCPCS,250,RC,outpatient,,248.2,248.2,,210.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.05,22,,percent of total billed charges,,,,,,,,,223.38,90,,percent of total billed charges,,,205.51,82.8,,percent of total billed charges,,,210.97,85,,percent of total billed charges,,,,,,,,,218.42,88,,percent of total billed charges,,13.8,,,,fee schedule,,,189.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13.8,,,,fee schedule,,,62.05,22,,percent of total billed charges,,,225.86,91,,percent of total billed charges,,,235.79,95,,percent of total billed charges,,,206.01,83,,percent of total billed charges,,,206.01,83,,percent of total billed charges,,,,,,,,,,,,,,,206.01,83,,percent of total billed charges,,,235.79,95,,percent of total billed charges,,,223.38,90,,percent of total billed charges,,,223.38,90,,percent of total billed charges,,,203.52,82,,percent of total billed charges,,,223.38,90,,percent of total billed charges,,,210.97,85,,percent of total billed charges,,13.8,235.79,
MORPHINE SULF VIAL:4MG/ML,32015088,CDM,,,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,,,,,,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,16.88,64.15,
MORPHINE SULF(ROXANOL)PO SOL :30MG/1.5ML,32015106,CDM,,,250,RC,outpatient,,16.39,16.39,,13.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.1,22,,percent of total billed charges,,,,,,,,,14.75,90,,percent of total billed charges,,,13.57,82.8,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,,,,,,,,14.42,88,,percent of total billed charges,,,,,,,,,12.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.1,22,,percent of total billed charges,,,14.91,91,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,13.6,83,,percent of total billed charges,,,,,,,,,,,,,,,13.6,83,,percent of total billed charges,,,15.57,95,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.44,82,,percent of total billed charges,,,14.75,90,,percent of total billed charges,,,13.93,85,,percent of total billed charges,,4.1,15.57,
DRONABINOL(MARINOL)CAP:5MG,32015107,CDM,Q0167,HCPCS,250,RC,outpatient,,129.42,129.42,,109.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,32.36,22,,percent of total billed charges,,,,,,,,,116.48,90,,percent of total billed charges,,,107.16,82.8,,percent of total billed charges,,,110.01,85,,percent of total billed charges,,,,,,,,,113.89,88,,percent of total billed charges,,,,,,,,,98.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,32.36,22,,percent of total billed charges,,,117.77,91,,percent of total billed charges,,,122.95,95,,percent of total billed charges,,,107.42,83,,percent of total billed charges,,,107.42,83,,percent of total billed charges,,,,,,,,,,,,,,,107.42,83,,percent of total billed charges,,,122.95,95,,percent of total billed charges,,,116.48,90,,percent of total billed charges,,,116.48,90,,percent of total billed charges,,,106.12,82,,percent of total billed charges,,,116.48,90,,percent of total billed charges,,,110.01,85,,percent of total billed charges,,32.36,122.95,
SORBITOL SOLUTION SOL 70% UD:30ML,32015204,CDM,J8499,HCPCS,250,RC,outpatient,,34.89,34.89,,29.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.72,22,,percent of total billed charges,,,,,,,,,31.4,90,,percent of total billed charges,,,28.89,82.8,,percent of total billed charges,,,29.66,85,,percent of total billed charges,,,,,,,,,30.7,88,,percent of total billed charges,,,,,,,,,26.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.72,22,,percent of total billed charges,,,31.75,91,,percent of total billed charges,,,33.15,95,,percent of total billed charges,,,28.96,83,,percent of total billed charges,,,28.96,83,,percent of total billed charges,,,,,,,,,,,,,,,28.96,83,,percent of total billed charges,,,33.15,95,,percent of total billed charges,,,31.4,90,,percent of total billed charges,,,31.4,90,,percent of total billed charges,,,28.61,82,,percent of total billed charges,,,31.4,90,,percent of total billed charges,,,29.66,85,,percent of total billed charges,,8.72,33.15,
GRANISETRON (KYTRIL)MDV:4MG/4ML,32015235,CDM,J1626,HCPCS,636,RC,outpatient,,106.42,106.42,,90.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.61,22,,percent of total billed charges,,,,,,,,,95.78,90,,percent of total billed charges,,,88.12,82.8,,percent of total billed charges,,,90.46,85,,percent of total billed charges,,,,,,,,,93.65,88,,percent of total billed charges,,7.72,,,,fee schedule,,,81.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.72,,,,fee schedule,,,26.61,22,,percent of total billed charges,,,96.84,91,,percent of total billed charges,,,101.1,95,,percent of total billed charges,,,88.33,83,,percent of total billed charges,,,88.33,83,,percent of total billed charges,,,,,,,,,,,,,,,88.33,83,,percent of total billed charges,,,101.1,95,,percent of total billed charges,,,95.78,90,,percent of total billed charges,,,95.78,90,,percent of total billed charges,,,87.26,82,,percent of total billed charges,,,95.78,90,,percent of total billed charges,,,90.46,85,,percent of total billed charges,,7.72,101.1,
BEVACIZUMAB(AVASTIN):400MG/16ML,32015368,CDM,J9035,HCPCS,636,RC,outpatient,,15062.18,15062.18,,12787.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3765.55,22,,percent of total billed charges,,,,,,,,,13555.96,90,,percent of total billed charges,,,12471.49,82.8,,percent of total billed charges,,,12802.85,85,,percent of total billed charges,,,,,,,,,13254.72,88,,percent of total billed charges,,13247.18,,,,fee schedule,,,11507.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,13247.18,,,,fee schedule,,,3765.55,22,,percent of total billed charges,,,13706.58,91,,percent of total billed charges,,,14309.07,95,,percent of total billed charges,,,12501.61,83,,percent of total billed charges,,,12501.61,83,,percent of total billed charges,,,,,,,,,,,,,,,12501.61,83,,percent of total billed charges,,,14309.07,95,,percent of total billed charges,,,13555.96,90,,percent of total billed charges,,,13555.96,90,,percent of total billed charges,,,12350.99,82,,percent of total billed charges,,,13555.96,90,,percent of total billed charges,,,12802.85,85,,percent of total billed charges,,3765.55,14309.07,
LIDOCAINE W/EPI 1.5% TEST DOSE AMP: 5ML,32015369,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
IPILIMUMAB(YERVOY)IV: 50MG/10ML,32015374,CDM,J9228,HCPCS,636,RC,outpatient,,33895.84,33895.84,,28777.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8473.96,22,,percent of total billed charges,,,,,,,,,30506.26,90,,percent of total billed charges,,,28065.76,82.8,,percent of total billed charges,,,28811.46,85,,percent of total billed charges,,,,,,,,,29828.34,88,,percent of total billed charges,,57086.4,,,,fee schedule,,,25896.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,57086.4,,,,fee schedule,,,8473.96,22,,percent of total billed charges,,,30845.21,91,,percent of total billed charges,,,32201.05,95,,percent of total billed charges,,,28133.55,83,,percent of total billed charges,,,28133.55,83,,percent of total billed charges,,,,,,,,,,,,,,,28133.55,83,,percent of total billed charges,,,32201.05,95,,percent of total billed charges,,,30506.26,90,,percent of total billed charges,,,30506.26,90,,percent of total billed charges,,,27794.59,82,,percent of total billed charges,,,30506.26,90,,percent of total billed charges,,,28811.46,85,,percent of total billed charges,,8473.96,57086.4,
APREPITANT(CINVANTI)VL:130MG/18ML,32015376,CDM,J0185,HCPCS,636,RC,outpatient,,2901.54,2901.54,,2463.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,725.39,22,,percent of total billed charges,,,,,,,,,2611.39,90,,percent of total billed charges,,,2402.48,82.8,,percent of total billed charges,,,2466.31,85,,percent of total billed charges,,,,,,,,,2553.36,88,,percent of total billed charges,,218.66,,,,fee schedule,,,2216.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,218.66,,,,fee schedule,,,725.39,22,,percent of total billed charges,,,2640.4,91,,percent of total billed charges,,,2756.46,95,,percent of total billed charges,,,2408.28,83,,percent of total billed charges,,,2408.28,83,,percent of total billed charges,,,,,,,,,,,,,,,2408.28,83,,percent of total billed charges,,,2756.46,95,,percent of total billed charges,,,2611.39,90,,percent of total billed charges,,,2611.39,90,,percent of total billed charges,,,2379.26,82,,percent of total billed charges,,,2611.39,90,,percent of total billed charges,,,2466.31,85,,percent of total billed charges,,218.66,2756.46,
DOXOrubicin LIPOSOMAL VIAL: 50MG/25ML,32015456,CDM,Q2050,HCPCS,636,RC,outpatient,,10356.44,10356.44,,8792.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2589.11,22,,percent of total billed charges,,,,,,,,,9320.8,90,,percent of total billed charges,,,8575.13,82.8,,percent of total billed charges,,,8802.97,85,,percent of total billed charges,,,,,,,,,9113.67,88,,percent of total billed charges,,1455.81,,,,fee schedule,,,7912.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1455.81,,,,fee schedule,,,2589.11,22,,percent of total billed charges,,,9424.36,91,,percent of total billed charges,,,9838.62,95,,percent of total billed charges,,,8595.85,83,,percent of total billed charges,,,8595.85,83,,percent of total billed charges,,,,,,,,,,,,,,,8595.85,83,,percent of total billed charges,,,9838.62,95,,percent of total billed charges,,,9320.8,90,,percent of total billed charges,,,9320.8,90,,percent of total billed charges,,,8492.28,82,,percent of total billed charges,,,9320.8,90,,percent of total billed charges,,,8802.97,85,,percent of total billed charges,,1455.81,9838.62,
DOXOrubicin LIPOSOMAL VIAL: 20MG/10ML,32015457,CDM,Q2050,HCPCS,636,RC,outpatient,,6738.57,6738.57,,5721.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1684.64,22,,percent of total billed charges,,,,,,,,,6064.71,90,,percent of total billed charges,,,5579.54,82.8,,percent of total billed charges,,,5727.78,85,,percent of total billed charges,,,,,,,,,5929.94,88,,percent of total billed charges,,1455.81,,,,fee schedule,,,5148.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1455.81,,,,fee schedule,,,1684.64,22,,percent of total billed charges,,,6132.1,91,,percent of total billed charges,,,6401.64,95,,percent of total billed charges,,,5593.01,83,,percent of total billed charges,,,5593.01,83,,percent of total billed charges,,,,,,,,,,,,,,,5593.01,83,,percent of total billed charges,,,6401.64,95,,percent of total billed charges,,,6064.71,90,,percent of total billed charges,,,6064.71,90,,percent of total billed charges,,,5525.63,82,,percent of total billed charges,,,6064.71,90,,percent of total billed charges,,,5727.78,85,,percent of total billed charges,,1455.81,6401.64,
HYDROmorphone (DILAUDID) VIAL:1MG/ML,32015489,CDM,J1170,HCPCS,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,3.47,,,,fee schedule,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.47,,,,fee schedule,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,3.47,64.15,
VALSARTAN(DIOVAN)TAB:160MG,32015493,CDM,,,250,RC,outpatient,,14.75,14.75,,12.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.69,22,,percent of total billed charges,,,,,,,,,13.28,90,,percent of total billed charges,,,12.21,82.8,,percent of total billed charges,,,12.54,85,,percent of total billed charges,,,,,,,,,12.98,88,,percent of total billed charges,,,,,,,,,11.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.69,22,,percent of total billed charges,,,13.42,91,,percent of total billed charges,,,14.01,95,,percent of total billed charges,,,12.24,83,,percent of total billed charges,,,12.24,83,,percent of total billed charges,,,,,,,,,,,,,,,12.24,83,,percent of total billed charges,,,14.01,95,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,12.1,82,,percent of total billed charges,,,13.28,90,,percent of total billed charges,,,12.54,85,,percent of total billed charges,,3.69,14.01,
BECLOMETH DIPROP(QVAR) HFA:40MCG(10.6GM),32015537,CDM,J7622,HCPCS,250,RC,outpatient,,2858.79,2858.79,,2427.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,714.7,22,,percent of total billed charges,,,,,,,,,2572.91,90,,percent of total billed charges,,,2367.08,82.8,,percent of total billed charges,,,2429.97,85,,percent of total billed charges,,,,,,,,,2515.74,88,,percent of total billed charges,,,,,,,,,2184.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,714.7,22,,percent of total billed charges,,,2601.5,91,,percent of total billed charges,,,2715.85,95,,percent of total billed charges,,,2372.8,83,,percent of total billed charges,,,2372.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2372.8,83,,percent of total billed charges,,,2715.85,95,,percent of total billed charges,,,2572.91,90,,percent of total billed charges,,,2572.91,90,,percent of total billed charges,,,2344.21,82,,percent of total billed charges,,,2572.91,90,,percent of total billed charges,,,2429.97,85,,percent of total billed charges,,714.7,2715.85,
LIDOCAINE HCL 2% VIAL:(20MG/ML) (2ML),32015564,CDM,J2001,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
LIDOCAINE HCL 2% VIAL:(20MG/ML) (10ML),32015682,CDM,J2001,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
IRINOTECAN(CAMPTOSAR):300MG/15ML,32015730,CDM,J9206,HCPCS,636,RC,outpatient,,894.34,894.34,,759.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,223.59,22,,percent of total billed charges,,,,,,,,,804.91,90,,percent of total billed charges,,,740.51,82.8,,percent of total billed charges,,,760.19,85,,percent of total billed charges,,,,,,,,,787.02,88,,percent of total billed charges,,114.58,,,,fee schedule,,,683.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,114.58,,,,fee schedule,,,223.59,22,,percent of total billed charges,,,813.85,91,,percent of total billed charges,,,849.62,95,,percent of total billed charges,,,742.3,83,,percent of total billed charges,,,742.3,83,,percent of total billed charges,,,,,,,,,,,,,,,742.3,83,,percent of total billed charges,,,849.62,95,,percent of total billed charges,,,804.91,90,,percent of total billed charges,,,804.91,90,,percent of total billed charges,,,733.36,82,,percent of total billed charges,,,804.91,90,,percent of total billed charges,,,760.19,85,,percent of total billed charges,,114.58,849.62,
OCTREOTIDE ACETATE (SANDOSTATIN): 30MG,32015753,CDM,J2353,HCPCS,636,RC,outpatient,,28008.9,28008.9,,23779.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7002.23,22,,percent of total billed charges,,,,,,,,,25208.01,90,,percent of total billed charges,,,23191.37,82.8,,percent of total billed charges,,,23807.57,85,,percent of total billed charges,,,,,,,,,24647.83,88,,percent of total billed charges,,8278.44,,,,fee schedule,,,21398.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8278.44,,,,fee schedule,,,7002.23,22,,percent of total billed charges,,,25488.1,91,,percent of total billed charges,,,26608.46,95,,percent of total billed charges,,,23247.39,83,,percent of total billed charges,,,23247.39,83,,percent of total billed charges,,,,,,,,,,,,,,,23247.39,83,,percent of total billed charges,,,26608.46,95,,percent of total billed charges,,,25208.01,90,,percent of total billed charges,,,25208.01,90,,percent of total billed charges,,,22967.3,82,,percent of total billed charges,,,25208.01,90,,percent of total billed charges,,,23807.57,85,,percent of total billed charges,,7002.23,26608.46,
MORPHINE SULF VIAL:2MG/ML,32015790,CDM,,,250,RC,outpatient,,67.53,67.53,,57.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.88,22,,percent of total billed charges,,,,,,,,,60.78,90,,percent of total billed charges,,,55.91,82.8,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,,,,,,,,59.43,88,,percent of total billed charges,,,,,,,,,51.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.88,22,,percent of total billed charges,,,61.45,91,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,56.05,83,,percent of total billed charges,,,,,,,,,,,,,,,56.05,83,,percent of total billed charges,,,64.15,95,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,55.37,82,,percent of total billed charges,,,60.78,90,,percent of total billed charges,,,57.4,85,,percent of total billed charges,,16.88,64.15,
SACUBITRIL/VALSARTA(ENTRESTO)TAB:24/26MG,32015810,CDM,J8499,HCPCS,250,RC,outpatient,,173.86,173.86,,147.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.47,22,,percent of total billed charges,,,,,,,,,156.47,90,,percent of total billed charges,,,143.96,82.8,,percent of total billed charges,,,147.78,85,,percent of total billed charges,,,,,,,,,153,88,,percent of total billed charges,,,,,,,,,132.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.47,22,,percent of total billed charges,,,158.21,91,,percent of total billed charges,,,165.17,95,,percent of total billed charges,,,144.3,83,,percent of total billed charges,,,144.3,83,,percent of total billed charges,,,,,,,,,,,,,,,144.3,83,,percent of total billed charges,,,165.17,95,,percent of total billed charges,,,156.47,90,,percent of total billed charges,,,156.47,90,,percent of total billed charges,,,142.57,82,,percent of total billed charges,,,156.47,90,,percent of total billed charges,,,147.78,85,,percent of total billed charges,,43.47,165.17,
SACUBITRIL/VALSARTA(ENTRESTO)TAB:49/51MG,32015811,CDM,J8499,HCPCS,250,RC,outpatient,,172.88,172.88,,146.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.22,22,,percent of total billed charges,,,,,,,,,155.59,90,,percent of total billed charges,,,143.14,82.8,,percent of total billed charges,,,146.95,85,,percent of total billed charges,,,,,,,,,152.13,88,,percent of total billed charges,,,,,,,,,132.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.22,22,,percent of total billed charges,,,157.32,91,,percent of total billed charges,,,164.24,95,,percent of total billed charges,,,143.49,83,,percent of total billed charges,,,143.49,83,,percent of total billed charges,,,,,,,,,,,,,,,143.49,83,,percent of total billed charges,,,164.24,95,,percent of total billed charges,,,155.59,90,,percent of total billed charges,,,155.59,90,,percent of total billed charges,,,141.76,82,,percent of total billed charges,,,155.59,90,,percent of total billed charges,,,146.95,85,,percent of total billed charges,,43.22,164.24,
SACUBITRIL/VALSART(ENTRESTO)TAB:97/103MG,32015812,CDM,J8499,HCPCS,250,RC,outpatient,,161.6,161.6,,137.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.4,22,,percent of total billed charges,,,,,,,,,145.44,90,,percent of total billed charges,,,133.8,82.8,,percent of total billed charges,,,137.36,85,,percent of total billed charges,,,,,,,,,142.21,88,,percent of total billed charges,,,,,,,,,123.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.4,22,,percent of total billed charges,,,147.06,91,,percent of total billed charges,,,153.52,95,,percent of total billed charges,,,134.13,83,,percent of total billed charges,,,134.13,83,,percent of total billed charges,,,,,,,,,,,,,,,134.13,83,,percent of total billed charges,,,153.52,95,,percent of total billed charges,,,145.44,90,,percent of total billed charges,,,145.44,90,,percent of total billed charges,,,132.51,82,,percent of total billed charges,,,145.44,90,,percent of total billed charges,,,137.36,85,,percent of total billed charges,,40.4,153.52,
FLUZONE HIGH DOSE (2018-2019)SYR:0.5ML,32015818,CDM,90662,CPT,636,RC,outpatient,,743.2,743.2,,630.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,185.8,22,,percent of total billed charges,,,,,,,,,668.88,90,,percent of total billed charges,,,615.37,82.8,,percent of total billed charges,,,631.72,85,,percent of total billed charges,,,,,,,,,654.02,88,,percent of total billed charges,,,,,,,,,567.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,185.8,22,,percent of total billed charges,,,676.31,91,,percent of total billed charges,,,706.04,95,,percent of total billed charges,,,616.86,83,,percent of total billed charges,,,616.86,83,,percent of total billed charges,,,,,,,,,,,,,,,616.86,83,,percent of total billed charges,,,706.04,95,,percent of total billed charges,,,668.88,90,,percent of total billed charges,,,668.88,90,,percent of total billed charges,,,609.42,82,,percent of total billed charges,,,668.88,90,,percent of total billed charges,,,631.72,85,,percent of total billed charges,,185.8,706.04,
FLUZONE QUAD(2018-2019)SYR:0.5ML,32015819,CDM,90686,CPT,636,RC,outpatient,,277.07,277.07,,235.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.27,22,,percent of total billed charges,,,,,,,,,249.36,90,,percent of total billed charges,,,229.41,82.8,,percent of total billed charges,,,235.51,85,,percent of total billed charges,,,,,,,,,243.82,88,,percent of total billed charges,,,,,,,,,211.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.27,22,,percent of total billed charges,,,252.13,91,,percent of total billed charges,,,263.22,95,,percent of total billed charges,,,229.97,83,,percent of total billed charges,,,229.97,83,,percent of total billed charges,,,,,,,,,,,,,,,229.97,83,,percent of total billed charges,,,263.22,95,,percent of total billed charges,,,249.36,90,,percent of total billed charges,,,249.36,90,,percent of total billed charges,,,227.2,82,,percent of total billed charges,,,249.36,90,,percent of total billed charges,,,235.51,85,,percent of total billed charges,,69.27,263.22,
LIDOCAINE 4% (LARYNG-O-JET) TOP SOL:4ML,32015827,CDM,J3490,HCPCS,250,RC,outpatient,,477.94,477.94,,405.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.49,22,,percent of total billed charges,,,,,,,,,430.15,90,,percent of total billed charges,,,395.73,82.8,,percent of total billed charges,,,406.25,85,,percent of total billed charges,,,,,,,,,420.59,88,,percent of total billed charges,,,,,,,,,365.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.49,22,,percent of total billed charges,,,434.93,91,,percent of total billed charges,,,454.04,95,,percent of total billed charges,,,396.69,83,,percent of total billed charges,,,396.69,83,,percent of total billed charges,,,,,,,,,,,,,,,396.69,83,,percent of total billed charges,,,454.04,95,,percent of total billed charges,,,430.15,90,,percent of total billed charges,,,430.15,90,,percent of total billed charges,,,391.91,82,,percent of total billed charges,,,430.15,90,,percent of total billed charges,,,406.25,85,,percent of total billed charges,,119.49,454.04,
RIFAXIMIN(XIFAXAN)TAB:550MG,32015863,CDM,J8499,HCPCS,250,RC,outpatient,,720.65,720.65,,611.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,180.16,22,,percent of total billed charges,,,,,,,,,648.59,90,,percent of total billed charges,,,596.7,82.8,,percent of total billed charges,,,612.55,85,,percent of total billed charges,,,,,,,,,634.17,88,,percent of total billed charges,,,,,,,,,550.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,180.16,22,,percent of total billed charges,,,655.79,91,,percent of total billed charges,,,684.62,95,,percent of total billed charges,,,598.14,83,,percent of total billed charges,,,598.14,83,,percent of total billed charges,,,,,,,,,,,,,,,598.14,83,,percent of total billed charges,,,684.62,95,,percent of total billed charges,,,648.59,90,,percent of total billed charges,,,648.59,90,,percent of total billed charges,,,590.93,82,,percent of total billed charges,,,648.59,90,,percent of total billed charges,,,612.55,85,,percent of total billed charges,,180.16,684.62,
DEXTROSE(GLUCOSE) 40% GEL:  15GM/30ML,32015924,CDM,J8499,HCPCS,250,RC,outpatient,,19.61,19.61,,16.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4.9,22,,percent of total billed charges,,,,,,,,,17.65,90,,percent of total billed charges,,,16.24,82.8,,percent of total billed charges,,,16.67,85,,percent of total billed charges,,,,,,,,,17.26,88,,percent of total billed charges,,,,,,,,,14.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4.9,22,,percent of total billed charges,,,17.85,91,,percent of total billed charges,,,18.63,95,,percent of total billed charges,,,16.28,83,,percent of total billed charges,,,16.28,83,,percent of total billed charges,,,,,,,,,,,,,,,16.28,83,,percent of total billed charges,,,18.63,95,,percent of total billed charges,,,17.65,90,,percent of total billed charges,,,17.65,90,,percent of total billed charges,,,16.08,82,,percent of total billed charges,,,17.65,90,,percent of total billed charges,,,16.67,85,,percent of total billed charges,,4.9,18.63,
FACTOR VIII (HUMATE-P): 2092 UNITS,32015994,CDM,J7187,HCPCS,636,RC,outpatient,,8896.23,8896.23,,7552.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2224.06,22,,percent of total billed charges,,,,,,,,,8006.61,90,,percent of total billed charges,,,7366.08,82.8,,percent of total billed charges,,,7561.8,85,,percent of total billed charges,,,,,,,,,7828.68,88,,percent of total billed charges,,12958.7,,,,fee schedule,,,6796.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,12958.7,,,,fee schedule,,,2224.06,22,,percent of total billed charges,,,8095.57,91,,percent of total billed charges,,,8451.42,95,,percent of total billed charges,,,7383.87,83,,percent of total billed charges,,,7383.87,83,,percent of total billed charges,,,,,,,,,,,,,,,7383.87,83,,percent of total billed charges,,,8451.42,95,,percent of total billed charges,,,8006.61,90,,percent of total billed charges,,,8006.61,90,,percent of total billed charges,,,7294.91,82,,percent of total billed charges,,,8006.61,90,,percent of total billed charges,,,7561.8,85,,percent of total billed charges,,2224.06,12958.7,
FACTOR VIII (HUMATE-P): 461 UNITS,32015995,CDM,J7187,HCPCS,636,RC,outpatient,,6074.72,6074.72,,5157.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1518.68,22,,percent of total billed charges,,,,,,,,,5467.25,90,,percent of total billed charges,,,5029.87,82.8,,percent of total billed charges,,,5163.51,85,,percent of total billed charges,,,,,,,,,5345.75,88,,percent of total billed charges,,12958.7,,,,fee schedule,,,4641.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,12958.7,,,,fee schedule,,,1518.68,22,,percent of total billed charges,,,5528,91,,percent of total billed charges,,,5770.98,95,,percent of total billed charges,,,5042.02,83,,percent of total billed charges,,,5042.02,83,,percent of total billed charges,,,,,,,,,,,,,,,5042.02,83,,percent of total billed charges,,,5770.98,95,,percent of total billed charges,,,5467.25,90,,percent of total billed charges,,,5467.25,90,,percent of total billed charges,,,4981.27,82,,percent of total billed charges,,,5467.25,90,,percent of total billed charges,,,5163.51,85,,percent of total billed charges,,1518.68,12958.7,
ELEVIEW SUBMUCOSAL INJ:  10ML,32016084,CDM,J3490,HCPCS,250,RC,outpatient,,1411.4,1411.4,,1198.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,352.85,22,,percent of total billed charges,,,,,,,,,1270.26,90,,percent of total billed charges,,,1168.64,82.8,,percent of total billed charges,,,1199.69,85,,percent of total billed charges,,,,,,,,,1242.03,88,,percent of total billed charges,,,,,,,,,1078.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,352.85,22,,percent of total billed charges,,,1284.37,91,,percent of total billed charges,,,1340.83,95,,percent of total billed charges,,,1171.46,83,,percent of total billed charges,,,1171.46,83,,percent of total billed charges,,,,,,,,,,,,,,,1171.46,83,,percent of total billed charges,,,1340.83,95,,percent of total billed charges,,,1270.26,90,,percent of total billed charges,,,1270.26,90,,percent of total billed charges,,,1157.35,82,,percent of total billed charges,,,1270.26,90,,percent of total billed charges,,,1199.69,85,,percent of total billed charges,,352.85,1340.83,
BACTERIOSTATIC WATER FOR INJ VIAL: 30ML,32016222,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
GOLIMUMAB (SIMPONI) VIAL: 50MG/4ML,32016223,CDM,J1602,HCPCS,636,RC,outpatient,,8838.72,8838.72,,7504.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2209.68,22,,percent of total billed charges,,,,,,,,,7954.85,90,,percent of total billed charges,,,7318.46,82.8,,percent of total billed charges,,,7512.91,85,,percent of total billed charges,,,,,,,,,7778.07,88,,percent of total billed charges,,,,,,,,,6752.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2209.68,22,,percent of total billed charges,,,8043.24,91,,percent of total billed charges,,,8396.78,95,,percent of total billed charges,,,7336.14,83,,percent of total billed charges,,,7336.14,83,,percent of total billed charges,,,,,,,,,,,,,,,7336.14,83,,percent of total billed charges,,,8396.78,95,,percent of total billed charges,,,7954.85,90,,percent of total billed charges,,,7954.85,90,,percent of total billed charges,,,7247.75,82,,percent of total billed charges,,,7954.85,90,,percent of total billed charges,,,7512.91,85,,percent of total billed charges,,2209.68,8396.78,
KADCYLA (ADO-TRASTUZUMAB) VIAL 160MG,32016258,CDM,J9354,HCPCS,636,RC,outpatient,,26563.36,26563.36,,22552.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6640.84,22,,percent of total billed charges,,,,,,,,,23907.02,90,,percent of total billed charges,,,21994.46,82.8,,percent of total billed charges,,,22578.86,85,,percent of total billed charges,,,,,,,,,23375.76,88,,percent of total billed charges,,14278,,,,fee schedule,,,20294.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14278,,,,fee schedule,,,6640.84,22,,percent of total billed charges,,,24172.66,91,,percent of total billed charges,,,25235.19,95,,percent of total billed charges,,,22047.59,83,,percent of total billed charges,,,22047.59,83,,percent of total billed charges,,,,,,,,,,,,,,,22047.59,83,,percent of total billed charges,,,25235.19,95,,percent of total billed charges,,,23907.02,90,,percent of total billed charges,,,23907.02,90,,percent of total billed charges,,,21781.96,82,,percent of total billed charges,,,23907.02,90,,percent of total billed charges,,,22578.86,85,,percent of total billed charges,,6640.84,25235.19,
CARFLIZOMIB (KYPROLIS) VIAL 60MG,32016302,CDM,J9047,HCPCS,636,RC,outpatient,,10969.83,10969.83,,9313.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2742.46,22,,percent of total billed charges,,,,,,,,,9872.85,90,,percent of total billed charges,,,9083.02,82.8,,percent of total billed charges,,,9324.36,85,,percent of total billed charges,,,,,,,,,9653.45,88,,percent of total billed charges,,7044.32,,,,fee schedule,,,8380.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7044.32,,,,fee schedule,,,2742.46,22,,percent of total billed charges,,,9982.55,91,,percent of total billed charges,,,10421.34,95,,percent of total billed charges,,,9104.96,83,,percent of total billed charges,,,9104.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9104.96,83,,percent of total billed charges,,,10421.34,95,,percent of total billed charges,,,9872.85,90,,percent of total billed charges,,,9872.85,90,,percent of total billed charges,,,8995.26,82,,percent of total billed charges,,,9872.85,90,,percent of total billed charges,,,9324.36,85,,percent of total billed charges,,2742.46,10421.34,
CARFLIZOMIB (KYPROLIS) VIAL 10MG,32016303,CDM,J9047,HCPCS,636,RC,outpatient,,2974.04,2974.04,,2524.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,743.51,22,,percent of total billed charges,,,,,,,,,2676.64,90,,percent of total billed charges,,,2462.51,82.8,,percent of total billed charges,,,2527.93,85,,percent of total billed charges,,,,,,,,,2617.16,88,,percent of total billed charges,,7044.32,,,,fee schedule,,,2272.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7044.32,,,,fee schedule,,,743.51,22,,percent of total billed charges,,,2706.38,91,,percent of total billed charges,,,2825.34,95,,percent of total billed charges,,,2468.45,83,,percent of total billed charges,,,2468.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2468.45,83,,percent of total billed charges,,,2825.34,95,,percent of total billed charges,,,2676.64,90,,percent of total billed charges,,,2676.64,90,,percent of total billed charges,,,2438.71,82,,percent of total billed charges,,,2676.64,90,,percent of total billed charges,,,2527.93,85,,percent of total billed charges,,743.51,7044.32,
IMMUNE GLOBULIN(GAMUNEX-C)SDV:40GM/400ML,32016350,CDM,J1561,HCPCS,636,RC,outpatient,,18170.46,18170.46,,15426.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4542.62,22,,percent of total billed charges,,,,,,,,,16353.41,90,,percent of total billed charges,,,15045.14,82.8,,percent of total billed charges,,,15444.89,85,,percent of total billed charges,,,,,,,,,15990,88,,percent of total billed charges,,11167,,,,fee schedule,,,13882.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11167,,,,fee schedule,,,4542.62,22,,percent of total billed charges,,,16535.12,91,,percent of total billed charges,,,17261.94,95,,percent of total billed charges,,,15081.48,83,,percent of total billed charges,,,15081.48,83,,percent of total billed charges,,,,,,,,,,,,,,,15081.48,83,,percent of total billed charges,,,17261.94,95,,percent of total billed charges,,,16353.41,90,,percent of total billed charges,,,16353.41,90,,percent of total billed charges,,,14899.78,82,,percent of total billed charges,,,16353.41,90,,percent of total billed charges,,,15444.89,85,,percent of total billed charges,,4542.62,17261.94,
EPINEPHrine VIAL:1MG/ML,32016434,CDM,J0171,HCPCS,250,RC,outpatient,,252.78,252.78,,214.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.2,22,,percent of total billed charges,,,,,,,,,227.5,90,,percent of total billed charges,,,209.3,82.8,,percent of total billed charges,,,214.86,85,,percent of total billed charges,,,,,,,,,222.45,88,,percent of total billed charges,,7.28,,,,fee schedule,,,193.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7.28,,,,fee schedule,,,63.2,22,,percent of total billed charges,,,230.03,91,,percent of total billed charges,,,240.14,95,,percent of total billed charges,,,209.81,83,,percent of total billed charges,,,209.81,83,,percent of total billed charges,,,,,,,,,,,,,,,209.81,83,,percent of total billed charges,,,240.14,95,,percent of total billed charges,,,227.5,90,,percent of total billed charges,,,227.5,90,,percent of total billed charges,,,207.28,82,,percent of total billed charges,,,227.5,90,,percent of total billed charges,,,214.86,85,,percent of total billed charges,,7.28,240.14,
IMMUNE GLOBULIN(GAMUNEX-C)SDV:5GM/50ML,32016457,CDM,J1561,HCPCS,636,RC,outpatient,,3805.74,3805.74,,3231.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,951.44,22,,percent of total billed charges,,,,,,,,,3425.17,90,,percent of total billed charges,,,3151.15,82.8,,percent of total billed charges,,,3234.88,85,,percent of total billed charges,,,,,,,,,3349.05,88,,percent of total billed charges,,11167,,,,fee schedule,,,2907.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11167,,,,fee schedule,,,951.44,22,,percent of total billed charges,,,3463.22,91,,percent of total billed charges,,,3615.45,95,,percent of total billed charges,,,3158.76,83,,percent of total billed charges,,,3158.76,83,,percent of total billed charges,,,,,,,,,,,,,,,3158.76,83,,percent of total billed charges,,,3615.45,95,,percent of total billed charges,,,3425.17,90,,percent of total billed charges,,,3425.17,90,,percent of total billed charges,,,3120.71,82,,percent of total billed charges,,,3425.17,90,,percent of total billed charges,,,3234.88,85,,percent of total billed charges,,951.44,11167,
EPINEPHrine 0.3MG/NS30ML - JAGASIA LOCAL,32016516,CDM,,,258,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
BLEOMYCIN VIAL: 15 UNITS,32016553,CDM,J9040,HCPCS,636,RC,outpatient,,334.49,334.49,,283.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.62,22,,percent of total billed charges,,,,,,,,,301.04,90,,percent of total billed charges,,,276.96,82.8,,percent of total billed charges,,,284.32,85,,percent of total billed charges,,,,,,,,,294.35,88,,percent of total billed charges,,97.2,,,,fee schedule,,,255.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,97.2,,,,fee schedule,,,83.62,22,,percent of total billed charges,,,304.39,91,,percent of total billed charges,,,317.77,95,,percent of total billed charges,,,277.63,83,,percent of total billed charges,,,277.63,83,,percent of total billed charges,,,,,,,,,,,,,,,277.63,83,,percent of total billed charges,,,317.77,95,,percent of total billed charges,,,301.04,90,,percent of total billed charges,,,301.04,90,,percent of total billed charges,,,274.28,82,,percent of total billed charges,,,301.04,90,,percent of total billed charges,,,284.32,85,,percent of total billed charges,,83.62,317.77,
KETAMINE(KETALAR) VIAL:200MG/20ML,32016586,CDM,J3490,HCPCS,250,RC,outpatient,,334.32,334.32,,283.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.58,22,,percent of total billed charges,,,,,,,,,300.89,90,,percent of total billed charges,,,276.82,82.8,,percent of total billed charges,,,284.17,85,,percent of total billed charges,,,,,,,,,294.2,88,,percent of total billed charges,,,,,,,,,255.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.58,22,,percent of total billed charges,,,304.23,91,,percent of total billed charges,,,317.6,95,,percent of total billed charges,,,277.49,83,,percent of total billed charges,,,277.49,83,,percent of total billed charges,,,,,,,,,,,,,,,277.49,83,,percent of total billed charges,,,317.6,95,,percent of total billed charges,,,300.89,90,,percent of total billed charges,,,300.89,90,,percent of total billed charges,,,274.14,82,,percent of total billed charges,,,300.89,90,,percent of total billed charges,,,284.17,85,,percent of total billed charges,,83.58,317.6,
DEFEROXAMINE (DESFERAL)VIAL 500MG,32016620,CDM,J0895,HCPCS,636,RC,outpatient,,551.61,551.61,,468.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,137.9,22,,percent of total billed charges,,,,,,,,,496.45,90,,percent of total billed charges,,,456.73,82.8,,percent of total billed charges,,,468.87,85,,percent of total billed charges,,,,,,,,,485.42,88,,percent of total billed charges,,31.71,,,,fee schedule,,,421.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,31.71,,,,fee schedule,,,137.9,22,,percent of total billed charges,,,501.97,91,,percent of total billed charges,,,524.03,95,,percent of total billed charges,,,457.84,83,,percent of total billed charges,,,457.84,83,,percent of total billed charges,,,,,,,,,,,,,,,457.84,83,,percent of total billed charges,,,524.03,95,,percent of total billed charges,,,496.45,90,,percent of total billed charges,,,496.45,90,,percent of total billed charges,,,452.32,82,,percent of total billed charges,,,496.45,90,,percent of total billed charges,,,468.87,85,,percent of total billed charges,,31.71,524.03,
MISOPROSTOL(CYTOTEC)TAB:200MCG,32016625,CDM,J8499,HCPCS,250,RC,outpatient,,15.36,15.36,,13.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.84,22,,percent of total billed charges,,,,,,,,,13.82,90,,percent of total billed charges,,,12.72,82.8,,percent of total billed charges,,,13.06,85,,percent of total billed charges,,,,,,,,,13.52,88,,percent of total billed charges,,,,,,,,,11.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.84,22,,percent of total billed charges,,,13.98,91,,percent of total billed charges,,,14.59,95,,percent of total billed charges,,,12.75,83,,percent of total billed charges,,,12.75,83,,percent of total billed charges,,,,,,,,,,,,,,,12.75,83,,percent of total billed charges,,,14.59,95,,percent of total billed charges,,,13.82,90,,percent of total billed charges,,,13.82,90,,percent of total billed charges,,,12.6,82,,percent of total billed charges,,,13.82,90,,percent of total billed charges,,,13.06,85,,percent of total billed charges,,3.84,14.59,
BUPRENORPHINE(BUPRENEX)AMP:0.3MG/ML,32016656,CDM,J0592,HCPCS,250,RC,outpatient,,252.45,252.45,,214.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.11,22,,percent of total billed charges,,,,,,,,,227.21,90,,percent of total billed charges,,,209.03,82.8,,percent of total billed charges,,,214.58,85,,percent of total billed charges,,,,,,,,,222.16,88,,percent of total billed charges,,,,,,,,,192.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.11,22,,percent of total billed charges,,,229.73,91,,percent of total billed charges,,,239.83,95,,percent of total billed charges,,,209.53,83,,percent of total billed charges,,,209.53,83,,percent of total billed charges,,,,,,,,,,,,,,,209.53,83,,percent of total billed charges,,,239.83,95,,percent of total billed charges,,,227.21,90,,percent of total billed charges,,,227.21,90,,percent of total billed charges,,,207.01,82,,percent of total billed charges,,,227.21,90,,percent of total billed charges,,,214.58,85,,percent of total billed charges,,63.11,239.83,
IMMUNE GLOBULIN(GAMUNEX-C)SDV:1GM/10ML,32016675,CDM,J1561,HCPCS,636,RC,outpatient,,1291.32,1291.32,,1096.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,322.83,22,,percent of total billed charges,,,,,,,,,1162.19,90,,percent of total billed charges,,,1069.21,82.8,,percent of total billed charges,,,1097.62,85,,percent of total billed charges,,,,,,,,,1136.36,88,,percent of total billed charges,,11167,,,,fee schedule,,,986.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11167,,,,fee schedule,,,322.83,22,,percent of total billed charges,,,1175.1,91,,percent of total billed charges,,,1226.75,95,,percent of total billed charges,,,1071.8,83,,percent of total billed charges,,,1071.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1071.8,83,,percent of total billed charges,,,1226.75,95,,percent of total billed charges,,,1162.19,90,,percent of total billed charges,,,1162.19,90,,percent of total billed charges,,,1058.88,82,,percent of total billed charges,,,1162.19,90,,percent of total billed charges,,,1097.62,85,,percent of total billed charges,,322.83,11167,
NIVOLUMAB(OPDIVO)40MG/4ML,32016677,CDM,J9299,HCPCS,636,RC,outpatient,,5030.06,5030.06,,4270.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1257.52,22,,percent of total billed charges,,,,,,,,,4527.05,90,,percent of total billed charges,,,4164.89,82.8,,percent of total billed charges,,,4275.55,85,,percent of total billed charges,,,,,,,,,4426.45,88,,percent of total billed charges,,14182.56,,,,fee schedule,,,3842.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14182.56,,,,fee schedule,,,1257.52,22,,percent of total billed charges,,,4577.35,91,,percent of total billed charges,,,4778.56,95,,percent of total billed charges,,,4174.95,83,,percent of total billed charges,,,4174.95,83,,percent of total billed charges,,,,,,,,,,,,,,,4174.95,83,,percent of total billed charges,,,4778.56,95,,percent of total billed charges,,,4527.05,90,,percent of total billed charges,,,4527.05,90,,percent of total billed charges,,,4124.65,82,,percent of total billed charges,,,4527.05,90,,percent of total billed charges,,,4275.55,85,,percent of total billed charges,,1257.52,14182.56,
IMMUNE GLOBULIN(GAMUNEX-C)SDV:10GM/100ML,32016754,CDM,J1561,HCPCS,636,RC,outpatient,,4542.62,4542.62,,3856.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1135.66,22,,percent of total billed charges,,,,,,,,,4088.36,90,,percent of total billed charges,,,3761.29,82.8,,percent of total billed charges,,,3861.23,85,,percent of total billed charges,,,,,,,,,3997.51,88,,percent of total billed charges,,11167,,,,fee schedule,,,3470.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11167,,,,fee schedule,,,1135.66,22,,percent of total billed charges,,,4133.78,91,,percent of total billed charges,,,4315.49,95,,percent of total billed charges,,,3770.37,83,,percent of total billed charges,,,3770.37,83,,percent of total billed charges,,,,,,,,,,,,,,,3770.37,83,,percent of total billed charges,,,4315.49,95,,percent of total billed charges,,,4088.36,90,,percent of total billed charges,,,4088.36,90,,percent of total billed charges,,,3724.95,82,,percent of total billed charges,,,4088.36,90,,percent of total billed charges,,,3861.23,85,,percent of total billed charges,,1135.66,11167,
ERYTHROMYCIN BASE OPTH OINT:0.5% 3.5GM,32016768,CDM,J3490,HCPCS,250,RC,outpatient,,236.79,236.79,,201.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.2,22,,percent of total billed charges,,,,,,,,,213.11,90,,percent of total billed charges,,,196.06,82.8,,percent of total billed charges,,,201.27,85,,percent of total billed charges,,,,,,,,,208.38,88,,percent of total billed charges,,,,,,,,,180.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.2,22,,percent of total billed charges,,,215.48,91,,percent of total billed charges,,,224.95,95,,percent of total billed charges,,,196.54,83,,percent of total billed charges,,,196.54,83,,percent of total billed charges,,,,,,,,,,,,,,,196.54,83,,percent of total billed charges,,,224.95,95,,percent of total billed charges,,,213.11,90,,percent of total billed charges,,,213.11,90,,percent of total billed charges,,,194.17,82,,percent of total billed charges,,,213.11,90,,percent of total billed charges,,,201.27,85,,percent of total billed charges,,59.2,224.95,
RABIES I.G.(HyperRAB):300IntUnits/ML,32016858,CDM,90375,CPT,250,RC,outpatient,,5041.24,5041.24,,4280.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1260.31,22,,percent of total billed charges,,,,,,,,,4537.12,90,,percent of total billed charges,,,4174.15,82.8,,percent of total billed charges,,,4285.05,85,,percent of total billed charges,,,,,,,,,4436.29,88,,percent of total billed charges,,,,,,,,,3851.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1260.31,22,,percent of total billed charges,,,4587.53,91,,percent of total billed charges,,,4789.18,95,,percent of total billed charges,,,4184.23,83,,percent of total billed charges,,,4184.23,83,,percent of total billed charges,,,,,,,,,,,,,,,4184.23,83,,percent of total billed charges,,,4789.18,95,,percent of total billed charges,,,4537.12,90,,percent of total billed charges,,,4537.12,90,,percent of total billed charges,,,4133.82,82,,percent of total billed charges,,,4537.12,90,,percent of total billed charges,,,4285.05,85,,percent of total billed charges,,1260.31,4789.18,
SODIUM PHOS VIAL:15MMOL/5ML,32016887,CDM,J3490,HCPCS,250,RC,outpatient,,276.96,276.96,,235.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.24,22,,percent of total billed charges,,,,,,,,,249.26,90,,percent of total billed charges,,,229.32,82.8,,percent of total billed charges,,,235.42,85,,percent of total billed charges,,,,,,,,,243.72,88,,percent of total billed charges,,,,,,,,,211.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,69.24,22,,percent of total billed charges,,,252.03,91,,percent of total billed charges,,,263.11,95,,percent of total billed charges,,,229.88,83,,percent of total billed charges,,,229.88,83,,percent of total billed charges,,,,,,,,,,,,,,,229.88,83,,percent of total billed charges,,,263.11,95,,percent of total billed charges,,,249.26,90,,percent of total billed charges,,,249.26,90,,percent of total billed charges,,,227.11,82,,percent of total billed charges,,,249.26,90,,percent of total billed charges,,,235.42,85,,percent of total billed charges,,69.24,263.11,
ANDEXANET ALFA(ANDEXXA)IV VIAL:200MG,32016924,CDM,J7169,HCPCS,636,RC,outpatient,,11753.46,11753.46,,9978.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2938.37,22,,percent of total billed charges,,,,,,,,,10578.11,90,,percent of total billed charges,,,9731.86,82.8,,percent of total billed charges,,,9990.44,85,,percent of total billed charges,,,,,,,,,10343.04,88,,percent of total billed charges,,21510,,,,fee schedule,,,8979.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21510,,,,fee schedule,,,2938.37,22,,percent of total billed charges,,,10695.65,91,,percent of total billed charges,,,11165.79,95,,percent of total billed charges,,,9755.37,83,,percent of total billed charges,,,9755.37,83,,percent of total billed charges,,,,,,,,,,,,,,,9755.37,83,,percent of total billed charges,,,11165.79,95,,percent of total billed charges,,,10578.11,90,,percent of total billed charges,,,10578.11,90,,percent of total billed charges,,,9637.84,82,,percent of total billed charges,,,10578.11,90,,percent of total billed charges,,,9990.44,85,,percent of total billed charges,,2938.37,21510,
PROTAMINE SULF VIAL:50MG/5ML,32017038,CDM,J2720,HCPCS,250,RC,outpatient,,227.45,227.45,,193.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.86,22,,percent of total billed charges,,,,,,,,,204.71,90,,percent of total billed charges,,,188.33,82.8,,percent of total billed charges,,,193.33,85,,percent of total billed charges,,,,,,,,,200.16,88,,percent of total billed charges,,8.14,,,,fee schedule,,,173.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8.14,,,,fee schedule,,,56.86,22,,percent of total billed charges,,,206.98,91,,percent of total billed charges,,,216.08,95,,percent of total billed charges,,,188.78,83,,percent of total billed charges,,,188.78,83,,percent of total billed charges,,,,,,,,,,,,,,,188.78,83,,percent of total billed charges,,,216.08,95,,percent of total billed charges,,,204.71,90,,percent of total billed charges,,,204.71,90,,percent of total billed charges,,,186.51,82,,percent of total billed charges,,,204.71,90,,percent of total billed charges,,,193.33,85,,percent of total billed charges,,8.14,216.08,
ROMOSOZUMAB SYR (EVENITY)210MG/2.34ML,32017148,CDM,J3111,HCPCS,636,RC,outpatient,,9960.84,9960.84,,8456.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2490.21,22,,percent of total billed charges,,,,,,,,,8964.76,90,,percent of total billed charges,,,8247.58,82.8,,percent of total billed charges,,,8466.71,85,,percent of total billed charges,,,,,,,,,8765.54,88,,percent of total billed charges,,2058,,,,fee schedule,,,7610.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2058,,,,fee schedule,,,2490.21,22,,percent of total billed charges,,,9064.36,91,,percent of total billed charges,,,9462.8,95,,percent of total billed charges,,,8267.5,83,,percent of total billed charges,,,8267.5,83,,percent of total billed charges,,,,,,,,,,,,,,,8267.5,83,,percent of total billed charges,,,9462.8,95,,percent of total billed charges,,,8964.76,90,,percent of total billed charges,,,8964.76,90,,percent of total billed charges,,,8167.89,82,,percent of total billed charges,,,8964.76,90,,percent of total billed charges,,,8466.71,85,,percent of total billed charges,,2058,9462.8,
INFLU VACC(FluBLOK) 2019-2020 SYR 0.5ML:,32017158,CDM,90682,CPT,636,RC,outpatient,,704.87,704.87,,598.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,176.22,22,,percent of total billed charges,,,,,,,,,634.38,90,,percent of total billed charges,,,583.63,82.8,,percent of total billed charges,,,599.14,85,,percent of total billed charges,,,,,,,,,620.29,88,,percent of total billed charges,,,,,,,,,538.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,176.22,22,,percent of total billed charges,,,641.43,91,,percent of total billed charges,,,669.63,95,,percent of total billed charges,,,585.04,83,,percent of total billed charges,,,585.04,83,,percent of total billed charges,,,,,,,,,,,,,,,585.04,83,,percent of total billed charges,,,669.63,95,,percent of total billed charges,,,634.38,90,,percent of total billed charges,,,634.38,90,,percent of total billed charges,,,577.99,82,,percent of total billed charges,,,634.38,90,,percent of total billed charges,,,599.14,85,,percent of total billed charges,,176.22,669.63,
BUPRENORPHINE/NALOXONE(SUBOXO)FILM:8-2MG,32017174,CDM,J0574,HCPCS,250,RC,outpatient,,51.31,51.31,,43.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.83,22,,percent of total billed charges,,,,,,,,,46.18,90,,percent of total billed charges,,,42.48,82.8,,percent of total billed charges,,,43.61,85,,percent of total billed charges,,,,,,,,,45.15,88,,percent of total billed charges,,,,,,,,,39.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.83,22,,percent of total billed charges,,,46.69,91,,percent of total billed charges,,,48.74,95,,percent of total billed charges,,,42.59,83,,percent of total billed charges,,,42.59,83,,percent of total billed charges,,,,,,,,,,,,,,,42.59,83,,percent of total billed charges,,,48.74,95,,percent of total billed charges,,,46.18,90,,percent of total billed charges,,,46.18,90,,percent of total billed charges,,,42.07,82,,percent of total billed charges,,,46.18,90,,percent of total billed charges,,,43.61,85,,percent of total billed charges,,12.83,48.74,
LEVONORGESTREL (MIRENA) IUD: 52MG,32017198,CDM,J7298,HCPCS,636,RC,outpatient,,4863.23,4863.23,,4128.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1215.81,22,,percent of total billed charges,,,,,,,,,4376.91,90,,percent of total billed charges,,,4026.75,82.8,,percent of total billed charges,,,4133.75,85,,percent of total billed charges,,,,,,,,,4279.64,88,,percent of total billed charges,,1053.23,,,,fee schedule,,,3715.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1053.23,,,,fee schedule,,,1215.81,22,,percent of total billed charges,,,4425.54,91,,percent of total billed charges,,,4620.07,95,,percent of total billed charges,,,4036.48,83,,percent of total billed charges,,,4036.48,83,,percent of total billed charges,,,,,,,,,,,,,,,4036.48,83,,percent of total billed charges,,,4620.07,95,,percent of total billed charges,,,4376.91,90,,percent of total billed charges,,,4376.91,90,,percent of total billed charges,,,3987.85,82,,percent of total billed charges,,,4376.91,90,,percent of total billed charges,,,4133.75,85,,percent of total billed charges,,1053.23,4620.07,
PARAGARD COPPER IUD,32017199,CDM,J7300,HCPCS,636,RC,outpatient,,6687.07,6687.07,,5677.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1671.77,22,,percent of total billed charges,,,,,,,,,6018.36,90,,percent of total billed charges,,,5536.89,82.8,,percent of total billed charges,,,5684.01,85,,percent of total billed charges,,,,,,,,,5884.62,88,,percent of total billed charges,,979.9,,,,fee schedule,,,5108.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,979.9,,,,fee schedule,,,1671.77,22,,percent of total billed charges,,,6085.23,91,,percent of total billed charges,,,6352.72,95,,percent of total billed charges,,,5550.27,83,,percent of total billed charges,,,5550.27,83,,percent of total billed charges,,,,,,,,,,,,,,,5550.27,83,,percent of total billed charges,,,6352.72,95,,percent of total billed charges,,,6018.36,90,,percent of total billed charges,,,6018.36,90,,percent of total billed charges,,,5483.4,82,,percent of total billed charges,,,6018.36,90,,percent of total billed charges,,,5684.01,85,,percent of total billed charges,,979.9,6352.72,
ETONOGESTREL (NEXPLANON) IMPLANT: 68 MG,32017200,CDM,J7307,HCPCS,636,RC,outpatient,,13148.98,13148.98,,11163.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3287.25,22,,percent of total billed charges,,,,,,,,,11834.08,90,,percent of total billed charges,,,10887.36,82.8,,percent of total billed charges,,,11176.63,85,,percent of total billed charges,,,,,,,,,11571.1,88,,percent of total billed charges,,1044.41,,,,fee schedule,,,10045.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1044.41,,,,fee schedule,,,3287.25,22,,percent of total billed charges,,,11965.57,91,,percent of total billed charges,,,12491.53,95,,percent of total billed charges,,,10913.65,83,,percent of total billed charges,,,10913.65,83,,percent of total billed charges,,,,,,,,,,,,,,,10913.65,83,,percent of total billed charges,,,12491.53,95,,percent of total billed charges,,,11834.08,90,,percent of total billed charges,,,11834.08,90,,percent of total billed charges,,,10782.16,82,,percent of total billed charges,,,11834.08,90,,percent of total billed charges,,,11176.63,85,,percent of total billed charges,,1044.41,12491.53,
INFLU VACC(FLUZONE) 2019-2020 SYR 0.5ML:,32017251,CDM,90682,CPT,636,RC,outpatient,,314.54,314.54,,267.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.64,22,,percent of total billed charges,,,,,,,,,283.09,90,,percent of total billed charges,,,260.44,82.8,,percent of total billed charges,,,267.36,85,,percent of total billed charges,,,,,,,,,276.8,88,,percent of total billed charges,,,,,,,,,240.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.64,22,,percent of total billed charges,,,286.23,91,,percent of total billed charges,,,298.81,95,,percent of total billed charges,,,261.07,83,,percent of total billed charges,,,261.07,83,,percent of total billed charges,,,,,,,,,,,,,,,261.07,83,,percent of total billed charges,,,298.81,95,,percent of total billed charges,,,283.09,90,,percent of total billed charges,,,283.09,90,,percent of total billed charges,,,257.92,82,,percent of total billed charges,,,283.09,90,,percent of total billed charges,,,267.36,85,,percent of total billed charges,,78.64,298.81,
BUPRENORPHINE/NALOXONE(SUBOXO)FILM:4-1MG,32017265,CDM,J0574,HCPCS,250,RC,outpatient,,60.46,60.46,,51.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.12,22,,percent of total billed charges,,,,,,,,,54.41,90,,percent of total billed charges,,,50.06,82.8,,percent of total billed charges,,,51.39,85,,percent of total billed charges,,,,,,,,,53.2,88,,percent of total billed charges,,,,,,,,,46.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.12,22,,percent of total billed charges,,,55.02,91,,percent of total billed charges,,,57.44,95,,percent of total billed charges,,,50.18,83,,percent of total billed charges,,,50.18,83,,percent of total billed charges,,,,,,,,,,,,,,,50.18,83,,percent of total billed charges,,,57.44,95,,percent of total billed charges,,,54.41,90,,percent of total billed charges,,,54.41,90,,percent of total billed charges,,,49.58,82,,percent of total billed charges,,,54.41,90,,percent of total billed charges,,,51.39,85,,percent of total billed charges,,15.12,57.44,
EPLERENONE(INSPRA)TAB: 25MG,32017266,CDM,J8499,HCPCS,250,RC,outpatient,,46.73,46.73,,39.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11.68,22,,percent of total billed charges,,,,,,,,,42.06,90,,percent of total billed charges,,,38.69,82.8,,percent of total billed charges,,,39.72,85,,percent of total billed charges,,,,,,,,,41.12,88,,percent of total billed charges,,,,,,,,,35.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11.68,22,,percent of total billed charges,,,42.52,91,,percent of total billed charges,,,44.39,95,,percent of total billed charges,,,38.79,83,,percent of total billed charges,,,38.79,83,,percent of total billed charges,,,,,,,,,,,,,,,38.79,83,,percent of total billed charges,,,44.39,95,,percent of total billed charges,,,42.06,90,,percent of total billed charges,,,42.06,90,,percent of total billed charges,,,38.32,82,,percent of total billed charges,,,42.06,90,,percent of total billed charges,,,39.72,85,,percent of total billed charges,,11.68,44.39,
RANOLAZINE(RANEXA) ER TAB:500MG,32017267,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
PEGFILGRASTIM-CBQV(UDENYCA)SYR 6MG/0.6ML,32017269,CDM,Q5111,HCPCS,636,RC,outpatient,,19194.26,19194.26,,16295.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4798.57,22,,percent of total billed charges,,,,,,,,,17274.83,90,,percent of total billed charges,,,15892.85,82.8,,percent of total billed charges,,,16315.12,85,,percent of total billed charges,,,,,,,,,16890.95,88,,percent of total billed charges,,1963.2,,,,fee schedule,,,14664.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1963.2,,,,fee schedule,,,4798.57,22,,percent of total billed charges,,,17466.78,91,,percent of total billed charges,,,18234.55,95,,percent of total billed charges,,,15931.24,83,,percent of total billed charges,,,15931.24,83,,percent of total billed charges,,,,,,,,,,,,,,,15931.24,83,,percent of total billed charges,,,18234.55,95,,percent of total billed charges,,,17274.83,90,,percent of total billed charges,,,17274.83,90,,percent of total billed charges,,,15739.29,82,,percent of total billed charges,,,17274.83,90,,percent of total billed charges,,,16315.12,85,,percent of total billed charges,,1963.2,18234.55,
DEXRAZOXANE(ZINECARD) VIAL:250MG,32017291,CDM,J1190,HCPCS,636,RC,outpatient,,1763.87,1763.87,,1497.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,440.97,22,,percent of total billed charges,,,,,,,,,1587.48,90,,percent of total billed charges,,,1460.48,82.8,,percent of total billed charges,,,1499.29,85,,percent of total billed charges,,,,,,,,,1552.21,88,,percent of total billed charges,,940.21,,,,fee schedule,,,1347.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,940.21,,,,fee schedule,,,440.97,22,,percent of total billed charges,,,1605.12,91,,percent of total billed charges,,,1675.68,95,,percent of total billed charges,,,1464.01,83,,percent of total billed charges,,,1464.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1464.01,83,,percent of total billed charges,,,1675.68,95,,percent of total billed charges,,,1587.48,90,,percent of total billed charges,,,1587.48,90,,percent of total billed charges,,,1446.37,82,,percent of total billed charges,,,1587.48,90,,percent of total billed charges,,,1499.29,85,,percent of total billed charges,,440.97,1675.68,
DEXRAZOXANE(ZINECARD) VIAL:500MG,32017292,CDM,J1190,HCPCS,636,RC,outpatient,,2207.05,2207.05,,1873.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,551.76,22,,percent of total billed charges,,,,,,,,,1986.35,90,,percent of total billed charges,,,1827.44,82.8,,percent of total billed charges,,,1875.99,85,,percent of total billed charges,,,,,,,,,1942.2,88,,percent of total billed charges,,940.21,,,,fee schedule,,,1686.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,940.21,,,,fee schedule,,,551.76,22,,percent of total billed charges,,,2008.42,91,,percent of total billed charges,,,2096.7,95,,percent of total billed charges,,,1831.85,83,,percent of total billed charges,,,1831.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1831.85,83,,percent of total billed charges,,,2096.7,95,,percent of total billed charges,,,1986.35,90,,percent of total billed charges,,,1986.35,90,,percent of total billed charges,,,1809.78,82,,percent of total billed charges,,,1986.35,90,,percent of total billed charges,,,1875.99,85,,percent of total billed charges,,551.76,2096.7,
FLUZONE HIGH DOSE (2019-2020)SYR:0.5ML,32017314,CDM,90662,CPT,636,RC,outpatient,,704.87,704.87,,598.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,176.22,22,,percent of total billed charges,,,,,,,,,634.38,90,,percent of total billed charges,,,583.63,82.8,,percent of total billed charges,,,599.14,85,,percent of total billed charges,,,,,,,,,620.29,88,,percent of total billed charges,,,,,,,,,538.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,176.22,22,,percent of total billed charges,,,641.43,91,,percent of total billed charges,,,669.63,95,,percent of total billed charges,,,585.04,83,,percent of total billed charges,,,585.04,83,,percent of total billed charges,,,,,,,,,,,,,,,585.04,83,,percent of total billed charges,,,669.63,95,,percent of total billed charges,,,634.38,90,,percent of total billed charges,,,634.38,90,,percent of total billed charges,,,577.99,82,,percent of total billed charges,,,634.38,90,,percent of total billed charges,,,599.14,85,,percent of total billed charges,,176.22,669.63,
POLOCAINE(MEPIV) 1% MPF: 300MG/30ML,32017350,CDM,,,250,RC,outpatient,,127.78,127.78,,108.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.95,22,,percent of total billed charges,,,,,,,,,115,90,,percent of total billed charges,,,105.8,82.8,,percent of total billed charges,,,108.61,85,,percent of total billed charges,,,,,,,,,112.45,88,,percent of total billed charges,,,,,,,,,97.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.95,22,,percent of total billed charges,,,116.28,91,,percent of total billed charges,,,121.39,95,,percent of total billed charges,,,106.06,83,,percent of total billed charges,,,106.06,83,,percent of total billed charges,,,,,,,,,,,,,,,106.06,83,,percent of total billed charges,,,121.39,95,,percent of total billed charges,,,115,90,,percent of total billed charges,,,115,90,,percent of total billed charges,,,104.78,82,,percent of total billed charges,,,115,90,,percent of total billed charges,,,108.61,85,,percent of total billed charges,,31.95,121.39,
VANCOMYCIN INTRAOCULAR INJ 8MG/0.8ML,32017356,CDM,,,258,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
CYCLOPENTOLATE(CYCLOGYL)DROP 1%:2ML,32017358,CDM,J3490,HCPCS,250,RC,outpatient,,88.07,88.07,,74.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.02,22,,percent of total billed charges,,,,,,,,,79.26,90,,percent of total billed charges,,,72.92,82.8,,percent of total billed charges,,,74.86,85,,percent of total billed charges,,,,,,,,,77.5,88,,percent of total billed charges,,,,,,,,,67.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.02,22,,percent of total billed charges,,,80.14,91,,percent of total billed charges,,,83.67,95,,percent of total billed charges,,,73.1,83,,percent of total billed charges,,,73.1,83,,percent of total billed charges,,,,,,,,,,,,,,,73.1,83,,percent of total billed charges,,,83.67,95,,percent of total billed charges,,,79.26,90,,percent of total billed charges,,,79.26,90,,percent of total billed charges,,,72.22,82,,percent of total billed charges,,,79.26,90,,percent of total billed charges,,,74.86,85,,percent of total billed charges,,22.02,83.67,
PHENYLEPH(NEO-SYNPHR)DROP 2.5%(EYE):2ML,32017359,CDM,J3490,HCPCS,250,RC,outpatient,,498.32,498.32,,423.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.58,22,,percent of total billed charges,,,,,,,,,448.49,90,,percent of total billed charges,,,412.61,82.8,,percent of total billed charges,,,423.57,85,,percent of total billed charges,,,,,,,,,438.52,88,,percent of total billed charges,,,,,,,,,380.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.58,22,,percent of total billed charges,,,453.47,91,,percent of total billed charges,,,473.4,95,,percent of total billed charges,,,413.61,83,,percent of total billed charges,,,413.61,83,,percent of total billed charges,,,,,,,,,,,,,,,413.61,83,,percent of total billed charges,,,473.4,95,,percent of total billed charges,,,448.49,90,,percent of total billed charges,,,448.49,90,,percent of total billed charges,,,408.62,82,,percent of total billed charges,,,448.49,90,,percent of total billed charges,,,423.57,85,,percent of total billed charges,,124.58,473.4,
CLONIDINE(CATAPRES) TAB THP:0.1MG (1x6),32017362,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
LOPERAMIDE(IMODIUM) TAB THP:2MG (1x8),32017363,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
HydrOXYzine(Atarax) TAB THP:25MG (1x3),32017364,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
TRAZODONE(DESERYL)TAB THP:50MG (1x1),32017365,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
FACTOR VIII (HEMOFIL-M): 538 UNITS/10ML,32017673,CDM,J7190,HCPCS,636,RC,outpatient,,3918.61,3918.61,,3326.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,979.65,22,,percent of total billed charges,,,,,,,,,3526.75,90,,percent of total billed charges,,,3244.61,82.8,,percent of total billed charges,,,3330.82,85,,percent of total billed charges,,,,,,,,,3448.38,88,,percent of total billed charges,,7062.5,,,,fee schedule,,,2993.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7062.5,,,,fee schedule,,,979.65,22,,percent of total billed charges,,,3565.94,91,,percent of total billed charges,,,3722.68,95,,percent of total billed charges,,,3252.45,83,,percent of total billed charges,,,3252.45,83,,percent of total billed charges,,,,,,,,,,,,,,,3252.45,83,,percent of total billed charges,,,3722.68,95,,percent of total billed charges,,,3526.75,90,,percent of total billed charges,,,3526.75,90,,percent of total billed charges,,,3213.26,82,,percent of total billed charges,,,3526.75,90,,percent of total billed charges,,,3330.82,85,,percent of total billed charges,,979.65,7062.5,
FACTOR VIII (HEMOFIL-M): 1830 UNITS/10ML,32017674,CDM,J7190,HCPCS,636,RC,outpatient,,7781.13,7781.13,,6606.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1945.28,22,,percent of total billed charges,,,,,,,,,7003.02,90,,percent of total billed charges,,,6442.78,82.8,,percent of total billed charges,,,6613.96,85,,percent of total billed charges,,,,,,,,,6847.39,88,,percent of total billed charges,,7062.5,,,,fee schedule,,,5944.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7062.5,,,,fee schedule,,,1945.28,22,,percent of total billed charges,,,7080.83,91,,percent of total billed charges,,,7392.07,95,,percent of total billed charges,,,6458.34,83,,percent of total billed charges,,,6458.34,83,,percent of total billed charges,,,,,,,,,,,,,,,6458.34,83,,percent of total billed charges,,,7392.07,95,,percent of total billed charges,,,7003.02,90,,percent of total billed charges,,,7003.02,90,,percent of total billed charges,,,6380.53,82,,percent of total billed charges,,,7003.02,90,,percent of total billed charges,,,6613.96,85,,percent of total billed charges,,1945.28,7392.07,
FACTOR VIII (HEMOFIL-M): 1110 UNITS/10ML,32017675,CDM,J7190,HCPCS,636,RC,outpatient,,4825.17,4825.17,,4096.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1206.29,22,,percent of total billed charges,,,,,,,,,4342.65,90,,percent of total billed charges,,,3995.24,82.8,,percent of total billed charges,,,4101.39,85,,percent of total billed charges,,,,,,,,,4246.15,88,,percent of total billed charges,,7062.5,,,,fee schedule,,,3686.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7062.5,,,,fee schedule,,,1206.29,22,,percent of total billed charges,,,4390.9,91,,percent of total billed charges,,,4583.91,95,,percent of total billed charges,,,4004.89,83,,percent of total billed charges,,,4004.89,83,,percent of total billed charges,,,,,,,,,,,,,,,4004.89,83,,percent of total billed charges,,,4583.91,95,,percent of total billed charges,,,4342.65,90,,percent of total billed charges,,,4342.65,90,,percent of total billed charges,,,3956.64,82,,percent of total billed charges,,,4342.65,90,,percent of total billed charges,,,4101.39,85,,percent of total billed charges,,1206.29,7062.5,
FACTOR VIII (HEMOFIL-M): 330 UNITS/10ML,32017676,CDM,J7190,HCPCS,636,RC,outpatient,,2179.66,2179.66,,1850.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,544.92,22,,percent of total billed charges,,,,,,,,,1961.69,90,,percent of total billed charges,,,1804.76,82.8,,percent of total billed charges,,,1852.71,85,,percent of total billed charges,,,,,,,,,1918.1,88,,percent of total billed charges,,7062.5,,,,fee schedule,,,1665.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7062.5,,,,fee schedule,,,544.92,22,,percent of total billed charges,,,1983.49,91,,percent of total billed charges,,,2070.68,95,,percent of total billed charges,,,1809.12,83,,percent of total billed charges,,,1809.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1809.12,83,,percent of total billed charges,,,2070.68,95,,percent of total billed charges,,,1961.69,90,,percent of total billed charges,,,1961.69,90,,percent of total billed charges,,,1787.32,82,,percent of total billed charges,,,1961.69,90,,percent of total billed charges,,,1852.71,85,,percent of total billed charges,,544.92,7062.5,
FACTOR VIII (HEMOFIL-M): 1790 UNITS/10ML,32017718,CDM,J7190,HCPCS,636,RC,outpatient,,7955.01,7955.01,,6753.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1988.75,22,,percent of total billed charges,,,,,,,,,7159.51,90,,percent of total billed charges,,,6586.75,82.8,,percent of total billed charges,,,6761.76,85,,percent of total billed charges,,,,,,,,,7000.41,88,,percent of total billed charges,,7062.5,,,,fee schedule,,,6077.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7062.5,,,,fee schedule,,,1988.75,22,,percent of total billed charges,,,7239.06,91,,percent of total billed charges,,,7557.26,95,,percent of total billed charges,,,6602.66,83,,percent of total billed charges,,,6602.66,83,,percent of total billed charges,,,,,,,,,,,,,,,6602.66,83,,percent of total billed charges,,,7557.26,95,,percent of total billed charges,,,7159.51,90,,percent of total billed charges,,,7159.51,90,,percent of total billed charges,,,6523.11,82,,percent of total billed charges,,,7159.51,90,,percent of total billed charges,,,6761.76,85,,percent of total billed charges,,1988.75,7557.26,
FACTOR VIII (HEMOFIL-M): 1670 UNITS/10ML,32017725,CDM,J7190,HCPCS,636,RC,outpatient,,6896.52,6896.52,,5855.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1724.13,22,,percent of total billed charges,,,,,,,,,6206.87,90,,percent of total billed charges,,,5710.32,82.8,,percent of total billed charges,,,5862.04,85,,percent of total billed charges,,,,,,,,,6068.94,88,,percent of total billed charges,,7062.5,,,,fee schedule,,,5268.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7062.5,,,,fee schedule,,,1724.13,22,,percent of total billed charges,,,6275.83,91,,percent of total billed charges,,,6551.69,95,,percent of total billed charges,,,5724.11,83,,percent of total billed charges,,,5724.11,83,,percent of total billed charges,,,,,,,,,,,,,,,5724.11,83,,percent of total billed charges,,,6551.69,95,,percent of total billed charges,,,6206.87,90,,percent of total billed charges,,,6206.87,90,,percent of total billed charges,,,5655.15,82,,percent of total billed charges,,,6206.87,90,,percent of total billed charges,,,5862.04,85,,percent of total billed charges,,1724.13,7062.5,
FACTOR VIII (HEMOFIL-M): 315 UNITS/10ML,32017726,CDM,J7190,HCPCS,636,RC,outpatient,,2403.6,2403.6,,2040.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,600.9,22,,percent of total billed charges,,,,,,,,,2163.24,90,,percent of total billed charges,,,1990.18,82.8,,percent of total billed charges,,,2043.06,85,,percent of total billed charges,,,,,,,,,2115.17,88,,percent of total billed charges,,7062.5,,,,fee schedule,,,1836.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,7062.5,,,,fee schedule,,,600.9,22,,percent of total billed charges,,,2187.28,91,,percent of total billed charges,,,2283.42,95,,percent of total billed charges,,,1994.99,83,,percent of total billed charges,,,1994.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1994.99,83,,percent of total billed charges,,,2283.42,95,,percent of total billed charges,,,2163.24,90,,percent of total billed charges,,,2163.24,90,,percent of total billed charges,,,1970.95,82,,percent of total billed charges,,,2163.24,90,,percent of total billed charges,,,2043.06,85,,percent of total billed charges,,600.9,7062.5,
METHOTREXATE VL:50MG/2ML,32017849,CDM,J9250,HCPCS,636,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,6.29,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6.29,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,6.29,59.21,
MEPERIDINE (DEMEROL) SYR:25MG/ML,32017851,CDM,,,250,RC,outpatient,,94.28,94.28,,80.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.57,22,,percent of total billed charges,,,,,,,,,84.85,90,,percent of total billed charges,,,78.06,82.8,,percent of total billed charges,,,80.14,85,,percent of total billed charges,,,,,,,,,82.97,88,,percent of total billed charges,,,,,,,,,72.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.57,22,,percent of total billed charges,,,85.79,91,,percent of total billed charges,,,89.57,95,,percent of total billed charges,,,78.25,83,,percent of total billed charges,,,78.25,83,,percent of total billed charges,,,,,,,,,,,,,,,78.25,83,,percent of total billed charges,,,89.57,95,,percent of total billed charges,,,84.85,90,,percent of total billed charges,,,84.85,90,,percent of total billed charges,,,77.31,82,,percent of total billed charges,,,84.85,90,,percent of total billed charges,,,80.14,85,,percent of total billed charges,,23.57,89.57,
REMDESIVIR (INVESTIGATIONAL)VIAL : 100MG,32017883,CDM,,,250,RC,outpatient,,4116.84,4116.84,,3495.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1029.21,22,,percent of total billed charges,,,,,,,,,3705.16,90,,percent of total billed charges,,,3408.74,82.8,,percent of total billed charges,,,3499.31,85,,percent of total billed charges,,,,,,,,,3622.82,88,,percent of total billed charges,,,,,,,,,3145.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1029.21,22,,percent of total billed charges,,,3746.32,91,,percent of total billed charges,,,3911,95,,percent of total billed charges,,,3416.98,83,,percent of total billed charges,,,3416.98,83,,percent of total billed charges,,,,,,,,,,,,,,,3416.98,83,,percent of total billed charges,,,3911,95,,percent of total billed charges,,,3705.16,90,,percent of total billed charges,,,3705.16,90,,percent of total billed charges,,,3375.81,82,,percent of total billed charges,,,3705.16,90,,percent of total billed charges,,,3499.31,85,,percent of total billed charges,,1029.21,3911,
TOCILIZUMAB (ACTEMRA) VIAL: 400MG/20ML,32018020,CDM,J3262,HCPCS,636,RC,outpatient,,11429.01,11429.01,,9703.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2857.25,22,,percent of total billed charges,,,,,,,,,10286.11,90,,percent of total billed charges,,,9463.22,82.8,,percent of total billed charges,,,9714.66,85,,percent of total billed charges,,,,,,,,,10057.53,88,,percent of total billed charges,,4931.2,,,,fee schedule,,,8731.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,4931.2,,,,fee schedule,,,2857.25,22,,percent of total billed charges,,,10400.4,91,,percent of total billed charges,,,10857.56,95,,percent of total billed charges,,,9486.08,83,,percent of total billed charges,,,9486.08,83,,percent of total billed charges,,,,,,,,,,,,,,,9486.08,83,,percent of total billed charges,,,10857.56,95,,percent of total billed charges,,,10286.11,90,,percent of total billed charges,,,10286.11,90,,percent of total billed charges,,,9371.79,82,,percent of total billed charges,,,10286.11,90,,percent of total billed charges,,,9714.66,85,,percent of total billed charges,,2857.25,10857.56,
carBAMazepine(TEGretol XR)TAB:100MG,32018098,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
COSYNTROPIN(CORTROSYN)VIAL:0.25MG,32018115,CDM,J0834,HCPCS,636,RC,outpatient,,350.73,350.73,,297.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.68,22,,percent of total billed charges,,,,,,,,,315.66,90,,percent of total billed charges,,,290.4,82.8,,percent of total billed charges,,,298.12,85,,percent of total billed charges,,,,,,,,,308.64,88,,percent of total billed charges,,93.17,,,,fee schedule,,,267.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,93.17,,,,fee schedule,,,87.68,22,,percent of total billed charges,,,319.16,91,,percent of total billed charges,,,333.19,95,,percent of total billed charges,,,291.11,83,,percent of total billed charges,,,291.11,83,,percent of total billed charges,,,,,,,,,,,,,,,291.11,83,,percent of total billed charges,,,333.19,95,,percent of total billed charges,,,315.66,90,,percent of total billed charges,,,315.66,90,,percent of total billed charges,,,287.6,82,,percent of total billed charges,,,315.66,90,,percent of total billed charges,,,298.12,85,,percent of total billed charges,,87.68,333.19,
COSYNTROPIN(CORTROSYN) VIAL: 0.25MG,32018116,CDM,J0834,HCPCS,636,RC,outpatient,,386.77,386.77,,328.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.69,22,,percent of total billed charges,,,,,,,,,348.09,90,,percent of total billed charges,,,320.25,82.8,,percent of total billed charges,,,328.75,85,,percent of total billed charges,,,,,,,,,340.36,88,,percent of total billed charges,,93.17,,,,fee schedule,,,295.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,93.17,,,,fee schedule,,,96.69,22,,percent of total billed charges,,,351.96,91,,percent of total billed charges,,,367.43,95,,percent of total billed charges,,,321.02,83,,percent of total billed charges,,,321.02,83,,percent of total billed charges,,,,,,,,,,,,,,,321.02,83,,percent of total billed charges,,,367.43,95,,percent of total billed charges,,,348.09,90,,percent of total billed charges,,,348.09,90,,percent of total billed charges,,,317.15,82,,percent of total billed charges,,,348.09,90,,percent of total billed charges,,,328.75,85,,percent of total billed charges,,93.17,367.43,
AMINO ACID 4.25%/DEXTROSE 10% 1000 ML,32018244,CDM,J3490,HCPCS,250,RC,outpatient,,601.64,601.64,,510.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.41,22,,percent of total billed charges,,,,,,,,,541.48,90,,percent of total billed charges,,,498.16,82.8,,percent of total billed charges,,,511.39,85,,percent of total billed charges,,,,,,,,,529.44,88,,percent of total billed charges,,,,,,,,,459.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.41,22,,percent of total billed charges,,,547.49,91,,percent of total billed charges,,,571.56,95,,percent of total billed charges,,,499.36,83,,percent of total billed charges,,,499.36,83,,percent of total billed charges,,,,,,,,,,,,,,,499.36,83,,percent of total billed charges,,,571.56,95,,percent of total billed charges,,,541.48,90,,percent of total billed charges,,,541.48,90,,percent of total billed charges,,,493.34,82,,percent of total billed charges,,,541.48,90,,percent of total billed charges,,,511.39,85,,percent of total billed charges,,150.41,571.56,
INFLU VACC(FLUZONE) 2020-2021 SYR 0.5ML:,32018285,CDM,90686,CPT,636,RC,outpatient,,297.88,297.88,,252.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.47,22,,percent of total billed charges,,,,,,,,,268.09,90,,percent of total billed charges,,,246.64,82.8,,percent of total billed charges,,,253.2,85,,percent of total billed charges,,,,,,,,,262.13,88,,percent of total billed charges,,,,,,,,,227.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.47,22,,percent of total billed charges,,,271.07,91,,percent of total billed charges,,,282.99,95,,percent of total billed charges,,,247.24,83,,percent of total billed charges,,,247.24,83,,percent of total billed charges,,,,,,,,,,,,,,,247.24,83,,percent of total billed charges,,,282.99,95,,percent of total billed charges,,,268.09,90,,percent of total billed charges,,,268.09,90,,percent of total billed charges,,,244.26,82,,percent of total billed charges,,,268.09,90,,percent of total billed charges,,,253.2,85,,percent of total billed charges,,74.47,282.99,
CASTOR OIL 59 ML,32018286,CDM,J3490,HCPCS,250,RC,outpatient,,56.46,56.46,,47.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.12,22,,percent of total billed charges,,,,,,,,,50.81,90,,percent of total billed charges,,,46.75,82.8,,percent of total billed charges,,,47.99,85,,percent of total billed charges,,,,,,,,,49.68,88,,percent of total billed charges,,,,,,,,,43.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.12,22,,percent of total billed charges,,,51.38,91,,percent of total billed charges,,,53.64,95,,percent of total billed charges,,,46.86,83,,percent of total billed charges,,,46.86,83,,percent of total billed charges,,,,,,,,,,,,,,,46.86,83,,percent of total billed charges,,,53.64,95,,percent of total billed charges,,,50.81,90,,percent of total billed charges,,,50.81,90,,percent of total billed charges,,,46.3,82,,percent of total billed charges,,,50.81,90,,percent of total billed charges,,,47.99,85,,percent of total billed charges,,14.12,53.64,
SULF/TRIM(BACTRIM)SUS UD:800-160MG/20ML,32018332,CDM,J8499,HCPCS,250,RC,outpatient,UD,163.24,163.24,,138.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.81,22,,percent of total billed charges,,,,,,,,,146.92,90,,percent of total billed charges,,,135.16,82.8,,percent of total billed charges,,,138.75,85,,percent of total billed charges,,,,,,,,,143.65,88,,percent of total billed charges,,,,,,,,,124.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.81,22,,percent of total billed charges,,,148.55,91,,percent of total billed charges,,,155.08,95,,percent of total billed charges,,,135.49,83,,percent of total billed charges,,,135.49,83,,percent of total billed charges,,,,,,,,,,,,,,,135.49,83,,percent of total billed charges,,,155.08,95,,percent of total billed charges,,,146.92,90,,percent of total billed charges,,,146.92,90,,percent of total billed charges,,,133.86,82,,percent of total billed charges,,,146.92,90,,percent of total billed charges,,,138.75,85,,percent of total billed charges,,40.81,155.08,
INFLU VACC(FluBLOK) 2020-2021 SYR 0.5ML:,32018337,CDM,90686,CPT,636,RC,outpatient,,754.28,754.28,,640.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,188.57,22,,percent of total billed charges,,,,,,,,,678.85,90,,percent of total billed charges,,,624.54,82.8,,percent of total billed charges,,,641.14,85,,percent of total billed charges,,,,,,,,,663.77,88,,percent of total billed charges,,,,,,,,,576.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,188.57,22,,percent of total billed charges,,,686.39,91,,percent of total billed charges,,,716.57,95,,percent of total billed charges,,,626.05,83,,percent of total billed charges,,,626.05,83,,percent of total billed charges,,,,,,,,,,,,,,,626.05,83,,percent of total billed charges,,,716.57,95,,percent of total billed charges,,,678.85,90,,percent of total billed charges,,,678.85,90,,percent of total billed charges,,,618.51,82,,percent of total billed charges,,,678.85,90,,percent of total billed charges,,,641.14,85,,percent of total billed charges,,188.57,716.57,
TRIAMCINO(OROLONE) 0.1%DENTAL PASTE:5GM,32018339,CDM,J3490,HCPCS,250,RC,outpatient,,489.28,489.28,,415.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.32,22,,percent of total billed charges,,,,,,,,,440.35,90,,percent of total billed charges,,,405.12,82.8,,percent of total billed charges,,,415.89,85,,percent of total billed charges,,,,,,,,,430.57,88,,percent of total billed charges,,,,,,,,,373.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.32,22,,percent of total billed charges,,,445.24,91,,percent of total billed charges,,,464.82,95,,percent of total billed charges,,,406.1,83,,percent of total billed charges,,,406.1,83,,percent of total billed charges,,,,,,,,,,,,,,,406.1,83,,percent of total billed charges,,,464.82,95,,percent of total billed charges,,,440.35,90,,percent of total billed charges,,,440.35,90,,percent of total billed charges,,,401.21,82,,percent of total billed charges,,,440.35,90,,percent of total billed charges,,,415.89,85,,percent of total billed charges,,122.32,464.82,
CYCLOPENTOLATE(CYCLOGYL)DROP 2%:2ML,32018364,CDM,J3490,HCPCS,250,RC,outpatient,,600.78,600.78,,510.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.2,22,,percent of total billed charges,,,,,,,,,540.7,90,,percent of total billed charges,,,497.45,82.8,,percent of total billed charges,,,510.66,85,,percent of total billed charges,,,,,,,,,528.69,88,,percent of total billed charges,,,,,,,,,459,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.2,22,,percent of total billed charges,,,546.71,91,,percent of total billed charges,,,570.74,95,,percent of total billed charges,,,498.65,83,,percent of total billed charges,,,498.65,83,,percent of total billed charges,,,,,,,,,,,,,,,498.65,83,,percent of total billed charges,,,570.74,95,,percent of total billed charges,,,540.7,90,,percent of total billed charges,,,540.7,90,,percent of total billed charges,,,492.64,82,,percent of total billed charges,,,540.7,90,,percent of total billed charges,,,510.66,85,,percent of total billed charges,,150.2,570.74,
"HEParin25,000UNITS/0.45%NS500ML(PREMIX)",32018423,CDM,J1644,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
"LIDOCAINE W/EPI 1:200,000 VIAL 2%:20ML",32018448,CDM,J3490,HCPCS,250,RC,outpatient,,255.82,255.82,,217.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.96,22,,percent of total billed charges,,,,,,,,,230.24,90,,percent of total billed charges,,,211.82,82.8,,percent of total billed charges,,,217.45,85,,percent of total billed charges,,,,,,,,,225.12,88,,percent of total billed charges,,,,,,,,,195.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.96,22,,percent of total billed charges,,,232.8,91,,percent of total billed charges,,,243.03,95,,percent of total billed charges,,,212.33,83,,percent of total billed charges,,,212.33,83,,percent of total billed charges,,,,,,,,,,,,,,,212.33,83,,percent of total billed charges,,,243.03,95,,percent of total billed charges,,,230.24,90,,percent of total billed charges,,,230.24,90,,percent of total billed charges,,,209.77,82,,percent of total billed charges,,,230.24,90,,percent of total billed charges,,,217.45,85,,percent of total billed charges,,63.96,243.03,
LIDOCAINE HCL 2%PF VIAL:(20MG/ML) (5ML),32018471,CDM,J2001,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,0.75,,,,fee schedule,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,0.75,60.99,
ONABOTULINUMTOXINA(BOTOX-THER):100 UNITS,32018491,CDM,J0585,HCPCS,250,RC,outpatient,,5019.38,5019.38,,4261.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1254.85,22,,percent of total billed charges,,,,,,,,,4517.44,90,,percent of total billed charges,,,4156.05,82.8,,percent of total billed charges,,,4266.47,85,,percent of total billed charges,,,,,,,,,4417.05,88,,percent of total billed charges,,2491.6,,,,fee schedule,,,3834.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2491.6,,,,fee schedule,,,1254.85,22,,percent of total billed charges,,,4567.64,91,,percent of total billed charges,,,4768.41,95,,percent of total billed charges,,,4166.09,83,,percent of total billed charges,,,4166.09,83,,percent of total billed charges,,,,,,,,,,,,,,,4166.09,83,,percent of total billed charges,,,4768.41,95,,percent of total billed charges,,,4517.44,90,,percent of total billed charges,,,4517.44,90,,percent of total billed charges,,,4115.89,82,,percent of total billed charges,,,4517.44,90,,percent of total billed charges,,,4266.47,85,,percent of total billed charges,,1254.85,4768.41,
METHOTREXATE VL:250MG/10ML,32018495,CDM,J9250,HCPCS,636,RC,outpatient,,106.7,106.7,,90.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.68,22,,percent of total billed charges,,,,,,,,,96.03,90,,percent of total billed charges,,,88.35,82.8,,percent of total billed charges,,,90.7,85,,percent of total billed charges,,,,,,,,,93.9,88,,percent of total billed charges,,6.29,,,,fee schedule,,,81.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6.29,,,,fee schedule,,,26.68,22,,percent of total billed charges,,,97.1,91,,percent of total billed charges,,,101.37,95,,percent of total billed charges,,,88.56,83,,percent of total billed charges,,,88.56,83,,percent of total billed charges,,,,,,,,,,,,,,,88.56,83,,percent of total billed charges,,,101.37,95,,percent of total billed charges,,,96.03,90,,percent of total billed charges,,,96.03,90,,percent of total billed charges,,,87.49,82,,percent of total billed charges,,,96.03,90,,percent of total billed charges,,,90.7,85,,percent of total billed charges,,6.29,101.37,
PERJETA (PERTUZUMAB) VIAL: 420MG/14ML,32018569,CDM,J9306,HCPCS,636,RC,outpatient,,26129.97,26129.97,,22184.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6532.49,22,,percent of total billed charges,,,,,,,,,23516.97,90,,percent of total billed charges,,,21635.62,82.8,,percent of total billed charges,,,22210.47,85,,percent of total billed charges,,,,,,,,,22994.37,88,,percent of total billed charges,,12125.4,,,,fee schedule,,,19963.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,12125.4,,,,fee schedule,,,6532.49,22,,percent of total billed charges,,,23778.27,91,,percent of total billed charges,,,24823.47,95,,percent of total billed charges,,,21687.88,83,,percent of total billed charges,,,21687.88,83,,percent of total billed charges,,,,,,,,,,,,,,,21687.88,83,,percent of total billed charges,,,24823.47,95,,percent of total billed charges,,,23516.97,90,,percent of total billed charges,,,23516.97,90,,percent of total billed charges,,,21426.58,82,,percent of total billed charges,,,23516.97,90,,percent of total billed charges,,,22210.47,85,,percent of total billed charges,,6532.49,24823.47,
DOCUSATE(COLACE)LIQUID UD:100MG/10ML,32018586,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
ENOXAPARIN(LOVENOX): 150MG/ML,32018626,CDM,J1650,HCPCS,250,RC,outpatient,,214.22,214.22,,181.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.56,22,,percent of total billed charges,,,,,,,,,192.8,90,,percent of total billed charges,,,177.37,82.8,,percent of total billed charges,,,182.09,85,,percent of total billed charges,,,,,,,,,188.51,88,,percent of total billed charges,,15.16,,,,fee schedule,,,163.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.16,,,,fee schedule,,,53.56,22,,percent of total billed charges,,,194.94,91,,percent of total billed charges,,,203.51,95,,percent of total billed charges,,,177.8,83,,percent of total billed charges,,,177.8,83,,percent of total billed charges,,,,,,,,,,,,,,,177.8,83,,percent of total billed charges,,,203.51,95,,percent of total billed charges,,,192.8,90,,percent of total billed charges,,,192.8,90,,percent of total billed charges,,,175.66,82,,percent of total billed charges,,,192.8,90,,percent of total billed charges,,,182.09,85,,percent of total billed charges,,15.16,203.51,
MELOXICAM(ANJESO)VL:30MG/ML,32018628,CDM,J1738,HCPCS,250,RC,outpatient,,1366.01,1366.01,,1159.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,341.5,22,,percent of total billed charges,,,,,,,,,1229.41,90,,percent of total billed charges,,,1131.06,82.8,,percent of total billed charges,,,1161.11,85,,percent of total billed charges,,,,,,,,,1202.09,88,,percent of total billed charges,,89.86,,,,fee schedule,,,1043.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,89.86,,,,fee schedule,,,341.5,22,,percent of total billed charges,,,1243.07,91,,percent of total billed charges,,,1297.71,95,,percent of total billed charges,,,1133.79,83,,percent of total billed charges,,,1133.79,83,,percent of total billed charges,,,,,,,,,,,,,,,1133.79,83,,percent of total billed charges,,,1297.71,95,,percent of total billed charges,,,1229.41,90,,percent of total billed charges,,,1229.41,90,,percent of total billed charges,,,1120.13,82,,percent of total billed charges,,,1229.41,90,,percent of total billed charges,,,1161.11,85,,percent of total billed charges,,89.86,1297.71,
riTUXimab-ABBS(TRUXIMA)VIAL:500MG/50ML,32018685,CDM,Q5115,HCPCS,636,RC,outpatient,,19976.13,19976.13,,16959.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4994.03,22,,percent of total billed charges,,,,,,,,,17978.52,90,,percent of total billed charges,,,16540.24,82.8,,percent of total billed charges,,,16979.71,85,,percent of total billed charges,,,,,,,,,17578.99,88,,percent of total billed charges,,6680.52,,,,fee schedule,,,15261.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6680.52,,,,fee schedule,,,4994.03,22,,percent of total billed charges,,,18178.28,91,,percent of total billed charges,,,18977.32,95,,percent of total billed charges,,,16580.19,83,,percent of total billed charges,,,16580.19,83,,percent of total billed charges,,,,,,,,,,,,,,,16580.19,83,,percent of total billed charges,,,18977.32,95,,percent of total billed charges,,,17978.52,90,,percent of total billed charges,,,17978.52,90,,percent of total billed charges,,,16380.43,82,,percent of total billed charges,,,17978.52,90,,percent of total billed charges,,,16979.71,85,,percent of total billed charges,,4994.03,18977.32,
ACETAMIN/CODEINE SOL: 300-30MG/12.5ML UD,32018920,CDM,,,250,RC,outpatient,,24.58,24.58,,20.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.15,22,,percent of total billed charges,,,,,,,,,22.12,90,,percent of total billed charges,,,20.35,82.8,,percent of total billed charges,,,20.89,85,,percent of total billed charges,,,,,,,,,21.63,88,,percent of total billed charges,,,,,,,,,18.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.15,22,,percent of total billed charges,,,22.37,91,,percent of total billed charges,,,23.35,95,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,,,,,,,,,,,,,,20.4,83,,percent of total billed charges,,,23.35,95,,percent of total billed charges,,,22.12,90,,percent of total billed charges,,,22.12,90,,percent of total billed charges,,,20.16,82,,percent of total billed charges,,,22.12,90,,percent of total billed charges,,,20.89,85,,percent of total billed charges,,6.15,23.35,
OXYCODONE ORAL SOL : 5MG/5ML UD,32018921,CDM,J8499,HCPCS,250,RC,outpatient,,65.03,65.03,,55.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.26,22,,percent of total billed charges,,,,,,,,,58.53,90,,percent of total billed charges,,,53.84,82.8,,percent of total billed charges,,,55.28,85,,percent of total billed charges,,,,,,,,,57.23,88,,percent of total billed charges,,,,,,,,,49.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.26,22,,percent of total billed charges,,,59.18,91,,percent of total billed charges,,,61.78,95,,percent of total billed charges,,,53.97,83,,percent of total billed charges,,,53.97,83,,percent of total billed charges,,,,,,,,,,,,,,,53.97,83,,percent of total billed charges,,,61.78,95,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,53.32,82,,percent of total billed charges,,,58.53,90,,percent of total billed charges,,,55.28,85,,percent of total billed charges,,16.26,61.78,
BUPIVACAINE/EPI(SENSORCAI)VL 0.25%:50ML,32018976,CDM,J3490,HCPCS,250,RC,outpatient,,150.67,150.67,,127.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.67,22,,percent of total billed charges,,,,,,,,,135.6,90,,percent of total billed charges,,,124.75,82.8,,percent of total billed charges,,,128.07,85,,percent of total billed charges,,,,,,,,,132.59,88,,percent of total billed charges,,,,,,,,,115.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.67,22,,percent of total billed charges,,,137.11,91,,percent of total billed charges,,,143.14,95,,percent of total billed charges,,,125.06,83,,percent of total billed charges,,,125.06,83,,percent of total billed charges,,,,,,,,,,,,,,,125.06,83,,percent of total billed charges,,,143.14,95,,percent of total billed charges,,,135.6,90,,percent of total billed charges,,,135.6,90,,percent of total billed charges,,,123.55,82,,percent of total billed charges,,,135.6,90,,percent of total billed charges,,,128.07,85,,percent of total billed charges,,37.67,143.14,
PROPRANOLOL(INDERAL)TAB:40MG,32019123,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DIBUCAINE TOPICAL OINT 1%: 28GM,32019139,CDM,J3490,HCPCS,250,RC,outpatient,,51.07,51.07,,43.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12.77,22,,percent of total billed charges,,,,,,,,,45.96,90,,percent of total billed charges,,,42.29,82.8,,percent of total billed charges,,,43.41,85,,percent of total billed charges,,,,,,,,,44.94,88,,percent of total billed charges,,,,,,,,,39.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12.77,22,,percent of total billed charges,,,46.47,91,,percent of total billed charges,,,48.52,95,,percent of total billed charges,,,42.39,83,,percent of total billed charges,,,42.39,83,,percent of total billed charges,,,,,,,,,,,,,,,42.39,83,,percent of total billed charges,,,48.52,95,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,41.88,82,,percent of total billed charges,,,45.96,90,,percent of total billed charges,,,43.41,85,,percent of total billed charges,,12.77,48.52,
MITOMYCIN IV VIAL: 40 MG,32019270,CDM,J9280,HCPCS,636,RC,outpatient,,2183.51,2183.51,,1853.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,545.88,22,,percent of total billed charges,,,,,,,,,1965.16,90,,percent of total billed charges,,,1807.95,82.8,,percent of total billed charges,,,1855.98,85,,percent of total billed charges,,,,,,,,,1921.49,88,,percent of total billed charges,,542.94,,,,fee schedule,,,1668.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,542.94,,,,fee schedule,,,545.88,22,,percent of total billed charges,,,1986.99,91,,percent of total billed charges,,,2074.33,95,,percent of total billed charges,,,1812.31,83,,percent of total billed charges,,,1812.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1812.31,83,,percent of total billed charges,,,2074.33,95,,percent of total billed charges,,,1965.16,90,,percent of total billed charges,,,1965.16,90,,percent of total billed charges,,,1790.48,82,,percent of total billed charges,,,1965.16,90,,percent of total billed charges,,,1855.98,85,,percent of total billed charges,,542.94,2074.33,
METHACHOLINE INHALATION KIT (NEPHRON),32019298,CDM,J7674,HCPCS,250,RC,outpatient,,1961.82,1961.82,,1665.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,490.46,22,,percent of total billed charges,,,,,,,,,1765.64,90,,percent of total billed charges,,,1624.39,82.8,,percent of total billed charges,,,1667.55,85,,percent of total billed charges,,,,,,,,,1726.4,88,,percent of total billed charges,,162.5,,,,fee schedule,,,1498.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,162.5,,,,fee schedule,,,490.46,22,,percent of total billed charges,,,1785.26,91,,percent of total billed charges,,,1863.73,95,,percent of total billed charges,,,1628.31,83,,percent of total billed charges,,,1628.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1628.31,83,,percent of total billed charges,,,1863.73,95,,percent of total billed charges,,,1765.64,90,,percent of total billed charges,,,1765.64,90,,percent of total billed charges,,,1608.69,82,,percent of total billed charges,,,1765.64,90,,percent of total billed charges,,,1667.55,85,,percent of total billed charges,,162.5,1863.73,
FORMOTEROL(PERFOROMIST):20MCG/2ML UD NEB,32019308,CDM,J7609,HCPCS,250,RC,outpatient,,79.41,79.41,,67.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.85,22,,percent of total billed charges,,,,,,,,,71.47,90,,percent of total billed charges,,,65.75,82.8,,percent of total billed charges,,,67.5,85,,percent of total billed charges,,,,,,,,,69.88,88,,percent of total billed charges,,,,,,,,,60.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.85,22,,percent of total billed charges,,,72.26,91,,percent of total billed charges,,,75.44,95,,percent of total billed charges,,,65.91,83,,percent of total billed charges,,,65.91,83,,percent of total billed charges,,,,,,,,,,,,,,,65.91,83,,percent of total billed charges,,,75.44,95,,percent of total billed charges,,,71.47,90,,percent of total billed charges,,,71.47,90,,percent of total billed charges,,,65.12,82,,percent of total billed charges,,,71.47,90,,percent of total billed charges,,,67.5,85,,percent of total billed charges,,19.85,75.44,
CYRAMZA (RAMUCIRUMAB) VIAL 100MG,32019352,CDM,J9308,HCPCS,636,RC,outpatient,,5819.54,5819.54,,4940.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1454.89,22,,percent of total billed charges,,,,,,,,,5237.59,90,,percent of total billed charges,,,4818.58,82.8,,percent of total billed charges,,,4946.61,85,,percent of total billed charges,,,,,,,,,5121.2,88,,percent of total billed charges,,16405,,,,fee schedule,,,4446.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,16405,,,,fee schedule,,,1454.89,22,,percent of total billed charges,,,5295.78,91,,percent of total billed charges,,,5528.56,95,,percent of total billed charges,,,4830.22,83,,percent of total billed charges,,,4830.22,83,,percent of total billed charges,,,,,,,,,,,,,,,4830.22,83,,percent of total billed charges,,,5528.56,95,,percent of total billed charges,,,5237.59,90,,percent of total billed charges,,,5237.59,90,,percent of total billed charges,,,4772.02,82,,percent of total billed charges,,,5237.59,90,,percent of total billed charges,,,4946.61,85,,percent of total billed charges,,1454.89,16405,
KETAMINE(KETALAR) 503B SYR:50MG/5ML,32019360,CDM,J3490,HCPCS,250,RC,outpatient,,85.78,85.78,,72.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.45,22,,percent of total billed charges,,,,,,,,,77.2,90,,percent of total billed charges,,,71.03,82.8,,percent of total billed charges,,,72.91,85,,percent of total billed charges,,,,,,,,,75.49,88,,percent of total billed charges,,,,,,,,,65.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.45,22,,percent of total billed charges,,,78.06,91,,percent of total billed charges,,,81.49,95,,percent of total billed charges,,,71.2,83,,percent of total billed charges,,,71.2,83,,percent of total billed charges,,,,,,,,,,,,,,,71.2,83,,percent of total billed charges,,,81.49,95,,percent of total billed charges,,,77.2,90,,percent of total billed charges,,,77.2,90,,percent of total billed charges,,,70.34,82,,percent of total billed charges,,,77.2,90,,percent of total billed charges,,,72.91,85,,percent of total billed charges,,21.45,81.49,
KETAMINE(KETALAR) 503B VIAL:50MG/5ML,32019362,CDM,J3490,HCPCS,250,RC,outpatient,,68.63,68.63,,58.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.16,22,,percent of total billed charges,,,,,,,,,61.77,90,,percent of total billed charges,,,56.83,82.8,,percent of total billed charges,,,58.34,85,,percent of total billed charges,,,,,,,,,60.39,88,,percent of total billed charges,,,,,,,,,52.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.16,22,,percent of total billed charges,,,62.45,91,,percent of total billed charges,,,65.2,95,,percent of total billed charges,,,56.96,83,,percent of total billed charges,,,56.96,83,,percent of total billed charges,,,,,,,,,,,,,,,56.96,83,,percent of total billed charges,,,65.2,95,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,56.28,82,,percent of total billed charges,,,61.77,90,,percent of total billed charges,,,58.34,85,,percent of total billed charges,,17.16,65.2,
BUPIVACAINE/EPI(SENSORCAI)VL 0.5%:50ML,32019432,CDM,J3490,HCPCS,250,RC,outpatient,,301.47,301.47,,255.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.37,22,,percent of total billed charges,,,,,,,,,271.32,90,,percent of total billed charges,,,249.62,82.8,,percent of total billed charges,,,256.25,85,,percent of total billed charges,,,,,,,,,265.29,88,,percent of total billed charges,,,,,,,,,230.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.37,22,,percent of total billed charges,,,274.34,91,,percent of total billed charges,,,286.4,95,,percent of total billed charges,,,250.22,83,,percent of total billed charges,,,250.22,83,,percent of total billed charges,,,,,,,,,,,,,,,250.22,83,,percent of total billed charges,,,286.4,95,,percent of total billed charges,,,271.32,90,,percent of total billed charges,,,271.32,90,,percent of total billed charges,,,247.21,82,,percent of total billed charges,,,271.32,90,,percent of total billed charges,,,256.25,85,,percent of total billed charges,,75.37,286.4,
ASCLERA (POLIDOCANOL) 0.5% INJ:10MG/2ML,32019443,CDM,J3490,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
KANJINTI(TRASTUZUM-ANNS) MDV 420MG J/10,32019467,CDM,Q5117,HCPCS,636,RC,outpatient,,1297.36,1297.36,,1101.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,324.34,22,,percent of total billed charges,,,,,,,,,1167.62,90,,percent of total billed charges,,,1074.21,82.8,,percent of total billed charges,,,1102.76,85,,percent of total billed charges,,,,,,,,,1141.68,88,,percent of total billed charges,,3269.9,,,,fee schedule,,,991.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3269.9,,,,fee schedule,,,324.34,22,,percent of total billed charges,,,1180.6,91,,percent of total billed charges,,,1232.49,95,,percent of total billed charges,,,1076.81,83,,percent of total billed charges,,,1076.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1076.81,83,,percent of total billed charges,,,1232.49,95,,percent of total billed charges,,,1167.62,90,,percent of total billed charges,,,1167.62,90,,percent of total billed charges,,,1063.84,82,,percent of total billed charges,,,1167.62,90,,percent of total billed charges,,,1102.76,85,,percent of total billed charges,,324.34,3269.9,
TOCILIZUMAB (ACTEMRA) VIAL: 200MG/10ML,32019475,CDM,J3262,HCPCS,636,RC,outpatient,,5333.04,5333.04,,4527.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1333.26,22,,percent of total billed charges,,,,,,,,,4799.74,90,,percent of total billed charges,,,4415.76,82.8,,percent of total billed charges,,,4533.08,85,,percent of total billed charges,,,,,,,,,4693.08,88,,percent of total billed charges,,4931.2,,,,fee schedule,,,4074.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,4931.2,,,,fee schedule,,,1333.26,22,,percent of total billed charges,,,4853.07,91,,percent of total billed charges,,,5066.39,95,,percent of total billed charges,,,4426.42,83,,percent of total billed charges,,,4426.42,83,,percent of total billed charges,,,,,,,,,,,,,,,4426.42,83,,percent of total billed charges,,,5066.39,95,,percent of total billed charges,,,4799.74,90,,percent of total billed charges,,,4799.74,90,,percent of total billed charges,,,4373.09,82,,percent of total billed charges,,,4799.74,90,,percent of total billed charges,,,4533.08,85,,percent of total billed charges,,1333.26,5066.39,
"LIDOCAINE W/EPI 1:100,000 VIAL 1%:50ML",32019483,CDM,J3490,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
BUPIVACAINE/EPI(SENSORCAI)VL 0.5%:10ML,32019486,CDM,J3490,HCPCS,250,RC,outpatient,,91.51,91.51,,77.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.88,22,,percent of total billed charges,,,,,,,,,82.36,90,,percent of total billed charges,,,75.77,82.8,,percent of total billed charges,,,77.78,85,,percent of total billed charges,,,,,,,,,80.53,88,,percent of total billed charges,,,,,,,,,69.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.88,22,,percent of total billed charges,,,83.27,91,,percent of total billed charges,,,86.93,95,,percent of total billed charges,,,75.95,83,,percent of total billed charges,,,75.95,83,,percent of total billed charges,,,,,,,,,,,,,,,75.95,83,,percent of total billed charges,,,86.93,95,,percent of total billed charges,,,82.36,90,,percent of total billed charges,,,82.36,90,,percent of total billed charges,,,75.04,82,,percent of total billed charges,,,82.36,90,,percent of total billed charges,,,77.78,85,,percent of total billed charges,,22.88,86.93,
dexmedeTOMidin(PRECEDEX)IV:1000MCG/250ML,32019575,CDM,J3490,HCPCS,250,RC,outpatient,,1237.16,1237.16,,1050.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,309.29,22,,percent of total billed charges,,,,,,,,,1113.44,90,,percent of total billed charges,,,1024.37,82.8,,percent of total billed charges,,,1051.59,85,,percent of total billed charges,,,,,,,,,1088.7,88,,percent of total billed charges,,,,,,,,,945.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,309.29,22,,percent of total billed charges,,,1125.82,91,,percent of total billed charges,,,1175.3,95,,percent of total billed charges,,,1026.84,83,,percent of total billed charges,,,1026.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1026.84,83,,percent of total billed charges,,,1175.3,95,,percent of total billed charges,,,1113.44,90,,percent of total billed charges,,,1113.44,90,,percent of total billed charges,,,1014.47,82,,percent of total billed charges,,,1113.44,90,,percent of total billed charges,,,1051.59,85,,percent of total billed charges,,309.29,1175.3,
TEMAZEPAM(RESTORIL)CAP:7.5MG,32019588,CDM,J8499,HCPCS,250,RC,outpatient,,41.71,41.71,,35.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10.43,22,,percent of total billed charges,,,,,,,,,37.54,90,,percent of total billed charges,,,34.54,82.8,,percent of total billed charges,,,35.45,85,,percent of total billed charges,,,,,,,,,36.7,88,,percent of total billed charges,,,,,,,,,31.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10.43,22,,percent of total billed charges,,,37.96,91,,percent of total billed charges,,,39.62,95,,percent of total billed charges,,,34.62,83,,percent of total billed charges,,,34.62,83,,percent of total billed charges,,,,,,,,,,,,,,,34.62,83,,percent of total billed charges,,,39.62,95,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,34.2,82,,percent of total billed charges,,,37.54,90,,percent of total billed charges,,,35.45,85,,percent of total billed charges,,10.43,39.62,
CLINDAMYCIN-IVPB PREMIX:900MG/NS50ML,32019608,CDM,J3490,HCPCS,250,RC,outpatient,,220.43,220.43,,187.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.11,22,,percent of total billed charges,,,,,,,,,198.39,90,,percent of total billed charges,,,182.52,82.8,,percent of total billed charges,,,187.37,85,,percent of total billed charges,,,,,,,,,193.98,88,,percent of total billed charges,,,,,,,,,168.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.11,22,,percent of total billed charges,,,200.59,91,,percent of total billed charges,,,209.41,95,,percent of total billed charges,,,182.96,83,,percent of total billed charges,,,182.96,83,,percent of total billed charges,,,,,,,,,,,,,,,182.96,83,,percent of total billed charges,,,209.41,95,,percent of total billed charges,,,198.39,90,,percent of total billed charges,,,198.39,90,,percent of total billed charges,,,180.75,82,,percent of total billed charges,,,198.39,90,,percent of total billed charges,,,187.37,85,,percent of total billed charges,,55.11,209.41,
CLINDAMYCIN-IVPB PREMIX:600MG/NS50ML,32019609,CDM,J3490,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
CLINDAMYCIN-IVPB PREMIX:300MG/NS50ML,32019610,CDM,J3490,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
MEPIVACAINE 1% MDV: 10MG/ML (50ML),32019611,CDM,J0670,HCPCS,250,RC,outpatient,,102.03,102.03,,86.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.51,22,,percent of total billed charges,,,,,,,,,91.83,90,,percent of total billed charges,,,84.48,82.8,,percent of total billed charges,,,86.73,85,,percent of total billed charges,,,,,,,,,89.79,88,,percent of total billed charges,,,,,,,,,77.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.51,22,,percent of total billed charges,,,92.85,91,,percent of total billed charges,,,96.93,95,,percent of total billed charges,,,84.68,83,,percent of total billed charges,,,84.68,83,,percent of total billed charges,,,,,,,,,,,,,,,84.68,83,,percent of total billed charges,,,96.93,95,,percent of total billed charges,,,91.83,90,,percent of total billed charges,,,91.83,90,,percent of total billed charges,,,83.66,82,,percent of total billed charges,,,91.83,90,,percent of total billed charges,,,86.73,85,,percent of total billed charges,,25.51,96.93,
OPIUM TINCTURE ORAL: 10MG/ML 118ML,32019679,CDM,J8499,HCPCS,250,RC,outpatient,,2220.6,2220.6,,1885.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,555.15,22,,percent of total billed charges,,,,,,,,,1998.54,90,,percent of total billed charges,,,1838.66,82.8,,percent of total billed charges,,,1887.51,85,,percent of total billed charges,,,,,,,,,1954.13,88,,percent of total billed charges,,,,,,,,,1696.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,555.15,22,,percent of total billed charges,,,2020.75,91,,percent of total billed charges,,,2109.57,95,,percent of total billed charges,,,1843.1,83,,percent of total billed charges,,,1843.1,83,,percent of total billed charges,,,,,,,,,,,,,,,1843.1,83,,percent of total billed charges,,,2109.57,95,,percent of total billed charges,,,1998.54,90,,percent of total billed charges,,,1998.54,90,,percent of total billed charges,,,1820.89,82,,percent of total billed charges,,,1998.54,90,,percent of total billed charges,,,1887.51,85,,percent of total billed charges,,555.15,2109.57,
OPIUM TINCTURE ORAL: 6MG/0.6ML UD,32019681,CDM,J8499,HCPCS,250,RC,outpatient,,25.98,25.98,,22.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.5,22,,percent of total billed charges,,,,,,,,,23.38,90,,percent of total billed charges,,,21.51,82.8,,percent of total billed charges,,,22.08,85,,percent of total billed charges,,,,,,,,,22.86,88,,percent of total billed charges,,,,,,,,,19.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.5,22,,percent of total billed charges,,,23.64,91,,percent of total billed charges,,,24.68,95,,percent of total billed charges,,,21.56,83,,percent of total billed charges,,,21.56,83,,percent of total billed charges,,,,,,,,,,,,,,,21.56,83,,percent of total billed charges,,,24.68,95,,percent of total billed charges,,,23.38,90,,percent of total billed charges,,,23.38,90,,percent of total billed charges,,,21.3,82,,percent of total billed charges,,,23.38,90,,percent of total billed charges,,,22.08,85,,percent of total billed charges,,6.5,24.68,
INFLU VACC(FLUZONE) 2021-2022 SYR 0.5ML:,32019707,CDM,90688,CPT,636,RC,outpatient,,304.09,304.09,,258.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.02,22,,percent of total billed charges,,,,,,,,,273.68,90,,percent of total billed charges,,,251.79,82.8,,percent of total billed charges,,,258.48,85,,percent of total billed charges,,,,,,,,,267.6,88,,percent of total billed charges,,,,,,,,,232.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.02,22,,percent of total billed charges,,,276.72,91,,percent of total billed charges,,,288.89,95,,percent of total billed charges,,,252.39,83,,percent of total billed charges,,,252.39,83,,percent of total billed charges,,,,,,,,,,,,,,,252.39,83,,percent of total billed charges,,,288.89,95,,percent of total billed charges,,,273.68,90,,percent of total billed charges,,,273.68,90,,percent of total billed charges,,,249.35,82,,percent of total billed charges,,,273.68,90,,percent of total billed charges,,,258.48,85,,percent of total billed charges,,76.02,288.89,
INFLU HD(FLUZONE HD)2021-2022 SYR 0.7ML:,32019708,CDM,90662,CPT,636,RC,outpatient,,822.1,822.1,,697.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,205.53,22,,percent of total billed charges,,,,,,,,,739.89,90,,percent of total billed charges,,,680.7,82.8,,percent of total billed charges,,,698.79,85,,percent of total billed charges,,,,,,,,,723.45,88,,percent of total billed charges,,,,,,,,,628.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,205.53,22,,percent of total billed charges,,,748.11,91,,percent of total billed charges,,,781,95,,percent of total billed charges,,,682.34,83,,percent of total billed charges,,,682.34,83,,percent of total billed charges,,,,,,,,,,,,,,,682.34,83,,percent of total billed charges,,,781,95,,percent of total billed charges,,,739.89,90,,percent of total billed charges,,,739.89,90,,percent of total billed charges,,,674.12,82,,percent of total billed charges,,,739.89,90,,percent of total billed charges,,,698.79,85,,percent of total billed charges,,205.53,781,
ZN/CU//MANG/SE(TRALEMENT)VIAL:1ML,32019748,CDM,J3490,HCPCS,250,RC,outpatient,,324.68,324.68,,275.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,81.17,22,,percent of total billed charges,,,,,,,,,292.21,90,,percent of total billed charges,,,268.84,82.8,,percent of total billed charges,,,275.98,85,,percent of total billed charges,,,,,,,,,285.72,88,,percent of total billed charges,,,,,,,,,248.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,81.17,22,,percent of total billed charges,,,295.46,91,,percent of total billed charges,,,308.45,95,,percent of total billed charges,,,269.48,83,,percent of total billed charges,,,269.48,83,,percent of total billed charges,,,,,,,,,,,,,,,269.48,83,,percent of total billed charges,,,308.45,95,,percent of total billed charges,,,292.21,90,,percent of total billed charges,,,292.21,90,,percent of total billed charges,,,266.24,82,,percent of total billed charges,,,292.21,90,,percent of total billed charges,,,275.98,85,,percent of total billed charges,,81.17,308.45,
CONG ESTROGEN(PREMARIN)VAG CR:0.625MG/GM,32019749,CDM,J3490,HCPCS,250,RC,outpatient,,3245.07,3245.07,,2755.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,811.27,22,,percent of total billed charges,,,,,,,,,2920.56,90,,percent of total billed charges,,,2686.92,82.8,,percent of total billed charges,,,2758.31,85,,percent of total billed charges,,,,,,,,,2855.66,88,,percent of total billed charges,,,,,,,,,2479.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,811.27,22,,percent of total billed charges,,,2953.01,91,,percent of total billed charges,,,3082.82,95,,percent of total billed charges,,,2693.41,83,,percent of total billed charges,,,2693.41,83,,percent of total billed charges,,,,,,,,,,,,,,,2693.41,83,,percent of total billed charges,,,3082.82,95,,percent of total billed charges,,,2920.56,90,,percent of total billed charges,,,2920.56,90,,percent of total billed charges,,,2660.96,82,,percent of total billed charges,,,2920.56,90,,percent of total billed charges,,,2758.31,85,,percent of total billed charges,,811.27,3082.82,
AMINO ACID 5%/DEXTROSE 20% 2000 ML,32019752,CDM,J3490,HCPCS,250,RC,outpatient,,1107.2,1107.2,,940.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,276.8,22,,percent of total billed charges,,,,,,,,,996.48,90,,percent of total billed charges,,,916.76,82.8,,percent of total billed charges,,,941.12,85,,percent of total billed charges,,,,,,,,,974.34,88,,percent of total billed charges,,,,,,,,,845.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,276.8,22,,percent of total billed charges,,,1007.55,91,,percent of total billed charges,,,1051.84,95,,percent of total billed charges,,,918.98,83,,percent of total billed charges,,,918.98,83,,percent of total billed charges,,,,,,,,,,,,,,,918.98,83,,percent of total billed charges,,,1051.84,95,,percent of total billed charges,,,996.48,90,,percent of total billed charges,,,996.48,90,,percent of total billed charges,,,907.9,82,,percent of total billed charges,,,996.48,90,,percent of total billed charges,,,941.12,85,,percent of total billed charges,,276.8,1051.84,
AMINO ACID 5%/DEXTROSE 20% 1000 ML,32019753,CDM,J3490,HCPCS,250,RC,outpatient,,762.42,762.42,,647.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,190.61,22,,percent of total billed charges,,,,,,,,,686.18,90,,percent of total billed charges,,,631.28,82.8,,percent of total billed charges,,,648.06,85,,percent of total billed charges,,,,,,,,,670.93,88,,percent of total billed charges,,,,,,,,,582.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,190.61,22,,percent of total billed charges,,,693.8,91,,percent of total billed charges,,,724.3,95,,percent of total billed charges,,,632.81,83,,percent of total billed charges,,,632.81,83,,percent of total billed charges,,,,,,,,,,,,,,,632.81,83,,percent of total billed charges,,,724.3,95,,percent of total billed charges,,,686.18,90,,percent of total billed charges,,,686.18,90,,percent of total billed charges,,,625.18,82,,percent of total billed charges,,,686.18,90,,percent of total billed charges,,,648.06,85,,percent of total billed charges,,190.61,724.3,
INSUL LISPRO(humaLOG KWIKPEN)300UNIT/3ML,32019770,CDM,J1815,HCPCS,250,RC,outpatient,,326.31,326.31,,277.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,81.58,22,,percent of total billed charges,,,,,,,,,293.68,90,,percent of total billed charges,,,270.18,82.8,,percent of total billed charges,,,277.36,85,,percent of total billed charges,,,,,,,,,287.15,88,,percent of total billed charges,,,,,,,,,249.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,81.58,22,,percent of total billed charges,,,296.94,91,,percent of total billed charges,,,309.99,95,,percent of total billed charges,,,270.84,83,,percent of total billed charges,,,270.84,83,,percent of total billed charges,,,,,,,,,,,,,,,270.84,83,,percent of total billed charges,,,309.99,95,,percent of total billed charges,,,293.68,90,,percent of total billed charges,,,293.68,90,,percent of total billed charges,,,267.57,82,,percent of total billed charges,,,293.68,90,,percent of total billed charges,,,277.36,85,,percent of total billed charges,,81.58,309.99,
insul REG(humuLIN R):100UNITS/ML (10ML),32019771,CDM,J1815,HCPCS,250,RC,outpatient,,252.94,252.94,,214.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.24,22,,percent of total billed charges,,,,,,,,,227.65,90,,percent of total billed charges,,,209.43,82.8,,percent of total billed charges,,,215,85,,percent of total billed charges,,,,,,,,,222.59,88,,percent of total billed charges,,,,,,,,,193.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.24,22,,percent of total billed charges,,,230.18,91,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,,,,,,,,,,,,,209.94,83,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,207.41,82,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,215,85,,percent of total billed charges,,63.24,240.29,
insul NPH/R(humuLIN 70/30) VIAL:10ML,32019772,CDM,J1815,HCPCS,250,RC,outpatient,,243.93,243.93,,207.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60.98,22,,percent of total billed charges,,,,,,,,,219.54,90,,percent of total billed charges,,,201.97,82.8,,percent of total billed charges,,,207.34,85,,percent of total billed charges,,,,,,,,,214.66,88,,percent of total billed charges,,,,,,,,,186.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60.98,22,,percent of total billed charges,,,221.98,91,,percent of total billed charges,,,231.73,95,,percent of total billed charges,,,202.46,83,,percent of total billed charges,,,202.46,83,,percent of total billed charges,,,,,,,,,,,,,,,202.46,83,,percent of total billed charges,,,231.73,95,,percent of total billed charges,,,219.54,90,,percent of total billed charges,,,219.54,90,,percent of total billed charges,,,200.02,82,,percent of total billed charges,,,219.54,90,,percent of total billed charges,,,207.34,85,,percent of total billed charges,,60.98,231.73,
insul NPH(humuLIN N):100UNIT/ML  (10ML),32019773,CDM,J1815,HCPCS,250,RC,outpatient,,252.94,252.94,,214.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.24,22,,percent of total billed charges,,,,,,,,,227.65,90,,percent of total billed charges,,,209.43,82.8,,percent of total billed charges,,,215,85,,percent of total billed charges,,,,,,,,,222.59,88,,percent of total billed charges,,,,,,,,,193.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.24,22,,percent of total billed charges,,,230.18,91,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,,,,,,,,,,,,,209.94,83,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,207.41,82,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,215,85,,percent of total billed charges,,63.24,240.29,
insul LISPRO(humaLOG)VIAL 75/25 (10ML),32019774,CDM,J1815,HCPCS,250,RC,outpatient,,777.85,777.85,,660.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,194.46,22,,percent of total billed charges,,,,,,,,,700.07,90,,percent of total billed charges,,,644.06,82.8,,percent of total billed charges,,,661.17,85,,percent of total billed charges,,,,,,,,,684.51,88,,percent of total billed charges,,,,,,,,,594.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,194.46,22,,percent of total billed charges,,,707.84,91,,percent of total billed charges,,,738.96,95,,percent of total billed charges,,,645.62,83,,percent of total billed charges,,,645.62,83,,percent of total billed charges,,,,,,,,,,,,,,,645.62,83,,percent of total billed charges,,,738.96,95,,percent of total billed charges,,,700.07,90,,percent of total billed charges,,,700.07,90,,percent of total billed charges,,,637.84,82,,percent of total billed charges,,,700.07,90,,percent of total billed charges,,,661.17,85,,percent of total billed charges,,194.46,738.96,
PHENYLEPH(NEOSYNPHRIN)*503BVIAL:1MG/10ML,32019778,CDM,J2370,HCPCS,250,RC,outpatient,,89.38,89.38,,75.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.35,22,,percent of total billed charges,,,,,,,,,80.44,90,,percent of total billed charges,,,74.01,82.8,,percent of total billed charges,,,75.97,85,,percent of total billed charges,,,,,,,,,78.65,88,,percent of total billed charges,,,,,,,,,68.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.35,22,,percent of total billed charges,,,81.34,91,,percent of total billed charges,,,84.91,95,,percent of total billed charges,,,74.19,83,,percent of total billed charges,,,74.19,83,,percent of total billed charges,,,,,,,,,,,,,,,74.19,83,,percent of total billed charges,,,84.91,95,,percent of total billed charges,,,80.44,90,,percent of total billed charges,,,80.44,90,,percent of total billed charges,,,73.29,82,,percent of total billed charges,,,80.44,90,,percent of total billed charges,,,75.97,85,,percent of total billed charges,,22.35,84.91,
POLYETHYLENE GLYCOL(MIRALAX)PWD:238GM,32019822,CDM,J8499,HCPCS,250,RC,outpatient,,99.84,99.84,,84.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.96,22,,percent of total billed charges,,,,,,,,,89.86,90,,percent of total billed charges,,,82.67,82.8,,percent of total billed charges,,,84.86,85,,percent of total billed charges,,,,,,,,,87.86,88,,percent of total billed charges,,,,,,,,,76.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.96,22,,percent of total billed charges,,,90.85,91,,percent of total billed charges,,,94.85,95,,percent of total billed charges,,,82.87,83,,percent of total billed charges,,,82.87,83,,percent of total billed charges,,,,,,,,,,,,,,,82.87,83,,percent of total billed charges,,,94.85,95,,percent of total billed charges,,,89.86,90,,percent of total billed charges,,,89.86,90,,percent of total billed charges,,,81.87,82,,percent of total billed charges,,,89.86,90,,percent of total billed charges,,,84.86,85,,percent of total billed charges,,24.96,94.85,
DOXYLAMINE (UNISOM)TAB:25MG,32019824,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
DARATUMUMAB-HYA(DARZALEX)SDV:1800MG/15ML,32019878,CDM,J9144,HCPCS,636,RC,outpatient,,39332.56,39332.56,,33393.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9833.14,22,,percent of total billed charges,,,,,,,,,35399.3,90,,percent of total billed charges,,,32567.36,82.8,,percent of total billed charges,,,33432.68,85,,percent of total billed charges,,,,,,,,,34612.65,88,,percent of total billed charges,,8417.34,,,,fee schedule,,,30050.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,8417.34,,,,fee schedule,,,9833.14,22,,percent of total billed charges,,,35792.63,91,,percent of total billed charges,,,37365.93,95,,percent of total billed charges,,,32646.02,83,,percent of total billed charges,,,32646.02,83,,percent of total billed charges,,,,,,,,,,,,,,,32646.02,83,,percent of total billed charges,,,37365.93,95,,percent of total billed charges,,,35399.3,90,,percent of total billed charges,,,35399.3,90,,percent of total billed charges,,,32252.7,82,,percent of total billed charges,,,35399.3,90,,percent of total billed charges,,,33432.68,85,,percent of total billed charges,,8417.34,37365.93,
BUPIVACAINE LIPOSOME(Exparel)VL1.3%:10ML,32019923,CDM,C9290,HCPCS,250,RC,outpatient,,2751.95,2751.95,,2336.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,687.99,22,,percent of total billed charges,,,,,,,,,2476.76,90,,percent of total billed charges,,,2278.61,82.8,,percent of total billed charges,,,2339.16,85,,percent of total billed charges,,,,,,,,,2421.72,88,,percent of total billed charges,,,,,,,,,2102.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,687.99,22,,percent of total billed charges,,,2504.27,91,,percent of total billed charges,,,2614.35,95,,percent of total billed charges,,,2284.12,83,,percent of total billed charges,,,2284.12,83,,percent of total billed charges,,,,,,,,,,,,,,,2284.12,83,,percent of total billed charges,,,2614.35,95,,percent of total billed charges,,,2476.76,90,,percent of total billed charges,,,2476.76,90,,percent of total billed charges,,,2256.6,82,,percent of total billed charges,,,2476.76,90,,percent of total billed charges,,,2339.16,85,,percent of total billed charges,,687.99,2614.35,
BENDAMUSTINE(BENDEKA)MDV:100MG/4ML J/1,32019927,CDM,J9034,HCPCS,636,RC,outpatient,,418.14,418.14,,355,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.54,22,,percent of total billed charges,,,,,,,,,376.33,90,,percent of total billed charges,,,346.22,82.8,,percent of total billed charges,,,355.42,85,,percent of total billed charges,,,,,,,,,367.96,88,,percent of total billed charges,,6973.6,,,,fee schedule,,,319.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6973.6,,,,fee schedule,,,104.54,22,,percent of total billed charges,,,380.51,91,,percent of total billed charges,,,397.23,95,,percent of total billed charges,,,347.06,83,,percent of total billed charges,,,347.06,83,,percent of total billed charges,,,,,,,,,,,,,,,347.06,83,,percent of total billed charges,,,397.23,95,,percent of total billed charges,,,376.33,90,,percent of total billed charges,,,376.33,90,,percent of total billed charges,,,342.87,82,,percent of total billed charges,,,376.33,90,,percent of total billed charges,,,355.42,85,,percent of total billed charges,,104.54,6973.6,
riTUXimab-ABBS(TRUXIMA)VIAL:100MG/10ML,32019929,CDM,Q5115,HCPCS,636,RC,outpatient,,4747.56,4747.56,,4030.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1186.89,22,,percent of total billed charges,,,,,,,,,4272.8,90,,percent of total billed charges,,,3930.98,82.8,,percent of total billed charges,,,4035.43,85,,percent of total billed charges,,,,,,,,,4177.85,88,,percent of total billed charges,,6680.52,,,,fee schedule,,,3627.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,6680.52,,,,fee schedule,,,1186.89,22,,percent of total billed charges,,,4320.28,91,,percent of total billed charges,,,4510.18,95,,percent of total billed charges,,,3940.47,83,,percent of total billed charges,,,3940.47,83,,percent of total billed charges,,,,,,,,,,,,,,,3940.47,83,,percent of total billed charges,,,4510.18,95,,percent of total billed charges,,,4272.8,90,,percent of total billed charges,,,4272.8,90,,percent of total billed charges,,,3893,82,,percent of total billed charges,,,4272.8,90,,percent of total billed charges,,,4035.43,85,,percent of total billed charges,,1186.89,6680.52,
dexmedeTOMidin(PRECEDEX)IV:200MCG/50ML,32019988,CDM,J3490,HCPCS,250,RC,outpatient,,204.41,204.41,,173.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,51.1,22,,percent of total billed charges,,,,,,,,,183.97,90,,percent of total billed charges,,,169.25,82.8,,percent of total billed charges,,,173.75,85,,percent of total billed charges,,,,,,,,,179.88,88,,percent of total billed charges,,,,,,,,,156.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,51.1,22,,percent of total billed charges,,,186.01,91,,percent of total billed charges,,,194.19,95,,percent of total billed charges,,,169.66,83,,percent of total billed charges,,,169.66,83,,percent of total billed charges,,,,,,,,,,,,,,,169.66,83,,percent of total billed charges,,,194.19,95,,percent of total billed charges,,,183.97,90,,percent of total billed charges,,,183.97,90,,percent of total billed charges,,,167.62,82,,percent of total billed charges,,,183.97,90,,percent of total billed charges,,,173.75,85,,percent of total billed charges,,51.1,194.19,
IV NS 0.9%  25ML,32020025,CDM,J7050,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
SODIUM ZIRCONIUM(LOKELMA)PAC:10G UD,32020065,CDM,J8499,HCPCS,250,RC,outpatient,,405,405,,343.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.25,22,,percent of total billed charges,,,,,,,,,364.5,90,,percent of total billed charges,,,335.34,82.8,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,,,,,,,,356.4,88,,percent of total billed charges,,,,,,,,,309.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.25,22,,percent of total billed charges,,,368.55,91,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,,,,,,,,,,,,,336.15,83,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,332.1,82,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,101.25,384.75,
ETHYL ALCOHOL(ABLYSINOL) 99% AMP: 5ML,32020079,CDM,J2001,HCPCS,250,RC,outpatient,,6550.53,6550.53,,5561.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1637.63,22,,percent of total billed charges,,,,,,,,,5895.48,90,,percent of total billed charges,,,5423.84,82.8,,percent of total billed charges,,,5567.95,85,,percent of total billed charges,,,,,,,,,5764.47,88,,percent of total billed charges,,0.75,,,,fee schedule,,,5004.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,1637.63,22,,percent of total billed charges,,,5960.98,91,,percent of total billed charges,,,6223,95,,percent of total billed charges,,,5436.94,83,,percent of total billed charges,,,5436.94,83,,percent of total billed charges,,,,,,,,,,,,,,,5436.94,83,,percent of total billed charges,,,6223,95,,percent of total billed charges,,,5895.48,90,,percent of total billed charges,,,5895.48,90,,percent of total billed charges,,,5371.43,82,,percent of total billed charges,,,5895.48,90,,percent of total billed charges,,,5567.95,85,,percent of total billed charges,,0.75,6223,
INCLISIRAN (LEQVIO) SYR: 284MG/1.5ML,32020211,CDM,J1306,HCPCS,636,RC,outpatient,,15356.25,15356.25,,13037.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3839.06,22,,percent of total billed charges,,,,,,,,,13820.63,90,,percent of total billed charges,,,12714.98,82.8,,percent of total billed charges,,,13052.81,85,,percent of total billed charges,,,,,,,,,13513.5,88,,percent of total billed charges,,3423.05,,,,fee schedule,,,11732.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3423.05,,,,fee schedule,,,3839.06,22,,percent of total billed charges,,,13974.19,91,,percent of total billed charges,,,14588.44,95,,percent of total billed charges,,,12745.69,83,,percent of total billed charges,,,12745.69,83,,percent of total billed charges,,,,,,,,,,,,,,,12745.69,83,,percent of total billed charges,,,14588.44,95,,percent of total billed charges,,,13820.63,90,,percent of total billed charges,,,13820.63,90,,percent of total billed charges,,,12592.13,82,,percent of total billed charges,,,13820.63,90,,percent of total billed charges,,,13052.81,85,,percent of total billed charges,,3423.05,14588.44,
AMISULPRIDE(BARHEMSYS)INJ:10MG/4ML,32020212,CDM,J3490,HCPCS,250,RC,outpatient,,1192.32,1192.32,,1012.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,298.08,22,,percent of total billed charges,,,,,,,,,1073.09,90,,percent of total billed charges,,,987.24,82.8,,percent of total billed charges,,,1013.47,85,,percent of total billed charges,,,,,,,,,1049.24,88,,percent of total billed charges,,,,,,,,,910.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,298.08,22,,percent of total billed charges,,,1085.01,91,,percent of total billed charges,,,1132.7,95,,percent of total billed charges,,,989.63,83,,percent of total billed charges,,,989.63,83,,percent of total billed charges,,,,,,,,,,,,,,,989.63,83,,percent of total billed charges,,,1132.7,95,,percent of total billed charges,,,1073.09,90,,percent of total billed charges,,,1073.09,90,,percent of total billed charges,,,977.7,82,,percent of total billed charges,,,1073.09,90,,percent of total billed charges,,,1013.47,85,,percent of total billed charges,,298.08,1132.7,
LANOLIN OINT 7GM,32020262,CDM,J3490,HCPCS,250,RC,outpatient,,39.22,39.22,,33.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.81,22,,percent of total billed charges,,,,,,,,,35.3,90,,percent of total billed charges,,,32.47,82.8,,percent of total billed charges,,,33.34,85,,percent of total billed charges,,,,,,,,,34.51,88,,percent of total billed charges,,,,,,,,,29.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.81,22,,percent of total billed charges,,,35.69,91,,percent of total billed charges,,,37.26,95,,percent of total billed charges,,,32.55,83,,percent of total billed charges,,,32.55,83,,percent of total billed charges,,,,,,,,,,,,,,,32.55,83,,percent of total billed charges,,,37.26,95,,percent of total billed charges,,,35.3,90,,percent of total billed charges,,,35.3,90,,percent of total billed charges,,,32.16,82,,percent of total billed charges,,,35.3,90,,percent of total billed charges,,,33.34,85,,percent of total billed charges,,9.81,37.26,
risperiDONE(risperDAL)TAB:1MG,32020289,CDM,J8499,HCPCS,250,RC,outpatient,,13.55,13.55,,11.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.39,22,,percent of total billed charges,,,,,,,,,12.2,90,,percent of total billed charges,,,11.22,82.8,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,,,,,,,,11.92,88,,percent of total billed charges,,,,,,,,,10.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.39,22,,percent of total billed charges,,,12.33,91,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,11.25,83,,percent of total billed charges,,,,,,,,,,,,,,,11.25,83,,percent of total billed charges,,,12.87,95,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.11,82,,percent of total billed charges,,,12.2,90,,percent of total billed charges,,,11.52,85,,percent of total billed charges,,3.39,12.87,
IMMUNE GLOBULIN(GAMMAGARD)SDV:30GM/300ML,32020299,CDM,J1569,HCPCS,636,RC,outpatient,,14150.24,14150.24,,12013.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3537.56,22,,percent of total billed charges,,,,,,,,,12735.22,90,,percent of total billed charges,,,11716.4,82.8,,percent of total billed charges,,,12027.7,85,,percent of total billed charges,,,,,,,,,12452.21,88,,percent of total billed charges,,11307.25,,,,fee schedule,,,10810.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11307.25,,,,fee schedule,,,3537.56,22,,percent of total billed charges,,,12876.72,91,,percent of total billed charges,,,13442.73,95,,percent of total billed charges,,,11744.7,83,,percent of total billed charges,,,11744.7,83,,percent of total billed charges,,,,,,,,,,,,,,,11744.7,83,,percent of total billed charges,,,13442.73,95,,percent of total billed charges,,,12735.22,90,,percent of total billed charges,,,12735.22,90,,percent of total billed charges,,,11603.2,82,,percent of total billed charges,,,12735.22,90,,percent of total billed charges,,,12027.7,85,,percent of total billed charges,,3537.56,13442.73,
LABETALOL(TRANDATE)VIAL:200MG/40ML,32020300,CDM,J3490,HCPCS,250,RC,outpatient,,73.61,73.61,,62.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.4,22,,percent of total billed charges,,,,,,,,,66.25,90,,percent of total billed charges,,,60.95,82.8,,percent of total billed charges,,,62.57,85,,percent of total billed charges,,,,,,,,,64.78,88,,percent of total billed charges,,,,,,,,,56.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.4,22,,percent of total billed charges,,,66.99,91,,percent of total billed charges,,,69.93,95,,percent of total billed charges,,,61.1,83,,percent of total billed charges,,,61.1,83,,percent of total billed charges,,,,,,,,,,,,,,,61.1,83,,percent of total billed charges,,,69.93,95,,percent of total billed charges,,,66.25,90,,percent of total billed charges,,,66.25,90,,percent of total billed charges,,,60.36,82,,percent of total billed charges,,,66.25,90,,percent of total billed charges,,,62.57,85,,percent of total billed charges,,18.4,69.93,
guaiFENesin/DM(ROBITUSDM)200MG/20MG/10ML,32020330,CDM,J8499,HCPCS,250,RC,outpatient,,33.54,33.54,,28.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.39,22,,percent of total billed charges,,,,,,,,,30.19,90,,percent of total billed charges,,,27.77,82.8,,percent of total billed charges,,,28.51,85,,percent of total billed charges,,,,,,,,,29.52,88,,percent of total billed charges,,,,,,,,,25.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.39,22,,percent of total billed charges,,,30.52,91,,percent of total billed charges,,,31.86,95,,percent of total billed charges,,,27.84,83,,percent of total billed charges,,,27.84,83,,percent of total billed charges,,,,,,,,,,,,,,,27.84,83,,percent of total billed charges,,,31.86,95,,percent of total billed charges,,,30.19,90,,percent of total billed charges,,,30.19,90,,percent of total billed charges,,,27.5,82,,percent of total billed charges,,,30.19,90,,percent of total billed charges,,,28.51,85,,percent of total billed charges,,8.39,31.86,
DEXTROSE 50%-WATER SYR:50ML (ADMIXED),32020350,CDM,J3490,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
DEXTROSE 70% WATER,32020352,CDM,J3490,HCPCS,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
RIVAROXABAN(XARELTO) TABS:2.5MG,32020477,CDM,J8499,HCPCS,250,RC,outpatient,,109.15,109.15,,92.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.29,22,,percent of total billed charges,,,,,,,,,98.24,90,,percent of total billed charges,,,90.38,82.8,,percent of total billed charges,,,92.78,85,,percent of total billed charges,,,,,,,,,96.05,88,,percent of total billed charges,,,,,,,,,83.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.29,22,,percent of total billed charges,,,99.33,91,,percent of total billed charges,,,103.69,95,,percent of total billed charges,,,90.59,83,,percent of total billed charges,,,90.59,83,,percent of total billed charges,,,,,,,,,,,,,,,90.59,83,,percent of total billed charges,,,103.69,95,,percent of total billed charges,,,98.24,90,,percent of total billed charges,,,98.24,90,,percent of total billed charges,,,89.5,82,,percent of total billed charges,,,98.24,90,,percent of total billed charges,,,92.78,85,,percent of total billed charges,,27.29,103.69,
LIDOCAINE HCL 1% VIAL:(10MG/ML) (50ML),32020478,CDM,J2001,HCPCS,250,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,0.75,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,0.75,59.21,
SOTRADECOL 3% INJ:60MG/2ML,32020493,CDM,J3490,HCPCS,250,RC,outpatient,,1083.21,1083.21,,919.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,270.8,22,,percent of total billed charges,,,,,,,,,974.89,90,,percent of total billed charges,,,896.9,82.8,,percent of total billed charges,,,920.73,85,,percent of total billed charges,,,,,,,,,953.22,88,,percent of total billed charges,,,,,,,,,827.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,270.8,22,,percent of total billed charges,,,985.72,91,,percent of total billed charges,,,1029.05,95,,percent of total billed charges,,,899.06,83,,percent of total billed charges,,,899.06,83,,percent of total billed charges,,,,,,,,,,,,,,,899.06,83,,percent of total billed charges,,,1029.05,95,,percent of total billed charges,,,974.89,90,,percent of total billed charges,,,974.89,90,,percent of total billed charges,,,888.23,82,,percent of total billed charges,,,974.89,90,,percent of total billed charges,,,920.73,85,,percent of total billed charges,,270.8,1029.05,
LABETALOL(TRANDATE)SDV:20MG/4ML,32020512,CDM,J3490,HCPCS,250,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
LIPIODOL (ETHIODIZED OIL) INJ:4.8G/10ML,32020524,CDM,J3490,HCPCS,250,RC,outpatient,,6043.28,6043.28,,5130.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1510.82,22,,percent of total billed charges,,,,,,,,,5438.95,90,,percent of total billed charges,,,5003.84,82.8,,percent of total billed charges,,,5136.79,85,,percent of total billed charges,,,,,,,,,5318.09,88,,percent of total billed charges,,,,,,,,,4617.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1510.82,22,,percent of total billed charges,,,5499.38,91,,percent of total billed charges,,,5741.12,95,,percent of total billed charges,,,5015.92,83,,percent of total billed charges,,,5015.92,83,,percent of total billed charges,,,,,,,,,,,,,,,5015.92,83,,percent of total billed charges,,,5741.12,95,,percent of total billed charges,,,5438.95,90,,percent of total billed charges,,,5438.95,90,,percent of total billed charges,,,4955.49,82,,percent of total billed charges,,,5438.95,90,,percent of total billed charges,,,5136.79,85,,percent of total billed charges,,1510.82,5741.12,
BEVACIZUMAB-AWWB(MVASI):400MG/16ML,32020635,CDM,Q5107,HCPCS,636,RC,outpatient,,12859.29,12859.29,,10917.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3214.82,22,,percent of total billed charges,,,,,,,,,11573.36,90,,percent of total billed charges,,,10647.49,82.8,,percent of total billed charges,,,10930.4,85,,percent of total billed charges,,,,,,,,,11316.18,88,,percent of total billed charges,,5758.9,,,,fee schedule,,,9824.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,5758.9,,,,fee schedule,,,3214.82,22,,percent of total billed charges,,,11701.95,91,,percent of total billed charges,,,12216.33,95,,percent of total billed charges,,,10673.21,83,,percent of total billed charges,,,10673.21,83,,percent of total billed charges,,,,,,,,,,,,,,,10673.21,83,,percent of total billed charges,,,12216.33,95,,percent of total billed charges,,,11573.36,90,,percent of total billed charges,,,11573.36,90,,percent of total billed charges,,,10544.62,82,,percent of total billed charges,,,11573.36,90,,percent of total billed charges,,,10930.4,85,,percent of total billed charges,,3214.82,12216.33,
LEUPROLIDE(LUPRON DEPO)(3MONTHS) 11.25MG,32020645,CDM,J1950,HCPCS,636,RC,outpatient,,21723.8,21723.8,,18443.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5430.95,22,,percent of total billed charges,,,,,,,,,19551.42,90,,percent of total billed charges,,,17987.31,82.8,,percent of total billed charges,,,18465.23,85,,percent of total billed charges,,,,,,,,,19116.94,88,,percent of total billed charges,,11820.38,,,,fee schedule,,,16596.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11820.38,,,,fee schedule,,,5430.95,22,,percent of total billed charges,,,19768.66,91,,percent of total billed charges,,,20637.61,95,,percent of total billed charges,,,18030.75,83,,percent of total billed charges,,,18030.75,83,,percent of total billed charges,,,,,,,,,,,,,,,18030.75,83,,percent of total billed charges,,,20637.61,95,,percent of total billed charges,,,19551.42,90,,percent of total billed charges,,,19551.42,90,,percent of total billed charges,,,17813.52,82,,percent of total billed charges,,,19551.42,90,,percent of total billed charges,,,18465.23,85,,percent of total billed charges,,5430.95,20637.61,
LEUPROLIDE(LUPRON DEPO)(3MONTHS) 11.25MG,32020646,CDM,J1950,HCPCS,636,RC,outpatient,,21723.8,21723.8,,18443.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5430.95,22,,percent of total billed charges,,,,,,,,,19551.42,90,,percent of total billed charges,,,17987.31,82.8,,percent of total billed charges,,,18465.23,85,,percent of total billed charges,,,,,,,,,19116.94,88,,percent of total billed charges,,11820.38,,,,fee schedule,,,16596.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,11820.38,,,,fee schedule,,,5430.95,22,,percent of total billed charges,,,19768.66,91,,percent of total billed charges,,,20637.61,95,,percent of total billed charges,,,18030.75,83,,percent of total billed charges,,,18030.75,83,,percent of total billed charges,,,,,,,,,,,,,,,18030.75,83,,percent of total billed charges,,,20637.61,95,,percent of total billed charges,,,19551.42,90,,percent of total billed charges,,,19551.42,90,,percent of total billed charges,,,17813.52,82,,percent of total billed charges,,,19551.42,90,,percent of total billed charges,,,18465.23,85,,percent of total billed charges,,5430.95,20637.61,
INFLU VACC(FLUZONE) 2022-2023 SYR 0.5ML:,32020675,CDM,90686,CPT,636,RC,outpatient,,319.61,319.61,,271.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,79.9,22,,percent of total billed charges,,,,,,,,,287.65,90,,percent of total billed charges,,,264.64,82.8,,percent of total billed charges,,,271.67,85,,percent of total billed charges,,,,,,,,,281.26,88,,percent of total billed charges,,,,,,,,,244.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,79.9,22,,percent of total billed charges,,,290.85,91,,percent of total billed charges,,,303.63,95,,percent of total billed charges,,,265.28,83,,percent of total billed charges,,,265.28,83,,percent of total billed charges,,,,,,,,,,,,,,,265.28,83,,percent of total billed charges,,,303.63,95,,percent of total billed charges,,,287.65,90,,percent of total billed charges,,,287.65,90,,percent of total billed charges,,,262.08,82,,percent of total billed charges,,,287.65,90,,percent of total billed charges,,,271.67,85,,percent of total billed charges,,79.9,303.63,
CLINDAMYCIN-IVPB PREMIX:900MG/D5W50ML,32020676,CDM,J3490,HCPCS,250,RC,outpatient,,248.69,248.69,,211.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.17,22,,percent of total billed charges,,,,,,,,,223.82,90,,percent of total billed charges,,,205.92,82.8,,percent of total billed charges,,,211.39,85,,percent of total billed charges,,,,,,,,,218.85,88,,percent of total billed charges,,,,,,,,,190,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.17,22,,percent of total billed charges,,,226.31,91,,percent of total billed charges,,,236.26,95,,percent of total billed charges,,,206.41,83,,percent of total billed charges,,,206.41,83,,percent of total billed charges,,,,,,,,,,,,,,,206.41,83,,percent of total billed charges,,,236.26,95,,percent of total billed charges,,,223.82,90,,percent of total billed charges,,,223.82,90,,percent of total billed charges,,,203.93,82,,percent of total billed charges,,,223.82,90,,percent of total billed charges,,,211.39,85,,percent of total billed charges,,62.17,236.26,
NORTRIPTYLINE(PAMELOR)TAB:25MG,32020773,CDM,J8499,HCPCS,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
INFLU HD(FLUZONE HD)2022-2023 SYR 0.7ML:,32020818,CDM,90662,CPT,636,RC,outpatient,,833.73,833.73,,707.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208.43,22,,percent of total billed charges,,,,,,,,,750.36,90,,percent of total billed charges,,,690.33,82.8,,percent of total billed charges,,,708.67,85,,percent of total billed charges,,,,,,,,,733.68,88,,percent of total billed charges,,,,,,,,,636.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208.43,22,,percent of total billed charges,,,758.69,91,,percent of total billed charges,,,792.04,95,,percent of total billed charges,,,692,83,,percent of total billed charges,,,692,83,,percent of total billed charges,,,,,,,,,,,,,,,692,83,,percent of total billed charges,,,792.04,95,,percent of total billed charges,,,750.36,90,,percent of total billed charges,,,750.36,90,,percent of total billed charges,,,683.66,82,,percent of total billed charges,,,750.36,90,,percent of total billed charges,,,708.67,85,,percent of total billed charges,,208.43,792.04,
NIVOLUMAB(OPDIVO) 240MG/24ML,32020845,CDM,J9299,HCPCS,636,RC,outpatient,,33326.51,33326.51,,28294.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8331.63,22,,percent of total billed charges,,,,,,,,,29993.86,90,,percent of total billed charges,,,27594.35,82.8,,percent of total billed charges,,,28327.53,85,,percent of total billed charges,,,,,,,,,29327.33,88,,percent of total billed charges,,14182.56,,,,fee schedule,,,25461.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14182.56,,,,fee schedule,,,8331.63,22,,percent of total billed charges,,,30327.12,91,,percent of total billed charges,,,31660.18,95,,percent of total billed charges,,,27661,83,,percent of total billed charges,,,27661,83,,percent of total billed charges,,,,,,,,,,,,,,,27661,83,,percent of total billed charges,,,31660.18,95,,percent of total billed charges,,,29993.86,90,,percent of total billed charges,,,29993.86,90,,percent of total billed charges,,,27327.74,82,,percent of total billed charges,,,29993.86,90,,percent of total billed charges,,,28327.53,85,,percent of total billed charges,,8331.63,31660.18,
KADCYLA (ADO-TRASTUZUMAB) VIAL 100MG,32020851,CDM,J9354,HCPCS,636,RC,outpatient,,16602.14,16602.14,,14095.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4150.54,22,,percent of total billed charges,,,,,,,,,14941.93,90,,percent of total billed charges,,,13746.57,82.8,,percent of total billed charges,,,14111.82,85,,percent of total billed charges,,,,,,,,,14609.88,88,,percent of total billed charges,,14278,,,,fee schedule,,,12684.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14278,,,,fee schedule,,,4150.54,22,,percent of total billed charges,,,15107.95,91,,percent of total billed charges,,,15772.03,95,,percent of total billed charges,,,13779.78,83,,percent of total billed charges,,,13779.78,83,,percent of total billed charges,,,,,,,,,,,,,,,13779.78,83,,percent of total billed charges,,,15772.03,95,,percent of total billed charges,,,14941.93,90,,percent of total billed charges,,,14941.93,90,,percent of total billed charges,,,13613.75,82,,percent of total billed charges,,,14941.93,90,,percent of total billed charges,,,14111.82,85,,percent of total billed charges,,4150.54,15772.03,
dexmedeTOMidin(PRECEDEX)VIAL:200MCG/2ML,32020918,CDM,J3490,HCPCS,250,RC,outpatient,,122.55,122.55,,104.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,30.64,22,,percent of total billed charges,,,,,,,,,110.3,90,,percent of total billed charges,,,101.47,82.8,,percent of total billed charges,,,104.17,85,,percent of total billed charges,,,,,,,,,107.84,88,,percent of total billed charges,,,,,,,,,93.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,30.64,22,,percent of total billed charges,,,111.52,91,,percent of total billed charges,,,116.42,95,,percent of total billed charges,,,101.72,83,,percent of total billed charges,,,101.72,83,,percent of total billed charges,,,,,,,,,,,,,,,101.72,83,,percent of total billed charges,,,116.42,95,,percent of total billed charges,,,110.3,90,,percent of total billed charges,,,110.3,90,,percent of total billed charges,,,100.49,82,,percent of total billed charges,,,110.3,90,,percent of total billed charges,,,104.17,85,,percent of total billed charges,,30.64,116.42,
DOCEtaxel(TaxoTERE)MDV: 160MG/8ML (J/1),32020974,CDM,J9171,HCPCS,636,RC,outpatient,,15.44,15.44,,13.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.86,22,,percent of total billed charges,,,,,,,,,13.9,90,,percent of total billed charges,,,12.78,82.8,,percent of total billed charges,,,13.12,85,,percent of total billed charges,,,,,,,,,13.59,88,,percent of total billed charges,,121.68,,,,fee schedule,,,11.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,121.68,,,,fee schedule,,,3.86,22,,percent of total billed charges,,,14.05,91,,percent of total billed charges,,,14.67,95,,percent of total billed charges,,,12.82,83,,percent of total billed charges,,,12.82,83,,percent of total billed charges,,,,,,,,,,,,,,,12.82,83,,percent of total billed charges,,,14.67,95,,percent of total billed charges,,,13.9,90,,percent of total billed charges,,,13.9,90,,percent of total billed charges,,,12.66,82,,percent of total billed charges,,,13.9,90,,percent of total billed charges,,,13.12,85,,percent of total billed charges,,3.86,121.68,
inFLIXimab-DYYB(INFLECTRA PR)VIAL 100MG,32021017,CDM,Q5103,HCPCS,636,RC,outpatient,,4133.07,4133.07,,3508.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1033.27,22,,percent of total billed charges,,,,,,,,,3719.76,90,,percent of total billed charges,,,3422.18,82.8,,percent of total billed charges,,,3513.11,85,,percent of total billed charges,,,,,,,,,3637.1,88,,percent of total billed charges,,3868.13,,,,fee schedule,,,3157.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3868.13,,,,fee schedule,,,1033.27,22,,percent of total billed charges,,,3761.09,91,,percent of total billed charges,,,3926.42,95,,percent of total billed charges,,,3430.45,83,,percent of total billed charges,,,3430.45,83,,percent of total billed charges,,,,,,,,,,,,,,,3430.45,83,,percent of total billed charges,,,3926.42,95,,percent of total billed charges,,,3719.76,90,,percent of total billed charges,,,3719.76,90,,percent of total billed charges,,,3389.12,82,,percent of total billed charges,,,3719.76,90,,percent of total billed charges,,,3513.11,85,,percent of total billed charges,,1033.27,3926.42,
VORICONAZOLE(VFEND)TAB:200MG,32021021,CDM,J8499,HCPCS,250,RC,outpatient,,22.29,22.29,,18.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.57,22,,percent of total billed charges,,,,,,,,,20.06,90,,percent of total billed charges,,,18.46,82.8,,percent of total billed charges,,,18.95,85,,percent of total billed charges,,,,,,,,,19.62,88,,percent of total billed charges,,,,,,,,,17.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.57,22,,percent of total billed charges,,,20.28,91,,percent of total billed charges,,,21.18,95,,percent of total billed charges,,,18.5,83,,percent of total billed charges,,,18.5,83,,percent of total billed charges,,,,,,,,,,,,,,,18.5,83,,percent of total billed charges,,,21.18,95,,percent of total billed charges,,,20.06,90,,percent of total billed charges,,,20.06,90,,percent of total billed charges,,,18.28,82,,percent of total billed charges,,,20.06,90,,percent of total billed charges,,,18.95,85,,percent of total billed charges,,5.57,21.18,
PEGFILGRASTIM-JMDB(FULPHILA)SYR6MG/0.6ML,32021036,CDM,Q5108,HCPCS,636,RC,outpatient,,19431,19431,,16496.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4857.75,22,,percent of total billed charges,,,,,,,,,17487.9,90,,percent of total billed charges,,,16088.87,82.8,,percent of total billed charges,,,16516.35,85,,percent of total billed charges,,,,,,,,,17099.28,88,,percent of total billed charges,,1693.37,,,,fee schedule,,,14845.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,1693.37,,,,fee schedule,,,4857.75,22,,percent of total billed charges,,,17682.21,91,,percent of total billed charges,,,18459.45,95,,percent of total billed charges,,,16127.73,83,,percent of total billed charges,,,16127.73,83,,percent of total billed charges,,,,,,,,,,,,,,,16127.73,83,,percent of total billed charges,,,18459.45,95,,percent of total billed charges,,,17487.9,90,,percent of total billed charges,,,17487.9,90,,percent of total billed charges,,,15933.42,82,,percent of total billed charges,,,17487.9,90,,percent of total billed charges,,,16516.35,85,,percent of total billed charges,,1693.37,18459.45,
SACITUZUMAB GOV (TRODELVY) VIAL 180MG,32021068,CDM,J9317,HCPCS,636,RC,outpatient,,10547.24,10547.24,,8954.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2636.81,22,,percent of total billed charges,,,,,,,,,9492.52,90,,percent of total billed charges,,,8733.11,82.8,,percent of total billed charges,,,8965.15,85,,percent of total billed charges,,,,,,,,,9281.57,88,,percent of total billed charges,,16018,,,,fee schedule,,,8058.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,16018,,,,fee schedule,,,2636.81,22,,percent of total billed charges,,,9597.99,91,,percent of total billed charges,,,10019.88,95,,percent of total billed charges,,,8754.21,83,,percent of total billed charges,,,8754.21,83,,percent of total billed charges,,,,,,,,,,,,,,,8754.21,83,,percent of total billed charges,,,10019.88,95,,percent of total billed charges,,,9492.52,90,,percent of total billed charges,,,9492.52,90,,percent of total billed charges,,,8648.74,82,,percent of total billed charges,,,9492.52,90,,percent of total billed charges,,,8965.15,85,,percent of total billed charges,,2636.81,16018,
riTUXimab-PVVR(RUXIENCE)VIAL:500MG/50ML,32021076,CDM,Q5119,HCPCS,636,RC,outpatient,,16934.4,16934.4,,14377.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4233.6,22,,percent of total billed charges,,,,,,,,,15240.96,90,,percent of total billed charges,,,14021.68,82.8,,percent of total billed charges,,,14394.24,85,,percent of total billed charges,,,,,,,,,14902.27,88,,percent of total billed charges,,3775.4,,,,fee schedule,,,12937.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3775.4,,,,fee schedule,,,4233.6,22,,percent of total billed charges,,,15410.3,91,,percent of total billed charges,,,16087.68,95,,percent of total billed charges,,,14055.55,83,,percent of total billed charges,,,14055.55,83,,percent of total billed charges,,,,,,,,,,,,,,,14055.55,83,,percent of total billed charges,,,16087.68,95,,percent of total billed charges,,,15240.96,90,,percent of total billed charges,,,15240.96,90,,percent of total billed charges,,,13886.21,82,,percent of total billed charges,,,15240.96,90,,percent of total billed charges,,,14394.24,85,,percent of total billed charges,,3775.4,16087.68,
FILGRASTIM-SNDZ (ZARXIO)SYR:300MCG/0.5ML,32021093,CDM,Q5101,HCPCS,636,RC,outpatient,,2172.12,2172.12,,1844.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,543.03,22,,percent of total billed charges,,,,,,,,,1954.91,90,,percent of total billed charges,,,1798.52,82.8,,percent of total billed charges,,,1846.3,85,,percent of total billed charges,,,,,,,,,1911.47,88,,percent of total billed charges,,131.04,,,,fee schedule,,,1659.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,131.04,,,,fee schedule,,,543.03,22,,percent of total billed charges,,,1976.63,91,,percent of total billed charges,,,2063.51,95,,percent of total billed charges,,,1802.86,83,,percent of total billed charges,,,1802.86,83,,percent of total billed charges,,,,,,,,,,,,,,,1802.86,83,,percent of total billed charges,,,2063.51,95,,percent of total billed charges,,,1954.91,90,,percent of total billed charges,,,1954.91,90,,percent of total billed charges,,,1781.14,82,,percent of total billed charges,,,1954.91,90,,percent of total billed charges,,,1846.3,85,,percent of total billed charges,,131.04,2063.51,
ALPROSTADIL (EDEX) SYRINGE: 20MCG,32021193,CDM,J0270,HCPCS,636,RC,outpatient,,1552.1,1552.1,,1317.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,388.03,22,,percent of total billed charges,,,,,,,,,1396.89,90,,percent of total billed charges,,,1285.14,82.8,,percent of total billed charges,,,1319.29,85,,percent of total billed charges,,,,,,,,,1365.85,88,,percent of total billed charges,,,,,,,,,1185.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,388.03,22,,percent of total billed charges,,,1412.41,91,,percent of total billed charges,,,1474.5,95,,percent of total billed charges,,,1288.24,83,,percent of total billed charges,,,1288.24,83,,percent of total billed charges,,,,,,,,,,,,,,,1288.24,83,,percent of total billed charges,,,1474.5,95,,percent of total billed charges,,,1396.89,90,,percent of total billed charges,,,1396.89,90,,percent of total billed charges,,,1272.72,82,,percent of total billed charges,,,1396.89,90,,percent of total billed charges,,,1319.29,85,,percent of total billed charges,,388.03,1474.5,
INFLUENZA VIRUS VACCINE,32401018,CDM,90658,CPT,636,RC,outpatient,,21,21,,17.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.25,22,,percent of total billed charges,,,,,,,,,18.9,90,,percent of total billed charges,,,17.39,82.8,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,,,,,,,,18.48,88,,percent of total billed charges,,,,,,,,,16.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.25,22,,percent of total billed charges,,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.22,82,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,5.25,19.95,
DEXTROSE 70%-WATER SOL : 70%,32500071,CDM,,,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
HESPAN 6% IN NS 500 ML,32500136,CDM,,,250,RC,outpatient,,186.5,186.5,,158.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.63,22,,percent of total billed charges,,,,,,,,,167.85,90,,percent of total billed charges,,,154.42,82.8,,percent of total billed charges,,,158.53,85,,percent of total billed charges,,,,,,,,,164.12,88,,percent of total billed charges,,,,,,,,,142.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.63,22,,percent of total billed charges,,,169.72,91,,percent of total billed charges,,,177.18,95,,percent of total billed charges,,,154.8,83,,percent of total billed charges,,,154.8,83,,percent of total billed charges,,,,,,,,,,,,,,,154.8,83,,percent of total billed charges,,,177.18,95,,percent of total billed charges,,,167.85,90,,percent of total billed charges,,,167.85,90,,percent of total billed charges,,,152.93,82,,percent of total billed charges,,,167.85,90,,percent of total billed charges,,,158.53,85,,percent of total billed charges,,46.63,177.18,
TETANUS IMM GLOB(HYPERTET)SYR:250UNITS,32500146,CDM,J1670,HCPCS,636,RC,outpatient,,4013.84,4013.84,,3407.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1003.46,22,,percent of total billed charges,,,,,,,,,3612.46,90,,percent of total billed charges,,,3323.46,82.8,,percent of total billed charges,,,3411.76,85,,percent of total billed charges,,,,,,,,,3532.18,88,,percent of total billed charges,,537.77,,,,fee schedule,,,3066.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,537.77,,,,fee schedule,,,1003.46,22,,percent of total billed charges,,,3652.59,91,,percent of total billed charges,,,3813.15,95,,percent of total billed charges,,,3331.49,83,,percent of total billed charges,,,3331.49,83,,percent of total billed charges,,,,,,,,,,,,,,,3331.49,83,,percent of total billed charges,,,3813.15,95,,percent of total billed charges,,,3612.46,90,,percent of total billed charges,,,3612.46,90,,percent of total billed charges,,,3291.35,82,,percent of total billed charges,,,3612.46,90,,percent of total billed charges,,,3411.76,85,,percent of total billed charges,,537.77,3813.15,
FAT EMULSIONS (INTRALIPID) : 20% 500 ML,32500171,CDM,,,250,RC,outpatient,,541.02,541.02,,459.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,135.26,22,,percent of total billed charges,,,,,,,,,486.92,90,,percent of total billed charges,,,447.96,82.8,,percent of total billed charges,,,459.87,85,,percent of total billed charges,,,,,,,,,476.1,88,,percent of total billed charges,,,,,,,,,413.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,135.26,22,,percent of total billed charges,,,492.33,91,,percent of total billed charges,,,513.97,95,,percent of total billed charges,,,449.05,83,,percent of total billed charges,,,449.05,83,,percent of total billed charges,,,,,,,,,,,,,,,449.05,83,,percent of total billed charges,,,513.97,95,,percent of total billed charges,,,486.92,90,,percent of total billed charges,,,486.92,90,,percent of total billed charges,,,443.64,82,,percent of total billed charges,,,486.92,90,,percent of total billed charges,,,459.87,85,,percent of total billed charges,,135.26,513.97,
CONTAINER EMPTY MCGAW MIXING BAG :2000ML,32500271,CDM,,,250,RC,outpatient,,134.33,134.33,,114.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.58,22,,percent of total billed charges,,,,,,,,,120.9,90,,percent of total billed charges,,,111.23,82.8,,percent of total billed charges,,,114.18,85,,percent of total billed charges,,,,,,,,,118.21,88,,percent of total billed charges,,,,,,,,,102.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.58,22,,percent of total billed charges,,,122.24,91,,percent of total billed charges,,,127.61,95,,percent of total billed charges,,,111.49,83,,percent of total billed charges,,,111.49,83,,percent of total billed charges,,,,,,,,,,,,,,,111.49,83,,percent of total billed charges,,,127.61,95,,percent of total billed charges,,,120.9,90,,percent of total billed charges,,,120.9,90,,percent of total billed charges,,,110.15,82,,percent of total billed charges,,,120.9,90,,percent of total billed charges,,,114.18,85,,percent of total billed charges,,33.58,127.61,
IV VENIPUNCTURE ST(BTRFLY 21X3/4IN 12IN),32500401,CDM,,,250,RC,outpatient,,8.25,8.25,,7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.06,22,,percent of total billed charges,,,,,,,,,7.43,90,,percent of total billed charges,,,6.83,82.8,,percent of total billed charges,,,7.01,85,,percent of total billed charges,,,,,,,,,7.26,88,,percent of total billed charges,,,,,,,,,6.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.06,22,,percent of total billed charges,,,7.51,91,,percent of total billed charges,,,7.84,95,,percent of total billed charges,,,6.85,83,,percent of total billed charges,,,6.85,83,,percent of total billed charges,,,,,,,,,,,,,,,6.85,83,,percent of total billed charges,,,7.84,95,,percent of total billed charges,,,7.43,90,,percent of total billed charges,,,7.43,90,,percent of total billed charges,,,6.77,82,,percent of total billed charges,,,7.43,90,,percent of total billed charges,,,7.01,85,,percent of total billed charges,,2.06,7.84,
IV VENIPUNCTURE (BTRFLY 25X3/4 12TBG),32500406,CDM,,,250,RC,outpatient,,9.2,9.2,,7.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.3,22,,percent of total billed charges,,,,,,,,,8.28,90,,percent of total billed charges,,,7.62,82.8,,percent of total billed charges,,,7.82,85,,percent of total billed charges,,,,,,,,,8.1,88,,percent of total billed charges,,,,,,,,,7.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.3,22,,percent of total billed charges,,,8.37,91,,percent of total billed charges,,,8.74,95,,percent of total billed charges,,,7.64,83,,percent of total billed charges,,,7.64,83,,percent of total billed charges,,,,,,,,,,,,,,,7.64,83,,percent of total billed charges,,,8.74,95,,percent of total billed charges,,,8.28,90,,percent of total billed charges,,,8.28,90,,percent of total billed charges,,,7.54,82,,percent of total billed charges,,,8.28,90,,percent of total billed charges,,,7.82,85,,percent of total billed charges,,2.3,8.74,
EXTENSION SET,32500411,CDM,,,250,RC,outpatient,,23.5,23.5,,19.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.88,22,,percent of total billed charges,,,,,,,,,21.15,90,,percent of total billed charges,,,19.46,82.8,,percent of total billed charges,,,19.98,85,,percent of total billed charges,,,,,,,,,20.68,88,,percent of total billed charges,,,,,,,,,17.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.88,22,,percent of total billed charges,,,21.39,91,,percent of total billed charges,,,22.33,95,,percent of total billed charges,,,19.51,83,,percent of total billed charges,,,19.51,83,,percent of total billed charges,,,,,,,,,,,,,,,19.51,83,,percent of total billed charges,,,22.33,95,,percent of total billed charges,,,21.15,90,,percent of total billed charges,,,21.15,90,,percent of total billed charges,,,19.27,82,,percent of total billed charges,,,21.15,90,,percent of total billed charges,,,19.98,85,,percent of total billed charges,,5.88,22.33,
IV VENIPUNCTURE NEEDLE SET (BUTTERFLY),32500421,CDM,,,250,RC,outpatient,,8.88,8.88,,7.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.22,22,,percent of total billed charges,,,,,,,,,7.99,90,,percent of total billed charges,,,7.35,82.8,,percent of total billed charges,,,7.55,85,,percent of total billed charges,,,,,,,,,7.81,88,,percent of total billed charges,,,,,,,,,6.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.22,22,,percent of total billed charges,,,8.08,91,,percent of total billed charges,,,8.44,95,,percent of total billed charges,,,7.37,83,,percent of total billed charges,,,7.37,83,,percent of total billed charges,,,,,,,,,,,,,,,7.37,83,,percent of total billed charges,,,8.44,95,,percent of total billed charges,,,7.99,90,,percent of total billed charges,,,7.99,90,,percent of total billed charges,,,7.28,82,,percent of total billed charges,,,7.99,90,,percent of total billed charges,,,7.55,85,,percent of total billed charges,,2.22,8.44,
IV VENIPUNCTURE NEEDLE SET (BUTTERFLY),32500426,CDM,,,250,RC,outpatient,,8.72,8.72,,7.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.18,22,,percent of total billed charges,,,,,,,,,7.85,90,,percent of total billed charges,,,7.22,82.8,,percent of total billed charges,,,7.41,85,,percent of total billed charges,,,,,,,,,7.67,88,,percent of total billed charges,,,,,,,,,6.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.18,22,,percent of total billed charges,,,7.94,91,,percent of total billed charges,,,8.28,95,,percent of total billed charges,,,7.24,83,,percent of total billed charges,,,7.24,83,,percent of total billed charges,,,,,,,,,,,,,,,7.24,83,,percent of total billed charges,,,8.28,95,,percent of total billed charges,,,7.85,90,,percent of total billed charges,,,7.85,90,,percent of total billed charges,,,7.15,82,,percent of total billed charges,,,7.85,90,,percent of total billed charges,,,7.41,85,,percent of total billed charges,,2.18,8.28,
IV ADMIN EXTENSION SET INFUS SET,32500431,CDM,,,250,RC,outpatient,,36.48,36.48,,30.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.12,22,,percent of total billed charges,,,,,,,,,32.83,90,,percent of total billed charges,,,30.21,82.8,,percent of total billed charges,,,31.01,85,,percent of total billed charges,,,,,,,,,32.1,88,,percent of total billed charges,,,,,,,,,27.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.12,22,,percent of total billed charges,,,33.2,91,,percent of total billed charges,,,34.66,95,,percent of total billed charges,,,30.28,83,,percent of total billed charges,,,30.28,83,,percent of total billed charges,,,,,,,,,,,,,,,30.28,83,,percent of total billed charges,,,34.66,95,,percent of total billed charges,,,32.83,90,,percent of total billed charges,,,32.83,90,,percent of total billed charges,,,29.91,82,,percent of total billed charges,,,32.83,90,,percent of total billed charges,,,31.01,85,,percent of total billed charges,,9.12,34.66,
IV VENIPUNCTURE NEEDLE SET (BUTTERFLY),32500461,CDM,,,250,RC,outpatient,,8.72,8.72,,7.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.18,22,,percent of total billed charges,,,,,,,,,7.85,90,,percent of total billed charges,,,7.22,82.8,,percent of total billed charges,,,7.41,85,,percent of total billed charges,,,,,,,,,7.67,88,,percent of total billed charges,,,,,,,,,6.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.18,22,,percent of total billed charges,,,7.94,91,,percent of total billed charges,,,8.28,95,,percent of total billed charges,,,7.24,83,,percent of total billed charges,,,7.24,83,,percent of total billed charges,,,,,,,,,,,,,,,7.24,83,,percent of total billed charges,,,8.28,95,,percent of total billed charges,,,7.85,90,,percent of total billed charges,,,7.85,90,,percent of total billed charges,,,7.15,82,,percent of total billed charges,,,7.85,90,,percent of total billed charges,,,7.41,85,,percent of total billed charges,,2.18,8.28,
IV EQUIPMENT (PCA MINI BORE SET),32500481,CDM,,,250,RC,outpatient,,63.76,63.76,,54.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.94,22,,percent of total billed charges,,,,,,,,,57.38,90,,percent of total billed charges,,,52.79,82.8,,percent of total billed charges,,,54.2,85,,percent of total billed charges,,,,,,,,,56.11,88,,percent of total billed charges,,,,,,,,,48.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.94,22,,percent of total billed charges,,,58.02,91,,percent of total billed charges,,,60.57,95,,percent of total billed charges,,,52.92,83,,percent of total billed charges,,,52.92,83,,percent of total billed charges,,,,,,,,,,,,,,,52.92,83,,percent of total billed charges,,,60.57,95,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,52.28,82,,percent of total billed charges,,,57.38,90,,percent of total billed charges,,,54.2,85,,percent of total billed charges,,15.94,60.57,
SODIUM CHLORIDE IRRIG SOLN 0.9%:3000ML,32500516,CDM,,,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
FAT EMULSIONS (LIPOSYN II) EMU : 10%,32500526,CDM,,,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
AMINOSYN 3.5% IN DEXTROSE 5% 1000 ML,32500599,CDM,,,250,RC,outpatient,,298.33,298.33,,253.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,74.58,22,,percent of total billed charges,,,,,,,,,268.5,90,,percent of total billed charges,,,247.02,82.8,,percent of total billed charges,,,253.58,85,,percent of total billed charges,,,,,,,,,262.53,88,,percent of total billed charges,,,,,,,,,227.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,74.58,22,,percent of total billed charges,,,271.48,91,,percent of total billed charges,,,283.41,95,,percent of total billed charges,,,247.61,83,,percent of total billed charges,,,247.61,83,,percent of total billed charges,,,,,,,,,,,,,,,247.61,83,,percent of total billed charges,,,283.41,95,,percent of total billed charges,,,268.5,90,,percent of total billed charges,,,268.5,90,,percent of total billed charges,,,244.63,82,,percent of total billed charges,,,268.5,90,,percent of total billed charges,,,253.58,85,,percent of total billed charges,,74.58,283.41,
AMINOSYN 4.25%/DEXTROSE 25% 1000 ML,32500600,CDM,J3490,HCPCS,250,RC,outpatient,,529.09,529.09,,449.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.27,22,,percent of total billed charges,,,,,,,,,476.18,90,,percent of total billed charges,,,438.09,82.8,,percent of total billed charges,,,449.73,85,,percent of total billed charges,,,,,,,,,465.6,88,,percent of total billed charges,,,,,,,,,404.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.27,22,,percent of total billed charges,,,481.47,91,,percent of total billed charges,,,502.64,95,,percent of total billed charges,,,439.14,83,,percent of total billed charges,,,439.14,83,,percent of total billed charges,,,,,,,,,,,,,,,439.14,83,,percent of total billed charges,,,502.64,95,,percent of total billed charges,,,476.18,90,,percent of total billed charges,,,476.18,90,,percent of total billed charges,,,433.85,82,,percent of total billed charges,,,476.18,90,,percent of total billed charges,,,449.73,85,,percent of total billed charges,,132.27,502.64,
IV MAG SULF 40GM/SW1000ML(PREMIX),32505647,CDM,J3475,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,15.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,15.22,,,,fee schedule,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,15.22,187.11,
MANNITOL SOL 20% 250 ML,32505716,CDM,J2150,HCPCS,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,34.78,,,,fee schedule,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,34.78,,,,fee schedule,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,34.78,181.67,
IV MANNITOL SOL 20%:500 ML,32505731,CDM,J2150,HCPCS,250,RC,outpatient,,277.23,277.23,,235.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,69.31,22,,percent of total billed charges,,,,,,,,,249.51,90,,percent of total billed charges,,,229.55,82.8,,percent of total billed charges,,,235.65,85,,percent of total billed charges,,,,,,,,,243.96,88,,percent of total billed charges,,34.78,,,,fee schedule,,,211.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,34.78,,,,fee schedule,,,69.31,22,,percent of total billed charges,,,252.28,91,,percent of total billed charges,,,263.37,95,,percent of total billed charges,,,230.1,83,,percent of total billed charges,,,230.1,83,,percent of total billed charges,,,,,,,,,,,,,,,230.1,83,,percent of total billed charges,,,263.37,95,,percent of total billed charges,,,249.51,90,,percent of total billed charges,,,249.51,90,,percent of total billed charges,,,227.33,82,,percent of total billed charges,,,249.51,90,,percent of total billed charges,,,235.65,85,,percent of total billed charges,,34.78,263.37,
DEXTROSE 20%-WATER SOL : 500ML,32505736,CDM,,,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
IV D 50% W (HAL) 500 ML,32505741,CDM,,,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
IV NS 3% (HYPERTONIC)500ML  (PREMIX),32505742,CDM,J7131,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,2.4,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,2.4,,,,fee schedule,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,2.4,187.11,
IV NS1000ML/KCL20MEQ    (PREMIX),32505743,CDM,J3480,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,3.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.22,187.11,
IV D5W 100ML,32505771,CDM,J7060,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV NS 0.9% 50ML,32505776,CDM,J3490,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV NS 0.9%  100ML,32505781,CDM,J7050,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
FREAMINE III SOL:8.50% 500ML,32505786,CDM,,,250,RC,outpatient,,897.39,897.39,,761.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,224.35,22,,percent of total billed charges,,,,,,,,,807.65,90,,percent of total billed charges,,,743.04,82.8,,percent of total billed charges,,,762.78,85,,percent of total billed charges,,,,,,,,,789.7,88,,percent of total billed charges,,,,,,,,,685.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,224.35,22,,percent of total billed charges,,,816.62,91,,percent of total billed charges,,,852.52,95,,percent of total billed charges,,,744.83,83,,percent of total billed charges,,,744.83,83,,percent of total billed charges,,,,,,,,,,,,,,,744.83,83,,percent of total billed charges,,,852.52,95,,percent of total billed charges,,,807.65,90,,percent of total billed charges,,,807.65,90,,percent of total billed charges,,,735.86,82,,percent of total billed charges,,,807.65,90,,percent of total billed charges,,,762.78,85,,percent of total billed charges,,224.35,852.52,
ETHYL ALCOHOL/D5W (DEXTROSE) SOL:5%-5%,32505796,CDM,,,250,RC,outpatient,,348.44,348.44,,295.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.11,22,,percent of total billed charges,,,,,,,,,313.6,90,,percent of total billed charges,,,288.51,82.8,,percent of total billed charges,,,296.17,85,,percent of total billed charges,,,,,,,,,306.63,88,,percent of total billed charges,,,,,,,,,266.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.11,22,,percent of total billed charges,,,317.08,91,,percent of total billed charges,,,331.02,95,,percent of total billed charges,,,289.21,83,,percent of total billed charges,,,289.21,83,,percent of total billed charges,,,,,,,,,,,,,,,289.21,83,,percent of total billed charges,,,331.02,95,,percent of total billed charges,,,313.6,90,,percent of total billed charges,,,313.6,90,,percent of total billed charges,,,285.72,82,,percent of total billed charges,,,313.6,90,,percent of total billed charges,,,296.17,85,,percent of total billed charges,,87.11,331.02,
WATER FOR IRRIGATION STERILE SOL:1000ML,32505806,CDM,J3490,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
WATER FOR IRRIGATION STERILE SOL 2000ML,32505811,CDM,,,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
SODIUM CL IRRIG SOL 0.9% BOTTLE:1000ML,32505816,CDM,J3490,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
SODIUM CL IRRIG SOLN SOL : 0.90% 2000ML,32505821,CDM,,,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
SORBITOL SOLUTION SOL : 3.30% 2000ML,32505831,CDM,,,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
SORBITOL SOLUTION SOL : 3.30% 4000ML,32505836,CDM,,,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
ACETIC ACID SOL : 0.25%    1000 ML,32505841,CDM,,,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
BLOOD ADMINISTRATN SET (HORIZON PUMP),32505846,CDM,,,250,RC,outpatient,,101.19,101.19,,85.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.3,22,,percent of total billed charges,,,,,,,,,91.07,90,,percent of total billed charges,,,83.79,82.8,,percent of total billed charges,,,86.01,85,,percent of total billed charges,,,,,,,,,89.05,88,,percent of total billed charges,,,,,,,,,77.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.3,22,,percent of total billed charges,,,92.08,91,,percent of total billed charges,,,96.13,95,,percent of total billed charges,,,83.99,83,,percent of total billed charges,,,83.99,83,,percent of total billed charges,,,,,,,,,,,,,,,83.99,83,,percent of total billed charges,,,96.13,95,,percent of total billed charges,,,91.07,90,,percent of total billed charges,,,91.07,90,,percent of total billed charges,,,82.98,82,,percent of total billed charges,,,91.07,90,,percent of total billed charges,,,86.01,85,,percent of total billed charges,,25.3,96.13,
"IV HEParin 25,000UNITS/D5W500ML(PREMIX)",32505861,CDM,J1644,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV NS 0.9% 1000ML,32505876,CDM,J7050,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV EQUIPMENT (PLASTIC DUST CAP),32505881,CDM,,,250,RC,outpatient,,29,29,,24.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7.25,22,,percent of total billed charges,,,,,,,,,26.1,90,,percent of total billed charges,,,24.01,82.8,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,,,,,,,,25.52,88,,percent of total billed charges,,,,,,,,,22.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7.25,22,,percent of total billed charges,,,26.39,91,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,,,,,,,,,,,,,24.07,83,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,23.78,82,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,7.25,27.55,
IV CATHETER PLUG,32505886,CDM,,,250,RC,outpatient,,10.5,10.5,,8.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.63,22,,percent of total billed charges,,,,,,,,,9.45,90,,percent of total billed charges,,,8.69,82.8,,percent of total billed charges,,,8.93,85,,percent of total billed charges,,,,,,,,,9.24,88,,percent of total billed charges,,,,,,,,,8.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.63,22,,percent of total billed charges,,,9.56,91,,percent of total billed charges,,,9.98,95,,percent of total billed charges,,,8.72,83,,percent of total billed charges,,,8.72,83,,percent of total billed charges,,,,,,,,,,,,,,,8.72,83,,percent of total billed charges,,,9.98,95,,percent of total billed charges,,,9.45,90,,percent of total billed charges,,,9.45,90,,percent of total billed charges,,,8.61,82,,percent of total billed charges,,,9.45,90,,percent of total billed charges,,,8.93,85,,percent of total billed charges,,2.63,9.98,
IV EQUIPMENT IV,32505891,CDM,,,250,RC,outpatient,,25.22,25.22,,21.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.31,22,,percent of total billed charges,,,,,,,,,22.7,90,,percent of total billed charges,,,20.88,82.8,,percent of total billed charges,,,21.44,85,,percent of total billed charges,,,,,,,,,22.19,88,,percent of total billed charges,,,,,,,,,19.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.31,22,,percent of total billed charges,,,22.95,91,,percent of total billed charges,,,23.96,95,,percent of total billed charges,,,20.93,83,,percent of total billed charges,,,20.93,83,,percent of total billed charges,,,,,,,,,,,,,,,20.93,83,,percent of total billed charges,,,23.96,95,,percent of total billed charges,,,22.7,90,,percent of total billed charges,,,22.7,90,,percent of total billed charges,,,20.68,82,,percent of total billed charges,,,22.7,90,,percent of total billed charges,,,21.44,85,,percent of total billed charges,,6.31,23.96,
CONTAINER EMPTY BOT : 2000ML,32505896,CDM,,,250,RC,outpatient,,134.33,134.33,,114.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.58,22,,percent of total billed charges,,,,,,,,,120.9,90,,percent of total billed charges,,,111.23,82.8,,percent of total billed charges,,,114.18,85,,percent of total billed charges,,,,,,,,,118.21,88,,percent of total billed charges,,,,,,,,,102.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.58,22,,percent of total billed charges,,,122.24,91,,percent of total billed charges,,,127.61,95,,percent of total billed charges,,,111.49,83,,percent of total billed charges,,,111.49,83,,percent of total billed charges,,,,,,,,,,,,,,,111.49,83,,percent of total billed charges,,,127.61,95,,percent of total billed charges,,,120.9,90,,percent of total billed charges,,,120.9,90,,percent of total billed charges,,,110.15,82,,percent of total billed charges,,,120.9,90,,percent of total billed charges,,,114.18,85,,percent of total billed charges,,33.58,127.61,
TRANSFER SETS (TRANSFER SET),32505901,CDM,,,250,RC,outpatient,,77.87,77.87,,66.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.47,22,,percent of total billed charges,,,,,,,,,70.08,90,,percent of total billed charges,,,64.48,82.8,,percent of total billed charges,,,66.19,85,,percent of total billed charges,,,,,,,,,68.53,88,,percent of total billed charges,,,,,,,,,59.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.47,22,,percent of total billed charges,,,70.86,91,,percent of total billed charges,,,73.98,95,,percent of total billed charges,,,64.63,83,,percent of total billed charges,,,64.63,83,,percent of total billed charges,,,,,,,,,,,,,,,64.63,83,,percent of total billed charges,,,73.98,95,,percent of total billed charges,,,70.08,90,,percent of total billed charges,,,70.08,90,,percent of total billed charges,,,63.85,82,,percent of total billed charges,,,70.08,90,,percent of total billed charges,,,66.19,85,,percent of total billed charges,,19.47,73.98,
IV ADMIN EXTENSION SET-FILTER INFUS SET,32505911,CDM,,,250,RC,outpatient,,125.77,125.77,,106.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,31.44,22,,percent of total billed charges,,,,,,,,,113.19,90,,percent of total billed charges,,,104.14,82.8,,percent of total billed charges,,,106.9,85,,percent of total billed charges,,,,,,,,,110.68,88,,percent of total billed charges,,,,,,,,,96.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,31.44,22,,percent of total billed charges,,,114.45,91,,percent of total billed charges,,,119.48,95,,percent of total billed charges,,,104.39,83,,percent of total billed charges,,,104.39,83,,percent of total billed charges,,,,,,,,,,,,,,,104.39,83,,percent of total billed charges,,,119.48,95,,percent of total billed charges,,,113.19,90,,percent of total billed charges,,,113.19,90,,percent of total billed charges,,,103.13,82,,percent of total billed charges,,,113.19,90,,percent of total billed charges,,,106.9,85,,percent of total billed charges,,31.44,119.48,
IV LIDOCAINE(XYLOCAINE) 2GM/D5W500ML:,32505916,CDM,J2001,HCPCS,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,0.75,,,,fee schedule,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,0.75,181.67,
IV D5W1000ML,32506196,CDM,J7070,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV D5W 500ML,32506201,CDM,J7060,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV D5W 250ML,32506206,CDM,J7060,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV DEXTROSE 10%-WATER SOL 1000ML,32506211,CDM,J3490,HCPCS,250,RC,outpatient,UD,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV DEXTROSE 10%-WATER SOL 250ML,32506212,CDM,J3490,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV D5NS 1000ML,32506216,CDM,J3490,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV D5NS 1000ML/KCL20MEQ  (PREMIX),32506217,CDM,J3480,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,3.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.22,187.11,
IV D51/2NS 1000ML,32506221,CDM,J3490,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV D51/4NS 250ML,32506227,CDM,J3490,HCPCS,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
IV D51/4NS1000ML,32506231,CDM,J3490,HCPCS,250,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
IV D51/4NS1000ML/KCL20MEQ  (PREMIX),32506232,CDM,J3480,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,3.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.22,187.11,
D5 1/4 NS 500ML,32506236,CDM,J3490,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV D51/2NS 1000ML/KCL20MEQ  (PREMIX),32506241,CDM,J3480,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,3.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.22,187.11,
IV D51/2NS 1000ML/KCL40MEQ  (PREMIX),32506242,CDM,J3480,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,3.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.22,187.11,
IV RINGERS LACTATE 1000ML,32506246,CDM,J7120,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV LR  500ML,32506251,CDM,J7120,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV D5LR 1000ML,32506256,CDM,J3490,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV NS 0.9%  500ML,32506261,CDM,J7050,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV NS 0.9%  250ML,32506266,CDM,J7050,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV 0.45% NS 1000ML,32506271,CDM,J3490,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,,,,,,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,49.24,187.11,
IV 0.45% NS 1000ML/KCL20MEQ    (PREMIX),32506272,CDM,J3480,HCPCS,250,RC,outpatient,,196.96,196.96,,167.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,49.24,22,,percent of total billed charges,,,,,,,,,177.26,90,,percent of total billed charges,,,163.08,82.8,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,,,,,,,,173.32,88,,percent of total billed charges,,3.22,,,,fee schedule,,,150.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,49.24,22,,percent of total billed charges,,,179.23,91,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,163.48,83,,percent of total billed charges,,,,,,,,,,,,,,,163.48,83,,percent of total billed charges,,,187.11,95,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,161.51,82,,percent of total billed charges,,,177.26,90,,percent of total billed charges,,,167.42,85,,percent of total billed charges,,3.22,187.11,
PCA-HYDROmorphone :30MG/30ML,32599769,CDM,,,250,RC,outpatient,,306.05,306.05,,259.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.51,22,,percent of total billed charges,,,,,,,,,275.45,90,,percent of total billed charges,,,253.41,82.8,,percent of total billed charges,,,260.14,85,,percent of total billed charges,,,,,,,,,269.32,88,,percent of total billed charges,,,,,,,,,233.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.51,22,,percent of total billed charges,,,278.51,91,,percent of total billed charges,,,290.75,95,,percent of total billed charges,,,254.02,83,,percent of total billed charges,,,254.02,83,,percent of total billed charges,,,,,,,,,,,,,,,254.02,83,,percent of total billed charges,,,290.75,95,,percent of total billed charges,,,275.45,90,,percent of total billed charges,,,275.45,90,,percent of total billed charges,,,250.96,82,,percent of total billed charges,,,275.45,90,,percent of total billed charges,,,260.14,85,,percent of total billed charges,,76.51,290.75,
IV ISOPROTERENOL(ISUPREL):1MG/NS250ML,32599770,CDM,,,250,RC,outpatient,,684.63,684.63,,581.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,171.16,22,,percent of total billed charges,,,,,,,,,616.17,90,,percent of total billed charges,,,566.87,82.8,,percent of total billed charges,,,581.94,85,,percent of total billed charges,,,,,,,,,602.47,88,,percent of total billed charges,,,,,,,,,523.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,171.16,22,,percent of total billed charges,,,623.01,91,,percent of total billed charges,,,650.4,95,,percent of total billed charges,,,568.24,83,,percent of total billed charges,,,568.24,83,,percent of total billed charges,,,,,,,,,,,,,,,568.24,83,,percent of total billed charges,,,650.4,95,,percent of total billed charges,,,616.17,90,,percent of total billed charges,,,616.17,90,,percent of total billed charges,,,561.4,82,,percent of total billed charges,,,616.17,90,,percent of total billed charges,,,581.94,85,,percent of total billed charges,,171.16,650.4,
VANCOMYCIN-VIAL:2GM (FOR STERILE FIELD),32599773,CDM,,,250,RC,outpatient,,100.24,100.24,,85.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.06,22,,percent of total billed charges,,,,,,,,,90.22,90,,percent of total billed charges,,,83,82.8,,percent of total billed charges,,,85.2,85,,percent of total billed charges,,,,,,,,,88.21,88,,percent of total billed charges,,,,,,,,,76.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.06,22,,percent of total billed charges,,,91.22,91,,percent of total billed charges,,,95.23,95,,percent of total billed charges,,,83.2,83,,percent of total billed charges,,,83.2,83,,percent of total billed charges,,,,,,,,,,,,,,,83.2,83,,percent of total billed charges,,,95.23,95,,percent of total billed charges,,,90.22,90,,percent of total billed charges,,,90.22,90,,percent of total billed charges,,,82.2,82,,percent of total billed charges,,,90.22,90,,percent of total billed charges,,,85.2,85,,percent of total billed charges,,25.06,95.23,
MAG SULF-IVPB 4GM/NS250ML(PHARM MIX),32599776,CDM,,,258,RC,outpatient,,53.58,53.58,,45.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.4,22,,percent of total billed charges,,,,,,,,,48.22,90,,percent of total billed charges,,,44.36,82.8,,percent of total billed charges,,,45.54,85,,percent of total billed charges,,,,,,,,,47.15,88,,percent of total billed charges,,,,,,,,,40.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.4,22,,percent of total billed charges,,,48.76,91,,percent of total billed charges,,,50.9,95,,percent of total billed charges,,,44.47,83,,percent of total billed charges,,,44.47,83,,percent of total billed charges,,,,,,,,,,,,,,,44.47,83,,percent of total billed charges,,,50.9,95,,percent of total billed charges,,,48.22,90,,percent of total billed charges,,,48.22,90,,percent of total billed charges,,,43.94,82,,percent of total billed charges,,,48.22,90,,percent of total billed charges,,,45.54,85,,percent of total billed charges,,13.4,50.9,
MAG SULF-IVPB 3GM/NS250ML(PHARM-MIX),32599777,CDM,,,258,RC,outpatient,,53.58,53.58,,45.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.4,22,,percent of total billed charges,,,,,,,,,48.22,90,,percent of total billed charges,,,44.36,82.8,,percent of total billed charges,,,45.54,85,,percent of total billed charges,,,,,,,,,47.15,88,,percent of total billed charges,,,,,,,,,40.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.4,22,,percent of total billed charges,,,48.76,91,,percent of total billed charges,,,50.9,95,,percent of total billed charges,,,44.47,83,,percent of total billed charges,,,44.47,83,,percent of total billed charges,,,,,,,,,,,,,,,44.47,83,,percent of total billed charges,,,50.9,95,,percent of total billed charges,,,48.22,90,,percent of total billed charges,,,48.22,90,,percent of total billed charges,,,43.94,82,,percent of total billed charges,,,48.22,90,,percent of total billed charges,,,45.54,85,,percent of total billed charges,,13.4,50.9,
IV IRON SUCROSE(VENOFER):200MG/NS100ML,32599797,CDM,,,636,RC,outpatient,,583.33,583.33,,495.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,145.83,22,,percent of total billed charges,,,,,,,,,525,90,,percent of total billed charges,,,483,82.8,,percent of total billed charges,,,495.83,85,,percent of total billed charges,,,,,,,,,513.33,88,,percent of total billed charges,,,,,,,,,445.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,145.83,22,,percent of total billed charges,,,530.83,91,,percent of total billed charges,,,554.16,95,,percent of total billed charges,,,484.16,83,,percent of total billed charges,,,484.16,83,,percent of total billed charges,,,,,,,,,,,,,,,484.16,83,,percent of total billed charges,,,554.16,95,,percent of total billed charges,,,525,90,,percent of total billed charges,,,525,90,,percent of total billed charges,,,478.33,82,,percent of total billed charges,,,525,90,,percent of total billed charges,,,495.83,85,,percent of total billed charges,,145.83,554.16,
IV LR 1000ML+PITOCIN:10 UNITS (COMPD),32599815,CDM,,,258,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
levETIRAcetam(KEPPRA)-IVPB:500MG/NS100ML,32599828,CDM,,,250,RC,outpatient,,240.2,240.2,,203.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60.05,22,,percent of total billed charges,,,,,,,,,216.18,90,,percent of total billed charges,,,198.89,82.8,,percent of total billed charges,,,204.17,85,,percent of total billed charges,,,,,,,,,211.38,88,,percent of total billed charges,,,,,,,,,183.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60.05,22,,percent of total billed charges,,,218.58,91,,percent of total billed charges,,,228.19,95,,percent of total billed charges,,,199.37,83,,percent of total billed charges,,,199.37,83,,percent of total billed charges,,,,,,,,,,,,,,,199.37,83,,percent of total billed charges,,,228.19,95,,percent of total billed charges,,,216.18,90,,percent of total billed charges,,,216.18,90,,percent of total billed charges,,,196.96,82,,percent of total billed charges,,,216.18,90,,percent of total billed charges,,,204.17,85,,percent of total billed charges,,60.05,228.19,
IMIPENEM(PRIMAXIN)-IVPB:250MG/NS100ML,32599846,CDM,,,258,RC,outpatient,,310.19,310.19,,263.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.55,22,,percent of total billed charges,,,,,,,,,279.17,90,,percent of total billed charges,,,256.84,82.8,,percent of total billed charges,,,263.66,85,,percent of total billed charges,,,,,,,,,272.97,88,,percent of total billed charges,,,,,,,,,236.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.55,22,,percent of total billed charges,,,282.27,91,,percent of total billed charges,,,294.68,95,,percent of total billed charges,,,257.46,83,,percent of total billed charges,,,257.46,83,,percent of total billed charges,,,,,,,,,,,,,,,257.46,83,,percent of total billed charges,,,294.68,95,,percent of total billed charges,,,279.17,90,,percent of total billed charges,,,279.17,90,,percent of total billed charges,,,254.36,82,,percent of total billed charges,,,279.17,90,,percent of total billed charges,,,263.66,85,,percent of total billed charges,,77.55,294.68,
ON-Q-PUMP-400/ROPIVACAINE 0.2%:500ML,32599861,CDM,,,258,RC,outpatient,,1116.46,1116.46,,947.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,279.12,22,,percent of total billed charges,,,,,,,,,1004.81,90,,percent of total billed charges,,,924.43,82.8,,percent of total billed charges,,,948.99,85,,percent of total billed charges,,,,,,,,,982.48,88,,percent of total billed charges,,,,,,,,,852.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,279.12,22,,percent of total billed charges,,,1015.98,91,,percent of total billed charges,,,1060.64,95,,percent of total billed charges,,,926.66,83,,percent of total billed charges,,,926.66,83,,percent of total billed charges,,,,,,,,,,,,,,,926.66,83,,percent of total billed charges,,,1060.64,95,,percent of total billed charges,,,1004.81,90,,percent of total billed charges,,,1004.81,90,,percent of total billed charges,,,915.5,82,,percent of total billed charges,,,1004.81,90,,percent of total billed charges,,,948.99,85,,percent of total billed charges,,279.12,1060.64,
PENICILLIN- IVPB:24MIL UNITS/NS500ML,32599867,CDM,,,258,RC,outpatient,,139.75,139.75,,118.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.94,22,,percent of total billed charges,,,,,,,,,125.78,90,,percent of total billed charges,,,115.71,82.8,,percent of total billed charges,,,118.79,85,,percent of total billed charges,,,,,,,,,122.98,88,,percent of total billed charges,,,,,,,,,106.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.94,22,,percent of total billed charges,,,127.17,91,,percent of total billed charges,,,132.76,95,,percent of total billed charges,,,115.99,83,,percent of total billed charges,,,115.99,83,,percent of total billed charges,,,,,,,,,,,,,,,115.99,83,,percent of total billed charges,,,132.76,95,,percent of total billed charges,,,125.78,90,,percent of total billed charges,,,125.78,90,,percent of total billed charges,,,114.6,82,,percent of total billed charges,,,125.78,90,,percent of total billed charges,,,118.79,85,,percent of total billed charges,,34.94,132.76,
PCA-fentaNYL:10MCG/ML(30ML),32599870,CDM,,,250,RC,outpatient,,194.77,194.77,,165.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.69,22,,percent of total billed charges,,,,,,,,,175.29,90,,percent of total billed charges,,,161.27,82.8,,percent of total billed charges,,,165.55,85,,percent of total billed charges,,,,,,,,,171.4,88,,percent of total billed charges,,,,,,,,,148.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.69,22,,percent of total billed charges,,,177.24,91,,percent of total billed charges,,,185.03,95,,percent of total billed charges,,,161.66,83,,percent of total billed charges,,,161.66,83,,percent of total billed charges,,,,,,,,,,,,,,,161.66,83,,percent of total billed charges,,,185.03,95,,percent of total billed charges,,,175.29,90,,percent of total billed charges,,,175.29,90,,percent of total billed charges,,,159.71,82,,percent of total billed charges,,,175.29,90,,percent of total billed charges,,,165.55,85,,percent of total billed charges,,48.69,185.03,
vinBLASTine(VELBAN)10MG/10ML:J/1MG,32599871,CDM,J9360,HCPCS,636,RC,outpatient,,69.94,69.94,,59.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.49,22,,percent of total billed charges,,,,,,,,,62.95,90,,percent of total billed charges,,,57.91,82.8,,percent of total billed charges,,,59.45,85,,percent of total billed charges,,,,,,,,,61.55,88,,percent of total billed charges,,179.86,,,,fee schedule,,,53.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,179.86,,,,fee schedule,,,17.49,22,,percent of total billed charges,,,63.65,91,,percent of total billed charges,,,66.44,95,,percent of total billed charges,,,58.05,83,,percent of total billed charges,,,58.05,83,,percent of total billed charges,,,,,,,,,,,,,,,58.05,83,,percent of total billed charges,,,66.44,95,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,57.35,82,,percent of total billed charges,,,62.95,90,,percent of total billed charges,,,59.45,85,,percent of total billed charges,,17.49,179.86,
LEUCOVORIN:600MG/NS250ML,32599874,CDM,,,636,RC,outpatient,,87.39,87.39,,74.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.85,22,,percent of total billed charges,,,,,,,,,78.65,90,,percent of total billed charges,,,72.36,82.8,,percent of total billed charges,,,74.28,85,,percent of total billed charges,,,,,,,,,76.9,88,,percent of total billed charges,,,,,,,,,66.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.85,22,,percent of total billed charges,,,79.52,91,,percent of total billed charges,,,83.02,95,,percent of total billed charges,,,72.53,83,,percent of total billed charges,,,72.53,83,,percent of total billed charges,,,,,,,,,,,,,,,72.53,83,,percent of total billed charges,,,83.02,95,,percent of total billed charges,,,78.65,90,,percent of total billed charges,,,78.65,90,,percent of total billed charges,,,71.66,82,,percent of total billed charges,,,78.65,90,,percent of total billed charges,,,74.28,85,,percent of total billed charges,,21.85,83.02,
DOXOrubicin(ADRIAMYCIN):10MG/5ML,32599894,CDM,J9000,HCPCS,636,RC,outpatient,,114.38,114.38,,97.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.6,22,,percent of total billed charges,,,,,,,,,102.94,90,,percent of total billed charges,,,94.71,82.8,,percent of total billed charges,,,97.22,85,,percent of total billed charges,,,,,,,,,100.65,88,,percent of total billed charges,,43.69,,,,fee schedule,,,87.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,43.69,,,,fee schedule,,,28.6,22,,percent of total billed charges,,,104.09,91,,percent of total billed charges,,,108.66,95,,percent of total billed charges,,,94.94,83,,percent of total billed charges,,,94.94,83,,percent of total billed charges,,,,,,,,,,,,,,,94.94,83,,percent of total billed charges,,,108.66,95,,percent of total billed charges,,,102.94,90,,percent of total billed charges,,,102.94,90,,percent of total billed charges,,,93.79,82,,percent of total billed charges,,,102.94,90,,percent of total billed charges,,,97.22,85,,percent of total billed charges,,28.6,108.66,
FLUOROURACIL(5-FU):500MG/10ML,32599895,CDM,J9190,HCPCS,636,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,47.2,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,47.2,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
nitroGLYCERIN/D5W BTL : 25MG /250ML (PD),32599908,CDM,,,250,RC,outpatient,,88.5,88.5,,75.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22.13,22,,percent of total billed charges,,,,,,,,,79.65,90,,percent of total billed charges,,,73.28,82.8,,percent of total billed charges,,,75.23,85,,percent of total billed charges,,,,,,,,,77.88,88,,percent of total billed charges,,,,,,,,,67.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22.13,22,,percent of total billed charges,,,80.54,91,,percent of total billed charges,,,84.08,95,,percent of total billed charges,,,73.46,83,,percent of total billed charges,,,73.46,83,,percent of total billed charges,,,,,,,,,,,,,,,73.46,83,,percent of total billed charges,,,84.08,95,,percent of total billed charges,,,79.65,90,,percent of total billed charges,,,79.65,90,,percent of total billed charges,,,72.57,82,,percent of total billed charges,,,79.65,90,,percent of total billed charges,,,75.23,85,,percent of total billed charges,,22.13,84.08,
IV LIDOCAINE 2GM/D5W500ML,32599909,CDM,J2001,HCPCS,258,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,0.75,,,,fee schedule,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,0.75,,,,fee schedule,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,0.75,181.67,
ROPIVACAI(NAROPIN)0.2%:100ML(EPIDURAL),32599915,CDM,,,250,RC,outpatient,,677.06,677.06,,574.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,169.27,22,,percent of total billed charges,,,,,,,,,609.35,90,,percent of total billed charges,,,560.61,82.8,,percent of total billed charges,,,575.5,85,,percent of total billed charges,,,,,,,,,595.81,88,,percent of total billed charges,,,,,,,,,517.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,169.27,22,,percent of total billed charges,,,616.12,91,,percent of total billed charges,,,643.21,95,,percent of total billed charges,,,561.96,83,,percent of total billed charges,,,561.96,83,,percent of total billed charges,,,,,,,,,,,,,,,561.96,83,,percent of total billed charges,,,643.21,95,,percent of total billed charges,,,609.35,90,,percent of total billed charges,,,609.35,90,,percent of total billed charges,,,555.19,82,,percent of total billed charges,,,609.35,90,,percent of total billed charges,,,575.5,85,,percent of total billed charges,,169.27,643.21,
POTASSIUM CHLORIDE-IVPB:20MEQ/100 ML*,32599916,CDM,J3480,HCPCS,250,RC,outpatient,,658.83,658.83,,559.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,164.71,22,,percent of total billed charges,,,,,,,,,592.95,90,,percent of total billed charges,,,545.51,82.8,,percent of total billed charges,,,560.01,85,,percent of total billed charges,,,,,,,,,579.77,88,,percent of total billed charges,,3.22,,,,fee schedule,,,503.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.22,,,,fee schedule,,,164.71,22,,percent of total billed charges,,,599.54,91,,percent of total billed charges,,,625.89,95,,percent of total billed charges,,,546.83,83,,percent of total billed charges,,,546.83,83,,percent of total billed charges,,,,,,,,,,,,,,,546.83,83,,percent of total billed charges,,,625.89,95,,percent of total billed charges,,,592.95,90,,percent of total billed charges,,,592.95,90,,percent of total billed charges,,,540.24,82,,percent of total billed charges,,,592.95,90,,percent of total billed charges,,,560.01,85,,percent of total billed charges,,3.22,625.89,
TRIAMCIN(KENALOG)NEB TX:400MCG,32599920,CDM,,,250,RC,outpatient,,12,12,,10.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3,22,,percent of total billed charges,,,,,,,,,10.8,90,,percent of total billed charges,,,9.94,82.8,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,,,,,,,,10.56,88,,percent of total billed charges,,,,,,,,,9.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3,22,,percent of total billed charges,,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,9.84,82,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,3,11.4,
MORPHINE SULF VIAL PCA:30MG/30ML,32599922,CDM,,,250,RC,outpatient,,77.25,77.25,,65.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.31,22,,percent of total billed charges,,,,,,,,,69.53,90,,percent of total billed charges,,,63.96,82.8,,percent of total billed charges,,,65.66,85,,percent of total billed charges,,,,,,,,,67.98,88,,percent of total billed charges,,,,,,,,,59.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.31,22,,percent of total billed charges,,,70.3,91,,percent of total billed charges,,,73.39,95,,percent of total billed charges,,,64.12,83,,percent of total billed charges,,,64.12,83,,percent of total billed charges,,,,,,,,,,,,,,,64.12,83,,percent of total billed charges,,,73.39,95,,percent of total billed charges,,,69.53,90,,percent of total billed charges,,,69.53,90,,percent of total billed charges,,,63.35,82,,percent of total billed charges,,,69.53,90,,percent of total billed charges,,,65.66,85,,percent of total billed charges,,19.31,73.39,
NitroGLY (NITRO-STAT)0.4MG 25'S  (PD),32599924,CDM,,,250,RC,outpatient,,13.16,13.16,,11.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3.29,22,,percent of total billed charges,,,,,,,,,11.84,90,,percent of total billed charges,,,10.9,82.8,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,,,,,,,,11.58,88,,percent of total billed charges,,,,,,,,,10.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3.29,22,,percent of total billed charges,,,11.98,91,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,10.92,83,,percent of total billed charges,,,,,,,,,,,,,,,10.92,83,,percent of total billed charges,,,12.5,95,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,10.79,82,,percent of total billed charges,,,11.84,90,,percent of total billed charges,,,11.19,85,,percent of total billed charges,,3.29,12.5,
IV D5.45NS/KCL 40MEQ 1000ML: (PREMIX),32599935,CDM,,,250,RC,outpatient,,100,100,,84.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25,22,,percent of total billed charges,,,,,,,,,90,90,,percent of total billed charges,,,82.8,82.8,,percent of total billed charges,,,85,85,,percent of total billed charges,,,,,,,,,88,88,,percent of total billed charges,,,,,,,,,76.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25,22,,percent of total billed charges,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,83,83,,percent of total billed charges,,,,,,,,,,,,,,,83,83,,percent of total billed charges,,,95,95,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,82,82,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,25,95,
IV NS1000ML+ POTASSIUM PHOS:45MM(PREMIX),32599949,CDM,,,258,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,,,,,,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,47.81,181.67,
CLINDAMYCIN(CLEOCIN)-IVPB:900MG/NS100ML,32599986,CDM,,,258,RC,outpatient,,64.2,64.2,,54.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.05,22,,percent of total billed charges,,,,,,,,,57.78,90,,percent of total billed charges,,,53.16,82.8,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,,,,,,,,56.5,88,,percent of total billed charges,,,,,,,,,49.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.05,22,,percent of total billed charges,,,58.42,91,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,53.29,83,,percent of total billed charges,,,,,,,,,,,,,,,53.29,83,,percent of total billed charges,,,60.99,95,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,52.64,82,,percent of total billed charges,,,57.78,90,,percent of total billed charges,,,54.57,85,,percent of total billed charges,,16.05,60.99,
X RHC VNG BASIC VESTIBULAR EVALUATION,34010501,CDM,92540,CPT,471,RC,outpatient,TC,280,280,,237.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,70,22,,percent of total billed charges,,,,,,,,,252,90,,percent of total billed charges,,,231.84,82.8,,percent of total billed charges,,,238,85,,percent of total billed charges,,,,,,,,,246.4,88,,percent of total billed charges,,,,,,,,,213.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,70,22,,percent of total billed charges,,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,,,,,,,,,,,,,232.4,83,,percent of total billed charges,,,266,95,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,229.6,82,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,70,266,
X RHC VNG CALORIC VESTIBULAR,34010502,CDM,92543,CPT,471,RC,outpatient,TC,63,63,,53.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.75,22,,percent of total billed charges,,,,,,,,,56.7,90,,percent of total billed charges,,,52.16,82.8,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,,,,,,,,55.44,88,,percent of total billed charges,,,,,,,,,48.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.75,22,,percent of total billed charges,,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,,,,,,,,,,,,,52.29,83,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,51.66,82,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,15.75,59.85,
X RHC VNG SINUSOIDAL VERTICLE AXIS TEST,34010503,CDM,92546,CPT,471,RC,outpatient,TC,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.75,22,,percent of total billed charges,,,,,,,,,207.9,90,,percent of total billed charges,,,191.27,82.8,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.75,22,,percent of total billed charges,,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,57.75,219.45,
VNG BASIC VESTIBULAR EVALUATION,34010540,CDM,92540,CPT,471,RC,outpatient,,809,809,,686.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,202.25,22,,percent of total billed charges,,,,,,,,,728.1,90,,percent of total billed charges,,,669.85,82.8,,percent of total billed charges,,,687.65,85,,percent of total billed charges,,,,,,,,,711.92,88,,percent of total billed charges,,,,,,,,,618.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,202.25,22,,percent of total billed charges,,,736.19,91,,percent of total billed charges,,,768.55,95,,percent of total billed charges,,,671.47,83,,percent of total billed charges,,,671.47,83,,percent of total billed charges,,,,,,,,,,,,,,,671.47,83,,percent of total billed charges,,,768.55,95,,percent of total billed charges,,,728.1,90,,percent of total billed charges,,,728.1,90,,percent of total billed charges,,,663.38,82,,percent of total billed charges,,,728.1,90,,percent of total billed charges,,,687.65,85,,percent of total billed charges,,202.25,768.55,
VNG CALORIC VESTIBULAR,34010543,CDM,92543,CPT,471,RC,outpatient,,354,354,,300.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88.5,22,,percent of total billed charges,,,,,,,,,318.6,90,,percent of total billed charges,,,293.11,82.8,,percent of total billed charges,,,300.9,85,,percent of total billed charges,,,,,,,,,311.52,88,,percent of total billed charges,,,,,,,,,270.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88.5,22,,percent of total billed charges,,,322.14,91,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,,,,,,,,,,,,,293.82,83,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,290.28,82,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,300.9,85,,percent of total billed charges,,88.5,336.3,
VNG SINUSOIDAL VERTICLE AXIS ROTATIONAL,34010546,CDM,92546,CPT,471,RC,outpatient,,607,607,,515.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,151.75,22,,percent of total billed charges,,,,,,,,,546.3,90,,percent of total billed charges,,,502.6,82.8,,percent of total billed charges,,,515.95,85,,percent of total billed charges,,,,,,,,,534.16,88,,percent of total billed charges,,,,,,,,,463.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,151.75,22,,percent of total billed charges,,,552.37,91,,percent of total billed charges,,,576.65,95,,percent of total billed charges,,,503.81,83,,percent of total billed charges,,,503.81,83,,percent of total billed charges,,,,,,,,,,,,,,,503.81,83,,percent of total billed charges,,,576.65,95,,percent of total billed charges,,,546.3,90,,percent of total billed charges,,,546.3,90,,percent of total billed charges,,,497.74,82,,percent of total billed charges,,,546.3,90,,percent of total billed charges,,,515.95,85,,percent of total billed charges,,151.75,576.65,
VNG MEDICARE CALORIC VESTIBULAR,34010743,CDM,92543,CPT,471,RC,outpatient,,482,482,,409.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,120.5,22,,percent of total billed charges,,,,,,,,,433.8,90,,percent of total billed charges,,,399.1,82.8,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,,,,,,,,424.16,88,,percent of total billed charges,,,,,,,,,368.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,120.5,22,,percent of total billed charges,,,438.62,91,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,,,,,,,,,,,,,400.06,83,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,395.24,82,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,120.5,457.9,
VNG SPONTANEOUS NYSTAGMUS TEST W/RECORD,34109500,CDM,92541,CPT,471,RC,outpatient,,389,389,,330.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.25,22,,percent of total billed charges,,,,,,,,,350.1,90,,percent of total billed charges,,,322.09,82.8,,percent of total billed charges,,,330.65,85,,percent of total billed charges,,,,,,,,,342.32,88,,percent of total billed charges,,,,,,,,,297.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.25,22,,percent of total billed charges,,,353.99,91,,percent of total billed charges,,,369.55,95,,percent of total billed charges,,,322.87,83,,percent of total billed charges,,,322.87,83,,percent of total billed charges,,,,,,,,,,,,,,,322.87,83,,percent of total billed charges,,,369.55,95,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,318.98,82,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,330.65,85,,percent of total billed charges,,97.25,369.55,
VNG POSITORIAL NYSTAGMUS TEST,34109501,CDM,92542,CPT,471,RC,outpatient,,391,391,,331.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.75,22,,percent of total billed charges,,,,,,,,,351.9,90,,percent of total billed charges,,,323.75,82.8,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,,,,,,,,344.08,88,,percent of total billed charges,,,,,,,,,298.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.75,22,,percent of total billed charges,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,,,,,,,,,,,,,324.53,83,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,320.62,82,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,97.75,371.45,
VNG CALORIC VESTIBULAR,34109502,CDM,92543,CPT,471,RC,outpatient,,482,482,,409.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,120.5,22,,percent of total billed charges,,,,,,,,,433.8,90,,percent of total billed charges,,,399.1,82.8,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,,,,,,,,424.16,88,,percent of total billed charges,,,,,,,,,368.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,120.5,22,,percent of total billed charges,,,438.62,91,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,,,,,,,,,,,,,400.06,83,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,395.24,82,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,120.5,457.9,
VNG OPTOKIN NYSTAGMUS BI DIRECT FOC PERI,34109503,CDM,92544,CPT,471,RC,outpatient,,352,352,,298.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88,22,,percent of total billed charges,,,,,,,,,316.8,90,,percent of total billed charges,,,291.46,82.8,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,,,,,,,,309.76,88,,percent of total billed charges,,,,,,,,,268.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88,22,,percent of total billed charges,,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,,,,,,,,,,,,,292.16,83,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,288.64,82,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,88,334.4,
VNG OSCILLATING TRACKING TEST W/RECODING,34109504,CDM,92545,CPT,471,RC,outpatient,,334,334,,283.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.5,22,,percent of total billed charges,,,,,,,,,300.6,90,,percent of total billed charges,,,276.55,82.8,,percent of total billed charges,,,283.9,85,,percent of total billed charges,,,,,,,,,293.92,88,,percent of total billed charges,,,,,,,,,255.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.5,22,,percent of total billed charges,,,303.94,91,,percent of total billed charges,,,317.3,95,,percent of total billed charges,,,277.22,83,,percent of total billed charges,,,277.22,83,,percent of total billed charges,,,,,,,,,,,,,,,277.22,83,,percent of total billed charges,,,317.3,95,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,273.88,82,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,283.9,85,,percent of total billed charges,,83.5,317.3,
VNG SINUSODIAL VERTICAL AXIS ROTATIONAL,34109505,CDM,92546,CPT,471,RC,outpatient,,607,607,,515.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,151.75,22,,percent of total billed charges,,,,,,,,,546.3,90,,percent of total billed charges,,,502.6,82.8,,percent of total billed charges,,,515.95,85,,percent of total billed charges,,,,,,,,,534.16,88,,percent of total billed charges,,,,,,,,,463.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,151.75,22,,percent of total billed charges,,,552.37,91,,percent of total billed charges,,,576.65,95,,percent of total billed charges,,,503.81,83,,percent of total billed charges,,,503.81,83,,percent of total billed charges,,,,,,,,,,,,,,,503.81,83,,percent of total billed charges,,,576.65,95,,percent of total billed charges,,,546.3,90,,percent of total billed charges,,,546.3,90,,percent of total billed charges,,,497.74,82,,percent of total billed charges,,,546.3,90,,percent of total billed charges,,,515.95,85,,percent of total billed charges,,151.75,576.65,
VNG MEDICARE CALORIC VESTIBULAR,34109507,CDM,92543,CPT,471,RC,outpatient,,482,482,,409.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,120.5,22,,percent of total billed charges,,,,,,,,,433.8,90,,percent of total billed charges,,,399.1,82.8,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,,,,,,,,424.16,88,,percent of total billed charges,,,,,,,,,368.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,120.5,22,,percent of total billed charges,,,438.62,91,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,,,,,,,,,,,,,400.06,83,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,395.24,82,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,120.5,457.9,
PT KNEE STRAPPING,34900000,CDM,29530,CPT,420,RC,outpatient,GP,431,431,,365.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,107.75,22,,percent of total billed charges,,,,,,,,,387.9,90,,percent of total billed charges,,,356.87,82.8,,percent of total billed charges,,,366.35,85,,percent of total billed charges,,,,,,,,,379.28,88,,percent of total billed charges,,,,,,,,,329.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,107.75,22,,percent of total billed charges,,,392.21,91,,percent of total billed charges,,,409.45,95,,percent of total billed charges,,,357.73,83,,percent of total billed charges,,,357.73,83,,percent of total billed charges,,,,,,,,,,,,,,,357.73,83,,percent of total billed charges,,,409.45,95,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,353.42,82,,percent of total billed charges,,,387.9,90,,percent of total billed charges,,,366.35,85,,percent of total billed charges,,107.75,409.45,
PT HAND FINGER STRAPPING,34900001,CDM,29280,CPT,420,RC,outpatient,GP,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92,22,,percent of total billed charges,,,,,,,,,331.2,90,,percent of total billed charges,,,304.7,82.8,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92,22,,percent of total billed charges,,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,92,349.6,
PT HIP STRAPPING,34900002,CDM,29520,CPT,420,RC,outpatient,GP,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
PT ELBOW WRIST STRAPPING,34900003,CDM,29260,CPT,420,RC,outpatient,GP,407,407,,345.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.75,22,,percent of total billed charges,,,,,,,,,366.3,90,,percent of total billed charges,,,337,82.8,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,,,,,,,,358.16,88,,percent of total billed charges,,,,,,,,,310.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.75,22,,percent of total billed charges,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,,,,,,,,,,,,,337.81,83,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,333.74,82,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,101.75,386.65,
PT TOE STRAPPING,34900004,CDM,29550,CPT,420,RC,outpatient,GP,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.25,22,,percent of total billed charges,,,,,,,,,155.7,90,,percent of total billed charges,,,143.24,82.8,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.25,22,,percent of total billed charges,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,43.25,164.35,
PT ANKLESTRAPPING,34900005,CDM,29540,CPT,420,RC,outpatient,GP,405,405,,343.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.25,22,,percent of total billed charges,,,,,,,,,364.5,90,,percent of total billed charges,,,335.34,82.8,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,,,,,,,,356.4,88,,percent of total billed charges,,,,,,,,,309.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.25,22,,percent of total billed charges,,,368.55,91,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,,,,,,,,,,,,,336.15,83,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,332.1,82,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,101.25,384.75,
PT SHOULDER STRAPPING,34900066,CDM,29240,CPT,420,RC,outpatient,GP,405,405,,343.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.25,22,,percent of total billed charges,,,,,,,,,364.5,90,,percent of total billed charges,,,335.34,82.8,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,,,,,,,,356.4,88,,percent of total billed charges,,,,,,,,,309.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.25,22,,percent of total billed charges,,,368.55,91,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,,,,,,,,,,,,,336.15,83,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,332.1,82,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,101.25,384.75,
SM WORK HARDNG/CONDITIONING EA ADDTL HR,34900620,CDM,97546,CPT,951,RC,outpatient,,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.25,22,,percent of total billed charges,,,,,,,,,260.1,90,,percent of total billed charges,,,239.29,82.8,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.25,22,,percent of total billed charges,,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,72.25,274.55,
PT WORK HARDNG/CONDITIONING EA ADDTL HR,34900622,CDM,97546,CPT,420,RC,outpatient,GP,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.25,22,,percent of total billed charges,,,,,,,,,260.1,90,,percent of total billed charges,,,239.29,82.8,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.25,22,,percent of total billed charges,,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,72.25,274.55,
PT PHY PERFORM TEST/MEASURE EA 15 MIN,34900624,CDM,97750,CPT,420,RC,outpatient,GP,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.75,22,,percent of total billed charges,,,,,,,,,215.1,90,,percent of total billed charges,,,197.89,82.8,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.75,22,,percent of total billed charges,,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,59.75,227.05,
PT BIOFEEDBACK TRAINING,34900650,CDM,90901,CPT,420,RC,outpatient,GP,235,235,,199.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,58.75,22,,percent of total billed charges,,,,,,,,,211.5,90,,percent of total billed charges,,,194.58,82.8,,percent of total billed charges,,,199.75,85,,percent of total billed charges,,,,,,,,,206.8,88,,percent of total billed charges,,,,,,,,,179.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,58.75,22,,percent of total billed charges,,,213.85,91,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,,,,,,,,,,,,,195.05,83,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,192.7,82,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,199.75,85,,percent of total billed charges,,58.75,223.25,
"PT BIOFEEDBACK, PERI/URO/RECTAL",34900655,CDM,90912,CPT,420,RC,outpatient,GP,230,230,,195.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.5,22,,percent of total billed charges,,,,,,,,,207,90,,percent of total billed charges,,,190.44,82.8,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,,,,,,,,202.4,88,,percent of total billed charges,,,,,,,,,175.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.5,22,,percent of total billed charges,,,209.3,91,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,,,,,,,,,,,,,190.9,83,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,188.6,82,,percent of total billed charges,,,207,90,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,57.5,218.5,
PT MOD 59 RE-EVALUATION,34900700,CDM,97002,CPT,424,RC,outpatient,GP,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
PT RE-EVALUATION,34900705,CDM,97002,CPT,424,RC,outpatient,GP,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.5,22,,percent of total billed charges,,,,,,,,,351,90,,percent of total billed charges,,,322.92,82.8,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.5,22,,percent of total billed charges,,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,97.5,370.5,
PT ELEC STIM (UNATTENDED),34900707,CDM,G0283,HCPCS,420,RC,outpatient,GP,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,44,167.2,
PT MEDICARE ELEC STIM (UNATTENDED),34900708,CDM,G0283,HCPCS,420,RC,outpatient,GP,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.75,22,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,121.72,82.8,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.75,22,,percent of total billed charges,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,36.75,139.65,
PT E-STIM: STAGE III-IV WOUND,34900710,CDM,G0281,HCPCS,420,RC,outpatient,GP,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
PT AQUATIC THERAPY EA 15 MINUTES,34900725,CDM,97113,CPT,420,RC,outpatient,GP,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.5,22,,percent of total billed charges,,,,,,,,,275.4,90,,percent of total billed charges,,,253.37,82.8,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.5,22,,percent of total billed charges,,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,76.5,290.7,
X RHC MAGNATHERM,34901000,CDM,97024,CPT,420,RC,outpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6,22,,percent of total billed charges,,,,,,,,,21.6,90,,percent of total billed charges,,,19.87,82.8,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6,22,,percent of total billed charges,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,6,22.8,
PT MOD 59 MECHANICAL TRACTION,34901005,CDM,97012,CPT,420,RC,outpatient,59,179,179,,151.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.75,22,,percent of total billed charges,,,,,,,,,161.1,90,,percent of total billed charges,,,148.21,82.8,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,,,,,,,,157.52,88,,percent of total billed charges,,,,,,,,,136.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.75,22,,percent of total billed charges,,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,146.78,82,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,44.75,170.05,
PT MECHANICAL TRACTION,34901009,CDM,97012,CPT,420,RC,outpatient,GP,179,179,,151.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.75,22,,percent of total billed charges,,,,,,,,,161.1,90,,percent of total billed charges,,,148.21,82.8,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,,,,,,,,157.52,88,,percent of total billed charges,,,,,,,,,136.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.75,22,,percent of total billed charges,,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,146.78,82,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,44.75,170.05,
PT HOT/COLD PACK,34901010,CDM,97010,CPT,420,RC,outpatient,GP,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.75,22,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,121.72,82.8,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.75,22,,percent of total billed charges,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,36.75,139.65,
"PT ORTHOTICS MGMT&TRNG, UE&LE, EA 15 MIN",34901025,CDM,97760,CPT,420,RC,outpatient,GP,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
"PT PROSTHETIC TRNG, UE & LE, EA 15 MIN",34901026,CDM,97761,CPT,420,RC,outpatient,GP,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
PT FUNCTIONAL THERAPEUTIC ACTIVITY,34901027,CDM,97530,CPT,420,RC,outpatient,GP,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
"PT SENSORY INTEGRATION TQS, EA 15 MIN",34901030,CDM,97533,CPT,420,RC,outpatient,GP,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43,22,,percent of total billed charges,,,,,,,,,154.8,90,,percent of total billed charges,,,142.42,82.8,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43,22,,percent of total billed charges,,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,43,163.4,
"PT W/C MGT/PROPULSION TRNG, EA 15 MIN",34901031,CDM,97542,CPT,420,RC,outpatient,GP,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
"PT CKOUT ORTH/PROSTH USE,EST PT EA 15MIN",34901032,CDM,97763,CPT,420,RC,outpatient,GP,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.5,22,,percent of total billed charges,,,,,,,,,307.8,90,,percent of total billed charges,,,283.18,82.8,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.5,22,,percent of total billed charges,,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,85.5,324.9,
"PT HOME INST, SELF CARE, ADLS/EA 15 MINS",34901033,CDM,97535,CPT,420,RC,outpatient,GP,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62,22,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,205.34,82.8,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62,22,,percent of total billed charges,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,62,235.6,
SM WORK HARDENING/CONDITIONING INT 2 HRS,34901034,CDM,97545,CPT,951,RC,outpatient,,562,562,,477.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,140.5,22,,percent of total billed charges,,,,,,,,,505.8,90,,percent of total billed charges,,,465.34,82.8,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,,,,,,,,494.56,88,,percent of total billed charges,,,,,,,,,429.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,140.5,22,,percent of total billed charges,,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,,,,,,,,,,,,,466.46,83,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,460.84,82,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,140.5,533.9,
PT WORK HARDENING/CONDITIONING INT 2 HRS,34901035,CDM,97545,CPT,420,RC,outpatient,GP,562,562,,477.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,140.5,22,,percent of total billed charges,,,,,,,,,505.8,90,,percent of total billed charges,,,465.34,82.8,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,,,,,,,,494.56,88,,percent of total billed charges,,,,,,,,,429.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,140.5,22,,percent of total billed charges,,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,,,,,,,,,,,,,466.46,83,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,460.84,82,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,140.5,533.9,
PT NONSELECTIVE DEBRIDEMENT,34901037,CDM,97602,CPT,420,RC,outpatient,GP,360,360,,305.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90,22,,percent of total billed charges,,,,,,,,,324,90,,percent of total billed charges,,,298.08,82.8,,percent of total billed charges,,,306,85,,percent of total billed charges,,,,,,,,,316.8,88,,percent of total billed charges,,,,,,,,,275.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90,22,,percent of total billed charges,,,327.6,91,,percent of total billed charges,,,342,95,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,,,,,,,,,,,,,298.8,83,,percent of total billed charges,,,342,95,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,295.2,82,,percent of total billed charges,,,324,90,,percent of total billed charges,,,306,85,,percent of total billed charges,,90,342,
"PT SELECTIVE DEBRIDEMENT,20 SQ CM OR LES",34901040,CDM,97597,CPT,420,RC,outpatient,GP,400,400,,339.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100,22,,percent of total billed charges,,,,,,,,,360,90,,percent of total billed charges,,,331.2,82.8,,percent of total billed charges,,,340,85,,percent of total billed charges,,,,,,,,,352,88,,percent of total billed charges,,,,,,,,,305.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100,22,,percent of total billed charges,,,364,91,,percent of total billed charges,,,380,95,,percent of total billed charges,,,332,83,,percent of total billed charges,,,332,83,,percent of total billed charges,,,,,,,,,,,,,,,332,83,,percent of total billed charges,,,380,95,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,328,82,,percent of total billed charges,,,360,90,,percent of total billed charges,,,340,85,,percent of total billed charges,,100,380,
"PT SELECTIVE DEBRIDEMENT, >20 SQ CM",34901042,CDM,97598,CPT,420,RC,outpatient,GP,501,501,,425.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125.25,22,,percent of total billed charges,,,,,,,,,450.9,90,,percent of total billed charges,,,414.83,82.8,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,,,,,,,,440.88,88,,percent of total billed charges,,,,,,,,,382.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125.25,22,,percent of total billed charges,,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,,,,,,,,,,,,,415.83,83,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,410.82,82,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,125.25,475.95,
PT PAXTON IPA THERP EXERCISE EA 15 MIN,34901089,CDM,97110,CPT,420,RC,outpatient,GP,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
PT THERAPEUTIC EXERCISE EA 15 MIN,34901090,CDM,97110,CPT,420,RC,outpatient,GP,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
"PT THER EX EA 15 MIN, IPA U6",34901091,CDM,97110,CPT,420,RC,outpatient,GP,194,194,,164.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,48.5,22,,percent of total billed charges,,,,,,,,,174.6,90,,percent of total billed charges,,,160.63,82.8,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,,,,,,,,170.72,88,,percent of total billed charges,,,,,,,,,148.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,48.5,22,,percent of total billed charges,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,,,,,,,,,,,,,161.02,83,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,159.08,82,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,48.5,184.3,
PT COMM/WORK RE-INTEG. TRNG. EA 15 MIN,34901092,CDM,97537,CPT,420,RC,outpatient,GP,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38,22,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,125.86,82.8,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38,22,,percent of total billed charges,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,38,144.4,
PT MEPIFORM - 1 SHEET,34901126,CDM,,,270,RC,outpatient,,113,113,,95.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.25,22,,percent of total billed charges,,,,,,,,,101.7,90,,percent of total billed charges,,,93.56,82.8,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,,,,,,,,99.44,88,,percent of total billed charges,,,,,,,,,86.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.25,22,,percent of total billed charges,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,92.66,82,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,28.25,107.35,
PT MOD 59 THERAPEUTIC ACTIVITY,34901127,CDM,97530,CPT,420,RC,outpatient,GP,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
*PT THERABAND PER YARD(V0708),34901173,CDM,,,270,RC,outpatient,,24,24,,20.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6,22,,percent of total billed charges,,,,,,,,,21.6,90,,percent of total billed charges,,,19.87,82.8,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,,,,,,,,21.12,88,,percent of total billed charges,,,,,,,,,18.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6,22,,percent of total billed charges,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,19.68,82,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,6,22.8,
PT MOD 59 THERAPEUTIC EXERCISE,34901190,CDM,97110,CPT,420,RC,outpatient,GP,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
PT CONTRAST BATH EA 15 MIN,34901199,CDM,97034,CPT,420,RC,outpatient,GP,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
PT MOD-59 MANUAL THERAPY,34901230,CDM,97140,CPT,420,RC,outpatient,GP,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
PT MANUAL THERAPY TQS EA 15 MIN,34901231,CDM,97140,CPT,420,RC,outpatient,XU,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
PT GROUP,34901235,CDM,97150,CPT,420,RC,outpatient,GP,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27,22,,percent of total billed charges,,,,,,,,,97.2,90,,percent of total billed charges,,,89.42,82.8,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27,22,,percent of total billed charges,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,27,102.6,
PT HIP STRAPPING W THCAP,34901305,CDM,29520,CPT,420,RC,outpatient,KX,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
PT ELBOW WRIST STRAPPING W THCAP,34901306,CDM,29260,CPT,420,RC,outpatient,KX,339,339,,287.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,84.75,22,,percent of total billed charges,,,,,,,,,305.1,90,,percent of total billed charges,,,280.69,82.8,,percent of total billed charges,,,288.15,85,,percent of total billed charges,,,,,,,,,298.32,88,,percent of total billed charges,,,,,,,,,259,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,84.75,22,,percent of total billed charges,,,308.49,91,,percent of total billed charges,,,322.05,95,,percent of total billed charges,,,281.37,83,,percent of total billed charges,,,281.37,83,,percent of total billed charges,,,,,,,,,,,,,,,281.37,83,,percent of total billed charges,,,322.05,95,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,277.98,82,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,288.15,85,,percent of total billed charges,,84.75,322.05,
PT TOE STRAPPING W THCAP,34901307,CDM,29550,CPT,420,RC,outpatient,KX,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.25,22,,percent of total billed charges,,,,,,,,,155.7,90,,percent of total billed charges,,,143.24,82.8,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.25,22,,percent of total billed charges,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,43.25,164.35,
PT HAND FINGER STRAPPING W THCAP,34901308,CDM,29280,CPT,420,RC,outpatient,KX,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92,22,,percent of total billed charges,,,,,,,,,331.2,90,,percent of total billed charges,,,304.7,82.8,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92,22,,percent of total billed charges,,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,92,349.6,
PT KNEE STRAPPING W THCAP,34901309,CDM,29530,CPT,420,RC,outpatient,KX,405,405,,343.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.25,22,,percent of total billed charges,,,,,,,,,364.5,90,,percent of total billed charges,,,335.34,82.8,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,,,,,,,,356.4,88,,percent of total billed charges,,,,,,,,,309.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.25,22,,percent of total billed charges,,,368.55,91,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,,,,,,,,,,,,,336.15,83,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,332.1,82,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,101.25,384.75,
PT SHOULDER STRAPPING W THCAP,34901310,CDM,29240,CPT,420,RC,outpatient,KX,405,405,,343.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.25,22,,percent of total billed charges,,,,,,,,,364.5,90,,percent of total billed charges,,,335.34,82.8,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,,,,,,,,356.4,88,,percent of total billed charges,,,,,,,,,309.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.25,22,,percent of total billed charges,,,368.55,91,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,,,,,,,,,,,,,336.15,83,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,332.1,82,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,101.25,384.75,
PT ANKLESTRAPPING W THCAP,34901311,CDM,29540,CPT,420,RC,outpatient,KX,405,405,,343.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.25,22,,percent of total billed charges,,,,,,,,,364.5,90,,percent of total billed charges,,,335.34,82.8,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,,,,,,,,356.4,88,,percent of total billed charges,,,,,,,,,309.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.25,22,,percent of total billed charges,,,368.55,91,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,336.15,83,,percent of total billed charges,,,,,,,,,,,,,,,336.15,83,,percent of total billed charges,,,384.75,95,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,332.1,82,,percent of total billed charges,,,364.5,90,,percent of total billed charges,,,344.25,85,,percent of total billed charges,,101.25,384.75,
PT BIOFEEDBACK TRAINING W THCAP,34901312,CDM,90901,CPT,420,RC,outpatient,KX,235,235,,199.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,58.75,22,,percent of total billed charges,,,,,,,,,211.5,90,,percent of total billed charges,,,194.58,82.8,,percent of total billed charges,,,199.75,85,,percent of total billed charges,,,,,,,,,206.8,88,,percent of total billed charges,,,,,,,,,179.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,58.75,22,,percent of total billed charges,,,213.85,91,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,,,,,,,,,,,,,195.05,83,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,192.7,82,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,199.75,85,,percent of total billed charges,,58.75,223.25,
"PT BIOFEEDBACK, PERI/URO/RECTAL W THCAP",34901313,CDM,90912,CPT,420,RC,outpatient,KX,230,230,,195.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.5,22,,percent of total billed charges,,,,,,,,,207,90,,percent of total billed charges,,,190.44,82.8,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,,,,,,,,202.4,88,,percent of total billed charges,,,,,,,,,175.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.5,22,,percent of total billed charges,,,209.3,91,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,,,,,,,,,,,,,190.9,83,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,188.6,82,,percent of total billed charges,,,207,90,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,57.5,218.5,
PT RE-EVALUATION W THCAP,34901315,CDM,97002,CPT,424,RC,outpatient,KX,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
PT HOT/COLD PACK W THCAP,34901316,CDM,97010,CPT,420,RC,outpatient,KX,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.75,22,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,121.72,82.8,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.75,22,,percent of total billed charges,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,36.75,139.65,
PT MECHANICAL TRACTION W THCAP,34901317,CDM,97012,CPT,420,RC,outpatient,KX,179,179,,151.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.75,22,,percent of total billed charges,,,,,,,,,161.1,90,,percent of total billed charges,,,148.21,82.8,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,,,,,,,,157.52,88,,percent of total billed charges,,,,,,,,,136.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.75,22,,percent of total billed charges,,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,146.78,82,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,44.75,170.05,
PT ELEC STIM (UNATTENDED) W THCAP,34901318,CDM,97014,CPT,420,RC,outpatient,KX,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,44,167.2,
PT VASOPNEUMATIC DEVICE W THCAP,34901319,CDM,97016,CPT,420,RC,outpatient,KX,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33,22,,percent of total billed charges,,,,,,,,,118.8,90,,percent of total billed charges,,,109.3,82.8,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33,22,,percent of total billed charges,,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,33,125.4,
PT PARAFFIN BATH I W THCAP,34901320,CDM,97018,CPT,420,RC,outpatient,KX,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
PT WHIRLPOOL SUPERVISED/UNATTED W THCAP,34901321,CDM,97022,CPT,420,RC,outpatient,KX,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.5,22,,percent of total billed charges,,,,,,,,,239.4,90,,percent of total billed charges,,,220.25,82.8,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.5,22,,percent of total billed charges,,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,66.5,252.7,
"PT ELEICAL STIM ATTED, EA 15 MIN W THCAP",34901322,CDM,97032,CPT,420,RC,outpatient,KX,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,38.5,146.3,
PT IONTOPHORESIS EA 15 MIN W THCAP,34901323,CDM,97033,CPT,420,RC,outpatient,KX,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.75,22,,percent of total billed charges,,,,,,,,,207.9,90,,percent of total billed charges,,,191.27,82.8,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.75,22,,percent of total billed charges,,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,57.75,219.45,
PT CONTRAST BATH EA 15 MIN W THCAP,34901324,CDM,97034,CPT,420,RC,outpatient,KX,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
PT ULTRASOUND/PHONOP EA 15 MIN W THCAP,34901325,CDM,97035,CPT,420,RC,outpatient,KX,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
PT THERAPEUTIC EXERISE EA 15 MIN W THCAP,34901326,CDM,97110,CPT,420,RC,outpatient,KX,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
PT NEUROMUSC RE-ED EA 15 MIN W THCAP,34901327,CDM,97112,CPT,420,RC,outpatient,KX,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.5,22,,percent of total billed charges,,,,,,,,,214.2,90,,percent of total billed charges,,,197.06,82.8,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.5,22,,percent of total billed charges,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,59.5,226.1,
PT AQUATIC THERAPY EA 15 MINUTES W THCAP,34901328,CDM,97113,CPT,420,RC,outpatient,KX,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.5,22,,percent of total billed charges,,,,,,,,,275.4,90,,percent of total billed charges,,,253.37,82.8,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.5,22,,percent of total billed charges,,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,76.5,290.7,
PT GAIT TRAINING EA 15 MIN W THCAP,34901329,CDM,97116,CPT,420,RC,outpatient,KX,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.75,22,,percent of total billed charges,,,,,,,,,182.7,90,,percent of total billed charges,,,168.08,82.8,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.75,22,,percent of total billed charges,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,50.75,192.85,
PT MANUAL THERAPY TQS EA 15 MIN W THCAP,34901330,CDM,97140,CPT,420,RC,outpatient,KX,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
PT FUNCTIONAL THERAUTIC ACTIVITY W THCAP,34901331,CDM,97530,CPT,420,RC,outpatient,KX,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
"PT SENY INTEGTION TQS, EA 15 MIN W THCAP",34901332,CDM,97533,CPT,420,RC,outpatient,KX,172,172,,146.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43,22,,percent of total billed charges,,,,,,,,,154.8,90,,percent of total billed charges,,,142.42,82.8,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,,,,,,,,151.36,88,,percent of total billed charges,,,,,,,,,131.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43,22,,percent of total billed charges,,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,,,,,,,,,,,,,142.76,83,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,141.04,82,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,43,163.4,
"PT HE INST, SELF CE, /EA 15 MINS W THCAP",34901333,CDM,97535,CPT,420,RC,outpatient,KX,248,248,,210.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62,22,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,205.34,82.8,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,,,,,,,,218.24,88,,percent of total billed charges,,,,,,,,,189.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62,22,,percent of total billed charges,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,203.36,82,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,62,235.6,
PT COM/WK RE-ING. TRG. EA 15 MIN W THCAP,34901334,CDM,97537,CPT,420,RC,outpatient,KX,152,152,,129.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38,22,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,125.86,82.8,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,,,,,,,,133.76,88,,percent of total billed charges,,,,,,,,,116.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38,22,,percent of total billed charges,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,,,,,,,,,,,,,126.16,83,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,124.64,82,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,38,144.4,
"PT W/C MGT/PRON TRNG, EA 15 MIN W THCAP",34901335,CDM,97542,CPT,420,RC,outpatient,KX,181,181,,153.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,45.25,22,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,149.87,82.8,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,,,,,,,,159.28,88,,percent of total billed charges,,,,,,,,,138.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,45.25,22,,percent of total billed charges,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,148.42,82,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,45.25,171.95,
PT WORK HARING/CONNING INT 2 HRS W THCAP,34901336,CDM,97545,CPT,420,RC,outpatient,KX,562,562,,477.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,140.5,22,,percent of total billed charges,,,,,,,,,505.8,90,,percent of total billed charges,,,465.34,82.8,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,,,,,,,,494.56,88,,percent of total billed charges,,,,,,,,,429.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,140.5,22,,percent of total billed charges,,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,,,,,,,,,,,,,466.46,83,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,460.84,82,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,140.5,533.9,
PT WORK HARDNG/CONING EA DTL HR W THCAP,34901337,CDM,97546,CPT,420,RC,outpatient,KX,289,289,,245.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.25,22,,percent of total billed charges,,,,,,,,,260.1,90,,percent of total billed charges,,,239.29,82.8,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,,,,,,,,254.32,88,,percent of total billed charges,,,,,,,,,220.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.25,22,,percent of total billed charges,,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,,,,,,,,,,,,,239.87,83,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,236.98,82,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,72.25,274.55,
PT PHY PM TEST/MEARE EA 15 MIN W THCAP,34901338,CDM,97750,CPT,420,RC,outpatient,KX,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.75,22,,percent of total billed charges,,,,,,,,,215.1,90,,percent of total billed charges,,,197.89,82.8,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.75,22,,percent of total billed charges,,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,59.75,227.05,
"PT ORTH MT&TRG, UE&LE, EA 15 MIN W THCAP",34901339,CDM,97760,CPT,420,RC,outpatient,KX,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
"PT PRIC TRNG, UE & LE, EA 15 MIN W THCAP",34901340,CDM,97761,CPT,420,RC,outpatient,KX,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
"PT COT OH/PRO USE,ET PT EA 15MIN W THCAP",34901341,CDM,97763,CPT,420,RC,outpatient,KX,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.5,22,,percent of total billed charges,,,,,,,,,307.8,90,,percent of total billed charges,,,283.18,82.8,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.5,22,,percent of total billed charges,,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,85.5,324.9,
PT MEDIE ELEC STIM (UNATTENDED) W THCAP,34901342,CDM,G0283,HCPCS,420,RC,outpatient,KX,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.75,22,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,121.72,82.8,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.75,22,,percent of total billed charges,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,36.75,139.65,
PT NEUROMUSC RE-ED EA 15 MIN,34901390,CDM,97112,CPT,420,RC,outpatient,GP,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.5,22,,percent of total billed charges,,,,,,,,,214.2,90,,percent of total billed charges,,,197.06,82.8,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.5,22,,percent of total billed charges,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,59.5,226.1,
PT EVAL LOW COMPLEX W THCAP,34901400,CDM,97161,CPT,424,RC,outpatient,KX,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.5,22,,percent of total billed charges,,,,,,,,,351,90,,percent of total billed charges,,,322.92,82.8,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.5,22,,percent of total billed charges,,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,97.5,370.5,
PT EVAL LOW COMPLEX,34901401,CDM,97161,CPT,424,RC,outpatient,GP,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.5,22,,percent of total billed charges,,,,,,,,,351,90,,percent of total billed charges,,,322.92,82.8,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.5,22,,percent of total billed charges,,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,97.5,370.5,
PT IPA EVAL LOW COMPLEX,34901402,CDM,97161,CPT,424,RC,outpatient,GP,88,88,,74.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22,22,,percent of total billed charges,,,,,,,,,79.2,90,,percent of total billed charges,,,72.86,82.8,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,,,,,,,,77.44,88,,percent of total billed charges,,,,,,,,,67.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22,22,,percent of total billed charges,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,,,,,,,,,,,,,73.04,83,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,72.16,82,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,22,83.6,
PT PAXTON IPA EVAL LOW COMPLEX,34901403,CDM,97161,CPT,420,RC,outpatient,GP,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.5,22,,percent of total billed charges,,,,,,,,,91.8,90,,percent of total billed charges,,,84.46,82.8,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.5,22,,percent of total billed charges,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,25.5,96.9,
PT EVAL MOD COMPLEX W THCAP,34901404,CDM,97162,CPT,424,RC,outpatient,KX,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.5,22,,percent of total billed charges,,,,,,,,,351,90,,percent of total billed charges,,,322.92,82.8,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.5,22,,percent of total billed charges,,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,97.5,370.5,
PT EVAL MOD COMPLEX,34901405,CDM,97162,CPT,424,RC,outpatient,GP,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.5,22,,percent of total billed charges,,,,,,,,,351,90,,percent of total billed charges,,,322.92,82.8,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.5,22,,percent of total billed charges,,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,97.5,370.5,
PT IPA EVAL MOD COMPLEX,34901406,CDM,97162,CPT,424,RC,outpatient,GP,88,88,,74.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22,22,,percent of total billed charges,,,,,,,,,79.2,90,,percent of total billed charges,,,72.86,82.8,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,,,,,,,,77.44,88,,percent of total billed charges,,,,,,,,,67.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22,22,,percent of total billed charges,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,,,,,,,,,,,,,73.04,83,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,72.16,82,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,22,83.6,
PT PAXTON IPA EVAL MOD COMPLEX,34901407,CDM,97162,CPT,420,RC,outpatient,GP,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.5,22,,percent of total billed charges,,,,,,,,,91.8,90,,percent of total billed charges,,,84.46,82.8,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.5,22,,percent of total billed charges,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,25.5,96.9,
PT EVAL HIGH COMPLEX W THCAP,34901408,CDM,97163,CPT,424,RC,outpatient,KX,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.5,22,,percent of total billed charges,,,,,,,,,351,90,,percent of total billed charges,,,322.92,82.8,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.5,22,,percent of total billed charges,,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,97.5,370.5,
PT EVAL HIGH COMPLEX,34901409,CDM,97163,CPT,424,RC,outpatient,GP,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.5,22,,percent of total billed charges,,,,,,,,,351,90,,percent of total billed charges,,,322.92,82.8,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.5,22,,percent of total billed charges,,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,97.5,370.5,
PT IPA EVAL HIGH COMPLEX,34901410,CDM,97163,CPT,424,RC,outpatient,GP,88,88,,74.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,22,22,,percent of total billed charges,,,,,,,,,79.2,90,,percent of total billed charges,,,72.86,82.8,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,,,,,,,,77.44,88,,percent of total billed charges,,,,,,,,,67.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,22,22,,percent of total billed charges,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,,,,,,,,,,,,,73.04,83,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,72.16,82,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,22,83.6,
PT PAXTON IPA EVAL HIGH COMPLEX,34901411,CDM,97163,CPT,420,RC,outpatient,GP,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.5,22,,percent of total billed charges,,,,,,,,,91.8,90,,percent of total billed charges,,,84.46,82.8,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.5,22,,percent of total billed charges,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,25.5,96.9,
PT MOD 59 RE-EVAL EST PLAN CARE,34901412,CDM,97164,CPT,424,RC,outpatient,GP,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
PT RE-EVALUATION EST PLAN CARE,34901413,CDM,97164,CPT,424,RC,outpatient,GP,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.5,22,,percent of total billed charges,,,,,,,,,351,90,,percent of total billed charges,,,322.92,82.8,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.5,22,,percent of total billed charges,,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,97.5,370.5,
PT RE-EVAL EST PLAN CARE W THCAP,34901414,CDM,97164,CPT,424,RC,outpatient,KX,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
PT PARAFFIN BATH I,34901504,CDM,97018,CPT,420,RC,outpatient,GP,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
PT VASOPNEUMATIC DEVICE,34901510,CDM,97016,CPT,420,RC,outpatient,GP,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33,22,,percent of total billed charges,,,,,,,,,118.8,90,,percent of total billed charges,,,109.3,82.8,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33,22,,percent of total billed charges,,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,33,125.4,
PT HEEL LIFT,34901615,CDM,,,270,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
PT OVERDOOR PULLEYS,34901645,CDM,,,270,RC,outpatient,,74,74,,62.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.5,22,,percent of total billed charges,,,,,,,,,66.6,90,,percent of total billed charges,,,61.27,82.8,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,,,,,,,,65.12,88,,percent of total billed charges,,,,,,,,,56.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.5,22,,percent of total billed charges,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,,,,,,,,,,,,,61.42,83,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,60.68,82,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,18.5,70.3,
PT THERAPY BALL 45 CM,34901675,CDM,,,270,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
PT THERAPY BALL 55 CM,34901676,CDM,,,270,RC,outpatient,,74,74,,62.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,18.5,22,,percent of total billed charges,,,,,,,,,66.6,90,,percent of total billed charges,,,61.27,82.8,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,,,,,,,,65.12,88,,percent of total billed charges,,,,,,,,,56.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,18.5,22,,percent of total billed charges,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,,,,,,,,,,,,,61.42,83,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,60.68,82,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,18.5,70.3,
PT THERAPY BALL 65 CM,34901677,CDM,,,270,RC,outpatient,,86,86,,73.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21.5,22,,percent of total billed charges,,,,,,,,,77.4,90,,percent of total billed charges,,,71.21,82.8,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,,,,,,,,75.68,88,,percent of total billed charges,,,,,,,,,65.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21.5,22,,percent of total billed charges,,,78.26,91,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,,,,,,,,,,,,,71.38,83,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,70.52,82,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,21.5,81.7,
PT THERAPY BALL 75 CM,34901678,CDM,,,270,RC,outpatient,,103,103,,87.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.75,22,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,85.28,82.8,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,,,,,,,,90.64,88,,percent of total billed charges,,,,,,,,,78.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.75,22,,percent of total billed charges,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,84.46,82,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,25.75,97.85,
PT GAIT TRAINING EA 15 MIN THERAPY ASSIS,34901700,CDM,97116,CPT,420,RC,outpatient,CQ,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.75,22,,percent of total billed charges,,,,,,,,,182.7,90,,percent of total billed charges,,,168.08,82.8,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.75,22,,percent of total billed charges,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,50.75,192.85,
PT THERAPEUTIC EXERCISE EA 15 MIN THER A,34901701,CDM,97110,CPT,420,RC,outpatient,CQ,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
PT NEUROMUSC RE-ED EA 15 MIN THERAPY AS,34901702,CDM,97112,CPT,420,RC,outpatient,CQ,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.5,22,,percent of total billed charges,,,,,,,,,214.2,90,,percent of total billed charges,,,197.06,82.8,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.5,22,,percent of total billed charges,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,59.5,226.1,
PT FUNCTIONAL THERAPEUTIC ACTIVITY THER,34901703,CDM,97530,CPT,420,RC,outpatient,CQ,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
PT MANUAL THERAPY TQS EA 15 MIN THERAPY,34901704,CDM,97140,CPT,420,RC,outpatient,CQ,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
PT ULTRASOUND/PHONOP EA 15 MIN,34901801,CDM,97035,CPT,420,RC,outpatient,GP,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
PT WHIRLPOOL SUPERVISED/UNATTENDED,34902007,CDM,97022,CPT,420,RC,outpatient,GP,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.5,22,,percent of total billed charges,,,,,,,,,239.4,90,,percent of total billed charges,,,220.25,82.8,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.5,22,,percent of total billed charges,,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,66.5,252.7,
APPLICATION MODALITY DIATHERMY,34902010,CDM,97024,CPT,420,RC,outpatient,,159,159,,134.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,39.75,22,,percent of total billed charges,,,,,,,,,143.1,90,,percent of total billed charges,,,131.65,82.8,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,,,,,,,,139.92,88,,percent of total billed charges,,,,,,,,,121.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,39.75,22,,percent of total billed charges,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,,,,,,,,,,,,,131.97,83,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,130.38,82,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,39.75,151.05,
PT UNLIST MODALITY SPEC TYPE&TIME CONSTA,34902020,CDM,97039,CPT,420,RC,outpatient,GP,167,167,,141.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41.75,22,,percent of total billed charges,,,,,,,,,150.3,90,,percent of total billed charges,,,138.28,82.8,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,,,,,,,,146.96,88,,percent of total billed charges,,,,,,,,,127.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41.75,22,,percent of total billed charges,,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,,,,,,,,,,,,,138.61,83,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,136.94,82,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,41.75,158.65,
PT UNLISTED MODALITY EA 15 MIN,34903104,CDM,97139,CPT,420,RC,outpatient,GP,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
PT GAIT TRAINING EA 15 MIN,34903302,CDM,97116,CPT,420,RC,outpatient,GP,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.75,22,,percent of total billed charges,,,,,,,,,182.7,90,,percent of total billed charges,,,168.08,82.8,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.75,22,,percent of total billed charges,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,50.75,192.85,
"PT ELECTRICAL STIM ATTENDED, EA 15 MIN",34905002,CDM,97032,CPT,420,RC,outpatient,GP,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,38.5,146.3,
PT STRAPPING - SHOULDER,34905111,CDM,29240,CPT,420,RC,outpatient,GP,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.5,22,,percent of total billed charges,,,,,,,,,196.2,90,,percent of total billed charges,,,180.5,82.8,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,,,,,,,,191.84,88,,percent of total billed charges,,,,,,,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.5,22,,percent of total billed charges,,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,54.5,207.1,
PT STRAPPING - ANKLE,34905116,CDM,29540,CPT,420,RC,outpatient,GP,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.25,22,,percent of total billed charges,,,,,,,,,155.7,90,,percent of total billed charges,,,143.24,82.8,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.25,22,,percent of total billed charges,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,43.25,164.35,
* TENS APPLICATION (V0904),34905118,CDM,64550,CPT,420,RC,outpatient,GP,78,78,,66.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.5,22,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,64.58,82.8,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,,,,,,,,68.64,88,,percent of total billed charges,,,,,,,,,59.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.5,22,,percent of total billed charges,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,63.96,82,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,19.5,74.1,
PT IONTOPHORESIS EA 15 MIN,34907204,CDM,97033,CPT,420,RC,outpatient,GP,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.75,22,,percent of total billed charges,,,,,,,,,207.9,90,,percent of total billed charges,,,191.27,82.8,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.75,22,,percent of total billed charges,,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,57.75,219.45,
SM ATHLETIC TRAINING EVALUATION,34907500,CDM,97005,CPT,951,RC,outpatient,,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.25,22,,percent of total billed charges,,,,,,,,,422.1,90,,percent of total billed charges,,,388.33,82.8,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.25,22,,percent of total billed charges,,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,117.25,445.55,
SM ATHLETIC TRAINING RE-EVALUATION,34907505,CDM,97006,CPT,951,RC,outpatient,,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.25,22,,percent of total billed charges,,,,,,,,,422.1,90,,percent of total billed charges,,,388.33,82.8,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.25,22,,percent of total billed charges,,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,117.25,445.55,
SM AQUATIC THERAPY EA 15 MINUTES,34907510,CDM,97113,CPT,951,RC,outpatient,,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.5,22,,percent of total billed charges,,,,,,,,,275.4,90,,percent of total billed charges,,,253.37,82.8,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.5,22,,percent of total billed charges,,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,76.5,290.7,
SM BIOFEEDBACK TRAINING,34907515,CDM,90901,CPT,951,RC,outpatient,,235,235,,199.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,58.75,22,,percent of total billed charges,,,,,,,,,211.5,90,,percent of total billed charges,,,194.58,82.8,,percent of total billed charges,,,199.75,85,,percent of total billed charges,,,,,,,,,206.8,88,,percent of total billed charges,,,,,,,,,179.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,58.75,22,,percent of total billed charges,,,213.85,91,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,,,,,,,,,,,,,195.05,83,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,192.7,82,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,199.75,85,,percent of total billed charges,,58.75,223.25,
SM CONTRAST BATH EA 15 MINUTES,34907520,CDM,97034,CPT,951,RC,outpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
SM ELECTICAL STIMULATION (UNATTENDED),34907525,CDM,97014,CPT,951,RC,outpatient,,176,176,,149.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44,22,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,145.73,82.8,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,,,,,,,,154.88,88,,percent of total billed charges,,,,,,,,,134.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44,22,,percent of total billed charges,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,144.32,82,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,44,167.2,
SM ELECTRICAL STIM ATTENDED EA 15 MIN,34907527,CDM,97032,CPT,951,RC,outpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,,,,,,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,38.5,146.3,
SM FUNCTIONAL THERA ACT EA 15 MIN,34907530,CDM,97530,CPT,951,RC,outpatient,,250,250,,212.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.5,22,,percent of total billed charges,,,,,,,,,225,90,,percent of total billed charges,,,207,82.8,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,,,,,,,,220,88,,percent of total billed charges,,,,,,,,,191,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.5,22,,percent of total billed charges,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,,,,,,,,,,,,,207.5,83,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,205,82,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,62.5,237.5,
SM GAIT TRAINING EA 15 MINUTES,34907535,CDM,97116,CPT,951,RC,outpatient,,203,203,,172.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,50.75,22,,percent of total billed charges,,,,,,,,,182.7,90,,percent of total billed charges,,,168.08,82.8,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,,,,,,,,178.64,88,,percent of total billed charges,,,,,,,,,155.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,50.75,22,,percent of total billed charges,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,,,,,,,,,,,,,168.49,83,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,166.46,82,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,50.75,192.85,
SM GROUP,34907538,CDM,97150,CPT,951,RC,outpatient,,108,108,,91.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27,22,,percent of total billed charges,,,,,,,,,97.2,90,,percent of total billed charges,,,89.42,82.8,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,,,,,,,,95.04,88,,percent of total billed charges,,,,,,,,,82.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27,22,,percent of total billed charges,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,,,,,,,,,,,,,89.64,83,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,88.56,82,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,27,102.6,
SM IONTOPHORESIS EA 15 MINUTES,34907540,CDM,97033,CPT,951,RC,outpatient,,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.75,22,,percent of total billed charges,,,,,,,,,207.9,90,,percent of total billed charges,,,191.27,82.8,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.75,22,,percent of total billed charges,,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,57.75,219.45,
SM MANUAL THER TQS EA 15 MINUTES,34907545,CDM,97140,CPT,951,RC,outpatient,,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
SM MECHANICAL TRACTION,34907550,CDM,97012,CPT,951,RC,outpatient,,179,179,,151.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,44.75,22,,percent of total billed charges,,,,,,,,,161.1,90,,percent of total billed charges,,,148.21,82.8,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,,,,,,,,157.52,88,,percent of total billed charges,,,,,,,,,136.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,44.75,22,,percent of total billed charges,,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,146.78,82,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,44.75,170.05,
SM NEUROMUSC RE-ED EA 15 MINUTES,34907555,CDM,97112,CPT,951,RC,outpatient,,238,238,,202.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.5,22,,percent of total billed charges,,,,,,,,,214.2,90,,percent of total billed charges,,,197.06,82.8,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,,,,,,,,209.44,88,,percent of total billed charges,,,,,,,,,181.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.5,22,,percent of total billed charges,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,,,,,,,,,,,,,197.54,83,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,195.16,82,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,59.5,226.1,
"SM ORTHOTIC MGT&TRNG, UE&LE, EA 15 MIN",34907560,CDM,97760,CPT,951,RC,outpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
"SM CKOUT FOR ORTHOTIC USE, EST PT, 15 MN",34907562,CDM,97763,CPT,951,RC,outpatient,,342,342,,290.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.5,22,,percent of total billed charges,,,,,,,,,307.8,90,,percent of total billed charges,,,283.18,82.8,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,,,,,,,,300.96,88,,percent of total billed charges,,,,,,,,,261.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.5,22,,percent of total billed charges,,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,280.44,82,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,85.5,324.9,
SM PARAFFIN BATH I,34907565,CDM,97018,CPT,951,RC,outpatient,,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
SM VASOPNEUMATIC DEVICE,34907567,CDM,97016,CPT,951,RC,outpatient,,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33,22,,percent of total billed charges,,,,,,,,,118.8,90,,percent of total billed charges,,,109.3,82.8,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33,22,,percent of total billed charges,,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,33,125.4,
SM PHY PERFORM TEST/MEAS EA 15 MIN,34907570,CDM,97750,CPT,951,RC,outpatient,,239,239,,202.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,59.75,22,,percent of total billed charges,,,,,,,,,215.1,90,,percent of total billed charges,,,197.89,82.8,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,,,,,,,,210.32,88,,percent of total billed charges,,,,,,,,,182.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,59.75,22,,percent of total billed charges,,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,,,,,,,,,,,,,198.37,83,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,195.98,82,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,59.75,227.05,
PHYSICAL PERFORMANCE TEST 30 MIN FCE,34907575,CDM,97750,CPT,420,RC,outpatient,GP,344,344,,292.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,86,22,,percent of total billed charges,,,,,,,,,309.6,90,,percent of total billed charges,,,284.83,82.8,,percent of total billed charges,,,292.4,85,,percent of total billed charges,,,,,,,,,302.72,88,,percent of total billed charges,,,,,,,,,262.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,86,22,,percent of total billed charges,,,313.04,91,,percent of total billed charges,,,326.8,95,,percent of total billed charges,,,285.52,83,,percent of total billed charges,,,285.52,83,,percent of total billed charges,,,,,,,,,,,,,,,285.52,83,,percent of total billed charges,,,326.8,95,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,282.08,82,,percent of total billed charges,,,309.6,90,,percent of total billed charges,,,292.4,85,,percent of total billed charges,,86,326.8,
SM STRAPPING - SHOULDER,34907578,CDM,29240,CPT,951,RC,outpatient,,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.5,22,,percent of total billed charges,,,,,,,,,196.2,90,,percent of total billed charges,,,180.5,82.8,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,,,,,,,,191.84,88,,percent of total billed charges,,,,,,,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.5,22,,percent of total billed charges,,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,54.5,207.1,
SM STRAPPING - TOES,34907580,CDM,29550,CPT,951,RC,outpatient,,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.25,22,,percent of total billed charges,,,,,,,,,155.7,90,,percent of total billed charges,,,143.24,82.8,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.25,22,,percent of total billed charges,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,43.25,164.35,
SM THERAPEUTIC EXERCISE EA 15 MIN,34907595,CDM,97110,CPT,951,RC,outpatient,,228,228,,193.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57,22,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,188.78,82.8,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,,,,,,,,200.64,88,,percent of total billed charges,,,,,,,,,174.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57,22,,percent of total billed charges,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,186.96,82,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,57,216.6,
SM ULTRASOUND/PHONOP EA 15 MIN,34907600,CDM,97035,CPT,951,RC,outpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
SM UNLISTED MODALITY EA 15 MIN,34907605,CDM,97139,CPT,951,RC,outpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
SM WHIRLPOOL SUPERVISED/UNATTENDED,34907610,CDM,97022,CPT,951,RC,outpatient,,266,266,,225.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,66.5,22,,percent of total billed charges,,,,,,,,,239.4,90,,percent of total billed charges,,,220.25,82.8,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,,,,,,,,234.08,88,,percent of total billed charges,,,,,,,,,203.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,66.5,22,,percent of total billed charges,,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,,,,,,,,,,,,,220.78,83,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,218.12,82,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,66.5,252.7,
SM ELBOW WRIST STRAPPING,34990000,CDM,29260,CPT,951,RC,outpatient,,410,410,,348.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,102.5,22,,percent of total billed charges,,,,,,,,,369,90,,percent of total billed charges,,,339.48,82.8,,percent of total billed charges,,,348.5,85,,percent of total billed charges,,,,,,,,,360.8,88,,percent of total billed charges,,,,,,,,,313.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,102.5,22,,percent of total billed charges,,,373.1,91,,percent of total billed charges,,,389.5,95,,percent of total billed charges,,,340.3,83,,percent of total billed charges,,,340.3,83,,percent of total billed charges,,,,,,,,,,,,,,,340.3,83,,percent of total billed charges,,,389.5,95,,percent of total billed charges,,,369,90,,percent of total billed charges,,,369,90,,percent of total billed charges,,,336.2,82,,percent of total billed charges,,,369,90,,percent of total billed charges,,,348.5,85,,percent of total billed charges,,102.5,389.5,
SM HAND FINGER STRAPPING,34990001,CDM,29280,CPT,951,RC,outpatient,,368,368,,312.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,92,22,,percent of total billed charges,,,,,,,,,331.2,90,,percent of total billed charges,,,304.7,82.8,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,,,,,,,,323.84,88,,percent of total billed charges,,,,,,,,,281.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,92,22,,percent of total billed charges,,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,301.76,82,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,92,349.6,
SM HIP STRAPPING,34990002,CDM,29520,CPT,951,RC,outpatient,,303,303,,257.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.75,22,,percent of total billed charges,,,,,,,,,272.7,90,,percent of total billed charges,,,250.88,82.8,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,,,,,,,,266.64,88,,percent of total billed charges,,,,,,,,,231.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.75,22,,percent of total billed charges,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,248.46,82,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,75.75,287.85,
SM KNEE STRAPPING,34990003,CDM,29530,CPT,951,RC,outpatient,,432,432,,366.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108,22,,percent of total billed charges,,,,,,,,,388.8,90,,percent of total billed charges,,,357.7,82.8,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,,,,,,,,380.16,88,,percent of total billed charges,,,,,,,,,330.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108,22,,percent of total billed charges,,,393.12,91,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,,,,,,,,,,,,,358.56,83,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,354.24,82,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,108,410.4,
SM ANKLESTRAPPING,34990004,CDM,29540,CPT,951,RC,outpatient,,173,173,,146.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,43.25,22,,percent of total billed charges,,,,,,,,,155.7,90,,percent of total billed charges,,,143.24,82.8,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,,,,,,,,152.24,88,,percent of total billed charges,,,,,,,,,132.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,43.25,22,,percent of total billed charges,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,141.86,82,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,43.25,164.35,
SM SHOULDER STRAPPING,34990006,CDM,29240,CPT,951,RC,outpatient,,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.5,22,,percent of total billed charges,,,,,,,,,196.2,90,,percent of total billed charges,,,180.5,82.8,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,,,,,,,,191.84,88,,percent of total billed charges,,,,,,,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,54.5,22,,percent of total billed charges,,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,54.5,207.1,
SM HOT/COLD PACK,34997650,CDM,97010,CPT,951,RC,outpatient,GP,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.75,22,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,121.72,82.8,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.75,22,,percent of total billed charges,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,36.75,139.65,
OT FINGER SPLINT,35200400,CDM,,,270,RC,outpatient,,44,44,,37.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11,22,,percent of total billed charges,,,,,,,,,39.6,90,,percent of total billed charges,,,36.43,82.8,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,,,,,,,,38.72,88,,percent of total billed charges,,,,,,,,,33.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11,22,,percent of total billed charges,,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,36.08,82,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,11,41.8,
OT HAND SPLINT,35200401,CDM,,,270,RC,outpatient,,79,79,,67.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,19.75,22,,percent of total billed charges,,,,,,,,,71.1,90,,percent of total billed charges,,,65.41,82.8,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,,,,,,,,69.52,88,,percent of total billed charges,,,,,,,,,60.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,19.75,22,,percent of total billed charges,,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,,,,,,,,,,,,,65.57,83,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,64.78,82,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,19.75,75.05,
OT WRIST SPLINT,35200402,CDM,,,270,RC,outpatient,,113,113,,95.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.25,22,,percent of total billed charges,,,,,,,,,101.7,90,,percent of total billed charges,,,93.56,82.8,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,,,,,,,,99.44,88,,percent of total billed charges,,,,,,,,,86.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.25,22,,percent of total billed charges,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,92.66,82,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,28.25,107.35,
OT ELBOW SPLINT,35200403,CDM,,,270,RC,outpatient,,190,190,,161.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.5,22,,percent of total billed charges,,,,,,,,,171,90,,percent of total billed charges,,,157.32,82.8,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,,,,,,,,167.2,88,,percent of total billed charges,,,,,,,,,145.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,47.5,22,,percent of total billed charges,,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,,,,,,,,,,,,,157.7,83,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,155.8,82,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,47.5,180.5,
OT UE SPLINT,35200404,CDM,,,270,RC,outpatient,,350,350,,297.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,87.5,22,,percent of total billed charges,,,,,,,,,315,90,,percent of total billed charges,,,289.8,82.8,,percent of total billed charges,,,297.5,85,,percent of total billed charges,,,,,,,,,308,88,,percent of total billed charges,,,,,,,,,267.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,87.5,22,,percent of total billed charges,,,318.5,91,,percent of total billed charges,,,332.5,95,,percent of total billed charges,,,290.5,83,,percent of total billed charges,,,290.5,83,,percent of total billed charges,,,,,,,,,,,,,,,290.5,83,,percent of total billed charges,,,332.5,95,,percent of total billed charges,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,287,82,,percent of total billed charges,,,315,90,,percent of total billed charges,,,297.5,85,,percent of total billed charges,,87.5,332.5,
OT HOT/COLD PACK W THCAP,35901313,CDM,97010,CPT,430,RC,outpatient,KX,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.75,22,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,121.72,82.8,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.75,22,,percent of total billed charges,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,36.75,139.65,
OT AQUATIC THERAPY EA 15 MINUTES,35910008,CDM,97113,CPT,430,RC,outpatient,GO,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.5,22,,percent of total billed charges,,,,,,,,,275.4,90,,percent of total billed charges,,,253.37,82.8,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.5,22,,percent of total billed charges,,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,76.5,290.7,
OT AQUATIC THERAPY EA 15 MINUTES W THCAP,35910009,CDM,97113,CPT,430,RC,outpatient,KX,306,306,,259.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,76.5,22,,percent of total billed charges,,,,,,,,,275.4,90,,percent of total billed charges,,,253.37,82.8,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,,,,,,,,269.28,88,,percent of total billed charges,,,,,,,,,233.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,76.5,22,,percent of total billed charges,,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,250.92,82,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,76.5,290.7,
OT HOT/COLD PACK,35990750,CDM,97010,CPT,430,RC,outpatient,GO,147,147,,124.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.75,22,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,121.72,82.8,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,,,,,,,,129.36,88,,percent of total billed charges,,,,,,,,,112.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.75,22,,percent of total billed charges,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,120.54,82,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,36.75,139.65,
E-STIM,81000500,CDM,G0281,HCPCS,761,RC,outpatient,,146,146,,123.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,36.5,22,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,120.89,82.8,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,,,,,,,,128.48,88,,percent of total billed charges,,,,,,,,,111.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,36.5,22,,percent of total billed charges,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,119.72,82,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,36.5,138.7,
FOLLOW-UP ASSESSMENT 0-60 MIN LEVEL 1,13900001,CDM,G0463,HCPCS,510,RC,outpatient,PO,54,54,,45.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.5,22,,percent of total billed charges,,,,,,,,,48.6,90,,percent of total billed charges,,,44.71,82.8,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,,,,,,,,47.52,88,,percent of total billed charges,,,,,,,,,41.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.5,22,,percent of total billed charges,,,49.14,91,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,,,,,,,,,,,,,44.82,83,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,44.28,82,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,13.5,51.3,
FOLLOW-UP ASSESSMENT 0-60 MIN LEVEL 2,13900002,CDM,G0463,HCPCS,510,RC,outpatient,PO,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
FOLLOW-UP ASSESSMENT 0-60 MIN LEVEL 3,13900003,CDM,G0463,HCPCS,510,RC,outpatient,PO,97,97,,82.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,24.25,22,,percent of total billed charges,,,,,,,,,87.3,90,,percent of total billed charges,,,80.32,82.8,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,,,,,,,,85.36,88,,percent of total billed charges,,,,,,,,,74.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,24.25,22,,percent of total billed charges,,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,,,,,,,,,,,,,80.51,83,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,79.54,82,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,24.25,92.15,
FOLLOW-UP ASSESSMENT 0-60 MIN LEVEL 4,13900004,CDM,G0463,HCPCS,510,RC,outpatient,PO,134,134,,113.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.5,22,,percent of total billed charges,,,,,,,,,120.6,90,,percent of total billed charges,,,110.95,82.8,,percent of total billed charges,,,113.9,85,,percent of total billed charges,,,,,,,,,117.92,88,,percent of total billed charges,,,,,,,,,102.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.5,22,,percent of total billed charges,,,121.94,91,,percent of total billed charges,,,127.3,95,,percent of total billed charges,,,111.22,83,,percent of total billed charges,,,111.22,83,,percent of total billed charges,,,,,,,,,,,,,,,111.22,83,,percent of total billed charges,,,127.3,95,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,109.88,82,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,113.9,85,,percent of total billed charges,,33.5,127.3,
FOLLOW-UP ASSESSMENT 0-60 MIN LEVEL 5,13900005,CDM,G0463,HCPCS,510,RC,outpatient,PO,161,161,,136.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.25,22,,percent of total billed charges,,,,,,,,,144.9,90,,percent of total billed charges,,,133.31,82.8,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,,,,,,,,141.68,88,,percent of total billed charges,,,,,,,,,123,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.25,22,,percent of total billed charges,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,132.02,82,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,40.25,152.95,
EUFLEXXA INJ PER DOSE,13900050,CDM,J7323,HCPCS,636,RC,outpatient,,1791,1791,,1520.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,447.75,22,,percent of total billed charges,,,,,,,,,1611.9,90,,percent of total billed charges,,,1482.95,82.8,,percent of total billed charges,,,1522.35,85,,percent of total billed charges,,,,,,,,,1576.08,88,,percent of total billed charges,,261.77,,,,fee schedule,,,1368.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,261.77,,,,fee schedule,,,447.75,22,,percent of total billed charges,,,1629.81,91,,percent of total billed charges,,,1701.45,95,,percent of total billed charges,,,1486.53,83,,percent of total billed charges,,,1486.53,83,,percent of total billed charges,,,,,,,,,,,,,,,1486.53,83,,percent of total billed charges,,,1701.45,95,,percent of total billed charges,,,1611.9,90,,percent of total billed charges,,,1611.9,90,,percent of total billed charges,,,1468.62,82,,percent of total billed charges,,,1611.9,90,,percent of total billed charges,,,1522.35,85,,percent of total billed charges,,261.77,1701.45,
SYNVISC OR SYNVISC-ONE INJ PER DOSE,13900051,CDM,J7325,HCPCS,636,RC,outpatient,,1696,1696,,1439.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,424,22,,percent of total billed charges,,,,,,,,,1526.4,90,,percent of total billed charges,,,1404.29,82.8,,percent of total billed charges,,,1441.6,85,,percent of total billed charges,,,,,,,,,1492.48,88,,percent of total billed charges,,973.06,,,,fee schedule,,,1295.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,973.06,,,,fee schedule,,,424,22,,percent of total billed charges,,,1543.36,91,,percent of total billed charges,,,1611.2,95,,percent of total billed charges,,,1407.68,83,,percent of total billed charges,,,1407.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1407.68,83,,percent of total billed charges,,,1611.2,95,,percent of total billed charges,,,1526.4,90,,percent of total billed charges,,,1526.4,90,,percent of total billed charges,,,1390.72,82,,percent of total billed charges,,,1526.4,90,,percent of total billed charges,,,1441.6,85,,percent of total billed charges,,424,1611.2,
METHYLPREDNISOLONE INJ PER DOSE,13900052,CDM,J1030,HCPCS,636,RC,outpatient,,92,92,,78.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23,22,,percent of total billed charges,,,,,,,,,82.8,90,,percent of total billed charges,,,76.18,82.8,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,,,,,,,,80.96,88,,percent of total billed charges,,29.81,,,,fee schedule,,,70.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,29.81,,,,fee schedule,,,23,22,,percent of total billed charges,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,,,,,,,,,,,,,76.36,83,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,75.44,82,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,23,87.4,
TRIAMCINOLONE ACET INJ NOS,13900053,CDM,J3301,HCPCS,636,RC,outpatient,,258,258,,219.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,64.5,22,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,213.62,82.8,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,,,,,,,,227.04,88,,percent of total billed charges,,17.47,,,,fee schedule,,,197.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,17.47,,,,fee schedule,,,64.5,22,,percent of total billed charges,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,,,,,,,,,,,,,214.14,83,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,211.56,82,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,17.47,245.1,
HYALURONAN GEL-ONE,13900054,CDM,J7326,HCPCS,636,RC,outpatient,,3771,3771,,3201.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,942.75,22,,percent of total billed charges,,,,,,,,,3393.9,90,,percent of total billed charges,,,3122.39,82.8,,percent of total billed charges,,,3205.35,85,,percent of total billed charges,,,,,,,,,3318.48,88,,percent of total billed charges,,984.46,,,,fee schedule,,,2881.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,984.46,,,,fee schedule,,,942.75,22,,percent of total billed charges,,,3431.61,91,,percent of total billed charges,,,3582.45,95,,percent of total billed charges,,,3129.93,83,,percent of total billed charges,,,3129.93,83,,percent of total billed charges,,,,,,,,,,,,,,,3129.93,83,,percent of total billed charges,,,3582.45,95,,percent of total billed charges,,,3393.9,90,,percent of total billed charges,,,3393.9,90,,percent of total billed charges,,,3092.22,82,,percent of total billed charges,,,3393.9,90,,percent of total billed charges,,,3205.35,85,,percent of total billed charges,,942.75,3582.45,
X DRAIN/INJ MINOR JT/BURSA LT,24200005,CDM,20605,CPT,360,RC,outpatient,LT,1974,1974,,1675.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,493.5,22,,percent of total billed charges,,,,,,,,,1776.6,90,,percent of total billed charges,,,1634.47,82.8,,percent of total billed charges,,,1677.9,85,,percent of total billed charges,,,,,,,,,1737.12,88,,percent of total billed charges,,,,,,,,,1508.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,493.5,22,,percent of total billed charges,,,1796.34,91,,percent of total billed charges,,,1875.3,95,,percent of total billed charges,,,1638.42,83,,percent of total billed charges,,,1638.42,83,,percent of total billed charges,,,,,,,,,,,,,,,1638.42,83,,percent of total billed charges,,,1875.3,95,,percent of total billed charges,,,1776.6,90,,percent of total billed charges,,,1776.6,90,,percent of total billed charges,,,1618.68,82,,percent of total billed charges,,,1776.6,90,,percent of total billed charges,,,1677.9,85,,percent of total billed charges,,493.5,1875.3,
X DRAIN/INJ MINOR JT/BURSA RT,24200006,CDM,20605,CPT,360,RC,outpatient,RT,1974,1974,,1675.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,493.5,22,,percent of total billed charges,,,,,,,,,1776.6,90,,percent of total billed charges,,,1634.47,82.8,,percent of total billed charges,,,1677.9,85,,percent of total billed charges,,,,,,,,,1737.12,88,,percent of total billed charges,,,,,,,,,1508.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,493.5,22,,percent of total billed charges,,,1796.34,91,,percent of total billed charges,,,1875.3,95,,percent of total billed charges,,,1638.42,83,,percent of total billed charges,,,1638.42,83,,percent of total billed charges,,,,,,,,,,,,,,,1638.42,83,,percent of total billed charges,,,1875.3,95,,percent of total billed charges,,,1776.6,90,,percent of total billed charges,,,1776.6,90,,percent of total billed charges,,,1618.68,82,,percent of total billed charges,,,1776.6,90,,percent of total billed charges,,,1677.9,85,,percent of total billed charges,,493.5,1875.3,
X DRAIN/INJ MINOR JT/BURSA BIL,24200007,CDM,20605,CPT,360,RC,outpatient,50,3947,3947,,3351,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,986.75,22,,percent of total billed charges,,,,,,,,,3552.3,90,,percent of total billed charges,,,3268.12,82.8,,percent of total billed charges,,,3354.95,85,,percent of total billed charges,,,,,,,,,3473.36,88,,percent of total billed charges,,,,,,,,,3015.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,986.75,22,,percent of total billed charges,,,3591.77,91,,percent of total billed charges,,,3749.65,95,,percent of total billed charges,,,3276.01,83,,percent of total billed charges,,,3276.01,83,,percent of total billed charges,,,,,,,,,,,,,,,3276.01,83,,percent of total billed charges,,,3749.65,95,,percent of total billed charges,,,3552.3,90,,percent of total billed charges,,,3552.3,90,,percent of total billed charges,,,3236.54,82,,percent of total billed charges,,,3552.3,90,,percent of total billed charges,,,3354.95,85,,percent of total billed charges,,986.75,3749.65,
X DRAIN/INJ MAJOR JT/BURSA LT,24200008,CDM,20610,CPT,320,RC,outpatient,LT,2349,2349,,1994.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,587.25,22,,percent of total billed charges,,,,,,,,,2114.1,90,,percent of total billed charges,,,1944.97,82.8,,percent of total billed charges,,,1996.65,85,,percent of total billed charges,,,,,,,,,2067.12,88,,percent of total billed charges,,,,,,,,,1794.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,587.25,22,,percent of total billed charges,,,2137.59,91,,percent of total billed charges,,,2231.55,95,,percent of total billed charges,,,1949.67,83,,percent of total billed charges,,,1949.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1949.67,83,,percent of total billed charges,,,2231.55,95,,percent of total billed charges,,,2114.1,90,,percent of total billed charges,,,2114.1,90,,percent of total billed charges,,,1926.18,82,,percent of total billed charges,,,2114.1,90,,percent of total billed charges,,,1996.65,85,,percent of total billed charges,,587.25,2231.55,
X DRAIN/INJ MAJOR JT/BURSA RT,24200009,CDM,20610,CPT,320,RC,outpatient,RT,2349,2349,,1994.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,587.25,22,,percent of total billed charges,,,,,,,,,2114.1,90,,percent of total billed charges,,,1944.97,82.8,,percent of total billed charges,,,1996.65,85,,percent of total billed charges,,,,,,,,,2067.12,88,,percent of total billed charges,,,,,,,,,1794.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,587.25,22,,percent of total billed charges,,,2137.59,91,,percent of total billed charges,,,2231.55,95,,percent of total billed charges,,,1949.67,83,,percent of total billed charges,,,1949.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1949.67,83,,percent of total billed charges,,,2231.55,95,,percent of total billed charges,,,2114.1,90,,percent of total billed charges,,,2114.1,90,,percent of total billed charges,,,1926.18,82,,percent of total billed charges,,,2114.1,90,,percent of total billed charges,,,1996.65,85,,percent of total billed charges,,587.25,2231.55,
X MANDIBLE 4V+,26100024,CDM,70110,CPT,320,RC,outpatient,TC,680,680,,577.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,170,22,,percent of total billed charges,,,,,,,,,612,90,,percent of total billed charges,,,563.04,82.8,,percent of total billed charges,,,578,85,,percent of total billed charges,,,,,,,,,598.4,88,,percent of total billed charges,,,,,,,,,519.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,170,22,,percent of total billed charges,,,618.8,91,,percent of total billed charges,,,646,95,,percent of total billed charges,,,564.4,83,,percent of total billed charges,,,564.4,83,,percent of total billed charges,,,,,,,,,,,,,,,564.4,83,,percent of total billed charges,,,646,95,,percent of total billed charges,,,612,90,,percent of total billed charges,,,612,90,,percent of total billed charges,,,557.6,82,,percent of total billed charges,,,612,90,,percent of total billed charges,,,578,85,,percent of total billed charges,,170,646,
X TMJ RT,26100030,CDM,70328,CPT,320,RC,outpatient,RT,363,363,,308.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90.75,22,,percent of total billed charges,,,,,,,,,326.7,90,,percent of total billed charges,,,300.56,82.8,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,,,,,,,,319.44,88,,percent of total billed charges,,,,,,,,,277.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90.75,22,,percent of total billed charges,,,330.33,91,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,,,,,,,,,,,,,301.29,83,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,297.66,82,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,90.75,344.85,
X TMJ LT,26100031,CDM,70328,CPT,320,RC,outpatient,LT,363,363,,308.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90.75,22,,percent of total billed charges,,,,,,,,,326.7,90,,percent of total billed charges,,,300.56,82.8,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,,,,,,,,319.44,88,,percent of total billed charges,,,,,,,,,277.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90.75,22,,percent of total billed charges,,,330.33,91,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,,,,,,,,,,,,,301.29,83,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,297.66,82,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,90.75,344.85,
X TMJ BILATERAL,26100032,CDM,70330,CPT,320,RC,outpatient,TC,729,729,,618.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,182.25,22,,percent of total billed charges,,,,,,,,,656.1,90,,percent of total billed charges,,,603.61,82.8,,percent of total billed charges,,,619.65,85,,percent of total billed charges,,,,,,,,,641.52,88,,percent of total billed charges,,,,,,,,,556.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,182.25,22,,percent of total billed charges,,,663.39,91,,percent of total billed charges,,,692.55,95,,percent of total billed charges,,,605.07,83,,percent of total billed charges,,,605.07,83,,percent of total billed charges,,,,,,,,,,,,,,,605.07,83,,percent of total billed charges,,,692.55,95,,percent of total billed charges,,,656.1,90,,percent of total billed charges,,,656.1,90,,percent of total billed charges,,,597.78,82,,percent of total billed charges,,,656.1,90,,percent of total billed charges,,,619.65,85,,percent of total billed charges,,182.25,692.55,
X SINUS 3V+,26100040,CDM,70220,CPT,320,RC,outpatient,TC,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195.5,22,,percent of total billed charges,,,,,,,,,703.8,90,,percent of total billed charges,,,647.5,82.8,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195.5,22,,percent of total billed charges,,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,195.5,742.9,
X MASTOIDS 3V+,26100057,CDM,70130,CPT,320,RC,outpatient,TC,500,500,,424.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125,22,,percent of total billed charges,,,,,,,,,450,90,,percent of total billed charges,,,414,82.8,,percent of total billed charges,,,425,85,,percent of total billed charges,,,,,,,,,440,88,,percent of total billed charges,,,,,,,,,382,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125,22,,percent of total billed charges,,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,415,83,,percent of total billed charges,,,,,,,,,,,,,,,415,83,,percent of total billed charges,,,475,95,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,410,82,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,125,475,
X NASAL BONES 3V+,26100065,CDM,70160,CPT,320,RC,outpatient,TC,498,498,,422.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.5,22,,percent of total billed charges,,,,,,,,,448.2,90,,percent of total billed charges,,,412.34,82.8,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,,,,,,,,438.24,88,,percent of total billed charges,,,,,,,,,380.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.5,22,,percent of total billed charges,,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,,,,,,,,,,,,,413.34,83,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,408.36,82,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,124.5,473.1,
X FACIAL BONES 3V+,26100073,CDM,70150,CPT,320,RC,outpatient,TC,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195.5,22,,percent of total billed charges,,,,,,,,,703.8,90,,percent of total billed charges,,,647.5,82.8,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195.5,22,,percent of total billed charges,,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,195.5,742.9,
X FACIAL BONES 1-2V,26100081,CDM,70140,CPT,320,RC,outpatient,,456,456,,387.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,114,22,,percent of total billed charges,,,,,,,,,410.4,90,,percent of total billed charges,,,377.57,82.8,,percent of total billed charges,,,387.6,85,,percent of total billed charges,,,,,,,,,401.28,88,,percent of total billed charges,,,,,,,,,348.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,114,22,,percent of total billed charges,,,414.96,91,,percent of total billed charges,,,433.2,95,,percent of total billed charges,,,378.48,83,,percent of total billed charges,,,378.48,83,,percent of total billed charges,,,,,,,,,,,,,,,378.48,83,,percent of total billed charges,,,433.2,95,,percent of total billed charges,,,410.4,90,,percent of total billed charges,,,410.4,90,,percent of total billed charges,,,373.92,82,,percent of total billed charges,,,410.4,90,,percent of total billed charges,,,387.6,85,,percent of total billed charges,,114,433.2,
X ORBITS 4V+,26100107,CDM,70200,CPT,320,RC,outpatient,TC,656,656,,556.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,164,22,,percent of total billed charges,,,,,,,,,590.4,90,,percent of total billed charges,,,543.17,82.8,,percent of total billed charges,,,557.6,85,,percent of total billed charges,,,,,,,,,577.28,88,,percent of total billed charges,,,,,,,,,501.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,164,22,,percent of total billed charges,,,596.96,91,,percent of total billed charges,,,623.2,95,,percent of total billed charges,,,544.48,83,,percent of total billed charges,,,544.48,83,,percent of total billed charges,,,,,,,,,,,,,,,544.48,83,,percent of total billed charges,,,623.2,95,,percent of total billed charges,,,590.4,90,,percent of total billed charges,,,590.4,90,,percent of total billed charges,,,537.92,82,,percent of total billed charges,,,590.4,90,,percent of total billed charges,,,557.6,85,,percent of total billed charges,,164,623.2,
X SKULL 4V+,26100115,CDM,70260,CPT,320,RC,outpatient,TC,811,811,,688.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,202.75,22,,percent of total billed charges,,,,,,,,,729.9,90,,percent of total billed charges,,,671.51,82.8,,percent of total billed charges,,,689.35,85,,percent of total billed charges,,,,,,,,,713.68,88,,percent of total billed charges,,,,,,,,,619.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,202.75,22,,percent of total billed charges,,,738.01,91,,percent of total billed charges,,,770.45,95,,percent of total billed charges,,,673.13,83,,percent of total billed charges,,,673.13,83,,percent of total billed charges,,,,,,,,,,,,,,,673.13,83,,percent of total billed charges,,,770.45,95,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,665.02,82,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,689.35,85,,percent of total billed charges,,202.75,770.45,
X SHOULDER RIGHT 2V+,26100123,CDM,73030,CPT,320,RC,outpatient,RT,530,530,,449.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.5,22,,percent of total billed charges,,,,,,,,,477,90,,percent of total billed charges,,,438.84,82.8,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,,,,,,,,466.4,88,,percent of total billed charges,,,,,,,,,404.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.5,22,,percent of total billed charges,,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,,,,,,,,,,,,,439.9,83,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,434.6,82,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,132.5,503.5,
X SHOULDER LEFT 2V+,26100124,CDM,73030,CPT,320,RC,outpatient,LT,530,530,,449.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.5,22,,percent of total billed charges,,,,,,,,,477,90,,percent of total billed charges,,,438.84,82.8,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,,,,,,,,466.4,88,,percent of total billed charges,,,,,,,,,404.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.5,22,,percent of total billed charges,,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,,,,,,,,,,,,,439.9,83,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,434.6,82,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,132.5,503.5,
X ELBOW RIGHT 3V+,26100131,CDM,73080,CPT,320,RC,outpatient,RT,511,511,,433.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.75,22,,percent of total billed charges,,,,,,,,,459.9,90,,percent of total billed charges,,,423.11,82.8,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,,,,,,,,449.68,88,,percent of total billed charges,,,,,,,,,390.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.75,22,,percent of total billed charges,,,465.01,91,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,,,,,,,,,,,,,424.13,83,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,419.02,82,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,127.75,485.45,
X ELBOW LEFT 3V+,26100132,CDM,73080,CPT,320,RC,outpatient,LT,511,511,,433.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.75,22,,percent of total billed charges,,,,,,,,,459.9,90,,percent of total billed charges,,,423.11,82.8,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,,,,,,,,449.68,88,,percent of total billed charges,,,,,,,,,390.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.75,22,,percent of total billed charges,,,465.01,91,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,424.13,83,,percent of total billed charges,,,,,,,,,,,,,,,424.13,83,,percent of total billed charges,,,485.45,95,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,419.02,82,,percent of total billed charges,,,459.9,90,,percent of total billed charges,,,434.35,85,,percent of total billed charges,,127.75,485.45,
X CLAVICLE RIGHT 2V+,26100149,CDM,73000,CPT,320,RC,outpatient,RT,437,437,,371.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.25,22,,percent of total billed charges,,,,,,,,,393.3,90,,percent of total billed charges,,,361.84,82.8,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,,,,,,,,384.56,88,,percent of total billed charges,,,,,,,,,333.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.25,22,,percent of total billed charges,,,397.67,91,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,,,,,,,,,,,,,362.71,83,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,358.34,82,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,109.25,415.15,
X CLAVICLE LEFT 2V+,26100150,CDM,73000,CPT,320,RC,outpatient,LT,437,437,,371.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.25,22,,percent of total billed charges,,,,,,,,,393.3,90,,percent of total billed charges,,,361.84,82.8,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,,,,,,,,384.56,88,,percent of total billed charges,,,,,,,,,333.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.25,22,,percent of total billed charges,,,397.67,91,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,,,,,,,,,,,,,362.71,83,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,358.34,82,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,109.25,415.15,
X HUMERUS RIGHT 2V+,26100156,CDM,73060,CPT,320,RC,outpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X HUMERUS LEFT 2V+,26100157,CDM,73060,CPT,320,RC,outpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X SCAPULA RIGHT 2V+,26100164,CDM,73010,CPT,320,RC,outpatient,RT,482,482,,409.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,120.5,22,,percent of total billed charges,,,,,,,,,433.8,90,,percent of total billed charges,,,399.1,82.8,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,,,,,,,,424.16,88,,percent of total billed charges,,,,,,,,,368.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,120.5,22,,percent of total billed charges,,,438.62,91,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,,,,,,,,,,,,,400.06,83,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,395.24,82,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,120.5,457.9,
X FOREARM RIGHT 2V+,26100172,CDM,73090,CPT,320,RC,outpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X FOREARM LEFT 2V+,26100173,CDM,73090,CPT,320,RC,outpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X WRIST RIGHT 3V+,26100180,CDM,73110,CPT,320,RC,outpatient,RT,500,500,,424.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125,22,,percent of total billed charges,,,,,,,,,450,90,,percent of total billed charges,,,414,82.8,,percent of total billed charges,,,425,85,,percent of total billed charges,,,,,,,,,440,88,,percent of total billed charges,,,,,,,,,382,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125,22,,percent of total billed charges,,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,415,83,,percent of total billed charges,,,,,,,,,,,,,,,415,83,,percent of total billed charges,,,475,95,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,410,82,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,125,475,
X WRIST LEFT 3V+,26100181,CDM,73110,CPT,320,RC,outpatient,LT,500,500,,424.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125,22,,percent of total billed charges,,,,,,,,,450,90,,percent of total billed charges,,,414,82.8,,percent of total billed charges,,,425,85,,percent of total billed charges,,,,,,,,,440,88,,percent of total billed charges,,,,,,,,,382,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125,22,,percent of total billed charges,,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,415,83,,percent of total billed charges,,,,,,,,,,,,,,,415,83,,percent of total billed charges,,,475,95,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,410,82,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,125,475,
X HAND BIL 1V EA (DJD),26100197,CDM,73120,CPT,320,RC,outpatient,50,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X HAND RIGHT 3V+,26100198,CDM,73130,CPT,320,RC,outpatient,RT,506,506,,429.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126.5,22,,percent of total billed charges,,,,,,,,,455.4,90,,percent of total billed charges,,,418.97,82.8,,percent of total billed charges,,,430.1,85,,percent of total billed charges,,,,,,,,,445.28,88,,percent of total billed charges,,,,,,,,,386.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126.5,22,,percent of total billed charges,,,460.46,91,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,,,,,,,,,,,,,419.98,83,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,414.92,82,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,430.1,85,,percent of total billed charges,,126.5,480.7,
X HAND LEFT 3V+,26100199,CDM,73130,CPT,320,RC,outpatient,LT,506,506,,429.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126.5,22,,percent of total billed charges,,,,,,,,,455.4,90,,percent of total billed charges,,,418.97,82.8,,percent of total billed charges,,,430.1,85,,percent of total billed charges,,,,,,,,,445.28,88,,percent of total billed charges,,,,,,,,,386.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126.5,22,,percent of total billed charges,,,460.46,91,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,,,,,,,,,,,,,419.98,83,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,414.92,82,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,430.1,85,,percent of total billed charges,,126.5,480.7,
X FINGER (DO NOT USE),26100206,CDM,73140,CPT,320,RC,outpatient,RT,418,418,,354.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104.5,22,,percent of total billed charges,,,,,,,,,376.2,90,,percent of total billed charges,,,346.1,82.8,,percent of total billed charges,,,355.3,85,,percent of total billed charges,,,,,,,,,367.84,88,,percent of total billed charges,,,,,,,,,319.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104.5,22,,percent of total billed charges,,,380.38,91,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,346.94,83,,percent of total billed charges,,,,,,,,,,,,,,,346.94,83,,percent of total billed charges,,,397.1,95,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,342.76,82,,percent of total billed charges,,,376.2,90,,percent of total billed charges,,,355.3,85,,percent of total billed charges,,104.5,397.1,
X FINGER 2V+ 1OR>1DIGIT,26100207,CDM,73140,CPT,320,RC,outpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X AC JTS W/WO WTS,26100214,CDM,73050,CPT,320,RC,outpatient,,491,491,,416.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122.75,22,,percent of total billed charges,,,,,,,,,441.9,90,,percent of total billed charges,,,406.55,82.8,,percent of total billed charges,,,417.35,85,,percent of total billed charges,,,,,,,,,432.08,88,,percent of total billed charges,,,,,,,,,375.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122.75,22,,percent of total billed charges,,,446.81,91,,percent of total billed charges,,,466.45,95,,percent of total billed charges,,,407.53,83,,percent of total billed charges,,,407.53,83,,percent of total billed charges,,,,,,,,,,,,,,,407.53,83,,percent of total billed charges,,,466.45,95,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,402.62,82,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,417.35,85,,percent of total billed charges,,122.75,466.45,
X PELVIS 1-2V,26100222,CDM,72170,CPT,320,RC,outpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X FEMUR RIGHT 2V+,26100230,CDM,73552,CPT,320,RC,outpatient,TC,500,500,,424.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125,22,,percent of total billed charges,,,,,,,,,450,90,,percent of total billed charges,,,414,82.8,,percent of total billed charges,,,425,85,,percent of total billed charges,,,,,,,,,440,88,,percent of total billed charges,,,,,,,,,382,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125,22,,percent of total billed charges,,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,415,83,,percent of total billed charges,,,,,,,,,,,,,,,415,83,,percent of total billed charges,,,475,95,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,410,82,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,125,475,
X FEMUR LEFT 2V+,26100231,CDM,73552,CPT,320,RC,outpatient,TC,500,500,,424.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125,22,,percent of total billed charges,,,,,,,,,450,90,,percent of total billed charges,,,414,82.8,,percent of total billed charges,,,425,85,,percent of total billed charges,,,,,,,,,440,88,,percent of total billed charges,,,,,,,,,382,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125,22,,percent of total billed charges,,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,415,83,,percent of total billed charges,,,,,,,,,,,,,,,415,83,,percent of total billed charges,,,475,95,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,410,82,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,125,475,
X HIP RIGHT 2V+ W/PELVIS,26100248,CDM,73502,CPT,320,RC,outpatient,TC,946,946,,803.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,236.5,22,,percent of total billed charges,,,,,,,,,851.4,90,,percent of total billed charges,,,783.29,82.8,,percent of total billed charges,,,804.1,85,,percent of total billed charges,,,,,,,,,832.48,88,,percent of total billed charges,,,,,,,,,722.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,236.5,22,,percent of total billed charges,,,860.86,91,,percent of total billed charges,,,898.7,95,,percent of total billed charges,,,785.18,83,,percent of total billed charges,,,785.18,83,,percent of total billed charges,,,,,,,,,,,,,,,785.18,83,,percent of total billed charges,,,898.7,95,,percent of total billed charges,,,851.4,90,,percent of total billed charges,,,851.4,90,,percent of total billed charges,,,775.72,82,,percent of total billed charges,,,851.4,90,,percent of total billed charges,,,804.1,85,,percent of total billed charges,,236.5,898.7,
X HIP LEFT 2V+ W/PELVIS,26100249,CDM,73502,CPT,320,RC,outpatient,TC,946,946,,803.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,236.5,22,,percent of total billed charges,,,,,,,,,851.4,90,,percent of total billed charges,,,783.29,82.8,,percent of total billed charges,,,804.1,85,,percent of total billed charges,,,,,,,,,832.48,88,,percent of total billed charges,,,,,,,,,722.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,236.5,22,,percent of total billed charges,,,860.86,91,,percent of total billed charges,,,898.7,95,,percent of total billed charges,,,785.18,83,,percent of total billed charges,,,785.18,83,,percent of total billed charges,,,,,,,,,,,,,,,785.18,83,,percent of total billed charges,,,898.7,95,,percent of total billed charges,,,851.4,90,,percent of total billed charges,,,851.4,90,,percent of total billed charges,,,775.72,82,,percent of total billed charges,,,851.4,90,,percent of total billed charges,,,804.1,85,,percent of total billed charges,,236.5,898.7,
X KNEE RIGHT 1-2V,26100255,CDM,73560,CPT,320,RC,outpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X KNEE LEFT 1-2V,26100256,CDM,73560,CPT,320,RC,outpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X LOWER LEG RIGHT 2V+,26100263,CDM,73590,CPT,320,RC,outpatient,RT,470,470,,399.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.5,22,,percent of total billed charges,,,,,,,,,423,90,,percent of total billed charges,,,389.16,82.8,,percent of total billed charges,,,399.5,85,,percent of total billed charges,,,,,,,,,413.6,88,,percent of total billed charges,,,,,,,,,359.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.5,22,,percent of total billed charges,,,427.7,91,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,,,,,,,,,,,,,390.1,83,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,423,90,,percent of total billed charges,,,423,90,,percent of total billed charges,,,385.4,82,,percent of total billed charges,,,423,90,,percent of total billed charges,,,399.5,85,,percent of total billed charges,,117.5,446.5,
X LOWER LEG LEFT 2V+,26100264,CDM,73590,CPT,320,RC,outpatient,LT,470,470,,399.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.5,22,,percent of total billed charges,,,,,,,,,423,90,,percent of total billed charges,,,389.16,82.8,,percent of total billed charges,,,399.5,85,,percent of total billed charges,,,,,,,,,413.6,88,,percent of total billed charges,,,,,,,,,359.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.5,22,,percent of total billed charges,,,427.7,91,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,,,,,,,,,,,,,390.1,83,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,423,90,,percent of total billed charges,,,423,90,,percent of total billed charges,,,385.4,82,,percent of total billed charges,,,423,90,,percent of total billed charges,,,399.5,85,,percent of total billed charges,,117.5,446.5,
X ANKLE RIGHT 3V+,26100271,CDM,73610,CPT,320,RC,outpatient,RT,506,506,,429.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126.5,22,,percent of total billed charges,,,,,,,,,455.4,90,,percent of total billed charges,,,418.97,82.8,,percent of total billed charges,,,430.1,85,,percent of total billed charges,,,,,,,,,445.28,88,,percent of total billed charges,,,,,,,,,386.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126.5,22,,percent of total billed charges,,,460.46,91,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,,,,,,,,,,,,,419.98,83,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,414.92,82,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,430.1,85,,percent of total billed charges,,126.5,480.7,
X ANKLE LEFT 3V+,26100272,CDM,73610,CPT,320,RC,outpatient,LT,506,506,,429.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,126.5,22,,percent of total billed charges,,,,,,,,,455.4,90,,percent of total billed charges,,,418.97,82.8,,percent of total billed charges,,,430.1,85,,percent of total billed charges,,,,,,,,,445.28,88,,percent of total billed charges,,,,,,,,,386.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,126.5,22,,percent of total billed charges,,,460.46,91,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,,,,,,,,,,,,,419.98,83,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,414.92,82,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,430.1,85,,percent of total billed charges,,126.5,480.7,
X ANKLE BILATERAL 3V+,26100273,CDM,73610,CPT,320,RC,outpatient,50,1009,1009,,856.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,252.25,22,,percent of total billed charges,,,,,,,,,908.1,90,,percent of total billed charges,,,835.45,82.8,,percent of total billed charges,,,857.65,85,,percent of total billed charges,,,,,,,,,887.92,88,,percent of total billed charges,,,,,,,,,770.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,252.25,22,,percent of total billed charges,,,918.19,91,,percent of total billed charges,,,958.55,95,,percent of total billed charges,,,837.47,83,,percent of total billed charges,,,837.47,83,,percent of total billed charges,,,,,,,,,,,,,,,837.47,83,,percent of total billed charges,,,958.55,95,,percent of total billed charges,,,908.1,90,,percent of total billed charges,,,908.1,90,,percent of total billed charges,,,827.38,82,,percent of total billed charges,,,908.1,90,,percent of total billed charges,,,857.65,85,,percent of total billed charges,,252.25,958.55,
X ANKLE BILATERAL 2V,26100275,CDM,73600,CPT,320,RC,outpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,231.25,22,,percent of total billed charges,,,,,,,,,832.5,90,,percent of total billed charges,,,765.9,82.8,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,231.25,22,,percent of total billed charges,,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,231.25,878.75,
X FOOT RIGHT 3V+,26100289,CDM,73630,CPT,320,RC,outpatient,RT,495,495,,420.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.75,22,,percent of total billed charges,,,,,,,,,445.5,90,,percent of total billed charges,,,409.86,82.8,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,,,,,,,,435.6,88,,percent of total billed charges,,,,,,,,,378.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.75,22,,percent of total billed charges,,,450.45,91,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,,,,,,,,,,,,,410.85,83,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,405.9,82,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,123.75,470.25,
X FOOT LEFT 3V+,26100290,CDM,73630,CPT,320,RC,outpatient,LT,495,495,,420.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.75,22,,percent of total billed charges,,,,,,,,,445.5,90,,percent of total billed charges,,,409.86,82.8,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,,,,,,,,435.6,88,,percent of total billed charges,,,,,,,,,378.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.75,22,,percent of total billed charges,,,450.45,91,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,,,,,,,,,,,,,410.85,83,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,405.9,82,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,123.75,470.25,
X TOES (DO NOT USE),26100297,CDM,73660,CPT,320,RC,outpatient,RT,389,389,,330.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.25,22,,percent of total billed charges,,,,,,,,,350.1,90,,percent of total billed charges,,,322.09,82.8,,percent of total billed charges,,,330.65,85,,percent of total billed charges,,,,,,,,,342.32,88,,percent of total billed charges,,,,,,,,,297.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.25,22,,percent of total billed charges,,,353.99,91,,percent of total billed charges,,,369.55,95,,percent of total billed charges,,,322.87,83,,percent of total billed charges,,,322.87,83,,percent of total billed charges,,,,,,,,,,,,,,,322.87,83,,percent of total billed charges,,,369.55,95,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,318.98,82,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,330.65,85,,percent of total billed charges,,97.25,369.55,
X CALCANEUS RIGHT 2V+,26100305,CDM,73650,CPT,320,RC,outpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X CALCANEUS LEFT 2V+,26100306,CDM,73650,CPT,320,RC,outpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X PELVIS W/HIP (CHILD),26100315,CDM,73501,CPT,320,RC,outpatient,,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.25,22,,percent of total billed charges,,,,,,,,,299.7,90,,percent of total billed charges,,,275.72,82.8,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.25,22,,percent of total billed charges,,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,83.25,316.35,
X ABDOMEN 1V,26100321,CDM,74018,CPT,320,RC,outpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X ABDOMEN 2V+,26100339,CDM,74019,CPT,320,RC,outpatient,TC,569,569,,483.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,142.25,22,,percent of total billed charges,,,,,,,,,512.1,90,,percent of total billed charges,,,471.13,82.8,,percent of total billed charges,,,483.65,85,,percent of total billed charges,,,,,,,,,500.72,88,,percent of total billed charges,,,,,,,,,434.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,142.25,22,,percent of total billed charges,,,517.79,91,,percent of total billed charges,,,540.55,95,,percent of total billed charges,,,472.27,83,,percent of total billed charges,,,472.27,83,,percent of total billed charges,,,,,,,,,,,,,,,472.27,83,,percent of total billed charges,,,540.55,95,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,466.58,82,,percent of total billed charges,,,512.1,90,,percent of total billed charges,,,483.65,85,,percent of total billed charges,,142.25,540.55,
X SHOULDER ARTHRO RIGHT,26100347,CDM,73040,CPT,320,RC,outpatient,RT,1656,1656,,1405.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,414,22,,percent of total billed charges,,,,,,,,,1490.4,90,,percent of total billed charges,,,1371.17,82.8,,percent of total billed charges,,,1407.6,85,,percent of total billed charges,,,,,,,,,1457.28,88,,percent of total billed charges,,,,,,,,,1265.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,414,22,,percent of total billed charges,,,1506.96,91,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1374.48,83,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1357.92,82,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1407.6,85,,percent of total billed charges,,414,1573.2,
X SHOULDER ARTHRO LEFT,26100348,CDM,73040,CPT,320,RC,outpatient,LT,1656,1656,,1405.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,414,22,,percent of total billed charges,,,,,,,,,1490.4,90,,percent of total billed charges,,,1371.17,82.8,,percent of total billed charges,,,1407.6,85,,percent of total billed charges,,,,,,,,,1457.28,88,,percent of total billed charges,,,,,,,,,1265.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,414,22,,percent of total billed charges,,,1506.96,91,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1374.48,83,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1357.92,82,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1407.6,85,,percent of total billed charges,,414,1573.2,
X SHOULDER LEFT 1V,26100349,CDM,73020,CPT,320,RC,outpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X SHOULDER RIGHT 1V,26100350,CDM,73020,CPT,320,RC,outpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X FLUORO >1 HR (DNU 2/21/19),26100354,CDM,76001,CPT,320,RC,outpatient,TC,2216,2216,,1881.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,554,22,,percent of total billed charges,,,,,,,,,1994.4,90,,percent of total billed charges,,,1834.85,82.8,,percent of total billed charges,,,1883.6,85,,percent of total billed charges,,,,,,,,,1950.08,88,,percent of total billed charges,,,,,,,,,1693.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,554,22,,percent of total billed charges,,,2016.56,91,,percent of total billed charges,,,2105.2,95,,percent of total billed charges,,,1839.28,83,,percent of total billed charges,,,1839.28,83,,percent of total billed charges,,,,,,,,,,,,,,,1839.28,83,,percent of total billed charges,,,2105.2,95,,percent of total billed charges,,,1994.4,90,,percent of total billed charges,,,1994.4,90,,percent of total billed charges,,,1817.12,82,,percent of total billed charges,,,1994.4,90,,percent of total billed charges,,,1883.6,85,,percent of total billed charges,,554,2105.2,
X C SPINE 4 OR 5 VIEWS,26100362,CDM,72050,CPT,320,RC,outpatient,TC,862,862,,731.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,215.5,22,,percent of total billed charges,,,,,,,,,775.8,90,,percent of total billed charges,,,713.74,82.8,,percent of total billed charges,,,732.7,85,,percent of total billed charges,,,,,,,,,758.56,88,,percent of total billed charges,,,,,,,,,658.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,215.5,22,,percent of total billed charges,,,784.42,91,,percent of total billed charges,,,818.9,95,,percent of total billed charges,,,715.46,83,,percent of total billed charges,,,715.46,83,,percent of total billed charges,,,,,,,,,,,,,,,715.46,83,,percent of total billed charges,,,818.9,95,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,706.84,82,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,732.7,85,,percent of total billed charges,,215.5,818.9,
X C SPINE 6 OR MORE VIEWS,26100370,CDM,72052,CPT,320,RC,outpatient,TC,972,972,,825.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243,22,,percent of total billed charges,,,,,,,,,874.8,90,,percent of total billed charges,,,804.82,82.8,,percent of total billed charges,,,826.2,85,,percent of total billed charges,,,,,,,,,855.36,88,,percent of total billed charges,,,,,,,,,742.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243,22,,percent of total billed charges,,,884.52,91,,percent of total billed charges,,,923.4,95,,percent of total billed charges,,,806.76,83,,percent of total billed charges,,,806.76,83,,percent of total billed charges,,,,,,,,,,,,,,,806.76,83,,percent of total billed charges,,,923.4,95,,percent of total billed charges,,,874.8,90,,percent of total billed charges,,,874.8,90,,percent of total billed charges,,,797.04,82,,percent of total billed charges,,,874.8,90,,percent of total billed charges,,,826.2,85,,percent of total billed charges,,243,923.4,
X T SPINE 3V,26100388,CDM,72072,CPT,320,RC,outpatient,TC,666,666,,565.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.5,22,,percent of total billed charges,,,,,,,,,599.4,90,,percent of total billed charges,,,551.45,82.8,,percent of total billed charges,,,566.1,85,,percent of total billed charges,,,,,,,,,586.08,88,,percent of total billed charges,,,,,,,,,508.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.5,22,,percent of total billed charges,,,606.06,91,,percent of total billed charges,,,632.7,95,,percent of total billed charges,,,552.78,83,,percent of total billed charges,,,552.78,83,,percent of total billed charges,,,,,,,,,,,,,,,552.78,83,,percent of total billed charges,,,632.7,95,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,546.12,82,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,566.1,85,,percent of total billed charges,,166.5,632.7,
X THORACOLUMBAR 2V,26100389,CDM,72080,CPT,320,RC,outpatient,,543,543,,461.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,135.75,22,,percent of total billed charges,,,,,,,,,488.7,90,,percent of total billed charges,,,449.6,82.8,,percent of total billed charges,,,461.55,85,,percent of total billed charges,,,,,,,,,477.84,88,,percent of total billed charges,,,,,,,,,414.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,135.75,22,,percent of total billed charges,,,494.13,91,,percent of total billed charges,,,515.85,95,,percent of total billed charges,,,450.69,83,,percent of total billed charges,,,450.69,83,,percent of total billed charges,,,,,,,,,,,,,,,450.69,83,,percent of total billed charges,,,515.85,95,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,445.26,82,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,461.55,85,,percent of total billed charges,,135.75,515.85,
X L SPINE 2-3V,26100393,CDM,72100,CPT,320,RC,outpatient,TC,595,595,,505.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,148.75,22,,percent of total billed charges,,,,,,,,,535.5,90,,percent of total billed charges,,,492.66,82.8,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,,,,,,,,523.6,88,,percent of total billed charges,,,,,,,,,454.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,148.75,22,,percent of total billed charges,,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,,,,,,,,,,,,,493.85,83,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,487.9,82,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,148.75,565.25,
X L SPINE 4-5V,26100396,CDM,72110,CPT,320,RC,outpatient,TC,922,922,,782.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,230.5,22,,percent of total billed charges,,,,,,,,,829.8,90,,percent of total billed charges,,,763.42,82.8,,percent of total billed charges,,,783.7,85,,percent of total billed charges,,,,,,,,,811.36,88,,percent of total billed charges,,,,,,,,,704.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,230.5,22,,percent of total billed charges,,,839.02,91,,percent of total billed charges,,,875.9,95,,percent of total billed charges,,,765.26,83,,percent of total billed charges,,,765.26,83,,percent of total billed charges,,,,,,,,,,,,,,,765.26,83,,percent of total billed charges,,,875.9,95,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,756.04,82,,percent of total billed charges,,,829.8,90,,percent of total billed charges,,,783.7,85,,percent of total billed charges,,230.5,875.9,
X ESI PAIN MGT C/T SPINE,26100400,CDM,62321,CPT,360,RC,outpatient,TC,4678,4678,,3971.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1169.5,22,,percent of total billed charges,,,,,,,,,4210.2,90,,percent of total billed charges,,,3873.38,82.8,,percent of total billed charges,,,3976.3,85,,percent of total billed charges,,,,,,,,,4116.64,88,,percent of total billed charges,,,,,,,,,3573.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1169.5,22,,percent of total billed charges,,,4256.98,91,,percent of total billed charges,,,4444.1,95,,percent of total billed charges,,,3882.74,83,,percent of total billed charges,,,3882.74,83,,percent of total billed charges,,,,,,,,,,,,,,,3882.74,83,,percent of total billed charges,,,4444.1,95,,percent of total billed charges,,,4210.2,90,,percent of total billed charges,,,4210.2,90,,percent of total billed charges,,,3835.96,82,,percent of total billed charges,,,4210.2,90,,percent of total billed charges,,,3976.3,85,,percent of total billed charges,,1169.5,4444.1,
X ESI PAIN MGT L SPINE WO IMAGING,26100401,CDM,62322,CPT,320,RC,outpatient,TC,7269,7269,,6171.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1817.25,22,,percent of total billed charges,,,,,,,,,6542.1,90,,percent of total billed charges,,,6018.73,82.8,,percent of total billed charges,,,6178.65,85,,percent of total billed charges,,,,,,,,,6396.72,88,,percent of total billed charges,,,,,,,,,5553.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1817.25,22,,percent of total billed charges,,,6614.79,91,,percent of total billed charges,,,6905.55,95,,percent of total billed charges,,,6033.27,83,,percent of total billed charges,,,6033.27,83,,percent of total billed charges,,,,,,,,,,,,,,,6033.27,83,,percent of total billed charges,,,6905.55,95,,percent of total billed charges,,,6542.1,90,,percent of total billed charges,,,6542.1,90,,percent of total billed charges,,,5960.58,82,,percent of total billed charges,,,6542.1,90,,percent of total billed charges,,,6178.65,85,,percent of total billed charges,,1817.25,6905.55,
X FACET INJ/NERVE BL L/S 1LVL,26100402,CDM,64493,CPT,320,RC,outpatient,TC,3571,3571,,3031.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,892.75,22,,percent of total billed charges,,,,,,,,,3213.9,90,,percent of total billed charges,,,2956.79,82.8,,percent of total billed charges,,,3035.35,85,,percent of total billed charges,,,,,,,,,3142.48,88,,percent of total billed charges,,,,,,,,,2728.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,892.75,22,,percent of total billed charges,,,3249.61,91,,percent of total billed charges,,,3392.45,95,,percent of total billed charges,,,2963.93,83,,percent of total billed charges,,,2963.93,83,,percent of total billed charges,,,,,,,,,,,,,,,2963.93,83,,percent of total billed charges,,,3392.45,95,,percent of total billed charges,,,3213.9,90,,percent of total billed charges,,,3213.9,90,,percent of total billed charges,,,2928.22,82,,percent of total billed charges,,,3213.9,90,,percent of total billed charges,,,3035.35,85,,percent of total billed charges,,892.75,3392.45,
X ESI PAIN MGT L SPINE W/IMAGING,26100403,CDM,62323,CPT,320,RC,outpatient,TC,8921,8921,,7573.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2230.25,22,,percent of total billed charges,,,,,,,,,8028.9,90,,percent of total billed charges,,,7386.59,82.8,,percent of total billed charges,,,7582.85,85,,percent of total billed charges,,,,,,,,,7850.48,88,,percent of total billed charges,,,,,,,,,6815.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2230.25,22,,percent of total billed charges,,,8118.11,91,,percent of total billed charges,,,8474.95,95,,percent of total billed charges,,,7404.43,83,,percent of total billed charges,,,7404.43,83,,percent of total billed charges,,,,,,,,,,,,,,,7404.43,83,,percent of total billed charges,,,8474.95,95,,percent of total billed charges,,,8028.9,90,,percent of total billed charges,,,8028.9,90,,percent of total billed charges,,,7315.22,82,,percent of total billed charges,,,8028.9,90,,percent of total billed charges,,,7582.85,85,,percent of total billed charges,,2230.25,8474.95,
X SACRUM AND COCCYX 2V+,26100404,CDM,72220,CPT,320,RC,outpatient,TC,501,501,,425.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125.25,22,,percent of total billed charges,,,,,,,,,450.9,90,,percent of total billed charges,,,414.83,82.8,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,,,,,,,,440.88,88,,percent of total billed charges,,,,,,,,,382.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125.25,22,,percent of total billed charges,,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,,,,,,,,,,,,,415.83,83,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,410.82,82,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,125.25,475.95,
X FACET INJ/NERVE BL L/S 2LVL,26100405,CDM,64494,CPT,320,RC,outpatient,TC,2121,2121,,1800.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,530.25,22,,percent of total billed charges,,,,,,,,,1908.9,90,,percent of total billed charges,,,1756.19,82.8,,percent of total billed charges,,,1802.85,85,,percent of total billed charges,,,,,,,,,1866.48,88,,percent of total billed charges,,,,,,,,,1620.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,530.25,22,,percent of total billed charges,,,1930.11,91,,percent of total billed charges,,,2014.95,95,,percent of total billed charges,,,1760.43,83,,percent of total billed charges,,,1760.43,83,,percent of total billed charges,,,,,,,,,,,,,,,1760.43,83,,percent of total billed charges,,,2014.95,95,,percent of total billed charges,,,1908.9,90,,percent of total billed charges,,,1908.9,90,,percent of total billed charges,,,1739.22,82,,percent of total billed charges,,,1908.9,90,,percent of total billed charges,,,1802.85,85,,percent of total billed charges,,530.25,2014.95,
X FACET INJ/NERVE BL L/S 3LVL,26100406,CDM,64495,CPT,320,RC,outpatient,TC,1956,1956,,1660.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,489,22,,percent of total billed charges,,,,,,,,,1760.4,90,,percent of total billed charges,,,1619.57,82.8,,percent of total billed charges,,,1662.6,85,,percent of total billed charges,,,,,,,,,1721.28,88,,percent of total billed charges,,,,,,,,,1494.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,489,22,,percent of total billed charges,,,1779.96,91,,percent of total billed charges,,,1858.2,95,,percent of total billed charges,,,1623.48,83,,percent of total billed charges,,,1623.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1623.48,83,,percent of total billed charges,,,1858.2,95,,percent of total billed charges,,,1760.4,90,,percent of total billed charges,,,1760.4,90,,percent of total billed charges,,,1603.92,82,,percent of total billed charges,,,1760.4,90,,percent of total billed charges,,,1662.6,85,,percent of total billed charges,,489,1858.2,
X INJ TRANSFORAMINAL EPIDURAL C/T SINGLE,26100407,CDM,64479,CPT,360,RC,outpatient,TC,3928,3928,,3334.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,982,22,,percent of total billed charges,,,,,,,,,3535.2,90,,percent of total billed charges,,,3252.38,82.8,,percent of total billed charges,,,3338.8,85,,percent of total billed charges,,,,,,,,,3456.64,88,,percent of total billed charges,,,,,,,,,3000.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,982,22,,percent of total billed charges,,,3574.48,91,,percent of total billed charges,,,3731.6,95,,percent of total billed charges,,,3260.24,83,,percent of total billed charges,,,3260.24,83,,percent of total billed charges,,,,,,,,,,,,,,,3260.24,83,,percent of total billed charges,,,3731.6,95,,percent of total billed charges,,,3535.2,90,,percent of total billed charges,,,3535.2,90,,percent of total billed charges,,,3220.96,82,,percent of total billed charges,,,3535.2,90,,percent of total billed charges,,,3338.8,85,,percent of total billed charges,,982,3731.6,
X INJ TRANSFORAMINAL EPIDURAL C/T EACH,26100408,CDM,64480,CPT,360,RC,outpatient,TC,2387,2387,,2026.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,596.75,22,,percent of total billed charges,,,,,,,,,2148.3,90,,percent of total billed charges,,,1976.44,82.8,,percent of total billed charges,,,2028.95,85,,percent of total billed charges,,,,,,,,,2100.56,88,,percent of total billed charges,,,,,,,,,1823.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,596.75,22,,percent of total billed charges,,,2172.17,91,,percent of total billed charges,,,2267.65,95,,percent of total billed charges,,,1981.21,83,,percent of total billed charges,,,1981.21,83,,percent of total billed charges,,,,,,,,,,,,,,,1981.21,83,,percent of total billed charges,,,2267.65,95,,percent of total billed charges,,,2148.3,90,,percent of total billed charges,,,2148.3,90,,percent of total billed charges,,,1957.34,82,,percent of total billed charges,,,2148.3,90,,percent of total billed charges,,,2028.95,85,,percent of total billed charges,,596.75,2267.65,
X INTERCOSTAL NERVE BLOCK EACH ADD,26100409,CDM,64421,CPT,360,RC,outpatient,TC,3239,3239,,2749.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,809.75,22,,percent of total billed charges,,,,,,,,,2915.1,90,,percent of total billed charges,,,2681.89,82.8,,percent of total billed charges,,,2753.15,85,,percent of total billed charges,,,,,,,,,2850.32,88,,percent of total billed charges,,,,,,,,,2474.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,809.75,22,,percent of total billed charges,,,2947.49,91,,percent of total billed charges,,,3077.05,95,,percent of total billed charges,,,2688.37,83,,percent of total billed charges,,,2688.37,83,,percent of total billed charges,,,,,,,,,,,,,,,2688.37,83,,percent of total billed charges,,,3077.05,95,,percent of total billed charges,,,2915.1,90,,percent of total billed charges,,,2915.1,90,,percent of total billed charges,,,2655.98,82,,percent of total billed charges,,,2915.1,90,,percent of total billed charges,,,2753.15,85,,percent of total billed charges,,809.75,3077.05,
X INTERCOSTAL NERVE BLOCK INITIAL,26100410,CDM,64420,CPT,360,RC,outpatient,TC,2924,2924,,2482.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,731,22,,percent of total billed charges,,,,,,,,,2631.6,90,,percent of total billed charges,,,2421.07,82.8,,percent of total billed charges,,,2485.4,85,,percent of total billed charges,,,,,,,,,2573.12,88,,percent of total billed charges,,,,,,,,,2233.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,731,22,,percent of total billed charges,,,2660.84,91,,percent of total billed charges,,,2777.8,95,,percent of total billed charges,,,2426.92,83,,percent of total billed charges,,,2426.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2426.92,83,,percent of total billed charges,,,2777.8,95,,percent of total billed charges,,,2631.6,90,,percent of total billed charges,,,2631.6,90,,percent of total billed charges,,,2397.68,82,,percent of total billed charges,,,2631.6,90,,percent of total billed charges,,,2485.4,85,,percent of total billed charges,,731,2777.8,
X KNEE RIGHT 3V,26100412,CDM,73562,CPT,320,RC,outpatient,RT,549,549,,466.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,137.25,22,,percent of total billed charges,,,,,,,,,494.1,90,,percent of total billed charges,,,454.57,82.8,,percent of total billed charges,,,466.65,85,,percent of total billed charges,,,,,,,,,483.12,88,,percent of total billed charges,,,,,,,,,419.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,137.25,22,,percent of total billed charges,,,499.59,91,,percent of total billed charges,,,521.55,95,,percent of total billed charges,,,455.67,83,,percent of total billed charges,,,455.67,83,,percent of total billed charges,,,,,,,,,,,,,,,455.67,83,,percent of total billed charges,,,521.55,95,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,450.18,82,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,466.65,85,,percent of total billed charges,,137.25,521.55,
X KNEE LEFT 3V,26100413,CDM,73562,CPT,320,RC,outpatient,LT,549,549,,466.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,137.25,22,,percent of total billed charges,,,,,,,,,494.1,90,,percent of total billed charges,,,454.57,82.8,,percent of total billed charges,,,466.65,85,,percent of total billed charges,,,,,,,,,483.12,88,,percent of total billed charges,,,,,,,,,419.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,137.25,22,,percent of total billed charges,,,499.59,91,,percent of total billed charges,,,521.55,95,,percent of total billed charges,,,455.67,83,,percent of total billed charges,,,455.67,83,,percent of total billed charges,,,,,,,,,,,,,,,455.67,83,,percent of total billed charges,,,521.55,95,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,450.18,82,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,466.65,85,,percent of total billed charges,,137.25,521.55,
X FLUORO UP TO 1 HR,26100438,CDM,76000,CPT,320,RC,outpatient,TC,1650,1650,,1400.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,412.5,22,,percent of total billed charges,,,,,,,,,1485,90,,percent of total billed charges,,,1366.2,82.8,,percent of total billed charges,,,1402.5,85,,percent of total billed charges,,,,,,,,,1452,88,,percent of total billed charges,,,,,,,,,1260.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,412.5,22,,percent of total billed charges,,,1501.5,91,,percent of total billed charges,,,1567.5,95,,percent of total billed charges,,,1369.5,83,,percent of total billed charges,,,1369.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1369.5,83,,percent of total billed charges,,,1567.5,95,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1353,82,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1402.5,85,,percent of total billed charges,,412.5,1567.5,
X FLUORO GUIDE/CENT LINE,26100441,CDM,77001,CPT,320,RC,outpatient,TC,1650,1650,,1400.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,412.5,22,,percent of total billed charges,,,,,,,,,1485,90,,percent of total billed charges,,,1366.2,82.8,,percent of total billed charges,,,1402.5,85,,percent of total billed charges,,,,,,,,,1452,88,,percent of total billed charges,,,,,,,,,1260.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,412.5,22,,percent of total billed charges,,,1501.5,91,,percent of total billed charges,,,1567.5,95,,percent of total billed charges,,,1369.5,83,,percent of total billed charges,,,1369.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1369.5,83,,percent of total billed charges,,,1567.5,95,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1353,82,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1402.5,85,,percent of total billed charges,,412.5,1567.5,
X FLUORO GUIDE/EPIDURAL,26100442,CDM,77003,CPT,320,RC,outpatient,TC,1650,1650,,1400.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,412.5,22,,percent of total billed charges,,,,,,,,,1485,90,,percent of total billed charges,,,1366.2,82.8,,percent of total billed charges,,,1402.5,85,,percent of total billed charges,,,,,,,,,1452,88,,percent of total billed charges,,,,,,,,,1260.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,412.5,22,,percent of total billed charges,,,1501.5,91,,percent of total billed charges,,,1567.5,95,,percent of total billed charges,,,1369.5,83,,percent of total billed charges,,,1369.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1369.5,83,,percent of total billed charges,,,1567.5,95,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1353,82,,percent of total billed charges,,,1485,90,,percent of total billed charges,,,1402.5,85,,percent of total billed charges,,412.5,1567.5,
X FLUORO GUIDE/NDLPLCMNT,26100443,CDM,77002,CPT,320,RC,outpatient,TC,2319,2319,,1968.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,579.75,22,,percent of total billed charges,,,,,,,,,2087.1,90,,percent of total billed charges,,,1920.13,82.8,,percent of total billed charges,,,1971.15,85,,percent of total billed charges,,,,,,,,,2040.72,88,,percent of total billed charges,,,,,,,,,1771.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,579.75,22,,percent of total billed charges,,,2110.29,91,,percent of total billed charges,,,2203.05,95,,percent of total billed charges,,,1924.77,83,,percent of total billed charges,,,1924.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1924.77,83,,percent of total billed charges,,,2203.05,95,,percent of total billed charges,,,2087.1,90,,percent of total billed charges,,,2087.1,90,,percent of total billed charges,,,1901.58,82,,percent of total billed charges,,,2087.1,90,,percent of total billed charges,,,1971.15,85,,percent of total billed charges,,579.75,2203.05,
X JT SURVEY (1V+ JTS),26100455,CDM,77077,CPT,320,RC,outpatient,TC,403,403,,342.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100.75,22,,percent of total billed charges,,,,,,,,,362.7,90,,percent of total billed charges,,,333.68,82.8,,percent of total billed charges,,,342.55,85,,percent of total billed charges,,,,,,,,,354.64,88,,percent of total billed charges,,,,,,,,,307.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100.75,22,,percent of total billed charges,,,366.73,91,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,,,,,,,,,,,,,334.49,83,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,330.46,82,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,342.55,85,,percent of total billed charges,,100.75,382.85,
X L SPINE BENDING 2-3V,26100461,CDM,72120,CPT,320,RC,outpatient,TC,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195.5,22,,percent of total billed charges,,,,,,,,,703.8,90,,percent of total billed charges,,,647.5,82.8,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195.5,22,,percent of total billed charges,,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,195.5,742.9,
X L SPINE W/BEND MIN 6 VIEWS,26100462,CDM,72114,CPT,320,RC,outpatient,TC,1031,1031,,875.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,257.75,22,,percent of total billed charges,,,,,,,,,927.9,90,,percent of total billed charges,,,853.67,82.8,,percent of total billed charges,,,876.35,85,,percent of total billed charges,,,,,,,,,907.28,88,,percent of total billed charges,,,,,,,,,787.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,257.75,22,,percent of total billed charges,,,938.21,91,,percent of total billed charges,,,979.45,95,,percent of total billed charges,,,855.73,83,,percent of total billed charges,,,855.73,83,,percent of total billed charges,,,,,,,,,,,,,,,855.73,83,,percent of total billed charges,,,979.45,95,,percent of total billed charges,,,927.9,90,,percent of total billed charges,,,927.9,90,,percent of total billed charges,,,845.42,82,,percent of total billed charges,,,927.9,90,,percent of total billed charges,,,876.35,85,,percent of total billed charges,,257.75,979.45,
X FLUORO GD/EPI BILATERAL,26100499,CDM,77003,CPT,320,RC,outpatient,50,3293,3293,,2795.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,823.25,22,,percent of total billed charges,,,,,,,,,2963.7,90,,percent of total billed charges,,,2726.6,82.8,,percent of total billed charges,,,2799.05,85,,percent of total billed charges,,,,,,,,,2897.84,88,,percent of total billed charges,,,,,,,,,2515.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,823.25,22,,percent of total billed charges,,,2996.63,91,,percent of total billed charges,,,3128.35,95,,percent of total billed charges,,,2733.19,83,,percent of total billed charges,,,2733.19,83,,percent of total billed charges,,,,,,,,,,,,,,,2733.19,83,,percent of total billed charges,,,3128.35,95,,percent of total billed charges,,,2963.7,90,,percent of total billed charges,,,2963.7,90,,percent of total billed charges,,,2700.26,82,,percent of total billed charges,,,2963.7,90,,percent of total billed charges,,,2799.05,85,,percent of total billed charges,,823.25,3128.35,
X SI JOINT <3V,26100502,CDM,72200,CPT,320,RC,outpatient,TC,400,400,,339.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100,22,,percent of total billed charges,,,,,,,,,360,90,,percent of total billed charges,,,331.2,82.8,,percent of total billed charges,,,340,85,,percent of total billed charges,,,,,,,,,352,88,,percent of total billed charges,,,,,,,,,305.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100,22,,percent of total billed charges,,,364,91,,percent of total billed charges,,,380,95,,percent of total billed charges,,,332,83,,percent of total billed charges,,,332,83,,percent of total billed charges,,,,,,,,,,,,,,,332,83,,percent of total billed charges,,,380,95,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,328,82,,percent of total billed charges,,,360,90,,percent of total billed charges,,,340,85,,percent of total billed charges,,100,380,
X SI JOINT 3V+,26100503,CDM,72202,CPT,320,RC,outpatient,TC,501,501,,425.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125.25,22,,percent of total billed charges,,,,,,,,,450.9,90,,percent of total billed charges,,,414.83,82.8,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,,,,,,,,440.88,88,,percent of total billed charges,,,,,,,,,382.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125.25,22,,percent of total billed charges,,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,,,,,,,,,,,,,415.83,83,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,410.82,82,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,125.25,475.95,
X MYELOGRAM CERVICAL,26100549,CDM,62302,CPT,320,RC,outpatient,TC,5837,5837,,4955.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1459.25,22,,percent of total billed charges,,,,,,,,,5253.3,90,,percent of total billed charges,,,4833.04,82.8,,percent of total billed charges,,,4961.45,85,,percent of total billed charges,,,,,,,,,5136.56,88,,percent of total billed charges,,,,,,,,,4459.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1459.25,22,,percent of total billed charges,,,5311.67,91,,percent of total billed charges,,,5545.15,95,,percent of total billed charges,,,4844.71,83,,percent of total billed charges,,,4844.71,83,,percent of total billed charges,,,,,,,,,,,,,,,4844.71,83,,percent of total billed charges,,,5545.15,95,,percent of total billed charges,,,5253.3,90,,percent of total billed charges,,,5253.3,90,,percent of total billed charges,,,4786.34,82,,percent of total billed charges,,,5253.3,90,,percent of total billed charges,,,4961.45,85,,percent of total billed charges,,1459.25,5545.15,
X PELVIS 3V+,26100560,CDM,72190,CPT,320,RC,outpatient,TC,605,605,,513.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,151.25,22,,percent of total billed charges,,,,,,,,,544.5,90,,percent of total billed charges,,,500.94,82.8,,percent of total billed charges,,,514.25,85,,percent of total billed charges,,,,,,,,,532.4,88,,percent of total billed charges,,,,,,,,,462.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,151.25,22,,percent of total billed charges,,,550.55,91,,percent of total billed charges,,,574.75,95,,percent of total billed charges,,,502.15,83,,percent of total billed charges,,,502.15,83,,percent of total billed charges,,,,,,,,,,,,,,,502.15,83,,percent of total billed charges,,,574.75,95,,percent of total billed charges,,,544.5,90,,percent of total billed charges,,,544.5,90,,percent of total billed charges,,,496.1,82,,percent of total billed charges,,,544.5,90,,percent of total billed charges,,,514.25,85,,percent of total billed charges,,151.25,574.75,
X BODYGRAM FB/CHILD,26100578,CDM,76010,CPT,320,RC,outpatient,TC,488,488,,414.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,122,22,,percent of total billed charges,,,,,,,,,439.2,90,,percent of total billed charges,,,404.06,82.8,,percent of total billed charges,,,414.8,85,,percent of total billed charges,,,,,,,,,429.44,88,,percent of total billed charges,,,,,,,,,372.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,122,22,,percent of total billed charges,,,444.08,91,,percent of total billed charges,,,463.6,95,,percent of total billed charges,,,405.04,83,,percent of total billed charges,,,405.04,83,,percent of total billed charges,,,,,,,,,,,,,,,405.04,83,,percent of total billed charges,,,463.6,95,,percent of total billed charges,,,439.2,90,,percent of total billed charges,,,439.2,90,,percent of total billed charges,,,400.16,82,,percent of total billed charges,,,439.2,90,,percent of total billed charges,,,414.8,85,,percent of total billed charges,,122,463.6,
X UP EXT INFANT RIGHT 2V,26100586,CDM,73092,CPT,320,RC,outpatient,RT,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
X UP EXT INFANT LEFT 2V,26100587,CDM,73092,CPT,320,RC,outpatient,LT,375,375,,318.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93.75,22,,percent of total billed charges,,,,,,,,,337.5,90,,percent of total billed charges,,,310.5,82.8,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,,,,,,,,330,88,,percent of total billed charges,,,,,,,,,286.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93.75,22,,percent of total billed charges,,,341.25,91,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,311.25,83,,percent of total billed charges,,,,,,,,,,,,,,,311.25,83,,percent of total billed charges,,,356.25,95,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,307.5,82,,percent of total billed charges,,,337.5,90,,percent of total billed charges,,,318.75,85,,percent of total billed charges,,93.75,356.25,
X SPINE SURVEY (2V FULL SPINE),26100594,CDM,72082,CPT,320,RC,outpatient,,937,937,,795.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,234.25,22,,percent of total billed charges,,,,,,,,,843.3,90,,percent of total billed charges,,,775.84,82.8,,percent of total billed charges,,,796.45,85,,percent of total billed charges,,,,,,,,,824.56,88,,percent of total billed charges,,,,,,,,,715.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,234.25,22,,percent of total billed charges,,,852.67,91,,percent of total billed charges,,,890.15,95,,percent of total billed charges,,,777.71,83,,percent of total billed charges,,,777.71,83,,percent of total billed charges,,,,,,,,,,,,,,,777.71,83,,percent of total billed charges,,,890.15,95,,percent of total billed charges,,,843.3,90,,percent of total billed charges,,,843.3,90,,percent of total billed charges,,,768.34,82,,percent of total billed charges,,,843.3,90,,percent of total billed charges,,,796.45,85,,percent of total billed charges,,234.25,890.15,
X KNEE BILATERAL 3V,26100597,CDM,73562,CPT,320,RC,outpatient,50,1101,1101,,934.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,275.25,22,,percent of total billed charges,,,,,,,,,990.9,90,,percent of total billed charges,,,911.63,82.8,,percent of total billed charges,,,935.85,85,,percent of total billed charges,,,,,,,,,968.88,88,,percent of total billed charges,,,,,,,,,841.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,275.25,22,,percent of total billed charges,,,1001.91,91,,percent of total billed charges,,,1045.95,95,,percent of total billed charges,,,913.83,83,,percent of total billed charges,,,913.83,83,,percent of total billed charges,,,,,,,,,,,,,,,913.83,83,,percent of total billed charges,,,1045.95,95,,percent of total billed charges,,,990.9,90,,percent of total billed charges,,,990.9,90,,percent of total billed charges,,,902.82,82,,percent of total billed charges,,,990.9,90,,percent of total billed charges,,,935.85,85,,percent of total billed charges,,275.25,1045.95,
X MYELOGRAM LUMBAR,26100602,CDM,62304,CPT,320,RC,outpatient,TC,5773,5773,,4901.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1443.25,22,,percent of total billed charges,,,,,,,,,5195.7,90,,percent of total billed charges,,,4780.04,82.8,,percent of total billed charges,,,4907.05,85,,percent of total billed charges,,,,,,,,,5080.24,88,,percent of total billed charges,,,,,,,,,4410.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1443.25,22,,percent of total billed charges,,,5253.43,91,,percent of total billed charges,,,5484.35,95,,percent of total billed charges,,,4791.59,83,,percent of total billed charges,,,4791.59,83,,percent of total billed charges,,,,,,,,,,,,,,,4791.59,83,,percent of total billed charges,,,5484.35,95,,percent of total billed charges,,,5195.7,90,,percent of total billed charges,,,5195.7,90,,percent of total billed charges,,,4733.86,82,,percent of total billed charges,,,5195.7,90,,percent of total billed charges,,,4907.05,85,,percent of total billed charges,,1443.25,5484.35,
X CHEST 2V,26100628,CDM,71046,CPT,324,RC,outpatient,TC,470,470,,399.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.5,22,,percent of total billed charges,,,,,,,,,423,90,,percent of total billed charges,,,389.16,82.8,,percent of total billed charges,,,399.5,85,,percent of total billed charges,,,,,,,,,413.6,88,,percent of total billed charges,,,,,,,,,359.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.5,22,,percent of total billed charges,,,427.7,91,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,,,,,,,,,,,,,390.1,83,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,423,90,,percent of total billed charges,,,423,90,,percent of total billed charges,,,385.4,82,,percent of total billed charges,,,423,90,,percent of total billed charges,,,399.5,85,,percent of total billed charges,,117.5,446.5,
X CHEST PA OR LAT W/FLUORO,26100636,CDM,76000,CPT,324,RC,outpatient,TC,1095,1095,,929.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,273.75,22,,percent of total billed charges,,,,,,,,,985.5,90,,percent of total billed charges,,,906.66,82.8,,percent of total billed charges,,,930.75,85,,percent of total billed charges,,,,,,,,,963.6,88,,percent of total billed charges,,,,,,,,,836.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,273.75,22,,percent of total billed charges,,,996.45,91,,percent of total billed charges,,,1040.25,95,,percent of total billed charges,,,908.85,83,,percent of total billed charges,,,908.85,83,,percent of total billed charges,,,,,,,,,,,,,,,908.85,83,,percent of total billed charges,,,1040.25,95,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,897.9,82,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,930.75,85,,percent of total billed charges,,273.75,1040.25,
X BONE SURVEY COMPLETE,26100650,CDM,77075,CPT,320,RC,outpatient,TC,1359,1359,,1153.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,339.75,22,,percent of total billed charges,,,,,,,,,1223.1,90,,percent of total billed charges,,,1125.25,82.8,,percent of total billed charges,,,1155.15,85,,percent of total billed charges,,,,,,,,,1195.92,88,,percent of total billed charges,,,,,,,,,1038.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,339.75,22,,percent of total billed charges,,,1236.69,91,,percent of total billed charges,,,1291.05,95,,percent of total billed charges,,,1127.97,83,,percent of total billed charges,,,1127.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1127.97,83,,percent of total billed charges,,,1291.05,95,,percent of total billed charges,,,1223.1,90,,percent of total billed charges,,,1223.1,90,,percent of total billed charges,,,1114.38,82,,percent of total billed charges,,,1223.1,90,,percent of total billed charges,,,1155.15,85,,percent of total billed charges,,339.75,1291.05,
X MYELOGRAM THORACIC,26100677,CDM,62303,CPT,320,RC,outpatient,TC,5688,5688,,4829.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1422,22,,percent of total billed charges,,,,,,,,,5119.2,90,,percent of total billed charges,,,4709.66,82.8,,percent of total billed charges,,,4834.8,85,,percent of total billed charges,,,,,,,,,5005.44,88,,percent of total billed charges,,,,,,,,,4345.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1422,22,,percent of total billed charges,,,5176.08,91,,percent of total billed charges,,,5403.6,95,,percent of total billed charges,,,4721.04,83,,percent of total billed charges,,,4721.04,83,,percent of total billed charges,,,,,,,,,,,,,,,4721.04,83,,percent of total billed charges,,,5403.6,95,,percent of total billed charges,,,5119.2,90,,percent of total billed charges,,,5119.2,90,,percent of total billed charges,,,4664.16,82,,percent of total billed charges,,,5119.2,90,,percent of total billed charges,,,4834.8,85,,percent of total billed charges,,1422,5403.6,
X RIBS RIGHT 2V,26100685,CDM,71100,CPT,320,RC,outpatient,RT,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.75,22,,percent of total billed charges,,,,,,,,,449.1,90,,percent of total billed charges,,,413.17,82.8,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.75,22,,percent of total billed charges,,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,124.75,474.05,
X RIBS LEFT 2V,26100686,CDM,71100,CPT,320,RC,outpatient,LT,499,499,,423.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,124.75,22,,percent of total billed charges,,,,,,,,,449.1,90,,percent of total billed charges,,,413.17,82.8,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,,,,,,,,439.12,88,,percent of total billed charges,,,,,,,,,381.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,124.75,22,,percent of total billed charges,,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,,,,,,,,,,,,,414.17,83,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,409.18,82,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,124.75,474.05,
X RIBS LEFT W/PA CXR 3V+,26100687,CDM,71101,CPT,320,RC,outpatient,LT,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195.5,22,,percent of total billed charges,,,,,,,,,703.8,90,,percent of total billed charges,,,647.5,82.8,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195.5,22,,percent of total billed charges,,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,195.5,742.9,
X RIBS RIGHT W/PA CXR 3V+,26100688,CDM,71101,CPT,320,RC,outpatient,RT,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195.5,22,,percent of total billed charges,,,,,,,,,703.8,90,,percent of total billed charges,,,647.5,82.8,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195.5,22,,percent of total billed charges,,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,195.5,742.9,
X RIBS BILATERAL W/PA CXR 4V+,26100689,CDM,71111,CPT,320,RC,outpatient,TC,936,936,,794.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,234,22,,percent of total billed charges,,,,,,,,,842.4,90,,percent of total billed charges,,,775.01,82.8,,percent of total billed charges,,,795.6,85,,percent of total billed charges,,,,,,,,,823.68,88,,percent of total billed charges,,,,,,,,,715.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,234,22,,percent of total billed charges,,,851.76,91,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,,,,,,,,,,,,,776.88,83,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,767.52,82,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,795.6,85,,percent of total billed charges,,234,889.2,
X RIBS BILATERAL 3V+,26100693,CDM,71110,CPT,320,RC,outpatient,TC,704,704,,597.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,176,22,,percent of total billed charges,,,,,,,,,633.6,90,,percent of total billed charges,,,582.91,82.8,,percent of total billed charges,,,598.4,85,,percent of total billed charges,,,,,,,,,619.52,88,,percent of total billed charges,,,,,,,,,537.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,176,22,,percent of total billed charges,,,640.64,91,,percent of total billed charges,,,668.8,95,,percent of total billed charges,,,584.32,83,,percent of total billed charges,,,584.32,83,,percent of total billed charges,,,,,,,,,,,,,,,584.32,83,,percent of total billed charges,,,668.8,95,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,577.28,82,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,598.4,85,,percent of total billed charges,,176,668.8,
X STERNUM 2V+,26100701,CDM,71120,CPT,320,RC,outpatient,TC,494,494,,419.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123.5,22,,percent of total billed charges,,,,,,,,,444.6,90,,percent of total billed charges,,,409.03,82.8,,percent of total billed charges,,,419.9,85,,percent of total billed charges,,,,,,,,,434.72,88,,percent of total billed charges,,,,,,,,,377.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123.5,22,,percent of total billed charges,,,449.54,91,,percent of total billed charges,,,469.3,95,,percent of total billed charges,,,410.02,83,,percent of total billed charges,,,410.02,83,,percent of total billed charges,,,,,,,,,,,,,,,410.02,83,,percent of total billed charges,,,469.3,95,,percent of total billed charges,,,444.6,90,,percent of total billed charges,,,444.6,90,,percent of total billed charges,,,405.08,82,,percent of total billed charges,,,444.6,90,,percent of total billed charges,,,419.9,85,,percent of total billed charges,,123.5,469.3,
X HIP ARTHROGRAM RIGHT,26100707,CDM,73525,CPT,320,RC,outpatient,RT,1656,1656,,1405.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,414,22,,percent of total billed charges,,,,,,,,,1490.4,90,,percent of total billed charges,,,1371.17,82.8,,percent of total billed charges,,,1407.6,85,,percent of total billed charges,,,,,,,,,1457.28,88,,percent of total billed charges,,,,,,,,,1265.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,414,22,,percent of total billed charges,,,1506.96,91,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1374.48,83,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1357.92,82,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1407.6,85,,percent of total billed charges,,414,1573.2,
X HIP ARTHROGRAM LEFT,26100708,CDM,73525,CPT,320,RC,outpatient,LT,1656,1656,,1405.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,414,22,,percent of total billed charges,,,,,,,,,1490.4,90,,percent of total billed charges,,,1371.17,82.8,,percent of total billed charges,,,1407.6,85,,percent of total billed charges,,,,,,,,,1457.28,88,,percent of total billed charges,,,,,,,,,1265.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,414,22,,percent of total billed charges,,,1506.96,91,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1374.48,83,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1357.92,82,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1407.6,85,,percent of total billed charges,,414,1573.2,
X HIPS BILAT W/ PELVIS,26100719,CDM,73521,CPT,320,RC,outpatient,TC,1693,1693,,1437.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,423.25,22,,percent of total billed charges,,,,,,,,,1523.7,90,,percent of total billed charges,,,1401.8,82.8,,percent of total billed charges,,,1439.05,85,,percent of total billed charges,,,,,,,,,1489.84,88,,percent of total billed charges,,,,,,,,,1293.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,423.25,22,,percent of total billed charges,,,1540.63,91,,percent of total billed charges,,,1608.35,95,,percent of total billed charges,,,1405.19,83,,percent of total billed charges,,,1405.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1405.19,83,,percent of total billed charges,,,1608.35,95,,percent of total billed charges,,,1523.7,90,,percent of total billed charges,,,1523.7,90,,percent of total billed charges,,,1388.26,82,,percent of total billed charges,,,1523.7,90,,percent of total billed charges,,,1439.05,85,,percent of total billed charges,,423.25,1608.35,
X SMALL BOWEL,26100735,CDM,74250,CPT,320,RC,outpatient,TC,1296,1296,,1100.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,324,22,,percent of total billed charges,,,,,,,,,1166.4,90,,percent of total billed charges,,,1073.09,82.8,,percent of total billed charges,,,1101.6,85,,percent of total billed charges,,,,,,,,,1140.48,88,,percent of total billed charges,,,,,,,,,990.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,324,22,,percent of total billed charges,,,1179.36,91,,percent of total billed charges,,,1231.2,95,,percent of total billed charges,,,1075.68,83,,percent of total billed charges,,,1075.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1075.68,83,,percent of total billed charges,,,1231.2,95,,percent of total billed charges,,,1166.4,90,,percent of total billed charges,,,1166.4,90,,percent of total billed charges,,,1062.72,82,,percent of total billed charges,,,1166.4,90,,percent of total billed charges,,,1101.6,85,,percent of total billed charges,,324,1231.2,
X ESOPHAGUS,26100743,CDM,74220,CPT,320,RC,outpatient,TC,982,982,,833.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,245.5,22,,percent of total billed charges,,,,,,,,,883.8,90,,percent of total billed charges,,,813.1,82.8,,percent of total billed charges,,,834.7,85,,percent of total billed charges,,,,,,,,,864.16,88,,percent of total billed charges,,,,,,,,,750.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,245.5,22,,percent of total billed charges,,,893.62,91,,percent of total billed charges,,,932.9,95,,percent of total billed charges,,,815.06,83,,percent of total billed charges,,,815.06,83,,percent of total billed charges,,,,,,,,,,,,,,,815.06,83,,percent of total billed charges,,,932.9,95,,percent of total billed charges,,,883.8,90,,percent of total billed charges,,,883.8,90,,percent of total billed charges,,,805.24,82,,percent of total billed charges,,,883.8,90,,percent of total billed charges,,,834.7,85,,percent of total billed charges,,245.5,932.9,
X UGI W/O KUB,26100750,CDM,74240,CPT,320,RC,outpatient,TC,1185,1185,,1006.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,296.25,22,,percent of total billed charges,,,,,,,,,1066.5,90,,percent of total billed charges,,,981.18,82.8,,percent of total billed charges,,,1007.25,85,,percent of total billed charges,,,,,,,,,1042.8,88,,percent of total billed charges,,,,,,,,,905.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,296.25,22,,percent of total billed charges,,,1078.35,91,,percent of total billed charges,,,1125.75,95,,percent of total billed charges,,,983.55,83,,percent of total billed charges,,,983.55,83,,percent of total billed charges,,,,,,,,,,,,,,,983.55,83,,percent of total billed charges,,,1125.75,95,,percent of total billed charges,,,1066.5,90,,percent of total billed charges,,,1066.5,90,,percent of total billed charges,,,971.7,82,,percent of total billed charges,,,1066.5,90,,percent of total billed charges,,,1007.25,85,,percent of total billed charges,,296.25,1125.75,
X COLON,26100768,CDM,74270,CPT,320,RC,outpatient,TC,1578,1578,,1339.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,394.5,22,,percent of total billed charges,,,,,,,,,1420.2,90,,percent of total billed charges,,,1306.58,82.8,,percent of total billed charges,,,1341.3,85,,percent of total billed charges,,,,,,,,,1388.64,88,,percent of total billed charges,,,,,,,,,1205.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,394.5,22,,percent of total billed charges,,,1435.98,91,,percent of total billed charges,,,1499.1,95,,percent of total billed charges,,,1309.74,83,,percent of total billed charges,,,1309.74,83,,percent of total billed charges,,,,,,,,,,,,,,,1309.74,83,,percent of total billed charges,,,1499.1,95,,percent of total billed charges,,,1420.2,90,,percent of total billed charges,,,1420.2,90,,percent of total billed charges,,,1293.96,82,,percent of total billed charges,,,1420.2,90,,percent of total billed charges,,,1341.3,85,,percent of total billed charges,,394.5,1499.1,
SINOGRAFFIN LOW OSMOLAR CN 100-199 mg/ml,26100784,CDM,Q9965,HCPCS,636,RC,outpatient,,133,133,,112.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.25,22,,percent of total billed charges,,,,,,,,,119.7,90,,percent of total billed charges,,,110.12,82.8,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,,,,,,,,117.04,88,,percent of total billed charges,,,,,,,,,101.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.25,22,,percent of total billed charges,,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,,,,,,,,,,,,,110.39,83,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,109.06,82,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,33.25,126.35,
*SINOGRAFFIN <150MG/ML PER ML(V 0508),26100785,CDM,Q9965,HCPCS,636,RC,outpatient,,133,133,,112.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33.25,22,,percent of total billed charges,,,,,,,,,119.7,90,,percent of total billed charges,,,110.12,82.8,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,,,,,,,,117.04,88,,percent of total billed charges,,,,,,,,,101.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33.25,22,,percent of total billed charges,,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,,,,,,,,,,,,,110.39,83,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,109.06,82,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,33.25,126.35,
X HYSTROSALPING CATH,26100788,CDM,58340,CPT,360,RC,outpatient,,1107,1107,,939.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,276.75,22,,percent of total billed charges,,,,,,,,,996.3,90,,percent of total billed charges,,,916.6,82.8,,percent of total billed charges,,,940.95,85,,percent of total billed charges,,,,,,,,,974.16,88,,percent of total billed charges,,,,,,,,,845.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,276.75,22,,percent of total billed charges,,,1007.37,91,,percent of total billed charges,,,1051.65,95,,percent of total billed charges,,,918.81,83,,percent of total billed charges,,,918.81,83,,percent of total billed charges,,,,,,,,,,,,,,,918.81,83,,percent of total billed charges,,,1051.65,95,,percent of total billed charges,,,996.3,90,,percent of total billed charges,,,996.3,90,,percent of total billed charges,,,907.74,82,,percent of total billed charges,,,996.3,90,,percent of total billed charges,,,940.95,85,,percent of total billed charges,,276.75,1051.65,
X HYSTEROSALPINGOGRAPHY,26100789,CDM,74740,CPT,320,RC,outpatient,TC,2734,2734,,2321.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,683.5,22,,percent of total billed charges,,,,,,,,,2460.6,90,,percent of total billed charges,,,2263.75,82.8,,percent of total billed charges,,,2323.9,85,,percent of total billed charges,,,,,,,,,2405.92,88,,percent of total billed charges,,,,,,,,,2088.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,683.5,22,,percent of total billed charges,,,2487.94,91,,percent of total billed charges,,,2597.3,95,,percent of total billed charges,,,2269.22,83,,percent of total billed charges,,,2269.22,83,,percent of total billed charges,,,,,,,,,,,,,,,2269.22,83,,percent of total billed charges,,,2597.3,95,,percent of total billed charges,,,2460.6,90,,percent of total billed charges,,,2460.6,90,,percent of total billed charges,,,2241.88,82,,percent of total billed charges,,,2460.6,90,,percent of total billed charges,,,2323.9,85,,percent of total billed charges,,683.5,2597.3,
X ORC (CHOLANGIOGRAMS),26100792,CDM,74300,CPT,320,RC,outpatient,TC,1329,1329,,1128.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,332.25,22,,percent of total billed charges,,,,,,,,,1196.1,90,,percent of total billed charges,,,1100.41,82.8,,percent of total billed charges,,,1129.65,85,,percent of total billed charges,,,,,,,,,1169.52,88,,percent of total billed charges,,,,,,,,,1015.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,332.25,22,,percent of total billed charges,,,1209.39,91,,percent of total billed charges,,,1262.55,95,,percent of total billed charges,,,1103.07,83,,percent of total billed charges,,,1103.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1103.07,83,,percent of total billed charges,,,1262.55,95,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1089.78,82,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1129.65,85,,percent of total billed charges,,332.25,1262.55,
X ORC (CHOLANG) ADDL SETS,26100795,CDM,74301,CPT,320,RC,outpatient,TC,546,546,,463.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,136.5,22,,percent of total billed charges,,,,,,,,,491.4,90,,percent of total billed charges,,,452.09,82.8,,percent of total billed charges,,,464.1,85,,percent of total billed charges,,,,,,,,,480.48,88,,percent of total billed charges,,,,,,,,,417.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,136.5,22,,percent of total billed charges,,,496.86,91,,percent of total billed charges,,,518.7,95,,percent of total billed charges,,,453.18,83,,percent of total billed charges,,,453.18,83,,percent of total billed charges,,,,,,,,,,,,,,,453.18,83,,percent of total billed charges,,,518.7,95,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,447.72,82,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,464.1,85,,percent of total billed charges,,136.5,518.7,
X T-TUBE CHOLE INJECTION,26100805,CDM,47531,CPT,361,RC,outpatient,,1431,1431,,1214.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,357.75,22,,percent of total billed charges,,,,,,,,,1287.9,90,,percent of total billed charges,,,1184.87,82.8,,percent of total billed charges,,,1216.35,85,,percent of total billed charges,,,,,,,,,1259.28,88,,percent of total billed charges,,,,,,,,,1093.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,357.75,22,,percent of total billed charges,,,1302.21,91,,percent of total billed charges,,,1359.45,95,,percent of total billed charges,,,1187.73,83,,percent of total billed charges,,,1187.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1187.73,83,,percent of total billed charges,,,1359.45,95,,percent of total billed charges,,,1287.9,90,,percent of total billed charges,,,1287.9,90,,percent of total billed charges,,,1173.42,82,,percent of total billed charges,,,1287.9,90,,percent of total billed charges,,,1216.35,85,,percent of total billed charges,,357.75,1359.45,
X COLON W/AIR,26100818,CDM,74280,CPT,320,RC,outpatient,,1744,1744,,1480.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,436,22,,percent of total billed charges,,,,,,,,,1569.6,90,,percent of total billed charges,,,1444.03,82.8,,percent of total billed charges,,,1482.4,85,,percent of total billed charges,,,,,,,,,1534.72,88,,percent of total billed charges,,,,,,,,,1332.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,436,22,,percent of total billed charges,,,1587.04,91,,percent of total billed charges,,,1656.8,95,,percent of total billed charges,,,1447.52,83,,percent of total billed charges,,,1447.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1447.52,83,,percent of total billed charges,,,1656.8,95,,percent of total billed charges,,,1569.6,90,,percent of total billed charges,,,1569.6,90,,percent of total billed charges,,,1430.08,82,,percent of total billed charges,,,1569.6,90,,percent of total billed charges,,,1482.4,85,,percent of total billed charges,,436,1656.8,
* DFU X IVP W/O TOMOGRAPHY,26100826,CDM,74400,CPT,320,RC,outpatient,TC,1226,1226,,1040.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,306.5,22,,percent of total billed charges,,,,,,,,,1103.4,90,,percent of total billed charges,,,1015.13,82.8,,percent of total billed charges,,,1042.1,85,,percent of total billed charges,,,,,,,,,1078.88,88,,percent of total billed charges,,,,,,,,,936.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,306.5,22,,percent of total billed charges,,,1115.66,91,,percent of total billed charges,,,1164.7,95,,percent of total billed charges,,,1017.58,83,,percent of total billed charges,,,1017.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1017.58,83,,percent of total billed charges,,,1164.7,95,,percent of total billed charges,,,1103.4,90,,percent of total billed charges,,,1103.4,90,,percent of total billed charges,,,1005.32,82,,percent of total billed charges,,,1103.4,90,,percent of total billed charges,,,1042.1,85,,percent of total billed charges,,306.5,1164.7,
X SCAPULA LEFT 2V+,26100834,CDM,73010,CPT,320,RC,outpatient,LT,482,482,,409.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,120.5,22,,percent of total billed charges,,,,,,,,,433.8,90,,percent of total billed charges,,,399.1,82.8,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,,,,,,,,424.16,88,,percent of total billed charges,,,,,,,,,368.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,120.5,22,,percent of total billed charges,,,438.62,91,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,,,,,,,,,,,,,400.06,83,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,395.24,82,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,120.5,457.9,
X RETRO PYELOGRAM,26100842,CDM,74400,CPT,320,RC,outpatient,TC,2246,2246,,1906.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,561.5,22,,percent of total billed charges,,,,,,,,,2021.4,90,,percent of total billed charges,,,1859.69,82.8,,percent of total billed charges,,,1909.1,85,,percent of total billed charges,,,,,,,,,1976.48,88,,percent of total billed charges,,,,,,,,,1715.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,561.5,22,,percent of total billed charges,,,2043.86,91,,percent of total billed charges,,,2133.7,95,,percent of total billed charges,,,1864.18,83,,percent of total billed charges,,,1864.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1864.18,83,,percent of total billed charges,,,2133.7,95,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,1841.72,82,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,1909.1,85,,percent of total billed charges,,561.5,2133.7,
X CYSTOGRAM,26100859,CDM,74430,CPT,320,RC,outpatient,TC,2246,2246,,1906.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,561.5,22,,percent of total billed charges,,,,,,,,,2021.4,90,,percent of total billed charges,,,1859.69,82.8,,percent of total billed charges,,,1909.1,85,,percent of total billed charges,,,,,,,,,1976.48,88,,percent of total billed charges,,,,,,,,,1715.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,561.5,22,,percent of total billed charges,,,2043.86,91,,percent of total billed charges,,,2133.7,95,,percent of total billed charges,,,1864.18,83,,percent of total billed charges,,,1864.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1864.18,83,,percent of total billed charges,,,2133.7,95,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,1841.72,82,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,1909.1,85,,percent of total billed charges,,561.5,2133.7,
X HIP LEFT 1V W/PELVIS,26100877,CDM,73501,CPT,320,RC,outpatient,TC,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,231.25,22,,percent of total billed charges,,,,,,,,,832.5,90,,percent of total billed charges,,,765.9,82.8,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,231.25,22,,percent of total billed charges,,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,231.25,878.75,
X HIP RIGHT 1V W/PELVIS,26100878,CDM,73501,CPT,320,RC,outpatient,TC,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,231.25,22,,percent of total billed charges,,,,,,,,,832.5,90,,percent of total billed charges,,,765.9,82.8,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,231.25,22,,percent of total billed charges,,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,231.25,878.75,
X SINUS-TRACT STUDY,26100883,CDM,76080,CPT,320,RC,outpatient,TC,1155,1155,,980.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,288.75,22,,percent of total billed charges,,,,,,,,,1039.5,90,,percent of total billed charges,,,956.34,82.8,,percent of total billed charges,,,981.75,85,,percent of total billed charges,,,,,,,,,1016.4,88,,percent of total billed charges,,,,,,,,,882.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,288.75,22,,percent of total billed charges,,,1051.05,91,,percent of total billed charges,,,1097.25,95,,percent of total billed charges,,,958.65,83,,percent of total billed charges,,,958.65,83,,percent of total billed charges,,,,,,,,,,,,,,,958.65,83,,percent of total billed charges,,,1097.25,95,,percent of total billed charges,,,1039.5,90,,percent of total billed charges,,,1039.5,90,,percent of total billed charges,,,947.1,82,,percent of total billed charges,,,1039.5,90,,percent of total billed charges,,,981.75,85,,percent of total billed charges,,288.75,1097.25,
X TOES 2V+1OR>1DIGIT,26100917,CDM,73660,CPT,320,RC,outpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X VENOGRAPHY EXTREMITY UNILATERAL RS&I,26100925,CDM,75820,CPT,320,RC,outpatient,TC,2856,2856,,2424.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,714,22,,percent of total billed charges,,,,,,,,,2570.4,90,,percent of total billed charges,,,2364.77,82.8,,percent of total billed charges,,,2427.6,85,,percent of total billed charges,,,,,,,,,2513.28,88,,percent of total billed charges,,,,,,,,,2181.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,714,22,,percent of total billed charges,,,2598.96,91,,percent of total billed charges,,,2713.2,95,,percent of total billed charges,,,2370.48,83,,percent of total billed charges,,,2370.48,83,,percent of total billed charges,,,,,,,,,,,,,,,2370.48,83,,percent of total billed charges,,,2713.2,95,,percent of total billed charges,,,2570.4,90,,percent of total billed charges,,,2570.4,90,,percent of total billed charges,,,2341.92,82,,percent of total billed charges,,,2570.4,90,,percent of total billed charges,,,2427.6,85,,percent of total billed charges,,714,2713.2,
X VENOGRAPHY EXTREMITY BILATERAL RS&I,26100941,CDM,75822,CPT,320,RC,outpatient,TC,3486,3486,,2959.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,871.5,22,,percent of total billed charges,,,,,,,,,3137.4,90,,percent of total billed charges,,,2886.41,82.8,,percent of total billed charges,,,2963.1,85,,percent of total billed charges,,,,,,,,,3067.68,88,,percent of total billed charges,,,,,,,,,2663.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,871.5,22,,percent of total billed charges,,,3172.26,91,,percent of total billed charges,,,3311.7,95,,percent of total billed charges,,,2893.38,83,,percent of total billed charges,,,2893.38,83,,percent of total billed charges,,,,,,,,,,,,,,,2893.38,83,,percent of total billed charges,,,3311.7,95,,percent of total billed charges,,,3137.4,90,,percent of total billed charges,,,3137.4,90,,percent of total billed charges,,,2858.52,82,,percent of total billed charges,,,3137.4,90,,percent of total billed charges,,,2963.1,85,,percent of total billed charges,,871.5,3311.7,
X ARTERIOGRAM RT (UP OR LOW),26100945,CDM,75710,CPT,320,RC,outpatient,RT,7168,7168,,6085.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1792,22,,percent of total billed charges,,,,,,,,,6451.2,90,,percent of total billed charges,,,5935.1,82.8,,percent of total billed charges,,,6092.8,85,,percent of total billed charges,,,,,,,,,6307.84,88,,percent of total billed charges,,,,,,,,,5476.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1792,22,,percent of total billed charges,,,6522.88,91,,percent of total billed charges,,,6809.6,95,,percent of total billed charges,,,5949.44,83,,percent of total billed charges,,,5949.44,83,,percent of total billed charges,,,,,,,,,,,,,,,5949.44,83,,percent of total billed charges,,,6809.6,95,,percent of total billed charges,,,6451.2,90,,percent of total billed charges,,,6451.2,90,,percent of total billed charges,,,5877.76,82,,percent of total billed charges,,,6451.2,90,,percent of total billed charges,,,6092.8,85,,percent of total billed charges,,1792,6809.6,
X ARTERIOGRAM LT (UP OR LOW),26100946,CDM,75710,CPT,320,RC,outpatient,LT,7168,7168,,6085.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1792,22,,percent of total billed charges,,,,,,,,,6451.2,90,,percent of total billed charges,,,5935.1,82.8,,percent of total billed charges,,,6092.8,85,,percent of total billed charges,,,,,,,,,6307.84,88,,percent of total billed charges,,,,,,,,,5476.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1792,22,,percent of total billed charges,,,6522.88,91,,percent of total billed charges,,,6809.6,95,,percent of total billed charges,,,5949.44,83,,percent of total billed charges,,,5949.44,83,,percent of total billed charges,,,,,,,,,,,,,,,5949.44,83,,percent of total billed charges,,,6809.6,95,,percent of total billed charges,,,6451.2,90,,percent of total billed charges,,,6451.2,90,,percent of total billed charges,,,5877.76,82,,percent of total billed charges,,,6451.2,90,,percent of total billed charges,,,6092.8,85,,percent of total billed charges,,1792,6809.6,
X ARTERIOGRAM BIL (UP OR LOW),26100947,CDM,75716,CPT,320,RC,outpatient,TC,7892,7892,,6700.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1973,22,,percent of total billed charges,,,,,,,,,7102.8,90,,percent of total billed charges,,,6534.58,82.8,,percent of total billed charges,,,6708.2,85,,percent of total billed charges,,,,,,,,,6944.96,88,,percent of total billed charges,,,,,,,,,6029.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1973,22,,percent of total billed charges,,,7181.72,91,,percent of total billed charges,,,7497.4,95,,percent of total billed charges,,,6550.36,83,,percent of total billed charges,,,6550.36,83,,percent of total billed charges,,,,,,,,,,,,,,,6550.36,83,,percent of total billed charges,,,7497.4,95,,percent of total billed charges,,,7102.8,90,,percent of total billed charges,,,7102.8,90,,percent of total billed charges,,,6471.44,82,,percent of total billed charges,,,7102.8,90,,percent of total billed charges,,,6708.2,85,,percent of total billed charges,,1973,7497.4,
X ARTERIOGRAM INJECT,26100948,CDM,36140,CPT,769,RC,outpatient,,4519,4519,,3836.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1129.75,22,,percent of total billed charges,,,,,,,,,4067.1,90,,percent of total billed charges,,,3741.73,82.8,,percent of total billed charges,,,3841.15,85,,percent of total billed charges,,,,,,,,,3976.72,88,,percent of total billed charges,,,,,,,,,3452.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1129.75,22,,percent of total billed charges,,,4112.29,91,,percent of total billed charges,,,4293.05,95,,percent of total billed charges,,,3750.77,83,,percent of total billed charges,,,3750.77,83,,percent of total billed charges,,,,,,,,,,,,,,,3750.77,83,,percent of total billed charges,,,4293.05,95,,percent of total billed charges,,,4067.1,90,,percent of total billed charges,,,4067.1,90,,percent of total billed charges,,,3705.58,82,,percent of total billed charges,,,4067.1,90,,percent of total billed charges,,,3841.15,85,,percent of total billed charges,,1129.75,4293.05,
X LUMBAR PUNCTURE,26101006,CDM,62270,CPT,320,RC,outpatient,TC,3124,3124,,2652.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,781,22,,percent of total billed charges,,,,,,,,,2811.6,90,,percent of total billed charges,,,2586.67,82.8,,percent of total billed charges,,,2655.4,85,,percent of total billed charges,,,,,,,,,2749.12,88,,percent of total billed charges,,,,,,,,,2386.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,781,22,,percent of total billed charges,,,2842.84,91,,percent of total billed charges,,,2967.8,95,,percent of total billed charges,,,2592.92,83,,percent of total billed charges,,,2592.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2592.92,83,,percent of total billed charges,,,2967.8,95,,percent of total billed charges,,,2811.6,90,,percent of total billed charges,,,2811.6,90,,percent of total billed charges,,,2561.68,82,,percent of total billed charges,,,2811.6,90,,percent of total billed charges,,,2655.4,85,,percent of total billed charges,,781,2967.8,
X C SPINE 1V,26101261,CDM,72020,CPT,320,RC,outpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X MYELOGRAM INJECTION,26101279,CDM,62284,CPT,769,RC,outpatient,TC,2055,2055,,1744.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,513.75,22,,percent of total billed charges,,,,,,,,,1849.5,90,,percent of total billed charges,,,1701.54,82.8,,percent of total billed charges,,,1746.75,85,,percent of total billed charges,,,,,,,,,1808.4,88,,percent of total billed charges,,,,,,,,,1570.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,513.75,22,,percent of total billed charges,,,1870.05,91,,percent of total billed charges,,,1952.25,95,,percent of total billed charges,,,1705.65,83,,percent of total billed charges,,,1705.65,83,,percent of total billed charges,,,,,,,,,,,,,,,1705.65,83,,percent of total billed charges,,,1952.25,95,,percent of total billed charges,,,1849.5,90,,percent of total billed charges,,,1849.5,90,,percent of total billed charges,,,1685.1,82,,percent of total billed charges,,,1849.5,90,,percent of total billed charges,,,1746.75,85,,percent of total billed charges,,513.75,1952.25,
X SHOULDER ARTHRO/INJ,26101287,CDM,23350,CPT,361,RC,outpatient,TC,1420,1420,,1205.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,355,22,,percent of total billed charges,,,,,,,,,1278,90,,percent of total billed charges,,,1175.76,82.8,,percent of total billed charges,,,1207,85,,percent of total billed charges,,,,,,,,,1249.6,88,,percent of total billed charges,,,,,,,,,1084.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,355,22,,percent of total billed charges,,,1292.2,91,,percent of total billed charges,,,1349,95,,percent of total billed charges,,,1178.6,83,,percent of total billed charges,,,1178.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1178.6,83,,percent of total billed charges,,,1349,95,,percent of total billed charges,,,1278,90,,percent of total billed charges,,,1278,90,,percent of total billed charges,,,1164.4,82,,percent of total billed charges,,,1278,90,,percent of total billed charges,,,1207,85,,percent of total billed charges,,355,1349,
X L SPINE 1V,26101295,CDM,72020,CPT,320,RC,outpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X T SPINE 1V,26101303,CDM,72020,CPT,320,RC,outpatient,TC,395,395,,335.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.75,22,,percent of total billed charges,,,,,,,,,355.5,90,,percent of total billed charges,,,327.06,82.8,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,,,,,,,,347.6,88,,percent of total billed charges,,,,,,,,,301.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.75,22,,percent of total billed charges,,,359.45,91,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,,,,,,,,,,,,,327.85,83,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,323.9,82,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,98.75,375.25,
X T SPINE 2V,26101305,CDM,72070,CPT,320,RC,outpatient,TC,519,519,,440.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,129.75,22,,percent of total billed charges,,,,,,,,,467.1,90,,percent of total billed charges,,,429.73,82.8,,percent of total billed charges,,,441.15,85,,percent of total billed charges,,,,,,,,,456.72,88,,percent of total billed charges,,,,,,,,,396.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,129.75,22,,percent of total billed charges,,,472.29,91,,percent of total billed charges,,,493.05,95,,percent of total billed charges,,,430.77,83,,percent of total billed charges,,,430.77,83,,percent of total billed charges,,,,,,,,,,,,,,,430.77,83,,percent of total billed charges,,,493.05,95,,percent of total billed charges,,,467.1,90,,percent of total billed charges,,,467.1,90,,percent of total billed charges,,,425.58,82,,percent of total billed charges,,,467.1,90,,percent of total billed charges,,,441.15,85,,percent of total billed charges,,129.75,493.05,
X T SPINE 4V+,26101306,CDM,72074,CPT,320,RC,outpatient,TC,688,688,,584.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,172,22,,percent of total billed charges,,,,,,,,,619.2,90,,percent of total billed charges,,,569.66,82.8,,percent of total billed charges,,,584.8,85,,percent of total billed charges,,,,,,,,,605.44,88,,percent of total billed charges,,,,,,,,,525.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,172,22,,percent of total billed charges,,,626.08,91,,percent of total billed charges,,,653.6,95,,percent of total billed charges,,,571.04,83,,percent of total billed charges,,,571.04,83,,percent of total billed charges,,,,,,,,,,,,,,,571.04,83,,percent of total billed charges,,,653.6,95,,percent of total billed charges,,,619.2,90,,percent of total billed charges,,,619.2,90,,percent of total billed charges,,,564.16,82,,percent of total billed charges,,,619.2,90,,percent of total billed charges,,,584.8,85,,percent of total billed charges,,172,653.6,
X CYSTOGRAPHY INJECT PFA,26101311,CDM,51600,CPT,769,RC,outpatient,TC,1582,1582,,1343.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,395.5,22,,percent of total billed charges,,,,,,,,,1423.8,90,,percent of total billed charges,,,1309.9,82.8,,percent of total billed charges,,,1344.7,85,,percent of total billed charges,,,,,,,,,1392.16,88,,percent of total billed charges,,,,,,,,,1208.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,395.5,22,,percent of total billed charges,,,1439.62,91,,percent of total billed charges,,,1502.9,95,,percent of total billed charges,,,1313.06,83,,percent of total billed charges,,,1313.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1313.06,83,,percent of total billed charges,,,1502.9,95,,percent of total billed charges,,,1423.8,90,,percent of total billed charges,,,1423.8,90,,percent of total billed charges,,,1297.24,82,,percent of total billed charges,,,1423.8,90,,percent of total billed charges,,,1344.7,85,,percent of total billed charges,,395.5,1502.9,
DX DXAVERFXASSESS(<2YRTRN),26101315,CDM,77086,CPT,320,RC,outpatient,TC,586,586,,497.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,146.5,22,,percent of total billed charges,,,,,,,,,527.4,90,,percent of total billed charges,,,485.21,82.8,,percent of total billed charges,,,498.1,85,,percent of total billed charges,,,,,,,,,515.68,88,,percent of total billed charges,,,,,,,,,447.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,146.5,22,,percent of total billed charges,,,533.26,91,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,,,,,,,,,,,,,486.38,83,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,480.52,82,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,498.1,85,,percent of total billed charges,,146.5,556.7,
DX DXA BONE DENS/WRIST,26101317,CDM,77081,CPT,320,RC,outpatient,TC,645,645,,547.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,161.25,22,,percent of total billed charges,,,,,,,,,580.5,90,,percent of total billed charges,,,534.06,82.8,,percent of total billed charges,,,548.25,85,,percent of total billed charges,,,,,,,,,567.6,88,,percent of total billed charges,,,,,,,,,492.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,161.25,22,,percent of total billed charges,,,586.95,91,,percent of total billed charges,,,612.75,95,,percent of total billed charges,,,535.35,83,,percent of total billed charges,,,535.35,83,,percent of total billed charges,,,,,,,,,,,,,,,535.35,83,,percent of total billed charges,,,612.75,95,,percent of total billed charges,,,580.5,90,,percent of total billed charges,,,580.5,90,,percent of total billed charges,,,528.9,82,,percent of total billed charges,,,580.5,90,,percent of total billed charges,,,548.25,85,,percent of total billed charges,,161.25,612.75,
DX DXA BONE DENS/HIP/SPINE,26101319,CDM,77080,CPT,320,RC,outpatient,TC,950,950,,806.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,237.5,22,,percent of total billed charges,,,,,,,,,855,90,,percent of total billed charges,,,786.6,82.8,,percent of total billed charges,,,807.5,85,,percent of total billed charges,,,,,,,,,836,88,,percent of total billed charges,,,,,,,,,725.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,237.5,22,,percent of total billed charges,,,864.5,91,,percent of total billed charges,,,902.5,95,,percent of total billed charges,,,788.5,83,,percent of total billed charges,,,788.5,83,,percent of total billed charges,,,,,,,,,,,,,,,788.5,83,,percent of total billed charges,,,902.5,95,,percent of total billed charges,,,855,90,,percent of total billed charges,,,855,90,,percent of total billed charges,,,779,82,,percent of total billed charges,,,855,90,,percent of total billed charges,,,807.5,85,,percent of total billed charges,,237.5,902.5,
X BAR SWAL W/ SPEECH,26101337,CDM,74230,CPT,320,RC,outpatient,TC,1040,1040,,882.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260,22,,percent of total billed charges,,,,,,,,,936,90,,percent of total billed charges,,,861.12,82.8,,percent of total billed charges,,,884,85,,percent of total billed charges,,,,,,,,,915.2,88,,percent of total billed charges,,,,,,,,,794.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260,22,,percent of total billed charges,,,946.4,91,,percent of total billed charges,,,988,95,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,863.2,83,,percent of total billed charges,,,,,,,,,,,,,,,863.2,83,,percent of total billed charges,,,988,95,,percent of total billed charges,,,936,90,,percent of total billed charges,,,936,90,,percent of total billed charges,,,852.8,82,,percent of total billed charges,,,936,90,,percent of total billed charges,,,884,85,,percent of total billed charges,,260,988,
X KNEE ARTHRO INJECT,26101543,CDM,27369,CPT,769,RC,outpatient,TC,957,957,,812.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,239.25,22,,percent of total billed charges,,,,,,,,,861.3,90,,percent of total billed charges,,,792.4,82.8,,percent of total billed charges,,,813.45,85,,percent of total billed charges,,,,,,,,,842.16,88,,percent of total billed charges,,,,,,,,,731.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,239.25,22,,percent of total billed charges,,,870.87,91,,percent of total billed charges,,,909.15,95,,percent of total billed charges,,,794.31,83,,percent of total billed charges,,,794.31,83,,percent of total billed charges,,,,,,,,,,,,,,,794.31,83,,percent of total billed charges,,,909.15,95,,percent of total billed charges,,,861.3,90,,percent of total billed charges,,,861.3,90,,percent of total billed charges,,,784.74,82,,percent of total billed charges,,,861.3,90,,percent of total billed charges,,,813.45,85,,percent of total billed charges,,239.25,909.15,
X VENOGRAM INJECT,26101576,CDM,36005,CPT,769,RC,outpatient,,2415,2415,,2050.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,603.75,22,,percent of total billed charges,,,,,,,,,2173.5,90,,percent of total billed charges,,,1999.62,82.8,,percent of total billed charges,,,2052.75,85,,percent of total billed charges,,,,,,,,,2125.2,88,,percent of total billed charges,,,,,,,,,1845.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,603.75,22,,percent of total billed charges,,,2197.65,91,,percent of total billed charges,,,2294.25,95,,percent of total billed charges,,,2004.45,83,,percent of total billed charges,,,2004.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2004.45,83,,percent of total billed charges,,,2294.25,95,,percent of total billed charges,,,2173.5,90,,percent of total billed charges,,,2173.5,90,,percent of total billed charges,,,1980.3,82,,percent of total billed charges,,,2173.5,90,,percent of total billed charges,,,2052.75,85,,percent of total billed charges,,603.75,2294.25,
X SINUS-TRACT INJECT,26101584,CDM,20501,CPT,769,RC,outpatient,,1101,1101,,934.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,275.25,22,,percent of total billed charges,,,,,,,,,990.9,90,,percent of total billed charges,,,911.63,82.8,,percent of total billed charges,,,935.85,85,,percent of total billed charges,,,,,,,,,968.88,88,,percent of total billed charges,,,,,,,,,841.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,275.25,22,,percent of total billed charges,,,1001.91,91,,percent of total billed charges,,,1045.95,95,,percent of total billed charges,,,913.83,83,,percent of total billed charges,,,913.83,83,,percent of total billed charges,,,,,,,,,,,,,,,913.83,83,,percent of total billed charges,,,1045.95,95,,percent of total billed charges,,,990.9,90,,percent of total billed charges,,,990.9,90,,percent of total billed charges,,,902.82,82,,percent of total billed charges,,,990.9,90,,percent of total billed charges,,,935.85,85,,percent of total billed charges,,275.25,1045.95,
X ANKLE RIGHT 2V,26101592,CDM,73600,CPT,320,RC,outpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X ANKLE LEFT 2V,26101593,CDM,73600,CPT,320,RC,outpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X SKULL 1-3V,26101600,CDM,70250,CPT,320,RC,outpatient,TC,509,509,,432.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.25,22,,percent of total billed charges,,,,,,,,,458.1,90,,percent of total billed charges,,,421.45,82.8,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,,,,,,,,447.92,88,,percent of total billed charges,,,,,,,,,388.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.25,22,,percent of total billed charges,,,463.19,91,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,,,,,,,,,,,,,422.47,83,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,417.38,82,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,127.25,483.55,
X ELBOW ARTHRO INJECT,26101614,CDM,24220,CPT,769,RC,outpatient,TC,873,873,,741.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.25,22,,percent of total billed charges,,,,,,,,,785.7,90,,percent of total billed charges,,,722.84,82.8,,percent of total billed charges,,,742.05,85,,percent of total billed charges,,,,,,,,,768.24,88,,percent of total billed charges,,,,,,,,,666.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.25,22,,percent of total billed charges,,,794.43,91,,percent of total billed charges,,,829.35,95,,percent of total billed charges,,,724.59,83,,percent of total billed charges,,,724.59,83,,percent of total billed charges,,,,,,,,,,,,,,,724.59,83,,percent of total billed charges,,,829.35,95,,percent of total billed charges,,,785.7,90,,percent of total billed charges,,,785.7,90,,percent of total billed charges,,,715.86,82,,percent of total billed charges,,,785.7,90,,percent of total billed charges,,,742.05,85,,percent of total billed charges,,218.25,829.35,
X ELBOW ARTHROGRAM LEFT,26101615,CDM,73085,CPT,320,RC,outpatient,LT,1360,1360,,1154.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,340,22,,percent of total billed charges,,,,,,,,,1224,90,,percent of total billed charges,,,1126.08,82.8,,percent of total billed charges,,,1156,85,,percent of total billed charges,,,,,,,,,1196.8,88,,percent of total billed charges,,,,,,,,,1039.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,340,22,,percent of total billed charges,,,1237.6,91,,percent of total billed charges,,,1292,95,,percent of total billed charges,,,1128.8,83,,percent of total billed charges,,,1128.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1128.8,83,,percent of total billed charges,,,1292,95,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1115.2,82,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1156,85,,percent of total billed charges,,340,1292,
X ELBOW ARTHROGRAM RIGHT,26101616,CDM,73085,CPT,320,RC,outpatient,RT,1360,1360,,1154.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,340,22,,percent of total billed charges,,,,,,,,,1224,90,,percent of total billed charges,,,1126.08,82.8,,percent of total billed charges,,,1156,85,,percent of total billed charges,,,,,,,,,1196.8,88,,percent of total billed charges,,,,,,,,,1039.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,340,22,,percent of total billed charges,,,1237.6,91,,percent of total billed charges,,,1292,95,,percent of total billed charges,,,1128.8,83,,percent of total billed charges,,,1128.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1128.8,83,,percent of total billed charges,,,1292,95,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1115.2,82,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1156,85,,percent of total billed charges,,340,1292,
X WRIST LEFT 2V,26101617,CDM,73100,CPT,320,RC,outpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X WRIST RIGHT 2V,26101618,CDM,73100,CPT,320,RC,outpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X WRIST ARTHRO INJECT,26101619,CDM,25246,CPT,769,RC,outpatient,TC,896,896,,760.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,224,22,,percent of total billed charges,,,,,,,,,806.4,90,,percent of total billed charges,,,741.89,82.8,,percent of total billed charges,,,761.6,85,,percent of total billed charges,,,,,,,,,788.48,88,,percent of total billed charges,,,,,,,,,684.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,224,22,,percent of total billed charges,,,815.36,91,,percent of total billed charges,,,851.2,95,,percent of total billed charges,,,743.68,83,,percent of total billed charges,,,743.68,83,,percent of total billed charges,,,,,,,,,,,,,,,743.68,83,,percent of total billed charges,,,851.2,95,,percent of total billed charges,,,806.4,90,,percent of total billed charges,,,806.4,90,,percent of total billed charges,,,734.72,82,,percent of total billed charges,,,806.4,90,,percent of total billed charges,,,761.6,85,,percent of total billed charges,,224,851.2,
X WRIST ARTHROGRAM RIGHT,26101620,CDM,73115,CPT,320,RC,outpatient,RT,1346,1346,,1142.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,336.5,22,,percent of total billed charges,,,,,,,,,1211.4,90,,percent of total billed charges,,,1114.49,82.8,,percent of total billed charges,,,1144.1,85,,percent of total billed charges,,,,,,,,,1184.48,88,,percent of total billed charges,,,,,,,,,1028.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,336.5,22,,percent of total billed charges,,,1224.86,91,,percent of total billed charges,,,1278.7,95,,percent of total billed charges,,,1117.18,83,,percent of total billed charges,,,1117.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1117.18,83,,percent of total billed charges,,,1278.7,95,,percent of total billed charges,,,1211.4,90,,percent of total billed charges,,,1211.4,90,,percent of total billed charges,,,1103.72,82,,percent of total billed charges,,,1211.4,90,,percent of total billed charges,,,1144.1,85,,percent of total billed charges,,336.5,1278.7,
X WRIST ARTHROGRAM LEFT,26101621,CDM,73115,CPT,320,RC,outpatient,LT,1346,1346,,1142.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,336.5,22,,percent of total billed charges,,,,,,,,,1211.4,90,,percent of total billed charges,,,1114.49,82.8,,percent of total billed charges,,,1144.1,85,,percent of total billed charges,,,,,,,,,1184.48,88,,percent of total billed charges,,,,,,,,,1028.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,336.5,22,,percent of total billed charges,,,1224.86,91,,percent of total billed charges,,,1278.7,95,,percent of total billed charges,,,1117.18,83,,percent of total billed charges,,,1117.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1117.18,83,,percent of total billed charges,,,1278.7,95,,percent of total billed charges,,,1211.4,90,,percent of total billed charges,,,1211.4,90,,percent of total billed charges,,,1103.72,82,,percent of total billed charges,,,1211.4,90,,percent of total billed charges,,,1144.1,85,,percent of total billed charges,,336.5,1278.7,
X C SPINE 2V OR 3V,26101627,CDM,72040,CPT,320,RC,outpatient,TC,549,549,,466.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,137.25,22,,percent of total billed charges,,,,,,,,,494.1,90,,percent of total billed charges,,,454.57,82.8,,percent of total billed charges,,,466.65,85,,percent of total billed charges,,,,,,,,,483.12,88,,percent of total billed charges,,,,,,,,,419.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,137.25,22,,percent of total billed charges,,,499.59,91,,percent of total billed charges,,,521.55,95,,percent of total billed charges,,,455.67,83,,percent of total billed charges,,,455.67,83,,percent of total billed charges,,,,,,,,,,,,,,,455.67,83,,percent of total billed charges,,,521.55,95,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,450.18,82,,percent of total billed charges,,,494.1,90,,percent of total billed charges,,,466.65,85,,percent of total billed charges,,137.25,521.55,
X FOOT RIGHT 2V,26101634,CDM,73620,CPT,320,RC,outpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X FOOT LEFT 2V,26101635,CDM,73620,CPT,320,RC,outpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X CHEST 4V,26101659,CDM,71048,CPT,324,RC,outpatient,TC,660,660,,560.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,165,22,,percent of total billed charges,,,,,,,,,594,90,,percent of total billed charges,,,546.48,82.8,,percent of total billed charges,,,561,85,,percent of total billed charges,,,,,,,,,580.8,88,,percent of total billed charges,,,,,,,,,504.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,165,22,,percent of total billed charges,,,600.6,91,,percent of total billed charges,,,627,95,,percent of total billed charges,,,547.8,83,,percent of total billed charges,,,547.8,83,,percent of total billed charges,,,,,,,,,,,,,,,547.8,83,,percent of total billed charges,,,627,95,,percent of total billed charges,,,594,90,,percent of total billed charges,,,594,90,,percent of total billed charges,,,541.2,82,,percent of total billed charges,,,594,90,,percent of total billed charges,,,561,85,,percent of total billed charges,,165,627,
X ELBOW RIGHT 2V,26101675,CDM,73070,CPT,320,RC,outpatient,RT,395,395,,335.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.75,22,,percent of total billed charges,,,,,,,,,355.5,90,,percent of total billed charges,,,327.06,82.8,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,,,,,,,,347.6,88,,percent of total billed charges,,,,,,,,,301.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.75,22,,percent of total billed charges,,,359.45,91,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,,,,,,,,,,,,,327.85,83,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,323.9,82,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,98.75,375.25,
X ELBOW LEFT 2V,26101676,CDM,73070,CPT,320,RC,outpatient,LT,395,395,,335.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,98.75,22,,percent of total billed charges,,,,,,,,,355.5,90,,percent of total billed charges,,,327.06,82.8,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,,,,,,,,347.6,88,,percent of total billed charges,,,,,,,,,301.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,98.75,22,,percent of total billed charges,,,359.45,91,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,,,,,,,,,,,,,327.85,83,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,323.9,82,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,98.75,375.25,
X HAND RIGHT 2V,26101683,CDM,73120,CPT,320,RC,outpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X HAND LEFT 2V,26101684,CDM,73120,CPT,320,RC,outpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X CHEST SPCL (DECUB) 1V+,26101691,CDM,71046,CPT,324,RC,outpatient,TC,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.5,22,,percent of total billed charges,,,,,,,,,351,90,,percent of total billed charges,,,322.92,82.8,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.5,22,,percent of total billed charges,,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,97.5,370.5,
X SIJTARTHOSTEROIDINJRT,26101888,CDM,27096,CPT,320,RC,outpatient,RT,1757,1757,,1491.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,439.25,22,,percent of total billed charges,,,,,,,,,1581.3,90,,percent of total billed charges,,,1454.8,82.8,,percent of total billed charges,,,1493.45,85,,percent of total billed charges,,,,,,,,,1546.16,88,,percent of total billed charges,,,,,,,,,1342.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,439.25,22,,percent of total billed charges,,,1598.87,91,,percent of total billed charges,,,1669.15,95,,percent of total billed charges,,,1458.31,83,,percent of total billed charges,,,1458.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1458.31,83,,percent of total billed charges,,,1669.15,95,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1440.74,82,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1493.45,85,,percent of total billed charges,,439.25,1669.15,
X SI JTARTHOSTEROIDINJLT,26101889,CDM,27096,CPT,320,RC,outpatient,LT,1757,1757,,1491.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,439.25,22,,percent of total billed charges,,,,,,,,,1581.3,90,,percent of total billed charges,,,1454.8,82.8,,percent of total billed charges,,,1493.45,85,,percent of total billed charges,,,,,,,,,1546.16,88,,percent of total billed charges,,,,,,,,,1342.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,439.25,22,,percent of total billed charges,,,1598.87,91,,percent of total billed charges,,,1669.15,95,,percent of total billed charges,,,1458.31,83,,percent of total billed charges,,,1458.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1458.31,83,,percent of total billed charges,,,1669.15,95,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1440.74,82,,percent of total billed charges,,,1581.3,90,,percent of total billed charges,,,1493.45,85,,percent of total billed charges,,439.25,1669.15,
* DNU X SI ARTHRO/INJECTION,26101890,CDM,27096,CPT,361,RC,outpatient,,2070,2070,,1757.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,517.5,22,,percent of total billed charges,,,,,,,,,1863,90,,percent of total billed charges,,,1713.96,82.8,,percent of total billed charges,,,1759.5,85,,percent of total billed charges,,,,,,,,,1821.6,88,,percent of total billed charges,,,,,,,,,1581.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,517.5,22,,percent of total billed charges,,,1883.7,91,,percent of total billed charges,,,1966.5,95,,percent of total billed charges,,,1718.1,83,,percent of total billed charges,,,1718.1,83,,percent of total billed charges,,,,,,,,,,,,,,,1718.1,83,,percent of total billed charges,,,1966.5,95,,percent of total billed charges,,,1863,90,,percent of total billed charges,,,1863,90,,percent of total billed charges,,,1697.4,82,,percent of total billed charges,,,1863,90,,percent of total billed charges,,,1759.5,85,,percent of total billed charges,,517.5,1966.5,
X SI JTARTHOSTEROIDINJBIL,26101891,CDM,27096,CPT,320,RC,outpatient,50,3513,3513,,2982.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,878.25,22,,percent of total billed charges,,,,,,,,,3161.7,90,,percent of total billed charges,,,2908.76,82.8,,percent of total billed charges,,,2986.05,85,,percent of total billed charges,,,,,,,,,3091.44,88,,percent of total billed charges,,,,,,,,,2683.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,878.25,22,,percent of total billed charges,,,3196.83,91,,percent of total billed charges,,,3337.35,95,,percent of total billed charges,,,2915.79,83,,percent of total billed charges,,,2915.79,83,,percent of total billed charges,,,,,,,,,,,,,,,2915.79,83,,percent of total billed charges,,,3337.35,95,,percent of total billed charges,,,3161.7,90,,percent of total billed charges,,,3161.7,90,,percent of total billed charges,,,2880.66,82,,percent of total billed charges,,,3161.7,90,,percent of total billed charges,,,2986.05,85,,percent of total billed charges,,878.25,3337.35,
X LUMBARPUNCFORPATHANAL,26101892,CDM,62270,CPT,320,RC,outpatient,TC,1817,1817,,1542.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,454.25,22,,percent of total billed charges,,,,,,,,,1635.3,90,,percent of total billed charges,,,1504.48,82.8,,percent of total billed charges,,,1544.45,85,,percent of total billed charges,,,,,,,,,1598.96,88,,percent of total billed charges,,,,,,,,,1388.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,454.25,22,,percent of total billed charges,,,1653.47,91,,percent of total billed charges,,,1726.15,95,,percent of total billed charges,,,1508.11,83,,percent of total billed charges,,,1508.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1508.11,83,,percent of total billed charges,,,1726.15,95,,percent of total billed charges,,,1635.3,90,,percent of total billed charges,,,1635.3,90,,percent of total billed charges,,,1489.94,82,,percent of total billed charges,,,1635.3,90,,percent of total billed charges,,,1544.45,85,,percent of total billed charges,,454.25,1726.15,
X LOW EXT INFANT RIGHT 2V,26101980,CDM,73592,CPT,320,RC,outpatient,RT,427,427,,362.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,106.75,22,,percent of total billed charges,,,,,,,,,384.3,90,,percent of total billed charges,,,353.56,82.8,,percent of total billed charges,,,362.95,85,,percent of total billed charges,,,,,,,,,375.76,88,,percent of total billed charges,,,,,,,,,326.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,106.75,22,,percent of total billed charges,,,388.57,91,,percent of total billed charges,,,405.65,95,,percent of total billed charges,,,354.41,83,,percent of total billed charges,,,354.41,83,,percent of total billed charges,,,,,,,,,,,,,,,354.41,83,,percent of total billed charges,,,405.65,95,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,350.14,82,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,362.95,85,,percent of total billed charges,,106.75,405.65,
X LOW EXT INFANT LEFT 2V,26101981,CDM,73592,CPT,320,RC,outpatient,LT,427,427,,362.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,106.75,22,,percent of total billed charges,,,,,,,,,384.3,90,,percent of total billed charges,,,353.56,82.8,,percent of total billed charges,,,362.95,85,,percent of total billed charges,,,,,,,,,375.76,88,,percent of total billed charges,,,,,,,,,326.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,106.75,22,,percent of total billed charges,,,388.57,91,,percent of total billed charges,,,405.65,95,,percent of total billed charges,,,354.41,83,,percent of total billed charges,,,354.41,83,,percent of total billed charges,,,,,,,,,,,,,,,354.41,83,,percent of total billed charges,,,405.65,95,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,350.14,82,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,362.95,85,,percent of total billed charges,,106.75,405.65,
X HIP ARTHRO INJ,26101987,CDM,27093,CPT,361,RC,outpatient,TC,1656,1656,,1405.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,414,22,,percent of total billed charges,,,,,,,,,1490.4,90,,percent of total billed charges,,,1371.17,82.8,,percent of total billed charges,,,1407.6,85,,percent of total billed charges,,,,,,,,,1457.28,88,,percent of total billed charges,,,,,,,,,1265.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,414,22,,percent of total billed charges,,,1506.96,91,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,1374.48,83,,percent of total billed charges,,,,,,,,,,,,,,,1374.48,83,,percent of total billed charges,,,1573.2,95,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1357.92,82,,percent of total billed charges,,,1490.4,90,,percent of total billed charges,,,1407.6,85,,percent of total billed charges,,414,1573.2,
X LOW EXT INFANT BIL 2V,26101989,CDM,73592,CPT,320,RC,outpatient,50,854,854,,725.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,213.5,22,,percent of total billed charges,,,,,,,,,768.6,90,,percent of total billed charges,,,707.11,82.8,,percent of total billed charges,,,725.9,85,,percent of total billed charges,,,,,,,,,751.52,88,,percent of total billed charges,,,,,,,,,652.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,213.5,22,,percent of total billed charges,,,777.14,91,,percent of total billed charges,,,811.3,95,,percent of total billed charges,,,708.82,83,,percent of total billed charges,,,708.82,83,,percent of total billed charges,,,,,,,,,,,,,,,708.82,83,,percent of total billed charges,,,811.3,95,,percent of total billed charges,,,768.6,90,,percent of total billed charges,,,768.6,90,,percent of total billed charges,,,700.28,82,,percent of total billed charges,,,768.6,90,,percent of total billed charges,,,725.9,85,,percent of total billed charges,,213.5,811.3,
X HIP ARTHRO INJ BIL,26101999,CDM,27093,CPT,361,RC,outpatient,50,3315,3315,,2814.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,828.75,22,,percent of total billed charges,,,,,,,,,2983.5,90,,percent of total billed charges,,,2744.82,82.8,,percent of total billed charges,,,2817.75,85,,percent of total billed charges,,,,,,,,,2917.2,88,,percent of total billed charges,,,,,,,,,2532.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,828.75,22,,percent of total billed charges,,,3016.65,91,,percent of total billed charges,,,3149.25,95,,percent of total billed charges,,,2751.45,83,,percent of total billed charges,,,2751.45,83,,percent of total billed charges,,,,,,,,,,,,,,,2751.45,83,,percent of total billed charges,,,3149.25,95,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2718.3,82,,percent of total billed charges,,,2983.5,90,,percent of total billed charges,,,2817.75,85,,percent of total billed charges,,828.75,3149.25,
X MANDIBLE 1-3V,26102010,CDM,70100,CPT,320,RC,outpatient,TC,445,445,,377.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,111.25,22,,percent of total billed charges,,,,,,,,,400.5,90,,percent of total billed charges,,,368.46,82.8,,percent of total billed charges,,,378.25,85,,percent of total billed charges,,,,,,,,,391.6,88,,percent of total billed charges,,,,,,,,,339.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,111.25,22,,percent of total billed charges,,,404.95,91,,percent of total billed charges,,,422.75,95,,percent of total billed charges,,,369.35,83,,percent of total billed charges,,,369.35,83,,percent of total billed charges,,,,,,,,,,,,,,,369.35,83,,percent of total billed charges,,,422.75,95,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,364.9,82,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,378.25,85,,percent of total billed charges,,111.25,422.75,
X MASTOIDS 1-2V,26102015,CDM,70120,CPT,320,RC,outpatient,TC,441,441,,374.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.25,22,,percent of total billed charges,,,,,,,,,396.9,90,,percent of total billed charges,,,365.15,82.8,,percent of total billed charges,,,374.85,85,,percent of total billed charges,,,,,,,,,388.08,88,,percent of total billed charges,,,,,,,,,336.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.25,22,,percent of total billed charges,,,401.31,91,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,,,,,,,,,,,,,366.03,83,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,361.62,82,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,374.85,85,,percent of total billed charges,,110.25,418.95,
X SINUS 1-2V,26102244,CDM,70210,CPT,320,RC,outpatient,TC,379,379,,321.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94.75,22,,percent of total billed charges,,,,,,,,,341.1,90,,percent of total billed charges,,,313.81,82.8,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,,,,,,,,333.52,88,,percent of total billed charges,,,,,,,,,289.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94.75,22,,percent of total billed charges,,,344.89,91,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,,,,,,,,,,,,,314.57,83,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,310.78,82,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,94.75,360.05,
X CLAVICLE BILATERAL,26102300,CDM,73000,CPT,320,RC,outpatient,50,875,875,,742.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,218.75,22,,percent of total billed charges,,,,,,,,,787.5,90,,percent of total billed charges,,,724.5,82.8,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,,,,,,,,770,88,,percent of total billed charges,,,,,,,,,668.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,218.75,22,,percent of total billed charges,,,796.25,91,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,726.25,83,,percent of total billed charges,,,,,,,,,,,,,,,726.25,83,,percent of total billed charges,,,831.25,95,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,717.5,82,,percent of total billed charges,,,787.5,90,,percent of total billed charges,,,743.75,85,,percent of total billed charges,,218.75,831.25,
X ELBOW BILATERAL 3V+,26102301,CDM,73080,CPT,320,RC,outpatient,50,1022,1022,,867.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,255.5,22,,percent of total billed charges,,,,,,,,,919.8,90,,percent of total billed charges,,,846.22,82.8,,percent of total billed charges,,,868.7,85,,percent of total billed charges,,,,,,,,,899.36,88,,percent of total billed charges,,,,,,,,,780.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,255.5,22,,percent of total billed charges,,,930.02,91,,percent of total billed charges,,,970.9,95,,percent of total billed charges,,,848.26,83,,percent of total billed charges,,,848.26,83,,percent of total billed charges,,,,,,,,,,,,,,,848.26,83,,percent of total billed charges,,,970.9,95,,percent of total billed charges,,,919.8,90,,percent of total billed charges,,,919.8,90,,percent of total billed charges,,,838.04,82,,percent of total billed charges,,,919.8,90,,percent of total billed charges,,,868.7,85,,percent of total billed charges,,255.5,970.9,
X FEMUR BILATERAL 2V,26102302,CDM,73552,CPT,320,RC,outpatient,TC,1002,1002,,850.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,250.5,22,,percent of total billed charges,,,,,,,,,901.8,90,,percent of total billed charges,,,829.66,82.8,,percent of total billed charges,,,851.7,85,,percent of total billed charges,,,,,,,,,881.76,88,,percent of total billed charges,,,,,,,,,765.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,250.5,22,,percent of total billed charges,,,911.82,91,,percent of total billed charges,,,951.9,95,,percent of total billed charges,,,831.66,83,,percent of total billed charges,,,831.66,83,,percent of total billed charges,,,,,,,,,,,,,,,831.66,83,,percent of total billed charges,,,951.9,95,,percent of total billed charges,,,901.8,90,,percent of total billed charges,,,901.8,90,,percent of total billed charges,,,821.64,82,,percent of total billed charges,,,901.8,90,,percent of total billed charges,,,851.7,85,,percent of total billed charges,,250.5,951.9,
X FINGER BIL (DO NOT USE),26102303,CDM,73140,CPT,320,RC,outpatient,50,22,22,,18.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.5,22,,percent of total billed charges,,,,,,,,,19.8,90,,percent of total billed charges,,,18.22,82.8,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,,,,,,,,19.36,88,,percent of total billed charges,,,,,,,,,16.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.5,22,,percent of total billed charges,,,20.02,91,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,,,,,,,,,,,,,18.26,83,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.04,82,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,5.5,20.9,
X FOOT BILATERAL 3V+,26102304,CDM,73630,CPT,320,RC,outpatient,50,989,989,,839.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,247.25,22,,percent of total billed charges,,,,,,,,,890.1,90,,percent of total billed charges,,,818.89,82.8,,percent of total billed charges,,,840.65,85,,percent of total billed charges,,,,,,,,,870.32,88,,percent of total billed charges,,,,,,,,,755.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,247.25,22,,percent of total billed charges,,,899.99,91,,percent of total billed charges,,,939.55,95,,percent of total billed charges,,,820.87,83,,percent of total billed charges,,,820.87,83,,percent of total billed charges,,,,,,,,,,,,,,,820.87,83,,percent of total billed charges,,,939.55,95,,percent of total billed charges,,,890.1,90,,percent of total billed charges,,,890.1,90,,percent of total billed charges,,,810.98,82,,percent of total billed charges,,,890.1,90,,percent of total billed charges,,,840.65,85,,percent of total billed charges,,247.25,939.55,
X FOREARM BILATERAL,26102305,CDM,73090,CPT,320,RC,outpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,231.25,22,,percent of total billed charges,,,,,,,,,832.5,90,,percent of total billed charges,,,765.9,82.8,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,231.25,22,,percent of total billed charges,,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,231.25,878.75,
X HAND BILATERAL 3V+,26102306,CDM,73130,CPT,320,RC,outpatient,50,1009,1009,,856.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,252.25,22,,percent of total billed charges,,,,,,,,,908.1,90,,percent of total billed charges,,,835.45,82.8,,percent of total billed charges,,,857.65,85,,percent of total billed charges,,,,,,,,,887.92,88,,percent of total billed charges,,,,,,,,,770.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,252.25,22,,percent of total billed charges,,,918.19,91,,percent of total billed charges,,,958.55,95,,percent of total billed charges,,,837.47,83,,percent of total billed charges,,,837.47,83,,percent of total billed charges,,,,,,,,,,,,,,,837.47,83,,percent of total billed charges,,,958.55,95,,percent of total billed charges,,,908.1,90,,percent of total billed charges,,,908.1,90,,percent of total billed charges,,,827.38,82,,percent of total billed charges,,,908.1,90,,percent of total billed charges,,,857.65,85,,percent of total billed charges,,252.25,958.55,
X HUMERUS BILATERAL 2V+,26102307,CDM,73060,CPT,320,RC,outpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,231.25,22,,percent of total billed charges,,,,,,,,,832.5,90,,percent of total billed charges,,,765.9,82.8,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,231.25,22,,percent of total billed charges,,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,231.25,878.75,
X KNEE BILATERAL 1-2V,26102308,CDM,73560,CPT,320,RC,outpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,231.25,22,,percent of total billed charges,,,,,,,,,832.5,90,,percent of total billed charges,,,765.9,82.8,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,231.25,22,,percent of total billed charges,,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,231.25,878.75,
X LOWER LEG BILATERAL 2V+,26102309,CDM,73590,CPT,320,RC,outpatient,50,941,941,,798.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.25,22,,percent of total billed charges,,,,,,,,,846.9,90,,percent of total billed charges,,,779.15,82.8,,percent of total billed charges,,,799.85,85,,percent of total billed charges,,,,,,,,,828.08,88,,percent of total billed charges,,,,,,,,,718.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.25,22,,percent of total billed charges,,,856.31,91,,percent of total billed charges,,,893.95,95,,percent of total billed charges,,,781.03,83,,percent of total billed charges,,,781.03,83,,percent of total billed charges,,,,,,,,,,,,,,,781.03,83,,percent of total billed charges,,,893.95,95,,percent of total billed charges,,,846.9,90,,percent of total billed charges,,,846.9,90,,percent of total billed charges,,,771.62,82,,percent of total billed charges,,,846.9,90,,percent of total billed charges,,,799.85,85,,percent of total billed charges,,235.25,893.95,
X CALCANEUS BILATERAL 2V+,26102310,CDM,73650,CPT,320,RC,outpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,231.25,22,,percent of total billed charges,,,,,,,,,832.5,90,,percent of total billed charges,,,765.9,82.8,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,231.25,22,,percent of total billed charges,,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,231.25,878.75,
X SHOULDER BILATERAL 2V+,26102311,CDM,73030,CPT,320,RC,outpatient,50,1057,1057,,897.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,264.25,22,,percent of total billed charges,,,,,,,,,951.3,90,,percent of total billed charges,,,875.2,82.8,,percent of total billed charges,,,898.45,85,,percent of total billed charges,,,,,,,,,930.16,88,,percent of total billed charges,,,,,,,,,807.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,264.25,22,,percent of total billed charges,,,961.87,91,,percent of total billed charges,,,1004.15,95,,percent of total billed charges,,,877.31,83,,percent of total billed charges,,,877.31,83,,percent of total billed charges,,,,,,,,,,,,,,,877.31,83,,percent of total billed charges,,,1004.15,95,,percent of total billed charges,,,951.3,90,,percent of total billed charges,,,951.3,90,,percent of total billed charges,,,866.74,82,,percent of total billed charges,,,951.3,90,,percent of total billed charges,,,898.45,85,,percent of total billed charges,,264.25,1004.15,
X WRIST BILATERAL 3V+,26102313,CDM,73110,CPT,320,RC,outpatient,50,1002,1002,,850.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,250.5,22,,percent of total billed charges,,,,,,,,,901.8,90,,percent of total billed charges,,,829.66,82.8,,percent of total billed charges,,,851.7,85,,percent of total billed charges,,,,,,,,,881.76,88,,percent of total billed charges,,,,,,,,,765.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,250.5,22,,percent of total billed charges,,,911.82,91,,percent of total billed charges,,,951.9,95,,percent of total billed charges,,,831.66,83,,percent of total billed charges,,,831.66,83,,percent of total billed charges,,,,,,,,,,,,,,,831.66,83,,percent of total billed charges,,,951.9,95,,percent of total billed charges,,,901.8,90,,percent of total billed charges,,,901.8,90,,percent of total billed charges,,,821.64,82,,percent of total billed charges,,,901.8,90,,percent of total billed charges,,,851.7,85,,percent of total billed charges,,250.5,951.9,
X FOOT BILATERAL 2V,26102314,CDM,73620,CPT,320,RC,outpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,231.25,22,,percent of total billed charges,,,,,,,,,832.5,90,,percent of total billed charges,,,765.9,82.8,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,231.25,22,,percent of total billed charges,,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,231.25,878.75,
X ELBOW BILATERAL 2V,26102315,CDM,73070,CPT,320,RC,outpatient,50,792,792,,672.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,198,22,,percent of total billed charges,,,,,,,,,712.8,90,,percent of total billed charges,,,655.78,82.8,,percent of total billed charges,,,673.2,85,,percent of total billed charges,,,,,,,,,696.96,88,,percent of total billed charges,,,,,,,,,605.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,198,22,,percent of total billed charges,,,720.72,91,,percent of total billed charges,,,752.4,95,,percent of total billed charges,,,657.36,83,,percent of total billed charges,,,657.36,83,,percent of total billed charges,,,,,,,,,,,,,,,657.36,83,,percent of total billed charges,,,752.4,95,,percent of total billed charges,,,712.8,90,,percent of total billed charges,,,712.8,90,,percent of total billed charges,,,649.44,82,,percent of total billed charges,,,712.8,90,,percent of total billed charges,,,673.2,85,,percent of total billed charges,,198,752.4,
X HAND BILATERAL 2V,26102316,CDM,73120,CPT,320,RC,outpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,231.25,22,,percent of total billed charges,,,,,,,,,832.5,90,,percent of total billed charges,,,765.9,82.8,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,231.25,22,,percent of total billed charges,,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,231.25,878.75,
X WRIST BILATERAL 2V,26102317,CDM,73100,CPT,320,RC,outpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,231.25,22,,percent of total billed charges,,,,,,,,,832.5,90,,percent of total billed charges,,,765.9,82.8,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,231.25,22,,percent of total billed charges,,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,231.25,878.75,
X KNEE BILATERAL 4V+,26102318,CDM,73564,CPT,320,RC,outpatient,50,1563,1563,,1326.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,390.75,22,,percent of total billed charges,,,,,,,,,1406.7,90,,percent of total billed charges,,,1294.16,82.8,,percent of total billed charges,,,1328.55,85,,percent of total billed charges,,,,,,,,,1375.44,88,,percent of total billed charges,,,,,,,,,1194.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,390.75,22,,percent of total billed charges,,,1422.33,91,,percent of total billed charges,,,1484.85,95,,percent of total billed charges,,,1297.29,83,,percent of total billed charges,,,1297.29,83,,percent of total billed charges,,,,,,,,,,,,,,,1297.29,83,,percent of total billed charges,,,1484.85,95,,percent of total billed charges,,,1406.7,90,,percent of total billed charges,,,1406.7,90,,percent of total billed charges,,,1281.66,82,,percent of total billed charges,,,1406.7,90,,percent of total billed charges,,,1328.55,85,,percent of total billed charges,,390.75,1484.85,
X SHOULDER BILATERAL 1V,26102319,CDM,73020,CPT,320,RC,outpatient,50,925,925,,785.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,231.25,22,,percent of total billed charges,,,,,,,,,832.5,90,,percent of total billed charges,,,765.9,82.8,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,,,,,,,,814,88,,percent of total billed charges,,,,,,,,,706.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,231.25,22,,percent of total billed charges,,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,,,,,,,,,,,,,767.75,83,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,758.5,82,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,231.25,878.75,
X KNEE RIGHT 4V+,26103036,CDM,73564,CPT,320,RC,outpatient,RT,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195.5,22,,percent of total billed charges,,,,,,,,,703.8,90,,percent of total billed charges,,,647.5,82.8,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195.5,22,,percent of total billed charges,,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,195.5,742.9,
X KNEE LEFT 4V+,26103037,CDM,73564,CPT,320,RC,outpatient,LT,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195.5,22,,percent of total billed charges,,,,,,,,,703.8,90,,percent of total billed charges,,,647.5,82.8,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195.5,22,,percent of total billed charges,,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,195.5,742.9,
X SCNOGRM(LEGLENGTH),26103180,CDM,77073,CPT,320,RC,outpatient,TC,1042,1042,,884.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260.5,22,,percent of total billed charges,,,,,,,,,937.8,90,,percent of total billed charges,,,862.78,82.8,,percent of total billed charges,,,885.7,85,,percent of total billed charges,,,,,,,,,916.96,88,,percent of total billed charges,,,,,,,,,796.09,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260.5,22,,percent of total billed charges,,,948.22,91,,percent of total billed charges,,,989.9,95,,percent of total billed charges,,,864.86,83,,percent of total billed charges,,,864.86,83,,percent of total billed charges,,,,,,,,,,,,,,,864.86,83,,percent of total billed charges,,,989.9,95,,percent of total billed charges,,,937.8,90,,percent of total billed charges,,,937.8,90,,percent of total billed charges,,,854.44,82,,percent of total billed charges,,,937.8,90,,percent of total billed charges,,,885.7,85,,percent of total billed charges,,260.5,989.9,
X UGI W/AIR W/O KUB,26103986,CDM,74246,CPT,320,RC,outpatient,TC,1303,1303,,1106.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,325.75,22,,percent of total billed charges,,,,,,,,,1172.7,90,,percent of total billed charges,,,1078.88,82.8,,percent of total billed charges,,,1107.55,85,,percent of total billed charges,,,,,,,,,1146.64,88,,percent of total billed charges,,,,,,,,,995.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,325.75,22,,percent of total billed charges,,,1185.73,91,,percent of total billed charges,,,1237.85,95,,percent of total billed charges,,,1081.49,83,,percent of total billed charges,,,1081.49,83,,percent of total billed charges,,,,,,,,,,,,,,,1081.49,83,,percent of total billed charges,,,1237.85,95,,percent of total billed charges,,,1172.7,90,,percent of total billed charges,,,1172.7,90,,percent of total billed charges,,,1068.46,82,,percent of total billed charges,,,1172.7,90,,percent of total billed charges,,,1107.55,85,,percent of total billed charges,,325.75,1237.85,
X CHEST 1V,26104026,CDM,71045,CPT,324,RC,outpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X KNEE ARTHRO RIGHT,26104034,CDM,73580,CPT,320,RC,outpatient,RT,1538,1538,,1305.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.5,22,,percent of total billed charges,,,,,,,,,1384.2,90,,percent of total billed charges,,,1273.46,82.8,,percent of total billed charges,,,1307.3,85,,percent of total billed charges,,,,,,,,,1353.44,88,,percent of total billed charges,,,,,,,,,1175.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.5,22,,percent of total billed charges,,,1399.58,91,,percent of total billed charges,,,1461.1,95,,percent of total billed charges,,,1276.54,83,,percent of total billed charges,,,1276.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1276.54,83,,percent of total billed charges,,,1461.1,95,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1261.16,82,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1307.3,85,,percent of total billed charges,,384.5,1461.1,
X KNEE ARTHRO LEFT,26104035,CDM,73580,CPT,320,RC,outpatient,LT,1538,1538,,1305.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,384.5,22,,percent of total billed charges,,,,,,,,,1384.2,90,,percent of total billed charges,,,1273.46,82.8,,percent of total billed charges,,,1307.3,85,,percent of total billed charges,,,,,,,,,1353.44,88,,percent of total billed charges,,,,,,,,,1175.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,384.5,22,,percent of total billed charges,,,1399.58,91,,percent of total billed charges,,,1461.1,95,,percent of total billed charges,,,1276.54,83,,percent of total billed charges,,,1276.54,83,,percent of total billed charges,,,,,,,,,,,,,,,1276.54,83,,percent of total billed charges,,,1461.1,95,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1261.16,82,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1307.3,85,,percent of total billed charges,,384.5,1461.1,
X CHEST W/AP LORDOTIC 3V,26104042,CDM,71047,CPT,324,RC,outpatient,TC,512,512,,434.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,128,22,,percent of total billed charges,,,,,,,,,460.8,90,,percent of total billed charges,,,423.94,82.8,,percent of total billed charges,,,435.2,85,,percent of total billed charges,,,,,,,,,450.56,88,,percent of total billed charges,,,,,,,,,391.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,128,22,,percent of total billed charges,,,465.92,91,,percent of total billed charges,,,486.4,95,,percent of total billed charges,,,424.96,83,,percent of total billed charges,,,424.96,83,,percent of total billed charges,,,,,,,,,,,,,,,424.96,83,,percent of total billed charges,,,486.4,95,,percent of total billed charges,,,460.8,90,,percent of total billed charges,,,460.8,90,,percent of total billed charges,,,419.84,82,,percent of total billed charges,,,460.8,90,,percent of total billed charges,,,435.2,85,,percent of total billed charges,,128,486.4,
X CHEST PA OR LAT W/OBLIQUES,26104059,CDM,71047,CPT,324,RC,outpatient,TC,585,585,,496.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,146.25,22,,percent of total billed charges,,,,,,,,,526.5,90,,percent of total billed charges,,,484.38,82.8,,percent of total billed charges,,,497.25,85,,percent of total billed charges,,,,,,,,,514.8,88,,percent of total billed charges,,,,,,,,,446.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,146.25,22,,percent of total billed charges,,,532.35,91,,percent of total billed charges,,,555.75,95,,percent of total billed charges,,,485.55,83,,percent of total billed charges,,,485.55,83,,percent of total billed charges,,,,,,,,,,,,,,,485.55,83,,percent of total billed charges,,,555.75,95,,percent of total billed charges,,,526.5,90,,percent of total billed charges,,,526.5,90,,percent of total billed charges,,,479.7,82,,percent of total billed charges,,,526.5,90,,percent of total billed charges,,,497.25,85,,percent of total billed charges,,146.25,555.75,
X SCOLIOSIS,26104067,CDM,72081,CPT,320,RC,outpatient,TC,474,474,,402.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,118.5,22,,percent of total billed charges,,,,,,,,,426.6,90,,percent of total billed charges,,,392.47,82.8,,percent of total billed charges,,,402.9,85,,percent of total billed charges,,,,,,,,,417.12,88,,percent of total billed charges,,,,,,,,,362.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,118.5,22,,percent of total billed charges,,,431.34,91,,percent of total billed charges,,,450.3,95,,percent of total billed charges,,,393.42,83,,percent of total billed charges,,,393.42,83,,percent of total billed charges,,,,,,,,,,,,,,,393.42,83,,percent of total billed charges,,,450.3,95,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,388.68,82,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,402.9,85,,percent of total billed charges,,118.5,450.3,
X NECK SOFT TISSUE 2V,26104075,CDM,70360,CPT,320,RC,outpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X CYSTOGRAM VOIDING (VCUG),26104083,CDM,74455,CPT,320,RC,outpatient,TC,2246,2246,,1906.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,561.5,22,,percent of total billed charges,,,,,,,,,2021.4,90,,percent of total billed charges,,,1859.69,82.8,,percent of total billed charges,,,1909.1,85,,percent of total billed charges,,,,,,,,,1976.48,88,,percent of total billed charges,,,,,,,,,1715.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,561.5,22,,percent of total billed charges,,,2043.86,91,,percent of total billed charges,,,2133.7,95,,percent of total billed charges,,,1864.18,83,,percent of total billed charges,,,1864.18,83,,percent of total billed charges,,,,,,,,,,,,,,,1864.18,83,,percent of total billed charges,,,2133.7,95,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,1841.72,82,,percent of total billed charges,,,2021.4,90,,percent of total billed charges,,,1909.1,85,,percent of total billed charges,,561.5,2133.7,
X UGI W/ AIR W/ SBFT,26104091,CDM,74246,CPT,320,RC,outpatient,TC,1935,1935,,1642.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.75,22,,percent of total billed charges,,,,,,,,,1741.5,90,,percent of total billed charges,,,1602.18,82.8,,percent of total billed charges,,,1644.75,85,,percent of total billed charges,,,,,,,,,1702.8,88,,percent of total billed charges,,,,,,,,,1478.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.75,22,,percent of total billed charges,,,1760.85,91,,percent of total billed charges,,,1838.25,95,,percent of total billed charges,,,1606.05,83,,percent of total billed charges,,,1606.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1606.05,83,,percent of total billed charges,,,1838.25,95,,percent of total billed charges,,,1741.5,90,,percent of total billed charges,,,1741.5,90,,percent of total billed charges,,,1586.7,82,,percent of total billed charges,,,1741.5,90,,percent of total billed charges,,,1644.75,85,,percent of total billed charges,,483.75,1838.25,
X UGI W/KUB,26104092,CDM,74240,CPT,320,RC,outpatient,TC,1466,1466,,1244.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,366.5,22,,percent of total billed charges,,,,,,,,,1319.4,90,,percent of total billed charges,,,1213.85,82.8,,percent of total billed charges,,,1246.1,85,,percent of total billed charges,,,,,,,,,1290.08,88,,percent of total billed charges,,,,,,,,,1120.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,366.5,22,,percent of total billed charges,,,1334.06,91,,percent of total billed charges,,,1392.7,95,,percent of total billed charges,,,1216.78,83,,percent of total billed charges,,,1216.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1216.78,83,,percent of total billed charges,,,1392.7,95,,percent of total billed charges,,,1319.4,90,,percent of total billed charges,,,1319.4,90,,percent of total billed charges,,,1202.12,82,,percent of total billed charges,,,1319.4,90,,percent of total billed charges,,,1246.1,85,,percent of total billed charges,,366.5,1392.7,
X UGI W/SBFT,26104093,CDM,74248,CPT,320,RC,outpatient,TC,1933,1933,,1641.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,483.25,22,,percent of total billed charges,,,,,,,,,1739.7,90,,percent of total billed charges,,,1600.52,82.8,,percent of total billed charges,,,1643.05,85,,percent of total billed charges,,,,,,,,,1701.04,88,,percent of total billed charges,,,,,,,,,1476.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,483.25,22,,percent of total billed charges,,,1759.03,91,,percent of total billed charges,,,1836.35,95,,percent of total billed charges,,,1604.39,83,,percent of total billed charges,,,1604.39,83,,percent of total billed charges,,,,,,,,,,,,,,,1604.39,83,,percent of total billed charges,,,1836.35,95,,percent of total billed charges,,,1739.7,90,,percent of total billed charges,,,1739.7,90,,percent of total billed charges,,,1585.06,82,,percent of total billed charges,,,1739.7,90,,percent of total billed charges,,,1643.05,85,,percent of total billed charges,,483.25,1836.35,
X UGI W/ AIR W/ KUB,26104094,CDM,74246,CPT,320,RC,outpatient,TC,1558,1558,,1322.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,389.5,22,,percent of total billed charges,,,,,,,,,1402.2,90,,percent of total billed charges,,,1290.02,82.8,,percent of total billed charges,,,1324.3,85,,percent of total billed charges,,,,,,,,,1371.04,88,,percent of total billed charges,,,,,,,,,1190.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,389.5,22,,percent of total billed charges,,,1417.78,91,,percent of total billed charges,,,1480.1,95,,percent of total billed charges,,,1293.14,83,,percent of total billed charges,,,1293.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1293.14,83,,percent of total billed charges,,,1480.1,95,,percent of total billed charges,,,1402.2,90,,percent of total billed charges,,,1402.2,90,,percent of total billed charges,,,1277.56,82,,percent of total billed charges,,,1402.2,90,,percent of total billed charges,,,1324.3,85,,percent of total billed charges,,389.5,1480.1,
X ABD OBSTR W/PA CHEST,26104109,CDM,74022,CPT,320,RC,outpatient,TC,785,785,,666.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,196.25,22,,percent of total billed charges,,,,,,,,,706.5,90,,percent of total billed charges,,,649.98,82.8,,percent of total billed charges,,,667.25,85,,percent of total billed charges,,,,,,,,,690.8,88,,percent of total billed charges,,,,,,,,,599.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,196.25,22,,percent of total billed charges,,,714.35,91,,percent of total billed charges,,,745.75,95,,percent of total billed charges,,,651.55,83,,percent of total billed charges,,,651.55,83,,percent of total billed charges,,,,,,,,,,,,,,,651.55,83,,percent of total billed charges,,,745.75,95,,percent of total billed charges,,,706.5,90,,percent of total billed charges,,,706.5,90,,percent of total billed charges,,,643.7,82,,percent of total billed charges,,,706.5,90,,percent of total billed charges,,,667.25,85,,percent of total billed charges,,196.25,745.75,
X SC JTS 3V+,26104133,CDM,71130,CPT,320,RC,outpatient,TC,445,445,,377.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,111.25,22,,percent of total billed charges,,,,,,,,,400.5,90,,percent of total billed charges,,,368.46,82.8,,percent of total billed charges,,,378.25,85,,percent of total billed charges,,,,,,,,,391.6,88,,percent of total billed charges,,,,,,,,,339.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,111.25,22,,percent of total billed charges,,,404.95,91,,percent of total billed charges,,,422.75,95,,percent of total billed charges,,,369.35,83,,percent of total billed charges,,,369.35,83,,percent of total billed charges,,,,,,,,,,,,,,,369.35,83,,percent of total billed charges,,,422.75,95,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,364.9,82,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,378.25,85,,percent of total billed charges,,111.25,422.75,
X BONE AGE STUDY,26104510,CDM,77072,CPT,320,RC,outpatient,TC,415,415,,352.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,103.75,22,,percent of total billed charges,,,,,,,,,373.5,90,,percent of total billed charges,,,343.62,82.8,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,,,,,,,,365.2,88,,percent of total billed charges,,,,,,,,,317.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,103.75,22,,percent of total billed charges,,,377.65,91,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,,,,,,,,,,,,,344.45,83,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,340.3,82,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,103.75,394.25,
X KNEES AP WB BIL/1 FILM,26104521,CDM,73565,CPT,320,RC,outpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X STRESS (ANY JT),26104701,CDM,77071,CPT,320,RC,outpatient,TC,364,364,,309.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,91,22,,percent of total billed charges,,,,,,,,,327.6,90,,percent of total billed charges,,,301.39,82.8,,percent of total billed charges,,,309.4,85,,percent of total billed charges,,,,,,,,,320.32,88,,percent of total billed charges,,,,,,,,,278.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,91,22,,percent of total billed charges,,,331.24,91,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,,,,,,,,,,,,,302.12,83,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,298.48,82,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,309.4,85,,percent of total billed charges,,91,345.8,
X ORBIT (FB LOC),26104800,CDM,70030,CPT,320,RC,outpatient,TC,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X NAVICULAR RIGHT 2V,26158998,CDM,73100,CPT,320,RC,outpatient,RT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X NAVICULAR LEFT 2V,26158999,CDM,73100,CPT,320,RC,outpatient,LT,462,462,,392.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.5,22,,percent of total billed charges,,,,,,,,,415.8,90,,percent of total billed charges,,,382.54,82.8,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,,,,,,,,406.56,88,,percent of total billed charges,,,,,,,,,352.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.5,22,,percent of total billed charges,,,420.42,91,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,383.46,83,,percent of total billed charges,,,,,,,,,,,,,,,383.46,83,,percent of total billed charges,,,438.9,95,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,378.84,82,,percent of total billed charges,,,415.8,90,,percent of total billed charges,,,392.7,85,,percent of total billed charges,,115.5,438.9,
X PICC LINE WO IMAGING,26200000,CDM,36569,CPT,320,RC,outpatient,TC,9006,9006,,7646.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2251.5,22,,percent of total billed charges,,,,,,,,,8105.4,90,,percent of total billed charges,,,7456.97,82.8,,percent of total billed charges,,,7655.1,85,,percent of total billed charges,,,,,,,,,7925.28,88,,percent of total billed charges,,,,,,,,,6880.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2251.5,22,,percent of total billed charges,,,8195.46,91,,percent of total billed charges,,,8555.7,95,,percent of total billed charges,,,7474.98,83,,percent of total billed charges,,,7474.98,83,,percent of total billed charges,,,,,,,,,,,,,,,7474.98,83,,percent of total billed charges,,,8555.7,95,,percent of total billed charges,,,8105.4,90,,percent of total billed charges,,,8105.4,90,,percent of total billed charges,,,7384.92,82,,percent of total billed charges,,,8105.4,90,,percent of total billed charges,,,7655.1,85,,percent of total billed charges,,2251.5,8555.7,
X EPIBLOODPATCHW/FLUORO,26200001,CDM,62273,CPT,320,RC,outpatient,TC,7778,7778,,6603.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1944.5,22,,percent of total billed charges,,,,,,,,,7000.2,90,,percent of total billed charges,,,6440.18,82.8,,percent of total billed charges,,,6611.3,85,,percent of total billed charges,,,,,,,,,6844.64,88,,percent of total billed charges,,,,,,,,,5942.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1944.5,22,,percent of total billed charges,,,7077.98,91,,percent of total billed charges,,,7389.1,95,,percent of total billed charges,,,6455.74,83,,percent of total billed charges,,,6455.74,83,,percent of total billed charges,,,,,,,,,,,,,,,6455.74,83,,percent of total billed charges,,,7389.1,95,,percent of total billed charges,,,7000.2,90,,percent of total billed charges,,,7000.2,90,,percent of total billed charges,,,6377.96,82,,percent of total billed charges,,,7000.2,90,,percent of total billed charges,,,6611.3,85,,percent of total billed charges,,1944.5,7389.1,
X TRIGGERPTINJ1OR2MUSCLE,26200006,CDM,20552,CPT,320,RC,outpatient,,1732,1732,,1470.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,433,22,,percent of total billed charges,,,,,,,,,1558.8,90,,percent of total billed charges,,,1434.1,82.8,,percent of total billed charges,,,1472.2,85,,percent of total billed charges,,,,,,,,,1524.16,88,,percent of total billed charges,,,,,,,,,1323.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,433,22,,percent of total billed charges,,,1576.12,91,,percent of total billed charges,,,1645.4,95,,percent of total billed charges,,,1437.56,83,,percent of total billed charges,,,1437.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1437.56,83,,percent of total billed charges,,,1645.4,95,,percent of total billed charges,,,1558.8,90,,percent of total billed charges,,,1558.8,90,,percent of total billed charges,,,1420.24,82,,percent of total billed charges,,,1558.8,90,,percent of total billed charges,,,1472.2,85,,percent of total billed charges,,433,1645.4,
X DRAIN/INJ MAJOR JT/BURSA BIL,26200007,CDM,20610,CPT,320,RC,outpatient,50,5025,5025,,4266.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1256.25,22,,percent of total billed charges,,,,,,,,,4522.5,90,,percent of total billed charges,,,4160.7,82.8,,percent of total billed charges,,,4271.25,85,,percent of total billed charges,,,,,,,,,4422,88,,percent of total billed charges,,,,,,,,,3839.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1256.25,22,,percent of total billed charges,,,4572.75,91,,percent of total billed charges,,,4773.75,95,,percent of total billed charges,,,4170.75,83,,percent of total billed charges,,,4170.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4170.75,83,,percent of total billed charges,,,4773.75,95,,percent of total billed charges,,,4522.5,90,,percent of total billed charges,,,4522.5,90,,percent of total billed charges,,,4120.5,82,,percent of total billed charges,,,4522.5,90,,percent of total billed charges,,,4271.25,85,,percent of total billed charges,,1256.25,4773.75,
X FACIAL NERVE BLOCK,26200008,CDM,64999,CPT,920,RC,outpatient,TC,2094,2094,,1777.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,523.5,22,,percent of total billed charges,,,,,,,,,1884.6,90,,percent of total billed charges,,,1733.83,82.8,,percent of total billed charges,,,1779.9,85,,percent of total billed charges,,,,,,,,,1842.72,88,,percent of total billed charges,,,,,,,,,1599.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,523.5,22,,percent of total billed charges,,,1905.54,91,,percent of total billed charges,,,1989.3,95,,percent of total billed charges,,,1738.02,83,,percent of total billed charges,,,1738.02,83,,percent of total billed charges,,,,,,,,,,,,,,,1738.02,83,,percent of total billed charges,,,1989.3,95,,percent of total billed charges,,,1884.6,90,,percent of total billed charges,,,1884.6,90,,percent of total billed charges,,,1717.08,82,,percent of total billed charges,,,1884.6,90,,percent of total billed charges,,,1779.9,85,,percent of total billed charges,,523.5,1989.3,
X lUMBAR DISCOGRAM,26200009,CDM,72295,CPT,320,RC,outpatient,TC,19639,19639,,16673.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4909.75,22,,percent of total billed charges,,,,,,,,,17675.1,90,,percent of total billed charges,,,16261.09,82.8,,percent of total billed charges,,,16693.15,85,,percent of total billed charges,,,,,,,,,17282.32,88,,percent of total billed charges,,,,,,,,,15004.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4909.75,22,,percent of total billed charges,,,17871.49,91,,percent of total billed charges,,,18657.05,95,,percent of total billed charges,,,16300.37,83,,percent of total billed charges,,,16300.37,83,,percent of total billed charges,,,,,,,,,,,,,,,16300.37,83,,percent of total billed charges,,,18657.05,95,,percent of total billed charges,,,17675.1,90,,percent of total billed charges,,,17675.1,90,,percent of total billed charges,,,16103.98,82,,percent of total billed charges,,,17675.1,90,,percent of total billed charges,,,16693.15,85,,percent of total billed charges,,4909.75,18657.05,
X IVPW/OTOM(XPARTOFCTIVP),26200011,CDM,74410,CPT,320,RC,outpatient,TC,1428,1428,,1212.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,357,22,,percent of total billed charges,,,,,,,,,1285.2,90,,percent of total billed charges,,,1182.38,82.8,,percent of total billed charges,,,1213.8,85,,percent of total billed charges,,,,,,,,,1256.64,88,,percent of total billed charges,,,,,,,,,1090.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,357,22,,percent of total billed charges,,,1299.48,91,,percent of total billed charges,,,1356.6,95,,percent of total billed charges,,,1185.24,83,,percent of total billed charges,,,1185.24,83,,percent of total billed charges,,,,,,,,,,,,,,,1185.24,83,,percent of total billed charges,,,1356.6,95,,percent of total billed charges,,,1285.2,90,,percent of total billed charges,,,1285.2,90,,percent of total billed charges,,,1170.96,82,,percent of total billed charges,,,1285.2,90,,percent of total billed charges,,,1213.8,85,,percent of total billed charges,,357,1356.6,
X INSERTION OF CHEST TUBE LT,26200013,CDM,32551,CPT,920,RC,outpatient,LT,3003,3003,,2549.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,750.75,22,,percent of total billed charges,,,,,,,,,2702.7,90,,percent of total billed charges,,,2486.48,82.8,,percent of total billed charges,,,2552.55,85,,percent of total billed charges,,,,,,,,,2642.64,88,,percent of total billed charges,,,,,,,,,2294.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,750.75,22,,percent of total billed charges,,,2732.73,91,,percent of total billed charges,,,2852.85,95,,percent of total billed charges,,,2492.49,83,,percent of total billed charges,,,2492.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2492.49,83,,percent of total billed charges,,,2852.85,95,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2462.46,82,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2552.55,85,,percent of total billed charges,,750.75,2852.85,
X IVC FILTER,26200016,CDM,37191,CPT,360,RC,outpatient,,16826,16826,,14285.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4206.5,22,,percent of total billed charges,,,,,,,,,15143.4,90,,percent of total billed charges,,,13931.93,82.8,,percent of total billed charges,,,14302.1,85,,percent of total billed charges,,,,,,,,,14806.88,88,,percent of total billed charges,,,,,,,,,12855.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4206.5,22,,percent of total billed charges,,,15311.66,91,,percent of total billed charges,,,15984.7,95,,percent of total billed charges,,,13965.58,83,,percent of total billed charges,,,13965.58,83,,percent of total billed charges,,,,,,,,,,,,,,,13965.58,83,,percent of total billed charges,,,15984.7,95,,percent of total billed charges,,,15143.4,90,,percent of total billed charges,,,15143.4,90,,percent of total billed charges,,,13797.32,82,,percent of total billed charges,,,15143.4,90,,percent of total billed charges,,,14302.1,85,,percent of total billed charges,,4206.5,15984.7,
X IVC FILTER REMOVAL,26200017,CDM,37193,CPT,360,RC,outpatient,,12717,12717,,10796.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3179.25,22,,percent of total billed charges,,,,,,,,,11445.3,90,,percent of total billed charges,,,10529.68,82.8,,percent of total billed charges,,,10809.45,85,,percent of total billed charges,,,,,,,,,11190.96,88,,percent of total billed charges,,,,,,,,,9715.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3179.25,22,,percent of total billed charges,,,11572.47,91,,percent of total billed charges,,,12081.15,95,,percent of total billed charges,,,10555.11,83,,percent of total billed charges,,,10555.11,83,,percent of total billed charges,,,,,,,,,,,,,,,10555.11,83,,percent of total billed charges,,,12081.15,95,,percent of total billed charges,,,11445.3,90,,percent of total billed charges,,,11445.3,90,,percent of total billed charges,,,10427.94,82,,percent of total billed charges,,,11445.3,90,,percent of total billed charges,,,10809.45,85,,percent of total billed charges,,3179.25,12081.15,
X REMOVAL OF TUNNELED CT CATH,26200018,CDM,36590,CPT,360,RC,outpatient,TC,6236,6236,,5294.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1559,22,,percent of total billed charges,,,,,,,,,5612.4,90,,percent of total billed charges,,,5163.41,82.8,,percent of total billed charges,,,5300.6,85,,percent of total billed charges,,,,,,,,,5487.68,88,,percent of total billed charges,,,,,,,,,4764.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1559,22,,percent of total billed charges,,,5674.76,91,,percent of total billed charges,,,5924.2,95,,percent of total billed charges,,,5175.88,83,,percent of total billed charges,,,5175.88,83,,percent of total billed charges,,,,,,,,,,,,,,,5175.88,83,,percent of total billed charges,,,5924.2,95,,percent of total billed charges,,,5612.4,90,,percent of total billed charges,,,5612.4,90,,percent of total billed charges,,,5113.52,82,,percent of total billed charges,,,5612.4,90,,percent of total billed charges,,,5300.6,85,,percent of total billed charges,,1559,5924.2,
UL DRAIN JOINT BURSA LT W/US,26200020,CDM,20611,CPT,320,RC,outpatient,LT,2513,2513,,2133.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,628.25,22,,percent of total billed charges,,,,,,,,,2261.7,90,,percent of total billed charges,,,2080.76,82.8,,percent of total billed charges,,,2136.05,85,,percent of total billed charges,,,,,,,,,2211.44,88,,percent of total billed charges,,,,,,,,,1919.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,628.25,22,,percent of total billed charges,,,2286.83,91,,percent of total billed charges,,,2387.35,95,,percent of total billed charges,,,2085.79,83,,percent of total billed charges,,,2085.79,83,,percent of total billed charges,,,,,,,,,,,,,,,2085.79,83,,percent of total billed charges,,,2387.35,95,,percent of total billed charges,,,2261.7,90,,percent of total billed charges,,,2261.7,90,,percent of total billed charges,,,2060.66,82,,percent of total billed charges,,,2261.7,90,,percent of total billed charges,,,2136.05,85,,percent of total billed charges,,628.25,2387.35,
UL DRAIN JOINT BURSA RT W/US,26200021,CDM,20611,CPT,320,RC,outpatient,RT,2513,2513,,2133.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,628.25,22,,percent of total billed charges,,,,,,,,,2261.7,90,,percent of total billed charges,,,2080.76,82.8,,percent of total billed charges,,,2136.05,85,,percent of total billed charges,,,,,,,,,2211.44,88,,percent of total billed charges,,,,,,,,,1919.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,628.25,22,,percent of total billed charges,,,2286.83,91,,percent of total billed charges,,,2387.35,95,,percent of total billed charges,,,2085.79,83,,percent of total billed charges,,,2085.79,83,,percent of total billed charges,,,,,,,,,,,,,,,2085.79,83,,percent of total billed charges,,,2387.35,95,,percent of total billed charges,,,2261.7,90,,percent of total billed charges,,,2261.7,90,,percent of total billed charges,,,2060.66,82,,percent of total billed charges,,,2261.7,90,,percent of total billed charges,,,2136.05,85,,percent of total billed charges,,628.25,2387.35,
UL DRAIN JOINT BURSABIL W/US,26200022,CDM,20611,CPT,320,RC,outpatient,50,5025,5025,,4266.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1256.25,22,,percent of total billed charges,,,,,,,,,4522.5,90,,percent of total billed charges,,,4160.7,82.8,,percent of total billed charges,,,4271.25,85,,percent of total billed charges,,,,,,,,,4422,88,,percent of total billed charges,,,,,,,,,3839.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1256.25,22,,percent of total billed charges,,,4572.75,91,,percent of total billed charges,,,4773.75,95,,percent of total billed charges,,,4170.75,83,,percent of total billed charges,,,4170.75,83,,percent of total billed charges,,,,,,,,,,,,,,,4170.75,83,,percent of total billed charges,,,4773.75,95,,percent of total billed charges,,,4522.5,90,,percent of total billed charges,,,4522.5,90,,percent of total billed charges,,,4120.5,82,,percent of total billed charges,,,4522.5,90,,percent of total billed charges,,,4271.25,85,,percent of total billed charges,,1256.25,4773.75,
X HIP JOINT BX BIL,26200023,CDM,27052,CPT,320,RC,outpatient,50,15657,15657,,13292.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3914.25,22,,percent of total billed charges,,,,,,,,,14091.3,90,,percent of total billed charges,,,12964,82.8,,percent of total billed charges,,,13308.45,85,,percent of total billed charges,,,,,,,,,13778.16,88,,percent of total billed charges,,,,,,,,,11961.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3914.25,22,,percent of total billed charges,,,14247.87,91,,percent of total billed charges,,,14874.15,95,,percent of total billed charges,,,12995.31,83,,percent of total billed charges,,,12995.31,83,,percent of total billed charges,,,,,,,,,,,,,,,12995.31,83,,percent of total billed charges,,,14874.15,95,,percent of total billed charges,,,14091.3,90,,percent of total billed charges,,,14091.3,90,,percent of total billed charges,,,12838.74,82,,percent of total billed charges,,,14091.3,90,,percent of total billed charges,,,13308.45,85,,percent of total billed charges,,3914.25,14874.15,
X HIP JOINT BX LT,26200024,CDM,27052,CPT,320,RC,outpatient,LT,7829,7829,,6646.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1957.25,22,,percent of total billed charges,,,,,,,,,7046.1,90,,percent of total billed charges,,,6482.41,82.8,,percent of total billed charges,,,6654.65,85,,percent of total billed charges,,,,,,,,,6889.52,88,,percent of total billed charges,,,,,,,,,5981.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1957.25,22,,percent of total billed charges,,,7124.39,91,,percent of total billed charges,,,7437.55,95,,percent of total billed charges,,,6498.07,83,,percent of total billed charges,,,6498.07,83,,percent of total billed charges,,,,,,,,,,,,,,,6498.07,83,,percent of total billed charges,,,7437.55,95,,percent of total billed charges,,,7046.1,90,,percent of total billed charges,,,7046.1,90,,percent of total billed charges,,,6419.78,82,,percent of total billed charges,,,7046.1,90,,percent of total billed charges,,,6654.65,85,,percent of total billed charges,,1957.25,7437.55,
X HIP JOINT BX RT,26200025,CDM,27052,CPT,320,RC,outpatient,RT,7829,7829,,6646.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1957.25,22,,percent of total billed charges,,,,,,,,,7046.1,90,,percent of total billed charges,,,6482.41,82.8,,percent of total billed charges,,,6654.65,85,,percent of total billed charges,,,,,,,,,6889.52,88,,percent of total billed charges,,,,,,,,,5981.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1957.25,22,,percent of total billed charges,,,7124.39,91,,percent of total billed charges,,,7437.55,95,,percent of total billed charges,,,6498.07,83,,percent of total billed charges,,,6498.07,83,,percent of total billed charges,,,,,,,,,,,,,,,6498.07,83,,percent of total billed charges,,,7437.55,95,,percent of total billed charges,,,7046.1,90,,percent of total billed charges,,,7046.1,90,,percent of total billed charges,,,6419.78,82,,percent of total billed charges,,,7046.1,90,,percent of total billed charges,,,6654.65,85,,percent of total billed charges,,1957.25,7437.55,
X BONE BX DEEP,26200026,CDM,20225,CPT,320,RC,outpatient,TC,4515,4515,,3833.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1128.75,22,,percent of total billed charges,,,,,,,,,4063.5,90,,percent of total billed charges,,,3738.42,82.8,,percent of total billed charges,,,3837.75,85,,percent of total billed charges,,,,,,,,,3973.2,88,,percent of total billed charges,,,,,,,,,3449.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1128.75,22,,percent of total billed charges,,,4108.65,91,,percent of total billed charges,,,4289.25,95,,percent of total billed charges,,,3747.45,83,,percent of total billed charges,,,3747.45,83,,percent of total billed charges,,,,,,,,,,,,,,,3747.45,83,,percent of total billed charges,,,4289.25,95,,percent of total billed charges,,,4063.5,90,,percent of total billed charges,,,4063.5,90,,percent of total billed charges,,,3702.3,82,,percent of total billed charges,,,4063.5,90,,percent of total billed charges,,,3837.75,85,,percent of total billed charges,,1128.75,4289.25,
X BONE BX SUPERFICIAL,26200027,CDM,20220,CPT,320,RC,outpatient,TC,3196,3196,,2713.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,799,22,,percent of total billed charges,,,,,,,,,2876.4,90,,percent of total billed charges,,,2646.29,82.8,,percent of total billed charges,,,2716.6,85,,percent of total billed charges,,,,,,,,,2812.48,88,,percent of total billed charges,,,,,,,,,2441.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,799,22,,percent of total billed charges,,,2908.36,91,,percent of total billed charges,,,3036.2,95,,percent of total billed charges,,,2652.68,83,,percent of total billed charges,,,2652.68,83,,percent of total billed charges,,,,,,,,,,,,,,,2652.68,83,,percent of total billed charges,,,3036.2,95,,percent of total billed charges,,,2876.4,90,,percent of total billed charges,,,2876.4,90,,percent of total billed charges,,,2620.72,82,,percent of total billed charges,,,2876.4,90,,percent of total billed charges,,,2716.6,85,,percent of total billed charges,,799,3036.2,
X GROSHONG CATHETER,26200029,CDM,36556,CPT,320,RC,outpatient,TC,9507,9507,,8071.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2376.75,22,,percent of total billed charges,,,,,,,,,8556.3,90,,percent of total billed charges,,,7871.8,82.8,,percent of total billed charges,,,8080.95,85,,percent of total billed charges,,,,,,,,,8366.16,88,,percent of total billed charges,,,,,,,,,7263.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2376.75,22,,percent of total billed charges,,,8651.37,91,,percent of total billed charges,,,9031.65,95,,percent of total billed charges,,,7890.81,83,,percent of total billed charges,,,7890.81,83,,percent of total billed charges,,,,,,,,,,,,,,,7890.81,83,,percent of total billed charges,,,9031.65,95,,percent of total billed charges,,,8556.3,90,,percent of total billed charges,,,8556.3,90,,percent of total billed charges,,,7795.74,82,,percent of total billed charges,,,8556.3,90,,percent of total billed charges,,,8080.95,85,,percent of total billed charges,,2376.75,9031.65,
X GROSHONG REMOVAL CATHETER,26200030,CDM,36589,CPT,320,RC,outpatient,TC,7163,7163,,6081.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1790.75,22,,percent of total billed charges,,,,,,,,,6446.7,90,,percent of total billed charges,,,5930.96,82.8,,percent of total billed charges,,,6088.55,85,,percent of total billed charges,,,,,,,,,6303.44,88,,percent of total billed charges,,,,,,,,,5472.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1790.75,22,,percent of total billed charges,,,6518.33,91,,percent of total billed charges,,,6804.85,95,,percent of total billed charges,,,5945.29,83,,percent of total billed charges,,,5945.29,83,,percent of total billed charges,,,,,,,,,,,,,,,5945.29,83,,percent of total billed charges,,,6804.85,95,,percent of total billed charges,,,6446.7,90,,percent of total billed charges,,,6446.7,90,,percent of total billed charges,,,5873.66,82,,percent of total billed charges,,,6446.7,90,,percent of total billed charges,,,6088.55,85,,percent of total billed charges,,1790.75,6804.85,
X IR AAA REPAIR,26200032,CDM,34701,CPT,360,RC,outpatient,,21149,21149,,17955.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5287.25,22,,percent of total billed charges,,,,,,,,,19034.1,90,,percent of total billed charges,,,17511.37,82.8,,percent of total billed charges,,,17976.65,85,,percent of total billed charges,,,,,,,,,18611.12,88,,percent of total billed charges,,,,,,,,,16157.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5287.25,22,,percent of total billed charges,,,19245.59,91,,percent of total billed charges,,,20091.55,95,,percent of total billed charges,,,17553.67,83,,percent of total billed charges,,,17553.67,83,,percent of total billed charges,,,,,,,,,,,,,,,17553.67,83,,percent of total billed charges,,,20091.55,95,,percent of total billed charges,,,19034.1,90,,percent of total billed charges,,,19034.1,90,,percent of total billed charges,,,17342.18,82,,percent of total billed charges,,,19034.1,90,,percent of total billed charges,,,17976.65,85,,percent of total billed charges,,5287.25,20091.55,
X IR CATH ABD AO/RUN OFF,26200033,CDM,75630,CPT,320,RC,outpatient,,9621,9621,,8168.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2405.25,22,,percent of total billed charges,,,,,,,,,8658.9,90,,percent of total billed charges,,,7966.19,82.8,,percent of total billed charges,,,8177.85,85,,percent of total billed charges,,,,,,,,,8466.48,88,,percent of total billed charges,,,,,,,,,7350.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2405.25,22,,percent of total billed charges,,,8755.11,91,,percent of total billed charges,,,9139.95,95,,percent of total billed charges,,,7985.43,83,,percent of total billed charges,,,7985.43,83,,percent of total billed charges,,,,,,,,,,,,,,,7985.43,83,,percent of total billed charges,,,9139.95,95,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,7889.22,82,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,8177.85,85,,percent of total billed charges,,2405.25,9139.95,
X IR ABDOMINAL AORTOGRAM,26200034,CDM,75625,CPT,360,RC,outpatient,,8186,8186,,6949.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2046.5,22,,percent of total billed charges,,,,,,,,,7367.4,90,,percent of total billed charges,,,6778.01,82.8,,percent of total billed charges,,,6958.1,85,,percent of total billed charges,,,,,,,,,7203.68,88,,percent of total billed charges,,,,,,,,,6254.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2046.5,22,,percent of total billed charges,,,7449.26,91,,percent of total billed charges,,,7776.7,95,,percent of total billed charges,,,6794.38,83,,percent of total billed charges,,,6794.38,83,,percent of total billed charges,,,,,,,,,,,,,,,6794.38,83,,percent of total billed charges,,,7776.7,95,,percent of total billed charges,,,7367.4,90,,percent of total billed charges,,,7367.4,90,,percent of total billed charges,,,6712.52,82,,percent of total billed charges,,,7367.4,90,,percent of total billed charges,,,6958.1,85,,percent of total billed charges,,2046.5,7776.7,
X IR BIL KISSING STENTS,26200035,CDM,37221,CPT,360,RC,outpatient,,32736,32736,,27792.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8184,22,,percent of total billed charges,,,,,,,,,29462.4,90,,percent of total billed charges,,,27105.41,82.8,,percent of total billed charges,,,27825.6,85,,percent of total billed charges,,,,,,,,,28807.68,88,,percent of total billed charges,,,,,,,,,25010.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8184,22,,percent of total billed charges,,,29789.76,91,,percent of total billed charges,,,31099.2,95,,percent of total billed charges,,,27170.88,83,,percent of total billed charges,,,27170.88,83,,percent of total billed charges,,,,,,,,,,,,,,,27170.88,83,,percent of total billed charges,,,31099.2,95,,percent of total billed charges,,,29462.4,90,,percent of total billed charges,,,29462.4,90,,percent of total billed charges,,,26843.52,82,,percent of total billed charges,,,29462.4,90,,percent of total billed charges,,,27825.6,85,,percent of total billed charges,,8184,31099.2,
X PICC LINE W IMAGING,26200036,CDM,36573,CPT,320,RC,outpatient,TC,9511,9511,,8074.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2377.75,22,,percent of total billed charges,,,,,,,,,8559.9,90,,percent of total billed charges,,,7875.11,82.8,,percent of total billed charges,,,8084.35,85,,percent of total billed charges,,,,,,,,,8369.68,88,,percent of total billed charges,,,,,,,,,7266.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2377.75,22,,percent of total billed charges,,,8655.01,91,,percent of total billed charges,,,9035.45,95,,percent of total billed charges,,,7894.13,83,,percent of total billed charges,,,7894.13,83,,percent of total billed charges,,,,,,,,,,,,,,,7894.13,83,,percent of total billed charges,,,9035.45,95,,percent of total billed charges,,,8559.9,90,,percent of total billed charges,,,8559.9,90,,percent of total billed charges,,,7799.02,82,,percent of total billed charges,,,8559.9,90,,percent of total billed charges,,,8084.35,85,,percent of total billed charges,,2377.75,9035.45,
X IR AAA REPAIR,26200037,CDM,34701,CPT,360,RC,outpatient,,20026,20026,,17002.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5006.5,22,,percent of total billed charges,,,,,,,,,18023.4,90,,percent of total billed charges,,,16581.53,82.8,,percent of total billed charges,,,17022.1,85,,percent of total billed charges,,,,,,,,,17622.88,88,,percent of total billed charges,,,,,,,,,15299.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5006.5,22,,percent of total billed charges,,,18223.66,91,,percent of total billed charges,,,19024.7,95,,percent of total billed charges,,,16621.58,83,,percent of total billed charges,,,16621.58,83,,percent of total billed charges,,,,,,,,,,,,,,,16621.58,83,,percent of total billed charges,,,19024.7,95,,percent of total billed charges,,,18023.4,90,,percent of total billed charges,,,18023.4,90,,percent of total billed charges,,,16421.32,82,,percent of total billed charges,,,18023.4,90,,percent of total billed charges,,,17022.1,85,,percent of total billed charges,,5006.5,19024.7,
X BONE BIOPSY,26200038,CDM,20225,CPT,320,RC,outpatient,TC,4383,4383,,3721.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1095.75,22,,percent of total billed charges,,,,,,,,,3944.7,90,,percent of total billed charges,,,3629.12,82.8,,percent of total billed charges,,,3725.55,85,,percent of total billed charges,,,,,,,,,3857.04,88,,percent of total billed charges,,,,,,,,,3348.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1095.75,22,,percent of total billed charges,,,3988.53,91,,percent of total billed charges,,,4163.85,95,,percent of total billed charges,,,3637.89,83,,percent of total billed charges,,,3637.89,83,,percent of total billed charges,,,,,,,,,,,,,,,3637.89,83,,percent of total billed charges,,,4163.85,95,,percent of total billed charges,,,3944.7,90,,percent of total billed charges,,,3944.7,90,,percent of total billed charges,,,3594.06,82,,percent of total billed charges,,,3944.7,90,,percent of total billed charges,,,3725.55,85,,percent of total billed charges,,1095.75,4163.85,
X INSERTION CHEST TUBE RIGHT,26200039,CDM,32551,CPT,920,RC,outpatient,RT,3003,3003,,2549.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,750.75,22,,percent of total billed charges,,,,,,,,,2702.7,90,,percent of total billed charges,,,2486.48,82.8,,percent of total billed charges,,,2552.55,85,,percent of total billed charges,,,,,,,,,2642.64,88,,percent of total billed charges,,,,,,,,,2294.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,750.75,22,,percent of total billed charges,,,2732.73,91,,percent of total billed charges,,,2852.85,95,,percent of total billed charges,,,2492.49,83,,percent of total billed charges,,,2492.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2492.49,83,,percent of total billed charges,,,2852.85,95,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2462.46,82,,percent of total billed charges,,,2702.7,90,,percent of total billed charges,,,2552.55,85,,percent of total billed charges,,750.75,2852.85,
X ARTHROCENTESISPHYSPRCDR,26200499,CDM,20605,CPT,320,RC,outpatient,,1285,1285,,1090.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,321.25,22,,percent of total billed charges,,,,,,,,,1156.5,90,,percent of total billed charges,,,1063.98,82.8,,percent of total billed charges,,,1092.25,85,,percent of total billed charges,,,,,,,,,1130.8,88,,percent of total billed charges,,,,,,,,,981.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,321.25,22,,percent of total billed charges,,,1169.35,91,,percent of total billed charges,,,1220.75,95,,percent of total billed charges,,,1066.55,83,,percent of total billed charges,,,1066.55,83,,percent of total billed charges,,,,,,,,,,,,,,,1066.55,83,,percent of total billed charges,,,1220.75,95,,percent of total billed charges,,,1156.5,90,,percent of total billed charges,,,1156.5,90,,percent of total billed charges,,,1053.7,82,,percent of total billed charges,,,1156.5,90,,percent of total billed charges,,,1092.25,85,,percent of total billed charges,,321.25,1220.75,
X HIP 1V BILATERAL W/PELV,26355587,CDM,73501,CPT,320,RC,outpatient,,1514,1514,,1285.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,378.5,22,,percent of total billed charges,,,,,,,,,1362.6,90,,percent of total billed charges,,,1253.59,82.8,,percent of total billed charges,,,1286.9,85,,percent of total billed charges,,,,,,,,,1332.32,88,,percent of total billed charges,,,,,,,,,1156.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,378.5,22,,percent of total billed charges,,,1377.74,91,,percent of total billed charges,,,1438.3,95,,percent of total billed charges,,,1256.62,83,,percent of total billed charges,,,1256.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1256.62,83,,percent of total billed charges,,,1438.3,95,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1241.48,82,,percent of total billed charges,,,1362.6,90,,percent of total billed charges,,,1286.9,85,,percent of total billed charges,,378.5,1438.3,
X INJ FORAMEN EPIDURAL L/S,26700119,CDM,64483,CPT,360,RC,outpatient,TC,3465,3465,,2941.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,866.25,22,,percent of total billed charges,,,,,,,,,3118.5,90,,percent of total billed charges,,,2869.02,82.8,,percent of total billed charges,,,2945.25,85,,percent of total billed charges,,,,,,,,,3049.2,88,,percent of total billed charges,,,,,,,,,2647.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,866.25,22,,percent of total billed charges,,,3153.15,91,,percent of total billed charges,,,3291.75,95,,percent of total billed charges,,,2875.95,83,,percent of total billed charges,,,2875.95,83,,percent of total billed charges,,,,,,,,,,,,,,,2875.95,83,,percent of total billed charges,,,3291.75,95,,percent of total billed charges,,,3118.5,90,,percent of total billed charges,,,3118.5,90,,percent of total billed charges,,,2841.3,82,,percent of total billed charges,,,3118.5,90,,percent of total billed charges,,,2945.25,85,,percent of total billed charges,,866.25,3291.75,
X INJ FORAMEN EPIDURAL L/S EACH ADDITION,26700300,CDM,64484,CPT,320,RC,outpatient,TC,2619,2619,,2223.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,654.75,22,,percent of total billed charges,,,,,,,,,2357.1,90,,percent of total billed charges,,,2168.53,82.8,,percent of total billed charges,,,2226.15,85,,percent of total billed charges,,,,,,,,,2304.72,88,,percent of total billed charges,,,,,,,,,2000.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,654.75,22,,percent of total billed charges,,,2383.29,91,,percent of total billed charges,,,2488.05,95,,percent of total billed charges,,,2173.77,83,,percent of total billed charges,,,2173.77,83,,percent of total billed charges,,,,,,,,,,,,,,,2173.77,83,,percent of total billed charges,,,2488.05,95,,percent of total billed charges,,,2357.1,90,,percent of total billed charges,,,2357.1,90,,percent of total billed charges,,,2147.58,82,,percent of total billed charges,,,2357.1,90,,percent of total billed charges,,,2226.15,85,,percent of total billed charges,,654.75,2488.05,
X CATH ABDAO/RUN OFF,27100900,CDM,75630,CPT,320,RC,outpatient,,8514,8514,,7228.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2128.5,22,,percent of total billed charges,,,,,,,,,7662.6,90,,percent of total billed charges,,,7049.59,82.8,,percent of total billed charges,,,7236.9,85,,percent of total billed charges,,,,,,,,,7492.32,88,,percent of total billed charges,,,,,,,,,6504.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2128.5,22,,percent of total billed charges,,,7747.74,91,,percent of total billed charges,,,8088.3,95,,percent of total billed charges,,,7066.62,83,,percent of total billed charges,,,7066.62,83,,percent of total billed charges,,,,,,,,,,,,,,,7066.62,83,,percent of total billed charges,,,8088.3,95,,percent of total billed charges,,,7662.6,90,,percent of total billed charges,,,7662.6,90,,percent of total billed charges,,,6981.48,82,,percent of total billed charges,,,7662.6,90,,percent of total billed charges,,,7236.9,85,,percent of total billed charges,,2128.5,8088.3,
CTA CARDIAC W CONTRAST & SCORE,29100525,CDM,75572,CPT,320,RC,outpatient,TC,5229,5229,,4439.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1307.25,22,,percent of total billed charges,,,,,,,,,4706.1,90,,percent of total billed charges,,,4329.61,82.8,,percent of total billed charges,,,4444.65,85,,percent of total billed charges,,,,,,,,,4601.52,88,,percent of total billed charges,,,,,,,,,3994.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1307.25,22,,percent of total billed charges,,,4758.39,91,,percent of total billed charges,,,4967.55,95,,percent of total billed charges,,,4340.07,83,,percent of total billed charges,,,4340.07,83,,percent of total billed charges,,,,,,,,,,,,,,,4340.07,83,,percent of total billed charges,,,4967.55,95,,percent of total billed charges,,,4706.1,90,,percent of total billed charges,,,4706.1,90,,percent of total billed charges,,,4287.78,82,,percent of total billed charges,,,4706.1,90,,percent of total billed charges,,,4444.65,85,,percent of total billed charges,,1307.25,4967.55,
*DNU GADOLINIUM PER ML (V0108),31100002,CDM,Q9952,HCPCS,270,RC,outpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.25,22,,percent of total billed charges,,,,,,,,,62.1,90,,percent of total billed charges,,,57.13,82.8,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.25,22,,percent of total billed charges,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,17.25,65.55,
GAD PER ML MR AGENT NDC: 00270-5164-14,31100012,CDM,A9579,HCPCS,636,RC,outpatient,,69,69,,58.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.25,22,,percent of total billed charges,,,,,,,,,62.1,90,,percent of total billed charges,,,57.13,82.8,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,,,,,,,,60.72,88,,percent of total billed charges,,,,,,,,,52.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.25,22,,percent of total billed charges,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,,,,,,,,,,,,,57.27,83,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,56.58,82,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,17.25,65.55,
SPINAL LUMBAR PUNCTURE,33762270,CDM,62270,CPT,370,RC,outpatient,,3124,3124,,2652.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,781,22,,percent of total billed charges,,,,,,,,,2811.6,90,,percent of total billed charges,,,2586.67,82.8,,percent of total billed charges,,,2655.4,85,,percent of total billed charges,,,,,,,,,2749.12,88,,percent of total billed charges,,,,,,,,,2386.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,781,22,,percent of total billed charges,,,2842.84,91,,percent of total billed charges,,,2967.8,95,,percent of total billed charges,,,2592.92,83,,percent of total billed charges,,,2592.92,83,,percent of total billed charges,,,,,,,,,,,,,,,2592.92,83,,percent of total billed charges,,,2967.8,95,,percent of total billed charges,,,2811.6,90,,percent of total billed charges,,,2811.6,90,,percent of total billed charges,,,2561.68,82,,percent of total billed charges,,,2811.6,90,,percent of total billed charges,,,2655.4,85,,percent of total billed charges,,781,2967.8,
EEG AWAKE & ASLEEP,14801592,CDM,95819,CPT,740,RC,outpatient,,1881,1881,,1596.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,470.25,22,,percent of total billed charges,,,,,,,,,1692.9,90,,percent of total billed charges,,,1557.47,82.8,,percent of total billed charges,,,1598.85,85,,percent of total billed charges,,,,,,,,,1655.28,88,,percent of total billed charges,,,,,,,,,1437.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,470.25,22,,percent of total billed charges,,,1711.71,91,,percent of total billed charges,,,1786.95,95,,percent of total billed charges,,,1561.23,83,,percent of total billed charges,,,1561.23,83,,percent of total billed charges,,,,,,,,,,,,,,,1561.23,83,,percent of total billed charges,,,1786.95,95,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1542.42,82,,percent of total billed charges,,,1692.9,90,,percent of total billed charges,,,1598.85,85,,percent of total billed charges,,470.25,1786.95,
"ST TX OF SPEECH,LNG,COMM &/OR AUDITORY",3643968,CDM,92507,CPT,440,RC,outpatient,GN,500,500,,424.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125,22,,percent of total billed charges,,,,,,,,,450,90,,percent of total billed charges,,,414,82.8,,percent of total billed charges,,,425,85,,percent of total billed charges,,,,,,,,,440,88,,percent of total billed charges,,,,,,,,,382,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125,22,,percent of total billed charges,,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,415,83,,percent of total billed charges,,,,,,,,,,,,,,,415,83,,percent of total billed charges,,,475,95,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,410,82,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,125,475,
IPA SPEECH THERAPY TREATMENT 15 MIN,3643969,CDM,92507,CPT,440,RC,outpatient,GN,500,500,,424.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,125,22,,percent of total billed charges,,,,,,,,,450,90,,percent of total billed charges,,,414,82.8,,percent of total billed charges,,,425,85,,percent of total billed charges,,,,,,,,,440,88,,percent of total billed charges,,,,,,,,,382,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,125,22,,percent of total billed charges,,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,415,83,,percent of total billed charges,,,,,,,,,,,,,,,415,83,,percent of total billed charges,,,475,95,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,410,82,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,125,475,
IPA SPEECH THERAPY EVALUATION 15 MIN,3643980,CDM,92521,CPT,440,RC,outpatient,GN,363,363,,308.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90.75,22,,percent of total billed charges,,,,,,,,,326.7,90,,percent of total billed charges,,,300.56,82.8,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,,,,,,,,319.44,88,,percent of total billed charges,,,,,,,,,277.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90.75,22,,percent of total billed charges,,,330.33,91,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,,,,,,,,,,,,,301.29,83,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,297.66,82,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,90.75,344.85,
"ST EVAL OF SPEECH,LNG,COMM &/OR AUDITORY",3643984,CDM,92521,CPT,444,RC,outpatient,GN,750,750,,636.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,187.5,22,,percent of total billed charges,,,,,,,,,675,90,,percent of total billed charges,,,621,82.8,,percent of total billed charges,,,637.5,85,,percent of total billed charges,,,,,,,,,660,88,,percent of total billed charges,,,,,,,,,573,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,187.5,22,,percent of total billed charges,,,682.5,91,,percent of total billed charges,,,712.5,95,,percent of total billed charges,,,622.5,83,,percent of total billed charges,,,622.5,83,,percent of total billed charges,,,,,,,,,,,,,,,622.5,83,,percent of total billed charges,,,712.5,95,,percent of total billed charges,,,675,90,,percent of total billed charges,,,675,90,,percent of total billed charges,,,615,82,,percent of total billed charges,,,675,90,,percent of total billed charges,,,637.5,85,,percent of total billed charges,,187.5,712.5,
"*ST EVAL IPA  SPCH,LNG,COMM,AUD IPA(V71)",3643985,CDM,92506,CPT,444,RC,outpatient,GN,376,376,,319.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94,22,,percent of total billed charges,,,,,,,,,338.4,90,,percent of total billed charges,,,311.33,82.8,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,,,,,,,,330.88,88,,percent of total billed charges,,,,,,,,,287.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94,22,,percent of total billed charges,,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,,,,,,,,,,,,,312.08,83,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,308.32,82,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,94,357.2,
ST TREATMENT OF SWALLOWING DYSFUNCTION,3644736,CDM,92526,CPT,440,RC,outpatient,GN,452,452,,383.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,113,22,,percent of total billed charges,,,,,,,,,406.8,90,,percent of total billed charges,,,374.26,82.8,,percent of total billed charges,,,384.2,85,,percent of total billed charges,,,,,,,,,397.76,88,,percent of total billed charges,,,,,,,,,345.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,113,22,,percent of total billed charges,,,411.32,91,,percent of total billed charges,,,429.4,95,,percent of total billed charges,,,375.16,83,,percent of total billed charges,,,375.16,83,,percent of total billed charges,,,,,,,,,,,,,,,375.16,83,,percent of total billed charges,,,429.4,95,,percent of total billed charges,,,406.8,90,,percent of total billed charges,,,406.8,90,,percent of total billed charges,,,370.64,82,,percent of total billed charges,,,406.8,90,,percent of total billed charges,,,384.2,85,,percent of total billed charges,,113,429.4,
"ST ASSESS OF APAHASIA W/INTERP,EA HR",3644740,CDM,96105,CPT,440,RC,outpatient,GN,650,650,,551.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,162.5,22,,percent of total billed charges,,,,,,,,,585,90,,percent of total billed charges,,,538.2,82.8,,percent of total billed charges,,,552.5,85,,percent of total billed charges,,,,,,,,,572,88,,percent of total billed charges,,,,,,,,,496.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,162.5,22,,percent of total billed charges,,,591.5,91,,percent of total billed charges,,,617.5,95,,percent of total billed charges,,,539.5,83,,percent of total billed charges,,,539.5,83,,percent of total billed charges,,,,,,,,,,,,,,,539.5,83,,percent of total billed charges,,,617.5,95,,percent of total billed charges,,,585,90,,percent of total billed charges,,,585,90,,percent of total billed charges,,,533,82,,percent of total billed charges,,,585,90,,percent of total billed charges,,,552.5,85,,percent of total billed charges,,162.5,617.5,
"ST DEVELOPE TESTING W INTERP, EA HR",3644741,CDM,96111,CPT,440,RC,outpatient,GN,650,650,,551.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,162.5,22,,percent of total billed charges,,,,,,,,,585,90,,percent of total billed charges,,,538.2,82.8,,percent of total billed charges,,,552.5,85,,percent of total billed charges,,,,,,,,,572,88,,percent of total billed charges,,,,,,,,,496.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,162.5,22,,percent of total billed charges,,,591.5,91,,percent of total billed charges,,,617.5,95,,percent of total billed charges,,,539.5,83,,percent of total billed charges,,,539.5,83,,percent of total billed charges,,,,,,,,,,,,,,,539.5,83,,percent of total billed charges,,,617.5,95,,percent of total billed charges,,,585,90,,percent of total billed charges,,,585,90,,percent of total billed charges,,,533,82,,percent of total billed charges,,,585,90,,percent of total billed charges,,,552.5,85,,percent of total billed charges,,162.5,617.5,
"ST COGNITIVE SKILLS DEVELOPMNT,EA 15 MIN",3644747,CDM,97129,CPT,440,RC,outpatient,GN,132,132,,112.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,33,22,,percent of total billed charges,,,,,,,,,118.8,90,,percent of total billed charges,,,109.3,82.8,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,,,,,,,,116.16,88,,percent of total billed charges,,,,,,,,,100.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,33,22,,percent of total billed charges,,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,,,,,,,,,,,,,109.56,83,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,108.24,82,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,33,125.4,
ST CLINICAL SWALLOW EVAL,3644748,CDM,92610,CPT,444,RC,outpatient,GN,648,648,,550.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,162,22,,percent of total billed charges,,,,,,,,,583.2,90,,percent of total billed charges,,,536.54,82.8,,percent of total billed charges,,,550.8,85,,percent of total billed charges,,,,,,,,,570.24,88,,percent of total billed charges,,,,,,,,,495.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,162,22,,percent of total billed charges,,,589.68,91,,percent of total billed charges,,,615.6,95,,percent of total billed charges,,,537.84,83,,percent of total billed charges,,,537.84,83,,percent of total billed charges,,,,,,,,,,,,,,,537.84,83,,percent of total billed charges,,,615.6,95,,percent of total billed charges,,,583.2,90,,percent of total billed charges,,,583.2,90,,percent of total billed charges,,,531.36,82,,percent of total billed charges,,,583.2,90,,percent of total billed charges,,,550.8,85,,percent of total billed charges,,162,615.6,
ST BARIUM SWALLOW EVALUATION,3644749,CDM,92611,CPT,444,RC,outpatient,GN,907,907,,770.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,226.75,22,,percent of total billed charges,,,,,,,,,816.3,90,,percent of total billed charges,,,751,82.8,,percent of total billed charges,,,770.95,85,,percent of total billed charges,,,,,,,,,798.16,88,,percent of total billed charges,,,,,,,,,692.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,226.75,22,,percent of total billed charges,,,825.37,91,,percent of total billed charges,,,861.65,95,,percent of total billed charges,,,752.81,83,,percent of total billed charges,,,752.81,83,,percent of total billed charges,,,,,,,,,,,,,,,752.81,83,,percent of total billed charges,,,861.65,95,,percent of total billed charges,,,816.3,90,,percent of total billed charges,,,816.3,90,,percent of total billed charges,,,743.74,82,,percent of total billed charges,,,816.3,90,,percent of total billed charges,,,770.95,85,,percent of total billed charges,,226.75,861.65,
ST EVAL OF SPEECH DEVICE (1 HOUR),3644750,CDM,92607,CPT,444,RC,outpatient,GN,650,650,,551.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,162.5,22,,percent of total billed charges,,,,,,,,,585,90,,percent of total billed charges,,,538.2,82.8,,percent of total billed charges,,,552.5,85,,percent of total billed charges,,,,,,,,,572,88,,percent of total billed charges,,,,,,,,,496.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,162.5,22,,percent of total billed charges,,,591.5,91,,percent of total billed charges,,,617.5,95,,percent of total billed charges,,,539.5,83,,percent of total billed charges,,,539.5,83,,percent of total billed charges,,,,,,,,,,,,,,,539.5,83,,percent of total billed charges,,,617.5,95,,percent of total billed charges,,,585,90,,percent of total billed charges,,,585,90,,percent of total billed charges,,,533,82,,percent of total billed charges,,,585,90,,percent of total billed charges,,,552.5,85,,percent of total billed charges,,162.5,617.5,
"ST EVAL OF SPEECH DEVICE,EA ADDTL 30 MIN",3644752,CDM,92608,CPT,444,RC,outpatient,GN,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
"*ST TX SP,LNG,COMM,AUDITO IPA U6(V0710)",3644755,CDM,92507,CPT,440,RC,outpatient,GN,343,343,,291.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,85.75,22,,percent of total billed charges,,,,,,,,,308.7,90,,percent of total billed charges,,,284,82.8,,percent of total billed charges,,,291.55,85,,percent of total billed charges,,,,,,,,,301.84,88,,percent of total billed charges,,,,,,,,,262.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,85.75,22,,percent of total billed charges,,,312.13,91,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,,,,,,,,,,,,,284.69,83,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,281.26,82,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,291.55,85,,percent of total billed charges,,85.75,325.85,
ST STANDARDIZD COGN PERF TEST PER HOUR,3644760,CDM,96125,CPT,444,RC,outpatient,GN,650,650,,551.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,162.5,22,,percent of total billed charges,,,,,,,,,585,90,,percent of total billed charges,,,538.2,82.8,,percent of total billed charges,,,552.5,85,,percent of total billed charges,,,,,,,,,572,88,,percent of total billed charges,,,,,,,,,496.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,162.5,22,,percent of total billed charges,,,591.5,91,,percent of total billed charges,,,617.5,95,,percent of total billed charges,,,539.5,83,,percent of total billed charges,,,539.5,83,,percent of total billed charges,,,,,,,,,,,,,,,539.5,83,,percent of total billed charges,,,617.5,95,,percent of total billed charges,,,585,90,,percent of total billed charges,,,585,90,,percent of total billed charges,,,533,82,,percent of total billed charges,,,585,90,,percent of total billed charges,,,552.5,85,,percent of total billed charges,,162.5,617.5,
IPA EVALUATION OF SPEECH,36000200,CDM,92521,CPT,440,RC,outpatient,GN,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.5,22,,percent of total billed charges,,,,,,,,,351,90,,percent of total billed charges,,,322.92,82.8,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.5,22,,percent of total billed charges,,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,97.5,370.5,
IPA EVALUATION OF SPEECH SOUND PROD,36000201,CDM,92522,CPT,440,RC,outpatient,GN,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.5,22,,percent of total billed charges,,,,,,,,,351,90,,percent of total billed charges,,,322.92,82.8,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.5,22,,percent of total billed charges,,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,97.5,370.5,
IPA EVALUATION OFSOUND PRODUCTION W LANG,36000202,CDM,92523,CPT,440,RC,outpatient,GN,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.5,22,,percent of total billed charges,,,,,,,,,351,90,,percent of total billed charges,,,322.92,82.8,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.5,22,,percent of total billed charges,,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,97.5,370.5,
IPA BEHAVIORAL AND QUAL ANALYSIS OF V,36000203,CDM,92524,CPT,440,RC,outpatient,GN,390,390,,331.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,97.5,22,,percent of total billed charges,,,,,,,,,351,90,,percent of total billed charges,,,322.92,82.8,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,,,,,,,,343.2,88,,percent of total billed charges,,,,,,,,,297.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,97.5,22,,percent of total billed charges,,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,,,,,,,,,,,,,323.7,83,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,319.8,82,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,97.5,370.5,
 SPEECH THERAPY EVALUATION 15 MIN,36092521,CDM,92521,CPT,440,RC,outpatient,GN,780,780,,662.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195,22,,percent of total billed charges,,,,,,,,,702,90,,percent of total billed charges,,,645.84,82.8,,percent of total billed charges,,,663,85,,percent of total billed charges,,,,,,,,,686.4,88,,percent of total billed charges,,,,,,,,,595.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195,22,,percent of total billed charges,,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,,,,,,,,,,,,,647.4,83,,percent of total billed charges,,,741,95,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,639.6,82,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,195,741,
EVALUATION OF SPEECH SOUND PRODUCTION,36092522,CDM,92522,CPT,440,RC,outpatient,GN,780,780,,662.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195,22,,percent of total billed charges,,,,,,,,,702,90,,percent of total billed charges,,,645.84,82.8,,percent of total billed charges,,,663,85,,percent of total billed charges,,,,,,,,,686.4,88,,percent of total billed charges,,,,,,,,,595.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195,22,,percent of total billed charges,,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,,,,,,,,,,,,,647.4,83,,percent of total billed charges,,,741,95,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,639.6,82,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,195,741,
EVALUATION OFSOUND PRODUCTION W LANGUAGE,36092523,CDM,92523,CPT,440,RC,outpatient,GN,780,780,,662.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195,22,,percent of total billed charges,,,,,,,,,702,90,,percent of total billed charges,,,645.84,82.8,,percent of total billed charges,,,663,85,,percent of total billed charges,,,,,,,,,686.4,88,,percent of total billed charges,,,,,,,,,595.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195,22,,percent of total billed charges,,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,,,,,,,,,,,,,647.4,83,,percent of total billed charges,,,741,95,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,639.6,82,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,195,741,
BEHAVIORAL AND QUALITATIVE ANALYSIS OF V,36092524,CDM,92524,CPT,440,RC,outpatient,GN,780,780,,662.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195,22,,percent of total billed charges,,,,,,,,,702,90,,percent of total billed charges,,,645.84,82.8,,percent of total billed charges,,,663,85,,percent of total billed charges,,,,,,,,,686.4,88,,percent of total billed charges,,,,,,,,,595.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195,22,,percent of total billed charges,,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,,,,,,,,,,,,,647.4,83,,percent of total billed charges,,,741,95,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,639.6,82,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,195,741,
"ST COGE SKILLS DEVT,EA 15 MIN W THCAP",36901300,CDM,97129,CPT,440,RC,outpatient,KX,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
"ST TX OF SPEECH,LNG,COMM &/OR AUDITORY",36901301,CDM,92507,CPT,440,RC,outpatient,KX,520,520,,441.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130,22,,percent of total billed charges,,,,,,,,,468,90,,percent of total billed charges,,,430.56,82.8,,percent of total billed charges,,,442,85,,percent of total billed charges,,,,,,,,,457.6,88,,percent of total billed charges,,,,,,,,,397.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130,22,,percent of total billed charges,,,473.2,91,,percent of total billed charges,,,494,95,,percent of total billed charges,,,431.6,83,,percent of total billed charges,,,431.6,83,,percent of total billed charges,,,,,,,,,,,,,,,431.6,83,,percent of total billed charges,,,494,95,,percent of total billed charges,,,468,90,,percent of total billed charges,,,468,90,,percent of total billed charges,,,426.4,82,,percent of total billed charges,,,468,90,,percent of total billed charges,,,442,85,,percent of total billed charges,,130,494,
 SPEECH THERAPY EVN 15 MIN W THCAP,36901302,CDM,92521,CPT,440,RC,outpatient,KX,780,780,,662.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195,22,,percent of total billed charges,,,,,,,,,702,90,,percent of total billed charges,,,645.84,82.8,,percent of total billed charges,,,663,85,,percent of total billed charges,,,,,,,,,686.4,88,,percent of total billed charges,,,,,,,,,595.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195,22,,percent of total billed charges,,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,,,,,,,,,,,,,647.4,83,,percent of total billed charges,,,741,95,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,639.6,82,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,195,741,
EVALN OF SPEECH SOUND PRODN W THCAP,36901303,CDM,92522,CPT,440,RC,outpatient,KX,780,780,,662.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195,22,,percent of total billed charges,,,,,,,,,702,90,,percent of total billed charges,,,645.84,82.8,,percent of total billed charges,,,663,85,,percent of total billed charges,,,,,,,,,686.4,88,,percent of total billed charges,,,,,,,,,595.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195,22,,percent of total billed charges,,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,,,,,,,,,,,,,647.4,83,,percent of total billed charges,,,741,95,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,639.6,82,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,195,741,
EVAON OFSOUND PRODN W LANGUAGE W THCAP,36901304,CDM,92523,CPT,440,RC,outpatient,KX,780,780,,662.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195,22,,percent of total billed charges,,,,,,,,,702,90,,percent of total billed charges,,,645.84,82.8,,percent of total billed charges,,,663,85,,percent of total billed charges,,,,,,,,,686.4,88,,percent of total billed charges,,,,,,,,,595.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195,22,,percent of total billed charges,,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,,,,,,,,,,,,,647.4,83,,percent of total billed charges,,,741,95,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,639.6,82,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,195,741,
BEHL AND QUALITAE ANALYSIS OF V W THCAP,36901305,CDM,92524,CPT,440,RC,outpatient,KX,780,780,,662.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195,22,,percent of total billed charges,,,,,,,,,702,90,,percent of total billed charges,,,645.84,82.8,,percent of total billed charges,,,663,85,,percent of total billed charges,,,,,,,,,686.4,88,,percent of total billed charges,,,,,,,,,595.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195,22,,percent of total billed charges,,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,,,,,,,,,,,,,647.4,83,,percent of total billed charges,,,741,95,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,639.6,82,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,195,741,
ST TREATMENT OF SW DYSN W THCAP,36901306,CDM,92526,CPT,440,RC,outpatient,KX,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.25,22,,percent of total billed charges,,,,,,,,,422.1,90,,percent of total billed charges,,,388.33,82.8,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.25,22,,percent of total billed charges,,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,117.25,445.55,
ST EVAL OF SPEECH DEVIC (1 HOUR) W THCAP,36901308,CDM,92607,CPT,444,RC,outpatient,KX,676,676,,573.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,169,22,,percent of total billed charges,,,,,,,,,608.4,90,,percent of total billed charges,,,559.73,82.8,,percent of total billed charges,,,574.6,85,,percent of total billed charges,,,,,,,,,594.88,88,,percent of total billed charges,,,,,,,,,516.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,169,22,,percent of total billed charges,,,615.16,91,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,,,,,,,,,,,,,561.08,83,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,554.32,82,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,574.6,85,,percent of total billed charges,,169,642.2,
"ST EVAL OF SPCH ,EA ADDTL 30 MIN W THCAP",36901309,CDM,92608,CPT,444,RC,outpatient,KX,223,223,,189.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.75,22,,percent of total billed charges,,,,,,,,,200.7,90,,percent of total billed charges,,,184.64,82.8,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,,,,,,,,196.24,88,,percent of total billed charges,,,,,,,,,170.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.75,22,,percent of total billed charges,,,202.93,91,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,,,,,,,,,,,,,185.09,83,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,182.86,82,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,55.75,211.85,
ST CLINICAL SWALLOW EVAL W THCAP,36901310,CDM,92610,CPT,444,RC,outpatient,KX,674,674,,572.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,168.5,22,,percent of total billed charges,,,,,,,,,606.6,90,,percent of total billed charges,,,558.07,82.8,,percent of total billed charges,,,572.9,85,,percent of total billed charges,,,,,,,,,593.12,88,,percent of total billed charges,,,,,,,,,514.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,168.5,22,,percent of total billed charges,,,613.34,91,,percent of total billed charges,,,640.3,95,,percent of total billed charges,,,559.42,83,,percent of total billed charges,,,559.42,83,,percent of total billed charges,,,,,,,,,,,,,,,559.42,83,,percent of total billed charges,,,640.3,95,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,552.68,82,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,572.9,85,,percent of total billed charges,,168.5,640.3,
ST BARIUM SWALLOW EVALUATION W THCAP,36901311,CDM,92611,CPT,444,RC,outpatient,KX,944,944,,801.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,236,22,,percent of total billed charges,,,,,,,,,849.6,90,,percent of total billed charges,,,781.63,82.8,,percent of total billed charges,,,802.4,85,,percent of total billed charges,,,,,,,,,830.72,88,,percent of total billed charges,,,,,,,,,721.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,236,22,,percent of total billed charges,,,859.04,91,,percent of total billed charges,,,896.8,95,,percent of total billed charges,,,783.52,83,,percent of total billed charges,,,783.52,83,,percent of total billed charges,,,,,,,,,,,,,,,783.52,83,,percent of total billed charges,,,896.8,95,,percent of total billed charges,,,849.6,90,,percent of total billed charges,,,849.6,90,,percent of total billed charges,,,774.08,82,,percent of total billed charges,,,849.6,90,,percent of total billed charges,,,802.4,85,,percent of total billed charges,,236,896.8,
"ST ASSESS OF APIA W/INTERP,EA HR W THCAP",36901312,CDM,96105,CPT,440,RC,outpatient,KX,676,676,,573.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,169,22,,percent of total billed charges,,,,,,,,,608.4,90,,percent of total billed charges,,,559.73,82.8,,percent of total billed charges,,,574.6,85,,percent of total billed charges,,,,,,,,,594.88,88,,percent of total billed charges,,,,,,,,,516.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,169,22,,percent of total billed charges,,,615.16,91,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,,,,,,,,,,,,,561.08,83,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,554.32,82,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,574.6,85,,percent of total billed charges,,169,642.2,
"ST DEVE TESTING W INTERP, EA HR W THCAP",36901313,CDM,96111,CPT,440,RC,outpatient,KX,676,676,,573.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,169,22,,percent of total billed charges,,,,,,,,,608.4,90,,percent of total billed charges,,,559.73,82.8,,percent of total billed charges,,,574.6,85,,percent of total billed charges,,,,,,,,,594.88,88,,percent of total billed charges,,,,,,,,,516.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,169,22,,percent of total billed charges,,,615.16,91,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,,,,,,,,,,,,,561.08,83,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,554.32,82,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,574.6,85,,percent of total billed charges,,169,642.2,
ST STAND COGN PERF TEST PER HOUR W THCAP,36901314,CDM,96125,CPT,444,RC,outpatient,KX,676,676,,573.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,169,22,,percent of total billed charges,,,,,,,,,608.4,90,,percent of total billed charges,,,559.73,82.8,,percent of total billed charges,,,574.6,85,,percent of total billed charges,,,,,,,,,594.88,88,,percent of total billed charges,,,,,,,,,516.46,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,169,22,,percent of total billed charges,,,615.16,91,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,,,,,,,,,,,,,561.08,83,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,554.32,82,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,574.6,85,,percent of total billed charges,,169,642.2,
ST ORAL SPEECH DEVICE EVAL,36901315,CDM,92597,CPT,440,RC,outpatient,GN,654,654,,555.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,163.5,22,,percent of total billed charges,,,,,,,,,588.6,90,,percent of total billed charges,,,541.51,82.8,,percent of total billed charges,,,555.9,85,,percent of total billed charges,,,,,,,,,575.52,88,,percent of total billed charges,,,,,,,,,499.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,163.5,22,,percent of total billed charges,,,595.14,91,,percent of total billed charges,,,621.3,95,,percent of total billed charges,,,542.82,83,,percent of total billed charges,,,542.82,83,,percent of total billed charges,,,,,,,,,,,,,,,542.82,83,,percent of total billed charges,,,621.3,95,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,536.28,82,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,555.9,85,,percent of total billed charges,,163.5,621.3,
ST ENDOSCOPY SWALLOW VID,36901316,CDM,92612,CPT,440,RC,outpatient,GN,841,841,,714.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,210.25,22,,percent of total billed charges,,,,,,,,,756.9,90,,percent of total billed charges,,,696.35,82.8,,percent of total billed charges,,,714.85,85,,percent of total billed charges,,,,,,,,,740.08,88,,percent of total billed charges,,,,,,,,,642.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,210.25,22,,percent of total billed charges,,,765.31,91,,percent of total billed charges,,,798.95,95,,percent of total billed charges,,,698.03,83,,percent of total billed charges,,,698.03,83,,percent of total billed charges,,,,,,,,,,,,,,,698.03,83,,percent of total billed charges,,,798.95,95,,percent of total billed charges,,,756.9,90,,percent of total billed charges,,,756.9,90,,percent of total billed charges,,,689.62,82,,percent of total billed charges,,,756.9,90,,percent of total billed charges,,,714.85,85,,percent of total billed charges,,210.25,798.95,
YAG LASER EYE PROCEDURE,18300279,CDM,,,360,RC,outpatient,,3874,3874,,3289.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,968.5,22,,percent of total billed charges,,,,,,,,,3486.6,90,,percent of total billed charges,,,3207.67,82.8,,percent of total billed charges,,,3292.9,85,,percent of total billed charges,,,,,,,,,3409.12,88,,percent of total billed charges,,,,,,,,,2959.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,968.5,22,,percent of total billed charges,,,3525.34,91,,percent of total billed charges,,,3680.3,95,,percent of total billed charges,,,3215.42,83,,percent of total billed charges,,,3215.42,83,,percent of total billed charges,,,,,,,,,,,,,,,3215.42,83,,percent of total billed charges,,,3680.3,95,,percent of total billed charges,,,3486.6,90,,percent of total billed charges,,,3486.6,90,,percent of total billed charges,,,3176.68,82,,percent of total billed charges,,,3486.6,90,,percent of total billed charges,,,3292.9,85,,percent of total billed charges,,968.5,3680.3,
FOREIGN BODY REMOVAL (ENDOSCOPIC) MAJOR,18307927,CDM,,,360,RC,outpatient,,1945,1945,,1651.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,486.25,22,,percent of total billed charges,,,,,,,,,1750.5,90,,percent of total billed charges,,,1610.46,82.8,,percent of total billed charges,,,1653.25,85,,percent of total billed charges,,,,,,,,,1711.6,88,,percent of total billed charges,,,,,,,,,1485.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,486.25,22,,percent of total billed charges,,,1769.95,91,,percent of total billed charges,,,1847.75,95,,percent of total billed charges,,,1614.35,83,,percent of total billed charges,,,1614.35,83,,percent of total billed charges,,,,,,,,,,,,,,,1614.35,83,,percent of total billed charges,,,1847.75,95,,percent of total billed charges,,,1750.5,90,,percent of total billed charges,,,1750.5,90,,percent of total billed charges,,,1594.9,82,,percent of total billed charges,,,1750.5,90,,percent of total billed charges,,,1653.25,85,,percent of total billed charges,,486.25,1847.75,
* Z/OR (V0405),18307931,CDM,,,270,RC,outpatient,,314,314,,266.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.5,22,,percent of total billed charges,,,,,,,,,282.6,90,,percent of total billed charges,,,259.99,82.8,,percent of total billed charges,,,266.9,85,,percent of total billed charges,,,,,,,,,276.32,88,,percent of total billed charges,,,,,,,,,239.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.5,22,,percent of total billed charges,,,285.74,91,,percent of total billed charges,,,298.3,95,,percent of total billed charges,,,260.62,83,,percent of total billed charges,,,260.62,83,,percent of total billed charges,,,,,,,,,,,,,,,260.62,83,,percent of total billed charges,,,298.3,95,,percent of total billed charges,,,282.6,90,,percent of total billed charges,,,282.6,90,,percent of total billed charges,,,257.48,82,,percent of total billed charges,,,282.6,90,,percent of total billed charges,,,266.9,85,,percent of total billed charges,,78.5,298.3,
FOREIGN BODY REMOVAL (ENDOSCOPIC) MINOR,18307959,CDM,,,360,RC,outpatient,,614,614,,521.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,153.5,22,,percent of total billed charges,,,,,,,,,552.6,90,,percent of total billed charges,,,508.39,82.8,,percent of total billed charges,,,521.9,85,,percent of total billed charges,,,,,,,,,540.32,88,,percent of total billed charges,,,,,,,,,469.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,153.5,22,,percent of total billed charges,,,558.74,91,,percent of total billed charges,,,583.3,95,,percent of total billed charges,,,509.62,83,,percent of total billed charges,,,509.62,83,,percent of total billed charges,,,,,,,,,,,,,,,509.62,83,,percent of total billed charges,,,583.3,95,,percent of total billed charges,,,552.6,90,,percent of total billed charges,,,552.6,90,,percent of total billed charges,,,503.48,82,,percent of total billed charges,,,552.6,90,,percent of total billed charges,,,521.9,85,,percent of total billed charges,,153.5,583.3,
* ANESTHESIA CHG CPT 00120 1 HOUR(V0306),18400120,CDM,120,CPT,370,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
* ANESTHESIA CHG CPT 00140 1 HOUR(V0306),18400140,CDM,140,CPT,370,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
* ANESTHESIA CHG CPT 00142 1 HOUR(V0306),18400142,CDM,142,CPT,370,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
* ANESTHESIA CHG CPT 00300 1 HOUR(V0306),18400300,CDM,300,CPT,370,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
* ANESTHESIA CHG CPT 00320 1 HOUR(V0306),18400320,CDM,320,CPT,370,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
* ANESTHESIA CHG CPT 00400 1 HOUR(V0306),18400400,CDM,400,CPT,370,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
* ANESTHESIA CHG CPT 00750 1 HOUR(V0306),18400750,CDM,750,CPT,370,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
* ANESTHESIA CHG CPT 00790 1 HOUR(V0306),18400790,CDM,790,CPT,370,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
* ANESTHESIA CHG CPT 00830 1 HOUR(V0306),18400830,CDM,830,CPT,370,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
* ANESTHESIA CHG CPT 00840 1 HOUR(V0306),18400840,CDM,840,CPT,370,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
* ANESTHESIA CHG CPT 01480 1 HOUR(V0306),18401480,CDM,1480,CPT,370,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
* ANESTHESIA CHG CPT 01961 1 HOUR(V0306),18401961,CDM,1961,CPT,370,RC,outpatient,,665,665,,564.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,166.25,22,,percent of total billed charges,,,,,,,,,598.5,90,,percent of total billed charges,,,550.62,82.8,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,,,,,,,,585.2,88,,percent of total billed charges,,,,,,,,,508.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,166.25,22,,percent of total billed charges,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,,,,,,,,,,,,,551.95,83,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,545.3,82,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,166.25,631.75,
*ANESTHESIA EGD(V1007),18502000,CDM,,,370,RC,outpatient,,540,540,,458.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,135,22,,percent of total billed charges,,,,,,,,,486,90,,percent of total billed charges,,,447.12,82.8,,percent of total billed charges,,,459,85,,percent of total billed charges,,,,,,,,,475.2,88,,percent of total billed charges,,,,,,,,,412.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,135,22,,percent of total billed charges,,,491.4,91,,percent of total billed charges,,,513,95,,percent of total billed charges,,,448.2,83,,percent of total billed charges,,,448.2,83,,percent of total billed charges,,,,,,,,,,,,,,,448.2,83,,percent of total billed charges,,,513,95,,percent of total billed charges,,,486,90,,percent of total billed charges,,,486,90,,percent of total billed charges,,,442.8,82,,percent of total billed charges,,,486,90,,percent of total billed charges,,,459,85,,percent of total billed charges,,135,513,
*ANESTHESIA COLONOSCOPY(V1007),18502005,CDM,,,370,RC,outpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.75,22,,percent of total billed charges,,,,,,,,,2.7,90,,percent of total billed charges,,,2.48,82.8,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.75,22,,percent of total billed charges,,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,0.75,2.85,
*ANESTHESIA EPIDURAL BLOOD PATCH(V1007),18502010,CDM,62273,CPT,360,RC,outpatient,,286,286,,242.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.5,22,,percent of total billed charges,,,,,,,,,257.4,90,,percent of total billed charges,,,236.81,82.8,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,,,,,,,,251.68,88,,percent of total billed charges,,,,,,,,,218.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.5,22,,percent of total billed charges,,,260.26,91,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,,,,,,,,,,,,,237.38,83,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,234.52,82,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,71.5,271.7,
ANESTHESIA EPIDURAL STEROID INJ,18502015,CDM,,,370,RC,outpatient,,286,286,,242.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.5,22,,percent of total billed charges,,,,,,,,,257.4,90,,percent of total billed charges,,,236.81,82.8,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,,,,,,,,251.68,88,,percent of total billed charges,,,,,,,,,218.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.5,22,,percent of total billed charges,,,260.26,91,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,,,,,,,,,,,,,237.38,83,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,234.52,82,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,71.5,271.7,
ANESTHESIA INTERCOSTAL NERVE,18502020,CDM,,,370,RC,outpatient,,286,286,,242.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.5,22,,percent of total billed charges,,,,,,,,,257.4,90,,percent of total billed charges,,,236.81,82.8,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,,,,,,,,251.68,88,,percent of total billed charges,,,,,,,,,218.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.5,22,,percent of total billed charges,,,260.26,91,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,,,,,,,,,,,,,237.38,83,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,234.52,82,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,71.5,271.7,
ANESTHESIA LABOR EPIDURAL,18502025,CDM,,,370,RC,outpatient,,286,286,,242.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.5,22,,percent of total billed charges,,,,,,,,,257.4,90,,percent of total billed charges,,,236.81,82.8,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,,,,,,,,251.68,88,,percent of total billed charges,,,,,,,,,218.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.5,22,,percent of total billed charges,,,260.26,91,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,,,,,,,,,,,,,237.38,83,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,234.52,82,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,71.5,271.7,
ANESTHESIA DX LUMBAR PUNCTURE,18502030,CDM,,,370,RC,outpatient,,286,286,,242.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,71.5,22,,percent of total billed charges,,,,,,,,,257.4,90,,percent of total billed charges,,,236.81,82.8,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,,,,,,,,251.68,88,,percent of total billed charges,,,,,,,,,218.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,71.5,22,,percent of total billed charges,,,260.26,91,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,237.38,83,,percent of total billed charges,,,,,,,,,,,,,,,237.38,83,,percent of total billed charges,,,271.7,95,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,234.52,82,,percent of total billed charges,,,257.4,90,,percent of total billed charges,,,243.1,85,,percent of total billed charges,,71.5,271.7,
*ANESTHESIA TECH FEE 1/2 HOUR(V1007),18502035,CDM,,,370,RC,outpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.75,22,,percent of total billed charges,,,,,,,,,2.7,90,,percent of total billed charges,,,2.48,82.8,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.75,22,,percent of total billed charges,,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,0.75,2.85,
 *ANESTHESIA TECH FEE 1 HOUR(V 1007),18502040,CDM,,,370,RC,outpatient,,1143,1143,,970.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,285.75,22,,percent of total billed charges,,,,,,,,,1028.7,90,,percent of total billed charges,,,946.4,82.8,,percent of total billed charges,,,971.55,85,,percent of total billed charges,,,,,,,,,1005.84,88,,percent of total billed charges,,,,,,,,,873.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,285.75,22,,percent of total billed charges,,,1040.13,91,,percent of total billed charges,,,1085.85,95,,percent of total billed charges,,,948.69,83,,percent of total billed charges,,,948.69,83,,percent of total billed charges,,,,,,,,,,,,,,,948.69,83,,percent of total billed charges,,,1085.85,95,,percent of total billed charges,,,1028.7,90,,percent of total billed charges,,,1028.7,90,,percent of total billed charges,,,937.26,82,,percent of total billed charges,,,1028.7,90,,percent of total billed charges,,,971.55,85,,percent of total billed charges,,285.75,1085.85,
DILATION OF ESOPHAGUS,18601120,CDM,,,360,RC,outpatient,,2336,2336,,1983.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,584,22,,percent of total billed charges,,,,,,,,,2102.4,90,,percent of total billed charges,,,1934.21,82.8,,percent of total billed charges,,,1985.6,85,,percent of total billed charges,,,,,,,,,2055.68,88,,percent of total billed charges,,,,,,,,,1784.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,584,22,,percent of total billed charges,,,2125.76,91,,percent of total billed charges,,,2219.2,95,,percent of total billed charges,,,1938.88,83,,percent of total billed charges,,,1938.88,83,,percent of total billed charges,,,,,,,,,,,,,,,1938.88,83,,percent of total billed charges,,,2219.2,95,,percent of total billed charges,,,2102.4,90,,percent of total billed charges,,,2102.4,90,,percent of total billed charges,,,1915.52,82,,percent of total billed charges,,,2102.4,90,,percent of total billed charges,,,1985.6,85,,percent of total billed charges,,584,2219.2,
BRAVO GASTROESOPHAGEAL REFLUX TEST,18601121,CDM,91035,CPT,360,RC,outpatient,,3254,3254,,2762.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,813.5,22,,percent of total billed charges,,,,,,,,,2928.6,90,,percent of total billed charges,,,2694.31,82.8,,percent of total billed charges,,,2765.9,85,,percent of total billed charges,,,,,,,,,2863.52,88,,percent of total billed charges,,,,,,,,,2486.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,813.5,22,,percent of total billed charges,,,2961.14,91,,percent of total billed charges,,,3091.3,95,,percent of total billed charges,,,2700.82,83,,percent of total billed charges,,,2700.82,83,,percent of total billed charges,,,,,,,,,,,,,,,2700.82,83,,percent of total billed charges,,,3091.3,95,,percent of total billed charges,,,2928.6,90,,percent of total billed charges,,,2928.6,90,,percent of total billed charges,,,2668.28,82,,percent of total billed charges,,,2928.6,90,,percent of total billed charges,,,2765.9,85,,percent of total billed charges,,813.5,3091.3,
ENDOSCOPIC MUCOSAL RESECTION,18601122,CDM,,,360,RC,outpatient,,1329,1329,,1128.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,332.25,22,,percent of total billed charges,,,,,,,,,1196.1,90,,percent of total billed charges,,,1100.41,82.8,,percent of total billed charges,,,1129.65,85,,percent of total billed charges,,,,,,,,,1169.52,88,,percent of total billed charges,,,,,,,,,1015.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,332.25,22,,percent of total billed charges,,,1209.39,91,,percent of total billed charges,,,1262.55,95,,percent of total billed charges,,,1103.07,83,,percent of total billed charges,,,1103.07,83,,percent of total billed charges,,,,,,,,,,,,,,,1103.07,83,,percent of total billed charges,,,1262.55,95,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1089.78,82,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1129.65,85,,percent of total billed charges,,332.25,1262.55,
PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE,18601123,CDM,43246,CPT,360,RC,outpatient,,3573,3573,,3033.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,893.25,22,,percent of total billed charges,,,,,,,,,3215.7,90,,percent of total billed charges,,,2958.44,82.8,,percent of total billed charges,,,3037.05,85,,percent of total billed charges,,,,,,,,,3144.24,88,,percent of total billed charges,,,,,,,,,2729.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,893.25,22,,percent of total billed charges,,,3251.43,91,,percent of total billed charges,,,3394.35,95,,percent of total billed charges,,,2965.59,83,,percent of total billed charges,,,2965.59,83,,percent of total billed charges,,,,,,,,,,,,,,,2965.59,83,,percent of total billed charges,,,3394.35,95,,percent of total billed charges,,,3215.7,90,,percent of total billed charges,,,3215.7,90,,percent of total billed charges,,,2929.86,82,,percent of total billed charges,,,3215.7,90,,percent of total billed charges,,,3037.05,85,,percent of total billed charges,,893.25,3394.35,
ESOPH BALLOON DISTENSION TEST,18601124,CDM,91040,CPT,750,RC,outpatient,,2675,2675,,2271.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,668.75,22,,percent of total billed charges,,,,,,,,,2407.5,90,,percent of total billed charges,,,2214.9,82.8,,percent of total billed charges,,,2273.75,85,,percent of total billed charges,,,,,,,,,2354,88,,percent of total billed charges,,,,,,,,,2043.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,668.75,22,,percent of total billed charges,,,2434.25,91,,percent of total billed charges,,,2541.25,95,,percent of total billed charges,,,2220.25,83,,percent of total billed charges,,,2220.25,83,,percent of total billed charges,,,,,,,,,,,,,,,2220.25,83,,percent of total billed charges,,,2541.25,95,,percent of total billed charges,,,2407.5,90,,percent of total billed charges,,,2407.5,90,,percent of total billed charges,,,2193.5,82,,percent of total billed charges,,,2407.5,90,,percent of total billed charges,,,2273.75,85,,percent of total billed charges,,668.75,2541.25,
ENDOSCOPY SMALL INTESTINE,18601125,CDM,44360,CPT,360,RC,outpatient,,5413,5413,,4595.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1353.25,22,,percent of total billed charges,,,,,,,,,4871.7,90,,percent of total billed charges,,,4481.96,82.8,,percent of total billed charges,,,4601.05,85,,percent of total billed charges,,,,,,,,,4763.44,88,,percent of total billed charges,,,,,,,,,4135.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1353.25,22,,percent of total billed charges,,,4925.83,91,,percent of total billed charges,,,5142.35,95,,percent of total billed charges,,,4492.79,83,,percent of total billed charges,,,4492.79,83,,percent of total billed charges,,,,,,,,,,,,,,,4492.79,83,,percent of total billed charges,,,5142.35,95,,percent of total billed charges,,,4871.7,90,,percent of total billed charges,,,4871.7,90,,percent of total billed charges,,,4438.66,82,,percent of total billed charges,,,4871.7,90,,percent of total billed charges,,,4601.05,85,,percent of total billed charges,,1353.25,5142.35,
SIGMOIDOSCOPY,18601144,CDM,,,360,RC,outpatient,,6153,6153,,5223.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1538.25,22,,percent of total billed charges,,,,,,,,,5537.7,90,,percent of total billed charges,,,5094.68,82.8,,percent of total billed charges,,,5230.05,85,,percent of total billed charges,,,,,,,,,5414.64,88,,percent of total billed charges,,,,,,,,,4700.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1538.25,22,,percent of total billed charges,,,5599.23,91,,percent of total billed charges,,,5845.35,95,,percent of total billed charges,,,5106.99,83,,percent of total billed charges,,,5106.99,83,,percent of total billed charges,,,,,,,,,,,,,,,5106.99,83,,percent of total billed charges,,,5845.35,95,,percent of total billed charges,,,5537.7,90,,percent of total billed charges,,,5537.7,90,,percent of total billed charges,,,5045.46,82,,percent of total billed charges,,,5537.7,90,,percent of total billed charges,,,5230.05,85,,percent of total billed charges,,1538.25,5845.35,
* URETEROSCOPY (V1004),18601146,CDM,,,360,RC,outpatient,,973,973,,826.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,243.25,22,,percent of total billed charges,,,,,,,,,875.7,90,,percent of total billed charges,,,805.64,82.8,,percent of total billed charges,,,827.05,85,,percent of total billed charges,,,,,,,,,856.24,88,,percent of total billed charges,,,,,,,,,743.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,243.25,22,,percent of total billed charges,,,885.43,91,,percent of total billed charges,,,924.35,95,,percent of total billed charges,,,807.59,83,,percent of total billed charges,,,807.59,83,,percent of total billed charges,,,,,,,,,,,,,,,807.59,83,,percent of total billed charges,,,924.35,95,,percent of total billed charges,,,875.7,90,,percent of total billed charges,,,875.7,90,,percent of total billed charges,,,797.86,82,,percent of total billed charges,,,875.7,90,,percent of total billed charges,,,827.05,85,,percent of total billed charges,,243.25,924.35,
QUICK-LIFT SURGERY,18602050,CDM,,,360,RC,outpatient,,12746,12746,,10821.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3186.5,22,,percent of total billed charges,,,,,,,,,11471.4,90,,percent of total billed charges,,,10553.69,82.8,,percent of total billed charges,,,10834.1,85,,percent of total billed charges,,,,,,,,,11216.48,88,,percent of total billed charges,,,,,,,,,9737.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3186.5,22,,percent of total billed charges,,,11598.86,91,,percent of total billed charges,,,12108.7,95,,percent of total billed charges,,,10579.18,83,,percent of total billed charges,,,10579.18,83,,percent of total billed charges,,,,,,,,,,,,,,,10579.18,83,,percent of total billed charges,,,12108.7,95,,percent of total billed charges,,,11471.4,90,,percent of total billed charges,,,11471.4,90,,percent of total billed charges,,,10451.72,82,,percent of total billed charges,,,11471.4,90,,percent of total billed charges,,,10834.1,85,,percent of total billed charges,,3186.5,12108.7,
COSMETIC NECK CONTOUR SURGERY,18602051,CDM,,,360,RC,outpatient,,3190,3190,,2708.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,797.5,22,,percent of total billed charges,,,,,,,,,2871,90,,percent of total billed charges,,,2641.32,82.8,,percent of total billed charges,,,2711.5,85,,percent of total billed charges,,,,,,,,,2807.2,88,,percent of total billed charges,,,,,,,,,2437.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,797.5,22,,percent of total billed charges,,,2902.9,91,,percent of total billed charges,,,3030.5,95,,percent of total billed charges,,,2647.7,83,,percent of total billed charges,,,2647.7,83,,percent of total billed charges,,,,,,,,,,,,,,,2647.7,83,,percent of total billed charges,,,3030.5,95,,percent of total billed charges,,,2871,90,,percent of total billed charges,,,2871,90,,percent of total billed charges,,,2615.8,82,,percent of total billed charges,,,2871,90,,percent of total billed charges,,,2711.5,85,,percent of total billed charges,,797.5,3030.5,
COSMETIC EYELIDS UPPER/LOW SURGERY,18602052,CDM,,,360,RC,outpatient,,8500,8500,,7216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2125,22,,percent of total billed charges,,,,,,,,,7650,90,,percent of total billed charges,,,7038,82.8,,percent of total billed charges,,,7225,85,,percent of total billed charges,,,,,,,,,7480,88,,percent of total billed charges,,,,,,,,,6494,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2125,22,,percent of total billed charges,,,7735,91,,percent of total billed charges,,,8075,95,,percent of total billed charges,,,7055,83,,percent of total billed charges,,,7055,83,,percent of total billed charges,,,,,,,,,,,,,,,7055,83,,percent of total billed charges,,,8075,95,,percent of total billed charges,,,7650,90,,percent of total billed charges,,,7650,90,,percent of total billed charges,,,6970,82,,percent of total billed charges,,,7650,90,,percent of total billed charges,,,7225,85,,percent of total billed charges,,2125,8075,
COSMETIC FOREHEAD LIFT SURGERY,18602053,CDM,,,360,RC,outpatient,,7436,7436,,6313.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1859,22,,percent of total billed charges,,,,,,,,,6692.4,90,,percent of total billed charges,,,6157.01,82.8,,percent of total billed charges,,,6320.6,85,,percent of total billed charges,,,,,,,,,6543.68,88,,percent of total billed charges,,,,,,,,,5681.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1859,22,,percent of total billed charges,,,6766.76,91,,percent of total billed charges,,,7064.2,95,,percent of total billed charges,,,6171.88,83,,percent of total billed charges,,,6171.88,83,,percent of total billed charges,,,,,,,,,,,,,,,6171.88,83,,percent of total billed charges,,,7064.2,95,,percent of total billed charges,,,6692.4,90,,percent of total billed charges,,,6692.4,90,,percent of total billed charges,,,6097.52,82,,percent of total billed charges,,,6692.4,90,,percent of total billed charges,,,6320.6,85,,percent of total billed charges,,1859,7064.2,
COSMETIC LIPO PER AREA SURGERY,18602054,CDM,,,360,RC,outpatient,,5951,5951,,5052.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1487.75,22,,percent of total billed charges,,,,,,,,,5355.9,90,,percent of total billed charges,,,4927.43,82.8,,percent of total billed charges,,,5058.35,85,,percent of total billed charges,,,,,,,,,5236.88,88,,percent of total billed charges,,,,,,,,,4546.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1487.75,22,,percent of total billed charges,,,5415.41,91,,percent of total billed charges,,,5653.45,95,,percent of total billed charges,,,4939.33,83,,percent of total billed charges,,,4939.33,83,,percent of total billed charges,,,,,,,,,,,,,,,4939.33,83,,percent of total billed charges,,,5653.45,95,,percent of total billed charges,,,5355.9,90,,percent of total billed charges,,,5355.9,90,,percent of total billed charges,,,4879.82,82,,percent of total billed charges,,,5355.9,90,,percent of total billed charges,,,5058.35,85,,percent of total billed charges,,1487.75,5653.45,
COSMETIC COLLAGEN FILL SURGERY,18602055,CDM,,,360,RC,outpatient,,2132,2132,,1810.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,533,22,,percent of total billed charges,,,,,,,,,1918.8,90,,percent of total billed charges,,,1765.3,82.8,,percent of total billed charges,,,1812.2,85,,percent of total billed charges,,,,,,,,,1876.16,88,,percent of total billed charges,,,,,,,,,1628.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,533,22,,percent of total billed charges,,,1940.12,91,,percent of total billed charges,,,2025.4,95,,percent of total billed charges,,,1769.56,83,,percent of total billed charges,,,1769.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1769.56,83,,percent of total billed charges,,,2025.4,95,,percent of total billed charges,,,1918.8,90,,percent of total billed charges,,,1918.8,90,,percent of total billed charges,,,1748.24,82,,percent of total billed charges,,,1918.8,90,,percent of total billed charges,,,1812.2,85,,percent of total billed charges,,533,2025.4,
COSMETIC BROWLIFT SURGERY,18602056,CDM,,,360,RC,outpatient,,2550,2550,,2164.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,637.5,22,,percent of total billed charges,,,,,,,,,2295,90,,percent of total billed charges,,,2111.4,82.8,,percent of total billed charges,,,2167.5,85,,percent of total billed charges,,,,,,,,,2244,88,,percent of total billed charges,,,,,,,,,1948.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,637.5,22,,percent of total billed charges,,,2320.5,91,,percent of total billed charges,,,2422.5,95,,percent of total billed charges,,,2116.5,83,,percent of total billed charges,,,2116.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2116.5,83,,percent of total billed charges,,,2422.5,95,,percent of total billed charges,,,2295,90,,percent of total billed charges,,,2295,90,,percent of total billed charges,,,2091,82,,percent of total billed charges,,,2295,90,,percent of total billed charges,,,2167.5,85,,percent of total billed charges,,637.5,2422.5,
COSMETIC FACE/NECK/COUNT/LIPO,18602057,CDM,,,360,RC,outpatient,,16063,16063,,13637.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4015.75,22,,percent of total billed charges,,,,,,,,,14456.7,90,,percent of total billed charges,,,13300.16,82.8,,percent of total billed charges,,,13653.55,85,,percent of total billed charges,,,,,,,,,14135.44,88,,percent of total billed charges,,,,,,,,,12272.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4015.75,22,,percent of total billed charges,,,14617.33,91,,percent of total billed charges,,,15259.85,95,,percent of total billed charges,,,13332.29,83,,percent of total billed charges,,,13332.29,83,,percent of total billed charges,,,,,,,,,,,,,,,13332.29,83,,percent of total billed charges,,,15259.85,95,,percent of total billed charges,,,14456.7,90,,percent of total billed charges,,,14456.7,90,,percent of total billed charges,,,13171.66,82,,percent of total billed charges,,,14456.7,90,,percent of total billed charges,,,13653.55,85,,percent of total billed charges,,4015.75,15259.85,
BRACHIAL PLEXUS CONT INFUS BY CATHETER,18602061,CDM,64416,CPT,360,RC,outpatient,,1139,1139,,967.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.75,22,,percent of total billed charges,,,,,,,,,1025.1,90,,percent of total billed charges,,,943.09,82.8,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,,,,,,,,1002.32,88,,percent of total billed charges,,,,,,,,,870.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.75,22,,percent of total billed charges,,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,,,,,,,,,,,,,945.37,83,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,933.98,82,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,284.75,1082.05,
INJECTION ANESTHETIC AGENT AXILLARY NERV,18602063,CDM,64417,CPT,360,RC,outpatient,,1139,1139,,967.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.75,22,,percent of total billed charges,,,,,,,,,1025.1,90,,percent of total billed charges,,,943.09,82.8,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,,,,,,,,1002.32,88,,percent of total billed charges,,,,,,,,,870.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.75,22,,percent of total billed charges,,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,,,,,,,,,,,,,945.37,83,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,933.98,82,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,284.75,1082.05,
SCIATIC NERVE CONT INFUS BY CATHETER,18602066,CDM,64446,CPT,360,RC,outpatient,,1139,1139,,967.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,284.75,22,,percent of total billed charges,,,,,,,,,1025.1,90,,percent of total billed charges,,,943.09,82.8,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,,,,,,,,1002.32,88,,percent of total billed charges,,,,,,,,,870.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,284.75,22,,percent of total billed charges,,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,,,,,,,,,,,,,945.37,83,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,933.98,82,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,284.75,1082.05,
FEMORAL NERVE CONT INFUS BY CATHETER,18602068,CDM,64448,CPT,360,RC,outpatient,,2276,2276,,1932.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,569,22,,percent of total billed charges,,,,,,,,,2048.4,90,,percent of total billed charges,,,1884.53,82.8,,percent of total billed charges,,,1934.6,85,,percent of total billed charges,,,,,,,,,2002.88,88,,percent of total billed charges,,,,,,,,,1738.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,569,22,,percent of total billed charges,,,2071.16,91,,percent of total billed charges,,,2162.2,95,,percent of total billed charges,,,1889.08,83,,percent of total billed charges,,,1889.08,83,,percent of total billed charges,,,,,,,,,,,,,,,1889.08,83,,percent of total billed charges,,,2162.2,95,,percent of total billed charges,,,2048.4,90,,percent of total billed charges,,,2048.4,90,,percent of total billed charges,,,1866.32,82,,percent of total billed charges,,,2048.4,90,,percent of total billed charges,,,1934.6,85,,percent of total billed charges,,569,2162.2,
LUMBAR PLEXUS POST APPR CONT INF CATHETR,18602069,CDM,64449,CPT,360,RC,outpatient,,1913,1913,,1624.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,478.25,22,,percent of total billed charges,,,,,,,,,1721.7,90,,percent of total billed charges,,,1583.96,82.8,,percent of total billed charges,,,1626.05,85,,percent of total billed charges,,,,,,,,,1683.44,88,,percent of total billed charges,,,,,,,,,1461.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,478.25,22,,percent of total billed charges,,,1740.83,91,,percent of total billed charges,,,1817.35,95,,percent of total billed charges,,,1587.79,83,,percent of total billed charges,,,1587.79,83,,percent of total billed charges,,,,,,,,,,,,,,,1587.79,83,,percent of total billed charges,,,1817.35,95,,percent of total billed charges,,,1721.7,90,,percent of total billed charges,,,1721.7,90,,percent of total billed charges,,,1568.66,82,,percent of total billed charges,,,1721.7,90,,percent of total billed charges,,,1626.05,85,,percent of total billed charges,,478.25,1817.35,
MINOR PROCEDURE UP TO 1/2 HOUR,18602070,CDM,,,360,RC,outpatient,,3608,3608,,3063.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,902,22,,percent of total billed charges,,,,,,,,,3247.2,90,,percent of total billed charges,,,2987.42,82.8,,percent of total billed charges,,,3066.8,85,,percent of total billed charges,,,,,,,,,3175.04,88,,percent of total billed charges,,,,,,,,,2756.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,902,22,,percent of total billed charges,,,3283.28,91,,percent of total billed charges,,,3427.6,95,,percent of total billed charges,,,2994.64,83,,percent of total billed charges,,,2994.64,83,,percent of total billed charges,,,,,,,,,,,,,,,2994.64,83,,percent of total billed charges,,,3427.6,95,,percent of total billed charges,,,3247.2,90,,percent of total billed charges,,,3247.2,90,,percent of total billed charges,,,2958.56,82,,percent of total billed charges,,,3247.2,90,,percent of total billed charges,,,3066.8,85,,percent of total billed charges,,902,3427.6,
MINOR PROCEDURE UP TO 1 HOUR,18602071,CDM,,,360,RC,outpatient,,4739,4739,,4023.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1184.75,22,,percent of total billed charges,,,,,,,,,4265.1,90,,percent of total billed charges,,,3923.89,82.8,,percent of total billed charges,,,4028.15,85,,percent of total billed charges,,,,,,,,,4170.32,88,,percent of total billed charges,,,,,,,,,3620.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1184.75,22,,percent of total billed charges,,,4312.49,91,,percent of total billed charges,,,4502.05,95,,percent of total billed charges,,,3933.37,83,,percent of total billed charges,,,3933.37,83,,percent of total billed charges,,,,,,,,,,,,,,,3933.37,83,,percent of total billed charges,,,4502.05,95,,percent of total billed charges,,,4265.1,90,,percent of total billed charges,,,4265.1,90,,percent of total billed charges,,,3885.98,82,,percent of total billed charges,,,4265.1,90,,percent of total billed charges,,,4028.15,85,,percent of total billed charges,,1184.75,4502.05,
MINOR PROCEDURE UP TO 1 1/2 HOURS,18602072,CDM,,,360,RC,outpatient,,6020,6020,,5110.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1505,22,,percent of total billed charges,,,,,,,,,5418,90,,percent of total billed charges,,,4984.56,82.8,,percent of total billed charges,,,5117,85,,percent of total billed charges,,,,,,,,,5297.6,88,,percent of total billed charges,,,,,,,,,4599.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1505,22,,percent of total billed charges,,,5478.2,91,,percent of total billed charges,,,5719,95,,percent of total billed charges,,,4996.6,83,,percent of total billed charges,,,4996.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4996.6,83,,percent of total billed charges,,,5719,95,,percent of total billed charges,,,5418,90,,percent of total billed charges,,,5418,90,,percent of total billed charges,,,4936.4,82,,percent of total billed charges,,,5418,90,,percent of total billed charges,,,5117,85,,percent of total billed charges,,1505,5719,
MINOR PROCEDURE UP TO 2 HOURS,18602073,CDM,,,360,RC,outpatient,,8054,8054,,6837.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2013.5,22,,percent of total billed charges,,,,,,,,,7248.6,90,,percent of total billed charges,,,6668.71,82.8,,percent of total billed charges,,,6845.9,85,,percent of total billed charges,,,,,,,,,7087.52,88,,percent of total billed charges,,,,,,,,,6153.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2013.5,22,,percent of total billed charges,,,7329.14,91,,percent of total billed charges,,,7651.3,95,,percent of total billed charges,,,6684.82,83,,percent of total billed charges,,,6684.82,83,,percent of total billed charges,,,,,,,,,,,,,,,6684.82,83,,percent of total billed charges,,,7651.3,95,,percent of total billed charges,,,7248.6,90,,percent of total billed charges,,,7248.6,90,,percent of total billed charges,,,6604.28,82,,percent of total billed charges,,,7248.6,90,,percent of total billed charges,,,6845.9,85,,percent of total billed charges,,2013.5,7651.3,
MINOR COMPLICATED UP TO 1 HOUR,18602075,CDM,,,360,RC,outpatient,,5243,5243,,4451.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1310.75,22,,percent of total billed charges,,,,,,,,,4718.7,90,,percent of total billed charges,,,4341.2,82.8,,percent of total billed charges,,,4456.55,85,,percent of total billed charges,,,,,,,,,4613.84,88,,percent of total billed charges,,,,,,,,,4005.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1310.75,22,,percent of total billed charges,,,4771.13,91,,percent of total billed charges,,,4980.85,95,,percent of total billed charges,,,4351.69,83,,percent of total billed charges,,,4351.69,83,,percent of total billed charges,,,,,,,,,,,,,,,4351.69,83,,percent of total billed charges,,,4980.85,95,,percent of total billed charges,,,4718.7,90,,percent of total billed charges,,,4718.7,90,,percent of total billed charges,,,4299.26,82,,percent of total billed charges,,,4718.7,90,,percent of total billed charges,,,4456.55,85,,percent of total billed charges,,1310.75,4980.85,
MINOR COMPLICATED UP TO 2 HOURS,18602076,CDM,,,360,RC,outpatient,,7179,7179,,6094.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1794.75,22,,percent of total billed charges,,,,,,,,,6461.1,90,,percent of total billed charges,,,5944.21,82.8,,percent of total billed charges,,,6102.15,85,,percent of total billed charges,,,,,,,,,6317.52,88,,percent of total billed charges,,,,,,,,,5484.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1794.75,22,,percent of total billed charges,,,6532.89,91,,percent of total billed charges,,,6820.05,95,,percent of total billed charges,,,5958.57,83,,percent of total billed charges,,,5958.57,83,,percent of total billed charges,,,,,,,,,,,,,,,5958.57,83,,percent of total billed charges,,,6820.05,95,,percent of total billed charges,,,6461.1,90,,percent of total billed charges,,,6461.1,90,,percent of total billed charges,,,5886.78,82,,percent of total billed charges,,,6461.1,90,,percent of total billed charges,,,6102.15,85,,percent of total billed charges,,1794.75,6820.05,
MINOR COMPLICATED UP TO 3 HOURS,18602077,CDM,,,360,RC,outpatient,,11648,11648,,9889.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2912,22,,percent of total billed charges,,,,,,,,,10483.2,90,,percent of total billed charges,,,9644.54,82.8,,percent of total billed charges,,,9900.8,85,,percent of total billed charges,,,,,,,,,10250.24,88,,percent of total billed charges,,,,,,,,,8899.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2912,22,,percent of total billed charges,,,10599.68,91,,percent of total billed charges,,,11065.6,95,,percent of total billed charges,,,9667.84,83,,percent of total billed charges,,,9667.84,83,,percent of total billed charges,,,,,,,,,,,,,,,9667.84,83,,percent of total billed charges,,,11065.6,95,,percent of total billed charges,,,10483.2,90,,percent of total billed charges,,,10483.2,90,,percent of total billed charges,,,9551.36,82,,percent of total billed charges,,,10483.2,90,,percent of total billed charges,,,9900.8,85,,percent of total billed charges,,2912,11065.6,
MAJOR PROCEDURE UP TO 1 HOUR,18602080,CDM,,,360,RC,outpatient,,9568,9568,,8123.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2392,22,,percent of total billed charges,,,,,,,,,8611.2,90,,percent of total billed charges,,,7922.3,82.8,,percent of total billed charges,,,8132.8,85,,percent of total billed charges,,,,,,,,,8419.84,88,,percent of total billed charges,,,,,,,,,7309.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2392,22,,percent of total billed charges,,,8706.88,91,,percent of total billed charges,,,9089.6,95,,percent of total billed charges,,,7941.44,83,,percent of total billed charges,,,7941.44,83,,percent of total billed charges,,,,,,,,,,,,,,,7941.44,83,,percent of total billed charges,,,9089.6,95,,percent of total billed charges,,,8611.2,90,,percent of total billed charges,,,8611.2,90,,percent of total billed charges,,,7845.76,82,,percent of total billed charges,,,8611.2,90,,percent of total billed charges,,,8132.8,85,,percent of total billed charges,,2392,9089.6,
MAJOR PROCEDURE UP TO 2 HOURS,18602081,CDM,,,360,RC,outpatient,,13306,13306,,11296.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3326.5,22,,percent of total billed charges,,,,,,,,,11975.4,90,,percent of total billed charges,,,11017.37,82.8,,percent of total billed charges,,,11310.1,85,,percent of total billed charges,,,,,,,,,11709.28,88,,percent of total billed charges,,,,,,,,,10165.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3326.5,22,,percent of total billed charges,,,12108.46,91,,percent of total billed charges,,,12640.7,95,,percent of total billed charges,,,11043.98,83,,percent of total billed charges,,,11043.98,83,,percent of total billed charges,,,,,,,,,,,,,,,11043.98,83,,percent of total billed charges,,,12640.7,95,,percent of total billed charges,,,11975.4,90,,percent of total billed charges,,,11975.4,90,,percent of total billed charges,,,10910.92,82,,percent of total billed charges,,,11975.4,90,,percent of total billed charges,,,11310.1,85,,percent of total billed charges,,3326.5,12640.7,
MAJOR PROCEDURE UP TO 3 HOURS,18602082,CDM,,,360,RC,outpatient,,18026,18026,,15304.07,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4506.5,22,,percent of total billed charges,,,,,,,,,16223.4,90,,percent of total billed charges,,,14925.53,82.8,,percent of total billed charges,,,15322.1,85,,percent of total billed charges,,,,,,,,,15862.88,88,,percent of total billed charges,,,,,,,,,13771.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4506.5,22,,percent of total billed charges,,,16403.66,91,,percent of total billed charges,,,17124.7,95,,percent of total billed charges,,,14961.58,83,,percent of total billed charges,,,14961.58,83,,percent of total billed charges,,,,,,,,,,,,,,,14961.58,83,,percent of total billed charges,,,17124.7,95,,percent of total billed charges,,,16223.4,90,,percent of total billed charges,,,16223.4,90,,percent of total billed charges,,,14781.32,82,,percent of total billed charges,,,16223.4,90,,percent of total billed charges,,,15322.1,85,,percent of total billed charges,,4506.5,17124.7,
MAJOR PROCEDURE UP TO 4 HOURS,18602083,CDM,,,360,RC,outpatient,,20352,20352,,17278.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5088,22,,percent of total billed charges,,,,,,,,,18316.8,90,,percent of total billed charges,,,16851.46,82.8,,percent of total billed charges,,,17299.2,85,,percent of total billed charges,,,,,,,,,17909.76,88,,percent of total billed charges,,,,,,,,,15548.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5088,22,,percent of total billed charges,,,18520.32,91,,percent of total billed charges,,,19334.4,95,,percent of total billed charges,,,16892.16,83,,percent of total billed charges,,,16892.16,83,,percent of total billed charges,,,,,,,,,,,,,,,16892.16,83,,percent of total billed charges,,,19334.4,95,,percent of total billed charges,,,18316.8,90,,percent of total billed charges,,,18316.8,90,,percent of total billed charges,,,16688.64,82,,percent of total billed charges,,,18316.8,90,,percent of total billed charges,,,17299.2,85,,percent of total billed charges,,5088,19334.4,
MAJOR PROCEDURE OVER 4 HOURS,18602084,CDM,,,360,RC,outpatient,,22423,22423,,19037.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5605.75,22,,percent of total billed charges,,,,,,,,,20180.7,90,,percent of total billed charges,,,18566.24,82.8,,percent of total billed charges,,,19059.55,85,,percent of total billed charges,,,,,,,,,19732.24,88,,percent of total billed charges,,,,,,,,,17131.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5605.75,22,,percent of total billed charges,,,20404.93,91,,percent of total billed charges,,,21301.85,95,,percent of total billed charges,,,18611.09,83,,percent of total billed charges,,,18611.09,83,,percent of total billed charges,,,,,,,,,,,,,,,18611.09,83,,percent of total billed charges,,,21301.85,95,,percent of total billed charges,,,20180.7,90,,percent of total billed charges,,,20180.7,90,,percent of total billed charges,,,18386.86,82,,percent of total billed charges,,,20180.7,90,,percent of total billed charges,,,19059.55,85,,percent of total billed charges,,5605.75,21301.85,
MAJOR COMPLICATED UP TO 1 HOUR,18602090,CDM,,,360,RC,outpatient,,15873,15873,,13476.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3968.25,22,,percent of total billed charges,,,,,,,,,14285.7,90,,percent of total billed charges,,,13142.84,82.8,,percent of total billed charges,,,13492.05,85,,percent of total billed charges,,,,,,,,,13968.24,88,,percent of total billed charges,,,,,,,,,12126.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3968.25,22,,percent of total billed charges,,,14444.43,91,,percent of total billed charges,,,15079.35,95,,percent of total billed charges,,,13174.59,83,,percent of total billed charges,,,13174.59,83,,percent of total billed charges,,,,,,,,,,,,,,,13174.59,83,,percent of total billed charges,,,15079.35,95,,percent of total billed charges,,,14285.7,90,,percent of total billed charges,,,14285.7,90,,percent of total billed charges,,,13015.86,82,,percent of total billed charges,,,14285.7,90,,percent of total billed charges,,,13492.05,85,,percent of total billed charges,,3968.25,15079.35,
MAJOR COMPLICATED UP TO 2 HOURS,18602091,CDM,,,360,RC,outpatient,,26204,26204,,22247.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6551,22,,percent of total billed charges,,,,,,,,,23583.6,90,,percent of total billed charges,,,21696.91,82.8,,percent of total billed charges,,,22273.4,85,,percent of total billed charges,,,,,,,,,23059.52,88,,percent of total billed charges,,,,,,,,,20019.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6551,22,,percent of total billed charges,,,23845.64,91,,percent of total billed charges,,,24893.8,95,,percent of total billed charges,,,21749.32,83,,percent of total billed charges,,,21749.32,83,,percent of total billed charges,,,,,,,,,,,,,,,21749.32,83,,percent of total billed charges,,,24893.8,95,,percent of total billed charges,,,23583.6,90,,percent of total billed charges,,,23583.6,90,,percent of total billed charges,,,21487.28,82,,percent of total billed charges,,,23583.6,90,,percent of total billed charges,,,22273.4,85,,percent of total billed charges,,6551,24893.8,
MAJOR COMPLICATED UP TO 3 HOURS,18602092,CDM,,,360,RC,outpatient,,33234,33234,,28215.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8308.5,22,,percent of total billed charges,,,,,,,,,29910.6,90,,percent of total billed charges,,,27517.75,82.8,,percent of total billed charges,,,28248.9,85,,percent of total billed charges,,,,,,,,,29245.92,88,,percent of total billed charges,,,,,,,,,25390.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8308.5,22,,percent of total billed charges,,,30242.94,91,,percent of total billed charges,,,31572.3,95,,percent of total billed charges,,,27584.22,83,,percent of total billed charges,,,27584.22,83,,percent of total billed charges,,,,,,,,,,,,,,,27584.22,83,,percent of total billed charges,,,31572.3,95,,percent of total billed charges,,,29910.6,90,,percent of total billed charges,,,29910.6,90,,percent of total billed charges,,,27251.88,82,,percent of total billed charges,,,29910.6,90,,percent of total billed charges,,,28248.9,85,,percent of total billed charges,,8308.5,31572.3,
MAJOR COMPLICATED UP TO 4 HOURS,18602093,CDM,,,360,RC,outpatient,,40034,40034,,33988.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10008.5,22,,percent of total billed charges,,,,,,,,,36030.6,90,,percent of total billed charges,,,33148.15,82.8,,percent of total billed charges,,,34028.9,85,,percent of total billed charges,,,,,,,,,35229.92,88,,percent of total billed charges,,,,,,,,,30585.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10008.5,22,,percent of total billed charges,,,36430.94,91,,percent of total billed charges,,,38032.3,95,,percent of total billed charges,,,33228.22,83,,percent of total billed charges,,,33228.22,83,,percent of total billed charges,,,,,,,,,,,,,,,33228.22,83,,percent of total billed charges,,,38032.3,95,,percent of total billed charges,,,36030.6,90,,percent of total billed charges,,,36030.6,90,,percent of total billed charges,,,32827.88,82,,percent of total billed charges,,,36030.6,90,,percent of total billed charges,,,34028.9,85,,percent of total billed charges,,10008.5,38032.3,
MAJOR COMPLICATED UP TO 5 HOURS,18602094,CDM,,,360,RC,outpatient,,41452,41452,,35192.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10363,22,,percent of total billed charges,,,,,,,,,37306.8,90,,percent of total billed charges,,,34322.26,82.8,,percent of total billed charges,,,35234.2,85,,percent of total billed charges,,,,,,,,,36477.76,88,,percent of total billed charges,,,,,,,,,31669.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10363,22,,percent of total billed charges,,,37721.32,91,,percent of total billed charges,,,39379.4,95,,percent of total billed charges,,,34405.16,83,,percent of total billed charges,,,34405.16,83,,percent of total billed charges,,,,,,,,,,,,,,,34405.16,83,,percent of total billed charges,,,39379.4,95,,percent of total billed charges,,,37306.8,90,,percent of total billed charges,,,37306.8,90,,percent of total billed charges,,,33990.64,82,,percent of total billed charges,,,37306.8,90,,percent of total billed charges,,,35234.2,85,,percent of total billed charges,,10363,39379.4,
MAJOR COMPLICATED UP TO 6 HOURS,18602095,CDM,,,360,RC,outpatient,,58737,58737,,49867.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14684.25,22,,percent of total billed charges,,,,,,,,,52863.3,90,,percent of total billed charges,,,48634.24,82.8,,percent of total billed charges,,,49926.45,85,,percent of total billed charges,,,,,,,,,51688.56,88,,percent of total billed charges,,,,,,,,,44875.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14684.25,22,,percent of total billed charges,,,53450.67,91,,percent of total billed charges,,,55800.15,95,,percent of total billed charges,,,48751.71,83,,percent of total billed charges,,,48751.71,83,,percent of total billed charges,,,,,,,,,,,,,,,48751.71,83,,percent of total billed charges,,,55800.15,95,,percent of total billed charges,,,52863.3,90,,percent of total billed charges,,,52863.3,90,,percent of total billed charges,,,48164.34,82,,percent of total billed charges,,,52863.3,90,,percent of total billed charges,,,49926.45,85,,percent of total billed charges,,14684.25,55800.15,
MAJOR COMPLICATED UP TO 7 HOURS,18602096,CDM,,,360,RC,outpatient,,61326,61326,,52065.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15331.5,22,,percent of total billed charges,,,,,,,,,55193.4,90,,percent of total billed charges,,,50777.93,82.8,,percent of total billed charges,,,52127.1,85,,percent of total billed charges,,,,,,,,,53966.88,88,,percent of total billed charges,,,,,,,,,46853.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15331.5,22,,percent of total billed charges,,,55806.66,91,,percent of total billed charges,,,58259.7,95,,percent of total billed charges,,,50900.58,83,,percent of total billed charges,,,50900.58,83,,percent of total billed charges,,,,,,,,,,,,,,,50900.58,83,,percent of total billed charges,,,58259.7,95,,percent of total billed charges,,,55193.4,90,,percent of total billed charges,,,55193.4,90,,percent of total billed charges,,,50287.32,82,,percent of total billed charges,,,55193.4,90,,percent of total billed charges,,,52127.1,85,,percent of total billed charges,,15331.5,58259.7,
MAJOR COMPLICATED UP TO 8 HOURS,18602097,CDM,,,360,RC,outpatient,,63788,63788,,54156.01,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15947,22,,percent of total billed charges,,,,,,,,,57409.2,90,,percent of total billed charges,,,52816.46,82.8,,percent of total billed charges,,,54219.8,85,,percent of total billed charges,,,,,,,,,56133.44,88,,percent of total billed charges,,,,,,,,,48734.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15947,22,,percent of total billed charges,,,58047.08,91,,percent of total billed charges,,,60598.6,95,,percent of total billed charges,,,52944.04,83,,percent of total billed charges,,,52944.04,83,,percent of total billed charges,,,,,,,,,,,,,,,52944.04,83,,percent of total billed charges,,,60598.6,95,,percent of total billed charges,,,57409.2,90,,percent of total billed charges,,,57409.2,90,,percent of total billed charges,,,52306.16,82,,percent of total billed charges,,,57409.2,90,,percent of total billed charges,,,54219.8,85,,percent of total billed charges,,15947,60598.6,
MAJOR COMPLICATED OVER 8 HOURS,18602098,CDM,,,360,RC,outpatient,,68328,68328,,58010.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17082,22,,percent of total billed charges,,,,,,,,,61495.2,90,,percent of total billed charges,,,56575.58,82.8,,percent of total billed charges,,,58078.8,85,,percent of total billed charges,,,,,,,,,60128.64,88,,percent of total billed charges,,,,,,,,,52202.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17082,22,,percent of total billed charges,,,62178.48,91,,percent of total billed charges,,,64911.6,95,,percent of total billed charges,,,56712.24,83,,percent of total billed charges,,,56712.24,83,,percent of total billed charges,,,,,,,,,,,,,,,56712.24,83,,percent of total billed charges,,,64911.6,95,,percent of total billed charges,,,61495.2,90,,percent of total billed charges,,,61495.2,90,,percent of total billed charges,,,56028.96,82,,percent of total billed charges,,,61495.2,90,,percent of total billed charges,,,58078.8,85,,percent of total billed charges,,17082,64911.6,
MAJOR PROCEDURE UP TO 1 HOUR,18602110,CDM,,,360,RC,outpatient,,13964,13964,,11855.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3491,22,,percent of total billed charges,,,,,,,,,12567.6,90,,percent of total billed charges,,,11562.19,82.8,,percent of total billed charges,,,11869.4,85,,percent of total billed charges,,,,,,,,,12288.32,88,,percent of total billed charges,,,,,,,,,10668.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3491,22,,percent of total billed charges,,,12707.24,91,,percent of total billed charges,,,13265.8,95,,percent of total billed charges,,,11590.12,83,,percent of total billed charges,,,11590.12,83,,percent of total billed charges,,,,,,,,,,,,,,,11590.12,83,,percent of total billed charges,,,13265.8,95,,percent of total billed charges,,,12567.6,90,,percent of total billed charges,,,12567.6,90,,percent of total billed charges,,,11450.48,82,,percent of total billed charges,,,12567.6,90,,percent of total billed charges,,,11869.4,85,,percent of total billed charges,,3491,13265.8,
MAJOR PROCEDURE UP TO 2 HOURS,18602111,CDM,,,360,RC,outpatient,,17581,17581,,14926.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4395.25,22,,percent of total billed charges,,,,,,,,,15822.9,90,,percent of total billed charges,,,14557.07,82.8,,percent of total billed charges,,,14943.85,85,,percent of total billed charges,,,,,,,,,15471.28,88,,percent of total billed charges,,,,,,,,,13431.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4395.25,22,,percent of total billed charges,,,15998.71,91,,percent of total billed charges,,,16701.95,95,,percent of total billed charges,,,14592.23,83,,percent of total billed charges,,,14592.23,83,,percent of total billed charges,,,,,,,,,,,,,,,14592.23,83,,percent of total billed charges,,,16701.95,95,,percent of total billed charges,,,15822.9,90,,percent of total billed charges,,,15822.9,90,,percent of total billed charges,,,14416.42,82,,percent of total billed charges,,,15822.9,90,,percent of total billed charges,,,14943.85,85,,percent of total billed charges,,4395.25,16701.95,
MAJOR PROCEDURE UP TO 3 HOURS,18602112,CDM,,,360,RC,outpatient,,22024,22024,,18698.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5506,22,,percent of total billed charges,,,,,,,,,19821.6,90,,percent of total billed charges,,,18235.87,82.8,,percent of total billed charges,,,18720.4,85,,percent of total billed charges,,,,,,,,,19381.12,88,,percent of total billed charges,,,,,,,,,16826.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5506,22,,percent of total billed charges,,,20041.84,91,,percent of total billed charges,,,20922.8,95,,percent of total billed charges,,,18279.92,83,,percent of total billed charges,,,18279.92,83,,percent of total billed charges,,,,,,,,,,,,,,,18279.92,83,,percent of total billed charges,,,20922.8,95,,percent of total billed charges,,,19821.6,90,,percent of total billed charges,,,19821.6,90,,percent of total billed charges,,,18059.68,82,,percent of total billed charges,,,19821.6,90,,percent of total billed charges,,,18720.4,85,,percent of total billed charges,,5506,20922.8,
MAJOR PROCEDURE UP TO 4 HOURS,18602113,CDM,,,360,RC,outpatient,,23158,23158,,19661.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5789.5,22,,percent of total billed charges,,,,,,,,,20842.2,90,,percent of total billed charges,,,19174.82,82.8,,percent of total billed charges,,,19684.3,85,,percent of total billed charges,,,,,,,,,20379.04,88,,percent of total billed charges,,,,,,,,,17692.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5789.5,22,,percent of total billed charges,,,21073.78,91,,percent of total billed charges,,,22000.1,95,,percent of total billed charges,,,19221.14,83,,percent of total billed charges,,,19221.14,83,,percent of total billed charges,,,,,,,,,,,,,,,19221.14,83,,percent of total billed charges,,,22000.1,95,,percent of total billed charges,,,20842.2,90,,percent of total billed charges,,,20842.2,90,,percent of total billed charges,,,18989.56,82,,percent of total billed charges,,,20842.2,90,,percent of total billed charges,,,19684.3,85,,percent of total billed charges,,5789.5,22000.1,
MAJOR PROCEDURE OVER 4 HOURS,18602114,CDM,,,360,RC,outpatient,,26600,26600,,22583.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6650,22,,percent of total billed charges,,,,,,,,,23940,90,,percent of total billed charges,,,22024.8,82.8,,percent of total billed charges,,,22610,85,,percent of total billed charges,,,,,,,,,23408,88,,percent of total billed charges,,,,,,,,,20322.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6650,22,,percent of total billed charges,,,24206,91,,percent of total billed charges,,,25270,95,,percent of total billed charges,,,22078,83,,percent of total billed charges,,,22078,83,,percent of total billed charges,,,,,,,,,,,,,,,22078,83,,percent of total billed charges,,,25270,95,,percent of total billed charges,,,23940,90,,percent of total billed charges,,,23940,90,,percent of total billed charges,,,21812,82,,percent of total billed charges,,,23940,90,,percent of total billed charges,,,22610,85,,percent of total billed charges,,6650,25270,
MAJOR COMPLICATED UP TO 1 HOUR,18602120,CDM,,,360,RC,outpatient,,19684,19684,,16711.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4921,22,,percent of total billed charges,,,,,,,,,17715.6,90,,percent of total billed charges,,,16298.35,82.8,,percent of total billed charges,,,16731.4,85,,percent of total billed charges,,,,,,,,,17321.92,88,,percent of total billed charges,,,,,,,,,15038.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4921,22,,percent of total billed charges,,,17912.44,91,,percent of total billed charges,,,18699.8,95,,percent of total billed charges,,,16337.72,83,,percent of total billed charges,,,16337.72,83,,percent of total billed charges,,,,,,,,,,,,,,,16337.72,83,,percent of total billed charges,,,18699.8,95,,percent of total billed charges,,,17715.6,90,,percent of total billed charges,,,17715.6,90,,percent of total billed charges,,,16140.88,82,,percent of total billed charges,,,17715.6,90,,percent of total billed charges,,,16731.4,85,,percent of total billed charges,,4921,18699.8,
MAJOR COMPLICATED UP TO 2 HOURS,18602121,CDM,,,360,RC,outpatient,,28155,28155,,23903.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7038.75,22,,percent of total billed charges,,,,,,,,,25339.5,90,,percent of total billed charges,,,23312.34,82.8,,percent of total billed charges,,,23931.75,85,,percent of total billed charges,,,,,,,,,24776.4,88,,percent of total billed charges,,,,,,,,,21510.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7038.75,22,,percent of total billed charges,,,25621.05,91,,percent of total billed charges,,,26747.25,95,,percent of total billed charges,,,23368.65,83,,percent of total billed charges,,,23368.65,83,,percent of total billed charges,,,,,,,,,,,,,,,23368.65,83,,percent of total billed charges,,,26747.25,95,,percent of total billed charges,,,25339.5,90,,percent of total billed charges,,,25339.5,90,,percent of total billed charges,,,23087.1,82,,percent of total billed charges,,,25339.5,90,,percent of total billed charges,,,23931.75,85,,percent of total billed charges,,7038.75,26747.25,
MAJOR COMPLICATED UP TO 3 HOURS,18602122,CDM,,,360,RC,outpatient,,37165,37165,,31553.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9291.25,22,,percent of total billed charges,,,,,,,,,33448.5,90,,percent of total billed charges,,,30772.62,82.8,,percent of total billed charges,,,31590.25,85,,percent of total billed charges,,,,,,,,,32705.2,88,,percent of total billed charges,,,,,,,,,28394.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9291.25,22,,percent of total billed charges,,,33820.15,91,,percent of total billed charges,,,35306.75,95,,percent of total billed charges,,,30846.95,83,,percent of total billed charges,,,30846.95,83,,percent of total billed charges,,,,,,,,,,,,,,,30846.95,83,,percent of total billed charges,,,35306.75,95,,percent of total billed charges,,,33448.5,90,,percent of total billed charges,,,33448.5,90,,percent of total billed charges,,,30475.3,82,,percent of total billed charges,,,33448.5,90,,percent of total billed charges,,,31590.25,85,,percent of total billed charges,,9291.25,35306.75,
MAJOR COMPLICATED UP TO 4 HOURS,18602123,CDM,,,360,RC,outpatient,,45353,45353,,38504.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,11338.25,22,,percent of total billed charges,,,,,,,,,40817.7,90,,percent of total billed charges,,,37552.28,82.8,,percent of total billed charges,,,38550.05,85,,percent of total billed charges,,,,,,,,,39910.64,88,,percent of total billed charges,,,,,,,,,34649.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,11338.25,22,,percent of total billed charges,,,41271.23,91,,percent of total billed charges,,,43085.35,95,,percent of total billed charges,,,37642.99,83,,percent of total billed charges,,,37642.99,83,,percent of total billed charges,,,,,,,,,,,,,,,37642.99,83,,percent of total billed charges,,,43085.35,95,,percent of total billed charges,,,40817.7,90,,percent of total billed charges,,,40817.7,90,,percent of total billed charges,,,37189.46,82,,percent of total billed charges,,,40817.7,90,,percent of total billed charges,,,38550.05,85,,percent of total billed charges,,11338.25,43085.35,
MAJOR COMPLICATED UP TO 5 HOURS,18602124,CDM,,,360,RC,outpatient,,52431,52431,,44513.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13107.75,22,,percent of total billed charges,,,,,,,,,47187.9,90,,percent of total billed charges,,,43412.87,82.8,,percent of total billed charges,,,44566.35,85,,percent of total billed charges,,,,,,,,,46139.28,88,,percent of total billed charges,,,,,,,,,40057.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13107.75,22,,percent of total billed charges,,,47712.21,91,,percent of total billed charges,,,49809.45,95,,percent of total billed charges,,,43517.73,83,,percent of total billed charges,,,43517.73,83,,percent of total billed charges,,,,,,,,,,,,,,,43517.73,83,,percent of total billed charges,,,49809.45,95,,percent of total billed charges,,,47187.9,90,,percent of total billed charges,,,47187.9,90,,percent of total billed charges,,,42993.42,82,,percent of total billed charges,,,47187.9,90,,percent of total billed charges,,,44566.35,85,,percent of total billed charges,,13107.75,49809.45,
MAJOR COMPLICATED UP TO 6 HOURS,18602125,CDM,,,360,RC,outpatient,,60660,60660,,51500.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15165,22,,percent of total billed charges,,,,,,,,,54594,90,,percent of total billed charges,,,50226.48,82.8,,percent of total billed charges,,,51561,85,,percent of total billed charges,,,,,,,,,53380.8,88,,percent of total billed charges,,,,,,,,,46344.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15165,22,,percent of total billed charges,,,55200.6,91,,percent of total billed charges,,,57627,95,,percent of total billed charges,,,50347.8,83,,percent of total billed charges,,,50347.8,83,,percent of total billed charges,,,,,,,,,,,,,,,50347.8,83,,percent of total billed charges,,,57627,95,,percent of total billed charges,,,54594,90,,percent of total billed charges,,,54594,90,,percent of total billed charges,,,49741.2,82,,percent of total billed charges,,,54594,90,,percent of total billed charges,,,51561,85,,percent of total billed charges,,15165,57627,
MAJOR COMPLICATED UP TO 7 HOURS,18602126,CDM,,,360,RC,outpatient,,69030,69030,,58606.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17257.5,22,,percent of total billed charges,,,,,,,,,62127,90,,percent of total billed charges,,,57156.84,82.8,,percent of total billed charges,,,58675.5,85,,percent of total billed charges,,,,,,,,,60746.4,88,,percent of total billed charges,,,,,,,,,52738.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17257.5,22,,percent of total billed charges,,,62817.3,91,,percent of total billed charges,,,65578.5,95,,percent of total billed charges,,,57294.9,83,,percent of total billed charges,,,57294.9,83,,percent of total billed charges,,,,,,,,,,,,,,,57294.9,83,,percent of total billed charges,,,65578.5,95,,percent of total billed charges,,,62127,90,,percent of total billed charges,,,62127,90,,percent of total billed charges,,,56604.6,82,,percent of total billed charges,,,62127,90,,percent of total billed charges,,,58675.5,85,,percent of total billed charges,,17257.5,65578.5,
MAJOR COMPLICATED UP TO 8 HOURS,18602127,CDM,,,360,RC,outpatient,,80561,80561,,68396.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20140.25,22,,percent of total billed charges,,,,,,,,,72504.9,90,,percent of total billed charges,,,66704.51,82.8,,percent of total billed charges,,,68476.85,85,,percent of total billed charges,,,,,,,,,70893.68,88,,percent of total billed charges,,,,,,,,,61548.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20140.25,22,,percent of total billed charges,,,73310.51,91,,percent of total billed charges,,,76532.95,95,,percent of total billed charges,,,66865.63,83,,percent of total billed charges,,,66865.63,83,,percent of total billed charges,,,,,,,,,,,,,,,66865.63,83,,percent of total billed charges,,,76532.95,95,,percent of total billed charges,,,72504.9,90,,percent of total billed charges,,,72504.9,90,,percent of total billed charges,,,66060.02,82,,percent of total billed charges,,,72504.9,90,,percent of total billed charges,,,68476.85,85,,percent of total billed charges,,20140.25,76532.95,
MAJOR COMPLICATED OVER 8 HOURS,18602128,CDM,,,360,RC,outpatient,,85528,85528,,72613.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,21382,22,,percent of total billed charges,,,,,,,,,76975.2,90,,percent of total billed charges,,,70817.18,82.8,,percent of total billed charges,,,72698.8,85,,percent of total billed charges,,,,,,,,,75264.64,88,,percent of total billed charges,,,,,,,,,65343.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,21382,22,,percent of total billed charges,,,77830.48,91,,percent of total billed charges,,,81251.6,95,,percent of total billed charges,,,70988.24,83,,percent of total billed charges,,,70988.24,83,,percent of total billed charges,,,,,,,,,,,,,,,70988.24,83,,percent of total billed charges,,,81251.6,95,,percent of total billed charges,,,76975.2,90,,percent of total billed charges,,,76975.2,90,,percent of total billed charges,,,70132.96,82,,percent of total billed charges,,,76975.2,90,,percent of total billed charges,,,72698.8,85,,percent of total billed charges,,21382,81251.6,
MAJOR SURGERY EXTRACORPOREAL SHOCKWAVE,18602130,CDM,50590,CPT,360,RC,outpatient,,19964,19964,,16949.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4991,22,,percent of total billed charges,,,,,,,,,17967.6,90,,percent of total billed charges,,,16530.19,82.8,,percent of total billed charges,,,16969.4,85,,percent of total billed charges,,,,,,,,,17568.32,88,,percent of total billed charges,,,,,,,,,15252.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4991,22,,percent of total billed charges,,,18167.24,91,,percent of total billed charges,,,18965.8,95,,percent of total billed charges,,,16570.12,83,,percent of total billed charges,,,16570.12,83,,percent of total billed charges,,,,,,,,,,,,,,,16570.12,83,,percent of total billed charges,,,18965.8,95,,percent of total billed charges,,,17967.6,90,,percent of total billed charges,,,17967.6,90,,percent of total billed charges,,,16370.48,82,,percent of total billed charges,,,17967.6,90,,percent of total billed charges,,,16969.4,85,,percent of total billed charges,,4991,18965.8,
MAJOR COMPLICATED III UP TO 1 HOUR,18602140,CDM,,,360,RC,outpatient,,25993,25993,,22068.06,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6498.25,22,,percent of total billed charges,,,,,,,,,23393.7,90,,percent of total billed charges,,,21522.2,82.8,,percent of total billed charges,,,22094.05,85,,percent of total billed charges,,,,,,,,,22873.84,88,,percent of total billed charges,,,,,,,,,19858.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6498.25,22,,percent of total billed charges,,,23653.63,91,,percent of total billed charges,,,24693.35,95,,percent of total billed charges,,,21574.19,83,,percent of total billed charges,,,21574.19,83,,percent of total billed charges,,,,,,,,,,,,,,,21574.19,83,,percent of total billed charges,,,24693.35,95,,percent of total billed charges,,,23393.7,90,,percent of total billed charges,,,23393.7,90,,percent of total billed charges,,,21314.26,82,,percent of total billed charges,,,23393.7,90,,percent of total billed charges,,,22094.05,85,,percent of total billed charges,,6498.25,24693.35,
MAJOR COMPLICATED III UP TO 2 HOURS,18602141,CDM,,,360,RC,outpatient,,34255,34255,,29082.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8563.75,22,,percent of total billed charges,,,,,,,,,30829.5,90,,percent of total billed charges,,,28363.14,82.8,,percent of total billed charges,,,29116.75,85,,percent of total billed charges,,,,,,,,,30144.4,88,,percent of total billed charges,,,,,,,,,26170.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8563.75,22,,percent of total billed charges,,,31172.05,91,,percent of total billed charges,,,32542.25,95,,percent of total billed charges,,,28431.65,83,,percent of total billed charges,,,28431.65,83,,percent of total billed charges,,,,,,,,,,,,,,,28431.65,83,,percent of total billed charges,,,32542.25,95,,percent of total billed charges,,,30829.5,90,,percent of total billed charges,,,30829.5,90,,percent of total billed charges,,,28089.1,82,,percent of total billed charges,,,30829.5,90,,percent of total billed charges,,,29116.75,85,,percent of total billed charges,,8563.75,32542.25,
MAJOR COMPLICATED III UP TO 3 HOURS,18602142,CDM,,,360,RC,outpatient,,41802,41802,,35489.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10450.5,22,,percent of total billed charges,,,,,,,,,37621.8,90,,percent of total billed charges,,,34612.06,82.8,,percent of total billed charges,,,35531.7,85,,percent of total billed charges,,,,,,,,,36785.76,88,,percent of total billed charges,,,,,,,,,31936.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10450.5,22,,percent of total billed charges,,,38039.82,91,,percent of total billed charges,,,39711.9,95,,percent of total billed charges,,,34695.66,83,,percent of total billed charges,,,34695.66,83,,percent of total billed charges,,,,,,,,,,,,,,,34695.66,83,,percent of total billed charges,,,39711.9,95,,percent of total billed charges,,,37621.8,90,,percent of total billed charges,,,37621.8,90,,percent of total billed charges,,,34277.64,82,,percent of total billed charges,,,37621.8,90,,percent of total billed charges,,,35531.7,85,,percent of total billed charges,,10450.5,39711.9,
MAJOR COMPLICATED III UP TO 4 HOURS,18602143,CDM,,,360,RC,outpatient,,48326,48326,,41028.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12081.5,22,,percent of total billed charges,,,,,,,,,43493.4,90,,percent of total billed charges,,,40013.93,82.8,,percent of total billed charges,,,41077.1,85,,percent of total billed charges,,,,,,,,,42526.88,88,,percent of total billed charges,,,,,,,,,36921.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12081.5,22,,percent of total billed charges,,,43976.66,91,,percent of total billed charges,,,45909.7,95,,percent of total billed charges,,,40110.58,83,,percent of total billed charges,,,40110.58,83,,percent of total billed charges,,,,,,,,,,,,,,,40110.58,83,,percent of total billed charges,,,45909.7,95,,percent of total billed charges,,,43493.4,90,,percent of total billed charges,,,43493.4,90,,percent of total billed charges,,,39627.32,82,,percent of total billed charges,,,43493.4,90,,percent of total billed charges,,,41077.1,85,,percent of total billed charges,,12081.5,45909.7,
MAJOR COMPLICATED III UP TO 5 HOURS,18602144,CDM,,,360,RC,outpatient,,55724,55724,,47309.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13931,22,,percent of total billed charges,,,,,,,,,50151.6,90,,percent of total billed charges,,,46139.47,82.8,,percent of total billed charges,,,47365.4,85,,percent of total billed charges,,,,,,,,,49037.12,88,,percent of total billed charges,,,,,,,,,42573.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13931,22,,percent of total billed charges,,,50708.84,91,,percent of total billed charges,,,52937.8,95,,percent of total billed charges,,,46250.92,83,,percent of total billed charges,,,46250.92,83,,percent of total billed charges,,,,,,,,,,,,,,,46250.92,83,,percent of total billed charges,,,52937.8,95,,percent of total billed charges,,,50151.6,90,,percent of total billed charges,,,50151.6,90,,percent of total billed charges,,,45693.68,82,,percent of total billed charges,,,50151.6,90,,percent of total billed charges,,,47365.4,85,,percent of total billed charges,,13931,52937.8,
MAJOR COMPLICATED III UP TO 6 HOURS,18602145,CDM,,,360,RC,outpatient,,63624,63624,,54016.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15906,22,,percent of total billed charges,,,,,,,,,57261.6,90,,percent of total billed charges,,,52680.67,82.8,,percent of total billed charges,,,54080.4,85,,percent of total billed charges,,,,,,,,,55989.12,88,,percent of total billed charges,,,,,,,,,48608.74,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15906,22,,percent of total billed charges,,,57897.84,91,,percent of total billed charges,,,60442.8,95,,percent of total billed charges,,,52807.92,83,,percent of total billed charges,,,52807.92,83,,percent of total billed charges,,,,,,,,,,,,,,,52807.92,83,,percent of total billed charges,,,60442.8,95,,percent of total billed charges,,,57261.6,90,,percent of total billed charges,,,57261.6,90,,percent of total billed charges,,,52171.68,82,,percent of total billed charges,,,57261.6,90,,percent of total billed charges,,,54080.4,85,,percent of total billed charges,,15906,60442.8,
ESOPHAGOGASTROSCOPY EGD,18603035,CDM,,,360,RC,outpatient,,7683,7683,,6522.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1920.75,22,,percent of total billed charges,,,,,,,,,6914.7,90,,percent of total billed charges,,,6361.52,82.8,,percent of total billed charges,,,6530.55,85,,percent of total billed charges,,,,,,,,,6761.04,88,,percent of total billed charges,,,,,,,,,5869.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1920.75,22,,percent of total billed charges,,,6991.53,91,,percent of total billed charges,,,7298.85,95,,percent of total billed charges,,,6376.89,83,,percent of total billed charges,,,6376.89,83,,percent of total billed charges,,,,,,,,,,,,,,,6376.89,83,,percent of total billed charges,,,7298.85,95,,percent of total billed charges,,,6914.7,90,,percent of total billed charges,,,6914.7,90,,percent of total billed charges,,,6300.06,82,,percent of total billed charges,,,6914.7,90,,percent of total billed charges,,,6530.55,85,,percent of total billed charges,,1920.75,7298.85,
ESOPHAGOGASTROSCOPY EGD WITH ENDOFLIP,18603036,CDM,,,360,RC,outpatient,,11022,11022,,9357.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2755.5,22,,percent of total billed charges,,,,,,,,,9919.8,90,,percent of total billed charges,,,9126.22,82.8,,percent of total billed charges,,,9368.7,85,,percent of total billed charges,,,,,,,,,9699.36,88,,percent of total billed charges,,,,,,,,,8420.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2755.5,22,,percent of total billed charges,,,10030.02,91,,percent of total billed charges,,,10470.9,95,,percent of total billed charges,,,9148.26,83,,percent of total billed charges,,,9148.26,83,,percent of total billed charges,,,,,,,,,,,,,,,9148.26,83,,percent of total billed charges,,,10470.9,95,,percent of total billed charges,,,9919.8,90,,percent of total billed charges,,,9919.8,90,,percent of total billed charges,,,9038.04,82,,percent of total billed charges,,,9919.8,90,,percent of total billed charges,,,9368.7,85,,percent of total billed charges,,2755.5,10470.9,
COMPLETE COLONOSCOPY,18603076,CDM,,,360,RC,outpatient,,7783,7783,,6607.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1945.75,22,,percent of total billed charges,,,,,,,,,7004.7,90,,percent of total billed charges,,,6444.32,82.8,,percent of total billed charges,,,6615.55,85,,percent of total billed charges,,,,,,,,,6849.04,88,,percent of total billed charges,,,,,,,,,5946.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1945.75,22,,percent of total billed charges,,,7082.53,91,,percent of total billed charges,,,7393.85,95,,percent of total billed charges,,,6459.89,83,,percent of total billed charges,,,6459.89,83,,percent of total billed charges,,,,,,,,,,,,,,,6459.89,83,,percent of total billed charges,,,7393.85,95,,percent of total billed charges,,,7004.7,90,,percent of total billed charges,,,7004.7,90,,percent of total billed charges,,,6382.06,82,,percent of total billed charges,,,7004.7,90,,percent of total billed charges,,,6615.55,85,,percent of total billed charges,,1945.75,7393.85,
PROCTOSCOPY,18603077,CDM,,,360,RC,outpatient,,6236,6236,,5294.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1559,22,,percent of total billed charges,,,,,,,,,5612.4,90,,percent of total billed charges,,,5163.41,82.8,,percent of total billed charges,,,5300.6,85,,percent of total billed charges,,,,,,,,,5487.68,88,,percent of total billed charges,,,,,,,,,4764.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1559,22,,percent of total billed charges,,,5674.76,91,,percent of total billed charges,,,5924.2,95,,percent of total billed charges,,,5175.88,83,,percent of total billed charges,,,5175.88,83,,percent of total billed charges,,,,,,,,,,,,,,,5175.88,83,,percent of total billed charges,,,5924.2,95,,percent of total billed charges,,,5612.4,90,,percent of total billed charges,,,5612.4,90,,percent of total billed charges,,,5113.52,82,,percent of total billed charges,,,5612.4,90,,percent of total billed charges,,,5300.6,85,,percent of total billed charges,,1559,5924.2,
 TRANSESOPHAGEAL ECHO,18603080,CDM,,,360,RC,outpatient,,7872,7872,,6683.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1968,22,,percent of total billed charges,,,,,,,,,7084.8,90,,percent of total billed charges,,,6518.02,82.8,,percent of total billed charges,,,6691.2,85,,percent of total billed charges,,,,,,,,,6927.36,88,,percent of total billed charges,,,,,,,,,6014.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1968,22,,percent of total billed charges,,,7163.52,91,,percent of total billed charges,,,7478.4,95,,percent of total billed charges,,,6533.76,83,,percent of total billed charges,,,6533.76,83,,percent of total billed charges,,,,,,,,,,,,,,,6533.76,83,,percent of total billed charges,,,7478.4,95,,percent of total billed charges,,,7084.8,90,,percent of total billed charges,,,7084.8,90,,percent of total billed charges,,,6455.04,82,,percent of total billed charges,,,7084.8,90,,percent of total billed charges,,,6691.2,85,,percent of total billed charges,,1968,7478.4,
ENDOSCOPIC BIOPSY,18603084,CDM,,,360,RC,outpatient,,1432,1432,,1215.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,358,22,,percent of total billed charges,,,,,,,,,1288.8,90,,percent of total billed charges,,,1185.7,82.8,,percent of total billed charges,,,1217.2,85,,percent of total billed charges,,,,,,,,,1260.16,88,,percent of total billed charges,,,,,,,,,1094.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,358,22,,percent of total billed charges,,,1303.12,91,,percent of total billed charges,,,1360.4,95,,percent of total billed charges,,,1188.56,83,,percent of total billed charges,,,1188.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1188.56,83,,percent of total billed charges,,,1360.4,95,,percent of total billed charges,,,1288.8,90,,percent of total billed charges,,,1288.8,90,,percent of total billed charges,,,1174.24,82,,percent of total billed charges,,,1288.8,90,,percent of total billed charges,,,1217.2,85,,percent of total billed charges,,358,1360.4,
POLYPECTOMY,18603092,CDM,,,360,RC,outpatient,,1332,1332,,1130.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,333,22,,percent of total billed charges,,,,,,,,,1198.8,90,,percent of total billed charges,,,1102.9,82.8,,percent of total billed charges,,,1132.2,85,,percent of total billed charges,,,,,,,,,1172.16,88,,percent of total billed charges,,,,,,,,,1017.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,333,22,,percent of total billed charges,,,1212.12,91,,percent of total billed charges,,,1265.4,95,,percent of total billed charges,,,1105.56,83,,percent of total billed charges,,,1105.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1105.56,83,,percent of total billed charges,,,1265.4,95,,percent of total billed charges,,,1198.8,90,,percent of total billed charges,,,1198.8,90,,percent of total billed charges,,,1092.24,82,,percent of total billed charges,,,1198.8,90,,percent of total billed charges,,,1132.2,85,,percent of total billed charges,,333,1265.4,
X LUMBARKYPHOPLASTYINOR,26200002,CDM,22514,CPT,320,RC,outpatient,TC,15687,15687,,13318.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3921.75,22,,percent of total billed charges,,,,,,,,,14118.3,90,,percent of total billed charges,,,12988.84,82.8,,percent of total billed charges,,,13333.95,85,,percent of total billed charges,,,,,,,,,13804.56,88,,percent of total billed charges,,,,,,,,,11984.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3921.75,22,,percent of total billed charges,,,14275.17,91,,percent of total billed charges,,,14902.65,95,,percent of total billed charges,,,13020.21,83,,percent of total billed charges,,,13020.21,83,,percent of total billed charges,,,,,,,,,,,,,,,13020.21,83,,percent of total billed charges,,,14902.65,95,,percent of total billed charges,,,14118.3,90,,percent of total billed charges,,,14118.3,90,,percent of total billed charges,,,12863.34,82,,percent of total billed charges,,,14118.3,90,,percent of total billed charges,,,13333.95,85,,percent of total billed charges,,3921.75,14902.65,
X LUMBARVRTEBROPLSTYINOR,26200003,CDM,22511,CPT,360,RC,outpatient,TC,17217,17217,,14617.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4304.25,22,,percent of total billed charges,,,,,,,,,15495.3,90,,percent of total billed charges,,,14255.68,82.8,,percent of total billed charges,,,14634.45,85,,percent of total billed charges,,,,,,,,,15150.96,88,,percent of total billed charges,,,,,,,,,13153.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4304.25,22,,percent of total billed charges,,,15667.47,91,,percent of total billed charges,,,16356.15,95,,percent of total billed charges,,,14290.11,83,,percent of total billed charges,,,14290.11,83,,percent of total billed charges,,,,,,,,,,,,,,,14290.11,83,,percent of total billed charges,,,16356.15,95,,percent of total billed charges,,,15495.3,90,,percent of total billed charges,,,15495.3,90,,percent of total billed charges,,,14117.94,82,,percent of total billed charges,,,15495.3,90,,percent of total billed charges,,,14634.45,85,,percent of total billed charges,,4304.25,16356.15,
X TSPINEKYPHOPLASTYINOR,26200004,CDM,22513,CPT,360,RC,outpatient,TC,25378,25378,,21545.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6344.5,22,,percent of total billed charges,,,,,,,,,22840.2,90,,percent of total billed charges,,,21012.98,82.8,,percent of total billed charges,,,21571.3,85,,percent of total billed charges,,,,,,,,,22332.64,88,,percent of total billed charges,,,,,,,,,19388.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6344.5,22,,percent of total billed charges,,,23093.98,91,,percent of total billed charges,,,24109.1,95,,percent of total billed charges,,,21063.74,83,,percent of total billed charges,,,21063.74,83,,percent of total billed charges,,,,,,,,,,,,,,,21063.74,83,,percent of total billed charges,,,24109.1,95,,percent of total billed charges,,,22840.2,90,,percent of total billed charges,,,22840.2,90,,percent of total billed charges,,,20809.96,82,,percent of total billed charges,,,22840.2,90,,percent of total billed charges,,,21571.3,85,,percent of total billed charges,,6344.5,24109.1,
X TSPINEVRTEBROPLSTYINOR,26200005,CDM,22510,CPT,360,RC,outpatient,TC,17504,17504,,14860.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4376,22,,percent of total billed charges,,,,,,,,,15753.6,90,,percent of total billed charges,,,14493.31,82.8,,percent of total billed charges,,,14878.4,85,,percent of total billed charges,,,,,,,,,15403.52,88,,percent of total billed charges,,,,,,,,,13373.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4376,22,,percent of total billed charges,,,15928.64,91,,percent of total billed charges,,,16628.8,95,,percent of total billed charges,,,14528.32,83,,percent of total billed charges,,,14528.32,83,,percent of total billed charges,,,,,,,,,,,,,,,14528.32,83,,percent of total billed charges,,,16628.8,95,,percent of total billed charges,,,15753.6,90,,percent of total billed charges,,,15753.6,90,,percent of total billed charges,,,14353.28,82,,percent of total billed charges,,,15753.6,90,,percent of total billed charges,,,14878.4,85,,percent of total billed charges,,4376,16628.8,
X INJPROCED FORSPINALDISK,26200010,CDM,62290,CPT,360,RC,outpatient,,4833,4833,,4103.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1208.25,22,,percent of total billed charges,,,,,,,,,4349.7,90,,percent of total billed charges,,,4001.72,82.8,,percent of total billed charges,,,4108.05,85,,percent of total billed charges,,,,,,,,,4253.04,88,,percent of total billed charges,,,,,,,,,3692.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1208.25,22,,percent of total billed charges,,,4398.03,91,,percent of total billed charges,,,4591.35,95,,percent of total billed charges,,,4011.39,83,,percent of total billed charges,,,4011.39,83,,percent of total billed charges,,,,,,,,,,,,,,,4011.39,83,,percent of total billed charges,,,4591.35,95,,percent of total billed charges,,,4349.7,90,,percent of total billed charges,,,4349.7,90,,percent of total billed charges,,,3963.06,82,,percent of total billed charges,,,4349.7,90,,percent of total billed charges,,,4108.05,85,,percent of total billed charges,,1208.25,4591.35,
X VERTBRPLSTYEAADDLVLTORL,26200015,CDM,22512,CPT,360,RC,outpatient,TC,10599,10599,,8998.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2649.75,22,,percent of total billed charges,,,,,,,,,9539.1,90,,percent of total billed charges,,,8775.97,82.8,,percent of total billed charges,,,9009.15,85,,percent of total billed charges,,,,,,,,,9327.12,88,,percent of total billed charges,,,,,,,,,8097.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2649.75,22,,percent of total billed charges,,,9645.09,91,,percent of total billed charges,,,10069.05,95,,percent of total billed charges,,,8797.17,83,,percent of total billed charges,,,8797.17,83,,percent of total billed charges,,,,,,,,,,,,,,,8797.17,83,,percent of total billed charges,,,10069.05,95,,percent of total billed charges,,,9539.1,90,,percent of total billed charges,,,9539.1,90,,percent of total billed charges,,,8691.18,82,,percent of total billed charges,,,9539.1,90,,percent of total billed charges,,,9009.15,85,,percent of total billed charges,,2649.75,10069.05,
X TSPINEKYPHOEAADDLVL,26200028,CDM,22515,CPT,360,RC,outpatient,TC,12204,12204,,10361.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3051,22,,percent of total billed charges,,,,,,,,,10983.6,90,,percent of total billed charges,,,10104.91,82.8,,percent of total billed charges,,,10373.4,85,,percent of total billed charges,,,,,,,,,10739.52,88,,percent of total billed charges,,,,,,,,,9323.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3051,22,,percent of total billed charges,,,11105.64,91,,percent of total billed charges,,,11593.8,95,,percent of total billed charges,,,10129.32,83,,percent of total billed charges,,,10129.32,83,,percent of total billed charges,,,,,,,,,,,,,,,10129.32,83,,percent of total billed charges,,,11593.8,95,,percent of total billed charges,,,10983.6,90,,percent of total billed charges,,,10983.6,90,,percent of total billed charges,,,10007.28,82,,percent of total billed charges,,,10983.6,90,,percent of total billed charges,,,10373.4,85,,percent of total billed charges,,3051,11593.8,
X TSPINEVRTEBROBXINOR,26200031,CDM,20250,CPT,360,RC,outpatient,TC,10144,10144,,8612.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2536,22,,percent of total billed charges,,,,,,,,,9129.6,90,,percent of total billed charges,,,8399.23,82.8,,percent of total billed charges,,,8622.4,85,,percent of total billed charges,,,,,,,,,8926.72,88,,percent of total billed charges,,,,,,,,,7750.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2536,22,,percent of total billed charges,,,9231.04,91,,percent of total billed charges,,,9636.8,95,,percent of total billed charges,,,8419.52,83,,percent of total billed charges,,,8419.52,83,,percent of total billed charges,,,,,,,,,,,,,,,8419.52,83,,percent of total billed charges,,,9636.8,95,,percent of total billed charges,,,9129.6,90,,percent of total billed charges,,,9129.6,90,,percent of total billed charges,,,8318.08,82,,percent of total billed charges,,,9129.6,90,,percent of total billed charges,,,8622.4,85,,percent of total billed charges,,2536,9636.8,
X LUMBARKYPHOPLASTYINOR(AUG),26200040,CDM,22514,CPT,360,RC,outpatient,TC,20879,20879,,17726.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5219.75,22,,percent of total billed charges,,,,,,,,,18791.1,90,,percent of total billed charges,,,17287.81,82.8,,percent of total billed charges,,,17747.15,85,,percent of total billed charges,,,,,,,,,18373.52,88,,percent of total billed charges,,,,,,,,,15951.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5219.75,22,,percent of total billed charges,,,18999.89,91,,percent of total billed charges,,,19835.05,95,,percent of total billed charges,,,17329.57,83,,percent of total billed charges,,,17329.57,83,,percent of total billed charges,,,,,,,,,,,,,,,17329.57,83,,percent of total billed charges,,,19835.05,95,,percent of total billed charges,,,18791.1,90,,percent of total billed charges,,,18791.1,90,,percent of total billed charges,,,17120.78,82,,percent of total billed charges,,,18791.1,90,,percent of total billed charges,,,17747.15,85,,percent of total billed charges,,5219.75,19835.05,
X FACET INJ C/T SPINE LVL 1,26700116,CDM,64490,CPT,320,RC,outpatient,TC,3207,3207,,2722.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,801.75,22,,percent of total billed charges,,,,,,,,,2886.3,90,,percent of total billed charges,,,2655.4,82.8,,percent of total billed charges,,,2725.95,85,,percent of total billed charges,,,,,,,,,2822.16,88,,percent of total billed charges,,,,,,,,,2450.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,801.75,22,,percent of total billed charges,,,2918.37,91,,percent of total billed charges,,,3046.65,95,,percent of total billed charges,,,2661.81,83,,percent of total billed charges,,,2661.81,83,,percent of total billed charges,,,,,,,,,,,,,,,2661.81,83,,percent of total billed charges,,,3046.65,95,,percent of total billed charges,,,2886.3,90,,percent of total billed charges,,,2886.3,90,,percent of total billed charges,,,2629.74,82,,percent of total billed charges,,,2886.3,90,,percent of total billed charges,,,2725.95,85,,percent of total billed charges,,801.75,3046.65,
X FACET INJ C/T SPINE LVL 2,26700117,CDM,64491,CPT,320,RC,outpatient,TC,1632,1632,,1385.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,408,22,,percent of total billed charges,,,,,,,,,1468.8,90,,percent of total billed charges,,,1351.3,82.8,,percent of total billed charges,,,1387.2,85,,percent of total billed charges,,,,,,,,,1436.16,88,,percent of total billed charges,,,,,,,,,1246.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,408,22,,percent of total billed charges,,,1485.12,91,,percent of total billed charges,,,1550.4,95,,percent of total billed charges,,,1354.56,83,,percent of total billed charges,,,1354.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1354.56,83,,percent of total billed charges,,,1550.4,95,,percent of total billed charges,,,1468.8,90,,percent of total billed charges,,,1468.8,90,,percent of total billed charges,,,1338.24,82,,percent of total billed charges,,,1468.8,90,,percent of total billed charges,,,1387.2,85,,percent of total billed charges,,408,1550.4,
X FACET INJ C/T SPINE LVL 3,26700118,CDM,64492,CPT,320,RC,outpatient,TC,1540,1540,,1307.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,385,22,,percent of total billed charges,,,,,,,,,1386,90,,percent of total billed charges,,,1275.12,82.8,,percent of total billed charges,,,1309,85,,percent of total billed charges,,,,,,,,,1355.2,88,,percent of total billed charges,,,,,,,,,1176.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,385,22,,percent of total billed charges,,,1401.4,91,,percent of total billed charges,,,1463,95,,percent of total billed charges,,,1278.2,83,,percent of total billed charges,,,1278.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1278.2,83,,percent of total billed charges,,,1463,95,,percent of total billed charges,,,1386,90,,percent of total billed charges,,,1386,90,,percent of total billed charges,,,1262.8,82,,percent of total billed charges,,,1386,90,,percent of total billed charges,,,1309,85,,percent of total billed charges,,385,1463,
UL ECHO TEE TRANESOPHAGEAL,27200500,CDM,93312,CPT,480,RC,outpatient,TC,5600,5600,,4754.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1400,22,,percent of total billed charges,,,,,,,,,5040,90,,percent of total billed charges,,,4636.8,82.8,,percent of total billed charges,,,4760,85,,percent of total billed charges,,,,,,,,,4928,88,,percent of total billed charges,,,,,,,,,4278.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1400,22,,percent of total billed charges,,,5096,91,,percent of total billed charges,,,5320,95,,percent of total billed charges,,,4648,83,,percent of total billed charges,,,4648,83,,percent of total billed charges,,,,,,,,,,,,,,,4648,83,,percent of total billed charges,,,5320,95,,percent of total billed charges,,,5040,90,,percent of total billed charges,,,5040,90,,percent of total billed charges,,,4592,82,,percent of total billed charges,,,5040,90,,percent of total billed charges,,,4760,85,,percent of total billed charges,,1400,5320,
INJ EPIDURAL CERV THORAC SINGLE,33762310,CDM,62320,CPT,360,RC,outpatient,,2455,2455,,2084.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,613.75,22,,percent of total billed charges,,,,,,,,,2209.5,90,,percent of total billed charges,,,2032.74,82.8,,percent of total billed charges,,,2086.75,85,,percent of total billed charges,,,,,,,,,2160.4,88,,percent of total billed charges,,,,,,,,,1875.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,613.75,22,,percent of total billed charges,,,2234.05,91,,percent of total billed charges,,,2332.25,95,,percent of total billed charges,,,2037.65,83,,percent of total billed charges,,,2037.65,83,,percent of total billed charges,,,,,,,,,,,,,,,2037.65,83,,percent of total billed charges,,,2332.25,95,,percent of total billed charges,,,2209.5,90,,percent of total billed charges,,,2209.5,90,,percent of total billed charges,,,2013.1,82,,percent of total billed charges,,,2209.5,90,,percent of total billed charges,,,2086.75,85,,percent of total billed charges,,613.75,2332.25,
INJ ANES ILIOINGUINAL ILIOHYPOGASTRIC NR,33764425,CDM,64425,CPT,360,RC,outpatient,,2267,2267,,1924.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,566.75,22,,percent of total billed charges,,,,,,,,,2040.3,90,,percent of total billed charges,,,1877.08,82.8,,percent of total billed charges,,,1926.95,85,,percent of total billed charges,,,,,,,,,1994.96,88,,percent of total billed charges,,,,,,,,,1731.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,566.75,22,,percent of total billed charges,,,2062.97,91,,percent of total billed charges,,,2153.65,95,,percent of total billed charges,,,1881.61,83,,percent of total billed charges,,,1881.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1881.61,83,,percent of total billed charges,,,2153.65,95,,percent of total billed charges,,,2040.3,90,,percent of total billed charges,,,2040.3,90,,percent of total billed charges,,,1858.94,82,,percent of total billed charges,,,2040.3,90,,percent of total billed charges,,,1926.95,85,,percent of total billed charges,,566.75,2153.65,
INJ FORAMEN EPIDURAL L/S,33764483,CDM,64483,CPT,360,RC,outpatient,,2455,2455,,2084.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,613.75,22,,percent of total billed charges,,,,,,,,,2209.5,90,,percent of total billed charges,,,2032.74,82.8,,percent of total billed charges,,,2086.75,85,,percent of total billed charges,,,,,,,,,2160.4,88,,percent of total billed charges,,,,,,,,,1875.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,613.75,22,,percent of total billed charges,,,2234.05,91,,percent of total billed charges,,,2332.25,95,,percent of total billed charges,,,2037.65,83,,percent of total billed charges,,,2037.65,83,,percent of total billed charges,,,,,,,,,,,,,,,2037.65,83,,percent of total billed charges,,,2332.25,95,,percent of total billed charges,,,2209.5,90,,percent of total billed charges,,,2209.5,90,,percent of total billed charges,,,2013.1,82,,percent of total billed charges,,,2209.5,90,,percent of total billed charges,,,2086.75,85,,percent of total billed charges,,613.75,2332.25,
TAP BLOCK BI INJECTION,33764488,CDM,64488,CPT,360,RC,outpatient,,3893,3893,,3305.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,973.25,22,,percent of total billed charges,,,,,,,,,3503.7,90,,percent of total billed charges,,,3223.4,82.8,,percent of total billed charges,,,3309.05,85,,percent of total billed charges,,,,,,,,,3425.84,88,,percent of total billed charges,,,,,,,,,2974.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,973.25,22,,percent of total billed charges,,,3542.63,91,,percent of total billed charges,,,3698.35,95,,percent of total billed charges,,,3231.19,83,,percent of total billed charges,,,3231.19,83,,percent of total billed charges,,,,,,,,,,,,,,,3231.19,83,,percent of total billed charges,,,3698.35,95,,percent of total billed charges,,,3503.7,90,,percent of total billed charges,,,3503.7,90,,percent of total billed charges,,,3192.26,82,,percent of total billed charges,,,3503.7,90,,percent of total billed charges,,,3309.05,85,,percent of total billed charges,,973.25,3698.35,
BLOOD ADMINISTRATION SERVICE,880071,CDM,36430,CPT,391,RC,outpatient,,1766,1766,,1499.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,441.5,22,,percent of total billed charges,,,,,,,,,1589.4,90,,percent of total billed charges,,,1462.25,82.8,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,,,,,,,,1554.08,88,,percent of total billed charges,,,,,,,,,1349.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,441.5,22,,percent of total billed charges,,,1607.06,91,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.78,83,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1448.12,82,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,441.5,1677.7,
BLOOD ADMINISTRATION UP TO 6 HOURS,880072,CDM,36430,CPT,391,RC,outpatient,,1709,1709,,1450.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,427.25,22,,percent of total billed charges,,,,,,,,,1538.1,90,,percent of total billed charges,,,1415.05,82.8,,percent of total billed charges,,,1452.65,85,,percent of total billed charges,,,,,,,,,1503.92,88,,percent of total billed charges,,,,,,,,,1305.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,427.25,22,,percent of total billed charges,,,1555.19,91,,percent of total billed charges,,,1623.55,95,,percent of total billed charges,,,1418.47,83,,percent of total billed charges,,,1418.47,83,,percent of total billed charges,,,,,,,,,,,,,,,1418.47,83,,percent of total billed charges,,,1623.55,95,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1401.38,82,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1452.65,85,,percent of total billed charges,,427.25,1623.55,
EXTENDED RECOVERY 1ST HOUR,880080,CDM,,,710,RC,outpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.25,22,,percent of total billed charges,,,,,,,,,188.1,90,,percent of total billed charges,,,173.05,82.8,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.25,22,,percent of total billed charges,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,52.25,198.55,
EXTENDED RECOVERY EACH ADDTL HOUR,880081,CDM,,,710,RC,outpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.25,22,,percent of total billed charges,,,,,,,,,98.1,90,,percent of total billed charges,,,90.25,82.8,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.25,22,,percent of total billed charges,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,27.25,103.55,
"IV INFUSION, HYDRATION, UP TO 1 HOUR",880100,CDM,96360,CPT,260,RC,outpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208,22,,percent of total billed charges,,,,,,,,,748.8,90,,percent of total billed charges,,,688.9,82.8,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208,22,,percent of total billed charges,,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,208,790.4,
"IV INFUSION, HYDRATION, ADDTL HOUR",880101,CDM,96361,CPT,260,RC,outpatient,XU,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
"IV INFUSION, THERAPEUTIC, UP TO 1 HOUR",880102,CDM,96365,CPT,260,RC,outpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208,22,,percent of total billed charges,,,,,,,,,748.8,90,,percent of total billed charges,,,688.9,82.8,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208,22,,percent of total billed charges,,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,208,790.4,
"IV INFUSION, THERAPEUTIC, ADDTL HOUR",880103,CDM,96366,CPT,260,RC,outpatient,XU,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.75,22,,percent of total billed charges,,,,,,,,,225.9,90,,percent of total billed charges,,,207.83,82.8,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.75,22,,percent of total billed charges,,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,62.75,238.45,
CONCURRENT ADDT'L MEDICATED SOLUTION,880104,CDM,96368,CPT,260,RC,outpatient,XU,522,522,,443.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.5,22,,percent of total billed charges,,,,,,,,,469.8,90,,percent of total billed charges,,,432.22,82.8,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,,,,,,,,459.36,88,,percent of total billed charges,,,,,,,,,398.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.5,22,,percent of total billed charges,,,475.02,91,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,,,,,,,,,,,,,433.26,83,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,428.04,82,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,130.5,495.9,
IM/SQ INJECTION,880105,CDM,96372,CPT,260,RC,outpatient,XU,352,352,,298.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88,22,,percent of total billed charges,,,,,,,,,316.8,90,,percent of total billed charges,,,291.46,82.8,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,,,,,,,,309.76,88,,percent of total billed charges,,,,,,,,,268.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88,22,,percent of total billed charges,,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,,,,,,,,,,,,,292.16,83,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,288.64,82,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,88,334.4,
"IVP, SINGLE OR INITIAL",880106,CDM,96374,CPT,260,RC,outpatient,XU,436,436,,370.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109,22,,percent of total billed charges,,,,,,,,,392.4,90,,percent of total billed charges,,,361.01,82.8,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,,,,,,,,383.68,88,,percent of total billed charges,,,,,,,,,333.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109,22,,percent of total billed charges,,,396.76,91,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,,,,,,,,,,,,,361.88,83,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,357.52,82,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,109,414.2,
"IVP, EACH ADDTL OF NEW SUBSTANCE/DRUG",880107,CDM,96375,CPT,260,RC,outpatient,XU,359,359,,304.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.75,22,,percent of total billed charges,,,,,,,,,323.1,90,,percent of total billed charges,,,297.25,82.8,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,,,,,,,,315.92,88,,percent of total billed charges,,,,,,,,,274.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.75,22,,percent of total billed charges,,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,,,,,,,,,,,,,297.97,83,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,294.38,82,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,89.75,341.05,
"IVP, EACH ADDTL SEQUENTIAL INTRA PUSH",880108,CDM,96376,CPT,260,RC,outpatient,XU,274,274,,232.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.5,22,,percent of total billed charges,,,,,,,,,246.6,90,,percent of total billed charges,,,226.87,82.8,,percent of total billed charges,,,232.9,85,,percent of total billed charges,,,,,,,,,241.12,88,,percent of total billed charges,,,,,,,,,209.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.5,22,,percent of total billed charges,,,249.34,91,,percent of total billed charges,,,260.3,95,,percent of total billed charges,,,227.42,83,,percent of total billed charges,,,227.42,83,,percent of total billed charges,,,,,,,,,,,,,,,227.42,83,,percent of total billed charges,,,260.3,95,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,224.68,82,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,232.9,85,,percent of total billed charges,,68.5,260.3,
NURSING CARE OBSERV FIRST HOUR,880120,CDM,G0378,HCPCS,762,RC,outpatient,,1135,1135,,963.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,283.75,22,,percent of total billed charges,,,,,,,,,1021.5,90,,percent of total billed charges,,,939.78,82.8,,percent of total billed charges,,,964.75,85,,percent of total billed charges,,,,,,,,,998.8,88,,percent of total billed charges,,,,,,,,,867.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,283.75,22,,percent of total billed charges,,,1032.85,91,,percent of total billed charges,,,1078.25,95,,percent of total billed charges,,,942.05,83,,percent of total billed charges,,,942.05,83,,percent of total billed charges,,,,,,,,,,,,,,,942.05,83,,percent of total billed charges,,,1078.25,95,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,930.7,82,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,964.75,85,,percent of total billed charges,,283.75,1078.25,
NURSING CARE OBSERV ADDTL HOUR,880121,CDM,G0378,HCPCS,762,RC,outpatient,,187,187,,158.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46.75,22,,percent of total billed charges,,,,,,,,,168.3,90,,percent of total billed charges,,,154.84,82.8,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,,,,,,,,164.56,88,,percent of total billed charges,,,,,,,,,142.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46.75,22,,percent of total billed charges,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,153.34,82,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,46.75,177.65,
TELEMETRY OBSERVATION FIRST HOUR,880122,CDM,G0378,HCPCS,762,RC,outpatient,,1553,1553,,1318.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,388.25,22,,percent of total billed charges,,,,,,,,,1397.7,90,,percent of total billed charges,,,1285.88,82.8,,percent of total billed charges,,,1320.05,85,,percent of total billed charges,,,,,,,,,1366.64,88,,percent of total billed charges,,,,,,,,,1186.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,388.25,22,,percent of total billed charges,,,1413.23,91,,percent of total billed charges,,,1475.35,95,,percent of total billed charges,,,1288.99,83,,percent of total billed charges,,,1288.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1288.99,83,,percent of total billed charges,,,1475.35,95,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1273.46,82,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1320.05,85,,percent of total billed charges,,388.25,1475.35,
TELEMETRY OBSERVATION ADDTL HOUR,880123,CDM,G0378,HCPCS,762,RC,outpatient,,184,184,,156.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,46,22,,percent of total billed charges,,,,,,,,,165.6,90,,percent of total billed charges,,,152.35,82.8,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,,,,,,,,161.92,88,,percent of total billed charges,,,,,,,,,140.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,46,22,,percent of total billed charges,,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,,,,,,,,,,,,,152.72,83,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,150.88,82,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,46,174.8,
UL 3D RENDERING,27100000,CDM,76376,CPT,402,RC,outpatient,TC,1413,1413,,1199.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,353.25,22,,percent of total billed charges,,,,,,,,,1271.7,90,,percent of total billed charges,,,1169.96,82.8,,percent of total billed charges,,,1201.05,85,,percent of total billed charges,,,,,,,,,1243.44,88,,percent of total billed charges,,,,,,,,,1079.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,353.25,22,,percent of total billed charges,,,1285.83,91,,percent of total billed charges,,,1342.35,95,,percent of total billed charges,,,1172.79,83,,percent of total billed charges,,,1172.79,83,,percent of total billed charges,,,,,,,,,,,,,,,1172.79,83,,percent of total billed charges,,,1342.35,95,,percent of total billed charges,,,1271.7,90,,percent of total billed charges,,,1271.7,90,,percent of total billed charges,,,1158.66,82,,percent of total billed charges,,,1271.7,90,,percent of total billed charges,,,1201.05,85,,percent of total billed charges,,353.25,1342.35,
UL OB BIOPHYS WO NST,27100008,CDM,76819,CPT,402,RC,outpatient,TC,1358,1358,,1152.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,339.5,22,,percent of total billed charges,,,,,,,,,1222.2,90,,percent of total billed charges,,,1124.42,82.8,,percent of total billed charges,,,1154.3,85,,percent of total billed charges,,,,,,,,,1195.04,88,,percent of total billed charges,,,,,,,,,1037.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,339.5,22,,percent of total billed charges,,,1235.78,91,,percent of total billed charges,,,1290.1,95,,percent of total billed charges,,,1127.14,83,,percent of total billed charges,,,1127.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1127.14,83,,percent of total billed charges,,,1290.1,95,,percent of total billed charges,,,1222.2,90,,percent of total billed charges,,,1222.2,90,,percent of total billed charges,,,1113.56,82,,percent of total billed charges,,,1222.2,90,,percent of total billed charges,,,1154.3,85,,percent of total billed charges,,339.5,1290.1,
UL OB BIOPHYS W0/NST(EAADDL),27100009,CDM,76819,CPT,402,RC,outpatient,59,1041,1041,,883.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,260.25,22,,percent of total billed charges,,,,,,,,,936.9,90,,percent of total billed charges,,,861.95,82.8,,percent of total billed charges,,,884.85,85,,percent of total billed charges,,,,,,,,,916.08,88,,percent of total billed charges,,,,,,,,,795.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,260.25,22,,percent of total billed charges,,,947.31,91,,percent of total billed charges,,,988.95,95,,percent of total billed charges,,,864.03,83,,percent of total billed charges,,,864.03,83,,percent of total billed charges,,,,,,,,,,,,,,,864.03,83,,percent of total billed charges,,,988.95,95,,percent of total billed charges,,,936.9,90,,percent of total billed charges,,,936.9,90,,percent of total billed charges,,,853.62,82,,percent of total billed charges,,,936.9,90,,percent of total billed charges,,,884.85,85,,percent of total billed charges,,260.25,988.95,
UL OB BIOPHYS W NST,27100010,CDM,76818,CPT,402,RC,outpatient,TC,2244,2244,,1905.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,561,22,,percent of total billed charges,,,,,,,,,2019.6,90,,percent of total billed charges,,,1858.03,82.8,,percent of total billed charges,,,1907.4,85,,percent of total billed charges,,,,,,,,,1974.72,88,,percent of total billed charges,,,,,,,,,1714.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,561,22,,percent of total billed charges,,,2042.04,91,,percent of total billed charges,,,2131.8,95,,percent of total billed charges,,,1862.52,83,,percent of total billed charges,,,1862.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1862.52,83,,percent of total billed charges,,,2131.8,95,,percent of total billed charges,,,2019.6,90,,percent of total billed charges,,,2019.6,90,,percent of total billed charges,,,1840.08,82,,percent of total billed charges,,,2019.6,90,,percent of total billed charges,,,1907.4,85,,percent of total billed charges,,561,2131.8,
UL OB BIOPHYS W/NST(EAADDL),27100011,CDM,76818,CPT,402,RC,outpatient,59,1927,1927,,1636.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,481.75,22,,percent of total billed charges,,,,,,,,,1734.3,90,,percent of total billed charges,,,1595.56,82.8,,percent of total billed charges,,,1637.95,85,,percent of total billed charges,,,,,,,,,1695.76,88,,percent of total billed charges,,,,,,,,,1472.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,481.75,22,,percent of total billed charges,,,1753.57,91,,percent of total billed charges,,,1830.65,95,,percent of total billed charges,,,1599.41,83,,percent of total billed charges,,,1599.41,83,,percent of total billed charges,,,,,,,,,,,,,,,1599.41,83,,percent of total billed charges,,,1830.65,95,,percent of total billed charges,,,1734.3,90,,percent of total billed charges,,,1734.3,90,,percent of total billed charges,,,1580.14,82,,percent of total billed charges,,,1734.3,90,,percent of total billed charges,,,1637.95,85,,percent of total billed charges,,481.75,1830.65,
UL UMBLICAL ARTERY DOPPLER,27100012,CDM,76820,CPT,402,RC,outpatient,TC,791,791,,671.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,197.75,22,,percent of total billed charges,,,,,,,,,711.9,90,,percent of total billed charges,,,654.95,82.8,,percent of total billed charges,,,672.35,85,,percent of total billed charges,,,,,,,,,696.08,88,,percent of total billed charges,,,,,,,,,604.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,197.75,22,,percent of total billed charges,,,719.81,91,,percent of total billed charges,,,751.45,95,,percent of total billed charges,,,656.53,83,,percent of total billed charges,,,656.53,83,,percent of total billed charges,,,,,,,,,,,,,,,656.53,83,,percent of total billed charges,,,751.45,95,,percent of total billed charges,,,711.9,90,,percent of total billed charges,,,711.9,90,,percent of total billed charges,,,648.62,82,,percent of total billed charges,,,711.9,90,,percent of total billed charges,,,672.35,85,,percent of total billed charges,,197.75,751.45,
UL AMNIOCENT GUIDE,27100016,CDM,76946,CPT,402,RC,outpatient,TC,1217,1217,,1033.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,304.25,22,,percent of total billed charges,,,,,,,,,1095.3,90,,percent of total billed charges,,,1007.68,82.8,,percent of total billed charges,,,1034.45,85,,percent of total billed charges,,,,,,,,,1070.96,88,,percent of total billed charges,,,,,,,,,929.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,304.25,22,,percent of total billed charges,,,1107.47,91,,percent of total billed charges,,,1156.15,95,,percent of total billed charges,,,1010.11,83,,percent of total billed charges,,,1010.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1010.11,83,,percent of total billed charges,,,1156.15,95,,percent of total billed charges,,,1095.3,90,,percent of total billed charges,,,1095.3,90,,percent of total billed charges,,,997.94,82,,percent of total billed charges,,,1095.3,90,,percent of total billed charges,,,1034.45,85,,percent of total billed charges,,304.25,1156.15,
UL AV FISTULA DUPLEX,27100030,CDM,93990,CPT,402,RC,outpatient,TC,1172,1172,,995.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,293,22,,percent of total billed charges,,,,,,,,,1054.8,90,,percent of total billed charges,,,970.42,82.8,,percent of total billed charges,,,996.2,85,,percent of total billed charges,,,,,,,,,1031.36,88,,percent of total billed charges,,,,,,,,,895.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,293,22,,percent of total billed charges,,,1066.52,91,,percent of total billed charges,,,1113.4,95,,percent of total billed charges,,,972.76,83,,percent of total billed charges,,,972.76,83,,percent of total billed charges,,,,,,,,,,,,,,,972.76,83,,percent of total billed charges,,,1113.4,95,,percent of total billed charges,,,1054.8,90,,percent of total billed charges,,,1054.8,90,,percent of total billed charges,,,961.04,82,,percent of total billed charges,,,1054.8,90,,percent of total billed charges,,,996.2,85,,percent of total billed charges,,293,1113.4,
UL ECHOCARDIO REAL TIME,27100099,CDM,93307,CPT,480,RC,outpatient,,1724,1724,,1463.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,431,22,,percent of total billed charges,,,,,,,,,1551.6,90,,percent of total billed charges,,,1427.47,82.8,,percent of total billed charges,,,1465.4,85,,percent of total billed charges,,,,,,,,,1517.12,88,,percent of total billed charges,,,,,,,,,1317.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,431,22,,percent of total billed charges,,,1568.84,91,,percent of total billed charges,,,1637.8,95,,percent of total billed charges,,,1430.92,83,,percent of total billed charges,,,1430.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1430.92,83,,percent of total billed charges,,,1637.8,95,,percent of total billed charges,,,1551.6,90,,percent of total billed charges,,,1551.6,90,,percent of total billed charges,,,1413.68,82,,percent of total billed charges,,,1551.6,90,,percent of total billed charges,,,1465.4,85,,percent of total billed charges,,431,1637.8,
UL ECHOCARDIO COLOR MAP,27100487,CDM,93325,CPT,480,RC,outpatient,,965,965,,819.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,241.25,22,,percent of total billed charges,,,,,,,,,868.5,90,,percent of total billed charges,,,799.02,82.8,,percent of total billed charges,,,820.25,85,,percent of total billed charges,,,,,,,,,849.2,88,,percent of total billed charges,,,,,,,,,737.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,241.25,22,,percent of total billed charges,,,878.15,91,,percent of total billed charges,,,916.75,95,,percent of total billed charges,,,800.95,83,,percent of total billed charges,,,800.95,83,,percent of total billed charges,,,,,,,,,,,,,,,800.95,83,,percent of total billed charges,,,916.75,95,,percent of total billed charges,,,868.5,90,,percent of total billed charges,,,868.5,90,,percent of total billed charges,,,791.3,82,,percent of total billed charges,,,868.5,90,,percent of total billed charges,,,820.25,85,,percent of total billed charges,,241.25,916.75,
UL ECHO/COMPLETE,27100488,CDM,93306,CPT,480,RC,outpatient,,4541,4541,,3855.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1135.25,22,,percent of total billed charges,,,,,,,,,4086.9,90,,percent of total billed charges,,,3759.95,82.8,,percent of total billed charges,,,3859.85,85,,percent of total billed charges,,,,,,,,,3996.08,88,,percent of total billed charges,,,,,,,,,3469.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1135.25,22,,percent of total billed charges,,,4132.31,91,,percent of total billed charges,,,4313.95,95,,percent of total billed charges,,,3769.03,83,,percent of total billed charges,,,3769.03,83,,percent of total billed charges,,,,,,,,,,,,,,,3769.03,83,,percent of total billed charges,,,4313.95,95,,percent of total billed charges,,,4086.9,90,,percent of total billed charges,,,4086.9,90,,percent of total billed charges,,,3723.62,82,,percent of total billed charges,,,4086.9,90,,percent of total billed charges,,,3859.85,85,,percent of total billed charges,,1135.25,4313.95,
UL ECHO EXERCISE STRESS,27100489,CDM,93350,CPT,480,RC,outpatient,TC,3598,3598,,3054.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,899.5,22,,percent of total billed charges,,,,,,,,,3238.2,90,,percent of total billed charges,,,2979.14,82.8,,percent of total billed charges,,,3058.3,85,,percent of total billed charges,,,,,,,,,3166.24,88,,percent of total billed charges,,,,,,,,,2748.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,899.5,22,,percent of total billed charges,,,3274.18,91,,percent of total billed charges,,,3418.1,95,,percent of total billed charges,,,2986.34,83,,percent of total billed charges,,,2986.34,83,,percent of total billed charges,,,,,,,,,,,,,,,2986.34,83,,percent of total billed charges,,,3418.1,95,,percent of total billed charges,,,3238.2,90,,percent of total billed charges,,,3238.2,90,,percent of total billed charges,,,2950.36,82,,percent of total billed charges,,,3238.2,90,,percent of total billed charges,,,3058.3,85,,percent of total billed charges,,899.5,3418.1,
UL ECHO/LIMITED OR F/U,27100490,CDM,93308,CPT,480,RC,outpatient,,2113,2113,,1793.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,528.25,22,,percent of total billed charges,,,,,,,,,1901.7,90,,percent of total billed charges,,,1749.56,82.8,,percent of total billed charges,,,1796.05,85,,percent of total billed charges,,,,,,,,,1859.44,88,,percent of total billed charges,,,,,,,,,1614.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,528.25,22,,percent of total billed charges,,,1922.83,91,,percent of total billed charges,,,2007.35,95,,percent of total billed charges,,,1753.79,83,,percent of total billed charges,,,1753.79,83,,percent of total billed charges,,,,,,,,,,,,,,,1753.79,83,,percent of total billed charges,,,2007.35,95,,percent of total billed charges,,,1901.7,90,,percent of total billed charges,,,1901.7,90,,percent of total billed charges,,,1732.66,82,,percent of total billed charges,,,1901.7,90,,percent of total billed charges,,,1796.05,85,,percent of total billed charges,,528.25,2007.35,
UL DOPPLER ECHO F/U OR LTD,27100491,CDM,93321,CPT,480,RC,outpatient,,2119,2119,,1799.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,529.75,22,,percent of total billed charges,,,,,,,,,1907.1,90,,percent of total billed charges,,,1754.53,82.8,,percent of total billed charges,,,1801.15,85,,percent of total billed charges,,,,,,,,,1864.72,88,,percent of total billed charges,,,,,,,,,1618.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,529.75,22,,percent of total billed charges,,,1928.29,91,,percent of total billed charges,,,2013.05,95,,percent of total billed charges,,,1758.77,83,,percent of total billed charges,,,1758.77,83,,percent of total billed charges,,,,,,,,,,,,,,,1758.77,83,,percent of total billed charges,,,2013.05,95,,percent of total billed charges,,,1907.1,90,,percent of total billed charges,,,1907.1,90,,percent of total billed charges,,,1737.58,82,,percent of total billed charges,,,1907.1,90,,percent of total billed charges,,,1801.15,85,,percent of total billed charges,,529.75,2013.05,
UL ECHO DOBUTAMINE STRESS,27100493,CDM,93350,CPT,480,RC,outpatient,TC,3598,3598,,3054.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,899.5,22,,percent of total billed charges,,,,,,,,,3238.2,90,,percent of total billed charges,,,2979.14,82.8,,percent of total billed charges,,,3058.3,85,,percent of total billed charges,,,,,,,,,3166.24,88,,percent of total billed charges,,,,,,,,,2748.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,899.5,22,,percent of total billed charges,,,3274.18,91,,percent of total billed charges,,,3418.1,95,,percent of total billed charges,,,2986.34,83,,percent of total billed charges,,,2986.34,83,,percent of total billed charges,,,,,,,,,,,,,,,2986.34,83,,percent of total billed charges,,,3418.1,95,,percent of total billed charges,,,3238.2,90,,percent of total billed charges,,,3238.2,90,,percent of total billed charges,,,2950.36,82,,percent of total billed charges,,,3238.2,90,,percent of total billed charges,,,3058.3,85,,percent of total billed charges,,899.5,3418.1,
UL ECHO COMPLETE PEDIATRIC,27100498,CDM,93306,CPT,480,RC,outpatient,,4541,4541,,3855.31,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1135.25,22,,percent of total billed charges,,,,,,,,,4086.9,90,,percent of total billed charges,,,3759.95,82.8,,percent of total billed charges,,,3859.85,85,,percent of total billed charges,,,,,,,,,3996.08,88,,percent of total billed charges,,,,,,,,,3469.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1135.25,22,,percent of total billed charges,,,4132.31,91,,percent of total billed charges,,,4313.95,95,,percent of total billed charges,,,3769.03,83,,percent of total billed charges,,,3769.03,83,,percent of total billed charges,,,,,,,,,,,,,,,3769.03,83,,percent of total billed charges,,,4313.95,95,,percent of total billed charges,,,4086.9,90,,percent of total billed charges,,,4086.9,90,,percent of total billed charges,,,3723.62,82,,percent of total billed charges,,,4086.9,90,,percent of total billed charges,,,3859.85,85,,percent of total billed charges,,1135.25,4313.95,
* DNU US ECHO TEE TRANSESOPHAGEAL,27100499,CDM,93312,CPT,480,RC,outpatient,,6023,6023,,5113.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1505.75,22,,percent of total billed charges,,,,,,,,,5420.7,90,,percent of total billed charges,,,4987.04,82.8,,percent of total billed charges,,,5119.55,85,,percent of total billed charges,,,,,,,,,5300.24,88,,percent of total billed charges,,,,,,,,,4601.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1505.75,22,,percent of total billed charges,,,5480.93,91,,percent of total billed charges,,,5721.85,95,,percent of total billed charges,,,4999.09,83,,percent of total billed charges,,,4999.09,83,,percent of total billed charges,,,,,,,,,,,,,,,4999.09,83,,percent of total billed charges,,,5721.85,95,,percent of total billed charges,,,5420.7,90,,percent of total billed charges,,,5420.7,90,,percent of total billed charges,,,4938.86,82,,percent of total billed charges,,,5420.7,90,,percent of total billed charges,,,5119.55,85,,percent of total billed charges,,1505.75,5721.85,
UL ECHO CONTRAST/COMPLETE,27100500,CDM,C8929,HCPCS,480,RC,outpatient,,4773,4773,,4052.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1193.25,22,,percent of total billed charges,,,,,,,,,4295.7,90,,percent of total billed charges,,,3952.04,82.8,,percent of total billed charges,,,4057.05,85,,percent of total billed charges,,,,,,,,,4200.24,88,,percent of total billed charges,,,,,,,,,3646.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1193.25,22,,percent of total billed charges,,,4343.43,91,,percent of total billed charges,,,4534.35,95,,percent of total billed charges,,,3961.59,83,,percent of total billed charges,,,3961.59,83,,percent of total billed charges,,,,,,,,,,,,,,,3961.59,83,,percent of total billed charges,,,4534.35,95,,percent of total billed charges,,,4295.7,90,,percent of total billed charges,,,4295.7,90,,percent of total billed charges,,,3913.86,82,,percent of total billed charges,,,4295.7,90,,percent of total billed charges,,,4057.05,85,,percent of total billed charges,,1193.25,4534.35,
UL ECHO CONTRAST/LIMITED OR F/U,27100501,CDM,C8929,HCPCS,480,RC,outpatient,,4773,4773,,4052.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1193.25,22,,percent of total billed charges,,,,,,,,,4295.7,90,,percent of total billed charges,,,3952.04,82.8,,percent of total billed charges,,,4057.05,85,,percent of total billed charges,,,,,,,,,4200.24,88,,percent of total billed charges,,,,,,,,,3646.57,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1193.25,22,,percent of total billed charges,,,4343.43,91,,percent of total billed charges,,,4534.35,95,,percent of total billed charges,,,3961.59,83,,percent of total billed charges,,,3961.59,83,,percent of total billed charges,,,,,,,,,,,,,,,3961.59,83,,percent of total billed charges,,,4534.35,95,,percent of total billed charges,,,4295.7,90,,percent of total billed charges,,,4295.7,90,,percent of total billed charges,,,3913.86,82,,percent of total billed charges,,,4295.7,90,,percent of total billed charges,,,4057.05,85,,percent of total billed charges,,1193.25,4534.35,
UL TRANSVAGINAL (NOT OB),27100529,CDM,76830,CPT,402,RC,outpatient,TC,1526,1526,,1295.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,381.5,22,,percent of total billed charges,,,,,,,,,1373.4,90,,percent of total billed charges,,,1263.53,82.8,,percent of total billed charges,,,1297.1,85,,percent of total billed charges,,,,,,,,,1342.88,88,,percent of total billed charges,,,,,,,,,1165.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,381.5,22,,percent of total billed charges,,,1388.66,91,,percent of total billed charges,,,1449.7,95,,percent of total billed charges,,,1266.58,83,,percent of total billed charges,,,1266.58,83,,percent of total billed charges,,,,,,,,,,,,,,,1266.58,83,,percent of total billed charges,,,1449.7,95,,percent of total billed charges,,,1373.4,90,,percent of total billed charges,,,1373.4,90,,percent of total billed charges,,,1251.32,82,,percent of total billed charges,,,1373.4,90,,percent of total billed charges,,,1297.1,85,,percent of total billed charges,,381.5,1449.7,
UL TRANSRECTAL (SURGERY),27100537,CDM,76872,CPT,402,RC,outpatient,TC,1231,1231,,1045.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,307.75,22,,percent of total billed charges,,,,,,,,,1107.9,90,,percent of total billed charges,,,1019.27,82.8,,percent of total billed charges,,,1046.35,85,,percent of total billed charges,,,,,,,,,1083.28,88,,percent of total billed charges,,,,,,,,,940.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,307.75,22,,percent of total billed charges,,,1120.21,91,,percent of total billed charges,,,1169.45,95,,percent of total billed charges,,,1021.73,83,,percent of total billed charges,,,1021.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1021.73,83,,percent of total billed charges,,,1169.45,95,,percent of total billed charges,,,1107.9,90,,percent of total billed charges,,,1107.9,90,,percent of total billed charges,,,1009.42,82,,percent of total billed charges,,,1107.9,90,,percent of total billed charges,,,1046.35,85,,percent of total billed charges,,307.75,1169.45,
UL TRANSRECTAL (IN DEPT),27100538,CDM,76872,CPT,402,RC,outpatient,TC,1234,1234,,1047.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,308.5,22,,percent of total billed charges,,,,,,,,,1110.6,90,,percent of total billed charges,,,1021.75,82.8,,percent of total billed charges,,,1048.9,85,,percent of total billed charges,,,,,,,,,1085.92,88,,percent of total billed charges,,,,,,,,,942.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,308.5,22,,percent of total billed charges,,,1122.94,91,,percent of total billed charges,,,1172.3,95,,percent of total billed charges,,,1024.22,83,,percent of total billed charges,,,1024.22,83,,percent of total billed charges,,,,,,,,,,,,,,,1024.22,83,,percent of total billed charges,,,1172.3,95,,percent of total billed charges,,,1110.6,90,,percent of total billed charges,,,1110.6,90,,percent of total billed charges,,,1011.88,82,,percent of total billed charges,,,1110.6,90,,percent of total billed charges,,,1048.9,85,,percent of total billed charges,,308.5,1172.3,
UL UP EXTVENDOPBILAT,27100545,CDM,93970,CPT,921,RC,outpatient,TC,3662,3662,,3109.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,915.5,22,,percent of total billed charges,,,,,,,,,3295.8,90,,percent of total billed charges,,,3032.14,82.8,,percent of total billed charges,,,3112.7,85,,percent of total billed charges,,,,,,,,,3222.56,88,,percent of total billed charges,,,,,,,,,2797.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,915.5,22,,percent of total billed charges,,,3332.42,91,,percent of total billed charges,,,3478.9,95,,percent of total billed charges,,,3039.46,83,,percent of total billed charges,,,3039.46,83,,percent of total billed charges,,,,,,,,,,,,,,,3039.46,83,,percent of total billed charges,,,3478.9,95,,percent of total billed charges,,,3295.8,90,,percent of total billed charges,,,3295.8,90,,percent of total billed charges,,,3002.84,82,,percent of total billed charges,,,3295.8,90,,percent of total billed charges,,,3112.7,85,,percent of total billed charges,,915.5,3478.9,
UL LOW EXTVENDOPBILAT,27100546,CDM,93970,CPT,921,RC,outpatient,TC,2591,2591,,2199.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,647.75,22,,percent of total billed charges,,,,,,,,,2331.9,90,,percent of total billed charges,,,2145.35,82.8,,percent of total billed charges,,,2202.35,85,,percent of total billed charges,,,,,,,,,2280.08,88,,percent of total billed charges,,,,,,,,,1979.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,647.75,22,,percent of total billed charges,,,2357.81,91,,percent of total billed charges,,,2461.45,95,,percent of total billed charges,,,2150.53,83,,percent of total billed charges,,,2150.53,83,,percent of total billed charges,,,,,,,,,,,,,,,2150.53,83,,percent of total billed charges,,,2461.45,95,,percent of total billed charges,,,2331.9,90,,percent of total billed charges,,,2331.9,90,,percent of total billed charges,,,2124.62,82,,percent of total billed charges,,,2331.9,90,,percent of total billed charges,,,2202.35,85,,percent of total billed charges,,647.75,2461.45,
UL INF HIPS BIL W/DR,27100889,CDM,76885,CPT,402,RC,outpatient,TC,1005,1005,,853.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,251.25,22,,percent of total billed charges,,,,,,,,,904.5,90,,percent of total billed charges,,,832.14,82.8,,percent of total billed charges,,,854.25,85,,percent of total billed charges,,,,,,,,,884.4,88,,percent of total billed charges,,,,,,,,,767.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,251.25,22,,percent of total billed charges,,,914.55,91,,percent of total billed charges,,,954.75,95,,percent of total billed charges,,,834.15,83,,percent of total billed charges,,,834.15,83,,percent of total billed charges,,,,,,,,,,,,,,,834.15,83,,percent of total billed charges,,,954.75,95,,percent of total billed charges,,,904.5,90,,percent of total billed charges,,,904.5,90,,percent of total billed charges,,,824.1,82,,percent of total billed charges,,,904.5,90,,percent of total billed charges,,,854.25,85,,percent of total billed charges,,251.25,954.75,
UL INF HIPS NO DR,27100890,CDM,76886,CPT,402,RC,outpatient,TC,943,943,,800.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.75,22,,percent of total billed charges,,,,,,,,,848.7,90,,percent of total billed charges,,,780.8,82.8,,percent of total billed charges,,,801.55,85,,percent of total billed charges,,,,,,,,,829.84,88,,percent of total billed charges,,,,,,,,,720.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.75,22,,percent of total billed charges,,,858.13,91,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,,,,,,,,,,,,,782.69,83,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,773.26,82,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,801.55,85,,percent of total billed charges,,235.75,895.85,
UL UP EXT NON-VASC RIGHT COMPLETE,27100891,CDM,76881,CPT,402,RC,outpatient,RT,1505,1505,,1277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,376.25,22,,percent of total billed charges,,,,,,,,,1354.5,90,,percent of total billed charges,,,1246.14,82.8,,percent of total billed charges,,,1279.25,85,,percent of total billed charges,,,,,,,,,1324.4,88,,percent of total billed charges,,,,,,,,,1149.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,376.25,22,,percent of total billed charges,,,1369.55,91,,percent of total billed charges,,,1429.75,95,,percent of total billed charges,,,1249.15,83,,percent of total billed charges,,,1249.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1249.15,83,,percent of total billed charges,,,1429.75,95,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1234.1,82,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1279.25,85,,percent of total billed charges,,376.25,1429.75,
UL UP EXT NON-VASC LEFT COMPLETE,27100892,CDM,76881,CPT,402,RC,outpatient,LT,1505,1505,,1277.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,376.25,22,,percent of total billed charges,,,,,,,,,1354.5,90,,percent of total billed charges,,,1246.14,82.8,,percent of total billed charges,,,1279.25,85,,percent of total billed charges,,,,,,,,,1324.4,88,,percent of total billed charges,,,,,,,,,1149.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,376.25,22,,percent of total billed charges,,,1369.55,91,,percent of total billed charges,,,1429.75,95,,percent of total billed charges,,,1249.15,83,,percent of total billed charges,,,1249.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1249.15,83,,percent of total billed charges,,,1429.75,95,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1234.1,82,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1279.25,85,,percent of total billed charges,,376.25,1429.75,
UL LOW EXT NON-VASC RIGHT COMPLETE,27100893,CDM,76881,CPT,402,RC,outpatient,RT,1195,1195,,1014.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,298.75,22,,percent of total billed charges,,,,,,,,,1075.5,90,,percent of total billed charges,,,989.46,82.8,,percent of total billed charges,,,1015.75,85,,percent of total billed charges,,,,,,,,,1051.6,88,,percent of total billed charges,,,,,,,,,912.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,298.75,22,,percent of total billed charges,,,1087.45,91,,percent of total billed charges,,,1135.25,95,,percent of total billed charges,,,991.85,83,,percent of total billed charges,,,991.85,83,,percent of total billed charges,,,,,,,,,,,,,,,991.85,83,,percent of total billed charges,,,1135.25,95,,percent of total billed charges,,,1075.5,90,,percent of total billed charges,,,1075.5,90,,percent of total billed charges,,,979.9,82,,percent of total billed charges,,,1075.5,90,,percent of total billed charges,,,1015.75,85,,percent of total billed charges,,298.75,1135.25,
UL LOW EXT NON-VASC LEFT COMPLETE,27100894,CDM,76881,CPT,402,RC,outpatient,LT,1195,1195,,1014.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,298.75,22,,percent of total billed charges,,,,,,,,,1075.5,90,,percent of total billed charges,,,989.46,82.8,,percent of total billed charges,,,1015.75,85,,percent of total billed charges,,,,,,,,,1051.6,88,,percent of total billed charges,,,,,,,,,912.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,298.75,22,,percent of total billed charges,,,1087.45,91,,percent of total billed charges,,,1135.25,95,,percent of total billed charges,,,991.85,83,,percent of total billed charges,,,991.85,83,,percent of total billed charges,,,,,,,,,,,,,,,991.85,83,,percent of total billed charges,,,1135.25,95,,percent of total billed charges,,,1075.5,90,,percent of total billed charges,,,1075.5,90,,percent of total billed charges,,,979.9,82,,percent of total billed charges,,,1075.5,90,,percent of total billed charges,,,1015.75,85,,percent of total billed charges,,298.75,1135.25,
UL EXT NON VASCULAR LIMITED RT LIMITED,27100895,CDM,76882,CPT,402,RC,outpatient,RT,1169,1169,,992.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,292.25,22,,percent of total billed charges,,,,,,,,,1052.1,90,,percent of total billed charges,,,967.93,82.8,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,,,,,,,,1028.72,88,,percent of total billed charges,,,,,,,,,893.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,292.25,22,,percent of total billed charges,,,1063.79,91,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,,,,,,,,,,,,,970.27,83,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,958.58,82,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,292.25,1110.55,
UL EXT NON VASCULAR LIMITED LEFT LIMITED,27100896,CDM,76882,CPT,402,RC,outpatient,LT,1169,1169,,992.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,292.25,22,,percent of total billed charges,,,,,,,,,1052.1,90,,percent of total billed charges,,,967.93,82.8,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,,,,,,,,1028.72,88,,percent of total billed charges,,,,,,,,,893.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,292.25,22,,percent of total billed charges,,,1063.79,91,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,,,,,,,,,,,,,970.27,83,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,958.58,82,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,292.25,1110.55,
UL JNT NON VASC RIGHT LIMITED,27100898,CDM,76882,CPT,402,RC,outpatient,RT,1169,1169,,992.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,292.25,22,,percent of total billed charges,,,,,,,,,1052.1,90,,percent of total billed charges,,,967.93,82.8,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,,,,,,,,1028.72,88,,percent of total billed charges,,,,,,,,,893.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,292.25,22,,percent of total billed charges,,,1063.79,91,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,,,,,,,,,,,,,970.27,83,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,958.58,82,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,292.25,1110.55,
UL JNT NON VASC LEFT LIMITED,27100899,CDM,76882,CPT,402,RC,outpatient,LT,1169,1169,,992.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,292.25,22,,percent of total billed charges,,,,,,,,,1052.1,90,,percent of total billed charges,,,967.93,82.8,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,,,,,,,,1028.72,88,,percent of total billed charges,,,,,,,,,893.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,292.25,22,,percent of total billed charges,,,1063.79,91,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,,,,,,,,,,,,,970.27,83,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,958.58,82,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,292.25,1110.55,
UL SOFT TISSUE LIMITED,27100901,CDM,76882,CPT,402,RC,outpatient,TC,1169,1169,,992.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,292.25,22,,percent of total billed charges,,,,,,,,,1052.1,90,,percent of total billed charges,,,967.93,82.8,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,,,,,,,,1028.72,88,,percent of total billed charges,,,,,,,,,893.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,292.25,22,,percent of total billed charges,,,1063.79,91,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,,,,,,,,,,,,,970.27,83,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,958.58,82,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,292.25,1110.55,
UL ST HEADAND/ORNECK,27101141,CDM,76536,CPT,402,RC,outpatient,TC,1607,1607,,1364.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,401.75,22,,percent of total billed charges,,,,,,,,,1446.3,90,,percent of total billed charges,,,1330.6,82.8,,percent of total billed charges,,,1365.95,85,,percent of total billed charges,,,,,,,,,1414.16,88,,percent of total billed charges,,,,,,,,,1227.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,401.75,22,,percent of total billed charges,,,1462.37,91,,percent of total billed charges,,,1526.65,95,,percent of total billed charges,,,1333.81,83,,percent of total billed charges,,,1333.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1333.81,83,,percent of total billed charges,,,1526.65,95,,percent of total billed charges,,,1446.3,90,,percent of total billed charges,,,1446.3,90,,percent of total billed charges,,,1317.74,82,,percent of total billed charges,,,1446.3,90,,percent of total billed charges,,,1365.95,85,,percent of total billed charges,,401.75,1526.65,
UL ABD LTD (SNGL ORGAN/QUAD),27101345,CDM,76705,CPT,402,RC,outpatient,TC,1617,1617,,1372.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,404.25,22,,percent of total billed charges,,,,,,,,,1455.3,90,,percent of total billed charges,,,1338.88,82.8,,percent of total billed charges,,,1374.45,85,,percent of total billed charges,,,,,,,,,1422.96,88,,percent of total billed charges,,,,,,,,,1235.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,404.25,22,,percent of total billed charges,,,1471.47,91,,percent of total billed charges,,,1536.15,95,,percent of total billed charges,,,1342.11,83,,percent of total billed charges,,,1342.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1342.11,83,,percent of total billed charges,,,1536.15,95,,percent of total billed charges,,,1455.3,90,,percent of total billed charges,,,1455.3,90,,percent of total billed charges,,,1325.94,82,,percent of total billed charges,,,1455.3,90,,percent of total billed charges,,,1374.45,85,,percent of total billed charges,,404.25,1536.15,
UL LIVER ELASTOGRAPHY,27101346,CDM,76981,CPT,402,RC,outpatient,TC,1051,1051,,892.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,262.75,22,,percent of total billed charges,,,,,,,,,945.9,90,,percent of total billed charges,,,870.23,82.8,,percent of total billed charges,,,893.35,85,,percent of total billed charges,,,,,,,,,924.88,88,,percent of total billed charges,,,,,,,,,802.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,262.75,22,,percent of total billed charges,,,956.41,91,,percent of total billed charges,,,998.45,95,,percent of total billed charges,,,872.33,83,,percent of total billed charges,,,872.33,83,,percent of total billed charges,,,,,,,,,,,,,,,872.33,83,,percent of total billed charges,,,998.45,95,,percent of total billed charges,,,945.9,90,,percent of total billed charges,,,945.9,90,,percent of total billed charges,,,861.82,82,,percent of total billed charges,,,945.9,90,,percent of total billed charges,,,893.35,85,,percent of total billed charges,,262.75,998.45,
BX THORACENTESIS,27101450,CDM,32555,CPT,361,RC,outpatient,,3058,3058,,2596.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,764.5,22,,percent of total billed charges,,,,,,,,,2752.2,90,,percent of total billed charges,,,2532.02,82.8,,percent of total billed charges,,,2599.3,85,,percent of total billed charges,,,,,,,,,2691.04,88,,percent of total billed charges,,,,,,,,,2336.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,764.5,22,,percent of total billed charges,,,2782.78,91,,percent of total billed charges,,,2905.1,95,,percent of total billed charges,,,2538.14,83,,percent of total billed charges,,,2538.14,83,,percent of total billed charges,,,,,,,,,,,,,,,2538.14,83,,percent of total billed charges,,,2905.1,95,,percent of total billed charges,,,2752.2,90,,percent of total billed charges,,,2752.2,90,,percent of total billed charges,,,2507.56,82,,percent of total billed charges,,,2752.2,90,,percent of total billed charges,,,2599.3,85,,percent of total billed charges,,764.5,2905.1,
UL BREAST CORE BX LT (EA),27101454,CDM,19083,CPT,402,RC,outpatient,LT,5772,5772,,4900.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1443,22,,percent of total billed charges,,,,,,,,,5194.8,90,,percent of total billed charges,,,4779.22,82.8,,percent of total billed charges,,,4906.2,85,,percent of total billed charges,,,,,,,,,5079.36,88,,percent of total billed charges,,,,,,,,,4409.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1443,22,,percent of total billed charges,,,5252.52,91,,percent of total billed charges,,,5483.4,95,,percent of total billed charges,,,4790.76,83,,percent of total billed charges,,,4790.76,83,,percent of total billed charges,,,,,,,,,,,,,,,4790.76,83,,percent of total billed charges,,,5483.4,95,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,4733.04,82,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,4906.2,85,,percent of total billed charges,,1443,5483.4,
UL BREAST CORE BX RT (EA),27101455,CDM,19083,CPT,402,RC,outpatient,RT,5772,5772,,4900.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1443,22,,percent of total billed charges,,,,,,,,,5194.8,90,,percent of total billed charges,,,4779.22,82.8,,percent of total billed charges,,,4906.2,85,,percent of total billed charges,,,,,,,,,5079.36,88,,percent of total billed charges,,,,,,,,,4409.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1443,22,,percent of total billed charges,,,5252.52,91,,percent of total billed charges,,,5483.4,95,,percent of total billed charges,,,4790.76,83,,percent of total billed charges,,,4790.76,83,,percent of total billed charges,,,,,,,,,,,,,,,4790.76,83,,percent of total billed charges,,,5483.4,95,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,4733.04,82,,percent of total billed charges,,,5194.8,90,,percent of total billed charges,,,4906.2,85,,percent of total billed charges,,1443,5483.4,
UL PARACENTESIS W/ IMAGING,27101456,CDM,49083,CPT,361,RC,outpatient,TC,3538,3538,,3003.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,884.5,22,,percent of total billed charges,,,,,,,,,3184.2,90,,percent of total billed charges,,,2929.46,82.8,,percent of total billed charges,,,3007.3,85,,percent of total billed charges,,,,,,,,,3113.44,88,,percent of total billed charges,,,,,,,,,2703.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,884.5,22,,percent of total billed charges,,,3219.58,91,,percent of total billed charges,,,3361.1,95,,percent of total billed charges,,,2936.54,83,,percent of total billed charges,,,2936.54,83,,percent of total billed charges,,,,,,,,,,,,,,,2936.54,83,,percent of total billed charges,,,3361.1,95,,percent of total billed charges,,,3184.2,90,,percent of total billed charges,,,3184.2,90,,percent of total billed charges,,,2901.16,82,,percent of total billed charges,,,3184.2,90,,percent of total billed charges,,,3007.3,85,,percent of total billed charges,,884.5,3361.1,
ASSOCIATED 19000 BREAST ASPIRATION SINGL,27101457,CDM,19000,CPT,361,RC,outpatient,TC,1814,1814,,1540.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,453.5,22,,percent of total billed charges,,,,,,,,,1632.6,90,,percent of total billed charges,,,1501.99,82.8,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,,,,,,,,1596.32,88,,percent of total billed charges,,,,,,,,,1385.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,453.5,22,,percent of total billed charges,,,1650.74,91,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.62,83,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1487.48,82,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,453.5,1723.3,
ASSOCIATED 19001 BREAST ASPIRATION MULT,27101458,CDM,19001,CPT,361,RC,outpatient,TC,1968,1968,,1670.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,492,22,,percent of total billed charges,,,,,,,,,1771.2,90,,percent of total billed charges,,,1629.5,82.8,,percent of total billed charges,,,1672.8,85,,percent of total billed charges,,,,,,,,,1731.84,88,,percent of total billed charges,,,,,,,,,1503.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,492,22,,percent of total billed charges,,,1790.88,91,,percent of total billed charges,,,1869.6,95,,percent of total billed charges,,,1633.44,83,,percent of total billed charges,,,1633.44,83,,percent of total billed charges,,,,,,,,,,,,,,,1633.44,83,,percent of total billed charges,,,1869.6,95,,percent of total billed charges,,,1771.2,90,,percent of total billed charges,,,1771.2,90,,percent of total billed charges,,,1613.76,82,,percent of total billed charges,,,1771.2,90,,percent of total billed charges,,,1672.8,85,,percent of total billed charges,,492,1869.6,
* DNU BX BREAST ASPIR ADDL LT,27101459,CDM,19001,CPT,361,RC,outpatient,TC,1814,1814,,1540.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,453.5,22,,percent of total billed charges,,,,,,,,,1632.6,90,,percent of total billed charges,,,1501.99,82.8,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,,,,,,,,1596.32,88,,percent of total billed charges,,,,,,,,,1385.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,453.5,22,,percent of total billed charges,,,1650.74,91,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.62,83,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1487.48,82,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,453.5,1723.3,
BX NEEDLE ASPIR/NON-SPEC,27101460,CDM,10005,CPT,361,RC,outpatient,TC,1814,1814,,1540.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,453.5,22,,percent of total billed charges,,,,,,,,,1632.6,90,,percent of total billed charges,,,1501.99,82.8,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,,,,,,,,1596.32,88,,percent of total billed charges,,,,,,,,,1385.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,453.5,22,,percent of total billed charges,,,1650.74,91,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.62,83,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1487.48,82,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,453.5,1723.3,
UL BREAST NEEDLE LOCALIZATION W/US LT,27101461,CDM,19285,CPT,402,RC,outpatient,LT,3976,3976,,3375.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,994,22,,percent of total billed charges,,,,,,,,,3578.4,90,,percent of total billed charges,,,3292.13,82.8,,percent of total billed charges,,,3379.6,85,,percent of total billed charges,,,,,,,,,3498.88,88,,percent of total billed charges,,,,,,,,,3037.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,994,22,,percent of total billed charges,,,3618.16,91,,percent of total billed charges,,,3777.2,95,,percent of total billed charges,,,3300.08,83,,percent of total billed charges,,,3300.08,83,,percent of total billed charges,,,,,,,,,,,,,,,3300.08,83,,percent of total billed charges,,,3777.2,95,,percent of total billed charges,,,3578.4,90,,percent of total billed charges,,,3578.4,90,,percent of total billed charges,,,3260.32,82,,percent of total billed charges,,,3578.4,90,,percent of total billed charges,,,3379.6,85,,percent of total billed charges,,994,3777.2,
UL BREAST NEEDLE LOCALIZATION W/US RT,27101462,CDM,19285,CPT,402,RC,outpatient,RT,3976,3976,,3375.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,994,22,,percent of total billed charges,,,,,,,,,3578.4,90,,percent of total billed charges,,,3292.13,82.8,,percent of total billed charges,,,3379.6,85,,percent of total billed charges,,,,,,,,,3498.88,88,,percent of total billed charges,,,,,,,,,3037.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,994,22,,percent of total billed charges,,,3618.16,91,,percent of total billed charges,,,3777.2,95,,percent of total billed charges,,,3300.08,83,,percent of total billed charges,,,3300.08,83,,percent of total billed charges,,,,,,,,,,,,,,,3300.08,83,,percent of total billed charges,,,3777.2,95,,percent of total billed charges,,,3578.4,90,,percent of total billed charges,,,3578.4,90,,percent of total billed charges,,,3260.32,82,,percent of total billed charges,,,3578.4,90,,percent of total billed charges,,,3379.6,85,,percent of total billed charges,,994,3777.2,
UL THYROID BX,27101463,CDM,60100,CPT,361,RC,outpatient,TC,2178,2178,,1849.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,544.5,22,,percent of total billed charges,,,,,,,,,1960.2,90,,percent of total billed charges,,,1803.38,82.8,,percent of total billed charges,,,1851.3,85,,percent of total billed charges,,,,,,,,,1916.64,88,,percent of total billed charges,,,,,,,,,1663.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,544.5,22,,percent of total billed charges,,,1981.98,91,,percent of total billed charges,,,2069.1,95,,percent of total billed charges,,,1807.74,83,,percent of total billed charges,,,1807.74,83,,percent of total billed charges,,,,,,,,,,,,,,,1807.74,83,,percent of total billed charges,,,2069.1,95,,percent of total billed charges,,,1960.2,90,,percent of total billed charges,,,1960.2,90,,percent of total billed charges,,,1785.96,82,,percent of total billed charges,,,1960.2,90,,percent of total billed charges,,,1851.3,85,,percent of total billed charges,,544.5,2069.1,
UL NECK/CHEST BX,27101464,CDM,21550,CPT,361,RC,outpatient,TC,6570,6570,,5577.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1642.5,22,,percent of total billed charges,,,,,,,,,5913,90,,percent of total billed charges,,,5439.96,82.8,,percent of total billed charges,,,5584.5,85,,percent of total billed charges,,,,,,,,,5781.6,88,,percent of total billed charges,,,,,,,,,5019.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1642.5,22,,percent of total billed charges,,,5978.7,91,,percent of total billed charges,,,6241.5,95,,percent of total billed charges,,,5453.1,83,,percent of total billed charges,,,5453.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5453.1,83,,percent of total billed charges,,,6241.5,95,,percent of total billed charges,,,5913,90,,percent of total billed charges,,,5913,90,,percent of total billed charges,,,5387.4,82,,percent of total billed charges,,,5913,90,,percent of total billed charges,,,5584.5,85,,percent of total billed charges,,1642.5,6241.5,
UL THORACENTESIS W/IMG,27101465,CDM,32555,CPT,361,RC,outpatient,TC,3967,3967,,3367.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,991.75,22,,percent of total billed charges,,,,,,,,,3570.3,90,,percent of total billed charges,,,3284.68,82.8,,percent of total billed charges,,,3371.95,85,,percent of total billed charges,,,,,,,,,3490.96,88,,percent of total billed charges,,,,,,,,,3030.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,991.75,22,,percent of total billed charges,,,3609.97,91,,percent of total billed charges,,,3768.65,95,,percent of total billed charges,,,3292.61,83,,percent of total billed charges,,,3292.61,83,,percent of total billed charges,,,,,,,,,,,,,,,3292.61,83,,percent of total billed charges,,,3768.65,95,,percent of total billed charges,,,3570.3,90,,percent of total billed charges,,,3570.3,90,,percent of total billed charges,,,3252.94,82,,percent of total billed charges,,,3570.3,90,,percent of total billed charges,,,3371.95,85,,percent of total billed charges,,991.75,3768.65,
UL AMNIOCENTESIS,27101477,CDM,59000,CPT,769,RC,outpatient,,1480,1480,,1256.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,370,22,,percent of total billed charges,,,,,,,,,1332,90,,percent of total billed charges,,,1225.44,82.8,,percent of total billed charges,,,1258,85,,percent of total billed charges,,,,,,,,,1302.4,88,,percent of total billed charges,,,,,,,,,1130.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,370,22,,percent of total billed charges,,,1346.8,91,,percent of total billed charges,,,1406,95,,percent of total billed charges,,,1228.4,83,,percent of total billed charges,,,1228.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1228.4,83,,percent of total billed charges,,,1406,95,,percent of total billed charges,,,1332,90,,percent of total billed charges,,,1332,90,,percent of total billed charges,,,1213.6,82,,percent of total billed charges,,,1332,90,,percent of total billed charges,,,1258,85,,percent of total billed charges,,370,1406,
UL RETROPERIT/LTD,27101485,CDM,76775,CPT,402,RC,outpatient,TC,1477,1477,,1253.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,369.25,22,,percent of total billed charges,,,,,,,,,1329.3,90,,percent of total billed charges,,,1222.96,82.8,,percent of total billed charges,,,1255.45,85,,percent of total billed charges,,,,,,,,,1299.76,88,,percent of total billed charges,,,,,,,,,1128.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,369.25,22,,percent of total billed charges,,,1344.07,91,,percent of total billed charges,,,1403.15,95,,percent of total billed charges,,,1225.91,83,,percent of total billed charges,,,1225.91,83,,percent of total billed charges,,,,,,,,,,,,,,,1225.91,83,,percent of total billed charges,,,1403.15,95,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1211.14,82,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1255.45,85,,percent of total billed charges,,369.25,1403.15,
UL RETROPERIT/COMPL,27101493,CDM,76770,CPT,402,RC,outpatient,TC,1775,1775,,1506.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,443.75,22,,percent of total billed charges,,,,,,,,,1597.5,90,,percent of total billed charges,,,1469.7,82.8,,percent of total billed charges,,,1508.75,85,,percent of total billed charges,,,,,,,,,1562,88,,percent of total billed charges,,,,,,,,,1356.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,443.75,22,,percent of total billed charges,,,1615.25,91,,percent of total billed charges,,,1686.25,95,,percent of total billed charges,,,1473.25,83,,percent of total billed charges,,,1473.25,83,,percent of total billed charges,,,,,,,,,,,,,,,1473.25,83,,percent of total billed charges,,,1686.25,95,,percent of total billed charges,,,1597.5,90,,percent of total billed charges,,,1597.5,90,,percent of total billed charges,,,1455.5,82,,percent of total billed charges,,,1597.5,90,,percent of total billed charges,,,1508.75,85,,percent of total billed charges,,443.75,1686.25,
UL OB LTD (1OR>1 FETUS),27101501,CDM,76815,CPT,402,RC,outpatient,TC,1175,1175,,997.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,293.75,22,,percent of total billed charges,,,,,,,,,1057.5,90,,percent of total billed charges,,,972.9,82.8,,percent of total billed charges,,,998.75,85,,percent of total billed charges,,,,,,,,,1034,88,,percent of total billed charges,,,,,,,,,897.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,293.75,22,,percent of total billed charges,,,1069.25,91,,percent of total billed charges,,,1116.25,95,,percent of total billed charges,,,975.25,83,,percent of total billed charges,,,975.25,83,,percent of total billed charges,,,,,,,,,,,,,,,975.25,83,,percent of total billed charges,,,1116.25,95,,percent of total billed charges,,,1057.5,90,,percent of total billed charges,,,1057.5,90,,percent of total billed charges,,,963.5,82,,percent of total billed charges,,,1057.5,90,,percent of total billed charges,,,998.75,85,,percent of total billed charges,,293.75,1116.25,
UL BX BREAST W/DEVICE ADDL LESION US IMA,27101510,CDM,19084,CPT,402,RC,outpatient,TC,4873,4873,,4137.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1218.25,22,,percent of total billed charges,,,,,,,,,4385.7,90,,percent of total billed charges,,,4034.84,82.8,,percent of total billed charges,,,4142.05,85,,percent of total billed charges,,,,,,,,,4288.24,88,,percent of total billed charges,,,,,,,,,3722.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1218.25,22,,percent of total billed charges,,,4434.43,91,,percent of total billed charges,,,4629.35,95,,percent of total billed charges,,,4044.59,83,,percent of total billed charges,,,4044.59,83,,percent of total billed charges,,,,,,,,,,,,,,,4044.59,83,,percent of total billed charges,,,4629.35,95,,percent of total billed charges,,,4385.7,90,,percent of total billed charges,,,4385.7,90,,percent of total billed charges,,,3995.86,82,,percent of total billed charges,,,4385.7,90,,percent of total billed charges,,,4142.05,85,,percent of total billed charges,,1218.25,4629.35,
UL GUIDED FLUID COLLECTION DRAINAGE,27101518,CDM,10030,CPT,402,RC,outpatient,TC,3821,3821,,3244.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,955.25,22,,percent of total billed charges,,,,,,,,,3438.9,90,,percent of total billed charges,,,3163.79,82.8,,percent of total billed charges,,,3247.85,85,,percent of total billed charges,,,,,,,,,3362.48,88,,percent of total billed charges,,,,,,,,,2919.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,955.25,22,,percent of total billed charges,,,3477.11,91,,percent of total billed charges,,,3629.95,95,,percent of total billed charges,,,3171.43,83,,percent of total billed charges,,,3171.43,83,,percent of total billed charges,,,,,,,,,,,,,,,3171.43,83,,percent of total billed charges,,,3629.95,95,,percent of total billed charges,,,3438.9,90,,percent of total billed charges,,,3438.9,90,,percent of total billed charges,,,3133.22,82,,percent of total billed charges,,,3438.9,90,,percent of total billed charges,,,3247.85,85,,percent of total billed charges,,955.25,3629.95,
UL OB (2-3 TRIM/EA ADDL),27101519,CDM,76810,CPT,402,RC,outpatient,TC,1551,1551,,1316.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,387.75,22,,percent of total billed charges,,,,,,,,,1395.9,90,,percent of total billed charges,,,1284.23,82.8,,percent of total billed charges,,,1318.35,85,,percent of total billed charges,,,,,,,,,1364.88,88,,percent of total billed charges,,,,,,,,,1184.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,387.75,22,,percent of total billed charges,,,1411.41,91,,percent of total billed charges,,,1473.45,95,,percent of total billed charges,,,1287.33,83,,percent of total billed charges,,,1287.33,83,,percent of total billed charges,,,,,,,,,,,,,,,1287.33,83,,percent of total billed charges,,,1473.45,95,,percent of total billed charges,,,1395.9,90,,percent of total billed charges,,,1395.9,90,,percent of total billed charges,,,1271.82,82,,percent of total billed charges,,,1395.9,90,,percent of total billed charges,,,1318.35,85,,percent of total billed charges,,387.75,1473.45,
UL BREAST NDLLOCWIRE1SITE (V05-17),27101527,CDM,76942,CPT,402,RC,outpatient,TC,1866,1866,,1584.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,466.5,22,,percent of total billed charges,,,,,,,,,1679.4,90,,percent of total billed charges,,,1545.05,82.8,,percent of total billed charges,,,1586.1,85,,percent of total billed charges,,,,,,,,,1642.08,88,,percent of total billed charges,,,,,,,,,1425.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,466.5,22,,percent of total billed charges,,,1698.06,91,,percent of total billed charges,,,1772.7,95,,percent of total billed charges,,,1548.78,83,,percent of total billed charges,,,1548.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1548.78,83,,percent of total billed charges,,,1772.7,95,,percent of total billed charges,,,1679.4,90,,percent of total billed charges,,,1679.4,90,,percent of total billed charges,,,1530.12,82,,percent of total billed charges,,,1679.4,90,,percent of total billed charges,,,1586.1,85,,percent of total billed charges,,466.5,1772.7,
* DNU BX BREAST ASPIR ADDL RT,27101560,CDM,19001,CPT,361,RC,outpatient,,1814,1814,,1540.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,453.5,22,,percent of total billed charges,,,,,,,,,1632.6,90,,percent of total billed charges,,,1501.99,82.8,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,,,,,,,,1596.32,88,,percent of total billed charges,,,,,,,,,1385.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,453.5,22,,percent of total billed charges,,,1650.74,91,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.62,83,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1487.48,82,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,453.5,1723.3,
BX THYROID,27101561,CDM,60100,CPT,402,RC,outpatient,TC,1814,1814,,1540.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,453.5,22,,percent of total billed charges,,,,,,,,,1632.6,90,,percent of total billed charges,,,1501.99,82.8,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,,,,,,,,1596.32,88,,percent of total billed charges,,,,,,,,,1385.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,453.5,22,,percent of total billed charges,,,1650.74,91,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.62,83,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1487.48,82,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,453.5,1723.3,
UL FINE NEEDLE ASPIRATION,27101600,CDM,10005,CPT,402,RC,outpatient,TC,2131,2131,,1809.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,532.75,22,,percent of total billed charges,,,,,,,,,1917.9,90,,percent of total billed charges,,,1764.47,82.8,,percent of total billed charges,,,1811.35,85,,percent of total billed charges,,,,,,,,,1875.28,88,,percent of total billed charges,,,,,,,,,1628.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,532.75,22,,percent of total billed charges,,,1939.21,91,,percent of total billed charges,,,2024.45,95,,percent of total billed charges,,,1768.73,83,,percent of total billed charges,,,1768.73,83,,percent of total billed charges,,,,,,,,,,,,,,,1768.73,83,,percent of total billed charges,,,2024.45,95,,percent of total billed charges,,,1917.9,90,,percent of total billed charges,,,1917.9,90,,percent of total billed charges,,,1747.42,82,,percent of total billed charges,,,1917.9,90,,percent of total billed charges,,,1811.35,85,,percent of total billed charges,,532.75,2024.45,
UL ECHOCARDIO DOPPLER,27101709,CDM,93320,CPT,480,RC,outpatient,,1332,1332,,1130.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,333,22,,percent of total billed charges,,,,,,,,,1198.8,90,,percent of total billed charges,,,1102.9,82.8,,percent of total billed charges,,,1132.2,85,,percent of total billed charges,,,,,,,,,1172.16,88,,percent of total billed charges,,,,,,,,,1017.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,333,22,,percent of total billed charges,,,1212.12,91,,percent of total billed charges,,,1265.4,95,,percent of total billed charges,,,1105.56,83,,percent of total billed charges,,,1105.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1105.56,83,,percent of total billed charges,,,1265.4,95,,percent of total billed charges,,,1198.8,90,,percent of total billed charges,,,1198.8,90,,percent of total billed charges,,,1092.24,82,,percent of total billed charges,,,1198.8,90,,percent of total billed charges,,,1132.2,85,,percent of total billed charges,,333,1265.4,
UL ARTERIAL STUDY TCPO2 1-2 LVL,27101714,CDM,93922,CPT,921,RC,outpatient,TC,1241,1241,,1053.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,310.25,22,,percent of total billed charges,,,,,,,,,1116.9,90,,percent of total billed charges,,,1027.55,82.8,,percent of total billed charges,,,1054.85,85,,percent of total billed charges,,,,,,,,,1092.08,88,,percent of total billed charges,,,,,,,,,948.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,310.25,22,,percent of total billed charges,,,1129.31,91,,percent of total billed charges,,,1178.95,95,,percent of total billed charges,,,1030.03,83,,percent of total billed charges,,,1030.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1030.03,83,,percent of total billed charges,,,1178.95,95,,percent of total billed charges,,,1116.9,90,,percent of total billed charges,,,1116.9,90,,percent of total billed charges,,,1017.62,82,,percent of total billed charges,,,1116.9,90,,percent of total billed charges,,,1054.85,85,,percent of total billed charges,,310.25,1178.95,
UL LOW EXT ABI LMTD/UNI,27101715,CDM,93922,CPT,921,RC,outpatient,TC,1241,1241,,1053.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,310.25,22,,percent of total billed charges,,,,,,,,,1116.9,90,,percent of total billed charges,,,1027.55,82.8,,percent of total billed charges,,,1054.85,85,,percent of total billed charges,,,,,,,,,1092.08,88,,percent of total billed charges,,,,,,,,,948.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,310.25,22,,percent of total billed charges,,,1129.31,91,,percent of total billed charges,,,1178.95,95,,percent of total billed charges,,,1030.03,83,,percent of total billed charges,,,1030.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1030.03,83,,percent of total billed charges,,,1178.95,95,,percent of total billed charges,,,1116.9,90,,percent of total billed charges,,,1116.9,90,,percent of total billed charges,,,1017.62,82,,percent of total billed charges,,,1116.9,90,,percent of total billed charges,,,1054.85,85,,percent of total billed charges,,310.25,1178.95,
UL LOW EXT ART DUPLEX BIL,27101716,CDM,93925,CPT,921,RC,outpatient,TC,3289,3289,,2792.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,822.25,22,,percent of total billed charges,,,,,,,,,2960.1,90,,percent of total billed charges,,,2723.29,82.8,,percent of total billed charges,,,2795.65,85,,percent of total billed charges,,,,,,,,,2894.32,88,,percent of total billed charges,,,,,,,,,2512.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,822.25,22,,percent of total billed charges,,,2992.99,91,,percent of total billed charges,,,3124.55,95,,percent of total billed charges,,,2729.87,83,,percent of total billed charges,,,2729.87,83,,percent of total billed charges,,,,,,,,,,,,,,,2729.87,83,,percent of total billed charges,,,3124.55,95,,percent of total billed charges,,,2960.1,90,,percent of total billed charges,,,2960.1,90,,percent of total billed charges,,,2696.98,82,,percent of total billed charges,,,2960.1,90,,percent of total billed charges,,,2795.65,85,,percent of total billed charges,,822.25,3124.55,
UL ARTERIAL STUDY TCPO2 3+ LVL,27101718,CDM,93923,CPT,921,RC,outpatient,TC,2645,2645,,2245.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,661.25,22,,percent of total billed charges,,,,,,,,,2380.5,90,,percent of total billed charges,,,2190.06,82.8,,percent of total billed charges,,,2248.25,85,,percent of total billed charges,,,,,,,,,2327.6,88,,percent of total billed charges,,,,,,,,,2020.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,661.25,22,,percent of total billed charges,,,2406.95,91,,percent of total billed charges,,,2512.75,95,,percent of total billed charges,,,2195.35,83,,percent of total billed charges,,,2195.35,83,,percent of total billed charges,,,,,,,,,,,,,,,2195.35,83,,percent of total billed charges,,,2512.75,95,,percent of total billed charges,,,2380.5,90,,percent of total billed charges,,,2380.5,90,,percent of total billed charges,,,2168.9,82,,percent of total billed charges,,,2380.5,90,,percent of total billed charges,,,2248.25,85,,percent of total billed charges,,661.25,2512.75,
UL LOW EXT ART DUPLEX RT,27101719,CDM,93926,CPT,921,RC,outpatient,RT,2669,2669,,2265.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,667.25,22,,percent of total billed charges,,,,,,,,,2402.1,90,,percent of total billed charges,,,2209.93,82.8,,percent of total billed charges,,,2268.65,85,,percent of total billed charges,,,,,,,,,2348.72,88,,percent of total billed charges,,,,,,,,,2039.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,667.25,22,,percent of total billed charges,,,2428.79,91,,percent of total billed charges,,,2535.55,95,,percent of total billed charges,,,2215.27,83,,percent of total billed charges,,,2215.27,83,,percent of total billed charges,,,,,,,,,,,,,,,2215.27,83,,percent of total billed charges,,,2535.55,95,,percent of total billed charges,,,2402.1,90,,percent of total billed charges,,,2402.1,90,,percent of total billed charges,,,2188.58,82,,percent of total billed charges,,,2402.1,90,,percent of total billed charges,,,2268.65,85,,percent of total billed charges,,667.25,2535.55,
UL UP EXT ARTDOPRESTONLY,27101720,CDM,93923,CPT,921,RC,outpatient,TC,2645,2645,,2245.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,661.25,22,,percent of total billed charges,,,,,,,,,2380.5,90,,percent of total billed charges,,,2190.06,82.8,,percent of total billed charges,,,2248.25,85,,percent of total billed charges,,,,,,,,,2327.6,88,,percent of total billed charges,,,,,,,,,2020.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,661.25,22,,percent of total billed charges,,,2406.95,91,,percent of total billed charges,,,2512.75,95,,percent of total billed charges,,,2195.35,83,,percent of total billed charges,,,2195.35,83,,percent of total billed charges,,,,,,,,,,,,,,,2195.35,83,,percent of total billed charges,,,2512.75,95,,percent of total billed charges,,,2380.5,90,,percent of total billed charges,,,2380.5,90,,percent of total billed charges,,,2168.9,82,,percent of total billed charges,,,2380.5,90,,percent of total billed charges,,,2248.25,85,,percent of total billed charges,,661.25,2512.75,
UL LOW EXT ABI REST MIN EXERCISE,27101721,CDM,93923,CPT,921,RC,outpatient,TC,2641,2641,,2242.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,660.25,22,,percent of total billed charges,,,,,,,,,2376.9,90,,percent of total billed charges,,,2186.75,82.8,,percent of total billed charges,,,2244.85,85,,percent of total billed charges,,,,,,,,,2324.08,88,,percent of total billed charges,,,,,,,,,2017.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,660.25,22,,percent of total billed charges,,,2403.31,91,,percent of total billed charges,,,2508.95,95,,percent of total billed charges,,,2192.03,83,,percent of total billed charges,,,2192.03,83,,percent of total billed charges,,,,,,,,,,,,,,,2192.03,83,,percent of total billed charges,,,2508.95,95,,percent of total billed charges,,,2376.9,90,,percent of total billed charges,,,2376.9,90,,percent of total billed charges,,,2165.62,82,,percent of total billed charges,,,2376.9,90,,percent of total billed charges,,,2244.85,85,,percent of total billed charges,,660.25,2508.95,
UL LOW EXT ABI REST/STRESS TREADMILL,27101722,CDM,93924,CPT,921,RC,outpatient,TC,3558,3558,,3020.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,889.5,22,,percent of total billed charges,,,,,,,,,3202.2,90,,percent of total billed charges,,,2946.02,82.8,,percent of total billed charges,,,3024.3,85,,percent of total billed charges,,,,,,,,,3131.04,88,,percent of total billed charges,,,,,,,,,2718.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,889.5,22,,percent of total billed charges,,,3237.78,91,,percent of total billed charges,,,3380.1,95,,percent of total billed charges,,,2953.14,83,,percent of total billed charges,,,2953.14,83,,percent of total billed charges,,,,,,,,,,,,,,,2953.14,83,,percent of total billed charges,,,3380.1,95,,percent of total billed charges,,,3202.2,90,,percent of total billed charges,,,3202.2,90,,percent of total billed charges,,,2917.56,82,,percent of total billed charges,,,3202.2,90,,percent of total billed charges,,,3024.3,85,,percent of total billed charges,,889.5,3380.1,
UL LOW EXT ART DUPLEX LEFT,27101723,CDM,93926,CPT,921,RC,outpatient,LT,2669,2669,,2265.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,667.25,22,,percent of total billed charges,,,,,,,,,2402.1,90,,percent of total billed charges,,,2209.93,82.8,,percent of total billed charges,,,2268.65,85,,percent of total billed charges,,,,,,,,,2348.72,88,,percent of total billed charges,,,,,,,,,2039.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,667.25,22,,percent of total billed charges,,,2428.79,91,,percent of total billed charges,,,2535.55,95,,percent of total billed charges,,,2215.27,83,,percent of total billed charges,,,2215.27,83,,percent of total billed charges,,,,,,,,,,,,,,,2215.27,83,,percent of total billed charges,,,2535.55,95,,percent of total billed charges,,,2402.1,90,,percent of total billed charges,,,2402.1,90,,percent of total billed charges,,,2188.58,82,,percent of total billed charges,,,2402.1,90,,percent of total billed charges,,,2268.65,85,,percent of total billed charges,,667.25,2535.55,
UL UP EXT ART DUPLEX BIL,27101724,CDM,93930,CPT,921,RC,outpatient,TC,5595,5595,,4750.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1398.75,22,,percent of total billed charges,,,,,,,,,5035.5,90,,percent of total billed charges,,,4632.66,82.8,,percent of total billed charges,,,4755.75,85,,percent of total billed charges,,,,,,,,,4923.6,88,,percent of total billed charges,,,,,,,,,4274.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1398.75,22,,percent of total billed charges,,,5091.45,91,,percent of total billed charges,,,5315.25,95,,percent of total billed charges,,,4643.85,83,,percent of total billed charges,,,4643.85,83,,percent of total billed charges,,,,,,,,,,,,,,,4643.85,83,,percent of total billed charges,,,5315.25,95,,percent of total billed charges,,,5035.5,90,,percent of total billed charges,,,5035.5,90,,percent of total billed charges,,,4587.9,82,,percent of total billed charges,,,5035.5,90,,percent of total billed charges,,,4755.75,85,,percent of total billed charges,,1398.75,5315.25,
UL UP EXT ART DUPLEX RT,27101725,CDM,93931,CPT,921,RC,outpatient,RT,2798,2798,,2375.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,699.5,22,,percent of total billed charges,,,,,,,,,2518.2,90,,percent of total billed charges,,,2316.74,82.8,,percent of total billed charges,,,2378.3,85,,percent of total billed charges,,,,,,,,,2462.24,88,,percent of total billed charges,,,,,,,,,2137.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,699.5,22,,percent of total billed charges,,,2546.18,91,,percent of total billed charges,,,2658.1,95,,percent of total billed charges,,,2322.34,83,,percent of total billed charges,,,2322.34,83,,percent of total billed charges,,,,,,,,,,,,,,,2322.34,83,,percent of total billed charges,,,2658.1,95,,percent of total billed charges,,,2518.2,90,,percent of total billed charges,,,2518.2,90,,percent of total billed charges,,,2294.36,82,,percent of total billed charges,,,2518.2,90,,percent of total billed charges,,,2378.3,85,,percent of total billed charges,,699.5,2658.1,
UL UP EXT ART DUPLEX LT,27101726,CDM,93931,CPT,921,RC,outpatient,LT,2798,2798,,2375.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,699.5,22,,percent of total billed charges,,,,,,,,,2518.2,90,,percent of total billed charges,,,2316.74,82.8,,percent of total billed charges,,,2378.3,85,,percent of total billed charges,,,,,,,,,2462.24,88,,percent of total billed charges,,,,,,,,,2137.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,699.5,22,,percent of total billed charges,,,2546.18,91,,percent of total billed charges,,,2658.1,95,,percent of total billed charges,,,2322.34,83,,percent of total billed charges,,,2322.34,83,,percent of total billed charges,,,,,,,,,,,,,,,2322.34,83,,percent of total billed charges,,,2658.1,95,,percent of total billed charges,,,2518.2,90,,percent of total billed charges,,,2518.2,90,,percent of total billed charges,,,2294.36,82,,percent of total billed charges,,,2518.2,90,,percent of total billed charges,,,2378.3,85,,percent of total billed charges,,699.5,2658.1,
UL UP EXT VEN DOP RIGHT,27101733,CDM,93971,CPT,921,RC,outpatient,RT,1847,1847,,1568.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,461.75,22,,percent of total billed charges,,,,,,,,,1662.3,90,,percent of total billed charges,,,1529.32,82.8,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,,,,,,,,1625.36,88,,percent of total billed charges,,,,,,,,,1411.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,461.75,22,,percent of total billed charges,,,1680.77,91,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1533.01,83,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1514.54,82,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,461.75,1754.65,
UL UP EXT VEN DOP LEFT,27101734,CDM,93971,CPT,921,RC,outpatient,LT,1847,1847,,1568.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,461.75,22,,percent of total billed charges,,,,,,,,,1662.3,90,,percent of total billed charges,,,1529.32,82.8,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,,,,,,,,1625.36,88,,percent of total billed charges,,,,,,,,,1411.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,461.75,22,,percent of total billed charges,,,1680.77,91,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1533.01,83,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1514.54,82,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,461.75,1754.65,
UL LOW EXT VEN DOP RIGHT,27101735,CDM,93971,CPT,921,RC,outpatient,RT,1847,1847,,1568.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,461.75,22,,percent of total billed charges,,,,,,,,,1662.3,90,,percent of total billed charges,,,1529.32,82.8,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,,,,,,,,1625.36,88,,percent of total billed charges,,,,,,,,,1411.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,461.75,22,,percent of total billed charges,,,1680.77,91,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1533.01,83,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1514.54,82,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,461.75,1754.65,
UL LOW EXT VEN DOP LEFT,27101736,CDM,93971,CPT,921,RC,outpatient,LT,1847,1847,,1568.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,461.75,22,,percent of total billed charges,,,,,,,,,1662.3,90,,percent of total billed charges,,,1529.32,82.8,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,,,,,,,,1625.36,88,,percent of total billed charges,,,,,,,,,1411.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,461.75,22,,percent of total billed charges,,,1680.77,91,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1533.01,83,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1514.54,82,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,461.75,1754.65,
UL VEN REFLUX BILATERAL,27101750,CDM,93970,CPT,921,RC,outpatient,TC,3693,3693,,3135.36,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,923.25,22,,percent of total billed charges,,,,,,,,,3323.7,90,,percent of total billed charges,,,3057.8,82.8,,percent of total billed charges,,,3139.05,85,,percent of total billed charges,,,,,,,,,3249.84,88,,percent of total billed charges,,,,,,,,,2821.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,923.25,22,,percent of total billed charges,,,3360.63,91,,percent of total billed charges,,,3508.35,95,,percent of total billed charges,,,3065.19,83,,percent of total billed charges,,,3065.19,83,,percent of total billed charges,,,,,,,,,,,,,,,3065.19,83,,percent of total billed charges,,,3508.35,95,,percent of total billed charges,,,3323.7,90,,percent of total billed charges,,,3323.7,90,,percent of total billed charges,,,3028.26,82,,percent of total billed charges,,,3323.7,90,,percent of total billed charges,,,3139.05,85,,percent of total billed charges,,923.25,3508.35,
UL VEN REFLUX RIGHT,27101751,CDM,93971,CPT,921,RC,outpatient,RT,1847,1847,,1568.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,461.75,22,,percent of total billed charges,,,,,,,,,1662.3,90,,percent of total billed charges,,,1529.32,82.8,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,,,,,,,,1625.36,88,,percent of total billed charges,,,,,,,,,1411.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,461.75,22,,percent of total billed charges,,,1680.77,91,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1533.01,83,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1514.54,82,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,461.75,1754.65,
UL VEN REFLUX LEFT,27101752,CDM,93971,CPT,921,RC,outpatient,LT,1847,1847,,1568.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,461.75,22,,percent of total billed charges,,,,,,,,,1662.3,90,,percent of total billed charges,,,1529.32,82.8,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,,,,,,,,1625.36,88,,percent of total billed charges,,,,,,,,,1411.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,461.75,22,,percent of total billed charges,,,1680.77,91,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,,,,,,,,,,,,,1533.01,83,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1514.54,82,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,461.75,1754.65,
UL CHEST (NON-CARDIAC),27101758,CDM,76604,CPT,402,RC,outpatient,TC,1296,1296,,1100.3,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,324,22,,percent of total billed charges,,,,,,,,,1166.4,90,,percent of total billed charges,,,1073.09,82.8,,percent of total billed charges,,,1101.6,85,,percent of total billed charges,,,,,,,,,1140.48,88,,percent of total billed charges,,,,,,,,,990.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,324,22,,percent of total billed charges,,,1179.36,91,,percent of total billed charges,,,1231.2,95,,percent of total billed charges,,,1075.68,83,,percent of total billed charges,,,1075.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1075.68,83,,percent of total billed charges,,,1231.2,95,,percent of total billed charges,,,1166.4,90,,percent of total billed charges,,,1166.4,90,,percent of total billed charges,,,1062.72,82,,percent of total billed charges,,,1166.4,90,,percent of total billed charges,,,1101.6,85,,percent of total billed charges,,324,1231.2,
*DNU ASSOCIATED 19102 NEEDLE CORE OR BX,27102100,CDM,19102,CPT,361,RC,outpatient,TC,1814,1814,,1540.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,453.5,22,,percent of total billed charges,,,,,,,,,1632.6,90,,percent of total billed charges,,,1501.99,82.8,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,,,,,,,,1596.32,88,,percent of total billed charges,,,,,,,,,1385.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,453.5,22,,percent of total billed charges,,,1650.74,91,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,1505.62,83,,percent of total billed charges,,,,,,,,,,,,,,,1505.62,83,,percent of total billed charges,,,1723.3,95,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1487.48,82,,percent of total billed charges,,,1632.6,90,,percent of total billed charges,,,1541.9,85,,percent of total billed charges,,453.5,1723.3,
UL OB(2-3TRIM/1GESTATION),27103002,CDM,76805,CPT,402,RC,outpatient,TC,1759,1759,,1493.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,439.75,22,,percent of total billed charges,,,,,,,,,1583.1,90,,percent of total billed charges,,,1456.45,82.8,,percent of total billed charges,,,1495.15,85,,percent of total billed charges,,,,,,,,,1547.92,88,,percent of total billed charges,,,,,,,,,1343.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,439.75,22,,percent of total billed charges,,,1600.69,91,,percent of total billed charges,,,1671.05,95,,percent of total billed charges,,,1459.97,83,,percent of total billed charges,,,1459.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1459.97,83,,percent of total billed charges,,,1671.05,95,,percent of total billed charges,,,1583.1,90,,percent of total billed charges,,,1583.1,90,,percent of total billed charges,,,1442.38,82,,percent of total billed charges,,,1583.1,90,,percent of total billed charges,,,1495.15,85,,percent of total billed charges,,439.75,1671.05,
UL OB (1ST TRIM/1 GEST),27103003,CDM,76801,CPT,402,RC,outpatient,TC,1574,1574,,1336.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,393.5,22,,percent of total billed charges,,,,,,,,,1416.6,90,,percent of total billed charges,,,1303.27,82.8,,percent of total billed charges,,,1337.9,85,,percent of total billed charges,,,,,,,,,1385.12,88,,percent of total billed charges,,,,,,,,,1202.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,393.5,22,,percent of total billed charges,,,1432.34,91,,percent of total billed charges,,,1495.3,95,,percent of total billed charges,,,1306.42,83,,percent of total billed charges,,,1306.42,83,,percent of total billed charges,,,,,,,,,,,,,,,1306.42,83,,percent of total billed charges,,,1495.3,95,,percent of total billed charges,,,1416.6,90,,percent of total billed charges,,,1416.6,90,,percent of total billed charges,,,1290.68,82,,percent of total billed charges,,,1416.6,90,,percent of total billed charges,,,1337.9,85,,percent of total billed charges,,393.5,1495.3,
UL OB(1STTRIM/EAADDLGEST),27103005,CDM,76802,CPT,402,RC,outpatient,TC,1039,1039,,882.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,259.75,22,,percent of total billed charges,,,,,,,,,935.1,90,,percent of total billed charges,,,860.29,82.8,,percent of total billed charges,,,883.15,85,,percent of total billed charges,,,,,,,,,914.32,88,,percent of total billed charges,,,,,,,,,793.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,259.75,22,,percent of total billed charges,,,945.49,91,,percent of total billed charges,,,987.05,95,,percent of total billed charges,,,862.37,83,,percent of total billed charges,,,862.37,83,,percent of total billed charges,,,,,,,,,,,,,,,862.37,83,,percent of total billed charges,,,987.05,95,,percent of total billed charges,,,935.1,90,,percent of total billed charges,,,935.1,90,,percent of total billed charges,,,851.98,82,,percent of total billed charges,,,935.1,90,,percent of total billed charges,,,883.15,85,,percent of total billed charges,,259.75,987.05,
UL TRANSVAGINAL (OB),27103006,CDM,76817,CPT,402,RC,outpatient,TC,1383,1383,,1174.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,345.75,22,,percent of total billed charges,,,,,,,,,1244.7,90,,percent of total billed charges,,,1145.12,82.8,,percent of total billed charges,,,1175.55,85,,percent of total billed charges,,,,,,,,,1217.04,88,,percent of total billed charges,,,,,,,,,1056.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,345.75,22,,percent of total billed charges,,,1258.53,91,,percent of total billed charges,,,1313.85,95,,percent of total billed charges,,,1147.89,83,,percent of total billed charges,,,1147.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1147.89,83,,percent of total billed charges,,,1313.85,95,,percent of total billed charges,,,1244.7,90,,percent of total billed charges,,,1244.7,90,,percent of total billed charges,,,1134.06,82,,percent of total billed charges,,,1244.7,90,,percent of total billed charges,,,1175.55,85,,percent of total billed charges,,345.75,1313.85,
UL OB ADDITIONAL STUDY OF FETUS,27103007,CDM,76811,CPT,402,RC,outpatient,TC,1759,1759,,1493.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,439.75,22,,percent of total billed charges,,,,,,,,,1583.1,90,,percent of total billed charges,,,1456.45,82.8,,percent of total billed charges,,,1495.15,85,,percent of total billed charges,,,,,,,,,1547.92,88,,percent of total billed charges,,,,,,,,,1343.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,439.75,22,,percent of total billed charges,,,1600.69,91,,percent of total billed charges,,,1671.05,95,,percent of total billed charges,,,1459.97,83,,percent of total billed charges,,,1459.97,83,,percent of total billed charges,,,,,,,,,,,,,,,1459.97,83,,percent of total billed charges,,,1671.05,95,,percent of total billed charges,,,1583.1,90,,percent of total billed charges,,,1583.1,90,,percent of total billed charges,,,1442.38,82,,percent of total billed charges,,,1583.1,90,,percent of total billed charges,,,1495.15,85,,percent of total billed charges,,439.75,1671.05,
UL OB FOLLOW UP,27103010,CDM,76816,CPT,402,RC,outpatient,TC,1169,1169,,992.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,292.25,22,,percent of total billed charges,,,,,,,,,1052.1,90,,percent of total billed charges,,,967.93,82.8,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,,,,,,,,1028.72,88,,percent of total billed charges,,,,,,,,,893.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,292.25,22,,percent of total billed charges,,,1063.79,91,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,970.27,83,,percent of total billed charges,,,,,,,,,,,,,,,970.27,83,,percent of total billed charges,,,1110.55,95,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,958.58,82,,percent of total billed charges,,,1052.1,90,,percent of total billed charges,,,993.65,85,,percent of total billed charges,,292.25,1110.55,
UL OB F/U TWINS(2FETUS),27103011,CDM,76816,CPT,402,RC,outpatient,59,2135,2135,,1812.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,533.75,22,,percent of total billed charges,,,,,,,,,1921.5,90,,percent of total billed charges,,,1767.78,82.8,,percent of total billed charges,,,1814.75,85,,percent of total billed charges,,,,,,,,,1878.8,88,,percent of total billed charges,,,,,,,,,1631.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,533.75,22,,percent of total billed charges,,,1942.85,91,,percent of total billed charges,,,2028.25,95,,percent of total billed charges,,,1772.05,83,,percent of total billed charges,,,1772.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1772.05,83,,percent of total billed charges,,,2028.25,95,,percent of total billed charges,,,1921.5,90,,percent of total billed charges,,,1921.5,90,,percent of total billed charges,,,1750.7,82,,percent of total billed charges,,,1921.5,90,,percent of total billed charges,,,1814.75,85,,percent of total billed charges,,533.75,2028.25,
UL BLADDERONLY/PELVICLTD,27103043,CDM,76857,CPT,402,RC,outpatient,TC,1225,1225,,1040.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,306.25,22,,percent of total billed charges,,,,,,,,,1102.5,90,,percent of total billed charges,,,1014.3,82.8,,percent of total billed charges,,,1041.25,85,,percent of total billed charges,,,,,,,,,1078,88,,percent of total billed charges,,,,,,,,,935.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,306.25,22,,percent of total billed charges,,,1114.75,91,,percent of total billed charges,,,1163.75,95,,percent of total billed charges,,,1016.75,83,,percent of total billed charges,,,1016.75,83,,percent of total billed charges,,,,,,,,,,,,,,,1016.75,83,,percent of total billed charges,,,1163.75,95,,percent of total billed charges,,,1102.5,90,,percent of total billed charges,,,1102.5,90,,percent of total billed charges,,,1004.5,82,,percent of total billed charges,,,1102.5,90,,percent of total billed charges,,,1041.25,85,,percent of total billed charges,,306.25,1163.75,
UL PELVIC,27103044,CDM,76856,CPT,402,RC,outpatient,TC,1805,1805,,1532.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,451.25,22,,percent of total billed charges,,,,,,,,,1624.5,90,,percent of total billed charges,,,1494.54,82.8,,percent of total billed charges,,,1534.25,85,,percent of total billed charges,,,,,,,,,1588.4,88,,percent of total billed charges,,,,,,,,,1379.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,451.25,22,,percent of total billed charges,,,1642.55,91,,percent of total billed charges,,,1714.75,95,,percent of total billed charges,,,1498.15,83,,percent of total billed charges,,,1498.15,83,,percent of total billed charges,,,,,,,,,,,,,,,1498.15,83,,percent of total billed charges,,,1714.75,95,,percent of total billed charges,,,1624.5,90,,percent of total billed charges,,,1624.5,90,,percent of total billed charges,,,1480.1,82,,percent of total billed charges,,,1624.5,90,,percent of total billed charges,,,1534.25,85,,percent of total billed charges,,451.25,1714.75,
UL INFANT SACRUM,27103045,CDM,76857,CPT,402,RC,outpatient,TC,1116,1116,,947.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,279,22,,percent of total billed charges,,,,,,,,,1004.4,90,,percent of total billed charges,,,924.05,82.8,,percent of total billed charges,,,948.6,85,,percent of total billed charges,,,,,,,,,982.08,88,,percent of total billed charges,,,,,,,,,852.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,279,22,,percent of total billed charges,,,1015.56,91,,percent of total billed charges,,,1060.2,95,,percent of total billed charges,,,926.28,83,,percent of total billed charges,,,926.28,83,,percent of total billed charges,,,,,,,,,,,,,,,926.28,83,,percent of total billed charges,,,1060.2,95,,percent of total billed charges,,,1004.4,90,,percent of total billed charges,,,1004.4,90,,percent of total billed charges,,,915.12,82,,percent of total billed charges,,,1004.4,90,,percent of total billed charges,,,948.6,85,,percent of total billed charges,,279,1060.2,
UL GALLBLADDER LTD,27103077,CDM,76705,CPT,402,RC,outpatient,TC,1617,1617,,1372.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,404.25,22,,percent of total billed charges,,,,,,,,,1455.3,90,,percent of total billed charges,,,1338.88,82.8,,percent of total billed charges,,,1374.45,85,,percent of total billed charges,,,,,,,,,1422.96,88,,percent of total billed charges,,,,,,,,,1235.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,404.25,22,,percent of total billed charges,,,1471.47,91,,percent of total billed charges,,,1536.15,95,,percent of total billed charges,,,1342.11,83,,percent of total billed charges,,,1342.11,83,,percent of total billed charges,,,,,,,,,,,,,,,1342.11,83,,percent of total billed charges,,,1536.15,95,,percent of total billed charges,,,1455.3,90,,percent of total billed charges,,,1455.3,90,,percent of total billed charges,,,1325.94,82,,percent of total billed charges,,,1455.3,90,,percent of total billed charges,,,1374.45,85,,percent of total billed charges,,404.25,1536.15,
UL LIVER NEEDLE BIOPSY,27103078,CDM,47000,CPT,921,RC,outpatient,TC,4643,4643,,3941.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1160.75,22,,percent of total billed charges,,,,,,,,,4178.7,90,,percent of total billed charges,,,3844.4,82.8,,percent of total billed charges,,,3946.55,85,,percent of total billed charges,,,,,,,,,4085.84,88,,percent of total billed charges,,,,,,,,,3547.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1160.75,22,,percent of total billed charges,,,4225.13,91,,percent of total billed charges,,,4410.85,95,,percent of total billed charges,,,3853.69,83,,percent of total billed charges,,,3853.69,83,,percent of total billed charges,,,,,,,,,,,,,,,3853.69,83,,percent of total billed charges,,,4410.85,95,,percent of total billed charges,,,4178.7,90,,percent of total billed charges,,,4178.7,90,,percent of total billed charges,,,3807.26,82,,percent of total billed charges,,,4178.7,90,,percent of total billed charges,,,3946.55,85,,percent of total billed charges,,1160.75,4410.85,
UL LIVER DUPLEX,27103080,CDM,93975,CPT,921,RC,outpatient,TC,2363,2363,,2006.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,590.75,22,,percent of total billed charges,,,,,,,,,2126.7,90,,percent of total billed charges,,,1956.56,82.8,,percent of total billed charges,,,2008.55,85,,percent of total billed charges,,,,,,,,,2079.44,88,,percent of total billed charges,,,,,,,,,1805.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,590.75,22,,percent of total billed charges,,,2150.33,91,,percent of total billed charges,,,2244.85,95,,percent of total billed charges,,,1961.29,83,,percent of total billed charges,,,1961.29,83,,percent of total billed charges,,,,,,,,,,,,,,,1961.29,83,,percent of total billed charges,,,2244.85,95,,percent of total billed charges,,,2126.7,90,,percent of total billed charges,,,2126.7,90,,percent of total billed charges,,,1937.66,82,,percent of total billed charges,,,2126.7,90,,percent of total billed charges,,,2008.55,85,,percent of total billed charges,,590.75,2244.85,
UL AORTA ONLY,27103085,CDM,76775,CPT,402,RC,outpatient,TC,1477,1477,,1253.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,369.25,22,,percent of total billed charges,,,,,,,,,1329.3,90,,percent of total billed charges,,,1222.96,82.8,,percent of total billed charges,,,1255.45,85,,percent of total billed charges,,,,,,,,,1299.76,88,,percent of total billed charges,,,,,,,,,1128.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,369.25,22,,percent of total billed charges,,,1344.07,91,,percent of total billed charges,,,1403.15,95,,percent of total billed charges,,,1225.91,83,,percent of total billed charges,,,1225.91,83,,percent of total billed charges,,,,,,,,,,,,,,,1225.91,83,,percent of total billed charges,,,1403.15,95,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1211.14,82,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1255.45,85,,percent of total billed charges,,369.25,1403.15,
UL ABDOMINAL AORTA SCREEN AAA,27103086,CDM,76706,CPT,402,RC,outpatient,TC,1477,1477,,1253.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,369.25,22,,percent of total billed charges,,,,,,,,,1329.3,90,,percent of total billed charges,,,1222.96,82.8,,percent of total billed charges,,,1255.45,85,,percent of total billed charges,,,,,,,,,1299.76,88,,percent of total billed charges,,,,,,,,,1128.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,369.25,22,,percent of total billed charges,,,1344.07,91,,percent of total billed charges,,,1403.15,95,,percent of total billed charges,,,1225.91,83,,percent of total billed charges,,,1225.91,83,,percent of total billed charges,,,,,,,,,,,,,,,1225.91,83,,percent of total billed charges,,,1403.15,95,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1211.14,82,,percent of total billed charges,,,1329.3,90,,percent of total billed charges,,,1255.45,85,,percent of total billed charges,,369.25,1403.15,
* DNU US UNLISTED PROCEDURE,27103089,CDM,76999,CPT,402,RC,outpatient,TC,913,913,,775.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,228.25,22,,percent of total billed charges,,,,,,,,,821.7,90,,percent of total billed charges,,,755.96,82.8,,percent of total billed charges,,,776.05,85,,percent of total billed charges,,,,,,,,,803.44,88,,percent of total billed charges,,,,,,,,,697.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,228.25,22,,percent of total billed charges,,,830.83,91,,percent of total billed charges,,,867.35,95,,percent of total billed charges,,,757.79,83,,percent of total billed charges,,,757.79,83,,percent of total billed charges,,,,,,,,,,,,,,,757.79,83,,percent of total billed charges,,,867.35,95,,percent of total billed charges,,,821.7,90,,percent of total billed charges,,,821.7,90,,percent of total billed charges,,,748.66,82,,percent of total billed charges,,,821.7,90,,percent of total billed charges,,,776.05,85,,percent of total billed charges,,228.25,867.35,
UL PROSTATE BIOPSY,27103090,CDM,55700,CPT,402,RC,outpatient,,7825,7825,,6643.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1956.25,22,,percent of total billed charges,,,,,,,,,7042.5,90,,percent of total billed charges,,,6479.1,82.8,,percent of total billed charges,,,6651.25,85,,percent of total billed charges,,,,,,,,,6886,88,,percent of total billed charges,,,,,,,,,5978.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1956.25,22,,percent of total billed charges,,,7120.75,91,,percent of total billed charges,,,7433.75,95,,percent of total billed charges,,,6494.75,83,,percent of total billed charges,,,6494.75,83,,percent of total billed charges,,,,,,,,,,,,,,,6494.75,83,,percent of total billed charges,,,7433.75,95,,percent of total billed charges,,,7042.5,90,,percent of total billed charges,,,7042.5,90,,percent of total billed charges,,,6416.5,82,,percent of total billed charges,,,7042.5,90,,percent of total billed charges,,,6651.25,85,,percent of total billed charges,,1956.25,7433.75,
UL SCLEROTHERAPY FLUID COLLECTION W/IMG,27103091,CDM,,,361,RC,outpatient,,4253,4253,,3610.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1063.25,22,,percent of total billed charges,,,,,,,,,3827.7,90,,percent of total billed charges,,,3521.48,82.8,,percent of total billed charges,,,3615.05,85,,percent of total billed charges,,,,,,,,,3742.64,88,,percent of total billed charges,,,,,,,,,3249.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1063.25,22,,percent of total billed charges,,,3870.23,91,,percent of total billed charges,,,4040.35,95,,percent of total billed charges,,,3529.99,83,,percent of total billed charges,,,3529.99,83,,percent of total billed charges,,,,,,,,,,,,,,,3529.99,83,,percent of total billed charges,,,4040.35,95,,percent of total billed charges,,,3827.7,90,,percent of total billed charges,,,3827.7,90,,percent of total billed charges,,,3487.46,82,,percent of total billed charges,,,3827.7,90,,percent of total billed charges,,,3615.05,85,,percent of total billed charges,,1063.25,4040.35,
UL FOREIGN BODY REMOVAL,27103095,CDM,20520,CPT,361,RC,outpatient,,6845,6845,,5811.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1711.25,22,,percent of total billed charges,,,,,,,,,6160.5,90,,percent of total billed charges,,,5667.66,82.8,,percent of total billed charges,,,5818.25,85,,percent of total billed charges,,,,,,,,,6023.6,88,,percent of total billed charges,,,,,,,,,5229.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1711.25,22,,percent of total billed charges,,,6228.95,91,,percent of total billed charges,,,6502.75,95,,percent of total billed charges,,,5681.35,83,,percent of total billed charges,,,5681.35,83,,percent of total billed charges,,,,,,,,,,,,,,,5681.35,83,,percent of total billed charges,,,6502.75,95,,percent of total billed charges,,,6160.5,90,,percent of total billed charges,,,6160.5,90,,percent of total billed charges,,,5612.9,82,,percent of total billed charges,,,6160.5,90,,percent of total billed charges,,,5818.25,85,,percent of total billed charges,,1711.25,6502.75,
UL ABD COMPLETE,27103127,CDM,76700,CPT,402,RC,outpatient,TC,2149,2149,,1824.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,537.25,22,,percent of total billed charges,,,,,,,,,1934.1,90,,percent of total billed charges,,,1779.37,82.8,,percent of total billed charges,,,1826.65,85,,percent of total billed charges,,,,,,,,,1891.12,88,,percent of total billed charges,,,,,,,,,1641.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,537.25,22,,percent of total billed charges,,,1955.59,91,,percent of total billed charges,,,2041.55,95,,percent of total billed charges,,,1783.67,83,,percent of total billed charges,,,1783.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1783.67,83,,percent of total billed charges,,,2041.55,95,,percent of total billed charges,,,1934.1,90,,percent of total billed charges,,,1934.1,90,,percent of total billed charges,,,1762.18,82,,percent of total billed charges,,,1934.1,90,,percent of total billed charges,,,1826.65,85,,percent of total billed charges,,537.25,2041.55,
UL RENAL ARTERY DOP,27103136,CDM,93976,CPT,921,RC,outpatient,TC,1582,1582,,1343.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,395.5,22,,percent of total billed charges,,,,,,,,,1423.8,90,,percent of total billed charges,,,1309.9,82.8,,percent of total billed charges,,,1344.7,85,,percent of total billed charges,,,,,,,,,1392.16,88,,percent of total billed charges,,,,,,,,,1208.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,395.5,22,,percent of total billed charges,,,1439.62,91,,percent of total billed charges,,,1502.9,95,,percent of total billed charges,,,1313.06,83,,percent of total billed charges,,,1313.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1313.06,83,,percent of total billed charges,,,1502.9,95,,percent of total billed charges,,,1423.8,90,,percent of total billed charges,,,1423.8,90,,percent of total billed charges,,,1297.24,82,,percent of total billed charges,,,1423.8,90,,percent of total billed charges,,,1344.7,85,,percent of total billed charges,,395.5,1502.9,
UL BREAST LIMITED RIGHT,27103330,CDM,76642,CPT,402,RC,outpatient,RT,1095,1095,,929.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,273.75,22,,percent of total billed charges,,,,,,,,,985.5,90,,percent of total billed charges,,,906.66,82.8,,percent of total billed charges,,,930.75,85,,percent of total billed charges,,,,,,,,,963.6,88,,percent of total billed charges,,,,,,,,,836.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,273.75,22,,percent of total billed charges,,,996.45,91,,percent of total billed charges,,,1040.25,95,,percent of total billed charges,,,908.85,83,,percent of total billed charges,,,908.85,83,,percent of total billed charges,,,,,,,,,,,,,,,908.85,83,,percent of total billed charges,,,1040.25,95,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,897.9,82,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,930.75,85,,percent of total billed charges,,273.75,1040.25,
UL BREAST LIMITED LEFT,27103331,CDM,76642,CPT,402,RC,outpatient,LT,1095,1095,,929.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,273.75,22,,percent of total billed charges,,,,,,,,,985.5,90,,percent of total billed charges,,,906.66,82.8,,percent of total billed charges,,,930.75,85,,percent of total billed charges,,,,,,,,,963.6,88,,percent of total billed charges,,,,,,,,,836.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,273.75,22,,percent of total billed charges,,,996.45,91,,percent of total billed charges,,,1040.25,95,,percent of total billed charges,,,908.85,83,,percent of total billed charges,,,908.85,83,,percent of total billed charges,,,,,,,,,,,,,,,908.85,83,,percent of total billed charges,,,1040.25,95,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,897.9,82,,percent of total billed charges,,,985.5,90,,percent of total billed charges,,,930.75,85,,percent of total billed charges,,273.75,1040.25,
UL BREAST LIMITED BILATERAL,27103332,CDM,76642,CPT,402,RC,outpatient,50,2188,2188,,1857.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,547,22,,percent of total billed charges,,,,,,,,,1969.2,90,,percent of total billed charges,,,1811.66,82.8,,percent of total billed charges,,,1859.8,85,,percent of total billed charges,,,,,,,,,1925.44,88,,percent of total billed charges,,,,,,,,,1671.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,547,22,,percent of total billed charges,,,1991.08,91,,percent of total billed charges,,,2078.6,95,,percent of total billed charges,,,1816.04,83,,percent of total billed charges,,,1816.04,83,,percent of total billed charges,,,,,,,,,,,,,,,1816.04,83,,percent of total billed charges,,,2078.6,95,,percent of total billed charges,,,1969.2,90,,percent of total billed charges,,,1969.2,90,,percent of total billed charges,,,1794.16,82,,percent of total billed charges,,,1969.2,90,,percent of total billed charges,,,1859.8,85,,percent of total billed charges,,547,2078.6,
UL BREAST COMPLETE RIGHT,27103333,CDM,76641,CPT,402,RC,outpatient,RT,1367,1367,,1160.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,341.75,22,,percent of total billed charges,,,,,,,,,1230.3,90,,percent of total billed charges,,,1131.88,82.8,,percent of total billed charges,,,1161.95,85,,percent of total billed charges,,,,,,,,,1202.96,88,,percent of total billed charges,,,,,,,,,1044.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,341.75,22,,percent of total billed charges,,,1243.97,91,,percent of total billed charges,,,1298.65,95,,percent of total billed charges,,,1134.61,83,,percent of total billed charges,,,1134.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1134.61,83,,percent of total billed charges,,,1298.65,95,,percent of total billed charges,,,1230.3,90,,percent of total billed charges,,,1230.3,90,,percent of total billed charges,,,1120.94,82,,percent of total billed charges,,,1230.3,90,,percent of total billed charges,,,1161.95,85,,percent of total billed charges,,341.75,1298.65,
UL BREAST COMPLETE LEFT,27103334,CDM,76641,CPT,402,RC,outpatient,LT,1367,1367,,1160.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,341.75,22,,percent of total billed charges,,,,,,,,,1230.3,90,,percent of total billed charges,,,1131.88,82.8,,percent of total billed charges,,,1161.95,85,,percent of total billed charges,,,,,,,,,1202.96,88,,percent of total billed charges,,,,,,,,,1044.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,341.75,22,,percent of total billed charges,,,1243.97,91,,percent of total billed charges,,,1298.65,95,,percent of total billed charges,,,1134.61,83,,percent of total billed charges,,,1134.61,83,,percent of total billed charges,,,,,,,,,,,,,,,1134.61,83,,percent of total billed charges,,,1298.65,95,,percent of total billed charges,,,1230.3,90,,percent of total billed charges,,,1230.3,90,,percent of total billed charges,,,1120.94,82,,percent of total billed charges,,,1230.3,90,,percent of total billed charges,,,1161.95,85,,percent of total billed charges,,341.75,1298.65,
UL BREAST COMPLETE BILATERAL,27103335,CDM,76641,CPT,402,RC,outpatient,50,2576,2576,,2187.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,644,22,,percent of total billed charges,,,,,,,,,2318.4,90,,percent of total billed charges,,,2132.93,82.8,,percent of total billed charges,,,2189.6,85,,percent of total billed charges,,,,,,,,,2266.88,88,,percent of total billed charges,,,,,,,,,1968.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,644,22,,percent of total billed charges,,,2344.16,91,,percent of total billed charges,,,2447.2,95,,percent of total billed charges,,,2138.08,83,,percent of total billed charges,,,2138.08,83,,percent of total billed charges,,,,,,,,,,,,,,,2138.08,83,,percent of total billed charges,,,2447.2,95,,percent of total billed charges,,,2318.4,90,,percent of total billed charges,,,2318.4,90,,percent of total billed charges,,,2112.32,82,,percent of total billed charges,,,2318.4,90,,percent of total billed charges,,,2189.6,85,,percent of total billed charges,,644,2447.2,
ASSOC 19285 BREAST LOCAL US SINGLE,27103995,CDM,19285,CPT,320,RC,outpatient,TC,1748,1748,,1484.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,437,22,,percent of total billed charges,,,,,,,,,1573.2,90,,percent of total billed charges,,,1447.34,82.8,,percent of total billed charges,,,1485.8,85,,percent of total billed charges,,,,,,,,,1538.24,88,,percent of total billed charges,,,,,,,,,1335.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,437,22,,percent of total billed charges,,,1590.68,91,,percent of total billed charges,,,1660.6,95,,percent of total billed charges,,,1450.84,83,,percent of total billed charges,,,1450.84,83,,percent of total billed charges,,,,,,,,,,,,,,,1450.84,83,,percent of total billed charges,,,1660.6,95,,percent of total billed charges,,,1573.2,90,,percent of total billed charges,,,1573.2,90,,percent of total billed charges,,,1433.36,82,,percent of total billed charges,,,1573.2,90,,percent of total billed charges,,,1485.8,85,,percent of total billed charges,,437,1660.6,
ASSOC 19286 BREAST LOCAL US EACH ADD,27103996,CDM,19286,CPT,320,RC,outpatient,TC,1749,1749,,1484.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,437.25,22,,percent of total billed charges,,,,,,,,,1574.1,90,,percent of total billed charges,,,1448.17,82.8,,percent of total billed charges,,,1486.65,85,,percent of total billed charges,,,,,,,,,1539.12,88,,percent of total billed charges,,,,,,,,,1336.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,437.25,22,,percent of total billed charges,,,1591.59,91,,percent of total billed charges,,,1661.55,95,,percent of total billed charges,,,1451.67,83,,percent of total billed charges,,,1451.67,83,,percent of total billed charges,,,,,,,,,,,,,,,1451.67,83,,percent of total billed charges,,,1661.55,95,,percent of total billed charges,,,1574.1,90,,percent of total billed charges,,,1574.1,90,,percent of total billed charges,,,1434.18,82,,percent of total billed charges,,,1574.1,90,,percent of total billed charges,,,1486.65,85,,percent of total billed charges,,437.25,1661.55,
UL THYROID(ST NECK),27104141,CDM,76536,CPT,402,RC,outpatient,TC,1607,1607,,1364.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,401.75,22,,percent of total billed charges,,,,,,,,,1446.3,90,,percent of total billed charges,,,1330.6,82.8,,percent of total billed charges,,,1365.95,85,,percent of total billed charges,,,,,,,,,1414.16,88,,percent of total billed charges,,,,,,,,,1227.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,401.75,22,,percent of total billed charges,,,1462.37,91,,percent of total billed charges,,,1526.65,95,,percent of total billed charges,,,1333.81,83,,percent of total billed charges,,,1333.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1333.81,83,,percent of total billed charges,,,1526.65,95,,percent of total billed charges,,,1446.3,90,,percent of total billed charges,,,1446.3,90,,percent of total billed charges,,,1317.74,82,,percent of total billed charges,,,1446.3,90,,percent of total billed charges,,,1365.95,85,,percent of total billed charges,,401.75,1526.65,
UL PANCREAS BX,27104150,CDM,48102,CPT,360,RC,outpatient,TC,4747,4747,,4030.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1186.75,22,,percent of total billed charges,,,,,,,,,4272.3,90,,percent of total billed charges,,,3930.52,82.8,,percent of total billed charges,,,4034.95,85,,percent of total billed charges,,,,,,,,,4177.36,88,,percent of total billed charges,,,,,,,,,3626.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1186.75,22,,percent of total billed charges,,,4319.77,91,,percent of total billed charges,,,4509.65,95,,percent of total billed charges,,,3940.01,83,,percent of total billed charges,,,3940.01,83,,percent of total billed charges,,,,,,,,,,,,,,,3940.01,83,,percent of total billed charges,,,4509.65,95,,percent of total billed charges,,,4272.3,90,,percent of total billed charges,,,4272.3,90,,percent of total billed charges,,,3892.54,82,,percent of total billed charges,,,4272.3,90,,percent of total billed charges,,,4034.95,85,,percent of total billed charges,,1186.75,4509.65,
UL INSERTION OF SUPRAPUBIC CATH,27104151,CDM,51102,CPT,360,RC,outpatient,TC,9524,9524,,8085.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2381,22,,percent of total billed charges,,,,,,,,,8571.6,90,,percent of total billed charges,,,7885.87,82.8,,percent of total billed charges,,,8095.4,85,,percent of total billed charges,,,,,,,,,8381.12,88,,percent of total billed charges,,,,,,,,,7276.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2381,22,,percent of total billed charges,,,8666.84,91,,percent of total billed charges,,,9047.8,95,,percent of total billed charges,,,7904.92,83,,percent of total billed charges,,,7904.92,83,,percent of total billed charges,,,,,,,,,,,,,,,7904.92,83,,percent of total billed charges,,,9047.8,95,,percent of total billed charges,,,8571.6,90,,percent of total billed charges,,,8571.6,90,,percent of total billed charges,,,7809.68,82,,percent of total billed charges,,,8571.6,90,,percent of total billed charges,,,8095.4,85,,percent of total billed charges,,2381,9047.8,
UL CAROTID ART,27104158,CDM,93880,CPT,921,RC,outpatient,TC,2509,2509,,2130.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,627.25,22,,percent of total billed charges,,,,,,,,,2258.1,90,,percent of total billed charges,,,2077.45,82.8,,percent of total billed charges,,,2132.65,85,,percent of total billed charges,,,,,,,,,2207.92,88,,percent of total billed charges,,,,,,,,,1916.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,627.25,22,,percent of total billed charges,,,2283.19,91,,percent of total billed charges,,,2383.55,95,,percent of total billed charges,,,2082.47,83,,percent of total billed charges,,,2082.47,83,,percent of total billed charges,,,,,,,,,,,,,,,2082.47,83,,percent of total billed charges,,,2383.55,95,,percent of total billed charges,,,2258.1,90,,percent of total billed charges,,,2258.1,90,,percent of total billed charges,,,2057.38,82,,percent of total billed charges,,,2258.1,90,,percent of total billed charges,,,2132.65,85,,percent of total billed charges,,627.25,2383.55,
UL NEONATAL BRAIN,27104182,CDM,76506,CPT,402,RC,outpatient,TC,1307,1307,,1109.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,326.75,22,,percent of total billed charges,,,,,,,,,1176.3,90,,percent of total billed charges,,,1082.2,82.8,,percent of total billed charges,,,1110.95,85,,percent of total billed charges,,,,,,,,,1150.16,88,,percent of total billed charges,,,,,,,,,998.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,326.75,22,,percent of total billed charges,,,1189.37,91,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1084.81,83,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1071.74,82,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1110.95,85,,percent of total billed charges,,326.75,1241.65,
UL SCROTUM,27104513,CDM,76870,CPT,402,RC,outpatient,TC,1658,1658,,1407.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,414.5,22,,percent of total billed charges,,,,,,,,,1492.2,90,,percent of total billed charges,,,1372.82,82.8,,percent of total billed charges,,,1409.3,85,,percent of total billed charges,,,,,,,,,1459.04,88,,percent of total billed charges,,,,,,,,,1266.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,414.5,22,,percent of total billed charges,,,1508.78,91,,percent of total billed charges,,,1575.1,95,,percent of total billed charges,,,1376.14,83,,percent of total billed charges,,,1376.14,83,,percent of total billed charges,,,,,,,,,,,,,,,1376.14,83,,percent of total billed charges,,,1575.1,95,,percent of total billed charges,,,1492.2,90,,percent of total billed charges,,,1492.2,90,,percent of total billed charges,,,1359.56,82,,percent of total billed charges,,,1492.2,90,,percent of total billed charges,,,1409.3,85,,percent of total billed charges,,414.5,1575.1,
UL SCLEROTHERAPY FLUID COLLECTION W/IMG,27193091,CDM,,,,,outpatient,,4253,4253,,3610.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1063.25,22,,percent of total billed charges,,,,,,,,,3827.7,90,,percent of total billed charges,,,3521.48,82.8,,percent of total billed charges,,,3615.05,85,,percent of total billed charges,,,,,,,,,3742.64,88,,percent of total billed charges,,,,,,,,,3249.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1063.25,22,,percent of total billed charges,,,3870.23,91,,percent of total billed charges,,,4040.35,95,,percent of total billed charges,,,3529.99,83,,percent of total billed charges,,,3529.99,83,,percent of total billed charges,,,,,,,,,,,,,,,3529.99,83,,percent of total billed charges,,,4040.35,95,,percent of total billed charges,,,3827.7,90,,percent of total billed charges,,,3827.7,90,,percent of total billed charges,,,3487.46,82,,percent of total billed charges,,,3827.7,90,,percent of total billed charges,,,3615.05,85,,percent of total billed charges,,1063.25,4040.35,
UL DUPLEX AORTA-IVC-ILIAC,27200501,CDM,93978,CPT,921,RC,outpatient,TC,1915,1915,,1625.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,478.75,22,,percent of total billed charges,,,,,,,,,1723.5,90,,percent of total billed charges,,,1585.62,82.8,,percent of total billed charges,,,1627.75,85,,percent of total billed charges,,,,,,,,,1685.2,88,,percent of total billed charges,,,,,,,,,1463.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,478.75,22,,percent of total billed charges,,,1742.65,91,,percent of total billed charges,,,1819.25,95,,percent of total billed charges,,,1589.45,83,,percent of total billed charges,,,1589.45,83,,percent of total billed charges,,,,,,,,,,,,,,,1589.45,83,,percent of total billed charges,,,1819.25,95,,percent of total billed charges,,,1723.5,90,,percent of total billed charges,,,1723.5,90,,percent of total billed charges,,,1570.3,82,,percent of total billed charges,,,1723.5,90,,percent of total billed charges,,,1627.75,85,,percent of total billed charges,,478.75,1819.25,
UL IR ENDOVENOUS ABLATION 1ST VEIN,27200502,CDM,36475,CPT,360,RC,outpatient,TC,12656,12656,,10744.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3164,22,,percent of total billed charges,,,,,,,,,11390.4,90,,percent of total billed charges,,,10479.17,82.8,,percent of total billed charges,,,10757.6,85,,percent of total billed charges,,,,,,,,,11137.28,88,,percent of total billed charges,,,,,,,,,9669.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3164,22,,percent of total billed charges,,,11516.96,91,,percent of total billed charges,,,12023.2,95,,percent of total billed charges,,,10504.48,83,,percent of total billed charges,,,10504.48,83,,percent of total billed charges,,,,,,,,,,,,,,,10504.48,83,,percent of total billed charges,,,12023.2,95,,percent of total billed charges,,,11390.4,90,,percent of total billed charges,,,11390.4,90,,percent of total billed charges,,,10377.92,82,,percent of total billed charges,,,11390.4,90,,percent of total billed charges,,,10757.6,85,,percent of total billed charges,,3164,12023.2,
UL IR ENDOVENOUS ABLATION VEIN ADD-ON,27200503,CDM,36476,CPT,360,RC,outpatient,TC,7660,7660,,6503.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1915,22,,percent of total billed charges,,,,,,,,,6894,90,,percent of total billed charges,,,6342.48,82.8,,percent of total billed charges,,,6511,85,,percent of total billed charges,,,,,,,,,6740.8,88,,percent of total billed charges,,,,,,,,,5852.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1915,22,,percent of total billed charges,,,6970.6,91,,percent of total billed charges,,,7277,95,,percent of total billed charges,,,6357.8,83,,percent of total billed charges,,,6357.8,83,,percent of total billed charges,,,,,,,,,,,,,,,6357.8,83,,percent of total billed charges,,,7277,95,,percent of total billed charges,,,6894,90,,percent of total billed charges,,,6894,90,,percent of total billed charges,,,6281.2,82,,percent of total billed charges,,,6894,90,,percent of total billed charges,,,6511,85,,percent of total billed charges,,1915,7277,
UL IR VENASEAL ENDOVEN THER CHEM ADS 1ST,27200504,CDM,36482,CPT,360,RC,outpatient,,15687,15687,,13318.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3921.75,22,,percent of total billed charges,,,,,,,,,14118.3,90,,percent of total billed charges,,,12988.84,82.8,,percent of total billed charges,,,13333.95,85,,percent of total billed charges,,,,,,,,,13804.56,88,,percent of total billed charges,,,,,,,,,11984.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3921.75,22,,percent of total billed charges,,,14275.17,91,,percent of total billed charges,,,14902.65,95,,percent of total billed charges,,,13020.21,83,,percent of total billed charges,,,13020.21,83,,percent of total billed charges,,,,,,,,,,,,,,,13020.21,83,,percent of total billed charges,,,14902.65,95,,percent of total billed charges,,,14118.3,90,,percent of total billed charges,,,14118.3,90,,percent of total billed charges,,,12863.34,82,,percent of total billed charges,,,14118.3,90,,percent of total billed charges,,,13333.95,85,,percent of total billed charges,,3921.75,14902.65,
UL IR VENASEAL ENDOVEN THER CHEM AD SBSQ,27200505,CDM,36483,CPT,360,RC,outpatient,,10175,10175,,8638.58,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2543.75,22,,percent of total billed charges,,,,,,,,,9157.5,90,,percent of total billed charges,,,8424.9,82.8,,percent of total billed charges,,,8648.75,85,,percent of total billed charges,,,,,,,,,8954,88,,percent of total billed charges,,,,,,,,,7773.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2543.75,22,,percent of total billed charges,,,9259.25,91,,percent of total billed charges,,,9666.25,95,,percent of total billed charges,,,8445.25,83,,percent of total billed charges,,,8445.25,83,,percent of total billed charges,,,,,,,,,,,,,,,8445.25,83,,percent of total billed charges,,,9666.25,95,,percent of total billed charges,,,9157.5,90,,percent of total billed charges,,,9157.5,90,,percent of total billed charges,,,8343.5,82,,percent of total billed charges,,,9157.5,90,,percent of total billed charges,,,8648.75,85,,percent of total billed charges,,2543.75,9666.25,
UL DRAINAGE OF HEMATOMA/FLUID COLLECTION,27200506,CDM,10140,CPT,360,RC,outpatient,,8147,8147,,6916.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2036.75,22,,percent of total billed charges,,,,,,,,,7332.3,90,,percent of total billed charges,,,6745.72,82.8,,percent of total billed charges,,,6924.95,85,,percent of total billed charges,,,,,,,,,7169.36,88,,percent of total billed charges,,,,,,,,,6224.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2036.75,22,,percent of total billed charges,,,7413.77,91,,percent of total billed charges,,,7739.65,95,,percent of total billed charges,,,6762.01,83,,percent of total billed charges,,,6762.01,83,,percent of total billed charges,,,,,,,,,,,,,,,6762.01,83,,percent of total billed charges,,,7739.65,95,,percent of total billed charges,,,7332.3,90,,percent of total billed charges,,,7332.3,90,,percent of total billed charges,,,6680.54,82,,percent of total billed charges,,,7332.3,90,,percent of total billed charges,,,6924.95,85,,percent of total billed charges,,2036.75,7739.65,
UL MICRO PHLEB 10-20-STABS,27200507,CDM,37765,CPT,360,RC,outpatient,TC,11975,11975,,10166.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2993.75,22,,percent of total billed charges,,,,,,,,,10777.5,90,,percent of total billed charges,,,9915.3,82.8,,percent of total billed charges,,,10178.75,85,,percent of total billed charges,,,,,,,,,10538,88,,percent of total billed charges,,,,,,,,,9148.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2993.75,22,,percent of total billed charges,,,10897.25,91,,percent of total billed charges,,,11376.25,95,,percent of total billed charges,,,9939.25,83,,percent of total billed charges,,,9939.25,83,,percent of total billed charges,,,,,,,,,,,,,,,9939.25,83,,percent of total billed charges,,,11376.25,95,,percent of total billed charges,,,10777.5,90,,percent of total billed charges,,,10777.5,90,,percent of total billed charges,,,9819.5,82,,percent of total billed charges,,,10777.5,90,,percent of total billed charges,,,10178.75,85,,percent of total billed charges,,2993.75,11376.25,
UL MICRO PHLEB 20 PLUS STABS,27200508,CDM,37766,CPT,360,RC,outpatient,TC,14376,14376,,12205.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3594,22,,percent of total billed charges,,,,,,,,,12938.4,90,,percent of total billed charges,,,11903.33,82.8,,percent of total billed charges,,,12219.6,85,,percent of total billed charges,,,,,,,,,12650.88,88,,percent of total billed charges,,,,,,,,,10983.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3594,22,,percent of total billed charges,,,13082.16,91,,percent of total billed charges,,,13657.2,95,,percent of total billed charges,,,11932.08,83,,percent of total billed charges,,,11932.08,83,,percent of total billed charges,,,,,,,,,,,,,,,11932.08,83,,percent of total billed charges,,,13657.2,95,,percent of total billed charges,,,12938.4,90,,percent of total billed charges,,,12938.4,90,,percent of total billed charges,,,11788.32,82,,percent of total billed charges,,,12938.4,90,,percent of total billed charges,,,12219.6,85,,percent of total billed charges,,3594,13657.2,
UL INTRAVASCULAR ULTRASOUND INTIAL,27200509,CDM,37252,CPT,360,RC,outpatient,TC,10280,10280,,8727.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2570,22,,percent of total billed charges,,,,,,,,,9252,90,,percent of total billed charges,,,8511.84,82.8,,percent of total billed charges,,,8738,85,,percent of total billed charges,,,,,,,,,9046.4,88,,percent of total billed charges,,,,,,,,,7853.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2570,22,,percent of total billed charges,,,9354.8,91,,percent of total billed charges,,,9766,95,,percent of total billed charges,,,8532.4,83,,percent of total billed charges,,,8532.4,83,,percent of total billed charges,,,,,,,,,,,,,,,8532.4,83,,percent of total billed charges,,,9766,95,,percent of total billed charges,,,9252,90,,percent of total billed charges,,,9252,90,,percent of total billed charges,,,8429.6,82,,percent of total billed charges,,,9252,90,,percent of total billed charges,,,8738,85,,percent of total billed charges,,2570,9766,
UL INTRAVASCULAR ULTRASOUND ADDITIONAL,27200510,CDM,37253,CPT,360,RC,outpatient,TC,8562,8562,,7269.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2140.5,22,,percent of total billed charges,,,,,,,,,7705.8,90,,percent of total billed charges,,,7089.34,82.8,,percent of total billed charges,,,7277.7,85,,percent of total billed charges,,,,,,,,,7534.56,88,,percent of total billed charges,,,,,,,,,6541.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2140.5,22,,percent of total billed charges,,,7791.42,91,,percent of total billed charges,,,8133.9,95,,percent of total billed charges,,,7106.46,83,,percent of total billed charges,,,7106.46,83,,percent of total billed charges,,,,,,,,,,,,,,,7106.46,83,,percent of total billed charges,,,8133.9,95,,percent of total billed charges,,,7705.8,90,,percent of total billed charges,,,7705.8,90,,percent of total billed charges,,,7020.84,82,,percent of total billed charges,,,7705.8,90,,percent of total billed charges,,,7277.7,85,,percent of total billed charges,,2140.5,8133.9,
UL VASCULAR EMBOLIZATION/OCCLUSION,27200511,CDM,37241,CPT,360,RC,outpatient,TC,37235,37235,,31612.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9308.75,22,,percent of total billed charges,,,,,,,,,33511.5,90,,percent of total billed charges,,,30830.58,82.8,,percent of total billed charges,,,31649.75,85,,percent of total billed charges,,,,,,,,,32766.8,88,,percent of total billed charges,,,,,,,,,28447.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9308.75,22,,percent of total billed charges,,,33883.85,91,,percent of total billed charges,,,35373.25,95,,percent of total billed charges,,,30905.05,83,,percent of total billed charges,,,30905.05,83,,percent of total billed charges,,,,,,,,,,,,,,,30905.05,83,,percent of total billed charges,,,35373.25,95,,percent of total billed charges,,,33511.5,90,,percent of total billed charges,,,33511.5,90,,percent of total billed charges,,,30532.7,82,,percent of total billed charges,,,33511.5,90,,percent of total billed charges,,,31649.75,85,,percent of total billed charges,,9308.75,35373.25,
UL RADIOFREQUENCY ABLATION THYROID,27200512,CDM,0673T,CPT,360,RC,outpatient,,15054,15054,,12780.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3763.5,22,,percent of total billed charges,,,,,,,,,13548.6,90,,percent of total billed charges,,,12464.71,82.8,,percent of total billed charges,,,12795.9,85,,percent of total billed charges,,,,,,,,,13247.52,88,,percent of total billed charges,,,,,,,,,11501.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3763.5,22,,percent of total billed charges,,,13699.14,91,,percent of total billed charges,,,14301.3,95,,percent of total billed charges,,,12494.82,83,,percent of total billed charges,,,12494.82,83,,percent of total billed charges,,,,,,,,,,,,,,,12494.82,83,,percent of total billed charges,,,14301.3,95,,percent of total billed charges,,,13548.6,90,,percent of total billed charges,,,13548.6,90,,percent of total billed charges,,,12344.28,82,,percent of total billed charges,,,13548.6,90,,percent of total billed charges,,,12795.9,85,,percent of total billed charges,,3763.5,14301.3,
UL UP EXT NONVASC BILAT COMPLETE,27235478,CDM,76881,CPT,402,RC,outpatient,50,2860,2860,,2428.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,715,22,,percent of total billed charges,,,,,,,,,2574,90,,percent of total billed charges,,,2368.08,82.8,,percent of total billed charges,,,2431,85,,percent of total billed charges,,,,,,,,,2516.8,88,,percent of total billed charges,,,,,,,,,2185.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,715,22,,percent of total billed charges,,,2602.6,91,,percent of total billed charges,,,2717,95,,percent of total billed charges,,,2373.8,83,,percent of total billed charges,,,2373.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2373.8,83,,percent of total billed charges,,,2717,95,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2345.2,82,,percent of total billed charges,,,2574,90,,percent of total billed charges,,,2431,85,,percent of total billed charges,,715,2717,
BX ABDOMEN,29100009,CDM,49180,CPT,361,RC,outpatient,,1595,1595,,1354.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,398.75,22,,percent of total billed charges,,,,,,,,,1435.5,90,,percent of total billed charges,,,1320.66,82.8,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,,,,,,,,1403.6,88,,percent of total billed charges,,,,,,,,,1218.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,398.75,22,,percent of total billed charges,,,1451.45,91,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1323.85,83,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1307.9,82,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,398.75,1515.25,
BX LIVER,29100010,CDM,47000,CPT,361,RC,outpatient,,1595,1595,,1354.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,398.75,22,,percent of total billed charges,,,,,,,,,1435.5,90,,percent of total billed charges,,,1320.66,82.8,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,,,,,,,,1403.6,88,,percent of total billed charges,,,,,,,,,1218.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,398.75,22,,percent of total billed charges,,,1451.45,91,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1323.85,83,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1307.9,82,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,398.75,1515.25,
BX LUNG PFA,29100011,CDM,32408,CPT,361,RC,outpatient,TC,1595,1595,,1354.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,398.75,22,,percent of total billed charges,,,,,,,,,1435.5,90,,percent of total billed charges,,,1320.66,82.8,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,,,,,,,,1403.6,88,,percent of total billed charges,,,,,,,,,1218.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,398.75,22,,percent of total billed charges,,,1451.45,91,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1323.85,83,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1307.9,82,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,398.75,1515.25,
BX ADRENAL,29100012,CDM,60540,CPT,361,RC,outpatient,,1595,1595,,1354.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,398.75,22,,percent of total billed charges,,,,,,,,,1435.5,90,,percent of total billed charges,,,1320.66,82.8,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,,,,,,,,1403.6,88,,percent of total billed charges,,,,,,,,,1218.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,398.75,22,,percent of total billed charges,,,1451.45,91,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1323.85,83,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1307.9,82,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,398.75,1515.25,
BX PLEURA,29100013,CDM,32400,CPT,361,RC,outpatient,,1595,1595,,1354.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,398.75,22,,percent of total billed charges,,,,,,,,,1435.5,90,,percent of total billed charges,,,1320.66,82.8,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,,,,,,,,1403.6,88,,percent of total billed charges,,,,,,,,,1218.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,398.75,22,,percent of total billed charges,,,1451.45,91,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1323.85,83,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1307.9,82,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,398.75,1515.25,
BX MUSCLE PFA,29100014,CDM,20206,CPT,361,RC,outpatient,TC,1595,1595,,1354.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,398.75,22,,percent of total billed charges,,,,,,,,,1435.5,90,,percent of total billed charges,,,1320.66,82.8,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,,,,,,,,1403.6,88,,percent of total billed charges,,,,,,,,,1218.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,398.75,22,,percent of total billed charges,,,1451.45,91,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1323.85,83,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1307.9,82,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,398.75,1515.25,
FOLLOW UP ASSESSMENT 0-60MIN,1000100,CDM,G0463,HCPCS,510,RC,outpatient,,387,387,,328.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,96.75,22,,percent of total billed charges,,,,,,,,,348.3,90,,percent of total billed charges,,,320.44,82.8,,percent of total billed charges,,,328.95,85,,percent of total billed charges,,,,,,,,,340.56,88,,percent of total billed charges,,,,,,,,,295.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,96.75,22,,percent of total billed charges,,,352.17,91,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,,,,,,,,,,,,,321.21,83,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,317.34,82,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,328.95,85,,percent of total billed charges,,96.75,367.65,
TELEPSY DIAGNOSTIC EVAL NO MED SERVICES,1000101,CDM,90791,CPT,900,RC,outpatient,GT,421,421,,357.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,105.25,22,,percent of total billed charges,,,,,,,,,378.9,90,,percent of total billed charges,,,348.59,82.8,,percent of total billed charges,,,357.85,85,,percent of total billed charges,,,,,,,,,370.48,88,,percent of total billed charges,,,,,,,,,321.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,105.25,22,,percent of total billed charges,,,383.11,91,,percent of total billed charges,,,399.95,95,,percent of total billed charges,,,349.43,83,,percent of total billed charges,,,349.43,83,,percent of total billed charges,,,,,,,,,,,,,,,349.43,83,,percent of total billed charges,,,399.95,95,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,345.22,82,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,357.85,85,,percent of total billed charges,,105.25,399.95,
TELEPSY DIAGNOSTIC EVAL WITH MED SERVICE,1000102,CDM,90792,CPT,900,RC,outpatient,GT,685,685,,581.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,171.25,22,,percent of total billed charges,,,,,,,,,616.5,90,,percent of total billed charges,,,567.18,82.8,,percent of total billed charges,,,582.25,85,,percent of total billed charges,,,,,,,,,602.8,88,,percent of total billed charges,,,,,,,,,523.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,171.25,22,,percent of total billed charges,,,623.35,91,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,,,,,,,,,,,,,568.55,83,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,561.7,82,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,582.25,85,,percent of total billed charges,,171.25,650.75,
TELEPSY INDIVIDUAL THERAPY 30 MIN,1000103,CDM,90832,CPT,914,RC,outpatient,GT,516,516,,438.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,129,22,,percent of total billed charges,,,,,,,,,464.4,90,,percent of total billed charges,,,427.25,82.8,,percent of total billed charges,,,438.6,85,,percent of total billed charges,,,,,,,,,454.08,88,,percent of total billed charges,,,,,,,,,394.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,129,22,,percent of total billed charges,,,469.56,91,,percent of total billed charges,,,490.2,95,,percent of total billed charges,,,428.28,83,,percent of total billed charges,,,428.28,83,,percent of total billed charges,,,,,,,,,,,,,,,428.28,83,,percent of total billed charges,,,490.2,95,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,423.12,82,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,438.6,85,,percent of total billed charges,,129,490.2,
TELEPSY INDIVIDUAL THERAPY 45 MIN,1000104,CDM,90834,CPT,914,RC,outpatient,GT,621,621,,527.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,155.25,22,,percent of total billed charges,,,,,,,,,558.9,90,,percent of total billed charges,,,514.19,82.8,,percent of total billed charges,,,527.85,85,,percent of total billed charges,,,,,,,,,546.48,88,,percent of total billed charges,,,,,,,,,474.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,155.25,22,,percent of total billed charges,,,565.11,91,,percent of total billed charges,,,589.95,95,,percent of total billed charges,,,515.43,83,,percent of total billed charges,,,515.43,83,,percent of total billed charges,,,,,,,,,,,,,,,515.43,83,,percent of total billed charges,,,589.95,95,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,509.22,82,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,527.85,85,,percent of total billed charges,,155.25,589.95,
TELEPSY INDIVIDUAL THERAPY 60 MIN,1000105,CDM,90837,CPT,914,RC,outpatient,GT,685,685,,581.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,171.25,22,,percent of total billed charges,,,,,,,,,616.5,90,,percent of total billed charges,,,567.18,82.8,,percent of total billed charges,,,582.25,85,,percent of total billed charges,,,,,,,,,602.8,88,,percent of total billed charges,,,,,,,,,523.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,171.25,22,,percent of total billed charges,,,623.35,91,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,,,,,,,,,,,,,568.55,83,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,561.7,82,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,582.25,85,,percent of total billed charges,,171.25,650.75,
TELEPSYCH,1000106,CDM,Q3014,HCPCS,914,RC,outpatient,,154,154,,130.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.5,22,,percent of total billed charges,,,,,,,,,138.6,90,,percent of total billed charges,,,127.51,82.8,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,,,,,,,,135.52,88,,percent of total billed charges,,25,,,,fee schedule,,,117.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,25,,,,fee schedule,,,38.5,22,,percent of total billed charges,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,,,,,,,,,,,,,127.82,83,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,126.28,82,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,25,146.3,
DIAGNOSTIC EVALUATION NO MED SERVICES,1090791,CDM,90791,CPT,900,RC,outpatient,,421,421,,357.43,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,105.25,22,,percent of total billed charges,,,,,,,,,378.9,90,,percent of total billed charges,,,348.59,82.8,,percent of total billed charges,,,357.85,85,,percent of total billed charges,,,,,,,,,370.48,88,,percent of total billed charges,,,,,,,,,321.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,105.25,22,,percent of total billed charges,,,383.11,91,,percent of total billed charges,,,399.95,95,,percent of total billed charges,,,349.43,83,,percent of total billed charges,,,349.43,83,,percent of total billed charges,,,,,,,,,,,,,,,349.43,83,,percent of total billed charges,,,399.95,95,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,345.22,82,,percent of total billed charges,,,378.9,90,,percent of total billed charges,,,357.85,85,,percent of total billed charges,,105.25,399.95,
DIAGNOSTIC EVALUATION WITH MED SERVICES,1090792,CDM,90792,CPT,900,RC,outpatient,,685,685,,581.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,171.25,22,,percent of total billed charges,,,,,,,,,616.5,90,,percent of total billed charges,,,567.18,82.8,,percent of total billed charges,,,582.25,85,,percent of total billed charges,,,,,,,,,602.8,88,,percent of total billed charges,,,,,,,,,523.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,171.25,22,,percent of total billed charges,,,623.35,91,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,,,,,,,,,,,,,568.55,83,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,561.7,82,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,582.25,85,,percent of total billed charges,,171.25,650.75,
INITIAL EVALUATION ASSESSMENT,1090801,CDM,90791,CPT,900,RC,outpatient,,687,687,,583.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,171.75,22,,percent of total billed charges,,,,,,,,,618.3,90,,percent of total billed charges,,,568.84,82.8,,percent of total billed charges,,,583.95,85,,percent of total billed charges,,,,,,,,,604.56,88,,percent of total billed charges,,,,,,,,,524.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,171.75,22,,percent of total billed charges,,,625.17,91,,percent of total billed charges,,,652.65,95,,percent of total billed charges,,,570.21,83,,percent of total billed charges,,,570.21,83,,percent of total billed charges,,,,,,,,,,,,,,,570.21,83,,percent of total billed charges,,,652.65,95,,percent of total billed charges,,,618.3,90,,percent of total billed charges,,,618.3,90,,percent of total billed charges,,,563.34,82,,percent of total billed charges,,,618.3,90,,percent of total billed charges,,,583.95,85,,percent of total billed charges,,171.75,652.65,
INDIVIDUAL THERAPY 45 MIN,1090806,CDM,90834,CPT,914,RC,outpatient,,621,621,,527.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,155.25,22,,percent of total billed charges,,,,,,,,,558.9,90,,percent of total billed charges,,,514.19,82.8,,percent of total billed charges,,,527.85,85,,percent of total billed charges,,,,,,,,,546.48,88,,percent of total billed charges,,,,,,,,,474.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,155.25,22,,percent of total billed charges,,,565.11,91,,percent of total billed charges,,,589.95,95,,percent of total billed charges,,,515.43,83,,percent of total billed charges,,,515.43,83,,percent of total billed charges,,,,,,,,,,,,,,,515.43,83,,percent of total billed charges,,,589.95,95,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,509.22,82,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,527.85,85,,percent of total billed charges,,155.25,589.95,
INDIVIDUAL THERAPY 30 MIN,1090832,CDM,90832,CPT,914,RC,outpatient,,516,516,,438.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,129,22,,percent of total billed charges,,,,,,,,,464.4,90,,percent of total billed charges,,,427.25,82.8,,percent of total billed charges,,,438.6,85,,percent of total billed charges,,,,,,,,,454.08,88,,percent of total billed charges,,,,,,,,,394.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,129,22,,percent of total billed charges,,,469.56,91,,percent of total billed charges,,,490.2,95,,percent of total billed charges,,,428.28,83,,percent of total billed charges,,,428.28,83,,percent of total billed charges,,,,,,,,,,,,,,,428.28,83,,percent of total billed charges,,,490.2,95,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,423.12,82,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,438.6,85,,percent of total billed charges,,129,490.2,
INDIVIDUAL THERAPY 60 MIN,1090837,CDM,90837,CPT,914,RC,outpatient,,685,685,,581.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,171.25,22,,percent of total billed charges,,,,,,,,,616.5,90,,percent of total billed charges,,,567.18,82.8,,percent of total billed charges,,,582.25,85,,percent of total billed charges,,,,,,,,,602.8,88,,percent of total billed charges,,,,,,,,,523.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,171.25,22,,percent of total billed charges,,,623.35,91,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,,,,,,,,,,,,,568.55,83,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,561.7,82,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,582.25,85,,percent of total billed charges,,171.25,650.75,
PSYCHOTHERAPY FOR CRISIS 0-60 MIN,1090839,CDM,90839,CPT,914,RC,outpatient,,775,775,,657.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,193.75,22,,percent of total billed charges,,,,,,,,,697.5,90,,percent of total billed charges,,,641.7,82.8,,percent of total billed charges,,,658.75,85,,percent of total billed charges,,,,,,,,,682,88,,percent of total billed charges,,,,,,,,,592.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,193.75,22,,percent of total billed charges,,,705.25,91,,percent of total billed charges,,,736.25,95,,percent of total billed charges,,,643.25,83,,percent of total billed charges,,,643.25,83,,percent of total billed charges,,,,,,,,,,,,,,,643.25,83,,percent of total billed charges,,,736.25,95,,percent of total billed charges,,,697.5,90,,percent of total billed charges,,,697.5,90,,percent of total billed charges,,,635.5,82,,percent of total billed charges,,,697.5,90,,percent of total billed charges,,,658.75,85,,percent of total billed charges,,193.75,736.25,
PSYCHOTHERAPY FOR CRISIS EACH ADD 30MIN,1090840,CDM,90840,CPT,914,RC,outpatient,,231,231,,196.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,57.75,22,,percent of total billed charges,,,,,,,,,207.9,90,,percent of total billed charges,,,191.27,82.8,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,,,,,,,,203.28,88,,percent of total billed charges,,,,,,,,,176.48,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,57.75,22,,percent of total billed charges,,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,,,,,,,,,,,,,191.73,83,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,189.42,82,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,57.75,219.45,
FAMILY THERAPY W/O PATIENT 1 HR,1090846,CDM,90846,CPT,916,RC,outpatient,,413,413,,350.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,103.25,22,,percent of total billed charges,,,,,,,,,371.7,90,,percent of total billed charges,,,341.96,82.8,,percent of total billed charges,,,351.05,85,,percent of total billed charges,,,,,,,,,363.44,88,,percent of total billed charges,,,,,,,,,315.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,103.25,22,,percent of total billed charges,,,375.83,91,,percent of total billed charges,,,392.35,95,,percent of total billed charges,,,342.79,83,,percent of total billed charges,,,342.79,83,,percent of total billed charges,,,,,,,,,,,,,,,342.79,83,,percent of total billed charges,,,392.35,95,,percent of total billed charges,,,371.7,90,,percent of total billed charges,,,371.7,90,,percent of total billed charges,,,338.66,82,,percent of total billed charges,,,371.7,90,,percent of total billed charges,,,351.05,85,,percent of total billed charges,,103.25,392.35,
FAMILY THERAPY WITH PATIENT 1 HR,1090847,CDM,90847,CPT,916,RC,outpatient,,685,685,,581.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,171.25,22,,percent of total billed charges,,,,,,,,,616.5,90,,percent of total billed charges,,,567.18,82.8,,percent of total billed charges,,,582.25,85,,percent of total billed charges,,,,,,,,,602.8,88,,percent of total billed charges,,,,,,,,,523.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,171.25,22,,percent of total billed charges,,,623.35,91,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,,,,,,,,,,,,,568.55,83,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,561.7,82,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,582.25,85,,percent of total billed charges,,171.25,650.75,
MULTI-FAMILY GROUP PSYCHOTHERAPY,1090849,CDM,90849,CPT,916,RC,outpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.25,22,,percent of total billed charges,,,,,,,,,202.5,90,,percent of total billed charges,,,186.3,82.8,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.25,22,,percent of total billed charges,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,56.25,213.75,
GROUP THERAPY,1090853,CDM,90853,CPT,915,RC,outpatient,,379,379,,321.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,94.75,22,,percent of total billed charges,,,,,,,,,341.1,90,,percent of total billed charges,,,313.81,82.8,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,,,,,,,,333.52,88,,percent of total billed charges,,,,,,,,,289.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,94.75,22,,percent of total billed charges,,,344.89,91,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,,,,,,,,,,,,,314.57,83,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,310.78,82,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,94.75,360.05,
BEHAVIOR HEALTH FOLLOW UP ASSESSMENT,1090862,CDM,90863,CPT,900,RC,outpatient,,260,260,,220.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65,22,,percent of total billed charges,,,,,,,,,234,90,,percent of total billed charges,,,215.28,82.8,,percent of total billed charges,,,221,85,,percent of total billed charges,,,,,,,,,228.8,88,,percent of total billed charges,,,,,,,,,198.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65,22,,percent of total billed charges,,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,,,,,,,,,,,,,215.8,83,,percent of total billed charges,,,247,95,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,213.2,82,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,65,247,
 FOLLOW UP ASSESSMENT,1090863,CDM,90863,CPT,900,RC,outpatient,,260,260,,220.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65,22,,percent of total billed charges,,,,,,,,,234,90,,percent of total billed charges,,,215.28,82.8,,percent of total billed charges,,,221,85,,percent of total billed charges,,,,,,,,,228.8,88,,percent of total billed charges,,,,,,,,,198.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65,22,,percent of total billed charges,,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,,,,,,,,,,,,,215.8,83,,percent of total billed charges,,,247,95,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,213.2,82,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,65,247,
INTRA UTERINE PRESSURE GAUGE,6132599,CDM,,,290,RC,outpatient,,164,164,,139.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,41,22,,percent of total billed charges,,,,,,,,,147.6,90,,percent of total billed charges,,,135.79,82.8,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,,,,,,,,144.32,88,,percent of total billed charges,,,,,,,,,125.3,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,41,22,,percent of total billed charges,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,134.48,82,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,41,155.8,
X RHC EMG-TC MOTOR NERVE CONDUCTION TEST,14800002,CDM,95903,CPT,922,RC,outpatient,TC,113,113,,95.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,28.25,22,,percent of total billed charges,,,,,,,,,101.7,90,,percent of total billed charges,,,93.56,82.8,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,,,,,,,,99.44,88,,percent of total billed charges,,,,,,,,,86.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,28.25,22,,percent of total billed charges,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,92.66,82,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,28.25,107.35,
X RHC EMG-TC NERVE SENSORY,14800003,CDM,95904,CPT,922,RC,outpatient,TC,106,106,,89.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.5,22,,percent of total billed charges,,,,,,,,,95.4,90,,percent of total billed charges,,,87.77,82.8,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,,,,,,,,93.28,88,,percent of total billed charges,,,,,,,,,80.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.5,22,,percent of total billed charges,,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,,,,,,,,,,,,,87.98,83,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,86.92,82,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,26.5,100.7,
EXTENDED RECOVERY 1ST HOUR,15500000,CDM,,,710,RC,outpatient,,209,209,,177.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.25,22,,percent of total billed charges,,,,,,,,,188.1,90,,percent of total billed charges,,,173.05,82.8,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,,,,,,,,183.92,88,,percent of total billed charges,,,,,,,,,159.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.25,22,,percent of total billed charges,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,171.38,82,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,52.25,198.55,
EXTENDED RECOVERY EACH ADDTL HOUR,15500001,CDM,,,710,RC,outpatient,,109,109,,92.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.25,22,,percent of total billed charges,,,,,,,,,98.1,90,,percent of total billed charges,,,90.25,82.8,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,,,,,,,,95.92,88,,percent of total billed charges,,,,,,,,,83.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.25,22,,percent of total billed charges,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,89.38,82,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,27.25,103.55,
NURSING CARE OBSERV FIRST HOUR,15500002,CDM,G0378,HCPCS,762,RC,outpatient,,1135,1135,,963.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,283.75,22,,percent of total billed charges,,,,,,,,,1021.5,90,,percent of total billed charges,,,939.78,82.8,,percent of total billed charges,,,964.75,85,,percent of total billed charges,,,,,,,,,998.8,88,,percent of total billed charges,,,,,,,,,867.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,283.75,22,,percent of total billed charges,,,1032.85,91,,percent of total billed charges,,,1078.25,95,,percent of total billed charges,,,942.05,83,,percent of total billed charges,,,942.05,83,,percent of total billed charges,,,,,,,,,,,,,,,942.05,83,,percent of total billed charges,,,1078.25,95,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,930.7,82,,percent of total billed charges,,,1021.5,90,,percent of total billed charges,,,964.75,85,,percent of total billed charges,,283.75,1078.25,
NURSING CARE OBSERV ADDTL HOUR,15500003,CDM,G0378,HCPCS,762,RC,outpatient,,37,37,,31.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9.25,22,,percent of total billed charges,,,,,,,,,33.3,90,,percent of total billed charges,,,30.64,82.8,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,,,,,,,,32.56,88,,percent of total billed charges,,,,,,,,,28.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9.25,22,,percent of total billed charges,,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,30.34,82,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,9.25,35.15,
TELEMETRY OBSERVATION FIRST HOUR,15500004,CDM,G0378,HCPCS,762,RC,outpatient,,1553,1553,,1318.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,388.25,22,,percent of total billed charges,,,,,,,,,1397.7,90,,percent of total billed charges,,,1285.88,82.8,,percent of total billed charges,,,1320.05,85,,percent of total billed charges,,,,,,,,,1366.64,88,,percent of total billed charges,,,,,,,,,1186.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,388.25,22,,percent of total billed charges,,,1413.23,91,,percent of total billed charges,,,1475.35,95,,percent of total billed charges,,,1288.99,83,,percent of total billed charges,,,1288.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1288.99,83,,percent of total billed charges,,,1475.35,95,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1273.46,82,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1320.05,85,,percent of total billed charges,,388.25,1475.35,
TELEMETRY OBSERVATION ADDTL HOUR,15500005,CDM,G0378,HCPCS,762,RC,outpatient,,95,95,,80.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.75,22,,percent of total billed charges,,,,,,,,,85.5,90,,percent of total billed charges,,,78.66,82.8,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,,,,,,,,83.6,88,,percent of total billed charges,,,,,,,,,72.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.75,22,,percent of total billed charges,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,,,,,,,,,,,,,78.85,83,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,77.9,82,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,23.75,90.25,
"IV INFUSION, HYDRATION, UP TO 1 HOUR",15500006,CDM,96360,CPT,260,RC,outpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208,22,,percent of total billed charges,,,,,,,,,748.8,90,,percent of total billed charges,,,688.9,82.8,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208,22,,percent of total billed charges,,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,208,790.4,
"IV INFUSION, HYDRATION, ADDTL HOUR",15500007,CDM,96361,CPT,260,RC,outpatient,XU,240,240,,203.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,60,22,,percent of total billed charges,,,,,,,,,216,90,,percent of total billed charges,,,198.72,82.8,,percent of total billed charges,,,204,85,,percent of total billed charges,,,,,,,,,211.2,88,,percent of total billed charges,,,,,,,,,183.36,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,60,22,,percent of total billed charges,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,,,,,,,,,,,,,199.2,83,,percent of total billed charges,,,228,95,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,196.8,82,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,60,228,
"IV INFUSION, THERAPEUTIC, UP TO 1 HOUR",15500008,CDM,96365,CPT,260,RC,outpatient,XU,832,832,,706.37,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,208,22,,percent of total billed charges,,,,,,,,,748.8,90,,percent of total billed charges,,,688.9,82.8,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,,,,,,,,732.16,88,,percent of total billed charges,,,,,,,,,635.65,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,208,22,,percent of total billed charges,,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,,,,,,,,,,,,,690.56,83,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,682.24,82,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,208,790.4,
"IV INFUSION, THERAPEUTIC, ADDTL HOUR",15500009,CDM,96366,CPT,260,RC,outpatient,XU,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.75,22,,percent of total billed charges,,,,,,,,,225.9,90,,percent of total billed charges,,,207.83,82.8,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.75,22,,percent of total billed charges,,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,62.75,238.45,
CONCURRENT ADDT'L MEDICATED SOLUTION,15500010,CDM,96368,CPT,260,RC,outpatient,XU,522,522,,443.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,130.5,22,,percent of total billed charges,,,,,,,,,469.8,90,,percent of total billed charges,,,432.22,82.8,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,,,,,,,,459.36,88,,percent of total billed charges,,,,,,,,,398.81,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,130.5,22,,percent of total billed charges,,,475.02,91,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,,,,,,,,,,,,,433.26,83,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,428.04,82,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,130.5,495.9,
IM/SQ INJECTION,15500011,CDM,96372,CPT,260,RC,outpatient,XU,352,352,,298.85,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,88,22,,percent of total billed charges,,,,,,,,,316.8,90,,percent of total billed charges,,,291.46,82.8,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,,,,,,,,309.76,88,,percent of total billed charges,,,,,,,,,268.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,88,22,,percent of total billed charges,,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,,,,,,,,,,,,,292.16,83,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,288.64,82,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,88,334.4,
"IVP, SINGLE OR INITIAL",15500012,CDM,96374,CPT,260,RC,outpatient,XU,436,436,,370.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109,22,,percent of total billed charges,,,,,,,,,392.4,90,,percent of total billed charges,,,361.01,82.8,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,,,,,,,,383.68,88,,percent of total billed charges,,,,,,,,,333.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109,22,,percent of total billed charges,,,396.76,91,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,,,,,,,,,,,,,361.88,83,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,357.52,82,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,109,414.2,
"IVP, EACH ADDTL OF NEW SUBSTANCE/DRUG",15500013,CDM,96375,CPT,260,RC,outpatient,XU,359,359,,304.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.75,22,,percent of total billed charges,,,,,,,,,323.1,90,,percent of total billed charges,,,297.25,82.8,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,,,,,,,,315.92,88,,percent of total billed charges,,,,,,,,,274.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.75,22,,percent of total billed charges,,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,,,,,,,,,,,,,297.97,83,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,294.38,82,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,89.75,341.05,
"IVP, EACH ADDTL SEQUENTIAL INTRA PUSH",15500014,CDM,96376,CPT,260,RC,outpatient,XU,274,274,,232.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,68.5,22,,percent of total billed charges,,,,,,,,,246.6,90,,percent of total billed charges,,,226.87,82.8,,percent of total billed charges,,,232.9,85,,percent of total billed charges,,,,,,,,,241.12,88,,percent of total billed charges,,,,,,,,,209.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,68.5,22,,percent of total billed charges,,,249.34,91,,percent of total billed charges,,,260.3,95,,percent of total billed charges,,,227.42,83,,percent of total billed charges,,,227.42,83,,percent of total billed charges,,,,,,,,,,,,,,,227.42,83,,percent of total billed charges,,,260.3,95,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,224.68,82,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,232.9,85,,percent of total billed charges,,68.5,260.3,
BLOOD ADMINISTRATION SERVICE,15500015,CDM,36430,CPT,391,RC,outpatient,,1766,1766,,1499.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,441.5,22,,percent of total billed charges,,,,,,,,,1589.4,90,,percent of total billed charges,,,1462.25,82.8,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,,,,,,,,1554.08,88,,percent of total billed charges,,,,,,,,,1349.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,441.5,22,,percent of total billed charges,,,1607.06,91,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1465.78,83,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1448.12,82,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,441.5,1677.7,
PERIPHERAL VASCULAR REHAB,15802080,CDM,93668,CPT,480,RC,outpatient,,313,313,,265.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.25,22,,percent of total billed charges,,,,,,,,,281.7,90,,percent of total billed charges,,,259.16,82.8,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,,,,,,,,275.44,88,,percent of total billed charges,,,,,,,,,239.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.25,22,,percent of total billed charges,,,284.83,91,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,,,,,,,,,,,,,259.79,83,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,256.66,82,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,78.25,297.35,
*ADHESIVE DRESSING 4 X 6 (4 X 3 PAD),23304026,CDM,,,270,RC,outpatient,,5,5,,4.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.25,22,,percent of total billed charges,,,,,,,,,4.5,90,,percent of total billed charges,,,4.14,82.8,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,,,,,,,,4.4,88,,percent of total billed charges,,,,,,,,,3.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.25,22,,percent of total billed charges,,,4.55,91,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,,,,,,,,,,,,,4.15,83,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.1,82,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,1.25,4.75,
* SUTURE (DO NOT USE)(0605),23720151,CDM,,,270,RC,outpatient,,2,2,,1.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.5,22,,percent of total billed charges,,,,,,,,,1.8,90,,percent of total billed charges,,,1.66,82.8,,percent of total billed charges,,,1.7,85,,percent of total billed charges,,,,,,,,,1.76,88,,percent of total billed charges,,,,,,,,,1.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.5,22,,percent of total billed charges,,,1.82,91,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,,,,,,,,,,,,,1.66,83,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.64,82,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.7,85,,percent of total billed charges,,0.5,1.9,
BULLOUS PEMPHIGOID 180/ 230 IGG,25200165,CDM,,,300,RC,outpatient,,107.23,107.23,,91.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,26.81,22,,percent of total billed charges,,,,,,,,,96.51,90,,percent of total billed charges,,,88.79,82.8,,percent of total billed charges,,,91.15,85,,percent of total billed charges,,,,,,,,,94.36,88,,percent of total billed charges,,,,,,,,,81.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,26.81,22,,percent of total billed charges,,,97.58,91,,percent of total billed charges,,,101.87,95,,percent of total billed charges,,,89,83,,percent of total billed charges,,,89,83,,percent of total billed charges,,,,,,,,,,,,,,,89,83,,percent of total billed charges,,,101.87,95,,percent of total billed charges,,,96.51,90,,percent of total billed charges,,,96.51,90,,percent of total billed charges,,,87.93,82,,percent of total billed charges,,,96.51,90,,percent of total billed charges,,,91.15,85,,percent of total billed charges,,26.81,101.87,
COVID NAAT SURGICAL,25202884,CDM,87635,CPT,300,RC,outpatient,,254,254,,215.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.5,22,,percent of total billed charges,,,,,,,,,228.6,90,,percent of total billed charges,,,210.31,82.8,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,,,,,,,,223.52,88,,percent of total billed charges,,,,,,,,,194.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.5,22,,percent of total billed charges,,,231.14,91,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,,,,,,,,,,,,,210.82,83,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,208.28,82,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,63.5,241.3,
STAPLER EEA INTRALUMINAL 33MM,30180011,CDM,,,270,RC,outpatient,,1821.37,1821.37,,1546.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,455.34,22,,percent of total billed charges,,,,,,,,,1639.23,90,,percent of total billed charges,,,1508.09,82.8,,percent of total billed charges,,,1548.16,85,,percent of total billed charges,,,,,,,,,1602.81,88,,percent of total billed charges,,,,,,,,,1391.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,455.34,22,,percent of total billed charges,,,1657.45,91,,percent of total billed charges,,,1730.3,95,,percent of total billed charges,,,1511.74,83,,percent of total billed charges,,,1511.74,83,,percent of total billed charges,,,,,,,,,,,,,,,1511.74,83,,percent of total billed charges,,,1730.3,95,,percent of total billed charges,,,1639.23,90,,percent of total billed charges,,,1639.23,90,,percent of total billed charges,,,1493.52,82,,percent of total billed charges,,,1639.23,90,,percent of total billed charges,,,1548.16,85,,percent of total billed charges,,455.34,1730.3,
COBLATOR WAND PROCISE EZ,30180319,CDM,,,270,RC,outpatient,,2007.85,2007.85,,1704.66,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,501.96,22,,percent of total billed charges,,,,,,,,,1807.07,90,,percent of total billed charges,,,1662.5,82.8,,percent of total billed charges,,,1706.67,85,,percent of total billed charges,,,,,,,,,1766.91,88,,percent of total billed charges,,,,,,,,,1534,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,501.96,22,,percent of total billed charges,,,1827.14,91,,percent of total billed charges,,,1907.46,95,,percent of total billed charges,,,1666.52,83,,percent of total billed charges,,,1666.52,83,,percent of total billed charges,,,,,,,,,,,,,,,1666.52,83,,percent of total billed charges,,,1907.46,95,,percent of total billed charges,,,1807.07,90,,percent of total billed charges,,,1807.07,90,,percent of total billed charges,,,1646.44,82,,percent of total billed charges,,,1807.07,90,,percent of total billed charges,,,1706.67,85,,percent of total billed charges,,501.96,1907.46,
DEPUY INSERT SIGMA XLK 2.5 X 8,30180699,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY DELTA HEAD CER 12/14 32MM +1,30180906,CDM,,,278,RC,outpatient,,15642.97,15642.97,,13280.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3910.74,22,,percent of total billed charges,,,,,,,,,14078.67,90,,percent of total billed charges,,,12952.38,82.8,,percent of total billed charges,,,13296.52,85,,percent of total billed charges,,,,,,,,,13765.81,88,,percent of total billed charges,,,,,,,,,11951.23,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3910.74,22,,percent of total billed charges,,,14235.1,91,,percent of total billed charges,,,14860.82,95,,percent of total billed charges,,,12983.67,83,,percent of total billed charges,,,12983.67,83,,percent of total billed charges,,,,,,,,,,,,,,,12983.67,83,,percent of total billed charges,,,14860.82,95,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,12827.24,82,,percent of total billed charges,,,14078.67,90,,percent of total billed charges,,,13296.52,85,,percent of total billed charges,,3910.74,14860.82,
DEPUY STEM TRI-LOCK STD OFFSET SZ1,30180907,CDM,,,278,RC,outpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10178.29,22,,percent of total billed charges,,,,,,,,,36641.83,90,,percent of total billed charges,,,33710.48,82.8,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10178.29,22,,percent of total billed charges,,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,10178.29,38677.48,
DEPUY STEM TRI-LOCK HI OFFSET SZ8,30180925,CDM,,,278,RC,outpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10178.29,22,,percent of total billed charges,,,,,,,,,36641.83,90,,percent of total billed charges,,,33710.48,82.8,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10178.29,22,,percent of total billed charges,,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,10178.29,38677.48,
DEPUY S-ROM SPEC-3 11/13 40MM,30180980,CDM,,,278,RC,outpatient,,14125.35,14125.35,,11992.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3531.34,22,,percent of total billed charges,,,,,,,,,12712.82,90,,percent of total billed charges,,,11695.79,82.8,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,,,,,,,,12430.31,88,,percent of total billed charges,,,,,,,,,10791.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3531.34,22,,percent of total billed charges,,,12854.07,91,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,11724.04,83,,percent of total billed charges,,,,,,,,,,,,,,,11724.04,83,,percent of total billed charges,,,13419.08,95,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,11582.79,82,,percent of total billed charges,,,12712.82,90,,percent of total billed charges,,,12006.55,85,,percent of total billed charges,,3531.34,13419.08,
DEPUY FEMUR POROUS LT SZ2.5,30181006,CDM,,,278,RC,outpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9038.93,22,,percent of total billed charges,,,,,,,,,32540.16,90,,percent of total billed charges,,,29936.94,82.8,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9038.93,22,,percent of total billed charges,,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,9038.93,34347.94,
DEPUY FEMUR POROUS C/R RT SZ2.5,30181007,CDM,,,278,RC,outpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9038.93,22,,percent of total billed charges,,,,,,,,,32540.16,90,,percent of total billed charges,,,29936.94,82.8,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9038.93,22,,percent of total billed charges,,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,9038.93,34347.94,
DEPUY STEM TRI-LOCK HI OFFSET SZ6,30181015,CDM,,,278,RC,outpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10178.29,22,,percent of total billed charges,,,,,,,,,36641.83,90,,percent of total billed charges,,,33710.48,82.8,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10178.29,22,,percent of total billed charges,,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,10178.29,38677.48,
DEPUY FEMUR POROUS LT SZ3,30181021,CDM,,,278,RC,outpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9038.93,22,,percent of total billed charges,,,,,,,,,32540.16,90,,percent of total billed charges,,,29936.94,82.8,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9038.93,22,,percent of total billed charges,,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,9038.93,34347.94,
DEPUY FEMUR POROUS LT SZ5,30181023,CDM,,,278,RC,outpatient,,36155.73,36155.73,,30696.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9038.93,22,,percent of total billed charges,,,,,,,,,32540.16,90,,percent of total billed charges,,,29936.94,82.8,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,,,,,,,,31817.04,88,,percent of total billed charges,,,,,,,,,27622.98,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9038.93,22,,percent of total billed charges,,,32901.71,91,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,30009.26,83,,percent of total billed charges,,,,,,,,,,,,,,,30009.26,83,,percent of total billed charges,,,34347.94,95,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,29647.7,82,,percent of total billed charges,,,32540.16,90,,percent of total billed charges,,,30732.37,85,,percent of total billed charges,,9038.93,34347.94,
DEPUY STEM TRI-LOCK HI OFFSET SZ4,30181099,CDM,,,278,RC,outpatient,,40713.14,40713.14,,34565.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10178.29,22,,percent of total billed charges,,,,,,,,,36641.83,90,,percent of total billed charges,,,33710.48,82.8,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,,,,,,,,35827.56,88,,percent of total billed charges,,,,,,,,,31104.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10178.29,22,,percent of total billed charges,,,37048.96,91,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,33791.91,83,,percent of total billed charges,,,,,,,,,,,,,,,33791.91,83,,percent of total billed charges,,,38677.48,95,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,33384.77,82,,percent of total billed charges,,,36641.83,90,,percent of total billed charges,,,34606.17,85,,percent of total billed charges,,10178.29,38677.48,
DEPUY STEM SUMMIT STD SZ8,30181357,CDM,,,278,RC,outpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8814.57,22,,percent of total billed charges,,,,,,,,,31732.45,90,,percent of total billed charges,,,29193.86,82.8,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8814.57,22,,percent of total billed charges,,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,8814.57,33495.37,
DEPUY STEM SUMMIT TAPER SZ9 HI OFF,30181420,CDM,,,278,RC,outpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8814.57,22,,percent of total billed charges,,,,,,,,,31732.45,90,,percent of total billed charges,,,29193.86,82.8,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8814.57,22,,percent of total billed charges,,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,8814.57,33495.37,
DEPUY FEMORAL SIGMA UNI RM/LL SZ4,30181449,CDM,,,278,RC,outpatient,,20376.33,20376.33,,17299.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5094.08,22,,percent of total billed charges,,,,,,,,,18338.7,90,,percent of total billed charges,,,16871.6,82.8,,percent of total billed charges,,,17319.88,85,,percent of total billed charges,,,,,,,,,17931.17,88,,percent of total billed charges,,,,,,,,,15567.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5094.08,22,,percent of total billed charges,,,18542.46,91,,percent of total billed charges,,,19357.51,95,,percent of total billed charges,,,16912.35,83,,percent of total billed charges,,,16912.35,83,,percent of total billed charges,,,,,,,,,,,,,,,16912.35,83,,percent of total billed charges,,,19357.51,95,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,16708.59,82,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,17319.88,85,,percent of total billed charges,,5094.08,19357.51,
DEPUY FIXED TIBIAL TRAY HP RM/LL SZ4,30181451,CDM,,,278,RC,outpatient,,12374.51,12374.51,,10505.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3093.63,22,,percent of total billed charges,,,,,,,,,11137.06,90,,percent of total billed charges,,,10246.09,82.8,,percent of total billed charges,,,10518.33,85,,percent of total billed charges,,,,,,,,,10889.57,88,,percent of total billed charges,,,,,,,,,9454.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3093.63,22,,percent of total billed charges,,,11260.8,91,,percent of total billed charges,,,11755.78,95,,percent of total billed charges,,,10270.84,83,,percent of total billed charges,,,10270.84,83,,percent of total billed charges,,,,,,,,,,,,,,,10270.84,83,,percent of total billed charges,,,11755.78,95,,percent of total billed charges,,,11137.06,90,,percent of total billed charges,,,11137.06,90,,percent of total billed charges,,,10147.1,82,,percent of total billed charges,,,11137.06,90,,percent of total billed charges,,,10518.33,85,,percent of total billed charges,,3093.63,11755.78,
DEPUY INSERT SIGMA XLK 5 X 17,30181467,CDM,,,278,RC,outpatient,,14248.07,14248.07,,12096.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.02,22,,percent of total billed charges,,,,,,,,,12823.26,90,,percent of total billed charges,,,11797.4,82.8,,percent of total billed charges,,,12110.86,85,,percent of total billed charges,,,,,,,,,12538.3,88,,percent of total billed charges,,,,,,,,,10885.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.02,22,,percent of total billed charges,,,12965.74,91,,percent of total billed charges,,,13535.67,95,,percent of total billed charges,,,11825.9,83,,percent of total billed charges,,,11825.9,83,,percent of total billed charges,,,,,,,,,,,,,,,11825.9,83,,percent of total billed charges,,,13535.67,95,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,11683.42,82,,percent of total billed charges,,,12823.26,90,,percent of total billed charges,,,12110.86,85,,percent of total billed charges,,3562.02,13535.67,
DEPUY INSERT SIGMA XLK 4 X 20,30181660,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY INSERT SIGMA XLK 4 X 17.5,30181661,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY INSERT XLK 8MM SZ4,30181684,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY MBT KEEL TRAY SZ5,30181779,CDM,,,278,RC,outpatient,,22901.45,22901.45,,19443.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5725.36,22,,percent of total billed charges,,,,,,,,,20611.31,90,,percent of total billed charges,,,18962.4,82.8,,percent of total billed charges,,,19466.23,85,,percent of total billed charges,,,,,,,,,20153.28,88,,percent of total billed charges,,,,,,,,,17496.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5725.36,22,,percent of total billed charges,,,20840.32,91,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19008.2,83,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,18779.19,82,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,19466.23,85,,percent of total billed charges,,5725.36,21756.38,
DEPUY FEMORAL SIGMA UNI RM/LL SZ5,30181805,CDM,,,278,RC,outpatient,,20376.33,20376.33,,17299.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5094.08,22,,percent of total billed charges,,,,,,,,,18338.7,90,,percent of total billed charges,,,16871.6,82.8,,percent of total billed charges,,,17319.88,85,,percent of total billed charges,,,,,,,,,17931.17,88,,percent of total billed charges,,,,,,,,,15567.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5094.08,22,,percent of total billed charges,,,18542.46,91,,percent of total billed charges,,,19357.51,95,,percent of total billed charges,,,16912.35,83,,percent of total billed charges,,,16912.35,83,,percent of total billed charges,,,,,,,,,,,,,,,16912.35,83,,percent of total billed charges,,,19357.51,95,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,16708.59,82,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,17319.88,85,,percent of total billed charges,,5094.08,19357.51,
DEPUY MTB KEEL TRAY SZ4,30181823,CDM,,,270,RC,outpatient,,22901.45,22901.45,,19443.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5725.36,22,,percent of total billed charges,,,,,,,,,20611.31,90,,percent of total billed charges,,,18962.4,82.8,,percent of total billed charges,,,19466.23,85,,percent of total billed charges,,,,,,,,,20153.28,88,,percent of total billed charges,,,,,,,,,17496.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5725.36,22,,percent of total billed charges,,,20840.32,91,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19008.2,83,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,18779.19,82,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,19466.23,85,,percent of total billed charges,,5725.36,21756.38,
DEPUY FEMORAL SIGMA UNI LM/RL SZ4,30181897,CDM,,,278,RC,outpatient,,20376.33,20376.33,,17299.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5094.08,22,,percent of total billed charges,,,,,,,,,18338.7,90,,percent of total billed charges,,,16871.6,82.8,,percent of total billed charges,,,17319.88,85,,percent of total billed charges,,,,,,,,,17931.17,88,,percent of total billed charges,,,,,,,,,15567.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5094.08,22,,percent of total billed charges,,,18542.46,91,,percent of total billed charges,,,19357.51,95,,percent of total billed charges,,,16912.35,83,,percent of total billed charges,,,16912.35,83,,percent of total billed charges,,,,,,,,,,,,,,,16912.35,83,,percent of total billed charges,,,19357.51,95,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,16708.59,82,,percent of total billed charges,,,18338.7,90,,percent of total billed charges,,,17319.88,85,,percent of total billed charges,,5094.08,19357.51,
DEPUY TIBIAL TRAY FIXED BEARING SZ4,30181898,CDM,,,278,RC,outpatient,,12374.51,12374.51,,10505.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3093.63,22,,percent of total billed charges,,,,,,,,,11137.06,90,,percent of total billed charges,,,10246.09,82.8,,percent of total billed charges,,,10518.33,85,,percent of total billed charges,,,,,,,,,10889.57,88,,percent of total billed charges,,,,,,,,,9454.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3093.63,22,,percent of total billed charges,,,11260.8,91,,percent of total billed charges,,,11755.78,95,,percent of total billed charges,,,10270.84,83,,percent of total billed charges,,,10270.84,83,,percent of total billed charges,,,,,,,,,,,,,,,10270.84,83,,percent of total billed charges,,,11755.78,95,,percent of total billed charges,,,11137.06,90,,percent of total billed charges,,,11137.06,90,,percent of total billed charges,,,10147.1,82,,percent of total billed charges,,,11137.06,90,,percent of total billed charges,,,10518.33,85,,percent of total billed charges,,3093.63,11755.78,
THERMOFLECT BOUFFANT CAP ADULT,30182026,CDM,,,270,RC,outpatient,,6.65,6.65,,5.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1.66,22,,percent of total billed charges,,,,,,,,,5.99,90,,percent of total billed charges,,,5.51,82.8,,percent of total billed charges,,,5.65,85,,percent of total billed charges,,,,,,,,,5.85,88,,percent of total billed charges,,,,,,,,,5.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1.66,22,,percent of total billed charges,,,6.05,91,,percent of total billed charges,,,6.32,95,,percent of total billed charges,,,5.52,83,,percent of total billed charges,,,5.52,83,,percent of total billed charges,,,,,,,,,,,,,,,5.52,83,,percent of total billed charges,,,6.32,95,,percent of total billed charges,,,5.99,90,,percent of total billed charges,,,5.99,90,,percent of total billed charges,,,5.45,82,,percent of total billed charges,,,5.99,90,,percent of total billed charges,,,5.65,85,,percent of total billed charges,,1.66,6.32,
DEPUY TIBIAL TRAY RP SZ3,30182056,CDM,,,278,RC,outpatient,,22901.45,22901.45,,19443.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5725.36,22,,percent of total billed charges,,,,,,,,,20611.31,90,,percent of total billed charges,,,18962.4,82.8,,percent of total billed charges,,,19466.23,85,,percent of total billed charges,,,,,,,,,20153.28,88,,percent of total billed charges,,,,,,,,,17496.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5725.36,22,,percent of total billed charges,,,20840.32,91,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19008.2,83,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,18779.19,82,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,19466.23,85,,percent of total billed charges,,5725.36,21756.38,
DEPUY INSERT XLK 10MM SZ4,30182327,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY INSERT SIGMA XLK 2 X 10,30182370,CDM,,,278,RC,outpatient,,14248.52,14248.52,,12096.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3562.13,22,,percent of total billed charges,,,,,,,,,12823.67,90,,percent of total billed charges,,,11797.77,82.8,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,,,,,,,,12538.7,88,,percent of total billed charges,,,,,,,,,10885.87,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3562.13,22,,percent of total billed charges,,,12966.15,91,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,11826.27,83,,percent of total billed charges,,,,,,,,,,,,,,,11826.27,83,,percent of total billed charges,,,13536.09,95,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,11683.79,82,,percent of total billed charges,,,12823.67,90,,percent of total billed charges,,,12111.24,85,,percent of total billed charges,,3562.13,13536.09,
DEPUY INSERT TIBIAL AOX 10MM SZ3,30182610,CDM,,,278,RC,outpatient,,17068.29,17068.29,,14490.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4267.07,22,,percent of total billed charges,,,,,,,,,15361.46,90,,percent of total billed charges,,,14132.54,82.8,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,,,,,,,,15020.1,88,,percent of total billed charges,,,,,,,,,13040.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4267.07,22,,percent of total billed charges,,,15532.14,91,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,14166.68,83,,percent of total billed charges,,,,,,,,,,,,,,,14166.68,83,,percent of total billed charges,,,16214.88,95,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,13996,82,,percent of total billed charges,,,15361.46,90,,percent of total billed charges,,,14508.05,85,,percent of total billed charges,,4267.07,16214.88,
DEPUY-MITEK MICROFIX ANCHOR #3/0,30182731,CDM,,,278,RC,outpatient,,1678.5,1678.5,,1425.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,419.63,22,,percent of total billed charges,,,,,,,,,1510.65,90,,percent of total billed charges,,,1389.8,82.8,,percent of total billed charges,,,1426.73,85,,percent of total billed charges,,,,,,,,,1477.08,88,,percent of total billed charges,,,,,,,,,1282.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,419.63,22,,percent of total billed charges,,,1527.44,91,,percent of total billed charges,,,1594.58,95,,percent of total billed charges,,,1393.16,83,,percent of total billed charges,,,1393.16,83,,percent of total billed charges,,,,,,,,,,,,,,,1393.16,83,,percent of total billed charges,,,1594.58,95,,percent of total billed charges,,,1510.65,90,,percent of total billed charges,,,1510.65,90,,percent of total billed charges,,,1376.37,82,,percent of total billed charges,,,1510.65,90,,percent of total billed charges,,,1426.73,85,,percent of total billed charges,,419.63,1594.58,
STENT URETERAL POLARIS,30182795,CDM,,,270,RC,outpatient,,904.8,904.8,,768.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,226.2,22,,percent of total billed charges,,,,,,,,,814.32,90,,percent of total billed charges,,,749.17,82.8,,percent of total billed charges,,,769.08,85,,percent of total billed charges,,,,,,,,,796.22,88,,percent of total billed charges,,,,,,,,,691.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,226.2,22,,percent of total billed charges,,,823.37,91,,percent of total billed charges,,,859.56,95,,percent of total billed charges,,,750.98,83,,percent of total billed charges,,,750.98,83,,percent of total billed charges,,,,,,,,,,,,,,,750.98,83,,percent of total billed charges,,,859.56,95,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,741.94,82,,percent of total billed charges,,,814.32,90,,percent of total billed charges,,,769.08,85,,percent of total billed charges,,226.2,859.56,
DEPUY MBT KEEL TRAY SZ2.0,30182953,CDM,,,278,RC,outpatient,,22901.45,22901.45,,19443.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5725.36,22,,percent of total billed charges,,,,,,,,,20611.31,90,,percent of total billed charges,,,18962.4,82.8,,percent of total billed charges,,,19466.23,85,,percent of total billed charges,,,,,,,,,20153.28,88,,percent of total billed charges,,,,,,,,,17496.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5725.36,22,,percent of total billed charges,,,20840.32,91,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,19008.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19008.2,83,,percent of total billed charges,,,21756.38,95,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,18779.19,82,,percent of total billed charges,,,20611.31,90,,percent of total billed charges,,,19466.23,85,,percent of total billed charges,,5725.36,21756.38,
WRIGHT STEM PROFEMUR 5/8 SZ14,30183005,CDM,,,278,RC,outpatient,,18713.5,18713.5,,15887.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4678.38,22,,percent of total billed charges,,,,,,,,,16842.15,90,,percent of total billed charges,,,15494.78,82.8,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,,,,,,,,16467.88,88,,percent of total billed charges,,,,,,,,,14297.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4678.38,22,,percent of total billed charges,,,17029.29,91,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,15532.21,83,,percent of total billed charges,,,,,,,,,,,,,,,15532.21,83,,percent of total billed charges,,,17777.83,95,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15345.07,82,,percent of total billed charges,,,16842.15,90,,percent of total billed charges,,,15906.48,85,,percent of total billed charges,,4678.38,17777.83,
DEPUY TIBIAL TRAY FB SZ 6,30183207,CDM,,,278,RC,outpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4782.85,22,,percent of total billed charges,,,,,,,,,17218.25,90,,percent of total billed charges,,,15840.79,82.8,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4782.85,22,,percent of total billed charges,,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,4782.85,18174.82,
DEPUY INSERT TIBIAL 4 X 5MM,30183318,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY ATTUNE TIBIA SZ 4,30183319,CDM,,,278,RC,outpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4782.85,22,,percent of total billed charges,,,,,,,,,17218.25,90,,percent of total billed charges,,,15840.79,82.8,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4782.85,22,,percent of total billed charges,,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,4782.85,18174.82,
DEPUY TRAY TIBIAL CEMENTED SZ 7,30183328,CDM,,,278,RC,outpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4782.85,22,,percent of total billed charges,,,,,,,,,17218.25,90,,percent of total billed charges,,,15840.79,82.8,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4782.85,22,,percent of total billed charges,,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,4782.85,18174.82,
DEPUY INSERT PS SZ 4 8MM,30183348,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY ATTUNE INSERT AOX SZ 7 8MM,30183418,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY TRAY TIBIAL SZ 8,30183460,CDM,,,278,RC,outpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4782.85,22,,percent of total billed charges,,,,,,,,,17218.25,90,,percent of total billed charges,,,15840.79,82.8,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4782.85,22,,percent of total billed charges,,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,4782.85,18174.82,
DEPUY ATTUNE FEMUR SZ 3 LEFT,30183549,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY INSERT AOX 5MM SZ 3,30183550,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY ATTUNE TIBIA TRAY SZ 3,30183551,CDM,,,278,RC,outpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4782.85,22,,percent of total billed charges,,,,,,,,,17218.25,90,,percent of total billed charges,,,15840.79,82.8,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4782.85,22,,percent of total billed charges,,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,4782.85,18174.82,
DEPUY ATTUNE FEMUR SZ 4N LT,30183567,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY FEMUR ATTUNE 4N RIGHT,30183577,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY ATTUNE INSERT AOX SZ 7 10MM,30183695,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY INSERT AOX 5MM SZ 3,30183723,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY ATTUNE FEMUR CR SZ 6 RT,30183734,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY ATTUNE FEMUR CR SZ 5 LT,30183747,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY FEMUR ATTUNE SZ 7 LT CR,30183838,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY INSERT AOX SZ 7 6MM,30183839,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY INSERT AOX SZ 4 6MM,30183841,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY FEMUR CR  SZ 4W RIGHT,30183847,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY ATTUNE FEMUR CR SZ 3 LT,30183867,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY ATTUNE TRAY FB SZ 10,30183880,CDM,,,278,RC,outpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4782.85,22,,percent of total billed charges,,,,,,,,,17218.25,90,,percent of total billed charges,,,15840.79,82.8,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4782.85,22,,percent of total billed charges,,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,4782.85,18174.82,
DEPUY INSERT AOX SZ 7 7MM,30184046,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
MASK FACE LG ADULT INFL SZ 6,30184223,CDM,,,270,RC,outpatient,,21.23,21.23,,18.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5.31,22,,percent of total billed charges,,,,,,,,,19.11,90,,percent of total billed charges,,,17.58,82.8,,percent of total billed charges,,,18.05,85,,percent of total billed charges,,,,,,,,,18.68,88,,percent of total billed charges,,,,,,,,,16.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5.31,22,,percent of total billed charges,,,19.32,91,,percent of total billed charges,,,20.17,95,,percent of total billed charges,,,17.62,83,,percent of total billed charges,,,17.62,83,,percent of total billed charges,,,,,,,,,,,,,,,17.62,83,,percent of total billed charges,,,20.17,95,,percent of total billed charges,,,19.11,90,,percent of total billed charges,,,19.11,90,,percent of total billed charges,,,17.41,82,,percent of total billed charges,,,19.11,90,,percent of total billed charges,,,18.05,85,,percent of total billed charges,,5.31,20.17,
SPLINT FINGER STRIP PADDED 1/2X18,30184245,CDM,,,270,RC,outpatient,,8.79,8.79,,7.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.2,22,,percent of total billed charges,,,,,,,,,7.91,90,,percent of total billed charges,,,7.28,82.8,,percent of total billed charges,,,7.47,85,,percent of total billed charges,,,,,,,,,7.74,88,,percent of total billed charges,,,,,,,,,6.72,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.2,22,,percent of total billed charges,,,8,91,,percent of total billed charges,,,8.35,95,,percent of total billed charges,,,7.3,83,,percent of total billed charges,,,7.3,83,,percent of total billed charges,,,,,,,,,,,,,,,7.3,83,,percent of total billed charges,,,8.35,95,,percent of total billed charges,,,7.91,90,,percent of total billed charges,,,7.91,90,,percent of total billed charges,,,7.21,82,,percent of total billed charges,,,7.91,90,,percent of total billed charges,,,7.47,85,,percent of total billed charges,,2.2,8.35,
DEPUY ATTUNE FEMUR SZ 3N LT CR,30184256,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY INSERT AOX SZ 3 5MM,30184257,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY FEMUR SZ 7 RT CR,30184262,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY INSERT SZ 7 5MM CR,30184263,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY STEM SUMMIT SZ 6 STD,30184374,CDM,,,278,RC,outpatient,,35258.28,35258.28,,29934.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8814.57,22,,percent of total billed charges,,,,,,,,,31732.45,90,,percent of total billed charges,,,29193.86,82.8,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,,,,,,,,31027.29,88,,percent of total billed charges,,,,,,,,,26937.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8814.57,22,,percent of total billed charges,,,32085.03,91,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,29264.37,83,,percent of total billed charges,,,,,,,,,,,,,,,29264.37,83,,percent of total billed charges,,,33495.37,95,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,28911.79,82,,percent of total billed charges,,,31732.45,90,,percent of total billed charges,,,29969.54,85,,percent of total billed charges,,8814.57,33495.37,
DEPUY INSERT AOX 6MM SZ 4,30184430,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY ATTUNE RP SZ 4,30184431,CDM,,,278,RC,outpatient,,21286.98,21286.98,,18072.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5321.75,22,,percent of total billed charges,,,,,,,,,19158.28,90,,percent of total billed charges,,,17625.62,82.8,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,,,,,,,,18732.54,88,,percent of total billed charges,,,,,,,,,16263.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5321.75,22,,percent of total billed charges,,,19371.15,91,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,,,,,,,,,,,,,17668.19,83,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,17455.32,82,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,5321.75,20222.63,
DEPUY TIBIA TRAY RP SZ 7,30184529,CDM,,,270,RC,outpatient,,21286.98,21286.98,,18072.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5321.75,22,,percent of total billed charges,,,,,,,,,19158.28,90,,percent of total billed charges,,,17625.62,82.8,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,,,,,,,,18732.54,88,,percent of total billed charges,,,,,,,,,16263.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5321.75,22,,percent of total billed charges,,,19371.15,91,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,,,,,,,,,,,,,17668.19,83,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,17455.32,82,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,5321.75,20222.63,
DEPUY INSERT CR 6MM SZ 7,30184565,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY INSERT FB STAB 8MM,30184621,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY ATTUNE TIBIA MBT SZ 9,30184625,CDM,,,278,RC,outpatient,,21286.98,21286.98,,18072.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5321.75,22,,percent of total billed charges,,,,,,,,,19158.28,90,,percent of total billed charges,,,17625.62,82.8,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,,,,,,,,18732.54,88,,percent of total billed charges,,,,,,,,,16263.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5321.75,22,,percent of total billed charges,,,19371.15,91,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,,,,,,,,,,,,,17668.19,83,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,17455.32,82,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,5321.75,20222.63,
DEPUY INSERT RP SZ 7 6MM,30184626,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY INSERT STAB FB 9 X 5MM,30184660,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY BIPOLAR CUP 54 OD,30184681,CDM,,,278,RC,outpatient,,8125.07,8125.07,,6898.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2031.27,22,,percent of total billed charges,,,,,,,,,7312.56,90,,percent of total billed charges,,,6727.56,82.8,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,,,,,,,,7150.06,88,,percent of total billed charges,,,,,,,,,6207.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2031.27,22,,percent of total billed charges,,,7393.81,91,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,6743.81,83,,percent of total billed charges,,,,,,,,,,,,,,,6743.81,83,,percent of total billed charges,,,7718.82,95,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6662.56,82,,percent of total billed charges,,,7312.56,90,,percent of total billed charges,,,6906.31,85,,percent of total billed charges,,2031.27,7718.82,
DEPUY INSERT AOX CR SZ 5 7MM,30184722,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY ATTUNE TIBIA TRAY SZ 8,30184728,CDM,,,278,RC,outpatient,,21286.98,21286.98,,18072.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5321.75,22,,percent of total billed charges,,,,,,,,,19158.28,90,,percent of total billed charges,,,17625.62,82.8,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,,,,,,,,18732.54,88,,percent of total billed charges,,,,,,,,,16263.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5321.75,22,,percent of total billed charges,,,19371.15,91,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,,,,,,,,,,,,,17668.19,83,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,17455.32,82,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,5321.75,20222.63,
DEPUY FEMUR SZ 4 NARROW CR L,30184729,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY INSERT CR 7MM SZ 4,30184730,CDM,,,278,RC,outpatient,,14349.73,14349.73,,12182.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3587.43,22,,percent of total billed charges,,,,,,,,,12914.76,90,,percent of total billed charges,,,11881.58,82.8,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,,,,,,,,12627.76,88,,percent of total billed charges,,,,,,,,,10963.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3587.43,22,,percent of total billed charges,,,13058.25,91,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,11910.28,83,,percent of total billed charges,,,,,,,,,,,,,,,11910.28,83,,percent of total billed charges,,,13632.24,95,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,11766.78,82,,percent of total billed charges,,,12914.76,90,,percent of total billed charges,,,12197.27,85,,percent of total billed charges,,3587.43,13632.24,
DEPUY INSERT RP 8MM SZ 7,30184734,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY TIBIA TRAY RP SZ 6,30184735,CDM,,,270,RC,outpatient,,21286.98,21286.98,,18072.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5321.75,22,,percent of total billed charges,,,,,,,,,19158.28,90,,percent of total billed charges,,,17625.62,82.8,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,,,,,,,,18732.54,88,,percent of total billed charges,,,,,,,,,16263.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5321.75,22,,percent of total billed charges,,,19371.15,91,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,,,,,,,,,,,,,17668.19,83,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,17455.32,82,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,5321.75,20222.63,
DEPUY INSERT RP SZ 5 5MM,30184831,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY ATTUNE RP TIBIAL TRAY SZ 3,30184832,CDM,,,278,RC,outpatient,,21286.98,21286.98,,18072.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5321.75,22,,percent of total billed charges,,,,,,,,,19158.28,90,,percent of total billed charges,,,17625.62,82.8,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,,,,,,,,18732.54,88,,percent of total billed charges,,,,,,,,,16263.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5321.75,22,,percent of total billed charges,,,19371.15,91,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,,,,,,,,,,,,,17668.19,83,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,17455.32,82,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,5321.75,20222.63,
DEPUY ATTUNE PATELLA DOME SZ 29,30184869,CDM,,,278,RC,outpatient,,6897.67,6897.67,,5856.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1724.42,22,,percent of total billed charges,,,,,,,,,6207.9,90,,percent of total billed charges,,,5711.27,82.8,,percent of total billed charges,,,5863.02,85,,percent of total billed charges,,,,,,,,,6069.95,88,,percent of total billed charges,,,,,,,,,5269.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1724.42,22,,percent of total billed charges,,,6276.88,91,,percent of total billed charges,,,6552.79,95,,percent of total billed charges,,,5725.07,83,,percent of total billed charges,,,5725.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5725.07,83,,percent of total billed charges,,,6552.79,95,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,5656.09,82,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,5863.02,85,,percent of total billed charges,,1724.42,6552.79,
DEPUY ATTUNE FEMUR SZ 3N LT PS,30184870,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY INSERT RP SZ 6 8MM,30184889,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY INSERT RP 10MM SZ 8,30185021,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY INSERT RP SZ 4 8MM,30185027,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
NEEDLE CARR-LOCKE INJECTION 25GA (NC),30185093,CDM,,,270,RC,outpatient,,441,441,,374.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.25,22,,percent of total billed charges,,,,,,,,,396.9,90,,percent of total billed charges,,,365.15,82.8,,percent of total billed charges,,,374.85,85,,percent of total billed charges,,,,,,,,,388.08,88,,percent of total billed charges,,,,,,,,,336.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.25,22,,percent of total billed charges,,,401.31,91,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,,,,,,,,,,,,,366.03,83,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,361.62,82,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,374.85,85,,percent of total billed charges,,110.25,418.95,
DEPUY INSERT AOX RP 5MM,30185147,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY FEMUR LEFT 10MM,30185224,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY TIBIA MBT 10MM,30185225,CDM,,,278,RC,outpatient,,21286.98,21286.98,,18072.65,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5321.75,22,,percent of total billed charges,,,,,,,,,19158.28,90,,percent of total billed charges,,,17625.62,82.8,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,,,,,,,,18732.54,88,,percent of total billed charges,,,,,,,,,16263.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5321.75,22,,percent of total billed charges,,,19371.15,91,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,17668.19,83,,percent of total billed charges,,,,,,,,,,,,,,,17668.19,83,,percent of total billed charges,,,20222.63,95,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,17455.32,82,,percent of total billed charges,,,19158.28,90,,percent of total billed charges,,,18093.93,85,,percent of total billed charges,,5321.75,20222.63,
DEPUY INSERT 5MM 10,30185226,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY PATELLA 41MM,30185232,CDM,,,278,RC,outpatient,,6897.67,6897.67,,5856.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1724.42,22,,percent of total billed charges,,,,,,,,,6207.9,90,,percent of total billed charges,,,5711.27,82.8,,percent of total billed charges,,,5863.02,85,,percent of total billed charges,,,,,,,,,6069.95,88,,percent of total billed charges,,,,,,,,,5269.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1724.42,22,,percent of total billed charges,,,6276.88,91,,percent of total billed charges,,,6552.79,95,,percent of total billed charges,,,5725.07,83,,percent of total billed charges,,,5725.07,83,,percent of total billed charges,,,,,,,,,,,,,,,5725.07,83,,percent of total billed charges,,,6552.79,95,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,5656.09,82,,percent of total billed charges,,,6207.9,90,,percent of total billed charges,,,5863.02,85,,percent of total billed charges,,1724.42,6552.79,
DEPUY FEMUR ATTUNE PS SZ 4 LFT,30185295,CDM,,,278,RC,outpatient,,28281.83,28281.83,,24011.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7070.46,22,,percent of total billed charges,,,,,,,,,25453.65,90,,percent of total billed charges,,,23417.36,82.8,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,,,,,,,,24888.01,88,,percent of total billed charges,,,,,,,,,21607.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7070.46,22,,percent of total billed charges,,,25736.47,91,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,23473.92,83,,percent of total billed charges,,,,,,,,,,,,,,,23473.92,83,,percent of total billed charges,,,26867.74,95,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,23191.1,82,,percent of total billed charges,,,25453.65,90,,percent of total billed charges,,,24039.56,85,,percent of total billed charges,,7070.46,26867.74,
DEPUY TIBIAL TRAY FB SIZE 5,30185317,CDM,,,270,RC,outpatient,,19131.39,19131.39,,16242.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4782.85,22,,percent of total billed charges,,,,,,,,,17218.25,90,,percent of total billed charges,,,15840.79,82.8,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,,,,,,,,16835.62,88,,percent of total billed charges,,,,,,,,,14616.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4782.85,22,,percent of total billed charges,,,17409.56,91,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,15879.05,83,,percent of total billed charges,,,,,,,,,,,,,,,15879.05,83,,percent of total billed charges,,,18174.82,95,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,15687.74,82,,percent of total billed charges,,,17218.25,90,,percent of total billed charges,,,16261.68,85,,percent of total billed charges,,4782.85,18174.82,
DEPUY TRAY TIBIAL FB SZ 8,30185400,CDM,,,278,RC,outpatient,,19747.26,19747.26,,16765.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4936.82,22,,percent of total billed charges,,,,,,,,,17772.53,90,,percent of total billed charges,,,16350.73,82.8,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,,,,,,,,17377.59,88,,percent of total billed charges,,,,,,,,,15086.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4936.82,22,,percent of total billed charges,,,17970.01,91,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,,,,,,,,,,,,,16390.23,83,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16192.75,82,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,4936.82,18759.9,
DEPUY TRAY TIBIAL FB SZ 5,30185401,CDM,,,278,RC,outpatient,,19747.26,19747.26,,16765.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4936.82,22,,percent of total billed charges,,,,,,,,,17772.53,90,,percent of total billed charges,,,16350.73,82.8,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,,,,,,,,17377.59,88,,percent of total billed charges,,,,,,,,,15086.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4936.82,22,,percent of total billed charges,,,17970.01,91,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,,,,,,,,,,,,,16390.23,83,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16192.75,82,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,4936.82,18759.9,
DEPUY ATTUNE TIBIAL TRAY FB SZ 7,30185420,CDM,,,278,RC,outpatient,,19747.26,19747.26,,16765.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4936.82,22,,percent of total billed charges,,,,,,,,,17772.53,90,,percent of total billed charges,,,16350.73,82.8,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,,,,,,,,17377.59,88,,percent of total billed charges,,,,,,,,,15086.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4936.82,22,,percent of total billed charges,,,17970.01,91,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,,,,,,,,,,,,,16390.23,83,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16192.75,82,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,4936.82,18759.9,
DEPUY TRAY TIBIAL FB SZ 3,30185536,CDM,,,278,RC,outpatient,,19747.26,19747.26,,16765.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4936.82,22,,percent of total billed charges,,,,,,,,,17772.53,90,,percent of total billed charges,,,16350.73,82.8,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,,,,,,,,17377.59,88,,percent of total billed charges,,,,,,,,,15086.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4936.82,22,,percent of total billed charges,,,17970.01,91,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,,,,,,,,,,,,,16390.23,83,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16192.75,82,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,4936.82,18759.9,
DEPUY LINER ALTRX 40 X 58,30185681,CDM,,,278,RC,outpatient,,17691.38,17691.38,,15019.98,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4422.85,22,,percent of total billed charges,,,,,,,,,15922.24,90,,percent of total billed charges,,,14648.46,82.8,,percent of total billed charges,,,15037.67,85,,percent of total billed charges,,,,,,,,,15568.41,88,,percent of total billed charges,,,,,,,,,13516.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4422.85,22,,percent of total billed charges,,,16099.16,91,,percent of total billed charges,,,16806.81,95,,percent of total billed charges,,,14683.85,83,,percent of total billed charges,,,14683.85,83,,percent of total billed charges,,,,,,,,,,,,,,,14683.85,83,,percent of total billed charges,,,16806.81,95,,percent of total billed charges,,,15922.24,90,,percent of total billed charges,,,15922.24,90,,percent of total billed charges,,,14506.93,82,,percent of total billed charges,,,15922.24,90,,percent of total billed charges,,,15037.67,85,,percent of total billed charges,,4422.85,16806.81,
DEPUY FEMUR ATTUNE RT SZ 7,30186023,CDM,,,278,RC,outpatient,,31272.74,31272.74,,26550.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7818.19,22,,percent of total billed charges,,,,,,,,,28145.47,90,,percent of total billed charges,,,25893.83,82.8,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,,,,,,,,27520.01,88,,percent of total billed charges,,,,,,,,,23892.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7818.19,22,,percent of total billed charges,,,28458.19,91,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,25956.37,83,,percent of total billed charges,,,,,,,,,,,,,,,25956.37,83,,percent of total billed charges,,,29709.1,95,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,25643.65,82,,percent of total billed charges,,,28145.47,90,,percent of total billed charges,,,26581.83,85,,percent of total billed charges,,7818.19,29709.1,
DEPUY TIBIA ATTUNE RP SZ 7,30186024,CDM,,,278,RC,outpatient,,22629.36,22629.36,,19212.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5657.34,22,,percent of total billed charges,,,,,,,,,20366.42,90,,percent of total billed charges,,,18737.11,82.8,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,,,,,,,,19913.84,88,,percent of total billed charges,,,,,,,,,17288.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5657.34,22,,percent of total billed charges,,,20592.72,91,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,,,,,,,,,,,,,18782.37,83,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,18556.08,82,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,5657.34,21497.89,
DEPUY TIBIA ATTUNE RP SZ 5,30186039,CDM,,,278,RC,outpatient,,22629.36,22629.36,,19212.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5657.34,22,,percent of total billed charges,,,,,,,,,20366.42,90,,percent of total billed charges,,,18737.11,82.8,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,,,,,,,,19913.84,88,,percent of total billed charges,,,,,,,,,17288.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5657.34,22,,percent of total billed charges,,,20592.72,91,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,,,,,,,,,,,,,18782.37,83,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,18556.08,82,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,5657.34,21497.89,
DEPUY INSERT ATTUNE TIBIAL SZ 5 6MM,30186040,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY CERAMIC HEAD 32MM +1MM TS,30186175,CDM,,,278,RC,outpatient,,14631.05,14631.05,,12421.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,3657.76,22,,percent of total billed charges,,,,,,,,,13167.95,90,,percent of total billed charges,,,12114.51,82.8,,percent of total billed charges,,,12436.39,85,,percent of total billed charges,,,,,,,,,12875.32,88,,percent of total billed charges,,,,,,,,,11178.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,3657.76,22,,percent of total billed charges,,,13314.26,91,,percent of total billed charges,,,13899.5,95,,percent of total billed charges,,,12143.77,83,,percent of total billed charges,,,12143.77,83,,percent of total billed charges,,,,,,,,,,,,,,,12143.77,83,,percent of total billed charges,,,13899.5,95,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,11997.46,82,,percent of total billed charges,,,13167.95,90,,percent of total billed charges,,,12436.39,85,,percent of total billed charges,,3657.76,13899.5,
DEPUY TIBIA ATTUNE RP SZ 4,30186189,CDM,,,278,RC,outpatient,,22629.36,22629.36,,19212.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5657.34,22,,percent of total billed charges,,,,,,,,,20366.42,90,,percent of total billed charges,,,18737.11,82.8,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,,,,,,,,19913.84,88,,percent of total billed charges,,,,,,,,,17288.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5657.34,22,,percent of total billed charges,,,20592.72,91,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,,,,,,,,,,,,,18782.37,83,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,18556.08,82,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,5657.34,21497.89,
DEPUY INSERT RP SZ 5 10MM,30186190,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY STEM CORAIL HI OFFSET SZ10,30186246,CDM,,,278,RC,outpatient,,38427.68,38427.68,,32625.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,9606.92,22,,percent of total billed charges,,,,,,,,,34584.91,90,,percent of total billed charges,,,31818.12,82.8,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,,,,,,,,33816.36,88,,percent of total billed charges,,,,,,,,,29358.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,9606.92,22,,percent of total billed charges,,,34969.19,91,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,31894.97,83,,percent of total billed charges,,,,,,,,,,,,,,,31894.97,83,,percent of total billed charges,,,36506.3,95,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,31510.7,82,,percent of total billed charges,,,34584.91,90,,percent of total billed charges,,,32663.53,85,,percent of total billed charges,,9606.92,36506.3,
DEPUY TIBIA  ATTUNE RP SZ 9,30186299,CDM,,,278,RC,outpatient,,19747.26,19747.26,,16765.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4936.82,22,,percent of total billed charges,,,,,,,,,17772.53,90,,percent of total billed charges,,,16350.73,82.8,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,,,,,,,,17377.59,88,,percent of total billed charges,,,,,,,,,15086.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4936.82,22,,percent of total billed charges,,,17970.01,91,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,,,,,,,,,,,,,16390.23,83,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16192.75,82,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,4936.82,18759.9,
DEPUY TRAY TIBIAL FB SZ 4,30186392,CDM,,,278,RC,outpatient,,19747.26,19747.26,,16765.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4936.82,22,,percent of total billed charges,,,,,,,,,17772.53,90,,percent of total billed charges,,,16350.73,82.8,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,,,,,,,,17377.59,88,,percent of total billed charges,,,,,,,,,15086.91,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4936.82,22,,percent of total billed charges,,,17970.01,91,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,16390.23,83,,percent of total billed charges,,,,,,,,,,,,,,,16390.23,83,,percent of total billed charges,,,18759.9,95,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16192.75,82,,percent of total billed charges,,,17772.53,90,,percent of total billed charges,,,16785.17,85,,percent of total billed charges,,4936.82,18759.9,
DEPUY ATTUNE INSERT RP SZ 5 8MM,30186418,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY INSERT RP SZ 6 7MM,30186476,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY PRESSFIT TIBIA SZ. 5,30186506,CDM,,,278,RC,outpatient,,27458.8,27458.8,,23312.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6864.7,22,,percent of total billed charges,,,,,,,,,24712.92,90,,percent of total billed charges,,,22735.89,82.8,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,,,,,,,,24163.74,88,,percent of total billed charges,,,,,,,,,20978.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6864.7,22,,percent of total billed charges,,,24987.51,91,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,,,,,,,,,,,,,22790.8,83,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,22516.22,82,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,6864.7,26085.86,
DEPUY PRESSFIT FEMUR LEFT 5N,30186507,CDM,,,278,RC,outpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10046.3,22,,percent of total billed charges,,,,,,,,,36166.69,90,,percent of total billed charges,,,33273.35,82.8,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10046.3,22,,percent of total billed charges,,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,10046.3,38175.95,
DEPUY ATTUNE INSERT CR 6MM SZ 5,30186508,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY FEMUR CEMENTLESS CR RIGHT 5,30186539,CDM,,,278,RC,outpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10046.3,22,,percent of total billed charges,,,,,,,,,36166.69,90,,percent of total billed charges,,,33273.35,82.8,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10046.3,22,,percent of total billed charges,,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,10046.3,38175.95,
DEPUY INSERT CR RP 5MM,30186540,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY PRESSFIT FEMUR PS 5N LEFT,30186598,CDM,,,278,RC,outpatient,,41399.35,41399.35,,35148.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10349.84,22,,percent of total billed charges,,,,,,,,,37259.42,90,,percent of total billed charges,,,34278.66,82.8,,percent of total billed charges,,,35189.45,85,,percent of total billed charges,,,,,,,,,36431.43,88,,percent of total billed charges,,,,,,,,,31629.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10349.84,22,,percent of total billed charges,,,37673.41,91,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,,,,,,,,,,,,,34361.46,83,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,33947.47,82,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,35189.45,85,,percent of total billed charges,,10349.84,39329.38,
DEPUY PRESSFIT FEMUR CR 6N LEFT,30186599,CDM,,,278,RC,outpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10046.3,22,,percent of total billed charges,,,,,,,,,36166.69,90,,percent of total billed charges,,,33273.35,82.8,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10046.3,22,,percent of total billed charges,,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,10046.3,38175.95,
DEPUY PRESSFIT TIBIA SZ. 6 RP,30186600,CDM,,,278,RC,outpatient,,27458.8,27458.8,,23312.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6864.7,22,,percent of total billed charges,,,,,,,,,24712.92,90,,percent of total billed charges,,,22735.89,82.8,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,,,,,,,,24163.74,88,,percent of total billed charges,,,,,,,,,20978.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6864.7,22,,percent of total billed charges,,,24987.51,91,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,,,,,,,,,,,,,22790.8,83,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,22516.22,82,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,6864.7,26085.86,
DEPUY INSERT RP SZ 6 5MM,30186601,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY PRESSFIT FEMUR CEMTLESS SZ 6 LEFT,30186643,CDM,,,278,RC,outpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10046.3,22,,percent of total billed charges,,,,,,,,,36166.69,90,,percent of total billed charges,,,33273.35,82.8,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10046.3,22,,percent of total billed charges,,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,10046.3,38175.95,
DEPUY INSERT RP 7MM SZ 7,30186652,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY TIBIA RP SZ 8,30186653,CDM,,,278,RC,outpatient,,22629.36,22629.36,,19212.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5657.34,22,,percent of total billed charges,,,,,,,,,20366.42,90,,percent of total billed charges,,,18737.11,82.8,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,,,,,,,,19913.84,88,,percent of total billed charges,,,,,,,,,17288.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5657.34,22,,percent of total billed charges,,,20592.72,91,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,,,,,,,,,,,,,18782.37,83,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,18556.08,82,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,5657.34,21497.89,
DEPUY INSERT RP 8MM SZ 8,30186654,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY PRESSFIT FEMUR CR SZ 6 RIGHT,30186668,CDM,,,278,RC,outpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10046.3,22,,percent of total billed charges,,,,,,,,,36166.69,90,,percent of total billed charges,,,33273.35,82.8,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10046.3,22,,percent of total billed charges,,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,10046.3,38175.95,
DEPUY INSERT 8MM,30186676,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY INSERT ATTUNE SZ 12,30186699,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY TIBIA  ATTUNE RP SZ 9,30186702,CDM,,,278,RC,outpatient,,22629.36,22629.36,,19212.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,5657.34,22,,percent of total billed charges,,,,,,,,,20366.42,90,,percent of total billed charges,,,18737.11,82.8,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,,,,,,,,19913.84,88,,percent of total billed charges,,,,,,,,,17288.83,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,5657.34,22,,percent of total billed charges,,,20592.72,91,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,18782.37,83,,percent of total billed charges,,,,,,,,,,,,,,,18782.37,83,,percent of total billed charges,,,21497.89,95,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,18556.08,82,,percent of total billed charges,,,20366.42,90,,percent of total billed charges,,,19234.96,85,,percent of total billed charges,,5657.34,21497.89,
DEPUY ATTUNE FEMUR PRESSFIT CR SZ 4 LEFT,30186729,CDM,,,278,RC,outpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10046.3,22,,percent of total billed charges,,,,,,,,,36166.69,90,,percent of total billed charges,,,33273.35,82.8,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10046.3,22,,percent of total billed charges,,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,10046.3,38175.95,
DEPUY INSERT PRESSFIT 5MM,30186730,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY FEMUR PRESSFIT PS 7 RIGHT,30186779,CDM,,,278,RC,outpatient,,41399.35,41399.35,,35148.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10349.84,22,,percent of total billed charges,,,,,,,,,37259.42,90,,percent of total billed charges,,,34278.66,82.8,,percent of total billed charges,,,35189.45,85,,percent of total billed charges,,,,,,,,,36431.43,88,,percent of total billed charges,,,,,,,,,31629.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10349.84,22,,percent of total billed charges,,,37673.41,91,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,,,,,,,,,,,,,34361.46,83,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,33947.47,82,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,35189.45,85,,percent of total billed charges,,10349.84,39329.38,
DEPUY TIBIA PRESSFIT PS 7,30186780,CDM,,,278,RC,outpatient,,27458.8,27458.8,,23312.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6864.7,22,,percent of total billed charges,,,,,,,,,24712.92,90,,percent of total billed charges,,,22735.89,82.8,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,,,,,,,,24163.74,88,,percent of total billed charges,,,,,,,,,20978.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6864.7,22,,percent of total billed charges,,,24987.51,91,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,,,,,,,,,,,,,22790.8,83,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,22516.22,82,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,6864.7,26085.86,
DEPUY FEMUR POROUS CR SZ 6N RIGHT,30186911,CDM,,,278,RC,outpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10046.3,22,,percent of total billed charges,,,,,,,,,36166.69,90,,percent of total billed charges,,,33273.35,82.8,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10046.3,22,,percent of total billed charges,,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,10046.3,38175.95,
DEPUY PRESSFIT INSERT 6MM RP,30186912,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY LINER ALTRX +4 40 X 62,30186921,CDM,,,278,RC,outpatient,,17600.51,17600.51,,14942.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4400.13,22,,percent of total billed charges,,,,,,,,,15840.46,90,,percent of total billed charges,,,14573.22,82.8,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,,,,,,,,15488.45,88,,percent of total billed charges,,,,,,,,,13446.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4400.13,22,,percent of total billed charges,,,16016.46,91,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,14608.42,83,,percent of total billed charges,,,,,,,,,,,,,,,14608.42,83,,percent of total billed charges,,,16720.48,95,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14432.42,82,,percent of total billed charges,,,15840.46,90,,percent of total billed charges,,,14960.43,85,,percent of total billed charges,,4400.13,16720.48,
DEPUY PRESSFIT TIBIA SZ. 4,30187515,CDM,,,278,RC,outpatient,,27458.8,27458.8,,23312.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6864.7,22,,percent of total billed charges,,,,,,,,,24712.92,90,,percent of total billed charges,,,22735.89,82.8,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,,,,,,,,24163.74,88,,percent of total billed charges,,,,,,,,,20978.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6864.7,22,,percent of total billed charges,,,24987.51,91,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,,,,,,,,,,,,,22790.8,83,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,22516.22,82,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,6864.7,26085.86,
DEPUY PRESSFIT FEMUR 6N LEFT,30187516,CDM,,,278,RC,outpatient,,41399.35,41399.35,,35148.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10349.84,22,,percent of total billed charges,,,,,,,,,37259.42,90,,percent of total billed charges,,,34278.66,82.8,,percent of total billed charges,,,35189.45,85,,percent of total billed charges,,,,,,,,,36431.43,88,,percent of total billed charges,,,,,,,,,31629.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10349.84,22,,percent of total billed charges,,,37673.41,91,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,,,,,,,,,,,,,34361.46,83,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,33947.47,82,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,35189.45,85,,percent of total billed charges,,10349.84,39329.38,
DEPUY ATTUNE INSERT SZ 5 7MM,30187543,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY ATTUNE FEMUR SZ 6 NAR RT,30187624,CDM,,,278,RC,outpatient,,41399.35,41399.35,,35148.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10349.84,22,,percent of total billed charges,,,,,,,,,37259.42,90,,percent of total billed charges,,,34278.66,82.8,,percent of total billed charges,,,35189.45,85,,percent of total billed charges,,,,,,,,,36431.43,88,,percent of total billed charges,,,,,,,,,31629.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10349.84,22,,percent of total billed charges,,,37673.41,91,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,,,,,,,,,,,,,34361.46,83,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,33947.47,82,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,35189.45,85,,percent of total billed charges,,10349.84,39329.38,
DEPUY ATTUNE FEMUR PRESSFIT RT SZ 9,30187767,CDM,,,278,RC,outpatient,,41399.35,41399.35,,35148.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10349.84,22,,percent of total billed charges,,,,,,,,,37259.42,90,,percent of total billed charges,,,34278.66,82.8,,percent of total billed charges,,,35189.45,85,,percent of total billed charges,,,,,,,,,36431.43,88,,percent of total billed charges,,,,,,,,,31629.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10349.84,22,,percent of total billed charges,,,37673.41,91,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,34361.46,83,,percent of total billed charges,,,,,,,,,,,,,,,34361.46,83,,percent of total billed charges,,,39329.38,95,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,33947.47,82,,percent of total billed charges,,,37259.42,90,,percent of total billed charges,,,35189.45,85,,percent of total billed charges,,10349.84,39329.38,
DEPUY ATTUNE INSERT PRESSFIT SZ 9 X 12MM,30187768,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
DEPUY ATTUNE FEMUR CR RT SZ 9,30188192,CDM,,,278,RC,outpatient,,40185.21,40185.21,,34117.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10046.3,22,,percent of total billed charges,,,,,,,,,36166.69,90,,percent of total billed charges,,,33273.35,82.8,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,,,,,,,,35362.98,88,,percent of total billed charges,,,,,,,,,30701.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10046.3,22,,percent of total billed charges,,,36568.54,91,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,33353.72,83,,percent of total billed charges,,,,,,,,,,,,,,,33353.72,83,,percent of total billed charges,,,38175.95,95,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,32951.87,82,,percent of total billed charges,,,36166.69,90,,percent of total billed charges,,,34157.43,85,,percent of total billed charges,,10046.3,38175.95,
DEPUY ATTUNE TIBIA PRESSFIT RP SZ9,30188193,CDM,,,278,RC,outpatient,,27458.8,27458.8,,23312.52,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6864.7,22,,percent of total billed charges,,,,,,,,,24712.92,90,,percent of total billed charges,,,22735.89,82.8,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,,,,,,,,24163.74,88,,percent of total billed charges,,,,,,,,,20978.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6864.7,22,,percent of total billed charges,,,24987.51,91,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,22790.8,83,,percent of total billed charges,,,,,,,,,,,,,,,22790.8,83,,percent of total billed charges,,,26085.86,95,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,22516.22,82,,percent of total billed charges,,,24712.92,90,,percent of total billed charges,,,23339.98,85,,percent of total billed charges,,6864.7,26085.86,
DEPUY ATTUNE INSERT TIBIAL CR RP SZ 9 10,30188194,CDM,,,278,RC,outpatient,,16738.35,16738.35,,14210.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,4184.59,22,,percent of total billed charges,,,,,,,,,15064.52,90,,percent of total billed charges,,,13859.35,82.8,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,,,,,,,,14729.75,88,,percent of total billed charges,,,,,,,,,12788.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,4184.59,22,,percent of total billed charges,,,15231.9,91,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,13892.83,83,,percent of total billed charges,,,,,,,,,,,,,,,13892.83,83,,percent of total billed charges,,,15901.43,95,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,13725.45,82,,percent of total billed charges,,,15064.52,90,,percent of total billed charges,,,14227.6,85,,percent of total billed charges,,4184.59,15901.43,
CATH DRAINAGE 10FR (NC),30260097,CDM,,,270,RC,outpatient,,1393.15,1393.15,,1182.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,348.29,22,,percent of total billed charges,,,,,,,,,1253.84,90,,percent of total billed charges,,,1153.53,82.8,,percent of total billed charges,,,1184.18,85,,percent of total billed charges,,,,,,,,,1225.97,88,,percent of total billed charges,,,,,,,,,1064.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,348.29,22,,percent of total billed charges,,,1267.77,91,,percent of total billed charges,,,1323.49,95,,percent of total billed charges,,,1156.31,83,,percent of total billed charges,,,1156.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1156.31,83,,percent of total billed charges,,,1323.49,95,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1142.38,82,,percent of total billed charges,,,1253.84,90,,percent of total billed charges,,,1184.18,85,,percent of total billed charges,,348.29,1323.49,
SENSOR ADHESIVE PED. PDTX LNCS (NC),30330046,CDM,,,270,RC,outpatient,,63.47,63.47,,53.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.87,22,,percent of total billed charges,,,,,,,,,57.12,90,,percent of total billed charges,,,52.55,82.8,,percent of total billed charges,,,53.95,85,,percent of total billed charges,,,,,,,,,55.85,88,,percent of total billed charges,,,,,,,,,48.49,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.87,22,,percent of total billed charges,,,57.76,91,,percent of total billed charges,,,60.3,95,,percent of total billed charges,,,52.68,83,,percent of total billed charges,,,52.68,83,,percent of total billed charges,,,,,,,,,,,,,,,52.68,83,,percent of total billed charges,,,60.3,95,,percent of total billed charges,,,57.12,90,,percent of total billed charges,,,57.12,90,,percent of total billed charges,,,52.05,82,,percent of total billed charges,,,57.12,90,,percent of total billed charges,,,53.95,85,,percent of total billed charges,,15.87,60.3,
ARM LYMPH BANDAGE KIT,30340012,CDM,,,270,RC,outpatient,,509.7,509.7,,432.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.43,22,,percent of total billed charges,,,,,,,,,458.73,90,,percent of total billed charges,,,422.03,82.8,,percent of total billed charges,,,433.25,85,,percent of total billed charges,,,,,,,,,448.54,88,,percent of total billed charges,,,,,,,,,389.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.43,22,,percent of total billed charges,,,463.83,91,,percent of total billed charges,,,484.22,95,,percent of total billed charges,,,423.05,83,,percent of total billed charges,,,423.05,83,,percent of total billed charges,,,,,,,,,,,,,,,423.05,83,,percent of total billed charges,,,484.22,95,,percent of total billed charges,,,458.73,90,,percent of total billed charges,,,458.73,90,,percent of total billed charges,,,417.95,82,,percent of total billed charges,,,458.73,90,,percent of total billed charges,,,433.25,85,,percent of total billed charges,,127.43,484.22,
DRESSING WOUND AQUACEL/AG 6X6,30810001,CDM,,,270,RC,outpatient,,151.4,151.4,,128.54,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,37.85,22,,percent of total billed charges,,,,,,,,,136.26,90,,percent of total billed charges,,,125.36,82.8,,percent of total billed charges,,,128.69,85,,percent of total billed charges,,,,,,,,,133.23,88,,percent of total billed charges,,,,,,,,,115.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,37.85,22,,percent of total billed charges,,,137.77,91,,percent of total billed charges,,,143.83,95,,percent of total billed charges,,,125.66,83,,percent of total billed charges,,,125.66,83,,percent of total billed charges,,,,,,,,,,,,,,,125.66,83,,percent of total billed charges,,,143.83,95,,percent of total billed charges,,,136.26,90,,percent of total billed charges,,,136.26,90,,percent of total billed charges,,,124.15,82,,percent of total billed charges,,,136.26,90,,percent of total billed charges,,,128.69,85,,percent of total billed charges,,37.85,143.83,
DRESSING FIBRACOL PLUS COLLAGEN-2,30810002,CDM,,,270,RC,outpatient,,65.81,65.81,,55.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.45,22,,percent of total billed charges,,,,,,,,,59.23,90,,percent of total billed charges,,,54.49,82.8,,percent of total billed charges,,,55.94,85,,percent of total billed charges,,,,,,,,,57.91,88,,percent of total billed charges,,,,,,,,,50.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.45,22,,percent of total billed charges,,,59.89,91,,percent of total billed charges,,,62.52,95,,percent of total billed charges,,,54.62,83,,percent of total billed charges,,,54.62,83,,percent of total billed charges,,,,,,,,,,,,,,,54.62,83,,percent of total billed charges,,,62.52,95,,percent of total billed charges,,,59.23,90,,percent of total billed charges,,,59.23,90,,percent of total billed charges,,,53.96,82,,percent of total billed charges,,,59.23,90,,percent of total billed charges,,,55.94,85,,percent of total billed charges,,16.45,62.52,
DRESSING DUO-DERM 6X6 THIN,30810003,CDM,,,270,RC,outpatient,,25.01,25.01,,21.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,6.25,22,,percent of total billed charges,,,,,,,,,22.51,90,,percent of total billed charges,,,20.71,82.8,,percent of total billed charges,,,21.26,85,,percent of total billed charges,,,,,,,,,22.01,88,,percent of total billed charges,,,,,,,,,19.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,6.25,22,,percent of total billed charges,,,22.76,91,,percent of total billed charges,,,23.76,95,,percent of total billed charges,,,20.76,83,,percent of total billed charges,,,20.76,83,,percent of total billed charges,,,,,,,,,,,,,,,20.76,83,,percent of total billed charges,,,23.76,95,,percent of total billed charges,,,22.51,90,,percent of total billed charges,,,22.51,90,,percent of total billed charges,,,20.51,82,,percent of total billed charges,,,22.51,90,,percent of total billed charges,,,21.26,85,,percent of total billed charges,,6.25,23.76,
DRESSING PROMOGRAN 19.1 SQ. IN,30810008,CDM,,,270,RC,outpatient,,155.48,155.48,,132,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,38.87,22,,percent of total billed charges,,,,,,,,,139.93,90,,percent of total billed charges,,,128.74,82.8,,percent of total billed charges,,,132.16,85,,percent of total billed charges,,,,,,,,,136.82,88,,percent of total billed charges,,,,,,,,,118.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,38.87,22,,percent of total billed charges,,,141.49,91,,percent of total billed charges,,,147.71,95,,percent of total billed charges,,,129.05,83,,percent of total billed charges,,,129.05,83,,percent of total billed charges,,,,,,,,,,,,,,,129.05,83,,percent of total billed charges,,,147.71,95,,percent of total billed charges,,,139.93,90,,percent of total billed charges,,,139.93,90,,percent of total billed charges,,,127.49,82,,percent of total billed charges,,,139.93,90,,percent of total billed charges,,,132.16,85,,percent of total billed charges,,38.87,147.71,
BETAMETHASONE DIPROP GLY OINT : 0.05%,32000227,CDM,,,,,outpatient,,111.75,111.75,,94.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,27.94,22,,percent of total billed charges,,,,,,,,,100.58,90,,percent of total billed charges,,,92.53,82.8,,percent of total billed charges,,,94.99,85,,percent of total billed charges,,,,,,,,,98.34,88,,percent of total billed charges,,,,,,,,,85.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,27.94,22,,percent of total billed charges,,,101.69,91,,percent of total billed charges,,,106.16,95,,percent of total billed charges,,,92.75,83,,percent of total billed charges,,,92.75,83,,percent of total billed charges,,,,,,,,,,,,,,,92.75,83,,percent of total billed charges,,,106.16,95,,percent of total billed charges,,,100.58,90,,percent of total billed charges,,,100.58,90,,percent of total billed charges,,,91.64,82,,percent of total billed charges,,,100.58,90,,percent of total billed charges,,,94.99,85,,percent of total billed charges,,27.94,106.16,
POLY B/TRIM(POLYTRIM)EYE DROP:10ML,32000484,CDM,J3490,HCPCS,250,RC,outpatient,,95.26,95.26,,80.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,23.82,22,,percent of total billed charges,,,,,,,,,85.73,90,,percent of total billed charges,,,78.88,82.8,,percent of total billed charges,,,80.97,85,,percent of total billed charges,,,,,,,,,83.83,88,,percent of total billed charges,,,,,,,,,72.78,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,23.82,22,,percent of total billed charges,,,86.69,91,,percent of total billed charges,,,90.5,95,,percent of total billed charges,,,79.07,83,,percent of total billed charges,,,79.07,83,,percent of total billed charges,,,,,,,,,,,,,,,79.07,83,,percent of total billed charges,,,90.5,95,,percent of total billed charges,,,85.73,90,,percent of total billed charges,,,85.73,90,,percent of total billed charges,,,78.11,82,,percent of total billed charges,,,85.73,90,,percent of total billed charges,,,80.97,85,,percent of total billed charges,,23.82,90.5,
IBANDRONATE (BONIVA)SYRINGE: 3MG/3ML,32000485,CDM,J1740,HCPCS,250,RC,outpatient,,1764,1764,,1497.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,441,22,,percent of total billed charges,,,,,,,,,1587.6,90,,percent of total billed charges,,,1460.59,82.8,,percent of total billed charges,,,1499.4,85,,percent of total billed charges,,,,,,,,,1552.32,88,,percent of total billed charges,,77.54,,,,fee schedule,,,1347.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,77.54,,,,fee schedule,,,441,22,,percent of total billed charges,,,1605.24,91,,percent of total billed charges,,,1675.8,95,,percent of total billed charges,,,1464.12,83,,percent of total billed charges,,,1464.12,83,,percent of total billed charges,,,,,,,,,,,,,,,1464.12,83,,percent of total billed charges,,,1675.8,95,,percent of total billed charges,,,1587.6,90,,percent of total billed charges,,,1587.6,90,,percent of total billed charges,,,1446.48,82,,percent of total billed charges,,,1587.6,90,,percent of total billed charges,,,1499.4,85,,percent of total billed charges,,77.54,1675.8,
ALPROSTADIL(PROSTIN VR PED)AMP:500MCG/ML,32000493,CDM,J0270,HCPCS,250,RC,outpatient,,1730.8,1730.8,,1469.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,432.7,22,,percent of total billed charges,,,,,,,,,1557.72,90,,percent of total billed charges,,,1433.1,82.8,,percent of total billed charges,,,1471.18,85,,percent of total billed charges,,,,,,,,,1523.1,88,,percent of total billed charges,,,,,,,,,1322.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,432.7,22,,percent of total billed charges,,,1575.03,91,,percent of total billed charges,,,1644.26,95,,percent of total billed charges,,,1436.56,83,,percent of total billed charges,,,1436.56,83,,percent of total billed charges,,,,,,,,,,,,,,,1436.56,83,,percent of total billed charges,,,1644.26,95,,percent of total billed charges,,,1557.72,90,,percent of total billed charges,,,1557.72,90,,percent of total billed charges,,,1419.26,82,,percent of total billed charges,,,1557.72,90,,percent of total billed charges,,,1471.18,85,,percent of total billed charges,,432.7,1644.26,
LAMIVUDINE/ZIDOVUD(COMBIVR)TAB:150-300MG,32004052,CDM,,,,,outpatient,,301.25,301.25,,255.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,75.31,22,,percent of total billed charges,,,,,,,,,271.13,90,,percent of total billed charges,,,249.44,82.8,,percent of total billed charges,,,256.06,85,,percent of total billed charges,,,,,,,,,265.1,88,,percent of total billed charges,,,,,,,,,230.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,75.31,22,,percent of total billed charges,,,274.14,91,,percent of total billed charges,,,286.19,95,,percent of total billed charges,,,250.04,83,,percent of total billed charges,,,250.04,83,,percent of total billed charges,,,,,,,,,,,,,,,250.04,83,,percent of total billed charges,,,286.19,95,,percent of total billed charges,,,271.13,90,,percent of total billed charges,,,271.13,90,,percent of total billed charges,,,247.03,82,,percent of total billed charges,,,271.13,90,,percent of total billed charges,,,256.06,85,,percent of total billed charges,,75.31,286.19,
RYAN ACETAMINOPHEN MAX,32014161,CDM,,,258,RC,outpatient,,10,10,,8.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2.5,22,,percent of total billed charges,,,,,,,,,9,90,,percent of total billed charges,,,8.28,82.8,,percent of total billed charges,,,8.5,85,,percent of total billed charges,,,,,,,,,8.8,88,,percent of total billed charges,,,,,,,,,7.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2.5,22,,percent of total billed charges,,,9.1,91,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,,,,,,,,,,,,,8.3,83,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,9,90,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.2,82,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.5,85,,percent of total billed charges,,2.5,9.5,
NAFCILLIN-IVPB:1GM/NS50ML,32014505,CDM,,,258,RC,outpatient,,71.42,71.42,,60.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,17.86,22,,percent of total billed charges,,,,,,,,,64.28,90,,percent of total billed charges,,,59.14,82.8,,percent of total billed charges,,,60.71,85,,percent of total billed charges,,,,,,,,,62.85,88,,percent of total billed charges,,,,,,,,,54.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,17.86,22,,percent of total billed charges,,,64.99,91,,percent of total billed charges,,,67.85,95,,percent of total billed charges,,,59.28,83,,percent of total billed charges,,,59.28,83,,percent of total billed charges,,,,,,,,,,,,,,,59.28,83,,percent of total billed charges,,,67.85,95,,percent of total billed charges,,,64.28,90,,percent of total billed charges,,,64.28,90,,percent of total billed charges,,,58.56,82,,percent of total billed charges,,,64.28,90,,percent of total billed charges,,,60.71,85,,percent of total billed charges,,17.86,67.85,
AMPicillin-IVPB:1GM/NS50ML,32014511,CDM,,,258,RC,outpatient,,55,55,,46.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,13.75,22,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,45.54,82.8,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,,,,,,,,48.4,88,,percent of total billed charges,,,,,,,,,42.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,13.75,22,,percent of total billed charges,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,45.1,82,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,13.75,52.25,
AMPicillin NEONATE:250MG/SW5ML,32016178,CDM,,,258,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
GENTAMICIN-IVPB:(PEDS) __MG/NS10ML,32017051,CDM,J1580,HCPCS,258,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,21.3,,,,fee schedule,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21.3,,,,fee schedule,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
GENTAMICIN-IVPB:(NN)11.25MG/NS2.5ML,32599788,CDM,,,258,RC,outpatient,,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12,22,,percent of total billed charges,,,,,,,,,43.2,90,,percent of total billed charges,,,39.74,82.8,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12,22,,percent of total billed charges,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,12,45.6,
GENTAMICIN-IVPB:(NN)10MG/NS2.5ML,32599789,CDM,,,258,RC,outpatient,,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12,22,,percent of total billed charges,,,,,,,,,43.2,90,,percent of total billed charges,,,39.74,82.8,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12,22,,percent of total billed charges,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,12,45.6,
GENTAMICIN-IVPB:(NN) 8.75MG/NS2.5ML,32599790,CDM,,,258,RC,outpatient,,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12,22,,percent of total billed charges,,,,,,,,,43.2,90,,percent of total billed charges,,,39.74,82.8,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12,22,,percent of total billed charges,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,12,45.6,
GENTAMICIN-IVPB:(NN) 7.5MG/NS2.5ML,32599791,CDM,,,258,RC,outpatient,,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12,22,,percent of total billed charges,,,,,,,,,43.2,90,,percent of total billed charges,,,39.74,82.8,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12,22,,percent of total billed charges,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,12,45.6,
GENTAMICIN-IVPB:(NN) 6.25MG/NS2.5ML,32599792,CDM,,,258,RC,outpatient,,48,48,,40.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,12,22,,percent of total billed charges,,,,,,,,,43.2,90,,percent of total billed charges,,,39.74,82.8,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,,,,,,,,42.24,88,,percent of total billed charges,,,,,,,,,36.67,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,12,22,,percent of total billed charges,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,39.36,82,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,12,45.6,
GENTAMICIN-IVPB:(NN) 5MG/NS2.5ML,32599793,CDM,J1580,HCPCS,258,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,21.3,,,,fee schedule,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,21.3,,,,fee schedule,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
ZITHROMAX-IVPB:250MG/NS250ML,32599801,CDM,,,258,RC,outpatient,,57,57,,48.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,14.25,22,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,47.2,82.8,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,,,,,,,,50.16,88,,percent of total billed charges,,,,,,,,,43.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,14.25,22,,percent of total billed charges,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,46.74,82,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,14.25,54.15,
KINEVAC-SYR:  5 MCG/ NS 5 ML     (PD),32599802,CDM,,,258,RC,outpatient,,1584.84,1584.84,,1345.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,396.21,22,,percent of total billed charges,,,,,,,,,1426.36,90,,percent of total billed charges,,,1312.25,82.8,,percent of total billed charges,,,1347.11,85,,percent of total billed charges,,,,,,,,,1394.66,88,,percent of total billed charges,,,,,,,,,1210.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,396.21,22,,percent of total billed charges,,,1442.2,91,,percent of total billed charges,,,1505.6,95,,percent of total billed charges,,,1315.42,83,,percent of total billed charges,,,1315.42,83,,percent of total billed charges,,,,,,,,,,,,,,,1315.42,83,,percent of total billed charges,,,1505.6,95,,percent of total billed charges,,,1426.36,90,,percent of total billed charges,,,1426.36,90,,percent of total billed charges,,,1299.57,82,,percent of total billed charges,,,1426.36,90,,percent of total billed charges,,,1347.11,85,,percent of total billed charges,,396.21,1505.6,
ceFOXitin(MEFOXIN)-IVPB:500MG/SW5ML,32599816,CDM,,,258,RC,outpatient,,66.88,66.88,,56.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,16.72,22,,percent of total billed charges,,,,,,,,,60.19,90,,percent of total billed charges,,,55.38,82.8,,percent of total billed charges,,,56.85,85,,percent of total billed charges,,,,,,,,,58.85,88,,percent of total billed charges,,,,,,,,,51.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,16.72,22,,percent of total billed charges,,,60.86,91,,percent of total billed charges,,,63.54,95,,percent of total billed charges,,,55.51,83,,percent of total billed charges,,,55.51,83,,percent of total billed charges,,,,,,,,,,,,,,,55.51,83,,percent of total billed charges,,,63.54,95,,percent of total billed charges,,,60.19,90,,percent of total billed charges,,,60.19,90,,percent of total billed charges,,,54.84,82,,percent of total billed charges,,,60.19,90,,percent of total billed charges,,,56.85,85,,percent of total billed charges,,16.72,63.54,
IMIPENEM(PRIMAXIN)-IVPB:1GM/NS250ML,32599847,CDM,,,258,RC,outpatient,,310.19,310.19,,263.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,77.55,22,,percent of total billed charges,,,,,,,,,279.17,90,,percent of total billed charges,,,256.84,82.8,,percent of total billed charges,,,263.66,85,,percent of total billed charges,,,,,,,,,272.97,88,,percent of total billed charges,,,,,,,,,236.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,77.55,22,,percent of total billed charges,,,282.27,91,,percent of total billed charges,,,294.68,95,,percent of total billed charges,,,257.46,83,,percent of total billed charges,,,257.46,83,,percent of total billed charges,,,,,,,,,,,,,,,257.46,83,,percent of total billed charges,,,294.68,95,,percent of total billed charges,,,279.17,90,,percent of total billed charges,,,279.17,90,,percent of total billed charges,,,254.36,82,,percent of total billed charges,,,279.17,90,,percent of total billed charges,,,263.66,85,,percent of total billed charges,,77.55,294.68,
IV LIPOSYN(INTRALIPIDS/FAT) 20% 500ML,32599929,CDM,J3490,HCPCS,250,RC,outpatient,,475.8,475.8,,403.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,118.95,22,,percent of total billed charges,,,,,,,,,428.22,90,,percent of total billed charges,,,393.96,82.8,,percent of total billed charges,,,404.43,85,,percent of total billed charges,,,,,,,,,418.7,88,,percent of total billed charges,,,,,,,,,363.51,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,118.95,22,,percent of total billed charges,,,432.98,91,,percent of total billed charges,,,452.01,95,,percent of total billed charges,,,394.91,83,,percent of total billed charges,,,394.91,83,,percent of total billed charges,,,,,,,,,,,,,,,394.91,83,,percent of total billed charges,,,452.01,95,,percent of total billed charges,,,428.22,90,,percent of total billed charges,,,428.22,90,,percent of total billed charges,,,390.16,82,,percent of total billed charges,,,428.22,90,,percent of total billed charges,,,404.43,85,,percent of total billed charges,,118.95,452.01,
INSULIN(HUMULIN R)-IVPB:100UNITS/NS100ML,32599933,CDM,,,258,RC,outpatient,,252.94,252.94,,214.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.24,22,,percent of total billed charges,,,,,,,,,227.65,90,,percent of total billed charges,,,209.43,82.8,,percent of total billed charges,,,215,85,,percent of total billed charges,,,,,,,,,222.59,88,,percent of total billed charges,,,,,,,,,193.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.24,22,,percent of total billed charges,,,230.18,91,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,209.94,83,,percent of total billed charges,,,,,,,,,,,,,,,209.94,83,,percent of total billed charges,,,240.29,95,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,207.41,82,,percent of total billed charges,,,227.65,90,,percent of total billed charges,,,215,85,,percent of total billed charges,,63.24,240.29,
LEVOFLOX(LEVAQUIN)-IVPB:500MG/D5W100ML,32599942,CDM,J1956,HCPCS,258,RC,outpatient,,191.23,191.23,,162.35,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,47.81,22,,percent of total billed charges,,,,,,,,,172.11,90,,percent of total billed charges,,,158.34,82.8,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,,,,,,,,168.28,88,,percent of total billed charges,,3.21,,,,fee schedule,,,146.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,3.21,,,,fee schedule,,,47.81,22,,percent of total billed charges,,,174.02,91,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,158.72,83,,percent of total billed charges,,,,,,,,,,,,,,,158.72,83,,percent of total billed charges,,,181.67,95,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,156.81,82,,percent of total billed charges,,,172.11,90,,percent of total billed charges,,,162.55,85,,percent of total billed charges,,3.21,181.67,
KCL-IVPB: 20MEQ/ SW 100 ML  (RIDER) (PD),32599944,CDM,,,258,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
TOBRAMYCIN-IVPB: 160MG/SW20ML,32599957,CDM,,,258,RC,outpatient,,62.33,62.33,,52.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,15.58,22,,percent of total billed charges,,,,,,,,,56.1,90,,percent of total billed charges,,,51.61,82.8,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,,,,,,,,54.85,88,,percent of total billed charges,,,,,,,,,47.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,15.58,22,,percent of total billed charges,,,56.72,91,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,51.73,83,,percent of total billed charges,,,,,,,,,,,,,,,51.73,83,,percent of total billed charges,,,59.21,95,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,51.11,82,,percent of total billed charges,,,56.1,90,,percent of total billed charges,,,52.98,85,,percent of total billed charges,,15.58,59.21,
MULTIPLE SLEEP LATENCY TESTING MSLT,38000050,CDM,95805,CPT,740,RC,outpatient,TC,4706,4706,,3995.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1176.5,22,,percent of total billed charges,,,,,,,,,4235.4,90,,percent of total billed charges,,,3896.57,82.8,,percent of total billed charges,,,4000.1,85,,percent of total billed charges,,,,,,,,,4141.28,88,,percent of total billed charges,,,,,,,,,3595.38,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1176.5,22,,percent of total billed charges,,,4282.46,91,,percent of total billed charges,,,4470.7,95,,percent of total billed charges,,,3905.98,83,,percent of total billed charges,,,3905.98,83,,percent of total billed charges,,,,,,,,,,,,,,,3905.98,83,,percent of total billed charges,,,4470.7,95,,percent of total billed charges,,,4235.4,90,,percent of total billed charges,,,4235.4,90,,percent of total billed charges,,,3858.92,82,,percent of total billed charges,,,4235.4,90,,percent of total billed charges,,,4000.1,85,,percent of total billed charges,,1176.5,4470.7,
SLEEP STUDY W/O CPAP,38000100,CDM,95810,CPT,920,RC,outpatient,,9008,9008,,7647.79,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2252,22,,percent of total billed charges,,,,,,,,,8107.2,90,,percent of total billed charges,,,7458.62,82.8,,percent of total billed charges,,,7656.8,85,,percent of total billed charges,,,,,,,,,7927.04,88,,percent of total billed charges,,,,,,,,,6882.11,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2252,22,,percent of total billed charges,,,8197.28,91,,percent of total billed charges,,,8557.6,95,,percent of total billed charges,,,7476.64,83,,percent of total billed charges,,,7476.64,83,,percent of total billed charges,,,,,,,,,,,,,,,7476.64,83,,percent of total billed charges,,,8557.6,95,,percent of total billed charges,,,8107.2,90,,percent of total billed charges,,,8107.2,90,,percent of total billed charges,,,7386.56,82,,percent of total billed charges,,,8107.2,90,,percent of total billed charges,,,7656.8,85,,percent of total billed charges,,2252,8557.6,
SLEEP STUDY WITH CPAP,38000150,CDM,95811,CPT,920,RC,outpatient,,9621,9621,,8168.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2405.25,22,,percent of total billed charges,,,,,,,,,8658.9,90,,percent of total billed charges,,,7966.19,82.8,,percent of total billed charges,,,8177.85,85,,percent of total billed charges,,,,,,,,,8466.48,88,,percent of total billed charges,,,,,,,,,7350.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2405.25,22,,percent of total billed charges,,,8755.11,91,,percent of total billed charges,,,9139.95,95,,percent of total billed charges,,,7985.43,83,,percent of total billed charges,,,7985.43,83,,percent of total billed charges,,,,,,,,,,,,,,,7985.43,83,,percent of total billed charges,,,9139.95,95,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,7889.22,82,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,8177.85,85,,percent of total billed charges,,2405.25,9139.95,
SLEEP STUDY SPLIT/ CPAP,38000200,CDM,95811,CPT,740,RC,outpatient,,9621,9621,,8168.23,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,2405.25,22,,percent of total billed charges,,,,,,,,,8658.9,90,,percent of total billed charges,,,7966.19,82.8,,percent of total billed charges,,,8177.85,85,,percent of total billed charges,,,,,,,,,8466.48,88,,percent of total billed charges,,,,,,,,,7350.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,2405.25,22,,percent of total billed charges,,,8755.11,91,,percent of total billed charges,,,9139.95,95,,percent of total billed charges,,,7985.43,83,,percent of total billed charges,,,7985.43,83,,percent of total billed charges,,,,,,,,,,,,,,,7985.43,83,,percent of total billed charges,,,9139.95,95,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,7889.22,82,,percent of total billed charges,,,8658.9,90,,percent of total billed charges,,,8177.85,85,,percent of total billed charges,,2405.25,9139.95,
**OVERNIGHT PULSE OXIMETRY(V0710),38000250,CDM,94762,CPT,410,RC,outpatient,,263,263,,223.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,65.75,22,,percent of total billed charges,,,,,,,,,236.7,90,,percent of total billed charges,,,217.76,82.8,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,,,,,,,,231.44,88,,percent of total billed charges,,,,,,,,,200.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,65.75,22,,percent of total billed charges,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,,,,,,,,,,,,,218.29,83,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,215.66,82,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,65.75,249.85,
SLEEP STUDY UNATTENDED & RESPIRATORY EFF,38000275,CDM,95806,CPT,920,RC,outpatient,,1883,1883,,1598.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,470.75,22,,percent of total billed charges,,,,,,,,,1694.7,90,,percent of total billed charges,,,1559.12,82.8,,percent of total billed charges,,,1600.55,85,,percent of total billed charges,,,,,,,,,1657.04,88,,percent of total billed charges,,,,,,,,,1438.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,470.75,22,,percent of total billed charges,,,1713.53,91,,percent of total billed charges,,,1788.85,95,,percent of total billed charges,,,1562.89,83,,percent of total billed charges,,,1562.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1562.89,83,,percent of total billed charges,,,1788.85,95,,percent of total billed charges,,,1694.7,90,,percent of total billed charges,,,1694.7,90,,percent of total billed charges,,,1544.06,82,,percent of total billed charges,,,1694.7,90,,percent of total billed charges,,,1600.55,85,,percent of total billed charges,,470.75,1788.85,
WATCHPAT SLEEP STUDY,38000280,CDM,95800,CPT,920,RC,outpatient,,1783,1783,,1513.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,445.75,22,,percent of total billed charges,,,,,,,,,1604.7,90,,percent of total billed charges,,,1476.32,82.8,,percent of total billed charges,,,1515.55,85,,percent of total billed charges,,,,,,,,,1569.04,88,,percent of total billed charges,,,,,,,,,1362.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,445.75,22,,percent of total billed charges,,,1622.53,91,,percent of total billed charges,,,1693.85,95,,percent of total billed charges,,,1479.89,83,,percent of total billed charges,,,1479.89,83,,percent of total billed charges,,,,,,,,,,,,,,,1479.89,83,,percent of total billed charges,,,1693.85,95,,percent of total billed charges,,,1604.7,90,,percent of total billed charges,,,1604.7,90,,percent of total billed charges,,,1462.06,82,,percent of total billed charges,,,1604.7,90,,percent of total billed charges,,,1515.55,85,,percent of total billed charges,,445.75,1693.85,
SLEEP STUDY SUSPENDED,38000300,CDM,95807,CPT,740,RC,outpatient,,3828,3828,,3249.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,957,22,,percent of total billed charges,,,,,,,,,3445.2,90,,percent of total billed charges,,,3169.58,82.8,,percent of total billed charges,,,3253.8,85,,percent of total billed charges,,,,,,,,,3368.64,88,,percent of total billed charges,,,,,,,,,2924.59,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,957,22,,percent of total billed charges,,,3483.48,91,,percent of total billed charges,,,3636.6,95,,percent of total billed charges,,,3177.24,83,,percent of total billed charges,,,3177.24,83,,percent of total billed charges,,,,,,,,,,,,,,,3177.24,83,,percent of total billed charges,,,3636.6,95,,percent of total billed charges,,,3445.2,90,,percent of total billed charges,,,3445.2,90,,percent of total billed charges,,,3138.96,82,,percent of total billed charges,,,3445.2,90,,percent of total billed charges,,,3253.8,85,,percent of total billed charges,,957,3636.6,
PAXTON EMG EACH NERVE W/O WAVE,40109000,CDM,95900,CPT,922,RC,outpatient,,118,118,,100.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,29.5,22,,percent of total billed charges,,,,,,,,,106.2,90,,percent of total billed charges,,,97.7,82.8,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,,,,,,,,103.84,88,,percent of total billed charges,,,,,,,,,90.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,29.5,22,,percent of total billed charges,,,107.38,91,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,,,,,,,,,,,,,97.94,83,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,96.76,82,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,29.5,112.1,
PAXTON EMG EACH NERVE MOTOR W F STUDY,40109003,CDM,95903,CPT,922,RC,outpatient,,163,163,,138.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,40.75,22,,percent of total billed charges,,,,,,,,,146.7,90,,percent of total billed charges,,,134.96,82.8,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,,,,,,,,143.44,88,,percent of total billed charges,,,,,,,,,124.53,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,40.75,22,,percent of total billed charges,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,,,,,,,,,,,,,135.29,83,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,133.66,82,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,40.75,154.85,
PAXTON EMG EACH NERVE SENSORY,40109004,CDM,95904,CPT,922,RC,outpatient,,102,102,,86.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,25.5,22,,percent of total billed charges,,,,,,,,,91.8,90,,percent of total billed charges,,,84.46,82.8,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,,,,,,,,89.76,88,,percent of total billed charges,,,,,,,,,77.93,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,25.5,22,,percent of total billed charges,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,83.64,82,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,25.5,96.9,
ABDOMINOPLASTY MINI S /SAL ABDOMEN,49000001,CDM,15877,CPT,360,RC,outpatient,,3897,3897,,3308.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,974.25,22,,percent of total billed charges,,,,,,,,,3507.3,90,,percent of total billed charges,,,3226.72,82.8,,percent of total billed charges,,,3312.45,85,,percent of total billed charges,,,,,,,,,3429.36,88,,percent of total billed charges,,,,,,,,,2977.31,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,974.25,22,,percent of total billed charges,,,3546.27,91,,percent of total billed charges,,,3702.15,95,,percent of total billed charges,,,3234.51,83,,percent of total billed charges,,,3234.51,83,,percent of total billed charges,,,,,,,,,,,,,,,3234.51,83,,percent of total billed charges,,,3702.15,95,,percent of total billed charges,,,3507.3,90,,percent of total billed charges,,,3507.3,90,,percent of total billed charges,,,3195.54,82,,percent of total billed charges,,,3507.3,90,,percent of total billed charges,,,3312.45,85,,percent of total billed charges,,974.25,3702.15,
ABDOMINOPLASTY TOTAL SAL ABDOMEN,49000002,CDM,15847,CPT,360,RC,outpatient,,5160,5160,,4380.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1290,22,,percent of total billed charges,,,,,,,,,4644,90,,percent of total billed charges,,,4272.48,82.8,,percent of total billed charges,,,4386,85,,percent of total billed charges,,,,,,,,,4540.8,88,,percent of total billed charges,,,,,,,,,3942.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1290,22,,percent of total billed charges,,,4695.6,91,,percent of total billed charges,,,4902,95,,percent of total billed charges,,,4282.8,83,,percent of total billed charges,,,4282.8,83,,percent of total billed charges,,,,,,,,,,,,,,,4282.8,83,,percent of total billed charges,,,4902,95,,percent of total billed charges,,,4644,90,,percent of total billed charges,,,4644,90,,percent of total billed charges,,,4231.2,82,,percent of total billed charges,,,4644,90,,percent of total billed charges,,,4386,85,,percent of total billed charges,,1290,4902,
AUGMENTATION MAMMOPL BILAT IMPL ENDO,49000003,CDM,19325,CPT,360,RC,outpatient,,3764,3764,,3195.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,941,22,,percent of total billed charges,,,,,,,,,3387.6,90,,percent of total billed charges,,,3116.59,82.8,,percent of total billed charges,,,3199.4,85,,percent of total billed charges,,,,,,,,,3312.32,88,,percent of total billed charges,,,,,,,,,2875.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,941,22,,percent of total billed charges,,,3425.24,91,,percent of total billed charges,,,3575.8,95,,percent of total billed charges,,,3124.12,83,,percent of total billed charges,,,3124.12,83,,percent of total billed charges,,,,,,,,,,,,,,,3124.12,83,,percent of total billed charges,,,3575.8,95,,percent of total billed charges,,,3387.6,90,,percent of total billed charges,,,3387.6,90,,percent of total billed charges,,,3086.48,82,,percent of total billed charges,,,3387.6,90,,percent of total billed charges,,,3199.4,85,,percent of total billed charges,,941,3575.8,
AUGMENTATION MAMMOPL BILAT IMPL LOW,49000004,CDM,19325,CPT,360,RC,outpatient,,2997,2997,,2544.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,749.25,22,,percent of total billed charges,,,,,,,,,2697.3,90,,percent of total billed charges,,,2481.52,82.8,,percent of total billed charges,,,2547.45,85,,percent of total billed charges,,,,,,,,,2637.36,88,,percent of total billed charges,,,,,,,,,2289.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,749.25,22,,percent of total billed charges,,,2727.27,91,,percent of total billed charges,,,2847.15,95,,percent of total billed charges,,,2487.51,83,,percent of total billed charges,,,2487.51,83,,percent of total billed charges,,,,,,,,,,,,,,,2487.51,83,,percent of total billed charges,,,2847.15,95,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2457.54,82,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2547.45,85,,percent of total billed charges,,749.25,2847.15,
AUGMENTATION MAMMOPL BILAT IMPL MOD,49000005,CDM,19325,CPT,360,RC,outpatient,,2997,2997,,2544.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,749.25,22,,percent of total billed charges,,,,,,,,,2697.3,90,,percent of total billed charges,,,2481.52,82.8,,percent of total billed charges,,,2547.45,85,,percent of total billed charges,,,,,,,,,2637.36,88,,percent of total billed charges,,,,,,,,,2289.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,749.25,22,,percent of total billed charges,,,2727.27,91,,percent of total billed charges,,,2847.15,95,,percent of total billed charges,,,2487.51,83,,percent of total billed charges,,,2487.51,83,,percent of total billed charges,,,,,,,,,,,,,,,2487.51,83,,percent of total billed charges,,,2847.15,95,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2457.54,82,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2547.45,85,,percent of total billed charges,,749.25,2847.15,
AUGMENTATION MAMMOPL BILAT IMPL HIGH,49000006,CDM,19325,CPT,360,RC,outpatient,,2997,2997,,2544.45,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,749.25,22,,percent of total billed charges,,,,,,,,,2697.3,90,,percent of total billed charges,,,2481.52,82.8,,percent of total billed charges,,,2547.45,85,,percent of total billed charges,,,,,,,,,2637.36,88,,percent of total billed charges,,,,,,,,,2289.71,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,749.25,22,,percent of total billed charges,,,2727.27,91,,percent of total billed charges,,,2847.15,95,,percent of total billed charges,,,2487.51,83,,percent of total billed charges,,,2487.51,83,,percent of total billed charges,,,,,,,,,,,,,,,2487.51,83,,percent of total billed charges,,,2847.15,95,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2457.54,82,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2547.45,85,,percent of total billed charges,,749.25,2847.15,
AUGMENTATION MAMMOPL UNILATERAL IMPLANT,49000007,CDM,19325,CPT,360,RC,outpatient,,2224,2224,,1888.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,556,22,,percent of total billed charges,,,,,,,,,2001.6,90,,percent of total billed charges,,,1841.47,82.8,,percent of total billed charges,,,1890.4,85,,percent of total billed charges,,,,,,,,,1957.12,88,,percent of total billed charges,,,,,,,,,1699.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,556,22,,percent of total billed charges,,,2023.84,91,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1845.92,83,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1823.68,82,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1890.4,85,,percent of total billed charges,,556,2112.8,
AUGMENTATION MAMMOPL SILICONE UNILATERAL,49000008,CDM,19325,CPT,360,RC,outpatient,,2224,2224,,1888.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,556,22,,percent of total billed charges,,,,,,,,,2001.6,90,,percent of total billed charges,,,1841.47,82.8,,percent of total billed charges,,,1890.4,85,,percent of total billed charges,,,,,,,,,1957.12,88,,percent of total billed charges,,,,,,,,,1699.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,556,22,,percent of total billed charges,,,2023.84,91,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1845.92,83,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1823.68,82,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1890.4,85,,percent of total billed charges,,556,2112.8,
AUGMENTATION MAMMOPL SILICONE BILATERAL,49000009,CDM,19325,CPT,360,RC,outpatient,,3672,3672,,3117.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,918,22,,percent of total billed charges,,,,,,,,,3304.8,90,,percent of total billed charges,,,3040.42,82.8,,percent of total billed charges,,,3121.2,85,,percent of total billed charges,,,,,,,,,3231.36,88,,percent of total billed charges,,,,,,,,,2805.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,918,22,,percent of total billed charges,,,3341.52,91,,percent of total billed charges,,,3488.4,95,,percent of total billed charges,,,3047.76,83,,percent of total billed charges,,,3047.76,83,,percent of total billed charges,,,,,,,,,,,,,,,3047.76,83,,percent of total billed charges,,,3488.4,95,,percent of total billed charges,,,3304.8,90,,percent of total billed charges,,,3304.8,90,,percent of total billed charges,,,3011.04,82,,percent of total billed charges,,,3304.8,90,,percent of total billed charges,,,3121.2,85,,percent of total billed charges,,918,3488.4,
CAPSULECTOMY W/IMPLANT EXC UNIL SALINE,49000010,CDM,19371,CPT,360,RC,outpatient,,2770,2770,,2351.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,692.5,22,,percent of total billed charges,,,,,,,,,2493,90,,percent of total billed charges,,,2293.56,82.8,,percent of total billed charges,,,2354.5,85,,percent of total billed charges,,,,,,,,,2437.6,88,,percent of total billed charges,,,,,,,,,2116.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,692.5,22,,percent of total billed charges,,,2520.7,91,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2299.1,83,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2271.4,82,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2354.5,85,,percent of total billed charges,,692.5,2631.5,
CAPSULECTOMY W/IMPLANT EXC BILAT SALINE,49000011,CDM,19371,CPT,360,RC,outpatient,,3471,3471,,2946.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,867.75,22,,percent of total billed charges,,,,,,,,,3123.9,90,,percent of total billed charges,,,2873.99,82.8,,percent of total billed charges,,,2950.35,85,,percent of total billed charges,,,,,,,,,3054.48,88,,percent of total billed charges,,,,,,,,,2651.84,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,867.75,22,,percent of total billed charges,,,3158.61,91,,percent of total billed charges,,,3297.45,95,,percent of total billed charges,,,2880.93,83,,percent of total billed charges,,,2880.93,83,,percent of total billed charges,,,,,,,,,,,,,,,2880.93,83,,percent of total billed charges,,,3297.45,95,,percent of total billed charges,,,3123.9,90,,percent of total billed charges,,,3123.9,90,,percent of total billed charges,,,2846.22,82,,percent of total billed charges,,,3123.9,90,,percent of total billed charges,,,2950.35,85,,percent of total billed charges,,867.75,3297.45,
CAPSULECTOMY W/IMPLANT EXC UNI SILICONE,49000012,CDM,19371,CPT,360,RC,outpatient,,2770,2770,,2351.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,692.5,22,,percent of total billed charges,,,,,,,,,2493,90,,percent of total billed charges,,,2293.56,82.8,,percent of total billed charges,,,2354.5,85,,percent of total billed charges,,,,,,,,,2437.6,88,,percent of total billed charges,,,,,,,,,2116.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,692.5,22,,percent of total billed charges,,,2520.7,91,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2299.1,83,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2271.4,82,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2354.5,85,,percent of total billed charges,,692.5,2631.5,
CAPSULECTOMY W/IMPLANT EXC BILA SILICONE,49000013,CDM,19371,CPT,360,RC,outpatient,,5400,5400,,4584.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1350,22,,percent of total billed charges,,,,,,,,,4860,90,,percent of total billed charges,,,4471.2,82.8,,percent of total billed charges,,,4590,85,,percent of total billed charges,,,,,,,,,4752,88,,percent of total billed charges,,,,,,,,,4125.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1350,22,,percent of total billed charges,,,4914,91,,percent of total billed charges,,,5130,95,,percent of total billed charges,,,4482,83,,percent of total billed charges,,,4482,83,,percent of total billed charges,,,,,,,,,,,,,,,4482,83,,percent of total billed charges,,,5130,95,,percent of total billed charges,,,4860,90,,percent of total billed charges,,,4860,90,,percent of total billed charges,,,4428,82,,percent of total billed charges,,,4860,90,,percent of total billed charges,,,4590,85,,percent of total billed charges,,1350,5130,
CAPSULOTOMY PERIPROSTHETIC UNILATERAL,49000014,CDM,19371,CPT,360,RC,outpatient,,2224,2224,,1888.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,556,22,,percent of total billed charges,,,,,,,,,2001.6,90,,percent of total billed charges,,,1841.47,82.8,,percent of total billed charges,,,1890.4,85,,percent of total billed charges,,,,,,,,,1957.12,88,,percent of total billed charges,,,,,,,,,1699.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,556,22,,percent of total billed charges,,,2023.84,91,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1845.92,83,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1823.68,82,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1890.4,85,,percent of total billed charges,,556,2112.8,
CAPSULOTOMY PERIPROSTHETIC BILATERAL,49000015,CDM,19371,CPT,360,RC,outpatient,,2770,2770,,2351.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,692.5,22,,percent of total billed charges,,,,,,,,,2493,90,,percent of total billed charges,,,2293.56,82.8,,percent of total billed charges,,,2354.5,85,,percent of total billed charges,,,,,,,,,2437.6,88,,percent of total billed charges,,,,,,,,,2116.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,692.5,22,,percent of total billed charges,,,2520.7,91,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2299.1,83,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2271.4,82,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2354.5,85,,percent of total billed charges,,692.5,2631.5,
CAPSULOTOMY OPEN PERIPROSTH UNILATERAL,49000016,CDM,19370,CPT,360,RC,outpatient,,2770,2770,,2351.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,692.5,22,,percent of total billed charges,,,,,,,,,2493,90,,percent of total billed charges,,,2293.56,82.8,,percent of total billed charges,,,2354.5,85,,percent of total billed charges,,,,,,,,,2437.6,88,,percent of total billed charges,,,,,,,,,2116.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,692.5,22,,percent of total billed charges,,,2520.7,91,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2299.1,83,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2271.4,82,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2354.5,85,,percent of total billed charges,,692.5,2631.5,
CAPSULOTOMY OPEN PERIPROSTH BILATERAL,49000017,CDM,19370,CPT,360,RC,outpatient,,2770,2770,,2351.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,692.5,22,,percent of total billed charges,,,,,,,,,2493,90,,percent of total billed charges,,,2293.56,82.8,,percent of total billed charges,,,2354.5,85,,percent of total billed charges,,,,,,,,,2437.6,88,,percent of total billed charges,,,,,,,,,2116.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,692.5,22,,percent of total billed charges,,,2520.7,91,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,2299.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2299.1,83,,percent of total billed charges,,,2631.5,95,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2271.4,82,,percent of total billed charges,,,2493,90,,percent of total billed charges,,,2354.5,85,,percent of total billed charges,,692.5,2631.5,
MASTECTOMY GYNECOMASTIA UNILATERAL,49000018,CDM,19300,CPT,360,RC,outpatient,,2472,2472,,2098.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,618,22,,percent of total billed charges,,,,,,,,,2224.8,90,,percent of total billed charges,,,2046.82,82.8,,percent of total billed charges,,,2101.2,85,,percent of total billed charges,,,,,,,,,2175.36,88,,percent of total billed charges,,,,,,,,,1888.61,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,618,22,,percent of total billed charges,,,2249.52,91,,percent of total billed charges,,,2348.4,95,,percent of total billed charges,,,2051.76,83,,percent of total billed charges,,,2051.76,83,,percent of total billed charges,,,,,,,,,,,,,,,2051.76,83,,percent of total billed charges,,,2348.4,95,,percent of total billed charges,,,2224.8,90,,percent of total billed charges,,,2224.8,90,,percent of total billed charges,,,2027.04,82,,percent of total billed charges,,,2224.8,90,,percent of total billed charges,,,2101.2,85,,percent of total billed charges,,618,2348.4,
MASTECTOMY GYNECOMASTIA BILATERAL,49000019,CDM,19300,CPT,360,RC,outpatient,,4018,4018,,3411.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1004.5,22,,percent of total billed charges,,,,,,,,,3616.2,90,,percent of total billed charges,,,3326.9,82.8,,percent of total billed charges,,,3415.3,85,,percent of total billed charges,,,,,,,,,3535.84,88,,percent of total billed charges,,,,,,,,,3069.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1004.5,22,,percent of total billed charges,,,3656.38,91,,percent of total billed charges,,,3817.1,95,,percent of total billed charges,,,3334.94,83,,percent of total billed charges,,,3334.94,83,,percent of total billed charges,,,,,,,,,,,,,,,3334.94,83,,percent of total billed charges,,,3817.1,95,,percent of total billed charges,,,3616.2,90,,percent of total billed charges,,,3616.2,90,,percent of total billed charges,,,3294.76,82,,percent of total billed charges,,,3616.2,90,,percent of total billed charges,,,3415.3,85,,percent of total billed charges,,1004.5,3817.1,
MASTOPEXY AUGMENTATION MAMOPLASTY,49000020,CDM,19340,CPT,360,RC,outpatient,,4851,4851,,4118.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1212.75,22,,percent of total billed charges,,,,,,,,,4365.9,90,,percent of total billed charges,,,4016.63,82.8,,percent of total billed charges,,,4123.35,85,,percent of total billed charges,,,,,,,,,4268.88,88,,percent of total billed charges,,,,,,,,,3706.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1212.75,22,,percent of total billed charges,,,4414.41,91,,percent of total billed charges,,,4608.45,95,,percent of total billed charges,,,4026.33,83,,percent of total billed charges,,,4026.33,83,,percent of total billed charges,,,,,,,,,,,,,,,4026.33,83,,percent of total billed charges,,,4608.45,95,,percent of total billed charges,,,4365.9,90,,percent of total billed charges,,,4365.9,90,,percent of total billed charges,,,3977.82,82,,percent of total billed charges,,,4365.9,90,,percent of total billed charges,,,4123.35,85,,percent of total billed charges,,1212.75,4608.45,
MASTOPEXY AUGMENTATION MAMO SILICONE,49000021,CDM,19340,CPT,360,RC,outpatient,,5346,5346,,4538.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1336.5,22,,percent of total billed charges,,,,,,,,,4811.4,90,,percent of total billed charges,,,4426.49,82.8,,percent of total billed charges,,,4544.1,85,,percent of total billed charges,,,,,,,,,4704.48,88,,percent of total billed charges,,,,,,,,,4084.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1336.5,22,,percent of total billed charges,,,4864.86,91,,percent of total billed charges,,,5078.7,95,,percent of total billed charges,,,4437.18,83,,percent of total billed charges,,,4437.18,83,,percent of total billed charges,,,,,,,,,,,,,,,4437.18,83,,percent of total billed charges,,,5078.7,95,,percent of total billed charges,,,4811.4,90,,percent of total billed charges,,,4811.4,90,,percent of total billed charges,,,4383.72,82,,percent of total billed charges,,,4811.4,90,,percent of total billed charges,,,4544.1,85,,percent of total billed charges,,1336.5,5078.7,
MASTOPEXY UNILATERAL,49000022,CDM,19316,CPT,360,RC,outpatient,,3081,3081,,2615.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,770.25,22,,percent of total billed charges,,,,,,,,,2772.9,90,,percent of total billed charges,,,2551.07,82.8,,percent of total billed charges,,,2618.85,85,,percent of total billed charges,,,,,,,,,2711.28,88,,percent of total billed charges,,,,,,,,,2353.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,770.25,22,,percent of total billed charges,,,2803.71,91,,percent of total billed charges,,,2926.95,95,,percent of total billed charges,,,2557.23,83,,percent of total billed charges,,,2557.23,83,,percent of total billed charges,,,,,,,,,,,,,,,2557.23,83,,percent of total billed charges,,,2926.95,95,,percent of total billed charges,,,2772.9,90,,percent of total billed charges,,,2772.9,90,,percent of total billed charges,,,2526.42,82,,percent of total billed charges,,,2772.9,90,,percent of total billed charges,,,2618.85,85,,percent of total billed charges,,770.25,2926.95,
MASTOPEXY BIILATERAL,49000023,CDM,19316,CPT,360,RC,outpatient,,3720,3720,,3158.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,930,22,,percent of total billed charges,,,,,,,,,3348,90,,percent of total billed charges,,,3080.16,82.8,,percent of total billed charges,,,3162,85,,percent of total billed charges,,,,,,,,,3273.6,88,,percent of total billed charges,,,,,,,,,2842.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,930,22,,percent of total billed charges,,,3385.2,91,,percent of total billed charges,,,3534,95,,percent of total billed charges,,,3087.6,83,,percent of total billed charges,,,3087.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3087.6,83,,percent of total billed charges,,,3534,95,,percent of total billed charges,,,3348,90,,percent of total billed charges,,,3348,90,,percent of total billed charges,,,3050.4,82,,percent of total billed charges,,,3348,90,,percent of total billed charges,,,3162,85,,percent of total billed charges,,930,3534,
REDUCTION MAMMOPLASTY UNILATERAL,49000024,CDM,19318,CPT,360,RC,outpatient,,4593,4593,,3899.46,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1148.25,22,,percent of total billed charges,,,,,,,,,4133.7,90,,percent of total billed charges,,,3803,82.8,,percent of total billed charges,,,3904.05,85,,percent of total billed charges,,,,,,,,,4041.84,88,,percent of total billed charges,,,,,,,,,3509.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1148.25,22,,percent of total billed charges,,,4179.63,91,,percent of total billed charges,,,4363.35,95,,percent of total billed charges,,,3812.19,83,,percent of total billed charges,,,3812.19,83,,percent of total billed charges,,,,,,,,,,,,,,,3812.19,83,,percent of total billed charges,,,4363.35,95,,percent of total billed charges,,,4133.7,90,,percent of total billed charges,,,4133.7,90,,percent of total billed charges,,,3766.26,82,,percent of total billed charges,,,4133.7,90,,percent of total billed charges,,,3904.05,85,,percent of total billed charges,,1148.25,4363.35,
REDUCTION MAMMOPLASTY BILATERAL,49000025,CDM,19318,CPT,360,RC,outpatient,,5068,5068,,4302.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1267,22,,percent of total billed charges,,,,,,,,,4561.2,90,,percent of total billed charges,,,4196.3,82.8,,percent of total billed charges,,,4307.8,85,,percent of total billed charges,,,,,,,,,4459.84,88,,percent of total billed charges,,,,,,,,,3871.95,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1267,22,,percent of total billed charges,,,4611.88,91,,percent of total billed charges,,,4814.6,95,,percent of total billed charges,,,4206.44,83,,percent of total billed charges,,,4206.44,83,,percent of total billed charges,,,,,,,,,,,,,,,4206.44,83,,percent of total billed charges,,,4814.6,95,,percent of total billed charges,,,4561.2,90,,percent of total billed charges,,,4561.2,90,,percent of total billed charges,,,4155.76,82,,percent of total billed charges,,,4561.2,90,,percent of total billed charges,,,4307.8,85,,percent of total billed charges,,1267,4814.6,
BROWLIFT ENDO OR OPEN,49000026,CDM,67900,CPT,360,RC,outpatient,,2855,2855,,2423.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,713.75,22,,percent of total billed charges,,,,,,,,,2569.5,90,,percent of total billed charges,,,2363.94,82.8,,percent of total billed charges,,,2426.75,85,,percent of total billed charges,,,,,,,,,2512.4,88,,percent of total billed charges,,,,,,,,,2181.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,713.75,22,,percent of total billed charges,,,2598.05,91,,percent of total billed charges,,,2712.25,95,,percent of total billed charges,,,2369.65,83,,percent of total billed charges,,,2369.65,83,,percent of total billed charges,,,,,,,,,,,,,,,2369.65,83,,percent of total billed charges,,,2712.25,95,,percent of total billed charges,,,2569.5,90,,percent of total billed charges,,,2569.5,90,,percent of total billed charges,,,2341.1,82,,percent of total billed charges,,,2569.5,90,,percent of total billed charges,,,2426.75,85,,percent of total billed charges,,713.75,2712.25,
CHIN AUGMENTATION,49000027,CDM,21120,CPT,360,RC,outpatient,,3089,3089,,2622.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,772.25,22,,percent of total billed charges,,,,,,,,,2780.1,90,,percent of total billed charges,,,2557.69,82.8,,percent of total billed charges,,,2625.65,85,,percent of total billed charges,,,,,,,,,2718.32,88,,percent of total billed charges,,,,,,,,,2360,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,772.25,22,,percent of total billed charges,,,2810.99,91,,percent of total billed charges,,,2934.55,95,,percent of total billed charges,,,2563.87,83,,percent of total billed charges,,,2563.87,83,,percent of total billed charges,,,,,,,,,,,,,,,2563.87,83,,percent of total billed charges,,,2934.55,95,,percent of total billed charges,,,2780.1,90,,percent of total billed charges,,,2780.1,90,,percent of total billed charges,,,2532.98,82,,percent of total billed charges,,,2780.1,90,,percent of total billed charges,,,2625.65,85,,percent of total billed charges,,772.25,2934.55,
OTOPLASTY UNILATERAL,49000028,CDM,69300,CPT,360,RC,outpatient,,2293,2293,,1946.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,573.25,22,,percent of total billed charges,,,,,,,,,2063.7,90,,percent of total billed charges,,,1898.6,82.8,,percent of total billed charges,,,1949.05,85,,percent of total billed charges,,,,,,,,,2017.84,88,,percent of total billed charges,,,,,,,,,1751.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,573.25,22,,percent of total billed charges,,,2086.63,91,,percent of total billed charges,,,2178.35,95,,percent of total billed charges,,,1903.19,83,,percent of total billed charges,,,1903.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1903.19,83,,percent of total billed charges,,,2178.35,95,,percent of total billed charges,,,2063.7,90,,percent of total billed charges,,,2063.7,90,,percent of total billed charges,,,1880.26,82,,percent of total billed charges,,,2063.7,90,,percent of total billed charges,,,1949.05,85,,percent of total billed charges,,573.25,2178.35,
OTOPLASTY BILATERAL,49000029,CDM,69300,CPT,360,RC,outpatient,,3121,3121,,2649.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,780.25,22,,percent of total billed charges,,,,,,,,,2808.9,90,,percent of total billed charges,,,2584.19,82.8,,percent of total billed charges,,,2652.85,85,,percent of total billed charges,,,,,,,,,2746.48,88,,percent of total billed charges,,,,,,,,,2384.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,780.25,22,,percent of total billed charges,,,2840.11,91,,percent of total billed charges,,,2964.95,95,,percent of total billed charges,,,2590.43,83,,percent of total billed charges,,,2590.43,83,,percent of total billed charges,,,,,,,,,,,,,,,2590.43,83,,percent of total billed charges,,,2964.95,95,,percent of total billed charges,,,2808.9,90,,percent of total billed charges,,,2808.9,90,,percent of total billed charges,,,2559.22,82,,percent of total billed charges,,,2808.9,90,,percent of total billed charges,,,2652.85,85,,percent of total billed charges,,780.25,2964.95,
BLEPHAROPLASTY SKIN FAT BILAT LOWER COMP,49000030,CDM,15821,CPT,360,RC,outpatient,,2093,2093,,1776.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,523.25,22,,percent of total billed charges,,,,,,,,,1883.7,90,,percent of total billed charges,,,1733,82.8,,percent of total billed charges,,,1779.05,85,,percent of total billed charges,,,,,,,,,1841.84,88,,percent of total billed charges,,,,,,,,,1599.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,523.25,22,,percent of total billed charges,,,1904.63,91,,percent of total billed charges,,,1988.35,95,,percent of total billed charges,,,1737.19,83,,percent of total billed charges,,,1737.19,83,,percent of total billed charges,,,,,,,,,,,,,,,1737.19,83,,percent of total billed charges,,,1988.35,95,,percent of total billed charges,,,1883.7,90,,percent of total billed charges,,,1883.7,90,,percent of total billed charges,,,1716.26,82,,percent of total billed charges,,,1883.7,90,,percent of total billed charges,,,1779.05,85,,percent of total billed charges,,523.25,1988.35,
BLEPHAROPLASTY SKIN BILAT UPPER,49000031,CDM,15822,CPT,360,RC,outpatient,,2583,2583,,2192.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,645.75,22,,percent of total billed charges,,,,,,,,,2324.7,90,,percent of total billed charges,,,2138.72,82.8,,percent of total billed charges,,,2195.55,85,,percent of total billed charges,,,,,,,,,2273.04,88,,percent of total billed charges,,,,,,,,,1973.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,645.75,22,,percent of total billed charges,,,2350.53,91,,percent of total billed charges,,,2453.85,95,,percent of total billed charges,,,2143.89,83,,percent of total billed charges,,,2143.89,83,,percent of total billed charges,,,,,,,,,,,,,,,2143.89,83,,percent of total billed charges,,,2453.85,95,,percent of total billed charges,,,2324.7,90,,percent of total billed charges,,,2324.7,90,,percent of total billed charges,,,2118.06,82,,percent of total billed charges,,,2324.7,90,,percent of total billed charges,,,2195.55,85,,percent of total billed charges,,645.75,2453.85,
BLEPHAROPLASTY BILATERAL UPPER/LOWER,49000032,CDM,15822,CPT,360,RC,outpatient,,3121,3121,,2649.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,780.25,22,,percent of total billed charges,,,,,,,,,2808.9,90,,percent of total billed charges,,,2584.19,82.8,,percent of total billed charges,,,2652.85,85,,percent of total billed charges,,,,,,,,,2746.48,88,,percent of total billed charges,,,,,,,,,2384.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,780.25,22,,percent of total billed charges,,,2840.11,91,,percent of total billed charges,,,2964.95,95,,percent of total billed charges,,,2590.43,83,,percent of total billed charges,,,2590.43,83,,percent of total billed charges,,,,,,,,,,,,,,,2590.43,83,,percent of total billed charges,,,2964.95,95,,percent of total billed charges,,,2808.9,90,,percent of total billed charges,,,2808.9,90,,percent of total billed charges,,,2559.22,82,,percent of total billed charges,,,2808.9,90,,percent of total billed charges,,,2652.85,85,,percent of total billed charges,,780.25,2964.95,
RHYTIDECTOMY CHEEK LIFT SMAS FLAP,49000033,CDM,15829,CPT,360,RC,outpatient,,5756,5756,,4886.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1439,22,,percent of total billed charges,,,,,,,,,5180.4,90,,percent of total billed charges,,,4765.97,82.8,,percent of total billed charges,,,4892.6,85,,percent of total billed charges,,,,,,,,,5065.28,88,,percent of total billed charges,,,,,,,,,4397.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1439,22,,percent of total billed charges,,,5237.96,91,,percent of total billed charges,,,5468.2,95,,percent of total billed charges,,,4777.48,83,,percent of total billed charges,,,4777.48,83,,percent of total billed charges,,,,,,,,,,,,,,,4777.48,83,,percent of total billed charges,,,5468.2,95,,percent of total billed charges,,,5180.4,90,,percent of total billed charges,,,5180.4,90,,percent of total billed charges,,,4719.92,82,,percent of total billed charges,,,5180.4,90,,percent of total billed charges,,,4892.6,85,,percent of total billed charges,,1439,5468.2,
RHYTIDECTOMY CHEEK LIFT SMAS NECK LIFT,49000034,CDM,15828,CPT,360,RC,outpatient,,6476,6476,,5498.12,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1619,22,,percent of total billed charges,,,,,,,,,5828.4,90,,percent of total billed charges,,,5362.13,82.8,,percent of total billed charges,,,5504.6,85,,percent of total billed charges,,,,,,,,,5698.88,88,,percent of total billed charges,,,,,,,,,4947.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1619,22,,percent of total billed charges,,,5893.16,91,,percent of total billed charges,,,6152.2,95,,percent of total billed charges,,,5375.08,83,,percent of total billed charges,,,5375.08,83,,percent of total billed charges,,,,,,,,,,,,,,,5375.08,83,,percent of total billed charges,,,6152.2,95,,percent of total billed charges,,,5828.4,90,,percent of total billed charges,,,5828.4,90,,percent of total billed charges,,,5310.32,82,,percent of total billed charges,,,5828.4,90,,percent of total billed charges,,,5504.6,85,,percent of total billed charges,,1619,6152.2,
RHYTIDECTOMY NECKLIFT W/PLATSYMAL TIGHT,49000035,CDM,15825,CPT,360,RC,outpatient,,3973,3973,,3373.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,993.25,22,,percent of total billed charges,,,,,,,,,3575.7,90,,percent of total billed charges,,,3289.64,82.8,,percent of total billed charges,,,3377.05,85,,percent of total billed charges,,,,,,,,,3496.24,88,,percent of total billed charges,,,,,,,,,3035.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,993.25,22,,percent of total billed charges,,,3615.43,91,,percent of total billed charges,,,3774.35,95,,percent of total billed charges,,,3297.59,83,,percent of total billed charges,,,3297.59,83,,percent of total billed charges,,,,,,,,,,,,,,,3297.59,83,,percent of total billed charges,,,3774.35,95,,percent of total billed charges,,,3575.7,90,,percent of total billed charges,,,3575.7,90,,percent of total billed charges,,,3257.86,82,,percent of total billed charges,,,3575.7,90,,percent of total billed charges,,,3377.05,85,,percent of total billed charges,,993.25,3774.35,
RHINOPLASTY COMP W/BONY PYRAMID FX,49000036,CDM,30410,CPT,360,RC,outpatient,,3609,3609,,3064.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,902.25,22,,percent of total billed charges,,,,,,,,,3248.1,90,,percent of total billed charges,,,2988.25,82.8,,percent of total billed charges,,,3067.65,85,,percent of total billed charges,,,,,,,,,3175.92,88,,percent of total billed charges,,,,,,,,,2757.28,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,902.25,22,,percent of total billed charges,,,3284.19,91,,percent of total billed charges,,,3428.55,95,,percent of total billed charges,,,2995.47,83,,percent of total billed charges,,,2995.47,83,,percent of total billed charges,,,,,,,,,,,,,,,2995.47,83,,percent of total billed charges,,,3428.55,95,,percent of total billed charges,,,3248.1,90,,percent of total billed charges,,,3248.1,90,,percent of total billed charges,,,2959.38,82,,percent of total billed charges,,,3248.1,90,,percent of total billed charges,,,3067.65,85,,percent of total billed charges,,902.25,3428.55,
BUTTOCK LIFT,49000037,CDM,15835,CPT,360,RC,outpatient,,4128,4128,,3504.67,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1032,22,,percent of total billed charges,,,,,,,,,3715.2,90,,percent of total billed charges,,,3417.98,82.8,,percent of total billed charges,,,3508.8,85,,percent of total billed charges,,,,,,,,,3632.64,88,,percent of total billed charges,,,,,,,,,3153.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1032,22,,percent of total billed charges,,,3756.48,91,,percent of total billed charges,,,3921.6,95,,percent of total billed charges,,,3426.24,83,,percent of total billed charges,,,3426.24,83,,percent of total billed charges,,,,,,,,,,,,,,,3426.24,83,,percent of total billed charges,,,3921.6,95,,percent of total billed charges,,,3715.2,90,,percent of total billed charges,,,3715.2,90,,percent of total billed charges,,,3384.96,82,,percent of total billed charges,,,3715.2,90,,percent of total billed charges,,,3508.8,85,,percent of total billed charges,,1032,3921.6,
THIGH LIFT BILATERAL,49000038,CDM,15832,CPT,360,RC,outpatient,,4757,4757,,4038.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1189.25,22,,percent of total billed charges,,,,,,,,,4281.3,90,,percent of total billed charges,,,3938.8,82.8,,percent of total billed charges,,,4043.45,85,,percent of total billed charges,,,,,,,,,4186.16,88,,percent of total billed charges,,,,,,,,,3634.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1189.25,22,,percent of total billed charges,,,4328.87,91,,percent of total billed charges,,,4519.15,95,,percent of total billed charges,,,3948.31,83,,percent of total billed charges,,,3948.31,83,,percent of total billed charges,,,,,,,,,,,,,,,3948.31,83,,percent of total billed charges,,,4519.15,95,,percent of total billed charges,,,4281.3,90,,percent of total billed charges,,,4281.3,90,,percent of total billed charges,,,3900.74,82,,percent of total billed charges,,,4281.3,90,,percent of total billed charges,,,4043.45,85,,percent of total billed charges,,1189.25,4519.15,
THIGH LIFT UNILATERAL,49000039,CDM,15832,CPT,360,RC,outpatient,,3690,3690,,3132.81,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,922.5,22,,percent of total billed charges,,,,,,,,,3321,90,,percent of total billed charges,,,3055.32,82.8,,percent of total billed charges,,,3136.5,85,,percent of total billed charges,,,,,,,,,3247.2,88,,percent of total billed charges,,,,,,,,,2819.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,922.5,22,,percent of total billed charges,,,3357.9,91,,percent of total billed charges,,,3505.5,95,,percent of total billed charges,,,3062.7,83,,percent of total billed charges,,,3062.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3062.7,83,,percent of total billed charges,,,3505.5,95,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3025.8,82,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3136.5,85,,percent of total billed charges,,922.5,3505.5,
ARM LIFT BRACHIOPLASTY BILATERAL,49000040,CDM,15836,CPT,360,RC,outpatient,,3262,3262,,2769.44,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,815.5,22,,percent of total billed charges,,,,,,,,,2935.8,90,,percent of total billed charges,,,2700.94,82.8,,percent of total billed charges,,,2772.7,85,,percent of total billed charges,,,,,,,,,2870.56,88,,percent of total billed charges,,,,,,,,,2492.17,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,815.5,22,,percent of total billed charges,,,2968.42,91,,percent of total billed charges,,,3098.9,95,,percent of total billed charges,,,2707.46,83,,percent of total billed charges,,,2707.46,83,,percent of total billed charges,,,,,,,,,,,,,,,2707.46,83,,percent of total billed charges,,,3098.9,95,,percent of total billed charges,,,2935.8,90,,percent of total billed charges,,,2935.8,90,,percent of total billed charges,,,2674.84,82,,percent of total billed charges,,,2935.8,90,,percent of total billed charges,,,2772.7,85,,percent of total billed charges,,815.5,3098.9,
SUCTION ASSITED LIPECTOMY HEAD NECK,49000041,CDM,15876,CPT,360,RC,outpatient,,2224,2224,,1888.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,556,22,,percent of total billed charges,,,,,,,,,2001.6,90,,percent of total billed charges,,,1841.47,82.8,,percent of total billed charges,,,1890.4,85,,percent of total billed charges,,,,,,,,,1957.12,88,,percent of total billed charges,,,,,,,,,1699.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,556,22,,percent of total billed charges,,,2023.84,91,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1845.92,83,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1823.68,82,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1890.4,85,,percent of total billed charges,,556,2112.8,
SUCTION ASSITED LIPECTOMY TRUCK,49000042,CDM,15877,CPT,360,RC,outpatient,,2760,2760,,2343.24,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,690,22,,percent of total billed charges,,,,,,,,,2484,90,,percent of total billed charges,,,2285.28,82.8,,percent of total billed charges,,,2346,85,,percent of total billed charges,,,,,,,,,2428.8,88,,percent of total billed charges,,,,,,,,,2108.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,690,22,,percent of total billed charges,,,2511.6,91,,percent of total billed charges,,,2622,95,,percent of total billed charges,,,2290.8,83,,percent of total billed charges,,,2290.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2290.8,83,,percent of total billed charges,,,2622,95,,percent of total billed charges,,,2484,90,,percent of total billed charges,,,2484,90,,percent of total billed charges,,,2263.2,82,,percent of total billed charges,,,2484,90,,percent of total billed charges,,,2346,85,,percent of total billed charges,,690,2622,
SUCTION ASSITED LIPECTOMY UPPER EXTR,49000043,CDM,15878,CPT,360,RC,outpatient,,2224,2224,,1888.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,556,22,,percent of total billed charges,,,,,,,,,2001.6,90,,percent of total billed charges,,,1841.47,82.8,,percent of total billed charges,,,1890.4,85,,percent of total billed charges,,,,,,,,,1957.12,88,,percent of total billed charges,,,,,,,,,1699.14,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,556,22,,percent of total billed charges,,,2023.84,91,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,1845.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1845.92,83,,percent of total billed charges,,,2112.8,95,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1823.68,82,,percent of total billed charges,,,2001.6,90,,percent of total billed charges,,,1890.4,85,,percent of total billed charges,,556,2112.8,
SUCTION ASSITED LIPECTOMY LOWER EXTR,49000044,CDM,15879,CPT,360,RC,outpatient,,2400,2400,,2037.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,600,22,,percent of total billed charges,,,,,,,,,2160,90,,percent of total billed charges,,,1987.2,82.8,,percent of total billed charges,,,2040,85,,percent of total billed charges,,,,,,,,,2112,88,,percent of total billed charges,,,,,,,,,1833.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,600,22,,percent of total billed charges,,,2184,91,,percent of total billed charges,,,2280,95,,percent of total billed charges,,,1992,83,,percent of total billed charges,,,1992,83,,percent of total billed charges,,,,,,,,,,,,,,,1992,83,,percent of total billed charges,,,2280,95,,percent of total billed charges,,,2160,90,,percent of total billed charges,,,2160,90,,percent of total billed charges,,,1968,82,,percent of total billed charges,,,2160,90,,percent of total billed charges,,,2040,85,,percent of total billed charges,,600,2280,
FF ADMINISTRATION FLU VACCINE,50320000,CDM,G0008,HCPCS,771,RC,outpatient,,33,33,,28.02,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,8.25,22,,percent of total billed charges,,,,,,,,,29.7,90,,percent of total billed charges,,,27.32,82.8,,percent of total billed charges,,,28.05,85,,percent of total billed charges,,,,,,,,,29.04,88,,percent of total billed charges,,,,,,,,,25.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,8.25,22,,percent of total billed charges,,,30.03,91,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,,,,,,,,,,,,,27.39,83,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,27.06,82,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,28.05,85,,percent of total billed charges,,8.25,31.35,
<=MAINTENANCE WORK REQUEST=>,53230001,CDM,,,636,RC,outpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.75,22,,percent of total billed charges,,,,,,,,,2.7,90,,percent of total billed charges,,,2.48,82.8,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.75,22,,percent of total billed charges,,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,0.75,2.85,
<=ELECTRICAL WORK REQUEST=>,53230002,CDM,,,636,RC,outpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.75,22,,percent of total billed charges,,,,,,,,,2.7,90,,percent of total billed charges,,,2.48,82.8,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.75,22,,percent of total billed charges,,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,0.75,2.85,
<=PLUMBING WORK REQUEST=>,53230003,CDM,,,636,RC,outpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.75,22,,percent of total billed charges,,,,,,,,,2.7,90,,percent of total billed charges,,,2.48,82.8,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.75,22,,percent of total billed charges,,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,0.75,2.85,
<=HVAC WORK REQUEST=>,53230004,CDM,,,636,RC,outpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.75,22,,percent of total billed charges,,,,,,,,,2.7,90,,percent of total billed charges,,,2.48,82.8,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.75,22,,percent of total billed charges,,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,0.75,2.85,
<=PAINTING WORK REQUEST=>,53230005,CDM,,,636,RC,outpatient,,3,3,,2.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,0.75,22,,percent of total billed charges,,,,,,,,,2.7,90,,percent of total billed charges,,,2.48,82.8,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,,,,,,,,2.64,88,,percent of total billed charges,,,,,,,,,2.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,0.75,22,,percent of total billed charges,,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.46,82,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,0.75,2.85,
MODERNA COVID-19 VACCINE ADMIN 1ST DOSE,58000001,CDM,0011A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
MODERNA COVID-19 VACCINE ADMIN 2ND DOSE,58000002,CDM,0012A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
PFIZER COVID-19 VACCINE ADMIN 1ST DOSE,58000003,CDM,0001A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
PFIZER COVID-19 VACCINE ADMIN 2ND DOSE,58000004,CDM,0002A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
MODERNA COVID-19 VACCINE ADMIN 3RD DOSE,58000005,CDM,0013A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
PFIZER COVID-19 VACCINE ADMIN 3RD DOSE,58000006,CDM,0003A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
PFIZER COVID-19 VACCINE ADMIN 1ST D/PEDS,58000007,CDM,0071A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
PFIZER COVID-19 VACCINE ADMIN 2ND D/PEDS,58000008,CDM,0072A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
PFIZER COVID-19 VACCINE ADMIN 4TH DOSE,58000009,CDM,0004A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
MODERNA COVID-19 VACCINE ADMIN 4TH DOSE,58000010,CDM,0064A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
PFIZER COVID-19 VACCINE ADMIN 3RD D/PEDS,58000011,CDM,0073A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
MODERNA COVID-19 VACCINE ADMIN 1ST D/PED,58000012,CDM,0104A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
MODERNA COVID-19 VACCINE BIVALENT 18+,58000013,CDM,0134A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
PFIZER COVID-19 VACCINE BIVALENT 12+,58000014,CDM,0124A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
PFIZER COVID-19 PED (6 MONTH-4 YEAR) 1ST,58000015,CDM,0081A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
PFIZER COVID-19 PED (6 MONTH-4 YEAR) 2ND,58000016,CDM,0082A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
PFIZER COVID-19 PED (6 MONTH-4 YEAR) 3RD,58000017,CDM,0083A,CPT,771,RC,outpatient,,80,80,,67.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,20,22,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,66.24,82.8,,percent of total billed charges,,,68,85,,percent of total billed charges,,,,,,,,,70.4,88,,percent of total billed charges,,,,,,,,,61.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,20,22,,percent of total billed charges,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,76,95,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,65.6,82,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,20,76,
MASK FIT TEST,62000000,CDM,,,220,RC,outpatient,,40,40,,33.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,10,22,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,33.12,82.8,,percent of total billed charges,,,34,85,,percent of total billed charges,,,,,,,,,35.2,88,,percent of total billed charges,,,,,,,,,30.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,10,22,,percent of total billed charges,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,,,,,,,,,,,,,33.2,83,,percent of total billed charges,,,38,95,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,32.8,82,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,10,38,
NEG PRESS WOUND TX </= 50 CM,4540501,CDM,97607,CPT,510,RC,outpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.25,22,,percent of total billed charges,,,,,,,,,414.9,90,,percent of total billed charges,,,381.71,82.8,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.25,22,,percent of total billed charges,,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,115.25,437.95,
NEW E&M PATIENT LEVEL 1,8100100,CDM,G0463,HCPCS,510,RC,outpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.5,22,,percent of total billed charges,,,,,,,,,365.4,90,,percent of total billed charges,,,336.17,82.8,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.5,22,,percent of total billed charges,,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,101.5,385.7,
NEW E&M PATIENT LEVEL 2,8100101,CDM,G0463,HCPCS,510,RC,outpatient,,492,492,,417.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123,22,,percent of total billed charges,,,,,,,,,442.8,90,,percent of total billed charges,,,407.38,82.8,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,,,,,,,,432.96,88,,percent of total billed charges,,,,,,,,,375.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123,22,,percent of total billed charges,,,447.72,91,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,,,,,,,,,,,,,408.36,83,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,403.44,82,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,123,467.4,
NEW E&M PATIENT LEVEL 3,8100102,CDM,G0463,HCPCS,510,RC,outpatient,,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.75,22,,percent of total billed charges,,,,,,,,,542.7,90,,percent of total billed charges,,,499.28,82.8,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.75,22,,percent of total billed charges,,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,150.75,572.85,
NEW E&M PATIENT LEVEL 4,8100103,CDM,G0463,HCPCS,510,RC,outpatient,,755,755,,641,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,188.75,22,,percent of total billed charges,,,,,,,,,679.5,90,,percent of total billed charges,,,625.14,82.8,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,,,,,,,,664.4,88,,percent of total billed charges,,,,,,,,,576.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,188.75,22,,percent of total billed charges,,,687.05,91,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,,,,,,,,,,,,,626.65,83,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,619.1,82,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,188.75,717.25,
NEW E&M PATIENT LEVEL 5,8100104,CDM,G0463,HCPCS,510,RC,outpatient,,962,962,,816.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,240.5,22,,percent of total billed charges,,,,,,,,,865.8,90,,percent of total billed charges,,,796.54,82.8,,percent of total billed charges,,,817.7,85,,percent of total billed charges,,,,,,,,,846.56,88,,percent of total billed charges,,,,,,,,,734.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,240.5,22,,percent of total billed charges,,,875.42,91,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,,,,,,,,,,,,,798.46,83,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,788.84,82,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,817.7,85,,percent of total billed charges,,240.5,913.9,
ESTABLISHED E&M PATIENT LEVEL 1,8100120,CDM,G0463,HCPCS,510,RC,outpatient,,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93,22,,percent of total billed charges,,,,,,,,,334.8,90,,percent of total billed charges,,,308.02,82.8,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93,22,,percent of total billed charges,,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,93,353.4,
ESTABLISHED E&M PATIENT LEVEL 2,8100121,CDM,G0463,HCPCS,510,RC,outpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.25,22,,percent of total billed charges,,,,,,,,,414.9,90,,percent of total billed charges,,,381.71,82.8,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.25,22,,percent of total billed charges,,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,115.25,437.95,
ESTABLISHED E&M PATIENT LEVEL 3,8100122,CDM,G0463,HCPCS,510,RC,outpatient,,586,586,,497.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,146.5,22,,percent of total billed charges,,,,,,,,,527.4,90,,percent of total billed charges,,,485.21,82.8,,percent of total billed charges,,,498.1,85,,percent of total billed charges,,,,,,,,,515.68,88,,percent of total billed charges,,,,,,,,,447.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,146.5,22,,percent of total billed charges,,,533.26,91,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,,,,,,,,,,,,,486.38,83,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,480.52,82,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,498.1,85,,percent of total billed charges,,146.5,556.7,
ESTABLISHED E&M PATIENT LEVEL 4,8100123,CDM,G0463,HCPCS,510,RC,outpatient,,727,727,,617.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,181.75,22,,percent of total billed charges,,,,,,,,,654.3,90,,percent of total billed charges,,,601.96,82.8,,percent of total billed charges,,,617.95,85,,percent of total billed charges,,,,,,,,,639.76,88,,percent of total billed charges,,,,,,,,,555.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,181.75,22,,percent of total billed charges,,,661.57,91,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,,,,,,,,,,,,,603.41,83,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,596.14,82,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,617.95,85,,percent of total billed charges,,181.75,690.65,
ESTABLISHED E&M PATIENT LEVEL 5,8100124,CDM,G0463,HCPCS,510,RC,outpatient,,943,943,,800.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.75,22,,percent of total billed charges,,,,,,,,,848.7,90,,percent of total billed charges,,,780.8,82.8,,percent of total billed charges,,,801.55,85,,percent of total billed charges,,,,,,,,,829.84,88,,percent of total billed charges,,,,,,,,,720.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.75,22,,percent of total billed charges,,,858.13,91,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,,,,,,,,,,,,,782.69,83,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,773.26,82,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,801.55,85,,percent of total billed charges,,235.75,895.85,
INC/DRAIN ABSCESS - SIMPLE OR SIN W/MOD,8110060,CDM,10060,CPT,761,RC,outpatient,59,654,654,,555.25,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,163.5,22,,percent of total billed charges,,,,,,,,,588.6,90,,percent of total billed charges,,,541.51,82.8,,percent of total billed charges,,,555.9,85,,percent of total billed charges,,,,,,,,,575.52,88,,percent of total billed charges,,,,,,,,,499.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,163.5,22,,percent of total billed charges,,,595.14,91,,percent of total billed charges,,,621.3,95,,percent of total billed charges,,,542.82,83,,percent of total billed charges,,,542.82,83,,percent of total billed charges,,,,,,,,,,,,,,,542.82,83,,percent of total billed charges,,,621.3,95,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,536.28,82,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,555.9,85,,percent of total billed charges,,163.5,621.3,
INC/DRAIN ABS- COMPLICATED OR MULT W/MOD,8110061,CDM,10061,CPT,761,RC,outpatient,59,477,477,,404.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.25,22,,percent of total billed charges,,,,,,,,,429.3,90,,percent of total billed charges,,,394.96,82.8,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,,,,,,,,419.76,88,,percent of total billed charges,,,,,,,,,364.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.25,22,,percent of total billed charges,,,434.07,91,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,,,,,,,,,,,,,395.91,83,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,391.14,82,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,119.25,453.15,
DEBRIDEMENT SKIN & SUBC TISSUE W/MOD,8111042,CDM,11042,CPT,761,RC,outpatient,59,1435,1435,,1218.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,358.75,22,,percent of total billed charges,,,,,,,,,1291.5,90,,percent of total billed charges,,,1188.18,82.8,,percent of total billed charges,,,1219.75,85,,percent of total billed charges,,,,,,,,,1262.8,88,,percent of total billed charges,,,,,,,,,1096.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,358.75,22,,percent of total billed charges,,,1305.85,91,,percent of total billed charges,,,1363.25,95,,percent of total billed charges,,,1191.05,83,,percent of total billed charges,,,1191.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1191.05,83,,percent of total billed charges,,,1363.25,95,,percent of total billed charges,,,1291.5,90,,percent of total billed charges,,,1291.5,90,,percent of total billed charges,,,1176.7,82,,percent of total billed charges,,,1291.5,90,,percent of total billed charges,,,1219.75,85,,percent of total billed charges,,358.75,1363.25,
DEBRIDE MUSC FAS<20 W/MOD,8111043,CDM,11043,CPT,761,RC,outpatient,59,1440,1440,,1222.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,360,22,,percent of total billed charges,,,,,,,,,1296,90,,percent of total billed charges,,,1192.32,82.8,,percent of total billed charges,,,1224,85,,percent of total billed charges,,,,,,,,,1267.2,88,,percent of total billed charges,,,,,,,,,1100.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,360,22,,percent of total billed charges,,,1310.4,91,,percent of total billed charges,,,1368,95,,percent of total billed charges,,,1195.2,83,,percent of total billed charges,,,1195.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1195.2,83,,percent of total billed charges,,,1368,95,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1180.8,82,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1224,85,,percent of total billed charges,,360,1368,
DEBRIDEMENT BONE < 20 W/MOD,8111044,CDM,11044,CPT,761,RC,outpatient,59,2623,2623,,2226.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,655.75,22,,percent of total billed charges,,,,,,,,,2360.7,90,,percent of total billed charges,,,2171.84,82.8,,percent of total billed charges,,,2229.55,85,,percent of total billed charges,,,,,,,,,2308.24,88,,percent of total billed charges,,,,,,,,,2003.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,655.75,22,,percent of total billed charges,,,2386.93,91,,percent of total billed charges,,,2491.85,95,,percent of total billed charges,,,2177.09,83,,percent of total billed charges,,,2177.09,83,,percent of total billed charges,,,,,,,,,,,,,,,2177.09,83,,percent of total billed charges,,,2491.85,95,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2150.86,82,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2229.55,85,,percent of total billed charges,,655.75,2491.85,
DEBRIDE SUBQ EA ADDTL 20 SQCM W/MOD,8111045,CDM,11045,CPT,761,RC,outpatient,59,1193,1193,,1012.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,298.25,22,,percent of total billed charges,,,,,,,,,1073.7,90,,percent of total billed charges,,,987.8,82.8,,percent of total billed charges,,,1014.05,85,,percent of total billed charges,,,,,,,,,1049.84,88,,percent of total billed charges,,,,,,,,,911.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,298.25,22,,percent of total billed charges,,,1085.63,91,,percent of total billed charges,,,1133.35,95,,percent of total billed charges,,,990.19,83,,percent of total billed charges,,,990.19,83,,percent of total billed charges,,,,,,,,,,,,,,,990.19,83,,percent of total billed charges,,,1133.35,95,,percent of total billed charges,,,1073.7,90,,percent of total billed charges,,,1073.7,90,,percent of total billed charges,,,978.26,82,,percent of total billed charges,,,1073.7,90,,percent of total billed charges,,,1014.05,85,,percent of total billed charges,,298.25,1133.35,
DEBRIDE MUSC FAS EA ADDTL <20 W/MOD,8111046,CDM,11046,CPT,761,RC,outpatient,59,1440,1440,,1222.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,360,22,,percent of total billed charges,,,,,,,,,1296,90,,percent of total billed charges,,,1192.32,82.8,,percent of total billed charges,,,1224,85,,percent of total billed charges,,,,,,,,,1267.2,88,,percent of total billed charges,,,,,,,,,1100.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,360,22,,percent of total billed charges,,,1310.4,91,,percent of total billed charges,,,1368,95,,percent of total billed charges,,,1195.2,83,,percent of total billed charges,,,1195.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1195.2,83,,percent of total billed charges,,,1368,95,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1180.8,82,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1224,85,,percent of total billed charges,,360,1368,
DEBRIDEMENT BONE EA ADDTL < 20 W/MOD,8111047,CDM,11047,CPT,761,RC,outpatient,59,2623,2623,,2226.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,655.75,22,,percent of total billed charges,,,,,,,,,2360.7,90,,percent of total billed charges,,,2171.84,82.8,,percent of total billed charges,,,2229.55,85,,percent of total billed charges,,,,,,,,,2308.24,88,,percent of total billed charges,,,,,,,,,2003.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,655.75,22,,percent of total billed charges,,,2386.93,91,,percent of total billed charges,,,2491.85,95,,percent of total billed charges,,,2177.09,83,,percent of total billed charges,,,2177.09,83,,percent of total billed charges,,,,,,,,,,,,,,,2177.09,83,,percent of total billed charges,,,2491.85,95,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2150.86,82,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2229.55,85,,percent of total billed charges,,655.75,2491.85,
PARE/CUT BENIGH HYPERKERA 2-4 LES W/MOD,8111056,CDM,11056,CPT,761,RC,outpatient,59,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.5,22,,percent of total billed charges,,,,,,,,,419.4,90,,percent of total billed charges,,,385.85,82.8,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.5,22,,percent of total billed charges,,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,116.5,442.7,
PARE/CUT BENIGH HYPERKERA >4 LES W/MOD,8111057,CDM,11057,CPT,761,RC,outpatient,59,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.5,22,,percent of total billed charges,,,,,,,,,419.4,90,,percent of total billed charges,,,385.85,82.8,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.5,22,,percent of total billed charges,,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,116.5,442.7,
BX SKIN/SQ TISSUE MUCOUS MEMB SNGL W/MOD,8111100,CDM,11102,CPT,761,RC,outpatient,59,668,668,,567.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,167,22,,percent of total billed charges,,,,,,,,,601.2,90,,percent of total billed charges,,,553.1,82.8,,percent of total billed charges,,,567.8,85,,percent of total billed charges,,,,,,,,,587.84,88,,percent of total billed charges,,,,,,,,,510.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,167,22,,percent of total billed charges,,,607.88,91,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,,,,,,,,,,,,,554.44,83,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,547.76,82,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,567.8,85,,percent of total billed charges,,167,634.6,
"BX SKIN, EA SEP/ADDT'L LESION W/MOD",8111101,CDM,11103,CPT,761,RC,outpatient,59,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.5,22,,percent of total billed charges,,,,,,,,,394.2,90,,percent of total billed charges,,,362.66,82.8,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.5,22,,percent of total billed charges,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,109.5,416.1,
FF EX BEN LESION MARGINS >4.0CM W MOD,8111406,CDM,11406,CPT,761,RC,outpatient,59,6271,6271,,5324.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1567.75,22,,percent of total billed charges,,,,,,,,,5643.9,90,,percent of total billed charges,,,5192.39,82.8,,percent of total billed charges,,,5330.35,85,,percent of total billed charges,,,,,,,,,5518.48,88,,percent of total billed charges,,,,,,,,,4791.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1567.75,22,,percent of total billed charges,,,5706.61,91,,percent of total billed charges,,,5957.45,95,,percent of total billed charges,,,5204.93,83,,percent of total billed charges,,,5204.93,83,,percent of total billed charges,,,,,,,,,,,,,,,5204.93,83,,percent of total billed charges,,,5957.45,95,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5142.22,82,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5330.35,85,,percent of total billed charges,,1567.75,5957.45,
TRIM NAILS NONDYSTROPHIC W/MOD,8111719,CDM,11719,CPT,761,RC,outpatient,59,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
"DEBRID OF NAIL(S), ANY METH, 1-5 W/MOD",8111720,CDM,11720,CPT,761,RC,outpatient,59,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.25,22,,percent of total billed charges,,,,,,,,,299.7,90,,percent of total billed charges,,,275.72,82.8,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.25,22,,percent of total billed charges,,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,83.25,316.35,
"DEBRID NAILS, ANY METH, 6 OR MORE W/MOD",8111721,CDM,11721,CPT,761,RC,outpatient,59,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.25,22,,percent of total billed charges,,,,,,,,,422.1,90,,percent of total billed charges,,,388.33,82.8,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.25,22,,percent of total billed charges,,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,117.25,445.55,
"AVUL NAIL PLATE, PTL OR COMP, SNGL W/MOD",8111730,CDM,11730,CPT,761,RC,outpatient,59,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.5,22,,percent of total billed charges,,,,,,,,,394.2,90,,percent of total billed charges,,,362.66,82.8,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.5,22,,percent of total billed charges,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,109.5,416.1,
AVULSION EA ADDT'L NAIL PLATE W/MOD,8111732,CDM,11732,CPT,761,RC,outpatient,59,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.25,22,,percent of total billed charges,,,,,,,,,321.3,90,,percent of total billed charges,,,295.6,82.8,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.25,22,,percent of total billed charges,,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,89.25,339.15,
"EXC NAIL & NA MATRIX, PTL OR COMP W/MOD",8111750,CDM,11750,CPT,761,RC,outpatient,59,1282,1282,,1088.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,320.5,22,,percent of total billed charges,,,,,,,,,1153.8,90,,percent of total billed charges,,,1061.5,82.8,,percent of total billed charges,,,1089.7,85,,percent of total billed charges,,,,,,,,,1128.16,88,,percent of total billed charges,,,,,,,,,979.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,320.5,22,,percent of total billed charges,,,1166.62,91,,percent of total billed charges,,,1217.9,95,,percent of total billed charges,,,1064.06,83,,percent of total billed charges,,,1064.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1064.06,83,,percent of total billed charges,,,1217.9,95,,percent of total billed charges,,,1153.8,90,,percent of total billed charges,,,1153.8,90,,percent of total billed charges,,,1051.24,82,,percent of total billed charges,,,1153.8,90,,percent of total billed charges,,,1089.7,85,,percent of total billed charges,,320.5,1217.9,
FF AP SKIN SUB 1ST SQ CM TR AR LEG W/MOD,8115271,CDM,15271,CPT,761,RC,outpatient,59,2037,2037,,1729.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,509.25,22,,percent of total billed charges,,,,,,,,,1833.3,90,,percent of total billed charges,,,1686.64,82.8,,percent of total billed charges,,,1731.45,85,,percent of total billed charges,,,,,,,,,1792.56,88,,percent of total billed charges,,,,,,,,,1556.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,509.25,22,,percent of total billed charges,,,1853.67,91,,percent of total billed charges,,,1935.15,95,,percent of total billed charges,,,1690.71,83,,percent of total billed charges,,,1690.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1690.71,83,,percent of total billed charges,,,1935.15,95,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1670.34,82,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1731.45,85,,percent of total billed charges,,509.25,1935.15,
FF APL SKIN SUB ECH AD 25 SQ CM TR W/MOD,8115272,CDM,15272,CPT,761,RC,outpatient,59,223,223,,189.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.75,22,,percent of total billed charges,,,,,,,,,200.7,90,,percent of total billed charges,,,184.64,82.8,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,,,,,,,,196.24,88,,percent of total billed charges,,,,,,,,,170.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.75,22,,percent of total billed charges,,,202.93,91,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,,,,,,,,,,,,,185.09,83,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,182.86,82,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,55.75,211.85,
FF APL SKIN SUB 1ST 100 SQ CM TK A W/MOD,8115273,CDM,15273,CPT,761,RC,outpatient,59,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1467.75,22,,percent of total billed charges,,,,,,,,,5283.9,90,,percent of total billed charges,,,4861.19,82.8,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1467.75,22,,percent of total billed charges,,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,1467.75,5577.45,
FF APPL SKIN SUB ECH ADD 100 W/MOD,8115274,CDM,15274,CPT,761,RC,outpatient,59,442,442,,375.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.5,22,,percent of total billed charges,,,,,,,,,397.8,90,,percent of total billed charges,,,365.98,82.8,,percent of total billed charges,,,375.7,85,,percent of total billed charges,,,,,,,,,388.96,88,,percent of total billed charges,,,,,,,,,337.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.5,22,,percent of total billed charges,,,402.22,91,,percent of total billed charges,,,419.9,95,,percent of total billed charges,,,366.86,83,,percent of total billed charges,,,366.86,83,,percent of total billed charges,,,,,,,,,,,,,,,366.86,83,,percent of total billed charges,,,419.9,95,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,362.44,82,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,375.7,85,,percent of total billed charges,,110.5,419.9,
FF APL SKIN SUB 1ST SQ CM FAC SCA W/MOD,8115275,CDM,15275,CPT,761,RC,outpatient,59,2648,2648,,2248.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,662,22,,percent of total billed charges,,,,,,,,,2383.2,90,,percent of total billed charges,,,2192.54,82.8,,percent of total billed charges,,,2250.8,85,,percent of total billed charges,,,,,,,,,2330.24,88,,percent of total billed charges,,,,,,,,,2023.07,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,662,22,,percent of total billed charges,,,2409.68,91,,percent of total billed charges,,,2515.6,95,,percent of total billed charges,,,2197.84,83,,percent of total billed charges,,,2197.84,83,,percent of total billed charges,,,,,,,,,,,,,,,2197.84,83,,percent of total billed charges,,,2515.6,95,,percent of total billed charges,,,2383.2,90,,percent of total billed charges,,,2383.2,90,,percent of total billed charges,,,2171.36,82,,percent of total billed charges,,,2383.2,90,,percent of total billed charges,,,2250.8,85,,percent of total billed charges,,662,2515.6,
FF APL SKIN SUB ECH AD 25 SQ CM FA W/MOD,8115276,CDM,15276,CPT,761,RC,outpatient,59,622,622,,528.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,155.5,22,,percent of total billed charges,,,,,,,,,559.8,90,,percent of total billed charges,,,515.02,82.8,,percent of total billed charges,,,528.7,85,,percent of total billed charges,,,,,,,,,547.36,88,,percent of total billed charges,,,,,,,,,475.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,155.5,22,,percent of total billed charges,,,566.02,91,,percent of total billed charges,,,590.9,95,,percent of total billed charges,,,516.26,83,,percent of total billed charges,,,516.26,83,,percent of total billed charges,,,,,,,,,,,,,,,516.26,83,,percent of total billed charges,,,590.9,95,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,510.04,82,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,528.7,85,,percent of total billed charges,,155.5,590.9,
FF APL SKIN SUB 1ST 100 SQ CM FA W/MOD,8115277,CDM,15277,CPT,761,RC,outpatient,59,1941,1941,,1647.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,485.25,22,,percent of total billed charges,,,,,,,,,1746.9,90,,percent of total billed charges,,,1607.15,82.8,,percent of total billed charges,,,1649.85,85,,percent of total billed charges,,,,,,,,,1708.08,88,,percent of total billed charges,,,,,,,,,1482.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,485.25,22,,percent of total billed charges,,,1766.31,91,,percent of total billed charges,,,1843.95,95,,percent of total billed charges,,,1611.03,83,,percent of total billed charges,,,1611.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1611.03,83,,percent of total billed charges,,,1843.95,95,,percent of total billed charges,,,1746.9,90,,percent of total billed charges,,,1746.9,90,,percent of total billed charges,,,1591.62,82,,percent of total billed charges,,,1746.9,90,,percent of total billed charges,,,1649.85,85,,percent of total billed charges,,485.25,1843.95,
FF APPL SKIN SUB ECH ADD 100 FACE W/MOD,8115278,CDM,15278,CPT,761,RC,outpatient,59,557,557,,472.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,139.25,22,,percent of total billed charges,,,,,,,,,501.3,90,,percent of total billed charges,,,461.2,82.8,,percent of total billed charges,,,473.45,85,,percent of total billed charges,,,,,,,,,490.16,88,,percent of total billed charges,,,,,,,,,425.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,139.25,22,,percent of total billed charges,,,506.87,91,,percent of total billed charges,,,529.15,95,,percent of total billed charges,,,462.31,83,,percent of total billed charges,,,462.31,83,,percent of total billed charges,,,,,,,,,,,,,,,462.31,83,,percent of total billed charges,,,529.15,95,,percent of total billed charges,,,501.3,90,,percent of total billed charges,,,501.3,90,,percent of total billed charges,,,456.74,82,,percent of total billed charges,,,501.3,90,,percent of total billed charges,,,473.45,85,,percent of total billed charges,,139.25,529.15,
"DRESSINGS/DEBRIDEMENT BURNS, SMALL W/MOD",8116020,CDM,16020,CPT,761,RC,outpatient,59,432,432,,366.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108,22,,percent of total billed charges,,,,,,,,,388.8,90,,percent of total billed charges,,,357.7,82.8,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,,,,,,,,380.16,88,,percent of total billed charges,,,,,,,,,330.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108,22,,percent of total billed charges,,,393.12,91,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,,,,,,,,,,,,,358.56,83,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,354.24,82,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,108,410.4,
"DRESSINGS/DEBRIDEMT BURNS, MEDIUM W/MOD",8116025,CDM,16025,CPT,761,RC,outpatient,59,477,477,,404.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.25,22,,percent of total billed charges,,,,,,,,,429.3,90,,percent of total billed charges,,,394.96,82.8,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,,,,,,,,419.76,88,,percent of total billed charges,,,,,,,,,364.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.25,22,,percent of total billed charges,,,434.07,91,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,,,,,,,,,,,,,395.91,83,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,391.14,82,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,119.25,453.15,
"DRESSINGS/DEBRIDEMENT BURNS, LARGE W/MOD",8116030,CDM,16030,CPT,761,RC,outpatient,59,678,678,,575.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,169.5,22,,percent of total billed charges,,,,,,,,,610.2,90,,percent of total billed charges,,,561.38,82.8,,percent of total billed charges,,,576.3,85,,percent of total billed charges,,,,,,,,,596.64,88,,percent of total billed charges,,,,,,,,,517.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,169.5,22,,percent of total billed charges,,,616.98,91,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,,,,,,,,,,,,,562.74,83,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,555.96,82,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,576.3,85,,percent of total billed charges,,169.5,644.1,
CHEMICAL CAUTER GRANULATION TISSUE W/MOD,8117250,CDM,17250,CPT,761,RC,outpatient,59,617,617,,523.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,154.25,22,,percent of total billed charges,,,,,,,,,555.3,90,,percent of total billed charges,,,510.88,82.8,,percent of total billed charges,,,524.45,85,,percent of total billed charges,,,,,,,,,542.96,88,,percent of total billed charges,,,,,,,,,471.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,154.25,22,,percent of total billed charges,,,561.47,91,,percent of total billed charges,,,586.15,95,,percent of total billed charges,,,512.11,83,,percent of total billed charges,,,512.11,83,,percent of total billed charges,,,,,,,,,,,,,,,512.11,83,,percent of total billed charges,,,586.15,95,,percent of total billed charges,,,555.3,90,,percent of total billed charges,,,555.3,90,,percent of total billed charges,,,505.94,82,,percent of total billed charges,,,555.3,90,,percent of total billed charges,,,524.45,85,,percent of total billed charges,,154.25,586.15,
NEW E&M PATIENT LEVEL 1 W MOD,8130100,CDM,99202,CPT,761,RC,outpatient,25,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.5,22,,percent of total billed charges,,,,,,,,,365.4,90,,percent of total billed charges,,,336.17,82.8,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.5,22,,percent of total billed charges,,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,101.5,385.7,
NEW OFFICE O/P SF 15-29 MIN W MOD,8130101,CDM,99202,CPT,761,RC,outpatient,25,492,492,,417.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123,22,,percent of total billed charges,,,,,,,,,442.8,90,,percent of total billed charges,,,407.38,82.8,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,,,,,,,,432.96,88,,percent of total billed charges,,,,,,,,,375.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123,22,,percent of total billed charges,,,447.72,91,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,,,,,,,,,,,,,408.36,83,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,403.44,82,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,123,467.4,
NEW OFFICE O/P LOW 30-44 MIN W MOD,8130102,CDM,99203,CPT,761,RC,outpatient,25,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.75,22,,percent of total billed charges,,,,,,,,,542.7,90,,percent of total billed charges,,,499.28,82.8,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.75,22,,percent of total billed charges,,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,150.75,572.85,
NEW OFFICE O/P NEW MOD 45-59 MIN W MOD,8130103,CDM,99204,CPT,761,RC,outpatient,25,755,755,,641,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,188.75,22,,percent of total billed charges,,,,,,,,,679.5,90,,percent of total billed charges,,,625.14,82.8,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,,,,,,,,664.4,88,,percent of total billed charges,,,,,,,,,576.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,188.75,22,,percent of total billed charges,,,687.05,91,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,,,,,,,,,,,,,626.65,83,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,619.1,82,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,188.75,717.25,
NEW OFFICE O/P HI 60-74 MIN W MOD,8130104,CDM,99205,CPT,761,RC,outpatient,25,962,962,,816.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,240.5,22,,percent of total billed charges,,,,,,,,,865.8,90,,percent of total billed charges,,,796.54,82.8,,percent of total billed charges,,,817.7,85,,percent of total billed charges,,,,,,,,,846.56,88,,percent of total billed charges,,,,,,,,,734.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,240.5,22,,percent of total billed charges,,,875.42,91,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,,,,,,,,,,,,,798.46,83,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,788.84,82,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,817.7,85,,percent of total billed charges,,240.5,913.9,
DEBRIDE OPEN WND 20 SQCM W/MOD,8197597,CDM,97597,CPT,761,RC,outpatient,59,668,668,,567.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,167,22,,percent of total billed charges,,,,,,,,,601.2,90,,percent of total billed charges,,,553.1,82.8,,percent of total billed charges,,,567.8,85,,percent of total billed charges,,,,,,,,,587.84,88,,percent of total billed charges,,,,,,,,,510.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,167,22,,percent of total billed charges,,,607.88,91,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,,,,,,,,,,,,,554.44,83,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,547.76,82,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,567.8,85,,percent of total billed charges,,167,634.6,
DEBRIDE OPEN WND EA ADDT 20 SQCM W/MOD,8197598,CDM,97598,CPT,761,RC,outpatient,59,800,800,,679.2,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,200,22,,percent of total billed charges,,,,,,,,,720,90,,percent of total billed charges,,,662.4,82.8,,percent of total billed charges,,,680,85,,percent of total billed charges,,,,,,,,,704,88,,percent of total billed charges,,,,,,,,,611.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,200,22,,percent of total billed charges,,,728,91,,percent of total billed charges,,,760,95,,percent of total billed charges,,,664,83,,percent of total billed charges,,,664,83,,percent of total billed charges,,,,,,,,,,,,,,,664,83,,percent of total billed charges,,,760,95,,percent of total billed charges,,,720,90,,percent of total billed charges,,,720,90,,percent of total billed charges,,,656,82,,percent of total billed charges,,,720,90,,percent of total billed charges,,,680,85,,percent of total billed charges,,200,760,
NON-SELECTIVE DEBRIDEMENT W/MOD,8197602,CDM,97602,CPT,761,RC,outpatient,59,509,509,,432.14,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,127.25,22,,percent of total billed charges,,,,,,,,,458.1,90,,percent of total billed charges,,,421.45,82.8,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,,,,,,,,447.92,88,,percent of total billed charges,,,,,,,,,388.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,127.25,22,,percent of total billed charges,,,463.19,91,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,,,,,,,,,,,,,422.47,83,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,417.38,82,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,127.25,483.55,
NEG PRES WD THER 50 SQ CM OR LESS W/MOD,8197605,CDM,97605,CPT,761,RC,outpatient,59,444,444,,376.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,111,22,,percent of total billed charges,,,,,,,,,399.6,90,,percent of total billed charges,,,367.63,82.8,,percent of total billed charges,,,377.4,85,,percent of total billed charges,,,,,,,,,390.72,88,,percent of total billed charges,,,,,,,,,339.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,111,22,,percent of total billed charges,,,404.04,91,,percent of total billed charges,,,421.8,95,,percent of total billed charges,,,368.52,83,,percent of total billed charges,,,368.52,83,,percent of total billed charges,,,,,,,,,,,,,,,368.52,83,,percent of total billed charges,,,421.8,95,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,364.08,82,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,377.4,85,,percent of total billed charges,,111,421.8,
NEG PRES WOUND THERAPY > 50 SQ CM W/MOD,8197606,CDM,97606,CPT,761,RC,outpatient,59,559,559,,474.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,139.75,22,,percent of total billed charges,,,,,,,,,503.1,90,,percent of total billed charges,,,462.85,82.8,,percent of total billed charges,,,475.15,85,,percent of total billed charges,,,,,,,,,491.92,88,,percent of total billed charges,,,,,,,,,427.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,139.75,22,,percent of total billed charges,,,508.69,91,,percent of total billed charges,,,531.05,95,,percent of total billed charges,,,463.97,83,,percent of total billed charges,,,463.97,83,,percent of total billed charges,,,,,,,,,,,,,,,463.97,83,,percent of total billed charges,,,531.05,95,,percent of total billed charges,,,503.1,90,,percent of total billed charges,,,503.1,90,,percent of total billed charges,,,458.38,82,,percent of total billed charges,,,503.1,90,,percent of total billed charges,,,475.15,85,,percent of total billed charges,,139.75,531.05,
OFFICE O/P EST MINIMAL W MOD PROB,8199211,CDM,99211,CPT,761,RC,outpatient,25,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93,22,,percent of total billed charges,,,,,,,,,334.8,90,,percent of total billed charges,,,308.02,82.8,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93,22,,percent of total billed charges,,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,93,353.4,
EST OFFICE O/P SF 10-19 MIN W MOD,8199212,CDM,99212,CPT,761,RC,outpatient,25,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.25,22,,percent of total billed charges,,,,,,,,,414.9,90,,percent of total billed charges,,,381.71,82.8,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.25,22,,percent of total billed charges,,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,115.25,437.95,
EST OFFICE O/P LOW 20-29 MIN W MOD,8199213,CDM,99213,CPT,761,RC,outpatient,25,586,586,,497.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,146.5,22,,percent of total billed charges,,,,,,,,,527.4,90,,percent of total billed charges,,,485.21,82.8,,percent of total billed charges,,,498.1,85,,percent of total billed charges,,,,,,,,,515.68,88,,percent of total billed charges,,,,,,,,,447.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,146.5,22,,percent of total billed charges,,,533.26,91,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,,,,,,,,,,,,,486.38,83,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,480.52,82,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,498.1,85,,percent of total billed charges,,146.5,556.7,
EST OFFICE O/P MOD 30-39 MIN W MOD,8199214,CDM,99214,CPT,761,RC,outpatient,25,727,727,,617.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,181.75,22,,percent of total billed charges,,,,,,,,,654.3,90,,percent of total billed charges,,,601.96,82.8,,percent of total billed charges,,,617.95,85,,percent of total billed charges,,,,,,,,,639.76,88,,percent of total billed charges,,,,,,,,,555.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,181.75,22,,percent of total billed charges,,,661.57,91,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,,,,,,,,,,,,,603.41,83,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,596.14,82,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,617.95,85,,percent of total billed charges,,181.75,690.65,
EST OFFICE O/P HI 40-54 MIN W MOD,8199215,CDM,99215,CPT,761,RC,outpatient,25,943,943,,800.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.75,22,,percent of total billed charges,,,,,,,,,848.7,90,,percent of total billed charges,,,780.8,82.8,,percent of total billed charges,,,801.55,85,,percent of total billed charges,,,,,,,,,829.84,88,,percent of total billed charges,,,,,,,,,720.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.75,22,,percent of total billed charges,,,858.13,91,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,,,,,,,,,,,,,782.69,83,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,773.26,82,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,801.55,85,,percent of total billed charges,,235.75,895.85,
NEW E&M PATIENT-LEVEL 1,81000100,CDM,99202,CPT,761,RC,outpatient,,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.5,22,,percent of total billed charges,,,,,,,,,365.4,90,,percent of total billed charges,,,336.17,82.8,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.5,22,,percent of total billed charges,,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,101.5,385.7,
NEW OFFICE O/P SF 15-29 MIN,81000101,CDM,99202,CPT,761,RC,outpatient,,492,492,,417.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123,22,,percent of total billed charges,,,,,,,,,442.8,90,,percent of total billed charges,,,407.38,82.8,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,,,,,,,,432.96,88,,percent of total billed charges,,,,,,,,,375.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123,22,,percent of total billed charges,,,447.72,91,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,,,,,,,,,,,,,408.36,83,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,403.44,82,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,123,467.4,
NEW OFFICE O/P NEW 30-44 MIN,81000102,CDM,99203,CPT,761,RC,outpatient,,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.75,22,,percent of total billed charges,,,,,,,,,542.7,90,,percent of total billed charges,,,499.28,82.8,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.75,22,,percent of total billed charges,,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,150.75,572.85,
NEW OFFICE O/P NEW MOD 45-59 MIN,81000103,CDM,99204,CPT,761,RC,outpatient,,755,755,,641,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,188.75,22,,percent of total billed charges,,,,,,,,,679.5,90,,percent of total billed charges,,,625.14,82.8,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,,,,,,,,664.4,88,,percent of total billed charges,,,,,,,,,576.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,188.75,22,,percent of total billed charges,,,687.05,91,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,,,,,,,,,,,,,626.65,83,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,619.1,82,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,188.75,717.25,
NEW OFFICE O/P HI 60-74 MIN,81000104,CDM,99205,CPT,761,RC,outpatient,,962,962,,816.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,240.5,22,,percent of total billed charges,,,,,,,,,865.8,90,,percent of total billed charges,,,796.54,82.8,,percent of total billed charges,,,817.7,85,,percent of total billed charges,,,,,,,,,846.56,88,,percent of total billed charges,,,,,,,,,734.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,240.5,22,,percent of total billed charges,,,875.42,91,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,,,,,,,,,,,,,798.46,83,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,788.84,82,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,817.7,85,,percent of total billed charges,,240.5,913.9,
DEBRIDE OPEN WND 20 SQCM,81000105,CDM,97597,CPT,761,RC,outpatient,,754,754,,640.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,188.5,22,,percent of total billed charges,,,,,,,,,678.6,90,,percent of total billed charges,,,624.31,82.8,,percent of total billed charges,,,640.9,85,,percent of total billed charges,,,,,,,,,663.52,88,,percent of total billed charges,,,,,,,,,576.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,188.5,22,,percent of total billed charges,,,686.14,91,,percent of total billed charges,,,716.3,95,,percent of total billed charges,,,625.82,83,,percent of total billed charges,,,625.82,83,,percent of total billed charges,,,,,,,,,,,,,,,625.82,83,,percent of total billed charges,,,716.3,95,,percent of total billed charges,,,678.6,90,,percent of total billed charges,,,678.6,90,,percent of total billed charges,,,618.28,82,,percent of total billed charges,,,678.6,90,,percent of total billed charges,,,640.9,85,,percent of total billed charges,,188.5,716.3,
DEBRIDE OPEN WND EA ADDT 20 SQCM,81000106,CDM,97598,CPT,761,RC,outpatient,,754,754,,640.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,188.5,22,,percent of total billed charges,,,,,,,,,678.6,90,,percent of total billed charges,,,624.31,82.8,,percent of total billed charges,,,640.9,85,,percent of total billed charges,,,,,,,,,663.52,88,,percent of total billed charges,,,,,,,,,576.06,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,188.5,22,,percent of total billed charges,,,686.14,91,,percent of total billed charges,,,716.3,95,,percent of total billed charges,,,625.82,83,,percent of total billed charges,,,625.82,83,,percent of total billed charges,,,,,,,,,,,,,,,625.82,83,,percent of total billed charges,,,716.3,95,,percent of total billed charges,,,678.6,90,,percent of total billed charges,,,678.6,90,,percent of total billed charges,,,618.28,82,,percent of total billed charges,,,678.6,90,,percent of total billed charges,,,640.9,85,,percent of total billed charges,,188.5,716.3,
FF APPL SKIN SUB 1ST SQ CM TRUNK ARM LEG,81000110,CDM,15271,CPT,761,RC,outpatient,,3452,3452,,2930.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,863,22,,percent of total billed charges,,,,,,,,,3106.8,90,,percent of total billed charges,,,2858.26,82.8,,percent of total billed charges,,,2934.2,85,,percent of total billed charges,,,,,,,,,3037.76,88,,percent of total billed charges,,,,,,,,,2637.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,863,22,,percent of total billed charges,,,3141.32,91,,percent of total billed charges,,,3279.4,95,,percent of total billed charges,,,2865.16,83,,percent of total billed charges,,,2865.16,83,,percent of total billed charges,,,,,,,,,,,,,,,2865.16,83,,percent of total billed charges,,,3279.4,95,,percent of total billed charges,,,3106.8,90,,percent of total billed charges,,,3106.8,90,,percent of total billed charges,,,2830.64,82,,percent of total billed charges,,,3106.8,90,,percent of total billed charges,,,2934.2,85,,percent of total billed charges,,863,3279.4,
FF APPL SKIN SUB ECH ADD 25 SQ CM TRUNK,81000111,CDM,15272,CPT,761,RC,outpatient,,223,223,,189.33,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,55.75,22,,percent of total billed charges,,,,,,,,,200.7,90,,percent of total billed charges,,,184.64,82.8,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,,,,,,,,196.24,88,,percent of total billed charges,,,,,,,,,170.37,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,55.75,22,,percent of total billed charges,,,202.93,91,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,,,,,,,,,,,,,185.09,83,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,182.86,82,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,55.75,211.85,
FF APPL SKIN SUB 1ST 100 SQ CM TRUNK ARM,81000112,CDM,15273,CPT,761,RC,outpatient,,5871,5871,,4984.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1467.75,22,,percent of total billed charges,,,,,,,,,5283.9,90,,percent of total billed charges,,,4861.19,82.8,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,,,,,,,,5166.48,88,,percent of total billed charges,,,,,,,,,4485.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1467.75,22,,percent of total billed charges,,,5342.61,91,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,4872.93,83,,percent of total billed charges,,,,,,,,,,,,,,,4872.93,83,,percent of total billed charges,,,5577.45,95,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4814.22,82,,percent of total billed charges,,,5283.9,90,,percent of total billed charges,,,4990.35,85,,percent of total billed charges,,1467.75,5577.45,
FF APPL SKIN SUB ECH ADD 100,81000113,CDM,15274,CPT,761,RC,outpatient,,442,442,,375.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,110.5,22,,percent of total billed charges,,,,,,,,,397.8,90,,percent of total billed charges,,,365.98,82.8,,percent of total billed charges,,,375.7,85,,percent of total billed charges,,,,,,,,,388.96,88,,percent of total billed charges,,,,,,,,,337.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,110.5,22,,percent of total billed charges,,,402.22,91,,percent of total billed charges,,,419.9,95,,percent of total billed charges,,,366.86,83,,percent of total billed charges,,,366.86,83,,percent of total billed charges,,,,,,,,,,,,,,,366.86,83,,percent of total billed charges,,,419.9,95,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,362.44,82,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,375.7,85,,percent of total billed charges,,110.5,419.9,
FF APPL SKIN SUB 1ST SQ CM FACE SCALP,81000114,CDM,15275,CPT,761,RC,outpatient,,2643,2643,,2243.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,660.75,22,,percent of total billed charges,,,,,,,,,2378.7,90,,percent of total billed charges,,,2188.4,82.8,,percent of total billed charges,,,2246.55,85,,percent of total billed charges,,,,,,,,,2325.84,88,,percent of total billed charges,,,,,,,,,2019.25,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,660.75,22,,percent of total billed charges,,,2405.13,91,,percent of total billed charges,,,2510.85,95,,percent of total billed charges,,,2193.69,83,,percent of total billed charges,,,2193.69,83,,percent of total billed charges,,,,,,,,,,,,,,,2193.69,83,,percent of total billed charges,,,2510.85,95,,percent of total billed charges,,,2378.7,90,,percent of total billed charges,,,2378.7,90,,percent of total billed charges,,,2167.26,82,,percent of total billed charges,,,2378.7,90,,percent of total billed charges,,,2246.55,85,,percent of total billed charges,,660.75,2510.85,
FF APPL SKIN SUB ECH ADD 25 SQ CM FACE,81000115,CDM,15276,CPT,761,RC,outpatient,,622,622,,528.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,155.5,22,,percent of total billed charges,,,,,,,,,559.8,90,,percent of total billed charges,,,515.02,82.8,,percent of total billed charges,,,528.7,85,,percent of total billed charges,,,,,,,,,547.36,88,,percent of total billed charges,,,,,,,,,475.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,155.5,22,,percent of total billed charges,,,566.02,91,,percent of total billed charges,,,590.9,95,,percent of total billed charges,,,516.26,83,,percent of total billed charges,,,516.26,83,,percent of total billed charges,,,,,,,,,,,,,,,516.26,83,,percent of total billed charges,,,590.9,95,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,510.04,82,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,528.7,85,,percent of total billed charges,,155.5,590.9,
FF APPL SKIN SUB 1ST 100 SQ CM FACE,81000116,CDM,15277,CPT,761,RC,outpatient,,1941,1941,,1647.91,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,485.25,22,,percent of total billed charges,,,,,,,,,1746.9,90,,percent of total billed charges,,,1607.15,82.8,,percent of total billed charges,,,1649.85,85,,percent of total billed charges,,,,,,,,,1708.08,88,,percent of total billed charges,,,,,,,,,1482.92,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,485.25,22,,percent of total billed charges,,,1766.31,91,,percent of total billed charges,,,1843.95,95,,percent of total billed charges,,,1611.03,83,,percent of total billed charges,,,1611.03,83,,percent of total billed charges,,,,,,,,,,,,,,,1611.03,83,,percent of total billed charges,,,1843.95,95,,percent of total billed charges,,,1746.9,90,,percent of total billed charges,,,1746.9,90,,percent of total billed charges,,,1591.62,82,,percent of total billed charges,,,1746.9,90,,percent of total billed charges,,,1649.85,85,,percent of total billed charges,,485.25,1843.95,
FF APPL SKIN SUB ECH ADD 100 FACE,81000117,CDM,15278,CPT,761,RC,outpatient,,557,557,,472.89,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,139.25,22,,percent of total billed charges,,,,,,,,,501.3,90,,percent of total billed charges,,,461.2,82.8,,percent of total billed charges,,,473.45,85,,percent of total billed charges,,,,,,,,,490.16,88,,percent of total billed charges,,,,,,,,,425.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,139.25,22,,percent of total billed charges,,,506.87,91,,percent of total billed charges,,,529.15,95,,percent of total billed charges,,,462.31,83,,percent of total billed charges,,,462.31,83,,percent of total billed charges,,,,,,,,,,,,,,,462.31,83,,percent of total billed charges,,,529.15,95,,percent of total billed charges,,,501.3,90,,percent of total billed charges,,,501.3,90,,percent of total billed charges,,,456.74,82,,percent of total billed charges,,,501.3,90,,percent of total billed charges,,,473.45,85,,percent of total billed charges,,139.25,529.15,
FF APPLICATION OF SKIN SUB UP 25 SQ CM,81000118,CDM,C5271,HCPCS,761,RC,outpatient,,2037,2037,,1729.41,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,509.25,22,,percent of total billed charges,,,,,,,,,1833.3,90,,percent of total billed charges,,,1686.64,82.8,,percent of total billed charges,,,1731.45,85,,percent of total billed charges,,,,,,,,,1792.56,88,,percent of total billed charges,,,,,,,,,1556.27,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,509.25,22,,percent of total billed charges,,,1853.67,91,,percent of total billed charges,,,1935.15,95,,percent of total billed charges,,,1690.71,83,,percent of total billed charges,,,1690.71,83,,percent of total billed charges,,,,,,,,,,,,,,,1690.71,83,,percent of total billed charges,,,1935.15,95,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1670.34,82,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1731.45,85,,percent of total billed charges,,509.25,1935.15,
OFFICE O/P EST MINIMAL PROB,81000120,CDM,99211,CPT,761,RC,outpatient,,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93,22,,percent of total billed charges,,,,,,,,,334.8,90,,percent of total billed charges,,,308.02,82.8,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93,22,,percent of total billed charges,,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,93,353.4,
EST OFFICE O/P SF 10-19 MIN,81000121,CDM,99212,CPT,761,RC,outpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.25,22,,percent of total billed charges,,,,,,,,,414.9,90,,percent of total billed charges,,,381.71,82.8,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.25,22,,percent of total billed charges,,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,115.25,437.95,
EST OFFICE O/P LOW 20-29 MIN,81000122,CDM,99213,CPT,761,RC,outpatient,,586,586,,497.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,146.5,22,,percent of total billed charges,,,,,,,,,527.4,90,,percent of total billed charges,,,485.21,82.8,,percent of total billed charges,,,498.1,85,,percent of total billed charges,,,,,,,,,515.68,88,,percent of total billed charges,,,,,,,,,447.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,146.5,22,,percent of total billed charges,,,533.26,91,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,,,,,,,,,,,,,486.38,83,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,480.52,82,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,498.1,85,,percent of total billed charges,,146.5,556.7,
EST OFFICE O/P MOD 30-39 MIN,81000123,CDM,99214,CPT,761,RC,outpatient,,727,727,,617.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,181.75,22,,percent of total billed charges,,,,,,,,,654.3,90,,percent of total billed charges,,,601.96,82.8,,percent of total billed charges,,,617.95,85,,percent of total billed charges,,,,,,,,,639.76,88,,percent of total billed charges,,,,,,,,,555.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,181.75,22,,percent of total billed charges,,,661.57,91,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,,,,,,,,,,,,,603.41,83,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,596.14,82,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,617.95,85,,percent of total billed charges,,181.75,690.65,
EST OFFICE O/P HI 40-54 MIN,81000124,CDM,99215,CPT,761,RC,outpatient,,943,943,,800.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.75,22,,percent of total billed charges,,,,,,,,,848.7,90,,percent of total billed charges,,,780.8,82.8,,percent of total billed charges,,,801.55,85,,percent of total billed charges,,,,,,,,,829.84,88,,percent of total billed charges,,,,,,,,,720.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.75,22,,percent of total billed charges,,,858.13,91,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,,,,,,,,,,,,,782.69,83,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,773.26,82,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,801.55,85,,percent of total billed charges,,235.75,895.85,
SIMPLE SU 2.5 S N T EX,81000125,CDM,12001,CPT,761,RC,outpatient,,463,463,,393.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.75,22,,percent of total billed charges,,,,,,,,,416.7,90,,percent of total billed charges,,,383.36,82.8,,percent of total billed charges,,,393.55,85,,percent of total billed charges,,,,,,,,,407.44,88,,percent of total billed charges,,,,,,,,,353.73,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.75,22,,percent of total billed charges,,,421.33,91,,percent of total billed charges,,,439.85,95,,percent of total billed charges,,,384.29,83,,percent of total billed charges,,,384.29,83,,percent of total billed charges,,,,,,,,,,,,,,,384.29,83,,percent of total billed charges,,,439.85,95,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,379.66,82,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,393.55,85,,percent of total billed charges,,115.75,439.85,
NEW E&M PATIENT LEVEL 1 W MOD,81000126,CDM,G0463,HCPCS,510,RC,outpatient,25,406,406,,344.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,101.5,22,,percent of total billed charges,,,,,,,,,365.4,90,,percent of total billed charges,,,336.17,82.8,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,,,,,,,,357.28,88,,percent of total billed charges,,,,,,,,,310.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,101.5,22,,percent of total billed charges,,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,,,,,,,,,,,,,336.98,83,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,332.92,82,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,101.5,385.7,
NEW E&M PATIENT LEVEL 2 W MOD,81000127,CDM,G0463,HCPCS,510,RC,outpatient,25,492,492,,417.71,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,123,22,,percent of total billed charges,,,,,,,,,442.8,90,,percent of total billed charges,,,407.38,82.8,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,,,,,,,,432.96,88,,percent of total billed charges,,,,,,,,,375.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,123,22,,percent of total billed charges,,,447.72,91,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,,,,,,,,,,,,,408.36,83,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,403.44,82,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,123,467.4,
NEW E&M PATIENT LEVEL 3 W MOD,81000128,CDM,G0463,HCPCS,510,RC,outpatient,25,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.75,22,,percent of total billed charges,,,,,,,,,542.7,90,,percent of total billed charges,,,499.28,82.8,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.75,22,,percent of total billed charges,,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,150.75,572.85,
NEW E&M PATIENT LEVEL 4 W MOD,81000129,CDM,G0463,HCPCS,510,RC,outpatient,25,755,755,,641,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,188.75,22,,percent of total billed charges,,,,,,,,,679.5,90,,percent of total billed charges,,,625.14,82.8,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,,,,,,,,664.4,88,,percent of total billed charges,,,,,,,,,576.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,188.75,22,,percent of total billed charges,,,687.05,91,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,,,,,,,,,,,,,626.65,83,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,619.1,82,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,188.75,717.25,
NEW E&M PATIENT LEVEL 5 W MOD,81000130,CDM,G0463,HCPCS,510,RC,outpatient,25,962,962,,816.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,240.5,22,,percent of total billed charges,,,,,,,,,865.8,90,,percent of total billed charges,,,796.54,82.8,,percent of total billed charges,,,817.7,85,,percent of total billed charges,,,,,,,,,846.56,88,,percent of total billed charges,,,,,,,,,734.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,240.5,22,,percent of total billed charges,,,875.42,91,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,798.46,83,,percent of total billed charges,,,,,,,,,,,,,,,798.46,83,,percent of total billed charges,,,913.9,95,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,788.84,82,,percent of total billed charges,,,865.8,90,,percent of total billed charges,,,817.7,85,,percent of total billed charges,,240.5,913.9,
ESTABLISHED E&M PATIENT LEVEL 1 W MOD,81000131,CDM,G0463,HCPCS,510,RC,outpatient,25,372,372,,315.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,93,22,,percent of total billed charges,,,,,,,,,334.8,90,,percent of total billed charges,,,308.02,82.8,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,,,,,,,,327.36,88,,percent of total billed charges,,,,,,,,,284.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,93,22,,percent of total billed charges,,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,,,,,,,,,,,,,308.76,83,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,305.04,82,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,93,353.4,
ESTABLISHED E&M PATIENT LEVEL 2 W MOD,81000132,CDM,G0463,HCPCS,510,RC,outpatient,25,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.25,22,,percent of total billed charges,,,,,,,,,414.9,90,,percent of total billed charges,,,381.71,82.8,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.25,22,,percent of total billed charges,,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,115.25,437.95,
ESTABLISHED E&M PATIENT LEVEL 3 W MOD,81000133,CDM,G0463,HCPCS,510,RC,outpatient,25,586,586,,497.51,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,146.5,22,,percent of total billed charges,,,,,,,,,527.4,90,,percent of total billed charges,,,485.21,82.8,,percent of total billed charges,,,498.1,85,,percent of total billed charges,,,,,,,,,515.68,88,,percent of total billed charges,,,,,,,,,447.7,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,146.5,22,,percent of total billed charges,,,533.26,91,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,486.38,83,,percent of total billed charges,,,,,,,,,,,,,,,486.38,83,,percent of total billed charges,,,556.7,95,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,480.52,82,,percent of total billed charges,,,527.4,90,,percent of total billed charges,,,498.1,85,,percent of total billed charges,,146.5,556.7,
ESTABLISHED E&M PATIENT LEVEL 4 W MOD,81000134,CDM,G0463,HCPCS,510,RC,outpatient,25,727,727,,617.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,181.75,22,,percent of total billed charges,,,,,,,,,654.3,90,,percent of total billed charges,,,601.96,82.8,,percent of total billed charges,,,617.95,85,,percent of total billed charges,,,,,,,,,639.76,88,,percent of total billed charges,,,,,,,,,555.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,181.75,22,,percent of total billed charges,,,661.57,91,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,,,,,,,,,,,,,603.41,83,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,596.14,82,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,617.95,85,,percent of total billed charges,,181.75,690.65,
ESTABLISHED E&M PATIENT LEVEL 5 W MOD,81000135,CDM,G0463,HCPCS,510,RC,outpatient,25,943,943,,800.61,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,235.75,22,,percent of total billed charges,,,,,,,,,848.7,90,,percent of total billed charges,,,780.8,82.8,,percent of total billed charges,,,801.55,85,,percent of total billed charges,,,,,,,,,829.84,88,,percent of total billed charges,,,,,,,,,720.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,235.75,22,,percent of total billed charges,,,858.13,91,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,782.69,83,,percent of total billed charges,,,,,,,,,,,,,,,782.69,83,,percent of total billed charges,,,895.85,95,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,773.26,82,,percent of total billed charges,,,848.7,90,,percent of total billed charges,,,801.55,85,,percent of total billed charges,,235.75,895.85,
DEBRIDE EXT ECZEMATOUS SKIN(UP TO 10%),81000201,CDM,11000,CPT,761,RC,outpatient,,531,531,,450.82,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,132.75,22,,percent of total billed charges,,,,,,,,,477.9,90,,percent of total billed charges,,,439.67,82.8,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,,,,,,,,467.28,88,,percent of total billed charges,,,,,,,,,405.68,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,132.75,22,,percent of total billed charges,,,483.21,91,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,,,,,,,,,,,,,440.73,83,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,435.42,82,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,132.75,504.45,
EACH ADDT'L 10% BODY SURFACE,81000202,CDM,11001,CPT,761,RC,outpatient,,416,416,,353.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,104,22,,percent of total billed charges,,,,,,,,,374.4,90,,percent of total billed charges,,,344.45,82.8,,percent of total billed charges,,,353.6,85,,percent of total billed charges,,,,,,,,,366.08,88,,percent of total billed charges,,,,,,,,,317.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,104,22,,percent of total billed charges,,,378.56,91,,percent of total billed charges,,,395.2,95,,percent of total billed charges,,,345.28,83,,percent of total billed charges,,,345.28,83,,percent of total billed charges,,,,,,,,,,,,,,,345.28,83,,percent of total billed charges,,,395.2,95,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,341.12,82,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,353.6,85,,percent of total billed charges,,104,395.2,
DEBRIDEMENT SKIN PARTIAL THICKNESS,81000203,CDM,11042,CPT,761,RC,outpatient,,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.75,22,,percent of total billed charges,,,,,,,,,542.7,90,,percent of total billed charges,,,499.28,82.8,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.75,22,,percent of total billed charges,,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,150.75,572.85,
DEBRIDEMENT SKIN FULL THICKNESS,81000204,CDM,11043,CPT,761,RC,outpatient,,715,715,,607.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178.75,22,,percent of total billed charges,,,,,,,,,643.5,90,,percent of total billed charges,,,592.02,82.8,,percent of total billed charges,,,607.75,85,,percent of total billed charges,,,,,,,,,629.2,88,,percent of total billed charges,,,,,,,,,546.26,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178.75,22,,percent of total billed charges,,,650.65,91,,percent of total billed charges,,,679.25,95,,percent of total billed charges,,,593.45,83,,percent of total billed charges,,,593.45,83,,percent of total billed charges,,,,,,,,,,,,,,,593.45,83,,percent of total billed charges,,,679.25,95,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,586.3,82,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,607.75,85,,percent of total billed charges,,178.75,679.25,
DEBRIDEMENT SKIN & SUBCUTANEOUS TISSUE,81000205,CDM,11042,CPT,761,RC,outpatient,,1622,1622,,1377.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,405.5,22,,percent of total billed charges,,,,,,,,,1459.8,90,,percent of total billed charges,,,1343.02,82.8,,percent of total billed charges,,,1378.7,85,,percent of total billed charges,,,,,,,,,1427.36,88,,percent of total billed charges,,,,,,,,,1239.21,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,405.5,22,,percent of total billed charges,,,1476.02,91,,percent of total billed charges,,,1540.9,95,,percent of total billed charges,,,1346.26,83,,percent of total billed charges,,,1346.26,83,,percent of total billed charges,,,,,,,,,,,,,,,1346.26,83,,percent of total billed charges,,,1540.9,95,,percent of total billed charges,,,1459.8,90,,percent of total billed charges,,,1459.8,90,,percent of total billed charges,,,1330.04,82,,percent of total billed charges,,,1459.8,90,,percent of total billed charges,,,1378.7,85,,percent of total billed charges,,405.5,1540.9,
DEBRIDE MUSC FAS<20,81000206,CDM,11043,CPT,761,RC,outpatient,,2071,2071,,1758.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,517.75,22,,percent of total billed charges,,,,,,,,,1863.9,90,,percent of total billed charges,,,1714.79,82.8,,percent of total billed charges,,,1760.35,85,,percent of total billed charges,,,,,,,,,1822.48,88,,percent of total billed charges,,,,,,,,,1582.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,517.75,22,,percent of total billed charges,,,1884.61,91,,percent of total billed charges,,,1967.45,95,,percent of total billed charges,,,1718.93,83,,percent of total billed charges,,,1718.93,83,,percent of total billed charges,,,,,,,,,,,,,,,1718.93,83,,percent of total billed charges,,,1967.45,95,,percent of total billed charges,,,1863.9,90,,percent of total billed charges,,,1863.9,90,,percent of total billed charges,,,1698.22,82,,percent of total billed charges,,,1863.9,90,,percent of total billed charges,,,1760.35,85,,percent of total billed charges,,517.75,1967.45,
DEBRIDEMENT BONE < 20,81000207,CDM,11044,CPT,761,RC,outpatient,,2951,2951,,2505.4,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,737.75,22,,percent of total billed charges,,,,,,,,,2655.9,90,,percent of total billed charges,,,2443.43,82.8,,percent of total billed charges,,,2508.35,85,,percent of total billed charges,,,,,,,,,2596.88,88,,percent of total billed charges,,,,,,,,,2254.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,737.75,22,,percent of total billed charges,,,2685.41,91,,percent of total billed charges,,,2803.45,95,,percent of total billed charges,,,2449.33,83,,percent of total billed charges,,,2449.33,83,,percent of total billed charges,,,,,,,,,,,,,,,2449.33,83,,percent of total billed charges,,,2803.45,95,,percent of total billed charges,,,2655.9,90,,percent of total billed charges,,,2655.9,90,,percent of total billed charges,,,2419.82,82,,percent of total billed charges,,,2655.9,90,,percent of total billed charges,,,2508.35,85,,percent of total billed charges,,737.75,2803.45,
NON-SELECTIVE DEBRIDEMENT,81000208,CDM,97602,CPT,761,RC,outpatient,,756,756,,641.84,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,189,22,,percent of total billed charges,,,,,,,,,680.4,90,,percent of total billed charges,,,625.97,82.8,,percent of total billed charges,,,642.6,85,,percent of total billed charges,,,,,,,,,665.28,88,,percent of total billed charges,,,,,,,,,577.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,189,22,,percent of total billed charges,,,687.96,91,,percent of total billed charges,,,718.2,95,,percent of total billed charges,,,627.48,83,,percent of total billed charges,,,627.48,83,,percent of total billed charges,,,,,,,,,,,,,,,627.48,83,,percent of total billed charges,,,718.2,95,,percent of total billed charges,,,680.4,90,,percent of total billed charges,,,680.4,90,,percent of total billed charges,,,619.92,82,,percent of total billed charges,,,680.4,90,,percent of total billed charges,,,642.6,85,,percent of total billed charges,,189,718.2,
"SEL DEBRIDEMENT, 20 SQ CM OR LESS",81000210,CDM,97597,CPT,761,RC,outpatient,,255,255,,216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.75,22,,percent of total billed charges,,,,,,,,,229.5,90,,percent of total billed charges,,,211.14,82.8,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,,,,,,,,224.4,88,,percent of total billed charges,,,,,,,,,194.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.75,22,,percent of total billed charges,,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,209.1,82,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,63.75,242.25,
"SEL DEBRIDEMENT, GREATER THAN 20 SQ CM",81000211,CDM,97598,CPT,761,RC,outpatient,,381,381,,323.47,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,95.25,22,,percent of total billed charges,,,,,,,,,342.9,90,,percent of total billed charges,,,315.47,82.8,,percent of total billed charges,,,323.85,85,,percent of total billed charges,,,,,,,,,335.28,88,,percent of total billed charges,,,,,,,,,291.08,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,95.25,22,,percent of total billed charges,,,346.71,91,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,,,,,,,,,,,,,316.23,83,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,312.42,82,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,323.85,85,,percent of total billed charges,,95.25,361.95,
NEG PRESSURE WOUND THER 50 SQ CM OR LESS,81000212,CDM,97605,CPT,761,RC,outpatient,,444,444,,376.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,111,22,,percent of total billed charges,,,,,,,,,399.6,90,,percent of total billed charges,,,367.63,82.8,,percent of total billed charges,,,377.4,85,,percent of total billed charges,,,,,,,,,390.72,88,,percent of total billed charges,,,,,,,,,339.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,111,22,,percent of total billed charges,,,404.04,91,,percent of total billed charges,,,421.8,95,,percent of total billed charges,,,368.52,83,,percent of total billed charges,,,368.52,83,,percent of total billed charges,,,,,,,,,,,,,,,368.52,83,,percent of total billed charges,,,421.8,95,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,364.08,82,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,377.4,85,,percent of total billed charges,,111,421.8,
NEG PRESSURE WOUND THERAPY > 50 SQ CM,81000213,CDM,97606,CPT,761,RC,outpatient,,668,668,,567.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,167,22,,percent of total billed charges,,,,,,,,,601.2,90,,percent of total billed charges,,,553.1,82.8,,percent of total billed charges,,,567.8,85,,percent of total billed charges,,,,,,,,,587.84,88,,percent of total billed charges,,,,,,,,,510.35,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,167,22,,percent of total billed charges,,,607.88,91,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,554.44,83,,percent of total billed charges,,,,,,,,,,,,,,,554.44,83,,percent of total billed charges,,,634.6,95,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,547.76,82,,percent of total billed charges,,,601.2,90,,percent of total billed charges,,,567.8,85,,percent of total billed charges,,167,634.6,
NEG PRESS WOUND TX 50 SQ CM  REDUCED SER,81000214,CDM,97605,CPT,761,RC,outpatient,52,444,444,,376.96,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,111,22,,percent of total billed charges,,,,,,,,,399.6,90,,percent of total billed charges,,,367.63,82.8,,percent of total billed charges,,,377.4,85,,percent of total billed charges,,,,,,,,,390.72,88,,percent of total billed charges,,,,,,,,,339.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,111,22,,percent of total billed charges,,,404.04,91,,percent of total billed charges,,,421.8,95,,percent of total billed charges,,,368.52,83,,percent of total billed charges,,,368.52,83,,percent of total billed charges,,,,,,,,,,,,,,,368.52,83,,percent of total billed charges,,,421.8,95,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,364.08,82,,percent of total billed charges,,,399.6,90,,percent of total billed charges,,,377.4,85,,percent of total billed charges,,111,421.8,
DEBRIDE SUBQ EA ADDTL 20 SQCM,81000215,CDM,11045,CPT,761,RC,outpatient,,1307,1307,,1109.64,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,326.75,22,,percent of total billed charges,,,,,,,,,1176.3,90,,percent of total billed charges,,,1082.2,82.8,,percent of total billed charges,,,1110.95,85,,percent of total billed charges,,,,,,,,,1150.16,88,,percent of total billed charges,,,,,,,,,998.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,326.75,22,,percent of total billed charges,,,1189.37,91,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,,,,,,,,,,,,,1084.81,83,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1071.74,82,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1110.95,85,,percent of total billed charges,,326.75,1241.65,
DEBRIDE MUSC FAS EA ADDTL <20,81000216,CDM,11046,CPT,761,RC,outpatient,,1440,1440,,1222.56,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,360,22,,percent of total billed charges,,,,,,,,,1296,90,,percent of total billed charges,,,1192.32,82.8,,percent of total billed charges,,,1224,85,,percent of total billed charges,,,,,,,,,1267.2,88,,percent of total billed charges,,,,,,,,,1100.16,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,360,22,,percent of total billed charges,,,1310.4,91,,percent of total billed charges,,,1368,95,,percent of total billed charges,,,1195.2,83,,percent of total billed charges,,,1195.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1195.2,83,,percent of total billed charges,,,1368,95,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1180.8,82,,percent of total billed charges,,,1296,90,,percent of total billed charges,,,1224,85,,percent of total billed charges,,360,1368,
DEBRIDEMENT BONE EA ADDTL < 20,81000217,CDM,11047,CPT,761,RC,outpatient,,2623,2623,,2226.93,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,655.75,22,,percent of total billed charges,,,,,,,,,2360.7,90,,percent of total billed charges,,,2171.84,82.8,,percent of total billed charges,,,2229.55,85,,percent of total billed charges,,,,,,,,,2308.24,88,,percent of total billed charges,,,,,,,,,2003.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,655.75,22,,percent of total billed charges,,,2386.93,91,,percent of total billed charges,,,2491.85,95,,percent of total billed charges,,,2177.09,83,,percent of total billed charges,,,2177.09,83,,percent of total billed charges,,,,,,,,,,,,,,,2177.09,83,,percent of total billed charges,,,2491.85,95,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2150.86,82,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2229.55,85,,percent of total billed charges,,655.75,2491.85,
DERMAGRAFT 1 SQCM USED,81000218,CDM,Q4106,HCPCS,761,RC,outpatient,,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.75,22,,percent of total billed charges,,,,,,,,,225.9,90,,percent of total billed charges,,,207.83,82.8,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.75,22,,percent of total billed charges,,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,62.75,238.45,
DERMAGRAFT 1 SQCM NOT USED,81000219,CDM,Q4106,HCPCS,761,RC,outpatient,JW,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.75,22,,percent of total billed charges,,,,,,,,,225.9,90,,percent of total billed charges,,,207.83,82.8,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.75,22,,percent of total billed charges,,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,62.75,238.45,
PARE/CUT BENIGH HYPERKERATOTIC SGL LES,81000220,CDM,11055,CPT,761,RC,outpatient,,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116,22,,percent of total billed charges,,,,,,,,,417.6,90,,percent of total billed charges,,,384.19,82.8,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116,22,,percent of total billed charges,,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,116,440.8,
PARE/CUT BENIGH HYPERKERATOTIC 2-4 LES,81000221,CDM,11056,CPT,761,RC,outpatient,,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116,22,,percent of total billed charges,,,,,,,,,417.6,90,,percent of total billed charges,,,384.19,82.8,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116,22,,percent of total billed charges,,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,116,440.8,
PARE/CUT BENIGH HYPERKERATOTIC >4 LES,81000222,CDM,11057,CPT,761,RC,outpatient,,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.5,22,,percent of total billed charges,,,,,,,,,419.4,90,,percent of total billed charges,,,385.85,82.8,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.5,22,,percent of total billed charges,,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,116.5,442.7,
REMOVAL SKIN TAGS 15 OR LESS,81000225,CDM,11200,CPT,761,RC,outpatient,,313,313,,265.74,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,78.25,22,,percent of total billed charges,,,,,,,,,281.7,90,,percent of total billed charges,,,259.16,82.8,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,,,,,,,,275.44,88,,percent of total billed charges,,,,,,,,,239.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,78.25,22,,percent of total billed charges,,,284.83,91,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,,,,,,,,,,,,,259.79,83,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,256.66,82,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,78.25,297.35,
BX SKIN/SQ TISSUE MUCOUS MEMBRANE SNGL,81000240,CDM,11102,CPT,761,RC,outpatient,,581,581,,493.27,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,145.25,22,,percent of total billed charges,,,,,,,,,522.9,90,,percent of total billed charges,,,481.07,82.8,,percent of total billed charges,,,493.85,85,,percent of total billed charges,,,,,,,,,511.28,88,,percent of total billed charges,,,,,,,,,443.88,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,145.25,22,,percent of total billed charges,,,528.71,91,,percent of total billed charges,,,551.95,95,,percent of total billed charges,,,482.23,83,,percent of total billed charges,,,482.23,83,,percent of total billed charges,,,,,,,,,,,,,,,482.23,83,,percent of total billed charges,,,551.95,95,,percent of total billed charges,,,522.9,90,,percent of total billed charges,,,522.9,90,,percent of total billed charges,,,476.42,82,,percent of total billed charges,,,522.9,90,,percent of total billed charges,,,493.85,85,,percent of total billed charges,,145.25,551.95,
"BX SKIN, EA SEPARATE/ADDT'L LESION",81000241,CDM,11103,CPT,761,RC,outpatient,,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.5,22,,percent of total billed charges,,,,,,,,,394.2,90,,percent of total billed charges,,,362.66,82.8,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.5,22,,percent of total billed charges,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,109.5,416.1,
"BX BONE, TROCAR OR NEEDLE, SUPERFICIAL",81000242,CDM,20220,CPT,761,RC,outpatient,,1995,1995,,1693.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,498.75,22,,percent of total billed charges,,,,,,,,,1795.5,90,,percent of total billed charges,,,1651.86,82.8,,percent of total billed charges,,,1695.75,85,,percent of total billed charges,,,,,,,,,1755.6,88,,percent of total billed charges,,,,,,,,,1524.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,498.75,22,,percent of total billed charges,,,1815.45,91,,percent of total billed charges,,,1895.25,95,,percent of total billed charges,,,1655.85,83,,percent of total billed charges,,,1655.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1655.85,83,,percent of total billed charges,,,1895.25,95,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1635.9,82,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1695.75,85,,percent of total billed charges,,498.75,1895.25,
"BX BONE,OPEN;SUPERFICIAL",81000243,CDM,20240,CPT,761,RC,outpatient,,5618,5618,,4769.68,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1404.5,22,,percent of total billed charges,,,,,,,,,5056.2,90,,percent of total billed charges,,,4651.7,82.8,,percent of total billed charges,,,4775.3,85,,percent of total billed charges,,,,,,,,,4943.84,88,,percent of total billed charges,,,,,,,,,4292.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1404.5,22,,percent of total billed charges,,,5112.38,91,,percent of total billed charges,,,5337.1,95,,percent of total billed charges,,,4662.94,83,,percent of total billed charges,,,4662.94,83,,percent of total billed charges,,,,,,,,,,,,,,,4662.94,83,,percent of total billed charges,,,5337.1,95,,percent of total billed charges,,,5056.2,90,,percent of total billed charges,,,5056.2,90,,percent of total billed charges,,,4606.76,82,,percent of total billed charges,,,5056.2,90,,percent of total billed charges,,,4775.3,85,,percent of total billed charges,,1404.5,5337.1,
TRIM NAILS NONDYSTROPHIC,81000250,CDM,11719,CPT,761,RC,outpatient,,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
INC/DRAIN ABSCESS - SIMPLE OR SINGLE,81000260,CDM,10060,CPT,761,RC,outpatient,,1335,1335,,1133.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,333.75,22,,percent of total billed charges,,,,,,,,,1201.5,90,,percent of total billed charges,,,1105.38,82.8,,percent of total billed charges,,,1134.75,85,,percent of total billed charges,,,,,,,,,1174.8,88,,percent of total billed charges,,,,,,,,,1019.94,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,333.75,22,,percent of total billed charges,,,1214.85,91,,percent of total billed charges,,,1268.25,95,,percent of total billed charges,,,1108.05,83,,percent of total billed charges,,,1108.05,83,,percent of total billed charges,,,,,,,,,,,,,,,1108.05,83,,percent of total billed charges,,,1268.25,95,,percent of total billed charges,,,1201.5,90,,percent of total billed charges,,,1201.5,90,,percent of total billed charges,,,1094.7,82,,percent of total billed charges,,,1201.5,90,,percent of total billed charges,,,1134.75,85,,percent of total billed charges,,333.75,1268.25,
INC/DRAIN ABSCESS - COMPLICATED OR MULT,81000261,CDM,10061,CPT,761,RC,outpatient,,477,477,,404.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.25,22,,percent of total billed charges,,,,,,,,,429.3,90,,percent of total billed charges,,,394.96,82.8,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,,,,,,,,419.76,88,,percent of total billed charges,,,,,,,,,364.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.25,22,,percent of total billed charges,,,434.07,91,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,,,,,,,,,,,,,395.91,83,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,391.14,82,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,119.25,453.15,
"INC/DRAIN HEMATOMA,SEROMA,FLUID COLLECT",81000262,CDM,10140,CPT,761,RC,outpatient,,2871,2871,,2437.48,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,717.75,22,,percent of total billed charges,,,,,,,,,2583.9,90,,percent of total billed charges,,,2377.19,82.8,,percent of total billed charges,,,2440.35,85,,percent of total billed charges,,,,,,,,,2526.48,88,,percent of total billed charges,,,,,,,,,2193.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,717.75,22,,percent of total billed charges,,,2612.61,91,,percent of total billed charges,,,2727.45,95,,percent of total billed charges,,,2382.93,83,,percent of total billed charges,,,2382.93,83,,percent of total billed charges,,,,,,,,,,,,,,,2382.93,83,,percent of total billed charges,,,2727.45,95,,percent of total billed charges,,,2583.9,90,,percent of total billed charges,,,2583.9,90,,percent of total billed charges,,,2354.22,82,,percent of total billed charges,,,2583.9,90,,percent of total billed charges,,,2440.35,85,,percent of total billed charges,,717.75,2727.45,
"PUNC ASP ABSCESS,HEMATOMA,BULLA OR CYST",81000263,CDM,10160,CPT,761,RC,outpatient,,457,457,,387.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,114.25,22,,percent of total billed charges,,,,,,,,,411.3,90,,percent of total billed charges,,,378.4,82.8,,percent of total billed charges,,,388.45,85,,percent of total billed charges,,,,,,,,,402.16,88,,percent of total billed charges,,,,,,,,,349.15,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,114.25,22,,percent of total billed charges,,,415.87,91,,percent of total billed charges,,,434.15,95,,percent of total billed charges,,,379.31,83,,percent of total billed charges,,,379.31,83,,percent of total billed charges,,,,,,,,,,,,,,,379.31,83,,percent of total billed charges,,,434.15,95,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,374.74,82,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,388.45,85,,percent of total billed charges,,114.25,434.15,
"INC/DRAIN, COMPLEX, POST-OP WOUND INF",81000264,CDM,10180,CPT,761,RC,outpatient,,7314,7314,,6209.59,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1828.5,22,,percent of total billed charges,,,,,,,,,6582.6,90,,percent of total billed charges,,,6055.99,82.8,,percent of total billed charges,,,6216.9,85,,percent of total billed charges,,,,,,,,,6436.32,88,,percent of total billed charges,,,,,,,,,5587.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1828.5,22,,percent of total billed charges,,,6655.74,91,,percent of total billed charges,,,6948.3,95,,percent of total billed charges,,,6070.62,83,,percent of total billed charges,,,6070.62,83,,percent of total billed charges,,,,,,,,,,,,,,,6070.62,83,,percent of total billed charges,,,6948.3,95,,percent of total billed charges,,,6582.6,90,,percent of total billed charges,,,6582.6,90,,percent of total billed charges,,,5997.48,82,,percent of total billed charges,,,6582.6,90,,percent of total billed charges,,,6216.9,85,,percent of total billed charges,,1828.5,6948.3,
TENOTOMY OPEN EXTENSOR FOOT/TOE TENDON,81000270,CDM,28234,CPT,761,RC,outpatient,,4390,4390,,3727.11,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1097.5,22,,percent of total billed charges,,,,,,,,,3951,90,,percent of total billed charges,,,3634.92,82.8,,percent of total billed charges,,,3731.5,85,,percent of total billed charges,,,,,,,,,3863.2,88,,percent of total billed charges,,,,,,,,,3353.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1097.5,22,,percent of total billed charges,,,3994.9,91,,percent of total billed charges,,,4170.5,95,,percent of total billed charges,,,3643.7,83,,percent of total billed charges,,,3643.7,83,,percent of total billed charges,,,,,,,,,,,,,,,3643.7,83,,percent of total billed charges,,,4170.5,95,,percent of total billed charges,,,3951,90,,percent of total billed charges,,,3951,90,,percent of total billed charges,,,3599.8,82,,percent of total billed charges,,,3951,90,,percent of total billed charges,,,3731.5,85,,percent of total billed charges,,1097.5,4170.5,
"DEBRIDEMENT OF NAIL(S), ANY METHOD, 1-5",81000280,CDM,11720,CPT,761,RC,outpatient,,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.25,22,,percent of total billed charges,,,,,,,,,299.7,90,,percent of total billed charges,,,275.72,82.8,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.25,22,,percent of total billed charges,,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,83.25,316.35,
"DEBRIDEMENT NAILS, ANY METHOD, 6 OR MORE",81000281,CDM,11721,CPT,761,RC,outpatient,,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.25,22,,percent of total billed charges,,,,,,,,,422.1,90,,percent of total billed charges,,,388.33,82.8,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.25,22,,percent of total billed charges,,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,117.25,445.55,
"AVULSION NAIL PLATE, PTL OR COMP, SNGL",81000282,CDM,11730,CPT,761,RC,outpatient,,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.5,22,,percent of total billed charges,,,,,,,,,394.2,90,,percent of total billed charges,,,362.66,82.8,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.5,22,,percent of total billed charges,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,109.5,416.1,
AVULSION EA ADDT'L NAIL PLATE,81000283,CDM,11732,CPT,761,RC,outpatient,,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.25,22,,percent of total billed charges,,,,,,,,,321.3,90,,percent of total billed charges,,,295.6,82.8,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.25,22,,percent of total billed charges,,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,89.25,339.15,
"EXCISION NAIL & NAIL MATRIX, PTL OR COMP",81000284,CDM,11750,CPT,761,RC,outpatient,,1282,1282,,1088.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,320.5,22,,percent of total billed charges,,,,,,,,,1153.8,90,,percent of total billed charges,,,1061.5,82.8,,percent of total billed charges,,,1089.7,85,,percent of total billed charges,,,,,,,,,1128.16,88,,percent of total billed charges,,,,,,,,,979.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,320.5,22,,percent of total billed charges,,,1166.62,91,,percent of total billed charges,,,1217.9,95,,percent of total billed charges,,,1064.06,83,,percent of total billed charges,,,1064.06,83,,percent of total billed charges,,,,,,,,,,,,,,,1064.06,83,,percent of total billed charges,,,1217.9,95,,percent of total billed charges,,,1153.8,90,,percent of total billed charges,,,1153.8,90,,percent of total billed charges,,,1051.24,82,,percent of total billed charges,,,1153.8,90,,percent of total billed charges,,,1089.7,85,,percent of total billed charges,,320.5,1217.9,
"INIT PREP OF TAL SITE, FIRST 100 SQ CM",81000290,CDM,15002,CPT,761,RC,outpatient,,2999,2999,,2546.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,749.75,22,,percent of total billed charges,,,,,,,,,2699.1,90,,percent of total billed charges,,,2483.17,82.8,,percent of total billed charges,,,2549.15,85,,percent of total billed charges,,,,,,,,,2639.12,88,,percent of total billed charges,,,,,,,,,2291.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,749.75,22,,percent of total billed charges,,,2729.09,91,,percent of total billed charges,,,2849.05,95,,percent of total billed charges,,,2489.17,83,,percent of total billed charges,,,2489.17,83,,percent of total billed charges,,,,,,,,,,,,,,,2489.17,83,,percent of total billed charges,,,2849.05,95,,percent of total billed charges,,,2699.1,90,,percent of total billed charges,,,2699.1,90,,percent of total billed charges,,,2459.18,82,,percent of total billed charges,,,2699.1,90,,percent of total billed charges,,,2549.15,85,,percent of total billed charges,,749.75,2849.05,
"INIT PREP OF ENTF SITE, FIRST 100 SQ CM",81000291,CDM,15004,CPT,761,RC,outpatient,,2999,2999,,2546.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,749.75,22,,percent of total billed charges,,,,,,,,,2699.1,90,,percent of total billed charges,,,2483.17,82.8,,percent of total billed charges,,,2549.15,85,,percent of total billed charges,,,,,,,,,2639.12,88,,percent of total billed charges,,,,,,,,,2291.24,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,749.75,22,,percent of total billed charges,,,2729.09,91,,percent of total billed charges,,,2849.05,95,,percent of total billed charges,,,2489.17,83,,percent of total billed charges,,,2489.17,83,,percent of total billed charges,,,,,,,,,,,,,,,2489.17,83,,percent of total billed charges,,,2849.05,95,,percent of total billed charges,,,2699.1,90,,percent of total billed charges,,,2699.1,90,,percent of total billed charges,,,2459.18,82,,percent of total billed charges,,,2699.1,90,,percent of total billed charges,,,2549.15,85,,percent of total billed charges,,749.75,2849.05,
"SURG SITE PREP TAL, EA ADDT'L 100 SQ CM",81000292,CDM,15003,CPT,761,RC,outpatient,,2748,2748,,2333.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,687,22,,percent of total billed charges,,,,,,,,,2473.2,90,,percent of total billed charges,,,2275.34,82.8,,percent of total billed charges,,,2335.8,85,,percent of total billed charges,,,,,,,,,2418.24,88,,percent of total billed charges,,,,,,,,,2099.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,687,22,,percent of total billed charges,,,2500.68,91,,percent of total billed charges,,,2610.6,95,,percent of total billed charges,,,2280.84,83,,percent of total billed charges,,,2280.84,83,,percent of total billed charges,,,,,,,,,,,,,,,2280.84,83,,percent of total billed charges,,,2610.6,95,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2253.36,82,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2335.8,85,,percent of total billed charges,,687,2610.6,
"SURG SITE EMTF PREP, EA ADDT'L 100 SQ CM",81000293,CDM,15005,CPT,761,RC,outpatient,,2748,2748,,2333.05,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,687,22,,percent of total billed charges,,,,,,,,,2473.2,90,,percent of total billed charges,,,2275.34,82.8,,percent of total billed charges,,,2335.8,85,,percent of total billed charges,,,,,,,,,2418.24,88,,percent of total billed charges,,,,,,,,,2099.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,687,22,,percent of total billed charges,,,2500.68,91,,percent of total billed charges,,,2610.6,95,,percent of total billed charges,,,2280.84,83,,percent of total billed charges,,,2280.84,83,,percent of total billed charges,,,,,,,,,,,,,,,2280.84,83,,percent of total billed charges,,,2610.6,95,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2253.36,82,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2335.8,85,,percent of total billed charges,,687,2610.6,
"PINCH GRAFT, UP TO 2 CM DIAMETER",81000302,CDM,15050,CPT,761,RC,outpatient,,3125,3125,,2653.13,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,781.25,22,,percent of total billed charges,,,,,,,,,2812.5,90,,percent of total billed charges,,,2587.5,82.8,,percent of total billed charges,,,2656.25,85,,percent of total billed charges,,,,,,,,,2750,88,,percent of total billed charges,,,,,,,,,2387.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,781.25,22,,percent of total billed charges,,,2843.75,91,,percent of total billed charges,,,2968.75,95,,percent of total billed charges,,,2593.75,83,,percent of total billed charges,,,2593.75,83,,percent of total billed charges,,,,,,,,,,,,,,,2593.75,83,,percent of total billed charges,,,2968.75,95,,percent of total billed charges,,,2812.5,90,,percent of total billed charges,,,2812.5,90,,percent of total billed charges,,,2562.5,82,,percent of total billed charges,,,2812.5,90,,percent of total billed charges,,,2656.25,85,,percent of total billed charges,,781.25,2968.75,
APL APLIGRAF SKIN SUBS/NEO 1ST 25 SQ CM,81000303,CDM,15271,CPT,761,RC,outpatient,,2011,2011,,1707.34,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,502.75,22,,percent of total billed charges,,,,,,,,,1809.9,90,,percent of total billed charges,,,1665.11,82.8,,percent of total billed charges,,,1709.35,85,,percent of total billed charges,,,,,,,,,1769.68,88,,percent of total billed charges,,,,,,,,,1536.4,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,502.75,22,,percent of total billed charges,,,1830.01,91,,percent of total billed charges,,,1910.45,95,,percent of total billed charges,,,1669.13,83,,percent of total billed charges,,,1669.13,83,,percent of total billed charges,,,,,,,,,,,,,,,1669.13,83,,percent of total billed charges,,,1910.45,95,,percent of total billed charges,,,1809.9,90,,percent of total billed charges,,,1809.9,90,,percent of total billed charges,,,1649.02,82,,percent of total billed charges,,,1809.9,90,,percent of total billed charges,,,1709.35,85,,percent of total billed charges,,502.75,1910.45,
APL APLIG SKIN SUBS/NEODERM ADD 25 SQ CM,81000304,CDM,15271,CPT,761,RC,outpatient,,2010,2010,,1706.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,502.5,22,,percent of total billed charges,,,,,,,,,1809,90,,percent of total billed charges,,,1664.28,82.8,,percent of total billed charges,,,1708.5,85,,percent of total billed charges,,,,,,,,,1768.8,88,,percent of total billed charges,,,,,,,,,1535.64,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,502.5,22,,percent of total billed charges,,,1829.1,91,,percent of total billed charges,,,1909.5,95,,percent of total billed charges,,,1668.3,83,,percent of total billed charges,,,1668.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1668.3,83,,percent of total billed charges,,,1909.5,95,,percent of total billed charges,,,1809,90,,percent of total billed charges,,,1809,90,,percent of total billed charges,,,1648.2,82,,percent of total billed charges,,,1809,90,,percent of total billed charges,,,1708.5,85,,percent of total billed charges,,502.5,1909.5,
APPLY DERMAGRAFT 100,81000305,CDM,15727,CPT,761,RC,outpatient,,1366,1366,,1159.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,341.5,22,,percent of total billed charges,,,,,,,,,1229.4,90,,percent of total billed charges,,,1131.05,82.8,,percent of total billed charges,,,1161.1,85,,percent of total billed charges,,,,,,,,,1202.08,88,,percent of total billed charges,,,,,,,,,1043.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,341.5,22,,percent of total billed charges,,,1243.06,91,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1133.78,83,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1120.12,82,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1161.1,85,,percent of total billed charges,,341.5,1297.7,
APPL OASIS 1ST 100 SQCM,81000307,CDM,15271,CPT,761,RC,outpatient,,2184,2184,,1854.22,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,546,22,,percent of total billed charges,,,,,,,,,1965.6,90,,percent of total billed charges,,,1808.35,82.8,,percent of total billed charges,,,1856.4,85,,percent of total billed charges,,,,,,,,,1921.92,88,,percent of total billed charges,,,,,,,,,1668.58,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,546,22,,percent of total billed charges,,,1987.44,91,,percent of total billed charges,,,2074.8,95,,percent of total billed charges,,,1812.72,83,,percent of total billed charges,,,1812.72,83,,percent of total billed charges,,,,,,,,,,,,,,,1812.72,83,,percent of total billed charges,,,2074.8,95,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1790.88,82,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1856.4,85,,percent of total billed charges,,546,2074.8,
"APPL XENOGRAFT,SKIN; EA ADDT'L 100 SQ CM",81000308,CDM,15274,CPT,761,RC,outpatient,,1995,1995,,1693.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,498.75,22,,percent of total billed charges,,,,,,,,,1795.5,90,,percent of total billed charges,,,1651.86,82.8,,percent of total billed charges,,,1695.75,85,,percent of total billed charges,,,,,,,,,1755.6,88,,percent of total billed charges,,,,,,,,,1524.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,498.75,22,,percent of total billed charges,,,1815.45,91,,percent of total billed charges,,,1895.25,95,,percent of total billed charges,,,1655.85,83,,percent of total billed charges,,,1655.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1655.85,83,,percent of total billed charges,,,1895.25,95,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1635.9,82,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1695.75,85,,percent of total billed charges,,498.75,1895.25,
"DERMAL TISSUE, HUMAN ORIGIN PER44 SQ CM",81000310,CDM,Q4101,HCPCS,278,RC,outpatient,,6614,6614,,5615.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1653.5,22,,percent of total billed charges,,,,,,,,,5952.6,90,,percent of total billed charges,,,5476.39,82.8,,percent of total billed charges,,,5621.9,85,,percent of total billed charges,,,,,,,,,5820.32,88,,percent of total billed charges,,,,,,,,,5053.1,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1653.5,22,,percent of total billed charges,,,6018.74,91,,percent of total billed charges,,,6283.3,95,,percent of total billed charges,,,5489.62,83,,percent of total billed charges,,,5489.62,83,,percent of total billed charges,,,,,,,,,,,,,,,5489.62,83,,percent of total billed charges,,,6283.3,95,,percent of total billed charges,,,5952.6,90,,percent of total billed charges,,,5952.6,90,,percent of total billed charges,,,5423.48,82,,percent of total billed charges,,,5952.6,90,,percent of total billed charges,,,5621.9,85,,percent of total billed charges,,1653.5,6283.3,
"DERMAL TISSUE, HUMAN ORIGIN PER SQ CM",81000312,CDM,Q4106,HCPCS,636,RC,outpatient,,4248,4248,,3606.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1062,22,,percent of total billed charges,,,,,,,,,3823.2,90,,percent of total billed charges,,,3517.34,82.8,,percent of total billed charges,,,3610.8,85,,percent of total billed charges,,,,,,,,,3738.24,88,,percent of total billed charges,,,,,,,,,3245.47,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1062,22,,percent of total billed charges,,,3865.68,91,,percent of total billed charges,,,4035.6,95,,percent of total billed charges,,,3525.84,83,,percent of total billed charges,,,3525.84,83,,percent of total billed charges,,,,,,,,,,,,,,,3525.84,83,,percent of total billed charges,,,4035.6,95,,percent of total billed charges,,,3823.2,90,,percent of total billed charges,,,3823.2,90,,percent of total billed charges,,,3483.36,82,,percent of total billed charges,,,3823.2,90,,percent of total billed charges,,,3610.8,85,,percent of total billed charges,,1062,4035.6,
HARVEST SKIN FOR TISSUE CULT AUTOGRAFT,81000314,CDM,15040,CPT,761,RC,outpatient,,2199,2199,,1866.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,549.75,22,,percent of total billed charges,,,,,,,,,1979.1,90,,percent of total billed charges,,,1820.77,82.8,,percent of total billed charges,,,1869.15,85,,percent of total billed charges,,,,,,,,,1935.12,88,,percent of total billed charges,,,,,,,,,1680.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,549.75,22,,percent of total billed charges,,,2001.09,91,,percent of total billed charges,,,2089.05,95,,percent of total billed charges,,,1825.17,83,,percent of total billed charges,,,1825.17,83,,percent of total billed charges,,,,,,,,,,,,,,,1825.17,83,,percent of total billed charges,,,2089.05,95,,percent of total billed charges,,,1979.1,90,,percent of total billed charges,,,1979.1,90,,percent of total billed charges,,,1803.18,82,,percent of total billed charges,,,1979.1,90,,percent of total billed charges,,,1869.15,85,,percent of total billed charges,,549.75,2089.05,
APL OASIS EA ADDTL 100 SQCM,81000324,CDM,15274,CPT,761,RC,outpatient,,1995,1995,,1693.76,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,498.75,22,,percent of total billed charges,,,,,,,,,1795.5,90,,percent of total billed charges,,,1651.86,82.8,,percent of total billed charges,,,1695.75,85,,percent of total billed charges,,,,,,,,,1755.6,88,,percent of total billed charges,,,,,,,,,1524.18,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,498.75,22,,percent of total billed charges,,,1815.45,91,,percent of total billed charges,,,1895.25,95,,percent of total billed charges,,,1655.85,83,,percent of total billed charges,,,1655.85,83,,percent of total billed charges,,,,,,,,,,,,,,,1655.85,83,,percent of total billed charges,,,1895.25,95,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1635.9,82,,percent of total billed charges,,,1795.5,90,,percent of total billed charges,,,1695.75,85,,percent of total billed charges,,498.75,1895.25,
APPLY DERMAGRAFT + 100 SQCM,81000325,CDM,15278,CPT,761,RC,outpatient,,1366,1366,,1159.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,341.5,22,,percent of total billed charges,,,,,,,,,1229.4,90,,percent of total billed charges,,,1131.05,82.8,,percent of total billed charges,,,1161.1,85,,percent of total billed charges,,,,,,,,,1202.08,88,,percent of total billed charges,,,,,,,,,1043.62,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,341.5,22,,percent of total billed charges,,,1243.06,91,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,1133.78,83,,percent of total billed charges,,,,,,,,,,,,,,,1133.78,83,,percent of total billed charges,,,1297.7,95,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1120.12,82,,percent of total billed charges,,,1229.4,90,,percent of total billed charges,,,1161.1,85,,percent of total billed charges,,341.5,1297.7,
"DRESSINGS/DEBRIDEMENT BURNS, SMALL",81000350,CDM,16020,CPT,761,RC,outpatient,,432,432,,366.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,108,22,,percent of total billed charges,,,,,,,,,388.8,90,,percent of total billed charges,,,357.7,82.8,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,,,,,,,,380.16,88,,percent of total billed charges,,,,,,,,,330.05,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,108,22,,percent of total billed charges,,,393.12,91,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,358.56,83,,percent of total billed charges,,,,,,,,,,,,,,,358.56,83,,percent of total billed charges,,,410.4,95,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,354.24,82,,percent of total billed charges,,,388.8,90,,percent of total billed charges,,,367.2,85,,percent of total billed charges,,108,410.4,
"DRESSINGS/DEBRIDEMENT BURNS, MEDIUM",81000351,CDM,16025,CPT,761,RC,outpatient,,477,477,,404.97,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,119.25,22,,percent of total billed charges,,,,,,,,,429.3,90,,percent of total billed charges,,,394.96,82.8,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,,,,,,,,419.76,88,,percent of total billed charges,,,,,,,,,364.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,119.25,22,,percent of total billed charges,,,434.07,91,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,,,,,,,,,,,,,395.91,83,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,391.14,82,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,119.25,453.15,
"DRESSINGS/DEBRIDEMENT BURNS, LARGE",81000352,CDM,16030,CPT,761,RC,outpatient,,678,678,,575.62,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,169.5,22,,percent of total billed charges,,,,,,,,,610.2,90,,percent of total billed charges,,,561.38,82.8,,percent of total billed charges,,,576.3,85,,percent of total billed charges,,,,,,,,,596.64,88,,percent of total billed charges,,,,,,,,,517.99,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,169.5,22,,percent of total billed charges,,,616.98,91,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,,,,,,,,,,,,,562.74,83,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,555.96,82,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,576.3,85,,percent of total billed charges,,169.5,644.1,
CHEMICAL CAUTER GRANULATION TISSUE,81000370,CDM,17250,CPT,761,RC,outpatient,,712,712,,604.49,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,178,22,,percent of total billed charges,,,,,,,,,640.8,90,,percent of total billed charges,,,589.54,82.8,,percent of total billed charges,,,605.2,85,,percent of total billed charges,,,,,,,,,626.56,88,,percent of total billed charges,,,,,,,,,543.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,178,22,,percent of total billed charges,,,647.92,91,,percent of total billed charges,,,676.4,95,,percent of total billed charges,,,590.96,83,,percent of total billed charges,,,590.96,83,,percent of total billed charges,,,,,,,,,,,,,,,590.96,83,,percent of total billed charges,,,676.4,95,,percent of total billed charges,,,640.8,90,,percent of total billed charges,,,640.8,90,,percent of total billed charges,,,583.84,82,,percent of total billed charges,,,640.8,90,,percent of total billed charges,,,605.2,85,,percent of total billed charges,,178,676.4,
"CHEMICAL CAUTERIZATION, 1ST LESION",81000371,CDM,17000,CPT,761,RC,outpatient,,255,255,,216.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,63.75,22,,percent of total billed charges,,,,,,,,,229.5,90,,percent of total billed charges,,,211.14,82.8,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,,,,,,,,224.4,88,,percent of total billed charges,,,,,,,,,194.82,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,63.75,22,,percent of total billed charges,,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,209.1,82,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,63.75,242.25,
"CHEM CAUTERIZATION, 2ND THRU 14TH LESION",81000372,CDM,17003,CPT,761,RC,outpatient,,227,227,,192.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.75,22,,percent of total billed charges,,,,,,,,,204.3,90,,percent of total billed charges,,,187.96,82.8,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,,,,,,,,199.76,88,,percent of total billed charges,,,,,,,,,173.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.75,22,,percent of total billed charges,,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,,,,,,,,,,,,,188.41,83,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,186.14,82,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,56.75,215.65,
PARE/CUT BENIGH HYPERKERATOTIC SGL LES,81000373,CDM,11055,CPT,761,RC,outpatient,Q7,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116,22,,percent of total billed charges,,,,,,,,,417.6,90,,percent of total billed charges,,,384.19,82.8,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116,22,,percent of total billed charges,,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,116,440.8,
PARE/CUT BENIGH HYPERKERATOTIC SGL LES,81000374,CDM,11055,CPT,761,RC,outpatient,Q8,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116,22,,percent of total billed charges,,,,,,,,,417.6,90,,percent of total billed charges,,,384.19,82.8,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116,22,,percent of total billed charges,,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,116,440.8,
PARE/CUT BENIGH HYPERKERATOTIC SGL LES,81000375,CDM,11055,CPT,761,RC,outpatient,Q9,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116,22,,percent of total billed charges,,,,,,,,,417.6,90,,percent of total billed charges,,,384.19,82.8,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116,22,,percent of total billed charges,,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,116,440.8,
PARE/CUT BENIGH HYPERKERATOTIC SGL LES,81000376,CDM,11055,CPT,761,RC,outpatient,Q7,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116,22,,percent of total billed charges,,,,,,,,,417.6,90,,percent of total billed charges,,,384.19,82.8,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116,22,,percent of total billed charges,,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,116,440.8,
PARE/CUT BENIGH HYPERKERATOTIC SGL LES,81000377,CDM,11055,CPT,761,RC,outpatient,Q8,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116,22,,percent of total billed charges,,,,,,,,,417.6,90,,percent of total billed charges,,,384.19,82.8,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116,22,,percent of total billed charges,,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,116,440.8,
PARE/CUT BENIGH HYPERKERATOTIC SGL LES,81000378,CDM,11055,CPT,761,RC,outpatient,Q9,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116,22,,percent of total billed charges,,,,,,,,,417.6,90,,percent of total billed charges,,,384.19,82.8,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116,22,,percent of total billed charges,,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,116,440.8,
PARE/CUT BENIGH HYPERKERATOTIC 2-4 LES,81000379,CDM,11056,CPT,761,RC,outpatient,Q7,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116,22,,percent of total billed charges,,,,,,,,,417.6,90,,percent of total billed charges,,,384.19,82.8,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116,22,,percent of total billed charges,,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,116,440.8,
PARE/CUT BENIGH HYPERKERATOTIC 2-4 LES,81000380,CDM,11056,CPT,761,RC,outpatient,Q8,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116,22,,percent of total billed charges,,,,,,,,,417.6,90,,percent of total billed charges,,,384.19,82.8,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116,22,,percent of total billed charges,,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,116,440.8,
PARE/CUT BENIGH HYPERKERATOTIC 2-4 LES,81000381,CDM,11056,CPT,761,RC,outpatient,Q9,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116,22,,percent of total billed charges,,,,,,,,,417.6,90,,percent of total billed charges,,,384.19,82.8,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116,22,,percent of total billed charges,,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,116,440.8,
PARE/CUT BENIGH HYPERKERA 2-4 LES W/MOD,81000382,CDM,11056,CPT,761,RC,outpatient,Q7,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.5,22,,percent of total billed charges,,,,,,,,,419.4,90,,percent of total billed charges,,,385.85,82.8,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.5,22,,percent of total billed charges,,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,116.5,442.7,
PARE/CUT BENIGH HYPERKERA 2-4 LES W/MOD,81000383,CDM,11056,CPT,761,RC,outpatient,Q8,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.5,22,,percent of total billed charges,,,,,,,,,419.4,90,,percent of total billed charges,,,385.85,82.8,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.5,22,,percent of total billed charges,,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,116.5,442.7,
PARE/CUT BENIGH HYPERKERA 2-4 LES W/MOD,81000384,CDM,11056,CPT,761,RC,outpatient,Q9,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.5,22,,percent of total billed charges,,,,,,,,,419.4,90,,percent of total billed charges,,,385.85,82.8,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.5,22,,percent of total billed charges,,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,116.5,442.7,
PARE/CUT BENIGH HYPERKERATOTIC >4 LES,81000385,CDM,11057,CPT,761,RC,outpatient,Q7,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.5,22,,percent of total billed charges,,,,,,,,,419.4,90,,percent of total billed charges,,,385.85,82.8,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.5,22,,percent of total billed charges,,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,116.5,442.7,
PARE/CUT BENIGH HYPERKERATOTIC >4 LES,81000386,CDM,11057,CPT,761,RC,outpatient,Q8,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.5,22,,percent of total billed charges,,,,,,,,,419.4,90,,percent of total billed charges,,,385.85,82.8,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.5,22,,percent of total billed charges,,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,116.5,442.7,
PARE/CUT BENIGH HYPERKERATOTIC >4 LES,81000387,CDM,11057,CPT,761,RC,outpatient,Q9,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.5,22,,percent of total billed charges,,,,,,,,,419.4,90,,percent of total billed charges,,,385.85,82.8,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.5,22,,percent of total billed charges,,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,116.5,442.7,
PARE/CUT BENIGH HYPERKERA >4 LES W/MOD,81000388,CDM,11057,CPT,761,RC,outpatient,Q7,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.5,22,,percent of total billed charges,,,,,,,,,419.4,90,,percent of total billed charges,,,385.85,82.8,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.5,22,,percent of total billed charges,,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,116.5,442.7,
PARE/CUT BENIGH HYPERKERA >4 LES W/MOD,81000389,CDM,11057,CPT,761,RC,outpatient,Q8,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.5,22,,percent of total billed charges,,,,,,,,,419.4,90,,percent of total billed charges,,,385.85,82.8,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.5,22,,percent of total billed charges,,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,116.5,442.7,
PARE/CUT BENIGH HYPERKERA >4 LES W/MOD,81000390,CDM,11057,CPT,761,RC,outpatient,Q9,466,466,,395.63,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116.5,22,,percent of total billed charges,,,,,,,,,419.4,90,,percent of total billed charges,,,385.85,82.8,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,,,,,,,,410.08,88,,percent of total billed charges,,,,,,,,,356.02,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116.5,22,,percent of total billed charges,,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,,,,,,,,,,,,,386.78,83,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,382.12,82,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,116.5,442.7,
TRIM NAILS NONDYSTROPHIC,81000391,CDM,11719,CPT,761,RC,outpatient,Q7,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
TRIM NAILS NONDYSTROPHIC,81000392,CDM,11719,CPT,761,RC,outpatient,Q8,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
TRIM NAILS NONDYSTROPHIC,81000393,CDM,11719,CPT,761,RC,outpatient,Q9,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
TRIM NAILS NONDYSTROPHIC W/MOD,81000394,CDM,11719,CPT,761,RC,outpatient,Q7,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
TRIM NAILS NONDYSTROPHIC W/MOD,81000395,CDM,11719,CPT,761,RC,outpatient,Q8,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
TRIM NAILS NONDYSTROPHIC W/MOD,81000396,CDM,11719,CPT,761,RC,outpatient,Q9,212,212,,179.99,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53,22,,percent of total billed charges,,,,,,,,,190.8,90,,percent of total billed charges,,,175.54,82.8,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,,,,,,,,186.56,88,,percent of total billed charges,,,,,,,,,161.97,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53,22,,percent of total billed charges,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,,,,,,,,,,,,,175.96,83,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,173.84,82,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,53,201.4,
"DEBRIDEMENT OF NAIL(S), ANY METHOD, 1-5",81000397,CDM,11720,CPT,761,RC,outpatient,Q7,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.25,22,,percent of total billed charges,,,,,,,,,299.7,90,,percent of total billed charges,,,275.72,82.8,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.25,22,,percent of total billed charges,,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,83.25,316.35,
"DEBRIDEMENT OF NAIL(S), ANY METHOD, 1-5",81000398,CDM,11720,CPT,761,RC,outpatient,Q8,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.25,22,,percent of total billed charges,,,,,,,,,299.7,90,,percent of total billed charges,,,275.72,82.8,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.25,22,,percent of total billed charges,,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,83.25,316.35,
"DEBRIDEMENT OF NAIL(S), ANY METHOD, 1-5",81000399,CDM,11720,CPT,761,RC,outpatient,Q9,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.25,22,,percent of total billed charges,,,,,,,,,299.7,90,,percent of total billed charges,,,275.72,82.8,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.25,22,,percent of total billed charges,,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,83.25,316.35,
APPLICATION OF SHORT LEG CAST,81000400,CDM,29405,CPT,761,RC,outpatient,,1074,1074,,911.83,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,268.5,22,,percent of total billed charges,,,,,,,,,966.6,90,,percent of total billed charges,,,889.27,82.8,,percent of total billed charges,,,912.9,85,,percent of total billed charges,,,,,,,,,945.12,88,,percent of total billed charges,,,,,,,,,820.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,268.5,22,,percent of total billed charges,,,977.34,91,,percent of total billed charges,,,1020.3,95,,percent of total billed charges,,,891.42,83,,percent of total billed charges,,,891.42,83,,percent of total billed charges,,,,,,,,,,,,,,,891.42,83,,percent of total billed charges,,,1020.3,95,,percent of total billed charges,,,966.6,90,,percent of total billed charges,,,966.6,90,,percent of total billed charges,,,880.68,82,,percent of total billed charges,,,966.6,90,,percent of total billed charges,,,912.9,85,,percent of total billed charges,,268.5,1020.3,
APPL/REM  WRAP SINGLE,81000401,CDM,29580,CPT,761,RC,outpatient,,704,704,,597.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,176,22,,percent of total billed charges,,,,,,,,,633.6,90,,percent of total billed charges,,,582.91,82.8,,percent of total billed charges,,,598.4,85,,percent of total billed charges,,,,,,,,,619.52,88,,percent of total billed charges,,,,,,,,,537.86,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,176,22,,percent of total billed charges,,,640.64,91,,percent of total billed charges,,,668.8,95,,percent of total billed charges,,,584.32,83,,percent of total billed charges,,,584.32,83,,percent of total billed charges,,,,,,,,,,,,,,,584.32,83,,percent of total billed charges,,,668.8,95,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,577.28,82,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,598.4,85,,percent of total billed charges,,176,668.8,
APPL/REM WRAP BILAT,81000402,CDM,29580,CPT,761,RC,outpatient,50,855,855,,725.9,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,213.75,22,,percent of total billed charges,,,,,,,,,769.5,90,,percent of total billed charges,,,707.94,82.8,,percent of total billed charges,,,726.75,85,,percent of total billed charges,,,,,,,,,752.4,88,,percent of total billed charges,,,,,,,,,653.22,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,213.75,22,,percent of total billed charges,,,778.05,91,,percent of total billed charges,,,812.25,95,,percent of total billed charges,,,709.65,83,,percent of total billed charges,,,709.65,83,,percent of total billed charges,,,,,,,,,,,,,,,709.65,83,,percent of total billed charges,,,812.25,95,,percent of total billed charges,,,769.5,90,,percent of total billed charges,,,769.5,90,,percent of total billed charges,,,701.1,82,,percent of total billed charges,,,769.5,90,,percent of total billed charges,,,726.75,85,,percent of total billed charges,,213.75,812.25,
"APPLY SHORT LEG CAST, WALKING",81000403,CDM,29425,CPT,761,RC,outpatient,,363,363,,308.19,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,90.75,22,,percent of total billed charges,,,,,,,,,326.7,90,,percent of total billed charges,,,300.56,82.8,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,,,,,,,,319.44,88,,percent of total billed charges,,,,,,,,,277.33,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,90.75,22,,percent of total billed charges,,,330.33,91,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,,,,,,,,,,,,,301.29,83,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,297.66,82,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,90.75,344.85,
APPLY RIGID TOTAL CONTACT LEG CAST,81000404,CDM,29445,CPT,761,RC,outpatient,,1091,1091,,926.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,272.75,22,,percent of total billed charges,,,,,,,,,981.9,90,,percent of total billed charges,,,903.35,82.8,,percent of total billed charges,,,927.35,85,,percent of total billed charges,,,,,,,,,960.08,88,,percent of total billed charges,,,,,,,,,833.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,272.75,22,,percent of total billed charges,,,992.81,91,,percent of total billed charges,,,1036.45,95,,percent of total billed charges,,,905.53,83,,percent of total billed charges,,,905.53,83,,percent of total billed charges,,,,,,,,,,,,,,,905.53,83,,percent of total billed charges,,,1036.45,95,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,894.62,82,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,927.35,85,,percent of total billed charges,,272.75,1036.45,
M-L WRAP UNI,81000405,CDM,29581,CPT,761,RC,outpatient,,662,662,,562.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,165.5,22,,percent of total billed charges,,,,,,,,,595.8,90,,percent of total billed charges,,,548.14,82.8,,percent of total billed charges,,,562.7,85,,percent of total billed charges,,,,,,,,,582.56,88,,percent of total billed charges,,,,,,,,,505.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,165.5,22,,percent of total billed charges,,,602.42,91,,percent of total billed charges,,,628.9,95,,percent of total billed charges,,,549.46,83,,percent of total billed charges,,,549.46,83,,percent of total billed charges,,,,,,,,,,,,,,,549.46,83,,percent of total billed charges,,,628.9,95,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,542.84,82,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,562.7,85,,percent of total billed charges,,165.5,628.9,
M-L WRAP BIL,81000406,CDM,29581,CPT,761,RC,outpatient,50,1324,1324,,1124.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,331,22,,percent of total billed charges,,,,,,,,,1191.6,90,,percent of total billed charges,,,1096.27,82.8,,percent of total billed charges,,,1125.4,85,,percent of total billed charges,,,,,,,,,1165.12,88,,percent of total billed charges,,,,,,,,,1011.54,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,331,22,,percent of total billed charges,,,1204.84,91,,percent of total billed charges,,,1257.8,95,,percent of total billed charges,,,1098.92,83,,percent of total billed charges,,,1098.92,83,,percent of total billed charges,,,,,,,,,,,,,,,1098.92,83,,percent of total billed charges,,,1257.8,95,,percent of total billed charges,,,1191.6,90,,percent of total billed charges,,,1191.6,90,,percent of total billed charges,,,1085.68,82,,percent of total billed charges,,,1191.6,90,,percent of total billed charges,,,1125.4,85,,percent of total billed charges,,331,1257.8,
M-L WRAP UNI WITH MODIFIER,81000407,CDM,29581,CPT,761,RC,outpatient,59,662,662,,562.04,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,165.5,22,,percent of total billed charges,,,,,,,,,595.8,90,,percent of total billed charges,,,548.14,82.8,,percent of total billed charges,,,562.7,85,,percent of total billed charges,,,,,,,,,582.56,88,,percent of total billed charges,,,,,,,,,505.77,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,165.5,22,,percent of total billed charges,,,602.42,91,,percent of total billed charges,,,628.9,95,,percent of total billed charges,,,549.46,83,,percent of total billed charges,,,549.46,83,,percent of total billed charges,,,,,,,,,,,,,,,549.46,83,,percent of total billed charges,,,628.9,95,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,542.84,82,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,562.7,85,,percent of total billed charges,,165.5,628.9,
APPLY RIGID TL CONTACT LEG CAST WITH MOD,81000408,CDM,29445,CPT,761,RC,outpatient,59,1091,1091,,926.26,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,272.75,22,,percent of total billed charges,,,,,,,,,981.9,90,,percent of total billed charges,,,903.35,82.8,,percent of total billed charges,,,927.35,85,,percent of total billed charges,,,,,,,,,960.08,88,,percent of total billed charges,,,,,,,,,833.52,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,272.75,22,,percent of total billed charges,,,992.81,91,,percent of total billed charges,,,1036.45,95,,percent of total billed charges,,,905.53,83,,percent of total billed charges,,,905.53,83,,percent of total billed charges,,,,,,,,,,,,,,,905.53,83,,percent of total billed charges,,,1036.45,95,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,894.62,82,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,927.35,85,,percent of total billed charges,,272.75,1036.45,
APLIGRAF 1 SQCM USED,81000410,CDM,Q4101,HCPCS,278,RC,outpatient,,210,210,,178.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.5,22,,percent of total billed charges,,,,,,,,,189,90,,percent of total billed charges,,,173.88,82.8,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,,,,,,,,184.8,88,,percent of total billed charges,,,,,,,,,160.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.5,22,,percent of total billed charges,,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,,,,,,,,,,,,,174.3,83,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,172.2,82,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,52.5,199.5,
APLIGRAF 1 SQCM NOT USED,81000411,CDM,Q4101,HCPCS,278,RC,outpatient,JW,210,210,,178.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.5,22,,percent of total billed charges,,,,,,,,,189,90,,percent of total billed charges,,,173.88,82.8,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,,,,,,,,184.8,88,,percent of total billed charges,,,,,,,,,160.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.5,22,,percent of total billed charges,,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,,,,,,,,,,,,,174.3,83,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,172.2,82,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,52.5,199.5,
OASIS 1 SQCM USED,81000412,CDM,Q4102,HCPCS,278,RC,outpatient,,28,28,,23.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7,22,,percent of total billed charges,,,,,,,,,25.2,90,,percent of total billed charges,,,23.18,82.8,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,,,,,,,,24.64,88,,percent of total billed charges,,,,,,,,,21.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7,22,,percent of total billed charges,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,,,,,,,,,,,,,23.24,83,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,22.96,82,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,7,26.6,
OASIS 1 SQCM  NOT USED,81000413,CDM,Q4102,HCPCS,278,RC,outpatient,JW,28,28,,23.77,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,7,22,,percent of total billed charges,,,,,,,,,25.2,90,,percent of total billed charges,,,23.18,82.8,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,,,,,,,,24.64,88,,percent of total billed charges,,,,,,,,,21.39,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,7,22,,percent of total billed charges,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,,,,,,,,,,,,,23.24,83,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,22.96,82,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,7,26.6,
OASIS ULTRA TRI LAYER 1 SQCM USED,81000414,CDM,Q4124,HCPCS,272,RC,outpatient,JC,251,251,,213.1,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,62.75,22,,percent of total billed charges,,,,,,,,,225.9,90,,percent of total billed charges,,,207.83,82.8,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,,,,,,,,220.88,88,,percent of total billed charges,,,,,,,,,191.76,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,62.75,22,,percent of total billed charges,,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,,,,,,,,,,,,,208.33,83,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,205.82,82,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,62.75,238.45,
APLI SKIN SUB PER SQ CM,81000415,CDM,Q4101,HCPCS,636,RC,outpatient,,225,225,,191.03,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,56.25,22,,percent of total billed charges,,,,,,,,,202.5,90,,percent of total billed charges,,,186.3,82.8,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,,,,,,,,198,88,,percent of total billed charges,,,,,,,,,171.9,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,56.25,22,,percent of total billed charges,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,,,,,,,,,,,,,186.75,83,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,184.5,82,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,56.25,213.75,
"IV INFUSION THERAPY, UP TO 1 HOUR",81000420,CDM,96365,CPT,761,RC,outpatient,XU,672,672,,570.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,168,22,,percent of total billed charges,,,,,,,,,604.8,90,,percent of total billed charges,,,556.42,82.8,,percent of total billed charges,,,571.2,85,,percent of total billed charges,,,,,,,,,591.36,88,,percent of total billed charges,,,,,,,,,513.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,168,22,,percent of total billed charges,,,611.52,91,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,,,,,,,,,,,,,557.76,83,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,551.04,82,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,571.2,85,,percent of total billed charges,,168,638.4,
"IV INFUSION THERAPY, ADDL HR, TO 8 HR",81000425,CDM,96366,CPT,761,RC,outpatient,XU,210,210,,178.29,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,52.5,22,,percent of total billed charges,,,,,,,,,189,90,,percent of total billed charges,,,173.88,82.8,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,,,,,,,,184.8,88,,percent of total billed charges,,,,,,,,,160.44,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,52.5,22,,percent of total billed charges,,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,,,,,,,,,,,,,174.3,83,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,172.2,82,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,52.5,199.5,
IM/SQ INJECTION,81000430,CDM,96372,CPT,761,RC,outpatient,XU,214,214,,181.69,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,53.5,22,,percent of total billed charges,,,,,,,,,192.6,90,,percent of total billed charges,,,177.19,82.8,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,,,,,,,,188.32,88,,percent of total billed charges,,,,,,,,,163.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,53.5,22,,percent of total billed charges,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,,,,,,,,,,,,,177.62,83,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,175.48,82,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,53.5,203.3,
IM INJECTION OF ANTIBIOTIC,81000431,CDM,96372,CPT,761,RC,outpatient,XU,290,290,,246.21,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,72.5,22,,percent of total billed charges,,,,,,,,,261,90,,percent of total billed charges,,,240.12,82.8,,percent of total billed charges,,,246.5,85,,percent of total billed charges,,,,,,,,,255.2,88,,percent of total billed charges,,,,,,,,,221.56,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,72.5,22,,percent of total billed charges,,,263.9,91,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,,,,,,,,,,,,,240.7,83,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,261,90,,percent of total billed charges,,,261,90,,percent of total billed charges,,,237.8,82,,percent of total billed charges,,,261,90,,percent of total billed charges,,,246.5,85,,percent of total billed charges,,72.5,275.5,
"SUBCUT INFU THERAPY,INITIAL UP TO 1 HOUR",81000432,CDM,96369,CPT,761,RC,outpatient,,672,672,,570.53,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,168,22,,percent of total billed charges,,,,,,,,,604.8,90,,percent of total billed charges,,,556.42,82.8,,percent of total billed charges,,,571.2,85,,percent of total billed charges,,,,,,,,,591.36,88,,percent of total billed charges,,,,,,,,,513.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,168,22,,percent of total billed charges,,,611.52,91,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,,,,,,,,,,,,,557.76,83,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,551.04,82,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,571.2,85,,percent of total billed charges,,168,638.4,
NON-INV STUDIES UPPER/LOWER EXTR SINGLE,81000450,CDM,93922,CPT,921,RC,outpatient,,878,878,,745.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,219.5,22,,percent of total billed charges,,,,,,,,,790.2,90,,percent of total billed charges,,,726.98,82.8,,percent of total billed charges,,,746.3,85,,percent of total billed charges,,,,,,,,,772.64,88,,percent of total billed charges,,,,,,,,,670.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,219.5,22,,percent of total billed charges,,,798.98,91,,percent of total billed charges,,,834.1,95,,percent of total billed charges,,,728.74,83,,percent of total billed charges,,,728.74,83,,percent of total billed charges,,,,,,,,,,,,,,,728.74,83,,percent of total billed charges,,,834.1,95,,percent of total billed charges,,,790.2,90,,percent of total billed charges,,,790.2,90,,percent of total billed charges,,,719.96,82,,percent of total billed charges,,,790.2,90,,percent of total billed charges,,,746.3,85,,percent of total billed charges,,219.5,834.1,
"NON-INV STUDIES UPPER/LOWER EXT, MULTIPL",81000451,CDM,93923,CPT,921,RC,outpatient,,1357,1357,,1152.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,339.25,22,,percent of total billed charges,,,,,,,,,1221.3,90,,percent of total billed charges,,,1123.6,82.8,,percent of total billed charges,,,1153.45,85,,percent of total billed charges,,,,,,,,,1194.16,88,,percent of total billed charges,,,,,,,,,1036.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,339.25,22,,percent of total billed charges,,,1234.87,91,,percent of total billed charges,,,1289.15,95,,percent of total billed charges,,,1126.31,83,,percent of total billed charges,,,1126.31,83,,percent of total billed charges,,,,,,,,,,,,,,,1126.31,83,,percent of total billed charges,,,1289.15,95,,percent of total billed charges,,,1221.3,90,,percent of total billed charges,,,1221.3,90,,percent of total billed charges,,,1112.74,82,,percent of total billed charges,,,1221.3,90,,percent of total billed charges,,,1153.45,85,,percent of total billed charges,,339.25,1289.15,
NON-INV STUDIES UPPER/LOWER EXTR UNILATR,81000452,CDM,93922,CPT,921,RC,outpatient,52,815,815,,691.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,203.75,22,,percent of total billed charges,,,,,,,,,733.5,90,,percent of total billed charges,,,674.82,82.8,,percent of total billed charges,,,692.75,85,,percent of total billed charges,,,,,,,,,717.2,88,,percent of total billed charges,,,,,,,,,622.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,203.75,22,,percent of total billed charges,,,741.65,91,,percent of total billed charges,,,774.25,95,,percent of total billed charges,,,676.45,83,,percent of total billed charges,,,676.45,83,,percent of total billed charges,,,,,,,,,,,,,,,676.45,83,,percent of total billed charges,,,774.25,95,,percent of total billed charges,,,733.5,90,,percent of total billed charges,,,733.5,90,,percent of total billed charges,,,668.3,82,,percent of total billed charges,,,733.5,90,,percent of total billed charges,,,692.75,85,,percent of total billed charges,,203.75,774.25,
"NON-INV STUDIES UPPER/LOWER EXT,UNILATRL",81000453,CDM,93923,CPT,921,RC,outpatient,52,1253,1253,,1063.8,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,313.25,22,,percent of total billed charges,,,,,,,,,1127.7,90,,percent of total billed charges,,,1037.48,82.8,,percent of total billed charges,,,1065.05,85,,percent of total billed charges,,,,,,,,,1102.64,88,,percent of total billed charges,,,,,,,,,957.29,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,313.25,22,,percent of total billed charges,,,1140.23,91,,percent of total billed charges,,,1190.35,95,,percent of total billed charges,,,1039.99,83,,percent of total billed charges,,,1039.99,83,,percent of total billed charges,,,,,,,,,,,,,,,1039.99,83,,percent of total billed charges,,,1190.35,95,,percent of total billed charges,,,1127.7,90,,percent of total billed charges,,,1127.7,90,,percent of total billed charges,,,1027.46,82,,percent of total billed charges,,,1127.7,90,,percent of total billed charges,,,1065.05,85,,percent of total billed charges,,313.25,1190.35,
EPIDERMAL AUTOGRAFT ARMS FIRST 100 SQ CM,81000460,CDM,15110,CPT,761,RC,outpatient,,7652,7652,,6496.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1913,22,,percent of total billed charges,,,,,,,,,6886.8,90,,percent of total billed charges,,,6335.86,82.8,,percent of total billed charges,,,6504.2,85,,percent of total billed charges,,,,,,,,,6733.76,88,,percent of total billed charges,,,,,,,,,5846.13,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1913,22,,percent of total billed charges,,,6963.32,91,,percent of total billed charges,,,7269.4,95,,percent of total billed charges,,,6351.16,83,,percent of total billed charges,,,6351.16,83,,percent of total billed charges,,,,,,,,,,,,,,,6351.16,83,,percent of total billed charges,,,7269.4,95,,percent of total billed charges,,,6886.8,90,,percent of total billed charges,,,6886.8,90,,percent of total billed charges,,,6274.64,82,,percent of total billed charges,,,6886.8,90,,percent of total billed charges,,,6504.2,85,,percent of total billed charges,,1913,7269.4,
EPIDRM A-GRFT-FACE/NCK/HF/G 100 SQ CM<,81000462,CDM,15115,CPT,761,RC,outpatient,,5630,5630,,4779.87,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1407.5,22,,percent of total billed charges,,,,,,,,,5067,90,,percent of total billed charges,,,4661.64,82.8,,percent of total billed charges,,,4785.5,85,,percent of total billed charges,,,,,,,,,4954.4,88,,percent of total billed charges,,,,,,,,,4301.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1407.5,22,,percent of total billed charges,,,5123.3,91,,percent of total billed charges,,,5348.5,95,,percent of total billed charges,,,4672.9,83,,percent of total billed charges,,,4672.9,83,,percent of total billed charges,,,,,,,,,,,,,,,4672.9,83,,percent of total billed charges,,,5348.5,95,,percent of total billed charges,,,5067,90,,percent of total billed charges,,,5067,90,,percent of total billed charges,,,4616.6,82,,percent of total billed charges,,,5067,90,,percent of total billed charges,,,4785.5,85,,percent of total billed charges,,1407.5,5348.5,
NEG PRESS WOUND TX </= 50 CM,81000464,CDM,97607,CPT,761,RC,outpatient,,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.25,22,,percent of total billed charges,,,,,,,,,414.9,90,,percent of total billed charges,,,381.71,82.8,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.25,22,,percent of total billed charges,,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,115.25,437.95,
NEG PRESS WOUND TX >50 CM,81000465,CDM,97608,CPT,761,RC,outpatient,,632,632,,536.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,158,22,,percent of total billed charges,,,,,,,,,568.8,90,,percent of total billed charges,,,523.3,82.8,,percent of total billed charges,,,537.2,85,,percent of total billed charges,,,,,,,,,556.16,88,,percent of total billed charges,,,,,,,,,482.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,158,22,,percent of total billed charges,,,575.12,91,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,,,,,,,,,,,,,524.56,83,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,518.24,82,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,537.2,85,,percent of total billed charges,,158,600.4,
HYALOMATRIX 1 SQCM USED,81000470,CDM,Q4117,HCPCS,278,RC,outpatient,,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
HYALOMATRIX 1 SQCM  NOT USED,81000471,CDM,Q4117,HCPCS,278,RC,outpatient,JW,138,138,,117.16,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,34.5,22,,percent of total billed charges,,,,,,,,,124.2,90,,percent of total billed charges,,,114.26,82.8,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,,,,,,,,121.44,88,,percent of total billed charges,,,,,,,,,105.43,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,34.5,22,,percent of total billed charges,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,,,,,,,,,,,,,114.54,83,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,113.16,82,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,34.5,131.1,
GRAFIX STRAVIX PRIME 1 SQCM USED,81000480,CDM,Q4133,HCPCS,270,RC,outpatient,JC,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
GRAFIX STRAVIX PRIME 1 SQCM NOT USED,81000481,CDM,Q4133,HCPCS,278,RC,outpatient,JW,1950,1950,,1655.55,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,487.5,22,,percent of total billed charges,,,,,,,,,1755,90,,percent of total billed charges,,,1614.6,82.8,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,,,,,,,,1716,88,,percent of total billed charges,,,,,,,,,1489.8,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,487.5,22,,percent of total billed charges,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1618.5,83,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1599,82,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,487.5,1852.5,
FF EX BEN LESION MARGINS >4.0CM,81000501,CDM,11406,CPT,761,RC,outpatient,,6271,6271,,5324.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1567.75,22,,percent of total billed charges,,,,,,,,,5643.9,90,,percent of total billed charges,,,5192.39,82.8,,percent of total billed charges,,,5330.35,85,,percent of total billed charges,,,,,,,,,5518.48,88,,percent of total billed charges,,,,,,,,,4791.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1567.75,22,,percent of total billed charges,,,5706.61,91,,percent of total billed charges,,,5957.45,95,,percent of total billed charges,,,5204.93,83,,percent of total billed charges,,,5204.93,83,,percent of total billed charges,,,,,,,,,,,,,,,5204.93,83,,percent of total billed charges,,,5957.45,95,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5142.22,82,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5330.35,85,,percent of total billed charges,,1567.75,5957.45,
"DEBRID OF NAIL(S), ANY METH, 1-5 W/MOD",81000502,CDM,11720,CPT,761,RC,outpatient,Q7,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.25,22,,percent of total billed charges,,,,,,,,,299.7,90,,percent of total billed charges,,,275.72,82.8,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.25,22,,percent of total billed charges,,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,83.25,316.35,
"DEBRID OF NAIL(S), ANY METH, 1-5 W/MOD",81000503,CDM,11720,CPT,761,RC,outpatient,Q8,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.25,22,,percent of total billed charges,,,,,,,,,299.7,90,,percent of total billed charges,,,275.72,82.8,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.25,22,,percent of total billed charges,,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,83.25,316.35,
"DEBRID OF NAIL(S), ANY METH, 1-5 W/MOD",81000504,CDM,11720,CPT,761,RC,outpatient,Q9,333,333,,282.72,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,83.25,22,,percent of total billed charges,,,,,,,,,299.7,90,,percent of total billed charges,,,275.72,82.8,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,,,,,,,,293.04,88,,percent of total billed charges,,,,,,,,,254.41,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,83.25,22,,percent of total billed charges,,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,,,,,,,,,,,,,276.39,83,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,273.06,82,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,83.25,316.35,
"DEBRIDEMENT NAILS, ANY METHOD, 6 OR MORE",81000505,CDM,11721,CPT,761,RC,outpatient,Q7,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.25,22,,percent of total billed charges,,,,,,,,,422.1,90,,percent of total billed charges,,,388.33,82.8,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.25,22,,percent of total billed charges,,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,117.25,445.55,
"DEBRIDEMENT NAILS, ANY METHOD, 6 OR MORE",81000506,CDM,11721,CPT,761,RC,outpatient,Q8,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.25,22,,percent of total billed charges,,,,,,,,,422.1,90,,percent of total billed charges,,,388.33,82.8,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.25,22,,percent of total billed charges,,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,117.25,445.55,
"DEBRIDEMENT NAILS, ANY METHOD, 6 OR MORE",81000507,CDM,11721,CPT,761,RC,outpatient,Q9,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.25,22,,percent of total billed charges,,,,,,,,,422.1,90,,percent of total billed charges,,,388.33,82.8,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.25,22,,percent of total billed charges,,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,117.25,445.55,
"DEBRID NAILS, ANY METH, 6 OR MORE W/MOD",81000508,CDM,11721,CPT,761,RC,outpatient,Q7,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.25,22,,percent of total billed charges,,,,,,,,,422.1,90,,percent of total billed charges,,,388.33,82.8,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.25,22,,percent of total billed charges,,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,117.25,445.55,
"DEBRID NAILS, ANY METH, 6 OR MORE W/MOD",81000509,CDM,11721,CPT,761,RC,outpatient,Q8,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.25,22,,percent of total billed charges,,,,,,,,,422.1,90,,percent of total billed charges,,,388.33,82.8,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.25,22,,percent of total billed charges,,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,117.25,445.55,
"DEBRID NAILS, ANY METH, 6 OR MORE W/MOD",81000510,CDM,11721,CPT,761,RC,outpatient,Q9,469,469,,398.18,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,117.25,22,,percent of total billed charges,,,,,,,,,422.1,90,,percent of total billed charges,,,388.33,82.8,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,,,,,,,,412.72,88,,percent of total billed charges,,,,,,,,,358.32,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,117.25,22,,percent of total billed charges,,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,,,,,,,,,,,,,389.27,83,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,384.58,82,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,117.25,445.55,
"AVULSION NAIL PLATE, PTL OR COMP, SNGL",81000511,CDM,11730,CPT,761,RC,outpatient,Q7,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.5,22,,percent of total billed charges,,,,,,,,,394.2,90,,percent of total billed charges,,,362.66,82.8,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.5,22,,percent of total billed charges,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,109.5,416.1,
"AVULSION NAIL PLATE, PTL OR COMP, SNGL",81000512,CDM,11730,CPT,761,RC,outpatient,Q8,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.5,22,,percent of total billed charges,,,,,,,,,394.2,90,,percent of total billed charges,,,362.66,82.8,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.5,22,,percent of total billed charges,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,109.5,416.1,
"AVULSION NAIL PLATE, PTL OR COMP, SNGL",81000513,CDM,11730,CPT,761,RC,outpatient,Q9,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.5,22,,percent of total billed charges,,,,,,,,,394.2,90,,percent of total billed charges,,,362.66,82.8,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.5,22,,percent of total billed charges,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,109.5,416.1,
"AVUL NAIL PLATE, PTL OR COMP, SNGL W/MOD",81000514,CDM,11730,CPT,761,RC,outpatient,Q7,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.5,22,,percent of total billed charges,,,,,,,,,394.2,90,,percent of total billed charges,,,362.66,82.8,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.5,22,,percent of total billed charges,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,109.5,416.1,
"AVUL NAIL PLATE, PTL OR COMP, SNGL W/MOD",81000515,CDM,11730,CPT,761,RC,outpatient,Q8,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.5,22,,percent of total billed charges,,,,,,,,,394.2,90,,percent of total billed charges,,,362.66,82.8,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.5,22,,percent of total billed charges,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,109.5,416.1,
"AVUL NAIL PLATE, PTL OR COMP, SNGL W/MOD",81000516,CDM,11730,CPT,761,RC,outpatient,Q9,438,438,,371.86,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,109.5,22,,percent of total billed charges,,,,,,,,,394.2,90,,percent of total billed charges,,,362.66,82.8,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,,,,,,,,385.44,88,,percent of total billed charges,,,,,,,,,334.63,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,109.5,22,,percent of total billed charges,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,,,,,,,,,,,,,363.54,83,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,359.16,82,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,109.5,416.1,
AVULSION EA ADDT'L NAIL PLATE,81000517,CDM,11732,CPT,761,RC,outpatient,Q7,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.25,22,,percent of total billed charges,,,,,,,,,321.3,90,,percent of total billed charges,,,295.6,82.8,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.25,22,,percent of total billed charges,,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,89.25,339.15,
AVULSION EA ADDT'L NAIL PLATE,81000518,CDM,11732,CPT,761,RC,outpatient,Q8,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.25,22,,percent of total billed charges,,,,,,,,,321.3,90,,percent of total billed charges,,,295.6,82.8,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.25,22,,percent of total billed charges,,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,89.25,339.15,
AVULSION EA ADDT'L NAIL PLATE,81000519,CDM,11732,CPT,761,RC,outpatient,Q9,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.25,22,,percent of total billed charges,,,,,,,,,321.3,90,,percent of total billed charges,,,295.6,82.8,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.25,22,,percent of total billed charges,,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,89.25,339.15,
AVULSION EA ADDT'L NAIL PLATE W/MOD,81000520,CDM,11732,CPT,761,RC,outpatient,Q7,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.25,22,,percent of total billed charges,,,,,,,,,321.3,90,,percent of total billed charges,,,295.6,82.8,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.25,22,,percent of total billed charges,,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,89.25,339.15,
AVULSION EA ADDT'L NAIL PLATE W/MOD,81000521,CDM,11732,CPT,761,RC,outpatient,Q8,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.25,22,,percent of total billed charges,,,,,,,,,321.3,90,,percent of total billed charges,,,295.6,82.8,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.25,22,,percent of total billed charges,,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,89.25,339.15,
AVULSION EA ADDT'L NAIL PLATE W/MOD,81000522,CDM,11732,CPT,761,RC,outpatient,Q9,357,357,,303.09,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,89.25,22,,percent of total billed charges,,,,,,,,,321.3,90,,percent of total billed charges,,,295.6,82.8,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,,,,,,,,314.16,88,,percent of total billed charges,,,,,,,,,272.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,89.25,22,,percent of total billed charges,,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,,,,,,,,,,,,,296.31,83,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,292.74,82,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,89.25,339.15,
FF VISIT-NEW PATIENT,81000550,CDM,G0463,HCPCS,510,RC,outpatient,,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.75,22,,percent of total billed charges,,,,,,,,,542.7,90,,percent of total billed charges,,,499.28,82.8,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.75,22,,percent of total billed charges,,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,150.75,572.85,
FF VISIT-NEW PATIENT W/MOD,81000551,CDM,G0463,HCPCS,510,RC,outpatient,25,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.75,22,,percent of total billed charges,,,,,,,,,542.7,90,,percent of total billed charges,,,499.28,82.8,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.75,22,,percent of total billed charges,,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,150.75,572.85,
FF VISIT-ESTABLISHED PATIENT,81000552,CDM,G0463,HCPCS,510,RC,outpatient,,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.75,22,,percent of total billed charges,,,,,,,,,542.7,90,,percent of total billed charges,,,499.28,82.8,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.75,22,,percent of total billed charges,,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,150.75,572.85,
FF VISIT-ESTABLISHED PATIENT WITH MOD,81000553,CDM,G0463,HCPCS,510,RC,outpatient,25,603,603,,511.95,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,150.75,22,,percent of total billed charges,,,,,,,,,542.7,90,,percent of total billed charges,,,499.28,82.8,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,,,,,,,,530.64,88,,percent of total billed charges,,,,,,,,,460.69,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,150.75,22,,percent of total billed charges,,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,,,,,,,,,,,,,500.49,83,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,494.46,82,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,150.75,572.85,
 EXCISION BEN LESION MARGINS,81000554,CDM,11406,CPT,761,RC,outpatient,,6271,6271,,5324.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1567.75,22,,percent of total billed charges,,,,,,,,,5643.9,90,,percent of total billed charges,,,5192.39,82.8,,percent of total billed charges,,,5330.35,85,,percent of total billed charges,,,,,,,,,5518.48,88,,percent of total billed charges,,,,,,,,,4791.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1567.75,22,,percent of total billed charges,,,5706.61,91,,percent of total billed charges,,,5957.45,95,,percent of total billed charges,,,5204.93,83,,percent of total billed charges,,,5204.93,83,,percent of total billed charges,,,,,,,,,,,,,,,5204.93,83,,percent of total billed charges,,,5957.45,95,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5142.22,82,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5330.35,85,,percent of total billed charges,,1567.75,5957.45,
SCALP TRK EXT LYR 2.6 TO 7.5 CM,81000600,CDM,12032,CPT,761,RC,outpatient,,2096,2096,,1779.5,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,524,22,,percent of total billed charges,,,,,,,,,1886.4,90,,percent of total billed charges,,,1735.49,82.8,,percent of total billed charges,,,1781.6,85,,percent of total billed charges,,,,,,,,,1844.48,88,,percent of total billed charges,,,,,,,,,1601.34,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,524,22,,percent of total billed charges,,,1907.36,91,,percent of total billed charges,,,1991.2,95,,percent of total billed charges,,,1739.68,83,,percent of total billed charges,,,1739.68,83,,percent of total billed charges,,,,,,,,,,,,,,,1739.68,83,,percent of total billed charges,,,1991.2,95,,percent of total billed charges,,,1886.4,90,,percent of total billed charges,,,1886.4,90,,percent of total billed charges,,,1718.72,82,,percent of total billed charges,,,1886.4,90,,percent of total billed charges,,,1781.6,85,,percent of total billed charges,,524,1991.2,
EXC TR-EXT MAL MARG >4,81000601,CDM,11606,CPT,761,RC,outpatient,,5822,5822,,4942.88,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1455.5,22,,percent of total billed charges,,,,,,,,,5239.8,90,,percent of total billed charges,,,4820.62,82.8,,percent of total billed charges,,,4948.7,85,,percent of total billed charges,,,,,,,,,5123.36,88,,percent of total billed charges,,,,,,,,,4448.01,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1455.5,22,,percent of total billed charges,,,5298.02,91,,percent of total billed charges,,,5530.9,95,,percent of total billed charges,,,4832.26,83,,percent of total billed charges,,,4832.26,83,,percent of total billed charges,,,,,,,,,,,,,,,4832.26,83,,percent of total billed charges,,,5530.9,95,,percent of total billed charges,,,5239.8,90,,percent of total billed charges,,,5239.8,90,,percent of total billed charges,,,4774.04,82,,percent of total billed charges,,,5239.8,90,,percent of total billed charges,,,4948.7,85,,percent of total billed charges,,1455.5,5530.9,
DESTRUCTION OF SKIN LESIONS,81000602,CDM,17106,CPT,761,RC,outpatient,,1316,1316,,1117.28,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,329,22,,percent of total billed charges,,,,,,,,,1184.4,90,,percent of total billed charges,,,1089.65,82.8,,percent of total billed charges,,,1118.6,85,,percent of total billed charges,,,,,,,,,1158.08,88,,percent of total billed charges,,,,,,,,,1005.42,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,329,22,,percent of total billed charges,,,1197.56,91,,percent of total billed charges,,,1250.2,95,,percent of total billed charges,,,1092.28,83,,percent of total billed charges,,,1092.28,83,,percent of total billed charges,,,,,,,,,,,,,,,1092.28,83,,percent of total billed charges,,,1250.2,95,,percent of total billed charges,,,1184.4,90,,percent of total billed charges,,,1184.4,90,,percent of total billed charges,,,1079.12,82,,percent of total billed charges,,,1184.4,90,,percent of total billed charges,,,1118.6,85,,percent of total billed charges,,329,1250.2,
DESTRUCTION OF MALIGNANT SKIN LESIONS,81000603,CDM,17262,CPT,761,RC,outpatient,,567,567,,481.38,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,141.75,22,,percent of total billed charges,,,,,,,,,510.3,90,,percent of total billed charges,,,469.48,82.8,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,,,,,,,,498.96,88,,percent of total billed charges,,,,,,,,,433.19,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,141.75,22,,percent of total billed charges,,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,,,,,,,,,,,,,470.61,83,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,464.94,82,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,141.75,538.65,
NEG PRESS WOUND TX </= 50 CM WITH MOD,81000604,CDM,97607,CPT,761,RC,outpatient,59,461,461,,391.39,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,115.25,22,,percent of total billed charges,,,,,,,,,414.9,90,,percent of total billed charges,,,381.71,82.8,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,,,,,,,,405.68,88,,percent of total billed charges,,,,,,,,,352.2,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,115.25,22,,percent of total billed charges,,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,,,,,,,,,,,,,382.63,83,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,378.02,82,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,115.25,437.95,
NEG PRESS WOUND TX >50 CM WITH MOD,81000605,CDM,97608,CPT,761,RC,outpatient,59,632,632,,536.57,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,158,22,,percent of total billed charges,,,,,,,,,568.8,90,,percent of total billed charges,,,523.3,82.8,,percent of total billed charges,,,537.2,85,,percent of total billed charges,,,,,,,,,556.16,88,,percent of total billed charges,,,,,,,,,482.85,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,158,22,,percent of total billed charges,,,575.12,91,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,,,,,,,,,,,,,524.56,83,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,518.24,82,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,537.2,85,,percent of total billed charges,,158,600.4,
LOW FREQUENCY NON-CONTACT NON-THERMAL US,81000612,CDM,97610,CPT,761,RC,outpatient,,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195.5,22,,percent of total billed charges,,,,,,,,,703.8,90,,percent of total billed charges,,,647.5,82.8,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195.5,22,,percent of total billed charges,,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,195.5,742.9,
LOW FREQ NON-CONCT NON-THERMAL US W MOD,81000613,CDM,97610,CPT,761,RC,outpatient,59,782,782,,663.92,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,195.5,22,,percent of total billed charges,,,,,,,,,703.8,90,,percent of total billed charges,,,647.5,82.8,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,,,,,,,,688.16,88,,percent of total billed charges,,,,,,,,,597.45,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,195.5,22,,percent of total billed charges,,,711.62,91,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,649.06,83,,percent of total billed charges,,,,,,,,,,,,,,,649.06,83,,percent of total billed charges,,,742.9,95,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,641.24,82,,percent of total billed charges,,,703.8,90,,percent of total billed charges,,,664.7,85,,percent of total billed charges,,195.5,742.9,
TRIMMING OF DYSTROPHIC NAILS,81000614,CDM,G0127,HCPCS,761,RC,outpatient,,218,218,,185.08,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,54.5,22,,percent of total billed charges,,,,,,,,,196.2,90,,percent of total billed charges,,,180.5,82.8,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,,,,,,,,191.84,88,,percent of total billed charges,,14.35,,,,fee schedule,,,166.55,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,14.35,,,,fee schedule,,,54.5,22,,percent of total billed charges,,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,178.76,82,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,14.35,207.1,
EPIFIX PER SQ CM,81000615,CDM,Q4186,HCPCS,636,RC,outpatient,,1154,1154,,979.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,288.5,22,,percent of total billed charges,,,,,,,,,1038.6,90,,percent of total billed charges,,,955.51,82.8,,percent of total billed charges,,,980.9,85,,percent of total billed charges,,,,,,,,,1015.52,88,,percent of total billed charges,,,,,,,,,881.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,288.5,22,,percent of total billed charges,,,1050.14,91,,percent of total billed charges,,,1096.3,95,,percent of total billed charges,,,957.82,83,,percent of total billed charges,,,957.82,83,,percent of total billed charges,,,,,,,,,,,,,,,957.82,83,,percent of total billed charges,,,1096.3,95,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,946.28,82,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,980.9,85,,percent of total billed charges,,288.5,1096.3,
EPIFIX SQ CM NOT USED,81000616,CDM,Q4186,HCPCS,636,RC,outpatient,JW,1154,1154,,979.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,288.5,22,,percent of total billed charges,,,,,,,,,1038.6,90,,percent of total billed charges,,,955.51,82.8,,percent of total billed charges,,,980.9,85,,percent of total billed charges,,,,,,,,,1015.52,88,,percent of total billed charges,,,,,,,,,881.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,288.5,22,,percent of total billed charges,,,1050.14,91,,percent of total billed charges,,,1096.3,95,,percent of total billed charges,,,957.82,83,,percent of total billed charges,,,957.82,83,,percent of total billed charges,,,,,,,,,,,,,,,957.82,83,,percent of total billed charges,,,1096.3,95,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,946.28,82,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,980.9,85,,percent of total billed charges,,288.5,1096.3,
EPIFIX SQ CM WITH MODIFIER,81000617,CDM,Q4186,HCPCS,636,RC,outpatient,JC,1154,1154,,979.75,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,288.5,22,,percent of total billed charges,,,,,,,,,1038.6,90,,percent of total billed charges,,,955.51,82.8,,percent of total billed charges,,,980.9,85,,percent of total billed charges,,,,,,,,,1015.52,88,,percent of total billed charges,,,,,,,,,881.66,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,288.5,22,,percent of total billed charges,,,1050.14,91,,percent of total billed charges,,,1096.3,95,,percent of total billed charges,,,957.82,83,,percent of total billed charges,,,957.82,83,,percent of total billed charges,,,,,,,,,,,,,,,957.82,83,,percent of total billed charges,,,1096.3,95,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,946.28,82,,percent of total billed charges,,,1038.6,90,,percent of total billed charges,,,980.9,85,,percent of total billed charges,,288.5,1096.3,
PUNCH BX SKIN SINGLE LESION,81000618,CDM,11104,CPT,761,RC,outpatient,,949,949,,805.7,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,237.25,22,,percent of total billed charges,,,,,,,,,854.1,90,,percent of total billed charges,,,785.77,82.8,,percent of total billed charges,,,806.65,85,,percent of total billed charges,,,,,,,,,835.12,88,,percent of total billed charges,,,,,,,,,725.04,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,237.25,22,,percent of total billed charges,,,863.59,91,,percent of total billed charges,,,901.55,95,,percent of total billed charges,,,787.67,83,,percent of total billed charges,,,787.67,83,,percent of total billed charges,,,,,,,,,,,,,,,787.67,83,,percent of total billed charges,,,901.55,95,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,778.18,82,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,806.65,85,,percent of total billed charges,,237.25,901.55,
PUNCH BX SKIN EA SEP/ADDITIONAL LESION,81000619,CDM,11105,CPT,761,RC,outpatient,,627,627,,532.32,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,156.75,22,,percent of total billed charges,,,,,,,,,564.3,90,,percent of total billed charges,,,519.16,82.8,,percent of total billed charges,,,532.95,85,,percent of total billed charges,,,,,,,,,551.76,88,,percent of total billed charges,,,,,,,,,479.03,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,156.75,22,,percent of total billed charges,,,570.57,91,,percent of total billed charges,,,595.65,95,,percent of total billed charges,,,520.41,83,,percent of total billed charges,,,520.41,83,,percent of total billed charges,,,,,,,,,,,,,,,520.41,83,,percent of total billed charges,,,595.65,95,,percent of total billed charges,,,564.3,90,,percent of total billed charges,,,564.3,90,,percent of total billed charges,,,514.14,82,,percent of total billed charges,,,564.3,90,,percent of total billed charges,,,532.95,85,,percent of total billed charges,,156.75,595.65,
TENOTOMY,81000620,CDM,28010,CPT,761,RC,outpatient,,4229,4229,,3590.42,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1057.25,22,,percent of total billed charges,,,,,,,,,3806.1,90,,percent of total billed charges,,,3501.61,82.8,,percent of total billed charges,,,3594.65,85,,percent of total billed charges,,,,,,,,,3721.52,88,,percent of total billed charges,,,,,,,,,3230.96,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1057.25,22,,percent of total billed charges,,,3848.39,91,,percent of total billed charges,,,4017.55,95,,percent of total billed charges,,,3510.07,83,,percent of total billed charges,,,3510.07,83,,percent of total billed charges,,,,,,,,,,,,,,,3510.07,83,,percent of total billed charges,,,4017.55,95,,percent of total billed charges,,,3806.1,90,,percent of total billed charges,,,3806.1,90,,percent of total billed charges,,,3467.78,82,,percent of total billed charges,,,3806.1,90,,percent of total billed charges,,,3594.65,85,,percent of total billed charges,,1057.25,4017.55,
PARE/CUT BENIGH HYPERKERATOTIC W/MODIFIE,81001220,CDM,11055,CPT,761,RC,outpatient,59,464,464,,393.94,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,116,22,,percent of total billed charges,,,,,,,,,417.6,90,,percent of total billed charges,,,384.19,82.8,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,,,,,,,,408.32,88,,percent of total billed charges,,,,,,,,,354.5,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,116,22,,percent of total billed charges,,,422.24,91,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,385.12,83,,percent of total billed charges,,,,,,,,,,,,,,,385.12,83,,percent of total billed charges,,,440.8,95,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,380.48,82,,percent of total billed charges,,,417.6,90,,percent of total billed charges,,,394.4,85,,percent of total billed charges,,116,440.8,
EXCISION BENIGN LESIONS 0.6 TO 1.0 CM,81011401,CDM,11401,CPT,761,RC,outpatient,,2717,2717,,2306.73,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,679.25,22,,percent of total billed charges,,,,,,,,,2445.3,90,,percent of total billed charges,,,2249.68,82.8,,percent of total billed charges,,,2309.45,85,,percent of total billed charges,,,,,,,,,2390.96,88,,percent of total billed charges,,,,,,,,,2075.79,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,679.25,22,,percent of total billed charges,,,2472.47,91,,percent of total billed charges,,,2581.15,95,,percent of total billed charges,,,2255.11,83,,percent of total billed charges,,,2255.11,83,,percent of total billed charges,,,,,,,,,,,,,,,2255.11,83,,percent of total billed charges,,,2581.15,95,,percent of total billed charges,,,2445.3,90,,percent of total billed charges,,,2445.3,90,,percent of total billed charges,,,2227.94,82,,percent of total billed charges,,,2445.3,90,,percent of total billed charges,,,2309.45,85,,percent of total billed charges,,679.25,2581.15,
EXCISION BENIGN LESIONS 1.1 TO 2.0 CM,81011402,CDM,11402,CPT,761,RC,outpatient,,3330,3330,,2827.17,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,832.5,22,,percent of total billed charges,,,,,,,,,2997,90,,percent of total billed charges,,,2757.24,82.8,,percent of total billed charges,,,2830.5,85,,percent of total billed charges,,,,,,,,,2930.4,88,,percent of total billed charges,,,,,,,,,2544.12,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,832.5,22,,percent of total billed charges,,,3030.3,91,,percent of total billed charges,,,3163.5,95,,percent of total billed charges,,,2763.9,83,,percent of total billed charges,,,2763.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2763.9,83,,percent of total billed charges,,,3163.5,95,,percent of total billed charges,,,2997,90,,percent of total billed charges,,,2997,90,,percent of total billed charges,,,2730.6,82,,percent of total billed charges,,,2997,90,,percent of total billed charges,,,2830.5,85,,percent of total billed charges,,832.5,3163.5,
EXCISION BENIGN LESIONS INCLUD MARGINS,81011420,CDM,11420,CPT,761,RC,outpatient,,4403,4403,,3738.15,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,1100.75,22,,percent of total billed charges,,,,,,,,,3962.7,90,,percent of total billed charges,,,3645.68,82.8,,percent of total billed charges,,,3742.55,85,,percent of total billed charges,,,,,,,,,3874.64,88,,percent of total billed charges,,,,,,,,,3363.89,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,1100.75,22,,percent of total billed charges,,,4006.73,91,,percent of total billed charges,,,4182.85,95,,percent of total billed charges,,,3654.49,83,,percent of total billed charges,,,3654.49,83,,percent of total billed charges,,,,,,,,,,,,,,,3654.49,83,,percent of total billed charges,,,4182.85,95,,percent of total billed charges,,,3962.7,90,,percent of total billed charges,,,3962.7,90,,percent of total billed charges,,,3610.46,82,,percent of total billed charges,,,3962.7,90,,percent of total billed charges,,,3742.55,85,,percent of total billed charges,,1100.75,4182.85,
ABRASION SINGLE LESION,81015786,CDM,15786,CPT,761,RC,outpatient,,400,400,,339.6,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,100,22,,percent of total billed charges,,,,,,,,,360,90,,percent of total billed charges,,,331.2,82.8,,percent of total billed charges,,,340,85,,percent of total billed charges,,,,,,,,,352,88,,percent of total billed charges,,,,,,,,,305.6,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,100,22,,percent of total billed charges,,,364,91,,percent of total billed charges,,,380,95,,percent of total billed charges,,,332,83,,percent of total billed charges,,,332,83,,percent of total billed charges,,,,,,,,,,,,,,,332,83,,percent of total billed charges,,,380,95,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,328,82,,percent of total billed charges,,,360,90,,percent of total billed charges,,,340,85,,percent of total billed charges,,100,380,
DESTRUCTION OF BENIGN LESIONS UP TO 14,81017110,CDM,17110,CPT,761,RC,outpatient,,518,518,,439.78,84.9,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,129.5,22,,percent of total billed charges,,,,,,,,,466.2,90,,percent of total billed charges,,,428.9,82.8,,percent of total billed charges,,,440.3,85,,percent of total billed charges,,,,,,,,,455.84,88,,percent of total billed charges,,,,,,,,,395.75,76.4,,percent of total billed charges,Anesthesia - reimbursement is per 15 Minutes,,,,,,,,129.5,22,,percent of total billed charges,,,471.38,91,,percent of total billed charges,,,492.1,95,,percent of total billed charges,,,429.94,83,,percent of total billed charges,,,429.94,83,,percent of total billed charges,,,,,,,,,,,,,,,429.94,83,,percent of total billed charges,,,492.1,95,,percent of total billed charges,,,466.2,90,,percent of total billed charges,,,466.2,90,,percent of total billed charges,,,424.76,82,,percent of total billed charges,,,466.2,90,,percent of total billed charges,,,440.3,85,,percent of total billed charges,,129.5,492.1,
PHOTOCHEMOTHERAPY,1,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,212.41,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,212.41,,,,other,Services are paid on an EAPG basis,212.41,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,212.41,212.41,
SUPERFICIAL NEEDLE BIOPSY AND ASPIRATION,2,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1302.03,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1302.03,,,,other,Services are paid on an EAPG basis,1302.03,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1302.03,1302.03,
LEVEL I SKIN INCISION AND DRAINAGE,3,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,643.2,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,643.2,,,,other,Services are paid on an EAPG basis,643.2,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,643.2,643.2,
LEVEL II SKIN INCISION AND DRAINAGE,4,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2243.38,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2243.38,,,,other,Services are paid on an EAPG basis,2243.38,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2243.38,2243.38,
NAIL PROCEDURES,5,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,175.57,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,175.57,,,,other,Services are paid on an EAPG basis,175.57,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,175.57,175.57,
LEVEL I SKIN DEBRIDEMENT AND DESTRUCTION,6,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,656.32,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,656.32,,,,other,Services are paid on an EAPG basis,656.32,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,656.32,656.32,
LEVEL II SKIN DEBRIDEMENT AND DESTRUCTION,7,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1785.56,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1785.56,,,,other,Services are paid on an EAPG basis,1785.56,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1785.56,1785.56,
LEVEL III SKIN DEBRIDEMENT AND DESTRUCTION,8,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2562.99,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2562.99,,,,other,Services are paid on an EAPG basis,2562.99,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2562.99,2562.99,
LEVEL I EXCISION AND BIOPSY OF SKIN AND SOFT TISSUE,9,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1379.42,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1379.42,,,,other,Services are paid on an EAPG basis,1379.42,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1379.42,1379.42,
LEVEL II EXCISION AND BIOPSY OF SKIN AND SOFT TISSUE,10,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2758.84,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2758.84,,,,other,Services are paid on an EAPG basis,2758.84,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2758.84,2758.84,
LEVEL III EXCISION AND BIOPSY OF SKIN AND SOFT TISSUE,11,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6729.73,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6729.73,,,,other,Services are paid on an EAPG basis,6729.73,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6729.73,6729.73,
LEVEL I SKIN REPAIR,12,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,615.77,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,615.77,,,,other,Services are paid on an EAPG basis,615.77,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,615.77,615.77,
LEVEL II SKIN REPAIR,13,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1060.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1060.6,,,,other,Services are paid on an EAPG basis,1060.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1060.6,1060.6,
LEVEL III SKIN REPAIR,14,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3390.64,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3390.64,,,,other,Services are paid on an EAPG basis,3390.64,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3390.64,3390.64,
LEVEL IV SKIN REPAIR,15,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3751.73,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3751.73,,,,other,Services are paid on an EAPG basis,3751.73,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3751.73,3751.73,
LEVEL I BREAST PROCEDURES,20,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2638.65,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2638.65,,,,other,Services are paid on an EAPG basis,2638.65,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2638.65,2638.65,
LEVEL II BREAST PROCEDURES,21,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6040.82,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6040.82,,,,other,Services are paid on an EAPG basis,6040.82,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6040.82,6040.82,
LEVEL III BREAST PROCEDURES,22,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11124.53,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11124.53,,,,other,Services are paid on an EAPG basis,11124.53,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11124.53,11124.53,
LEVEL I MUSCULOSKELETAL PROCEDURES EXCLUDING HAND AND FOOT,30,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3810.3,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3810.3,,,,other,Services are paid on an EAPG basis,3810.3,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3810.3,3810.3,
LEVEL II MUSCULOSKELETAL PROCEDURES EXCLUDING HAND AND FOOT,31,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6159.02,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6159.02,,,,other,Services are paid on an EAPG basis,6159.02,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6159.02,6159.02,
LEVEL III MUSCULOSKELETAL PROCEDURES EXCLUDING HAND AND FOOT,32,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8786.14,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8786.14,,,,other,Services are paid on an EAPG basis,8786.14,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8786.14,8786.14,
LEVEL I HAND PROCEDURES,33,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2481.5,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2481.5,,,,other,Services are paid on an EAPG basis,2481.5,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2481.5,2481.5,
LEVEL II HAND PROCEDURES,34,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4074.65,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4074.65,,,,other,Services are paid on an EAPG basis,4074.65,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4074.65,4074.65,
LEVEL I FOOT PROCEDURES,35,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4039.4,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4039.4,,,,other,Services are paid on an EAPG basis,4039.4,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4039.4,4039.4,
LEVEL II FOOT PROCEDURES,36,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9394.23,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9394.23,,,,other,Services are paid on an EAPG basis,9394.23,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9394.23,9394.23,
LEVEL I ARTHROSCOPY,37,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4394.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4394.79,,,,other,Services are paid on an EAPG basis,4394.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4394.79,4394.79,
LEVEL II ARTHROSCOPY,38,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10487.16,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10487.16,,,,other,Services are paid on an EAPG basis,10487.16,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10487.16,10487.16,
REPLACEMENT OF CAST,39,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,695.94,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,695.94,,,,other,Services are paid on an EAPG basis,695.94,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,695.94,695.94,
"SPLINT, STRAPPING AND CAST REMOVAL",40,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,539.44,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,539.44,,,,other,Services are paid on an EAPG basis,539.44,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,539.44,539.44,
"CLOSED TREATMENT FX & DISLOCATION OF FINGER, TOE & TRUNK",41,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1215.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1215.37,,,,other,Services are paid on an EAPG basis,1215.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1215.37,1215.37,
"CLOSED TREATMENT FX & DISLOCATION EXC FINGER, TOE & TRUNK",42,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1235.12,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1235.12,,,,other,Services are paid on an EAPG basis,1235.12,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1235.12,1235.12,
OPEN OR PERCUTANEOUS TREATMENT OF FRACTURES,43,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9594.18,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9594.18,,,,other,Services are paid on an EAPG basis,9594.18,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9594.18,9594.18,
BONE OR JOINT MANIPULATION UNDER ANESTHESIA,44,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2172.09,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2172.09,,,,other,Services are paid on an EAPG basis,2172.09,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2172.09,2172.09,
BUNION PROCEDURES,45,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6027.83,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6027.83,,,,other,Services are paid on an EAPG basis,6027.83,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6027.83,6027.83,
LEVEL I ARTHROPLASTY,46,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5294.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5294.79,,,,other,Services are paid on an EAPG basis,5294.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5294.79,5294.79,
LEVEL II ARTHROPLASTY,47,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18686.95,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18686.95,,,,other,Services are paid on an EAPG basis,18686.95,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18686.95,18686.95,
HAND AND FOOT TENOTOMY,48,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2556.1,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2556.1,,,,other,Services are paid on an EAPG basis,2556.1,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2556.1,2556.1,
ARTHROCENTESIS AND LIGAMENT OR TENDON INJECTION,49,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,692.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,692.89,,,,other,Services are paid on an EAPG basis,692.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,692.89,692.89,
PULMONARY TESTS,60,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,489.09,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,489.09,,,,other,Services are paid on an EAPG basis,489.09,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,489.09,489.09,
"NEEDLE AND CATHETER BIOPSY, ASPIRATION, LAVAGE AND INTUBATION",61,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1480.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1480.79,,,,other,Services are paid on an EAPG basis,1480.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1480.79,1480.79,
LEVEL I ENDOSCOPY OF THE UPPER AIRWAY,62,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,864.49,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,864.49,,,,other,Services are paid on an EAPG basis,864.49,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,864.49,864.49,
LEVEL II ENDOSCOPY OF THE UPPER AIRWAY,63,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6286.36,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6286.36,,,,other,Services are paid on an EAPG basis,6286.36,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6286.36,6286.36,
ENDOSCOPY OF THE LOWER AIRWAY,64,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3705.75,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3705.75,,,,other,Services are paid on an EAPG basis,3705.75,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3705.75,3705.75,
RESPIRATORY THERAPY,65,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,519.17,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,519.17,,,,other,Services are paid on an EAPG basis,519.17,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,519.17,519.17,
PULMONARY REHABILITATION,66,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,274.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,274.43,,,,other,Services are paid on an EAPG basis,274.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,274.43,274.43,
VENTILATION ASSISTANCE AND MANAGEMENT,67,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1567.58,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1567.58,,,,other,Services are paid on an EAPG basis,1567.58,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1567.58,1567.58,
"LEVEL I VASCULAR LIGATION, REPAIR AND RECONSTRUCTION",78,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4409.63,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4409.63,,,,other,Services are paid on an EAPG basis,4409.63,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4409.63,4409.63,
LEVEL I PERIPHERAL VASCULAR AND TRANSCATHETER PROCEDURES,79,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10592.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10592.24,,,,other,Services are paid on an EAPG basis,10592.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10592.24,10592.24,
EXERCISE TOLERANCE TESTS,80,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,653.4,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,653.4,,,,other,Services are paid on an EAPG basis,653.4,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,653.4,653.4,
ECHOCARDIOGRAPHY,81,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1038.47,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1038.47,,,,other,Services are paid on an EAPG basis,1038.47,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1038.47,1038.47,
CARDIAC ELECTROPHYSIOLOGIC TESTS AND MONITORING,82,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25644.2,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25644.2,,,,other,Services are paid on an EAPG basis,25644.2,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25644.2,25644.2,
PLACEMENT OF TRANSVENOUS CATHETERS,83,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3643.47,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3643.47,,,,other,Services are paid on an EAPG basis,3643.47,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3643.47,3643.47,
DIAGNOSTIC CARDIAC CATHETERIZATION,84,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5215.02,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5215.02,,,,other,Services are paid on an EAPG basis,5215.02,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5215.02,5215.02,
LEVEL II PERIPHERAL VASCULAR AND TRANSCATHETER PROCEDURES,85,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10592.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10592.24,,,,other,Services are paid on an EAPG basis,10592.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10592.24,10592.24,
PACEMAKER AND OTHER CARDIOVASCULAR DEVICE INSERTION AND REPLACEMENT,86,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17219.28,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17219.28,,,,other,Services are paid on an EAPG basis,17219.28,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17219.28,17219.28,
REMOVAL OR REVISION OF PACEMAKERS AND OTHER CARDIOVASCULAR DEVICES,87,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12463,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12463,,,,other,Services are paid on an EAPG basis,12463,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12463,12463,
LEVEL I CARDIOTHORACIC PROCEDURES W OR W/O VASCULAR DEVICE,88,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6669.84,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6669.84,,,,other,Services are paid on an EAPG basis,6669.84,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6669.84,6669.84,
LEVEL II CARDIOTHORACIC PROCEDURES W OR W/O VASCULAR DEVICE,89,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8522.05,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8522.05,,,,other,Services are paid on an EAPG basis,8522.05,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8522.05,8522.05,
SECONDARY VARICOSE VEINS AND VASCULAR INJECTION,90,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1878.58,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1878.58,,,,other,Services are paid on an EAPG basis,1878.58,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1878.58,1878.58,
"LEVEL II VASCULAR LIGATION, REPAIR AND RECONSTRUCTION",91,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5163.08,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5163.08,,,,other,Services are paid on an EAPG basis,5163.08,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5163.08,5163.08,
RESUSCITATION,92,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1445.81,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1445.81,,,,other,Services are paid on an EAPG basis,1445.81,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1445.81,1445.81,
CARDIOVERSION,93,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1304.15,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1304.15,,,,other,Services are paid on an EAPG basis,1304.15,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1304.15,1304.15,
CARDIAC REHABILITATION,94,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1031.58,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1031.58,,,,other,Services are paid on an EAPG basis,1031.58,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1031.58,1031.58,
THROMBOLYSIS,95,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1433.35,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1433.35,,,,other,Services are paid on an EAPG basis,1433.35,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1433.35,1433.35,
ATRIAL AND VENTRICULAR RECORDING AND PACING,96,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11178.72,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11178.72,,,,other,Services are paid on an EAPG basis,11178.72,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11178.72,11178.72,
AICD IMPLANT,97,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49392.86,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49392.86,,,,other,Services are paid on an EAPG basis,49392.86,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49392.86,49392.86,
CORONARY ANGIOPLASTY AND RELATED PROCEDURES,99,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18405.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18405.37,,,,other,Services are paid on an EAPG basis,18405.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18405.37,18405.37,
LEVEL III CARDIOTHORACIC PROCEDURES W OR W/O VASCULAR DEVICE,101,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22977.19,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22977.19,,,,other,Services are paid on an EAPG basis,22977.19,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22977.19,22977.19,
PHARMACOTHERAPY BY EXTENDED INFUSION,110,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1046.95,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1046.95,,,,other,Services are paid on an EAPG basis,1046.95,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1046.95,1046.95,
PHARMACOTHERAPY EXCEPT BY EXTENDED INFUSION,111,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,669.7,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,669.7,,,,other,Services are paid on an EAPG basis,669.7,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,669.7,669.7,
PHLEBOTOMY,112,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,189.62,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,189.62,,,,other,Services are paid on an EAPG basis,189.62,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,189.62,189.62,
LEVEL I BLOOD AND BLOOD PRODUCT EXCHANGE,113,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1420.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1420.89,,,,other,Services are paid on an EAPG basis,1420.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1420.89,1420.89,
LEVEL II BLOOD AND BLOOD PRODUCT EXCHANGE,114,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5535.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5535.43,,,,other,Services are paid on an EAPG basis,5535.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5535.43,5535.43,
DEEP LYMPH STRUCTURE AND THYROID PROCEDURES,115,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5180.44,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5180.44,,,,other,Services are paid on an EAPG basis,5180.44,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5180.44,5180.44,
ALLERGY TESTS,116,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,84.41,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,84.41,,,,other,Services are paid on an EAPG basis,84.41,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,84.41,84.41,
NUTRITION THERAPY,118,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,375.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,375.93,,,,other,Services are paid on an EAPG basis,375.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,375.93,375.93,
ALIMENTARY TESTS AND SIMPLE TUBE PLACEMENT,130,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1288.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1288.92,,,,other,Services are paid on an EAPG basis,1288.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1288.92,1288.92,
ESOPHAGEAL DILATION WITHOUT ENDOSCOPY,131,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1479.33,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1479.33,,,,other,Services are paid on an EAPG basis,1479.33,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1479.33,1479.33,
ANOSCOPY WITH BIOPSY AND DIAGNOSTIC PROCTOSIGMOIDOSCOPY,132,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1404.07,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1404.07,,,,other,Services are paid on an EAPG basis,1404.07,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1404.07,1404.07,
PROCTOSIGMOIDOSCOPY WITH EXCISION OR BIOPSY,133,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1703.27,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1703.27,,,,other,Services are paid on an EAPG basis,1703.27,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1703.27,1703.27,
DIAGNOSTIC UPPER GI ENDOSCOPY OR INTUBATION,134,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1675.31,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1675.31,,,,other,Services are paid on an EAPG basis,1675.31,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1675.31,1675.31,
THERAPEUTIC UPPER GI ENDOSCOPY OR INTUBATION,135,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2312.41,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2312.41,,,,other,Services are paid on an EAPG basis,2312.41,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2312.41,2312.41,
DIAGNOSTIC LOWER GASTROINTESTINAL ENDOSCOPY,136,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1606.01,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1606.01,,,,other,Services are paid on an EAPG basis,1606.01,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1606.01,1606.01,
THERAPEUTIC COLONOSCOPY,137,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1787.28,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1787.28,,,,other,Services are paid on an EAPG basis,1787.28,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1787.28,1787.28,
ERCP AND MISCELLANEOUS GI ENDOSCOPY PROCEDURES,138,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4889.98,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4889.98,,,,other,Services are paid on an EAPG basis,4889.98,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4889.98,4889.98,
LEVEL I HERNIA REPAIR,139,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4994.26,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4994.26,,,,other,Services are paid on an EAPG basis,4994.26,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4994.26,4994.26,
LEVEL II HERNIA REPAIR,140,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6000.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6000.67,,,,other,Services are paid on an EAPG basis,6000.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6000.67,6000.67,
LEVEL I ANAL AND RECTAL PROCEDURES,141,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2998.68,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2998.68,,,,other,Services are paid on an EAPG basis,2998.68,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2998.68,2998.68,
LEVEL II ANAL AND RECTAL PROCEDURES,142,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4240.95,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4240.95,,,,other,Services are paid on an EAPG basis,4240.95,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4240.95,4240.95,
LEVEL I GASTROINTESTINAL PROCEDURES,143,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3603.58,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3603.58,,,,other,Services are paid on an EAPG basis,3603.58,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3603.58,3603.58,
LEVEL II GASTROINTESTINAL PROCEDURES,144,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9756.51,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9756.51,,,,other,Services are paid on an EAPG basis,9756.51,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9756.51,9756.51,
LEVEL I LAPAROSCOPY,145,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6219.57,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6219.57,,,,other,Services are paid on an EAPG basis,6219.57,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6219.57,6219.57,
LEVEL II LAPAROSCOPY,146,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7897.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7897.93,,,,other,Services are paid on an EAPG basis,7897.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7897.93,7897.93,
LEVEL III LAPAROSCOPY,147,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9903.06,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9903.06,,,,other,Services are paid on an EAPG basis,9903.06,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9903.06,9903.06,
LEVEL IV LAPAROSCOPY,148,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14458.45,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14458.45,,,,other,Services are paid on an EAPG basis,14458.45,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14458.45,14458.45,
SCREENING COLORECTAL SERVICES,149,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1452.7,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1452.7,,,,other,Services are paid on an EAPG basis,1452.7,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1452.7,1452.7,
EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY,160,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5512.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5512.37,,,,other,Services are paid on an EAPG basis,5512.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5512.37,5512.37,
URINARY STUDIES AND PROCEDURES,161,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,887.81,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,887.81,,,,other,Services are paid on an EAPG basis,887.81,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,887.81,887.81,
URINARY DILATATION,162,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,600.53,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,600.53,,,,other,Services are paid on an EAPG basis,600.53,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,600.53,600.53,
LEVEL I BLADDER AND KIDNEY PROCEDURES,163,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2323.41,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2323.41,,,,other,Services are paid on an EAPG basis,2323.41,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2323.41,2323.41,
LEVEL II BLADDER AND KIDNEY PROCEDURES,164,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4942.19,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4942.19,,,,other,Services are paid on an EAPG basis,4942.19,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4942.19,4942.19,
LEVEL III BLADDER AND KIDNEY PROCEDURES,165,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7770.06,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7770.06,,,,other,Services are paid on an EAPG basis,7770.06,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7770.06,7770.06,
LEVEL I URETHRA AND PROSTATE PROCEDURES,166,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3131.06,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3131.06,,,,other,Services are paid on an EAPG basis,3131.06,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3131.06,3131.06,
LEVEL II URETHRA AND PROSTATE PROCEDURES,167,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10188.62,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10188.62,,,,other,Services are paid on an EAPG basis,10188.62,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10188.62,10188.62,
HEMODIALYSIS,168,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2030.57,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2030.57,,,,other,Services are paid on an EAPG basis,2030.57,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2030.57,2030.57,
PERITONEAL DIALYSIS,169,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2016.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2016.92,,,,other,Services are paid on an EAPG basis,2016.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2016.92,2016.92,
TESTICULAR AND EPIDIDYMAL PROCEDURES,180,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3670.23,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3670.23,,,,other,Services are paid on an EAPG basis,3670.23,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3670.23,3670.23,
CIRCUMCISION,181,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3208.57,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3208.57,,,,other,Services are paid on an EAPG basis,3208.57,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3208.57,3208.57,
INSERTION OF PENILE PROSTHESIS,182,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25963.02,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25963.02,,,,other,Services are paid on an EAPG basis,25963.02,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25963.02,25963.02,
OTHER PENILE PROCEDURES,183,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5120.81,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5120.81,,,,other,Services are paid on an EAPG basis,5120.81,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5120.81,5120.81,
DESTRUCTION OR RESECTION OF PROSTATE,184,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6279.2,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6279.2,,,,other,Services are paid on an EAPG basis,6279.2,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6279.2,6279.2,
PROSTATE NEEDLE AND PUNCH BIOPSY,185,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2471.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2471.69,,,,other,Services are paid on an EAPG basis,2471.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2471.69,2471.69,
ARTIFICIAL FERTILIZATION,190,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,657.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,657.24,,,,other,Services are paid on an EAPG basis,657.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,657.24,657.24,
LEVEL I FETAL PROCEDURES,191,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,523.94,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,523.94,,,,other,Services are paid on an EAPG basis,523.94,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,523.94,523.94,
LEVEL II FETAL PROCEDURES,192,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1809.54,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1809.54,,,,other,Services are paid on an EAPG basis,1809.54,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1809.54,1809.54,
TREATMENT OF INCOMPLETE ABORTION,193,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3236.53,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3236.53,,,,other,Services are paid on an EAPG basis,3236.53,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3236.53,3236.53,
THERAPEUTIC ABORTION,194,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3692.36,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3692.36,,,,other,Services are paid on an EAPG basis,3692.36,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3692.36,3692.36,
VAGINAL DELIVERY,195,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4035.96,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4035.96,,,,other,Services are paid on an EAPG basis,4035.96,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4035.96,4035.96,
LEVEL I FEMALE REPRODUCTIVE PROCEDURES,196,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2761.09,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2761.09,,,,other,Services are paid on an EAPG basis,2761.09,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2761.09,2761.09,
LEVEL II FEMALE REPRODUCTIVE PROCEDURES,197,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5998.81,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5998.81,,,,other,Services are paid on an EAPG basis,5998.81,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5998.81,5998.81,
LEVEL III FEMALE REPRODUCTIVE PROCEDURES,198,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8444.27,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8444.27,,,,other,Services are paid on an EAPG basis,8444.27,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8444.27,8444.27,
DILATION AND CURETTAGE,199,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3150.53,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3150.53,,,,other,Services are paid on an EAPG basis,3150.53,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3150.53,3150.53,
HYSTEROSCOPY,200,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4391.08,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4391.08,,,,other,Services are paid on an EAPG basis,4391.08,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4391.08,4391.08,
COLPOSCOPY,201,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1147.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1147.93,,,,other,Services are paid on an EAPG basis,1147.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1147.93,1147.93,
EXTENDED EEG STUDIES,210,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,981.63,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,981.63,,,,other,Services are paid on an EAPG basis,981.63,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,981.63,981.63,
ELECTROENCEPHALOGRAM,211,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,554.29,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,554.29,,,,other,Services are paid on an EAPG basis,554.29,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,554.29,554.29,
ELECTROCONVULSIVE THERAPY,212,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1037.68,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1037.68,,,,other,Services are paid on an EAPG basis,1037.68,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1037.68,1037.68,
NERVE AND MUSCLE TESTS,213,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,702.83,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,702.83,,,,other,Services are paid on an EAPG basis,702.83,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,702.83,702.83,
"LEVEL I NERVOUS SYSTEM INJECTIONS, STIMULATIONS OR CRANIAL TAP",214,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,941.34,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,941.34,,,,other,Services are paid on an EAPG basis,941.34,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,941.34,941.34,
LEVEL I REVISION OR REMOVAL OF NEUROLOGICAL DEVICE,215,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8432.74,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8432.74,,,,other,Services are paid on an EAPG basis,8432.74,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8432.74,8432.74,
LEVEL II REVISION OR REMOVAL OF NEUROLOGICAL DEVICE,216,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11423.07,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11423.07,,,,other,Services are paid on an EAPG basis,11423.07,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11423.07,11423.07,
LEVEL I NERVE PROCEDURES,217,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2290.29,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2290.29,,,,other,Services are paid on an EAPG basis,2290.29,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2290.29,2290.29,
LEVEL II NERVE PROCEDURES,218,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10495.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10495.24,,,,other,Services are paid on an EAPG basis,10495.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10495.24,10495.24,
SPINAL TAP,219,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1105.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1105.92,,,,other,Services are paid on an EAPG basis,1105.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1105.92,1105.92,
"LEVEL II NERVOUS SYSTEM INJECTIONS, STIMULATIONS OR CRANIAL TAP",220,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1707.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1707.25,,,,other,Services are paid on an EAPG basis,1707.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1707.25,1707.25,
LAMINOTOMY AND LAMINECTOMY,221,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9508.18,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9508.18,,,,other,Services are paid on an EAPG basis,9508.18,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9508.18,9508.18,
SLEEP STUDIES,222,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1642.45,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1642.45,,,,other,Services are paid on an EAPG basis,1642.45,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1642.45,1642.45,
LEVEL III NERVE PROCEDURES,223,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26646.5,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26646.5,,,,other,Services are paid on an EAPG basis,26646.5,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26646.5,26646.5,
LEVEL IV NERVE PROCEDURES,224,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,48234.47,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,48234.47,,,,other,Services are paid on an EAPG basis,48234.47,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,48234.47,48234.47,
MINOR OPHTHALMOLOGICAL TESTS AND PROCEDURES,230,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,752.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,752.92,,,,other,Services are paid on an EAPG basis,752.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,752.92,752.92,
FITTING OF CONTACT LENSES,231,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,337.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,337.37,,,,other,Services are paid on an EAPG basis,337.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,337.37,337.37,
LASER EYE PROCEDURES,232,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1172.04,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1172.04,,,,other,Services are paid on an EAPG basis,1172.04,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1172.04,1172.04,
CATARACT PROCEDURES,233,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3474.12,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3474.12,,,,other,Services are paid on an EAPG basis,3474.12,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3474.12,3474.12,
LEVEL I ANTERIOR SEGMENT EYE PROCEDURES,234,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2820.72,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2820.72,,,,other,Services are paid on an EAPG basis,2820.72,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2820.72,2820.72,
LEVEL II ANTERIOR SEGMENT EYE PROCEDURES,235,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4496.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4496.69,,,,other,Services are paid on an EAPG basis,4496.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4496.69,4496.69,
LEVEL III ANTERIOR SEGMENT EYE PROCEDURES,236,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5868.16,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5868.16,,,,other,Services are paid on an EAPG basis,5868.16,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5868.16,5868.16,
LEVEL I POSTERIOR SEGMENT EYE PROCEDURES,237,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4553.01,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4553.01,,,,other,Services are paid on an EAPG basis,4553.01,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4553.01,4553.01,
LEVEL II POSTERIOR SEGMENT EYE PROCEDURES,238,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6344.4,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6344.4,,,,other,Services are paid on an EAPG basis,6344.4,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6344.4,6344.4,
STRABISMUS AND MUSCLE EYE PROCEDURES,239,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4077.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4077.43,,,,other,Services are paid on an EAPG basis,4077.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4077.43,4077.43,
LEVEL I REPAIR AND PLASTIC PROCEDURES OF EYE,240,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1298.19,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1298.19,,,,other,Services are paid on an EAPG basis,1298.19,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1298.19,1298.19,
LEVEL II REPAIR AND PLASTIC PROCEDURES OF EYE,241,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3474.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3474.25,,,,other,Services are paid on an EAPG basis,3474.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3474.25,3474.25,
COCHLEAR DEVICE IMPLANTATION,250,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58292.96,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58292.96,,,,other,Services are paid on an EAPG basis,58292.96,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58292.96,58292.96,
OTORHINOLARYNGOLOGIC FUNCTION TESTS,251,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,466.83,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,466.83,,,,other,Services are paid on an EAPG basis,466.83,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,466.83,466.83,
LEVEL I FACIAL AND ENT PROCEDURES,252,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2739.36,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2739.36,,,,other,Services are paid on an EAPG basis,2739.36,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2739.36,2739.36,
LEVEL II FACIAL AND ENT PROCEDURES,253,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4816.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4816.97,,,,other,Services are paid on an EAPG basis,4816.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4816.97,4816.97,
LEVEL III FACIAL AND ENT PROCEDURES,254,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5708.22,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5708.22,,,,other,Services are paid on an EAPG basis,5708.22,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5708.22,5708.22,
LEVEL IV FACIAL AND ENT PROCEDURES,255,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8413.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8413.92,,,,other,Services are paid on an EAPG basis,8413.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8413.92,8413.92,
TONSIL AND ADENOID PROCEDURES,256,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3857.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3857.6,,,,other,Services are paid on an EAPG basis,3857.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3857.6,3857.6,
AUDIOMETRY,257,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,295.5,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,295.5,,,,other,Services are paid on an EAPG basis,295.5,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,295.5,295.5,
CASE MANAGEMENT AND CARE PLANNING SERVICES,260,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,260.38,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,260.38,,,,other,Services are paid on an EAPG basis,260.38,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,260.38,260.38,
OCCUPATIONAL THERAPY,270,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1150.71,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1150.71,,,,other,Services are paid on an EAPG basis,1150.71,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1150.71,1150.71,
PHYSICAL THERAPY,271,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,723.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,723.37,,,,other,Services are paid on an EAPG basis,723.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,723.37,723.37,
SPEECH THERAPY AND EVALUATION,272,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,534.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,534.67,,,,other,Services are paid on an EAPG basis,534.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,534.67,534.67,
MANIPULATION THERAPY,273,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,99.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,99.25,,,,other,Services are paid on an EAPG basis,99.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,99.25,99.25,
"OCCUPATIONAL/PHYSICAL THERAPY, GROUP",274,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236,,,,other,Services are paid on an EAPG basis,236,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236,236,
"SPEECH THERAPY & EVALUATION, GROUP",275,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,157.95,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,157.95,,,,other,Services are paid on an EAPG basis,157.95,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,157.95,157.95,
VASCULAR RADIOLOGY EXCEPT VENOGRAPHY OF EXTREMITY,280,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5727.7,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5727.7,,,,other,Services are paid on an EAPG basis,5727.7,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5727.7,5727.7,
MAGNETIC RESONANCE ANGIOGRAPHY - HEAD AND/OR NECK,281,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,907.82,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,907.82,,,,other,Services are paid on an EAPG basis,907.82,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,907.82,907.82,
MAGNETIC RESONANCE ANGIOGRAPHY - CHEST,282,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,843.42,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,843.42,,,,other,Services are paid on an EAPG basis,843.42,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,843.42,843.42,
MAGNETIC RESONANCE ANGIOGRAPHY - OTHER SITES,283,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,958.84,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,958.84,,,,other,Services are paid on an EAPG basis,958.84,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,958.84,958.84,
MYELOGRAPHY,284,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1296.34,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1296.34,,,,other,Services are paid on an EAPG basis,1296.34,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1296.34,1296.34,
MISCELLANEOUS RADIOLOGICAL PROCEDURES WITH CONTRAST,285,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,743.11,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,743.11,,,,other,Services are paid on an EAPG basis,743.11,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,743.11,743.11,
MAMMOGRAPHY & OTHER RELATED PROCEDURES,286,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,147.88,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,147.88,,,,other,Services are paid on an EAPG basis,147.88,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,147.88,147.88,
DIGESTIVE RADIOLOGY,287,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,261.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,261.97,,,,other,Services are paid on an EAPG basis,261.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,261.97,261.97,
DIAGNOSTIC ULTRASOUND EXCEPT OBSTETRICAL AND VASCULAR OF LOWER EXTREMITIES,288,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,325.57,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,325.57,,,,other,Services are paid on an EAPG basis,325.57,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,325.57,325.57,
VASCULAR DIAGNOSTIC ULTRASOUND OF LOWER EXTREMITIES,289,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,428.53,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,428.53,,,,other,Services are paid on an EAPG basis,428.53,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,428.53,428.53,
PET SCANS,290,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2619.04,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2619.04,,,,other,Services are paid on an EAPG basis,2619.04,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2619.04,2619.04,
BONE DENSITOMETRY,291,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,188.16,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,188.16,,,,other,Services are paid on an EAPG basis,188.16,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,188.16,188.16,
MRI- ABDOMEN,292,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,888.74,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,888.74,,,,other,Services are paid on an EAPG basis,888.74,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,888.74,888.74,
MRI- JOINTS,293,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500.49,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500.49,,,,other,Services are paid on an EAPG basis,500.49,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,500.49,500.49,
MRI- BACK,294,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,599.21,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,599.21,,,,other,Services are paid on an EAPG basis,599.21,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,599.21,599.21,
MRI- CHEST,295,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1019.39,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1019.39,,,,other,Services are paid on an EAPG basis,1019.39,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1019.39,1019.39,
MRI- OTHER,296,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,741.52,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,741.52,,,,other,Services are paid on an EAPG basis,741.52,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,741.52,741.52,
MRI BRAIN AND MAGNETOENCEPHALOGRAPHY,297,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,830.83,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,830.83,,,,other,Services are paid on an EAPG basis,830.83,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,830.83,830.83,
CAT SCAN BACK,298,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,337.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,337.37,,,,other,Services are paid on an EAPG basis,337.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,337.37,337.37,
CAT SCAN - BRAIN,299,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,611.66,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,611.66,,,,other,Services are paid on an EAPG basis,611.66,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,611.66,611.66,
CAT SCAN - ABDOMEN,300,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,672.35,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,672.35,,,,other,Services are paid on an EAPG basis,672.35,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,672.35,672.35,
CAT SCAN - OTHER,301,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,297.22,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,297.22,,,,other,Services are paid on an EAPG basis,297.22,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,297.22,297.22,
"ANGIOGRAPHY, OTHER",302,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,671.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,671.69,,,,other,Services are paid on an EAPG basis,671.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,671.69,671.69,
"ANGIOGRAPHY, CEREBRAL",303,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,783.39,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,783.39,,,,other,Services are paid on an EAPG basis,783.39,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,783.39,783.39,
DEVELOPMENTAL & NEUROPSYCHOLOGICAL TESTING,310,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1719.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1719.97,,,,other,Services are paid on an EAPG basis,1719.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1719.97,1719.97,
FULL DAY PARTIAL HOSPITALIZATION FOR SUBSTANCE ABUSE,311,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,230.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,230.43,,,,other,Services are paid on an EAPG basis,230.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,230.43,230.43,
FULL DAY PARTIAL HOSPITALIZATION FOR MENTAL ILLNESS,312,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,828.05,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,828.05,,,,other,Services are paid on an EAPG basis,828.05,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,828.05,828.05,
HALF DAY PARTIAL HOSPITALIZATION FOR SUBSTANCE ABUSE,313,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,207.38,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,207.38,,,,other,Services are paid on an EAPG basis,207.38,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,207.38,207.38,
HALF DAY PARTIAL HOSPITALIZATION FOR MENTAL ILLNESS,314,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,623.45,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,623.45,,,,other,Services are paid on an EAPG basis,623.45,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,623.45,623.45,
COUNSELLING OR INDIVIDUAL BRIEF PSYCHOTHERAPY,315,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,316.83,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,316.83,,,,other,Services are paid on an EAPG basis,316.83,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,316.83,316.83,
INDIVIDUAL COMPREHENSIVE PSYCHOTHERAPY,316,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,317.36,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,317.36,,,,other,Services are paid on an EAPG basis,317.36,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,317.36,317.36,
FAMILY PSYCHOTHERAPY,317,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,334.59,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,334.59,,,,other,Services are paid on an EAPG basis,334.59,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,334.59,334.59,
GROUP PSYCHOTHERAPY,318,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,450,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,450,,,,other,Services are paid on an EAPG basis,450,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,450,450,
ACTIVITY THERAPY,319,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,180.74,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,180.74,,,,other,Services are paid on an EAPG basis,180.74,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,180.74,180.74,
MENTAL HEALTH & SUBSTANCE ABUSE - CASE MANAGEMENT AND TREATMENT PLAN DEVELOPMENT,320,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.59,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.59,,,,other,Services are paid on an EAPG basis,354.59,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,354.59,354.59,
CRISIS INTERVENTION,321,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,509.36,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,509.36,,,,other,Services are paid on an EAPG basis,509.36,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,509.36,509.36,
MEDICATION ADMINISTRATION & OBSERVATION,322,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,300.8,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,300.8,,,,other,Services are paid on an EAPG basis,300.8,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,300.8,300.8,
MENTAL HEALTH ASSESSMENT,323,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,588.87,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,588.87,,,,other,Services are paid on an EAPG basis,588.87,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,588.87,588.87,
MENTAL HEALTH SCREENING & BRIEF ASSESSMENT,324,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,263.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,263.43,,,,other,Services are paid on an EAPG basis,263.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,263.43,263.43,
INTENSIVE OUTPATIENT PSYCHIATRIC TREATMENT,327,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1275.8,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1275.8,,,,other,Services are paid on an EAPG basis,1275.8,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1275.8,1275.8,
"DAY REHABILITATION, HALF DAY",328,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,626.64,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,626.64,,,,other,Services are paid on an EAPG basis,626.64,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,626.64,626.64,
"DAY REHABILITATION, FULL DAY",329,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1037.28,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1037.28,,,,other,Services are paid on an EAPG basis,1037.28,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1037.28,1037.28,
LEVEL I DIAGNOSTIC NUCLEAR MEDICINE,330,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,803.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,803.93,,,,other,Services are paid on an EAPG basis,803.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,803.93,803.93,
LEVEL II DIAGNOSTIC NUCLEAR MEDICINE,331,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,900.8,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,900.8,,,,other,Services are paid on an EAPG basis,900.8,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,900.8,900.8,
LEVEL III DIAGNOSTIC NUCLEAR MEDICINE,332,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1972.26,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1972.26,,,,other,Services are paid on an EAPG basis,1972.26,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1972.26,1972.26,
THERAPEUTIC NUCLEAR MEDICINE,340,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,654.2,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,654.2,,,,other,Services are paid on an EAPG basis,654.2,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,654.2,654.2,
RADIATION THERAPY AND HYPERTHERMIA,341,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,636.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,636.97,,,,other,Services are paid on an EAPG basis,636.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,636.97,636.97,
LEVEL I AFTERLOADING BRACHYTHERAPY,342,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3911.4,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3911.4,,,,other,Services are paid on an EAPG basis,3911.4,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3911.4,3911.4,
RADIATION TREATMENT DELIVERY,343,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1763.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1763.43,,,,other,Services are paid on an EAPG basis,1763.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1763.43,1763.43,
INSTILLATION OF RADIOELEMENT SOLUTIONS,344,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2491.17,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2491.17,,,,other,Services are paid on an EAPG basis,2491.17,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2491.17,2491.17,
HYPERTHERMIC THERAPIES,345,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2995.9,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2995.9,,,,other,Services are paid on an EAPG basis,2995.9,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2995.9,2995.9,
RADIOSURGERY,346,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9731.99,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9731.99,,,,other,Services are paid on an EAPG basis,9731.99,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9731.99,9731.99,
HIGH ENERGY NEUTRON RADIATION TREATMENT DELIVERY,347,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1050.27,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1050.27,,,,other,Services are paid on an EAPG basis,1050.27,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1050.27,1050.27,
PROTON TREATMENT DELIVERY,348,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6110.12,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6110.12,,,,other,Services are paid on an EAPG basis,6110.12,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6110.12,6110.12,
LEVEL II AFTERLOADING BRACHYTHERAPY,349,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33254.99,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33254.99,,,,other,Services are paid on an EAPG basis,33254.99,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33254.99,33254.99,
LEVEL I  ADJUNCTIVE GENERAL DENTAL SERVICES,350,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,512.41,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,512.41,,,,other,Services are paid on an EAPG basis,512.41,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,512.41,512.41,
LEVEL II ADJUNCTIVE GENERAL DENTAL SERVICES,351,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,586.35,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,586.35,,,,other,Services are paid on an EAPG basis,586.35,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,586.35,586.35,
LEVEL I PERIODONTICS,352,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2109.28,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2109.28,,,,other,Services are paid on an EAPG basis,2109.28,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2109.28,2109.28,
"LEVEL I PROSTHODONTICS, FIXED",353,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,204.06,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,204.06,,,,other,Services are paid on an EAPG basis,204.06,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,204.06,204.06,
"LEVEL II PROSTHODONTICS, FIXED",354,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,763.38,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,763.38,,,,other,Services are paid on an EAPG basis,763.38,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,763.38,763.38,
"LEVEL III PROSTHODONTICS, FIXED",355,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,944.39,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,944.39,,,,other,Services are paid on an EAPG basis,944.39,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,944.39,944.39,
"LEVEL I PROSTHODONTICS, REMOVABLE",356,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.69,,,,other,Services are paid on an EAPG basis,413.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.69,413.69,
"LEVEL II PROSTHODONTICS, REMOVABLE",357,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,511.35,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,511.35,,,,other,Services are paid on an EAPG basis,511.35,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,511.35,511.35,
"LEVEL III PROSTHODONTICS, REMOVABLE",358,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,609.01,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,609.01,,,,other,Services are paid on an EAPG basis,609.01,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,609.01,609.01,
LEVEL I MAXILLOFACIAL PROSTHETICS,359,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,114.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,114.89,,,,other,Services are paid on an EAPG basis,114.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,114.89,114.89,
LEVEL II MAXILLOFACIAL PROSTHETICS,360,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,600.13,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,600.13,,,,other,Services are paid on an EAPG basis,600.13,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,600.13,600.13,
LEVEL I DENTAL RESTORATIONS,361,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3515.86,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3515.86,,,,other,Services are paid on an EAPG basis,3515.86,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3515.86,3515.86,
LEVEL II DENTAL RESTORATIONS,362,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3808.04,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3808.04,,,,other,Services are paid on an EAPG basis,3808.04,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3808.04,3808.04,
LEVEL III DENTAL RESTORATION,363,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4188.87,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4188.87,,,,other,Services are paid on an EAPG basis,4188.87,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4188.87,4188.87,
LEVEL I ENDODONTICS,364,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,280.39,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,280.39,,,,other,Services are paid on an EAPG basis,280.39,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,280.39,280.39,
LEVEL II ENDODONTICS,365,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,504.2,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,504.2,,,,other,Services are paid on an EAPG basis,504.2,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,504.2,504.2,
LEVEL III ENDODONTICS,366,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,507.91,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,507.91,,,,other,Services are paid on an EAPG basis,507.91,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,507.91,507.91,
LEVEL I ORAL AND MAXILLOFACIAL SURGERY,367,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1480.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1480.92,,,,other,Services are paid on an EAPG basis,1480.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1480.92,1480.92,
LEVEL II ORAL AND MAXILLOFACIAL SURGERY,368,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1539.75,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1539.75,,,,other,Services are paid on an EAPG basis,1539.75,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1539.75,1539.75,
LEVEL III ORAL AND MAXILLOFACIAL SURGERY,369,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1693.73,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1693.73,,,,other,Services are paid on an EAPG basis,1693.73,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1693.73,1693.73,
LEVEL IV ORAL AND MAXILLOFACIAL SURGERY,370,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1693.73,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1693.73,,,,other,Services are paid on an EAPG basis,1693.73,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1693.73,1693.73,
LEVEL I ORTHODONTICS,371,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,665.59,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,665.59,,,,other,Services are paid on an EAPG basis,665.59,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,665.59,665.59,
SEALANT,372,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,91.96,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,91.96,,,,other,Services are paid on an EAPG basis,91.96,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,91.96,91.96,
LEVEL I DENTAL FILM,373,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,119.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,119.92,,,,other,Services are paid on an EAPG basis,119.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,119.92,119.92,
LEVEL II DENTAL FILM,374,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,328.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,328.89,,,,other,Services are paid on an EAPG basis,328.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,328.89,328.89,
DENTAL ANESTHESIA,375,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,91.7,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,91.7,,,,other,Services are paid on an EAPG basis,91.7,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,91.7,91.7,
DIAGNOSTIC DENTAL PROCEDURES,376,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,489.36,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,489.36,,,,other,Services are paid on an EAPG basis,489.36,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,489.36,489.36,
PREVENTIVE DENTAL PROCEDURES,377,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,370.76,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,370.76,,,,other,Services are paid on an EAPG basis,370.76,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,370.76,370.76,
LEVEL II PERIODONTICS,378,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2238.08,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2238.08,,,,other,Services are paid on an EAPG basis,2238.08,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2238.08,2238.08,
LEVEL II ORTHODONTICS,379,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,732.11,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,732.11,,,,other,Services are paid on an EAPG basis,732.11,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,732.11,732.11,
ANESTHESIA,380,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.49,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.49,,,,other,Services are paid on an EAPG basis,50.49,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.49,50.49,
LEVEL I DENTAL IMPLANTS,381,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2585.38,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2585.38,,,,other,Services are paid on an EAPG basis,2585.38,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2585.38,2585.38,
LEVEL II DENTAL IMPLANTS,382,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2843.91,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2843.91,,,,other,Services are paid on an EAPG basis,2843.91,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2843.91,2843.91,
LEVEL I MOLECULAR PATHOLOGY AND GENETIC TESTS,385,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.6,,,,other,Services are paid on an EAPG basis,85.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.6,85.6,
LEVEL II MOLECULAR PATHOLOGY AND GENETIC TESTS,386,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,278.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,278.67,,,,other,Services are paid on an EAPG basis,278.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,278.67,278.67,
LEVEL III MOLECULAR PATHOLOGY AND GENETIC TESTS,387,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,790.81,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,790.81,,,,other,Services are paid on an EAPG basis,790.81,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,790.81,790.81,
LEVEL I PATHOLOGY,390,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,68.9,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,68.9,,,,other,Services are paid on an EAPG basis,68.9,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,68.9,68.9,
LEVEL II PATHOLOGY,391,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.8,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.8,,,,other,Services are paid on an EAPG basis,75.8,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.8,75.8,
PAP SMEARS,392,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.96,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.96,,,,other,Services are paid on an EAPG basis,49.96,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.96,49.96,
BLOOD AND TISSUE TYPING,393,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,87.19,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,87.19,,,,other,Services are paid on an EAPG basis,87.19,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,87.19,87.19,
LEVEL I IMMUNOLOGY TESTS,394,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.6,,,,other,Services are paid on an EAPG basis,21.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.6,21.6,
LEVEL II IMMUNOLOGY TESTS,395,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.24,,,,other,Services are paid on an EAPG basis,37.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.24,37.24,
LEVEL I MICROBIOLOGY TESTS,396,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.23,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.23,,,,other,Services are paid on an EAPG basis,17.23,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.23,17.23,
LEVEL II MICROBIOLOGY TESTS,397,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.24,,,,other,Services are paid on an EAPG basis,57.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.24,57.24,
LEVEL I ENDOCRINOLOGY TESTS,398,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.46,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.46,,,,other,Services are paid on an EAPG basis,32.46,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.46,32.46,
LEVEL II ENDOCRINOLOGY TESTS,399,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.45,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.45,,,,other,Services are paid on an EAPG basis,56.45,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.45,56.45,
LEVEL I CHEMISTRY TESTS,400,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.12,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.12,,,,other,Services are paid on an EAPG basis,24.12,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,24.12,24.12,
LEVEL II CHEMISTRY TESTS,401,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.93,,,,other,Services are paid on an EAPG basis,64.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.93,64.93,
BASIC CHEMISTRY TESTS,402,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.73,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.73,,,,other,Services are paid on an EAPG basis,10.73,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.73,10.73,
ORGAN OR DISEASE ORIENTED PANELS,403,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22,,,,other,Services are paid on an EAPG basis,22,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22,22,
TOXICOLOGY TESTS,404,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.42,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.42,,,,other,Services are paid on an EAPG basis,29.42,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.42,29.42,
THERAPEUTIC DRUG MONITORING,405,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.69,,,,other,Services are paid on an EAPG basis,27.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.69,27.69,
LEVEL I CLOTTING TESTS,406,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.75,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.75,,,,other,Services are paid on an EAPG basis,8.75,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.75,8.75,
LEVEL II CLOTTING TESTS,407,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.97,,,,other,Services are paid on an EAPG basis,25.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.97,25.97,
LEVEL I HEMATOLOGY TESTS,408,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.97,,,,other,Services are paid on an EAPG basis,14.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.97,14.97,
LEVEL II HEMATOLOGY TESTS,409,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.79,,,,other,Services are paid on an EAPG basis,22.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.79,22.79,
URINALYSIS,410,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.61,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.61,,,,other,Services are paid on an EAPG basis,8.61,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.61,8.61,
BLOOD AND URINE DIPSTICK TESTS,411,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.43,,,,other,Services are paid on an EAPG basis,5.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.43,5.43,
SIMPLE PULMONARY FUNCTION TESTS,412,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,160.07,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,160.07,,,,other,Services are paid on an EAPG basis,160.07,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,160.07,160.07,
CARDIOGRAM,413,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,55.12,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,55.12,,,,other,Services are paid on an EAPG basis,55.12,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,55.12,55.12,
LEVEL I IMMUNIZATION,414,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,47.04,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,47.04,,,,other,Services are paid on an EAPG basis,47.04,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,47.04,47.04,
LEVEL II IMMUNIZATION,415,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,198.1,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,198.1,,,,other,Services are paid on an EAPG basis,198.1,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,198.1,198.1,
LEVEL III IMMUNIZATION,416,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,491.74,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,491.74,,,,other,Services are paid on an EAPG basis,491.74,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,491.74,491.74,
MINOR REPRODUCTIVE PROCEDURES,417,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,384.14,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,384.14,,,,other,Services are paid on an EAPG basis,384.14,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,384.14,384.14,
MINOR CARDIAC AND VASCULAR TESTS,418,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,303.58,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,303.58,,,,other,Services are paid on an EAPG basis,303.58,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,303.58,303.58,
"MINOR OPHTHALMOLOGICAL INJECTION, SCRAPING AND TESTS",419,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,102.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,102.69,,,,other,Services are paid on an EAPG basis,102.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,102.69,102.69,
PACEMAKER AND OTHER ELECTRONIC ANALYSIS,420,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,542.23,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,542.23,,,,other,Services are paid on an EAPG basis,542.23,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,542.23,542.23,
TUBE CHANGE,421,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,447.35,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,447.35,,,,other,Services are paid on an EAPG basis,447.35,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,447.35,447.35,
PROVISION OF VISION AIDS,422,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,609.14,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,609.14,,,,other,Services are paid on an EAPG basis,609.14,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,609.14,609.14,
INTRODUCTION OF NEEDLE AND CATHETER,423,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,597.09,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,597.09,,,,other,Services are paid on an EAPG basis,597.09,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,597.09,597.09,
DRESSINGS AND OTHER MINOR PROCEDURES,424,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,304.11,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,304.11,,,,other,Services are paid on an EAPG basis,304.11,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,304.11,304.11,
LEVEL I OTHER MISCELLANEOUS ANCILLARY PROCEDURES,425,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.04,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.04,,,,other,Services are paid on an EAPG basis,5.04,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.04,5.04,
PSYCHOTROPIC MEDICATION MANAGEMENT,426,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,233.61,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,233.61,,,,other,Services are paid on an EAPG basis,233.61,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,233.61,233.61,
BIOFEEDBACK AND OTHER TRAINING,427,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,463.65,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,463.65,,,,other,Services are paid on an EAPG basis,463.65,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,463.65,463.65,
"PATIENT EDUCATION, INDIVIDUAL",428,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.25,,,,other,Services are paid on an EAPG basis,77.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,77.25,77.25,
"PATIENT EDUCATION, GROUP",429,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,98.45,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,98.45,,,,other,Services are paid on an EAPG basis,98.45,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,98.45,98.45,
CLASS II CHEMOTHERAPY DRUGS,431,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,292.18,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,292.18,,,,other,Services are paid on an EAPG basis,292.18,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,292.18,292.18,
CLASS III CHEMOTHERAPY DRUGS,432,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,378.05,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,378.05,,,,other,Services are paid on an EAPG basis,378.05,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,378.05,378.05,
CLASS IV CHEMOTHERAPY DRUGS,433,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,711.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,711.97,,,,other,Services are paid on an EAPG basis,711.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,711.97,711.97,
CLASS V CHEMOTHERAPY DRUGS,434,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,875.62,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,875.62,,,,other,Services are paid on an EAPG basis,875.62,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,875.62,875.62,
CLASS II PHARMACOTHERAPY,436,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,171.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,171.6,,,,other,Services are paid on an EAPG basis,171.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,171.6,171.6,
CLASS III PHARMACOTHERAPY,437,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,373.28,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,373.28,,,,other,Services are paid on an EAPG basis,373.28,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,373.28,373.28,
CLASS IV PHARMACOTHERAPY,438,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,683.61,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,683.61,,,,other,Services are paid on an EAPG basis,683.61,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,683.61,683.61,
CLASS V PHARMACOTHERAPY,439,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,717.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,717.93,,,,other,Services are paid on an EAPG basis,717.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,717.93,717.93,
CLASS VI PHARMACOTHERAPY,440,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1441.83,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1441.83,,,,other,Services are paid on an EAPG basis,1441.83,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1441.83,1441.83,
CLASS VI CHEMOTHERAPY DRUGS,441,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,919.21,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,919.21,,,,other,Services are paid on an EAPG basis,919.21,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,919.21,919.21,
CLASS VII CHEMOTHERAPY DRUGS,443,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1948.01,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1948.01,,,,other,Services are paid on an EAPG basis,1948.01,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1948.01,1948.01,
CLASS VII PHARMACOTHERAPY,444,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3056.72,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3056.72,,,,other,Services are paid on an EAPG basis,3056.72,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3056.72,3056.72,
EXPANDED HOURS ACCESS,448,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,98.32,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,98.32,,,,other,Services are paid on an EAPG basis,98.32,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,98.32,98.32,
OBSERVATION,450,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2444.39,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2444.39,,,,other,Services are paid on an EAPG basis,2444.39,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2444.39,2444.39,
SMOKING CESSATION TREATMENT,451,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,69.3,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,69.3,,,,other,Services are paid on an EAPG basis,69.3,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,69.3,69.3,
IMPLANTED TISSUE OF ANY TYPE,455,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,989.05,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,989.05,,,,other,Services are paid on an EAPG basis,989.05,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,989.05,989.05,
VENIPUNCTURE,457,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,103.75,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,103.75,,,,other,Services are paid on an EAPG basis,103.75,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,103.75,103.75,
ALLERGY THERAPY,458,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,52.61,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,52.61,,,,other,Services are paid on an EAPG basis,52.61,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,52.61,52.61,
VACCINE ADMINISTRATION,459,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,87.32,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,87.32,,,,other,Services are paid on an EAPG basis,87.32,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,87.32,87.32,
CLASS VIII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,460,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3209.63,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3209.63,,,,other,Services are paid on an EAPG basis,3209.63,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3209.63,3209.63,
CLASS IX COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,461,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4640.73,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4640.73,,,,other,Services are paid on an EAPG basis,4640.73,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4640.73,4640.73,
CLASS X COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,462,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6891.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6891.93,,,,other,Services are paid on an EAPG basis,6891.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6891.93,6891.93,
CLASS XI COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,463,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9490.96,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9490.96,,,,other,Services are paid on an EAPG basis,9490.96,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,9490.96,9490.96,
CLASS XII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,464,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15117.16,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15117.16,,,,other,Services are paid on an EAPG basis,15117.16,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,15117.16,15117.16,
CLASS XIII COMBINED CHEMOTHERAPY AND PHARMACOTHERAPY,465,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40417.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40417.37,,,,other,Services are paid on an EAPG basis,40417.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40417.37,40417.37,
OBSTETRICAL ULTRASOUND,470,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,210.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,210.69,,,,other,Services are paid on an EAPG basis,210.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,210.69,210.69,
PLAIN FILM,471,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,119.13,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,119.13,,,,other,Services are paid on an EAPG basis,119.13,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,119.13,119.13,
ULTRASOUND GUIDANCE,472,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,237.59,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,237.59,,,,other,Services are paid on an EAPG basis,237.59,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,237.59,237.59,
CT GUIDANCE,473,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,229.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,229.24,,,,other,Services are paid on an EAPG basis,229.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,229.24,229.24,
RADIOLOGICAL GUIDANCE FOR THERAPEUTIC OR DIAGNOSTIC PROCEDURES,474,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,678.84,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,678.84,,,,other,Services are paid on an EAPG basis,678.84,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,678.84,678.84,
MRI GUIDANCE,475,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,405.88,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,405.88,,,,other,Services are paid on an EAPG basis,405.88,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,405.88,405.88,
LEVEL I THERAPEUTIC RADIATION TREATMENT PREPARATION,476,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,731.18,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,731.18,,,,other,Services are paid on an EAPG basis,731.18,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,731.18,731.18,
LEVEL II THERAPEUTIC RADIATION TREATMENT PREPARATION,477,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1629.73,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1629.73,,,,other,Services are paid on an EAPG basis,1629.73,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1629.73,1629.73,
MEDICAL RADIATION PHYSICS,478,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,256.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,256.93,,,,other,Services are paid on an EAPG basis,256.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,256.93,256.93,
TREATMENT DEVICE DESIGN AND CONSTRUCTION,479,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,442.45,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,442.45,,,,other,Services are paid on an EAPG basis,442.45,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,442.45,442.45,
TELETHERAPY/BRACHYTHERAPY CALCULATION,480,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,210.16,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,210.16,,,,other,Services are paid on an EAPG basis,210.16,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,210.16,210.16,
THERAPEUTIC RADIOLOGY SIMULATION FIELD SETTING,481,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1295.94,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1295.94,,,,other,Services are paid on an EAPG basis,1295.94,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1295.94,1295.94,
RADIOELEMENT APPLICATION,482,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7669.09,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7669.09,,,,other,Services are paid on an EAPG basis,7669.09,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7669.09,7669.09,
RADIATION THERAPY MANAGEMENT,483,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,263.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,263.69,,,,other,Services are paid on an EAPG basis,263.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,263.69,263.69,
THERAPEUTIC RADIOLOGY TREATMENT PLANNING,484,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,915.5,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,915.5,,,,other,Services are paid on an EAPG basis,915.5,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,915.5,915.5,
CORNEAL TISSUE PROCESSING,485,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5220.99,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5220.99,,,,other,Services are paid on an EAPG basis,5220.99,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5220.99,5220.99,
BASIC BLOOD TYPING,486,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.38,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.38,,,,other,Services are paid on an EAPG basis,13.38,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.38,13.38,
MINOR CARDIAC MONITORING,487,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,147.88,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,147.88,,,,other,Services are paid on an EAPG basis,147.88,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,147.88,147.88,
MINOR DEVICE EVALUATION & ELECTRONIC ANALYSIS,488,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,90.5,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,90.5,,,,other,Services are paid on an EAPG basis,90.5,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,90.5,90.5,
LEVEL II OTHER MISCELLANEOUS ANCILLARY PROCEDURES,489,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,255.61,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,255.61,,,,other,Services are paid on an EAPG basis,255.61,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,255.61,255.61,
ANCILLARY THERAPEUTIC SERVICES,493,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,59.1,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,59.1,,,,other,Services are paid on an EAPG basis,59.1,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,59.1,59.1,
TELEHEALTH FACILITATION,497,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.27,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.27,,,,other,Services are paid on an EAPG basis,31.27,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,31.27,31.27,
"MAJOR SIGNS, SYMPTOMS AND FINDINGS",510,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,296.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,296.69,,,,other,Services are paid on an EAPG basis,296.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,296.69,296.69,
SPINAL DIAGNOSES & INJURIES,520,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,300.27,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,300.27,,,,other,Services are paid on an EAPG basis,300.27,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,300.27,300.27,
NERVOUS SYSTEM MALIGNANCY,521,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,328.22,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,328.22,,,,other,Services are paid on an EAPG basis,328.22,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,328.22,328.22,
DEGENERATIVE NERVOUS SYSTEM DIAGNOSES EXC MULT SCLEROSIS,522,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,240.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,240.37,,,,other,Services are paid on an EAPG basis,240.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,240.37,240.37,
MULTIPLE SCLEROSIS & OTHER DEMYELINATING DISEASES,523,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,281.58,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,281.58,,,,other,Services are paid on an EAPG basis,281.58,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,281.58,281.58,
LEVEL I CNS DIAGNOSES,524,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,250.18,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,250.18,,,,other,Services are paid on an EAPG basis,250.18,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,250.18,250.18,
LEVEL II CNS DIAGNOSES,525,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,279.99,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,279.99,,,,other,Services are paid on an EAPG basis,279.99,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,279.99,279.99,
TRANSIENT ISCHEMIA,526,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,320.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,320.67,,,,other,Services are paid on an EAPG basis,320.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,320.67,320.67,
PERIPHERAL AND CRANIAL NERVE DIAGNOSES,527,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,287.15,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,287.15,,,,other,Services are paid on an EAPG basis,287.15,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,287.15,287.15,
NONTRAUMATIC STUPOR & COMA,528,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,430.52,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,430.52,,,,other,Services are paid on an EAPG basis,430.52,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,430.52,430.52,
SEIZURE,529,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,320.41,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,320.41,,,,other,Services are paid on an EAPG basis,320.41,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,320.41,320.41,
HEADACHES OTHER THAN MIGRAINE,530,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,317.76,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,317.76,,,,other,Services are paid on an EAPG basis,317.76,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,317.76,317.76,
MIGRAINE,531,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,341.21,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,341.21,,,,other,Services are paid on an EAPG basis,341.21,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,341.21,341.21,
HEAD TRAUMA,532,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,442.45,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,442.45,,,,other,Services are paid on an EAPG basis,442.45,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,442.45,442.45,
AFTEREFFECTS OF CEREBROVASCULAR ACCIDENT,533,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,269.39,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,269.39,,,,other,Services are paid on an EAPG basis,269.39,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,269.39,269.39,
NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARC,534,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,251.5,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,251.5,,,,other,Services are paid on an EAPG basis,251.5,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,251.5,251.5,
CVA & PRECEREBRAL OCCLUSION W INFARCT,535,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,295.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,295.89,,,,other,Services are paid on an EAPG basis,295.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,295.89,295.89,
CEREBRAL PALSY,536,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,309.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,309.67,,,,other,Services are paid on an EAPG basis,309.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,309.67,309.67,
ACUTE MAJOR EYE INFECTIONS,550,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,242.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,242.89,,,,other,Services are paid on an EAPG basis,242.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,242.89,242.89,
CATARACTS,551,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,208.7,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,208.7,,,,other,Services are paid on an EAPG basis,208.7,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,208.7,208.7,
GLAUCOMA,552,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,260.78,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,260.78,,,,other,Services are paid on an EAPG basis,260.78,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,260.78,260.78,
LEVEL I OTHER OPHTHALMIC DIAGNOSES,553,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,242.62,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,242.62,,,,other,Services are paid on an EAPG basis,242.62,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,242.62,242.62,
LEVEL II OTHER OPHTHALMIC DIAGNOSES,554,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,325.31,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,325.31,,,,other,Services are paid on an EAPG basis,325.31,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,325.31,325.31,
CONJUNCTIVITIS,555,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,248.85,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,248.85,,,,other,Services are paid on an EAPG basis,248.85,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,248.85,248.85,
"EAR, NOSE, MOUTH, THROAT, CRANIAL/FACIAL MALIGNANCIES",560,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,298.01,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,298.01,,,,other,Services are paid on an EAPG basis,298.01,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,298.01,298.01,
VERTIGINOUS DIAGNOSES EXCEPT FOR BENIGN VERTIGO,561,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,378.58,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,378.58,,,,other,Services are paid on an EAPG basis,378.58,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,378.58,378.58,
INFECTIONS OF UPPER RESPIRATORY TRACT & OTITIS MEDIA,562,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,257.07,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,257.07,,,,other,Services are paid on an EAPG basis,257.07,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,257.07,257.07,
DENTAL & ORAL DIAGNOSES & INJURIES,563,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,261.57,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,261.57,,,,other,Services are paid on an EAPG basis,261.57,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,261.57,261.57,
"LEVEL I OTHER EAR, NOSE, MOUTH,THROAT & CRANIAL/FACIAL DIAGNOSES",564,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,271.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,271.25,,,,other,Services are paid on an EAPG basis,271.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,271.25,271.25,
"LEVEL II OTHER EAR, NOSE, MOUTH,THROAT & CRANIAL/FACIAL DIAGNOSES",565,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,322.26,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,322.26,,,,other,Services are paid on an EAPG basis,322.26,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,322.26,322.26,
CYSTIC FIBROSIS - PULMONARY DISEASE,570,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,552.56,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,552.56,,,,other,Services are paid on an EAPG basis,552.56,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,552.56,552.56,
RESPIRATORY MALIGNANCY,571,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,330.34,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,330.34,,,,other,Services are paid on an EAPG basis,330.34,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,330.34,330.34,
BRONCHIOLITIS & RSV PNEUMONIA,572,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,381.23,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,381.23,,,,other,Services are paid on an EAPG basis,381.23,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,381.23,381.23,
COMMUNITY ACQUIRED PNUEMONIA,573,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,430.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,430.79,,,,other,Services are paid on an EAPG basis,430.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,430.79,430.79,
CHRONIC OBSTRUCTIVE PULMONARY DISEASE,574,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,341.34,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,341.34,,,,other,Services are paid on an EAPG basis,341.34,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,341.34,341.34,
ASTHMA,575,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,316.96,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,316.96,,,,other,Services are paid on an EAPG basis,316.96,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,316.96,316.96,
LEVEL I OTHER RESPIRATORY DIAGNOSES,576,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,370.1,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,370.1,,,,other,Services are paid on an EAPG basis,370.1,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,370.1,370.1,
LEVEL II OTHER RESPIRATORY DIAGNOSES,577,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,427.21,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,427.21,,,,other,Services are paid on an EAPG basis,427.21,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,427.21,427.21,
PNEUMONIA EXCEPT FOR COMMUNITY ACQUIRED PNEUMONIA,578,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,321.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,321.6,,,,other,Services are paid on an EAPG basis,321.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,321.6,321.6,
STATUS ASTHMATICUS,579,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,322.66,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,322.66,,,,other,Services are paid on an EAPG basis,322.66,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,322.66,322.66,
ACUTE MYOCARDIAL INFARCTION,591,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,755.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,755.43,,,,other,Services are paid on an EAPG basis,755.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,755.43,755.43,
LEVEL I CARDIOVASCULAR DIAGNOSES,592,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,342.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,342.67,,,,other,Services are paid on an EAPG basis,342.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,342.67,342.67,
LEVEL II CARDIOVASCULAR DIAGNOSES,593,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,312.32,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,312.32,,,,other,Services are paid on an EAPG basis,312.32,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,312.32,312.32,
HEART FAILURE,594,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,395.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,395.67,,,,other,Services are paid on an EAPG basis,395.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,395.67,395.67,
CARDIAC ARREST OR OTHER CAUSES OF MORTALITY,595,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,646.51,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,646.51,,,,other,Services are paid on an EAPG basis,646.51,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,646.51,646.51,
PERIPHERAL & OTHER VASCULAR DIAGNOSES,596,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,295.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,295.89,,,,other,Services are paid on an EAPG basis,295.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,295.89,295.89,
PHLEBITIS,597,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,250.04,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,250.04,,,,other,Services are paid on an EAPG basis,250.04,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,250.04,250.04,
ANGINA PECTORIS & CORONARY ATHEROSCLEROSIS,598,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,243.82,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,243.82,,,,other,Services are paid on an EAPG basis,243.82,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,243.82,243.82,
HYPERTENSION,599,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,265.95,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,265.95,,,,other,Services are paid on an EAPG basis,265.95,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,265.95,265.95,
CARDIAC STRUCTURAL & VALVULAR DIAGNOSES,600,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,242.49,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,242.49,,,,other,Services are paid on an EAPG basis,242.49,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,242.49,242.49,
LEVEL I CARDIAC ARRHYTHMIA & CONDUCTION DIAGNOSES,601,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,298.01,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,298.01,,,,other,Services are paid on an EAPG basis,298.01,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,298.01,298.01,
ATRIAL FIBRILLATION,602,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,248.98,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,248.98,,,,other,Services are paid on an EAPG basis,248.98,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,248.98,248.98,
LEVEL II CARDIAC ARRHYTHMIA & CONDUCTION DIAGNOSES,603,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,307.29,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,307.29,,,,other,Services are paid on an EAPG basis,307.29,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,307.29,307.29,
CHEST PAIN,604,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,654.86,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,654.86,,,,other,Services are paid on an EAPG basis,654.86,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,654.86,654.86,
SYNCOPE & COLLAPSE,605,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,485.12,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,485.12,,,,other,Services are paid on an EAPG basis,485.12,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,485.12,485.12,
DIGESTIVE MALIGNANCY,620,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,333.13,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,333.13,,,,other,Services are paid on an EAPG basis,333.13,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,333.13,333.13,
PEPTIC ULCER & GASTRITIS,621,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,476.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,476.37,,,,other,Services are paid on an EAPG basis,476.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,476.37,476.37,
ESOPHAGITIS,623,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,319.48,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,319.48,,,,other,Services are paid on an EAPG basis,319.48,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,319.48,319.48,
LEVEL I GASTROINTESTINAL DIAGNOSES,624,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,309.41,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,309.41,,,,other,Services are paid on an EAPG basis,309.41,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,309.41,309.41,
LEVEL II GASTROINTESTINAL DIAGNOSES,625,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,337.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,337.24,,,,other,Services are paid on an EAPG basis,337.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,337.24,337.24,
INFLAMMATORY BOWEL DISEASE,626,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,271.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,271.25,,,,other,Services are paid on an EAPG basis,271.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,271.25,271.25,
"NON-BACTERIAL GASTROENTERITIS, NAUSEA & VOMITING",627,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,439.13,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,439.13,,,,other,Services are paid on an EAPG basis,439.13,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,439.13,439.13,
ABDOMINAL PAIN,628,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,451.86,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,451.86,,,,other,Services are paid on an EAPG basis,451.86,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,451.86,451.86,
"MALFUNCTION, REACTION & COMPLICATION OF GI DEVICE OR PROCEDURE",629,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,363.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,363.6,,,,other,Services are paid on an EAPG basis,363.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,363.6,363.6,
CONSTIPATION,630,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,397.53,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,397.53,,,,other,Services are paid on an EAPG basis,397.53,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,397.53,397.53,
HERNIA,631,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,282.38,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,282.38,,,,other,Services are paid on an EAPG basis,282.38,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,282.38,282.38,
IRRITABLE BOWEL SYNDROME,632,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,235.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,235.6,,,,other,Services are paid on an EAPG basis,235.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,235.6,235.6,
ALCOHOLIC LIVER DISEASE,633,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,338.03,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,338.03,,,,other,Services are paid on an EAPG basis,338.03,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,338.03,338.03,
MALIGNANCY OF HEPATOBILIARY SYSTEM & PANCREAS,634,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,359.23,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,359.23,,,,other,Services are paid on an EAPG basis,359.23,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,359.23,359.23,
PANCREAS DIAGNOSES EXCEPT MALIGNANCY,635,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,365.86,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,365.86,,,,other,Services are paid on an EAPG basis,365.86,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,365.86,365.86,
HEPATITIS WITHOUT COMA,636,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,307.16,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,307.16,,,,other,Services are paid on an EAPG basis,307.16,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,307.16,307.16,
GALLBLADDER & BILIARY TRACT DIAGNOSES,637,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,311.26,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,311.26,,,,other,Services are paid on an EAPG basis,311.26,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,311.26,311.26,
CHOLECYSTITIS,638,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,420.98,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,420.98,,,,other,Services are paid on an EAPG basis,420.98,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,420.98,420.98,
LEVEL I HEPATOBILIARY DIAGNOSES,639,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,322.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,322.92,,,,other,Services are paid on an EAPG basis,322.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,322.92,322.92,
LEVEL II HEPATOBILIARY DIAGNOSES,640,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,330.34,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,330.34,,,,other,Services are paid on an EAPG basis,330.34,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,330.34,330.34,
FRACTURE OF FEMUR,650,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,700.44,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,700.44,,,,other,Services are paid on an EAPG basis,700.44,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,700.44,700.44,
FRACTURE OF PELVIS OR DISLOCATION OF HIP,651,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,547,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,547,,,,other,Services are paid on an EAPG basis,547,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,547,547,
"FRACTURES & DISLOCATIONS EXCEPT FEMUR, PELVIS & BACK",652,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,483.53,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,483.53,,,,other,Services are paid on an EAPG basis,483.53,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,483.53,483.53,
MUSCULOSKELETAL MALIGNANCY & PATHOLOGICAL FRACTURES,653,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,386.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,386.79,,,,other,Services are paid on an EAPG basis,386.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,386.79,386.79,
"OSTEOMYELITIS, SEPTIC ARTHRITIS & OTHER MUSCULOSKELETAL INFECTIONS",654,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,304.64,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,304.64,,,,other,Services are paid on an EAPG basis,304.64,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,304.64,304.64,
CONNECTIVE TISSUE DIAGNOSES,655,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,272.04,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,272.04,,,,other,Services are paid on an EAPG basis,272.04,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,272.04,272.04,
BACK & NECK DIAGNOSES EXCEPT LUMBAR DISC DIAGNOSES,656,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,359.76,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,359.76,,,,other,Services are paid on an EAPG basis,359.76,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,359.76,359.76,
LUMBAR DISC DIAGNOSES,657,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,318.95,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,318.95,,,,other,Services are paid on an EAPG basis,318.95,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,318.95,318.95,
LUMBAR DISC DIAGNOSES WITH SCIATICA,658,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,353.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,353.67,,,,other,Services are paid on an EAPG basis,353.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,353.67,353.67,
"MALFUNCTION, REACTION, COMPLIC OF ORTHOPEDIC DEVICE OR PROCEDURE",659,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,335.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,335.25,,,,other,Services are paid on an EAPG basis,335.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,335.25,335.25,
LEVEL I OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES,660,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,335.91,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,335.91,,,,other,Services are paid on an EAPG basis,335.91,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,335.91,335.91,
LEVEL II OTHER MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE DIAGNOSES,661,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,343.2,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,343.2,,,,other,Services are paid on an EAPG basis,343.2,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,343.2,343.2,
OSTEOPOROSIS,662,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,242.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,242.89,,,,other,Services are paid on an EAPG basis,242.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,242.89,242.89,
PAIN,663,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,309.81,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,309.81,,,,other,Services are paid on an EAPG basis,309.81,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,309.81,309.81,
SKIN ULCERS,670,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,369.17,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,369.17,,,,other,Services are paid on an EAPG basis,369.17,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,369.17,369.17,
MAJOR SKIN DIAGNOSES,671,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,278.14,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,278.14,,,,other,Services are paid on an EAPG basis,278.14,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,278.14,278.14,
MALIGNANT BREAST DIAGNOSES,672,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,302.12,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,302.12,,,,other,Services are paid on an EAPG basis,302.12,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,302.12,302.12,
CELLULITIS & OTHER BACTERIAL SKIN INFECTIONS,673,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,305.7,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,305.7,,,,other,Services are paid on an EAPG basis,305.7,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,305.7,305.7,
"CONTUSION, OPEN WOUND & OTHER TRAUMA TO SKIN & SUBCUTANEOUS TISSUE",674,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,390.64,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,390.64,,,,other,Services are paid on an EAPG basis,390.64,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,390.64,390.64,
"OTHER SKIN, SUBCUTANEOUS TISSUE & BREAST DIAGNOSES",675,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,249.91,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,249.91,,,,other,Services are paid on an EAPG basis,249.91,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,249.91,249.91,
DECUBITUS ULCER,676,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,382.95,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,382.95,,,,other,Services are paid on an EAPG basis,382.95,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,382.95,382.95,
"MALNUTRITION, FAILURE TO THRIVE & OTHER NUTRITIONAL DIAGNOSES",690,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,283.83,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,283.83,,,,other,Services are paid on an EAPG basis,283.83,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,283.83,283.83,
INBORN ERRORS OF METABOLISM,691,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,247.39,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,247.39,,,,other,Services are paid on an EAPG basis,247.39,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,247.39,247.39,
LEVEL I ENDOCRINE DIAGNOSES,692,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,263.16,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,263.16,,,,other,Services are paid on an EAPG basis,263.16,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,263.16,263.16,
LEVEL II ENDOCRINE DIAGNOSES,693,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,280.65,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,280.65,,,,other,Services are paid on an EAPG basis,280.65,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,280.65,280.65,
ELECTROLYTE DISORDERS,694,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,462.85,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,462.85,,,,other,Services are paid on an EAPG basis,462.85,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,462.85,462.85,
OBESITY,695,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,263.3,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,263.3,,,,other,Services are paid on an EAPG basis,263.3,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,263.3,263.3,
DIABETES WITH OPHTHALMIC MANIFESTATIONS,710,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,265.02,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,265.02,,,,other,Services are paid on an EAPG basis,265.02,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,265.02,265.02,
DIABETES WITH OTHER MANIFESTATIONS & COMPLICATIONS,711,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,334.59,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,334.59,,,,other,Services are paid on an EAPG basis,334.59,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,334.59,334.59,
DIABETES WITH NEUROLOGIC MANIFESTATIONS,712,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,273.76,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,273.76,,,,other,Services are paid on an EAPG basis,273.76,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,273.76,273.76,
DIABETES WITHOUT COMPLICATIONS,713,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,256.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,256.93,,,,other,Services are paid on an EAPG basis,256.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,256.93,256.93,
DIABETES WITH RENAL MANIFESTATIONS,714,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,269.39,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,269.39,,,,other,Services are paid on an EAPG basis,269.39,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,269.39,269.39,
RENAL FAILURE,720,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,302.52,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,302.52,,,,other,Services are paid on an EAPG basis,302.52,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,302.52,302.52,
KIDNEY & URINARY TRACT MALIGNANCY,721,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,324.78,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,324.78,,,,other,Services are paid on an EAPG basis,324.78,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,324.78,324.78,
NEPHRITIS & NEPHROSIS,722,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,313.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,313.25,,,,other,Services are paid on an EAPG basis,313.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,313.25,313.25,
KIDNEY AND CHRONIC URINARY TRACT INFECTIONS,723,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,386.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,386.79,,,,other,Services are paid on an EAPG basis,386.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,386.79,386.79,
URINARY STONES & ACQUIRED UPPER URINARY TRACT OBSTRUCTION,724,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,316.17,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,316.17,,,,other,Services are paid on an EAPG basis,316.17,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,316.17,316.17,
"MALFUNCTION, REACTION, COMPLIC OF GENITOURINARY DEVICE OR PROC",725,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,422.17,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,422.17,,,,other,Services are paid on an EAPG basis,422.17,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,422.17,422.17,
"OTHER KIDNEY & URINARY TRACT DIAGNOSES, SIGNS & SYMPTOMS",726,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,320.14,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,320.14,,,,other,Services are paid on an EAPG basis,320.14,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,320.14,320.14,
ACUTE LOWER URINARY TRACT INFECTIONS,727,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,410.12,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,410.12,,,,other,Services are paid on an EAPG basis,410.12,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,410.12,410.12,
"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",740,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,309.41,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,309.41,,,,other,Services are paid on an EAPG basis,309.41,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,309.41,309.41,
MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,741,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,283.44,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,283.44,,,,other,Services are paid on an EAPG basis,283.44,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,283.44,283.44,
NEOPLASMS OF THE MALE REPRODUCTIVE SYSTEM,742,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,239.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,239.97,,,,other,Services are paid on an EAPG basis,239.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,239.97,239.97,
PROSTATITIS,743,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,272.57,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,272.57,,,,other,Services are paid on an EAPG basis,272.57,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,272.57,272.57,
MALE REPRODUCTIVE INFECTIONS,744,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,311.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,311.79,,,,other,Services are paid on an EAPG basis,311.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,311.79,311.79,
FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,750,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,308.88,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,308.88,,,,other,Services are paid on an EAPG basis,308.88,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,308.88,308.88,
FEMALE REPRODUCTIVE SYSTEM INFECTIONS,751,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,325.18,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,325.18,,,,other,Services are paid on an EAPG basis,325.18,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,325.18,325.18,
LEVEL I MENSTRUAL AND OTHER FEMALE DIAGNOSES,752,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,298.94,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,298.94,,,,other,Services are paid on an EAPG basis,298.94,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,298.94,298.94,
LEVEL II MENSTRUAL AND OTHER FEMALE DIAGNOSES,753,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,334.72,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,334.72,,,,other,Services are paid on an EAPG basis,334.72,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,334.72,334.72,
VAGINAL DELIVERY,760,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,475.04,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,475.04,,,,other,Services are paid on an EAPG basis,475.04,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,475.04,475.04,
POSTPARTUM & POST ABORTION DIAGNOSES W/O PROCEDURE,761,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,375.8,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,375.8,,,,other,Services are paid on an EAPG basis,375.8,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,375.8,375.8,
THREATENED ABORTION,762,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,574.56,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,574.56,,,,other,Services are paid on an EAPG basis,574.56,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,574.56,574.56,
"ABORTION W/O D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",763,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,551.9,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,551.9,,,,other,Services are paid on an EAPG basis,551.9,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,551.9,551.9,
FALSE LABOR,764,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,536.66,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,536.66,,,,other,Services are paid on an EAPG basis,536.66,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,536.66,536.66,
OTHER ANTEPARTUM DIAGNOSES,765,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,420.98,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,420.98,,,,other,Services are paid on an EAPG basis,420.98,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,420.98,420.98,
ROUTINE PRENATAL CARE,766,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,316.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,316.43,,,,other,Services are paid on an EAPG basis,316.43,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,316.43,316.43,
NORMAL NEONATE,770,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,275.62,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,275.62,,,,other,Services are paid on an EAPG basis,275.62,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,275.62,275.62,
LEVEL I NEONATAL DIAGNOSES,771,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,280.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,280.92,,,,other,Services are paid on an EAPG basis,280.92,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,280.92,280.92,
LEVEL II NEONATAL DIAGNOSES,772,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,312.19,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,312.19,,,,other,Services are paid on an EAPG basis,312.19,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,312.19,312.19,
OTHER HEMATOLOGICAL DIAGNOSES,780,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,348.1,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,348.1,,,,other,Services are paid on an EAPG basis,348.1,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,348.1,348.1,
COAGULATION & PLATELET DIAGNOSES,781,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,308.22,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,308.22,,,,other,Services are paid on an EAPG basis,308.22,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,308.22,308.22,
CONGENITAL FACTOR DEFICIENCIES,782,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,315.64,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,315.64,,,,other,Services are paid on an EAPG basis,315.64,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,315.64,315.64,
SICKLE CELL ANEMIA CRISIS,783,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,779.55,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,779.55,,,,other,Services are paid on an EAPG basis,779.55,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,779.55,779.55,
SICKLE CELL ANEMIA,784,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,399.78,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,399.78,,,,other,Services are paid on an EAPG basis,399.78,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,399.78,399.78,
ANEMIA EXCEPT FOR IRON DEFICIENCY ANEMIA AND SICKLE CELL ANEMIA,785,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,327.3,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,327.3,,,,other,Services are paid on an EAPG basis,327.3,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,327.3,327.3,
IRON DEFICIENCY ANEMIA,786,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,314.58,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,314.58,,,,other,Services are paid on an EAPG basis,314.58,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,314.58,314.58,
ACUTE LEUKEMIA,800,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,434.36,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,434.36,,,,other,Services are paid on an EAPG basis,434.36,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,434.36,434.36,
"LYMPHOMA, MYELOMA & NON-ACUTE LEUKEMIA",801,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,364.27,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,364.27,,,,other,Services are paid on an EAPG basis,364.27,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,364.27,364.27,
RADIOTHERAPY,802,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,395.01,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,395.01,,,,other,Services are paid on an EAPG basis,395.01,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,395.01,395.01,
CHEMOTHERAPY,803,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,400.18,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,400.18,,,,other,Services are paid on an EAPG basis,400.18,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,400.18,400.18,
LYMPHATIC & OTHER MALIGNANCIES & NEOPLASMS OF UNCERTAIN BEHAVIOR,804,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,351.68,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,351.68,,,,other,Services are paid on an EAPG basis,351.68,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,351.68,351.68,
SEPTICEMIA & DISSEMINATED INFECTIONS,805,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,629.29,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,629.29,,,,other,Services are paid on an EAPG basis,629.29,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,629.29,629.29,
"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS AND COMPLICATIONS",806,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,345.85,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,345.85,,,,other,Services are paid on an EAPG basis,345.85,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,345.85,345.85,
FEVER,807,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,429.59,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,429.59,,,,other,Services are paid on an EAPG basis,429.59,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,429.59,429.59,
VIRAL ILLNESS,808,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,434.76,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,434.76,,,,other,Services are paid on an EAPG basis,434.76,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,434.76,434.76,
OTHER INFECTIOUS & PARASITIC DISEASES,809,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,282.64,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,282.64,,,,other,Services are paid on an EAPG basis,282.64,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,282.64,282.64,
H. PYLORI INFECTION,810,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,238.78,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,238.78,,,,other,Services are paid on an EAPG basis,238.78,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,238.78,238.78,
SCHIZOPHRENIA,820,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,327.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,327.69,,,,other,Services are paid on an EAPG basis,327.69,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,327.69,327.69,
MAJOR DEPRESSIVE DIAGNOSES & OTHER/UNSPECIFIED PSYCHOSES,821,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,296.16,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,296.16,,,,other,Services are paid on an EAPG basis,296.16,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,296.16,296.16,
PERSONALITY & IMPULSE CONTROL DIAGNOSES,822,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,363.07,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,363.07,,,,other,Services are paid on an EAPG basis,363.07,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,363.07,363.07,
BIPOLAR DISORDERS,823,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,290.33,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,290.33,,,,other,Services are paid on an EAPG basis,290.33,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,290.33,290.33,
DEPRESSION EXCEPT MAJOR DEPRESSIVE DIAGNOSES,824,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,262.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,262.24,,,,other,Services are paid on an EAPG basis,262.24,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,262.24,262.24,
ADJUSTMENT DISORDERS & NEUROSES EXCEPT DEPRESSIVE DIAGNOSES,825,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,291.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,291.25,,,,other,Services are paid on an EAPG basis,291.25,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,291.25,291.25,
ACUTE ANXIETY & DELIRIUM STATES,826,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,356.98,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,356.98,,,,other,Services are paid on an EAPG basis,356.98,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,356.98,356.98,
ORGANIC MENTAL HEALTH DISTURBANCES,827,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,310.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,310.6,,,,other,Services are paid on an EAPG basis,310.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,310.6,310.6,
MENTAL RETARDATION,828,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,252.83,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,252.83,,,,other,Services are paid on an EAPG basis,252.83,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,252.83,252.83,
CHILDHOOD BEHAVIORAL DIAGNOSES,829,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,269.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,269.79,,,,other,Services are paid on an EAPG basis,269.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,269.79,269.79,
EATING DISORDERS,830,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,386.26,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,386.26,,,,other,Services are paid on an EAPG basis,386.26,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,386.26,386.26,
OTHER MENTAL HEALTH DIAGNOSES,831,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,327.3,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,327.3,,,,other,Services are paid on an EAPG basis,327.3,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,327.3,327.3,
OPIOID ABUSE & DEPENDENCE,840,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,276.55,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,276.55,,,,other,Services are paid on an EAPG basis,276.55,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,276.55,276.55,
COCAINE ABUSE & DEPENDENCE,841,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,553.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,553.89,,,,other,Services are paid on an EAPG basis,553.89,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,553.89,553.89,
ALCOHOL ABUSE & DEPENDENCE,842,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,515.86,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,515.86,,,,other,Services are paid on an EAPG basis,515.86,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,515.86,515.86,
OTHER DRUG ABUSE & DEPENDENCE,843,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,486.31,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,486.31,,,,other,Services are paid on an EAPG basis,486.31,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,486.31,486.31,
ALLERGIC REACTIONS,850,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,430.26,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,430.26,,,,other,Services are paid on an EAPG basis,430.26,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,430.26,430.26,
POISONING OF MEDICINAL AGENTS,851,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,513.74,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,513.74,,,,other,Services are paid on an EAPG basis,513.74,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,513.74,513.74,
OTHER COMPLICATIONS OF TREATMENT,852,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,365.59,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,365.59,,,,other,Services are paid on an EAPG basis,365.59,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,365.59,365.59,
"OTHER INJURY, POISONING & TOXIC EFFECT DIAGNOSES",853,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,365.46,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,365.46,,,,other,Services are paid on an EAPG basis,365.46,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,365.46,365.46,
TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,854,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,369.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,369.97,,,,other,Services are paid on an EAPG basis,369.97,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,369.97,369.97,
EXTENSIVE 3RD DEGREE OR FULL THICKNESS BURNS W/O SKIN GRAFT,860,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,439.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,439.93,,,,other,Services are paid on an EAPG basis,439.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,439.93,439.93,
PARTIAL THICKNESS BURNS W OR W/O SKIN GRAFT,861,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,396.33,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,396.33,,,,other,Services are paid on an EAPG basis,396.33,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,396.33,396.33,
REHABILITATION,870,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,208.17,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,208.17,,,,other,Services are paid on an EAPG basis,208.17,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,208.17,208.17,
"SIGNS, SYMPTOMS & OTHER FACTORS INFLUENCING HEALTH STATUS",871,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,300.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,300.93,,,,other,Services are paid on an EAPG basis,300.93,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,300.93,300.93,
OTHER AFTERCARE & CONVALESCENCE,872,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236.79,,,,other,Services are paid on an EAPG basis,236.79,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236.79,236.79,
NEONATAL AFTERCARE,873,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,239.71,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,239.71,,,,other,Services are paid on an EAPG basis,239.71,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,239.71,239.71,
JOINT REPLACEMENT,874,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,261.44,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,261.44,,,,other,Services are paid on an EAPG basis,261.44,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,261.44,261.44,
CONTRACEPTIVE MANAGEMENT,875,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,320.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,320.67,,,,other,Services are paid on an EAPG basis,320.67,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,320.67,320.67,
ADULT PREVENTIVE MEDICINE,876,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,326.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,326.37,,,,other,Services are paid on an EAPG basis,326.37,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,326.37,326.37,
CHILD PREVENTIVE MEDICINE,877,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,260.78,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,260.78,,,,other,Services are paid on an EAPG basis,260.78,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,260.78,260.78,
GYNECOLOGIC PREVENTIVE MEDICINE,878,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,272.84,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,272.84,,,,other,Services are paid on an EAPG basis,272.84,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,272.84,272.84,
PREVENTIVE OR SCREENING ENCOUNTER,879,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,302.52,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,302.52,,,,other,Services are paid on an EAPG basis,302.52,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,302.52,302.52,
HIV INFECTION,880,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,334.59,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,334.59,,,,other,Services are paid on an EAPG basis,334.59,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,334.59,334.59,
AIDS,881,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,369.17,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,369.17,,,,other,Services are paid on an EAPG basis,369.17,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,369.17,369.17,
GENETIC COUNSELING,882,EAPG,,,,,outpatient,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,407.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,407.6,,,,other,Services are paid on an EAPG basis,407.6,,,,other,Services are paid on an EAPG basis,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,407.6,407.6,
PFIZER 1ST ADMIN SARSCOV2 30MCG/0.3ML,0001A,CDM,0001A,CPT,,,both,,83,83,16.94,,,,fee schedule,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,40,,,,fee schedule,,40,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,16.94,78.85,
ADM SARSCOV2 30MCG/0.3ML 2ND,0002A,CDM,0002A,CPT,,,both,,83,83,28.39,,,,fee schedule,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,40,,,,fee schedule,,40,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,24.9,78.85,
ADM SARSCOV2 30MCG/0.3ML 3RD,0003A,CDM,0003A,CPT,,,both,,83,83,,,,,,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,40,,,,fee schedule,,40,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,24.9,78.85,
MODERNA 1ST ADMIN SARSCOV2 100MCG/0.5ML,0011A,CDM,0011A,CPT,,,both,,83,83,16.94,,,,fee schedule,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,40,,,,fee schedule,,40,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,16.94,78.85,
MODERNA 2ND ADMIN SARSCOV2 100MCG/0.5ML,0012A,CDM,0012A,CPT,,,both,,83,83,28.39,,,,fee schedule,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,40,,,,fee schedule,,40,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,24.9,78.85,
MODERNA 3RD ADMIN SARSCOV2 100MCG/0.5ML,0013A,CDM,0013A,CPT,,,both,,83,83,,,,,,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,40,,,,fee schedule,,40,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,24.9,78.85,
MODERNA ADM SARSCOV2 50MCG/0.25ML LOW DOSE BOOSTER,0064A,CDM,0064A,CPT,,,both,,83,83,,,,,,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,40,,,,fee schedule,,40,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,24.9,78.85,
Immunization Admin First Dose 6 - 11 Years,0091A,CDM,0091A,CPT,,,both,,80,80,,,,,,,,,,,,,,,,,,,,68,85,,percent of total billed charges,,40,,,,fee schedule,,40,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,24,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,24,76,
Immunization Admin Second Dose 6 - 11 Years,0092A,CDM,0092A,CPT,,,both,,80,80,,,,,,,,,,,,,,,,,,,,68,85,,percent of total billed charges,,40,,,,fee schedule,,40,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,24,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,24,76,
Immunization Admin Third Dose 6 - 11 Years,0093A,CDM,0093A,CPT,,,both,,80,80,,,,,,,,,,,,,,,,,,,,68,85,,percent of total billed charges,,40,,,,fee schedule,,40,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,24,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,24,76,
ADM SARSCOV2 50 MCG/.05 MLBST,0094A,CDM,0094A,CPT,,,both,,83,83,,,,,,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,40,,,,fee schedule,,40,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,24.9,78.85,
Immunization Admin Moderna 1st Dose 25mcg/0.25mL,0111A,CDM,0111A,CPT,,,both,,83,83,,,,,,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,40,,,,fee schedule,,40,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,24.9,78.85,
Immunization Admin Moderna 2nd Dose 25mcg/0.25mL,0112A,CDM,0112A,CPT,,,both,,83,83,,,,,,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,40,,,,fee schedule,,40,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,24.9,78.85,
Immunization Admin Pfizer Bivalent Booster 12yo+,0124A,CDM,0124A,CPT,,,both,,83,83,,,,,,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,24.9,78.85,
Immunization Admin Moderna Bivalent Booster 18yo+,0134A,CDM,0134A,CPT,,,both,,83,83,,,,,,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,24.9,78.85,
Immunization Admin Moderna Bivalent Booster 6-11yo,0144A,CDM,0144A,CPT,,,both,,83,83,,,,,,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,24.9,78.85,
Immunization Admin Pfizer Bivalent Booster 5-11yo,0154A,CDM,0154A,CPT,,,both,,83,83,,,,,,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,24.9,78.85,
Immunization Admin Of Covid 19,0164A,CDM,0164A,CPT,,,both,,80,80,,,,,,,,,,,,,,,,,,,,68,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,24,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,24,76,
AUDIOMETRY AIR ONLY,0208T,CDM,0208T,CPT,,,both,,62,62,44.81,,,,fee schedule,,,,,,,,,,,,,,,52.7,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,18.6,58.9,
NJX PLATELET PLASMA,0232T,CDM,0232T,CPT,,,both,,260,260,650.02,,,,fee schedule,,,,,,,,,,,,,,,221,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,78,83,,percent of total billed charges,,,,,,,,,,,,,,,215.8,83,,percent of total billed charges,,,,,,,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,78,650.02,
PERIPH FIELD STIMUL TRIAL,0282T,CDM,0282T,CPT,,,both,,11013,11013,,,,,,,,,,,,,,,,,,,,9361.05,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10021.83,91,,percent of total billed charges,,,10462.35,95,,percent of total billed charges,,,9140.79,83,,percent of total billed charges,,,3303.9,83,,percent of total billed charges,,,,,,,,,,,,,,,9140.79,83,,percent of total billed charges,,,,,,,,,9911.7,90,,percent of total billed charges,,,9911.7,90,,percent of total billed charges,,,9911.7,90,,percent of total billed charges,,,9911.7,90,,percent of total billed charges,,,9361.05,85,,percent of total billed charges,,3303.9,10462.35,
1ST PRENATAL CARE VST,0500F,CDM,0500F,CPT,,,both,,164,164,0.01,,,,fee schedule,,,,,,,,44.1,,,,fee schedule,,,139.4,85,,percent of total billed charges,,,,,,,,,,,,,,44.1,,,,fee schedule,,,,,,,,44.1,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,49.2,83,,percent of total billed charges,,44.1,,,,fee schedule,,44.1,,,,fee schedule,,,136.12,83,,percent of total billed charges,,,,,,,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,0.01,155.8,
SBSQ PRENATAL CARE VST,0502F,CDM,0502F,CPT,,,both,,125,125,0.01,,,,fee schedule,,,,,,,,44.1,,,,fee schedule,,,106.25,85,,percent of total billed charges,,,,,,,,,,,,,,44.1,,,,fee schedule,,,,,,,,44.1,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,113.75,91,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,37.5,83,,percent of total billed charges,,44.1,,,,fee schedule,,44.1,,,,fee schedule,,,103.75,83,,percent of total billed charges,,,,,,,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,0.01,118.75,
POSTPARTUM CARE VST,0503F,CDM,0503F,CPT,,,both,,125,125,0.01,,,,fee schedule,,,,,,,,88.57,,,,fee schedule,,,106.25,85,,percent of total billed charges,,,,,,,,,,,,,,88.57,,,,fee schedule,,,,,,,,88.57,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,113.75,91,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,37.5,83,,percent of total billed charges,,88.57,,,,fee schedule,,88.57,,,,fee schedule,,,103.75,83,,percent of total billed charges,,,,,,,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,0.01,118.75,
FNA W/O IMAGE,10021,CDM,10021,CPT,,,both,,493,493,93.9,,,,fee schedule,,,,,,,,49.8,,,,fee schedule,,,419.05,85,,percent of total billed charges,,92.31,,,,fee schedule,,57.33,,,,fee schedule,,49.8,,,,fee schedule,,126.67,,,,fee schedule,,49.8,,,,fee schedule,,91.14,,,,fee schedule,,55.24,,,,fee schedule,,55.24,,,,fee schedule,,,448.63,91,,percent of total billed charges,,,468.35,95,,percent of total billed charges,,,409.19,83,,percent of total billed charges,,,147.9,83,,percent of total billed charges,,49.8,,,,fee schedule,,49.8,,,,fee schedule,,,409.19,83,,percent of total billed charges,,81.2,,,,fee schedule,,,443.7,90,,percent of total billed charges,,,443.7,90,,percent of total billed charges,,,443.7,90,,percent of total billed charges,,,443.7,90,,percent of total billed charges,,,419.05,85,,percent of total billed charges,,49.8,468.35,
Fine Needle Aspiration With Image Guidance,10022,CDM,10022,CPT,,,both,,513,513,,,,,,,,,,,,,,,,,,,,436.05,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,117.39,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,466.83,91,,percent of total billed charges,,,487.35,95,,percent of total billed charges,,,425.79,83,,percent of total billed charges,,,153.9,83,,percent of total billed charges,,,,,,,,,,,,,,,425.79,83,,percent of total billed charges,,,,,,,,,461.7,90,,percent of total billed charges,,,461.7,90,,percent of total billed charges,,,461.7,90,,percent of total billed charges,,,461.7,90,,percent of total billed charges,,,436.05,85,,percent of total billed charges,,117.39,487.35,
ACNE SURGERY,10040,CDM,10040,CPT,,,both,,276,276,88.72,,,,fee schedule,,,,,,,,35.2,,,,fee schedule,,,234.6,85,,percent of total billed charges,,86.96,,,,fee schedule,,54.01,,,,fee schedule,,35.2,,,,fee schedule,,134.63,,,,fee schedule,,35.2,,,,fee schedule,,86.11,,,,fee schedule,,52.19,,,,fee schedule,,52.19,,,,fee schedule,,,251.16,91,,percent of total billed charges,,,262.2,95,,percent of total billed charges,,,229.08,83,,percent of total billed charges,,,82.8,83,,percent of total billed charges,,35.2,,,,fee schedule,,35.2,,,,fee schedule,,,229.08,83,,percent of total billed charges,,76.71,,,,fee schedule,,,248.4,90,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,234.6,85,,percent of total billed charges,,35.2,262.2,
"DRAINAGE OF SKIN ABSCESS, SINGLE AND SIMPLE",10060,CDM,10060,CPT,,,both,,360,360,180.89,,,,fee schedule,,,,,,,,36,,,,fee schedule,,,306,85,,percent of total billed charges,,172.03,,,,fee schedule,,106.84,,,,fee schedule,,36,,,,fee schedule,,147.23,,,,fee schedule,,36,,,,fee schedule,,175.57,,,,fee schedule,,106.41,,,,fee schedule,,106.41,,,,fee schedule,,,327.6,91,,percent of total billed charges,,,342,95,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,108,83,,percent of total billed charges,,36,,,,fee schedule,,36,,,,fee schedule,,,298.8,83,,percent of total billed charges,,156.42,,,,fee schedule,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,306,85,,percent of total billed charges,,36,342,
DRAINAGE OF SKIN ABSCESS,10060P,CDM,10060,CPT,,,both,P,235,235,180.89,,,,fee schedule,,,,,,,,36,,,,fee schedule,,,199.75,85,,percent of total billed charges,,172.03,,,,fee schedule,,106.84,,,,fee schedule,,36,,,,fee schedule,,147.23,,,,fee schedule,,36,,,,fee schedule,,175.57,,,,fee schedule,,106.41,,,,fee schedule,,106.41,,,,fee schedule,,,213.85,91,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,70.5,83,,percent of total billed charges,,36,,,,fee schedule,,36,,,,fee schedule,,,195.05,83,,percent of total billed charges,,156.42,,,,fee schedule,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,199.75,85,,percent of total billed charges,,36,223.25,
DRAINAGE OF SKIN ABSCESS,10060T,CDM,10060,CPT,,,both,T,125,125,180.89,,,,fee schedule,,,,,,,,36,,,,fee schedule,,,106.25,85,,percent of total billed charges,,172.03,,,,fee schedule,,106.84,,,,fee schedule,,36,,,,fee schedule,,147.23,,,,fee schedule,,36,,,,fee schedule,,175.57,,,,fee schedule,,106.41,,,,fee schedule,,106.41,,,,fee schedule,,,113.75,91,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,37.5,83,,percent of total billed charges,,36,,,,fee schedule,,36,,,,fee schedule,,,103.75,83,,percent of total billed charges,,156.42,,,,fee schedule,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,36,180.89,
Incision And Drainage Abscess Complicated/Multiple,10061,CDM,10061,CPT,,,both,,805,805,315.12,,,,fee schedule,,,,,,,,66.5,,,,fee schedule,,,684.25,85,,percent of total billed charges,,304.93,,,,fee schedule,,189.38,,,,fee schedule,,66.5,,,,fee schedule,,275.89,,,,fee schedule,,66.5,,,,fee schedule,,305.85,,,,fee schedule,,185.36,,,,fee schedule,,185.36,,,,fee schedule,,,732.55,91,,percent of total billed charges,,,764.75,95,,percent of total billed charges,,,668.15,83,,percent of total billed charges,,,241.5,83,,percent of total billed charges,,66.5,,,,fee schedule,,66.5,,,,fee schedule,,,668.15,83,,percent of total billed charges,,272.48,,,,fee schedule,,,724.5,90,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,684.25,85,,percent of total billed charges,,66.5,764.75,
Incision And Drainage Abscess Complicated/Multiple,10061P,CDM,10061,CPT,,,both,P,655,655,315.12,,,,fee schedule,,,,,,,,66.5,,,,fee schedule,,,556.75,85,,percent of total billed charges,,304.93,,,,fee schedule,,189.38,,,,fee schedule,,66.5,,,,fee schedule,,275.89,,,,fee schedule,,66.5,,,,fee schedule,,305.85,,,,fee schedule,,185.36,,,,fee schedule,,185.36,,,,fee schedule,,,596.05,91,,percent of total billed charges,,,622.25,95,,percent of total billed charges,,,543.65,83,,percent of total billed charges,,,196.5,83,,percent of total billed charges,,66.5,,,,fee schedule,,66.5,,,,fee schedule,,,543.65,83,,percent of total billed charges,,272.48,,,,fee schedule,,,589.5,90,,percent of total billed charges,,,589.5,90,,percent of total billed charges,,,589.5,90,,percent of total billed charges,,,589.5,90,,percent of total billed charges,,,556.75,85,,percent of total billed charges,,66.5,622.25,
Incision And Drainage Abscess Complicated/Multiple,10061T,CDM,10061,CPT,,,both,T,150,150,315.12,,,,fee schedule,,,,,,,,66.5,,,,fee schedule,,,127.5,85,,percent of total billed charges,,304.93,,,,fee schedule,,189.38,,,,fee schedule,,66.5,,,,fee schedule,,275.89,,,,fee schedule,,66.5,,,,fee schedule,,305.85,,,,fee schedule,,185.36,,,,fee schedule,,185.36,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,66.5,,,,fee schedule,,66.5,,,,fee schedule,,,124.5,83,,percent of total billed charges,,272.48,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,45,315.12,
DRAINAGE OF PILONIDAL CYST,10080,CDM,10080,CPT,,,both,,666,666,179.74,,,,fee schedule,,,,,,,,70.65,,,,fee schedule,,,566.1,85,,percent of total billed charges,,173.82,,,,fee schedule,,107.95,,,,fee schedule,,70.65,,,,fee schedule,,158.51,,,,fee schedule,,70.65,,,,fee schedule,,174.45,,,,fee schedule,,105.73,,,,fee schedule,,105.73,,,,fee schedule,,,606.06,91,,percent of total billed charges,,,632.7,95,,percent of total billed charges,,,552.78,83,,percent of total billed charges,,,199.8,83,,percent of total billed charges,,70.65,,,,fee schedule,,70.65,,,,fee schedule,,,552.78,83,,percent of total billed charges,,155.42,,,,fee schedule,,,599.4,90,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,599.4,90,,percent of total billed charges,,,566.1,85,,percent of total billed charges,,70.65,632.7,
DRAINAGE OF PILONIDAL CYST,10081,CDM,10081,CPT,,,both,,1125,1125,293.8,,,,fee schedule,,,,,,,,131.8,,,,fee schedule,,,956.25,85,,percent of total billed charges,,287.98,,,,fee schedule,,178.85,,,,fee schedule,,131.8,,,,fee schedule,,278.55,,,,fee schedule,,131.8,,,,fee schedule,,285.16,,,,fee schedule,,172.82,,,,fee schedule,,172.82,,,,fee schedule,,,1023.75,91,,percent of total billed charges,,,1068.75,95,,percent of total billed charges,,,933.75,83,,percent of total billed charges,,,337.5,83,,percent of total billed charges,,131.8,,,,fee schedule,,131.8,,,,fee schedule,,,933.75,83,,percent of total billed charges,,254.05,,,,fee schedule,,,1012.5,90,,percent of total billed charges,,,1012.5,90,,percent of total billed charges,,,1012.5,90,,percent of total billed charges,,,1012.5,90,,percent of total billed charges,,,956.25,85,,percent of total billed charges,,131.8,1068.75,
INCISION&REMOVAL FOREIGN BODY SUBQ TISS SMPL,10120,CDM,10120,CPT,,,both,,466,466,180.89,,,,fee schedule,,,,,,,,39.05,,,,fee schedule,,,396.1,85,,percent of total billed charges,,169.9,,,,fee schedule,,105.52,,,,fee schedule,,39.05,,,,fee schedule,,153.2,,,,fee schedule,,39.05,,,,fee schedule,,175.57,,,,fee schedule,,106.41,,,,fee schedule,,106.41,,,,fee schedule,,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,139.8,83,,percent of total billed charges,,39.05,,,,fee schedule,,39.05,,,,fee schedule,,,386.78,83,,percent of total billed charges,,156.42,,,,fee schedule,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,39.05,442.7,
REMOVE FOREIGN BODY,10120P,CDM,10120,CPT,,,both,P,302,302,180.89,,,,fee schedule,,,,,,,,39.05,,,,fee schedule,,,256.7,85,,percent of total billed charges,,169.9,,,,fee schedule,,105.52,,,,fee schedule,,39.05,,,,fee schedule,,153.2,,,,fee schedule,,39.05,,,,fee schedule,,175.57,,,,fee schedule,,106.41,,,,fee schedule,,106.41,,,,fee schedule,,,274.82,91,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,90.6,83,,percent of total billed charges,,39.05,,,,fee schedule,,39.05,,,,fee schedule,,,250.66,83,,percent of total billed charges,,156.42,,,,fee schedule,,,271.8,90,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,256.7,85,,percent of total billed charges,,39.05,286.9,
REMOVE FOREIGN BODY,10120T,CDM,10120,CPT,,,both,T,164,164,180.89,,,,fee schedule,,,,,,,,39.05,,,,fee schedule,,,139.4,85,,percent of total billed charges,,169.9,,,,fee schedule,,105.52,,,,fee schedule,,39.05,,,,fee schedule,,153.2,,,,fee schedule,,39.05,,,,fee schedule,,175.57,,,,fee schedule,,106.41,,,,fee schedule,,106.41,,,,fee schedule,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,49.2,83,,percent of total billed charges,,39.05,,,,fee schedule,,39.05,,,,fee schedule,,,136.12,83,,percent of total billed charges,,156.42,,,,fee schedule,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,39.05,180.89,
INCISION&REMOVAL FOREIGN BODY SUBQ TISS COMP,10121,CDM,10121,CPT,,,both,,901,901,315.12,,,,fee schedule,,,,,,,,77.6,,,,fee schedule,,,765.85,85,,percent of total billed charges,,308.06,,,,fee schedule,,191.32,,,,fee schedule,,77.6,,,,fee schedule,,317.68,,,,fee schedule,,77.6,,,,fee schedule,,305.85,,,,fee schedule,,185.36,,,,fee schedule,,185.36,,,,fee schedule,,,819.91,91,,percent of total billed charges,,,855.95,95,,percent of total billed charges,,,747.83,83,,percent of total billed charges,,,270.3,83,,percent of total billed charges,,77.6,,,,fee schedule,,77.6,,,,fee schedule,,,747.83,83,,percent of total billed charges,,272.48,,,,fee schedule,,,810.9,90,,percent of total billed charges,,,810.9,90,,percent of total billed charges,,,810.9,90,,percent of total billed charges,,,810.9,90,,percent of total billed charges,,,765.85,85,,percent of total billed charges,,77.6,855.95,
REMOVE FOREIGN BODY,10121P,CDM,10121,CPT,,,both,P,724,724,315.12,,,,fee schedule,,,,,,,,77.6,,,,fee schedule,,,615.4,85,,percent of total billed charges,,308.06,,,,fee schedule,,191.32,,,,fee schedule,,77.6,,,,fee schedule,,317.68,,,,fee schedule,,77.6,,,,fee schedule,,305.85,,,,fee schedule,,185.36,,,,fee schedule,,185.36,,,,fee schedule,,,658.84,91,,percent of total billed charges,,,687.8,95,,percent of total billed charges,,,600.92,83,,percent of total billed charges,,,217.2,83,,percent of total billed charges,,77.6,,,,fee schedule,,77.6,,,,fee schedule,,,600.92,83,,percent of total billed charges,,272.48,,,,fee schedule,,,651.6,90,,percent of total billed charges,,,651.6,90,,percent of total billed charges,,,651.6,90,,percent of total billed charges,,,651.6,90,,percent of total billed charges,,,615.4,85,,percent of total billed charges,,77.6,687.8,
REMOVE FOREIGN BODY,10121T,CDM,10121,CPT,,,both,T,177,177,315.12,,,,fee schedule,,,,,,,,77.6,,,,fee schedule,,,150.45,85,,percent of total billed charges,,308.06,,,,fee schedule,,191.32,,,,fee schedule,,77.6,,,,fee schedule,,317.68,,,,fee schedule,,77.6,,,,fee schedule,,305.85,,,,fee schedule,,185.36,,,,fee schedule,,185.36,,,,fee schedule,,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,53.1,83,,percent of total billed charges,,77.6,,,,fee schedule,,77.6,,,,fee schedule,,,146.91,83,,percent of total billed charges,,272.48,,,,fee schedule,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,53.1,317.68,
I&D HEMATOMA SEROMA/FLUID COLLECTION,10140,CDM,10140,CPT,,,both,,515,515,202.2,,,,fee schedule,,,,,,,,41.5,,,,fee schedule,,,437.75,85,,percent of total billed charges,,196.04,,,,fee schedule,,121.75,,,,fee schedule,,41.5,,,,fee schedule,,199.63,,,,fee schedule,,41.5,,,,fee schedule,,196.26,,,,fee schedule,,118.94,,,,fee schedule,,118.94,,,,fee schedule,,,468.65,91,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,154.5,83,,percent of total billed charges,,41.5,,,,fee schedule,,41.5,,,,fee schedule,,,427.45,83,,percent of total billed charges,,174.85,,,,fee schedule,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,41.5,489.25,
DRAINAGE OF HEMATOMA/FLUID,10140AS,CDM,10140,CPT,,,both,AS,265,265,202.2,,,,fee schedule,,,,,,,,41.5,,,,fee schedule,,,225.25,85,,percent of total billed charges,,196.04,,,,fee schedule,,121.75,,,,fee schedule,,41.5,,,,fee schedule,,199.63,,,,fee schedule,,41.5,,,,fee schedule,,196.26,,,,fee schedule,,118.94,,,,fee schedule,,118.94,,,,fee schedule,,,241.15,91,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,79.5,83,,percent of total billed charges,,41.5,,,,fee schedule,,41.5,,,,fee schedule,,,219.95,83,,percent of total billed charges,,174.85,,,,fee schedule,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,41.5,251.75,
I&D HEMATOMA SEROMA/FLUID COLLECTION,10140P,CDM,10140,CPT,,,both,P,300,300,202.2,,,,fee schedule,,,,,,,,41.5,,,,fee schedule,,,255,85,,percent of total billed charges,,196.04,,,,fee schedule,,121.75,,,,fee schedule,,41.5,,,,fee schedule,,199.63,,,,fee schedule,,41.5,,,,fee schedule,,196.26,,,,fee schedule,,118.94,,,,fee schedule,,118.94,,,,fee schedule,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,90,83,,percent of total billed charges,,41.5,,,,fee schedule,,41.5,,,,fee schedule,,,249,83,,percent of total billed charges,,174.85,,,,fee schedule,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,41.5,285,
I&D HEMATOMA SEROMA/FLUID COLLECTION,10140TC,CDM,10140,CPT,,,both,TC,215,215,202.2,,,,fee schedule,,,,,,,,41.5,,,,fee schedule,,,182.75,85,,percent of total billed charges,,196.04,,,,fee schedule,,121.75,,,,fee schedule,,41.5,,,,fee schedule,,199.63,,,,fee schedule,,41.5,,,,fee schedule,,196.26,,,,fee schedule,,118.94,,,,fee schedule,,118.94,,,,fee schedule,,,195.65,91,,percent of total billed charges,,,204.25,95,,percent of total billed charges,,,178.45,83,,percent of total billed charges,,,64.5,83,,percent of total billed charges,,41.5,,,,fee schedule,,41.5,,,,fee schedule,,,178.45,83,,percent of total billed charges,,174.85,,,,fee schedule,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,182.75,85,,percent of total billed charges,,41.5,204.25,
PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,10160,CDM,10160,CPT,,,both,,443,443,165.91,,,,fee schedule,,,,,,,,35.95,,,,fee schedule,,,376.55,85,,percent of total billed charges,,157.07,,,,fee schedule,,97.55,,,,fee schedule,,35.95,,,,fee schedule,,160.5,,,,fee schedule,,35.95,,,,fee schedule,,161.03,,,,fee schedule,,97.6,,,,fee schedule,,97.6,,,,fee schedule,,,403.13,91,,percent of total billed charges,,,420.85,95,,percent of total billed charges,,,367.69,83,,percent of total billed charges,,,132.9,83,,percent of total billed charges,,35.95,,,,fee schedule,,35.95,,,,fee schedule,,,367.69,83,,percent of total billed charges,,143.46,,,,fee schedule,,,398.7,90,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,376.55,85,,percent of total billed charges,,35.95,420.85,
PUNCTURE DRAINAGE OF LESION,10160P,CDM,10160,CPT,,,both,P,280,280,165.91,,,,fee schedule,,,,,,,,35.95,,,,fee schedule,,,238,85,,percent of total billed charges,,157.07,,,,fee schedule,,97.55,,,,fee schedule,,35.95,,,,fee schedule,,160.5,,,,fee schedule,,35.95,,,,fee schedule,,161.03,,,,fee schedule,,97.6,,,,fee schedule,,97.6,,,,fee schedule,,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,84,83,,percent of total billed charges,,35.95,,,,fee schedule,,35.95,,,,fee schedule,,,232.4,83,,percent of total billed charges,,143.46,,,,fee schedule,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,35.95,266,
PUNCTURE DRAINAGE OF LESION,10160T,CDM,10160,CPT,,,both,T,163,163,165.91,,,,fee schedule,,,,,,,,35.95,,,,fee schedule,,,138.55,85,,percent of total billed charges,,157.07,,,,fee schedule,,97.55,,,,fee schedule,,35.95,,,,fee schedule,,160.5,,,,fee schedule,,35.95,,,,fee schedule,,161.03,,,,fee schedule,,97.6,,,,fee schedule,,97.6,,,,fee schedule,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,48.9,83,,percent of total billed charges,,35.95,,,,fee schedule,,35.95,,,,fee schedule,,,135.29,83,,percent of total billed charges,,143.46,,,,fee schedule,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,35.95,165.91,
INCISION&DRAINAGE COMPLEX PO WOUND INFECTION,10180,CDM,10180,CPT,,,both,,918,918,307.63,,,,fee schedule,,,,,,,,130.55,,,,fee schedule,,,780.3,85,,percent of total billed charges,,299.55,,,,fee schedule,,186.03,,,,fee schedule,,130.55,,,,fee schedule,,302.42,,,,fee schedule,,130.55,,,,fee schedule,,298.58,,,,fee schedule,,180.96,,,,fee schedule,,180.96,,,,fee schedule,,,835.38,91,,percent of total billed charges,,,872.1,95,,percent of total billed charges,,,761.94,83,,percent of total billed charges,,,275.4,83,,percent of total billed charges,,130.55,,,,fee schedule,,130.55,,,,fee schedule,,,761.94,83,,percent of total billed charges,,266.01,,,,fee schedule,,,826.2,90,,percent of total billed charges,,,826.2,90,,percent of total billed charges,,,826.2,90,,percent of total billed charges,,,826.2,90,,percent of total billed charges,,,780.3,85,,percent of total billed charges,,130.55,872.1,
"COMPLEX DRAINAGE, WOUND",1018080,CDM,10180,CPT,,,both,80,313,313,307.63,,,,fee schedule,,,,,,,,130.55,,,,fee schedule,,,266.05,85,,percent of total billed charges,,299.55,,,,fee schedule,,186.03,,,,fee schedule,,130.55,,,,fee schedule,,302.42,,,,fee schedule,,130.55,,,,fee schedule,,298.58,,,,fee schedule,,180.96,,,,fee schedule,,180.96,,,,fee schedule,,,284.83,91,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,93.9,83,,percent of total billed charges,,130.55,,,,fee schedule,,130.55,,,,fee schedule,,,259.79,83,,percent of total billed charges,,266.01,,,,fee schedule,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,93.9,307.63,
"COMPLEX DRAINAGE, WOUND",10180AS,CDM,10180,CPT,,,both,AS,689,689,307.63,,,,fee schedule,,,,,,,,130.55,,,,fee schedule,,,585.65,85,,percent of total billed charges,,299.55,,,,fee schedule,,186.03,,,,fee schedule,,130.55,,,,fee schedule,,302.42,,,,fee schedule,,130.55,,,,fee schedule,,298.58,,,,fee schedule,,180.96,,,,fee schedule,,180.96,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,130.55,,,,fee schedule,,130.55,,,,fee schedule,,,571.87,83,,percent of total billed charges,,266.01,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,130.55,654.55,
DBRDMT X10SV ECZMT/INFCT SKN UP 10% BDY SURF,11000,CDM,11000,CPT,,,both,,187,187,46.09,,,,fee schedule,,,,,,,,77.7,,,,fee schedule,,,158.95,85,,percent of total billed charges,,46.96,,,,fee schedule,,29.17,,,,fee schedule,,77.7,,,,fee schedule,,59.03,,,,fee schedule,,77.7,,,,fee schedule,,44.73,,,,fee schedule,,27.11,,,,fee schedule,,27.11,,,,fee schedule,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,56.1,83,,percent of total billed charges,,77.7,,,,fee schedule,,77.7,,,,fee schedule,,,155.21,83,,percent of total billed charges,,39.85,,,,fee schedule,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,27.11,177.65,
DBRDMT X10SV ECZMT/INFCT SKN EA 10% BDY SURF ADD-ON,11001,CDM,11001,CPT,,,both,,110,110,25.35,,,,fee schedule,,,,,,,,20.85,,,,fee schedule,,,93.5,85,,percent of total billed charges,,24.52,,,,fee schedule,,15.23,,,,fee schedule,,20.85,,,,fee schedule,,29.18,,,,fee schedule,,20.85,,,,fee schedule,,24.6,,,,fee schedule,,14.91,,,,fee schedule,,14.91,,,,fee schedule,,,100.1,91,,percent of total billed charges,,,104.5,95,,percent of total billed charges,,,91.3,83,,percent of total billed charges,,,33,83,,percent of total billed charges,,20.85,,,,fee schedule,,20.85,,,,fee schedule,,,91.3,83,,percent of total billed charges,,21.92,,,,fee schedule,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,93.5,85,,percent of total billed charges,,14.91,104.5,
DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENITALIA T&PR,11004,CDM,11004,CPT,,,both,,2391,2391,967.82,,,,fee schedule,,,,,,,,154.43,,,,fee schedule,,,2032.35,85,,percent of total billed charges,,980.91,,,,fee schedule,,609.19,,,,fee schedule,,154.43,,,,fee schedule,,986.85,,,,fee schedule,,154.43,,,,fee schedule,,939.35,,,,fee schedule,,569.3,,,,fee schedule,,569.3,,,,fee schedule,,,2175.81,91,,percent of total billed charges,,,2271.45,95,,percent of total billed charges,,,1984.53,83,,percent of total billed charges,,,717.3,83,,percent of total billed charges,,154.43,,,,fee schedule,,154.43,,,,fee schedule,,,1984.53,83,,percent of total billed charges,,836.88,,,,fee schedule,,,2151.9,90,,percent of total billed charges,,,2151.9,90,,percent of total billed charges,,,2151.9,90,,percent of total billed charges,,,2151.9,90,,percent of total billed charges,,,2032.35,85,,percent of total billed charges,,154.43,2271.45,
DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL,11005,CDM,11005,CPT,,,both,,3106,3106,1318.65,,,,fee schedule,,,,,,,,154.43,,,,fee schedule,,,2640.1,85,,percent of total billed charges,,1346.11,,,,fee schedule,,835.99,,,,fee schedule,,154.43,,,,fee schedule,,1344.32,,,,fee schedule,,154.43,,,,fee schedule,,1279.87,,,,fee schedule,,775.68,,,,fee schedule,,775.68,,,,fee schedule,,,2826.46,91,,percent of total billed charges,,,2950.7,95,,percent of total billed charges,,,2577.98,83,,percent of total billed charges,,,931.8,83,,percent of total billed charges,,154.43,,,,fee schedule,,154.43,,,,fee schedule,,,2577.98,83,,percent of total billed charges,,1140.25,,,,fee schedule,,,2795.4,90,,percent of total billed charges,,,2795.4,90,,percent of total billed charges,,,2795.4,90,,percent of total billed charges,,,2795.4,90,,percent of total billed charges,,,2640.1,85,,percent of total billed charges,,154.43,2950.7,
DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT/ABDL,11006,CDM,11006,CPT,,,both,,3045,3045,1193.07,,,,fee schedule,,,,,,,,154.43,,,,fee schedule,,,2588.25,85,,percent of total billed charges,,1211.62,,,,fee schedule,,752.47,,,,fee schedule,,154.43,,,,fee schedule,,1242.85,,,,fee schedule,,154.43,,,,fee schedule,,1157.98,,,,fee schedule,,701.8,,,,fee schedule,,701.8,,,,fee schedule,,,2770.95,91,,percent of total billed charges,,,2892.75,95,,percent of total billed charges,,,2527.35,83,,percent of total billed charges,,,913.5,83,,percent of total billed charges,,154.43,,,,fee schedule,,154.43,,,,fee schedule,,,2527.35,83,,percent of total billed charges,,1031.65,,,,fee schedule,,,2740.5,90,,percent of total billed charges,,,2740.5,90,,percent of total billed charges,,,2740.5,90,,percent of total billed charges,,,2740.5,90,,percent of total billed charges,,,2588.25,85,,percent of total billed charges,,154.43,2892.75,
REMOVAL PROSTHETIC MATRL ABDL WALL FOR INFECTION,11008,CDM,11008,CPT,,,both,,1229,1229,465.47,,,,fee schedule,,,,,,,,154.43,,,,fee schedule,,,1044.65,85,,percent of total billed charges,,475.01,,,,fee schedule,,295,,,,fee schedule,,154.43,,,,fee schedule,,506.03,,,,fee schedule,,154.43,,,,fee schedule,,451.78,,,,fee schedule,,273.81,,,,fee schedule,,273.81,,,,fee schedule,,,1118.39,91,,percent of total billed charges,,,1167.55,95,,percent of total billed charges,,,1020.07,83,,percent of total billed charges,,,368.7,83,,percent of total billed charges,,154.43,,,,fee schedule,,154.43,,,,fee schedule,,,1020.07,83,,percent of total billed charges,,402.5,,,,fee schedule,,,1106.1,90,,percent of total billed charges,,,1106.1,90,,percent of total billed charges,,,1106.1,90,,percent of total billed charges,,,1106.1,90,,percent of total billed charges,,,1044.65,85,,percent of total billed charges,,154.43,1167.55,
DBRDMT W/RMVL FM FX&/DISLC SKN&SUBQ TISS,11010,CDM,11010,CPT,,,both,,1675,1675,474.12,,,,fee schedule,,,,,,,,127.6,,,,fee schedule,,,1423.75,85,,percent of total billed charges,,466.05,,,,fee schedule,,289.44,,,,fee schedule,,127.6,,,,fee schedule,,491.44,,,,fee schedule,,127.6,,,,fee schedule,,460.17,,,,fee schedule,,278.89,,,,fee schedule,,278.89,,,,fee schedule,,,1524.25,91,,percent of total billed charges,,,1591.25,95,,percent of total billed charges,,,1390.25,83,,percent of total billed charges,,,502.5,83,,percent of total billed charges,,127.6,,,,fee schedule,,127.6,,,,fee schedule,,,1390.25,83,,percent of total billed charges,,409.97,,,,fee schedule,,,1507.5,90,,percent of total billed charges,,,1507.5,90,,percent of total billed charges,,,1507.5,90,,percent of total billed charges,,,1507.5,90,,percent of total billed charges,,,1423.75,85,,percent of total billed charges,,127.6,1591.25,
"DEBRIDE SKIN, FX",11010AS,CDM,11010,CPT,,,both,AS,689,689,474.12,,,,fee schedule,,,,,,,,127.6,,,,fee schedule,,,585.65,85,,percent of total billed charges,,466.05,,,,fee schedule,,289.44,,,,fee schedule,,127.6,,,,fee schedule,,491.44,,,,fee schedule,,127.6,,,,fee schedule,,460.17,,,,fee schedule,,278.89,,,,fee schedule,,278.89,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,127.6,,,,fee schedule,,127.6,,,,fee schedule,,,571.87,83,,percent of total billed charges,,409.97,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,127.6,654.55,
DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC,11011,CDM,11011,CPT,,,both,,1999,1999,506.38,,,,fee schedule,,,,,,,,157.9,,,,fee schedule,,,1699.15,85,,percent of total billed charges,,504.81,,,,fee schedule,,313.51,,,,fee schedule,,157.9,,,,fee schedule,,529.24,,,,fee schedule,,157.9,,,,fee schedule,,491.48,,,,fee schedule,,297.87,,,,fee schedule,,297.87,,,,fee schedule,,,1819.09,91,,percent of total billed charges,,,1899.05,95,,percent of total billed charges,,,1659.17,83,,percent of total billed charges,,,599.7,83,,percent of total billed charges,,157.9,,,,fee schedule,,157.9,,,,fee schedule,,,1659.17,83,,percent of total billed charges,,437.87,,,,fee schedule,,,1799.1,90,,percent of total billed charges,,,1799.1,90,,percent of total billed charges,,,1799.1,90,,percent of total billed charges,,,1799.1,90,,percent of total billed charges,,,1699.15,85,,percent of total billed charges,,157.9,1899.05,
DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC,11012,CDM,11012,CPT,,,both,,3106,3106,711.46,,,,fee schedule,,,,,,,,218.4,,,,fee schedule,,,2640.1,85,,percent of total billed charges,,707.46,,,,fee schedule,,439.36,,,,fee schedule,,218.4,,,,fee schedule,,784.57,,,,fee schedule,,218.4,,,,fee schedule,,690.54,,,,fee schedule,,418.51,,,,fee schedule,,418.51,,,,fee schedule,,,2826.46,91,,percent of total billed charges,,,2950.7,95,,percent of total billed charges,,,2577.98,83,,percent of total billed charges,,,931.8,83,,percent of total billed charges,,218.4,,,,fee schedule,,218.4,,,,fee schedule,,,2577.98,83,,percent of total billed charges,,615.21,,,,fee schedule,,,2795.4,90,,percent of total billed charges,,,2795.4,90,,percent of total billed charges,,,2795.4,90,,percent of total billed charges,,,2795.4,90,,percent of total billed charges,,,2640.1,85,,percent of total billed charges,,218.4,2950.7,
REMOVAL DAMAGED SKIN AND UNDERLYING TISSUE,11042,CDM,11042,CPT,,,both,,317,317,101.97,,,,fee schedule,,,,,,,,70.55,,,,fee schedule,,,269.45,85,,percent of total billed charges,,100.72,,,,fee schedule,,62.55,,,,fee schedule,,70.55,,,,fee schedule,,112.08,,,,fee schedule,,70.55,,,,fee schedule,,98.97,,,,fee schedule,,59.98,,,,fee schedule,,59.98,,,,fee schedule,,,288.47,91,,percent of total billed charges,,,301.15,95,,percent of total billed charges,,,263.11,83,,percent of total billed charges,,,95.1,83,,percent of total billed charges,,70.55,,,,fee schedule,,70.55,,,,fee schedule,,,263.11,83,,percent of total billed charges,,88.17,,,,fee schedule,,,285.3,90,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,269.45,85,,percent of total billed charges,,59.98,301.15,
DEBRIDE SUBCUTANEOUS TISSUE,11042AS,CDM,11042,CPT,,,both,AS,211,211,101.97,,,,fee schedule,,,,,,,,70.55,,,,fee schedule,,,179.35,85,,percent of total billed charges,,100.72,,,,fee schedule,,62.55,,,,fee schedule,,70.55,,,,fee schedule,,112.08,,,,fee schedule,,70.55,,,,fee schedule,,98.97,,,,fee schedule,,59.98,,,,fee schedule,,59.98,,,,fee schedule,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,63.3,83,,percent of total billed charges,,70.55,,,,fee schedule,,70.55,,,,fee schedule,,,175.13,83,,percent of total billed charges,,88.17,,,,fee schedule,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,59.98,200.45,
DEBRIDEMENT SUBCUTANEOUS TISSUE&MUSCLE,11043,CDM,11043,CPT,,,both,,810,810,262.12,,,,fee schedule,,,,,,,,170.55,,,,fee schedule,,,688.5,85,,percent of total billed charges,,260.28,,,,fee schedule,,161.64,,,,fee schedule,,170.55,,,,fee schedule,,348.85,,,,fee schedule,,170.55,,,,fee schedule,,254.41,,,,fee schedule,,154.19,,,,fee schedule,,154.19,,,,fee schedule,,,737.1,91,,percent of total billed charges,,,769.5,95,,percent of total billed charges,,,672.3,83,,percent of total billed charges,,,243,83,,percent of total billed charges,,170.55,,,,fee schedule,,170.55,,,,fee schedule,,,672.3,83,,percent of total billed charges,,226.65,,,,fee schedule,,,729,90,,percent of total billed charges,,,729,90,,percent of total billed charges,,,729,90,,percent of total billed charges,,,729,90,,percent of total billed charges,,,688.5,85,,percent of total billed charges,,154.19,769.5,
DEBRIDE MUSCLE/FASCIA,1104380,CDM,11043,CPT,,,both,80,423,423,262.12,,,,fee schedule,,,,,,,,170.55,,,,fee schedule,,,359.55,85,,percent of total billed charges,,260.28,,,,fee schedule,,161.64,,,,fee schedule,,170.55,,,,fee schedule,,348.85,,,,fee schedule,,170.55,,,,fee schedule,,254.41,,,,fee schedule,,154.19,,,,fee schedule,,154.19,,,,fee schedule,,,384.93,91,,percent of total billed charges,,,401.85,95,,percent of total billed charges,,,351.09,83,,percent of total billed charges,,,126.9,83,,percent of total billed charges,,170.55,,,,fee schedule,,170.55,,,,fee schedule,,,351.09,83,,percent of total billed charges,,226.65,,,,fee schedule,,,380.7,90,,percent of total billed charges,,,380.7,90,,percent of total billed charges,,,380.7,90,,percent of total billed charges,,,380.7,90,,percent of total billed charges,,,359.55,85,,percent of total billed charges,,126.9,401.85,
DEBRIDE MUSCLE/FASCIA,11043AS,CDM,11043,CPT,,,both,AS,530,530,262.12,,,,fee schedule,,,,,,,,170.55,,,,fee schedule,,,450.5,85,,percent of total billed charges,,260.28,,,,fee schedule,,161.64,,,,fee schedule,,170.55,,,,fee schedule,,348.85,,,,fee schedule,,170.55,,,,fee schedule,,254.41,,,,fee schedule,,154.19,,,,fee schedule,,154.19,,,,fee schedule,,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,159,83,,percent of total billed charges,,170.55,,,,fee schedule,,170.55,,,,fee schedule,,,439.9,83,,percent of total billed charges,,226.65,,,,fee schedule,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,154.19,503.5,
"DEBRIDEMENT, BONE",11044,CDM,11044,CPT,,,both,,1217,1217,384.25,,,,fee schedule,,,,,,,,219.35,,,,fee schedule,,,1034.45,85,,percent of total billed charges,,382.45,,,,fee schedule,,237.52,,,,fee schedule,,219.35,,,,fee schedule,,478.17,,,,fee schedule,,219.35,,,,fee schedule,,372.95,,,,fee schedule,,226.03,,,,fee schedule,,226.03,,,,fee schedule,,,1107.47,91,,percent of total billed charges,,,1156.15,95,,percent of total billed charges,,,1010.11,83,,percent of total billed charges,,,365.1,83,,percent of total billed charges,,219.35,,,,fee schedule,,219.35,,,,fee schedule,,,1010.11,83,,percent of total billed charges,,332.26,,,,fee schedule,,,1095.3,90,,percent of total billed charges,,,1095.3,90,,percent of total billed charges,,,1095.3,90,,percent of total billed charges,,,1095.3,90,,percent of total billed charges,,,1034.45,85,,percent of total billed charges,,219.35,1156.15,
DEB SUBQ TISSUE ADD-ON,11045,CDM,11045,CPT,,,both,,133,133,43.21,,,,fee schedule,,,,,,,,,,,,,,,113.05,85,,percent of total billed charges,,44.95,,,,fee schedule,,27.92,,,,fee schedule,,,,,,,,,,,,,,,,,,,,41.94,,,,fee schedule,,25.42,,,,fee schedule,,25.42,,,,fee schedule,,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,39.9,83,,percent of total billed charges,,,,,,,,,,,,,,,110.39,83,,percent of total billed charges,,37.36,,,,fee schedule,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,25.42,126.35,
DEB MUSC/FASCIA ADD-ON,11046,CDM,11046,CPT,,,both,,235,235,93.33,,,,fee schedule,,,,,,,,,,,,,,,199.75,85,,percent of total billed charges,,95.16,,,,fee schedule,,59.1,,,,fee schedule,,,,,,,,,,,,,,,,,,,,90.58,,,,fee schedule,,54.9,,,,fee schedule,,54.9,,,,fee schedule,,,213.85,91,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,70.5,83,,percent of total billed charges,,,,,,,,,,,,,,,195.05,83,,percent of total billed charges,,80.7,,,,fee schedule,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,199.75,85,,percent of total billed charges,,54.9,223.25,
PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,11055,CDM,11055,CPT,,,both,,131,131,27.08,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,111.35,85,,percent of total billed charges,,27.43,,,,fee schedule,,17.04,,,,fee schedule,,22.15,,,,fee schedule,,43.11,,,,fee schedule,,22.15,,,,fee schedule,,26.28,,,,fee schedule,,15.93,,,,fee schedule,,15.93,,,,fee schedule,,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,39.3,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,108.73,83,,percent of total billed charges,,23.41,,,,fee schedule,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,15.93,124.45,
PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4<,11056,CDM,11056,CPT,,,both,,159,159,37.45,,,,fee schedule,,,,,,,,13.93,,,,fee schedule,,,135.15,85,,percent of total billed charges,,37.78,,,,fee schedule,,23.46,,,,fee schedule,,13.93,,,,fee schedule,,60.35,,,,fee schedule,,13.93,,,,fee schedule,,36.34,,,,fee schedule,,22.03,,,,fee schedule,,22.03,,,,fee schedule,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,47.7,83,,percent of total billed charges,,13.93,,,,fee schedule,,13.93,,,,fee schedule,,,131.97,83,,percent of total billed charges,,32.38,,,,fee schedule,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,13.93,151.05,
"TRIM SKIN LESIONS, 2 TO 4",11056P,CDM,11056,CPT,,,both,P,66,66,37.45,,,,fee schedule,,,,,,,,13.93,,,,fee schedule,,,56.1,85,,percent of total billed charges,,37.78,,,,fee schedule,,23.46,,,,fee schedule,,13.93,,,,fee schedule,,60.35,,,,fee schedule,,13.93,,,,fee schedule,,36.34,,,,fee schedule,,22.03,,,,fee schedule,,22.03,,,,fee schedule,,,60.06,91,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,13.93,,,,fee schedule,,13.93,,,,fee schedule,,,54.78,83,,percent of total billed charges,,32.38,,,,fee schedule,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,13.93,62.7,
"TRIM SKIN LESIONS, 2 TO 4",11056T,CDM,11056,CPT,,,both,T,93,93,37.45,,,,fee schedule,,,,,,,,13.93,,,,fee schedule,,,79.05,85,,percent of total billed charges,,37.78,,,,fee schedule,,23.46,,,,fee schedule,,13.93,,,,fee schedule,,60.35,,,,fee schedule,,13.93,,,,fee schedule,,36.34,,,,fee schedule,,22.03,,,,fee schedule,,22.03,,,,fee schedule,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,13.93,,,,fee schedule,,13.93,,,,fee schedule,,,77.19,83,,percent of total billed charges,,32.38,,,,fee schedule,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,13.93,88.35,
"TRIM SKIN LESIONS, OVER 4",11057,CDM,11057,CPT,,,both,,306,306,48.39,,,,fee schedule,,,,,,,,18.21,,,,fee schedule,,,260.1,85,,percent of total billed charges,,48.82,,,,fee schedule,,30.32,,,,fee schedule,,18.21,,,,fee schedule,,78.92,,,,fee schedule,,18.21,,,,fee schedule,,46.97,,,,fee schedule,,28.47,,,,fee schedule,,28.47,,,,fee schedule,,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,91.8,83,,percent of total billed charges,,18.21,,,,fee schedule,,18.21,,,,fee schedule,,,253.98,83,,percent of total billed charges,,41.84,,,,fee schedule,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,18.21,290.7,
"TRIM SKIN LESIONS, OVER 4",11057P,CDM,11057,CPT,,,both,P,150,150,48.39,,,,fee schedule,,,,,,,,18.21,,,,fee schedule,,,127.5,85,,percent of total billed charges,,48.82,,,,fee schedule,,30.32,,,,fee schedule,,18.21,,,,fee schedule,,78.92,,,,fee schedule,,18.21,,,,fee schedule,,46.97,,,,fee schedule,,28.47,,,,fee schedule,,28.47,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,18.21,,,,fee schedule,,18.21,,,,fee schedule,,,124.5,83,,percent of total billed charges,,41.84,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,18.21,142.5,
"TRIM SKIN LESIONS, OVER 4",11057T,CDM,11057,CPT,,,both,T,156,156,48.39,,,,fee schedule,,,,,,,,18.21,,,,fee schedule,,,132.6,85,,percent of total billed charges,,48.82,,,,fee schedule,,30.32,,,,fee schedule,,18.21,,,,fee schedule,,78.92,,,,fee schedule,,18.21,,,,fee schedule,,46.97,,,,fee schedule,,28.47,,,,fee schedule,,28.47,,,,fee schedule,,,141.96,91,,percent of total billed charges,,,148.2,95,,percent of total billed charges,,,129.48,83,,percent of total billed charges,,,46.8,83,,percent of total billed charges,,18.21,,,,fee schedule,,18.21,,,,fee schedule,,,129.48,83,,percent of total billed charges,,41.84,,,,fee schedule,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,132.6,85,,percent of total billed charges,,18.21,148.2,
TANGNTL BX SKIN SINGLE LES,11102,CDM,11102,CPT,,,both,,254,254,64.52,,,,fee schedule,,,,,,,,24.37,,,,fee schedule,,,215.9,85,,percent of total billed charges,,63.02,,,,fee schedule,,39.14,,,,fee schedule,,24.37,,,,fee schedule,,,,,,,,24.37,,,,fee schedule,,62.62,,,,fee schedule,,37.95,,,,fee schedule,,37.95,,,,fee schedule,,,231.14,91,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,76.2,83,,percent of total billed charges,,24.37,,,,fee schedule,,24.37,,,,fee schedule,,,210.82,83,,percent of total billed charges,,55.79,,,,fee schedule,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,24.37,241.3,
PUNCH BX SKIN SINGLE LESION,11104,CDM,11104,CPT,,,both,,466,466,80.08,,,,fee schedule,,,,,,,,30.56,,,,fee schedule,,,396.1,85,,percent of total billed charges,,78.57,,,,fee schedule,,48.8,,,,fee schedule,,30.56,,,,fee schedule,,,,,,,,30.56,,,,fee schedule,,77.72,,,,fee schedule,,47.1,,,,fee schedule,,47.1,,,,fee schedule,,,424.06,91,,percent of total billed charges,,,442.7,95,,percent of total billed charges,,,386.78,83,,percent of total billed charges,,,139.8,83,,percent of total billed charges,,30.56,,,,fee schedule,,30.56,,,,fee schedule,,,386.78,83,,percent of total billed charges,,69.24,,,,fee schedule,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,419.4,90,,percent of total billed charges,,,396.1,85,,percent of total billed charges,,30.56,442.7,
PUNCH BX SKIN SINGLE LESION,11104P,CDM,11104,CPT,,,both,P,305,305,80.08,,,,fee schedule,,,,,,,,30.56,,,,fee schedule,,,259.25,85,,percent of total billed charges,,78.57,,,,fee schedule,,48.8,,,,fee schedule,,30.56,,,,fee schedule,,,,,,,,30.56,,,,fee schedule,,77.72,,,,fee schedule,,47.1,,,,fee schedule,,47.1,,,,fee schedule,,,277.55,91,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,91.5,83,,percent of total billed charges,,30.56,,,,fee schedule,,30.56,,,,fee schedule,,,253.15,83,,percent of total billed charges,,69.24,,,,fee schedule,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,30.56,289.75,
PUNCH BX SKIN SINGLE LESION,11104T,CDM,11104,CPT,,,both,T,161,161,80.08,,,,fee schedule,,,,,,,,30.56,,,,fee schedule,,,136.85,85,,percent of total billed charges,,78.57,,,,fee schedule,,48.8,,,,fee schedule,,30.56,,,,fee schedule,,,,,,,,30.56,,,,fee schedule,,77.72,,,,fee schedule,,47.1,,,,fee schedule,,47.1,,,,fee schedule,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,48.3,83,,percent of total billed charges,,30.56,,,,fee schedule,,30.56,,,,fee schedule,,,133.63,83,,percent of total billed charges,,69.24,,,,fee schedule,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,30.56,152.95,
PUNCH BX SKIN EA SEP/ADDL,11105,CDM,11105,CPT,,,both,,230,230,43.78,,,,fee schedule,,,,,,,,49.98,,,,fee schedule,,,195.5,85,,percent of total billed charges,,43,,,,fee schedule,,26.71,,,,fee schedule,,49.98,,,,fee schedule,,,,,,,,49.98,,,,fee schedule,,42.49,,,,fee schedule,,25.75,,,,fee schedule,,25.75,,,,fee schedule,,,209.3,91,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,69,83,,percent of total billed charges,,49.98,,,,fee schedule,,49.98,,,,fee schedule,,,190.9,83,,percent of total billed charges,,37.86,,,,fee schedule,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,25.75,218.5,
PUNCH BX SKIN EA SEP/ADDL,11105P,CDM,11105,CPT,,,both,P,75,75,43.78,,,,fee schedule,,,,,,,,49.98,,,,fee schedule,,,63.75,85,,percent of total billed charges,,43,,,,fee schedule,,26.71,,,,fee schedule,,49.98,,,,fee schedule,,,,,,,,49.98,,,,fee schedule,,42.49,,,,fee schedule,,25.75,,,,fee schedule,,25.75,,,,fee schedule,,,68.25,91,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,22.5,83,,percent of total billed charges,,49.98,,,,fee schedule,,49.98,,,,fee schedule,,,62.25,83,,percent of total billed charges,,37.86,,,,fee schedule,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,22.5,71.25,
PUNCH BX SKIN EA SEP/ADDL,11105T,CDM,11105,CPT,,,both,T,155,155,43.78,,,,fee schedule,,,,,,,,49.98,,,,fee schedule,,,131.75,85,,percent of total billed charges,,43,,,,fee schedule,,26.71,,,,fee schedule,,49.98,,,,fee schedule,,,,,,,,49.98,,,,fee schedule,,42.49,,,,fee schedule,,25.75,,,,fee schedule,,25.75,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,49.98,,,,fee schedule,,49.98,,,,fee schedule,,,128.65,83,,percent of total billed charges,,37.86,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,25.75,147.25,
INCAL BX SKN SINGLE LES,11106,CDM,11106,CPT,,,both,,563,563,96.21,,,,fee schedule,,,,,,,,37.22,,,,fee schedule,,,478.55,85,,percent of total billed charges,,95.24,,,,fee schedule,,59.15,,,,fee schedule,,37.22,,,,fee schedule,,,,,,,,37.22,,,,fee schedule,,93.38,,,,fee schedule,,56.59,,,,fee schedule,,56.59,,,,fee schedule,,,512.33,91,,percent of total billed charges,,,534.85,95,,percent of total billed charges,,,467.29,83,,percent of total billed charges,,,168.9,83,,percent of total billed charges,,37.22,,,,fee schedule,,37.22,,,,fee schedule,,,467.29,83,,percent of total billed charges,,83.19,,,,fee schedule,,,506.7,90,,percent of total billed charges,,,506.7,90,,percent of total billed charges,,,506.7,90,,percent of total billed charges,,,506.7,90,,percent of total billed charges,,,478.55,85,,percent of total billed charges,,37.22,534.85,
INCAL BX SKN EA SEP/ADDL,11107,CDM,11107,CPT,,,both,,161,161,52.42,,,,fee schedule,,,,,,,,39.74,,,,fee schedule,,,136.85,85,,percent of total billed charges,,52.29,,,,fee schedule,,32.48,,,,fee schedule,,39.74,,,,fee schedule,,,,,,,,39.74,,,,fee schedule,,50.88,,,,fee schedule,,30.84,,,,fee schedule,,30.84,,,,fee schedule,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,48.3,83,,percent of total billed charges,,39.74,,,,fee schedule,,39.74,,,,fee schedule,,,133.63,83,,percent of total billed charges,,45.33,,,,fee schedule,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,30.84,152.95,
REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA UP W/15<,11200,CDM,11200,CPT,,,both,,265,265,131.35,,,,fee schedule,,,,,,,,35.65,,,,fee schedule,,,225.25,85,,percent of total billed charges,,73.4,,,,fee schedule,,76.44,,,,fee schedule,,35.65,,,,fee schedule,,104.79,,,,fee schedule,,35.65,,,,fee schedule,,127.48,,,,fee schedule,,77.26,,,,fee schedule,,77.26,,,,fee schedule,,,241.15,91,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,79.5,83,,percent of total billed charges,,35.65,,,,fee schedule,,35.65,,,,fee schedule,,,219.95,83,,percent of total billed charges,,113.58,,,,fee schedule,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,35.65,251.75,
REMOVAL OF SKIN TAGS,11200P,CDM,11200,CPT,,,both,P,110,110,131.35,,,,fee schedule,,,,,,,,35.65,,,,fee schedule,,,93.5,85,,percent of total billed charges,,73.4,,,,fee schedule,,76.44,,,,fee schedule,,35.65,,,,fee schedule,,104.79,,,,fee schedule,,35.65,,,,fee schedule,,127.48,,,,fee schedule,,77.26,,,,fee schedule,,77.26,,,,fee schedule,,,100.1,91,,percent of total billed charges,,,104.5,95,,percent of total billed charges,,,91.3,83,,percent of total billed charges,,,33,83,,percent of total billed charges,,35.65,,,,fee schedule,,35.65,,,,fee schedule,,,91.3,83,,percent of total billed charges,,113.58,,,,fee schedule,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,93.5,85,,percent of total billed charges,,33,131.35,
REMOVAL OF SKIN TAGS,11200T,CDM,11200,CPT,,,both,T,155,155,131.35,,,,fee schedule,,,,,,,,35.65,,,,fee schedule,,,131.75,85,,percent of total billed charges,,73.4,,,,fee schedule,,76.44,,,,fee schedule,,35.65,,,,fee schedule,,104.79,,,,fee schedule,,35.65,,,,fee schedule,,127.48,,,,fee schedule,,77.26,,,,fee schedule,,77.26,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,35.65,,,,fee schedule,,35.65,,,,fee schedule,,,128.65,83,,percent of total billed charges,,113.58,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,35.65,147.25,
REMOVE SKIN TAGS ADD-ON,11201,CDM,11201,CPT,,,both,,102,102,28.23,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,86.7,85,,percent of total billed charges,,16.41,,,,fee schedule,,17.09,,,,fee schedule,,15.2,,,,fee schedule,,28.52,,,,fee schedule,,15.2,,,,fee schedule,,27.4,,,,fee schedule,,16.6,,,,fee schedule,,16.6,,,,fee schedule,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,30.6,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,84.66,83,,percent of total billed charges,,24.41,,,,fee schedule,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,15.2,96.9,
REMOVE SKIN TAGS ADD-ON,11201P,CDM,11201,CPT,,,both,P,25,25,28.23,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,21.25,85,,percent of total billed charges,,16.41,,,,fee schedule,,17.09,,,,fee schedule,,15.2,,,,fee schedule,,28.52,,,,fee schedule,,15.2,,,,fee schedule,,27.4,,,,fee schedule,,16.6,,,,fee schedule,,16.6,,,,fee schedule,,,22.75,91,,percent of total billed charges,,,23.75,95,,percent of total billed charges,,,20.75,83,,percent of total billed charges,,,7.5,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,20.75,83,,percent of total billed charges,,24.41,,,,fee schedule,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,21.25,85,,percent of total billed charges,,7.5,28.52,
REMOVE SKIN TAGS ADD-ON,11201T,CDM,11201,CPT,,,both,T,77,77,28.23,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,65.45,85,,percent of total billed charges,,16.41,,,,fee schedule,,17.09,,,,fee schedule,,15.2,,,,fee schedule,,28.52,,,,fee schedule,,15.2,,,,fee schedule,,27.4,,,,fee schedule,,16.6,,,,fee schedule,,16.6,,,,fee schedule,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,63.91,83,,percent of total billed charges,,24.41,,,,fee schedule,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,15.2,73.15,
SHAVING SKIN LES 1 TRUNK/ARM/LEG DIAM 0.5CM/<,11300,CDM,11300,CPT,,,both,,263,263,58.18,,,,fee schedule,,,,,,,,21.1,,,,fee schedule,,,223.55,85,,percent of total billed charges,,57.39,,,,fee schedule,,35.64,,,,fee schedule,,21.1,,,,fee schedule,,49.74,,,,fee schedule,,21.1,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,78.9,83,,percent of total billed charges,,21.1,,,,fee schedule,,21.1,,,,fee schedule,,,218.29,83,,percent of total billed charges,,50.31,,,,fee schedule,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,21.1,249.85,
SHAVE SKIN LESION,11300P,CDM,11300,CPT,,,both,P,108,108,58.18,,,,fee schedule,,,,,,,,21.1,,,,fee schedule,,,91.8,85,,percent of total billed charges,,57.39,,,,fee schedule,,35.64,,,,fee schedule,,21.1,,,,fee schedule,,49.74,,,,fee schedule,,21.1,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,32.4,83,,percent of total billed charges,,21.1,,,,fee schedule,,21.1,,,,fee schedule,,,89.64,83,,percent of total billed charges,,50.31,,,,fee schedule,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,21.1,102.6,
SHAVE SKIN LESION,11300T,CDM,11300,CPT,,,both,T,155,155,58.18,,,,fee schedule,,,,,,,,21.1,,,,fee schedule,,,131.75,85,,percent of total billed charges,,57.39,,,,fee schedule,,35.64,,,,fee schedule,,21.1,,,,fee schedule,,49.74,,,,fee schedule,,21.1,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,21.1,,,,fee schedule,,21.1,,,,fee schedule,,,128.65,83,,percent of total billed charges,,50.31,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,21.1,147.25,
SHAVE SKIN LESION,11301,CDM,11301,CPT,,,both,,315,315,87.56,,,,fee schedule,,,,,,,,29.2,,,,fee schedule,,,267.75,85,,percent of total billed charges,,85.32,,,,fee schedule,,52.98,,,,fee schedule,,29.2,,,,fee schedule,,84.89,,,,fee schedule,,29.2,,,,fee schedule,,84.99,,,,fee schedule,,51.51,,,,fee schedule,,51.51,,,,fee schedule,,,286.65,91,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,94.5,83,,percent of total billed charges,,29.2,,,,fee schedule,,29.2,,,,fee schedule,,,261.45,83,,percent of total billed charges,,75.72,,,,fee schedule,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,29.2,299.25,
SHAVE SKIN LESION,11301P,CDM,11301,CPT,,,both,P,158,158,87.56,,,,fee schedule,,,,,,,,29.2,,,,fee schedule,,,134.3,85,,percent of total billed charges,,85.32,,,,fee schedule,,52.98,,,,fee schedule,,29.2,,,,fee schedule,,84.89,,,,fee schedule,,29.2,,,,fee schedule,,84.99,,,,fee schedule,,51.51,,,,fee schedule,,51.51,,,,fee schedule,,,143.78,91,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,47.4,83,,percent of total billed charges,,29.2,,,,fee schedule,,29.2,,,,fee schedule,,,131.14,83,,percent of total billed charges,,75.72,,,,fee schedule,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,29.2,150.1,
SHAVE SKIN LESION,11301T,CDM,11301,CPT,,,both,T,157,157,87.56,,,,fee schedule,,,,,,,,29.2,,,,fee schedule,,,133.45,85,,percent of total billed charges,,85.32,,,,fee schedule,,52.98,,,,fee schedule,,29.2,,,,fee schedule,,84.89,,,,fee schedule,,29.2,,,,fee schedule,,84.99,,,,fee schedule,,51.51,,,,fee schedule,,51.51,,,,fee schedule,,,142.87,91,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,47.1,83,,percent of total billed charges,,29.2,,,,fee schedule,,29.2,,,,fee schedule,,,130.31,83,,percent of total billed charges,,75.72,,,,fee schedule,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,133.45,85,,percent of total billed charges,,29.2,149.15,
SHAVE SKIN LESION,11302,CDM,11302,CPT,,,both,,361,361,101.97,,,,fee schedule,,,,,,,,37.5,,,,fee schedule,,,306.85,85,,percent of total billed charges,,100.23,,,,fee schedule,,62.25,,,,fee schedule,,37.5,,,,fee schedule,,103.46,,,,fee schedule,,37.5,,,,fee schedule,,98.97,,,,fee schedule,,59.98,,,,fee schedule,,59.98,,,,fee schedule,,,328.51,91,,percent of total billed charges,,,342.95,95,,percent of total billed charges,,,299.63,83,,percent of total billed charges,,,108.3,83,,percent of total billed charges,,37.5,,,,fee schedule,,37.5,,,,fee schedule,,,299.63,83,,percent of total billed charges,,88.17,,,,fee schedule,,,324.9,90,,percent of total billed charges,,,324.9,90,,percent of total billed charges,,,324.9,90,,percent of total billed charges,,,324.9,90,,percent of total billed charges,,,306.85,85,,percent of total billed charges,,37.5,342.95,
SHAVE SKIN LESION,11302P,CDM,11302,CPT,,,both,P,204,204,101.97,,,,fee schedule,,,,,,,,37.5,,,,fee schedule,,,173.4,85,,percent of total billed charges,,100.23,,,,fee schedule,,62.25,,,,fee schedule,,37.5,,,,fee schedule,,103.46,,,,fee schedule,,37.5,,,,fee schedule,,98.97,,,,fee schedule,,59.98,,,,fee schedule,,59.98,,,,fee schedule,,,185.64,91,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,61.2,83,,percent of total billed charges,,37.5,,,,fee schedule,,37.5,,,,fee schedule,,,169.32,83,,percent of total billed charges,,88.17,,,,fee schedule,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,173.4,85,,percent of total billed charges,,37.5,193.8,
SHAVE SKIN LESION,11302T,CDM,11302,CPT,,,both,T,157,157,101.97,,,,fee schedule,,,,,,,,37.5,,,,fee schedule,,,133.45,85,,percent of total billed charges,,100.23,,,,fee schedule,,62.25,,,,fee schedule,,37.5,,,,fee schedule,,103.46,,,,fee schedule,,37.5,,,,fee schedule,,98.97,,,,fee schedule,,59.98,,,,fee schedule,,59.98,,,,fee schedule,,,142.87,91,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,47.1,83,,percent of total billed charges,,37.5,,,,fee schedule,,37.5,,,,fee schedule,,,130.31,83,,percent of total billed charges,,88.17,,,,fee schedule,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,133.45,85,,percent of total billed charges,,37.5,149.15,
SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM,11303,CDM,11303,CPT,,,both,,422,422,120.98,,,,fee schedule,,,,,,,,45.7,,,,fee schedule,,,358.7,85,,percent of total billed charges,,117.91,,,,fee schedule,,73.23,,,,fee schedule,,45.7,,,,fee schedule,,121.37,,,,fee schedule,,45.7,,,,fee schedule,,117.42,,,,fee schedule,,71.16,,,,fee schedule,,71.16,,,,fee schedule,,,384.02,91,,percent of total billed charges,,,400.9,95,,percent of total billed charges,,,350.26,83,,percent of total billed charges,,,126.6,83,,percent of total billed charges,,45.7,,,,fee schedule,,45.7,,,,fee schedule,,,350.26,83,,percent of total billed charges,,104.61,,,,fee schedule,,,379.8,90,,percent of total billed charges,,,379.8,90,,percent of total billed charges,,,379.8,90,,percent of total billed charges,,,379.8,90,,percent of total billed charges,,,358.7,85,,percent of total billed charges,,45.7,400.9,
SHAVE SKIN LESION,11303P,CDM,11303,CPT,,,both,P,265,265,120.98,,,,fee schedule,,,,,,,,45.7,,,,fee schedule,,,225.25,85,,percent of total billed charges,,117.91,,,,fee schedule,,73.23,,,,fee schedule,,45.7,,,,fee schedule,,121.37,,,,fee schedule,,45.7,,,,fee schedule,,117.42,,,,fee schedule,,71.16,,,,fee schedule,,71.16,,,,fee schedule,,,241.15,91,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,79.5,83,,percent of total billed charges,,45.7,,,,fee schedule,,45.7,,,,fee schedule,,,219.95,83,,percent of total billed charges,,104.61,,,,fee schedule,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,45.7,251.75,
SHAVE SKIN LESION,11303T,CDM,11303,CPT,,,both,T,157,157,120.98,,,,fee schedule,,,,,,,,45.7,,,,fee schedule,,,133.45,85,,percent of total billed charges,,117.91,,,,fee schedule,,73.23,,,,fee schedule,,45.7,,,,fee schedule,,121.37,,,,fee schedule,,45.7,,,,fee schedule,,117.42,,,,fee schedule,,71.16,,,,fee schedule,,71.16,,,,fee schedule,,,142.87,91,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,47.1,83,,percent of total billed charges,,45.7,,,,fee schedule,,45.7,,,,fee schedule,,,130.31,83,,percent of total billed charges,,104.61,,,,fee schedule,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,133.45,85,,percent of total billed charges,,45.7,149.15,
SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<,11305,CDM,11305,CPT,,,both,,243,243,63.95,,,,fee schedule,,,,,,,,22.25,,,,fee schedule,,,206.55,85,,percent of total billed charges,,64.96,,,,fee schedule,,40.34,,,,fee schedule,,22.25,,,,fee schedule,,66.98,,,,fee schedule,,22.25,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,221.13,91,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,72.9,83,,percent of total billed charges,,22.25,,,,fee schedule,,22.25,,,,fee schedule,,,201.69,83,,percent of total billed charges,,55.29,,,,fee schedule,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,206.55,85,,percent of total billed charges,,22.25,230.85,
SHAVE SKIN LESION,11305P,CDM,11305,CPT,,,both,P,113,113,63.95,,,,fee schedule,,,,,,,,22.25,,,,fee schedule,,,96.05,85,,percent of total billed charges,,64.96,,,,fee schedule,,40.34,,,,fee schedule,,22.25,,,,fee schedule,,66.98,,,,fee schedule,,22.25,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,33.9,83,,percent of total billed charges,,22.25,,,,fee schedule,,22.25,,,,fee schedule,,,93.79,83,,percent of total billed charges,,55.29,,,,fee schedule,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,22.25,107.35,
SHAVE SKIN LESION,11305T,CDM,11305,CPT,,,both,T,130,130,63.95,,,,fee schedule,,,,,,,,22.25,,,,fee schedule,,,110.5,85,,percent of total billed charges,,64.96,,,,fee schedule,,40.34,,,,fee schedule,,22.25,,,,fee schedule,,66.98,,,,fee schedule,,22.25,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,39,83,,percent of total billed charges,,22.25,,,,fee schedule,,22.25,,,,fee schedule,,,107.9,83,,percent of total billed charges,,55.29,,,,fee schedule,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,22.25,123.5,
SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM,11306,CDM,11306,CPT,,,both,,297,297,84.11,,,,fee schedule,,,,,,,,31.25,,,,fee schedule,,,252.45,85,,percent of total billed charges,,82.96,,,,fee schedule,,51.52,,,,fee schedule,,31.25,,,,fee schedule,,98.82,,,,fee schedule,,31.25,,,,fee schedule,,81.63,,,,fee schedule,,49.48,,,,fee schedule,,49.48,,,,fee schedule,,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,89.1,83,,percent of total billed charges,,31.25,,,,fee schedule,,31.25,,,,fee schedule,,,246.51,83,,percent of total billed charges,,72.73,,,,fee schedule,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,31.25,282.15,
SHAVE SKIN LESION,11306P,CDM,11306,CPT,,,both,P,141,141,84.11,,,,fee schedule,,,,,,,,31.25,,,,fee schedule,,,119.85,85,,percent of total billed charges,,82.96,,,,fee schedule,,51.52,,,,fee schedule,,31.25,,,,fee schedule,,98.82,,,,fee schedule,,31.25,,,,fee schedule,,81.63,,,,fee schedule,,49.48,,,,fee schedule,,49.48,,,,fee schedule,,,128.31,91,,percent of total billed charges,,,133.95,95,,percent of total billed charges,,,117.03,83,,percent of total billed charges,,,42.3,83,,percent of total billed charges,,31.25,,,,fee schedule,,31.25,,,,fee schedule,,,117.03,83,,percent of total billed charges,,72.73,,,,fee schedule,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,119.85,85,,percent of total billed charges,,31.25,133.95,
SHAVE SKIN LESION,11306T,CDM,11306,CPT,,,both,T,156,156,84.11,,,,fee schedule,,,,,,,,31.25,,,,fee schedule,,,132.6,85,,percent of total billed charges,,82.96,,,,fee schedule,,51.52,,,,fee schedule,,31.25,,,,fee schedule,,98.82,,,,fee schedule,,31.25,,,,fee schedule,,81.63,,,,fee schedule,,49.48,,,,fee schedule,,49.48,,,,fee schedule,,,141.96,91,,percent of total billed charges,,,148.2,95,,percent of total billed charges,,,129.48,83,,percent of total billed charges,,,46.8,83,,percent of total billed charges,,31.25,,,,fee schedule,,31.25,,,,fee schedule,,,129.48,83,,percent of total billed charges,,72.73,,,,fee schedule,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,132.6,85,,percent of total billed charges,,31.25,148.2,
SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM,11307,CDM,11307,CPT,,,both,,350,350,107.15,,,,fee schedule,,,,,,,,37.5,,,,fee schedule,,,297.5,85,,percent of total billed charges,,105.79,,,,fee schedule,,65.7,,,,fee schedule,,37.5,,,,fee schedule,,113.41,,,,fee schedule,,37.5,,,,fee schedule,,104,,,,fee schedule,,63.03,,,,fee schedule,,63.03,,,,fee schedule,,,318.5,91,,percent of total billed charges,,,332.5,95,,percent of total billed charges,,,290.5,83,,percent of total billed charges,,,105,83,,percent of total billed charges,,37.5,,,,fee schedule,,37.5,,,,fee schedule,,,290.5,83,,percent of total billed charges,,92.65,,,,fee schedule,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,297.5,85,,percent of total billed charges,,37.5,332.5,
SHAVING SKIN LESION 1 S/N/H/G DIAM >2.0 CM,11308,CDM,11308,CPT,,,both,,384,384,119.25,,,,fee schedule,,,,,,,,45.7,,,,fee schedule,,,326.4,85,,percent of total billed charges,,119.52,,,,fee schedule,,74.23,,,,fee schedule,,45.7,,,,fee schedule,,141.26,,,,fee schedule,,45.7,,,,fee schedule,,115.74,,,,fee schedule,,70.15,,,,fee schedule,,70.15,,,,fee schedule,,,349.44,91,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,115.2,83,,percent of total billed charges,,45.7,,,,fee schedule,,45.7,,,,fee schedule,,,318.72,83,,percent of total billed charges,,103.12,,,,fee schedule,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,326.4,85,,percent of total billed charges,,45.7,364.8,
SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<,11310,CDM,11310,CPT,,,both,,295,295,78.35,,,,fee schedule,,,,,,,,32.4,,,,fee schedule,,,250.75,85,,percent of total billed charges,,76.29,,,,fee schedule,,47.38,,,,fee schedule,,32.4,,,,fee schedule,,72.95,,,,fee schedule,,32.4,,,,fee schedule,,76.04,,,,fee schedule,,46.09,,,,fee schedule,,46.09,,,,fee schedule,,,268.45,91,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,88.5,83,,percent of total billed charges,,32.4,,,,fee schedule,,32.4,,,,fee schedule,,,244.85,83,,percent of total billed charges,,67.75,,,,fee schedule,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,32.4,280.25,
SHAVE SKIN LESION,11310P,CDM,11310,CPT,,,both,P,234,234,78.35,,,,fee schedule,,,,,,,,32.4,,,,fee schedule,,,198.9,85,,percent of total billed charges,,76.29,,,,fee schedule,,47.38,,,,fee schedule,,32.4,,,,fee schedule,,72.95,,,,fee schedule,,32.4,,,,fee schedule,,76.04,,,,fee schedule,,46.09,,,,fee schedule,,46.09,,,,fee schedule,,,212.94,91,,percent of total billed charges,,,222.3,95,,percent of total billed charges,,,194.22,83,,percent of total billed charges,,,70.2,83,,percent of total billed charges,,32.4,,,,fee schedule,,32.4,,,,fee schedule,,,194.22,83,,percent of total billed charges,,67.75,,,,fee schedule,,,210.6,90,,percent of total billed charges,,,210.6,90,,percent of total billed charges,,,210.6,90,,percent of total billed charges,,,210.6,90,,percent of total billed charges,,,198.9,85,,percent of total billed charges,,32.4,222.3,
SHAVE SKIN LESION,11310T,CDM,11310,CPT,,,both,T,61,61,78.35,,,,fee schedule,,,,,,,,32.4,,,,fee schedule,,,51.85,85,,percent of total billed charges,,76.29,,,,fee schedule,,47.38,,,,fee schedule,,32.4,,,,fee schedule,,72.95,,,,fee schedule,,32.4,,,,fee schedule,,76.04,,,,fee schedule,,46.09,,,,fee schedule,,46.09,,,,fee schedule,,,55.51,91,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,18.3,83,,percent of total billed charges,,32.4,,,,fee schedule,,32.4,,,,fee schedule,,,50.63,83,,percent of total billed charges,,67.75,,,,fee schedule,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,18.3,78.35,
SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM,11311,CDM,11311,CPT,,,both,,346,346,107.15,,,,fee schedule,,,,,,,,40.55,,,,fee schedule,,,294.1,85,,percent of total billed charges,,104.22,,,,fee schedule,,64.72,,,,fee schedule,,40.55,,,,fee schedule,,106.11,,,,fee schedule,,40.55,,,,fee schedule,,104,,,,fee schedule,,63.03,,,,fee schedule,,63.03,,,,fee schedule,,,314.86,91,,percent of total billed charges,,,328.7,95,,percent of total billed charges,,,287.18,83,,percent of total billed charges,,,103.8,83,,percent of total billed charges,,40.55,,,,fee schedule,,40.55,,,,fee schedule,,,287.18,83,,percent of total billed charges,,92.65,,,,fee schedule,,,311.4,90,,percent of total billed charges,,,311.4,90,,percent of total billed charges,,,311.4,90,,percent of total billed charges,,,311.4,90,,percent of total billed charges,,,294.1,85,,percent of total billed charges,,40.55,328.7,
SHAVE SKIN LESION,11311P,CDM,11311,CPT,,,both,P,189,189,107.15,,,,fee schedule,,,,,,,,40.55,,,,fee schedule,,,160.65,85,,percent of total billed charges,,104.22,,,,fee schedule,,64.72,,,,fee schedule,,40.55,,,,fee schedule,,106.11,,,,fee schedule,,40.55,,,,fee schedule,,104,,,,fee schedule,,63.03,,,,fee schedule,,63.03,,,,fee schedule,,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,56.7,83,,percent of total billed charges,,40.55,,,,fee schedule,,40.55,,,,fee schedule,,,156.87,83,,percent of total billed charges,,92.65,,,,fee schedule,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,40.55,179.55,
SHAVE SKIN LESION,11311T,CDM,11311,CPT,,,both,T,157,157,107.15,,,,fee schedule,,,,,,,,40.55,,,,fee schedule,,,133.45,85,,percent of total billed charges,,104.22,,,,fee schedule,,64.72,,,,fee schedule,,40.55,,,,fee schedule,,106.11,,,,fee schedule,,40.55,,,,fee schedule,,104,,,,fee schedule,,63.03,,,,fee schedule,,63.03,,,,fee schedule,,,142.87,91,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,47.1,83,,percent of total billed charges,,40.55,,,,fee schedule,,40.55,,,,fee schedule,,,130.31,83,,percent of total billed charges,,92.65,,,,fee schedule,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,133.45,85,,percent of total billed charges,,40.55,149.15,
SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM,11312,CDM,11312,CPT,,,both,,406,406,128.47,,,,fee schedule,,,,,,,,48.8,,,,fee schedule,,,345.1,85,,percent of total billed charges,,122.96,,,,fee schedule,,76.36,,,,fee schedule,,48.8,,,,fee schedule,,120.04,,,,fee schedule,,48.8,,,,fee schedule,,124.69,,,,fee schedule,,75.57,,,,fee schedule,,75.57,,,,fee schedule,,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,121.8,83,,percent of total billed charges,,48.8,,,,fee schedule,,48.8,,,,fee schedule,,,336.98,83,,percent of total billed charges,,111.09,,,,fee schedule,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,48.8,385.7,
SHAVE SKIN LESION,11312P,CDM,11312,CPT,,,both,P,249,249,128.47,,,,fee schedule,,,,,,,,48.8,,,,fee schedule,,,211.65,85,,percent of total billed charges,,122.96,,,,fee schedule,,76.36,,,,fee schedule,,48.8,,,,fee schedule,,120.04,,,,fee schedule,,48.8,,,,fee schedule,,124.69,,,,fee schedule,,75.57,,,,fee schedule,,75.57,,,,fee schedule,,,226.59,91,,percent of total billed charges,,,236.55,95,,percent of total billed charges,,,206.67,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,48.8,,,,fee schedule,,48.8,,,,fee schedule,,,206.67,83,,percent of total billed charges,,111.09,,,,fee schedule,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,211.65,85,,percent of total billed charges,,48.8,236.55,
SHAVE SKIN LESION,11312T,CDM,11312,CPT,,,both,T,157,157,128.47,,,,fee schedule,,,,,,,,48.8,,,,fee schedule,,,133.45,85,,percent of total billed charges,,122.96,,,,fee schedule,,76.36,,,,fee schedule,,48.8,,,,fee schedule,,120.04,,,,fee schedule,,48.8,,,,fee schedule,,124.69,,,,fee schedule,,75.57,,,,fee schedule,,75.57,,,,fee schedule,,,142.87,91,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,47.1,83,,percent of total billed charges,,48.8,,,,fee schedule,,48.8,,,,fee schedule,,,130.31,83,,percent of total billed charges,,111.09,,,,fee schedule,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,133.45,85,,percent of total billed charges,,47.1,149.15,
"SHAVE SKIN LESION, >2.0cm",11313,CDM,11313,CPT,,,both,,494,494,163.03,,,,fee schedule,,,,,,,,57.1,,,,fee schedule,,,419.9,85,,percent of total billed charges,,161.13,,,,fee schedule,,100.07,,,,fee schedule,,57.1,,,,fee schedule,,161.82,,,,fee schedule,,57.1,,,,fee schedule,,158.24,,,,fee schedule,,95.9,,,,fee schedule,,95.9,,,,fee schedule,,,449.54,91,,percent of total billed charges,,,469.3,95,,percent of total billed charges,,,410.02,83,,percent of total billed charges,,,148.2,83,,percent of total billed charges,,57.1,,,,fee schedule,,57.1,,,,fee schedule,,,410.02,83,,percent of total billed charges,,140.97,,,,fee schedule,,,444.6,90,,percent of total billed charges,,,444.6,90,,percent of total billed charges,,,444.6,90,,percent of total billed charges,,,444.6,90,,percent of total billed charges,,,419.9,85,,percent of total billed charges,,57.1,469.3,
SHAVE SKIN LESION,11313P,CDM,11313,CPT,,,both,P,335,335,163.03,,,,fee schedule,,,,,,,,57.1,,,,fee schedule,,,284.75,85,,percent of total billed charges,,161.13,,,,fee schedule,,100.07,,,,fee schedule,,57.1,,,,fee schedule,,161.82,,,,fee schedule,,57.1,,,,fee schedule,,158.24,,,,fee schedule,,95.9,,,,fee schedule,,95.9,,,,fee schedule,,,304.85,91,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,100.5,83,,percent of total billed charges,,57.1,,,,fee schedule,,57.1,,,,fee schedule,,,278.05,83,,percent of total billed charges,,140.97,,,,fee schedule,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,57.1,318.25,
SHAVE SKIN LESION,11313T,CDM,11313,CPT,,,both,T,159,159,163.03,,,,fee schedule,,,,,,,,57.1,,,,fee schedule,,,135.15,85,,percent of total billed charges,,161.13,,,,fee schedule,,100.07,,,,fee schedule,,57.1,,,,fee schedule,,161.82,,,,fee schedule,,57.1,,,,fee schedule,,158.24,,,,fee schedule,,95.9,,,,fee schedule,,95.9,,,,fee schedule,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,47.7,83,,percent of total billed charges,,57.1,,,,fee schedule,,57.1,,,,fee schedule,,,131.97,83,,percent of total billed charges,,140.97,,,,fee schedule,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,47.7,163.03,
EXC B9 LES MRGN XCP SK TG T/A/L 0.5 CM/<,11400,CDM,11400,CPT,,,both,,412,412,144.6,,,,fee schedule,,,,,,,,39.05,,,,fee schedule,,,350.2,85,,percent of total billed charges,,136.71,,,,fee schedule,,84.9,,,,fee schedule,,39.05,,,,fee schedule,,119.38,,,,fee schedule,,39.05,,,,fee schedule,,140.34,,,,fee schedule,,85.06,,,,fee schedule,,85.06,,,,fee schedule,,,374.92,91,,percent of total billed charges,,,391.4,95,,percent of total billed charges,,,341.96,83,,percent of total billed charges,,,123.6,83,,percent of total billed charges,,39.05,,,,fee schedule,,39.05,,,,fee schedule,,,341.96,83,,percent of total billed charges,,125.03,,,,fee schedule,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,350.2,85,,percent of total billed charges,,39.05,391.4,
EXC TR-EXT B9+MARG 0.5 < CM,11400P,CDM,11400,CPT,,,both,P,255,255,144.6,,,,fee schedule,,,,,,,,39.05,,,,fee schedule,,,216.75,85,,percent of total billed charges,,136.71,,,,fee schedule,,84.9,,,,fee schedule,,39.05,,,,fee schedule,,119.38,,,,fee schedule,,39.05,,,,fee schedule,,140.34,,,,fee schedule,,85.06,,,,fee schedule,,85.06,,,,fee schedule,,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,76.5,83,,percent of total billed charges,,39.05,,,,fee schedule,,39.05,,,,fee schedule,,,211.65,83,,percent of total billed charges,,125.03,,,,fee schedule,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,39.05,242.25,
EXC TR-EXT B9+MARG 0.5 < CM,11400T,CDM,11400,CPT,,,both,T,157,157,144.6,,,,fee schedule,,,,,,,,39.05,,,,fee schedule,,,133.45,85,,percent of total billed charges,,136.71,,,,fee schedule,,84.9,,,,fee schedule,,39.05,,,,fee schedule,,119.38,,,,fee schedule,,39.05,,,,fee schedule,,140.34,,,,fee schedule,,85.06,,,,fee schedule,,85.06,,,,fee schedule,,,142.87,91,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,47.1,83,,percent of total billed charges,,39.05,,,,fee schedule,,39.05,,,,fee schedule,,,130.31,83,,percent of total billed charges,,125.03,,,,fee schedule,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,133.45,85,,percent of total billed charges,,39.05,149.15,
EXC B9 LES MRGN XCP SK TG T/A/L 0.6-1.0 CM,11401,CDM,11401,CPT,,,both,,478,478,182.62,,,,fee schedule,,,,,,,,50.2,,,,fee schedule,,,406.3,85,,percent of total billed charges,,174.19,,,,fee schedule,,108.18,,,,fee schedule,,50.2,,,,fee schedule,,155.85,,,,fee schedule,,50.2,,,,fee schedule,,177.25,,,,fee schedule,,107.42,,,,fee schedule,,107.42,,,,fee schedule,,,434.98,91,,percent of total billed charges,,,454.1,95,,percent of total billed charges,,,396.74,83,,percent of total billed charges,,,143.4,83,,percent of total billed charges,,50.2,,,,fee schedule,,50.2,,,,fee schedule,,,396.74,83,,percent of total billed charges,,157.91,,,,fee schedule,,,430.2,90,,percent of total billed charges,,,430.2,90,,percent of total billed charges,,,430.2,90,,percent of total billed charges,,,430.2,90,,percent of total billed charges,,,406.3,85,,percent of total billed charges,,50.2,454.1,
EXC TR-EXT B9+MARG 0.6-1 CM,11401P,CDM,11401,CPT,,,both,P,347,347,182.62,,,,fee schedule,,,,,,,,50.2,,,,fee schedule,,,294.95,85,,percent of total billed charges,,174.19,,,,fee schedule,,108.18,,,,fee schedule,,50.2,,,,fee schedule,,155.85,,,,fee schedule,,50.2,,,,fee schedule,,177.25,,,,fee schedule,,107.42,,,,fee schedule,,107.42,,,,fee schedule,,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,104.1,83,,percent of total billed charges,,50.2,,,,fee schedule,,50.2,,,,fee schedule,,,288.01,83,,percent of total billed charges,,157.91,,,,fee schedule,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,50.2,329.65,
EXC TR-EXT B9+MARG 0.6-1 CM,11401T,CDM,11401,CPT,,,both,T,131,131,182.62,,,,fee schedule,,,,,,,,50.2,,,,fee schedule,,,111.35,85,,percent of total billed charges,,174.19,,,,fee schedule,,108.18,,,,fee schedule,,50.2,,,,fee schedule,,155.85,,,,fee schedule,,50.2,,,,fee schedule,,177.25,,,,fee schedule,,107.42,,,,fee schedule,,107.42,,,,fee schedule,,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,39.3,83,,percent of total billed charges,,50.2,,,,fee schedule,,50.2,,,,fee schedule,,,108.73,83,,percent of total billed charges,,157.91,,,,fee schedule,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,39.3,182.62,
EXC TR-EXT B9+MARG 1.1-2 CM,11402,CDM,11402,CPT,,,both,,562,562,198.75,,,,fee schedule,,,,,,,,64.8,,,,fee schedule,,,477.7,85,,percent of total billed charges,,191.5,,,,fee schedule,,118.93,,,,fee schedule,,64.8,,,,fee schedule,,180.39,,,,fee schedule,,64.8,,,,fee schedule,,192.9,,,,fee schedule,,116.91,,,,fee schedule,,116.91,,,,fee schedule,,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,168.6,83,,percent of total billed charges,,64.8,,,,fee schedule,,64.8,,,,fee schedule,,,466.46,83,,percent of total billed charges,,171.86,,,,fee schedule,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,64.8,533.9,
EXC TR-EXT B9+MARG 1.1-2 CM,11402P,CDM,11402,CPT,,,both,P,409,409,198.75,,,,fee schedule,,,,,,,,64.8,,,,fee schedule,,,347.65,85,,percent of total billed charges,,191.5,,,,fee schedule,,118.93,,,,fee schedule,,64.8,,,,fee schedule,,180.39,,,,fee schedule,,64.8,,,,fee schedule,,192.9,,,,fee schedule,,116.91,,,,fee schedule,,116.91,,,,fee schedule,,,372.19,91,,percent of total billed charges,,,388.55,95,,percent of total billed charges,,,339.47,83,,percent of total billed charges,,,122.7,83,,percent of total billed charges,,64.8,,,,fee schedule,,64.8,,,,fee schedule,,,339.47,83,,percent of total billed charges,,171.86,,,,fee schedule,,,368.1,90,,percent of total billed charges,,,368.1,90,,percent of total billed charges,,,368.1,90,,percent of total billed charges,,,368.1,90,,percent of total billed charges,,,347.65,85,,percent of total billed charges,,64.8,388.55,
EXC TR-EXT B9+MARG 1.1-2 CM,11402T,CDM,11402,CPT,,,both,T,153,153,198.75,,,,fee schedule,,,,,,,,64.8,,,,fee schedule,,,130.05,85,,percent of total billed charges,,191.5,,,,fee schedule,,118.93,,,,fee schedule,,64.8,,,,fee schedule,,180.39,,,,fee schedule,,64.8,,,,fee schedule,,192.9,,,,fee schedule,,116.91,,,,fee schedule,,116.91,,,,fee schedule,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,45.9,83,,percent of total billed charges,,64.8,,,,fee schedule,,64.8,,,,fee schedule,,,126.99,83,,percent of total billed charges,,171.86,,,,fee schedule,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,45.9,198.75,
EXC B9 LES MRGN XCP SK TG T/A/L 2.1-3.0 CM,11403,CDM,11403,CPT,,,both,,674,674,256.36,,,,fee schedule,,,,,,,,77.9,,,,fee schedule,,,572.9,85,,percent of total billed charges,,244.83,,,,fee schedule,,152.05,,,,fee schedule,,77.9,,,,fee schedule,,217.53,,,,fee schedule,,77.9,,,,fee schedule,,248.82,,,,fee schedule,,150.8,,,,fee schedule,,150.8,,,,fee schedule,,,613.34,91,,percent of total billed charges,,,640.3,95,,percent of total billed charges,,,559.42,83,,percent of total billed charges,,,202.2,83,,percent of total billed charges,,77.9,,,,fee schedule,,77.9,,,,fee schedule,,,559.42,83,,percent of total billed charges,,221.67,,,,fee schedule,,,606.6,90,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,572.9,85,,percent of total billed charges,,77.9,640.3,
EXC TR-EXT B9+MARG 2.1-3 CM,11403P,CDM,11403,CPT,,,both,P,480,480,256.36,,,,fee schedule,,,,,,,,77.9,,,,fee schedule,,,408,85,,percent of total billed charges,,244.83,,,,fee schedule,,152.05,,,,fee schedule,,77.9,,,,fee schedule,,217.53,,,,fee schedule,,77.9,,,,fee schedule,,248.82,,,,fee schedule,,150.8,,,,fee schedule,,150.8,,,,fee schedule,,,436.8,91,,percent of total billed charges,,,456,95,,percent of total billed charges,,,398.4,83,,percent of total billed charges,,,144,83,,percent of total billed charges,,77.9,,,,fee schedule,,77.9,,,,fee schedule,,,398.4,83,,percent of total billed charges,,221.67,,,,fee schedule,,,432,90,,percent of total billed charges,,,432,90,,percent of total billed charges,,,432,90,,percent of total billed charges,,,432,90,,percent of total billed charges,,,408,85,,percent of total billed charges,,77.9,456,
EXC TR-EXT B9+MARG 2.1-3 CM,11403T,CDM,11403,CPT,,,both,T,194,194,256.36,,,,fee schedule,,,,,,,,77.9,,,,fee schedule,,,164.9,85,,percent of total billed charges,,244.83,,,,fee schedule,,152.05,,,,fee schedule,,77.9,,,,fee schedule,,217.53,,,,fee schedule,,77.9,,,,fee schedule,,248.82,,,,fee schedule,,150.8,,,,fee schedule,,150.8,,,,fee schedule,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,58.2,83,,percent of total billed charges,,77.9,,,,fee schedule,,77.9,,,,fee schedule,,,161.02,83,,percent of total billed charges,,221.67,,,,fee schedule,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,58.2,256.36,
EXC B9 LES MRGN XCP SK TG T/A/L 3.1-4.0 CM,11404,CDM,11404,CPT,,,both,,833,833,282.86,,,,fee schedule,,,,,,,,92.4,,,,fee schedule,,,708.05,85,,percent of total billed charges,,272.64,,,,fee schedule,,169.32,,,,fee schedule,,92.4,,,,fee schedule,,243.4,,,,fee schedule,,92.4,,,,fee schedule,,274.54,,,,fee schedule,,166.39,,,,fee schedule,,166.39,,,,fee schedule,,,758.03,91,,percent of total billed charges,,,791.35,95,,percent of total billed charges,,,691.39,83,,percent of total billed charges,,,249.9,83,,percent of total billed charges,,92.4,,,,fee schedule,,92.4,,,,fee schedule,,,691.39,83,,percent of total billed charges,,244.59,,,,fee schedule,,,749.7,90,,percent of total billed charges,,,749.7,90,,percent of total billed charges,,,749.7,90,,percent of total billed charges,,,749.7,90,,percent of total billed charges,,,708.05,85,,percent of total billed charges,,92.4,791.35,
EXC TR-EXT B9+MARG 3.1-4 CM,11404P,CDM,11404,CPT,,,both,P,658,658,282.86,,,,fee schedule,,,,,,,,92.4,,,,fee schedule,,,559.3,85,,percent of total billed charges,,272.64,,,,fee schedule,,169.32,,,,fee schedule,,92.4,,,,fee schedule,,243.4,,,,fee schedule,,92.4,,,,fee schedule,,274.54,,,,fee schedule,,166.39,,,,fee schedule,,166.39,,,,fee schedule,,,598.78,91,,percent of total billed charges,,,625.1,95,,percent of total billed charges,,,546.14,83,,percent of total billed charges,,,197.4,83,,percent of total billed charges,,92.4,,,,fee schedule,,92.4,,,,fee schedule,,,546.14,83,,percent of total billed charges,,244.59,,,,fee schedule,,,592.2,90,,percent of total billed charges,,,592.2,90,,percent of total billed charges,,,592.2,90,,percent of total billed charges,,,592.2,90,,percent of total billed charges,,,559.3,85,,percent of total billed charges,,92.4,625.1,
EXC TR-EXT B9+MARG 3.1-4 CM,11404T,CDM,11404,CPT,,,both,T,175,175,282.86,,,,fee schedule,,,,,,,,92.4,,,,fee schedule,,,148.75,85,,percent of total billed charges,,272.64,,,,fee schedule,,169.32,,,,fee schedule,,92.4,,,,fee schedule,,243.4,,,,fee schedule,,92.4,,,,fee schedule,,274.54,,,,fee schedule,,166.39,,,,fee schedule,,166.39,,,,fee schedule,,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,52.5,83,,percent of total billed charges,,92.4,,,,fee schedule,,92.4,,,,fee schedule,,,145.25,83,,percent of total billed charges,,244.59,,,,fee schedule,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,52.5,282.86,
EXC TR-EXT B9+MARG > 4.0 CM,11406,CDM,11406,CPT,,,both,,1218,1218,425.72,,,,fee schedule,,,,,,,,108,,,,fee schedule,,,1035.3,85,,percent of total billed charges,,417.25,,,,fee schedule,,259.13,,,,fee schedule,,108,,,,fee schedule,,313.7,,,,fee schedule,,108,,,,fee schedule,,413.2,,,,fee schedule,,250.43,,,,fee schedule,,250.43,,,,fee schedule,,,1108.38,91,,percent of total billed charges,,,1157.1,95,,percent of total billed charges,,,1010.94,83,,percent of total billed charges,,,365.4,83,,percent of total billed charges,,108,,,,fee schedule,,108,,,,fee schedule,,,1010.94,83,,percent of total billed charges,,368.13,,,,fee schedule,,,1096.2,90,,percent of total billed charges,,,1096.2,90,,percent of total billed charges,,,1096.2,90,,percent of total billed charges,,,1096.2,90,,percent of total billed charges,,,1035.3,85,,percent of total billed charges,,108,1157.1,
EXC TR-EXT B9+MARG > 4.0 CM,11406P,CDM,11406,CPT,,,both,P,1032,1032,425.72,,,,fee schedule,,,,,,,,108,,,,fee schedule,,,877.2,85,,percent of total billed charges,,417.25,,,,fee schedule,,259.13,,,,fee schedule,,108,,,,fee schedule,,313.7,,,,fee schedule,,108,,,,fee schedule,,413.2,,,,fee schedule,,250.43,,,,fee schedule,,250.43,,,,fee schedule,,,939.12,91,,percent of total billed charges,,,980.4,95,,percent of total billed charges,,,856.56,83,,percent of total billed charges,,,309.6,83,,percent of total billed charges,,108,,,,fee schedule,,108,,,,fee schedule,,,856.56,83,,percent of total billed charges,,368.13,,,,fee schedule,,,928.8,90,,percent of total billed charges,,,928.8,90,,percent of total billed charges,,,928.8,90,,percent of total billed charges,,,928.8,90,,percent of total billed charges,,,877.2,85,,percent of total billed charges,,108,980.4,
EXC TR-EXT B9+MARG > 4.0 CM,11406T,CDM,11406,CPT,,,both,T,186,186,425.72,,,,fee schedule,,,,,,,,108,,,,fee schedule,,,158.1,85,,percent of total billed charges,,417.25,,,,fee schedule,,259.13,,,,fee schedule,,108,,,,fee schedule,,313.7,,,,fee schedule,,108,,,,fee schedule,,413.2,,,,fee schedule,,250.43,,,,fee schedule,,250.43,,,,fee schedule,,,169.26,91,,percent of total billed charges,,,176.7,95,,percent of total billed charges,,,154.38,83,,percent of total billed charges,,,55.8,83,,percent of total billed charges,,108,,,,fee schedule,,108,,,,fee schedule,,,154.38,83,,percent of total billed charges,,368.13,,,,fee schedule,,,167.4,90,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,158.1,85,,percent of total billed charges,,55.8,425.72,
EXC B9 LES MRGN XCP SK TG S/N/H/F/G 0.5 CM/<,11420,CDM,11420,CPT,,,both,,417,417,141.14,,,,fee schedule,,,,,,,,38.3,,,,fee schedule,,,354.45,85,,percent of total billed charges,,135.09,,,,fee schedule,,83.9,,,,fee schedule,,38.3,,,,fee schedule,,133.3,,,,fee schedule,,38.3,,,,fee schedule,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,379.47,91,,percent of total billed charges,,,396.15,95,,percent of total billed charges,,,346.11,83,,percent of total billed charges,,,125.1,83,,percent of total billed charges,,38.3,,,,fee schedule,,38.3,,,,fee schedule,,,346.11,83,,percent of total billed charges,,122.04,,,,fee schedule,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,354.45,85,,percent of total billed charges,,38.3,396.15,
EXC H-F-NK-SP B9+MARG 0.5 <,11420P,CDM,11420,CPT,,,both,P,254,254,141.14,,,,fee schedule,,,,,,,,38.3,,,,fee schedule,,,215.9,85,,percent of total billed charges,,135.09,,,,fee schedule,,83.9,,,,fee schedule,,38.3,,,,fee schedule,,133.3,,,,fee schedule,,38.3,,,,fee schedule,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,231.14,91,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,76.2,83,,percent of total billed charges,,38.3,,,,fee schedule,,38.3,,,,fee schedule,,,210.82,83,,percent of total billed charges,,122.04,,,,fee schedule,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,38.3,241.3,
EXC H-F-NK-SP B9+MARG 0.5 <,11420T,CDM,11420,CPT,,,both,T,163,163,141.14,,,,fee schedule,,,,,,,,38.3,,,,fee schedule,,,138.55,85,,percent of total billed charges,,135.09,,,,fee schedule,,83.9,,,,fee schedule,,38.3,,,,fee schedule,,133.3,,,,fee schedule,,38.3,,,,fee schedule,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,48.9,83,,percent of total billed charges,,38.3,,,,fee schedule,,38.3,,,,fee schedule,,,135.29,83,,percent of total billed charges,,122.04,,,,fee schedule,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,38.3,154.85,
EXC B9 LES MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM,11421,CDM,11421,CPT,,,both,,521,521,188.38,,,,fee schedule,,,,,,,,50.85,,,,fee schedule,,,442.85,85,,percent of total billed charges,,180.48,,,,fee schedule,,112.09,,,,fee schedule,,50.85,,,,fee schedule,,176.41,,,,fee schedule,,50.85,,,,fee schedule,,182.84,,,,fee schedule,,110.81,,,,fee schedule,,110.81,,,,fee schedule,,,474.11,91,,percent of total billed charges,,,494.95,95,,percent of total billed charges,,,432.43,83,,percent of total billed charges,,,156.3,83,,percent of total billed charges,,50.85,,,,fee schedule,,50.85,,,,fee schedule,,,432.43,83,,percent of total billed charges,,162.89,,,,fee schedule,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,442.85,85,,percent of total billed charges,,50.85,494.95,
EXC H-F-NK-SP B9+MARG 0.6-1,11421P,CDM,11421,CPT,,,both,P,355,355,188.38,,,,fee schedule,,,,,,,,50.85,,,,fee schedule,,,301.75,85,,percent of total billed charges,,180.48,,,,fee schedule,,112.09,,,,fee schedule,,50.85,,,,fee schedule,,176.41,,,,fee schedule,,50.85,,,,fee schedule,,182.84,,,,fee schedule,,110.81,,,,fee schedule,,110.81,,,,fee schedule,,,323.05,91,,percent of total billed charges,,,337.25,95,,percent of total billed charges,,,294.65,83,,percent of total billed charges,,,106.5,83,,percent of total billed charges,,50.85,,,,fee schedule,,50.85,,,,fee schedule,,,294.65,83,,percent of total billed charges,,162.89,,,,fee schedule,,,319.5,90,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,301.75,85,,percent of total billed charges,,50.85,337.25,
EXC H-F-NK-SP B9+MARG 0.6-1,11421T,CDM,11421,CPT,,,both,T,166,166,188.38,,,,fee schedule,,,,,,,,50.85,,,,fee schedule,,,141.1,85,,percent of total billed charges,,180.48,,,,fee schedule,,112.09,,,,fee schedule,,50.85,,,,fee schedule,,176.41,,,,fee schedule,,50.85,,,,fee schedule,,182.84,,,,fee schedule,,110.81,,,,fee schedule,,110.81,,,,fee schedule,,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,50.85,,,,fee schedule,,50.85,,,,fee schedule,,,137.78,83,,percent of total billed charges,,162.89,,,,fee schedule,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,49.8,188.38,
EXC B9 LES MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM,11422,CDM,11422,CPT,,,both,,611,611,233.31,,,,fee schedule,,,,,,,,64.8,,,,fee schedule,,,519.35,85,,percent of total billed charges,,223.16,,,,fee schedule,,138.59,,,,fee schedule,,64.8,,,,fee schedule,,206.26,,,,fee schedule,,64.8,,,,fee schedule,,226.45,,,,fee schedule,,137.24,,,,fee schedule,,137.24,,,,fee schedule,,,556.01,91,,percent of total billed charges,,,580.45,95,,percent of total billed charges,,,507.13,83,,percent of total billed charges,,,183.3,83,,percent of total billed charges,,64.8,,,,fee schedule,,64.8,,,,fee schedule,,,507.13,83,,percent of total billed charges,,201.75,,,,fee schedule,,,549.9,90,,percent of total billed charges,,,549.9,90,,percent of total billed charges,,,549.9,90,,percent of total billed charges,,,549.9,90,,percent of total billed charges,,,519.35,85,,percent of total billed charges,,64.8,580.45,
EXC H-F-NK-SP B9+MARG 1.1-2,11422P,CDM,11422,CPT,,,both,P,434,434,233.31,,,,fee schedule,,,,,,,,64.8,,,,fee schedule,,,368.9,85,,percent of total billed charges,,223.16,,,,fee schedule,,138.59,,,,fee schedule,,64.8,,,,fee schedule,,206.26,,,,fee schedule,,64.8,,,,fee schedule,,226.45,,,,fee schedule,,137.24,,,,fee schedule,,137.24,,,,fee schedule,,,394.94,91,,percent of total billed charges,,,412.3,95,,percent of total billed charges,,,360.22,83,,percent of total billed charges,,,130.2,83,,percent of total billed charges,,64.8,,,,fee schedule,,64.8,,,,fee schedule,,,360.22,83,,percent of total billed charges,,201.75,,,,fee schedule,,,390.6,90,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,390.6,90,,percent of total billed charges,,,368.9,85,,percent of total billed charges,,64.8,412.3,
EXC H-F-NK-SP B9+MARG 1.1-2,11422T,CDM,11422,CPT,,,both,T,177,177,233.31,,,,fee schedule,,,,,,,,64.8,,,,fee schedule,,,150.45,85,,percent of total billed charges,,223.16,,,,fee schedule,,138.59,,,,fee schedule,,64.8,,,,fee schedule,,206.26,,,,fee schedule,,64.8,,,,fee schedule,,226.45,,,,fee schedule,,137.24,,,,fee schedule,,137.24,,,,fee schedule,,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,53.1,83,,percent of total billed charges,,64.8,,,,fee schedule,,64.8,,,,fee schedule,,,146.91,83,,percent of total billed charges,,201.75,,,,fee schedule,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,53.1,233.31,
EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM,11423,CDM,11423,CPT,,,both,,757,757,268.45,,,,fee schedule,,,,,,,,77.9,,,,fee schedule,,,643.45,85,,percent of total billed charges,,257.45,,,,fee schedule,,159.89,,,,fee schedule,,77.9,,,,fee schedule,,242.73,,,,fee schedule,,77.9,,,,fee schedule,,260.56,,,,fee schedule,,157.91,,,,fee schedule,,157.91,,,,fee schedule,,,688.87,91,,percent of total billed charges,,,719.15,95,,percent of total billed charges,,,628.31,83,,percent of total billed charges,,,227.1,83,,percent of total billed charges,,77.9,,,,fee schedule,,77.9,,,,fee schedule,,,628.31,83,,percent of total billed charges,,232.13,,,,fee schedule,,,681.3,90,,percent of total billed charges,,,681.3,90,,percent of total billed charges,,,681.3,90,,percent of total billed charges,,,681.3,90,,percent of total billed charges,,,643.45,85,,percent of total billed charges,,77.9,719.15,
EXC H-F-NK-SP B9+MARG 2.1-3,11423P,CDM,11423,CPT,,,both,P,551,551,268.45,,,,fee schedule,,,,,,,,77.9,,,,fee schedule,,,468.35,85,,percent of total billed charges,,257.45,,,,fee schedule,,159.89,,,,fee schedule,,77.9,,,,fee schedule,,242.73,,,,fee schedule,,77.9,,,,fee schedule,,260.56,,,,fee schedule,,157.91,,,,fee schedule,,157.91,,,,fee schedule,,,501.41,91,,percent of total billed charges,,,523.45,95,,percent of total billed charges,,,457.33,83,,percent of total billed charges,,,165.3,83,,percent of total billed charges,,77.9,,,,fee schedule,,77.9,,,,fee schedule,,,457.33,83,,percent of total billed charges,,232.13,,,,fee schedule,,,495.9,90,,percent of total billed charges,,,495.9,90,,percent of total billed charges,,,495.9,90,,percent of total billed charges,,,495.9,90,,percent of total billed charges,,,468.35,85,,percent of total billed charges,,77.9,523.45,
EXC H-F-NK-SP B9+MARG 2.1-3,11423T,CDM,11423,CPT,,,both,T,206,206,268.45,,,,fee schedule,,,,,,,,77.9,,,,fee schedule,,,175.1,85,,percent of total billed charges,,257.45,,,,fee schedule,,159.89,,,,fee schedule,,77.9,,,,fee schedule,,242.73,,,,fee schedule,,77.9,,,,fee schedule,,260.56,,,,fee schedule,,157.91,,,,fee schedule,,157.91,,,,fee schedule,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,61.8,83,,percent of total billed charges,,77.9,,,,fee schedule,,77.9,,,,fee schedule,,,170.98,83,,percent of total billed charges,,232.13,,,,fee schedule,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,61.8,268.45,
EXC H-F-NK-SP B9+MARG 3.1-4,11424,CDM,11424,CPT,,,both,,923,923,306.48,,,,fee schedule,,,,,,,,92.4,,,,fee schedule,,,784.55,85,,percent of total billed charges,,295.45,,,,fee schedule,,183.49,,,,fee schedule,,92.4,,,,fee schedule,,283.85,,,,fee schedule,,92.4,,,,fee schedule,,297.46,,,,fee schedule,,180.28,,,,fee schedule,,180.28,,,,fee schedule,,,839.93,91,,percent of total billed charges,,,876.85,95,,percent of total billed charges,,,766.09,83,,percent of total billed charges,,,276.9,83,,percent of total billed charges,,92.4,,,,fee schedule,,92.4,,,,fee schedule,,,766.09,83,,percent of total billed charges,,265.01,,,,fee schedule,,,830.7,90,,percent of total billed charges,,,830.7,90,,percent of total billed charges,,,830.7,90,,percent of total billed charges,,,830.7,90,,percent of total billed charges,,,784.55,85,,percent of total billed charges,,92.4,876.85,
EXC H-F-NK-SP B9+MARG 3.1-4,11424P,CDM,11424,CPT,,,both,P,693,693,306.48,,,,fee schedule,,,,,,,,92.4,,,,fee schedule,,,589.05,85,,percent of total billed charges,,295.45,,,,fee schedule,,183.49,,,,fee schedule,,92.4,,,,fee schedule,,283.85,,,,fee schedule,,92.4,,,,fee schedule,,297.46,,,,fee schedule,,180.28,,,,fee schedule,,180.28,,,,fee schedule,,,630.63,91,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,207.9,83,,percent of total billed charges,,92.4,,,,fee schedule,,92.4,,,,fee schedule,,,575.19,83,,percent of total billed charges,,265.01,,,,fee schedule,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,589.05,85,,percent of total billed charges,,92.4,658.35,
EXC H-F-NK-SP B9+MARG 3.1-4,11424T,CDM,11424,CPT,,,both,T,230,230,306.48,,,,fee schedule,,,,,,,,92.4,,,,fee schedule,,,195.5,85,,percent of total billed charges,,295.45,,,,fee schedule,,183.49,,,,fee schedule,,92.4,,,,fee schedule,,283.85,,,,fee schedule,,92.4,,,,fee schedule,,297.46,,,,fee schedule,,180.28,,,,fee schedule,,180.28,,,,fee schedule,,,209.3,91,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,69,83,,percent of total billed charges,,92.4,,,,fee schedule,,92.4,,,,fee schedule,,,190.9,83,,percent of total billed charges,,265.01,,,,fee schedule,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,69,306.48,
EXC H-F-NK-SP B9+MARG > 4 CM,11426,CDM,11426,CPT,,,both,,1361,1361,463.17,,,,fee schedule,,,,,,,,127.48,,,,fee schedule,,,1156.85,85,,percent of total billed charges,,456.89,,,,fee schedule,,283.75,,,,fee schedule,,127.48,,,,fee schedule,,417.16,,,,fee schedule,,127.48,,,,fee schedule,,449.55,,,,fee schedule,,272.45,,,,fee schedule,,272.45,,,,fee schedule,,,1238.51,91,,percent of total billed charges,,,1292.95,95,,percent of total billed charges,,,1129.63,83,,percent of total billed charges,,,408.3,83,,percent of total billed charges,,127.48,,,,fee schedule,,127.48,,,,fee schedule,,,1129.63,83,,percent of total billed charges,,400.51,,,,fee schedule,,,1224.9,90,,percent of total billed charges,,,1224.9,90,,percent of total billed charges,,,1224.9,90,,percent of total billed charges,,,1224.9,90,,percent of total billed charges,,,1156.85,85,,percent of total billed charges,,127.48,1292.95,
EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<,11440,CDM,11440,CPT,,,both,,459,459,182.62,,,,fee schedule,,,,,,,,54.15,,,,fee schedule,,,390.15,85,,percent of total billed charges,,171.53,,,,fee schedule,,106.53,,,,fee schedule,,54.15,,,,fee schedule,,162.49,,,,fee schedule,,54.15,,,,fee schedule,,177.25,,,,fee schedule,,107.42,,,,fee schedule,,107.42,,,,fee schedule,,,417.69,91,,percent of total billed charges,,,436.05,95,,percent of total billed charges,,,380.97,83,,percent of total billed charges,,,137.7,83,,percent of total billed charges,,54.15,,,,fee schedule,,54.15,,,,fee schedule,,,380.97,83,,percent of total billed charges,,157.91,,,,fee schedule,,,413.1,90,,percent of total billed charges,,,413.1,90,,percent of total billed charges,,,413.1,90,,percent of total billed charges,,,413.1,90,,percent of total billed charges,,,390.15,85,,percent of total billed charges,,54.15,436.05,
EXC FACE-MM B9+MARG 0.5 < CM,11440P,CDM,11440,CPT,,,both,P,324,324,182.62,,,,fee schedule,,,,,,,,54.15,,,,fee schedule,,,275.4,85,,percent of total billed charges,,171.53,,,,fee schedule,,106.53,,,,fee schedule,,54.15,,,,fee schedule,,162.49,,,,fee schedule,,54.15,,,,fee schedule,,177.25,,,,fee schedule,,107.42,,,,fee schedule,,107.42,,,,fee schedule,,,294.84,91,,percent of total billed charges,,,307.8,95,,percent of total billed charges,,,268.92,83,,percent of total billed charges,,,97.2,83,,percent of total billed charges,,54.15,,,,fee schedule,,54.15,,,,fee schedule,,,268.92,83,,percent of total billed charges,,157.91,,,,fee schedule,,,291.6,90,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,275.4,85,,percent of total billed charges,,54.15,307.8,
EXC FACE-MM B9+MARG 0.5 < CM,11440T,CDM,11440,CPT,,,both,T,135,135,182.62,,,,fee schedule,,,,,,,,54.15,,,,fee schedule,,,114.75,85,,percent of total billed charges,,171.53,,,,fee schedule,,106.53,,,,fee schedule,,54.15,,,,fee schedule,,162.49,,,,fee schedule,,54.15,,,,fee schedule,,177.25,,,,fee schedule,,107.42,,,,fee schedule,,107.42,,,,fee schedule,,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,40.5,83,,percent of total billed charges,,54.15,,,,fee schedule,,54.15,,,,fee schedule,,,112.05,83,,percent of total billed charges,,157.91,,,,fee schedule,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,40.5,182.62,
EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM,11441,CDM,11441,CPT,,,both,,587,587,228.7,,,,fee schedule,,,,,,,,75.3,,,,fee schedule,,,498.95,85,,percent of total billed charges,,217.98,,,,fee schedule,,135.37,,,,fee schedule,,75.3,,,,fee schedule,,205.59,,,,fee schedule,,75.3,,,,fee schedule,,221.98,,,,fee schedule,,134.53,,,,fee schedule,,134.53,,,,fee schedule,,,534.17,91,,percent of total billed charges,,,557.65,95,,percent of total billed charges,,,487.21,83,,percent of total billed charges,,,176.1,83,,percent of total billed charges,,75.3,,,,fee schedule,,75.3,,,,fee schedule,,,487.21,83,,percent of total billed charges,,197.76,,,,fee schedule,,,528.3,90,,percent of total billed charges,,,528.3,90,,percent of total billed charges,,,528.3,90,,percent of total billed charges,,,528.3,90,,percent of total billed charges,,,498.95,85,,percent of total billed charges,,75.3,557.65,
EXC FACE-MM B9+MARG 0.6-1 CM,11441P,CDM,11441,CPT,,,both,P,415,415,228.7,,,,fee schedule,,,,,,,,75.3,,,,fee schedule,,,352.75,85,,percent of total billed charges,,217.98,,,,fee schedule,,135.37,,,,fee schedule,,75.3,,,,fee schedule,,205.59,,,,fee schedule,,75.3,,,,fee schedule,,221.98,,,,fee schedule,,134.53,,,,fee schedule,,134.53,,,,fee schedule,,,377.65,91,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,75.3,,,,fee schedule,,75.3,,,,fee schedule,,,344.45,83,,percent of total billed charges,,197.76,,,,fee schedule,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,75.3,394.25,
EXC FACE-MM B9+MARG 0.6-1 CM,11441T,CDM,11441,CPT,,,both,T,172,172,228.7,,,,fee schedule,,,,,,,,75.3,,,,fee schedule,,,146.2,85,,percent of total billed charges,,217.98,,,,fee schedule,,135.37,,,,fee schedule,,75.3,,,,fee schedule,,205.59,,,,fee schedule,,75.3,,,,fee schedule,,221.98,,,,fee schedule,,134.53,,,,fee schedule,,134.53,,,,fee schedule,,,156.52,91,,percent of total billed charges,,,163.4,95,,percent of total billed charges,,,142.76,83,,percent of total billed charges,,,51.6,83,,percent of total billed charges,,75.3,,,,fee schedule,,75.3,,,,fee schedule,,,142.76,83,,percent of total billed charges,,197.76,,,,fee schedule,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,154.8,90,,percent of total billed charges,,,146.2,85,,percent of total billed charges,,51.6,228.7,
EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM,11442,CDM,11442,CPT,,,both,,689,689,252.32,,,,fee schedule,,,,,,,,96.4,,,,fee schedule,,,585.65,85,,percent of total billed charges,,241.12,,,,fee schedule,,149.75,,,,fee schedule,,96.4,,,,fee schedule,,228.14,,,,fee schedule,,96.4,,,,fee schedule,,244.9,,,,fee schedule,,148.43,,,,fee schedule,,148.43,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,96.4,,,,fee schedule,,96.4,,,,fee schedule,,,571.87,83,,percent of total billed charges,,218.19,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,96.4,654.55,
EXC FACE-MM B9+MARG 1.1-2 CM,11442P,CDM,11442,CPT,,,both,P,498,498,252.32,,,,fee schedule,,,,,,,,96.4,,,,fee schedule,,,423.3,85,,percent of total billed charges,,241.12,,,,fee schedule,,149.75,,,,fee schedule,,96.4,,,,fee schedule,,228.14,,,,fee schedule,,96.4,,,,fee schedule,,244.9,,,,fee schedule,,148.43,,,,fee schedule,,148.43,,,,fee schedule,,,453.18,91,,percent of total billed charges,,,473.1,95,,percent of total billed charges,,,413.34,83,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,96.4,,,,fee schedule,,96.4,,,,fee schedule,,,413.34,83,,percent of total billed charges,,218.19,,,,fee schedule,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,448.2,90,,percent of total billed charges,,,423.3,85,,percent of total billed charges,,96.4,473.1,
EXC FACE-MM B9+MARG 1.1-2 CM,11442T,CDM,11442,CPT,,,both,T,191,191,252.32,,,,fee schedule,,,,,,,,96.4,,,,fee schedule,,,162.35,85,,percent of total billed charges,,241.12,,,,fee schedule,,149.75,,,,fee schedule,,96.4,,,,fee schedule,,228.14,,,,fee schedule,,96.4,,,,fee schedule,,244.9,,,,fee schedule,,148.43,,,,fee schedule,,148.43,,,,fee schedule,,,173.81,91,,percent of total billed charges,,,181.45,95,,percent of total billed charges,,,158.53,83,,percent of total billed charges,,,57.3,83,,percent of total billed charges,,96.4,,,,fee schedule,,96.4,,,,fee schedule,,,158.53,83,,percent of total billed charges,,218.19,,,,fee schedule,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,162.35,85,,percent of total billed charges,,57.3,252.32,
EXC FACE-MM B9+MARG 2.1-3 CM,11443,CDM,11443,CPT,,,both,,863,863,307.05,,,,fee schedule,,,,,,,,111,,,,fee schedule,,,733.55,85,,percent of total billed charges,,295.85,,,,fee schedule,,183.74,,,,fee schedule,,111,,,,fee schedule,,285.84,,,,fee schedule,,111,,,,fee schedule,,298.02,,,,fee schedule,,180.62,,,,fee schedule,,180.62,,,,fee schedule,,,785.33,91,,percent of total billed charges,,,819.85,95,,percent of total billed charges,,,716.29,83,,percent of total billed charges,,,258.9,83,,percent of total billed charges,,111,,,,fee schedule,,111,,,,fee schedule,,,716.29,83,,percent of total billed charges,,265.51,,,,fee schedule,,,776.7,90,,percent of total billed charges,,,776.7,90,,percent of total billed charges,,,776.7,90,,percent of total billed charges,,,776.7,90,,percent of total billed charges,,,733.55,85,,percent of total billed charges,,111,819.85,
EXC FACE-MM B9+MARG 2.1-3 CM,11443P,CDM,11443,CPT,,,both,P,687,687,307.05,,,,fee schedule,,,,,,,,111,,,,fee schedule,,,583.95,85,,percent of total billed charges,,295.85,,,,fee schedule,,183.74,,,,fee schedule,,111,,,,fee schedule,,285.84,,,,fee schedule,,111,,,,fee schedule,,298.02,,,,fee schedule,,180.62,,,,fee schedule,,180.62,,,,fee schedule,,,625.17,91,,percent of total billed charges,,,652.65,95,,percent of total billed charges,,,570.21,83,,percent of total billed charges,,,206.1,83,,percent of total billed charges,,111,,,,fee schedule,,111,,,,fee schedule,,,570.21,83,,percent of total billed charges,,265.51,,,,fee schedule,,,618.3,90,,percent of total billed charges,,,618.3,90,,percent of total billed charges,,,618.3,90,,percent of total billed charges,,,618.3,90,,percent of total billed charges,,,583.95,85,,percent of total billed charges,,111,652.65,
EXC FACE-MM B9+MARG 2.1-3 CM,11443T,CDM,11443,CPT,,,both,T,176,176,307.05,,,,fee schedule,,,,,,,,111,,,,fee schedule,,,149.6,85,,percent of total billed charges,,295.85,,,,fee schedule,,183.74,,,,fee schedule,,111,,,,fee schedule,,285.84,,,,fee schedule,,111,,,,fee schedule,,298.02,,,,fee schedule,,180.62,,,,fee schedule,,180.62,,,,fee schedule,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,52.8,83,,percent of total billed charges,,111,,,,fee schedule,,111,,,,fee schedule,,,146.08,83,,percent of total billed charges,,265.51,,,,fee schedule,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,52.8,307.05,
EXC FACE-MM B9+MARG 3.1-4 CM,11444,CDM,11444,CPT,,,both,,1139,1139,387.13,,,,fee schedule,,,,,,,,117.55,,,,fee schedule,,,968.15,85,,percent of total billed charges,,375.91,,,,fee schedule,,233.45,,,,fee schedule,,117.55,,,,fee schedule,,372.06,,,,fee schedule,,117.55,,,,fee schedule,,375.74,,,,fee schedule,,227.72,,,,fee schedule,,227.72,,,,fee schedule,,,1036.49,91,,percent of total billed charges,,,1082.05,95,,percent of total billed charges,,,945.37,83,,percent of total billed charges,,,341.7,83,,percent of total billed charges,,117.55,,,,fee schedule,,117.55,,,,fee schedule,,,945.37,83,,percent of total billed charges,,334.75,,,,fee schedule,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,1025.1,90,,percent of total billed charges,,,968.15,85,,percent of total billed charges,,117.55,1082.05,
EXC FACE-MM B9+MARG 3.1-4 CM,11444P,CDM,11444,CPT,,,both,P,955,955,387.13,,,,fee schedule,,,,,,,,117.55,,,,fee schedule,,,811.75,85,,percent of total billed charges,,375.91,,,,fee schedule,,233.45,,,,fee schedule,,117.55,,,,fee schedule,,372.06,,,,fee schedule,,117.55,,,,fee schedule,,375.74,,,,fee schedule,,227.72,,,,fee schedule,,227.72,,,,fee schedule,,,869.05,91,,percent of total billed charges,,,907.25,95,,percent of total billed charges,,,792.65,83,,percent of total billed charges,,,286.5,83,,percent of total billed charges,,117.55,,,,fee schedule,,117.55,,,,fee schedule,,,792.65,83,,percent of total billed charges,,334.75,,,,fee schedule,,,859.5,90,,percent of total billed charges,,,859.5,90,,percent of total billed charges,,,859.5,90,,percent of total billed charges,,,859.5,90,,percent of total billed charges,,,811.75,85,,percent of total billed charges,,117.55,907.25,
EXC FACE-MM B9+MARG 3.1-4 CM,11444T,CDM,11444,CPT,,,both,T,184,184,387.13,,,,fee schedule,,,,,,,,117.55,,,,fee schedule,,,156.4,85,,percent of total billed charges,,375.91,,,,fee schedule,,233.45,,,,fee schedule,,117.55,,,,fee schedule,,372.06,,,,fee schedule,,117.55,,,,fee schedule,,375.74,,,,fee schedule,,227.72,,,,fee schedule,,227.72,,,,fee schedule,,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,55.2,83,,percent of total billed charges,,117.55,,,,fee schedule,,117.55,,,,fee schedule,,,152.72,83,,percent of total billed charges,,334.75,,,,fee schedule,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,55.2,387.13,
EXC FACE-MM B9+MARG > 4 CM,11446,CDM,11446,CPT,,,both,,1585,1585,542.09,,,,fee schedule,,,,,,,,146.37,,,,fee schedule,,,1347.25,85,,percent of total billed charges,,534.64,,,,fee schedule,,332.04,,,,fee schedule,,146.37,,,,fee schedule,,508.68,,,,fee schedule,,146.37,,,,fee schedule,,526.15,,,,fee schedule,,318.88,,,,fee schedule,,318.88,,,,fee schedule,,,1442.35,91,,percent of total billed charges,,,1505.75,95,,percent of total billed charges,,,1315.55,83,,percent of total billed charges,,,475.5,83,,percent of total billed charges,,146.37,,,,fee schedule,,146.37,,,,fee schedule,,,1315.55,83,,percent of total billed charges,,468.75,,,,fee schedule,,,1426.5,90,,percent of total billed charges,,,1426.5,90,,percent of total billed charges,,,1426.5,90,,percent of total billed charges,,,1426.5,90,,percent of total billed charges,,,1347.25,85,,percent of total billed charges,,146.37,1505.75,
EXC FACE-MM B9+MARG > 4 CM,11446P,CDM,11446,CPT,,,both,P,1388,1388,542.09,,,,fee schedule,,,,,,,,146.37,,,,fee schedule,,,1179.8,85,,percent of total billed charges,,534.64,,,,fee schedule,,332.04,,,,fee schedule,,146.37,,,,fee schedule,,508.68,,,,fee schedule,,146.37,,,,fee schedule,,526.15,,,,fee schedule,,318.88,,,,fee schedule,,318.88,,,,fee schedule,,,1263.08,91,,percent of total billed charges,,,1318.6,95,,percent of total billed charges,,,1152.04,83,,percent of total billed charges,,,416.4,83,,percent of total billed charges,,146.37,,,,fee schedule,,146.37,,,,fee schedule,,,1152.04,83,,percent of total billed charges,,468.75,,,,fee schedule,,,1249.2,90,,percent of total billed charges,,,1249.2,90,,percent of total billed charges,,,1249.2,90,,percent of total billed charges,,,1249.2,90,,percent of total billed charges,,,1179.8,85,,percent of total billed charges,,146.37,1318.6,
EXC FACE-MM B9+MARG > 4 CM,11446T,CDM,11446,CPT,,,both,T,197,197,542.09,,,,fee schedule,,,,,,,,146.37,,,,fee schedule,,,167.45,85,,percent of total billed charges,,534.64,,,,fee schedule,,332.04,,,,fee schedule,,146.37,,,,fee schedule,,508.68,,,,fee schedule,,146.37,,,,fee schedule,,526.15,,,,fee schedule,,318.88,,,,fee schedule,,318.88,,,,fee schedule,,,179.27,91,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,59.1,83,,percent of total billed charges,,146.37,,,,fee schedule,,146.37,,,,fee schedule,,,163.51,83,,percent of total billed charges,,468.75,,,,fee schedule,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,167.45,85,,percent of total billed charges,,59.1,542.09,
"REMOVAL, SWEAT GLAND LESION, SIMPLE OR INTERMEDIATE",11450,CDM,11450,CPT,,,both,,1491,1491,452.22,,,,fee schedule,,,,,,,,215.4,,,,fee schedule,,,1267.35,85,,percent of total billed charges,,442.29,,,,fee schedule,,274.68,,,,fee schedule,,215.4,,,,fee schedule,,337.57,,,,fee schedule,,215.4,,,,fee schedule,,438.92,,,,fee schedule,,266.01,,,,fee schedule,,266.01,,,,fee schedule,,,1356.81,91,,percent of total billed charges,,,1416.45,95,,percent of total billed charges,,,1237.53,83,,percent of total billed charges,,,447.3,83,,percent of total billed charges,,215.4,,,,fee schedule,,215.4,,,,fee schedule,,,1237.53,83,,percent of total billed charges,,391.04,,,,fee schedule,,,1341.9,90,,percent of total billed charges,,,1341.9,90,,percent of total billed charges,,,1341.9,90,,percent of total billed charges,,,1341.9,90,,percent of total billed charges,,,1267.35,85,,percent of total billed charges,,215.4,1416.45,
"REMOVAL, SWEAT GLAND LESION",11462,CDM,11462,CPT,,,both,,1353,1353,428.61,,,,fee schedule,,,,,,,,215.4,,,,fee schedule,,,1150.05,85,,percent of total billed charges,,418.99,,,,fee schedule,,260.21,,,,fee schedule,,215.4,,,,fee schedule,,319.67,,,,fee schedule,,215.4,,,,fee schedule,,416,,,,fee schedule,,252.12,,,,fee schedule,,252.12,,,,fee schedule,,,1231.23,91,,percent of total billed charges,,,1285.35,95,,percent of total billed charges,,,1122.99,83,,percent of total billed charges,,,405.9,83,,percent of total billed charges,,215.4,,,,fee schedule,,215.4,,,,fee schedule,,,1122.99,83,,percent of total billed charges,,370.62,,,,fee schedule,,,1217.7,90,,percent of total billed charges,,,1217.7,90,,percent of total billed charges,,,1217.7,90,,percent of total billed charges,,,1217.7,90,,percent of total billed charges,,,1150.05,85,,percent of total billed charges,,215.4,1285.35,
"REMOVAL, SWEAT GLAND LESION",11470,CDM,11470,CPT,,,both,,1861,1861,496.58,,,,fee schedule,,,,,,,,291.3,,,,fee schedule,,,1581.85,85,,percent of total billed charges,,481.67,,,,fee schedule,,299.14,,,,fee schedule,,291.3,,,,fee schedule,,391.29,,,,fee schedule,,291.3,,,,fee schedule,,481.98,,,,fee schedule,,292.11,,,,fee schedule,,292.11,,,,fee schedule,,,1693.51,91,,percent of total billed charges,,,1767.95,95,,percent of total billed charges,,,1544.63,83,,percent of total billed charges,,,558.3,83,,percent of total billed charges,,291.3,,,,fee schedule,,291.3,,,,fee schedule,,,1544.63,83,,percent of total billed charges,,429.4,,,,fee schedule,,,1674.9,90,,percent of total billed charges,,,1674.9,90,,percent of total billed charges,,,1674.9,90,,percent of total billed charges,,,1674.9,90,,percent of total billed charges,,,1581.85,85,,percent of total billed charges,,291.3,1767.95,
EXC TR-EXT MLG+MARG 0.5 < CM,11600,CDM,11600,CPT,,,both,,766,766,209.69,,,,fee schedule,,,,,,,,54.15,,,,fee schedule,,,651.1,85,,percent of total billed charges,,202.15,,,,fee schedule,,125.55,,,,fee schedule,,54.15,,,,fee schedule,,157.84,,,,fee schedule,,54.15,,,,fee schedule,,203.53,,,,fee schedule,,123.35,,,,fee schedule,,123.35,,,,fee schedule,,,697.06,91,,percent of total billed charges,,,727.7,95,,percent of total billed charges,,,635.78,83,,percent of total billed charges,,,229.8,83,,percent of total billed charges,,54.15,,,,fee schedule,,54.15,,,,fee schedule,,,635.78,83,,percent of total billed charges,,181.32,,,,fee schedule,,,689.4,90,,percent of total billed charges,,,689.4,90,,percent of total billed charges,,,689.4,90,,percent of total billed charges,,,689.4,90,,percent of total billed charges,,,651.1,85,,percent of total billed charges,,54.15,727.7,
EXC TR-EXT MLG+MARG 0.5 < CM,11600P,CDM,11600,CPT,,,both,P,593,593,209.69,,,,fee schedule,,,,,,,,54.15,,,,fee schedule,,,504.05,85,,percent of total billed charges,,202.15,,,,fee schedule,,125.55,,,,fee schedule,,54.15,,,,fee schedule,,157.84,,,,fee schedule,,54.15,,,,fee schedule,,203.53,,,,fee schedule,,123.35,,,,fee schedule,,123.35,,,,fee schedule,,,539.63,91,,percent of total billed charges,,,563.35,95,,percent of total billed charges,,,492.19,83,,percent of total billed charges,,,177.9,83,,percent of total billed charges,,54.15,,,,fee schedule,,54.15,,,,fee schedule,,,492.19,83,,percent of total billed charges,,181.32,,,,fee schedule,,,533.7,90,,percent of total billed charges,,,533.7,90,,percent of total billed charges,,,533.7,90,,percent of total billed charges,,,533.7,90,,percent of total billed charges,,,504.05,85,,percent of total billed charges,,54.15,563.35,
EXC TR-EXT MLG+MARG 0.5 < CM,11600T,CDM,11600,CPT,,,both,T,173,173,209.69,,,,fee schedule,,,,,,,,54.15,,,,fee schedule,,,147.05,85,,percent of total billed charges,,202.15,,,,fee schedule,,125.55,,,,fee schedule,,54.15,,,,fee schedule,,157.84,,,,fee schedule,,54.15,,,,fee schedule,,203.53,,,,fee schedule,,123.35,,,,fee schedule,,123.35,,,,fee schedule,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,51.9,83,,percent of total billed charges,,54.15,,,,fee schedule,,54.15,,,,fee schedule,,,143.59,83,,percent of total billed charges,,181.32,,,,fee schedule,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,51.9,209.69,
EXC TR-EXT MLG+MARG 0.6-1 CM,11601,CDM,11601,CPT,,,both,,836,836,254.05,,,,fee schedule,,,,,,,,75.3,,,,fee schedule,,,710.6,85,,percent of total billed charges,,245.48,,,,fee schedule,,152.45,,,,fee schedule,,75.3,,,,fee schedule,,208.25,,,,fee schedule,,75.3,,,,fee schedule,,246.58,,,,fee schedule,,149.44,,,,fee schedule,,149.44,,,,fee schedule,,,760.76,91,,percent of total billed charges,,,794.2,95,,percent of total billed charges,,,693.88,83,,percent of total billed charges,,,250.8,83,,percent of total billed charges,,75.3,,,,fee schedule,,75.3,,,,fee schedule,,,693.88,83,,percent of total billed charges,,219.68,,,,fee schedule,,,752.4,90,,percent of total billed charges,,,752.4,90,,percent of total billed charges,,,752.4,90,,percent of total billed charges,,,752.4,90,,percent of total billed charges,,,710.6,85,,percent of total billed charges,,75.3,794.2,
EXC TR-EXT MLG+MARG 1.1-2 CM,11602,CDM,11602,CPT,,,both,,945,945,275.94,,,,fee schedule,,,,,,,,96.4,,,,fee schedule,,,803.25,85,,percent of total billed charges,,266.19,,,,fee schedule,,165.32,,,,fee schedule,,96.4,,,,fee schedule,,221.51,,,,fee schedule,,96.4,,,,fee schedule,,267.83,,,,fee schedule,,162.32,,,,fee schedule,,162.32,,,,fee schedule,,,859.95,91,,percent of total billed charges,,,897.75,95,,percent of total billed charges,,,784.35,83,,percent of total billed charges,,,283.5,83,,percent of total billed charges,,96.4,,,,fee schedule,,96.4,,,,fee schedule,,,784.35,83,,percent of total billed charges,,238.61,,,,fee schedule,,,850.5,90,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,850.5,90,,percent of total billed charges,,,803.25,85,,percent of total billed charges,,96.4,897.75,
EXC TR-EXT MLG+MARG 1.1-2 CM,11602P,CDM,11602,CPT,,,both,P,767,767,275.94,,,,fee schedule,,,,,,,,96.4,,,,fee schedule,,,651.95,85,,percent of total billed charges,,266.19,,,,fee schedule,,165.32,,,,fee schedule,,96.4,,,,fee schedule,,221.51,,,,fee schedule,,96.4,,,,fee schedule,,267.83,,,,fee schedule,,162.32,,,,fee schedule,,162.32,,,,fee schedule,,,697.97,91,,percent of total billed charges,,,728.65,95,,percent of total billed charges,,,636.61,83,,percent of total billed charges,,,230.1,83,,percent of total billed charges,,96.4,,,,fee schedule,,96.4,,,,fee schedule,,,636.61,83,,percent of total billed charges,,238.61,,,,fee schedule,,,690.3,90,,percent of total billed charges,,,690.3,90,,percent of total billed charges,,,690.3,90,,percent of total billed charges,,,690.3,90,,percent of total billed charges,,,651.95,85,,percent of total billed charges,,96.4,728.65,
EXC TR-EXT MLG+MARG 1.1-2 CM,11602T,CDM,11602,CPT,,,both,T,178,178,275.94,,,,fee schedule,,,,,,,,96.4,,,,fee schedule,,,151.3,85,,percent of total billed charges,,266.19,,,,fee schedule,,165.32,,,,fee schedule,,96.4,,,,fee schedule,,221.51,,,,fee schedule,,96.4,,,,fee schedule,,267.83,,,,fee schedule,,162.32,,,,fee schedule,,162.32,,,,fee schedule,,,161.98,91,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,53.4,83,,percent of total billed charges,,96.4,,,,fee schedule,,96.4,,,,fee schedule,,,147.74,83,,percent of total billed charges,,238.61,,,,fee schedule,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,53.4,275.94,
EXC TR-EXT MLG+MARG 2.1-3 CM,11603,CDM,11603,CPT,,,both,,1103,1103,330.67,,,,fee schedule,,,,,,,,117.55,,,,fee schedule,,,937.55,85,,percent of total billed charges,,319.23,,,,fee schedule,,198.25,,,,fee schedule,,117.55,,,,fee schedule,,244.06,,,,fee schedule,,117.55,,,,fee schedule,,320.95,,,,fee schedule,,194.51,,,,fee schedule,,194.51,,,,fee schedule,,,1003.73,91,,percent of total billed charges,,,1047.85,95,,percent of total billed charges,,,915.49,83,,percent of total billed charges,,,330.9,83,,percent of total billed charges,,117.55,,,,fee schedule,,117.55,,,,fee schedule,,,915.49,83,,percent of total billed charges,,285.93,,,,fee schedule,,,992.7,90,,percent of total billed charges,,,992.7,90,,percent of total billed charges,,,992.7,90,,percent of total billed charges,,,992.7,90,,percent of total billed charges,,,937.55,85,,percent of total billed charges,,117.55,1047.85,
EXC TR-EXT MLG+MARG 3.1-4 CM,11604,CDM,11604,CPT,,,both,,1294,1294,364.08,,,,fee schedule,,,,,,,,138.75,,,,fee schedule,,,1099.9,85,,percent of total billed charges,,352.99,,,,fee schedule,,219.22,,,,fee schedule,,138.75,,,,fee schedule,,264.62,,,,fee schedule,,138.75,,,,fee schedule,,353.38,,,,fee schedule,,214.17,,,,fee schedule,,214.17,,,,fee schedule,,,1177.54,91,,percent of total billed charges,,,1229.3,95,,percent of total billed charges,,,1074.02,83,,percent of total billed charges,,,388.2,83,,percent of total billed charges,,138.75,,,,fee schedule,,138.75,,,,fee schedule,,,1074.02,83,,percent of total billed charges,,314.83,,,,fee schedule,,,1164.6,90,,percent of total billed charges,,,1164.6,90,,percent of total billed charges,,,1164.6,90,,percent of total billed charges,,,1164.6,90,,percent of total billed charges,,,1099.9,85,,percent of total billed charges,,138.75,1229.3,
EXC TR-EXT MLG+MARG 3.1-4 CM,11604P,CDM,11604,CPT,,,both,P,1106,1106,364.08,,,,fee schedule,,,,,,,,138.75,,,,fee schedule,,,940.1,85,,percent of total billed charges,,352.99,,,,fee schedule,,219.22,,,,fee schedule,,138.75,,,,fee schedule,,264.62,,,,fee schedule,,138.75,,,,fee schedule,,353.38,,,,fee schedule,,214.17,,,,fee schedule,,214.17,,,,fee schedule,,,1006.46,91,,percent of total billed charges,,,1050.7,95,,percent of total billed charges,,,917.98,83,,percent of total billed charges,,,331.8,83,,percent of total billed charges,,138.75,,,,fee schedule,,138.75,,,,fee schedule,,,917.98,83,,percent of total billed charges,,314.83,,,,fee schedule,,,995.4,90,,percent of total billed charges,,,995.4,90,,percent of total billed charges,,,995.4,90,,percent of total billed charges,,,995.4,90,,percent of total billed charges,,,940.1,85,,percent of total billed charges,,138.75,1050.7,
EXC TR-EXT MLG+MARG 3.1-4 CM,11604T,CDM,11604,CPT,,,both,T,188,188,364.08,,,,fee schedule,,,,,,,,138.75,,,,fee schedule,,,159.8,85,,percent of total billed charges,,352.99,,,,fee schedule,,219.22,,,,fee schedule,,138.75,,,,fee schedule,,264.62,,,,fee schedule,,138.75,,,,fee schedule,,353.38,,,,fee schedule,,214.17,,,,fee schedule,,214.17,,,,fee schedule,,,171.08,91,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,56.4,83,,percent of total billed charges,,138.75,,,,fee schedule,,138.75,,,,fee schedule,,,156.04,83,,percent of total billed charges,,314.83,,,,fee schedule,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,56.4,364.08,
EXC TR-EXT MLG+MARG > 4 CM,11606,CDM,11606,CPT,,,both,,1991,1991,540.94,,,,fee schedule,,,,,,,,185.52,,,,fee schedule,,,1692.35,85,,percent of total billed charges,,534.88,,,,fee schedule,,332.19,,,,fee schedule,,185.52,,,,fee schedule,,365.43,,,,fee schedule,,185.52,,,,fee schedule,,525.03,,,,fee schedule,,318.2,,,,fee schedule,,318.2,,,,fee schedule,,,1811.81,91,,percent of total billed charges,,,1891.45,95,,percent of total billed charges,,,1652.53,83,,percent of total billed charges,,,597.3,83,,percent of total billed charges,,185.52,,,,fee schedule,,185.52,,,,fee schedule,,,1652.53,83,,percent of total billed charges,,467.76,,,,fee schedule,,,1791.9,90,,percent of total billed charges,,,1791.9,90,,percent of total billed charges,,,1791.9,90,,percent of total billed charges,,,1791.9,90,,percent of total billed charges,,,1692.35,85,,percent of total billed charges,,185.52,1891.45,
EXC TR-EXT MAL+MARG >4 CM,11606P,CDM,11606,CPT,,,both,P,1533,1533,540.94,,,,fee schedule,,,,,,,,185.52,,,,fee schedule,,,1303.05,85,,percent of total billed charges,,534.88,,,,fee schedule,,332.19,,,,fee schedule,,185.52,,,,fee schedule,,365.43,,,,fee schedule,,185.52,,,,fee schedule,,525.03,,,,fee schedule,,318.2,,,,fee schedule,,318.2,,,,fee schedule,,,1395.03,91,,percent of total billed charges,,,1456.35,95,,percent of total billed charges,,,1272.39,83,,percent of total billed charges,,,459.9,83,,percent of total billed charges,,185.52,,,,fee schedule,,185.52,,,,fee schedule,,,1272.39,83,,percent of total billed charges,,467.76,,,,fee schedule,,,1379.7,90,,percent of total billed charges,,,1379.7,90,,percent of total billed charges,,,1379.7,90,,percent of total billed charges,,,1379.7,90,,percent of total billed charges,,,1303.05,85,,percent of total billed charges,,185.52,1456.35,
EXC TR-EXT MAL+MARG >4 CM,11606T,CDM,11606,CPT,,,both,T,458,458,540.94,,,,fee schedule,,,,,,,,185.52,,,,fee schedule,,,389.3,85,,percent of total billed charges,,534.88,,,,fee schedule,,332.19,,,,fee schedule,,185.52,,,,fee schedule,,365.43,,,,fee schedule,,185.52,,,,fee schedule,,525.03,,,,fee schedule,,318.2,,,,fee schedule,,318.2,,,,fee schedule,,,416.78,91,,percent of total billed charges,,,435.1,95,,percent of total billed charges,,,380.14,83,,percent of total billed charges,,,137.4,83,,percent of total billed charges,,185.52,,,,fee schedule,,185.52,,,,fee schedule,,,380.14,83,,percent of total billed charges,,467.76,,,,fee schedule,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,389.3,85,,percent of total billed charges,,137.4,540.94,
EXC H-F-NK-SP MLG+MARG 0.5 <,11620,CDM,11620,CPT,,,both,,773,773,210.85,,,,fee schedule,,,,,,,,54.15,,,,fee schedule,,,657.05,85,,percent of total billed charges,,203.27,,,,fee schedule,,126.24,,,,fee schedule,,54.15,,,,fee schedule,,148.56,,,,fee schedule,,54.15,,,,fee schedule,,204.64,,,,fee schedule,,124.03,,,,fee schedule,,124.03,,,,fee schedule,,,703.43,91,,percent of total billed charges,,,734.35,95,,percent of total billed charges,,,641.59,83,,percent of total billed charges,,,231.9,83,,percent of total billed charges,,54.15,,,,fee schedule,,54.15,,,,fee schedule,,,641.59,83,,percent of total billed charges,,182.32,,,,fee schedule,,,695.7,90,,percent of total billed charges,,,695.7,90,,percent of total billed charges,,,695.7,90,,percent of total billed charges,,,695.7,90,,percent of total billed charges,,,657.05,85,,percent of total billed charges,,54.15,734.35,
EXC H-F-NK-SP MLG+MARG 0.5 <,11620P,CDM,11620,CPT,,,both,P,600,600,210.85,,,,fee schedule,,,,,,,,54.15,,,,fee schedule,,,510,85,,percent of total billed charges,,203.27,,,,fee schedule,,126.24,,,,fee schedule,,54.15,,,,fee schedule,,148.56,,,,fee schedule,,54.15,,,,fee schedule,,204.64,,,,fee schedule,,124.03,,,,fee schedule,,124.03,,,,fee schedule,,,546,91,,percent of total billed charges,,,570,95,,percent of total billed charges,,,498,83,,percent of total billed charges,,,180,83,,percent of total billed charges,,54.15,,,,fee schedule,,54.15,,,,fee schedule,,,498,83,,percent of total billed charges,,182.32,,,,fee schedule,,,540,90,,percent of total billed charges,,,540,90,,percent of total billed charges,,,540,90,,percent of total billed charges,,,540,90,,percent of total billed charges,,,510,85,,percent of total billed charges,,54.15,570,
EXC H-F-NK-SP MLG+MARG 0.5 <,11620T,CDM,11620,CPT,,,both,T,173,173,210.85,,,,fee schedule,,,,,,,,54.15,,,,fee schedule,,,147.05,85,,percent of total billed charges,,203.27,,,,fee schedule,,126.24,,,,fee schedule,,54.15,,,,fee schedule,,148.56,,,,fee schedule,,54.15,,,,fee schedule,,204.64,,,,fee schedule,,124.03,,,,fee schedule,,124.03,,,,fee schedule,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,51.9,83,,percent of total billed charges,,54.15,,,,fee schedule,,54.15,,,,fee schedule,,,143.59,83,,percent of total billed charges,,182.32,,,,fee schedule,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,51.9,210.85,
EXC H-F-NK-SP MLG+MARG 0.6-1,11621,CDM,11621,CPT,,,both,,900,900,255.78,,,,fee schedule,,,,,,,,75.3,,,,fee schedule,,,765,85,,percent of total billed charges,,246.6,,,,fee schedule,,153.15,,,,fee schedule,,75.3,,,,fee schedule,,206.92,,,,fee schedule,,75.3,,,,fee schedule,,248.26,,,,fee schedule,,150.46,,,,fee schedule,,150.46,,,,fee schedule,,,819,91,,percent of total billed charges,,,855,95,,percent of total billed charges,,,747,83,,percent of total billed charges,,,270,83,,percent of total billed charges,,75.3,,,,fee schedule,,75.3,,,,fee schedule,,,747,83,,percent of total billed charges,,221.17,,,,fee schedule,,,810,90,,percent of total billed charges,,,810,90,,percent of total billed charges,,,810,90,,percent of total billed charges,,,810,90,,percent of total billed charges,,,765,85,,percent of total billed charges,,75.3,855,
EXC H-F-NK-SP MLG+MARG 1.1-2,11622,CDM,11622,CPT,,,both,,1020,1020,289.19,,,,fee schedule,,,,,,,,96.4,,,,fee schedule,,,867,85,,percent of total billed charges,,278.93,,,,fee schedule,,173.23,,,,fee schedule,,96.4,,,,fee schedule,,240.08,,,,fee schedule,,96.4,,,,fee schedule,,280.69,,,,fee schedule,,170.11,,,,fee schedule,,170.11,,,,fee schedule,,,928.2,91,,percent of total billed charges,,,969,95,,percent of total billed charges,,,846.6,83,,percent of total billed charges,,,306,83,,percent of total billed charges,,96.4,,,,fee schedule,,96.4,,,,fee schedule,,,846.6,83,,percent of total billed charges,,250.07,,,,fee schedule,,,918,90,,percent of total billed charges,,,918,90,,percent of total billed charges,,,918,90,,percent of total billed charges,,,918,90,,percent of total billed charges,,,867,85,,percent of total billed charges,,96.4,969,
EXC H-F-NK-SP MLG+MARG 1.1-2,11622P,CDM,11622,CPT,,,both,P,840,840,289.19,,,,fee schedule,,,,,,,,96.4,,,,fee schedule,,,714,85,,percent of total billed charges,,278.93,,,,fee schedule,,173.23,,,,fee schedule,,96.4,,,,fee schedule,,240.08,,,,fee schedule,,96.4,,,,fee schedule,,280.69,,,,fee schedule,,170.11,,,,fee schedule,,170.11,,,,fee schedule,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,252,83,,percent of total billed charges,,96.4,,,,fee schedule,,96.4,,,,fee schedule,,,697.2,83,,percent of total billed charges,,250.07,,,,fee schedule,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,96.4,798,
EXC H-F-NK-SP MLG+MARG 1.1-2,11622T,CDM,11622,CPT,,,both,T,180,180,289.19,,,,fee schedule,,,,,,,,96.4,,,,fee schedule,,,153,85,,percent of total billed charges,,278.93,,,,fee schedule,,173.23,,,,fee schedule,,96.4,,,,fee schedule,,240.08,,,,fee schedule,,96.4,,,,fee schedule,,280.69,,,,fee schedule,,170.11,,,,fee schedule,,170.11,,,,fee schedule,,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,54,83,,percent of total billed charges,,96.4,,,,fee schedule,,96.4,,,,fee schedule,,,149.4,83,,percent of total billed charges,,250.07,,,,fee schedule,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,54,289.19,
EXC H-F-NK-SP MLG+MARG 2.1-3,11623,CDM,11623,CPT,,,both,,1270,1270,358.32,,,,fee schedule,,,,,,,,117.55,,,,fee schedule,,,1079.5,85,,percent of total billed charges,,347.2,,,,fee schedule,,215.63,,,,fee schedule,,117.55,,,,fee schedule,,291.15,,,,fee schedule,,117.55,,,,fee schedule,,347.78,,,,fee schedule,,210.78,,,,fee schedule,,210.78,,,,fee schedule,,,1155.7,91,,percent of total billed charges,,,1206.5,95,,percent of total billed charges,,,1054.1,83,,percent of total billed charges,,,381,83,,percent of total billed charges,,117.55,,,,fee schedule,,117.55,,,,fee schedule,,,1054.1,83,,percent of total billed charges,,309.84,,,,fee schedule,,,1143,90,,percent of total billed charges,,,1143,90,,percent of total billed charges,,,1143,90,,percent of total billed charges,,,1143,90,,percent of total billed charges,,,1079.5,85,,percent of total billed charges,,117.55,1206.5,
EXC H-F-NK-SP MLG+MARG 3.1-4,11624,CDM,11624,CPT,,,both,,1665,1665,406.71,,,,fee schedule,,,,,,,,138.75,,,,fee schedule,,,1415.25,85,,percent of total billed charges,,396.78,,,,fee schedule,,246.41,,,,fee schedule,,138.75,,,,fee schedule,,338.24,,,,fee schedule,,138.75,,,,fee schedule,,394.75,,,,fee schedule,,239.24,,,,fee schedule,,239.24,,,,fee schedule,,,1515.15,91,,percent of total billed charges,,,1581.75,95,,percent of total billed charges,,,1381.95,83,,percent of total billed charges,,,499.5,83,,percent of total billed charges,,138.75,,,,fee schedule,,138.75,,,,fee schedule,,,1381.95,83,,percent of total billed charges,,351.69,,,,fee schedule,,,1498.5,90,,percent of total billed charges,,,1498.5,90,,percent of total billed charges,,,1498.5,90,,percent of total billed charges,,,1498.5,90,,percent of total billed charges,,,1415.25,85,,percent of total billed charges,,138.75,1581.75,
EXC H-F-NK-SP MLG+MAR > 4 CM,11626,CDM,11626,CPT,,,both,,2168,2168,498.89,,,,fee schedule,,,,,,,,185.52,,,,fee schedule,,,1842.8,85,,percent of total billed charges,,492.68,,,,fee schedule,,305.97,,,,fee schedule,,185.52,,,,fee schedule,,472.2,,,,fee schedule,,185.52,,,,fee schedule,,484.21,,,,fee schedule,,293.46,,,,fee schedule,,293.46,,,,fee schedule,,,1972.88,91,,percent of total billed charges,,,2059.6,95,,percent of total billed charges,,,1799.44,83,,percent of total billed charges,,,650.4,83,,percent of total billed charges,,185.52,,,,fee schedule,,185.52,,,,fee schedule,,,1799.44,83,,percent of total billed charges,,431.39,,,,fee schedule,,,1951.2,90,,percent of total billed charges,,,1951.2,90,,percent of total billed charges,,,1951.2,90,,percent of total billed charges,,,1951.2,90,,percent of total billed charges,,,1842.8,85,,percent of total billed charges,,185.52,2059.6,
EXC FACE-MM MALIG+MARG 0.5 <,11640,CDM,11640,CPT,,,both,,843,843,216.61,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,716.55,85,,percent of total billed charges,,208.74,,,,fee schedule,,129.64,,,,fee schedule,,107,,,,fee schedule,,169.78,,,,fee schedule,,107,,,,fee schedule,,210.24,,,,fee schedule,,127.42,,,,fee schedule,,127.42,,,,fee schedule,,,767.13,91,,percent of total billed charges,,,800.85,95,,percent of total billed charges,,,699.69,83,,percent of total billed charges,,,252.9,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,699.69,83,,percent of total billed charges,,187.3,,,,fee schedule,,,758.7,90,,percent of total billed charges,,,758.7,90,,percent of total billed charges,,,758.7,90,,percent of total billed charges,,,758.7,90,,percent of total billed charges,,,716.55,85,,percent of total billed charges,,107,800.85,
EXC FACE-MM MALIG+MARG 0.6-1,11641,CDM,11641,CPT,,,both,,1036,1036,266.15,,,,fee schedule,,,,,,,,149.25,,,,fee schedule,,,880.6,85,,percent of total billed charges,,256.1,,,,fee schedule,,159.05,,,,fee schedule,,149.25,,,,fee schedule,,255.33,,,,fee schedule,,149.25,,,,fee schedule,,258.32,,,,fee schedule,,156.56,,,,fee schedule,,156.56,,,,fee schedule,,,942.76,91,,percent of total billed charges,,,984.2,95,,percent of total billed charges,,,859.88,83,,percent of total billed charges,,,310.8,83,,percent of total billed charges,,149.25,,,,fee schedule,,149.25,,,,fee schedule,,,859.88,83,,percent of total billed charges,,230.14,,,,fee schedule,,,932.4,90,,percent of total billed charges,,,932.4,90,,percent of total billed charges,,,932.4,90,,percent of total billed charges,,,932.4,90,,percent of total billed charges,,,880.6,85,,percent of total billed charges,,149.25,984.2,
EXC FACE-MM MALIG+MARG 0.6-1,11641P,CDM,11641,CPT,,,both,P,855,855,266.15,,,,fee schedule,,,,,,,,149.25,,,,fee schedule,,,726.75,85,,percent of total billed charges,,256.1,,,,fee schedule,,159.05,,,,fee schedule,,149.25,,,,fee schedule,,255.33,,,,fee schedule,,149.25,,,,fee schedule,,258.32,,,,fee schedule,,156.56,,,,fee schedule,,156.56,,,,fee schedule,,,778.05,91,,percent of total billed charges,,,812.25,95,,percent of total billed charges,,,709.65,83,,percent of total billed charges,,,256.5,83,,percent of total billed charges,,149.25,,,,fee schedule,,149.25,,,,fee schedule,,,709.65,83,,percent of total billed charges,,230.14,,,,fee schedule,,,769.5,90,,percent of total billed charges,,,769.5,90,,percent of total billed charges,,,769.5,90,,percent of total billed charges,,,769.5,90,,percent of total billed charges,,,726.75,85,,percent of total billed charges,,149.25,812.25,
EXC FACE-MM MALIG+MARG 0.6-1,11641T,CDM,11641,CPT,,,both,T,181,181,266.15,,,,fee schedule,,,,,,,,149.25,,,,fee schedule,,,153.85,85,,percent of total billed charges,,256.1,,,,fee schedule,,159.05,,,,fee schedule,,149.25,,,,fee schedule,,255.33,,,,fee schedule,,149.25,,,,fee schedule,,258.32,,,,fee schedule,,156.56,,,,fee schedule,,156.56,,,,fee schedule,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,54.3,83,,percent of total billed charges,,149.25,,,,fee schedule,,149.25,,,,fee schedule,,,150.23,83,,percent of total billed charges,,230.14,,,,fee schedule,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,54.3,266.15,
EXC FACE-MM MALIG+MARG 1.1-2,11642,CDM,11642,CPT,,,both,,1213,1213,310.51,,,,fee schedule,,,,,,,,192.95,,,,fee schedule,,,1031.05,85,,percent of total billed charges,,301.02,,,,fee schedule,,186.94,,,,fee schedule,,192.95,,,,fee schedule,,297.78,,,,fee schedule,,192.95,,,,fee schedule,,301.38,,,,fee schedule,,182.65,,,,fee schedule,,182.65,,,,fee schedule,,,1103.83,91,,percent of total billed charges,,,1152.35,95,,percent of total billed charges,,,1006.79,83,,percent of total billed charges,,,363.9,83,,percent of total billed charges,,192.95,,,,fee schedule,,192.95,,,,fee schedule,,,1006.79,83,,percent of total billed charges,,268.5,,,,fee schedule,,,1091.7,90,,percent of total billed charges,,,1091.7,90,,percent of total billed charges,,,1091.7,90,,percent of total billed charges,,,1091.7,90,,percent of total billed charges,,,1031.05,85,,percent of total billed charges,,182.65,1152.35,
EXC FACE-MM MALIG+MARG 1.1-2,11642P,CDM,11642,CPT,,,both,P,963,963,310.51,,,,fee schedule,,,,,,,,192.95,,,,fee schedule,,,818.55,85,,percent of total billed charges,,301.02,,,,fee schedule,,186.94,,,,fee schedule,,192.95,,,,fee schedule,,297.78,,,,fee schedule,,192.95,,,,fee schedule,,301.38,,,,fee schedule,,182.65,,,,fee schedule,,182.65,,,,fee schedule,,,876.33,91,,percent of total billed charges,,,914.85,95,,percent of total billed charges,,,799.29,83,,percent of total billed charges,,,288.9,83,,percent of total billed charges,,192.95,,,,fee schedule,,192.95,,,,fee schedule,,,799.29,83,,percent of total billed charges,,268.5,,,,fee schedule,,,866.7,90,,percent of total billed charges,,,866.7,90,,percent of total billed charges,,,866.7,90,,percent of total billed charges,,,866.7,90,,percent of total billed charges,,,818.55,85,,percent of total billed charges,,182.65,914.85,
EXC FACE-MM MALIG+MARG 1.1-2,11642T,CDM,11642,CPT,,,both,T,250,250,310.51,,,,fee schedule,,,,,,,,192.95,,,,fee schedule,,,212.5,85,,percent of total billed charges,,301.02,,,,fee schedule,,186.94,,,,fee schedule,,192.95,,,,fee schedule,,297.78,,,,fee schedule,,192.95,,,,fee schedule,,301.38,,,,fee schedule,,182.65,,,,fee schedule,,182.65,,,,fee schedule,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,75,83,,percent of total billed charges,,192.95,,,,fee schedule,,192.95,,,,fee schedule,,,207.5,83,,percent of total billed charges,,268.5,,,,fee schedule,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,75,310.51,
EXC FACE-MM MALIG+MARG 2.1-3,11643,CDM,11643,CPT,,,both,,1552,1552,388.28,,,,fee schedule,,,,,,,,235.2,,,,fee schedule,,,1319.2,85,,percent of total billed charges,,377.62,,,,fee schedule,,234.52,,,,fee schedule,,235.2,,,,fee schedule,,352.16,,,,fee schedule,,235.2,,,,fee schedule,,376.86,,,,fee schedule,,228.4,,,,fee schedule,,228.4,,,,fee schedule,,,1412.32,91,,percent of total billed charges,,,1474.4,95,,percent of total billed charges,,,1288.16,83,,percent of total billed charges,,,465.6,83,,percent of total billed charges,,235.2,,,,fee schedule,,235.2,,,,fee schedule,,,1288.16,83,,percent of total billed charges,,335.75,,,,fee schedule,,,1396.8,90,,percent of total billed charges,,,1396.8,90,,percent of total billed charges,,,1396.8,90,,percent of total billed charges,,,1396.8,90,,percent of total billed charges,,,1319.2,85,,percent of total billed charges,,228.4,1474.4,
EXC FACE-MM MALIG+MARG 3.1-4,11644,CDM,11644,CPT,,,both,,1940,1940,481.6,,,,fee schedule,,,,,,,,278.8,,,,fee schedule,,,1649,85,,percent of total billed charges,,471.21,,,,fee schedule,,292.64,,,,fee schedule,,278.8,,,,fee schedule,,453.63,,,,fee schedule,,278.8,,,,fee schedule,,467.44,,,,fee schedule,,283.3,,,,fee schedule,,283.3,,,,fee schedule,,,1765.4,91,,percent of total billed charges,,,1843,95,,percent of total billed charges,,,1610.2,83,,percent of total billed charges,,,582,83,,percent of total billed charges,,278.8,,,,fee schedule,,278.8,,,,fee schedule,,,1610.2,83,,percent of total billed charges,,416.45,,,,fee schedule,,,1746,90,,percent of total billed charges,,,1746,90,,percent of total billed charges,,,1746,90,,percent of total billed charges,,,1746,90,,percent of total billed charges,,,1649,85,,percent of total billed charges,,278.8,1843,
EXC FACE-MM MLG+MARG > 4 CM,11646,CDM,11646,CPT,,,both,,2772,2772,666.53,,,,fee schedule,,,,,,,,294.77,,,,fee schedule,,,2356.2,85,,percent of total billed charges,,656.84,,,,fee schedule,,407.93,,,,fee schedule,,294.77,,,,fee schedule,,663.87,,,,fee schedule,,294.77,,,,fee schedule,,646.92,,,,fee schedule,,392.07,,,,fee schedule,,392.07,,,,fee schedule,,,2522.52,91,,percent of total billed charges,,,2633.4,95,,percent of total billed charges,,,2300.76,83,,percent of total billed charges,,,831.6,83,,percent of total billed charges,,294.77,,,,fee schedule,,294.77,,,,fee schedule,,,2300.76,83,,percent of total billed charges,,576.35,,,,fee schedule,,,2494.8,90,,percent of total billed charges,,,2494.8,90,,percent of total billed charges,,,2494.8,90,,percent of total billed charges,,,2494.8,90,,percent of total billed charges,,,2356.2,85,,percent of total billed charges,,294.77,2633.4,
TRIM NAIL(S),11719,CDM,11719,CPT,,,both,,73,73,12.67,,,,fee schedule,,,,,,,,15.9,,,,fee schedule,,,62.05,85,,percent of total billed charges,,12.74,,,,fee schedule,,7.91,,,,fee schedule,,15.9,,,,fee schedule,,17.24,,,,fee schedule,,15.9,,,,fee schedule,,12.3,,,,fee schedule,,7.46,,,,fee schedule,,7.46,,,,fee schedule,,,66.43,91,,percent of total billed charges,,,69.35,95,,percent of total billed charges,,,60.59,83,,percent of total billed charges,,,21.9,83,,percent of total billed charges,,15.9,,,,fee schedule,,15.9,,,,fee schedule,,,60.59,83,,percent of total billed charges,,10.96,,,,fee schedule,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,62.05,85,,percent of total billed charges,,7.46,69.35,
TRIM NAIL(S),11719P,CDM,11719,CPT,,,both,P,61,61,12.67,,,,fee schedule,,,,,,,,15.9,,,,fee schedule,,,51.85,85,,percent of total billed charges,,12.74,,,,fee schedule,,7.91,,,,fee schedule,,15.9,,,,fee schedule,,17.24,,,,fee schedule,,15.9,,,,fee schedule,,12.3,,,,fee schedule,,7.46,,,,fee schedule,,7.46,,,,fee schedule,,,55.51,91,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,18.3,83,,percent of total billed charges,,15.9,,,,fee schedule,,15.9,,,,fee schedule,,,50.63,83,,percent of total billed charges,,10.96,,,,fee schedule,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,7.46,57.95,
TRIM NAIL(S),11719T,CDM,11719,CPT,,,both,T,12,12,12.67,,,,fee schedule,,,,,,,,15.9,,,,fee schedule,,,10.2,85,,percent of total billed charges,,12.74,,,,fee schedule,,7.91,,,,fee schedule,,15.9,,,,fee schedule,,17.24,,,,fee schedule,,15.9,,,,fee schedule,,12.3,,,,fee schedule,,7.46,,,,fee schedule,,7.46,,,,fee schedule,,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,3.6,83,,percent of total billed charges,,15.9,,,,fee schedule,,15.9,,,,fee schedule,,,9.96,83,,percent of total billed charges,,10.96,,,,fee schedule,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,3.6,17.24,
"DEBRIDE NAIL, 1-5",11720,CDM,11720,CPT,,,both,,92,92,24.77,,,,fee schedule,,,,,,,,15.9,,,,fee schedule,,,78.2,85,,percent of total billed charges,,25.15,,,,fee schedule,,15.62,,,,fee schedule,,15.9,,,,fee schedule,,31.83,,,,fee schedule,,15.9,,,,fee schedule,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,27.6,83,,percent of total billed charges,,15.9,,,,fee schedule,,15.9,,,,fee schedule,,,76.36,83,,percent of total billed charges,,21.42,,,,fee schedule,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,14.57,87.4,
"DEBRIDE NAIL, 1-5",11720P,CDM,11720,CPT,,,both,P,40,40,24.77,,,,fee schedule,,,,,,,,15.9,,,,fee schedule,,,34,85,,percent of total billed charges,,25.15,,,,fee schedule,,15.62,,,,fee schedule,,15.9,,,,fee schedule,,31.83,,,,fee schedule,,15.9,,,,fee schedule,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,12,83,,percent of total billed charges,,15.9,,,,fee schedule,,15.9,,,,fee schedule,,,33.2,83,,percent of total billed charges,,21.42,,,,fee schedule,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,12,38,
"DEBRIDE NAIL, 1-5",11720Q8,CDM,11720,CPT,,,both,Q8,92,92,24.77,,,,fee schedule,,,,,,,,15.9,,,,fee schedule,,,78.2,85,,percent of total billed charges,,25.15,,,,fee schedule,,15.62,,,,fee schedule,,15.9,,,,fee schedule,,31.83,,,,fee schedule,,15.9,,,,fee schedule,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,27.6,83,,percent of total billed charges,,15.9,,,,fee schedule,,15.9,,,,fee schedule,,,76.36,83,,percent of total billed charges,,21.42,,,,fee schedule,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,14.57,87.4,
"DEBRIDE NAIL, 1-5",11720T,CDM,11720,CPT,,,both,T,52,52,24.77,,,,fee schedule,,,,,,,,15.9,,,,fee schedule,,,44.2,85,,percent of total billed charges,,25.15,,,,fee schedule,,15.62,,,,fee schedule,,15.9,,,,fee schedule,,31.83,,,,fee schedule,,15.9,,,,fee schedule,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,15.6,83,,percent of total billed charges,,15.9,,,,fee schedule,,15.9,,,,fee schedule,,,43.16,83,,percent of total billed charges,,21.42,,,,fee schedule,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,14.57,49.4,
"DEBRIDE NAIL, 6 OR MORE",11721,CDM,11721,CPT,,,both,,209,209,40.33,,,,fee schedule,,,,,,,,18.1,,,,fee schedule,,,177.65,85,,percent of total billed charges,,40.65,,,,fee schedule,,25.24,,,,fee schedule,,18.1,,,,fee schedule,,54.38,,,,fee schedule,,18.1,,,,fee schedule,,39.14,,,,fee schedule,,23.72,,,,fee schedule,,23.72,,,,fee schedule,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,62.7,83,,percent of total billed charges,,18.1,,,,fee schedule,,18.1,,,,fee schedule,,,173.47,83,,percent of total billed charges,,34.87,,,,fee schedule,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,18.1,198.55,
"DEBRIDE NAIL, 6 OR MORE",11721P,CDM,11721,CPT,,,both,P,54,54,40.33,,,,fee schedule,,,,,,,,18.1,,,,fee schedule,,,45.9,85,,percent of total billed charges,,40.65,,,,fee schedule,,25.24,,,,fee schedule,,18.1,,,,fee schedule,,54.38,,,,fee schedule,,18.1,,,,fee schedule,,39.14,,,,fee schedule,,23.72,,,,fee schedule,,23.72,,,,fee schedule,,,49.14,91,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,16.2,83,,percent of total billed charges,,18.1,,,,fee schedule,,18.1,,,,fee schedule,,,44.82,83,,percent of total billed charges,,34.87,,,,fee schedule,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,16.2,54.38,
"DEBRIDE NAIL, 6 OR MORE",11721Q8,CDM,11721,CPT,,,both,Q8,209,209,40.33,,,,fee schedule,,,,,,,,18.1,,,,fee schedule,,,177.65,85,,percent of total billed charges,,40.65,,,,fee schedule,,25.24,,,,fee schedule,,18.1,,,,fee schedule,,54.38,,,,fee schedule,,18.1,,,,fee schedule,,39.14,,,,fee schedule,,23.72,,,,fee schedule,,23.72,,,,fee schedule,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,62.7,83,,percent of total billed charges,,18.1,,,,fee schedule,,18.1,,,,fee schedule,,,173.47,83,,percent of total billed charges,,34.87,,,,fee schedule,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,18.1,198.55,
"DEBRIDE NAIL, 6 OR MORE",11721T,CDM,11721,CPT,,,both,T,155,155,40.33,,,,fee schedule,,,,,,,,18.1,,,,fee schedule,,,131.75,85,,percent of total billed charges,,40.65,,,,fee schedule,,25.24,,,,fee schedule,,18.1,,,,fee schedule,,54.38,,,,fee schedule,,18.1,,,,fee schedule,,39.14,,,,fee schedule,,23.72,,,,fee schedule,,23.72,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,18.1,,,,fee schedule,,18.1,,,,fee schedule,,,128.65,83,,percent of total billed charges,,34.87,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,18.1,147.25,
AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,11730,CDM,11730,CPT,,,both,,274,274,91.6,,,,fee schedule,,,,,,,,34.3,,,,fee schedule,,,232.9,85,,percent of total billed charges,,90.34,,,,fee schedule,,56.11,,,,fee schedule,,34.3,,,,fee schedule,,112.75,,,,fee schedule,,34.3,,,,fee schedule,,88.9,,,,fee schedule,,53.88,,,,fee schedule,,53.88,,,,fee schedule,,,249.34,91,,percent of total billed charges,,,260.3,95,,percent of total billed charges,,,227.42,83,,percent of total billed charges,,,82.2,83,,percent of total billed charges,,34.3,,,,fee schedule,,34.3,,,,fee schedule,,,227.42,83,,percent of total billed charges,,79.2,,,,fee schedule,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,232.9,85,,percent of total billed charges,,34.3,260.3,
REMOVAL OF NAIL PLATE,11730P,CDM,11730,CPT,,,both,P,204,204,91.6,,,,fee schedule,,,,,,,,34.3,,,,fee schedule,,,173.4,85,,percent of total billed charges,,90.34,,,,fee schedule,,56.11,,,,fee schedule,,34.3,,,,fee schedule,,112.75,,,,fee schedule,,34.3,,,,fee schedule,,88.9,,,,fee schedule,,53.88,,,,fee schedule,,53.88,,,,fee schedule,,,185.64,91,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,61.2,83,,percent of total billed charges,,34.3,,,,fee schedule,,34.3,,,,fee schedule,,,169.32,83,,percent of total billed charges,,79.2,,,,fee schedule,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,173.4,85,,percent of total billed charges,,34.3,193.8,
REMOVAL OF NAIL PLATE,11730T,CDM,11730,CPT,,,both,T,70,70,91.6,,,,fee schedule,,,,,,,,34.3,,,,fee schedule,,,59.5,85,,percent of total billed charges,,90.34,,,,fee schedule,,56.11,,,,fee schedule,,34.3,,,,fee schedule,,112.75,,,,fee schedule,,34.3,,,,fee schedule,,88.9,,,,fee schedule,,53.88,,,,fee schedule,,53.88,,,,fee schedule,,,63.7,91,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,21,83,,percent of total billed charges,,34.3,,,,fee schedule,,34.3,,,,fee schedule,,,58.1,83,,percent of total billed charges,,79.2,,,,fee schedule,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,21,112.75,
"REMOVE NAIL PLATE, ADD-ON",11732,CDM,11732,CPT,,,both,,142,142,29.38,,,,fee schedule,,,,,,,,14.45,,,,fee schedule,,,120.7,85,,percent of total billed charges,,29.72,,,,fee schedule,,18.45,,,,fee schedule,,14.45,,,,fee schedule,,57.04,,,,fee schedule,,14.45,,,,fee schedule,,28.52,,,,fee schedule,,17.28,,,,fee schedule,,17.28,,,,fee schedule,,,129.22,91,,percent of total billed charges,,,134.9,95,,percent of total billed charges,,,117.86,83,,percent of total billed charges,,,42.6,83,,percent of total billed charges,,14.45,,,,fee schedule,,14.45,,,,fee schedule,,,117.86,83,,percent of total billed charges,,25.41,,,,fee schedule,,,127.8,90,,percent of total billed charges,,,127.8,90,,percent of total billed charges,,,127.8,90,,percent of total billed charges,,,127.8,90,,percent of total billed charges,,,120.7,85,,percent of total billed charges,,14.45,134.9,
EVACUATION SUBUNGUAL HEMATOMA,11740,CDM,11740,CPT,,,both,,189,189,54.73,,,,fee schedule,,,,,,,,36,,,,fee schedule,,,160.65,85,,percent of total billed charges,,51.48,,,,fee schedule,,31.97,,,,fee schedule,,36,,,,fee schedule,,50.4,,,,fee schedule,,36,,,,fee schedule,,53.12,,,,fee schedule,,32.19,,,,fee schedule,,32.19,,,,fee schedule,,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,56.7,83,,percent of total billed charges,,36,,,,fee schedule,,36,,,,fee schedule,,,156.87,83,,percent of total billed charges,,47.32,,,,fee schedule,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,31.97,179.55,
DRAIN BLOOD FROM UNDER NAIL,11740P,CDM,11740,CPT,,,both,P,60,60,54.73,,,,fee schedule,,,,,,,,36,,,,fee schedule,,,51,85,,percent of total billed charges,,51.48,,,,fee schedule,,31.97,,,,fee schedule,,36,,,,fee schedule,,50.4,,,,fee schedule,,36,,,,fee schedule,,53.12,,,,fee schedule,,32.19,,,,fee schedule,,32.19,,,,fee schedule,,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,18,83,,percent of total billed charges,,36,,,,fee schedule,,36,,,,fee schedule,,,49.8,83,,percent of total billed charges,,47.32,,,,fee schedule,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,18,57,
DRAIN BLOOD FROM UNDER NAIL,11740T,CDM,11740,CPT,,,both,T,129,129,54.73,,,,fee schedule,,,,,,,,36,,,,fee schedule,,,109.65,85,,percent of total billed charges,,51.48,,,,fee schedule,,31.97,,,,fee schedule,,36,,,,fee schedule,,50.4,,,,fee schedule,,36,,,,fee schedule,,53.12,,,,fee schedule,,32.19,,,,fee schedule,,32.19,,,,fee schedule,,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,38.7,83,,percent of total billed charges,,36,,,,fee schedule,,36,,,,fee schedule,,,107.07,83,,percent of total billed charges,,47.32,,,,fee schedule,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,31.97,122.55,
EXCISION NAIL MATRIX PERMANENT REMOVAL,11750,CDM,11750,CPT,,,both,,660,660,172.25,,,,fee schedule,,,,,,,,61.85,,,,fee schedule,,,561,85,,percent of total billed charges,,168.02,,,,fee schedule,,104.35,,,,fee schedule,,61.85,,,,fee schedule,,254.01,,,,fee schedule,,61.85,,,,fee schedule,,167.18,,,,fee schedule,,101.32,,,,fee schedule,,101.32,,,,fee schedule,,,600.6,91,,percent of total billed charges,,,627,95,,percent of total billed charges,,,547.8,83,,percent of total billed charges,,,198,83,,percent of total billed charges,,61.85,,,,fee schedule,,61.85,,,,fee schedule,,,547.8,83,,percent of total billed charges,,148.94,,,,fee schedule,,,594,90,,percent of total billed charges,,,594,90,,percent of total billed charges,,,594,90,,percent of total billed charges,,,594,90,,percent of total billed charges,,,561,85,,percent of total billed charges,,61.85,627,
REMOVAL OF NAIL BED,11750P,CDM,11750,CPT,,,both,P,490,490,172.25,,,,fee schedule,,,,,,,,61.85,,,,fee schedule,,,416.5,85,,percent of total billed charges,,168.02,,,,fee schedule,,104.35,,,,fee schedule,,61.85,,,,fee schedule,,254.01,,,,fee schedule,,61.85,,,,fee schedule,,167.18,,,,fee schedule,,101.32,,,,fee schedule,,101.32,,,,fee schedule,,,445.9,91,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,147,83,,percent of total billed charges,,61.85,,,,fee schedule,,61.85,,,,fee schedule,,,406.7,83,,percent of total billed charges,,148.94,,,,fee schedule,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,61.85,465.5,
REMOVAL OF NAIL BED,11750T,CDM,11750,CPT,,,both,T,170,170,172.25,,,,fee schedule,,,,,,,,61.85,,,,fee schedule,,,144.5,85,,percent of total billed charges,,168.02,,,,fee schedule,,104.35,,,,fee schedule,,61.85,,,,fee schedule,,254.01,,,,fee schedule,,61.85,,,,fee schedule,,167.18,,,,fee schedule,,101.32,,,,fee schedule,,101.32,,,,fee schedule,,,154.7,91,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,51,83,,percent of total billed charges,,61.85,,,,fee schedule,,61.85,,,,fee schedule,,,141.1,83,,percent of total billed charges,,148.94,,,,fee schedule,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,51,254.01,
REPAIR OF NAIL BED,11760,CDM,11760,CPT,,,both,,931,931,189.53,,,,fee schedule,,,,,,,,60.8,,,,fee schedule,,,791.35,85,,percent of total billed charges,,185.5,,,,fee schedule,,115.21,,,,fee schedule,,60.8,,,,fee schedule,,236.1,,,,fee schedule,,60.8,,,,fee schedule,,183.96,,,,fee schedule,,111.49,,,,fee schedule,,111.49,,,,fee schedule,,,847.21,91,,percent of total billed charges,,,884.45,95,,percent of total billed charges,,,772.73,83,,percent of total billed charges,,,279.3,83,,percent of total billed charges,,60.8,,,,fee schedule,,60.8,,,,fee schedule,,,772.73,83,,percent of total billed charges,,163.89,,,,fee schedule,,,837.9,90,,percent of total billed charges,,,837.9,90,,percent of total billed charges,,,837.9,90,,percent of total billed charges,,,837.9,90,,percent of total billed charges,,,791.35,85,,percent of total billed charges,,60.8,884.45,
REPAIR OF NAIL BED,11760P,CDM,11760,CPT,,,both,P,753,753,189.53,,,,fee schedule,,,,,,,,60.8,,,,fee schedule,,,640.05,85,,percent of total billed charges,,185.5,,,,fee schedule,,115.21,,,,fee schedule,,60.8,,,,fee schedule,,236.1,,,,fee schedule,,60.8,,,,fee schedule,,183.96,,,,fee schedule,,111.49,,,,fee schedule,,111.49,,,,fee schedule,,,685.23,91,,percent of total billed charges,,,715.35,95,,percent of total billed charges,,,624.99,83,,percent of total billed charges,,,225.9,83,,percent of total billed charges,,60.8,,,,fee schedule,,60.8,,,,fee schedule,,,624.99,83,,percent of total billed charges,,163.89,,,,fee schedule,,,677.7,90,,percent of total billed charges,,,677.7,90,,percent of total billed charges,,,677.7,90,,percent of total billed charges,,,677.7,90,,percent of total billed charges,,,640.05,85,,percent of total billed charges,,60.8,715.35,
REPAIR OF NAIL BED,11760T,CDM,11760,CPT,,,both,T,178,178,189.53,,,,fee schedule,,,,,,,,60.8,,,,fee schedule,,,151.3,85,,percent of total billed charges,,185.5,,,,fee schedule,,115.21,,,,fee schedule,,60.8,,,,fee schedule,,236.1,,,,fee schedule,,60.8,,,,fee schedule,,183.96,,,,fee schedule,,111.49,,,,fee schedule,,111.49,,,,fee schedule,,,161.98,91,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,53.4,83,,percent of total billed charges,,60.8,,,,fee schedule,,60.8,,,,fee schedule,,,147.74,83,,percent of total billed charges,,163.89,,,,fee schedule,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,53.4,236.1,
"EXCISION OF NAIL FOLD, TOE",11765,CDM,11765,CPT,,,both,,417,417,157.85,,,,fee schedule,,,,,,,,38.4,,,,fee schedule,,,354.45,85,,percent of total billed charges,,150.96,,,,fee schedule,,93.75,,,,fee schedule,,38.4,,,,fee schedule,,101.47,,,,fee schedule,,38.4,,,,fee schedule,,153.2,,,,fee schedule,,92.85,,,,fee schedule,,92.85,,,,fee schedule,,,379.47,91,,percent of total billed charges,,,396.15,95,,percent of total billed charges,,,346.11,83,,percent of total billed charges,,,125.1,83,,percent of total billed charges,,38.4,,,,fee schedule,,38.4,,,,fee schedule,,,346.11,83,,percent of total billed charges,,136.49,,,,fee schedule,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,354.45,85,,percent of total billed charges,,38.4,396.15,
"EXCISION OF NAIL FOLD, TOE",11765P,CDM,11765,CPT,,,both,P,296,296,157.85,,,,fee schedule,,,,,,,,38.4,,,,fee schedule,,,251.6,85,,percent of total billed charges,,150.96,,,,fee schedule,,93.75,,,,fee schedule,,38.4,,,,fee schedule,,101.47,,,,fee schedule,,38.4,,,,fee schedule,,153.2,,,,fee schedule,,92.85,,,,fee schedule,,92.85,,,,fee schedule,,,269.36,91,,percent of total billed charges,,,281.2,95,,percent of total billed charges,,,245.68,83,,percent of total billed charges,,,88.8,83,,percent of total billed charges,,38.4,,,,fee schedule,,38.4,,,,fee schedule,,,245.68,83,,percent of total billed charges,,136.49,,,,fee schedule,,,266.4,90,,percent of total billed charges,,,266.4,90,,percent of total billed charges,,,266.4,90,,percent of total billed charges,,,266.4,90,,percent of total billed charges,,,251.6,85,,percent of total billed charges,,38.4,281.2,
"EXCISION OF NAIL FOLD, TOE",11765T,CDM,11765,CPT,,,both,T,121,121,157.85,,,,fee schedule,,,,,,,,38.4,,,,fee schedule,,,102.85,85,,percent of total billed charges,,150.96,,,,fee schedule,,93.75,,,,fee schedule,,38.4,,,,fee schedule,,101.47,,,,fee schedule,,38.4,,,,fee schedule,,153.2,,,,fee schedule,,92.85,,,,fee schedule,,92.85,,,,fee schedule,,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,36.3,83,,percent of total billed charges,,38.4,,,,fee schedule,,38.4,,,,fee schedule,,,100.43,83,,percent of total billed charges,,136.49,,,,fee schedule,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,36.3,157.85,
REMOVAL OF PILONIDAL LESION,11770,CDM,11770,CPT,,,both,,1145,1145,319.73,,,,fee schedule,,,,,,,,215.4,,,,fee schedule,,,973.25,85,,percent of total billed charges,,317.34,,,,fee schedule,,197.08,,,,fee schedule,,215.4,,,,fee schedule,,293.14,,,,fee schedule,,215.4,,,,fee schedule,,310.32,,,,fee schedule,,188.07,,,,fee schedule,,188.07,,,,fee schedule,,,1041.95,91,,percent of total billed charges,,,1087.75,95,,percent of total billed charges,,,950.35,83,,percent of total billed charges,,,343.5,83,,percent of total billed charges,,215.4,,,,fee schedule,,215.4,,,,fee schedule,,,950.35,83,,percent of total billed charges,,276.47,,,,fee schedule,,,1030.5,90,,percent of total billed charges,,,1030.5,90,,percent of total billed charges,,,1030.5,90,,percent of total billed charges,,,1030.5,90,,percent of total billed charges,,,973.25,85,,percent of total billed charges,,188.07,1087.75,
REMOVAL OF PILONIDAL LESION,11770P,CDM,11770,CPT,,,both,P,961,961,319.73,,,,fee schedule,,,,,,,,215.4,,,,fee schedule,,,816.85,85,,percent of total billed charges,,317.34,,,,fee schedule,,197.08,,,,fee schedule,,215.4,,,,fee schedule,,293.14,,,,fee schedule,,215.4,,,,fee schedule,,310.32,,,,fee schedule,,188.07,,,,fee schedule,,188.07,,,,fee schedule,,,874.51,91,,percent of total billed charges,,,912.95,95,,percent of total billed charges,,,797.63,83,,percent of total billed charges,,,288.3,83,,percent of total billed charges,,215.4,,,,fee schedule,,215.4,,,,fee schedule,,,797.63,83,,percent of total billed charges,,276.47,,,,fee schedule,,,864.9,90,,percent of total billed charges,,,864.9,90,,percent of total billed charges,,,864.9,90,,percent of total billed charges,,,864.9,90,,percent of total billed charges,,,816.85,85,,percent of total billed charges,,188.07,912.95,
REMOVAL OF PILONIDAL LESION,11770T,CDM,11770,CPT,,,both,T,184,184,319.73,,,,fee schedule,,,,,,,,215.4,,,,fee schedule,,,156.4,85,,percent of total billed charges,,317.34,,,,fee schedule,,197.08,,,,fee schedule,,215.4,,,,fee schedule,,293.14,,,,fee schedule,,215.4,,,,fee schedule,,310.32,,,,fee schedule,,188.07,,,,fee schedule,,188.07,,,,fee schedule,,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,55.2,83,,percent of total billed charges,,215.4,,,,fee schedule,,215.4,,,,fee schedule,,,152.72,83,,percent of total billed charges,,276.47,,,,fee schedule,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,55.2,319.73,
REMOVAL OF PILONIDAL LESION,11771,CDM,11771,CPT,,,both,,2076,2076,776.56,,,,fee schedule,,,,,,,,291.3,,,,fee schedule,,,1764.6,85,,percent of total billed charges,,766.28,,,,fee schedule,,475.89,,,,fee schedule,,291.3,,,,fee schedule,,647.95,,,,fee schedule,,291.3,,,,fee schedule,,753.72,,,,fee schedule,,456.8,,,,fee schedule,,456.8,,,,fee schedule,,,1889.16,91,,percent of total billed charges,,,1972.2,95,,percent of total billed charges,,,1723.08,83,,percent of total billed charges,,,622.8,83,,percent of total billed charges,,291.3,,,,fee schedule,,291.3,,,,fee schedule,,,1723.08,83,,percent of total billed charges,,671.5,,,,fee schedule,,,1868.4,90,,percent of total billed charges,,,1868.4,90,,percent of total billed charges,,,1868.4,90,,percent of total billed charges,,,1868.4,90,,percent of total billed charges,,,1764.6,85,,percent of total billed charges,,291.3,1972.2,
REMOVAL OF PILONIDAL LESION,11771P,CDM,11771,CPT,,,both,P,1865,1865,776.56,,,,fee schedule,,,,,,,,291.3,,,,fee schedule,,,1585.25,85,,percent of total billed charges,,766.28,,,,fee schedule,,475.89,,,,fee schedule,,291.3,,,,fee schedule,,647.95,,,,fee schedule,,291.3,,,,fee schedule,,753.72,,,,fee schedule,,456.8,,,,fee schedule,,456.8,,,,fee schedule,,,1697.15,91,,percent of total billed charges,,,1771.75,95,,percent of total billed charges,,,1547.95,83,,percent of total billed charges,,,559.5,83,,percent of total billed charges,,291.3,,,,fee schedule,,291.3,,,,fee schedule,,,1547.95,83,,percent of total billed charges,,671.5,,,,fee schedule,,,1678.5,90,,percent of total billed charges,,,1678.5,90,,percent of total billed charges,,,1678.5,90,,percent of total billed charges,,,1678.5,90,,percent of total billed charges,,,1585.25,85,,percent of total billed charges,,291.3,1771.75,
REMOVAL OF PILONIDAL LESION,11771T,CDM,11771,CPT,,,both,T,211,211,776.56,,,,fee schedule,,,,,,,,291.3,,,,fee schedule,,,179.35,85,,percent of total billed charges,,766.28,,,,fee schedule,,475.89,,,,fee schedule,,291.3,,,,fee schedule,,647.95,,,,fee schedule,,291.3,,,,fee schedule,,753.72,,,,fee schedule,,456.8,,,,fee schedule,,456.8,,,,fee schedule,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,63.3,83,,percent of total billed charges,,291.3,,,,fee schedule,,291.3,,,,fee schedule,,,175.13,83,,percent of total billed charges,,671.5,,,,fee schedule,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,63.3,776.56,
REMOVAL OF PILONIDAL LESION,11772,CDM,11772,CPT,,,both,,2511,2511,1001.23,,,,fee schedule,,,,,,,,341.25,,,,fee schedule,,,2134.35,85,,percent of total billed charges,,986.32,,,,fee schedule,,612.55,,,,fee schedule,,341.25,,,,fee schedule,,856.86,,,,fee schedule,,341.25,,,,fee schedule,,971.78,,,,fee schedule,,588.96,,,,fee schedule,,588.96,,,,fee schedule,,,2285.01,91,,percent of total billed charges,,,2385.45,95,,percent of total billed charges,,,2084.13,83,,percent of total billed charges,,,753.3,83,,percent of total billed charges,,341.25,,,,fee schedule,,341.25,,,,fee schedule,,,2084.13,83,,percent of total billed charges,,865.77,,,,fee schedule,,,2259.9,90,,percent of total billed charges,,,2259.9,90,,percent of total billed charges,,,2259.9,90,,percent of total billed charges,,,2259.9,90,,percent of total billed charges,,,2134.35,85,,percent of total billed charges,,341.25,2385.45,
REMOVAL OF PILONIDAL LESION,11772P,CDM,11772,CPT,,,both,P,2287,2287,1001.23,,,,fee schedule,,,,,,,,341.25,,,,fee schedule,,,1943.95,85,,percent of total billed charges,,986.32,,,,fee schedule,,612.55,,,,fee schedule,,341.25,,,,fee schedule,,856.86,,,,fee schedule,,341.25,,,,fee schedule,,971.78,,,,fee schedule,,588.96,,,,fee schedule,,588.96,,,,fee schedule,,,2081.17,91,,percent of total billed charges,,,2172.65,95,,percent of total billed charges,,,1898.21,83,,percent of total billed charges,,,686.1,83,,percent of total billed charges,,341.25,,,,fee schedule,,341.25,,,,fee schedule,,,1898.21,83,,percent of total billed charges,,865.77,,,,fee schedule,,,2058.3,90,,percent of total billed charges,,,2058.3,90,,percent of total billed charges,,,2058.3,90,,percent of total billed charges,,,2058.3,90,,percent of total billed charges,,,1943.95,85,,percent of total billed charges,,341.25,2172.65,
REMOVAL OF PILONIDAL LESION,11772T,CDM,11772,CPT,,,both,T,224,224,1001.23,,,,fee schedule,,,,,,,,341.25,,,,fee schedule,,,190.4,85,,percent of total billed charges,,986.32,,,,fee schedule,,612.55,,,,fee schedule,,341.25,,,,fee schedule,,856.86,,,,fee schedule,,341.25,,,,fee schedule,,971.78,,,,fee schedule,,588.96,,,,fee schedule,,588.96,,,,fee schedule,,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,67.2,83,,percent of total billed charges,,341.25,,,,fee schedule,,341.25,,,,fee schedule,,,185.92,83,,percent of total billed charges,,865.77,,,,fee schedule,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,67.2,1001.23,
INJECTION INTO SKIN LESIONS,11900,CDM,11900,CPT,,,both,,174,174,51.27,,,,fee schedule,,,,,,,,21.1,,,,fee schedule,,,147.9,85,,percent of total billed charges,,49.21,,,,fee schedule,,30.56,,,,fee schedule,,21.1,,,,fee schedule,,50.4,,,,fee schedule,,21.1,,,,fee schedule,,49.76,,,,fee schedule,,30.16,,,,fee schedule,,30.16,,,,fee schedule,,,158.34,91,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,52.2,83,,percent of total billed charges,,21.1,,,,fee schedule,,21.1,,,,fee schedule,,,144.42,83,,percent of total billed charges,,44.33,,,,fee schedule,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,21.1,165.3,
REPLACE TISSUE EXPANDER,11970,CDM,11970,CPT,,,both,,4170,4170,969.55,,,,fee schedule,,,,,,,,475.7,,,,fee schedule,,,3544.5,85,,percent of total billed charges,,943.94,,,,fee schedule,,586.23,,,,fee schedule,,475.7,,,,fee schedule,,942.42,,,,fee schedule,,475.7,,,,fee schedule,,941.03,,,,fee schedule,,570.32,,,,fee schedule,,570.32,,,,fee schedule,,,3794.7,91,,percent of total billed charges,,,3961.5,95,,percent of total billed charges,,,3461.1,83,,percent of total billed charges,,,1251,83,,percent of total billed charges,,475.7,,,,fee schedule,,475.7,,,,fee schedule,,,3461.1,83,,percent of total billed charges,,838.37,,,,fee schedule,,,3753,90,,percent of total billed charges,,,3753,90,,percent of total billed charges,,,3753,90,,percent of total billed charges,,,3753,90,,percent of total billed charges,,,3544.5,85,,percent of total billed charges,,475.7,3961.5,
REMOVAL OF CONTRACEPTIVE CAP,11976,CDM,11976,CPT,,,both,,526,526,159,,,,fee schedule,,,,,,,,108,,,,fee schedule,,,447.1,85,,percent of total billed charges,,159.33,,,,fee schedule,,98.95,,,,fee schedule,,108,,,,fee schedule,,177.08,,,,fee schedule,,108,,,,fee schedule,,154.32,,,,fee schedule,,93.53,,,,fee schedule,,93.53,,,,fee schedule,,,478.66,91,,percent of total billed charges,,,499.7,95,,percent of total billed charges,,,436.58,83,,percent of total billed charges,,,157.8,83,,percent of total billed charges,,108,,,,fee schedule,,108,,,,fee schedule,,,436.58,83,,percent of total billed charges,,137.49,,,,fee schedule,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,447.1,85,,percent of total billed charges,,93.53,499.7,
INSERT DRUG IMPLANT DEVICE,11981,CDM,11981,CPT,,,both,,617,617,107.15,,,,fee schedule,,,,,,,,88,,,,fee schedule,,,524.45,85,,percent of total billed charges,,108.81,,,,fee schedule,,67.58,,,,fee schedule,,88,,,,fee schedule,,151.21,,,,fee schedule,,88,,,,fee schedule,,104,,,,fee schedule,,63.03,,,,fee schedule,,63.03,,,,fee schedule,,,561.47,91,,percent of total billed charges,,,586.15,95,,percent of total billed charges,,,512.11,83,,percent of total billed charges,,,185.1,83,,percent of total billed charges,,88,,,,fee schedule,,88,,,,fee schedule,,,512.11,83,,percent of total billed charges,,92.65,,,,fee schedule,,,555.3,90,,percent of total billed charges,,,555.3,90,,percent of total billed charges,,,555.3,90,,percent of total billed charges,,,555.3,90,,percent of total billed charges,,,524.45,85,,percent of total billed charges,,63.03,586.15,
INSERT DRUG IMPLANT DEVICE,11981AS,CDM,11981,CPT,,,both,AS,318,318,107.15,,,,fee schedule,,,,,,,,88,,,,fee schedule,,,270.3,85,,percent of total billed charges,,108.81,,,,fee schedule,,67.58,,,,fee schedule,,88,,,,fee schedule,,151.21,,,,fee schedule,,88,,,,fee schedule,,104,,,,fee schedule,,63.03,,,,fee schedule,,63.03,,,,fee schedule,,,289.38,91,,percent of total billed charges,,,302.1,95,,percent of total billed charges,,,263.94,83,,percent of total billed charges,,,95.4,83,,percent of total billed charges,,88,,,,fee schedule,,88,,,,fee schedule,,,263.94,83,,percent of total billed charges,,92.65,,,,fee schedule,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,270.3,85,,percent of total billed charges,,63.03,302.1,
INSERT DRUG IMPLANT DEVICE,11981P,CDM,11981,CPT,,,both,P,355,355,107.15,,,,fee schedule,,,,,,,,88,,,,fee schedule,,,301.75,85,,percent of total billed charges,,108.81,,,,fee schedule,,67.58,,,,fee schedule,,88,,,,fee schedule,,151.21,,,,fee schedule,,88,,,,fee schedule,,104,,,,fee schedule,,63.03,,,,fee schedule,,63.03,,,,fee schedule,,,323.05,91,,percent of total billed charges,,,337.25,95,,percent of total billed charges,,,294.65,83,,percent of total billed charges,,,106.5,83,,percent of total billed charges,,88,,,,fee schedule,,88,,,,fee schedule,,,294.65,83,,percent of total billed charges,,92.65,,,,fee schedule,,,319.5,90,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,301.75,85,,percent of total billed charges,,63.03,337.25,
INSERT DRUG IMPLANT DEVICE,11981T,CDM,11981,CPT,,,both,T,262,262,107.15,,,,fee schedule,,,,,,,,88,,,,fee schedule,,,222.7,85,,percent of total billed charges,,108.81,,,,fee schedule,,67.58,,,,fee schedule,,88,,,,fee schedule,,151.21,,,,fee schedule,,88,,,,fee schedule,,104,,,,fee schedule,,63.03,,,,fee schedule,,63.03,,,,fee schedule,,,238.42,91,,percent of total billed charges,,,248.9,95,,percent of total billed charges,,,217.46,83,,percent of total billed charges,,,78.6,83,,percent of total billed charges,,88,,,,fee schedule,,88,,,,fee schedule,,,217.46,83,,percent of total billed charges,,92.65,,,,fee schedule,,,235.8,90,,percent of total billed charges,,,235.8,90,,percent of total billed charges,,,235.8,90,,percent of total billed charges,,,235.8,90,,percent of total billed charges,,,222.7,85,,percent of total billed charges,,63.03,248.9,
REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,11982,CDM,11982,CPT,,,both,,538,538,126.74,,,,fee schedule,,,,,,,,99,,,,fee schedule,,,457.3,85,,percent of total billed charges,,127.34,,,,fee schedule,,79.08,,,,fee schedule,,99,,,,fee schedule,,184.37,,,,fee schedule,,99,,,,fee schedule,,123.01,,,,fee schedule,,74.55,,,,fee schedule,,74.55,,,,fee schedule,,,489.58,91,,percent of total billed charges,,,511.1,95,,percent of total billed charges,,,446.54,83,,percent of total billed charges,,,161.4,83,,percent of total billed charges,,99,,,,fee schedule,,99,,,,fee schedule,,,446.54,83,,percent of total billed charges,,109.59,,,,fee schedule,,,484.2,90,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,457.3,85,,percent of total billed charges,,74.55,511.1,
REMOVE DRUG IMPLANT DEVICE,1198280,CDM,11982,CPT,,,both,80,102,102,126.74,,,,fee schedule,,,,,,,,99,,,,fee schedule,,,86.7,85,,percent of total billed charges,,127.34,,,,fee schedule,,79.08,,,,fee schedule,,99,,,,fee schedule,,184.37,,,,fee schedule,,99,,,,fee schedule,,123.01,,,,fee schedule,,74.55,,,,fee schedule,,74.55,,,,fee schedule,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,30.6,83,,percent of total billed charges,,99,,,,fee schedule,,99,,,,fee schedule,,,84.66,83,,percent of total billed charges,,109.59,,,,fee schedule,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,30.6,184.37,
REMOVE DRUG IMPLANT DEVICE,11982AS,CDM,11982,CPT,,,both,AS,318,318,126.74,,,,fee schedule,,,,,,,,99,,,,fee schedule,,,270.3,85,,percent of total billed charges,,127.34,,,,fee schedule,,79.08,,,,fee schedule,,99,,,,fee schedule,,184.37,,,,fee schedule,,99,,,,fee schedule,,123.01,,,,fee schedule,,74.55,,,,fee schedule,,74.55,,,,fee schedule,,,289.38,91,,percent of total billed charges,,,302.1,95,,percent of total billed charges,,,263.94,83,,percent of total billed charges,,,95.4,83,,percent of total billed charges,,99,,,,fee schedule,,99,,,,fee schedule,,,263.94,83,,percent of total billed charges,,109.59,,,,fee schedule,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,270.3,85,,percent of total billed charges,,74.55,302.1,
REMOVE/INSERT DRUG IMPLANT,11983,CDM,11983,CPT,,,both,,862,862,177.43,,,,fee schedule,,,,,,,,143,,,,fee schedule,,,732.7,85,,percent of total billed charges,,177.28,,,,fee schedule,,110.1,,,,fee schedule,,143,,,,fee schedule,,332.27,,,,fee schedule,,143,,,,fee schedule,,172.21,,,,fee schedule,,104.37,,,,fee schedule,,104.37,,,,fee schedule,,,784.42,91,,percent of total billed charges,,,818.9,95,,percent of total billed charges,,,715.46,83,,percent of total billed charges,,,258.6,83,,percent of total billed charges,,143,,,,fee schedule,,143,,,,fee schedule,,,715.46,83,,percent of total billed charges,,153.43,,,,fee schedule,,,775.8,90,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,732.7,85,,percent of total billed charges,,104.37,818.9,
REMOVE/INSERT DRUG IMPLANT,11983AS,CDM,11983,CPT,,,both,AS,689,689,177.43,,,,fee schedule,,,,,,,,143,,,,fee schedule,,,585.65,85,,percent of total billed charges,,177.28,,,,fee schedule,,110.1,,,,fee schedule,,143,,,,fee schedule,,332.27,,,,fee schedule,,143,,,,fee schedule,,172.21,,,,fee schedule,,104.37,,,,fee schedule,,104.37,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,143,,,,fee schedule,,143,,,,fee schedule,,,571.87,83,,percent of total billed charges,,153.43,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,104.37,654.55,
REMOVE/INSERT DRUG IMPLANT,11983P,CDM,11983,CPT,,,both,P,686,686,177.43,,,,fee schedule,,,,,,,,143,,,,fee schedule,,,583.1,85,,percent of total billed charges,,177.28,,,,fee schedule,,110.1,,,,fee schedule,,143,,,,fee schedule,,332.27,,,,fee schedule,,143,,,,fee schedule,,172.21,,,,fee schedule,,104.37,,,,fee schedule,,104.37,,,,fee schedule,,,624.26,91,,percent of total billed charges,,,651.7,95,,percent of total billed charges,,,569.38,83,,percent of total billed charges,,,205.8,83,,percent of total billed charges,,143,,,,fee schedule,,143,,,,fee schedule,,,569.38,83,,percent of total billed charges,,153.43,,,,fee schedule,,,617.4,90,,percent of total billed charges,,,617.4,90,,percent of total billed charges,,,617.4,90,,percent of total billed charges,,,617.4,90,,percent of total billed charges,,,583.1,85,,percent of total billed charges,,104.37,651.7,
REMOVE/INSERT DRUG IMPLANT,11983T,CDM,11983,CPT,,,both,T,176,176,177.43,,,,fee schedule,,,,,,,,143,,,,fee schedule,,,149.6,85,,percent of total billed charges,,177.28,,,,fee schedule,,110.1,,,,fee schedule,,143,,,,fee schedule,,332.27,,,,fee schedule,,143,,,,fee schedule,,172.21,,,,fee schedule,,104.37,,,,fee schedule,,104.37,,,,fee schedule,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,52.8,83,,percent of total billed charges,,143,,,,fee schedule,,143,,,,fee schedule,,,146.08,83,,percent of total billed charges,,153.43,,,,fee schedule,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,52.8,332.27,
SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<,12001,CDM,12001,CPT,,,both,,457,457,77.2,,,,fee schedule,,,,,,,,53.1,,,,fee schedule,,,388.45,85,,percent of total billed charges,,77.75,,,,fee schedule,,48.29,,,,fee schedule,,53.1,,,,fee schedule,,174.42,,,,fee schedule,,53.1,,,,fee schedule,,74.92,,,,fee schedule,,45.41,,,,fee schedule,,45.41,,,,fee schedule,,,415.87,91,,percent of total billed charges,,,434.15,95,,percent of total billed charges,,,379.31,83,,percent of total billed charges,,,137.1,83,,percent of total billed charges,,53.1,,,,fee schedule,,53.1,,,,fee schedule,,,379.31,83,,percent of total billed charges,,66.75,,,,fee schedule,,,411.3,90,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,388.45,85,,percent of total billed charges,,45.41,434.15,
REPAIR SUPERFICIAL WOUND(S),12001P,CDM,12001,CPT,,,both,P,389,389,77.2,,,,fee schedule,,,,,,,,53.1,,,,fee schedule,,,330.65,85,,percent of total billed charges,,77.75,,,,fee schedule,,48.29,,,,fee schedule,,53.1,,,,fee schedule,,174.42,,,,fee schedule,,53.1,,,,fee schedule,,74.92,,,,fee schedule,,45.41,,,,fee schedule,,45.41,,,,fee schedule,,,353.99,91,,percent of total billed charges,,,369.55,95,,percent of total billed charges,,,322.87,83,,percent of total billed charges,,,116.7,83,,percent of total billed charges,,53.1,,,,fee schedule,,53.1,,,,fee schedule,,,322.87,83,,percent of total billed charges,,66.75,,,,fee schedule,,,350.1,90,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,330.65,85,,percent of total billed charges,,45.41,369.55,
REPAIR SUPERFICIAL WOUND(S),12001T,CDM,12001,CPT,,,both,T,68,68,77.2,,,,fee schedule,,,,,,,,53.1,,,,fee schedule,,,57.8,85,,percent of total billed charges,,77.75,,,,fee schedule,,48.29,,,,fee schedule,,53.1,,,,fee schedule,,174.42,,,,fee schedule,,53.1,,,,fee schedule,,74.92,,,,fee schedule,,45.41,,,,fee schedule,,45.41,,,,fee schedule,,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,53.1,,,,fee schedule,,53.1,,,,fee schedule,,,56.44,83,,percent of total billed charges,,66.75,,,,fee schedule,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,20.4,174.42,
REPAIR SUPERFICIAL WOUND(S),12002,CDM,12002,CPT,,,both,,563,563,100.81,,,,fee schedule,,,,,,,,58.4,,,,fee schedule,,,478.55,85,,percent of total billed charges,,101.9,,,,fee schedule,,63.28,,,,fee schedule,,58.4,,,,fee schedule,,194.98,,,,fee schedule,,58.4,,,,fee schedule,,97.85,,,,fee schedule,,59.3,,,,fee schedule,,59.3,,,,fee schedule,,,512.33,91,,percent of total billed charges,,,534.85,95,,percent of total billed charges,,,467.29,83,,percent of total billed charges,,,168.9,83,,percent of total billed charges,,58.4,,,,fee schedule,,58.4,,,,fee schedule,,,467.29,83,,percent of total billed charges,,87.17,,,,fee schedule,,,506.7,90,,percent of total billed charges,,,506.7,90,,percent of total billed charges,,,506.7,90,,percent of total billed charges,,,506.7,90,,percent of total billed charges,,,478.55,85,,percent of total billed charges,,58.4,534.85,
REPAIR SUPERFICIAL WOUND(S),12002P,CDM,12002,CPT,,,both,P,396,396,100.81,,,,fee schedule,,,,,,,,58.4,,,,fee schedule,,,336.6,85,,percent of total billed charges,,101.9,,,,fee schedule,,63.28,,,,fee schedule,,58.4,,,,fee schedule,,194.98,,,,fee schedule,,58.4,,,,fee schedule,,97.85,,,,fee schedule,,59.3,,,,fee schedule,,59.3,,,,fee schedule,,,360.36,91,,percent of total billed charges,,,376.2,95,,percent of total billed charges,,,328.68,83,,percent of total billed charges,,,118.8,83,,percent of total billed charges,,58.4,,,,fee schedule,,58.4,,,,fee schedule,,,328.68,83,,percent of total billed charges,,87.17,,,,fee schedule,,,356.4,90,,percent of total billed charges,,,356.4,90,,percent of total billed charges,,,356.4,90,,percent of total billed charges,,,356.4,90,,percent of total billed charges,,,336.6,85,,percent of total billed charges,,58.4,376.2,
REPAIR SUPERFICIAL WOUND(S),12002T,CDM,12002,CPT,,,both,T,167,167,100.81,,,,fee schedule,,,,,,,,58.4,,,,fee schedule,,,141.95,85,,percent of total billed charges,,101.9,,,,fee schedule,,63.28,,,,fee schedule,,58.4,,,,fee schedule,,194.98,,,,fee schedule,,58.4,,,,fee schedule,,97.85,,,,fee schedule,,59.3,,,,fee schedule,,59.3,,,,fee schedule,,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,50.1,83,,percent of total billed charges,,58.4,,,,fee schedule,,58.4,,,,fee schedule,,,138.61,83,,percent of total billed charges,,87.17,,,,fee schedule,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,50.1,194.98,
SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM,12004,CDM,12004,CPT,,,both,,697,697,125.01,,,,fee schedule,,,,,,,,69.7,,,,fee schedule,,,592.45,85,,percent of total billed charges,,126.04,,,,fee schedule,,78.28,,,,fee schedule,,69.7,,,,fee schedule,,230.13,,,,fee schedule,,69.7,,,,fee schedule,,121.33,,,,fee schedule,,73.54,,,,fee schedule,,73.54,,,,fee schedule,,,634.27,91,,percent of total billed charges,,,662.15,95,,percent of total billed charges,,,578.51,83,,percent of total billed charges,,,209.1,83,,percent of total billed charges,,69.7,,,,fee schedule,,69.7,,,,fee schedule,,,578.51,83,,percent of total billed charges,,108.1,,,,fee schedule,,,627.3,90,,percent of total billed charges,,,627.3,90,,percent of total billed charges,,,627.3,90,,percent of total billed charges,,,627.3,90,,percent of total billed charges,,,592.45,85,,percent of total billed charges,,69.7,662.15,
SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20CM,12005,CDM,12005,CPT,,,both,,879,879,161.88,,,,fee schedule,,,,,,,,100.4,,,,fee schedule,,,747.15,85,,percent of total billed charges,,165.77,,,,fee schedule,,102.95,,,,fee schedule,,100.4,,,,fee schedule,,287.83,,,,fee schedule,,100.4,,,,fee schedule,,157.12,,,,fee schedule,,95.22,,,,fee schedule,,95.22,,,,fee schedule,,,799.89,91,,percent of total billed charges,,,835.05,95,,percent of total billed charges,,,729.57,83,,percent of total billed charges,,,263.7,83,,percent of total billed charges,,100.4,,,,fee schedule,,100.4,,,,fee schedule,,,729.57,83,,percent of total billed charges,,139.98,,,,fee schedule,,,791.1,90,,percent of total billed charges,,,791.1,90,,percent of total billed charges,,,791.1,90,,percent of total billed charges,,,791.1,90,,percent of total billed charges,,,747.15,85,,percent of total billed charges,,95.22,835.05,
SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,12006,CDM,12006,CPT,,,both,,1032,1032,199.32,,,,fee schedule,,,,,,,,145.8,,,,fee schedule,,,877.2,85,,percent of total billed charges,,203.23,,,,fee schedule,,126.22,,,,fee schedule,,145.8,,,,fee schedule,,368.08,,,,fee schedule,,145.8,,,,fee schedule,,193.46,,,,fee schedule,,117.25,,,,fee schedule,,117.25,,,,fee schedule,,,939.12,91,,percent of total billed charges,,,980.4,95,,percent of total billed charges,,,856.56,83,,percent of total billed charges,,,309.6,83,,percent of total billed charges,,145.8,,,,fee schedule,,145.8,,,,fee schedule,,,856.56,83,,percent of total billed charges,,172.36,,,,fee schedule,,,928.8,90,,percent of total billed charges,,,928.8,90,,percent of total billed charges,,,928.8,90,,percent of total billed charges,,,928.8,90,,percent of total billed charges,,,877.2,85,,percent of total billed charges,,117.25,980.4,
SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK >30.0CM,12007,CDM,12007,CPT,,,both,,1141,1141,247.72,,,,fee schedule,,,,,,,,195.8,,,,fee schedule,,,969.85,85,,percent of total billed charges,,252.5,,,,fee schedule,,156.81,,,,fee schedule,,195.8,,,,fee schedule,,421.8,,,,fee schedule,,195.8,,,,fee schedule,,240.43,,,,fee schedule,,145.71,,,,fee schedule,,145.71,,,,fee schedule,,,1038.31,91,,percent of total billed charges,,,1083.95,95,,percent of total billed charges,,,947.03,83,,percent of total billed charges,,,342.3,83,,percent of total billed charges,,195.8,,,,fee schedule,,195.8,,,,fee schedule,,,947.03,83,,percent of total billed charges,,214.2,,,,fee schedule,,,1026.9,90,,percent of total billed charges,,,1026.9,90,,percent of total billed charges,,,1026.9,90,,percent of total billed charges,,,1026.9,90,,percent of total billed charges,,,969.85,85,,percent of total billed charges,,145.71,1083.95,
SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<,12011,CDM,12011,CPT,,,both,,553,553,94.48,,,,fee schedule,,,,,,,,56.4,,,,fee schedule,,,470.05,85,,percent of total billed charges,,95.53,,,,fee schedule,,59.33,,,,fee schedule,,56.4,,,,fee schedule,,179.73,,,,fee schedule,,56.4,,,,fee schedule,,91.7,,,,fee schedule,,55.58,,,,fee schedule,,55.58,,,,fee schedule,,,503.23,91,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,165.9,83,,percent of total billed charges,,56.4,,,,fee schedule,,56.4,,,,fee schedule,,,458.99,83,,percent of total billed charges,,81.7,,,,fee schedule,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,55.58,525.35,
REPAIR SUPERFICIAL WOUND(S),12011P,CDM,12011,CPT,,,both,P,386,386,94.48,,,,fee schedule,,,,,,,,56.4,,,,fee schedule,,,328.1,85,,percent of total billed charges,,95.53,,,,fee schedule,,59.33,,,,fee schedule,,56.4,,,,fee schedule,,179.73,,,,fee schedule,,56.4,,,,fee schedule,,91.7,,,,fee schedule,,55.58,,,,fee schedule,,55.58,,,,fee schedule,,,351.26,91,,percent of total billed charges,,,366.7,95,,percent of total billed charges,,,320.38,83,,percent of total billed charges,,,115.8,83,,percent of total billed charges,,56.4,,,,fee schedule,,56.4,,,,fee schedule,,,320.38,83,,percent of total billed charges,,81.7,,,,fee schedule,,,347.4,90,,percent of total billed charges,,,347.4,90,,percent of total billed charges,,,347.4,90,,percent of total billed charges,,,347.4,90,,percent of total billed charges,,,328.1,85,,percent of total billed charges,,55.58,366.7,
REPAIR SUPERFICIAL WOUND(S),12011T,CDM,12011,CPT,,,both,T,167,167,94.48,,,,fee schedule,,,,,,,,56.4,,,,fee schedule,,,141.95,85,,percent of total billed charges,,95.53,,,,fee schedule,,59.33,,,,fee schedule,,56.4,,,,fee schedule,,179.73,,,,fee schedule,,56.4,,,,fee schedule,,91.7,,,,fee schedule,,55.58,,,,fee schedule,,55.58,,,,fee schedule,,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,50.1,83,,percent of total billed charges,,56.4,,,,fee schedule,,56.4,,,,fee schedule,,,138.61,83,,percent of total billed charges,,81.7,,,,fee schedule,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,50.1,179.73,
SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0CM,12013,CDM,12013,CPT,,,both,,625,625,100.24,,,,fee schedule,,,,,,,,64,,,,fee schedule,,,531.25,85,,percent of total billed charges,,101.56,,,,fee schedule,,63.07,,,,fee schedule,,64,,,,fee schedule,,206.26,,,,fee schedule,,64,,,,fee schedule,,97.29,,,,fee schedule,,58.96,,,,fee schedule,,58.96,,,,fee schedule,,,568.75,91,,percent of total billed charges,,,593.75,95,,percent of total billed charges,,,518.75,83,,percent of total billed charges,,,187.5,83,,percent of total billed charges,,64,,,,fee schedule,,64,,,,fee schedule,,,518.75,83,,percent of total billed charges,,86.68,,,,fee schedule,,,562.5,90,,percent of total billed charges,,,562.5,90,,percent of total billed charges,,,562.5,90,,percent of total billed charges,,,562.5,90,,percent of total billed charges,,,531.25,85,,percent of total billed charges,,58.96,593.75,
SIMPLE REPAIR F/E/E/N/L/M 5.1-7.5CM,12014,CDM,12014,CPT,,,both,,759,759,127.89,,,,fee schedule,,,,,,,,112.9,,,,fee schedule,,,645.15,85,,percent of total billed charges,,130.53,,,,fee schedule,,81.06,,,,fee schedule,,112.9,,,,fee schedule,,248.7,,,,fee schedule,,112.9,,,,fee schedule,,124.13,,,,fee schedule,,75.23,,,,fee schedule,,75.23,,,,fee schedule,,,690.69,91,,percent of total billed charges,,,721.05,95,,percent of total billed charges,,,629.97,83,,percent of total billed charges,,,227.7,83,,percent of total billed charges,,112.9,,,,fee schedule,,112.9,,,,fee schedule,,,629.97,83,,percent of total billed charges,,110.59,,,,fee schedule,,,683.1,90,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,645.15,85,,percent of total billed charges,,75.23,721.05,
SIMPLE REPAIR F/E/E/N/L/M 7.6-12.5 CM,12015,CDM,12015,CPT,,,both,,954,954,161.3,,,,fee schedule,,,,,,,,125.5,,,,fee schedule,,,810.9,85,,percent of total billed charges,,164.75,,,,fee schedule,,102.32,,,,fee schedule,,125.5,,,,fee schedule,,314.36,,,,fee schedule,,125.5,,,,fee schedule,,156.56,,,,fee schedule,,94.88,,,,fee schedule,,94.88,,,,fee schedule,,,868.14,91,,percent of total billed charges,,,906.3,95,,percent of total billed charges,,,791.82,83,,percent of total billed charges,,,286.2,83,,percent of total billed charges,,125.5,,,,fee schedule,,125.5,,,,fee schedule,,,791.82,83,,percent of total billed charges,,139.48,,,,fee schedule,,,858.6,90,,percent of total billed charges,,,858.6,90,,percent of total billed charges,,,858.6,90,,percent of total billed charges,,,858.6,90,,percent of total billed charges,,,810.9,85,,percent of total billed charges,,94.88,906.3,
SIMPLE REPAIR F/E/E/N/L/M 12.6-20.0 CM,12016,CDM,12016,CPT,,,both,,1225,1225,218.91,,,,fee schedule,,,,,,,,200.75,,,,fee schedule,,,1041.25,85,,percent of total billed charges,,224.67,,,,fee schedule,,139.53,,,,fee schedule,,200.75,,,,fee schedule,,385.99,,,,fee schedule,,200.75,,,,fee schedule,,212.47,,,,fee schedule,,128.77,,,,fee schedule,,128.77,,,,fee schedule,,,1114.75,91,,percent of total billed charges,,,1163.75,95,,percent of total billed charges,,,1016.75,83,,percent of total billed charges,,,367.5,83,,percent of total billed charges,,200.75,,,,fee schedule,,200.75,,,,fee schedule,,,1016.75,83,,percent of total billed charges,,189.29,,,,fee schedule,,,1102.5,90,,percent of total billed charges,,,1102.5,90,,percent of total billed charges,,,1102.5,90,,percent of total billed charges,,,1102.5,90,,percent of total billed charges,,,1041.25,85,,percent of total billed charges,,128.77,1163.75,
REPAIR SUPERFICIAL WOUND(S),12016P,CDM,12016,CPT,,,both,P,1039,1039,218.91,,,,fee schedule,,,,,,,,200.75,,,,fee schedule,,,883.15,85,,percent of total billed charges,,224.67,,,,fee schedule,,139.53,,,,fee schedule,,200.75,,,,fee schedule,,385.99,,,,fee schedule,,200.75,,,,fee schedule,,212.47,,,,fee schedule,,128.77,,,,fee schedule,,128.77,,,,fee schedule,,,945.49,91,,percent of total billed charges,,,987.05,95,,percent of total billed charges,,,862.37,83,,percent of total billed charges,,,311.7,83,,percent of total billed charges,,200.75,,,,fee schedule,,200.75,,,,fee schedule,,,862.37,83,,percent of total billed charges,,189.29,,,,fee schedule,,,935.1,90,,percent of total billed charges,,,935.1,90,,percent of total billed charges,,,935.1,90,,percent of total billed charges,,,935.1,90,,percent of total billed charges,,,883.15,85,,percent of total billed charges,,128.77,987.05,
REPAIR SUPERFICIAL WOUND(S),12016T,CDM,12016,CPT,,,both,T,186,186,218.91,,,,fee schedule,,,,,,,,200.75,,,,fee schedule,,,158.1,85,,percent of total billed charges,,224.67,,,,fee schedule,,139.53,,,,fee schedule,,200.75,,,,fee schedule,,385.99,,,,fee schedule,,200.75,,,,fee schedule,,212.47,,,,fee schedule,,128.77,,,,fee schedule,,128.77,,,,fee schedule,,,169.26,91,,percent of total billed charges,,,176.7,95,,percent of total billed charges,,,154.38,83,,percent of total billed charges,,,55.8,83,,percent of total billed charges,,200.75,,,,fee schedule,,200.75,,,,fee schedule,,,154.38,83,,percent of total billed charges,,189.29,,,,fee schedule,,,167.4,90,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,158.1,85,,percent of total billed charges,,55.8,385.99,
SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0CM,12017,CDM,12017,CPT,,,both,,796,796,263.27,,,,fee schedule,,,,,,,,259.2,,,,fee schedule,,,676.6,85,,percent of total billed charges,,266.68,,,,fee schedule,,165.62,,,,fee schedule,,259.2,,,,fee schedule,,469.55,,,,fee schedule,,259.2,,,,fee schedule,,255.53,,,,fee schedule,,154.86,,,,fee schedule,,154.86,,,,fee schedule,,,724.36,91,,percent of total billed charges,,,756.2,95,,percent of total billed charges,,,660.68,83,,percent of total billed charges,,,238.8,83,,percent of total billed charges,,259.2,,,,fee schedule,,259.2,,,,fee schedule,,,660.68,83,,percent of total billed charges,,227.65,,,,fee schedule,,,716.4,90,,percent of total billed charges,,,716.4,90,,percent of total billed charges,,,716.4,90,,percent of total billed charges,,,716.4,90,,percent of total billed charges,,,676.6,85,,percent of total billed charges,,154.86,756.2,
SIMPLE REPAIR F/E/E/N/L/M >30.0CM,12018,CDM,12018,CPT,,,both,,964,964,297.26,,,,fee schedule,,,,,,,,272.63,,,,fee schedule,,,819.4,85,,percent of total billed charges,,303.08,,,,fee schedule,,188.22,,,,fee schedule,,272.63,,,,fee schedule,,555.77,,,,fee schedule,,272.63,,,,fee schedule,,288.52,,,,fee schedule,,174.86,,,,fee schedule,,174.86,,,,fee schedule,,,877.24,91,,percent of total billed charges,,,915.8,95,,percent of total billed charges,,,800.12,83,,percent of total billed charges,,,289.2,83,,percent of total billed charges,,272.63,,,,fee schedule,,272.63,,,,fee schedule,,,800.12,83,,percent of total billed charges,,257.04,,,,fee schedule,,,867.6,90,,percent of total billed charges,,,867.6,90,,percent of total billed charges,,,867.6,90,,percent of total billed charges,,,867.6,90,,percent of total billed charges,,,819.4,85,,percent of total billed charges,,174.86,915.8,
TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,12020,CDM,12020,CPT,,,both,,796,796,323.76,,,,fee schedule,,,,,,,,139.3,,,,fee schedule,,,676.6,85,,percent of total billed charges,,313.86,,,,fee schedule,,194.92,,,,fee schedule,,139.3,,,,fee schedule,,320.99,,,,fee schedule,,139.3,,,,fee schedule,,314.24,,,,fee schedule,,190.45,,,,fee schedule,,190.45,,,,fee schedule,,,724.36,91,,percent of total billed charges,,,756.2,95,,percent of total billed charges,,,660.68,83,,percent of total billed charges,,,238.8,83,,percent of total billed charges,,139.3,,,,fee schedule,,139.3,,,,fee schedule,,,660.68,83,,percent of total billed charges,,279.96,,,,fee schedule,,,716.4,90,,percent of total billed charges,,,716.4,90,,percent of total billed charges,,,716.4,90,,percent of total billed charges,,,716.4,90,,percent of total billed charges,,,676.6,85,,percent of total billed charges,,139.3,756.2,
CLOSURE OF SPLIT WOUND,12020AS,CDM,12020,CPT,,,both,AS,530,530,323.76,,,,fee schedule,,,,,,,,139.3,,,,fee schedule,,,450.5,85,,percent of total billed charges,,313.86,,,,fee schedule,,194.92,,,,fee schedule,,139.3,,,,fee schedule,,320.99,,,,fee schedule,,139.3,,,,fee schedule,,314.24,,,,fee schedule,,190.45,,,,fee schedule,,190.45,,,,fee schedule,,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,159,83,,percent of total billed charges,,139.3,,,,fee schedule,,139.3,,,,fee schedule,,,439.9,83,,percent of total billed charges,,279.96,,,,fee schedule,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,139.3,503.5,
CLOSURE OF SPLIT WOUND,12020P,CDM,12020,CPT,,,both,P,472,472,323.76,,,,fee schedule,,,,,,,,139.3,,,,fee schedule,,,401.2,85,,percent of total billed charges,,313.86,,,,fee schedule,,194.92,,,,fee schedule,,139.3,,,,fee schedule,,320.99,,,,fee schedule,,139.3,,,,fee schedule,,314.24,,,,fee schedule,,190.45,,,,fee schedule,,190.45,,,,fee schedule,,,429.52,91,,percent of total billed charges,,,448.4,95,,percent of total billed charges,,,391.76,83,,percent of total billed charges,,,141.6,83,,percent of total billed charges,,139.3,,,,fee schedule,,139.3,,,,fee schedule,,,391.76,83,,percent of total billed charges,,279.96,,,,fee schedule,,,424.8,90,,percent of total billed charges,,,424.8,90,,percent of total billed charges,,,424.8,90,,percent of total billed charges,,,424.8,90,,percent of total billed charges,,,401.2,85,,percent of total billed charges,,139.3,448.4,
CLOSURE OF SPLIT WOUND,12020T,CDM,12020,CPT,,,both,T,324,324,323.76,,,,fee schedule,,,,,,,,139.3,,,,fee schedule,,,275.4,85,,percent of total billed charges,,313.86,,,,fee schedule,,194.92,,,,fee schedule,,139.3,,,,fee schedule,,320.99,,,,fee schedule,,139.3,,,,fee schedule,,314.24,,,,fee schedule,,190.45,,,,fee schedule,,190.45,,,,fee schedule,,,294.84,91,,percent of total billed charges,,,307.8,95,,percent of total billed charges,,,268.92,83,,percent of total billed charges,,,97.2,83,,percent of total billed charges,,139.3,,,,fee schedule,,139.3,,,,fee schedule,,,268.92,83,,percent of total billed charges,,279.96,,,,fee schedule,,,291.6,90,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,275.4,85,,percent of total billed charges,,97.2,323.76,
TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,12021,CDM,12021,CPT,,,both,,523,523,242.53,,,,fee schedule,,,,,,,,88.7,,,,fee schedule,,,444.55,85,,percent of total billed charges,,235.39,,,,fee schedule,,146.19,,,,fee schedule,,88.7,,,,fee schedule,,230.8,,,,fee schedule,,88.7,,,,fee schedule,,235.4,,,,fee schedule,,142.67,,,,fee schedule,,142.67,,,,fee schedule,,,475.93,91,,percent of total billed charges,,,496.85,95,,percent of total billed charges,,,434.09,83,,percent of total billed charges,,,156.9,83,,percent of total billed charges,,88.7,,,,fee schedule,,88.7,,,,fee schedule,,,434.09,83,,percent of total billed charges,,209.72,,,,fee schedule,,,470.7,90,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,470.7,90,,percent of total billed charges,,,444.55,85,,percent of total billed charges,,88.7,496.85,
REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,12031,CDM,12031,CPT,,,both,,672,672,259.81,,,,fee schedule,,,,,,,,64.7,,,,fee schedule,,,571.2,85,,percent of total billed charges,,249.38,,,,fee schedule,,154.87,,,,fee schedule,,64.7,,,,fee schedule,,218.19,,,,fee schedule,,64.7,,,,fee schedule,,252.17,,,,fee schedule,,152.83,,,,fee schedule,,152.83,,,,fee schedule,,,611.52,91,,percent of total billed charges,,,638.4,95,,percent of total billed charges,,,557.76,83,,percent of total billed charges,,,201.6,83,,percent of total billed charges,,64.7,,,,fee schedule,,64.7,,,,fee schedule,,,557.76,83,,percent of total billed charges,,224.66,,,,fee schedule,,,604.8,90,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,604.8,90,,percent of total billed charges,,,571.2,85,,percent of total billed charges,,64.7,638.4,
LAYER CLOSURE OF WOUND(S),12031P,CDM,12031,CPT,,,both,P,502,502,259.81,,,,fee schedule,,,,,,,,64.7,,,,fee schedule,,,426.7,85,,percent of total billed charges,,249.38,,,,fee schedule,,154.87,,,,fee schedule,,64.7,,,,fee schedule,,218.19,,,,fee schedule,,64.7,,,,fee schedule,,252.17,,,,fee schedule,,152.83,,,,fee schedule,,152.83,,,,fee schedule,,,456.82,91,,percent of total billed charges,,,476.9,95,,percent of total billed charges,,,416.66,83,,percent of total billed charges,,,150.6,83,,percent of total billed charges,,64.7,,,,fee schedule,,64.7,,,,fee schedule,,,416.66,83,,percent of total billed charges,,224.66,,,,fee schedule,,,451.8,90,,percent of total billed charges,,,451.8,90,,percent of total billed charges,,,451.8,90,,percent of total billed charges,,,451.8,90,,percent of total billed charges,,,426.7,85,,percent of total billed charges,,64.7,476.9,
LAYER CLOSURE OF WOUND(S),12031T,CDM,12031,CPT,,,both,T,170,170,259.81,,,,fee schedule,,,,,,,,64.7,,,,fee schedule,,,144.5,85,,percent of total billed charges,,249.38,,,,fee schedule,,154.87,,,,fee schedule,,64.7,,,,fee schedule,,218.19,,,,fee schedule,,64.7,,,,fee schedule,,252.17,,,,fee schedule,,152.83,,,,fee schedule,,152.83,,,,fee schedule,,,154.7,91,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,51,83,,percent of total billed charges,,64.7,,,,fee schedule,,64.7,,,,fee schedule,,,141.1,83,,percent of total billed charges,,224.66,,,,fee schedule,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,51,259.81,
REPAIR INTERMEDIATE S/A/T/E 2.6CM - 7.5CM,12032,CDM,12032,CPT,,,both,,832,832,324.91,,,,fee schedule,,,,,,,,81.6,,,,fee schedule,,,707.2,85,,percent of total billed charges,,310.89,,,,fee schedule,,193.07,,,,fee schedule,,81.6,,,,fee schedule,,293.8,,,,fee schedule,,81.6,,,,fee schedule,,315.35,,,,fee schedule,,191.12,,,,fee schedule,,191.12,,,,fee schedule,,,757.12,91,,percent of total billed charges,,,790.4,95,,percent of total billed charges,,,690.56,83,,percent of total billed charges,,,249.6,83,,percent of total billed charges,,81.6,,,,fee schedule,,81.6,,,,fee schedule,,,690.56,83,,percent of total billed charges,,280.95,,,,fee schedule,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,748.8,90,,percent of total billed charges,,,707.2,85,,percent of total billed charges,,81.6,790.4,
LAYER CLOSURE OF WOUND(S),12032P,CDM,12032,CPT,,,both,P,657,657,324.91,,,,fee schedule,,,,,,,,81.6,,,,fee schedule,,,558.45,85,,percent of total billed charges,,310.89,,,,fee schedule,,193.07,,,,fee schedule,,81.6,,,,fee schedule,,293.8,,,,fee schedule,,81.6,,,,fee schedule,,315.35,,,,fee schedule,,191.12,,,,fee schedule,,191.12,,,,fee schedule,,,597.87,91,,percent of total billed charges,,,624.15,95,,percent of total billed charges,,,545.31,83,,percent of total billed charges,,,197.1,83,,percent of total billed charges,,81.6,,,,fee schedule,,81.6,,,,fee schedule,,,545.31,83,,percent of total billed charges,,280.95,,,,fee schedule,,,591.3,90,,percent of total billed charges,,,591.3,90,,percent of total billed charges,,,591.3,90,,percent of total billed charges,,,591.3,90,,percent of total billed charges,,,558.45,85,,percent of total billed charges,,81.6,624.15,
LAYER CLOSURE OF WOUND(S),12032T,CDM,12032,CPT,,,both,T,175,175,324.91,,,,fee schedule,,,,,,,,81.6,,,,fee schedule,,,148.75,85,,percent of total billed charges,,310.89,,,,fee schedule,,193.07,,,,fee schedule,,81.6,,,,fee schedule,,293.8,,,,fee schedule,,81.6,,,,fee schedule,,315.35,,,,fee schedule,,191.12,,,,fee schedule,,191.12,,,,fee schedule,,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,52.5,83,,percent of total billed charges,,81.6,,,,fee schedule,,81.6,,,,fee schedule,,,145.25,83,,percent of total billed charges,,280.95,,,,fee schedule,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,52.5,324.91,
REPAIR INTERMEDIATE S/A/T/E 7.6cm - 12.5cm,12034,CDM,12034,CPT,,,both,,1048,1048,351.41,,,,fee schedule,,,,,,,,106.65,,,,fee schedule,,,890.8,85,,percent of total billed charges,,340.78,,,,fee schedule,,211.64,,,,fee schedule,,106.65,,,,fee schedule,,307.06,,,,fee schedule,,106.65,,,,fee schedule,,341.07,,,,fee schedule,,206.71,,,,fee schedule,,206.71,,,,fee schedule,,,953.68,91,,percent of total billed charges,,,995.6,95,,percent of total billed charges,,,869.84,83,,percent of total billed charges,,,314.4,83,,percent of total billed charges,,106.65,,,,fee schedule,,106.65,,,,fee schedule,,,869.84,83,,percent of total billed charges,,303.87,,,,fee schedule,,,943.2,90,,percent of total billed charges,,,943.2,90,,percent of total billed charges,,,943.2,90,,percent of total billed charges,,,943.2,90,,percent of total billed charges,,,890.8,85,,percent of total billed charges,,106.65,995.6,
REPAIR INTERMEDIATE S/A/T/E 12.6cm - 20cm,12035,CDM,12035,CPT,,,both,,1418,1418,413.63,,,,fee schedule,,,,,,,,144.3,,,,fee schedule,,,1205.3,85,,percent of total billed charges,,405.28,,,,fee schedule,,251.7,,,,fee schedule,,144.3,,,,fee schedule,,394.61,,,,fee schedule,,144.3,,,,fee schedule,,401.46,,,,fee schedule,,243.31,,,,fee schedule,,243.31,,,,fee schedule,,,1290.38,91,,percent of total billed charges,,,1347.1,95,,percent of total billed charges,,,1176.94,83,,percent of total billed charges,,,425.4,83,,percent of total billed charges,,144.3,,,,fee schedule,,144.3,,,,fee schedule,,,1176.94,83,,percent of total billed charges,,357.67,,,,fee schedule,,,1276.2,90,,percent of total billed charges,,,1276.2,90,,percent of total billed charges,,,1276.2,90,,percent of total billed charges,,,1276.2,90,,percent of total billed charges,,,1205.3,85,,percent of total billed charges,,144.3,1347.1,
LAYER CLOSURE OF WOUND(S),12035P,CDM,12035,CPT,,,both,P,1226,1226,413.63,,,,fee schedule,,,,,,,,144.3,,,,fee schedule,,,1042.1,85,,percent of total billed charges,,405.28,,,,fee schedule,,251.7,,,,fee schedule,,144.3,,,,fee schedule,,394.61,,,,fee schedule,,144.3,,,,fee schedule,,401.46,,,,fee schedule,,243.31,,,,fee schedule,,243.31,,,,fee schedule,,,1115.66,91,,percent of total billed charges,,,1164.7,95,,percent of total billed charges,,,1017.58,83,,percent of total billed charges,,,367.8,83,,percent of total billed charges,,144.3,,,,fee schedule,,144.3,,,,fee schedule,,,1017.58,83,,percent of total billed charges,,357.67,,,,fee schedule,,,1103.4,90,,percent of total billed charges,,,1103.4,90,,percent of total billed charges,,,1103.4,90,,percent of total billed charges,,,1103.4,90,,percent of total billed charges,,,1042.1,85,,percent of total billed charges,,144.3,1164.7,
LAYER CLOSURE OF WOUND(S),12035T,CDM,12035,CPT,,,both,T,192,192,413.63,,,,fee schedule,,,,,,,,144.3,,,,fee schedule,,,163.2,85,,percent of total billed charges,,405.28,,,,fee schedule,,251.7,,,,fee schedule,,144.3,,,,fee schedule,,394.61,,,,fee schedule,,144.3,,,,fee schedule,,401.46,,,,fee schedule,,243.31,,,,fee schedule,,243.31,,,,fee schedule,,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,57.6,83,,percent of total billed charges,,144.3,,,,fee schedule,,144.3,,,,fee schedule,,,159.36,83,,percent of total billed charges,,357.67,,,,fee schedule,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,57.6,413.63,
REPAIR INTERMEDIATE S/A/T/E 20.1CM - 30.0CM,12036,CDM,12036,CPT,,,both,,1723,1723,482.76,,,,fee schedule,,,,,,,,194.5,,,,fee schedule,,,1464.55,85,,percent of total billed charges,,480.54,,,,fee schedule,,298.43,,,,fee schedule,,194.5,,,,fee schedule,,470.88,,,,fee schedule,,194.5,,,,fee schedule,,468.56,,,,fee schedule,,283.97,,,,fee schedule,,283.97,,,,fee schedule,,,1567.93,91,,percent of total billed charges,,,1636.85,95,,percent of total billed charges,,,1430.09,83,,percent of total billed charges,,,516.9,83,,percent of total billed charges,,194.5,,,,fee schedule,,194.5,,,,fee schedule,,,1430.09,83,,percent of total billed charges,,417.44,,,,fee schedule,,,1550.7,90,,percent of total billed charges,,,1550.7,90,,percent of total billed charges,,,1550.7,90,,percent of total billed charges,,,1550.7,90,,percent of total billed charges,,,1464.55,85,,percent of total billed charges,,194.5,1636.85,
LAYER CLOSURE OF WOUND(S),12036P,CDM,12036,CPT,,,both,P,1522,1522,482.76,,,,fee schedule,,,,,,,,194.5,,,,fee schedule,,,1293.7,85,,percent of total billed charges,,480.54,,,,fee schedule,,298.43,,,,fee schedule,,194.5,,,,fee schedule,,470.88,,,,fee schedule,,194.5,,,,fee schedule,,468.56,,,,fee schedule,,283.97,,,,fee schedule,,283.97,,,,fee schedule,,,1385.02,91,,percent of total billed charges,,,1445.9,95,,percent of total billed charges,,,1263.26,83,,percent of total billed charges,,,456.6,83,,percent of total billed charges,,194.5,,,,fee schedule,,194.5,,,,fee schedule,,,1263.26,83,,percent of total billed charges,,417.44,,,,fee schedule,,,1369.8,90,,percent of total billed charges,,,1369.8,90,,percent of total billed charges,,,1369.8,90,,percent of total billed charges,,,1369.8,90,,percent of total billed charges,,,1293.7,85,,percent of total billed charges,,194.5,1445.9,
LAYER CLOSURE OF WOUND(S),12036T,CDM,12036,CPT,,,both,T,201,201,482.76,,,,fee schedule,,,,,,,,194.5,,,,fee schedule,,,170.85,85,,percent of total billed charges,,480.54,,,,fee schedule,,298.43,,,,fee schedule,,194.5,,,,fee schedule,,470.88,,,,fee schedule,,194.5,,,,fee schedule,,468.56,,,,fee schedule,,283.97,,,,fee schedule,,283.97,,,,fee schedule,,,182.91,91,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,60.3,83,,percent of total billed charges,,194.5,,,,fee schedule,,194.5,,,,fee schedule,,,166.83,83,,percent of total billed charges,,417.44,,,,fee schedule,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,60.3,482.76,
REPAIR INTERMEDIATE S/A/T/E >30.0CM,12037,CDM,12037,CPT,,,both,,1943,1943,561.1,,,,fee schedule,,,,,,,,261.12,,,,fee schedule,,,1651.55,85,,percent of total billed charges,,557.09,,,,fee schedule,,345.97,,,,fee schedule,,261.12,,,,fee schedule,,546.48,,,,fee schedule,,261.12,,,,fee schedule,,544.6,,,,fee schedule,,330.06,,,,fee schedule,,330.06,,,,fee schedule,,,1768.13,91,,percent of total billed charges,,,1845.85,95,,percent of total billed charges,,,1612.69,83,,percent of total billed charges,,,582.9,83,,percent of total billed charges,,261.12,,,,fee schedule,,261.12,,,,fee schedule,,,1612.69,83,,percent of total billed charges,,485.19,,,,fee schedule,,,1748.7,90,,percent of total billed charges,,,1748.7,90,,percent of total billed charges,,,1748.7,90,,percent of total billed charges,,,1748.7,90,,percent of total billed charges,,,1651.55,85,,percent of total billed charges,,261.12,1845.85,
LAYER CLOSURE OF WOUND(S),12037P,CDM,12037,CPT,,,both,P,1736,1736,561.1,,,,fee schedule,,,,,,,,261.12,,,,fee schedule,,,1475.6,85,,percent of total billed charges,,557.09,,,,fee schedule,,345.97,,,,fee schedule,,261.12,,,,fee schedule,,546.48,,,,fee schedule,,261.12,,,,fee schedule,,544.6,,,,fee schedule,,330.06,,,,fee schedule,,330.06,,,,fee schedule,,,1579.76,91,,percent of total billed charges,,,1649.2,95,,percent of total billed charges,,,1440.88,83,,percent of total billed charges,,,520.8,83,,percent of total billed charges,,261.12,,,,fee schedule,,261.12,,,,fee schedule,,,1440.88,83,,percent of total billed charges,,485.19,,,,fee schedule,,,1562.4,90,,percent of total billed charges,,,1562.4,90,,percent of total billed charges,,,1562.4,90,,percent of total billed charges,,,1562.4,90,,percent of total billed charges,,,1475.6,85,,percent of total billed charges,,261.12,1649.2,
LAYER CLOSURE OF WOUND(S),12037T,CDM,12037,CPT,,,both,T,207,207,561.1,,,,fee schedule,,,,,,,,261.12,,,,fee schedule,,,175.95,85,,percent of total billed charges,,557.09,,,,fee schedule,,345.97,,,,fee schedule,,261.12,,,,fee schedule,,546.48,,,,fee schedule,,261.12,,,,fee schedule,,544.6,,,,fee schedule,,330.06,,,,fee schedule,,330.06,,,,fee schedule,,,188.37,91,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,62.1,83,,percent of total billed charges,,261.12,,,,fee schedule,,261.12,,,,fee schedule,,,171.81,83,,percent of total billed charges,,485.19,,,,fee schedule,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,175.95,85,,percent of total billed charges,,62.1,561.1,
REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<,12041,CDM,12041,CPT,,,both,,785,785,248.29,,,,fee schedule,,,,,,,,72.1,,,,fee schedule,,,667.25,85,,percent of total billed charges,,238.72,,,,fee schedule,,148.25,,,,fee schedule,,72.1,,,,fee schedule,,245.39,,,,fee schedule,,72.1,,,,fee schedule,,240.99,,,,fee schedule,,146.05,,,,fee schedule,,146.05,,,,fee schedule,,,714.35,91,,percent of total billed charges,,,745.75,95,,percent of total billed charges,,,651.55,83,,percent of total billed charges,,,235.5,83,,percent of total billed charges,,72.1,,,,fee schedule,,72.1,,,,fee schedule,,,651.55,83,,percent of total billed charges,,214.7,,,,fee schedule,,,706.5,90,,percent of total billed charges,,,706.5,90,,percent of total billed charges,,,706.5,90,,percent of total billed charges,,,706.5,90,,percent of total billed charges,,,667.25,85,,percent of total billed charges,,72.1,745.75,
LAYER CLOSURE OF WOUND(S),12041P,CDM,12041,CPT,,,both,P,612,612,248.29,,,,fee schedule,,,,,,,,72.1,,,,fee schedule,,,520.2,85,,percent of total billed charges,,238.72,,,,fee schedule,,148.25,,,,fee schedule,,72.1,,,,fee schedule,,245.39,,,,fee schedule,,72.1,,,,fee schedule,,240.99,,,,fee schedule,,146.05,,,,fee schedule,,146.05,,,,fee schedule,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,183.6,83,,percent of total billed charges,,72.1,,,,fee schedule,,72.1,,,,fee schedule,,,507.96,83,,percent of total billed charges,,214.7,,,,fee schedule,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,72.1,581.4,
LAYER CLOSURE OF WOUND(S),12041T,CDM,12041,CPT,,,both,T,173,173,248.29,,,,fee schedule,,,,,,,,72.1,,,,fee schedule,,,147.05,85,,percent of total billed charges,,238.72,,,,fee schedule,,148.25,,,,fee schedule,,72.1,,,,fee schedule,,245.39,,,,fee schedule,,72.1,,,,fee schedule,,240.99,,,,fee schedule,,146.05,,,,fee schedule,,146.05,,,,fee schedule,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,51.9,83,,percent of total billed charges,,72.1,,,,fee schedule,,72.1,,,,fee schedule,,,143.59,83,,percent of total billed charges,,214.7,,,,fee schedule,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,51.9,248.29,
REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM,12042,CDM,12042,CPT,,,both,,840,840,334.13,,,,fee schedule,,,,,,,,94.1,,,,fee schedule,,,714,85,,percent of total billed charges,,323.17,,,,fee schedule,,200.7,,,,fee schedule,,94.1,,,,fee schedule,,291.15,,,,fee schedule,,94.1,,,,fee schedule,,324.3,,,,fee schedule,,196.55,,,,fee schedule,,196.55,,,,fee schedule,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,252,83,,percent of total billed charges,,94.1,,,,fee schedule,,94.1,,,,fee schedule,,,697.2,83,,percent of total billed charges,,288.92,,,,fee schedule,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,94.1,798,
REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5 CM,12044,CDM,12044,CPT,,,both,,1178,1178,365.81,,,,fee schedule,,,,,,,,119.2,,,,fee schedule,,,1001.3,85,,percent of total billed charges,,355.16,,,,fee schedule,,220.57,,,,fee schedule,,119.2,,,,fee schedule,,333.59,,,,fee schedule,,119.2,,,,fee schedule,,355.05,,,,fee schedule,,215.18,,,,fee schedule,,215.18,,,,fee schedule,,,1071.98,91,,percent of total billed charges,,,1119.1,95,,percent of total billed charges,,,977.74,83,,percent of total billed charges,,,353.4,83,,percent of total billed charges,,119.2,,,,fee schedule,,119.2,,,,fee schedule,,,977.74,83,,percent of total billed charges,,316.32,,,,fee schedule,,,1060.2,90,,percent of total billed charges,,,1060.2,90,,percent of total billed charges,,,1060.2,90,,percent of total billed charges,,,1060.2,90,,percent of total billed charges,,,1001.3,85,,percent of total billed charges,,119.2,1119.1,
REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,12045,CDM,12045,CPT,,,both,,1484,1484,471.81,,,,fee schedule,,,,,,,,156.85,,,,fee schedule,,,1261.4,85,,percent of total billed charges,,454.08,,,,fee schedule,,282,,,,fee schedule,,156.85,,,,fee schedule,,418.48,,,,fee schedule,,156.85,,,,fee schedule,,457.93,,,,fee schedule,,277.54,,,,fee schedule,,277.54,,,,fee schedule,,,1350.44,91,,percent of total billed charges,,,1409.8,95,,percent of total billed charges,,,1231.72,83,,percent of total billed charges,,,445.2,83,,percent of total billed charges,,156.85,,,,fee schedule,,156.85,,,,fee schedule,,,1231.72,83,,percent of total billed charges,,407.98,,,,fee schedule,,,1335.6,90,,percent of total billed charges,,,1335.6,90,,percent of total billed charges,,,1335.6,90,,percent of total billed charges,,,1335.6,90,,percent of total billed charges,,,1261.4,85,,percent of total billed charges,,156.85,1409.8,
REPAIR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM,12046,CDM,12046,CPT,,,both,,1445,1445,546.7,,,,fee schedule,,,,,,,,207.1,,,,fee schedule,,,1228.25,85,,percent of total billed charges,,542.57,,,,fee schedule,,336.96,,,,fee schedule,,207.1,,,,fee schedule,,497.4,,,,fee schedule,,207.1,,,,fee schedule,,530.62,,,,fee schedule,,321.59,,,,fee schedule,,321.59,,,,fee schedule,,,1314.95,91,,percent of total billed charges,,,1372.75,95,,percent of total billed charges,,,1199.35,83,,percent of total billed charges,,,433.5,83,,percent of total billed charges,,207.1,,,,fee schedule,,207.1,,,,fee schedule,,,1199.35,83,,percent of total billed charges,,472.74,,,,fee schedule,,,1300.5,90,,percent of total billed charges,,,1300.5,90,,percent of total billed charges,,,1300.5,90,,percent of total billed charges,,,1300.5,90,,percent of total billed charges,,,1228.25,85,,percent of total billed charges,,207.1,1372.75,
REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM,12047,CDM,12047,CPT,,,both,,1675,1675,607.77,,,,fee schedule,,,,,,,,270.45,,,,fee schedule,,,1423.75,85,,percent of total billed charges,,604.3,,,,fee schedule,,375.3,,,,fee schedule,,270.45,,,,fee schedule,,549.13,,,,fee schedule,,270.45,,,,fee schedule,,589.89,,,,fee schedule,,357.51,,,,fee schedule,,357.51,,,,fee schedule,,,1524.25,91,,percent of total billed charges,,,1591.25,95,,percent of total billed charges,,,1390.25,83,,percent of total billed charges,,,502.5,83,,percent of total billed charges,,270.45,,,,fee schedule,,270.45,,,,fee schedule,,,1390.25,83,,percent of total billed charges,,525.54,,,,fee schedule,,,1507.5,90,,percent of total billed charges,,,1507.5,90,,percent of total billed charges,,,1507.5,90,,percent of total billed charges,,,1507.5,90,,percent of total billed charges,,,1423.75,85,,percent of total billed charges,,270.45,1591.25,
REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 2.5 CM <,12051,CDM,12051,CPT,,,both,,877,877,290.35,,,,fee schedule,,,,,,,,74.7,,,,fee schedule,,,745.45,85,,percent of total billed charges,,279.37,,,,fee schedule,,173.5,,,,fee schedule,,74.7,,,,fee schedule,,273.24,,,,fee schedule,,74.7,,,,fee schedule,,281.81,,,,fee schedule,,170.79,,,,fee schedule,,170.79,,,,fee schedule,,,798.07,91,,percent of total billed charges,,,833.15,95,,percent of total billed charges,,,727.91,83,,percent of total billed charges,,,263.1,83,,percent of total billed charges,,74.7,,,,fee schedule,,74.7,,,,fee schedule,,,727.91,83,,percent of total billed charges,,251.06,,,,fee schedule,,,789.3,90,,percent of total billed charges,,,789.3,90,,percent of total billed charges,,,789.3,90,,percent of total billed charges,,,789.3,90,,percent of total billed charges,,,745.45,85,,percent of total billed charges,,74.7,833.15,
INTMD RPR FACE/MM 2.5 CM/<,12051P,CDM,12051,CPT,,,both,P,654,654,290.35,,,,fee schedule,,,,,,,,74.7,,,,fee schedule,,,555.9,85,,percent of total billed charges,,279.37,,,,fee schedule,,173.5,,,,fee schedule,,74.7,,,,fee schedule,,273.24,,,,fee schedule,,74.7,,,,fee schedule,,281.81,,,,fee schedule,,170.79,,,,fee schedule,,170.79,,,,fee schedule,,,595.14,91,,percent of total billed charges,,,621.3,95,,percent of total billed charges,,,542.82,83,,percent of total billed charges,,,196.2,83,,percent of total billed charges,,74.7,,,,fee schedule,,74.7,,,,fee schedule,,,542.82,83,,percent of total billed charges,,251.06,,,,fee schedule,,,588.6,90,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,588.6,90,,percent of total billed charges,,,555.9,85,,percent of total billed charges,,74.7,621.3,
INTMD RPR FACE/MM 2.5 CM/<,12051T,CDM,12051,CPT,,,both,T,223,223,290.35,,,,fee schedule,,,,,,,,74.7,,,,fee schedule,,,189.55,85,,percent of total billed charges,,279.37,,,,fee schedule,,173.5,,,,fee schedule,,74.7,,,,fee schedule,,273.24,,,,fee schedule,,74.7,,,,fee schedule,,281.81,,,,fee schedule,,170.79,,,,fee schedule,,170.79,,,,fee schedule,,,202.93,91,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,66.9,83,,percent of total billed charges,,74.7,,,,fee schedule,,74.7,,,,fee schedule,,,185.09,83,,percent of total billed charges,,251.06,,,,fee schedule,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,66.9,290.35,
REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 2.6 - 5.0 CM,12052,CDM,12052,CPT,,,both,,936,936,341.62,,,,fee schedule,,,,,,,,94.1,,,,fee schedule,,,795.6,85,,percent of total billed charges,,329.22,,,,fee schedule,,204.46,,,,fee schedule,,94.1,,,,fee schedule,,291.15,,,,fee schedule,,94.1,,,,fee schedule,,331.57,,,,fee schedule,,200.95,,,,fee schedule,,200.95,,,,fee schedule,,,851.76,91,,percent of total billed charges,,,889.2,95,,percent of total billed charges,,,776.88,83,,percent of total billed charges,,,280.8,83,,percent of total billed charges,,94.1,,,,fee schedule,,94.1,,,,fee schedule,,,776.88,83,,percent of total billed charges,,295.4,,,,fee schedule,,,842.4,90,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,842.4,90,,percent of total billed charges,,,795.6,85,,percent of total billed charges,,94.1,889.2,
INTMD RPR FACE/MM 2.6-5.0 CM,12052P,CDM,12052,CPT,,,both,P,680,680,341.62,,,,fee schedule,,,,,,,,94.1,,,,fee schedule,,,578,85,,percent of total billed charges,,329.22,,,,fee schedule,,204.46,,,,fee schedule,,94.1,,,,fee schedule,,291.15,,,,fee schedule,,94.1,,,,fee schedule,,331.57,,,,fee schedule,,200.95,,,,fee schedule,,200.95,,,,fee schedule,,,618.8,91,,percent of total billed charges,,,646,95,,percent of total billed charges,,,564.4,83,,percent of total billed charges,,,204,83,,percent of total billed charges,,94.1,,,,fee schedule,,94.1,,,,fee schedule,,,564.4,83,,percent of total billed charges,,295.4,,,,fee schedule,,,612,90,,percent of total billed charges,,,612,90,,percent of total billed charges,,,612,90,,percent of total billed charges,,,612,90,,percent of total billed charges,,,578,85,,percent of total billed charges,,94.1,646,
INTMD RPR FACE/MM 2.6-5.0 CM,12052T,CDM,12052,CPT,,,both,T,256,256,341.62,,,,fee schedule,,,,,,,,94.1,,,,fee schedule,,,217.6,85,,percent of total billed charges,,329.22,,,,fee schedule,,204.46,,,,fee schedule,,94.1,,,,fee schedule,,291.15,,,,fee schedule,,94.1,,,,fee schedule,,331.57,,,,fee schedule,,200.95,,,,fee schedule,,200.95,,,,fee schedule,,,232.96,91,,percent of total billed charges,,,243.2,95,,percent of total billed charges,,,212.48,83,,percent of total billed charges,,,76.8,83,,percent of total billed charges,,94.1,,,,fee schedule,,94.1,,,,fee schedule,,,212.48,83,,percent of total billed charges,,295.4,,,,fee schedule,,,230.4,90,,percent of total billed charges,,,230.4,90,,percent of total billed charges,,,230.4,90,,percent of total billed charges,,,230.4,90,,percent of total billed charges,,,217.6,85,,percent of total billed charges,,76.8,341.62,
REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 5.1 - 7.5 CM,12053,CDM,12053,CPT,,,both,,1147,1147,368.69,,,,fee schedule,,,,,,,,112.9,,,,fee schedule,,,974.95,85,,percent of total billed charges,,355.65,,,,fee schedule,,220.87,,,,fee schedule,,112.9,,,,fee schedule,,324.31,,,,fee schedule,,112.9,,,,fee schedule,,357.85,,,,fee schedule,,216.88,,,,fee schedule,,216.88,,,,fee schedule,,,1043.77,91,,percent of total billed charges,,,1089.65,95,,percent of total billed charges,,,952.01,83,,percent of total billed charges,,,344.1,83,,percent of total billed charges,,112.9,,,,fee schedule,,112.9,,,,fee schedule,,,952.01,83,,percent of total billed charges,,318.81,,,,fee schedule,,,1032.3,90,,percent of total billed charges,,,1032.3,90,,percent of total billed charges,,,1032.3,90,,percent of total billed charges,,,1032.3,90,,percent of total billed charges,,,974.95,85,,percent of total billed charges,,112.9,1089.65,
REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 7.6 - 12.5 CM,12054,CDM,12054,CPT,,,both,,1426,1426,376.76,,,,fee schedule,,,,,,,,131.8,,,,fee schedule,,,1212.1,85,,percent of total billed charges,,367.84,,,,fee schedule,,228.44,,,,fee schedule,,131.8,,,,fee schedule,,356.8,,,,fee schedule,,131.8,,,,fee schedule,,365.68,,,,fee schedule,,221.62,,,,fee schedule,,221.62,,,,fee schedule,,,1297.66,91,,percent of total billed charges,,,1354.7,95,,percent of total billed charges,,,1183.58,83,,percent of total billed charges,,,427.8,83,,percent of total billed charges,,131.8,,,,fee schedule,,131.8,,,,fee schedule,,,1183.58,83,,percent of total billed charges,,325.78,,,,fee schedule,,,1283.4,90,,percent of total billed charges,,,1283.4,90,,percent of total billed charges,,,1283.4,90,,percent of total billed charges,,,1283.4,90,,percent of total billed charges,,,1212.1,85,,percent of total billed charges,,131.8,1354.7,
REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 12.6 - 20.0 CM,12055,CDM,12055,CPT,,,both,,1871,1871,515.02,,,,fee schedule,,,,,,,,169.4,,,,fee schedule,,,1590.35,85,,percent of total billed charges,,502.16,,,,fee schedule,,311.87,,,,fee schedule,,169.4,,,,fee schedule,,463.58,,,,fee schedule,,169.4,,,,fee schedule,,499.87,,,,fee schedule,,302.95,,,,fee schedule,,302.95,,,,fee schedule,,,1702.61,91,,percent of total billed charges,,,1777.45,95,,percent of total billed charges,,,1552.93,83,,percent of total billed charges,,,561.3,83,,percent of total billed charges,,169.4,,,,fee schedule,,169.4,,,,fee schedule,,,1552.93,83,,percent of total billed charges,,445.34,,,,fee schedule,,,1683.9,90,,percent of total billed charges,,,1683.9,90,,percent of total billed charges,,,1683.9,90,,percent of total billed charges,,,1683.9,90,,percent of total billed charges,,,1590.35,85,,percent of total billed charges,,169.4,1777.45,
REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC 20.1 - 30.0 CM,12056,CDM,12056,CPT,,,both,,1554,1554,660.77,,,,fee schedule,,,,,,,,219.6,,,,fee schedule,,,1320.9,85,,percent of total billed charges,,644.62,,,,fee schedule,,400.34,,,,fee schedule,,219.6,,,,fee schedule,,586.94,,,,fee schedule,,219.6,,,,fee schedule,,641.33,,,,fee schedule,,388.69,,,,fee schedule,,388.69,,,,fee schedule,,,1414.14,91,,percent of total billed charges,,,1476.3,95,,percent of total billed charges,,,1289.82,83,,percent of total billed charges,,,466.2,83,,percent of total billed charges,,219.6,,,,fee schedule,,219.6,,,,fee schedule,,,1289.82,83,,percent of total billed charges,,571.37,,,,fee schedule,,,1398.6,90,,percent of total billed charges,,,1398.6,90,,percent of total billed charges,,,1398.6,90,,percent of total billed charges,,,1398.6,90,,percent of total billed charges,,,1320.9,85,,percent of total billed charges,,219.6,1476.3,
REPAIR INTERMEDIATE F/E/E/N/L/M&/MUC > 30.0 CM,12057,CDM,12057,CPT,,,both,,1743,1743,720.1,,,,fee schedule,,,,,,,,305.68,,,,fee schedule,,,1481.55,85,,percent of total billed charges,,704.54,,,,fee schedule,,437.55,,,,fee schedule,,305.68,,,,fee schedule,,679.12,,,,fee schedule,,305.68,,,,fee schedule,,698.92,,,,fee schedule,,423.59,,,,fee schedule,,423.59,,,,fee schedule,,,1586.13,91,,percent of total billed charges,,,1655.85,95,,percent of total billed charges,,,1446.69,83,,percent of total billed charges,,,522.9,83,,percent of total billed charges,,305.68,,,,fee schedule,,305.68,,,,fee schedule,,,1446.69,83,,percent of total billed charges,,622.68,,,,fee schedule,,,1568.7,90,,percent of total billed charges,,,1568.7,90,,percent of total billed charges,,,1568.7,90,,percent of total billed charges,,,1568.7,90,,percent of total billed charges,,,1481.55,85,,percent of total billed charges,,305.68,1655.85,
REPAIR COMPLEX TRUNK 1.1 - 2.5 CM,13100,CDM,13100,CPT,,,both,,977,977,342.77,,,,fee schedule,,,,,,,,110.04,,,,fee schedule,,,830.45,85,,percent of total billed charges,,332.17,,,,fee schedule,,206.29,,,,fee schedule,,110.04,,,,fee schedule,,377.36,,,,fee schedule,,110.04,,,,fee schedule,,332.69,,,,fee schedule,,201.63,,,,fee schedule,,201.63,,,,fee schedule,,,889.07,91,,percent of total billed charges,,,928.15,95,,percent of total billed charges,,,810.91,83,,percent of total billed charges,,,293.1,83,,percent of total billed charges,,110.04,,,,fee schedule,,110.04,,,,fee schedule,,,810.91,83,,percent of total billed charges,,296.39,,,,fee schedule,,,879.3,90,,percent of total billed charges,,,879.3,90,,percent of total billed charges,,,879.3,90,,percent of total billed charges,,,879.3,90,,percent of total billed charges,,,830.45,85,,percent of total billed charges,,110.04,928.15,
REPAIR COMPLEX TRUNK 2.6 - 7.5 CM,13101,CDM,13101,CPT,,,both,,1172,1172,422.84,,,,fee schedule,,,,,,,,127.57,,,,fee schedule,,,996.2,85,,percent of total billed charges,,410.01,,,,fee schedule,,254.64,,,,fee schedule,,127.57,,,,fee schedule,,455.62,,,,fee schedule,,127.57,,,,fee schedule,,410.41,,,,fee schedule,,248.73,,,,fee schedule,,248.73,,,,fee schedule,,,1066.52,91,,percent of total billed charges,,,1113.4,95,,percent of total billed charges,,,972.76,83,,percent of total billed charges,,,351.6,83,,percent of total billed charges,,127.57,,,,fee schedule,,127.57,,,,fee schedule,,,972.76,83,,percent of total billed charges,,365.64,,,,fee schedule,,,1054.8,90,,percent of total billed charges,,,1054.8,90,,percent of total billed charges,,,1054.8,90,,percent of total billed charges,,,1054.8,90,,percent of total billed charges,,,996.2,85,,percent of total billed charges,,127.57,1113.4,
REPAIR COMPLEX TRUNK EA 5.0 CM/<,13102,CDM,13102,CPT,,,both,,458,458,122.13,,,,fee schedule,,,,,,,,,,,,,,,389.3,85,,percent of total billed charges,,122.31,,,,fee schedule,,75.96,,,,fee schedule,,,,,,,,128.66,,,,fee schedule,,,,,,,,118.54,,,,fee schedule,,71.84,,,,fee schedule,,71.84,,,,fee schedule,,,416.78,91,,percent of total billed charges,,,435.1,95,,percent of total billed charges,,,380.14,83,,percent of total billed charges,,,137.4,83,,percent of total billed charges,,,,,,,,,,,,,,,380.14,83,,percent of total billed charges,,105.61,,,,fee schedule,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,389.3,85,,percent of total billed charges,,71.84,435.1,
REPAIR COMPLEX SCALP/ARM/LEG 1.1 - 2.5 CM,13120,CDM,13120,CPT,,,both,,1016,1016,396.92,,,,fee schedule,,,,,,,,114.98,,,,fee schedule,,,863.6,85,,percent of total billed charges,,385.59,,,,fee schedule,,239.47,,,,fee schedule,,114.98,,,,fee schedule,,392.62,,,,fee schedule,,114.98,,,,fee schedule,,385.25,,,,fee schedule,,233.48,,,,fee schedule,,233.48,,,,fee schedule,,,924.56,91,,percent of total billed charges,,,965.2,95,,percent of total billed charges,,,843.28,83,,percent of total billed charges,,,304.8,83,,percent of total billed charges,,114.98,,,,fee schedule,,114.98,,,,fee schedule,,,843.28,83,,percent of total billed charges,,343.22,,,,fee schedule,,,914.4,90,,percent of total billed charges,,,914.4,90,,percent of total billed charges,,,914.4,90,,percent of total billed charges,,,914.4,90,,percent of total billed charges,,,863.6,85,,percent of total billed charges,,114.98,965.2,
REPAIR COMPLEX SCALP/ARM/LEG 2.6 - 7.5 CM,13121,CDM,13121,CPT,,,both,,1288,1288,438.97,,,,fee schedule,,,,,,,,138.55,,,,fee schedule,,,1094.8,85,,percent of total billed charges,,426.2,,,,fee schedule,,264.69,,,,fee schedule,,138.55,,,,fee schedule,,490.77,,,,fee schedule,,138.55,,,,fee schedule,,426.06,,,,fee schedule,,258.22,,,,fee schedule,,258.22,,,,fee schedule,,,1172.08,91,,percent of total billed charges,,,1223.6,95,,percent of total billed charges,,,1069.04,83,,percent of total billed charges,,,386.4,83,,percent of total billed charges,,138.55,,,,fee schedule,,138.55,,,,fee schedule,,,1069.04,83,,percent of total billed charges,,379.58,,,,fee schedule,,,1159.2,90,,percent of total billed charges,,,1159.2,90,,percent of total billed charges,,,1159.2,90,,percent of total billed charges,,,1159.2,90,,percent of total billed charges,,,1094.8,85,,percent of total billed charges,,138.55,1223.6,
REPAIR COMPLEX SCALP/ARM/LEG EA 5 CM/<,13122,CDM,13122,CPT,,,both,,497,497,141.14,,,,fee schedule,,,,,,,,,,,,,,,422.45,85,,percent of total billed charges,,138.77,,,,fee schedule,,86.18,,,,fee schedule,,,,,,,,147.23,,,,fee schedule,,,,,,,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,452.27,91,,percent of total billed charges,,,472.15,95,,percent of total billed charges,,,412.51,83,,percent of total billed charges,,,149.1,83,,percent of total billed charges,,,,,,,,,,,,,,,412.51,83,,percent of total billed charges,,122.04,,,,fee schedule,,,447.3,90,,percent of total billed charges,,,447.3,90,,percent of total billed charges,,,447.3,90,,percent of total billed charges,,,447.3,90,,percent of total billed charges,,,422.45,85,,percent of total billed charges,,83.02,472.15,
REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1 - 2.5 CM,13131,CDM,13131,CPT,,,both,,1178,1178,412.47,,,,fee schedule,,,,,,,,127.85,,,,fee schedule,,,1001.3,85,,percent of total billed charges,,401.4,,,,fee schedule,,249.29,,,,fee schedule,,127.85,,,,fee schedule,,447,,,,fee schedule,,127.85,,,,fee schedule,,400.34,,,,fee schedule,,242.63,,,,fee schedule,,242.63,,,,fee schedule,,,1071.98,91,,percent of total billed charges,,,1119.1,95,,percent of total billed charges,,,977.74,83,,percent of total billed charges,,,353.4,83,,percent of total billed charges,,127.85,,,,fee schedule,,127.85,,,,fee schedule,,,977.74,83,,percent of total billed charges,,356.67,,,,fee schedule,,,1060.2,90,,percent of total billed charges,,,1060.2,90,,percent of total billed charges,,,1060.2,90,,percent of total billed charges,,,1060.2,90,,percent of total billed charges,,,1001.3,85,,percent of total billed charges,,127.85,1119.1,
REPAIR OF WOUND OR LESION,13131AS,CDM,13131,CPT,,,both,AS,689,689,412.47,,,,fee schedule,,,,,,,,127.85,,,,fee schedule,,,585.65,85,,percent of total billed charges,,401.4,,,,fee schedule,,249.29,,,,fee schedule,,127.85,,,,fee schedule,,447,,,,fee schedule,,127.85,,,,fee schedule,,400.34,,,,fee schedule,,242.63,,,,fee schedule,,242.63,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,127.85,,,,fee schedule,,127.85,,,,fee schedule,,,571.87,83,,percent of total billed charges,,356.67,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,127.85,654.55,
CMPLX RPR F/C/C/M/N/AX/G/H/F,13131P,CDM,13131,CPT,,,both,P,855,855,412.47,,,,fee schedule,,,,,,,,127.85,,,,fee schedule,,,726.75,85,,percent of total billed charges,,401.4,,,,fee schedule,,249.29,,,,fee schedule,,127.85,,,,fee schedule,,447,,,,fee schedule,,127.85,,,,fee schedule,,400.34,,,,fee schedule,,242.63,,,,fee schedule,,242.63,,,,fee schedule,,,778.05,91,,percent of total billed charges,,,812.25,95,,percent of total billed charges,,,709.65,83,,percent of total billed charges,,,256.5,83,,percent of total billed charges,,127.85,,,,fee schedule,,127.85,,,,fee schedule,,,709.65,83,,percent of total billed charges,,356.67,,,,fee schedule,,,769.5,90,,percent of total billed charges,,,769.5,90,,percent of total billed charges,,,769.5,90,,percent of total billed charges,,,769.5,90,,percent of total billed charges,,,726.75,85,,percent of total billed charges,,127.85,812.25,
CMPLX RPR F/C/C/M/N/AX/G/H/F,13131T,CDM,13131,CPT,,,both,T,323,323,412.47,,,,fee schedule,,,,,,,,127.85,,,,fee schedule,,,274.55,85,,percent of total billed charges,,401.4,,,,fee schedule,,249.29,,,,fee schedule,,127.85,,,,fee schedule,,447,,,,fee schedule,,127.85,,,,fee schedule,,400.34,,,,fee schedule,,242.63,,,,fee schedule,,242.63,,,,fee schedule,,,293.93,91,,percent of total billed charges,,,306.85,95,,percent of total billed charges,,,268.09,83,,percent of total billed charges,,,96.9,83,,percent of total billed charges,,127.85,,,,fee schedule,,127.85,,,,fee schedule,,,268.09,83,,percent of total billed charges,,356.67,,,,fee schedule,,,290.7,90,,percent of total billed charges,,,290.7,90,,percent of total billed charges,,,290.7,90,,percent of total billed charges,,,290.7,90,,percent of total billed charges,,,274.55,85,,percent of total billed charges,,96.9,447,
REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6 - 7.5 CM,13132,CDM,13132,CPT,,,both,,1615,1615,516.75,,,,fee schedule,,,,,,,,178.18,,,,fee schedule,,,1372.75,85,,percent of total billed charges,,502.54,,,,fee schedule,,312.1,,,,fee schedule,,178.18,,,,fee schedule,,693.05,,,,fee schedule,,178.18,,,,fee schedule,,501.55,,,,fee schedule,,303.97,,,,fee schedule,,303.97,,,,fee schedule,,,1469.65,91,,percent of total billed charges,,,1534.25,95,,percent of total billed charges,,,1340.45,83,,percent of total billed charges,,,484.5,83,,percent of total billed charges,,178.18,,,,fee schedule,,178.18,,,,fee schedule,,,1340.45,83,,percent of total billed charges,,446.83,,,,fee schedule,,,1453.5,90,,percent of total billed charges,,,1453.5,90,,percent of total billed charges,,,1453.5,90,,percent of total billed charges,,,1453.5,90,,percent of total billed charges,,,1372.75,85,,percent of total billed charges,,178.18,1534.25,
REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA 5 CM/<,13133,CDM,13133,CPT,,,both,,669,669,212.57,,,,fee schedule,,,,,,,,,,,,,,,568.65,85,,percent of total billed charges,,209.38,,,,fee schedule,,130.04,,,,fee schedule,,,,,,,,225.49,,,,fee schedule,,,,,,,,206.32,,,,fee schedule,,125.04,,,,fee schedule,,125.04,,,,fee schedule,,,608.79,91,,percent of total billed charges,,,635.55,95,,percent of total billed charges,,,555.27,83,,percent of total billed charges,,,200.7,83,,percent of total billed charges,,,,,,,,,,,,,,,555.27,83,,percent of total billed charges,,183.81,,,,fee schedule,,,602.1,90,,percent of total billed charges,,,602.1,90,,percent of total billed charges,,,602.1,90,,percent of total billed charges,,,602.1,90,,percent of total billed charges,,,568.65,85,,percent of total billed charges,,125.04,635.55,
Repair Complex Eyelid/Nose/Ear/Lip 1.1-2.5cm,13151,CDM,13151,CPT,,,both,,1341,1341,475.27,,,,fee schedule,,,,,,,,160.83,,,,fee schedule,,,1139.85,85,,percent of total billed charges,,463.04,,,,fee schedule,,287.57,,,,fee schedule,,160.83,,,,fee schedule,,523.93,,,,fee schedule,,160.83,,,,fee schedule,,461.29,,,,fee schedule,,279.57,,,,fee schedule,,279.57,,,,fee schedule,,,1220.31,91,,percent of total billed charges,,,1273.95,95,,percent of total billed charges,,,1113.03,83,,percent of total billed charges,,,402.3,83,,percent of total billed charges,,160.83,,,,fee schedule,,160.83,,,,fee schedule,,,1113.03,83,,percent of total billed charges,,410.97,,,,fee schedule,,,1206.9,90,,percent of total billed charges,,,1206.9,90,,percent of total billed charges,,,1206.9,90,,percent of total billed charges,,,1206.9,90,,percent of total billed charges,,,1139.85,85,,percent of total billed charges,,160.83,1273.95,
Repair Complex Eyelid/Nose/Ear/Lip 2.6 - 7.5 CM,13152,CDM,13152,CPT,,,both,,1807,1807,572.63,,,,fee schedule,,,,,,,,205.55,,,,fee schedule,,,1535.95,85,,percent of total billed charges,,557.91,,,,fee schedule,,346.49,,,,fee schedule,,205.55,,,,fee schedule,,714.94,,,,fee schedule,,205.55,,,,fee schedule,,555.78,,,,fee schedule,,336.84,,,,fee schedule,,336.84,,,,fee schedule,,,1644.37,91,,percent of total billed charges,,,1716.65,95,,percent of total billed charges,,,1499.81,83,,percent of total billed charges,,,542.1,83,,percent of total billed charges,,205.55,,,,fee schedule,,205.55,,,,fee schedule,,,1499.81,83,,percent of total billed charges,,495.15,,,,fee schedule,,,1626.3,90,,percent of total billed charges,,,1626.3,90,,percent of total billed charges,,,1626.3,90,,percent of total billed charges,,,1626.3,90,,percent of total billed charges,,,1535.95,85,,percent of total billed charges,,205.55,1716.65,
Repair Complex Eyelid/Nose/Ear/Lip EA 5 CM/<,13153,CDM,13153,CPT,,,both,,856,856,233.31,,,,fee schedule,,,,,,,,,,,,,,,727.6,85,,percent of total billed charges,,230.4,,,,fee schedule,,143.09,,,,fee schedule,,,,,,,,250.03,,,,fee schedule,,,,,,,,226.45,,,,fee schedule,,137.24,,,,fee schedule,,137.24,,,,fee schedule,,,778.96,91,,percent of total billed charges,,,813.2,95,,percent of total billed charges,,,710.48,83,,percent of total billed charges,,,256.8,83,,percent of total billed charges,,,,,,,,,,,,,,,710.48,83,,percent of total billed charges,,201.75,,,,fee schedule,,,770.4,90,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,727.6,85,,percent of total billed charges,,137.24,813.2,
LATE CLOSURE OF WOUND,13160,CDM,13160,CPT,,,both,,3281,3281,1368.2,,,,fee schedule,,,,,,,,295.88,,,,fee schedule,,,2788.85,85,,percent of total billed charges,,1348.27,,,,fee schedule,,837.33,,,,fee schedule,,295.88,,,,fee schedule,,1267.39,,,,fee schedule,,295.88,,,,fee schedule,,1327.95,,,,fee schedule,,804.82,,,,fee schedule,,804.82,,,,fee schedule,,,2985.71,91,,percent of total billed charges,,,3116.95,95,,percent of total billed charges,,,2723.23,83,,percent of total billed charges,,,984.3,83,,percent of total billed charges,,295.88,,,,fee schedule,,295.88,,,,fee schedule,,,2723.23,83,,percent of total billed charges,,1183.09,,,,fee schedule,,,2952.9,90,,percent of total billed charges,,,2952.9,90,,percent of total billed charges,,,2952.9,90,,percent of total billed charges,,,2952.9,90,,percent of total billed charges,,,2788.85,85,,percent of total billed charges,,295.88,3116.95,
LATE CLOSURE OF WOUND,13160AS,CDM,13160,CPT,,,both,AS,689,689,1368.2,,,,fee schedule,,,,,,,,295.88,,,,fee schedule,,,585.65,85,,percent of total billed charges,,1348.27,,,,fee schedule,,837.33,,,,fee schedule,,295.88,,,,fee schedule,,1267.39,,,,fee schedule,,295.88,,,,fee schedule,,1327.95,,,,fee schedule,,804.82,,,,fee schedule,,804.82,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,295.88,,,,fee schedule,,295.88,,,,fee schedule,,,571.87,83,,percent of total billed charges,,1183.09,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,1368.2,
LATE CLOSURE OF WOUND,13160AS80,CDM,13160,CPT,,,both,,689,689,1368.2,,,,fee schedule,,,,,,,,295.88,,,,fee schedule,,,585.65,85,,percent of total billed charges,,1348.27,,,,fee schedule,,837.33,,,,fee schedule,,295.88,,,,fee schedule,,1267.39,,,,fee schedule,,295.88,,,,fee schedule,,1327.95,,,,fee schedule,,804.82,,,,fee schedule,,804.82,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,295.88,,,,fee schedule,,295.88,,,,fee schedule,,,571.87,83,,percent of total billed charges,,1183.09,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,1368.2,
ATT/REARRANGEMENT SCALP/ARM/LEG 10 CM/<,14020,CDM,14020,CPT,,,both,,2496,2496,970.7,,,,fee schedule,,,,,,,,244.4,,,,fee schedule,,,2121.6,85,,percent of total billed charges,,932.47,,,,fee schedule,,579.11,,,,fee schedule,,244.4,,,,fee schedule,,911.91,,,,fee schedule,,244.4,,,,fee schedule,,942.15,,,,fee schedule,,571,,,,fee schedule,,571,,,,fee schedule,,,2271.36,91,,percent of total billed charges,,,2371.2,95,,percent of total billed charges,,,2071.68,83,,percent of total billed charges,,,748.8,83,,percent of total billed charges,,244.4,,,,fee schedule,,244.4,,,,fee schedule,,,2071.68,83,,percent of total billed charges,,839.37,,,,fee schedule,,,2246.4,90,,percent of total billed charges,,,2246.4,90,,percent of total billed charges,,,2246.4,90,,percent of total billed charges,,,2246.4,90,,percent of total billed charges,,,2121.6,85,,percent of total billed charges,,244.4,2371.2,
SKIN TISSUE REARRANGEMENT,14021,CDM,14021,CPT,,,both,,2305,2305,1213.81,,,,fee schedule,,,,,,,,328.07,,,,fee schedule,,,1959.25,85,,percent of total billed charges,,1172.59,,,,fee schedule,,728.23,,,,fee schedule,,328.07,,,,fee schedule,,1270.04,,,,fee schedule,,328.07,,,,fee schedule,,1178.11,,,,fee schedule,,714,,,,fee schedule,,714,,,,fee schedule,,,2097.55,91,,percent of total billed charges,,,2189.75,95,,percent of total billed charges,,,1913.15,83,,percent of total billed charges,,,691.5,83,,percent of total billed charges,,328.07,,,,fee schedule,,328.07,,,,fee schedule,,,1913.15,83,,percent of total billed charges,,1049.58,,,,fee schedule,,,2074.5,90,,percent of total billed charges,,,2074.5,90,,percent of total billed charges,,,2074.5,90,,percent of total billed charges,,,2074.5,90,,percent of total billed charges,,,1959.25,85,,percent of total billed charges,,328.07,2189.75,
SKIN TISSUE REARRANGEMENT,14040,CDM,14040,CPT,,,both,,2705,2705,1068.06,,,,fee schedule,,,,,,,,277.07,,,,fee schedule,,,2299.25,85,,percent of total billed charges,,1028.67,,,,fee schedule,,638.85,,,,fee schedule,,277.07,,,,fee schedule,,1041.9,,,,fee schedule,,277.07,,,,fee schedule,,1036.64,,,,fee schedule,,628.27,,,,fee schedule,,628.27,,,,fee schedule,,,2461.55,91,,percent of total billed charges,,,2569.75,95,,percent of total billed charges,,,2245.15,83,,percent of total billed charges,,,811.5,83,,percent of total billed charges,,277.07,,,,fee schedule,,277.07,,,,fee schedule,,,2245.15,83,,percent of total billed charges,,923.55,,,,fee schedule,,,2434.5,90,,percent of total billed charges,,,2434.5,90,,percent of total billed charges,,,2434.5,90,,percent of total billed charges,,,2434.5,90,,percent of total billed charges,,,2299.25,85,,percent of total billed charges,,277.07,2569.75,
SKIN TISSUE REARRANGEMENT,14041,CDM,14041,CPT,,,both,,2722,2722,1303.67,,,,fee schedule,,,,,,,,375.1,,,,fee schedule,,,2313.7,85,,percent of total billed charges,,1257.47,,,,fee schedule,,780.94,,,,fee schedule,,375.1,,,,fee schedule,,1386.1,,,,fee schedule,,375.1,,,,fee schedule,,1265.33,,,,fee schedule,,766.87,,,,fee schedule,,766.87,,,,fee schedule,,,2477.02,91,,percent of total billed charges,,,2585.9,95,,percent of total billed charges,,,2259.26,83,,percent of total billed charges,,,816.6,83,,percent of total billed charges,,375.1,,,,fee schedule,,375.1,,,,fee schedule,,,2259.26,83,,percent of total billed charges,,1127.29,,,,fee schedule,,,2449.8,90,,percent of total billed charges,,,2449.8,90,,percent of total billed charges,,,2449.8,90,,percent of total billed charges,,,2449.8,90,,percent of total billed charges,,,2313.7,85,,percent of total billed charges,,375.1,2585.9,
SKIN TISSUE REARRANGEMENT,14060,CDM,14060,CPT,,,both,,2761,2761,1138.91,,,,fee schedule,,,,,,,,299.29,,,,fee schedule,,,2346.85,85,,percent of total billed charges,,1096.22,,,,fee schedule,,680.8,,,,fee schedule,,299.29,,,,fee schedule,,1100.92,,,,fee schedule,,299.29,,,,fee schedule,,1105.42,,,,fee schedule,,669.95,,,,fee schedule,,669.95,,,,fee schedule,,,2512.51,91,,percent of total billed charges,,,2622.95,95,,percent of total billed charges,,,2291.63,83,,percent of total billed charges,,,828.3,83,,percent of total billed charges,,299.29,,,,fee schedule,,299.29,,,,fee schedule,,,2291.63,83,,percent of total billed charges,,984.83,,,,fee schedule,,,2484.9,90,,percent of total billed charges,,,2484.9,90,,percent of total billed charges,,,2484.9,90,,percent of total billed charges,,,2484.9,90,,percent of total billed charges,,,2346.85,85,,percent of total billed charges,,299.29,2622.95,
TIS TRNFR ANY 30.1-60 SQ CM,14301,CDM,14301,CPT,,,both,,4226,4226,1489.17,,,,fee schedule,,,,,,,,496.65,,,,fee schedule,,,3592.1,85,,percent of total billed charges,,1450.66,,,,fee schedule,,900.92,,,,fee schedule,,496.65,,,,fee schedule,,,,,,,,496.65,,,,fee schedule,,1445.37,,,,fee schedule,,875.98,,,,fee schedule,,875.98,,,,fee schedule,,,3845.66,91,,percent of total billed charges,,,4014.7,95,,percent of total billed charges,,,3507.58,83,,percent of total billed charges,,,1267.8,83,,percent of total billed charges,,496.65,,,,fee schedule,,496.65,,,,fee schedule,,,3507.58,83,,percent of total billed charges,,1287.7,,,,fee schedule,,,3803.4,90,,percent of total billed charges,,,3803.4,90,,percent of total billed charges,,,3803.4,90,,percent of total billed charges,,,3803.4,90,,percent of total billed charges,,,3592.1,85,,percent of total billed charges,,496.65,4014.7,
"WND PREP, CH/INF, TRK/ARM/LG",15002,CDM,15002,CPT,,,both,,1597,1597,374.45,,,,fee schedule,,,,,,,,87.85,,,,fee schedule,,,1357.45,85,,percent of total billed charges,,372.16,,,,fee schedule,,231.13,,,,fee schedule,,87.85,,,,fee schedule,,,,,,,,87.85,,,,fee schedule,,363.44,,,,fee schedule,,220.27,,,,fee schedule,,220.27,,,,fee schedule,,,1453.27,91,,percent of total billed charges,,,1517.15,95,,percent of total billed charges,,,1325.51,83,,percent of total billed charges,,,479.1,83,,percent of total billed charges,,87.85,,,,fee schedule,,87.85,,,,fee schedule,,,1325.51,83,,percent of total billed charges,,323.79,,,,fee schedule,,,1437.3,90,,percent of total billed charges,,,1437.3,90,,percent of total billed charges,,,1437.3,90,,percent of total billed charges,,,1437.3,90,,percent of total billed charges,,,1357.45,85,,percent of total billed charges,,87.85,1517.15,
"WND PREP CH/INF, F/N/HF/G",15004,CDM,15004,CPT,,,both,,1886,1886,444.16,,,,fee schedule,,,,,,,,102.63,,,,fee schedule,,,1603.1,85,,percent of total billed charges,,441.84,,,,fee schedule,,274.4,,,,fee schedule,,102.63,,,,fee schedule,,,,,,,,102.63,,,,fee schedule,,431.1,,,,fee schedule,,261.27,,,,fee schedule,,261.27,,,,fee schedule,,,1716.26,91,,percent of total billed charges,,,1791.7,95,,percent of total billed charges,,,1565.38,83,,percent of total billed charges,,,565.8,83,,percent of total billed charges,,102.63,,,,fee schedule,,102.63,,,,fee schedule,,,1565.38,83,,percent of total billed charges,,384.07,,,,fee schedule,,,1697.4,90,,percent of total billed charges,,,1697.4,90,,percent of total billed charges,,,1697.4,90,,percent of total billed charges,,,1697.4,90,,percent of total billed charges,,,1603.1,85,,percent of total billed charges,,102.63,1791.7,
PINCH GRAFT 1/MLT C > SM ULCER TIP/OTH AREA 2 CM,15050,CDM,15050,CPT,,,both,,2313,2313,796.15,,,,fee schedule,,,,,,,,131.8,,,,fee schedule,,,1966.05,85,,percent of total billed charges,,772.3,,,,fee schedule,,479.63,,,,fee schedule,,131.8,,,,fee schedule,,660.55,,,,fee schedule,,131.8,,,,fee schedule,,772.73,,,,fee schedule,,468.32,,,,fee schedule,,468.32,,,,fee schedule,,,2104.83,91,,percent of total billed charges,,,2197.35,95,,percent of total billed charges,,,1919.79,83,,percent of total billed charges,,,693.9,83,,percent of total billed charges,,131.8,,,,fee schedule,,131.8,,,,fee schedule,,,1919.79,83,,percent of total billed charges,,688.43,,,,fee schedule,,,2081.7,90,,percent of total billed charges,,,2081.7,90,,percent of total billed charges,,,2081.7,90,,percent of total billed charges,,,2081.7,90,,percent of total billed charges,,,1966.05,85,,percent of total billed charges,,131.8,2197.35,
"SKIN SPLT GRFT, TRNK/ARM/LEG",15100,CDM,15100,CPT,,,both,,3924,3924,1231.66,,,,fee schedule,,,,,,,,263.55,,,,fee schedule,,,3335.4,85,,percent of total billed charges,,1206.54,,,,fee schedule,,749.31,,,,fee schedule,,263.55,,,,fee schedule,,1201.07,,,,fee schedule,,263.55,,,,fee schedule,,1195.44,,,,fee schedule,,724.51,,,,fee schedule,,724.51,,,,fee schedule,,,3570.84,91,,percent of total billed charges,,,3727.8,95,,percent of total billed charges,,,3256.92,83,,percent of total billed charges,,,1177.2,83,,percent of total billed charges,,263.55,,,,fee schedule,,263.55,,,,fee schedule,,,3256.92,83,,percent of total billed charges,,1065.03,,,,fee schedule,,,3531.6,90,,percent of total billed charges,,,3531.6,90,,percent of total billed charges,,,3531.6,90,,percent of total billed charges,,,3531.6,90,,percent of total billed charges,,,3335.4,85,,percent of total billed charges,,263.55,3727.8,
"SKIN SPLT GRFT, TRNK/ARM/LEG",15100AS,CDM,15100,CPT,,,both,AS,689,689,1231.66,,,,fee schedule,,,,,,,,263.55,,,,fee schedule,,,585.65,85,,percent of total billed charges,,1206.54,,,,fee schedule,,749.31,,,,fee schedule,,263.55,,,,fee schedule,,1201.07,,,,fee schedule,,263.55,,,,fee schedule,,1195.44,,,,fee schedule,,724.51,,,,fee schedule,,724.51,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,263.55,,,,fee schedule,,263.55,,,,fee schedule,,,571.87,83,,percent of total billed charges,,1065.03,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,1231.66,
EPIDRM AUTOGRFT TRNK/ARM/LEG,15110,CDM,15110,CPT,,,both,,3087,3087,1226.48,,,,fee schedule,,,,,,,,71.01,,,,fee schedule,,,2623.95,85,,percent of total billed charges,,1207.3,,,,fee schedule,,749.78,,,,fee schedule,,71.01,,,,fee schedule,,,,,,,,71.01,,,,fee schedule,,1190.41,,,,fee schedule,,721.46,,,,fee schedule,,721.46,,,,fee schedule,,,2809.17,91,,percent of total billed charges,,,2932.65,95,,percent of total billed charges,,,2562.21,83,,percent of total billed charges,,,926.1,83,,percent of total billed charges,,71.01,,,,fee schedule,,71.01,,,,fee schedule,,,2562.21,83,,percent of total billed charges,,1060.54,,,,fee schedule,,,2778.3,90,,percent of total billed charges,,,2778.3,90,,percent of total billed charges,,,2778.3,90,,percent of total billed charges,,,2778.3,90,,percent of total billed charges,,,2623.95,85,,percent of total billed charges,,71.01,2932.65,
EPIDRM AUTOGRFT T/A/L ADD-ON,15111,CDM,15111,CPT,,,both,,474,474,174.55,,,,fee schedule,,,,,,,,,,,,,,,402.9,85,,percent of total billed charges,,176.11,,,,fee schedule,,109.37,,,,fee schedule,,,,,,,,,,,,,,,,,,,,169.42,,,,fee schedule,,102.68,,,,fee schedule,,102.68,,,,fee schedule,,,431.34,91,,percent of total billed charges,,,450.3,95,,percent of total billed charges,,,393.42,83,,percent of total billed charges,,,142.2,83,,percent of total billed charges,,,,,,,,,,,,,,,393.42,83,,percent of total billed charges,,150.94,,,,fee schedule,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,402.9,85,,percent of total billed charges,,102.68,450.3,
EPIDRM A-GRFT FACE/NCK/HF/G,15115,CDM,15115,CPT,,,both,,3300,3300,1183.27,,,,fee schedule,,,,,,,,,,,,,,,2805,85,,percent of total billed charges,,1167.63,,,,fee schedule,,725.15,,,,fee schedule,,,,,,,,,,,,,,,,,,,,1148.47,,,,fee schedule,,696.04,,,,fee schedule,,696.04,,,,fee schedule,,,3003,91,,percent of total billed charges,,,3135,95,,percent of total billed charges,,,2739,83,,percent of total billed charges,,,990,83,,percent of total billed charges,,,,,,,,,,,,,,,2739,83,,percent of total billed charges,,1023.18,,,,fee schedule,,,2970,90,,percent of total billed charges,,,2970,90,,percent of total billed charges,,,2970,90,,percent of total billed charges,,,2970,90,,percent of total billed charges,,,2805,85,,percent of total billed charges,,696.04,3135,
EPIDRM A-GRFT F/N/HF/G ADDL,15116,CDM,15116,CPT,,,both,,817,817,238.5,,,,fee schedule,,,,,,,,,,,,,,,694.45,85,,percent of total billed charges,,252.81,,,,fee schedule,,157,,,,fee schedule,,,,,,,,,,,,,,,,,,,,231.48,,,,fee schedule,,140.29,,,,fee schedule,,140.29,,,,fee schedule,,,743.47,91,,percent of total billed charges,,,776.15,95,,percent of total billed charges,,,678.11,83,,percent of total billed charges,,,245.1,83,,percent of total billed charges,,,,,,,,,,,,,,,678.11,83,,percent of total billed charges,,206.23,,,,fee schedule,,,735.3,90,,percent of total billed charges,,,735.3,90,,percent of total billed charges,,,735.3,90,,percent of total billed charges,,,735.3,90,,percent of total billed charges,,,694.45,85,,percent of total billed charges,,140.29,776.15,
SKN SPLT A-GRFT FAC/NCK/HF/G,15120,CDM,15120,CPT,,,both,,4542,4542,1184.43,,,,fee schedule,,,,,,,,307.9,,,,fee schedule,,,3860.7,85,,percent of total billed charges,,1158.03,,,,fee schedule,,719.18,,,,fee schedule,,307.9,,,,fee schedule,,1243.51,,,,fee schedule,,307.9,,,,fee schedule,,1149.59,,,,fee schedule,,696.72,,,,fee schedule,,696.72,,,,fee schedule,,,4133.22,91,,percent of total billed charges,,,4314.9,95,,percent of total billed charges,,,3769.86,83,,percent of total billed charges,,,1362.6,83,,percent of total billed charges,,307.9,,,,fee schedule,,307.9,,,,fee schedule,,,3769.86,83,,percent of total billed charges,,1024.18,,,,fee schedule,,,4087.8,90,,percent of total billed charges,,,4087.8,90,,percent of total billed charges,,,4087.8,90,,percent of total billed charges,,,4087.8,90,,percent of total billed charges,,,3860.7,85,,percent of total billed charges,,307.9,4314.9,
SKIN FULL GRAFT SCLP/ARM/LEG,15220,CDM,15220,CPT,,,both,,2874,2874,1045.01,,,,fee schedule,,,,,,,,307.9,,,,fee schedule,,,2442.9,85,,percent of total billed charges,,1007.68,,,,fee schedule,,625.81,,,,fee schedule,,307.9,,,,fee schedule,,1019.35,,,,fee schedule,,307.9,,,,fee schedule,,1014.28,,,,fee schedule,,614.71,,,,fee schedule,,614.71,,,,fee schedule,,,2615.34,91,,percent of total billed charges,,,2730.3,95,,percent of total billed charges,,,2385.42,83,,percent of total billed charges,,,862.2,83,,percent of total billed charges,,307.9,,,,fee schedule,,307.9,,,,fee schedule,,,2385.42,83,,percent of total billed charges,,903.63,,,,fee schedule,,,2586.6,90,,percent of total billed charges,,,2586.6,90,,percent of total billed charges,,,2586.6,90,,percent of total billed charges,,,2586.6,90,,percent of total billed charges,,,2442.9,85,,percent of total billed charges,,307.9,2730.3,
SKIN FULL GRFT FACE/GENIT/HF,15240,CDM,15240,CPT,,,both,,3716,3716,1362.43,,,,fee schedule,,,,,,,,308.96,,,,fee schedule,,,3158.6,85,,percent of total billed charges,,1311.69,,,,fee schedule,,814.62,,,,fee schedule,,308.96,,,,fee schedule,,1188.47,,,,fee schedule,,308.96,,,,fee schedule,,1322.36,,,,fee schedule,,801.43,,,,fee schedule,,801.43,,,,fee schedule,,,3381.56,91,,percent of total billed charges,,,3530.2,95,,percent of total billed charges,,,3084.28,83,,percent of total billed charges,,,1114.8,83,,percent of total billed charges,,308.96,,,,fee schedule,,308.96,,,,fee schedule,,,3084.28,83,,percent of total billed charges,,1178.11,,,,fee schedule,,,3344.4,90,,percent of total billed charges,,,3344.4,90,,percent of total billed charges,,,3344.4,90,,percent of total billed charges,,,3344.4,90,,percent of total billed charges,,,3158.6,85,,percent of total billed charges,,308.96,3530.2,
SKIN FULL GRAFT ADD-ON,15241,CDM,15241,CPT,,,both,,968,968,179.74,,,,fee schedule,,,,,,,,,,,,,,,822.8,85,,percent of total billed charges,,178.37,,,,fee schedule,,110.77,,,,fee schedule,,,,,,,,198.3,,,,fee schedule,,,,,,,,174.45,,,,fee schedule,,105.73,,,,fee schedule,,105.73,,,,fee schedule,,,880.88,91,,percent of total billed charges,,,919.6,95,,percent of total billed charges,,,803.44,83,,percent of total billed charges,,,290.4,83,,percent of total billed charges,,,,,,,,,,,,,,,803.44,83,,percent of total billed charges,,155.42,,,,fee schedule,,,871.2,90,,percent of total billed charges,,,871.2,90,,percent of total billed charges,,,871.2,90,,percent of total billed charges,,,871.2,90,,percent of total billed charges,,,822.8,85,,percent of total billed charges,,105.73,919.6,
SKIN FULL GRAFT EEN LIPS,15260,CDM,15260,CPT,,,both,,3379,3379,1446.54,,,,fee schedule,,,,,,,,332.72,,,,fee schedule,,,2872.15,85,,percent of total billed charges,,1392.08,,,,fee schedule,,864.54,,,,fee schedule,,332.72,,,,fee schedule,,1281.98,,,,fee schedule,,332.72,,,,fee schedule,,1404,,,,fee schedule,,850.91,,,,fee schedule,,850.91,,,,fee schedule,,,3074.89,91,,percent of total billed charges,,,3210.05,95,,percent of total billed charges,,,2804.57,83,,percent of total billed charges,,,1013.7,83,,percent of total billed charges,,332.72,,,,fee schedule,,332.72,,,,fee schedule,,,2804.57,83,,percent of total billed charges,,1250.83,,,,fee schedule,,,3041.1,90,,percent of total billed charges,,,3041.1,90,,percent of total billed charges,,,3041.1,90,,percent of total billed charges,,,3041.1,90,,percent of total billed charges,,,2872.15,85,,percent of total billed charges,,332.72,3210.05,
SKIN SUB GRAFT TRUNK/ARM/LEG ADULT,15271,CDM,15271,CPT,,,both,,580,580,142.29,,,,fee schedule,,,,,,,,52.87,,,,fee schedule,,,493,85,,percent of total billed charges,,142.05,,,,fee schedule,,88.22,,,,fee schedule,,52.87,,,,fee schedule,,,,,,,,52.87,,,,fee schedule,,138.11,,,,fee schedule,,83.7,,,,fee schedule,,83.7,,,,fee schedule,,,527.8,91,,percent of total billed charges,,,551,95,,percent of total billed charges,,,481.4,83,,percent of total billed charges,,,174,83,,percent of total billed charges,,52.87,,,,fee schedule,,52.87,,,,fee schedule,,,481.4,83,,percent of total billed charges,,123.04,,,,fee schedule,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,493,85,,percent of total billed charges,,52.87,551,
SKIN SUB GRAFT TRUNK/ARM/LEG CHILD,15273,CDM,15273,CPT,,,both,,1822,1822,334.13,,,,fee schedule,,,,,,,,126.08,,,,fee schedule,,,1548.7,85,,percent of total billed charges,,337.87,,,,fee schedule,,209.83,,,,fee schedule,,126.08,,,,fee schedule,,,,,,,,126.08,,,,fee schedule,,324.3,,,,fee schedule,,196.55,,,,fee schedule,,196.55,,,,fee schedule,,,1658.02,91,,percent of total billed charges,,,1730.9,95,,percent of total billed charges,,,1512.26,83,,percent of total billed charges,,,546.6,83,,percent of total billed charges,,126.08,,,,fee schedule,,126.08,,,,fee schedule,,,1512.26,83,,percent of total billed charges,,288.92,,,,fee schedule,,,1639.8,90,,percent of total billed charges,,,1639.8,90,,percent of total billed charges,,,1639.8,90,,percent of total billed charges,,,1639.8,90,,percent of total billed charges,,,1548.7,85,,percent of total billed charges,,126.08,1730.9,
APPL SKIN SUB ECH ADD 100,15274,CDM,15274,CPT,,,both,,539,539,76.62,,,,fee schedule,,,,,,,,,,,,,,,458.15,85,,percent of total billed charges,,78.24,,,,fee schedule,,48.59,,,,fee schedule,,,,,,,,,,,,,,,,,,,,74.37,,,,fee schedule,,45.07,,,,fee schedule,,45.07,,,,fee schedule,,,490.49,91,,percent of total billed charges,,,512.05,95,,percent of total billed charges,,,447.37,83,,percent of total billed charges,,,161.7,83,,percent of total billed charges,,,,,,,,,,,,,,,447.37,83,,percent of total billed charges,,66.25,,,,fee schedule,,,485.1,90,,percent of total billed charges,,,485.1,90,,percent of total billed charges,,,485.1,90,,percent of total billed charges,,,485.1,90,,percent of total billed charges,,,458.15,85,,percent of total billed charges,,45.07,512.05,
APPL SKIN SUB 1st 25 SQ CM,15275,CDM,15275,CPT,,,both,,632,632,158.42,,,,fee schedule,,,,,,,,61.61,,,,fee schedule,,,537.2,85,,percent of total billed charges,,158.33,,,,fee schedule,,98.33,,,,fee schedule,,61.61,,,,fee schedule,,,,,,,,61.61,,,,fee schedule,,153.76,,,,fee schedule,,93.19,,,,fee schedule,,93.19,,,,fee schedule,,,575.12,91,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,189.6,83,,percent of total billed charges,,61.61,,,,fee schedule,,61.61,,,,fee schedule,,,524.56,83,,percent of total billed charges,,136.99,,,,fee schedule,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,537.2,85,,percent of total billed charges,,61.61,600.4,
APPL SKIN SUB ECH ADD 25,15276,CDM,15276,CPT,,,both,,188,188,42.63,,,,fee schedule,,,,,,,,,,,,,,,159.8,85,,percent of total billed charges,,43.73,,,,fee schedule,,27.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,41.38,,,,fee schedule,,25.08,,,,fee schedule,,25.08,,,,fee schedule,,,171.08,91,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,56.4,83,,percent of total billed charges,,,,,,,,,,,,,,,156.04,83,,percent of total billed charges,,36.86,,,,fee schedule,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,25.08,178.6,
APPL SKIN SUB 1st SQ CM,15277,CDM,15277,CPT,,,both,,2441,2441,383.09,,,,fee schedule,,,,,,,,130.46,,,,fee schedule,,,2074.85,85,,percent of total billed charges,,384.79,,,,fee schedule,,238.97,,,,fee schedule,,130.46,,,,fee schedule,,,,,,,,130.46,,,,fee schedule,,371.83,,,,fee schedule,,225.35,,,,fee schedule,,225.35,,,,fee schedule,,,2221.31,91,,percent of total billed charges,,,2318.95,95,,percent of total billed charges,,,2026.03,83,,percent of total billed charges,,,732.3,83,,percent of total billed charges,,130.46,,,,fee schedule,,130.46,,,,fee schedule,,,2026.03,83,,percent of total billed charges,,331.26,,,,fee schedule,,,2196.9,90,,percent of total billed charges,,,2196.9,90,,percent of total billed charges,,,2196.9,90,,percent of total billed charges,,,2196.9,90,,percent of total billed charges,,,2074.85,85,,percent of total billed charges,,130.46,2318.95,
APPL SKIN SUB  ECH ADD 100,15278,CDM,15278,CPT,,,both,,640,640,95.05,,,,fee schedule,,,,,,,,33.62,,,,fee schedule,,,544,85,,percent of total billed charges,,97.14,,,,fee schedule,,60.33,,,,fee schedule,,33.62,,,,fee schedule,,,,,,,,33.62,,,,fee schedule,,92.26,,,,fee schedule,,55.91,,,,fee schedule,,55.91,,,,fee schedule,,,582.4,91,,percent of total billed charges,,,608,95,,percent of total billed charges,,,531.2,83,,percent of total billed charges,,,192,83,,percent of total billed charges,,33.62,,,,fee schedule,,33.62,,,,fee schedule,,,531.2,83,,percent of total billed charges,,82.19,,,,fee schedule,,,576,90,,percent of total billed charges,,,576,90,,percent of total billed charges,,,576,90,,percent of total billed charges,,,576,90,,percent of total billed charges,,,544,85,,percent of total billed charges,,33.62,608,
FORM SKIN PEDICLE FLAP,15576,CDM,15576,CPT,,,both,,3442,3442,1111.84,,,,fee schedule,,,,,,,,296.3,,,,fee schedule,,,2925.7,85,,percent of total billed charges,,1081.29,,,,fee schedule,,671.53,,,,fee schedule,,296.3,,,,fee schedule,,1089.65,,,,fee schedule,,296.3,,,,fee schedule,,1079.14,,,,fee schedule,,654.02,,,,fee schedule,,654.02,,,,fee schedule,,,3132.22,91,,percent of total billed charges,,,3269.9,95,,percent of total billed charges,,,2856.86,83,,percent of total billed charges,,,1032.6,83,,percent of total billed charges,,296.3,,,,fee schedule,,296.3,,,,fee schedule,,,2856.86,83,,percent of total billed charges,,961.41,,,,fee schedule,,,3097.8,90,,percent of total billed charges,,,3097.8,90,,percent of total billed charges,,,3097.8,90,,percent of total billed charges,,,3097.8,90,,percent of total billed charges,,,2925.7,85,,percent of total billed charges,,296.3,3269.9,
TRANSFER SKIN PEDICLE FLAP,15650,CDM,15650,CPT,,,both,,2754,2754,695.33,,,,fee schedule,,,,,,,,168.27,,,,fee schedule,,,2340.9,85,,percent of total billed charges,,632.43,,,,fee schedule,,392.76,,,,fee schedule,,168.27,,,,fee schedule,,569.69,,,,fee schedule,,168.27,,,,fee schedule,,674.88,,,,fee schedule,,409.02,,,,fee schedule,,409.02,,,,fee schedule,,,2506.14,91,,percent of total billed charges,,,2616.3,95,,percent of total billed charges,,,2285.82,83,,percent of total billed charges,,,826.2,83,,percent of total billed charges,,168.27,,,,fee schedule,,168.27,,,,fee schedule,,,2285.82,83,,percent of total billed charges,,601.26,,,,fee schedule,,,2478.6,90,,percent of total billed charges,,,2478.6,90,,percent of total billed charges,,,2478.6,90,,percent of total billed charges,,,2478.6,90,,percent of total billed charges,,,2340.9,85,,percent of total billed charges,,168.27,2616.3,
"MUSCLE-SKIN GRAFT, TRUNK",15734,CDM,15734,CPT,,,both,,6925,6925,2579.7,,,,fee schedule,,,,,,,,569.25,,,,fee schedule,,,5886.25,85,,percent of total billed charges,,2563.47,,,,fee schedule,,1592.02,,,,fee schedule,,569.25,,,,fee schedule,,2166.69,,,,fee schedule,,569.25,,,,fee schedule,,2503.82,,,,fee schedule,,1517.47,,,,fee schedule,,1517.47,,,,fee schedule,,,6301.75,91,,percent of total billed charges,,,6578.75,95,,percent of total billed charges,,,5747.75,83,,percent of total billed charges,,,2077.5,83,,percent of total billed charges,,569.25,,,,fee schedule,,569.25,,,,fee schedule,,,5747.75,83,,percent of total billed charges,,2230.68,,,,fee schedule,,,6232.5,90,,percent of total billed charges,,,6232.5,90,,percent of total billed charges,,,6232.5,90,,percent of total billed charges,,,6232.5,90,,percent of total billed charges,,,5886.25,85,,percent of total billed charges,,569.25,6578.75,
ACCELULAR DERM MATRIX IMPLANT,15777,CDM,15777,CPT,,,both,,1232,1232,366.96,,,,fee schedule,,,,,,,,130.27,,,,fee schedule,,,1047.2,85,,percent of total billed charges,,367.41,,,,fee schedule,,228.18,,,,fee schedule,,130.27,,,,fee schedule,,,,,,,,130.27,,,,fee schedule,,356.17,,,,fee schedule,,215.86,,,,fee schedule,,215.86,,,,fee schedule,,,1121.12,91,,percent of total billed charges,,,1170.4,95,,percent of total billed charges,,,1022.56,83,,percent of total billed charges,,,369.6,83,,percent of total billed charges,,130.27,,,,fee schedule,,130.27,,,,fee schedule,,,1022.56,83,,percent of total billed charges,,317.32,,,,fee schedule,,,1108.8,90,,percent of total billed charges,,,1108.8,90,,percent of total billed charges,,,1108.8,90,,percent of total billed charges,,,1108.8,90,,percent of total billed charges,,,1047.2,85,,percent of total billed charges,,130.27,1170.4,
ACCELULAR DERM MATRIX IMPLANT,15777AS,CDM,15777,CPT,,,both,AS,689,689,366.96,,,,fee schedule,,,,,,,,130.27,,,,fee schedule,,,585.65,85,,percent of total billed charges,,367.41,,,,fee schedule,,228.18,,,,fee schedule,,130.27,,,,fee schedule,,,,,,,,130.27,,,,fee schedule,,356.17,,,,fee schedule,,215.86,,,,fee schedule,,215.86,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,130.27,,,,fee schedule,,130.27,,,,fee schedule,,,571.87,83,,percent of total billed charges,,317.32,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,130.27,654.55,
"ABRASION, LESION, SINGLE",15786,CDM,15786,CPT,,,both,,958,958,230.43,,,,fee schedule,,,,,,,,,,,,,,,814.3,85,,percent of total billed charges,,221.49,,,,fee schedule,,137.55,,,,fee schedule,,,,,,,,230.8,,,,fee schedule,,,,,,,,223.66,,,,fee schedule,,135.55,,,,fee schedule,,135.55,,,,fee schedule,,,871.78,91,,percent of total billed charges,,,910.1,95,,percent of total billed charges,,,795.14,83,,percent of total billed charges,,,287.4,83,,percent of total billed charges,,,,,,,,,,,,,,,795.14,83,,percent of total billed charges,,199.26,,,,fee schedule,,,862.2,90,,percent of total billed charges,,,862.2,90,,percent of total billed charges,,,862.2,90,,percent of total billed charges,,,862.2,90,,percent of total billed charges,,,814.3,85,,percent of total billed charges,,135.55,910.1,
"ABRASION, LESIONS, ADD-ON",15787,CDM,15787,CPT,,,both,,277,277,28.23,,,,fee schedule,,,,,,,,,,,,,,,235.45,85,,percent of total billed charges,,28.61,,,,fee schedule,,17.77,,,,fee schedule,,,,,,,,35.15,,,,fee schedule,,,,,,,,27.4,,,,fee schedule,,16.6,,,,fee schedule,,16.6,,,,fee schedule,,,252.07,91,,percent of total billed charges,,,263.15,95,,percent of total billed charges,,,229.91,83,,percent of total billed charges,,,83.1,83,,percent of total billed charges,,,,,,,,,,,,,,,229.91,83,,percent of total billed charges,,24.41,,,,fee schedule,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,235.45,85,,percent of total billed charges,,16.6,263.15,
REVISION OF LOWER EYELID,15820,CDM,15820,CPT,,,both,,3850,3850,880.83,,,,fee schedule,,,,,,,,651.1,,,,fee schedule,,,3272.5,85,,percent of total billed charges,,840.34,,,,fee schedule,,521.89,,,,fee schedule,,651.1,,,,fee schedule,,736.82,,,,fee schedule,,651.1,,,,fee schedule,,854.92,,,,fee schedule,,518.14,,,,fee schedule,,518.14,,,,fee schedule,,,3503.5,91,,percent of total billed charges,,,3657.5,95,,percent of total billed charges,,,3195.5,83,,percent of total billed charges,,,1155,83,,percent of total billed charges,,651.1,,,,fee schedule,,651.1,,,,fee schedule,,,3195.5,83,,percent of total billed charges,,761.66,,,,fee schedule,,,3465,90,,percent of total billed charges,,,3465,90,,percent of total billed charges,,,3465,90,,percent of total billed charges,,,3465,90,,percent of total billed charges,,,3272.5,85,,percent of total billed charges,,518.14,3657.5,
REVISION OF LOWER EYELID,15821,CDM,15821,CPT,,,both,,5881,5881,941.32,,,,fee schedule,,,,,,,,651.1,,,,fee schedule,,,4998.85,85,,percent of total billed charges,,905.11,,,,fee schedule,,562.11,,,,fee schedule,,651.1,,,,fee schedule,,787.23,,,,fee schedule,,651.1,,,,fee schedule,,913.63,,,,fee schedule,,553.72,,,,fee schedule,,553.72,,,,fee schedule,,,5351.71,91,,percent of total billed charges,,,5586.95,95,,percent of total billed charges,,,4881.23,83,,percent of total billed charges,,,1764.3,83,,percent of total billed charges,,651.1,,,,fee schedule,,651.1,,,,fee schedule,,,4881.23,83,,percent of total billed charges,,813.96,,,,fee schedule,,,5292.9,90,,percent of total billed charges,,,5292.9,90,,percent of total billed charges,,,5292.9,90,,percent of total billed charges,,,5292.9,90,,percent of total billed charges,,,4998.85,85,,percent of total billed charges,,553.72,5586.95,
"Blepharoplasty, Skin Fat, Bilat, Lower Complex",1582101,CDM,15821,CPT,,,both,,5055,5055,941.32,,,,fee schedule,,,,,,,,651.1,,,,fee schedule,,,4296.75,85,,percent of total billed charges,,905.11,,,,fee schedule,,562.11,,,,fee schedule,,651.1,,,,fee schedule,,787.23,,,,fee schedule,,651.1,,,,fee schedule,,913.63,,,,fee schedule,,553.72,,,,fee schedule,,553.72,,,,fee schedule,,,4600.05,91,,percent of total billed charges,,,4802.25,95,,percent of total billed charges,,,4195.65,83,,percent of total billed charges,,,1516.5,83,,percent of total billed charges,,651.1,,,,fee schedule,,651.1,,,,fee schedule,,,4195.65,83,,percent of total billed charges,,813.96,,,,fee schedule,,,4549.5,90,,percent of total billed charges,,,4549.5,90,,percent of total billed charges,,,4549.5,90,,percent of total billed charges,,,4549.5,90,,percent of total billed charges,,,4296.75,85,,percent of total billed charges,,553.72,4802.25,
"Blepharoplasty, Bilat, Upper Lower",1582102,CDM,15821,CPT,,,both,,6144,6144,941.32,,,,fee schedule,,,,,,,,651.1,,,,fee schedule,,,5222.4,85,,percent of total billed charges,,905.11,,,,fee schedule,,562.11,,,,fee schedule,,651.1,,,,fee schedule,,787.23,,,,fee schedule,,651.1,,,,fee schedule,,913.63,,,,fee schedule,,553.72,,,,fee schedule,,553.72,,,,fee schedule,,,5591.04,91,,percent of total billed charges,,,5836.8,95,,percent of total billed charges,,,5099.52,83,,percent of total billed charges,,,1843.2,83,,percent of total billed charges,,651.1,,,,fee schedule,,651.1,,,,fee schedule,,,5099.52,83,,percent of total billed charges,,813.96,,,,fee schedule,,,5529.6,90,,percent of total billed charges,,,5529.6,90,,percent of total billed charges,,,5529.6,90,,percent of total billed charges,,,5529.6,90,,percent of total billed charges,,,5222.4,85,,percent of total billed charges,,553.72,5836.8,
REVISION OF UPPER EYELID,15822,CDM,15822,CPT,,,both,,1885,1885,684.96,,,,fee schedule,,,,,,,,651.1,,,,fee schedule,,,1602.25,85,,percent of total billed charges,,657.93,,,,fee schedule,,408.6,,,,fee schedule,,651.1,,,,fee schedule,,616.12,,,,fee schedule,,651.1,,,,fee schedule,,664.82,,,,fee schedule,,402.92,,,,fee schedule,,402.92,,,,fee schedule,,,1715.35,91,,percent of total billed charges,,,1790.75,95,,percent of total billed charges,,,1564.55,83,,percent of total billed charges,,,565.5,83,,percent of total billed charges,,651.1,,,,fee schedule,,651.1,,,,fee schedule,,,1564.55,83,,percent of total billed charges,,592.29,,,,fee schedule,,,1696.5,90,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1602.25,85,,percent of total billed charges,,402.92,1790.75,
"Blepharoplasty, Skin, Bilat, Upper",1582201,CDM,15822,CPT,,,both,,4784,4784,684.96,,,,fee schedule,,,,,,,,651.1,,,,fee schedule,,,4066.4,85,,percent of total billed charges,,657.93,,,,fee schedule,,408.6,,,,fee schedule,,651.1,,,,fee schedule,,616.12,,,,fee schedule,,651.1,,,,fee schedule,,664.82,,,,fee schedule,,402.92,,,,fee schedule,,402.92,,,,fee schedule,,,4353.44,91,,percent of total billed charges,,,4544.8,95,,percent of total billed charges,,,3970.72,83,,percent of total billed charges,,,1435.2,83,,percent of total billed charges,,651.1,,,,fee schedule,,651.1,,,,fee schedule,,,3970.72,83,,percent of total billed charges,,592.29,,,,fee schedule,,,4305.6,90,,percent of total billed charges,,,4305.6,90,,percent of total billed charges,,,4305.6,90,,percent of total billed charges,,,4305.6,90,,percent of total billed charges,,,4066.4,85,,percent of total billed charges,,402.92,4544.8,
"Blepharoplasty, Bilat, Upper Lower",1582202,CDM,15822,CPT,,,both,,6271,6271,684.96,,,,fee schedule,,,,,,,,651.1,,,,fee schedule,,,5330.35,85,,percent of total billed charges,,657.93,,,,fee schedule,,408.6,,,,fee schedule,,651.1,,,,fee schedule,,616.12,,,,fee schedule,,651.1,,,,fee schedule,,664.82,,,,fee schedule,,402.92,,,,fee schedule,,402.92,,,,fee schedule,,,5706.61,91,,percent of total billed charges,,,5957.45,95,,percent of total billed charges,,,5204.93,83,,percent of total billed charges,,,1881.3,83,,percent of total billed charges,,651.1,,,,fee schedule,,651.1,,,,fee schedule,,,5204.93,83,,percent of total billed charges,,592.29,,,,fee schedule,,,5643.9,90,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5643.9,90,,percent of total billed charges,,,5330.35,85,,percent of total billed charges,,402.92,5957.45,
REMOVAL OF NECK WRINKLES,15825,CDM,15825,CPT,,,both,,4780,4780,,,,,,,,,,,,,,,,,,,,4063,85,,percent of total billed charges,,2089.58,,,,fee schedule,,1297.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4349.8,91,,percent of total billed charges,,,4541,95,,percent of total billed charges,,,3967.4,83,,percent of total billed charges,,,1434,83,,percent of total billed charges,,,,,,,,,,,,,,,3967.4,83,,percent of total billed charges,,,,,,,,,4302,90,,percent of total billed charges,,,4302,90,,percent of total billed charges,,,4302,90,,percent of total billed charges,,,4302,90,,percent of total billed charges,,,4063,85,,percent of total billed charges,,1297.72,4541,
REMOVAL OF FACE WRINKLES,15828,CDM,15828,CPT,,,both,,8322,8322,,,,,,,,,,,,,,,,,,,,7073.7,85,,percent of total billed charges,,3947.37,,,,fee schedule,,2451.49,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7573.02,91,,percent of total billed charges,,,7905.9,95,,percent of total billed charges,,,6907.26,83,,percent of total billed charges,,,2496.6,83,,percent of total billed charges,,,,,,,,,,,,,,,6907.26,83,,percent of total billed charges,,,,,,,,,7489.8,90,,percent of total billed charges,,,7489.8,90,,percent of total billed charges,,,7489.8,90,,percent of total billed charges,,,7489.8,90,,percent of total billed charges,,,7073.7,85,,percent of total billed charges,,2451.49,7905.9,
REMOVAL OF SKIN WRINKLES,15829,CDM,15829,CPT,,,both,,7030,7030,,,,,,,,,,,,,,,,,,,,5975.5,85,,percent of total billed charges,,4411.45,,,,fee schedule,,2739.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6397.3,91,,percent of total billed charges,,,6678.5,95,,percent of total billed charges,,,5834.9,83,,percent of total billed charges,,,2109,83,,percent of total billed charges,,,,,,,,,,,,,,,5834.9,83,,percent of total billed charges,,,,,,,,,6327,90,,percent of total billed charges,,,6327,90,,percent of total billed charges,,,6327,90,,percent of total billed charges,,,6327,90,,percent of total billed charges,,,5975.5,85,,percent of total billed charges,,2109,6678.5,
EXC SKIN ABD,15830,CDM,15830,CPT,,,both,,3514,3514,2018.02,,,,fee schedule,,,,,,,,,,,,,,,2986.9,85,,percent of total billed charges,,1985.21,,,,fee schedule,,1232.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,1958.66,,,,fee schedule,,1187.07,,,,fee schedule,,1187.07,,,,fee schedule,,,3197.74,91,,percent of total billed charges,,,3338.3,95,,percent of total billed charges,,,2916.62,83,,percent of total billed charges,,,1054.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2916.62,83,,percent of total billed charges,,1744.99,,,,fee schedule,,,3162.6,90,,percent of total billed charges,,,3162.6,90,,percent of total billed charges,,,3162.6,90,,percent of total billed charges,,,3162.6,90,,percent of total billed charges,,,2986.9,85,,percent of total billed charges,,1054.2,3338.3,
"Abdominoplasty, Mini, SAL",1583001,CDM,15830,CPT,,,both,,3897,3897,2018.02,,,,fee schedule,,,,,,,,,,,,,,,3312.45,85,,percent of total billed charges,,1985.21,,,,fee schedule,,1232.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,1958.66,,,,fee schedule,,1187.07,,,,fee schedule,,1187.07,,,,fee schedule,,,3546.27,91,,percent of total billed charges,,,3702.15,95,,percent of total billed charges,,,3234.51,83,,percent of total billed charges,,,1169.1,83,,percent of total billed charges,,,,,,,,,,,,,,,3234.51,83,,percent of total billed charges,,1744.99,,,,fee schedule,,,3507.3,90,,percent of total billed charges,,,3507.3,90,,percent of total billed charges,,,3507.3,90,,percent of total billed charges,,,3507.3,90,,percent of total billed charges,,,3312.45,85,,percent of total billed charges,,1169.1,3702.15,
Abdominoplasty Total SAL,1583002,CDM,15830,CPT,,,both,,3616,3616,2018.02,,,,fee schedule,,,,,,,,,,,,,,,3073.6,85,,percent of total billed charges,,1985.21,,,,fee schedule,,1232.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,1958.66,,,,fee schedule,,1187.07,,,,fee schedule,,1187.07,,,,fee schedule,,,3290.56,91,,percent of total billed charges,,,3435.2,95,,percent of total billed charges,,,3001.28,83,,percent of total billed charges,,,1084.8,83,,percent of total billed charges,,,,,,,,,,,,,,,3001.28,83,,percent of total billed charges,,1744.99,,,,fee schedule,,,3254.4,90,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3254.4,90,,percent of total billed charges,,,3073.6,85,,percent of total billed charges,,1084.8,3435.2,
EXCISE EXCESSIVE SKIN TISSUE,15832,CDM,15832,CPT,,,both,,6007,6007,1589.99,,,,fee schedule,,,,,,,,340.15,,,,fee schedule,,,5105.95,85,,percent of total billed charges,,1547.67,,,,fee schedule,,961.17,,,,fee schedule,,340.15,,,,fee schedule,,1429.21,,,,fee schedule,,340.15,,,,fee schedule,,1543.22,,,,fee schedule,,935.29,,,,fee schedule,,935.29,,,,fee schedule,,,5466.37,91,,percent of total billed charges,,,5706.65,95,,percent of total billed charges,,,4985.81,83,,percent of total billed charges,,,1802.1,83,,percent of total billed charges,,340.15,,,,fee schedule,,340.15,,,,fee schedule,,,4985.81,83,,percent of total billed charges,,1374.87,,,,fee schedule,,,5406.3,90,,percent of total billed charges,,,5406.3,90,,percent of total billed charges,,,5406.3,90,,percent of total billed charges,,,5406.3,90,,percent of total billed charges,,,5105.95,85,,percent of total billed charges,,340.15,5706.65,
Thigh Lift Bilat,1583201,CDM,15832,CPT,,,both,,5663,5663,1589.99,,,,fee schedule,,,,,,,,340.15,,,,fee schedule,,,4813.55,85,,percent of total billed charges,,1547.67,,,,fee schedule,,961.17,,,,fee schedule,,340.15,,,,fee schedule,,1429.21,,,,fee schedule,,340.15,,,,fee schedule,,1543.22,,,,fee schedule,,935.29,,,,fee schedule,,935.29,,,,fee schedule,,,5153.33,91,,percent of total billed charges,,,5379.85,95,,percent of total billed charges,,,4700.29,83,,percent of total billed charges,,,1698.9,83,,percent of total billed charges,,340.15,,,,fee schedule,,340.15,,,,fee schedule,,,4700.29,83,,percent of total billed charges,,1374.87,,,,fee schedule,,,5096.7,90,,percent of total billed charges,,,5096.7,90,,percent of total billed charges,,,5096.7,90,,percent of total billed charges,,,5096.7,90,,percent of total billed charges,,,4813.55,85,,percent of total billed charges,,340.15,5379.85,
Thigh Lift Unilat,1583202,CDM,15832,CPT,,,both,,4102,4102,1589.99,,,,fee schedule,,,,,,,,340.15,,,,fee schedule,,,3486.7,85,,percent of total billed charges,,1547.67,,,,fee schedule,,961.17,,,,fee schedule,,340.15,,,,fee schedule,,1429.21,,,,fee schedule,,340.15,,,,fee schedule,,1543.22,,,,fee schedule,,935.29,,,,fee schedule,,935.29,,,,fee schedule,,,3732.82,91,,percent of total billed charges,,,3896.9,95,,percent of total billed charges,,,3404.66,83,,percent of total billed charges,,,1230.6,83,,percent of total billed charges,,340.15,,,,fee schedule,,340.15,,,,fee schedule,,,3404.66,83,,percent of total billed charges,,1374.87,,,,fee schedule,,,3691.8,90,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3486.7,85,,percent of total billed charges,,340.15,3896.9,
EXCISE EXCESSIVE SKIN TISSUE,15835,CDM,15835,CPT,,,both,,4901,4901,1604.97,,,,fee schedule,,,,,,,,319.1,,,,fee schedule,,,4165.85,85,,percent of total billed charges,,1566.12,,,,fee schedule,,972.63,,,,fee schedule,,319.1,,,,fee schedule,,1378.14,,,,fee schedule,,319.1,,,,fee schedule,,1557.76,,,,fee schedule,,944.1,,,,fee schedule,,944.1,,,,fee schedule,,,4459.91,91,,percent of total billed charges,,,4655.95,95,,percent of total billed charges,,,4067.83,83,,percent of total billed charges,,,1470.3,83,,percent of total billed charges,,319.1,,,,fee schedule,,319.1,,,,fee schedule,,,4067.83,83,,percent of total billed charges,,1387.82,,,,fee schedule,,,4410.9,90,,percent of total billed charges,,,4410.9,90,,percent of total billed charges,,,4410.9,90,,percent of total billed charges,,,4410.9,90,,percent of total billed charges,,,4165.85,85,,percent of total billed charges,,319.1,4655.95,
EXCISE EXCESSIVE SKIN TISSUE,15836,CDM,15836,CPT,,,both,,4170,4170,1375.11,,,,fee schedule,,,,,,,,265.3,,,,fee schedule,,,3544.5,85,,percent of total billed charges,,1337.5,,,,fee schedule,,830.65,,,,fee schedule,,265.3,,,,fee schedule,,1155.97,,,,fee schedule,,265.3,,,,fee schedule,,1334.66,,,,fee schedule,,808.89,,,,fee schedule,,808.89,,,,fee schedule,,,3794.7,91,,percent of total billed charges,,,3961.5,95,,percent of total billed charges,,,3461.1,83,,percent of total billed charges,,,1251,83,,percent of total billed charges,,265.3,,,,fee schedule,,265.3,,,,fee schedule,,,3461.1,83,,percent of total billed charges,,1189.06,,,,fee schedule,,,3753,90,,percent of total billed charges,,,3753,90,,percent of total billed charges,,,3753,90,,percent of total billed charges,,,3753,90,,percent of total billed charges,,,3544.5,85,,percent of total billed charges,,265.3,3961.5,
EXCISE EXCESSIVE SKIN TISSUE,15839,CDM,15839,CPT,,,both,,3974,3974,1276.02,,,,fee schedule,,,,,,,,237.8,,,,fee schedule,,,3377.9,85,,percent of total billed charges,,1247.39,,,,fee schedule,,774.68,,,,fee schedule,,237.8,,,,fee schedule,,1123.47,,,,fee schedule,,237.8,,,,fee schedule,,1238.49,,,,fee schedule,,750.6,,,,fee schedule,,750.6,,,,fee schedule,,,3616.34,91,,percent of total billed charges,,,3775.3,95,,percent of total billed charges,,,3298.42,83,,percent of total billed charges,,,1192.2,83,,percent of total billed charges,,237.8,,,,fee schedule,,237.8,,,,fee schedule,,,3298.42,83,,percent of total billed charges,,1103.38,,,,fee schedule,,,3576.6,90,,percent of total billed charges,,,3576.6,90,,percent of total billed charges,,,3576.6,90,,percent of total billed charges,,,3576.6,90,,percent of total billed charges,,,3377.9,85,,percent of total billed charges,,237.8,3775.3,
EXC SKIN ABD ADD-ON,15847,CDM,15847,CPT,,,both,,4158,4158,,,,,,,,,,,,,,,,,,,,3534.3,85,,percent of total billed charges,,812.49,,,,fee schedule,,504.59,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3783.78,91,,percent of total billed charges,,,3950.1,95,,percent of total billed charges,,,3451.14,83,,percent of total billed charges,,,1247.4,83,,percent of total billed charges,,,,,,,,,,,,,,,3451.14,83,,percent of total billed charges,,,,,,,,,3742.2,90,,percent of total billed charges,,,3742.2,90,,percent of total billed charges,,,3742.2,90,,percent of total billed charges,,,3742.2,90,,percent of total billed charges,,,3534.3,85,,percent of total billed charges,,504.59,3950.1,
Abdominoplasty Total SAL,1584702,CDM,15847,CPT,,,both,,5515,5515,,,,,,,,,,,,,,,,,,,,4687.75,85,,percent of total billed charges,,812.49,,,,fee schedule,,504.59,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5018.65,91,,percent of total billed charges,,,5239.25,95,,percent of total billed charges,,,4577.45,83,,percent of total billed charges,,,1654.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4577.45,83,,percent of total billed charges,,,,,,,,,4963.5,90,,percent of total billed charges,,,4963.5,90,,percent of total billed charges,,,4963.5,90,,percent of total billed charges,,,4963.5,90,,percent of total billed charges,,,4687.75,85,,percent of total billed charges,,504.59,5239.25,
SUCTION ASSISTED LIPECTOMY,15876,CDM,15876,CPT,,,both,,2720,2720,,,,,,,,,,,,,,,,,,,,2312,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2475.2,91,,percent of total billed charges,,,2584,95,,percent of total billed charges,,,2257.6,83,,percent of total billed charges,,,816,83,,percent of total billed charges,,,,,,,,,,,,,,,2257.6,83,,percent of total billed charges,,,,,,,,,2448,90,,percent of total billed charges,,,2448,90,,percent of total billed charges,,,2448,90,,percent of total billed charges,,,2448,90,,percent of total billed charges,,,2312,85,,percent of total billed charges,,816,2584,
SUCTION ASSISTED LIPECTOMY,15877,CDM,15877,CPT,,,both,,3732,3732,,,,,,,,,,,,,,,,,,,,3172.2,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3396.12,91,,percent of total billed charges,,,3545.4,95,,percent of total billed charges,,,3097.56,83,,percent of total billed charges,,,1119.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3097.56,83,,percent of total billed charges,,,,,,,,,3358.8,90,,percent of total billed charges,,,3358.8,90,,percent of total billed charges,,,3358.8,90,,percent of total billed charges,,,3358.8,90,,percent of total billed charges,,,3172.2,85,,percent of total billed charges,,1119.6,3545.4,
Abdominoplasty Total SAL,1587702,CDM,15877,CPT,,,both,,5515,5515,,,,,,,,,,,,,,,,,,,,4687.75,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5018.65,91,,percent of total billed charges,,,5239.25,95,,percent of total billed charges,,,4577.45,83,,percent of total billed charges,,,1654.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4577.45,83,,percent of total billed charges,,,,,,,,,4963.5,90,,percent of total billed charges,,,4963.5,90,,percent of total billed charges,,,4963.5,90,,percent of total billed charges,,,4963.5,90,,percent of total billed charges,,,4687.75,85,,percent of total billed charges,,1654.5,5239.25,
SUCTION ASSISTED LIPECTOMY UPPER EXTREMITY,15878,CDM,15878,CPT,,,both,,2564,2564,,,,,,,,,,,,,,,,,,,,2179.4,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2333.24,91,,percent of total billed charges,,,2435.8,95,,percent of total billed charges,,,2128.12,83,,percent of total billed charges,,,769.2,83,,percent of total billed charges,,,,,,,,,,,,,,,2128.12,83,,percent of total billed charges,,,,,,,,,2307.6,90,,percent of total billed charges,,,2307.6,90,,percent of total billed charges,,,2307.6,90,,percent of total billed charges,,,2307.6,90,,percent of total billed charges,,,2179.4,85,,percent of total billed charges,,769.2,2435.8,
SUCTION ASSISTED LIPECTOMY LOWER EXTREMITY,15879,CDM,15879,CPT,,,both,,3795,3795,,,,,,,,,,,,,,,,,,,,3225.75,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3453.45,91,,percent of total billed charges,,,3605.25,95,,percent of total billed charges,,,3149.85,83,,percent of total billed charges,,,1138.5,83,,percent of total billed charges,,,,,,,,,,,,,,,3149.85,83,,percent of total billed charges,,,,,,,,,3415.5,90,,percent of total billed charges,,,3415.5,90,,percent of total billed charges,,,3415.5,90,,percent of total billed charges,,,3415.5,90,,percent of total billed charges,,,3225.75,85,,percent of total billed charges,,1138.5,3605.25,
REMOVAL OF TAIL BONE ULCER,15920,CDM,15920,CPT,,,both,,1854,1854,1108.38,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,1575.9,85,,percent of total billed charges,,1085.97,,,,fee schedule,,674.43,,,,fee schedule,,374.55,,,,fee schedule,,962.98,,,,fee schedule,,374.55,,,,fee schedule,,1075.78,,,,fee schedule,,651.99,,,,fee schedule,,651.99,,,,fee schedule,,,1687.14,91,,percent of total billed charges,,,1761.3,95,,percent of total billed charges,,,1538.82,83,,percent of total billed charges,,,556.2,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,1538.82,83,,percent of total billed charges,,958.42,,,,fee schedule,,,1668.6,90,,percent of total billed charges,,,1668.6,90,,percent of total billed charges,,,1668.6,90,,percent of total billed charges,,,1668.6,90,,percent of total billed charges,,,1575.9,85,,percent of total billed charges,,374.55,1761.3,
REMOVE HIP PRESSURE SORE,15940,CDM,15940,CPT,,,both,,2250,2250,1224.75,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,1912.5,85,,percent of total billed charges,,1197.12,,,,fee schedule,,743.46,,,,fee schedule,,449.5,,,,fee schedule,,1113.52,,,,fee schedule,,449.5,,,,fee schedule,,1188.73,,,,fee schedule,,720.44,,,,fee schedule,,720.44,,,,fee schedule,,,2047.5,91,,percent of total billed charges,,,2137.5,95,,percent of total billed charges,,,1867.5,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,1867.5,83,,percent of total billed charges,,1059.05,,,,fee schedule,,,2025,90,,percent of total billed charges,,,2025,90,,percent of total billed charges,,,2025,90,,percent of total billed charges,,,2025,90,,percent of total billed charges,,,1912.5,85,,percent of total billed charges,,449.5,2137.5,
EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY,15950,CDM,15950,CPT,,,both,,2080,2080,1100.89,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,1768,85,,percent of total billed charges,,1067.85,,,,fee schedule,,663.18,,,,fee schedule,,449.5,,,,fee schedule,,925.17,,,,fee schedule,,449.5,,,,fee schedule,,1068.51,,,,fee schedule,,647.58,,,,fee schedule,,647.58,,,,fee schedule,,,1892.8,91,,percent of total billed charges,,,1976,95,,percent of total billed charges,,,1726.4,83,,percent of total billed charges,,,624,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,1726.4,83,,percent of total billed charges,,951.95,,,,fee schedule,,,1872,90,,percent of total billed charges,,,1872,90,,percent of total billed charges,,,1872,90,,percent of total billed charges,,,1872,90,,percent of total billed charges,,,1768,85,,percent of total billed charges,,449.5,1976,
INITIAL TREATMENT OF BURN(S),16000,CDM,16000,CPT,,,both,,248,248,78.35,,,,fee schedule,,,,,,,,45.8,,,,fee schedule,,,210.8,85,,percent of total billed charges,,76.69,,,,fee schedule,,47.63,,,,fee schedule,,45.8,,,,fee schedule,,81.57,,,,fee schedule,,45.8,,,,fee schedule,,76.04,,,,fee schedule,,46.09,,,,fee schedule,,46.09,,,,fee schedule,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,74.4,83,,percent of total billed charges,,45.8,,,,fee schedule,,45.8,,,,fee schedule,,,205.84,83,,percent of total billed charges,,67.75,,,,fee schedule,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,45.8,235.6,
"DRESS/DEBRID P-THICK BURN, S",16020,CDM,16020,CPT,,,both,,288,288,95.05,,,,fee schedule,,,,,,,,24.9,,,,fee schedule,,,244.8,85,,percent of total billed charges,,90.51,,,,fee schedule,,56.21,,,,fee schedule,,24.9,,,,fee schedule,,96.83,,,,fee schedule,,24.9,,,,fee schedule,,92.26,,,,fee schedule,,55.91,,,,fee schedule,,55.91,,,,fee schedule,,,262.08,91,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,86.4,83,,percent of total billed charges,,24.9,,,,fee schedule,,24.9,,,,fee schedule,,,239.04,83,,percent of total billed charges,,82.19,,,,fee schedule,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,244.8,85,,percent of total billed charges,,24.9,273.6,
"DRESS/DEBRID P-THICK BURN, M",16025,CDM,16025,CPT,,,both,,492,492,188.96,,,,fee schedule,,,,,,,,49.5,,,,fee schedule,,,418.2,85,,percent of total billed charges,,187.17,,,,fee schedule,,116.24,,,,fee schedule,,49.5,,,,fee schedule,,198.96,,,,fee schedule,,49.5,,,,fee schedule,,183.4,,,,fee schedule,,111.15,,,,fee schedule,,111.15,,,,fee schedule,,,447.72,91,,percent of total billed charges,,,467.4,95,,percent of total billed charges,,,408.36,83,,percent of total billed charges,,,147.6,83,,percent of total billed charges,,49.5,,,,fee schedule,,49.5,,,,fee schedule,,,408.36,83,,percent of total billed charges,,163.39,,,,fee schedule,,,442.8,90,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,442.8,90,,percent of total billed charges,,,418.2,85,,percent of total billed charges,,49.5,467.4,
"DRESS/DEBRID P-THICK BURN, L",16030,CDM,16030,CPT,,,both,,715,715,225.25,,,,fee schedule,,,,,,,,61.65,,,,fee schedule,,,607.75,85,,percent of total billed charges,,222.73,,,,fee schedule,,138.32,,,,fee schedule,,61.65,,,,fee schedule,,228.14,,,,fee schedule,,61.65,,,,fee schedule,,218.62,,,,fee schedule,,132.5,,,,fee schedule,,132.5,,,,fee schedule,,,650.65,91,,percent of total billed charges,,,679.25,95,,percent of total billed charges,,,593.45,83,,percent of total billed charges,,,214.5,83,,percent of total billed charges,,61.65,,,,fee schedule,,61.65,,,,fee schedule,,,593.45,83,,percent of total billed charges,,194.77,,,,fee schedule,,,643.5,90,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,607.75,85,,percent of total billed charges,,61.65,679.25,
DESTRUCTION PREMALIGNANT LESION 1ST,17000,CDM,17000,CPT,,,both,,229,229,93.9,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,194.65,85,,percent of total billed charges,,89.9,,,,fee schedule,,55.83,,,,fee schedule,,52.7,,,,fee schedule,,77.6,,,,fee schedule,,52.7,,,,fee schedule,,91.14,,,,fee schedule,,55.24,,,,fee schedule,,55.24,,,,fee schedule,,,208.39,91,,percent of total billed charges,,,217.55,95,,percent of total billed charges,,,190.07,83,,percent of total billed charges,,,68.7,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,190.07,83,,percent of total billed charges,,81.2,,,,fee schedule,,,206.1,90,,percent of total billed charges,,,206.1,90,,percent of total billed charges,,,206.1,90,,percent of total billed charges,,,206.1,90,,percent of total billed charges,,,194.65,85,,percent of total billed charges,,52.7,217.55,
DESTROY BENIGN/PREMLG LESION,17000P,CDM,17000,CPT,,,both,P,160,160,93.9,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,136,85,,percent of total billed charges,,89.9,,,,fee schedule,,55.83,,,,fee schedule,,52.7,,,,fee schedule,,77.6,,,,fee schedule,,52.7,,,,fee schedule,,91.14,,,,fee schedule,,55.24,,,,fee schedule,,55.24,,,,fee schedule,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,48,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,132.8,83,,percent of total billed charges,,81.2,,,,fee schedule,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,48,152,
DESTROY BENIGN/PREMLG LESION,17000T,CDM,17000,CPT,,,both,T,69,69,93.9,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,58.65,85,,percent of total billed charges,,89.9,,,,fee schedule,,55.83,,,,fee schedule,,52.7,,,,fee schedule,,77.6,,,,fee schedule,,52.7,,,,fee schedule,,91.14,,,,fee schedule,,55.24,,,,fee schedule,,55.24,,,,fee schedule,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,20.7,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,57.27,83,,percent of total billed charges,,81.2,,,,fee schedule,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,20.7,93.9,
DESTRUCTION PREMALIGNANT LESION 2-14 EA,17003,CDM,17003,CPT,,,both,,63,63,3.46,,,,fee schedule,,,,,,,,115.05,,,,fee schedule,,,53.55,85,,percent of total billed charges,,3.4,,,,fee schedule,,2.11,,,,fee schedule,,115.05,,,,fee schedule,,15.25,,,,fee schedule,,115.05,,,,fee schedule,,3.35,,,,fee schedule,,2.03,,,,fee schedule,,2.03,,,,fee schedule,,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,18.9,83,,percent of total billed charges,,115.05,,,,fee schedule,,115.05,,,,fee schedule,,,52.29,83,,percent of total billed charges,,2.99,,,,fee schedule,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,2.03,115.05,
"DESTROY LESIONS, 2-14",17003P,CDM,17003,CPT,,,both,P,59,59,3.46,,,,fee schedule,,,,,,,,115.05,,,,fee schedule,,,50.15,85,,percent of total billed charges,,3.4,,,,fee schedule,,2.11,,,,fee schedule,,115.05,,,,fee schedule,,15.25,,,,fee schedule,,115.05,,,,fee schedule,,3.35,,,,fee schedule,,2.03,,,,fee schedule,,2.03,,,,fee schedule,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,17.7,83,,percent of total billed charges,,115.05,,,,fee schedule,,115.05,,,,fee schedule,,,48.97,83,,percent of total billed charges,,2.99,,,,fee schedule,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,2.03,115.05,
"DESTROY LESIONS, 2-14",17003T,CDM,17003,CPT,,,both,T,4,4,3.46,,,,fee schedule,,,,,,,,115.05,,,,fee schedule,,,3.4,85,,percent of total billed charges,,3.4,,,,fee schedule,,2.11,,,,fee schedule,,115.05,,,,fee schedule,,15.25,,,,fee schedule,,115.05,,,,fee schedule,,3.35,,,,fee schedule,,2.03,,,,fee schedule,,2.03,,,,fee schedule,,,3.64,91,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,1.2,83,,percent of total billed charges,,115.05,,,,fee schedule,,115.05,,,,fee schedule,,,3.32,83,,percent of total billed charges,,2.99,,,,fee schedule,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,1.2,115.05,
"DESTROY LESIONS, 15 OR MORE",17004,CDM,17004,CPT,,,both,,565,565,169.94,,,,fee schedule,,,,,,,,86.59,,,,fee schedule,,,480.25,85,,percent of total billed charges,,160.03,,,,fee schedule,,99.38,,,,fee schedule,,86.59,,,,fee schedule,,299.11,,,,fee schedule,,86.59,,,,fee schedule,,164.95,,,,fee schedule,,99.97,,,,fee schedule,,99.97,,,,fee schedule,,,514.15,91,,percent of total billed charges,,,536.75,95,,percent of total billed charges,,,468.95,83,,percent of total billed charges,,,169.5,83,,percent of total billed charges,,86.59,,,,fee schedule,,86.59,,,,fee schedule,,,468.95,83,,percent of total billed charges,,146.95,,,,fee schedule,,,508.5,90,,percent of total billed charges,,,508.5,90,,percent of total billed charges,,,508.5,90,,percent of total billed charges,,,508.5,90,,percent of total billed charges,,,480.25,85,,percent of total billed charges,,86.59,536.75,
"DESTROY LESIONS, 15 OR MORE",17004P,CDM,17004,CPT,,,both,P,398,398,169.94,,,,fee schedule,,,,,,,,86.59,,,,fee schedule,,,338.3,85,,percent of total billed charges,,160.03,,,,fee schedule,,99.38,,,,fee schedule,,86.59,,,,fee schedule,,299.11,,,,fee schedule,,86.59,,,,fee schedule,,164.95,,,,fee schedule,,99.97,,,,fee schedule,,99.97,,,,fee schedule,,,362.18,91,,percent of total billed charges,,,378.1,95,,percent of total billed charges,,,330.34,83,,percent of total billed charges,,,119.4,83,,percent of total billed charges,,86.59,,,,fee schedule,,86.59,,,,fee schedule,,,330.34,83,,percent of total billed charges,,146.95,,,,fee schedule,,,358.2,90,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,358.2,90,,percent of total billed charges,,,338.3,85,,percent of total billed charges,,86.59,378.1,
"DESTROY LESIONS, 15 OR MORE",17004T,CDM,17004,CPT,,,both,T,167,167,169.94,,,,fee schedule,,,,,,,,86.59,,,,fee schedule,,,141.95,85,,percent of total billed charges,,160.03,,,,fee schedule,,99.38,,,,fee schedule,,86.59,,,,fee schedule,,299.11,,,,fee schedule,,86.59,,,,fee schedule,,164.95,,,,fee schedule,,99.97,,,,fee schedule,,99.97,,,,fee schedule,,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,50.1,83,,percent of total billed charges,,86.59,,,,fee schedule,,86.59,,,,fee schedule,,,138.61,83,,percent of total billed charges,,146.95,,,,fee schedule,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,50.1,299.11,
DESTRUCTION OF SKIN LESIONS,17106,CDM,17106,CPT,,,both,,1404,1404,472.96,,,,fee schedule,,,,,,,,125.35,,,,fee schedule,,,1193.4,85,,percent of total billed charges,,452.49,,,,fee schedule,,281.02,,,,fee schedule,,125.35,,,,fee schedule,,547.81,,,,fee schedule,,125.35,,,,fee schedule,,459.05,,,,fee schedule,,278.21,,,,fee schedule,,278.21,,,,fee schedule,,,1277.64,91,,percent of total billed charges,,,1333.8,95,,percent of total billed charges,,,1165.32,83,,percent of total billed charges,,,421.2,83,,percent of total billed charges,,125.35,,,,fee schedule,,125.35,,,,fee schedule,,,1165.32,83,,percent of total billed charges,,408.97,,,,fee schedule,,,1263.6,90,,percent of total billed charges,,,1263.6,90,,percent of total billed charges,,,1263.6,90,,percent of total billed charges,,,1263.6,90,,percent of total billed charges,,,1193.4,85,,percent of total billed charges,,125.35,1333.8,
DESTRUCTION BENIGN LESIONS UP TO 14,17110,CDM,17110,CPT,,,both,,315,315,115.22,,,,fee schedule,,,,,,,,74.9,,,,fee schedule,,,267.75,85,,percent of total billed charges,,108.61,,,,fee schedule,,67.45,,,,fee schedule,,74.9,,,,fee schedule,,92.85,,,,fee schedule,,74.9,,,,fee schedule,,111.83,,,,fee schedule,,67.77,,,,fee schedule,,67.77,,,,fee schedule,,,286.65,91,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,94.5,83,,percent of total billed charges,,74.9,,,,fee schedule,,74.9,,,,fee schedule,,,261.45,83,,percent of total billed charges,,99.63,,,,fee schedule,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,67.45,299.25,
"DESTRUCT LESION, 1-14",17110P,CDM,17110,CPT,,,both,P,155,155,115.22,,,,fee schedule,,,,,,,,74.9,,,,fee schedule,,,131.75,85,,percent of total billed charges,,108.61,,,,fee schedule,,67.45,,,,fee schedule,,74.9,,,,fee schedule,,92.85,,,,fee schedule,,74.9,,,,fee schedule,,111.83,,,,fee schedule,,67.77,,,,fee schedule,,67.77,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,74.9,,,,fee schedule,,74.9,,,,fee schedule,,,128.65,83,,percent of total billed charges,,99.63,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,46.5,147.25,
"DESTRUCT LESION, 1-14",17110T,CDM,17110,CPT,,,both,T,160,160,115.22,,,,fee schedule,,,,,,,,74.9,,,,fee schedule,,,136,85,,percent of total billed charges,,108.61,,,,fee schedule,,67.45,,,,fee schedule,,74.9,,,,fee schedule,,92.85,,,,fee schedule,,74.9,,,,fee schedule,,111.83,,,,fee schedule,,67.77,,,,fee schedule,,67.77,,,,fee schedule,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,48,83,,percent of total billed charges,,74.9,,,,fee schedule,,74.9,,,,fee schedule,,,132.8,83,,percent of total billed charges,,99.63,,,,fee schedule,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,48,152,
"DESTRUCT LESION, 15 OR MORE",17111,CDM,17111,CPT,,,both,,438,438,141.14,,,,fee schedule,,,,,,,,43.05,,,,fee schedule,,,372.3,85,,percent of total billed charges,,133.19,,,,fee schedule,,82.71,,,,fee schedule,,43.05,,,,fee schedule,,118.05,,,,fee schedule,,43.05,,,,fee schedule,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,131.4,83,,percent of total billed charges,,43.05,,,,fee schedule,,43.05,,,,fee schedule,,,363.54,83,,percent of total billed charges,,122.04,,,,fee schedule,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,43.05,416.1,
"DESTRUCT LESION, 15 OR MORE",17111P,CDM,17111,CPT,,,both,P,275,275,141.14,,,,fee schedule,,,,,,,,43.05,,,,fee schedule,,,233.75,85,,percent of total billed charges,,133.19,,,,fee schedule,,82.71,,,,fee schedule,,43.05,,,,fee schedule,,118.05,,,,fee schedule,,43.05,,,,fee schedule,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,250.25,91,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,82.5,83,,percent of total billed charges,,43.05,,,,fee schedule,,43.05,,,,fee schedule,,,228.25,83,,percent of total billed charges,,122.04,,,,fee schedule,,,247.5,90,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,233.75,85,,percent of total billed charges,,43.05,261.25,
"DESTRUCT LESION, 15 OR MORE",17111T,CDM,17111,CPT,,,both,T,163,163,141.14,,,,fee schedule,,,,,,,,43.05,,,,fee schedule,,,138.55,85,,percent of total billed charges,,133.19,,,,fee schedule,,82.71,,,,fee schedule,,43.05,,,,fee schedule,,118.05,,,,fee schedule,,43.05,,,,fee schedule,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,48.9,83,,percent of total billed charges,,43.05,,,,fee schedule,,43.05,,,,fee schedule,,,135.29,83,,percent of total billed charges,,122.04,,,,fee schedule,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,43.05,154.85,
"CHEMICAL CAUTERY, TISSUE",17250,CDM,17250,CPT,,,both,,220,220,63.95,,,,fee schedule,,,,,,,,18.9,,,,fee schedule,,,187,85,,percent of total billed charges,,62.51,,,,fee schedule,,38.82,,,,fee schedule,,18.9,,,,fee schedule,,59.03,,,,fee schedule,,18.9,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,200.2,91,,percent of total billed charges,,,209,95,,percent of total billed charges,,,182.6,83,,percent of total billed charges,,,66,83,,percent of total billed charges,,18.9,,,,fee schedule,,18.9,,,,fee schedule,,,182.6,83,,percent of total billed charges,,55.29,,,,fee schedule,,,198,90,,percent of total billed charges,,,198,90,,percent of total billed charges,,,198,90,,percent of total billed charges,,,198,90,,percent of total billed charges,,,187,85,,percent of total billed charges,,18.9,209,
"CHEMICAL CAUTERY, TISSUE",17250P,CDM,17250,CPT,,,both,P,90,90,63.95,,,,fee schedule,,,,,,,,18.9,,,,fee schedule,,,76.5,85,,percent of total billed charges,,62.51,,,,fee schedule,,38.82,,,,fee schedule,,18.9,,,,fee schedule,,59.03,,,,fee schedule,,18.9,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,18.9,,,,fee schedule,,18.9,,,,fee schedule,,,74.7,83,,percent of total billed charges,,55.29,,,,fee schedule,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,18.9,85.5,
"CHEMICAL CAUTERY, TISSUE",17250T,CDM,17250,CPT,,,both,T,130,130,63.95,,,,fee schedule,,,,,,,,18.9,,,,fee schedule,,,110.5,85,,percent of total billed charges,,62.51,,,,fee schedule,,38.82,,,,fee schedule,,18.9,,,,fee schedule,,59.03,,,,fee schedule,,18.9,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,39,83,,percent of total billed charges,,18.9,,,,fee schedule,,18.9,,,,fee schedule,,,107.9,83,,percent of total billed charges,,55.29,,,,fee schedule,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,18.9,123.5,
DESTRUCTION OF SKIN LESIONS,17260,CDM,17260,CPT,,,both,,314,314,120.98,,,,fee schedule,,,,,,,,40.6,,,,fee schedule,,,266.9,85,,percent of total billed charges,,115.95,,,,fee schedule,,72.01,,,,fee schedule,,40.6,,,,fee schedule,,107.44,,,,fee schedule,,40.6,,,,fee schedule,,117.42,,,,fee schedule,,71.16,,,,fee schedule,,71.16,,,,fee schedule,,,285.74,91,,percent of total billed charges,,,298.3,95,,percent of total billed charges,,,260.62,83,,percent of total billed charges,,,94.2,83,,percent of total billed charges,,40.6,,,,fee schedule,,40.6,,,,fee schedule,,,260.62,83,,percent of total billed charges,,104.61,,,,fee schedule,,,282.6,90,,percent of total billed charges,,,282.6,90,,percent of total billed charges,,,282.6,90,,percent of total billed charges,,,282.6,90,,percent of total billed charges,,,266.9,85,,percent of total billed charges,,40.6,298.3,
DESTRUCTION OF SKIN LESIONS,17280,CDM,17280,CPT,,,both,,411,411,147.48,,,,fee schedule,,,,,,,,96.2,,,,fee schedule,,,349.35,85,,percent of total billed charges,,141.01,,,,fee schedule,,87.57,,,,fee schedule,,96.2,,,,fee schedule,,134.63,,,,fee schedule,,96.2,,,,fee schedule,,143.14,,,,fee schedule,,86.75,,,,fee schedule,,86.75,,,,fee schedule,,,374.01,91,,percent of total billed charges,,,390.45,95,,percent of total billed charges,,,341.13,83,,percent of total billed charges,,,123.3,83,,percent of total billed charges,,96.2,,,,fee schedule,,96.2,,,,fee schedule,,,341.13,83,,percent of total billed charges,,127.52,,,,fee schedule,,,369.9,90,,percent of total billed charges,,,369.9,90,,percent of total billed charges,,,369.9,90,,percent of total billed charges,,,369.9,90,,percent of total billed charges,,,349.35,85,,percent of total billed charges,,86.75,390.45,
DESTRUCTION OF SKIN LESIONS,17280P,CDM,17280,CPT,,,both,P,249,249,147.48,,,,fee schedule,,,,,,,,96.2,,,,fee schedule,,,211.65,85,,percent of total billed charges,,141.01,,,,fee schedule,,87.57,,,,fee schedule,,96.2,,,,fee schedule,,134.63,,,,fee schedule,,96.2,,,,fee schedule,,143.14,,,,fee schedule,,86.75,,,,fee schedule,,86.75,,,,fee schedule,,,226.59,91,,percent of total billed charges,,,236.55,95,,percent of total billed charges,,,206.67,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,96.2,,,,fee schedule,,96.2,,,,fee schedule,,,206.67,83,,percent of total billed charges,,127.52,,,,fee schedule,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,211.65,85,,percent of total billed charges,,74.7,236.55,
DESTRUCTION OF SKIN LESIONS,17280T,CDM,17280,CPT,,,both,T,162,162,147.48,,,,fee schedule,,,,,,,,96.2,,,,fee schedule,,,137.7,85,,percent of total billed charges,,141.01,,,,fee schedule,,87.57,,,,fee schedule,,96.2,,,,fee schedule,,134.63,,,,fee schedule,,96.2,,,,fee schedule,,143.14,,,,fee schedule,,86.75,,,,fee schedule,,86.75,,,,fee schedule,,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,48.6,83,,percent of total billed charges,,96.2,,,,fee schedule,,96.2,,,,fee schedule,,,134.46,83,,percent of total billed charges,,127.52,,,,fee schedule,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,48.6,153.9,
CRYOTHERAPY CO2 SLUSH LIQ N2 ACNE,17340,CDM,17340,CPT,,,both,,164,164,84.68,,,,fee schedule,,,,,,,,26.2,,,,fee schedule,,,139.4,85,,percent of total billed charges,,81.99,,,,fee schedule,,50.92,,,,fee schedule,,26.2,,,,fee schedule,,77.6,,,,fee schedule,,26.2,,,,fee schedule,,82.19,,,,fee schedule,,49.81,,,,fee schedule,,49.81,,,,fee schedule,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,49.2,83,,percent of total billed charges,,26.2,,,,fee schedule,,26.2,,,,fee schedule,,,136.12,83,,percent of total billed charges,,73.23,,,,fee schedule,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,26.2,155.8,
DRAINAGE OF BREAST LESION,19000,CDM,19000,CPT,,,both,,352,352,72.59,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,299.2,85,,percent of total billed charges,,72.4,,,,fee schedule,,44.96,,,,fee schedule,,37.4,,,,fee schedule,,81.57,,,,fee schedule,,37.4,,,,fee schedule,,70.45,,,,fee schedule,,42.7,,,,fee schedule,,42.7,,,,fee schedule,,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,105.6,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,292.16,83,,percent of total billed charges,,62.77,,,,fee schedule,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,37.4,334.4,
INCISION OF BREAST LESION,19020,CDM,19020,CPT,,,both,,1589,1589,542.67,,,,fee schedule,,,,,,,,135.9,,,,fee schedule,,,1350.65,85,,percent of total billed charges,,529.03,,,,fee schedule,,328.55,,,,fee schedule,,135.9,,,,fee schedule,,442.36,,,,fee schedule,,135.9,,,,fee schedule,,526.71,,,,fee schedule,,319.22,,,,fee schedule,,319.22,,,,fee schedule,,,1445.99,91,,percent of total billed charges,,,1509.55,95,,percent of total billed charges,,,1318.87,83,,percent of total billed charges,,,476.7,83,,percent of total billed charges,,135.9,,,,fee schedule,,135.9,,,,fee schedule,,,1318.87,83,,percent of total billed charges,,469.25,,,,fee schedule,,,1430.1,90,,percent of total billed charges,,,1430.1,90,,percent of total billed charges,,,1430.1,90,,percent of total billed charges,,,1430.1,90,,percent of total billed charges,,,1350.65,85,,percent of total billed charges,,135.9,1509.55,
BX BREAST PERCUT W/O IMAGE,19100,CDM,19100,CPT,,,both,,459,459,118.1,,,,fee schedule,,,,,,,,59.6,,,,fee schedule,,,390.15,85,,percent of total billed charges,,121.01,,,,fee schedule,,75.15,,,,fee schedule,,59.6,,,,fee schedule,,122.69,,,,fee schedule,,59.6,,,,fee schedule,,114.62,,,,fee schedule,,69.47,,,,fee schedule,,69.47,,,,fee schedule,,,417.69,91,,percent of total billed charges,,,436.05,95,,percent of total billed charges,,,380.97,83,,percent of total billed charges,,,137.7,83,,percent of total billed charges,,59.6,,,,fee schedule,,59.6,,,,fee schedule,,,380.97,83,,percent of total billed charges,,102.12,,,,fee schedule,,,413.1,90,,percent of total billed charges,,,413.1,90,,percent of total billed charges,,,413.1,90,,percent of total billed charges,,,413.1,90,,percent of total billed charges,,,390.15,85,,percent of total billed charges,,59.6,436.05,
"BIOPSY OF BREAST, OPEN",19101,CDM,19101,CPT,,,both,,1120,1120,386.55,,,,fee schedule,,,,,,,,192.85,,,,fee schedule,,,952,85,,percent of total billed charges,,384.13,,,,fee schedule,,238.56,,,,fee schedule,,192.85,,,,fee schedule,,362.77,,,,fee schedule,,192.85,,,,fee schedule,,375.18,,,,fee schedule,,227.38,,,,fee schedule,,227.38,,,,fee schedule,,,1019.2,91,,percent of total billed charges,,,1064,95,,percent of total billed charges,,,929.6,83,,percent of total billed charges,,,336,83,,percent of total billed charges,,192.85,,,,fee schedule,,192.85,,,,fee schedule,,,929.6,83,,percent of total billed charges,,334.25,,,,fee schedule,,,1008,90,,percent of total billed charges,,,1008,90,,percent of total billed charges,,,1008,90,,percent of total billed charges,,,1008,90,,percent of total billed charges,,,952,85,,percent of total billed charges,,192.85,1064,
NIPPLE EXPLORATION,19110,CDM,19110,CPT,,,both,,1527,1527,610.07,,,,fee schedule,,,,,,,,240,,,,fee schedule,,,1297.95,85,,percent of total billed charges,,598.79,,,,fee schedule,,371.87,,,,fee schedule,,240,,,,fee schedule,,511.33,,,,fee schedule,,240,,,,fee schedule,,592.13,,,,fee schedule,,358.87,,,,fee schedule,,358.87,,,,fee schedule,,,1389.57,91,,percent of total billed charges,,,1450.65,95,,percent of total billed charges,,,1267.41,83,,percent of total billed charges,,,458.1,83,,percent of total billed charges,,240,,,,fee schedule,,240,,,,fee schedule,,,1267.41,83,,percent of total billed charges,,527.53,,,,fee schedule,,,1374.3,90,,percent of total billed charges,,,1374.3,90,,percent of total billed charges,,,1374.3,90,,percent of total billed charges,,,1374.3,90,,percent of total billed charges,,,1297.95,85,,percent of total billed charges,,240,1450.65,
REMOVAL OF BREAST LESION,19120,CDM,19120,CPT,,,both,,1654,1654,722.41,,,,fee schedule,,,,,,,,240,,,,fee schedule,,,1405.9,85,,percent of total billed charges,,714.27,,,,fee schedule,,443.59,,,,fee schedule,,240,,,,fee schedule,,618.77,,,,fee schedule,,240,,,,fee schedule,,701.16,,,,fee schedule,,424.95,,,,fee schedule,,424.95,,,,fee schedule,,,1505.14,91,,percent of total billed charges,,,1571.3,95,,percent of total billed charges,,,1372.82,83,,percent of total billed charges,,,496.2,83,,percent of total billed charges,,240,,,,fee schedule,,240,,,,fee schedule,,,1372.82,83,,percent of total billed charges,,624.67,,,,fee schedule,,,1488.6,90,,percent of total billed charges,,,1488.6,90,,percent of total billed charges,,,1488.6,90,,percent of total billed charges,,,1488.6,90,,percent of total billed charges,,,1405.9,85,,percent of total billed charges,,240,1571.3,
"EXCISION, BREAST LESION",19125,CDM,19125,CPT,,,both,,1900,1900,799.03,,,,fee schedule,,,,,,,,240,,,,fee schedule,,,1615,85,,percent of total billed charges,,794.21,,,,fee schedule,,493.24,,,,fee schedule,,240,,,,fee schedule,,671.16,,,,fee schedule,,240,,,,fee schedule,,775.53,,,,fee schedule,,470.02,,,,fee schedule,,470.02,,,,fee schedule,,,1729,91,,percent of total billed charges,,,1805,95,,percent of total billed charges,,,1577,83,,percent of total billed charges,,,570,83,,percent of total billed charges,,240,,,,fee schedule,,240,,,,fee schedule,,,1577,83,,percent of total billed charges,,690.92,,,,fee schedule,,,1710,90,,percent of total billed charges,,,1710,90,,percent of total billed charges,,,1710,90,,percent of total billed charges,,,1710,90,,percent of total billed charges,,,1615,85,,percent of total billed charges,,240,1805,
REMOVAL OF BREAST TISSUE,19140,CDM,19140,CPT,,,both,,3249,3249,,,,,,,,,,,,,,,,,,,,2761.65,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,611.48,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,2956.59,91,,percent of total billed charges,,,3086.55,95,,percent of total billed charges,,,2696.67,83,,percent of total billed charges,,,974.7,83,,percent of total billed charges,,,,,,,,,,,,,,,2696.67,83,,percent of total billed charges,,,,,,,,,2924.1,90,,percent of total billed charges,,,2924.1,90,,percent of total billed charges,,,2924.1,90,,percent of total billed charges,,,2924.1,90,,percent of total billed charges,,,2761.65,85,,percent of total billed charges,,611.48,3086.55,
"Masectomy For Gynecomastia, Unilat",1914001,CDM,19140,CPT,,,both,,2887,2887,,,,,,,,,,,,,,,,,,,,2453.95,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,611.48,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,2627.17,91,,percent of total billed charges,,,2742.65,95,,percent of total billed charges,,,2396.21,83,,percent of total billed charges,,,866.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2396.21,83,,percent of total billed charges,,,,,,,,,2598.3,90,,percent of total billed charges,,,2598.3,90,,percent of total billed charges,,,2598.3,90,,percent of total billed charges,,,2598.3,90,,percent of total billed charges,,,2453.95,85,,percent of total billed charges,,611.48,2742.65,
"Masectomy For Gynecomastia,bilat",1914002,CDM,19140,CPT,,,both,,3459,3459,,,,,,,,,,,,,,,,,,,,2940.15,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,611.48,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,3147.69,91,,percent of total billed charges,,,3286.05,95,,percent of total billed charges,,,2870.97,83,,percent of total billed charges,,,1037.7,83,,percent of total billed charges,,,,,,,,,,,,,,,2870.97,83,,percent of total billed charges,,,,,,,,,3113.1,90,,percent of total billed charges,,,3113.1,90,,percent of total billed charges,,,3113.1,90,,percent of total billed charges,,,3113.1,90,,percent of total billed charges,,,2940.15,85,,percent of total billed charges,,611.48,3286.05,
Mastectomy For Gynecomastia,19300,CDM,19300,CPT,,,both,,1919,1919,751.21,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,1631.15,85,,percent of total billed charges,,733.68,,,,fee schedule,,455.65,,,,fee schedule,,374.55,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,729.12,,,,fee schedule,,441.89,,,,fee schedule,,441.89,,,,fee schedule,,,1746.29,91,,percent of total billed charges,,,1823.05,95,,percent of total billed charges,,,1592.77,83,,percent of total billed charges,,,575.7,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,1592.77,83,,percent of total billed charges,,649.58,,,,fee schedule,,,1727.1,90,,percent of total billed charges,,,1727.1,90,,percent of total billed charges,,,1727.1,90,,percent of total billed charges,,,1727.1,90,,percent of total billed charges,,,1631.15,85,,percent of total billed charges,,374.55,1823.05,
Lumpectomy,19301,CDM,19301,CPT,,,both,,2303,2303,1140.07,,,,fee schedule,,,,,,,,310.8,,,,fee schedule,,,1957.55,85,,percent of total billed charges,,1141.67,,,,fee schedule,,709.03,,,,fee schedule,,310.8,,,,fee schedule,,,,,,,,310.8,,,,fee schedule,,1106.54,,,,fee schedule,,670.63,,,,fee schedule,,670.63,,,,fee schedule,,,2095.73,91,,percent of total billed charges,,,2187.85,95,,percent of total billed charges,,,1911.49,83,,percent of total billed charges,,,690.9,83,,percent of total billed charges,,310.8,,,,fee schedule,,310.8,,,,fee schedule,,,1911.49,83,,percent of total billed charges,,985.82,,,,fee schedule,,,2072.7,90,,percent of total billed charges,,,2072.7,90,,percent of total billed charges,,,2072.7,90,,percent of total billed charges,,,2072.7,90,,percent of total billed charges,,,1957.55,85,,percent of total billed charges,,310.8,2187.85,
Simple Mastectomy Complete,19303,CDM,19303,CPT,,,both,,3356,3356,1652.2,,,,fee schedule,,,,,,,,461.95,,,,fee schedule,,,2852.6,85,,percent of total billed charges,,1657.99,,,,fee schedule,,1029.68,,,,fee schedule,,461.95,,,,fee schedule,,,,,,,,461.95,,,,fee schedule,,1603.61,,,,fee schedule,,971.88,,,,fee schedule,,971.88,,,,fee schedule,,,3053.96,91,,percent of total billed charges,,,3188.2,95,,percent of total billed charges,,,2785.48,83,,percent of total billed charges,,,1006.8,83,,percent of total billed charges,,461.95,,,,fee schedule,,461.95,,,,fee schedule,,,2785.48,83,,percent of total billed charges,,1428.67,,,,fee schedule,,,3020.4,90,,percent of total billed charges,,,3020.4,90,,percent of total billed charges,,,3020.4,90,,percent of total billed charges,,,3020.4,90,,percent of total billed charges,,,2852.6,85,,percent of total billed charges,,461.95,3188.2,
Modified Radical Mastectomy,19307,CDM,19307,CPT,,,both,,4177,4177,2036.45,,,,fee schedule,,,,,,,,738.1,,,,fee schedule,,,3550.45,85,,percent of total billed charges,,2040.41,,,,fee schedule,,1267.18,,,,fee schedule,,738.1,,,,fee schedule,,,,,,,,738.1,,,,fee schedule,,1976.56,,,,fee schedule,,1197.91,,,,fee schedule,,1197.91,,,,fee schedule,,,3801.07,91,,percent of total billed charges,,,3968.15,95,,percent of total billed charges,,,3466.91,83,,percent of total billed charges,,,1253.1,83,,percent of total billed charges,,738.1,,,,fee schedule,,738.1,,,,fee schedule,,,3466.91,83,,percent of total billed charges,,1760.93,,,,fee schedule,,,3759.3,90,,percent of total billed charges,,,3759.3,90,,percent of total billed charges,,,3759.3,90,,percent of total billed charges,,,3759.3,90,,percent of total billed charges,,,3550.45,85,,percent of total billed charges,,738.1,3968.15,
MASTOPEXY,19316,CDM,19316,CPT,,,both,,4889,4889,1367.04,,,,fee schedule,,,,,,,,567.1,,,,fee schedule,,,4155.65,85,,percent of total billed charges,,1337.89,,,,fee schedule,,830.89,,,,fee schedule,,567.1,,,,fee schedule,,1311.82,,,,fee schedule,,567.1,,,,fee schedule,,1326.84,,,,fee schedule,,804.14,,,,fee schedule,,804.14,,,,fee schedule,,,4448.99,91,,percent of total billed charges,,,4644.55,95,,percent of total billed charges,,,4057.87,83,,percent of total billed charges,,,1466.7,83,,percent of total billed charges,,567.1,,,,fee schedule,,567.1,,,,fee schedule,,,4057.87,83,,percent of total billed charges,,1182.09,,,,fee schedule,,,4400.1,90,,percent of total billed charges,,,4400.1,90,,percent of total billed charges,,,4400.1,90,,percent of total billed charges,,,4400.1,90,,percent of total billed charges,,,4155.65,85,,percent of total billed charges,,567.1,4644.55,
"Mastopexy, Unilat",1931601,CDM,19316,CPT,,,both,,2542,2542,1367.04,,,,fee schedule,,,,,,,,567.1,,,,fee schedule,,,2160.7,85,,percent of total billed charges,,1337.89,,,,fee schedule,,830.89,,,,fee schedule,,567.1,,,,fee schedule,,1311.82,,,,fee schedule,,567.1,,,,fee schedule,,1326.84,,,,fee schedule,,804.14,,,,fee schedule,,804.14,,,,fee schedule,,,2313.22,91,,percent of total billed charges,,,2414.9,95,,percent of total billed charges,,,2109.86,83,,percent of total billed charges,,,762.6,83,,percent of total billed charges,,567.1,,,,fee schedule,,567.1,,,,fee schedule,,,2109.86,83,,percent of total billed charges,,1182.09,,,,fee schedule,,,2287.8,90,,percent of total billed charges,,,2287.8,90,,percent of total billed charges,,,2287.8,90,,percent of total billed charges,,,2287.8,90,,percent of total billed charges,,,2160.7,85,,percent of total billed charges,,567.1,2414.9,
"Mastopexy, Bilat",1931602,CDM,19316,CPT,,,both,,2858,2858,1367.04,,,,fee schedule,,,,,,,,567.1,,,,fee schedule,,,2429.3,85,,percent of total billed charges,,1337.89,,,,fee schedule,,830.89,,,,fee schedule,,567.1,,,,fee schedule,,1311.82,,,,fee schedule,,567.1,,,,fee schedule,,1326.84,,,,fee schedule,,804.14,,,,fee schedule,,804.14,,,,fee schedule,,,2600.78,91,,percent of total billed charges,,,2715.1,95,,percent of total billed charges,,,2372.14,83,,percent of total billed charges,,,857.4,83,,percent of total billed charges,,567.1,,,,fee schedule,,567.1,,,,fee schedule,,,2372.14,83,,percent of total billed charges,,1182.09,,,,fee schedule,,,2572.2,90,,percent of total billed charges,,,2572.2,90,,percent of total billed charges,,,2572.2,90,,percent of total billed charges,,,2572.2,90,,percent of total billed charges,,,2429.3,85,,percent of total billed charges,,567.1,2715.1,
REDUCTION MAMMAPLASTY,19318,CDM,19318,CPT,,,both,,7111,7111,1883.79,,,,fee schedule,,,,,,,,374.6,,,,fee schedule,,,6044.35,85,,percent of total billed charges,,1849.55,,,,fee schedule,,1148.65,,,,fee schedule,,374.6,,,,fee schedule,,1965.08,,,,fee schedule,,374.6,,,,fee schedule,,1828.38,,,,fee schedule,,1108.11,,,,fee schedule,,1108.11,,,,fee schedule,,,6471.01,91,,percent of total billed charges,,,6755.45,95,,percent of total billed charges,,,5902.13,83,,percent of total billed charges,,,2133.3,83,,percent of total billed charges,,374.6,,,,fee schedule,,374.6,,,,fee schedule,,,5902.13,83,,percent of total billed charges,,1628.92,,,,fee schedule,,,6399.9,90,,percent of total billed charges,,,6399.9,90,,percent of total billed charges,,,6399.9,90,,percent of total billed charges,,,6399.9,90,,percent of total billed charges,,,6044.35,85,,percent of total billed charges,,374.6,6755.45,
"Reduction Mammoplasty, Unilat",1931801,CDM,19318,CPT,,,both,,4102,4102,1883.79,,,,fee schedule,,,,,,,,374.6,,,,fee schedule,,,3486.7,85,,percent of total billed charges,,1849.55,,,,fee schedule,,1148.65,,,,fee schedule,,374.6,,,,fee schedule,,1965.08,,,,fee schedule,,374.6,,,,fee schedule,,1828.38,,,,fee schedule,,1108.11,,,,fee schedule,,1108.11,,,,fee schedule,,,3732.82,91,,percent of total billed charges,,,3896.9,95,,percent of total billed charges,,,3404.66,83,,percent of total billed charges,,,1230.6,83,,percent of total billed charges,,374.6,,,,fee schedule,,374.6,,,,fee schedule,,,3404.66,83,,percent of total billed charges,,1628.92,,,,fee schedule,,,3691.8,90,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3486.7,85,,percent of total billed charges,,374.6,3896.9,
"Reduction Mammoplasty,bilat",1931802,CDM,19318,CPT,,,both,,3551,3551,1883.79,,,,fee schedule,,,,,,,,374.6,,,,fee schedule,,,3018.35,85,,percent of total billed charges,,1849.55,,,,fee schedule,,1148.65,,,,fee schedule,,374.6,,,,fee schedule,,1965.08,,,,fee schedule,,374.6,,,,fee schedule,,1828.38,,,,fee schedule,,1108.11,,,,fee schedule,,1108.11,,,,fee schedule,,,3231.41,91,,percent of total billed charges,,,3373.45,95,,percent of total billed charges,,,2947.33,83,,percent of total billed charges,,,1065.3,83,,percent of total billed charges,,374.6,,,,fee schedule,,374.6,,,,fee schedule,,,2947.33,83,,percent of total billed charges,,1628.92,,,,fee schedule,,,3195.9,90,,percent of total billed charges,,,3195.9,90,,percent of total billed charges,,,3195.9,90,,percent of total billed charges,,,3195.9,90,,percent of total billed charges,,,3018.35,85,,percent of total billed charges,,374.6,3373.45,
"Augmentation Mammoplasty, Bilat, Implant, Endo",1932501,CDM,19325,CPT,,,both,,2588,2588,1062.3,,,,fee schedule,,,,,,,,567.1,,,,fee schedule,,,2199.8,85,,percent of total billed charges,,1032.44,,,,fee schedule,,641.19,,,,fee schedule,,567.1,,,,fee schedule,,1078.37,,,,fee schedule,,567.1,,,,fee schedule,,1031.05,,,,fee schedule,,624.88,,,,fee schedule,,624.88,,,,fee schedule,,,2355.08,91,,percent of total billed charges,,,2458.6,95,,percent of total billed charges,,,2148.04,83,,percent of total billed charges,,,776.4,83,,percent of total billed charges,,567.1,,,,fee schedule,,567.1,,,,fee schedule,,,2148.04,83,,percent of total billed charges,,918.57,,,,fee schedule,,,2329.2,90,,percent of total billed charges,,,2329.2,90,,percent of total billed charges,,,2329.2,90,,percent of total billed charges,,,2329.2,90,,percent of total billed charges,,,2199.8,85,,percent of total billed charges,,567.1,2458.6,
"Augmentation Mammoplasty, Bilat, Implant, Low Prof",1932502,CDM,19325,CPT,,,both,,4104,4104,1062.3,,,,fee schedule,,,,,,,,567.1,,,,fee schedule,,,3488.4,85,,percent of total billed charges,,1032.44,,,,fee schedule,,641.19,,,,fee schedule,,567.1,,,,fee schedule,,1078.37,,,,fee schedule,,567.1,,,,fee schedule,,1031.05,,,,fee schedule,,624.88,,,,fee schedule,,624.88,,,,fee schedule,,,3734.64,91,,percent of total billed charges,,,3898.8,95,,percent of total billed charges,,,3406.32,83,,percent of total billed charges,,,1231.2,83,,percent of total billed charges,,567.1,,,,fee schedule,,567.1,,,,fee schedule,,,3406.32,83,,percent of total billed charges,,918.57,,,,fee schedule,,,3693.6,90,,percent of total billed charges,,,3693.6,90,,percent of total billed charges,,,3693.6,90,,percent of total billed charges,,,3693.6,90,,percent of total billed charges,,,3488.4,85,,percent of total billed charges,,567.1,3898.8,
"Augmentation Mammoplasty, Bilat, Implant, Mod Prof",1932503,CDM,19325,CPT,,,both,,4350,4350,1062.3,,,,fee schedule,,,,,,,,567.1,,,,fee schedule,,,3697.5,85,,percent of total billed charges,,1032.44,,,,fee schedule,,641.19,,,,fee schedule,,567.1,,,,fee schedule,,1078.37,,,,fee schedule,,567.1,,,,fee schedule,,1031.05,,,,fee schedule,,624.88,,,,fee schedule,,624.88,,,,fee schedule,,,3958.5,91,,percent of total billed charges,,,4132.5,95,,percent of total billed charges,,,3610.5,83,,percent of total billed charges,,,1305,83,,percent of total billed charges,,567.1,,,,fee schedule,,567.1,,,,fee schedule,,,3610.5,83,,percent of total billed charges,,918.57,,,,fee schedule,,,3915,90,,percent of total billed charges,,,3915,90,,percent of total billed charges,,,3915,90,,percent of total billed charges,,,3915,90,,percent of total billed charges,,,3697.5,85,,percent of total billed charges,,567.1,4132.5,
"Augmentation Mammoplasty,bilat, Implant, High Prof",1932504,CDM,19325,CPT,,,both,,4822,4822,1062.3,,,,fee schedule,,,,,,,,567.1,,,,fee schedule,,,4098.7,85,,percent of total billed charges,,1032.44,,,,fee schedule,,641.19,,,,fee schedule,,567.1,,,,fee schedule,,1078.37,,,,fee schedule,,567.1,,,,fee schedule,,1031.05,,,,fee schedule,,624.88,,,,fee schedule,,624.88,,,,fee schedule,,,4388.02,91,,percent of total billed charges,,,4580.9,95,,percent of total billed charges,,,4002.26,83,,percent of total billed charges,,,1446.6,83,,percent of total billed charges,,567.1,,,,fee schedule,,567.1,,,,fee schedule,,,4002.26,83,,percent of total billed charges,,918.57,,,,fee schedule,,,4339.8,90,,percent of total billed charges,,,4339.8,90,,percent of total billed charges,,,4339.8,90,,percent of total billed charges,,,4339.8,90,,percent of total billed charges,,,4098.7,85,,percent of total billed charges,,567.1,4580.9,
"Augmentation Mammoplasty,unilat, Implant",1932505,CDM,19325,CPT,,,both,,4518,4518,1062.3,,,,fee schedule,,,,,,,,567.1,,,,fee schedule,,,3840.3,85,,percent of total billed charges,,1032.44,,,,fee schedule,,641.19,,,,fee schedule,,567.1,,,,fee schedule,,1078.37,,,,fee schedule,,567.1,,,,fee schedule,,1031.05,,,,fee schedule,,624.88,,,,fee schedule,,624.88,,,,fee schedule,,,4111.38,91,,percent of total billed charges,,,4292.1,95,,percent of total billed charges,,,3749.94,83,,percent of total billed charges,,,1355.4,83,,percent of total billed charges,,567.1,,,,fee schedule,,567.1,,,,fee schedule,,,3749.94,83,,percent of total billed charges,,918.57,,,,fee schedule,,,4066.2,90,,percent of total billed charges,,,4066.2,90,,percent of total billed charges,,,4066.2,90,,percent of total billed charges,,,4066.2,90,,percent of total billed charges,,,3840.3,85,,percent of total billed charges,,567.1,4292.1,
"Augmentation Mammoplasty,silicone, Bilat",1932507,CDM,19325,CPT,,,both,,2989,2989,1062.3,,,,fee schedule,,,,,,,,567.1,,,,fee schedule,,,2540.65,85,,percent of total billed charges,,1032.44,,,,fee schedule,,641.19,,,,fee schedule,,567.1,,,,fee schedule,,1078.37,,,,fee schedule,,567.1,,,,fee schedule,,1031.05,,,,fee schedule,,624.88,,,,fee schedule,,624.88,,,,fee schedule,,,2719.99,91,,percent of total billed charges,,,2839.55,95,,percent of total billed charges,,,2480.87,83,,percent of total billed charges,,,896.7,83,,percent of total billed charges,,567.1,,,,fee schedule,,567.1,,,,fee schedule,,,2480.87,83,,percent of total billed charges,,918.57,,,,fee schedule,,,2690.1,90,,percent of total billed charges,,,2690.1,90,,percent of total billed charges,,,2690.1,90,,percent of total billed charges,,,2690.1,90,,percent of total billed charges,,,2540.65,85,,percent of total billed charges,,567.1,2839.55,
IMMT INSJ BRST PROSTH FLWG MASTOPEXY MAST/RCNST,19340,CDM,19340,CPT,,,both,,6503,6503,1311.16,,,,fee schedule,,,,,,,,310.8,,,,fee schedule,,,5527.55,85,,percent of total billed charges,,1279.72,,,,fee schedule,,794.76,,,,fee schedule,,310.8,,,,fee schedule,,694.38,,,,fee schedule,,310.8,,,,fee schedule,,1272.6,,,,fee schedule,,771.27,,,,fee schedule,,771.27,,,,fee schedule,,,5917.73,91,,percent of total billed charges,,,6177.85,95,,percent of total billed charges,,,5397.49,83,,percent of total billed charges,,,1950.9,83,,percent of total billed charges,,310.8,,,,fee schedule,,310.8,,,,fee schedule,,,5397.49,83,,percent of total billed charges,,1133.77,,,,fee schedule,,,5852.7,90,,percent of total billed charges,,,5852.7,90,,percent of total billed charges,,,5852.7,90,,percent of total billed charges,,,5852.7,90,,percent of total billed charges,,,5527.55,85,,percent of total billed charges,,310.8,6177.85,
"Mastopexy, Augmentation Mammoplasty",1934001,CDM,19340,CPT,,,both,,3335,3335,1311.16,,,,fee schedule,,,,,,,,310.8,,,,fee schedule,,,2834.75,85,,percent of total billed charges,,1279.72,,,,fee schedule,,794.76,,,,fee schedule,,310.8,,,,fee schedule,,694.38,,,,fee schedule,,310.8,,,,fee schedule,,1272.6,,,,fee schedule,,771.27,,,,fee schedule,,771.27,,,,fee schedule,,,3034.85,91,,percent of total billed charges,,,3168.25,95,,percent of total billed charges,,,2768.05,83,,percent of total billed charges,,,1000.5,83,,percent of total billed charges,,310.8,,,,fee schedule,,310.8,,,,fee schedule,,,2768.05,83,,percent of total billed charges,,1133.77,,,,fee schedule,,,3001.5,90,,percent of total billed charges,,,3001.5,90,,percent of total billed charges,,,3001.5,90,,percent of total billed charges,,,3001.5,90,,percent of total billed charges,,,2834.75,85,,percent of total billed charges,,310.8,3168.25,
"Mastopexy, Augmentation Mammoplasty, Silicone",1934002,CDM,19340,CPT,,,both,,3746,3746,1311.16,,,,fee schedule,,,,,,,,310.8,,,,fee schedule,,,3184.1,85,,percent of total billed charges,,1279.72,,,,fee schedule,,794.76,,,,fee schedule,,310.8,,,,fee schedule,,694.38,,,,fee schedule,,310.8,,,,fee schedule,,1272.6,,,,fee schedule,,771.27,,,,fee schedule,,771.27,,,,fee schedule,,,3408.86,91,,percent of total billed charges,,,3558.7,95,,percent of total billed charges,,,3109.18,83,,percent of total billed charges,,,1123.8,83,,percent of total billed charges,,310.8,,,,fee schedule,,310.8,,,,fee schedule,,,3109.18,83,,percent of total billed charges,,1133.77,,,,fee schedule,,,3371.4,90,,percent of total billed charges,,,3371.4,90,,percent of total billed charges,,,3371.4,90,,percent of total billed charges,,,3371.4,90,,percent of total billed charges,,,3184.1,85,,percent of total billed charges,,310.8,3558.7,
BREAST RECONSTRUCTION,19350,CDM,19350,CPT,,,both,,5738,5738,1162.53,,,,fee schedule,,,,,,,,310.55,,,,fee schedule,,,4877.3,85,,percent of total billed charges,,1132.03,,,,fee schedule,,703.04,,,,fee schedule,,310.55,,,,fee schedule,,1158.62,,,,fee schedule,,310.55,,,,fee schedule,,1128.34,,,,fee schedule,,683.84,,,,fee schedule,,683.84,,,,fee schedule,,,5221.58,91,,percent of total billed charges,,,5451.1,95,,percent of total billed charges,,,4762.54,83,,percent of total billed charges,,,1721.4,83,,percent of total billed charges,,310.55,,,,fee schedule,,310.55,,,,fee schedule,,,4762.54,83,,percent of total billed charges,,1005.25,,,,fee schedule,,,5164.2,90,,percent of total billed charges,,,5164.2,90,,percent of total billed charges,,,5164.2,90,,percent of total billed charges,,,5164.2,90,,percent of total billed charges,,,4877.3,85,,percent of total billed charges,,310.55,5451.1,
RCNSTJ IMMT/DLYD W/TISS EXPANDER SBSQ XPNSJ,19357,CDM,19357,CPT,,,both,,4432,4432,2000.16,,,,fee schedule,,,,,,,,532.3,,,,fee schedule,,,3767.2,85,,percent of total billed charges,,1946.64,,,,fee schedule,,1208.95,,,,fee schedule,,532.3,,,,fee schedule,,2427.33,,,,fee schedule,,532.3,,,,fee schedule,,1941.33,,,,fee schedule,,1176.56,,,,fee schedule,,1176.56,,,,fee schedule,,,4033.12,91,,percent of total billed charges,,,4210.4,95,,percent of total billed charges,,,3678.56,83,,percent of total billed charges,,,1329.6,83,,percent of total billed charges,,532.3,,,,fee schedule,,532.3,,,,fee schedule,,,3678.56,83,,percent of total billed charges,,1729.55,,,,fee schedule,,,3988.8,90,,percent of total billed charges,,,3988.8,90,,percent of total billed charges,,,3988.8,90,,percent of total billed charges,,,3988.8,90,,percent of total billed charges,,,3767.2,85,,percent of total billed charges,,532.3,4210.4,
OPEN PERIPROSTHETIC CAPSULOTOMY BREAST,19370,CDM,19370,CPT,,,both,,3873,3873,1159.08,,,,fee schedule,,,,,,,,242.7,,,,fee schedule,,,3292.05,85,,percent of total billed charges,,1129.84,,,,fee schedule,,701.68,,,,fee schedule,,242.7,,,,fee schedule,,1075.06,,,,fee schedule,,242.7,,,,fee schedule,,1124.99,,,,fee schedule,,681.81,,,,fee schedule,,681.81,,,,fee schedule,,,3524.43,91,,percent of total billed charges,,,3679.35,95,,percent of total billed charges,,,3214.59,83,,percent of total billed charges,,,1161.9,83,,percent of total billed charges,,242.7,,,,fee schedule,,242.7,,,,fee schedule,,,3214.59,83,,percent of total billed charges,,1002.26,,,,fee schedule,,,3485.7,90,,percent of total billed charges,,,3485.7,90,,percent of total billed charges,,,3485.7,90,,percent of total billed charges,,,3485.7,90,,percent of total billed charges,,,3292.05,85,,percent of total billed charges,,242.7,3679.35,
"Casulotomy, Open Periprosthetic, Unilat",1937001,CDM,19370,CPT,,,both,,3440,3440,1159.08,,,,fee schedule,,,,,,,,242.7,,,,fee schedule,,,2924,85,,percent of total billed charges,,1129.84,,,,fee schedule,,701.68,,,,fee schedule,,242.7,,,,fee schedule,,1075.06,,,,fee schedule,,242.7,,,,fee schedule,,1124.99,,,,fee schedule,,681.81,,,,fee schedule,,681.81,,,,fee schedule,,,3130.4,91,,percent of total billed charges,,,3268,95,,percent of total billed charges,,,2855.2,83,,percent of total billed charges,,,1032,83,,percent of total billed charges,,242.7,,,,fee schedule,,242.7,,,,fee schedule,,,2855.2,83,,percent of total billed charges,,1002.26,,,,fee schedule,,,3096,90,,percent of total billed charges,,,3096,90,,percent of total billed charges,,,3096,90,,percent of total billed charges,,,3096,90,,percent of total billed charges,,,2924,85,,percent of total billed charges,,242.7,3268,
"Casulotomy, Open Periprostheticbilat",1937002,CDM,19370,CPT,,,both,,4369,4369,1159.08,,,,fee schedule,,,,,,,,242.7,,,,fee schedule,,,3713.65,85,,percent of total billed charges,,1129.84,,,,fee schedule,,701.68,,,,fee schedule,,242.7,,,,fee schedule,,1075.06,,,,fee schedule,,242.7,,,,fee schedule,,1124.99,,,,fee schedule,,681.81,,,,fee schedule,,681.81,,,,fee schedule,,,3975.79,91,,percent of total billed charges,,,4150.55,95,,percent of total billed charges,,,3626.27,83,,percent of total billed charges,,,1310.7,83,,percent of total billed charges,,242.7,,,,fee schedule,,242.7,,,,fee schedule,,,3626.27,83,,percent of total billed charges,,1002.26,,,,fee schedule,,,3932.1,90,,percent of total billed charges,,,3932.1,90,,percent of total billed charges,,,3932.1,90,,percent of total billed charges,,,3932.1,90,,percent of total billed charges,,,3713.65,85,,percent of total billed charges,,242.7,4150.55,
"Capsulotomy, Periprosthetic, Unilat",1937101,CDM,19371,CPT,,,both,,3440,3440,1230.51,,,,fee schedule,,,,,,,,297,,,,fee schedule,,,2924,85,,percent of total billed charges,,1200.74,,,,fee schedule,,745.71,,,,fee schedule,,297,,,,fee schedule,,1243.51,,,,fee schedule,,297,,,,fee schedule,,1194.32,,,,fee schedule,,723.83,,,,fee schedule,,723.83,,,,fee schedule,,,3130.4,91,,percent of total billed charges,,,3268,95,,percent of total billed charges,,,2855.2,83,,percent of total billed charges,,,1032,83,,percent of total billed charges,,297,,,,fee schedule,,297,,,,fee schedule,,,2855.2,83,,percent of total billed charges,,1064.03,,,,fee schedule,,,3096,90,,percent of total billed charges,,,3096,90,,percent of total billed charges,,,3096,90,,percent of total billed charges,,,3096,90,,percent of total billed charges,,,2924,85,,percent of total billed charges,,297,3268,
"Capsulotomy, Periprosthetic, Bilat",1937102,CDM,19371,CPT,,,both,,4369,4369,1230.51,,,,fee schedule,,,,,,,,297,,,,fee schedule,,,3713.65,85,,percent of total billed charges,,1200.74,,,,fee schedule,,745.71,,,,fee schedule,,297,,,,fee schedule,,1243.51,,,,fee schedule,,297,,,,fee schedule,,1194.32,,,,fee schedule,,723.83,,,,fee schedule,,723.83,,,,fee schedule,,,3975.79,91,,percent of total billed charges,,,4150.55,95,,percent of total billed charges,,,3626.27,83,,percent of total billed charges,,,1310.7,83,,percent of total billed charges,,297,,,,fee schedule,,297,,,,fee schedule,,,3626.27,83,,percent of total billed charges,,1064.03,,,,fee schedule,,,3932.1,90,,percent of total billed charges,,,3932.1,90,,percent of total billed charges,,,3932.1,90,,percent of total billed charges,,,3932.1,90,,percent of total billed charges,,,3713.65,85,,percent of total billed charges,,297,4150.55,
"Capsulectomy W Implant Exc, Bilat, Silicone",1937103,CDM,19371,CPT,,,both,,7097,7097,1230.51,,,,fee schedule,,,,,,,,297,,,,fee schedule,,,6032.45,85,,percent of total billed charges,,1200.74,,,,fee schedule,,745.71,,,,fee schedule,,297,,,,fee schedule,,1243.51,,,,fee schedule,,297,,,,fee schedule,,1194.32,,,,fee schedule,,723.83,,,,fee schedule,,723.83,,,,fee schedule,,,6458.27,91,,percent of total billed charges,,,6742.15,95,,percent of total billed charges,,,5890.51,83,,percent of total billed charges,,,2129.1,83,,percent of total billed charges,,297,,,,fee schedule,,297,,,,fee schedule,,,5890.51,83,,percent of total billed charges,,1064.03,,,,fee schedule,,,6387.3,90,,percent of total billed charges,,,6387.3,90,,percent of total billed charges,,,6387.3,90,,percent of total billed charges,,,6387.3,90,,percent of total billed charges,,,6032.45,85,,percent of total billed charges,,297,6742.15,
"Capsulectomy W Implant Exc, Unilat, Silicone",1937104,CDM,19371,CPT,,,both,,5090,5090,1230.51,,,,fee schedule,,,,,,,,297,,,,fee schedule,,,4326.5,85,,percent of total billed charges,,1200.74,,,,fee schedule,,745.71,,,,fee schedule,,297,,,,fee schedule,,1243.51,,,,fee schedule,,297,,,,fee schedule,,1194.32,,,,fee schedule,,723.83,,,,fee schedule,,723.83,,,,fee schedule,,,4631.9,91,,percent of total billed charges,,,4835.5,95,,percent of total billed charges,,,4224.7,83,,percent of total billed charges,,,1527,83,,percent of total billed charges,,297,,,,fee schedule,,297,,,,fee schedule,,,4224.7,83,,percent of total billed charges,,1064.03,,,,fee schedule,,,4581,90,,percent of total billed charges,,,4581,90,,percent of total billed charges,,,4581,90,,percent of total billed charges,,,4581,90,,percent of total billed charges,,,4326.5,85,,percent of total billed charges,,297,4835.5,
"Capsulectomy W Implant Exc, Bilat, Saline",1937105,CDM,19371,CPT,,,both,,6065,6065,1230.51,,,,fee schedule,,,,,,,,297,,,,fee schedule,,,5155.25,85,,percent of total billed charges,,1200.74,,,,fee schedule,,745.71,,,,fee schedule,,297,,,,fee schedule,,1243.51,,,,fee schedule,,297,,,,fee schedule,,1194.32,,,,fee schedule,,723.83,,,,fee schedule,,723.83,,,,fee schedule,,,5519.15,91,,percent of total billed charges,,,5761.75,95,,percent of total billed charges,,,5033.95,83,,percent of total billed charges,,,1819.5,83,,percent of total billed charges,,297,,,,fee schedule,,297,,,,fee schedule,,,5033.95,83,,percent of total billed charges,,1064.03,,,,fee schedule,,,5458.5,90,,percent of total billed charges,,,5458.5,90,,percent of total billed charges,,,5458.5,90,,percent of total billed charges,,,5458.5,90,,percent of total billed charges,,,5155.25,85,,percent of total billed charges,,297,5761.75,
"Capsulectomy W Implant Exc, Unilat, Saline",1937106,CDM,19371,CPT,,,both,,4045,4045,1230.51,,,,fee schedule,,,,,,,,297,,,,fee schedule,,,3438.25,85,,percent of total billed charges,,1200.74,,,,fee schedule,,745.71,,,,fee schedule,,297,,,,fee schedule,,1243.51,,,,fee schedule,,297,,,,fee schedule,,1194.32,,,,fee schedule,,723.83,,,,fee schedule,,723.83,,,,fee schedule,,,3680.95,91,,percent of total billed charges,,,3842.75,95,,percent of total billed charges,,,3357.35,83,,percent of total billed charges,,,1213.5,83,,percent of total billed charges,,297,,,,fee schedule,,297,,,,fee schedule,,,3357.35,83,,percent of total billed charges,,1064.03,,,,fee schedule,,,3640.5,90,,percent of total billed charges,,,3640.5,90,,percent of total billed charges,,,3640.5,90,,percent of total billed charges,,,3640.5,90,,percent of total billed charges,,,3438.25,85,,percent of total billed charges,,297,3842.75,
INCISION DRAINAGE OF SOFT TISSUE ABSCESS,20005,CDM,20005,CPT,,,both,,1193,1193,,,,,,,,,,,,,,,,,,,,1014.05,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,404.56,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,1085.63,91,,percent of total billed charges,,,1133.35,95,,percent of total billed charges,,,990.19,83,,percent of total billed charges,,,357.9,83,,percent of total billed charges,,,,,,,,,,,,,,,990.19,83,,percent of total billed charges,,,,,,,,,1073.7,90,,percent of total billed charges,,,1073.7,90,,percent of total billed charges,,,1073.7,90,,percent of total billed charges,,,1073.7,90,,percent of total billed charges,,,1014.05,85,,percent of total billed charges,,357.9,1133.35,
"EXPLORE WOUND, ABDOMEN",20102,CDM,20102,CPT,,,both,,1684,1684,436.67,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,1431.4,85,,percent of total billed charges,,565.83,,,,fee schedule,,273.34,,,,fee schedule,,480,,,,fee schedule,,419.15,,,,fee schedule,,480,,,,fee schedule,,423.83,,,,fee schedule,,256.86,,,,fee schedule,,256.86,,,,fee schedule,,,1532.44,91,,percent of total billed charges,,,1599.8,95,,percent of total billed charges,,,1397.72,83,,percent of total billed charges,,,505.2,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,1397.72,83,,percent of total billed charges,,377.59,,,,fee schedule,,,1515.6,90,,percent of total billed charges,,,1515.6,90,,percent of total billed charges,,,1515.6,90,,percent of total billed charges,,,1515.6,90,,percent of total billed charges,,,1431.4,85,,percent of total billed charges,,256.86,1599.8,
"EXPLORE WOUND, EXTREMITY",20103,CDM,20103,CPT,,,both,,2611,2611,593.36,,,,fee schedule,,,,,,,,213.31,,,,fee schedule,,,2219.35,85,,percent of total billed charges,,752.97,,,,fee schedule,,363.75,,,,fee schedule,,213.31,,,,fee schedule,,622.75,,,,fee schedule,,213.31,,,,fee schedule,,575.91,,,,fee schedule,,349.04,,,,fee schedule,,349.04,,,,fee schedule,,,2376.01,91,,percent of total billed charges,,,2480.45,95,,percent of total billed charges,,,2167.13,83,,percent of total billed charges,,,783.3,83,,percent of total billed charges,,213.31,,,,fee schedule,,213.31,,,,fee schedule,,,2167.13,83,,percent of total billed charges,,513.09,,,,fee schedule,,,2349.9,90,,percent of total billed charges,,,2349.9,90,,percent of total billed charges,,,2349.9,90,,percent of total billed charges,,,2349.9,90,,percent of total billed charges,,,2219.35,85,,percent of total billed charges,,213.31,2480.45,
"BONE BIOPSY, TROCAR/NEEDLE DEEP",20225,CDM,20225,CPT,,,both,,1244,1244,219.49,,,,fee schedule,,,,,,,,187.3,,,,fee schedule,,,1057.4,85,,percent of total billed charges,,280.06,,,,fee schedule,,135.3,,,,fee schedule,,187.3,,,,fee schedule,,213.55,,,,fee schedule,,187.3,,,,fee schedule,,213.03,,,,fee schedule,,129.11,,,,fee schedule,,129.11,,,,fee schedule,,,1132.04,91,,percent of total billed charges,,,1181.8,95,,percent of total billed charges,,,1032.52,83,,percent of total billed charges,,,373.2,83,,percent of total billed charges,,187.3,,,,fee schedule,,187.3,,,,fee schedule,,,1032.52,83,,percent of total billed charges,,189.79,,,,fee schedule,,,1119.6,90,,percent of total billed charges,,,1119.6,90,,percent of total billed charges,,,1119.6,90,,percent of total billed charges,,,1119.6,90,,percent of total billed charges,,,1057.4,85,,percent of total billed charges,,129.11,1181.8,
"BONE BIOPSY, TROCAR/NEEDLE",20225AS,CDM,20225,CPT,,,both,AS,689,689,219.49,,,,fee schedule,,,,,,,,187.3,,,,fee schedule,,,585.65,85,,percent of total billed charges,,280.06,,,,fee schedule,,135.3,,,,fee schedule,,187.3,,,,fee schedule,,213.55,,,,fee schedule,,187.3,,,,fee schedule,,213.03,,,,fee schedule,,129.11,,,,fee schedule,,129.11,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,187.3,,,,fee schedule,,187.3,,,,fee schedule,,,571.87,83,,percent of total billed charges,,189.79,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,129.11,654.55,
FOOT EXAMINATION PERFORMED,2028F,CDM,2028F,CPT,,,both,,90,90,,,,,,,,,,,,,,,,,,,,76.5,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,27,85.5,
REMOVAL OF FOREIGN BODY,20520,CDM,20520,CPT,,,both,,704,704,253.48,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,598.4,85,,percent of total billed charges,,315.55,,,,fee schedule,,152.44,,,,fee schedule,,107,,,,fee schedule,,253.34,,,,fee schedule,,107,,,,fee schedule,,246.02,,,,fee schedule,,149.1,,,,fee schedule,,149.1,,,,fee schedule,,,640.64,91,,percent of total billed charges,,,668.8,95,,percent of total billed charges,,,584.32,83,,percent of total billed charges,,,211.2,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,584.32,83,,percent of total billed charges,,219.18,,,,fee schedule,,,633.6,90,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,598.4,85,,percent of total billed charges,,107,668.8,
REMOVAL OF FOREIGN BODY,20520P,CDM,20520,CPT,,,both,P,533,533,253.48,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,453.05,85,,percent of total billed charges,,315.55,,,,fee schedule,,152.44,,,,fee schedule,,107,,,,fee schedule,,253.34,,,,fee schedule,,107,,,,fee schedule,,246.02,,,,fee schedule,,149.1,,,,fee schedule,,149.1,,,,fee schedule,,,485.03,91,,percent of total billed charges,,,506.35,95,,percent of total billed charges,,,442.39,83,,percent of total billed charges,,,159.9,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,442.39,83,,percent of total billed charges,,219.18,,,,fee schedule,,,479.7,90,,percent of total billed charges,,,479.7,90,,percent of total billed charges,,,479.7,90,,percent of total billed charges,,,479.7,90,,percent of total billed charges,,,453.05,85,,percent of total billed charges,,107,506.35,
REMOVAL OF FOREIGN BODY,20520T,CDM,20520,CPT,,,both,T,171,171,253.48,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,145.35,85,,percent of total billed charges,,315.55,,,,fee schedule,,152.44,,,,fee schedule,,107,,,,fee schedule,,253.34,,,,fee schedule,,107,,,,fee schedule,,246.02,,,,fee schedule,,149.1,,,,fee schedule,,149.1,,,,fee schedule,,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,51.3,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,141.93,83,,percent of total billed charges,,219.18,,,,fee schedule,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,51.3,315.55,
RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP,20525,CDM,20525,CPT,,,both,,1867,1867,425.72,,,,fee schedule,,,,,,,,167.8,,,,fee schedule,,,1586.95,85,,percent of total billed charges,,535.64,,,,fee schedule,,258.76,,,,fee schedule,,167.8,,,,fee schedule,,437.72,,,,fee schedule,,167.8,,,,fee schedule,,413.2,,,,fee schedule,,250.43,,,,fee schedule,,250.43,,,,fee schedule,,,1698.97,91,,percent of total billed charges,,,1773.65,95,,percent of total billed charges,,,1549.61,83,,percent of total billed charges,,,560.1,83,,percent of total billed charges,,167.8,,,,fee schedule,,167.8,,,,fee schedule,,,1549.61,83,,percent of total billed charges,,368.13,,,,fee schedule,,,1680.3,90,,percent of total billed charges,,,1680.3,90,,percent of total billed charges,,,1680.3,90,,percent of total billed charges,,,1680.3,90,,percent of total billed charges,,,1586.95,85,,percent of total billed charges,,167.8,1773.65,
INJECTION THERAPEUTIC CARPAL TUNNEL,20526,CDM,20526,CPT,,,both,,342,342,97.93,,,,fee schedule,,,,,,,,31.35,,,,fee schedule,,,290.7,85,,percent of total billed charges,,125.45,,,,fee schedule,,60.6,,,,fee schedule,,31.35,,,,fee schedule,,104.79,,,,fee schedule,,31.35,,,,fee schedule,,95.05,,,,fee schedule,,57.61,,,,fee schedule,,57.61,,,,fee schedule,,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,102.6,83,,percent of total billed charges,,31.35,,,,fee schedule,,31.35,,,,fee schedule,,,283.86,83,,percent of total billed charges,,84.68,,,,fee schedule,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,31.35,324.9,
"THER INJECTION, CARP TUNNEL",20526P,CDM,20526,CPT,,,both,P,263,263,97.93,,,,fee schedule,,,,,,,,31.35,,,,fee schedule,,,223.55,85,,percent of total billed charges,,125.45,,,,fee schedule,,60.6,,,,fee schedule,,31.35,,,,fee schedule,,104.79,,,,fee schedule,,31.35,,,,fee schedule,,95.05,,,,fee schedule,,57.61,,,,fee schedule,,57.61,,,,fee schedule,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,78.9,83,,percent of total billed charges,,31.35,,,,fee schedule,,31.35,,,,fee schedule,,,218.29,83,,percent of total billed charges,,84.68,,,,fee schedule,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,31.35,249.85,
"THER INJECTION, CARP TUNNEL",20526T,CDM,20526,CPT,,,both,T,79,79,97.93,,,,fee schedule,,,,,,,,31.35,,,,fee schedule,,,67.15,85,,percent of total billed charges,,125.45,,,,fee schedule,,60.6,,,,fee schedule,,31.35,,,,fee schedule,,104.79,,,,fee schedule,,31.35,,,,fee schedule,,95.05,,,,fee schedule,,57.61,,,,fee schedule,,57.61,,,,fee schedule,,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,23.7,83,,percent of total billed charges,,31.35,,,,fee schedule,,31.35,,,,fee schedule,,,65.57,83,,percent of total billed charges,,84.68,,,,fee schedule,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,23.7,125.45,
INJ DUPUYTRENCORD W/ENZYME,20527,CDM,20527,CPT,,,both,,236,236,112.91,,,,fee schedule,,,,,,,,35.65,,,,fee schedule,,,200.6,85,,percent of total billed charges,,142.46,,,,fee schedule,,68.82,,,,fee schedule,,35.65,,,,fee schedule,,,,,,,,35.65,,,,fee schedule,,109.59,,,,fee schedule,,66.42,,,,fee schedule,,66.42,,,,fee schedule,,,214.76,91,,percent of total billed charges,,,224.2,95,,percent of total billed charges,,,195.88,83,,percent of total billed charges,,,70.8,83,,percent of total billed charges,,35.65,,,,fee schedule,,35.65,,,,fee schedule,,,195.88,83,,percent of total billed charges,,97.64,,,,fee schedule,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,200.6,85,,percent of total billed charges,,35.65,224.2,
INJ DUPUYTREN CORD W/ENZYME,20527P,CDM,20527,CPT,,,both,P,150,150,112.91,,,,fee schedule,,,,,,,,35.65,,,,fee schedule,,,127.5,85,,percent of total billed charges,,142.46,,,,fee schedule,,68.82,,,,fee schedule,,35.65,,,,fee schedule,,,,,,,,35.65,,,,fee schedule,,109.59,,,,fee schedule,,66.42,,,,fee schedule,,66.42,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,35.65,,,,fee schedule,,35.65,,,,fee schedule,,,124.5,83,,percent of total billed charges,,97.64,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,35.65,142.5,
INJ DUPUYTREN CORD W/ENZYME,20527T,CDM,20527,CPT,,,both,T,86,86,112.91,,,,fee schedule,,,,,,,,35.65,,,,fee schedule,,,73.1,85,,percent of total billed charges,,142.46,,,,fee schedule,,68.82,,,,fee schedule,,35.65,,,,fee schedule,,,,,,,,35.65,,,,fee schedule,,109.59,,,,fee schedule,,66.42,,,,fee schedule,,66.42,,,,fee schedule,,,78.26,91,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,25.8,83,,percent of total billed charges,,35.65,,,,fee schedule,,35.65,,,,fee schedule,,,71.38,83,,percent of total billed charges,,97.64,,,,fee schedule,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,25.8,142.46,
INJECTION 1 TENDON SHEATH/LIGAMENT Fluoro Guided,20550,CDM,20550,CPT,,,both,,262,262,66.83,,,,fee schedule,,,,,,,,31.75,,,,fee schedule,,,222.7,85,,percent of total billed charges,,85.41,,,,fee schedule,,41.37,,,,fee schedule,,31.75,,,,fee schedule,,70.3,,,,fee schedule,,31.75,,,,fee schedule,,64.86,,,,fee schedule,,39.31,,,,fee schedule,,39.31,,,,fee schedule,,,238.42,91,,percent of total billed charges,,,248.9,95,,percent of total billed charges,,,217.46,83,,percent of total billed charges,,,78.6,83,,percent of total billed charges,,31.75,,,,fee schedule,,31.75,,,,fee schedule,,,217.46,83,,percent of total billed charges,,57.78,,,,fee schedule,,,235.8,90,,percent of total billed charges,,,235.8,90,,percent of total billed charges,,,235.8,90,,percent of total billed charges,,,235.8,90,,percent of total billed charges,,,222.7,85,,percent of total billed charges,,31.75,248.9,
INJ TENDON SHEATH/LIGAMENT,20550P,CDM,20550,CPT,,,both,P,207,207,66.83,,,,fee schedule,,,,,,,,31.75,,,,fee schedule,,,175.95,85,,percent of total billed charges,,85.41,,,,fee schedule,,41.37,,,,fee schedule,,31.75,,,,fee schedule,,70.3,,,,fee schedule,,31.75,,,,fee schedule,,64.86,,,,fee schedule,,39.31,,,,fee schedule,,39.31,,,,fee schedule,,,188.37,91,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,62.1,83,,percent of total billed charges,,31.75,,,,fee schedule,,31.75,,,,fee schedule,,,171.81,83,,percent of total billed charges,,57.78,,,,fee schedule,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,175.95,85,,percent of total billed charges,,31.75,196.65,
INJ TENDON SHEATH/LIGAMENT,20550T,CDM,20550,CPT,,,both,T,55,55,66.83,,,,fee schedule,,,,,,,,31.75,,,,fee schedule,,,46.75,85,,percent of total billed charges,,85.41,,,,fee schedule,,41.37,,,,fee schedule,,31.75,,,,fee schedule,,70.3,,,,fee schedule,,31.75,,,,fee schedule,,64.86,,,,fee schedule,,39.31,,,,fee schedule,,39.31,,,,fee schedule,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,16.5,83,,percent of total billed charges,,31.75,,,,fee schedule,,31.75,,,,fee schedule,,,45.65,83,,percent of total billed charges,,57.78,,,,fee schedule,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,16.5,85.41,
INJECTION SINGLE TENDON ORIGIN/INSERTION,20551,CDM,20551,CPT,,,both,,273,273,66.83,,,,fee schedule,,,,,,,,31.75,,,,fee schedule,,,232.05,85,,percent of total billed charges,,85.43,,,,fee schedule,,41.27,,,,fee schedule,,31.75,,,,fee schedule,,76.93,,,,fee schedule,,31.75,,,,fee schedule,,64.86,,,,fee schedule,,39.31,,,,fee schedule,,39.31,,,,fee schedule,,,248.43,91,,percent of total billed charges,,,259.35,95,,percent of total billed charges,,,226.59,83,,percent of total billed charges,,,81.9,83,,percent of total billed charges,,31.75,,,,fee schedule,,31.75,,,,fee schedule,,,226.59,83,,percent of total billed charges,,57.78,,,,fee schedule,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,232.05,85,,percent of total billed charges,,31.75,259.35,
INJ TENDON ORIGIN/INSERTION,20551P,CDM,20551,CPT,,,both,P,217,217,66.83,,,,fee schedule,,,,,,,,31.75,,,,fee schedule,,,184.45,85,,percent of total billed charges,,85.43,,,,fee schedule,,41.27,,,,fee schedule,,31.75,,,,fee schedule,,76.93,,,,fee schedule,,31.75,,,,fee schedule,,64.86,,,,fee schedule,,39.31,,,,fee schedule,,39.31,,,,fee schedule,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,65.1,83,,percent of total billed charges,,31.75,,,,fee schedule,,31.75,,,,fee schedule,,,180.11,83,,percent of total billed charges,,57.78,,,,fee schedule,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,31.75,206.15,
INJ TENDON ORIGIN/INSERTION,20551T,CDM,20551,CPT,,,both,T,56,56,66.83,,,,fee schedule,,,,,,,,31.75,,,,fee schedule,,,47.6,85,,percent of total billed charges,,85.43,,,,fee schedule,,41.27,,,,fee schedule,,31.75,,,,fee schedule,,76.93,,,,fee schedule,,31.75,,,,fee schedule,,64.86,,,,fee schedule,,39.31,,,,fee schedule,,39.31,,,,fee schedule,,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,16.8,83,,percent of total billed charges,,31.75,,,,fee schedule,,31.75,,,,fee schedule,,,46.48,83,,percent of total billed charges,,57.78,,,,fee schedule,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,16.8,85.43,
INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,20552,CDM,20552,CPT,,,both,,263,263,63.37,,,,fee schedule,,,,,,,,31.75,,,,fee schedule,,,223.55,85,,percent of total billed charges,,82.1,,,,fee schedule,,39.66,,,,fee schedule,,31.75,,,,fee schedule,,60.35,,,,fee schedule,,31.75,,,,fee schedule,,61.51,,,,fee schedule,,37.28,,,,fee schedule,,37.28,,,,fee schedule,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,78.9,83,,percent of total billed charges,,31.75,,,,fee schedule,,31.75,,,,fee schedule,,,218.29,83,,percent of total billed charges,,54.8,,,,fee schedule,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,31.75,249.85,
"INJ TRIGGER POINT, 1/2 MUSCL",20552P,CDM,20552,CPT,,,both,P,209,209,63.37,,,,fee schedule,,,,,,,,31.75,,,,fee schedule,,,177.65,85,,percent of total billed charges,,82.1,,,,fee schedule,,39.66,,,,fee schedule,,31.75,,,,fee schedule,,60.35,,,,fee schedule,,31.75,,,,fee schedule,,61.51,,,,fee schedule,,37.28,,,,fee schedule,,37.28,,,,fee schedule,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,62.7,83,,percent of total billed charges,,31.75,,,,fee schedule,,31.75,,,,fee schedule,,,173.47,83,,percent of total billed charges,,54.8,,,,fee schedule,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,31.75,198.55,
"INJ TRIGGER POINT, 1/2 MUSCL",20552T,CDM,20552,CPT,,,both,T,54,54,63.37,,,,fee schedule,,,,,,,,31.75,,,,fee schedule,,,45.9,85,,percent of total billed charges,,82.1,,,,fee schedule,,39.66,,,,fee schedule,,31.75,,,,fee schedule,,60.35,,,,fee schedule,,31.75,,,,fee schedule,,61.51,,,,fee schedule,,37.28,,,,fee schedule,,37.28,,,,fee schedule,,,49.14,91,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,16.2,83,,percent of total billed charges,,31.75,,,,fee schedule,,31.75,,,,fee schedule,,,44.82,83,,percent of total billed charges,,54.8,,,,fee schedule,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,16.2,82.1,
"INJECT TRIGGER POINTS, =/> 3",20553,CDM,20553,CPT,,,both,,335,335,72.59,,,,fee schedule,,,,,,,,31.75,,,,fee schedule,,,284.75,85,,percent of total billed charges,,93.16,,,,fee schedule,,45,,,,fee schedule,,31.75,,,,fee schedule,,67.65,,,,fee schedule,,31.75,,,,fee schedule,,70.45,,,,fee schedule,,42.7,,,,fee schedule,,42.7,,,,fee schedule,,,304.85,91,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,100.5,83,,percent of total billed charges,,31.75,,,,fee schedule,,31.75,,,,fee schedule,,,278.05,83,,percent of total billed charges,,62.77,,,,fee schedule,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,31.75,318.25,
"INJECT TRIGGER POINTS, =/> 3",20553P,CDM,20553,CPT,,,both,P,175,175,72.59,,,,fee schedule,,,,,,,,31.75,,,,fee schedule,,,148.75,85,,percent of total billed charges,,93.16,,,,fee schedule,,45,,,,fee schedule,,31.75,,,,fee schedule,,67.65,,,,fee schedule,,31.75,,,,fee schedule,,70.45,,,,fee schedule,,42.7,,,,fee schedule,,42.7,,,,fee schedule,,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,52.5,83,,percent of total billed charges,,31.75,,,,fee schedule,,31.75,,,,fee schedule,,,145.25,83,,percent of total billed charges,,62.77,,,,fee schedule,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,31.75,166.25,
"INJECT TRIGGER POINTS, =/> 3",20553T,CDM,20553,CPT,,,both,T,160,160,72.59,,,,fee schedule,,,,,,,,31.75,,,,fee schedule,,,136,85,,percent of total billed charges,,93.16,,,,fee schedule,,45,,,,fee schedule,,31.75,,,,fee schedule,,67.65,,,,fee schedule,,31.75,,,,fee schedule,,70.45,,,,fee schedule,,42.7,,,,fee schedule,,42.7,,,,fee schedule,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,48,83,,percent of total billed charges,,31.75,,,,fee schedule,,31.75,,,,fee schedule,,,132.8,83,,percent of total billed charges,,62.77,,,,fee schedule,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,31.75,152,
NDL INSJ W/O NJX 1 OR 2 MUSC,20560,CDM,20560,CPT,,,both,,37,37,25.35,,,,fee schedule,,,,,,,,,,,,,,,31.45,85,,percent of total billed charges,,55.87,,,,fee schedule,,26.99,,,,fee schedule,,,,,,,,,,,,,,,,,,,,24.6,,,,fee schedule,,14.91,,,,fee schedule,,14.91,,,,fee schedule,,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,11.1,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,21.92,,,,fee schedule,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,11.1,55.87,
NDL INSJ W/O NJX 3+ MUSC,20561,CDM,20561,CPT,,,both,,47,47,38.02,,,,fee schedule,,,,,,,,,,,,,,,39.95,85,,percent of total billed charges,,79.5,,,,fee schedule,,38.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,36.9,,,,fee schedule,,22.37,,,,fee schedule,,22.37,,,,fee schedule,,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,14.1,83,,percent of total billed charges,,,,,,,,,,,,,,,39.01,83,,percent of total billed charges,,32.88,,,,fee schedule,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,14.1,79.5,
ARTHROCENTESIS ASPIR/INJECTION SMALL JT/BURSA,20600,CDM,20600,CPT,,,both,,236,236,60.49,,,,fee schedule,,,,,,,,30.4,,,,fee schedule,,,200.6,85,,percent of total billed charges,,78,,,,fee schedule,,36.28,,,,fee schedule,,30.4,,,,fee schedule,,72.29,,,,fee schedule,,30.4,,,,fee schedule,,58.71,,,,fee schedule,,35.58,,,,fee schedule,,35.58,,,,fee schedule,,,214.76,91,,percent of total billed charges,,,224.2,95,,percent of total billed charges,,,195.88,83,,percent of total billed charges,,,70.8,83,,percent of total billed charges,,30.4,,,,fee schedule,,30.4,,,,fee schedule,,,195.88,83,,percent of total billed charges,,52.3,,,,fee schedule,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,200.6,85,,percent of total billed charges,,30.4,224.2,
"DRAIN/INJECT, JOINT/BURSA",20600P,CDM,20600,CPT,,,both,P,185,185,60.49,,,,fee schedule,,,,,,,,30.4,,,,fee schedule,,,157.25,85,,percent of total billed charges,,78,,,,fee schedule,,36.28,,,,fee schedule,,30.4,,,,fee schedule,,72.29,,,,fee schedule,,30.4,,,,fee schedule,,58.71,,,,fee schedule,,35.58,,,,fee schedule,,35.58,,,,fee schedule,,,168.35,91,,percent of total billed charges,,,175.75,95,,percent of total billed charges,,,153.55,83,,percent of total billed charges,,,55.5,83,,percent of total billed charges,,30.4,,,,fee schedule,,30.4,,,,fee schedule,,,153.55,83,,percent of total billed charges,,52.3,,,,fee schedule,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,157.25,85,,percent of total billed charges,,30.4,175.75,
"DRAIN/INJECT, JOINT/BURSA",20600T,CDM,20600,CPT,,,both,T,51,51,60.49,,,,fee schedule,,,,,,,,30.4,,,,fee schedule,,,43.35,85,,percent of total billed charges,,78,,,,fee schedule,,36.28,,,,fee schedule,,30.4,,,,fee schedule,,72.29,,,,fee schedule,,30.4,,,,fee schedule,,58.71,,,,fee schedule,,35.58,,,,fee schedule,,35.58,,,,fee schedule,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,30.4,,,,fee schedule,,30.4,,,,fee schedule,,,42.33,83,,percent of total billed charges,,52.3,,,,fee schedule,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,15.3,78,
DRAIN/INJ JOINT/BURSA W/US,20604,CDM,20604,CPT,,,both,,376,376,78.35,,,,fee schedule,,,,,,,,28.22,,,,fee schedule,,,319.6,85,,percent of total billed charges,,100.24,,,,fee schedule,,46.63,,,,fee schedule,,28.22,,,,fee schedule,,,,,,,,28.22,,,,fee schedule,,76.04,,,,fee schedule,,46.09,,,,fee schedule,,46.09,,,,fee schedule,,,342.16,91,,percent of total billed charges,,,357.2,95,,percent of total billed charges,,,312.08,83,,percent of total billed charges,,,112.8,83,,percent of total billed charges,,28.22,,,,fee schedule,,28.22,,,,fee schedule,,,312.08,83,,percent of total billed charges,,67.75,,,,fee schedule,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,338.4,90,,percent of total billed charges,,,319.6,85,,percent of total billed charges,,28.22,357.2,
DRAIN/INJ JOINT/BURSA W/US,20604 P,CDM,20604,CPT,,,both, P,185,185,78.35,,,,fee schedule,,,,,,,,28.22,,,,fee schedule,,,157.25,85,,percent of total billed charges,,100.24,,,,fee schedule,,46.63,,,,fee schedule,,28.22,,,,fee schedule,,,,,,,,28.22,,,,fee schedule,,76.04,,,,fee schedule,,46.09,,,,fee schedule,,46.09,,,,fee schedule,,,168.35,91,,percent of total billed charges,,,175.75,95,,percent of total billed charges,,,153.55,83,,percent of total billed charges,,,55.5,83,,percent of total billed charges,,28.22,,,,fee schedule,,28.22,,,,fee schedule,,,153.55,83,,percent of total billed charges,,67.75,,,,fee schedule,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,157.25,85,,percent of total billed charges,,28.22,175.75,
DRAIN/INJ JOINT/BURSA W/US,20604 T,CDM,20604,CPT,,,both, T,191,191,78.35,,,,fee schedule,,,,,,,,28.22,,,,fee schedule,,,162.35,85,,percent of total billed charges,,100.24,,,,fee schedule,,46.63,,,,fee schedule,,28.22,,,,fee schedule,,,,,,,,28.22,,,,fee schedule,,76.04,,,,fee schedule,,46.09,,,,fee schedule,,46.09,,,,fee schedule,,,173.81,91,,percent of total billed charges,,,181.45,95,,percent of total billed charges,,,158.53,83,,percent of total billed charges,,,57.3,83,,percent of total billed charges,,28.22,,,,fee schedule,,28.22,,,,fee schedule,,,158.53,83,,percent of total billed charges,,67.75,,,,fee schedule,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,162.35,85,,percent of total billed charges,,28.22,181.45,
ARTHROCENTESIS ASPIR/INJECTION INTERM JT/BURSA,20605,CDM,20605,CPT,,,both,,259,259,63.37,,,,fee schedule,,,,,,,,33,,,,fee schedule,,,220.15,85,,percent of total billed charges,,80.87,,,,fee schedule,,37.62,,,,fee schedule,,33,,,,fee schedule,,74.28,,,,fee schedule,,33,,,,fee schedule,,61.51,,,,fee schedule,,37.28,,,,fee schedule,,37.28,,,,fee schedule,,,235.69,91,,percent of total billed charges,,,246.05,95,,percent of total billed charges,,,214.97,83,,percent of total billed charges,,,77.7,83,,percent of total billed charges,,33,,,,fee schedule,,33,,,,fee schedule,,,214.97,83,,percent of total billed charges,,54.8,,,,fee schedule,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,220.15,85,,percent of total billed charges,,33,246.05,
"DRAIN/INJECT, JOINT/BURSA",20605P,CDM,20605,CPT,,,both,P,204,204,63.37,,,,fee schedule,,,,,,,,33,,,,fee schedule,,,173.4,85,,percent of total billed charges,,80.87,,,,fee schedule,,37.62,,,,fee schedule,,33,,,,fee schedule,,74.28,,,,fee schedule,,33,,,,fee schedule,,61.51,,,,fee schedule,,37.28,,,,fee schedule,,37.28,,,,fee schedule,,,185.64,91,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,61.2,83,,percent of total billed charges,,33,,,,fee schedule,,33,,,,fee schedule,,,169.32,83,,percent of total billed charges,,54.8,,,,fee schedule,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,173.4,85,,percent of total billed charges,,33,193.8,
"DRAIN/INJECT, JOINT/BURSA",20605T,CDM,20605,CPT,,,both,T,55,55,63.37,,,,fee schedule,,,,,,,,33,,,,fee schedule,,,46.75,85,,percent of total billed charges,,80.87,,,,fee schedule,,37.62,,,,fee schedule,,33,,,,fee schedule,,74.28,,,,fee schedule,,33,,,,fee schedule,,61.51,,,,fee schedule,,37.28,,,,fee schedule,,37.28,,,,fee schedule,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,16.5,83,,percent of total billed charges,,33,,,,fee schedule,,33,,,,fee schedule,,,45.65,83,,percent of total billed charges,,54.8,,,,fee schedule,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,16.5,80.87,
DRAIN/INJ JOINT/BURSA W/US,20606,CDM,20606,CPT,,,both,,372,372,88.72,,,,fee schedule,,,,,,,,32.29,,,,fee schedule,,,316.2,85,,percent of total billed charges,,112.8,,,,fee schedule,,52.47,,,,fee schedule,,32.29,,,,fee schedule,,,,,,,,32.29,,,,fee schedule,,86.11,,,,fee schedule,,52.19,,,,fee schedule,,52.19,,,,fee schedule,,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,111.6,83,,percent of total billed charges,,32.29,,,,fee schedule,,32.29,,,,fee schedule,,,308.76,83,,percent of total billed charges,,76.71,,,,fee schedule,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,32.29,353.4,
DRAIN/INJ JOINT/BURSA W/US,20606P,CDM,20606,CPT,,,both,P,261,261,88.72,,,,fee schedule,,,,,,,,32.29,,,,fee schedule,,,221.85,85,,percent of total billed charges,,112.8,,,,fee schedule,,52.47,,,,fee schedule,,32.29,,,,fee schedule,,,,,,,,32.29,,,,fee schedule,,86.11,,,,fee schedule,,52.19,,,,fee schedule,,52.19,,,,fee schedule,,,237.51,91,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,78.3,83,,percent of total billed charges,,32.29,,,,fee schedule,,32.29,,,,fee schedule,,,216.63,83,,percent of total billed charges,,76.71,,,,fee schedule,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,221.85,85,,percent of total billed charges,,32.29,247.95,
DRAIN/INJ JOINT/BURSA W/US,20606T,CDM,20606,CPT,,,both,T,111,111,88.72,,,,fee schedule,,,,,,,,32.29,,,,fee schedule,,,94.35,85,,percent of total billed charges,,112.8,,,,fee schedule,,52.47,,,,fee schedule,,32.29,,,,fee schedule,,,,,,,,32.29,,,,fee schedule,,86.11,,,,fee schedule,,52.19,,,,fee schedule,,52.19,,,,fee schedule,,,101.01,91,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,33.3,83,,percent of total billed charges,,32.29,,,,fee schedule,,32.29,,,,fee schedule,,,92.13,83,,percent of total billed charges,,76.71,,,,fee schedule,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,94.35,85,,percent of total billed charges,,32.29,112.8,
ARTHROCENTESIS ASPIR/INJECTION MAJOR JT/BURSA,20610,CDM,20610,CPT,,,both,,326,326,77.2,,,,fee schedule,,,,,,,,31.8,,,,fee schedule,,,277.1,85,,percent of total billed charges,,105.07,,,,fee schedule,,45.88,,,,fee schedule,,31.8,,,,fee schedule,,86.88,,,,fee schedule,,31.8,,,,fee schedule,,74.92,,,,fee schedule,,45.41,,,,fee schedule,,45.41,,,,fee schedule,,,296.66,91,,percent of total billed charges,,,309.7,95,,percent of total billed charges,,,270.58,83,,percent of total billed charges,,,97.8,83,,percent of total billed charges,,31.8,,,,fee schedule,,31.8,,,,fee schedule,,,270.58,83,,percent of total billed charges,,66.75,,,,fee schedule,,,293.4,90,,percent of total billed charges,,,293.4,90,,percent of total billed charges,,,293.4,90,,percent of total billed charges,,,293.4,90,,percent of total billed charges,,,277.1,85,,percent of total billed charges,,31.8,309.7,
"DRAIN/INJECT, JOINT/BURSA",20610P,CDM,20610,CPT,,,both,P,260,260,77.2,,,,fee schedule,,,,,,,,31.8,,,,fee schedule,,,221,85,,percent of total billed charges,,105.07,,,,fee schedule,,45.88,,,,fee schedule,,31.8,,,,fee schedule,,86.88,,,,fee schedule,,31.8,,,,fee schedule,,74.92,,,,fee schedule,,45.41,,,,fee schedule,,45.41,,,,fee schedule,,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,78,83,,percent of total billed charges,,31.8,,,,fee schedule,,31.8,,,,fee schedule,,,215.8,83,,percent of total billed charges,,66.75,,,,fee schedule,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,31.8,247,
"DRAIN/INJECT, JOINT/BURSA",20610T,CDM,20610,CPT,,,both,T,66,66,77.2,,,,fee schedule,,,,,,,,31.8,,,,fee schedule,,,56.1,85,,percent of total billed charges,,105.07,,,,fee schedule,,45.88,,,,fee schedule,,31.8,,,,fee schedule,,86.88,,,,fee schedule,,31.8,,,,fee schedule,,74.92,,,,fee schedule,,45.41,,,,fee schedule,,45.41,,,,fee schedule,,,60.06,91,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,31.8,,,,fee schedule,,31.8,,,,fee schedule,,,54.78,83,,percent of total billed charges,,66.75,,,,fee schedule,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,19.8,105.07,
DRAIN/INJ JOINT/BURSA W/US,20611,CDM,20611,CPT,,,both,,503,503,102.54,,,,fee schedule,,,,,,,,38.11,,,,fee schedule,,,427.55,85,,percent of total billed charges,,129.11,,,,fee schedule,,60.06,,,,fee schedule,,38.11,,,,fee schedule,,,,,,,,38.11,,,,fee schedule,,99.53,,,,fee schedule,,60.32,,,,fee schedule,,60.32,,,,fee schedule,,,457.73,91,,percent of total billed charges,,,477.85,95,,percent of total billed charges,,,417.49,83,,percent of total billed charges,,,150.9,83,,percent of total billed charges,,38.11,,,,fee schedule,,38.11,,,,fee schedule,,,417.49,83,,percent of total billed charges,,88.67,,,,fee schedule,,,452.7,90,,percent of total billed charges,,,452.7,90,,percent of total billed charges,,,452.7,90,,percent of total billed charges,,,452.7,90,,percent of total billed charges,,,427.55,85,,percent of total billed charges,,38.11,477.85,
DRAIN/INJ JOINT/BURSA W/US,20611P,CDM,20611,CPT,,,both,P,415,415,102.54,,,,fee schedule,,,,,,,,38.11,,,,fee schedule,,,352.75,85,,percent of total billed charges,,129.11,,,,fee schedule,,60.06,,,,fee schedule,,38.11,,,,fee schedule,,,,,,,,38.11,,,,fee schedule,,99.53,,,,fee schedule,,60.32,,,,fee schedule,,60.32,,,,fee schedule,,,377.65,91,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,38.11,,,,fee schedule,,38.11,,,,fee schedule,,,344.45,83,,percent of total billed charges,,88.67,,,,fee schedule,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,38.11,394.25,
DRAIN/INJ JOINT/BURSA W/US,20611T,CDM,20611,CPT,,,both,T,88,88,102.54,,,,fee schedule,,,,,,,,38.11,,,,fee schedule,,,74.8,85,,percent of total billed charges,,129.11,,,,fee schedule,,60.06,,,,fee schedule,,38.11,,,,fee schedule,,,,,,,,38.11,,,,fee schedule,,99.53,,,,fee schedule,,60.32,,,,fee schedule,,60.32,,,,fee schedule,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,26.4,83,,percent of total billed charges,,38.11,,,,fee schedule,,38.11,,,,fee schedule,,,73.04,83,,percent of total billed charges,,88.67,,,,fee schedule,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,26.4,129.11,
ASPIRATION/INJECTION GANGLION CYST ANY LOCATION,20612,CDM,20612,CPT,,,both,,273,273,70.28,,,,fee schedule,,,,,,,,31.8,,,,fee schedule,,,232.05,85,,percent of total billed charges,,89.41,,,,fee schedule,,41.59,,,,fee schedule,,31.8,,,,fee schedule,,76.27,,,,fee schedule,,31.8,,,,fee schedule,,68.21,,,,fee schedule,,41.34,,,,fee schedule,,41.34,,,,fee schedule,,,248.43,91,,percent of total billed charges,,,259.35,95,,percent of total billed charges,,,226.59,83,,percent of total billed charges,,,81.9,83,,percent of total billed charges,,31.8,,,,fee schedule,,31.8,,,,fee schedule,,,226.59,83,,percent of total billed charges,,60.77,,,,fee schedule,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,232.05,85,,percent of total billed charges,,31.8,259.35,
ASPIRATE/INJ GANGLION CYST,20612P,CDM,20612,CPT,,,both,P,150,150,70.28,,,,fee schedule,,,,,,,,31.8,,,,fee schedule,,,127.5,85,,percent of total billed charges,,89.41,,,,fee schedule,,41.59,,,,fee schedule,,31.8,,,,fee schedule,,76.27,,,,fee schedule,,31.8,,,,fee schedule,,68.21,,,,fee schedule,,41.34,,,,fee schedule,,41.34,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,31.8,,,,fee schedule,,31.8,,,,fee schedule,,,124.5,83,,percent of total billed charges,,60.77,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,31.8,142.5,
ASPIRATE/INJ GANGLION CYST,20612T,CDM,20612,CPT,,,both,T,123,123,70.28,,,,fee schedule,,,,,,,,31.8,,,,fee schedule,,,104.55,85,,percent of total billed charges,,89.41,,,,fee schedule,,41.59,,,,fee schedule,,31.8,,,,fee schedule,,76.27,,,,fee schedule,,31.8,,,,fee schedule,,68.21,,,,fee schedule,,41.34,,,,fee schedule,,41.34,,,,fee schedule,,,111.93,91,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,36.9,83,,percent of total billed charges,,31.8,,,,fee schedule,,31.8,,,,fee schedule,,,102.09,83,,percent of total billed charges,,60.77,,,,fee schedule,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,104.55,85,,percent of total billed charges,,31.8,116.85,
TREATMENT OF BONE CYST,20615,CDM,20615,CPT,,,both,,908,908,277.67,,,,fee schedule,,,,,,,,73.35,,,,fee schedule,,,771.8,85,,percent of total billed charges,,343.01,,,,fee schedule,,159.57,,,,fee schedule,,73.35,,,,fee schedule,,286.51,,,,fee schedule,,73.35,,,,fee schedule,,269.5,,,,fee schedule,,163.34,,,,fee schedule,,163.34,,,,fee schedule,,,826.28,91,,percent of total billed charges,,,862.6,95,,percent of total billed charges,,,753.64,83,,percent of total billed charges,,,272.4,83,,percent of total billed charges,,73.35,,,,fee schedule,,73.35,,,,fee schedule,,,753.64,83,,percent of total billed charges,,240.1,,,,fee schedule,,,817.2,90,,percent of total billed charges,,,817.2,90,,percent of total billed charges,,,817.2,90,,percent of total billed charges,,,817.2,90,,percent of total billed charges,,,771.8,85,,percent of total billed charges,,73.35,862.6,
TREATMENT OF BONE CYST,20615 P,CDM,20615,CPT,,,both, P,531,531,277.67,,,,fee schedule,,,,,,,,73.35,,,,fee schedule,,,451.35,85,,percent of total billed charges,,343.01,,,,fee schedule,,159.57,,,,fee schedule,,73.35,,,,fee schedule,,286.51,,,,fee schedule,,73.35,,,,fee schedule,,269.5,,,,fee schedule,,163.34,,,,fee schedule,,163.34,,,,fee schedule,,,483.21,91,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,159.3,83,,percent of total billed charges,,73.35,,,,fee schedule,,73.35,,,,fee schedule,,,440.73,83,,percent of total billed charges,,240.1,,,,fee schedule,,,477.9,90,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,73.35,504.45,
TREATMENT OF BONE CYST,20615 T,CDM,20615,CPT,,,both, T,377,377,277.67,,,,fee schedule,,,,,,,,73.35,,,,fee schedule,,,320.45,85,,percent of total billed charges,,343.01,,,,fee schedule,,159.57,,,,fee schedule,,73.35,,,,fee schedule,,286.51,,,,fee schedule,,73.35,,,,fee schedule,,269.5,,,,fee schedule,,163.34,,,,fee schedule,,163.34,,,,fee schedule,,,343.07,91,,percent of total billed charges,,,358.15,95,,percent of total billed charges,,,312.91,83,,percent of total billed charges,,,113.1,83,,percent of total billed charges,,73.35,,,,fee schedule,,73.35,,,,fee schedule,,,312.91,83,,percent of total billed charges,,240.1,,,,fee schedule,,,339.3,90,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,320.45,85,,percent of total billed charges,,73.35,358.15,
INSERT AND REMOVE BONE PIN,20650,CDM,20650,CPT,,,both,,938,938,282.28,,,,fee schedule,,,,,,,,141.5,,,,fee schedule,,,797.3,85,,percent of total billed charges,,347.52,,,,fee schedule,,167.88,,,,fee schedule,,141.5,,,,fee schedule,,271.25,,,,fee schedule,,141.5,,,,fee schedule,,273.98,,,,fee schedule,,166.05,,,,fee schedule,,166.05,,,,fee schedule,,,853.58,91,,percent of total billed charges,,,891.1,95,,percent of total billed charges,,,778.54,83,,percent of total billed charges,,,281.4,83,,percent of total billed charges,,141.5,,,,fee schedule,,141.5,,,,fee schedule,,,778.54,83,,percent of total billed charges,,244.09,,,,fee schedule,,,844.2,90,,percent of total billed charges,,,844.2,90,,percent of total billed charges,,,844.2,90,,percent of total billed charges,,,844.2,90,,percent of total billed charges,,,797.3,85,,percent of total billed charges,,141.5,891.1,
"APPLY, REM FIXATION DEVICE",20660,CDM,20660,CPT,,,both,,1556,1556,415.93,,,,fee schedule,,,,,,,,192.85,,,,fee schedule,,,1322.6,85,,percent of total billed charges,,538.11,,,,fee schedule,,259.96,,,,fee schedule,,192.85,,,,fee schedule,,309.72,,,,fee schedule,,192.85,,,,fee schedule,,403.7,,,,fee schedule,,244.67,,,,fee schedule,,244.67,,,,fee schedule,,,1415.96,91,,percent of total billed charges,,,1478.2,95,,percent of total billed charges,,,1291.48,83,,percent of total billed charges,,,466.8,83,,percent of total billed charges,,192.85,,,,fee schedule,,192.85,,,,fee schedule,,,1291.48,83,,percent of total billed charges,,359.66,,,,fee schedule,,,1400.4,90,,percent of total billed charges,,,1400.4,90,,percent of total billed charges,,,1400.4,90,,percent of total billed charges,,,1400.4,90,,percent of total billed charges,,,1322.6,85,,percent of total billed charges,,192.85,1478.2,
APPLICATION OF HEAD BRACE,20661,CDM,20661,CPT,,,both,,2730,2730,900.99,,,,fee schedule,,,,,,,,192.85,,,,fee schedule,,,2320.5,85,,percent of total billed charges,,1107.45,,,,fee schedule,,535,,,,fee schedule,,192.85,,,,fee schedule,,722.89,,,,fee schedule,,192.85,,,,fee schedule,,874.49,,,,fee schedule,,530,,,,fee schedule,,530,,,,fee schedule,,,2484.3,91,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,819,83,,percent of total billed charges,,192.85,,,,fee schedule,,192.85,,,,fee schedule,,,2265.9,83,,percent of total billed charges,,779.09,,,,fee schedule,,,2457,90,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,192.85,2593.5,
APPLICATION OF PELVIS BRACE,20662,CDM,20662,CPT,,,both,,2381,2381,905.6,,,,fee schedule,,,,,,,,203.85,,,,fee schedule,,,2023.85,85,,percent of total billed charges,,1126.99,,,,fee schedule,,544.43,,,,fee schedule,,203.85,,,,fee schedule,,805.13,,,,fee schedule,,203.85,,,,fee schedule,,878.97,,,,fee schedule,,532.71,,,,fee schedule,,532.71,,,,fee schedule,,,2166.71,91,,percent of total billed charges,,,2261.95,95,,percent of total billed charges,,,1976.23,83,,percent of total billed charges,,,714.3,83,,percent of total billed charges,,203.85,,,,fee schedule,,203.85,,,,fee schedule,,,1976.23,83,,percent of total billed charges,,783.08,,,,fee schedule,,,2142.9,90,,percent of total billed charges,,,2142.9,90,,percent of total billed charges,,,2142.9,90,,percent of total billed charges,,,2142.9,90,,percent of total billed charges,,,2023.85,85,,percent of total billed charges,,203.85,2261.95,
APPLICATION OF THIGH BRACE,20663,CDM,20663,CPT,,,both,,2417,2417,834.74,,,,fee schedule,,,,,,,,170.05,,,,fee schedule,,,2054.45,85,,percent of total billed charges,,1036.48,,,,fee schedule,,500.71,,,,fee schedule,,170.05,,,,fee schedule,,741.46,,,,fee schedule,,170.05,,,,fee schedule,,810.19,,,,fee schedule,,491.03,,,,fee schedule,,491.03,,,,fee schedule,,,2199.47,91,,percent of total billed charges,,,2296.15,95,,percent of total billed charges,,,2006.11,83,,percent of total billed charges,,,725.1,83,,percent of total billed charges,,170.05,,,,fee schedule,,170.05,,,,fee schedule,,,2006.11,83,,percent of total billed charges,,721.81,,,,fee schedule,,,2175.3,90,,percent of total billed charges,,,2175.3,90,,percent of total billed charges,,,2175.3,90,,percent of total billed charges,,,2175.3,90,,percent of total billed charges,,,2054.45,85,,percent of total billed charges,,170.05,2296.15,
APPL HALO 6/> PINS THIN SKULL OSTEOLOGY ANES,20664,CDM,20664,CPT,,,both,,4555,4555,1546.21,,,,fee schedule,,,,,,,,271.45,,,,fee schedule,,,3871.75,85,,percent of total billed charges,,1943.28,,,,fee schedule,,938.78,,,,fee schedule,,271.45,,,,fee schedule,,1112.2,,,,fee schedule,,271.45,,,,fee schedule,,1500.73,,,,fee schedule,,909.53,,,,fee schedule,,909.53,,,,fee schedule,,,4145.05,91,,percent of total billed charges,,,4327.25,95,,percent of total billed charges,,,3780.65,83,,percent of total billed charges,,,1366.5,83,,percent of total billed charges,,271.45,,,,fee schedule,,271.45,,,,fee schedule,,,3780.65,83,,percent of total billed charges,,1337.01,,,,fee schedule,,,4099.5,90,,percent of total billed charges,,,4099.5,90,,percent of total billed charges,,,4099.5,90,,percent of total billed charges,,,4099.5,90,,percent of total billed charges,,,3871.75,85,,percent of total billed charges,,271.45,4327.25,
REMOVAL TONG/HALO APPLIED BY ANOTHER PHYSICIAN,20665,CDM,20665,CPT,,,both,,606,606,167.64,,,,fee schedule,,,,,,,,134.6,,,,fee schedule,,,515.1,85,,percent of total billed charges,,203.89,,,,fee schedule,,98.5,,,,fee schedule,,134.6,,,,fee schedule,,188.35,,,,fee schedule,,134.6,,,,fee schedule,,162.71,,,,fee schedule,,98.61,,,,fee schedule,,98.61,,,,fee schedule,,,551.46,91,,percent of total billed charges,,,575.7,95,,percent of total billed charges,,,502.98,83,,percent of total billed charges,,,181.8,83,,percent of total billed charges,,134.6,,,,fee schedule,,134.6,,,,fee schedule,,,502.98,83,,percent of total billed charges,,144.96,,,,fee schedule,,,545.4,90,,percent of total billed charges,,,545.4,90,,percent of total billed charges,,,545.4,90,,percent of total billed charges,,,545.4,90,,percent of total billed charges,,,515.1,85,,percent of total billed charges,,98.5,575.7,
REMOVAL OF SUPPORT IMPLANT,20670,CDM,20670,CPT,,,both,,1584,1584,249.44,,,,fee schedule,,,,,,,,134.6,,,,fee schedule,,,1346.4,85,,percent of total billed charges,,307.98,,,,fee schedule,,148.78,,,,fee schedule,,134.6,,,,fee schedule,,272.58,,,,fee schedule,,134.6,,,,fee schedule,,242.11,,,,fee schedule,,146.73,,,,fee schedule,,146.73,,,,fee schedule,,,1441.44,91,,percent of total billed charges,,,1504.8,95,,percent of total billed charges,,,1314.72,83,,percent of total billed charges,,,475.2,83,,percent of total billed charges,,134.6,,,,fee schedule,,134.6,,,,fee schedule,,,1314.72,83,,percent of total billed charges,,215.7,,,,fee schedule,,,1425.6,90,,percent of total billed charges,,,1425.6,90,,percent of total billed charges,,,1425.6,90,,percent of total billed charges,,,1425.6,90,,percent of total billed charges,,,1346.4,85,,percent of total billed charges,,134.6,1504.8,
REMOVAL OF SUPPORT IMPLANT,20680,CDM,20680,CPT,,,both,,2486,2486,723.56,,,,fee schedule,,,,,,,,233,,,,fee schedule,,,2113.1,85,,percent of total billed charges,,907.87,,,,fee schedule,,438.58,,,,fee schedule,,233,,,,fee schedule,,504.04,,,,fee schedule,,233,,,,fee schedule,,702.28,,,,fee schedule,,425.62,,,,fee schedule,,425.62,,,,fee schedule,,,2262.26,91,,percent of total billed charges,,,2361.7,95,,percent of total billed charges,,,2063.38,83,,percent of total billed charges,,,745.8,83,,percent of total billed charges,,233,,,,fee schedule,,233,,,,fee schedule,,,2063.38,83,,percent of total billed charges,,625.67,,,,fee schedule,,,2237.4,90,,percent of total billed charges,,,2237.4,90,,percent of total billed charges,,,2237.4,90,,percent of total billed charges,,,2237.4,90,,percent of total billed charges,,,2113.1,85,,percent of total billed charges,,233,2361.7,
REMOVAL OF SUPPORT IMPLANT,20680AS80,CDM,20680,CPT,,,both,,689,689,723.56,,,,fee schedule,,,,,,,,233,,,,fee schedule,,,585.65,85,,percent of total billed charges,,907.87,,,,fee schedule,,438.58,,,,fee schedule,,233,,,,fee schedule,,504.04,,,,fee schedule,,233,,,,fee schedule,,702.28,,,,fee schedule,,425.62,,,,fee schedule,,425.62,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,233,,,,fee schedule,,233,,,,fee schedule,,,571.87,83,,percent of total billed charges,,625.67,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,907.87,
APPLY BONE FIXATION DEVICE,20690,CDM,20690,CPT,,,both,,2624,2624,1030.61,,,,fee schedule,,,,,,,,172.8,,,,fee schedule,,,2230.4,85,,percent of total billed charges,,1301.69,,,,fee schedule,,628.83,,,,fee schedule,,172.8,,,,fee schedule,,437.72,,,,fee schedule,,172.8,,,,fee schedule,,1000.3,,,,fee schedule,,606.24,,,,fee schedule,,606.24,,,,fee schedule,,,2387.84,91,,percent of total billed charges,,,2492.8,95,,percent of total billed charges,,,2177.92,83,,percent of total billed charges,,,787.2,83,,percent of total billed charges,,172.8,,,,fee schedule,,172.8,,,,fee schedule,,,2177.92,83,,percent of total billed charges,,891.18,,,,fee schedule,,,2361.6,90,,percent of total billed charges,,,2361.6,90,,percent of total billed charges,,,2361.6,90,,percent of total billed charges,,,2361.6,90,,percent of total billed charges,,,2230.4,85,,percent of total billed charges,,172.8,2492.8,
APPLY BONE FIXATION DEVICE,20692,CDM,20692,CPT,,,both,,4787,4787,1937.37,,,,fee schedule,,,,,,,,297,,,,fee schedule,,,4068.95,85,,percent of total billed charges,,2431.19,,,,fee schedule,,1174.48,,,,fee schedule,,297,,,,fee schedule,,742.79,,,,fee schedule,,297,,,,fee schedule,,1880.38,,,,fee schedule,,1139.63,,,,fee schedule,,1139.63,,,,fee schedule,,,4356.17,91,,percent of total billed charges,,,4547.65,95,,percent of total billed charges,,,3973.21,83,,percent of total billed charges,,,1436.1,83,,percent of total billed charges,,297,,,,fee schedule,,297,,,,fee schedule,,,3973.21,83,,percent of total billed charges,,1675.25,,,,fee schedule,,,4308.3,90,,percent of total billed charges,,,4308.3,90,,percent of total billed charges,,,4308.3,90,,percent of total billed charges,,,4308.3,90,,percent of total billed charges,,,4068.95,85,,percent of total billed charges,,297,4547.65,
REMOVE EXTERNAL FIXATION SYSTEM UNDER ANES,20694,CDM,20694,CPT,,,both,,2108,2108,591.64,,,,fee schedule,,,,,,,,152.95,,,,fee schedule,,,1791.8,85,,percent of total billed charges,,732.63,,,,fee schedule,,353.92,,,,fee schedule,,152.95,,,,fee schedule,,588.93,,,,fee schedule,,152.95,,,,fee schedule,,574.24,,,,fee schedule,,348.02,,,,fee schedule,,348.02,,,,fee schedule,,,1918.28,91,,percent of total billed charges,,,2002.6,95,,percent of total billed charges,,,1749.64,83,,percent of total billed charges,,,632.4,83,,percent of total billed charges,,152.95,,,,fee schedule,,152.95,,,,fee schedule,,,1749.64,83,,percent of total billed charges,,511.59,,,,fee schedule,,,1897.2,90,,percent of total billed charges,,,1897.2,90,,percent of total billed charges,,,1897.2,90,,percent of total billed charges,,,1897.2,90,,percent of total billed charges,,,1791.8,85,,percent of total billed charges,,152.95,2002.6,
MNL PREP&INSJ DP RX DLVR DEV,20700,CDM,20700,CPT,,,both,,395,395,144.6,,,,fee schedule,,,,,,,,52.76,,,,fee schedule,,,335.75,85,,percent of total billed charges,,187.46,,,,fee schedule,,90.56,,,,fee schedule,,52.76,,,,fee schedule,,,,,,,,52.76,,,,fee schedule,,140.34,,,,fee schedule,,85.06,,,,fee schedule,,85.06,,,,fee schedule,,,359.45,91,,percent of total billed charges,,,375.25,95,,percent of total billed charges,,,327.85,83,,percent of total billed charges,,,118.5,83,,percent of total billed charges,,52.76,,,,fee schedule,,52.76,,,,fee schedule,,,327.85,83,,percent of total billed charges,,125.03,,,,fee schedule,,,355.5,90,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,355.5,90,,percent of total billed charges,,,335.75,85,,percent of total billed charges,,52.76,375.25,
RMVL DEEP RX DELIVERY DEVICE,20701,CDM,20701,CPT,,,both,,295,295,110.61,,,,fee schedule,,,,,,,,39.3,,,,fee schedule,,,250.75,85,,percent of total billed charges,,142.76,,,,fee schedule,,68.97,,,,fee schedule,,39.3,,,,fee schedule,,,,,,,,39.3,,,,fee schedule,,107.35,,,,fee schedule,,65.06,,,,fee schedule,,65.06,,,,fee schedule,,,268.45,91,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,88.5,83,,percent of total billed charges,,39.3,,,,fee schedule,,39.3,,,,fee schedule,,,244.85,83,,percent of total billed charges,,95.64,,,,fee schedule,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,39.3,280.25,
MNL PREP&INSJ I-ARTIC RX DEV,20704,CDM,20704,CPT,,,both,,683,683,251.17,,,,fee schedule,,,,,,,,91.53,,,,fee schedule,,,580.55,85,,percent of total billed charges,,333.84,,,,fee schedule,,161.28,,,,fee schedule,,91.53,,,,fee schedule,,,,,,,,91.53,,,,fee schedule,,243.78,,,,fee schedule,,147.75,,,,fee schedule,,147.75,,,,fee schedule,,,621.53,91,,percent of total billed charges,,,648.85,95,,percent of total billed charges,,,566.89,83,,percent of total billed charges,,,204.9,83,,percent of total billed charges,,91.53,,,,fee schedule,,91.53,,,,fee schedule,,,566.89,83,,percent of total billed charges,,217.19,,,,fee schedule,,,614.7,90,,percent of total billed charges,,,614.7,90,,percent of total billed charges,,,614.7,90,,percent of total billed charges,,,614.7,90,,percent of total billed charges,,,580.55,85,,percent of total billed charges,,91.53,648.85,
REMOVAL OF BONE FOR GRAFT,20900,CDM,20900,CPT,,,both,,1949,1949,311.08,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,1656.65,85,,percent of total billed charges,,396.27,,,,fee schedule,,191.43,,,,fee schedule,,224.7,,,,fee schedule,,806.46,,,,fee schedule,,224.7,,,,fee schedule,,301.93,,,,fee schedule,,182.99,,,,fee schedule,,182.99,,,,fee schedule,,,1773.59,91,,percent of total billed charges,,,1851.55,95,,percent of total billed charges,,,1617.67,83,,percent of total billed charges,,,584.7,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,1617.67,83,,percent of total billed charges,,269,,,,fee schedule,,,1754.1,90,,percent of total billed charges,,,1754.1,90,,percent of total billed charges,,,1754.1,90,,percent of total billed charges,,,1754.1,90,,percent of total billed charges,,,1656.65,85,,percent of total billed charges,,182.99,1851.55,
REMOVAL OF BONE FOR GRAFT,20902,CDM,20902,CPT,,,both,,2386,2386,472.39,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,2028.1,85,,percent of total billed charges,,606.67,,,,fee schedule,,293.08,,,,fee schedule,,374.55,,,,fee schedule,,1041.23,,,,fee schedule,,374.55,,,,fee schedule,,458.49,,,,fee schedule,,277.88,,,,fee schedule,,277.88,,,,fee schedule,,,2171.26,91,,percent of total billed charges,,,2266.7,95,,percent of total billed charges,,,1980.38,83,,percent of total billed charges,,,715.8,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,1980.38,83,,percent of total billed charges,,408.48,,,,fee schedule,,,2147.4,90,,percent of total billed charges,,,2147.4,90,,percent of total billed charges,,,2147.4,90,,percent of total billed charges,,,2147.4,90,,percent of total billed charges,,,2028.1,85,,percent of total billed charges,,277.88,2266.7,
SPINAL BONE ALLOGRAFT MORSELIZED/OSTEOPROMOTIVE,20930,CDM,20930,CPT,,,both,,964,964,,,,,,,,,,,,,,,,,,,,819.4,85,,percent of total billed charges,,251.64,,,,fee schedule,,121.56,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,877.24,91,,percent of total billed charges,,,915.8,95,,percent of total billed charges,,,800.12,83,,percent of total billed charges,,,289.2,83,,percent of total billed charges,,,,,,,,,,,,,,,800.12,83,,percent of total billed charges,,,,,,,,,867.6,90,,percent of total billed charges,,,867.6,90,,percent of total billed charges,,,867.6,90,,percent of total billed charges,,,867.6,90,,percent of total billed charges,,,819.4,85,,percent of total billed charges,,121.56,915.8,
SPINAL BONE ALLOGRAFT,20931,CDM,20931,CPT,,,both,,902,902,189.53,,,,fee schedule,,,,,,,,,,,,,,,766.7,85,,percent of total billed charges,,251.29,,,,fee schedule,,118.97,,,,fee schedule,,,,,,,,209.57,,,,fee schedule,,,,,,,,183.96,,,,fee schedule,,111.49,,,,fee schedule,,111.49,,,,fee schedule,,,820.82,91,,percent of total billed charges,,,856.9,95,,percent of total billed charges,,,748.66,83,,percent of total billed charges,,,270.6,83,,percent of total billed charges,,,,,,,,,,,,,,,748.66,83,,percent of total billed charges,,163.89,,,,fee schedule,,,811.8,90,,percent of total billed charges,,,811.8,90,,percent of total billed charges,,,811.8,90,,percent of total billed charges,,,811.8,90,,percent of total billed charges,,,766.7,85,,percent of total billed charges,,111.49,856.9,
SPINAL BONE AUTOGRAFT,20936,CDM,20936,CPT,,,both,,1146,1146,,,,,,,,,,,,,,,,,,,,974.1,85,,percent of total billed charges,,267.75,,,,fee schedule,,129.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1042.86,91,,percent of total billed charges,,,1088.7,95,,percent of total billed charges,,,951.18,83,,percent of total billed charges,,,343.8,83,,percent of total billed charges,,,,,,,,,,,,,,,951.18,83,,percent of total billed charges,,,,,,,,,1031.4,90,,percent of total billed charges,,,1031.4,90,,percent of total billed charges,,,1031.4,90,,percent of total billed charges,,,1031.4,90,,percent of total billed charges,,,974.1,85,,percent of total billed charges,,129.35,1088.7,
SPINAL BONE AUTOGRAFT,20937,CDM,20937,CPT,,,both,,1137,1137,286.31,,,,fee schedule,,,,,,,,,,,,,,,966.45,85,,percent of total billed charges,,370.13,,,,fee schedule,,178.81,,,,fee schedule,,,,,,,,317.01,,,,fee schedule,,,,,,,,277.89,,,,fee schedule,,168.42,,,,fee schedule,,168.42,,,,fee schedule,,,1034.67,91,,percent of total billed charges,,,1080.15,95,,percent of total billed charges,,,943.71,83,,percent of total billed charges,,,341.1,83,,percent of total billed charges,,,,,,,,,,,,,,,943.71,83,,percent of total billed charges,,247.58,,,,fee schedule,,,1023.3,90,,percent of total billed charges,,,1023.3,90,,percent of total billed charges,,,1023.3,90,,percent of total billed charges,,,1023.3,90,,percent of total billed charges,,,966.45,85,,percent of total billed charges,,168.42,1080.15,
BONE MARROW ASPIR BONE GRFG,20939,CDM,20939,CPT,,,both,,324,324,120.4,,,,fee schedule,,,,,,,,,,,,,,,275.4,85,,percent of total billed charges,,154.36,,,,fee schedule,,74.57,,,,fee schedule,,,,,,,,,,,,,,,,,,,,116.86,,,,fee schedule,,70.82,,,,fee schedule,,70.82,,,,fee schedule,,,294.84,91,,percent of total billed charges,,,307.8,95,,percent of total billed charges,,,268.92,83,,percent of total billed charges,,,97.2,83,,percent of total billed charges,,,,,,,,,,,,,,,268.92,83,,percent of total billed charges,,104.11,,,,fee schedule,,,291.6,90,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,275.4,85,,percent of total billed charges,,70.82,307.8,
"FLUID PRESSURE, MUSCLE",20950,CDM,20950,CPT,,,both,,920,920,150.36,,,,fee schedule,,,,,,,,44.8,,,,fee schedule,,,782,85,,percent of total billed charges,,190.33,,,,fee schedule,,91.95,,,,fee schedule,,44.8,,,,fee schedule,,161.82,,,,fee schedule,,44.8,,,,fee schedule,,145.94,,,,fee schedule,,88.45,,,,fee schedule,,88.45,,,,fee schedule,,,837.2,91,,percent of total billed charges,,,874,95,,percent of total billed charges,,,763.6,83,,percent of total billed charges,,,276,83,,percent of total billed charges,,44.8,,,,fee schedule,,44.8,,,,fee schedule,,,763.6,83,,percent of total billed charges,,130.02,,,,fee schedule,,,828,90,,percent of total billed charges,,,828,90,,percent of total billed charges,,,828,90,,percent of total billed charges,,,828,90,,percent of total billed charges,,,782,85,,percent of total billed charges,,44.8,874,
ELECTRICAL BONE STIMULATION,20975,CDM,20975,CPT,,,both,,1545,1545,300.72,,,,fee schedule,,,,,,,,82.9,,,,fee schedule,,,1313.25,85,,percent of total billed charges,,378.35,,,,fee schedule,,182.78,,,,fee schedule,,82.9,,,,fee schedule,,319,,,,fee schedule,,82.9,,,,fee schedule,,291.87,,,,fee schedule,,176.89,,,,fee schedule,,176.89,,,,fee schedule,,,1405.95,91,,percent of total billed charges,,,1467.75,95,,percent of total billed charges,,,1282.35,83,,percent of total billed charges,,,463.5,83,,percent of total billed charges,,82.9,,,,fee schedule,,82.9,,,,fee schedule,,,1282.35,83,,percent of total billed charges,,260.03,,,,fee schedule,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1313.25,85,,percent of total billed charges,,82.9,1467.75,
CPTR-ASST DIR MS PX,20985,CDM,20985,CPT,,,both,,807,807,247.72,,,,fee schedule,,,,,,,,83.23,,,,fee schedule,,,685.95,85,,percent of total billed charges,,319.58,,,,fee schedule,,154.39,,,,fee schedule,,83.23,,,,fee schedule,,,,,,,,83.23,,,,fee schedule,,240.43,,,,fee schedule,,145.71,,,,fee schedule,,145.71,,,,fee schedule,,,734.37,91,,percent of total billed charges,,,766.65,95,,percent of total billed charges,,,669.81,83,,percent of total billed charges,,,242.1,83,,percent of total billed charges,,83.23,,,,fee schedule,,83.23,,,,fee schedule,,,669.81,83,,percent of total billed charges,,214.2,,,,fee schedule,,,726.3,90,,percent of total billed charges,,,726.3,90,,percent of total billed charges,,,726.3,90,,percent of total billed charges,,,726.3,90,,percent of total billed charges,,,685.95,85,,percent of total billed charges,,83.23,766.65,
Exc Tumor Face Or Scalp Subcu Less Than 2 Cm,21011,CDM,21011,CPT,,,both,,1369,1369,449.92,,,,fee schedule,,,,,,,,135,,,,fee schedule,,,1163.65,85,,percent of total billed charges,,554.61,,,,fee schedule,,267.93,,,,fee schedule,,135,,,,fee schedule,,,,,,,,135,,,,fee schedule,,436.69,,,,fee schedule,,264.66,,,,fee schedule,,264.66,,,,fee schedule,,,1245.79,91,,percent of total billed charges,,,1300.55,95,,percent of total billed charges,,,1136.27,83,,percent of total billed charges,,,410.7,83,,percent of total billed charges,,135,,,,fee schedule,,135,,,,fee schedule,,,1136.27,83,,percent of total billed charges,,389.05,,,,fee schedule,,,1232.1,90,,percent of total billed charges,,,1232.1,90,,percent of total billed charges,,,1232.1,90,,percent of total billed charges,,,1232.1,90,,percent of total billed charges,,,1163.65,85,,percent of total billed charges,,135,1300.55,
EXC FACE LES SBQ 2 CM/<,21012,CDM,21012,CPT,,,both,,1503,1503,587.6,,,,fee schedule,,,,,,,,186.15,,,,fee schedule,,,1277.55,85,,percent of total billed charges,,736.38,,,,fee schedule,,355.74,,,,fee schedule,,186.15,,,,fee schedule,,,,,,,,186.15,,,,fee schedule,,570.32,,,,fee schedule,,345.65,,,,fee schedule,,345.65,,,,fee schedule,,,1367.73,91,,percent of total billed charges,,,1427.85,95,,percent of total billed charges,,,1247.49,83,,percent of total billed charges,,,450.9,83,,percent of total billed charges,,186.15,,,,fee schedule,,186.15,,,,fee schedule,,,1247.49,83,,percent of total billed charges,,508.1,,,,fee schedule,,,1352.7,90,,percent of total billed charges,,,1352.7,90,,percent of total billed charges,,,1352.7,90,,percent of total billed charges,,,1352.7,90,,percent of total billed charges,,,1277.55,85,,percent of total billed charges,,186.15,1427.85,
EXC FACE LES SBQ 2 CM/<,21012P,CDM,21012,CPT,,,both,P,1309,1309,587.6,,,,fee schedule,,,,,,,,186.15,,,,fee schedule,,,1112.65,85,,percent of total billed charges,,736.38,,,,fee schedule,,355.74,,,,fee schedule,,186.15,,,,fee schedule,,,,,,,,186.15,,,,fee schedule,,570.32,,,,fee schedule,,345.65,,,,fee schedule,,345.65,,,,fee schedule,,,1191.19,91,,percent of total billed charges,,,1243.55,95,,percent of total billed charges,,,1086.47,83,,percent of total billed charges,,,392.7,83,,percent of total billed charges,,186.15,,,,fee schedule,,186.15,,,,fee schedule,,,1086.47,83,,percent of total billed charges,,508.1,,,,fee schedule,,,1178.1,90,,percent of total billed charges,,,1178.1,90,,percent of total billed charges,,,1178.1,90,,percent of total billed charges,,,1178.1,90,,percent of total billed charges,,,1112.65,85,,percent of total billed charges,,186.15,1243.55,
EXC FACE LES SBQ 2 CM/<,21012T,CDM,21012,CPT,,,both,T,194,194,587.6,,,,fee schedule,,,,,,,,186.15,,,,fee schedule,,,164.9,85,,percent of total billed charges,,736.38,,,,fee schedule,,355.74,,,,fee schedule,,186.15,,,,fee schedule,,,,,,,,186.15,,,,fee schedule,,570.32,,,,fee schedule,,345.65,,,,fee schedule,,345.65,,,,fee schedule,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,58.2,83,,percent of total billed charges,,186.15,,,,fee schedule,,186.15,,,,fee schedule,,,161.02,83,,percent of total billed charges,,508.1,,,,fee schedule,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,58.2,736.38,
EXC FACE TUM DEEP < 2 CM,21013,CDM,21013,CPT,,,both,,2243,2243,696.48,,,,fee schedule,,,,,,,,219.07,,,,fee schedule,,,1906.55,85,,percent of total billed charges,,868.49,,,,fee schedule,,419.56,,,,fee schedule,,219.07,,,,fee schedule,,,,,,,,219.07,,,,fee schedule,,676,,,,fee schedule,,409.7,,,,fee schedule,,409.7,,,,fee schedule,,,2041.13,91,,percent of total billed charges,,,2130.85,95,,percent of total billed charges,,,1861.69,83,,percent of total billed charges,,,672.9,83,,percent of total billed charges,,219.07,,,,fee schedule,,219.07,,,,fee schedule,,,1861.69,83,,percent of total billed charges,,602.25,,,,fee schedule,,,2018.7,90,,percent of total billed charges,,,2018.7,90,,percent of total billed charges,,,2018.7,90,,percent of total billed charges,,,2018.7,90,,percent of total billed charges,,,1906.55,85,,percent of total billed charges,,219.07,2130.85,
GENIOPLASTY AUGMENTATION,21120,CDM,21120,CPT,,,both,,3867,3867,879.68,,,,fee schedule,,,,,,,,1198.7,,,,fee schedule,,,3286.95,85,,percent of total billed charges,,1089.84,,,,fee schedule,,526.49,,,,fee schedule,,1198.7,,,,fee schedule,,862.83,,,,fee schedule,,1198.7,,,,fee schedule,,853.8,,,,fee schedule,,517.46,,,,fee schedule,,517.46,,,,fee schedule,,,3518.97,91,,percent of total billed charges,,,3673.65,95,,percent of total billed charges,,,3209.61,83,,percent of total billed charges,,,1160.1,83,,percent of total billed charges,,1198.7,,,,fee schedule,,1198.7,,,,fee schedule,,,3209.61,83,,percent of total billed charges,,760.66,,,,fee schedule,,,3480.3,90,,percent of total billed charges,,,3480.3,90,,percent of total billed charges,,,3480.3,90,,percent of total billed charges,,,3480.3,90,,percent of total billed charges,,,3286.95,85,,percent of total billed charges,,517.46,3673.65,
TREATMENT OF NOSE FRACTURE,21315,CDM,21315,CPT,,,both,,1459,1459,103.69,,,,fee schedule,,,,,,,,176.2,,,,fee schedule,,,1240.15,85,,percent of total billed charges,,128.19,,,,fee schedule,,61.93,,,,fee schedule,,176.2,,,,fee schedule,,234.11,,,,fee schedule,,176.2,,,,fee schedule,,100.64,,,,fee schedule,,61,,,,fee schedule,,61,,,,fee schedule,,,1327.69,91,,percent of total billed charges,,,1386.05,95,,percent of total billed charges,,,1210.97,83,,percent of total billed charges,,,437.7,83,,percent of total billed charges,,176.2,,,,fee schedule,,176.2,,,,fee schedule,,,1210.97,83,,percent of total billed charges,,89.67,,,,fee schedule,,,1313.1,90,,percent of total billed charges,,,1313.1,90,,percent of total billed charges,,,1313.1,90,,percent of total billed charges,,,1313.1,90,,percent of total billed charges,,,1240.15,85,,percent of total billed charges,,61,1386.05,
TREATMENT OF NOSE FRACTURE,21320,CDM,21320,CPT,,,both,,1260,1260,163.03,,,,fee schedule,,,,,,,,280.25,,,,fee schedule,,,1071,85,,percent of total billed charges,,207.56,,,,fee schedule,,100.27,,,,fee schedule,,280.25,,,,fee schedule,,242.07,,,,fee schedule,,280.25,,,,fee schedule,,158.24,,,,fee schedule,,95.9,,,,fee schedule,,95.9,,,,fee schedule,,,1146.6,91,,percent of total billed charges,,,1197,95,,percent of total billed charges,,,1045.8,83,,percent of total billed charges,,,378,83,,percent of total billed charges,,280.25,,,,fee schedule,,280.25,,,,fee schedule,,,1045.8,83,,percent of total billed charges,,140.97,,,,fee schedule,,,1134,90,,percent of total billed charges,,,1134,90,,percent of total billed charges,,,1134,90,,percent of total billed charges,,,1134,90,,percent of total billed charges,,,1071,85,,percent of total billed charges,,95.9,1197,
Exc Lipoma Neck >3cm,21552,CDM,21552,CPT,,,both,,742,742,774.25,,,,fee schedule,,,,,,,,251.32,,,,fee schedule,,,630.7,85,,percent of total billed charges,,984.58,,,,fee schedule,,475.64,,,,fee schedule,,251.32,,,,fee schedule,,,,,,,,251.32,,,,fee schedule,,751.48,,,,fee schedule,,455.44,,,,fee schedule,,455.44,,,,fee schedule,,,675.22,91,,percent of total billed charges,,,704.9,95,,percent of total billed charges,,,615.86,83,,percent of total billed charges,,,222.6,83,,percent of total billed charges,,251.32,,,,fee schedule,,251.32,,,,fee schedule,,,615.86,83,,percent of total billed charges,,669.5,,,,fee schedule,,,667.8,90,,percent of total billed charges,,,667.8,90,,percent of total billed charges,,,667.8,90,,percent of total billed charges,,,667.8,90,,percent of total billed charges,,,630.7,85,,percent of total billed charges,,222.6,984.58,
EXC NECK TUM DEEP 5 CM/>,21554,CDM,21554,CPT,,,both,,3811,3811,1263.92,,,,fee schedule,,,,,,,,413.28,,,,fee schedule,,,3239.35,85,,percent of total billed charges,,1609.35,,,,fee schedule,,777.46,,,,fee schedule,,413.28,,,,fee schedule,,,,,,,,413.28,,,,fee schedule,,1226.75,,,,fee schedule,,743.49,,,,fee schedule,,743.49,,,,fee schedule,,,3468.01,91,,percent of total billed charges,,,3620.45,95,,percent of total billed charges,,,3163.13,83,,percent of total billed charges,,,1143.3,83,,percent of total billed charges,,413.28,,,,fee schedule,,413.28,,,,fee schedule,,,3163.13,83,,percent of total billed charges,,1092.92,,,,fee schedule,,,3429.9,90,,percent of total billed charges,,,3429.9,90,,percent of total billed charges,,,3429.9,90,,percent of total billed charges,,,3429.9,90,,percent of total billed charges,,,3239.35,85,,percent of total billed charges,,413.28,3620.45,
"REMOVE LESION, NECK/CHEST",21555,CDM,21555,CPT,,,both,,1634,1634,532.3,,,,fee schedule,,,,,,,,124,,,,fee schedule,,,1388.9,85,,percent of total billed charges,,665.94,,,,fee schedule,,321.71,,,,fee schedule,,124,,,,fee schedule,,535.21,,,,fee schedule,,124,,,,fee schedule,,516.64,,,,fee schedule,,313.12,,,,fee schedule,,313.12,,,,fee schedule,,,1486.94,91,,percent of total billed charges,,,1552.3,95,,percent of total billed charges,,,1356.22,83,,percent of total billed charges,,,490.2,83,,percent of total billed charges,,124,,,,fee schedule,,124,,,,fee schedule,,,1356.22,83,,percent of total billed charges,,460.28,,,,fee schedule,,,1470.6,90,,percent of total billed charges,,,1470.6,90,,percent of total billed charges,,,1470.6,90,,percent of total billed charges,,,1470.6,90,,percent of total billed charges,,,1388.9,85,,percent of total billed charges,,124,1552.3,
"REMOVE LESION, NECK/CHEST",21556,CDM,21556,CPT,,,both,,2342,2342,920,,,,fee schedule,,,,,,,,270.27,,,,fee schedule,,,1990.7,85,,percent of total billed charges,,1161.25,,,,fee schedule,,560.98,,,,fee schedule,,270.27,,,,fee schedule,,684.43,,,,fee schedule,,270.27,,,,fee schedule,,892.94,,,,fee schedule,,541.18,,,,fee schedule,,541.18,,,,fee schedule,,,2131.22,91,,percent of total billed charges,,,2224.9,95,,percent of total billed charges,,,1943.86,83,,percent of total billed charges,,,702.6,83,,percent of total billed charges,,270.27,,,,fee schedule,,270.27,,,,fee schedule,,,1943.86,83,,percent of total billed charges,,795.53,,,,fee schedule,,,2107.8,90,,percent of total billed charges,,,2107.8,90,,percent of total billed charges,,,2107.8,90,,percent of total billed charges,,,2107.8,90,,percent of total billed charges,,,1990.7,85,,percent of total billed charges,,270.27,2224.9,
"REMOVE LESION, BACK OR FLANK",21930,CDM,21930,CPT,,,both,,1892,1892,631.39,,,,fee schedule,,,,,,,,149.8,,,,fee schedule,,,1608.2,85,,percent of total billed charges,,793.75,,,,fee schedule,,383.45,,,,fee schedule,,149.8,,,,fee schedule,,598.88,,,,fee schedule,,149.8,,,,fee schedule,,612.82,,,,fee schedule,,371.4,,,,fee schedule,,371.4,,,,fee schedule,,,1721.72,91,,percent of total billed charges,,,1797.4,95,,percent of total billed charges,,,1570.36,83,,percent of total billed charges,,,567.6,83,,percent of total billed charges,,149.8,,,,fee schedule,,149.8,,,,fee schedule,,,1570.36,83,,percent of total billed charges,,545.96,,,,fee schedule,,,1702.8,90,,percent of total billed charges,,,1702.8,90,,percent of total billed charges,,,1702.8,90,,percent of total billed charges,,,1702.8,90,,percent of total billed charges,,,1608.2,85,,percent of total billed charges,,149.8,1797.4,
Ecx Lipoma > 3cm  Flank,21931,CDM,21931,CPT,,,both,,2220,2220,812.85,,,,fee schedule,,,,,,,,263.72,,,,fee schedule,,,1887,85,,percent of total billed charges,,1036.98,,,,fee schedule,,500.95,,,,fee schedule,,263.72,,,,fee schedule,,,,,,,,263.72,,,,fee schedule,,788.94,,,,fee schedule,,478.15,,,,fee schedule,,478.15,,,,fee schedule,,,2020.2,91,,percent of total billed charges,,,2109,95,,percent of total billed charges,,,1842.6,83,,percent of total billed charges,,,666,83,,percent of total billed charges,,263.72,,,,fee schedule,,263.72,,,,fee schedule,,,1842.6,83,,percent of total billed charges,,702.88,,,,fee schedule,,,1998,90,,percent of total billed charges,,,1998,90,,percent of total billed charges,,,1998,90,,percent of total billed charges,,,1998,90,,percent of total billed charges,,,1887,85,,percent of total billed charges,,263.72,2109,
EXC BACK TUM DEEP < 5 CM,21932,CDM,21932,CPT,,,both,,3193,3193,1151.01,,,,fee schedule,,,,,,,,378.77,,,,fee schedule,,,2714.05,85,,percent of total billed charges,,1462.24,,,,fee schedule,,706.39,,,,fee schedule,,378.77,,,,fee schedule,,,,,,,,378.77,,,,fee schedule,,1117.16,,,,fee schedule,,677.07,,,,fee schedule,,677.07,,,,fee schedule,,,2905.63,91,,percent of total billed charges,,,3033.35,95,,percent of total billed charges,,,2650.19,83,,percent of total billed charges,,,957.9,83,,percent of total billed charges,,378.77,,,,fee schedule,,378.77,,,,fee schedule,,,2650.19,83,,percent of total billed charges,,995.29,,,,fee schedule,,,2873.7,90,,percent of total billed charges,,,2873.7,90,,percent of total billed charges,,,2873.7,90,,percent of total billed charges,,,2873.7,90,,percent of total billed charges,,,2714.05,85,,percent of total billed charges,,378.77,3033.35,
EXC BACK TUM DEEP 5 CM/>,21933,CDM,21933,CPT,,,both,,3419,3419,1276.02,,,,fee schedule,,,,,,,,418.56,,,,fee schedule,,,2906.15,85,,percent of total billed charges,,1632.96,,,,fee schedule,,788.86,,,,fee schedule,,418.56,,,,fee schedule,,,,,,,,418.56,,,,fee schedule,,1238.49,,,,fee schedule,,750.6,,,,fee schedule,,750.6,,,,fee schedule,,,3111.29,91,,percent of total billed charges,,,3248.05,95,,percent of total billed charges,,,2837.77,83,,percent of total billed charges,,,1025.7,83,,percent of total billed charges,,418.56,,,,fee schedule,,418.56,,,,fee schedule,,,2837.77,83,,percent of total billed charges,,1103.38,,,,fee schedule,,,3077.1,90,,percent of total billed charges,,,3077.1,90,,percent of total billed charges,,,3077.1,90,,percent of total billed charges,,,3077.1,90,,percent of total billed charges,,,2906.15,85,,percent of total billed charges,,418.56,3248.05,
"I/D, P-SPINE, C/T/CERV-THOR",22010,CDM,22010,CPT,,,both,,3090,3090,1678.7,,,,fee schedule,,,,,,,,453.3,,,,fee schedule,,,2626.5,85,,percent of total billed charges,,2129.93,,,,fee schedule,,1028.95,,,,fee schedule,,453.3,,,,fee schedule,,,,,,,,453.3,,,,fee schedule,,1629.33,,,,fee schedule,,987.47,,,,fee schedule,,987.47,,,,fee schedule,,,2811.9,91,,percent of total billed charges,,,2935.5,95,,percent of total billed charges,,,2564.7,83,,percent of total billed charges,,,927,83,,percent of total billed charges,,453.3,,,,fee schedule,,453.3,,,,fee schedule,,,2564.7,83,,percent of total billed charges,,1451.59,,,,fee schedule,,,2781,90,,percent of total billed charges,,,2781,90,,percent of total billed charges,,,2781,90,,percent of total billed charges,,,2781,90,,percent of total billed charges,,,2626.5,85,,percent of total billed charges,,453.3,2935.5,
"REMOVE PART, LUMBAR VERTEBRA",22102,CDM,22102,CPT,,,both,,7590,7590,1345.73,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,6451.5,85,,percent of total billed charges,,1697.79,,,,fee schedule,,820.19,,,,fee schedule,,299.7,,,,fee schedule,,1299.22,,,,fee schedule,,299.7,,,,fee schedule,,1306.15,,,,fee schedule,,791.6,,,,fee schedule,,791.6,,,,fee schedule,,,6906.9,91,,percent of total billed charges,,,7210.5,95,,percent of total billed charges,,,6299.7,83,,percent of total billed charges,,,2277,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,6299.7,83,,percent of total billed charges,,1163.66,,,,fee schedule,,,6831,90,,percent of total billed charges,,,6831,90,,percent of total billed charges,,,6831,90,,percent of total billed charges,,,6831,90,,percent of total billed charges,,,6451.5,85,,percent of total billed charges,,299.7,7210.5,
"REMOVE PART, LUMBAR VERTEBRA",22114,CDM,22114,CPT,,,both,,4884,4884,1980,,,,fee schedule,,,,,,,,718.7,,,,fee schedule,,,4151.4,85,,percent of total billed charges,,2510.71,,,,fee schedule,,1212.9,,,,fee schedule,,718.7,,,,fee schedule,,1626.84,,,,fee schedule,,718.7,,,,fee schedule,,1921.76,,,,fee schedule,,1164.7,,,,fee schedule,,1164.7,,,,fee schedule,,,4444.44,91,,percent of total billed charges,,,4639.8,95,,percent of total billed charges,,,4053.72,83,,percent of total billed charges,,,1465.2,83,,percent of total billed charges,,718.7,,,,fee schedule,,718.7,,,,fee schedule,,,4053.72,83,,percent of total billed charges,,1712.11,,,,fee schedule,,,4395.6,90,,percent of total billed charges,,,4395.6,90,,percent of total billed charges,,,4395.6,90,,percent of total billed charges,,,4395.6,90,,percent of total billed charges,,,4151.4,85,,percent of total billed charges,,718.7,4639.8,
REVISION OF LUMBAR SPINE,22214,CDM,22214,CPT,,,both,,4916,4916,2620.02,,,,fee schedule,,,,,,,,973.9,,,,fee schedule,,,4178.6,85,,percent of total billed charges,,3326.07,,,,fee schedule,,1606.79,,,,fee schedule,,973.9,,,,fee schedule,,2457.18,,,,fee schedule,,973.9,,,,fee schedule,,2542.96,,,,fee schedule,,1541.19,,,,fee schedule,,1541.19,,,,fee schedule,,,4473.56,91,,percent of total billed charges,,,4670.2,95,,percent of total billed charges,,,4080.28,83,,percent of total billed charges,,,1474.8,83,,percent of total billed charges,,973.9,,,,fee schedule,,973.9,,,,fee schedule,,,4080.28,83,,percent of total billed charges,,2265.55,,,,fee schedule,,,4424.4,90,,percent of total billed charges,,,4424.4,90,,percent of total billed charges,,,4424.4,90,,percent of total billed charges,,,4424.4,90,,percent of total billed charges,,,4178.6,85,,percent of total billed charges,,973.9,4670.2,
"REVISE, EXTRA SPINE SEGMENT",22216,CDM,22216,CPT,,,both,,2009,2009,621.02,,,,fee schedule,,,,,,,,1139.55,,,,fee schedule,,,1707.65,85,,percent of total billed charges,,805.9,,,,fee schedule,,389.32,,,,fee schedule,,1139.55,,,,fee schedule,,692.39,,,,fee schedule,,1139.55,,,,fee schedule,,602.75,,,,fee schedule,,365.3,,,,fee schedule,,365.3,,,,fee schedule,,,1828.19,91,,percent of total billed charges,,,1908.55,95,,percent of total billed charges,,,1667.47,83,,percent of total billed charges,,,602.7,83,,percent of total billed charges,,1139.55,,,,fee schedule,,1139.55,,,,fee schedule,,,1667.47,83,,percent of total billed charges,,537,,,,fee schedule,,,1808.1,90,,percent of total billed charges,,,1808.1,90,,percent of total billed charges,,,1808.1,90,,percent of total billed charges,,,1808.1,90,,percent of total billed charges,,,1707.65,85,,percent of total billed charges,,365.3,1908.55,
TREAT SPINE FRACTURE,22310,CDM,22310,CPT,,,both,,1832,1832,517.9,,,,fee schedule,,,,,,,,98.8,,,,fee schedule,,,1557.2,85,,percent of total billed charges,,642.61,,,,fee schedule,,310.44,,,,fee schedule,,98.8,,,,fee schedule,,360.78,,,,fee schedule,,98.8,,,,fee schedule,,502.67,,,,fee schedule,,304.65,,,,fee schedule,,304.65,,,,fee schedule,,,1667.12,91,,percent of total billed charges,,,1740.4,95,,percent of total billed charges,,,1520.56,83,,percent of total billed charges,,,549.6,83,,percent of total billed charges,,98.8,,,,fee schedule,,98.8,,,,fee schedule,,,1520.56,83,,percent of total billed charges,,447.83,,,,fee schedule,,,1648.8,90,,percent of total billed charges,,,1648.8,90,,percent of total billed charges,,,1648.8,90,,percent of total billed charges,,,1648.8,90,,percent of total billed charges,,,1557.2,85,,percent of total billed charges,,98.8,1740.4,
PERQ VERTEBRAL AUGMENTATION,22513,CDM,22513,CPT,,,both,,16191,16191,872.76,,,,fee schedule,,,,,,,,336.16,,,,fee schedule,,,13762.35,85,,percent of total billed charges,,1115.16,,,,fee schedule,,538.72,,,,fee schedule,,336.16,,,,fee schedule,,,,,,,,336.16,,,,fee schedule,,847.1,,,,fee schedule,,513.39,,,,fee schedule,,513.39,,,,fee schedule,,,14733.81,91,,percent of total billed charges,,,15381.45,95,,percent of total billed charges,,,13438.53,83,,percent of total billed charges,,,4857.3,83,,percent of total billed charges,,336.16,,,,fee schedule,,336.16,,,,fee schedule,,,13438.53,83,,percent of total billed charges,,754.68,,,,fee schedule,,,14571.9,90,,percent of total billed charges,,,14571.9,90,,percent of total billed charges,,,14571.9,90,,percent of total billed charges,,,14571.9,90,,percent of total billed charges,,,13762.35,85,,percent of total billed charges,,336.16,15381.45,
Kyphoplasty PERQ VERTEBRAL AUGMENTATION,22514,CDM,22514,CPT,,,both,,15741,15741,814,,,,fee schedule,,,,,,,,312.97,,,,fee schedule,,,13379.85,85,,percent of total billed charges,,1037.04,,,,fee schedule,,500.98,,,,fee schedule,,312.97,,,,fee schedule,,,,,,,,312.97,,,,fee schedule,,790.06,,,,fee schedule,,478.83,,,,fee schedule,,478.83,,,,fee schedule,,,14324.31,91,,percent of total billed charges,,,14953.95,95,,percent of total billed charges,,,13065.03,83,,percent of total billed charges,,,4722.3,83,,percent of total billed charges,,312.97,,,,fee schedule,,312.97,,,,fee schedule,,,13065.03,83,,percent of total billed charges,,703.87,,,,fee schedule,,,14166.9,90,,percent of total billed charges,,,14166.9,90,,percent of total billed charges,,,14166.9,90,,percent of total billed charges,,,14166.9,90,,percent of total billed charges,,,13379.85,85,,percent of total billed charges,,312.97,14953.95,
PERQ VERTEBRAL AUGMENTATION,22515,CDM,22515,CPT,,,both,,151120,151120,372.15,,,,fee schedule,,,,,,,,715.25,,,,fee schedule,,,128452,85,,percent of total billed charges,,481.12,,,,fee schedule,,232.42,,,,fee schedule,,715.25,,,,fee schedule,,,,,,,,715.25,,,,fee schedule,,361.2,,,,fee schedule,,218.91,,,,fee schedule,,218.91,,,,fee schedule,,,137519.2,91,,percent of total billed charges,,,143564,95,,percent of total billed charges,,,125429.6,83,,percent of total billed charges,,,45336,83,,percent of total billed charges,,715.25,,,,fee schedule,,715.25,,,,fee schedule,,,125429.6,83,,percent of total billed charges,,321.8,,,,fee schedule,,,136008,90,,percent of total billed charges,,,136008,90,,percent of total billed charges,,,136008,90,,percent of total billed charges,,,136008,90,,percent of total billed charges,,,128452,85,,percent of total billed charges,,218.91,143564,
NECK SPINE FUSE/REMOVE ADDL,22551,CDM,22551,CPT,,,both,,11498,11498,2945.51,,,,fee schedule,,,,,,,,1062.48,,,,fee schedule,,,9773.3,85,,percent of total billed charges,,3778.57,,,,fee schedule,,1825.38,,,,fee schedule,,1062.48,,,,fee schedule,,,,,,,,1062.48,,,,fee schedule,,2858.88,,,,fee schedule,,1732.65,,,,fee schedule,,1732.65,,,,fee schedule,,,10463.18,91,,percent of total billed charges,,,10923.1,95,,percent of total billed charges,,,9543.34,83,,percent of total billed charges,,,3449.4,83,,percent of total billed charges,,1062.48,,,,fee schedule,,1062.48,,,,fee schedule,,,9543.34,83,,percent of total billed charges,,2547,,,,fee schedule,,,10348.2,90,,percent of total billed charges,,,10348.2,90,,percent of total billed charges,,,10348.2,90,,percent of total billed charges,,,10348.2,90,,percent of total billed charges,,,9773.3,85,,percent of total billed charges,,1062.48,10923.1,
ADDL NECK SPINE FUSION,22552,CDM,22552,CPT,,,both,,2558,2558,679.78,,,,fee schedule,,,,,,,,1240.9,,,,fee schedule,,,2174.3,85,,percent of total billed charges,,883.2,,,,fee schedule,,426.66,,,,fee schedule,,1240.9,,,,fee schedule,,,,,,,,1240.9,,,,fee schedule,,659.78,,,,fee schedule,,399.87,,,,fee schedule,,399.87,,,,fee schedule,,,2327.78,91,,percent of total billed charges,,,2430.1,95,,percent of total billed charges,,,2123.14,83,,percent of total billed charges,,,767.4,83,,percent of total billed charges,,1240.9,,,,fee schedule,,1240.9,,,,fee schedule,,,2123.14,83,,percent of total billed charges,,587.81,,,,fee schedule,,,2302.2,90,,percent of total billed charges,,,2302.2,90,,percent of total billed charges,,,2302.2,90,,percent of total billed charges,,,2302.2,90,,percent of total billed charges,,,2174.3,85,,percent of total billed charges,,399.87,2430.1,
NECK SPINE FUSION,22554,CDM,22554,CPT,,,both,,8038,8038,2187.96,,,,fee schedule,,,,,,,,1642.65,,,,fee schedule,,,6832.3,85,,percent of total billed charges,,2840.29,,,,fee schedule,,1344.68,,,,fee schedule,,1642.65,,,,fee schedule,,2338.47,,,,fee schedule,,1642.65,,,,fee schedule,,2123.61,,,,fee schedule,,1287.04,,,,fee schedule,,1287.04,,,,fee schedule,,,7314.58,91,,percent of total billed charges,,,7636.1,95,,percent of total billed charges,,,6671.54,83,,percent of total billed charges,,,2411.4,83,,percent of total billed charges,,1642.65,,,,fee schedule,,1642.65,,,,fee schedule,,,6671.54,83,,percent of total billed charges,,1891.94,,,,fee schedule,,,7234.2,90,,percent of total billed charges,,,7234.2,90,,percent of total billed charges,,,7234.2,90,,percent of total billed charges,,,7234.2,90,,percent of total billed charges,,,6832.3,85,,percent of total billed charges,,1287.04,7636.1,
LUMBAR SPINE FUSION,22558,CDM,22558,CPT,,,both,,9400,9400,2636.15,,,,fee schedule,,,,,,,,1642.65,,,,fee schedule,,,7990,85,,percent of total billed charges,,3382.91,,,,fee schedule,,1634.25,,,,fee schedule,,1642.65,,,,fee schedule,,2551.35,,,,fee schedule,,1642.65,,,,fee schedule,,2558.62,,,,fee schedule,,1550.68,,,,fee schedule,,1550.68,,,,fee schedule,,,8554,91,,percent of total billed charges,,,8930,95,,percent of total billed charges,,,7802,83,,percent of total billed charges,,,2820,83,,percent of total billed charges,,1642.65,,,,fee schedule,,1642.65,,,,fee schedule,,,7802,83,,percent of total billed charges,,2279.5,,,,fee schedule,,,8460,90,,percent of total billed charges,,,8460,90,,percent of total billed charges,,,8460,90,,percent of total billed charges,,,8460,90,,percent of total billed charges,,,7990,85,,percent of total billed charges,,1550.68,8930,
ADDITIONAL SPINAL FUSION,22585,CDM,22585,CPT,,,both,,2124,2124,557.65,,,,fee schedule,,,,,,,,1057.75,,,,fee schedule,,,1805.4,85,,percent of total billed charges,,724.26,,,,fee schedule,,349.88,,,,fee schedule,,1057.75,,,,fee schedule,,629.38,,,,fee schedule,,1057.75,,,,fee schedule,,541.25,,,,fee schedule,,328.03,,,,fee schedule,,328.03,,,,fee schedule,,,1932.84,91,,percent of total billed charges,,,2017.8,95,,percent of total billed charges,,,1762.92,83,,percent of total billed charges,,,637.2,83,,percent of total billed charges,,1057.75,,,,fee schedule,,1057.75,,,,fee schedule,,,1762.92,83,,percent of total billed charges,,482.2,,,,fee schedule,,,1911.6,90,,percent of total billed charges,,,1911.6,90,,percent of total billed charges,,,1911.6,90,,percent of total billed charges,,,1911.6,90,,percent of total billed charges,,,1805.4,85,,percent of total billed charges,,328.03,2017.8,
PRESCRL FUSE W/ INSTR L5/S1,22586,CDM,22586,CPT,,,both,,13189,13189,3534.27,,,,fee schedule,,,,,,,,950.83,,,,fee schedule,,,11210.65,85,,percent of total billed charges,,4532.51,,,,fee schedule,,2189.6,,,,fee schedule,,950.83,,,,fee schedule,,,,,,,,950.83,,,,fee schedule,,3430.32,,,,fee schedule,,2078.98,,,,fee schedule,,2078.98,,,,fee schedule,,,12001.99,91,,percent of total billed charges,,,12529.55,95,,percent of total billed charges,,,10946.87,83,,percent of total billed charges,,,3956.7,83,,percent of total billed charges,,950.83,,,,fee schedule,,950.83,,,,fee schedule,,,10946.87,83,,percent of total billed charges,,3056.1,,,,fee schedule,,,11870.1,90,,percent of total billed charges,,,11870.1,90,,percent of total billed charges,,,11870.1,90,,percent of total billed charges,,,11870.1,90,,percent of total billed charges,,,11210.65,85,,percent of total billed charges,,950.83,12529.55,
NECK SPINAL FUSION,22595,CDM,22595,CPT,,,both,,9541,9541,2634.42,,,,fee schedule,,,,,,,,1198.7,,,,fee schedule,,,8109.85,85,,percent of total billed charges,,3360.05,,,,fee schedule,,1623.2,,,,fee schedule,,1198.7,,,,fee schedule,,2418.05,,,,fee schedule,,1198.7,,,,fee schedule,,2556.94,,,,fee schedule,,1549.66,,,,fee schedule,,1549.66,,,,fee schedule,,,8682.31,91,,percent of total billed charges,,,9063.95,95,,percent of total billed charges,,,7919.03,83,,percent of total billed charges,,,2862.3,83,,percent of total billed charges,,1198.7,,,,fee schedule,,1198.7,,,,fee schedule,,,7919.03,83,,percent of total billed charges,,2278,,,,fee schedule,,,8586.9,90,,percent of total billed charges,,,8586.9,90,,percent of total billed charges,,,8586.9,90,,percent of total billed charges,,,8586.9,90,,percent of total billed charges,,,8109.85,85,,percent of total billed charges,,1198.7,9063.95,
NECK SPINE FUSION,22600,CDM,22600,CPT,,,both,,8137,8137,2262.28,,,,fee schedule,,,,,,,,1198.7,,,,fee schedule,,,6916.45,85,,percent of total billed charges,,2870.3,,,,fee schedule,,1386.61,,,,fee schedule,,1198.7,,,,fee schedule,,2051.96,,,,fee schedule,,1198.7,,,,fee schedule,,2195.74,,,,fee schedule,,1330.75,,,,fee schedule,,1330.75,,,,fee schedule,,,7404.67,91,,percent of total billed charges,,,7730.15,95,,percent of total billed charges,,,6753.71,83,,percent of total billed charges,,,2441.1,83,,percent of total billed charges,,1198.7,,,,fee schedule,,1198.7,,,,fee schedule,,,6753.71,83,,percent of total billed charges,,1956.2,,,,fee schedule,,,7323.3,90,,percent of total billed charges,,,7323.3,90,,percent of total billed charges,,,7323.3,90,,percent of total billed charges,,,7323.3,90,,percent of total billed charges,,,6916.45,85,,percent of total billed charges,,1198.7,7730.15,
THORAX SPINE FUSION,22610,CDM,22610,CPT,,,both,,8307,8307,2223.1,,,,fee schedule,,,,,,,,1198.7,,,,fee schedule,,,7060.95,85,,percent of total billed charges,,2817.41,,,,fee schedule,,1361.06,,,,fee schedule,,1198.7,,,,fee schedule,,2045.33,,,,fee schedule,,1198.7,,,,fee schedule,,2157.72,,,,fee schedule,,1307.71,,,,fee schedule,,1307.71,,,,fee schedule,,,7559.37,91,,percent of total billed charges,,,7891.65,95,,percent of total billed charges,,,6894.81,83,,percent of total billed charges,,,2492.1,83,,percent of total billed charges,,1198.7,,,,fee schedule,,1198.7,,,,fee schedule,,,6894.81,83,,percent of total billed charges,,1922.33,,,,fee schedule,,,7476.3,90,,percent of total billed charges,,,7476.3,90,,percent of total billed charges,,,7476.3,90,,percent of total billed charges,,,7476.3,90,,percent of total billed charges,,,7060.95,85,,percent of total billed charges,,1198.7,7891.65,
LUMBAR SPINE FUSION,22612,CDM,22612,CPT,,,both,,10212,10212,2737.54,,,,fee schedule,,,,,,,,1198.7,,,,fee schedule,,,8680.2,85,,percent of total billed charges,,3506.03,,,,fee schedule,,1693.72,,,,fee schedule,,1198.7,,,,fee schedule,,2621.65,,,,fee schedule,,1198.7,,,,fee schedule,,2657.03,,,,fee schedule,,1610.32,,,,fee schedule,,1610.32,,,,fee schedule,,,9292.92,91,,percent of total billed charges,,,9701.4,95,,percent of total billed charges,,,8475.96,83,,percent of total billed charges,,,3063.6,83,,percent of total billed charges,,1198.7,,,,fee schedule,,1198.7,,,,fee schedule,,,8475.96,83,,percent of total billed charges,,2367.17,,,,fee schedule,,,9190.8,90,,percent of total billed charges,,,9190.8,90,,percent of total billed charges,,,9190.8,90,,percent of total billed charges,,,9190.8,90,,percent of total billed charges,,,8680.2,85,,percent of total billed charges,,1198.7,9701.4,
"SPINE FUSION, EXTRA SEGMENT",22614,CDM,22614,CPT,,,both,,2768,2768,670.56,,,,fee schedule,,,,,,,,,,,,,,,2352.8,85,,percent of total billed charges,,870.38,,,,fee schedule,,420.47,,,,fee schedule,,,,,,,,738.81,,,,fee schedule,,,,,,,,650.84,,,,fee schedule,,394.45,,,,fee schedule,,394.45,,,,fee schedule,,,2518.88,91,,percent of total billed charges,,,2629.6,95,,percent of total billed charges,,,2297.44,83,,percent of total billed charges,,,830.4,83,,percent of total billed charges,,,,,,,,,,,,,,,2297.44,83,,percent of total billed charges,,579.84,,,,fee schedule,,,2491.2,90,,percent of total billed charges,,,2491.2,90,,percent of total billed charges,,,2491.2,90,,percent of total billed charges,,,2491.2,90,,percent of total billed charges,,,2352.8,85,,percent of total billed charges,,394.45,2629.6,
LUMBAR SPINE FUSION,22630,CDM,22630,CPT,,,both,,9929,9929,2702.98,,,,fee schedule,,,,,,,,1198.7,,,,fee schedule,,,8439.65,85,,percent of total billed charges,,3506.7,,,,fee schedule,,1694.04,,,,fee schedule,,1198.7,,,,fee schedule,,2586.5,,,,fee schedule,,1198.7,,,,fee schedule,,2623.48,,,,fee schedule,,1589.99,,,,fee schedule,,1589.99,,,,fee schedule,,,9035.39,91,,percent of total billed charges,,,9432.55,95,,percent of total billed charges,,,8241.07,83,,percent of total billed charges,,,2978.7,83,,percent of total billed charges,,1198.7,,,,fee schedule,,1198.7,,,,fee schedule,,,8241.07,83,,percent of total billed charges,,2337.28,,,,fee schedule,,,8936.1,90,,percent of total billed charges,,,8936.1,90,,percent of total billed charges,,,8936.1,90,,percent of total billed charges,,,8936.1,90,,percent of total billed charges,,,8439.65,85,,percent of total billed charges,,1198.7,9432.55,
"SPINE FUSION, EXTRA SEGMENT",22632,CDM,22632,CPT,,,both,,2071,2071,550.73,,,,fee schedule,,,,,,,,,,,,,,,1760.35,85,,percent of total billed charges,,715.94,,,,fee schedule,,345.86,,,,fee schedule,,,,,,,,598.21,,,,fee schedule,,,,,,,,534.54,,,,fee schedule,,323.96,,,,fee schedule,,323.96,,,,fee schedule,,,1884.61,91,,percent of total billed charges,,,1967.45,95,,percent of total billed charges,,,1718.93,83,,percent of total billed charges,,,621.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1718.93,83,,percent of total billed charges,,476.22,,,,fee schedule,,,1863.9,90,,percent of total billed charges,,,1863.9,90,,percent of total billed charges,,,1863.9,90,,percent of total billed charges,,,1863.9,90,,percent of total billed charges,,,1760.35,85,,percent of total billed charges,,323.96,1967.45,
LUMBAR SPINE FUSION COMBINED,22633,CDM,22633,CPT,,,both,,11492,11492,3126.4,,,,fee schedule,,,,,,,,1132.79,,,,fee schedule,,,9768.2,85,,percent of total billed charges,,4104.49,,,,fee schedule,,1982.83,,,,fee schedule,,1132.79,,,,fee schedule,,,,,,,,1132.79,,,,fee schedule,,3034.45,,,,fee schedule,,1839.06,,,,fee schedule,,1839.06,,,,fee schedule,,,10457.72,91,,percent of total billed charges,,,10917.4,95,,percent of total billed charges,,,9538.36,83,,percent of total billed charges,,,3447.6,83,,percent of total billed charges,,1132.79,,,,fee schedule,,1132.79,,,,fee schedule,,,9538.36,83,,percent of total billed charges,,2703.42,,,,fee schedule,,,10342.8,90,,percent of total billed charges,,,10342.8,90,,percent of total billed charges,,,10342.8,90,,percent of total billed charges,,,10342.8,90,,percent of total billed charges,,,9768.2,85,,percent of total billed charges,,1132.79,10917.4,
SPINE FUSION EXTRA SEGMENT,22634,CDM,22634,CPT,,,both,,3129,3129,830.71,,,,fee schedule,,,,,,,,,,,,,,,2659.65,85,,percent of total billed charges,,1105.25,,,,fee schedule,,533.93,,,,fee schedule,,,,,,,,,,,,,,,,,,,,806.28,,,,fee schedule,,488.65,,,,fee schedule,,488.65,,,,fee schedule,,,2847.39,91,,percent of total billed charges,,,2972.55,95,,percent of total billed charges,,,2597.07,83,,percent of total billed charges,,,938.7,83,,percent of total billed charges,,,,,,,,,,,,,,,2597.07,83,,percent of total billed charges,,718.32,,,,fee schedule,,,2816.1,90,,percent of total billed charges,,,2816.1,90,,percent of total billed charges,,,2816.1,90,,percent of total billed charges,,,2816.1,90,,percent of total billed charges,,,2659.65,85,,percent of total billed charges,,488.65,2972.55,
EXPLORATION OF SPINAL FUSION,22830,CDM,22830,CPT,,,both,,5875,5875,1426.38,,,,fee schedule,,,,,,,,443.39,,,,fee schedule,,,4993.75,85,,percent of total billed charges,,1810.27,,,,fee schedule,,874.52,,,,fee schedule,,443.39,,,,fee schedule,,1394.72,,,,fee schedule,,443.39,,,,fee schedule,,1384.43,,,,fee schedule,,839.05,,,,fee schedule,,839.05,,,,fee schedule,,,5346.25,91,,percent of total billed charges,,,5581.25,95,,percent of total billed charges,,,4876.25,83,,percent of total billed charges,,,1762.5,83,,percent of total billed charges,,443.39,,,,fee schedule,,443.39,,,,fee schedule,,,4876.25,83,,percent of total billed charges,,1233.4,,,,fee schedule,,,5287.5,90,,percent of total billed charges,,,5287.5,90,,percent of total billed charges,,,5287.5,90,,percent of total billed charges,,,5287.5,90,,percent of total billed charges,,,4993.75,85,,percent of total billed charges,,443.39,5581.25,
EXPLORATION OF SPINAL FUSION,22830AS,CDM,22830,CPT,,,both,AS,689,689,1426.38,,,,fee schedule,,,,,,,,443.39,,,,fee schedule,,,585.65,85,,percent of total billed charges,,1810.27,,,,fee schedule,,874.52,,,,fee schedule,,443.39,,,,fee schedule,,1394.72,,,,fee schedule,,443.39,,,,fee schedule,,1384.43,,,,fee schedule,,839.05,,,,fee schedule,,839.05,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,443.39,,,,fee schedule,,443.39,,,,fee schedule,,,571.87,83,,percent of total billed charges,,1233.4,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,1810.27,
INSERT SPINE FIXATION DEVICE,22840,CDM,22840,CPT,,,both,,5544,5544,1299.07,,,,fee schedule,,,,,,,,1872.9,,,,fee schedule,,,4712.4,85,,percent of total billed charges,,1688.35,,,,fee schedule,,815.62,,,,fee schedule,,1872.9,,,,fee schedule,,1440.48,,,,fee schedule,,1872.9,,,,fee schedule,,1260.86,,,,fee schedule,,764.16,,,,fee schedule,,764.16,,,,fee schedule,,,5045.04,91,,percent of total billed charges,,,5266.8,95,,percent of total billed charges,,,4601.52,83,,percent of total billed charges,,,1663.2,83,,percent of total billed charges,,1872.9,,,,fee schedule,,1872.9,,,,fee schedule,,,4601.52,83,,percent of total billed charges,,1123.31,,,,fee schedule,,,4989.6,90,,percent of total billed charges,,,4989.6,90,,percent of total billed charges,,,4989.6,90,,percent of total billed charges,,,4989.6,90,,percent of total billed charges,,,4712.4,85,,percent of total billed charges,,764.16,5266.8,
INSERT SPINE FIXATION DEVICE,22842,CDM,22842,CPT,,,both,,5899,5899,1308.86,,,,fee schedule,,,,,,,,1872.9,,,,fee schedule,,,5014.15,85,,percent of total billed charges,,1698.24,,,,fee schedule,,820.4,,,,fee schedule,,1872.9,,,,fee schedule,,1439.82,,,,fee schedule,,1872.9,,,,fee schedule,,1270.36,,,,fee schedule,,769.92,,,,fee schedule,,769.92,,,,fee schedule,,,5368.09,91,,percent of total billed charges,,,5604.05,95,,percent of total billed charges,,,4896.17,83,,percent of total billed charges,,,1769.7,83,,percent of total billed charges,,1872.9,,,,fee schedule,,1872.9,,,,fee schedule,,,4896.17,83,,percent of total billed charges,,1131.78,,,,fee schedule,,,5309.1,90,,percent of total billed charges,,,5309.1,90,,percent of total billed charges,,,5309.1,90,,percent of total billed charges,,,5309.1,90,,percent of total billed charges,,,5014.15,85,,percent of total billed charges,,769.92,5604.05,
INSERT SPINE FIXATION DEVICE,22843,CDM,22843,CPT,,,both,,5811,5811,1401.03,,,,fee schedule,,,,,,,,1872.9,,,,fee schedule,,,4939.35,85,,percent of total billed charges,,1815.61,,,,fee schedule,,877.1,,,,fee schedule,,1872.9,,,,fee schedule,,1514.1,,,,fee schedule,,1872.9,,,,fee schedule,,1359.83,,,,fee schedule,,824.14,,,,fee schedule,,824.14,,,,fee schedule,,,5288.01,91,,percent of total billed charges,,,5520.45,95,,percent of total billed charges,,,4823.13,83,,percent of total billed charges,,,1743.3,83,,percent of total billed charges,,1872.9,,,,fee schedule,,1872.9,,,,fee schedule,,,4823.13,83,,percent of total billed charges,,1211.48,,,,fee schedule,,,5229.9,90,,percent of total billed charges,,,5229.9,90,,percent of total billed charges,,,5229.9,90,,percent of total billed charges,,,5229.9,90,,percent of total billed charges,,,4939.35,85,,percent of total billed charges,,824.14,5520.45,
INSERT SPINE FIXATION DEVICE,22845,CDM,22845,CPT,,,both,,5741,5741,1246.64,,,,fee schedule,,,,,,,,1872.9,,,,fee schedule,,,4879.85,85,,percent of total billed charges,,1654.47,,,,fee schedule,,783.28,,,,fee schedule,,1872.9,,,,fee schedule,,1377.48,,,,fee schedule,,1872.9,,,,fee schedule,,1209.98,,,,fee schedule,,733.32,,,,fee schedule,,733.32,,,,fee schedule,,,5224.31,91,,percent of total billed charges,,,5453.95,95,,percent of total billed charges,,,4765.03,83,,percent of total billed charges,,,1722.3,83,,percent of total billed charges,,1872.9,,,,fee schedule,,1872.9,,,,fee schedule,,,4765.03,83,,percent of total billed charges,,1077.98,,,,fee schedule,,,5166.9,90,,percent of total billed charges,,,5166.9,90,,percent of total billed charges,,,5166.9,90,,percent of total billed charges,,,5166.9,90,,percent of total billed charges,,,4879.85,85,,percent of total billed charges,,733.32,5453.95,
INSERT SPINE FIXATION DEVICE,22846,CDM,22846,CPT,,,both,,6023,6023,1297.34,,,,fee schedule,,,,,,,,1872.9,,,,fee schedule,,,5119.55,85,,percent of total billed charges,,1685.6,,,,fee schedule,,814.3,,,,fee schedule,,1872.9,,,,fee schedule,,1432.53,,,,fee schedule,,1872.9,,,,fee schedule,,1259.18,,,,fee schedule,,763.14,,,,fee schedule,,763.14,,,,fee schedule,,,5480.93,91,,percent of total billed charges,,,5721.85,95,,percent of total billed charges,,,4999.09,83,,percent of total billed charges,,,1806.9,83,,percent of total billed charges,,1872.9,,,,fee schedule,,1872.9,,,,fee schedule,,,4999.09,83,,percent of total billed charges,,1121.82,,,,fee schedule,,,5420.7,90,,percent of total billed charges,,,5420.7,90,,percent of total billed charges,,,5420.7,90,,percent of total billed charges,,,5420.7,90,,percent of total billed charges,,,5119.55,85,,percent of total billed charges,,763.14,5721.85,
INSERT PELV FIXATION DEVICE,22848,CDM,22848,CPT,,,both,,2346,2346,615.83,,,,fee schedule,,,,,,,,351,,,,fee schedule,,,1994.1,85,,percent of total billed charges,,797.78,,,,fee schedule,,385.4,,,,fee schedule,,351,,,,fee schedule,,683.77,,,,fee schedule,,351,,,,fee schedule,,597.72,,,,fee schedule,,362.25,,,,fee schedule,,362.25,,,,fee schedule,,,2134.86,91,,percent of total billed charges,,,2228.7,95,,percent of total billed charges,,,1947.18,83,,percent of total billed charges,,,703.8,83,,percent of total billed charges,,351,,,,fee schedule,,351,,,,fee schedule,,,1947.18,83,,percent of total billed charges,,532.51,,,,fee schedule,,,2111.4,90,,percent of total billed charges,,,2111.4,90,,percent of total billed charges,,,2111.4,90,,percent of total billed charges,,,2111.4,90,,percent of total billed charges,,,1994.1,85,,percent of total billed charges,,351,2228.7,
REINSERT SPINAL FIXATION,22849,CDM,22849,CPT,,,both,,7938,7938,2259.97,,,,fee schedule,,,,,,,,1134.1,,,,fee schedule,,,6747.3,85,,percent of total billed charges,,2891.13,,,,fee schedule,,1396.67,,,,fee schedule,,1134.1,,,,fee schedule,,2255.56,,,,fee schedule,,1134.1,,,,fee schedule,,2193.5,,,,fee schedule,,1329.39,,,,fee schedule,,1329.39,,,,fee schedule,,,7223.58,91,,percent of total billed charges,,,7541.1,95,,percent of total billed charges,,,6588.54,83,,percent of total billed charges,,,2381.4,83,,percent of total billed charges,,1134.1,,,,fee schedule,,1134.1,,,,fee schedule,,,6588.54,83,,percent of total billed charges,,1954.21,,,,fee schedule,,,7144.2,90,,percent of total billed charges,,,7144.2,90,,percent of total billed charges,,,7144.2,90,,percent of total billed charges,,,7144.2,90,,percent of total billed charges,,,6747.3,85,,percent of total billed charges,,1134.1,7541.1,
REMOVE SPINE FIXATION DEVICE,22850,CDM,22850,CPT,,,both,,4283,4283,1276.6,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,3640.55,85,,percent of total billed charges,,1621.17,,,,fee schedule,,783.17,,,,fee schedule,,449.5,,,,fee schedule,,1226.93,,,,fee schedule,,449.5,,,,fee schedule,,1239.05,,,,fee schedule,,750.94,,,,fee schedule,,750.94,,,,fee schedule,,,3897.53,91,,percent of total billed charges,,,4068.85,95,,percent of total billed charges,,,3554.89,83,,percent of total billed charges,,,1284.9,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,3554.89,83,,percent of total billed charges,,1103.88,,,,fee schedule,,,3854.7,90,,percent of total billed charges,,,3854.7,90,,percent of total billed charges,,,3854.7,90,,percent of total billed charges,,,3854.7,90,,percent of total billed charges,,,3640.55,85,,percent of total billed charges,,449.5,4068.85,
REMOVE SPINE FIXATION DEVICE,22852,CDM,22852,CPT,,,both,,4604,4604,1228.78,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,3913.4,85,,percent of total billed charges,,1555.25,,,,fee schedule,,751.32,,,,fee schedule,,449.5,,,,fee schedule,,1169.9,,,,fee schedule,,449.5,,,,fee schedule,,1192.64,,,,fee schedule,,722.81,,,,fee schedule,,722.81,,,,fee schedule,,,4189.64,91,,percent of total billed charges,,,4373.8,95,,percent of total billed charges,,,3821.32,83,,percent of total billed charges,,,1381.2,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,3821.32,83,,percent of total billed charges,,1062.54,,,,fee schedule,,,4143.6,90,,percent of total billed charges,,,4143.6,90,,percent of total billed charges,,,4143.6,90,,percent of total billed charges,,,4143.6,90,,percent of total billed charges,,,3913.4,85,,percent of total billed charges,,449.5,4373.8,
REMOVE SPINE FIXATION DEVICE,22852AS,CDM,22852,CPT,,,both,AS,689,689,1228.78,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,585.65,85,,percent of total billed charges,,1555.25,,,,fee schedule,,751.32,,,,fee schedule,,449.5,,,,fee schedule,,1169.9,,,,fee schedule,,449.5,,,,fee schedule,,1192.64,,,,fee schedule,,722.81,,,,fee schedule,,722.81,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,571.87,83,,percent of total billed charges,,1062.54,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,1555.25,
INSJ BIOMECHANICAL DEVICE,22853,CDM,22853,CPT,,,both,,1771,1771,442.43,,,,fee schedule,,,,,,,,837.6,,,,fee schedule,,,1505.35,85,,percent of total billed charges,,574.49,,,,fee schedule,,277.53,,,,fee schedule,,837.6,,,,fee schedule,,,,,,,,837.6,,,,fee schedule,,429.42,,,,fee schedule,,260.25,,,,fee schedule,,260.25,,,,fee schedule,,,1611.61,91,,percent of total billed charges,,,1682.45,95,,percent of total billed charges,,,1469.93,83,,percent of total billed charges,,,531.3,83,,percent of total billed charges,,837.6,,,,fee schedule,,837.6,,,,fee schedule,,,1469.93,83,,percent of total billed charges,,382.57,,,,fee schedule,,,1593.9,90,,percent of total billed charges,,,1593.9,90,,percent of total billed charges,,,1593.9,90,,percent of total billed charges,,,1593.9,90,,percent of total billed charges,,,1505.35,85,,percent of total billed charges,,260.25,1682.45,
INSJ BIOMECHANICAL DEVICE,22854,CDM,22854,CPT,,,both,,2086,2086,575.51,,,,fee schedule,,,,,,,,1084.25,,,,fee schedule,,,1773.1,85,,percent of total billed charges,,746.52,,,,fee schedule,,360.63,,,,fee schedule,,1084.25,,,,fee schedule,,,,,,,,1084.25,,,,fee schedule,,558.58,,,,fee schedule,,338.53,,,,fee schedule,,338.53,,,,fee schedule,,,1898.26,91,,percent of total billed charges,,,1981.7,95,,percent of total billed charges,,,1731.38,83,,percent of total billed charges,,,625.8,83,,percent of total billed charges,,1084.25,,,,fee schedule,,1084.25,,,,fee schedule,,,1731.38,83,,percent of total billed charges,,497.64,,,,fee schedule,,,1877.4,90,,percent of total billed charges,,,1877.4,90,,percent of total billed charges,,,1877.4,90,,percent of total billed charges,,,1877.4,90,,percent of total billed charges,,,1773.1,85,,percent of total billed charges,,338.53,1981.7,
REMOVE SPINE FIXATION DEVICE,22855,CDM,22855,CPT,,,both,,6506,6506,1921.81,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,5530.1,85,,percent of total billed charges,,2450.29,,,,fee schedule,,1183.71,,,,fee schedule,,449.5,,,,fee schedule,,1868.25,,,,fee schedule,,449.5,,,,fee schedule,,1865.29,,,,fee schedule,,1130.48,,,,fee schedule,,1130.48,,,,fee schedule,,,5920.46,91,,percent of total billed charges,,,6180.7,95,,percent of total billed charges,,,5399.98,83,,percent of total billed charges,,,1951.8,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,5399.98,83,,percent of total billed charges,,1661.8,,,,fee schedule,,,5855.4,90,,percent of total billed charges,,,5855.4,90,,percent of total billed charges,,,5855.4,90,,percent of total billed charges,,,5855.4,90,,percent of total billed charges,,,5530.1,85,,percent of total billed charges,,449.5,6180.7,
CERV ARTIFIC DISKECTOMY,22856,CDM,22856,CPT,,,both,,10124,10124,2809.55,,,,fee schedule,,,,,,,,925,,,,fee schedule,,,8605.4,85,,percent of total billed charges,,3613.37,,,,fee schedule,,1745.58,,,,fee schedule,,925,,,,fee schedule,,,,,,,,925,,,,fee schedule,,2726.92,,,,fee schedule,,1652.68,,,,fee schedule,,1652.68,,,,fee schedule,,,9212.84,91,,percent of total billed charges,,,9617.8,95,,percent of total billed charges,,,8402.92,83,,percent of total billed charges,,,3037.2,83,,percent of total billed charges,,925,,,,fee schedule,,925,,,,fee schedule,,,8402.92,83,,percent of total billed charges,,2429.44,,,,fee schedule,,,9111.6,90,,percent of total billed charges,,,9111.6,90,,percent of total billed charges,,,9111.6,90,,percent of total billed charges,,,9111.6,90,,percent of total billed charges,,,8605.4,85,,percent of total billed charges,,925,9617.8,
SECOND LEVEL CER DISKECTOMY,22858,CDM,22858,CPT,,,both,,3617,3617,867.58,,,,fee schedule,,,,,,,,317.99,,,,fee schedule,,,3074.45,85,,percent of total billed charges,,1125.25,,,,fee schedule,,543.6,,,,fee schedule,,317.99,,,,fee schedule,,,,,,,,317.99,,,,fee schedule,,842.06,,,,fee schedule,,510.34,,,,fee schedule,,510.34,,,,fee schedule,,,3291.47,91,,percent of total billed charges,,,3436.15,95,,percent of total billed charges,,,3002.11,83,,percent of total billed charges,,,1085.1,83,,percent of total billed charges,,317.99,,,,fee schedule,,317.99,,,,fee schedule,,,3002.11,83,,percent of total billed charges,,750.2,,,,fee schedule,,,3255.3,90,,percent of total billed charges,,,3255.3,90,,percent of total billed charges,,,3255.3,90,,percent of total billed charges,,,3255.3,90,,percent of total billed charges,,,3074.45,85,,percent of total billed charges,,317.99,3436.15,
INSJ BIOMECHANICAL DEVICE,22859,CDM,22859,CPT,,,both,,22447,22447,570.9,,,,fee schedule,,,,,,,,1084.25,,,,fee schedule,,,19079.95,85,,percent of total billed charges,,740.79,,,,fee schedule,,357.87,,,,fee schedule,,1084.25,,,,fee schedule,,,,,,,,1084.25,,,,fee schedule,,554.11,,,,fee schedule,,335.82,,,,fee schedule,,335.82,,,,fee schedule,,,20426.77,91,,percent of total billed charges,,,21324.65,95,,percent of total billed charges,,,18631.01,83,,percent of total billed charges,,,6734.1,83,,percent of total billed charges,,1084.25,,,,fee schedule,,1084.25,,,,fee schedule,,,18631.01,83,,percent of total billed charges,,493.66,,,,fee schedule,,,20202.3,90,,percent of total billed charges,,,20202.3,90,,percent of total billed charges,,,20202.3,90,,percent of total billed charges,,,20202.3,90,,percent of total billed charges,,,19079.95,85,,percent of total billed charges,,335.82,21324.65,
REVISE CERV ARTIFIC DISC,22861,CDM,22861,CPT,,,both,,16003,16003,4025.66,,,,fee schedule,,,,,,,,1121.23,,,,fee schedule,,,13602.55,85,,percent of total billed charges,,5183.52,,,,fee schedule,,2504.1,,,,fee schedule,,1121.23,,,,fee schedule,,,,,,,,1121.23,,,,fee schedule,,3907.26,,,,fee schedule,,2368.04,,,,fee schedule,,2368.04,,,,fee schedule,,,14562.73,91,,percent of total billed charges,,,15202.85,95,,percent of total billed charges,,,13282.49,83,,percent of total billed charges,,,4800.9,83,,percent of total billed charges,,1121.23,,,,fee schedule,,1121.23,,,,fee schedule,,,13282.49,83,,percent of total billed charges,,3481.02,,,,fee schedule,,,14402.7,90,,percent of total billed charges,,,14402.7,90,,percent of total billed charges,,,14402.7,90,,percent of total billed charges,,,14402.7,90,,percent of total billed charges,,,13602.55,85,,percent of total billed charges,,1121.23,15202.85,
REMOVE CERV ARTIF DISC,22864,CDM,22864,CPT,,,both,,12951,12951,3594.75,,,,fee schedule,,,,,,,,1051.39,,,,fee schedule,,,11008.35,85,,percent of total billed charges,,4623.59,,,,fee schedule,,2233.6,,,,fee schedule,,1051.39,,,,fee schedule,,,,,,,,1051.39,,,,fee schedule,,3489.03,,,,fee schedule,,2114.56,,,,fee schedule,,2114.56,,,,fee schedule,,,11785.41,91,,percent of total billed charges,,,12303.45,95,,percent of total billed charges,,,10749.33,83,,percent of total billed charges,,,3885.3,83,,percent of total billed charges,,1051.39,,,,fee schedule,,1051.39,,,,fee schedule,,,10749.33,83,,percent of total billed charges,,3108.41,,,,fee schedule,,,11655.9,90,,percent of total billed charges,,,11655.9,90,,percent of total billed charges,,,11655.9,90,,percent of total billed charges,,,11655.9,90,,percent of total billed charges,,,11008.35,85,,percent of total billed charges,,1051.39,12303.45,
REMOVE ABDOMINAL WALL LESION,22900,CDM,22900,CPT,,,both,,2478,2478,978.76,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,2106.3,85,,percent of total billed charges,,1246.61,,,,fee schedule,,602.22,,,,fee schedule,,224.7,,,,fee schedule,,647.29,,,,fee schedule,,224.7,,,,fee schedule,,949.98,,,,fee schedule,,575.74,,,,fee schedule,,575.74,,,,fee schedule,,,2254.98,91,,percent of total billed charges,,,2354.1,95,,percent of total billed charges,,,2056.74,83,,percent of total billed charges,,,743.4,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,2056.74,83,,percent of total billed charges,,846.34,,,,fee schedule,,,2230.2,90,,percent of total billed charges,,,2230.2,90,,percent of total billed charges,,,2230.2,90,,percent of total billed charges,,,2230.2,90,,percent of total billed charges,,,2106.3,85,,percent of total billed charges,,224.7,2354.1,
Exc Tumor Soft Tissue Abd Wall>3cm,22903,CDM,22903,CPT,,,both,,2358,2358,762.73,,,,fee schedule,,,,,,,,245.8,,,,fee schedule,,,2004.3,85,,percent of total billed charges,,972.41,,,,fee schedule,,469.76,,,,fee schedule,,245.8,,,,fee schedule,,,,,,,,245.8,,,,fee schedule,,740.3,,,,fee schedule,,448.67,,,,fee schedule,,448.67,,,,fee schedule,,,2145.78,91,,percent of total billed charges,,,2240.1,95,,percent of total billed charges,,,1957.14,83,,percent of total billed charges,,,707.4,83,,percent of total billed charges,,245.8,,,,fee schedule,,245.8,,,,fee schedule,,,1957.14,83,,percent of total billed charges,,659.54,,,,fee schedule,,,2122.2,90,,percent of total billed charges,,,2122.2,90,,percent of total billed charges,,,2122.2,90,,percent of total billed charges,,,2122.2,90,,percent of total billed charges,,,2004.3,85,,percent of total billed charges,,245.8,2240.1,
DRAIN SHOULDER LESION,23030,CDM,23030,CPT,,,both,,1695,1695,440.7,,,,fee schedule,,,,,,,,125.5,,,,fee schedule,,,1440.75,85,,percent of total billed charges,,556.64,,,,fee schedule,,268.91,,,,fee schedule,,125.5,,,,fee schedule,,454.3,,,,fee schedule,,125.5,,,,fee schedule,,427.74,,,,fee schedule,,259.24,,,,fee schedule,,259.24,,,,fee schedule,,,1542.45,91,,percent of total billed charges,,,1610.25,95,,percent of total billed charges,,,1406.85,83,,percent of total billed charges,,,508.5,83,,percent of total billed charges,,125.5,,,,fee schedule,,125.5,,,,fee schedule,,,1406.85,83,,percent of total billed charges,,381.08,,,,fee schedule,,,1525.5,90,,percent of total billed charges,,,1525.5,90,,percent of total billed charges,,,1525.5,90,,percent of total billed charges,,,1525.5,90,,percent of total billed charges,,,1440.75,85,,percent of total billed charges,,125.5,1610.25,
DRAIN SHOULDER LESION,23030P,CDM,23030,CPT,,,both,P,1495,1495,440.7,,,,fee schedule,,,,,,,,125.5,,,,fee schedule,,,1270.75,85,,percent of total billed charges,,556.64,,,,fee schedule,,268.91,,,,fee schedule,,125.5,,,,fee schedule,,454.3,,,,fee schedule,,125.5,,,,fee schedule,,427.74,,,,fee schedule,,259.24,,,,fee schedule,,259.24,,,,fee schedule,,,1360.45,91,,percent of total billed charges,,,1420.25,95,,percent of total billed charges,,,1240.85,83,,percent of total billed charges,,,448.5,83,,percent of total billed charges,,125.5,,,,fee schedule,,125.5,,,,fee schedule,,,1240.85,83,,percent of total billed charges,,381.08,,,,fee schedule,,,1345.5,90,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1270.75,85,,percent of total billed charges,,125.5,1420.25,
DRAIN SHOULDER LESION,23030T,CDM,23030,CPT,,,both,T,200,200,440.7,,,,fee schedule,,,,,,,,125.5,,,,fee schedule,,,170,85,,percent of total billed charges,,556.64,,,,fee schedule,,268.91,,,,fee schedule,,125.5,,,,fee schedule,,454.3,,,,fee schedule,,125.5,,,,fee schedule,,427.74,,,,fee schedule,,259.24,,,,fee schedule,,259.24,,,,fee schedule,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,60,83,,percent of total billed charges,,125.5,,,,fee schedule,,125.5,,,,fee schedule,,,166,83,,percent of total billed charges,,381.08,,,,fee schedule,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,60,556.64,
"Exc, Tumor, Soft Tissue Shoulder Area, Subcu 3 Cm",23071,CDM,23071,CPT,,,both,,1936,1936,727.59,,,,fee schedule,,,,,,,,233.57,,,,fee schedule,,,1645.6,85,,percent of total billed charges,,924.28,,,,fee schedule,,446.51,,,,fee schedule,,233.57,,,,fee schedule,,,,,,,,233.57,,,,fee schedule,,706.19,,,,fee schedule,,428,,,,fee schedule,,428,,,,fee schedule,,,1761.76,91,,percent of total billed charges,,,1839.2,95,,percent of total billed charges,,,1606.88,83,,percent of total billed charges,,,580.8,83,,percent of total billed charges,,233.57,,,,fee schedule,,233.57,,,,fee schedule,,,1606.88,83,,percent of total billed charges,,629.15,,,,fee schedule,,,1742.4,90,,percent of total billed charges,,,1742.4,90,,percent of total billed charges,,,1742.4,90,,percent of total billed charges,,,1742.4,90,,percent of total billed charges,,,1645.6,85,,percent of total billed charges,,233.57,1839.2,
EXC SHOULDER TUM DEEP 5 CM/>,23073,CDM,23073,CPT,,,both,,3716,3716,1206.32,,,,fee schedule,,,,,,,,387.83,,,,fee schedule,,,3158.6,85,,percent of total billed charges,,1531.92,,,,fee schedule,,740.05,,,,fee schedule,,387.83,,,,fee schedule,,,,,,,,387.83,,,,fee schedule,,1170.84,,,,fee schedule,,709.6,,,,fee schedule,,709.6,,,,fee schedule,,,3381.56,91,,percent of total billed charges,,,3530.2,95,,percent of total billed charges,,,3084.28,83,,percent of total billed charges,,,1114.8,83,,percent of total billed charges,,387.83,,,,fee schedule,,387.83,,,,fee schedule,,,3084.28,83,,percent of total billed charges,,1043.11,,,,fee schedule,,,3344.4,90,,percent of total billed charges,,,3344.4,90,,percent of total billed charges,,,3344.4,90,,percent of total billed charges,,,3344.4,90,,percent of total billed charges,,,3158.6,85,,percent of total billed charges,,387.83,3530.2,
REMOVAL OF SHOULDER LESION,23075,CDM,23075,CPT,,,both,,2162,2162,569.75,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,1837.7,85,,percent of total billed charges,,717.02,,,,fee schedule,,346.38,,,,fee schedule,,224.7,,,,fee schedule,,297.78,,,,fee schedule,,224.7,,,,fee schedule,,552.99,,,,fee schedule,,335.14,,,,fee schedule,,335.14,,,,fee schedule,,,1967.42,91,,percent of total billed charges,,,2053.9,95,,percent of total billed charges,,,1794.46,83,,percent of total billed charges,,,648.6,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,1794.46,83,,percent of total billed charges,,492.66,,,,fee schedule,,,1945.8,90,,percent of total billed charges,,,1945.8,90,,percent of total billed charges,,,1945.8,90,,percent of total billed charges,,,1945.8,90,,percent of total billed charges,,,1837.7,85,,percent of total billed charges,,224.7,2053.9,
REMOVAL OF SHOULDER LESION,23075P,CDM,23075,CPT,,,both,P,1949,1949,569.75,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,1656.65,85,,percent of total billed charges,,717.02,,,,fee schedule,,346.38,,,,fee schedule,,224.7,,,,fee schedule,,297.78,,,,fee schedule,,224.7,,,,fee schedule,,552.99,,,,fee schedule,,335.14,,,,fee schedule,,335.14,,,,fee schedule,,,1773.59,91,,percent of total billed charges,,,1851.55,95,,percent of total billed charges,,,1617.67,83,,percent of total billed charges,,,584.7,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,1617.67,83,,percent of total billed charges,,492.66,,,,fee schedule,,,1754.1,90,,percent of total billed charges,,,1754.1,90,,percent of total billed charges,,,1754.1,90,,percent of total billed charges,,,1754.1,90,,percent of total billed charges,,,1656.65,85,,percent of total billed charges,,224.7,1851.55,
REMOVAL OF SHOULDER LESION,23075T,CDM,23075,CPT,,,both,T,213,213,569.75,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,181.05,85,,percent of total billed charges,,717.02,,,,fee schedule,,346.38,,,,fee schedule,,224.7,,,,fee schedule,,297.78,,,,fee schedule,,224.7,,,,fee schedule,,552.99,,,,fee schedule,,335.14,,,,fee schedule,,335.14,,,,fee schedule,,,193.83,91,,percent of total billed charges,,,202.35,95,,percent of total billed charges,,,176.79,83,,percent of total billed charges,,,63.9,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,176.79,83,,percent of total billed charges,,492.66,,,,fee schedule,,,191.7,90,,percent of total billed charges,,,191.7,90,,percent of total billed charges,,,191.7,90,,percent of total billed charges,,,191.7,90,,percent of total billed charges,,,181.05,85,,percent of total billed charges,,63.9,717.02,
REMOVAL OF SHOULDER LESION,23076,CDM,23076,CPT,,,both,,3541,3541,943.05,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,3009.85,85,,percent of total billed charges,,1190.2,,,,fee schedule,,574.97,,,,fee schedule,,449.5,,,,fee schedule,,946.4,,,,fee schedule,,449.5,,,,fee schedule,,915.31,,,,fee schedule,,554.73,,,,fee schedule,,554.73,,,,fee schedule,,,3222.31,91,,percent of total billed charges,,,3363.95,95,,percent of total billed charges,,,2939.03,83,,percent of total billed charges,,,1062.3,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,2939.03,83,,percent of total billed charges,,815.46,,,,fee schedule,,,3186.9,90,,percent of total billed charges,,,3186.9,90,,percent of total billed charges,,,3186.9,90,,percent of total billed charges,,,3186.9,90,,percent of total billed charges,,,3009.85,85,,percent of total billed charges,,449.5,3363.95,
REMOVE TUMOR OF SHOULDER,23077,CDM,23077,CPT,,,both,,5989,5989,1945.43,,,,fee schedule,,,,,,,,641.38,,,,fee schedule,,,5090.65,85,,percent of total billed charges,,2501.14,,,,fee schedule,,1208.27,,,,fee schedule,,641.38,,,,fee schedule,,1894.12,,,,fee schedule,,641.38,,,,fee schedule,,1888.21,,,,fee schedule,,1144.37,,,,fee schedule,,1144.37,,,,fee schedule,,,5449.99,91,,percent of total billed charges,,,5689.55,95,,percent of total billed charges,,,4970.87,83,,percent of total billed charges,,,1796.7,83,,percent of total billed charges,,641.38,,,,fee schedule,,641.38,,,,fee schedule,,,4970.87,83,,percent of total billed charges,,1682.22,,,,fee schedule,,,5390.1,90,,percent of total billed charges,,,5390.1,90,,percent of total billed charges,,,5390.1,90,,percent of total billed charges,,,5390.1,90,,percent of total billed charges,,,5090.65,85,,percent of total billed charges,,641.38,5689.55,
"PARTIAL REMOVAL, COLLAR BONE",23120,CDM,23120,CPT,,,both,,3138,3138,1024.27,,,,fee schedule,,,,,,,,362,,,,fee schedule,,,2667.3,85,,percent of total billed charges,,1276.63,,,,fee schedule,,616.73,,,,fee schedule,,362,,,,fee schedule,,979.56,,,,fee schedule,,362,,,,fee schedule,,994.15,,,,fee schedule,,602.51,,,,fee schedule,,602.51,,,,fee schedule,,,2855.58,91,,percent of total billed charges,,,2981.1,95,,percent of total billed charges,,,2604.54,83,,percent of total billed charges,,,941.4,83,,percent of total billed charges,,362,,,,fee schedule,,362,,,,fee schedule,,,2604.54,83,,percent of total billed charges,,885.7,,,,fee schedule,,,2824.2,90,,percent of total billed charges,,,2824.2,90,,percent of total billed charges,,,2824.2,90,,percent of total billed charges,,,2824.2,90,,percent of total billed charges,,,2667.3,85,,percent of total billed charges,,362,2981.1,
"REMOVE SHOULDER BONE, PART",23130,CDM,23130,CPT,,,both,,3770,3770,1077.85,,,,fee schedule,,,,,,,,362,,,,fee schedule,,,3204.5,85,,percent of total billed charges,,1347.71,,,,fee schedule,,651.07,,,,fee schedule,,362,,,,fee schedule,,1058.48,,,,fee schedule,,362,,,,fee schedule,,1046.15,,,,fee schedule,,634.03,,,,fee schedule,,634.03,,,,fee schedule,,,3430.7,91,,percent of total billed charges,,,3581.5,95,,percent of total billed charges,,,3129.1,83,,percent of total billed charges,,,1131,83,,percent of total billed charges,,362,,,,fee schedule,,362,,,,fee schedule,,,3129.1,83,,percent of total billed charges,,932.02,,,,fee schedule,,,3393,90,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3393,90,,percent of total billed charges,,,3204.5,85,,percent of total billed charges,,362,3581.5,
REMOVAL OF HUMERUS LESION,23150,CDM,23150,CPT,,,both,,3667,3667,1161.38,,,,fee schedule,,,,,,,,275.8,,,,fee schedule,,,3116.95,85,,percent of total billed charges,,1445.47,,,,fee schedule,,698.29,,,,fee schedule,,275.8,,,,fee schedule,,1104.9,,,,fee schedule,,275.8,,,,fee schedule,,1127.22,,,,fee schedule,,683.17,,,,fee schedule,,683.17,,,,fee schedule,,,3336.97,91,,percent of total billed charges,,,3483.65,95,,percent of total billed charges,,,3043.61,83,,percent of total billed charges,,,1100.1,83,,percent of total billed charges,,275.8,,,,fee schedule,,275.8,,,,fee schedule,,,3043.61,83,,percent of total billed charges,,1004.25,,,,fee schedule,,,3300.3,90,,percent of total billed charges,,,3300.3,90,,percent of total billed charges,,,3300.3,90,,percent of total billed charges,,,3300.3,90,,percent of total billed charges,,,3116.95,85,,percent of total billed charges,,275.8,3483.65,
INCISION OF TENDON/MUSCLE,23405,CDM,23405,CPT,,,both,,3122,3122,1070.94,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,2653.7,85,,percent of total billed charges,,1349.45,,,,fee schedule,,651.91,,,,fee schedule,,299.7,,,,fee schedule,,1107.55,,,,fee schedule,,299.7,,,,fee schedule,,1039.44,,,,fee schedule,,629.96,,,,fee schedule,,629.96,,,,fee schedule,,,2841.02,91,,percent of total billed charges,,,2965.9,95,,percent of total billed charges,,,2591.26,83,,percent of total billed charges,,,936.6,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,2591.26,83,,percent of total billed charges,,926.05,,,,fee schedule,,,2809.8,90,,percent of total billed charges,,,2809.8,90,,percent of total billed charges,,,2809.8,90,,percent of total billed charges,,,2809.8,90,,percent of total billed charges,,,2653.7,85,,percent of total billed charges,,299.7,2965.9,
"REPAIR ROTATOR CUFF, ACUTE",23410,CDM,23410,CPT,,,both,,4733,4733,1422.35,,,,fee schedule,,,,,,,,779.7,,,,fee schedule,,,4023.05,85,,percent of total billed charges,,1789.14,,,,fee schedule,,864.31,,,,fee schedule,,779.7,,,,fee schedule,,1587.72,,,,fee schedule,,779.7,,,,fee schedule,,1380.51,,,,fee schedule,,836.67,,,,fee schedule,,836.67,,,,fee schedule,,,4307.03,91,,percent of total billed charges,,,4496.35,95,,percent of total billed charges,,,3928.39,83,,percent of total billed charges,,,1419.9,83,,percent of total billed charges,,779.7,,,,fee schedule,,779.7,,,,fee schedule,,,3928.39,83,,percent of total billed charges,,1229.91,,,,fee schedule,,,4259.7,90,,percent of total billed charges,,,4259.7,90,,percent of total billed charges,,,4259.7,90,,percent of total billed charges,,,4259.7,90,,percent of total billed charges,,,4023.05,85,,percent of total billed charges,,779.7,4496.35,
"REPAIR ROTATOR CUFF, CHRONIC",23412,CDM,23412,CPT,,,both,,5103,5103,1477.08,,,,fee schedule,,,,,,,,779.7,,,,fee schedule,,,4337.55,85,,percent of total billed charges,,1859.91,,,,fee schedule,,898.5,,,,fee schedule,,779.7,,,,fee schedule,,1687.2,,,,fee schedule,,779.7,,,,fee schedule,,1433.63,,,,fee schedule,,868.87,,,,fee schedule,,868.87,,,,fee schedule,,,4643.73,91,,percent of total billed charges,,,4847.85,95,,percent of total billed charges,,,4235.49,83,,percent of total billed charges,,,1530.9,83,,percent of total billed charges,,779.7,,,,fee schedule,,779.7,,,,fee schedule,,,4235.49,83,,percent of total billed charges,,1277.24,,,,fee schedule,,,4592.7,90,,percent of total billed charges,,,4592.7,90,,percent of total billed charges,,,4592.7,90,,percent of total billed charges,,,4592.7,90,,percent of total billed charges,,,4337.55,85,,percent of total billed charges,,779.7,4847.85,
RELEASE OF SHOULDER LIGAMENT,23415,CDM,23415,CPT,,,both,,3201,3201,1214.38,,,,fee schedule,,,,,,,,674.2,,,,fee schedule,,,2720.85,85,,percent of total billed charges,,1523.48,,,,fee schedule,,735.98,,,,fee schedule,,674.2,,,,fee schedule,,1303.2,,,,fee schedule,,674.2,,,,fee schedule,,1178.66,,,,fee schedule,,714.34,,,,fee schedule,,714.34,,,,fee schedule,,,2912.91,91,,percent of total billed charges,,,3040.95,95,,percent of total billed charges,,,2656.83,83,,percent of total billed charges,,,960.3,83,,percent of total billed charges,,674.2,,,,fee schedule,,674.2,,,,fee schedule,,,2656.83,83,,percent of total billed charges,,1050.08,,,,fee schedule,,,2880.9,90,,percent of total billed charges,,,2880.9,90,,percent of total billed charges,,,2880.9,90,,percent of total billed charges,,,2880.9,90,,percent of total billed charges,,,2720.85,85,,percent of total billed charges,,674.2,3040.95,
REPAIR OF SHOULDER,23420,CDM,23420,CPT,,,both,,5401,5401,1687.35,,,,fee schedule,,,,,,,,674.2,,,,fee schedule,,,4590.85,85,,percent of total billed charges,,2125.84,,,,fee schedule,,1026.97,,,,fee schedule,,674.2,,,,fee schedule,,1750.2,,,,fee schedule,,674.2,,,,fee schedule,,1637.72,,,,fee schedule,,992.56,,,,fee schedule,,992.56,,,,fee schedule,,,4914.91,91,,percent of total billed charges,,,5130.95,95,,percent of total billed charges,,,4482.83,83,,percent of total billed charges,,,1620.3,83,,percent of total billed charges,,674.2,,,,fee schedule,,674.2,,,,fee schedule,,,4482.83,83,,percent of total billed charges,,1459.06,,,,fee schedule,,,4860.9,90,,percent of total billed charges,,,4860.9,90,,percent of total billed charges,,,4860.9,90,,percent of total billed charges,,,4860.9,90,,percent of total billed charges,,,4590.85,85,,percent of total billed charges,,674.2,5130.95,
REPAIR BICEPS TENDON,23430,CDM,23430,CPT,,,both,,3968,3968,1292.15,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,3372.8,85,,percent of total billed charges,,1623.57,,,,fee schedule,,784.33,,,,fee schedule,,449.5,,,,fee schedule,,1311.16,,,,fee schedule,,449.5,,,,fee schedule,,1254.15,,,,fee schedule,,760.09,,,,fee schedule,,760.09,,,,fee schedule,,,3610.88,91,,percent of total billed charges,,,3769.6,95,,percent of total billed charges,,,3293.44,83,,percent of total billed charges,,,1190.4,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,3293.44,83,,percent of total billed charges,,1117.33,,,,fee schedule,,,3571.2,90,,percent of total billed charges,,,3571.2,90,,percent of total billed charges,,,3571.2,90,,percent of total billed charges,,,3571.2,90,,percent of total billed charges,,,3372.8,85,,percent of total billed charges,,449.5,3769.6,
REMOVE/TRANSPLANT TENDON,23440,CDM,23440,CPT,,,both,,4728,4728,1311.74,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,4018.8,85,,percent of total billed charges,,1654.53,,,,fee schedule,,799.29,,,,fee schedule,,449.5,,,,fee schedule,,1360.24,,,,fee schedule,,449.5,,,,fee schedule,,1273.16,,,,fee schedule,,771.61,,,,fee schedule,,771.61,,,,fee schedule,,,4302.48,91,,percent of total billed charges,,,4491.6,95,,percent of total billed charges,,,3924.24,83,,percent of total billed charges,,,1418.4,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,3924.24,83,,percent of total billed charges,,1134.27,,,,fee schedule,,,4255.2,90,,percent of total billed charges,,,4255.2,90,,percent of total billed charges,,,4255.2,90,,percent of total billed charges,,,4255.2,90,,percent of total billed charges,,,4018.8,85,,percent of total billed charges,,449.5,4491.6,
REPAIR SHOULDER CAPSULE,23455,CDM,23455,CPT,,,both,,5578,5578,1708.66,,,,fee schedule,,,,,,,,839.35,,,,fee schedule,,,4741.3,85,,percent of total billed charges,,2173.47,,,,fee schedule,,1049.98,,,,fee schedule,,839.35,,,,fee schedule,,1806.57,,,,fee schedule,,839.35,,,,fee schedule,,1658.41,,,,fee schedule,,1005.09,,,,fee schedule,,1005.09,,,,fee schedule,,,5075.98,91,,percent of total billed charges,,,5299.1,95,,percent of total billed charges,,,4629.74,83,,percent of total billed charges,,,1673.4,83,,percent of total billed charges,,839.35,,,,fee schedule,,839.35,,,,fee schedule,,,4629.74,83,,percent of total billed charges,,1477.49,,,,fee schedule,,,5020.2,90,,percent of total billed charges,,,5020.2,90,,percent of total billed charges,,,5020.2,90,,percent of total billed charges,,,5020.2,90,,percent of total billed charges,,,4741.3,85,,percent of total billed charges,,839.35,5299.1,
REPAIR SHOULDER CAPSULE,23462,CDM,23462,CPT,,,both,,5757,5757,1844.62,,,,fee schedule,,,,,,,,839.35,,,,fee schedule,,,4893.45,85,,percent of total billed charges,,2336.96,,,,fee schedule,,1128.96,,,,fee schedule,,839.35,,,,fee schedule,,1896.77,,,,fee schedule,,839.35,,,,fee schedule,,1790.36,,,,fee schedule,,1085.07,,,,fee schedule,,1085.07,,,,fee schedule,,,5238.87,91,,percent of total billed charges,,,5469.15,95,,percent of total billed charges,,,4778.31,83,,percent of total billed charges,,,1727.1,83,,percent of total billed charges,,839.35,,,,fee schedule,,839.35,,,,fee schedule,,,4778.31,83,,percent of total billed charges,,1595.05,,,,fee schedule,,,5181.3,90,,percent of total billed charges,,,5181.3,90,,percent of total billed charges,,,5181.3,90,,percent of total billed charges,,,5181.3,90,,percent of total billed charges,,,4893.45,85,,percent of total billed charges,,839.35,5469.15,
REPAIR SHOULDER CAPSULE,23466,CDM,23466,CPT,,,both,,5979,5979,1938.52,,,,fee schedule,,,,,,,,584.4,,,,fee schedule,,,5082.15,85,,percent of total billed charges,,2443.79,,,,fee schedule,,1180.56,,,,fee schedule,,584.4,,,,fee schedule,,1856.31,,,,fee schedule,,584.4,,,,fee schedule,,1881.5,,,,fee schedule,,1140.3,,,,fee schedule,,1140.3,,,,fee schedule,,,5440.89,91,,percent of total billed charges,,,5680.05,95,,percent of total billed charges,,,4962.57,83,,percent of total billed charges,,,1793.7,83,,percent of total billed charges,,584.4,,,,fee schedule,,584.4,,,,fee schedule,,,4962.57,83,,percent of total billed charges,,1676.25,,,,fee schedule,,,5381.1,90,,percent of total billed charges,,,5381.1,90,,percent of total billed charges,,,5381.1,90,,percent of total billed charges,,,5381.1,90,,percent of total billed charges,,,5082.15,85,,percent of total billed charges,,584.4,5680.05,
RECONSTRUCT SHOULDER JOINT,23470,CDM,23470,CPT,,,both,,6011,6011,2065.26,,,,fee schedule,,,,,,,,839.35,,,,fee schedule,,,5109.35,85,,percent of total billed charges,,2621.58,,,,fee schedule,,1266.46,,,,fee schedule,,839.35,,,,fee schedule,,2141.49,,,,fee schedule,,839.35,,,,fee schedule,,2004.51,,,,fee schedule,,1214.86,,,,fee schedule,,1214.86,,,,fee schedule,,,5470.01,91,,percent of total billed charges,,,5710.45,95,,percent of total billed charges,,,4989.13,83,,percent of total billed charges,,,1803.3,83,,percent of total billed charges,,839.35,,,,fee schedule,,839.35,,,,fee schedule,,,4989.13,83,,percent of total billed charges,,1785.84,,,,fee schedule,,,5409.9,90,,percent of total billed charges,,,5409.9,90,,percent of total billed charges,,,5409.9,90,,percent of total billed charges,,,5409.9,90,,percent of total billed charges,,,5109.35,85,,percent of total billed charges,,839.35,5710.45,
RECONSTRUCT SHOULDER JOINT,23472,CDM,23472,CPT,,,both,,7988,7988,2488.1,,,,fee schedule,,,,,,,,1498.3,,,,fee schedule,,,6789.8,85,,percent of total billed charges,,3164.53,,,,fee schedule,,1528.75,,,,fee schedule,,1498.3,,,,fee schedule,,2591.15,,,,fee schedule,,1498.3,,,,fee schedule,,2414.92,,,,fee schedule,,1463.59,,,,fee schedule,,1463.59,,,,fee schedule,,,7269.08,91,,percent of total billed charges,,,7588.6,95,,percent of total billed charges,,,6630.04,83,,percent of total billed charges,,,2396.4,83,,percent of total billed charges,,1498.3,,,,fee schedule,,1498.3,,,,fee schedule,,,6630.04,83,,percent of total billed charges,,2151.47,,,,fee schedule,,,7189.2,90,,percent of total billed charges,,,7189.2,90,,percent of total billed charges,,,7189.2,90,,percent of total billed charges,,,7189.2,90,,percent of total billed charges,,,6789.8,85,,percent of total billed charges,,1463.59,7588.6,
RECONSTRUCT SHOULDER JOINT,23472AS,CDM,23472,CPT,,,both,AS,689,689,2488.1,,,,fee schedule,,,,,,,,1498.3,,,,fee schedule,,,585.65,85,,percent of total billed charges,,3164.53,,,,fee schedule,,1528.75,,,,fee schedule,,1498.3,,,,fee schedule,,2591.15,,,,fee schedule,,1498.3,,,,fee schedule,,2414.92,,,,fee schedule,,1463.59,,,,fee schedule,,1463.59,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,1498.3,,,,fee schedule,,1498.3,,,,fee schedule,,,571.87,83,,percent of total billed charges,,2151.47,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,3164.53,
REVIS RECONST SHOULDER JOINT,23473,CDM,23473,CPT,,,both,,7473,7473,2769.23,,,,fee schedule,,,,,,,,984.68,,,,fee schedule,,,6352.05,85,,percent of total billed charges,,3529.69,,,,fee schedule,,1705.15,,,,fee schedule,,984.68,,,,fee schedule,,,,,,,,984.68,,,,fee schedule,,2687.78,,,,fee schedule,,1628.96,,,,fee schedule,,1628.96,,,,fee schedule,,,6800.43,91,,percent of total billed charges,,,7099.35,95,,percent of total billed charges,,,6202.59,83,,percent of total billed charges,,,2241.9,83,,percent of total billed charges,,984.68,,,,fee schedule,,984.68,,,,fee schedule,,,6202.59,83,,percent of total billed charges,,2394.57,,,,fee schedule,,,6725.7,90,,percent of total billed charges,,,6725.7,90,,percent of total billed charges,,,6725.7,90,,percent of total billed charges,,,6725.7,90,,percent of total billed charges,,,6352.05,85,,percent of total billed charges,,984.68,7099.35,
REVIS RECONST SHOULDER JOINT,23474,CDM,23474,CPT,,,both,,7619,7619,2989.29,,,,fee schedule,,,,,,,,1064.97,,,,fee schedule,,,6476.15,85,,percent of total billed charges,,3810.85,,,,fee schedule,,1840.98,,,,fee schedule,,1064.97,,,,fee schedule,,,,,,,,1064.97,,,,fee schedule,,2901.37,,,,fee schedule,,1758.41,,,,fee schedule,,1758.41,,,,fee schedule,,,6933.29,91,,percent of total billed charges,,,7238.05,95,,percent of total billed charges,,,6323.77,83,,percent of total billed charges,,,2285.7,83,,percent of total billed charges,,1064.97,,,,fee schedule,,1064.97,,,,fee schedule,,,6323.77,83,,percent of total billed charges,,2584.86,,,,fee schedule,,,6857.1,90,,percent of total billed charges,,,6857.1,90,,percent of total billed charges,,,6857.1,90,,percent of total billed charges,,,6857.1,90,,percent of total billed charges,,,6476.15,85,,percent of total billed charges,,1064.97,7238.05,
TREAT CLAVICLE FRACTURE,23500,CDM,23500,CPT,,,both,,930,930,406.14,,,,fee schedule,,,,,,,,112.4,,,,fee schedule,,,790.5,85,,percent of total billed charges,,490.26,,,,fee schedule,,236.84,,,,fee schedule,,112.4,,,,fee schedule,,324.31,,,,fee schedule,,112.4,,,,fee schedule,,394.19,,,,fee schedule,,238.9,,,,fee schedule,,238.9,,,,fee schedule,,,846.3,91,,percent of total billed charges,,,883.5,95,,percent of total billed charges,,,771.9,83,,percent of total billed charges,,,279,83,,percent of total billed charges,,112.4,,,,fee schedule,,112.4,,,,fee schedule,,,771.9,83,,percent of total billed charges,,351.19,,,,fee schedule,,,837,90,,percent of total billed charges,,,837,90,,percent of total billed charges,,,837,90,,percent of total billed charges,,,837,90,,percent of total billed charges,,,790.5,85,,percent of total billed charges,,112.4,883.5,
TREAT CLAVICLE FRACTURE,23500P,CDM,23500,CPT,,,both,P,632,632,406.14,,,,fee schedule,,,,,,,,112.4,,,,fee schedule,,,537.2,85,,percent of total billed charges,,490.26,,,,fee schedule,,236.84,,,,fee schedule,,112.4,,,,fee schedule,,324.31,,,,fee schedule,,112.4,,,,fee schedule,,394.19,,,,fee schedule,,238.9,,,,fee schedule,,238.9,,,,fee schedule,,,575.12,91,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,189.6,83,,percent of total billed charges,,112.4,,,,fee schedule,,112.4,,,,fee schedule,,,524.56,83,,percent of total billed charges,,351.19,,,,fee schedule,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,537.2,85,,percent of total billed charges,,112.4,600.4,
TREAT CLAVICLE FRACTURE,23500T,CDM,23500,CPT,,,both,T,298,298,406.14,,,,fee schedule,,,,,,,,112.4,,,,fee schedule,,,253.3,85,,percent of total billed charges,,490.26,,,,fee schedule,,236.84,,,,fee schedule,,112.4,,,,fee schedule,,324.31,,,,fee schedule,,112.4,,,,fee schedule,,394.19,,,,fee schedule,,238.9,,,,fee schedule,,238.9,,,,fee schedule,,,271.18,91,,percent of total billed charges,,,283.1,95,,percent of total billed charges,,,247.34,83,,percent of total billed charges,,,89.4,83,,percent of total billed charges,,112.4,,,,fee schedule,,112.4,,,,fee schedule,,,247.34,83,,percent of total billed charges,,351.19,,,,fee schedule,,,268.2,90,,percent of total billed charges,,,268.2,90,,percent of total billed charges,,,268.2,90,,percent of total billed charges,,,268.2,90,,percent of total billed charges,,,253.3,85,,percent of total billed charges,,89.4,490.26,
TREAT CLAVICLE FRACTURE,23505,CDM,23505,CPT,,,both,,1475,1475,589.33,,,,fee schedule,,,,,,,,187.3,,,,fee schedule,,,1253.75,85,,percent of total billed charges,,728.97,,,,fee schedule,,352.16,,,,fee schedule,,187.3,,,,fee schedule,,537.86,,,,fee schedule,,187.3,,,,fee schedule,,572,,,,fee schedule,,346.67,,,,fee schedule,,346.67,,,,fee schedule,,,1342.25,91,,percent of total billed charges,,,1401.25,95,,percent of total billed charges,,,1224.25,83,,percent of total billed charges,,,442.5,83,,percent of total billed charges,,187.3,,,,fee schedule,,187.3,,,,fee schedule,,,1224.25,83,,percent of total billed charges,,509.6,,,,fee schedule,,,1327.5,90,,percent of total billed charges,,,1327.5,90,,percent of total billed charges,,,1327.5,90,,percent of total billed charges,,,1327.5,90,,percent of total billed charges,,,1253.75,85,,percent of total billed charges,,187.3,1401.25,
TREAT CLAVICLE FRACTURE,23515,CDM,23515,CPT,,,both,,3208,3208,1252.98,,,,fee schedule,,,,,,,,419,,,,fee schedule,,,2726.8,85,,percent of total billed charges,,1569.05,,,,fee schedule,,757.99,,,,fee schedule,,419,,,,fee schedule,,1009.4,,,,fee schedule,,419,,,,fee schedule,,1216.13,,,,fee schedule,,737.05,,,,fee schedule,,737.05,,,,fee schedule,,,2919.28,91,,percent of total billed charges,,,3047.6,95,,percent of total billed charges,,,2662.64,83,,percent of total billed charges,,,962.4,83,,percent of total billed charges,,419,,,,fee schedule,,419,,,,fee schedule,,,2662.64,83,,percent of total billed charges,,1083.46,,,,fee schedule,,,2887.2,90,,percent of total billed charges,,,2887.2,90,,percent of total billed charges,,,2887.2,90,,percent of total billed charges,,,2887.2,90,,percent of total billed charges,,,2726.8,85,,percent of total billed charges,,419,3047.6,
TREAT CLAVICLE DISLOCATION,23520,CDM,23520,CPT,,,both,,1044,1044,422.84,,,,fee schedule,,,,,,,,112.4,,,,fee schedule,,,887.4,85,,percent of total billed charges,,513.29,,,,fee schedule,,247.96,,,,fee schedule,,112.4,,,,fee schedule,,346.19,,,,fee schedule,,112.4,,,,fee schedule,,410.41,,,,fee schedule,,248.73,,,,fee schedule,,248.73,,,,fee schedule,,,950.04,91,,percent of total billed charges,,,991.8,95,,percent of total billed charges,,,866.52,83,,percent of total billed charges,,,313.2,83,,percent of total billed charges,,112.4,,,,fee schedule,,112.4,,,,fee schedule,,,866.52,83,,percent of total billed charges,,365.64,,,,fee schedule,,,939.6,90,,percent of total billed charges,,,939.6,90,,percent of total billed charges,,,939.6,90,,percent of total billed charges,,,939.6,90,,percent of total billed charges,,,887.4,85,,percent of total billed charges,,112.4,991.8,
TREAT CLAVICLE DISLOCATION,23525,CDM,23525,CPT,,,both,,1706,1706,641.76,,,,fee schedule,,,,,,,,162.3,,,,fee schedule,,,1450.1,85,,percent of total billed charges,,786.17,,,,fee schedule,,379.79,,,,fee schedule,,162.3,,,,fee schedule,,528.58,,,,fee schedule,,162.3,,,,fee schedule,,622.88,,,,fee schedule,,377.5,,,,fee schedule,,377.5,,,,fee schedule,,,1552.46,91,,percent of total billed charges,,,1620.7,95,,percent of total billed charges,,,1415.98,83,,percent of total billed charges,,,511.8,83,,percent of total billed charges,,162.3,,,,fee schedule,,162.3,,,,fee schedule,,,1415.98,83,,percent of total billed charges,,554.93,,,,fee schedule,,,1535.4,90,,percent of total billed charges,,,1535.4,90,,percent of total billed charges,,,1535.4,90,,percent of total billed charges,,,1535.4,90,,percent of total billed charges,,,1450.1,85,,percent of total billed charges,,162.3,1620.7,
TREAT CLAVICLE DISLOCATION,23532,CDM,23532,CPT,,,both,,2748,2748,1092.25,,,,fee schedule,,,,,,,,786.6,,,,fee schedule,,,2335.8,85,,percent of total billed charges,,1366.54,,,,fee schedule,,660.16,,,,fee schedule,,786.6,,,,fee schedule,,1084.34,,,,fee schedule,,786.6,,,,fee schedule,,1060.13,,,,fee schedule,,642.5,,,,fee schedule,,642.5,,,,fee schedule,,,2500.68,91,,percent of total billed charges,,,2610.6,95,,percent of total billed charges,,,2280.84,83,,percent of total billed charges,,,824.4,83,,percent of total billed charges,,786.6,,,,fee schedule,,786.6,,,,fee schedule,,,2280.84,83,,percent of total billed charges,,944.48,,,,fee schedule,,,2473.2,90,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2335.8,85,,percent of total billed charges,,642.5,2610.6,
TREAT CLAVICLE DISLOCATION,23540,CDM,23540,CPT,,,both,,980,980,420.54,,,,fee schedule,,,,,,,,112.4,,,,fee schedule,,,833,85,,percent of total billed charges,,509.37,,,,fee schedule,,246.07,,,,fee schedule,,112.4,,,,fee schedule,,322.32,,,,fee schedule,,112.4,,,,fee schedule,,408.17,,,,fee schedule,,247.38,,,,fee schedule,,247.38,,,,fee schedule,,,891.8,91,,percent of total billed charges,,,931,95,,percent of total billed charges,,,813.4,83,,percent of total billed charges,,,294,83,,percent of total billed charges,,112.4,,,,fee schedule,,112.4,,,,fee schedule,,,813.4,83,,percent of total billed charges,,363.64,,,,fee schedule,,,882,90,,percent of total billed charges,,,882,90,,percent of total billed charges,,,882,90,,percent of total billed charges,,,882,90,,percent of total billed charges,,,833,85,,percent of total billed charges,,112.4,931,
TREAT CLAVICLE DISLOCATION,23545,CDM,23545,CPT,,,both,,1581,1581,572.05,,,,fee schedule,,,,,,,,228.9,,,,fee schedule,,,1343.85,85,,percent of total billed charges,,687.22,,,,fee schedule,,331.99,,,,fee schedule,,228.9,,,,fee schedule,,460.93,,,,fee schedule,,228.9,,,,fee schedule,,555.22,,,,fee schedule,,336.5,,,,fee schedule,,336.5,,,,fee schedule,,,1438.71,91,,percent of total billed charges,,,1501.95,95,,percent of total billed charges,,,1312.23,83,,percent of total billed charges,,,474.3,83,,percent of total billed charges,,228.9,,,,fee schedule,,228.9,,,,fee schedule,,,1312.23,83,,percent of total billed charges,,494.65,,,,fee schedule,,,1422.9,90,,percent of total billed charges,,,1422.9,90,,percent of total billed charges,,,1422.9,90,,percent of total billed charges,,,1422.9,90,,percent of total billed charges,,,1343.85,85,,percent of total billed charges,,228.9,1501.95,
TREAT CLAVICLE DISLOCATION,23550,CDM,23550,CPT,,,both,,3177,3177,997.77,,,,fee schedule,,,,,,,,503.6,,,,fee schedule,,,2700.45,85,,percent of total billed charges,,1247.45,,,,fee schedule,,602.63,,,,fee schedule,,503.6,,,,fee schedule,,982.87,,,,fee schedule,,503.6,,,,fee schedule,,968.43,,,,fee schedule,,586.93,,,,fee schedule,,586.93,,,,fee schedule,,,2891.07,91,,percent of total billed charges,,,3018.15,95,,percent of total billed charges,,,2636.91,83,,percent of total billed charges,,,953.1,83,,percent of total billed charges,,503.6,,,,fee schedule,,503.6,,,,fee schedule,,,2636.91,83,,percent of total billed charges,,862.78,,,,fee schedule,,,2859.3,90,,percent of total billed charges,,,2859.3,90,,percent of total billed charges,,,2859.3,90,,percent of total billed charges,,,2859.3,90,,percent of total billed charges,,,2700.45,85,,percent of total billed charges,,503.6,3018.15,
TREAT CLAVICLE DISLOCATION,23552,CDM,23552,CPT,,,both,,3764,3764,1127.39,,,,fee schedule,,,,,,,,561.85,,,,fee schedule,,,3199.4,85,,percent of total billed charges,,1427.04,,,,fee schedule,,689.39,,,,fee schedule,,561.85,,,,fee schedule,,1141.38,,,,fee schedule,,561.85,,,,fee schedule,,1094.23,,,,fee schedule,,663.17,,,,fee schedule,,663.17,,,,fee schedule,,,3425.24,91,,percent of total billed charges,,,3575.8,95,,percent of total billed charges,,,3124.12,83,,percent of total billed charges,,,1129.2,83,,percent of total billed charges,,561.85,,,,fee schedule,,561.85,,,,fee schedule,,,3124.12,83,,percent of total billed charges,,974.86,,,,fee schedule,,,3387.6,90,,percent of total billed charges,,,3387.6,90,,percent of total billed charges,,,3387.6,90,,percent of total billed charges,,,3387.6,90,,percent of total billed charges,,,3199.4,85,,percent of total billed charges,,561.85,3575.8,
TREAT SHOULDER BLADE FX,23570,CDM,23570,CPT,,,both,,997,997,429.76,,,,fee schedule,,,,,,,,79.6,,,,fee schedule,,,847.45,85,,percent of total billed charges,,522.64,,,,fee schedule,,252.48,,,,fee schedule,,79.6,,,,fee schedule,,362.77,,,,fee schedule,,79.6,,,,fee schedule,,417.12,,,,fee schedule,,252.8,,,,fee schedule,,252.8,,,,fee schedule,,,907.27,91,,percent of total billed charges,,,947.15,95,,percent of total billed charges,,,827.51,83,,percent of total billed charges,,,299.1,83,,percent of total billed charges,,79.6,,,,fee schedule,,79.6,,,,fee schedule,,,827.51,83,,percent of total billed charges,,371.61,,,,fee schedule,,,897.3,90,,percent of total billed charges,,,897.3,90,,percent of total billed charges,,,897.3,90,,percent of total billed charges,,,897.3,90,,percent of total billed charges,,,847.45,85,,percent of total billed charges,,79.6,947.15,
TREAT SHOULDER BLADE FX,23575,CDM,23575,CPT,,,both,,1807,1807,669.41,,,,fee schedule,,,,,,,,241.35,,,,fee schedule,,,1535.95,85,,percent of total billed charges,,827.07,,,,fee schedule,,399.55,,,,fee schedule,,241.35,,,,fee schedule,,591.58,,,,fee schedule,,241.35,,,,fee schedule,,649.72,,,,fee schedule,,393.77,,,,fee schedule,,393.77,,,,fee schedule,,,1644.37,91,,percent of total billed charges,,,1716.65,95,,percent of total billed charges,,,1499.81,83,,percent of total billed charges,,,542.1,83,,percent of total billed charges,,241.35,,,,fee schedule,,241.35,,,,fee schedule,,,1499.81,83,,percent of total billed charges,,578.84,,,,fee schedule,,,1626.3,90,,percent of total billed charges,,,1626.3,90,,percent of total billed charges,,,1626.3,90,,percent of total billed charges,,,1626.3,90,,percent of total billed charges,,,1535.95,85,,percent of total billed charges,,241.35,1716.65,
TREAT SCAPULA FRACTURE,23585,CDM,23585,CPT,,,both,,4431,4431,1689.07,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,3766.35,85,,percent of total billed charges,,2140.02,,,,fee schedule,,1033.82,,,,fee schedule,,449.5,,,,fee schedule,,1201.73,,,,fee schedule,,449.5,,,,fee schedule,,1639.39,,,,fee schedule,,993.57,,,,fee schedule,,993.57,,,,fee schedule,,,4032.21,91,,percent of total billed charges,,,4209.45,95,,percent of total billed charges,,,3677.73,83,,percent of total billed charges,,,1329.3,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,3677.73,83,,percent of total billed charges,,1460.55,,,,fee schedule,,,3987.9,90,,percent of total billed charges,,,3987.9,90,,percent of total billed charges,,,3987.9,90,,percent of total billed charges,,,3987.9,90,,percent of total billed charges,,,3766.35,85,,percent of total billed charges,,449.5,4209.45,
TREAT HUMERUS FRACTURE,23600,CDM,23600,CPT,,,both,,1369,1369,560.53,,,,fee schedule,,,,,,,,194.2,,,,fee schedule,,,1163.65,85,,percent of total billed charges,,682.43,,,,fee schedule,,329.68,,,,fee schedule,,194.2,,,,fee schedule,,460.27,,,,fee schedule,,194.2,,,,fee schedule,,544.04,,,,fee schedule,,329.72,,,,fee schedule,,329.72,,,,fee schedule,,,1245.79,91,,percent of total billed charges,,,1300.55,95,,percent of total billed charges,,,1136.27,83,,percent of total billed charges,,,410.7,83,,percent of total billed charges,,194.2,,,,fee schedule,,194.2,,,,fee schedule,,,1136.27,83,,percent of total billed charges,,484.69,,,,fee schedule,,,1232.1,90,,percent of total billed charges,,,1232.1,90,,percent of total billed charges,,,1232.1,90,,percent of total billed charges,,,1232.1,90,,percent of total billed charges,,,1163.65,85,,percent of total billed charges,,194.2,1300.55,
TREAT HUMERUS FRACTURE,23600P,CDM,23600,CPT,,,both,P,954,954,560.53,,,,fee schedule,,,,,,,,194.2,,,,fee schedule,,,810.9,85,,percent of total billed charges,,682.43,,,,fee schedule,,329.68,,,,fee schedule,,194.2,,,,fee schedule,,460.27,,,,fee schedule,,194.2,,,,fee schedule,,544.04,,,,fee schedule,,329.72,,,,fee schedule,,329.72,,,,fee schedule,,,868.14,91,,percent of total billed charges,,,906.3,95,,percent of total billed charges,,,791.82,83,,percent of total billed charges,,,286.2,83,,percent of total billed charges,,194.2,,,,fee schedule,,194.2,,,,fee schedule,,,791.82,83,,percent of total billed charges,,484.69,,,,fee schedule,,,858.6,90,,percent of total billed charges,,,858.6,90,,percent of total billed charges,,,858.6,90,,percent of total billed charges,,,858.6,90,,percent of total billed charges,,,810.9,85,,percent of total billed charges,,194.2,906.3,
TREAT HUMERUS FRACTURE,23600T,CDM,23600,CPT,,,both,T,415,415,560.53,,,,fee schedule,,,,,,,,194.2,,,,fee schedule,,,352.75,85,,percent of total billed charges,,682.43,,,,fee schedule,,329.68,,,,fee schedule,,194.2,,,,fee schedule,,460.27,,,,fee schedule,,194.2,,,,fee schedule,,544.04,,,,fee schedule,,329.72,,,,fee schedule,,329.72,,,,fee schedule,,,377.65,91,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,194.2,,,,fee schedule,,194.2,,,,fee schedule,,,344.45,83,,percent of total billed charges,,484.69,,,,fee schedule,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,124.5,682.43,
TREAT HUMERUS FRACTURE,23605,CDM,23605,CPT,,,both,,2139,2139,752.94,,,,fee schedule,,,,,,,,277.5,,,,fee schedule,,,1818.15,85,,percent of total billed charges,,930.94,,,,fee schedule,,449.73,,,,fee schedule,,277.5,,,,fee schedule,,714.27,,,,fee schedule,,277.5,,,,fee schedule,,730.79,,,,fee schedule,,442.91,,,,fee schedule,,442.91,,,,fee schedule,,,1946.49,91,,percent of total billed charges,,,2032.05,95,,percent of total billed charges,,,1775.37,83,,percent of total billed charges,,,641.7,83,,percent of total billed charges,,277.5,,,,fee schedule,,277.5,,,,fee schedule,,,1775.37,83,,percent of total billed charges,,651.07,,,,fee schedule,,,1925.1,90,,percent of total billed charges,,,1925.1,90,,percent of total billed charges,,,1925.1,90,,percent of total billed charges,,,1925.1,90,,percent of total billed charges,,,1818.15,85,,percent of total billed charges,,277.5,2032.05,
TREAT HUMERUS FRACTURE,23615,CDM,23615,CPT,,,both,,4108,4108,1530.65,,,,fee schedule,,,,,,,,545.25,,,,fee schedule,,,3491.8,85,,percent of total billed charges,,1927.79,,,,fee schedule,,931.29,,,,fee schedule,,545.25,,,,fee schedule,,1311.16,,,,fee schedule,,545.25,,,,fee schedule,,1485.63,,,,fee schedule,,900.38,,,,fee schedule,,900.38,,,,fee schedule,,,3738.28,91,,percent of total billed charges,,,3902.6,95,,percent of total billed charges,,,3409.64,83,,percent of total billed charges,,,1232.4,83,,percent of total billed charges,,545.25,,,,fee schedule,,545.25,,,,fee schedule,,,3409.64,83,,percent of total billed charges,,1323.56,,,,fee schedule,,,3697.2,90,,percent of total billed charges,,,3697.2,90,,percent of total billed charges,,,3697.2,90,,percent of total billed charges,,,3697.2,90,,percent of total billed charges,,,3491.8,85,,percent of total billed charges,,545.25,3902.6,
TREAT HUMERUS FRACTURE,23616,CDM,23616,CPT,,,both,,6768,6768,2132.66,,,,fee schedule,,,,,,,,975.25,,,,fee schedule,,,5752.8,85,,percent of total billed charges,,2699.61,,,,fee schedule,,1304.15,,,,fee schedule,,975.25,,,,fee schedule,,2587.17,,,,fee schedule,,975.25,,,,fee schedule,,2069.93,,,,fee schedule,,1254.5,,,,fee schedule,,1254.5,,,,fee schedule,,,6158.88,91,,percent of total billed charges,,,6429.6,95,,percent of total billed charges,,,5617.44,83,,percent of total billed charges,,,2030.4,83,,percent of total billed charges,,975.25,,,,fee schedule,,975.25,,,,fee schedule,,,5617.44,83,,percent of total billed charges,,1844.12,,,,fee schedule,,,6091.2,90,,percent of total billed charges,,,6091.2,90,,percent of total billed charges,,,6091.2,90,,percent of total billed charges,,,6091.2,90,,percent of total billed charges,,,5752.8,85,,percent of total billed charges,,975.25,6429.6,
TREAT HUMERUS FRACTURE,23620,CDM,23620,CPT,,,both,,1152,1152,462.02,,,,fee schedule,,,,,,,,111,,,,fee schedule,,,979.2,85,,percent of total billed charges,,563.41,,,,fee schedule,,272.18,,,,fee schedule,,111,,,,fee schedule,,382.01,,,,fee schedule,,111,,,,fee schedule,,448.43,,,,fee schedule,,271.78,,,,fee schedule,,271.78,,,,fee schedule,,,1048.32,91,,percent of total billed charges,,,1094.4,95,,percent of total billed charges,,,956.16,83,,percent of total billed charges,,,345.6,83,,percent of total billed charges,,111,,,,fee schedule,,111,,,,fee schedule,,,956.16,83,,percent of total billed charges,,399.51,,,,fee schedule,,,1036.8,90,,percent of total billed charges,,,1036.8,90,,percent of total billed charges,,,1036.8,90,,percent of total billed charges,,,1036.8,90,,percent of total billed charges,,,979.2,85,,percent of total billed charges,,111,1094.4,
TREAT HUMERUS FRACTURE,23625,CDM,23625,CPT,,,both,,1720,1720,628.51,,,,fee schedule,,,,,,,,163.7,,,,fee schedule,,,1462,85,,percent of total billed charges,,768.43,,,,fee schedule,,371.22,,,,fee schedule,,163.7,,,,fee schedule,,584.95,,,,fee schedule,,163.7,,,,fee schedule,,610.02,,,,fee schedule,,369.71,,,,fee schedule,,369.71,,,,fee schedule,,,1565.2,91,,percent of total billed charges,,,1634,95,,percent of total billed charges,,,1427.6,83,,percent of total billed charges,,,516,83,,percent of total billed charges,,163.7,,,,fee schedule,,163.7,,,,fee schedule,,,1427.6,83,,percent of total billed charges,,543.47,,,,fee schedule,,,1548,90,,percent of total billed charges,,,1548,90,,percent of total billed charges,,,1548,90,,percent of total billed charges,,,1548,90,,percent of total billed charges,,,1462,85,,percent of total billed charges,,163.7,1634,
TREAT HUMERUS FRACTURE,23630,CDM,23630,CPT,,,both,,3293,3293,1355.52,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,2799.05,85,,percent of total billed charges,,1696.23,,,,fee schedule,,819.43,,,,fee schedule,,524.4,,,,fee schedule,,1009.4,,,,fee schedule,,524.4,,,,fee schedule,,1315.65,,,,fee schedule,,797.37,,,,fee schedule,,797.37,,,,fee schedule,,,2996.63,91,,percent of total billed charges,,,3128.35,95,,percent of total billed charges,,,2733.19,83,,percent of total billed charges,,,987.9,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,2733.19,83,,percent of total billed charges,,1172.13,,,,fee schedule,,,2963.7,90,,percent of total billed charges,,,2963.7,90,,percent of total billed charges,,,2963.7,90,,percent of total billed charges,,,2963.7,90,,percent of total billed charges,,,2799.05,85,,percent of total billed charges,,524.4,3128.35,
TREAT SHOULDER DISLOCATION,23650,CDM,23650,CPT,,,both,,1344,1344,530.57,,,,fee schedule,,,,,,,,178.9,,,,fee schedule,,,1142.4,85,,percent of total billed charges,,646.16,,,,fee schedule,,312.15,,,,fee schedule,,178.9,,,,fee schedule,,427.1,,,,fee schedule,,178.9,,,,fee schedule,,514.97,,,,fee schedule,,312.1,,,,fee schedule,,312.1,,,,fee schedule,,,1223.04,91,,percent of total billed charges,,,1276.8,95,,percent of total billed charges,,,1115.52,83,,percent of total billed charges,,,403.2,83,,percent of total billed charges,,178.9,,,,fee schedule,,178.9,,,,fee schedule,,,1115.52,83,,percent of total billed charges,,458.79,,,,fee schedule,,,1209.6,90,,percent of total billed charges,,,1209.6,90,,percent of total billed charges,,,1209.6,90,,percent of total billed charges,,,1209.6,90,,percent of total billed charges,,,1142.4,85,,percent of total billed charges,,178.9,1276.8,
TREAT SHOULDER DISLOCATION,23655,CDM,23655,CPT,,,both,,1692,1692,716.07,,,,fee schedule,,,,,,,,255.2,,,,fee schedule,,,1438.2,85,,percent of total billed charges,,889.92,,,,fee schedule,,429.91,,,,fee schedule,,255.2,,,,fee schedule,,622.09,,,,fee schedule,,255.2,,,,fee schedule,,695.01,,,,fee schedule,,421.22,,,,fee schedule,,421.22,,,,fee schedule,,,1539.72,91,,percent of total billed charges,,,1607.4,95,,percent of total billed charges,,,1404.36,83,,percent of total billed charges,,,507.6,83,,percent of total billed charges,,255.2,,,,fee schedule,,255.2,,,,fee schedule,,,1404.36,83,,percent of total billed charges,,619.19,,,,fee schedule,,,1522.8,90,,percent of total billed charges,,,1522.8,90,,percent of total billed charges,,,1522.8,90,,percent of total billed charges,,,1522.8,90,,percent of total billed charges,,,1438.2,85,,percent of total billed charges,,255.2,1607.4,
TREAT SHOULDER DISLOCATION,23660,CDM,23660,CPT,,,both,,2820,2820,1023.12,,,,fee schedule,,,,,,,,419,,,,fee schedule,,,2397,85,,percent of total billed charges,,1273.55,,,,fee schedule,,615.24,,,,fee schedule,,419,,,,fee schedule,,1003.43,,,,fee schedule,,419,,,,fee schedule,,993.03,,,,fee schedule,,601.84,,,,fee schedule,,601.84,,,,fee schedule,,,2566.2,91,,percent of total billed charges,,,2679,95,,percent of total billed charges,,,2340.6,83,,percent of total billed charges,,,846,83,,percent of total billed charges,,419,,,,fee schedule,,419,,,,fee schedule,,,2340.6,83,,percent of total billed charges,,884.7,,,,fee schedule,,,2538,90,,percent of total billed charges,,,2538,90,,percent of total billed charges,,,2538,90,,percent of total billed charges,,,2538,90,,percent of total billed charges,,,2397,85,,percent of total billed charges,,419,2679,
TREAT DISLOCATION/FRACTURE,23665,CDM,23665,CPT,,,both,,1810,1810,703.97,,,,fee schedule,,,,,,,,206.7,,,,fee schedule,,,1538.5,85,,percent of total billed charges,,871.48,,,,fee schedule,,421,,,,fee schedule,,206.7,,,,fee schedule,,654.58,,,,fee schedule,,206.7,,,,fee schedule,,683.27,,,,fee schedule,,414.1,,,,fee schedule,,414.1,,,,fee schedule,,,1647.1,91,,percent of total billed charges,,,1719.5,95,,percent of total billed charges,,,1502.3,83,,percent of total billed charges,,,543,83,,percent of total billed charges,,206.7,,,,fee schedule,,206.7,,,,fee schedule,,,1502.3,83,,percent of total billed charges,,608.73,,,,fee schedule,,,1629,90,,percent of total billed charges,,,1629,90,,percent of total billed charges,,,1629,90,,percent of total billed charges,,,1629,90,,percent of total billed charges,,,1538.5,85,,percent of total billed charges,,206.7,1719.5,
TREAT DISLOCATION/FRACTURE,23670,CDM,23670,CPT,,,both,,3930,3930,1508.76,,,,fee schedule,,,,,,,,842.1,,,,fee schedule,,,3340.5,85,,percent of total billed charges,,1895.33,,,,fee schedule,,915.61,,,,fee schedule,,842.1,,,,fee schedule,,1065.11,,,,fee schedule,,842.1,,,,fee schedule,,1464.38,,,,fee schedule,,887.51,,,,fee schedule,,887.51,,,,fee schedule,,,3576.3,91,,percent of total billed charges,,,3733.5,95,,percent of total billed charges,,,3261.9,83,,percent of total billed charges,,,1179,83,,percent of total billed charges,,842.1,,,,fee schedule,,842.1,,,,fee schedule,,,3261.9,83,,percent of total billed charges,,1304.63,,,,fee schedule,,,3537,90,,percent of total billed charges,,,3537,90,,percent of total billed charges,,,3537,90,,percent of total billed charges,,,3537,90,,percent of total billed charges,,,3340.5,85,,percent of total billed charges,,842.1,3733.5,
TREAT DISLOCATION/FRACTURE,23675,CDM,23675,CPT,,,both,,2471,2471,877.37,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,2100.35,85,,percent of total billed charges,,1092.69,,,,fee schedule,,527.87,,,,fee schedule,,299.7,,,,fee schedule,,850.89,,,,fee schedule,,299.7,,,,fee schedule,,851.57,,,,fee schedule,,516.1,,,,fee schedule,,516.1,,,,fee schedule,,,2248.61,91,,percent of total billed charges,,,2347.45,95,,percent of total billed charges,,,2050.93,83,,percent of total billed charges,,,741.3,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,2050.93,83,,percent of total billed charges,,758.67,,,,fee schedule,,,2223.9,90,,percent of total billed charges,,,2223.9,90,,percent of total billed charges,,,2223.9,90,,percent of total billed charges,,,2223.9,90,,percent of total billed charges,,,2100.35,85,,percent of total billed charges,,299.7,2347.45,
TREAT DISLOCATION/FRACTURE,23680,CDM,23680,CPT,,,both,,4179,4179,1610.15,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3552.15,85,,percent of total billed charges,,2025.08,,,,fee schedule,,978.29,,,,fee schedule,,599.35,,,,fee schedule,,1316.46,,,,fee schedule,,599.35,,,,fee schedule,,1562.79,,,,fee schedule,,947.15,,,,fee schedule,,947.15,,,,fee schedule,,,3802.89,91,,percent of total billed charges,,,3970.05,95,,percent of total billed charges,,,3468.57,83,,percent of total billed charges,,,1253.7,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3468.57,83,,percent of total billed charges,,1392.31,,,,fee schedule,,,3761.1,90,,percent of total billed charges,,,3761.1,90,,percent of total billed charges,,,3761.1,90,,percent of total billed charges,,,3761.1,90,,percent of total billed charges,,,3552.15,85,,percent of total billed charges,,599.35,3970.05,
FIXATION OF SHOULDER,23700,CDM,23700,CPT,,,both,,1123,1123,340.46,,,,fee schedule,,,,,,,,194.2,,,,fee schedule,,,954.55,85,,percent of total billed charges,,426.06,,,,fee schedule,,205.83,,,,fee schedule,,194.2,,,,fee schedule,,339.56,,,,fee schedule,,194.2,,,,fee schedule,,330.45,,,,fee schedule,,200.27,,,,fee schedule,,200.27,,,,fee schedule,,,1021.93,91,,percent of total billed charges,,,1066.85,95,,percent of total billed charges,,,932.09,83,,percent of total billed charges,,,336.9,83,,percent of total billed charges,,194.2,,,,fee schedule,,194.2,,,,fee schedule,,,932.09,83,,percent of total billed charges,,294.4,,,,fee schedule,,,1010.7,90,,percent of total billed charges,,,1010.7,90,,percent of total billed charges,,,1010.7,90,,percent of total billed charges,,,1010.7,90,,percent of total billed charges,,,954.55,85,,percent of total billed charges,,194.2,1066.85,
SHOULDER SURGERY PROCEDURE,23929,CDM,23929,CPT,,,both,,384,384,,,,,,,,,,,,,,,,,,,,326.4,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,349.44,91,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,115.2,83,,percent of total billed charges,,,,,,,,,,,,,,,318.72,83,,percent of total billed charges,,,,,,,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,326.4,85,,percent of total billed charges,,115.2,364.8,
DRAINAGE OF ARM LESION,23930,CDM,23930,CPT,,,both,,1318,1318,373.3,,,,fee schedule,,,,,,,,179.7,,,,fee schedule,,,1120.3,85,,percent of total billed charges,,470.05,,,,fee schedule,,227.08,,,,fee schedule,,179.7,,,,fee schedule,,375.37,,,,fee schedule,,179.7,,,,fee schedule,,362.32,,,,fee schedule,,219.59,,,,fee schedule,,219.59,,,,fee schedule,,,1199.38,91,,percent of total billed charges,,,1252.1,95,,percent of total billed charges,,,1093.94,83,,percent of total billed charges,,,395.4,83,,percent of total billed charges,,179.7,,,,fee schedule,,179.7,,,,fee schedule,,,1093.94,83,,percent of total billed charges,,322.8,,,,fee schedule,,,1186.2,90,,percent of total billed charges,,,1186.2,90,,percent of total billed charges,,,1186.2,90,,percent of total billed charges,,,1186.2,90,,percent of total billed charges,,,1120.3,85,,percent of total billed charges,,179.7,1252.1,
DRAINAGE OF ARM BURSA,23931,CDM,23931,CPT,,,both,,1192,1192,279.98,,,,fee schedule,,,,,,,,141.3,,,,fee schedule,,,1013.2,85,,percent of total billed charges,,344.61,,,,fee schedule,,166.48,,,,fee schedule,,141.3,,,,fee schedule,,279.87,,,,fee schedule,,141.3,,,,fee schedule,,271.74,,,,fee schedule,,164.69,,,,fee schedule,,164.69,,,,fee schedule,,,1084.72,91,,percent of total billed charges,,,1132.4,95,,percent of total billed charges,,,989.36,83,,percent of total billed charges,,,357.6,83,,percent of total billed charges,,141.3,,,,fee schedule,,141.3,,,,fee schedule,,,989.36,83,,percent of total billed charges,,242.1,,,,fee schedule,,,1072.8,90,,percent of total billed charges,,,1072.8,90,,percent of total billed charges,,,1072.8,90,,percent of total billed charges,,,1072.8,90,,percent of total billed charges,,,1013.2,85,,percent of total billed charges,,141.3,1132.4,
RELEASE ELBOW JOINT,24006,CDM,24006,CPT,,,both,,4076,4076,1238,,,,fee schedule,,,,,,,,380.15,,,,fee schedule,,,3464.6,85,,percent of total billed charges,,1552.51,,,,fee schedule,,750,,,,fee schedule,,380.15,,,,fee schedule,,1228.92,,,,fee schedule,,380.15,,,,fee schedule,,1201.59,,,,fee schedule,,728.24,,,,fee schedule,,728.24,,,,fee schedule,,,3709.16,91,,percent of total billed charges,,,3872.2,95,,percent of total billed charges,,,3383.08,83,,percent of total billed charges,,,1222.8,83,,percent of total billed charges,,380.15,,,,fee schedule,,380.15,,,,fee schedule,,,3383.08,83,,percent of total billed charges,,1070.51,,,,fee schedule,,,3668.4,90,,percent of total billed charges,,,3668.4,90,,percent of total billed charges,,,3668.4,90,,percent of total billed charges,,,3668.4,90,,percent of total billed charges,,,3464.6,85,,percent of total billed charges,,380.15,3872.2,
BIOPSY ARM/ELBOW SOFT TISSUE,24065,CDM,24065,CPT,,,both,,665,665,279.98,,,,fee schedule,,,,,,,,113.6,,,,fee schedule,,,565.25,85,,percent of total billed charges,,351.39,,,,fee schedule,,169.75,,,,fee schedule,,113.6,,,,fee schedule,,264.62,,,,fee schedule,,113.6,,,,fee schedule,,271.74,,,,fee schedule,,164.69,,,,fee schedule,,164.69,,,,fee schedule,,,605.15,91,,percent of total billed charges,,,631.75,95,,percent of total billed charges,,,551.95,83,,percent of total billed charges,,,199.5,83,,percent of total billed charges,,113.6,,,,fee schedule,,113.6,,,,fee schedule,,,551.95,83,,percent of total billed charges,,242.1,,,,fee schedule,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,598.5,90,,percent of total billed charges,,,565.25,85,,percent of total billed charges,,113.6,631.75,
BIOPSY ARM/ELBOW SOFT TISSUE,24065P,CDM,24065,CPT,,,both,P,495,495,279.98,,,,fee schedule,,,,,,,,113.6,,,,fee schedule,,,420.75,85,,percent of total billed charges,,351.39,,,,fee schedule,,169.75,,,,fee schedule,,113.6,,,,fee schedule,,264.62,,,,fee schedule,,113.6,,,,fee schedule,,271.74,,,,fee schedule,,164.69,,,,fee schedule,,164.69,,,,fee schedule,,,450.45,91,,percent of total billed charges,,,470.25,95,,percent of total billed charges,,,410.85,83,,percent of total billed charges,,,148.5,83,,percent of total billed charges,,113.6,,,,fee schedule,,113.6,,,,fee schedule,,,410.85,83,,percent of total billed charges,,242.1,,,,fee schedule,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,445.5,90,,percent of total billed charges,,,420.75,85,,percent of total billed charges,,113.6,470.25,
BIOPSY ARM/ELBOW SOFT TISSUE,24065T,CDM,24065,CPT,,,both,T,170,170,279.98,,,,fee schedule,,,,,,,,113.6,,,,fee schedule,,,144.5,85,,percent of total billed charges,,351.39,,,,fee schedule,,169.75,,,,fee schedule,,113.6,,,,fee schedule,,264.62,,,,fee schedule,,113.6,,,,fee schedule,,271.74,,,,fee schedule,,164.69,,,,fee schedule,,164.69,,,,fee schedule,,,154.7,91,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,51,83,,percent of total billed charges,,113.6,,,,fee schedule,,113.6,,,,fee schedule,,,141.1,83,,percent of total billed charges,,242.1,,,,fee schedule,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,51,351.39,
EXC ARM/ELBOW LES SC 3 CM/>,24071,CDM,24071,CPT,,,both,,1658,1658,702.82,,,,fee schedule,,,,,,,,226.29,,,,fee schedule,,,1409.3,85,,percent of total billed charges,,892.07,,,,fee schedule,,430.95,,,,fee schedule,,226.29,,,,fee schedule,,,,,,,,226.29,,,,fee schedule,,682.15,,,,fee schedule,,413.42,,,,fee schedule,,413.42,,,,fee schedule,,,1508.78,91,,percent of total billed charges,,,1575.1,95,,percent of total billed charges,,,1376.14,83,,percent of total billed charges,,,497.4,83,,percent of total billed charges,,226.29,,,,fee schedule,,226.29,,,,fee schedule,,,1376.14,83,,percent of total billed charges,,607.73,,,,fee schedule,,,1492.2,90,,percent of total billed charges,,,1492.2,90,,percent of total billed charges,,,1492.2,90,,percent of total billed charges,,,1492.2,90,,percent of total billed charges,,,1409.3,85,,percent of total billed charges,,226.29,1575.1,
Exc Tmor Upper Arm >5cm,24073,CDM,24073,CPT,,,both,,2930,2930,1199.4,,,,fee schedule,,,,,,,,389.59,,,,fee schedule,,,2490.5,85,,percent of total billed charges,,1522.5,,,,fee schedule,,735.5,,,,fee schedule,,389.59,,,,fee schedule,,,,,,,,389.59,,,,fee schedule,,1164.13,,,,fee schedule,,705.53,,,,fee schedule,,705.53,,,,fee schedule,,,2666.3,91,,percent of total billed charges,,,2783.5,95,,percent of total billed charges,,,2431.9,83,,percent of total billed charges,,,879,83,,percent of total billed charges,,389.59,,,,fee schedule,,389.59,,,,fee schedule,,,2431.9,83,,percent of total billed charges,,1037.13,,,,fee schedule,,,2637,90,,percent of total billed charges,,,2637,90,,percent of total billed charges,,,2637,90,,percent of total billed charges,,,2637,90,,percent of total billed charges,,,2490.5,85,,percent of total billed charges,,389.59,2783.5,
REMOVE ARM/ELBOW LESION,24075,CDM,24075,CPT,,,both,,1779,1779,573.78,,,,fee schedule,,,,,,,,149.8,,,,fee schedule,,,1512.15,85,,percent of total billed charges,,718.58,,,,fee schedule,,347.14,,,,fee schedule,,149.8,,,,fee schedule,,520.62,,,,fee schedule,,149.8,,,,fee schedule,,556.9,,,,fee schedule,,337.52,,,,fee schedule,,337.52,,,,fee schedule,,,1618.89,91,,percent of total billed charges,,,1690.05,95,,percent of total billed charges,,,1476.57,83,,percent of total billed charges,,,533.7,83,,percent of total billed charges,,149.8,,,,fee schedule,,149.8,,,,fee schedule,,,1476.57,83,,percent of total billed charges,,496.15,,,,fee schedule,,,1601.1,90,,percent of total billed charges,,,1601.1,90,,percent of total billed charges,,,1601.1,90,,percent of total billed charges,,,1601.1,90,,percent of total billed charges,,,1512.15,85,,percent of total billed charges,,149.8,1690.05,
REMOVE ARM/ELBOW LESION,24076,CDM,24076,CPT,,,both,,2530,2530,951.11,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,2150.5,85,,percent of total billed charges,,1191.79,,,,fee schedule,,575.74,,,,fee schedule,,224.7,,,,fee schedule,,800.49,,,,fee schedule,,224.7,,,,fee schedule,,923.14,,,,fee schedule,,559.48,,,,fee schedule,,559.48,,,,fee schedule,,,2302.3,91,,percent of total billed charges,,,2403.5,95,,percent of total billed charges,,,2099.9,83,,percent of total billed charges,,,759,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,2099.9,83,,percent of total billed charges,,822.43,,,,fee schedule,,,2277,90,,percent of total billed charges,,,2277,90,,percent of total billed charges,,,2277,90,,percent of total billed charges,,,2277,90,,percent of total billed charges,,,2150.5,85,,percent of total billed charges,,224.7,2403.5,
EXPLORE/TREAT ELBOW JOINT,24101,CDM,24101,CPT,,,both,,3185,3185,881.41,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,2707.25,85,,percent of total billed charges,,1095.71,,,,fee schedule,,529.32,,,,fee schedule,,480,,,,fee schedule,,867.47,,,,fee schedule,,480,,,,fee schedule,,855.48,,,,fee schedule,,518.47,,,,fee schedule,,518.47,,,,fee schedule,,,2898.35,91,,percent of total billed charges,,,3025.75,95,,percent of total billed charges,,,2643.55,83,,percent of total billed charges,,,955.5,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2643.55,83,,percent of total billed charges,,762.16,,,,fee schedule,,,2866.5,90,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2866.5,90,,percent of total billed charges,,,2707.25,85,,percent of total billed charges,,480,3025.75,
REMOVE ELBOW JOINT LINING,24102,CDM,24102,CPT,,,both,,3738,3738,1072.67,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,3177.3,85,,percent of total billed charges,,1349.78,,,,fee schedule,,652.06,,,,fee schedule,,524.4,,,,fee schedule,,1071.74,,,,fee schedule,,524.4,,,,fee schedule,,1041.12,,,,fee schedule,,630.98,,,,fee schedule,,630.98,,,,fee schedule,,,3401.58,91,,percent of total billed charges,,,3551.1,95,,percent of total billed charges,,,3102.54,83,,percent of total billed charges,,,1121.4,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,3102.54,83,,percent of total billed charges,,927.54,,,,fee schedule,,,3364.2,90,,percent of total billed charges,,,3364.2,90,,percent of total billed charges,,,3364.2,90,,percent of total billed charges,,,3364.2,90,,percent of total billed charges,,,3177.3,85,,percent of total billed charges,,524.4,3551.1,
REMOVAL OF ELBOW BURSA,24105,CDM,24105,CPT,,,both,,1909,1909,631.39,,,,fee schedule,,,,,,,,380.15,,,,fee schedule,,,1622.65,85,,percent of total billed charges,,775.44,,,,fee schedule,,374.6,,,,fee schedule,,380.15,,,,fee schedule,,569.69,,,,fee schedule,,380.15,,,,fee schedule,,612.82,,,,fee schedule,,371.4,,,,fee schedule,,371.4,,,,fee schedule,,,1737.19,91,,percent of total billed charges,,,1813.55,95,,percent of total billed charges,,,1584.47,83,,percent of total billed charges,,,572.7,83,,percent of total billed charges,,380.15,,,,fee schedule,,380.15,,,,fee schedule,,,1584.47,83,,percent of total billed charges,,545.96,,,,fee schedule,,,1718.1,90,,percent of total billed charges,,,1718.1,90,,percent of total billed charges,,,1718.1,90,,percent of total billed charges,,,1718.1,90,,percent of total billed charges,,,1622.65,85,,percent of total billed charges,,371.4,1813.55,
REMOVE ELBOW LESION,24120,CDM,24120,CPT,,,both,,3111,3111,929.8,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,2644.35,85,,percent of total billed charges,,1160.19,,,,fee schedule,,560.47,,,,fee schedule,,449.5,,,,fee schedule,,905.28,,,,fee schedule,,449.5,,,,fee schedule,,902.45,,,,fee schedule,,546.94,,,,fee schedule,,546.94,,,,fee schedule,,,2831.01,91,,percent of total billed charges,,,2955.45,95,,percent of total billed charges,,,2582.13,83,,percent of total billed charges,,,933.3,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,2582.13,83,,percent of total billed charges,,804,,,,fee schedule,,,2799.9,90,,percent of total billed charges,,,2799.9,90,,percent of total billed charges,,,2799.9,90,,percent of total billed charges,,,2799.9,90,,percent of total billed charges,,,2644.35,85,,percent of total billed charges,,449.5,2955.45,
REMOVE/GRAFT BONE LESION,24126,CDM,24126,CPT,,,both,,2831,2831,1133.15,,,,fee schedule,,,,,,,,749.2,,,,fee schedule,,,2406.35,85,,percent of total billed charges,,1421.27,,,,fee schedule,,686.6,,,,fee schedule,,749.2,,,,fee schedule,,1092.96,,,,fee schedule,,749.2,,,,fee schedule,,1099.83,,,,fee schedule,,666.56,,,,fee schedule,,666.56,,,,fee schedule,,,2576.21,91,,percent of total billed charges,,,2689.45,95,,percent of total billed charges,,,2349.73,83,,percent of total billed charges,,,849.3,83,,percent of total billed charges,,749.2,,,,fee schedule,,749.2,,,,fee schedule,,,2349.73,83,,percent of total billed charges,,979.84,,,,fee schedule,,,2547.9,90,,percent of total billed charges,,,2547.9,90,,percent of total billed charges,,,2547.9,90,,percent of total billed charges,,,2547.9,90,,percent of total billed charges,,,2406.35,85,,percent of total billed charges,,666.56,2689.45,
REMOVE/GRAFT BONE LESION,24126P,CDM,24126,CPT,,,both,P,2598,2598,1133.15,,,,fee schedule,,,,,,,,749.2,,,,fee schedule,,,2208.3,85,,percent of total billed charges,,1421.27,,,,fee schedule,,686.6,,,,fee schedule,,749.2,,,,fee schedule,,1092.96,,,,fee schedule,,749.2,,,,fee schedule,,1099.83,,,,fee schedule,,666.56,,,,fee schedule,,666.56,,,,fee schedule,,,2364.18,91,,percent of total billed charges,,,2468.1,95,,percent of total billed charges,,,2156.34,83,,percent of total billed charges,,,779.4,83,,percent of total billed charges,,749.2,,,,fee schedule,,749.2,,,,fee schedule,,,2156.34,83,,percent of total billed charges,,979.84,,,,fee schedule,,,2338.2,90,,percent of total billed charges,,,2338.2,90,,percent of total billed charges,,,2338.2,90,,percent of total billed charges,,,2338.2,90,,percent of total billed charges,,,2208.3,85,,percent of total billed charges,,666.56,2468.1,
REMOVE/GRAFT BONE LESION,24126T,CDM,24126,CPT,,,both,T,233,233,1133.15,,,,fee schedule,,,,,,,,749.2,,,,fee schedule,,,198.05,85,,percent of total billed charges,,1421.27,,,,fee schedule,,686.6,,,,fee schedule,,749.2,,,,fee schedule,,1092.96,,,,fee schedule,,749.2,,,,fee schedule,,1099.83,,,,fee schedule,,666.56,,,,fee schedule,,666.56,,,,fee schedule,,,212.03,91,,percent of total billed charges,,,221.35,95,,percent of total billed charges,,,193.39,83,,percent of total billed charges,,,69.9,83,,percent of total billed charges,,749.2,,,,fee schedule,,749.2,,,,fee schedule,,,193.39,83,,percent of total billed charges,,979.84,,,,fee schedule,,,209.7,90,,percent of total billed charges,,,209.7,90,,percent of total billed charges,,,209.7,90,,percent of total billed charges,,,209.7,90,,percent of total billed charges,,,198.05,85,,percent of total billed charges,,69.9,1421.27,
REMOVAL OF HEAD OF RADIUS,24130,CDM,24130,CPT,,,both,,2868,2868,896.38,,,,fee schedule,,,,,,,,492.55,,,,fee schedule,,,2437.8,85,,percent of total billed charges,,1108.13,,,,fee schedule,,535.32,,,,fee schedule,,492.55,,,,fee schedule,,881.4,,,,fee schedule,,492.55,,,,fee schedule,,870.02,,,,fee schedule,,527.28,,,,fee schedule,,527.28,,,,fee schedule,,,2609.88,91,,percent of total billed charges,,,2724.6,95,,percent of total billed charges,,,2380.44,83,,percent of total billed charges,,,860.4,83,,percent of total billed charges,,492.55,,,,fee schedule,,492.55,,,,fee schedule,,,2380.44,83,,percent of total billed charges,,775.11,,,,fee schedule,,,2581.2,90,,percent of total billed charges,,,2581.2,90,,percent of total billed charges,,,2581.2,90,,percent of total billed charges,,,2581.2,90,,percent of total billed charges,,,2437.8,85,,percent of total billed charges,,492.55,2724.6,
PARTIAL REMOVAL OF ARM BONE,24140,CDM,24140,CPT,,,both,,3979,3979,1224.18,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3382.15,85,,percent of total billed charges,,1535.17,,,,fee schedule,,741.62,,,,fee schedule,,480,,,,fee schedule,,1311.16,,,,fee schedule,,480,,,,fee schedule,,1188.17,,,,fee schedule,,720.1,,,,fee schedule,,720.1,,,,fee schedule,,,3620.89,91,,percent of total billed charges,,,3780.05,95,,percent of total billed charges,,,3302.57,83,,percent of total billed charges,,,1193.7,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3302.57,83,,percent of total billed charges,,1058.55,,,,fee schedule,,,3581.1,90,,percent of total billed charges,,,3581.1,90,,percent of total billed charges,,,3581.1,90,,percent of total billed charges,,,3581.1,90,,percent of total billed charges,,,3382.15,85,,percent of total billed charges,,480,3780.05,
PARTIAL REMOVAL OF ELBOW,24147,CDM,24147,CPT,,,both,,3230,3230,1096.86,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,2745.5,85,,percent of total billed charges,,1366.11,,,,fee schedule,,659.95,,,,fee schedule,,480,,,,fee schedule,,1153.98,,,,fee schedule,,480,,,,fee schedule,,1064.6,,,,fee schedule,,645.21,,,,fee schedule,,645.21,,,,fee schedule,,,2939.3,91,,percent of total billed charges,,,3068.5,95,,percent of total billed charges,,,2680.9,83,,percent of total billed charges,,,969,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2680.9,83,,percent of total billed charges,,948.46,,,,fee schedule,,,2907,90,,percent of total billed charges,,,2907,90,,percent of total billed charges,,,2907,90,,percent of total billed charges,,,2907,90,,percent of total billed charges,,,2745.5,85,,percent of total billed charges,,480,3068.5,
RADICAL RESECTION OF ELBOW,24149,CDM,24149,CPT,,,both,,6140,6140,2042.79,,,,fee schedule,,,,,,,,708.52,,,,fee schedule,,,5219,85,,percent of total billed charges,,2559.24,,,,fee schedule,,1236.34,,,,fee schedule,,708.52,,,,fee schedule,,1863.61,,,,fee schedule,,708.52,,,,fee schedule,,1982.71,,,,fee schedule,,1201.64,,,,fee schedule,,1201.64,,,,fee schedule,,,5587.4,91,,percent of total billed charges,,,5833,95,,percent of total billed charges,,,5096.2,83,,percent of total billed charges,,,1842,83,,percent of total billed charges,,708.52,,,,fee schedule,,708.52,,,,fee schedule,,,5096.2,83,,percent of total billed charges,,1766.41,,,,fee schedule,,,5526,90,,percent of total billed charges,,,5526,90,,percent of total billed charges,,,5526,90,,percent of total billed charges,,,5526,90,,percent of total billed charges,,,5219,85,,percent of total billed charges,,708.52,5833,
REMOVAL OF ARM FOREIGN BODY,24200,CDM,24200,CPT,,,both,,841,841,241.38,,,,fee schedule,,,,,,,,169.3,,,,fee schedule,,,714.85,85,,percent of total billed charges,,305.71,,,,fee schedule,,147.68,,,,fee schedule,,169.3,,,,fee schedule,,237.43,,,,fee schedule,,169.3,,,,fee schedule,,234.28,,,,fee schedule,,141.99,,,,fee schedule,,141.99,,,,fee schedule,,,765.31,91,,percent of total billed charges,,,798.95,95,,percent of total billed charges,,,698.03,83,,percent of total billed charges,,,252.3,83,,percent of total billed charges,,169.3,,,,fee schedule,,169.3,,,,fee schedule,,,698.03,83,,percent of total billed charges,,208.72,,,,fee schedule,,,756.9,90,,percent of total billed charges,,,756.9,90,,percent of total billed charges,,,756.9,90,,percent of total billed charges,,,756.9,90,,percent of total billed charges,,,714.85,85,,percent of total billed charges,,141.99,798.95,
REMOVAL OF ARM FOREIGN BODY,24201,CDM,24201,CPT,,,both,,2590,2590,638.88,,,,fee schedule,,,,,,,,245.55,,,,fee schedule,,,2201.5,85,,percent of total billed charges,,798.6,,,,fee schedule,,385.8,,,,fee schedule,,245.55,,,,fee schedule,,626.07,,,,fee schedule,,245.55,,,,fee schedule,,620.08,,,,fee schedule,,375.81,,,,fee schedule,,375.81,,,,fee schedule,,,2356.9,91,,percent of total billed charges,,,2460.5,95,,percent of total billed charges,,,2149.7,83,,percent of total billed charges,,,777,83,,percent of total billed charges,,245.55,,,,fee schedule,,245.55,,,,fee schedule,,,2149.7,83,,percent of total billed charges,,552.44,,,,fee schedule,,,2331,90,,percent of total billed charges,,,2331,90,,percent of total billed charges,,,2331,90,,percent of total billed charges,,,2331,90,,percent of total billed charges,,,2201.5,85,,percent of total billed charges,,245.55,2460.5,
INJECTION FOR ELBOW X-RAY,24220,CDM,24220,CPT,,,both,,755,755,113.49,,,,fee schedule,,,,,,,,105.15,,,,fee schedule,,,641.75,85,,percent of total billed charges,,143.77,,,,fee schedule,,69.45,,,,fee schedule,,105.15,,,,fee schedule,,122.03,,,,fee schedule,,105.15,,,,fee schedule,,110.15,,,,fee schedule,,66.76,,,,fee schedule,,66.76,,,,fee schedule,,,687.05,91,,percent of total billed charges,,,717.25,95,,percent of total billed charges,,,626.65,83,,percent of total billed charges,,,226.5,83,,percent of total billed charges,,105.15,,,,fee schedule,,105.15,,,,fee schedule,,,626.65,83,,percent of total billed charges,,98.13,,,,fee schedule,,,679.5,90,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,679.5,90,,percent of total billed charges,,,641.75,85,,percent of total billed charges,,66.76,717.25,
MANIPULATE ELBOW W/ANESTH,24300,CDM,24300,CPT,,,both,,2205,2205,765.04,,,,fee schedule,,,,,,,,66.7,,,,fee schedule,,,1874.25,85,,percent of total billed charges,,932.82,,,,fee schedule,,450.64,,,,fee schedule,,66.7,,,,fee schedule,,667.85,,,,fee schedule,,66.7,,,,fee schedule,,742.54,,,,fee schedule,,450.02,,,,fee schedule,,450.02,,,,fee schedule,,,2006.55,91,,percent of total billed charges,,,2094.75,95,,percent of total billed charges,,,1830.15,83,,percent of total billed charges,,,661.5,83,,percent of total billed charges,,66.7,,,,fee schedule,,66.7,,,,fee schedule,,,1830.15,83,,percent of total billed charges,,661.53,,,,fee schedule,,,1984.5,90,,percent of total billed charges,,,1984.5,90,,percent of total billed charges,,,1984.5,90,,percent of total billed charges,,,1984.5,90,,percent of total billed charges,,,1874.25,85,,percent of total billed charges,,66.7,2094.75,
REVISION OF ARM TENDON,24310,CDM,24310,CPT,,,both,,2413,2413,830.71,,,,fee schedule,,,,,,,,188.7,,,,fee schedule,,,2051.05,85,,percent of total billed charges,,1036.94,,,,fee schedule,,500.93,,,,fee schedule,,188.7,,,,fee schedule,,828.34,,,,fee schedule,,188.7,,,,fee schedule,,806.28,,,,fee schedule,,488.65,,,,fee schedule,,488.65,,,,fee schedule,,,2195.83,91,,percent of total billed charges,,,2292.35,95,,percent of total billed charges,,,2002.79,83,,percent of total billed charges,,,723.9,83,,percent of total billed charges,,188.7,,,,fee schedule,,188.7,,,,fee schedule,,,2002.79,83,,percent of total billed charges,,718.32,,,,fee schedule,,,2171.7,90,,percent of total billed charges,,,2171.7,90,,percent of total billed charges,,,2171.7,90,,percent of total billed charges,,,2171.7,90,,percent of total billed charges,,,2051.05,85,,percent of total billed charges,,188.7,2292.35,
REPAIR ARM TENDON/MUSCLE,24341,CDM,24341,CPT,,,both,,3925,3925,1300.22,,,,fee schedule,,,,,,,,274.2,,,,fee schedule,,,3336.25,85,,percent of total billed charges,,1614.95,,,,fee schedule,,780.17,,,,fee schedule,,274.2,,,,fee schedule,,1136.74,,,,fee schedule,,274.2,,,,fee schedule,,1261.98,,,,fee schedule,,764.83,,,,fee schedule,,764.83,,,,fee schedule,,,3571.75,91,,percent of total billed charges,,,3728.75,95,,percent of total billed charges,,,3257.75,83,,percent of total billed charges,,,1177.5,83,,percent of total billed charges,,274.2,,,,fee schedule,,274.2,,,,fee schedule,,,3257.75,83,,percent of total billed charges,,1124.31,,,,fee schedule,,,3532.5,90,,percent of total billed charges,,,3532.5,90,,percent of total billed charges,,,3532.5,90,,percent of total billed charges,,,3532.5,90,,percent of total billed charges,,,3336.25,85,,percent of total billed charges,,274.2,3728.75,
REPAIR OF RUPTURED TENDON,24342,CDM,24342,CPT,,,both,,4537,4537,1344,,,,fee schedule,,,,,,,,535.45,,,,fee schedule,,,3856.45,85,,percent of total billed charges,,1692.8,,,,fee schedule,,817.77,,,,fee schedule,,535.45,,,,fee schedule,,1386.1,,,,fee schedule,,535.45,,,,fee schedule,,1304.47,,,,fee schedule,,790.59,,,,fee schedule,,790.59,,,,fee schedule,,,4128.67,91,,percent of total billed charges,,,4310.15,95,,percent of total billed charges,,,3765.71,83,,percent of total billed charges,,,1361.1,83,,percent of total billed charges,,535.45,,,,fee schedule,,535.45,,,,fee schedule,,,3765.71,83,,percent of total billed charges,,1162.16,,,,fee schedule,,,4083.3,90,,percent of total billed charges,,,4083.3,90,,percent of total billed charges,,,4083.3,90,,percent of total billed charges,,,4083.3,90,,percent of total billed charges,,,3856.45,85,,percent of total billed charges,,535.45,4310.15,
RECONSTRUCT ELBOW MED LIGMNT,24346,CDM,24346,CPT,,,both,,5848,5848,1912.02,,,,fee schedule,,,,,,,,651.95,,,,fee schedule,,,4970.8,85,,percent of total billed charges,,2406.6,,,,fee schedule,,1162.6,,,,fee schedule,,651.95,,,,fee schedule,,1832.44,,,,fee schedule,,651.95,,,,fee schedule,,1855.78,,,,fee schedule,,1124.72,,,,fee schedule,,1124.72,,,,fee schedule,,,5321.68,91,,percent of total billed charges,,,5555.6,95,,percent of total billed charges,,,4853.84,83,,percent of total billed charges,,,1754.4,83,,percent of total billed charges,,651.95,,,,fee schedule,,651.95,,,,fee schedule,,,4853.84,83,,percent of total billed charges,,1653.33,,,,fee schedule,,,5263.2,90,,percent of total billed charges,,,5263.2,90,,percent of total billed charges,,,5263.2,90,,percent of total billed charges,,,5263.2,90,,percent of total billed charges,,,4970.8,85,,percent of total billed charges,,651.95,5555.6,
"REPAIR ELBOW, PERC",24357,CDM,24357,CPT,,,both,,2210,2210,727.59,,,,fee schedule,,,,,,,,233.94,,,,fee schedule,,,1878.5,85,,percent of total billed charges,,905.69,,,,fee schedule,,437.53,,,,fee schedule,,233.94,,,,fee schedule,,,,,,,,233.94,,,,fee schedule,,706.19,,,,fee schedule,,428,,,,fee schedule,,428,,,,fee schedule,,,2011.1,91,,percent of total billed charges,,,2099.5,95,,percent of total billed charges,,,1834.3,83,,percent of total billed charges,,,663,83,,percent of total billed charges,,233.94,,,,fee schedule,,233.94,,,,fee schedule,,,1834.3,83,,percent of total billed charges,,629.15,,,,fee schedule,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1989,90,,percent of total billed charges,,,1878.5,85,,percent of total billed charges,,233.94,2099.5,
"REPAIR ELBOW W/DEB, OPEN",24358,CDM,24358,CPT,,,both,,2822,2822,923.46,,,,fee schedule,,,,,,,,275.71,,,,fee schedule,,,2398.7,85,,percent of total billed charges,,1149.91,,,,fee schedule,,555.51,,,,fee schedule,,275.71,,,,fee schedule,,,,,,,,275.71,,,,fee schedule,,896.3,,,,fee schedule,,543.21,,,,fee schedule,,543.21,,,,fee schedule,,,2568.02,91,,percent of total billed charges,,,2680.9,95,,percent of total billed charges,,,2342.26,83,,percent of total billed charges,,,846.6,83,,percent of total billed charges,,275.71,,,,fee schedule,,275.71,,,,fee schedule,,,2342.26,83,,percent of total billed charges,,798.52,,,,fee schedule,,,2539.8,90,,percent of total billed charges,,,2539.8,90,,percent of total billed charges,,,2539.8,90,,percent of total billed charges,,,2539.8,90,,percent of total billed charges,,,2398.7,85,,percent of total billed charges,,275.71,2680.9,
REPAIR ELBOW DEB/ATTCH OPEN,24359,CDM,24359,CPT,,,both,,3610,3610,1153.89,,,,fee schedule,,,,,,,,341.04,,,,fee schedule,,,3068.5,85,,percent of total billed charges,,1443.63,,,,fee schedule,,697.4,,,,fee schedule,,341.04,,,,fee schedule,,,,,,,,341.04,,,,fee schedule,,1119.96,,,,fee schedule,,678.76,,,,fee schedule,,678.76,,,,fee schedule,,,3285.1,91,,percent of total billed charges,,,3429.5,95,,percent of total billed charges,,,2996.3,83,,percent of total billed charges,,,1083,83,,percent of total billed charges,,341.04,,,,fee schedule,,341.04,,,,fee schedule,,,2996.3,83,,percent of total billed charges,,997.78,,,,fee schedule,,,3249,90,,percent of total billed charges,,,3249,90,,percent of total billed charges,,,3249,90,,percent of total billed charges,,,3249,90,,percent of total billed charges,,,3068.5,85,,percent of total billed charges,,341.04,3429.5,
REPLACE ELBOW JOINT,24363,CDM,24363,CPT,,,both,,7704,7704,2495.01,,,,fee schedule,,,,,,,,1123.7,,,,fee schedule,,,6548.4,85,,percent of total billed charges,,3160.76,,,,fee schedule,,1526.93,,,,fee schedule,,1123.7,,,,fee schedule,,2329.84,,,,fee schedule,,1123.7,,,,fee schedule,,2421.63,,,,fee schedule,,1467.65,,,,fee schedule,,1467.65,,,,fee schedule,,,7010.64,91,,percent of total billed charges,,,7318.8,95,,percent of total billed charges,,,6394.32,83,,percent of total billed charges,,,2311.2,83,,percent of total billed charges,,1123.7,,,,fee schedule,,1123.7,,,,fee schedule,,,6394.32,83,,percent of total billed charges,,2157.45,,,,fee schedule,,,6933.6,90,,percent of total billed charges,,,6933.6,90,,percent of total billed charges,,,6933.6,90,,percent of total billed charges,,,6933.6,90,,percent of total billed charges,,,6548.4,85,,percent of total billed charges,,1123.7,7318.8,
REPLACE ELBOW JOINT,24363AS80,CDM,24363,CPT,,,both,,689,689,2495.01,,,,fee schedule,,,,,,,,1123.7,,,,fee schedule,,,585.65,85,,percent of total billed charges,,3160.76,,,,fee schedule,,1526.93,,,,fee schedule,,1123.7,,,,fee schedule,,2329.84,,,,fee schedule,,1123.7,,,,fee schedule,,2421.63,,,,fee schedule,,1467.65,,,,fee schedule,,1467.65,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,1123.7,,,,fee schedule,,1123.7,,,,fee schedule,,,571.87,83,,percent of total billed charges,,2157.45,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,3160.76,
RECONSTRUCT HEAD OF RADIUS,24365,CDM,24365,CPT,,,both,,3259,3259,1115.87,,,,fee schedule,,,,,,,,1123.7,,,,fee schedule,,,2770.15,85,,percent of total billed charges,,1402.11,,,,fee schedule,,677.34,,,,fee schedule,,1123.7,,,,fee schedule,,1126.79,,,,fee schedule,,1123.7,,,,fee schedule,,1083.05,,,,fee schedule,,656.4,,,,fee schedule,,656.4,,,,fee schedule,,,2965.69,91,,percent of total billed charges,,,3096.05,95,,percent of total billed charges,,,2704.97,83,,percent of total billed charges,,,977.7,83,,percent of total billed charges,,1123.7,,,,fee schedule,,1123.7,,,,fee schedule,,,2704.97,83,,percent of total billed charges,,964.9,,,,fee schedule,,,2933.1,90,,percent of total billed charges,,,2933.1,90,,percent of total billed charges,,,2933.1,90,,percent of total billed charges,,,2933.1,90,,percent of total billed charges,,,2770.15,85,,percent of total billed charges,,656.4,3096.05,
RECONSTRUCT HEAD OF RADIUS,24366,CDM,24366,CPT,,,both,,3549,3549,1182.7,,,,fee schedule,,,,,,,,1123.7,,,,fee schedule,,,3016.65,85,,percent of total billed charges,,1487.15,,,,fee schedule,,718.43,,,,fee schedule,,1123.7,,,,fee schedule,,1205.05,,,,fee schedule,,1123.7,,,,fee schedule,,1147.91,,,,fee schedule,,695.7,,,,fee schedule,,695.7,,,,fee schedule,,,3229.59,91,,percent of total billed charges,,,3371.55,95,,percent of total billed charges,,,2945.67,83,,percent of total billed charges,,,1064.7,83,,percent of total billed charges,,1123.7,,,,fee schedule,,1123.7,,,,fee schedule,,,2945.67,83,,percent of total billed charges,,1022.69,,,,fee schedule,,,3194.1,90,,percent of total billed charges,,,3194.1,90,,percent of total billed charges,,,3194.1,90,,percent of total billed charges,,,3194.1,90,,percent of total billed charges,,,3016.65,85,,percent of total billed charges,,695.7,3371.55,
REVISION OF HUMERUS,24400,CDM,24400,CPT,,,both,,5107,5107,1436.75,,,,fee schedule,,,,,,,,541.05,,,,fee schedule,,,4340.95,85,,percent of total billed charges,,1800.85,,,,fee schedule,,869.97,,,,fee schedule,,541.05,,,,fee schedule,,1442.47,,,,fee schedule,,541.05,,,,fee schedule,,1394.49,,,,fee schedule,,845.15,,,,fee schedule,,845.15,,,,fee schedule,,,4647.37,91,,percent of total billed charges,,,4851.65,95,,percent of total billed charges,,,4238.81,83,,percent of total billed charges,,,1532.1,83,,percent of total billed charges,,541.05,,,,fee schedule,,541.05,,,,fee schedule,,,4238.81,83,,percent of total billed charges,,1242.37,,,,fee schedule,,,4596.3,90,,percent of total billed charges,,,4596.3,90,,percent of total billed charges,,,4596.3,90,,percent of total billed charges,,,4596.3,90,,percent of total billed charges,,,4340.95,85,,percent of total billed charges,,541.05,4851.65,
REPAIR OF HUMERUS,24430,CDM,24430,CPT,,,both,,4583,4583,1825.03,,,,fee schedule,,,,,,,,636.8,,,,fee schedule,,,3895.55,85,,percent of total billed charges,,2303.13,,,,fee schedule,,1112.62,,,,fee schedule,,636.8,,,,fee schedule,,1638.12,,,,fee schedule,,636.8,,,,fee schedule,,1771.35,,,,fee schedule,,1073.55,,,,fee schedule,,1073.55,,,,fee schedule,,,4170.53,91,,percent of total billed charges,,,4353.85,95,,percent of total billed charges,,,3803.89,83,,percent of total billed charges,,,1374.9,83,,percent of total billed charges,,636.8,,,,fee schedule,,636.8,,,,fee schedule,,,3803.89,83,,percent of total billed charges,,1578.11,,,,fee schedule,,,4124.7,90,,percent of total billed charges,,,4124.7,90,,percent of total billed charges,,,4124.7,90,,percent of total billed charges,,,4124.7,90,,percent of total billed charges,,,3895.55,85,,percent of total billed charges,,636.8,4353.85,
REPAIR HUMERUS WITH GRAFT,24435,CDM,24435,CPT,,,both,,5979,5979,1867.08,,,,fee schedule,,,,,,,,958.6,,,,fee schedule,,,5082.15,85,,percent of total billed charges,,2352.99,,,,fee schedule,,1136.7,,,,fee schedule,,958.6,,,,fee schedule,,1740.92,,,,fee schedule,,958.6,,,,fee schedule,,1812.17,,,,fee schedule,,1098.28,,,,fee schedule,,1098.28,,,,fee schedule,,,5440.89,91,,percent of total billed charges,,,5680.05,95,,percent of total billed charges,,,4962.57,83,,percent of total billed charges,,,1793.7,83,,percent of total billed charges,,958.6,,,,fee schedule,,958.6,,,,fee schedule,,,4962.57,83,,percent of total billed charges,,1614.48,,,,fee schedule,,,5381.1,90,,percent of total billed charges,,,5381.1,90,,percent of total billed charges,,,5381.1,90,,percent of total billed charges,,,5381.1,90,,percent of total billed charges,,,5082.15,85,,percent of total billed charges,,958.6,5680.05,
TREAT HUMERUS FRACTURE,24500,CDM,24500,CPT,,,both,,1405,1405,592.21,,,,fee schedule,,,,,,,,153.95,,,,fee schedule,,,1194.25,85,,percent of total billed charges,,723.49,,,,fee schedule,,349.51,,,,fee schedule,,153.95,,,,fee schedule,,488.78,,,,fee schedule,,153.95,,,,fee schedule,,574.79,,,,fee schedule,,348.36,,,,fee schedule,,348.36,,,,fee schedule,,,1278.55,91,,percent of total billed charges,,,1334.75,95,,percent of total billed charges,,,1166.15,83,,percent of total billed charges,,,421.5,83,,percent of total billed charges,,153.95,,,,fee schedule,,153.95,,,,fee schedule,,,1166.15,83,,percent of total billed charges,,512.09,,,,fee schedule,,,1264.5,90,,percent of total billed charges,,,1264.5,90,,percent of total billed charges,,,1264.5,90,,percent of total billed charges,,,1264.5,90,,percent of total billed charges,,,1194.25,85,,percent of total billed charges,,153.95,1334.75,
TREAT HUMERUS FRACTURE,24500P,CDM,24500,CPT,,,both,P,968,968,592.21,,,,fee schedule,,,,,,,,153.95,,,,fee schedule,,,822.8,85,,percent of total billed charges,,723.49,,,,fee schedule,,349.51,,,,fee schedule,,153.95,,,,fee schedule,,488.78,,,,fee schedule,,153.95,,,,fee schedule,,574.79,,,,fee schedule,,348.36,,,,fee schedule,,348.36,,,,fee schedule,,,880.88,91,,percent of total billed charges,,,919.6,95,,percent of total billed charges,,,803.44,83,,percent of total billed charges,,,290.4,83,,percent of total billed charges,,153.95,,,,fee schedule,,153.95,,,,fee schedule,,,803.44,83,,percent of total billed charges,,512.09,,,,fee schedule,,,871.2,90,,percent of total billed charges,,,871.2,90,,percent of total billed charges,,,871.2,90,,percent of total billed charges,,,871.2,90,,percent of total billed charges,,,822.8,85,,percent of total billed charges,,153.95,919.6,
TREAT HUMERUS FRACTURE,24500T,CDM,24500,CPT,,,both,T,437,437,592.21,,,,fee schedule,,,,,,,,153.95,,,,fee schedule,,,371.45,85,,percent of total billed charges,,723.49,,,,fee schedule,,349.51,,,,fee schedule,,153.95,,,,fee schedule,,488.78,,,,fee schedule,,153.95,,,,fee schedule,,574.79,,,,fee schedule,,348.36,,,,fee schedule,,348.36,,,,fee schedule,,,397.67,91,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,131.1,83,,percent of total billed charges,,153.95,,,,fee schedule,,153.95,,,,fee schedule,,,362.71,83,,percent of total billed charges,,512.09,,,,fee schedule,,,393.3,90,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,131.1,723.49,
TREAT HUMERUS FRACTURE,24505,CDM,24505,CPT,,,both,,2146,2146,796.72,,,,fee schedule,,,,,,,,295.5,,,,fee schedule,,,1824.1,85,,percent of total billed charges,,987.41,,,,fee schedule,,477,,,,fee schedule,,295.5,,,,fee schedule,,756.06,,,,fee schedule,,295.5,,,,fee schedule,,773.29,,,,fee schedule,,468.66,,,,fee schedule,,468.66,,,,fee schedule,,,1952.86,91,,percent of total billed charges,,,2038.7,95,,percent of total billed charges,,,1781.18,83,,percent of total billed charges,,,643.8,83,,percent of total billed charges,,295.5,,,,fee schedule,,295.5,,,,fee schedule,,,1781.18,83,,percent of total billed charges,,688.93,,,,fee schedule,,,1931.4,90,,percent of total billed charges,,,1931.4,90,,percent of total billed charges,,,1931.4,90,,percent of total billed charges,,,1931.4,90,,percent of total billed charges,,,1824.1,85,,percent of total billed charges,,295.5,2038.7,
TREAT HUMERUS FRACTURE,24515,CDM,24515,CPT,,,both,,4190,4190,1527.77,,,,fee schedule,,,,,,,,624.3,,,,fee schedule,,,3561.5,85,,percent of total billed charges,,1922.37,,,,fee schedule,,928.67,,,,fee schedule,,624.3,,,,fee schedule,,1524.71,,,,fee schedule,,624.3,,,,fee schedule,,1482.84,,,,fee schedule,,898.69,,,,fee schedule,,898.69,,,,fee schedule,,,3812.9,91,,percent of total billed charges,,,3980.5,95,,percent of total billed charges,,,3477.7,83,,percent of total billed charges,,,1257,83,,percent of total billed charges,,624.3,,,,fee schedule,,624.3,,,,fee schedule,,,3477.7,83,,percent of total billed charges,,1321.07,,,,fee schedule,,,3771,90,,percent of total billed charges,,,3771,90,,percent of total billed charges,,,3771,90,,percent of total billed charges,,,3771,90,,percent of total billed charges,,,3561.5,85,,percent of total billed charges,,624.3,3980.5,
TREAT HUMERUS FRACTURE,24516,CDM,24516,CPT,,,both,,4090,4090,1489.17,,,,fee schedule,,,,,,,,624.3,,,,fee schedule,,,3476.5,85,,percent of total billed charges,,1878.29,,,,fee schedule,,907.38,,,,fee schedule,,624.3,,,,fee schedule,,1507.47,,,,fee schedule,,624.3,,,,fee schedule,,1445.37,,,,fee schedule,,875.98,,,,fee schedule,,875.98,,,,fee schedule,,,3721.9,91,,percent of total billed charges,,,3885.5,95,,percent of total billed charges,,,3394.7,83,,percent of total billed charges,,,1227,83,,percent of total billed charges,,624.3,,,,fee schedule,,624.3,,,,fee schedule,,,3394.7,83,,percent of total billed charges,,1287.7,,,,fee schedule,,,3681,90,,percent of total billed charges,,,3681,90,,percent of total billed charges,,,3681,90,,percent of total billed charges,,,3681,90,,percent of total billed charges,,,3476.5,85,,percent of total billed charges,,624.3,3885.5,
TREAT HUMERUS FRACTURE,24530,CDM,24530,CPT,,,both,,1577,1577,622.75,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,1340.45,85,,percent of total billed charges,,761.44,,,,fee schedule,,367.84,,,,fee schedule,,299.7,,,,fee schedule,,535.87,,,,fee schedule,,299.7,,,,fee schedule,,604.43,,,,fee schedule,,366.32,,,,fee schedule,,366.32,,,,fee schedule,,,1435.07,91,,percent of total billed charges,,,1498.15,95,,percent of total billed charges,,,1308.91,83,,percent of total billed charges,,,473.1,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,1308.91,83,,percent of total billed charges,,538.49,,,,fee schedule,,,1419.3,90,,percent of total billed charges,,,1419.3,90,,percent of total billed charges,,,1419.3,90,,percent of total billed charges,,,1419.3,90,,percent of total billed charges,,,1340.45,85,,percent of total billed charges,,299.7,1498.15,
TREAT HUMERUS FRACTURE,24535,CDM,24535,CPT,,,both,,2633,2633,1000.66,,,,fee schedule,,,,,,,,334.4,,,,fee schedule,,,2238.05,85,,percent of total billed charges,,1240.74,,,,fee schedule,,599.39,,,,fee schedule,,334.4,,,,fee schedule,,970.27,,,,fee schedule,,334.4,,,,fee schedule,,971.22,,,,fee schedule,,588.62,,,,fee schedule,,588.62,,,,fee schedule,,,2396.03,91,,percent of total billed charges,,,2501.35,95,,percent of total billed charges,,,2185.39,83,,percent of total billed charges,,,789.9,83,,percent of total billed charges,,334.4,,,,fee schedule,,334.4,,,,fee schedule,,,2185.39,83,,percent of total billed charges,,865.27,,,,fee schedule,,,2369.7,90,,percent of total billed charges,,,2369.7,90,,percent of total billed charges,,,2369.7,90,,percent of total billed charges,,,2369.7,90,,percent of total billed charges,,,2238.05,85,,percent of total billed charges,,334.4,2501.35,
TREAT HUMERUS FRACTURE,24538,CDM,24538,CPT,,,both,,3828,3828,1376.26,,,,fee schedule,,,,,,,,405.1,,,,fee schedule,,,3253.8,85,,percent of total billed charges,,1722.16,,,,fee schedule,,831.96,,,,fee schedule,,405.1,,,,fee schedule,,1305.85,,,,fee schedule,,405.1,,,,fee schedule,,1335.78,,,,fee schedule,,809.57,,,,fee schedule,,809.57,,,,fee schedule,,,3483.48,91,,percent of total billed charges,,,3636.6,95,,percent of total billed charges,,,3177.24,83,,percent of total billed charges,,,1148.4,83,,percent of total billed charges,,405.1,,,,fee schedule,,405.1,,,,fee schedule,,,3177.24,83,,percent of total billed charges,,1190.06,,,,fee schedule,,,3445.2,90,,percent of total billed charges,,,3445.2,90,,percent of total billed charges,,,3445.2,90,,percent of total billed charges,,,3445.2,90,,percent of total billed charges,,,3253.8,85,,percent of total billed charges,,405.1,3636.6,
TREAT HUMERUS FRACTURE,24546,CDM,24546,CPT,,,both,,5276,5276,1792.77,,,,fee schedule,,,,,,,,718.7,,,,fee schedule,,,4484.6,85,,percent of total billed charges,,2263.82,,,,fee schedule,,1093.63,,,,fee schedule,,718.7,,,,fee schedule,,1967.07,,,,fee schedule,,718.7,,,,fee schedule,,1740.04,,,,fee schedule,,1054.57,,,,fee schedule,,1054.57,,,,fee schedule,,,4801.16,91,,percent of total billed charges,,,5012.2,95,,percent of total billed charges,,,4379.08,83,,percent of total billed charges,,,1582.8,83,,percent of total billed charges,,718.7,,,,fee schedule,,718.7,,,,fee schedule,,,4379.08,83,,percent of total billed charges,,1550.22,,,,fee schedule,,,4748.4,90,,percent of total billed charges,,,4748.4,90,,percent of total billed charges,,,4748.4,90,,percent of total billed charges,,,4748.4,90,,percent of total billed charges,,,4484.6,85,,percent of total billed charges,,718.7,5012.2,
TREAT HUMERUS FRACTURE,24560,CDM,24560,CPT,,,both,,1293,1293,524.23,,,,fee schedule,,,,,,,,199.75,,,,fee schedule,,,1099.05,85,,percent of total billed charges,,639.21,,,,fee schedule,,308.8,,,,fee schedule,,199.75,,,,fee schedule,,424.45,,,,fee schedule,,199.75,,,,fee schedule,,508.82,,,,fee schedule,,308.37,,,,fee schedule,,308.37,,,,fee schedule,,,1176.63,91,,percent of total billed charges,,,1228.35,95,,percent of total billed charges,,,1073.19,83,,percent of total billed charges,,,387.9,83,,percent of total billed charges,,199.75,,,,fee schedule,,199.75,,,,fee schedule,,,1073.19,83,,percent of total billed charges,,453.31,,,,fee schedule,,,1163.7,90,,percent of total billed charges,,,1163.7,90,,percent of total billed charges,,,1163.7,90,,percent of total billed charges,,,1163.7,90,,percent of total billed charges,,,1099.05,85,,percent of total billed charges,,199.75,1228.35,
TREAT HUMERUS FRACTURE,24565,CDM,24565,CPT,,,both,,2347,2347,871.04,,,,fee schedule,,,,,,,,242.8,,,,fee schedule,,,1994.95,85,,percent of total billed charges,,1076.42,,,,fee schedule,,520,,,,fee schedule,,242.8,,,,fee schedule,,793.86,,,,fee schedule,,242.8,,,,fee schedule,,845.42,,,,fee schedule,,512.37,,,,fee schedule,,512.37,,,,fee schedule,,,2135.77,91,,percent of total billed charges,,,2229.65,95,,percent of total billed charges,,,1948.01,83,,percent of total billed charges,,,704.1,83,,percent of total billed charges,,242.8,,,,fee schedule,,242.8,,,,fee schedule,,,1948.01,83,,percent of total billed charges,,753.19,,,,fee schedule,,,2112.3,90,,percent of total billed charges,,,2112.3,90,,percent of total billed charges,,,2112.3,90,,percent of total billed charges,,,2112.3,90,,percent of total billed charges,,,1994.95,85,,percent of total billed charges,,242.8,2229.65,
TREAT HUMERUS FRACTURE,24566,CDM,24566,CPT,,,both,,3168,3168,1255.28,,,,fee schedule,,,,,,,,257.3,,,,fee schedule,,,2692.8,85,,percent of total billed charges,,1566.49,,,,fee schedule,,756.75,,,,fee schedule,,257.3,,,,fee schedule,,1142.7,,,,fee schedule,,257.3,,,,fee schedule,,1218.36,,,,fee schedule,,738.4,,,,fee schedule,,738.4,,,,fee schedule,,,2882.88,91,,percent of total billed charges,,,3009.6,95,,percent of total billed charges,,,2629.44,83,,percent of total billed charges,,,950.4,83,,percent of total billed charges,,257.3,,,,fee schedule,,257.3,,,,fee schedule,,,2629.44,83,,percent of total billed charges,,1085.45,,,,fee schedule,,,2851.2,90,,percent of total billed charges,,,2851.2,90,,percent of total billed charges,,,2851.2,90,,percent of total billed charges,,,2851.2,90,,percent of total billed charges,,,2692.8,85,,percent of total billed charges,,257.3,3009.6,
TREAT HUMERUS FRACTURE,24575,CDM,24575,CPT,,,both,,3556,3556,1273.14,,,,fee schedule,,,,,,,,718.7,,,,fee schedule,,,3022.6,85,,percent of total billed charges,,1594.49,,,,fee schedule,,770.28,,,,fee schedule,,718.7,,,,fee schedule,,1383.45,,,,fee schedule,,718.7,,,,fee schedule,,1235.7,,,,fee schedule,,748.91,,,,fee schedule,,748.91,,,,fee schedule,,,3235.96,91,,percent of total billed charges,,,3378.2,95,,percent of total billed charges,,,2951.48,83,,percent of total billed charges,,,1066.8,83,,percent of total billed charges,,718.7,,,,fee schedule,,718.7,,,,fee schedule,,,2951.48,83,,percent of total billed charges,,1100.89,,,,fee schedule,,,3200.4,90,,percent of total billed charges,,,3200.4,90,,percent of total billed charges,,,3200.4,90,,percent of total billed charges,,,3200.4,90,,percent of total billed charges,,,3022.6,85,,percent of total billed charges,,718.7,3378.2,
TREAT HUMERUS FRACTURE,24576,CDM,24576,CPT,,,both,,1431,1431,555.92,,,,fee schedule,,,,,,,,188.7,,,,fee schedule,,,1216.35,85,,percent of total billed charges,,677.36,,,,fee schedule,,327.22,,,,fee schedule,,188.7,,,,fee schedule,,464.91,,,,fee schedule,,188.7,,,,fee schedule,,539.57,,,,fee schedule,,327.01,,,,fee schedule,,327.01,,,,fee schedule,,,1302.21,91,,percent of total billed charges,,,1359.45,95,,percent of total billed charges,,,1187.73,83,,percent of total billed charges,,,429.3,83,,percent of total billed charges,,188.7,,,,fee schedule,,188.7,,,,fee schedule,,,1187.73,83,,percent of total billed charges,,480.71,,,,fee schedule,,,1287.9,90,,percent of total billed charges,,,1287.9,90,,percent of total billed charges,,,1287.9,90,,percent of total billed charges,,,1287.9,90,,percent of total billed charges,,,1216.35,85,,percent of total billed charges,,188.7,1359.45,
TREAT HUMERUS FRACTURE,24577,CDM,24577,CPT,,,both,,2418,2418,892.93,,,,fee schedule,,,,,,,,245.55,,,,fee schedule,,,2055.3,85,,percent of total billed charges,,1107.19,,,,fee schedule,,534.87,,,,fee schedule,,245.55,,,,fee schedule,,832.99,,,,fee schedule,,245.55,,,,fee schedule,,866.67,,,,fee schedule,,525.25,,,,fee schedule,,525.25,,,,fee schedule,,,2200.38,91,,percent of total billed charges,,,2297.1,95,,percent of total billed charges,,,2006.94,83,,percent of total billed charges,,,725.4,83,,percent of total billed charges,,245.55,,,,fee schedule,,245.55,,,,fee schedule,,,2006.94,83,,percent of total billed charges,,772.12,,,,fee schedule,,,2176.2,90,,percent of total billed charges,,,2176.2,90,,percent of total billed charges,,,2176.2,90,,percent of total billed charges,,,2176.2,90,,percent of total billed charges,,,2055.3,85,,percent of total billed charges,,245.55,2297.1,
TREAT HUMERUS FRACTURE,24579,CDM,24579,CPT,,,both,,4105,4105,1448.85,,,,fee schedule,,,,,,,,718.7,,,,fee schedule,,,3489.25,85,,percent of total billed charges,,1816.22,,,,fee schedule,,877.4,,,,fee schedule,,718.7,,,,fee schedule,,1484.92,,,,fee schedule,,718.7,,,,fee schedule,,1406.23,,,,fee schedule,,852.26,,,,fee schedule,,852.26,,,,fee schedule,,,3735.55,91,,percent of total billed charges,,,3899.75,95,,percent of total billed charges,,,3407.15,83,,percent of total billed charges,,,1231.5,83,,percent of total billed charges,,718.7,,,,fee schedule,,718.7,,,,fee schedule,,,3407.15,83,,percent of total billed charges,,1252.83,,,,fee schedule,,,3694.5,90,,percent of total billed charges,,,3694.5,90,,percent of total billed charges,,,3694.5,90,,percent of total billed charges,,,3694.5,90,,percent of total billed charges,,,3489.25,85,,percent of total billed charges,,718.7,3899.75,
TREAT HUMERUS FRACTURE,24582,CDM,24582,CPT,,,both,,3670,3670,1421.2,,,,fee schedule,,,,,,,,405.1,,,,fee schedule,,,3119.5,85,,percent of total billed charges,,1772.73,,,,fee schedule,,856.39,,,,fee schedule,,405.1,,,,fee schedule,,1268.05,,,,fee schedule,,405.1,,,,fee schedule,,1379.4,,,,fee schedule,,836,,,,fee schedule,,836,,,,fee schedule,,,3339.7,91,,percent of total billed charges,,,3486.5,95,,percent of total billed charges,,,3046.1,83,,percent of total billed charges,,,1101,83,,percent of total billed charges,,405.1,,,,fee schedule,,405.1,,,,fee schedule,,,3046.1,83,,percent of total billed charges,,1228.92,,,,fee schedule,,,3303,90,,percent of total billed charges,,,3303,90,,percent of total billed charges,,,3303,90,,percent of total billed charges,,,3303,90,,percent of total billed charges,,,3119.5,85,,percent of total billed charges,,405.1,3486.5,
TREAT ELBOW FRACTURE,24586,CDM,24586,CPT,,,both,,5260,5260,1878.03,,,,fee schedule,,,,,,,,480.65,,,,fee schedule,,,4471,85,,percent of total billed charges,,2373.43,,,,fee schedule,,1146.58,,,,fee schedule,,480.65,,,,fee schedule,,1923.3,,,,fee schedule,,480.65,,,,fee schedule,,1822.79,,,,fee schedule,,1104.72,,,,fee schedule,,1104.72,,,,fee schedule,,,4786.6,91,,percent of total billed charges,,,4997,95,,percent of total billed charges,,,4365.8,83,,percent of total billed charges,,,1578,83,,percent of total billed charges,,480.65,,,,fee schedule,,480.65,,,,fee schedule,,,4365.8,83,,percent of total billed charges,,1623.94,,,,fee schedule,,,4734,90,,percent of total billed charges,,,4734,90,,percent of total billed charges,,,4734,90,,percent of total billed charges,,,4734,90,,percent of total billed charges,,,4471,85,,percent of total billed charges,,480.65,4997,
TREAT ELBOW FRACTURE,24587,CDM,24587,CPT,,,both,,4821,4821,1881.49,,,,fee schedule,,,,,,,,1123.7,,,,fee schedule,,,4097.85,85,,percent of total billed charges,,2381.6,,,,fee schedule,,1150.52,,,,fee schedule,,1123.7,,,,fee schedule,,1900.75,,,,fee schedule,,1123.7,,,,fee schedule,,1826.15,,,,fee schedule,,1106.76,,,,fee schedule,,1106.76,,,,fee schedule,,,4387.11,91,,percent of total billed charges,,,4579.95,95,,percent of total billed charges,,,4001.43,83,,percent of total billed charges,,,1446.3,83,,percent of total billed charges,,1123.7,,,,fee schedule,,1123.7,,,,fee schedule,,,4001.43,83,,percent of total billed charges,,1626.93,,,,fee schedule,,,4338.9,90,,percent of total billed charges,,,4338.9,90,,percent of total billed charges,,,4338.9,90,,percent of total billed charges,,,4338.9,90,,percent of total billed charges,,,4097.85,85,,percent of total billed charges,,1106.76,4579.95,
TREAT ELBOW DISLOCATION,24600,CDM,24600,CPT,,,both,,1528,1528,605.46,,,,fee schedule,,,,,,,,208.05,,,,fee schedule,,,1298.8,85,,percent of total billed charges,,744.75,,,,fee schedule,,359.78,,,,fee schedule,,208.05,,,,fee schedule,,543.17,,,,fee schedule,,208.05,,,,fee schedule,,587.65,,,,fee schedule,,356.15,,,,fee schedule,,356.15,,,,fee schedule,,,1390.48,91,,percent of total billed charges,,,1451.6,95,,percent of total billed charges,,,1268.24,83,,percent of total billed charges,,,458.4,83,,percent of total billed charges,,208.05,,,,fee schedule,,208.05,,,,fee schedule,,,1268.24,83,,percent of total billed charges,,523.55,,,,fee schedule,,,1375.2,90,,percent of total billed charges,,,1375.2,90,,percent of total billed charges,,,1375.2,90,,percent of total billed charges,,,1375.2,90,,percent of total billed charges,,,1298.8,85,,percent of total billed charges,,208.05,1451.6,
TREAT ELBOW DISLOCATION,24605,CDM,24605,CPT,,,both,,1933,1933,838.78,,,,fee schedule,,,,,,,,242.8,,,,fee schedule,,,1643.05,85,,percent of total billed charges,,1040.08,,,,fee schedule,,502.45,,,,fee schedule,,242.8,,,,fee schedule,,771.97,,,,fee schedule,,242.8,,,,fee schedule,,814.11,,,,fee schedule,,493.4,,,,fee schedule,,493.4,,,,fee schedule,,,1759.03,91,,percent of total billed charges,,,1836.35,95,,percent of total billed charges,,,1604.39,83,,percent of total billed charges,,,579.9,83,,percent of total billed charges,,242.8,,,,fee schedule,,242.8,,,,fee schedule,,,1604.39,83,,percent of total billed charges,,725.29,,,,fee schedule,,,1739.7,90,,percent of total billed charges,,,1739.7,90,,percent of total billed charges,,,1739.7,90,,percent of total billed charges,,,1739.7,90,,percent of total billed charges,,,1643.05,85,,percent of total billed charges,,242.8,1836.35,
TREAT ELBOW DISLOCATION,24615,CDM,24615,CPT,,,both,,3521,3521,1241.46,,,,fee schedule,,,,,,,,419,,,,fee schedule,,,2992.85,85,,percent of total billed charges,,1557.66,,,,fee schedule,,752.49,,,,fee schedule,,419,,,,fee schedule,,1247.49,,,,fee schedule,,419,,,,fee schedule,,1204.94,,,,fee schedule,,730.27,,,,fee schedule,,730.27,,,,fee schedule,,,3204.11,91,,percent of total billed charges,,,3344.95,95,,percent of total billed charges,,,2922.43,83,,percent of total billed charges,,,1056.3,83,,percent of total billed charges,,419,,,,fee schedule,,419,,,,fee schedule,,,2922.43,83,,percent of total billed charges,,1073.5,,,,fee schedule,,,3168.9,90,,percent of total billed charges,,,3168.9,90,,percent of total billed charges,,,3168.9,90,,percent of total billed charges,,,3168.9,90,,percent of total billed charges,,,2992.85,85,,percent of total billed charges,,419,3344.95,
TREAT ELBOW FRACTURE,24620,CDM,24620,CPT,,,both,,2487,2487,1028.31,,,,fee schedule,,,,,,,,259.4,,,,fee schedule,,,2113.95,85,,percent of total billed charges,,1231.33,,,,fee schedule,,594.84,,,,fee schedule,,259.4,,,,fee schedule,,945.07,,,,fee schedule,,259.4,,,,fee schedule,,998.06,,,,fee schedule,,604.89,,,,fee schedule,,604.89,,,,fee schedule,,,2263.17,91,,percent of total billed charges,,,2362.65,95,,percent of total billed charges,,,2064.21,83,,percent of total billed charges,,,746.1,83,,percent of total billed charges,,259.4,,,,fee schedule,,259.4,,,,fee schedule,,,2064.21,83,,percent of total billed charges,,889.18,,,,fee schedule,,,2238.3,90,,percent of total billed charges,,,2238.3,90,,percent of total billed charges,,,2238.3,90,,percent of total billed charges,,,2238.3,90,,percent of total billed charges,,,2113.95,85,,percent of total billed charges,,259.4,2362.65,
TREAT ELBOW FRACTURE,24635,CDM,24635,CPT,,,both,,4215,4215,1177.51,,,,fee schedule,,,,,,,,482.8,,,,fee schedule,,,3582.75,85,,percent of total billed charges,,1467.95,,,,fee schedule,,709.15,,,,fee schedule,,482.8,,,,fee schedule,,1954.47,,,,fee schedule,,482.8,,,,fee schedule,,1142.88,,,,fee schedule,,692.65,,,,fee schedule,,692.65,,,,fee schedule,,,3835.65,91,,percent of total billed charges,,,4004.25,95,,percent of total billed charges,,,3498.45,83,,percent of total billed charges,,,1264.5,83,,percent of total billed charges,,482.8,,,,fee schedule,,482.8,,,,fee schedule,,,3498.45,83,,percent of total billed charges,,1018.2,,,,fee schedule,,,3793.5,90,,percent of total billed charges,,,3793.5,90,,percent of total billed charges,,,3793.5,90,,percent of total billed charges,,,3793.5,90,,percent of total billed charges,,,3582.75,85,,percent of total billed charges,,482.8,4004.25,
TREAT ELBOW DISLOCATION,24640,CDM,24640,CPT,,,both,,592,592,137.68,,,,fee schedule,,,,,,,,180.3,,,,fee schedule,,,503.2,85,,percent of total billed charges,,172.86,,,,fee schedule,,83.51,,,,fee schedule,,180.3,,,,fee schedule,,140.6,,,,fee schedule,,180.3,,,,fee schedule,,133.63,,,,fee schedule,,80.99,,,,fee schedule,,80.99,,,,fee schedule,,,538.72,91,,percent of total billed charges,,,562.4,95,,percent of total billed charges,,,491.36,83,,percent of total billed charges,,,177.6,83,,percent of total billed charges,,180.3,,,,fee schedule,,180.3,,,,fee schedule,,,491.36,83,,percent of total billed charges,,119.06,,,,fee schedule,,,532.8,90,,percent of total billed charges,,,532.8,90,,percent of total billed charges,,,532.8,90,,percent of total billed charges,,,532.8,90,,percent of total billed charges,,,503.2,85,,percent of total billed charges,,80.99,562.4,
TREAT RADIUS FRACTURE,24650,CDM,24650,CPT,,,both,,1087,1087,436.67,,,,fee schedule,,,,,,,,142.9,,,,fee schedule,,,923.95,85,,percent of total billed charges,,528.06,,,,fee schedule,,255.1,,,,fee schedule,,142.9,,,,fee schedule,,347.52,,,,fee schedule,,142.9,,,,fee schedule,,423.83,,,,fee schedule,,256.86,,,,fee schedule,,256.86,,,,fee schedule,,,989.17,91,,percent of total billed charges,,,1032.65,95,,percent of total billed charges,,,902.21,83,,percent of total billed charges,,,326.1,83,,percent of total billed charges,,142.9,,,,fee schedule,,142.9,,,,fee schedule,,,902.21,83,,percent of total billed charges,,377.59,,,,fee schedule,,,978.3,90,,percent of total billed charges,,,978.3,90,,percent of total billed charges,,,978.3,90,,percent of total billed charges,,,978.3,90,,percent of total billed charges,,,923.95,85,,percent of total billed charges,,142.9,1032.65,
TREAT RADIUS FRACTURE,24655,CDM,24655,CPT,,,both,,1903,1903,713.77,,,,fee schedule,,,,,,,,208.05,,,,fee schedule,,,1617.55,85,,percent of total billed charges,,879.02,,,,fee schedule,,424.64,,,,fee schedule,,208.05,,,,fee schedule,,653.92,,,,fee schedule,,208.05,,,,fee schedule,,692.77,,,,fee schedule,,419.86,,,,fee schedule,,419.86,,,,fee schedule,,,1731.73,91,,percent of total billed charges,,,1807.85,95,,percent of total billed charges,,,1579.49,83,,percent of total billed charges,,,570.9,83,,percent of total billed charges,,208.05,,,,fee schedule,,208.05,,,,fee schedule,,,1579.49,83,,percent of total billed charges,,617.2,,,,fee schedule,,,1712.7,90,,percent of total billed charges,,,1712.7,90,,percent of total billed charges,,,1712.7,90,,percent of total billed charges,,,1712.7,90,,percent of total billed charges,,,1617.55,85,,percent of total billed charges,,208.05,1807.85,
TREAT RADIUS FRACTURE,24665,CDM,24665,CPT,,,both,,3132,3132,1144.68,,,,fee schedule,,,,,,,,400.9,,,,fee schedule,,,2662.2,85,,percent of total billed charges,,1429.71,,,,fee schedule,,690.68,,,,fee schedule,,400.9,,,,fee schedule,,1128.78,,,,fee schedule,,400.9,,,,fee schedule,,1111.01,,,,fee schedule,,673.34,,,,fee schedule,,673.34,,,,fee schedule,,,2850.12,91,,percent of total billed charges,,,2975.4,95,,percent of total billed charges,,,2599.56,83,,percent of total billed charges,,,939.6,83,,percent of total billed charges,,400.9,,,,fee schedule,,400.9,,,,fee schedule,,,2599.56,83,,percent of total billed charges,,989.81,,,,fee schedule,,,2818.8,90,,percent of total billed charges,,,2818.8,90,,percent of total billed charges,,,2818.8,90,,percent of total billed charges,,,2818.8,90,,percent of total billed charges,,,2662.2,85,,percent of total billed charges,,400.9,2975.4,
TREAT RADIUS FRACTURE,24665P,CDM,24665,CPT,,,both,P,2890,2890,1144.68,,,,fee schedule,,,,,,,,400.9,,,,fee schedule,,,2456.5,85,,percent of total billed charges,,1429.71,,,,fee schedule,,690.68,,,,fee schedule,,400.9,,,,fee schedule,,1128.78,,,,fee schedule,,400.9,,,,fee schedule,,1111.01,,,,fee schedule,,673.34,,,,fee schedule,,673.34,,,,fee schedule,,,2629.9,91,,percent of total billed charges,,,2745.5,95,,percent of total billed charges,,,2398.7,83,,percent of total billed charges,,,867,83,,percent of total billed charges,,400.9,,,,fee schedule,,400.9,,,,fee schedule,,,2398.7,83,,percent of total billed charges,,989.81,,,,fee schedule,,,2601,90,,percent of total billed charges,,,2601,90,,percent of total billed charges,,,2601,90,,percent of total billed charges,,,2601,90,,percent of total billed charges,,,2456.5,85,,percent of total billed charges,,400.9,2745.5,
TREAT RADIUS FRACTURE,24665T,CDM,24665,CPT,,,both,T,242,242,1144.68,,,,fee schedule,,,,,,,,400.9,,,,fee schedule,,,205.7,85,,percent of total billed charges,,1429.71,,,,fee schedule,,690.68,,,,fee schedule,,400.9,,,,fee schedule,,1128.78,,,,fee schedule,,400.9,,,,fee schedule,,1111.01,,,,fee schedule,,673.34,,,,fee schedule,,673.34,,,,fee schedule,,,220.22,91,,percent of total billed charges,,,229.9,95,,percent of total billed charges,,,200.86,83,,percent of total billed charges,,,72.6,83,,percent of total billed charges,,400.9,,,,fee schedule,,400.9,,,,fee schedule,,,200.86,83,,percent of total billed charges,,989.81,,,,fee schedule,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,205.7,85,,percent of total billed charges,,72.6,1429.71,
TREAT RADIUS FRACTURE,24666,CDM,24666,CPT,,,both,,3604,3604,1273.72,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,3063.4,85,,percent of total billed charges,,1594.8,,,,fee schedule,,770.43,,,,fee schedule,,449.5,,,,fee schedule,,1269.38,,,,fee schedule,,449.5,,,,fee schedule,,1236.26,,,,fee schedule,,749.25,,,,fee schedule,,749.25,,,,fee schedule,,,3279.64,91,,percent of total billed charges,,,3423.8,95,,percent of total billed charges,,,2991.32,83,,percent of total billed charges,,,1081.2,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,2991.32,83,,percent of total billed charges,,1101.39,,,,fee schedule,,,3243.6,90,,percent of total billed charges,,,3243.6,90,,percent of total billed charges,,,3243.6,90,,percent of total billed charges,,,3243.6,90,,percent of total billed charges,,,3063.4,85,,percent of total billed charges,,449.5,3423.8,
TREAT RADIUS FRACTURE,24666P,CDM,24666,CPT,,,both,P,3349,3349,1273.72,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,2846.65,85,,percent of total billed charges,,1594.8,,,,fee schedule,,770.43,,,,fee schedule,,449.5,,,,fee schedule,,1269.38,,,,fee schedule,,449.5,,,,fee schedule,,1236.26,,,,fee schedule,,749.25,,,,fee schedule,,749.25,,,,fee schedule,,,3047.59,91,,percent of total billed charges,,,3181.55,95,,percent of total billed charges,,,2779.67,83,,percent of total billed charges,,,1004.7,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,2779.67,83,,percent of total billed charges,,1101.39,,,,fee schedule,,,3014.1,90,,percent of total billed charges,,,3014.1,90,,percent of total billed charges,,,3014.1,90,,percent of total billed charges,,,3014.1,90,,percent of total billed charges,,,2846.65,85,,percent of total billed charges,,449.5,3181.55,
TREAT RADIUS FRACTURE,24666T,CDM,24666,CPT,,,both,T,255,255,1273.72,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,216.75,85,,percent of total billed charges,,1594.8,,,,fee schedule,,770.43,,,,fee schedule,,449.5,,,,fee schedule,,1269.38,,,,fee schedule,,449.5,,,,fee schedule,,1236.26,,,,fee schedule,,749.25,,,,fee schedule,,749.25,,,,fee schedule,,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,76.5,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,211.65,83,,percent of total billed charges,,1101.39,,,,fee schedule,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,76.5,1594.8,
TREAT ULNAR FRACTURE,24670,CDM,24670,CPT,,,both,,1197,1197,475.84,,,,fee schedule,,,,,,,,181.65,,,,fee schedule,,,1017.45,85,,percent of total billed charges,,580.68,,,,fee schedule,,280.52,,,,fee schedule,,181.65,,,,fee schedule,,397.92,,,,fee schedule,,181.65,,,,fee schedule,,461.85,,,,fee schedule,,279.91,,,,fee schedule,,279.91,,,,fee schedule,,,1089.27,91,,percent of total billed charges,,,1137.15,95,,percent of total billed charges,,,993.51,83,,percent of total billed charges,,,359.1,83,,percent of total billed charges,,181.65,,,,fee schedule,,181.65,,,,fee schedule,,,993.51,83,,percent of total billed charges,,411.47,,,,fee schedule,,,1077.3,90,,percent of total billed charges,,,1077.3,90,,percent of total billed charges,,,1077.3,90,,percent of total billed charges,,,1077.3,90,,percent of total billed charges,,,1017.45,85,,percent of total billed charges,,181.65,1137.15,
TREAT ULNAR FRACTURE,24670P,CDM,24670,CPT,,,both,P,1012,1012,475.84,,,,fee schedule,,,,,,,,181.65,,,,fee schedule,,,860.2,85,,percent of total billed charges,,580.68,,,,fee schedule,,280.52,,,,fee schedule,,181.65,,,,fee schedule,,397.92,,,,fee schedule,,181.65,,,,fee schedule,,461.85,,,,fee schedule,,279.91,,,,fee schedule,,279.91,,,,fee schedule,,,920.92,91,,percent of total billed charges,,,961.4,95,,percent of total billed charges,,,839.96,83,,percent of total billed charges,,,303.6,83,,percent of total billed charges,,181.65,,,,fee schedule,,181.65,,,,fee schedule,,,839.96,83,,percent of total billed charges,,411.47,,,,fee schedule,,,910.8,90,,percent of total billed charges,,,910.8,90,,percent of total billed charges,,,910.8,90,,percent of total billed charges,,,910.8,90,,percent of total billed charges,,,860.2,85,,percent of total billed charges,,181.65,961.4,
TREAT ULNAR FRACTURE,24670T,CDM,24670,CPT,,,both,T,185,185,475.84,,,,fee schedule,,,,,,,,181.65,,,,fee schedule,,,157.25,85,,percent of total billed charges,,580.68,,,,fee schedule,,280.52,,,,fee schedule,,181.65,,,,fee schedule,,397.92,,,,fee schedule,,181.65,,,,fee schedule,,461.85,,,,fee schedule,,279.91,,,,fee schedule,,279.91,,,,fee schedule,,,168.35,91,,percent of total billed charges,,,175.75,95,,percent of total billed charges,,,153.55,83,,percent of total billed charges,,,55.5,83,,percent of total billed charges,,181.65,,,,fee schedule,,181.65,,,,fee schedule,,,153.55,83,,percent of total billed charges,,411.47,,,,fee schedule,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,157.25,85,,percent of total billed charges,,55.5,580.68,
TREAT ULNAR FRACTURE,24675,CDM,24675,CPT,,,both,,1944,1944,736.23,,,,fee schedule,,,,,,,,206.7,,,,fee schedule,,,1652.4,85,,percent of total billed charges,,917.92,,,,fee schedule,,443.43,,,,fee schedule,,206.7,,,,fee schedule,,693.05,,,,fee schedule,,206.7,,,,fee schedule,,714.58,,,,fee schedule,,433.08,,,,fee schedule,,433.08,,,,fee schedule,,,1769.04,91,,percent of total billed charges,,,1846.8,95,,percent of total billed charges,,,1613.52,83,,percent of total billed charges,,,583.2,83,,percent of total billed charges,,206.7,,,,fee schedule,,206.7,,,,fee schedule,,,1613.52,83,,percent of total billed charges,,636.63,,,,fee schedule,,,1749.6,90,,percent of total billed charges,,,1749.6,90,,percent of total billed charges,,,1749.6,90,,percent of total billed charges,,,1749.6,90,,percent of total billed charges,,,1652.4,85,,percent of total billed charges,,206.7,1846.8,
TREAT ULNAR FRACTURE,24675P,CDM,24675,CPT,,,both,P,1737,1737,736.23,,,,fee schedule,,,,,,,,206.7,,,,fee schedule,,,1476.45,85,,percent of total billed charges,,917.92,,,,fee schedule,,443.43,,,,fee schedule,,206.7,,,,fee schedule,,693.05,,,,fee schedule,,206.7,,,,fee schedule,,714.58,,,,fee schedule,,433.08,,,,fee schedule,,433.08,,,,fee schedule,,,1580.67,91,,percent of total billed charges,,,1650.15,95,,percent of total billed charges,,,1441.71,83,,percent of total billed charges,,,521.1,83,,percent of total billed charges,,206.7,,,,fee schedule,,206.7,,,,fee schedule,,,1441.71,83,,percent of total billed charges,,636.63,,,,fee schedule,,,1563.3,90,,percent of total billed charges,,,1563.3,90,,percent of total billed charges,,,1563.3,90,,percent of total billed charges,,,1563.3,90,,percent of total billed charges,,,1476.45,85,,percent of total billed charges,,206.7,1650.15,
TREAT ULNAR FRACTURE,24675T,CDM,24675,CPT,,,both,T,207,207,736.23,,,,fee schedule,,,,,,,,206.7,,,,fee schedule,,,175.95,85,,percent of total billed charges,,917.92,,,,fee schedule,,443.43,,,,fee schedule,,206.7,,,,fee schedule,,693.05,,,,fee schedule,,206.7,,,,fee schedule,,714.58,,,,fee schedule,,433.08,,,,fee schedule,,433.08,,,,fee schedule,,,188.37,91,,percent of total billed charges,,,196.65,95,,percent of total billed charges,,,171.81,83,,percent of total billed charges,,,62.1,83,,percent of total billed charges,,206.7,,,,fee schedule,,206.7,,,,fee schedule,,,171.81,83,,percent of total billed charges,,636.63,,,,fee schedule,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,186.3,90,,percent of total billed charges,,,175.95,85,,percent of total billed charges,,62.1,917.92,
TREAT ULNAR FRACTURE,24685,CDM,24685,CPT,,,both,,3268,3268,1138.34,,,,fee schedule,,,,,,,,556.35,,,,fee schedule,,,2777.8,85,,percent of total billed charges,,1421.29,,,,fee schedule,,686.61,,,,fee schedule,,556.35,,,,fee schedule,,1181.17,,,,fee schedule,,556.35,,,,fee schedule,,1104.86,,,,fee schedule,,669.61,,,,fee schedule,,669.61,,,,fee schedule,,,2973.88,91,,percent of total billed charges,,,3104.6,95,,percent of total billed charges,,,2712.44,83,,percent of total billed charges,,,980.4,83,,percent of total billed charges,,556.35,,,,fee schedule,,556.35,,,,fee schedule,,,2712.44,83,,percent of total billed charges,,984.33,,,,fee schedule,,,2941.2,90,,percent of total billed charges,,,2941.2,90,,percent of total billed charges,,,2941.2,90,,percent of total billed charges,,,2941.2,90,,percent of total billed charges,,,2777.8,85,,percent of total billed charges,,556.35,3104.6,
TREAT ULNAR FRACTURE,24685P,CDM,24685,CPT,,,both,P,3022,3022,1138.34,,,,fee schedule,,,,,,,,556.35,,,,fee schedule,,,2568.7,85,,percent of total billed charges,,1421.29,,,,fee schedule,,686.61,,,,fee schedule,,556.35,,,,fee schedule,,1181.17,,,,fee schedule,,556.35,,,,fee schedule,,1104.86,,,,fee schedule,,669.61,,,,fee schedule,,669.61,,,,fee schedule,,,2750.02,91,,percent of total billed charges,,,2870.9,95,,percent of total billed charges,,,2508.26,83,,percent of total billed charges,,,906.6,83,,percent of total billed charges,,556.35,,,,fee schedule,,556.35,,,,fee schedule,,,2508.26,83,,percent of total billed charges,,984.33,,,,fee schedule,,,2719.8,90,,percent of total billed charges,,,2719.8,90,,percent of total billed charges,,,2719.8,90,,percent of total billed charges,,,2719.8,90,,percent of total billed charges,,,2568.7,85,,percent of total billed charges,,556.35,2870.9,
TREAT ULNAR FRACTURE,24685T,CDM,24685,CPT,,,both,T,246,246,1138.34,,,,fee schedule,,,,,,,,556.35,,,,fee schedule,,,209.1,85,,percent of total billed charges,,1421.29,,,,fee schedule,,686.61,,,,fee schedule,,556.35,,,,fee schedule,,1181.17,,,,fee schedule,,556.35,,,,fee schedule,,1104.86,,,,fee schedule,,669.61,,,,fee schedule,,669.61,,,,fee schedule,,,223.86,91,,percent of total billed charges,,,233.7,95,,percent of total billed charges,,,204.18,83,,percent of total billed charges,,,73.8,83,,percent of total billed charges,,556.35,,,,fee schedule,,556.35,,,,fee schedule,,,204.18,83,,percent of total billed charges,,984.33,,,,fee schedule,,,221.4,90,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,209.1,85,,percent of total billed charges,,73.8,1421.29,
INCISION OF TENDON SHEATH,25000,CDM,25000,CPT,,,both,,2066,2066,606.61,,,,fee schedule,,,,,,,,351,,,,fee schedule,,,1756.1,85,,percent of total billed charges,,741.32,,,,fee schedule,,358.12,,,,fee schedule,,351,,,,fee schedule,,714.27,,,,fee schedule,,351,,,,fee schedule,,588.77,,,,fee schedule,,356.83,,,,fee schedule,,356.83,,,,fee schedule,,,1880.06,91,,percent of total billed charges,,,1962.7,95,,percent of total billed charges,,,1714.78,83,,percent of total billed charges,,,619.8,83,,percent of total billed charges,,351,,,,fee schedule,,351,,,,fee schedule,,,1714.78,83,,percent of total billed charges,,524.54,,,,fee schedule,,,1859.4,90,,percent of total billed charges,,,1859.4,90,,percent of total billed charges,,,1859.4,90,,percent of total billed charges,,,1859.4,90,,percent of total billed charges,,,1756.1,85,,percent of total billed charges,,351,1962.7,
DECOMPRESS FOREARM 1 SPACE,25020,CDM,25020,CPT,,,both,,3162,3162,1297.91,,,,fee schedule,,,,,,,,388.5,,,,fee schedule,,,2687.7,85,,percent of total billed charges,,1603.53,,,,fee schedule,,774.64,,,,fee schedule,,388.5,,,,fee schedule,,1087.66,,,,fee schedule,,388.5,,,,fee schedule,,1259.74,,,,fee schedule,,763.48,,,,fee schedule,,763.48,,,,fee schedule,,,2877.42,91,,percent of total billed charges,,,3003.9,95,,percent of total billed charges,,,2624.46,83,,percent of total billed charges,,,948.6,83,,percent of total billed charges,,388.5,,,,fee schedule,,388.5,,,,fee schedule,,,2624.46,83,,percent of total billed charges,,1122.31,,,,fee schedule,,,2845.8,90,,percent of total billed charges,,,2845.8,90,,percent of total billed charges,,,2845.8,90,,percent of total billed charges,,,2845.8,90,,percent of total billed charges,,,2687.7,85,,percent of total billed charges,,388.5,3003.9,
DECOMPRESS FOREARM 2 SPACES,25024,CDM,25024,CPT,,,both,,3190,3190,1343.42,,,,fee schedule,,,,,,,,458.2,,,,fee schedule,,,2711.5,85,,percent of total billed charges,,1707.51,,,,fee schedule,,824.88,,,,fee schedule,,458.2,,,,fee schedule,,1211.68,,,,fee schedule,,458.2,,,,fee schedule,,1303.91,,,,fee schedule,,790.25,,,,fee schedule,,790.25,,,,fee schedule,,,2902.9,91,,percent of total billed charges,,,3030.5,95,,percent of total billed charges,,,2647.7,83,,percent of total billed charges,,,957,83,,percent of total billed charges,,458.2,,,,fee schedule,,458.2,,,,fee schedule,,,2647.7,83,,percent of total billed charges,,1161.67,,,,fee schedule,,,2871,90,,percent of total billed charges,,,2871,90,,percent of total billed charges,,,2871,90,,percent of total billed charges,,,2871,90,,percent of total billed charges,,,2711.5,85,,percent of total billed charges,,458.2,3030.5,
DECOMPRESS FOREARM 2 SPACES,25025,CDM,25025,CPT,,,both,,5063,5063,2118.25,,,,fee schedule,,,,,,,,588.15,,,,fee schedule,,,4303.55,85,,percent of total billed charges,,2583.41,,,,fee schedule,,1248.01,,,,fee schedule,,588.15,,,,fee schedule,,1870.9,,,,fee schedule,,588.15,,,,fee schedule,,2055.95,,,,fee schedule,,1246.03,,,,fee schedule,,1246.03,,,,fee schedule,,,4607.33,91,,percent of total billed charges,,,4809.85,95,,percent of total billed charges,,,4202.29,83,,percent of total billed charges,,,1518.9,83,,percent of total billed charges,,588.15,,,,fee schedule,,588.15,,,,fee schedule,,,4202.29,83,,percent of total billed charges,,1831.67,,,,fee schedule,,,4556.7,90,,percent of total billed charges,,,4556.7,90,,percent of total billed charges,,,4556.7,90,,percent of total billed charges,,,4556.7,90,,percent of total billed charges,,,4303.55,85,,percent of total billed charges,,588.15,4809.85,
EXC FOREARM LES SC 3 CM/>,25071,CDM,25071,CPT,,,both,,2057,2057,735.66,,,,fee schedule,,,,,,,,236.7,,,,fee schedule,,,1748.45,85,,percent of total billed charges,,929.3,,,,fee schedule,,448.93,,,,fee schedule,,236.7,,,,fee schedule,,,,,,,,236.7,,,,fee schedule,,714.02,,,,fee schedule,,432.74,,,,fee schedule,,432.74,,,,fee schedule,,,1871.87,91,,percent of total billed charges,,,1954.15,95,,percent of total billed charges,,,1707.31,83,,percent of total billed charges,,,617.1,83,,percent of total billed charges,,236.7,,,,fee schedule,,236.7,,,,fee schedule,,,1707.31,83,,percent of total billed charges,,636.13,,,,fee schedule,,,1851.3,90,,percent of total billed charges,,,1851.3,90,,percent of total billed charges,,,1851.3,90,,percent of total billed charges,,,1851.3,90,,percent of total billed charges,,,1748.45,85,,percent of total billed charges,,236.7,1954.15,
REMOVAL FOREARM LESION SUBCU,25075,CDM,25075,CPT,,,both,,1738,1738,550.16,,,,fee schedule,,,,,,,,149.8,,,,fee schedule,,,1477.3,85,,percent of total billed charges,,640.24,,,,fee schedule,,330.86,,,,fee schedule,,149.8,,,,fee schedule,,671.83,,,,fee schedule,,149.8,,,,fee schedule,,533.98,,,,fee schedule,,323.62,,,,fee schedule,,323.62,,,,fee schedule,,,1581.58,91,,percent of total billed charges,,,1651.1,95,,percent of total billed charges,,,1442.54,83,,percent of total billed charges,,,521.4,83,,percent of total billed charges,,149.8,,,,fee schedule,,149.8,,,,fee schedule,,,1442.54,83,,percent of total billed charges,,475.73,,,,fee schedule,,,1564.2,90,,percent of total billed charges,,,1564.2,90,,percent of total billed charges,,,1564.2,90,,percent of total billed charges,,,1564.2,90,,percent of total billed charges,,,1477.3,85,,percent of total billed charges,,149.8,1651.1,
EXPLORE/TREAT WRIST JOINT,25101,CDM,25101,CPT,,,both,,2353,2353,708.58,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,2000.05,85,,percent of total billed charges,,879.24,,,,fee schedule,,424.75,,,,fee schedule,,480,,,,fee schedule,,750.75,,,,fee schedule,,480,,,,fee schedule,,687.74,,,,fee schedule,,416.81,,,,fee schedule,,416.81,,,,fee schedule,,,2141.23,91,,percent of total billed charges,,,2235.35,95,,percent of total billed charges,,,1952.99,83,,percent of total billed charges,,,705.9,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,1952.99,83,,percent of total billed charges,,612.71,,,,fee schedule,,,2117.7,90,,percent of total billed charges,,,2117.7,90,,percent of total billed charges,,,2117.7,90,,percent of total billed charges,,,2117.7,90,,percent of total billed charges,,,2000.05,85,,percent of total billed charges,,416.81,2235.35,
REMOVE WRIST JOINT LINING,25105,CDM,25105,CPT,,,both,,2882,2882,853.18,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,2449.7,85,,percent of total billed charges,,1055.58,,,,fee schedule,,509.94,,,,fee schedule,,480,,,,fee schedule,,931.8,,,,fee schedule,,480,,,,fee schedule,,828.08,,,,fee schedule,,501.87,,,,fee schedule,,501.87,,,,fee schedule,,,2622.62,91,,percent of total billed charges,,,2737.9,95,,percent of total billed charges,,,2392.06,83,,percent of total billed charges,,,864.6,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2392.06,83,,percent of total billed charges,,737.75,,,,fee schedule,,,2593.8,90,,percent of total billed charges,,,2593.8,90,,percent of total billed charges,,,2593.8,90,,percent of total billed charges,,,2593.8,90,,percent of total billed charges,,,2449.7,85,,percent of total billed charges,,480,2737.9,
EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY,25111,CDM,25111,CPT,,,both,,1501,1501,569.75,,,,fee schedule,,,,,,,,214,,,,fee schedule,,,1275.85,85,,percent of total billed charges,,698.78,,,,fee schedule,,337.57,,,,fee schedule,,214,,,,fee schedule,,570.36,,,,fee schedule,,214,,,,fee schedule,,552.99,,,,fee schedule,,335.14,,,,fee schedule,,335.14,,,,fee schedule,,,1365.91,91,,percent of total billed charges,,,1425.95,95,,percent of total billed charges,,,1245.83,83,,percent of total billed charges,,,450.3,83,,percent of total billed charges,,214,,,,fee schedule,,214,,,,fee schedule,,,1245.83,83,,percent of total billed charges,,492.66,,,,fee schedule,,,1350.9,90,,percent of total billed charges,,,1350.9,90,,percent of total billed charges,,,1350.9,90,,percent of total billed charges,,,1350.9,90,,percent of total billed charges,,,1275.85,85,,percent of total billed charges,,214,1425.95,
REREMOVE WRIST TENDON LESION,25112,CDM,25112,CPT,,,both,,2182,2182,683.81,,,,fee schedule,,,,,,,,214,,,,fee schedule,,,1854.7,85,,percent of total billed charges,,845.7,,,,fee schedule,,408.55,,,,fee schedule,,214,,,,fee schedule,,694.38,,,,fee schedule,,214,,,,fee schedule,,663.7,,,,fee schedule,,402.24,,,,fee schedule,,402.24,,,,fee schedule,,,1985.62,91,,percent of total billed charges,,,2072.9,95,,percent of total billed charges,,,1811.06,83,,percent of total billed charges,,,654.6,83,,percent of total billed charges,,214,,,,fee schedule,,214,,,,fee schedule,,,1811.06,83,,percent of total billed charges,,591.29,,,,fee schedule,,,1963.8,90,,percent of total billed charges,,,1963.8,90,,percent of total billed charges,,,1963.8,90,,percent of total billed charges,,,1963.8,90,,percent of total billed charges,,,1854.7,85,,percent of total billed charges,,214,2072.9,
REMOVE WRIST/FOREARM LESION,25115,CDM,25115,CPT,,,both,,4528,4528,1315.77,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3848.8,85,,percent of total billed charges,,1638.75,,,,fee schedule,,791.66,,,,fee schedule,,599.35,,,,fee schedule,,1600.98,,,,fee schedule,,599.35,,,,fee schedule,,1277.07,,,,fee schedule,,773.98,,,,fee schedule,,773.98,,,,fee schedule,,,4120.48,91,,percent of total billed charges,,,4301.6,95,,percent of total billed charges,,,3758.24,83,,percent of total billed charges,,,1358.4,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3758.24,83,,percent of total billed charges,,1137.76,,,,fee schedule,,,4075.2,90,,percent of total billed charges,,,4075.2,90,,percent of total billed charges,,,4075.2,90,,percent of total billed charges,,,4075.2,90,,percent of total billed charges,,,3848.8,85,,percent of total billed charges,,599.35,4301.6,
REMOVE WRIST/FOREARM LESION,25116,CDM,25116,CPT,,,both,,3885,3885,1053.08,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3302.25,85,,percent of total billed charges,,1306.03,,,,fee schedule,,630.93,,,,fee schedule,,599.35,,,,fee schedule,,1415.28,,,,fee schedule,,599.35,,,,fee schedule,,1022.11,,,,fee schedule,,619.46,,,,fee schedule,,619.46,,,,fee schedule,,,3535.35,91,,percent of total billed charges,,,3690.75,95,,percent of total billed charges,,,3224.55,83,,percent of total billed charges,,,1165.5,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3224.55,83,,percent of total billed charges,,910.6,,,,fee schedule,,,3496.5,90,,percent of total billed charges,,,3496.5,90,,percent of total billed charges,,,3496.5,90,,percent of total billed charges,,,3496.5,90,,percent of total billed charges,,,3302.25,85,,percent of total billed charges,,599.35,3690.75,
EXCISE WRIST TENDON SHEATH,25118,CDM,25118,CPT,,,both,,2505,2505,670.56,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,2129.25,85,,percent of total billed charges,,828.59,,,,fee schedule,,400.28,,,,fee schedule,,480,,,,fee schedule,,714.94,,,,fee schedule,,480,,,,fee schedule,,650.84,,,,fee schedule,,394.45,,,,fee schedule,,394.45,,,,fee schedule,,,2279.55,91,,percent of total billed charges,,,2379.75,95,,percent of total billed charges,,,2079.15,83,,percent of total billed charges,,,751.5,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2079.15,83,,percent of total billed charges,,579.84,,,,fee schedule,,,2254.5,90,,percent of total billed charges,,,2254.5,90,,percent of total billed charges,,,2254.5,90,,percent of total billed charges,,,2254.5,90,,percent of total billed charges,,,2129.25,85,,percent of total billed charges,,394.45,2379.75,
REMOVE/GRAFT FOREARM LESION,25125,CDM,25125,CPT,,,both,,3031,3031,1039.25,,,,fee schedule,,,,,,,,674.2,,,,fee schedule,,,2576.35,85,,percent of total billed charges,,1298.57,,,,fee schedule,,627.32,,,,fee schedule,,674.2,,,,fee schedule,,1417.27,,,,fee schedule,,674.2,,,,fee schedule,,1008.69,,,,fee schedule,,611.33,,,,fee schedule,,611.33,,,,fee schedule,,,2758.21,91,,percent of total billed charges,,,2879.45,95,,percent of total billed charges,,,2515.73,83,,percent of total billed charges,,,909.3,83,,percent of total billed charges,,674.2,,,,fee schedule,,674.2,,,,fee schedule,,,2515.73,83,,percent of total billed charges,,898.65,,,,fee schedule,,,2727.9,90,,percent of total billed charges,,,2727.9,90,,percent of total billed charges,,,2727.9,90,,percent of total billed charges,,,2727.9,90,,percent of total billed charges,,,2576.35,85,,percent of total billed charges,,611.33,2879.45,
REMOVAL OF WRIST LESION,25130,CDM,25130,CPT,,,both,,2702,2702,789.81,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,2296.7,85,,percent of total billed charges,,977.23,,,,fee schedule,,472.09,,,,fee schedule,,299.7,,,,fee schedule,,827.02,,,,fee schedule,,299.7,,,,fee schedule,,766.58,,,,fee schedule,,464.59,,,,fee schedule,,464.59,,,,fee schedule,,,2458.82,91,,percent of total billed charges,,,2566.9,95,,percent of total billed charges,,,2242.66,83,,percent of total billed charges,,,810.6,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,2242.66,83,,percent of total billed charges,,682.95,,,,fee schedule,,,2431.8,90,,percent of total billed charges,,,2431.8,90,,percent of total billed charges,,,2431.8,90,,percent of total billed charges,,,2431.8,90,,percent of total billed charges,,,2296.7,85,,percent of total billed charges,,299.7,2566.9,
REMOVE FOREARM BONE LESION,25145,CDM,25145,CPT,,,both,,2946,2946,910.79,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,2504.1,85,,percent of total billed charges,,1135.97,,,,fee schedule,,548.77,,,,fee schedule,,359.3,,,,fee schedule,,1287.95,,,,fee schedule,,359.3,,,,fee schedule,,884,,,,fee schedule,,535.76,,,,fee schedule,,535.76,,,,fee schedule,,,2680.86,91,,percent of total billed charges,,,2798.7,95,,percent of total billed charges,,,2445.18,83,,percent of total billed charges,,,883.8,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,2445.18,83,,percent of total billed charges,,787.56,,,,fee schedule,,,2651.4,90,,percent of total billed charges,,,2651.4,90,,percent of total billed charges,,,2651.4,90,,percent of total billed charges,,,2651.4,90,,percent of total billed charges,,,2504.1,85,,percent of total billed charges,,359.3,2798.7,
PARTIAL REMOVAL OF ULNA,25150,CDM,25150,CPT,,,both,,3213,3213,989.71,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,2731.05,85,,percent of total billed charges,,1236.36,,,,fee schedule,,597.27,,,,fee schedule,,359.3,,,,fee schedule,,1090.31,,,,fee schedule,,359.3,,,,fee schedule,,960.6,,,,fee schedule,,582.18,,,,fee schedule,,582.18,,,,fee schedule,,,2923.83,91,,percent of total billed charges,,,3052.35,95,,percent of total billed charges,,,2666.79,83,,percent of total billed charges,,,963.9,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,2666.79,83,,percent of total billed charges,,855.81,,,,fee schedule,,,2891.7,90,,percent of total billed charges,,,2891.7,90,,percent of total billed charges,,,2891.7,90,,percent of total billed charges,,,2891.7,90,,percent of total billed charges,,,2731.05,85,,percent of total billed charges,,359.3,3052.35,
REMOVE FOREARM FOREIGN BODY,25248,CDM,25248,CPT,,,both,,2485,2485,725.86,,,,fee schedule,,,,,,,,181.25,,,,fee schedule,,,2112.25,85,,percent of total billed charges,,915.54,,,,fee schedule,,442.29,,,,fee schedule,,181.25,,,,fee schedule,,951.04,,,,fee schedule,,181.25,,,,fee schedule,,704.51,,,,fee schedule,,426.98,,,,fee schedule,,426.98,,,,fee schedule,,,2261.35,91,,percent of total billed charges,,,2360.75,95,,percent of total billed charges,,,2062.55,83,,percent of total billed charges,,,745.5,83,,percent of total billed charges,,181.25,,,,fee schedule,,181.25,,,,fee schedule,,,2062.55,83,,percent of total billed charges,,627.66,,,,fee schedule,,,2236.5,90,,percent of total billed charges,,,2236.5,90,,percent of total billed charges,,,2236.5,90,,percent of total billed charges,,,2236.5,90,,percent of total billed charges,,,2112.25,85,,percent of total billed charges,,181.25,2360.75,
REPAIR FOREARM TENDON/MUSCLE,25260,CDM,25260,CPT,,,both,,3729,3729,1108.38,,,,fee schedule,,,,,,,,283.5,,,,fee schedule,,,3169.65,85,,percent of total billed charges,,1377.09,,,,fee schedule,,665.25,,,,fee schedule,,283.5,,,,fee schedule,,1476.96,,,,fee schedule,,283.5,,,,fee schedule,,1075.78,,,,fee schedule,,651.99,,,,fee schedule,,651.99,,,,fee schedule,,,3393.39,91,,percent of total billed charges,,,3542.55,95,,percent of total billed charges,,,3095.07,83,,percent of total billed charges,,,1118.7,83,,percent of total billed charges,,283.5,,,,fee schedule,,283.5,,,,fee schedule,,,3095.07,83,,percent of total billed charges,,958.42,,,,fee schedule,,,3356.1,90,,percent of total billed charges,,,3356.1,90,,percent of total billed charges,,,3356.1,90,,percent of total billed charges,,,3356.1,90,,percent of total billed charges,,,3169.65,85,,percent of total billed charges,,283.5,3542.55,
REPAIR FOREARM TENDON/MUSCLE,25270,CDM,25270,CPT,,,both,,3122,3122,864.12,,,,fee schedule,,,,,,,,2952.4,,,,fee schedule,,,2653.7,85,,percent of total billed charges,,1072.43,,,,fee schedule,,518.08,,,,fee schedule,,2952.4,,,,fee schedule,,1256.78,,,,fee schedule,,2952.4,,,,fee schedule,,838.71,,,,fee schedule,,508.31,,,,fee schedule,,508.31,,,,fee schedule,,,2841.02,91,,percent of total billed charges,,,2965.9,95,,percent of total billed charges,,,2591.26,83,,percent of total billed charges,,,936.6,83,,percent of total billed charges,,2952.4,,,,fee schedule,,2952.4,,,,fee schedule,,,2591.26,83,,percent of total billed charges,,747.21,,,,fee schedule,,,2809.8,90,,percent of total billed charges,,,2809.8,90,,percent of total billed charges,,,2809.8,90,,percent of total billed charges,,,2809.8,90,,percent of total billed charges,,,2653.7,85,,percent of total billed charges,,508.31,2965.9,
REPAIR FOREARM TENDON/MUSCLE,25274,CDM,25274,CPT,,,both,,3818,3818,1159.08,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,3245.3,85,,percent of total billed charges,,1446.05,,,,fee schedule,,698.57,,,,fee schedule,,359.3,,,,fee schedule,,1571.8,,,,fee schedule,,359.3,,,,fee schedule,,1124.99,,,,fee schedule,,681.81,,,,fee schedule,,681.81,,,,fee schedule,,,3474.38,91,,percent of total billed charges,,,3627.1,95,,percent of total billed charges,,,3168.94,83,,percent of total billed charges,,,1145.4,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,3168.94,83,,percent of total billed charges,,1002.26,,,,fee schedule,,,3436.2,90,,percent of total billed charges,,,3436.2,90,,percent of total billed charges,,,3436.2,90,,percent of total billed charges,,,3436.2,90,,percent of total billed charges,,,3245.3,85,,percent of total billed charges,,359.3,3627.1,
RELEASE WRIST/FOREARM TENDON,25295,CDM,25295,CPT,,,both,,3241,3241,921.16,,,,fee schedule,,,,,,,,277.5,,,,fee schedule,,,2754.85,85,,percent of total billed charges,,1144.91,,,,fee schedule,,553.09,,,,fee schedule,,277.5,,,,fee schedule,,1305.85,,,,fee schedule,,277.5,,,,fee schedule,,894.06,,,,fee schedule,,541.86,,,,fee schedule,,541.86,,,,fee schedule,,,2949.31,91,,percent of total billed charges,,,3078.95,95,,percent of total billed charges,,,2690.03,83,,percent of total billed charges,,,972.3,83,,percent of total billed charges,,277.5,,,,fee schedule,,277.5,,,,fee schedule,,,2690.03,83,,percent of total billed charges,,796.53,,,,fee schedule,,,2916.9,90,,percent of total billed charges,,,2916.9,90,,percent of total billed charges,,,2916.9,90,,percent of total billed charges,,,2916.9,90,,percent of total billed charges,,,2754.85,85,,percent of total billed charges,,277.5,3078.95,
TRANSPLANT FOREARM TENDON,25310,CDM,25310,CPT,,,both,,4259,4259,1083.61,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3620.15,85,,percent of total billed charges,,1346.65,,,,fee schedule,,650.55,,,,fee schedule,,480,,,,fee schedule,,1483.59,,,,fee schedule,,480,,,,fee schedule,,1051.74,,,,fee schedule,,637.42,,,,fee schedule,,637.42,,,,fee schedule,,,3875.69,91,,percent of total billed charges,,,4046.05,95,,percent of total billed charges,,,3534.97,83,,percent of total billed charges,,,1277.7,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3534.97,83,,percent of total billed charges,,937,,,,fee schedule,,,3833.1,90,,percent of total billed charges,,,3833.1,90,,percent of total billed charges,,,3833.1,90,,percent of total billed charges,,,3833.1,90,,percent of total billed charges,,,3620.15,85,,percent of total billed charges,,480,4046.05,
TRANSPLANT FOREARM TENDON,25312,CDM,25312,CPT,,,both,,3536,3536,1248.37,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,3005.6,85,,percent of total billed charges,,1558.31,,,,fee schedule,,752.8,,,,fee schedule,,524.4,,,,fee schedule,,1652.05,,,,fee schedule,,524.4,,,,fee schedule,,1211.65,,,,fee schedule,,734.34,,,,fee schedule,,734.34,,,,fee schedule,,,3217.76,91,,percent of total billed charges,,,3359.2,95,,percent of total billed charges,,,2934.88,83,,percent of total billed charges,,,1060.8,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,2934.88,83,,percent of total billed charges,,1079.47,,,,fee schedule,,,3182.4,90,,percent of total billed charges,,,3182.4,90,,percent of total billed charges,,,3182.4,90,,percent of total billed charges,,,3182.4,90,,percent of total billed charges,,,3005.6,85,,percent of total billed charges,,524.4,3359.2,
REPAIR/REVISE WRIST JOINT,25320,CDM,25320,CPT,,,both,,5181,5181,1715,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,4403.85,85,,percent of total billed charges,,2130.11,,,,fee schedule,,1029.03,,,,fee schedule,,449.5,,,,fee schedule,,1573.13,,,,fee schedule,,449.5,,,,fee schedule,,1664.56,,,,fee schedule,,1008.82,,,,fee schedule,,1008.82,,,,fee schedule,,,4714.71,91,,percent of total billed charges,,,4921.95,95,,percent of total billed charges,,,4300.23,83,,percent of total billed charges,,,1554.3,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,4300.23,83,,percent of total billed charges,,1482.97,,,,fee schedule,,,4662.9,90,,percent of total billed charges,,,4662.9,90,,percent of total billed charges,,,4662.9,90,,percent of total billed charges,,,4662.9,90,,percent of total billed charges,,,4403.85,85,,percent of total billed charges,,449.5,4921.95,
REVISION OF RADIUS,25355,CDM,25355,CPT,,,both,,3922,3922,1328.45,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3333.7,85,,percent of total billed charges,,1672.96,,,,fee schedule,,808.19,,,,fee schedule,,480,,,,fee schedule,,1756.17,,,,fee schedule,,480,,,,fee schedule,,1289.37,,,,fee schedule,,781.44,,,,fee schedule,,781.44,,,,fee schedule,,,3569.02,91,,percent of total billed charges,,,3725.9,95,,percent of total billed charges,,,3255.26,83,,percent of total billed charges,,,1176.6,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3255.26,83,,percent of total billed charges,,1148.72,,,,fee schedule,,,3529.8,90,,percent of total billed charges,,,3529.8,90,,percent of total billed charges,,,3529.8,90,,percent of total billed charges,,,3529.8,90,,percent of total billed charges,,,3333.7,85,,percent of total billed charges,,480,3725.9,
REPAIR/GRAFT RADIUS OR ULNA,25405,CDM,25405,CPT,,,both,,5774,5774,1792.77,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,4907.9,85,,percent of total billed charges,,2264.99,,,,fee schedule,,1094.19,,,,fee schedule,,599.35,,,,fee schedule,,2248.93,,,,fee schedule,,599.35,,,,fee schedule,,1740.04,,,,fee schedule,,1054.57,,,,fee schedule,,1054.57,,,,fee schedule,,,5254.34,91,,percent of total billed charges,,,5485.3,95,,percent of total billed charges,,,4792.42,83,,percent of total billed charges,,,1732.2,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,4792.42,83,,percent of total billed charges,,1550.22,,,,fee schedule,,,5196.6,90,,percent of total billed charges,,,5196.6,90,,percent of total billed charges,,,5196.6,90,,percent of total billed charges,,,5196.6,90,,percent of total billed charges,,,4907.9,85,,percent of total billed charges,,599.35,5485.3,
REPAIR WRIST JOINT(S),25447,CDM,25447,CPT,,,both,,4787,4787,1445.39,,,,fee schedule,,,,,,,,494.84,,,,fee schedule,,,4068.95,85,,percent of total billed charges,,1803.35,,,,fee schedule,,871.18,,,,fee schedule,,494.84,,,,fee schedule,,1365.54,,,,fee schedule,,494.84,,,,fee schedule,,1402.88,,,,fee schedule,,850.23,,,,fee schedule,,850.23,,,,fee schedule,,,4356.17,91,,percent of total billed charges,,,4547.65,95,,percent of total billed charges,,,3973.21,83,,percent of total billed charges,,,1436.1,83,,percent of total billed charges,,494.84,,,,fee schedule,,494.84,,,,fee schedule,,,3973.21,83,,percent of total billed charges,,1249.84,,,,fee schedule,,,4308.3,90,,percent of total billed charges,,,4308.3,90,,percent of total billed charges,,,4308.3,90,,percent of total billed charges,,,4308.3,90,,percent of total billed charges,,,4068.95,85,,percent of total billed charges,,494.84,4547.65,
TREAT FRACTURE OF RADIUS,25500,CDM,25500,CPT,,,both,,980,980,457.41,,,,fee schedule,,,,,,,,112.4,,,,fee schedule,,,833,85,,percent of total billed charges,,556.7,,,,fee schedule,,268.94,,,,fee schedule,,112.4,,,,fee schedule,,364.1,,,,fee schedule,,112.4,,,,fee schedule,,443.96,,,,fee schedule,,269.06,,,,fee schedule,,269.06,,,,fee schedule,,,891.8,91,,percent of total billed charges,,,931,95,,percent of total billed charges,,,813.4,83,,percent of total billed charges,,,294,83,,percent of total billed charges,,112.4,,,,fee schedule,,112.4,,,,fee schedule,,,813.4,83,,percent of total billed charges,,395.52,,,,fee schedule,,,882,90,,percent of total billed charges,,,882,90,,percent of total billed charges,,,882,90,,percent of total billed charges,,,882,90,,percent of total billed charges,,,833,85,,percent of total billed charges,,112.4,931,
TREAT FRACTURE OF RADIUS,25505,CDM,25505,CPT,,,both,,2007,2007,812.85,,,,fee schedule,,,,,,,,210.9,,,,fee schedule,,,1705.95,85,,percent of total billed charges,,999.91,,,,fee schedule,,483.05,,,,fee schedule,,210.9,,,,fee schedule,,758.04,,,,fee schedule,,210.9,,,,fee schedule,,788.94,,,,fee schedule,,478.15,,,,fee schedule,,478.15,,,,fee schedule,,,1826.37,91,,percent of total billed charges,,,1906.65,95,,percent of total billed charges,,,1665.81,83,,percent of total billed charges,,,602.1,83,,percent of total billed charges,,210.9,,,,fee schedule,,210.9,,,,fee schedule,,,1665.81,83,,percent of total billed charges,,702.88,,,,fee schedule,,,1806.3,90,,percent of total billed charges,,,1806.3,90,,percent of total billed charges,,,1806.3,90,,percent of total billed charges,,,1806.3,90,,percent of total billed charges,,,1705.95,85,,percent of total billed charges,,210.9,1906.65,
TREAT FRACTURE OF RADIUS,25505P,CDM,25505,CPT,,,both,P,1397,1397,812.85,,,,fee schedule,,,,,,,,210.9,,,,fee schedule,,,1187.45,85,,percent of total billed charges,,999.91,,,,fee schedule,,483.05,,,,fee schedule,,210.9,,,,fee schedule,,758.04,,,,fee schedule,,210.9,,,,fee schedule,,788.94,,,,fee schedule,,478.15,,,,fee schedule,,478.15,,,,fee schedule,,,1271.27,91,,percent of total billed charges,,,1327.15,95,,percent of total billed charges,,,1159.51,83,,percent of total billed charges,,,419.1,83,,percent of total billed charges,,210.9,,,,fee schedule,,210.9,,,,fee schedule,,,1159.51,83,,percent of total billed charges,,702.88,,,,fee schedule,,,1257.3,90,,percent of total billed charges,,,1257.3,90,,percent of total billed charges,,,1257.3,90,,percent of total billed charges,,,1257.3,90,,percent of total billed charges,,,1187.45,85,,percent of total billed charges,,210.9,1327.15,
TREAT FRACTURE OF RADIUS,25505T,CDM,25505,CPT,,,both,T,610,610,812.85,,,,fee schedule,,,,,,,,210.9,,,,fee schedule,,,518.5,85,,percent of total billed charges,,999.91,,,,fee schedule,,483.05,,,,fee schedule,,210.9,,,,fee schedule,,758.04,,,,fee schedule,,210.9,,,,fee schedule,,788.94,,,,fee schedule,,478.15,,,,fee schedule,,478.15,,,,fee schedule,,,555.1,91,,percent of total billed charges,,,579.5,95,,percent of total billed charges,,,506.3,83,,percent of total billed charges,,,183,83,,percent of total billed charges,,210.9,,,,fee schedule,,210.9,,,,fee schedule,,,506.3,83,,percent of total billed charges,,702.88,,,,fee schedule,,,549,90,,percent of total billed charges,,,549,90,,percent of total billed charges,,,549,90,,percent of total billed charges,,,549,90,,percent of total billed charges,,,518.5,85,,percent of total billed charges,,183,999.91,
TREAT FRACTURE OF RADIUS,25515,CDM,25515,CPT,,,both,,3092,3092,1166.57,,,,fee schedule,,,,,,,,554.9,,,,fee schedule,,,2628.2,85,,percent of total billed charges,,1457.49,,,,fee schedule,,704.1,,,,fee schedule,,554.9,,,,fee schedule,,1205.71,,,,fee schedule,,554.9,,,,fee schedule,,1132.26,,,,fee schedule,,686.22,,,,fee schedule,,686.22,,,,fee schedule,,,2813.72,91,,percent of total billed charges,,,2937.4,95,,percent of total billed charges,,,2566.36,83,,percent of total billed charges,,,927.6,83,,percent of total billed charges,,554.9,,,,fee schedule,,554.9,,,,fee schedule,,,2566.36,83,,percent of total billed charges,,1008.74,,,,fee schedule,,,2782.8,90,,percent of total billed charges,,,2782.8,90,,percent of total billed charges,,,2782.8,90,,percent of total billed charges,,,2782.8,90,,percent of total billed charges,,,2628.2,85,,percent of total billed charges,,554.9,2937.4,
TREAT FRACTURE OF RADIUS,25520,CDM,25520,CPT,,,both,,2302,2302,956.87,,,,fee schedule,,,,,,,,267.8,,,,fee schedule,,,1956.7,85,,percent of total billed charges,,1186.8,,,,fee schedule,,573.33,,,,fee schedule,,267.8,,,,fee schedule,,884.05,,,,fee schedule,,267.8,,,,fee schedule,,928.73,,,,fee schedule,,562.87,,,,fee schedule,,562.87,,,,fee schedule,,,2094.82,91,,percent of total billed charges,,,2186.9,95,,percent of total billed charges,,,1910.66,83,,percent of total billed charges,,,690.6,83,,percent of total billed charges,,267.8,,,,fee schedule,,267.8,,,,fee schedule,,,1910.66,83,,percent of total billed charges,,827.41,,,,fee schedule,,,2071.8,90,,percent of total billed charges,,,2071.8,90,,percent of total billed charges,,,2071.8,90,,percent of total billed charges,,,2071.8,90,,percent of total billed charges,,,1956.7,85,,percent of total billed charges,,267.8,2186.9,
TREAT FRACTURE OF RADIUS,25525,CDM,25525,CPT,,,both,,3797,3797,1375.11,,,,fee schedule,,,,,,,,443.95,,,,fee schedule,,,3227.45,85,,percent of total billed charges,,1715.53,,,,fee schedule,,828.75,,,,fee schedule,,443.95,,,,fee schedule,,1605.62,,,,fee schedule,,443.95,,,,fee schedule,,1334.66,,,,fee schedule,,808.89,,,,fee schedule,,808.89,,,,fee schedule,,,3455.27,91,,percent of total billed charges,,,3607.15,95,,percent of total billed charges,,,3151.51,83,,percent of total billed charges,,,1139.1,83,,percent of total billed charges,,443.95,,,,fee schedule,,443.95,,,,fee schedule,,,3151.51,83,,percent of total billed charges,,1189.06,,,,fee schedule,,,3417.3,90,,percent of total billed charges,,,3417.3,90,,percent of total billed charges,,,3417.3,90,,percent of total billed charges,,,3417.3,90,,percent of total billed charges,,,3227.45,85,,percent of total billed charges,,443.95,3607.15,
TREAT FRACTURE OF RADIUS,25526,CDM,25526,CPT,,,both,,5774,5774,1658.54,,,,fee schedule,,,,,,,,577.42,,,,fee schedule,,,4907.9,85,,percent of total billed charges,,2086.96,,,,fee schedule,,1008.19,,,,fee schedule,,577.42,,,,fee schedule,,1896.11,,,,fee schedule,,577.42,,,,fee schedule,,1609.76,,,,fee schedule,,975.61,,,,fee schedule,,975.61,,,,fee schedule,,,5254.34,91,,percent of total billed charges,,,5485.3,95,,percent of total billed charges,,,4792.42,83,,percent of total billed charges,,,1732.2,83,,percent of total billed charges,,577.42,,,,fee schedule,,577.42,,,,fee schedule,,,4792.42,83,,percent of total billed charges,,1434.15,,,,fee schedule,,,5196.6,90,,percent of total billed charges,,,5196.6,90,,percent of total billed charges,,,5196.6,90,,percent of total billed charges,,,5196.6,90,,percent of total billed charges,,,4907.9,85,,percent of total billed charges,,577.42,5485.3,
TREAT FRACTURE OF ULNA,25530,CDM,25530,CPT,,,both,,999,999,431.49,,,,fee schedule,,,,,,,,199.75,,,,fee schedule,,,849.15,85,,percent of total billed charges,,521.24,,,,fee schedule,,251.81,,,,fee schedule,,199.75,,,,fee schedule,,349.51,,,,fee schedule,,199.75,,,,fee schedule,,418.79,,,,fee schedule,,253.82,,,,fee schedule,,253.82,,,,fee schedule,,,909.09,91,,percent of total billed charges,,,949.05,95,,percent of total billed charges,,,829.17,83,,percent of total billed charges,,,299.7,83,,percent of total billed charges,,199.75,,,,fee schedule,,199.75,,,,fee schedule,,,829.17,83,,percent of total billed charges,,373.11,,,,fee schedule,,,899.1,90,,percent of total billed charges,,,899.1,90,,percent of total billed charges,,,899.1,90,,percent of total billed charges,,,899.1,90,,percent of total billed charges,,,849.15,85,,percent of total billed charges,,199.75,949.05,
TREAT FRACTURE OF ULNA,25530P,CDM,25530,CPT,,,both,P,681,681,431.49,,,,fee schedule,,,,,,,,199.75,,,,fee schedule,,,578.85,85,,percent of total billed charges,,521.24,,,,fee schedule,,251.81,,,,fee schedule,,199.75,,,,fee schedule,,349.51,,,,fee schedule,,199.75,,,,fee schedule,,418.79,,,,fee schedule,,253.82,,,,fee schedule,,253.82,,,,fee schedule,,,619.71,91,,percent of total billed charges,,,646.95,95,,percent of total billed charges,,,565.23,83,,percent of total billed charges,,,204.3,83,,percent of total billed charges,,199.75,,,,fee schedule,,199.75,,,,fee schedule,,,565.23,83,,percent of total billed charges,,373.11,,,,fee schedule,,,612.9,90,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,578.85,85,,percent of total billed charges,,199.75,646.95,
TREAT FRACTURE OF ULNA,25530T,CDM,25530,CPT,,,both,T,318,318,431.49,,,,fee schedule,,,,,,,,199.75,,,,fee schedule,,,270.3,85,,percent of total billed charges,,521.24,,,,fee schedule,,251.81,,,,fee schedule,,199.75,,,,fee schedule,,349.51,,,,fee schedule,,199.75,,,,fee schedule,,418.79,,,,fee schedule,,253.82,,,,fee schedule,,253.82,,,,fee schedule,,,289.38,91,,percent of total billed charges,,,302.1,95,,percent of total billed charges,,,263.94,83,,percent of total billed charges,,,95.4,83,,percent of total billed charges,,199.75,,,,fee schedule,,199.75,,,,fee schedule,,,263.94,83,,percent of total billed charges,,373.11,,,,fee schedule,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,270.3,85,,percent of total billed charges,,95.4,521.24,
TREAT FRACTURE OF ULNA,25535,CDM,25535,CPT,,,both,,1933,1933,805.94,,,,fee schedule,,,,,,,,240,,,,fee schedule,,,1643.05,85,,percent of total billed charges,,995.57,,,,fee schedule,,480.95,,,,fee schedule,,240,,,,fee schedule,,746.77,,,,fee schedule,,240,,,,fee schedule,,782.24,,,,fee schedule,,474.08,,,,fee schedule,,474.08,,,,fee schedule,,,1759.03,91,,percent of total billed charges,,,1836.35,95,,percent of total billed charges,,,1604.39,83,,percent of total billed charges,,,579.9,83,,percent of total billed charges,,240,,,,fee schedule,,240,,,,fee schedule,,,1604.39,83,,percent of total billed charges,,696.9,,,,fee schedule,,,1739.7,90,,percent of total billed charges,,,1739.7,90,,percent of total billed charges,,,1739.7,90,,percent of total billed charges,,,1739.7,90,,percent of total billed charges,,,1643.05,85,,percent of total billed charges,,240,1836.35,
TREAT FRACTURE OF ULNA,25545,CDM,25545,CPT,,,both,,2982,2982,1090.52,,,,fee schedule,,,,,,,,538.2,,,,fee schedule,,,2534.7,85,,percent of total billed charges,,1357.4,,,,fee schedule,,655.74,,,,fee schedule,,538.2,,,,fee schedule,,1196.42,,,,fee schedule,,538.2,,,,fee schedule,,1058.45,,,,fee schedule,,641.48,,,,fee schedule,,641.48,,,,fee schedule,,,2713.62,91,,percent of total billed charges,,,2832.9,95,,percent of total billed charges,,,2475.06,83,,percent of total billed charges,,,894.6,83,,percent of total billed charges,,538.2,,,,fee schedule,,538.2,,,,fee schedule,,,2475.06,83,,percent of total billed charges,,942.98,,,,fee schedule,,,2683.8,90,,percent of total billed charges,,,2683.8,90,,percent of total billed charges,,,2683.8,90,,percent of total billed charges,,,2683.8,90,,percent of total billed charges,,,2534.7,85,,percent of total billed charges,,538.2,2832.9,
TREAT FRACTURE OF ULNA,25545P,CDM,25545,CPT,,,both,P,2745,2745,1090.52,,,,fee schedule,,,,,,,,538.2,,,,fee schedule,,,2333.25,85,,percent of total billed charges,,1357.4,,,,fee schedule,,655.74,,,,fee schedule,,538.2,,,,fee schedule,,1196.42,,,,fee schedule,,538.2,,,,fee schedule,,1058.45,,,,fee schedule,,641.48,,,,fee schedule,,641.48,,,,fee schedule,,,2497.95,91,,percent of total billed charges,,,2607.75,95,,percent of total billed charges,,,2278.35,83,,percent of total billed charges,,,823.5,83,,percent of total billed charges,,538.2,,,,fee schedule,,538.2,,,,fee schedule,,,2278.35,83,,percent of total billed charges,,942.98,,,,fee schedule,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2333.25,85,,percent of total billed charges,,538.2,2607.75,
TREAT FRACTURE OF ULNA,25545T,CDM,25545,CPT,,,both,T,237,237,1090.52,,,,fee schedule,,,,,,,,538.2,,,,fee schedule,,,201.45,85,,percent of total billed charges,,1357.4,,,,fee schedule,,655.74,,,,fee schedule,,538.2,,,,fee schedule,,1196.42,,,,fee schedule,,538.2,,,,fee schedule,,1058.45,,,,fee schedule,,641.48,,,,fee schedule,,641.48,,,,fee schedule,,,215.67,91,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,71.1,83,,percent of total billed charges,,538.2,,,,fee schedule,,538.2,,,,fee schedule,,,196.71,83,,percent of total billed charges,,942.98,,,,fee schedule,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,71.1,1357.4,
TREAT FRACTURE RADIUS/ULNA,25560,CDM,25560,CPT,,,both,,1091,1091,460.29,,,,fee schedule,,,,,,,,176.2,,,,fee schedule,,,927.35,85,,percent of total billed charges,,560.26,,,,fee schedule,,270.65,,,,fee schedule,,176.2,,,,fee schedule,,356.14,,,,fee schedule,,176.2,,,,fee schedule,,446.75,,,,fee schedule,,270.76,,,,fee schedule,,270.76,,,,fee schedule,,,992.81,91,,percent of total billed charges,,,1036.45,95,,percent of total billed charges,,,905.53,83,,percent of total billed charges,,,327.3,83,,percent of total billed charges,,176.2,,,,fee schedule,,176.2,,,,fee schedule,,,905.53,83,,percent of total billed charges,,398.02,,,,fee schedule,,,981.9,90,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,927.35,85,,percent of total billed charges,,176.2,1036.45,
TREAT FRACTURE RADIUS & ULNA,25560P,CDM,25560,CPT,,,both,P,752,752,460.29,,,,fee schedule,,,,,,,,176.2,,,,fee schedule,,,639.2,85,,percent of total billed charges,,560.26,,,,fee schedule,,270.65,,,,fee schedule,,176.2,,,,fee schedule,,356.14,,,,fee schedule,,176.2,,,,fee schedule,,446.75,,,,fee schedule,,270.76,,,,fee schedule,,270.76,,,,fee schedule,,,684.32,91,,percent of total billed charges,,,714.4,95,,percent of total billed charges,,,624.16,83,,percent of total billed charges,,,225.6,83,,percent of total billed charges,,176.2,,,,fee schedule,,176.2,,,,fee schedule,,,624.16,83,,percent of total billed charges,,398.02,,,,fee schedule,,,676.8,90,,percent of total billed charges,,,676.8,90,,percent of total billed charges,,,676.8,90,,percent of total billed charges,,,676.8,90,,percent of total billed charges,,,639.2,85,,percent of total billed charges,,176.2,714.4,
TREAT FRACTURE RADIUS & ULNA,25560T,CDM,25560,CPT,,,both,T,339,339,460.29,,,,fee schedule,,,,,,,,176.2,,,,fee schedule,,,288.15,85,,percent of total billed charges,,560.26,,,,fee schedule,,270.65,,,,fee schedule,,176.2,,,,fee schedule,,356.14,,,,fee schedule,,176.2,,,,fee schedule,,446.75,,,,fee schedule,,270.76,,,,fee schedule,,270.76,,,,fee schedule,,,308.49,91,,percent of total billed charges,,,322.05,95,,percent of total billed charges,,,281.37,83,,percent of total billed charges,,,101.7,83,,percent of total billed charges,,176.2,,,,fee schedule,,176.2,,,,fee schedule,,,281.37,83,,percent of total billed charges,,398.02,,,,fee schedule,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,288.15,85,,percent of total billed charges,,101.7,560.26,
TREAT FRACTURE RADIUS/ULNA,25565,CDM,25565,CPT,,,both,,2201,2201,822.07,,,,fee schedule,,,,,,,,292.6,,,,fee schedule,,,1870.85,85,,percent of total billed charges,,1019.83,,,,fee schedule,,492.67,,,,fee schedule,,292.6,,,,fee schedule,,791.21,,,,fee schedule,,292.6,,,,fee schedule,,797.89,,,,fee schedule,,483.57,,,,fee schedule,,483.57,,,,fee schedule,,,2002.91,91,,percent of total billed charges,,,2090.95,95,,percent of total billed charges,,,1826.83,83,,percent of total billed charges,,,660.3,83,,percent of total billed charges,,292.6,,,,fee schedule,,292.6,,,,fee schedule,,,1826.83,83,,percent of total billed charges,,710.85,,,,fee schedule,,,1980.9,90,,percent of total billed charges,,,1980.9,90,,percent of total billed charges,,,1980.9,90,,percent of total billed charges,,,1980.9,90,,percent of total billed charges,,,1870.85,85,,percent of total billed charges,,292.6,2090.95,
TREAT FRACTURE RADIUS/ULNA,25574,CDM,25574,CPT,,,both,,3132,3132,1177.51,,,,fee schedule,,,,,,,,538.2,,,,fee schedule,,,2662.2,85,,percent of total billed charges,,1468.36,,,,fee schedule,,709.35,,,,fee schedule,,538.2,,,,fee schedule,,1021.34,,,,fee schedule,,538.2,,,,fee schedule,,1142.88,,,,fee schedule,,692.65,,,,fee schedule,,692.65,,,,fee schedule,,,2850.12,91,,percent of total billed charges,,,2975.4,95,,percent of total billed charges,,,2599.56,83,,percent of total billed charges,,,939.6,83,,percent of total billed charges,,538.2,,,,fee schedule,,538.2,,,,fee schedule,,,2599.56,83,,percent of total billed charges,,1018.2,,,,fee schedule,,,2818.8,90,,percent of total billed charges,,,2818.8,90,,percent of total billed charges,,,2818.8,90,,percent of total billed charges,,,2818.8,90,,percent of total billed charges,,,2662.2,85,,percent of total billed charges,,538.2,2975.4,
TREAT FRACTURE RADIUS/ULNA,25575,CDM,25575,CPT,,,both,,4091,4091,1569.25,,,,fee schedule,,,,,,,,592.4,,,,fee schedule,,,3477.35,85,,percent of total billed charges,,1969.72,,,,fee schedule,,951.55,,,,fee schedule,,592.4,,,,fee schedule,,1439.16,,,,fee schedule,,592.4,,,,fee schedule,,1523.09,,,,fee schedule,,923.09,,,,fee schedule,,923.09,,,,fee schedule,,,3722.81,91,,percent of total billed charges,,,3886.45,95,,percent of total billed charges,,,3395.53,83,,percent of total billed charges,,,1227.3,83,,percent of total billed charges,,592.4,,,,fee schedule,,592.4,,,,fee schedule,,,3395.53,83,,percent of total billed charges,,1356.94,,,,fee schedule,,,3681.9,90,,percent of total billed charges,,,3681.9,90,,percent of total billed charges,,,3681.9,90,,percent of total billed charges,,,3681.9,90,,percent of total billed charges,,,3477.35,85,,percent of total billed charges,,592.4,3886.45,
TREAT FRACTURE RADIUS/ULNA,25600,CDM,25600,CPT,,,both,,1216,1216,575.51,,,,fee schedule,,,,,,,,155.35,,,,fee schedule,,,1033.6,85,,percent of total billed charges,,696.39,,,,fee schedule,,323.96,,,,fee schedule,,155.35,,,,fee schedule,,397.92,,,,fee schedule,,155.35,,,,fee schedule,,558.58,,,,fee schedule,,338.53,,,,fee schedule,,338.53,,,,fee schedule,,,1106.56,91,,percent of total billed charges,,,1155.2,95,,percent of total billed charges,,,1009.28,83,,percent of total billed charges,,,364.8,83,,percent of total billed charges,,155.35,,,,fee schedule,,155.35,,,,fee schedule,,,1009.28,83,,percent of total billed charges,,497.64,,,,fee schedule,,,1094.4,90,,percent of total billed charges,,,1094.4,90,,percent of total billed charges,,,1094.4,90,,percent of total billed charges,,,1094.4,90,,percent of total billed charges,,,1033.6,85,,percent of total billed charges,,155.35,1155.2,
TREAT FRACTURE RADIUS/ULNA,25600P,CDM,25600,CPT,,,both,P,800,800,575.51,,,,fee schedule,,,,,,,,155.35,,,,fee schedule,,,680,85,,percent of total billed charges,,696.39,,,,fee schedule,,323.96,,,,fee schedule,,155.35,,,,fee schedule,,397.92,,,,fee schedule,,155.35,,,,fee schedule,,558.58,,,,fee schedule,,338.53,,,,fee schedule,,338.53,,,,fee schedule,,,728,91,,percent of total billed charges,,,760,95,,percent of total billed charges,,,664,83,,percent of total billed charges,,,240,83,,percent of total billed charges,,155.35,,,,fee schedule,,155.35,,,,fee schedule,,,664,83,,percent of total billed charges,,497.64,,,,fee schedule,,,720,90,,percent of total billed charges,,,720,90,,percent of total billed charges,,,720,90,,percent of total billed charges,,,720,90,,percent of total billed charges,,,680,85,,percent of total billed charges,,155.35,760,
TREAT FRACTURE RADIUS/ULNA,25600T,CDM,25600,CPT,,,both,T,416,416,575.51,,,,fee schedule,,,,,,,,155.35,,,,fee schedule,,,353.6,85,,percent of total billed charges,,696.39,,,,fee schedule,,323.96,,,,fee schedule,,155.35,,,,fee schedule,,397.92,,,,fee schedule,,155.35,,,,fee schedule,,558.58,,,,fee schedule,,338.53,,,,fee schedule,,338.53,,,,fee schedule,,,378.56,91,,percent of total billed charges,,,395.2,95,,percent of total billed charges,,,345.28,83,,percent of total billed charges,,,124.8,83,,percent of total billed charges,,155.35,,,,fee schedule,,155.35,,,,fee schedule,,,345.28,83,,percent of total billed charges,,497.64,,,,fee schedule,,,374.4,90,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,353.6,85,,percent of total billed charges,,124.8,696.39,
TREAT FRACTURE RADIUS/ULNA,25605,CDM,25605,CPT,,,both,,2213,2213,900.42,,,,fee schedule,,,,,,,,294.1,,,,fee schedule,,,1881.05,85,,percent of total billed charges,,1116.22,,,,fee schedule,,539.23,,,,fee schedule,,294.1,,,,fee schedule,,860.18,,,,fee schedule,,294.1,,,,fee schedule,,873.93,,,,fee schedule,,529.66,,,,fee schedule,,529.66,,,,fee schedule,,,2013.83,91,,percent of total billed charges,,,2102.35,95,,percent of total billed charges,,,1836.79,83,,percent of total billed charges,,,663.9,83,,percent of total billed charges,,294.1,,,,fee schedule,,294.1,,,,fee schedule,,,1836.79,83,,percent of total billed charges,,778.6,,,,fee schedule,,,1991.7,90,,percent of total billed charges,,,1991.7,90,,percent of total billed charges,,,1991.7,90,,percent of total billed charges,,,1991.7,90,,percent of total billed charges,,,1881.05,85,,percent of total billed charges,,294.1,2102.35,
TREAT FX DISTAL RADIAL,25606,CDM,25606,CPT,,,both,,2868,2868,1165.41,,,,fee schedule,,,,,,,,301,,,,fee schedule,,,2437.8,85,,percent of total billed charges,,1450.71,,,,fee schedule,,700.82,,,,fee schedule,,301,,,,fee schedule,,,,,,,,301,,,,fee schedule,,1131.14,,,,fee schedule,,685.54,,,,fee schedule,,685.54,,,,fee schedule,,,2609.88,91,,percent of total billed charges,,,2724.6,95,,percent of total billed charges,,,2380.44,83,,percent of total billed charges,,,860.4,83,,percent of total billed charges,,301,,,,fee schedule,,301,,,,fee schedule,,,2380.44,83,,percent of total billed charges,,1007.74,,,,fee schedule,,,2581.2,90,,percent of total billed charges,,,2581.2,90,,percent of total billed charges,,,2581.2,90,,percent of total billed charges,,,2581.2,90,,percent of total billed charges,,,2437.8,85,,percent of total billed charges,,301,2724.6,
TREAT FX RAD EXTRA-ARTICUL,25607,CDM,25607,CPT,,,both,,3151,3151,1288.7,,,,fee schedule,,,,,,,,443.95,,,,fee schedule,,,2678.35,85,,percent of total billed charges,,1603.99,,,,fee schedule,,774.87,,,,fee schedule,,443.95,,,,fee schedule,,,,,,,,443.95,,,,fee schedule,,1250.79,,,,fee schedule,,758.06,,,,fee schedule,,758.06,,,,fee schedule,,,2867.41,91,,percent of total billed charges,,,2993.45,95,,percent of total billed charges,,,2615.33,83,,percent of total billed charges,,,945.3,83,,percent of total billed charges,,443.95,,,,fee schedule,,443.95,,,,fee schedule,,,2615.33,83,,percent of total billed charges,,1114.34,,,,fee schedule,,,2835.9,90,,percent of total billed charges,,,2835.9,90,,percent of total billed charges,,,2835.9,90,,percent of total billed charges,,,2835.9,90,,percent of total billed charges,,,2678.35,85,,percent of total billed charges,,443.95,2993.45,
TREAT FX RAD INTRA-ARTICUL,25608,CDM,25608,CPT,,,both,,3556,3556,1438.48,,,,fee schedule,,,,,,,,443.95,,,,fee schedule,,,3022.6,85,,percent of total billed charges,,1799.64,,,,fee schedule,,869.39,,,,fee schedule,,443.95,,,,fee schedule,,,,,,,,443.95,,,,fee schedule,,1396.17,,,,fee schedule,,846.16,,,,fee schedule,,846.16,,,,fee schedule,,,3235.96,91,,percent of total billed charges,,,3378.2,95,,percent of total billed charges,,,2951.48,83,,percent of total billed charges,,,1066.8,83,,percent of total billed charges,,443.95,,,,fee schedule,,443.95,,,,fee schedule,,,2951.48,83,,percent of total billed charges,,1243.86,,,,fee schedule,,,3200.4,90,,percent of total billed charges,,,3200.4,90,,percent of total billed charges,,,3200.4,90,,percent of total billed charges,,,3200.4,90,,percent of total billed charges,,,3022.6,85,,percent of total billed charges,,443.95,3378.2,
TREAT FX RADIAL 3+ FRAG,25609,CDM,25609,CPT,,,both,,4599,4599,1823.88,,,,fee schedule,,,,,,,,443.95,,,,fee schedule,,,3909.15,85,,percent of total billed charges,,2286.65,,,,fee schedule,,1104.65,,,,fee schedule,,443.95,,,,fee schedule,,,,,,,,443.95,,,,fee schedule,,1770.23,,,,fee schedule,,1072.87,,,,fee schedule,,1072.87,,,,fee schedule,,,4185.09,91,,percent of total billed charges,,,4369.05,95,,percent of total billed charges,,,3817.17,83,,percent of total billed charges,,,1379.7,83,,percent of total billed charges,,443.95,,,,fee schedule,,443.95,,,,fee schedule,,,3817.17,83,,percent of total billed charges,,1577.12,,,,fee schedule,,,4139.1,90,,percent of total billed charges,,,4139.1,90,,percent of total billed charges,,,4139.1,90,,percent of total billed charges,,,4139.1,90,,percent of total billed charges,,,3909.15,85,,percent of total billed charges,,443.95,4369.05,
TREAT WRIST BONE FRACTURE,25622,CDM,25622,CPT,,,both,,1211,1211,505.22,,,,fee schedule,,,,,,,,147.1,,,,fee schedule,,,1029.35,85,,percent of total billed charges,,614.17,,,,fee schedule,,296.7,,,,fee schedule,,147.1,,,,fee schedule,,404.56,,,,fee schedule,,147.1,,,,fee schedule,,490.36,,,,fee schedule,,297.19,,,,fee schedule,,297.19,,,,fee schedule,,,1102.01,91,,percent of total billed charges,,,1150.45,95,,percent of total billed charges,,,1005.13,83,,percent of total billed charges,,,363.3,83,,percent of total billed charges,,147.1,,,,fee schedule,,147.1,,,,fee schedule,,,1005.13,83,,percent of total billed charges,,436.87,,,,fee schedule,,,1089.9,90,,percent of total billed charges,,,1089.9,90,,percent of total billed charges,,,1089.9,90,,percent of total billed charges,,,1089.9,90,,percent of total billed charges,,,1029.35,85,,percent of total billed charges,,147.1,1150.45,
TREAT WRIST BONE FRACTURE,25622P,CDM,25622,CPT,,,both,P,465,465,505.22,,,,fee schedule,,,,,,,,147.1,,,,fee schedule,,,395.25,85,,percent of total billed charges,,614.17,,,,fee schedule,,296.7,,,,fee schedule,,147.1,,,,fee schedule,,404.56,,,,fee schedule,,147.1,,,,fee schedule,,490.36,,,,fee schedule,,297.19,,,,fee schedule,,297.19,,,,fee schedule,,,423.15,91,,percent of total billed charges,,,441.75,95,,percent of total billed charges,,,385.95,83,,percent of total billed charges,,,139.5,83,,percent of total billed charges,,147.1,,,,fee schedule,,147.1,,,,fee schedule,,,385.95,83,,percent of total billed charges,,436.87,,,,fee schedule,,,418.5,90,,percent of total billed charges,,,418.5,90,,percent of total billed charges,,,418.5,90,,percent of total billed charges,,,418.5,90,,percent of total billed charges,,,395.25,85,,percent of total billed charges,,139.5,614.17,
TREAT WRIST BONE FRACTURE,25622T,CDM,25622,CPT,,,both,T,746,746,505.22,,,,fee schedule,,,,,,,,147.1,,,,fee schedule,,,634.1,85,,percent of total billed charges,,614.17,,,,fee schedule,,296.7,,,,fee schedule,,147.1,,,,fee schedule,,404.56,,,,fee schedule,,147.1,,,,fee schedule,,490.36,,,,fee schedule,,297.19,,,,fee schedule,,297.19,,,,fee schedule,,,678.86,91,,percent of total billed charges,,,708.7,95,,percent of total billed charges,,,619.18,83,,percent of total billed charges,,,223.8,83,,percent of total billed charges,,147.1,,,,fee schedule,,147.1,,,,fee schedule,,,619.18,83,,percent of total billed charges,,436.87,,,,fee schedule,,,671.4,90,,percent of total billed charges,,,671.4,90,,percent of total billed charges,,,671.4,90,,percent of total billed charges,,,671.4,90,,percent of total billed charges,,,634.1,85,,percent of total billed charges,,147.1,708.7,
TREAT WRIST BONE FRACTURE,25624,CDM,25624,CPT,,,both,,1910,1910,785.78,,,,fee schedule,,,,,,,,181.1,,,,fee schedule,,,1623.5,85,,percent of total billed charges,,966.72,,,,fee schedule,,467.01,,,,fee schedule,,181.1,,,,fee schedule,,684.43,,,,fee schedule,,181.1,,,,fee schedule,,762.67,,,,fee schedule,,462.22,,,,fee schedule,,462.22,,,,fee schedule,,,1738.1,91,,percent of total billed charges,,,1814.5,95,,percent of total billed charges,,,1585.3,83,,percent of total billed charges,,,573,83,,percent of total billed charges,,181.1,,,,fee schedule,,181.1,,,,fee schedule,,,1585.3,83,,percent of total billed charges,,679.47,,,,fee schedule,,,1719,90,,percent of total billed charges,,,1719,90,,percent of total billed charges,,,1719,90,,percent of total billed charges,,,1719,90,,percent of total billed charges,,,1623.5,85,,percent of total billed charges,,181.1,1814.5,
TREAT WRIST BONE FRACTURE,25628,CDM,25628,CPT,,,both,,3310,3310,1251.25,,,,fee schedule,,,,,,,,335.7,,,,fee schedule,,,2813.5,85,,percent of total billed charges,,1566.29,,,,fee schedule,,756.66,,,,fee schedule,,335.7,,,,fee schedule,,1167.24,,,,fee schedule,,335.7,,,,fee schedule,,1214.45,,,,fee schedule,,736.03,,,,fee schedule,,736.03,,,,fee schedule,,,3012.1,91,,percent of total billed charges,,,3144.5,95,,percent of total billed charges,,,2747.3,83,,percent of total billed charges,,,993,83,,percent of total billed charges,,335.7,,,,fee schedule,,335.7,,,,fee schedule,,,2747.3,83,,percent of total billed charges,,1081.96,,,,fee schedule,,,2979,90,,percent of total billed charges,,,2979,90,,percent of total billed charges,,,2979,90,,percent of total billed charges,,,2979,90,,percent of total billed charges,,,2813.5,85,,percent of total billed charges,,335.7,3144.5,
TREAT WRIST BONE FRACTURE,25630,CDM,25630,CPT,,,both,,1181,1181,505.22,,,,fee schedule,,,,,,,,201.1,,,,fee schedule,,,1003.85,85,,percent of total billed charges,,616.36,,,,fee schedule,,297.76,,,,fee schedule,,201.1,,,,fee schedule,,414.5,,,,fee schedule,,201.1,,,,fee schedule,,490.36,,,,fee schedule,,297.19,,,,fee schedule,,297.19,,,,fee schedule,,,1074.71,91,,percent of total billed charges,,,1121.95,95,,percent of total billed charges,,,980.23,83,,percent of total billed charges,,,354.3,83,,percent of total billed charges,,201.1,,,,fee schedule,,201.1,,,,fee schedule,,,980.23,83,,percent of total billed charges,,436.87,,,,fee schedule,,,1062.9,90,,percent of total billed charges,,,1062.9,90,,percent of total billed charges,,,1062.9,90,,percent of total billed charges,,,1062.9,90,,percent of total billed charges,,,1003.85,85,,percent of total billed charges,,201.1,1121.95,
TREAT WRIST BONE FRACTURE,25635,CDM,25635,CPT,,,both,,1778,1778,746.03,,,,fee schedule,,,,,,,,174.6,,,,fee schedule,,,1511.3,85,,percent of total billed charges,,919.71,,,,fee schedule,,444.3,,,,fee schedule,,174.6,,,,fee schedule,,596.22,,,,fee schedule,,174.6,,,,fee schedule,,724.08,,,,fee schedule,,438.84,,,,fee schedule,,438.84,,,,fee schedule,,,1617.98,91,,percent of total billed charges,,,1689.1,95,,percent of total billed charges,,,1475.74,83,,percent of total billed charges,,,533.4,83,,percent of total billed charges,,174.6,,,,fee schedule,,174.6,,,,fee schedule,,,1475.74,83,,percent of total billed charges,,645.09,,,,fee schedule,,,1600.2,90,,percent of total billed charges,,,1600.2,90,,percent of total billed charges,,,1600.2,90,,percent of total billed charges,,,1600.2,90,,percent of total billed charges,,,1511.3,85,,percent of total billed charges,,174.6,1689.1,
TREAT WRIST BONE FRACTURE,25645,CDM,25645,CPT,,,both,,2623,2623,998.35,,,,fee schedule,,,,,,,,335.7,,,,fee schedule,,,2229.55,85,,percent of total billed charges,,1248.02,,,,fee schedule,,602.91,,,,fee schedule,,335.7,,,,fee schedule,,998.79,,,,fee schedule,,335.7,,,,fee schedule,,968.99,,,,fee schedule,,587.27,,,,fee schedule,,587.27,,,,fee schedule,,,2386.93,91,,percent of total billed charges,,,2491.85,95,,percent of total billed charges,,,2177.09,83,,percent of total billed charges,,,786.9,83,,percent of total billed charges,,335.7,,,,fee schedule,,335.7,,,,fee schedule,,,2177.09,83,,percent of total billed charges,,863.28,,,,fee schedule,,,2360.7,90,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2360.7,90,,percent of total billed charges,,,2229.55,85,,percent of total billed charges,,335.7,2491.85,
TREAT WRIST BONE FRACTURE,25650,CDM,25650,CPT,,,both,,1281,1281,544.97,,,,fee schedule,,,,,,,,126.9,,,,fee schedule,,,1088.85,85,,percent of total billed charges,,662.95,,,,fee schedule,,320.26,,,,fee schedule,,126.9,,,,fee schedule,,441.03,,,,fee schedule,,126.9,,,,fee schedule,,528.95,,,,fee schedule,,320.57,,,,fee schedule,,320.57,,,,fee schedule,,,1165.71,91,,percent of total billed charges,,,1216.95,95,,percent of total billed charges,,,1063.23,83,,percent of total billed charges,,,384.3,83,,percent of total billed charges,,126.9,,,,fee schedule,,126.9,,,,fee schedule,,,1063.23,83,,percent of total billed charges,,471.24,,,,fee schedule,,,1152.9,90,,percent of total billed charges,,,1152.9,90,,percent of total billed charges,,,1152.9,90,,percent of total billed charges,,,1152.9,90,,percent of total billed charges,,,1088.85,85,,percent of total billed charges,,126.9,1216.95,
PIN ULNAR STYLOID FRACTURE,25651,CDM,25651,CPT,,,both,,2213,2213,857.79,,,,fee schedule,,,,,,,,271.25,,,,fee schedule,,,1881.05,85,,percent of total billed charges,,1059.53,,,,fee schedule,,511.85,,,,fee schedule,,271.25,,,,fee schedule,,772.64,,,,fee schedule,,271.25,,,,fee schedule,,832.56,,,,fee schedule,,504.58,,,,fee schedule,,504.58,,,,fee schedule,,,2013.83,91,,percent of total billed charges,,,2102.35,95,,percent of total billed charges,,,1836.79,83,,percent of total billed charges,,,663.9,83,,percent of total billed charges,,271.25,,,,fee schedule,,271.25,,,,fee schedule,,,1836.79,83,,percent of total billed charges,,741.73,,,,fee schedule,,,1991.7,90,,percent of total billed charges,,,1991.7,90,,percent of total billed charges,,,1991.7,90,,percent of total billed charges,,,1991.7,90,,percent of total billed charges,,,1881.05,85,,percent of total billed charges,,271.25,2102.35,
TREAT FRACTURE ULNAR STYLOID,25652,CDM,25652,CPT,,,both,,2923,2923,1087.07,,,,fee schedule,,,,,,,,374,,,,fee schedule,,,2484.55,85,,percent of total billed charges,,1354.77,,,,fee schedule,,654.47,,,,fee schedule,,374,,,,fee schedule,,1047.2,,,,fee schedule,,374,,,,fee schedule,,1055.09,,,,fee schedule,,639.45,,,,fee schedule,,639.45,,,,fee schedule,,,2659.93,91,,percent of total billed charges,,,2776.85,95,,percent of total billed charges,,,2426.09,83,,percent of total billed charges,,,876.9,83,,percent of total billed charges,,374,,,,fee schedule,,374,,,,fee schedule,,,2426.09,83,,percent of total billed charges,,939.99,,,,fee schedule,,,2630.7,90,,percent of total billed charges,,,2630.7,90,,percent of total billed charges,,,2630.7,90,,percent of total billed charges,,,2630.7,90,,percent of total billed charges,,,2484.55,85,,percent of total billed charges,,374,2776.85,
TREAT WRIST DISLOCATION,25660,CDM,25660,CPT,,,both,,1634,1634,790.39,,,,fee schedule,,,,,,,,139,,,,fee schedule,,,1388.9,85,,percent of total billed charges,,974.19,,,,fee schedule,,470.62,,,,fee schedule,,139,,,,fee schedule,,665.2,,,,fee schedule,,139,,,,fee schedule,,767.14,,,,fee schedule,,464.93,,,,fee schedule,,464.93,,,,fee schedule,,,1486.94,91,,percent of total billed charges,,,1552.3,95,,percent of total billed charges,,,1356.22,83,,percent of total billed charges,,,490.2,83,,percent of total billed charges,,139,,,,fee schedule,,139,,,,fee schedule,,,1356.22,83,,percent of total billed charges,,683.45,,,,fee schedule,,,1470.6,90,,percent of total billed charges,,,1470.6,90,,percent of total billed charges,,,1470.6,90,,percent of total billed charges,,,1470.6,90,,percent of total billed charges,,,1388.9,85,,percent of total billed charges,,139,1552.3,
TREAT WRIST DISLOCATION,25670,CDM,25670,CPT,,,both,,2678,2678,1060.57,,,,fee schedule,,,,,,,,266.7,,,,fee schedule,,,2276.3,85,,percent of total billed charges,,1329.03,,,,fee schedule,,642.04,,,,fee schedule,,266.7,,,,fee schedule,,1071.74,,,,fee schedule,,266.7,,,,fee schedule,,1029.37,,,,fee schedule,,623.86,,,,fee schedule,,623.86,,,,fee schedule,,,2436.98,91,,percent of total billed charges,,,2544.1,95,,percent of total billed charges,,,2222.74,83,,percent of total billed charges,,,803.4,83,,percent of total billed charges,,266.7,,,,fee schedule,,266.7,,,,fee schedule,,,2222.74,83,,percent of total billed charges,,917.08,,,,fee schedule,,,2410.2,90,,percent of total billed charges,,,2410.2,90,,percent of total billed charges,,,2410.2,90,,percent of total billed charges,,,2410.2,90,,percent of total billed charges,,,2276.3,85,,percent of total billed charges,,266.7,2544.1,
PIN RADIOULNAR DISLOCATION,25671,CDM,25671,CPT,,,both,,2125,2125,929.22,,,,fee schedule,,,,,,,,205.3,,,,fee schedule,,,1806.25,85,,percent of total billed charges,,1151.33,,,,fee schedule,,556.19,,,,fee schedule,,205.3,,,,fee schedule,,870.13,,,,fee schedule,,205.3,,,,fee schedule,,901.89,,,,fee schedule,,546.6,,,,fee schedule,,546.6,,,,fee schedule,,,1933.75,91,,percent of total billed charges,,,2018.75,95,,percent of total billed charges,,,1763.75,83,,percent of total billed charges,,,637.5,83,,percent of total billed charges,,205.3,,,,fee schedule,,205.3,,,,fee schedule,,,1763.75,83,,percent of total billed charges,,803.5,,,,fee schedule,,,1912.5,90,,percent of total billed charges,,,1912.5,90,,percent of total billed charges,,,1912.5,90,,percent of total billed charges,,,1912.5,90,,percent of total billed charges,,,1806.25,85,,percent of total billed charges,,205.3,2018.75,
TREAT WRIST DISLOCATION,25675,CDM,25675,CPT,,,both,,1756,1756,727.59,,,,fee schedule,,,,,,,,168.25,,,,fee schedule,,,1492.6,85,,percent of total billed charges,,887.49,,,,fee schedule,,428.73,,,,fee schedule,,168.25,,,,fee schedule,,655.91,,,,fee schedule,,168.25,,,,fee schedule,,706.19,,,,fee schedule,,428,,,,fee schedule,,428,,,,fee schedule,,,1597.96,91,,percent of total billed charges,,,1668.2,95,,percent of total billed charges,,,1457.48,83,,percent of total billed charges,,,526.8,83,,percent of total billed charges,,168.25,,,,fee schedule,,168.25,,,,fee schedule,,,1457.48,83,,percent of total billed charges,,629.15,,,,fee schedule,,,1580.4,90,,percent of total billed charges,,,1580.4,90,,percent of total billed charges,,,1580.4,90,,percent of total billed charges,,,1580.4,90,,percent of total billed charges,,,1492.6,85,,percent of total billed charges,,168.25,1668.2,
TREAT WRIST DISLOCATION,25676,CDM,25676,CPT,,,both,,3198,3198,1099.17,,,,fee schedule,,,,,,,,270.4,,,,fee schedule,,,2718.3,85,,percent of total billed charges,,1373.92,,,,fee schedule,,663.73,,,,fee schedule,,270.4,,,,fee schedule,,1104.9,,,,fee schedule,,270.4,,,,fee schedule,,1066.84,,,,fee schedule,,646.57,,,,fee schedule,,646.57,,,,fee schedule,,,2910.18,91,,percent of total billed charges,,,3038.1,95,,percent of total billed charges,,,2654.34,83,,percent of total billed charges,,,959.4,83,,percent of total billed charges,,270.4,,,,fee schedule,,270.4,,,,fee schedule,,,2654.34,83,,percent of total billed charges,,950.45,,,,fee schedule,,,2878.2,90,,percent of total billed charges,,,2878.2,90,,percent of total billed charges,,,2878.2,90,,percent of total billed charges,,,2878.2,90,,percent of total billed charges,,,2718.3,85,,percent of total billed charges,,270.4,3038.1,
TREAT WRIST FRACTURE,25680,CDM,25680,CPT,,,both,,1884,1884,930.95,,,,fee schedule,,,,,,,,240,,,,fee schedule,,,1601.4,85,,percent of total billed charges,,1154.12,,,,fee schedule,,557.54,,,,fee schedule,,240,,,,fee schedule,,760.03,,,,fee schedule,,240,,,,fee schedule,,903.57,,,,fee schedule,,547.62,,,,fee schedule,,547.62,,,,fee schedule,,,1714.44,91,,percent of total billed charges,,,1789.8,95,,percent of total billed charges,,,1563.72,83,,percent of total billed charges,,,565.2,83,,percent of total billed charges,,240,,,,fee schedule,,240,,,,fee schedule,,,1563.72,83,,percent of total billed charges,,805,,,,fee schedule,,,1695.6,90,,percent of total billed charges,,,1695.6,90,,percent of total billed charges,,,1695.6,90,,percent of total billed charges,,,1695.6,90,,percent of total billed charges,,,1601.4,85,,percent of total billed charges,,240,1789.8,
TREAT WRIST FRACTURE,25685,CDM,25685,CPT,,,both,,3334,3334,1278.33,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,2833.9,85,,percent of total billed charges,,1607.16,,,,fee schedule,,776.4,,,,fee schedule,,449.5,,,,fee schedule,,1268.71,,,,fee schedule,,449.5,,,,fee schedule,,1240.73,,,,fee schedule,,751.96,,,,fee schedule,,751.96,,,,fee schedule,,,3033.94,91,,percent of total billed charges,,,3167.3,95,,percent of total billed charges,,,2767.22,83,,percent of total billed charges,,,1000.2,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,2767.22,83,,percent of total billed charges,,1105.38,,,,fee schedule,,,3000.6,90,,percent of total billed charges,,,3000.6,90,,percent of total billed charges,,,3000.6,90,,percent of total billed charges,,,3000.6,90,,percent of total billed charges,,,2833.9,85,,percent of total billed charges,,449.5,3167.3,
TREAT WRIST DISLOCATION,25690,CDM,25690,CPT,,,both,,1927,1927,863.55,,,,fee schedule,,,,,,,,188.65,,,,fee schedule,,,1637.95,85,,percent of total billed charges,,1069.86,,,,fee schedule,,516.84,,,,fee schedule,,188.65,,,,fee schedule,,785.9,,,,fee schedule,,188.65,,,,fee schedule,,838.15,,,,fee schedule,,507.97,,,,fee schedule,,507.97,,,,fee schedule,,,1753.57,91,,percent of total billed charges,,,1830.65,95,,percent of total billed charges,,,1599.41,83,,percent of total billed charges,,,578.1,83,,percent of total billed charges,,188.65,,,,fee schedule,,188.65,,,,fee schedule,,,1599.41,83,,percent of total billed charges,,746.71,,,,fee schedule,,,1734.3,90,,percent of total billed charges,,,1734.3,90,,percent of total billed charges,,,1734.3,90,,percent of total billed charges,,,1734.3,90,,percent of total billed charges,,,1637.95,85,,percent of total billed charges,,188.65,1830.65,
TREAT WRIST DISLOCATION,25695,CDM,25695,CPT,,,both,,2544,2544,1105.5,,,,fee schedule,,,,,,,,276.5,,,,fee schedule,,,2162.4,85,,percent of total billed charges,,1387.78,,,,fee schedule,,670.42,,,,fee schedule,,276.5,,,,fee schedule,,1110.21,,,,fee schedule,,276.5,,,,fee schedule,,1072.99,,,,fee schedule,,650.3,,,,fee schedule,,650.3,,,,fee schedule,,,2315.04,91,,percent of total billed charges,,,2416.8,95,,percent of total billed charges,,,2111.52,83,,percent of total billed charges,,,763.2,83,,percent of total billed charges,,276.5,,,,fee schedule,,276.5,,,,fee schedule,,,2111.52,83,,percent of total billed charges,,955.93,,,,fee schedule,,,2289.6,90,,percent of total billed charges,,,2289.6,90,,percent of total billed charges,,,2289.6,90,,percent of total billed charges,,,2289.6,90,,percent of total billed charges,,,2162.4,85,,percent of total billed charges,,276.5,2416.8,
FUSION OF HAND BONES,25820,CDM,25820,CPT,,,both,,3115,3115,1134.31,,,,fee schedule,,,,,,,,664.25,,,,fee schedule,,,2647.75,85,,percent of total billed charges,,1408.19,,,,fee schedule,,680.28,,,,fee schedule,,664.25,,,,fee schedule,,1094.29,,,,fee schedule,,664.25,,,,fee schedule,,1100.94,,,,fee schedule,,667.24,,,,fee schedule,,667.24,,,,fee schedule,,,2834.65,91,,percent of total billed charges,,,2959.25,95,,percent of total billed charges,,,2585.45,83,,percent of total billed charges,,,934.5,83,,percent of total billed charges,,664.25,,,,fee schedule,,664.25,,,,fee schedule,,,2585.45,83,,percent of total billed charges,,980.84,,,,fee schedule,,,2803.5,90,,percent of total billed charges,,,2803.5,90,,percent of total billed charges,,,2803.5,90,,percent of total billed charges,,,2803.5,90,,percent of total billed charges,,,2647.75,85,,percent of total billed charges,,664.25,2959.25,
FUSE HAND BONES WITH GRAFT,25825,CDM,25825,CPT,,,both,,4083,4083,1382.02,,,,fee schedule,,,,,,,,718.7,,,,fee schedule,,,3470.55,85,,percent of total billed charges,,1720.4,,,,fee schedule,,831.1,,,,fee schedule,,718.7,,,,fee schedule,,1319.12,,,,fee schedule,,718.7,,,,fee schedule,,1341.37,,,,fee schedule,,812.95,,,,fee schedule,,812.95,,,,fee schedule,,,3715.53,91,,percent of total billed charges,,,3878.85,95,,percent of total billed charges,,,3388.89,83,,percent of total billed charges,,,1224.9,83,,percent of total billed charges,,718.7,,,,fee schedule,,718.7,,,,fee schedule,,,3388.89,83,,percent of total billed charges,,1195.04,,,,fee schedule,,,3674.7,90,,percent of total billed charges,,,3674.7,90,,percent of total billed charges,,,3674.7,90,,percent of total billed charges,,,3674.7,90,,percent of total billed charges,,,3470.55,85,,percent of total billed charges,,718.7,3878.85,
"FUSION, RADIOULNAR JNT/ULNA",25830,CDM,25830,CPT,,,both,,3575,3575,1766.27,,,,fee schedule,,,,,,,,786.6,,,,fee schedule,,,3038.75,85,,percent of total billed charges,,2243.52,,,,fee schedule,,1083.82,,,,fee schedule,,786.6,,,,fee schedule,,1723.67,,,,fee schedule,,786.6,,,,fee schedule,,1714.32,,,,fee schedule,,1038.98,,,,fee schedule,,1038.98,,,,fee schedule,,,3253.25,91,,percent of total billed charges,,,3396.25,95,,percent of total billed charges,,,2967.25,83,,percent of total billed charges,,,1072.5,83,,percent of total billed charges,,786.6,,,,fee schedule,,786.6,,,,fee schedule,,,2967.25,83,,percent of total billed charges,,1527.3,,,,fee schedule,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3217.5,90,,percent of total billed charges,,,3038.75,85,,percent of total billed charges,,786.6,3396.25,
AMPUTATION OF HAND,25927,CDM,25927,CPT,,,both,,3248,3248,1509.91,,,,fee schedule,,,,,,,,302.6,,,,fee schedule,,,2760.8,85,,percent of total billed charges,,1882.9,,,,fee schedule,,909.61,,,,fee schedule,,302.6,,,,fee schedule,,1441.15,,,,fee schedule,,302.6,,,,fee schedule,,1465.5,,,,fee schedule,,888.18,,,,fee schedule,,888.18,,,,fee schedule,,,2955.68,91,,percent of total billed charges,,,3085.6,95,,percent of total billed charges,,,2695.84,83,,percent of total billed charges,,,974.4,83,,percent of total billed charges,,302.6,,,,fee schedule,,302.6,,,,fee schedule,,,2695.84,83,,percent of total billed charges,,1305.63,,,,fee schedule,,,2923.2,90,,percent of total billed charges,,,2923.2,90,,percent of total billed charges,,,2923.2,90,,percent of total billed charges,,,2923.2,90,,percent of total billed charges,,,2760.8,85,,percent of total billed charges,,302.6,3085.6,
DRAINAGE OF FINGER ABSCESS,26010,CDM,26010,CPT,,,both,,886,886,244.84,,,,fee schedule,,,,,,,,76.25,,,,fee schedule,,,753.1,85,,percent of total billed charges,,301.87,,,,fee schedule,,145.83,,,,fee schedule,,76.25,,,,fee schedule,,221.51,,,,fee schedule,,76.25,,,,fee schedule,,237.63,,,,fee schedule,,144.02,,,,fee schedule,,144.02,,,,fee schedule,,,806.26,91,,percent of total billed charges,,,841.7,95,,percent of total billed charges,,,735.38,83,,percent of total billed charges,,,265.8,83,,percent of total billed charges,,76.25,,,,fee schedule,,76.25,,,,fee schedule,,,735.38,83,,percent of total billed charges,,211.71,,,,fee schedule,,,797.4,90,,percent of total billed charges,,,797.4,90,,percent of total billed charges,,,797.4,90,,percent of total billed charges,,,797.4,90,,percent of total billed charges,,,753.1,85,,percent of total billed charges,,76.25,841.7,
DRAINAGE OF FINGER ABSCESS,26011,CDM,26011,CPT,,,both,,1547,1547,322.61,,,,fee schedule,,,,,,,,97.4,,,,fee schedule,,,1314.95,85,,percent of total billed charges,,399.77,,,,fee schedule,,193.12,,,,fee schedule,,97.4,,,,fee schedule,,320.33,,,,fee schedule,,97.4,,,,fee schedule,,313.12,,,,fee schedule,,189.77,,,,fee schedule,,189.77,,,,fee schedule,,,1407.77,91,,percent of total billed charges,,,1469.65,95,,percent of total billed charges,,,1284.01,83,,percent of total billed charges,,,464.1,83,,percent of total billed charges,,97.4,,,,fee schedule,,97.4,,,,fee schedule,,,1284.01,83,,percent of total billed charges,,278.96,,,,fee schedule,,,1392.3,90,,percent of total billed charges,,,1392.3,90,,percent of total billed charges,,,1392.3,90,,percent of total billed charges,,,1392.3,90,,percent of total billed charges,,,1314.95,85,,percent of total billed charges,,97.4,1469.65,
DRAIN HAND TENDON SHEATH,26020,CDM,26020,CPT,,,both,,2451,2451,970.7,,,,fee schedule,,,,,,,,191.8,,,,fee schedule,,,2083.35,85,,percent of total billed charges,,1206.23,,,,fee schedule,,582.71,,,,fee schedule,,191.8,,,,fee schedule,,711.62,,,,fee schedule,,191.8,,,,fee schedule,,942.15,,,,fee schedule,,571,,,,fee schedule,,571,,,,fee schedule,,,2230.41,91,,percent of total billed charges,,,2328.45,95,,percent of total billed charges,,,2034.33,83,,percent of total billed charges,,,735.3,83,,percent of total billed charges,,191.8,,,,fee schedule,,191.8,,,,fee schedule,,,2034.33,83,,percent of total billed charges,,839.37,,,,fee schedule,,,2205.9,90,,percent of total billed charges,,,2205.9,90,,percent of total billed charges,,,2205.9,90,,percent of total billed charges,,,2205.9,90,,percent of total billed charges,,,2083.35,85,,percent of total billed charges,,191.8,2328.45,
DRAINAGE OF PALM BURSA,26025,CDM,26025,CPT,,,both,,2420,2420,732.78,,,,fee schedule,,,,,,,,201.6,,,,fee schedule,,,2057,85,,percent of total billed charges,,912.68,,,,fee schedule,,440.91,,,,fee schedule,,201.6,,,,fee schedule,,708.3,,,,fee schedule,,201.6,,,,fee schedule,,711.22,,,,fee schedule,,431.05,,,,fee schedule,,431.05,,,,fee schedule,,,2202.2,91,,percent of total billed charges,,,2299,95,,percent of total billed charges,,,2008.6,83,,percent of total billed charges,,,726,83,,percent of total billed charges,,201.6,,,,fee schedule,,201.6,,,,fee schedule,,,2008.6,83,,percent of total billed charges,,633.64,,,,fee schedule,,,2178,90,,percent of total billed charges,,,2178,90,,percent of total billed charges,,,2178,90,,percent of total billed charges,,,2178,90,,percent of total billed charges,,,2057,85,,percent of total billed charges,,201.6,2299,
RELEASE PALM CONTRACTURE,26045,CDM,26045,CPT,,,both,,2579,2579,826.68,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,2192.15,85,,percent of total billed charges,,1024.53,,,,fee schedule,,494.94,,,,fee schedule,,449.5,,,,fee schedule,,803.14,,,,fee schedule,,449.5,,,,fee schedule,,802.36,,,,fee schedule,,486.28,,,,fee schedule,,486.28,,,,fee schedule,,,2346.89,91,,percent of total billed charges,,,2450.05,95,,percent of total billed charges,,,2140.57,83,,percent of total billed charges,,,773.7,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,2140.57,83,,percent of total billed charges,,714.83,,,,fee schedule,,,2321.1,90,,percent of total billed charges,,,2321.1,90,,percent of total billed charges,,,2321.1,90,,percent of total billed charges,,,2321.1,90,,percent of total billed charges,,,2192.15,85,,percent of total billed charges,,449.5,2450.05,
INCISE FINGER TENDON SHEATH,26055,CDM,26055,CPT,,,both,,2668,2668,510.41,,,,fee schedule,,,,,,,,235.8,,,,fee schedule,,,2267.8,85,,percent of total billed charges,,627.07,,,,fee schedule,,302.93,,,,fee schedule,,235.8,,,,fee schedule,,468.22,,,,fee schedule,,235.8,,,,fee schedule,,495.4,,,,fee schedule,,300.24,,,,fee schedule,,300.24,,,,fee schedule,,,2427.88,91,,percent of total billed charges,,,2534.6,95,,percent of total billed charges,,,2214.44,83,,percent of total billed charges,,,800.4,83,,percent of total billed charges,,235.8,,,,fee schedule,,235.8,,,,fee schedule,,,2214.44,83,,percent of total billed charges,,441.35,,,,fee schedule,,,2401.2,90,,percent of total billed charges,,,2401.2,90,,percent of total billed charges,,,2401.2,90,,percent of total billed charges,,,2401.2,90,,percent of total billed charges,,,2267.8,85,,percent of total billed charges,,235.8,2534.6,
INCISION OF FINGER TENDON,26060,CDM,26060,CPT,,,both,,1316,1316,447.04,,,,fee schedule,,,,,,,,107.9,,,,fee schedule,,,1118.6,85,,percent of total billed charges,,551.86,,,,fee schedule,,266.6,,,,fee schedule,,107.9,,,,fee schedule,,448.33,,,,fee schedule,,107.9,,,,fee schedule,,433.89,,,,fee schedule,,262.96,,,,fee schedule,,262.96,,,,fee schedule,,,1197.56,91,,percent of total billed charges,,,1250.2,95,,percent of total billed charges,,,1092.28,83,,percent of total billed charges,,,394.8,83,,percent of total billed charges,,107.9,,,,fee schedule,,107.9,,,,fee schedule,,,1092.28,83,,percent of total billed charges,,386.56,,,,fee schedule,,,1184.4,90,,percent of total billed charges,,,1184.4,90,,percent of total billed charges,,,1184.4,90,,percent of total billed charges,,,1184.4,90,,percent of total billed charges,,,1118.6,85,,percent of total billed charges,,107.9,1250.2,
EXPLORE/TREAT FINGER JOINT,26075,CDM,26075,CPT,,,both,,2239,2239,593.94,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,1903.15,85,,percent of total billed charges,,730.74,,,,fee schedule,,353.01,,,,fee schedule,,224.7,,,,fee schedule,,535.21,,,,fee schedule,,224.7,,,,fee schedule,,576.47,,,,fee schedule,,349.38,,,,fee schedule,,349.38,,,,fee schedule,,,2037.49,91,,percent of total billed charges,,,2127.05,95,,percent of total billed charges,,,1858.37,83,,percent of total billed charges,,,671.7,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,1858.37,83,,percent of total billed charges,,513.58,,,,fee schedule,,,2015.1,90,,percent of total billed charges,,,2015.1,90,,percent of total billed charges,,,2015.1,90,,percent of total billed charges,,,2015.1,90,,percent of total billed charges,,,1903.15,85,,percent of total billed charges,,224.7,2127.05,
EXPLORE/TREAT FINGER JOINT,26080,CDM,26080,CPT,,,both,,2041,2041,698.21,,,,fee schedule,,,,,,,,187.3,,,,fee schedule,,,1734.85,85,,percent of total billed charges,,861.16,,,,fee schedule,,416.01,,,,fee schedule,,187.3,,,,fee schedule,,644.64,,,,fee schedule,,187.3,,,,fee schedule,,677.68,,,,fee schedule,,410.71,,,,fee schedule,,410.71,,,,fee schedule,,,1857.31,91,,percent of total billed charges,,,1938.95,95,,percent of total billed charges,,,1694.03,83,,percent of total billed charges,,,612.3,83,,percent of total billed charges,,187.3,,,,fee schedule,,187.3,,,,fee schedule,,,1694.03,83,,percent of total billed charges,,603.75,,,,fee schedule,,,1836.9,90,,percent of total billed charges,,,1836.9,90,,percent of total billed charges,,,1836.9,90,,percent of total billed charges,,,1836.9,90,,percent of total billed charges,,,1734.85,85,,percent of total billed charges,,187.3,1938.95,
BIOPSY FINGER JOINT LINING,26110,CDM,26110,CPT,,,both,,1825,1825,571.47,,,,fee schedule,,,,,,,,187.3,,,,fee schedule,,,1551.25,85,,percent of total billed charges,,703.39,,,,fee schedule,,339.8,,,,fee schedule,,187.3,,,,fee schedule,,536.53,,,,fee schedule,,187.3,,,,fee schedule,,554.67,,,,fee schedule,,336.16,,,,fee schedule,,336.16,,,,fee schedule,,,1660.75,91,,percent of total billed charges,,,1733.75,95,,percent of total billed charges,,,1514.75,83,,percent of total billed charges,,,547.5,83,,percent of total billed charges,,187.3,,,,fee schedule,,187.3,,,,fee schedule,,,1514.75,83,,percent of total billed charges,,494.16,,,,fee schedule,,,1642.5,90,,percent of total billed charges,,,1642.5,90,,percent of total billed charges,,,1642.5,90,,percent of total billed charges,,,1642.5,90,,percent of total billed charges,,,1551.25,85,,percent of total billed charges,,187.3,1733.75,
EXC HAND LES SC 1.5 CM/>,26111,CDM,26111,CPT,,,both,,2266,2266,723.56,,,,fee schedule,,,,,,,,228.07,,,,fee schedule,,,1926.1,85,,percent of total billed charges,,901.17,,,,fee schedule,,435.34,,,,fee schedule,,228.07,,,,fee schedule,,,,,,,,228.07,,,,fee schedule,,702.28,,,,fee schedule,,425.62,,,,fee schedule,,425.62,,,,fee schedule,,,2062.06,91,,percent of total billed charges,,,2152.7,95,,percent of total billed charges,,,1880.78,83,,percent of total billed charges,,,679.8,83,,percent of total billed charges,,228.07,,,,fee schedule,,228.07,,,,fee schedule,,,1880.78,83,,percent of total billed charges,,625.67,,,,fee schedule,,,2039.4,90,,percent of total billed charges,,,2039.4,90,,percent of total billed charges,,,2039.4,90,,percent of total billed charges,,,2039.4,90,,percent of total billed charges,,,1926.1,85,,percent of total billed charges,,228.07,2152.7,
REMOVAL HAND LESION SUBCUT,26115,CDM,26115,CPT,,,both,,2487,2487,579.54,,,,fee schedule,,,,,,,,149.8,,,,fee schedule,,,2113.95,85,,percent of total billed charges,,714.66,,,,fee schedule,,345.24,,,,fee schedule,,149.8,,,,fee schedule,,610.15,,,,fee schedule,,149.8,,,,fee schedule,,562.49,,,,fee schedule,,340.91,,,,fee schedule,,340.91,,,,fee schedule,,,2263.17,91,,percent of total billed charges,,,2362.65,95,,percent of total billed charges,,,2064.21,83,,percent of total billed charges,,,746.1,83,,percent of total billed charges,,149.8,,,,fee schedule,,149.8,,,,fee schedule,,,2064.21,83,,percent of total billed charges,,501.13,,,,fee schedule,,,2238.3,90,,percent of total billed charges,,,2238.3,90,,percent of total billed charges,,,2238.3,90,,percent of total billed charges,,,2238.3,90,,percent of total billed charges,,,2113.95,85,,percent of total billed charges,,149.8,2362.65,
RELEASE PALM CONTRACTURE,26121,CDM,26121,CPT,,,both,,4002,4002,1046.17,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,3401.7,85,,percent of total billed charges,,1300.92,,,,fee schedule,,628.46,,,,fee schedule,,449.5,,,,fee schedule,,1037.92,,,,fee schedule,,449.5,,,,fee schedule,,1015.4,,,,fee schedule,,615.39,,,,fee schedule,,615.39,,,,fee schedule,,,3641.82,91,,percent of total billed charges,,,3801.9,95,,percent of total billed charges,,,3321.66,83,,percent of total billed charges,,,1200.6,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,3321.66,83,,percent of total billed charges,,904.63,,,,fee schedule,,,3601.8,90,,percent of total billed charges,,,3601.8,90,,percent of total billed charges,,,3601.8,90,,percent of total billed charges,,,3601.8,90,,percent of total billed charges,,,3401.7,85,,percent of total billed charges,,449.5,3801.9,
RELEASE PALM CONTRACTURE,26123,CDM,26123,CPT,,,both,,4894,4894,1456.91,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,4159.9,85,,percent of total billed charges,,1812.93,,,,fee schedule,,875.81,,,,fee schedule,,524.4,,,,fee schedule,,1296.57,,,,fee schedule,,524.4,,,,fee schedule,,1414.06,,,,fee schedule,,857.01,,,,fee schedule,,857.01,,,,fee schedule,,,4453.54,91,,percent of total billed charges,,,4649.3,95,,percent of total billed charges,,,4062.02,83,,percent of total billed charges,,,1468.2,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,4062.02,83,,percent of total billed charges,,1259.8,,,,fee schedule,,,4404.6,90,,percent of total billed charges,,,4404.6,90,,percent of total billed charges,,,4404.6,90,,percent of total billed charges,,,4404.6,90,,percent of total billed charges,,,4159.9,85,,percent of total billed charges,,524.4,4649.3,
RELEASE PALM CONTRACTURE,26125,CDM,26125,CPT,,,both,,1719,1719,459.71,,,,fee schedule,,,,,,,,,,,,,,,1461.15,85,,percent of total billed charges,,590.19,,,,fee schedule,,285.11,,,,fee schedule,,,,,,,,513.32,,,,fee schedule,,,,,,,,446.19,,,,fee schedule,,270.42,,,,fee schedule,,270.42,,,,fee schedule,,,1564.29,91,,percent of total billed charges,,,1633.05,95,,percent of total billed charges,,,1426.77,83,,percent of total billed charges,,,515.7,83,,percent of total billed charges,,,,,,,,,,,,,,,1426.77,83,,percent of total billed charges,,397.52,,,,fee schedule,,,1547.1,90,,percent of total billed charges,,,1547.1,90,,percent of total billed charges,,,1547.1,90,,percent of total billed charges,,,1547.1,90,,percent of total billed charges,,,1461.15,85,,percent of total billed charges,,270.42,1633.05,
REMOVE WRIST JOINT LINING,26130,CDM,26130,CPT,,,both,,2328,2328,821.49,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,1978.8,85,,percent of total billed charges,,1020.72,,,,fee schedule,,493.1,,,,fee schedule,,374.55,,,,fee schedule,,775.29,,,,fee schedule,,374.55,,,,fee schedule,,797.33,,,,fee schedule,,483.23,,,,fee schedule,,483.23,,,,fee schedule,,,2118.48,91,,percent of total billed charges,,,2211.6,95,,percent of total billed charges,,,1932.24,83,,percent of total billed charges,,,698.4,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,1932.24,83,,percent of total billed charges,,710.35,,,,fee schedule,,,2095.2,90,,percent of total billed charges,,,2095.2,90,,percent of total billed charges,,,2095.2,90,,percent of total billed charges,,,2095.2,90,,percent of total billed charges,,,1978.8,85,,percent of total billed charges,,374.55,2211.6,
"TENDON EXCISION, PALM/FINGER",26145,CDM,26145,CPT,,,both,,3157,3157,901.57,,,,fee schedule,,,,,,,,252.8,,,,fee schedule,,,2683.45,85,,percent of total billed charges,,1119.33,,,,fee schedule,,540.73,,,,fee schedule,,252.8,,,,fee schedule,,883.39,,,,fee schedule,,252.8,,,,fee schedule,,875.05,,,,fee schedule,,530.33,,,,fee schedule,,530.33,,,,fee schedule,,,2872.87,91,,percent of total billed charges,,,2999.15,95,,percent of total billed charges,,,2620.31,83,,percent of total billed charges,,,947.1,83,,percent of total billed charges,,252.8,,,,fee schedule,,252.8,,,,fee schedule,,,2620.31,83,,percent of total billed charges,,779.59,,,,fee schedule,,,2841.3,90,,percent of total billed charges,,,2841.3,90,,percent of total billed charges,,,2841.3,90,,percent of total billed charges,,,2841.3,90,,percent of total billed charges,,,2683.45,85,,percent of total billed charges,,252.8,2999.15,
REMOVE TENDON SHEATH LESION,26160,CDM,26160,CPT,,,both,,2688,2688,553.62,,,,fee schedule,,,,,,,,210.1,,,,fee schedule,,,2284.8,85,,percent of total billed charges,,680.57,,,,fee schedule,,328.78,,,,fee schedule,,210.1,,,,fee schedule,,513.98,,,,fee schedule,,210.1,,,,fee schedule,,537.33,,,,fee schedule,,325.66,,,,fee schedule,,325.66,,,,fee schedule,,,2446.08,91,,percent of total billed charges,,,2553.6,95,,percent of total billed charges,,,2231.04,83,,percent of total billed charges,,,806.4,83,,percent of total billed charges,,210.1,,,,fee schedule,,210.1,,,,fee schedule,,,2231.04,83,,percent of total billed charges,,478.71,,,,fee schedule,,,2419.2,90,,percent of total billed charges,,,2419.2,90,,percent of total billed charges,,,2419.2,90,,percent of total billed charges,,,2419.2,90,,percent of total billed charges,,,2284.8,85,,percent of total billed charges,,210.1,2553.6,
"REMOVAL OF PALM TENDON, EACH",26170,CDM,26170,CPT,,,both,,2161,2161,715.49,,,,fee schedule,,,,,,,,240,,,,fee schedule,,,1836.85,85,,percent of total billed charges,,884.43,,,,fee schedule,,427.26,,,,fee schedule,,240,,,,fee schedule,,689.73,,,,fee schedule,,240,,,,fee schedule,,694.45,,,,fee schedule,,420.88,,,,fee schedule,,420.88,,,,fee schedule,,,1966.51,91,,percent of total billed charges,,,2052.95,95,,percent of total billed charges,,,1793.63,83,,percent of total billed charges,,,648.3,83,,percent of total billed charges,,240,,,,fee schedule,,240,,,,fee schedule,,,1793.63,83,,percent of total billed charges,,618.69,,,,fee schedule,,,1944.9,90,,percent of total billed charges,,,1944.9,90,,percent of total billed charges,,,1944.9,90,,percent of total billed charges,,,1944.9,90,,percent of total billed charges,,,1836.85,85,,percent of total billed charges,,240,2052.95,
REMOVAL OF FINGER LESION,26210,CDM,26210,CPT,,,both,,3011,3011,784.62,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,2559.35,85,,percent of total billed charges,,967.01,,,,fee schedule,,467.15,,,,fee schedule,,224.7,,,,fee schedule,,751.41,,,,fee schedule,,224.7,,,,fee schedule,,761.55,,,,fee schedule,,461.54,,,,fee schedule,,461.54,,,,fee schedule,,,2740.01,91,,percent of total billed charges,,,2860.45,95,,percent of total billed charges,,,2499.13,83,,percent of total billed charges,,,903.3,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,2499.13,83,,percent of total billed charges,,678.47,,,,fee schedule,,,2709.9,90,,percent of total billed charges,,,2709.9,90,,percent of total billed charges,,,2709.9,90,,percent of total billed charges,,,2709.9,90,,percent of total billed charges,,,2559.35,85,,percent of total billed charges,,224.7,2860.45,
PARTIAL REMOVAL OF HAND BONE,26230,CDM,26230,CPT,,,both,,2738,2738,873.92,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,2327.3,85,,percent of total billed charges,,1086.85,,,,fee schedule,,525.04,,,,fee schedule,,299.7,,,,fee schedule,,876.76,,,,fee schedule,,299.7,,,,fee schedule,,848.21,,,,fee schedule,,514.07,,,,fee schedule,,514.07,,,,fee schedule,,,2491.58,91,,percent of total billed charges,,,2601.1,95,,percent of total billed charges,,,2272.54,83,,percent of total billed charges,,,821.4,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,2272.54,83,,percent of total billed charges,,755.68,,,,fee schedule,,,2464.2,90,,percent of total billed charges,,,2464.2,90,,percent of total billed charges,,,2464.2,90,,percent of total billed charges,,,2464.2,90,,percent of total billed charges,,,2327.3,85,,percent of total billed charges,,299.7,2601.1,
"PARTIAL REMOVAL, FINGER BONE",26235,CDM,26235,CPT,,,both,,2527,2527,860.09,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,2147.95,85,,percent of total billed charges,,1068.9,,,,fee schedule,,516.37,,,,fee schedule,,224.7,,,,fee schedule,,857.53,,,,fee schedule,,224.7,,,,fee schedule,,834.79,,,,fee schedule,,505.94,,,,fee schedule,,505.94,,,,fee schedule,,,2299.57,91,,percent of total billed charges,,,2400.65,95,,percent of total billed charges,,,2097.41,83,,percent of total billed charges,,,758.1,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,2097.41,83,,percent of total billed charges,,743.73,,,,fee schedule,,,2274.3,90,,percent of total billed charges,,,2274.3,90,,percent of total billed charges,,,2274.3,90,,percent of total billed charges,,,2274.3,90,,percent of total billed charges,,,2147.95,85,,percent of total billed charges,,224.7,2400.65,
"PARTIAL REMOVAL, FINGER BONE",26236,CDM,26236,CPT,,,both,,2291,2291,770.8,,,,fee schedule,,,,,,,,204.05,,,,fee schedule,,,1947.35,85,,percent of total billed charges,,959.29,,,,fee schedule,,463.42,,,,fee schedule,,204.05,,,,fee schedule,,757.38,,,,fee schedule,,204.05,,,,fee schedule,,748.13,,,,fee schedule,,453.41,,,,fee schedule,,453.41,,,,fee schedule,,,2084.81,91,,percent of total billed charges,,,2176.45,95,,percent of total billed charges,,,1901.53,83,,percent of total billed charges,,,687.3,83,,percent of total billed charges,,204.05,,,,fee schedule,,204.05,,,,fee schedule,,,1901.53,83,,percent of total billed charges,,666.51,,,,fee schedule,,,2061.9,90,,percent of total billed charges,,,2061.9,90,,percent of total billed charges,,,2061.9,90,,percent of total billed charges,,,2061.9,90,,percent of total billed charges,,,1947.35,85,,percent of total billed charges,,204.05,2176.45,
REMOVAL OF IMPLANT FROM HAND,26320,CDM,26320,CPT,,,both,,5979,5979,612.38,,,,fee schedule,,,,,,,,233,,,,fee schedule,,,5082.15,85,,percent of total billed charges,,757.91,,,,fee schedule,,366.14,,,,fee schedule,,233,,,,fee schedule,,587.6,,,,fee schedule,,233,,,,fee schedule,,594.36,,,,fee schedule,,360.22,,,,fee schedule,,360.22,,,,fee schedule,,,5440.89,91,,percent of total billed charges,,,5680.05,95,,percent of total billed charges,,,4962.57,83,,percent of total billed charges,,,1793.7,83,,percent of total billed charges,,233,,,,fee schedule,,233,,,,fee schedule,,,4962.57,83,,percent of total billed charges,,529.52,,,,fee schedule,,,5381.1,90,,percent of total billed charges,,,5381.1,90,,percent of total billed charges,,,5381.1,90,,percent of total billed charges,,,5381.1,90,,percent of total billed charges,,,5082.15,85,,percent of total billed charges,,233,5680.05,
REPAIR FINGER/HAND TENDON,26350,CDM,26350,CPT,,,both,,5417,5417,1310.01,,,,fee schedule,,,,,,,,274.4,,,,fee schedule,,,4604.45,85,,percent of total billed charges,,1615.31,,,,fee schedule,,780.34,,,,fee schedule,,274.4,,,,fee schedule,,1425.89,,,,fee schedule,,274.4,,,,fee schedule,,1271.48,,,,fee schedule,,770.59,,,,fee schedule,,770.59,,,,fee schedule,,,4929.47,91,,percent of total billed charges,,,5146.15,95,,percent of total billed charges,,,4496.11,83,,percent of total billed charges,,,1625.1,83,,percent of total billed charges,,274.4,,,,fee schedule,,274.4,,,,fee schedule,,,4496.11,83,,percent of total billed charges,,1132.77,,,,fee schedule,,,4875.3,90,,percent of total billed charges,,,4875.3,90,,percent of total billed charges,,,4875.3,90,,percent of total billed charges,,,4875.3,90,,percent of total billed charges,,,4604.45,85,,percent of total billed charges,,274.4,5146.15,
REPAIR FINGER/HAND TENDON,26356,CDM,26356,CPT,,,both,,5149,5149,1386.63,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,4376.65,85,,percent of total billed charges,,1719.54,,,,fee schedule,,830.69,,,,fee schedule,,359.3,,,,fee schedule,,1832.44,,,,fee schedule,,359.3,,,,fee schedule,,1345.85,,,,fee schedule,,815.66,,,,fee schedule,,815.66,,,,fee schedule,,,4685.59,91,,percent of total billed charges,,,4891.55,95,,percent of total billed charges,,,4273.67,83,,percent of total billed charges,,,1544.7,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,4273.67,83,,percent of total billed charges,,1199.03,,,,fee schedule,,,4634.1,90,,percent of total billed charges,,,4634.1,90,,percent of total billed charges,,,4634.1,90,,percent of total billed charges,,,4634.1,90,,percent of total billed charges,,,4376.65,85,,percent of total billed charges,,359.3,4891.55,
REPAIR FINGER/HAND TENDON,26357,CDM,26357,CPT,,,both,,4160,4160,1551.97,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,3536,85,,percent of total billed charges,,1937.12,,,,fee schedule,,935.8,,,,fee schedule,,359.3,,,,fee schedule,,1692.5,,,,fee schedule,,359.3,,,,fee schedule,,1506.32,,,,fee schedule,,912.92,,,,fee schedule,,912.92,,,,fee schedule,,,3785.6,91,,percent of total billed charges,,,3952,95,,percent of total billed charges,,,3452.8,83,,percent of total billed charges,,,1248,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,3452.8,83,,percent of total billed charges,,1341.99,,,,fee schedule,,,3744,90,,percent of total billed charges,,,3744,90,,percent of total billed charges,,,3744,90,,percent of total billed charges,,,3744,90,,percent of total billed charges,,,3536,85,,percent of total billed charges,,359.3,3952,
REPAIR FINGER/HAND TENDON,26370,CDM,26370,CPT,,,both,,4102,4102,1375.68,,,,fee schedule,,,,,,,,307.2,,,,fee schedule,,,3486.7,85,,percent of total billed charges,,1706.24,,,,fee schedule,,824.27,,,,fee schedule,,307.2,,,,fee schedule,,1545.93,,,,fee schedule,,307.2,,,,fee schedule,,1335.22,,,,fee schedule,,809.23,,,,fee schedule,,809.23,,,,fee schedule,,,3732.82,91,,percent of total billed charges,,,3896.9,95,,percent of total billed charges,,,3404.66,83,,percent of total billed charges,,,1230.6,83,,percent of total billed charges,,307.2,,,,fee schedule,,307.2,,,,fee schedule,,,3404.66,83,,percent of total billed charges,,1189.56,,,,fee schedule,,,3691.8,90,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3486.7,85,,percent of total billed charges,,307.2,3896.9,
REPAIR FINGER/HAND TENDON,26373,CDM,26373,CPT,,,both,,3761,3761,1543.9,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3196.85,85,,percent of total billed charges,,1920.72,,,,fee schedule,,927.88,,,,fee schedule,,480,,,,fee schedule,,1685.87,,,,fee schedule,,480,,,,fee schedule,,1498.49,,,,fee schedule,,908.18,,,,fee schedule,,908.18,,,,fee schedule,,,3422.51,91,,percent of total billed charges,,,3572.95,95,,percent of total billed charges,,,3121.63,83,,percent of total billed charges,,,1128.3,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3121.63,83,,percent of total billed charges,,1335.02,,,,fee schedule,,,3384.9,90,,percent of total billed charges,,,3384.9,90,,percent of total billed charges,,,3384.9,90,,percent of total billed charges,,,3384.9,90,,percent of total billed charges,,,3196.85,85,,percent of total billed charges,,480,3572.95,
REPAIR HAND TENDON,26410,CDM,26410,CPT,,,both,,2914,2914,1057.69,,,,fee schedule,,,,,,,,222,,,,fee schedule,,,2476.9,85,,percent of total billed charges,,1301.43,,,,fee schedule,,628.7,,,,fee schedule,,222,,,,fee schedule,,1145.36,,,,fee schedule,,222,,,,fee schedule,,1026.58,,,,fee schedule,,622.17,,,,fee schedule,,622.17,,,,fee schedule,,,2651.74,91,,percent of total billed charges,,,2768.3,95,,percent of total billed charges,,,2418.62,83,,percent of total billed charges,,,874.2,83,,percent of total billed charges,,222,,,,fee schedule,,222,,,,fee schedule,,,2418.62,83,,percent of total billed charges,,914.59,,,,fee schedule,,,2622.6,90,,percent of total billed charges,,,2622.6,90,,percent of total billed charges,,,2622.6,90,,percent of total billed charges,,,2622.6,90,,percent of total billed charges,,,2476.9,85,,percent of total billed charges,,222,2768.3,
REPAIR/GRAFT HAND TENDON,26412,CDM,26412,CPT,,,both,,3024,3024,1258.74,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,2570.4,85,,percent of total billed charges,,1556.14,,,,fee schedule,,751.75,,,,fee schedule,,299.7,,,,fee schedule,,1361.56,,,,fee schedule,,299.7,,,,fee schedule,,1221.72,,,,fee schedule,,740.44,,,,fee schedule,,740.44,,,,fee schedule,,,2751.84,91,,percent of total billed charges,,,2872.8,95,,percent of total billed charges,,,2509.92,83,,percent of total billed charges,,,907.2,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,2509.92,83,,percent of total billed charges,,1088.44,,,,fee schedule,,,2721.6,90,,percent of total billed charges,,,2721.6,90,,percent of total billed charges,,,2721.6,90,,percent of total billed charges,,,2721.6,90,,percent of total billed charges,,,2570.4,85,,percent of total billed charges,,299.7,2872.8,
"EXCISION, HAND/FINGER TENDON",26415,CDM,26415,CPT,,,both,,3095,3095,1491.48,,,,fee schedule,,,,,,,,306.95,,,,fee schedule,,,2630.75,85,,percent of total billed charges,,1859.06,,,,fee schedule,,898.09,,,,fee schedule,,306.95,,,,fee schedule,,1398.04,,,,fee schedule,,306.95,,,,fee schedule,,1447.61,,,,fee schedule,,877.34,,,,fee schedule,,877.34,,,,fee schedule,,,2816.45,91,,percent of total billed charges,,,2940.25,95,,percent of total billed charges,,,2568.85,83,,percent of total billed charges,,,928.5,83,,percent of total billed charges,,306.95,,,,fee schedule,,306.95,,,,fee schedule,,,2568.85,83,,percent of total billed charges,,1289.69,,,,fee schedule,,,2785.5,90,,percent of total billed charges,,,2785.5,90,,percent of total billed charges,,,2785.5,90,,percent of total billed charges,,,2785.5,90,,percent of total billed charges,,,2630.75,85,,percent of total billed charges,,306.95,2940.25,
REPAIR FINGER TENDON,26418,CDM,26418,CPT,,,both,,3030,3030,1097.44,,,,fee schedule,,,,,,,,201.65,,,,fee schedule,,,2575.5,85,,percent of total billed charges,,1344.26,,,,fee schedule,,649.4,,,,fee schedule,,201.65,,,,fee schedule,,1140.71,,,,fee schedule,,201.65,,,,fee schedule,,1065.16,,,,fee schedule,,645.55,,,,fee schedule,,645.55,,,,fee schedule,,,2757.3,91,,percent of total billed charges,,,2878.5,95,,percent of total billed charges,,,2514.9,83,,percent of total billed charges,,,909,83,,percent of total billed charges,,201.65,,,,fee schedule,,201.65,,,,fee schedule,,,2514.9,83,,percent of total billed charges,,948.96,,,,fee schedule,,,2727,90,,percent of total billed charges,,,2727,90,,percent of total billed charges,,,2727,90,,percent of total billed charges,,,2727,90,,percent of total billed charges,,,2575.5,85,,percent of total billed charges,,201.65,2878.5,
REPAIR/GRAFT FINGER TENDON,26428,CDM,26428,CPT,,,both,,3347,3347,1398.15,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,2844.95,85,,percent of total billed charges,,1734.9,,,,fee schedule,,838.11,,,,fee schedule,,599.35,,,,fee schedule,,1468.34,,,,fee schedule,,599.35,,,,fee schedule,,1357.03,,,,fee schedule,,822.44,,,,fee schedule,,822.44,,,,fee schedule,,,3045.77,91,,percent of total billed charges,,,3179.65,95,,percent of total billed charges,,,2778.01,83,,percent of total billed charges,,,1004.1,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,2778.01,83,,percent of total billed charges,,1208.99,,,,fee schedule,,,3012.3,90,,percent of total billed charges,,,3012.3,90,,percent of total billed charges,,,3012.3,90,,percent of total billed charges,,,3012.3,90,,percent of total billed charges,,,2844.95,85,,percent of total billed charges,,599.35,3179.65,
REPAIR FINGER TENDON,26432,CDM,26432,CPT,,,both,,2423,2423,958.03,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,2059.55,85,,percent of total billed charges,,1175.75,,,,fee schedule,,567.99,,,,fee schedule,,359.3,,,,fee schedule,,987.51,,,,fee schedule,,359.3,,,,fee schedule,,929.85,,,,fee schedule,,563.54,,,,fee schedule,,563.54,,,,fee schedule,,,2204.93,91,,percent of total billed charges,,,2301.85,95,,percent of total billed charges,,,2011.09,83,,percent of total billed charges,,,726.9,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,2011.09,83,,percent of total billed charges,,828.41,,,,fee schedule,,,2180.7,90,,percent of total billed charges,,,2180.7,90,,percent of total billed charges,,,2180.7,90,,percent of total billed charges,,,2180.7,90,,percent of total billed charges,,,2059.55,85,,percent of total billed charges,,359.3,2301.85,
REPAIR FINGER TENDON,26433,CDM,26433,CPT,,,both,,2761,2761,1007.57,,,,fee schedule,,,,,,,,222,,,,fee schedule,,,2346.85,85,,percent of total billed charges,,1239.89,,,,fee schedule,,598.97,,,,fee schedule,,222,,,,fee schedule,,1064.45,,,,fee schedule,,222,,,,fee schedule,,977.93,,,,fee schedule,,592.69,,,,fee schedule,,592.69,,,,fee schedule,,,2512.51,91,,percent of total billed charges,,,2622.95,95,,percent of total billed charges,,,2291.63,83,,percent of total billed charges,,,828.3,83,,percent of total billed charges,,222,,,,fee schedule,,222,,,,fee schedule,,,2291.63,83,,percent of total billed charges,,871.25,,,,fee schedule,,,2484.9,90,,percent of total billed charges,,,2484.9,90,,percent of total billed charges,,,2484.9,90,,percent of total billed charges,,,2484.9,90,,percent of total billed charges,,,2346.85,85,,percent of total billed charges,,222,2622.95,
REPAIR/GRAFT FINGER TENDON,26434,CDM,26434,CPT,,,both,,2945,2945,1221.87,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,2503.25,85,,percent of total billed charges,,1514.78,,,,fee schedule,,731.77,,,,fee schedule,,359.3,,,,fee schedule,,1230.25,,,,fee schedule,,359.3,,,,fee schedule,,1185.93,,,,fee schedule,,718.75,,,,fee schedule,,718.75,,,,fee schedule,,,2679.95,91,,percent of total billed charges,,,2797.75,95,,percent of total billed charges,,,2444.35,83,,percent of total billed charges,,,883.5,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,2444.35,83,,percent of total billed charges,,1056.56,,,,fee schedule,,,2650.5,90,,percent of total billed charges,,,2650.5,90,,percent of total billed charges,,,2650.5,90,,percent of total billed charges,,,2650.5,90,,percent of total billed charges,,,2503.25,85,,percent of total billed charges,,359.3,2797.75,
REALIGNMENT OF TENDONS,26437,CDM,26437,CPT,,,both,,3210,3210,1171.75,,,,fee schedule,,,,,,,,225.1,,,,fee schedule,,,2728.5,85,,percent of total billed charges,,1445.74,,,,fee schedule,,698.42,,,,fee schedule,,225.1,,,,fee schedule,,1211.68,,,,fee schedule,,225.1,,,,fee schedule,,1137.29,,,,fee schedule,,689.27,,,,fee schedule,,689.27,,,,fee schedule,,,2921.1,91,,percent of total billed charges,,,3049.5,95,,percent of total billed charges,,,2664.3,83,,percent of total billed charges,,,963,83,,percent of total billed charges,,225.1,,,,fee schedule,,225.1,,,,fee schedule,,,2664.3,83,,percent of total billed charges,,1013.22,,,,fee schedule,,,2889,90,,percent of total billed charges,,,2889,90,,percent of total billed charges,,,2889,90,,percent of total billed charges,,,2889,90,,percent of total billed charges,,,2728.5,85,,percent of total billed charges,,225.1,3049.5,
RELEASE PALM/FINGER TENDON,26440,CDM,26440,CPT,,,both,,3278,3278,1144.1,,,,fee schedule,,,,,,,,417.6,,,,fee schedule,,,2786.3,85,,percent of total billed charges,,1408.78,,,,fee schedule,,680.57,,,,fee schedule,,417.6,,,,fee schedule,,1272.03,,,,fee schedule,,417.6,,,,fee schedule,,1110.45,,,,fee schedule,,673,,,,fee schedule,,673,,,,fee schedule,,,2982.98,91,,percent of total billed charges,,,3114.1,95,,percent of total billed charges,,,2720.74,83,,percent of total billed charges,,,983.4,83,,percent of total billed charges,,417.6,,,,fee schedule,,417.6,,,,fee schedule,,,2720.74,83,,percent of total billed charges,,989.31,,,,fee schedule,,,2950.2,90,,percent of total billed charges,,,2950.2,90,,percent of total billed charges,,,2950.2,90,,percent of total billed charges,,,2950.2,90,,percent of total billed charges,,,2786.3,85,,percent of total billed charges,,417.6,3114.1,
RELEASE HAND/FINGER TENDON,26445,CDM,26445,CPT,,,both,,1999,1999,1067.48,,,,fee schedule,,,,,,,,240,,,,fee schedule,,,1699.15,85,,percent of total billed charges,,1313.63,,,,fee schedule,,634.6,,,,fee schedule,,240,,,,fee schedule,,1199.08,,,,fee schedule,,240,,,,fee schedule,,1036.08,,,,fee schedule,,627.93,,,,fee schedule,,627.93,,,,fee schedule,,,1819.09,91,,percent of total billed charges,,,1899.05,95,,percent of total billed charges,,,1659.17,83,,percent of total billed charges,,,599.7,83,,percent of total billed charges,,240,,,,fee schedule,,240,,,,fee schedule,,,1659.17,83,,percent of total billed charges,,923.06,,,,fee schedule,,,1799.1,90,,percent of total billed charges,,,1799.1,90,,percent of total billed charges,,,1799.1,90,,percent of total billed charges,,,1799.1,90,,percent of total billed charges,,,1699.15,85,,percent of total billed charges,,240,1899.05,
INCISION OF FINGER TENDON,26455,CDM,26455,CPT,,,both,,1919,1919,813.43,,,,fee schedule,,,,,,,,240,,,,fee schedule,,,1631.15,85,,percent of total billed charges,,991.4,,,,fee schedule,,478.93,,,,fee schedule,,240,,,,fee schedule,,761.36,,,,fee schedule,,240,,,,fee schedule,,789.5,,,,fee schedule,,478.49,,,,fee schedule,,478.49,,,,fee schedule,,,1746.29,91,,percent of total billed charges,,,1823.05,95,,percent of total billed charges,,,1592.77,83,,percent of total billed charges,,,575.7,83,,percent of total billed charges,,240,,,,fee schedule,,240,,,,fee schedule,,,1592.77,83,,percent of total billed charges,,703.38,,,,fee schedule,,,1727.1,90,,percent of total billed charges,,,1727.1,90,,percent of total billed charges,,,1727.1,90,,percent of total billed charges,,,1727.1,90,,percent of total billed charges,,,1631.15,85,,percent of total billed charges,,240,1823.05,
TRANSPLANT HAND TENDON,26480,CDM,26480,CPT,,,both,,4188,4188,1377.99,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3559.8,85,,percent of total billed charges,,1700.55,,,,fee schedule,,821.51,,,,fee schedule,,480,,,,fee schedule,,1507.47,,,,fee schedule,,480,,,,fee schedule,,1337.46,,,,fee schedule,,810.58,,,,fee schedule,,810.58,,,,fee schedule,,,3811.08,91,,percent of total billed charges,,,3978.6,95,,percent of total billed charges,,,3476.04,83,,percent of total billed charges,,,1256.4,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3476.04,83,,percent of total billed charges,,1191.56,,,,fee schedule,,,3769.2,90,,percent of total billed charges,,,3769.2,90,,percent of total billed charges,,,3769.2,90,,percent of total billed charges,,,3769.2,90,,percent of total billed charges,,,3559.8,85,,percent of total billed charges,,480,3978.6,
REVISE THUMB TENDON,26496,CDM,26496,CPT,,,both,,3870,3870,1587.11,,,,fee schedule,,,,,,,,490.99,,,,fee schedule,,,3289.5,85,,percent of total billed charges,,1982.15,,,,fee schedule,,957.55,,,,fee schedule,,490.99,,,,fee schedule,,1608.28,,,,fee schedule,,490.99,,,,fee schedule,,1540.43,,,,fee schedule,,933.59,,,,fee schedule,,933.59,,,,fee schedule,,,3521.7,91,,percent of total billed charges,,,3676.5,95,,percent of total billed charges,,,3212.1,83,,percent of total billed charges,,,1161,83,,percent of total billed charges,,490.99,,,,fee schedule,,490.99,,,,fee schedule,,,3212.1,83,,percent of total billed charges,,1372.38,,,,fee schedule,,,3483,90,,percent of total billed charges,,,3483,90,,percent of total billed charges,,,3483,90,,percent of total billed charges,,,3483,90,,percent of total billed charges,,,3289.5,85,,percent of total billed charges,,490.99,3676.5,
FINGER TENDON TRANSFER,26497,CDM,26497,CPT,,,both,,3950,3950,1585.38,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,3357.5,85,,percent of total billed charges,,1979.96,,,,fee schedule,,956.5,,,,fee schedule,,374.55,,,,fee schedule,,1626.18,,,,fee schedule,,374.55,,,,fee schedule,,1538.75,,,,fee schedule,,932.58,,,,fee schedule,,932.58,,,,fee schedule,,,3594.5,91,,percent of total billed charges,,,3752.5,95,,percent of total billed charges,,,3278.5,83,,percent of total billed charges,,,1185,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,3278.5,83,,percent of total billed charges,,1370.89,,,,fee schedule,,,3555,90,,percent of total billed charges,,,3555,90,,percent of total billed charges,,,3555,90,,percent of total billed charges,,,3555,90,,percent of total billed charges,,,3357.5,85,,percent of total billed charges,,374.55,3752.5,
FINGER TENDON TRANSFER,26498,CDM,26498,CPT,,,both,,5265,5265,2056.04,,,,fee schedule,,,,,,,,693.7,,,,fee schedule,,,4475.25,85,,percent of total billed charges,,2586.31,,,,fee schedule,,1249.42,,,,fee schedule,,693.7,,,,fee schedule,,2137.51,,,,fee schedule,,693.7,,,,fee schedule,,1995.57,,,,fee schedule,,1209.43,,,,fee schedule,,1209.43,,,,fee schedule,,,4791.15,91,,percent of total billed charges,,,5001.75,95,,percent of total billed charges,,,4369.95,83,,percent of total billed charges,,,1579.5,83,,percent of total billed charges,,693.7,,,,fee schedule,,693.7,,,,fee schedule,,,4369.95,83,,percent of total billed charges,,1777.87,,,,fee schedule,,,4738.5,90,,percent of total billed charges,,,4738.5,90,,percent of total billed charges,,,4738.5,90,,percent of total billed charges,,,4738.5,90,,percent of total billed charges,,,4475.25,85,,percent of total billed charges,,693.7,5001.75,
FUSION OF KNUCKLE JOINT,26516,CDM,26516,CPT,,,both,,3722,3722,1303.67,,,,fee schedule,,,,,,,,255,,,,fee schedule,,,3163.7,85,,percent of total billed charges,,1617.79,,,,fee schedule,,781.54,,,,fee schedule,,255,,,,fee schedule,,1356.26,,,,fee schedule,,255,,,,fee schedule,,1265.33,,,,fee schedule,,766.87,,,,fee schedule,,766.87,,,,fee schedule,,,3387.02,91,,percent of total billed charges,,,3535.9,95,,percent of total billed charges,,,3089.26,83,,percent of total billed charges,,,1116.6,83,,percent of total billed charges,,255,,,,fee schedule,,255,,,,fee schedule,,,3089.26,83,,percent of total billed charges,,1127.29,,,,fee schedule,,,3349.8,90,,percent of total billed charges,,,3349.8,90,,percent of total billed charges,,,3349.8,90,,percent of total billed charges,,,3349.8,90,,percent of total billed charges,,,3163.7,85,,percent of total billed charges,,255,3535.9,
RELEASE FINGER CONTRACTURE,26525,CDM,26525,CPT,,,both,,3406,3406,1204.59,,,,fee schedule,,,,,,,,262.2,,,,fee schedule,,,2895.1,85,,percent of total billed charges,,1482.21,,,,fee schedule,,716.04,,,,fee schedule,,262.2,,,,fee schedule,,1332.38,,,,fee schedule,,262.2,,,,fee schedule,,1169.16,,,,fee schedule,,708.58,,,,fee schedule,,708.58,,,,fee schedule,,,3099.46,91,,percent of total billed charges,,,3235.7,95,,percent of total billed charges,,,2826.98,83,,percent of total billed charges,,,1021.8,83,,percent of total billed charges,,262.2,,,,fee schedule,,262.2,,,,fee schedule,,,2826.98,83,,percent of total billed charges,,1041.61,,,,fee schedule,,,3065.4,90,,percent of total billed charges,,,3065.4,90,,percent of total billed charges,,,3065.4,90,,percent of total billed charges,,,3065.4,90,,percent of total billed charges,,,2895.1,85,,percent of total billed charges,,262.2,3235.7,
REVISE KNUCKLE JOINT,26530,CDM,26530,CPT,,,both,,2931,2931,942.47,,,,fee schedule,,,,,,,,289.3,,,,fee schedule,,,2491.35,85,,percent of total billed charges,,1175.71,,,,fee schedule,,567.97,,,,fee schedule,,289.3,,,,fee schedule,,918.54,,,,fee schedule,,289.3,,,,fee schedule,,914.75,,,,fee schedule,,554.39,,,,fee schedule,,554.39,,,,fee schedule,,,2667.21,91,,percent of total billed charges,,,2784.45,95,,percent of total billed charges,,,2432.73,83,,percent of total billed charges,,,879.3,83,,percent of total billed charges,,289.3,,,,fee schedule,,289.3,,,,fee schedule,,,2432.73,83,,percent of total billed charges,,814.96,,,,fee schedule,,,2637.9,90,,percent of total billed charges,,,2637.9,90,,percent of total billed charges,,,2637.9,90,,percent of total billed charges,,,2637.9,90,,percent of total billed charges,,,2491.35,85,,percent of total billed charges,,289.3,2784.45,
REVISE/IMPLANT FINGER JOINT,26536,CDM,26536,CPT,,,both,,3506,3506,1315.2,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,2980.1,85,,percent of total billed charges,,1621.64,,,,fee schedule,,783.4,,,,fee schedule,,524.4,,,,fee schedule,,1124.13,,,,fee schedule,,524.4,,,,fee schedule,,1276.51,,,,fee schedule,,773.64,,,,fee schedule,,773.64,,,,fee schedule,,,3190.46,91,,percent of total billed charges,,,3330.7,95,,percent of total billed charges,,,2909.98,83,,percent of total billed charges,,,1051.8,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,2909.98,83,,percent of total billed charges,,1137.26,,,,fee schedule,,,3155.4,90,,percent of total billed charges,,,3155.4,90,,percent of total billed charges,,,3155.4,90,,percent of total billed charges,,,3155.4,90,,percent of total billed charges,,,2980.1,85,,percent of total billed charges,,524.4,3330.7,
REPAIR HAND JOINT,26540,CDM,26540,CPT,,,both,,3556,3556,1228.21,,,,fee schedule,,,,,,,,346.75,,,,fee schedule,,,3022.6,85,,percent of total billed charges,,1519.71,,,,fee schedule,,734.16,,,,fee schedule,,346.75,,,,fee schedule,,1278,,,,fee schedule,,346.75,,,,fee schedule,,1192.08,,,,fee schedule,,722.48,,,,fee schedule,,722.48,,,,fee schedule,,,3235.96,91,,percent of total billed charges,,,3378.2,95,,percent of total billed charges,,,2951.48,83,,percent of total billed charges,,,1066.8,83,,percent of total billed charges,,346.75,,,,fee schedule,,346.75,,,,fee schedule,,,2951.48,83,,percent of total billed charges,,1062.04,,,,fee schedule,,,3200.4,90,,percent of total billed charges,,,3200.4,90,,percent of total billed charges,,,3200.4,90,,percent of total billed charges,,,3200.4,90,,percent of total billed charges,,,3022.6,85,,percent of total billed charges,,346.75,3378.2,
REPAIR HAND JOINT WITH GRAFT,26541,CDM,26541,CPT,,,both,,4243,4243,1459.22,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,3606.55,85,,percent of total billed charges,,1815.92,,,,fee schedule,,877.25,,,,fee schedule,,374.55,,,,fee schedule,,1543.28,,,,fee schedule,,374.55,,,,fee schedule,,1416.3,,,,fee schedule,,858.36,,,,fee schedule,,858.36,,,,fee schedule,,,3861.13,91,,percent of total billed charges,,,4030.85,95,,percent of total billed charges,,,3521.69,83,,percent of total billed charges,,,1272.9,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,3521.69,83,,percent of total billed charges,,1261.79,,,,fee schedule,,,3818.7,90,,percent of total billed charges,,,3818.7,90,,percent of total billed charges,,,3818.7,90,,percent of total billed charges,,,3818.7,90,,percent of total billed charges,,,3606.55,85,,percent of total billed charges,,374.55,4030.85,
CORRECT METACARPAL FLAW,26565,CDM,26565,CPT,,,both,,2835,2835,1252.4,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,2409.75,85,,percent of total billed charges,,1560.11,,,,fee schedule,,753.67,,,,fee schedule,,359.3,,,,fee schedule,,1308.51,,,,fee schedule,,359.3,,,,fee schedule,,1215.57,,,,fee schedule,,736.71,,,,fee schedule,,736.71,,,,fee schedule,,,2579.85,91,,percent of total billed charges,,,2693.25,95,,percent of total billed charges,,,2353.05,83,,percent of total billed charges,,,850.5,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,2353.05,83,,percent of total billed charges,,1082.96,,,,fee schedule,,,2551.5,90,,percent of total billed charges,,,2551.5,90,,percent of total billed charges,,,2551.5,90,,percent of total billed charges,,,2551.5,90,,percent of total billed charges,,,2409.75,85,,percent of total billed charges,,359.3,2693.25,
CORRECT FINGER DEFORMITY,26567,CDM,26567,CPT,,,both,,2912,2912,1262.2,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,2475.2,85,,percent of total billed charges,,1564.74,,,,fee schedule,,755.91,,,,fee schedule,,359.3,,,,fee schedule,,1312.49,,,,fee schedule,,359.3,,,,fee schedule,,1225.07,,,,fee schedule,,742.47,,,,fee schedule,,742.47,,,,fee schedule,,,2649.92,91,,percent of total billed charges,,,2766.4,95,,percent of total billed charges,,,2416.96,83,,percent of total billed charges,,,873.6,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,2416.96,83,,percent of total billed charges,,1091.43,,,,fee schedule,,,2620.8,90,,percent of total billed charges,,,2620.8,90,,percent of total billed charges,,,2620.8,90,,percent of total billed charges,,,2620.8,90,,percent of total billed charges,,,2475.2,85,,percent of total billed charges,,359.3,2766.4,
TREAT METACARPAL FRACTURE,26600,CDM,26600,CPT,,,both,,1074,1074,509.26,,,,fee schedule,,,,,,,,93.7,,,,fee schedule,,,912.9,85,,percent of total billed charges,,616.89,,,,fee schedule,,298.01,,,,fee schedule,,93.7,,,,fee schedule,,324.97,,,,fee schedule,,93.7,,,,fee schedule,,494.28,,,,fee schedule,,299.56,,,,fee schedule,,299.56,,,,fee schedule,,,977.34,91,,percent of total billed charges,,,1020.3,95,,percent of total billed charges,,,891.42,83,,percent of total billed charges,,,322.2,83,,percent of total billed charges,,93.7,,,,fee schedule,,93.7,,,,fee schedule,,,891.42,83,,percent of total billed charges,,440.36,,,,fee schedule,,,966.6,90,,percent of total billed charges,,,966.6,90,,percent of total billed charges,,,966.6,90,,percent of total billed charges,,,966.6,90,,percent of total billed charges,,,912.9,85,,percent of total billed charges,,93.7,1020.3,
TREAT METACARPAL FRACTURE,26600P,CDM,26600,CPT,,,both,P,704,704,509.26,,,,fee schedule,,,,,,,,93.7,,,,fee schedule,,,598.4,85,,percent of total billed charges,,616.89,,,,fee schedule,,298.01,,,,fee schedule,,93.7,,,,fee schedule,,324.97,,,,fee schedule,,93.7,,,,fee schedule,,494.28,,,,fee schedule,,299.56,,,,fee schedule,,299.56,,,,fee schedule,,,640.64,91,,percent of total billed charges,,,668.8,95,,percent of total billed charges,,,584.32,83,,percent of total billed charges,,,211.2,83,,percent of total billed charges,,93.7,,,,fee schedule,,93.7,,,,fee schedule,,,584.32,83,,percent of total billed charges,,440.36,,,,fee schedule,,,633.6,90,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,598.4,85,,percent of total billed charges,,93.7,668.8,
TREAT METACARPAL FRACTURE,26600T,CDM,26600,CPT,,,both,T,370,370,509.26,,,,fee schedule,,,,,,,,93.7,,,,fee schedule,,,314.5,85,,percent of total billed charges,,616.89,,,,fee schedule,,298.01,,,,fee schedule,,93.7,,,,fee schedule,,324.97,,,,fee schedule,,93.7,,,,fee schedule,,494.28,,,,fee schedule,,299.56,,,,fee schedule,,299.56,,,,fee schedule,,,336.7,91,,percent of total billed charges,,,351.5,95,,percent of total billed charges,,,307.1,83,,percent of total billed charges,,,111,83,,percent of total billed charges,,93.7,,,,fee schedule,,93.7,,,,fee schedule,,,307.1,83,,percent of total billed charges,,440.36,,,,fee schedule,,,333,90,,percent of total billed charges,,,333,90,,percent of total billed charges,,,333,90,,percent of total billed charges,,,333,90,,percent of total billed charges,,,314.5,85,,percent of total billed charges,,93.7,616.89,
TREAT METACARPAL FRACTURE,26605,CDM,26605,CPT,,,both,,1333,1333,528.27,,,,fee schedule,,,,,,,,138.75,,,,fee schedule,,,1133.05,85,,percent of total billed charges,,646.38,,,,fee schedule,,312.26,,,,fee schedule,,138.75,,,,fee schedule,,460.93,,,,fee schedule,,138.75,,,,fee schedule,,512.73,,,,fee schedule,,310.75,,,,fee schedule,,310.75,,,,fee schedule,,,1213.03,91,,percent of total billed charges,,,1266.35,95,,percent of total billed charges,,,1106.39,83,,percent of total billed charges,,,399.9,83,,percent of total billed charges,,138.75,,,,fee schedule,,138.75,,,,fee schedule,,,1106.39,83,,percent of total billed charges,,456.8,,,,fee schedule,,,1199.7,90,,percent of total billed charges,,,1199.7,90,,percent of total billed charges,,,1199.7,90,,percent of total billed charges,,,1199.7,90,,percent of total billed charges,,,1133.05,85,,percent of total billed charges,,138.75,1266.35,
TREAT METACARPAL FRACTURE,26605P,CDM,26605,CPT,,,both,P,940,940,528.27,,,,fee schedule,,,,,,,,138.75,,,,fee schedule,,,799,85,,percent of total billed charges,,646.38,,,,fee schedule,,312.26,,,,fee schedule,,138.75,,,,fee schedule,,460.93,,,,fee schedule,,138.75,,,,fee schedule,,512.73,,,,fee schedule,,310.75,,,,fee schedule,,310.75,,,,fee schedule,,,855.4,91,,percent of total billed charges,,,893,95,,percent of total billed charges,,,780.2,83,,percent of total billed charges,,,282,83,,percent of total billed charges,,138.75,,,,fee schedule,,138.75,,,,fee schedule,,,780.2,83,,percent of total billed charges,,456.8,,,,fee schedule,,,846,90,,percent of total billed charges,,,846,90,,percent of total billed charges,,,846,90,,percent of total billed charges,,,846,90,,percent of total billed charges,,,799,85,,percent of total billed charges,,138.75,893,
TREAT METACARPAL FRACTURE,26605T,CDM,26605,CPT,,,both,T,393,393,528.27,,,,fee schedule,,,,,,,,138.75,,,,fee schedule,,,334.05,85,,percent of total billed charges,,646.38,,,,fee schedule,,312.26,,,,fee schedule,,138.75,,,,fee schedule,,460.93,,,,fee schedule,,138.75,,,,fee schedule,,512.73,,,,fee schedule,,310.75,,,,fee schedule,,310.75,,,,fee schedule,,,357.63,91,,percent of total billed charges,,,373.35,95,,percent of total billed charges,,,326.19,83,,percent of total billed charges,,,117.9,83,,percent of total billed charges,,138.75,,,,fee schedule,,138.75,,,,fee schedule,,,326.19,83,,percent of total billed charges,,456.8,,,,fee schedule,,,353.7,90,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,334.05,85,,percent of total billed charges,,117.9,646.38,
TREAT METACARPAL FRACTURE,26607,CDM,26607,CPT,,,both,,1695,1695,892.93,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,1440.75,85,,percent of total billed charges,,1108.59,,,,fee schedule,,535.54,,,,fee schedule,,299.7,,,,fee schedule,,827.02,,,,fee schedule,,299.7,,,,fee schedule,,866.67,,,,fee schedule,,525.25,,,,fee schedule,,525.25,,,,fee schedule,,,1542.45,91,,percent of total billed charges,,,1610.25,95,,percent of total billed charges,,,1406.85,83,,percent of total billed charges,,,508.5,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,1406.85,83,,percent of total billed charges,,772.12,,,,fee schedule,,,1525.5,90,,percent of total billed charges,,,1525.5,90,,percent of total billed charges,,,1525.5,90,,percent of total billed charges,,,1525.5,90,,percent of total billed charges,,,1440.75,85,,percent of total billed charges,,299.7,1610.25,
TREAT METACARPAL FRACTURE,26607P,CDM,26607,CPT,,,both,P,1495,1495,892.93,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,1270.75,85,,percent of total billed charges,,1108.59,,,,fee schedule,,535.54,,,,fee schedule,,299.7,,,,fee schedule,,827.02,,,,fee schedule,,299.7,,,,fee schedule,,866.67,,,,fee schedule,,525.25,,,,fee schedule,,525.25,,,,fee schedule,,,1360.45,91,,percent of total billed charges,,,1420.25,95,,percent of total billed charges,,,1240.85,83,,percent of total billed charges,,,448.5,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,1240.85,83,,percent of total billed charges,,772.12,,,,fee schedule,,,1345.5,90,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1345.5,90,,percent of total billed charges,,,1270.75,85,,percent of total billed charges,,299.7,1420.25,
TREAT METACARPAL FRACTURE,26607T,CDM,26607,CPT,,,both,T,200,200,892.93,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,170,85,,percent of total billed charges,,1108.59,,,,fee schedule,,535.54,,,,fee schedule,,299.7,,,,fee schedule,,827.02,,,,fee schedule,,299.7,,,,fee schedule,,866.67,,,,fee schedule,,525.25,,,,fee schedule,,525.25,,,,fee schedule,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,60,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,166,83,,percent of total billed charges,,772.12,,,,fee schedule,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,60,1108.59,
TREAT METACARPAL FRACTURE,26608,CDM,26608,CPT,,,both,,2391,2391,845.11,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,2032.35,85,,percent of total billed charges,,1044.22,,,,fee schedule,,504.45,,,,fee schedule,,299.7,,,,fee schedule,,827.02,,,,fee schedule,,299.7,,,,fee schedule,,820.26,,,,fee schedule,,497.13,,,,fee schedule,,497.13,,,,fee schedule,,,2175.81,91,,percent of total billed charges,,,2271.45,95,,percent of total billed charges,,,1984.53,83,,percent of total billed charges,,,717.3,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,1984.53,83,,percent of total billed charges,,730.77,,,,fee schedule,,,2151.9,90,,percent of total billed charges,,,2151.9,90,,percent of total billed charges,,,2151.9,90,,percent of total billed charges,,,2151.9,90,,percent of total billed charges,,,2032.35,85,,percent of total billed charges,,299.7,2271.45,
TREAT METACARPAL FRACTURE,26615,CDM,26615,CPT,,,both,,2672,2672,1004.11,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,2271.2,85,,percent of total billed charges,,1246.65,,,,fee schedule,,602.24,,,,fee schedule,,299.7,,,,fee schedule,,760.7,,,,fee schedule,,299.7,,,,fee schedule,,974.58,,,,fee schedule,,590.65,,,,fee schedule,,590.65,,,,fee schedule,,,2431.52,91,,percent of total billed charges,,,2538.4,95,,percent of total billed charges,,,2217.76,83,,percent of total billed charges,,,801.6,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,2217.76,83,,percent of total billed charges,,868.26,,,,fee schedule,,,2404.8,90,,percent of total billed charges,,,2404.8,90,,percent of total billed charges,,,2404.8,90,,percent of total billed charges,,,2404.8,90,,percent of total billed charges,,,2271.2,85,,percent of total billed charges,,299.7,2538.4,
TREAT THUMB FRACTURE,26645,CDM,26645,CPT,,,both,,1970,1970,697.06,,,,fee schedule,,,,,,,,166.4,,,,fee schedule,,,1674.5,85,,percent of total billed charges,,862.74,,,,fee schedule,,416.78,,,,fee schedule,,166.4,,,,fee schedule,,611.48,,,,fee schedule,,166.4,,,,fee schedule,,676.56,,,,fee schedule,,410.04,,,,fee schedule,,410.04,,,,fee schedule,,,1792.7,91,,percent of total billed charges,,,1871.5,95,,percent of total billed charges,,,1635.1,83,,percent of total billed charges,,,591,83,,percent of total billed charges,,166.4,,,,fee schedule,,166.4,,,,fee schedule,,,1635.1,83,,percent of total billed charges,,602.75,,,,fee schedule,,,1773,90,,percent of total billed charges,,,1773,90,,percent of total billed charges,,,1773,90,,percent of total billed charges,,,1773,90,,percent of total billed charges,,,1674.5,85,,percent of total billed charges,,166.4,1871.5,
TREAT THUMB FRACTURE,26650,CDM,26650,CPT,,,both,,2466,2466,845.69,,,,fee schedule,,,,,,,,240,,,,fee schedule,,,2096.1,85,,percent of total billed charges,,1041.41,,,,fee schedule,,503.09,,,,fee schedule,,240,,,,fee schedule,,884.05,,,,fee schedule,,240,,,,fee schedule,,820.82,,,,fee schedule,,497.46,,,,fee schedule,,497.46,,,,fee schedule,,,2244.06,91,,percent of total billed charges,,,2342.7,95,,percent of total billed charges,,,2046.78,83,,percent of total billed charges,,,739.8,83,,percent of total billed charges,,240,,,,fee schedule,,240,,,,fee schedule,,,2046.78,83,,percent of total billed charges,,731.27,,,,fee schedule,,,2219.4,90,,percent of total billed charges,,,2219.4,90,,percent of total billed charges,,,2219.4,90,,percent of total billed charges,,,2219.4,90,,percent of total billed charges,,,2096.1,85,,percent of total billed charges,,240,2342.7,
TREAT THUMB FRACTURE,26665,CDM,26665,CPT,,,both,,2861,2861,1092.25,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,2431.85,85,,percent of total billed charges,,1349.4,,,,fee schedule,,651.88,,,,fee schedule,,374.55,,,,fee schedule,,1000.12,,,,fee schedule,,374.55,,,,fee schedule,,1060.13,,,,fee schedule,,642.5,,,,fee schedule,,642.5,,,,fee schedule,,,2603.51,91,,percent of total billed charges,,,2717.95,95,,percent of total billed charges,,,2374.63,83,,percent of total billed charges,,,858.3,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,2374.63,83,,percent of total billed charges,,944.48,,,,fee schedule,,,2574.9,90,,percent of total billed charges,,,2574.9,90,,percent of total billed charges,,,2574.9,90,,percent of total billed charges,,,2574.9,90,,percent of total billed charges,,,2431.85,85,,percent of total billed charges,,374.55,2717.95,
TREAT HAND DISLOCATION,26675,CDM,26675,CPT,,,both,,2091,2091,744.87,,,,fee schedule,,,,,,,,181.55,,,,fee schedule,,,1777.35,85,,percent of total billed charges,,920.12,,,,fee schedule,,444.5,,,,fee schedule,,181.55,,,,fee schedule,,653.26,,,,fee schedule,,181.55,,,,fee schedule,,722.97,,,,fee schedule,,438.16,,,,fee schedule,,438.16,,,,fee schedule,,,1902.81,91,,percent of total billed charges,,,1986.45,95,,percent of total billed charges,,,1735.53,83,,percent of total billed charges,,,627.3,83,,percent of total billed charges,,181.55,,,,fee schedule,,181.55,,,,fee schedule,,,1735.53,83,,percent of total billed charges,,644.1,,,,fee schedule,,,1881.9,90,,percent of total billed charges,,,1881.9,90,,percent of total billed charges,,,1881.9,90,,percent of total billed charges,,,1881.9,90,,percent of total billed charges,,,1777.35,85,,percent of total billed charges,,181.55,1986.45,
TREAT HAND DISLOCATION,26675P,CDM,26675,CPT,,,both,P,1880,1880,744.87,,,,fee schedule,,,,,,,,181.55,,,,fee schedule,,,1598,85,,percent of total billed charges,,920.12,,,,fee schedule,,444.5,,,,fee schedule,,181.55,,,,fee schedule,,653.26,,,,fee schedule,,181.55,,,,fee schedule,,722.97,,,,fee schedule,,438.16,,,,fee schedule,,438.16,,,,fee schedule,,,1710.8,91,,percent of total billed charges,,,1786,95,,percent of total billed charges,,,1560.4,83,,percent of total billed charges,,,564,83,,percent of total billed charges,,181.55,,,,fee schedule,,181.55,,,,fee schedule,,,1560.4,83,,percent of total billed charges,,644.1,,,,fee schedule,,,1692,90,,percent of total billed charges,,,1692,90,,percent of total billed charges,,,1692,90,,percent of total billed charges,,,1692,90,,percent of total billed charges,,,1598,85,,percent of total billed charges,,181.55,1786,
TREAT HAND DISLOCATION,26675T,CDM,26675,CPT,,,both,T,211,211,744.87,,,,fee schedule,,,,,,,,181.55,,,,fee schedule,,,179.35,85,,percent of total billed charges,,920.12,,,,fee schedule,,444.5,,,,fee schedule,,181.55,,,,fee schedule,,653.26,,,,fee schedule,,181.55,,,,fee schedule,,722.97,,,,fee schedule,,438.16,,,,fee schedule,,438.16,,,,fee schedule,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,63.3,83,,percent of total billed charges,,181.55,,,,fee schedule,,181.55,,,,fee schedule,,,175.13,83,,percent of total billed charges,,644.1,,,,fee schedule,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,63.3,920.12,
PIN HAND DISLOCATION,26676,CDM,26676,CPT,,,both,,2482,2482,894.66,,,,fee schedule,,,,,,,,262.2,,,,fee schedule,,,2109.7,85,,percent of total billed charges,,1101.28,,,,fee schedule,,532.02,,,,fee schedule,,262.2,,,,fee schedule,,867.47,,,,fee schedule,,262.2,,,,fee schedule,,868.34,,,,fee schedule,,526.27,,,,fee schedule,,526.27,,,,fee schedule,,,2258.62,91,,percent of total billed charges,,,2357.9,95,,percent of total billed charges,,,2060.06,83,,percent of total billed charges,,,744.6,83,,percent of total billed charges,,262.2,,,,fee schedule,,262.2,,,,fee schedule,,,2060.06,83,,percent of total billed charges,,773.61,,,,fee schedule,,,2233.8,90,,percent of total billed charges,,,2233.8,90,,percent of total billed charges,,,2233.8,90,,percent of total billed charges,,,2233.8,90,,percent of total billed charges,,,2109.7,85,,percent of total billed charges,,262.2,2357.9,
TREAT KNUCKLE DISLOCATION,26700,CDM,26700,CPT,,,both,,1176,1176,555.34,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,999.6,85,,percent of total billed charges,,681.58,,,,fee schedule,,329.26,,,,fee schedule,,107,,,,fee schedule,,456.95,,,,fee schedule,,107,,,,fee schedule,,539.01,,,,fee schedule,,326.67,,,,fee schedule,,326.67,,,,fee schedule,,,1070.16,91,,percent of total billed charges,,,1117.2,95,,percent of total billed charges,,,976.08,83,,percent of total billed charges,,,352.8,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,976.08,83,,percent of total billed charges,,480.21,,,,fee schedule,,,1058.4,90,,percent of total billed charges,,,1058.4,90,,percent of total billed charges,,,1058.4,90,,percent of total billed charges,,,1058.4,90,,percent of total billed charges,,,999.6,85,,percent of total billed charges,,107,1117.2,
TREAT KNUCKLE DISLOCATION,26715,CDM,26715,CPT,,,both,,2730,2730,1001.23,,,,fee schedule,,,,,,,,274.65,,,,fee schedule,,,2320.5,85,,percent of total billed charges,,1242.29,,,,fee schedule,,600.13,,,,fee schedule,,274.65,,,,fee schedule,,805.8,,,,fee schedule,,274.65,,,,fee schedule,,971.78,,,,fee schedule,,588.96,,,,fee schedule,,588.96,,,,fee schedule,,,2484.3,91,,percent of total billed charges,,,2593.5,95,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,,819,83,,percent of total billed charges,,274.65,,,,fee schedule,,274.65,,,,fee schedule,,,2265.9,83,,percent of total billed charges,,865.77,,,,fee schedule,,,2457,90,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2457,90,,percent of total billed charges,,,2320.5,85,,percent of total billed charges,,274.65,2593.5,
"TREAT FINGER FRACTURE, EACH",26720,CDM,26720,CPT,,,both,,840,840,335.86,,,,fee schedule,,,,,,,,97.05,,,,fee schedule,,,714,85,,percent of total billed charges,,405.65,,,,fee schedule,,195.96,,,,fee schedule,,97.05,,,,fee schedule,,260.64,,,,fee schedule,,97.05,,,,fee schedule,,325.98,,,,fee schedule,,197.56,,,,fee schedule,,197.56,,,,fee schedule,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,252,83,,percent of total billed charges,,97.05,,,,fee schedule,,97.05,,,,fee schedule,,,697.2,83,,percent of total billed charges,,290.42,,,,fee schedule,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,97.05,798,
"TREAT FINGER FRACTURE, EACH",26720P,CDM,26720,CPT,,,both,P,430,430,335.86,,,,fee schedule,,,,,,,,97.05,,,,fee schedule,,,365.5,85,,percent of total billed charges,,405.65,,,,fee schedule,,195.96,,,,fee schedule,,97.05,,,,fee schedule,,260.64,,,,fee schedule,,97.05,,,,fee schedule,,325.98,,,,fee schedule,,197.56,,,,fee schedule,,197.56,,,,fee schedule,,,391.3,91,,percent of total billed charges,,,408.5,95,,percent of total billed charges,,,356.9,83,,percent of total billed charges,,,129,83,,percent of total billed charges,,97.05,,,,fee schedule,,97.05,,,,fee schedule,,,356.9,83,,percent of total billed charges,,290.42,,,,fee schedule,,,387,90,,percent of total billed charges,,,387,90,,percent of total billed charges,,,387,90,,percent of total billed charges,,,387,90,,percent of total billed charges,,,365.5,85,,percent of total billed charges,,97.05,408.5,
"TREAT FINGER FRACTURE, EACH",26720T,CDM,26720,CPT,,,both,T,410,410,335.86,,,,fee schedule,,,,,,,,97.05,,,,fee schedule,,,348.5,85,,percent of total billed charges,,405.65,,,,fee schedule,,195.96,,,,fee schedule,,97.05,,,,fee schedule,,260.64,,,,fee schedule,,97.05,,,,fee schedule,,325.98,,,,fee schedule,,197.56,,,,fee schedule,,197.56,,,,fee schedule,,,373.1,91,,percent of total billed charges,,,389.5,95,,percent of total billed charges,,,340.3,83,,percent of total billed charges,,,123,83,,percent of total billed charges,,97.05,,,,fee schedule,,97.05,,,,fee schedule,,,340.3,83,,percent of total billed charges,,290.42,,,,fee schedule,,,369,90,,percent of total billed charges,,,369,90,,percent of total billed charges,,,369,90,,percent of total billed charges,,,369,90,,percent of total billed charges,,,348.5,85,,percent of total billed charges,,97.05,405.65,
"TREAT FINGER FRACTURE, EACH",26725,CDM,26725,CPT,,,both,,1428,1428,539.79,,,,fee schedule,,,,,,,,130.35,,,,fee schedule,,,1213.8,85,,percent of total billed charges,,663.08,,,,fee schedule,,320.33,,,,fee schedule,,130.35,,,,fee schedule,,485.47,,,,fee schedule,,130.35,,,,fee schedule,,523.91,,,,fee schedule,,317.52,,,,fee schedule,,317.52,,,,fee schedule,,,1299.48,91,,percent of total billed charges,,,1356.6,95,,percent of total billed charges,,,1185.24,83,,percent of total billed charges,,,428.4,83,,percent of total billed charges,,130.35,,,,fee schedule,,130.35,,,,fee schedule,,,1185.24,83,,percent of total billed charges,,466.76,,,,fee schedule,,,1285.2,90,,percent of total billed charges,,,1285.2,90,,percent of total billed charges,,,1285.2,90,,percent of total billed charges,,,1285.2,90,,percent of total billed charges,,,1213.8,85,,percent of total billed charges,,130.35,1356.6,
TREAT FINGER FRACTURE EACH,26725P,CDM,26725,CPT,,,both,P,836,836,539.79,,,,fee schedule,,,,,,,,130.35,,,,fee schedule,,,710.6,85,,percent of total billed charges,,663.08,,,,fee schedule,,320.33,,,,fee schedule,,130.35,,,,fee schedule,,485.47,,,,fee schedule,,130.35,,,,fee schedule,,523.91,,,,fee schedule,,317.52,,,,fee schedule,,317.52,,,,fee schedule,,,760.76,91,,percent of total billed charges,,,794.2,95,,percent of total billed charges,,,693.88,83,,percent of total billed charges,,,250.8,83,,percent of total billed charges,,130.35,,,,fee schedule,,130.35,,,,fee schedule,,,693.88,83,,percent of total billed charges,,466.76,,,,fee schedule,,,752.4,90,,percent of total billed charges,,,752.4,90,,percent of total billed charges,,,752.4,90,,percent of total billed charges,,,752.4,90,,percent of total billed charges,,,710.6,85,,percent of total billed charges,,130.35,794.2,
TREAT FINGER FRACTURE EACH,26725T,CDM,26725,CPT,,,both,T,592,592,539.79,,,,fee schedule,,,,,,,,130.35,,,,fee schedule,,,503.2,85,,percent of total billed charges,,663.08,,,,fee schedule,,320.33,,,,fee schedule,,130.35,,,,fee schedule,,485.47,,,,fee schedule,,130.35,,,,fee schedule,,523.91,,,,fee schedule,,317.52,,,,fee schedule,,317.52,,,,fee schedule,,,538.72,91,,percent of total billed charges,,,562.4,95,,percent of total billed charges,,,491.36,83,,percent of total billed charges,,,177.6,83,,percent of total billed charges,,130.35,,,,fee schedule,,130.35,,,,fee schedule,,,491.36,83,,percent of total billed charges,,466.76,,,,fee schedule,,,532.8,90,,percent of total billed charges,,,532.8,90,,percent of total billed charges,,,532.8,90,,percent of total billed charges,,,532.8,90,,percent of total billed charges,,,503.2,85,,percent of total billed charges,,130.35,663.08,
"TREAT FINGER FRACTURE, EACH",26727,CDM,26727,CPT,,,both,,2331,2331,832.44,,,,fee schedule,,,,,,,,171,,,,fee schedule,,,1981.35,85,,percent of total billed charges,,1026.82,,,,fee schedule,,496.05,,,,fee schedule,,171,,,,fee schedule,,814.42,,,,fee schedule,,171,,,,fee schedule,,807.96,,,,fee schedule,,489.67,,,,fee schedule,,489.67,,,,fee schedule,,,2121.21,91,,percent of total billed charges,,,2214.45,95,,percent of total billed charges,,,1934.73,83,,percent of total billed charges,,,699.3,83,,percent of total billed charges,,171,,,,fee schedule,,171,,,,fee schedule,,,1934.73,83,,percent of total billed charges,,719.81,,,,fee schedule,,,2097.9,90,,percent of total billed charges,,,2097.9,90,,percent of total billed charges,,,2097.9,90,,percent of total billed charges,,,2097.9,90,,percent of total billed charges,,,1981.35,85,,percent of total billed charges,,171,2214.45,
"TREAT FINGER FRACTURE, EACH",26735,CDM,26735,CPT,,,both,,2798,2798,1037.52,,,,fee schedule,,,,,,,,263.55,,,,fee schedule,,,2378.3,85,,percent of total billed charges,,1289.37,,,,fee schedule,,622.88,,,,fee schedule,,263.55,,,,fee schedule,,825.69,,,,fee schedule,,263.55,,,,fee schedule,,1007.01,,,,fee schedule,,610.31,,,,fee schedule,,610.31,,,,fee schedule,,,2546.18,91,,percent of total billed charges,,,2658.1,95,,percent of total billed charges,,,2322.34,83,,percent of total billed charges,,,839.4,83,,percent of total billed charges,,263.55,,,,fee schedule,,263.55,,,,fee schedule,,,2322.34,83,,percent of total billed charges,,897.15,,,,fee schedule,,,2518.2,90,,percent of total billed charges,,,2518.2,90,,percent of total billed charges,,,2518.2,90,,percent of total billed charges,,,2518.2,90,,percent of total billed charges,,,2378.3,85,,percent of total billed charges,,263.55,2658.1,
"TREAT FINGER FRACTURE, EACH",26740,CDM,26740,CPT,,,both,,1007,1007,391.74,,,,fee schedule,,,,,,,,97.05,,,,fee schedule,,,855.95,85,,percent of total billed charges,,475.05,,,,fee schedule,,229.49,,,,fee schedule,,97.05,,,,fee schedule,,326.96,,,,fee schedule,,97.05,,,,fee schedule,,380.21,,,,fee schedule,,230.43,,,,fee schedule,,230.43,,,,fee schedule,,,916.37,91,,percent of total billed charges,,,956.65,95,,percent of total billed charges,,,835.81,83,,percent of total billed charges,,,302.1,83,,percent of total billed charges,,97.05,,,,fee schedule,,97.05,,,,fee schedule,,,835.81,83,,percent of total billed charges,,338.74,,,,fee schedule,,,906.3,90,,percent of total billed charges,,,906.3,90,,percent of total billed charges,,,906.3,90,,percent of total billed charges,,,906.3,90,,percent of total billed charges,,,855.95,85,,percent of total billed charges,,97.05,956.65,
"TREAT FINGER FRACTURE, EACH",26742,CDM,26742,CPT,,,both,,1506,1506,595.09,,,,fee schedule,,,,,,,,150.5,,,,fee schedule,,,1280.1,85,,percent of total billed charges,,733.25,,,,fee schedule,,354.22,,,,fee schedule,,150.5,,,,fee schedule,,549.13,,,,fee schedule,,150.5,,,,fee schedule,,577.59,,,,fee schedule,,350.05,,,,fee schedule,,350.05,,,,fee schedule,,,1370.46,91,,percent of total billed charges,,,1430.7,95,,percent of total billed charges,,,1249.98,83,,percent of total billed charges,,,451.8,83,,percent of total billed charges,,150.5,,,,fee schedule,,150.5,,,,fee schedule,,,1249.98,83,,percent of total billed charges,,514.58,,,,fee schedule,,,1355.4,90,,percent of total billed charges,,,1355.4,90,,percent of total billed charges,,,1355.4,90,,percent of total billed charges,,,1355.4,90,,percent of total billed charges,,,1280.1,85,,percent of total billed charges,,150.5,1430.7,
"TREAT FINGER FRACTURE, EACH",26746,CDM,26746,CPT,,,both,,3422,3422,1291,,,,fee schedule,,,,,,,,263.55,,,,fee schedule,,,2908.7,85,,percent of total billed charges,,1612.49,,,,fee schedule,,778.98,,,,fee schedule,,263.55,,,,fee schedule,,813.09,,,,fee schedule,,263.55,,,,fee schedule,,1253.03,,,,fee schedule,,759.41,,,,fee schedule,,759.41,,,,fee schedule,,,3114.02,91,,percent of total billed charges,,,3250.9,95,,percent of total billed charges,,,2840.26,83,,percent of total billed charges,,,1026.6,83,,percent of total billed charges,,263.55,,,,fee schedule,,263.55,,,,fee schedule,,,2840.26,83,,percent of total billed charges,,1116.34,,,,fee schedule,,,3079.8,90,,percent of total billed charges,,,3079.8,90,,percent of total billed charges,,,3079.8,90,,percent of total billed charges,,,3079.8,90,,percent of total billed charges,,,2908.7,85,,percent of total billed charges,,263.55,3250.9,
"TREAT FINGER FRACTURE, EACH",26750,CDM,26750,CPT,,,both,,963,963,337.58,,,,fee schedule,,,,,,,,97.05,,,,fee schedule,,,818.55,85,,percent of total billed charges,,406.59,,,,fee schedule,,196.42,,,,fee schedule,,97.05,,,,fee schedule,,259.98,,,,fee schedule,,97.05,,,,fee schedule,,327.66,,,,fee schedule,,198.58,,,,fee schedule,,198.58,,,,fee schedule,,,876.33,91,,percent of total billed charges,,,914.85,95,,percent of total billed charges,,,799.29,83,,percent of total billed charges,,,288.9,83,,percent of total billed charges,,97.05,,,,fee schedule,,97.05,,,,fee schedule,,,799.29,83,,percent of total billed charges,,291.91,,,,fee schedule,,,866.7,90,,percent of total billed charges,,,866.7,90,,percent of total billed charges,,,866.7,90,,percent of total billed charges,,,866.7,90,,percent of total billed charges,,,818.55,85,,percent of total billed charges,,97.05,914.85,
"TREAT FINGER FRACTURE, EACH",26755,CDM,26755,CPT,,,both,,1253,1253,487.94,,,,fee schedule,,,,,,,,104.1,,,,fee schedule,,,1065.05,85,,percent of total billed charges,,599.95,,,,fee schedule,,289.83,,,,fee schedule,,104.1,,,,fee schedule,,431.08,,,,fee schedule,,104.1,,,,fee schedule,,473.59,,,,fee schedule,,287.02,,,,fee schedule,,287.02,,,,fee schedule,,,1140.23,91,,percent of total billed charges,,,1190.35,95,,percent of total billed charges,,,1039.99,83,,percent of total billed charges,,,375.9,83,,percent of total billed charges,,104.1,,,,fee schedule,,104.1,,,,fee schedule,,,1039.99,83,,percent of total billed charges,,421.93,,,,fee schedule,,,1127.7,90,,percent of total billed charges,,,1127.7,90,,percent of total billed charges,,,1127.7,90,,percent of total billed charges,,,1127.7,90,,percent of total billed charges,,,1065.05,85,,percent of total billed charges,,104.1,1190.35,
"PIN FINGER FRACTURE, EACH",26756,CDM,26756,CPT,,,both,,2010,2010,746.6,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,1708.5,85,,percent of total billed charges,,918.58,,,,fee schedule,,443.75,,,,fee schedule,,224.7,,,,fee schedule,,716.26,,,,fee schedule,,224.7,,,,fee schedule,,724.64,,,,fee schedule,,439.18,,,,fee schedule,,439.18,,,,fee schedule,,,1829.1,91,,percent of total billed charges,,,1909.5,95,,percent of total billed charges,,,1668.3,83,,percent of total billed charges,,,603,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,1668.3,83,,percent of total billed charges,,645.59,,,,fee schedule,,,1809,90,,percent of total billed charges,,,1809,90,,percent of total billed charges,,,1809,90,,percent of total billed charges,,,1809,90,,percent of total billed charges,,,1708.5,85,,percent of total billed charges,,224.7,1909.5,
"TREAT FINGER FRACTURE, EACH",26765,CDM,26765,CPT,,,both,,2168,2168,880.25,,,,fee schedule,,,,,,,,285.8,,,,fee schedule,,,1842.8,85,,percent of total billed charges,,1085.38,,,,fee schedule,,524.33,,,,fee schedule,,285.8,,,,fee schedule,,608.82,,,,fee schedule,,285.8,,,,fee schedule,,854.36,,,,fee schedule,,517.8,,,,fee schedule,,517.8,,,,fee schedule,,,1972.88,91,,percent of total billed charges,,,2059.6,95,,percent of total billed charges,,,1799.44,83,,percent of total billed charges,,,650.4,83,,percent of total billed charges,,285.8,,,,fee schedule,,285.8,,,,fee schedule,,,1799.44,83,,percent of total billed charges,,761.16,,,,fee schedule,,,1951.2,90,,percent of total billed charges,,,1951.2,90,,percent of total billed charges,,,1951.2,90,,percent of total billed charges,,,1951.2,90,,percent of total billed charges,,,1842.8,85,,percent of total billed charges,,285.8,2059.6,
TREAT FINGER DISLOCATION,26770,CDM,26770,CPT,,,both,,1084,1084,464.9,,,,fee schedule,,,,,,,,92.5,,,,fee schedule,,,921.4,85,,percent of total billed charges,,568.03,,,,fee schedule,,274.41,,,,fee schedule,,92.5,,,,fee schedule,,378.69,,,,fee schedule,,92.5,,,,fee schedule,,451.23,,,,fee schedule,,273.47,,,,fee schedule,,273.47,,,,fee schedule,,,986.44,91,,percent of total billed charges,,,1029.8,95,,percent of total billed charges,,,899.72,83,,percent of total billed charges,,,325.2,83,,percent of total billed charges,,92.5,,,,fee schedule,,92.5,,,,fee schedule,,,899.72,83,,percent of total billed charges,,402,,,,fee schedule,,,975.6,90,,percent of total billed charges,,,975.6,90,,percent of total billed charges,,,975.6,90,,percent of total billed charges,,,975.6,90,,percent of total billed charges,,,921.4,85,,percent of total billed charges,,92.5,1029.8,
TREAT FINGER DISLOCATION,26770P,CDM,26770,CPT,,,both,P,902,902,464.9,,,,fee schedule,,,,,,,,92.5,,,,fee schedule,,,766.7,85,,percent of total billed charges,,568.03,,,,fee schedule,,274.41,,,,fee schedule,,92.5,,,,fee schedule,,378.69,,,,fee schedule,,92.5,,,,fee schedule,,451.23,,,,fee schedule,,273.47,,,,fee schedule,,273.47,,,,fee schedule,,,820.82,91,,percent of total billed charges,,,856.9,95,,percent of total billed charges,,,748.66,83,,percent of total billed charges,,,270.6,83,,percent of total billed charges,,92.5,,,,fee schedule,,92.5,,,,fee schedule,,,748.66,83,,percent of total billed charges,,402,,,,fee schedule,,,811.8,90,,percent of total billed charges,,,811.8,90,,percent of total billed charges,,,811.8,90,,percent of total billed charges,,,811.8,90,,percent of total billed charges,,,766.7,85,,percent of total billed charges,,92.5,856.9,
TREAT FINGER DISLOCATION,26770T,CDM,26770,CPT,,,both,T,182,182,464.9,,,,fee schedule,,,,,,,,92.5,,,,fee schedule,,,154.7,85,,percent of total billed charges,,568.03,,,,fee schedule,,274.41,,,,fee schedule,,92.5,,,,fee schedule,,378.69,,,,fee schedule,,92.5,,,,fee schedule,,451.23,,,,fee schedule,,273.47,,,,fee schedule,,273.47,,,,fee schedule,,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,54.6,83,,percent of total billed charges,,92.5,,,,fee schedule,,92.5,,,,fee schedule,,,151.06,83,,percent of total billed charges,,402,,,,fee schedule,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,54.6,568.03,
TREAT FINGER DISLOCATION,26775,CDM,26775,CPT,,,both,,1497,1497,628.51,,,,fee schedule,,,,,,,,132.45,,,,fee schedule,,,1272.45,85,,percent of total billed charges,,765.56,,,,fee schedule,,369.83,,,,fee schedule,,132.45,,,,fee schedule,,532.55,,,,fee schedule,,132.45,,,,fee schedule,,610.02,,,,fee schedule,,369.71,,,,fee schedule,,369.71,,,,fee schedule,,,1362.27,91,,percent of total billed charges,,,1422.15,95,,percent of total billed charges,,,1242.51,83,,percent of total billed charges,,,449.1,83,,percent of total billed charges,,132.45,,,,fee schedule,,132.45,,,,fee schedule,,,1242.51,83,,percent of total billed charges,,543.47,,,,fee schedule,,,1347.3,90,,percent of total billed charges,,,1347.3,90,,percent of total billed charges,,,1347.3,90,,percent of total billed charges,,,1347.3,90,,percent of total billed charges,,,1272.45,85,,percent of total billed charges,,132.45,1422.15,
FUSION OF KNUCKLE,26850,CDM,26850,CPT,,,both,,3667,3667,1288.7,,,,fee schedule,,,,,,,,262.2,,,,fee schedule,,,3116.95,85,,percent of total billed charges,,1596.64,,,,fee schedule,,771.32,,,,fee schedule,,262.2,,,,fee schedule,,1340.34,,,,fee schedule,,262.2,,,,fee schedule,,1250.79,,,,fee schedule,,758.06,,,,fee schedule,,758.06,,,,fee schedule,,,3336.97,91,,percent of total billed charges,,,3483.65,95,,percent of total billed charges,,,3043.61,83,,percent of total billed charges,,,1100.1,83,,percent of total billed charges,,262.2,,,,fee schedule,,262.2,,,,fee schedule,,,3043.61,83,,percent of total billed charges,,1114.34,,,,fee schedule,,,3300.3,90,,percent of total billed charges,,,3300.3,90,,percent of total billed charges,,,3300.3,90,,percent of total billed charges,,,3300.3,90,,percent of total billed charges,,,3116.95,85,,percent of total billed charges,,262.2,3483.65,
FUSION OF FINGER JOINT,26860,CDM,26860,CPT,,,both,,3101,3101,1076.7,,,,fee schedule,,,,,,,,200.65,,,,fee schedule,,,2635.85,85,,percent of total billed charges,,1321.31,,,,fee schedule,,638.31,,,,fee schedule,,200.65,,,,fee schedule,,1100.26,,,,fee schedule,,200.65,,,,fee schedule,,1045.03,,,,fee schedule,,633.35,,,,fee schedule,,633.35,,,,fee schedule,,,2821.91,91,,percent of total billed charges,,,2945.95,95,,percent of total billed charges,,,2573.83,83,,percent of total billed charges,,,930.3,83,,percent of total billed charges,,200.65,,,,fee schedule,,200.65,,,,fee schedule,,,2573.83,83,,percent of total billed charges,,931.03,,,,fee schedule,,,2790.9,90,,percent of total billed charges,,,2790.9,90,,percent of total billed charges,,,2790.9,90,,percent of total billed charges,,,2790.9,90,,percent of total billed charges,,,2635.85,85,,percent of total billed charges,,200.65,2945.95,
FUSION/GRAFT OF FINGER JOINT,26862,CDM,26862,CPT,,,both,,3683,3683,1342.27,,,,fee schedule,,,,,,,,274.6,,,,fee schedule,,,3130.55,85,,percent of total billed charges,,1664.04,,,,fee schedule,,803.88,,,,fee schedule,,274.6,,,,fee schedule,,1378.81,,,,fee schedule,,274.6,,,,fee schedule,,1302.79,,,,fee schedule,,789.57,,,,fee schedule,,789.57,,,,fee schedule,,,3351.53,91,,percent of total billed charges,,,3498.85,95,,percent of total billed charges,,,3056.89,83,,percent of total billed charges,,,1104.9,83,,percent of total billed charges,,274.6,,,,fee schedule,,274.6,,,,fee schedule,,,3056.89,83,,percent of total billed charges,,1160.67,,,,fee schedule,,,3314.7,90,,percent of total billed charges,,,3314.7,90,,percent of total billed charges,,,3314.7,90,,percent of total billed charges,,,3314.7,90,,percent of total billed charges,,,3130.55,85,,percent of total billed charges,,274.6,3498.85,
AMPUTATE METACARPAL BONE,26910,CDM,26910,CPT,,,both,,3397,3397,1336.51,,,,fee schedule,,,,,,,,271.9,,,,fee schedule,,,2887.45,85,,percent of total billed charges,,1658.89,,,,fee schedule,,801.39,,,,fee schedule,,271.9,,,,fee schedule,,1323.76,,,,fee schedule,,271.9,,,,fee schedule,,1297.2,,,,fee schedule,,786.18,,,,fee schedule,,786.18,,,,fee schedule,,,3091.27,91,,percent of total billed charges,,,3227.15,95,,percent of total billed charges,,,2819.51,83,,percent of total billed charges,,,1019.1,83,,percent of total billed charges,,271.9,,,,fee schedule,,271.9,,,,fee schedule,,,2819.51,83,,percent of total billed charges,,1155.69,,,,fee schedule,,,3057.3,90,,percent of total billed charges,,,3057.3,90,,percent of total billed charges,,,3057.3,90,,percent of total billed charges,,,3057.3,90,,percent of total billed charges,,,2887.45,85,,percent of total billed charges,,271.9,3227.15,
AMPUTATION OF FINGER/THUMB,26951,CDM,26951,CPT,,,both,,2927,2927,1228.78,,,,fee schedule,,,,,,,,271.9,,,,fee schedule,,,2487.95,85,,percent of total billed charges,,1511.58,,,,fee schedule,,730.23,,,,fee schedule,,271.9,,,,fee schedule,,1023.33,,,,fee schedule,,271.9,,,,fee schedule,,1192.64,,,,fee schedule,,722.81,,,,fee schedule,,722.81,,,,fee schedule,,,2663.57,91,,percent of total billed charges,,,2780.65,95,,percent of total billed charges,,,2429.41,83,,percent of total billed charges,,,878.1,83,,percent of total billed charges,,271.9,,,,fee schedule,,271.9,,,,fee schedule,,,2429.41,83,,percent of total billed charges,,1062.54,,,,fee schedule,,,2634.3,90,,percent of total billed charges,,,2634.3,90,,percent of total billed charges,,,2634.3,90,,percent of total billed charges,,,2634.3,90,,percent of total billed charges,,,2487.95,85,,percent of total billed charges,,271.9,2780.65,
AMPUTATION OF FINGER/THUMB,26952,CDM,26952,CPT,,,both,,3224,3224,1200.56,,,,fee schedule,,,,,,,,259.4,,,,fee schedule,,,2740.4,85,,percent of total billed charges,,1484.52,,,,fee schedule,,717.15,,,,fee schedule,,259.4,,,,fee schedule,,1252.8,,,,fee schedule,,259.4,,,,fee schedule,,1165.25,,,,fee schedule,,706.21,,,,fee schedule,,706.21,,,,fee schedule,,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,967.2,83,,percent of total billed charges,,259.4,,,,fee schedule,,259.4,,,,fee schedule,,,2675.92,83,,percent of total billed charges,,1038.13,,,,fee schedule,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,259.4,3062.8,
HAND/FINGER SURGERY,26989,CDM,26989,CPT,,,both,,1067,1067,,,,,,,,,,,,,,,,,,,,906.95,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,970.97,91,,percent of total billed charges,,,1013.65,95,,percent of total billed charges,,,885.61,83,,percent of total billed charges,,,320.1,83,,percent of total billed charges,,,,,,,,,,,,,,,885.61,83,,percent of total billed charges,,,,,,,,,960.3,90,,percent of total billed charges,,,960.3,90,,percent of total billed charges,,,960.3,90,,percent of total billed charges,,,960.3,90,,percent of total billed charges,,,906.95,85,,percent of total billed charges,,320.1,1013.65,
DRAINAGE OF PELVIS LESION,26990,CDM,26990,CPT,,,both,,4348,4348,1184.43,,,,fee schedule,,,,,,,,262.45,,,,fee schedule,,,3695.8,85,,percent of total billed charges,,1484.59,,,,fee schedule,,717.19,,,,fee schedule,,262.45,,,,fee schedule,,1051.18,,,,fee schedule,,262.45,,,,fee schedule,,1149.59,,,,fee schedule,,696.72,,,,fee schedule,,696.72,,,,fee schedule,,,3956.68,91,,percent of total billed charges,,,4130.6,95,,percent of total billed charges,,,3608.84,83,,percent of total billed charges,,,1304.4,83,,percent of total billed charges,,262.45,,,,fee schedule,,262.45,,,,fee schedule,,,3608.84,83,,percent of total billed charges,,1024.18,,,,fee schedule,,,3913.2,90,,percent of total billed charges,,,3913.2,90,,percent of total billed charges,,,3913.2,90,,percent of total billed charges,,,3913.2,90,,percent of total billed charges,,,3695.8,85,,percent of total billed charges,,262.45,4130.6,
DRAINAGE OF PELVIS BURSA,26991,CDM,26991,CPT,,,both,,5636,5636,917.7,,,,fee schedule,,,,,,,,215.8,,,,fee schedule,,,4790.6,85,,percent of total billed charges,,1142.19,,,,fee schedule,,551.78,,,,fee schedule,,215.8,,,,fee schedule,,874.11,,,,fee schedule,,215.8,,,,fee schedule,,890.71,,,,fee schedule,,539.82,,,,fee schedule,,539.82,,,,fee schedule,,,5128.76,91,,percent of total billed charges,,,5354.2,95,,percent of total billed charges,,,4677.88,83,,percent of total billed charges,,,1690.8,83,,percent of total billed charges,,215.8,,,,fee schedule,,215.8,,,,fee schedule,,,4677.88,83,,percent of total billed charges,,793.54,,,,fee schedule,,,5072.4,90,,percent of total billed charges,,,5072.4,90,,percent of total billed charges,,,5072.4,90,,percent of total billed charges,,,5072.4,90,,percent of total billed charges,,,4790.6,85,,percent of total billed charges,,215.8,5354.2,
INCISION OF HIP TENDON,27000,CDM,27000,CPT,,,both,,4165,4165,681.51,,,,fee schedule,,,,,,,,197,,,,fee schedule,,,3540.25,85,,percent of total billed charges,,869.11,,,,fee schedule,,419.86,,,,fee schedule,,197,,,,fee schedule,,785.9,,,,fee schedule,,197,,,,fee schedule,,661.46,,,,fee schedule,,400.89,,,,fee schedule,,400.89,,,,fee schedule,,,3790.15,91,,percent of total billed charges,,,3956.75,95,,percent of total billed charges,,,3456.95,83,,percent of total billed charges,,,1249.5,83,,percent of total billed charges,,197,,,,fee schedule,,197,,,,fee schedule,,,3456.95,83,,percent of total billed charges,,589.3,,,,fee schedule,,,3748.5,90,,percent of total billed charges,,,3748.5,90,,percent of total billed charges,,,3748.5,90,,percent of total billed charges,,,3748.5,90,,percent of total billed charges,,,3540.25,85,,percent of total billed charges,,197,3956.75,
INCISION OF HIP TENDON,27001,CDM,27001,CPT,,,both,,4875,4875,941.89,,,,fee schedule,,,,,,,,202.2,,,,fee schedule,,,4143.75,85,,percent of total billed charges,,1179.5,,,,fee schedule,,569.8,,,,fee schedule,,202.2,,,,fee schedule,,944.41,,,,fee schedule,,202.2,,,,fee schedule,,914.19,,,,fee schedule,,554.06,,,,fee schedule,,554.06,,,,fee schedule,,,4436.25,91,,percent of total billed charges,,,4631.25,95,,percent of total billed charges,,,4046.25,83,,percent of total billed charges,,,1462.5,83,,percent of total billed charges,,202.2,,,,fee schedule,,202.2,,,,fee schedule,,,4046.25,83,,percent of total billed charges,,814.46,,,,fee schedule,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4387.5,90,,percent of total billed charges,,,4143.75,85,,percent of total billed charges,,202.2,4631.25,
INCISION OF HIP TENDON,27005,CDM,27005,CPT,,,both,,5549,5549,1242.03,,,,fee schedule,,,,,,,,274.65,,,,fee schedule,,,4716.65,85,,percent of total billed charges,,1579.13,,,,fee schedule,,762.86,,,,fee schedule,,274.65,,,,fee schedule,,1268.71,,,,fee schedule,,274.65,,,,fee schedule,,1205.5,,,,fee schedule,,730.61,,,,fee schedule,,730.61,,,,fee schedule,,,5049.59,91,,percent of total billed charges,,,5271.55,95,,percent of total billed charges,,,4605.67,83,,percent of total billed charges,,,1664.7,83,,percent of total billed charges,,274.65,,,,fee schedule,,274.65,,,,fee schedule,,,4605.67,83,,percent of total billed charges,,1073.99,,,,fee schedule,,,4994.1,90,,percent of total billed charges,,,4994.1,90,,percent of total billed charges,,,4994.1,90,,percent of total billed charges,,,4994.1,90,,percent of total billed charges,,,4716.65,85,,percent of total billed charges,,274.65,5271.55,
INCISION OF HIP/THIGH FASCIA,27025,CDM,27025,CPT,,,both,,4665,4665,1594.6,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,3965.25,85,,percent of total billed charges,,2014.47,,,,fee schedule,,973.17,,,,fee schedule,,374.55,,,,fee schedule,,1424.57,,,,fee schedule,,374.55,,,,fee schedule,,1547.7,,,,fee schedule,,938,,,,fee schedule,,938,,,,fee schedule,,,4245.15,91,,percent of total billed charges,,,4431.75,95,,percent of total billed charges,,,3871.95,83,,percent of total billed charges,,,1399.5,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,3871.95,83,,percent of total billed charges,,1378.86,,,,fee schedule,,,4198.5,90,,percent of total billed charges,,,4198.5,90,,percent of total billed charges,,,4198.5,90,,percent of total billed charges,,,4198.5,90,,percent of total billed charges,,,3965.25,85,,percent of total billed charges,,374.55,4431.75,
DRAINAGE OF HIP JOINT,27030,CDM,27030,CPT,,,both,,7165,7165,1619.37,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,6090.25,85,,percent of total billed charges,,2050.36,,,,fee schedule,,990.51,,,,fee schedule,,524.4,,,,fee schedule,,1648.07,,,,fee schedule,,524.4,,,,fee schedule,,1571.74,,,,fee schedule,,952.57,,,,fee schedule,,952.57,,,,fee schedule,,,6520.15,91,,percent of total billed charges,,,6806.75,95,,percent of total billed charges,,,5946.95,83,,percent of total billed charges,,,2149.5,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,5946.95,83,,percent of total billed charges,,1400.28,,,,fee schedule,,,6448.5,90,,percent of total billed charges,,,6448.5,90,,percent of total billed charges,,,6448.5,90,,percent of total billed charges,,,6448.5,90,,percent of total billed charges,,,6090.25,85,,percent of total billed charges,,524.4,6806.75,
EXPLORATION OF HIP JOINT,27033,CDM,27033,CPT,,,both,,7381,7381,1679.86,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,6273.85,85,,percent of total billed charges,,2125.47,,,,fee schedule,,1026.79,,,,fee schedule,,599.35,,,,fee schedule,,1696.48,,,,fee schedule,,599.35,,,,fee schedule,,1630.45,,,,fee schedule,,988.15,,,,fee schedule,,988.15,,,,fee schedule,,,6716.71,91,,percent of total billed charges,,,7011.95,95,,percent of total billed charges,,,6126.23,83,,percent of total billed charges,,,2214.3,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,6126.23,83,,percent of total billed charges,,1452.58,,,,fee schedule,,,6642.9,90,,percent of total billed charges,,,6642.9,90,,percent of total billed charges,,,6642.9,90,,percent of total billed charges,,,6642.9,90,,percent of total billed charges,,,6273.85,85,,percent of total billed charges,,599.35,7011.95,
DENERVATION OF HIP JOINT,27035,CDM,27035,CPT,,,both,,9572,9572,1930.45,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,8136.2,85,,percent of total billed charges,,2451.42,,,,fee schedule,,1184.26,,,,fee schedule,,599.35,,,,fee schedule,,1988.96,,,,fee schedule,,599.35,,,,fee schedule,,1873.67,,,,fee schedule,,1135.56,,,,fee schedule,,1135.56,,,,fee schedule,,,8710.52,91,,percent of total billed charges,,,9093.4,95,,percent of total billed charges,,,7944.76,83,,percent of total billed charges,,,2871.6,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,7944.76,83,,percent of total billed charges,,1669.27,,,,fee schedule,,,8614.8,90,,percent of total billed charges,,,8614.8,90,,percent of total billed charges,,,8614.8,90,,percent of total billed charges,,,8614.8,90,,percent of total billed charges,,,8136.2,85,,percent of total billed charges,,599.35,9093.4,
EXCISION OF HIP JOINT/MUSCLE,27036,CDM,27036,CPT,,,both,,7638,7638,1759.36,,,,fee schedule,,,,,,,,614.33,,,,fee schedule,,,6492.3,85,,percent of total billed charges,,2223.26,,,,fee schedule,,1074.03,,,,fee schedule,,614.33,,,,fee schedule,,1662.66,,,,fee schedule,,614.33,,,,fee schedule,,1707.61,,,,fee schedule,,1034.92,,,,fee schedule,,1034.92,,,,fee schedule,,,6950.58,91,,percent of total billed charges,,,7256.1,95,,percent of total billed charges,,,6339.54,83,,percent of total billed charges,,,2291.4,83,,percent of total billed charges,,614.33,,,,fee schedule,,614.33,,,,fee schedule,,,6339.54,83,,percent of total billed charges,,1521.33,,,,fee schedule,,,6874.2,90,,percent of total billed charges,,,6874.2,90,,percent of total billed charges,,,6874.2,90,,percent of total billed charges,,,6874.2,90,,percent of total billed charges,,,6492.3,85,,percent of total billed charges,,614.33,7256.1,
BIOPSY OF SOFT TISSUES,27040,CDM,27040,CPT,,,both,,1595,1595,342.19,,,,fee schedule,,,,,,,,113.6,,,,fee schedule,,,1355.75,85,,percent of total billed charges,,427.23,,,,fee schedule,,206.39,,,,fee schedule,,113.6,,,,fee schedule,,341.55,,,,fee schedule,,113.6,,,,fee schedule,,332.13,,,,fee schedule,,201.29,,,,fee schedule,,201.29,,,,fee schedule,,,1451.45,91,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,478.5,83,,percent of total billed charges,,113.6,,,,fee schedule,,113.6,,,,fee schedule,,,1323.85,83,,percent of total billed charges,,295.9,,,,fee schedule,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,113.6,1515.25,
Excisiontumor Soft Tissue Pelvis/hip 3cm Greater,27043,CDM,27043,CPT,,,both,,3288,3288,812.85,,,,fee schedule,,,,,,,,263.34,,,,fee schedule,,,2794.8,85,,percent of total billed charges,,1035.13,,,,fee schedule,,500.06,,,,fee schedule,,263.34,,,,fee schedule,,,,,,,,263.34,,,,fee schedule,,788.94,,,,fee schedule,,478.15,,,,fee schedule,,478.15,,,,fee schedule,,,2992.08,91,,percent of total billed charges,,,3123.6,95,,percent of total billed charges,,,2729.04,83,,percent of total billed charges,,,986.4,83,,percent of total billed charges,,263.34,,,,fee schedule,,263.34,,,,fee schedule,,,2729.04,83,,percent of total billed charges,,702.88,,,,fee schedule,,,2959.2,90,,percent of total billed charges,,,2959.2,90,,percent of total billed charges,,,2959.2,90,,percent of total billed charges,,,2959.2,90,,percent of total billed charges,,,2794.8,85,,percent of total billed charges,,263.34,3123.6,
EXC HIP/PELV TUM DEEP 5 CM/>,27045,CDM,27045,CPT,,,both,,3594,3594,1271.99,,,,fee schedule,,,,,,,,418.81,,,,fee schedule,,,3054.9,85,,percent of total billed charges,,1616.19,,,,fee schedule,,780.76,,,,fee schedule,,418.81,,,,fee schedule,,,,,,,,418.81,,,,fee schedule,,1234.58,,,,fee schedule,,748.23,,,,fee schedule,,748.23,,,,fee schedule,,,3270.54,91,,percent of total billed charges,,,3414.3,95,,percent of total billed charges,,,2983.02,83,,percent of total billed charges,,,1078.2,83,,percent of total billed charges,,418.81,,,,fee schedule,,418.81,,,,fee schedule,,,2983.02,83,,percent of total billed charges,,1099.9,,,,fee schedule,,,3234.6,90,,percent of total billed charges,,,3234.6,90,,percent of total billed charges,,,3234.6,90,,percent of total billed charges,,,3234.6,90,,percent of total billed charges,,,3054.9,85,,percent of total billed charges,,418.81,3414.3,
REMOVE HIP/PELVIS LESION,27047,CDM,27047,CPT,,,both,,3188,3188,625.05,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,2709.8,85,,percent of total billed charges,,789.57,,,,fee schedule,,381.43,,,,fee schedule,,224.7,,,,fee schedule,,876.1,,,,fee schedule,,224.7,,,,fee schedule,,606.67,,,,fee schedule,,367.68,,,,fee schedule,,367.68,,,,fee schedule,,,2901.08,91,,percent of total billed charges,,,3028.6,95,,percent of total billed charges,,,2646.04,83,,percent of total billed charges,,,956.4,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,2646.04,83,,percent of total billed charges,,540.48,,,,fee schedule,,,2869.2,90,,percent of total billed charges,,,2869.2,90,,percent of total billed charges,,,2869.2,90,,percent of total billed charges,,,2869.2,90,,percent of total billed charges,,,2709.8,85,,percent of total billed charges,,224.7,3028.6,
REMOVE HIP/PELVIS LESION,27048,CDM,27048,CPT,,,both,,3970,3970,1059.99,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,3374.5,85,,percent of total billed charges,,1339.56,,,,fee schedule,,647.13,,,,fee schedule,,374.55,,,,fee schedule,,791.87,,,,fee schedule,,374.55,,,,fee schedule,,1028.82,,,,fee schedule,,623.52,,,,fee schedule,,623.52,,,,fee schedule,,,3612.7,91,,percent of total billed charges,,,3771.5,95,,percent of total billed charges,,,3295.1,83,,percent of total billed charges,,,1191,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,3295.1,83,,percent of total billed charges,,916.58,,,,fee schedule,,,3573,90,,percent of total billed charges,,,3573,90,,percent of total billed charges,,,3573,90,,percent of total billed charges,,,3573,90,,percent of total billed charges,,,3374.5,85,,percent of total billed charges,,374.55,3771.5,
REMOVAL OF HIP JOINT LINING,27054,CDM,27054,CPT,,,both,,6404,6404,1198.83,,,,fee schedule,,,,,,,,749.2,,,,fee schedule,,,5443.4,85,,percent of total billed charges,,1499.28,,,,fee schedule,,724.29,,,,fee schedule,,749.2,,,,fee schedule,,1149.34,,,,fee schedule,,749.2,,,,fee schedule,,1163.57,,,,fee schedule,,705.19,,,,fee schedule,,705.19,,,,fee schedule,,,5827.64,91,,percent of total billed charges,,,6083.8,95,,percent of total billed charges,,,5315.32,83,,percent of total billed charges,,,1921.2,83,,percent of total billed charges,,749.2,,,,fee schedule,,749.2,,,,fee schedule,,,5315.32,83,,percent of total billed charges,,1036.63,,,,fee schedule,,,5763.6,90,,percent of total billed charges,,,5763.6,90,,percent of total billed charges,,,5763.6,90,,percent of total billed charges,,,5763.6,90,,percent of total billed charges,,,5443.4,85,,percent of total billed charges,,705.19,6083.8,
REMOVE FEMUR LESION/BURSA,27062,CDM,27062,CPT,,,both,,3454,3454,793.27,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,2935.9,85,,percent of total billed charges,,991,,,,fee schedule,,478.74,,,,fee schedule,,374.55,,,,fee schedule,,760.7,,,,fee schedule,,374.55,,,,fee schedule,,769.93,,,,fee schedule,,466.63,,,,fee schedule,,466.63,,,,fee schedule,,,3143.14,91,,percent of total billed charges,,,3281.3,95,,percent of total billed charges,,,2866.82,83,,percent of total billed charges,,,1036.2,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,2866.82,83,,percent of total billed charges,,685.94,,,,fee schedule,,,3108.6,90,,percent of total billed charges,,,3108.6,90,,percent of total billed charges,,,3108.6,90,,percent of total billed charges,,,3108.6,90,,percent of total billed charges,,,2935.9,85,,percent of total billed charges,,374.55,3281.3,
REMOVE FEMUR LESION/BURSA,27062AS,CDM,27062,CPT,,,both,AS,689,689,793.27,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,585.65,85,,percent of total billed charges,,991,,,,fee schedule,,478.74,,,,fee schedule,,374.55,,,,fee schedule,,760.7,,,,fee schedule,,374.55,,,,fee schedule,,769.93,,,,fee schedule,,466.63,,,,fee schedule,,466.63,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,571.87,83,,percent of total billed charges,,685.94,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,991,
PARTIAL REMOVAL OF HIP BONE,27070,CDM,27070,CPT,,,both,,7801,7801,1535.84,,,,fee schedule,,,,,,,,419,,,,fee schedule,,,6630.85,85,,percent of total billed charges,,1936.79,,,,fee schedule,,935.64,,,,fee schedule,,419,,,,fee schedule,,1428.55,,,,fee schedule,,419,,,,fee schedule,,1490.66,,,,fee schedule,,903.43,,,,fee schedule,,903.43,,,,fee schedule,,,7098.91,91,,percent of total billed charges,,,7410.95,95,,percent of total billed charges,,,6474.83,83,,percent of total billed charges,,,2340.3,83,,percent of total billed charges,,419,,,,fee schedule,,419,,,,fee schedule,,,6474.83,83,,percent of total billed charges,,1328.05,,,,fee schedule,,,7020.9,90,,percent of total billed charges,,,7020.9,90,,percent of total billed charges,,,7020.9,90,,percent of total billed charges,,,7020.9,90,,percent of total billed charges,,,6630.85,85,,percent of total billed charges,,419,7410.95,
REMOVAL OF TAIL BONE,27080,CDM,27080,CPT,,,both,,3600,3600,888.9,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,3060,85,,percent of total billed charges,,1122.47,,,,fee schedule,,542.25,,,,fee schedule,,359.3,,,,fee schedule,,804.47,,,,fee schedule,,359.3,,,,fee schedule,,862.75,,,,fee schedule,,522.88,,,,fee schedule,,522.88,,,,fee schedule,,,3276,91,,percent of total billed charges,,,3420,95,,percent of total billed charges,,,2988,83,,percent of total billed charges,,,1080,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,2988,83,,percent of total billed charges,,768.63,,,,fee schedule,,,3240,90,,percent of total billed charges,,,3240,90,,percent of total billed charges,,,3240,90,,percent of total billed charges,,,3240,90,,percent of total billed charges,,,3060,85,,percent of total billed charges,,359.3,3420,
REMOVE HIP FOREIGN BODY,27087,CDM,27087,CPT,,,both,,4383,4383,1068.06,,,,fee schedule,,,,,,,,247.2,,,,fee schedule,,,3725.55,85,,percent of total billed charges,,1351.38,,,,fee schedule,,652.84,,,,fee schedule,,247.2,,,,fee schedule,,1093.63,,,,fee schedule,,247.2,,,,fee schedule,,1036.64,,,,fee schedule,,628.27,,,,fee schedule,,628.27,,,,fee schedule,,,3988.53,91,,percent of total billed charges,,,4163.85,95,,percent of total billed charges,,,3637.89,83,,percent of total billed charges,,,1314.9,83,,percent of total billed charges,,247.2,,,,fee schedule,,247.2,,,,fee schedule,,,3637.89,83,,percent of total billed charges,,923.55,,,,fee schedule,,,3944.7,90,,percent of total billed charges,,,3944.7,90,,percent of total billed charges,,,3944.7,90,,percent of total billed charges,,,3944.7,90,,percent of total billed charges,,,3725.55,85,,percent of total billed charges,,247.2,4163.85,
REMOVAL OF HIP PROSTHESIS,27091,CDM,27091,CPT,,,both,,12766,12766,2740.42,,,,fee schedule,,,,,,,,694.45,,,,fee schedule,,,10851.1,85,,percent of total billed charges,,3487.22,,,,fee schedule,,1684.64,,,,fee schedule,,694.45,,,,fee schedule,,2644.87,,,,fee schedule,,694.45,,,,fee schedule,,2659.82,,,,fee schedule,,1612.01,,,,fee schedule,,1612.01,,,,fee schedule,,,11617.06,91,,percent of total billed charges,,,12127.7,95,,percent of total billed charges,,,10595.78,83,,percent of total billed charges,,,3829.8,83,,percent of total billed charges,,694.45,,,,fee schedule,,694.45,,,,fee schedule,,,10595.78,83,,percent of total billed charges,,2369.66,,,,fee schedule,,,11489.4,90,,percent of total billed charges,,,11489.4,90,,percent of total billed charges,,,11489.4,90,,percent of total billed charges,,,11489.4,90,,percent of total billed charges,,,10851.1,85,,percent of total billed charges,,694.45,12127.7,
REMOVAL OF HIP PROSTHESIS,27091AS80,CDM,27091,CPT,,,both,,689,689,2740.42,,,,fee schedule,,,,,,,,694.45,,,,fee schedule,,,585.65,85,,percent of total billed charges,,3487.22,,,,fee schedule,,1684.64,,,,fee schedule,,694.45,,,,fee schedule,,2644.87,,,,fee schedule,,694.45,,,,fee schedule,,2659.82,,,,fee schedule,,1612.01,,,,fee schedule,,1612.01,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,694.45,,,,fee schedule,,694.45,,,,fee schedule,,,571.87,83,,percent of total billed charges,,2369.66,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,3487.22,
INJECTION FOR HIP X-RAY,27093,CDM,27093,CPT,,,both,,1400,1400,116.94,,,,fee schedule,,,,,,,,106.7,,,,fee schedule,,,1190,85,,percent of total billed charges,,146.44,,,,fee schedule,,70.74,,,,fee schedule,,106.7,,,,fee schedule,,126.01,,,,fee schedule,,106.7,,,,fee schedule,,113.51,,,,fee schedule,,68.79,,,,fee schedule,,68.79,,,,fee schedule,,,1274,91,,percent of total billed charges,,,1330,95,,percent of total billed charges,,,1162,83,,percent of total billed charges,,,420,83,,percent of total billed charges,,106.7,,,,fee schedule,,106.7,,,,fee schedule,,,1162,83,,percent of total billed charges,,101.12,,,,fee schedule,,,1260,90,,percent of total billed charges,,,1260,90,,percent of total billed charges,,,1260,90,,percent of total billed charges,,,1260,90,,percent of total billed charges,,,1190,85,,percent of total billed charges,,68.79,1330,
INJECT SACROILIAC JOINT,27096,CDM,27096,CPT,,,both,,1629,1629,141.14,,,,fee schedule,,,,,,,,172.5,,,,fee schedule,,,1384.65,85,,percent of total billed charges,,177.04,,,,fee schedule,,85.53,,,,fee schedule,,172.5,,,,fee schedule,,121.37,,,,fee schedule,,172.5,,,,fee schedule,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,1482.39,91,,percent of total billed charges,,,1547.55,95,,percent of total billed charges,,,1352.07,83,,percent of total billed charges,,,488.7,83,,percent of total billed charges,,172.5,,,,fee schedule,,172.5,,,,fee schedule,,,1352.07,83,,percent of total billed charges,,122.04,,,,fee schedule,,,1466.1,90,,percent of total billed charges,,,1466.1,90,,percent of total billed charges,,,1466.1,90,,percent of total billed charges,,,1466.1,90,,percent of total billed charges,,,1384.65,85,,percent of total billed charges,,83.02,1547.55,
REVISION OF HIP TENDON,27097,CDM,27097,CPT,,,both,,6281,6281,1189.03,,,,fee schedule,,,,,,,,290.25,,,,fee schedule,,,5338.85,85,,percent of total billed charges,,1494.94,,,,fee schedule,,722.19,,,,fee schedule,,290.25,,,,fee schedule,,1110.87,,,,fee schedule,,290.25,,,,fee schedule,,1154.06,,,,fee schedule,,699.43,,,,fee schedule,,699.43,,,,fee schedule,,,5715.71,91,,percent of total billed charges,,,5966.95,95,,percent of total billed charges,,,5213.23,83,,percent of total billed charges,,,1884.3,83,,percent of total billed charges,,290.25,,,,fee schedule,,290.25,,,,fee schedule,,,5213.23,83,,percent of total billed charges,,1028.16,,,,fee schedule,,,5652.9,90,,percent of total billed charges,,,5652.9,90,,percent of total billed charges,,,5652.9,90,,percent of total billed charges,,,5652.9,90,,percent of total billed charges,,,5338.85,85,,percent of total billed charges,,290.25,5966.95,
RECONSTRUCTION OF HIP SOCKET,27122,CDM,27122,CPT,,,both,,9482,9482,1903.95,,,,fee schedule,,,,,,,,954.5,,,,fee schedule,,,8059.7,85,,percent of total billed charges,,2414.01,,,,fee schedule,,1166.18,,,,fee schedule,,954.5,,,,fee schedule,,1894.12,,,,fee schedule,,954.5,,,,fee schedule,,1847.95,,,,fee schedule,,1119.97,,,,fee schedule,,1119.97,,,,fee schedule,,,8628.62,91,,percent of total billed charges,,,9007.9,95,,percent of total billed charges,,,7870.06,83,,percent of total billed charges,,,2844.6,83,,percent of total billed charges,,954.5,,,,fee schedule,,954.5,,,,fee schedule,,,7870.06,83,,percent of total billed charges,,1646.36,,,,fee schedule,,,8533.8,90,,percent of total billed charges,,,8533.8,90,,percent of total billed charges,,,8533.8,90,,percent of total billed charges,,,8533.8,90,,percent of total billed charges,,,8059.7,85,,percent of total billed charges,,954.5,9007.9,
PARTIAL HIP REPLACEMENT,27125,CDM,27125,CPT,,,both,,8691,8691,1951.77,,,,fee schedule,,,,,,,,1026.65,,,,fee schedule,,,7387.35,85,,percent of total billed charges,,2473.01,,,,fee schedule,,1194.68,,,,fee schedule,,1026.65,,,,fee schedule,,1843.05,,,,fee schedule,,1026.65,,,,fee schedule,,1894.36,,,,fee schedule,,1148.1,,,,fee schedule,,1148.1,,,,fee schedule,,,7908.81,91,,percent of total billed charges,,,8256.45,95,,percent of total billed charges,,,7213.53,83,,percent of total billed charges,,,2607.3,83,,percent of total billed charges,,1026.65,,,,fee schedule,,1026.65,,,,fee schedule,,,7213.53,83,,percent of total billed charges,,1687.7,,,,fee schedule,,,7821.9,90,,percent of total billed charges,,,7821.9,90,,percent of total billed charges,,,7821.9,90,,percent of total billed charges,,,7821.9,90,,percent of total billed charges,,,7387.35,85,,percent of total billed charges,,1026.65,8256.45,
TOTAL HIP ARTHROPLASTY,27130,CDM,27130,CPT,,,both,,11922,11922,2211.58,,,,fee schedule,,,,,,,,1749.5,,,,fee schedule,,,10133.7,85,,percent of total billed charges,,2811.13,,,,fee schedule,,1358.03,,,,fee schedule,,1749.5,,,,fee schedule,,2443.25,,,,fee schedule,,1749.5,,,,fee schedule,,2146.53,,,,fee schedule,,1300.93,,,,fee schedule,,1300.93,,,,fee schedule,,,10849.02,91,,percent of total billed charges,,,11325.9,95,,percent of total billed charges,,,9895.26,83,,percent of total billed charges,,,3576.6,83,,percent of total billed charges,,1749.5,,,,fee schedule,,1749.5,,,,fee schedule,,,9895.26,83,,percent of total billed charges,,1912.37,,,,fee schedule,,,10729.8,90,,percent of total billed charges,,,10729.8,90,,percent of total billed charges,,,10729.8,90,,percent of total billed charges,,,10729.8,90,,percent of total billed charges,,,10133.7,85,,percent of total billed charges,,1300.93,11325.9,
TOTAL HIP ARTHROPLASTY,27130AS,CDM,27130,CPT,,,both,AS,689,689,2211.58,,,,fee schedule,,,,,,,,1749.5,,,,fee schedule,,,585.65,85,,percent of total billed charges,,2811.13,,,,fee schedule,,1358.03,,,,fee schedule,,1749.5,,,,fee schedule,,2443.25,,,,fee schedule,,1749.5,,,,fee schedule,,2146.53,,,,fee schedule,,1300.93,,,,fee schedule,,1300.93,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,1749.5,,,,fee schedule,,1749.5,,,,fee schedule,,,571.87,83,,percent of total billed charges,,1912.37,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,2811.13,
TOTAL HIP ARTHROPLASTY,27130AS80,CDM,27130,CPT,,,both,,689,689,2211.58,,,,fee schedule,,,,,,,,1749.5,,,,fee schedule,,,585.65,85,,percent of total billed charges,,2811.13,,,,fee schedule,,1358.03,,,,fee schedule,,1749.5,,,,fee schedule,,2443.25,,,,fee schedule,,1749.5,,,,fee schedule,,2146.53,,,,fee schedule,,1300.93,,,,fee schedule,,1300.93,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,1749.5,,,,fee schedule,,1749.5,,,,fee schedule,,,571.87,83,,percent of total billed charges,,1912.37,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,2811.13,
TOTAL HIP ARTHROPLASTY,27132,CDM,27132,CPT,,,both,,14177,14177,2872.92,,,,fee schedule,,,,,,,,1798.05,,,,fee schedule,,,12050.45,85,,percent of total billed charges,,3657.49,,,,fee schedule,,1766.89,,,,fee schedule,,1798.05,,,,fee schedule,,2844.49,,,,fee schedule,,1798.05,,,,fee schedule,,2788.43,,,,fee schedule,,1689.95,,,,fee schedule,,1689.95,,,,fee schedule,,,12901.07,91,,percent of total billed charges,,,13468.15,95,,percent of total billed charges,,,11766.91,83,,percent of total billed charges,,,4253.1,83,,percent of total billed charges,,1798.05,,,,fee schedule,,1798.05,,,,fee schedule,,,11766.91,83,,percent of total billed charges,,2484.23,,,,fee schedule,,,12759.3,90,,percent of total billed charges,,,12759.3,90,,percent of total billed charges,,,12759.3,90,,percent of total billed charges,,,12759.3,90,,percent of total billed charges,,,12050.45,85,,percent of total billed charges,,1689.95,13468.15,
REVISE HIP JOINT REPLACEMENT,27134,CDM,27134,CPT,,,both,,16413,16413,3269.84,,,,fee schedule,,,,,,,,1048.85,,,,fee schedule,,,13951.05,85,,percent of total billed charges,,4178.09,,,,fee schedule,,2018.39,,,,fee schedule,,1048.85,,,,fee schedule,,3392.3,,,,fee schedule,,1048.85,,,,fee schedule,,3173.67,,,,fee schedule,,1923.44,,,,fee schedule,,1923.44,,,,fee schedule,,,14935.83,91,,percent of total billed charges,,,15592.35,95,,percent of total billed charges,,,13622.79,83,,percent of total billed charges,,,4923.9,83,,percent of total billed charges,,1048.85,,,,fee schedule,,1048.85,,,,fee schedule,,,13622.79,83,,percent of total billed charges,,2827.45,,,,fee schedule,,,14771.7,90,,percent of total billed charges,,,14771.7,90,,percent of total billed charges,,,14771.7,90,,percent of total billed charges,,,14771.7,90,,percent of total billed charges,,,13951.05,85,,percent of total billed charges,,1048.85,15592.35,
REVISE HIP JOINT REPLACEMENT,27134AS,CDM,27134,CPT,,,both,AS,689,689,3269.84,,,,fee schedule,,,,,,,,1048.85,,,,fee schedule,,,585.65,85,,percent of total billed charges,,4178.09,,,,fee schedule,,2018.39,,,,fee schedule,,1048.85,,,,fee schedule,,3392.3,,,,fee schedule,,1048.85,,,,fee schedule,,3173.67,,,,fee schedule,,1923.44,,,,fee schedule,,1923.44,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,1048.85,,,,fee schedule,,1048.85,,,,fee schedule,,,571.87,83,,percent of total billed charges,,2827.45,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,4178.09,
REVISE HIP JOINT REPLACEMENT,27137,CDM,27137,CPT,,,both,,12632,12632,2518.63,,,,fee schedule,,,,,,,,1048.85,,,,fee schedule,,,10737.2,85,,percent of total billed charges,,3210.21,,,,fee schedule,,1550.82,,,,fee schedule,,1048.85,,,,fee schedule,,2566.61,,,,fee schedule,,1048.85,,,,fee schedule,,2444.55,,,,fee schedule,,1481.55,,,,fee schedule,,1481.55,,,,fee schedule,,,11495.12,91,,percent of total billed charges,,,12000.4,95,,percent of total billed charges,,,10484.56,83,,percent of total billed charges,,,3789.6,83,,percent of total billed charges,,1048.85,,,,fee schedule,,1048.85,,,,fee schedule,,,10484.56,83,,percent of total billed charges,,2177.88,,,,fee schedule,,,11368.8,90,,percent of total billed charges,,,11368.8,90,,percent of total billed charges,,,11368.8,90,,percent of total billed charges,,,11368.8,90,,percent of total billed charges,,,10737.2,85,,percent of total billed charges,,1048.85,12000.4,
REVISE HIP JOINT REPLACEMENT,27137AS,CDM,27137,CPT,,,both,AS,689,689,2518.63,,,,fee schedule,,,,,,,,1048.85,,,,fee schedule,,,585.65,85,,percent of total billed charges,,3210.21,,,,fee schedule,,1550.82,,,,fee schedule,,1048.85,,,,fee schedule,,2566.61,,,,fee schedule,,1048.85,,,,fee schedule,,2444.55,,,,fee schedule,,1481.55,,,,fee schedule,,1481.55,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,1048.85,,,,fee schedule,,1048.85,,,,fee schedule,,,571.87,83,,percent of total billed charges,,2177.88,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,3210.21,
REVISE HIP JOINT REPLACEMENT,27138,CDM,27138,CPT,,,both,,12967,12967,2615.99,,,,fee schedule,,,,,,,,1048.85,,,,fee schedule,,,11021.95,85,,percent of total billed charges,,3338.03,,,,fee schedule,,1612.56,,,,fee schedule,,1048.85,,,,fee schedule,,2674.05,,,,fee schedule,,1048.85,,,,fee schedule,,2539.05,,,,fee schedule,,1538.82,,,,fee schedule,,1538.82,,,,fee schedule,,,11799.97,91,,percent of total billed charges,,,12318.65,95,,percent of total billed charges,,,10762.61,83,,percent of total billed charges,,,3890.1,83,,percent of total billed charges,,1048.85,,,,fee schedule,,1048.85,,,,fee schedule,,,10762.61,83,,percent of total billed charges,,2262.06,,,,fee schedule,,,11670.3,90,,percent of total billed charges,,,11670.3,90,,percent of total billed charges,,,11670.3,90,,percent of total billed charges,,,11670.3,90,,percent of total billed charges,,,11021.95,85,,percent of total billed charges,,1048.85,12318.65,
INCISION/FIXATION OF FEMUR,27165,CDM,27165,CPT,,,both,,12009,12009,2370,,,,fee schedule,,,,,,,,898.95,,,,fee schedule,,,10207.65,85,,percent of total billed charges,,3013.59,,,,fee schedule,,1455.83,,,,fee schedule,,898.95,,,,fee schedule,,2245.62,,,,fee schedule,,898.95,,,,fee schedule,,2300.3,,,,fee schedule,,1394.12,,,,fee schedule,,1394.12,,,,fee schedule,,,10928.19,91,,percent of total billed charges,,,11408.55,95,,percent of total billed charges,,,9967.47,83,,percent of total billed charges,,,3602.7,83,,percent of total billed charges,,898.95,,,,fee schedule,,898.95,,,,fee schedule,,,9967.47,83,,percent of total billed charges,,2049.36,,,,fee schedule,,,10808.1,90,,percent of total billed charges,,,10808.1,90,,percent of total billed charges,,,10808.1,90,,percent of total billed charges,,,10808.1,90,,percent of total billed charges,,,10207.65,85,,percent of total billed charges,,898.95,11408.55,
REPAIR/GRAFT FEMUR HEAD/NECK,27170,CDM,27170,CPT,,,both,,9281,9281,2020.32,,,,fee schedule,,,,,,,,898.95,,,,fee schedule,,,7888.85,85,,percent of total billed charges,,2553.03,,,,fee schedule,,1233.34,,,,fee schedule,,898.95,,,,fee schedule,,1996.91,,,,fee schedule,,898.95,,,,fee schedule,,1960.9,,,,fee schedule,,1188.42,,,,fee schedule,,1188.42,,,,fee schedule,,,8445.71,91,,percent of total billed charges,,,8816.95,95,,percent of total billed charges,,,7703.23,83,,percent of total billed charges,,,2784.3,83,,percent of total billed charges,,898.95,,,,fee schedule,,898.95,,,,fee schedule,,,7703.23,83,,percent of total billed charges,,1746.98,,,,fee schedule,,,8352.9,90,,percent of total billed charges,,,8352.9,90,,percent of total billed charges,,,8352.9,90,,percent of total billed charges,,,8352.9,90,,percent of total billed charges,,,7888.85,85,,percent of total billed charges,,898.95,8816.95,
REINFORCE HIP BONES,27187,CDM,27187,CPT,,,both,,8126,8126,1722.49,,,,fee schedule,,,,,,,,950.5,,,,fee schedule,,,6907.1,85,,percent of total billed charges,,2179.46,,,,fee schedule,,1052.87,,,,fee schedule,,950.5,,,,fee schedule,,1736.27,,,,fee schedule,,950.5,,,,fee schedule,,1671.83,,,,fee schedule,,1013.23,,,,fee schedule,,1013.23,,,,fee schedule,,,7394.66,91,,percent of total billed charges,,,7719.7,95,,percent of total billed charges,,,6744.58,83,,percent of total billed charges,,,2437.8,83,,percent of total billed charges,,950.5,,,,fee schedule,,950.5,,,,fee schedule,,,6744.58,83,,percent of total billed charges,,1489.44,,,,fee schedule,,,7313.4,90,,percent of total billed charges,,,7313.4,90,,percent of total billed charges,,,7313.4,90,,percent of total billed charges,,,7313.4,90,,percent of total billed charges,,,6907.1,85,,percent of total billed charges,,950.5,7719.7,
TREAT TAIL BONE FRACTURE,27200,CDM,27200,CPT,,,both,,877,877,332.4,,,,fee schedule,,,,,,,,149.8,,,,fee schedule,,,745.45,85,,percent of total billed charges,,407.31,,,,fee schedule,,196.77,,,,fee schedule,,149.8,,,,fee schedule,,281.86,,,,fee schedule,,149.8,,,,fee schedule,,322.62,,,,fee schedule,,195.53,,,,fee schedule,,195.53,,,,fee schedule,,,798.07,91,,percent of total billed charges,,,833.15,95,,percent of total billed charges,,,727.91,83,,percent of total billed charges,,,263.1,83,,percent of total billed charges,,149.8,,,,fee schedule,,149.8,,,,fee schedule,,,727.91,83,,percent of total billed charges,,287.43,,,,fee schedule,,,789.3,90,,percent of total billed charges,,,789.3,90,,percent of total billed charges,,,789.3,90,,percent of total billed charges,,,789.3,90,,percent of total billed charges,,,745.45,85,,percent of total billed charges,,149.8,833.15,
TREAT PELVIC RING FRACTURE,27218,CDM,27218,CPT,,,both,,7684,7684,1980,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,6531.4,85,,percent of total billed charges,,2491.53,,,,fee schedule,,1203.63,,,,fee schedule,,599.35,,,,fee schedule,,2319.23,,,,fee schedule,,599.35,,,,fee schedule,,1921.76,,,,fee schedule,,1164.7,,,,fee schedule,,1164.7,,,,fee schedule,,,6992.44,91,,percent of total billed charges,,,7299.8,95,,percent of total billed charges,,,6377.72,83,,percent of total billed charges,,,2305.2,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,6377.72,83,,percent of total billed charges,,1712.11,,,,fee schedule,,,6915.6,90,,percent of total billed charges,,,6915.6,90,,percent of total billed charges,,,6915.6,90,,percent of total billed charges,,,6915.6,90,,percent of total billed charges,,,6531.4,85,,percent of total billed charges,,599.35,7299.8,
TREAT HIP SOCKET FRACTURE,27220,CDM,27220,CPT,,,both,,2396,2396,720.1,,,,fee schedule,,,,,,,,412,,,,fee schedule,,,2036.6,85,,percent of total billed charges,,901.47,,,,fee schedule,,435.49,,,,fee schedule,,412,,,,fee schedule,,851.56,,,,fee schedule,,412,,,,fee schedule,,698.92,,,,fee schedule,,423.59,,,,fee schedule,,423.59,,,,fee schedule,,,2180.36,91,,percent of total billed charges,,,2276.2,95,,percent of total billed charges,,,1988.68,83,,percent of total billed charges,,,718.8,83,,percent of total billed charges,,412,,,,fee schedule,,412,,,,fee schedule,,,1988.68,83,,percent of total billed charges,,622.68,,,,fee schedule,,,2156.4,90,,percent of total billed charges,,,2156.4,90,,percent of total billed charges,,,2156.4,90,,percent of total billed charges,,,2156.4,90,,percent of total billed charges,,,2036.6,85,,percent of total billed charges,,412,2276.2,
TREAT HIP FRACTURE(S),27227,CDM,27227,CPT,,,both,,9463,9463,2837.21,,,,fee schedule,,,,,,,,930.9,,,,fee schedule,,,8043.55,85,,percent of total billed charges,,3612.98,,,,fee schedule,,1745.39,,,,fee schedule,,930.9,,,,fee schedule,,2837.86,,,,fee schedule,,930.9,,,,fee schedule,,2753.76,,,,fee schedule,,1668.94,,,,fee schedule,,1668.94,,,,fee schedule,,,8611.33,91,,percent of total billed charges,,,8989.85,95,,percent of total billed charges,,,7854.29,83,,percent of total billed charges,,,2838.9,83,,percent of total billed charges,,930.9,,,,fee schedule,,930.9,,,,fee schedule,,,7854.29,83,,percent of total billed charges,,2453.35,,,,fee schedule,,,8516.7,90,,percent of total billed charges,,,8516.7,90,,percent of total billed charges,,,8516.7,90,,percent of total billed charges,,,8516.7,90,,percent of total billed charges,,,8043.55,85,,percent of total billed charges,,930.9,8989.85,
TREAT HIP FRACTURE(S),27228,CDM,27228,CPT,,,both,,11033,11033,3226.64,,,,fee schedule,,,,,,,,1198.7,,,,fee schedule,,,9378.05,85,,percent of total billed charges,,4112.09,,,,fee schedule,,1986.5,,,,fee schedule,,1198.7,,,,fee schedule,,3272.92,,,,fee schedule,,1198.7,,,,fee schedule,,3131.74,,,,fee schedule,,1898.02,,,,fee schedule,,1898.02,,,,fee schedule,,,10040.03,91,,percent of total billed charges,,,10481.35,95,,percent of total billed charges,,,9157.39,83,,percent of total billed charges,,,3309.9,83,,percent of total billed charges,,1198.7,,,,fee schedule,,1198.7,,,,fee schedule,,,9157.39,83,,percent of total billed charges,,2790.09,,,,fee schedule,,,9929.7,90,,percent of total billed charges,,,9929.7,90,,percent of total billed charges,,,9929.7,90,,percent of total billed charges,,,9929.7,90,,percent of total billed charges,,,9378.05,85,,percent of total billed charges,,1198.7,10481.35,
TREAT THIGH FRACTURE,27235,CDM,27235,CPT,,,both,,5198,5198,1566.94,,,,fee schedule,,,,,,,,674.2,,,,fee schedule,,,4418.3,85,,percent of total billed charges,,1983.73,,,,fee schedule,,958.32,,,,fee schedule,,674.2,,,,fee schedule,,1569.81,,,,fee schedule,,674.2,,,,fee schedule,,1520.86,,,,fee schedule,,921.73,,,,fee schedule,,921.73,,,,fee schedule,,,4730.18,91,,percent of total billed charges,,,4938.1,95,,percent of total billed charges,,,4314.34,83,,percent of total billed charges,,,1559.4,83,,percent of total billed charges,,674.2,,,,fee schedule,,674.2,,,,fee schedule,,,4314.34,83,,percent of total billed charges,,1354.95,,,,fee schedule,,,4678.2,90,,percent of total billed charges,,,4678.2,90,,percent of total billed charges,,,4678.2,90,,percent of total billed charges,,,4678.2,90,,percent of total billed charges,,,4418.3,85,,percent of total billed charges,,674.2,4938.1,
TREAT THIGH FRACTURE,27236,CDM,27236,CPT,,,both,,6065,6065,2056.61,,,,fee schedule,,,,,,,,1019.7,,,,fee schedule,,,5155.25,85,,percent of total billed charges,,2608.43,,,,fee schedule,,1260.1,,,,fee schedule,,1019.7,,,,fee schedule,,1942.53,,,,fee schedule,,1019.7,,,,fee schedule,,1996.13,,,,fee schedule,,1209.77,,,,fee schedule,,1209.77,,,,fee schedule,,,5519.15,91,,percent of total billed charges,,,5761.75,95,,percent of total billed charges,,,5033.95,83,,percent of total billed charges,,,1819.5,83,,percent of total billed charges,,1019.7,,,,fee schedule,,1019.7,,,,fee schedule,,,5033.95,83,,percent of total billed charges,,1778.37,,,,fee schedule,,,5458.5,90,,percent of total billed charges,,,5458.5,90,,percent of total billed charges,,,5458.5,90,,percent of total billed charges,,,5458.5,90,,percent of total billed charges,,,5155.25,85,,percent of total billed charges,,1019.7,5761.75,
TREAT THIGH FRACTURE,27238,CDM,27238,CPT,,,both,,2179,2179,818.04,,,,fee schedule,,,,,,,,183.8,,,,fee schedule,,,1852.15,85,,percent of total billed charges,,1017.87,,,,fee schedule,,491.72,,,,fee schedule,,183.8,,,,fee schedule,,764.01,,,,fee schedule,,183.8,,,,fee schedule,,793.98,,,,fee schedule,,481.2,,,,fee schedule,,481.2,,,,fee schedule,,,1982.89,91,,percent of total billed charges,,,2070.05,95,,percent of total billed charges,,,1808.57,83,,percent of total billed charges,,,653.7,83,,percent of total billed charges,,183.8,,,,fee schedule,,183.8,,,,fee schedule,,,1808.57,83,,percent of total billed charges,,707.36,,,,fee schedule,,,1961.1,90,,percent of total billed charges,,,1961.1,90,,percent of total billed charges,,,1961.1,90,,percent of total billed charges,,,1961.1,90,,percent of total billed charges,,,1852.15,85,,percent of total billed charges,,183.8,2070.05,
TREAT THIGH FRACTURE,27240,CDM,27240,CPT,,,both,,4652,4652,1655.08,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,3954.2,85,,percent of total billed charges,,2097.85,,,,fee schedule,,1013.45,,,,fee schedule,,449.5,,,,fee schedule,,1592.36,,,,fee schedule,,449.5,,,,fee schedule,,1606.41,,,,fee schedule,,973.58,,,,fee schedule,,973.58,,,,fee schedule,,,4233.32,91,,percent of total billed charges,,,4419.4,95,,percent of total billed charges,,,3861.16,83,,percent of total billed charges,,,1395.6,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,3861.16,83,,percent of total billed charges,,1431.16,,,,fee schedule,,,4186.8,90,,percent of total billed charges,,,4186.8,90,,percent of total billed charges,,,4186.8,90,,percent of total billed charges,,,4186.8,90,,percent of total billed charges,,,3954.2,85,,percent of total billed charges,,449.5,4419.4,
TREAT THIGH FRACTURE,27244,CDM,27244,CPT,,,both,,6026,6026,2115.95,,,,fee schedule,,,,,,,,933.8,,,,fee schedule,,,5122.1,85,,percent of total billed charges,,2683.91,,,,fee schedule,,1296.57,,,,fee schedule,,933.8,,,,fee schedule,,1985.64,,,,fee schedule,,933.8,,,,fee schedule,,2053.72,,,,fee schedule,,1244.68,,,,fee schedule,,1244.68,,,,fee schedule,,,5483.66,91,,percent of total billed charges,,,5724.7,95,,percent of total billed charges,,,5001.58,83,,percent of total billed charges,,,1807.8,83,,percent of total billed charges,,933.8,,,,fee schedule,,933.8,,,,fee schedule,,,5001.58,83,,percent of total billed charges,,1829.67,,,,fee schedule,,,5423.4,90,,percent of total billed charges,,,5423.4,90,,percent of total billed charges,,,5423.4,90,,percent of total billed charges,,,5423.4,90,,percent of total billed charges,,,5122.1,85,,percent of total billed charges,,933.8,5724.7,
TREAT THIGH FRACTURE,27245,CDM,27245,CPT,,,both,,6829,6829,2113.65,,,,fee schedule,,,,,,,,933.8,,,,fee schedule,,,5804.65,85,,percent of total billed charges,,2681.46,,,,fee schedule,,1295.38,,,,fee schedule,,933.8,,,,fee schedule,,2486.36,,,,fee schedule,,933.8,,,,fee schedule,,2051.48,,,,fee schedule,,1243.32,,,,fee schedule,,1243.32,,,,fee schedule,,,6214.39,91,,percent of total billed charges,,,6487.55,95,,percent of total billed charges,,,5668.07,83,,percent of total billed charges,,,2048.7,83,,percent of total billed charges,,933.8,,,,fee schedule,,933.8,,,,fee schedule,,,5668.07,83,,percent of total billed charges,,1827.68,,,,fee schedule,,,6146.1,90,,percent of total billed charges,,,6146.1,90,,percent of total billed charges,,,6146.1,90,,percent of total billed charges,,,6146.1,90,,percent of total billed charges,,,5804.65,85,,percent of total billed charges,,933.8,6487.55,
TREAT THIGH FRACTURE,27246,CDM,27246,CPT,,,both,,1819,1819,678.05,,,,fee schedule,,,,,,,,167,,,,fee schedule,,,1546.15,85,,percent of total billed charges,,842.43,,,,fee schedule,,406.97,,,,fee schedule,,167,,,,fee schedule,,657.9,,,,fee schedule,,167,,,,fee schedule,,658.11,,,,fee schedule,,398.85,,,,fee schedule,,398.85,,,,fee schedule,,,1655.29,91,,percent of total billed charges,,,1728.05,95,,percent of total billed charges,,,1509.77,83,,percent of total billed charges,,,545.7,83,,percent of total billed charges,,167,,,,fee schedule,,167,,,,fee schedule,,,1509.77,83,,percent of total billed charges,,586.31,,,,fee schedule,,,1637.1,90,,percent of total billed charges,,,1637.1,90,,percent of total billed charges,,,1637.1,90,,percent of total billed charges,,,1637.1,90,,percent of total billed charges,,,1546.15,85,,percent of total billed charges,,167,1728.05,
TREAT THIGH FRACTURE,27246P,CDM,27246,CPT,,,both,P,1094,1094,678.05,,,,fee schedule,,,,,,,,167,,,,fee schedule,,,929.9,85,,percent of total billed charges,,842.43,,,,fee schedule,,406.97,,,,fee schedule,,167,,,,fee schedule,,657.9,,,,fee schedule,,167,,,,fee schedule,,658.11,,,,fee schedule,,398.85,,,,fee schedule,,398.85,,,,fee schedule,,,995.54,91,,percent of total billed charges,,,1039.3,95,,percent of total billed charges,,,908.02,83,,percent of total billed charges,,,328.2,83,,percent of total billed charges,,167,,,,fee schedule,,167,,,,fee schedule,,,908.02,83,,percent of total billed charges,,586.31,,,,fee schedule,,,984.6,90,,percent of total billed charges,,,984.6,90,,percent of total billed charges,,,984.6,90,,percent of total billed charges,,,984.6,90,,percent of total billed charges,,,929.9,85,,percent of total billed charges,,167,1039.3,
TREAT THIGH FRACTURE,27246T,CDM,27246,CPT,,,both,T,725,725,678.05,,,,fee schedule,,,,,,,,167,,,,fee schedule,,,616.25,85,,percent of total billed charges,,842.43,,,,fee schedule,,406.97,,,,fee schedule,,167,,,,fee schedule,,657.9,,,,fee schedule,,167,,,,fee schedule,,658.11,,,,fee schedule,,398.85,,,,fee schedule,,398.85,,,,fee schedule,,,659.75,91,,percent of total billed charges,,,688.75,95,,percent of total billed charges,,,601.75,83,,percent of total billed charges,,,217.5,83,,percent of total billed charges,,167,,,,fee schedule,,167,,,,fee schedule,,,601.75,83,,percent of total billed charges,,586.31,,,,fee schedule,,,652.5,90,,percent of total billed charges,,,652.5,90,,percent of total billed charges,,,652.5,90,,percent of total billed charges,,,652.5,90,,percent of total billed charges,,,616.25,85,,percent of total billed charges,,167,842.43,
TREAT THIGH FRACTURE,27248,CDM,27248,CPT,,,both,,3395,3395,1289.85,,,,fee schedule,,,,,,,,779.7,,,,fee schedule,,,2885.75,85,,percent of total billed charges,,1634.18,,,,fee schedule,,789.45,,,,fee schedule,,779.7,,,,fee schedule,,1354.27,,,,fee schedule,,779.7,,,,fee schedule,,1251.91,,,,fee schedule,,758.73,,,,fee schedule,,758.73,,,,fee schedule,,,3089.45,91,,percent of total billed charges,,,3225.25,95,,percent of total billed charges,,,2817.85,83,,percent of total billed charges,,,1018.5,83,,percent of total billed charges,,779.7,,,,fee schedule,,779.7,,,,fee schedule,,,2817.85,83,,percent of total billed charges,,1115.34,,,,fee schedule,,,3055.5,90,,percent of total billed charges,,,3055.5,90,,percent of total billed charges,,,3055.5,90,,percent of total billed charges,,,3055.5,90,,percent of total billed charges,,,2885.75,85,,percent of total billed charges,,758.73,3225.25,
TREAT HIP DISLOCATION,27250,CDM,27250,CPT,,,both,,2064,2064,309.36,,,,fee schedule,,,,,,,,242.8,,,,fee schedule,,,1754.4,85,,percent of total billed charges,,405.58,,,,fee schedule,,195.93,,,,fee schedule,,242.8,,,,fee schedule,,807.12,,,,fee schedule,,242.8,,,,fee schedule,,300.26,,,,fee schedule,,181.97,,,,fee schedule,,181.97,,,,fee schedule,,,1878.24,91,,percent of total billed charges,,,1960.8,95,,percent of total billed charges,,,1713.12,83,,percent of total billed charges,,,619.2,83,,percent of total billed charges,,242.8,,,,fee schedule,,242.8,,,,fee schedule,,,1713.12,83,,percent of total billed charges,,267.5,,,,fee schedule,,,1857.6,90,,percent of total billed charges,,,1857.6,90,,percent of total billed charges,,,1857.6,90,,percent of total billed charges,,,1857.6,90,,percent of total billed charges,,,1754.4,85,,percent of total billed charges,,181.97,1960.8,
TREAT HIP DISLOCATION,27252,CDM,27252,CPT,,,both,,3305,3305,1305.98,,,,fee schedule,,,,,,,,284.9,,,,fee schedule,,,2809.25,85,,percent of total billed charges,,1655.59,,,,fee schedule,,799.8,,,,fee schedule,,284.9,,,,fee schedule,,1286.62,,,,fee schedule,,284.9,,,,fee schedule,,1267.57,,,,fee schedule,,768.22,,,,fee schedule,,768.22,,,,fee schedule,,,3007.55,91,,percent of total billed charges,,,3139.75,95,,percent of total billed charges,,,2743.15,83,,percent of total billed charges,,,991.5,83,,percent of total billed charges,,284.9,,,,fee schedule,,284.9,,,,fee schedule,,,2743.15,83,,percent of total billed charges,,1129.29,,,,fee schedule,,,2974.5,90,,percent of total billed charges,,,2974.5,90,,percent of total billed charges,,,2974.5,90,,percent of total billed charges,,,2974.5,90,,percent of total billed charges,,,2809.25,85,,percent of total billed charges,,284.9,3139.75,
TREAT HIP DISLOCATION,27253,CDM,27253,CPT,,,both,,4758,4758,1625.7,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,4044.3,85,,percent of total billed charges,,2057.91,,,,fee schedule,,994.15,,,,fee schedule,,599.35,,,,fee schedule,,1650.06,,,,fee schedule,,599.35,,,,fee schedule,,1577.89,,,,fee schedule,,956.3,,,,fee schedule,,956.3,,,,fee schedule,,,4329.78,91,,percent of total billed charges,,,4520.1,95,,percent of total billed charges,,,3949.14,83,,percent of total billed charges,,,1427.4,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3949.14,83,,percent of total billed charges,,1405.76,,,,fee schedule,,,4282.2,90,,percent of total billed charges,,,4282.2,90,,percent of total billed charges,,,4282.2,90,,percent of total billed charges,,,4282.2,90,,percent of total billed charges,,,4044.3,85,,percent of total billed charges,,599.35,4520.1,
TREAT HIP DISLOCATION,27265,CDM,27265,CPT,,,both,,2181,2181,729.9,,,,fee schedule,,,,,,,,242.8,,,,fee schedule,,,1853.85,85,,percent of total billed charges,,896.2,,,,fee schedule,,432.95,,,,fee schedule,,242.8,,,,fee schedule,,692.39,,,,fee schedule,,242.8,,,,fee schedule,,708.43,,,,fee schedule,,429.35,,,,fee schedule,,429.35,,,,fee schedule,,,1984.71,91,,percent of total billed charges,,,2071.95,95,,percent of total billed charges,,,1810.23,83,,percent of total billed charges,,,654.3,83,,percent of total billed charges,,242.8,,,,fee schedule,,242.8,,,,fee schedule,,,1810.23,83,,percent of total billed charges,,631.15,,,,fee schedule,,,1962.9,90,,percent of total billed charges,,,1962.9,90,,percent of total billed charges,,,1962.9,90,,percent of total billed charges,,,1962.9,90,,percent of total billed charges,,,1853.85,85,,percent of total billed charges,,242.8,2071.95,
TREAT HIP DISLOCATION,27266,CDM,27266,CPT,,,both,,2725,2725,1017.94,,,,fee schedule,,,,,,,,283,,,,fee schedule,,,2316.25,85,,percent of total billed charges,,1277.81,,,,fee schedule,,617.3,,,,fee schedule,,283,,,,fee schedule,,1000.78,,,,fee schedule,,283,,,,fee schedule,,988,,,,fee schedule,,598.79,,,,fee schedule,,598.79,,,,fee schedule,,,2479.75,91,,percent of total billed charges,,,2588.75,95,,percent of total billed charges,,,2261.75,83,,percent of total billed charges,,,817.5,83,,percent of total billed charges,,283,,,,fee schedule,,283,,,,fee schedule,,,2261.75,83,,percent of total billed charges,,880.22,,,,fee schedule,,,2452.5,90,,percent of total billed charges,,,2452.5,90,,percent of total billed charges,,,2452.5,90,,percent of total billed charges,,,2452.5,90,,percent of total billed charges,,,2316.25,85,,percent of total billed charges,,283,2588.75,
OPTX THIGH FX,27269,CDM,27269,CPT,,,both,,6038,6038,2136.69,,,,fee schedule,,,,,,,,655.58,,,,fee schedule,,,5132.3,85,,percent of total billed charges,,2716.46,,,,fee schedule,,1312.29,,,,fee schedule,,655.58,,,,fee schedule,,,,,,,,655.58,,,,fee schedule,,2073.85,,,,fee schedule,,1256.88,,,,fee schedule,,1256.88,,,,fee schedule,,,5494.58,91,,percent of total billed charges,,,5736.1,95,,percent of total billed charges,,,5011.54,83,,percent of total billed charges,,,1811.4,83,,percent of total billed charges,,655.58,,,,fee schedule,,655.58,,,,fee schedule,,,5011.54,83,,percent of total billed charges,,1847.61,,,,fee schedule,,,5434.2,90,,percent of total billed charges,,,5434.2,90,,percent of total billed charges,,,5434.2,90,,percent of total billed charges,,,5434.2,90,,percent of total billed charges,,,5132.3,85,,percent of total billed charges,,655.58,5736.1,
FUSION OF SACROILIAC JOINT,27280,CDM,27280,CPT,,,both,,4861,4861,2355.02,,,,fee schedule,,,,,,,,958.6,,,,fee schedule,,,4131.85,85,,percent of total billed charges,,3013.24,,,,fee schedule,,1455.66,,,,fee schedule,,958.6,,,,fee schedule,,1725,,,,fee schedule,,958.6,,,,fee schedule,,2285.76,,,,fee schedule,,1385.31,,,,fee schedule,,1385.31,,,,fee schedule,,,4423.51,91,,percent of total billed charges,,,4617.95,95,,percent of total billed charges,,,4034.63,83,,percent of total billed charges,,,1458.3,83,,percent of total billed charges,,958.6,,,,fee schedule,,958.6,,,,fee schedule,,,4034.63,83,,percent of total billed charges,,2036.4,,,,fee schedule,,,4374.9,90,,percent of total billed charges,,,4374.9,90,,percent of total billed charges,,,4374.9,90,,percent of total billed charges,,,4374.9,90,,percent of total billed charges,,,4131.85,85,,percent of total billed charges,,958.6,4617.95,
FUSION OF HIP JOINT,27284,CDM,27284,CPT,,,both,,8517,8517,2755.4,,,,fee schedule,,,,,,,,898.95,,,,fee schedule,,,7239.45,85,,percent of total billed charges,,3516.35,,,,fee schedule,,1698.71,,,,fee schedule,,898.95,,,,fee schedule,,2789.45,,,,fee schedule,,898.95,,,,fee schedule,,2674.36,,,,fee schedule,,1620.82,,,,fee schedule,,1620.82,,,,fee schedule,,,7750.47,91,,percent of total billed charges,,,8091.15,95,,percent of total billed charges,,,7069.11,83,,percent of total billed charges,,,2555.1,83,,percent of total billed charges,,898.95,,,,fee schedule,,898.95,,,,fee schedule,,,7069.11,83,,percent of total billed charges,,2382.61,,,,fee schedule,,,7665.3,90,,percent of total billed charges,,,7665.3,90,,percent of total billed charges,,,7665.3,90,,percent of total billed charges,,,7665.3,90,,percent of total billed charges,,,7239.45,85,,percent of total billed charges,,898.95,8091.15,
FUSION OF HIP JOINT,27286,CDM,27286,CPT,,,both,,7985,7985,2825.68,,,,fee schedule,,,,,,,,1033.5,,,,fee schedule,,,6787.25,85,,percent of total billed charges,,3595.46,,,,fee schedule,,1736.93,,,,fee schedule,,1033.5,,,,fee schedule,,2804.7,,,,fee schedule,,1033.5,,,,fee schedule,,2742.58,,,,fee schedule,,1662.17,,,,fee schedule,,1662.17,,,,fee schedule,,,7266.35,91,,percent of total billed charges,,,7585.75,95,,percent of total billed charges,,,6627.55,83,,percent of total billed charges,,,2395.5,83,,percent of total billed charges,,1033.5,,,,fee schedule,,1033.5,,,,fee schedule,,,6627.55,83,,percent of total billed charges,,2443.39,,,,fee schedule,,,7186.5,90,,percent of total billed charges,,,7186.5,90,,percent of total billed charges,,,7186.5,90,,percent of total billed charges,,,7186.5,90,,percent of total billed charges,,,6787.25,85,,percent of total billed charges,,1033.5,7585.75,
AMPUTATION OF LEG AT HIP,27295,CDM,27295,CPT,,,both,,6510,6510,2166.65,,,,fee schedule,,,,,,,,1198.7,,,,fee schedule,,,5533.5,85,,percent of total billed charges,,2776.39,,,,fee schedule,,1341.24,,,,fee schedule,,1198.7,,,,fee schedule,,2175.98,,,,fee schedule,,1198.7,,,,fee schedule,,2102.92,,,,fee schedule,,1274.5,,,,fee schedule,,1274.5,,,,fee schedule,,,5924.1,91,,percent of total billed charges,,,6184.5,95,,percent of total billed charges,,,5403.3,83,,percent of total billed charges,,,1953,83,,percent of total billed charges,,1198.7,,,,fee schedule,,1198.7,,,,fee schedule,,,5403.3,83,,percent of total billed charges,,1873.51,,,,fee schedule,,,5859,90,,percent of total billed charges,,,5859,90,,percent of total billed charges,,,5859,90,,percent of total billed charges,,,5859,90,,percent of total billed charges,,,5533.5,85,,percent of total billed charges,,1198.7,6184.5,
PELVIS/HIP JOINT SURGERY,27299,CDM,27299,CPT,,,both,,5827,5827,,,,,,,,,,,,,,,,,,,,4952.95,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5302.57,91,,percent of total billed charges,,,5535.65,95,,percent of total billed charges,,,4836.41,83,,percent of total billed charges,,,1748.1,83,,percent of total billed charges,,,,,,,,,,,,,,,4836.41,83,,percent of total billed charges,,,,,,,,,5244.3,90,,percent of total billed charges,,,5244.3,90,,percent of total billed charges,,,5244.3,90,,percent of total billed charges,,,5244.3,90,,percent of total billed charges,,,4952.95,85,,percent of total billed charges,,1748.1,5535.65,
DRAIN THIGH/KNEE LESION,27301,CDM,27301,CPT,,,both,,2982,2982,881.41,,,,fee schedule,,,,,,,,242.1,,,,fee schedule,,,2534.7,85,,percent of total billed charges,,1106.55,,,,fee schedule,,534.56,,,,fee schedule,,242.1,,,,fee schedule,,836.97,,,,fee schedule,,242.1,,,,fee schedule,,855.48,,,,fee schedule,,518.47,,,,fee schedule,,518.47,,,,fee schedule,,,2713.62,91,,percent of total billed charges,,,2832.9,95,,percent of total billed charges,,,2475.06,83,,percent of total billed charges,,,894.6,83,,percent of total billed charges,,242.1,,,,fee schedule,,242.1,,,,fee schedule,,,2475.06,83,,percent of total billed charges,,762.16,,,,fee schedule,,,2683.8,90,,percent of total billed charges,,,2683.8,90,,percent of total billed charges,,,2683.8,90,,percent of total billed charges,,,2683.8,90,,percent of total billed charges,,,2534.7,85,,percent of total billed charges,,242.1,2832.9,
INCISION OF THIGH TENDON,27306,CDM,27306,CPT,,,both,,1834,1834,582.42,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,1558.9,85,,percent of total billed charges,,728.3,,,,fee schedule,,351.83,,,,fee schedule,,374.55,,,,fee schedule,,673.82,,,,fee schedule,,374.55,,,,fee schedule,,565.29,,,,fee schedule,,342.6,,,,fee schedule,,342.6,,,,fee schedule,,,1668.94,91,,percent of total billed charges,,,1742.3,95,,percent of total billed charges,,,1522.22,83,,percent of total billed charges,,,550.2,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,1522.22,83,,percent of total billed charges,,503.62,,,,fee schedule,,,1650.6,90,,percent of total billed charges,,,1650.6,90,,percent of total billed charges,,,1650.6,90,,percent of total billed charges,,,1650.6,90,,percent of total billed charges,,,1558.9,85,,percent of total billed charges,,342.6,1742.3,
EXPLORATION OF KNEE JOINT,27310,CDM,27310,CPT,,,both,,4125,4125,1272.57,,,,fee schedule,,,,,,,,486.9,,,,fee schedule,,,3506.25,85,,percent of total billed charges,,1598.23,,,,fee schedule,,772.09,,,,fee schedule,,486.9,,,,fee schedule,,1221.63,,,,fee schedule,,486.9,,,,fee schedule,,1235.14,,,,fee schedule,,748.57,,,,fee schedule,,748.57,,,,fee schedule,,,3753.75,91,,percent of total billed charges,,,3918.75,95,,percent of total billed charges,,,3423.75,83,,percent of total billed charges,,,1237.5,83,,percent of total billed charges,,486.9,,,,fee schedule,,486.9,,,,fee schedule,,,3423.75,83,,percent of total billed charges,,1100.4,,,,fee schedule,,,3712.5,90,,percent of total billed charges,,,3712.5,90,,percent of total billed charges,,,3712.5,90,,percent of total billed charges,,,3712.5,90,,percent of total billed charges,,,3506.25,85,,percent of total billed charges,,486.9,3918.75,
"BIOPSY, THIGH SOFT TISSUES",27323,CDM,27323,CPT,,,both,,881,881,301.87,,,,fee schedule,,,,,,,,113.6,,,,fee schedule,,,748.85,85,,percent of total billed charges,,373.16,,,,fee schedule,,180.27,,,,fee schedule,,113.6,,,,fee schedule,,291.81,,,,fee schedule,,113.6,,,,fee schedule,,292.99,,,,fee schedule,,177.57,,,,fee schedule,,177.57,,,,fee schedule,,,801.71,91,,percent of total billed charges,,,836.95,95,,percent of total billed charges,,,731.23,83,,percent of total billed charges,,,264.3,83,,percent of total billed charges,,113.6,,,,fee schedule,,113.6,,,,fee schedule,,,731.23,83,,percent of total billed charges,,261.03,,,,fee schedule,,,792.9,90,,percent of total billed charges,,,792.9,90,,percent of total billed charges,,,792.9,90,,percent of total billed charges,,,792.9,90,,percent of total billed charges,,,748.85,85,,percent of total billed charges,,113.6,836.95,
"BIOPSY, THIGH SOFT TISSUES",27324,CDM,27324,CPT,,,both,,3008,3008,714.92,,,,fee schedule,,,,,,,,264.25,,,,fee schedule,,,2556.8,85,,percent of total billed charges,,885.43,,,,fee schedule,,427.74,,,,fee schedule,,264.25,,,,fee schedule,,649.94,,,,fee schedule,,264.25,,,,fee schedule,,693.89,,,,fee schedule,,420.54,,,,fee schedule,,420.54,,,,fee schedule,,,2737.28,91,,percent of total billed charges,,,2857.6,95,,percent of total billed charges,,,2496.64,83,,percent of total billed charges,,,902.4,83,,percent of total billed charges,,264.25,,,,fee schedule,,264.25,,,,fee schedule,,,2496.64,83,,percent of total billed charges,,618.19,,,,fee schedule,,,2707.2,90,,percent of total billed charges,,,2707.2,90,,percent of total billed charges,,,2707.2,90,,percent of total billed charges,,,2707.2,90,,percent of total billed charges,,,2556.8,85,,percent of total billed charges,,264.25,2857.6,
REMOVAL OF THIGH LESION,27327,CDM,27327,CPT,,,both,,1921,1921,546.7,,,,fee schedule,,,,,,,,156.3,,,,fee schedule,,,1632.85,85,,percent of total billed charges,,685.35,,,,fee schedule,,331.08,,,,fee schedule,,156.3,,,,fee schedule,,583.62,,,,fee schedule,,156.3,,,,fee schedule,,530.62,,,,fee schedule,,321.59,,,,fee schedule,,321.59,,,,fee schedule,,,1748.11,91,,percent of total billed charges,,,1824.95,95,,percent of total billed charges,,,1594.43,83,,percent of total billed charges,,,576.3,83,,percent of total billed charges,,156.3,,,,fee schedule,,156.3,,,,fee schedule,,,1594.43,83,,percent of total billed charges,,472.74,,,,fee schedule,,,1728.9,90,,percent of total billed charges,,,1728.9,90,,percent of total billed charges,,,1728.9,90,,percent of total billed charges,,,1728.9,90,,percent of total billed charges,,,1632.85,85,,percent of total billed charges,,156.3,1824.95,
REMOVAL OF THIGH LESION,27328,CDM,27328,CPT,,,both,,3018,3018,1081.31,,,,fee schedule,,,,,,,,295.5,,,,fee schedule,,,2565.3,85,,percent of total billed charges,,1365.83,,,,fee schedule,,659.82,,,,fee schedule,,295.5,,,,fee schedule,,713.61,,,,fee schedule,,295.5,,,,fee schedule,,1049.5,,,,fee schedule,,636.06,,,,fee schedule,,636.06,,,,fee schedule,,,2746.38,91,,percent of total billed charges,,,2867.1,95,,percent of total billed charges,,,2504.94,83,,percent of total billed charges,,,905.4,83,,percent of total billed charges,,295.5,,,,fee schedule,,295.5,,,,fee schedule,,,2504.94,83,,percent of total billed charges,,935.01,,,,fee schedule,,,2716.2,90,,percent of total billed charges,,,2716.2,90,,percent of total billed charges,,,2716.2,90,,percent of total billed charges,,,2716.2,90,,percent of total billed charges,,,2565.3,85,,percent of total billed charges,,295.5,2867.1,
"REMOVE TUMOR, THIGH/KNEE",27329,CDM,27329,CPT,,,both,,5984,5984,1795.65,,,,fee schedule,,,,,,,,570.2,,,,fee schedule,,,5086.4,85,,percent of total billed charges,,2290.57,,,,fee schedule,,1106.55,,,,fee schedule,,570.2,,,,fee schedule,,1673.27,,,,fee schedule,,570.2,,,,fee schedule,,1742.84,,,,fee schedule,,1056.26,,,,fee schedule,,1056.26,,,,fee schedule,,,5445.44,91,,percent of total billed charges,,,5684.8,95,,percent of total billed charges,,,4966.72,83,,percent of total billed charges,,,1795.2,83,,percent of total billed charges,,570.2,,,,fee schedule,,570.2,,,,fee schedule,,,4966.72,83,,percent of total billed charges,,1552.71,,,,fee schedule,,,5385.6,90,,percent of total billed charges,,,5385.6,90,,percent of total billed charges,,,5385.6,90,,percent of total billed charges,,,5385.6,90,,percent of total billed charges,,,5086.4,85,,percent of total billed charges,,570.2,5684.8,
EXPLORE/TREAT KNEE JOINT,27331,CDM,27331,CPT,,,both,,2938,2938,833.02,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,2497.3,85,,percent of total billed charges,,1036.88,,,,fee schedule,,500.91,,,,fee schedule,,599.35,,,,fee schedule,,821.71,,,,fee schedule,,599.35,,,,fee schedule,,808.51,,,,fee schedule,,490.01,,,,fee schedule,,490.01,,,,fee schedule,,,2673.58,91,,percent of total billed charges,,,2791.1,95,,percent of total billed charges,,,2438.54,83,,percent of total billed charges,,,881.4,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,2438.54,83,,percent of total billed charges,,720.31,,,,fee schedule,,,2644.2,90,,percent of total billed charges,,,2644.2,90,,percent of total billed charges,,,2644.2,90,,percent of total billed charges,,,2644.2,90,,percent of total billed charges,,,2497.3,85,,percent of total billed charges,,490.01,2791.1,
REMOVAL OF KNEE CARTILAGE,27332,CDM,27332,CPT,,,both,,3798,3798,1123.94,,,,fee schedule,,,,,,,,621.5,,,,fee schedule,,,3228.3,85,,percent of total billed charges,,1407.57,,,,fee schedule,,679.98,,,,fee schedule,,621.5,,,,fee schedule,,1114.19,,,,fee schedule,,621.5,,,,fee schedule,,1090.88,,,,fee schedule,,661.14,,,,fee schedule,,661.14,,,,fee schedule,,,3456.18,91,,percent of total billed charges,,,3608.1,95,,percent of total billed charges,,,3152.34,83,,percent of total billed charges,,,1139.4,83,,percent of total billed charges,,621.5,,,,fee schedule,,621.5,,,,fee schedule,,,3152.34,83,,percent of total billed charges,,971.87,,,,fee schedule,,,3418.2,90,,percent of total billed charges,,,3418.2,90,,percent of total billed charges,,,3418.2,90,,percent of total billed charges,,,3418.2,90,,percent of total billed charges,,,3228.3,85,,percent of total billed charges,,621.5,3608.1,
REMOVAL OF KNEE CARTILAGE,27333,CDM,27333,CPT,,,both,,3814,3814,1027.73,,,,fee schedule,,,,,,,,621.5,,,,fee schedule,,,3241.9,85,,percent of total billed charges,,1283.69,,,,fee schedule,,620.14,,,,fee schedule,,621.5,,,,fee schedule,,1009.4,,,,fee schedule,,621.5,,,,fee schedule,,997.5,,,,fee schedule,,604.55,,,,fee schedule,,604.55,,,,fee schedule,,,3470.74,91,,percent of total billed charges,,,3623.3,95,,percent of total billed charges,,,3165.62,83,,percent of total billed charges,,,1144.2,83,,percent of total billed charges,,621.5,,,,fee schedule,,621.5,,,,fee schedule,,,3165.62,83,,percent of total billed charges,,888.69,,,,fee schedule,,,3432.6,90,,percent of total billed charges,,,3432.6,90,,percent of total billed charges,,,3432.6,90,,percent of total billed charges,,,3432.6,90,,percent of total billed charges,,,3241.9,85,,percent of total billed charges,,604.55,3623.3,
REMOVE KNEE JOINT LINING,27334,CDM,27334,CPT,,,both,,4011,4011,1195.37,,,,fee schedule,,,,,,,,621.5,,,,fee schedule,,,3409.35,85,,percent of total billed charges,,1496.42,,,,fee schedule,,722.9,,,,fee schedule,,621.5,,,,fee schedule,,1166.58,,,,fee schedule,,621.5,,,,fee schedule,,1160.21,,,,fee schedule,,703.16,,,,fee schedule,,703.16,,,,fee schedule,,,3650.01,91,,percent of total billed charges,,,3810.45,95,,percent of total billed charges,,,3329.13,83,,percent of total billed charges,,,1203.3,83,,percent of total billed charges,,621.5,,,,fee schedule,,621.5,,,,fee schedule,,,3329.13,83,,percent of total billed charges,,1033.64,,,,fee schedule,,,3609.9,90,,percent of total billed charges,,,3609.9,90,,percent of total billed charges,,,3609.9,90,,percent of total billed charges,,,3609.9,90,,percent of total billed charges,,,3409.35,85,,percent of total billed charges,,621.5,3810.45,
REMOVE KNEE JOINT LINING,27335,CDM,27335,CPT,,,both,,4249,4249,1329.02,,,,fee schedule,,,,,,,,621.5,,,,fee schedule,,,3611.65,85,,percent of total billed charges,,1673.78,,,,fee schedule,,808.58,,,,fee schedule,,621.5,,,,fee schedule,,1321.77,,,,fee schedule,,621.5,,,,fee schedule,,1289.93,,,,fee schedule,,781.78,,,,fee schedule,,781.78,,,,fee schedule,,,3866.59,91,,percent of total billed charges,,,4036.55,95,,percent of total billed charges,,,3526.67,83,,percent of total billed charges,,,1274.7,83,,percent of total billed charges,,621.5,,,,fee schedule,,621.5,,,,fee schedule,,,3526.67,83,,percent of total billed charges,,1149.21,,,,fee schedule,,,3824.1,90,,percent of total billed charges,,,3824.1,90,,percent of total billed charges,,,3824.1,90,,percent of total billed charges,,,3824.1,90,,percent of total billed charges,,,3611.65,85,,percent of total billed charges,,621.5,4036.55,
REMOVE KNEE JOINT LINING,27335AS,CDM,27335,CPT,,,both,AS,689,689,1329.02,,,,fee schedule,,,,,,,,621.5,,,,fee schedule,,,585.65,85,,percent of total billed charges,,1673.78,,,,fee schedule,,808.58,,,,fee schedule,,621.5,,,,fee schedule,,1321.77,,,,fee schedule,,621.5,,,,fee schedule,,1289.93,,,,fee schedule,,781.78,,,,fee schedule,,781.78,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,621.5,,,,fee schedule,,621.5,,,,fee schedule,,,571.87,83,,percent of total billed charges,,1149.21,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,1673.78,
Exc Lipoma > 3 Cm,27337,CDM,27337,CPT,,,both,,1704,1704,726.44,,,,fee schedule,,,,,,,,233.88,,,,fee schedule,,,1448.4,85,,percent of total billed charges,,923.12,,,,fee schedule,,445.95,,,,fee schedule,,233.88,,,,fee schedule,,,,,,,,233.88,,,,fee schedule,,705.07,,,,fee schedule,,427.32,,,,fee schedule,,427.32,,,,fee schedule,,,1550.64,91,,percent of total billed charges,,,1618.8,95,,percent of total billed charges,,,1414.32,83,,percent of total billed charges,,,511.2,83,,percent of total billed charges,,233.88,,,,fee schedule,,233.88,,,,fee schedule,,,1414.32,83,,percent of total billed charges,,628.16,,,,fee schedule,,,1533.6,90,,percent of total billed charges,,,1533.6,90,,percent of total billed charges,,,1533.6,90,,percent of total billed charges,,,1533.6,90,,percent of total billed charges,,,1448.4,85,,percent of total billed charges,,233.88,1618.8,
Lipoma Knee 5cm Or Greater,27339,CDM,27339,CPT,,,both,,3920,3920,1302.52,,,,fee schedule,,,,,,,,422.81,,,,fee schedule,,,3332,85,,percent of total billed charges,,1661.72,,,,fee schedule,,802.76,,,,fee schedule,,422.81,,,,fee schedule,,,,,,,,422.81,,,,fee schedule,,1264.21,,,,fee schedule,,766.19,,,,fee schedule,,766.19,,,,fee schedule,,,3567.2,91,,percent of total billed charges,,,3724,95,,percent of total billed charges,,,3253.6,83,,percent of total billed charges,,,1176,83,,percent of total billed charges,,422.81,,,,fee schedule,,422.81,,,,fee schedule,,,3253.6,83,,percent of total billed charges,,1126.3,,,,fee schedule,,,3528,90,,percent of total billed charges,,,3528,90,,percent of total billed charges,,,3528,90,,percent of total billed charges,,,3528,90,,percent of total billed charges,,,3332,85,,percent of total billed charges,,422.81,3724,
REMOVAL OF KNEECAP BURSA,27340,CDM,27340,CPT,,,both,,2380,2380,655.58,,,,fee schedule,,,,,,,,240,,,,fee schedule,,,2023,85,,percent of total billed charges,,813.3,,,,fee schedule,,392.9,,,,fee schedule,,240,,,,fee schedule,,626.07,,,,fee schedule,,240,,,,fee schedule,,636.3,,,,fee schedule,,385.64,,,,fee schedule,,385.64,,,,fee schedule,,,2165.8,91,,percent of total billed charges,,,2261,95,,percent of total billed charges,,,1975.4,83,,percent of total billed charges,,,714,83,,percent of total billed charges,,240,,,,fee schedule,,240,,,,fee schedule,,,1975.4,83,,percent of total billed charges,,566.89,,,,fee schedule,,,2142,90,,percent of total billed charges,,,2142,90,,percent of total billed charges,,,2142,90,,percent of total billed charges,,,2142,90,,percent of total billed charges,,,2023,85,,percent of total billed charges,,240,2261,
REMOVAL OF KNEE CYST,27345,CDM,27345,CPT,,,both,,3060,3060,847.99,,,,fee schedule,,,,,,,,381.5,,,,fee schedule,,,2601,85,,percent of total billed charges,,1057.79,,,,fee schedule,,511.01,,,,fee schedule,,381.5,,,,fee schedule,,830.33,,,,fee schedule,,381.5,,,,fee schedule,,823.05,,,,fee schedule,,498.82,,,,fee schedule,,498.82,,,,fee schedule,,,2784.6,91,,percent of total billed charges,,,2907,95,,percent of total billed charges,,,2539.8,83,,percent of total billed charges,,,918,83,,percent of total billed charges,,381.5,,,,fee schedule,,381.5,,,,fee schedule,,,2539.8,83,,percent of total billed charges,,733.26,,,,fee schedule,,,2754,90,,percent of total billed charges,,,2754,90,,percent of total billed charges,,,2754,90,,percent of total billed charges,,,2754,90,,percent of total billed charges,,,2601,85,,percent of total billed charges,,381.5,2907,
REMOVE KNEE CYST,27347,CDM,27347,CPT,,,both,,2909,2909,920.58,,,,fee schedule,,,,,,,,381.5,,,,fee schedule,,,2472.65,85,,percent of total billed charges,,1146.04,,,,fee schedule,,553.64,,,,fee schedule,,381.5,,,,fee schedule,,806.46,,,,fee schedule,,381.5,,,,fee schedule,,893.5,,,,fee schedule,,541.52,,,,fee schedule,,541.52,,,,fee schedule,,,2647.19,91,,percent of total billed charges,,,2763.55,95,,percent of total billed charges,,,2414.47,83,,percent of total billed charges,,,872.7,83,,percent of total billed charges,,381.5,,,,fee schedule,,381.5,,,,fee schedule,,,2414.47,83,,percent of total billed charges,,796.03,,,,fee schedule,,,2618.1,90,,percent of total billed charges,,,2618.1,90,,percent of total billed charges,,,2618.1,90,,percent of total billed charges,,,2618.1,90,,percent of total billed charges,,,2472.65,85,,percent of total billed charges,,381.5,2763.55,
REMOVAL OF KNEECAP,27350,CDM,27350,CPT,,,both,,3914,3914,1139.49,,,,fee schedule,,,,,,,,636.8,,,,fee schedule,,,3326.9,85,,percent of total billed charges,,1427.96,,,,fee schedule,,689.83,,,,fee schedule,,636.8,,,,fee schedule,,1114.19,,,,fee schedule,,636.8,,,,fee schedule,,1105.98,,,,fee schedule,,670.29,,,,fee schedule,,670.29,,,,fee schedule,,,3561.74,91,,percent of total billed charges,,,3718.3,95,,percent of total billed charges,,,3248.62,83,,percent of total billed charges,,,1174.2,83,,percent of total billed charges,,636.8,,,,fee schedule,,636.8,,,,fee schedule,,,3248.62,83,,percent of total billed charges,,985.32,,,,fee schedule,,,3522.6,90,,percent of total billed charges,,,3522.6,90,,percent of total billed charges,,,3522.6,90,,percent of total billed charges,,,3522.6,90,,percent of total billed charges,,,3326.9,85,,percent of total billed charges,,636.8,3718.3,
"PARTIAL REMOVAL, LEG BONE(S)",27360,CDM,27360,CPT,,,both,,5623,5623,1569.82,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,4779.55,85,,percent of total billed charges,,1973.24,,,,fee schedule,,953.25,,,,fee schedule,,480,,,,fee schedule,,1444.46,,,,fee schedule,,480,,,,fee schedule,,1523.65,,,,fee schedule,,923.43,,,,fee schedule,,923.43,,,,fee schedule,,,5116.93,91,,percent of total billed charges,,,5341.85,95,,percent of total billed charges,,,4667.09,83,,percent of total billed charges,,,1686.9,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,4667.09,83,,percent of total billed charges,,1357.44,,,,fee schedule,,,5060.7,90,,percent of total billed charges,,,5060.7,90,,percent of total billed charges,,,5060.7,90,,percent of total billed charges,,,5060.7,90,,percent of total billed charges,,,4779.55,85,,percent of total billed charges,,480,5341.85,
EXTENSIVE LEG SURGERY,27365,CDM,27365,CPT,,,both,,9883,9883,3522.74,,,,fee schedule,,,,,,,,898.95,,,,fee schedule,,,8400.55,85,,percent of total billed charges,,4497.08,,,,fee schedule,,2172.49,,,,fee schedule,,898.95,,,,fee schedule,,2033.39,,,,fee schedule,,898.95,,,,fee schedule,,3419.13,,,,fee schedule,,2072.2,,,,fee schedule,,2072.2,,,,fee schedule,,,8993.53,91,,percent of total billed charges,,,9388.85,95,,percent of total billed charges,,,8202.89,83,,percent of total billed charges,,,2964.9,83,,percent of total billed charges,,898.95,,,,fee schedule,,898.95,,,,fee schedule,,,8202.89,83,,percent of total billed charges,,3046.14,,,,fee schedule,,,8894.7,90,,percent of total billed charges,,,8894.7,90,,percent of total billed charges,,,8894.7,90,,percent of total billed charges,,,8894.7,90,,percent of total billed charges,,,8400.55,85,,percent of total billed charges,,898.95,9388.85,
REMOVAL OF FOREIGN BODY,27372,CDM,27372,CPT,,,both,,2558,2558,696.48,,,,fee schedule,,,,,,,,174.1,,,,fee schedule,,,2174.3,85,,percent of total billed charges,,875.49,,,,fee schedule,,422.94,,,,fee schedule,,174.1,,,,fee schedule,,699.02,,,,fee schedule,,174.1,,,,fee schedule,,676,,,,fee schedule,,409.7,,,,fee schedule,,409.7,,,,fee schedule,,,2327.78,91,,percent of total billed charges,,,2430.1,95,,percent of total billed charges,,,2123.14,83,,percent of total billed charges,,,767.4,83,,percent of total billed charges,,174.1,,,,fee schedule,,174.1,,,,fee schedule,,,2123.14,83,,percent of total billed charges,,602.25,,,,fee schedule,,,2302.2,90,,percent of total billed charges,,,2302.2,90,,percent of total billed charges,,,2302.2,90,,percent of total billed charges,,,2302.2,90,,percent of total billed charges,,,2174.3,85,,percent of total billed charges,,174.1,2430.1,
REPAIR OF KNEECAP TENDON,27380,CDM,27380,CPT,,,both,,3511,3511,1088.22,,,,fee schedule,,,,,,,,412,,,,fee schedule,,,2984.35,85,,percent of total billed charges,,1357.94,,,,fee schedule,,656.01,,,,fee schedule,,412,,,,fee schedule,,1038.58,,,,fee schedule,,412,,,,fee schedule,,1056.21,,,,fee schedule,,640.13,,,,fee schedule,,640.13,,,,fee schedule,,,3195.01,91,,percent of total billed charges,,,3335.45,95,,percent of total billed charges,,,2914.13,83,,percent of total billed charges,,,1053.3,83,,percent of total billed charges,,412,,,,fee schedule,,412,,,,fee schedule,,,2914.13,83,,percent of total billed charges,,940.99,,,,fee schedule,,,3159.9,90,,percent of total billed charges,,,3159.9,90,,percent of total billed charges,,,3159.9,90,,percent of total billed charges,,,3159.9,90,,percent of total billed charges,,,2984.35,85,,percent of total billed charges,,412,3335.45,
REPAIR/GRAFT KNEECAP TENDON,27381,CDM,27381,CPT,,,both,,4367,4367,1426.38,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,3711.95,85,,percent of total billed charges,,1795.55,,,,fee schedule,,867.41,,,,fee schedule,,524.4,,,,fee schedule,,1404.01,,,,fee schedule,,524.4,,,,fee schedule,,1384.43,,,,fee schedule,,839.05,,,,fee schedule,,839.05,,,,fee schedule,,,3973.97,91,,percent of total billed charges,,,4148.65,95,,percent of total billed charges,,,3624.61,83,,percent of total billed charges,,,1310.1,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,3624.61,83,,percent of total billed charges,,1233.4,,,,fee schedule,,,3930.3,90,,percent of total billed charges,,,3930.3,90,,percent of total billed charges,,,3930.3,90,,percent of total billed charges,,,3930.3,90,,percent of total billed charges,,,3711.95,85,,percent of total billed charges,,524.4,4148.65,
REPAIR OF THIGH MUSCLE,27385,CDM,27385,CPT,,,both,,3896,3896,1059.42,,,,fee schedule,,,,,,,,419,,,,fee schedule,,,3311.6,85,,percent of total billed charges,,1319.45,,,,fee schedule,,637.41,,,,fee schedule,,419,,,,fee schedule,,1108.88,,,,fee schedule,,419,,,,fee schedule,,1028.26,,,,fee schedule,,623.19,,,,fee schedule,,623.19,,,,fee schedule,,,3545.36,91,,percent of total billed charges,,,3701.2,95,,percent of total billed charges,,,3233.68,83,,percent of total billed charges,,,1168.8,83,,percent of total billed charges,,419,,,,fee schedule,,419,,,,fee schedule,,,3233.68,83,,percent of total billed charges,,916.08,,,,fee schedule,,,3506.4,90,,percent of total billed charges,,,3506.4,90,,percent of total billed charges,,,3506.4,90,,percent of total billed charges,,,3506.4,90,,percent of total billed charges,,,3311.6,85,,percent of total billed charges,,419,3701.2,
REPAIR/GRAFT OF THIGH MUSCLE,27386,CDM,27386,CPT,,,both,,4261,4261,1486.87,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,3621.85,85,,percent of total billed charges,,1873.76,,,,fee schedule,,905.19,,,,fee schedule,,524.4,,,,fee schedule,,1449.77,,,,fee schedule,,524.4,,,,fee schedule,,1443.14,,,,fee schedule,,874.63,,,,fee schedule,,874.63,,,,fee schedule,,,3877.51,91,,percent of total billed charges,,,4047.95,95,,percent of total billed charges,,,3536.63,83,,percent of total billed charges,,,1278.3,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,3536.63,83,,percent of total billed charges,,1285.7,,,,fee schedule,,,3834.9,90,,percent of total billed charges,,,3834.9,90,,percent of total billed charges,,,3834.9,90,,percent of total billed charges,,,3834.9,90,,percent of total billed charges,,,3621.85,85,,percent of total billed charges,,524.4,4047.95,
REVISE THIGH MUSCLES/TENDONS,27400,CDM,27400,CPT,,,both,,4214,4214,1210.35,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3581.9,85,,percent of total billed charges,,1520.16,,,,fee schedule,,734.37,,,,fee schedule,,599.35,,,,fee schedule,,1165.25,,,,fee schedule,,599.35,,,,fee schedule,,1174.75,,,,fee schedule,,711.97,,,,fee schedule,,711.97,,,,fee schedule,,,3834.74,91,,percent of total billed charges,,,4003.3,95,,percent of total billed charges,,,3497.62,83,,percent of total billed charges,,,1264.2,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3497.62,83,,percent of total billed charges,,1046.6,,,,fee schedule,,,3792.6,90,,percent of total billed charges,,,3792.6,90,,percent of total billed charges,,,3792.6,90,,percent of total billed charges,,,3792.6,90,,percent of total billed charges,,,3581.9,85,,percent of total billed charges,,599.35,4003.3,
REPAIR OF KNEE LIGAMENT,27405,CDM,27405,CPT,,,both,,4385,4385,1175.21,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,3727.25,85,,percent of total billed charges,,1477.3,,,,fee schedule,,713.67,,,,fee schedule,,524.4,,,,fee schedule,,1168.57,,,,fee schedule,,524.4,,,,fee schedule,,1140.64,,,,fee schedule,,691.3,,,,fee schedule,,691.3,,,,fee schedule,,,3990.35,91,,percent of total billed charges,,,4165.75,95,,percent of total billed charges,,,3639.55,83,,percent of total billed charges,,,1315.5,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,3639.55,83,,percent of total billed charges,,1016.21,,,,fee schedule,,,3946.5,90,,percent of total billed charges,,,3946.5,90,,percent of total billed charges,,,3946.5,90,,percent of total billed charges,,,3946.5,90,,percent of total billed charges,,,3727.25,85,,percent of total billed charges,,524.4,4165.75,
REPAIR OF KNEE LIGAMENT,27407,CDM,27407,CPT,,,both,,4804,4804,1383.17,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,4083.4,85,,percent of total billed charges,,1740.58,,,,fee schedule,,840.86,,,,fee schedule,,524.4,,,,fee schedule,,1345.65,,,,fee schedule,,524.4,,,,fee schedule,,1342.49,,,,fee schedule,,813.63,,,,fee schedule,,813.63,,,,fee schedule,,,4371.64,91,,percent of total billed charges,,,4563.8,95,,percent of total billed charges,,,3987.32,83,,percent of total billed charges,,,1441.2,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,3987.32,83,,percent of total billed charges,,1196.04,,,,fee schedule,,,4323.6,90,,percent of total billed charges,,,4323.6,90,,percent of total billed charges,,,4323.6,90,,percent of total billed charges,,,4323.6,90,,percent of total billed charges,,,4083.4,85,,percent of total billed charges,,524.4,4563.8,
AUTOCHONDROCYTE IMPLANT KNEE,27412,CDM,27412,CPT,,,both,,10890,10890,2836.63,,,,fee schedule,,,,,,,,621.5,,,,fee schedule,,,9256.5,85,,percent of total billed charges,,3603.11,,,,fee schedule,,1740.62,,,,fee schedule,,621.5,,,,fee schedule,,2809.34,,,,fee schedule,,621.5,,,,fee schedule,,2753.2,,,,fee schedule,,1668.61,,,,fee schedule,,1668.61,,,,fee schedule,,,9909.9,91,,percent of total billed charges,,,10345.5,95,,percent of total billed charges,,,9038.7,83,,percent of total billed charges,,,3267,83,,percent of total billed charges,,621.5,,,,fee schedule,,621.5,,,,fee schedule,,,9038.7,83,,percent of total billed charges,,2452.85,,,,fee schedule,,,9801,90,,percent of total billed charges,,,9801,90,,percent of total billed charges,,,9801,90,,percent of total billed charges,,,9801,90,,percent of total billed charges,,,9256.5,85,,percent of total billed charges,,621.5,10345.5,
OSTEOCHONDRAL KNEE ALLOGRAFT,27415,CDM,27415,CPT,,,both,,7759,7759,2367.12,,,,fee schedule,,,,,,,,621.5,,,,fee schedule,,,6595.15,85,,percent of total billed charges,,2996.57,,,,fee schedule,,1447.61,,,,fee schedule,,621.5,,,,fee schedule,,2345.76,,,,fee schedule,,621.5,,,,fee schedule,,2297.5,,,,fee schedule,,1392.43,,,,fee schedule,,1392.43,,,,fee schedule,,,7060.69,91,,percent of total billed charges,,,7371.05,95,,percent of total billed charges,,,6439.97,83,,percent of total billed charges,,,2327.7,83,,percent of total billed charges,,621.5,,,,fee schedule,,621.5,,,,fee schedule,,,6439.97,83,,percent of total billed charges,,2046.86,,,,fee schedule,,,6983.1,90,,percent of total billed charges,,,6983.1,90,,percent of total billed charges,,,6983.1,90,,percent of total billed charges,,,6983.1,90,,percent of total billed charges,,,6595.15,85,,percent of total billed charges,,621.5,7371.05,
OSTEOCHONDRAL KNEE AUTOGRAFT,27416,CDM,27416,CPT,,,both,,5680,5680,1695.99,,,,fee schedule,,,,,,,,513.32,,,,fee schedule,,,4828,85,,percent of total billed charges,,2144.6,,,,fee schedule,,1036.03,,,,fee schedule,,513.32,,,,fee schedule,,,,,,,,513.32,,,,fee schedule,,1646.1,,,,fee schedule,,997.64,,,,fee schedule,,997.64,,,,fee schedule,,,5168.8,91,,percent of total billed charges,,,5396,95,,percent of total billed charges,,,4714.4,83,,percent of total billed charges,,,1704,83,,percent of total billed charges,,513.32,,,,fee schedule,,513.32,,,,fee schedule,,,4714.4,83,,percent of total billed charges,,1466.53,,,,fee schedule,,,5112,90,,percent of total billed charges,,,5112,90,,percent of total billed charges,,,5112,90,,percent of total billed charges,,,5112,90,,percent of total billed charges,,,4828,85,,percent of total billed charges,,513.32,5396,
REPAIR DEGENERATED KNEECAP,27418,CDM,27418,CPT,,,both,,5030,5030,1438.48,,,,fee schedule,,,,,,,,486.1,,,,fee schedule,,,4275.5,85,,percent of total billed charges,,1815.55,,,,fee schedule,,877.07,,,,fee schedule,,486.1,,,,fee schedule,,1432.53,,,,fee schedule,,486.1,,,,fee schedule,,1396.17,,,,fee schedule,,846.16,,,,fee schedule,,846.16,,,,fee schedule,,,4577.3,91,,percent of total billed charges,,,4778.5,95,,percent of total billed charges,,,4174.9,83,,percent of total billed charges,,,1509,83,,percent of total billed charges,,486.1,,,,fee schedule,,486.1,,,,fee schedule,,,4174.9,83,,percent of total billed charges,,1243.86,,,,fee schedule,,,4527,90,,percent of total billed charges,,,4527,90,,percent of total billed charges,,,4527,90,,percent of total billed charges,,,4527,90,,percent of total billed charges,,,4275.5,85,,percent of total billed charges,,486.1,4778.5,
REVISION OF UNSTABLE KNEECAP,27420,CDM,27420,CPT,,,both,,3632,3632,1296.19,,,,fee schedule,,,,,,,,620.1,,,,fee schedule,,,3087.2,85,,percent of total billed charges,,1621.35,,,,fee schedule,,783.26,,,,fee schedule,,620.1,,,,fee schedule,,1299.88,,,,fee schedule,,620.1,,,,fee schedule,,1258.06,,,,fee schedule,,762.46,,,,fee schedule,,762.46,,,,fee schedule,,,3305.12,91,,percent of total billed charges,,,3450.4,95,,percent of total billed charges,,,3014.56,83,,percent of total billed charges,,,1089.6,83,,percent of total billed charges,,620.1,,,,fee schedule,,620.1,,,,fee schedule,,,3014.56,83,,percent of total billed charges,,1120.82,,,,fee schedule,,,3268.8,90,,percent of total billed charges,,,3268.8,90,,percent of total billed charges,,,3268.8,90,,percent of total billed charges,,,3268.8,90,,percent of total billed charges,,,3087.2,85,,percent of total billed charges,,620.1,3450.4,
REVISION OF UNSTABLE KNEECAP,27422,CDM,27422,CPT,,,both,,4865,4865,1288.7,,,,fee schedule,,,,,,,,620.1,,,,fee schedule,,,4135.25,85,,percent of total billed charges,,1621.7,,,,fee schedule,,783.43,,,,fee schedule,,620.1,,,,fee schedule,,1297.89,,,,fee schedule,,620.1,,,,fee schedule,,1250.79,,,,fee schedule,,758.06,,,,fee schedule,,758.06,,,,fee schedule,,,4427.15,91,,percent of total billed charges,,,4621.75,95,,percent of total billed charges,,,4037.95,83,,percent of total billed charges,,,1459.5,83,,percent of total billed charges,,620.1,,,,fee schedule,,620.1,,,,fee schedule,,,4037.95,83,,percent of total billed charges,,1114.34,,,,fee schedule,,,4378.5,90,,percent of total billed charges,,,4378.5,90,,percent of total billed charges,,,4378.5,90,,percent of total billed charges,,,4378.5,90,,percent of total billed charges,,,4135.25,85,,percent of total billed charges,,620.1,4621.75,
LAT RETINACULAR RELEASE OPEN,27425,CDM,27425,CPT,,,both,,3633,3633,793.84,,,,fee schedule,,,,,,,,561.85,,,,fee schedule,,,3088.05,85,,percent of total billed charges,,984.47,,,,fee schedule,,475.58,,,,fee schedule,,561.85,,,,fee schedule,,771.31,,,,fee schedule,,561.85,,,,fee schedule,,770.49,,,,fee schedule,,466.97,,,,fee schedule,,466.97,,,,fee schedule,,,3306.03,91,,percent of total billed charges,,,3451.35,95,,percent of total billed charges,,,3015.39,83,,percent of total billed charges,,,1089.9,83,,percent of total billed charges,,561.85,,,,fee schedule,,561.85,,,,fee schedule,,,3015.39,83,,percent of total billed charges,,686.44,,,,fee schedule,,,3269.7,90,,percent of total billed charges,,,3269.7,90,,percent of total billed charges,,,3269.7,90,,percent of total billed charges,,,3269.7,90,,percent of total billed charges,,,3088.05,85,,percent of total billed charges,,466.97,3451.35,
"RECONSTRUCTION, KNEE",27427,CDM,27427,CPT,,,both,,4535,4535,1233.39,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,3854.75,85,,percent of total billed charges,,1551.93,,,,fee schedule,,749.72,,,,fee schedule,,524.4,,,,fee schedule,,1242.19,,,,fee schedule,,524.4,,,,fee schedule,,1197.12,,,,fee schedule,,725.52,,,,fee schedule,,725.52,,,,fee schedule,,,4126.85,91,,percent of total billed charges,,,4308.25,95,,percent of total billed charges,,,3764.05,83,,percent of total billed charges,,,1360.5,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,3764.05,83,,percent of total billed charges,,1066.52,,,,fee schedule,,,4081.5,90,,percent of total billed charges,,,4081.5,90,,percent of total billed charges,,,4081.5,90,,percent of total billed charges,,,4081.5,90,,percent of total billed charges,,,3854.75,85,,percent of total billed charges,,524.4,4308.25,
"RECONSTRUCTION, KNEE",27428,CDM,27428,CPT,,,both,,6945,6945,1932.18,,,,fee schedule,,,,,,,,621.1,,,,fee schedule,,,5903.25,85,,percent of total billed charges,,2437.06,,,,fee schedule,,1177.32,,,,fee schedule,,621.1,,,,fee schedule,,1830.45,,,,fee schedule,,621.1,,,,fee schedule,,1875.35,,,,fee schedule,,1136.58,,,,fee schedule,,1136.58,,,,fee schedule,,,6319.95,91,,percent of total billed charges,,,6597.75,95,,percent of total billed charges,,,5764.35,83,,percent of total billed charges,,,2083.5,83,,percent of total billed charges,,621.1,,,,fee schedule,,621.1,,,,fee schedule,,,5764.35,83,,percent of total billed charges,,1670.77,,,,fee schedule,,,6250.5,90,,percent of total billed charges,,,6250.5,90,,percent of total billed charges,,,6250.5,90,,percent of total billed charges,,,6250.5,90,,percent of total billed charges,,,5903.25,85,,percent of total billed charges,,621.1,6597.75,
"RECONSTRUCTION, KNEE",27429,CDM,27429,CPT,,,both,,7587,7587,2177.02,,,,fee schedule,,,,,,,,674.2,,,,fee schedule,,,6448.95,85,,percent of total billed charges,,2742.24,,,,fee schedule,,1324.74,,,,fee schedule,,674.2,,,,fee schedule,,2028.08,,,,fee schedule,,674.2,,,,fee schedule,,2112.99,,,,fee schedule,,1280.6,,,,fee schedule,,1280.6,,,,fee schedule,,,6904.17,91,,percent of total billed charges,,,7207.65,95,,percent of total billed charges,,,6297.21,83,,percent of total billed charges,,,2276.1,83,,percent of total billed charges,,674.2,,,,fee schedule,,674.2,,,,fee schedule,,,6297.21,83,,percent of total billed charges,,1882.48,,,,fee schedule,,,6828.3,90,,percent of total billed charges,,,6828.3,90,,percent of total billed charges,,,6828.3,90,,percent of total billed charges,,,6828.3,90,,percent of total billed charges,,,6448.95,85,,percent of total billed charges,,674.2,7207.65,
REVISION OF THIGH MUSCLES,27430,CDM,27430,CPT,,,both,,4738,4738,1289.27,,,,fee schedule,,,,,,,,561.85,,,,fee schedule,,,4027.3,85,,percent of total billed charges,,1622.18,,,,fee schedule,,783.66,,,,fee schedule,,561.85,,,,fee schedule,,1281.31,,,,fee schedule,,561.85,,,,fee schedule,,1251.35,,,,fee schedule,,758.4,,,,fee schedule,,758.4,,,,fee schedule,,,4311.58,91,,percent of total billed charges,,,4501.1,95,,percent of total billed charges,,,3932.54,83,,percent of total billed charges,,,1421.4,83,,percent of total billed charges,,561.85,,,,fee schedule,,561.85,,,,fee schedule,,,3932.54,83,,percent of total billed charges,,1114.84,,,,fee schedule,,,4264.2,90,,percent of total billed charges,,,4264.2,90,,percent of total billed charges,,,4264.2,90,,percent of total billed charges,,,4264.2,90,,percent of total billed charges,,,4027.3,85,,percent of total billed charges,,561.85,4501.1,
INCISION OF KNEE JOINT,27435,CDM,27435,CPT,,,both,,3742,3742,1406.79,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,3180.7,85,,percent of total billed charges,,1753.93,,,,fee schedule,,847.3,,,,fee schedule,,524.4,,,,fee schedule,,1301.87,,,,fee schedule,,524.4,,,,fee schedule,,1365.42,,,,fee schedule,,827.53,,,,fee schedule,,827.53,,,,fee schedule,,,3405.22,91,,percent of total billed charges,,,3554.9,95,,percent of total billed charges,,,3105.86,83,,percent of total billed charges,,,1122.6,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,3105.86,83,,percent of total billed charges,,1216.46,,,,fee schedule,,,3367.8,90,,percent of total billed charges,,,3367.8,90,,percent of total billed charges,,,3367.8,90,,percent of total billed charges,,,3367.8,90,,percent of total billed charges,,,3180.7,85,,percent of total billed charges,,524.4,3554.9,
REVISE KNEECAP WITH IMPLANT,27438,CDM,27438,CPT,,,both,,4759,4759,1456.34,,,,fee schedule,,,,,,,,958.6,,,,fee schedule,,,4045.15,85,,percent of total billed charges,,1835.5,,,,fee schedule,,886.71,,,,fee schedule,,958.6,,,,fee schedule,,1437.83,,,,fee schedule,,958.6,,,,fee schedule,,1413.5,,,,fee schedule,,856.67,,,,fee schedule,,856.67,,,,fee schedule,,,4330.69,91,,percent of total billed charges,,,4521.05,95,,percent of total billed charges,,,3949.97,83,,percent of total billed charges,,,1427.7,83,,percent of total billed charges,,958.6,,,,fee schedule,,958.6,,,,fee schedule,,,3949.97,83,,percent of total billed charges,,1259.3,,,,fee schedule,,,4283.1,90,,percent of total billed charges,,,4283.1,90,,percent of total billed charges,,,4283.1,90,,percent of total billed charges,,,4283.1,90,,percent of total billed charges,,,4045.15,85,,percent of total billed charges,,856.67,4521.05,
REVISION OF KNEE JOINT,27441,CDM,27441,CPT,,,both,,5003,5003,1429.26,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,4252.55,85,,percent of total billed charges,,1800.64,,,,fee schedule,,869.87,,,,fee schedule,,599.35,,,,fee schedule,,1283.3,,,,fee schedule,,599.35,,,,fee schedule,,1387.22,,,,fee schedule,,840.74,,,,fee schedule,,840.74,,,,fee schedule,,,4552.73,91,,percent of total billed charges,,,4752.85,95,,percent of total billed charges,,,4152.49,83,,percent of total billed charges,,,1500.9,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,4152.49,83,,percent of total billed charges,,1235.89,,,,fee schedule,,,4502.7,90,,percent of total billed charges,,,4502.7,90,,percent of total billed charges,,,4502.7,90,,percent of total billed charges,,,4502.7,90,,percent of total billed charges,,,4252.55,85,,percent of total billed charges,,599.35,4752.85,
REVISION OF KNEE JOINT,27442,CDM,27442,CPT,,,both,,3312,3312,1509.91,,,,fee schedule,,,,,,,,881,,,,fee schedule,,,2815.2,85,,percent of total billed charges,,1903.95,,,,fee schedule,,919.78,,,,fee schedule,,881,,,,fee schedule,,1515.43,,,,fee schedule,,881,,,,fee schedule,,1465.5,,,,fee schedule,,888.18,,,,fee schedule,,888.18,,,,fee schedule,,,3013.92,91,,percent of total billed charges,,,3146.4,95,,percent of total billed charges,,,2748.96,83,,percent of total billed charges,,,993.6,83,,percent of total billed charges,,881,,,,fee schedule,,881,,,,fee schedule,,,2748.96,83,,percent of total billed charges,,1305.63,,,,fee schedule,,,2980.8,90,,percent of total billed charges,,,2980.8,90,,percent of total billed charges,,,2980.8,90,,percent of total billed charges,,,2980.8,90,,percent of total billed charges,,,2815.2,85,,percent of total billed charges,,881,3146.4,
REVISION OF KNEE JOINT,27443,CDM,27443,CPT,,,both,,4954,4954,1415.43,,,,fee schedule,,,,,,,,881,,,,fee schedule,,,4210.9,85,,percent of total billed charges,,1783.44,,,,fee schedule,,861.56,,,,fee schedule,,881,,,,fee schedule,,1425.89,,,,fee schedule,,881,,,,fee schedule,,1373.8,,,,fee schedule,,832.61,,,,fee schedule,,832.61,,,,fee schedule,,,4508.14,91,,percent of total billed charges,,,4706.3,95,,percent of total billed charges,,,4111.82,83,,percent of total billed charges,,,1486.2,83,,percent of total billed charges,,881,,,,fee schedule,,881,,,,fee schedule,,,4111.82,83,,percent of total billed charges,,1223.93,,,,fee schedule,,,4458.6,90,,percent of total billed charges,,,4458.6,90,,percent of total billed charges,,,4458.6,90,,percent of total billed charges,,,4458.6,90,,percent of total billed charges,,,4210.9,85,,percent of total billed charges,,832.61,4706.3,
REVISION OF KNEE JOINT,27445,CDM,27445,CPT,,,both,,7908,7908,2162.04,,,,fee schedule,,,,,,,,1473.35,,,,fee schedule,,,6721.8,85,,percent of total billed charges,,2743.62,,,,fee schedule,,1325.41,,,,fee schedule,,1473.35,,,,fee schedule,,2191.9,,,,fee schedule,,1473.35,,,,fee schedule,,2098.45,,,,fee schedule,,1271.79,,,,fee schedule,,1271.79,,,,fee schedule,,,7196.28,91,,percent of total billed charges,,,7512.6,95,,percent of total billed charges,,,6563.64,83,,percent of total billed charges,,,2372.4,83,,percent of total billed charges,,1473.35,,,,fee schedule,,1473.35,,,,fee schedule,,,6563.64,83,,percent of total billed charges,,1869.53,,,,fee schedule,,,7117.2,90,,percent of total billed charges,,,7117.2,90,,percent of total billed charges,,,7117.2,90,,percent of total billed charges,,,7117.2,90,,percent of total billed charges,,,6721.8,85,,percent of total billed charges,,1271.79,7512.6,
Unicompartmental Knee,27446,CDM,27446,CPT,,,both,,6816,6816,1977.69,,,,fee schedule,,,,,,,,1473.35,,,,fee schedule,,,5793.6,85,,percent of total billed charges,,2525.57,,,,fee schedule,,1220.08,,,,fee schedule,,1473.35,,,,fee schedule,,1979.67,,,,fee schedule,,1473.35,,,,fee schedule,,1919.52,,,,fee schedule,,1163.35,,,,fee schedule,,1163.35,,,,fee schedule,,,6202.56,91,,percent of total billed charges,,,6475.2,95,,percent of total billed charges,,,5657.28,83,,percent of total billed charges,,,2044.8,83,,percent of total billed charges,,1473.35,,,,fee schedule,,1473.35,,,,fee schedule,,,5657.28,83,,percent of total billed charges,,1710.12,,,,fee schedule,,,6134.4,90,,percent of total billed charges,,,6134.4,90,,percent of total billed charges,,,6134.4,90,,percent of total billed charges,,,6134.4,90,,percent of total billed charges,,,5793.6,85,,percent of total billed charges,,1163.35,6475.2,
TOTAL KNEE ARTHROPLASTY,27447,CDM,27447,CPT,,,both,,8890,8890,2209.28,,,,fee schedule,,,,,,,,1473.35,,,,fee schedule,,,7556.5,85,,percent of total billed charges,,2808.19,,,,fee schedule,,1356.61,,,,fee schedule,,1473.35,,,,fee schedule,,2638.9,,,,fee schedule,,1473.35,,,,fee schedule,,2144.3,,,,fee schedule,,1299.57,,,,fee schedule,,1299.57,,,,fee schedule,,,8089.9,91,,percent of total billed charges,,,8445.5,95,,percent of total billed charges,,,7378.7,83,,percent of total billed charges,,,2667,83,,percent of total billed charges,,1473.35,,,,fee schedule,,1473.35,,,,fee schedule,,,7378.7,83,,percent of total billed charges,,1910.37,,,,fee schedule,,,8001,90,,percent of total billed charges,,,8001,90,,percent of total billed charges,,,8001,90,,percent of total billed charges,,,8001,90,,percent of total billed charges,,,7556.5,85,,percent of total billed charges,,1299.57,8445.5,
TOTAL KNEE ARTHROPLASTY,27447AS,CDM,27447,CPT,,,both,AS,689,689,2209.28,,,,fee schedule,,,,,,,,1473.35,,,,fee schedule,,,585.65,85,,percent of total billed charges,,2808.19,,,,fee schedule,,1356.61,,,,fee schedule,,1473.35,,,,fee schedule,,2638.9,,,,fee schedule,,1473.35,,,,fee schedule,,2144.3,,,,fee schedule,,1299.57,,,,fee schedule,,1299.57,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,1473.35,,,,fee schedule,,1473.35,,,,fee schedule,,,571.87,83,,percent of total billed charges,,1910.37,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,2808.19,
TOTAL KNEE ARTHROPLASTY,27447AS80,CDM,27447,CPT,,,both,,689,689,2209.28,,,,fee schedule,,,,,,,,1473.35,,,,fee schedule,,,585.65,85,,percent of total billed charges,,2808.19,,,,fee schedule,,1356.61,,,,fee schedule,,1473.35,,,,fee schedule,,2638.9,,,,fee schedule,,1473.35,,,,fee schedule,,2144.3,,,,fee schedule,,1299.57,,,,fee schedule,,1299.57,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,1473.35,,,,fee schedule,,1473.35,,,,fee schedule,,,571.87,83,,percent of total billed charges,,1910.37,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,2808.19,
INCISION OF THIGH,27450,CDM,27450,CPT,,,both,,6457,6457,1755.9,,,,fee schedule,,,,,,,,689.5,,,,fee schedule,,,5488.45,85,,percent of total billed charges,,2212.47,,,,fee schedule,,1068.82,,,,fee schedule,,689.5,,,,fee schedule,,1785.35,,,,fee schedule,,689.5,,,,fee schedule,,1704.26,,,,fee schedule,,1032.88,,,,fee schedule,,1032.88,,,,fee schedule,,,5875.87,91,,percent of total billed charges,,,6134.15,95,,percent of total billed charges,,,5359.31,83,,percent of total billed charges,,,1937.1,83,,percent of total billed charges,,689.5,,,,fee schedule,,689.5,,,,fee schedule,,,5359.31,83,,percent of total billed charges,,1518.34,,,,fee schedule,,,5811.3,90,,percent of total billed charges,,,5811.3,90,,percent of total billed charges,,,5811.3,90,,percent of total billed charges,,,5811.3,90,,percent of total billed charges,,,5488.45,85,,percent of total billed charges,,689.5,6134.15,
REALIGNMENT OF KNEE,27455,CDM,27455,CPT,,,both,,5721,5721,1664.88,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,4862.85,85,,percent of total billed charges,,2102.36,,,,fee schedule,,1015.63,,,,fee schedule,,524.4,,,,fee schedule,,1651.38,,,,fee schedule,,524.4,,,,fee schedule,,1615.91,,,,fee schedule,,979.34,,,,fee schedule,,979.34,,,,fee schedule,,,5206.11,91,,percent of total billed charges,,,5434.95,95,,percent of total billed charges,,,4748.43,83,,percent of total billed charges,,,1716.3,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,4748.43,83,,percent of total billed charges,,1439.63,,,,fee schedule,,,5148.9,90,,percent of total billed charges,,,5148.9,90,,percent of total billed charges,,,5148.9,90,,percent of total billed charges,,,5148.9,90,,percent of total billed charges,,,4862.85,85,,percent of total billed charges,,524.4,5434.95,
REALIGNMENT OF KNEE,27457,CDM,27457,CPT,,,both,,5488,5488,1660.85,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,4664.8,85,,percent of total billed charges,,2104.14,,,,fee schedule,,1016.49,,,,fee schedule,,524.4,,,,fee schedule,,1702.45,,,,fee schedule,,524.4,,,,fee schedule,,1612,,,,fee schedule,,976.97,,,,fee schedule,,976.97,,,,fee schedule,,,4994.08,91,,percent of total billed charges,,,5213.6,95,,percent of total billed charges,,,4555.04,83,,percent of total billed charges,,,1646.4,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,4555.04,83,,percent of total billed charges,,1436.14,,,,fee schedule,,,4939.2,90,,percent of total billed charges,,,4939.2,90,,percent of total billed charges,,,4939.2,90,,percent of total billed charges,,,4939.2,90,,percent of total billed charges,,,4664.8,85,,percent of total billed charges,,524.4,5213.6,
SHORTENING OF THIGH BONE,27465,CDM,27465,CPT,,,both,,7737,7737,2152.24,,,,fee schedule,,,,,,,,749.2,,,,fee schedule,,,6576.45,85,,percent of total billed charges,,2730.64,,,,fee schedule,,1319.14,,,,fee schedule,,749.2,,,,fee schedule,,1758.82,,,,fee schedule,,749.2,,,,fee schedule,,2088.94,,,,fee schedule,,1266.03,,,,fee schedule,,1266.03,,,,fee schedule,,,7040.67,91,,percent of total billed charges,,,7350.15,95,,percent of total billed charges,,,6421.71,83,,percent of total billed charges,,,2321.1,83,,percent of total billed charges,,749.2,,,,fee schedule,,749.2,,,,fee schedule,,,6421.71,83,,percent of total billed charges,,1861.06,,,,fee schedule,,,6963.3,90,,percent of total billed charges,,,6963.3,90,,percent of total billed charges,,,6963.3,90,,percent of total billed charges,,,6963.3,90,,percent of total billed charges,,,6576.45,85,,percent of total billed charges,,749.2,7350.15,
REPAIR OF THIGH,27470,CDM,27470,CPT,,,both,,6855,6855,2038.18,,,,fee schedule,,,,,,,,839.35,,,,fee schedule,,,5826.75,85,,percent of total billed charges,,2577.04,,,,fee schedule,,1244.94,,,,fee schedule,,839.35,,,,fee schedule,,2028.08,,,,fee schedule,,839.35,,,,fee schedule,,1978.23,,,,fee schedule,,1198.93,,,,fee schedule,,1198.93,,,,fee schedule,,,6238.05,91,,percent of total billed charges,,,6512.25,95,,percent of total billed charges,,,5689.65,83,,percent of total billed charges,,,2056.5,83,,percent of total billed charges,,839.35,,,,fee schedule,,839.35,,,,fee schedule,,,5689.65,83,,percent of total billed charges,,1762.43,,,,fee schedule,,,6169.5,90,,percent of total billed charges,,,6169.5,90,,percent of total billed charges,,,6169.5,90,,percent of total billed charges,,,6169.5,90,,percent of total billed charges,,,5826.75,85,,percent of total billed charges,,839.35,6512.25,
REPAIR/GRAFT OF THIGH,27472,CDM,27472,CPT,,,both,,7553,7553,2181.62,,,,fee schedule,,,,,,,,958.6,,,,fee schedule,,,6420.05,85,,percent of total billed charges,,2763.58,,,,fee schedule,,1335.05,,,,fee schedule,,958.6,,,,fee schedule,,2214.45,,,,fee schedule,,958.6,,,,fee schedule,,2117.46,,,,fee schedule,,1283.31,,,,fee schedule,,1283.31,,,,fee schedule,,,6873.23,91,,percent of total billed charges,,,7175.35,95,,percent of total billed charges,,,6268.99,83,,percent of total billed charges,,,2265.9,83,,percent of total billed charges,,958.6,,,,fee schedule,,958.6,,,,fee schedule,,,6268.99,83,,percent of total billed charges,,1886.46,,,,fee schedule,,,6797.7,90,,percent of total billed charges,,,6797.7,90,,percent of total billed charges,,,6797.7,90,,percent of total billed charges,,,6797.7,90,,percent of total billed charges,,,6420.05,85,,percent of total billed charges,,958.6,7175.35,
REVISE/REPLACE KNEE JOINT,27486,CDM,27486,CPT,,,both,,8092,8092,2417.24,,,,fee schedule,,,,,,,,736.6,,,,fee schedule,,,6878.2,85,,percent of total billed charges,,3069.58,,,,fee schedule,,1482.88,,,,fee schedule,,736.6,,,,fee schedule,,2390.86,,,,fee schedule,,736.6,,,,fee schedule,,2346.15,,,,fee schedule,,1421.91,,,,fee schedule,,1421.91,,,,fee schedule,,,7363.72,91,,percent of total billed charges,,,7687.4,95,,percent of total billed charges,,,6716.36,83,,percent of total billed charges,,,2427.6,83,,percent of total billed charges,,736.6,,,,fee schedule,,736.6,,,,fee schedule,,,6716.36,83,,percent of total billed charges,,2090.2,,,,fee schedule,,,7282.8,90,,percent of total billed charges,,,7282.8,90,,percent of total billed charges,,,7282.8,90,,percent of total billed charges,,,7282.8,90,,percent of total billed charges,,,6878.2,85,,percent of total billed charges,,736.6,7687.4,
REVISE/REPLACE KNEE JOINT,27486AS,CDM,27486,CPT,,,both,AS,689,689,2417.24,,,,fee schedule,,,,,,,,736.6,,,,fee schedule,,,585.65,85,,percent of total billed charges,,3069.58,,,,fee schedule,,1482.88,,,,fee schedule,,736.6,,,,fee schedule,,2390.86,,,,fee schedule,,736.6,,,,fee schedule,,2346.15,,,,fee schedule,,1421.91,,,,fee schedule,,1421.91,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,736.6,,,,fee schedule,,736.6,,,,fee schedule,,,571.87,83,,percent of total billed charges,,2090.2,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,3069.58,
REVISE/REPLACE KNEE JOINT,27487,CDM,27487,CPT,,,both,,10738,10738,3012.33,,,,fee schedule,,,,,,,,1473.3,,,,fee schedule,,,9127.3,85,,percent of total billed charges,,3838.06,,,,fee schedule,,1854.12,,,,fee schedule,,1473.3,,,,fee schedule,,3058.04,,,,fee schedule,,1473.3,,,,fee schedule,,2923.74,,,,fee schedule,,1771.96,,,,fee schedule,,1771.96,,,,fee schedule,,,9771.58,91,,percent of total billed charges,,,10201.1,95,,percent of total billed charges,,,8912.54,83,,percent of total billed charges,,,3221.4,83,,percent of total billed charges,,1473.3,,,,fee schedule,,1473.3,,,,fee schedule,,,8912.54,83,,percent of total billed charges,,2604.78,,,,fee schedule,,,9664.2,90,,percent of total billed charges,,,9664.2,90,,percent of total billed charges,,,9664.2,90,,percent of total billed charges,,,9664.2,90,,percent of total billed charges,,,9127.3,85,,percent of total billed charges,,1473.3,10201.1,
REMOVAL OF KNEE PROSTHESIS,27488,CDM,27488,CPT,,,both,,6701,6701,2070.44,,,,fee schedule,,,,,,,,524.65,,,,fee schedule,,,5695.85,85,,percent of total billed charges,,2621.57,,,,fee schedule,,1266.45,,,,fee schedule,,524.65,,,,fee schedule,,1997.58,,,,fee schedule,,524.65,,,,fee schedule,,2009.54,,,,fee schedule,,1217.91,,,,fee schedule,,1217.91,,,,fee schedule,,,6097.91,91,,percent of total billed charges,,,6365.95,95,,percent of total billed charges,,,5561.83,83,,percent of total billed charges,,,2010.3,83,,percent of total billed charges,,524.65,,,,fee schedule,,524.65,,,,fee schedule,,,5561.83,83,,percent of total billed charges,,1790.32,,,,fee schedule,,,6030.9,90,,percent of total billed charges,,,6030.9,90,,percent of total billed charges,,,6030.9,90,,percent of total billed charges,,,6030.9,90,,percent of total billed charges,,,5695.85,85,,percent of total billed charges,,524.65,6365.95,
REINFORCE THIGH,27495,CDM,27495,CPT,,,both,,6947,6947,1951.19,,,,fee schedule,,,,,,,,688.44,,,,fee schedule,,,5904.95,85,,percent of total billed charges,,2471.26,,,,fee schedule,,1193.84,,,,fee schedule,,688.44,,,,fee schedule,,1963.09,,,,fee schedule,,688.44,,,,fee schedule,,1893.8,,,,fee schedule,,1147.76,,,,fee schedule,,1147.76,,,,fee schedule,,,6321.77,91,,percent of total billed charges,,,6599.65,95,,percent of total billed charges,,,5766.01,83,,percent of total billed charges,,,2084.1,83,,percent of total billed charges,,688.44,,,,fee schedule,,688.44,,,,fee schedule,,,5766.01,83,,percent of total billed charges,,1687.21,,,,fee schedule,,,6252.3,90,,percent of total billed charges,,,6252.3,90,,percent of total billed charges,,,6252.3,90,,percent of total billed charges,,,6252.3,90,,percent of total billed charges,,,5904.95,85,,percent of total billed charges,,688.44,6599.65,
TREATMENT OF THIGH FRACTURE,27500,CDM,27500,CPT,,,both,,2559,2559,842.23,,,,fee schedule,,,,,,,,257.4,,,,fee schedule,,,2175.15,85,,percent of total billed charges,,1048.84,,,,fee schedule,,506.68,,,,fee schedule,,257.4,,,,fee schedule,,786.56,,,,fee schedule,,257.4,,,,fee schedule,,817.46,,,,fee schedule,,495.43,,,,fee schedule,,495.43,,,,fee schedule,,,2328.69,91,,percent of total billed charges,,,2431.05,95,,percent of total billed charges,,,2123.97,83,,percent of total billed charges,,,767.7,83,,percent of total billed charges,,257.4,,,,fee schedule,,257.4,,,,fee schedule,,,2123.97,83,,percent of total billed charges,,728.28,,,,fee schedule,,,2303.1,90,,percent of total billed charges,,,2303.1,90,,percent of total billed charges,,,2303.1,90,,percent of total billed charges,,,2303.1,90,,percent of total billed charges,,,2175.15,85,,percent of total billed charges,,257.4,2431.05,
TREATMENT OF THIGH FRACTURE,27501,CDM,27501,CPT,,,both,,2433,2433,869.88,,,,fee schedule,,,,,,,,263.2,,,,fee schedule,,,2068.05,85,,percent of total billed charges,,1087.09,,,,fee schedule,,525.16,,,,fee schedule,,263.2,,,,fee schedule,,815.74,,,,fee schedule,,263.2,,,,fee schedule,,844.3,,,,fee schedule,,511.7,,,,fee schedule,,511.7,,,,fee schedule,,,2214.03,91,,percent of total billed charges,,,2311.35,95,,percent of total billed charges,,,2019.39,83,,percent of total billed charges,,,729.9,83,,percent of total billed charges,,263.2,,,,fee schedule,,263.2,,,,fee schedule,,,2019.39,83,,percent of total billed charges,,752.19,,,,fee schedule,,,2189.7,90,,percent of total billed charges,,,2189.7,90,,percent of total billed charges,,,2189.7,90,,percent of total billed charges,,,2189.7,90,,percent of total billed charges,,,2068.05,85,,percent of total billed charges,,263.2,2311.35,
TREATMENT OF THIGH FRACTURE,27502,CDM,27502,CPT,,,both,,3968,3968,1310.59,,,,fee schedule,,,,,,,,338.5,,,,fee schedule,,,3372.8,85,,percent of total billed charges,,1668,,,,fee schedule,,805.79,,,,fee schedule,,338.5,,,,fee schedule,,1352.28,,,,fee schedule,,338.5,,,,fee schedule,,1272.04,,,,fee schedule,,770.93,,,,fee schedule,,770.93,,,,fee schedule,,,3610.88,91,,percent of total billed charges,,,3769.6,95,,percent of total billed charges,,,3293.44,83,,percent of total billed charges,,,1190.4,83,,percent of total billed charges,,338.5,,,,fee schedule,,338.5,,,,fee schedule,,,3293.44,83,,percent of total billed charges,,1133.27,,,,fee schedule,,,3571.2,90,,percent of total billed charges,,,3571.2,90,,percent of total billed charges,,,3571.2,90,,percent of total billed charges,,,3571.2,90,,percent of total billed charges,,,3372.8,85,,percent of total billed charges,,338.5,3769.6,
TREATMENT OF THIGH FRACTURE,27506,CDM,27506,CPT,,,both,,6680,6680,2307.21,,,,fee schedule,,,,,,,,910.1,,,,fee schedule,,,5678,85,,percent of total billed charges,,2920.7,,,,fee schedule,,1410.96,,,,fee schedule,,910.1,,,,fee schedule,,2198.53,,,,fee schedule,,910.1,,,,fee schedule,,2239.35,,,,fee schedule,,1357.18,,,,fee schedule,,1357.18,,,,fee schedule,,,6078.8,91,,percent of total billed charges,,,6346,95,,percent of total billed charges,,,5544.4,83,,percent of total billed charges,,,2004,83,,percent of total billed charges,,910.1,,,,fee schedule,,910.1,,,,fee schedule,,,5544.4,83,,percent of total billed charges,,1995.06,,,,fee schedule,,,6012,90,,percent of total billed charges,,,6012,90,,percent of total billed charges,,,6012,90,,percent of total billed charges,,,6012,90,,percent of total billed charges,,,5678,85,,percent of total billed charges,,910.1,6346,
TREATMENT OF THIGH FRACTURE,27507,CDM,27507,CPT,,,both,,5142,5142,1670.06,,,,fee schedule,,,,,,,,910.1,,,,fee schedule,,,4370.7,85,,percent of total billed charges,,2120.16,,,,fee schedule,,1024.22,,,,fee schedule,,910.1,,,,fee schedule,,1735.61,,,,fee schedule,,910.1,,,,fee schedule,,1620.94,,,,fee schedule,,982.39,,,,fee schedule,,982.39,,,,fee schedule,,,4679.22,91,,percent of total billed charges,,,4884.9,95,,percent of total billed charges,,,4267.86,83,,percent of total billed charges,,,1542.6,83,,percent of total billed charges,,910.1,,,,fee schedule,,910.1,,,,fee schedule,,,4267.86,83,,percent of total billed charges,,1444.11,,,,fee schedule,,,4627.8,90,,percent of total billed charges,,,4627.8,90,,percent of total billed charges,,,4627.8,90,,percent of total billed charges,,,4627.8,90,,percent of total billed charges,,,4370.7,85,,percent of total billed charges,,910.1,4884.9,
TREATMENT OF THIGH FRACTURE,27509,CDM,27509,CPT,,,both,,3293,3293,1179.24,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,2799.05,85,,percent of total billed charges,,1474.29,,,,fee schedule,,712.21,,,,fee schedule,,524.4,,,,fee schedule,,1126.79,,,,fee schedule,,524.4,,,,fee schedule,,1144.56,,,,fee schedule,,693.67,,,,fee schedule,,693.67,,,,fee schedule,,,2996.63,91,,percent of total billed charges,,,3128.35,95,,percent of total billed charges,,,2733.19,83,,percent of total billed charges,,,987.9,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,2733.19,83,,percent of total billed charges,,1019.7,,,,fee schedule,,,2963.7,90,,percent of total billed charges,,,2963.7,90,,percent of total billed charges,,,2963.7,90,,percent of total billed charges,,,2963.7,90,,percent of total billed charges,,,2799.05,85,,percent of total billed charges,,524.4,3128.35,
TREATMENT OF THIGH FRACTURE,27511,CDM,27511,CPT,,,both,,5348,5348,1717.88,,,,fee schedule,,,,,,,,836.55,,,,fee schedule,,,4545.8,85,,percent of total billed charges,,2182.23,,,,fee schedule,,1054.21,,,,fee schedule,,836.55,,,,fee schedule,,1800.6,,,,fee schedule,,836.55,,,,fee schedule,,1667.35,,,,fee schedule,,1010.52,,,,fee schedule,,1010.52,,,,fee schedule,,,4866.68,91,,percent of total billed charges,,,5080.6,95,,percent of total billed charges,,,4438.84,83,,percent of total billed charges,,,1604.4,83,,percent of total billed charges,,836.55,,,,fee schedule,,836.55,,,,fee schedule,,,4438.84,83,,percent of total billed charges,,1485.46,,,,fee schedule,,,4813.2,90,,percent of total billed charges,,,4813.2,90,,percent of total billed charges,,,4813.2,90,,percent of total billed charges,,,4813.2,90,,percent of total billed charges,,,4545.8,85,,percent of total billed charges,,836.55,5080.6,
TREATMENT OF THIGH FRACTURE,27514,CDM,27514,CPT,,,both,,7078,7078,1665.45,,,,fee schedule,,,,,,,,836.55,,,,fee schedule,,,6016.3,85,,percent of total billed charges,,2118.21,,,,fee schedule,,1023.29,,,,fee schedule,,836.55,,,,fee schedule,,2226.38,,,,fee schedule,,836.55,,,,fee schedule,,1616.47,,,,fee schedule,,979.68,,,,fee schedule,,979.68,,,,fee schedule,,,6440.98,91,,percent of total billed charges,,,6724.1,95,,percent of total billed charges,,,5874.74,83,,percent of total billed charges,,,2123.4,83,,percent of total billed charges,,836.55,,,,fee schedule,,836.55,,,,fee schedule,,,5874.74,83,,percent of total billed charges,,1440.13,,,,fee schedule,,,6370.2,90,,percent of total billed charges,,,6370.2,90,,percent of total billed charges,,,6370.2,90,,percent of total billed charges,,,6370.2,90,,percent of total billed charges,,,6016.3,85,,percent of total billed charges,,836.55,6724.1,
TREAT THIGH FX GROWTH PLATE,27516,CDM,27516,CPT,,,both,,2672,2672,852.03,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,2271.2,85,,percent of total billed charges,,1053.55,,,,fee schedule,,508.96,,,,fee schedule,,599.35,,,,fee schedule,,772.64,,,,fee schedule,,599.35,,,,fee schedule,,826.97,,,,fee schedule,,501.19,,,,fee schedule,,501.19,,,,fee schedule,,,2431.52,91,,percent of total billed charges,,,2538.4,95,,percent of total billed charges,,,2217.76,83,,percent of total billed charges,,,801.6,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,2217.76,83,,percent of total billed charges,,736.75,,,,fee schedule,,,2404.8,90,,percent of total billed charges,,,2404.8,90,,percent of total billed charges,,,2404.8,90,,percent of total billed charges,,,2404.8,90,,percent of total billed charges,,,2271.2,85,,percent of total billed charges,,501.19,2538.4,
TREAT THIGH FX GROWTH PLATE,27517,CDM,27517,CPT,,,both,,3578,3578,1202.28,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3041.3,85,,percent of total billed charges,,1502.79,,,,fee schedule,,725.98,,,,fee schedule,,599.35,,,,fee schedule,,1155.97,,,,fee schedule,,599.35,,,,fee schedule,,1166.92,,,,fee schedule,,707.23,,,,fee schedule,,707.23,,,,fee schedule,,,3255.98,91,,percent of total billed charges,,,3399.1,95,,percent of total billed charges,,,2969.74,83,,percent of total billed charges,,,1073.4,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,2969.74,83,,percent of total billed charges,,1039.62,,,,fee schedule,,,3220.2,90,,percent of total billed charges,,,3220.2,90,,percent of total billed charges,,,3220.2,90,,percent of total billed charges,,,3220.2,90,,percent of total billed charges,,,3041.3,85,,percent of total billed charges,,599.35,3399.1,
TREAT KNEECAP FRACTURE,27520,CDM,27520,CPT,,,both,,1390,1390,534.03,,,,fee schedule,,,,,,,,191.5,,,,fee schedule,,,1181.5,85,,percent of total billed charges,,651.92,,,,fee schedule,,314.93,,,,fee schedule,,191.5,,,,fee schedule,,447.66,,,,fee schedule,,191.5,,,,fee schedule,,518.32,,,,fee schedule,,314.13,,,,fee schedule,,314.13,,,,fee schedule,,,1264.9,91,,percent of total billed charges,,,1320.5,95,,percent of total billed charges,,,1153.7,83,,percent of total billed charges,,,417,83,,percent of total billed charges,,191.5,,,,fee schedule,,191.5,,,,fee schedule,,,1153.7,83,,percent of total billed charges,,461.78,,,,fee schedule,,,1251,90,,percent of total billed charges,,,1251,90,,percent of total billed charges,,,1251,90,,percent of total billed charges,,,1251,90,,percent of total billed charges,,,1181.5,85,,percent of total billed charges,,191.5,1320.5,
TREAT KNEECAP FRACTURE,27520P,CDM,27520,CPT,,,both,P,1199,1199,534.03,,,,fee schedule,,,,,,,,191.5,,,,fee schedule,,,1019.15,85,,percent of total billed charges,,651.92,,,,fee schedule,,314.93,,,,fee schedule,,191.5,,,,fee schedule,,447.66,,,,fee schedule,,191.5,,,,fee schedule,,518.32,,,,fee schedule,,314.13,,,,fee schedule,,314.13,,,,fee schedule,,,1091.09,91,,percent of total billed charges,,,1139.05,95,,percent of total billed charges,,,995.17,83,,percent of total billed charges,,,359.7,83,,percent of total billed charges,,191.5,,,,fee schedule,,191.5,,,,fee schedule,,,995.17,83,,percent of total billed charges,,461.78,,,,fee schedule,,,1079.1,90,,percent of total billed charges,,,1079.1,90,,percent of total billed charges,,,1079.1,90,,percent of total billed charges,,,1079.1,90,,percent of total billed charges,,,1019.15,85,,percent of total billed charges,,191.5,1139.05,
TREAT KNEECAP FRACTURE,27520T,CDM,27520,CPT,,,both,T,191,191,534.03,,,,fee schedule,,,,,,,,191.5,,,,fee schedule,,,162.35,85,,percent of total billed charges,,651.92,,,,fee schedule,,314.93,,,,fee schedule,,191.5,,,,fee schedule,,447.66,,,,fee schedule,,191.5,,,,fee schedule,,518.32,,,,fee schedule,,314.13,,,,fee schedule,,314.13,,,,fee schedule,,,173.81,91,,percent of total billed charges,,,181.45,95,,percent of total billed charges,,,158.53,83,,percent of total billed charges,,,57.3,83,,percent of total billed charges,,191.5,,,,fee schedule,,191.5,,,,fee schedule,,,158.53,83,,percent of total billed charges,,461.78,,,,fee schedule,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,162.35,85,,percent of total billed charges,,57.3,651.92,
TREAT KNEECAP FRACTURE,27524,CDM,27524,CPT,,,both,,3795,3795,1307.71,,,,fee schedule,,,,,,,,629.9,,,,fee schedule,,,3225.75,85,,percent of total billed charges,,1645.38,,,,fee schedule,,794.86,,,,fee schedule,,629.9,,,,fee schedule,,1321.77,,,,fee schedule,,629.9,,,,fee schedule,,1269.25,,,,fee schedule,,769.24,,,,fee schedule,,769.24,,,,fee schedule,,,3453.45,91,,percent of total billed charges,,,3605.25,95,,percent of total billed charges,,,3149.85,83,,percent of total billed charges,,,1138.5,83,,percent of total billed charges,,629.9,,,,fee schedule,,629.9,,,,fee schedule,,,3149.85,83,,percent of total billed charges,,1130.78,,,,fee schedule,,,3415.5,90,,percent of total billed charges,,,3415.5,90,,percent of total billed charges,,,3415.5,90,,percent of total billed charges,,,3415.5,90,,percent of total billed charges,,,3225.75,85,,percent of total billed charges,,629.9,3605.25,
TREAT KNEE FRACTURE,27530,CDM,27530,CPT,,,both,,1635,1635,512.71,,,,fee schedule,,,,,,,,288.5,,,,fee schedule,,,1389.75,85,,percent of total billed charges,,584.13,,,,fee schedule,,301.87,,,,fee schedule,,288.5,,,,fee schedule,,584.28,,,,fee schedule,,288.5,,,,fee schedule,,497.63,,,,fee schedule,,301.6,,,,fee schedule,,301.6,,,,fee schedule,,,1487.85,91,,percent of total billed charges,,,1553.25,95,,percent of total billed charges,,,1357.05,83,,percent of total billed charges,,,490.5,83,,percent of total billed charges,,288.5,,,,fee schedule,,288.5,,,,fee schedule,,,1357.05,83,,percent of total billed charges,,443.35,,,,fee schedule,,,1471.5,90,,percent of total billed charges,,,1471.5,90,,percent of total billed charges,,,1471.5,90,,percent of total billed charges,,,1471.5,90,,percent of total billed charges,,,1389.75,85,,percent of total billed charges,,288.5,1553.25,
TREAT KNEE FRACTURE,27530P,CDM,27530,CPT,,,both,P,1245,1245,512.71,,,,fee schedule,,,,,,,,288.5,,,,fee schedule,,,1058.25,85,,percent of total billed charges,,584.13,,,,fee schedule,,301.87,,,,fee schedule,,288.5,,,,fee schedule,,584.28,,,,fee schedule,,288.5,,,,fee schedule,,497.63,,,,fee schedule,,301.6,,,,fee schedule,,301.6,,,,fee schedule,,,1132.95,91,,percent of total billed charges,,,1182.75,95,,percent of total billed charges,,,1033.35,83,,percent of total billed charges,,,373.5,83,,percent of total billed charges,,288.5,,,,fee schedule,,288.5,,,,fee schedule,,,1033.35,83,,percent of total billed charges,,443.35,,,,fee schedule,,,1120.5,90,,percent of total billed charges,,,1120.5,90,,percent of total billed charges,,,1120.5,90,,percent of total billed charges,,,1120.5,90,,percent of total billed charges,,,1058.25,85,,percent of total billed charges,,288.5,1182.75,
TREAT KNEE FRACTURE,27530T,CDM,27530,CPT,,,both,T,390,390,512.71,,,,fee schedule,,,,,,,,288.5,,,,fee schedule,,,331.5,85,,percent of total billed charges,,584.13,,,,fee schedule,,301.87,,,,fee schedule,,288.5,,,,fee schedule,,584.28,,,,fee schedule,,288.5,,,,fee schedule,,497.63,,,,fee schedule,,301.6,,,,fee schedule,,301.6,,,,fee schedule,,,354.9,91,,percent of total billed charges,,,370.5,95,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,,117,83,,percent of total billed charges,,288.5,,,,fee schedule,,288.5,,,,fee schedule,,,323.7,83,,percent of total billed charges,,443.35,,,,fee schedule,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,351,90,,percent of total billed charges,,,331.5,85,,percent of total billed charges,,117,584.28,
TREAT KNEE FRACTURE,27532,CDM,27532,CPT,,,both,,2753,2753,1011.02,,,,fee schedule,,,,,,,,321.9,,,,fee schedule,,,2340.05,85,,percent of total billed charges,,1265.02,,,,fee schedule,,611.12,,,,fee schedule,,321.9,,,,fee schedule,,993.48,,,,fee schedule,,321.9,,,,fee schedule,,981.29,,,,fee schedule,,594.72,,,,fee schedule,,594.72,,,,fee schedule,,,2505.23,91,,percent of total billed charges,,,2615.35,95,,percent of total billed charges,,,2284.99,83,,percent of total billed charges,,,825.9,83,,percent of total billed charges,,321.9,,,,fee schedule,,321.9,,,,fee schedule,,,2284.99,83,,percent of total billed charges,,874.24,,,,fee schedule,,,2477.7,90,,percent of total billed charges,,,2477.7,90,,percent of total billed charges,,,2477.7,90,,percent of total billed charges,,,2477.7,90,,percent of total billed charges,,,2340.05,85,,percent of total billed charges,,321.9,2615.35,
TREAT KNEE FRACTURE,27535,CDM,27535,CPT,,,both,,4500,4500,1547.93,,,,fee schedule,,,,,,,,839.35,,,,fee schedule,,,3825,85,,percent of total billed charges,,1965.08,,,,fee schedule,,949.31,,,,fee schedule,,839.35,,,,fee schedule,,1562.51,,,,fee schedule,,839.35,,,,fee schedule,,1502.41,,,,fee schedule,,910.55,,,,fee schedule,,910.55,,,,fee schedule,,,4095,91,,percent of total billed charges,,,4275,95,,percent of total billed charges,,,3735,83,,percent of total billed charges,,,1350,83,,percent of total billed charges,,839.35,,,,fee schedule,,839.35,,,,fee schedule,,,3735,83,,percent of total billed charges,,1338.51,,,,fee schedule,,,4050,90,,percent of total billed charges,,,4050,90,,percent of total billed charges,,,4050,90,,percent of total billed charges,,,4050,90,,percent of total billed charges,,,3825,85,,percent of total billed charges,,839.35,4275,
TREAT KNEE FRACTURE,27536,CDM,27536,CPT,,,both,,5699,5699,2047.97,,,,fee schedule,,,,,,,,839.35,,,,fee schedule,,,4844.15,85,,percent of total billed charges,,2593.18,,,,fee schedule,,1252.73,,,,fee schedule,,839.35,,,,fee schedule,,1984.31,,,,fee schedule,,839.35,,,,fee schedule,,1987.74,,,,fee schedule,,1204.69,,,,fee schedule,,1204.69,,,,fee schedule,,,5186.09,91,,percent of total billed charges,,,5414.05,95,,percent of total billed charges,,,4730.17,83,,percent of total billed charges,,,1709.7,83,,percent of total billed charges,,839.35,,,,fee schedule,,839.35,,,,fee schedule,,,4730.17,83,,percent of total billed charges,,1770.89,,,,fee schedule,,,5129.1,90,,percent of total billed charges,,,5129.1,90,,percent of total billed charges,,,5129.1,90,,percent of total billed charges,,,5129.1,90,,percent of total billed charges,,,4844.15,85,,percent of total billed charges,,839.35,5414.05,
TREAT KNEE FRACTURE(S),27538,CDM,27538,CPT,,,both,,2391,2391,792.11,,,,fee schedule,,,,,,,,213.65,,,,fee schedule,,,2032.35,85,,percent of total billed charges,,983.53,,,,fee schedule,,475.13,,,,fee schedule,,213.65,,,,fee schedule,,720.24,,,,fee schedule,,213.65,,,,fee schedule,,768.82,,,,fee schedule,,465.95,,,,fee schedule,,465.95,,,,fee schedule,,,2175.81,91,,percent of total billed charges,,,2271.45,95,,percent of total billed charges,,,1984.53,83,,percent of total billed charges,,,717.3,83,,percent of total billed charges,,213.65,,,,fee schedule,,213.65,,,,fee schedule,,,1984.53,83,,percent of total billed charges,,684.95,,,,fee schedule,,,2151.9,90,,percent of total billed charges,,,2151.9,90,,percent of total billed charges,,,2151.9,90,,percent of total billed charges,,,2151.9,90,,percent of total billed charges,,,2032.35,85,,percent of total billed charges,,213.65,2271.45,
TREAT KNEE FRACTURE,27540,CDM,27540,CPT,,,both,,4451,4451,1413.71,,,,fee schedule,,,,,,,,958.6,,,,fee schedule,,,3783.35,85,,percent of total billed charges,,1777.32,,,,fee schedule,,858.6,,,,fee schedule,,958.6,,,,fee schedule,,1645.41,,,,fee schedule,,958.6,,,,fee schedule,,1372.13,,,,fee schedule,,831.59,,,,fee schedule,,831.59,,,,fee schedule,,,4050.41,91,,percent of total billed charges,,,4228.45,95,,percent of total billed charges,,,3694.33,83,,percent of total billed charges,,,1335.3,83,,percent of total billed charges,,958.6,,,,fee schedule,,958.6,,,,fee schedule,,,3694.33,83,,percent of total billed charges,,1222.44,,,,fee schedule,,,4005.9,90,,percent of total billed charges,,,4005.9,90,,percent of total billed charges,,,4005.9,90,,percent of total billed charges,,,4005.9,90,,percent of total billed charges,,,3783.35,85,,percent of total billed charges,,831.59,4228.45,
TREAT KNEE DISLOCATION,27552,CDM,27552,CPT,,,both,,2662,2662,1103.77,,,,fee schedule,,,,,,,,227.4,,,,fee schedule,,,2262.7,85,,percent of total billed charges,,1382.42,,,,fee schedule,,667.83,,,,fee schedule,,227.4,,,,fee schedule,,1072.4,,,,fee schedule,,227.4,,,,fee schedule,,1071.31,,,,fee schedule,,649.28,,,,fee schedule,,649.28,,,,fee schedule,,,2422.42,91,,percent of total billed charges,,,2528.9,95,,percent of total billed charges,,,2209.46,83,,percent of total billed charges,,,798.6,83,,percent of total billed charges,,227.4,,,,fee schedule,,227.4,,,,fee schedule,,,2209.46,83,,percent of total billed charges,,954.44,,,,fee schedule,,,2395.8,90,,percent of total billed charges,,,2395.8,90,,percent of total billed charges,,,2395.8,90,,percent of total billed charges,,,2395.8,90,,percent of total billed charges,,,2262.7,85,,percent of total billed charges,,227.4,2528.9,
TREAT KNEE DISLOCATION,27556,CDM,27556,CPT,,,both,,4555,4555,1513.94,,,,fee schedule,,,,,,,,656.2,,,,fee schedule,,,3871.75,85,,percent of total billed charges,,1921.21,,,,fee schedule,,928.11,,,,fee schedule,,656.2,,,,fee schedule,,1890.14,,,,fee schedule,,656.2,,,,fee schedule,,1469.42,,,,fee schedule,,890.56,,,,fee schedule,,890.56,,,,fee schedule,,,4145.05,91,,percent of total billed charges,,,4327.25,95,,percent of total billed charges,,,3780.65,83,,percent of total billed charges,,,1366.5,83,,percent of total billed charges,,656.2,,,,fee schedule,,656.2,,,,fee schedule,,,3780.65,83,,percent of total billed charges,,1309.12,,,,fee schedule,,,4099.5,90,,percent of total billed charges,,,4099.5,90,,percent of total billed charges,,,4099.5,90,,percent of total billed charges,,,4099.5,90,,percent of total billed charges,,,3871.75,85,,percent of total billed charges,,656.2,4327.25,
TREAT KNEE DISLOCATION,27557,CDM,27557,CPT,,,both,,5438,5438,1800.26,,,,fee schedule,,,,,,,,749.2,,,,fee schedule,,,4622.3,85,,percent of total billed charges,,2294.01,,,,fee schedule,,1108.21,,,,fee schedule,,749.2,,,,fee schedule,,2172,,,,fee schedule,,749.2,,,,fee schedule,,1747.31,,,,fee schedule,,1058.98,,,,fee schedule,,1058.98,,,,fee schedule,,,4948.58,91,,percent of total billed charges,,,5166.1,95,,percent of total billed charges,,,4513.54,83,,percent of total billed charges,,,1631.4,83,,percent of total billed charges,,749.2,,,,fee schedule,,749.2,,,,fee schedule,,,4513.54,83,,percent of total billed charges,,1556.69,,,,fee schedule,,,4894.2,90,,percent of total billed charges,,,4894.2,90,,percent of total billed charges,,,4894.2,90,,percent of total billed charges,,,4894.2,90,,percent of total billed charges,,,4622.3,85,,percent of total billed charges,,749.2,5166.1,
TREAT KNEE DISLOCATION,27558,CDM,27558,CPT,,,both,,6195,6195,2047.4,,,,fee schedule,,,,,,,,749.2,,,,fee schedule,,,5265.75,85,,percent of total billed charges,,2610.59,,,,fee schedule,,1261.15,,,,fee schedule,,749.2,,,,fee schedule,,2240.31,,,,fee schedule,,749.2,,,,fee schedule,,1987.18,,,,fee schedule,,1204.35,,,,fee schedule,,1204.35,,,,fee schedule,,,5637.45,91,,percent of total billed charges,,,5885.25,95,,percent of total billed charges,,,5141.85,83,,percent of total billed charges,,,1858.5,83,,percent of total billed charges,,749.2,,,,fee schedule,,749.2,,,,fee schedule,,,5141.85,83,,percent of total billed charges,,1770.4,,,,fee schedule,,,5575.5,90,,percent of total billed charges,,,5575.5,90,,percent of total billed charges,,,5575.5,90,,percent of total billed charges,,,5575.5,90,,percent of total billed charges,,,5265.75,85,,percent of total billed charges,,749.2,5885.25,
TREAT KNEECAP DISLOCATION,27560,CDM,27560,CPT,,,both,,1486,1486,605.46,,,,fee schedule,,,,,,,,149.8,,,,fee schedule,,,1263.1,85,,percent of total billed charges,,734.54,,,,fee schedule,,354.85,,,,fee schedule,,149.8,,,,fee schedule,,490.11,,,,fee schedule,,149.8,,,,fee schedule,,587.65,,,,fee schedule,,356.15,,,,fee schedule,,356.15,,,,fee schedule,,,1352.26,91,,percent of total billed charges,,,1411.7,95,,percent of total billed charges,,,1233.38,83,,percent of total billed charges,,,445.8,83,,percent of total billed charges,,149.8,,,,fee schedule,,149.8,,,,fee schedule,,,1233.38,83,,percent of total billed charges,,523.55,,,,fee schedule,,,1337.4,90,,percent of total billed charges,,,1337.4,90,,percent of total billed charges,,,1337.4,90,,percent of total billed charges,,,1337.4,90,,percent of total billed charges,,,1263.1,85,,percent of total billed charges,,149.8,1411.7,
TREAT KNEECAP DISLOCATION,27566,CDM,27566,CPT,,,both,,4651,4651,1545.05,,,,fee schedule,,,,,,,,383.25,,,,fee schedule,,,3953.35,85,,percent of total billed charges,,1952.28,,,,fee schedule,,943.12,,,,fee schedule,,383.25,,,,fee schedule,,1567.16,,,,fee schedule,,383.25,,,,fee schedule,,1499.61,,,,fee schedule,,908.85,,,,fee schedule,,908.85,,,,fee schedule,,,4232.41,91,,percent of total billed charges,,,4418.45,95,,percent of total billed charges,,,3860.33,83,,percent of total billed charges,,,1395.3,83,,percent of total billed charges,,383.25,,,,fee schedule,,383.25,,,,fee schedule,,,3860.33,83,,percent of total billed charges,,1336.02,,,,fee schedule,,,4185.9,90,,percent of total billed charges,,,4185.9,90,,percent of total billed charges,,,4185.9,90,,percent of total billed charges,,,4185.9,90,,percent of total billed charges,,,3953.35,85,,percent of total billed charges,,383.25,4418.45,
FIXATION OF KNEE JOINT,27570,CDM,27570,CPT,,,both,,974,974,266.73,,,,fee schedule,,,,,,,,66.7,,,,fee schedule,,,827.9,85,,percent of total billed charges,,329.84,,,,fee schedule,,159.34,,,,fee schedule,,66.7,,,,fee schedule,,252.68,,,,fee schedule,,66.7,,,,fee schedule,,258.88,,,,fee schedule,,156.9,,,,fee schedule,,156.9,,,,fee schedule,,,886.34,91,,percent of total billed charges,,,925.3,95,,percent of total billed charges,,,808.42,83,,percent of total billed charges,,,292.2,83,,percent of total billed charges,,66.7,,,,fee schedule,,66.7,,,,fee schedule,,,808.42,83,,percent of total billed charges,,230.64,,,,fee schedule,,,876.6,90,,percent of total billed charges,,,876.6,90,,percent of total billed charges,,,876.6,90,,percent of total billed charges,,,876.6,90,,percent of total billed charges,,,827.9,85,,percent of total billed charges,,66.7,925.3,
FIXATION OF KNEE JOINT,27570AS80,CDM,27570,CPT,,,both,,689,689,266.73,,,,fee schedule,,,,,,,,66.7,,,,fee schedule,,,585.65,85,,percent of total billed charges,,329.84,,,,fee schedule,,159.34,,,,fee schedule,,66.7,,,,fee schedule,,252.68,,,,fee schedule,,66.7,,,,fee schedule,,258.88,,,,fee schedule,,156.9,,,,fee schedule,,156.9,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,66.7,,,,fee schedule,,66.7,,,,fee schedule,,,571.87,83,,percent of total billed charges,,230.64,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,66.7,654.55,
FUSION OF KNEE,27580,CDM,27580,CPT,,,both,,6763,6763,2545.13,,,,fee schedule,,,,,,,,1384.6,,,,fee schedule,,,5748.55,85,,percent of total billed charges,,3226.76,,,,fee schedule,,1558.81,,,,fee schedule,,1384.6,,,,fee schedule,,2481.05,,,,fee schedule,,1384.6,,,,fee schedule,,2470.28,,,,fee schedule,,1497.14,,,,fee schedule,,1497.14,,,,fee schedule,,,6154.33,91,,percent of total billed charges,,,6424.85,95,,percent of total billed charges,,,5613.29,83,,percent of total billed charges,,,2028.9,83,,percent of total billed charges,,1384.6,,,,fee schedule,,1384.6,,,,fee schedule,,,5613.29,83,,percent of total billed charges,,2200.79,,,,fee schedule,,,6086.7,90,,percent of total billed charges,,,6086.7,90,,percent of total billed charges,,,6086.7,90,,percent of total billed charges,,,6086.7,90,,percent of total billed charges,,,5748.55,85,,percent of total billed charges,,1384.6,6424.85,
AMPUTATE LEG AT THIGH,27590,CDM,27590,CPT,,,both,,3867,3867,1343.42,,,,fee schedule,,,,,,,,649.25,,,,fee schedule,,,3286.95,85,,percent of total billed charges,,1754.11,,,,fee schedule,,847.39,,,,fee schedule,,649.25,,,,fee schedule,,1352.94,,,,fee schedule,,649.25,,,,fee schedule,,1303.91,,,,fee schedule,,790.25,,,,fee schedule,,790.25,,,,fee schedule,,,3518.97,91,,percent of total billed charges,,,3673.65,95,,percent of total billed charges,,,3209.61,83,,percent of total billed charges,,,1160.1,83,,percent of total billed charges,,649.25,,,,fee schedule,,649.25,,,,fee schedule,,,3209.61,83,,percent of total billed charges,,1161.67,,,,fee schedule,,,3480.3,90,,percent of total billed charges,,,3480.3,90,,percent of total billed charges,,,3480.3,90,,percent of total billed charges,,,3480.3,90,,percent of total billed charges,,,3286.95,85,,percent of total billed charges,,649.25,3673.65,
AMPUTATION FOLLOW-UP SURGERY,27594,CDM,27594,CPT,,,both,,2074,2074,867,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,1762.9,85,,percent of total billed charges,,1115.66,,,,fee schedule,,538.96,,,,fee schedule,,224.7,,,,fee schedule,,868.14,,,,fee schedule,,224.7,,,,fee schedule,,841.5,,,,fee schedule,,510,,,,fee schedule,,510,,,,fee schedule,,,1887.34,91,,percent of total billed charges,,,1970.3,95,,percent of total billed charges,,,1721.42,83,,percent of total billed charges,,,622.2,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,1721.42,83,,percent of total billed charges,,749.7,,,,fee schedule,,,1866.6,90,,percent of total billed charges,,,1866.6,90,,percent of total billed charges,,,1866.6,90,,percent of total billed charges,,,1866.6,90,,percent of total billed charges,,,1762.9,85,,percent of total billed charges,,224.7,1970.3,
AMPUTATION FOLLOW-UP SURGERY,27596,CDM,27596,CPT,,,both,,3448,3448,1226.48,,,,fee schedule,,,,,,,,574.35,,,,fee schedule,,,2930.8,85,,percent of total billed charges,,1580.51,,,,fee schedule,,763.53,,,,fee schedule,,574.35,,,,fee schedule,,1256.11,,,,fee schedule,,574.35,,,,fee schedule,,1190.41,,,,fee schedule,,721.46,,,,fee schedule,,721.46,,,,fee schedule,,,3137.68,91,,percent of total billed charges,,,3275.6,95,,percent of total billed charges,,,2861.84,83,,percent of total billed charges,,,1034.4,83,,percent of total billed charges,,574.35,,,,fee schedule,,574.35,,,,fee schedule,,,2861.84,83,,percent of total billed charges,,1060.54,,,,fee schedule,,,3103.2,90,,percent of total billed charges,,,3103.2,90,,percent of total billed charges,,,3103.2,90,,percent of total billed charges,,,3103.2,90,,percent of total billed charges,,,2930.8,85,,percent of total billed charges,,574.35,3275.6,
LEG SURGERY PROCEDURE,27599,CDM,27599,CPT,,,both,,1066,1066,,,,,,,,,,,,,,,,,,,,906.1,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,970.06,91,,percent of total billed charges,,,1012.7,95,,percent of total billed charges,,,884.78,83,,percent of total billed charges,,,319.8,83,,percent of total billed charges,,,,,,,,,,,,,,,884.78,83,,percent of total billed charges,,,,,,,,,959.4,90,,percent of total billed charges,,,959.4,90,,percent of total billed charges,,,959.4,90,,percent of total billed charges,,,959.4,90,,percent of total billed charges,,,906.1,85,,percent of total billed charges,,319.8,1012.7,
DECOMPRESSION OF LOWER LEG,27600,CDM,27600,CPT,,,both,,1888,1888,693.6,,,,fee schedule,,,,,,,,189.8,,,,fee schedule,,,1604.8,85,,percent of total billed charges,,887.28,,,,fee schedule,,428.63,,,,fee schedule,,189.8,,,,fee schedule,,730.19,,,,fee schedule,,189.8,,,,fee schedule,,673.2,,,,fee schedule,,408,,,,fee schedule,,408,,,,fee schedule,,,1718.08,91,,percent of total billed charges,,,1793.6,95,,percent of total billed charges,,,1567.04,83,,percent of total billed charges,,,566.4,83,,percent of total billed charges,,189.8,,,,fee schedule,,189.8,,,,fee schedule,,,1567.04,83,,percent of total billed charges,,599.76,,,,fee schedule,,,1699.2,90,,percent of total billed charges,,,1699.2,90,,percent of total billed charges,,,1699.2,90,,percent of total billed charges,,,1699.2,90,,percent of total billed charges,,,1604.8,85,,percent of total billed charges,,189.8,1793.6,
DECOMPRESSION OF LOWER LEG,27601,CDM,27601,CPT,,,both,,2144,2144,764.46,,,,fee schedule,,,,,,,,190.2,,,,fee schedule,,,1822.4,85,,percent of total billed charges,,975.32,,,,fee schedule,,471.16,,,,fee schedule,,190.2,,,,fee schedule,,748.1,,,,fee schedule,,190.2,,,,fee schedule,,741.98,,,,fee schedule,,449.68,,,,fee schedule,,449.68,,,,fee schedule,,,1951.04,91,,percent of total billed charges,,,2036.8,95,,percent of total billed charges,,,1779.52,83,,percent of total billed charges,,,643.2,83,,percent of total billed charges,,190.2,,,,fee schedule,,190.2,,,,fee schedule,,,1779.52,83,,percent of total billed charges,,661.03,,,,fee schedule,,,1929.6,90,,percent of total billed charges,,,1929.6,90,,percent of total billed charges,,,1929.6,90,,percent of total billed charges,,,1929.6,90,,percent of total billed charges,,,1822.4,85,,percent of total billed charges,,190.2,2036.8,
DRAIN LOWER LEG LESION,27603,CDM,27603,CPT,,,both,,2185,2185,678.05,,,,fee schedule,,,,,,,,211.6,,,,fee schedule,,,1857.25,85,,percent of total billed charges,,854.09,,,,fee schedule,,412.6,,,,fee schedule,,211.6,,,,fee schedule,,649.94,,,,fee schedule,,211.6,,,,fee schedule,,658.11,,,,fee schedule,,398.85,,,,fee schedule,,398.85,,,,fee schedule,,,1988.35,91,,percent of total billed charges,,,2075.75,95,,percent of total billed charges,,,1813.55,83,,percent of total billed charges,,,655.5,83,,percent of total billed charges,,211.6,,,,fee schedule,,211.6,,,,fee schedule,,,1813.55,83,,percent of total billed charges,,586.31,,,,fee schedule,,,1966.5,90,,percent of total billed charges,,,1966.5,90,,percent of total billed charges,,,1966.5,90,,percent of total billed charges,,,1966.5,90,,percent of total billed charges,,,1857.25,85,,percent of total billed charges,,211.6,2075.75,
INCISION OF ACHILLES TENDON,27605,CDM,27605,CPT,,,both,,1611,1611,314.54,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,1369.35,85,,percent of total billed charges,,392.73,,,,fee schedule,,189.72,,,,fee schedule,,359.3,,,,fee schedule,,371.4,,,,fee schedule,,359.3,,,,fee schedule,,305.29,,,,fee schedule,,185.02,,,,fee schedule,,185.02,,,,fee schedule,,,1466.01,91,,percent of total billed charges,,,1530.45,95,,percent of total billed charges,,,1337.13,83,,percent of total billed charges,,,483.3,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,1337.13,83,,percent of total billed charges,,271.99,,,,fee schedule,,,1449.9,90,,percent of total billed charges,,,1449.9,90,,percent of total billed charges,,,1449.9,90,,percent of total billed charges,,,1449.9,90,,percent of total billed charges,,,1369.35,85,,percent of total billed charges,,185.02,1530.45,
EXPLORE/TREAT ANKLE JOINT,27610,CDM,27610,CPT,,,both,,3267,3267,1117.02,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,2776.95,85,,percent of total billed charges,,1409.97,,,,fee schedule,,681.14,,,,fee schedule,,480,,,,fee schedule,,1107.55,,,,fee schedule,,480,,,,fee schedule,,1084.17,,,,fee schedule,,657.07,,,,fee schedule,,657.07,,,,fee schedule,,,2972.97,91,,percent of total billed charges,,,3103.65,95,,percent of total billed charges,,,2711.61,83,,percent of total billed charges,,,980.1,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2711.61,83,,percent of total billed charges,,965.9,,,,fee schedule,,,2940.3,90,,percent of total billed charges,,,2940.3,90,,percent of total billed charges,,,2940.3,90,,percent of total billed charges,,,2940.3,90,,percent of total billed charges,,,2776.95,85,,percent of total billed charges,,480,3103.65,
BIOPSY LOWER LEG SOFT TISSUE,27613,CDM,27613,CPT,,,both,,574,574,276.52,,,,fee schedule,,,,,,,,113.6,,,,fee schedule,,,487.9,85,,percent of total billed charges,,344.06,,,,fee schedule,,166.21,,,,fee schedule,,113.6,,,,fee schedule,,277.22,,,,fee schedule,,113.6,,,,fee schedule,,268.39,,,,fee schedule,,162.66,,,,fee schedule,,162.66,,,,fee schedule,,,522.34,91,,percent of total billed charges,,,545.3,95,,percent of total billed charges,,,476.42,83,,percent of total billed charges,,,172.2,83,,percent of total billed charges,,113.6,,,,fee schedule,,113.6,,,,fee schedule,,,476.42,83,,percent of total billed charges,,239.11,,,,fee schedule,,,516.6,90,,percent of total billed charges,,,516.6,90,,percent of total billed charges,,,516.6,90,,percent of total billed charges,,,516.6,90,,percent of total billed charges,,,487.9,85,,percent of total billed charges,,113.6,545.3,
REMOVE LOWER LEG LESION,27618,CDM,27618,CPT,,,both,,1756,1756,530.57,,,,fee schedule,,,,,,,,186.9,,,,fee schedule,,,1492.6,85,,percent of total billed charges,,664.17,,,,fee schedule,,320.85,,,,fee schedule,,186.9,,,,fee schedule,,647.29,,,,fee schedule,,186.9,,,,fee schedule,,514.97,,,,fee schedule,,312.1,,,,fee schedule,,312.1,,,,fee schedule,,,1597.96,91,,percent of total billed charges,,,1668.2,95,,percent of total billed charges,,,1457.48,83,,percent of total billed charges,,,526.8,83,,percent of total billed charges,,186.9,,,,fee schedule,,186.9,,,,fee schedule,,,1457.48,83,,percent of total billed charges,,458.79,,,,fee schedule,,,1580.4,90,,percent of total billed charges,,,1580.4,90,,percent of total billed charges,,,1580.4,90,,percent of total billed charges,,,1580.4,90,,percent of total billed charges,,,1492.6,85,,percent of total billed charges,,186.9,1668.2,
EXPLORE/TREAT ANKLE JOINT,27620,CDM,27620,CPT,,,both,,2648,2648,769.65,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,2250.8,85,,percent of total billed charges,,975.63,,,,fee schedule,,471.31,,,,fee schedule,,480,,,,fee schedule,,821.05,,,,fee schedule,,480,,,,fee schedule,,747.01,,,,fee schedule,,452.73,,,,fee schedule,,452.73,,,,fee schedule,,,2409.68,91,,percent of total billed charges,,,2515.6,95,,percent of total billed charges,,,2197.84,83,,percent of total billed charges,,,794.4,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2197.84,83,,percent of total billed charges,,665.52,,,,fee schedule,,,2383.2,90,,percent of total billed charges,,,2383.2,90,,percent of total billed charges,,,2383.2,90,,percent of total billed charges,,,2383.2,90,,percent of total billed charges,,,2250.8,85,,percent of total billed charges,,452.73,2515.6,
REMOVAL OF TENDON LESION,27630,CDM,27630,CPT,,,both,,2148,2148,614.68,,,,fee schedule,,,,,,,,188.65,,,,fee schedule,,,1825.8,85,,percent of total billed charges,,775.16,,,,fee schedule,,374.47,,,,fee schedule,,188.65,,,,fee schedule,,656.57,,,,fee schedule,,188.65,,,,fee schedule,,596.6,,,,fee schedule,,361.58,,,,fee schedule,,361.58,,,,fee schedule,,,1954.68,91,,percent of total billed charges,,,2040.6,95,,percent of total billed charges,,,1782.84,83,,percent of total billed charges,,,644.4,83,,percent of total billed charges,,188.65,,,,fee schedule,,188.65,,,,fee schedule,,,1782.84,83,,percent of total billed charges,,531.52,,,,fee schedule,,,1933.2,90,,percent of total billed charges,,,1933.2,90,,percent of total billed charges,,,1933.2,90,,percent of total billed charges,,,1933.2,90,,percent of total billed charges,,,1825.8,85,,percent of total billed charges,,188.65,2040.6,
EXC LEG/ANKLE LES SC 3 CM/>,27632,CDM,27632,CPT,,,both,,1746,1746,710.31,,,,fee schedule,,,,,,,,230.5,,,,fee schedule,,,1484.1,85,,percent of total billed charges,,905.08,,,,fee schedule,,437.23,,,,fee schedule,,230.5,,,,fee schedule,,,,,,,,230.5,,,,fee schedule,,689.42,,,,fee schedule,,417.83,,,,fee schedule,,417.83,,,,fee schedule,,,1588.86,91,,percent of total billed charges,,,1658.7,95,,percent of total billed charges,,,1449.18,83,,percent of total billed charges,,,523.8,83,,percent of total billed charges,,230.5,,,,fee schedule,,230.5,,,,fee schedule,,,1449.18,83,,percent of total billed charges,,614.21,,,,fee schedule,,,1571.4,90,,percent of total billed charges,,,1571.4,90,,percent of total billed charges,,,1571.4,90,,percent of total billed charges,,,1571.4,90,,percent of total billed charges,,,1484.1,85,,percent of total billed charges,,230.5,1658.7,
REMOVE LOWER LEG BONE LESION,27635,CDM,27635,CPT,,,both,,3216,3216,1004.69,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,2733.6,85,,percent of total billed charges,,1259.4,,,,fee schedule,,608.4,,,,fee schedule,,374.55,,,,fee schedule,,1047.87,,,,fee schedule,,374.55,,,,fee schedule,,975.14,,,,fee schedule,,590.99,,,,fee schedule,,590.99,,,,fee schedule,,,2926.56,91,,percent of total billed charges,,,3055.2,95,,percent of total billed charges,,,2669.28,83,,percent of total billed charges,,,964.8,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,2669.28,83,,percent of total billed charges,,868.76,,,,fee schedule,,,2894.4,90,,percent of total billed charges,,,2894.4,90,,percent of total billed charges,,,2894.4,90,,percent of total billed charges,,,2894.4,90,,percent of total billed charges,,,2733.6,85,,percent of total billed charges,,374.55,3055.2,
REMOVE/GRAFT LEG BONE LESION,27637,CDM,27637,CPT,,,both,,3600,3600,1284.09,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3060,85,,percent of total billed charges,,1600.38,,,,fee schedule,,773.12,,,,fee schedule,,599.35,,,,fee schedule,,1311.16,,,,fee schedule,,599.35,,,,fee schedule,,1246.32,,,,fee schedule,,755.35,,,,fee schedule,,755.35,,,,fee schedule,,,3276,91,,percent of total billed charges,,,3420,95,,percent of total billed charges,,,2988,83,,percent of total billed charges,,,1080,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,2988,83,,percent of total billed charges,,1110.36,,,,fee schedule,,,3240,90,,percent of total billed charges,,,3240,90,,percent of total billed charges,,,3240,90,,percent of total billed charges,,,3240,90,,percent of total billed charges,,,3060,85,,percent of total billed charges,,599.35,3420,
REMOVE/GRAFT LEG BONE LESION,27638,CDM,27638,CPT,,,both,,4016,4016,1293.3,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3413.6,85,,percent of total billed charges,,1636.46,,,,fee schedule,,790.55,,,,fee schedule,,599.35,,,,fee schedule,,1368.19,,,,fee schedule,,599.35,,,,fee schedule,,1255.27,,,,fee schedule,,760.77,,,,fee schedule,,760.77,,,,fee schedule,,,3654.56,91,,percent of total billed charges,,,3815.2,95,,percent of total billed charges,,,3333.28,83,,percent of total billed charges,,,1204.8,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3333.28,83,,percent of total billed charges,,1118.33,,,,fee schedule,,,3614.4,90,,percent of total billed charges,,,3614.4,90,,percent of total billed charges,,,3614.4,90,,percent of total billed charges,,,3614.4,90,,percent of total billed charges,,,3413.6,85,,percent of total billed charges,,599.35,3815.2,
PARTIAL REMOVAL OF FIBULA,27641,CDM,27641,CPT,,,both,,3653,3653,1127.97,,,,fee schedule,,,,,,,,335,,,,fee schedule,,,3105.05,85,,percent of total billed charges,,1420.88,,,,fee schedule,,686.41,,,,fee schedule,,335,,,,fee schedule,,1261.42,,,,fee schedule,,335,,,,fee schedule,,1094.79,,,,fee schedule,,663.51,,,,fee schedule,,663.51,,,,fee schedule,,,3324.23,91,,percent of total billed charges,,,3470.35,95,,percent of total billed charges,,,3031.99,83,,percent of total billed charges,,,1095.9,83,,percent of total billed charges,,335,,,,fee schedule,,335,,,,fee schedule,,,3031.99,83,,percent of total billed charges,,975.36,,,,fee schedule,,,3287.7,90,,percent of total billed charges,,,3287.7,90,,percent of total billed charges,,,3287.7,90,,percent of total billed charges,,,3287.7,90,,percent of total billed charges,,,3105.05,85,,percent of total billed charges,,335,3470.35,
EXTENSIVE LOWER LEG SURGERY,27646,CDM,27646,CPT,,,both,,7308,7308,2640.19,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,6211.8,85,,percent of total billed charges,,3356.03,,,,fee schedule,,1621.26,,,,fee schedule,,599.35,,,,fee schedule,,1703.11,,,,fee schedule,,599.35,,,,fee schedule,,2562.53,,,,fee schedule,,1553.05,,,,fee schedule,,1553.05,,,,fee schedule,,,6650.28,91,,percent of total billed charges,,,6942.6,95,,percent of total billed charges,,,6065.64,83,,percent of total billed charges,,,2192.4,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,6065.64,83,,percent of total billed charges,,2282.98,,,,fee schedule,,,6577.2,90,,percent of total billed charges,,,6577.2,90,,percent of total billed charges,,,6577.2,90,,percent of total billed charges,,,6577.2,90,,percent of total billed charges,,,6211.8,85,,percent of total billed charges,,599.35,6942.6,
REPAIR ACHILLES TENDON,27650,CDM,27650,CPT,,,both,,3683,3683,1138.91,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,3130.55,85,,percent of total billed charges,,1427.17,,,,fee schedule,,689.45,,,,fee schedule,,359.3,,,,fee schedule,,1244.17,,,,fee schedule,,359.3,,,,fee schedule,,1105.42,,,,fee schedule,,669.95,,,,fee schedule,,669.95,,,,fee schedule,,,3351.53,91,,percent of total billed charges,,,3498.85,95,,percent of total billed charges,,,3056.89,83,,percent of total billed charges,,,1104.9,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,3056.89,83,,percent of total billed charges,,984.83,,,,fee schedule,,,3314.7,90,,percent of total billed charges,,,3314.7,90,,percent of total billed charges,,,3314.7,90,,percent of total billed charges,,,3314.7,90,,percent of total billed charges,,,3130.55,85,,percent of total billed charges,,359.3,3498.85,
"REPAIR OF LEG TENDON, EACH",27658,CDM,27658,CPT,,,both,,2173,2173,640.03,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,1847.05,85,,percent of total billed charges,,796.19,,,,fee schedule,,384.63,,,,fee schedule,,224.7,,,,fee schedule,,683.77,,,,fee schedule,,224.7,,,,fee schedule,,621.2,,,,fee schedule,,376.49,,,,fee schedule,,376.49,,,,fee schedule,,,1977.43,91,,percent of total billed charges,,,2064.35,95,,percent of total billed charges,,,1803.59,83,,percent of total billed charges,,,651.9,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,1803.59,83,,percent of total billed charges,,553.44,,,,fee schedule,,,1955.7,90,,percent of total billed charges,,,1955.7,90,,percent of total billed charges,,,1955.7,90,,percent of total billed charges,,,1955.7,90,,percent of total billed charges,,,1847.05,85,,percent of total billed charges,,224.7,2064.35,
"REPAIR OF LEG TENDON, EACH",27659,CDM,27659,CPT,,,both,,2611,2611,812.85,,,,fee schedule,,,,,,,,416.2,,,,fee schedule,,,2219.35,85,,percent of total billed charges,,1019.11,,,,fee schedule,,492.32,,,,fee schedule,,416.2,,,,fee schedule,,896.65,,,,fee schedule,,416.2,,,,fee schedule,,788.94,,,,fee schedule,,478.15,,,,fee schedule,,478.15,,,,fee schedule,,,2376.01,91,,percent of total billed charges,,,2480.45,95,,percent of total billed charges,,,2167.13,83,,percent of total billed charges,,,783.3,83,,percent of total billed charges,,416.2,,,,fee schedule,,416.2,,,,fee schedule,,,2167.13,83,,percent of total billed charges,,702.88,,,,fee schedule,,,2349.9,90,,percent of total billed charges,,,2349.9,90,,percent of total billed charges,,,2349.9,90,,percent of total billed charges,,,2349.9,90,,percent of total billed charges,,,2219.35,85,,percent of total billed charges,,416.2,2480.45,
"REPAIR OF LEG TENDON, EACH",27664,CDM,27664,CPT,,,both,,2016,2016,630.81,,,,fee schedule,,,,,,,,182.5,,,,fee schedule,,,1713.6,85,,percent of total billed charges,,788.27,,,,fee schedule,,380.8,,,,fee schedule,,182.5,,,,fee schedule,,655.25,,,,fee schedule,,182.5,,,,fee schedule,,612.26,,,,fee schedule,,371.06,,,,fee schedule,,371.06,,,,fee schedule,,,1834.56,91,,percent of total billed charges,,,1915.2,95,,percent of total billed charges,,,1673.28,83,,percent of total billed charges,,,604.8,83,,percent of total billed charges,,182.5,,,,fee schedule,,182.5,,,,fee schedule,,,1673.28,83,,percent of total billed charges,,545.47,,,,fee schedule,,,1814.4,90,,percent of total billed charges,,,1814.4,90,,percent of total billed charges,,,1814.4,90,,percent of total billed charges,,,1814.4,90,,percent of total billed charges,,,1713.6,85,,percent of total billed charges,,182.5,1915.2,
RELEASE OF LOWER LEG TENDON,27680,CDM,27680,CPT,,,both,,2195,2195,724.14,,,,fee schedule,,,,,,,,381.5,,,,fee schedule,,,1865.75,85,,percent of total billed charges,,904.99,,,,fee schedule,,437.19,,,,fee schedule,,381.5,,,,fee schedule,,780.59,,,,fee schedule,,381.5,,,,fee schedule,,702.84,,,,fee schedule,,425.96,,,,fee schedule,,425.96,,,,fee schedule,,,1997.45,91,,percent of total billed charges,,,2085.25,95,,percent of total billed charges,,,1821.85,83,,percent of total billed charges,,,658.5,83,,percent of total billed charges,,381.5,,,,fee schedule,,381.5,,,,fee schedule,,,1821.85,83,,percent of total billed charges,,626.16,,,,fee schedule,,,1975.5,90,,percent of total billed charges,,,1975.5,90,,percent of total billed charges,,,1975.5,90,,percent of total billed charges,,,1975.5,90,,percent of total billed charges,,,1865.75,85,,percent of total billed charges,,381.5,2085.25,
RELEASE OF LOWER LEG TENDONS,27681,CDM,27681,CPT,,,both,,2593,2593,875.07,,,,fee schedule,,,,,,,,231,,,,fee schedule,,,2204.05,85,,percent of total billed charges,,1103.27,,,,fee schedule,,532.97,,,,fee schedule,,231,,,,fee schedule,,919.2,,,,fee schedule,,231,,,,fee schedule,,849.33,,,,fee schedule,,514.75,,,,fee schedule,,514.75,,,,fee schedule,,,2359.63,91,,percent of total billed charges,,,2463.35,95,,percent of total billed charges,,,2152.19,83,,percent of total billed charges,,,777.9,83,,percent of total billed charges,,231,,,,fee schedule,,231,,,,fee schedule,,,2152.19,83,,percent of total billed charges,,756.68,,,,fee schedule,,,2333.7,90,,percent of total billed charges,,,2333.7,90,,percent of total billed charges,,,2333.7,90,,percent of total billed charges,,,2333.7,90,,percent of total billed charges,,,2204.05,85,,percent of total billed charges,,231,2463.35,
REVISION OF LOWER LEG TENDON,27685,CDM,27685,CPT,,,both,,2617,2617,805.36,,,,fee schedule,,,,,,,,262.2,,,,fee schedule,,,2224.45,85,,percent of total billed charges,,1003.49,,,,fee schedule,,484.77,,,,fee schedule,,262.2,,,,fee schedule,,856.86,,,,fee schedule,,262.2,,,,fee schedule,,781.68,,,,fee schedule,,473.74,,,,fee schedule,,473.74,,,,fee schedule,,,2381.47,91,,percent of total billed charges,,,2486.15,95,,percent of total billed charges,,,2172.11,83,,percent of total billed charges,,,785.1,83,,percent of total billed charges,,262.2,,,,fee schedule,,262.2,,,,fee schedule,,,2172.11,83,,percent of total billed charges,,696.4,,,,fee schedule,,,2355.3,90,,percent of total billed charges,,,2355.3,90,,percent of total billed charges,,,2355.3,90,,percent of total billed charges,,,2355.3,90,,percent of total billed charges,,,2224.45,85,,percent of total billed charges,,262.2,2486.15,
REVISION OF CALF TENDON,27687,CDM,27687,CPT,,,both,,2384,2384,785.2,,,,fee schedule,,,,,,,,262.2,,,,fee schedule,,,2026.4,85,,percent of total billed charges,,981.52,,,,fee schedule,,474.16,,,,fee schedule,,262.2,,,,fee schedule,,831.66,,,,fee schedule,,262.2,,,,fee schedule,,762.11,,,,fee schedule,,461.88,,,,fee schedule,,461.88,,,,fee schedule,,,2169.44,91,,percent of total billed charges,,,2264.8,95,,percent of total billed charges,,,1978.72,83,,percent of total billed charges,,,715.2,83,,percent of total billed charges,,262.2,,,,fee schedule,,262.2,,,,fee schedule,,,1978.72,83,,percent of total billed charges,,678.97,,,,fee schedule,,,2145.6,90,,percent of total billed charges,,,2145.6,90,,percent of total billed charges,,,2145.6,90,,percent of total billed charges,,,2145.6,90,,percent of total billed charges,,,2026.4,85,,percent of total billed charges,,262.2,2264.8,
REVISE LOWER LEG TENDON,27690,CDM,27690,CPT,,,both,,2893,2893,1103.2,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,2459.05,85,,percent of total billed charges,,1387.86,,,,fee schedule,,670.46,,,,fee schedule,,299.7,,,,fee schedule,,1085.67,,,,fee schedule,,299.7,,,,fee schedule,,1070.75,,,,fee schedule,,648.94,,,,fee schedule,,648.94,,,,fee schedule,,,2632.63,91,,percent of total billed charges,,,2748.35,95,,percent of total billed charges,,,2401.19,83,,percent of total billed charges,,,867.9,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,2401.19,83,,percent of total billed charges,,953.94,,,,fee schedule,,,2603.7,90,,percent of total billed charges,,,2603.7,90,,percent of total billed charges,,,2603.7,90,,percent of total billed charges,,,2603.7,90,,percent of total billed charges,,,2459.05,85,,percent of total billed charges,,299.7,2748.35,
REVISE LOWER LEG TENDON,27691,CDM,27691,CPT,,,both,,3776,3776,1285.82,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,3209.6,85,,percent of total billed charges,,1615.55,,,,fee schedule,,780.45,,,,fee schedule,,524.4,,,,fee schedule,,1282.64,,,,fee schedule,,524.4,,,,fee schedule,,1248,,,,fee schedule,,756.36,,,,fee schedule,,756.36,,,,fee schedule,,,3436.16,91,,percent of total billed charges,,,3587.2,95,,percent of total billed charges,,,3134.08,83,,percent of total billed charges,,,1132.8,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,3134.08,83,,percent of total billed charges,,1111.85,,,,fee schedule,,,3398.4,90,,percent of total billed charges,,,3398.4,90,,percent of total billed charges,,,3398.4,90,,percent of total billed charges,,,3398.4,90,,percent of total billed charges,,,3209.6,85,,percent of total billed charges,,524.4,3587.2,
REVISE ADDITIONAL LEG TENDON,27692,CDM,27692,CPT,,,both,,718,718,171.1,,,,fee schedule,,,,,,,,149.8,,,,fee schedule,,,610.3,85,,percent of total billed charges,,221.77,,,,fee schedule,,107.13,,,,fee schedule,,149.8,,,,fee schedule,,206.92,,,,fee schedule,,149.8,,,,fee schedule,,166.06,,,,fee schedule,,100.64,,,,fee schedule,,100.64,,,,fee schedule,,,653.38,91,,percent of total billed charges,,,682.1,95,,percent of total billed charges,,,595.94,83,,percent of total billed charges,,,215.4,83,,percent of total billed charges,,149.8,,,,fee schedule,,149.8,,,,fee schedule,,,595.94,83,,percent of total billed charges,,147.95,,,,fee schedule,,,646.2,90,,percent of total billed charges,,,646.2,90,,percent of total billed charges,,,646.2,90,,percent of total billed charges,,,646.2,90,,percent of total billed charges,,,610.3,85,,percent of total billed charges,,100.64,682.1,
REPAIR OF ANKLE LIGAMENT,27695,CDM,27695,CPT,,,both,,2924,2924,839.35,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,2485.4,85,,percent of total billed charges,,1037.8,,,,fee schedule,,501.35,,,,fee schedule,,374.55,,,,fee schedule,,889.36,,,,fee schedule,,374.55,,,,fee schedule,,814.67,,,,fee schedule,,493.74,,,,fee schedule,,493.74,,,,fee schedule,,,2660.84,91,,percent of total billed charges,,,2777.8,95,,percent of total billed charges,,,2426.92,83,,percent of total billed charges,,,877.2,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,2426.92,83,,percent of total billed charges,,725.79,,,,fee schedule,,,2631.6,90,,percent of total billed charges,,,2631.6,90,,percent of total billed charges,,,2631.6,90,,percent of total billed charges,,,2631.6,90,,percent of total billed charges,,,2485.4,85,,percent of total billed charges,,374.55,2777.8,
REPAIR OF ANKLE LIGAMENTS,27696,CDM,27696,CPT,,,both,,3305,3305,947.66,,,,fee schedule,,,,,,,,561.85,,,,fee schedule,,,2809.25,85,,percent of total billed charges,,1192.3,,,,fee schedule,,575.99,,,,fee schedule,,561.85,,,,fee schedule,,1059.14,,,,fee schedule,,561.85,,,,fee schedule,,919.78,,,,fee schedule,,557.44,,,,fee schedule,,557.44,,,,fee schedule,,,3007.55,91,,percent of total billed charges,,,3139.75,95,,percent of total billed charges,,,2743.15,83,,percent of total billed charges,,,991.5,83,,percent of total billed charges,,561.85,,,,fee schedule,,561.85,,,,fee schedule,,,2743.15,83,,percent of total billed charges,,819.44,,,,fee schedule,,,2974.5,90,,percent of total billed charges,,,2974.5,90,,percent of total billed charges,,,2974.5,90,,percent of total billed charges,,,2974.5,90,,percent of total billed charges,,,2809.25,85,,percent of total billed charges,,557.44,3139.75,
REPAIR OF ANKLE LIGAMENT,27698,CDM,27698,CPT,,,both,,3929,3929,1106.65,,,,fee schedule,,,,,,,,453.7,,,,fee schedule,,,3339.65,85,,percent of total billed charges,,1385.67,,,,fee schedule,,669.4,,,,fee schedule,,453.7,,,,fee schedule,,1177.85,,,,fee schedule,,453.7,,,,fee schedule,,1074.11,,,,fee schedule,,650.97,,,,fee schedule,,650.97,,,,fee schedule,,,3575.39,91,,percent of total billed charges,,,3732.55,95,,percent of total billed charges,,,3261.07,83,,percent of total billed charges,,,1178.7,83,,percent of total billed charges,,453.7,,,,fee schedule,,453.7,,,,fee schedule,,,3261.07,83,,percent of total billed charges,,956.93,,,,fee schedule,,,3536.1,90,,percent of total billed charges,,,3536.1,90,,percent of total billed charges,,,3536.1,90,,percent of total billed charges,,,3536.1,90,,percent of total billed charges,,,3339.65,85,,percent of total billed charges,,453.7,3732.55,
REMOVAL OF ANKLE IMPLANT,27704,CDM,27704,CPT,,,both,,2652,2652,984.52,,,,fee schedule,,,,,,,,249.35,,,,fee schedule,,,2254.2,85,,percent of total billed charges,,1239.96,,,,fee schedule,,599.01,,,,fee schedule,,249.35,,,,fee schedule,,959,,,,fee schedule,,249.35,,,,fee schedule,,955.57,,,,fee schedule,,579.13,,,,fee schedule,,579.13,,,,fee schedule,,,2413.32,91,,percent of total billed charges,,,2519.4,95,,percent of total billed charges,,,2201.16,83,,percent of total billed charges,,,795.6,83,,percent of total billed charges,,249.35,,,,fee schedule,,249.35,,,,fee schedule,,,2201.16,83,,percent of total billed charges,,851.32,,,,fee schedule,,,2386.8,90,,percent of total billed charges,,,2386.8,90,,percent of total billed charges,,,2386.8,90,,percent of total billed charges,,,2386.8,90,,percent of total billed charges,,,2254.2,85,,percent of total billed charges,,249.35,2519.4,
INCISION OF TIBIA,27705,CDM,27705,CPT,,,both,,3782,3782,1305.4,,,,fee schedule,,,,,,,,412,,,,fee schedule,,,3214.7,85,,percent of total billed charges,,1655.81,,,,fee schedule,,799.9,,,,fee schedule,,412,,,,fee schedule,,1344.32,,,,fee schedule,,412,,,,fee schedule,,1267.01,,,,fee schedule,,767.88,,,,fee schedule,,767.88,,,,fee schedule,,,3441.62,91,,percent of total billed charges,,,3592.9,95,,percent of total billed charges,,,3139.06,83,,percent of total billed charges,,,1134.6,83,,percent of total billed charges,,412,,,,fee schedule,,412,,,,fee schedule,,,3139.06,83,,percent of total billed charges,,1128.79,,,,fee schedule,,,3403.8,90,,percent of total billed charges,,,3403.8,90,,percent of total billed charges,,,3403.8,90,,percent of total billed charges,,,3403.8,90,,percent of total billed charges,,,3214.7,85,,percent of total billed charges,,412,3592.9,
INCISION OF FIBULA,27707,CDM,27707,CPT,,,both,,2125,2125,705.7,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,1806.25,85,,percent of total billed charges,,871.33,,,,fee schedule,,420.93,,,,fee schedule,,359.3,,,,fee schedule,,665.86,,,,fee schedule,,359.3,,,,fee schedule,,684.95,,,,fee schedule,,415.12,,,,fee schedule,,415.12,,,,fee schedule,,,1933.75,91,,percent of total billed charges,,,2018.75,95,,percent of total billed charges,,,1763.75,83,,percent of total billed charges,,,637.5,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,1763.75,83,,percent of total billed charges,,610.22,,,,fee schedule,,,1912.5,90,,percent of total billed charges,,,1912.5,90,,percent of total billed charges,,,1912.5,90,,percent of total billed charges,,,1912.5,90,,percent of total billed charges,,,1806.25,85,,percent of total billed charges,,359.3,2018.75,
Revision Of Lower Leg,27715,CDM,27715,CPT,,,both,,5195,5195,1852.68,,,,fee schedule,,,,,,,,749.2,,,,fee schedule,,,4415.75,85,,percent of total billed charges,,2346.73,,,,fee schedule,,1133.68,,,,fee schedule,,749.2,,,,fee schedule,,1829.12,,,,fee schedule,,749.2,,,,fee schedule,,1798.19,,,,fee schedule,,1089.81,,,,fee schedule,,1089.81,,,,fee schedule,,,4727.45,91,,percent of total billed charges,,,4935.25,95,,percent of total billed charges,,,4311.85,83,,percent of total billed charges,,,1558.5,83,,percent of total billed charges,,749.2,,,,fee schedule,,749.2,,,,fee schedule,,,4311.85,83,,percent of total billed charges,,1602.02,,,,fee schedule,,,4675.5,90,,percent of total billed charges,,,4675.5,90,,percent of total billed charges,,,4675.5,90,,percent of total billed charges,,,4675.5,90,,percent of total billed charges,,,4415.75,85,,percent of total billed charges,,749.2,4935.25,
REPAIR/GRAFT OF TIBIA,27724,CDM,27724,CPT,,,both,,6539,6539,2162.61,,,,fee schedule,,,,,,,,840.75,,,,fee schedule,,,5558.15,85,,percent of total billed charges,,2748.57,,,,fee schedule,,1327.8,,,,fee schedule,,840.75,,,,fee schedule,,2231.69,,,,fee schedule,,840.75,,,,fee schedule,,2099.01,,,,fee schedule,,1272.13,,,,fee schedule,,1272.13,,,,fee schedule,,,5950.49,91,,percent of total billed charges,,,6212.05,95,,percent of total billed charges,,,5427.37,83,,percent of total billed charges,,,1961.7,83,,percent of total billed charges,,840.75,,,,fee schedule,,840.75,,,,fee schedule,,,5427.37,83,,percent of total billed charges,,1870.02,,,,fee schedule,,,5885.1,90,,percent of total billed charges,,,5885.1,90,,percent of total billed charges,,,5885.1,90,,percent of total billed charges,,,5885.1,90,,percent of total billed charges,,,5558.15,85,,percent of total billed charges,,840.75,6212.05,
REINFORCE TIBIA,27745,CDM,27745,CPT,,,both,,4004,4004,1309.44,,,,fee schedule,,,,,,,,378.05,,,,fee schedule,,,3403.4,85,,percent of total billed charges,,1653.42,,,,fee schedule,,798.75,,,,fee schedule,,378.05,,,,fee schedule,,1321.11,,,,fee schedule,,378.05,,,,fee schedule,,1270.92,,,,fee schedule,,770.26,,,,fee schedule,,770.26,,,,fee schedule,,,3643.64,91,,percent of total billed charges,,,3803.8,95,,percent of total billed charges,,,3323.32,83,,percent of total billed charges,,,1201.2,83,,percent of total billed charges,,378.05,,,,fee schedule,,378.05,,,,fee schedule,,,3323.32,83,,percent of total billed charges,,1132.28,,,,fee schedule,,,3603.6,90,,percent of total billed charges,,,3603.6,90,,percent of total billed charges,,,3603.6,90,,percent of total billed charges,,,3603.6,90,,percent of total billed charges,,,3403.4,85,,percent of total billed charges,,378.05,3803.8,
TREATMENT OF TIBIA FRACTURE,27750,CDM,27750,CPT,,,both,,1620,1620,571.47,,,,fee schedule,,,,,,,,208.05,,,,fee schedule,,,1377,85,,percent of total billed charges,,699.09,,,,fee schedule,,337.72,,,,fee schedule,,208.05,,,,fee schedule,,500.72,,,,fee schedule,,208.05,,,,fee schedule,,554.67,,,,fee schedule,,336.16,,,,fee schedule,,336.16,,,,fee schedule,,,1474.2,91,,percent of total billed charges,,,1539,95,,percent of total billed charges,,,1344.6,83,,percent of total billed charges,,,486,83,,percent of total billed charges,,208.05,,,,fee schedule,,208.05,,,,fee schedule,,,1344.6,83,,percent of total billed charges,,494.16,,,,fee schedule,,,1458,90,,percent of total billed charges,,,1458,90,,percent of total billed charges,,,1458,90,,percent of total billed charges,,,1458,90,,percent of total billed charges,,,1377,85,,percent of total billed charges,,208.05,1539,
TREATMENT OF TIBIA FRACTURE,27752,CDM,27752,CPT,,,both,,2481,2481,861.24,,,,fee schedule,,,,,,,,320.45,,,,fee schedule,,,2108.85,85,,percent of total billed charges,,1072.78,,,,fee schedule,,518.25,,,,fee schedule,,320.45,,,,fee schedule,,827.68,,,,fee schedule,,320.45,,,,fee schedule,,835.91,,,,fee schedule,,506.61,,,,fee schedule,,506.61,,,,fee schedule,,,2257.71,91,,percent of total billed charges,,,2356.95,95,,percent of total billed charges,,,2059.23,83,,percent of total billed charges,,,744.3,83,,percent of total billed charges,,320.45,,,,fee schedule,,320.45,,,,fee schedule,,,2059.23,83,,percent of total billed charges,,744.72,,,,fee schedule,,,2232.9,90,,percent of total billed charges,,,2232.9,90,,percent of total billed charges,,,2232.9,90,,percent of total billed charges,,,2232.9,90,,percent of total billed charges,,,2108.85,85,,percent of total billed charges,,320.45,2356.95,
TREATMENT OF TIBIA FRACTURE,27756,CDM,27756,CPT,,,both,,3120,3120,1005.84,,,,fee schedule,,,,,,,,738.1,,,,fee schedule,,,2652,85,,percent of total billed charges,,1261.78,,,,fee schedule,,609.55,,,,fee schedule,,738.1,,,,fee schedule,,953.69,,,,fee schedule,,738.1,,,,fee schedule,,976.26,,,,fee schedule,,591.67,,,,fee schedule,,591.67,,,,fee schedule,,,2839.2,91,,percent of total billed charges,,,2964,95,,percent of total billed charges,,,2589.6,83,,percent of total billed charges,,,936,83,,percent of total billed charges,,738.1,,,,fee schedule,,738.1,,,,fee schedule,,,2589.6,83,,percent of total billed charges,,869.76,,,,fee schedule,,,2808,90,,percent of total billed charges,,,2808,90,,percent of total billed charges,,,2808,90,,percent of total billed charges,,,2808,90,,percent of total billed charges,,,2652,85,,percent of total billed charges,,591.67,2964,
TREATMENT OF TIBIA FRACTURE,27758,CDM,27758,CPT,,,both,,4593,4593,1551.97,,,,fee schedule,,,,,,,,839.35,,,,fee schedule,,,3904.05,85,,percent of total billed charges,,1957.26,,,,fee schedule,,945.53,,,,fee schedule,,839.35,,,,fee schedule,,1514.1,,,,fee schedule,,839.35,,,,fee schedule,,1506.32,,,,fee schedule,,912.92,,,,fee schedule,,912.92,,,,fee schedule,,,4179.63,91,,percent of total billed charges,,,4363.35,95,,percent of total billed charges,,,3812.19,83,,percent of total billed charges,,,1377.9,83,,percent of total billed charges,,839.35,,,,fee schedule,,839.35,,,,fee schedule,,,3812.19,83,,percent of total billed charges,,1341.99,,,,fee schedule,,,4133.7,90,,percent of total billed charges,,,4133.7,90,,percent of total billed charges,,,4133.7,90,,percent of total billed charges,,,4133.7,90,,percent of total billed charges,,,3904.05,85,,percent of total billed charges,,839.35,4363.35,
TREATMENT OF TIBIA FRACTURE,27759,CDM,27759,CPT,,,both,,4894,4894,1723.06,,,,fee schedule,,,,,,,,839.35,,,,fee schedule,,,4159.9,85,,percent of total billed charges,,2180.63,,,,fee schedule,,1053.44,,,,fee schedule,,839.35,,,,fee schedule,,1750.86,,,,fee schedule,,839.35,,,,fee schedule,,1672.38,,,,fee schedule,,1013.57,,,,fee schedule,,1013.57,,,,fee schedule,,,4453.54,91,,percent of total billed charges,,,4649.3,95,,percent of total billed charges,,,4062.02,83,,percent of total billed charges,,,1468.2,83,,percent of total billed charges,,839.35,,,,fee schedule,,839.35,,,,fee schedule,,,4062.02,83,,percent of total billed charges,,1489.94,,,,fee schedule,,,4404.6,90,,percent of total billed charges,,,4404.6,90,,percent of total billed charges,,,4404.6,90,,percent of total billed charges,,,4404.6,90,,percent of total billed charges,,,4159.9,85,,percent of total billed charges,,839.35,4649.3,
TREATMENT OF ANKLE FRACTURE,27760,CDM,27760,CPT,,,both,,1545,1545,542.09,,,,fee schedule,,,,,,,,166.4,,,,fee schedule,,,1313.25,85,,percent of total billed charges,,664.74,,,,fee schedule,,321.13,,,,fee schedule,,166.4,,,,fee schedule,,467.56,,,,fee schedule,,166.4,,,,fee schedule,,526.15,,,,fee schedule,,318.88,,,,fee schedule,,318.88,,,,fee schedule,,,1405.95,91,,percent of total billed charges,,,1467.75,95,,percent of total billed charges,,,1282.35,83,,percent of total billed charges,,,463.5,83,,percent of total billed charges,,166.4,,,,fee schedule,,166.4,,,,fee schedule,,,1282.35,83,,percent of total billed charges,,468.75,,,,fee schedule,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1313.25,85,,percent of total billed charges,,166.4,1467.75,
TREATMENT OF ANKLE FRACTURE,27766,CDM,27766,CPT,,,both,,2987,2987,1055.38,,,,fee schedule,,,,,,,,535.45,,,,fee schedule,,,2538.95,85,,percent of total billed charges,,1314.13,,,,fee schedule,,634.84,,,,fee schedule,,535.45,,,,fee schedule,,1126.79,,,,fee schedule,,535.45,,,,fee schedule,,1024.34,,,,fee schedule,,620.81,,,,fee schedule,,620.81,,,,fee schedule,,,2718.17,91,,percent of total billed charges,,,2837.65,95,,percent of total billed charges,,,2479.21,83,,percent of total billed charges,,,896.1,83,,percent of total billed charges,,535.45,,,,fee schedule,,535.45,,,,fee schedule,,,2479.21,83,,percent of total billed charges,,912.6,,,,fee schedule,,,2688.3,90,,percent of total billed charges,,,2688.3,90,,percent of total billed charges,,,2688.3,90,,percent of total billed charges,,,2688.3,90,,percent of total billed charges,,,2538.95,85,,percent of total billed charges,,535.45,2837.65,
CLTX POST ANKLE FX,27767,CDM,27767,CPT,,,both,,1107,1107,513.87,,,,fee schedule,,,,,,,,131.63,,,,fee schedule,,,940.95,85,,percent of total billed charges,,623.31,,,,fee schedule,,301.12,,,,fee schedule,,131.63,,,,fee schedule,,,,,,,,131.63,,,,fee schedule,,498.75,,,,fee schedule,,302.27,,,,fee schedule,,302.27,,,,fee schedule,,,1007.37,91,,percent of total billed charges,,,1051.65,95,,percent of total billed charges,,,918.81,83,,percent of total billed charges,,,332.1,83,,percent of total billed charges,,131.63,,,,fee schedule,,131.63,,,,fee schedule,,,918.81,83,,percent of total billed charges,,444.34,,,,fee schedule,,,996.3,90,,percent of total billed charges,,,996.3,90,,percent of total billed charges,,,996.3,90,,percent of total billed charges,,,996.3,90,,percent of total billed charges,,,940.95,85,,percent of total billed charges,,131.63,1051.65,
CLTX POST ANKLE FX,27767P,CDM,27767,CPT,,,both,P,674,674,513.87,,,,fee schedule,,,,,,,,131.63,,,,fee schedule,,,572.9,85,,percent of total billed charges,,623.31,,,,fee schedule,,301.12,,,,fee schedule,,131.63,,,,fee schedule,,,,,,,,131.63,,,,fee schedule,,498.75,,,,fee schedule,,302.27,,,,fee schedule,,302.27,,,,fee schedule,,,613.34,91,,percent of total billed charges,,,640.3,95,,percent of total billed charges,,,559.42,83,,percent of total billed charges,,,202.2,83,,percent of total billed charges,,131.63,,,,fee schedule,,131.63,,,,fee schedule,,,559.42,83,,percent of total billed charges,,444.34,,,,fee schedule,,,606.6,90,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,572.9,85,,percent of total billed charges,,131.63,640.3,
CLTX POST ANKLE FX,27767T,CDM,27767,CPT,,,both,T,433,433,513.87,,,,fee schedule,,,,,,,,131.63,,,,fee schedule,,,368.05,85,,percent of total billed charges,,623.31,,,,fee schedule,,301.12,,,,fee schedule,,131.63,,,,fee schedule,,,,,,,,131.63,,,,fee schedule,,498.75,,,,fee schedule,,302.27,,,,fee schedule,,302.27,,,,fee schedule,,,394.03,91,,percent of total billed charges,,,411.35,95,,percent of total billed charges,,,359.39,83,,percent of total billed charges,,,129.9,83,,percent of total billed charges,,131.63,,,,fee schedule,,131.63,,,,fee schedule,,,359.39,83,,percent of total billed charges,,444.34,,,,fee schedule,,,389.7,90,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,368.05,85,,percent of total billed charges,,129.9,623.31,
OPTX POST ANKLE FX,27769,CDM,27769,CPT,,,both,,3478,3478,1260.47,,,,fee schedule,,,,,,,,362.81,,,,fee schedule,,,2956.3,85,,percent of total billed charges,,1590.13,,,,fee schedule,,768.18,,,,fee schedule,,362.81,,,,fee schedule,,,,,,,,362.81,,,,fee schedule,,1223.4,,,,fee schedule,,741.45,,,,fee schedule,,741.45,,,,fee schedule,,,3164.98,91,,percent of total billed charges,,,3304.1,95,,percent of total billed charges,,,2886.74,83,,percent of total billed charges,,,1043.4,83,,percent of total billed charges,,362.81,,,,fee schedule,,362.81,,,,fee schedule,,,2886.74,83,,percent of total billed charges,,1089.93,,,,fee schedule,,,3130.2,90,,percent of total billed charges,,,3130.2,90,,percent of total billed charges,,,3130.2,90,,percent of total billed charges,,,3130.2,90,,percent of total billed charges,,,2956.3,85,,percent of total billed charges,,362.81,3304.1,
TREATMENT OF FIBULA FRACTURE,27780,CDM,27780,CPT,,,both,,1188,1188,505.22,,,,fee schedule,,,,,,,,152.6,,,,fee schedule,,,1009.8,85,,percent of total billed charges,,617.57,,,,fee schedule,,298.34,,,,fee schedule,,152.6,,,,fee schedule,,415.17,,,,fee schedule,,152.6,,,,fee schedule,,490.36,,,,fee schedule,,297.19,,,,fee schedule,,297.19,,,,fee schedule,,,1081.08,91,,percent of total billed charges,,,1128.6,95,,percent of total billed charges,,,986.04,83,,percent of total billed charges,,,356.4,83,,percent of total billed charges,,152.6,,,,fee schedule,,152.6,,,,fee schedule,,,986.04,83,,percent of total billed charges,,436.87,,,,fee schedule,,,1069.2,90,,percent of total billed charges,,,1069.2,90,,percent of total billed charges,,,1069.2,90,,percent of total billed charges,,,1069.2,90,,percent of total billed charges,,,1009.8,85,,percent of total billed charges,,152.6,1128.6,
TREATMENT OF FIBULA FRACTURE,27781,CDM,27781,CPT,,,both,,2001,2001,711.46,,,,fee schedule,,,,,,,,217.8,,,,fee schedule,,,1700.85,85,,percent of total billed charges,,874.03,,,,fee schedule,,422.23,,,,fee schedule,,217.8,,,,fee schedule,,645.96,,,,fee schedule,,217.8,,,,fee schedule,,690.54,,,,fee schedule,,418.51,,,,fee schedule,,418.51,,,,fee schedule,,,1820.91,91,,percent of total billed charges,,,1900.95,95,,percent of total billed charges,,,1660.83,83,,percent of total billed charges,,,600.3,83,,percent of total billed charges,,217.8,,,,fee schedule,,217.8,,,,fee schedule,,,1660.83,83,,percent of total billed charges,,615.21,,,,fee schedule,,,1800.9,90,,percent of total billed charges,,,1800.9,90,,percent of total billed charges,,,1800.9,90,,percent of total billed charges,,,1800.9,90,,percent of total billed charges,,,1700.85,85,,percent of total billed charges,,217.8,1900.95,
TREATMENT OF FIBULA FRACTURE,27784,CDM,27784,CPT,,,both,,3117,3117,1233.39,,,,fee schedule,,,,,,,,416.2,,,,fee schedule,,,2649.45,85,,percent of total billed charges,,1540.9,,,,fee schedule,,744.39,,,,fee schedule,,416.2,,,,fee schedule,,980.22,,,,fee schedule,,416.2,,,,fee schedule,,1197.12,,,,fee schedule,,725.52,,,,fee schedule,,725.52,,,,fee schedule,,,2836.47,91,,percent of total billed charges,,,2961.15,95,,percent of total billed charges,,,2587.11,83,,percent of total billed charges,,,935.1,83,,percent of total billed charges,,416.2,,,,fee schedule,,416.2,,,,fee schedule,,,2587.11,83,,percent of total billed charges,,1066.52,,,,fee schedule,,,2805.3,90,,percent of total billed charges,,,2805.3,90,,percent of total billed charges,,,2805.3,90,,percent of total billed charges,,,2805.3,90,,percent of total billed charges,,,2649.45,85,,percent of total billed charges,,416.2,2961.15,
TREATMENT OF ANKLE FRACTURE,27786,CDM,27786,CPT,,,both,,1334,1334,508.68,,,,fee schedule,,,,,,,,152.6,,,,fee schedule,,,1133.9,85,,percent of total billed charges,,624.98,,,,fee schedule,,301.92,,,,fee schedule,,152.6,,,,fee schedule,,437.72,,,,fee schedule,,152.6,,,,fee schedule,,493.72,,,,fee schedule,,299.22,,,,fee schedule,,299.22,,,,fee schedule,,,1213.94,91,,percent of total billed charges,,,1267.3,95,,percent of total billed charges,,,1107.22,83,,percent of total billed charges,,,400.2,83,,percent of total billed charges,,152.6,,,,fee schedule,,152.6,,,,fee schedule,,,1107.22,83,,percent of total billed charges,,439.86,,,,fee schedule,,,1200.6,90,,percent of total billed charges,,,1200.6,90,,percent of total billed charges,,,1200.6,90,,percent of total billed charges,,,1200.6,90,,percent of total billed charges,,,1133.9,85,,percent of total billed charges,,152.6,1267.3,
TREATMENT OF ANKLE FRACTURE,27786P,CDM,27786,CPT,,,both,P,626,626,508.68,,,,fee schedule,,,,,,,,152.6,,,,fee schedule,,,532.1,85,,percent of total billed charges,,624.98,,,,fee schedule,,301.92,,,,fee schedule,,152.6,,,,fee schedule,,437.72,,,,fee schedule,,152.6,,,,fee schedule,,493.72,,,,fee schedule,,299.22,,,,fee schedule,,299.22,,,,fee schedule,,,569.66,91,,percent of total billed charges,,,594.7,95,,percent of total billed charges,,,519.58,83,,percent of total billed charges,,,187.8,83,,percent of total billed charges,,152.6,,,,fee schedule,,152.6,,,,fee schedule,,,519.58,83,,percent of total billed charges,,439.86,,,,fee schedule,,,563.4,90,,percent of total billed charges,,,563.4,90,,percent of total billed charges,,,563.4,90,,percent of total billed charges,,,563.4,90,,percent of total billed charges,,,532.1,85,,percent of total billed charges,,152.6,624.98,
TREATMENT OF ANKLE FRACTURE,27786T,CDM,27786,CPT,,,both,T,708,708,508.68,,,,fee schedule,,,,,,,,152.6,,,,fee schedule,,,601.8,85,,percent of total billed charges,,624.98,,,,fee schedule,,301.92,,,,fee schedule,,152.6,,,,fee schedule,,437.72,,,,fee schedule,,152.6,,,,fee schedule,,493.72,,,,fee schedule,,299.22,,,,fee schedule,,299.22,,,,fee schedule,,,644.28,91,,percent of total billed charges,,,672.6,95,,percent of total billed charges,,,587.64,83,,percent of total billed charges,,,212.4,83,,percent of total billed charges,,152.6,,,,fee schedule,,152.6,,,,fee schedule,,,587.64,83,,percent of total billed charges,,439.86,,,,fee schedule,,,637.2,90,,percent of total billed charges,,,637.2,90,,percent of total billed charges,,,637.2,90,,percent of total billed charges,,,637.2,90,,percent of total billed charges,,,601.8,85,,percent of total billed charges,,152.6,672.6,
TREATMENT OF ANKLE FRACTURE,27788,CDM,27788,CPT,,,both,,1766,1766,679.2,,,,fee schedule,,,,,,,,222,,,,fee schedule,,,1501.1,85,,percent of total billed charges,,839.55,,,,fee schedule,,405.58,,,,fee schedule,,222,,,,fee schedule,,649.94,,,,fee schedule,,222,,,,fee schedule,,659.22,,,,fee schedule,,399.53,,,,fee schedule,,399.53,,,,fee schedule,,,1607.06,91,,percent of total billed charges,,,1677.7,95,,percent of total billed charges,,,1465.78,83,,percent of total billed charges,,,529.8,83,,percent of total billed charges,,222,,,,fee schedule,,222,,,,fee schedule,,,1465.78,83,,percent of total billed charges,,587.31,,,,fee schedule,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1589.4,90,,percent of total billed charges,,,1501.1,85,,percent of total billed charges,,222,1677.7,
TREATMENT OF ANKLE FRACTURE,27788P,CDM,27788,CPT,,,both,P,1251,1251,679.2,,,,fee schedule,,,,,,,,222,,,,fee schedule,,,1063.35,85,,percent of total billed charges,,839.55,,,,fee schedule,,405.58,,,,fee schedule,,222,,,,fee schedule,,649.94,,,,fee schedule,,222,,,,fee schedule,,659.22,,,,fee schedule,,399.53,,,,fee schedule,,399.53,,,,fee schedule,,,1138.41,91,,percent of total billed charges,,,1188.45,95,,percent of total billed charges,,,1038.33,83,,percent of total billed charges,,,375.3,83,,percent of total billed charges,,222,,,,fee schedule,,222,,,,fee schedule,,,1038.33,83,,percent of total billed charges,,587.31,,,,fee schedule,,,1125.9,90,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1125.9,90,,percent of total billed charges,,,1063.35,85,,percent of total billed charges,,222,1188.45,
TREATMENT OF ANKLE FRACTURE,27788T,CDM,27788,CPT,,,both,T,515,515,679.2,,,,fee schedule,,,,,,,,222,,,,fee schedule,,,437.75,85,,percent of total billed charges,,839.55,,,,fee schedule,,405.58,,,,fee schedule,,222,,,,fee schedule,,649.94,,,,fee schedule,,222,,,,fee schedule,,659.22,,,,fee schedule,,399.53,,,,fee schedule,,399.53,,,,fee schedule,,,468.65,91,,percent of total billed charges,,,489.25,95,,percent of total billed charges,,,427.45,83,,percent of total billed charges,,,154.5,83,,percent of total billed charges,,222,,,,fee schedule,,222,,,,fee schedule,,,427.45,83,,percent of total billed charges,,587.31,,,,fee schedule,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,463.5,90,,percent of total billed charges,,,437.75,85,,percent of total billed charges,,154.5,839.55,
TREATMENT OF ANKLE FRACTURE,27792,CDM,27792,CPT,,,both,,3230,3230,1120.48,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,2745.5,85,,percent of total billed charges,,1404.72,,,,fee schedule,,678.6,,,,fee schedule,,299.7,,,,fee schedule,,1055.16,,,,fee schedule,,299.7,,,,fee schedule,,1087.52,,,,fee schedule,,659.11,,,,fee schedule,,659.11,,,,fee schedule,,,2939.3,91,,percent of total billed charges,,,3068.5,95,,percent of total billed charges,,,2680.9,83,,percent of total billed charges,,,969,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,2680.9,83,,percent of total billed charges,,968.89,,,,fee schedule,,,2907,90,,percent of total billed charges,,,2907,90,,percent of total billed charges,,,2907,90,,percent of total billed charges,,,2907,90,,percent of total billed charges,,,2745.5,85,,percent of total billed charges,,299.7,3068.5,
TREATMENT OF ANKLE FRACTURE,27808,CDM,27808,CPT,,,both,,1420,1420,541.52,,,,fee schedule,,,,,,,,208.05,,,,fee schedule,,,1207,85,,percent of total billed charges,,661.5,,,,fee schedule,,319.57,,,,fee schedule,,208.05,,,,fee schedule,,462.92,,,,fee schedule,,208.05,,,,fee schedule,,525.59,,,,fee schedule,,318.54,,,,fee schedule,,318.54,,,,fee schedule,,,1292.2,91,,percent of total billed charges,,,1349,95,,percent of total billed charges,,,1178.6,83,,percent of total billed charges,,,426,83,,percent of total billed charges,,208.05,,,,fee schedule,,208.05,,,,fee schedule,,,1178.6,83,,percent of total billed charges,,468.25,,,,fee schedule,,,1278,90,,percent of total billed charges,,,1278,90,,percent of total billed charges,,,1278,90,,percent of total billed charges,,,1278,90,,percent of total billed charges,,,1207,85,,percent of total billed charges,,208.05,1349,
TREATMENT OF ANKLE FRACTURE,27808P,CDM,27808,CPT,,,both,P,500,500,541.52,,,,fee schedule,,,,,,,,208.05,,,,fee schedule,,,425,85,,percent of total billed charges,,661.5,,,,fee schedule,,319.57,,,,fee schedule,,208.05,,,,fee schedule,,462.92,,,,fee schedule,,208.05,,,,fee schedule,,525.59,,,,fee schedule,,318.54,,,,fee schedule,,318.54,,,,fee schedule,,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,150,83,,percent of total billed charges,,208.05,,,,fee schedule,,208.05,,,,fee schedule,,,415,83,,percent of total billed charges,,468.25,,,,fee schedule,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,150,661.5,
TREATMENT OF ANKLE FRACTURE,27808T,CDM,27808,CPT,,,both,T,920,920,541.52,,,,fee schedule,,,,,,,,208.05,,,,fee schedule,,,782,85,,percent of total billed charges,,661.5,,,,fee schedule,,319.57,,,,fee schedule,,208.05,,,,fee schedule,,462.92,,,,fee schedule,,208.05,,,,fee schedule,,525.59,,,,fee schedule,,318.54,,,,fee schedule,,318.54,,,,fee schedule,,,837.2,91,,percent of total billed charges,,,874,95,,percent of total billed charges,,,763.6,83,,percent of total billed charges,,,276,83,,percent of total billed charges,,208.05,,,,fee schedule,,208.05,,,,fee schedule,,,763.6,83,,percent of total billed charges,,468.25,,,,fee schedule,,,828,90,,percent of total billed charges,,,828,90,,percent of total billed charges,,,828,90,,percent of total billed charges,,,828,90,,percent of total billed charges,,,782,85,,percent of total billed charges,,208.05,874,
TREATMENT OF ANKLE FRACTURE,27810,CDM,27810,CPT,,,both,,2162,2162,752.94,,,,fee schedule,,,,,,,,305.15,,,,fee schedule,,,1837.7,85,,percent of total billed charges,,930.05,,,,fee schedule,,449.29,,,,fee schedule,,305.15,,,,fee schedule,,734.17,,,,fee schedule,,305.15,,,,fee schedule,,730.79,,,,fee schedule,,442.91,,,,fee schedule,,442.91,,,,fee schedule,,,1967.42,91,,percent of total billed charges,,,2053.9,95,,percent of total billed charges,,,1794.46,83,,percent of total billed charges,,,648.6,83,,percent of total billed charges,,305.15,,,,fee schedule,,305.15,,,,fee schedule,,,1794.46,83,,percent of total billed charges,,651.07,,,,fee schedule,,,1945.8,90,,percent of total billed charges,,,1945.8,90,,percent of total billed charges,,,1945.8,90,,percent of total billed charges,,,1945.8,90,,percent of total billed charges,,,1837.7,85,,percent of total billed charges,,305.15,2053.9,
TREATMENT OF ANKLE FRACTURE,27814,CDM,27814,CPT,,,both,,3961,3961,1326.14,,,,fee schedule,,,,,,,,610.45,,,,fee schedule,,,3366.85,85,,percent of total billed charges,,1667.02,,,,fee schedule,,805.32,,,,fee schedule,,610.45,,,,fee schedule,,1395.39,,,,fee schedule,,610.45,,,,fee schedule,,1287.14,,,,fee schedule,,780.08,,,,fee schedule,,780.08,,,,fee schedule,,,3604.51,91,,percent of total billed charges,,,3762.95,95,,percent of total billed charges,,,3287.63,83,,percent of total billed charges,,,1188.3,83,,percent of total billed charges,,610.45,,,,fee schedule,,610.45,,,,fee schedule,,,3287.63,83,,percent of total billed charges,,1146.72,,,,fee schedule,,,3564.9,90,,percent of total billed charges,,,3564.9,90,,percent of total billed charges,,,3564.9,90,,percent of total billed charges,,,3564.9,90,,percent of total billed charges,,,3366.85,85,,percent of total billed charges,,610.45,3762.95,
TREATMENT OF ANKLE FRACTURE,27816,CDM,27816,CPT,,,both,,1360,1360,519.63,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,1156,85,,percent of total billed charges,,637.75,,,,fee schedule,,308.09,,,,fee schedule,,224.7,,,,fee schedule,,445.01,,,,fee schedule,,224.7,,,,fee schedule,,504.34,,,,fee schedule,,305.66,,,,fee schedule,,305.66,,,,fee schedule,,,1237.6,91,,percent of total billed charges,,,1292,95,,percent of total billed charges,,,1128.8,83,,percent of total billed charges,,,408,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,1128.8,83,,percent of total billed charges,,449.32,,,,fee schedule,,,1224,90,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1224,90,,percent of total billed charges,,,1156,85,,percent of total billed charges,,224.7,1292,
TREATMENT OF ANKLE FRACTURE,27818,CDM,27818,CPT,,,both,,2337,2337,773.68,,,,fee schedule,,,,,,,,369.05,,,,fee schedule,,,1986.45,85,,percent of total billed charges,,956.96,,,,fee schedule,,462.3,,,,fee schedule,,369.05,,,,fee schedule,,759.37,,,,fee schedule,,369.05,,,,fee schedule,,750.92,,,,fee schedule,,455.11,,,,fee schedule,,455.11,,,,fee schedule,,,2126.67,91,,percent of total billed charges,,,2220.15,95,,percent of total billed charges,,,1939.71,83,,percent of total billed charges,,,701.1,83,,percent of total billed charges,,369.05,,,,fee schedule,,369.05,,,,fee schedule,,,1939.71,83,,percent of total billed charges,,669,,,,fee schedule,,,2103.3,90,,percent of total billed charges,,,2103.3,90,,percent of total billed charges,,,2103.3,90,,percent of total billed charges,,,2103.3,90,,percent of total billed charges,,,1986.45,85,,percent of total billed charges,,369.05,2220.15,
TREATMENT OF ANKLE FRACTURE,27822,CDM,27822,CPT,,,both,,4314,4314,1517.4,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3666.9,85,,percent of total billed charges,,1907.96,,,,fee schedule,,921.71,,,,fee schedule,,599.35,,,,fee schedule,,1558.53,,,,fee schedule,,599.35,,,,fee schedule,,1472.77,,,,fee schedule,,892.59,,,,fee schedule,,892.59,,,,fee schedule,,,3925.74,91,,percent of total billed charges,,,4098.3,95,,percent of total billed charges,,,3580.62,83,,percent of total billed charges,,,1294.2,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3580.62,83,,percent of total billed charges,,1312.11,,,,fee schedule,,,3882.6,90,,percent of total billed charges,,,3882.6,90,,percent of total billed charges,,,3882.6,90,,percent of total billed charges,,,3882.6,90,,percent of total billed charges,,,3666.9,85,,percent of total billed charges,,599.35,4098.3,
TREATMENT OF ANKLE FRACTURE,27823,CDM,27823,CPT,,,both,,5072,5072,1706.93,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,4311.2,85,,percent of total billed charges,,2148.57,,,,fee schedule,,1037.95,,,,fee schedule,,599.35,,,,fee schedule,,1768.11,,,,fee schedule,,599.35,,,,fee schedule,,1656.73,,,,fee schedule,,1004.08,,,,fee schedule,,1004.08,,,,fee schedule,,,4615.52,91,,percent of total billed charges,,,4818.4,95,,percent of total billed charges,,,4209.76,83,,percent of total billed charges,,,1521.6,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,4209.76,83,,percent of total billed charges,,1475.99,,,,fee schedule,,,4564.8,90,,percent of total billed charges,,,4564.8,90,,percent of total billed charges,,,4564.8,90,,percent of total billed charges,,,4564.8,90,,percent of total billed charges,,,4311.2,85,,percent of total billed charges,,599.35,4818.4,
TREAT LOWER LEG FRACTURE,27824,CDM,27824,CPT,,,both,,1397,1397,540.37,,,,fee schedule,,,,,,,,232.2,,,,fee schedule,,,1187.45,85,,percent of total billed charges,,660.06,,,,fee schedule,,318.87,,,,fee schedule,,232.2,,,,fee schedule,,456.29,,,,fee schedule,,232.2,,,,fee schedule,,524.47,,,,fee schedule,,317.86,,,,fee schedule,,317.86,,,,fee schedule,,,1271.27,91,,percent of total billed charges,,,1327.15,95,,percent of total billed charges,,,1159.51,83,,percent of total billed charges,,,419.1,83,,percent of total billed charges,,232.2,,,,fee schedule,,232.2,,,,fee schedule,,,1159.51,83,,percent of total billed charges,,467.26,,,,fee schedule,,,1257.3,90,,percent of total billed charges,,,1257.3,90,,percent of total billed charges,,,1257.3,90,,percent of total billed charges,,,1257.3,90,,percent of total billed charges,,,1187.45,85,,percent of total billed charges,,232.2,1327.15,
TREAT LOWER LEG FRACTURE,27825,CDM,27825,CPT,,,both,,2631,2631,862.4,,,,fee schedule,,,,,,,,286.2,,,,fee schedule,,,2236.35,85,,percent of total billed charges,,1075.2,,,,fee schedule,,519.42,,,,fee schedule,,286.2,,,,fee schedule,,832.99,,,,fee schedule,,286.2,,,,fee schedule,,837.03,,,,fee schedule,,507.29,,,,fee schedule,,507.29,,,,fee schedule,,,2394.21,91,,percent of total billed charges,,,2499.45,95,,percent of total billed charges,,,2183.73,83,,percent of total billed charges,,,789.3,83,,percent of total billed charges,,286.2,,,,fee schedule,,286.2,,,,fee schedule,,,2183.73,83,,percent of total billed charges,,745.72,,,,fee schedule,,,2367.9,90,,percent of total billed charges,,,2367.9,90,,percent of total billed charges,,,2367.9,90,,percent of total billed charges,,,2367.9,90,,percent of total billed charges,,,2236.35,85,,percent of total billed charges,,286.2,2499.45,
TREAT LOWER LEG FRACTURE,27826,CDM,27826,CPT,,,both,,3696,3696,1482.84,,,,fee schedule,,,,,,,,515.7,,,,fee schedule,,,3141.6,85,,percent of total billed charges,,1860.21,,,,fee schedule,,898.65,,,,fee schedule,,515.7,,,,fee schedule,,1247.49,,,,fee schedule,,515.7,,,,fee schedule,,1439.22,,,,fee schedule,,872.26,,,,fee schedule,,872.26,,,,fee schedule,,,3363.36,91,,percent of total billed charges,,,3511.2,95,,percent of total billed charges,,,3067.68,83,,percent of total billed charges,,,1108.8,83,,percent of total billed charges,,515.7,,,,fee schedule,,515.7,,,,fee schedule,,,3067.68,83,,percent of total billed charges,,1282.22,,,,fee schedule,,,3326.4,90,,percent of total billed charges,,,3326.4,90,,percent of total billed charges,,,3326.4,90,,percent of total billed charges,,,3326.4,90,,percent of total billed charges,,,3141.6,85,,percent of total billed charges,,515.7,3511.2,
TREAT LOWER LEG FRACTURE,27827,CDM,27827,CPT,,,both,,5334,5334,1942.55,,,,fee schedule,,,,,,,,638,,,,fee schedule,,,4533.9,85,,percent of total billed charges,,2442.19,,,,fee schedule,,1179.79,,,,fee schedule,,638,,,,fee schedule,,1935.9,,,,fee schedule,,638,,,,fee schedule,,1885.42,,,,fee schedule,,1142.68,,,,fee schedule,,1142.68,,,,fee schedule,,,4853.94,91,,percent of total billed charges,,,5067.3,95,,percent of total billed charges,,,4427.22,83,,percent of total billed charges,,,1600.2,83,,percent of total billed charges,,638,,,,fee schedule,,638,,,,fee schedule,,,4427.22,83,,percent of total billed charges,,1679.73,,,,fee schedule,,,4800.6,90,,percent of total billed charges,,,4800.6,90,,percent of total billed charges,,,4800.6,90,,percent of total billed charges,,,4800.6,90,,percent of total billed charges,,,4533.9,85,,percent of total billed charges,,638,5067.3,
TREAT LOWER LEG FRACTURE,27828,CDM,27828,CPT,,,both,,6136,6136,2296.84,,,,fee schedule,,,,,,,,696.9,,,,fee schedule,,,5215.6,85,,percent of total billed charges,,2905.28,,,,fee schedule,,1403.51,,,,fee schedule,,696.9,,,,fee schedule,,2181.95,,,,fee schedule,,696.9,,,,fee schedule,,2229.29,,,,fee schedule,,1351.08,,,,fee schedule,,1351.08,,,,fee schedule,,,5583.76,91,,percent of total billed charges,,,5829.2,95,,percent of total billed charges,,,5092.88,83,,percent of total billed charges,,,1840.8,83,,percent of total billed charges,,696.9,,,,fee schedule,,696.9,,,,fee schedule,,,5092.88,83,,percent of total billed charges,,1986.09,,,,fee schedule,,,5522.4,90,,percent of total billed charges,,,5522.4,90,,percent of total billed charges,,,5522.4,90,,percent of total billed charges,,,5522.4,90,,percent of total billed charges,,,5215.6,85,,percent of total billed charges,,696.9,5829.2,
TREAT LOWER LEG JOINT,27829,CDM,27829,CPT,,,both,,3009,3009,1229.36,,,,fee schedule,,,,,,,,412,,,,fee schedule,,,2557.65,85,,percent of total billed charges,,1538.84,,,,fee schedule,,743.39,,,,fee schedule,,412,,,,fee schedule,,875.43,,,,fee schedule,,412,,,,fee schedule,,1193.2,,,,fee schedule,,723.15,,,,fee schedule,,723.15,,,,fee schedule,,,2738.19,91,,percent of total billed charges,,,2858.55,95,,percent of total billed charges,,,2497.47,83,,percent of total billed charges,,,902.7,83,,percent of total billed charges,,412,,,,fee schedule,,412,,,,fee schedule,,,2497.47,83,,percent of total billed charges,,1063.03,,,,fee schedule,,,2708.1,90,,percent of total billed charges,,,2708.1,90,,percent of total billed charges,,,2708.1,90,,percent of total billed charges,,,2708.1,90,,percent of total billed charges,,,2557.65,85,,percent of total billed charges,,412,2858.55,
TREAT ANKLE DISLOCATION,27840,CDM,27840,CPT,,,both,,1620,1620,680.93,,,,fee schedule,,,,,,,,138.2,,,,fee schedule,,,1377,85,,percent of total billed charges,,834.58,,,,fee schedule,,403.18,,,,fee schedule,,138.2,,,,fee schedule,,582.3,,,,fee schedule,,138.2,,,,fee schedule,,660.9,,,,fee schedule,,400.55,,,,fee schedule,,400.55,,,,fee schedule,,,1474.2,91,,percent of total billed charges,,,1539,95,,percent of total billed charges,,,1344.6,83,,percent of total billed charges,,,486,83,,percent of total billed charges,,138.2,,,,fee schedule,,138.2,,,,fee schedule,,,1344.6,83,,percent of total billed charges,,588.8,,,,fee schedule,,,1458,90,,percent of total billed charges,,,1458,90,,percent of total billed charges,,,1458,90,,percent of total billed charges,,,1458,90,,percent of total billed charges,,,1377,85,,percent of total billed charges,,138.2,1539,
TREAT ANKLE DISLOCATION,27842,CDM,27842,CPT,,,both,,1963,1963,857.79,,,,fee schedule,,,,,,,,208.05,,,,fee schedule,,,1668.55,85,,percent of total billed charges,,1083,,,,fee schedule,,523.19,,,,fee schedule,,208.05,,,,fee schedule,,815.08,,,,fee schedule,,208.05,,,,fee schedule,,832.56,,,,fee schedule,,504.58,,,,fee schedule,,504.58,,,,fee schedule,,,1786.33,91,,percent of total billed charges,,,1864.85,95,,percent of total billed charges,,,1629.29,83,,percent of total billed charges,,,588.9,83,,percent of total billed charges,,208.05,,,,fee schedule,,208.05,,,,fee schedule,,,1629.29,83,,percent of total billed charges,,741.73,,,,fee schedule,,,1766.7,90,,percent of total billed charges,,,1766.7,90,,percent of total billed charges,,,1766.7,90,,percent of total billed charges,,,1766.7,90,,percent of total billed charges,,,1668.55,85,,percent of total billed charges,,208.05,1864.85,
"FUSION OF ANKLE JOINT, OPEN",27870,CDM,27870,CPT,,,both,,5596,5596,1742.07,,,,fee schedule,,,,,,,,659,,,,fee schedule,,,4756.6,85,,percent of total billed charges,,2207.22,,,,fee schedule,,1066.28,,,,fee schedule,,659,,,,fee schedule,,1774.08,,,,fee schedule,,659,,,,fee schedule,,1690.84,,,,fee schedule,,1024.75,,,,fee schedule,,1024.75,,,,fee schedule,,,5092.36,91,,percent of total billed charges,,,5316.2,95,,percent of total billed charges,,,4644.68,83,,percent of total billed charges,,,1678.8,83,,percent of total billed charges,,659,,,,fee schedule,,659,,,,fee schedule,,,4644.68,83,,percent of total billed charges,,1506.38,,,,fee schedule,,,5036.4,90,,percent of total billed charges,,,5036.4,90,,percent of total billed charges,,,5036.4,90,,percent of total billed charges,,,5036.4,90,,percent of total billed charges,,,4756.6,85,,percent of total billed charges,,659,5316.2,
"FUSION OF ANKLE JOINT, OPEN",27870AS,CDM,27870,CPT,,,both,AS,689,689,1742.07,,,,fee schedule,,,,,,,,659,,,,fee schedule,,,585.65,85,,percent of total billed charges,,2207.22,,,,fee schedule,,1066.28,,,,fee schedule,,659,,,,fee schedule,,1774.08,,,,fee schedule,,659,,,,fee schedule,,1690.84,,,,fee schedule,,1024.75,,,,fee schedule,,1024.75,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,659,,,,fee schedule,,659,,,,fee schedule,,,571.87,83,,percent of total billed charges,,1506.38,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,2207.22,
AMPUTATION OF LOWER LEG,27880,CDM,27880,CPT,,,both,,3986,3986,1541.02,,,,fee schedule,,,,,,,,613.2,,,,fee schedule,,,3388.1,85,,percent of total billed charges,,2003.21,,,,fee schedule,,967.73,,,,fee schedule,,613.2,,,,fee schedule,,1372.17,,,,fee schedule,,613.2,,,,fee schedule,,1495.7,,,,fee schedule,,906.48,,,,fee schedule,,906.48,,,,fee schedule,,,3627.26,91,,percent of total billed charges,,,3786.7,95,,percent of total billed charges,,,3308.38,83,,percent of total billed charges,,,1195.8,83,,percent of total billed charges,,613.2,,,,fee schedule,,613.2,,,,fee schedule,,,3308.38,83,,percent of total billed charges,,1332.53,,,,fee schedule,,,3587.4,90,,percent of total billed charges,,,3587.4,90,,percent of total billed charges,,,3587.4,90,,percent of total billed charges,,,3587.4,90,,percent of total billed charges,,,3388.1,85,,percent of total billed charges,,613.2,3786.7,
AMPUTATION FOLLOW-UP SURGERY,27886,CDM,27886,CPT,,,both,,3364,3364,1113.57,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,2859.4,85,,percent of total billed charges,,1434.8,,,,fee schedule,,693.14,,,,fee schedule,,374.55,,,,fee schedule,,1140.71,,,,fee schedule,,374.55,,,,fee schedule,,1080.82,,,,fee schedule,,655.04,,,,fee schedule,,655.04,,,,fee schedule,,,3061.24,91,,percent of total billed charges,,,3195.8,95,,percent of total billed charges,,,2792.12,83,,percent of total billed charges,,,1009.2,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,2792.12,83,,percent of total billed charges,,962.91,,,,fee schedule,,,3027.6,90,,percent of total billed charges,,,3027.6,90,,percent of total billed charges,,,3027.6,90,,percent of total billed charges,,,3027.6,90,,percent of total billed charges,,,2859.4,85,,percent of total billed charges,,374.55,3195.8,
DECOMPRESSION OF LEG,27894,CDM,27894,CPT,,,both,,3348,3348,1402.18,,,,fee schedule,,,,,,,,293.2,,,,fee schedule,,,2845.8,85,,percent of total billed charges,,1800.17,,,,fee schedule,,869.64,,,,fee schedule,,293.2,,,,fee schedule,,1316.46,,,,fee schedule,,293.2,,,,fee schedule,,1360.94,,,,fee schedule,,824.81,,,,fee schedule,,824.81,,,,fee schedule,,,3046.68,91,,percent of total billed charges,,,3180.6,95,,percent of total billed charges,,,2778.84,83,,percent of total billed charges,,,1004.4,83,,percent of total billed charges,,293.2,,,,fee schedule,,293.2,,,,fee schedule,,,2778.84,83,,percent of total billed charges,,1212.48,,,,fee schedule,,,3013.2,90,,percent of total billed charges,,,3013.2,90,,percent of total billed charges,,,3013.2,90,,percent of total billed charges,,,3013.2,90,,percent of total billed charges,,,2845.8,85,,percent of total billed charges,,293.2,3180.6,
LEG/ANKLE SURGERY PROCEDURE,27899,CDM,27899,CPT,,,both,,483,483,,,,,,,,,,,,,,,,,,,,410.55,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,439.53,91,,percent of total billed charges,,,458.85,95,,percent of total billed charges,,,400.89,83,,percent of total billed charges,,,144.9,83,,percent of total billed charges,,,,,,,,,,,,,,,400.89,83,,percent of total billed charges,,,,,,,,,434.7,90,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,410.55,85,,percent of total billed charges,,144.9,458.85,
DRAINAGE OF BURSA OF FOOT,28001,CDM,28001,CPT,,,both,,1020,1020,164.18,,,,fee schedule,,,,,,,,136.05,,,,fee schedule,,,867,85,,percent of total billed charges,,211.99,,,,fee schedule,,102.41,,,,fee schedule,,136.05,,,,fee schedule,,332.93,,,,fee schedule,,136.05,,,,fee schedule,,159.35,,,,fee schedule,,96.58,,,,fee schedule,,96.58,,,,fee schedule,,,928.2,91,,percent of total billed charges,,,969,95,,percent of total billed charges,,,846.6,83,,percent of total billed charges,,,306,83,,percent of total billed charges,,136.05,,,,fee schedule,,136.05,,,,fee schedule,,,846.6,83,,percent of total billed charges,,141.97,,,,fee schedule,,,918,90,,percent of total billed charges,,,918,90,,percent of total billed charges,,,918,90,,percent of total billed charges,,,918,90,,percent of total billed charges,,,867,85,,percent of total billed charges,,96.58,969,
TREATMENT OF FOOT INFECTION,28002,CDM,28002,CPT,,,both,,2334,2334,239.07,,,,fee schedule,,,,,,,,143.95,,,,fee schedule,,,1983.9,85,,percent of total billed charges,,308.43,,,,fee schedule,,149,,,,fee schedule,,143.95,,,,fee schedule,,596.89,,,,fee schedule,,143.95,,,,fee schedule,,232.04,,,,fee schedule,,140.63,,,,fee schedule,,140.63,,,,fee schedule,,,2123.94,91,,percent of total billed charges,,,2217.3,95,,percent of total billed charges,,,1937.22,83,,percent of total billed charges,,,700.2,83,,percent of total billed charges,,143.95,,,,fee schedule,,143.95,,,,fee schedule,,,1937.22,83,,percent of total billed charges,,206.73,,,,fee schedule,,,2100.6,90,,percent of total billed charges,,,2100.6,90,,percent of total billed charges,,,2100.6,90,,percent of total billed charges,,,2100.6,90,,percent of total billed charges,,,1983.9,85,,percent of total billed charges,,140.63,2217.3,
TREATMENT OF FOOT INFECTION,28003,CDM,28003,CPT,,,both,,2897,2897,444.74,,,,fee schedule,,,,,,,,246.85,,,,fee schedule,,,2462.45,85,,percent of total billed charges,,575.86,,,,fee schedule,,278.19,,,,fee schedule,,246.85,,,,fee schedule,,978.23,,,,fee schedule,,246.85,,,,fee schedule,,431.66,,,,fee schedule,,261.61,,,,fee schedule,,261.61,,,,fee schedule,,,2636.27,91,,percent of total billed charges,,,2752.15,95,,percent of total billed charges,,,2404.51,83,,percent of total billed charges,,,869.1,83,,percent of total billed charges,,246.85,,,,fee schedule,,246.85,,,,fee schedule,,,2404.51,83,,percent of total billed charges,,384.57,,,,fee schedule,,,2607.3,90,,percent of total billed charges,,,2607.3,90,,percent of total billed charges,,,2607.3,90,,percent of total billed charges,,,2607.3,90,,percent of total billed charges,,,2462.45,85,,percent of total billed charges,,246.85,2752.15,
INCISION OF TOE TENDON,28010,CDM,28010,CPT,,,both,,949,949,356.6,,,,fee schedule,,,,,,,,123.35,,,,fee schedule,,,806.65,85,,percent of total billed charges,,440.54,,,,fee schedule,,212.82,,,,fee schedule,,123.35,,,,fee schedule,,370.07,,,,fee schedule,,123.35,,,,fee schedule,,346.11,,,,fee schedule,,209.76,,,,fee schedule,,209.76,,,,fee schedule,,,863.59,91,,percent of total billed charges,,,901.55,95,,percent of total billed charges,,,787.67,83,,percent of total billed charges,,,284.7,83,,percent of total billed charges,,123.35,,,,fee schedule,,123.35,,,,fee schedule,,,787.67,83,,percent of total billed charges,,308.35,,,,fee schedule,,,854.1,90,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,854.1,90,,percent of total billed charges,,,806.65,85,,percent of total billed charges,,123.35,901.55,
EXPLORATION OF FOOT JOINT,28022,CDM,28022,CPT,,,both,,2540,2540,562.26,,,,fee schedule,,,,,,,,153.65,,,,fee schedule,,,2159,85,,percent of total billed charges,,700.21,,,,fee schedule,,338.26,,,,fee schedule,,153.65,,,,fee schedule,,606.17,,,,fee schedule,,153.65,,,,fee schedule,,545.72,,,,fee schedule,,330.74,,,,fee schedule,,330.74,,,,fee schedule,,,2311.4,91,,percent of total billed charges,,,2413,95,,percent of total billed charges,,,2108.2,83,,percent of total billed charges,,,762,83,,percent of total billed charges,,153.65,,,,fee schedule,,153.65,,,,fee schedule,,,2108.2,83,,percent of total billed charges,,486.19,,,,fee schedule,,,2286,90,,percent of total billed charges,,,2286,90,,percent of total billed charges,,,2286,90,,percent of total billed charges,,,2286,90,,percent of total billed charges,,,2159,85,,percent of total billed charges,,153.65,2413,
DECOMPRESSION OF TIBIA NERVE,28035,CDM,28035,CPT,,,both,,3976,3976,618.14,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,3379.6,85,,percent of total billed charges,,763.63,,,,fee schedule,,368.9,,,,fee schedule,,524.4,,,,fee schedule,,654.58,,,,fee schedule,,524.4,,,,fee schedule,,599.96,,,,fee schedule,,363.61,,,,fee schedule,,363.61,,,,fee schedule,,,3618.16,91,,percent of total billed charges,,,3777.2,95,,percent of total billed charges,,,3300.08,83,,percent of total billed charges,,,1192.8,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,3300.08,83,,percent of total billed charges,,534.51,,,,fee schedule,,,3578.4,90,,percent of total billed charges,,,3578.4,90,,percent of total billed charges,,,3578.4,90,,percent of total billed charges,,,3578.4,90,,percent of total billed charges,,,3379.6,85,,percent of total billed charges,,363.61,3777.2,
Exc Soft Tissure Tumor Foot/toe >1.5,28039,CDM,28039,CPT,,,both,,2320,2320,587.03,,,,fee schedule,,,,,,,,189.1,,,,fee schedule,,,1972,85,,percent of total billed charges,,751.98,,,,fee schedule,,363.27,,,,fee schedule,,189.1,,,,fee schedule,,,,,,,,189.1,,,,fee schedule,,569.76,,,,fee schedule,,345.31,,,,fee schedule,,345.31,,,,fee schedule,,,2111.2,91,,percent of total billed charges,,,2204,95,,percent of total billed charges,,,1925.6,83,,percent of total billed charges,,,696,83,,percent of total billed charges,,189.1,,,,fee schedule,,189.1,,,,fee schedule,,,1925.6,83,,percent of total billed charges,,507.61,,,,fee schedule,,,2088,90,,percent of total billed charges,,,2088,90,,percent of total billed charges,,,2088,90,,percent of total billed charges,,,2088,90,,percent of total billed charges,,,1972,85,,percent of total billed charges,,189.1,2204,
EXC FOOT/TOE TUM DEP 1.5CM/>,28041,CDM,28041,CPT,,,both,,2281,2281,774.25,,,,fee schedule,,,,,,,,248.9,,,,fee schedule,,,1938.85,85,,percent of total billed charges,,970.57,,,,fee schedule,,468.87,,,,fee schedule,,248.9,,,,fee schedule,,,,,,,,248.9,,,,fee schedule,,751.48,,,,fee schedule,,455.44,,,,fee schedule,,455.44,,,,fee schedule,,,2075.71,91,,percent of total billed charges,,,2166.95,95,,percent of total billed charges,,,1893.23,83,,percent of total billed charges,,,684.3,83,,percent of total billed charges,,248.9,,,,fee schedule,,248.9,,,,fee schedule,,,1893.23,83,,percent of total billed charges,,669.5,,,,fee schedule,,,2052.9,90,,percent of total billed charges,,,2052.9,90,,percent of total billed charges,,,2052.9,90,,percent of total billed charges,,,2052.9,90,,percent of total billed charges,,,1938.85,85,,percent of total billed charges,,248.9,2166.95,
EXCISION OF FOOT LESION,28043,CDM,28043,CPT,,,both,,1574,1574,447.62,,,,fee schedule,,,,,,,,149.8,,,,fee schedule,,,1337.9,85,,percent of total billed charges,,555.93,,,,fee schedule,,268.56,,,,fee schedule,,149.8,,,,fee schedule,,474.86,,,,fee schedule,,149.8,,,,fee schedule,,434.45,,,,fee schedule,,263.3,,,,fee schedule,,263.3,,,,fee schedule,,,1432.34,91,,percent of total billed charges,,,1495.3,95,,percent of total billed charges,,,1306.42,83,,percent of total billed charges,,,472.2,83,,percent of total billed charges,,149.8,,,,fee schedule,,149.8,,,,fee schedule,,,1306.42,83,,percent of total billed charges,,387.06,,,,fee schedule,,,1416.6,90,,percent of total billed charges,,,1416.6,90,,percent of total billed charges,,,1416.6,90,,percent of total billed charges,,,1416.6,90,,percent of total billed charges,,,1337.9,85,,percent of total billed charges,,149.8,1495.3,
EXCISION OF FOOT LESION,28045,CDM,28045,CPT,,,both,,2524,2524,597.4,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,2145.4,85,,percent of total billed charges,,740.08,,,,fee schedule,,357.52,,,,fee schedule,,224.7,,,,fee schedule,,592.91,,,,fee schedule,,224.7,,,,fee schedule,,579.83,,,,fee schedule,,351.41,,,,fee schedule,,351.41,,,,fee schedule,,,2296.84,91,,percent of total billed charges,,,2397.8,95,,percent of total billed charges,,,2094.92,83,,percent of total billed charges,,,757.2,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,2094.92,83,,percent of total billed charges,,516.57,,,,fee schedule,,,2271.6,90,,percent of total billed charges,,,2271.6,90,,percent of total billed charges,,,2271.6,90,,percent of total billed charges,,,2271.6,90,,percent of total billed charges,,,2145.4,85,,percent of total billed charges,,224.7,2397.8,
"PARTIAL REMOVAL, FOOT FASCIA",28060,CDM,28060,CPT,,,both,,3092,3092,616.98,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,2628.2,85,,percent of total billed charges,,774.88,,,,fee schedule,,374.34,,,,fee schedule,,224.7,,,,fee schedule,,649.28,,,,fee schedule,,224.7,,,,fee schedule,,598.84,,,,fee schedule,,362.93,,,,fee schedule,,362.93,,,,fee schedule,,,2813.72,91,,percent of total billed charges,,,2937.4,95,,percent of total billed charges,,,2566.36,83,,percent of total billed charges,,,927.6,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,2566.36,83,,percent of total billed charges,,533.51,,,,fee schedule,,,2782.8,90,,percent of total billed charges,,,2782.8,90,,percent of total billed charges,,,2782.8,90,,percent of total billed charges,,,2782.8,90,,percent of total billed charges,,,2628.2,85,,percent of total billed charges,,224.7,2937.4,
EXCISE FOOT TENDON SHEATH,28086,CDM,28086,CPT,,,both,,3300,3300,610.07,,,,fee schedule,,,,,,,,184.5,,,,fee schedule,,,2805,85,,percent of total billed charges,,764.92,,,,fee schedule,,369.53,,,,fee schedule,,184.5,,,,fee schedule,,676.47,,,,fee schedule,,184.5,,,,fee schedule,,592.13,,,,fee schedule,,358.87,,,,fee schedule,,358.87,,,,fee schedule,,,3003,91,,percent of total billed charges,,,3135,95,,percent of total billed charges,,,2739,83,,percent of total billed charges,,,990,83,,percent of total billed charges,,184.5,,,,fee schedule,,184.5,,,,fee schedule,,,2739,83,,percent of total billed charges,,527.53,,,,fee schedule,,,2970,90,,percent of total billed charges,,,2970,90,,percent of total billed charges,,,2970,90,,percent of total billed charges,,,2970,90,,percent of total billed charges,,,2805,85,,percent of total billed charges,,184.5,3135,
REMOVAL OF FOOT LESION,28090,CDM,28090,CPT,,,both,,2614,2614,530,,,,fee schedule,,,,,,,,175.75,,,,fee schedule,,,2221.9,85,,percent of total billed charges,,657.2,,,,fee schedule,,317.49,,,,fee schedule,,175.75,,,,fee schedule,,559.75,,,,fee schedule,,175.75,,,,fee schedule,,514.41,,,,fee schedule,,311.76,,,,fee schedule,,311.76,,,,fee schedule,,,2378.74,91,,percent of total billed charges,,,2483.3,95,,percent of total billed charges,,,2169.62,83,,percent of total billed charges,,,784.2,83,,percent of total billed charges,,175.75,,,,fee schedule,,175.75,,,,fee schedule,,,2169.62,83,,percent of total billed charges,,458.29,,,,fee schedule,,,2352.6,90,,percent of total billed charges,,,2352.6,90,,percent of total billed charges,,,2352.6,90,,percent of total billed charges,,,2352.6,90,,percent of total billed charges,,,2221.9,85,,percent of total billed charges,,175.75,2483.3,
REMOVAL OF FOOT LESION,28104,CDM,28104,CPT,,,both,,5143,5143,607.19,,,,fee schedule,,,,,,,,259.4,,,,fee schedule,,,4371.55,85,,percent of total billed charges,,756.86,,,,fee schedule,,365.63,,,,fee schedule,,259.4,,,,fee schedule,,645.3,,,,fee schedule,,259.4,,,,fee schedule,,589.33,,,,fee schedule,,357.17,,,,fee schedule,,357.17,,,,fee schedule,,,4680.13,91,,percent of total billed charges,,,4885.85,95,,percent of total billed charges,,,4268.69,83,,percent of total billed charges,,,1542.9,83,,percent of total billed charges,,259.4,,,,fee schedule,,259.4,,,,fee schedule,,,4268.69,83,,percent of total billed charges,,525.04,,,,fee schedule,,,4628.7,90,,percent of total billed charges,,,4628.7,90,,percent of total billed charges,,,4628.7,90,,percent of total billed charges,,,4628.7,90,,percent of total billed charges,,,4371.55,85,,percent of total billed charges,,259.4,4885.85,
REMOVAL OF TOE LESIONS,28108,CDM,28108,CPT,,,both,,5986,5986,494.28,,,,fee schedule,,,,,,,,259.4,,,,fee schedule,,,5088.1,85,,percent of total billed charges,,614.46,,,,fee schedule,,296.84,,,,fee schedule,,259.4,,,,fee schedule,,525.92,,,,fee schedule,,259.4,,,,fee schedule,,479.74,,,,fee schedule,,290.75,,,,fee schedule,,290.75,,,,fee schedule,,,5447.26,91,,percent of total billed charges,,,5686.7,95,,percent of total billed charges,,,4968.38,83,,percent of total billed charges,,,1795.8,83,,percent of total billed charges,,259.4,,,,fee schedule,,259.4,,,,fee schedule,,,4968.38,83,,percent of total billed charges,,427.41,,,,fee schedule,,,5387.4,90,,percent of total billed charges,,,5387.4,90,,percent of total billed charges,,,5387.4,90,,percent of total billed charges,,,5387.4,90,,percent of total billed charges,,,5088.1,85,,percent of total billed charges,,259.4,5686.7,
PART REMOVAL OF METATARSAL,28110,CDM,28110,CPT,,,both,,3132,3132,501.19,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,2662.2,85,,percent of total billed charges,,620.49,,,,fee schedule,,299.75,,,,fee schedule,,359.3,,,,fee schedule,,519.29,,,,fee schedule,,359.3,,,,fee schedule,,486.45,,,,fee schedule,,294.82,,,,fee schedule,,294.82,,,,fee schedule,,,2850.12,91,,percent of total billed charges,,,2975.4,95,,percent of total billed charges,,,2599.56,83,,percent of total billed charges,,,939.6,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,2599.56,83,,percent of total billed charges,,433.38,,,,fee schedule,,,2818.8,90,,percent of total billed charges,,,2818.8,90,,percent of total billed charges,,,2818.8,90,,percent of total billed charges,,,2818.8,90,,percent of total billed charges,,,2662.2,85,,percent of total billed charges,,294.82,2975.4,
PART REMOVAL OF METATARSAL,28112,CDM,28112,CPT,,,both,,2190,2190,539.21,,,,fee schedule,,,,,,,,314.95,,,,fee schedule,,,1861.5,85,,percent of total billed charges,,670.37,,,,fee schedule,,323.85,,,,fee schedule,,314.95,,,,fee schedule,,575,,,,fee schedule,,314.95,,,,fee schedule,,523.35,,,,fee schedule,,317.18,,,,fee schedule,,317.18,,,,fee schedule,,,1992.9,91,,percent of total billed charges,,,2080.5,95,,percent of total billed charges,,,1817.7,83,,percent of total billed charges,,,657,83,,percent of total billed charges,,314.95,,,,fee schedule,,314.95,,,,fee schedule,,,1817.7,83,,percent of total billed charges,,466.26,,,,fee schedule,,,1971,90,,percent of total billed charges,,,1971,90,,percent of total billed charges,,,1971,90,,percent of total billed charges,,,1971,90,,percent of total billed charges,,,1861.5,85,,percent of total billed charges,,314.95,2080.5,
PART REMOVAL OF METATARSAL,28113,CDM,28113,CPT,,,both,,3083,3083,732.2,,,,fee schedule,,,,,,,,314.95,,,,fee schedule,,,2620.55,85,,percent of total billed charges,,906.31,,,,fee schedule,,437.83,,,,fee schedule,,314.95,,,,fee schedule,,644.64,,,,fee schedule,,314.95,,,,fee schedule,,710.67,,,,fee schedule,,430.71,,,,fee schedule,,430.71,,,,fee schedule,,,2805.53,91,,percent of total billed charges,,,2928.85,95,,percent of total billed charges,,,2558.89,83,,percent of total billed charges,,,924.9,83,,percent of total billed charges,,314.95,,,,fee schedule,,314.95,,,,fee schedule,,,2558.89,83,,percent of total billed charges,,633.14,,,,fee schedule,,,2774.7,90,,percent of total billed charges,,,2774.7,90,,percent of total billed charges,,,2774.7,90,,percent of total billed charges,,,2774.7,90,,percent of total billed charges,,,2620.55,85,,percent of total billed charges,,314.95,2928.85,
REMOVAL OF HEEL BONE,28118,CDM,28118,CPT,,,both,,3636,3636,724.14,,,,fee schedule,,,,,,,,346.75,,,,fee schedule,,,3090.6,85,,percent of total billed charges,,906.79,,,,fee schedule,,438.06,,,,fee schedule,,346.75,,,,fee schedule,,738.15,,,,fee schedule,,346.75,,,,fee schedule,,702.84,,,,fee schedule,,425.96,,,,fee schedule,,425.96,,,,fee schedule,,,3308.76,91,,percent of total billed charges,,,3454.2,95,,percent of total billed charges,,,3017.88,83,,percent of total billed charges,,,1090.8,83,,percent of total billed charges,,346.75,,,,fee schedule,,346.75,,,,fee schedule,,,3017.88,83,,percent of total billed charges,,626.16,,,,fee schedule,,,3272.4,90,,percent of total billed charges,,,3272.4,90,,percent of total billed charges,,,3272.4,90,,percent of total billed charges,,,3272.4,90,,percent of total billed charges,,,3090.6,85,,percent of total billed charges,,346.75,3454.2,
REMOVAL OF HEEL SPUR,28119,CDM,28119,CPT,,,both,,2306,2306,624.47,,,,fee schedule,,,,,,,,264.9,,,,fee schedule,,,1960.1,85,,percent of total billed charges,,780.12,,,,fee schedule,,376.87,,,,fee schedule,,264.9,,,,fee schedule,,649.94,,,,fee schedule,,264.9,,,,fee schedule,,606.11,,,,fee schedule,,367.34,,,,fee schedule,,367.34,,,,fee schedule,,,2098.46,91,,percent of total billed charges,,,2190.7,95,,percent of total billed charges,,,1913.98,83,,percent of total billed charges,,,691.8,83,,percent of total billed charges,,264.9,,,,fee schedule,,264.9,,,,fee schedule,,,1913.98,83,,percent of total billed charges,,539.99,,,,fee schedule,,,2075.4,90,,percent of total billed charges,,,2075.4,90,,percent of total billed charges,,,2075.4,90,,percent of total billed charges,,,2075.4,90,,percent of total billed charges,,,1960.1,85,,percent of total billed charges,,264.9,2190.7,
REMOVAL OF HEEL SPUR,28119P,CDM,28119,CPT,,,both,P,2088,2088,624.47,,,,fee schedule,,,,,,,,264.9,,,,fee schedule,,,1774.8,85,,percent of total billed charges,,780.12,,,,fee schedule,,376.87,,,,fee schedule,,264.9,,,,fee schedule,,649.94,,,,fee schedule,,264.9,,,,fee schedule,,606.11,,,,fee schedule,,367.34,,,,fee schedule,,367.34,,,,fee schedule,,,1900.08,91,,percent of total billed charges,,,1983.6,95,,percent of total billed charges,,,1733.04,83,,percent of total billed charges,,,626.4,83,,percent of total billed charges,,264.9,,,,fee schedule,,264.9,,,,fee schedule,,,1733.04,83,,percent of total billed charges,,539.99,,,,fee schedule,,,1879.2,90,,percent of total billed charges,,,1879.2,90,,percent of total billed charges,,,1879.2,90,,percent of total billed charges,,,1879.2,90,,percent of total billed charges,,,1774.8,85,,percent of total billed charges,,264.9,1983.6,
REMOVAL OF HEEL SPUR,28119T,CDM,28119,CPT,,,both,T,218,218,624.47,,,,fee schedule,,,,,,,,264.9,,,,fee schedule,,,185.3,85,,percent of total billed charges,,780.12,,,,fee schedule,,376.87,,,,fee schedule,,264.9,,,,fee schedule,,649.94,,,,fee schedule,,264.9,,,,fee schedule,,606.11,,,,fee schedule,,367.34,,,,fee schedule,,367.34,,,,fee schedule,,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,65.4,83,,percent of total billed charges,,264.9,,,,fee schedule,,264.9,,,,fee schedule,,,180.94,83,,percent of total billed charges,,539.99,,,,fee schedule,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,65.4,780.12,
PART REMOVAL OF ANKLE/HEEL,28120,CDM,28120,CPT,,,both,,2960,2960,854.91,,,,fee schedule,,,,,,,,259.4,,,,fee schedule,,,2516,85,,percent of total billed charges,,1071.52,,,,fee schedule,,517.64,,,,fee schedule,,259.4,,,,fee schedule,,701.01,,,,fee schedule,,259.4,,,,fee schedule,,829.76,,,,fee schedule,,502.89,,,,fee schedule,,502.89,,,,fee schedule,,,2693.6,91,,percent of total billed charges,,,2812,95,,percent of total billed charges,,,2456.8,83,,percent of total billed charges,,,888,83,,percent of total billed charges,,259.4,,,,fee schedule,,259.4,,,,fee schedule,,,2456.8,83,,percent of total billed charges,,739.24,,,,fee schedule,,,2664,90,,percent of total billed charges,,,2664,90,,percent of total billed charges,,,2664,90,,percent of total billed charges,,,2664,90,,percent of total billed charges,,,2516,85,,percent of total billed charges,,259.4,2812,
PARTIAL REMOVAL OF FOOT BONE,28122,CDM,28122,CPT,,,both,,3247,3247,752.36,,,,fee schedule,,,,,,,,253.9,,,,fee schedule,,,2759.95,85,,percent of total billed charges,,939.71,,,,fee schedule,,453.96,,,,fee schedule,,253.9,,,,fee schedule,,896.65,,,,fee schedule,,253.9,,,,fee schedule,,730.24,,,,fee schedule,,442.57,,,,fee schedule,,442.57,,,,fee schedule,,,2954.77,91,,percent of total billed charges,,,3084.65,95,,percent of total billed charges,,,2695.01,83,,percent of total billed charges,,,974.1,83,,percent of total billed charges,,253.9,,,,fee schedule,,253.9,,,,fee schedule,,,2695.01,83,,percent of total billed charges,,650.57,,,,fee schedule,,,2922.3,90,,percent of total billed charges,,,2922.3,90,,percent of total billed charges,,,2922.3,90,,percent of total billed charges,,,2922.3,90,,percent of total billed charges,,,2759.95,85,,percent of total billed charges,,253.9,3084.65,
PARTIAL REMOVAL OF TOE,28124,CDM,28124,CPT,,,both,,2563,2563,572.05,,,,fee schedule,,,,,,,,259.4,,,,fee schedule,,,2178.55,85,,percent of total billed charges,,710.18,,,,fee schedule,,343.08,,,,fee schedule,,259.4,,,,fee schedule,,600.2,,,,fee schedule,,259.4,,,,fee schedule,,555.22,,,,fee schedule,,336.5,,,,fee schedule,,336.5,,,,fee schedule,,,2332.33,91,,percent of total billed charges,,,2434.85,95,,percent of total billed charges,,,2127.29,83,,percent of total billed charges,,,768.9,83,,percent of total billed charges,,259.4,,,,fee schedule,,259.4,,,,fee schedule,,,2127.29,83,,percent of total billed charges,,494.65,,,,fee schedule,,,2306.7,90,,percent of total billed charges,,,2306.7,90,,percent of total billed charges,,,2306.7,90,,percent of total billed charges,,,2306.7,90,,percent of total billed charges,,,2178.55,85,,percent of total billed charges,,259.4,2434.85,
PARTIAL REMOVAL OF TOE,28126,CDM,28126,CPT,,,both,,1484,1484,426.88,,,,fee schedule,,,,,,,,209.4,,,,fee schedule,,,1261.4,85,,percent of total billed charges,,528.78,,,,fee schedule,,255.45,,,,fee schedule,,209.4,,,,fee schedule,,460.93,,,,fee schedule,,209.4,,,,fee schedule,,414.32,,,,fee schedule,,251.1,,,,fee schedule,,251.1,,,,fee schedule,,,1350.44,91,,percent of total billed charges,,,1409.8,95,,percent of total billed charges,,,1231.72,83,,percent of total billed charges,,,445.2,83,,percent of total billed charges,,209.4,,,,fee schedule,,209.4,,,,fee schedule,,,1231.72,83,,percent of total billed charges,,369.12,,,,fee schedule,,,1335.6,90,,percent of total billed charges,,,1335.6,90,,percent of total billed charges,,,1335.6,90,,percent of total billed charges,,,1335.6,90,,percent of total billed charges,,,1261.4,85,,percent of total billed charges,,209.4,1409.8,
REMOVAL OF ANKLE BONE,28130,CDM,28130,CPT,,,both,,2777,2777,1043.86,,,,fee schedule,,,,,,,,412,,,,fee schedule,,,2360.45,85,,percent of total billed charges,,1325.24,,,,fee schedule,,640.21,,,,fee schedule,,412,,,,fee schedule,,1065.11,,,,fee schedule,,412,,,,fee schedule,,1013.16,,,,fee schedule,,614.04,,,,fee schedule,,614.04,,,,fee schedule,,,2527.07,91,,percent of total billed charges,,,2638.15,95,,percent of total billed charges,,,2304.91,83,,percent of total billed charges,,,833.1,83,,percent of total billed charges,,412,,,,fee schedule,,412,,,,fee schedule,,,2304.91,83,,percent of total billed charges,,902.63,,,,fee schedule,,,2499.3,90,,percent of total billed charges,,,2499.3,90,,percent of total billed charges,,,2499.3,90,,percent of total billed charges,,,2499.3,90,,percent of total billed charges,,,2360.45,85,,percent of total billed charges,,412,2638.15,
REMOVAL OF FOOT FOREIGN BODY,28190,CDM,28190,CPT,,,both,,1225,1225,226.4,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,1041.25,85,,percent of total billed charges,,283.39,,,,fee schedule,,136.9,,,,fee schedule,,107,,,,fee schedule,,242.73,,,,fee schedule,,107,,,,fee schedule,,219.74,,,,fee schedule,,133.18,,,,fee schedule,,133.18,,,,fee schedule,,,1114.75,91,,percent of total billed charges,,,1163.75,95,,percent of total billed charges,,,1016.75,83,,percent of total billed charges,,,367.5,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,1016.75,83,,percent of total billed charges,,195.77,,,,fee schedule,,,1102.5,90,,percent of total billed charges,,,1102.5,90,,percent of total billed charges,,,1102.5,90,,percent of total billed charges,,,1102.5,90,,percent of total billed charges,,,1041.25,85,,percent of total billed charges,,107,1163.75,
REMOVAL OF FOOT FOREIGN BODY,28192,CDM,28192,CPT,,,both,,2156,2156,531.72,,,,fee schedule,,,,,,,,159.8,,,,fee schedule,,,1832.6,85,,percent of total billed charges,,664.27,,,,fee schedule,,320.9,,,,fee schedule,,159.8,,,,fee schedule,,587.6,,,,fee schedule,,159.8,,,,fee schedule,,516.09,,,,fee schedule,,312.78,,,,fee schedule,,312.78,,,,fee schedule,,,1961.96,91,,percent of total billed charges,,,2048.2,95,,percent of total billed charges,,,1789.48,83,,percent of total billed charges,,,646.8,83,,percent of total billed charges,,159.8,,,,fee schedule,,159.8,,,,fee schedule,,,1789.48,83,,percent of total billed charges,,459.78,,,,fee schedule,,,1940.4,90,,percent of total billed charges,,,1940.4,90,,percent of total billed charges,,,1940.4,90,,percent of total billed charges,,,1940.4,90,,percent of total billed charges,,,1832.6,85,,percent of total billed charges,,159.8,2048.2,
REMOVAL OF FOOT FOREIGN BODY,28193,CDM,28193,CPT,,,both,,2127,2127,627.35,,,,fee schedule,,,,,,,,180.3,,,,fee schedule,,,1807.95,85,,percent of total billed charges,,784.77,,,,fee schedule,,379.11,,,,fee schedule,,180.3,,,,fee schedule,,687.08,,,,fee schedule,,180.3,,,,fee schedule,,608.9,,,,fee schedule,,369.03,,,,fee schedule,,369.03,,,,fee schedule,,,1935.57,91,,percent of total billed charges,,,2020.65,95,,percent of total billed charges,,,1765.41,83,,percent of total billed charges,,,638.1,83,,percent of total billed charges,,180.3,,,,fee schedule,,180.3,,,,fee schedule,,,1765.41,83,,percent of total billed charges,,542.48,,,,fee schedule,,,1914.3,90,,percent of total billed charges,,,1914.3,90,,percent of total billed charges,,,1914.3,90,,percent of total billed charges,,,1914.3,90,,percent of total billed charges,,,1807.95,85,,percent of total billed charges,,180.3,2020.65,
REPAIR OF FOOT TENDON,28200,CDM,28200,CPT,,,both,,2927,2927,562.83,,,,fee schedule,,,,,,,,353.75,,,,fee schedule,,,2487.95,85,,percent of total billed charges,,702.68,,,,fee schedule,,339.46,,,,fee schedule,,353.75,,,,fee schedule,,580.31,,,,fee schedule,,353.75,,,,fee schedule,,546.28,,,,fee schedule,,331.08,,,,fee schedule,,331.08,,,,fee schedule,,,2663.57,91,,percent of total billed charges,,,2780.65,95,,percent of total billed charges,,,2429.41,83,,percent of total billed charges,,,878.1,83,,percent of total billed charges,,353.75,,,,fee schedule,,353.75,,,,fee schedule,,,2429.41,83,,percent of total billed charges,,486.68,,,,fee schedule,,,2634.3,90,,percent of total billed charges,,,2634.3,90,,percent of total billed charges,,,2634.3,90,,percent of total billed charges,,,2634.3,90,,percent of total billed charges,,,2487.95,85,,percent of total billed charges,,331.08,2780.65,
REPAIR/GRAFT OF FOOT TENDON,28202,CDM,28202,CPT,,,both,,3327,3327,737.96,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,2827.95,85,,percent of total billed charges,,920.22,,,,fee schedule,,444.55,,,,fee schedule,,480,,,,fee schedule,,811.1,,,,fee schedule,,480,,,,fee schedule,,716.26,,,,fee schedule,,434.1,,,,fee schedule,,434.1,,,,fee schedule,,,3027.57,91,,percent of total billed charges,,,3160.65,95,,percent of total billed charges,,,2761.41,83,,percent of total billed charges,,,998.1,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2761.41,83,,percent of total billed charges,,638.12,,,,fee schedule,,,2994.3,90,,percent of total billed charges,,,2994.3,90,,percent of total billed charges,,,2994.3,90,,percent of total billed charges,,,2994.3,90,,percent of total billed charges,,,2827.95,85,,percent of total billed charges,,434.1,3160.65,
REPAIR OF FOOT TENDON,28208,CDM,28208,CPT,,,both,,2432,2432,555.34,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,2067.2,85,,percent of total billed charges,,684.75,,,,fee schedule,,330.79,,,,fee schedule,,299.7,,,,fee schedule,,546.48,,,,fee schedule,,299.7,,,,fee schedule,,539.01,,,,fee schedule,,326.67,,,,fee schedule,,326.67,,,,fee schedule,,,2213.12,91,,percent of total billed charges,,,2310.4,95,,percent of total billed charges,,,2018.56,83,,percent of total billed charges,,,729.6,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,2018.56,83,,percent of total billed charges,,480.21,,,,fee schedule,,,2188.8,90,,percent of total billed charges,,,2188.8,90,,percent of total billed charges,,,2188.8,90,,percent of total billed charges,,,2188.8,90,,percent of total billed charges,,,2067.2,85,,percent of total billed charges,,299.7,2310.4,
INCISION OF FOOT TENDON(S),28230,CDM,28230,CPT,,,both,,2037,2037,489.67,,,,fee schedule,,,,,,,,173.4,,,,fee schedule,,,1731.45,85,,percent of total billed charges,,606.85,,,,fee schedule,,293.16,,,,fee schedule,,173.4,,,,fee schedule,,561.07,,,,fee schedule,,173.4,,,,fee schedule,,475.27,,,,fee schedule,,288.04,,,,fee schedule,,288.04,,,,fee schedule,,,1853.67,91,,percent of total billed charges,,,1935.15,95,,percent of total billed charges,,,1690.71,83,,percent of total billed charges,,,611.1,83,,percent of total billed charges,,173.4,,,,fee schedule,,173.4,,,,fee schedule,,,1690.71,83,,percent of total billed charges,,423.42,,,,fee schedule,,,1833.3,90,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1731.45,85,,percent of total billed charges,,173.4,1935.15,
INCISION OF TOE TENDON,28232,CDM,28232,CPT,,,both,,1437,1437,412.47,,,,fee schedule,,,,,,,,121.1,,,,fee schedule,,,1221.45,85,,percent of total billed charges,,512.55,,,,fee schedule,,247.61,,,,fee schedule,,121.1,,,,fee schedule,,473.53,,,,fee schedule,,121.1,,,,fee schedule,,400.34,,,,fee schedule,,242.63,,,,fee schedule,,242.63,,,,fee schedule,,,1307.67,91,,percent of total billed charges,,,1365.15,95,,percent of total billed charges,,,1192.71,83,,percent of total billed charges,,,431.1,83,,percent of total billed charges,,121.1,,,,fee schedule,,121.1,,,,fee schedule,,,1192.71,83,,percent of total billed charges,,356.67,,,,fee schedule,,,1293.3,90,,percent of total billed charges,,,1293.3,90,,percent of total billed charges,,,1293.3,90,,percent of total billed charges,,,1293.3,90,,percent of total billed charges,,,1221.45,85,,percent of total billed charges,,121.1,1365.15,
INCISION OF TOE TENDON,28232P,CDM,28232,CPT,,,both,P,1245,1245,412.47,,,,fee schedule,,,,,,,,121.1,,,,fee schedule,,,1058.25,85,,percent of total billed charges,,512.55,,,,fee schedule,,247.61,,,,fee schedule,,121.1,,,,fee schedule,,473.53,,,,fee schedule,,121.1,,,,fee schedule,,400.34,,,,fee schedule,,242.63,,,,fee schedule,,242.63,,,,fee schedule,,,1132.95,91,,percent of total billed charges,,,1182.75,95,,percent of total billed charges,,,1033.35,83,,percent of total billed charges,,,373.5,83,,percent of total billed charges,,121.1,,,,fee schedule,,121.1,,,,fee schedule,,,1033.35,83,,percent of total billed charges,,356.67,,,,fee schedule,,,1120.5,90,,percent of total billed charges,,,1120.5,90,,percent of total billed charges,,,1120.5,90,,percent of total billed charges,,,1120.5,90,,percent of total billed charges,,,1058.25,85,,percent of total billed charges,,121.1,1182.75,
INCISION OF TOE TENDON,28232T,CDM,28232,CPT,,,both,T,192,192,412.47,,,,fee schedule,,,,,,,,121.1,,,,fee schedule,,,163.2,85,,percent of total billed charges,,512.55,,,,fee schedule,,247.61,,,,fee schedule,,121.1,,,,fee schedule,,473.53,,,,fee schedule,,121.1,,,,fee schedule,,400.34,,,,fee schedule,,242.63,,,,fee schedule,,242.63,,,,fee schedule,,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,57.6,83,,percent of total billed charges,,121.1,,,,fee schedule,,121.1,,,,fee schedule,,,159.36,83,,percent of total billed charges,,356.67,,,,fee schedule,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,57.6,512.55,
INCISION OF FOOT TENDON,28234,CDM,28234,CPT,,,both,,2013,2013,461.44,,,,fee schedule,,,,,,,,121.05,,,,fee schedule,,,1711.05,85,,percent of total billed charges,,566.51,,,,fee schedule,,273.67,,,,fee schedule,,121.05,,,,fee schedule,,474.19,,,,fee schedule,,121.05,,,,fee schedule,,447.87,,,,fee schedule,,271.44,,,,fee schedule,,271.44,,,,fee schedule,,,1831.83,91,,percent of total billed charges,,,1912.35,95,,percent of total billed charges,,,1670.79,83,,percent of total billed charges,,,603.9,83,,percent of total billed charges,,121.05,,,,fee schedule,,121.05,,,,fee schedule,,,1670.79,83,,percent of total billed charges,,399.01,,,,fee schedule,,,1811.7,90,,percent of total billed charges,,,1811.7,90,,percent of total billed charges,,,1811.7,90,,percent of total billed charges,,,1811.7,90,,percent of total billed charges,,,1711.05,85,,percent of total billed charges,,121.05,1912.35,
INCISION OF FOOT TENDON,28234P,CDM,28234,CPT,,,both,P,1804,1804,461.44,,,,fee schedule,,,,,,,,121.05,,,,fee schedule,,,1533.4,85,,percent of total billed charges,,566.51,,,,fee schedule,,273.67,,,,fee schedule,,121.05,,,,fee schedule,,474.19,,,,fee schedule,,121.05,,,,fee schedule,,447.87,,,,fee schedule,,271.44,,,,fee schedule,,271.44,,,,fee schedule,,,1641.64,91,,percent of total billed charges,,,1713.8,95,,percent of total billed charges,,,1497.32,83,,percent of total billed charges,,,541.2,83,,percent of total billed charges,,121.05,,,,fee schedule,,121.05,,,,fee schedule,,,1497.32,83,,percent of total billed charges,,399.01,,,,fee schedule,,,1623.6,90,,percent of total billed charges,,,1623.6,90,,percent of total billed charges,,,1623.6,90,,percent of total billed charges,,,1623.6,90,,percent of total billed charges,,,1533.4,85,,percent of total billed charges,,121.05,1713.8,
INCISION OF FOOT TENDON,28234T,CDM,28234,CPT,,,both,T,209,209,461.44,,,,fee schedule,,,,,,,,121.05,,,,fee schedule,,,177.65,85,,percent of total billed charges,,566.51,,,,fee schedule,,273.67,,,,fee schedule,,121.05,,,,fee schedule,,474.19,,,,fee schedule,,121.05,,,,fee schedule,,447.87,,,,fee schedule,,271.44,,,,fee schedule,,271.44,,,,fee schedule,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,62.7,83,,percent of total billed charges,,121.05,,,,fee schedule,,121.05,,,,fee schedule,,,173.47,83,,percent of total billed charges,,399.01,,,,fee schedule,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,62.7,566.51,
REVISION OF FOOT TENDON,28238,CDM,28238,CPT,,,both,,3889,3889,844.54,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,3305.65,85,,percent of total billed charges,,1056.41,,,,fee schedule,,510.34,,,,fee schedule,,299.7,,,,fee schedule,,909.26,,,,fee schedule,,299.7,,,,fee schedule,,819.7,,,,fee schedule,,496.79,,,,fee schedule,,496.79,,,,fee schedule,,,3538.99,91,,percent of total billed charges,,,3694.55,95,,percent of total billed charges,,,3227.87,83,,percent of total billed charges,,,1166.7,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,3227.87,83,,percent of total billed charges,,730.28,,,,fee schedule,,,3500.1,90,,percent of total billed charges,,,3500.1,90,,percent of total billed charges,,,3500.1,90,,percent of total billed charges,,,3500.1,90,,percent of total billed charges,,,3305.65,85,,percent of total billed charges,,299.7,3694.55,
REVISION OF FOOT FASCIA,28250,CDM,28250,CPT,,,both,,3038,3038,708.01,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,2582.3,85,,percent of total billed charges,,872.97,,,,fee schedule,,421.72,,,,fee schedule,,359.3,,,,fee schedule,,720.91,,,,fee schedule,,359.3,,,,fee schedule,,687.18,,,,fee schedule,,416.47,,,,fee schedule,,416.47,,,,fee schedule,,,2764.58,91,,percent of total billed charges,,,2886.1,95,,percent of total billed charges,,,2521.54,83,,percent of total billed charges,,,911.4,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,2521.54,83,,percent of total billed charges,,612.22,,,,fee schedule,,,2734.2,90,,percent of total billed charges,,,2734.2,90,,percent of total billed charges,,,2734.2,90,,percent of total billed charges,,,2734.2,90,,percent of total billed charges,,,2582.3,85,,percent of total billed charges,,359.3,2886.1,
REPAIR OF HAMMERTOE,28285,CDM,28285,CPT,,,both,,2439,2439,661.34,,,,fee schedule,,,,,,,,270.5,,,,fee schedule,,,2073.15,85,,percent of total billed charges,,820.79,,,,fee schedule,,388.51,,,,fee schedule,,270.5,,,,fee schedule,,570.36,,,,fee schedule,,270.5,,,,fee schedule,,641.89,,,,fee schedule,,389.03,,,,fee schedule,,389.03,,,,fee schedule,,,2219.49,91,,percent of total billed charges,,,2317.05,95,,percent of total billed charges,,,2024.37,83,,percent of total billed charges,,,731.7,83,,percent of total billed charges,,270.5,,,,fee schedule,,270.5,,,,fee schedule,,,2024.37,83,,percent of total billed charges,,571.87,,,,fee schedule,,,2195.1,90,,percent of total billed charges,,,2195.1,90,,percent of total billed charges,,,2195.1,90,,percent of total billed charges,,,2195.1,90,,percent of total billed charges,,,2073.15,85,,percent of total billed charges,,270.5,2317.05,
PARTIAL REMOVAL OF FOOT BONE,28288,CDM,28288,CPT,,,both,,2615,2615,746.6,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,2222.75,85,,percent of total billed charges,,926.77,,,,fee schedule,,447.71,,,,fee schedule,,299.7,,,,fee schedule,,680.45,,,,fee schedule,,299.7,,,,fee schedule,,724.64,,,,fee schedule,,439.18,,,,fee schedule,,439.18,,,,fee schedule,,,2379.65,91,,percent of total billed charges,,,2484.25,95,,percent of total billed charges,,,2170.45,83,,percent of total billed charges,,,784.5,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,2170.45,83,,percent of total billed charges,,645.59,,,,fee schedule,,,2353.5,90,,percent of total billed charges,,,2353.5,90,,percent of total billed charges,,,2353.5,90,,percent of total billed charges,,,2353.5,90,,percent of total billed charges,,,2222.75,85,,percent of total billed charges,,299.7,2484.25,
REPAIR HALLUX RIGIDUS,28289,CDM,28289,CPT,,,both,,3283,3283,792.11,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,2790.55,85,,percent of total billed charges,,984.25,,,,fee schedule,,475.48,,,,fee schedule,,359.3,,,,fee schedule,,915.89,,,,fee schedule,,359.3,,,,fee schedule,,768.82,,,,fee schedule,,465.95,,,,fee schedule,,465.95,,,,fee schedule,,,2987.53,91,,percent of total billed charges,,,3118.85,95,,percent of total billed charges,,,2724.89,83,,percent of total billed charges,,,984.9,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,2724.89,83,,percent of total billed charges,,684.95,,,,fee schedule,,,2954.7,90,,percent of total billed charges,,,2954.7,90,,percent of total billed charges,,,2954.7,90,,percent of total billed charges,,,2954.7,90,,percent of total billed charges,,,2790.55,85,,percent of total billed charges,,359.3,3118.85,
CORRECTION OF BUNION,28292,CDM,28292,CPT,,,both,,3496,3496,828.98,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,2971.6,85,,percent of total billed charges,,1030.38,,,,fee schedule,,497.76,,,,fee schedule,,359.3,,,,fee schedule,,894,,,,fee schedule,,359.3,,,,fee schedule,,804.6,,,,fee schedule,,487.64,,,,fee schedule,,487.64,,,,fee schedule,,,3181.36,91,,percent of total billed charges,,,3321.2,95,,percent of total billed charges,,,2901.68,83,,percent of total billed charges,,,1048.8,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,2901.68,83,,percent of total billed charges,,716.83,,,,fee schedule,,,3146.4,90,,percent of total billed charges,,,3146.4,90,,percent of total billed charges,,,3146.4,90,,percent of total billed charges,,,3146.4,90,,percent of total billed charges,,,2971.6,85,,percent of total billed charges,,359.3,3321.2,
CORRECTION OF BUNION,28296,CDM,28296,CPT,,,both,,5123,5123,878.53,,,,fee schedule,,,,,,,,419,,,,fee schedule,,,4354.55,85,,percent of total billed charges,,1098.78,,,,fee schedule,,530.81,,,,fee schedule,,419,,,,fee schedule,,1046.54,,,,fee schedule,,419,,,,fee schedule,,852.69,,,,fee schedule,,516.78,,,,fee schedule,,516.78,,,,fee schedule,,,4661.93,91,,percent of total billed charges,,,4866.85,95,,percent of total billed charges,,,4252.09,83,,percent of total billed charges,,,1536.9,83,,percent of total billed charges,,419,,,,fee schedule,,419,,,,fee schedule,,,4252.09,83,,percent of total billed charges,,759.67,,,,fee schedule,,,4610.7,90,,percent of total billed charges,,,4610.7,90,,percent of total billed charges,,,4610.7,90,,percent of total billed charges,,,4610.7,90,,percent of total billed charges,,,4354.55,85,,percent of total billed charges,,419,4866.85,
INCISION OF HEEL BONE,28300,CDM,28300,CPT,,,both,,4654,4654,1123.94,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,3955.9,85,,percent of total billed charges,,1410.94,,,,fee schedule,,681.61,,,,fee schedule,,374.55,,,,fee schedule,,1199.74,,,,fee schedule,,374.55,,,,fee schedule,,1090.88,,,,fee schedule,,661.14,,,,fee schedule,,661.14,,,,fee schedule,,,4235.14,91,,percent of total billed charges,,,4421.3,95,,percent of total billed charges,,,3862.82,83,,percent of total billed charges,,,1396.2,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,3862.82,83,,percent of total billed charges,,971.87,,,,fee schedule,,,4188.6,90,,percent of total billed charges,,,4188.6,90,,percent of total billed charges,,,4188.6,90,,percent of total billed charges,,,4188.6,90,,percent of total billed charges,,,3955.9,85,,percent of total billed charges,,374.55,4421.3,
INCISION OF MIDFOOT BONES,28304,CDM,28304,CPT,,,both,,2446,2446,1059.42,,,,fee schedule,,,,,,,,283.6,,,,fee schedule,,,2079.1,85,,percent of total billed charges,,1324.95,,,,fee schedule,,640.07,,,,fee schedule,,283.6,,,,fee schedule,,1071.08,,,,fee schedule,,283.6,,,,fee schedule,,1028.26,,,,fee schedule,,623.19,,,,fee schedule,,623.19,,,,fee schedule,,,2225.86,91,,percent of total billed charges,,,2323.7,95,,percent of total billed charges,,,2030.18,83,,percent of total billed charges,,,733.8,83,,percent of total billed charges,,283.6,,,,fee schedule,,283.6,,,,fee schedule,,,2030.18,83,,percent of total billed charges,,916.08,,,,fee schedule,,,2201.4,90,,percent of total billed charges,,,2201.4,90,,percent of total billed charges,,,2201.4,90,,percent of total billed charges,,,2201.4,90,,percent of total billed charges,,,2079.1,85,,percent of total billed charges,,283.6,2323.7,
INCISION OF METATARSAL,28306,CDM,28306,CPT,,,both,,2971,2971,698.21,,,,fee schedule,,,,,,,,262.2,,,,fee schedule,,,2525.35,85,,percent of total billed charges,,867.99,,,,fee schedule,,419.31,,,,fee schedule,,262.2,,,,fee schedule,,720.24,,,,fee schedule,,262.2,,,,fee schedule,,677.68,,,,fee schedule,,410.71,,,,fee schedule,,410.71,,,,fee schedule,,,2703.61,91,,percent of total billed charges,,,2822.45,95,,percent of total billed charges,,,2465.93,83,,percent of total billed charges,,,891.3,83,,percent of total billed charges,,262.2,,,,fee schedule,,262.2,,,,fee schedule,,,2465.93,83,,percent of total billed charges,,603.75,,,,fee schedule,,,2673.9,90,,percent of total billed charges,,,2673.9,90,,percent of total billed charges,,,2673.9,90,,percent of total billed charges,,,2673.9,90,,percent of total billed charges,,,2525.35,85,,percent of total billed charges,,262.2,2822.45,
INCISION OF METATARSAL,28308,CDM,28308,CPT,,,both,,3035,3035,664.8,,,,fee schedule,,,,,,,,202.5,,,,fee schedule,,,2579.75,85,,percent of total billed charges,,824.99,,,,fee schedule,,398.54,,,,fee schedule,,202.5,,,,fee schedule,,640.66,,,,fee schedule,,202.5,,,,fee schedule,,645.25,,,,fee schedule,,391.06,,,,fee schedule,,391.06,,,,fee schedule,,,2761.85,91,,percent of total billed charges,,,2883.25,95,,percent of total billed charges,,,2519.05,83,,percent of total billed charges,,,910.5,83,,percent of total billed charges,,202.5,,,,fee schedule,,202.5,,,,fee schedule,,,2519.05,83,,percent of total billed charges,,574.86,,,,fee schedule,,,2731.5,90,,percent of total billed charges,,,2731.5,90,,percent of total billed charges,,,2731.5,90,,percent of total billed charges,,,2731.5,90,,percent of total billed charges,,,2579.75,85,,percent of total billed charges,,202.5,2883.25,
REMOVAL OF SESAMOID BONE,28315,CDM,28315,CPT,,,both,,2628,2628,561.68,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,2233.8,85,,percent of total billed charges,,701.94,,,,fee schedule,,339.1,,,,fee schedule,,224.7,,,,fee schedule,,584.28,,,,fee schedule,,224.7,,,,fee schedule,,545.16,,,,fee schedule,,330.4,,,,fee schedule,,330.4,,,,fee schedule,,,2391.48,91,,percent of total billed charges,,,2496.6,95,,percent of total billed charges,,,2181.24,83,,percent of total billed charges,,,788.4,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,2181.24,83,,percent of total billed charges,,485.69,,,,fee schedule,,,2365.2,90,,percent of total billed charges,,,2365.2,90,,percent of total billed charges,,,2365.2,90,,percent of total billed charges,,,2365.2,90,,percent of total billed charges,,,2233.8,85,,percent of total billed charges,,224.7,2496.6,
REPAIR OF METATARSALS,28322,CDM,28322,CPT,,,both,,4407,4407,998.93,,,,fee schedule,,,,,,,,244.9,,,,fee schedule,,,3745.95,85,,percent of total billed charges,,1247.96,,,,fee schedule,,602.87,,,,fee schedule,,244.9,,,,fee schedule,,1055.82,,,,fee schedule,,244.9,,,,fee schedule,,969.55,,,,fee schedule,,587.6,,,,fee schedule,,587.6,,,,fee schedule,,,4010.37,91,,percent of total billed charges,,,4186.65,95,,percent of total billed charges,,,3657.81,83,,percent of total billed charges,,,1322.1,83,,percent of total billed charges,,244.9,,,,fee schedule,,244.9,,,,fee schedule,,,3657.81,83,,percent of total billed charges,,863.78,,,,fee schedule,,,3966.3,90,,percent of total billed charges,,,3966.3,90,,percent of total billed charges,,,3966.3,90,,percent of total billed charges,,,3966.3,90,,percent of total billed charges,,,3745.95,85,,percent of total billed charges,,244.9,4186.65,
REPAIR WEBBED TOE(S),28345,CDM,28345,CPT,,,both,,2859,2859,619.29,,,,fee schedule,,,,,,,,216,,,,fee schedule,,,2430.15,85,,percent of total billed charges,,777.41,,,,fee schedule,,375.56,,,,fee schedule,,216,,,,fee schedule,,756.06,,,,fee schedule,,216,,,,fee schedule,,601.07,,,,fee schedule,,364.29,,,,fee schedule,,364.29,,,,fee schedule,,,2601.69,91,,percent of total billed charges,,,2716.05,95,,percent of total billed charges,,,2372.97,83,,percent of total billed charges,,,857.7,83,,percent of total billed charges,,216,,,,fee schedule,,216,,,,fee schedule,,,2372.97,83,,percent of total billed charges,,535.5,,,,fee schedule,,,2573.1,90,,percent of total billed charges,,,2573.1,90,,percent of total billed charges,,,2573.1,90,,percent of total billed charges,,,2573.1,90,,percent of total billed charges,,,2430.15,85,,percent of total billed charges,,216,2716.05,
TREATMENT OF HEEL FRACTURE,28400,CDM,28400,CPT,,,both,,1176,1176,403.83,,,,fee schedule,,,,,,,,114.2,,,,fee schedule,,,999.6,85,,percent of total billed charges,,491.28,,,,fee schedule,,237.33,,,,fee schedule,,114.2,,,,fee schedule,,367.42,,,,fee schedule,,114.2,,,,fee schedule,,391.96,,,,fee schedule,,237.55,,,,fee schedule,,237.55,,,,fee schedule,,,1070.16,91,,percent of total billed charges,,,1117.2,95,,percent of total billed charges,,,976.08,83,,percent of total billed charges,,,352.8,83,,percent of total billed charges,,114.2,,,,fee schedule,,114.2,,,,fee schedule,,,976.08,83,,percent of total billed charges,,349.2,,,,fee schedule,,,1058.4,90,,percent of total billed charges,,,1058.4,90,,percent of total billed charges,,,1058.4,90,,percent of total billed charges,,,1058.4,90,,percent of total billed charges,,,999.6,85,,percent of total billed charges,,114.2,1117.2,
TREATMENT OF HEEL FRACTURE,28400P,CDM,28400,CPT,,,both,P,490,490,403.83,,,,fee schedule,,,,,,,,114.2,,,,fee schedule,,,416.5,85,,percent of total billed charges,,491.28,,,,fee schedule,,237.33,,,,fee schedule,,114.2,,,,fee schedule,,367.42,,,,fee schedule,,114.2,,,,fee schedule,,391.96,,,,fee schedule,,237.55,,,,fee schedule,,237.55,,,,fee schedule,,,445.9,91,,percent of total billed charges,,,465.5,95,,percent of total billed charges,,,406.7,83,,percent of total billed charges,,,147,83,,percent of total billed charges,,114.2,,,,fee schedule,,114.2,,,,fee schedule,,,406.7,83,,percent of total billed charges,,349.2,,,,fee schedule,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,441,90,,percent of total billed charges,,,416.5,85,,percent of total billed charges,,114.2,491.28,
TREATMENT OF HEEL FRACTURE,28400T,CDM,28400,CPT,,,both,T,686,686,403.83,,,,fee schedule,,,,,,,,114.2,,,,fee schedule,,,583.1,85,,percent of total billed charges,,491.28,,,,fee schedule,,237.33,,,,fee schedule,,114.2,,,,fee schedule,,367.42,,,,fee schedule,,114.2,,,,fee schedule,,391.96,,,,fee schedule,,237.55,,,,fee schedule,,237.55,,,,fee schedule,,,624.26,91,,percent of total billed charges,,,651.7,95,,percent of total billed charges,,,569.38,83,,percent of total billed charges,,,205.8,83,,percent of total billed charges,,114.2,,,,fee schedule,,114.2,,,,fee schedule,,,569.38,83,,percent of total billed charges,,349.2,,,,fee schedule,,,617.4,90,,percent of total billed charges,,,617.4,90,,percent of total billed charges,,,617.4,90,,percent of total billed charges,,,617.4,90,,percent of total billed charges,,,583.1,85,,percent of total billed charges,,114.2,651.7,
TREATMENT OF HEEL FRACTURE,28405,CDM,28405,CPT,,,both,,1760,1760,712.61,,,,fee schedule,,,,,,,,228.9,,,,fee schedule,,,1496,85,,percent of total billed charges,,761,,,,fee schedule,,367.63,,,,fee schedule,,228.9,,,,fee schedule,,656.57,,,,fee schedule,,228.9,,,,fee schedule,,691.65,,,,fee schedule,,419.18,,,,fee schedule,,419.18,,,,fee schedule,,,1601.6,91,,percent of total billed charges,,,1672,95,,percent of total billed charges,,,1460.8,83,,percent of total billed charges,,,528,83,,percent of total billed charges,,228.9,,,,fee schedule,,228.9,,,,fee schedule,,,1460.8,83,,percent of total billed charges,,616.2,,,,fee schedule,,,1584,90,,percent of total billed charges,,,1584,90,,percent of total billed charges,,,1584,90,,percent of total billed charges,,,1584,90,,percent of total billed charges,,,1496,85,,percent of total billed charges,,228.9,1672,
TREAT HEEL FRACTURE,28415,CDM,28415,CPT,,,both,,5561,5561,1943.7,,,,fee schedule,,,,,,,,642.45,,,,fee schedule,,,4726.85,85,,percent of total billed charges,,2449.71,,,,fee schedule,,1183.43,,,,fee schedule,,642.45,,,,fee schedule,,2112.98,,,,fee schedule,,642.45,,,,fee schedule,,1886.53,,,,fee schedule,,1143.35,,,,fee schedule,,1143.35,,,,fee schedule,,,5060.51,91,,percent of total billed charges,,,5282.95,95,,percent of total billed charges,,,4615.63,83,,percent of total billed charges,,,1668.3,83,,percent of total billed charges,,642.45,,,,fee schedule,,642.45,,,,fee schedule,,,4615.63,83,,percent of total billed charges,,1680.73,,,,fee schedule,,,5004.9,90,,percent of total billed charges,,,5004.9,90,,percent of total billed charges,,,5004.9,90,,percent of total billed charges,,,5004.9,90,,percent of total billed charges,,,4726.85,85,,percent of total billed charges,,642.45,5282.95,
TREAT/GRAFT HEEL FRACTURE,28420,CDM,28420,CPT,,,both,,5232,5232,2245.57,,,,fee schedule,,,,,,,,671.85,,,,fee schedule,,,4447.2,85,,percent of total billed charges,,2832.39,,,,fee schedule,,1368.3,,,,fee schedule,,671.85,,,,fee schedule,,2140.83,,,,fee schedule,,671.85,,,,fee schedule,,2179.52,,,,fee schedule,,1320.92,,,,fee schedule,,1320.92,,,,fee schedule,,,4761.12,91,,percent of total billed charges,,,4970.4,95,,percent of total billed charges,,,4342.56,83,,percent of total billed charges,,,1569.6,83,,percent of total billed charges,,671.85,,,,fee schedule,,671.85,,,,fee schedule,,,4342.56,83,,percent of total billed charges,,1941.76,,,,fee schedule,,,4708.8,90,,percent of total billed charges,,,4708.8,90,,percent of total billed charges,,,4708.8,90,,percent of total billed charges,,,4708.8,90,,percent of total billed charges,,,4447.2,85,,percent of total billed charges,,671.85,4970.4,
TREATMENT OF ANKLE FRACTURE,28430,CDM,28430,CPT,,,both,,1103,1103,370.42,,,,fee schedule,,,,,,,,109,,,,fee schedule,,,937.55,85,,percent of total billed charges,,452.66,,,,fee schedule,,218.67,,,,fee schedule,,109,,,,fee schedule,,328.29,,,,fee schedule,,109,,,,fee schedule,,359.53,,,,fee schedule,,217.89,,,,fee schedule,,217.89,,,,fee schedule,,,1003.73,91,,percent of total billed charges,,,1047.85,95,,percent of total billed charges,,,915.49,83,,percent of total billed charges,,,330.9,83,,percent of total billed charges,,109,,,,fee schedule,,109,,,,fee schedule,,,915.49,83,,percent of total billed charges,,320.31,,,,fee schedule,,,992.7,90,,percent of total billed charges,,,992.7,90,,percent of total billed charges,,,992.7,90,,percent of total billed charges,,,992.7,90,,percent of total billed charges,,,937.55,85,,percent of total billed charges,,109,1047.85,
TREATMENT OF ANKLE FRACTURE,28430P,CDM,28430,CPT,,,both,P,820,820,370.42,,,,fee schedule,,,,,,,,109,,,,fee schedule,,,697,85,,percent of total billed charges,,452.66,,,,fee schedule,,218.67,,,,fee schedule,,109,,,,fee schedule,,328.29,,,,fee schedule,,109,,,,fee schedule,,359.53,,,,fee schedule,,217.89,,,,fee schedule,,217.89,,,,fee schedule,,,746.2,91,,percent of total billed charges,,,779,95,,percent of total billed charges,,,680.6,83,,percent of total billed charges,,,246,83,,percent of total billed charges,,109,,,,fee schedule,,109,,,,fee schedule,,,680.6,83,,percent of total billed charges,,320.31,,,,fee schedule,,,738,90,,percent of total billed charges,,,738,90,,percent of total billed charges,,,738,90,,percent of total billed charges,,,738,90,,percent of total billed charges,,,697,85,,percent of total billed charges,,109,779,
TREATMENT OF ANKLE FRACTURE,28430T,CDM,28430,CPT,,,both,T,283,283,370.42,,,,fee schedule,,,,,,,,109,,,,fee schedule,,,240.55,85,,percent of total billed charges,,452.66,,,,fee schedule,,218.67,,,,fee schedule,,109,,,,fee schedule,,328.29,,,,fee schedule,,109,,,,fee schedule,,359.53,,,,fee schedule,,217.89,,,,fee schedule,,217.89,,,,fee schedule,,,257.53,91,,percent of total billed charges,,,268.85,95,,percent of total billed charges,,,234.89,83,,percent of total billed charges,,,84.9,83,,percent of total billed charges,,109,,,,fee schedule,,109,,,,fee schedule,,,234.89,83,,percent of total billed charges,,320.31,,,,fee schedule,,,254.7,90,,percent of total billed charges,,,254.7,90,,percent of total billed charges,,,254.7,90,,percent of total billed charges,,,254.7,90,,percent of total billed charges,,,240.55,85,,percent of total billed charges,,84.9,452.66,
TREAT ANKLE FRACTURE,28445,CDM,28445,CPT,,,both,,5149,5149,1793.34,,,,fee schedule,,,,,,,,718.7,,,,fee schedule,,,4376.65,85,,percent of total billed charges,,2225.79,,,,fee schedule,,1075.26,,,,fee schedule,,718.7,,,,fee schedule,,1935.24,,,,fee schedule,,718.7,,,,fee schedule,,1740.6,,,,fee schedule,,1054.91,,,,fee schedule,,1054.91,,,,fee schedule,,,4685.59,91,,percent of total billed charges,,,4891.55,95,,percent of total billed charges,,,4273.67,83,,percent of total billed charges,,,1544.7,83,,percent of total billed charges,,718.7,,,,fee schedule,,718.7,,,,fee schedule,,,4273.67,83,,percent of total billed charges,,1550.72,,,,fee schedule,,,4634.1,90,,percent of total billed charges,,,4634.1,90,,percent of total billed charges,,,4634.1,90,,percent of total billed charges,,,4634.1,90,,percent of total billed charges,,,4376.65,85,,percent of total billed charges,,718.7,4891.55,
"TREAT MIDFOOT FRACTURE, EACH",28450,CDM,28450,CPT,,,both,,897,897,334.13,,,,fee schedule,,,,,,,,98,,,,fee schedule,,,762.45,85,,percent of total billed charges,,408.95,,,,fee schedule,,197.56,,,,fee schedule,,98,,,,fee schedule,,308.39,,,,fee schedule,,98,,,,fee schedule,,324.3,,,,fee schedule,,196.55,,,,fee schedule,,196.55,,,,fee schedule,,,816.27,91,,percent of total billed charges,,,852.15,95,,percent of total billed charges,,,744.51,83,,percent of total billed charges,,,269.1,83,,percent of total billed charges,,98,,,,fee schedule,,98,,,,fee schedule,,,744.51,83,,percent of total billed charges,,288.92,,,,fee schedule,,,807.3,90,,percent of total billed charges,,,807.3,90,,percent of total billed charges,,,807.3,90,,percent of total billed charges,,,807.3,90,,percent of total billed charges,,,762.45,85,,percent of total billed charges,,98,852.15,
TREAT MIDFOOT FRACTURE,28456,CDM,28456,CPT,,,both,,1415,1415,650.97,,,,fee schedule,,,,,,,,313.2,,,,fee schedule,,,1202.75,85,,percent of total billed charges,,793.69,,,,fee schedule,,383.42,,,,fee schedule,,313.2,,,,fee schedule,,482.15,,,,fee schedule,,313.2,,,,fee schedule,,631.83,,,,fee schedule,,382.93,,,,fee schedule,,382.93,,,,fee schedule,,,1287.65,91,,percent of total billed charges,,,1344.25,95,,percent of total billed charges,,,1174.45,83,,percent of total billed charges,,,424.5,83,,percent of total billed charges,,313.2,,,,fee schedule,,313.2,,,,fee schedule,,,1174.45,83,,percent of total billed charges,,562.9,,,,fee schedule,,,1273.5,90,,percent of total billed charges,,,1273.5,90,,percent of total billed charges,,,1273.5,90,,percent of total billed charges,,,1273.5,90,,percent of total billed charges,,,1202.75,85,,percent of total billed charges,,313.2,1344.25,
TREAT MIDFOOT FRACTURE,28456P,CDM,28456,CPT,,,both,P,1223,1223,650.97,,,,fee schedule,,,,,,,,313.2,,,,fee schedule,,,1039.55,85,,percent of total billed charges,,793.69,,,,fee schedule,,383.42,,,,fee schedule,,313.2,,,,fee schedule,,482.15,,,,fee schedule,,313.2,,,,fee schedule,,631.83,,,,fee schedule,,382.93,,,,fee schedule,,382.93,,,,fee schedule,,,1112.93,91,,percent of total billed charges,,,1161.85,95,,percent of total billed charges,,,1015.09,83,,percent of total billed charges,,,366.9,83,,percent of total billed charges,,313.2,,,,fee schedule,,313.2,,,,fee schedule,,,1015.09,83,,percent of total billed charges,,562.9,,,,fee schedule,,,1100.7,90,,percent of total billed charges,,,1100.7,90,,percent of total billed charges,,,1100.7,90,,percent of total billed charges,,,1100.7,90,,percent of total billed charges,,,1039.55,85,,percent of total billed charges,,313.2,1161.85,
TREAT MIDFOOT FRACTURE,28456T,CDM,28456,CPT,,,both,T,192,192,650.97,,,,fee schedule,,,,,,,,313.2,,,,fee schedule,,,163.2,85,,percent of total billed charges,,793.69,,,,fee schedule,,383.42,,,,fee schedule,,313.2,,,,fee schedule,,482.15,,,,fee schedule,,313.2,,,,fee schedule,,631.83,,,,fee schedule,,382.93,,,,fee schedule,,382.93,,,,fee schedule,,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,57.6,83,,percent of total billed charges,,313.2,,,,fee schedule,,313.2,,,,fee schedule,,,159.36,83,,percent of total billed charges,,562.9,,,,fee schedule,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,57.6,793.69,
TREAT METATARSAL FRACTURE,28470,CDM,28470,CPT,,,both,,997,997,358.9,,,,fee schedule,,,,,,,,97.05,,,,fee schedule,,,847.45,85,,percent of total billed charges,,437.88,,,,fee schedule,,211.53,,,,fee schedule,,97.05,,,,fee schedule,,313.03,,,,fee schedule,,97.05,,,,fee schedule,,348.34,,,,fee schedule,,211.12,,,,fee schedule,,211.12,,,,fee schedule,,,907.27,91,,percent of total billed charges,,,947.15,95,,percent of total billed charges,,,827.51,83,,percent of total billed charges,,,299.1,83,,percent of total billed charges,,97.05,,,,fee schedule,,97.05,,,,fee schedule,,,827.51,83,,percent of total billed charges,,310.34,,,,fee schedule,,,897.3,90,,percent of total billed charges,,,897.3,90,,percent of total billed charges,,,897.3,90,,percent of total billed charges,,,897.3,90,,percent of total billed charges,,,847.45,85,,percent of total billed charges,,97.05,947.15,
TREAT METATARSAL FRACTURE,28475,CDM,28475,CPT,,,both,,1176,1176,396.34,,,,fee schedule,,,,,,,,173.4,,,,fee schedule,,,999.6,85,,percent of total billed charges,,484.35,,,,fee schedule,,233.98,,,,fee schedule,,173.4,,,,fee schedule,,438.38,,,,fee schedule,,173.4,,,,fee schedule,,384.69,,,,fee schedule,,233.14,,,,fee schedule,,233.14,,,,fee schedule,,,1070.16,91,,percent of total billed charges,,,1117.2,95,,percent of total billed charges,,,976.08,83,,percent of total billed charges,,,352.8,83,,percent of total billed charges,,173.4,,,,fee schedule,,173.4,,,,fee schedule,,,976.08,83,,percent of total billed charges,,342.72,,,,fee schedule,,,1058.4,90,,percent of total billed charges,,,1058.4,90,,percent of total billed charges,,,1058.4,90,,percent of total billed charges,,,1058.4,90,,percent of total billed charges,,,999.6,85,,percent of total billed charges,,173.4,1117.2,
TREAT METATARSAL FRACTURE,28476,CDM,28476,CPT,,,both,,1793,1793,678.63,,,,fee schedule,,,,,,,,237.85,,,,fee schedule,,,1524.05,85,,percent of total billed charges,,830.11,,,,fee schedule,,401.02,,,,fee schedule,,237.85,,,,fee schedule,,589.59,,,,fee schedule,,237.85,,,,fee schedule,,658.67,,,,fee schedule,,399.19,,,,fee schedule,,399.19,,,,fee schedule,,,1631.63,91,,percent of total billed charges,,,1703.35,95,,percent of total billed charges,,,1488.19,83,,percent of total billed charges,,,537.9,83,,percent of total billed charges,,237.85,,,,fee schedule,,237.85,,,,fee schedule,,,1488.19,83,,percent of total billed charges,,586.81,,,,fee schedule,,,1613.7,90,,percent of total billed charges,,,1613.7,90,,percent of total billed charges,,,1613.7,90,,percent of total billed charges,,,1613.7,90,,percent of total billed charges,,,1524.05,85,,percent of total billed charges,,237.85,1703.35,
TREAT METATARSAL FRACTURE,28485,CDM,28485,CPT,,,both,,2631,2631,972.43,,,,fee schedule,,,,,,,,1505,,,,fee schedule,,,2236.35,85,,percent of total billed charges,,1207.4,,,,fee schedule,,583.28,,,,fee schedule,,1505,,,,fee schedule,,793.86,,,,fee schedule,,1505,,,,fee schedule,,943.83,,,,fee schedule,,572.02,,,,fee schedule,,572.02,,,,fee schedule,,,2394.21,91,,percent of total billed charges,,,2499.45,95,,percent of total billed charges,,,2183.73,83,,percent of total billed charges,,,789.3,83,,percent of total billed charges,,1505,,,,fee schedule,,1505,,,,fee schedule,,,2183.73,83,,percent of total billed charges,,840.86,,,,fee schedule,,,2367.9,90,,percent of total billed charges,,,2367.9,90,,percent of total billed charges,,,2367.9,90,,percent of total billed charges,,,2367.9,90,,percent of total billed charges,,,2236.35,85,,percent of total billed charges,,572.02,2499.45,
TREAT BIG TOE FRACTURE,28490,CDM,28490,CPT,,,both,,611,611,218.91,,,,fee schedule,,,,,,,,55.4,,,,fee schedule,,,519.35,85,,percent of total billed charges,,263.56,,,,fee schedule,,127.32,,,,fee schedule,,55.4,,,,fee schedule,,190.34,,,,fee schedule,,55.4,,,,fee schedule,,212.47,,,,fee schedule,,128.77,,,,fee schedule,,128.77,,,,fee schedule,,,556.01,91,,percent of total billed charges,,,580.45,95,,percent of total billed charges,,,507.13,83,,percent of total billed charges,,,183.3,83,,percent of total billed charges,,55.4,,,,fee schedule,,55.4,,,,fee schedule,,,507.13,83,,percent of total billed charges,,189.29,,,,fee schedule,,,549.9,90,,percent of total billed charges,,,549.9,90,,percent of total billed charges,,,549.9,90,,percent of total billed charges,,,549.9,90,,percent of total billed charges,,,519.35,85,,percent of total billed charges,,55.4,580.45,
TREAT BIG TOE FRACTURE,28495,CDM,28495,CPT,,,both,,711,711,259.24,,,,fee schedule,,,,,,,,69.3,,,,fee schedule,,,604.35,85,,percent of total billed charges,,316.78,,,,fee schedule,,153.03,,,,fee schedule,,69.3,,,,fee schedule,,254.67,,,,fee schedule,,69.3,,,,fee schedule,,251.61,,,,fee schedule,,152.49,,,,fee schedule,,152.49,,,,fee schedule,,,647.01,91,,percent of total billed charges,,,675.45,95,,percent of total billed charges,,,590.13,83,,percent of total billed charges,,,213.3,83,,percent of total billed charges,,69.3,,,,fee schedule,,69.3,,,,fee schedule,,,590.13,83,,percent of total billed charges,,224.16,,,,fee schedule,,,639.9,90,,percent of total billed charges,,,639.9,90,,percent of total billed charges,,,639.9,90,,percent of total billed charges,,,639.9,90,,percent of total billed charges,,,604.35,85,,percent of total billed charges,,69.3,675.45,
TREAT BIG TOE FRACTURE,28496,CDM,28496,CPT,,,both,,1927,1927,431.49,,,,fee schedule,,,,,,,,113.6,,,,fee schedule,,,1637.95,85,,percent of total billed charges,,520.37,,,,fee schedule,,251.38,,,,fee schedule,,113.6,,,,fee schedule,,389.97,,,,fee schedule,,113.6,,,,fee schedule,,418.79,,,,fee schedule,,253.82,,,,fee schedule,,253.82,,,,fee schedule,,,1753.57,91,,percent of total billed charges,,,1830.65,95,,percent of total billed charges,,,1599.41,83,,percent of total billed charges,,,578.1,83,,percent of total billed charges,,113.6,,,,fee schedule,,113.6,,,,fee schedule,,,1599.41,83,,percent of total billed charges,,373.11,,,,fee schedule,,,1734.3,90,,percent of total billed charges,,,1734.3,90,,percent of total billed charges,,,1734.3,90,,percent of total billed charges,,,1734.3,90,,percent of total billed charges,,,1637.95,85,,percent of total billed charges,,113.6,1830.65,
TREAT BIG TOE FRACTURE,28505,CDM,28505,CPT,,,both,,2352,2352,853.18,,,,fee schedule,,,,,,,,230.8,,,,fee schedule,,,1999.2,85,,percent of total billed charges,,1074.99,,,,fee schedule,,519.31,,,,fee schedule,,230.8,,,,fee schedule,,547.15,,,,fee schedule,,230.8,,,,fee schedule,,828.08,,,,fee schedule,,501.87,,,,fee schedule,,501.87,,,,fee schedule,,,2140.32,91,,percent of total billed charges,,,2234.4,95,,percent of total billed charges,,,1952.16,83,,percent of total billed charges,,,705.6,83,,percent of total billed charges,,230.8,,,,fee schedule,,230.8,,,,fee schedule,,,1952.16,83,,percent of total billed charges,,737.75,,,,fee schedule,,,2116.8,90,,percent of total billed charges,,,2116.8,90,,percent of total billed charges,,,2116.8,90,,percent of total billed charges,,,2116.8,90,,percent of total billed charges,,,1999.2,85,,percent of total billed charges,,230.8,2234.4,
TREATMENT OF TOE FRACTURE,28510,CDM,28510,CPT,,,both,,527,527,210.27,,,,fee schedule,,,,,,,,41.6,,,,fee schedule,,,447.95,85,,percent of total billed charges,,250.92,,,,fee schedule,,121.22,,,,fee schedule,,41.6,,,,fee schedule,,182.38,,,,fee schedule,,41.6,,,,fee schedule,,204.09,,,,fee schedule,,123.69,,,,fee schedule,,123.69,,,,fee schedule,,,479.57,91,,percent of total billed charges,,,500.65,95,,percent of total billed charges,,,437.41,83,,percent of total billed charges,,,158.1,83,,percent of total billed charges,,41.6,,,,fee schedule,,41.6,,,,fee schedule,,,437.41,83,,percent of total billed charges,,181.82,,,,fee schedule,,,474.3,90,,percent of total billed charges,,,474.3,90,,percent of total billed charges,,,474.3,90,,percent of total billed charges,,,474.3,90,,percent of total billed charges,,,447.95,85,,percent of total billed charges,,41.6,500.65,
TREATMENT OF TOE FRACTURE,28510P,CDM,28510,CPT,,,both,P,261,261,210.27,,,,fee schedule,,,,,,,,41.6,,,,fee schedule,,,221.85,85,,percent of total billed charges,,250.92,,,,fee schedule,,121.22,,,,fee schedule,,41.6,,,,fee schedule,,182.38,,,,fee schedule,,41.6,,,,fee schedule,,204.09,,,,fee schedule,,123.69,,,,fee schedule,,123.69,,,,fee schedule,,,237.51,91,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,78.3,83,,percent of total billed charges,,41.6,,,,fee schedule,,41.6,,,,fee schedule,,,216.63,83,,percent of total billed charges,,181.82,,,,fee schedule,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,221.85,85,,percent of total billed charges,,41.6,250.92,
TREATMENT OF TOE FRACTURE,28510T,CDM,28510,CPT,,,both,T,266,266,210.27,,,,fee schedule,,,,,,,,41.6,,,,fee schedule,,,226.1,85,,percent of total billed charges,,250.92,,,,fee schedule,,121.22,,,,fee schedule,,41.6,,,,fee schedule,,182.38,,,,fee schedule,,41.6,,,,fee schedule,,204.09,,,,fee schedule,,123.69,,,,fee schedule,,123.69,,,,fee schedule,,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,79.8,83,,percent of total billed charges,,41.6,,,,fee schedule,,41.6,,,,fee schedule,,,220.78,83,,percent of total billed charges,,181.82,,,,fee schedule,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,41.6,252.7,
TREATMENT OF TOE FRACTURE,28515,CDM,28515,CPT,,,both,,676,676,250.02,,,,fee schedule,,,,,,,,97.05,,,,fee schedule,,,574.6,85,,percent of total billed charges,,302.59,,,,fee schedule,,146.18,,,,fee schedule,,97.05,,,,fee schedule,,234.11,,,,fee schedule,,97.05,,,,fee schedule,,242.67,,,,fee schedule,,147.07,,,,fee schedule,,147.07,,,,fee schedule,,,615.16,91,,percent of total billed charges,,,642.2,95,,percent of total billed charges,,,561.08,83,,percent of total billed charges,,,202.8,83,,percent of total billed charges,,97.05,,,,fee schedule,,97.05,,,,fee schedule,,,561.08,83,,percent of total billed charges,,216.19,,,,fee schedule,,,608.4,90,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,608.4,90,,percent of total billed charges,,,574.6,85,,percent of total billed charges,,97.05,642.2,
TREAT SESAMOID BONE FRACTURE,28530,CDM,28530,CPT,,,both,,541,541,175.13,,,,fee schedule,,,,,,,,57.3,,,,fee schedule,,,459.85,85,,percent of total billed charges,,208.4,,,,fee schedule,,100.67,,,,fee schedule,,57.3,,,,fee schedule,,175.09,,,,fee schedule,,57.3,,,,fee schedule,,169.98,,,,fee schedule,,103.02,,,,fee schedule,,103.02,,,,fee schedule,,,492.31,91,,percent of total billed charges,,,513.95,95,,percent of total billed charges,,,449.03,83,,percent of total billed charges,,,162.3,83,,percent of total billed charges,,57.3,,,,fee schedule,,57.3,,,,fee schedule,,,449.03,83,,percent of total billed charges,,151.44,,,,fee schedule,,,486.9,90,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,459.85,85,,percent of total billed charges,,57.3,513.95,
REPAIR FOOT DISLOCATION,28555,CDM,28555,CPT,,,both,,3508,3508,1148.13,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,2981.8,85,,percent of total billed charges,,1427.1,,,,fee schedule,,689.42,,,,fee schedule,,480,,,,fee schedule,,862.17,,,,fee schedule,,480,,,,fee schedule,,1114.36,,,,fee schedule,,675.37,,,,fee schedule,,675.37,,,,fee schedule,,,3192.28,91,,percent of total billed charges,,,3332.6,95,,percent of total billed charges,,,2911.64,83,,percent of total billed charges,,,1052.4,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2911.64,83,,percent of total billed charges,,992.8,,,,fee schedule,,,3157.2,90,,percent of total billed charges,,,3157.2,90,,percent of total billed charges,,,3157.2,90,,percent of total billed charges,,,3157.2,90,,percent of total billed charges,,,2981.8,85,,percent of total billed charges,,480,3332.6,
TREAT FOOT DISLOCATION,28570,CDM,28570,CPT,,,both,,759,759,346.8,,,,fee schedule,,,,,,,,113.65,,,,fee schedule,,,645.15,85,,percent of total billed charges,,419.53,,,,fee schedule,,202.67,,,,fee schedule,,113.65,,,,fee schedule,,279.21,,,,fee schedule,,113.65,,,,fee schedule,,336.6,,,,fee schedule,,204,,,,fee schedule,,204,,,,fee schedule,,,690.69,91,,percent of total billed charges,,,721.05,95,,percent of total billed charges,,,629.97,83,,percent of total billed charges,,,227.7,83,,percent of total billed charges,,113.65,,,,fee schedule,,113.65,,,,fee schedule,,,629.97,83,,percent of total billed charges,,299.88,,,,fee schedule,,,683.1,90,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,645.15,85,,percent of total billed charges,,113.65,721.05,
TREAT FOOT DISLOCATION,28606,CDM,28606,CPT,,,both,,2189,2189,669.41,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,1860.65,85,,percent of total billed charges,,823.25,,,,fee schedule,,397.7,,,,fee schedule,,299.7,,,,fee schedule,,689.73,,,,fee schedule,,299.7,,,,fee schedule,,649.72,,,,fee schedule,,393.77,,,,fee schedule,,393.77,,,,fee schedule,,,1991.99,91,,percent of total billed charges,,,2079.55,95,,percent of total billed charges,,,1816.87,83,,percent of total billed charges,,,656.7,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,1816.87,83,,percent of total billed charges,,578.84,,,,fee schedule,,,1970.1,90,,percent of total billed charges,,,1970.1,90,,percent of total billed charges,,,1970.1,90,,percent of total billed charges,,,1970.1,90,,percent of total billed charges,,,1860.65,85,,percent of total billed charges,,299.7,2079.55,
REPAIR FOOT DISLOCATION,28615,CDM,28615,CPT,,,both,,3613,3613,1431.56,,,,fee schedule,,,,,,,,1842.25,,,,fee schedule,,,3071.05,85,,percent of total billed charges,,1785.89,,,,fee schedule,,862.74,,,,fee schedule,,1842.25,,,,fee schedule,,1133.42,,,,fee schedule,,1842.25,,,,fee schedule,,1389.46,,,,fee schedule,,842.1,,,,fee schedule,,842.1,,,,fee schedule,,,3287.83,91,,percent of total billed charges,,,3432.35,95,,percent of total billed charges,,,2998.79,83,,percent of total billed charges,,,1083.9,83,,percent of total billed charges,,1842.25,,,,fee schedule,,1842.25,,,,fee schedule,,,2998.79,83,,percent of total billed charges,,1237.88,,,,fee schedule,,,3251.7,90,,percent of total billed charges,,,3251.7,90,,percent of total billed charges,,,3251.7,90,,percent of total billed charges,,,3251.7,90,,percent of total billed charges,,,3071.05,85,,percent of total billed charges,,842.1,3432.35,
TREAT TOE DISLOCATION,28630,CDM,28630,CPT,,,both,,693,693,191.26,,,,fee schedule,,,,,,,,112.4,,,,fee schedule,,,589.05,85,,percent of total billed charges,,239.6,,,,fee schedule,,115.75,,,,fee schedule,,112.4,,,,fee schedule,,191.67,,,,fee schedule,,112.4,,,,fee schedule,,185.63,,,,fee schedule,,112.51,,,,fee schedule,,112.51,,,,fee schedule,,,630.63,91,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,207.9,83,,percent of total billed charges,,112.4,,,,fee schedule,,112.4,,,,fee schedule,,,575.19,83,,percent of total billed charges,,165.38,,,,fee schedule,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,589.05,85,,percent of total billed charges,,112.4,658.35,
TREAT TOE DISLOCATION,28665,CDM,28665,CPT,,,both,,679,679,214.3,,,,fee schedule,,,,,,,,117.85,,,,fee schedule,,,577.15,85,,percent of total billed charges,,271.5,,,,fee schedule,,131.16,,,,fee schedule,,117.85,,,,fee schedule,,238.75,,,,fee schedule,,117.85,,,,fee schedule,,208,,,,fee schedule,,126.06,,,,fee schedule,,126.06,,,,fee schedule,,,617.89,91,,percent of total billed charges,,,645.05,95,,percent of total billed charges,,,563.57,83,,percent of total billed charges,,,203.7,83,,percent of total billed charges,,117.85,,,,fee schedule,,117.85,,,,fee schedule,,,563.57,83,,percent of total billed charges,,185.31,,,,fee schedule,,,611.1,90,,percent of total billed charges,,,611.1,90,,percent of total billed charges,,,611.1,90,,percent of total billed charges,,,611.1,90,,percent of total billed charges,,,577.15,85,,percent of total billed charges,,117.85,645.05,
FUSION OF FOOT BONES,28715,CDM,28715,CPT,,,both,,5107,5107,1622.82,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,4340.95,85,,percent of total billed charges,,2039.61,,,,fee schedule,,985.31,,,,fee schedule,,599.35,,,,fee schedule,,1656.03,,,,fee schedule,,599.35,,,,fee schedule,,1575.09,,,,fee schedule,,954.6,,,,fee schedule,,954.6,,,,fee schedule,,,4647.37,91,,percent of total billed charges,,,4851.65,95,,percent of total billed charges,,,4238.81,83,,percent of total billed charges,,,1532.1,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,4238.81,83,,percent of total billed charges,,1403.27,,,,fee schedule,,,4596.3,90,,percent of total billed charges,,,4596.3,90,,percent of total billed charges,,,4596.3,90,,percent of total billed charges,,,4596.3,90,,percent of total billed charges,,,4340.95,85,,percent of total billed charges,,599.35,4851.65,
FUSION OF FOOT BONES,28725,CDM,28725,CPT,,,both,,4166,4166,1342.27,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3541.1,85,,percent of total billed charges,,1685.2,,,,fee schedule,,814.1,,,,fee schedule,,480,,,,fee schedule,,1437.83,,,,fee schedule,,480,,,,fee schedule,,1302.79,,,,fee schedule,,789.57,,,,fee schedule,,789.57,,,,fee schedule,,,3791.06,91,,percent of total billed charges,,,3957.7,95,,percent of total billed charges,,,3457.78,83,,percent of total billed charges,,,1249.8,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3457.78,83,,percent of total billed charges,,1160.67,,,,fee schedule,,,3749.4,90,,percent of total billed charges,,,3749.4,90,,percent of total billed charges,,,3749.4,90,,percent of total billed charges,,,3749.4,90,,percent of total billed charges,,,3541.1,85,,percent of total billed charges,,480,3957.7,
FUSION OF FOOT BONES,28740,CDM,28740,CPT,,,both,,3470,3470,1063.45,,,,fee schedule,,,,,,,,337.1,,,,fee schedule,,,2949.5,85,,percent of total billed charges,,1335.26,,,,fee schedule,,645.05,,,,fee schedule,,337.1,,,,fee schedule,,1040.57,,,,fee schedule,,337.1,,,,fee schedule,,1032.17,,,,fee schedule,,625.56,,,,fee schedule,,625.56,,,,fee schedule,,,3157.7,91,,percent of total billed charges,,,3296.5,95,,percent of total billed charges,,,2880.1,83,,percent of total billed charges,,,1041,83,,percent of total billed charges,,337.1,,,,fee schedule,,337.1,,,,fee schedule,,,2880.1,83,,percent of total billed charges,,919.57,,,,fee schedule,,,3123,90,,percent of total billed charges,,,3123,90,,percent of total billed charges,,,3123,90,,percent of total billed charges,,,3123,90,,percent of total billed charges,,,2949.5,85,,percent of total billed charges,,337.1,3296.5,
FUSION OF BIG TOE JOINT,28750,CDM,28750,CPT,,,both,,3630,3630,994.32,,,,fee schedule,,,,,,,,262.2,,,,fee schedule,,,3085.5,85,,percent of total billed charges,,1250.1,,,,fee schedule,,603.91,,,,fee schedule,,262.2,,,,fee schedule,,998.79,,,,fee schedule,,262.2,,,,fee schedule,,965.07,,,,fee schedule,,584.89,,,,fee schedule,,584.89,,,,fee schedule,,,3303.3,91,,percent of total billed charges,,,3448.5,95,,percent of total billed charges,,,3012.9,83,,percent of total billed charges,,,1089,83,,percent of total billed charges,,262.2,,,,fee schedule,,262.2,,,,fee schedule,,,3012.9,83,,percent of total billed charges,,859.79,,,,fee schedule,,,3267,90,,percent of total billed charges,,,3267,90,,percent of total billed charges,,,3267,90,,percent of total billed charges,,,3267,90,,percent of total billed charges,,,3085.5,85,,percent of total billed charges,,262.2,3448.5,
FUSION OF BIG TOE JOINT,28755,CDM,28755,CPT,,,both,,2234,2234,574.35,,,,fee schedule,,,,,,,,169.1,,,,fee schedule,,,1898.9,85,,percent of total billed charges,,718.17,,,,fee schedule,,346.94,,,,fee schedule,,169.1,,,,fee schedule,,605.51,,,,fee schedule,,169.1,,,,fee schedule,,557.46,,,,fee schedule,,337.86,,,,fee schedule,,337.86,,,,fee schedule,,,2032.94,91,,percent of total billed charges,,,2122.3,95,,percent of total billed charges,,,1854.22,83,,percent of total billed charges,,,670.2,83,,percent of total billed charges,,169.1,,,,fee schedule,,169.1,,,,fee schedule,,,1854.22,83,,percent of total billed charges,,496.65,,,,fee schedule,,,2010.6,90,,percent of total billed charges,,,2010.6,90,,percent of total billed charges,,,2010.6,90,,percent of total billed charges,,,2010.6,90,,percent of total billed charges,,,1898.9,85,,percent of total billed charges,,169.1,2122.3,
FUSION OF BIG TOE JOINT,28760,CDM,28760,CPT,,,both,,3089,3089,970.7,,,,fee schedule,,,,,,,,239.1,,,,fee schedule,,,2625.65,85,,percent of total billed charges,,1223.54,,,,fee schedule,,591.08,,,,fee schedule,,239.1,,,,fee schedule,,949.05,,,,fee schedule,,239.1,,,,fee schedule,,942.15,,,,fee schedule,,571,,,,fee schedule,,571,,,,fee schedule,,,2810.99,91,,percent of total billed charges,,,2934.55,95,,percent of total billed charges,,,2563.87,83,,percent of total billed charges,,,926.7,83,,percent of total billed charges,,239.1,,,,fee schedule,,239.1,,,,fee schedule,,,2563.87,83,,percent of total billed charges,,839.37,,,,fee schedule,,,2780.1,90,,percent of total billed charges,,,2780.1,90,,percent of total billed charges,,,2780.1,90,,percent of total billed charges,,,2780.1,90,,percent of total billed charges,,,2625.65,85,,percent of total billed charges,,239.1,2934.55,
AMPUTATION THRU METATARSAL,28805,CDM,28805,CPT,,,both,,3043,3043,1210.93,,,,fee schedule,,,,,,,,482.8,,,,fee schedule,,,2586.55,85,,percent of total billed charges,,1550.89,,,,fee schedule,,749.22,,,,fee schedule,,482.8,,,,fee schedule,,1007.41,,,,fee schedule,,482.8,,,,fee schedule,,1175.31,,,,fee schedule,,712.31,,,,fee schedule,,712.31,,,,fee schedule,,,2769.13,91,,percent of total billed charges,,,2890.85,95,,percent of total billed charges,,,2525.69,83,,percent of total billed charges,,,912.9,83,,percent of total billed charges,,482.8,,,,fee schedule,,482.8,,,,fee schedule,,,2525.69,83,,percent of total billed charges,,1047.09,,,,fee schedule,,,2738.7,90,,percent of total billed charges,,,2738.7,90,,percent of total billed charges,,,2738.7,90,,percent of total billed charges,,,2738.7,90,,percent of total billed charges,,,2586.55,85,,percent of total billed charges,,482.8,2890.85,
AMPUTATION TOE/METATARSAL,28810,CDM,28810,CPT,,,both,,1925,1925,725.29,,,,fee schedule,,,,,,,,419,,,,fee schedule,,,1636.25,85,,percent of total billed charges,,922.82,,,,fee schedule,,445.81,,,,fee schedule,,419,,,,fee schedule,,764.68,,,,fee schedule,,419,,,,fee schedule,,703.96,,,,fee schedule,,426.64,,,,fee schedule,,426.64,,,,fee schedule,,,1751.75,91,,percent of total billed charges,,,1828.75,95,,percent of total billed charges,,,1597.75,83,,percent of total billed charges,,,577.5,83,,percent of total billed charges,,419,,,,fee schedule,,419,,,,fee schedule,,,1597.75,83,,percent of total billed charges,,627.16,,,,fee schedule,,,1732.5,90,,percent of total billed charges,,,1732.5,90,,percent of total billed charges,,,1732.5,90,,percent of total billed charges,,,1732.5,90,,percent of total billed charges,,,1636.25,85,,percent of total billed charges,,419,1828.75,
AMPUTATION OF TOE,28820,CDM,28820,CPT,,,both,,2037,2037,304.17,,,,fee schedule,,,,,,,,167.1,,,,fee schedule,,,1731.45,85,,percent of total billed charges,,390.77,,,,fee schedule,,188.78,,,,fee schedule,,167.1,,,,fee schedule,,582.96,,,,fee schedule,,167.1,,,,fee schedule,,295.23,,,,fee schedule,,178.92,,,,fee schedule,,178.92,,,,fee schedule,,,1853.67,91,,percent of total billed charges,,,1935.15,95,,percent of total billed charges,,,1690.71,83,,percent of total billed charges,,,611.1,83,,percent of total billed charges,,167.1,,,,fee schedule,,167.1,,,,fee schedule,,,1690.71,83,,percent of total billed charges,,263.02,,,,fee schedule,,,1833.3,90,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1731.45,85,,percent of total billed charges,,167.1,1935.15,
PARTIAL AMPUTATION OF TOE,28825,CDM,28825,CPT,,,both,,2048,2048,294.38,,,,fee schedule,,,,,,,,145.6,,,,fee schedule,,,1740.8,85,,percent of total billed charges,,379.45,,,,fee schedule,,183.31,,,,fee schedule,,145.6,,,,fee schedule,,501.38,,,,fee schedule,,145.6,,,,fee schedule,,285.72,,,,fee schedule,,173.16,,,,fee schedule,,173.16,,,,fee schedule,,,1863.68,91,,percent of total billed charges,,,1945.6,95,,percent of total billed charges,,,1699.84,83,,percent of total billed charges,,,614.4,83,,percent of total billed charges,,145.6,,,,fee schedule,,145.6,,,,fee schedule,,,1699.84,83,,percent of total billed charges,,254.55,,,,fee schedule,,,1843.2,90,,percent of total billed charges,,,1843.2,90,,percent of total billed charges,,,1843.2,90,,percent of total billed charges,,,1843.2,90,,percent of total billed charges,,,1740.8,85,,percent of total billed charges,,145.6,1945.6,
APPLICATION OF SHOULDER CAST,29055,CDM,29055,CPT,,,both,,1080,1080,236.19,,,,fee schedule,,,,,,,,115.8,,,,fee schedule,,,918,85,,percent of total billed charges,,294.21,,,,fee schedule,,142.13,,,,fee schedule,,115.8,,,,fee schedule,,234.11,,,,fee schedule,,115.8,,,,fee schedule,,229.25,,,,fee schedule,,138.94,,,,fee schedule,,138.94,,,,fee schedule,,,982.8,91,,percent of total billed charges,,,1026,95,,percent of total billed charges,,,896.4,83,,percent of total billed charges,,,324,83,,percent of total billed charges,,115.8,,,,fee schedule,,115.8,,,,fee schedule,,,896.4,83,,percent of total billed charges,,204.24,,,,fee schedule,,,972,90,,percent of total billed charges,,,972,90,,percent of total billed charges,,,972,90,,percent of total billed charges,,,972,90,,percent of total billed charges,,,918,85,,percent of total billed charges,,115.8,1026,
APPLICATION OF SHOULDER CAST,29055P,CDM,29055,CPT,,,both,P,898,898,236.19,,,,fee schedule,,,,,,,,115.8,,,,fee schedule,,,763.3,85,,percent of total billed charges,,294.21,,,,fee schedule,,142.13,,,,fee schedule,,115.8,,,,fee schedule,,234.11,,,,fee schedule,,115.8,,,,fee schedule,,229.25,,,,fee schedule,,138.94,,,,fee schedule,,138.94,,,,fee schedule,,,817.18,91,,percent of total billed charges,,,853.1,95,,percent of total billed charges,,,745.34,83,,percent of total billed charges,,,269.4,83,,percent of total billed charges,,115.8,,,,fee schedule,,115.8,,,,fee schedule,,,745.34,83,,percent of total billed charges,,204.24,,,,fee schedule,,,808.2,90,,percent of total billed charges,,,808.2,90,,percent of total billed charges,,,808.2,90,,percent of total billed charges,,,808.2,90,,percent of total billed charges,,,763.3,85,,percent of total billed charges,,115.8,853.1,
APPLICATION OF SHOULDER CAST,29055T,CDM,29055,CPT,,,both,T,182,182,236.19,,,,fee schedule,,,,,,,,115.8,,,,fee schedule,,,154.7,85,,percent of total billed charges,,294.21,,,,fee schedule,,142.13,,,,fee schedule,,115.8,,,,fee schedule,,234.11,,,,fee schedule,,115.8,,,,fee schedule,,229.25,,,,fee schedule,,138.94,,,,fee schedule,,138.94,,,,fee schedule,,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,54.6,83,,percent of total billed charges,,115.8,,,,fee schedule,,115.8,,,,fee schedule,,,151.06,83,,percent of total billed charges,,204.24,,,,fee schedule,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,54.6,294.21,
APPLICATION OF LONG ARM CAST,29065,CDM,29065,CPT,,,both,,459,459,117.52,,,,fee schedule,,,,,,,,59.45,,,,fee schedule,,,390.15,85,,percent of total billed charges,,146.87,,,,fee schedule,,70.95,,,,fee schedule,,59.45,,,,fee schedule,,116.72,,,,fee schedule,,59.45,,,,fee schedule,,114.06,,,,fee schedule,,69.13,,,,fee schedule,,69.13,,,,fee schedule,,,417.69,91,,percent of total billed charges,,,436.05,95,,percent of total billed charges,,,380.97,83,,percent of total billed charges,,,137.7,83,,percent of total billed charges,,59.45,,,,fee schedule,,59.45,,,,fee schedule,,,380.97,83,,percent of total billed charges,,101.62,,,,fee schedule,,,413.1,90,,percent of total billed charges,,,413.1,90,,percent of total billed charges,,,413.1,90,,percent of total billed charges,,,413.1,90,,percent of total billed charges,,,390.15,85,,percent of total billed charges,,59.45,436.05,
APPLICATION OF LONG ARM CAST,29065P,CDM,29065,CPT,,,both,P,364,364,117.52,,,,fee schedule,,,,,,,,59.45,,,,fee schedule,,,309.4,85,,percent of total billed charges,,146.87,,,,fee schedule,,70.95,,,,fee schedule,,59.45,,,,fee schedule,,116.72,,,,fee schedule,,59.45,,,,fee schedule,,114.06,,,,fee schedule,,69.13,,,,fee schedule,,69.13,,,,fee schedule,,,331.24,91,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,109.2,83,,percent of total billed charges,,59.45,,,,fee schedule,,59.45,,,,fee schedule,,,302.12,83,,percent of total billed charges,,101.62,,,,fee schedule,,,327.6,90,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,309.4,85,,percent of total billed charges,,59.45,345.8,
APPLICATION OF LONG ARM CAST,29065T,CDM,29065,CPT,,,both,T,95,95,117.52,,,,fee schedule,,,,,,,,59.45,,,,fee schedule,,,80.75,85,,percent of total billed charges,,146.87,,,,fee schedule,,70.95,,,,fee schedule,,59.45,,,,fee schedule,,116.72,,,,fee schedule,,59.45,,,,fee schedule,,114.06,,,,fee schedule,,69.13,,,,fee schedule,,69.13,,,,fee schedule,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,28.5,83,,percent of total billed charges,,59.45,,,,fee schedule,,59.45,,,,fee schedule,,,78.85,83,,percent of total billed charges,,101.62,,,,fee schedule,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,28.5,146.87,
APPLICATION OF FOREARM CAST,29075,CDM,29075,CPT,,,both,,397,397,108.3,,,,fee schedule,,,,,,,,59.45,,,,fee schedule,,,337.45,85,,percent of total billed charges,,131.72,,,,fee schedule,,61.28,,,,fee schedule,,59.45,,,,fee schedule,,104.12,,,,fee schedule,,59.45,,,,fee schedule,,105.12,,,,fee schedule,,63.71,,,,fee schedule,,63.71,,,,fee schedule,,,361.27,91,,percent of total billed charges,,,377.15,95,,percent of total billed charges,,,329.51,83,,percent of total billed charges,,,119.1,83,,percent of total billed charges,,59.45,,,,fee schedule,,59.45,,,,fee schedule,,,329.51,83,,percent of total billed charges,,93.65,,,,fee schedule,,,357.3,90,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,357.3,90,,percent of total billed charges,,,337.45,85,,percent of total billed charges,,59.45,377.15,
APPLICATION OF FOREARM CAST,29075P,CDM,29075,CPT,,,both,P,311,311,108.3,,,,fee schedule,,,,,,,,59.45,,,,fee schedule,,,264.35,85,,percent of total billed charges,,131.72,,,,fee schedule,,61.28,,,,fee schedule,,59.45,,,,fee schedule,,104.12,,,,fee schedule,,59.45,,,,fee schedule,,105.12,,,,fee schedule,,63.71,,,,fee schedule,,63.71,,,,fee schedule,,,283.01,91,,percent of total billed charges,,,295.45,95,,percent of total billed charges,,,258.13,83,,percent of total billed charges,,,93.3,83,,percent of total billed charges,,59.45,,,,fee schedule,,59.45,,,,fee schedule,,,258.13,83,,percent of total billed charges,,93.65,,,,fee schedule,,,279.9,90,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,264.35,85,,percent of total billed charges,,59.45,295.45,
APPLICATION OF FOREARM CAST,29075T,CDM,29075,CPT,,,both,T,86,86,108.3,,,,fee schedule,,,,,,,,59.45,,,,fee schedule,,,73.1,85,,percent of total billed charges,,131.72,,,,fee schedule,,61.28,,,,fee schedule,,59.45,,,,fee schedule,,104.12,,,,fee schedule,,59.45,,,,fee schedule,,105.12,,,,fee schedule,,63.71,,,,fee schedule,,63.71,,,,fee schedule,,,78.26,91,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,25.8,83,,percent of total billed charges,,59.45,,,,fee schedule,,59.45,,,,fee schedule,,,71.38,83,,percent of total billed charges,,93.65,,,,fee schedule,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,25.8,131.72,
APPLY HAND/WRIST CAST,29085,CDM,29085,CPT,,,both,,427,427,115.79,,,,fee schedule,,,,,,,,49.3,,,,fee schedule,,,362.95,85,,percent of total billed charges,,144.62,,,,fee schedule,,69.86,,,,fee schedule,,49.3,,,,fee schedule,,108.1,,,,fee schedule,,49.3,,,,fee schedule,,112.39,,,,fee schedule,,68.11,,,,fee schedule,,68.11,,,,fee schedule,,,388.57,91,,percent of total billed charges,,,405.65,95,,percent of total billed charges,,,354.41,83,,percent of total billed charges,,,128.1,83,,percent of total billed charges,,49.3,,,,fee schedule,,49.3,,,,fee schedule,,,354.41,83,,percent of total billed charges,,100.13,,,,fee schedule,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,362.95,85,,percent of total billed charges,,49.3,405.65,
APPLY HAND/WRIST CAST,29085P,CDM,29085,CPT,,,both,P,335,335,115.79,,,,fee schedule,,,,,,,,49.3,,,,fee schedule,,,284.75,85,,percent of total billed charges,,144.62,,,,fee schedule,,69.86,,,,fee schedule,,49.3,,,,fee schedule,,108.1,,,,fee schedule,,49.3,,,,fee schedule,,112.39,,,,fee schedule,,68.11,,,,fee schedule,,68.11,,,,fee schedule,,,304.85,91,,percent of total billed charges,,,318.25,95,,percent of total billed charges,,,278.05,83,,percent of total billed charges,,,100.5,83,,percent of total billed charges,,49.3,,,,fee schedule,,49.3,,,,fee schedule,,,278.05,83,,percent of total billed charges,,100.13,,,,fee schedule,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,301.5,90,,percent of total billed charges,,,284.75,85,,percent of total billed charges,,49.3,318.25,
APPLY HAND/WRIST CAST,29085T,CDM,29085,CPT,,,both,T,92,92,115.79,,,,fee schedule,,,,,,,,49.3,,,,fee schedule,,,78.2,85,,percent of total billed charges,,144.62,,,,fee schedule,,69.86,,,,fee schedule,,49.3,,,,fee schedule,,108.1,,,,fee schedule,,49.3,,,,fee schedule,,112.39,,,,fee schedule,,68.11,,,,fee schedule,,68.11,,,,fee schedule,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,27.6,83,,percent of total billed charges,,49.3,,,,fee schedule,,49.3,,,,fee schedule,,,76.36,83,,percent of total billed charges,,100.13,,,,fee schedule,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,27.6,144.62,
APPLY FINGER CAST,29086,CDM,29086,CPT,,,both,,257,257,84.68,,,,fee schedule,,,,,,,,30.7,,,,fee schedule,,,218.45,85,,percent of total billed charges,,104.21,,,,fee schedule,,50.34,,,,fee schedule,,30.7,,,,fee schedule,,78.26,,,,fee schedule,,30.7,,,,fee schedule,,82.19,,,,fee schedule,,49.81,,,,fee schedule,,49.81,,,,fee schedule,,,233.87,91,,percent of total billed charges,,,244.15,95,,percent of total billed charges,,,213.31,83,,percent of total billed charges,,,77.1,83,,percent of total billed charges,,30.7,,,,fee schedule,,30.7,,,,fee schedule,,,213.31,83,,percent of total billed charges,,73.23,,,,fee schedule,,,231.3,90,,percent of total billed charges,,,231.3,90,,percent of total billed charges,,,231.3,90,,percent of total billed charges,,,231.3,90,,percent of total billed charges,,,218.45,85,,percent of total billed charges,,30.7,244.15,
APPLY FINGER CAST,29086P,CDM,29086,CPT,,,both,P,102,102,84.68,,,,fee schedule,,,,,,,,30.7,,,,fee schedule,,,86.7,85,,percent of total billed charges,,104.21,,,,fee schedule,,50.34,,,,fee schedule,,30.7,,,,fee schedule,,78.26,,,,fee schedule,,30.7,,,,fee schedule,,82.19,,,,fee schedule,,49.81,,,,fee schedule,,49.81,,,,fee schedule,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,30.6,83,,percent of total billed charges,,30.7,,,,fee schedule,,30.7,,,,fee schedule,,,84.66,83,,percent of total billed charges,,73.23,,,,fee schedule,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,30.6,104.21,
APPLY FINGER CAST,29086T,CDM,29086,CPT,,,both,T,155,155,84.68,,,,fee schedule,,,,,,,,30.7,,,,fee schedule,,,131.75,85,,percent of total billed charges,,104.21,,,,fee schedule,,50.34,,,,fee schedule,,30.7,,,,fee schedule,,78.26,,,,fee schedule,,30.7,,,,fee schedule,,82.19,,,,fee schedule,,49.81,,,,fee schedule,,49.81,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,30.7,,,,fee schedule,,30.7,,,,fee schedule,,,128.65,83,,percent of total billed charges,,73.23,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,30.7,147.25,
APPLY LONG ARM SPLINT,29105,CDM,29105,CPT,,,both,,435,435,72.59,,,,fee schedule,,,,,,,,42.1,,,,fee schedule,,,369.75,85,,percent of total billed charges,,91.56,,,,fee schedule,,44.23,,,,fee schedule,,42.1,,,,fee schedule,,99.48,,,,fee schedule,,42.1,,,,fee schedule,,70.45,,,,fee schedule,,42.7,,,,fee schedule,,42.7,,,,fee schedule,,,395.85,91,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,130.5,83,,percent of total billed charges,,42.1,,,,fee schedule,,42.1,,,,fee schedule,,,361.05,83,,percent of total billed charges,,62.77,,,,fee schedule,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,42.1,413.25,
APPLY LONG ARM SPLINT,29105P,CDM,29105,CPT,,,both,P,382,382,72.59,,,,fee schedule,,,,,,,,42.1,,,,fee schedule,,,324.7,85,,percent of total billed charges,,91.56,,,,fee schedule,,44.23,,,,fee schedule,,42.1,,,,fee schedule,,99.48,,,,fee schedule,,42.1,,,,fee schedule,,70.45,,,,fee schedule,,42.7,,,,fee schedule,,42.7,,,,fee schedule,,,347.62,91,,percent of total billed charges,,,362.9,95,,percent of total billed charges,,,317.06,83,,percent of total billed charges,,,114.6,83,,percent of total billed charges,,42.1,,,,fee schedule,,42.1,,,,fee schedule,,,317.06,83,,percent of total billed charges,,62.77,,,,fee schedule,,,343.8,90,,percent of total billed charges,,,343.8,90,,percent of total billed charges,,,343.8,90,,percent of total billed charges,,,343.8,90,,percent of total billed charges,,,324.7,85,,percent of total billed charges,,42.1,362.9,
APPLY LONG ARM SPLINT,29105T,CDM,29105,CPT,,,both,T,155,155,72.59,,,,fee schedule,,,,,,,,42.1,,,,fee schedule,,,131.75,85,,percent of total billed charges,,91.56,,,,fee schedule,,44.23,,,,fee schedule,,42.1,,,,fee schedule,,99.48,,,,fee schedule,,42.1,,,,fee schedule,,70.45,,,,fee schedule,,42.7,,,,fee schedule,,42.7,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,42.1,,,,fee schedule,,42.1,,,,fee schedule,,,128.65,83,,percent of total billed charges,,62.77,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,42.1,147.25,
APPLY FOREARM SPLINT,29125,CDM,29125,CPT,,,both,,316,316,69.71,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,268.6,85,,percent of total billed charges,,85.15,,,,fee schedule,,41.14,,,,fee schedule,,32.15,,,,fee schedule,,69.64,,,,fee schedule,,32.15,,,,fee schedule,,67.66,,,,fee schedule,,41,,,,fee schedule,,41,,,,fee schedule,,,287.56,91,,percent of total billed charges,,,300.2,95,,percent of total billed charges,,,262.28,83,,percent of total billed charges,,,94.8,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,262.28,83,,percent of total billed charges,,60.28,,,,fee schedule,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,284.4,90,,percent of total billed charges,,,268.6,85,,percent of total billed charges,,32.15,300.2,
APPLY FOREARM SPLINT,29125P,CDM,29125,CPT,,,both,P,259,259,69.71,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,220.15,85,,percent of total billed charges,,85.15,,,,fee schedule,,41.14,,,,fee schedule,,32.15,,,,fee schedule,,69.64,,,,fee schedule,,32.15,,,,fee schedule,,67.66,,,,fee schedule,,41,,,,fee schedule,,41,,,,fee schedule,,,235.69,91,,percent of total billed charges,,,246.05,95,,percent of total billed charges,,,214.97,83,,percent of total billed charges,,,77.7,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,214.97,83,,percent of total billed charges,,60.28,,,,fee schedule,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,220.15,85,,percent of total billed charges,,32.15,246.05,
APPLY FOREARM SPLINT,29125T,CDM,29125,CPT,,,both,T,57,57,69.71,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,48.45,85,,percent of total billed charges,,85.15,,,,fee schedule,,41.14,,,,fee schedule,,32.15,,,,fee schedule,,69.64,,,,fee schedule,,32.15,,,,fee schedule,,67.66,,,,fee schedule,,41,,,,fee schedule,,41,,,,fee schedule,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,17.1,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,47.31,83,,percent of total billed charges,,60.28,,,,fee schedule,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,17.1,85.15,
APPLY FOREARM SPLINT,29126,CDM,29126,CPT,,,both,,274,274,84.68,,,,fee schedule,,,,,,,,39.3,,,,fee schedule,,,232.9,85,,percent of total billed charges,,105.01,,,,fee schedule,,50.73,,,,fee schedule,,39.3,,,,fee schedule,,85.55,,,,fee schedule,,39.3,,,,fee schedule,,82.19,,,,fee schedule,,49.81,,,,fee schedule,,49.81,,,,fee schedule,,,249.34,91,,percent of total billed charges,,,260.3,95,,percent of total billed charges,,,227.42,83,,percent of total billed charges,,,82.2,83,,percent of total billed charges,,39.3,,,,fee schedule,,39.3,,,,fee schedule,,,227.42,83,,percent of total billed charges,,73.23,,,,fee schedule,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,232.9,85,,percent of total billed charges,,39.3,260.3,
APPLICATION OF FINGER SPLINT,29130,CDM,29130,CPT,,,both,,189,189,50.7,,,,fee schedule,,,,,,,,23,,,,fee schedule,,,160.65,85,,percent of total billed charges,,63.95,,,,fee schedule,,30.89,,,,fee schedule,,23,,,,fee schedule,,48.41,,,,fee schedule,,23,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,56.7,83,,percent of total billed charges,,23,,,,fee schedule,,23,,,,fee schedule,,,156.87,83,,percent of total billed charges,,43.84,,,,fee schedule,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,23,179.55,
APPLICATION OF FINGER SPLINT,29130P,CDM,29130,CPT,,,both,P,148,148,50.7,,,,fee schedule,,,,,,,,23,,,,fee schedule,,,125.8,85,,percent of total billed charges,,63.95,,,,fee schedule,,30.89,,,,fee schedule,,23,,,,fee schedule,,48.41,,,,fee schedule,,23,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,44.4,83,,percent of total billed charges,,23,,,,fee schedule,,23,,,,fee schedule,,,122.84,83,,percent of total billed charges,,43.84,,,,fee schedule,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,23,140.6,
APPLICATION OF FINGER SPLINT,29130T,CDM,29130,CPT,,,both,T,41,41,50.7,,,,fee schedule,,,,,,,,23,,,,fee schedule,,,34.85,85,,percent of total billed charges,,63.95,,,,fee schedule,,30.89,,,,fee schedule,,23,,,,fee schedule,,48.41,,,,fee schedule,,23,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,23,,,,fee schedule,,23,,,,fee schedule,,,34.03,83,,percent of total billed charges,,43.84,,,,fee schedule,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,12.3,63.95,
STRAPPING OF SHOULDER,29240,CDM,29240,CPT,,,both,,192,192,31.11,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,163.2,85,,percent of total billed charges,,39.92,,,,fee schedule,,19.28,,,,fee schedule,,37.4,,,,fee schedule,,74.28,,,,fee schedule,,37.4,,,,fee schedule,,30.19,,,,fee schedule,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,57.6,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,159.36,83,,percent of total billed charges,,26.9,,,,fee schedule,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,18.3,182.4,
STRAPPING OF ELBOW OR WRIST,29260,CDM,29260,CPT,,,both,,159,159,32.84,,,,fee schedule,,,,,,,,19.95,,,,fee schedule,,,135.15,85,,percent of total billed charges,,42.37,,,,fee schedule,,20.47,,,,fee schedule,,19.95,,,,fee schedule,,61.01,,,,fee schedule,,19.95,,,,fee schedule,,31.87,,,,fee schedule,,19.32,,,,fee schedule,,19.32,,,,fee schedule,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,47.7,83,,percent of total billed charges,,19.95,,,,fee schedule,,19.95,,,,fee schedule,,,131.97,83,,percent of total billed charges,,28.39,,,,fee schedule,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,19.32,151.05,
STRAPPING OF HAND OR FINGER,29280,CDM,29280,CPT,,,both,,185,185,33.99,,,,fee schedule,,,,,,,,19.3,,,,fee schedule,,,157.25,85,,percent of total billed charges,,43.06,,,,fee schedule,,20.8,,,,fee schedule,,19.3,,,,fee schedule,,57.04,,,,fee schedule,,19.3,,,,fee schedule,,32.99,,,,fee schedule,,19.99,,,,fee schedule,,19.99,,,,fee schedule,,,168.35,91,,percent of total billed charges,,,175.75,95,,percent of total billed charges,,,153.55,83,,percent of total billed charges,,,55.5,83,,percent of total billed charges,,19.3,,,,fee schedule,,19.3,,,,fee schedule,,,153.55,83,,percent of total billed charges,,29.39,,,,fee schedule,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,157.25,85,,percent of total billed charges,,19.3,175.75,
APPLICATION OF LONG LEG CAST,29345,CDM,29345,CPT,,,both,,595,595,171.1,,,,fee schedule,,,,,,,,79.3,,,,fee schedule,,,505.75,85,,percent of total billed charges,,214.44,,,,fee schedule,,103.59,,,,fee schedule,,79.3,,,,fee schedule,,178.4,,,,fee schedule,,79.3,,,,fee schedule,,166.06,,,,fee schedule,,100.64,,,,fee schedule,,100.64,,,,fee schedule,,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,178.5,83,,percent of total billed charges,,79.3,,,,fee schedule,,79.3,,,,fee schedule,,,493.85,83,,percent of total billed charges,,147.95,,,,fee schedule,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,79.3,565.25,
APPLICATION OF LONG LEG CAST,29345P,CDM,29345,CPT,,,both,P,458,458,171.1,,,,fee schedule,,,,,,,,79.3,,,,fee schedule,,,389.3,85,,percent of total billed charges,,214.44,,,,fee schedule,,103.59,,,,fee schedule,,79.3,,,,fee schedule,,178.4,,,,fee schedule,,79.3,,,,fee schedule,,166.06,,,,fee schedule,,100.64,,,,fee schedule,,100.64,,,,fee schedule,,,416.78,91,,percent of total billed charges,,,435.1,95,,percent of total billed charges,,,380.14,83,,percent of total billed charges,,,137.4,83,,percent of total billed charges,,79.3,,,,fee schedule,,79.3,,,,fee schedule,,,380.14,83,,percent of total billed charges,,147.95,,,,fee schedule,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,389.3,85,,percent of total billed charges,,79.3,435.1,
APPLICATION OF LONG LEG CAST,29345T,CDM,29345,CPT,,,both,T,137,137,171.1,,,,fee schedule,,,,,,,,79.3,,,,fee schedule,,,116.45,85,,percent of total billed charges,,214.44,,,,fee schedule,,103.59,,,,fee schedule,,79.3,,,,fee schedule,,178.4,,,,fee schedule,,79.3,,,,fee schedule,,166.06,,,,fee schedule,,100.64,,,,fee schedule,,100.64,,,,fee schedule,,,124.67,91,,percent of total billed charges,,,130.15,95,,percent of total billed charges,,,113.71,83,,percent of total billed charges,,,41.1,83,,percent of total billed charges,,79.3,,,,fee schedule,,79.3,,,,fee schedule,,,113.71,83,,percent of total billed charges,,147.95,,,,fee schedule,,,123.3,90,,percent of total billed charges,,,123.3,90,,percent of total billed charges,,,123.3,90,,percent of total billed charges,,,123.3,90,,percent of total billed charges,,,116.45,85,,percent of total billed charges,,41.1,214.44,
APPLICATION OF LONG LEG CAST,29355,CDM,29355,CPT,,,both,,607,607,182.62,,,,fee schedule,,,,,,,,92.4,,,,fee schedule,,,515.95,85,,percent of total billed charges,,229.38,,,,fee schedule,,110.81,,,,fee schedule,,92.4,,,,fee schedule,,191.67,,,,fee schedule,,92.4,,,,fee schedule,,177.25,,,,fee schedule,,107.42,,,,fee schedule,,107.42,,,,fee schedule,,,552.37,91,,percent of total billed charges,,,576.65,95,,percent of total billed charges,,,503.81,83,,percent of total billed charges,,,182.1,83,,percent of total billed charges,,92.4,,,,fee schedule,,92.4,,,,fee schedule,,,503.81,83,,percent of total billed charges,,157.91,,,,fee schedule,,,546.3,90,,percent of total billed charges,,,546.3,90,,percent of total billed charges,,,546.3,90,,percent of total billed charges,,,546.3,90,,percent of total billed charges,,,515.95,85,,percent of total billed charges,,92.4,576.65,
APPLICATION OF LONG LEG CAST,29355P,CDM,29355,CPT,,,both,P,460,460,182.62,,,,fee schedule,,,,,,,,92.4,,,,fee schedule,,,391,85,,percent of total billed charges,,229.38,,,,fee schedule,,110.81,,,,fee schedule,,92.4,,,,fee schedule,,191.67,,,,fee schedule,,92.4,,,,fee schedule,,177.25,,,,fee schedule,,107.42,,,,fee schedule,,107.42,,,,fee schedule,,,418.6,91,,percent of total billed charges,,,437,95,,percent of total billed charges,,,381.8,83,,percent of total billed charges,,,138,83,,percent of total billed charges,,92.4,,,,fee schedule,,92.4,,,,fee schedule,,,381.8,83,,percent of total billed charges,,157.91,,,,fee schedule,,,414,90,,percent of total billed charges,,,414,90,,percent of total billed charges,,,414,90,,percent of total billed charges,,,414,90,,percent of total billed charges,,,391,85,,percent of total billed charges,,92.4,437,
APPLICATION OF LONG LEG CAST,29355T,CDM,29355,CPT,,,both,T,147,147,182.62,,,,fee schedule,,,,,,,,92.4,,,,fee schedule,,,124.95,85,,percent of total billed charges,,229.38,,,,fee schedule,,110.81,,,,fee schedule,,92.4,,,,fee schedule,,191.67,,,,fee schedule,,92.4,,,,fee schedule,,177.25,,,,fee schedule,,107.42,,,,fee schedule,,107.42,,,,fee schedule,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,44.1,83,,percent of total billed charges,,92.4,,,,fee schedule,,92.4,,,,fee schedule,,,122.01,83,,percent of total billed charges,,157.91,,,,fee schedule,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,44.1,229.38,
APPLY SHORT LEG CAST,29405,CDM,29405,CPT,,,both,,408,408,100.24,,,,fee schedule,,,,,,,,70,,,,fee schedule,,,346.8,85,,percent of total billed charges,,123.99,,,,fee schedule,,59.9,,,,fee schedule,,70,,,,fee schedule,,113.41,,,,fee schedule,,70,,,,fee schedule,,97.29,,,,fee schedule,,58.96,,,,fee schedule,,58.96,,,,fee schedule,,,371.28,91,,percent of total billed charges,,,387.6,95,,percent of total billed charges,,,338.64,83,,percent of total billed charges,,,122.4,83,,percent of total billed charges,,70,,,,fee schedule,,70,,,,fee schedule,,,338.64,83,,percent of total billed charges,,86.68,,,,fee schedule,,,367.2,90,,percent of total billed charges,,,367.2,90,,percent of total billed charges,,,367.2,90,,percent of total billed charges,,,367.2,90,,percent of total billed charges,,,346.8,85,,percent of total billed charges,,58.96,387.6,
APPLY SHORT LEG CAST,29405P,CDM,29405,CPT,,,both,P,336,336,100.24,,,,fee schedule,,,,,,,,70,,,,fee schedule,,,285.6,85,,percent of total billed charges,,123.99,,,,fee schedule,,59.9,,,,fee schedule,,70,,,,fee schedule,,113.41,,,,fee schedule,,70,,,,fee schedule,,97.29,,,,fee schedule,,58.96,,,,fee schedule,,58.96,,,,fee schedule,,,305.76,91,,percent of total billed charges,,,319.2,95,,percent of total billed charges,,,278.88,83,,percent of total billed charges,,,100.8,83,,percent of total billed charges,,70,,,,fee schedule,,70,,,,fee schedule,,,278.88,83,,percent of total billed charges,,86.68,,,,fee schedule,,,302.4,90,,percent of total billed charges,,,302.4,90,,percent of total billed charges,,,302.4,90,,percent of total billed charges,,,302.4,90,,percent of total billed charges,,,285.6,85,,percent of total billed charges,,58.96,319.2,
APPLY SHORT LEG CAST,29405T,CDM,29405,CPT,,,both,T,82,82,100.24,,,,fee schedule,,,,,,,,70,,,,fee schedule,,,69.7,85,,percent of total billed charges,,123.99,,,,fee schedule,,59.9,,,,fee schedule,,70,,,,fee schedule,,113.41,,,,fee schedule,,70,,,,fee schedule,,97.29,,,,fee schedule,,58.96,,,,fee schedule,,58.96,,,,fee schedule,,,74.62,91,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,24.6,83,,percent of total billed charges,,70,,,,fee schedule,,70,,,,fee schedule,,,68.06,83,,percent of total billed charges,,86.68,,,,fee schedule,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,24.6,123.99,
APPLY SHORT LEG CAST,29425,CDM,29425,CPT,,,both,,436,436,92.75,,,,fee schedule,,,,,,,,75.3,,,,fee schedule,,,370.6,85,,percent of total billed charges,,115.38,,,,fee schedule,,55.74,,,,fee schedule,,75.3,,,,fee schedule,,126.01,,,,fee schedule,,75.3,,,,fee schedule,,90.02,,,,fee schedule,,54.56,,,,fee schedule,,54.56,,,,fee schedule,,,396.76,91,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,130.8,83,,percent of total billed charges,,75.3,,,,fee schedule,,75.3,,,,fee schedule,,,361.88,83,,percent of total billed charges,,80.2,,,,fee schedule,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,54.56,414.2,
APPLY SHORT LEG CAST,29425P,CDM,29425,CPT,,,both,P,358,358,92.75,,,,fee schedule,,,,,,,,75.3,,,,fee schedule,,,304.3,85,,percent of total billed charges,,115.38,,,,fee schedule,,55.74,,,,fee schedule,,75.3,,,,fee schedule,,126.01,,,,fee schedule,,75.3,,,,fee schedule,,90.02,,,,fee schedule,,54.56,,,,fee schedule,,54.56,,,,fee schedule,,,325.78,91,,percent of total billed charges,,,340.1,95,,percent of total billed charges,,,297.14,83,,percent of total billed charges,,,107.4,83,,percent of total billed charges,,75.3,,,,fee schedule,,75.3,,,,fee schedule,,,297.14,83,,percent of total billed charges,,80.2,,,,fee schedule,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,304.3,85,,percent of total billed charges,,54.56,340.1,
APPLY SHORT LEG CAST,29425T,CDM,29425,CPT,,,both,T,78,78,92.75,,,,fee schedule,,,,,,,,75.3,,,,fee schedule,,,66.3,85,,percent of total billed charges,,115.38,,,,fee schedule,,55.74,,,,fee schedule,,75.3,,,,fee schedule,,126.01,,,,fee schedule,,75.3,,,,fee schedule,,90.02,,,,fee schedule,,54.56,,,,fee schedule,,54.56,,,,fee schedule,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,75.3,,,,fee schedule,,75.3,,,,fee schedule,,,64.74,83,,percent of total billed charges,,80.2,,,,fee schedule,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,23.4,126.01,
APPLY RIGID LEG CAST,29445,CDM,29445,CPT,,,both,,525,525,167.64,,,,fee schedule,,,,,,,,91.65,,,,fee schedule,,,446.25,85,,percent of total billed charges,,214.84,,,,fee schedule,,103.79,,,,fee schedule,,91.65,,,,fee schedule,,198.96,,,,fee schedule,,91.65,,,,fee schedule,,162.71,,,,fee schedule,,98.61,,,,fee schedule,,98.61,,,,fee schedule,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,157.5,83,,percent of total billed charges,,91.65,,,,fee schedule,,91.65,,,,fee schedule,,,435.75,83,,percent of total billed charges,,144.96,,,,fee schedule,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,91.65,498.75,
"APPLICATION, LONG LEG SPLINT",29505,CDM,29505,CPT,,,both,,364,364,89.29,,,,fee schedule,,,,,,,,43.5,,,,fee schedule,,,309.4,85,,percent of total billed charges,,109.38,,,,fee schedule,,52.84,,,,fee schedule,,43.5,,,,fee schedule,,80.25,,,,fee schedule,,43.5,,,,fee schedule,,86.67,,,,fee schedule,,52.53,,,,fee schedule,,52.53,,,,fee schedule,,,331.24,91,,percent of total billed charges,,,345.8,95,,percent of total billed charges,,,302.12,83,,percent of total billed charges,,,109.2,83,,percent of total billed charges,,43.5,,,,fee schedule,,43.5,,,,fee schedule,,,302.12,83,,percent of total billed charges,,77.21,,,,fee schedule,,,327.6,90,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,327.6,90,,percent of total billed charges,,,309.4,85,,percent of total billed charges,,43.5,345.8,
"APPLICATION, LONG LEG SPLINT",29505P,CDM,29505,CPT,,,both,P,291,291,89.29,,,,fee schedule,,,,,,,,43.5,,,,fee schedule,,,247.35,85,,percent of total billed charges,,109.38,,,,fee schedule,,52.84,,,,fee schedule,,43.5,,,,fee schedule,,80.25,,,,fee schedule,,43.5,,,,fee schedule,,86.67,,,,fee schedule,,52.53,,,,fee schedule,,52.53,,,,fee schedule,,,264.81,91,,percent of total billed charges,,,276.45,95,,percent of total billed charges,,,241.53,83,,percent of total billed charges,,,87.3,83,,percent of total billed charges,,43.5,,,,fee schedule,,43.5,,,,fee schedule,,,241.53,83,,percent of total billed charges,,77.21,,,,fee schedule,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,247.35,85,,percent of total billed charges,,43.5,276.45,
"APPLICATION, LONG LEG SPLINT",29505T,CDM,29505,CPT,,,both,T,73,73,89.29,,,,fee schedule,,,,,,,,43.5,,,,fee schedule,,,62.05,85,,percent of total billed charges,,109.38,,,,fee schedule,,52.84,,,,fee schedule,,43.5,,,,fee schedule,,80.25,,,,fee schedule,,43.5,,,,fee schedule,,86.67,,,,fee schedule,,52.53,,,,fee schedule,,52.53,,,,fee schedule,,,66.43,91,,percent of total billed charges,,,69.35,95,,percent of total billed charges,,,60.59,83,,percent of total billed charges,,,21.9,83,,percent of total billed charges,,43.5,,,,fee schedule,,43.5,,,,fee schedule,,,60.59,83,,percent of total billed charges,,77.21,,,,fee schedule,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,62.05,85,,percent of total billed charges,,21.9,109.38,
APPLICATION LOWER LEG SPLINT,29515,CDM,29515,CPT,,,both,,328,328,84.68,,,,fee schedule,,,,,,,,35.85,,,,fee schedule,,,278.8,85,,percent of total billed charges,,105.54,,,,fee schedule,,50.99,,,,fee schedule,,35.85,,,,fee schedule,,84.89,,,,fee schedule,,35.85,,,,fee schedule,,82.19,,,,fee schedule,,49.81,,,,fee schedule,,49.81,,,,fee schedule,,,298.48,91,,percent of total billed charges,,,311.6,95,,percent of total billed charges,,,272.24,83,,percent of total billed charges,,,98.4,83,,percent of total billed charges,,35.85,,,,fee schedule,,35.85,,,,fee schedule,,,272.24,83,,percent of total billed charges,,73.23,,,,fee schedule,,,295.2,90,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,295.2,90,,percent of total billed charges,,,278.8,85,,percent of total billed charges,,35.85,311.6,
APPLICATION LOWER LEG SPLINT,29515P,CDM,29515,CPT,,,both,P,259,259,84.68,,,,fee schedule,,,,,,,,35.85,,,,fee schedule,,,220.15,85,,percent of total billed charges,,105.54,,,,fee schedule,,50.99,,,,fee schedule,,35.85,,,,fee schedule,,84.89,,,,fee schedule,,35.85,,,,fee schedule,,82.19,,,,fee schedule,,49.81,,,,fee schedule,,49.81,,,,fee schedule,,,235.69,91,,percent of total billed charges,,,246.05,95,,percent of total billed charges,,,214.97,83,,percent of total billed charges,,,77.7,83,,percent of total billed charges,,35.85,,,,fee schedule,,35.85,,,,fee schedule,,,214.97,83,,percent of total billed charges,,73.23,,,,fee schedule,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,220.15,85,,percent of total billed charges,,35.85,246.05,
APPLICATION LOWER LEG SPLINT,29515T,CDM,29515,CPT,,,both,T,69,69,84.68,,,,fee schedule,,,,,,,,35.85,,,,fee schedule,,,58.65,85,,percent of total billed charges,,105.54,,,,fee schedule,,50.99,,,,fee schedule,,35.85,,,,fee schedule,,84.89,,,,fee schedule,,35.85,,,,fee schedule,,82.19,,,,fee schedule,,49.81,,,,fee schedule,,49.81,,,,fee schedule,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,20.7,83,,percent of total billed charges,,35.85,,,,fee schedule,,35.85,,,,fee schedule,,,57.27,83,,percent of total billed charges,,73.23,,,,fee schedule,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,20.7,105.54,
STRAPPING OF HIP,29520,CDM,29520,CPT,,,both,,150,150,31.11,,,,fee schedule,,,,,,,,21.4,,,,fee schedule,,,127.5,85,,percent of total billed charges,,39.92,,,,fee schedule,,19.28,,,,fee schedule,,21.4,,,,fee schedule,,68.97,,,,fee schedule,,21.4,,,,fee schedule,,30.19,,,,fee schedule,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,21.4,,,,fee schedule,,21.4,,,,fee schedule,,,124.5,83,,percent of total billed charges,,26.9,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,18.3,142.5,
STRAPPING OF KNEE,29530,CDM,29530,CPT,,,both,,120,120,31.11,,,,fee schedule,,,,,,,,21.8,,,,fee schedule,,,102,85,,percent of total billed charges,,39.23,,,,fee schedule,,18.95,,,,fee schedule,,21.8,,,,fee schedule,,62.34,,,,fee schedule,,21.8,,,,fee schedule,,30.19,,,,fee schedule,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,36,83,,percent of total billed charges,,21.8,,,,fee schedule,,21.8,,,,fee schedule,,,99.6,83,,percent of total billed charges,,26.9,,,,fee schedule,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,18.3,114,
STRAPPING OF ANKLE AND/OR FT,29540,CDM,29540,CPT,,,both,,383,383,29.96,,,,fee schedule,,,,,,,,15.4,,,,fee schedule,,,325.55,85,,percent of total billed charges,,38.95,,,,fee schedule,,18.46,,,,fee schedule,,15.4,,,,fee schedule,,58.36,,,,fee schedule,,15.4,,,,fee schedule,,29.08,,,,fee schedule,,17.62,,,,fee schedule,,17.62,,,,fee schedule,,,348.53,91,,percent of total billed charges,,,363.85,95,,percent of total billed charges,,,317.89,83,,percent of total billed charges,,,114.9,83,,percent of total billed charges,,15.4,,,,fee schedule,,15.4,,,,fee schedule,,,317.89,83,,percent of total billed charges,,25.9,,,,fee schedule,,,344.7,90,,percent of total billed charges,,,344.7,90,,percent of total billed charges,,,344.7,90,,percent of total billed charges,,,344.7,90,,percent of total billed charges,,,325.55,85,,percent of total billed charges,,15.4,363.85,
STRAPPING OF TOES,29550,CDM,29550,CPT,,,both,,109,109,19.01,,,,fee schedule,,,,,,,,14.2,,,,fee schedule,,,92.65,85,,percent of total billed charges,,24.63,,,,fee schedule,,11.9,,,,fee schedule,,14.2,,,,fee schedule,,53.72,,,,fee schedule,,14.2,,,,fee schedule,,18.45,,,,fee schedule,,11.18,,,,fee schedule,,11.18,,,,fee schedule,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,32.7,83,,percent of total billed charges,,14.2,,,,fee schedule,,14.2,,,,fee schedule,,,90.47,83,,percent of total billed charges,,16.44,,,,fee schedule,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,11.18,103.55,
STRAPPING UNNA BOOT,29580,CDM,29580,CPT,,,both,,183,183,44.93,,,,fee schedule,,,,,,,,27,,,,fee schedule,,,155.55,85,,percent of total billed charges,,59.29,,,,fee schedule,,28.64,,,,fee schedule,,27,,,,fee schedule,,65.66,,,,fee schedule,,27,,,,fee schedule,,43.61,,,,fee schedule,,26.43,,,,fee schedule,,26.43,,,,fee schedule,,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,54.9,83,,percent of total billed charges,,27,,,,fee schedule,,27,,,,fee schedule,,,151.89,83,,percent of total billed charges,,38.86,,,,fee schedule,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,26.43,173.85,
APPLY MULTLAY COMPRS LWR LEG,29581,CDM,29581,CPT,,,both,,217,217,45.51,,,,fee schedule,,,,,,,,18.63,,,,fee schedule,,,184.45,85,,percent of total billed charges,,59.09,,,,fee schedule,,28.54,,,,fee schedule,,18.63,,,,fee schedule,,,,,,,,18.63,,,,fee schedule,,44.17,,,,fee schedule,,26.77,,,,fee schedule,,26.77,,,,fee schedule,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,65.1,83,,percent of total billed charges,,18.63,,,,fee schedule,,18.63,,,,fee schedule,,,180.11,83,,percent of total billed charges,,39.35,,,,fee schedule,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,18.63,206.15,
REMOVAL/REVISION OF CAST,29700,CDM,29700,CPT,,,both,,279,279,56.46,,,,fee schedule,,,,,,,,24.15,,,,fee schedule,,,237.15,85,,percent of total billed charges,,72.14,,,,fee schedule,,34.85,,,,fee schedule,,24.15,,,,fee schedule,,61.01,,,,fee schedule,,24.15,,,,fee schedule,,54.8,,,,fee schedule,,33.21,,,,fee schedule,,33.21,,,,fee schedule,,,253.89,91,,percent of total billed charges,,,265.05,95,,percent of total billed charges,,,231.57,83,,percent of total billed charges,,,83.7,83,,percent of total billed charges,,24.15,,,,fee schedule,,24.15,,,,fee schedule,,,231.57,83,,percent of total billed charges,,48.82,,,,fee schedule,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,237.15,85,,percent of total billed charges,,24.15,265.05,
REMOVAL/REVISION OF CAST,29705,CDM,29705,CPT,,,both,,342,342,76.62,,,,fee schedule,,,,,,,,25.6,,,,fee schedule,,,290.7,85,,percent of total billed charges,,96.85,,,,fee schedule,,46.79,,,,fee schedule,,25.6,,,,fee schedule,,83.56,,,,fee schedule,,25.6,,,,fee schedule,,74.37,,,,fee schedule,,45.07,,,,fee schedule,,45.07,,,,fee schedule,,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,102.6,83,,percent of total billed charges,,25.6,,,,fee schedule,,25.6,,,,fee schedule,,,283.86,83,,percent of total billed charges,,66.25,,,,fee schedule,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,25.6,324.9,
WINDOWING OF CAST,29730,CDM,29730,CPT,,,both,,240,240,76.04,,,,fee schedule,,,,,,,,36,,,,fee schedule,,,204,85,,percent of total billed charges,,96.3,,,,fee schedule,,46.52,,,,fee schedule,,36,,,,fee schedule,,80.91,,,,fee schedule,,36,,,,fee schedule,,73.81,,,,fee schedule,,44.73,,,,fee schedule,,44.73,,,,fee schedule,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,72,83,,percent of total billed charges,,36,,,,fee schedule,,36,,,,fee schedule,,,199.2,83,,percent of total billed charges,,65.75,,,,fee schedule,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,36,228,
CASTING/STRAPPING PROCEDURE,29799,CDM,29799,CPT,,,both,,404,404,,,,,,,,,,,,,,,,,,,,343.4,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,367.64,91,,percent of total billed charges,,,383.8,95,,percent of total billed charges,,,335.32,83,,percent of total billed charges,,,121.2,83,,percent of total billed charges,,,,,,,,,,,,,,,335.32,83,,percent of total billed charges,,,,,,,,,363.6,90,,percent of total billed charges,,,363.6,90,,percent of total billed charges,,,363.6,90,,percent of total billed charges,,,363.6,90,,percent of total billed charges,,,343.4,85,,percent of total billed charges,,121.2,383.8,
CASTING/STRAPPING PROCEDURE,29799P,CDM,29799,CPT,,,both,P,242,242,,,,,,,,,,,,,,,,,,,,205.7,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,220.22,91,,percent of total billed charges,,,229.9,95,,percent of total billed charges,,,200.86,83,,percent of total billed charges,,,72.6,83,,percent of total billed charges,,,,,,,,,,,,,,,200.86,83,,percent of total billed charges,,,,,,,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,205.7,85,,percent of total billed charges,,72.6,229.9,
CASTING/STRAPPING PROCEDURE,29799T,CDM,29799,CPT,,,both,T,162,162,,,,,,,,,,,,,,,,,,,,137.7,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,48.6,83,,percent of total billed charges,,,,,,,,,,,,,,,134.46,83,,percent of total billed charges,,,,,,,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,48.6,153.9,
"SHOULDER ARTHROSCOPY, DX",29805,CDM,29805,CPT,,,both,,2367,2367,816.31,,,,fee schedule,,,,,,,,325.2,,,,fee schedule,,,2011.95,85,,percent of total billed charges,,1018.56,,,,fee schedule,,492.05,,,,fee schedule,,325.2,,,,fee schedule,,832.32,,,,fee schedule,,325.2,,,,fee schedule,,792.3,,,,fee schedule,,480.18,,,,fee schedule,,480.18,,,,fee schedule,,,2153.97,91,,percent of total billed charges,,,2248.65,95,,percent of total billed charges,,,1964.61,83,,percent of total billed charges,,,710.1,83,,percent of total billed charges,,325.2,,,,fee schedule,,325.2,,,,fee schedule,,,1964.61,83,,percent of total billed charges,,705.87,,,,fee schedule,,,2130.3,90,,percent of total billed charges,,,2130.3,90,,percent of total billed charges,,,2130.3,90,,percent of total billed charges,,,2130.3,90,,percent of total billed charges,,,2011.95,85,,percent of total billed charges,,325.2,2248.65,
SHOULDER ARTHROSCOPY/SURGERY,29806,CDM,29806,CPT,,,both,,5964,5964,1827.91,,,,fee schedule,,,,,,,,673.3,,,,fee schedule,,,5069.4,85,,percent of total billed charges,,2311.58,,,,fee schedule,,1116.7,,,,fee schedule,,673.3,,,,fee schedule,,1854.32,,,,fee schedule,,673.3,,,,fee schedule,,1774.15,,,,fee schedule,,1075.24,,,,fee schedule,,1075.24,,,,fee schedule,,,5427.24,91,,percent of total billed charges,,,5665.8,95,,percent of total billed charges,,,4950.12,83,,percent of total billed charges,,,1789.2,83,,percent of total billed charges,,673.3,,,,fee schedule,,673.3,,,,fee schedule,,,4950.12,83,,percent of total billed charges,,1580.6,,,,fee schedule,,,5367.6,90,,percent of total billed charges,,,5367.6,90,,percent of total billed charges,,,5367.6,90,,percent of total billed charges,,,5367.6,90,,percent of total billed charges,,,5069.4,85,,percent of total billed charges,,673.3,5665.8,
SHOULDER ARTHROSCOPY/SURGERY,29807,CDM,29807,CPT,,,both,,5751,5751,1788.74,,,,fee schedule,,,,,,,,673.3,,,,fee schedule,,,4888.35,85,,percent of total billed charges,,2253.78,,,,fee schedule,,1088.78,,,,fee schedule,,673.3,,,,fee schedule,,1805.91,,,,fee schedule,,673.3,,,,fee schedule,,1736.13,,,,fee schedule,,1052.2,,,,fee schedule,,1052.2,,,,fee schedule,,,5233.41,91,,percent of total billed charges,,,5463.45,95,,percent of total billed charges,,,4773.33,83,,percent of total billed charges,,,1725.3,83,,percent of total billed charges,,673.3,,,,fee schedule,,673.3,,,,fee schedule,,,4773.33,83,,percent of total billed charges,,1546.73,,,,fee schedule,,,5175.9,90,,percent of total billed charges,,,5175.9,90,,percent of total billed charges,,,5175.9,90,,percent of total billed charges,,,5175.9,90,,percent of total billed charges,,,4888.35,85,,percent of total billed charges,,673.3,5463.45,
SHOULDER ARTHROSCOPY/SURGERY,29819,CDM,29819,CPT,,,both,,3746,3746,1019.67,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3184.1,85,,percent of total billed charges,,1278.23,,,,fee schedule,,617.5,,,,fee schedule,,480,,,,fee schedule,,1040.57,,,,fee schedule,,480,,,,fee schedule,,989.68,,,,fee schedule,,599.8,,,,fee schedule,,599.8,,,,fee schedule,,,3408.86,91,,percent of total billed charges,,,3558.7,95,,percent of total billed charges,,,3109.18,83,,percent of total billed charges,,,1123.8,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3109.18,83,,percent of total billed charges,,881.71,,,,fee schedule,,,3371.4,90,,percent of total billed charges,,,3371.4,90,,percent of total billed charges,,,3371.4,90,,percent of total billed charges,,,3371.4,90,,percent of total billed charges,,,3184.1,85,,percent of total billed charges,,480,3558.7,
SHOULDER ARTHROSCOPY/SURGERY,29820,CDM,29820,CPT,,,both,,3913,3913,926.92,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3326.05,85,,percent of total billed charges,,1168.97,,,,fee schedule,,564.72,,,,fee schedule,,480,,,,fee schedule,,960.32,,,,fee schedule,,480,,,,fee schedule,,899.65,,,,fee schedule,,545.25,,,,fee schedule,,545.25,,,,fee schedule,,,3560.83,91,,percent of total billed charges,,,3717.35,95,,percent of total billed charges,,,3247.79,83,,percent of total billed charges,,,1173.9,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3247.79,83,,percent of total billed charges,,801.51,,,,fee schedule,,,3521.7,90,,percent of total billed charges,,,3521.7,90,,percent of total billed charges,,,3521.7,90,,percent of total billed charges,,,3521.7,90,,percent of total billed charges,,,3326.05,85,,percent of total billed charges,,480,3717.35,
SHOULDER ARTHROSCOPY/SURGERY,29821,CDM,29821,CPT,,,both,,3508,3508,1031.76,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,2981.8,85,,percent of total billed charges,,1295.23,,,,fee schedule,,625.71,,,,fee schedule,,480,,,,fee schedule,,1048.53,,,,fee schedule,,480,,,,fee schedule,,1001.42,,,,fee schedule,,606.92,,,,fee schedule,,606.92,,,,fee schedule,,,3192.28,91,,percent of total billed charges,,,3332.6,95,,percent of total billed charges,,,2911.64,83,,percent of total billed charges,,,1052.4,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2911.64,83,,percent of total billed charges,,892.17,,,,fee schedule,,,3157.2,90,,percent of total billed charges,,,3157.2,90,,percent of total billed charges,,,3157.2,90,,percent of total billed charges,,,3157.2,90,,percent of total billed charges,,,2981.8,85,,percent of total billed charges,,480,3332.6,
SHOULDER ARTHROSCOPY/SURGERY,29822,CDM,29822,CPT,,,both,,3807,3807,940.74,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3235.95,85,,percent of total billed charges,,1177.36,,,,fee schedule,,568.77,,,,fee schedule,,480,,,,fee schedule,,1020.01,,,,fee schedule,,480,,,,fee schedule,,913.07,,,,fee schedule,,553.38,,,,fee schedule,,553.38,,,,fee schedule,,,3464.37,91,,percent of total billed charges,,,3616.65,95,,percent of total billed charges,,,3159.81,83,,percent of total billed charges,,,1142.1,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3159.81,83,,percent of total billed charges,,813.47,,,,fee schedule,,,3426.3,90,,percent of total billed charges,,,3426.3,90,,percent of total billed charges,,,3426.3,90,,percent of total billed charges,,,3426.3,90,,percent of total billed charges,,,3235.95,85,,percent of total billed charges,,480,3616.65,
SHOULDER ARTHROSCOPY/SURGERY,29823,CDM,29823,CPT,,,both,,4201,4201,1030.04,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3570.85,85,,percent of total billed charges,,1291.04,,,,fee schedule,,623.68,,,,fee schedule,,480,,,,fee schedule,,1112.2,,,,fee schedule,,480,,,,fee schedule,,999.74,,,,fee schedule,,605.9,,,,fee schedule,,605.9,,,,fee schedule,,,3822.91,91,,percent of total billed charges,,,3990.95,95,,percent of total billed charges,,,3486.83,83,,percent of total billed charges,,,1260.3,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3486.83,83,,percent of total billed charges,,890.68,,,,fee schedule,,,3780.9,90,,percent of total billed charges,,,3780.9,90,,percent of total billed charges,,,3780.9,90,,percent of total billed charges,,,3780.9,90,,percent of total billed charges,,,3570.85,85,,percent of total billed charges,,480,3990.95,
SHOULDER ARTHROSCOPY/SURGERY,29824,CDM,29824,CPT,,,both,,3954,3954,1176.36,,,,fee schedule,,,,,,,,526.45,,,,fee schedule,,,3360.9,85,,percent of total billed charges,,1473.57,,,,fee schedule,,711.87,,,,fee schedule,,526.45,,,,fee schedule,,1139.39,,,,fee schedule,,526.45,,,,fee schedule,,1141.76,,,,fee schedule,,691.98,,,,fee schedule,,691.98,,,,fee schedule,,,3598.14,91,,percent of total billed charges,,,3756.3,95,,percent of total billed charges,,,3281.82,83,,percent of total billed charges,,,1186.2,83,,percent of total billed charges,,526.45,,,,fee schedule,,526.45,,,,fee schedule,,,3281.82,83,,percent of total billed charges,,1017.21,,,,fee schedule,,,3558.6,90,,percent of total billed charges,,,3558.6,90,,percent of total billed charges,,,3558.6,90,,percent of total billed charges,,,3558.6,90,,percent of total billed charges,,,3360.9,85,,percent of total billed charges,,526.45,3756.3,
SHOULDER ARTHROSCOPY/SURGERY,29825,CDM,29825,CPT,,,both,,3720,3720,1019.67,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3162,85,,percent of total billed charges,,1278.03,,,,fee schedule,,617.4,,,,fee schedule,,480,,,,fee schedule,,1038.58,,,,fee schedule,,480,,,,fee schedule,,989.68,,,,fee schedule,,599.8,,,,fee schedule,,599.8,,,,fee schedule,,,3385.2,91,,percent of total billed charges,,,3534,95,,percent of total billed charges,,,3087.6,83,,percent of total billed charges,,,1116,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3087.6,83,,percent of total billed charges,,881.71,,,,fee schedule,,,3348,90,,percent of total billed charges,,,3348,90,,percent of total billed charges,,,3348,90,,percent of total billed charges,,,3348,90,,percent of total billed charges,,,3162,85,,percent of total billed charges,,480,3534,
SHOULDER ARTHROSCOPY/SURGERY,29826,CDM,29826,CPT,,,both,,4178,4178,294.38,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3551.3,85,,percent of total billed charges,,380.79,,,,fee schedule,,183.96,,,,fee schedule,,480,,,,fee schedule,,1197.09,,,,fee schedule,,480,,,,fee schedule,,285.72,,,,fee schedule,,173.16,,,,fee schedule,,173.16,,,,fee schedule,,,3801.98,91,,percent of total billed charges,,,3969.1,95,,percent of total billed charges,,,3467.74,83,,percent of total billed charges,,,1253.4,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3467.74,83,,percent of total billed charges,,254.55,,,,fee schedule,,,3760.2,90,,percent of total billed charges,,,3760.2,90,,percent of total billed charges,,,3760.2,90,,percent of total billed charges,,,3760.2,90,,percent of total billed charges,,,3551.3,85,,percent of total billed charges,,173.16,3969.1,
ARTHROSCOP ROTATOR CUFF REPR,29827,CDM,29827,CPT,,,both,,6055,6055,1846.34,,,,fee schedule,,,,,,,,674.2,,,,fee schedule,,,5146.75,85,,percent of total billed charges,,2333.82,,,,fee schedule,,1127.44,,,,fee schedule,,674.2,,,,fee schedule,,1956.46,,,,fee schedule,,674.2,,,,fee schedule,,1792.04,,,,fee schedule,,1086.08,,,,fee schedule,,1086.08,,,,fee schedule,,,5510.05,91,,percent of total billed charges,,,5752.25,95,,percent of total billed charges,,,5025.65,83,,percent of total billed charges,,,1816.5,83,,percent of total billed charges,,674.2,,,,fee schedule,,674.2,,,,fee schedule,,,5025.65,83,,percent of total billed charges,,1596.54,,,,fee schedule,,,5449.5,90,,percent of total billed charges,,,5449.5,90,,percent of total billed charges,,,5449.5,90,,percent of total billed charges,,,5449.5,90,,percent of total billed charges,,,5146.75,85,,percent of total billed charges,,674.2,5752.25,
ARTHROSCOPY BICEPS TENODESIS,29828,CDM,29828,CPT,,,both,,5114,5114,1583.65,,,,fee schedule,,,,,,,,484.9,,,,fee schedule,,,4346.9,85,,percent of total billed charges,,2001.56,,,,fee schedule,,966.93,,,,fee schedule,,484.9,,,,fee schedule,,,,,,,,484.9,,,,fee schedule,,1537.07,,,,fee schedule,,931.56,,,,fee schedule,,931.56,,,,fee schedule,,,4653.74,91,,percent of total billed charges,,,4858.3,95,,percent of total billed charges,,,4244.62,83,,percent of total billed charges,,,1534.2,83,,percent of total billed charges,,484.9,,,,fee schedule,,484.9,,,,fee schedule,,,4244.62,83,,percent of total billed charges,,1369.39,,,,fee schedule,,,4602.6,90,,percent of total billed charges,,,4602.6,90,,percent of total billed charges,,,4602.6,90,,percent of total billed charges,,,4602.6,90,,percent of total billed charges,,,4346.9,85,,percent of total billed charges,,484.9,4858.3,
ELBOW ARTHROSCOPY,29830,CDM,29830,CPT,,,both,,3175,3175,790.39,,,,fee schedule,,,,,,,,394.5,,,,fee schedule,,,2698.75,85,,percent of total billed charges,,986,,,,fee schedule,,476.33,,,,fee schedule,,394.5,,,,fee schedule,,799.16,,,,fee schedule,,394.5,,,,fee schedule,,767.14,,,,fee schedule,,464.93,,,,fee schedule,,464.93,,,,fee schedule,,,2889.25,91,,percent of total billed charges,,,3016.25,95,,percent of total billed charges,,,2635.25,83,,percent of total billed charges,,,952.5,83,,percent of total billed charges,,394.5,,,,fee schedule,,394.5,,,,fee schedule,,,2635.25,83,,percent of total billed charges,,683.45,,,,fee schedule,,,2857.5,90,,percent of total billed charges,,,2857.5,90,,percent of total billed charges,,,2857.5,90,,percent of total billed charges,,,2857.5,90,,percent of total billed charges,,,2698.75,85,,percent of total billed charges,,394.5,3016.25,
ELBOW ARTHROSCOPY/SURGERY,29834,CDM,29834,CPT,,,both,,3556,3556,857.21,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3022.6,85,,percent of total billed charges,,1070.23,,,,fee schedule,,517.01,,,,fee schedule,,480,,,,fee schedule,,872.78,,,,fee schedule,,480,,,,fee schedule,,832,,,,fee schedule,,504.24,,,,fee schedule,,504.24,,,,fee schedule,,,3235.96,91,,percent of total billed charges,,,3378.2,95,,percent of total billed charges,,,2951.48,83,,percent of total billed charges,,,1066.8,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2951.48,83,,percent of total billed charges,,741.24,,,,fee schedule,,,3200.4,90,,percent of total billed charges,,,3200.4,90,,percent of total billed charges,,,3200.4,90,,percent of total billed charges,,,3200.4,90,,percent of total billed charges,,,3022.6,85,,percent of total billed charges,,480,3378.2,
ELBOW ARTHROSCOPY/SURGERY,29835,CDM,29835,CPT,,,both,,3594,3594,886.59,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3054.9,85,,percent of total billed charges,,1110.43,,,,fee schedule,,536.44,,,,fee schedule,,480,,,,fee schedule,,892.68,,,,fee schedule,,480,,,,fee schedule,,860.51,,,,fee schedule,,521.52,,,,fee schedule,,521.52,,,,fee schedule,,,3270.54,91,,percent of total billed charges,,,3414.3,95,,percent of total billed charges,,,2983.02,83,,percent of total billed charges,,,1078.2,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2983.02,83,,percent of total billed charges,,766.64,,,,fee schedule,,,3234.6,90,,percent of total billed charges,,,3234.6,90,,percent of total billed charges,,,3234.6,90,,percent of total billed charges,,,3234.6,90,,percent of total billed charges,,,3054.9,85,,percent of total billed charges,,480,3414.3,
ELBOW ARTHROSCOPY/SURGERY,29836,CDM,29836,CPT,,,both,,3947,3947,1017.94,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3354.95,85,,percent of total billed charges,,1273.74,,,,fee schedule,,615.33,,,,fee schedule,,480,,,,fee schedule,,1030.62,,,,fee schedule,,480,,,,fee schedule,,988,,,,fee schedule,,598.79,,,,fee schedule,,598.79,,,,fee schedule,,,3591.77,91,,percent of total billed charges,,,3749.65,95,,percent of total billed charges,,,3276.01,83,,percent of total billed charges,,,1184.1,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3276.01,83,,percent of total billed charges,,880.22,,,,fee schedule,,,3552.3,90,,percent of total billed charges,,,3552.3,90,,percent of total billed charges,,,3552.3,90,,percent of total billed charges,,,3552.3,90,,percent of total billed charges,,,3354.95,85,,percent of total billed charges,,480,3749.65,
ELBOW ARTHROSCOPY/SURGERY,29837,CDM,29837,CPT,,,both,,3546,3546,917.7,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3014.1,85,,percent of total billed charges,,1152.47,,,,fee schedule,,556.75,,,,fee schedule,,480,,,,fee schedule,,939.76,,,,fee schedule,,480,,,,fee schedule,,890.71,,,,fee schedule,,539.82,,,,fee schedule,,539.82,,,,fee schedule,,,3226.86,91,,percent of total billed charges,,,3368.7,95,,percent of total billed charges,,,2943.18,83,,percent of total billed charges,,,1063.8,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2943.18,83,,percent of total billed charges,,793.54,,,,fee schedule,,,3191.4,90,,percent of total billed charges,,,3191.4,90,,percent of total billed charges,,,3191.4,90,,percent of total billed charges,,,3191.4,90,,percent of total billed charges,,,3014.1,85,,percent of total billed charges,,480,3368.7,
ELBOW ARTHROSCOPY/SURGERY,29838,CDM,29838,CPT,,,both,,4332,4332,1033.49,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3682.2,85,,percent of total billed charges,,1291.42,,,,fee schedule,,623.87,,,,fee schedule,,480,,,,fee schedule,,1051.85,,,,fee schedule,,480,,,,fee schedule,,1003.1,,,,fee schedule,,607.94,,,,fee schedule,,607.94,,,,fee schedule,,,3942.12,91,,percent of total billed charges,,,4115.4,95,,percent of total billed charges,,,3595.56,83,,percent of total billed charges,,,1299.6,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3595.56,83,,percent of total billed charges,,893.67,,,,fee schedule,,,3898.8,90,,percent of total billed charges,,,3898.8,90,,percent of total billed charges,,,3898.8,90,,percent of total billed charges,,,3898.8,90,,percent of total billed charges,,,3682.2,85,,percent of total billed charges,,480,4115.4,
WRIST ARTHROSCOPY,29840,CDM,29840,CPT,,,both,,2601,2601,787.5,,,,fee schedule,,,,,,,,356.1,,,,fee schedule,,,2210.85,85,,percent of total billed charges,,976.07,,,,fee schedule,,471.53,,,,fee schedule,,356.1,,,,fee schedule,,774.62,,,,fee schedule,,356.1,,,,fee schedule,,764.34,,,,fee schedule,,463.24,,,,fee schedule,,463.24,,,,fee schedule,,,2366.91,91,,percent of total billed charges,,,2470.95,95,,percent of total billed charges,,,2158.83,83,,percent of total billed charges,,,780.3,83,,percent of total billed charges,,356.1,,,,fee schedule,,356.1,,,,fee schedule,,,2158.83,83,,percent of total billed charges,,680.96,,,,fee schedule,,,2340.9,90,,percent of total billed charges,,,2340.9,90,,percent of total billed charges,,,2340.9,90,,percent of total billed charges,,,2340.9,90,,percent of total billed charges,,,2210.85,85,,percent of total billed charges,,356.1,2470.95,
WRIST ARTHROSCOPY/SURGERY,29843,CDM,29843,CPT,,,both,,3382,3382,847.99,,,,fee schedule,,,,,,,,356.1,,,,fee schedule,,,2874.7,85,,percent of total billed charges,,1058.11,,,,fee schedule,,511.16,,,,fee schedule,,356.1,,,,fee schedule,,831.66,,,,fee schedule,,356.1,,,,fee schedule,,823.05,,,,fee schedule,,498.82,,,,fee schedule,,498.82,,,,fee schedule,,,3077.62,91,,percent of total billed charges,,,3212.9,95,,percent of total billed charges,,,2807.06,83,,percent of total billed charges,,,1014.6,83,,percent of total billed charges,,356.1,,,,fee schedule,,356.1,,,,fee schedule,,,2807.06,83,,percent of total billed charges,,733.26,,,,fee schedule,,,3043.8,90,,percent of total billed charges,,,3043.8,90,,percent of total billed charges,,,3043.8,90,,percent of total billed charges,,,3043.8,90,,percent of total billed charges,,,2874.7,85,,percent of total billed charges,,356.1,3212.9,
WRIST ARTHROSCOPY/SURGERY,29844,CDM,29844,CPT,,,both,,3444,3444,871.04,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,2927.4,85,,percent of total billed charges,,1083.29,,,,fee schedule,,523.32,,,,fee schedule,,480,,,,fee schedule,,876.76,,,,fee schedule,,480,,,,fee schedule,,845.42,,,,fee schedule,,512.37,,,,fee schedule,,512.37,,,,fee schedule,,,3134.04,91,,percent of total billed charges,,,3271.8,95,,percent of total billed charges,,,2858.52,83,,percent of total billed charges,,,1033.2,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2858.52,83,,percent of total billed charges,,753.19,,,,fee schedule,,,3099.6,90,,percent of total billed charges,,,3099.6,90,,percent of total billed charges,,,3099.6,90,,percent of total billed charges,,,3099.6,90,,percent of total billed charges,,,2927.4,85,,percent of total billed charges,,480,3271.8,
WRIST ARTHROSCOPY/SURGERY,29845,CDM,29845,CPT,,,both,,3845,3845,1020.82,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3268.25,85,,percent of total billed charges,,1271.44,,,,fee schedule,,614.22,,,,fee schedule,,480,,,,fee schedule,,992.82,,,,fee schedule,,480,,,,fee schedule,,990.79,,,,fee schedule,,600.48,,,,fee schedule,,600.48,,,,fee schedule,,,3498.95,91,,percent of total billed charges,,,3652.75,95,,percent of total billed charges,,,3191.35,83,,percent of total billed charges,,,1153.5,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3191.35,83,,percent of total billed charges,,882.71,,,,fee schedule,,,3460.5,90,,percent of total billed charges,,,3460.5,90,,percent of total billed charges,,,3460.5,90,,percent of total billed charges,,,3460.5,90,,percent of total billed charges,,,3268.25,85,,percent of total billed charges,,480,3652.75,
WRIST ARTHROSCOPY/SURGERY,29846,CDM,29846,CPT,,,both,,3829,3829,910.79,,,,fee schedule,,,,,,,,356.1,,,,fee schedule,,,3254.65,85,,percent of total billed charges,,1134.33,,,,fee schedule,,547.98,,,,fee schedule,,356.1,,,,fee schedule,,918.54,,,,fee schedule,,356.1,,,,fee schedule,,884,,,,fee schedule,,535.76,,,,fee schedule,,535.76,,,,fee schedule,,,3484.39,91,,percent of total billed charges,,,3637.55,95,,percent of total billed charges,,,3178.07,83,,percent of total billed charges,,,1148.7,83,,percent of total billed charges,,356.1,,,,fee schedule,,356.1,,,,fee schedule,,,3178.07,83,,percent of total billed charges,,787.56,,,,fee schedule,,,3446.1,90,,percent of total billed charges,,,3446.1,90,,percent of total billed charges,,,3446.1,90,,percent of total billed charges,,,3446.1,90,,percent of total billed charges,,,3254.65,85,,percent of total billed charges,,356.1,3637.55,
WRIST ARTHROSCOPY/SURGERY,29847,CDM,29847,CPT,,,both,,3835,3835,947.08,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3259.75,85,,percent of total billed charges,,1186.39,,,,fee schedule,,573.13,,,,fee schedule,,480,,,,fee schedule,,951.04,,,,fee schedule,,480,,,,fee schedule,,919.22,,,,fee schedule,,557.11,,,,fee schedule,,557.11,,,,fee schedule,,,3489.85,91,,percent of total billed charges,,,3643.25,95,,percent of total billed charges,,,3183.05,83,,percent of total billed charges,,,1150.5,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3183.05,83,,percent of total billed charges,,818.95,,,,fee schedule,,,3451.5,90,,percent of total billed charges,,,3451.5,90,,percent of total billed charges,,,3451.5,90,,percent of total billed charges,,,3451.5,90,,percent of total billed charges,,,3259.75,85,,percent of total billed charges,,480,3643.25,
WRIST ENDOSCOPY/SURGERY,29848,CDM,29848,CPT,,,both,,3629,3629,891.78,,,,fee schedule,,,,,,,,456,,,,fee schedule,,,3084.65,85,,percent of total billed charges,,1106.15,,,,fee schedule,,534.37,,,,fee schedule,,456,,,,fee schedule,,789.22,,,,fee schedule,,456,,,,fee schedule,,865.55,,,,fee schedule,,524.57,,,,fee schedule,,524.57,,,,fee schedule,,,3302.39,91,,percent of total billed charges,,,3447.55,95,,percent of total billed charges,,,3012.07,83,,percent of total billed charges,,,1088.7,83,,percent of total billed charges,,456,,,,fee schedule,,456,,,,fee schedule,,,3012.07,83,,percent of total billed charges,,771.12,,,,fee schedule,,,3266.1,90,,percent of total billed charges,,,3266.1,90,,percent of total billed charges,,,3266.1,90,,percent of total billed charges,,,3266.1,90,,percent of total billed charges,,,3084.65,85,,percent of total billed charges,,456,3447.55,
KNEE ARTHROSCOPY/SURGERY,29851,CDM,29851,CPT,,,both,,6479,6479,1607.85,,,,fee schedule,,,,,,,,958.6,,,,fee schedule,,,5507.15,85,,percent of total billed charges,,2029.07,,,,fee schedule,,980.22,,,,fee schedule,,958.6,,,,fee schedule,,1670.62,,,,fee schedule,,958.6,,,,fee schedule,,1560.56,,,,fee schedule,,945.79,,,,fee schedule,,945.79,,,,fee schedule,,,5895.89,91,,percent of total billed charges,,,6155.05,95,,percent of total billed charges,,,5377.57,83,,percent of total billed charges,,,1943.7,83,,percent of total billed charges,,958.6,,,,fee schedule,,958.6,,,,fee schedule,,,5377.57,83,,percent of total billed charges,,1390.31,,,,fee schedule,,,5831.1,90,,percent of total billed charges,,,5831.1,90,,percent of total billed charges,,,5831.1,90,,percent of total billed charges,,,5831.1,90,,percent of total billed charges,,,5507.15,85,,percent of total billed charges,,945.79,6155.05,
TIBIAL ARTHROSCOPY/SURGERY,29855,CDM,29855,CPT,,,both,,4732,4732,1353.22,,,,fee schedule,,,,,,,,629.9,,,,fee schedule,,,4022.2,85,,percent of total billed charges,,1703.21,,,,fee schedule,,822.8,,,,fee schedule,,629.9,,,,fee schedule,,1404.67,,,,fee schedule,,629.9,,,,fee schedule,,1313.42,,,,fee schedule,,796.01,,,,fee schedule,,796.01,,,,fee schedule,,,4306.12,91,,percent of total billed charges,,,4495.4,95,,percent of total billed charges,,,3927.56,83,,percent of total billed charges,,,1419.6,83,,percent of total billed charges,,629.9,,,,fee schedule,,629.9,,,,fee schedule,,,3927.56,83,,percent of total billed charges,,1170.14,,,,fee schedule,,,4258.8,90,,percent of total billed charges,,,4258.8,90,,percent of total billed charges,,,4258.8,90,,percent of total billed charges,,,4258.8,90,,percent of total billed charges,,,4022.2,85,,percent of total billed charges,,629.9,4495.4,
TIBIAL ARTHROSCOPY/SURGERY,29856,CDM,29856,CPT,,,both,,6926,6926,1715.57,,,,fee schedule,,,,,,,,839.35,,,,fee schedule,,,5887.1,85,,percent of total billed charges,,2169.05,,,,fee schedule,,1047.84,,,,fee schedule,,839.35,,,,fee schedule,,1801.93,,,,fee schedule,,839.35,,,,fee schedule,,1665.12,,,,fee schedule,,1009.16,,,,fee schedule,,1009.16,,,,fee schedule,,,6302.66,91,,percent of total billed charges,,,6579.7,95,,percent of total billed charges,,,5748.58,83,,percent of total billed charges,,,2077.8,83,,percent of total billed charges,,839.35,,,,fee schedule,,839.35,,,,fee schedule,,,5748.58,83,,percent of total billed charges,,1483.47,,,,fee schedule,,,6233.4,90,,percent of total billed charges,,,6233.4,90,,percent of total billed charges,,,6233.4,90,,percent of total billed charges,,,6233.4,90,,percent of total billed charges,,,5887.1,85,,percent of total billed charges,,839.35,6579.7,
"HIP ARTHROSCOPY, DX",29860,CDM,29860,CPT,,,both,,4651,4651,1117.02,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,3953.35,85,,percent of total billed charges,,1400.14,,,,fee schedule,,676.39,,,,fee schedule,,374.55,,,,fee schedule,,1083.68,,,,fee schedule,,374.55,,,,fee schedule,,1084.17,,,,fee schedule,,657.07,,,,fee schedule,,657.07,,,,fee schedule,,,4232.41,91,,percent of total billed charges,,,4418.45,95,,percent of total billed charges,,,3860.33,83,,percent of total billed charges,,,1395.3,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,3860.33,83,,percent of total billed charges,,965.9,,,,fee schedule,,,4185.9,90,,percent of total billed charges,,,4185.9,90,,percent of total billed charges,,,4185.9,90,,percent of total billed charges,,,4185.9,90,,percent of total billed charges,,,3953.35,85,,percent of total billed charges,,374.55,4418.45,
HIP ARTHROSCOPY/SURGERY,29861,CDM,29861,CPT,,,both,,3794,3794,1232.24,,,,fee schedule,,,,,,,,486.9,,,,fee schedule,,,3224.9,85,,percent of total billed charges,,1566.41,,,,fee schedule,,756.72,,,,fee schedule,,486.9,,,,fee schedule,,1195.76,,,,fee schedule,,486.9,,,,fee schedule,,1196,,,,fee schedule,,724.85,,,,fee schedule,,724.85,,,,fee schedule,,,3452.54,91,,percent of total billed charges,,,3604.3,95,,percent of total billed charges,,,3149.02,83,,percent of total billed charges,,,1138.2,83,,percent of total billed charges,,486.9,,,,fee schedule,,486.9,,,,fee schedule,,,3149.02,83,,percent of total billed charges,,1065.53,,,,fee schedule,,,3414.6,90,,percent of total billed charges,,,3414.6,90,,percent of total billed charges,,,3414.6,90,,percent of total billed charges,,,3414.6,90,,percent of total billed charges,,,3224.9,85,,percent of total billed charges,,486.9,3604.3,
HIP ARTHROSCOPY/SURGERY,29862,CDM,29862,CPT,,,both,,4982,4982,1406.79,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,4234.7,85,,percent of total billed charges,,1774.64,,,,fee schedule,,857.31,,,,fee schedule,,599.35,,,,fee schedule,,1330.39,,,,fee schedule,,599.35,,,,fee schedule,,1365.42,,,,fee schedule,,827.53,,,,fee schedule,,827.53,,,,fee schedule,,,4533.62,91,,percent of total billed charges,,,4732.9,95,,percent of total billed charges,,,4135.06,83,,percent of total billed charges,,,1494.6,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,4135.06,83,,percent of total billed charges,,1216.46,,,,fee schedule,,,4483.8,90,,percent of total billed charges,,,4483.8,90,,percent of total billed charges,,,4483.8,90,,percent of total billed charges,,,4483.8,90,,percent of total billed charges,,,4234.7,85,,percent of total billed charges,,599.35,4732.9,
HIP ARTHROSCOPY/SURGERY,29863,CDM,29863,CPT,,,both,,4401,4401,1404.49,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3740.85,85,,percent of total billed charges,,1768.49,,,,fee schedule,,854.33,,,,fee schedule,,599.35,,,,fee schedule,,1314.47,,,,fee schedule,,599.35,,,,fee schedule,,1363.18,,,,fee schedule,,826.17,,,,fee schedule,,826.17,,,,fee schedule,,,4004.91,91,,percent of total billed charges,,,4180.95,95,,percent of total billed charges,,,3652.83,83,,percent of total billed charges,,,1320.3,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3652.83,83,,percent of total billed charges,,1214.47,,,,fee schedule,,,3960.9,90,,percent of total billed charges,,,3960.9,90,,percent of total billed charges,,,3960.9,90,,percent of total billed charges,,,3960.9,90,,percent of total billed charges,,,3740.85,85,,percent of total billed charges,,599.35,4180.95,
"AUTGRFT IMPLNT, KNEE W/SCOPE",29866,CDM,29866,CPT,,,both,,5814,5814,1819.84,,,,fee schedule,,,,,,,,631.2,,,,fee schedule,,,4941.9,85,,percent of total billed charges,,2294.11,,,,fee schedule,,1108.26,,,,fee schedule,,631.2,,,,fee schedule,,1831.11,,,,fee schedule,,631.2,,,,fee schedule,,1766.32,,,,fee schedule,,1070.5,,,,fee schedule,,1070.5,,,,fee schedule,,,5290.74,91,,percent of total billed charges,,,5523.3,95,,percent of total billed charges,,,4825.62,83,,percent of total billed charges,,,1744.2,83,,percent of total billed charges,,631.2,,,,fee schedule,,631.2,,,,fee schedule,,,4825.62,83,,percent of total billed charges,,1573.63,,,,fee schedule,,,5232.6,90,,percent of total billed charges,,,5232.6,90,,percent of total billed charges,,,5232.6,90,,percent of total billed charges,,,5232.6,90,,percent of total billed charges,,,4941.9,85,,percent of total billed charges,,631.2,5523.3,
"ALLGRFT IMPLNT, KNEE W/SCOPE",29867,CDM,29867,CPT,,,both,,8424,8424,2206.97,,,,fee schedule,,,,,,,,769.56,,,,fee schedule,,,7160.4,85,,percent of total billed charges,,2790.48,,,,fee schedule,,1348.05,,,,fee schedule,,769.56,,,,fee schedule,,2187.25,,,,fee schedule,,769.56,,,,fee schedule,,2142.06,,,,fee schedule,,1298.22,,,,fee schedule,,1298.22,,,,fee schedule,,,7665.84,91,,percent of total billed charges,,,8002.8,95,,percent of total billed charges,,,6991.92,83,,percent of total billed charges,,,2527.2,83,,percent of total billed charges,,769.56,,,,fee schedule,,769.56,,,,fee schedule,,,6991.92,83,,percent of total billed charges,,1908.38,,,,fee schedule,,,7581.6,90,,percent of total billed charges,,,7581.6,90,,percent of total billed charges,,,7581.6,90,,percent of total billed charges,,,7581.6,90,,percent of total billed charges,,,7160.4,85,,percent of total billed charges,,769.56,8002.8,
"MENISCAL TRNSPL, KNEE W/SCPE",29868,CDM,29868,CPT,,,both,,11616,11616,2873.5,,,,fee schedule,,,,,,,,1009.61,,,,fee schedule,,,9873.6,85,,percent of total billed charges,,3649.52,,,,fee schedule,,1763.04,,,,fee schedule,,1009.61,,,,fee schedule,,2965.2,,,,fee schedule,,1009.61,,,,fee schedule,,2788.98,,,,fee schedule,,1690.29,,,,fee schedule,,1690.29,,,,fee schedule,,,10570.56,91,,percent of total billed charges,,,11035.2,95,,percent of total billed charges,,,9641.28,83,,percent of total billed charges,,,3484.8,83,,percent of total billed charges,,1009.61,,,,fee schedule,,1009.61,,,,fee schedule,,,9641.28,83,,percent of total billed charges,,2484.73,,,,fee schedule,,,10454.4,90,,percent of total billed charges,,,10454.4,90,,percent of total billed charges,,,10454.4,90,,percent of total billed charges,,,10454.4,90,,percent of total billed charges,,,9873.6,85,,percent of total billed charges,,1009.61,11035.2,
"KNEE ARTHROSCOPY, DX",29870,CDM,29870,CPT,,,both,,2348,2348,707.43,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,1995.8,85,,percent of total billed charges,,825.72,,,,fee schedule,,426.72,,,,fee schedule,,374.55,,,,fee schedule,,714.94,,,,fee schedule,,374.55,,,,fee schedule,,686.62,,,,fee schedule,,416.13,,,,fee schedule,,416.13,,,,fee schedule,,,2136.68,91,,percent of total billed charges,,,2230.6,95,,percent of total billed charges,,,1948.84,83,,percent of total billed charges,,,704.4,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,1948.84,83,,percent of total billed charges,,611.72,,,,fee schedule,,,2113.2,90,,percent of total billed charges,,,2113.2,90,,percent of total billed charges,,,2113.2,90,,percent of total billed charges,,,2113.2,90,,percent of total billed charges,,,1995.8,85,,percent of total billed charges,,374.55,2230.6,
KNEE ARTHROSCOPY/DRAINAGE,29871,CDM,29871,CPT,,,both,,3245,3245,896.96,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,2758.25,85,,percent of total billed charges,,1119.18,,,,fee schedule,,540.66,,,,fee schedule,,374.55,,,,fee schedule,,897.32,,,,fee schedule,,374.55,,,,fee schedule,,870.58,,,,fee schedule,,527.62,,,,fee schedule,,527.62,,,,fee schedule,,,2952.95,91,,percent of total billed charges,,,3082.75,95,,percent of total billed charges,,,2693.35,83,,percent of total billed charges,,,973.5,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,2693.35,83,,percent of total billed charges,,775.61,,,,fee schedule,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2758.25,85,,percent of total billed charges,,374.55,3082.75,
KNEE ARTHROSCOPY/SURGERY,29873,CDM,29873,CPT,,,both,,3349,3349,933.83,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,2846.65,85,,percent of total billed charges,,1162.67,,,,fee schedule,,561.67,,,,fee schedule,,374.55,,,,fee schedule,,901.3,,,,fee schedule,,374.55,,,,fee schedule,,906.36,,,,fee schedule,,549.31,,,,fee schedule,,549.31,,,,fee schedule,,,3047.59,91,,percent of total billed charges,,,3181.55,95,,percent of total billed charges,,,2779.67,83,,percent of total billed charges,,,1004.7,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,2779.67,83,,percent of total billed charges,,807.49,,,,fee schedule,,,3014.1,90,,percent of total billed charges,,,3014.1,90,,percent of total billed charges,,,3014.1,90,,percent of total billed charges,,,3014.1,90,,percent of total billed charges,,,2846.65,85,,percent of total billed charges,,374.55,3181.55,
KNEE ARTHROSCOPY/SURGERY,29874,CDM,29874,CPT,,,both,,3805,3805,930.95,,,,fee schedule,,,,,,,,486.9,,,,fee schedule,,,3234.25,85,,percent of total billed charges,,1167.87,,,,fee schedule,,564.19,,,,fee schedule,,486.9,,,,fee schedule,,940.43,,,,fee schedule,,486.9,,,,fee schedule,,903.57,,,,fee schedule,,547.62,,,,fee schedule,,547.62,,,,fee schedule,,,3462.55,91,,percent of total billed charges,,,3614.75,95,,percent of total billed charges,,,3158.15,83,,percent of total billed charges,,,1141.5,83,,percent of total billed charges,,486.9,,,,fee schedule,,486.9,,,,fee schedule,,,3158.15,83,,percent of total billed charges,,805,,,,fee schedule,,,3424.5,90,,percent of total billed charges,,,3424.5,90,,percent of total billed charges,,,3424.5,90,,percent of total billed charges,,,3424.5,90,,percent of total billed charges,,,3234.25,85,,percent of total billed charges,,486.9,3614.75,
KNEE ARTHROSCOPY/SURGERY,29874AS80,CDM,29874,CPT,,,both,,689,689,930.95,,,,fee schedule,,,,,,,,486.9,,,,fee schedule,,,585.65,85,,percent of total billed charges,,1167.87,,,,fee schedule,,564.19,,,,fee schedule,,486.9,,,,fee schedule,,940.43,,,,fee schedule,,486.9,,,,fee schedule,,903.57,,,,fee schedule,,547.62,,,,fee schedule,,547.62,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,486.9,,,,fee schedule,,486.9,,,,fee schedule,,,571.87,83,,percent of total billed charges,,805,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,1167.87,
KNEE ARTHROSCOPY/SURGERY,29875,CDM,29875,CPT,,,both,,3919,3919,863.55,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3331.15,85,,percent of total billed charges,,1079.64,,,,fee schedule,,521.56,,,,fee schedule,,599.35,,,,fee schedule,,877.42,,,,fee schedule,,599.35,,,,fee schedule,,838.15,,,,fee schedule,,507.97,,,,fee schedule,,507.97,,,,fee schedule,,,3566.29,91,,percent of total billed charges,,,3723.05,95,,percent of total billed charges,,,3252.77,83,,percent of total billed charges,,,1175.7,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3252.77,83,,percent of total billed charges,,746.71,,,,fee schedule,,,3527.1,90,,percent of total billed charges,,,3527.1,90,,percent of total billed charges,,,3527.1,90,,percent of total billed charges,,,3527.1,90,,percent of total billed charges,,,3331.15,85,,percent of total billed charges,,507.97,3723.05,
KNEE ARTHROSCOPY/SURGERY,29876,CDM,29876,CPT,,,both,,4565,4565,1132,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3880.25,85,,percent of total billed charges,,1423.6,,,,fee schedule,,687.72,,,,fee schedule,,599.35,,,,fee schedule,,1080.36,,,,fee schedule,,599.35,,,,fee schedule,,1098.71,,,,fee schedule,,665.88,,,,fee schedule,,665.88,,,,fee schedule,,,4154.15,91,,percent of total billed charges,,,4336.75,95,,percent of total billed charges,,,3788.95,83,,percent of total billed charges,,,1369.5,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3788.95,83,,percent of total billed charges,,978.85,,,,fee schedule,,,4108.5,90,,percent of total billed charges,,,4108.5,90,,percent of total billed charges,,,4108.5,90,,percent of total billed charges,,,4108.5,90,,percent of total billed charges,,,3880.25,85,,percent of total billed charges,,599.35,4336.75,
KNEE ARTHROSCOPY/SURGERY,29877,CDM,29877,CPT,,,both,,4144,4144,1078.43,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3522.4,85,,percent of total billed charges,,1353.52,,,,fee schedule,,653.87,,,,fee schedule,,599.35,,,,fee schedule,,1017.36,,,,fee schedule,,599.35,,,,fee schedule,,1046.71,,,,fee schedule,,634.37,,,,fee schedule,,634.37,,,,fee schedule,,,3771.04,91,,percent of total billed charges,,,3936.8,95,,percent of total billed charges,,,3439.52,83,,percent of total billed charges,,,1243.2,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3439.52,83,,percent of total billed charges,,932.52,,,,fee schedule,,,3729.6,90,,percent of total billed charges,,,3729.6,90,,percent of total billed charges,,,3729.6,90,,percent of total billed charges,,,3729.6,90,,percent of total billed charges,,,3522.4,85,,percent of total billed charges,,599.35,3936.8,
KNEE ARTHROSCOPY/SURGERY,29879,CDM,29879,CPT,,,both,,4447,4447,1147.56,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3779.95,85,,percent of total billed charges,,1441.62,,,,fee schedule,,696.43,,,,fee schedule,,599.35,,,,fee schedule,,1096.28,,,,fee schedule,,599.35,,,,fee schedule,,1113.8,,,,fee schedule,,675.03,,,,fee schedule,,675.03,,,,fee schedule,,,4046.77,91,,percent of total billed charges,,,4224.65,95,,percent of total billed charges,,,3691.01,83,,percent of total billed charges,,,1334.1,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3691.01,83,,percent of total billed charges,,992.3,,,,fee schedule,,,4002.3,90,,percent of total billed charges,,,4002.3,90,,percent of total billed charges,,,4002.3,90,,percent of total billed charges,,,4002.3,90,,percent of total billed charges,,,3779.95,85,,percent of total billed charges,,599.35,4224.65,
KNEE ARTHROSCOPY/SURGERY,29880,CDM,29880,CPT,,,both,,5671,5671,977.04,,,,fee schedule,,,,,,,,621.5,,,,fee schedule,,,4820.35,85,,percent of total billed charges,,1143.33,,,,fee schedule,,590.85,,,,fee schedule,,621.5,,,,fee schedule,,1148.01,,,,fee schedule,,621.5,,,,fee schedule,,948.3,,,,fee schedule,,574.73,,,,fee schedule,,574.73,,,,fee schedule,,,5160.61,91,,percent of total billed charges,,,5387.45,95,,percent of total billed charges,,,4706.93,83,,percent of total billed charges,,,1701.3,83,,percent of total billed charges,,621.5,,,,fee schedule,,621.5,,,,fee schedule,,,4706.93,83,,percent of total billed charges,,844.85,,,,fee schedule,,,5103.9,90,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,5103.9,90,,percent of total billed charges,,,4820.35,85,,percent of total billed charges,,574.73,5387.45,
KNEE ARTHROSCOPY/SURGERY,29881,CDM,29881,CPT,,,both,,4714,4714,940.74,,,,fee schedule,,,,,,,,621.5,,,,fee schedule,,,4006.9,85,,percent of total billed charges,,1100.78,,,,fee schedule,,555.96,,,,fee schedule,,621.5,,,,fee schedule,,1063.78,,,,fee schedule,,621.5,,,,fee schedule,,913.07,,,,fee schedule,,553.38,,,,fee schedule,,553.38,,,,fee schedule,,,4289.74,91,,percent of total billed charges,,,4478.3,95,,percent of total billed charges,,,3912.62,83,,percent of total billed charges,,,1414.2,83,,percent of total billed charges,,621.5,,,,fee schedule,,621.5,,,,fee schedule,,,3912.62,83,,percent of total billed charges,,813.47,,,,fee schedule,,,4242.6,90,,percent of total billed charges,,,4242.6,90,,percent of total billed charges,,,4242.6,90,,percent of total billed charges,,,4242.6,90,,percent of total billed charges,,,4006.9,85,,percent of total billed charges,,553.38,4478.3,
KNEE ARTHROSCOPY/SURGERY,29882,CDM,29882,CPT,,,both,,4884,4884,1195.37,,,,fee schedule,,,,,,,,621.5,,,,fee schedule,,,4151.4,85,,percent of total billed charges,,1501.38,,,,fee schedule,,725.3,,,,fee schedule,,621.5,,,,fee schedule,,1151.33,,,,fee schedule,,621.5,,,,fee schedule,,1160.21,,,,fee schedule,,703.16,,,,fee schedule,,703.16,,,,fee schedule,,,4444.44,91,,percent of total billed charges,,,4639.8,95,,percent of total billed charges,,,4053.72,83,,percent of total billed charges,,,1465.2,83,,percent of total billed charges,,621.5,,,,fee schedule,,621.5,,,,fee schedule,,,4053.72,83,,percent of total billed charges,,1033.64,,,,fee schedule,,,4395.6,90,,percent of total billed charges,,,4395.6,90,,percent of total billed charges,,,4395.6,90,,percent of total billed charges,,,4395.6,90,,percent of total billed charges,,,4151.4,85,,percent of total billed charges,,621.5,4639.8,
KNEE ARTHROSCOPY/SURGERY,29883,CDM,29883,CPT,,,both,,5397,5397,1460.94,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,4587.45,85,,percent of total billed charges,,1833.83,,,,fee schedule,,885.9,,,,fee schedule,,599.35,,,,fee schedule,,1457.73,,,,fee schedule,,599.35,,,,fee schedule,,1417.98,,,,fee schedule,,859.38,,,,fee schedule,,859.38,,,,fee schedule,,,4911.27,91,,percent of total billed charges,,,5127.15,95,,percent of total billed charges,,,4479.51,83,,percent of total billed charges,,,1619.1,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,4479.51,83,,percent of total billed charges,,1263.29,,,,fee schedule,,,4857.3,90,,percent of total billed charges,,,4857.3,90,,percent of total billed charges,,,4857.3,90,,percent of total billed charges,,,4857.3,90,,percent of total billed charges,,,4587.45,85,,percent of total billed charges,,599.35,5127.15,
KNEE ARTHROSCOPY/SURGERY,29884,CDM,29884,CPT,,,both,,4177,4177,1075.55,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3550.45,85,,percent of total billed charges,,1345.94,,,,fee schedule,,650.21,,,,fee schedule,,599.35,,,,fee schedule,,1013.38,,,,fee schedule,,599.35,,,,fee schedule,,1043.91,,,,fee schedule,,632.67,,,,fee schedule,,632.67,,,,fee schedule,,,3801.07,91,,percent of total billed charges,,,3968.15,95,,percent of total billed charges,,,3466.91,83,,percent of total billed charges,,,1253.1,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3466.91,83,,percent of total billed charges,,930.03,,,,fee schedule,,,3759.3,90,,percent of total billed charges,,,3759.3,90,,percent of total billed charges,,,3759.3,90,,percent of total billed charges,,,3759.3,90,,percent of total billed charges,,,3550.45,85,,percent of total billed charges,,599.35,3968.15,
KNEE ARTHROSCOPY/SURGERY,29885,CDM,29885,CPT,,,both,,5395,5395,1311.74,,,,fee schedule,,,,,,,,621.5,,,,fee schedule,,,4585.75,85,,percent of total billed charges,,1648.43,,,,fee schedule,,796.34,,,,fee schedule,,621.5,,,,fee schedule,,1234.23,,,,fee schedule,,621.5,,,,fee schedule,,1273.16,,,,fee schedule,,771.61,,,,fee schedule,,771.61,,,,fee schedule,,,4909.45,91,,percent of total billed charges,,,5125.25,95,,percent of total billed charges,,,4477.85,83,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,621.5,,,,fee schedule,,621.5,,,,fee schedule,,,4477.85,83,,percent of total billed charges,,1134.27,,,,fee schedule,,,4855.5,90,,percent of total billed charges,,,4855.5,90,,percent of total billed charges,,,4855.5,90,,percent of total billed charges,,,4855.5,90,,percent of total billed charges,,,4585.75,85,,percent of total billed charges,,621.5,5125.25,
KNEE ARTHROSCOPY/SURGERY,29886,CDM,29886,CPT,,,both,,4625,4625,1106.08,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3931.25,85,,percent of total billed charges,,1385.19,,,,fee schedule,,669.17,,,,fee schedule,,599.35,,,,fee schedule,,1039.24,,,,fee schedule,,599.35,,,,fee schedule,,1073.55,,,,fee schedule,,650.63,,,,fee schedule,,650.63,,,,fee schedule,,,4208.75,91,,percent of total billed charges,,,4393.75,95,,percent of total billed charges,,,3838.75,83,,percent of total billed charges,,,1387.5,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3838.75,83,,percent of total billed charges,,956.43,,,,fee schedule,,,4162.5,90,,percent of total billed charges,,,4162.5,90,,percent of total billed charges,,,4162.5,90,,percent of total billed charges,,,4162.5,90,,percent of total billed charges,,,3931.25,85,,percent of total billed charges,,599.35,4393.75,
KNEE ARTHROSCOPY/SURGERY,29887,CDM,29887,CPT,,,both,,4557,4557,1306.55,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3873.45,85,,percent of total billed charges,,1640.85,,,,fee schedule,,792.68,,,,fee schedule,,599.35,,,,fee schedule,,1227.59,,,,fee schedule,,599.35,,,,fee schedule,,1268.13,,,,fee schedule,,768.56,,,,fee schedule,,768.56,,,,fee schedule,,,4146.87,91,,percent of total billed charges,,,4329.15,95,,percent of total billed charges,,,3782.31,83,,percent of total billed charges,,,1367.1,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3782.31,83,,percent of total billed charges,,1129.79,,,,fee schedule,,,4101.3,90,,percent of total billed charges,,,4101.3,90,,percent of total billed charges,,,4101.3,90,,percent of total billed charges,,,4101.3,90,,percent of total billed charges,,,3873.45,85,,percent of total billed charges,,599.35,4329.15,
KNEE ARTHROSCOPY/SURGERY,29888,CDM,29888,CPT,,,both,,7175,7175,1684.46,,,,fee schedule,,,,,,,,621.5,,,,fee schedule,,,6098.75,85,,percent of total billed charges,,2134,,,,fee schedule,,1030.91,,,,fee schedule,,621.5,,,,fee schedule,,1754.84,,,,fee schedule,,621.5,,,,fee schedule,,1634.92,,,,fee schedule,,990.86,,,,fee schedule,,990.86,,,,fee schedule,,,6529.25,91,,percent of total billed charges,,,6816.25,95,,percent of total billed charges,,,5955.25,83,,percent of total billed charges,,,2152.5,83,,percent of total billed charges,,621.5,,,,fee schedule,,621.5,,,,fee schedule,,,5955.25,83,,percent of total billed charges,,1456.57,,,,fee schedule,,,6457.5,90,,percent of total billed charges,,,6457.5,90,,percent of total billed charges,,,6457.5,90,,percent of total billed charges,,,6457.5,90,,percent of total billed charges,,,6098.75,85,,percent of total billed charges,,621.5,6816.25,
KNEE ARTHROSCOPY/SURGERY,29889,CDM,29889,CPT,,,both,,6821,6821,2114.8,,,,fee schedule,,,,,,,,621.5,,,,fee schedule,,,5797.85,85,,percent of total billed charges,,2671.41,,,,fee schedule,,1290.53,,,,fee schedule,,621.5,,,,fee schedule,,2065.22,,,,fee schedule,,621.5,,,,fee schedule,,2052.6,,,,fee schedule,,1244,,,,fee schedule,,1244,,,,fee schedule,,,6207.11,91,,percent of total billed charges,,,6479.95,95,,percent of total billed charges,,,5661.43,83,,percent of total billed charges,,,2046.3,83,,percent of total billed charges,,621.5,,,,fee schedule,,621.5,,,,fee schedule,,,5661.43,83,,percent of total billed charges,,1828.68,,,,fee schedule,,,6138.9,90,,percent of total billed charges,,,6138.9,90,,percent of total billed charges,,,6138.9,90,,percent of total billed charges,,,6138.9,90,,percent of total billed charges,,,5797.85,85,,percent of total billed charges,,621.5,6479.95,
ANKLE ARTHROSCOPY/SURGERY,29891,CDM,29891,CPT,,,both,,4204,4204,1158.5,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3573.4,85,,percent of total billed charges,,1454.32,,,,fee schedule,,702.56,,,,fee schedule,,480,,,,fee schedule,,1146.02,,,,fee schedule,,480,,,,fee schedule,,1124.43,,,,fee schedule,,681.47,,,,fee schedule,,681.47,,,,fee schedule,,,3825.64,91,,percent of total billed charges,,,3993.8,95,,percent of total billed charges,,,3489.32,83,,percent of total billed charges,,,1261.2,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3489.32,83,,percent of total billed charges,,1001.76,,,,fee schedule,,,3783.6,90,,percent of total billed charges,,,3783.6,90,,percent of total billed charges,,,3783.6,90,,percent of total billed charges,,,3783.6,90,,percent of total billed charges,,,3573.4,85,,percent of total billed charges,,480,3993.8,
ANKLE ARTHROSCOPY/SURGERY,29892,CDM,29892,CPT,,,both,,4283,4283,1107.23,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3640.55,85,,percent of total billed charges,,1380.18,,,,fee schedule,,666.75,,,,fee schedule,,480,,,,fee schedule,,1203.06,,,,fee schedule,,480,,,,fee schedule,,1074.66,,,,fee schedule,,651.31,,,,fee schedule,,651.31,,,,fee schedule,,,3897.53,91,,percent of total billed charges,,,4068.85,95,,percent of total billed charges,,,3554.89,83,,percent of total billed charges,,,1284.9,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3554.89,83,,percent of total billed charges,,957.43,,,,fee schedule,,,3854.7,90,,percent of total billed charges,,,3854.7,90,,percent of total billed charges,,,3854.7,90,,percent of total billed charges,,,3854.7,90,,percent of total billed charges,,,3640.55,85,,percent of total billed charges,,480,4068.85,
"SCOPE, PLANTAR FASCIOTOMY",29893,CDM,29893,CPT,,,both,,2803,2803,748.33,,,,fee schedule,,,,,,,,171.9,,,,fee schedule,,,2382.55,85,,percent of total billed charges,,924.95,,,,fee schedule,,446.83,,,,fee schedule,,171.9,,,,fee schedule,,653.26,,,,fee schedule,,171.9,,,,fee schedule,,726.32,,,,fee schedule,,440.19,,,,fee schedule,,440.19,,,,fee schedule,,,2550.73,91,,percent of total billed charges,,,2662.85,95,,percent of total billed charges,,,2326.49,83,,percent of total billed charges,,,840.9,83,,percent of total billed charges,,171.9,,,,fee schedule,,171.9,,,,fee schedule,,,2326.49,83,,percent of total billed charges,,647.09,,,,fee schedule,,,2522.7,90,,percent of total billed charges,,,2522.7,90,,percent of total billed charges,,,2522.7,90,,percent of total billed charges,,,2522.7,90,,percent of total billed charges,,,2382.55,85,,percent of total billed charges,,171.9,2662.85,
ANKLE ARTHROSCOPY/SURGERY,29894,CDM,29894,CPT,,,both,,3800,3800,858.36,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3230,85,,percent of total billed charges,,1095.67,,,,fee schedule,,529.31,,,,fee schedule,,480,,,,fee schedule,,915.89,,,,fee schedule,,480,,,,fee schedule,,833.12,,,,fee schedule,,504.92,,,,fee schedule,,504.92,,,,fee schedule,,,3458,91,,percent of total billed charges,,,3610,95,,percent of total billed charges,,,3154,83,,percent of total billed charges,,,1140,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3154,83,,percent of total billed charges,,742.23,,,,fee schedule,,,3420,90,,percent of total billed charges,,,3420,90,,percent of total billed charges,,,3420,90,,percent of total billed charges,,,3420,90,,percent of total billed charges,,,3230,85,,percent of total billed charges,,480,3610,
ANKLE ARTHROSCOPY/SURGERY,29895,CDM,29895,CPT,,,both,,3807,3807,801.33,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3235.95,85,,percent of total billed charges,,1016.42,,,,fee schedule,,491.02,,,,fee schedule,,480,,,,fee schedule,,898.64,,,,fee schedule,,480,,,,fee schedule,,777.76,,,,fee schedule,,471.37,,,,fee schedule,,471.37,,,,fee schedule,,,3464.37,91,,percent of total billed charges,,,3616.65,95,,percent of total billed charges,,,3159.81,83,,percent of total billed charges,,,1142.1,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3159.81,83,,percent of total billed charges,,692.92,,,,fee schedule,,,3426.3,90,,percent of total billed charges,,,3426.3,90,,percent of total billed charges,,,3426.3,90,,percent of total billed charges,,,3426.3,90,,percent of total billed charges,,,3235.95,85,,percent of total billed charges,,471.37,3616.65,
ANKLE ARTHROSCOPY/SURGERY,29897,CDM,29897,CPT,,,both,,3436,3436,861.82,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,2920.6,85,,percent of total billed charges,,1068.75,,,,fee schedule,,516.3,,,,fee schedule,,480,,,,fee schedule,,943.08,,,,fee schedule,,480,,,,fee schedule,,836.47,,,,fee schedule,,506.95,,,,fee schedule,,506.95,,,,fee schedule,,,3126.76,91,,percent of total billed charges,,,3264.2,95,,percent of total billed charges,,,2851.88,83,,percent of total billed charges,,,1030.8,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2851.88,83,,percent of total billed charges,,745.22,,,,fee schedule,,,3092.4,90,,percent of total billed charges,,,3092.4,90,,percent of total billed charges,,,3092.4,90,,percent of total billed charges,,,3092.4,90,,percent of total billed charges,,,2920.6,85,,percent of total billed charges,,480,3264.2,
ANKLE ARTHROSCOPY/SURGERY,29898,CDM,29898,CPT,,,both,,4256,4256,969.55,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3617.6,85,,percent of total billed charges,,1219.04,,,,fee schedule,,588.9,,,,fee schedule,,480,,,,fee schedule,,1045.88,,,,fee schedule,,480,,,,fee schedule,,941.03,,,,fee schedule,,570.32,,,,fee schedule,,570.32,,,,fee schedule,,,3872.96,91,,percent of total billed charges,,,4043.2,95,,percent of total billed charges,,,3532.48,83,,percent of total billed charges,,,1276.8,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3532.48,83,,percent of total billed charges,,838.37,,,,fee schedule,,,3830.4,90,,percent of total billed charges,,,3830.4,90,,percent of total billed charges,,,3830.4,90,,percent of total billed charges,,,3830.4,90,,percent of total billed charges,,,3617.6,85,,percent of total billed charges,,480,4043.2,
ANKLE ARTHROSCOPY/SURGERY,29899,CDM,29899,CPT,,,both,,5980,5980,1735.16,,,,fee schedule,,,,,,,,659,,,,fee schedule,,,5083,85,,percent of total billed charges,,2217.73,,,,fee schedule,,1071.36,,,,fee schedule,,659,,,,fee schedule,,1776.73,,,,fee schedule,,659,,,,fee schedule,,1684.13,,,,fee schedule,,1020.68,,,,fee schedule,,1020.68,,,,fee schedule,,,5441.8,91,,percent of total billed charges,,,5681,95,,percent of total billed charges,,,4963.4,83,,percent of total billed charges,,,1794,83,,percent of total billed charges,,659,,,,fee schedule,,659,,,,fee schedule,,,4963.4,83,,percent of total billed charges,,1500.4,,,,fee schedule,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5382,90,,percent of total billed charges,,,5083,85,,percent of total billed charges,,659,5681,
"MCP JOINT ARTHROSCOPY, DX",29900,CDM,29900,CPT,,,both,,3309,3309,879.68,,,,fee schedule,,,,,,,,288.6,,,,fee schedule,,,2812.65,85,,percent of total billed charges,,1089.31,,,,fee schedule,,526.23,,,,fee schedule,,288.6,,,,fee schedule,,809.11,,,,fee schedule,,288.6,,,,fee schedule,,853.8,,,,fee schedule,,517.46,,,,fee schedule,,517.46,,,,fee schedule,,,3011.19,91,,percent of total billed charges,,,3143.55,95,,percent of total billed charges,,,2746.47,83,,percent of total billed charges,,,992.7,83,,percent of total billed charges,,288.6,,,,fee schedule,,288.6,,,,fee schedule,,,2746.47,83,,percent of total billed charges,,760.66,,,,fee schedule,,,2978.1,90,,percent of total billed charges,,,2978.1,90,,percent of total billed charges,,,2978.1,90,,percent of total billed charges,,,2978.1,90,,percent of total billed charges,,,2812.65,85,,percent of total billed charges,,288.6,3143.55,
"MCP JOINT ARTHROSCOPY, SURG",29901,CDM,29901,CPT,,,both,,3731,3731,942.47,,,,fee schedule,,,,,,,,318.8,,,,fee schedule,,,3171.35,85,,percent of total billed charges,,1172.27,,,,fee schedule,,566.31,,,,fee schedule,,318.8,,,,fee schedule,,891.35,,,,fee schedule,,318.8,,,,fee schedule,,914.75,,,,fee schedule,,554.39,,,,fee schedule,,554.39,,,,fee schedule,,,3395.21,91,,percent of total billed charges,,,3544.45,95,,percent of total billed charges,,,3096.73,83,,percent of total billed charges,,,1119.3,83,,percent of total billed charges,,318.8,,,,fee schedule,,318.8,,,,fee schedule,,,3096.73,83,,percent of total billed charges,,814.96,,,,fee schedule,,,3357.9,90,,percent of total billed charges,,,3357.9,90,,percent of total billed charges,,,3357.9,90,,percent of total billed charges,,,3357.9,90,,percent of total billed charges,,,3171.35,85,,percent of total billed charges,,318.8,3544.45,
"MCP JOINT ARTHROSCOPY, SURG",29902,CDM,29902,CPT,,,both,,4236,4236,998.93,,,,fee schedule,,,,,,,,342.55,,,,fee schedule,,,3600.6,85,,percent of total billed charges,,1244.61,,,,fee schedule,,601.26,,,,fee schedule,,342.55,,,,fee schedule,,951.7,,,,fee schedule,,342.55,,,,fee schedule,,969.55,,,,fee schedule,,587.6,,,,fee schedule,,587.6,,,,fee schedule,,,3854.76,91,,percent of total billed charges,,,4024.2,95,,percent of total billed charges,,,3515.88,83,,percent of total billed charges,,,1270.8,83,,percent of total billed charges,,342.55,,,,fee schedule,,342.55,,,,fee schedule,,,3515.88,83,,percent of total billed charges,,863.78,,,,fee schedule,,,3812.4,90,,percent of total billed charges,,,3812.4,90,,percent of total billed charges,,,3812.4,90,,percent of total billed charges,,,3812.4,90,,percent of total billed charges,,,3600.6,85,,percent of total billed charges,,342.55,4024.2,
SUBTALAR ARTHRO W/FB RMVL,29904,CDM,29904,CPT,,,both,,4443,4443,1110.11,,,,fee schedule,,,,,,,,323.37,,,,fee schedule,,,3776.55,85,,percent of total billed charges,,1392.74,,,,fee schedule,,672.81,,,,fee schedule,,323.37,,,,fee schedule,,,,,,,,323.37,,,,fee schedule,,1077.46,,,,fee schedule,,653.01,,,,fee schedule,,653.01,,,,fee schedule,,,4043.13,91,,percent of total billed charges,,,4220.85,95,,percent of total billed charges,,,3687.69,83,,percent of total billed charges,,,1332.9,83,,percent of total billed charges,,323.37,,,,fee schedule,,323.37,,,,fee schedule,,,3687.69,83,,percent of total billed charges,,959.92,,,,fee schedule,,,3998.7,90,,percent of total billed charges,,,3998.7,90,,percent of total billed charges,,,3998.7,90,,percent of total billed charges,,,3998.7,90,,percent of total billed charges,,,3776.55,85,,percent of total billed charges,,323.37,4220.85,
SUBTALAR ARTHRO W/EXC,29905,CDM,29905,CPT,,,both,,4820,4820,879.68,,,,fee schedule,,,,,,,,347.96,,,,fee schedule,,,4097,85,,percent of total billed charges,,1106.84,,,,fee schedule,,534.7,,,,fee schedule,,347.96,,,,fee schedule,,,,,,,,347.96,,,,fee schedule,,853.8,,,,fee schedule,,517.46,,,,fee schedule,,517.46,,,,fee schedule,,,4386.2,91,,percent of total billed charges,,,4579,95,,percent of total billed charges,,,4000.6,83,,percent of total billed charges,,,1446,83,,percent of total billed charges,,347.96,,,,fee schedule,,347.96,,,,fee schedule,,,4000.6,83,,percent of total billed charges,,760.66,,,,fee schedule,,,4338,90,,percent of total billed charges,,,4338,90,,percent of total billed charges,,,4338,90,,percent of total billed charges,,,4338,90,,percent of total billed charges,,,4097,85,,percent of total billed charges,,347.96,4579,
SUBTALAR ARTHRO W/DEB,29906,CDM,29906,CPT,,,both,,4671,4671,1110.69,,,,fee schedule,,,,,,,,366.46,,,,fee schedule,,,3970.35,85,,percent of total billed charges,,1418.21,,,,fee schedule,,685.12,,,,fee schedule,,366.46,,,,fee schedule,,,,,,,,366.46,,,,fee schedule,,1078.02,,,,fee schedule,,653.35,,,,fee schedule,,653.35,,,,fee schedule,,,4250.61,91,,percent of total billed charges,,,4437.45,95,,percent of total billed charges,,,3876.93,83,,percent of total billed charges,,,1401.3,83,,percent of total billed charges,,366.46,,,,fee schedule,,366.46,,,,fee schedule,,,3876.93,83,,percent of total billed charges,,960.42,,,,fee schedule,,,4203.9,90,,percent of total billed charges,,,4203.9,90,,percent of total billed charges,,,4203.9,90,,percent of total billed charges,,,4203.9,90,,percent of total billed charges,,,3970.35,85,,percent of total billed charges,,366.46,4437.45,
SUBTALAR ARTHRO W/FUSION,29907,CDM,29907,CPT,,,both,,6100,6100,1519.13,,,,fee schedule,,,,,,,,451.2,,,,fee schedule,,,5185,85,,percent of total billed charges,,1912.83,,,,fee schedule,,924.07,,,,fee schedule,,451.2,,,,fee schedule,,,,,,,,451.2,,,,fee schedule,,1474.45,,,,fee schedule,,893.61,,,,fee schedule,,893.61,,,,fee schedule,,,5551,91,,percent of total billed charges,,,5795,95,,percent of total billed charges,,,5063,83,,percent of total billed charges,,,1830,83,,percent of total billed charges,,451.2,,,,fee schedule,,451.2,,,,fee schedule,,,5063,83,,percent of total billed charges,,1313.6,,,,fee schedule,,,5490,90,,percent of total billed charges,,,5490,90,,percent of total billed charges,,,5490,90,,percent of total billed charges,,,5490,90,,percent of total billed charges,,,5185,85,,percent of total billed charges,,451.2,5795,
HIP ARTHRO W/FEMOROPLASTY,29914,CDM,29914,CPT,,,both,,5167,5167,1716.73,,,,fee schedule,,,,,,,,619.03,,,,fee schedule,,,4391.95,85,,percent of total billed charges,,2179.86,,,,fee schedule,,1053.06,,,,fee schedule,,619.03,,,,fee schedule,,,,,,,,619.03,,,,fee schedule,,1666.23,,,,fee schedule,,1009.84,,,,fee schedule,,1009.84,,,,fee schedule,,,4701.97,91,,percent of total billed charges,,,4908.65,95,,percent of total billed charges,,,4288.61,83,,percent of total billed charges,,,1550.1,83,,percent of total billed charges,,619.03,,,,fee schedule,,619.03,,,,fee schedule,,,4288.61,83,,percent of total billed charges,,1484.46,,,,fee schedule,,,4650.3,90,,percent of total billed charges,,,4650.3,90,,percent of total billed charges,,,4650.3,90,,percent of total billed charges,,,4650.3,90,,percent of total billed charges,,,4391.95,85,,percent of total billed charges,,619.03,4908.65,
HIP ARTHRO ACETABULOPLASTY,29915,CDM,29915,CPT,,,both,,5051,5051,1756.48,,,,fee schedule,,,,,,,,630.63,,,,fee schedule,,,4293.35,85,,percent of total billed charges,,2244.3,,,,fee schedule,,1084.2,,,,fee schedule,,630.63,,,,fee schedule,,,,,,,,630.63,,,,fee schedule,,1704.81,,,,fee schedule,,1033.22,,,,fee schedule,,1033.22,,,,fee schedule,,,4596.41,91,,percent of total billed charges,,,4798.45,95,,percent of total billed charges,,,4192.33,83,,percent of total billed charges,,,1515.3,83,,percent of total billed charges,,630.63,,,,fee schedule,,630.63,,,,fee schedule,,,4192.33,83,,percent of total billed charges,,1518.83,,,,fee schedule,,,4545.9,90,,percent of total billed charges,,,4545.9,90,,percent of total billed charges,,,4545.9,90,,percent of total billed charges,,,4545.9,90,,percent of total billed charges,,,4293.35,85,,percent of total billed charges,,630.63,4798.45,
HIP ARTHRO W/LABRAL REPAIR,29916,CDM,29916,CPT,,,both,,5692,5692,1758.2,,,,fee schedule,,,,,,,,630.63,,,,fee schedule,,,4838.2,85,,percent of total billed charges,,2229.61,,,,fee schedule,,1077.1,,,,fee schedule,,630.63,,,,fee schedule,,,,,,,,630.63,,,,fee schedule,,1706.49,,,,fee schedule,,1034.24,,,,fee schedule,,1034.24,,,,fee schedule,,,5179.72,91,,percent of total billed charges,,,5407.4,95,,percent of total billed charges,,,4724.36,83,,percent of total billed charges,,,1707.6,83,,percent of total billed charges,,630.63,,,,fee schedule,,630.63,,,,fee schedule,,,4724.36,83,,percent of total billed charges,,1520.33,,,,fee schedule,,,5122.8,90,,percent of total billed charges,,,5122.8,90,,percent of total billed charges,,,5122.8,90,,percent of total billed charges,,,5122.8,90,,percent of total billed charges,,,4838.2,85,,percent of total billed charges,,630.63,5407.4,
ARTHROSCOPY OF JOINT,29999,CDM,29999,CPT,,,both,,4302,4302,,,,,,,,,,,,,,,,,,,,3656.7,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3914.82,91,,percent of total billed charges,,,4086.9,95,,percent of total billed charges,,,3570.66,83,,percent of total billed charges,,,1290.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3570.66,83,,percent of total billed charges,,,,,,,,,3871.8,90,,percent of total billed charges,,,3871.8,90,,percent of total billed charges,,,3871.8,90,,percent of total billed charges,,,3871.8,90,,percent of total billed charges,,,3656.7,85,,percent of total billed charges,,1290.6,4086.9,
DRAINAGE OF NOSE LESION,30000,CDM,30000,CPT,,,both,,761,761,210.27,,,,fee schedule,,,,,,,,46.7,,,,fee schedule,,,646.85,85,,percent of total billed charges,,214.33,,,,fee schedule,,124.41,,,,fee schedule,,46.7,,,,fee schedule,,194.98,,,,fee schedule,,46.7,,,,fee schedule,,204.09,,,,fee schedule,,123.69,,,,fee schedule,,123.69,,,,fee schedule,,,692.51,91,,percent of total billed charges,,,722.95,95,,percent of total billed charges,,,631.63,83,,percent of total billed charges,,,228.3,83,,percent of total billed charges,,46.7,,,,fee schedule,,46.7,,,,fee schedule,,,631.63,83,,percent of total billed charges,,181.82,,,,fee schedule,,,684.9,90,,percent of total billed charges,,,684.9,90,,percent of total billed charges,,,684.9,90,,percent of total billed charges,,,684.9,90,,percent of total billed charges,,,646.85,85,,percent of total billed charges,,46.7,722.95,
INTRANASAL BIOPSY,30100,CDM,30100,CPT,,,both,,472,472,116.37,,,,fee schedule,,,,,,,,55.4,,,,fee schedule,,,401.2,85,,percent of total billed charges,,119.9,,,,fee schedule,,69.6,,,,fee schedule,,55.4,,,,fee schedule,,121.37,,,,fee schedule,,55.4,,,,fee schedule,,112.95,,,,fee schedule,,68.45,,,,fee schedule,,68.45,,,,fee schedule,,,429.52,91,,percent of total billed charges,,,448.4,95,,percent of total billed charges,,,391.76,83,,percent of total billed charges,,,141.6,83,,percent of total billed charges,,55.4,,,,fee schedule,,55.4,,,,fee schedule,,,391.76,83,,percent of total billed charges,,100.62,,,,fee schedule,,,424.8,90,,percent of total billed charges,,,424.8,90,,percent of total billed charges,,,424.8,90,,percent of total billed charges,,,424.8,90,,percent of total billed charges,,,401.2,85,,percent of total billed charges,,55.4,448.4,
INTRANASAL BIOPSY,30100P,CDM,30100,CPT,,,both,P,379,379,116.37,,,,fee schedule,,,,,,,,55.4,,,,fee schedule,,,322.15,85,,percent of total billed charges,,119.9,,,,fee schedule,,69.6,,,,fee schedule,,55.4,,,,fee schedule,,121.37,,,,fee schedule,,55.4,,,,fee schedule,,112.95,,,,fee schedule,,68.45,,,,fee schedule,,68.45,,,,fee schedule,,,344.89,91,,percent of total billed charges,,,360.05,95,,percent of total billed charges,,,314.57,83,,percent of total billed charges,,,113.7,83,,percent of total billed charges,,55.4,,,,fee schedule,,55.4,,,,fee schedule,,,314.57,83,,percent of total billed charges,,100.62,,,,fee schedule,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,341.1,90,,percent of total billed charges,,,322.15,85,,percent of total billed charges,,55.4,360.05,
INTRANASAL BIOPSY,30100T,CDM,30100,CPT,,,both,T,93,93,116.37,,,,fee schedule,,,,,,,,55.4,,,,fee schedule,,,79.05,85,,percent of total billed charges,,119.9,,,,fee schedule,,69.6,,,,fee schedule,,55.4,,,,fee schedule,,121.37,,,,fee schedule,,55.4,,,,fee schedule,,112.95,,,,fee schedule,,68.45,,,,fee schedule,,68.45,,,,fee schedule,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,55.4,,,,fee schedule,,55.4,,,,fee schedule,,,77.19,83,,percent of total billed charges,,100.62,,,,fee schedule,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,27.9,121.37,
REMOVAL OF NOSE POLYP(S),30115,CDM,30115,CPT,,,both,,1896,1896,818.04,,,,fee schedule,,,,,,,,156.8,,,,fee schedule,,,1611.6,85,,percent of total billed charges,,837.51,,,,fee schedule,,486.13,,,,fee schedule,,156.8,,,,fee schedule,,697.03,,,,fee schedule,,156.8,,,,fee schedule,,793.98,,,,fee schedule,,481.2,,,,fee schedule,,481.2,,,,fee schedule,,,1725.36,91,,percent of total billed charges,,,1801.2,95,,percent of total billed charges,,,1573.68,83,,percent of total billed charges,,,568.8,83,,percent of total billed charges,,156.8,,,,fee schedule,,156.8,,,,fee schedule,,,1573.68,83,,percent of total billed charges,,707.36,,,,fee schedule,,,1706.4,90,,percent of total billed charges,,,1706.4,90,,percent of total billed charges,,,1706.4,90,,percent of total billed charges,,,1706.4,90,,percent of total billed charges,,,1611.6,85,,percent of total billed charges,,156.8,1801.2,
REMOVAL OF INTRANASAL LESION,30117,CDM,30117,CPT,,,both,,3404,3404,578.96,,,,fee schedule,,,,,,,,109.3,,,,fee schedule,,,2893.4,85,,percent of total billed charges,,587.76,,,,fee schedule,,341.17,,,,fee schedule,,109.3,,,,fee schedule,,533.88,,,,fee schedule,,109.3,,,,fee schedule,,561.93,,,,fee schedule,,340.57,,,,fee schedule,,340.57,,,,fee schedule,,,3097.64,91,,percent of total billed charges,,,3233.8,95,,percent of total billed charges,,,2825.32,83,,percent of total billed charges,,,1021.2,83,,percent of total billed charges,,109.3,,,,fee schedule,,109.3,,,,fee schedule,,,2825.32,83,,percent of total billed charges,,500.63,,,,fee schedule,,,3063.6,90,,percent of total billed charges,,,3063.6,90,,percent of total billed charges,,,3063.6,90,,percent of total billed charges,,,3063.6,90,,percent of total billed charges,,,2893.4,85,,percent of total billed charges,,109.3,3233.8,
RESECT INFERIOR TURBINATE,30140,CDM,30140,CPT,,,both,,2318,2318,306.48,,,,fee schedule,,,,,,,,180.3,,,,fee schedule,,,1970.3,85,,percent of total billed charges,,321.29,,,,fee schedule,,186.49,,,,fee schedule,,180.3,,,,fee schedule,,661.22,,,,fee schedule,,180.3,,,,fee schedule,,297.46,,,,fee schedule,,180.28,,,,fee schedule,,180.28,,,,fee schedule,,,2109.38,91,,percent of total billed charges,,,2202.1,95,,percent of total billed charges,,,1923.94,83,,percent of total billed charges,,,695.4,83,,percent of total billed charges,,180.3,,,,fee schedule,,180.3,,,,fee schedule,,,1923.94,83,,percent of total billed charges,,265.01,,,,fee schedule,,,2086.2,90,,percent of total billed charges,,,2086.2,90,,percent of total billed charges,,,2086.2,90,,percent of total billed charges,,,2086.2,90,,percent of total billed charges,,,1970.3,85,,percent of total billed charges,,180.28,2202.1,
INJECTION TREATMENT OF NOSE,30200,CDM,30200,CPT,,,both,,345,345,102.54,,,,fee schedule,,,,,,,,24.9,,,,fee schedule,,,293.25,85,,percent of total billed charges,,104.62,,,,fee schedule,,60.73,,,,fee schedule,,24.9,,,,fee schedule,,104.79,,,,fee schedule,,24.9,,,,fee schedule,,99.53,,,,fee schedule,,60.32,,,,fee schedule,,60.32,,,,fee schedule,,,313.95,91,,percent of total billed charges,,,327.75,95,,percent of total billed charges,,,286.35,83,,percent of total billed charges,,,103.5,83,,percent of total billed charges,,24.9,,,,fee schedule,,24.9,,,,fee schedule,,,286.35,83,,percent of total billed charges,,88.67,,,,fee schedule,,,310.5,90,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,293.25,85,,percent of total billed charges,,24.9,327.75,
INJECTION TREATMENT OF NOSE,30200P,CDM,30200,CPT,,,both,P,265,265,102.54,,,,fee schedule,,,,,,,,24.9,,,,fee schedule,,,225.25,85,,percent of total billed charges,,104.62,,,,fee schedule,,60.73,,,,fee schedule,,24.9,,,,fee schedule,,104.79,,,,fee schedule,,24.9,,,,fee schedule,,99.53,,,,fee schedule,,60.32,,,,fee schedule,,60.32,,,,fee schedule,,,241.15,91,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,79.5,83,,percent of total billed charges,,24.9,,,,fee schedule,,24.9,,,,fee schedule,,,219.95,83,,percent of total billed charges,,88.67,,,,fee schedule,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,24.9,251.75,
INJECTION TREATMENT OF NOSE,30200T,CDM,30200,CPT,,,both,T,80,80,102.54,,,,fee schedule,,,,,,,,24.9,,,,fee schedule,,,68,85,,percent of total billed charges,,104.62,,,,fee schedule,,60.73,,,,fee schedule,,24.9,,,,fee schedule,,104.79,,,,fee schedule,,24.9,,,,fee schedule,,99.53,,,,fee schedule,,60.32,,,,fee schedule,,60.32,,,,fee schedule,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,24,83,,percent of total billed charges,,24.9,,,,fee schedule,,24.9,,,,fee schedule,,,66.4,83,,percent of total billed charges,,88.67,,,,fee schedule,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,24,104.79,
REMOVE NASAL FOREIGN BODY,30300,CDM,30300,CPT,,,both,,830,830,216.03,,,,fee schedule,,,,,,,,39.05,,,,fee schedule,,,705.5,85,,percent of total billed charges,,218.98,,,,fee schedule,,127.1,,,,fee schedule,,39.05,,,,fee schedule,,200.95,,,,fee schedule,,39.05,,,,fee schedule,,209.68,,,,fee schedule,,127.08,,,,fee schedule,,127.08,,,,fee schedule,,,755.3,91,,percent of total billed charges,,,788.5,95,,percent of total billed charges,,,688.9,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,39.05,,,,fee schedule,,39.05,,,,fee schedule,,,688.9,83,,percent of total billed charges,,186.8,,,,fee schedule,,,747,90,,percent of total billed charges,,,747,90,,percent of total billed charges,,,747,90,,percent of total billed charges,,,747,90,,percent of total billed charges,,,705.5,85,,percent of total billed charges,,39.05,788.5,
RHINP PRIM COMPLETE XTRNL PARTS,30410,CDM,30410,CPT,,,both,,6628,6628,2467.36,,,,fee schedule,,,,,,,,749.2,,,,fee schedule,,,5633.8,85,,percent of total billed charges,,2553.11,,,,fee schedule,,1481.95,,,,fee schedule,,749.2,,,,fee schedule,,2171.34,,,,fee schedule,,749.2,,,,fee schedule,,2394.79,,,,fee schedule,,1451.39,,,,fee schedule,,1451.39,,,,fee schedule,,,6031.48,91,,percent of total billed charges,,,6296.6,95,,percent of total billed charges,,,5501.24,83,,percent of total billed charges,,,1988.4,83,,percent of total billed charges,,749.2,,,,fee schedule,,749.2,,,,fee schedule,,,5501.24,83,,percent of total billed charges,,2133.54,,,,fee schedule,,,5965.2,90,,percent of total billed charges,,,5965.2,90,,percent of total billed charges,,,5965.2,90,,percent of total billed charges,,,5965.2,90,,percent of total billed charges,,,5633.8,85,,percent of total billed charges,,749.2,6296.6,
RPR NSL VLV COLLAPSE W/RMDLG,30469,CDM,30469,CPT,,,both,,602,602,258.08,,,,fee schedule,,,,,,,,90.07,,,,fee schedule,,,511.7,85,,percent of total billed charges,,,,,,,,,,,,,,90.07,,,,fee schedule,,,,,,,,90.07,,,,fee schedule,,250.49,,,,fee schedule,,151.81,,,,fee schedule,,151.81,,,,fee schedule,,,547.82,91,,percent of total billed charges,,,571.9,95,,percent of total billed charges,,,499.66,83,,percent of total billed charges,,,180.6,83,,percent of total billed charges,,90.07,,,,fee schedule,,90.07,,,,fee schedule,,,499.66,83,,percent of total billed charges,,223.17,,,,fee schedule,,,541.8,90,,percent of total billed charges,,,541.8,90,,percent of total billed charges,,,541.8,90,,percent of total billed charges,,,541.8,90,,percent of total billed charges,,,511.7,85,,percent of total billed charges,,90.07,571.9,
RELEASE OF NASAL ADHESIONS,30560,CDM,30560,CPT,,,both,,588,588,262.12,,,,fee schedule,,,,,,,,42,,,,fee schedule,,,499.8,85,,percent of total billed charges,,267.88,,,,fee schedule,,155.49,,,,fee schedule,,42,,,,fee schedule,,231.46,,,,fee schedule,,42,,,,fee schedule,,254.41,,,,fee schedule,,154.19,,,,fee schedule,,154.19,,,,fee schedule,,,535.08,91,,percent of total billed charges,,,558.6,95,,percent of total billed charges,,,488.04,83,,percent of total billed charges,,,176.4,83,,percent of total billed charges,,42,,,,fee schedule,,42,,,,fee schedule,,,488.04,83,,percent of total billed charges,,226.65,,,,fee schedule,,,529.2,90,,percent of total billed charges,,,529.2,90,,percent of total billed charges,,,529.2,90,,percent of total billed charges,,,529.2,90,,percent of total billed charges,,,499.8,85,,percent of total billed charges,,42,558.6,
"ABLATE INF TURBINATE, SUPERF",30801,CDM,30801,CPT,,,both,,595,595,266.15,,,,fee schedule,,,,,,,,50.05,,,,fee schedule,,,505.75,85,,percent of total billed charges,,271.56,,,,fee schedule,,157.63,,,,fee schedule,,50.05,,,,fee schedule,,205.59,,,,fee schedule,,50.05,,,,fee schedule,,258.32,,,,fee schedule,,156.56,,,,fee schedule,,156.56,,,,fee schedule,,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,178.5,83,,percent of total billed charges,,50.05,,,,fee schedule,,50.05,,,,fee schedule,,,493.85,83,,percent of total billed charges,,230.14,,,,fee schedule,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,50.05,565.25,
"CAUTERIZATION, INNER NOSE",30802,CDM,30802,CPT,,,both,,808,808,353.71,,,,fee schedule,,,,,,,,71.15,,,,fee schedule,,,686.8,85,,percent of total billed charges,,364.14,,,,fee schedule,,211.36,,,,fee schedule,,71.15,,,,fee schedule,,302.42,,,,fee schedule,,71.15,,,,fee schedule,,343.31,,,,fee schedule,,208.07,,,,fee schedule,,208.07,,,,fee schedule,,,735.28,91,,percent of total billed charges,,,767.6,95,,percent of total billed charges,,,670.64,83,,percent of total billed charges,,,242.4,83,,percent of total billed charges,,71.15,,,,fee schedule,,71.15,,,,fee schedule,,,670.64,83,,percent of total billed charges,,305.86,,,,fee schedule,,,727.2,90,,percent of total billed charges,,,727.2,90,,percent of total billed charges,,,727.2,90,,percent of total billed charges,,,727.2,90,,percent of total billed charges,,,686.8,85,,percent of total billed charges,,71.15,767.6,
CONTROL OF NOSEBLEED,30901,CDM,30901,CPT,,,both,,425,425,97.36,,,,fee schedule,,,,,,,,74.9,,,,fee schedule,,,361.25,85,,percent of total billed charges,,104.31,,,,fee schedule,,60.55,,,,fee schedule,,74.9,,,,fee schedule,,108.77,,,,fee schedule,,74.9,,,,fee schedule,,94.49,,,,fee schedule,,57.27,,,,fee schedule,,57.27,,,,fee schedule,,,386.75,91,,percent of total billed charges,,,403.75,95,,percent of total billed charges,,,352.75,83,,percent of total billed charges,,,127.5,83,,percent of total billed charges,,74.9,,,,fee schedule,,74.9,,,,fee schedule,,,352.75,83,,percent of total billed charges,,84.19,,,,fee schedule,,,382.5,90,,percent of total billed charges,,,382.5,90,,percent of total billed charges,,,382.5,90,,percent of total billed charges,,,382.5,90,,percent of total billed charges,,,361.25,85,,percent of total billed charges,,57.27,403.75,
CONTROL OF NOSEBLEED,30901P,CDM,30901,CPT,,,both,P,343,343,97.36,,,,fee schedule,,,,,,,,74.9,,,,fee schedule,,,291.55,85,,percent of total billed charges,,104.31,,,,fee schedule,,60.55,,,,fee schedule,,74.9,,,,fee schedule,,108.77,,,,fee schedule,,74.9,,,,fee schedule,,94.49,,,,fee schedule,,57.27,,,,fee schedule,,57.27,,,,fee schedule,,,312.13,91,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,102.9,83,,percent of total billed charges,,74.9,,,,fee schedule,,74.9,,,,fee schedule,,,284.69,83,,percent of total billed charges,,84.19,,,,fee schedule,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,291.55,85,,percent of total billed charges,,57.27,325.85,
CONTROL OF NOSEBLEED,30901T,CDM,30901,CPT,,,both,T,82,82,97.36,,,,fee schedule,,,,,,,,74.9,,,,fee schedule,,,69.7,85,,percent of total billed charges,,104.31,,,,fee schedule,,60.55,,,,fee schedule,,74.9,,,,fee schedule,,108.77,,,,fee schedule,,74.9,,,,fee schedule,,94.49,,,,fee schedule,,57.27,,,,fee schedule,,57.27,,,,fee schedule,,,74.62,91,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,24.6,83,,percent of total billed charges,,74.9,,,,fee schedule,,74.9,,,,fee schedule,,,68.06,83,,percent of total billed charges,,84.19,,,,fee schedule,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,24.6,108.77,
CONTROL OF NOSEBLEED,30903,CDM,30903,CPT,,,both,,746,746,133.08,,,,fee schedule,,,,,,,,71.4,,,,fee schedule,,,634.1,85,,percent of total billed charges,,141.9,,,,fee schedule,,82.36,,,,fee schedule,,71.4,,,,fee schedule,,143.92,,,,fee schedule,,71.4,,,,fee schedule,,129.16,,,,fee schedule,,78.28,,,,fee schedule,,78.28,,,,fee schedule,,,678.86,91,,percent of total billed charges,,,708.7,95,,percent of total billed charges,,,619.18,83,,percent of total billed charges,,,223.8,83,,percent of total billed charges,,71.4,,,,fee schedule,,71.4,,,,fee schedule,,,619.18,83,,percent of total billed charges,,115.07,,,,fee schedule,,,671.4,90,,percent of total billed charges,,,671.4,90,,percent of total billed charges,,,671.4,90,,percent of total billed charges,,,671.4,90,,percent of total billed charges,,,634.1,85,,percent of total billed charges,,71.4,708.7,
CONTROL OF NOSEBLEED,30903P,CDM,30903,CPT,,,both,P,629,629,133.08,,,,fee schedule,,,,,,,,71.4,,,,fee schedule,,,534.65,85,,percent of total billed charges,,141.9,,,,fee schedule,,82.36,,,,fee schedule,,71.4,,,,fee schedule,,143.92,,,,fee schedule,,71.4,,,,fee schedule,,129.16,,,,fee schedule,,78.28,,,,fee schedule,,78.28,,,,fee schedule,,,572.39,91,,percent of total billed charges,,,597.55,95,,percent of total billed charges,,,522.07,83,,percent of total billed charges,,,188.7,83,,percent of total billed charges,,71.4,,,,fee schedule,,71.4,,,,fee schedule,,,522.07,83,,percent of total billed charges,,115.07,,,,fee schedule,,,566.1,90,,percent of total billed charges,,,566.1,90,,percent of total billed charges,,,566.1,90,,percent of total billed charges,,,566.1,90,,percent of total billed charges,,,534.65,85,,percent of total billed charges,,71.4,597.55,
CONTROL OF NOSEBLEED,30903T,CDM,30903,CPT,,,both,T,117,117,133.08,,,,fee schedule,,,,,,,,71.4,,,,fee schedule,,,99.45,85,,percent of total billed charges,,141.9,,,,fee schedule,,82.36,,,,fee schedule,,71.4,,,,fee schedule,,143.92,,,,fee schedule,,71.4,,,,fee schedule,,129.16,,,,fee schedule,,78.28,,,,fee schedule,,78.28,,,,fee schedule,,,106.47,91,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,35.1,83,,percent of total billed charges,,71.4,,,,fee schedule,,71.4,,,,fee schedule,,,97.11,83,,percent of total billed charges,,115.07,,,,fee schedule,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,99.45,85,,percent of total billed charges,,35.1,143.92,
CONTROL OF NOSEBLEED,30905,CDM,30905,CPT,,,both,,952,952,182.04,,,,fee schedule,,,,,,,,80.75,,,,fee schedule,,,809.2,85,,percent of total billed charges,,193.59,,,,fee schedule,,112.37,,,,fee schedule,,80.75,,,,fee schedule,,192.33,,,,fee schedule,,80.75,,,,fee schedule,,176.69,,,,fee schedule,,107.08,,,,fee schedule,,107.08,,,,fee schedule,,,866.32,91,,percent of total billed charges,,,904.4,95,,percent of total billed charges,,,790.16,83,,percent of total billed charges,,,285.6,83,,percent of total billed charges,,80.75,,,,fee schedule,,80.75,,,,fee schedule,,,790.16,83,,percent of total billed charges,,157.41,,,,fee schedule,,,856.8,90,,percent of total billed charges,,,856.8,90,,percent of total billed charges,,,856.8,90,,percent of total billed charges,,,856.8,90,,percent of total billed charges,,,809.2,85,,percent of total billed charges,,80.75,904.4,
"THER FX, NASAL INF TURBINATE",30930,CDM,30930,CPT,,,both,,681,681,204.51,,,,fee schedule,,,,,,,,90.1,,,,fee schedule,,,578.85,85,,percent of total billed charges,,208.5,,,,fee schedule,,121.03,,,,fee schedule,,90.1,,,,fee schedule,,198.96,,,,fee schedule,,90.1,,,,fee schedule,,198.49,,,,fee schedule,,120.3,,,,fee schedule,,120.3,,,,fee schedule,,,619.71,91,,percent of total billed charges,,,646.95,95,,percent of total billed charges,,,565.23,83,,percent of total billed charges,,,204.3,83,,percent of total billed charges,,90.1,,,,fee schedule,,90.1,,,,fee schedule,,,565.23,83,,percent of total billed charges,,176.84,,,,fee schedule,,,612.9,90,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,612.9,90,,percent of total billed charges,,,578.85,85,,percent of total billed charges,,90.1,646.95,
NASAL SURGERY PROCEDURE,30999,CDM,30999,CPT,,,both,,2318,2318,,,,,,,,,,,,,,,,,,,,1970.3,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2109.38,91,,percent of total billed charges,,,2202.1,95,,percent of total billed charges,,,1923.94,83,,percent of total billed charges,,,695.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1923.94,83,,percent of total billed charges,,,,,,,,,2086.2,90,,percent of total billed charges,,,2086.2,90,,percent of total billed charges,,,2086.2,90,,percent of total billed charges,,,2086.2,90,,percent of total billed charges,,,1970.3,85,,percent of total billed charges,,695.4,2202.1,
SPHENOID SINUS SURGERY,31051,CDM,31051,CPT,,,both,,2773,2773,1213.81,,,,fee schedule,,,,,,,,412,,,,fee schedule,,,2357.05,85,,percent of total billed charges,,1250.21,,,,fee schedule,,725.68,,,,fee schedule,,412,,,,fee schedule,,1059.8,,,,fee schedule,,412,,,,fee schedule,,1178.11,,,,fee schedule,,714,,,,fee schedule,,714,,,,fee schedule,,,2523.43,91,,percent of total billed charges,,,2634.35,95,,percent of total billed charges,,,2301.59,83,,percent of total billed charges,,,831.9,83,,percent of total billed charges,,412,,,,fee schedule,,412,,,,fee schedule,,,2301.59,83,,percent of total billed charges,,1049.58,,,,fee schedule,,,2495.7,90,,percent of total billed charges,,,2495.7,90,,percent of total billed charges,,,2495.7,90,,percent of total billed charges,,,2495.7,90,,percent of total billed charges,,,2357.05,85,,percent of total billed charges,,412,2634.35,
EXPLORATION OF SINUSES,31090,CDM,31090,CPT,,,both,,3626,3626,1935.64,,,,fee schedule,,,,,,,,718.7,,,,fee schedule,,,3082.1,85,,percent of total billed charges,,1996.54,,,,fee schedule,,1158.89,,,,fee schedule,,718.7,,,,fee schedule,,1525.37,,,,fee schedule,,718.7,,,,fee schedule,,1878.71,,,,fee schedule,,1138.61,,,,fee schedule,,1138.61,,,,fee schedule,,,3299.66,91,,percent of total billed charges,,,3444.7,95,,percent of total billed charges,,,3009.58,83,,percent of total billed charges,,,1087.8,83,,percent of total billed charges,,718.7,,,,fee schedule,,718.7,,,,fee schedule,,,3009.58,83,,percent of total billed charges,,1673.76,,,,fee schedule,,,3263.4,90,,percent of total billed charges,,,3263.4,90,,percent of total billed charges,,,3263.4,90,,percent of total billed charges,,,3263.4,90,,percent of total billed charges,,,3082.1,85,,percent of total billed charges,,718.7,3444.7,
REMOVAL OF ETHMOID SINUS,31200,CDM,31200,CPT,,,both,,2303,2303,1084.76,,,,fee schedule,,,,,,,,262.2,,,,fee schedule,,,1957.55,85,,percent of total billed charges,,1101.89,,,,fee schedule,,639.59,,,,fee schedule,,262.2,,,,fee schedule,,959.66,,,,fee schedule,,262.2,,,,fee schedule,,1052.86,,,,fee schedule,,638.1,,,,fee schedule,,638.1,,,,fee schedule,,,2095.73,91,,percent of total billed charges,,,2187.85,95,,percent of total billed charges,,,1911.49,83,,percent of total billed charges,,,690.9,83,,percent of total billed charges,,262.2,,,,fee schedule,,262.2,,,,fee schedule,,,1911.49,83,,percent of total billed charges,,938,,,,fee schedule,,,2072.7,90,,percent of total billed charges,,,2072.7,90,,percent of total billed charges,,,2072.7,90,,percent of total billed charges,,,2072.7,90,,percent of total billed charges,,,1957.55,85,,percent of total billed charges,,262.2,2187.85,
"NASAL ENDOSCOPY, DX",31231,CDM,31231,CPT,,,both,,860,860,111.18,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,731,85,,percent of total billed charges,,114.86,,,,fee schedule,,66.67,,,,fee schedule,,107,,,,fee schedule,,137.28,,,,fee schedule,,107,,,,fee schedule,,107.91,,,,fee schedule,,65.4,,,,fee schedule,,65.4,,,,fee schedule,,,782.6,91,,percent of total billed charges,,,817,95,,percent of total billed charges,,,713.8,83,,percent of total billed charges,,,258,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,713.8,83,,percent of total billed charges,,96.14,,,,fee schedule,,,774,90,,percent of total billed charges,,,774,90,,percent of total billed charges,,,774,90,,percent of total billed charges,,,774,90,,percent of total billed charges,,,731,85,,percent of total billed charges,,65.4,817,
NASAL ENDOSCOPY DX,31231P,CDM,31231,CPT,,,both,P,780,780,111.18,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,663,85,,percent of total billed charges,,114.86,,,,fee schedule,,66.67,,,,fee schedule,,107,,,,fee schedule,,137.28,,,,fee schedule,,107,,,,fee schedule,,107.91,,,,fee schedule,,65.4,,,,fee schedule,,65.4,,,,fee schedule,,,709.8,91,,percent of total billed charges,,,741,95,,percent of total billed charges,,,647.4,83,,percent of total billed charges,,,234,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,647.4,83,,percent of total billed charges,,96.14,,,,fee schedule,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,702,90,,percent of total billed charges,,,663,85,,percent of total billed charges,,65.4,741,
NASAL ENDOSCOPY DX,31231T,CDM,31231,CPT,,,both,T,80,80,111.18,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,68,85,,percent of total billed charges,,114.86,,,,fee schedule,,66.67,,,,fee schedule,,107,,,,fee schedule,,137.28,,,,fee schedule,,107,,,,fee schedule,,107.91,,,,fee schedule,,65.4,,,,fee schedule,,65.4,,,,fee schedule,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,24,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,66.4,83,,percent of total billed charges,,96.14,,,,fee schedule,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,24,137.28,
"NASAL/SINUS ENDOSCOPY, SURG",31237,CDM,31237,CPT,,,both,,1290,1290,274.22,,,,fee schedule,,,,,,,,102.55,,,,fee schedule,,,1096.5,85,,percent of total billed charges,,286.94,,,,fee schedule,,166.55,,,,fee schedule,,102.55,,,,fee schedule,,340.89,,,,fee schedule,,102.55,,,,fee schedule,,266.15,,,,fee schedule,,161.3,,,,fee schedule,,161.3,,,,fee schedule,,,1173.9,91,,percent of total billed charges,,,1225.5,95,,percent of total billed charges,,,1070.7,83,,percent of total billed charges,,,387,83,,percent of total billed charges,,102.55,,,,fee schedule,,102.55,,,,fee schedule,,,1070.7,83,,percent of total billed charges,,237.12,,,,fee schedule,,,1161,90,,percent of total billed charges,,,1161,90,,percent of total billed charges,,,1161,90,,percent of total billed charges,,,1161,90,,percent of total billed charges,,,1096.5,85,,percent of total billed charges,,102.55,1225.5,
NASAL/SINUS ENDOSCOPY SURG,31237p,CDM,31237,CPT,,,both,p,410,410,274.22,,,,fee schedule,,,,,,,,102.55,,,,fee schedule,,,348.5,85,,percent of total billed charges,,286.94,,,,fee schedule,,166.55,,,,fee schedule,,102.55,,,,fee schedule,,340.89,,,,fee schedule,,102.55,,,,fee schedule,,266.15,,,,fee schedule,,161.3,,,,fee schedule,,161.3,,,,fee schedule,,,373.1,91,,percent of total billed charges,,,389.5,95,,percent of total billed charges,,,340.3,83,,percent of total billed charges,,,123,83,,percent of total billed charges,,102.55,,,,fee schedule,,102.55,,,,fee schedule,,,340.3,83,,percent of total billed charges,,237.12,,,,fee schedule,,,369,90,,percent of total billed charges,,,369,90,,percent of total billed charges,,,369,90,,percent of total billed charges,,,369,90,,percent of total billed charges,,,348.5,85,,percent of total billed charges,,102.55,389.5,
NASAL/SINUS ENDOSCOPY SURG,31237T,CDM,31237,CPT,,,both,T,880,880,274.22,,,,fee schedule,,,,,,,,102.55,,,,fee schedule,,,748,85,,percent of total billed charges,,286.94,,,,fee schedule,,166.55,,,,fee schedule,,102.55,,,,fee schedule,,340.89,,,,fee schedule,,102.55,,,,fee schedule,,266.15,,,,fee schedule,,161.3,,,,fee schedule,,161.3,,,,fee schedule,,,800.8,91,,percent of total billed charges,,,836,95,,percent of total billed charges,,,730.4,83,,percent of total billed charges,,,264,83,,percent of total billed charges,,102.55,,,,fee schedule,,102.55,,,,fee schedule,,,730.4,83,,percent of total billed charges,,237.12,,,,fee schedule,,,792,90,,percent of total billed charges,,,792,90,,percent of total billed charges,,,792,90,,percent of total billed charges,,,792,90,,percent of total billed charges,,,748,85,,percent of total billed charges,,102.55,836,
"NASAL/SINUS ENDOSCOPY, SURG",31238,CDM,31238,CPT,,,both,,1339,1339,286.31,,,,fee schedule,,,,,,,,113.1,,,,fee schedule,,,1138.15,85,,percent of total billed charges,,300.57,,,,fee schedule,,174.46,,,,fee schedule,,113.1,,,,fee schedule,,372.72,,,,fee schedule,,113.1,,,,fee schedule,,277.89,,,,fee schedule,,168.42,,,,fee schedule,,168.42,,,,fee schedule,,,1218.49,91,,percent of total billed charges,,,1272.05,95,,percent of total billed charges,,,1111.37,83,,percent of total billed charges,,,401.7,83,,percent of total billed charges,,113.1,,,,fee schedule,,113.1,,,,fee schedule,,,1111.37,83,,percent of total billed charges,,247.58,,,,fee schedule,,,1205.1,90,,percent of total billed charges,,,1205.1,90,,percent of total billed charges,,,1205.1,90,,percent of total billed charges,,,1205.1,90,,percent of total billed charges,,,1138.15,85,,percent of total billed charges,,113.1,1272.05,
NASAL/SINUS ENDOSCOPY SURG,31238P,CDM,31238,CPT,,,both,P,750,750,286.31,,,,fee schedule,,,,,,,,113.1,,,,fee schedule,,,637.5,85,,percent of total billed charges,,300.57,,,,fee schedule,,174.46,,,,fee schedule,,113.1,,,,fee schedule,,372.72,,,,fee schedule,,113.1,,,,fee schedule,,277.89,,,,fee schedule,,168.42,,,,fee schedule,,168.42,,,,fee schedule,,,682.5,91,,percent of total billed charges,,,712.5,95,,percent of total billed charges,,,622.5,83,,percent of total billed charges,,,225,83,,percent of total billed charges,,113.1,,,,fee schedule,,113.1,,,,fee schedule,,,622.5,83,,percent of total billed charges,,247.58,,,,fee schedule,,,675,90,,percent of total billed charges,,,675,90,,percent of total billed charges,,,675,90,,percent of total billed charges,,,675,90,,percent of total billed charges,,,637.5,85,,percent of total billed charges,,113.1,712.5,
NASAL/SINUS ENDOSCOPY SURG,31238T,CDM,31238,CPT,,,both,T,589,589,286.31,,,,fee schedule,,,,,,,,113.1,,,,fee schedule,,,500.65,85,,percent of total billed charges,,300.57,,,,fee schedule,,174.46,,,,fee schedule,,113.1,,,,fee schedule,,372.72,,,,fee schedule,,113.1,,,,fee schedule,,277.89,,,,fee schedule,,168.42,,,,fee schedule,,168.42,,,,fee schedule,,,535.99,91,,percent of total billed charges,,,559.55,95,,percent of total billed charges,,,488.87,83,,percent of total billed charges,,,176.7,83,,percent of total billed charges,,113.1,,,,fee schedule,,113.1,,,,fee schedule,,,488.87,83,,percent of total billed charges,,247.58,,,,fee schedule,,,530.1,90,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,500.65,85,,percent of total billed charges,,113.1,559.55,
NSL/SINS NDSC TOTAL,31253,CDM,31253,CPT,,,both,,5923,5923,856.63,,,,fee schedule,,,,,,,,305.81,,,,fee schedule,,,5034.55,85,,percent of total billed charges,,908.57,,,,fee schedule,,527.38,,,,fee schedule,,305.81,,,,fee schedule,,,,,,,,305.81,,,,fee schedule,,831.44,,,,fee schedule,,503.9,,,,fee schedule,,503.9,,,,fee schedule,,,5389.93,91,,percent of total billed charges,,,5626.85,95,,percent of total billed charges,,,4916.09,83,,percent of total billed charges,,,1776.9,83,,percent of total billed charges,,305.81,,,,fee schedule,,305.81,,,,fee schedule,,,4916.09,83,,percent of total billed charges,,740.74,,,,fee schedule,,,5330.7,90,,percent of total billed charges,,,5330.7,90,,percent of total billed charges,,,5330.7,90,,percent of total billed charges,,,5330.7,90,,percent of total billed charges,,,5034.55,85,,percent of total billed charges,,305.81,5626.85,
REVISION OF ETHMOID SINUS,31254,CDM,31254,CPT,,,both,,2883,2883,416.51,,,,fee schedule,,,,,,,,262.2,,,,fee schedule,,,2450.55,85,,percent of total billed charges,,440.03,,,,fee schedule,,255.41,,,,fee schedule,,262.2,,,,fee schedule,,526.59,,,,fee schedule,,262.2,,,,fee schedule,,404.26,,,,fee schedule,,245,,,,fee schedule,,245,,,,fee schedule,,,2623.53,91,,percent of total billed charges,,,2738.85,95,,percent of total billed charges,,,2392.89,83,,percent of total billed charges,,,864.9,83,,percent of total billed charges,,262.2,,,,fee schedule,,262.2,,,,fee schedule,,,2392.89,83,,percent of total billed charges,,360.16,,,,fee schedule,,,2594.7,90,,percent of total billed charges,,,2594.7,90,,percent of total billed charges,,,2594.7,90,,percent of total billed charges,,,2594.7,90,,percent of total billed charges,,,2450.55,85,,percent of total billed charges,,245,2738.85,
REMOVAL OF ETHMOID SINUS,31255,CDM,31255,CPT,,,both,,3509,3509,554.19,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,2982.65,85,,percent of total billed charges,,588.09,,,,fee schedule,,341.35,,,,fee schedule,,449.5,,,,fee schedule,,781.92,,,,fee schedule,,449.5,,,,fee schedule,,537.89,,,,fee schedule,,325.99,,,,fee schedule,,325.99,,,,fee schedule,,,3193.19,91,,percent of total billed charges,,,3333.55,95,,percent of total billed charges,,,2912.47,83,,percent of total billed charges,,,1052.7,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,2912.47,83,,percent of total billed charges,,479.21,,,,fee schedule,,,3158.1,90,,percent of total billed charges,,,3158.1,90,,percent of total billed charges,,,3158.1,90,,percent of total billed charges,,,3158.1,90,,percent of total billed charges,,,2982.65,85,,percent of total billed charges,,325.99,3333.55,
EXPLORATION MAXILLARY SINUS,31256,CDM,31256,CPT,,,both,,2308,2308,308.78,,,,fee schedule,,,,,,,,180.3,,,,fee schedule,,,1961.8,85,,percent of total billed charges,,324.17,,,,fee schedule,,188.16,,,,fee schedule,,180.3,,,,fee schedule,,380.68,,,,fee schedule,,180.3,,,,fee schedule,,299.7,,,,fee schedule,,181.64,,,,fee schedule,,181.64,,,,fee schedule,,,2100.28,91,,percent of total billed charges,,,2192.6,95,,percent of total billed charges,,,1915.64,83,,percent of total billed charges,,,692.4,83,,percent of total billed charges,,180.3,,,,fee schedule,,180.3,,,,fee schedule,,,1915.64,83,,percent of total billed charges,,267,,,,fee schedule,,,2077.2,90,,percent of total billed charges,,,2077.2,90,,percent of total billed charges,,,2077.2,90,,percent of total billed charges,,,2077.2,90,,percent of total billed charges,,,1961.8,85,,percent of total billed charges,,180.3,2192.6,
NSL/SINS NDSC TOT W/SPHENDT,31257,CDM,31257,CPT,,,both,,2184,2184,763.31,,,,fee schedule,,,,,,,,272.08,,,,fee schedule,,,1856.4,85,,percent of total billed charges,,807.83,,,,fee schedule,,468.9,,,,fee schedule,,272.08,,,,fee schedule,,,,,,,,272.08,,,,fee schedule,,740.86,,,,fee schedule,,449.01,,,,fee schedule,,449.01,,,,fee schedule,,,1987.44,91,,percent of total billed charges,,,2074.8,95,,percent of total billed charges,,,1812.72,83,,percent of total billed charges,,,655.2,83,,percent of total billed charges,,272.08,,,,fee schedule,,272.08,,,,fee schedule,,,1812.72,83,,percent of total billed charges,,660.04,,,,fee schedule,,,1965.6,90,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1965.6,90,,percent of total billed charges,,,1856.4,85,,percent of total billed charges,,272.08,2074.8,
"ENDOSCOPY, MAXILLARY SINUS",31267,CDM,31267,CPT,,,both,,3944,3944,454.53,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,3352.4,85,,percent of total billed charges,,480.29,,,,fee schedule,,278.79,,,,fee schedule,,224.7,,,,fee schedule,,616.12,,,,fee schedule,,224.7,,,,fee schedule,,441.16,,,,fee schedule,,267.37,,,,fee schedule,,267.37,,,,fee schedule,,,3589.04,91,,percent of total billed charges,,,3746.8,95,,percent of total billed charges,,,3273.52,83,,percent of total billed charges,,,1183.2,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,3273.52,83,,percent of total billed charges,,393.03,,,,fee schedule,,,3549.6,90,,percent of total billed charges,,,3549.6,90,,percent of total billed charges,,,3549.6,90,,percent of total billed charges,,,3549.6,90,,percent of total billed charges,,,3352.4,85,,percent of total billed charges,,224.7,3746.8,
"NASAL/SINUS ENDOSCOPY, SURG",31288,CDM,31288,CPT,,,both,,1566,1566,401.53,,,,fee schedule,,,,,,,,412,,,,fee schedule,,,1331.1,85,,percent of total billed charges,,424.86,,,,fee schedule,,246.61,,,,fee schedule,,412,,,,fee schedule,,519.95,,,,fee schedule,,412,,,,fee schedule,,389.72,,,,fee schedule,,236.19,,,,fee schedule,,236.19,,,,fee schedule,,,1425.06,91,,percent of total billed charges,,,1487.7,95,,percent of total billed charges,,,1299.78,83,,percent of total billed charges,,,469.8,83,,percent of total billed charges,,412,,,,fee schedule,,412,,,,fee schedule,,,1299.78,83,,percent of total billed charges,,347.2,,,,fee schedule,,,1409.4,90,,percent of total billed charges,,,1409.4,90,,percent of total billed charges,,,1409.4,90,,percent of total billed charges,,,1409.4,90,,percent of total billed charges,,,1331.1,85,,percent of total billed charges,,236.19,1487.7,
INSERT EMERGENCY AIRWAY,31500,CDM,31500,CPT,,,both,,735,735,240.23,,,,fee schedule,,,,,,,,55.5,,,,fee schedule,,,624.75,85,,percent of total billed charges,,259.8,,,,fee schedule,,150.8,,,,fee schedule,,55.5,,,,fee schedule,,203.6,,,,fee schedule,,55.5,,,,fee schedule,,233.16,,,,fee schedule,,141.31,,,,fee schedule,,141.31,,,,fee schedule,,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,220.5,83,,percent of total billed charges,,55.5,,,,fee schedule,,55.5,,,,fee schedule,,,610.05,83,,percent of total billed charges,,207.73,,,,fee schedule,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,55.5,698.25,
DIAGNOSTIC LARYNGOSCOPY,31505,CDM,31505,CPT,,,both,,325,325,84.68,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,276.25,85,,percent of total billed charges,,86.84,,,,fee schedule,,50.41,,,,fee schedule,,37.4,,,,fee schedule,,84.23,,,,fee schedule,,37.4,,,,fee schedule,,82.19,,,,fee schedule,,49.81,,,,fee schedule,,49.81,,,,fee schedule,,,295.75,91,,percent of total billed charges,,,308.75,95,,percent of total billed charges,,,269.75,83,,percent of total billed charges,,,97.5,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,269.75,83,,percent of total billed charges,,73.23,,,,fee schedule,,,292.5,90,,percent of total billed charges,,,292.5,90,,percent of total billed charges,,,292.5,90,,percent of total billed charges,,,292.5,90,,percent of total billed charges,,,276.25,85,,percent of total billed charges,,37.4,308.75,
LARYNGOSCOPY W/BIOPSY,31535,CDM,31535,CPT,,,both,,1047,1047,322.61,,,,fee schedule,,,,,,,,224.6,,,,fee schedule,,,889.95,85,,percent of total billed charges,,339.01,,,,fee schedule,,196.78,,,,fee schedule,,224.6,,,,fee schedule,,358.79,,,,fee schedule,,224.6,,,,fee schedule,,313.12,,,,fee schedule,,189.77,,,,fee schedule,,189.77,,,,fee schedule,,,952.77,91,,percent of total billed charges,,,994.65,95,,percent of total billed charges,,,869.01,83,,percent of total billed charges,,,314.1,83,,percent of total billed charges,,224.6,,,,fee schedule,,224.6,,,,fee schedule,,,869.01,83,,percent of total billed charges,,278.96,,,,fee schedule,,,942.3,90,,percent of total billed charges,,,942.3,90,,percent of total billed charges,,,942.3,90,,percent of total billed charges,,,942.3,90,,percent of total billed charges,,,889.95,85,,percent of total billed charges,,189.77,994.65,
LARYNGOSCOPY W/BX/OP SCOPE,31536,CDM,31536,CPT,,,both,,1236,1236,360.05,,,,fee schedule,,,,,,,,224.6,,,,fee schedule,,,1050.6,85,,percent of total billed charges,,378.77,,,,fee schedule,,219.85,,,,fee schedule,,224.6,,,,fee schedule,,403.89,,,,fee schedule,,224.6,,,,fee schedule,,349.46,,,,fee schedule,,211.8,,,,fee schedule,,211.8,,,,fee schedule,,,1124.76,91,,percent of total billed charges,,,1174.2,95,,percent of total billed charges,,,1025.88,83,,percent of total billed charges,,,370.8,83,,percent of total billed charges,,224.6,,,,fee schedule,,224.6,,,,fee schedule,,,1025.88,83,,percent of total billed charges,,311.34,,,,fee schedule,,,1112.4,90,,percent of total billed charges,,,1112.4,90,,percent of total billed charges,,,1112.4,90,,percent of total billed charges,,,1112.4,90,,percent of total billed charges,,,1050.6,85,,percent of total billed charges,,211.8,1174.2,
LARYNGOSCOPY W/EXC OF TUMOR,31540,CDM,31540,CPT,,,both,,1541,1541,413.05,,,,fee schedule,,,,,,,,268.2,,,,fee schedule,,,1309.85,85,,percent of total billed charges,,435.79,,,,fee schedule,,252.95,,,,fee schedule,,268.2,,,,fee schedule,,464.24,,,,fee schedule,,268.2,,,,fee schedule,,400.9,,,,fee schedule,,242.97,,,,fee schedule,,242.97,,,,fee schedule,,,1402.31,91,,percent of total billed charges,,,1463.95,95,,percent of total billed charges,,,1279.03,83,,percent of total billed charges,,,462.3,83,,percent of total billed charges,,268.2,,,,fee schedule,,268.2,,,,fee schedule,,,1279.03,83,,percent of total billed charges,,357.17,,,,fee schedule,,,1386.9,90,,percent of total billed charges,,,1386.9,90,,percent of total billed charges,,,1386.9,90,,percent of total billed charges,,,1386.9,90,,percent of total billed charges,,,1309.85,85,,percent of total billed charges,,242.97,1463.95,
LARYNSCOP W/TUMR EXC + SCOPE,31541,CDM,31541,CPT,,,both,,1084,1084,450.5,,,,fee schedule,,,,,,,,268.2,,,,fee schedule,,,921.4,85,,percent of total billed charges,,473.95,,,,fee schedule,,275.11,,,,fee schedule,,268.2,,,,fee schedule,,508.68,,,,fee schedule,,268.2,,,,fee schedule,,437.25,,,,fee schedule,,265,,,,fee schedule,,265,,,,fee schedule,,,986.44,91,,percent of total billed charges,,,1029.8,95,,percent of total billed charges,,,899.72,83,,percent of total billed charges,,,325.2,83,,percent of total billed charges,,268.2,,,,fee schedule,,268.2,,,,fee schedule,,,899.72,83,,percent of total billed charges,,389.55,,,,fee schedule,,,975.6,90,,percent of total billed charges,,,975.6,90,,percent of total billed charges,,,975.6,90,,percent of total billed charges,,,975.6,90,,percent of total billed charges,,,921.4,85,,percent of total billed charges,,265,1029.8,
DIAGNOSTIC LARYNGOSCOPY,31575,CDM,31575,CPT,,,both,,521,521,116.94,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,442.85,85,,percent of total billed charges,,119.33,,,,fee schedule,,69.27,,,,fee schedule,,107,,,,fee schedule,,137.95,,,,fee schedule,,107,,,,fee schedule,,113.51,,,,fee schedule,,68.79,,,,fee schedule,,68.79,,,,fee schedule,,,474.11,91,,percent of total billed charges,,,494.95,95,,percent of total billed charges,,,432.43,83,,percent of total billed charges,,,156.3,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,432.43,83,,percent of total billed charges,,101.12,,,,fee schedule,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,442.85,85,,percent of total billed charges,,68.79,494.95,
DIAGNOSTIC LARYNGOSCOPY,31575P,CDM,31575,CPT,,,both,P,95,95,116.94,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,80.75,85,,percent of total billed charges,,119.33,,,,fee schedule,,69.27,,,,fee schedule,,107,,,,fee schedule,,137.95,,,,fee schedule,,107,,,,fee schedule,,113.51,,,,fee schedule,,68.79,,,,fee schedule,,68.79,,,,fee schedule,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,28.5,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,78.85,83,,percent of total billed charges,,101.12,,,,fee schedule,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,28.5,137.95,
DIAGNOSTIC LARYNGOSCOPY,31575T,CDM,31575,CPT,,,both,T,95,95,116.94,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,80.75,85,,percent of total billed charges,,119.33,,,,fee schedule,,69.27,,,,fee schedule,,107,,,,fee schedule,,137.95,,,,fee schedule,,107,,,,fee schedule,,113.51,,,,fee schedule,,68.79,,,,fee schedule,,68.79,,,,fee schedule,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,28.5,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,78.85,83,,percent of total billed charges,,101.12,,,,fee schedule,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,28.5,137.95,
LARYNGOSCOPY WITH BIOPSY,31576,CDM,31576,CPT,,,both,,925,925,203.93,,,,fee schedule,,,,,,,,224.6,,,,fee schedule,,,786.25,85,,percent of total billed charges,,212.13,,,,fee schedule,,123.13,,,,fee schedule,,224.6,,,,fee schedule,,226.15,,,,fee schedule,,224.6,,,,fee schedule,,197.94,,,,fee schedule,,119.96,,,,fee schedule,,119.96,,,,fee schedule,,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,277.5,83,,percent of total billed charges,,224.6,,,,fee schedule,,224.6,,,,fee schedule,,,767.75,83,,percent of total billed charges,,176.34,,,,fee schedule,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,119.96,878.75,
DIAGNOSTIC LARYNGOSCOPY,31579,CDM,31579,CPT,,,both,,778,778,205.09,,,,fee schedule,,,,,,,,192.95,,,,fee schedule,,,661.3,85,,percent of total billed charges,,213.22,,,,fee schedule,,123.76,,,,fee schedule,,192.95,,,,fee schedule,,260.64,,,,fee schedule,,192.95,,,,fee schedule,,199.05,,,,fee schedule,,120.64,,,,fee schedule,,120.64,,,,fee schedule,,,707.98,91,,percent of total billed charges,,,739.1,95,,percent of total billed charges,,,645.74,83,,percent of total billed charges,,,233.4,83,,percent of total billed charges,,192.95,,,,fee schedule,,192.95,,,,fee schedule,,,645.74,83,,percent of total billed charges,,177.34,,,,fee schedule,,,700.2,90,,percent of total billed charges,,,700.2,90,,percent of total billed charges,,,700.2,90,,percent of total billed charges,,,700.2,90,,percent of total billed charges,,,661.3,85,,percent of total billed charges,,120.64,739.1,
INCISION OF WINDPIPE,31600,CDM,31600,CPT,,,both,,1847,1847,521.93,,,,fee schedule,,,,,,,,266.4,,,,fee schedule,,,1569.95,85,,percent of total billed charges,,561.72,,,,fee schedule,,326.05,,,,fee schedule,,266.4,,,,fee schedule,,740.14,,,,fee schedule,,266.4,,,,fee schedule,,506.58,,,,fee schedule,,307.02,,,,fee schedule,,307.02,,,,fee schedule,,,1680.77,91,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,554.1,83,,percent of total billed charges,,266.4,,,,fee schedule,,266.4,,,,fee schedule,,,1533.01,83,,percent of total billed charges,,451.32,,,,fee schedule,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,266.4,1754.65,
INCISION OF WINDPIPE,31605,CDM,31605,CPT,,,both,,890,890,567.44,,,,fee schedule,,,,,,,,266.4,,,,fee schedule,,,756.5,85,,percent of total billed charges,,616.36,,,,fee schedule,,357.77,,,,fee schedule,,266.4,,,,fee schedule,,340.89,,,,fee schedule,,266.4,,,,fee schedule,,550.75,,,,fee schedule,,333.79,,,,fee schedule,,333.79,,,,fee schedule,,,809.9,91,,percent of total billed charges,,,845.5,95,,percent of total billed charges,,,738.7,83,,percent of total billed charges,,,267,83,,percent of total billed charges,,266.4,,,,fee schedule,,266.4,,,,fee schedule,,,738.7,83,,percent of total billed charges,,490.67,,,,fee schedule,,,801,90,,percent of total billed charges,,,801,90,,percent of total billed charges,,,801,90,,percent of total billed charges,,,801,90,,percent of total billed charges,,,756.5,85,,percent of total billed charges,,266.4,845.5,
VISUALIZATION OF WINDPIPE,31615,CDM,31615,CPT,,,both,,745,745,197.02,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,633.25,85,,percent of total billed charges,,206.73,,,,fee schedule,,120,,,,fee schedule,,107,,,,fee schedule,,229.47,,,,fee schedule,,107,,,,fee schedule,,191.23,,,,fee schedule,,115.89,,,,fee schedule,,115.89,,,,fee schedule,,,677.95,91,,percent of total billed charges,,,707.75,95,,percent of total billed charges,,,618.35,83,,percent of total billed charges,,,223.5,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,618.35,83,,percent of total billed charges,,170.36,,,,fee schedule,,,670.5,90,,percent of total billed charges,,,670.5,90,,percent of total billed charges,,,670.5,90,,percent of total billed charges,,,670.5,90,,percent of total billed charges,,,633.25,85,,percent of total billed charges,,107,707.75,
VISUALIZATION OF WINDPIPE,31615P,CDM,31615,CPT,,,both,P,260,260,197.02,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,221,85,,percent of total billed charges,,206.73,,,,fee schedule,,120,,,,fee schedule,,107,,,,fee schedule,,229.47,,,,fee schedule,,107,,,,fee schedule,,191.23,,,,fee schedule,,115.89,,,,fee schedule,,115.89,,,,fee schedule,,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,78,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,215.8,83,,percent of total billed charges,,170.36,,,,fee schedule,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,78,247,
VISUALIZATION OF WINDPIPE,31615T,CDM,31615,CPT,,,both,T,485,485,197.02,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,412.25,85,,percent of total billed charges,,206.73,,,,fee schedule,,120,,,,fee schedule,,107,,,,fee schedule,,229.47,,,,fee schedule,,107,,,,fee schedule,,191.23,,,,fee schedule,,115.89,,,,fee schedule,,115.89,,,,fee schedule,,,441.35,91,,percent of total billed charges,,,460.75,95,,percent of total billed charges,,,402.55,83,,percent of total billed charges,,,145.5,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,402.55,83,,percent of total billed charges,,170.36,,,,fee schedule,,,436.5,90,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,412.25,85,,percent of total billed charges,,107,460.75,
DX BRONCHOSCOPE/WASH,31622,CDM,31622,CPT,,,both,,1109,1109,221.79,,,,fee schedule,,,,,,,,235.2,,,,fee schedule,,,942.65,85,,percent of total billed charges,,237.79,,,,fee schedule,,138.02,,,,fee schedule,,235.2,,,,fee schedule,,267.94,,,,fee schedule,,235.2,,,,fee schedule,,215.27,,,,fee schedule,,130.47,,,,fee schedule,,130.47,,,,fee schedule,,,1009.19,91,,percent of total billed charges,,,1053.55,95,,percent of total billed charges,,,920.47,83,,percent of total billed charges,,,332.7,83,,percent of total billed charges,,235.2,,,,fee schedule,,235.2,,,,fee schedule,,,920.47,83,,percent of total billed charges,,191.78,,,,fee schedule,,,998.1,90,,percent of total billed charges,,,998.1,90,,percent of total billed charges,,,998.1,90,,percent of total billed charges,,,998.1,90,,percent of total billed charges,,,942.65,85,,percent of total billed charges,,130.47,1053.55,
DX BRONCHOSCOPE/BRUSH,31623,CDM,31623,CPT,,,both,,545,545,221.22,,,,fee schedule,,,,,,,,235.2,,,,fee schedule,,,463.25,85,,percent of total billed charges,,238.46,,,,fee schedule,,138.42,,,,fee schedule,,235.2,,,,fee schedule,,271.25,,,,fee schedule,,235.2,,,,fee schedule,,214.71,,,,fee schedule,,130.13,,,,fee schedule,,130.13,,,,fee schedule,,,495.95,91,,percent of total billed charges,,,517.75,95,,percent of total billed charges,,,452.35,83,,percent of total billed charges,,,163.5,83,,percent of total billed charges,,235.2,,,,fee schedule,,235.2,,,,fee schedule,,,452.35,83,,percent of total billed charges,,191.29,,,,fee schedule,,,490.5,90,,percent of total billed charges,,,490.5,90,,percent of total billed charges,,,490.5,90,,percent of total billed charges,,,490.5,90,,percent of total billed charges,,,463.25,85,,percent of total billed charges,,130.13,517.75,
NAVIGATIONAL BRONCHOSCOPY,31627,CDM,31627,CPT,,,both,,438,438,161.3,,,,fee schedule,,,,,,,,59.02,,,,fee schedule,,,372.3,85,,percent of total billed charges,,174.89,,,,fee schedule,,101.52,,,,fee schedule,,59.02,,,,fee schedule,,,,,,,,59.02,,,,fee schedule,,156.56,,,,fee schedule,,94.88,,,,fee schedule,,94.88,,,,fee schedule,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,131.4,83,,percent of total billed charges,,59.02,,,,fee schedule,,59.02,,,,fee schedule,,,363.54,83,,percent of total billed charges,,139.48,,,,fee schedule,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,59.02,416.1,
"BRONCHOSCOPY/LUNG BX, EACH",31628,CDM,31628,CPT,,,both,,702,702,294.95,,,,fee schedule,,,,,,,,246.95,,,,fee schedule,,,596.7,85,,percent of total billed charges,,316.25,,,,fee schedule,,183.57,,,,fee schedule,,246.95,,,,fee schedule,,350.84,,,,fee schedule,,246.95,,,,fee schedule,,286.28,,,,fee schedule,,173.5,,,,fee schedule,,173.5,,,,fee schedule,,,638.82,91,,percent of total billed charges,,,666.9,95,,percent of total billed charges,,,582.66,83,,percent of total billed charges,,,210.6,83,,percent of total billed charges,,246.95,,,,fee schedule,,246.95,,,,fee schedule,,,582.66,83,,percent of total billed charges,,255.05,,,,fee schedule,,,631.8,90,,percent of total billed charges,,,631.8,90,,percent of total billed charges,,,631.8,90,,percent of total billed charges,,,631.8,90,,percent of total billed charges,,,596.7,85,,percent of total billed charges,,173.5,666.9,
"BRONCHOSCOPY/LUNG BX, ADD'L",31632,CDM,31632,CPT,,,both,,198,198,82.96,,,,fee schedule,,,,,,,,30.94,,,,fee schedule,,,168.3,85,,percent of total billed charges,,89.15,,,,fee schedule,,51.75,,,,fee schedule,,30.94,,,,fee schedule,,101.47,,,,fee schedule,,30.94,,,,fee schedule,,80.52,,,,fee schedule,,48.8,,,,fee schedule,,48.8,,,,fee schedule,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,59.4,83,,percent of total billed charges,,30.94,,,,fee schedule,,30.94,,,,fee schedule,,,164.34,83,,percent of total billed charges,,71.73,,,,fee schedule,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,30.94,188.1,
INSERT PLEURAL CATH,32550,CDM,32550,CPT,,,both,,1700,1700,345.65,,,,fee schedule,,,,,,,,127.01,,,,fee schedule,,,1445,85,,percent of total billed charges,,371.63,,,,fee schedule,,215.71,,,,fee schedule,,127.01,,,,fee schedule,,,,,,,,127.01,,,,fee schedule,,335.48,,,,fee schedule,,203.32,,,,fee schedule,,203.32,,,,fee schedule,,,1547,91,,percent of total billed charges,,,1615,95,,percent of total billed charges,,,1411,83,,percent of total billed charges,,,510,83,,percent of total billed charges,,127.01,,,,fee schedule,,127.01,,,,fee schedule,,,1411,83,,percent of total billed charges,,298.89,,,,fee schedule,,,1530,90,,percent of total billed charges,,,1530,90,,percent of total billed charges,,,1530,90,,percent of total billed charges,,,1530,90,,percent of total billed charges,,,1445,85,,percent of total billed charges,,127.01,1615,
Tube Thoracostomy,32551,CDM,32551,CPT,,,both,,1017,1017,263.85,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,864.45,85,,percent of total billed charges,,288.4,,,,fee schedule,,167.4,,,,fee schedule,,224.7,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,256.09,,,,fee schedule,,155.2,,,,fee schedule,,155.2,,,,fee schedule,,,925.47,91,,percent of total billed charges,,,966.15,95,,percent of total billed charges,,,844.11,83,,percent of total billed charges,,,305.1,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,844.11,83,,percent of total billed charges,,228.15,,,,fee schedule,,,915.3,90,,percent of total billed charges,,,915.3,90,,percent of total billed charges,,,915.3,90,,percent of total billed charges,,,915.3,90,,percent of total billed charges,,,864.45,85,,percent of total billed charges,,155.2,966.15,
Thoracentesis,32554,CDM,32554,CPT,,,both,,938,938,149.78,,,,fee schedule,,,,,,,,53.85,,,,fee schedule,,,797.3,85,,percent of total billed charges,,162.52,,,,fee schedule,,94.33,,,,fee schedule,,53.85,,,,fee schedule,,,,,,,,53.85,,,,fee schedule,,145.38,,,,fee schedule,,88.11,,,,fee schedule,,88.11,,,,fee schedule,,,853.58,91,,percent of total billed charges,,,891.1,95,,percent of total billed charges,,,778.54,83,,percent of total billed charges,,,281.4,83,,percent of total billed charges,,53.85,,,,fee schedule,,53.85,,,,fee schedule,,,778.54,83,,percent of total billed charges,,129.52,,,,fee schedule,,,844.2,90,,percent of total billed charges,,,844.2,90,,percent of total billed charges,,,844.2,90,,percent of total billed charges,,,844.2,90,,percent of total billed charges,,,797.3,85,,percent of total billed charges,,53.85,891.1,
THORACENTESIS W/ IMAGING,32555,CDM,32555,CPT,,,both,,774,774,184.92,,,,fee schedule,,,,,,,,67.46,,,,fee schedule,,,657.9,85,,percent of total billed charges,,198.58,,,,fee schedule,,115.26,,,,fee schedule,,67.46,,,,fee schedule,,,,,,,,67.46,,,,fee schedule,,179.48,,,,fee schedule,,108.78,,,,fee schedule,,108.78,,,,fee schedule,,,704.34,91,,percent of total billed charges,,,735.3,95,,percent of total billed charges,,,642.42,83,,percent of total billed charges,,,232.2,83,,percent of total billed charges,,67.46,,,,fee schedule,,67.46,,,,fee schedule,,,642.42,83,,percent of total billed charges,,159.9,,,,fee schedule,,,696.6,90,,percent of total billed charges,,,696.6,90,,percent of total billed charges,,,696.6,90,,percent of total billed charges,,,696.6,90,,percent of total billed charges,,,657.9,85,,percent of total billed charges,,67.46,735.3,
INSERT CATH PLEURA W/O IMAGE,32556,CDM,32556,CPT,,,both,,1727,1727,210.27,,,,fee schedule,,,,,,,,74,,,,fee schedule,,,1467.95,85,,percent of total billed charges,,225.77,,,,fee schedule,,131.05,,,,fee schedule,,74,,,,fee schedule,,,,,,,,74,,,,fee schedule,,204.09,,,,fee schedule,,123.69,,,,fee schedule,,123.69,,,,fee schedule,,,1571.57,91,,percent of total billed charges,,,1640.65,95,,percent of total billed charges,,,1433.41,83,,percent of total billed charges,,,518.1,83,,percent of total billed charges,,74,,,,fee schedule,,74,,,,fee schedule,,,1433.41,83,,percent of total billed charges,,181.82,,,,fee schedule,,,1554.3,90,,percent of total billed charges,,,1554.3,90,,percent of total billed charges,,,1554.3,90,,percent of total billed charges,,,1554.3,90,,percent of total billed charges,,,1467.95,85,,percent of total billed charges,,74,1640.65,
INSERT CATH PLEURA W/ IMAGE,32557,CDM,32557,CPT,,,both,,1250,1250,252.32,,,,fee schedule,,,,,,,,102.37,,,,fee schedule,,,1062.5,85,,percent of total billed charges,,269.89,,,,fee schedule,,156.66,,,,fee schedule,,102.37,,,,fee schedule,,,,,,,,102.37,,,,fee schedule,,244.9,,,,fee schedule,,148.43,,,,fee schedule,,148.43,,,,fee schedule,,,1137.5,91,,percent of total billed charges,,,1187.5,95,,percent of total billed charges,,,1037.5,83,,percent of total billed charges,,,375,83,,percent of total billed charges,,102.37,,,,fee schedule,,102.37,,,,fee schedule,,,1037.5,83,,percent of total billed charges,,218.19,,,,fee schedule,,,1125,90,,percent of total billed charges,,,1125,90,,percent of total billed charges,,,1125,90,,percent of total billed charges,,,1125,90,,percent of total billed charges,,,1062.5,85,,percent of total billed charges,,102.37,1187.5,
INSERTION OF HEART PACEMAKER,33207,CDM,33207,CPT,,,both,,2753,2753,814.58,,,,fee schedule,,,,,,,,861.5,,,,fee schedule,,,2340.05,85,,percent of total billed charges,,822.47,,,,fee schedule,,510.7,,,,fee schedule,,861.5,,,,fee schedule,,882.06,,,,fee schedule,,861.5,,,,fee schedule,,790.62,,,,fee schedule,,479.17,,,,fee schedule,,479.17,,,,fee schedule,,,2505.23,91,,percent of total billed charges,,,2615.35,95,,percent of total billed charges,,,2284.99,83,,percent of total billed charges,,,825.9,83,,percent of total billed charges,,861.5,,,,fee schedule,,861.5,,,,fee schedule,,,2284.99,83,,percent of total billed charges,,704.37,,,,fee schedule,,,2477.7,90,,percent of total billed charges,,,2477.7,90,,percent of total billed charges,,,2477.7,90,,percent of total billed charges,,,2477.7,90,,percent of total billed charges,,,2340.05,85,,percent of total billed charges,,479.17,2615.35,
INSERTION OF HEART PACEMAKER,33208,CDM,33208,CPT,,,both,,2963,2963,882.56,,,,fee schedule,,,,,,,,861.5,,,,fee schedule,,,2518.55,85,,percent of total billed charges,,892.54,,,,fee schedule,,554.21,,,,fee schedule,,861.5,,,,fee schedule,,894,,,,fee schedule,,861.5,,,,fee schedule,,856.6,,,,fee schedule,,519.15,,,,fee schedule,,519.15,,,,fee schedule,,,2696.33,91,,percent of total billed charges,,,2814.85,95,,percent of total billed charges,,,2459.29,83,,percent of total billed charges,,,888.9,83,,percent of total billed charges,,861.5,,,,fee schedule,,861.5,,,,fee schedule,,,2459.29,83,,percent of total billed charges,,763.15,,,,fee schedule,,,2666.7,90,,percent of total billed charges,,,2666.7,90,,percent of total billed charges,,,2666.7,90,,percent of total billed charges,,,2666.7,90,,percent of total billed charges,,,2518.55,85,,percent of total billed charges,,519.15,2814.85,
INSERTION OF HEART ELECTRODE,33210,CDM,33210,CPT,,,both,,988,988,273.06,,,,fee schedule,,,,,,,,240,,,,fee schedule,,,839.8,85,,percent of total billed charges,,279.05,,,,fee schedule,,173.27,,,,fee schedule,,240,,,,fee schedule,,314.36,,,,fee schedule,,240,,,,fee schedule,,265.03,,,,fee schedule,,160.63,,,,fee schedule,,160.63,,,,fee schedule,,,899.08,91,,percent of total billed charges,,,938.6,95,,percent of total billed charges,,,820.04,83,,percent of total billed charges,,,296.4,83,,percent of total billed charges,,240,,,,fee schedule,,240,,,,fee schedule,,,820.04,83,,percent of total billed charges,,236.12,,,,fee schedule,,,889.2,90,,percent of total billed charges,,,889.2,90,,percent of total billed charges,,,889.2,90,,percent of total billed charges,,,889.2,90,,percent of total billed charges,,,839.8,85,,percent of total billed charges,,160.63,938.6,
INSERTION OF PULSE GENERATOR,33213,CDM,33213,CPT,,,both,,1745,1745,573.2,,,,fee schedule,,,,,,,,240,,,,fee schedule,,,1483.25,85,,percent of total billed charges,,576.57,,,,fee schedule,,358.02,,,,fee schedule,,240,,,,fee schedule,,700.35,,,,fee schedule,,240,,,,fee schedule,,556.34,,,,fee schedule,,337.18,,,,fee schedule,,337.18,,,,fee schedule,,,1587.95,91,,percent of total billed charges,,,1657.75,95,,percent of total billed charges,,,1448.35,83,,percent of total billed charges,,,523.5,83,,percent of total billed charges,,240,,,,fee schedule,,240,,,,fee schedule,,,1448.35,83,,percent of total billed charges,,495.65,,,,fee schedule,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1483.25,85,,percent of total billed charges,,240,1657.75,
"INSERT LEAD PACE-DEFIB, DUAL",33217,CDM,33217,CPT,,,both,,1532,1532,629.08,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,1302.2,85,,percent of total billed charges,,630.51,,,,fee schedule,,391.51,,,,fee schedule,,299.7,,,,fee schedule,,688.41,,,,fee schedule,,299.7,,,,fee schedule,,610.58,,,,fee schedule,,370.05,,,,fee schedule,,370.05,,,,fee schedule,,,1394.12,91,,percent of total billed charges,,,1455.4,95,,percent of total billed charges,,,1271.56,83,,percent of total billed charges,,,459.6,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,1271.56,83,,percent of total billed charges,,543.97,,,,fee schedule,,,1378.8,90,,percent of total billed charges,,,1378.8,90,,percent of total billed charges,,,1378.8,90,,percent of total billed charges,,,1378.8,90,,percent of total billed charges,,,1302.2,85,,percent of total billed charges,,299.7,1455.4,
L VENTRIC PACING LEAD ADD-ON,33225,CDM,33225,CPT,,,both,,1965,1965,786.93,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,1670.25,85,,percent of total billed charges,,806.64,,,,fee schedule,,500.87,,,,fee schedule,,299.7,,,,fee schedule,,799.83,,,,fee schedule,,299.7,,,,fee schedule,,763.78,,,,fee schedule,,462.9,,,,fee schedule,,462.9,,,,fee schedule,,,1788.15,91,,percent of total billed charges,,,1866.75,95,,percent of total billed charges,,,1630.95,83,,percent of total billed charges,,,589.5,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,1630.95,83,,percent of total billed charges,,680.46,,,,fee schedule,,,1768.5,90,,percent of total billed charges,,,1768.5,90,,percent of total billed charges,,,1768.5,90,,percent of total billed charges,,,1768.5,90,,percent of total billed charges,,,1670.25,85,,percent of total billed charges,,299.7,1866.75,
REM/REPL PACEMAKER PULSE GENERATOR SING LEAD,33227,CDM,33227,CPT,,,both,,1463,1463,578.39,,,,fee schedule,,,,,,,,207.33,,,,fee schedule,,,1243.55,85,,percent of total billed charges,,581.21,,,,fee schedule,,360.89,,,,fee schedule,,207.33,,,,fee schedule,,,,,,,,207.33,,,,fee schedule,,561.38,,,,fee schedule,,340.23,,,,fee schedule,,340.23,,,,fee schedule,,,1331.33,91,,percent of total billed charges,,,1389.85,95,,percent of total billed charges,,,1214.29,83,,percent of total billed charges,,,438.9,83,,percent of total billed charges,,207.33,,,,fee schedule,,207.33,,,,fee schedule,,,1214.29,83,,percent of total billed charges,,500.13,,,,fee schedule,,,1316.7,90,,percent of total billed charges,,,1316.7,90,,percent of total billed charges,,,1316.7,90,,percent of total billed charges,,,1316.7,90,,percent of total billed charges,,,1243.55,85,,percent of total billed charges,,207.33,1389.85,
REM/REPL PACEMAKER PULSE GENERATOR DUAL LEAD,33228,CDM,33228,CPT,,,both,,4872,4872,603.73,,,,fee schedule,,,,,,,,216.34,,,,fee schedule,,,4141.2,85,,percent of total billed charges,,608.87,,,,fee schedule,,378.07,,,,fee schedule,,216.34,,,,fee schedule,,,,,,,,216.34,,,,fee schedule,,585.98,,,,fee schedule,,355.14,,,,fee schedule,,355.14,,,,fee schedule,,,4433.52,91,,percent of total billed charges,,,4628.4,95,,percent of total billed charges,,,4043.76,83,,percent of total billed charges,,,1461.6,83,,percent of total billed charges,,216.34,,,,fee schedule,,216.34,,,,fee schedule,,,4043.76,83,,percent of total billed charges,,522.05,,,,fee schedule,,,4384.8,90,,percent of total billed charges,,,4384.8,90,,percent of total billed charges,,,4384.8,90,,percent of total billed charges,,,4384.8,90,,percent of total billed charges,,,4141.2,85,,percent of total billed charges,,216.34,4628.4,
REMOVAL OF PACEMAKER SYSTEM,33234,CDM,33234,CPT,,,both,,2362,2362,825.53,,,,fee schedule,,,,,,,,351,,,,fee schedule,,,2007.7,85,,percent of total billed charges,,831.61,,,,fee schedule,,516.37,,,,fee schedule,,351,,,,fee schedule,,882.06,,,,fee schedule,,351,,,,fee schedule,,801.25,,,,fee schedule,,485.6,,,,fee schedule,,485.6,,,,fee schedule,,,2149.42,91,,percent of total billed charges,,,2243.9,95,,percent of total billed charges,,,1960.46,83,,percent of total billed charges,,,708.6,83,,percent of total billed charges,,351,,,,fee schedule,,351,,,,fee schedule,,,1960.46,83,,percent of total billed charges,,713.84,,,,fee schedule,,,2125.8,90,,percent of total billed charges,,,2125.8,90,,percent of total billed charges,,,2125.8,90,,percent of total billed charges,,,2125.8,90,,percent of total billed charges,,,2007.7,85,,percent of total billed charges,,351,2243.9,
ELTRD/INSERT PACE-DEFIB,33249,CDM,33249,CPT,,,both,,4346,4346,1555.42,,,,fee schedule,,,,,,,,642.6,,,,fee schedule,,,3694.1,85,,percent of total billed charges,,1575.38,,,,fee schedule,,978.21,,,,fee schedule,,642.6,,,,fee schedule,,1551.9,,,,fee schedule,,642.6,,,,fee schedule,,1509.67,,,,fee schedule,,914.95,,,,fee schedule,,914.95,,,,fee schedule,,,3954.86,91,,percent of total billed charges,,,4128.7,95,,percent of total billed charges,,,3607.18,83,,percent of total billed charges,,,1303.8,83,,percent of total billed charges,,642.6,,,,fee schedule,,642.6,,,,fee schedule,,,3607.18,83,,percent of total billed charges,,1344.98,,,,fee schedule,,,3911.4,90,,percent of total billed charges,,,3911.4,90,,percent of total billed charges,,,3911.4,90,,percent of total billed charges,,,3911.4,90,,percent of total billed charges,,,3694.1,85,,percent of total billed charges,,642.6,4128.7,
IMPLANT PAT-ACTIVE HT RECORD,33282,CDM,33282,CPT,,,both,,1515,1515,,,,,,,,,,,,,,,,,,,,1287.75,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,559.08,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,1378.65,91,,percent of total billed charges,,,1439.25,95,,percent of total billed charges,,,1257.45,83,,percent of total billed charges,,,454.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1257.45,83,,percent of total billed charges,,,,,,,,,1363.5,90,,percent of total billed charges,,,1363.5,90,,percent of total billed charges,,,1363.5,90,,percent of total billed charges,,,1363.5,90,,percent of total billed charges,,,1287.75,85,,percent of total billed charges,,454.5,1439.25,
REMOVE PAT-ACTIVE HT RECORD,33284,CDM,33284,CPT,,,both,,1088,1088,,,,,,,,,,,,,,,,,,,,924.8,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,409.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,990.08,91,,percent of total billed charges,,,1033.6,95,,percent of total billed charges,,,903.04,83,,percent of total billed charges,,,326.4,83,,percent of total billed charges,,,,,,,,,,,,,,,903.04,83,,percent of total billed charges,,,,,,,,,979.2,90,,percent of total billed charges,,,979.2,90,,percent of total billed charges,,,979.2,90,,percent of total billed charges,,,979.2,90,,percent of total billed charges,,,924.8,85,,percent of total billed charges,,326.4,1033.6,
INSJ SUBQ CAR RHYTHM MNTR,33285,CDM,33285,CPT,,,both,,16480,16480,149.21,,,,fee schedule,,,,,,,,56.4,,,,fee schedule,,,14008,85,,percent of total billed charges,,150.51,,,,fee schedule,,92.53,,,,fee schedule,,56.4,,,,fee schedule,,,,,,,,56.4,,,,fee schedule,,144.82,,,,fee schedule,,87.77,,,,fee schedule,,87.77,,,,fee schedule,,,14996.8,91,,percent of total billed charges,,,15656,95,,percent of total billed charges,,,13678.4,83,,percent of total billed charges,,,4944,83,,percent of total billed charges,,56.4,,,,fee schedule,,56.4,,,,fee schedule,,,13678.4,83,,percent of total billed charges,,129.02,,,,fee schedule,,,14832,90,,percent of total billed charges,,,14832,90,,percent of total billed charges,,,14832,90,,percent of total billed charges,,,14832,90,,percent of total billed charges,,,14008,85,,percent of total billed charges,,56.4,15656,
RMVL SUBQ CAR RHYTHM MNTR,33286,CDM,33286,CPT,,,both,,476,476,146.9,,,,fee schedule,,,,,,,,55.29,,,,fee schedule,,,404.6,85,,percent of total billed charges,,148.76,,,,fee schedule,,91.45,,,,fee schedule,,55.29,,,,fee schedule,,,,,,,,55.29,,,,fee schedule,,142.58,,,,fee schedule,,86.41,,,,fee schedule,,86.41,,,,fee schedule,,,433.16,91,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,142.8,83,,percent of total billed charges,,55.29,,,,fee schedule,,55.29,,,,fee schedule,,,395.08,83,,percent of total billed charges,,127.03,,,,fee schedule,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,55.29,452.2,
"REPR PUL ART, UNIFOCAL W/CPB",33926,CDM,33926,CPT,,,both,,13864,13864,4074.63,,,,fee schedule,,,,,,,,1407.8,,,,fee schedule,,,11784.4,85,,percent of total billed charges,,4161.81,,,,fee schedule,,2558.63,,,,fee schedule,,1407.8,,,,fee schedule,,,,,,,,1407.8,,,,fee schedule,,3954.79,,,,fee schedule,,2396.84,,,,fee schedule,,2396.84,,,,fee schedule,,,12616.24,91,,percent of total billed charges,,,13170.8,95,,percent of total billed charges,,,11507.12,83,,percent of total billed charges,,,4159.2,83,,percent of total billed charges,,1407.8,,,,fee schedule,,1407.8,,,,fee schedule,,,11507.12,83,,percent of total billed charges,,3523.36,,,,fee schedule,,,12477.6,90,,percent of total billed charges,,,12477.6,90,,percent of total billed charges,,,12477.6,90,,percent of total billed charges,,,12477.6,90,,percent of total billed charges,,,11784.4,85,,percent of total billed charges,,1407.8,13170.8,
INSERT IA PERCUT DEVICE,33967,CDM,33967,CPT,,,both,,1351,1351,433.79,,,,fee schedule,,,,,,,,230.2,,,,fee schedule,,,1148.35,85,,percent of total billed charges,,446.09,,,,fee schedule,,274.25,,,,fee schedule,,230.2,,,,fee schedule,,466.23,,,,fee schedule,,230.2,,,,fee schedule,,421.03,,,,fee schedule,,255.17,,,,fee schedule,,255.17,,,,fee schedule,,,1229.41,91,,percent of total billed charges,,,1283.45,95,,percent of total billed charges,,,1121.33,83,,percent of total billed charges,,,405.3,83,,percent of total billed charges,,230.2,,,,fee schedule,,230.2,,,,fee schedule,,,1121.33,83,,percent of total billed charges,,375.1,,,,fee schedule,,,1215.9,90,,percent of total billed charges,,,1215.9,90,,percent of total billed charges,,,1215.9,90,,percent of total billed charges,,,1215.9,90,,percent of total billed charges,,,1148.35,85,,percent of total billed charges,,230.2,1283.45,
INSERT IA PERCUT DEVICE,33967P,CDM,33967,CPT,,,both,P,1161,1161,433.79,,,,fee schedule,,,,,,,,230.2,,,,fee schedule,,,986.85,85,,percent of total billed charges,,446.09,,,,fee schedule,,274.25,,,,fee schedule,,230.2,,,,fee schedule,,466.23,,,,fee schedule,,230.2,,,,fee schedule,,421.03,,,,fee schedule,,255.17,,,,fee schedule,,255.17,,,,fee schedule,,,1056.51,91,,percent of total billed charges,,,1102.95,95,,percent of total billed charges,,,963.63,83,,percent of total billed charges,,,348.3,83,,percent of total billed charges,,230.2,,,,fee schedule,,230.2,,,,fee schedule,,,963.63,83,,percent of total billed charges,,375.1,,,,fee schedule,,,1044.9,90,,percent of total billed charges,,,1044.9,90,,percent of total billed charges,,,1044.9,90,,percent of total billed charges,,,1044.9,90,,percent of total billed charges,,,986.85,85,,percent of total billed charges,,230.2,1102.95,
INSERT IA PERCUT DEVICE,33967T,CDM,33967,CPT,,,both,T,190,190,433.79,,,,fee schedule,,,,,,,,230.2,,,,fee schedule,,,161.5,85,,percent of total billed charges,,446.09,,,,fee schedule,,274.25,,,,fee schedule,,230.2,,,,fee schedule,,466.23,,,,fee schedule,,230.2,,,,fee schedule,,421.03,,,,fee schedule,,255.17,,,,fee schedule,,255.17,,,,fee schedule,,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,57,83,,percent of total billed charges,,230.2,,,,fee schedule,,230.2,,,,fee schedule,,,157.7,83,,percent of total billed charges,,375.1,,,,fee schedule,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,57,466.23,
REMOVE AORTIC ASSIST DEVICE,33968,CDM,33968,CPT,,,both,,196,196,57.03,,,,fee schedule,,,,,,,,162,,,,fee schedule,,,166.6,85,,percent of total billed charges,,56.8,,,,fee schedule,,34.92,,,,fee schedule,,162,,,,fee schedule,,62.34,,,,fee schedule,,162,,,,fee schedule,,55.35,,,,fee schedule,,33.55,,,,fee schedule,,33.55,,,,fee schedule,,,178.36,91,,percent of total billed charges,,,186.2,95,,percent of total billed charges,,,162.68,83,,percent of total billed charges,,,58.8,83,,percent of total billed charges,,162,,,,fee schedule,,162,,,,fee schedule,,,162.68,83,,percent of total billed charges,,49.32,,,,fee schedule,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,166.6,85,,percent of total billed charges,,33.55,186.2,
REMOVE AORTIC ASSIST DEVICE,33968P,CDM,33968,CPT,,,both,P,46,46,57.03,,,,fee schedule,,,,,,,,162,,,,fee schedule,,,39.1,85,,percent of total billed charges,,56.8,,,,fee schedule,,34.92,,,,fee schedule,,162,,,,fee schedule,,62.34,,,,fee schedule,,162,,,,fee schedule,,55.35,,,,fee schedule,,33.55,,,,fee schedule,,33.55,,,,fee schedule,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,13.8,83,,percent of total billed charges,,162,,,,fee schedule,,162,,,,fee schedule,,,38.18,83,,percent of total billed charges,,49.32,,,,fee schedule,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,13.8,162,
REMOVE AORTIC ASSIST DEVICE,33968T,CDM,33968,CPT,,,both,T,150,150,57.03,,,,fee schedule,,,,,,,,162,,,,fee schedule,,,127.5,85,,percent of total billed charges,,56.8,,,,fee schedule,,34.92,,,,fee schedule,,162,,,,fee schedule,,62.34,,,,fee schedule,,162,,,,fee schedule,,55.35,,,,fee schedule,,33.55,,,,fee schedule,,33.55,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,162,,,,fee schedule,,162,,,,fee schedule,,,124.5,83,,percent of total billed charges,,49.32,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,33.55,162,
REPAIR BLOOD VESSEL LESION,35206,CDM,35206,CPT,,,both,,4677,4677,1331.33,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3975.45,85,,percent of total billed charges,,1349.73,,,,fee schedule,,829.8,,,,fee schedule,,599.35,,,,fee schedule,,1433.85,,,,fee schedule,,599.35,,,,fee schedule,,1292.17,,,,fee schedule,,783.13,,,,fee schedule,,783.13,,,,fee schedule,,,4256.07,91,,percent of total billed charges,,,4443.15,95,,percent of total billed charges,,,3881.91,83,,percent of total billed charges,,,1403.1,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3881.91,83,,percent of total billed charges,,1151.21,,,,fee schedule,,,4209.3,90,,percent of total billed charges,,,4209.3,90,,percent of total billed charges,,,4209.3,90,,percent of total billed charges,,,4209.3,90,,percent of total billed charges,,,3975.45,85,,percent of total billed charges,,599.35,4443.15,
EXPLORE ABDOMINAL VESSELS,35840,CDM,35840,CPT,,,both,,4686,4686,2072.17,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3983.1,85,,percent of total billed charges,,2297.65,,,,fee schedule,,1295.68,,,,fee schedule,,480,,,,fee schedule,,1084.34,,,,fee schedule,,480,,,,fee schedule,,2011.22,,,,fee schedule,,1218.92,,,,fee schedule,,1218.92,,,,fee schedule,,,4264.26,91,,percent of total billed charges,,,4451.7,95,,percent of total billed charges,,,3889.38,83,,percent of total billed charges,,,1405.8,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3889.38,83,,percent of total billed charges,,1791.82,,,,fee schedule,,,4217.4,90,,percent of total billed charges,,,4217.4,90,,percent of total billed charges,,,4217.4,90,,percent of total billed charges,,,4217.4,90,,percent of total billed charges,,,3983.1,85,,percent of total billed charges,,480,4451.7,
PLACE NEEDLE IN VEIN,36000,CDM,36000,CPT,,,both,,120,120,15.55,,,,fee schedule,,,,,,,,,,,,,,,102,85,,percent of total billed charges,,16.43,,,,fee schedule,,9.26,,,,fee schedule,,,,,,,,15.92,,,,fee schedule,,,,,,,,15.1,,,,fee schedule,,9.15,,,,fee schedule,,9.15,,,,fee schedule,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,36,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,13.45,,,,fee schedule,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,9.15,114,
PLACE CATHETER IN ARTERY,36245,CDM,36245,CPT,,,both,,2417,2417,395.77,,,,fee schedule,,,,,,,,213.5,,,,fee schedule,,,2054.45,85,,percent of total billed charges,,413.07,,,,fee schedule,,249.23,,,,fee schedule,,213.5,,,,fee schedule,,443.02,,,,fee schedule,,213.5,,,,fee schedule,,384.13,,,,fee schedule,,232.81,,,,fee schedule,,232.81,,,,fee schedule,,,2199.47,91,,percent of total billed charges,,,2296.15,95,,percent of total billed charges,,,2006.11,83,,percent of total billed charges,,,725.1,83,,percent of total billed charges,,213.5,,,,fee schedule,,213.5,,,,fee schedule,,,2006.11,83,,percent of total billed charges,,342.22,,,,fee schedule,,,2175.3,90,,percent of total billed charges,,,2175.3,90,,percent of total billed charges,,,2175.3,90,,percent of total billed charges,,,2175.3,90,,percent of total billed charges,,,2054.45,85,,percent of total billed charges,,213.5,2296.15,
NON-ROUTINE BL DRAW > 3 YRS,36410,CDM,36410,CPT,,,both,,76,76,15.55,,,,fee schedule,,,,,,,,,,,,,,,64.6,85,,percent of total billed charges,,23.12,,,,fee schedule,,9.69,,,,fee schedule,,,,,,,,15.92,,,,fee schedule,,,,,,,,15.1,,,,fee schedule,,9.15,,,,fee schedule,,9.15,,,,fee schedule,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,,,,,,,,,,,,,,63.08,83,,percent of total billed charges,,13.45,,,,fee schedule,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,9.15,72.2,
NON-ROUTINE BL DRAW > 3 YRS,36410P,CDM,36410,CPT,,,both,P,26,26,15.55,,,,fee schedule,,,,,,,,,,,,,,,22.1,85,,percent of total billed charges,,23.12,,,,fee schedule,,9.69,,,,fee schedule,,,,,,,,15.92,,,,fee schedule,,,,,,,,15.1,,,,fee schedule,,9.15,,,,fee schedule,,9.15,,,,fee schedule,,,23.66,91,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,7.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21.58,83,,percent of total billed charges,,13.45,,,,fee schedule,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,7.8,24.7,
ROUTINE VENIPUNCTURE,36415,CDM,36415,CPT,,,both,,41,41,,,,,,,,,,,,,4.1,,,,fee schedule,,,34.85,85,,percent of total billed charges,,10,,,,fee schedule,,7,,,,fee schedule,,4.1,,,,fee schedule,,,,,,,,4.1,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,4.1,,,,fee schedule,,4.1,,,,fee schedule,,,34.03,83,,percent of total billed charges,,,,,,,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,4.1,38.95,
COLLJ CAPILLARY BLD SPEC,36416,CDM,36416,CPT,,,both,,28,28,,,,,,,,,,,,,4.1,,,,fee schedule,,,23.8,85,,percent of total billed charges,,10,,,,fee schedule,,7,,,,fee schedule,,4.1,,,,fee schedule,,,,,,,,4.1,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,8.4,83,,percent of total billed charges,,4.1,,,,fee schedule,,4.1,,,,fee schedule,,,23.24,83,,percent of total billed charges,,,,,,,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,4.1,26.6,
BLOOD TRANSFUSION SERVICE,36430,CDM,36430,CPT,,,both,,237,237,67.4,,,,fee schedule,,,,,,,,16.65,,,,fee schedule,,,201.45,85,,percent of total billed charges,,74.06,,,,fee schedule,,37.53,,,,fee schedule,,16.65,,,,fee schedule,,70.96,,,,fee schedule,,16.65,,,,fee schedule,,65.42,,,,fee schedule,,39.65,,,,fee schedule,,39.65,,,,fee schedule,,,215.67,91,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,71.1,83,,percent of total billed charges,,16.65,,,,fee schedule,,16.65,,,,fee schedule,,,196.71,83,,percent of total billed charges,,58.28,,,,fee schedule,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,16.65,225.15,
INJECTION THERAPY OF VEIN,36470,CDM,36470,CPT,,,both,,635,635,65.67,,,,fee schedule,,,,,,,,,,,,,,,539.75,85,,percent of total billed charges,,96.46,,,,fee schedule,,40.44,,,,fee schedule,,,,,,,,128.66,,,,fee schedule,,,,,,,,63.74,,,,fee schedule,,38.63,,,,fee schedule,,38.63,,,,fee schedule,,,577.85,91,,percent of total billed charges,,,603.25,95,,percent of total billed charges,,,527.05,83,,percent of total billed charges,,,190.5,83,,percent of total billed charges,,,,,,,,,,,,,,,527.05,83,,percent of total billed charges,,56.79,,,,fee schedule,,,571.5,90,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,571.5,90,,percent of total billed charges,,,539.75,85,,percent of total billed charges,,38.63,603.25,
NJX SCLRSNT 1 INCMPTNT VEIN,36470P,CDM,36470,CPT,,,both,P,516,516,65.67,,,,fee schedule,,,,,,,,,,,,,,,438.6,85,,percent of total billed charges,,96.46,,,,fee schedule,,40.44,,,,fee schedule,,,,,,,,128.66,,,,fee schedule,,,,,,,,63.74,,,,fee schedule,,38.63,,,,fee schedule,,38.63,,,,fee schedule,,,469.56,91,,percent of total billed charges,,,490.2,95,,percent of total billed charges,,,428.28,83,,percent of total billed charges,,,154.8,83,,percent of total billed charges,,,,,,,,,,,,,,,428.28,83,,percent of total billed charges,,56.79,,,,fee schedule,,,464.4,90,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,438.6,85,,percent of total billed charges,,38.63,490.2,
NJX SCLRSNT 1 INCMPTNT VEIN,36470T,CDM,36470,CPT,,,both,T,119,119,65.67,,,,fee schedule,,,,,,,,,,,,,,,101.15,85,,percent of total billed charges,,96.46,,,,fee schedule,,40.44,,,,fee schedule,,,,,,,,128.66,,,,fee schedule,,,,,,,,63.74,,,,fee schedule,,38.63,,,,fee schedule,,38.63,,,,fee schedule,,,108.29,91,,percent of total billed charges,,,113.05,95,,percent of total billed charges,,,98.77,83,,percent of total billed charges,,,35.7,83,,percent of total billed charges,,,,,,,,,,,,,,,98.77,83,,percent of total billed charges,,56.79,,,,fee schedule,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,101.15,85,,percent of total billed charges,,35.7,128.66,
INJECTION THERAPY OF VEINS,36471,CDM,36471,CPT,,,both,,724,724,128.47,,,,fee schedule,,,,,,,,,,,,,,,615.4,85,,percent of total billed charges,,192.12,,,,fee schedule,,80.55,,,,fee schedule,,,,,,,,180.39,,,,fee schedule,,,,,,,,124.69,,,,fee schedule,,75.57,,,,fee schedule,,75.57,,,,fee schedule,,,658.84,91,,percent of total billed charges,,,687.8,95,,percent of total billed charges,,,600.92,83,,percent of total billed charges,,,217.2,83,,percent of total billed charges,,,,,,,,,,,,,,,600.92,83,,percent of total billed charges,,111.09,,,,fee schedule,,,651.6,90,,percent of total billed charges,,,651.6,90,,percent of total billed charges,,,651.6,90,,percent of total billed charges,,,651.6,90,,percent of total billed charges,,,615.4,85,,percent of total billed charges,,75.57,687.8,
NJX SCLRSNT MLT INCMPTNT VN,36471P,CDM,36471,CPT,,,both,P,577,577,128.47,,,,fee schedule,,,,,,,,,,,,,,,490.45,85,,percent of total billed charges,,192.12,,,,fee schedule,,80.55,,,,fee schedule,,,,,,,,180.39,,,,fee schedule,,,,,,,,124.69,,,,fee schedule,,75.57,,,,fee schedule,,75.57,,,,fee schedule,,,525.07,91,,percent of total billed charges,,,548.15,95,,percent of total billed charges,,,478.91,83,,percent of total billed charges,,,173.1,83,,percent of total billed charges,,,,,,,,,,,,,,,478.91,83,,percent of total billed charges,,111.09,,,,fee schedule,,,519.3,90,,percent of total billed charges,,,519.3,90,,percent of total billed charges,,,519.3,90,,percent of total billed charges,,,519.3,90,,percent of total billed charges,,,490.45,85,,percent of total billed charges,,75.57,548.15,
NJX SCLRSNT MLT INCMPTNT VN,36471T,CDM,36471,CPT,,,both,T,147,147,128.47,,,,fee schedule,,,,,,,,,,,,,,,124.95,85,,percent of total billed charges,,192.12,,,,fee schedule,,80.55,,,,fee schedule,,,,,,,,180.39,,,,fee schedule,,,,,,,,124.69,,,,fee schedule,,75.57,,,,fee schedule,,75.57,,,,fee schedule,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,44.1,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,111.09,,,,fee schedule,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,44.1,192.12,
APHERESIS PLASMA,36514,CDM,36514,CPT,,,both,,959,959,157.85,,,,fee schedule,,,,,,,,,,,,,,,815.15,85,,percent of total billed charges,,232.98,,,,fee schedule,,97.68,,,,fee schedule,,,,,,,,167.79,,,,fee schedule,,,,,,,,153.2,,,,fee schedule,,92.85,,,,fee schedule,,92.85,,,,fee schedule,,,872.69,91,,percent of total billed charges,,,911.05,95,,percent of total billed charges,,,795.97,83,,percent of total billed charges,,,287.7,83,,percent of total billed charges,,,,,,,,,,,,,,,795.97,83,,percent of total billed charges,,136.49,,,,fee schedule,,,863.1,90,,percent of total billed charges,,,863.1,90,,percent of total billed charges,,,863.1,90,,percent of total billed charges,,,863.1,90,,percent of total billed charges,,,815.15,85,,percent of total billed charges,,92.85,911.05,
INSERT NON-TUNNEL CV CATH,36555,CDM,36555,CPT,,,both,,1064,1064,143.44,,,,fee schedule,,,,,,,,74.38,,,,fee schedule,,,904.4,85,,percent of total billed charges,,214.11,,,,fee schedule,,89.76,,,,fee schedule,,74.38,,,,fee schedule,,238.75,,,,fee schedule,,74.38,,,,fee schedule,,139.23,,,,fee schedule,,84.38,,,,fee schedule,,84.38,,,,fee schedule,,,968.24,91,,percent of total billed charges,,,1010.8,95,,percent of total billed charges,,,883.12,83,,percent of total billed charges,,,319.2,83,,percent of total billed charges,,74.38,,,,fee schedule,,74.38,,,,fee schedule,,,883.12,83,,percent of total billed charges,,124.04,,,,fee schedule,,,957.6,90,,percent of total billed charges,,,957.6,90,,percent of total billed charges,,,957.6,90,,percent of total billed charges,,,957.6,90,,percent of total billed charges,,,904.4,85,,percent of total billed charges,,74.38,1010.8,
INSERT NON-TUNNEL CV CATH,36556,CDM,36556,CPT,,,both,,852,852,142.87,,,,fee schedule,,,,,,,,67.13,,,,fee schedule,,,724.2,85,,percent of total billed charges,,213.12,,,,fee schedule,,89.35,,,,fee schedule,,67.13,,,,fee schedule,,227.48,,,,fee schedule,,67.13,,,,fee schedule,,138.67,,,,fee schedule,,84.04,,,,fee schedule,,84.04,,,,fee schedule,,,775.32,91,,percent of total billed charges,,,809.4,95,,percent of total billed charges,,,707.16,83,,percent of total billed charges,,,255.6,83,,percent of total billed charges,,67.13,,,,fee schedule,,67.13,,,,fee schedule,,,707.16,83,,percent of total billed charges,,123.54,,,,fee schedule,,,766.8,90,,percent of total billed charges,,,766.8,90,,percent of total billed charges,,,766.8,90,,percent of total billed charges,,,766.8,90,,percent of total billed charges,,,724.2,85,,percent of total billed charges,,67.13,809.4,
INSERT TUNNELED CV CATH,36558,CDM,36558,CPT,,,both,,1999,1999,440.7,,,,fee schedule,,,,,,,,158.02,,,,fee schedule,,,1699.15,85,,percent of total billed charges,,647.35,,,,fee schedule,,271.4,,,,fee schedule,,158.02,,,,fee schedule,,524.6,,,,fee schedule,,158.02,,,,fee schedule,,427.74,,,,fee schedule,,259.24,,,,fee schedule,,259.24,,,,fee schedule,,,1819.09,91,,percent of total billed charges,,,1899.05,95,,percent of total billed charges,,,1659.17,83,,percent of total billed charges,,,599.7,83,,percent of total billed charges,,158.02,,,,fee schedule,,158.02,,,,fee schedule,,,1659.17,83,,percent of total billed charges,,381.08,,,,fee schedule,,,1799.1,90,,percent of total billed charges,,,1799.1,90,,percent of total billed charges,,,1799.1,90,,percent of total billed charges,,,1799.1,90,,percent of total billed charges,,,1699.15,85,,percent of total billed charges,,158.02,1899.05,
INSERT MediPort CV CATH-tunneled,36561,CDM,36561,CPT,,,both,,3009,3009,565.14,,,,fee schedule,,,,,,,,190.09,,,,fee schedule,,,2557.65,85,,percent of total billed charges,,839.37,,,,fee schedule,,351.91,,,,fee schedule,,190.09,,,,fee schedule,,630.71,,,,fee schedule,,190.09,,,,fee schedule,,548.52,,,,fee schedule,,332.43,,,,fee schedule,,332.43,,,,fee schedule,,,2738.19,91,,percent of total billed charges,,,2858.55,95,,percent of total billed charges,,,2497.47,83,,percent of total billed charges,,,902.7,83,,percent of total billed charges,,190.09,,,,fee schedule,,190.09,,,,fee schedule,,,2497.47,83,,percent of total billed charges,,488.68,,,,fee schedule,,,2708.1,90,,percent of total billed charges,,,2708.1,90,,percent of total billed charges,,,2708.1,90,,percent of total billed charges,,,2708.1,90,,percent of total billed charges,,,2557.65,85,,percent of total billed charges,,190.09,2858.55,
REPLACE CVAD CATH,36580,CDM,36580,CPT,,,both,,600,600,111.18,,,,fee schedule,,,,,,,,38.25,,,,fee schedule,,,510,85,,percent of total billed charges,,165.25,,,,fee schedule,,69.28,,,,fee schedule,,38.25,,,,fee schedule,,126.67,,,,fee schedule,,38.25,,,,fee schedule,,107.91,,,,fee schedule,,65.4,,,,fee schedule,,65.4,,,,fee schedule,,,546,91,,percent of total billed charges,,,570,95,,percent of total billed charges,,,498,83,,percent of total billed charges,,,180,83,,percent of total billed charges,,38.25,,,,fee schedule,,38.25,,,,fee schedule,,,498,83,,percent of total billed charges,,96.14,,,,fee schedule,,,540,90,,percent of total billed charges,,,540,90,,percent of total billed charges,,,540,90,,percent of total billed charges,,,540,90,,percent of total billed charges,,,510,85,,percent of total billed charges,,38.25,570,
REMOVAL TUNNELED CV CATH,36590,CDM,36590,CPT,,,both,,1173,1173,323.76,,,,fee schedule,,,,,,,,107.54,,,,fee schedule,,,997.05,85,,percent of total billed charges,,478.56,,,,fee schedule,,200.64,,,,fee schedule,,107.54,,,,fee schedule,,361.45,,,,fee schedule,,107.54,,,,fee schedule,,314.24,,,,fee schedule,,190.45,,,,fee schedule,,190.45,,,,fee schedule,,,1067.43,91,,percent of total billed charges,,,1114.35,95,,percent of total billed charges,,,973.59,83,,percent of total billed charges,,,351.9,83,,percent of total billed charges,,107.54,,,,fee schedule,,107.54,,,,fee schedule,,,973.59,83,,percent of total billed charges,,279.96,,,,fee schedule,,,1055.7,90,,percent of total billed charges,,,1055.7,90,,percent of total billed charges,,,1055.7,90,,percent of total billed charges,,,1055.7,90,,percent of total billed charges,,,997.05,85,,percent of total billed charges,,107.54,1114.35,
DRAW BLOOD OFF VENOUS DEVICE,36591,CDM,36591,CPT,,,both,,101,101,46.09,,,,fee schedule,,,,,,,,,,,,,,,85.85,85,,percent of total billed charges,,45.75,,,,fee schedule,,26.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,44.73,,,,fee schedule,,27.11,,,,fee schedule,,27.11,,,,fee schedule,,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,30.3,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,39.85,,,,fee schedule,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,26.2,95.95,
COLLECT BLOOD FROM PICC,36592,CDM,36592,CPT,,,both,,102,102,50.12,,,,fee schedule,,,,,,,,,,,,,,,86.7,85,,percent of total billed charges,,57.57,,,,fee schedule,,29.18,,,,fee schedule,,,,,,,,,,,,,,,,,,,,48.65,,,,fee schedule,,29.48,,,,fee schedule,,29.48,,,,fee schedule,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,30.6,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,43.34,,,,fee schedule,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,29.18,96.9,
REPOSITION VENOUS CATHETER,36597,CDM,36597,CPT,,,both,,377,377,103.12,,,,fee schedule,,,,,,,,34.37,,,,fee schedule,,,320.45,85,,percent of total billed charges,,123.37,,,,fee schedule,,62.53,,,,fee schedule,,34.37,,,,fee schedule,,114.73,,,,fee schedule,,34.37,,,,fee schedule,,100.09,,,,fee schedule,,60.66,,,,fee schedule,,60.66,,,,fee schedule,,,343.07,91,,percent of total billed charges,,,358.15,95,,percent of total billed charges,,,312.91,83,,percent of total billed charges,,,113.1,83,,percent of total billed charges,,34.37,,,,fee schedule,,34.37,,,,fee schedule,,,312.91,83,,percent of total billed charges,,89.17,,,,fee schedule,,,339.3,90,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,320.45,85,,percent of total billed charges,,34.37,358.15,
WITHDRAWAL OF ARTERIAL BLOOD,36600,CDM,36600,CPT,,,both,,120,120,25.35,,,,fee schedule,,,,,,,,,,,,,,,102,85,,percent of total billed charges,,32.78,,,,fee schedule,,16.61,,,,fee schedule,,,,,,,,28.52,,,,fee schedule,,,,,,,,24.6,,,,fee schedule,,14.91,,,,fee schedule,,14.91,,,,fee schedule,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,36,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,21.92,,,,fee schedule,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,14.91,114,
"INSERTION CATHETER, ARTERY",36620,CDM,36620,CPT,,,both,,499,499,75.47,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,424.15,85,,percent of total billed charges,,92.13,,,,fee schedule,,46.69,,,,fee schedule,,37.4,,,,fee schedule,,96.83,,,,fee schedule,,37.4,,,,fee schedule,,73.25,,,,fee schedule,,44.39,,,,fee schedule,,44.39,,,,fee schedule,,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,149.7,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,414.17,83,,percent of total billed charges,,65.26,,,,fee schedule,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,37.4,474.05,
"INSERTION CATHETER, ARTERY",36625,CDM,36625,CPT,,,both,,608,608,179.16,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,516.8,85,,percent of total billed charges,,268.31,,,,fee schedule,,112.49,,,,fee schedule,,52.7,,,,fee schedule,,191.67,,,,fee schedule,,52.7,,,,fee schedule,,173.89,,,,fee schedule,,105.39,,,,fee schedule,,105.39,,,,fee schedule,,,553.28,91,,percent of total billed charges,,,577.6,95,,percent of total billed charges,,,504.64,83,,percent of total billed charges,,,182.4,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,504.64,83,,percent of total billed charges,,154.92,,,,fee schedule,,,547.2,90,,percent of total billed charges,,,547.2,90,,percent of total billed charges,,,547.2,90,,percent of total billed charges,,,547.2,90,,percent of total billed charges,,,516.8,85,,percent of total billed charges,,52.7,577.6,
FEM/POPL REVAS W/TLA,37224,CDM,37224,CPT,,,both,,8947,8947,744.3,,,,fee schedule,,,,,,,,294.36,,,,fee schedule,,,7604.95,85,,percent of total billed charges,,765.85,,,,fee schedule,,475.55,,,,fee schedule,,294.36,,,,fee schedule,,,,,,,,294.36,,,,fee schedule,,722.41,,,,fee schedule,,437.82,,,,fee schedule,,437.82,,,,fee schedule,,,8141.77,91,,percent of total billed charges,,,8499.65,95,,percent of total billed charges,,,7426.01,83,,percent of total billed charges,,,2684.1,83,,percent of total billed charges,,294.36,,,,fee schedule,,294.36,,,,fee schedule,,,7426.01,83,,percent of total billed charges,,643.6,,,,fee schedule,,,8052.3,90,,percent of total billed charges,,,8052.3,90,,percent of total billed charges,,,8052.3,90,,percent of total billed charges,,,8052.3,90,,percent of total billed charges,,,7604.95,85,,percent of total billed charges,,294.36,8499.65,
TIB/PER REVASC W/TLA,37228,CDM,37228,CPT,,,both,,12968,12968,906.75,,,,fee schedule,,,,,,,,360.05,,,,fee schedule,,,11022.8,85,,percent of total billed charges,,933.18,,,,fee schedule,,579.45,,,,fee schedule,,360.05,,,,fee schedule,,,,,,,,360.05,,,,fee schedule,,880.08,,,,fee schedule,,533.38,,,,fee schedule,,533.38,,,,fee schedule,,,11800.88,91,,percent of total billed charges,,,12319.6,95,,percent of total billed charges,,,10763.44,83,,percent of total billed charges,,,3890.4,83,,percent of total billed charges,,360.05,,,,fee schedule,,360.05,,,,fee schedule,,,10763.44,83,,percent of total billed charges,,784.08,,,,fee schedule,,,11671.2,90,,percent of total billed charges,,,11671.2,90,,percent of total billed charges,,,11671.2,90,,percent of total billed charges,,,11671.2,90,,percent of total billed charges,,,11022.8,85,,percent of total billed charges,,360.05,12319.6,
TEMPORAL ARTERY PROCEDURE,37609,CDM,37609,CPT,,,both,,1145,1145,351.41,,,,fee schedule,,,,,,,,112.4,,,,fee schedule,,,973.25,85,,percent of total billed charges,,514.96,,,,fee schedule,,215.9,,,,fee schedule,,112.4,,,,fee schedule,,353.49,,,,fee schedule,,112.4,,,,fee schedule,,341.07,,,,fee schedule,,206.71,,,,fee schedule,,206.71,,,,fee schedule,,,1041.95,91,,percent of total billed charges,,,1087.75,95,,percent of total billed charges,,,950.35,83,,percent of total billed charges,,,343.5,83,,percent of total billed charges,,112.4,,,,fee schedule,,112.4,,,,fee schedule,,,950.35,83,,percent of total billed charges,,303.87,,,,fee schedule,,,1030.5,90,,percent of total billed charges,,,1030.5,90,,percent of total billed charges,,,1030.5,90,,percent of total billed charges,,,1030.5,90,,percent of total billed charges,,,973.25,85,,percent of total billed charges,,112.4,1087.75,
TEMPORAL ARTERY PROCEDURE,37609P,CDM,37609,CPT,,,both,P,500,500,351.41,,,,fee schedule,,,,,,,,112.4,,,,fee schedule,,,425,85,,percent of total billed charges,,514.96,,,,fee schedule,,215.9,,,,fee schedule,,112.4,,,,fee schedule,,353.49,,,,fee schedule,,112.4,,,,fee schedule,,341.07,,,,fee schedule,,206.71,,,,fee schedule,,206.71,,,,fee schedule,,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,150,83,,percent of total billed charges,,112.4,,,,fee schedule,,112.4,,,,fee schedule,,,415,83,,percent of total billed charges,,303.87,,,,fee schedule,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,112.4,514.96,
TEMPORAL ARTERY PROCEDURE,37609T,CDM,37609,CPT,,,both,T,645,645,351.41,,,,fee schedule,,,,,,,,112.4,,,,fee schedule,,,548.25,85,,percent of total billed charges,,514.96,,,,fee schedule,,215.9,,,,fee schedule,,112.4,,,,fee schedule,,353.49,,,,fee schedule,,112.4,,,,fee schedule,,341.07,,,,fee schedule,,206.71,,,,fee schedule,,206.71,,,,fee schedule,,,586.95,91,,percent of total billed charges,,,612.75,95,,percent of total billed charges,,,535.35,83,,percent of total billed charges,,,193.5,83,,percent of total billed charges,,112.4,,,,fee schedule,,112.4,,,,fee schedule,,,535.35,83,,percent of total billed charges,,303.87,,,,fee schedule,,,580.5,90,,percent of total billed charges,,,580.5,90,,percent of total billed charges,,,580.5,90,,percent of total billed charges,,,580.5,90,,percent of total billed charges,,,548.25,85,,percent of total billed charges,,112.4,612.75,
LIGATE/DIVIDE/EXCISE VEIN,37785,CDM,37785,CPT,,,both,,1356,1356,433.21,,,,fee schedule,,,,,,,,131.25,,,,fee schedule,,,1152.6,85,,percent of total billed charges,,648.68,,,,fee schedule,,271.96,,,,fee schedule,,131.25,,,,fee schedule,,468.22,,,,fee schedule,,131.25,,,,fee schedule,,420.47,,,,fee schedule,,254.83,,,,fee schedule,,254.83,,,,fee schedule,,,1233.96,91,,percent of total billed charges,,,1288.2,95,,percent of total billed charges,,,1125.48,83,,percent of total billed charges,,,406.8,83,,percent of total billed charges,,131.25,,,,fee schedule,,131.25,,,,fee schedule,,,1125.48,83,,percent of total billed charges,,374.6,,,,fee schedule,,,1220.4,90,,percent of total billed charges,,,1220.4,90,,percent of total billed charges,,,1220.4,90,,percent of total billed charges,,,1220.4,90,,percent of total billed charges,,,1152.6,85,,percent of total billed charges,,131.25,1288.2,
"REMOVAL OF SPLEEN, TOTAL",38100,CDM,38100,CPT,,,both,,5603,5603,1977.11,,,,fee schedule,,,,,,,,770,,,,fee schedule,,,4762.55,85,,percent of total billed charges,,2276.8,,,,fee schedule,,1239.55,,,,fee schedule,,770,,,,fee schedule,,1494.2,,,,fee schedule,,770,,,,fee schedule,,1918.96,,,,fee schedule,,1163.01,,,,fee schedule,,1163.01,,,,fee schedule,,,5098.73,91,,percent of total billed charges,,,5322.85,95,,percent of total billed charges,,,4650.49,83,,percent of total billed charges,,,1680.9,83,,percent of total billed charges,,770,,,,fee schedule,,770,,,,fee schedule,,,4650.49,83,,percent of total billed charges,,1709.62,,,,fee schedule,,,5042.7,90,,percent of total billed charges,,,5042.7,90,,percent of total billed charges,,,5042.7,90,,percent of total billed charges,,,5042.7,90,,percent of total billed charges,,,4762.55,85,,percent of total billed charges,,770,5322.85,
"LAPAROSCOPE PROC, SPLEEN",38129,CDM,38129,CPT,,,both,,4996,4996,,,,,,,,,,,,,,,,,,,,4246.6,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4546.36,91,,percent of total billed charges,,,4746.2,95,,percent of total billed charges,,,4146.68,83,,percent of total billed charges,,,1498.8,83,,percent of total billed charges,,,,,,,,,,,,,,,4146.68,83,,percent of total billed charges,,,,,,,,,4496.4,90,,percent of total billed charges,,,4496.4,90,,percent of total billed charges,,,4496.4,90,,percent of total billed charges,,,4496.4,90,,percent of total billed charges,,,4246.6,85,,percent of total billed charges,,1498.8,4746.2,
BONE MARROW ASPIRATION,38220,CDM,38220,CPT,,,both,,747,747,115.22,,,,fee schedule,,,,,,,,50.15,,,,fee schedule,,,634.95,85,,percent of total billed charges,,129.43,,,,fee schedule,,70.46,,,,fee schedule,,50.15,,,,fee schedule,,110.09,,,,fee schedule,,50.15,,,,fee schedule,,111.83,,,,fee schedule,,67.77,,,,fee schedule,,67.77,,,,fee schedule,,,679.77,91,,percent of total billed charges,,,709.65,95,,percent of total billed charges,,,620.01,83,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,50.15,,,,fee schedule,,50.15,,,,fee schedule,,,620.01,83,,percent of total billed charges,,99.63,,,,fee schedule,,,672.3,90,,percent of total billed charges,,,672.3,90,,percent of total billed charges,,,672.3,90,,percent of total billed charges,,,672.3,90,,percent of total billed charges,,,634.95,85,,percent of total billed charges,,50.15,709.65,
BONE MARROW BIOPSY,38221,CDM,38221,CPT,,,both,,1107,1107,119.25,,,,fee schedule,,,,,,,,78.45,,,,fee schedule,,,940.95,85,,percent of total billed charges,,134.75,,,,fee schedule,,73.36,,,,fee schedule,,78.45,,,,fee schedule,,138.61,,,,fee schedule,,78.45,,,,fee schedule,,115.74,,,,fee schedule,,70.15,,,,fee schedule,,70.15,,,,fee schedule,,,1007.37,91,,percent of total billed charges,,,1051.65,95,,percent of total billed charges,,,918.81,83,,percent of total billed charges,,,332.1,83,,percent of total billed charges,,78.45,,,,fee schedule,,78.45,,,,fee schedule,,,918.81,83,,percent of total billed charges,,103.12,,,,fee schedule,,,996.3,90,,percent of total billed charges,,,996.3,90,,percent of total billed charges,,,996.3,90,,percent of total billed charges,,,996.3,90,,percent of total billed charges,,,940.95,85,,percent of total billed charges,,70.15,1051.65,
DX BONE MARROW BIOPSIES,38221P,CDM,38221,CPT,,,both,P,991,991,119.25,,,,fee schedule,,,,,,,,78.45,,,,fee schedule,,,842.35,85,,percent of total billed charges,,134.75,,,,fee schedule,,73.36,,,,fee schedule,,78.45,,,,fee schedule,,138.61,,,,fee schedule,,78.45,,,,fee schedule,,115.74,,,,fee schedule,,70.15,,,,fee schedule,,70.15,,,,fee schedule,,,901.81,91,,percent of total billed charges,,,941.45,95,,percent of total billed charges,,,822.53,83,,percent of total billed charges,,,297.3,83,,percent of total billed charges,,78.45,,,,fee schedule,,78.45,,,,fee schedule,,,822.53,83,,percent of total billed charges,,103.12,,,,fee schedule,,,891.9,90,,percent of total billed charges,,,891.9,90,,percent of total billed charges,,,891.9,90,,percent of total billed charges,,,891.9,90,,percent of total billed charges,,,842.35,85,,percent of total billed charges,,70.15,941.45,
DX BONE MARROW BIOPSIES,38221T,CDM,38221,CPT,,,both,T,116,116,119.25,,,,fee schedule,,,,,,,,78.45,,,,fee schedule,,,98.6,85,,percent of total billed charges,,134.75,,,,fee schedule,,73.36,,,,fee schedule,,78.45,,,,fee schedule,,138.61,,,,fee schedule,,78.45,,,,fee schedule,,115.74,,,,fee schedule,,70.15,,,,fee schedule,,70.15,,,,fee schedule,,,105.56,91,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,34.8,83,,percent of total billed charges,,78.45,,,,fee schedule,,78.45,,,,fee schedule,,,96.28,83,,percent of total billed charges,,103.12,,,,fee schedule,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,98.6,85,,percent of total billed charges,,34.8,138.61,
"BIOPSY/REMOVAL, LYMPH NODES",38500,CDM,38500,CPT,,,both,,1481,1481,440.7,,,,fee schedule,,,,,,,,85.7,,,,fee schedule,,,1258.85,85,,percent of total billed charges,,464.9,,,,fee schedule,,272.25,,,,fee schedule,,85.7,,,,fee schedule,,417.82,,,,fee schedule,,85.7,,,,fee schedule,,427.74,,,,fee schedule,,259.24,,,,fee schedule,,259.24,,,,fee schedule,,,1347.71,91,,percent of total billed charges,,,1406.95,95,,percent of total billed charges,,,1229.23,83,,percent of total billed charges,,,444.3,83,,percent of total billed charges,,85.7,,,,fee schedule,,85.7,,,,fee schedule,,,1229.23,83,,percent of total billed charges,,381.08,,,,fee schedule,,,1332.9,90,,percent of total billed charges,,,1332.9,90,,percent of total billed charges,,,1332.9,90,,percent of total billed charges,,,1332.9,90,,percent of total billed charges,,,1258.85,85,,percent of total billed charges,,85.7,1406.95,
"BIOPSY/REMOVAL, LYMPH NODES",38510,CDM,38510,CPT,,,both,,899,899,722.41,,,,fee schedule,,,,,,,,127.7,,,,fee schedule,,,764.15,85,,percent of total billed charges,,759.05,,,,fee schedule,,444.51,,,,fee schedule,,127.7,,,,fee schedule,,705.65,,,,fee schedule,,127.7,,,,fee schedule,,701.16,,,,fee schedule,,424.95,,,,fee schedule,,424.95,,,,fee schedule,,,818.09,91,,percent of total billed charges,,,854.05,95,,percent of total billed charges,,,746.17,83,,percent of total billed charges,,,269.7,83,,percent of total billed charges,,127.7,,,,fee schedule,,127.7,,,,fee schedule,,,746.17,83,,percent of total billed charges,,624.67,,,,fee schedule,,,809.1,90,,percent of total billed charges,,,809.1,90,,percent of total billed charges,,,809.1,90,,percent of total billed charges,,,809.1,90,,percent of total billed charges,,,764.15,85,,percent of total billed charges,,127.7,854.05,
"BIOPSY/REMOVAL, LYMPH NODES",38525,CDM,38525,CPT,,,both,,2725,2725,761.58,,,,fee schedule,,,,,,,,135.6,,,,fee schedule,,,2316.25,85,,percent of total billed charges,,804.6,,,,fee schedule,,470.57,,,,fee schedule,,135.6,,,,fee schedule,,673.15,,,,fee schedule,,135.6,,,,fee schedule,,739.18,,,,fee schedule,,447.99,,,,fee schedule,,447.99,,,,fee schedule,,,2479.75,91,,percent of total billed charges,,,2588.75,95,,percent of total billed charges,,,2261.75,83,,percent of total billed charges,,,817.5,83,,percent of total billed charges,,135.6,,,,fee schedule,,135.6,,,,fee schedule,,,2261.75,83,,percent of total billed charges,,658.54,,,,fee schedule,,,2452.5,90,,percent of total billed charges,,,2452.5,90,,percent of total billed charges,,,2452.5,90,,percent of total billed charges,,,2452.5,90,,percent of total billed charges,,,2316.25,85,,percent of total billed charges,,135.6,2588.75,
OPEN BX/EXC INGUINOFEM NODES,38531,CDM,38531,CPT,,,both,,2084,2084,771.95,,,,fee schedule,,,,,,,,270.07,,,,fee schedule,,,1771.4,85,,percent of total billed charges,,812.48,,,,fee schedule,,475.8,,,,fee schedule,,270.07,,,,fee schedule,,,,,,,,270.07,,,,fee schedule,,749.25,,,,fee schedule,,454.09,,,,fee schedule,,454.09,,,,fee schedule,,,1896.44,91,,percent of total billed charges,,,1979.8,95,,percent of total billed charges,,,1729.72,83,,percent of total billed charges,,,625.2,83,,percent of total billed charges,,270.07,,,,fee schedule,,270.07,,,,fee schedule,,,1729.72,83,,percent of total billed charges,,667.51,,,,fee schedule,,,1875.6,90,,percent of total billed charges,,,1875.6,90,,percent of total billed charges,,,1875.6,90,,percent of total billed charges,,,1875.6,90,,percent of total billed charges,,,1771.4,85,,percent of total billed charges,,270.07,1979.8,
"REMOVAL, ABDOMEN LYMPH NODES",38564,CDM,38564,CPT,,,both,,4020,4020,1207.47,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3417,85,,percent of total billed charges,,1287.53,,,,fee schedule,,753.99,,,,fee schedule,,599.35,,,,fee schedule,,1151.99,,,,fee schedule,,599.35,,,,fee schedule,,1171.95,,,,fee schedule,,710.28,,,,fee schedule,,710.28,,,,fee schedule,,,3658.2,91,,percent of total billed charges,,,3819,95,,percent of total billed charges,,,3336.6,83,,percent of total billed charges,,,1206,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3336.6,83,,percent of total billed charges,,1044.11,,,,fee schedule,,,3618,90,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3417,85,,percent of total billed charges,,599.35,3819,
REMOVE ARMPIT LYMPH NODES,38745,CDM,38745,CPT,,,both,,4558,4558,1520.28,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,3874.3,85,,percent of total billed charges,,1615.34,,,,fee schedule,,945.96,,,,fee schedule,,524.4,,,,fee schedule,,1383.45,,,,fee schedule,,524.4,,,,fee schedule,,1475.57,,,,fee schedule,,894.28,,,,fee schedule,,894.28,,,,fee schedule,,,4147.78,91,,percent of total billed charges,,,4330.1,95,,percent of total billed charges,,,3783.14,83,,percent of total billed charges,,,1367.4,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,3783.14,83,,percent of total billed charges,,1314.6,,,,fee schedule,,,4102.2,90,,percent of total billed charges,,,4102.2,90,,percent of total billed charges,,,4102.2,90,,percent of total billed charges,,,4102.2,90,,percent of total billed charges,,,3874.3,85,,percent of total billed charges,,524.4,4330.1,
IDENTIFY SENTINEL NODE,38792,CDM,38792,CPT,,,both,,350,350,55.3,,,,fee schedule,,,,,,,,105.4,,,,fee schedule,,,297.5,85,,percent of total billed charges,,59.78,,,,fee schedule,,35,,,,fee schedule,,105.4,,,,fee schedule,,67.65,,,,fee schedule,,105.4,,,,fee schedule,,53.68,,,,fee schedule,,32.53,,,,fee schedule,,32.53,,,,fee schedule,,,318.5,91,,percent of total billed charges,,,332.5,95,,percent of total billed charges,,,290.5,83,,percent of total billed charges,,,105,83,,percent of total billed charges,,105.4,,,,fee schedule,,105.4,,,,fee schedule,,,290.5,83,,percent of total billed charges,,47.82,,,,fee schedule,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,297.5,85,,percent of total billed charges,,32.53,332.5,
IO MAP OF SENT LYMPH NODE,38900,CDM,38900,CPT,,,both,,970,970,233.89,,,,fee schedule,,,,,,,,84.1,,,,fee schedule,,,824.5,85,,percent of total billed charges,,253.85,,,,fee schedule,,148.66,,,,fee schedule,,84.1,,,,fee schedule,,,,,,,,84.1,,,,fee schedule,,227.01,,,,fee schedule,,137.58,,,,fee schedule,,137.58,,,,fee schedule,,,882.7,91,,percent of total billed charges,,,921.5,95,,percent of total billed charges,,,805.1,83,,percent of total billed charges,,,291,83,,percent of total billed charges,,84.1,,,,fee schedule,,84.1,,,,fee schedule,,,805.1,83,,percent of total billed charges,,202.25,,,,fee schedule,,,873,90,,percent of total billed charges,,,873,90,,percent of total billed charges,,,873,90,,percent of total billed charges,,,873,90,,percent of total billed charges,,,824.5,85,,percent of total billed charges,,84.1,921.5,
REPAIR OF DIAPHRAGM HERNIA,39541,CDM,39541,CPT,,,both,,3859,3859,1599.2,,,,fee schedule,,,,,,,,682.6,,,,fee schedule,,,3280.15,85,,percent of total billed charges,,1827.03,,,,fee schedule,,1009.86,,,,fee schedule,,682.6,,,,fee schedule,,1516.75,,,,fee schedule,,682.6,,,,fee schedule,,1552.17,,,,fee schedule,,940.71,,,,fee schedule,,940.71,,,,fee schedule,,,3511.69,91,,percent of total billed charges,,,3666.05,95,,percent of total billed charges,,,3202.97,83,,percent of total billed charges,,,1157.7,83,,percent of total billed charges,,682.6,,,,fee schedule,,682.6,,,,fee schedule,,,3202.97,83,,percent of total billed charges,,1382.84,,,,fee schedule,,,3473.1,90,,percent of total billed charges,,,3473.1,90,,percent of total billed charges,,,3473.1,90,,percent of total billed charges,,,3473.1,90,,percent of total billed charges,,,3280.15,85,,percent of total billed charges,,682.6,3666.05,
BIOPSY OF LIP,40490,CDM,40490,CPT,,,both,,291,291,118.1,,,,fee schedule,,,,,,,,46.25,,,,fee schedule,,,247.35,85,,percent of total billed charges,,117.52,,,,fee schedule,,70.12,,,,fee schedule,,46.25,,,,fee schedule,,125.35,,,,fee schedule,,46.25,,,,fee schedule,,114.62,,,,fee schedule,,69.47,,,,fee schedule,,69.47,,,,fee schedule,,,264.81,91,,percent of total billed charges,,,276.45,95,,percent of total billed charges,,,241.53,83,,percent of total billed charges,,,87.3,83,,percent of total billed charges,,46.25,,,,fee schedule,,46.25,,,,fee schedule,,,241.53,83,,percent of total billed charges,,102.12,,,,fee schedule,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,247.35,85,,percent of total billed charges,,46.25,276.45,
BIOPSY OF LIP,40490P,CDM,40490,CPT,,,both,P,199,199,118.1,,,,fee schedule,,,,,,,,46.25,,,,fee schedule,,,169.15,85,,percent of total billed charges,,117.52,,,,fee schedule,,70.12,,,,fee schedule,,46.25,,,,fee schedule,,125.35,,,,fee schedule,,46.25,,,,fee schedule,,114.62,,,,fee schedule,,69.47,,,,fee schedule,,69.47,,,,fee schedule,,,181.09,91,,percent of total billed charges,,,189.05,95,,percent of total billed charges,,,165.17,83,,percent of total billed charges,,,59.7,83,,percent of total billed charges,,46.25,,,,fee schedule,,46.25,,,,fee schedule,,,165.17,83,,percent of total billed charges,,102.12,,,,fee schedule,,,179.1,90,,percent of total billed charges,,,179.1,90,,percent of total billed charges,,,179.1,90,,percent of total billed charges,,,179.1,90,,percent of total billed charges,,,169.15,85,,percent of total billed charges,,46.25,189.05,
BIOPSY OF LIP,40490T,CDM,40490,CPT,,,both,T,92,92,118.1,,,,fee schedule,,,,,,,,46.25,,,,fee schedule,,,78.2,85,,percent of total billed charges,,117.52,,,,fee schedule,,70.12,,,,fee schedule,,46.25,,,,fee schedule,,125.35,,,,fee schedule,,46.25,,,,fee schedule,,114.62,,,,fee schedule,,69.47,,,,fee schedule,,69.47,,,,fee schedule,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,27.6,83,,percent of total billed charges,,46.25,,,,fee schedule,,46.25,,,,fee schedule,,,76.36,83,,percent of total billed charges,,102.12,,,,fee schedule,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,27.6,125.35,
RECONSTRUCT LIP WITH FLAP,40525,CDM,40525,CPT,,,both,,1847,1847,953.42,,,,fee schedule,,,,,,,,629.9,,,,fee schedule,,,1569.95,85,,percent of total billed charges,,947.89,,,,fee schedule,,565.56,,,,fee schedule,,629.9,,,,fee schedule,,974.25,,,,fee schedule,,629.9,,,,fee schedule,,925.37,,,,fee schedule,,560.83,,,,fee schedule,,560.83,,,,fee schedule,,,1680.77,91,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,554.1,83,,percent of total billed charges,,629.9,,,,fee schedule,,629.9,,,,fee schedule,,,1533.01,83,,percent of total billed charges,,824.42,,,,fee schedule,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,554.1,1754.65,
PARTIAL REMOVAL OF LIP,40530,CDM,40530,CPT,,,both,,1577,1577,703.4,,,,fee schedule,,,,,,,,524.35,,,,fee schedule,,,1340.45,85,,percent of total billed charges,,697.92,,,,fee schedule,,416.41,,,,fee schedule,,524.35,,,,fee schedule,,697.69,,,,fee schedule,,524.35,,,,fee schedule,,682.71,,,,fee schedule,,413.76,,,,fee schedule,,413.76,,,,fee schedule,,,1435.07,91,,percent of total billed charges,,,1498.15,95,,percent of total billed charges,,,1308.91,83,,percent of total billed charges,,,473.1,83,,percent of total billed charges,,524.35,,,,fee schedule,,524.35,,,,fee schedule,,,1308.91,83,,percent of total billed charges,,608.23,,,,fee schedule,,,1419.3,90,,percent of total billed charges,,,1419.3,90,,percent of total billed charges,,,1419.3,90,,percent of total billed charges,,,1419.3,90,,percent of total billed charges,,,1340.45,85,,percent of total billed charges,,413.76,1498.15,
BIOPSY OF MOUTH LESION,40808,CDM,40808,CPT,,,both,,564,564,152.66,,,,fee schedule,,,,,,,,50.2,,,,fee schedule,,,479.4,85,,percent of total billed charges,,146.55,,,,fee schedule,,87.44,,,,fee schedule,,50.2,,,,fee schedule,,168.45,,,,fee schedule,,50.2,,,,fee schedule,,148.17,,,,fee schedule,,89.8,,,,fee schedule,,89.8,,,,fee schedule,,,513.24,91,,percent of total billed charges,,,535.8,95,,percent of total billed charges,,,468.12,83,,percent of total billed charges,,,169.2,83,,percent of total billed charges,,50.2,,,,fee schedule,,50.2,,,,fee schedule,,,468.12,83,,percent of total billed charges,,132.01,,,,fee schedule,,,507.6,90,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,479.4,85,,percent of total billed charges,,50.2,535.8,
BIOPSY OF MOUTH LESION,40808P,CDM,40808,CPT,,,both,P,445,445,152.66,,,,fee schedule,,,,,,,,50.2,,,,fee schedule,,,378.25,85,,percent of total billed charges,,146.55,,,,fee schedule,,87.44,,,,fee schedule,,50.2,,,,fee schedule,,168.45,,,,fee schedule,,50.2,,,,fee schedule,,148.17,,,,fee schedule,,89.8,,,,fee schedule,,89.8,,,,fee schedule,,,404.95,91,,percent of total billed charges,,,422.75,95,,percent of total billed charges,,,369.35,83,,percent of total billed charges,,,133.5,83,,percent of total billed charges,,50.2,,,,fee schedule,,50.2,,,,fee schedule,,,369.35,83,,percent of total billed charges,,132.01,,,,fee schedule,,,400.5,90,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,378.25,85,,percent of total billed charges,,50.2,422.75,
BIOPSY OF MOUTH LESION,40808T,CDM,40808,CPT,,,both,T,119,119,152.66,,,,fee schedule,,,,,,,,50.2,,,,fee schedule,,,101.15,85,,percent of total billed charges,,146.55,,,,fee schedule,,87.44,,,,fee schedule,,50.2,,,,fee schedule,,168.45,,,,fee schedule,,50.2,,,,fee schedule,,148.17,,,,fee schedule,,89.8,,,,fee schedule,,89.8,,,,fee schedule,,,108.29,91,,percent of total billed charges,,,113.05,95,,percent of total billed charges,,,98.77,83,,percent of total billed charges,,,35.7,83,,percent of total billed charges,,50.2,,,,fee schedule,,50.2,,,,fee schedule,,,98.77,83,,percent of total billed charges,,132.01,,,,fee schedule,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,101.15,85,,percent of total billed charges,,35.7,168.45,
EXCISION OF MOUTH LESION,40810,CDM,40810,CPT,,,both,,546,546,212.57,,,,fee schedule,,,,,,,,50.95,,,,fee schedule,,,464.1,85,,percent of total billed charges,,206.26,,,,fee schedule,,123.07,,,,fee schedule,,50.95,,,,fee schedule,,205.59,,,,fee schedule,,50.95,,,,fee schedule,,206.32,,,,fee schedule,,125.04,,,,fee schedule,,125.04,,,,fee schedule,,,496.86,91,,percent of total billed charges,,,518.7,95,,percent of total billed charges,,,453.18,83,,percent of total billed charges,,,163.8,83,,percent of total billed charges,,50.95,,,,fee schedule,,50.95,,,,fee schedule,,,453.18,83,,percent of total billed charges,,183.81,,,,fee schedule,,,491.4,90,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,464.1,85,,percent of total billed charges,,50.95,518.7,
EXCISION OF MOUTH LESION,40810P,CDM,40810,CPT,,,both,P,380,380,212.57,,,,fee schedule,,,,,,,,50.95,,,,fee schedule,,,323,85,,percent of total billed charges,,206.26,,,,fee schedule,,123.07,,,,fee schedule,,50.95,,,,fee schedule,,205.59,,,,fee schedule,,50.95,,,,fee schedule,,206.32,,,,fee schedule,,125.04,,,,fee schedule,,125.04,,,,fee schedule,,,345.8,91,,percent of total billed charges,,,361,95,,percent of total billed charges,,,315.4,83,,percent of total billed charges,,,114,83,,percent of total billed charges,,50.95,,,,fee schedule,,50.95,,,,fee schedule,,,315.4,83,,percent of total billed charges,,183.81,,,,fee schedule,,,342,90,,percent of total billed charges,,,342,90,,percent of total billed charges,,,342,90,,percent of total billed charges,,,342,90,,percent of total billed charges,,,323,85,,percent of total billed charges,,50.95,361,
EXCISION OF MOUTH LESION,40810T,CDM,40810,CPT,,,both,T,166,166,212.57,,,,fee schedule,,,,,,,,50.95,,,,fee schedule,,,141.1,85,,percent of total billed charges,,206.26,,,,fee schedule,,123.07,,,,fee schedule,,50.95,,,,fee schedule,,205.59,,,,fee schedule,,50.95,,,,fee schedule,,206.32,,,,fee schedule,,125.04,,,,fee schedule,,125.04,,,,fee schedule,,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,50.95,,,,fee schedule,,50.95,,,,fee schedule,,,137.78,83,,percent of total billed charges,,183.81,,,,fee schedule,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,49.8,212.57,
EXCISE LIP OR CHEEK FOLD,40819,CDM,40819,CPT,,,both,,752,752,341.62,,,,fee schedule,,,,,,,,149.8,,,,fee schedule,,,639.2,85,,percent of total billed charges,,334.42,,,,fee schedule,,199.53,,,,fee schedule,,149.8,,,,fee schedule,,382.67,,,,fee schedule,,149.8,,,,fee schedule,,331.57,,,,fee schedule,,200.95,,,,fee schedule,,200.95,,,,fee schedule,,,684.32,91,,percent of total billed charges,,,714.4,95,,percent of total billed charges,,,624.16,83,,percent of total billed charges,,,225.6,83,,percent of total billed charges,,149.8,,,,fee schedule,,149.8,,,,fee schedule,,,624.16,83,,percent of total billed charges,,295.4,,,,fee schedule,,,676.8,90,,percent of total billed charges,,,676.8,90,,percent of total billed charges,,,676.8,90,,percent of total billed charges,,,676.8,90,,percent of total billed charges,,,639.2,85,,percent of total billed charges,,149.8,714.4,
DRAINAGE OF MOUTH LESION,41000,CDM,41000,CPT,,,both,,562,562,182.04,,,,fee schedule,,,,,,,,44.65,,,,fee schedule,,,477.7,85,,percent of total billed charges,,180.64,,,,fee schedule,,107.78,,,,fee schedule,,44.65,,,,fee schedule,,187.69,,,,fee schedule,,44.65,,,,fee schedule,,176.69,,,,fee schedule,,107.08,,,,fee schedule,,107.08,,,,fee schedule,,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,168.6,83,,percent of total billed charges,,44.65,,,,fee schedule,,44.65,,,,fee schedule,,,466.46,83,,percent of total billed charges,,157.41,,,,fee schedule,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,44.65,533.9,
DRAINAGE OF MOUTH LESION,41000P,CDM,41000,CPT,,,both,P,417,417,182.04,,,,fee schedule,,,,,,,,44.65,,,,fee schedule,,,354.45,85,,percent of total billed charges,,180.64,,,,fee schedule,,107.78,,,,fee schedule,,44.65,,,,fee schedule,,187.69,,,,fee schedule,,44.65,,,,fee schedule,,176.69,,,,fee schedule,,107.08,,,,fee schedule,,107.08,,,,fee schedule,,,379.47,91,,percent of total billed charges,,,396.15,95,,percent of total billed charges,,,346.11,83,,percent of total billed charges,,,125.1,83,,percent of total billed charges,,44.65,,,,fee schedule,,44.65,,,,fee schedule,,,346.11,83,,percent of total billed charges,,157.41,,,,fee schedule,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,354.45,85,,percent of total billed charges,,44.65,396.15,
DRAINAGE OF MOUTH LESION,41000T,CDM,41000,CPT,,,both,T,145,145,182.04,,,,fee schedule,,,,,,,,44.65,,,,fee schedule,,,123.25,85,,percent of total billed charges,,180.64,,,,fee schedule,,107.78,,,,fee schedule,,44.65,,,,fee schedule,,187.69,,,,fee schedule,,44.65,,,,fee schedule,,176.69,,,,fee schedule,,107.08,,,,fee schedule,,107.08,,,,fee schedule,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,43.5,83,,percent of total billed charges,,44.65,,,,fee schedule,,44.65,,,,fee schedule,,,120.35,83,,percent of total billed charges,,157.41,,,,fee schedule,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,43.5,187.69,
INCISION OF TONGUE FOLD,41010,CDM,41010,CPT,,,both,,632,632,191.26,,,,fee schedule,,,,,,,,42.45,,,,fee schedule,,,537.2,85,,percent of total billed charges,,185.91,,,,fee schedule,,110.92,,,,fee schedule,,42.45,,,,fee schedule,,181.72,,,,fee schedule,,42.45,,,,fee schedule,,185.63,,,,fee schedule,,112.51,,,,fee schedule,,112.51,,,,fee schedule,,,575.12,91,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,189.6,83,,percent of total billed charges,,42.45,,,,fee schedule,,42.45,,,,fee schedule,,,524.56,83,,percent of total billed charges,,165.38,,,,fee schedule,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,537.2,85,,percent of total billed charges,,42.45,600.4,
BIOPSY OF TONGUE,41100,CDM,41100,CPT,,,both,,573,573,185.5,,,,fee schedule,,,,,,,,88.5,,,,fee schedule,,,487.05,85,,percent of total billed charges,,182.96,,,,fee schedule,,109.17,,,,fee schedule,,88.5,,,,fee schedule,,212.23,,,,fee schedule,,88.5,,,,fee schedule,,180.04,,,,fee schedule,,109.12,,,,fee schedule,,109.12,,,,fee schedule,,,521.43,91,,percent of total billed charges,,,544.35,95,,percent of total billed charges,,,475.59,83,,percent of total billed charges,,,171.9,83,,percent of total billed charges,,88.5,,,,fee schedule,,88.5,,,,fee schedule,,,475.59,83,,percent of total billed charges,,160.4,,,,fee schedule,,,515.7,90,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,487.05,85,,percent of total billed charges,,88.5,544.35,
BIOPSY OF TONGUE,41100P,CDM,41100,CPT,,,both,P,429,429,185.5,,,,fee schedule,,,,,,,,88.5,,,,fee schedule,,,364.65,85,,percent of total billed charges,,182.96,,,,fee schedule,,109.17,,,,fee schedule,,88.5,,,,fee schedule,,212.23,,,,fee schedule,,88.5,,,,fee schedule,,180.04,,,,fee schedule,,109.12,,,,fee schedule,,109.12,,,,fee schedule,,,390.39,91,,percent of total billed charges,,,407.55,95,,percent of total billed charges,,,356.07,83,,percent of total billed charges,,,128.7,83,,percent of total billed charges,,88.5,,,,fee schedule,,88.5,,,,fee schedule,,,356.07,83,,percent of total billed charges,,160.4,,,,fee schedule,,,386.1,90,,percent of total billed charges,,,386.1,90,,percent of total billed charges,,,386.1,90,,percent of total billed charges,,,386.1,90,,percent of total billed charges,,,364.65,85,,percent of total billed charges,,88.5,407.55,
BIOPSY OF TONGUE,41100T,CDM,41100,CPT,,,both,T,144,144,185.5,,,,fee schedule,,,,,,,,88.5,,,,fee schedule,,,122.4,85,,percent of total billed charges,,182.96,,,,fee schedule,,109.17,,,,fee schedule,,88.5,,,,fee schedule,,212.23,,,,fee schedule,,88.5,,,,fee schedule,,180.04,,,,fee schedule,,109.12,,,,fee schedule,,109.12,,,,fee schedule,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,43.2,83,,percent of total billed charges,,88.5,,,,fee schedule,,88.5,,,,fee schedule,,,119.52,83,,percent of total billed charges,,160.4,,,,fee schedule,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,43.2,212.23,
EXCISION OF TONGUE FOLD,41115,CDM,41115,CPT,,,both,,706,706,253.48,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,600.1,85,,percent of total billed charges,,248.98,,,,fee schedule,,148.55,,,,fee schedule,,224.7,,,,fee schedule,,250.03,,,,fee schedule,,224.7,,,,fee schedule,,246.02,,,,fee schedule,,149.1,,,,fee schedule,,149.1,,,,fee schedule,,,642.46,91,,percent of total billed charges,,,670.7,95,,percent of total billed charges,,,585.98,83,,percent of total billed charges,,,211.8,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,585.98,83,,percent of total billed charges,,219.18,,,,fee schedule,,,635.4,90,,percent of total billed charges,,,635.4,90,,percent of total billed charges,,,635.4,90,,percent of total billed charges,,,635.4,90,,percent of total billed charges,,,600.1,85,,percent of total billed charges,,148.55,670.7,
"TONGUE REMOVAL, NECK SURGERY",41145,CDM,41145,CPT,,,both,,8048,8048,4735.4,,,,fee schedule,,,,,,,,1048.85,,,,fee schedule,,,6840.8,85,,percent of total billed charges,,4731.54,,,,fee schedule,,2823.06,,,,fee schedule,,1048.85,,,,fee schedule,,4186.82,,,,fee schedule,,1048.85,,,,fee schedule,,4596.12,,,,fee schedule,,2785.53,,,,fee schedule,,2785.53,,,,fee schedule,,,7323.68,91,,percent of total billed charges,,,7645.6,95,,percent of total billed charges,,,6679.84,83,,percent of total billed charges,,,2414.4,83,,percent of total billed charges,,1048.85,,,,fee schedule,,1048.85,,,,fee schedule,,,6679.84,83,,percent of total billed charges,,4094.73,,,,fee schedule,,,7243.2,90,,percent of total billed charges,,,7243.2,90,,percent of total billed charges,,,7243.2,90,,percent of total billed charges,,,7243.2,90,,percent of total billed charges,,,6840.8,85,,percent of total billed charges,,1048.85,7645.6,
EXTRNL BEAM OTHER THAN PROST,4201F,CDM,4201F,CPT,,,both,,799,799,,,,,,,,,,,,,,,,,,,,679.15,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,727.09,91,,percent of total billed charges,,,759.05,95,,percent of total billed charges,,,663.17,83,,percent of total billed charges,,,239.7,83,,percent of total billed charges,,,,,,,,,,,,,,,663.17,83,,percent of total billed charges,,,,,,,,,719.1,90,,percent of total billed charges,,,719.1,90,,percent of total billed charges,,,719.1,90,,percent of total billed charges,,,719.1,90,,percent of total billed charges,,,679.15,85,,percent of total billed charges,,239.7,759.05,
BIOPSY ROOF OF MOUTH,42100,CDM,42100,CPT,,,both,,546,546,190.11,,,,fee schedule,,,,,,,,50.2,,,,fee schedule,,,464.1,85,,percent of total billed charges,,185.75,,,,fee schedule,,110.83,,,,fee schedule,,50.2,,,,fee schedule,,185.7,,,,fee schedule,,50.2,,,,fee schedule,,184.52,,,,fee schedule,,111.83,,,,fee schedule,,111.83,,,,fee schedule,,,496.86,91,,percent of total billed charges,,,518.7,95,,percent of total billed charges,,,453.18,83,,percent of total billed charges,,,163.8,83,,percent of total billed charges,,50.2,,,,fee schedule,,50.2,,,,fee schedule,,,453.18,83,,percent of total billed charges,,164.39,,,,fee schedule,,,491.4,90,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,464.1,85,,percent of total billed charges,,50.2,518.7,
"EXCISION LESION, MOUTH ROOF",42104,CDM,42104,CPT,,,both,,799,799,232.74,,,,fee schedule,,,,,,,,79.3,,,,fee schedule,,,679.15,85,,percent of total billed charges,,228.39,,,,fee schedule,,136.27,,,,fee schedule,,79.3,,,,fee schedule,,222.17,,,,fee schedule,,79.3,,,,fee schedule,,225.89,,,,fee schedule,,136.9,,,,fee schedule,,136.9,,,,fee schedule,,,727.09,91,,percent of total billed charges,,,759.05,95,,percent of total billed charges,,,663.17,83,,percent of total billed charges,,,239.7,83,,percent of total billed charges,,79.3,,,,fee schedule,,79.3,,,,fee schedule,,,663.17,83,,percent of total billed charges,,201.25,,,,fee schedule,,,719.1,90,,percent of total billed charges,,,719.1,90,,percent of total billed charges,,,719.1,90,,percent of total billed charges,,,719.1,90,,percent of total billed charges,,,679.15,85,,percent of total billed charges,,79.3,759.05,
EXCISION LESION MOUTH ROOF,42104P,CDM,42104,CPT,,,both,P,616,616,232.74,,,,fee schedule,,,,,,,,79.3,,,,fee schedule,,,523.6,85,,percent of total billed charges,,228.39,,,,fee schedule,,136.27,,,,fee schedule,,79.3,,,,fee schedule,,222.17,,,,fee schedule,,79.3,,,,fee schedule,,225.89,,,,fee schedule,,136.9,,,,fee schedule,,136.9,,,,fee schedule,,,560.56,91,,percent of total billed charges,,,585.2,95,,percent of total billed charges,,,511.28,83,,percent of total billed charges,,,184.8,83,,percent of total billed charges,,79.3,,,,fee schedule,,79.3,,,,fee schedule,,,511.28,83,,percent of total billed charges,,201.25,,,,fee schedule,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,554.4,90,,percent of total billed charges,,,523.6,85,,percent of total billed charges,,79.3,585.2,
EXCISION LESION MOUTH ROOF,42104T,CDM,42104,CPT,,,both,T,183,183,232.74,,,,fee schedule,,,,,,,,79.3,,,,fee schedule,,,155.55,85,,percent of total billed charges,,228.39,,,,fee schedule,,136.27,,,,fee schedule,,79.3,,,,fee schedule,,222.17,,,,fee schedule,,79.3,,,,fee schedule,,225.89,,,,fee schedule,,136.9,,,,fee schedule,,136.9,,,,fee schedule,,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,54.9,83,,percent of total billed charges,,79.3,,,,fee schedule,,79.3,,,,fee schedule,,,151.89,83,,percent of total billed charges,,201.25,,,,fee schedule,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,54.9,232.74,
"REPAIR PALATE, PHARYNX/UVULA",42145,CDM,42145,CPT,,,both,,3769,3769,1191.91,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,3203.65,85,,percent of total billed charges,,1184.59,,,,fee schedule,,706.78,,,,fee schedule,,359.3,,,,fee schedule,,1073.07,,,,fee schedule,,359.3,,,,fee schedule,,1156.86,,,,fee schedule,,701.13,,,,fee schedule,,701.13,,,,fee schedule,,,3429.79,91,,percent of total billed charges,,,3580.55,95,,percent of total billed charges,,,3128.27,83,,percent of total billed charges,,,1130.7,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,3128.27,83,,percent of total billed charges,,1030.66,,,,fee schedule,,,3392.1,90,,percent of total billed charges,,,3392.1,90,,percent of total billed charges,,,3392.1,90,,percent of total billed charges,,,3392.1,90,,percent of total billed charges,,,3203.65,85,,percent of total billed charges,,359.3,3580.55,
TREATMENT MOUTH ROOF LESION,42160,CDM,42160,CPT,,,both,,1013,1013,247.72,,,,fee schedule,,,,,,,,64.1,,,,fee schedule,,,861.05,85,,percent of total billed charges,,243.15,,,,fee schedule,,145.07,,,,fee schedule,,64.1,,,,fee schedule,,282.53,,,,fee schedule,,64.1,,,,fee schedule,,240.43,,,,fee schedule,,145.71,,,,fee schedule,,145.71,,,,fee schedule,,,921.83,91,,percent of total billed charges,,,962.35,95,,percent of total billed charges,,,840.79,83,,percent of total billed charges,,,303.9,83,,percent of total billed charges,,64.1,,,,fee schedule,,64.1,,,,fee schedule,,,840.79,83,,percent of total billed charges,,214.2,,,,fee schedule,,,911.7,90,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,911.7,90,,percent of total billed charges,,,861.05,85,,percent of total billed charges,,64.1,962.35,
TREATMENT MOUTH ROOF LESION,42160P,CDM,42160,CPT,,,both,P,833,833,247.72,,,,fee schedule,,,,,,,,64.1,,,,fee schedule,,,708.05,85,,percent of total billed charges,,243.15,,,,fee schedule,,145.07,,,,fee schedule,,64.1,,,,fee schedule,,282.53,,,,fee schedule,,64.1,,,,fee schedule,,240.43,,,,fee schedule,,145.71,,,,fee schedule,,145.71,,,,fee schedule,,,758.03,91,,percent of total billed charges,,,791.35,95,,percent of total billed charges,,,691.39,83,,percent of total billed charges,,,249.9,83,,percent of total billed charges,,64.1,,,,fee schedule,,64.1,,,,fee schedule,,,691.39,83,,percent of total billed charges,,214.2,,,,fee schedule,,,749.7,90,,percent of total billed charges,,,749.7,90,,percent of total billed charges,,,749.7,90,,percent of total billed charges,,,749.7,90,,percent of total billed charges,,,708.05,85,,percent of total billed charges,,64.1,791.35,
TREATMENT MOUTH ROOF LESION,42160T,CDM,42160,CPT,,,both,T,180,180,247.72,,,,fee schedule,,,,,,,,64.1,,,,fee schedule,,,153,85,,percent of total billed charges,,243.15,,,,fee schedule,,145.07,,,,fee schedule,,64.1,,,,fee schedule,,282.53,,,,fee schedule,,64.1,,,,fee schedule,,240.43,,,,fee schedule,,145.71,,,,fee schedule,,145.71,,,,fee schedule,,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,54,83,,percent of total billed charges,,64.1,,,,fee schedule,,64.1,,,,fee schedule,,,149.4,83,,percent of total billed charges,,214.2,,,,fee schedule,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,54,282.53,
INCISION OF SALIVARY GLAND FOR REMOVAL OF CALCULUS,42330,CDM,42330,CPT,,,both,,845,845,286.31,,,,fee schedule,,,,,,,,113.6,,,,fee schedule,,,718.25,85,,percent of total billed charges,,282.33,,,,fee schedule,,168.45,,,,fee schedule,,113.6,,,,fee schedule,,281.2,,,,fee schedule,,113.6,,,,fee schedule,,277.89,,,,fee schedule,,168.42,,,,fee schedule,,168.42,,,,fee schedule,,,768.95,91,,percent of total billed charges,,,802.75,95,,percent of total billed charges,,,701.35,83,,percent of total billed charges,,,253.5,83,,percent of total billed charges,,113.6,,,,fee schedule,,113.6,,,,fee schedule,,,701.35,83,,percent of total billed charges,,247.58,,,,fee schedule,,,760.5,90,,percent of total billed charges,,,760.5,90,,percent of total billed charges,,,760.5,90,,percent of total billed charges,,,760.5,90,,percent of total billed charges,,,718.25,85,,percent of total billed charges,,113.6,802.75,
EXCISE PAROTID GLAND/LESION,42415,CDM,42415,CPT,,,both,,4574,4574,1828.49,,,,fee schedule,,,,,,,,754.65,,,,fee schedule,,,3887.9,85,,percent of total billed charges,,1833.09,,,,fee schedule,,1093.7,,,,fee schedule,,754.65,,,,fee schedule,,1935.24,,,,fee schedule,,754.65,,,,fee schedule,,1774.71,,,,fee schedule,,1075.58,,,,fee schedule,,1075.58,,,,fee schedule,,,4162.34,91,,percent of total billed charges,,,4345.3,95,,percent of total billed charges,,,3796.42,83,,percent of total billed charges,,,1372.2,83,,percent of total billed charges,,754.65,,,,fee schedule,,754.65,,,,fee schedule,,,3796.42,83,,percent of total billed charges,,1581.1,,,,fee schedule,,,4116.6,90,,percent of total billed charges,,,4116.6,90,,percent of total billed charges,,,4116.6,90,,percent of total billed charges,,,4116.6,90,,percent of total billed charges,,,3887.9,85,,percent of total billed charges,,754.65,4345.3,
EXCISE PAROTID GLAND/LESION,42425,CDM,42425,CPT,,,both,,4022,4022,1453.46,,,,fee schedule,,,,,,,,892,,,,fee schedule,,,3418.7,85,,percent of total billed charges,,1451.53,,,,fee schedule,,866.05,,,,fee schedule,,892,,,,fee schedule,,1508.13,,,,fee schedule,,892,,,,fee schedule,,1410.71,,,,fee schedule,,854.97,,,,fee schedule,,854.97,,,,fee schedule,,,3660.02,91,,percent of total billed charges,,,3820.9,95,,percent of total billed charges,,,3338.26,83,,percent of total billed charges,,,1206.6,83,,percent of total billed charges,,892,,,,fee schedule,,892,,,,fee schedule,,,3338.26,83,,percent of total billed charges,,1256.81,,,,fee schedule,,,3619.8,90,,percent of total billed charges,,,3619.8,90,,percent of total billed charges,,,3619.8,90,,percent of total billed charges,,,3619.8,90,,percent of total billed charges,,,3418.7,85,,percent of total billed charges,,854.97,3820.9,
EXCISE SUBMAXILLARY GLAND,42440,CDM,42440,CPT,,,both,,2197,2197,721.26,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,1867.45,85,,percent of total billed charges,,715.69,,,,fee schedule,,427.02,,,,fee schedule,,480,,,,fee schedule,,819.06,,,,fee schedule,,480,,,,fee schedule,,700.04,,,,fee schedule,,424.27,,,,fee schedule,,424.27,,,,fee schedule,,,1999.27,91,,percent of total billed charges,,,2087.15,95,,percent of total billed charges,,,1823.51,83,,percent of total billed charges,,,659.1,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,1823.51,83,,percent of total billed charges,,623.67,,,,fee schedule,,,1977.3,90,,percent of total billed charges,,,1977.3,90,,percent of total billed charges,,,1977.3,90,,percent of total billed charges,,,1977.3,90,,percent of total billed charges,,,1867.45,85,,percent of total billed charges,,424.27,2087.15,
PAROTID DUCT DIVERSION,42510,CDM,42510,CPT,,,both,,2896,2896,1054.81,,,,fee schedule,,,,,,,,839.35,,,,fee schedule,,,2461.6,85,,percent of total billed charges,,1046.4,,,,fee schedule,,624.33,,,,fee schedule,,839.35,,,,fee schedule,,1100.26,,,,fee schedule,,839.35,,,,fee schedule,,1023.78,,,,fee schedule,,620.47,,,,fee schedule,,620.47,,,,fee schedule,,,2635.36,91,,percent of total billed charges,,,2751.2,95,,percent of total billed charges,,,2403.68,83,,percent of total billed charges,,,868.8,83,,percent of total billed charges,,839.35,,,,fee schedule,,839.35,,,,fee schedule,,,2403.68,83,,percent of total billed charges,,912.1,,,,fee schedule,,,2606.4,90,,percent of total billed charges,,,2606.4,90,,percent of total billed charges,,,2606.4,90,,percent of total billed charges,,,2606.4,90,,percent of total billed charges,,,2461.6,85,,percent of total billed charges,,620.47,2751.2,
SALIVARY SURGERY PROCEDURE,42699,CDM,42699,CPT,,,both,,1674,1674,,,,,,,,,,,,,,,,,,,,1422.9,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1523.34,91,,percent of total billed charges,,,1590.3,95,,percent of total billed charges,,,1389.42,83,,percent of total billed charges,,,502.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1389.42,83,,percent of total billed charges,,,,,,,,,1506.6,90,,percent of total billed charges,,,1506.6,90,,percent of total billed charges,,,1506.6,90,,percent of total billed charges,,,1506.6,90,,percent of total billed charges,,,1422.9,85,,percent of total billed charges,,502.2,1590.3,
DRAINAGE OF TONSIL ABSCESS,42700,CDM,42700,CPT,,,both,,662,662,235.62,,,,fee schedule,,,,,,,,79.3,,,,fee schedule,,,562.7,85,,percent of total billed charges,,230.4,,,,fee schedule,,137.46,,,,fee schedule,,79.3,,,,fee schedule,,228.81,,,,fee schedule,,79.3,,,,fee schedule,,228.69,,,,fee schedule,,138.6,,,,fee schedule,,138.6,,,,fee schedule,,,602.42,91,,percent of total billed charges,,,628.9,95,,percent of total billed charges,,,549.46,83,,percent of total billed charges,,,198.6,83,,percent of total billed charges,,79.3,,,,fee schedule,,79.3,,,,fee schedule,,,549.46,83,,percent of total billed charges,,203.74,,,,fee schedule,,,595.8,90,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,562.7,85,,percent of total billed charges,,79.3,628.9,
DRAINAGE OF TONSIL ABSCESS,42700P,CDM,42700,CPT,,,both,P,483,483,235.62,,,,fee schedule,,,,,,,,79.3,,,,fee schedule,,,410.55,85,,percent of total billed charges,,230.4,,,,fee schedule,,137.46,,,,fee schedule,,79.3,,,,fee schedule,,228.81,,,,fee schedule,,79.3,,,,fee schedule,,228.69,,,,fee schedule,,138.6,,,,fee schedule,,138.6,,,,fee schedule,,,439.53,91,,percent of total billed charges,,,458.85,95,,percent of total billed charges,,,400.89,83,,percent of total billed charges,,,144.9,83,,percent of total billed charges,,79.3,,,,fee schedule,,79.3,,,,fee schedule,,,400.89,83,,percent of total billed charges,,203.74,,,,fee schedule,,,434.7,90,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,434.7,90,,percent of total billed charges,,,410.55,85,,percent of total billed charges,,79.3,458.85,
DRAINAGE OF TONSIL ABSCESS,42700T,CDM,42700,CPT,,,both,T,179,179,235.62,,,,fee schedule,,,,,,,,79.3,,,,fee schedule,,,152.15,85,,percent of total billed charges,,230.4,,,,fee schedule,,137.46,,,,fee schedule,,79.3,,,,fee schedule,,228.81,,,,fee schedule,,79.3,,,,fee schedule,,228.69,,,,fee schedule,,138.6,,,,fee schedule,,138.6,,,,fee schedule,,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,53.7,83,,percent of total billed charges,,79.3,,,,fee schedule,,79.3,,,,fee schedule,,,148.57,83,,percent of total billed charges,,203.74,,,,fee schedule,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,53.7,235.62,
REMOVE PHARYNX FOREIGN BODY,42809,CDM,42809,CPT,,,both,,657,657,218.34,,,,fee schedule,,,,,,,,202.5,,,,fee schedule,,,558.45,85,,percent of total billed charges,,217.89,,,,fee schedule,,130.01,,,,fee schedule,,202.5,,,,fee schedule,,218.86,,,,fee schedule,,202.5,,,,fee schedule,,211.91,,,,fee schedule,,128.43,,,,fee schedule,,128.43,,,,fee schedule,,,597.87,91,,percent of total billed charges,,,624.15,95,,percent of total billed charges,,,545.31,83,,percent of total billed charges,,,197.1,83,,percent of total billed charges,,202.5,,,,fee schedule,,202.5,,,,fee schedule,,,545.31,83,,percent of total billed charges,,188.8,,,,fee schedule,,,591.3,90,,percent of total billed charges,,,591.3,90,,percent of total billed charges,,,591.3,90,,percent of total billed charges,,,591.3,90,,percent of total billed charges,,,558.45,85,,percent of total billed charges,,128.43,624.15,
REMOVE PHARYNX FOREIGN BODY,42809T,CDM,42809,CPT,,,both,T,170,170,218.34,,,,fee schedule,,,,,,,,202.5,,,,fee schedule,,,144.5,85,,percent of total billed charges,,217.89,,,,fee schedule,,130.01,,,,fee schedule,,202.5,,,,fee schedule,,218.86,,,,fee schedule,,202.5,,,,fee schedule,,211.91,,,,fee schedule,,128.43,,,,fee schedule,,128.43,,,,fee schedule,,,154.7,91,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,51,83,,percent of total billed charges,,202.5,,,,fee schedule,,202.5,,,,fee schedule,,,141.1,83,,percent of total billed charges,,188.8,,,,fee schedule,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,51,218.86,
REMOVE TONSILS AND ADENOIDS,42820,CDM,42820,CPT,,,both,,1503,1503,504.65,,,,fee schedule,,,,,,,,194.2,,,,fee schedule,,,1277.55,85,,percent of total billed charges,,500.21,,,,fee schedule,,298.45,,,,fee schedule,,194.2,,,,fee schedule,,497.4,,,,fee schedule,,194.2,,,,fee schedule,,489.81,,,,fee schedule,,296.85,,,,fee schedule,,296.85,,,,fee schedule,,,1367.73,91,,percent of total billed charges,,,1427.85,95,,percent of total billed charges,,,1247.49,83,,percent of total billed charges,,,450.9,83,,percent of total billed charges,,194.2,,,,fee schedule,,194.2,,,,fee schedule,,,1247.49,83,,percent of total billed charges,,436.37,,,,fee schedule,,,1352.7,90,,percent of total billed charges,,,1352.7,90,,percent of total billed charges,,,1352.7,90,,percent of total billed charges,,,1352.7,90,,percent of total billed charges,,,1277.55,85,,percent of total billed charges,,194.2,1427.85,
REMOVE TONSILS AND ADENOIDS,42821,CDM,42821,CPT,,,both,,1567,1567,528.84,,,,fee schedule,,,,,,,,202.5,,,,fee schedule,,,1331.95,85,,percent of total billed charges,,521.77,,,,fee schedule,,311.31,,,,fee schedule,,202.5,,,,fee schedule,,539.19,,,,fee schedule,,202.5,,,,fee schedule,,513.29,,,,fee schedule,,311.08,,,,fee schedule,,311.08,,,,fee schedule,,,1425.97,91,,percent of total billed charges,,,1488.65,95,,percent of total billed charges,,,1300.61,83,,percent of total billed charges,,,470.1,83,,percent of total billed charges,,202.5,,,,fee schedule,,202.5,,,,fee schedule,,,1300.61,83,,percent of total billed charges,,457.29,,,,fee schedule,,,1410.3,90,,percent of total billed charges,,,1410.3,90,,percent of total billed charges,,,1410.3,90,,percent of total billed charges,,,1410.3,90,,percent of total billed charges,,,1331.95,85,,percent of total billed charges,,202.5,1488.65,
REMOVAL OF TONSILS,42826,CDM,42826,CPT,,,both,,1175,1175,444.16,,,,fee schedule,,,,,,,,202.5,,,,fee schedule,,,998.75,85,,percent of total billed charges,,437.43,,,,fee schedule,,260.99,,,,fee schedule,,202.5,,,,fee schedule,,443.02,,,,fee schedule,,202.5,,,,fee schedule,,431.1,,,,fee schedule,,261.27,,,,fee schedule,,261.27,,,,fee schedule,,,1069.25,91,,percent of total billed charges,,,1116.25,95,,percent of total billed charges,,,975.25,83,,percent of total billed charges,,,352.5,83,,percent of total billed charges,,202.5,,,,fee schedule,,202.5,,,,fee schedule,,,975.25,83,,percent of total billed charges,,384.07,,,,fee schedule,,,1057.5,90,,percent of total billed charges,,,1057.5,90,,percent of total billed charges,,,1057.5,90,,percent of total billed charges,,,1057.5,90,,percent of total billed charges,,,998.75,85,,percent of total billed charges,,202.5,1116.25,
REMOVAL OF ADENOIDS,42830,CDM,42830,CPT,,,both,,997,997,368.69,,,,fee schedule,,,,,,,,142.9,,,,fee schedule,,,847.45,85,,percent of total billed charges,,361.83,,,,fee schedule,,215.88,,,,fee schedule,,142.9,,,,fee schedule,,353.49,,,,fee schedule,,142.9,,,,fee schedule,,357.85,,,,fee schedule,,216.88,,,,fee schedule,,216.88,,,,fee schedule,,,907.27,91,,percent of total billed charges,,,947.15,95,,percent of total billed charges,,,827.51,83,,percent of total billed charges,,,299.1,83,,percent of total billed charges,,142.9,,,,fee schedule,,142.9,,,,fee schedule,,,827.51,83,,percent of total billed charges,,318.81,,,,fee schedule,,,897.3,90,,percent of total billed charges,,,897.3,90,,percent of total billed charges,,,897.3,90,,percent of total billed charges,,,897.3,90,,percent of total billed charges,,,847.45,85,,percent of total billed charges,,142.9,947.15,
REMOVAL OF ADENOIDS,42831,CDM,42831,CPT,,,both,,1085,1085,401.53,,,,fee schedule,,,,,,,,142.9,,,,fee schedule,,,922.25,85,,percent of total billed charges,,392.21,,,,fee schedule,,234.01,,,,fee schedule,,142.9,,,,fee schedule,,382.67,,,,fee schedule,,142.9,,,,fee schedule,,389.72,,,,fee schedule,,236.19,,,,fee schedule,,236.19,,,,fee schedule,,,987.35,91,,percent of total billed charges,,,1030.75,95,,percent of total billed charges,,,900.55,83,,percent of total billed charges,,,325.5,83,,percent of total billed charges,,142.9,,,,fee schedule,,142.9,,,,fee schedule,,,900.55,83,,percent of total billed charges,,347.2,,,,fee schedule,,,976.5,90,,percent of total billed charges,,,976.5,90,,percent of total billed charges,,,976.5,90,,percent of total billed charges,,,976.5,90,,percent of total billed charges,,,922.25,85,,percent of total billed charges,,142.9,1030.75,
REMOVAL OF ADENOIDS,42835,CDM,42835,CPT,,,both,,975,975,344.5,,,,fee schedule,,,,,,,,142.9,,,,fee schedule,,,828.75,85,,percent of total billed charges,,335.67,,,,fee schedule,,200.28,,,,fee schedule,,142.9,,,,fee schedule,,329.61,,,,fee schedule,,142.9,,,,fee schedule,,334.37,,,,fee schedule,,202.65,,,,fee schedule,,202.65,,,,fee schedule,,,887.25,91,,percent of total billed charges,,,926.25,95,,percent of total billed charges,,,809.25,83,,percent of total billed charges,,,292.5,83,,percent of total billed charges,,142.9,,,,fee schedule,,142.9,,,,fee schedule,,,809.25,83,,percent of total billed charges,,297.89,,,,fee schedule,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,877.5,90,,percent of total billed charges,,,828.75,85,,percent of total billed charges,,142.9,926.25,
PARTIAL REMOVAL OF ESOPHAGUS,43116,CDM,43116,CPT,,,both,,21297,21297,8399.28,,,,fee schedule,,,,,,,,2106.3,,,,fee schedule,,,18102.45,85,,percent of total billed charges,,8782.66,,,,fee schedule,,5240.15,,,,fee schedule,,2106.3,,,,fee schedule,,3374.39,,,,fee schedule,,2106.3,,,,fee schedule,,8152.24,,,,fee schedule,,4940.75,,,,fee schedule,,4940.75,,,,fee schedule,,,19380.27,91,,percent of total billed charges,,,20232.15,95,,percent of total billed charges,,,17676.51,83,,percent of total billed charges,,,6389.1,83,,percent of total billed charges,,2106.3,,,,fee schedule,,2106.3,,,,fee schedule,,,17676.51,83,,percent of total billed charges,,7262.91,,,,fee schedule,,,19167.3,90,,percent of total billed charges,,,19167.3,90,,percent of total billed charges,,,19167.3,90,,percent of total billed charges,,,19167.3,90,,percent of total billed charges,,,18102.45,85,,percent of total billed charges,,2106.3,20232.15,
ESOPHAGOSCOPY RIGID TRNSO,43180,CDM,43180,CPT,,,both,,2516,2516,943.05,,,,fee schedule,,,,,,,,344.66,,,,fee schedule,,,2138.6,85,,percent of total billed charges,,948.48,,,,fee schedule,,565.91,,,,fee schedule,,344.66,,,,fee schedule,,,,,,,,344.66,,,,fee schedule,,915.31,,,,fee schedule,,554.73,,,,fee schedule,,554.73,,,,fee schedule,,,2289.56,91,,percent of total billed charges,,,2390.2,95,,percent of total billed charges,,,2088.28,83,,percent of total billed charges,,,754.8,83,,percent of total billed charges,,344.66,,,,fee schedule,,344.66,,,,fee schedule,,,2088.28,83,,percent of total billed charges,,815.46,,,,fee schedule,,,2264.4,90,,percent of total billed charges,,,2264.4,90,,percent of total billed charges,,,2264.4,90,,percent of total billed charges,,,2264.4,90,,percent of total billed charges,,,2138.6,85,,percent of total billed charges,,344.66,2390.2,
ESOPHAGOSCOPY FLEX DX BRUSH,43197,CDM,43197,CPT,,,both,,969,969,139.99,,,,fee schedule,,,,,,,,49.27,,,,fee schedule,,,823.65,85,,percent of total billed charges,,144.04,,,,fee schedule,,85.94,,,,fee schedule,,49.27,,,,fee schedule,,,,,,,,49.27,,,,fee schedule,,135.87,,,,fee schedule,,82.35,,,,fee schedule,,82.35,,,,fee schedule,,,881.79,91,,percent of total billed charges,,,920.55,95,,percent of total billed charges,,,804.27,83,,percent of total billed charges,,,290.7,83,,percent of total billed charges,,49.27,,,,fee schedule,,49.27,,,,fee schedule,,,804.27,83,,percent of total billed charges,,121.05,,,,fee schedule,,,872.1,90,,percent of total billed charges,,,872.1,90,,percent of total billed charges,,,872.1,90,,percent of total billed charges,,,872.1,90,,percent of total billed charges,,,823.65,85,,percent of total billed charges,,49.27,920.55,
ESOPHAGOSCOPY FLEX DX BRUSH,43197P,CDM,43197,CPT,,,both,P,840,840,139.99,,,,fee schedule,,,,,,,,49.27,,,,fee schedule,,,714,85,,percent of total billed charges,,144.04,,,,fee schedule,,85.94,,,,fee schedule,,49.27,,,,fee schedule,,,,,,,,49.27,,,,fee schedule,,135.87,,,,fee schedule,,82.35,,,,fee schedule,,82.35,,,,fee schedule,,,764.4,91,,percent of total billed charges,,,798,95,,percent of total billed charges,,,697.2,83,,percent of total billed charges,,,252,83,,percent of total billed charges,,49.27,,,,fee schedule,,49.27,,,,fee schedule,,,697.2,83,,percent of total billed charges,,121.05,,,,fee schedule,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,756,90,,percent of total billed charges,,,714,85,,percent of total billed charges,,49.27,798,
ESOPHAGOSCOPY FLEX DX BRUSH,43197T,CDM,43197,CPT,,,both,T,129,129,139.99,,,,fee schedule,,,,,,,,49.27,,,,fee schedule,,,109.65,85,,percent of total billed charges,,144.04,,,,fee schedule,,85.94,,,,fee schedule,,49.27,,,,fee schedule,,,,,,,,49.27,,,,fee schedule,,135.87,,,,fee schedule,,82.35,,,,fee schedule,,82.35,,,,fee schedule,,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,38.7,83,,percent of total billed charges,,49.27,,,,fee schedule,,49.27,,,,fee schedule,,,107.07,83,,percent of total billed charges,,121.05,,,,fee schedule,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,38.7,144.04,
ESOPHAGUS ENDOSCOPY,43200,CDM,43200,CPT,,,both,,1276,1276,149.21,,,,fee schedule,,,,,,,,186.2,,,,fee schedule,,,1084.6,85,,percent of total billed charges,,150.65,,,,fee schedule,,89.88,,,,fee schedule,,186.2,,,,fee schedule,,185.03,,,,fee schedule,,186.2,,,,fee schedule,,144.82,,,,fee schedule,,87.77,,,,fee schedule,,87.77,,,,fee schedule,,,1161.16,91,,percent of total billed charges,,,1212.2,95,,percent of total billed charges,,,1059.08,83,,percent of total billed charges,,,382.8,83,,percent of total billed charges,,186.2,,,,fee schedule,,186.2,,,,fee schedule,,,1059.08,83,,percent of total billed charges,,129.02,,,,fee schedule,,,1148.4,90,,percent of total billed charges,,,1148.4,90,,percent of total billed charges,,,1148.4,90,,percent of total billed charges,,,1148.4,90,,percent of total billed charges,,,1084.6,85,,percent of total billed charges,,87.77,1212.2,
"ESOPH ENDOSCOPY, DILATION",43220,CDM,43220,CPT,,,both,,2482,2482,199.9,,,,fee schedule,,,,,,,,142.7,,,,fee schedule,,,2109.7,85,,percent of total billed charges,,202.21,,,,fee schedule,,120.65,,,,fee schedule,,142.7,,,,fee schedule,,214.88,,,,fee schedule,,142.7,,,,fee schedule,,194.02,,,,fee schedule,,117.59,,,,fee schedule,,117.59,,,,fee schedule,,,2258.62,91,,percent of total billed charges,,,2357.9,95,,percent of total billed charges,,,2060.06,83,,percent of total billed charges,,,744.6,83,,percent of total billed charges,,142.7,,,,fee schedule,,142.7,,,,fee schedule,,,2060.06,83,,percent of total billed charges,,172.86,,,,fee schedule,,,2233.8,90,,percent of total billed charges,,,2233.8,90,,percent of total billed charges,,,2233.8,90,,percent of total billed charges,,,2233.8,90,,percent of total billed charges,,,2109.7,85,,percent of total billed charges,,117.59,2357.9,
ESOPHAGOSCOPY LESION ABLATE,43229,CDM,43229,CPT,,,both,,1406,1406,332.4,,,,fee schedule,,,,,,,,128.63,,,,fee schedule,,,1195.1,85,,percent of total billed charges,,337.73,,,,fee schedule,,201.5,,,,fee schedule,,128.63,,,,fee schedule,,,,,,,,128.63,,,,fee schedule,,322.62,,,,fee schedule,,195.53,,,,fee schedule,,195.53,,,,fee schedule,,,1279.46,91,,percent of total billed charges,,,1335.7,95,,percent of total billed charges,,,1166.98,83,,percent of total billed charges,,,421.8,83,,percent of total billed charges,,128.63,,,,fee schedule,,128.63,,,,fee schedule,,,1166.98,83,,percent of total billed charges,,287.43,,,,fee schedule,,,1265.4,90,,percent of total billed charges,,,1265.4,90,,percent of total billed charges,,,1265.4,90,,percent of total billed charges,,,1265.4,90,,percent of total billed charges,,,1195.1,85,,percent of total billed charges,,128.63,1335.7,
"UPPR GI ENDOSCOPY, DIAGNOSIS",43235,CDM,43235,CPT,,,both,,1238,1238,207.39,,,,fee schedule,,,,,,,,239.15,,,,fee schedule,,,1052.3,85,,percent of total billed charges,,215.83,,,,fee schedule,,125.47,,,,fee schedule,,239.15,,,,fee schedule,,238.75,,,,fee schedule,,239.15,,,,fee schedule,,201.29,,,,fee schedule,,121.99,,,,fee schedule,,121.99,,,,fee schedule,,,1126.58,91,,percent of total billed charges,,,1176.1,95,,percent of total billed charges,,,1027.54,83,,percent of total billed charges,,,371.4,83,,percent of total billed charges,,239.15,,,,fee schedule,,239.15,,,,fee schedule,,,1027.54,83,,percent of total billed charges,,179.33,,,,fee schedule,,,1114.2,90,,percent of total billed charges,,,1114.2,90,,percent of total billed charges,,,1114.2,90,,percent of total billed charges,,,1114.2,90,,percent of total billed charges,,,1052.3,85,,percent of total billed charges,,121.99,1176.1,
UPPR GI ENDOSCOPY W/US FN BX,43238,CDM,43238,CPT,,,both,,1320,1320,391.74,,,,fee schedule,,,,,,,,145.34,,,,fee schedule,,,1122,85,,percent of total billed charges,,403.23,,,,fee schedule,,235.99,,,,fee schedule,,145.34,,,,fee schedule,,492.1,,,,fee schedule,,145.34,,,,fee schedule,,380.21,,,,fee schedule,,230.43,,,,fee schedule,,230.43,,,,fee schedule,,,1201.2,91,,percent of total billed charges,,,1254,95,,percent of total billed charges,,,1095.6,83,,percent of total billed charges,,,396,83,,percent of total billed charges,,145.34,,,,fee schedule,,145.34,,,,fee schedule,,,1095.6,83,,percent of total billed charges,,338.74,,,,fee schedule,,,1188,90,,percent of total billed charges,,,1188,90,,percent of total billed charges,,,1188,90,,percent of total billed charges,,,1188,90,,percent of total billed charges,,,1122,85,,percent of total billed charges,,145.34,1254,
"UPPER GI ENDOSCOPY, BIOPSY",43239,CDM,43239,CPT,,,both,,1505,1505,233.89,,,,fee schedule,,,,,,,,249.7,,,,fee schedule,,,1279.25,85,,percent of total billed charges,,286.19,,,,fee schedule,,138.43,,,,fee schedule,,249.7,,,,fee schedule,,283.85,,,,fee schedule,,249.7,,,,fee schedule,,227.01,,,,fee schedule,,137.58,,,,fee schedule,,137.58,,,,fee schedule,,,1369.55,91,,percent of total billed charges,,,1429.75,95,,percent of total billed charges,,,1249.15,83,,percent of total billed charges,,,451.5,83,,percent of total billed charges,,249.7,,,,fee schedule,,249.7,,,,fee schedule,,,1249.15,83,,percent of total billed charges,,202.25,,,,fee schedule,,,1354.5,90,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1279.25,85,,percent of total billed charges,,137.58,1429.75,
UPPR GI SCOPE DILATE STRICTR,43245,CDM,43245,CPT,,,both,,1565,1565,297.26,,,,fee schedule,,,,,,,,249.7,,,,fee schedule,,,1330.25,85,,percent of total billed charges,,306.55,,,,fee schedule,,179.41,,,,fee schedule,,249.7,,,,fee schedule,,314.36,,,,fee schedule,,249.7,,,,fee schedule,,288.52,,,,fee schedule,,174.86,,,,fee schedule,,174.86,,,,fee schedule,,,1424.15,91,,percent of total billed charges,,,1486.75,95,,percent of total billed charges,,,1298.95,83,,percent of total billed charges,,,469.5,83,,percent of total billed charges,,249.7,,,,fee schedule,,249.7,,,,fee schedule,,,1298.95,83,,percent of total billed charges,,257.04,,,,fee schedule,,,1408.5,90,,percent of total billed charges,,,1408.5,90,,percent of total billed charges,,,1408.5,90,,percent of total billed charges,,,1408.5,90,,percent of total billed charges,,,1330.25,85,,percent of total billed charges,,174.86,1486.75,
PLACE GASTROSTOMY TUBE,43246,CDM,43246,CPT,,,both,,1585,1585,339.31,,,,fee schedule,,,,,,,,249.7,,,,fee schedule,,,1347.25,85,,percent of total billed charges,,351.16,,,,fee schedule,,205.51,,,,fee schedule,,249.7,,,,fee schedule,,421.14,,,,fee schedule,,249.7,,,,fee schedule,,329.33,,,,fee schedule,,199.6,,,,fee schedule,,199.6,,,,fee schedule,,,1442.35,91,,percent of total billed charges,,,1505.75,95,,percent of total billed charges,,,1315.55,83,,percent of total billed charges,,,475.5,83,,percent of total billed charges,,249.7,,,,fee schedule,,249.7,,,,fee schedule,,,1315.55,83,,percent of total billed charges,,293.41,,,,fee schedule,,,1426.5,90,,percent of total billed charges,,,1426.5,90,,percent of total billed charges,,,1426.5,90,,percent of total billed charges,,,1426.5,90,,percent of total billed charges,,,1347.25,85,,percent of total billed charges,,199.6,1505.75,
OPERATIVE UPPER GI ENDOSCOPY,43247,CDM,43247,CPT,,,both,,1405,1405,298.99,,,,fee schedule,,,,,,,,249.7,,,,fee schedule,,,1194.25,85,,percent of total billed charges,,308.59,,,,fee schedule,,180.6,,,,fee schedule,,249.7,,,,fee schedule,,332.93,,,,fee schedule,,249.7,,,,fee schedule,,290.19,,,,fee schedule,,175.87,,,,fee schedule,,175.87,,,,fee schedule,,,1278.55,91,,percent of total billed charges,,,1334.75,95,,percent of total billed charges,,,1166.15,83,,percent of total billed charges,,,421.5,83,,percent of total billed charges,,249.7,,,,fee schedule,,249.7,,,,fee schedule,,,1166.15,83,,percent of total billed charges,,258.54,,,,fee schedule,,,1264.5,90,,percent of total billed charges,,,1264.5,90,,percent of total billed charges,,,1264.5,90,,percent of total billed charges,,,1264.5,90,,percent of total billed charges,,,1194.25,85,,percent of total billed charges,,175.87,1334.75,
UPPR GI ENDOSCOPY/GUIDE WIRE,43248,CDM,43248,CPT,,,both,,1447,1447,280.55,,,,fee schedule,,,,,,,,295.95,,,,fee schedule,,,1229.95,85,,percent of total billed charges,,288.34,,,,fee schedule,,168.75,,,,fee schedule,,295.95,,,,fee schedule,,311.71,,,,fee schedule,,295.95,,,,fee schedule,,272.3,,,,fee schedule,,165.03,,,,fee schedule,,165.03,,,,fee schedule,,,1316.77,91,,percent of total billed charges,,,1374.65,95,,percent of total billed charges,,,1201.01,83,,percent of total billed charges,,,434.1,83,,percent of total billed charges,,295.95,,,,fee schedule,,295.95,,,,fee schedule,,,1201.01,83,,percent of total billed charges,,242.6,,,,fee schedule,,,1302.3,90,,percent of total billed charges,,,1302.3,90,,percent of total billed charges,,,1302.3,90,,percent of total billed charges,,,1302.3,90,,percent of total billed charges,,,1229.95,85,,percent of total billed charges,,165.03,1374.65,
"ESOPH ENDOSCOPY, DILATION",43249,CDM,43249,CPT,,,both,,2250,2250,259.81,,,,fee schedule,,,,,,,,113.4,,,,fee schedule,,,1912.5,85,,percent of total billed charges,,267.05,,,,fee schedule,,156.29,,,,fee schedule,,113.4,,,,fee schedule,,287.17,,,,fee schedule,,113.4,,,,fee schedule,,252.17,,,,fee schedule,,152.83,,,,fee schedule,,152.83,,,,fee schedule,,,2047.5,91,,percent of total billed charges,,,2137.5,95,,percent of total billed charges,,,1867.5,83,,percent of total billed charges,,,675,83,,percent of total billed charges,,113.4,,,,fee schedule,,113.4,,,,fee schedule,,,1867.5,83,,percent of total billed charges,,224.66,,,,fee schedule,,,2025,90,,percent of total billed charges,,,2025,90,,percent of total billed charges,,,2025,90,,percent of total billed charges,,,2025,90,,percent of total billed charges,,,1912.5,85,,percent of total billed charges,,113.4,2137.5,
UPPER GI ENDOSCOPY/TUMOR,43250,CDM,43250,CPT,,,both,,1611,1611,288.04,,,,fee schedule,,,,,,,,249.7,,,,fee schedule,,,1369.35,85,,percent of total billed charges,,297.3,,,,fee schedule,,174,,,,fee schedule,,249.7,,,,fee schedule,,316.35,,,,fee schedule,,249.7,,,,fee schedule,,279.57,,,,fee schedule,,169.44,,,,fee schedule,,169.44,,,,fee schedule,,,1466.01,91,,percent of total billed charges,,,1530.45,95,,percent of total billed charges,,,1337.13,83,,percent of total billed charges,,,483.3,83,,percent of total billed charges,,249.7,,,,fee schedule,,249.7,,,,fee schedule,,,1337.13,83,,percent of total billed charges,,249.07,,,,fee schedule,,,1449.9,90,,percent of total billed charges,,,1449.9,90,,percent of total billed charges,,,1449.9,90,,percent of total billed charges,,,1449.9,90,,percent of total billed charges,,,1369.35,85,,percent of total billed charges,,169.44,1530.45,
OPERATIVE UPPER GI ENDOSCOPY,43251,CDM,43251,CPT,,,both,,1709,1709,331.25,,,,fee schedule,,,,,,,,249.7,,,,fee schedule,,,1452.65,85,,percent of total billed charges,,345.23,,,,fee schedule,,202.16,,,,fee schedule,,249.7,,,,fee schedule,,362.11,,,,fee schedule,,249.7,,,,fee schedule,,321.5,,,,fee schedule,,194.85,,,,fee schedule,,194.85,,,,fee schedule,,,1555.19,91,,percent of total billed charges,,,1623.55,95,,percent of total billed charges,,,1418.47,83,,percent of total billed charges,,,512.7,83,,percent of total billed charges,,249.7,,,,fee schedule,,249.7,,,,fee schedule,,,1418.47,83,,percent of total billed charges,,286.43,,,,fee schedule,,,1538.1,90,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1538.1,90,,percent of total billed charges,,,1452.65,85,,percent of total billed charges,,194.85,1623.55,
OPERATIVE UPPER GI ENDOSCOPY,43255,CDM,43255,CPT,,,both,,1553,1553,338.16,,,,fee schedule,,,,,,,,249.7,,,,fee schedule,,,1320.05,85,,percent of total billed charges,,349.2,,,,fee schedule,,204.37,,,,fee schedule,,249.7,,,,fee schedule,,467.56,,,,fee schedule,,249.7,,,,fee schedule,,328.21,,,,fee schedule,,198.92,,,,fee schedule,,198.92,,,,fee schedule,,,1413.23,91,,percent of total billed charges,,,1475.35,95,,percent of total billed charges,,,1288.99,83,,percent of total billed charges,,,465.9,83,,percent of total billed charges,,249.7,,,,fee schedule,,249.7,,,,fee schedule,,,1288.99,83,,percent of total billed charges,,292.41,,,,fee schedule,,,1397.7,90,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1397.7,90,,percent of total billed charges,,,1320.05,85,,percent of total billed charges,,198.92,1475.35,
EGD LESION ABLATION,43270,CDM,43270,CPT,,,both,,1885,1885,378.49,,,,fee schedule,,,,,,,,151.95,,,,fee schedule,,,1602.25,85,,percent of total billed charges,,389.58,,,,fee schedule,,228,,,,fee schedule,,151.95,,,,fee schedule,,,,,,,,151.95,,,,fee schedule,,367.35,,,,fee schedule,,222.64,,,,fee schedule,,222.64,,,,fee schedule,,,1715.35,91,,percent of total billed charges,,,1790.75,95,,percent of total billed charges,,,1564.55,83,,percent of total billed charges,,,565.5,83,,percent of total billed charges,,151.95,,,,fee schedule,,151.95,,,,fee schedule,,,1564.55,83,,percent of total billed charges,,327.28,,,,fee schedule,,,1696.5,90,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1696.5,90,,percent of total billed charges,,,1602.25,85,,percent of total billed charges,,151.95,1790.75,
ESOPHAGUS SURGERY PROCEDURE,43499,CDM,43499,CPT,,,both,,6853,6853,,,,,,,,,,,,,,,,,,,,5825.05,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6236.23,91,,percent of total billed charges,,,6510.35,95,,percent of total billed charges,,,5687.99,83,,percent of total billed charges,,,2055.9,83,,percent of total billed charges,,,,,,,,,,,,,,,5687.99,83,,percent of total billed charges,,,,,,,,,6167.7,90,,percent of total billed charges,,,6167.7,90,,percent of total billed charges,,,6167.7,90,,percent of total billed charges,,,6167.7,90,,percent of total billed charges,,,5825.05,85,,percent of total billed charges,,2055.9,6510.35,
SURGICAL OPENING OF STOMACH,43500,CDM,43500,CPT,,,both,,3852,3852,1349.76,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3274.2,85,,percent of total billed charges,,1414.6,,,,fee schedule,,827.9,,,,fee schedule,,599.35,,,,fee schedule,,1154.64,,,,fee schedule,,599.35,,,,fee schedule,,1310.06,,,,fee schedule,,793.98,,,,fee schedule,,793.98,,,,fee schedule,,,3505.32,91,,percent of total billed charges,,,3659.4,95,,percent of total billed charges,,,3197.16,83,,percent of total billed charges,,,1155.6,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3197.16,83,,percent of total billed charges,,1167.15,,,,fee schedule,,,3466.8,90,,percent of total billed charges,,,3466.8,90,,percent of total billed charges,,,3466.8,90,,percent of total billed charges,,,3466.8,90,,percent of total billed charges,,,3274.2,85,,percent of total billed charges,,599.35,3659.4,
SURGICAL REPAIR OF STOMACH,43501,CDM,43501,CPT,,,both,,6027,6027,2315.85,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,5122.95,85,,percent of total billed charges,,2433.96,,,,fee schedule,,1424.47,,,,fee schedule,,599.35,,,,fee schedule,,2051.3,,,,fee schedule,,599.35,,,,fee schedule,,2247.74,,,,fee schedule,,1362.27,,,,fee schedule,,1362.27,,,,fee schedule,,,5484.57,91,,percent of total billed charges,,,5725.65,95,,percent of total billed charges,,,5002.41,83,,percent of total billed charges,,,1808.1,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,5002.41,83,,percent of total billed charges,,2002.53,,,,fee schedule,,,5424.3,90,,percent of total billed charges,,,5424.3,90,,percent of total billed charges,,,5424.3,90,,percent of total billed charges,,,5424.3,90,,percent of total billed charges,,,5122.95,85,,percent of total billed charges,,599.35,5725.65,
INCISION OF PYLORIC MUSCLE,43520,CDM,43520,CPT,,,both,,3510,3510,1187.88,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,2983.5,85,,percent of total billed charges,,1241.35,,,,fee schedule,,726.5,,,,fee schedule,,599.35,,,,fee schedule,,1097.61,,,,fee schedule,,599.35,,,,fee schedule,,1152.94,,,,fee schedule,,698.75,,,,fee schedule,,698.75,,,,fee schedule,,,3194.1,91,,percent of total billed charges,,,3334.5,95,,percent of total billed charges,,,2913.3,83,,percent of total billed charges,,,1053,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,2913.3,83,,percent of total billed charges,,1027.17,,,,fee schedule,,,3159,90,,percent of total billed charges,,,3159,90,,percent of total billed charges,,,3159,90,,percent of total billed charges,,,3159,90,,percent of total billed charges,,,2983.5,85,,percent of total billed charges,,599.35,3334.5,
"REMOVAL OF STOMACH, PARTIAL",43631,CDM,43631,CPT,,,both,,7183,7183,2486.95,,,,fee schedule,,,,,,,,915.65,,,,fee schedule,,,6105.55,85,,percent of total billed charges,,2611.03,,,,fee schedule,,1528.1,,,,fee schedule,,915.65,,,,fee schedule,,2298.01,,,,fee schedule,,915.65,,,,fee schedule,,2413.8,,,,fee schedule,,1462.91,,,,fee schedule,,1462.91,,,,fee schedule,,,6536.53,91,,percent of total billed charges,,,6823.85,95,,percent of total billed charges,,,5961.89,83,,percent of total billed charges,,,2154.9,83,,percent of total billed charges,,915.65,,,,fee schedule,,915.65,,,,fee schedule,,,5961.89,83,,percent of total billed charges,,2150.48,,,,fee schedule,,,6464.7,90,,percent of total billed charges,,,6464.7,90,,percent of total billed charges,,,6464.7,90,,percent of total billed charges,,,6464.7,90,,percent of total billed charges,,,6105.55,85,,percent of total billed charges,,915.65,6823.85,
"REMOVAL OF STOMACH, PARTIAL",43632,CDM,43632,CPT,,,both,,3050,3050,3493.36,,,,fee schedule,,,,,,,,915.65,,,,fee schedule,,,2592.5,85,,percent of total billed charges,,3665.65,,,,fee schedule,,2145.32,,,,fee schedule,,915.65,,,,fee schedule,,2298.01,,,,fee schedule,,915.65,,,,fee schedule,,3390.62,,,,fee schedule,,2054.92,,,,fee schedule,,2054.92,,,,fee schedule,,,2775.5,91,,percent of total billed charges,,,2897.5,95,,percent of total billed charges,,,2531.5,83,,percent of total billed charges,,,915,83,,percent of total billed charges,,915.65,,,,fee schedule,,915.65,,,,fee schedule,,,2531.5,83,,percent of total billed charges,,3020.73,,,,fee schedule,,,2745,90,,percent of total billed charges,,,2745,90,,percent of total billed charges,,,2745,90,,percent of total billed charges,,,2745,90,,percent of total billed charges,,,2592.5,85,,percent of total billed charges,,915,3665.65,
"REMOVAL OF STOMACH, PARTIAL",43633,CDM,43633,CPT,,,both,,9257,9257,3299.8,,,,fee schedule,,,,,,,,915.65,,,,fee schedule,,,7868.45,85,,percent of total billed charges,,3464.53,,,,fee schedule,,2027.61,,,,fee schedule,,915.65,,,,fee schedule,,2348.41,,,,fee schedule,,915.65,,,,fee schedule,,3202.75,,,,fee schedule,,1941.06,,,,fee schedule,,1941.06,,,,fee schedule,,,8423.87,91,,percent of total billed charges,,,8794.15,95,,percent of total billed charges,,,7683.31,83,,percent of total billed charges,,,2777.1,83,,percent of total billed charges,,915.65,,,,fee schedule,,915.65,,,,fee schedule,,,7683.31,83,,percent of total billed charges,,2853.36,,,,fee schedule,,,8331.3,90,,percent of total billed charges,,,8331.3,90,,percent of total billed charges,,,8331.3,90,,percent of total billed charges,,,8331.3,90,,percent of total billed charges,,,7868.45,85,,percent of total billed charges,,915.65,8794.15,
"REMOVAL OF STOMACH, PARTIAL",43635,CDM,43635,CPT,,,both,,1146,1146,192.41,,,,fee schedule,,,,,,,,1026.65,,,,fee schedule,,,974.1,85,,percent of total billed charges,,202.77,,,,fee schedule,,118.67,,,,fee schedule,,1026.65,,,,fee schedule,,200.95,,,,fee schedule,,1026.65,,,,fee schedule,,186.75,,,,fee schedule,,113.18,,,,fee schedule,,113.18,,,,fee schedule,,,1042.86,91,,percent of total billed charges,,,1088.7,95,,percent of total billed charges,,,951.18,83,,percent of total billed charges,,,343.8,83,,percent of total billed charges,,1026.65,,,,fee schedule,,1026.65,,,,fee schedule,,,951.18,83,,percent of total billed charges,,166.38,,,,fee schedule,,,1031.4,90,,percent of total billed charges,,,1031.4,90,,percent of total billed charges,,,1031.4,90,,percent of total billed charges,,,1031.4,90,,percent of total billed charges,,,974.1,85,,percent of total billed charges,,113.18,1088.7,
VAGOTOMY  PYLORUS REPAIR,43640,CDM,43640,CPT,,,both,,7366,7366,2052.01,,,,fee schedule,,,,,,,,812.9,,,,fee schedule,,,6261.1,85,,percent of total billed charges,,2148.58,,,,fee schedule,,1257.46,,,,fee schedule,,812.9,,,,fee schedule,,1754.84,,,,fee schedule,,812.9,,,,fee schedule,,1991.65,,,,fee schedule,,1207.06,,,,fee schedule,,1207.06,,,,fee schedule,,,6703.06,91,,percent of total billed charges,,,6997.7,95,,percent of total billed charges,,,6113.78,83,,percent of total billed charges,,,2209.8,83,,percent of total billed charges,,812.9,,,,fee schedule,,812.9,,,,fee schedule,,,6113.78,83,,percent of total billed charges,,1774.38,,,,fee schedule,,,6629.4,90,,percent of total billed charges,,,6629.4,90,,percent of total billed charges,,,6629.4,90,,percent of total billed charges,,,6629.4,90,,percent of total billed charges,,,6261.1,85,,percent of total billed charges,,812.9,6997.7,
RPLC GTUBE NO REVJ TRC,43762,CDM,43762,CPT,,,both,,1218,1218,62.79,,,,fee schedule,,,,,,,,23.66,,,,fee schedule,,,1035.3,85,,percent of total billed charges,,66.06,,,,fee schedule,,38.66,,,,fee schedule,,23.66,,,,fee schedule,,,,,,,,23.66,,,,fee schedule,,60.95,,,,fee schedule,,36.94,,,,fee schedule,,36.94,,,,fee schedule,,,1108.38,91,,percent of total billed charges,,,1157.1,95,,percent of total billed charges,,,1010.94,83,,percent of total billed charges,,,365.4,83,,percent of total billed charges,,23.66,,,,fee schedule,,23.66,,,,fee schedule,,,1010.94,83,,percent of total billed charges,,54.3,,,,fee schedule,,,1096.2,90,,percent of total billed charges,,,1096.2,90,,percent of total billed charges,,,1096.2,90,,percent of total billed charges,,,1096.2,90,,percent of total billed charges,,,1035.3,85,,percent of total billed charges,,23.66,1157.1,
FUSION OF STOMACH AND BOWEL,43820,CDM,43820,CPT,,,both,,5882,5882,2311.82,,,,fee schedule,,,,,,,,718.7,,,,fee schedule,,,4999.7,85,,percent of total billed charges,,2420.05,,,,fee schedule,,1416.33,,,,fee schedule,,718.7,,,,fee schedule,,1575.11,,,,fee schedule,,718.7,,,,fee schedule,,2243.82,,,,fee schedule,,1359.89,,,,fee schedule,,1359.89,,,,fee schedule,,,5352.62,91,,percent of total billed charges,,,5587.9,95,,percent of total billed charges,,,4882.06,83,,percent of total billed charges,,,1764.6,83,,percent of total billed charges,,718.7,,,,fee schedule,,718.7,,,,fee schedule,,,4882.06,83,,percent of total billed charges,,1999.04,,,,fee schedule,,,5293.8,90,,percent of total billed charges,,,5293.8,90,,percent of total billed charges,,,5293.8,90,,percent of total billed charges,,,5293.8,90,,percent of total billed charges,,,4999.7,85,,percent of total billed charges,,718.7,5587.9,
FUSION OF STOMACH AND BOWEL,43825,CDM,43825,CPT,,,both,,8198,8198,2257.67,,,,fee schedule,,,,,,,,898.95,,,,fee schedule,,,6968.3,85,,percent of total billed charges,,2366.87,,,,fee schedule,,1385.21,,,,fee schedule,,898.95,,,,fee schedule,,1971.05,,,,fee schedule,,898.95,,,,fee schedule,,2191.26,,,,fee schedule,,1328.04,,,,fee schedule,,1328.04,,,,fee schedule,,,7460.18,91,,percent of total billed charges,,,7788.1,95,,percent of total billed charges,,,6804.34,83,,percent of total billed charges,,,2459.4,83,,percent of total billed charges,,898.95,,,,fee schedule,,898.95,,,,fee schedule,,,6804.34,83,,percent of total billed charges,,1952.22,,,,fee schedule,,,7378.2,90,,percent of total billed charges,,,7378.2,90,,percent of total billed charges,,,7378.2,90,,percent of total billed charges,,,7378.2,90,,percent of total billed charges,,,6968.3,85,,percent of total billed charges,,898.95,7788.1,
PLACE GASTROSTOMY TUBE,43830,CDM,43830,CPT,,,both,,3533,3533,1214.38,,,,fee schedule,,,,,,,,399.5,,,,fee schedule,,,3003.05,85,,percent of total billed charges,,1260.29,,,,fee schedule,,737.58,,,,fee schedule,,399.5,,,,fee schedule,,1031.95,,,,fee schedule,,399.5,,,,fee schedule,,1178.66,,,,fee schedule,,714.34,,,,fee schedule,,714.34,,,,fee schedule,,,3215.03,91,,percent of total billed charges,,,3356.35,95,,percent of total billed charges,,,2932.39,83,,percent of total billed charges,,,1059.9,83,,percent of total billed charges,,399.5,,,,fee schedule,,399.5,,,,fee schedule,,,2932.39,83,,percent of total billed charges,,1050.08,,,,fee schedule,,,3179.7,90,,percent of total billed charges,,,3179.7,90,,percent of total billed charges,,,3179.7,90,,percent of total billed charges,,,3179.7,90,,percent of total billed charges,,,3003.05,85,,percent of total billed charges,,399.5,3356.35,
PLACE GASTROSTOMY TUBE,43832,CDM,43832,CPT,,,both,,4472,4472,1795.65,,,,fee schedule,,,,,,,,399.5,,,,fee schedule,,,3801.2,85,,percent of total billed charges,,1880.64,,,,fee schedule,,1100.65,,,,fee schedule,,399.5,,,,fee schedule,,1614.91,,,,fee schedule,,399.5,,,,fee schedule,,1742.84,,,,fee schedule,,1056.26,,,,fee schedule,,1056.26,,,,fee schedule,,,4069.52,91,,percent of total billed charges,,,4248.4,95,,percent of total billed charges,,,3711.76,83,,percent of total billed charges,,,1341.6,83,,percent of total billed charges,,399.5,,,,fee schedule,,399.5,,,,fee schedule,,,3711.76,83,,percent of total billed charges,,1552.71,,,,fee schedule,,,4024.8,90,,percent of total billed charges,,,4024.8,90,,percent of total billed charges,,,4024.8,90,,percent of total billed charges,,,4024.8,90,,percent of total billed charges,,,3801.2,85,,percent of total billed charges,,399.5,4248.4,
REPAIR OF STOMACH LESION,43840,CDM,43840,CPT,,,both,,5887,5887,2338.89,,,,fee schedule,,,,,,,,678.4,,,,fee schedule,,,5003.95,85,,percent of total billed charges,,2448.54,,,,fee schedule,,1433.01,,,,fee schedule,,678.4,,,,fee schedule,,1612.92,,,,fee schedule,,678.4,,,,fee schedule,,2270.1,,,,fee schedule,,1375.82,,,,fee schedule,,1375.82,,,,fee schedule,,,5357.17,91,,percent of total billed charges,,,5592.65,95,,percent of total billed charges,,,4886.21,83,,percent of total billed charges,,,1766.1,83,,percent of total billed charges,,678.4,,,,fee schedule,,678.4,,,,fee schedule,,,4886.21,83,,percent of total billed charges,,2022.46,,,,fee schedule,,,5298.3,90,,percent of total billed charges,,,5298.3,90,,percent of total billed charges,,,5298.3,90,,percent of total billed charges,,,5298.3,90,,percent of total billed charges,,,5003.95,85,,percent of total billed charges,,678.4,5592.65,
REVISE STOMACH-BOWEL FUSION,43860,CDM,43860,CPT,,,both,,9350,9350,2811.86,,,,fee schedule,,,,,,,,718.7,,,,fee schedule,,,7947.5,85,,percent of total billed charges,,2948.12,,,,fee schedule,,1725.38,,,,fee schedule,,718.7,,,,fee schedule,,2531.46,,,,fee schedule,,718.7,,,,fee schedule,,2729.16,,,,fee schedule,,1654.03,,,,fee schedule,,1654.03,,,,fee schedule,,,8508.5,91,,percent of total billed charges,,,8882.5,95,,percent of total billed charges,,,7760.5,83,,percent of total billed charges,,,2805,83,,percent of total billed charges,,718.7,,,,fee schedule,,718.7,,,,fee schedule,,,7760.5,83,,percent of total billed charges,,2431.43,,,,fee schedule,,,8415,90,,percent of total billed charges,,,8415,90,,percent of total billed charges,,,8415,90,,percent of total billed charges,,,8415,90,,percent of total billed charges,,,7947.5,85,,percent of total billed charges,,718.7,8882.5,
REPAIR STOMACH OPENING,43870,CDM,43870,CPT,,,both,,4102,4102,1224.75,,,,fee schedule,,,,,,,,240,,,,fee schedule,,,3486.7,85,,percent of total billed charges,,1274.34,,,,fee schedule,,745.8,,,,fee schedule,,240,,,,fee schedule,,1022.66,,,,fee schedule,,240,,,,fee schedule,,1188.73,,,,fee schedule,,720.44,,,,fee schedule,,720.44,,,,fee schedule,,,3732.82,91,,percent of total billed charges,,,3896.9,95,,percent of total billed charges,,,3404.66,83,,percent of total billed charges,,,1230.6,83,,percent of total billed charges,,240,,,,fee schedule,,240,,,,fee schedule,,,3404.66,83,,percent of total billed charges,,1059.05,,,,fee schedule,,,3691.8,90,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3691.8,90,,percent of total billed charges,,,3486.7,85,,percent of total billed charges,,240,3896.9,
FREEING OF BOWEL ADHESION,44005,CDM,44005,CPT,,,both,,4246,4246,1874.57,,,,fee schedule,,,,,,,,643.65,,,,fee schedule,,,3609.1,85,,percent of total billed charges,,1965.49,,,,fee schedule,,1150.3,,,,fee schedule,,643.65,,,,fee schedule,,1658.02,,,,fee schedule,,643.65,,,,fee schedule,,1819.44,,,,fee schedule,,1102.69,,,,fee schedule,,1102.69,,,,fee schedule,,,3863.86,91,,percent of total billed charges,,,4033.7,95,,percent of total billed charges,,,3524.18,83,,percent of total billed charges,,,1273.8,83,,percent of total billed charges,,643.65,,,,fee schedule,,643.65,,,,fee schedule,,,3524.18,83,,percent of total billed charges,,1620.95,,,,fee schedule,,,3821.4,90,,percent of total billed charges,,,3821.4,90,,percent of total billed charges,,,3821.4,90,,percent of total billed charges,,,3821.4,90,,percent of total billed charges,,,3609.1,85,,percent of total billed charges,,643.65,4033.7,
EXPLORE SMALL INTESTINE,44020,CDM,44020,CPT,,,both,,3485,3485,1674.1,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,2962.25,85,,percent of total billed charges,,1755.47,,,,fee schedule,,1027.38,,,,fee schedule,,599.35,,,,fee schedule,,1438.49,,,,fee schedule,,599.35,,,,fee schedule,,1624.86,,,,fee schedule,,984.76,,,,fee schedule,,984.76,,,,fee schedule,,,3171.35,91,,percent of total billed charges,,,3310.75,95,,percent of total billed charges,,,2892.55,83,,percent of total billed charges,,,1045.5,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,2892.55,83,,percent of total billed charges,,1447.6,,,,fee schedule,,,3136.5,90,,percent of total billed charges,,,3136.5,90,,percent of total billed charges,,,3136.5,90,,percent of total billed charges,,,3136.5,90,,percent of total billed charges,,,2962.25,85,,percent of total billed charges,,599.35,3310.75,
REDUCE BOWEL OBSTRUCTION,44050,CDM,44050,CPT,,,both,,3554,3554,1610.73,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3020.9,85,,percent of total billed charges,,1683.56,,,,fee schedule,,985.3,,,,fee schedule,,599.35,,,,fee schedule,,1443.8,,,,fee schedule,,599.35,,,,fee schedule,,1563.35,,,,fee schedule,,947.49,,,,fee schedule,,947.49,,,,fee schedule,,,3234.14,91,,percent of total billed charges,,,3376.3,95,,percent of total billed charges,,,2949.82,83,,percent of total billed charges,,,1066.2,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,2949.82,83,,percent of total billed charges,,1392.8,,,,fee schedule,,,3198.6,90,,percent of total billed charges,,,3198.6,90,,percent of total billed charges,,,3198.6,90,,percent of total billed charges,,,3198.6,90,,percent of total billed charges,,,3020.9,85,,percent of total billed charges,,599.35,3376.3,
EXCISE INTESTINE LESION(S),44110,CDM,44110,CPT,,,both,,3415,3415,1455.76,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,2902.75,85,,percent of total billed charges,,1510.87,,,,fee schedule,,884.23,,,,fee schedule,,599.35,,,,fee schedule,,1228.26,,,,fee schedule,,599.35,,,,fee schedule,,1412.94,,,,fee schedule,,856.33,,,,fee schedule,,856.33,,,,fee schedule,,,3107.65,91,,percent of total billed charges,,,3244.25,95,,percent of total billed charges,,,2834.45,83,,percent of total billed charges,,,1024.5,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,2834.45,83,,percent of total billed charges,,1258.8,,,,fee schedule,,,3073.5,90,,percent of total billed charges,,,3073.5,90,,percent of total billed charges,,,3073.5,90,,percent of total billed charges,,,3073.5,90,,percent of total billed charges,,,2902.75,85,,percent of total billed charges,,599.35,3244.25,
REMOVAL OF SMALL INTESTINE,44120,CDM,44120,CPT,,,both,,4929,4929,2096.36,,,,fee schedule,,,,,,,,806.1,,,,fee schedule,,,4189.65,85,,percent of total billed charges,,2196.81,,,,fee schedule,,1285.68,,,,fee schedule,,806.1,,,,fee schedule,,1739.59,,,,fee schedule,,806.1,,,,fee schedule,,2034.71,,,,fee schedule,,1233.16,,,,fee schedule,,1233.16,,,,fee schedule,,,4485.39,91,,percent of total billed charges,,,4682.55,95,,percent of total billed charges,,,4091.07,83,,percent of total billed charges,,,1478.7,83,,percent of total billed charges,,806.1,,,,fee schedule,,806.1,,,,fee schedule,,,4091.07,83,,percent of total billed charges,,1812.74,,,,fee schedule,,,4436.1,90,,percent of total billed charges,,,4436.1,90,,percent of total billed charges,,,4436.1,90,,percent of total billed charges,,,4436.1,90,,percent of total billed charges,,,4189.65,85,,percent of total billed charges,,806.1,4682.55,
BOWEL TO BOWEL FUSION,44130,CDM,44130,CPT,,,both,,4629,4629,2258.82,,,,fee schedule,,,,,,,,718.7,,,,fee schedule,,,3934.65,85,,percent of total billed charges,,2361.85,,,,fee schedule,,1382.27,,,,fee schedule,,718.7,,,,fee schedule,,1493.54,,,,fee schedule,,718.7,,,,fee schedule,,2192.38,,,,fee schedule,,1328.72,,,,fee schedule,,1328.72,,,,fee schedule,,,4212.39,91,,percent of total billed charges,,,4397.55,95,,percent of total billed charges,,,3842.07,83,,percent of total billed charges,,,1388.7,83,,percent of total billed charges,,718.7,,,,fee schedule,,718.7,,,,fee schedule,,,3842.07,83,,percent of total billed charges,,1953.21,,,,fee schedule,,,4166.1,90,,percent of total billed charges,,,4166.1,90,,percent of total billed charges,,,4166.1,90,,percent of total billed charges,,,4166.1,90,,percent of total billed charges,,,3934.65,85,,percent of total billed charges,,718.7,4397.55,
MOBILIZATION OF COLON,44139,CDM,44139,CPT,,,both,,570,570,205.09,,,,fee schedule,,,,,,,,108,,,,fee schedule,,,484.5,85,,percent of total billed charges,,216.91,,,,fee schedule,,126.95,,,,fee schedule,,108,,,,fee schedule,,216.87,,,,fee schedule,,108,,,,fee schedule,,199.05,,,,fee schedule,,120.64,,,,fee schedule,,120.64,,,,fee schedule,,,518.7,91,,percent of total billed charges,,,541.5,95,,percent of total billed charges,,,473.1,83,,percent of total billed charges,,,171,83,,percent of total billed charges,,108,,,,fee schedule,,108,,,,fee schedule,,,473.1,83,,percent of total billed charges,,177.34,,,,fee schedule,,,513,90,,percent of total billed charges,,,513,90,,percent of total billed charges,,,513,90,,percent of total billed charges,,,513,90,,percent of total billed charges,,,484.5,85,,percent of total billed charges,,108,541.5,
PARTIAL REMOVAL OF COLON,44140,CDM,44140,CPT,,,both,,5257,5257,2302.03,,,,fee schedule,,,,,,,,951.8,,,,fee schedule,,,4468.45,85,,percent of total billed charges,,2408.5,,,,fee schedule,,1409.57,,,,fee schedule,,951.8,,,,fee schedule,,2140.83,,,,fee schedule,,951.8,,,,fee schedule,,2234.32,,,,fee schedule,,1354.13,,,,fee schedule,,1354.13,,,,fee schedule,,,4783.87,91,,percent of total billed charges,,,4994.15,95,,percent of total billed charges,,,4363.31,83,,percent of total billed charges,,,1577.1,83,,percent of total billed charges,,951.8,,,,fee schedule,,951.8,,,,fee schedule,,,4363.31,83,,percent of total billed charges,,1990.57,,,,fee schedule,,,4731.3,90,,percent of total billed charges,,,4731.3,90,,percent of total billed charges,,,4731.3,90,,percent of total billed charges,,,4731.3,90,,percent of total billed charges,,,4468.45,85,,percent of total billed charges,,951.8,4994.15,
PARTIAL REMOVAL OF COLON,44141,CDM,44141,CPT,,,both,,6381,6381,3107.96,,,,fee schedule,,,,,,,,951.8,,,,fee schedule,,,5423.85,85,,percent of total billed charges,,3253.52,,,,fee schedule,,1904.12,,,,fee schedule,,951.8,,,,fee schedule,,2122.92,,,,fee schedule,,951.8,,,,fee schedule,,3016.55,,,,fee schedule,,1828.21,,,,fee schedule,,1828.21,,,,fee schedule,,,5806.71,91,,percent of total billed charges,,,6061.95,95,,percent of total billed charges,,,5296.23,83,,percent of total billed charges,,,1914.3,83,,percent of total billed charges,,951.8,,,,fee schedule,,951.8,,,,fee schedule,,,5296.23,83,,percent of total billed charges,,2687.48,,,,fee schedule,,,5742.9,90,,percent of total billed charges,,,5742.9,90,,percent of total billed charges,,,5742.9,90,,percent of total billed charges,,,5742.9,90,,percent of total billed charges,,,5423.85,85,,percent of total billed charges,,951.8,6061.95,
PARTIAL REMOVAL OF COLON,44143,CDM,44143,CPT,,,both,,6096,6096,2834.9,,,,fee schedule,,,,,,,,951.8,,,,fee schedule,,,5181.6,85,,percent of total billed charges,,2969.42,,,,fee schedule,,1737.85,,,,fee schedule,,951.8,,,,fee schedule,,2426.67,,,,fee schedule,,951.8,,,,fee schedule,,2751.52,,,,fee schedule,,1667.59,,,,fee schedule,,1667.59,,,,fee schedule,,,5547.36,91,,percent of total billed charges,,,5791.2,95,,percent of total billed charges,,,5059.68,83,,percent of total billed charges,,,1828.8,83,,percent of total billed charges,,951.8,,,,fee schedule,,951.8,,,,fee schedule,,,5059.68,83,,percent of total billed charges,,2451.36,,,,fee schedule,,,5486.4,90,,percent of total billed charges,,,5486.4,90,,percent of total billed charges,,,5486.4,90,,percent of total billed charges,,,5486.4,90,,percent of total billed charges,,,5181.6,85,,percent of total billed charges,,951.8,5791.2,
PARTIAL REMOVAL OF COLON,44145,CDM,44145,CPT,,,both,,6480,6480,2822.8,,,,fee schedule,,,,,,,,958.6,,,,fee schedule,,,5508,85,,percent of total billed charges,,2947.24,,,,fee schedule,,1724.87,,,,fee schedule,,958.6,,,,fee schedule,,2680.68,,,,fee schedule,,958.6,,,,fee schedule,,2739.78,,,,fee schedule,,1660.47,,,,fee schedule,,1660.47,,,,fee schedule,,,5896.8,91,,percent of total billed charges,,,6156,95,,percent of total billed charges,,,5378.4,83,,percent of total billed charges,,,1944,83,,percent of total billed charges,,958.6,,,,fee schedule,,958.6,,,,fee schedule,,,5378.4,83,,percent of total billed charges,,2440.9,,,,fee schedule,,,5832,90,,percent of total billed charges,,,5832,90,,percent of total billed charges,,,5832,90,,percent of total billed charges,,,5832,90,,percent of total billed charges,,,5508,85,,percent of total billed charges,,958.6,6156,
PARTIAL REMOVAL OF COLON,44146,CDM,44146,CPT,,,both,,7581,7581,3587.84,,,,fee schedule,,,,,,,,951.8,,,,fee schedule,,,6443.85,85,,percent of total billed charges,,3744.01,,,,fee schedule,,2191.18,,,,fee schedule,,951.8,,,,fee schedule,,2899.54,,,,fee schedule,,951.8,,,,fee schedule,,3482.32,,,,fee schedule,,2110.49,,,,fee schedule,,2110.49,,,,fee schedule,,,6898.71,91,,percent of total billed charges,,,7201.95,95,,percent of total billed charges,,,6292.23,83,,percent of total billed charges,,,2274.3,83,,percent of total billed charges,,951.8,,,,fee schedule,,951.8,,,,fee schedule,,,6292.23,83,,percent of total billed charges,,3102.43,,,,fee schedule,,,6822.9,90,,percent of total billed charges,,,6822.9,90,,percent of total billed charges,,,6822.9,90,,percent of total billed charges,,,6822.9,90,,percent of total billed charges,,,6443.85,85,,percent of total billed charges,,951.8,7201.95,
PARTIAL REMOVAL OF COLON,44147,CDM,44147,CPT,,,both,,6847,6847,3302.1,,,,fee schedule,,,,,,,,1198.7,,,,fee schedule,,,5819.95,85,,percent of total billed charges,,3462.34,,,,fee schedule,,2026.33,,,,fee schedule,,1198.7,,,,fee schedule,,2113.64,,,,fee schedule,,1198.7,,,,fee schedule,,3204.98,,,,fee schedule,,1942.41,,,,fee schedule,,1942.41,,,,fee schedule,,,6230.77,91,,percent of total billed charges,,,6504.65,95,,percent of total billed charges,,,5683.01,83,,percent of total billed charges,,,2054.1,83,,percent of total billed charges,,1198.7,,,,fee schedule,,1198.7,,,,fee schedule,,,5683.01,83,,percent of total billed charges,,2855.35,,,,fee schedule,,,6162.3,90,,percent of total billed charges,,,6162.3,90,,percent of total billed charges,,,6162.3,90,,percent of total billed charges,,,6162.3,90,,percent of total billed charges,,,5819.95,85,,percent of total billed charges,,1198.7,6504.65,
REMOVAL OF COLON/ILEOSTOMY,44155,CDM,44155,CPT,,,both,,8441,8441,3530.81,,,,fee schedule,,,,,,,,1198.7,,,,fee schedule,,,7174.85,85,,percent of total billed charges,,3675.04,,,,fee schedule,,2150.81,,,,fee schedule,,1198.7,,,,fee schedule,,2941.98,,,,fee schedule,,1198.7,,,,fee schedule,,3426.96,,,,fee schedule,,2076.95,,,,fee schedule,,2076.95,,,,fee schedule,,,7681.31,91,,percent of total billed charges,,,8018.95,95,,percent of total billed charges,,,7006.03,83,,percent of total billed charges,,,2532.3,83,,percent of total billed charges,,1198.7,,,,fee schedule,,1198.7,,,,fee schedule,,,7006.03,83,,percent of total billed charges,,3053.11,,,,fee schedule,,,7596.9,90,,percent of total billed charges,,,7596.9,90,,percent of total billed charges,,,7596.9,90,,percent of total billed charges,,,7596.9,90,,percent of total billed charges,,,7174.85,85,,percent of total billed charges,,1198.7,8018.95,
REMOVAL OF COLON,44160,CDM,44160,CPT,,,both,,5102,5102,2130.35,,,,fee schedule,,,,,,,,1198.7,,,,fee schedule,,,4336.7,85,,percent of total billed charges,,2224.58,,,,fee schedule,,1301.93,,,,fee schedule,,1198.7,,,,fee schedule,,1900.75,,,,fee schedule,,1198.7,,,,fee schedule,,2067.7,,,,fee schedule,,1253.15,,,,fee schedule,,1253.15,,,,fee schedule,,,4642.82,91,,percent of total billed charges,,,4846.9,95,,percent of total billed charges,,,4234.66,83,,percent of total billed charges,,,1530.6,83,,percent of total billed charges,,1198.7,,,,fee schedule,,1198.7,,,,fee schedule,,,4234.66,83,,percent of total billed charges,,1842.13,,,,fee schedule,,,4591.8,90,,percent of total billed charges,,,4591.8,90,,percent of total billed charges,,,4591.8,90,,percent of total billed charges,,,4591.8,90,,percent of total billed charges,,,4336.7,85,,percent of total billed charges,,1198.7,4846.9,
"LAP, ENTEROLYSIS",44180,CDM,44180,CPT,,,both,,3953,3953,1581.92,,,,fee schedule,,,,,,,,479.2,,,,fee schedule,,,3360.05,85,,percent of total billed charges,,1654.07,,,,fee schedule,,968.04,,,,fee schedule,,479.2,,,,fee schedule,,,,,,,,479.2,,,,fee schedule,,1535.4,,,,fee schedule,,930.54,,,,fee schedule,,930.54,,,,fee schedule,,,3597.23,91,,percent of total billed charges,,,3755.35,95,,percent of total billed charges,,,3280.99,83,,percent of total billed charges,,,1185.9,83,,percent of total billed charges,,479.2,,,,fee schedule,,479.2,,,,fee schedule,,,3280.99,83,,percent of total billed charges,,1367.9,,,,fee schedule,,,3557.7,90,,percent of total billed charges,,,3557.7,90,,percent of total billed charges,,,3557.7,90,,percent of total billed charges,,,3557.7,90,,percent of total billed charges,,,3360.05,85,,percent of total billed charges,,479.2,3755.35,
LAPARO PARTIAL COLECTOMY,44204,CDM,44204,CPT,,,both,,5610,5610,2628.09,,,,fee schedule,,,,,,,,973.8,,,,fee schedule,,,4768.5,85,,percent of total billed charges,,2745.51,,,,fee schedule,,1606.81,,,,fee schedule,,973.8,,,,fee schedule,,2524.16,,,,fee schedule,,973.8,,,,fee schedule,,2550.79,,,,fee schedule,,1545.93,,,,fee schedule,,1545.93,,,,fee schedule,,,5105.1,91,,percent of total billed charges,,,5329.5,95,,percent of total billed charges,,,4656.3,83,,percent of total billed charges,,,1683,83,,percent of total billed charges,,973.8,,,,fee schedule,,973.8,,,,fee schedule,,,4656.3,83,,percent of total billed charges,,2272.52,,,,fee schedule,,,5049,90,,percent of total billed charges,,,5049,90,,percent of total billed charges,,,5049,90,,percent of total billed charges,,,5049,90,,percent of total billed charges,,,4768.5,85,,percent of total billed charges,,973.8,5329.5,
LAP COLECTOMY PART W/ILEUM,44205,CDM,44205,CPT,,,both,,4506,4506,2282.44,,,,fee schedule,,,,,,,,861.8,,,,fee schedule,,,3830.1,85,,percent of total billed charges,,2381.46,,,,fee schedule,,1393.75,,,,fee schedule,,861.8,,,,fee schedule,,2238.32,,,,fee schedule,,861.8,,,,fee schedule,,2215.31,,,,fee schedule,,1342.61,,,,fee schedule,,1342.61,,,,fee schedule,,,4100.46,91,,percent of total billed charges,,,4280.7,95,,percent of total billed charges,,,3739.98,83,,percent of total billed charges,,,1351.8,83,,percent of total billed charges,,861.8,,,,fee schedule,,861.8,,,,fee schedule,,,3739.98,83,,percent of total billed charges,,1973.64,,,,fee schedule,,,4055.4,90,,percent of total billed charges,,,4055.4,90,,percent of total billed charges,,,4055.4,90,,percent of total billed charges,,,4055.4,90,,percent of total billed charges,,,3830.1,85,,percent of total billed charges,,861.8,4280.7,
L COLECTOMY/COLOPROCTOSTOMY,44207,CDM,44207,CPT,,,both,,7370,7370,3090.68,,,,fee schedule,,,,,,,,958.6,,,,fee schedule,,,6264.5,85,,percent of total billed charges,,3226.58,,,,fee schedule,,1888.35,,,,fee schedule,,958.6,,,,fee schedule,,2989.07,,,,fee schedule,,958.6,,,,fee schedule,,2999.78,,,,fee schedule,,1818.05,,,,fee schedule,,1818.05,,,,fee schedule,,,6706.7,91,,percent of total billed charges,,,7001.5,95,,percent of total billed charges,,,6117.1,83,,percent of total billed charges,,,2211,83,,percent of total billed charges,,958.6,,,,fee schedule,,958.6,,,,fee schedule,,,6117.1,83,,percent of total billed charges,,2672.53,,,,fee schedule,,,6633,90,,percent of total billed charges,,,6633,90,,percent of total billed charges,,,6633,90,,percent of total billed charges,,,6633,90,,percent of total billed charges,,,6264.5,85,,percent of total billed charges,,958.6,7001.5,
"LAPAROSCOPE PROC, INTESTINE",44238,CDM,44238,CPT,,,both,,5882,5882,,,,,,,,,,,,,,,,,,,,4999.7,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5352.62,91,,percent of total billed charges,,,5587.9,95,,percent of total billed charges,,,4882.06,83,,percent of total billed charges,,,1764.6,83,,percent of total billed charges,,,,,,,,,,,,,,,4882.06,83,,percent of total billed charges,,,,,,,,,5293.8,90,,percent of total billed charges,,,5293.8,90,,percent of total billed charges,,,5293.8,90,,percent of total billed charges,,,5293.8,90,,percent of total billed charges,,,4999.7,85,,percent of total billed charges,,1764.6,5587.9,
OPEN BOWEL TO SKIN,44300,CDM,44300,CPT,,,both,,3204,3204,1448.27,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,2723.4,85,,percent of total billed charges,,1512.65,,,,fee schedule,,885.27,,,,fee schedule,,599.35,,,,fee schedule,,1268.71,,,,fee schedule,,599.35,,,,fee schedule,,1405.67,,,,fee schedule,,851.92,,,,fee schedule,,851.92,,,,fee schedule,,,2915.64,91,,percent of total billed charges,,,3043.8,95,,percent of total billed charges,,,2659.32,83,,percent of total billed charges,,,961.2,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,2659.32,83,,percent of total billed charges,,1252.33,,,,fee schedule,,,2883.6,90,,percent of total billed charges,,,2883.6,90,,percent of total billed charges,,,2883.6,90,,percent of total billed charges,,,2883.6,90,,percent of total billed charges,,,2723.4,85,,percent of total billed charges,,599.35,3043.8,
ILEOSTOMY/JEJUNOSTOMY,44310,CDM,44310,CPT,,,both,,4228,4228,1782.98,,,,fee schedule,,,,,,,,629.9,,,,fee schedule,,,3593.8,85,,percent of total billed charges,,1856.88,,,,fee schedule,,1086.74,,,,fee schedule,,629.9,,,,fee schedule,,1629.5,,,,fee schedule,,629.9,,,,fee schedule,,1730.53,,,,fee schedule,,1048.81,,,,fee schedule,,1048.81,,,,fee schedule,,,3847.48,91,,percent of total billed charges,,,4016.6,95,,percent of total billed charges,,,3509.24,83,,percent of total billed charges,,,1268.4,83,,percent of total billed charges,,629.9,,,,fee schedule,,629.9,,,,fee schedule,,,3509.24,83,,percent of total billed charges,,1541.75,,,,fee schedule,,,3805.2,90,,percent of total billed charges,,,3805.2,90,,percent of total billed charges,,,3805.2,90,,percent of total billed charges,,,3805.2,90,,percent of total billed charges,,,3593.8,85,,percent of total billed charges,,629.9,4016.6,
REVISION OF ILEOSTOMY,44312,CDM,44312,CPT,,,both,,2446,2446,1026,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,2079.1,85,,percent of total billed charges,,1062.4,,,,fee schedule,,621.77,,,,fee schedule,,374.55,,,,fee schedule,,857.53,,,,fee schedule,,374.55,,,,fee schedule,,995.83,,,,fee schedule,,603.53,,,,fee schedule,,603.53,,,,fee schedule,,,2225.86,91,,percent of total billed charges,,,2323.7,95,,percent of total billed charges,,,2030.18,83,,percent of total billed charges,,,733.8,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,2030.18,83,,percent of total billed charges,,887.19,,,,fee schedule,,,2201.4,90,,percent of total billed charges,,,2201.4,90,,percent of total billed charges,,,2201.4,90,,percent of total billed charges,,,2201.4,90,,percent of total billed charges,,,2079.1,85,,percent of total billed charges,,374.55,2323.7,
REVISION OF ILEOSTOMY,44314,CDM,44314,CPT,,,both,,4149,4149,1723.64,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3526.65,85,,percent of total billed charges,,1788.47,,,,fee schedule,,1046.7,,,,fee schedule,,599.35,,,,fee schedule,,1545.93,,,,fee schedule,,599.35,,,,fee schedule,,1672.94,,,,fee schedule,,1013.91,,,,fee schedule,,1013.91,,,,fee schedule,,,3775.59,91,,percent of total billed charges,,,3941.55,95,,percent of total billed charges,,,3443.67,83,,percent of total billed charges,,,1244.7,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3443.67,83,,percent of total billed charges,,1490.44,,,,fee schedule,,,3734.1,90,,percent of total billed charges,,,3734.1,90,,percent of total billed charges,,,3734.1,90,,percent of total billed charges,,,3734.1,90,,percent of total billed charges,,,3526.65,85,,percent of total billed charges,,599.35,3941.55,
COLOSTOMY,44320,CDM,44320,CPT,,,both,,4438,4438,2057.77,,,,fee schedule,,,,,,,,535.45,,,,fee schedule,,,3772.3,85,,percent of total billed charges,,2145.75,,,,fee schedule,,1255.8,,,,fee schedule,,535.45,,,,fee schedule,,1823.15,,,,fee schedule,,535.45,,,,fee schedule,,1997.24,,,,fee schedule,,1210.45,,,,fee schedule,,1210.45,,,,fee schedule,,,4038.58,91,,percent of total billed charges,,,4216.1,95,,percent of total billed charges,,,3683.54,83,,percent of total billed charges,,,1331.4,83,,percent of total billed charges,,535.45,,,,fee schedule,,535.45,,,,fee schedule,,,3683.54,83,,percent of total billed charges,,1779.36,,,,fee schedule,,,3994.2,90,,percent of total billed charges,,,3994.2,90,,percent of total billed charges,,,3994.2,90,,percent of total billed charges,,,3994.2,90,,percent of total billed charges,,,3772.3,85,,percent of total billed charges,,535.45,4216.1,
REVISION OF COLOSTOMY,44345,CDM,44345,CPT,,,both,,3795,3795,1804.29,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3225.75,85,,percent of total billed charges,,1870.37,,,,fee schedule,,1094.63,,,,fee schedule,,480,,,,fee schedule,,1606.95,,,,fee schedule,,480,,,,fee schedule,,1751.22,,,,fee schedule,,1061.35,,,,fee schedule,,1061.35,,,,fee schedule,,,3453.45,91,,percent of total billed charges,,,3605.25,95,,percent of total billed charges,,,3149.85,83,,percent of total billed charges,,,1138.5,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3149.85,83,,percent of total billed charges,,1560.18,,,,fee schedule,,,3415.5,90,,percent of total billed charges,,,3415.5,90,,percent of total billed charges,,,3415.5,90,,percent of total billed charges,,,3415.5,90,,percent of total billed charges,,,3225.75,85,,percent of total billed charges,,480,3605.25,
"ENDOSCOPY, BOWEL POUCH/BIOP",44386,CDM,44386,CPT,,,both,,1545,1545,151.51,,,,fee schedule,,,,,,,,182.3,,,,fee schedule,,,1313.25,85,,percent of total billed charges,,155.74,,,,fee schedule,,91.14,,,,fee schedule,,182.3,,,,fee schedule,,211.56,,,,fee schedule,,182.3,,,,fee schedule,,147.05,,,,fee schedule,,89.12,,,,fee schedule,,89.12,,,,fee schedule,,,1405.95,91,,percent of total billed charges,,,1467.75,95,,percent of total billed charges,,,1282.35,83,,percent of total billed charges,,,463.5,83,,percent of total billed charges,,182.3,,,,fee schedule,,182.3,,,,fee schedule,,,1282.35,83,,percent of total billed charges,,131.01,,,,fee schedule,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1313.25,85,,percent of total billed charges,,89.12,1467.75,
COLONOSCOPY,44388,CDM,44388,CPT,,,both,,1438,1438,265,,,,fee schedule,,,,,,,,192.85,,,,fee schedule,,,1222.3,85,,percent of total billed charges,,273.59,,,,fee schedule,,160.12,,,,fee schedule,,192.85,,,,fee schedule,,280.54,,,,fee schedule,,192.85,,,,fee schedule,,257.2,,,,fee schedule,,155.88,,,,fee schedule,,155.88,,,,fee schedule,,,1308.58,91,,percent of total billed charges,,,1366.1,95,,percent of total billed charges,,,1193.54,83,,percent of total billed charges,,,431.4,83,,percent of total billed charges,,192.85,,,,fee schedule,,192.85,,,,fee schedule,,,1193.54,83,,percent of total billed charges,,229.15,,,,fee schedule,,,1294.2,90,,percent of total billed charges,,,1294.2,90,,percent of total billed charges,,,1294.2,90,,percent of total billed charges,,,1294.2,90,,percent of total billed charges,,,1222.3,85,,percent of total billed charges,,155.88,1366.1,
COLONOSCOPY WITH BIOPSY,44389,CDM,44389,CPT,,,both,,1329,1329,290.92,,,,fee schedule,,,,,,,,192.85,,,,fee schedule,,,1129.65,85,,percent of total billed charges,,299.84,,,,fee schedule,,175.48,,,,fee schedule,,192.85,,,,fee schedule,,309.72,,,,fee schedule,,192.85,,,,fee schedule,,282.37,,,,fee schedule,,171.13,,,,fee schedule,,171.13,,,,fee schedule,,,1209.39,91,,percent of total billed charges,,,1262.55,95,,percent of total billed charges,,,1103.07,83,,percent of total billed charges,,,398.7,83,,percent of total billed charges,,192.85,,,,fee schedule,,192.85,,,,fee schedule,,,1103.07,83,,percent of total billed charges,,251.56,,,,fee schedule,,,1196.1,90,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1129.65,85,,percent of total billed charges,,171.13,1262.55,
COLONOSCOPY  POLYPECTOMY,44392,CDM,44392,CPT,,,both,,1714,1714,338.16,,,,fee schedule,,,,,,,,230.8,,,,fee schedule,,,1456.9,85,,percent of total billed charges,,349.67,,,,fee schedule,,204.64,,,,fee schedule,,230.8,,,,fee schedule,,374.05,,,,fee schedule,,230.8,,,,fee schedule,,328.21,,,,fee schedule,,198.92,,,,fee schedule,,198.92,,,,fee schedule,,,1559.74,91,,percent of total billed charges,,,1628.3,95,,percent of total billed charges,,,1422.62,83,,percent of total billed charges,,,514.2,83,,percent of total billed charges,,230.8,,,,fee schedule,,230.8,,,,fee schedule,,,1422.62,83,,percent of total billed charges,,292.41,,,,fee schedule,,,1542.6,90,,percent of total billed charges,,,1542.6,90,,percent of total billed charges,,,1542.6,90,,percent of total billed charges,,,1542.6,90,,percent of total billed charges,,,1456.9,85,,percent of total billed charges,,198.92,1628.3,
COLONOSCOPY W/SNARE,44394,CDM,44394,CPT,,,both,,2028,2028,381.37,,,,fee schedule,,,,,,,,318.3,,,,fee schedule,,,1723.8,85,,percent of total billed charges,,395.35,,,,fee schedule,,231.38,,,,fee schedule,,318.3,,,,fee schedule,,432.41,,,,fee schedule,,318.3,,,,fee schedule,,370.15,,,,fee schedule,,224.33,,,,fee schedule,,224.33,,,,fee schedule,,,1845.48,91,,percent of total billed charges,,,1926.6,95,,percent of total billed charges,,,1683.24,83,,percent of total billed charges,,,608.4,83,,percent of total billed charges,,318.3,,,,fee schedule,,318.3,,,,fee schedule,,,1683.24,83,,percent of total billed charges,,329.77,,,,fee schedule,,,1825.2,90,,percent of total billed charges,,,1825.2,90,,percent of total billed charges,,,1825.2,90,,percent of total billed charges,,,1825.2,90,,percent of total billed charges,,,1723.8,85,,percent of total billed charges,,224.33,1926.6,
"SUTURE, SMALL INTESTINE",44602,CDM,44602,CPT,,,both,,5867,5867,2412.06,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,4986.95,85,,percent of total billed charges,,2534.54,,,,fee schedule,,1483.34,,,,fee schedule,,599.35,,,,fee schedule,,1621.54,,,,fee schedule,,599.35,,,,fee schedule,,2341.11,,,,fee schedule,,1418.86,,,,fee schedule,,1418.86,,,,fee schedule,,,5338.97,91,,percent of total billed charges,,,5573.65,95,,percent of total billed charges,,,4869.61,83,,percent of total billed charges,,,1760.1,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,4869.61,83,,percent of total billed charges,,2085.72,,,,fee schedule,,,5280.3,90,,percent of total billed charges,,,5280.3,90,,percent of total billed charges,,,5280.3,90,,percent of total billed charges,,,5280.3,90,,percent of total billed charges,,,4986.95,85,,percent of total billed charges,,599.35,5573.65,
"SUTURE, SMALL INTESTINE",44603,CDM,44603,CPT,,,both,,2544,2544,2769.23,,,,fee schedule,,,,,,,,674.2,,,,fee schedule,,,2162.4,85,,percent of total billed charges,,2898.29,,,,fee schedule,,1696.22,,,,fee schedule,,674.2,,,,fee schedule,,1875.55,,,,fee schedule,,674.2,,,,fee schedule,,2687.78,,,,fee schedule,,1628.96,,,,fee schedule,,1628.96,,,,fee schedule,,,2315.04,91,,percent of total billed charges,,,2416.8,95,,percent of total billed charges,,,2111.52,83,,percent of total billed charges,,,763.2,83,,percent of total billed charges,,674.2,,,,fee schedule,,674.2,,,,fee schedule,,,2111.52,83,,percent of total billed charges,,2394.57,,,,fee schedule,,,2289.6,90,,percent of total billed charges,,,2289.6,90,,percent of total billed charges,,,2289.6,90,,percent of total billed charges,,,2289.6,90,,percent of total billed charges,,,2162.4,85,,percent of total billed charges,,674.2,2898.29,
"SUTURE, LARGE INTESTINE",44604,CDM,44604,CPT,,,both,,5021,5021,1809.47,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,4267.85,85,,percent of total billed charges,,1890.99,,,,fee schedule,,1106.7,,,,fee schedule,,599.35,,,,fee schedule,,1624.86,,,,fee schedule,,599.35,,,,fee schedule,,1756.25,,,,fee schedule,,1064.4,,,,fee schedule,,1064.4,,,,fee schedule,,,4569.11,91,,percent of total billed charges,,,4769.95,95,,percent of total billed charges,,,4167.43,83,,percent of total billed charges,,,1506.3,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,4167.43,83,,percent of total billed charges,,1564.66,,,,fee schedule,,,4518.9,90,,percent of total billed charges,,,4518.9,90,,percent of total billed charges,,,4518.9,90,,percent of total billed charges,,,4518.9,90,,percent of total billed charges,,,4267.85,85,,percent of total billed charges,,599.35,4769.95,
REPAIR OF BOWEL LESION,44605,CDM,44605,CPT,,,both,,6541,6541,2222.53,,,,fee schedule,,,,,,,,718.7,,,,fee schedule,,,5559.85,85,,percent of total billed charges,,2330.01,,,,fee schedule,,1363.64,,,,fee schedule,,718.7,,,,fee schedule,,2014.16,,,,fee schedule,,718.7,,,,fee schedule,,2157.16,,,,fee schedule,,1307.37,,,,fee schedule,,1307.37,,,,fee schedule,,,5952.31,91,,percent of total billed charges,,,6213.95,95,,percent of total billed charges,,,5429.03,83,,percent of total billed charges,,,1962.3,83,,percent of total billed charges,,718.7,,,,fee schedule,,718.7,,,,fee schedule,,,5429.03,83,,percent of total billed charges,,1921.83,,,,fee schedule,,,5886.9,90,,percent of total billed charges,,,5886.9,90,,percent of total billed charges,,,5886.9,90,,percent of total billed charges,,,5886.9,90,,percent of total billed charges,,,5559.85,85,,percent of total billed charges,,718.7,6213.95,
REPAIR BOWEL OPENING,44620,CDM,44620,CPT,,,both,,3887,3887,1483.99,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,3303.95,85,,percent of total billed charges,,1541.15,,,,fee schedule,,901.95,,,,fee schedule,,359.3,,,,fee schedule,,1260.76,,,,fee schedule,,359.3,,,,fee schedule,,1440.34,,,,fee schedule,,872.93,,,,fee schedule,,872.93,,,,fee schedule,,,3537.17,91,,percent of total billed charges,,,3692.65,95,,percent of total billed charges,,,3226.21,83,,percent of total billed charges,,,1166.1,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,3226.21,83,,percent of total billed charges,,1283.21,,,,fee schedule,,,3498.3,90,,percent of total billed charges,,,3498.3,90,,percent of total billed charges,,,3498.3,90,,percent of total billed charges,,,3498.3,90,,percent of total billed charges,,,3303.95,85,,percent of total billed charges,,359.3,3692.65,
REPAIR BOWEL OPENING,44625,CDM,44625,CPT,,,both,,5165,5165,1729.98,,,,fee schedule,,,,,,,,729.7,,,,fee schedule,,,4390.25,85,,percent of total billed charges,,1798.88,,,,fee schedule,,1052.79,,,,fee schedule,,729.7,,,,fee schedule,,1535.99,,,,fee schedule,,729.7,,,,fee schedule,,1679.09,,,,fee schedule,,1017.63,,,,fee schedule,,1017.63,,,,fee schedule,,,4700.15,91,,percent of total billed charges,,,4906.75,95,,percent of total billed charges,,,4286.95,83,,percent of total billed charges,,,1549.5,83,,percent of total billed charges,,729.7,,,,fee schedule,,729.7,,,,fee schedule,,,4286.95,83,,percent of total billed charges,,1495.92,,,,fee schedule,,,4648.5,90,,percent of total billed charges,,,4648.5,90,,percent of total billed charges,,,4648.5,90,,percent of total billed charges,,,4648.5,90,,percent of total billed charges,,,4390.25,85,,percent of total billed charges,,729.7,4906.75,
REPAIR BOWEL OPENING,44626,CDM,44626,CPT,,,both,,6868,6868,2724.87,,,,fee schedule,,,,,,,,729.7,,,,fee schedule,,,5837.8,85,,percent of total billed charges,,2859.26,,,,fee schedule,,1673.38,,,,fee schedule,,729.7,,,,fee schedule,,2543.4,,,,fee schedule,,729.7,,,,fee schedule,,2644.73,,,,fee schedule,,1602.86,,,,fee schedule,,1602.86,,,,fee schedule,,,6249.88,91,,percent of total billed charges,,,6524.6,95,,percent of total billed charges,,,5700.44,83,,percent of total billed charges,,,2060.4,83,,percent of total billed charges,,729.7,,,,fee schedule,,729.7,,,,fee schedule,,,5700.44,83,,percent of total billed charges,,2356.21,,,,fee schedule,,,6181.2,90,,percent of total billed charges,,,6181.2,90,,percent of total billed charges,,,6181.2,90,,percent of total billed charges,,,6181.2,90,,percent of total billed charges,,,5837.8,85,,percent of total billed charges,,729.7,6524.6,
"SURGICAL REVISION, INTESTINE",44680,CDM,44680,CPT,,,both,,6068,6068,1853.83,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,5157.8,85,,percent of total billed charges,,1944.54,,,,fee schedule,,1138.04,,,,fee schedule,,599.35,,,,fee schedule,,1572.46,,,,fee schedule,,599.35,,,,fee schedule,,1799.31,,,,fee schedule,,1090.49,,,,fee schedule,,1090.49,,,,fee schedule,,,5521.88,91,,percent of total billed charges,,,5764.6,95,,percent of total billed charges,,,5036.44,83,,percent of total billed charges,,,1820.4,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,5036.44,83,,percent of total billed charges,,1603.02,,,,fee schedule,,,5461.2,90,,percent of total billed charges,,,5461.2,90,,percent of total billed charges,,,5461.2,90,,percent of total billed charges,,,5461.2,90,,percent of total billed charges,,,5157.8,85,,percent of total billed charges,,599.35,5764.6,
EXCISION OF BOWEL POUCH,44800,CDM,44800,CPT,,,both,,3594,3594,1335.94,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3054.9,85,,percent of total billed charges,,1376.56,,,,fee schedule,,805.63,,,,fee schedule,,480,,,,fee schedule,,1194.43,,,,fee schedule,,480,,,,fee schedule,,1296.64,,,,fee schedule,,785.84,,,,fee schedule,,785.84,,,,fee schedule,,,3270.54,91,,percent of total billed charges,,,3414.3,95,,percent of total billed charges,,,2983.02,83,,percent of total billed charges,,,1078.2,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2983.02,83,,percent of total billed charges,,1155.19,,,,fee schedule,,,3234.6,90,,percent of total billed charges,,,3234.6,90,,percent of total billed charges,,,3234.6,90,,percent of total billed charges,,,3234.6,90,,percent of total billed charges,,,3054.9,85,,percent of total billed charges,,480,3414.3,
EXCISION OF MESENTERY LESION,44820,CDM,44820,CPT,,,both,,3636,3636,1467.86,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3090.6,85,,percent of total billed charges,,1534.52,,,,fee schedule,,898.07,,,,fee schedule,,599.35,,,,fee schedule,,1265.4,,,,fee schedule,,599.35,,,,fee schedule,,1424.69,,,,fee schedule,,863.45,,,,fee schedule,,863.45,,,,fee schedule,,,3308.76,91,,percent of total billed charges,,,3454.2,95,,percent of total billed charges,,,3017.88,83,,percent of total billed charges,,,1090.8,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3017.88,83,,percent of total billed charges,,1269.27,,,,fee schedule,,,3272.4,90,,percent of total billed charges,,,3272.4,90,,percent of total billed charges,,,3272.4,90,,percent of total billed charges,,,3272.4,90,,percent of total billed charges,,,3090.6,85,,percent of total billed charges,,599.35,3454.2,
"DRAIN APP ABSCESS, OPEN",44900,CDM,44900,CPT,,,both,,3437,3437,1354.37,,,,fee schedule,,,,,,,,310.8,,,,fee schedule,,,2921.45,85,,percent of total billed charges,,1414.25,,,,fee schedule,,827.69,,,,fee schedule,,310.8,,,,fee schedule,,1067.76,,,,fee schedule,,310.8,,,,fee schedule,,1314.54,,,,fee schedule,,796.69,,,,fee schedule,,796.69,,,,fee schedule,,,3127.67,91,,percent of total billed charges,,,3265.15,95,,percent of total billed charges,,,2852.71,83,,percent of total billed charges,,,1031.1,83,,percent of total billed charges,,310.8,,,,fee schedule,,310.8,,,,fee schedule,,,2852.71,83,,percent of total billed charges,,1171.13,,,,fee schedule,,,3093.3,90,,percent of total billed charges,,,3093.3,90,,percent of total billed charges,,,3093.3,90,,percent of total billed charges,,,3093.3,90,,percent of total billed charges,,,2921.45,85,,percent of total billed charges,,310.8,3265.15,
APPENDECTOMY,44950,CDM,44950,CPT,,,both,,3152,3152,1106.65,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,2679.2,85,,percent of total billed charges,,1156.12,,,,fee schedule,,676.62,,,,fee schedule,,374.55,,,,fee schedule,,1034.6,,,,fee schedule,,374.55,,,,fee schedule,,1074.11,,,,fee schedule,,650.97,,,,fee schedule,,650.97,,,,fee schedule,,,2868.32,91,,percent of total billed charges,,,2994.4,95,,percent of total billed charges,,,2616.16,83,,percent of total billed charges,,,945.6,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,2616.16,83,,percent of total billed charges,,956.93,,,,fee schedule,,,2836.8,90,,percent of total billed charges,,,2836.8,90,,percent of total billed charges,,,2836.8,90,,percent of total billed charges,,,2836.8,90,,percent of total billed charges,,,2679.2,85,,percent of total billed charges,,374.55,2994.4,
APPENDECTOMY ADD-ON,44955,CDM,44955,CPT,,,both,,715,715,142.87,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,607.75,85,,percent of total billed charges,,149.2,,,,fee schedule,,87.32,,,,fee schedule,,374.55,,,,fee schedule,,149.88,,,,fee schedule,,374.55,,,,fee schedule,,138.67,,,,fee schedule,,84.04,,,,fee schedule,,84.04,,,,fee schedule,,,650.65,91,,percent of total billed charges,,,679.25,95,,percent of total billed charges,,,593.45,83,,percent of total billed charges,,,214.5,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,593.45,83,,percent of total billed charges,,123.54,,,,fee schedule,,,643.5,90,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,607.75,85,,percent of total billed charges,,84.04,679.25,
APPENDECTOMY,44960,CDM,44960,CPT,,,both,,4053,4053,1510.49,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3445.05,85,,percent of total billed charges,,1582.55,,,,fee schedule,,926.18,,,,fee schedule,,480,,,,fee schedule,,1277.34,,,,fee schedule,,480,,,,fee schedule,,1466.06,,,,fee schedule,,888.52,,,,fee schedule,,888.52,,,,fee schedule,,,3688.23,91,,percent of total billed charges,,,3850.35,95,,percent of total billed charges,,,3363.99,83,,percent of total billed charges,,,1215.9,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3363.99,83,,percent of total billed charges,,1306.13,,,,fee schedule,,,3647.7,90,,percent of total billed charges,,,3647.7,90,,percent of total billed charges,,,3647.7,90,,percent of total billed charges,,,3647.7,90,,percent of total billed charges,,,3445.05,85,,percent of total billed charges,,480,3850.35,
"LAPAROSCOPY, APPENDECTOMY",44970,CDM,44970,CPT,,,both,,3036,3036,1040.4,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,2580.6,85,,percent of total billed charges,,1081.23,,,,fee schedule,,632.79,,,,fee schedule,,374.55,,,,fee schedule,,921.86,,,,fee schedule,,374.55,,,,fee schedule,,1009.8,,,,fee schedule,,612,,,,fee schedule,,612,,,,fee schedule,,,2762.76,91,,percent of total billed charges,,,2884.2,95,,percent of total billed charges,,,2519.88,83,,percent of total billed charges,,,910.8,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,2519.88,83,,percent of total billed charges,,899.64,,,,fee schedule,,,2732.4,90,,percent of total billed charges,,,2732.4,90,,percent of total billed charges,,,2732.4,90,,percent of total billed charges,,,2732.4,90,,percent of total billed charges,,,2580.6,85,,percent of total billed charges,,374.55,2884.2,
DRAINAGE OF RECTAL ABSCESS,45005,CDM,45005,CPT,,,both,,920,920,288.62,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,782,85,,percent of total billed charges,,296.47,,,,fee schedule,,173.51,,,,fee schedule,,107,,,,fee schedule,,252.68,,,,fee schedule,,107,,,,fee schedule,,280.13,,,,fee schedule,,169.77,,,,fee schedule,,169.77,,,,fee schedule,,,837.2,91,,percent of total billed charges,,,874,95,,percent of total billed charges,,,763.6,83,,percent of total billed charges,,,276,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,763.6,83,,percent of total billed charges,,249.57,,,,fee schedule,,,828,90,,percent of total billed charges,,,828,90,,percent of total billed charges,,,828,90,,percent of total billed charges,,,828,90,,percent of total billed charges,,,782,85,,percent of total billed charges,,107,874,
BIOPSY OF RECTUM,45100,CDM,45100,CPT,,,both,,1726,1726,523.08,,,,fee schedule,,,,,,,,118,,,,fee schedule,,,1467.1,85,,percent of total billed charges,,528.43,,,,fee schedule,,309.26,,,,fee schedule,,118,,,,fee schedule,,427.77,,,,fee schedule,,118,,,,fee schedule,,507.7,,,,fee schedule,,307.7,,,,fee schedule,,307.7,,,,fee schedule,,,1570.66,91,,percent of total billed charges,,,1639.7,95,,percent of total billed charges,,,1432.58,83,,percent of total billed charges,,,517.8,83,,percent of total billed charges,,118,,,,fee schedule,,118,,,,fee schedule,,,1432.58,83,,percent of total billed charges,,452.31,,,,fee schedule,,,1553.4,90,,percent of total billed charges,,,1553.4,90,,percent of total billed charges,,,1553.4,90,,percent of total billed charges,,,1553.4,90,,percent of total billed charges,,,1467.1,85,,percent of total billed charges,,118,1639.7,
REMOVAL OF RECTUM,45110,CDM,45110,CPT,,,both,,9747,9747,3112,,,,fee schedule,,,,,,,,1079.3,,,,fee schedule,,,8284.95,85,,percent of total billed charges,,3225.58,,,,fee schedule,,1887.77,,,,fee schedule,,1079.3,,,,fee schedule,,2896.22,,,,fee schedule,,1079.3,,,,fee schedule,,3020.47,,,,fee schedule,,1830.59,,,,fee schedule,,1830.59,,,,fee schedule,,,8869.77,91,,percent of total billed charges,,,9259.65,95,,percent of total billed charges,,,8090.01,83,,percent of total billed charges,,,2924.1,83,,percent of total billed charges,,1079.3,,,,fee schedule,,1079.3,,,,fee schedule,,,8090.01,83,,percent of total billed charges,,2690.96,,,,fee schedule,,,8772.3,90,,percent of total billed charges,,,8772.3,90,,percent of total billed charges,,,8772.3,90,,percent of total billed charges,,,8772.3,90,,percent of total billed charges,,,8284.95,85,,percent of total billed charges,,1079.3,9259.65,
PROCTOSIGMOIDOSCOPY DX,45300,CDM,45300,CPT,,,both,,467,467,82.38,,,,fee schedule,,,,,,,,42.3,,,,fee schedule,,,396.95,85,,percent of total billed charges,,83.26,,,,fee schedule,,48.73,,,,fee schedule,,42.3,,,,fee schedule,,46.42,,,,fee schedule,,42.3,,,,fee schedule,,79.96,,,,fee schedule,,48.46,,,,fee schedule,,48.46,,,,fee schedule,,,424.97,91,,percent of total billed charges,,,443.65,95,,percent of total billed charges,,,387.61,83,,percent of total billed charges,,,140.1,83,,percent of total billed charges,,42.3,,,,fee schedule,,42.3,,,,fee schedule,,,387.61,83,,percent of total billed charges,,71.23,,,,fee schedule,,,420.3,90,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,396.95,85,,percent of total billed charges,,42.3,443.65,
PROCTOSIGMOIDOSCOPY DX,45300P,CDM,45300,CPT,,,both,P,353,353,82.38,,,,fee schedule,,,,,,,,42.3,,,,fee schedule,,,300.05,85,,percent of total billed charges,,83.26,,,,fee schedule,,48.73,,,,fee schedule,,42.3,,,,fee schedule,,46.42,,,,fee schedule,,42.3,,,,fee schedule,,79.96,,,,fee schedule,,48.46,,,,fee schedule,,48.46,,,,fee schedule,,,321.23,91,,percent of total billed charges,,,335.35,95,,percent of total billed charges,,,292.99,83,,percent of total billed charges,,,105.9,83,,percent of total billed charges,,42.3,,,,fee schedule,,42.3,,,,fee schedule,,,292.99,83,,percent of total billed charges,,71.23,,,,fee schedule,,,317.7,90,,percent of total billed charges,,,317.7,90,,percent of total billed charges,,,317.7,90,,percent of total billed charges,,,317.7,90,,percent of total billed charges,,,300.05,85,,percent of total billed charges,,42.3,335.35,
PROCTOSIGMOIDOSCOPY DX,45300T,CDM,45300,CPT,,,both,T,114,114,82.38,,,,fee schedule,,,,,,,,42.3,,,,fee schedule,,,96.9,85,,percent of total billed charges,,83.26,,,,fee schedule,,48.73,,,,fee schedule,,42.3,,,,fee schedule,,46.42,,,,fee schedule,,42.3,,,,fee schedule,,79.96,,,,fee schedule,,48.46,,,,fee schedule,,48.46,,,,fee schedule,,,103.74,91,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,34.2,83,,percent of total billed charges,,42.3,,,,fee schedule,,42.3,,,,fee schedule,,,94.62,83,,percent of total billed charges,,71.23,,,,fee schedule,,,102.6,90,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,96.9,85,,percent of total billed charges,,34.2,108.3,
PROCTOSIGMOIDOSCOPY W/BX,45305,CDM,45305,CPT,,,both,,793,793,124.43,,,,fee schedule,,,,,,,,72.6,,,,fee schedule,,,674.05,85,,percent of total billed charges,,127.4,,,,fee schedule,,74.56,,,,fee schedule,,72.6,,,,fee schedule,,107.44,,,,fee schedule,,72.6,,,,fee schedule,,120.77,,,,fee schedule,,73.2,,,,fee schedule,,73.2,,,,fee schedule,,,721.63,91,,percent of total billed charges,,,753.35,95,,percent of total billed charges,,,658.19,83,,percent of total billed charges,,,237.9,83,,percent of total billed charges,,72.6,,,,fee schedule,,72.6,,,,fee schedule,,,658.19,83,,percent of total billed charges,,107.6,,,,fee schedule,,,713.7,90,,percent of total billed charges,,,713.7,90,,percent of total billed charges,,,713.7,90,,percent of total billed charges,,,713.7,90,,percent of total billed charges,,,674.05,85,,percent of total billed charges,,72.6,753.35,
PROCTOSIGMOIDOSCOPY REMOVAL,45309,CDM,45309,CPT,,,both,,1038,1038,153.81,,,,fee schedule,,,,,,,,125.5,,,,fee schedule,,,882.3,85,,percent of total billed charges,,158.59,,,,fee schedule,,92.82,,,,fee schedule,,125.5,,,,fee schedule,,203.6,,,,fee schedule,,125.5,,,,fee schedule,,149.29,,,,fee schedule,,90.48,,,,fee schedule,,90.48,,,,fee schedule,,,944.58,91,,percent of total billed charges,,,986.1,95,,percent of total billed charges,,,861.54,83,,percent of total billed charges,,,311.4,83,,percent of total billed charges,,125.5,,,,fee schedule,,125.5,,,,fee schedule,,,861.54,83,,percent of total billed charges,,133,,,,fee schedule,,,934.2,90,,percent of total billed charges,,,934.2,90,,percent of total billed charges,,,934.2,90,,percent of total billed charges,,,934.2,90,,percent of total billed charges,,,882.3,85,,percent of total billed charges,,90.48,986.1,
DIAGNOSTIC SIGMOIDOSCOPY,45330,CDM,45330,CPT,,,both,,623,623,95.63,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,529.55,85,,percent of total billed charges,,96.71,,,,fee schedule,,56.6,,,,fee schedule,,107,,,,fee schedule,,102.13,,,,fee schedule,,107,,,,fee schedule,,92.82,,,,fee schedule,,56.25,,,,fee schedule,,56.25,,,,fee schedule,,,566.93,91,,percent of total billed charges,,,591.85,95,,percent of total billed charges,,,517.09,83,,percent of total billed charges,,,186.9,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,517.09,83,,percent of total billed charges,,82.69,,,,fee schedule,,,560.7,90,,percent of total billed charges,,,560.7,90,,percent of total billed charges,,,560.7,90,,percent of total billed charges,,,560.7,90,,percent of total billed charges,,,529.55,85,,percent of total billed charges,,56.25,591.85,
SIGMOIDOSCOPY AND BIOPSY,45331,CDM,45331,CPT,,,both,,815,815,122.13,,,,fee schedule,,,,,,,,142.7,,,,fee schedule,,,692.75,85,,percent of total billed charges,,123.29,,,,fee schedule,,72.15,,,,fee schedule,,142.7,,,,fee schedule,,121.37,,,,fee schedule,,142.7,,,,fee schedule,,118.54,,,,fee schedule,,71.84,,,,fee schedule,,71.84,,,,fee schedule,,,741.65,91,,percent of total billed charges,,,774.25,95,,percent of total billed charges,,,676.45,83,,percent of total billed charges,,,244.5,83,,percent of total billed charges,,142.7,,,,fee schedule,,142.7,,,,fee schedule,,,676.45,83,,percent of total billed charges,,105.61,,,,fee schedule,,,733.5,90,,percent of total billed charges,,,733.5,90,,percent of total billed charges,,,733.5,90,,percent of total billed charges,,,733.5,90,,percent of total billed charges,,,692.75,85,,percent of total billed charges,,71.84,774.25,
SIGMOIDOSCOPY W/FB REMOVAL,45332,CDM,45332,CPT,,,both,,820,820,177.43,,,,fee schedule,,,,,,,,125.5,,,,fee schedule,,,697,85,,percent of total billed charges,,182.98,,,,fee schedule,,107.09,,,,fee schedule,,125.5,,,,fee schedule,,182.38,,,,fee schedule,,125.5,,,,fee schedule,,172.21,,,,fee schedule,,104.37,,,,fee schedule,,104.37,,,,fee schedule,,,746.2,91,,percent of total billed charges,,,779,95,,percent of total billed charges,,,680.6,83,,percent of total billed charges,,,246,83,,percent of total billed charges,,125.5,,,,fee schedule,,125.5,,,,fee schedule,,,680.6,83,,percent of total billed charges,,153.43,,,,fee schedule,,,738,90,,percent of total billed charges,,,738,90,,percent of total billed charges,,,738,90,,percent of total billed charges,,,738,90,,percent of total billed charges,,,697,85,,percent of total billed charges,,104.37,779,
SIGMOIDOSCOPY  POLYPECTOMY,45333,CDM,45333,CPT,,,both,,1141,1141,159,,,,fee schedule,,,,,,,,161.2,,,,fee schedule,,,969.85,85,,percent of total billed charges,,163.5,,,,fee schedule,,95.69,,,,fee schedule,,161.2,,,,fee schedule,,181.72,,,,fee schedule,,161.2,,,,fee schedule,,154.32,,,,fee schedule,,93.53,,,,fee schedule,,93.53,,,,fee schedule,,,1038.31,91,,percent of total billed charges,,,1083.95,95,,percent of total billed charges,,,947.03,83,,percent of total billed charges,,,342.3,83,,percent of total billed charges,,161.2,,,,fee schedule,,161.2,,,,fee schedule,,,947.03,83,,percent of total billed charges,,137.49,,,,fee schedule,,,1026.9,90,,percent of total billed charges,,,1026.9,90,,percent of total billed charges,,,1026.9,90,,percent of total billed charges,,,1026.9,90,,percent of total billed charges,,,969.85,85,,percent of total billed charges,,93.53,1083.95,
SIGMOIDOSCOPY  DECOMPRESS,45337,CDM,45337,CPT,,,both,,905,905,193.56,,,,fee schedule,,,,,,,,125.5,,,,fee schedule,,,769.25,85,,percent of total billed charges,,200.56,,,,fee schedule,,117.38,,,,fee schedule,,125.5,,,,fee schedule,,236.76,,,,fee schedule,,125.5,,,,fee schedule,,187.87,,,,fee schedule,,113.86,,,,fee schedule,,113.86,,,,fee schedule,,,823.55,91,,percent of total billed charges,,,859.75,95,,percent of total billed charges,,,751.15,83,,percent of total billed charges,,,271.5,83,,percent of total billed charges,,125.5,,,,fee schedule,,125.5,,,,fee schedule,,,751.15,83,,percent of total billed charges,,167.38,,,,fee schedule,,,814.5,90,,percent of total billed charges,,,814.5,90,,percent of total billed charges,,,814.5,90,,percent of total billed charges,,,814.5,90,,percent of total billed charges,,,769.25,85,,percent of total billed charges,,113.86,859.75,
SIGMOIDOSCOPY W/TUMR REMOVE,45338,CDM,45338,CPT,,,both,,1118,1118,203.36,,,,fee schedule,,,,,,,,161.2,,,,fee schedule,,,950.3,85,,percent of total billed charges,,209.11,,,,fee schedule,,122.38,,,,fee schedule,,161.2,,,,fee schedule,,234.11,,,,fee schedule,,161.2,,,,fee schedule,,197.38,,,,fee schedule,,119.62,,,,fee schedule,,119.62,,,,fee schedule,,,1017.38,91,,percent of total billed charges,,,1062.1,95,,percent of total billed charges,,,927.94,83,,percent of total billed charges,,,335.4,83,,percent of total billed charges,,161.2,,,,fee schedule,,161.2,,,,fee schedule,,,927.94,83,,percent of total billed charges,,175.84,,,,fee schedule,,,1006.2,90,,percent of total billed charges,,,1006.2,90,,percent of total billed charges,,,1006.2,90,,percent of total billed charges,,,1006.2,90,,percent of total billed charges,,,950.3,85,,percent of total billed charges,,119.62,1062.1,
DIAGNOSTIC COLONOSCOPY,45378,CDM,45378,CPT,,,both,,1836,1836,312.24,,,,fee schedule,,,,,,,,214,,,,fee schedule,,,1560.6,85,,percent of total billed charges,,375.57,,,,fee schedule,,185.6,,,,fee schedule,,214,,,,fee schedule,,517.3,,,,fee schedule,,214,,,,fee schedule,,303.05,,,,fee schedule,,183.67,,,,fee schedule,,183.67,,,,fee schedule,,,1670.76,91,,percent of total billed charges,,,1744.2,95,,percent of total billed charges,,,1523.88,83,,percent of total billed charges,,,550.8,83,,percent of total billed charges,,214,,,,fee schedule,,214,,,,fee schedule,,,1523.88,83,,percent of total billed charges,,269.99,,,,fee schedule,,,1652.4,90,,percent of total billed charges,,,1652.4,90,,percent of total billed charges,,,1652.4,90,,percent of total billed charges,,,1652.4,90,,percent of total billed charges,,,1560.6,85,,percent of total billed charges,,183.67,1744.2,
COLONOSCOPY W/FB REMOVAL,45379,CDM,45379,CPT,,,both,,2053,2053,403.26,,,,fee schedule,,,,,,,,214,,,,fee schedule,,,1745.05,85,,percent of total billed charges,,487.21,,,,fee schedule,,240.78,,,,fee schedule,,214,,,,fee schedule,,456.29,,,,fee schedule,,214,,,,fee schedule,,391.4,,,,fee schedule,,237.21,,,,fee schedule,,237.21,,,,fee schedule,,,1868.23,91,,percent of total billed charges,,,1950.35,95,,percent of total billed charges,,,1703.99,83,,percent of total billed charges,,,615.9,83,,percent of total billed charges,,214,,,,fee schedule,,214,,,,fee schedule,,,1703.99,83,,percent of total billed charges,,348.7,,,,fee schedule,,,1847.7,90,,percent of total billed charges,,,1847.7,90,,percent of total billed charges,,,1847.7,90,,percent of total billed charges,,,1847.7,90,,percent of total billed charges,,,1745.05,85,,percent of total billed charges,,214,1950.35,
COLONOSCOPY AND BIOPSY,45380,CDM,45380,CPT,,,both,,2113,2113,339.31,,,,fee schedule,,,,,,,,214,,,,fee schedule,,,1796.05,85,,percent of total billed charges,,407.24,,,,fee schedule,,201.26,,,,fee schedule,,214,,,,fee schedule,,616.78,,,,fee schedule,,214,,,,fee schedule,,329.33,,,,fee schedule,,199.6,,,,fee schedule,,199.6,,,,fee schedule,,,1922.83,91,,percent of total billed charges,,,2007.35,95,,percent of total billed charges,,,1753.79,83,,percent of total billed charges,,,633.9,83,,percent of total billed charges,,214,,,,fee schedule,,214,,,,fee schedule,,,1753.79,83,,percent of total billed charges,,293.41,,,,fee schedule,,,1901.7,90,,percent of total billed charges,,,1901.7,90,,percent of total billed charges,,,1901.7,90,,percent of total billed charges,,,1901.7,90,,percent of total billed charges,,,1796.05,85,,percent of total billed charges,,199.6,2007.35,
"COLONOSCOPY, SUBMUCOUS INJ",45381,CDM,45381,CPT,,,both,,2120,2120,338.74,,,,fee schedule,,,,,,,,184.28,,,,fee schedule,,,1802,85,,percent of total billed charges,,407.24,,,,fee schedule,,201.26,,,,fee schedule,,184.28,,,,fee schedule,,408.54,,,,fee schedule,,184.28,,,,fee schedule,,328.77,,,,fee schedule,,199.26,,,,fee schedule,,199.26,,,,fee schedule,,,1929.2,91,,percent of total billed charges,,,2014,95,,percent of total billed charges,,,1759.6,83,,percent of total billed charges,,,636,83,,percent of total billed charges,,184.28,,,,fee schedule,,184.28,,,,fee schedule,,,1759.6,83,,percent of total billed charges,,292.91,,,,fee schedule,,,1908,90,,percent of total billed charges,,,1908,90,,percent of total billed charges,,,1908,90,,percent of total billed charges,,,1908,90,,percent of total billed charges,,,1802,85,,percent of total billed charges,,184.28,2014,
COLONOSCOPY/CONTROL BLEEDING,45382,CDM,45382,CPT,,,both,,1716,1716,437.25,,,,fee schedule,,,,,,,,283.4,,,,fee schedule,,,1458.6,85,,percent of total billed charges,,527.94,,,,fee schedule,,260.91,,,,fee schedule,,283.4,,,,fee schedule,,549.8,,,,fee schedule,,283.4,,,,fee schedule,,424.39,,,,fee schedule,,257.2,,,,fee schedule,,257.2,,,,fee schedule,,,1561.56,91,,percent of total billed charges,,,1630.2,95,,percent of total billed charges,,,1424.28,83,,percent of total billed charges,,,514.8,83,,percent of total billed charges,,283.4,,,,fee schedule,,283.4,,,,fee schedule,,,1424.28,83,,percent of total billed charges,,378.09,,,,fee schedule,,,1544.4,90,,percent of total billed charges,,,1544.4,90,,percent of total billed charges,,,1544.4,90,,percent of total billed charges,,,1544.4,90,,percent of total billed charges,,,1458.6,85,,percent of total billed charges,,257.2,1630.2,
LESION REMOVE COLONOSCOPY,45384,CDM,45384,CPT,,,both,,2249,2249,385.4,,,,fee schedule,,,,,,,,285.4,,,,fee schedule,,,1911.65,85,,percent of total billed charges,,468.12,,,,fee schedule,,231.34,,,,fee schedule,,285.4,,,,fee schedule,,456.95,,,,fee schedule,,285.4,,,,fee schedule,,374.06,,,,fee schedule,,226.71,,,,fee schedule,,226.71,,,,fee schedule,,,2046.59,91,,percent of total billed charges,,,2136.55,95,,percent of total billed charges,,,1866.67,83,,percent of total billed charges,,,674.7,83,,percent of total billed charges,,285.4,,,,fee schedule,,285.4,,,,fee schedule,,,1866.67,83,,percent of total billed charges,,333.26,,,,fee schedule,,,2024.1,90,,percent of total billed charges,,,2024.1,90,,percent of total billed charges,,,2024.1,90,,percent of total billed charges,,,2024.1,90,,percent of total billed charges,,,1911.65,85,,percent of total billed charges,,226.71,2136.55,
LESION REMOVAL COLONOSCOPY,45385,CDM,45385,CPT,,,both,,2508,2508,429.18,,,,fee schedule,,,,,,,,285.4,,,,fee schedule,,,2131.8,85,,percent of total billed charges,,518.37,,,,fee schedule,,256.17,,,,fee schedule,,285.4,,,,fee schedule,,513.98,,,,fee schedule,,285.4,,,,fee schedule,,416.56,,,,fee schedule,,252.46,,,,fee schedule,,252.46,,,,fee schedule,,,2282.28,91,,percent of total billed charges,,,2382.6,95,,percent of total billed charges,,,2081.64,83,,percent of total billed charges,,,752.4,83,,percent of total billed charges,,285.4,,,,fee schedule,,285.4,,,,fee schedule,,,2081.64,83,,percent of total billed charges,,371.12,,,,fee schedule,,,2257.2,90,,percent of total billed charges,,,2257.2,90,,percent of total billed charges,,,2257.2,90,,percent of total billed charges,,,2257.2,90,,percent of total billed charges,,,2131.8,85,,percent of total billed charges,,252.46,2382.6,
COLONOSCOPY W/ABLATION,45388,CDM,45388,CPT,,,both,,2269,2269,457.99,,,,fee schedule,,,,,,,,173.35,,,,fee schedule,,,1928.65,85,,percent of total billed charges,,471.99,,,,fee schedule,,276.23,,,,fee schedule,,173.35,,,,fee schedule,,,,,,,,173.35,,,,fee schedule,,444.52,,,,fee schedule,,269.4,,,,fee schedule,,269.4,,,,fee schedule,,,2064.79,91,,percent of total billed charges,,,2155.55,95,,percent of total billed charges,,,1883.27,83,,percent of total billed charges,,,680.7,83,,percent of total billed charges,,173.35,,,,fee schedule,,173.35,,,,fee schedule,,,1883.27,83,,percent of total billed charges,,396.02,,,,fee schedule,,,2042.1,90,,percent of total billed charges,,,2042.1,90,,percent of total billed charges,,,2042.1,90,,percent of total billed charges,,,2042.1,90,,percent of total billed charges,,,1928.65,85,,percent of total billed charges,,173.35,2155.55,
COLONOSCOPY W/RESECTION,45390,CDM,45390,CPT,,,both,,2236,2236,561.1,,,,fee schedule,,,,,,,,212.17,,,,fee schedule,,,1900.6,85,,percent of total billed charges,,578.41,,,,fee schedule,,338.51,,,,fee schedule,,212.17,,,,fee schedule,,,,,,,,212.17,,,,fee schedule,,544.6,,,,fee schedule,,330.06,,,,fee schedule,,330.06,,,,fee schedule,,,2034.76,91,,percent of total billed charges,,,2124.2,95,,percent of total billed charges,,,1855.88,83,,percent of total billed charges,,,670.8,83,,percent of total billed charges,,212.17,,,,fee schedule,,212.17,,,,fee schedule,,,1855.88,83,,percent of total billed charges,,485.19,,,,fee schedule,,,2012.4,90,,percent of total billed charges,,,2012.4,90,,percent of total billed charges,,,2012.4,90,,percent of total billed charges,,,2012.4,90,,percent of total billed charges,,,1900.6,85,,percent of total billed charges,,212.17,2124.2,
COLONOSCOPY W/DECOMPRESSION,45393,CDM,45393,CPT,,,both,,1987,1987,425.15,,,,fee schedule,,,,,,,,162.46,,,,fee schedule,,,1688.95,85,,percent of total billed charges,,442.8,,,,fee schedule,,259.15,,,,fee schedule,,162.46,,,,fee schedule,,,,,,,,162.46,,,,fee schedule,,412.64,,,,fee schedule,,250.09,,,,fee schedule,,250.09,,,,fee schedule,,,1808.17,91,,percent of total billed charges,,,1887.65,95,,percent of total billed charges,,,1649.21,83,,percent of total billed charges,,,596.1,83,,percent of total billed charges,,162.46,,,,fee schedule,,162.46,,,,fee schedule,,,1649.21,83,,percent of total billed charges,,367.63,,,,fee schedule,,,1788.3,90,,percent of total billed charges,,,1788.3,90,,percent of total billed charges,,,1788.3,90,,percent of total billed charges,,,1788.3,90,,percent of total billed charges,,,1688.95,85,,percent of total billed charges,,162.46,1887.65,
COLONOSCOPY W/BAND LIGATION,45398,CDM,45398,CPT,,,both,,2522,2522,399.23,,,,fee schedule,,,,,,,,151.15,,,,fee schedule,,,2143.7,85,,percent of total billed charges,,412.12,,,,fee schedule,,241.19,,,,fee schedule,,151.15,,,,fee schedule,,,,,,,,151.15,,,,fee schedule,,387.48,,,,fee schedule,,234.84,,,,fee schedule,,234.84,,,,fee schedule,,,2295.02,91,,percent of total billed charges,,,2395.9,95,,percent of total billed charges,,,2093.26,83,,percent of total billed charges,,,756.6,83,,percent of total billed charges,,151.15,,,,fee schedule,,151.15,,,,fee schedule,,,2093.26,83,,percent of total billed charges,,345.21,,,,fee schedule,,,2269.8,90,,percent of total billed charges,,,2269.8,90,,percent of total billed charges,,,2269.8,90,,percent of total billed charges,,,2269.8,90,,percent of total billed charges,,,2143.7,85,,percent of total billed charges,,151.15,2395.9,
"LAPAROSCOPE PROC, RECTUM",45499,CDM,45499,CPT,,,both,,5235,5235,,,,,,,,,,,,,,,,,,,,4449.75,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4763.85,91,,percent of total billed charges,,,4973.25,95,,percent of total billed charges,,,4345.05,83,,percent of total billed charges,,,1570.5,83,,percent of total billed charges,,,,,,,,,,,,,,,4345.05,83,,percent of total billed charges,,,,,,,,,4711.5,90,,percent of total billed charges,,,4711.5,90,,percent of total billed charges,,,4711.5,90,,percent of total billed charges,,,4711.5,90,,percent of total billed charges,,,4449.75,85,,percent of total billed charges,,1570.5,4973.25,
REPAIR OF RECTUM,45505,CDM,45505,CPT,,,both,,3271,3271,1040.4,,,,fee schedule,,,,,,,,419,,,,fee schedule,,,2780.35,85,,percent of total billed charges,,1058.57,,,,fee schedule,,619.53,,,,fee schedule,,419,,,,fee schedule,,813.75,,,,fee schedule,,419,,,,fee schedule,,1009.8,,,,fee schedule,,612,,,,fee schedule,,612,,,,fee schedule,,,2976.61,91,,percent of total billed charges,,,3107.45,95,,percent of total billed charges,,,2714.93,83,,percent of total billed charges,,,981.3,83,,percent of total billed charges,,419,,,,fee schedule,,419,,,,fee schedule,,,2714.93,83,,percent of total billed charges,,899.64,,,,fee schedule,,,2943.9,90,,percent of total billed charges,,,2943.9,90,,percent of total billed charges,,,2943.9,90,,percent of total billed charges,,,2943.9,90,,percent of total billed charges,,,2780.35,85,,percent of total billed charges,,419,3107.45,
CORRECT RECTAL PROLAPSE,45540,CDM,45540,CPT,,,both,,5363,5363,1801.41,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,4558.55,85,,percent of total billed charges,,1865.92,,,,fee schedule,,1092.03,,,,fee schedule,,599.35,,,,fee schedule,,1648.73,,,,fee schedule,,599.35,,,,fee schedule,,1748.43,,,,fee schedule,,1059.65,,,,fee schedule,,1059.65,,,,fee schedule,,,4880.33,91,,percent of total billed charges,,,5094.85,95,,percent of total billed charges,,,4451.29,83,,percent of total billed charges,,,1608.9,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,4451.29,83,,percent of total billed charges,,1557.69,,,,fee schedule,,,4826.7,90,,percent of total billed charges,,,4826.7,90,,percent of total billed charges,,,4826.7,90,,percent of total billed charges,,,4826.7,90,,percent of total billed charges,,,4558.55,85,,percent of total billed charges,,599.35,5094.85,
REPAIR RECTUM/REMOVE SIGMOID,45550,CDM,45550,CPT,,,both,,6375,6375,2495.01,,,,fee schedule,,,,,,,,749.2,,,,fee schedule,,,5418.75,85,,percent of total billed charges,,2581.16,,,,fee schedule,,1510.62,,,,fee schedule,,749.2,,,,fee schedule,,2305.3,,,,fee schedule,,749.2,,,,fee schedule,,2421.63,,,,fee schedule,,1467.65,,,,fee schedule,,1467.65,,,,fee schedule,,,5801.25,91,,percent of total billed charges,,,6056.25,95,,percent of total billed charges,,,5291.25,83,,percent of total billed charges,,,1912.5,83,,percent of total billed charges,,749.2,,,,fee schedule,,749.2,,,,fee schedule,,,5291.25,83,,percent of total billed charges,,2157.45,,,,fee schedule,,,5737.5,90,,percent of total billed charges,,,5737.5,90,,percent of total billed charges,,,5737.5,90,,percent of total billed charges,,,5737.5,90,,percent of total billed charges,,,5418.75,85,,percent of total billed charges,,749.2,6056.25,
REPAIR OF RECTOCELE,45560,CDM,45560,CPT,,,both,,3226,3226,1189.61,,,,fee schedule,,,,,,,,227.7,,,,fee schedule,,,2742.1,85,,percent of total billed charges,,1220.19,,,,fee schedule,,714.12,,,,fee schedule,,227.7,,,,fee schedule,,1110.21,,,,fee schedule,,227.7,,,,fee schedule,,1154.62,,,,fee schedule,,699.77,,,,fee schedule,,699.77,,,,fee schedule,,,2935.66,91,,percent of total billed charges,,,3064.7,95,,percent of total billed charges,,,2677.58,83,,percent of total billed charges,,,967.8,83,,percent of total billed charges,,227.7,,,,fee schedule,,227.7,,,,fee schedule,,,2677.58,83,,percent of total billed charges,,1028.66,,,,fee schedule,,,2903.4,90,,percent of total billed charges,,,2903.4,90,,percent of total billed charges,,,2903.4,90,,percent of total billed charges,,,2903.4,90,,percent of total billed charges,,,2742.1,85,,percent of total billed charges,,227.7,3064.7,
REMOVE RECTAL OBSTRUCTION,45915,CDM,45915,CPT,,,both,,925,925,395.19,,,,fee schedule,,,,,,,,77.6,,,,fee schedule,,,786.25,85,,percent of total billed charges,,404.05,,,,fee schedule,,236.47,,,,fee schedule,,77.6,,,,fee schedule,,366.75,,,,fee schedule,,77.6,,,,fee schedule,,383.57,,,,fee schedule,,232.47,,,,fee schedule,,232.47,,,,fee schedule,,,841.75,91,,percent of total billed charges,,,878.75,95,,percent of total billed charges,,,767.75,83,,percent of total billed charges,,,277.5,83,,percent of total billed charges,,77.6,,,,fee schedule,,77.6,,,,fee schedule,,,767.75,83,,percent of total billed charges,,341.73,,,,fee schedule,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,832.5,90,,percent of total billed charges,,,786.25,85,,percent of total billed charges,,77.6,878.75,
PLACEMENT OF SETON,46020,CDM,46020,CPT,,,both,,1148,1148,199.9,,,,fee schedule,,,,,,,,140.75,,,,fee schedule,,,975.8,85,,percent of total billed charges,,204.06,,,,fee schedule,,119.42,,,,fee schedule,,140.75,,,,fee schedule,,335.58,,,,fee schedule,,140.75,,,,fee schedule,,194.02,,,,fee schedule,,117.59,,,,fee schedule,,117.59,,,,fee schedule,,,1044.68,91,,percent of total billed charges,,,1090.6,95,,percent of total billed charges,,,952.84,83,,percent of total billed charges,,,344.4,83,,percent of total billed charges,,140.75,,,,fee schedule,,140.75,,,,fee schedule,,,952.84,83,,percent of total billed charges,,172.86,,,,fee schedule,,,1033.2,90,,percent of total billed charges,,,1033.2,90,,percent of total billed charges,,,1033.2,90,,percent of total billed charges,,,1033.2,90,,percent of total billed charges,,,975.8,85,,percent of total billed charges,,117.59,1090.6,
INCISION OF RECTAL ABSCESS,46040,CDM,46040,CPT,,,both,,1660,1660,736.23,,,,fee schedule,,,,,,,,149.8,,,,fee schedule,,,1411,85,,percent of total billed charges,,749.56,,,,fee schedule,,438.68,,,,fee schedule,,149.8,,,,fee schedule,,605.51,,,,fee schedule,,149.8,,,,fee schedule,,714.58,,,,fee schedule,,433.08,,,,fee schedule,,433.08,,,,fee schedule,,,1510.6,91,,percent of total billed charges,,,1577,95,,percent of total billed charges,,,1377.8,83,,percent of total billed charges,,,498,83,,percent of total billed charges,,149.8,,,,fee schedule,,149.8,,,,fee schedule,,,1377.8,83,,percent of total billed charges,,636.63,,,,fee schedule,,,1494,90,,percent of total billed charges,,,1494,90,,percent of total billed charges,,,1494,90,,percent of total billed charges,,,1494,90,,percent of total billed charges,,,1411,85,,percent of total billed charges,,149.8,1577,
INCISION OF RECTAL ABSCESS,46045,CDM,46045,CPT,,,both,,1370,1370,759.28,,,,fee schedule,,,,,,,,149.8,,,,fee schedule,,,1164.5,85,,percent of total billed charges,,775.93,,,,fee schedule,,454.11,,,,fee schedule,,149.8,,,,fee schedule,,512.66,,,,fee schedule,,149.8,,,,fee schedule,,736.94,,,,fee schedule,,446.63,,,,fee schedule,,446.63,,,,fee schedule,,,1246.7,91,,percent of total billed charges,,,1301.5,95,,percent of total billed charges,,,1137.1,83,,percent of total billed charges,,,411,83,,percent of total billed charges,,149.8,,,,fee schedule,,149.8,,,,fee schedule,,,1137.1,83,,percent of total billed charges,,656.55,,,,fee schedule,,,1233,90,,percent of total billed charges,,,1233,90,,percent of total billed charges,,,1233,90,,percent of total billed charges,,,1233,90,,percent of total billed charges,,,1164.5,85,,percent of total billed charges,,149.8,1301.5,
INCISION OF ANAL ABSCESS,46050,CDM,46050,CPT,,,both,,667,667,175.13,,,,fee schedule,,,,,,,,71.4,,,,fee schedule,,,566.95,85,,percent of total billed charges,,174.86,,,,fee schedule,,102.34,,,,fee schedule,,71.4,,,,fee schedule,,143.25,,,,fee schedule,,71.4,,,,fee schedule,,169.98,,,,fee schedule,,103.02,,,,fee schedule,,103.02,,,,fee schedule,,,606.97,91,,percent of total billed charges,,,633.65,95,,percent of total billed charges,,,553.61,83,,percent of total billed charges,,,200.1,83,,percent of total billed charges,,71.4,,,,fee schedule,,71.4,,,,fee schedule,,,553.61,83,,percent of total billed charges,,151.44,,,,fee schedule,,,600.3,90,,percent of total billed charges,,,600.3,90,,percent of total billed charges,,,600.3,90,,percent of total billed charges,,,600.3,90,,percent of total billed charges,,,566.95,85,,percent of total billed charges,,71.4,633.65,
INCISION OF RECTAL ABSCESS,46060,CDM,46060,CPT,,,both,,1668,1668,843.38,,,,fee schedule,,,,,,,,471.7,,,,fee schedule,,,1417.8,85,,percent of total billed charges,,853.59,,,,fee schedule,,499.57,,,,fee schedule,,471.7,,,,fee schedule,,635.35,,,,fee schedule,,471.7,,,,fee schedule,,818.58,,,,fee schedule,,496.11,,,,fee schedule,,496.11,,,,fee schedule,,,1517.88,91,,percent of total billed charges,,,1584.6,95,,percent of total billed charges,,,1384.44,83,,percent of total billed charges,,,500.4,83,,percent of total billed charges,,471.7,,,,fee schedule,,471.7,,,,fee schedule,,,1384.44,83,,percent of total billed charges,,729.28,,,,fee schedule,,,1501.2,90,,percent of total billed charges,,,1501.2,90,,percent of total billed charges,,,1501.2,90,,percent of total billed charges,,,1501.2,90,,percent of total billed charges,,,1417.8,85,,percent of total billed charges,,471.7,1584.6,
INCISE EXTERNAL HEMORRHOID,46083,CDM,46083,CPT,,,both,,670,670,189.53,,,,fee schedule,,,,,,,,64.1,,,,fee schedule,,,569.5,85,,percent of total billed charges,,192.46,,,,fee schedule,,112.64,,,,fee schedule,,64.1,,,,fee schedule,,163.81,,,,fee schedule,,64.1,,,,fee schedule,,183.96,,,,fee schedule,,111.49,,,,fee schedule,,111.49,,,,fee schedule,,,609.7,91,,percent of total billed charges,,,636.5,95,,percent of total billed charges,,,556.1,83,,percent of total billed charges,,,201,83,,percent of total billed charges,,64.1,,,,fee schedule,,64.1,,,,fee schedule,,,556.1,83,,percent of total billed charges,,163.89,,,,fee schedule,,,603,90,,percent of total billed charges,,,603,90,,percent of total billed charges,,,603,90,,percent of total billed charges,,,603,90,,percent of total billed charges,,,569.5,85,,percent of total billed charges,,64.1,636.5,
REMOVAL OF ANAL TAG,46220,CDM,46220,CPT,,,both,,592,592,209.69,,,,fee schedule,,,,,,,,71.4,,,,fee schedule,,,503.2,85,,percent of total billed charges,,211.29,,,,fee schedule,,123.65,,,,fee schedule,,71.4,,,,fee schedule,,177.74,,,,fee schedule,,71.4,,,,fee schedule,,203.53,,,,fee schedule,,123.35,,,,fee schedule,,123.35,,,,fee schedule,,,538.72,91,,percent of total billed charges,,,562.4,95,,percent of total billed charges,,,491.36,83,,percent of total billed charges,,,177.6,83,,percent of total billed charges,,71.4,,,,fee schedule,,71.4,,,,fee schedule,,,491.36,83,,percent of total billed charges,,181.32,,,,fee schedule,,,532.8,90,,percent of total billed charges,,,532.8,90,,percent of total billed charges,,,532.8,90,,percent of total billed charges,,,532.8,90,,percent of total billed charges,,,503.2,85,,percent of total billed charges,,71.4,562.4,
LIGATION OF HEMORRHOID(S),46221,CDM,46221,CPT,,,both,,694,694,332.4,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,589.9,85,,percent of total billed charges,,336.87,,,,fee schedule,,197.15,,,,fee schedule,,107,,,,fee schedule,,265.28,,,,fee schedule,,107,,,,fee schedule,,322.62,,,,fee schedule,,195.53,,,,fee schedule,,195.53,,,,fee schedule,,,631.54,91,,percent of total billed charges,,,659.3,95,,percent of total billed charges,,,576.02,83,,percent of total billed charges,,,208.2,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,576.02,83,,percent of total billed charges,,287.43,,,,fee schedule,,,624.6,90,,percent of total billed charges,,,624.6,90,,percent of total billed charges,,,624.6,90,,percent of total billed charges,,,624.6,90,,percent of total billed charges,,,589.9,85,,percent of total billed charges,,107,659.3,
REMOVAL OF ANAL TAGS,46230,CDM,46230,CPT,,,both,,1052,1052,298.41,,,,fee schedule,,,,,,,,84.65,,,,fee schedule,,,894.2,85,,percent of total billed charges,,302.61,,,,fee schedule,,177.1,,,,fee schedule,,84.65,,,,fee schedule,,275.23,,,,fee schedule,,84.65,,,,fee schedule,,289.63,,,,fee schedule,,175.54,,,,fee schedule,,175.54,,,,fee schedule,,,957.32,91,,percent of total billed charges,,,999.4,95,,percent of total billed charges,,,873.16,83,,percent of total billed charges,,,315.6,83,,percent of total billed charges,,84.65,,,,fee schedule,,84.65,,,,fee schedule,,,873.16,83,,percent of total billed charges,,258.04,,,,fee schedule,,,946.8,90,,percent of total billed charges,,,946.8,90,,percent of total billed charges,,,946.8,90,,percent of total billed charges,,,946.8,90,,percent of total billed charges,,,894.2,85,,percent of total billed charges,,84.65,999.4,
HEMORRHOIDECTOMY,46250,CDM,46250,CPT,,,both,,1723,1723,551.89,,,,fee schedule,,,,,,,,248.3,,,,fee schedule,,,1464.55,85,,percent of total billed charges,,561.31,,,,fee schedule,,328.5,,,,fee schedule,,248.3,,,,fee schedule,,461.59,,,,fee schedule,,248.3,,,,fee schedule,,535.65,,,,fee schedule,,324.64,,,,fee schedule,,324.64,,,,fee schedule,,,1567.93,91,,percent of total billed charges,,,1636.85,95,,percent of total billed charges,,,1430.09,83,,percent of total billed charges,,,516.9,83,,percent of total billed charges,,248.3,,,,fee schedule,,248.3,,,,fee schedule,,,1430.09,83,,percent of total billed charges,,477.22,,,,fee schedule,,,1550.7,90,,percent of total billed charges,,,1550.7,90,,percent of total billed charges,,,1550.7,90,,percent of total billed charges,,,1550.7,90,,percent of total billed charges,,,1464.55,85,,percent of total billed charges,,248.3,1636.85,
HEMORRHOIDECTOMY,46255,CDM,46255,CPT,,,both,,1691,1691,614.68,,,,fee schedule,,,,,,,,342.65,,,,fee schedule,,,1437.35,85,,percent of total billed charges,,629.46,,,,fee schedule,,368.39,,,,fee schedule,,342.65,,,,fee schedule,,529.24,,,,fee schedule,,342.65,,,,fee schedule,,596.6,,,,fee schedule,,361.58,,,,fee schedule,,361.58,,,,fee schedule,,,1538.81,91,,percent of total billed charges,,,1606.45,95,,percent of total billed charges,,,1403.53,83,,percent of total billed charges,,,507.3,83,,percent of total billed charges,,342.65,,,,fee schedule,,342.65,,,,fee schedule,,,1403.53,83,,percent of total billed charges,,531.52,,,,fee schedule,,,1521.9,90,,percent of total billed charges,,,1521.9,90,,percent of total billed charges,,,1521.9,90,,percent of total billed charges,,,1521.9,90,,percent of total billed charges,,,1437.35,85,,percent of total billed charges,,342.65,1606.45,
HEMORRHOIDECTOMY,46260,CDM,46260,CPT,,,both,,1987,1987,834.17,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,1688.95,85,,percent of total billed charges,,853.71,,,,fee schedule,,499.63,,,,fee schedule,,449.5,,,,fee schedule,,682.44,,,,fee schedule,,449.5,,,,fee schedule,,809.63,,,,fee schedule,,490.69,,,,fee schedule,,490.69,,,,fee schedule,,,1808.17,91,,percent of total billed charges,,,1887.65,95,,percent of total billed charges,,,1649.21,83,,percent of total billed charges,,,596.1,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,1649.21,83,,percent of total billed charges,,721.31,,,,fee schedule,,,1788.3,90,,percent of total billed charges,,,1788.3,90,,percent of total billed charges,,,1788.3,90,,percent of total billed charges,,,1788.3,90,,percent of total billed charges,,,1688.95,85,,percent of total billed charges,,449.5,1887.65,
REMOVAL OF ANAL FISTULA,46270,CDM,46270,CPT,,,both,,1406,1406,694.18,,,,fee schedule,,,,,,,,471.7,,,,fee schedule,,,1195.1,85,,percent of total billed charges,,701.98,,,,fee schedule,,410.84,,,,fee schedule,,471.7,,,,fee schedule,,464.24,,,,fee schedule,,471.7,,,,fee schedule,,673.76,,,,fee schedule,,408.34,,,,fee schedule,,408.34,,,,fee schedule,,,1279.46,91,,percent of total billed charges,,,1335.7,95,,percent of total billed charges,,,1166.98,83,,percent of total billed charges,,,421.8,83,,percent of total billed charges,,471.7,,,,fee schedule,,471.7,,,,fee schedule,,,1166.98,83,,percent of total billed charges,,600.26,,,,fee schedule,,,1265.4,90,,percent of total billed charges,,,1265.4,90,,percent of total billed charges,,,1265.4,90,,percent of total billed charges,,,1265.4,90,,percent of total billed charges,,,1195.1,85,,percent of total billed charges,,408.34,1335.7,
REMOVAL OF ANAL FISTULA,46275,CDM,46275,CPT,,,both,,1599,1599,729.9,,,,fee schedule,,,,,,,,471.7,,,,fee schedule,,,1359.15,85,,percent of total billed charges,,739.94,,,,fee schedule,,433.05,,,,fee schedule,,471.7,,,,fee schedule,,533.22,,,,fee schedule,,471.7,,,,fee schedule,,708.43,,,,fee schedule,,429.35,,,,fee schedule,,429.35,,,,fee schedule,,,1455.09,91,,percent of total billed charges,,,1519.05,95,,percent of total billed charges,,,1327.17,83,,percent of total billed charges,,,479.7,83,,percent of total billed charges,,471.7,,,,fee schedule,,471.7,,,,fee schedule,,,1327.17,83,,percent of total billed charges,,631.15,,,,fee schedule,,,1439.1,90,,percent of total billed charges,,,1439.1,90,,percent of total billed charges,,,1439.1,90,,percent of total billed charges,,,1439.1,90,,percent of total billed charges,,,1359.15,85,,percent of total billed charges,,429.35,1519.05,
REMOVAL OF HEMORRHOID CLOT,46320,CDM,46320,CPT,,,both,,724,724,194.72,,,,fee schedule,,,,,,,,62.9,,,,fee schedule,,,615.4,85,,percent of total billed charges,,198.6,,,,fee schedule,,116.23,,,,fee schedule,,62.9,,,,fee schedule,,175.09,,,,fee schedule,,62.9,,,,fee schedule,,188.99,,,,fee schedule,,114.54,,,,fee schedule,,114.54,,,,fee schedule,,,658.84,91,,percent of total billed charges,,,687.8,95,,percent of total billed charges,,,600.92,83,,percent of total billed charges,,,217.2,83,,percent of total billed charges,,62.9,,,,fee schedule,,62.9,,,,fee schedule,,,600.92,83,,percent of total billed charges,,168.37,,,,fee schedule,,,651.6,90,,percent of total billed charges,,,651.6,90,,percent of total billed charges,,,651.6,90,,percent of total billed charges,,,651.6,90,,percent of total billed charges,,,615.4,85,,percent of total billed charges,,62.9,687.8,
DIAGNOSTIC ANOSCOPY,46600,CDM,46600,CPT,,,both,,336,336,70.86,,,,fee schedule,,,,,,,,19.8,,,,fee schedule,,,285.6,85,,percent of total billed charges,,70.57,,,,fee schedule,,41.3,,,,fee schedule,,19.8,,,,fee schedule,,59.03,,,,fee schedule,,19.8,,,,fee schedule,,68.77,,,,fee schedule,,41.68,,,,fee schedule,,41.68,,,,fee schedule,,,305.76,91,,percent of total billed charges,,,319.2,95,,percent of total billed charges,,,278.88,83,,percent of total billed charges,,,100.8,83,,percent of total billed charges,,19.8,,,,fee schedule,,19.8,,,,fee schedule,,,278.88,83,,percent of total billed charges,,61.27,,,,fee schedule,,,302.4,90,,percent of total billed charges,,,302.4,90,,percent of total billed charges,,,302.4,90,,percent of total billed charges,,,302.4,90,,percent of total billed charges,,,285.6,85,,percent of total billed charges,,19.8,319.2,
DIAGNOSTIC ANOSCOPY,46600P,CDM,46600,CPT,,,both,P,181,181,70.86,,,,fee schedule,,,,,,,,19.8,,,,fee schedule,,,153.85,85,,percent of total billed charges,,70.57,,,,fee schedule,,41.3,,,,fee schedule,,19.8,,,,fee schedule,,59.03,,,,fee schedule,,19.8,,,,fee schedule,,68.77,,,,fee schedule,,41.68,,,,fee schedule,,41.68,,,,fee schedule,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,54.3,83,,percent of total billed charges,,19.8,,,,fee schedule,,19.8,,,,fee schedule,,,150.23,83,,percent of total billed charges,,61.27,,,,fee schedule,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,19.8,171.95,
DIAGNOSTIC ANOSCOPY,46600T,CDM,46600,CPT,,,both,T,155,155,70.86,,,,fee schedule,,,,,,,,19.8,,,,fee schedule,,,131.75,85,,percent of total billed charges,,70.57,,,,fee schedule,,41.3,,,,fee schedule,,19.8,,,,fee schedule,,59.03,,,,fee schedule,,19.8,,,,fee schedule,,68.77,,,,fee schedule,,41.68,,,,fee schedule,,41.68,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,19.8,,,,fee schedule,,19.8,,,,fee schedule,,,128.65,83,,percent of total billed charges,,61.27,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,19.8,147.25,
"ANOSCOPY, REMOVE LESION",46610,CDM,46610,CPT,,,both,,564,564,137.68,,,,fee schedule,,,,,,,,71.4,,,,fee schedule,,,479.4,85,,percent of total billed charges,,141.6,,,,fee schedule,,82.87,,,,fee schedule,,71.4,,,,fee schedule,,137.95,,,,fee schedule,,71.4,,,,fee schedule,,133.63,,,,fee schedule,,80.99,,,,fee schedule,,80.99,,,,fee schedule,,,513.24,91,,percent of total billed charges,,,535.8,95,,percent of total billed charges,,,468.12,83,,percent of total billed charges,,,169.2,83,,percent of total billed charges,,71.4,,,,fee schedule,,71.4,,,,fee schedule,,,468.12,83,,percent of total billed charges,,119.06,,,,fee schedule,,,507.6,90,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,479.4,85,,percent of total billed charges,,71.4,535.8,
"ANOSCOPY, CONTROL BLEEDING",46614,CDM,46614,CPT,,,both,,737,737,110.61,,,,fee schedule,,,,,,,,62,,,,fee schedule,,,626.45,85,,percent of total billed charges,,110.18,,,,fee schedule,,64.48,,,,fee schedule,,62,,,,fee schedule,,202.28,,,,fee schedule,,62,,,,fee schedule,,107.35,,,,fee schedule,,65.06,,,,fee schedule,,65.06,,,,fee schedule,,,670.67,91,,percent of total billed charges,,,700.15,95,,percent of total billed charges,,,611.71,83,,percent of total billed charges,,,221.1,83,,percent of total billed charges,,62,,,,fee schedule,,62,,,,fee schedule,,,611.71,83,,percent of total billed charges,,95.64,,,,fee schedule,,,663.3,90,,percent of total billed charges,,,663.3,90,,percent of total billed charges,,,663.3,90,,percent of total billed charges,,,663.3,90,,percent of total billed charges,,,626.45,85,,percent of total billed charges,,62,700.15,
"DESTRUCTION, ANAL LESION(S)",46900,CDM,46900,CPT,,,both,,501,501,236.19,,,,fee schedule,,,,,,,,62.7,,,,fee schedule,,,425.85,85,,percent of total billed charges,,236.49,,,,fee schedule,,138.41,,,,fee schedule,,62.7,,,,fee schedule,,222.17,,,,fee schedule,,62.7,,,,fee schedule,,229.25,,,,fee schedule,,138.94,,,,fee schedule,,138.94,,,,fee schedule,,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,150.3,83,,percent of total billed charges,,62.7,,,,fee schedule,,62.7,,,,fee schedule,,,415.83,83,,percent of total billed charges,,204.24,,,,fee schedule,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,62.7,475.95,
"DESTRUCTION, ANAL LESION(S)",46910,CDM,46910,CPT,,,both,,888,888,231.59,,,,fee schedule,,,,,,,,108.3,,,,fee schedule,,,754.8,85,,percent of total billed charges,,235.82,,,,fee schedule,,138.01,,,,fee schedule,,108.3,,,,fee schedule,,205.59,,,,fee schedule,,108.3,,,,fee schedule,,224.77,,,,fee schedule,,136.23,,,,fee schedule,,136.23,,,,fee schedule,,,808.08,91,,percent of total billed charges,,,843.6,95,,percent of total billed charges,,,737.04,83,,percent of total billed charges,,,266.4,83,,percent of total billed charges,,108.3,,,,fee schedule,,108.3,,,,fee schedule,,,737.04,83,,percent of total billed charges,,200.25,,,,fee schedule,,,799.2,90,,percent of total billed charges,,,799.2,90,,percent of total billed charges,,,799.2,90,,percent of total billed charges,,,799.2,90,,percent of total billed charges,,,754.8,85,,percent of total billed charges,,108.3,843.6,
"CRYOSURGERY, ANAL LESION(S)",46916,CDM,46916,CPT,,,both,,499,499,243.11,,,,fee schedule,,,,,,,,108.3,,,,fee schedule,,,424.15,85,,percent of total billed charges,,242.3,,,,fee schedule,,141.8,,,,fee schedule,,108.3,,,,fee schedule,,222.84,,,,fee schedule,,108.3,,,,fee schedule,,235.96,,,,fee schedule,,143,,,,fee schedule,,143,,,,fee schedule,,,454.09,91,,percent of total billed charges,,,474.05,95,,percent of total billed charges,,,414.17,83,,percent of total billed charges,,,149.7,83,,percent of total billed charges,,108.3,,,,fee schedule,,108.3,,,,fee schedule,,,414.17,83,,percent of total billed charges,,210.22,,,,fee schedule,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,449.1,90,,percent of total billed charges,,,424.15,85,,percent of total billed charges,,108.3,474.05,
"LASER SURGERY, ANAL LESIONS",46917,CDM,46917,CPT,,,both,,1712,1712,221.79,,,,fee schedule,,,,,,,,108.3,,,,fee schedule,,,1455.2,85,,percent of total billed charges,,222.26,,,,fee schedule,,130.08,,,,fee schedule,,108.3,,,,fee schedule,,211.56,,,,fee schedule,,108.3,,,,fee schedule,,215.27,,,,fee schedule,,130.47,,,,fee schedule,,130.47,,,,fee schedule,,,1557.92,91,,percent of total billed charges,,,1626.4,95,,percent of total billed charges,,,1420.96,83,,percent of total billed charges,,,513.6,83,,percent of total billed charges,,108.3,,,,fee schedule,,108.3,,,,fee schedule,,,1420.96,83,,percent of total billed charges,,191.78,,,,fee schedule,,,1540.8,90,,percent of total billed charges,,,1540.8,90,,percent of total billed charges,,,1540.8,90,,percent of total billed charges,,,1540.8,90,,percent of total billed charges,,,1455.2,85,,percent of total billed charges,,108.3,1626.4,
EXCISION OF ANAL LESION(S),46922,CDM,46922,CPT,,,both,,873,873,237.92,,,,fee schedule,,,,,,,,108.3,,,,fee schedule,,,742.05,85,,percent of total billed charges,,240.17,,,,fee schedule,,140.56,,,,fee schedule,,108.3,,,,fee schedule,,208.25,,,,fee schedule,,108.3,,,,fee schedule,,230.92,,,,fee schedule,,139.95,,,,fee schedule,,139.95,,,,fee schedule,,,794.43,91,,percent of total billed charges,,,829.35,95,,percent of total billed charges,,,724.59,83,,percent of total billed charges,,,261.9,83,,percent of total billed charges,,108.3,,,,fee schedule,,108.3,,,,fee schedule,,,724.59,83,,percent of total billed charges,,205.73,,,,fee schedule,,,785.7,90,,percent of total billed charges,,,785.7,90,,percent of total billed charges,,,785.7,90,,percent of total billed charges,,,785.7,90,,percent of total billed charges,,,742.05,85,,percent of total billed charges,,108.3,829.35,
"DESTRUCTION, ANAL LESION(S)",46924,CDM,46924,CPT,,,both,,1594,1594,310.51,,,,fee schedule,,,,,,,,181,,,,fee schedule,,,1354.9,85,,percent of total billed charges,,314.65,,,,fee schedule,,184.15,,,,fee schedule,,181,,,,fee schedule,,289.82,,,,fee schedule,,181,,,,fee schedule,,301.38,,,,fee schedule,,182.65,,,,fee schedule,,182.65,,,,fee schedule,,,1450.54,91,,percent of total billed charges,,,1514.3,95,,percent of total billed charges,,,1323.02,83,,percent of total billed charges,,,478.2,83,,percent of total billed charges,,181,,,,fee schedule,,181,,,,fee schedule,,,1323.02,83,,percent of total billed charges,,268.5,,,,fee schedule,,,1434.6,90,,percent of total billed charges,,,1434.6,90,,percent of total billed charges,,,1434.6,90,,percent of total billed charges,,,1434.6,90,,percent of total billed charges,,,1354.9,85,,percent of total billed charges,,181,1514.3,
"NEEDLE BIOPSY, LIVER ADD-ON",47001,CDM,47001,CPT,,,both,,553,553,176.86,,,,fee schedule,,,,,,,,65.9,,,,fee schedule,,,470.05,85,,percent of total billed charges,,186.21,,,,fee schedule,,108.98,,,,fee schedule,,65.9,,,,fee schedule,,185.03,,,,fee schedule,,65.9,,,,fee schedule,,171.66,,,,fee schedule,,104.03,,,,fee schedule,,104.03,,,,fee schedule,,,503.23,91,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,165.9,83,,percent of total billed charges,,65.9,,,,fee schedule,,65.9,,,,fee schedule,,,458.99,83,,percent of total billed charges,,152.93,,,,fee schedule,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,65.9,525.35,
WEDGE BIOPSY OF LIVER,47100,CDM,47100,CPT,,,both,,3567,3567,1463.83,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3031.95,85,,percent of total billed charges,,1520.52,,,,fee schedule,,889.88,,,,fee schedule,,480,,,,fee schedule,,1272.03,,,,fee schedule,,480,,,,fee schedule,,1420.77,,,,fee schedule,,861.07,,,,fee schedule,,861.07,,,,fee schedule,,,3245.97,91,,percent of total billed charges,,,3388.65,95,,percent of total billed charges,,,2960.61,83,,percent of total billed charges,,,1070.1,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2960.61,83,,percent of total billed charges,,1265.78,,,,fee schedule,,,3210.3,90,,percent of total billed charges,,,3210.3,90,,percent of total billed charges,,,3210.3,90,,percent of total billed charges,,,3210.3,90,,percent of total billed charges,,,3031.95,85,,percent of total billed charges,,480,3388.65,
"LAPAROSCOPE PROCEDURE, LIVER",47379,CDM,47379,CPT,,,both,,7419,7419,,,,,,,,,,,,,,,,,,,,6306.15,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6751.29,91,,percent of total billed charges,,,7048.05,95,,percent of total billed charges,,,6157.77,83,,percent of total billed charges,,,2225.7,83,,percent of total billed charges,,,,,,,,,,,,,,,6157.77,83,,percent of total billed charges,,,,,,,,,6677.1,90,,percent of total billed charges,,,6677.1,90,,percent of total billed charges,,,6677.1,90,,percent of total billed charges,,,6677.1,90,,percent of total billed charges,,,6306.15,85,,percent of total billed charges,,2225.7,7048.05,
INCISION OF BILE DUCT,47420,CDM,47420,CPT,,,both,,6612,6612,2291.66,,,,fee schedule,,,,,,,,647.9,,,,fee schedule,,,5620.2,85,,percent of total billed charges,,2401.9,,,,fee schedule,,1405.71,,,,fee schedule,,647.9,,,,fee schedule,,2068.54,,,,fee schedule,,647.9,,,,fee schedule,,2224.25,,,,fee schedule,,1348.03,,,,fee schedule,,1348.03,,,,fee schedule,,,6016.92,91,,percent of total billed charges,,,6281.4,95,,percent of total billed charges,,,5487.96,83,,percent of total billed charges,,,1983.6,83,,percent of total billed charges,,647.9,,,,fee schedule,,647.9,,,,fee schedule,,,5487.96,83,,percent of total billed charges,,1981.61,,,,fee schedule,,,5950.8,90,,percent of total billed charges,,,5950.8,90,,percent of total billed charges,,,5950.8,90,,percent of total billed charges,,,5950.8,90,,percent of total billed charges,,,5620.2,85,,percent of total billed charges,,647.9,6281.4,
"INCISION OF GALLBLADDER, OPEN",47480,CDM,47480,CPT,,,both,,4613,4613,1513.37,,,,fee schedule,,,,,,,,647.9,,,,fee schedule,,,3921.05,85,,percent of total billed charges,,1563.58,,,,fee schedule,,915.09,,,,fee schedule,,647.9,,,,fee schedule,,1199.74,,,,fee schedule,,647.9,,,,fee schedule,,1468.86,,,,fee schedule,,890.22,,,,fee schedule,,890.22,,,,fee schedule,,,4197.83,91,,percent of total billed charges,,,4382.35,95,,percent of total billed charges,,,3828.79,83,,percent of total billed charges,,,1383.9,83,,percent of total billed charges,,647.9,,,,fee schedule,,647.9,,,,fee schedule,,,3828.79,83,,percent of total billed charges,,1308.62,,,,fee schedule,,,4151.7,90,,percent of total billed charges,,,4151.7,90,,percent of total billed charges,,,4151.7,90,,percent of total billed charges,,,4151.7,90,,percent of total billed charges,,,3921.05,85,,percent of total billed charges,,647.9,4382.35,
BILE DUCT ENDOSCOPY ADD-ON,47550,CDM,47550,CPT,,,both,,894,894,279.98,,,,fee schedule,,,,,,,,94.3,,,,fee schedule,,,759.9,85,,percent of total billed charges,,297.11,,,,fee schedule,,173.89,,,,fee schedule,,94.3,,,,fee schedule,,293.8,,,,fee schedule,,94.3,,,,fee schedule,,271.74,,,,fee schedule,,164.69,,,,fee schedule,,164.69,,,,fee schedule,,,813.54,91,,percent of total billed charges,,,849.3,95,,percent of total billed charges,,,742.02,83,,percent of total billed charges,,,268.2,83,,percent of total billed charges,,94.3,,,,fee schedule,,94.3,,,,fee schedule,,,742.02,83,,percent of total billed charges,,242.1,,,,fee schedule,,,804.6,90,,percent of total billed charges,,,804.6,90,,percent of total billed charges,,,804.6,90,,percent of total billed charges,,,804.6,90,,percent of total billed charges,,,759.9,85,,percent of total billed charges,,94.3,849.3,
LAPAROSCOPIC CHOLECYSTECTOMY,47562,CDM,47562,CPT,,,both,,4270,4270,1138.34,,,,fee schedule,,,,,,,,647.9,,,,fee schedule,,,3629.5,85,,percent of total billed charges,,1188.06,,,,fee schedule,,695.31,,,,fee schedule,,647.9,,,,fee schedule,,1159.95,,,,fee schedule,,647.9,,,,fee schedule,,1104.86,,,,fee schedule,,669.61,,,,fee schedule,,669.61,,,,fee schedule,,,3885.7,91,,percent of total billed charges,,,4056.5,95,,percent of total billed charges,,,3544.1,83,,percent of total billed charges,,,1281,83,,percent of total billed charges,,647.9,,,,fee schedule,,647.9,,,,fee schedule,,,3544.1,83,,percent of total billed charges,,984.33,,,,fee schedule,,,3843,90,,percent of total billed charges,,,3843,90,,percent of total billed charges,,,3843,90,,percent of total billed charges,,,3843,90,,percent of total billed charges,,,3629.5,85,,percent of total billed charges,,647.9,4056.5,
LAPARO CHOLECYSTECTOMY/GRAPH,47563,CDM,47563,CPT,,,both,,4364,4364,1240.88,,,,fee schedule,,,,,,,,438.49,,,,fee schedule,,,3709.4,85,,percent of total billed charges,,1293.26,,,,fee schedule,,756.88,,,,fee schedule,,438.49,,,,fee schedule,,1244.84,,,,fee schedule,,438.49,,,,fee schedule,,1204.38,,,,fee schedule,,729.93,,,,fee schedule,,729.93,,,,fee schedule,,,3971.24,91,,percent of total billed charges,,,4145.8,95,,percent of total billed charges,,,3622.12,83,,percent of total billed charges,,,1309.2,83,,percent of total billed charges,,438.49,,,,fee schedule,,438.49,,,,fee schedule,,,3622.12,83,,percent of total billed charges,,1073,,,,fee schedule,,,3927.6,90,,percent of total billed charges,,,3927.6,90,,percent of total billed charges,,,3927.6,90,,percent of total billed charges,,,3927.6,90,,percent of total billed charges,,,3709.4,85,,percent of total billed charges,,438.49,4145.8,
REMOVAL OF GALLBLADDER,47600,CDM,47600,CPT,,,both,,5006,5006,1842.31,,,,fee schedule,,,,,,,,647.9,,,,fee schedule,,,4255.1,85,,percent of total billed charges,,1950.82,,,,fee schedule,,1140.34,,,,fee schedule,,647.9,,,,fee schedule,,1422.58,,,,fee schedule,,647.9,,,,fee schedule,,1788.13,,,,fee schedule,,1083.71,,,,fee schedule,,1083.71,,,,fee schedule,,,4555.46,91,,percent of total billed charges,,,4755.7,95,,percent of total billed charges,,,4154.98,83,,percent of total billed charges,,,1501.8,83,,percent of total billed charges,,647.9,,,,fee schedule,,647.9,,,,fee schedule,,,4154.98,83,,percent of total billed charges,,1593.06,,,,fee schedule,,,4505.4,90,,percent of total billed charges,,,4505.4,90,,percent of total billed charges,,,4505.4,90,,percent of total billed charges,,,4505.4,90,,percent of total billed charges,,,4255.1,85,,percent of total billed charges,,647.9,4755.7,
REMOVAL OF GALLBLADDER,47605,CDM,47605,CPT,,,both,,4651,4651,1943.13,,,,fee schedule,,,,,,,,699.2,,,,fee schedule,,,3953.35,85,,percent of total billed charges,,2060.35,,,,fee schedule,,1204.36,,,,fee schedule,,699.2,,,,fee schedule,,1530.68,,,,fee schedule,,699.2,,,,fee schedule,,1885.98,,,,fee schedule,,1143.02,,,,fee schedule,,1143.02,,,,fee schedule,,,4232.41,91,,percent of total billed charges,,,4418.45,95,,percent of total billed charges,,,3860.33,83,,percent of total billed charges,,,1395.3,83,,percent of total billed charges,,699.2,,,,fee schedule,,699.2,,,,fee schedule,,,3860.33,83,,percent of total billed charges,,1680.23,,,,fee schedule,,,4185.9,90,,percent of total billed charges,,,4185.9,90,,percent of total billed charges,,,4185.9,90,,percent of total billed charges,,,4185.9,90,,percent of total billed charges,,,3953.35,85,,percent of total billed charges,,699.2,4418.45,
REMOVAL OF GALLBLADDER,47610,CDM,47610,CPT,,,both,,6273,6273,2156.28,,,,fee schedule,,,,,,,,801.9,,,,fee schedule,,,5332.05,85,,percent of total billed charges,,2295.05,,,,fee schedule,,1341.55,,,,fee schedule,,801.9,,,,fee schedule,,1933.91,,,,fee schedule,,801.9,,,,fee schedule,,2092.86,,,,fee schedule,,1268.4,,,,fee schedule,,1268.4,,,,fee schedule,,,5708.43,91,,percent of total billed charges,,,5959.35,95,,percent of total billed charges,,,5206.59,83,,percent of total billed charges,,,1881.9,83,,percent of total billed charges,,801.9,,,,fee schedule,,801.9,,,,fee schedule,,,5206.59,83,,percent of total billed charges,,1864.54,,,,fee schedule,,,5645.7,90,,percent of total billed charges,,,5645.7,90,,percent of total billed charges,,,5645.7,90,,percent of total billed charges,,,5645.7,90,,percent of total billed charges,,,5332.05,85,,percent of total billed charges,,801.9,5959.35,
DRAINAGE OF ABDOMEN,48000,CDM,48000,CPT,,,both,,173,173,3233.55,,,,fee schedule,,,,,,,,718.7,,,,fee schedule,,,147.05,85,,percent of total billed charges,,3450.22,,,,fee schedule,,2016.8,,,,fee schedule,,718.7,,,,fee schedule,,2844.49,,,,fee schedule,,718.7,,,,fee schedule,,3138.45,,,,fee schedule,,1902.09,,,,fee schedule,,1902.09,,,,fee schedule,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,51.9,83,,percent of total billed charges,,718.7,,,,fee schedule,,718.7,,,,fee schedule,,,143.59,83,,percent of total billed charges,,2796.07,,,,fee schedule,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,51.9,3450.22,
EXPLORATION OF ABDOMEN,49000,CDM,49000,CPT,,,both,,4368,4368,1322.69,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3712.8,85,,percent of total billed charges,,1398.18,,,,fee schedule,,817.3,,,,fee schedule,,480,,,,fee schedule,,1227.59,,,,fee schedule,,480,,,,fee schedule,,1283.78,,,,fee schedule,,778.05,,,,fee schedule,,778.05,,,,fee schedule,,,3974.88,91,,percent of total billed charges,,,4149.6,95,,percent of total billed charges,,,3625.44,83,,percent of total billed charges,,,1310.4,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3625.44,83,,percent of total billed charges,,1143.73,,,,fee schedule,,,3931.2,90,,percent of total billed charges,,,3931.2,90,,percent of total billed charges,,,3931.2,90,,percent of total billed charges,,,3931.2,90,,percent of total billed charges,,,3712.8,85,,percent of total billed charges,,480,4149.6,
REOPENING OF ABDOMEN,49002,CDM,49002,CPT,,,both,,4292,4292,1790.46,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3648.2,85,,percent of total billed charges,,1901.31,,,,fee schedule,,1111.4,,,,fee schedule,,480,,,,fee schedule,,1115.51,,,,fee schedule,,480,,,,fee schedule,,1737.8,,,,fee schedule,,1053.21,,,,fee schedule,,1053.21,,,,fee schedule,,,3905.72,91,,percent of total billed charges,,,4077.4,95,,percent of total billed charges,,,3562.36,83,,percent of total billed charges,,,1287.6,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3562.36,83,,percent of total billed charges,,1548.22,,,,fee schedule,,,3862.8,90,,percent of total billed charges,,,3862.8,90,,percent of total billed charges,,,3862.8,90,,percent of total billed charges,,,3862.8,90,,percent of total billed charges,,,3648.2,85,,percent of total billed charges,,480,4077.4,
DRAIN ABDOMINAL ABSCESS,49020,CDM,49020,CPT,,,both,,6901,6901,2735.24,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,5865.85,85,,percent of total billed charges,,2900.29,,,,fee schedule,,1695.35,,,,fee schedule,,480,,,,fee schedule,,2370.3,,,,fee schedule,,480,,,,fee schedule,,2654.79,,,,fee schedule,,1608.96,,,,fee schedule,,1608.96,,,,fee schedule,,,6279.91,91,,percent of total billed charges,,,6555.95,95,,percent of total billed charges,,,5727.83,83,,percent of total billed charges,,,2070.3,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,5727.83,83,,percent of total billed charges,,2365.18,,,,fee schedule,,,6210.9,90,,percent of total billed charges,,,6210.9,90,,percent of total billed charges,,,6210.9,90,,percent of total billed charges,,,6210.9,90,,percent of total billed charges,,,5865.85,85,,percent of total billed charges,,480,6555.95,
ABDOMINAL PARACENTESIS W/O IMAGING GUIDANCE,49082,CDM,49082,CPT,,,both,,679,679,124.43,,,,fee schedule,,,,,,,,41.32,,,,fee schedule,,,577.15,85,,percent of total billed charges,,130.65,,,,fee schedule,,76.37,,,,fee schedule,,41.32,,,,fee schedule,,,,,,,,41.32,,,,fee schedule,,120.77,,,,fee schedule,,73.2,,,,fee schedule,,73.2,,,,fee schedule,,,617.89,91,,percent of total billed charges,,,645.05,95,,percent of total billed charges,,,563.57,83,,percent of total billed charges,,,203.7,83,,percent of total billed charges,,41.32,,,,fee schedule,,41.32,,,,fee schedule,,,563.57,83,,percent of total billed charges,,107.6,,,,fee schedule,,,611.1,90,,percent of total billed charges,,,611.1,90,,percent of total billed charges,,,611.1,90,,percent of total billed charges,,,611.1,90,,percent of total billed charges,,,577.15,85,,percent of total billed charges,,41.32,645.05,
ABDOMINAL PARACENTESIS W/ IMAGING,49083,CDM,49083,CPT,,,both,,680,680,179.74,,,,fee schedule,,,,,,,,63.95,,,,fee schedule,,,578,85,,percent of total billed charges,,187.33,,,,fee schedule,,109.5,,,,fee schedule,,63.95,,,,fee schedule,,,,,,,,63.95,,,,fee schedule,,174.45,,,,fee schedule,,105.73,,,,fee schedule,,105.73,,,,fee schedule,,,618.8,91,,percent of total billed charges,,,646,95,,percent of total billed charges,,,564.4,83,,percent of total billed charges,,,204,83,,percent of total billed charges,,63.95,,,,fee schedule,,63.95,,,,fee schedule,,,564.4,83,,percent of total billed charges,,155.42,,,,fee schedule,,,612,90,,percent of total billed charges,,,612,90,,percent of total billed charges,,,612,90,,percent of total billed charges,,,612,90,,percent of total billed charges,,,578,85,,percent of total billed charges,,63.95,646,
PERITONEAL LAVAGE,49084,CDM,49084,CPT,,,both,,497,497,183.19,,,,fee schedule,,,,,,,,58.94,,,,fee schedule,,,422.45,85,,percent of total billed charges,,194.5,,,,fee schedule,,113.69,,,,fee schedule,,58.94,,,,fee schedule,,,,,,,,58.94,,,,fee schedule,,177.81,,,,fee schedule,,107.76,,,,fee schedule,,107.76,,,,fee schedule,,,452.27,91,,percent of total billed charges,,,472.15,95,,percent of total billed charges,,,412.51,83,,percent of total billed charges,,,149.1,83,,percent of total billed charges,,58.94,,,,fee schedule,,58.94,,,,fee schedule,,,412.51,83,,percent of total billed charges,,158.41,,,,fee schedule,,,447.3,90,,percent of total billed charges,,,447.3,90,,percent of total billed charges,,,447.3,90,,percent of total billed charges,,,447.3,90,,percent of total billed charges,,,422.45,85,,percent of total billed charges,,58.94,472.15,
EXC ABD TUM 5 CM OR LESS,49203,CDM,49203,CPT,,,both,,5828,5828,2053.73,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,4953.8,85,,percent of total billed charges,,2135.34,,,,fee schedule,,1296.34,,,,fee schedule,,480,,,,fee schedule,,,,,,,,480,,,,fee schedule,,1993.33,,,,fee schedule,,1208.08,,,,fee schedule,,1208.08,,,,fee schedule,,,5303.48,91,,percent of total billed charges,,,5536.6,95,,percent of total billed charges,,,4837.24,83,,percent of total billed charges,,,1748.4,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,4837.24,83,,percent of total billed charges,,1775.88,,,,fee schedule,,,5245.2,90,,percent of total billed charges,,,5245.2,90,,percent of total billed charges,,,5245.2,90,,percent of total billed charges,,,5245.2,90,,percent of total billed charges,,,4953.8,85,,percent of total billed charges,,480,5536.6,
REMOVAL OF OMENTUM,49255,CDM,49255,CPT,,,both,,3692,3692,1364.74,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3138.2,85,,percent of total billed charges,,1405.91,,,,fee schedule,,853.51,,,,fee schedule,,599.35,,,,fee schedule,,1201.73,,,,fee schedule,,599.35,,,,fee schedule,,1324.6,,,,fee schedule,,802.79,,,,fee schedule,,802.79,,,,fee schedule,,,3359.72,91,,percent of total billed charges,,,3507.4,95,,percent of total billed charges,,,3064.36,83,,percent of total billed charges,,,1107.6,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3064.36,83,,percent of total billed charges,,1180.1,,,,fee schedule,,,3322.8,90,,percent of total billed charges,,,3322.8,90,,percent of total billed charges,,,3322.8,90,,percent of total billed charges,,,3322.8,90,,percent of total billed charges,,,3138.2,85,,percent of total billed charges,,599.35,3507.4,
DIAG LAP SEPARATE PROC,49320,CDM,49320,CPT,,,both,,2627,2627,566.87,,,,fee schedule,,,,,,,,302.4,,,,fee schedule,,,2232.95,85,,percent of total billed charges,,585.55,,,,fee schedule,,355.48,,,,fee schedule,,302.4,,,,fee schedule,,553.78,,,,fee schedule,,302.4,,,,fee schedule,,550.19,,,,fee schedule,,333.45,,,,fee schedule,,333.45,,,,fee schedule,,,2390.57,91,,percent of total billed charges,,,2495.65,95,,percent of total billed charges,,,2180.41,83,,percent of total billed charges,,,788.1,83,,percent of total billed charges,,302.4,,,,fee schedule,,302.4,,,,fee schedule,,,2180.41,83,,percent of total billed charges,,490.17,,,,fee schedule,,,2364.3,90,,percent of total billed charges,,,2364.3,90,,percent of total billed charges,,,2364.3,90,,percent of total billed charges,,,2364.3,90,,percent of total billed charges,,,2232.95,85,,percent of total billed charges,,302.4,2495.65,
"LAPAROSCOPY, BIOPSY",49321,CDM,49321,CPT,,,both,,2043,2043,593.94,,,,fee schedule,,,,,,,,302.4,,,,fee schedule,,,1736.55,85,,percent of total billed charges,,613.35,,,,fee schedule,,372.36,,,,fee schedule,,302.4,,,,fee schedule,,578.32,,,,fee schedule,,302.4,,,,fee schedule,,576.47,,,,fee schedule,,349.38,,,,fee schedule,,349.38,,,,fee schedule,,,1859.13,91,,percent of total billed charges,,,1940.85,95,,percent of total billed charges,,,1695.69,83,,percent of total billed charges,,,612.9,83,,percent of total billed charges,,302.4,,,,fee schedule,,302.4,,,,fee schedule,,,1695.69,83,,percent of total billed charges,,513.58,,,,fee schedule,,,1838.7,90,,percent of total billed charges,,,1838.7,90,,percent of total billed charges,,,1838.7,90,,percent of total billed charges,,,1838.7,90,,percent of total billed charges,,,1736.55,85,,percent of total billed charges,,302.4,1940.85,
"LAPAROSCOPY, ASPIRATION",49322,CDM,49322,CPT,,,both,,2203,2203,646.94,,,,fee schedule,,,,,,,,302.4,,,,fee schedule,,,1872.55,85,,percent of total billed charges,,669.8,,,,fee schedule,,406.63,,,,fee schedule,,302.4,,,,fee schedule,,622.75,,,,fee schedule,,302.4,,,,fee schedule,,627.91,,,,fee schedule,,380.55,,,,fee schedule,,380.55,,,,fee schedule,,,2004.73,91,,percent of total billed charges,,,2092.85,95,,percent of total billed charges,,,1828.49,83,,percent of total billed charges,,,660.9,83,,percent of total billed charges,,302.4,,,,fee schedule,,302.4,,,,fee schedule,,,1828.49,83,,percent of total billed charges,,559.41,,,,fee schedule,,,1982.7,90,,percent of total billed charges,,,1982.7,90,,percent of total billed charges,,,1982.7,90,,percent of total billed charges,,,1982.7,90,,percent of total billed charges,,,1872.55,85,,percent of total billed charges,,302.4,2092.85,
Ing Wound Exploration,49402,CDM,49402,CPT,,,both,,3889,3889,1470.16,,,,fee schedule,,,,,,,,406.05,,,,fee schedule,,,3305.65,85,,percent of total billed charges,,1529.96,,,,fee schedule,,928.82,,,,fee schedule,,406.05,,,,fee schedule,,,,,,,,406.05,,,,fee schedule,,1426.92,,,,fee schedule,,864.8,,,,fee schedule,,864.8,,,,fee schedule,,,3538.99,91,,percent of total billed charges,,,3694.55,95,,percent of total billed charges,,,3227.87,83,,percent of total billed charges,,,1166.7,83,,percent of total billed charges,,406.05,,,,fee schedule,,406.05,,,,fee schedule,,,3227.87,83,,percent of total billed charges,,1271.26,,,,fee schedule,,,3500.1,90,,percent of total billed charges,,,3500.1,90,,percent of total billed charges,,,3500.1,90,,percent of total billed charges,,,3500.1,90,,percent of total billed charges,,,3305.65,85,,percent of total billed charges,,406.05,3694.55,
INSERT TUN IP CATH PERC,49418,CDM,49418,CPT,,,both,,3158,3158,339.31,,,,fee schedule,,,,,,,,141.89,,,,fee schedule,,,2684.3,85,,percent of total billed charges,,349.64,,,,fee schedule,,212.27,,,,fee schedule,,141.89,,,,fee schedule,,,,,,,,141.89,,,,fee schedule,,329.33,,,,fee schedule,,199.6,,,,fee schedule,,199.6,,,,fee schedule,,,2873.78,91,,percent of total billed charges,,,3000.1,95,,percent of total billed charges,,,2621.14,83,,percent of total billed charges,,,947.4,83,,percent of total billed charges,,141.89,,,,fee schedule,,141.89,,,,fee schedule,,,2621.14,83,,percent of total billed charges,,293.41,,,,fee schedule,,,2842.2,90,,percent of total billed charges,,,2842.2,90,,percent of total billed charges,,,2842.2,90,,percent of total billed charges,,,2842.2,90,,percent of total billed charges,,,2684.3,85,,percent of total billed charges,,141.89,3000.1,
REMOVAL TUNNELED CATHETER,49422,CDM,49422,CPT,,,both,,1843,1843,377.33,,,,fee schedule,,,,,,,,240,,,,fee schedule,,,1566.55,85,,percent of total billed charges,,398.3,,,,fee schedule,,241.8,,,,fee schedule,,240,,,,fee schedule,,657.9,,,,fee schedule,,240,,,,fee schedule,,366.24,,,,fee schedule,,221.96,,,,fee schedule,,221.96,,,,fee schedule,,,1677.13,91,,percent of total billed charges,,,1750.85,95,,percent of total billed charges,,,1529.69,83,,percent of total billed charges,,,552.9,83,,percent of total billed charges,,240,,,,fee schedule,,240,,,,fee schedule,,,1529.69,83,,percent of total billed charges,,326.28,,,,fee schedule,,,1658.7,90,,percent of total billed charges,,,1658.7,90,,percent of total billed charges,,,1658.7,90,,percent of total billed charges,,,1658.7,90,,percent of total billed charges,,,1566.55,85,,percent of total billed charges,,221.96,1750.85,
PLACE GASTROSTOMY TUBE PERC,49440,CDM,49440,CPT,,,both,,1798,1798,342.77,,,,fee schedule,,,,,,,,133.76,,,,fee schedule,,,1528.3,85,,percent of total billed charges,,352.07,,,,fee schedule,,213.74,,,,fee schedule,,133.76,,,,fee schedule,,,,,,,,133.76,,,,fee schedule,,332.69,,,,fee schedule,,201.63,,,,fee schedule,,201.63,,,,fee schedule,,,1636.18,91,,percent of total billed charges,,,1708.1,95,,percent of total billed charges,,,1492.34,83,,percent of total billed charges,,,539.4,83,,percent of total billed charges,,133.76,,,,fee schedule,,133.76,,,,fee schedule,,,1492.34,83,,percent of total billed charges,,296.39,,,,fee schedule,,,1618.2,90,,percent of total billed charges,,,1618.2,90,,percent of total billed charges,,,1618.2,90,,percent of total billed charges,,,1618.2,90,,percent of total billed charges,,,1528.3,85,,percent of total billed charges,,133.76,1708.1,
PLACE CECOSTOMY TUBE PERC,49442,CDM,49442,CPT,,,both,,1843,1843,348.53,,,,fee schedule,,,,,,,,119.66,,,,fee schedule,,,1566.55,85,,percent of total billed charges,,354.77,,,,fee schedule,,215.38,,,,fee schedule,,119.66,,,,fee schedule,,,,,,,,119.66,,,,fee schedule,,338.28,,,,fee schedule,,205.02,,,,fee schedule,,205.02,,,,fee schedule,,,1677.13,91,,percent of total billed charges,,,1750.85,95,,percent of total billed charges,,,1529.69,83,,percent of total billed charges,,,552.9,83,,percent of total billed charges,,119.66,,,,fee schedule,,119.66,,,,fee schedule,,,1529.69,83,,percent of total billed charges,,301.38,,,,fee schedule,,,1658.7,90,,percent of total billed charges,,,1658.7,90,,percent of total billed charges,,,1658.7,90,,percent of total billed charges,,,1658.7,90,,percent of total billed charges,,,1566.55,85,,percent of total billed charges,,119.66,1750.85,
"RPR ING HERNIA, INIT, REDUCE",49500,CDM,49500,CPT,,,both,,2766,2766,721.83,,,,fee schedule,,,,,,,,362,,,,fee schedule,,,2351.1,85,,percent of total billed charges,,740.45,,,,fee schedule,,449.52,,,,fee schedule,,362,,,,fee schedule,,616.12,,,,fee schedule,,362,,,,fee schedule,,700.6,,,,fee schedule,,424.61,,,,fee schedule,,424.61,,,,fee schedule,,,2517.06,91,,percent of total billed charges,,,2627.7,95,,percent of total billed charges,,,2295.78,83,,percent of total billed charges,,,829.8,83,,percent of total billed charges,,362,,,,fee schedule,,362,,,,fee schedule,,,2295.78,83,,percent of total billed charges,,624.17,,,,fee schedule,,,2489.4,90,,percent of total billed charges,,,2489.4,90,,percent of total billed charges,,,2489.4,90,,percent of total billed charges,,,2489.4,90,,percent of total billed charges,,,2351.1,85,,percent of total billed charges,,362,2627.7,
"RPR ING HERNIA, INIT BLOCKED",49501,CDM,49501,CPT,,,both,,2817,2817,1050.2,,,,fee schedule,,,,,,,,387.05,,,,fee schedule,,,2394.45,85,,percent of total billed charges,,1089.14,,,,fee schedule,,661.2,,,,fee schedule,,387.05,,,,fee schedule,,938.44,,,,fee schedule,,387.05,,,,fee schedule,,1019.31,,,,fee schedule,,617.76,,,,fee schedule,,617.76,,,,fee schedule,,,2563.47,91,,percent of total billed charges,,,2676.15,95,,percent of total billed charges,,,2338.11,83,,percent of total billed charges,,,845.1,83,,percent of total billed charges,,387.05,,,,fee schedule,,387.05,,,,fee schedule,,,2338.11,83,,percent of total billed charges,,908.11,,,,fee schedule,,,2535.3,90,,percent of total billed charges,,,2535.3,90,,percent of total billed charges,,,2535.3,90,,percent of total billed charges,,,2535.3,90,,percent of total billed charges,,,2394.45,85,,percent of total billed charges,,387.05,2676.15,
PRP I/HERN INIT REDUC >5 YR,49505,CDM,49505,CPT,,,both,,3120,3120,905.03,,,,fee schedule,,,,,,,,387.05,,,,fee schedule,,,2652,85,,percent of total billed charges,,936.76,,,,fee schedule,,568.7,,,,fee schedule,,387.05,,,,fee schedule,,818.4,,,,fee schedule,,387.05,,,,fee schedule,,878.41,,,,fee schedule,,532.37,,,,fee schedule,,532.37,,,,fee schedule,,,2839.2,91,,percent of total billed charges,,,2964,95,,percent of total billed charges,,,2589.6,83,,percent of total billed charges,,,936,83,,percent of total billed charges,,387.05,,,,fee schedule,,387.05,,,,fee schedule,,,2589.6,83,,percent of total billed charges,,782.58,,,,fee schedule,,,2808,90,,percent of total billed charges,,,2808,90,,percent of total billed charges,,,2808,90,,percent of total billed charges,,,2808,90,,percent of total billed charges,,,2652,85,,percent of total billed charges,,387.05,2964,
PRP I/HERN INIT BLOCK >5 YR,49507,CDM,49507,CPT,,,both,,3214,3214,1017.36,,,,fee schedule,,,,,,,,387.05,,,,fee schedule,,,2731.9,85,,percent of total billed charges,,1052.55,,,,fee schedule,,638.99,,,,fee schedule,,387.05,,,,fee schedule,,1012.05,,,,fee schedule,,387.05,,,,fee schedule,,987.44,,,,fee schedule,,598.45,,,,fee schedule,,598.45,,,,fee schedule,,,2924.74,91,,percent of total billed charges,,,3053.3,95,,percent of total billed charges,,,2667.62,83,,percent of total billed charges,,,964.2,83,,percent of total billed charges,,387.05,,,,fee schedule,,387.05,,,,fee schedule,,,2667.62,83,,percent of total billed charges,,879.72,,,,fee schedule,,,2892.6,90,,percent of total billed charges,,,2892.6,90,,percent of total billed charges,,,2892.6,90,,percent of total billed charges,,,2892.6,90,,percent of total billed charges,,,2731.9,85,,percent of total billed charges,,387.05,3053.3,
"REREPAIR ING HERNIA, REDUCE",49520,CDM,49520,CPT,,,both,,3612,3612,1094.56,,,,fee schedule,,,,,,,,409.2,,,,fee schedule,,,3070.2,85,,percent of total billed charges,,1138.1,,,,fee schedule,,690.93,,,,fee schedule,,409.2,,,,fee schedule,,1016.03,,,,fee schedule,,409.2,,,,fee schedule,,1062.36,,,,fee schedule,,643.86,,,,fee schedule,,643.86,,,,fee schedule,,,3286.92,91,,percent of total billed charges,,,3431.4,95,,percent of total billed charges,,,2997.96,83,,percent of total billed charges,,,1083.6,83,,percent of total billed charges,,409.2,,,,fee schedule,,409.2,,,,fee schedule,,,2997.96,83,,percent of total billed charges,,946.47,,,,fee schedule,,,3250.8,90,,percent of total billed charges,,,3250.8,90,,percent of total billed charges,,,3250.8,90,,percent of total billed charges,,,3250.8,90,,percent of total billed charges,,,3070.2,85,,percent of total billed charges,,409.2,3431.4,
"REREPAIR ING HERNIA, BLOCKED",49521,CDM,49521,CPT,,,both,,3665,3665,1238.58,,,,fee schedule,,,,,,,,387.05,,,,fee schedule,,,3115.25,85,,percent of total billed charges,,1287.16,,,,fee schedule,,781.42,,,,fee schedule,,387.05,,,,fee schedule,,1242.85,,,,fee schedule,,387.05,,,,fee schedule,,1202.15,,,,fee schedule,,728.57,,,,fee schedule,,728.57,,,,fee schedule,,,3335.15,91,,percent of total billed charges,,,3481.75,95,,percent of total billed charges,,,3041.95,83,,percent of total billed charges,,,1099.5,83,,percent of total billed charges,,387.05,,,,fee schedule,,387.05,,,,fee schedule,,,3041.95,83,,percent of total billed charges,,1071,,,,fee schedule,,,3298.5,90,,percent of total billed charges,,,3298.5,90,,percent of total billed charges,,,3298.5,90,,percent of total billed charges,,,3298.5,90,,percent of total billed charges,,,3115.25,85,,percent of total billed charges,,387.05,3481.75,
"RPR REM HERNIA, INIT, REDUCE",49550,CDM,49550,CPT,,,both,,2579,2579,1000.08,,,,fee schedule,,,,,,,,409.2,,,,fee schedule,,,2192.15,85,,percent of total billed charges,,1033.91,,,,fee schedule,,627.68,,,,fee schedule,,409.2,,,,fee schedule,,919.87,,,,fee schedule,,409.2,,,,fee schedule,,970.66,,,,fee schedule,,588.28,,,,fee schedule,,588.28,,,,fee schedule,,,2346.89,91,,percent of total billed charges,,,2450.05,95,,percent of total billed charges,,,2140.57,83,,percent of total billed charges,,,773.7,83,,percent of total billed charges,,409.2,,,,fee schedule,,409.2,,,,fee schedule,,,2140.57,83,,percent of total billed charges,,864.77,,,,fee schedule,,,2321.1,90,,percent of total billed charges,,,2321.1,90,,percent of total billed charges,,,2321.1,90,,percent of total billed charges,,,2321.1,90,,percent of total billed charges,,,2192.15,85,,percent of total billed charges,,409.2,2450.05,
"RPR FEM HERNIA, INIT BLOCKED",49553,CDM,49553,CPT,,,both,,3067,3067,1094.56,,,,fee schedule,,,,,,,,409.2,,,,fee schedule,,,2606.95,85,,percent of total billed charges,,1135.97,,,,fee schedule,,689.64,,,,fee schedule,,409.2,,,,fee schedule,,999.45,,,,fee schedule,,409.2,,,,fee schedule,,1062.36,,,,fee schedule,,643.86,,,,fee schedule,,643.86,,,,fee schedule,,,2790.97,91,,percent of total billed charges,,,2913.65,95,,percent of total billed charges,,,2545.61,83,,percent of total billed charges,,,920.1,83,,percent of total billed charges,,409.2,,,,fee schedule,,409.2,,,,fee schedule,,,2545.61,83,,percent of total billed charges,,946.47,,,,fee schedule,,,2760.3,90,,percent of total billed charges,,,2760.3,90,,percent of total billed charges,,,2760.3,90,,percent of total billed charges,,,2760.3,90,,percent of total billed charges,,,2606.95,85,,percent of total billed charges,,409.2,2913.65,
"RPR VENTRAL HERN INIT, REDUC",49560,CDM,49560,CPT,,,both,,3586,3586,,,,,,,,,,,,,,,,,,,,3048.1,85,,percent of total billed charges,,1324.61,,,,fee schedule,,804.16,,,,fee schedule,,,,,,,,1206.37,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,3263.26,91,,percent of total billed charges,,,3406.7,95,,percent of total billed charges,,,2976.38,83,,percent of total billed charges,,,1075.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2976.38,83,,percent of total billed charges,,,,,,,,,3227.4,90,,percent of total billed charges,,,3227.4,90,,percent of total billed charges,,,3227.4,90,,percent of total billed charges,,,3227.4,90,,percent of total billed charges,,,3048.1,85,,percent of total billed charges,,804.16,3406.7,
"RPR VENTRAL HERN INIT, BLOCK",49561,CDM,49561,CPT,,,both,,4355,4355,,,,,,,,,,,,,,,,,,,,3701.75,85,,percent of total billed charges,,1670.45,,,,fee schedule,,1014.11,,,,fee schedule,,,,,,,,1467.68,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,3963.05,91,,percent of total billed charges,,,4137.25,95,,percent of total billed charges,,,3614.65,83,,percent of total billed charges,,,1306.5,83,,percent of total billed charges,,,,,,,,,,,,,,,3614.65,83,,percent of total billed charges,,,,,,,,,3919.5,90,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3919.5,90,,percent of total billed charges,,,3701.75,85,,percent of total billed charges,,1014.11,4137.25,
"REREPAIR VENTRL HERN, REDUCE",49565,CDM,49565,CPT,,,both,,3722,3722,,,,,,,,,,,,,,,,,,,,3163.7,85,,percent of total billed charges,,1378.18,,,,fee schedule,,836.68,,,,fee schedule,,,,,,,,1211.68,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,3387.02,91,,percent of total billed charges,,,3535.9,95,,percent of total billed charges,,,3089.26,83,,percent of total billed charges,,,1116.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3089.26,83,,percent of total billed charges,,,,,,,,,3349.8,90,,percent of total billed charges,,,3349.8,90,,percent of total billed charges,,,3349.8,90,,percent of total billed charges,,,3349.8,90,,percent of total billed charges,,,3163.7,85,,percent of total billed charges,,836.68,3535.9,
"REREPAIR VENTRL HERN, BLOCK",49566,CDM,49566,CPT,,,both,,4602,4602,,,,,,,,,,,,,,,,,,,,3911.7,85,,percent of total billed charges,,1684.79,,,,fee schedule,,1022.82,,,,fee schedule,,,,,,,,1483.59,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,4187.82,91,,percent of total billed charges,,,4371.9,95,,percent of total billed charges,,,3819.66,83,,percent of total billed charges,,,1380.6,83,,percent of total billed charges,,,,,,,,,,,,,,,3819.66,83,,percent of total billed charges,,,,,,,,,4141.8,90,,percent of total billed charges,,,4141.8,90,,percent of total billed charges,,,4141.8,90,,percent of total billed charges,,,4141.8,90,,percent of total billed charges,,,3911.7,85,,percent of total billed charges,,1022.82,4371.9,
HERNIA REPAIR W/MESH,49568,CDM,49568,CPT,,,both,,1349,1349,,,,,,,,,,,,,,,,,,,,1146.65,85,,percent of total billed charges,,479.56,,,,fee schedule,,291.14,,,,fee schedule,,,,,,,,476.85,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,1227.59,91,,percent of total billed charges,,,1281.55,95,,percent of total billed charges,,,1119.67,83,,percent of total billed charges,,,404.7,83,,percent of total billed charges,,,,,,,,,,,,,,,1119.67,83,,percent of total billed charges,,,,,,,,,1214.1,90,,percent of total billed charges,,,1214.1,90,,percent of total billed charges,,,1214.1,90,,percent of total billed charges,,,1214.1,90,,percent of total billed charges,,,1146.65,85,,percent of total billed charges,,291.14,1281.55,
"RPR EPIGASTRIC HERN, REDUCE",49570,CDM,49570,CPT,,,both,,2033,2033,,,,,,,,,,,,,,,,,,,,1728.05,85,,percent of total billed charges,,748.5,,,,fee schedule,,454.41,,,,fee schedule,,,,,,,,635.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,1850.03,91,,percent of total billed charges,,,1931.35,95,,percent of total billed charges,,,1687.39,83,,percent of total billed charges,,,609.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1687.39,83,,percent of total billed charges,,,,,,,,,1829.7,90,,percent of total billed charges,,,1829.7,90,,percent of total billed charges,,,1829.7,90,,percent of total billed charges,,,1829.7,90,,percent of total billed charges,,,1728.05,85,,percent of total billed charges,,454.41,1931.35,
"RPR EPIGASTRIC HERN, BLOCKED",49572,CDM,49572,CPT,,,both,,2601,2601,,,,,,,,,,,,,,,,,,,,2210.85,85,,percent of total billed charges,,930.45,,,,fee schedule,,564.87,,,,fee schedule,,,,,,,,733.51,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,2366.91,91,,percent of total billed charges,,,2470.95,95,,percent of total billed charges,,,2158.83,83,,percent of total billed charges,,,780.3,83,,percent of total billed charges,,,,,,,,,,,,,,,2158.83,83,,percent of total billed charges,,,,,,,,,2340.9,90,,percent of total billed charges,,,2340.9,90,,percent of total billed charges,,,2340.9,90,,percent of total billed charges,,,2340.9,90,,percent of total billed charges,,,2210.85,85,,percent of total billed charges,,564.87,2470.95,
"RPR UMBIL HERN, REDUC < 5 YR",49580,CDM,49580,CPT,,,both,,2381,2381,,,,,,,,,,,,,,,,,,,,2023.85,85,,percent of total billed charges,,598.47,,,,fee schedule,,363.33,,,,fee schedule,,,,,,,,476.85,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,2166.71,91,,percent of total billed charges,,,2261.95,95,,percent of total billed charges,,,1976.23,83,,percent of total billed charges,,,714.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1976.23,83,,percent of total billed charges,,,,,,,,,2142.9,90,,percent of total billed charges,,,2142.9,90,,percent of total billed charges,,,2142.9,90,,percent of total billed charges,,,2142.9,90,,percent of total billed charges,,,2023.85,85,,percent of total billed charges,,363.33,2261.95,
"RPR UMBIL HERN, REDUC > 5 YR",49585,CDM,49585,CPT,,,both,,2996,2996,,,,,,,,,,,,,,,,,,,,2546.6,85,,percent of total billed charges,,799.74,,,,fee schedule,,485.51,,,,fee schedule,,,,,,,,684.43,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,2726.36,91,,percent of total billed charges,,,2846.2,95,,percent of total billed charges,,,2486.68,83,,percent of total billed charges,,,898.8,83,,percent of total billed charges,,,,,,,,,,,,,,,2486.68,83,,percent of total billed charges,,,,,,,,,2696.4,90,,percent of total billed charges,,,2696.4,90,,percent of total billed charges,,,2696.4,90,,percent of total billed charges,,,2696.4,90,,percent of total billed charges,,,2546.6,85,,percent of total billed charges,,485.51,2846.2,
"RPR UMBIL HERN, BLOCK > 5 YR",49587,CDM,49587,CPT,,,both,,3008,3008,,,,,,,,,,,,,,,,,,,,2556.8,85,,percent of total billed charges,,854.23,,,,fee schedule,,518.6,,,,fee schedule,,,,,,,,813.09,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,2737.28,91,,percent of total billed charges,,,2857.6,95,,percent of total billed charges,,,2496.64,83,,percent of total billed charges,,,902.4,83,,percent of total billed charges,,,,,,,,,,,,,,,2496.64,83,,percent of total billed charges,,,,,,,,,2707.2,90,,percent of total billed charges,,,2707.2,90,,percent of total billed charges,,,2707.2,90,,percent of total billed charges,,,2707.2,90,,percent of total billed charges,,,2556.8,85,,percent of total billed charges,,518.6,2857.6,
RPR AA HRN 1ST < 3 CM RDC,49591,CDM,49591,CPT,,,both,,1405,1405,587.6,,,,fee schedule,,,,,,,,210.71,,,,fee schedule,,,1194.25,85,,percent of total billed charges,,,,,,,,,,,,,,210.71,,,,fee schedule,,,,,,,,210.71,,,,fee schedule,,570.32,,,,fee schedule,,345.65,,,,fee schedule,,345.65,,,,fee schedule,,,1278.55,91,,percent of total billed charges,,,1334.75,95,,percent of total billed charges,,,1166.15,83,,percent of total billed charges,,,421.5,83,,percent of total billed charges,,210.71,,,,fee schedule,,210.71,,,,fee schedule,,,1166.15,83,,percent of total billed charges,,508.1,,,,fee schedule,,,1264.5,90,,percent of total billed charges,,,1264.5,90,,percent of total billed charges,,,1264.5,90,,percent of total billed charges,,,1264.5,90,,percent of total billed charges,,,1194.25,85,,percent of total billed charges,,210.71,1334.75,
LAPARO HERNIA REPAIR INITIAL,49650,CDM,49650,CPT,,,both,,2481,2481,748.91,,,,fee schedule,,,,,,,,387.05,,,,fee schedule,,,2108.85,85,,percent of total billed charges,,772.37,,,,fee schedule,,468.9,,,,fee schedule,,387.05,,,,fee schedule,,687.74,,,,fee schedule,,387.05,,,,fee schedule,,726.88,,,,fee schedule,,440.53,,,,fee schedule,,440.53,,,,fee schedule,,,2257.71,91,,percent of total billed charges,,,2356.95,95,,percent of total billed charges,,,2059.23,83,,percent of total billed charges,,,744.3,83,,percent of total billed charges,,387.05,,,,fee schedule,,387.05,,,,fee schedule,,,2059.23,83,,percent of total billed charges,,647.58,,,,fee schedule,,,2232.9,90,,percent of total billed charges,,,2232.9,90,,percent of total billed charges,,,2232.9,90,,percent of total billed charges,,,2232.9,90,,percent of total billed charges,,,2108.85,85,,percent of total billed charges,,387.05,2356.95,
LAPARO HERNIA REPAIR RECUR,49651,CDM,49651,CPT,,,both,,3084,3084,978.19,,,,fee schedule,,,,,,,,409.2,,,,fee schedule,,,2621.4,85,,percent of total billed charges,,1009.44,,,,fee schedule,,612.82,,,,fee schedule,,409.2,,,,fee schedule,,888.7,,,,fee schedule,,409.2,,,,fee schedule,,949.42,,,,fee schedule,,575.4,,,,fee schedule,,575.4,,,,fee schedule,,,2806.44,91,,percent of total billed charges,,,2929.8,95,,percent of total billed charges,,,2559.72,83,,percent of total billed charges,,,925.2,83,,percent of total billed charges,,409.2,,,,fee schedule,,409.2,,,,fee schedule,,,2559.72,83,,percent of total billed charges,,845.84,,,,fee schedule,,,2775.6,90,,percent of total billed charges,,,2775.6,90,,percent of total billed charges,,,2775.6,90,,percent of total billed charges,,,2775.6,90,,percent of total billed charges,,,2621.4,85,,percent of total billed charges,,409.2,2929.8,
LAP VENT/ABD HERNIA REPAIR,49652,CDM,49652,CPT,,,both,,1675,1675,,,,,,,,,,,,,,,,,,,,1423.75,85,,percent of total billed charges,,1335.89,,,,fee schedule,,811,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1524.25,91,,percent of total billed charges,,,1591.25,95,,percent of total billed charges,,,1390.25,83,,percent of total billed charges,,,502.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1390.25,83,,percent of total billed charges,,,,,,,,,1507.5,90,,percent of total billed charges,,,1507.5,90,,percent of total billed charges,,,1507.5,90,,percent of total billed charges,,,1507.5,90,,percent of total billed charges,,,1423.75,85,,percent of total billed charges,,502.5,1591.25,
LAP VENT/ABD HERN PROC COMP,49653,CDM,49653,CPT,,,both,,5017,5017,,,,,,,,,,,,,,,,,,,,4264.45,85,,percent of total billed charges,,1674.07,,,,fee schedule,,1016.31,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4565.47,91,,percent of total billed charges,,,4766.15,95,,percent of total billed charges,,,4164.11,83,,percent of total billed charges,,,1505.1,83,,percent of total billed charges,,,,,,,,,,,,,,,4164.11,83,,percent of total billed charges,,,,,,,,,4515.3,90,,percent of total billed charges,,,4515.3,90,,percent of total billed charges,,,4515.3,90,,percent of total billed charges,,,4515.3,90,,percent of total billed charges,,,4264.45,85,,percent of total billed charges,,1016.31,4766.15,
LAP INC HERNIA REPAIR,49654,CDM,49654,CPT,,,both,,1912,1912,,,,,,,,,,,,,,,,,,,,1625.2,85,,percent of total billed charges,,1517.46,,,,fee schedule,,921.23,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1739.92,91,,percent of total billed charges,,,1816.4,95,,percent of total billed charges,,,1586.96,83,,percent of total billed charges,,,573.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1586.96,83,,percent of total billed charges,,,,,,,,,1720.8,90,,percent of total billed charges,,,1720.8,90,,percent of total billed charges,,,1720.8,90,,percent of total billed charges,,,1720.8,90,,percent of total billed charges,,,1625.2,85,,percent of total billed charges,,573.6,1816.4,
LAP INC HERN REPAIR COMP,49655,CDM,49655,CPT,,,both,,2351,2351,,,,,,,,,,,,,,,,,,,,1998.35,85,,percent of total billed charges,,1859.97,,,,fee schedule,,1129.17,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2139.41,91,,percent of total billed charges,,,2233.45,95,,percent of total billed charges,,,1951.33,83,,percent of total billed charges,,,705.3,83,,percent of total billed charges,,,,,,,,,,,,,,,1951.33,83,,percent of total billed charges,,,,,,,,,2115.9,90,,percent of total billed charges,,,2115.9,90,,percent of total billed charges,,,2115.9,90,,percent of total billed charges,,,2115.9,90,,percent of total billed charges,,,1998.35,85,,percent of total billed charges,,705.3,2233.45,
LAP INC HERNIA REPAIR RECUR,49656,CDM,49656,CPT,,,both,,3005,3005,,,,,,,,,,,,,,,,,,,,2554.25,85,,percent of total billed charges,,1650.2,,,,fee schedule,,1001.82,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2734.55,91,,percent of total billed charges,,,2854.75,95,,percent of total billed charges,,,2494.15,83,,percent of total billed charges,,,901.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2494.15,83,,percent of total billed charges,,,,,,,,,2704.5,90,,percent of total billed charges,,,2704.5,90,,percent of total billed charges,,,2704.5,90,,percent of total billed charges,,,2704.5,90,,percent of total billed charges,,,2554.25,85,,percent of total billed charges,,901.5,2854.75,
LAP INC HERN RECUR COMP,49657,CDM,49657,CPT,,,both,,6006,6006,,,,,,,,,,,,,,,,,,,,5105.1,85,,percent of total billed charges,,2372.81,,,,fee schedule,,1440.51,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5465.46,91,,percent of total billed charges,,,5705.7,95,,percent of total billed charges,,,4984.98,83,,percent of total billed charges,,,1801.8,83,,percent of total billed charges,,,,,,,,,,,,,,,4984.98,83,,percent of total billed charges,,,,,,,,,5405.4,90,,percent of total billed charges,,,5405.4,90,,percent of total billed charges,,,5405.4,90,,percent of total billed charges,,,5405.4,90,,percent of total billed charges,,,5105.1,85,,percent of total billed charges,,1440.51,5705.7,
"LAPARO PROC, HERNIA REPAIR",49659,CDM,49659,CPT,,,both,,2128,2128,,,,,,,,,,,,,,,,,,,,1808.8,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1936.48,91,,percent of total billed charges,,,2021.6,95,,percent of total billed charges,,,1766.24,83,,percent of total billed charges,,,638.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1766.24,83,,percent of total billed charges,,,,,,,,,1915.2,90,,percent of total billed charges,,,1915.2,90,,percent of total billed charges,,,1915.2,90,,percent of total billed charges,,,1915.2,90,,percent of total billed charges,,,1808.8,85,,percent of total billed charges,,638.4,2021.6,
REPAIR OF ABDOMINAL WALL,49900,CDM,49900,CPT,,,both,,3794,3794,1415.43,,,,fee schedule,,,,,,,,307.05,,,,fee schedule,,,3224.9,85,,percent of total billed charges,,1462.27,,,,fee schedule,,887.73,,,,fee schedule,,307.05,,,,fee schedule,,1328.4,,,,fee schedule,,307.05,,,,fee schedule,,1373.8,,,,fee schedule,,832.61,,,,fee schedule,,832.61,,,,fee schedule,,,3452.54,91,,percent of total billed charges,,,3604.3,95,,percent of total billed charges,,,3149.02,83,,percent of total billed charges,,,1138.2,83,,percent of total billed charges,,307.05,,,,fee schedule,,307.05,,,,fee schedule,,,3149.02,83,,percent of total billed charges,,1223.93,,,,fee schedule,,,3414.6,90,,percent of total billed charges,,,3414.6,90,,percent of total billed charges,,,3414.6,90,,percent of total billed charges,,,3414.6,90,,percent of total billed charges,,,3224.9,85,,percent of total billed charges,,307.05,3604.3,
REMOVAL OF KIDNEY STONE,50080,CDM,50080,CPT,,,both,,3463,3463,1183.85,,,,fee schedule,,,,,,,,434.2,,,,fee schedule,,,2943.55,85,,percent of total billed charges,,1967.98,,,,fee schedule,,933.26,,,,fee schedule,,434.2,,,,fee schedule,,1459.05,,,,fee schedule,,434.2,,,,fee schedule,,1149.03,,,,fee schedule,,696.38,,,,fee schedule,,696.38,,,,fee schedule,,,3151.33,91,,percent of total billed charges,,,3289.85,95,,percent of total billed charges,,,2874.29,83,,percent of total billed charges,,,1038.9,83,,percent of total billed charges,,434.2,,,,fee schedule,,434.2,,,,fee schedule,,,2874.29,83,,percent of total billed charges,,1023.68,,,,fee schedule,,,3116.7,90,,percent of total billed charges,,,3116.7,90,,percent of total billed charges,,,3116.7,90,,percent of total billed charges,,,3116.7,90,,percent of total billed charges,,,2943.55,85,,percent of total billed charges,,434.2,3289.85,
"REMOVE URETER STENT, PERCUT",50384,CDM,50384,CPT,,,both,,6928,6928,382.52,,,,fee schedule,,,,,,,,148.92,,,,fee schedule,,,5888.8,85,,percent of total billed charges,,512.89,,,,fee schedule,,243.22,,,,fee schedule,,148.92,,,,fee schedule,,,,,,,,148.92,,,,fee schedule,,371.27,,,,fee schedule,,225.01,,,,fee schedule,,225.01,,,,fee schedule,,,6304.48,91,,percent of total billed charges,,,6581.6,95,,percent of total billed charges,,,5750.24,83,,percent of total billed charges,,,2078.4,83,,percent of total billed charges,,148.92,,,,fee schedule,,148.92,,,,fee schedule,,,5750.24,83,,percent of total billed charges,,330.77,,,,fee schedule,,,6235.2,90,,percent of total billed charges,,,6235.2,90,,percent of total billed charges,,,6235.2,90,,percent of total billed charges,,,6235.2,90,,percent of total billed charges,,,5888.8,85,,percent of total billed charges,,148.92,6581.6,
REMOVE STENT VIA TRANSURETH,50386,CDM,50386,CPT,,,both,,3007,3007,273.06,,,,fee schedule,,,,,,,,104.23,,,,fee schedule,,,2555.95,85,,percent of total billed charges,,364.83,,,,fee schedule,,173.01,,,,fee schedule,,104.23,,,,fee schedule,,,,,,,,104.23,,,,fee schedule,,265.03,,,,fee schedule,,160.63,,,,fee schedule,,160.63,,,,fee schedule,,,2736.37,91,,percent of total billed charges,,,2856.65,95,,percent of total billed charges,,,2495.81,83,,percent of total billed charges,,,902.1,83,,percent of total billed charges,,104.23,,,,fee schedule,,104.23,,,,fee schedule,,,2495.81,83,,percent of total billed charges,,236.12,,,,fee schedule,,,2706.3,90,,percent of total billed charges,,,2706.3,90,,percent of total billed charges,,,2706.3,90,,percent of total billed charges,,,2706.3,90,,percent of total billed charges,,,2555.95,85,,percent of total billed charges,,104.23,2856.65,
FRAGMENTING OF KIDNEY STONE,50590,CDM,50590,CPT,,,both,,5255,5255,971.85,,,,fee schedule,,,,,,,,749.2,,,,fee schedule,,,4466.75,85,,percent of total billed charges,,1292.1,,,,fee schedule,,612.74,,,,fee schedule,,749.2,,,,fee schedule,,917.88,,,,fee schedule,,749.2,,,,fee schedule,,943.27,,,,fee schedule,,571.68,,,,fee schedule,,571.68,,,,fee schedule,,,4782.05,91,,percent of total billed charges,,,4992.25,95,,percent of total billed charges,,,4361.65,83,,percent of total billed charges,,,1576.5,83,,percent of total billed charges,,749.2,,,,fee schedule,,749.2,,,,fee schedule,,,4361.65,83,,percent of total billed charges,,840.37,,,,fee schedule,,,4729.5,90,,percent of total billed charges,,,4729.5,90,,percent of total billed charges,,,4729.5,90,,percent of total billed charges,,,4729.5,90,,percent of total billed charges,,,4466.75,85,,percent of total billed charges,,571.68,4992.25,
INCISE  DRAIN BLADDER,51040,CDM,51040,CPT,,,both,,1336,1336,497.74,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,1135.6,85,,percent of total billed charges,,656.2,,,,fee schedule,,311.19,,,,fee schedule,,449.5,,,,fee schedule,,495.42,,,,fee schedule,,449.5,,,,fee schedule,,483.1,,,,fee schedule,,292.79,,,,fee schedule,,292.79,,,,fee schedule,,,1215.76,91,,percent of total billed charges,,,1269.2,95,,percent of total billed charges,,,1108.88,83,,percent of total billed charges,,,400.8,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,1108.88,83,,percent of total billed charges,,430.39,,,,fee schedule,,,1202.4,90,,percent of total billed charges,,,1202.4,90,,percent of total billed charges,,,1202.4,90,,percent of total billed charges,,,1202.4,90,,percent of total billed charges,,,1135.6,85,,percent of total billed charges,,292.79,1269.2,
INCISE BLADDER/DRAIN URETER,51045,CDM,51045,CPT,,,both,,1782,1782,858.36,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,1514.7,85,,percent of total billed charges,,1156.21,,,,fee schedule,,548.3,,,,fee schedule,,449.5,,,,fee schedule,,744.78,,,,fee schedule,,449.5,,,,fee schedule,,833.12,,,,fee schedule,,504.92,,,,fee schedule,,504.92,,,,fee schedule,,,1621.62,91,,percent of total billed charges,,,1692.9,95,,percent of total billed charges,,,1479.06,83,,percent of total billed charges,,,534.6,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,1479.06,83,,percent of total billed charges,,742.23,,,,fee schedule,,,1603.8,90,,percent of total billed charges,,,1603.8,90,,percent of total billed charges,,,1603.8,90,,percent of total billed charges,,,1603.8,90,,percent of total billed charges,,,1514.7,85,,percent of total billed charges,,449.5,1692.9,
REMOVAL OF BLADDER STONE,51050,CDM,51050,CPT,,,both,,2270,2270,804.21,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,1929.5,85,,percent of total billed charges,,1066.9,,,,fee schedule,,505.94,,,,fee schedule,,599.35,,,,fee schedule,,732.18,,,,fee schedule,,599.35,,,,fee schedule,,780.56,,,,fee schedule,,473.07,,,,fee schedule,,473.07,,,,fee schedule,,,2065.7,91,,percent of total billed charges,,,2156.5,95,,percent of total billed charges,,,1884.1,83,,percent of total billed charges,,,681,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,1884.1,83,,percent of total billed charges,,695.41,,,,fee schedule,,,2043,90,,percent of total billed charges,,,2043,90,,percent of total billed charges,,,2043,90,,percent of total billed charges,,,2043,90,,percent of total billed charges,,,1929.5,85,,percent of total billed charges,,473.07,2156.5,
REMOVE URETER CALCULUS,51065,CDM,51065,CPT,,,both,,2877,2877,989.13,,,,fee schedule,,,,,,,,738.1,,,,fee schedule,,,2445.45,85,,percent of total billed charges,,1314.36,,,,fee schedule,,623.3,,,,fee schedule,,738.1,,,,fee schedule,,917.21,,,,fee schedule,,738.1,,,,fee schedule,,960.04,,,,fee schedule,,581.84,,,,fee schedule,,581.84,,,,fee schedule,,,2618.07,91,,percent of total billed charges,,,2733.15,95,,percent of total billed charges,,,2387.91,83,,percent of total billed charges,,,863.1,83,,percent of total billed charges,,738.1,,,,fee schedule,,738.1,,,,fee schedule,,,2387.91,83,,percent of total billed charges,,855.31,,,,fee schedule,,,2589.3,90,,percent of total billed charges,,,2589.3,90,,percent of total billed charges,,,2589.3,90,,percent of total billed charges,,,2589.3,90,,percent of total billed charges,,,2445.45,85,,percent of total billed charges,,581.84,2733.15,
DRAIN BL W/CATH INSERTION,51102,CDM,51102,CPT,,,both,,918,918,243.11,,,,fee schedule,,,,,,,,141.08,,,,fee schedule,,,780.3,85,,percent of total billed charges,,326.91,,,,fee schedule,,155.03,,,,fee schedule,,141.08,,,,fee schedule,,,,,,,,141.08,,,,fee schedule,,235.96,,,,fee schedule,,143,,,,fee schedule,,143,,,,fee schedule,,,835.38,91,,percent of total billed charges,,,872.1,95,,percent of total billed charges,,,761.94,83,,percent of total billed charges,,,275.4,83,,percent of total billed charges,,141.08,,,,fee schedule,,141.08,,,,fee schedule,,,761.94,83,,percent of total billed charges,,210.22,,,,fee schedule,,,826.2,90,,percent of total billed charges,,,826.2,90,,percent of total billed charges,,,826.2,90,,percent of total billed charges,,,826.2,90,,percent of total billed charges,,,780.3,85,,percent of total billed charges,,141.08,872.1,
DRAIN BL W/CATH INSERTION,51102P,CDM,51102,CPT,,,both,P,741,741,243.11,,,,fee schedule,,,,,,,,141.08,,,,fee schedule,,,629.85,85,,percent of total billed charges,,326.91,,,,fee schedule,,155.03,,,,fee schedule,,141.08,,,,fee schedule,,,,,,,,141.08,,,,fee schedule,,235.96,,,,fee schedule,,143,,,,fee schedule,,143,,,,fee schedule,,,674.31,91,,percent of total billed charges,,,703.95,95,,percent of total billed charges,,,615.03,83,,percent of total billed charges,,,222.3,83,,percent of total billed charges,,141.08,,,,fee schedule,,141.08,,,,fee schedule,,,615.03,83,,percent of total billed charges,,210.22,,,,fee schedule,,,666.9,90,,percent of total billed charges,,,666.9,90,,percent of total billed charges,,,666.9,90,,percent of total billed charges,,,666.9,90,,percent of total billed charges,,,629.85,85,,percent of total billed charges,,141.08,703.95,
DRAIN BL W/CATH INSERTION,51102T,CDM,51102,CPT,,,both,T,177,177,243.11,,,,fee schedule,,,,,,,,141.08,,,,fee schedule,,,150.45,85,,percent of total billed charges,,326.91,,,,fee schedule,,155.03,,,,fee schedule,,141.08,,,,fee schedule,,,,,,,,141.08,,,,fee schedule,,235.96,,,,fee schedule,,143,,,,fee schedule,,143,,,,fee schedule,,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,53.1,83,,percent of total billed charges,,141.08,,,,fee schedule,,141.08,,,,fee schedule,,,146.91,83,,percent of total billed charges,,210.22,,,,fee schedule,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,53.1,326.91,
REMOVAL OF BLADDER CYST,51500,CDM,51500,CPT,,,both,,2977,2977,1085.34,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,2530.45,85,,percent of total billed charges,,1444.77,,,,fee schedule,,685.14,,,,fee schedule,,599.35,,,,fee schedule,,1071.08,,,,fee schedule,,599.35,,,,fee schedule,,1053.42,,,,fee schedule,,638.43,,,,fee schedule,,638.43,,,,fee schedule,,,2709.07,91,,percent of total billed charges,,,2828.15,95,,percent of total billed charges,,,2470.91,83,,percent of total billed charges,,,893.1,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,2470.91,83,,percent of total billed charges,,938.5,,,,fee schedule,,,2679.3,90,,percent of total billed charges,,,2679.3,90,,percent of total billed charges,,,2679.3,90,,percent of total billed charges,,,2679.3,90,,percent of total billed charges,,,2530.45,85,,percent of total billed charges,,599.35,2828.15,
INJECTION FOR BLADDER X-RAY,51600,CDM,51600,CPT,,,both,,624,624,74.31,,,,fee schedule,,,,,,,,121.35,,,,fee schedule,,,530.4,85,,percent of total billed charges,,99.84,,,,fee schedule,,47.35,,,,fee schedule,,121.35,,,,fee schedule,,81.57,,,,fee schedule,,121.35,,,,fee schedule,,72.13,,,,fee schedule,,43.71,,,,fee schedule,,43.71,,,,fee schedule,,,567.84,91,,percent of total billed charges,,,592.8,95,,percent of total billed charges,,,517.92,83,,percent of total billed charges,,,187.2,83,,percent of total billed charges,,121.35,,,,fee schedule,,121.35,,,,fee schedule,,,517.92,83,,percent of total billed charges,,64.26,,,,fee schedule,,,561.6,90,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,530.4,85,,percent of total billed charges,,43.71,592.8,
IRRIGATION OF BLADDER,51700,CDM,51700,CPT,,,both,,383,383,51.27,,,,fee schedule,,,,,,,,44.6,,,,fee schedule,,,325.55,85,,percent of total billed charges,,70.64,,,,fee schedule,,33.5,,,,fee schedule,,44.6,,,,fee schedule,,81.57,,,,fee schedule,,44.6,,,,fee schedule,,49.76,,,,fee schedule,,30.16,,,,fee schedule,,30.16,,,,fee schedule,,,348.53,91,,percent of total billed charges,,,363.85,95,,percent of total billed charges,,,317.89,83,,percent of total billed charges,,,114.9,83,,percent of total billed charges,,44.6,,,,fee schedule,,44.6,,,,fee schedule,,,317.89,83,,percent of total billed charges,,44.33,,,,fee schedule,,,344.7,90,,percent of total billed charges,,,344.7,90,,percent of total billed charges,,,344.7,90,,percent of total billed charges,,,344.7,90,,percent of total billed charges,,,325.55,85,,percent of total billed charges,,30.16,363.85,
INSERT BLADDER CATHETER,51701,CDM,51701,CPT,,,both,,274,274,43.21,,,,fee schedule,,,,,,,,24.02,,,,fee schedule,,,232.9,85,,percent of total billed charges,,59.69,,,,fee schedule,,28.31,,,,fee schedule,,24.02,,,,fee schedule,,48.41,,,,fee schedule,,24.02,,,,fee schedule,,41.94,,,,fee schedule,,25.42,,,,fee schedule,,25.42,,,,fee schedule,,,249.34,91,,percent of total billed charges,,,260.3,95,,percent of total billed charges,,,227.42,83,,percent of total billed charges,,,82.2,83,,percent of total billed charges,,24.02,,,,fee schedule,,24.02,,,,fee schedule,,,227.42,83,,percent of total billed charges,,37.36,,,,fee schedule,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,232.9,85,,percent of total billed charges,,24.02,260.3,
INSERT BLADDER CATHETER,51701P,CDM,51701,CPT,,,both,P,120,120,43.21,,,,fee schedule,,,,,,,,24.02,,,,fee schedule,,,102,85,,percent of total billed charges,,59.69,,,,fee schedule,,28.31,,,,fee schedule,,24.02,,,,fee schedule,,48.41,,,,fee schedule,,24.02,,,,fee schedule,,41.94,,,,fee schedule,,25.42,,,,fee schedule,,25.42,,,,fee schedule,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,36,83,,percent of total billed charges,,24.02,,,,fee schedule,,24.02,,,,fee schedule,,,99.6,83,,percent of total billed charges,,37.36,,,,fee schedule,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,24.02,114,
INSERT BLADDER CATHETER,51701T,CDM,51701,CPT,,,both,T,154,154,43.21,,,,fee schedule,,,,,,,,24.02,,,,fee schedule,,,130.9,85,,percent of total billed charges,,59.69,,,,fee schedule,,28.31,,,,fee schedule,,24.02,,,,fee schedule,,48.41,,,,fee schedule,,24.02,,,,fee schedule,,41.94,,,,fee schedule,,25.42,,,,fee schedule,,25.42,,,,fee schedule,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,46.2,83,,percent of total billed charges,,24.02,,,,fee schedule,,24.02,,,,fee schedule,,,127.82,83,,percent of total billed charges,,37.36,,,,fee schedule,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,24.02,146.3,
INSERT TEMP BLADDER CATH,51702,CDM,51702,CPT,,,both,,373,373,42.63,,,,fee schedule,,,,,,,,24.02,,,,fee schedule,,,317.05,85,,percent of total billed charges,,58.76,,,,fee schedule,,27.86,,,,fee schedule,,24.02,,,,fee schedule,,51.73,,,,fee schedule,,24.02,,,,fee schedule,,41.38,,,,fee schedule,,25.08,,,,fee schedule,,25.08,,,,fee schedule,,,339.43,91,,percent of total billed charges,,,354.35,95,,percent of total billed charges,,,309.59,83,,percent of total billed charges,,,111.9,83,,percent of total billed charges,,24.02,,,,fee schedule,,24.02,,,,fee schedule,,,309.59,83,,percent of total billed charges,,36.86,,,,fee schedule,,,335.7,90,,percent of total billed charges,,,335.7,90,,percent of total billed charges,,,335.7,90,,percent of total billed charges,,,335.7,90,,percent of total billed charges,,,317.05,85,,percent of total billed charges,,24.02,354.35,
INSERT TEMP BLADDER CATH,51702P,CDM,51702,CPT,,,both,P,332,332,42.63,,,,fee schedule,,,,,,,,24.02,,,,fee schedule,,,282.2,85,,percent of total billed charges,,58.76,,,,fee schedule,,27.86,,,,fee schedule,,24.02,,,,fee schedule,,51.73,,,,fee schedule,,24.02,,,,fee schedule,,41.38,,,,fee schedule,,25.08,,,,fee schedule,,25.08,,,,fee schedule,,,302.12,91,,percent of total billed charges,,,315.4,95,,percent of total billed charges,,,275.56,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,24.02,,,,fee schedule,,24.02,,,,fee schedule,,,275.56,83,,percent of total billed charges,,36.86,,,,fee schedule,,,298.8,90,,percent of total billed charges,,,298.8,90,,percent of total billed charges,,,298.8,90,,percent of total billed charges,,,298.8,90,,percent of total billed charges,,,282.2,85,,percent of total billed charges,,24.02,315.4,
INSERT TEMP BLADDER CATH,51702T,CDM,51702,CPT,,,both,T,41,41,42.63,,,,fee schedule,,,,,,,,24.02,,,,fee schedule,,,34.85,85,,percent of total billed charges,,58.76,,,,fee schedule,,27.86,,,,fee schedule,,24.02,,,,fee schedule,,51.73,,,,fee schedule,,24.02,,,,fee schedule,,41.38,,,,fee schedule,,25.08,,,,fee schedule,,25.08,,,,fee schedule,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,24.02,,,,fee schedule,,24.02,,,,fee schedule,,,34.03,83,,percent of total billed charges,,36.86,,,,fee schedule,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,12.3,58.76,
"INSERT BLADDER CATH, COMPLEX",51703,CDM,51703,CPT,,,both,,473,473,129.62,,,,fee schedule,,,,,,,,26.18,,,,fee schedule,,,402.05,85,,percent of total billed charges,,174.93,,,,fee schedule,,82.95,,,,fee schedule,,26.18,,,,fee schedule,,141.93,,,,fee schedule,,26.18,,,,fee schedule,,125.81,,,,fee schedule,,76.25,,,,fee schedule,,76.25,,,,fee schedule,,,430.43,91,,percent of total billed charges,,,449.35,95,,percent of total billed charges,,,392.59,83,,percent of total billed charges,,,141.9,83,,percent of total billed charges,,26.18,,,,fee schedule,,26.18,,,,fee schedule,,,392.59,83,,percent of total billed charges,,112.08,,,,fee schedule,,,425.7,90,,percent of total billed charges,,,425.7,90,,percent of total billed charges,,,425.7,90,,percent of total billed charges,,,425.7,90,,percent of total billed charges,,,402.05,85,,percent of total billed charges,,26.18,449.35,
CHANGE OF BLADDER TUBE,51705,CDM,51705,CPT,,,both,,410,410,87.56,,,,fee schedule,,,,,,,,38.85,,,,fee schedule,,,348.5,85,,percent of total billed charges,,116.19,,,,fee schedule,,55.1,,,,fee schedule,,38.85,,,,fee schedule,,112.75,,,,fee schedule,,38.85,,,,fee schedule,,84.99,,,,fee schedule,,51.51,,,,fee schedule,,51.51,,,,fee schedule,,,373.1,91,,percent of total billed charges,,,389.5,95,,percent of total billed charges,,,340.3,83,,percent of total billed charges,,,123,83,,percent of total billed charges,,38.85,,,,fee schedule,,38.85,,,,fee schedule,,,340.3,83,,percent of total billed charges,,75.72,,,,fee schedule,,,369,90,,percent of total billed charges,,,369,90,,percent of total billed charges,,,369,90,,percent of total billed charges,,,369,90,,percent of total billed charges,,,348.5,85,,percent of total billed charges,,38.85,389.5,
TREATMENT OF BLADDER LESION,51720,CDM,51720,CPT,,,both,,441,441,74.31,,,,fee schedule,,,,,,,,66.85,,,,fee schedule,,,374.85,85,,percent of total billed charges,,99.27,,,,fee schedule,,47.07,,,,fee schedule,,66.85,,,,fee schedule,,185.03,,,,fee schedule,,66.85,,,,fee schedule,,72.13,,,,fee schedule,,43.71,,,,fee schedule,,43.71,,,,fee schedule,,,401.31,91,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,132.3,83,,percent of total billed charges,,66.85,,,,fee schedule,,66.85,,,,fee schedule,,,366.03,83,,percent of total billed charges,,64.26,,,,fee schedule,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,374.85,85,,percent of total billed charges,,43.71,418.95,
COMPLEX CYSTOMETROGRAM,51726,CDM,51726,CPT,,,both,,876,876,520.78,,,,fee schedule,,,,,,,,50.05,,,,fee schedule,,,744.6,85,,percent of total billed charges,,190.59,,,,fee schedule,,90.38,,,,fee schedule,,50.05,,,,fee schedule,,622.75,,,,fee schedule,,50.05,,,,fee schedule,,505.46,,,,fee schedule,,306.34,,,,fee schedule,,306.34,,,,fee schedule,,,797.16,91,,percent of total billed charges,,,832.2,95,,percent of total billed charges,,,727.08,83,,percent of total billed charges,,,262.8,83,,percent of total billed charges,,50.05,,,,fee schedule,,50.05,,,,fee schedule,,,727.08,83,,percent of total billed charges,,450.32,,,,fee schedule,,,788.4,90,,percent of total billed charges,,,788.4,90,,percent of total billed charges,,,788.4,90,,percent of total billed charges,,,788.4,90,,percent of total billed charges,,,744.6,85,,percent of total billed charges,,50.05,832.2,
COMPLEX CYSTOMETROGRAM,51726P,CDM,51726,CPT,,,both,P,360,360,520.78,,,,fee schedule,,,,,,,,50.05,,,,fee schedule,,,306,85,,percent of total billed charges,,190.59,,,,fee schedule,,90.38,,,,fee schedule,,50.05,,,,fee schedule,,622.75,,,,fee schedule,,50.05,,,,fee schedule,,505.46,,,,fee schedule,,306.34,,,,fee schedule,,306.34,,,,fee schedule,,,327.6,91,,percent of total billed charges,,,342,95,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,108,83,,percent of total billed charges,,50.05,,,,fee schedule,,50.05,,,,fee schedule,,,298.8,83,,percent of total billed charges,,450.32,,,,fee schedule,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,306,85,,percent of total billed charges,,50.05,622.75,
COMPLEX CYSTOMETROGRAM,51726t,CDM,51726,CPT,,,both,t,516,516,520.78,,,,fee schedule,,,,,,,,50.05,,,,fee schedule,,,438.6,85,,percent of total billed charges,,190.59,,,,fee schedule,,90.38,,,,fee schedule,,50.05,,,,fee schedule,,622.75,,,,fee schedule,,50.05,,,,fee schedule,,505.46,,,,fee schedule,,306.34,,,,fee schedule,,306.34,,,,fee schedule,,,469.56,91,,percent of total billed charges,,,490.2,95,,percent of total billed charges,,,428.28,83,,percent of total billed charges,,,154.8,83,,percent of total billed charges,,50.05,,,,fee schedule,,50.05,,,,fee schedule,,,428.28,83,,percent of total billed charges,,450.32,,,,fee schedule,,,464.4,90,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,438.6,85,,percent of total billed charges,,50.05,622.75,
"voiding pressure studies, any technique",51728,CDM,51728,CPT,,,both,,1033,1033,630.23,,,,fee schedule,,,,,,,,159.12,,,,fee schedule,,,878.05,85,,percent of total billed charges,,235.32,,,,fee schedule,,111.59,,,,fee schedule,,159.12,,,,fee schedule,,,,,,,,159.12,,,,fee schedule,,611.7,,,,fee schedule,,370.73,,,,fee schedule,,370.73,,,,fee schedule,,,940.03,91,,percent of total billed charges,,,981.35,95,,percent of total billed charges,,,857.39,83,,percent of total billed charges,,,309.9,83,,percent of total billed charges,,159.12,,,,fee schedule,,159.12,,,,fee schedule,,,857.39,83,,percent of total billed charges,,544.97,,,,fee schedule,,,929.7,90,,percent of total billed charges,,,929.7,90,,percent of total billed charges,,,929.7,90,,percent of total billed charges,,,929.7,90,,percent of total billed charges,,,878.05,85,,percent of total billed charges,,111.59,981.35,
CYSTOMETROGRAM W/VP,51728P,CDM,51728,CPT,,,both,P,877,877,630.23,,,,fee schedule,,,,,,,,159.12,,,,fee schedule,,,745.45,85,,percent of total billed charges,,235.32,,,,fee schedule,,111.59,,,,fee schedule,,159.12,,,,fee schedule,,,,,,,,159.12,,,,fee schedule,,611.7,,,,fee schedule,,370.73,,,,fee schedule,,370.73,,,,fee schedule,,,798.07,91,,percent of total billed charges,,,833.15,95,,percent of total billed charges,,,727.91,83,,percent of total billed charges,,,263.1,83,,percent of total billed charges,,159.12,,,,fee schedule,,159.12,,,,fee schedule,,,727.91,83,,percent of total billed charges,,544.97,,,,fee schedule,,,789.3,90,,percent of total billed charges,,,789.3,90,,percent of total billed charges,,,789.3,90,,percent of total billed charges,,,789.3,90,,percent of total billed charges,,,745.45,85,,percent of total billed charges,,111.59,833.15,
CYSTOMETROGRAM W/VP,51728T,CDM,51728,CPT,,,both,T,156,156,630.23,,,,fee schedule,,,,,,,,159.12,,,,fee schedule,,,132.6,85,,percent of total billed charges,,235.32,,,,fee schedule,,111.59,,,,fee schedule,,159.12,,,,fee schedule,,,,,,,,159.12,,,,fee schedule,,611.7,,,,fee schedule,,370.73,,,,fee schedule,,370.73,,,,fee schedule,,,141.96,91,,percent of total billed charges,,,148.2,95,,percent of total billed charges,,,129.48,83,,percent of total billed charges,,,46.8,83,,percent of total billed charges,,159.12,,,,fee schedule,,159.12,,,,fee schedule,,,129.48,83,,percent of total billed charges,,544.97,,,,fee schedule,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,132.6,85,,percent of total billed charges,,46.8,630.23,
"ELECTRO-UROFLOWMETRY, FIRST",51741,CDM,51741,CPT,,,both,,239,239,24.2,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,203.15,85,,percent of total billed charges,,21.74,,,,fee schedule,,9.27,,,,fee schedule,,52.7,,,,fee schedule,,135.29,,,,fee schedule,,52.7,,,,fee schedule,,23.48,,,,fee schedule,,14.23,,,,fee schedule,,14.23,,,,fee schedule,,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,71.7,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,198.37,83,,percent of total billed charges,,20.92,,,,fee schedule,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,9.27,227.05,
ELECTRO-UROFLOWMETRY FIRST,51741P,CDM,51741,CPT,,,both,P,103,103,24.2,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,87.55,85,,percent of total billed charges,,21.74,,,,fee schedule,,9.27,,,,fee schedule,,52.7,,,,fee schedule,,135.29,,,,fee schedule,,52.7,,,,fee schedule,,23.48,,,,fee schedule,,14.23,,,,fee schedule,,14.23,,,,fee schedule,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,30.9,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,85.49,83,,percent of total billed charges,,20.92,,,,fee schedule,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,9.27,135.29,
ELECTRO-UROFLOWMETRY FIRST,51741T,CDM,51741,CPT,,,both,T,136,136,24.2,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,115.6,85,,percent of total billed charges,,21.74,,,,fee schedule,,9.27,,,,fee schedule,,52.7,,,,fee schedule,,135.29,,,,fee schedule,,52.7,,,,fee schedule,,23.48,,,,fee schedule,,14.23,,,,fee schedule,,14.23,,,,fee schedule,,,123.76,91,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,40.8,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,112.88,83,,percent of total billed charges,,20.92,,,,fee schedule,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,9.27,135.29,
ANAL/URINARY MUSCLE STUDY,51784,CDM,51784,CPT,,,both,,675,675,110.03,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,573.75,85,,percent of total billed charges,,85.1,,,,fee schedule,,40.35,,,,fee schedule,,52.7,,,,fee schedule,,376.04,,,,fee schedule,,52.7,,,,fee schedule,,106.8,,,,fee schedule,,64.72,,,,fee schedule,,64.72,,,,fee schedule,,,614.25,91,,percent of total billed charges,,,641.25,95,,percent of total billed charges,,,560.25,83,,percent of total billed charges,,,202.5,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,560.25,83,,percent of total billed charges,,95.15,,,,fee schedule,,,607.5,90,,percent of total billed charges,,,607.5,90,,percent of total billed charges,,,607.5,90,,percent of total billed charges,,,607.5,90,,percent of total billed charges,,,573.75,85,,percent of total billed charges,,40.35,641.25,
ANAL/URINARY MUSCLE STUDY,51784P,CDM,51784,CPT,,,both,P,609,609,110.03,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,517.65,85,,percent of total billed charges,,85.1,,,,fee schedule,,40.35,,,,fee schedule,,52.7,,,,fee schedule,,376.04,,,,fee schedule,,52.7,,,,fee schedule,,106.8,,,,fee schedule,,64.72,,,,fee schedule,,64.72,,,,fee schedule,,,554.19,91,,percent of total billed charges,,,578.55,95,,percent of total billed charges,,,505.47,83,,percent of total billed charges,,,182.7,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,505.47,83,,percent of total billed charges,,95.15,,,,fee schedule,,,548.1,90,,percent of total billed charges,,,548.1,90,,percent of total billed charges,,,548.1,90,,percent of total billed charges,,,548.1,90,,percent of total billed charges,,,517.65,85,,percent of total billed charges,,40.35,578.55,
ANAL/URINARY MUSCLE STUDY,51784T,CDM,51784,CPT,,,both,T,66,66,110.03,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,56.1,85,,percent of total billed charges,,85.1,,,,fee schedule,,40.35,,,,fee schedule,,52.7,,,,fee schedule,,376.04,,,,fee schedule,,52.7,,,,fee schedule,,106.8,,,,fee schedule,,64.72,,,,fee schedule,,64.72,,,,fee schedule,,,60.06,91,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,54.78,83,,percent of total billed charges,,95.15,,,,fee schedule,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,19.8,376.04,
INTRAABDOMINAL PRESSURE TEST,51797,CDM,51797,CPT,,,both,,522,522,332.98,,,,fee schedule,,,,,,,,45,,,,fee schedule,,,443.7,85,,percent of total billed charges,,90.46,,,,fee schedule,,42.9,,,,fee schedule,,45,,,,fee schedule,,500.72,,,,fee schedule,,45,,,,fee schedule,,323.18,,,,fee schedule,,195.87,,,,fee schedule,,195.87,,,,fee schedule,,,475.02,91,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,156.6,83,,percent of total billed charges,,45,,,,fee schedule,,45,,,,fee schedule,,,433.26,83,,percent of total billed charges,,287.93,,,,fee schedule,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,42.9,500.72,
INTRAABDOMINAL PRESSURE TEST,51797P,CDM,51797,CPT,,,both,P,458,458,332.98,,,,fee schedule,,,,,,,,45,,,,fee schedule,,,389.3,85,,percent of total billed charges,,90.46,,,,fee schedule,,42.9,,,,fee schedule,,45,,,,fee schedule,,500.72,,,,fee schedule,,45,,,,fee schedule,,323.18,,,,fee schedule,,195.87,,,,fee schedule,,195.87,,,,fee schedule,,,416.78,91,,percent of total billed charges,,,435.1,95,,percent of total billed charges,,,380.14,83,,percent of total billed charges,,,137.4,83,,percent of total billed charges,,45,,,,fee schedule,,45,,,,fee schedule,,,380.14,83,,percent of total billed charges,,287.93,,,,fee schedule,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,412.2,90,,percent of total billed charges,,,389.3,85,,percent of total billed charges,,42.9,500.72,
INTRAABDOMINAL PRESSURE TEST,51797T,CDM,51797,CPT,,,both,T,64,64,332.98,,,,fee schedule,,,,,,,,45,,,,fee schedule,,,54.4,85,,percent of total billed charges,,90.46,,,,fee schedule,,42.9,,,,fee schedule,,45,,,,fee schedule,,500.72,,,,fee schedule,,45,,,,fee schedule,,323.18,,,,fee schedule,,195.87,,,,fee schedule,,195.87,,,,fee schedule,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,45,,,,fee schedule,,45,,,,fee schedule,,,53.12,83,,percent of total billed charges,,287.93,,,,fee schedule,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,19.2,500.72,
Bladder Scan/URINE CAPACITY,51798,CDM,51798,CPT,,,both,,78,78,18.43,,,,fee schedule,,,,,,,,17.56,,,,fee schedule,,,66.3,85,,percent of total billed charges,,35.06,,,,fee schedule,,10.65,,,,fee schedule,,17.56,,,,fee schedule,,27.85,,,,fee schedule,,17.56,,,,fee schedule,,17.89,,,,fee schedule,,10.84,,,,fee schedule,,10.84,,,,fee schedule,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,17.56,,,,fee schedule,,17.56,,,,fee schedule,,,64.74,83,,percent of total billed charges,,15.94,,,,fee schedule,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,10.65,74.1,
US URINE CAPACITY MEASURE,51798P,CDM,51798,CPT,,,both,P,51,51,18.43,,,,fee schedule,,,,,,,,17.56,,,,fee schedule,,,43.35,85,,percent of total billed charges,,35.06,,,,fee schedule,,10.65,,,,fee schedule,,17.56,,,,fee schedule,,27.85,,,,fee schedule,,17.56,,,,fee schedule,,17.89,,,,fee schedule,,10.84,,,,fee schedule,,10.84,,,,fee schedule,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,17.56,,,,fee schedule,,17.56,,,,fee schedule,,,42.33,83,,percent of total billed charges,,15.94,,,,fee schedule,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,10.65,48.45,
US URINE CAPACITY MEASURE,51798T,CDM,51798,CPT,,,both,T,27,27,18.43,,,,fee schedule,,,,,,,,17.56,,,,fee schedule,,,22.95,85,,percent of total billed charges,,35.06,,,,fee schedule,,10.65,,,,fee schedule,,17.56,,,,fee schedule,,27.85,,,,fee schedule,,17.56,,,,fee schedule,,17.89,,,,fee schedule,,10.84,,,,fee schedule,,10.84,,,,fee schedule,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,8.1,83,,percent of total billed charges,,17.56,,,,fee schedule,,17.56,,,,fee schedule,,,22.41,83,,percent of total billed charges,,15.94,,,,fee schedule,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,8.1,35.06,
REPAIR OF BLADDER WOUND,51860,CDM,51860,CPT,,,both,,3284,3284,1274.29,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,2791.4,85,,percent of total billed charges,,1704.51,,,,fee schedule,,808.31,,,,fee schedule,,599.35,,,,fee schedule,,1254.12,,,,fee schedule,,599.35,,,,fee schedule,,1236.82,,,,fee schedule,,749.58,,,,fee schedule,,749.58,,,,fee schedule,,,2988.44,91,,percent of total billed charges,,,3119.8,95,,percent of total billed charges,,,2725.72,83,,percent of total billed charges,,,985.2,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,2725.72,83,,percent of total billed charges,,1101.89,,,,fee schedule,,,2955.6,90,,percent of total billed charges,,,2955.6,90,,percent of total billed charges,,,2955.6,90,,percent of total billed charges,,,2955.6,90,,percent of total billed charges,,,2791.4,85,,percent of total billed charges,,599.35,3119.8,
REPAIR OF BLADDER WOUND,51865,CDM,51865,CPT,,,both,,4165,4165,1526.04,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3540.25,85,,percent of total billed charges,,2046.01,,,,fee schedule,,970.26,,,,fee schedule,,599.35,,,,fee schedule,,1522.06,,,,fee schedule,,599.35,,,,fee schedule,,1481.16,,,,fee schedule,,897.67,,,,fee schedule,,897.67,,,,fee schedule,,,3790.15,91,,percent of total billed charges,,,3956.75,95,,percent of total billed charges,,,3456.95,83,,percent of total billed charges,,,1249.5,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3456.95,83,,percent of total billed charges,,1319.58,,,,fee schedule,,,3748.5,90,,percent of total billed charges,,,3748.5,90,,percent of total billed charges,,,3748.5,90,,percent of total billed charges,,,3748.5,90,,percent of total billed charges,,,3540.25,85,,percent of total billed charges,,599.35,3956.75,
LAPARO SLING OPERATION,51992,CDM,51992,CPT,,,both,,3914,3914,1427.53,,,,fee schedule,,,,,,,,631.25,,,,fee schedule,,,3326.9,85,,percent of total billed charges,,1918.88,,,,fee schedule,,909.97,,,,fee schedule,,631.25,,,,fee schedule,,1431.86,,,,fee schedule,,631.25,,,,fee schedule,,1385.55,,,,fee schedule,,839.72,,,,fee schedule,,839.72,,,,fee schedule,,,3561.74,91,,percent of total billed charges,,,3718.3,95,,percent of total billed charges,,,3248.62,83,,percent of total billed charges,,,1174.2,83,,percent of total billed charges,,631.25,,,,fee schedule,,631.25,,,,fee schedule,,,3248.62,83,,percent of total billed charges,,1234.4,,,,fee schedule,,,3522.6,90,,percent of total billed charges,,,3522.6,90,,percent of total billed charges,,,3522.6,90,,percent of total billed charges,,,3522.6,90,,percent of total billed charges,,,3326.9,85,,percent of total billed charges,,631.25,3718.3,
CYSTOSCOPY,52000,CDM,52000,CPT,,,both,,930,930,135.96,,,,fee schedule,,,,,,,,85.9,,,,fee schedule,,,790.5,85,,percent of total billed charges,,183.23,,,,fee schedule,,86.89,,,,fee schedule,,85.9,,,,fee schedule,,192.99,,,,fee schedule,,85.9,,,,fee schedule,,131.96,,,,fee schedule,,79.97,,,,fee schedule,,79.97,,,,fee schedule,,,846.3,91,,percent of total billed charges,,,883.5,95,,percent of total billed charges,,,771.9,83,,percent of total billed charges,,,279,83,,percent of total billed charges,,85.9,,,,fee schedule,,85.9,,,,fee schedule,,,771.9,83,,percent of total billed charges,,117.56,,,,fee schedule,,,837,90,,percent of total billed charges,,,837,90,,percent of total billed charges,,,837,90,,percent of total billed charges,,,837,90,,percent of total billed charges,,,790.5,85,,percent of total billed charges,,79.97,883.5,
CYSTOSCOPY,52000P,CDM,52000,CPT,,,both,P,805,805,135.96,,,,fee schedule,,,,,,,,85.9,,,,fee schedule,,,684.25,85,,percent of total billed charges,,183.23,,,,fee schedule,,86.89,,,,fee schedule,,85.9,,,,fee schedule,,192.99,,,,fee schedule,,85.9,,,,fee schedule,,131.96,,,,fee schedule,,79.97,,,,fee schedule,,79.97,,,,fee schedule,,,732.55,91,,percent of total billed charges,,,764.75,95,,percent of total billed charges,,,668.15,83,,percent of total billed charges,,,241.5,83,,percent of total billed charges,,85.9,,,,fee schedule,,85.9,,,,fee schedule,,,668.15,83,,percent of total billed charges,,117.56,,,,fee schedule,,,724.5,90,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,724.5,90,,percent of total billed charges,,,684.25,85,,percent of total billed charges,,79.97,764.75,
CYSTOSCOPY,52000T,CDM,52000,CPT,,,both,T,125,125,135.96,,,,fee schedule,,,,,,,,85.9,,,,fee schedule,,,106.25,85,,percent of total billed charges,,183.23,,,,fee schedule,,86.89,,,,fee schedule,,85.9,,,,fee schedule,,192.99,,,,fee schedule,,85.9,,,,fee schedule,,131.96,,,,fee schedule,,79.97,,,,fee schedule,,79.97,,,,fee schedule,,,113.75,91,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,37.5,83,,percent of total billed charges,,85.9,,,,fee schedule,,85.9,,,,fee schedule,,,103.75,83,,percent of total billed charges,,117.56,,,,fee schedule,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,37.5,192.99,
"CYSTOSCOPY, REMOVAL OF CLOTS",52001,CDM,52001,CPT,,,both,,1560,1560,482.76,,,,fee schedule,,,,,,,,90.4,,,,fee schedule,,,1326,85,,percent of total billed charges,,648.4,,,,fee schedule,,307.49,,,,fee schedule,,90.4,,,,fee schedule,,510.01,,,,fee schedule,,90.4,,,,fee schedule,,468.56,,,,fee schedule,,283.97,,,,fee schedule,,283.97,,,,fee schedule,,,1419.6,91,,percent of total billed charges,,,1482,95,,percent of total billed charges,,,1294.8,83,,percent of total billed charges,,,468,83,,percent of total billed charges,,90.4,,,,fee schedule,,90.4,,,,fee schedule,,,1294.8,83,,percent of total billed charges,,417.44,,,,fee schedule,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1404,90,,percent of total billed charges,,,1326,85,,percent of total billed charges,,90.4,1482,
CYSTOSCOPY  URETER CATHETER,52005,CDM,52005,CPT,,,both,,1329,1329,222.94,,,,fee schedule,,,,,,,,118.9,,,,fee schedule,,,1129.65,85,,percent of total billed charges,,298.58,,,,fee schedule,,141.59,,,,fee schedule,,118.9,,,,fee schedule,,227.48,,,,fee schedule,,118.9,,,,fee schedule,,216.39,,,,fee schedule,,131.14,,,,fee schedule,,131.14,,,,fee schedule,,,1209.39,91,,percent of total billed charges,,,1262.55,95,,percent of total billed charges,,,1103.07,83,,percent of total billed charges,,,398.7,83,,percent of total billed charges,,118.9,,,,fee schedule,,118.9,,,,fee schedule,,,1103.07,83,,percent of total billed charges,,192.78,,,,fee schedule,,,1196.1,90,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1196.1,90,,percent of total billed charges,,,1129.65,85,,percent of total billed charges,,118.9,1262.55,
CYSTOSCOPY,52204,CDM,52204,CPT,,,both,,1915,1915,237.35,,,,fee schedule,,,,,,,,163.9,,,,fee schedule,,,1627.75,85,,percent of total billed charges,,318.68,,,,fee schedule,,151.12,,,,fee schedule,,163.9,,,,fee schedule,,228.14,,,,fee schedule,,163.9,,,,fee schedule,,230.37,,,,fee schedule,,139.62,,,,fee schedule,,139.62,,,,fee schedule,,,1742.65,91,,percent of total billed charges,,,1819.25,95,,percent of total billed charges,,,1589.45,83,,percent of total billed charges,,,574.5,83,,percent of total billed charges,,163.9,,,,fee schedule,,163.9,,,,fee schedule,,,1589.45,83,,percent of total billed charges,,205.23,,,,fee schedule,,,1723.5,90,,percent of total billed charges,,,1723.5,90,,percent of total billed charges,,,1723.5,90,,percent of total billed charges,,,1723.5,90,,percent of total billed charges,,,1627.75,85,,percent of total billed charges,,139.62,1819.25,
CYSTOSCOPY AND TREATMENT,52214,CDM,52214,CPT,,,both,,3775,3775,294.95,,,,fee schedule,,,,,,,,178.3,,,,fee schedule,,,3208.75,85,,percent of total billed charges,,398.85,,,,fee schedule,,189.14,,,,fee schedule,,178.3,,,,fee schedule,,350.84,,,,fee schedule,,178.3,,,,fee schedule,,286.28,,,,fee schedule,,173.5,,,,fee schedule,,173.5,,,,fee schedule,,,3435.25,91,,percent of total billed charges,,,3586.25,95,,percent of total billed charges,,,3133.25,83,,percent of total billed charges,,,1132.5,83,,percent of total billed charges,,178.3,,,,fee schedule,,178.3,,,,fee schedule,,,3133.25,83,,percent of total billed charges,,255.05,,,,fee schedule,,,3397.5,90,,percent of total billed charges,,,3397.5,90,,percent of total billed charges,,,3397.5,90,,percent of total billed charges,,,3397.5,90,,percent of total billed charges,,,3208.75,85,,percent of total billed charges,,173.5,3586.25,
CYSTOSCOPY AND TREATMENT,52224,CDM,52224,CPT,,,both,,3708,3708,341.62,,,,fee schedule,,,,,,,,295.95,,,,fee schedule,,,3151.8,85,,percent of total billed charges,,462.68,,,,fee schedule,,219.41,,,,fee schedule,,295.95,,,,fee schedule,,299.11,,,,fee schedule,,295.95,,,,fee schedule,,331.57,,,,fee schedule,,200.95,,,,fee schedule,,200.95,,,,fee schedule,,,3374.28,91,,percent of total billed charges,,,3522.6,95,,percent of total billed charges,,,3077.64,83,,percent of total billed charges,,,1112.4,83,,percent of total billed charges,,295.95,,,,fee schedule,,295.95,,,,fee schedule,,,3077.64,83,,percent of total billed charges,,295.4,,,,fee schedule,,,3337.2,90,,percent of total billed charges,,,3337.2,90,,percent of total billed charges,,,3337.2,90,,percent of total billed charges,,,3337.2,90,,percent of total billed charges,,,3151.8,85,,percent of total billed charges,,200.95,3522.6,
CYSTOSCOPY AND TREATMENT,52234,CDM,52234,CPT,,,both,,1588,1588,413.63,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,1349.8,85,,percent of total billed charges,,555.44,,,,fee schedule,,263.4,,,,fee schedule,,374.55,,,,fee schedule,,438.38,,,,fee schedule,,374.55,,,,fee schedule,,401.46,,,,fee schedule,,243.31,,,,fee schedule,,243.31,,,,fee schedule,,,1445.08,91,,percent of total billed charges,,,1508.6,95,,percent of total billed charges,,,1318.04,83,,percent of total billed charges,,,476.4,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,1318.04,83,,percent of total billed charges,,357.67,,,,fee schedule,,,1429.2,90,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1349.8,85,,percent of total billed charges,,243.31,1508.6,
CYSTOSCOPY AND TREATMENT,52235,CDM,52235,CPT,,,both,,1967,1967,485.06,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,1671.95,85,,percent of total billed charges,,650.56,,,,fee schedule,,308.51,,,,fee schedule,,374.55,,,,fee schedule,,514.65,,,,fee schedule,,374.55,,,,fee schedule,,470.79,,,,fee schedule,,285.33,,,,fee schedule,,285.33,,,,fee schedule,,,1789.97,91,,percent of total billed charges,,,1868.65,95,,percent of total billed charges,,,1632.61,83,,percent of total billed charges,,,590.1,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,1632.61,83,,percent of total billed charges,,419.44,,,,fee schedule,,,1770.3,90,,percent of total billed charges,,,1770.3,90,,percent of total billed charges,,,1770.3,90,,percent of total billed charges,,,1770.3,90,,percent of total billed charges,,,1671.95,85,,percent of total billed charges,,285.33,1868.65,
CYSTOSCOPY AND TREATMENT,52240,CDM,52240,CPT,,,both,,3043,3043,658.46,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,2586.55,85,,percent of total billed charges,,886.09,,,,fee schedule,,420.2,,,,fee schedule,,524.4,,,,fee schedule,,908.59,,,,fee schedule,,524.4,,,,fee schedule,,639.1,,,,fee schedule,,387.33,,,,fee schedule,,387.33,,,,fee schedule,,,2769.13,91,,percent of total billed charges,,,2890.85,95,,percent of total billed charges,,,2525.69,83,,percent of total billed charges,,,912.9,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,2525.69,83,,percent of total billed charges,,569.38,,,,fee schedule,,,2738.7,90,,percent of total billed charges,,,2738.7,90,,percent of total billed charges,,,2738.7,90,,percent of total billed charges,,,2738.7,90,,percent of total billed charges,,,2586.55,85,,percent of total billed charges,,387.33,2890.85,
Cystourethroscopy w/dilation of bladder for interstitial cystitis,52260,CDM,52260,CPT,,,both,,1076,1076,355.44,,,,fee schedule,,,,,,,,149.8,,,,fee schedule,,,914.6,85,,percent of total billed charges,,476.78,,,,fee schedule,,226.1,,,,fee schedule,,149.8,,,,fee schedule,,372.06,,,,fee schedule,,149.8,,,,fee schedule,,344.99,,,,fee schedule,,209.08,,,,fee schedule,,209.08,,,,fee schedule,,,979.16,91,,percent of total billed charges,,,1022.2,95,,percent of total billed charges,,,893.08,83,,percent of total billed charges,,,322.8,83,,percent of total billed charges,,149.8,,,,fee schedule,,149.8,,,,fee schedule,,,893.08,83,,percent of total billed charges,,307.35,,,,fee schedule,,,968.4,90,,percent of total billed charges,,,968.4,90,,percent of total billed charges,,,968.4,90,,percent of total billed charges,,,968.4,90,,percent of total billed charges,,,914.6,85,,percent of total billed charges,,149.8,1022.2,
CYSTOSCOPY AND TREATMENT,52265,CDM,52265,CPT,,,both,,787,787,274.22,,,,fee schedule,,,,,,,,142.7,,,,fee schedule,,,668.95,85,,percent of total billed charges,,367.28,,,,fee schedule,,174.17,,,,fee schedule,,142.7,,,,fee schedule,,283.19,,,,fee schedule,,142.7,,,,fee schedule,,266.15,,,,fee schedule,,161.3,,,,fee schedule,,161.3,,,,fee schedule,,,716.17,91,,percent of total billed charges,,,747.65,95,,percent of total billed charges,,,653.21,83,,percent of total billed charges,,,236.1,83,,percent of total billed charges,,142.7,,,,fee schedule,,142.7,,,,fee schedule,,,653.21,83,,percent of total billed charges,,237.12,,,,fee schedule,,,708.3,90,,percent of total billed charges,,,708.3,90,,percent of total billed charges,,,708.3,90,,percent of total billed charges,,,708.3,90,,percent of total billed charges,,,668.95,85,,percent of total billed charges,,142.7,747.65,
CYSTOSCOPY AND TREATMENT,52276,CDM,52276,CPT,,,both,,1697,1697,444.16,,,,fee schedule,,,,,,,,209.4,,,,fee schedule,,,1442.45,85,,percent of total billed charges,,596.87,,,,fee schedule,,283.05,,,,fee schedule,,209.4,,,,fee schedule,,472.2,,,,fee schedule,,209.4,,,,fee schedule,,431.1,,,,fee schedule,,261.27,,,,fee schedule,,261.27,,,,fee schedule,,,1544.27,91,,percent of total billed charges,,,1612.15,95,,percent of total billed charges,,,1408.51,83,,percent of total billed charges,,,509.1,83,,percent of total billed charges,,209.4,,,,fee schedule,,209.4,,,,fee schedule,,,1408.51,83,,percent of total billed charges,,384.07,,,,fee schedule,,,1527.3,90,,percent of total billed charges,,,1527.3,90,,percent of total billed charges,,,1527.3,90,,percent of total billed charges,,,1527.3,90,,percent of total billed charges,,,1442.45,85,,percent of total billed charges,,209.4,1612.15,
CYSTOSCOPY AND TREATMENT,52276P,CDM,52276,CPT,,,both,P,1497,1497,444.16,,,,fee schedule,,,,,,,,209.4,,,,fee schedule,,,1272.45,85,,percent of total billed charges,,596.87,,,,fee schedule,,283.05,,,,fee schedule,,209.4,,,,fee schedule,,472.2,,,,fee schedule,,209.4,,,,fee schedule,,431.1,,,,fee schedule,,261.27,,,,fee schedule,,261.27,,,,fee schedule,,,1362.27,91,,percent of total billed charges,,,1422.15,95,,percent of total billed charges,,,1242.51,83,,percent of total billed charges,,,449.1,83,,percent of total billed charges,,209.4,,,,fee schedule,,209.4,,,,fee schedule,,,1242.51,83,,percent of total billed charges,,384.07,,,,fee schedule,,,1347.3,90,,percent of total billed charges,,,1347.3,90,,percent of total billed charges,,,1347.3,90,,percent of total billed charges,,,1347.3,90,,percent of total billed charges,,,1272.45,85,,percent of total billed charges,,209.4,1422.15,
CYSTOSCOPY AND TREATMENT,52276T,CDM,52276,CPT,,,both,T,200,200,444.16,,,,fee schedule,,,,,,,,209.4,,,,fee schedule,,,170,85,,percent of total billed charges,,596.87,,,,fee schedule,,283.05,,,,fee schedule,,209.4,,,,fee schedule,,472.2,,,,fee schedule,,209.4,,,,fee schedule,,431.1,,,,fee schedule,,261.27,,,,fee schedule,,261.27,,,,fee schedule,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,60,83,,percent of total billed charges,,209.4,,,,fee schedule,,209.4,,,,fee schedule,,,166,83,,percent of total billed charges,,384.07,,,,fee schedule,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,60,596.87,
CYSTOSCOPY/URETHRAL DILATION,52281,CDM,52281,CPT,,,both,,1413,1413,256.36,,,,fee schedule,,,,,,,,134.8,,,,fee schedule,,,1201.05,85,,percent of total billed charges,,342.45,,,,fee schedule,,162.4,,,,fee schedule,,134.8,,,,fee schedule,,270.59,,,,fee schedule,,134.8,,,,fee schedule,,248.82,,,,fee schedule,,150.8,,,,fee schedule,,150.8,,,,fee schedule,,,1285.83,91,,percent of total billed charges,,,1342.35,95,,percent of total billed charges,,,1172.79,83,,percent of total billed charges,,,423.9,83,,percent of total billed charges,,134.8,,,,fee schedule,,134.8,,,,fee schedule,,,1172.79,83,,percent of total billed charges,,221.67,,,,fee schedule,,,1271.7,90,,percent of total billed charges,,,1271.7,90,,percent of total billed charges,,,1271.7,90,,percent of total billed charges,,,1271.7,90,,percent of total billed charges,,,1201.05,85,,percent of total billed charges,,134.8,1342.35,
CYSTOSCOPY CHEMODENERVATION,52287,CDM,52287,CPT,,,both,,1383,1383,285.74,,,,fee schedule,,,,,,,,99.37,,,,fee schedule,,,1175.55,85,,percent of total billed charges,,383.65,,,,fee schedule,,181.93,,,,fee schedule,,99.37,,,,fee schedule,,,,,,,,99.37,,,,fee schedule,,277.33,,,,fee schedule,,168.08,,,,fee schedule,,168.08,,,,fee schedule,,,1258.53,91,,percent of total billed charges,,,1313.85,95,,percent of total billed charges,,,1147.89,83,,percent of total billed charges,,,414.9,83,,percent of total billed charges,,99.37,,,,fee schedule,,99.37,,,,fee schedule,,,1147.89,83,,percent of total billed charges,,247.08,,,,fee schedule,,,1244.7,90,,percent of total billed charges,,,1244.7,90,,percent of total billed charges,,,1244.7,90,,percent of total billed charges,,,1244.7,90,,percent of total billed charges,,,1175.55,85,,percent of total billed charges,,99.37,1313.85,
CYSTOSCOPY CHEMODENERVATION,52287P,CDM,52287,CPT,,,both,P,761,761,285.74,,,,fee schedule,,,,,,,,99.37,,,,fee schedule,,,646.85,85,,percent of total billed charges,,383.65,,,,fee schedule,,181.93,,,,fee schedule,,99.37,,,,fee schedule,,,,,,,,99.37,,,,fee schedule,,277.33,,,,fee schedule,,168.08,,,,fee schedule,,168.08,,,,fee schedule,,,692.51,91,,percent of total billed charges,,,722.95,95,,percent of total billed charges,,,631.63,83,,percent of total billed charges,,,228.3,83,,percent of total billed charges,,99.37,,,,fee schedule,,99.37,,,,fee schedule,,,631.63,83,,percent of total billed charges,,247.08,,,,fee schedule,,,684.9,90,,percent of total billed charges,,,684.9,90,,percent of total billed charges,,,684.9,90,,percent of total billed charges,,,684.9,90,,percent of total billed charges,,,646.85,85,,percent of total billed charges,,99.37,722.95,
CYSTOSCOPY CHEMODENERVATION,52287T,CDM,52287,CPT,,,both,T,622,622,285.74,,,,fee schedule,,,,,,,,99.37,,,,fee schedule,,,528.7,85,,percent of total billed charges,,383.65,,,,fee schedule,,181.93,,,,fee schedule,,99.37,,,,fee schedule,,,,,,,,99.37,,,,fee schedule,,277.33,,,,fee schedule,,168.08,,,,fee schedule,,168.08,,,,fee schedule,,,566.02,91,,percent of total billed charges,,,590.9,95,,percent of total billed charges,,,516.26,83,,percent of total billed charges,,,186.6,83,,percent of total billed charges,,99.37,,,,fee schedule,,99.37,,,,fee schedule,,,516.26,83,,percent of total billed charges,,247.08,,,,fee schedule,,,559.8,90,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,528.7,85,,percent of total billed charges,,99.37,590.9,
"Cystourethroscopy w/ureteral meatotomy, unilateral or bilateral",52290,CDM,52290,CPT,,,both,,1181,1181,410.17,,,,fee schedule,,,,,,,,184.5,,,,fee schedule,,,1003.85,85,,percent of total billed charges,,550.85,,,,fee schedule,,261.23,,,,fee schedule,,184.5,,,,fee schedule,,434.4,,,,fee schedule,,184.5,,,,fee schedule,,398.11,,,,fee schedule,,241.28,,,,fee schedule,,241.28,,,,fee schedule,,,1074.71,91,,percent of total billed charges,,,1121.95,95,,percent of total billed charges,,,980.23,83,,percent of total billed charges,,,354.3,83,,percent of total billed charges,,184.5,,,,fee schedule,,184.5,,,,fee schedule,,,980.23,83,,percent of total billed charges,,354.68,,,,fee schedule,,,1062.9,90,,percent of total billed charges,,,1062.9,90,,percent of total billed charges,,,1062.9,90,,percent of total billed charges,,,1062.9,90,,percent of total billed charges,,,1003.85,85,,percent of total billed charges,,184.5,1121.95,
CYSTOSCOPY AND TREATMENT,52310,CDM,52310,CPT,,,both,,1311,1311,255.2,,,,fee schedule,,,,,,,,180.3,,,,fee schedule,,,1114.35,85,,percent of total billed charges,,341.64,,,,fee schedule,,162.01,,,,fee schedule,,180.3,,,,fee schedule,,267.94,,,,fee schedule,,180.3,,,,fee schedule,,247.7,,,,fee schedule,,150.12,,,,fee schedule,,150.12,,,,fee schedule,,,1193.01,91,,percent of total billed charges,,,1245.45,95,,percent of total billed charges,,,1088.13,83,,percent of total billed charges,,,393.3,83,,percent of total billed charges,,180.3,,,,fee schedule,,180.3,,,,fee schedule,,,1088.13,83,,percent of total billed charges,,220.68,,,,fee schedule,,,1179.9,90,,percent of total billed charges,,,1179.9,90,,percent of total billed charges,,,1179.9,90,,percent of total billed charges,,,1179.9,90,,percent of total billed charges,,,1114.35,85,,percent of total billed charges,,150.12,1245.45,
CYSTOSCOPY AND TREATMENT,52310P,CDM,52310,CPT,,,both,P,567,567,255.2,,,,fee schedule,,,,,,,,180.3,,,,fee schedule,,,481.95,85,,percent of total billed charges,,341.64,,,,fee schedule,,162.01,,,,fee schedule,,180.3,,,,fee schedule,,267.94,,,,fee schedule,,180.3,,,,fee schedule,,247.7,,,,fee schedule,,150.12,,,,fee schedule,,150.12,,,,fee schedule,,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,170.1,83,,percent of total billed charges,,180.3,,,,fee schedule,,180.3,,,,fee schedule,,,470.61,83,,percent of total billed charges,,220.68,,,,fee schedule,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,150.12,538.65,
CYSTOSCOPY AND TREATMENT,52310T,CDM,52310,CPT,,,both,T,704,704,255.2,,,,fee schedule,,,,,,,,180.3,,,,fee schedule,,,598.4,85,,percent of total billed charges,,341.64,,,,fee schedule,,162.01,,,,fee schedule,,180.3,,,,fee schedule,,267.94,,,,fee schedule,,180.3,,,,fee schedule,,247.7,,,,fee schedule,,150.12,,,,fee schedule,,150.12,,,,fee schedule,,,640.64,91,,percent of total billed charges,,,668.8,95,,percent of total billed charges,,,584.32,83,,percent of total billed charges,,,211.2,83,,percent of total billed charges,,180.3,,,,fee schedule,,180.3,,,,fee schedule,,,584.32,83,,percent of total billed charges,,220.68,,,,fee schedule,,,633.6,90,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,633.6,90,,percent of total billed charges,,,598.4,85,,percent of total billed charges,,150.12,668.8,
REMOVE BLADDER STONE,52317,CDM,52317,CPT,,,both,,3237,3237,582.42,,,,fee schedule,,,,,,,,342.15,,,,fee schedule,,,2751.45,85,,percent of total billed charges,,784.29,,,,fee schedule,,371.93,,,,fee schedule,,342.15,,,,fee schedule,,628.06,,,,fee schedule,,342.15,,,,fee schedule,,565.29,,,,fee schedule,,342.6,,,,fee schedule,,342.6,,,,fee schedule,,,2945.67,91,,percent of total billed charges,,,3075.15,95,,percent of total billed charges,,,2686.71,83,,percent of total billed charges,,,971.1,83,,percent of total billed charges,,342.15,,,,fee schedule,,342.15,,,,fee schedule,,,2686.71,83,,percent of total billed charges,,503.62,,,,fee schedule,,,2913.3,90,,percent of total billed charges,,,2913.3,90,,percent of total billed charges,,,2913.3,90,,percent of total billed charges,,,2913.3,90,,percent of total billed charges,,,2751.45,85,,percent of total billed charges,,342.15,3075.15,
REMOVE BLADDER STONE,52318,CDM,52318,CPT,,,both,,2785,2785,794.99,,,,fee schedule,,,,,,,,339.25,,,,fee schedule,,,2367.25,85,,percent of total billed charges,,1070.36,,,,fee schedule,,507.58,,,,fee schedule,,339.25,,,,fee schedule,,856.86,,,,fee schedule,,339.25,,,,fee schedule,,771.61,,,,fee schedule,,467.64,,,,fee schedule,,467.64,,,,fee schedule,,,2534.35,91,,percent of total billed charges,,,2645.75,95,,percent of total billed charges,,,2311.55,83,,percent of total billed charges,,,835.5,83,,percent of total billed charges,,339.25,,,,fee schedule,,339.25,,,,fee schedule,,,2311.55,83,,percent of total billed charges,,687.44,,,,fee schedule,,,2506.5,90,,percent of total billed charges,,,2506.5,90,,percent of total billed charges,,,2506.5,90,,percent of total billed charges,,,2506.5,90,,percent of total billed charges,,,2367.25,85,,percent of total billed charges,,339.25,2645.75,
CYSTOSCOPY AND TREATMENT,52320,CDM,52320,CPT,,,both,,1626,1626,413.63,,,,fee schedule,,,,,,,,249.7,,,,fee schedule,,,1382.1,85,,percent of total billed charges,,556.64,,,,fee schedule,,263.97,,,,fee schedule,,249.7,,,,fee schedule,,441.7,,,,fee schedule,,249.7,,,,fee schedule,,401.46,,,,fee schedule,,243.31,,,,fee schedule,,243.31,,,,fee schedule,,,1479.66,91,,percent of total billed charges,,,1544.7,95,,percent of total billed charges,,,1349.58,83,,percent of total billed charges,,,487.8,83,,percent of total billed charges,,249.7,,,,fee schedule,,249.7,,,,fee schedule,,,1349.58,83,,percent of total billed charges,,357.67,,,,fee schedule,,,1463.4,90,,percent of total billed charges,,,1463.4,90,,percent of total billed charges,,,1463.4,90,,percent of total billed charges,,,1463.4,90,,percent of total billed charges,,,1382.1,85,,percent of total billed charges,,243.31,1544.7,
"CYSTOSCOPY, STONE REMOVAL",52325,CDM,52325,CPT,,,both,,1847,1847,538.06,,,,fee schedule,,,,,,,,379.4,,,,fee schedule,,,1569.95,85,,percent of total billed charges,,723.18,,,,fee schedule,,342.95,,,,fee schedule,,379.4,,,,fee schedule,,576.99,,,,fee schedule,,379.4,,,,fee schedule,,522.24,,,,fee schedule,,316.51,,,,fee schedule,,316.51,,,,fee schedule,,,1680.77,91,,percent of total billed charges,,,1754.65,95,,percent of total billed charges,,,1533.01,83,,percent of total billed charges,,,554.1,83,,percent of total billed charges,,379.4,,,,fee schedule,,379.4,,,,fee schedule,,,1533.01,83,,percent of total billed charges,,465.26,,,,fee schedule,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1662.3,90,,percent of total billed charges,,,1569.95,85,,percent of total billed charges,,316.51,1754.65,
CYSTOSCOPY AND TREATMENT,52330,CDM,52330,CPT,,,both,,3092,3092,442.43,,,,fee schedule,,,,,,,,260.8,,,,fee schedule,,,2628.2,85,,percent of total billed charges,,595,,,,fee schedule,,282.16,,,,fee schedule,,260.8,,,,fee schedule,,473.53,,,,fee schedule,,260.8,,,,fee schedule,,429.42,,,,fee schedule,,260.25,,,,fee schedule,,260.25,,,,fee schedule,,,2813.72,91,,percent of total billed charges,,,2937.4,95,,percent of total billed charges,,,2566.36,83,,percent of total billed charges,,,927.6,83,,percent of total billed charges,,260.8,,,,fee schedule,,260.8,,,,fee schedule,,,2566.36,83,,percent of total billed charges,,382.57,,,,fee schedule,,,2782.8,90,,percent of total billed charges,,,2782.8,90,,percent of total billed charges,,,2782.8,90,,percent of total billed charges,,,2782.8,90,,percent of total billed charges,,,2628.2,85,,percent of total billed charges,,260.25,2937.4,
CYSTOSCOPY AND TREATMENT,52332,CDM,52332,CPT,,,both,,1984,1984,262.12,,,,fee schedule,,,,,,,,138.9,,,,fee schedule,,,1686.4,85,,percent of total billed charges,,364.66,,,,fee schedule,,166.13,,,,fee schedule,,138.9,,,,fee schedule,,271.25,,,,fee schedule,,138.9,,,,fee schedule,,254.41,,,,fee schedule,,154.19,,,,fee schedule,,154.19,,,,fee schedule,,,1805.44,91,,percent of total billed charges,,,1884.8,95,,percent of total billed charges,,,1646.72,83,,percent of total billed charges,,,595.2,83,,percent of total billed charges,,138.9,,,,fee schedule,,138.9,,,,fee schedule,,,1646.72,83,,percent of total billed charges,,226.65,,,,fee schedule,,,1785.6,90,,percent of total billed charges,,,1785.6,90,,percent of total billed charges,,,1785.6,90,,percent of total billed charges,,,1785.6,90,,percent of total billed charges,,,1686.4,85,,percent of total billed charges,,138.9,1884.8,
CYSTO W/URETER STRICTURE TX,52341,CDM,52341,CPT,,,both,,1748,1748,478.15,,,,fee schedule,,,,,,,,224.45,,,,fee schedule,,,1485.8,85,,percent of total billed charges,,640.39,,,,fee schedule,,303.69,,,,fee schedule,,224.45,,,,fee schedule,,572.35,,,,fee schedule,,224.45,,,,fee schedule,,464.09,,,,fee schedule,,281.26,,,,fee schedule,,281.26,,,,fee schedule,,,1590.68,91,,percent of total billed charges,,,1660.6,95,,percent of total billed charges,,,1450.84,83,,percent of total billed charges,,,524.4,83,,percent of total billed charges,,224.45,,,,fee schedule,,224.45,,,,fee schedule,,,1450.84,83,,percent of total billed charges,,413.46,,,,fee schedule,,,1573.2,90,,percent of total billed charges,,,1573.2,90,,percent of total billed charges,,,1573.2,90,,percent of total billed charges,,,1573.2,90,,percent of total billed charges,,,1485.8,85,,percent of total billed charges,,224.45,1660.6,
CYSTOURETERO/OR PYELOSCOPE,52351,CDM,52351,CPT,,,both,,1775,1775,508.1,,,,fee schedule,,,,,,,,178.3,,,,fee schedule,,,1508.75,85,,percent of total billed charges,,682.75,,,,fee schedule,,323.78,,,,fee schedule,,178.3,,,,fee schedule,,557.76,,,,fee schedule,,178.3,,,,fee schedule,,493.16,,,,fee schedule,,298.89,,,,fee schedule,,298.89,,,,fee schedule,,,1615.25,91,,percent of total billed charges,,,1686.25,95,,percent of total billed charges,,,1473.25,83,,percent of total billed charges,,,532.5,83,,percent of total billed charges,,178.3,,,,fee schedule,,178.3,,,,fee schedule,,,1473.25,83,,percent of total billed charges,,439.36,,,,fee schedule,,,1597.5,90,,percent of total billed charges,,,1597.5,90,,percent of total billed charges,,,1597.5,90,,percent of total billed charges,,,1597.5,90,,percent of total billed charges,,,1508.75,85,,percent of total billed charges,,178.3,1686.25,
CYSTOURETERO W/STONE REMOVE,52352,CDM,52352,CPT,,,both,,2122,2122,595.09,,,,fee schedule,,,,,,,,293.75,,,,fee schedule,,,1803.7,85,,percent of total billed charges,,798.92,,,,fee schedule,,378.86,,,,fee schedule,,293.75,,,,fee schedule,,653.92,,,,fee schedule,,293.75,,,,fee schedule,,577.59,,,,fee schedule,,350.05,,,,fee schedule,,350.05,,,,fee schedule,,,1931.02,91,,percent of total billed charges,,,2015.9,95,,percent of total billed charges,,,1761.26,83,,percent of total billed charges,,,636.6,83,,percent of total billed charges,,293.75,,,,fee schedule,,293.75,,,,fee schedule,,,1761.26,83,,percent of total billed charges,,514.58,,,,fee schedule,,,1909.8,90,,percent of total billed charges,,,1909.8,90,,percent of total billed charges,,,1909.8,90,,percent of total billed charges,,,1909.8,90,,percent of total billed charges,,,1803.7,85,,percent of total billed charges,,293.75,2015.9,
CYSTOURETERO W/LITHOTRIPSY,52353,CDM,52353,CPT,,,both,,2461,2461,658.46,,,,fee schedule,,,,,,,,262.2,,,,fee schedule,,,2091.85,85,,percent of total billed charges,,886.09,,,,fee schedule,,420.2,,,,fee schedule,,262.2,,,,fee schedule,,754.73,,,,fee schedule,,262.2,,,,fee schedule,,639.1,,,,fee schedule,,387.33,,,,fee schedule,,387.33,,,,fee schedule,,,2239.51,91,,percent of total billed charges,,,2337.95,95,,percent of total billed charges,,,2042.63,83,,percent of total billed charges,,,738.3,83,,percent of total billed charges,,262.2,,,,fee schedule,,262.2,,,,fee schedule,,,2042.63,83,,percent of total billed charges,,569.38,,,,fee schedule,,,2214.9,90,,percent of total billed charges,,,2214.9,90,,percent of total billed charges,,,2214.9,90,,percent of total billed charges,,,2214.9,90,,percent of total billed charges,,,2091.85,85,,percent of total billed charges,,262.2,2337.95,
CYSTOURETERO W/BIOPSY,52354,CDM,52354,CPT,,,both,,2369,2369,699.94,,,,fee schedule,,,,,,,,249.7,,,,fee schedule,,,2013.65,85,,percent of total billed charges,,942.27,,,,fee schedule,,446.84,,,,fee schedule,,249.7,,,,fee schedule,,697.69,,,,fee schedule,,249.7,,,,fee schedule,,679.35,,,,fee schedule,,411.73,,,,fee schedule,,411.73,,,,fee schedule,,,2155.79,91,,percent of total billed charges,,,2250.55,95,,percent of total billed charges,,,1966.27,83,,percent of total billed charges,,,710.7,83,,percent of total billed charges,,249.7,,,,fee schedule,,249.7,,,,fee schedule,,,1966.27,83,,percent of total billed charges,,605.24,,,,fee schedule,,,2132.1,90,,percent of total billed charges,,,2132.1,90,,percent of total billed charges,,,2132.1,90,,percent of total billed charges,,,2132.1,90,,percent of total billed charges,,,2013.65,85,,percent of total billed charges,,249.7,2250.55,
CYSTO/URETERO W/LITHOTRIPSY,52356,CDM,52356,CPT,,,both,,2194,2194,697.64,,,,fee schedule,,,,,,,,252.92,,,,fee schedule,,,1864.9,85,,percent of total billed charges,,939.4,,,,fee schedule,,445.48,,,,fee schedule,,252.92,,,,fee schedule,,,,,,,,252.92,,,,fee schedule,,677.12,,,,fee schedule,,410.37,,,,fee schedule,,410.37,,,,fee schedule,,,1996.54,91,,percent of total billed charges,,,2084.3,95,,percent of total billed charges,,,1821.02,83,,percent of total billed charges,,,658.2,83,,percent of total billed charges,,252.92,,,,fee schedule,,252.92,,,,fee schedule,,,1821.02,83,,percent of total billed charges,,603.25,,,,fee schedule,,,1974.6,90,,percent of total billed charges,,,1974.6,90,,percent of total billed charges,,,1974.6,90,,percent of total billed charges,,,1974.6,90,,percent of total billed charges,,,1864.9,85,,percent of total billed charges,,252.92,2084.3,
CYSTOURETHRO W/IMPLANT,52441,CDM,52441,CPT,,,both,,1082,1082,352.56,,,,fee schedule,,,,,,,,140.15,,,,fee schedule,,,919.7,85,,percent of total billed charges,,473.9,,,,fee schedule,,224.73,,,,fee schedule,,140.15,,,,fee schedule,,,,,,,,140.15,,,,fee schedule,,342.19,,,,fee schedule,,207.39,,,,fee schedule,,207.39,,,,fee schedule,,,984.62,91,,percent of total billed charges,,,1027.9,95,,percent of total billed charges,,,898.06,83,,percent of total billed charges,,,324.6,83,,percent of total billed charges,,140.15,,,,fee schedule,,140.15,,,,fee schedule,,,898.06,83,,percent of total billed charges,,304.86,,,,fee schedule,,,973.8,90,,percent of total billed charges,,,973.8,90,,percent of total billed charges,,,973.8,90,,percent of total billed charges,,,973.8,90,,percent of total billed charges,,,919.7,85,,percent of total billed charges,,140.15,1027.9,
REVISION OF BLADDER NECK,52500,CDM,52500,CPT,,,both,,2715,2715,839.35,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,2307.75,85,,percent of total billed charges,,1109.18,,,,fee schedule,,526,,,,fee schedule,,480,,,,fee schedule,,860.84,,,,fee schedule,,480,,,,fee schedule,,814.67,,,,fee schedule,,493.74,,,,fee schedule,,493.74,,,,fee schedule,,,2470.65,91,,percent of total billed charges,,,2579.25,95,,percent of total billed charges,,,2253.45,83,,percent of total billed charges,,,814.5,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,2253.45,83,,percent of total billed charges,,725.79,,,,fee schedule,,,2443.5,90,,percent of total billed charges,,,2443.5,90,,percent of total billed charges,,,2443.5,90,,percent of total billed charges,,,2443.5,90,,percent of total billed charges,,,2307.75,85,,percent of total billed charges,,480,2579.25,
PROSTATECTOMY (TURP),52601,CDM,52601,CPT,,,both,,4048,4048,1236.27,,,,fee schedule,,,,,,,,775.6,,,,fee schedule,,,3440.8,85,,percent of total billed charges,,1651.52,,,,fee schedule,,783.19,,,,fee schedule,,775.6,,,,fee schedule,,1214.99,,,,fee schedule,,775.6,,,,fee schedule,,1199.91,,,,fee schedule,,727.22,,,,fee schedule,,727.22,,,,fee schedule,,,3683.68,91,,percent of total billed charges,,,3845.6,95,,percent of total billed charges,,,3359.84,83,,percent of total billed charges,,,1214.4,83,,percent of total billed charges,,775.6,,,,fee schedule,,775.6,,,,fee schedule,,,3359.84,83,,percent of total billed charges,,1069.01,,,,fee schedule,,,3643.2,90,,percent of total billed charges,,,3643.2,90,,percent of total billed charges,,,3643.2,90,,percent of total billed charges,,,3643.2,90,,percent of total billed charges,,,3440.8,85,,percent of total billed charges,,727.22,3845.6,
REMOVE PROSTATE REGROWTH,52630,CDM,52630,CPT,,,both,,2457,2457,691.87,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,2088.45,85,,percent of total billed charges,,912.62,,,,fee schedule,,432.78,,,,fee schedule,,599.35,,,,fee schedule,,726.21,,,,fee schedule,,599.35,,,,fee schedule,,671.53,,,,fee schedule,,406.99,,,,fee schedule,,406.99,,,,fee schedule,,,2235.87,91,,percent of total billed charges,,,2334.15,95,,percent of total billed charges,,,2039.31,83,,percent of total billed charges,,,737.1,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,2039.31,83,,percent of total billed charges,,598.27,,,,fee schedule,,,2211.3,90,,percent of total billed charges,,,2211.3,90,,percent of total billed charges,,,2211.3,90,,percent of total billed charges,,,2211.3,90,,percent of total billed charges,,,2088.45,85,,percent of total billed charges,,406.99,2334.15,
RELIEVE BLADDER CONTRACTURE,52640,CDM,52640,CPT,,,both,,1716,1716,550.73,,,,fee schedule,,,,,,,,486.9,,,,fee schedule,,,1458.6,85,,percent of total billed charges,,720.41,,,,fee schedule,,341.63,,,,fee schedule,,486.9,,,,fee schedule,,665.86,,,,fee schedule,,486.9,,,,fee schedule,,534.54,,,,fee schedule,,323.96,,,,fee schedule,,323.96,,,,fee schedule,,,1561.56,91,,percent of total billed charges,,,1630.2,95,,percent of total billed charges,,,1424.28,83,,percent of total billed charges,,,514.8,83,,percent of total billed charges,,486.9,,,,fee schedule,,486.9,,,,fee schedule,,,1424.28,83,,percent of total billed charges,,476.22,,,,fee schedule,,,1544.4,90,,percent of total billed charges,,,1544.4,90,,percent of total billed charges,,,1544.4,90,,percent of total billed charges,,,1544.4,90,,percent of total billed charges,,,1458.6,85,,percent of total billed charges,,323.96,1630.2,
LASER SURGERY OF PROSTATE,52648,CDM,52648,CPT,,,both,,7753,7753,1177.51,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,6590.05,85,,percent of total billed charges,,1566.65,,,,fee schedule,,742.94,,,,fee schedule,,599.35,,,,fee schedule,,1112.2,,,,fee schedule,,599.35,,,,fee schedule,,1142.88,,,,fee schedule,,692.65,,,,fee schedule,,692.65,,,,fee schedule,,,7055.23,91,,percent of total billed charges,,,7365.35,95,,percent of total billed charges,,,6434.99,83,,percent of total billed charges,,,2325.9,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,6434.99,83,,percent of total billed charges,,1018.2,,,,fee schedule,,,6977.7,90,,percent of total billed charges,,,6977.7,90,,percent of total billed charges,,,6977.7,90,,percent of total billed charges,,,6977.7,90,,percent of total billed charges,,,6590.05,85,,percent of total billed charges,,599.35,7365.35,
PROSTATE LASER ENUCLEATION,52649,CDM,52649,CPT,,,both,,3972,3972,1402.76,,,,fee schedule,,,,,,,,562.42,,,,fee schedule,,,3376.2,85,,percent of total billed charges,,1870.02,,,,fee schedule,,886.8,,,,fee schedule,,562.42,,,,fee schedule,,,,,,,,562.42,,,,fee schedule,,1361.5,,,,fee schedule,,825.15,,,,fee schedule,,825.15,,,,fee schedule,,,3614.52,91,,percent of total billed charges,,,3773.4,95,,percent of total billed charges,,,3296.76,83,,percent of total billed charges,,,1191.6,83,,percent of total billed charges,,562.42,,,,fee schedule,,562.42,,,,fee schedule,,,3296.76,83,,percent of total billed charges,,1212.98,,,,fee schedule,,,3574.8,90,,percent of total billed charges,,,3574.8,90,,percent of total billed charges,,,3574.8,90,,percent of total billed charges,,,3574.8,90,,percent of total billed charges,,,3376.2,85,,percent of total billed charges,,562.42,3773.4,
INCISION OF URETHRA,53020,CDM,53020,CPT,,,both,,575,575,163.61,,,,fee schedule,,,,,,,,67.8,,,,fee schedule,,,488.75,85,,percent of total billed charges,,218.32,,,,fee schedule,,103.53,,,,fee schedule,,67.8,,,,fee schedule,,170.44,,,,fee schedule,,67.8,,,,fee schedule,,158.8,,,,fee schedule,,96.24,,,,fee schedule,,96.24,,,,fee schedule,,,523.25,91,,percent of total billed charges,,,546.25,95,,percent of total billed charges,,,477.25,83,,percent of total billed charges,,,172.5,83,,percent of total billed charges,,67.8,,,,fee schedule,,67.8,,,,fee schedule,,,477.25,83,,percent of total billed charges,,141.47,,,,fee schedule,,,517.5,90,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,517.5,90,,percent of total billed charges,,,488.75,85,,percent of total billed charges,,67.8,546.25,
TREATMENT OF URETHRA LESION,53260,CDM,53260,CPT,,,both,,851,851,310.51,,,,fee schedule,,,,,,,,113.6,,,,fee schedule,,,723.35,85,,percent of total billed charges,,411.17,,,,fee schedule,,194.98,,,,fee schedule,,113.6,,,,fee schedule,,309.05,,,,fee schedule,,113.6,,,,fee schedule,,301.38,,,,fee schedule,,182.65,,,,fee schedule,,182.65,,,,fee schedule,,,774.41,91,,percent of total billed charges,,,808.45,95,,percent of total billed charges,,,706.33,83,,percent of total billed charges,,,255.3,83,,percent of total billed charges,,113.6,,,,fee schedule,,113.6,,,,fee schedule,,,706.33,83,,percent of total billed charges,,268.5,,,,fee schedule,,,765.9,90,,percent of total billed charges,,,765.9,90,,percent of total billed charges,,,765.9,90,,percent of total billed charges,,,765.9,90,,percent of total billed charges,,,723.35,85,,percent of total billed charges,,113.6,808.45,
TREATMENT OF URETHRA LESION,53265,CDM,53265,CPT,,,both,,1003,1003,323.76,,,,fee schedule,,,,,,,,115,,,,fee schedule,,,852.55,85,,percent of total billed charges,,427.63,,,,fee schedule,,202.79,,,,fee schedule,,115,,,,fee schedule,,317.01,,,,fee schedule,,115,,,,fee schedule,,314.24,,,,fee schedule,,190.45,,,,fee schedule,,190.45,,,,fee schedule,,,912.73,91,,percent of total billed charges,,,952.85,95,,percent of total billed charges,,,832.49,83,,percent of total billed charges,,,300.9,83,,percent of total billed charges,,115,,,,fee schedule,,115,,,,fee schedule,,,832.49,83,,percent of total billed charges,,279.96,,,,fee schedule,,,902.7,90,,percent of total billed charges,,,902.7,90,,percent of total billed charges,,,902.7,90,,percent of total billed charges,,,902.7,90,,percent of total billed charges,,,852.55,85,,percent of total billed charges,,115,952.85,
REPAIR OF URETHRA INJURY,53502,CDM,53502,CPT,,,both,,2204,2204,828.41,,,,fee schedule,,,,,,,,289.28,,,,fee schedule,,,1873.4,85,,percent of total billed charges,,1100.61,,,,fee schedule,,521.93,,,,fee schedule,,289.28,,,,fee schedule,,811.1,,,,fee schedule,,289.28,,,,fee schedule,,804.04,,,,fee schedule,,487.3,,,,fee schedule,,487.3,,,,fee schedule,,,2005.64,91,,percent of total billed charges,,,2093.8,95,,percent of total billed charges,,,1829.32,83,,percent of total billed charges,,,661.2,83,,percent of total billed charges,,289.28,,,,fee schedule,,289.28,,,,fee schedule,,,1829.32,83,,percent of total billed charges,,716.33,,,,fee schedule,,,1983.6,90,,percent of total billed charges,,,1983.6,90,,percent of total billed charges,,,1983.6,90,,percent of total billed charges,,,1983.6,90,,percent of total billed charges,,,1873.4,85,,percent of total billed charges,,289.28,2093.8,
REPAIR OF URETHRA INJURY,53502AS,CDM,53502,CPT,,,both,AS,689,689,828.41,,,,fee schedule,,,,,,,,289.28,,,,fee schedule,,,585.65,85,,percent of total billed charges,,1100.61,,,,fee schedule,,521.93,,,,fee schedule,,289.28,,,,fee schedule,,811.1,,,,fee schedule,,289.28,,,,fee schedule,,804.04,,,,fee schedule,,487.3,,,,fee schedule,,487.3,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,289.28,,,,fee schedule,,289.28,,,,fee schedule,,,571.87,83,,percent of total billed charges,,716.33,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,1100.61,
DILATE URETHRA STRICTURE,53600,CDM,53600,CPT,,,both,,377,377,108.88,,,,fee schedule,,,,,,,,52.8,,,,fee schedule,,,320.45,85,,percent of total billed charges,,143.37,,,,fee schedule,,69.3,,,,fee schedule,,52.8,,,,fee schedule,,114.73,,,,fee schedule,,52.8,,,,fee schedule,,105.68,,,,fee schedule,,64.05,,,,fee schedule,,64.05,,,,fee schedule,,,343.07,91,,percent of total billed charges,,,358.15,95,,percent of total billed charges,,,312.91,83,,percent of total billed charges,,,113.1,83,,percent of total billed charges,,52.8,,,,fee schedule,,52.8,,,,fee schedule,,,312.91,83,,percent of total billed charges,,94.15,,,,fee schedule,,,339.3,90,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,339.3,90,,percent of total billed charges,,,320.45,85,,percent of total billed charges,,52.8,358.15,
DILATE URETHRA STRICTURE,53601,CDM,53601,CPT,,,both,,303,303,90.44,,,,fee schedule,,,,,,,,47.8,,,,fee schedule,,,257.55,85,,percent of total billed charges,,119.61,,,,fee schedule,,57.81,,,,fee schedule,,47.8,,,,fee schedule,,94.18,,,,fee schedule,,47.8,,,,fee schedule,,87.78,,,,fee schedule,,53.2,,,,fee schedule,,53.2,,,,fee schedule,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,90.9,83,,percent of total billed charges,,47.8,,,,fee schedule,,47.8,,,,fee schedule,,,251.49,83,,percent of total billed charges,,78.21,,,,fee schedule,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,47.8,287.85,
DILATE URETHRA STRICTURE,53601P,CDM,53601,CPT,,,both,P,147,147,90.44,,,,fee schedule,,,,,,,,47.8,,,,fee schedule,,,124.95,85,,percent of total billed charges,,119.61,,,,fee schedule,,57.81,,,,fee schedule,,47.8,,,,fee schedule,,94.18,,,,fee schedule,,47.8,,,,fee schedule,,87.78,,,,fee schedule,,53.2,,,,fee schedule,,53.2,,,,fee schedule,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,44.1,83,,percent of total billed charges,,47.8,,,,fee schedule,,47.8,,,,fee schedule,,,122.01,83,,percent of total billed charges,,78.21,,,,fee schedule,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,44.1,139.65,
DILATE URETHRA STRICTURE,53601T,CDM,53601,CPT,,,both,T,156,156,90.44,,,,fee schedule,,,,,,,,47.8,,,,fee schedule,,,132.6,85,,percent of total billed charges,,119.61,,,,fee schedule,,57.81,,,,fee schedule,,47.8,,,,fee schedule,,94.18,,,,fee schedule,,47.8,,,,fee schedule,,87.78,,,,fee schedule,,53.2,,,,fee schedule,,53.2,,,,fee schedule,,,141.96,91,,percent of total billed charges,,,148.2,95,,percent of total billed charges,,,129.48,83,,percent of total billed charges,,,46.8,83,,percent of total billed charges,,47.8,,,,fee schedule,,47.8,,,,fee schedule,,,129.48,83,,percent of total billed charges,,78.21,,,,fee schedule,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,132.6,85,,percent of total billed charges,,46.8,148.2,
DILATE URETHRA STRICTURE,53620,CDM,53620,CPT,,,both,,501,501,146.9,,,,fee schedule,,,,,,,,75.1,,,,fee schedule,,,425.85,85,,percent of total billed charges,,197.7,,,,fee schedule,,95.56,,,,fee schedule,,75.1,,,,fee schedule,,154.53,,,,fee schedule,,75.1,,,,fee schedule,,142.58,,,,fee schedule,,86.41,,,,fee schedule,,86.41,,,,fee schedule,,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,150.3,83,,percent of total billed charges,,75.1,,,,fee schedule,,75.1,,,,fee schedule,,,415.83,83,,percent of total billed charges,,127.03,,,,fee schedule,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,75.1,475.95,
DILATE URETHRA STRICTURE,53621,CDM,53621,CPT,,,both,,440,440,121.55,,,,fee schedule,,,,,,,,69.55,,,,fee schedule,,,374,85,,percent of total billed charges,,163.63,,,,fee schedule,,79.09,,,,fee schedule,,69.55,,,,fee schedule,,128.66,,,,fee schedule,,69.55,,,,fee schedule,,117.98,,,,fee schedule,,71.5,,,,fee schedule,,71.5,,,,fee schedule,,,400.4,91,,percent of total billed charges,,,418,95,,percent of total billed charges,,,365.2,83,,percent of total billed charges,,,132,83,,percent of total billed charges,,69.55,,,,fee schedule,,69.55,,,,fee schedule,,,365.2,83,,percent of total billed charges,,105.11,,,,fee schedule,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,374,85,,percent of total billed charges,,69.55,418,
DILATION OF URETHRA,53660,CDM,53660,CPT,,,both,,303,303,70.86,,,,fee schedule,,,,,,,,41.8,,,,fee schedule,,,257.55,85,,percent of total billed charges,,93.64,,,,fee schedule,,45.26,,,,fee schedule,,41.8,,,,fee schedule,,70.96,,,,fee schedule,,41.8,,,,fee schedule,,68.77,,,,fee schedule,,41.68,,,,fee schedule,,41.68,,,,fee schedule,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,90.9,83,,percent of total billed charges,,41.8,,,,fee schedule,,41.8,,,,fee schedule,,,251.49,83,,percent of total billed charges,,61.27,,,,fee schedule,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,41.68,287.85,
DILATION OF URETHRA,53660P,CDM,53660,CPT,,,both,P,148,148,70.86,,,,fee schedule,,,,,,,,41.8,,,,fee schedule,,,125.8,85,,percent of total billed charges,,93.64,,,,fee schedule,,45.26,,,,fee schedule,,41.8,,,,fee schedule,,70.96,,,,fee schedule,,41.8,,,,fee schedule,,68.77,,,,fee schedule,,41.68,,,,fee schedule,,41.68,,,,fee schedule,,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,44.4,83,,percent of total billed charges,,41.8,,,,fee schedule,,41.8,,,,fee schedule,,,122.84,83,,percent of total billed charges,,61.27,,,,fee schedule,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,41.68,140.6,
DILATION OF URETHRA,53660T,CDM,53660,CPT,,,both,T,155,155,70.86,,,,fee schedule,,,,,,,,41.8,,,,fee schedule,,,131.75,85,,percent of total billed charges,,93.64,,,,fee schedule,,45.26,,,,fee schedule,,41.8,,,,fee schedule,,70.96,,,,fee schedule,,41.8,,,,fee schedule,,68.77,,,,fee schedule,,41.68,,,,fee schedule,,41.68,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,41.8,,,,fee schedule,,41.8,,,,fee schedule,,,128.65,83,,percent of total billed charges,,61.27,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,41.68,147.25,
DILATION OF URETHRA,53661,CDM,53661,CPT,,,both,,259,259,69.13,,,,fee schedule,,,,,,,,42.1,,,,fee schedule,,,220.15,85,,percent of total billed charges,,90.84,,,,fee schedule,,43.91,,,,fee schedule,,42.1,,,,fee schedule,,70.3,,,,fee schedule,,42.1,,,,fee schedule,,67.1,,,,fee schedule,,40.66,,,,fee schedule,,40.66,,,,fee schedule,,,235.69,91,,percent of total billed charges,,,246.05,95,,percent of total billed charges,,,214.97,83,,percent of total billed charges,,,77.7,83,,percent of total billed charges,,42.1,,,,fee schedule,,42.1,,,,fee schedule,,,214.97,83,,percent of total billed charges,,59.78,,,,fee schedule,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,220.15,85,,percent of total billed charges,,40.66,246.05,
INSERT PROST URETHRAL STENT,53855,CDM,53855,CPT,,,both,,3224,3224,138.26,,,,fee schedule,,,,,,,,47.81,,,,fee schedule,,,2740.4,85,,percent of total billed charges,,187.79,,,,fee schedule,,90.77,,,,fee schedule,,47.81,,,,fee schedule,,,,,,,,47.81,,,,fee schedule,,134.19,,,,fee schedule,,81.33,,,,fee schedule,,81.33,,,,fee schedule,,,2933.84,91,,percent of total billed charges,,,3062.8,95,,percent of total billed charges,,,2675.92,83,,percent of total billed charges,,,967.2,83,,percent of total billed charges,,47.81,,,,fee schedule,,47.81,,,,fee schedule,,,2675.92,83,,percent of total billed charges,,119.55,,,,fee schedule,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2901.6,90,,percent of total billed charges,,,2740.4,85,,percent of total billed charges,,47.81,3062.8,
SLITTING OF PREPUCE,54000,CDM,54000,CPT,,,both,,632,632,188.96,,,,fee schedule,,,,,,,,74.9,,,,fee schedule,,,537.2,85,,percent of total billed charges,,248.28,,,,fee schedule,,119.73,,,,fee schedule,,74.9,,,,fee schedule,,171.11,,,,fee schedule,,74.9,,,,fee schedule,,183.4,,,,fee schedule,,111.15,,,,fee schedule,,111.15,,,,fee schedule,,,575.12,91,,percent of total billed charges,,,600.4,95,,percent of total billed charges,,,524.56,83,,percent of total billed charges,,,189.6,83,,percent of total billed charges,,74.9,,,,fee schedule,,74.9,,,,fee schedule,,,524.56,83,,percent of total billed charges,,163.39,,,,fee schedule,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,568.8,90,,percent of total billed charges,,,537.2,85,,percent of total billed charges,,74.9,600.4,
SLITTING OF PREPUCE,54001,CDM,54001,CPT,,,both,,773,773,239.65,,,,fee schedule,,,,,,,,87.85,,,,fee schedule,,,657.05,85,,percent of total billed charges,,314.98,,,,fee schedule,,151.9,,,,fee schedule,,87.85,,,,fee schedule,,229.47,,,,fee schedule,,87.85,,,,fee schedule,,232.6,,,,fee schedule,,140.97,,,,fee schedule,,140.97,,,,fee schedule,,,703.43,91,,percent of total billed charges,,,734.35,95,,percent of total billed charges,,,641.59,83,,percent of total billed charges,,,231.9,83,,percent of total billed charges,,87.85,,,,fee schedule,,87.85,,,,fee schedule,,,641.59,83,,percent of total billed charges,,207.23,,,,fee schedule,,,695.7,90,,percent of total billed charges,,,695.7,90,,percent of total billed charges,,,695.7,90,,percent of total billed charges,,,695.7,90,,percent of total billed charges,,,657.05,85,,percent of total billed charges,,87.85,734.35,
"DESTRUCTION, PENIS LESION(S)",54055,CDM,54055,CPT,,,both,,546,546,164.76,,,,fee schedule,,,,,,,,72.1,,,,fee schedule,,,464.1,85,,percent of total billed charges,,208.98,,,,fee schedule,,100.78,,,,fee schedule,,72.1,,,,fee schedule,,139.27,,,,fee schedule,,72.1,,,,fee schedule,,159.91,,,,fee schedule,,96.92,,,,fee schedule,,96.92,,,,fee schedule,,,496.86,91,,percent of total billed charges,,,518.7,95,,percent of total billed charges,,,453.18,83,,percent of total billed charges,,,163.8,83,,percent of total billed charges,,72.1,,,,fee schedule,,72.1,,,,fee schedule,,,453.18,83,,percent of total billed charges,,142.47,,,,fee schedule,,,491.4,90,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,464.1,85,,percent of total billed charges,,72.1,518.7,
"CRYOSURGERY, PENIS LESION(S)",54056,CDM,54056,CPT,,,both,,442,442,191.26,,,,fee schedule,,,,,,,,71.4,,,,fee schedule,,,375.7,85,,percent of total billed charges,,242.34,,,,fee schedule,,116.87,,,,fee schedule,,71.4,,,,fee schedule,,161.16,,,,fee schedule,,71.4,,,,fee schedule,,185.63,,,,fee schedule,,112.51,,,,fee schedule,,112.51,,,,fee schedule,,,402.22,91,,percent of total billed charges,,,419.9,95,,percent of total billed charges,,,366.86,83,,percent of total billed charges,,,132.6,83,,percent of total billed charges,,71.4,,,,fee schedule,,71.4,,,,fee schedule,,,366.86,83,,percent of total billed charges,,165.38,,,,fee schedule,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,375.7,85,,percent of total billed charges,,71.4,419.9,
"CRYOSURGERY, PENIS LESION(S)",54056P,CDM,54056,CPT,,,both,P,279,279,191.26,,,,fee schedule,,,,,,,,71.4,,,,fee schedule,,,237.15,85,,percent of total billed charges,,242.34,,,,fee schedule,,116.87,,,,fee schedule,,71.4,,,,fee schedule,,161.16,,,,fee schedule,,71.4,,,,fee schedule,,185.63,,,,fee schedule,,112.51,,,,fee schedule,,112.51,,,,fee schedule,,,253.89,91,,percent of total billed charges,,,265.05,95,,percent of total billed charges,,,231.57,83,,percent of total billed charges,,,83.7,83,,percent of total billed charges,,71.4,,,,fee schedule,,71.4,,,,fee schedule,,,231.57,83,,percent of total billed charges,,165.38,,,,fee schedule,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,237.15,85,,percent of total billed charges,,71.4,265.05,
"CRYOSURGERY, PENIS LESION(S)",54056T,CDM,54056,CPT,,,both,T,163,163,191.26,,,,fee schedule,,,,,,,,71.4,,,,fee schedule,,,138.55,85,,percent of total billed charges,,242.34,,,,fee schedule,,116.87,,,,fee schedule,,71.4,,,,fee schedule,,161.16,,,,fee schedule,,71.4,,,,fee schedule,,185.63,,,,fee schedule,,112.51,,,,fee schedule,,112.51,,,,fee schedule,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,48.9,83,,percent of total billed charges,,71.4,,,,fee schedule,,71.4,,,,fee schedule,,,135.29,83,,percent of total billed charges,,165.38,,,,fee schedule,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,48.9,242.34,
EXCISION OF PENIS LESION(S),54060,CDM,54060,CPT,,,both,,819,819,224.1,,,,fee schedule,,,,,,,,88.5,,,,fee schedule,,,696.15,85,,percent of total billed charges,,294.99,,,,fee schedule,,142.26,,,,fee schedule,,88.5,,,,fee schedule,,207.58,,,,fee schedule,,88.5,,,,fee schedule,,217.5,,,,fee schedule,,131.82,,,,fee schedule,,131.82,,,,fee schedule,,,745.29,91,,percent of total billed charges,,,778.05,95,,percent of total billed charges,,,679.77,83,,percent of total billed charges,,,245.7,83,,percent of total billed charges,,88.5,,,,fee schedule,,88.5,,,,fee schedule,,,679.77,83,,percent of total billed charges,,193.78,,,,fee schedule,,,737.1,90,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,737.1,90,,percent of total billed charges,,,696.15,85,,percent of total billed charges,,88.5,778.05,
"DESTRUCTION, PENIS LESION(S)",54065,CDM,54065,CPT,,,both,,1067,1067,293.8,,,,fee schedule,,,,,,,,107,,,,fee schedule,,,906.95,85,,percent of total billed charges,,381.3,,,,fee schedule,,183.88,,,,fee schedule,,107,,,,fee schedule,,251.36,,,,fee schedule,,107,,,,fee schedule,,285.16,,,,fee schedule,,172.82,,,,fee schedule,,172.82,,,,fee schedule,,,970.97,91,,percent of total billed charges,,,1013.65,95,,percent of total billed charges,,,885.61,83,,percent of total billed charges,,,320.1,83,,percent of total billed charges,,107,,,,fee schedule,,107,,,,fee schedule,,,885.61,83,,percent of total billed charges,,254.05,,,,fee schedule,,,960.3,90,,percent of total billed charges,,,960.3,90,,percent of total billed charges,,,960.3,90,,percent of total billed charges,,,960.3,90,,percent of total billed charges,,,906.95,85,,percent of total billed charges,,107,1013.65,
BIOPSY OF PENIS,54100,CDM,54100,CPT,,,both,,536,536,206.24,,,,fee schedule,,,,,,,,88.5,,,,fee schedule,,,455.6,85,,percent of total billed charges,,269.85,,,,fee schedule,,130.13,,,,fee schedule,,88.5,,,,fee schedule,,187.69,,,,fee schedule,,88.5,,,,fee schedule,,200.17,,,,fee schedule,,121.32,,,,fee schedule,,121.32,,,,fee schedule,,,487.76,91,,percent of total billed charges,,,509.2,95,,percent of total billed charges,,,444.88,83,,percent of total billed charges,,,160.8,83,,percent of total billed charges,,88.5,,,,fee schedule,,88.5,,,,fee schedule,,,444.88,83,,percent of total billed charges,,178.33,,,,fee schedule,,,482.4,90,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,482.4,90,,percent of total billed charges,,,455.6,85,,percent of total billed charges,,88.5,509.2,
TREATMENT OF PENIS LESION,54110,CDM,54110,CPT,,,both,,2698,2698,1062.3,,,,fee schedule,,,,,,,,321.45,,,,fee schedule,,,2293.3,85,,percent of total billed charges,,1425.6,,,,fee schedule,,687.49,,,,fee schedule,,321.45,,,,fee schedule,,1034.6,,,,fee schedule,,321.45,,,,fee schedule,,1031.05,,,,fee schedule,,624.88,,,,fee schedule,,624.88,,,,fee schedule,,,2455.18,91,,percent of total billed charges,,,2563.1,95,,percent of total billed charges,,,2239.34,83,,percent of total billed charges,,,809.4,83,,percent of total billed charges,,321.45,,,,fee schedule,,321.45,,,,fee schedule,,,2239.34,83,,percent of total billed charges,,918.57,,,,fee schedule,,,2428.2,90,,percent of total billed charges,,,2428.2,90,,percent of total billed charges,,,2428.2,90,,percent of total billed charges,,,2428.2,90,,percent of total billed charges,,,2293.3,85,,percent of total billed charges,,321.45,2563.1,
CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK,54150,CDM,54150,CPT,,,both,,816,816,164.18,,,,fee schedule,,,,,,,,77.5,,,,fee schedule,,,693.6,85,,percent of total billed charges,,223.16,,,,fee schedule,,107.41,,,,fee schedule,,77.5,,,,fee schedule,,177.08,,,,fee schedule,,77.5,,,,fee schedule,,159.35,,,,fee schedule,,96.58,,,,fee schedule,,96.58,,,,fee schedule,,,742.56,91,,percent of total billed charges,,,775.2,95,,percent of total billed charges,,,677.28,83,,percent of total billed charges,,,244.8,83,,percent of total billed charges,,77.5,,,,fee schedule,,77.5,,,,fee schedule,,,677.28,83,,percent of total billed charges,,141.97,,,,fee schedule,,,734.4,90,,percent of total billed charges,,,734.4,90,,percent of total billed charges,,,734.4,90,,percent of total billed charges,,,734.4,90,,percent of total billed charges,,,693.6,85,,percent of total billed charges,,77.5,775.2,
CIRCUMCISION,54160,CDM,54160,CPT,,,both,,769,769,247.72,,,,fee schedule,,,,,,,,99.8,,,,fee schedule,,,653.65,85,,percent of total billed charges,,329.35,,,,fee schedule,,158.83,,,,fee schedule,,99.8,,,,fee schedule,,249.37,,,,fee schedule,,99.8,,,,fee schedule,,240.43,,,,fee schedule,,145.71,,,,fee schedule,,145.71,,,,fee schedule,,,699.79,91,,percent of total billed charges,,,730.55,95,,percent of total billed charges,,,638.27,83,,percent of total billed charges,,,230.7,83,,percent of total billed charges,,99.8,,,,fee schedule,,99.8,,,,fee schedule,,,638.27,83,,percent of total billed charges,,214.2,,,,fee schedule,,,692.1,90,,percent of total billed charges,,,692.1,90,,percent of total billed charges,,,692.1,90,,percent of total billed charges,,,692.1,90,,percent of total billed charges,,,653.65,85,,percent of total billed charges,,99.8,730.55,
CIRCUMCISION,54161,CDM,54161,CPT,,,both,,1055,1055,336.43,,,,fee schedule,,,,,,,,146.7,,,,fee schedule,,,896.75,85,,percent of total billed charges,,447.2,,,,fee schedule,,215.66,,,,fee schedule,,146.7,,,,fee schedule,,336.25,,,,fee schedule,,146.7,,,,fee schedule,,326.54,,,,fee schedule,,197.9,,,,fee schedule,,197.9,,,,fee schedule,,,960.05,91,,percent of total billed charges,,,1002.25,95,,percent of total billed charges,,,875.65,83,,percent of total billed charges,,,316.5,83,,percent of total billed charges,,146.7,,,,fee schedule,,146.7,,,,fee schedule,,,875.65,83,,percent of total billed charges,,290.91,,,,fee schedule,,,949.5,90,,percent of total billed charges,,,949.5,90,,percent of total billed charges,,,949.5,90,,percent of total billed charges,,,949.5,90,,percent of total billed charges,,,896.75,85,,percent of total billed charges,,146.7,1002.25,
LYSIS PENIL CIRCUMIC LESION,54162,CDM,54162,CPT,,,both,,1012,1012,342.19,,,,fee schedule,,,,,,,,97.25,,,,fee schedule,,,860.2,85,,percent of total billed charges,,453.67,,,,fee schedule,,218.78,,,,fee schedule,,97.25,,,,fee schedule,,309.05,,,,fee schedule,,97.25,,,,fee schedule,,332.13,,,,fee schedule,,201.29,,,,fee schedule,,201.29,,,,fee schedule,,,920.92,91,,percent of total billed charges,,,961.4,95,,percent of total billed charges,,,839.96,83,,percent of total billed charges,,,303.6,83,,percent of total billed charges,,97.25,,,,fee schedule,,97.25,,,,fee schedule,,,839.96,83,,percent of total billed charges,,295.9,,,,fee schedule,,,910.8,90,,percent of total billed charges,,,910.8,90,,percent of total billed charges,,,910.8,90,,percent of total billed charges,,,910.8,90,,percent of total billed charges,,,860.2,85,,percent of total billed charges,,97.25,961.4,
REPAIR OF CIRCUMCISION,54163,CDM,54163,CPT,,,both,,1107,1107,373.88,,,,fee schedule,,,,,,,,137.4,,,,fee schedule,,,940.95,85,,percent of total billed charges,,491.07,,,,fee schedule,,236.81,,,,fee schedule,,137.4,,,,fee schedule,,346.19,,,,fee schedule,,137.4,,,,fee schedule,,362.88,,,,fee schedule,,219.93,,,,fee schedule,,219.93,,,,fee schedule,,,1007.37,91,,percent of total billed charges,,,1051.65,95,,percent of total billed charges,,,918.81,83,,percent of total billed charges,,,332.1,83,,percent of total billed charges,,137.4,,,,fee schedule,,137.4,,,,fee schedule,,,918.81,83,,percent of total billed charges,,323.29,,,,fee schedule,,,996.3,90,,percent of total billed charges,,,996.3,90,,percent of total billed charges,,,996.3,90,,percent of total billed charges,,,996.3,90,,percent of total billed charges,,,940.95,85,,percent of total billed charges,,137.4,1051.65,
FRENULOTOMY OF PENIS,54164,CDM,54164,CPT,,,both,,942,942,331.25,,,,fee schedule,,,,,,,,120.3,,,,fee schedule,,,800.7,85,,percent of total billed charges,,435.26,,,,fee schedule,,209.9,,,,fee schedule,,120.3,,,,fee schedule,,299.77,,,,fee schedule,,120.3,,,,fee schedule,,321.5,,,,fee schedule,,194.85,,,,fee schedule,,194.85,,,,fee schedule,,,857.22,91,,percent of total billed charges,,,894.9,95,,percent of total billed charges,,,781.86,83,,percent of total billed charges,,,282.6,83,,percent of total billed charges,,120.3,,,,fee schedule,,120.3,,,,fee schedule,,,781.86,83,,percent of total billed charges,,286.43,,,,fee schedule,,,847.8,90,,percent of total billed charges,,,847.8,90,,percent of total billed charges,,,847.8,90,,percent of total billed charges,,,847.8,90,,percent of total billed charges,,,800.7,85,,percent of total billed charges,,120.3,894.9,
TREATMENT OF PENIS LESION,54205,CDM,54205,CPT,,,both,,2106,2106,906.75,,,,fee schedule,,,,,,,,,,,,,,,1790.1,85,,percent of total billed charges,,1206.62,,,,fee schedule,,581.89,,,,fee schedule,,,,,,,,872.78,,,,fee schedule,,,,,,,,880.08,,,,fee schedule,,533.38,,,,fee schedule,,533.38,,,,fee schedule,,,1916.46,91,,percent of total billed charges,,,2000.7,95,,percent of total billed charges,,,1747.98,83,,percent of total billed charges,,,631.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1747.98,83,,percent of total billed charges,,784.08,,,,fee schedule,,,1895.4,90,,percent of total billed charges,,,1895.4,90,,percent of total billed charges,,,1895.4,90,,percent of total billed charges,,,1895.4,90,,percent of total billed charges,,,1790.1,85,,percent of total billed charges,,533.38,2000.7,
REVISION OF PENIS,54300,CDM,54300,CPT,,,both,,3276,3276,1098.01,,,,fee schedule,,,,,,,,425.8,,,,fee schedule,,,2784.6,85,,percent of total billed charges,,1470.1,,,,fee schedule,,708.95,,,,fee schedule,,425.8,,,,fee schedule,,1108.22,,,,fee schedule,,425.8,,,,fee schedule,,1065.72,,,,fee schedule,,645.89,,,,fee schedule,,645.89,,,,fee schedule,,,2981.16,91,,percent of total billed charges,,,3112.2,95,,percent of total billed charges,,,2719.08,83,,percent of total billed charges,,,982.8,83,,percent of total billed charges,,425.8,,,,fee schedule,,425.8,,,,fee schedule,,,2719.08,83,,percent of total billed charges,,949.46,,,,fee schedule,,,2948.4,90,,percent of total billed charges,,,2948.4,90,,percent of total billed charges,,,2948.4,90,,percent of total billed charges,,,2948.4,90,,percent of total billed charges,,,2784.6,85,,percent of total billed charges,,425.8,3112.2,
1 STG DSTL HYPSPAD RPR W/X10SV DSJ,54328,CDM,54328,CPT,,,both,,5710,5710,1588.84,,,,fee schedule,,,,,,,,958.6,,,,fee schedule,,,4853.5,85,,percent of total billed charges,,2128.92,,,,fee schedule,,1026.66,,,,fee schedule,,958.6,,,,fee schedule,,1581.08,,,,fee schedule,,958.6,,,,fee schedule,,1542.1,,,,fee schedule,,934.61,,,,fee schedule,,934.61,,,,fee schedule,,,5196.1,91,,percent of total billed charges,,,5424.5,95,,percent of total billed charges,,,4739.3,83,,percent of total billed charges,,,1713,83,,percent of total billed charges,,958.6,,,,fee schedule,,958.6,,,,fee schedule,,,4739.3,83,,percent of total billed charges,,1373.88,,,,fee schedule,,,5139,90,,percent of total billed charges,,,5139,90,,percent of total billed charges,,,5139,90,,percent of total billed charges,,,5139,90,,percent of total billed charges,,,4853.5,85,,percent of total billed charges,,934.61,5424.5,
REVISION OF PENIS,54420,CDM,54420,CPT,,,both,,2835,2835,1195.37,,,,fee schedule,,,,,,,,409.2,,,,fee schedule,,,2409.75,85,,percent of total billed charges,,1597.2,,,,fee schedule,,770.24,,,,fee schedule,,409.2,,,,fee schedule,,1177.85,,,,fee schedule,,409.2,,,,fee schedule,,1160.21,,,,fee schedule,,703.16,,,,fee schedule,,703.16,,,,fee schedule,,,2579.85,91,,percent of total billed charges,,,2693.25,95,,percent of total billed charges,,,2353.05,83,,percent of total billed charges,,,850.5,83,,percent of total billed charges,,409.2,,,,fee schedule,,409.2,,,,fee schedule,,,2353.05,83,,percent of total billed charges,,1033.64,,,,fee schedule,,,2551.5,90,,percent of total billed charges,,,2551.5,90,,percent of total billed charges,,,2551.5,90,,percent of total billed charges,,,2551.5,90,,percent of total billed charges,,,2409.75,85,,percent of total billed charges,,409.2,2693.25,
PREPUTIAL STRETCHING,54450,CDM,54450,CPT,,,both,,235,235,96.78,,,,fee schedule,,,,,,,,37.45,,,,fee schedule,,,199.75,85,,percent of total billed charges,,128.98,,,,fee schedule,,62.2,,,,fee schedule,,37.45,,,,fee schedule,,108.77,,,,fee schedule,,37.45,,,,fee schedule,,93.94,,,,fee schedule,,56.93,,,,fee schedule,,56.93,,,,fee schedule,,,213.85,91,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,70.5,83,,percent of total billed charges,,37.45,,,,fee schedule,,37.45,,,,fee schedule,,,195.05,83,,percent of total billed charges,,83.69,,,,fee schedule,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,199.75,85,,percent of total billed charges,,37.45,223.25,
PREPUTIAL STRETCHING,54450P,CDM,54450,CPT,,,both,P,83,83,96.78,,,,fee schedule,,,,,,,,37.45,,,,fee schedule,,,70.55,85,,percent of total billed charges,,128.98,,,,fee schedule,,62.2,,,,fee schedule,,37.45,,,,fee schedule,,108.77,,,,fee schedule,,37.45,,,,fee schedule,,93.94,,,,fee schedule,,56.93,,,,fee schedule,,56.93,,,,fee schedule,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,37.45,,,,fee schedule,,37.45,,,,fee schedule,,,68.89,83,,percent of total billed charges,,83.69,,,,fee schedule,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,24.9,128.98,
PREPUTIAL STRETCHING,54450T,CDM,54450,CPT,,,both,T,152,152,96.78,,,,fee schedule,,,,,,,,37.45,,,,fee schedule,,,129.2,85,,percent of total billed charges,,128.98,,,,fee schedule,,62.2,,,,fee schedule,,37.45,,,,fee schedule,,108.77,,,,fee schedule,,37.45,,,,fee schedule,,93.94,,,,fee schedule,,56.93,,,,fee schedule,,56.93,,,,fee schedule,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,45.6,83,,percent of total billed charges,,37.45,,,,fee schedule,,37.45,,,,fee schedule,,,126.16,83,,percent of total billed charges,,83.69,,,,fee schedule,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,37.45,144.4,
REMOVAL OF TESTIS,54520,CDM,54520,CPT,,,both,,1615,1615,560.53,,,,fee schedule,,,,,,,,351,,,,fee schedule,,,1372.75,85,,percent of total billed charges,,744.9,,,,fee schedule,,359.22,,,,fee schedule,,351,,,,fee schedule,,563.73,,,,fee schedule,,351,,,,fee schedule,,544.04,,,,fee schedule,,329.72,,,,fee schedule,,329.72,,,,fee schedule,,,1469.65,91,,percent of total billed charges,,,1534.25,95,,percent of total billed charges,,,1340.45,83,,percent of total billed charges,,,484.5,83,,percent of total billed charges,,351,,,,fee schedule,,351,,,,fee schedule,,,1340.45,83,,percent of total billed charges,,484.69,,,,fee schedule,,,1453.5,90,,percent of total billed charges,,,1453.5,90,,percent of total billed charges,,,1453.5,90,,percent of total billed charges,,,1453.5,90,,percent of total billed charges,,,1372.75,85,,percent of total billed charges,,329.72,1534.25,
REMOVAL OF TESTIS,54530,CDM,54530,CPT,,,both,,2363,2363,868.73,,,,fee schedule,,,,,,,,958.6,,,,fee schedule,,,2008.55,85,,percent of total billed charges,,1153.04,,,,fee schedule,,556.05,,,,fee schedule,,958.6,,,,fee schedule,,892.68,,,,fee schedule,,958.6,,,,fee schedule,,843.18,,,,fee schedule,,511.02,,,,fee schedule,,511.02,,,,fee schedule,,,2150.33,91,,percent of total billed charges,,,2244.85,95,,percent of total billed charges,,,1961.29,83,,percent of total billed charges,,,708.9,83,,percent of total billed charges,,958.6,,,,fee schedule,,958.6,,,,fee schedule,,,1961.29,83,,percent of total billed charges,,751.2,,,,fee schedule,,,2126.7,90,,percent of total billed charges,,,2126.7,90,,percent of total billed charges,,,2126.7,90,,percent of total billed charges,,,2126.7,90,,percent of total billed charges,,,2008.55,85,,percent of total billed charges,,511.02,2244.85,
SUSPENSION OF TESTIS,54620,CDM,54620,CPT,,,both,,2889,2889,508.68,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,2455.65,85,,percent of total billed charges,,676.92,,,,fee schedule,,326.44,,,,fee schedule,,299.7,,,,fee schedule,,510.01,,,,fee schedule,,299.7,,,,fee schedule,,493.72,,,,fee schedule,,299.22,,,,fee schedule,,299.22,,,,fee schedule,,,2628.99,91,,percent of total billed charges,,,2744.55,95,,percent of total billed charges,,,2397.87,83,,percent of total billed charges,,,866.7,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,2397.87,83,,percent of total billed charges,,439.86,,,,fee schedule,,,2600.1,90,,percent of total billed charges,,,2600.1,90,,percent of total billed charges,,,2600.1,90,,percent of total billed charges,,,2600.1,90,,percent of total billed charges,,,2455.65,85,,percent of total billed charges,,299.22,2744.55,
SUSPENSION OF TESTIS,54640,CDM,54640,CPT,,,both,,2889,2889,735.08,,,,fee schedule,,,,,,,,504.9,,,,fee schedule,,,2455.65,85,,percent of total billed charges,,986.76,,,,fee schedule,,475.86,,,,fee schedule,,504.9,,,,fee schedule,,746.11,,,,fee schedule,,504.9,,,,fee schedule,,713.46,,,,fee schedule,,432.4,,,,fee schedule,,432.4,,,,fee schedule,,,2628.99,91,,percent of total billed charges,,,2744.55,95,,percent of total billed charges,,,2397.87,83,,percent of total billed charges,,,866.7,83,,percent of total billed charges,,504.9,,,,fee schedule,,504.9,,,,fee schedule,,,2397.87,83,,percent of total billed charges,,635.63,,,,fee schedule,,,2600.1,90,,percent of total billed charges,,,2600.1,90,,percent of total billed charges,,,2600.1,90,,percent of total billed charges,,,2600.1,90,,percent of total billed charges,,,2455.65,85,,percent of total billed charges,,432.4,2744.55,
DRAINAGE OF SCROTUM,54700,CDM,54700,CPT,,,both,,907,907,362.93,,,,fee schedule,,,,,,,,128.3,,,,fee schedule,,,770.95,85,,percent of total billed charges,,483.1,,,,fee schedule,,232.97,,,,fee schedule,,128.3,,,,fee schedule,,373.39,,,,fee schedule,,128.3,,,,fee schedule,,352.26,,,,fee schedule,,213.49,,,,fee schedule,,213.49,,,,fee schedule,,,825.37,91,,percent of total billed charges,,,861.65,95,,percent of total billed charges,,,752.81,83,,percent of total billed charges,,,272.1,83,,percent of total billed charges,,128.3,,,,fee schedule,,128.3,,,,fee schedule,,,752.81,83,,percent of total billed charges,,313.83,,,,fee schedule,,,816.3,90,,percent of total billed charges,,,816.3,90,,percent of total billed charges,,,816.3,90,,percent of total billed charges,,,816.3,90,,percent of total billed charges,,,770.95,85,,percent of total billed charges,,128.3,861.65,
DRAINAGE OF SCROTUM,54700P,CDM,54700,CPT,,,both,P,730,730,362.93,,,,fee schedule,,,,,,,,128.3,,,,fee schedule,,,620.5,85,,percent of total billed charges,,483.1,,,,fee schedule,,232.97,,,,fee schedule,,128.3,,,,fee schedule,,373.39,,,,fee schedule,,128.3,,,,fee schedule,,352.26,,,,fee schedule,,213.49,,,,fee schedule,,213.49,,,,fee schedule,,,664.3,91,,percent of total billed charges,,,693.5,95,,percent of total billed charges,,,605.9,83,,percent of total billed charges,,,219,83,,percent of total billed charges,,128.3,,,,fee schedule,,128.3,,,,fee schedule,,,605.9,83,,percent of total billed charges,,313.83,,,,fee schedule,,,657,90,,percent of total billed charges,,,657,90,,percent of total billed charges,,,657,90,,percent of total billed charges,,,657,90,,percent of total billed charges,,,620.5,85,,percent of total billed charges,,128.3,693.5,
DRAINAGE OF SCROTUM,54700T,CDM,54700,CPT,,,both,T,177,177,362.93,,,,fee schedule,,,,,,,,128.3,,,,fee schedule,,,150.45,85,,percent of total billed charges,,483.1,,,,fee schedule,,232.97,,,,fee schedule,,128.3,,,,fee schedule,,373.39,,,,fee schedule,,128.3,,,,fee schedule,,352.26,,,,fee schedule,,213.49,,,,fee schedule,,213.49,,,,fee schedule,,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,53.1,83,,percent of total billed charges,,128.3,,,,fee schedule,,128.3,,,,fee schedule,,,146.91,83,,percent of total billed charges,,313.83,,,,fee schedule,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,53.1,483.1,
REMOVE EPIDIDYMIS LESION,54830,CDM,54830,CPT,,,both,,1541,1541,636.57,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,1309.85,85,,percent of total billed charges,,843.95,,,,fee schedule,,406.99,,,,fee schedule,,299.7,,,,fee schedule,,582.96,,,,fee schedule,,299.7,,,,fee schedule,,617.85,,,,fee schedule,,374.45,,,,fee schedule,,374.45,,,,fee schedule,,,1402.31,91,,percent of total billed charges,,,1463.95,95,,percent of total billed charges,,,1279.03,83,,percent of total billed charges,,,462.3,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,1279.03,83,,percent of total billed charges,,550.45,,,,fee schedule,,,1386.9,90,,percent of total billed charges,,,1386.9,90,,percent of total billed charges,,,1386.9,90,,percent of total billed charges,,,1386.9,90,,percent of total billed charges,,,1309.85,85,,percent of total billed charges,,299.7,1463.95,
REMOVE EPIDIDYMIS LESION,54840,CDM,54840,CPT,,,both,,1446,1446,551.31,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,1229.1,85,,percent of total billed charges,,730.05,,,,fee schedule,,352.06,,,,fee schedule,,299.7,,,,fee schedule,,553.11,,,,fee schedule,,299.7,,,,fee schedule,,535.1,,,,fee schedule,,324.3,,,,fee schedule,,324.3,,,,fee schedule,,,1315.86,91,,percent of total billed charges,,,1373.7,95,,percent of total billed charges,,,1200.18,83,,percent of total billed charges,,,433.8,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,1200.18,83,,percent of total billed charges,,476.72,,,,fee schedule,,,1301.4,90,,percent of total billed charges,,,1301.4,90,,percent of total billed charges,,,1301.4,90,,percent of total billed charges,,,1301.4,90,,percent of total billed charges,,,1229.1,85,,percent of total billed charges,,299.7,1373.7,
DRAINAGE OF HYDROCELE,55000,CDM,55000,CPT,,,both,,440,440,143.44,,,,fee schedule,,,,,,,,42.35,,,,fee schedule,,,374,85,,percent of total billed charges,,191.59,,,,fee schedule,,92.39,,,,fee schedule,,42.35,,,,fee schedule,,145.24,,,,fee schedule,,42.35,,,,fee schedule,,139.23,,,,fee schedule,,84.38,,,,fee schedule,,84.38,,,,fee schedule,,,400.4,91,,percent of total billed charges,,,418,95,,percent of total billed charges,,,365.2,83,,percent of total billed charges,,,132,83,,percent of total billed charges,,42.35,,,,fee schedule,,42.35,,,,fee schedule,,,365.2,83,,percent of total billed charges,,124.04,,,,fee schedule,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,374,85,,percent of total billed charges,,42.35,418,
DRAINAGE OF HYDROCELE,55000P,CDM,55000,CPT,,,both,P,277,277,143.44,,,,fee schedule,,,,,,,,42.35,,,,fee schedule,,,235.45,85,,percent of total billed charges,,191.59,,,,fee schedule,,92.39,,,,fee schedule,,42.35,,,,fee schedule,,145.24,,,,fee schedule,,42.35,,,,fee schedule,,139.23,,,,fee schedule,,84.38,,,,fee schedule,,84.38,,,,fee schedule,,,252.07,91,,percent of total billed charges,,,263.15,95,,percent of total billed charges,,,229.91,83,,percent of total billed charges,,,83.1,83,,percent of total billed charges,,42.35,,,,fee schedule,,42.35,,,,fee schedule,,,229.91,83,,percent of total billed charges,,124.04,,,,fee schedule,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,235.45,85,,percent of total billed charges,,42.35,263.15,
DRAINAGE OF HYDROCELE,55000T,CDM,55000,CPT,,,both,T,163,163,143.44,,,,fee schedule,,,,,,,,42.35,,,,fee schedule,,,138.55,85,,percent of total billed charges,,191.59,,,,fee schedule,,92.39,,,,fee schedule,,42.35,,,,fee schedule,,145.24,,,,fee schedule,,42.35,,,,fee schedule,,139.23,,,,fee schedule,,84.38,,,,fee schedule,,84.38,,,,fee schedule,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,48.9,83,,percent of total billed charges,,42.35,,,,fee schedule,,42.35,,,,fee schedule,,,135.29,83,,percent of total billed charges,,124.04,,,,fee schedule,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,42.35,191.59,
REMOVAL OF HYDROCELE,55040,CDM,55040,CPT,,,both,,1527,1527,577.81,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,1297.95,85,,percent of total billed charges,,767.81,,,,fee schedule,,370.27,,,,fee schedule,,299.7,,,,fee schedule,,575,,,,fee schedule,,299.7,,,,fee schedule,,560.82,,,,fee schedule,,339.89,,,,fee schedule,,339.89,,,,fee schedule,,,1389.57,91,,percent of total billed charges,,,1450.65,95,,percent of total billed charges,,,1267.41,83,,percent of total billed charges,,,458.1,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,1267.41,83,,percent of total billed charges,,499.64,,,,fee schedule,,,1374.3,90,,percent of total billed charges,,,1374.3,90,,percent of total billed charges,,,1374.3,90,,percent of total billed charges,,,1374.3,90,,percent of total billed charges,,,1297.95,85,,percent of total billed charges,,299.7,1450.65,
REMOVAL OF HYDROCELES,55041,CDM,55041,CPT,,,both,,2093,2093,873.34,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,1779.05,85,,percent of total billed charges,,1162.22,,,,fee schedule,,560.48,,,,fee schedule,,449.5,,,,fee schedule,,815.08,,,,fee schedule,,449.5,,,,fee schedule,,847.65,,,,fee schedule,,513.73,,,,fee schedule,,513.73,,,,fee schedule,,,1904.63,91,,percent of total billed charges,,,1988.35,95,,percent of total billed charges,,,1737.19,83,,percent of total billed charges,,,627.9,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,1737.19,83,,percent of total billed charges,,755.18,,,,fee schedule,,,1883.7,90,,percent of total billed charges,,,1883.7,90,,percent of total billed charges,,,1883.7,90,,percent of total billed charges,,,1883.7,90,,percent of total billed charges,,,1779.05,85,,percent of total billed charges,,449.5,1988.35,
REPAIR OF HYDROCELE,55060,CDM,55060,CPT,,,both,,1494,1494,649.82,,,,fee schedule,,,,,,,,259.4,,,,fee schedule,,,1269.9,85,,percent of total billed charges,,861.38,,,,fee schedule,,415.4,,,,fee schedule,,259.4,,,,fee schedule,,599.54,,,,fee schedule,,259.4,,,,fee schedule,,630.71,,,,fee schedule,,382.25,,,,fee schedule,,382.25,,,,fee schedule,,,1359.54,91,,percent of total billed charges,,,1419.3,95,,percent of total billed charges,,,1240.02,83,,percent of total billed charges,,,448.2,83,,percent of total billed charges,,259.4,,,,fee schedule,,259.4,,,,fee schedule,,,1240.02,83,,percent of total billed charges,,561.9,,,,fee schedule,,,1344.6,90,,percent of total billed charges,,,1344.6,90,,percent of total billed charges,,,1344.6,90,,percent of total billed charges,,,1344.6,90,,percent of total billed charges,,,1269.9,85,,percent of total billed charges,,259.4,1419.3,
DRAINAGE OF SCROTUM ABSCESS,55100,CDM,55100,CPT,,,both,,904,904,286.89,,,,fee schedule,,,,,,,,110.9,,,,fee schedule,,,768.4,85,,percent of total billed charges,,378.25,,,,fee schedule,,182.41,,,,fee schedule,,110.9,,,,fee schedule,,256,,,,fee schedule,,110.9,,,,fee schedule,,278.45,,,,fee schedule,,168.76,,,,fee schedule,,168.76,,,,fee schedule,,,822.64,91,,percent of total billed charges,,,858.8,95,,percent of total billed charges,,,750.32,83,,percent of total billed charges,,,271.2,83,,percent of total billed charges,,110.9,,,,fee schedule,,110.9,,,,fee schedule,,,750.32,83,,percent of total billed charges,,248.07,,,,fee schedule,,,813.6,90,,percent of total billed charges,,,813.6,90,,percent of total billed charges,,,813.6,90,,percent of total billed charges,,,813.6,90,,percent of total billed charges,,,768.4,85,,percent of total billed charges,,110.9,858.8,
DRAINAGE OF SCROTUM ABSCESS,55100P,CDM,55100,CPT,,,both,P,727,727,286.89,,,,fee schedule,,,,,,,,110.9,,,,fee schedule,,,617.95,85,,percent of total billed charges,,378.25,,,,fee schedule,,182.41,,,,fee schedule,,110.9,,,,fee schedule,,256,,,,fee schedule,,110.9,,,,fee schedule,,278.45,,,,fee schedule,,168.76,,,,fee schedule,,168.76,,,,fee schedule,,,661.57,91,,percent of total billed charges,,,690.65,95,,percent of total billed charges,,,603.41,83,,percent of total billed charges,,,218.1,83,,percent of total billed charges,,110.9,,,,fee schedule,,110.9,,,,fee schedule,,,603.41,83,,percent of total billed charges,,248.07,,,,fee schedule,,,654.3,90,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,654.3,90,,percent of total billed charges,,,617.95,85,,percent of total billed charges,,110.9,690.65,
DRAINAGE OF SCROTUM ABSCESS,55100T,CDM,55100,CPT,,,both,T,177,177,286.89,,,,fee schedule,,,,,,,,110.9,,,,fee schedule,,,150.45,85,,percent of total billed charges,,378.25,,,,fee schedule,,182.41,,,,fee schedule,,110.9,,,,fee schedule,,256,,,,fee schedule,,110.9,,,,fee schedule,,278.45,,,,fee schedule,,168.76,,,,fee schedule,,168.76,,,,fee schedule,,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,53.1,83,,percent of total billed charges,,110.9,,,,fee schedule,,110.9,,,,fee schedule,,,146.91,83,,percent of total billed charges,,248.07,,,,fee schedule,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,53.1,378.25,
EXPLORE SCROTUM,55110,CDM,55110,CPT,,,both,,1520,1520,663.65,,,,fee schedule,,,,,,,,,,,,,,,1292,85,,percent of total billed charges,,883.54,,,,fee schedule,,426.08,,,,fee schedule,,,,,,,,612.8,,,,fee schedule,,,,,,,,644.13,,,,fee schedule,,390.38,,,,fee schedule,,390.38,,,,fee schedule,,,1383.2,91,,percent of total billed charges,,,1444,95,,percent of total billed charges,,,1261.6,83,,percent of total billed charges,,,456,83,,percent of total billed charges,,,,,,,,,,,,,,,1261.6,83,,percent of total billed charges,,573.86,,,,fee schedule,,,1368,90,,percent of total billed charges,,,1368,90,,percent of total billed charges,,,1368,90,,percent of total billed charges,,,1368,90,,percent of total billed charges,,,1292,85,,percent of total billed charges,,390.38,1444,
REMOVAL OF SPERM DUCT(S),55250,CDM,55250,CPT,,,both,,1545,1545,391.74,,,,fee schedule,,,,,,,,408,,,,fee schedule,,,1313.25,85,,percent of total billed charges,,548.43,,,,fee schedule,,247.73,,,,fee schedule,,408,,,,fee schedule,,382.01,,,,fee schedule,,408,,,,fee schedule,,380.21,,,,fee schedule,,230.43,,,,fee schedule,,230.43,,,,fee schedule,,,1405.95,91,,percent of total billed charges,,,1467.75,95,,percent of total billed charges,,,1282.35,83,,percent of total billed charges,,,463.5,83,,percent of total billed charges,,408,,,,fee schedule,,408,,,,fee schedule,,,1282.35,83,,percent of total billed charges,,338.74,,,,fee schedule,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1313.25,85,,percent of total billed charges,,230.43,1467.75,
REMOVAL OF HYDROCELE,55500,CDM,55500,CPT,,,both,,1711,1711,672.86,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,1454.35,85,,percent of total billed charges,,819.42,,,,fee schedule,,432.63,,,,fee schedule,,359.3,,,,fee schedule,,611.48,,,,fee schedule,,359.3,,,,fee schedule,,653.07,,,,fee schedule,,395.8,,,,fee schedule,,395.8,,,,fee schedule,,,1557.01,91,,percent of total billed charges,,,1625.45,95,,percent of total billed charges,,,1420.13,83,,percent of total billed charges,,,513.3,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,1420.13,83,,percent of total billed charges,,581.83,,,,fee schedule,,,1539.9,90,,percent of total billed charges,,,1539.9,90,,percent of total billed charges,,,1539.9,90,,percent of total billed charges,,,1539.9,90,,percent of total billed charges,,,1454.35,85,,percent of total billed charges,,359.3,1625.45,
REMOVAL OF SPERM CORD LESION,55520,CDM,55520,CPT,,,both,,1693,1693,792.11,,,,fee schedule,,,,,,,,240,,,,fee schedule,,,1439.05,85,,percent of total billed charges,,1065.67,,,,fee schedule,,513.91,,,,fee schedule,,240,,,,fee schedule,,663.21,,,,fee schedule,,240,,,,fee schedule,,768.82,,,,fee schedule,,465.95,,,,fee schedule,,465.95,,,,fee schedule,,,1540.63,91,,percent of total billed charges,,,1608.35,95,,percent of total billed charges,,,1405.19,83,,percent of total billed charges,,,507.9,83,,percent of total billed charges,,240,,,,fee schedule,,240,,,,fee schedule,,,1405.19,83,,percent of total billed charges,,684.95,,,,fee schedule,,,1523.7,90,,percent of total billed charges,,,1523.7,90,,percent of total billed charges,,,1523.7,90,,percent of total billed charges,,,1523.7,90,,percent of total billed charges,,,1439.05,85,,percent of total billed charges,,240,1608.35,
REVISE SPERMATIC CORD VEINS,55530,CDM,55530,CPT,,,both,,1680,1680,602.01,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,1428,85,,percent of total billed charges,,801.88,,,,fee schedule,,386.7,,,,fee schedule,,359.3,,,,fee schedule,,603.52,,,,fee schedule,,359.3,,,,fee schedule,,584.3,,,,fee schedule,,354.12,,,,fee schedule,,354.12,,,,fee schedule,,,1528.8,91,,percent of total billed charges,,,1596,95,,percent of total billed charges,,,1394.4,83,,percent of total billed charges,,,504,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,1394.4,83,,percent of total billed charges,,520.56,,,,fee schedule,,,1512,90,,percent of total billed charges,,,1512,90,,percent of total billed charges,,,1512,90,,percent of total billed charges,,,1512,90,,percent of total billed charges,,,1428,85,,percent of total billed charges,,354.12,1596,
BIOPSY OF PROSTATE,55700,CDM,55700,CPT,,,both,,830,830,219.49,,,,fee schedule,,,,,,,,113.6,,,,fee schedule,,,705.5,85,,percent of total billed charges,,260.32,,,,fee schedule,,142.43,,,,fee schedule,,113.6,,,,fee schedule,,153.86,,,,fee schedule,,113.6,,,,fee schedule,,213.03,,,,fee schedule,,129.11,,,,fee schedule,,129.11,,,,fee schedule,,,755.3,91,,percent of total billed charges,,,788.5,95,,percent of total billed charges,,,688.9,83,,percent of total billed charges,,,249,83,,percent of total billed charges,,113.6,,,,fee schedule,,113.6,,,,fee schedule,,,688.9,83,,percent of total billed charges,,189.79,,,,fee schedule,,,747,90,,percent of total billed charges,,,747,90,,percent of total billed charges,,,747,90,,percent of total billed charges,,,747,90,,percent of total billed charges,,,705.5,85,,percent of total billed charges,,113.6,788.5,
BIOPSY OF PROSTATE,55700P,CDM,55700,CPT,,,both,P,648,648,219.49,,,,fee schedule,,,,,,,,113.6,,,,fee schedule,,,550.8,85,,percent of total billed charges,,260.32,,,,fee schedule,,142.43,,,,fee schedule,,113.6,,,,fee schedule,,153.86,,,,fee schedule,,113.6,,,,fee schedule,,213.03,,,,fee schedule,,129.11,,,,fee schedule,,129.11,,,,fee schedule,,,589.68,91,,percent of total billed charges,,,615.6,95,,percent of total billed charges,,,537.84,83,,percent of total billed charges,,,194.4,83,,percent of total billed charges,,113.6,,,,fee schedule,,113.6,,,,fee schedule,,,537.84,83,,percent of total billed charges,,189.79,,,,fee schedule,,,583.2,90,,percent of total billed charges,,,583.2,90,,percent of total billed charges,,,583.2,90,,percent of total billed charges,,,583.2,90,,percent of total billed charges,,,550.8,85,,percent of total billed charges,,113.6,615.6,
BIOPSY OF PROSTATE,55700T,CDM,55700,CPT,,,both,T,182,182,219.49,,,,fee schedule,,,,,,,,113.6,,,,fee schedule,,,154.7,85,,percent of total billed charges,,260.32,,,,fee schedule,,142.43,,,,fee schedule,,113.6,,,,fee schedule,,153.86,,,,fee schedule,,113.6,,,,fee schedule,,213.03,,,,fee schedule,,129.11,,,,fee schedule,,129.11,,,,fee schedule,,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,54.6,83,,percent of total billed charges,,113.6,,,,fee schedule,,113.6,,,,fee schedule,,,151.06,83,,percent of total billed charges,,189.79,,,,fee schedule,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,54.6,260.32,
PROSTATE SATURATION SAMPLING,55706,CDM,55706,CPT,,,both,,1517,1517,640.6,,,,fee schedule,,,,,,,,291.03,,,,fee schedule,,,1289.45,85,,percent of total billed charges,,850.86,,,,fee schedule,,410.32,,,,fee schedule,,291.03,,,,fee schedule,,,,,,,,291.03,,,,fee schedule,,621.76,,,,fee schedule,,376.83,,,,fee schedule,,376.83,,,,fee schedule,,,1380.47,91,,percent of total billed charges,,,1441.15,95,,percent of total billed charges,,,1259.11,83,,percent of total billed charges,,,455.1,83,,percent of total billed charges,,291.03,,,,fee schedule,,291.03,,,,fee schedule,,,1259.11,83,,percent of total billed charges,,553.93,,,,fee schedule,,,1365.3,90,,percent of total billed charges,,,1365.3,90,,percent of total billed charges,,,1365.3,90,,percent of total billed charges,,,1365.3,90,,percent of total billed charges,,,1289.45,85,,percent of total billed charges,,291.03,1441.15,
I  D OF VULVA/PERINEUM,56405,CDM,56405,CPT,,,both,,557,557,220.64,,,,fee schedule,,,,,,,,95.05,,,,fee schedule,,,473.45,85,,percent of total billed charges,,240.19,,,,fee schedule,,132.76,,,,fee schedule,,95.05,,,,fee schedule,,182.38,,,,fee schedule,,95.05,,,,fee schedule,,214.15,,,,fee schedule,,129.79,,,,fee schedule,,129.79,,,,fee schedule,,,506.87,91,,percent of total billed charges,,,529.15,95,,percent of total billed charges,,,462.31,83,,percent of total billed charges,,,167.1,83,,percent of total billed charges,,95.05,,,,fee schedule,,95.05,,,,fee schedule,,,462.31,83,,percent of total billed charges,,190.79,,,,fee schedule,,,501.3,90,,percent of total billed charges,,,501.3,90,,percent of total billed charges,,,501.3,90,,percent of total billed charges,,,501.3,90,,percent of total billed charges,,,473.45,85,,percent of total billed charges,,95.05,529.15,
DRAINAGE OF GLAND ABSCESS,56420,CDM,56420,CPT,,,both,,519,519,192.99,,,,fee schedule,,,,,,,,103.05,,,,fee schedule,,,441.15,85,,percent of total billed charges,,211.8,,,,fee schedule,,117.07,,,,fee schedule,,103.05,,,,fee schedule,,171.77,,,,fee schedule,,103.05,,,,fee schedule,,187.31,,,,fee schedule,,113.52,,,,fee schedule,,113.52,,,,fee schedule,,,472.29,91,,percent of total billed charges,,,493.05,95,,percent of total billed charges,,,430.77,83,,percent of total billed charges,,,155.7,83,,percent of total billed charges,,103.05,,,,fee schedule,,103.05,,,,fee schedule,,,430.77,83,,percent of total billed charges,,166.88,,,,fee schedule,,,467.1,90,,percent of total billed charges,,,467.1,90,,percent of total billed charges,,,467.1,90,,percent of total billed charges,,,467.1,90,,percent of total billed charges,,,441.15,85,,percent of total billed charges,,103.05,493.05,
DRAINAGE OF GLAND ABSCESS,56420P,CDM,56420,CPT,,,both,P,353,353,192.99,,,,fee schedule,,,,,,,,103.05,,,,fee schedule,,,300.05,85,,percent of total billed charges,,211.8,,,,fee schedule,,117.07,,,,fee schedule,,103.05,,,,fee schedule,,171.77,,,,fee schedule,,103.05,,,,fee schedule,,187.31,,,,fee schedule,,113.52,,,,fee schedule,,113.52,,,,fee schedule,,,321.23,91,,percent of total billed charges,,,335.35,95,,percent of total billed charges,,,292.99,83,,percent of total billed charges,,,105.9,83,,percent of total billed charges,,103.05,,,,fee schedule,,103.05,,,,fee schedule,,,292.99,83,,percent of total billed charges,,166.88,,,,fee schedule,,,317.7,90,,percent of total billed charges,,,317.7,90,,percent of total billed charges,,,317.7,90,,percent of total billed charges,,,317.7,90,,percent of total billed charges,,,300.05,85,,percent of total billed charges,,103.05,335.35,
DRAINAGE OF GLAND ABSCESS,56420T,CDM,56420,CPT,,,both,T,166,166,192.99,,,,fee schedule,,,,,,,,103.05,,,,fee schedule,,,141.1,85,,percent of total billed charges,,211.8,,,,fee schedule,,117.07,,,,fee schedule,,103.05,,,,fee schedule,,171.77,,,,fee schedule,,103.05,,,,fee schedule,,187.31,,,,fee schedule,,113.52,,,,fee schedule,,113.52,,,,fee schedule,,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,103.05,,,,fee schedule,,103.05,,,,fee schedule,,,137.78,83,,percent of total billed charges,,166.88,,,,fee schedule,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,49.8,211.8,
SURGERY FOR VULVA LESION,56440,CDM,56440,CPT,,,both,,803,803,312.81,,,,fee schedule,,,,,,,,202.5,,,,fee schedule,,,682.55,85,,percent of total billed charges,,344.47,,,,fee schedule,,190.4,,,,fee schedule,,202.5,,,,fee schedule,,324.31,,,,fee schedule,,202.5,,,,fee schedule,,303.61,,,,fee schedule,,184.01,,,,fee schedule,,184.01,,,,fee schedule,,,730.73,91,,percent of total billed charges,,,762.85,95,,percent of total billed charges,,,666.49,83,,percent of total billed charges,,,240.9,83,,percent of total billed charges,,202.5,,,,fee schedule,,202.5,,,,fee schedule,,,666.49,83,,percent of total billed charges,,270.49,,,,fee schedule,,,722.7,90,,percent of total billed charges,,,722.7,90,,percent of total billed charges,,,722.7,90,,percent of total billed charges,,,722.7,90,,percent of total billed charges,,,682.55,85,,percent of total billed charges,,184.01,762.85,
SURGERY FOR VULVA LESION,56440P,CDM,56440,CPT,,,both,P,629,629,312.81,,,,fee schedule,,,,,,,,202.5,,,,fee schedule,,,534.65,85,,percent of total billed charges,,344.47,,,,fee schedule,,190.4,,,,fee schedule,,202.5,,,,fee schedule,,324.31,,,,fee schedule,,202.5,,,,fee schedule,,303.61,,,,fee schedule,,184.01,,,,fee schedule,,184.01,,,,fee schedule,,,572.39,91,,percent of total billed charges,,,597.55,95,,percent of total billed charges,,,522.07,83,,percent of total billed charges,,,188.7,83,,percent of total billed charges,,202.5,,,,fee schedule,,202.5,,,,fee schedule,,,522.07,83,,percent of total billed charges,,270.49,,,,fee schedule,,,566.1,90,,percent of total billed charges,,,566.1,90,,percent of total billed charges,,,566.1,90,,percent of total billed charges,,,566.1,90,,percent of total billed charges,,,534.65,85,,percent of total billed charges,,184.01,597.55,
SURGERY FOR VULVA LESION,56440T,CDM,56440,CPT,,,both,T,174,174,312.81,,,,fee schedule,,,,,,,,202.5,,,,fee schedule,,,147.9,85,,percent of total billed charges,,344.47,,,,fee schedule,,190.4,,,,fee schedule,,202.5,,,,fee schedule,,324.31,,,,fee schedule,,202.5,,,,fee schedule,,303.61,,,,fee schedule,,184.01,,,,fee schedule,,184.01,,,,fee schedule,,,158.34,91,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,52.2,83,,percent of total billed charges,,202.5,,,,fee schedule,,202.5,,,,fee schedule,,,144.42,83,,percent of total billed charges,,270.49,,,,fee schedule,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,52.2,344.47,
"DESTROY, VULVA LESIONS, SIM",56501,CDM,56501,CPT,,,both,,437,437,232.16,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,371.45,85,,percent of total billed charges,,250.69,,,,fee schedule,,138.57,,,,fee schedule,,52.7,,,,fee schedule,,194.98,,,,fee schedule,,52.7,,,,fee schedule,,225.33,,,,fee schedule,,136.57,,,,fee schedule,,136.57,,,,fee schedule,,,397.67,91,,percent of total billed charges,,,415.15,95,,percent of total billed charges,,,362.71,83,,percent of total billed charges,,,131.1,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,362.71,83,,percent of total billed charges,,200.75,,,,fee schedule,,,393.3,90,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,393.3,90,,percent of total billed charges,,,371.45,85,,percent of total billed charges,,52.7,415.15,
"DESTROY, VULVA LESIONS, SIM",56501P,CDM,56501,CPT,,,both,P,274,274,232.16,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,232.9,85,,percent of total billed charges,,250.69,,,,fee schedule,,138.57,,,,fee schedule,,52.7,,,,fee schedule,,194.98,,,,fee schedule,,52.7,,,,fee schedule,,225.33,,,,fee schedule,,136.57,,,,fee schedule,,136.57,,,,fee schedule,,,249.34,91,,percent of total billed charges,,,260.3,95,,percent of total billed charges,,,227.42,83,,percent of total billed charges,,,82.2,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,227.42,83,,percent of total billed charges,,200.75,,,,fee schedule,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,246.6,90,,percent of total billed charges,,,232.9,85,,percent of total billed charges,,52.7,260.3,
"DESTROY, VULVA LESIONS, SIM",56501T,CDM,56501,CPT,,,both,T,163,163,232.16,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,138.55,85,,percent of total billed charges,,250.69,,,,fee schedule,,138.57,,,,fee schedule,,52.7,,,,fee schedule,,194.98,,,,fee schedule,,52.7,,,,fee schedule,,225.33,,,,fee schedule,,136.57,,,,fee schedule,,136.57,,,,fee schedule,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,48.9,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,135.29,83,,percent of total billed charges,,200.75,,,,fee schedule,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,48.9,250.69,
BIOPSY OF VULVA/PERINEUM,56605,CDM,56605,CPT,,,both,,329,329,101.97,,,,fee schedule,,,,,,,,108.3,,,,fee schedule,,,279.65,85,,percent of total billed charges,,114.15,,,,fee schedule,,63.09,,,,fee schedule,,108.3,,,,fee schedule,,112.08,,,,fee schedule,,108.3,,,,fee schedule,,98.97,,,,fee schedule,,59.98,,,,fee schedule,,59.98,,,,fee schedule,,,299.39,91,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,98.7,83,,percent of total billed charges,,108.3,,,,fee schedule,,108.3,,,,fee schedule,,,273.07,83,,percent of total billed charges,,88.17,,,,fee schedule,,,296.1,90,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,59.98,312.55,
BIOPSY OF VULVA/PERINEUM,56605P,CDM,56605,CPT,,,both,P,247,247,101.97,,,,fee schedule,,,,,,,,108.3,,,,fee schedule,,,209.95,85,,percent of total billed charges,,114.15,,,,fee schedule,,63.09,,,,fee schedule,,108.3,,,,fee schedule,,112.08,,,,fee schedule,,108.3,,,,fee schedule,,98.97,,,,fee schedule,,59.98,,,,fee schedule,,59.98,,,,fee schedule,,,224.77,91,,percent of total billed charges,,,234.65,95,,percent of total billed charges,,,205.01,83,,percent of total billed charges,,,74.1,83,,percent of total billed charges,,108.3,,,,fee schedule,,108.3,,,,fee schedule,,,205.01,83,,percent of total billed charges,,88.17,,,,fee schedule,,,222.3,90,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,209.95,85,,percent of total billed charges,,59.98,234.65,
BIOPSY OF VULVA/PERINEUM,56605T,CDM,56605,CPT,,,both,T,82,82,101.97,,,,fee schedule,,,,,,,,108.3,,,,fee schedule,,,69.7,85,,percent of total billed charges,,114.15,,,,fee schedule,,63.09,,,,fee schedule,,108.3,,,,fee schedule,,112.08,,,,fee schedule,,108.3,,,,fee schedule,,98.97,,,,fee schedule,,59.98,,,,fee schedule,,59.98,,,,fee schedule,,,74.62,91,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,24.6,83,,percent of total billed charges,,108.3,,,,fee schedule,,108.3,,,,fee schedule,,,68.06,83,,percent of total billed charges,,88.17,,,,fee schedule,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,24.6,114.15,
REMOVE VAGINA GLAND LESION,56740,CDM,56740,CPT,,,both,,1248,1248,546.13,,,,fee schedule,,,,,,,,226.1,,,,fee schedule,,,1060.8,85,,percent of total billed charges,,607.35,,,,fee schedule,,335.71,,,,fee schedule,,226.1,,,,fee schedule,,508.02,,,,fee schedule,,226.1,,,,fee schedule,,530.06,,,,fee schedule,,321.25,,,,fee schedule,,321.25,,,,fee schedule,,,1135.68,91,,percent of total billed charges,,,1185.6,95,,percent of total billed charges,,,1035.84,83,,percent of total billed charges,,,374.4,83,,percent of total billed charges,,226.1,,,,fee schedule,,226.1,,,,fee schedule,,,1035.84,83,,percent of total billed charges,,472.24,,,,fee schedule,,,1123.2,90,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1123.2,90,,percent of total billed charges,,,1060.8,85,,percent of total billed charges,,226.1,1185.6,
EXAM/BIOPSY OF VULVA W/SCOPE,56821,CDM,56821,CPT,,,both,,474,474,194.72,,,,fee schedule,,,,,,,,50.2,,,,fee schedule,,,402.9,85,,percent of total billed charges,,218.11,,,,fee schedule,,120.56,,,,fee schedule,,50.2,,,,fee schedule,,212.23,,,,fee schedule,,50.2,,,,fee schedule,,188.99,,,,fee schedule,,114.54,,,,fee schedule,,114.54,,,,fee schedule,,,431.34,91,,percent of total billed charges,,,450.3,95,,percent of total billed charges,,,393.42,83,,percent of total billed charges,,,142.2,83,,percent of total billed charges,,50.2,,,,fee schedule,,50.2,,,,fee schedule,,,393.42,83,,percent of total billed charges,,168.37,,,,fee schedule,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,402.9,85,,percent of total billed charges,,50.2,450.3,
DRAINAGE OF PELVIC ABSCESS,57010,CDM,57010,CPT,,,both,,1551,1551,794.42,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,1318.35,85,,percent of total billed charges,,876.32,,,,fee schedule,,484.37,,,,fee schedule,,224.7,,,,fee schedule,,696.37,,,,fee schedule,,224.7,,,,fee schedule,,771.05,,,,fee schedule,,467.3,,,,fee schedule,,467.3,,,,fee schedule,,,1411.41,91,,percent of total billed charges,,,1473.45,95,,percent of total billed charges,,,1287.33,83,,percent of total billed charges,,,465.3,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,1287.33,83,,percent of total billed charges,,686.94,,,,fee schedule,,,1395.9,90,,percent of total billed charges,,,1395.9,90,,percent of total billed charges,,,1395.9,90,,percent of total billed charges,,,1395.9,90,,percent of total billed charges,,,1318.35,85,,percent of total billed charges,,224.7,1473.45,
"DESTROY VAG LESIONS, SIMPLE",57061,CDM,57061,CPT,,,both,,440,440,200.48,,,,fee schedule,,,,,,,,45.4,,,,fee schedule,,,374,85,,percent of total billed charges,,216.27,,,,fee schedule,,119.54,,,,fee schedule,,45.4,,,,fee schedule,,167.13,,,,fee schedule,,45.4,,,,fee schedule,,194.58,,,,fee schedule,,117.93,,,,fee schedule,,117.93,,,,fee schedule,,,400.4,91,,percent of total billed charges,,,418,95,,percent of total billed charges,,,365.2,83,,percent of total billed charges,,,132,83,,percent of total billed charges,,45.4,,,,fee schedule,,45.4,,,,fee schedule,,,365.2,83,,percent of total billed charges,,173.35,,,,fee schedule,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,374,85,,percent of total billed charges,,45.4,418,
CLOSURE OF VAGINA,57120,CDM,57120,CPT,,,both,,2714,2714,919.43,,,,fee schedule,,,,,,,,299.7,,,,fee schedule,,,2306.9,85,,percent of total billed charges,,1017.53,,,,fee schedule,,562.42,,,,fee schedule,,299.7,,,,fee schedule,,853.55,,,,fee schedule,,299.7,,,,fee schedule,,892.39,,,,fee schedule,,540.84,,,,fee schedule,,540.84,,,,fee schedule,,,2469.74,91,,percent of total billed charges,,,2578.3,95,,percent of total billed charges,,,2252.62,83,,percent of total billed charges,,,814.2,83,,percent of total billed charges,,299.7,,,,fee schedule,,299.7,,,,fee schedule,,,2252.62,83,,percent of total billed charges,,795.03,,,,fee schedule,,,2442.6,90,,percent of total billed charges,,,2442.6,90,,percent of total billed charges,,,2442.6,90,,percent of total billed charges,,,2442.6,90,,percent of total billed charges,,,2306.9,85,,percent of total billed charges,,299.7,2578.3,
REMOVE VAGINA LESION,57135,CDM,57135,CPT,,,both,,811,811,326.06,,,,fee schedule,,,,,,,,121.55,,,,fee schedule,,,689.35,85,,percent of total billed charges,,357.19,,,,fee schedule,,197.43,,,,fee schedule,,121.55,,,,fee schedule,,307.06,,,,fee schedule,,121.55,,,,fee schedule,,316.47,,,,fee schedule,,191.8,,,,fee schedule,,191.8,,,,fee schedule,,,738.01,91,,percent of total billed charges,,,770.45,95,,percent of total billed charges,,,673.13,83,,percent of total billed charges,,,243.3,83,,percent of total billed charges,,121.55,,,,fee schedule,,121.55,,,,fee schedule,,,673.13,83,,percent of total billed charges,,281.95,,,,fee schedule,,,729.9,90,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,689.35,85,,percent of total billed charges,,121.55,770.45,
INSERT PESSARY/OTHER DEVICE,57160,CDM,57160,CPT,,,both,,244,244,78.92,,,,fee schedule,,,,,,,,27.65,,,,fee schedule,,,207.4,85,,percent of total billed charges,,87.37,,,,fee schedule,,48.29,,,,fee schedule,,27.65,,,,fee schedule,,88.21,,,,fee schedule,,27.65,,,,fee schedule,,76.6,,,,fee schedule,,46.43,,,,fee schedule,,46.43,,,,fee schedule,,,222.04,91,,percent of total billed charges,,,231.8,95,,percent of total billed charges,,,202.52,83,,percent of total billed charges,,,73.2,83,,percent of total billed charges,,27.65,,,,fee schedule,,27.65,,,,fee schedule,,,202.52,83,,percent of total billed charges,,68.25,,,,fee schedule,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,219.6,90,,percent of total billed charges,,,207.4,85,,percent of total billed charges,,27.65,231.8,
INSERT PESSARY/OTHER DEVICE,57160P,CDM,57160,CPT,,,both,P,89,89,78.92,,,,fee schedule,,,,,,,,27.65,,,,fee schedule,,,75.65,85,,percent of total billed charges,,87.37,,,,fee schedule,,48.29,,,,fee schedule,,27.65,,,,fee schedule,,88.21,,,,fee schedule,,27.65,,,,fee schedule,,76.6,,,,fee schedule,,46.43,,,,fee schedule,,46.43,,,,fee schedule,,,80.99,91,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,26.7,83,,percent of total billed charges,,27.65,,,,fee schedule,,27.65,,,,fee schedule,,,73.87,83,,percent of total billed charges,,68.25,,,,fee schedule,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,26.7,88.21,
INSERT PESSARY/OTHER DEVICE,57160T,CDM,57160,CPT,,,both,T,155,155,78.92,,,,fee schedule,,,,,,,,27.65,,,,fee schedule,,,131.75,85,,percent of total billed charges,,87.37,,,,fee schedule,,48.29,,,,fee schedule,,27.65,,,,fee schedule,,88.21,,,,fee schedule,,27.65,,,,fee schedule,,76.6,,,,fee schedule,,46.43,,,,fee schedule,,46.43,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,27.65,,,,fee schedule,,27.65,,,,fee schedule,,,128.65,83,,percent of total billed charges,,68.25,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,27.65,147.25,
FITTING OF DIAPHRAGM/CAP,57170,CDM,57170,CPT,,,both,,243,243,82.38,,,,fee schedule,,,,,,,,28.6,,,,fee schedule,,,206.55,85,,percent of total billed charges,,91.42,,,,fee schedule,,50.53,,,,fee schedule,,28.6,,,,fee schedule,,89.53,,,,fee schedule,,28.6,,,,fee schedule,,79.96,,,,fee schedule,,48.46,,,,fee schedule,,48.46,,,,fee schedule,,,221.13,91,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,72.9,83,,percent of total billed charges,,28.6,,,,fee schedule,,28.6,,,,fee schedule,,,201.69,83,,percent of total billed charges,,71.23,,,,fee schedule,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,206.55,85,,percent of total billed charges,,28.6,230.85,
REPAIR OF VAGINA,57200,CDM,57200,CPT,,,both,,1197,1197,574.93,,,,fee schedule,,,,,,,,188.9,,,,fee schedule,,,1017.45,85,,percent of total billed charges,,633.24,,,,fee schedule,,350.01,,,,fee schedule,,188.9,,,,fee schedule,,482.15,,,,fee schedule,,188.9,,,,fee schedule,,558.02,,,,fee schedule,,338.19,,,,fee schedule,,338.19,,,,fee schedule,,,1089.27,91,,percent of total billed charges,,,1137.15,95,,percent of total billed charges,,,993.51,83,,percent of total billed charges,,,359.1,83,,percent of total billed charges,,188.9,,,,fee schedule,,188.9,,,,fee schedule,,,993.51,83,,percent of total billed charges,,497.15,,,,fee schedule,,,1077.3,90,,percent of total billed charges,,,1077.3,90,,percent of total billed charges,,,1077.3,90,,percent of total billed charges,,,1077.3,90,,percent of total billed charges,,,1017.45,85,,percent of total billed charges,,188.9,1137.15,
REPAIR BLADDER  VAGINA,57240,CDM,57240,CPT,,,both,,2192,2192,1060.57,,,,fee schedule,,,,,,,,355.1,,,,fee schedule,,,1863.2,85,,percent of total billed charges,,1175.88,,,,fee schedule,,649.95,,,,fee schedule,,355.1,,,,fee schedule,,695.7,,,,fee schedule,,355.1,,,,fee schedule,,1029.37,,,,fee schedule,,623.86,,,,fee schedule,,623.86,,,,fee schedule,,,1994.72,91,,percent of total billed charges,,,2082.4,95,,percent of total billed charges,,,1819.36,83,,percent of total billed charges,,,657.6,83,,percent of total billed charges,,355.1,,,,fee schedule,,355.1,,,,fee schedule,,,1819.36,83,,percent of total billed charges,,917.08,,,,fee schedule,,,1972.8,90,,percent of total billed charges,,,1972.8,90,,percent of total billed charges,,,1972.8,90,,percent of total billed charges,,,1972.8,90,,percent of total billed charges,,,1863.2,85,,percent of total billed charges,,355.1,2082.4,
REPAIR RECTUM   VAGINA,57250,CDM,57250,CPT,,,both,,2279,2279,1065.75,,,,fee schedule,,,,,,,,314.95,,,,fee schedule,,,1937.15,85,,percent of total billed charges,,1184.47,,,,fee schedule,,654.7,,,,fee schedule,,314.95,,,,fee schedule,,645.96,,,,fee schedule,,314.95,,,,fee schedule,,1034.41,,,,fee schedule,,626.91,,,,fee schedule,,626.91,,,,fee schedule,,,2073.89,91,,percent of total billed charges,,,2165.05,95,,percent of total billed charges,,,1891.57,83,,percent of total billed charges,,,683.7,83,,percent of total billed charges,,314.95,,,,fee schedule,,314.95,,,,fee schedule,,,1891.57,83,,percent of total billed charges,,921.56,,,,fee schedule,,,2051.1,90,,percent of total billed charges,,,2051.1,90,,percent of total billed charges,,,2051.1,90,,percent of total billed charges,,,2051.1,90,,percent of total billed charges,,,1937.15,85,,percent of total billed charges,,314.95,2165.05,
REPAIR OF VAGINA,57260,CDM,57260,CPT,,,both,,3727,3727,1345.73,,,,fee schedule,,,,,,,,525.8,,,,fee schedule,,,3167.95,85,,percent of total billed charges,,1499.58,,,,fee schedule,,828.87,,,,fee schedule,,525.8,,,,fee schedule,,932.47,,,,fee schedule,,525.8,,,,fee schedule,,1306.15,,,,fee schedule,,791.6,,,,fee schedule,,791.6,,,,fee schedule,,,3391.57,91,,percent of total billed charges,,,3540.65,95,,percent of total billed charges,,,3093.41,83,,percent of total billed charges,,,1118.1,83,,percent of total billed charges,,525.8,,,,fee schedule,,525.8,,,,fee schedule,,,3093.41,83,,percent of total billed charges,,1163.66,,,,fee schedule,,,3354.3,90,,percent of total billed charges,,,3354.3,90,,percent of total billed charges,,,3354.3,90,,percent of total billed charges,,,3354.3,90,,percent of total billed charges,,,3167.95,85,,percent of total billed charges,,525.8,3540.65,
EXTENSIVE REPAIR OF VAGINA,57265,CDM,57265,CPT,,,both,,3335,3335,1506.46,,,,fee schedule,,,,,,,,532.8,,,,fee schedule,,,2834.75,85,,percent of total billed charges,,1680.76,,,,fee schedule,,929.01,,,,fee schedule,,532.8,,,,fee schedule,,1238.21,,,,fee schedule,,532.8,,,,fee schedule,,1462.15,,,,fee schedule,,886.15,,,,fee schedule,,886.15,,,,fee schedule,,,3034.85,91,,percent of total billed charges,,,3168.25,95,,percent of total billed charges,,,2768.05,83,,percent of total billed charges,,,1000.5,83,,percent of total billed charges,,532.8,,,,fee schedule,,532.8,,,,fee schedule,,,2768.05,83,,percent of total billed charges,,1302.64,,,,fee schedule,,,3001.5,90,,percent of total billed charges,,,3001.5,90,,percent of total billed charges,,,3001.5,90,,percent of total billed charges,,,3001.5,90,,percent of total billed charges,,,2834.75,85,,percent of total billed charges,,532.8,3168.25,
INSERT MESH/PELVIC FLR ADDON,57267,CDM,57267,CPT,,,both,,916,916,428.61,,,,fee schedule,,,,,,,,167.79,,,,fee schedule,,,778.6,85,,percent of total billed charges,,482.86,,,,fee schedule,,266.89,,,,fee schedule,,167.79,,,,fee schedule,,496.74,,,,fee schedule,,167.79,,,,fee schedule,,416,,,,fee schedule,,252.12,,,,fee schedule,,252.12,,,,fee schedule,,,833.56,91,,percent of total billed charges,,,870.2,95,,percent of total billed charges,,,760.28,83,,percent of total billed charges,,,274.8,83,,percent of total billed charges,,167.79,,,,fee schedule,,167.79,,,,fee schedule,,,760.28,83,,percent of total billed charges,,370.62,,,,fee schedule,,,824.4,90,,percent of total billed charges,,,824.4,90,,percent of total billed charges,,,824.4,90,,percent of total billed charges,,,824.4,90,,percent of total billed charges,,,778.6,85,,percent of total billed charges,,167.79,870.2,
REPAIR OF BOWEL BULGE,57268,CDM,57268,CPT,,,both,,1996,1996,877.95,,,,fee schedule,,,,,,,,532.8,,,,fee schedule,,,1696.6,85,,percent of total billed charges,,969.05,,,,fee schedule,,535.62,,,,fee schedule,,532.8,,,,fee schedule,,777.28,,,,fee schedule,,532.8,,,,fee schedule,,852.13,,,,fee schedule,,516.44,,,,fee schedule,,516.44,,,,fee schedule,,,1816.36,91,,percent of total billed charges,,,1896.2,95,,percent of total billed charges,,,1656.68,83,,percent of total billed charges,,,598.8,83,,percent of total billed charges,,532.8,,,,fee schedule,,532.8,,,,fee schedule,,,1656.68,83,,percent of total billed charges,,759.17,,,,fee schedule,,,1796.4,90,,percent of total billed charges,,,1796.4,90,,percent of total billed charges,,,1796.4,90,,percent of total billed charges,,,1796.4,90,,percent of total billed charges,,,1696.6,85,,percent of total billed charges,,516.44,1896.2,
SUSPENSION OF VAGINA,57280,CDM,57280,CPT,,,both,,3797,3797,1664.88,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3227.45,85,,percent of total billed charges,,1859.28,,,,fee schedule,,1027.69,,,,fee schedule,,599.35,,,,fee schedule,,1594.35,,,,fee schedule,,599.35,,,,fee schedule,,1615.91,,,,fee schedule,,979.34,,,,fee schedule,,979.34,,,,fee schedule,,,3455.27,91,,percent of total billed charges,,,3607.15,95,,percent of total billed charges,,,3151.51,83,,percent of total billed charges,,,1139.1,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3151.51,83,,percent of total billed charges,,1439.63,,,,fee schedule,,,3417.3,90,,percent of total billed charges,,,3417.3,90,,percent of total billed charges,,,3417.3,90,,percent of total billed charges,,,3417.3,90,,percent of total billed charges,,,3227.45,85,,percent of total billed charges,,599.35,3607.15,
"COLPOPEXY, EXTRAPERITONEAL",57282,CDM,57282,CPT,,,both,,2268,2268,1199.4,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,1927.8,85,,percent of total billed charges,,1333.68,,,,fee schedule,,737.17,,,,fee schedule,,480,,,,fee schedule,,821.05,,,,fee schedule,,480,,,,fee schedule,,1164.13,,,,fee schedule,,705.53,,,,fee schedule,,705.53,,,,fee schedule,,,2063.88,91,,percent of total billed charges,,,2154.6,95,,percent of total billed charges,,,1882.44,83,,percent of total billed charges,,,680.4,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,1882.44,83,,percent of total billed charges,,1037.13,,,,fee schedule,,,2041.2,90,,percent of total billed charges,,,2041.2,90,,percent of total billed charges,,,2041.2,90,,percent of total billed charges,,,2041.2,90,,percent of total billed charges,,,1927.8,85,,percent of total billed charges,,480,2154.6,
"COLPOPEXY, INTRAPERITONEAL",57283,CDM,57283,CPT,,,both,,2838,2838,1209.77,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,2412.3,85,,percent of total billed charges,,1343.88,,,,fee schedule,,742.81,,,,fee schedule,,599.35,,,,fee schedule,,1178.52,,,,fee schedule,,599.35,,,,fee schedule,,1174.19,,,,fee schedule,,711.63,,,,fee schedule,,711.63,,,,fee schedule,,,2582.58,91,,percent of total billed charges,,,2696.1,95,,percent of total billed charges,,,2355.54,83,,percent of total billed charges,,,851.4,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,2355.54,83,,percent of total billed charges,,1046.1,,,,fee schedule,,,2554.2,90,,percent of total billed charges,,,2554.2,90,,percent of total billed charges,,,2554.2,90,,percent of total billed charges,,,2554.2,90,,percent of total billed charges,,,2412.3,85,,percent of total billed charges,,599.35,2696.1,
Paravaginal Defect Repair; Vaginal Approach,57285,CDM,57285,CPT,,,both,,2508,2508,1196.52,,,,fee schedule,,,,,,,,352.36,,,,fee schedule,,,2131.8,85,,percent of total billed charges,,1331.96,,,,fee schedule,,736.22,,,,fee schedule,,352.36,,,,fee schedule,,,,,,,,352.36,,,,fee schedule,,1161.33,,,,fee schedule,,703.84,,,,fee schedule,,703.84,,,,fee schedule,,,2282.28,91,,percent of total billed charges,,,2382.6,95,,percent of total billed charges,,,2081.64,83,,percent of total billed charges,,,752.4,83,,percent of total billed charges,,352.36,,,,fee schedule,,352.36,,,,fee schedule,,,2081.64,83,,percent of total billed charges,,1034.64,,,,fee schedule,,,2257.2,90,,percent of total billed charges,,,2257.2,90,,percent of total billed charges,,,2257.2,90,,percent of total billed charges,,,2257.2,90,,percent of total billed charges,,,2131.8,85,,percent of total billed charges,,352.36,2382.6,
REVISE/REMOVE SLING REPAIR,57287,CDM,57287,CPT,,,both,,2282,2282,1282.36,,,,fee schedule,,,,,,,,467.5,,,,fee schedule,,,1939.7,85,,percent of total billed charges,,1416.55,,,,fee schedule,,782.98,,,,fee schedule,,467.5,,,,fee schedule,,1132.09,,,,fee schedule,,467.5,,,,fee schedule,,1244.64,,,,fee schedule,,754.33,,,,fee schedule,,754.33,,,,fee schedule,,,2076.62,91,,percent of total billed charges,,,2167.9,95,,percent of total billed charges,,,1894.06,83,,percent of total billed charges,,,684.6,83,,percent of total billed charges,,467.5,,,,fee schedule,,467.5,,,,fee schedule,,,1894.06,83,,percent of total billed charges,,1108.86,,,,fee schedule,,,2053.8,90,,percent of total billed charges,,,2053.8,90,,percent of total billed charges,,,2053.8,90,,percent of total billed charges,,,2053.8,90,,percent of total billed charges,,,1939.7,85,,percent of total billed charges,,467.5,2167.9,
REPAIR BLADDER DEFECT,57288,CDM,57288,CPT,,,both,,3202,3202,1281.78,,,,fee schedule,,,,,,,,631.25,,,,fee schedule,,,2721.7,85,,percent of total billed charges,,1421.45,,,,fee schedule,,785.68,,,,fee schedule,,631.25,,,,fee schedule,,1327.74,,,,fee schedule,,631.25,,,,fee schedule,,1244.08,,,,fee schedule,,753.99,,,,fee schedule,,753.99,,,,fee schedule,,,2913.82,91,,percent of total billed charges,,,3041.9,95,,percent of total billed charges,,,2657.66,83,,percent of total billed charges,,,960.6,83,,percent of total billed charges,,631.25,,,,fee schedule,,631.25,,,,fee schedule,,,2657.66,83,,percent of total billed charges,,1108.37,,,,fee schedule,,,2881.8,90,,percent of total billed charges,,,2881.8,90,,percent of total billed charges,,,2881.8,90,,percent of total billed charges,,,2881.8,90,,percent of total billed charges,,,2721.7,85,,percent of total billed charges,,631.25,3041.9,
CHANGE VAGINAL GRAFT,57295,CDM,57295,CPT,,,both,,1494,1494,868.16,,,,fee schedule,,,,,,,,269.31,,,,fee schedule,,,1269.9,85,,percent of total billed charges,,960.33,,,,fee schedule,,530.8,,,,fee schedule,,269.31,,,,fee schedule,,,,,,,,269.31,,,,fee schedule,,842.62,,,,fee schedule,,510.68,,,,fee schedule,,510.68,,,,fee schedule,,,1359.54,91,,percent of total billed charges,,,1419.3,95,,percent of total billed charges,,,1240.02,83,,percent of total billed charges,,,448.2,83,,percent of total billed charges,,269.31,,,,fee schedule,,269.31,,,,fee schedule,,,1240.02,83,,percent of total billed charges,,750.7,,,,fee schedule,,,1344.6,90,,percent of total billed charges,,,1344.6,90,,percent of total billed charges,,,1344.6,90,,percent of total billed charges,,,1344.6,90,,percent of total billed charges,,,1269.9,85,,percent of total billed charges,,269.31,1419.3,
REPAIR RECTUM-VAGINA FISTULA,57300,CDM,57300,CPT,,,both,,2359,2359,1059.42,,,,fee schedule,,,,,,,,466.15,,,,fee schedule,,,2005.15,85,,percent of total billed charges,,1174.14,,,,fee schedule,,648.98,,,,fee schedule,,466.15,,,,fee schedule,,844.92,,,,fee schedule,,466.15,,,,fee schedule,,1028.26,,,,fee schedule,,623.19,,,,fee schedule,,623.19,,,,fee schedule,,,2146.69,91,,percent of total billed charges,,,2241.05,95,,percent of total billed charges,,,1957.97,83,,percent of total billed charges,,,707.7,83,,percent of total billed charges,,466.15,,,,fee schedule,,466.15,,,,fee schedule,,,1957.97,83,,percent of total billed charges,,916.08,,,,fee schedule,,,2123.1,90,,percent of total billed charges,,,2123.1,90,,percent of total billed charges,,,2123.1,90,,percent of total billed charges,,,2123.1,90,,percent of total billed charges,,,2005.15,85,,percent of total billed charges,,466.15,2241.05,
PELVIC EXAMINATION,57410,CDM,57410,CPT,,,both,,430,430,180.89,,,,fee schedule,,,,,,,,53.3,,,,fee schedule,,,365.5,85,,percent of total billed charges,,200.79,,,,fee schedule,,110.99,,,,fee schedule,,53.3,,,,fee schedule,,186.36,,,,fee schedule,,53.3,,,,fee schedule,,175.57,,,,fee schedule,,106.41,,,,fee schedule,,106.41,,,,fee schedule,,,391.3,91,,percent of total billed charges,,,408.5,95,,percent of total billed charges,,,356.9,83,,percent of total billed charges,,,129,83,,percent of total billed charges,,53.3,,,,fee schedule,,53.3,,,,fee schedule,,,356.9,83,,percent of total billed charges,,156.42,,,,fee schedule,,,387,90,,percent of total billed charges,,,387,90,,percent of total billed charges,,,387,90,,percent of total billed charges,,,387,90,,percent of total billed charges,,,365.5,85,,percent of total billed charges,,53.3,408.5,
REMOVE VAGINAL FOREIGN BODY,57415,CDM,57415,CPT,,,both,,620,620,303.6,,,,fee schedule,,,,,,,,111,,,,fee schedule,,,527,85,,percent of total billed charges,,334.52,,,,fee schedule,,184.9,,,,fee schedule,,111,,,,fee schedule,,254.01,,,,fee schedule,,111,,,,fee schedule,,294.67,,,,fee schedule,,178.59,,,,fee schedule,,178.59,,,,fee schedule,,,564.2,91,,percent of total billed charges,,,589,95,,percent of total billed charges,,,514.6,83,,percent of total billed charges,,,186,83,,percent of total billed charges,,111,,,,fee schedule,,111,,,,fee schedule,,,514.6,83,,percent of total billed charges,,262.52,,,,fee schedule,,,558,90,,percent of total billed charges,,,558,90,,percent of total billed charges,,,558,90,,percent of total billed charges,,,558,90,,percent of total billed charges,,,527,85,,percent of total billed charges,,111,589,
EXAM OF VAGINA W/SCOPE,57420,CDM,57420,CPT,,,both,,465,465,153.24,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,395.25,85,,percent of total billed charges,,170.88,,,,fee schedule,,94.45,,,,fee schedule,,37.4,,,,fee schedule,,162.49,,,,fee schedule,,37.4,,,,fee schedule,,148.73,,,,fee schedule,,90.14,,,,fee schedule,,90.14,,,,fee schedule,,,423.15,91,,percent of total billed charges,,,441.75,95,,percent of total billed charges,,,385.95,83,,percent of total billed charges,,,139.5,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,385.95,83,,percent of total billed charges,,132.51,,,,fee schedule,,,418.5,90,,percent of total billed charges,,,418.5,90,,percent of total billed charges,,,418.5,90,,percent of total billed charges,,,418.5,90,,percent of total billed charges,,,395.25,85,,percent of total billed charges,,37.4,441.75,
EXAM OF VAGINA W/SCOPE,57420P,CDM,57420,CPT,,,both,P,301,301,153.24,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,255.85,85,,percent of total billed charges,,170.88,,,,fee schedule,,94.45,,,,fee schedule,,37.4,,,,fee schedule,,162.49,,,,fee schedule,,37.4,,,,fee schedule,,148.73,,,,fee schedule,,90.14,,,,fee schedule,,90.14,,,,fee schedule,,,273.91,91,,percent of total billed charges,,,285.95,95,,percent of total billed charges,,,249.83,83,,percent of total billed charges,,,90.3,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,249.83,83,,percent of total billed charges,,132.51,,,,fee schedule,,,270.9,90,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,270.9,90,,percent of total billed charges,,,255.85,85,,percent of total billed charges,,37.4,285.95,
EXAM OF VAGINA W/SCOPE,57420T,CDM,57420,CPT,,,both,T,164,164,153.24,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,139.4,85,,percent of total billed charges,,170.88,,,,fee schedule,,94.45,,,,fee schedule,,37.4,,,,fee schedule,,162.49,,,,fee schedule,,37.4,,,,fee schedule,,148.73,,,,fee schedule,,90.14,,,,fee schedule,,90.14,,,,fee schedule,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,49.2,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,136.12,83,,percent of total billed charges,,132.51,,,,fee schedule,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,37.4,170.88,
COLPOSCOPY ENTIRE VAG W/CERVIX BX,57421,CDM,57421,CPT,,,both,,612,612,207.97,,,,fee schedule,,,,,,,,50.2,,,,fee schedule,,,520.2,85,,percent of total billed charges,,232.9,,,,fee schedule,,128.73,,,,fee schedule,,50.2,,,,fee schedule,,226.82,,,,fee schedule,,50.2,,,,fee schedule,,201.85,,,,fee schedule,,122.33,,,,fee schedule,,122.33,,,,fee schedule,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,183.6,83,,percent of total billed charges,,50.2,,,,fee schedule,,50.2,,,,fee schedule,,,507.96,83,,percent of total billed charges,,179.83,,,,fee schedule,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,50.2,581.4,
"LAPAROSCOPY, SURG, COLPOPEXY",57425,CDM,57425,CPT,,,both,,3649,3649,1676.4,,,,fee schedule,,,,,,,,487.77,,,,fee schedule,,,3101.65,85,,percent of total billed charges,,1873.14,,,,fee schedule,,1035.34,,,,fee schedule,,487.77,,,,fee schedule,,1598.33,,,,fee schedule,,487.77,,,,fee schedule,,1627.09,,,,fee schedule,,986.12,,,,fee schedule,,986.12,,,,fee schedule,,,3320.59,91,,percent of total billed charges,,,3466.55,95,,percent of total billed charges,,,3028.67,83,,percent of total billed charges,,,1094.7,83,,percent of total billed charges,,487.77,,,,fee schedule,,487.77,,,,fee schedule,,,3028.67,83,,percent of total billed charges,,1449.59,,,,fee schedule,,,3284.1,90,,percent of total billed charges,,,3284.1,90,,percent of total billed charges,,,3284.1,90,,percent of total billed charges,,,3284.1,90,,percent of total billed charges,,,3101.65,85,,percent of total billed charges,,487.77,3466.55,
REVISE PROSTH VAG GRAFT LAP,57426,CDM,57426,CPT,,,both,,3577,3577,1503.58,,,,fee schedule,,,,,,,,491.98,,,,fee schedule,,,3040.45,85,,percent of total billed charges,,1672.05,,,,fee schedule,,924.2,,,,fee schedule,,491.98,,,,fee schedule,,,,,,,,491.98,,,,fee schedule,,1459.35,,,,fee schedule,,884.46,,,,fee schedule,,884.46,,,,fee schedule,,,3255.07,91,,percent of total billed charges,,,3398.15,95,,percent of total billed charges,,,2968.91,83,,percent of total billed charges,,,1073.1,83,,percent of total billed charges,,491.98,,,,fee schedule,,491.98,,,,fee schedule,,,2968.91,83,,percent of total billed charges,,1300.15,,,,fee schedule,,,3219.3,90,,percent of total billed charges,,,3219.3,90,,percent of total billed charges,,,3219.3,90,,percent of total billed charges,,,3219.3,90,,percent of total billed charges,,,3040.45,85,,percent of total billed charges,,491.98,3398.15,
EXAM OF CERVIX W/SCOPE,57452,CDM,57452,CPT,,,both,,417,417,156.12,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,354.45,85,,percent of total billed charges,,172.52,,,,fee schedule,,95.36,,,,fee schedule,,37.4,,,,fee schedule,,161.16,,,,fee schedule,,37.4,,,,fee schedule,,151.53,,,,fee schedule,,91.83,,,,fee schedule,,91.83,,,,fee schedule,,,379.47,91,,percent of total billed charges,,,396.15,95,,percent of total billed charges,,,346.11,83,,percent of total billed charges,,,125.1,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,346.11,83,,percent of total billed charges,,135,,,,fee schedule,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,354.45,85,,percent of total billed charges,,37.4,396.15,
BX/CURETT OF CERVIX W/SCOPE,57454,CDM,57454,CPT,,,both,,595,595,228.13,,,,fee schedule,,,,,,,,50.2,,,,fee schedule,,,505.75,85,,percent of total billed charges,,256.48,,,,fee schedule,,141.76,,,,fee schedule,,50.2,,,,fee schedule,,249.37,,,,fee schedule,,50.2,,,,fee schedule,,221.42,,,,fee schedule,,134.19,,,,fee schedule,,134.19,,,,fee schedule,,,541.45,91,,percent of total billed charges,,,565.25,95,,percent of total billed charges,,,493.85,83,,percent of total billed charges,,,178.5,83,,percent of total billed charges,,50.2,,,,fee schedule,,50.2,,,,fee schedule,,,493.85,83,,percent of total billed charges,,197.26,,,,fee schedule,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,535.5,90,,percent of total billed charges,,,505.75,85,,percent of total billed charges,,50.2,565.25,
BIOPSY OF CERVIX W/SCOPE,57455,CDM,57455,CPT,,,both,,531,531,186.07,,,,fee schedule,,,,,,,,50.2,,,,fee schedule,,,451.35,85,,percent of total billed charges,,209.04,,,,fee schedule,,115.54,,,,fee schedule,,50.2,,,,fee schedule,,205.59,,,,fee schedule,,50.2,,,,fee schedule,,180.6,,,,fee schedule,,109.46,,,,fee schedule,,109.46,,,,fee schedule,,,483.21,91,,percent of total billed charges,,,504.45,95,,percent of total billed charges,,,440.73,83,,percent of total billed charges,,,159.3,83,,percent of total billed charges,,50.2,,,,fee schedule,,50.2,,,,fee schedule,,,440.73,83,,percent of total billed charges,,160.9,,,,fee schedule,,,477.9,90,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,477.9,90,,percent of total billed charges,,,451.35,85,,percent of total billed charges,,50.2,504.45,
BIOPSY OF CERVIX W/SCOPE,57455P,CDM,57455,CPT,,,both,P,365,365,186.07,,,,fee schedule,,,,,,,,50.2,,,,fee schedule,,,310.25,85,,percent of total billed charges,,209.04,,,,fee schedule,,115.54,,,,fee schedule,,50.2,,,,fee schedule,,205.59,,,,fee schedule,,50.2,,,,fee schedule,,180.6,,,,fee schedule,,109.46,,,,fee schedule,,109.46,,,,fee schedule,,,332.15,91,,percent of total billed charges,,,346.75,95,,percent of total billed charges,,,302.95,83,,percent of total billed charges,,,109.5,83,,percent of total billed charges,,50.2,,,,fee schedule,,50.2,,,,fee schedule,,,302.95,83,,percent of total billed charges,,160.9,,,,fee schedule,,,328.5,90,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,310.25,85,,percent of total billed charges,,50.2,346.75,
BIOPSY OF CERVIX W/SCOPE,57455T,CDM,57455,CPT,,,both,T,166,166,186.07,,,,fee schedule,,,,,,,,50.2,,,,fee schedule,,,141.1,85,,percent of total billed charges,,209.04,,,,fee schedule,,115.54,,,,fee schedule,,50.2,,,,fee schedule,,205.59,,,,fee schedule,,50.2,,,,fee schedule,,180.6,,,,fee schedule,,109.46,,,,fee schedule,,109.46,,,,fee schedule,,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,50.2,,,,fee schedule,,50.2,,,,fee schedule,,,137.78,83,,percent of total billed charges,,160.9,,,,fee schedule,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,49.8,209.04,
ENDOCERV CURETTAGE W/SCOPE,57456,CDM,57456,CPT,,,both,,521,521,173.4,,,,fee schedule,,,,,,,,50.2,,,,fee schedule,,,442.85,85,,percent of total billed charges,,193.95,,,,fee schedule,,107.2,,,,fee schedule,,50.2,,,,fee schedule,,191.67,,,,fee schedule,,50.2,,,,fee schedule,,168.3,,,,fee schedule,,102,,,,fee schedule,,102,,,,fee schedule,,,474.11,91,,percent of total billed charges,,,494.95,95,,percent of total billed charges,,,432.43,83,,percent of total billed charges,,,156.3,83,,percent of total billed charges,,50.2,,,,fee schedule,,50.2,,,,fee schedule,,,432.43,83,,percent of total billed charges,,149.94,,,,fee schedule,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,442.85,85,,percent of total billed charges,,50.2,494.95,
"BX OF CERVIX W/SCOPE, LEEP",57460,CDM,57460,CPT,,,both,,1400,1400,273.64,,,,fee schedule,,,,,,,,77,,,,fee schedule,,,1190,85,,percent of total billed charges,,303.89,,,,fee schedule,,167.97,,,,fee schedule,,77,,,,fee schedule,,301.76,,,,fee schedule,,77,,,,fee schedule,,265.59,,,,fee schedule,,160.96,,,,fee schedule,,160.96,,,,fee schedule,,,1274,91,,percent of total billed charges,,,1330,95,,percent of total billed charges,,,1162,83,,percent of total billed charges,,,420,83,,percent of total billed charges,,77,,,,fee schedule,,77,,,,fee schedule,,,1162,83,,percent of total billed charges,,236.62,,,,fee schedule,,,1260,90,,percent of total billed charges,,,1260,90,,percent of total billed charges,,,1260,90,,percent of total billed charges,,,1260,90,,percent of total billed charges,,,1190,85,,percent of total billed charges,,77,1330,
"CONZ OF CERVIX W/SCOPE, LEEP",57461,CDM,57461,CPT,,,both,,1676,1676,314.54,,,,fee schedule,,,,,,,,172.05,,,,fee schedule,,,1424.6,85,,percent of total billed charges,,354.31,,,,fee schedule,,195.84,,,,fee schedule,,172.05,,,,fee schedule,,352.16,,,,fee schedule,,172.05,,,,fee schedule,,305.29,,,,fee schedule,,185.02,,,,fee schedule,,185.02,,,,fee schedule,,,1525.16,91,,percent of total billed charges,,,1592.2,95,,percent of total billed charges,,,1391.08,83,,percent of total billed charges,,,502.8,83,,percent of total billed charges,,172.05,,,,fee schedule,,172.05,,,,fee schedule,,,1391.08,83,,percent of total billed charges,,271.99,,,,fee schedule,,,1508.4,90,,percent of total billed charges,,,1508.4,90,,percent of total billed charges,,,1508.4,90,,percent of total billed charges,,,1508.4,90,,percent of total billed charges,,,1424.6,85,,percent of total billed charges,,172.05,1592.2,
BIOPSY OF CERVIX,57500,CDM,57500,CPT,,,both,,522,522,128.47,,,,fee schedule,,,,,,,,142.7,,,,fee schedule,,,443.7,85,,percent of total billed charges,,142.58,,,,fee schedule,,78.81,,,,fee schedule,,142.7,,,,fee schedule,,113.41,,,,fee schedule,,142.7,,,,fee schedule,,124.69,,,,fee schedule,,75.57,,,,fee schedule,,75.57,,,,fee schedule,,,475.02,91,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,156.6,83,,percent of total billed charges,,142.7,,,,fee schedule,,142.7,,,,fee schedule,,,433.26,83,,percent of total billed charges,,111.09,,,,fee schedule,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,75.57,495.9,
ENDOCERVICAL CURETTAGE,57505,CDM,57505,CPT,,,both,,440,440,189.53,,,,fee schedule,,,,,,,,48.55,,,,fee schedule,,,374,85,,percent of total billed charges,,205.89,,,,fee schedule,,113.8,,,,fee schedule,,48.55,,,,fee schedule,,157.18,,,,fee schedule,,48.55,,,,fee schedule,,183.96,,,,fee schedule,,111.49,,,,fee schedule,,111.49,,,,fee schedule,,,400.4,91,,percent of total billed charges,,,418,95,,percent of total billed charges,,,365.2,83,,percent of total billed charges,,,132,83,,percent of total billed charges,,48.55,,,,fee schedule,,48.55,,,,fee schedule,,,365.2,83,,percent of total billed charges,,163.89,,,,fee schedule,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,374,85,,percent of total billed charges,,48.55,418,
ENDOCERVICAL CURETTAGE,57505P,CDM,57505,CPT,,,both,P,200,200,189.53,,,,fee schedule,,,,,,,,48.55,,,,fee schedule,,,170,85,,percent of total billed charges,,205.89,,,,fee schedule,,113.8,,,,fee schedule,,48.55,,,,fee schedule,,157.18,,,,fee schedule,,48.55,,,,fee schedule,,183.96,,,,fee schedule,,111.49,,,,fee schedule,,111.49,,,,fee schedule,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,60,83,,percent of total billed charges,,48.55,,,,fee schedule,,48.55,,,,fee schedule,,,166,83,,percent of total billed charges,,163.89,,,,fee schedule,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,48.55,205.89,
ENDOCERVICAL CURETTAGE,57505T,CDM,57505,CPT,,,both,T,240,240,189.53,,,,fee schedule,,,,,,,,48.55,,,,fee schedule,,,204,85,,percent of total billed charges,,205.89,,,,fee schedule,,113.8,,,,fee schedule,,48.55,,,,fee schedule,,157.18,,,,fee schedule,,48.55,,,,fee schedule,,183.96,,,,fee schedule,,111.49,,,,fee schedule,,111.49,,,,fee schedule,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,72,83,,percent of total billed charges,,48.55,,,,fee schedule,,48.55,,,,fee schedule,,,199.2,83,,percent of total billed charges,,163.89,,,,fee schedule,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,48.55,228,
CAUTERIZATION OF CERVIX,57510,CDM,57510,CPT,,,both,,535,535,193.56,,,,fee schedule,,,,,,,,60.6,,,,fee schedule,,,454.75,85,,percent of total billed charges,,215.52,,,,fee schedule,,119.12,,,,fee schedule,,60.6,,,,fee schedule,,209.57,,,,fee schedule,,60.6,,,,fee schedule,,187.87,,,,fee schedule,,113.86,,,,fee schedule,,113.86,,,,fee schedule,,,486.85,91,,percent of total billed charges,,,508.25,95,,percent of total billed charges,,,444.05,83,,percent of total billed charges,,,160.5,83,,percent of total billed charges,,60.6,,,,fee schedule,,60.6,,,,fee schedule,,,444.05,83,,percent of total billed charges,,167.38,,,,fee schedule,,,481.5,90,,percent of total billed charges,,,481.5,90,,percent of total billed charges,,,481.5,90,,percent of total billed charges,,,481.5,90,,percent of total billed charges,,,454.75,85,,percent of total billed charges,,60.6,508.25,
CRYOCAUTERY OF CERVIX,57511,CDM,57511,CPT,,,both,,564,564,255.2,,,,fee schedule,,,,,,,,58.1,,,,fee schedule,,,479.4,85,,percent of total billed charges,,279.95,,,,fee schedule,,154.74,,,,fee schedule,,58.1,,,,fee schedule,,231.46,,,,fee schedule,,58.1,,,,fee schedule,,247.7,,,,fee schedule,,150.12,,,,fee schedule,,150.12,,,,fee schedule,,,513.24,91,,percent of total billed charges,,,535.8,95,,percent of total billed charges,,,468.12,83,,percent of total billed charges,,,169.2,83,,percent of total billed charges,,58.1,,,,fee schedule,,58.1,,,,fee schedule,,,468.12,83,,percent of total billed charges,,220.68,,,,fee schedule,,,507.6,90,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,507.6,90,,percent of total billed charges,,,479.4,85,,percent of total billed charges,,58.1,535.8,
CONIZATION OF CERVIX,57522,CDM,57522,CPT,,,both,,1216,1216,441.86,,,,fee schedule,,,,,,,,305.8,,,,fee schedule,,,1033.6,85,,percent of total billed charges,,486.13,,,,fee schedule,,268.7,,,,fee schedule,,305.8,,,,fee schedule,,411.19,,,,fee schedule,,305.8,,,,fee schedule,,428.86,,,,fee schedule,,259.91,,,,fee schedule,,259.91,,,,fee schedule,,,1106.56,91,,percent of total billed charges,,,1155.2,95,,percent of total billed charges,,,1009.28,83,,percent of total billed charges,,,364.8,83,,percent of total billed charges,,305.8,,,,fee schedule,,305.8,,,,fee schedule,,,1009.28,83,,percent of total billed charges,,382.07,,,,fee schedule,,,1094.4,90,,percent of total billed charges,,,1094.4,90,,percent of total billed charges,,,1094.4,90,,percent of total billed charges,,,1094.4,90,,percent of total billed charges,,,1033.6,85,,percent of total billed charges,,259.91,1155.2,
REVISION OF CERVIX,57720,CDM,57720,CPT,,,both,,1468,1468,581.27,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,1247.8,85,,percent of total billed charges,,639.65,,,,fee schedule,,353.56,,,,fee schedule,,359.3,,,,fee schedule,,510.67,,,,fee schedule,,359.3,,,,fee schedule,,564.17,,,,fee schedule,,341.92,,,,fee schedule,,341.92,,,,fee schedule,,,1335.88,91,,percent of total billed charges,,,1394.6,95,,percent of total billed charges,,,1218.44,83,,percent of total billed charges,,,440.4,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,1218.44,83,,percent of total billed charges,,502.63,,,,fee schedule,,,1321.2,90,,percent of total billed charges,,,1321.2,90,,percent of total billed charges,,,1321.2,90,,percent of total billed charges,,,1321.2,90,,percent of total billed charges,,,1247.8,85,,percent of total billed charges,,341.92,1394.6,
DILATION OF CERVICAL CANAL,57800,CDM,57800,CPT,,,both,,265,265,81.8,,,,fee schedule,,,,,,,,119.25,,,,fee schedule,,,225.25,85,,percent of total billed charges,,90.26,,,,fee schedule,,49.89,,,,fee schedule,,119.25,,,,fee schedule,,88.21,,,,fee schedule,,119.25,,,,fee schedule,,79.4,,,,fee schedule,,48.12,,,,fee schedule,,48.12,,,,fee schedule,,,241.15,91,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,79.5,83,,percent of total billed charges,,119.25,,,,fee schedule,,119.25,,,,fee schedule,,,219.95,83,,percent of total billed charges,,70.74,,,,fee schedule,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,48.12,251.75,
BIOPSY OF UTERUS LINING,58100,CDM,58100,CPT,,,both,,454,454,108.3,,,,fee schedule,,,,,,,,52.9,,,,fee schedule,,,385.9,85,,percent of total billed charges,,137.25,,,,fee schedule,,67.94,,,,fee schedule,,52.9,,,,fee schedule,,161.16,,,,fee schedule,,52.9,,,,fee schedule,,105.12,,,,fee schedule,,63.71,,,,fee schedule,,63.71,,,,fee schedule,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,52.9,,,,fee schedule,,52.9,,,,fee schedule,,,376.82,83,,percent of total billed charges,,93.65,,,,fee schedule,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,52.9,431.3,
BIOPSY OF UTERUS LINING,58100P,CDM,58100,CPT,,,both,P,290,290,108.3,,,,fee schedule,,,,,,,,52.9,,,,fee schedule,,,246.5,85,,percent of total billed charges,,137.25,,,,fee schedule,,67.94,,,,fee schedule,,52.9,,,,fee schedule,,161.16,,,,fee schedule,,52.9,,,,fee schedule,,105.12,,,,fee schedule,,63.71,,,,fee schedule,,63.71,,,,fee schedule,,,263.9,91,,percent of total billed charges,,,275.5,95,,percent of total billed charges,,,240.7,83,,percent of total billed charges,,,87,83,,percent of total billed charges,,52.9,,,,fee schedule,,52.9,,,,fee schedule,,,240.7,83,,percent of total billed charges,,93.65,,,,fee schedule,,,261,90,,percent of total billed charges,,,261,90,,percent of total billed charges,,,261,90,,percent of total billed charges,,,261,90,,percent of total billed charges,,,246.5,85,,percent of total billed charges,,52.9,275.5,
BIOPSY OF UTERUS LINING,58100T,CDM,58100,CPT,,,both,T,164,164,108.3,,,,fee schedule,,,,,,,,52.9,,,,fee schedule,,,139.4,85,,percent of total billed charges,,137.25,,,,fee schedule,,67.94,,,,fee schedule,,52.9,,,,fee schedule,,161.16,,,,fee schedule,,52.9,,,,fee schedule,,105.12,,,,fee schedule,,63.71,,,,fee schedule,,63.71,,,,fee schedule,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,49.2,83,,percent of total billed charges,,52.9,,,,fee schedule,,52.9,,,,fee schedule,,,136.12,83,,percent of total billed charges,,93.65,,,,fee schedule,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,49.2,161.16,
BX DONE W/COLPOSCOPY ADD-ON,58110,CDM,58110,CPT,,,both,,245,245,68.55,,,,fee schedule,,,,,,,,24.9,,,,fee schedule,,,208.25,85,,percent of total billed charges,,77.71,,,,fee schedule,,42.95,,,,fee schedule,,24.9,,,,fee schedule,,,,,,,,24.9,,,,fee schedule,,66.54,,,,fee schedule,,40.33,,,,fee schedule,,40.33,,,,fee schedule,,,222.95,91,,percent of total billed charges,,,232.75,95,,percent of total billed charges,,,203.35,83,,percent of total billed charges,,,73.5,83,,percent of total billed charges,,24.9,,,,fee schedule,,24.9,,,,fee schedule,,,203.35,83,,percent of total billed charges,,59.28,,,,fee schedule,,,220.5,90,,percent of total billed charges,,,220.5,90,,percent of total billed charges,,,220.5,90,,percent of total billed charges,,,220.5,90,,percent of total billed charges,,,208.25,85,,percent of total billed charges,,24.9,232.75,
DILATION AND CURETTAGE,58120,CDM,58120,CPT,,,both,,1356,1356,403.83,,,,fee schedule,,,,,,,,206.85,,,,fee schedule,,,1152.6,85,,percent of total billed charges,,448.01,,,,fee schedule,,247.63,,,,fee schedule,,206.85,,,,fee schedule,,366.75,,,,fee schedule,,206.85,,,,fee schedule,,391.96,,,,fee schedule,,237.55,,,,fee schedule,,237.55,,,,fee schedule,,,1233.96,91,,percent of total billed charges,,,1288.2,95,,percent of total billed charges,,,1125.48,83,,percent of total billed charges,,,406.8,83,,percent of total billed charges,,206.85,,,,fee schedule,,206.85,,,,fee schedule,,,1125.48,83,,percent of total billed charges,,349.2,,,,fee schedule,,,1220.4,90,,percent of total billed charges,,,1220.4,90,,percent of total billed charges,,,1220.4,90,,percent of total billed charges,,,1220.4,90,,percent of total billed charges,,,1152.6,85,,percent of total billed charges,,206.85,1288.2,
TOTAL HYSTERECTOMY,58150,CDM,58150,CPT,,,both,,4735,4735,1748.99,,,,fee schedule,,,,,,,,772.7,,,,fee schedule,,,4024.75,85,,percent of total billed charges,,1947.33,,,,fee schedule,,1076.35,,,,fee schedule,,772.7,,,,fee schedule,,1625.52,,,,fee schedule,,772.7,,,,fee schedule,,1697.55,,,,fee schedule,,1028.82,,,,fee schedule,,1028.82,,,,fee schedule,,,4308.85,91,,percent of total billed charges,,,4498.25,95,,percent of total billed charges,,,3930.05,83,,percent of total billed charges,,,1420.5,83,,percent of total billed charges,,772.7,,,,fee schedule,,772.7,,,,fee schedule,,,3930.05,83,,percent of total billed charges,,1512.36,,,,fee schedule,,,4261.5,90,,percent of total billed charges,,,4261.5,90,,percent of total billed charges,,,4261.5,90,,percent of total billed charges,,,4261.5,90,,percent of total billed charges,,,4024.75,85,,percent of total billed charges,,772.7,4498.25,
PARTIAL HYSTERECTOMY,58180,CDM,58180,CPT,,,both,,3905,3905,1655.08,,,,fee schedule,,,,,,,,652.05,,,,fee schedule,,,3319.25,85,,percent of total billed charges,,1848.27,,,,fee schedule,,1021.6,,,,fee schedule,,652.05,,,,fee schedule,,1615.57,,,,fee schedule,,652.05,,,,fee schedule,,1606.41,,,,fee schedule,,973.58,,,,fee schedule,,973.58,,,,fee schedule,,,3553.55,91,,percent of total billed charges,,,3709.75,95,,percent of total billed charges,,,3241.15,83,,percent of total billed charges,,,1171.5,83,,percent of total billed charges,,652.05,,,,fee schedule,,652.05,,,,fee schedule,,,3241.15,83,,percent of total billed charges,,1431.16,,,,fee schedule,,,3514.5,90,,percent of total billed charges,,,3514.5,90,,percent of total billed charges,,,3514.5,90,,percent of total billed charges,,,3514.5,90,,percent of total billed charges,,,3319.25,85,,percent of total billed charges,,652.05,3709.75,
VAGINAL HYSTERECTOMY,58260,CDM,58260,CPT,,,both,,5194,5194,1451.73,,,,fee schedule,,,,,,,,725.6,,,,fee schedule,,,4414.9,85,,percent of total billed charges,,1616.69,,,,fee schedule,,893.6,,,,fee schedule,,725.6,,,,fee schedule,,1406,,,,fee schedule,,725.6,,,,fee schedule,,1409.03,,,,fee schedule,,853.96,,,,fee schedule,,853.96,,,,fee schedule,,,4726.54,91,,percent of total billed charges,,,4934.3,95,,percent of total billed charges,,,4311.02,83,,percent of total billed charges,,,1558.2,83,,percent of total billed charges,,725.6,,,,fee schedule,,725.6,,,,fee schedule,,,4311.02,83,,percent of total billed charges,,1255.32,,,,fee schedule,,,4674.6,90,,percent of total billed charges,,,4674.6,90,,percent of total billed charges,,,4674.6,90,,percent of total billed charges,,,4674.6,90,,percent of total billed charges,,,4414.9,85,,percent of total billed charges,,725.6,4934.3,
VAG HYST INCLUDING T/O,58262,CDM,58262,CPT,,,both,,3776,3776,1602.09,,,,fee schedule,,,,,,,,725.6,,,,fee schedule,,,3209.6,85,,percent of total billed charges,,1788,,,,fee schedule,,988.29,,,,fee schedule,,725.6,,,,fee schedule,,1585.06,,,,fee schedule,,725.6,,,,fee schedule,,1554.97,,,,fee schedule,,942.4,,,,fee schedule,,942.4,,,,fee schedule,,,3436.16,91,,percent of total billed charges,,,3587.2,95,,percent of total billed charges,,,3134.08,83,,percent of total billed charges,,,1132.8,83,,percent of total billed charges,,725.6,,,,fee schedule,,725.6,,,,fee schedule,,,3134.08,83,,percent of total billed charges,,1385.33,,,,fee schedule,,,3398.4,90,,percent of total billed charges,,,3398.4,90,,percent of total billed charges,,,3398.4,90,,percent of total billed charges,,,3398.4,90,,percent of total billed charges,,,3209.6,85,,percent of total billed charges,,725.6,3587.2,
VAG HYST W/T/O   VAG REPAIR,58263,CDM,58263,CPT,,,both,,5978,5978,1718.45,,,,fee schedule,,,,,,,,725.6,,,,fee schedule,,,5081.3,85,,percent of total billed charges,,1917.53,,,,fee schedule,,1059.88,,,,fee schedule,,725.6,,,,fee schedule,,1713.72,,,,fee schedule,,725.6,,,,fee schedule,,1667.91,,,,fee schedule,,1010.86,,,,fee schedule,,1010.86,,,,fee schedule,,,5439.98,91,,percent of total billed charges,,,5679.1,95,,percent of total billed charges,,,4961.74,83,,percent of total billed charges,,,1793.4,83,,percent of total billed charges,,725.6,,,,fee schedule,,725.6,,,,fee schedule,,,4961.74,83,,percent of total billed charges,,1485.96,,,,fee schedule,,,5380.2,90,,percent of total billed charges,,,5380.2,90,,percent of total billed charges,,,5380.2,90,,percent of total billed charges,,,5380.2,90,,percent of total billed charges,,,5081.3,85,,percent of total billed charges,,725.6,5679.1,
"VAG HYST T/O   REPAIR, COMPL",58292,CDM,58292,CPT,,,both,,5253,5253,2265.16,,,,fee schedule,,,,,,,,725.6,,,,fee schedule,,,4465.05,85,,percent of total billed charges,,2535.58,,,,fee schedule,,1401.5,,,,fee schedule,,725.6,,,,fee schedule,,2326.53,,,,fee schedule,,725.6,,,,fee schedule,,2198.53,,,,fee schedule,,1332.44,,,,fee schedule,,1332.44,,,,fee schedule,,,4780.23,91,,percent of total billed charges,,,4990.35,95,,percent of total billed charges,,,4359.99,83,,percent of total billed charges,,,1575.9,83,,percent of total billed charges,,725.6,,,,fee schedule,,725.6,,,,fee schedule,,,4359.99,83,,percent of total billed charges,,1958.69,,,,fee schedule,,,4727.7,90,,percent of total billed charges,,,4727.7,90,,percent of total billed charges,,,4727.7,90,,percent of total billed charges,,,4727.7,90,,percent of total billed charges,,,4465.05,85,,percent of total billed charges,,725.6,4990.35,
INSERT INTRAUTERINE DEVICE,58300,CDM,58300,CPT,,,both,,389,389,86.41,,,,fee schedule,,,,,,,,88,,,,fee schedule,,,330.65,85,,percent of total billed charges,,89.57,,,,fee schedule,,53.34,,,,fee schedule,,88,,,,fee schedule,,100.14,,,,fee schedule,,88,,,,fee schedule,,83.87,,,,fee schedule,,50.83,,,,fee schedule,,50.83,,,,fee schedule,,,353.99,91,,percent of total billed charges,,,369.55,95,,percent of total billed charges,,,322.87,83,,percent of total billed charges,,,116.7,83,,percent of total billed charges,,88,,,,fee schedule,,88,,,,fee schedule,,,322.87,83,,percent of total billed charges,,74.72,,,,fee schedule,,,350.1,90,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,330.65,85,,percent of total billed charges,,50.83,369.55,
REMOVE INTRAUTERINE DEVICE,58301,CDM,58301,CPT,,,both,,362,362,113.49,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,307.7,85,,percent of total billed charges,,125.19,,,,fee schedule,,70.77,,,,fee schedule,,37.4,,,,fee schedule,,126.01,,,,fee schedule,,37.4,,,,fee schedule,,110.15,,,,fee schedule,,66.76,,,,fee schedule,,66.76,,,,fee schedule,,,329.42,91,,percent of total billed charges,,,343.9,95,,percent of total billed charges,,,300.46,83,,percent of total billed charges,,,108.6,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,300.46,83,,percent of total billed charges,,98.13,,,,fee schedule,,,325.8,90,,percent of total billed charges,,,325.8,90,,percent of total billed charges,,,325.8,90,,percent of total billed charges,,,325.8,90,,percent of total billed charges,,,307.7,85,,percent of total billed charges,,37.4,343.9,
REMOVE INTRAUTERINE DEVICE,58301P,CDM,58301,CPT,,,both,P,201,201,113.49,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,170.85,85,,percent of total billed charges,,125.19,,,,fee schedule,,70.77,,,,fee schedule,,37.4,,,,fee schedule,,126.01,,,,fee schedule,,37.4,,,,fee schedule,,110.15,,,,fee schedule,,66.76,,,,fee schedule,,66.76,,,,fee schedule,,,182.91,91,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,60.3,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,166.83,83,,percent of total billed charges,,98.13,,,,fee schedule,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,37.4,190.95,
REMOVE INTRAUTERINE DEVICE,58301T,CDM,58301,CPT,,,both,T,161,161,113.49,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,136.85,85,,percent of total billed charges,,125.19,,,,fee schedule,,70.77,,,,fee schedule,,37.4,,,,fee schedule,,126.01,,,,fee schedule,,37.4,,,,fee schedule,,110.15,,,,fee schedule,,66.76,,,,fee schedule,,66.76,,,,fee schedule,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,48.3,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,133.63,83,,percent of total billed charges,,98.13,,,,fee schedule,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,37.4,152.95,
LAPARO-VAG HYST INCL T/O,58552,CDM,58552,CPT,,,both,,3904,3904,1694.83,,,,fee schedule,,,,,,,,725,,,,fee schedule,,,3318.4,85,,percent of total billed charges,,1887.83,,,,fee schedule,,1043.47,,,,fee schedule,,725,,,,fee schedule,,1703.78,,,,fee schedule,,725,,,,fee schedule,,1644.99,,,,fee schedule,,996.96,,,,fee schedule,,996.96,,,,fee schedule,,,3552.64,91,,percent of total billed charges,,,3708.8,95,,percent of total billed charges,,,3240.32,83,,percent of total billed charges,,,1171.2,83,,percent of total billed charges,,725,,,,fee schedule,,725,,,,fee schedule,,,3240.32,83,,percent of total billed charges,,1465.53,,,,fee schedule,,,3513.6,90,,percent of total billed charges,,,3513.6,90,,percent of total billed charges,,,3513.6,90,,percent of total billed charges,,,3513.6,90,,percent of total billed charges,,,3318.4,85,,percent of total billed charges,,725,3708.8,
"HYSTEROSCOPY, DX, SEP PROC",58555,CDM,58555,CPT,,,both,,1486,1486,259.81,,,,fee schedule,,,,,,,,95.75,,,,fee schedule,,,1263.1,85,,percent of total billed charges,,288.15,,,,fee schedule,,159.27,,,,fee schedule,,95.75,,,,fee schedule,,350.17,,,,fee schedule,,95.75,,,,fee schedule,,252.17,,,,fee schedule,,152.83,,,,fee schedule,,152.83,,,,fee schedule,,,1352.26,91,,percent of total billed charges,,,1411.7,95,,percent of total billed charges,,,1233.38,83,,percent of total billed charges,,,445.8,83,,percent of total billed charges,,95.75,,,,fee schedule,,95.75,,,,fee schedule,,,1233.38,83,,percent of total billed charges,,224.66,,,,fee schedule,,,1337.4,90,,percent of total billed charges,,,1337.4,90,,percent of total billed charges,,,1337.4,90,,percent of total billed charges,,,1337.4,90,,percent of total billed charges,,,1263.1,85,,percent of total billed charges,,95.75,1411.7,
"HYSTEROSCOPY, BIOPSY",58558,CDM,58558,CPT,,,both,,2058,2058,396.92,,,,fee schedule,,,,,,,,145.8,,,,fee schedule,,,1749.3,85,,percent of total billed charges,,464.36,,,,fee schedule,,244.54,,,,fee schedule,,145.8,,,,fee schedule,,496.08,,,,fee schedule,,145.8,,,,fee schedule,,385.25,,,,fee schedule,,233.48,,,,fee schedule,,233.48,,,,fee schedule,,,1872.78,91,,percent of total billed charges,,,1955.1,95,,percent of total billed charges,,,1708.14,83,,percent of total billed charges,,,617.4,83,,percent of total billed charges,,145.8,,,,fee schedule,,145.8,,,,fee schedule,,,1708.14,83,,percent of total billed charges,,343.22,,,,fee schedule,,,1852.2,90,,percent of total billed charges,,,1852.2,90,,percent of total billed charges,,,1852.2,90,,percent of total billed charges,,,1852.2,90,,percent of total billed charges,,,1749.3,85,,percent of total billed charges,,145.8,1955.1,
"HYSTEROSCOPY, REMOVE FB",58562,CDM,58562,CPT,,,both,,1589,1589,380.21,,,,fee schedule,,,,,,,,361.85,,,,fee schedule,,,1350.65,85,,percent of total billed charges,,424.95,,,,fee schedule,,234.88,,,,fee schedule,,361.85,,,,fee schedule,,541.84,,,,fee schedule,,361.85,,,,fee schedule,,369.03,,,,fee schedule,,223.66,,,,fee schedule,,223.66,,,,fee schedule,,,1445.99,91,,percent of total billed charges,,,1509.55,95,,percent of total billed charges,,,1318.87,83,,percent of total billed charges,,,476.7,83,,percent of total billed charges,,361.85,,,,fee schedule,,361.85,,,,fee schedule,,,1318.87,83,,percent of total billed charges,,328.77,,,,fee schedule,,,1430.1,90,,percent of total billed charges,,,1430.1,90,,percent of total billed charges,,,1430.1,90,,percent of total billed charges,,,1430.1,90,,percent of total billed charges,,,1350.65,85,,percent of total billed charges,,223.66,1509.55,
"HYSTEROSCOPY, REMOVE FB",58562P,CDM,58562,CPT,,,both,P,1392,1392,380.21,,,,fee schedule,,,,,,,,361.85,,,,fee schedule,,,1183.2,85,,percent of total billed charges,,424.95,,,,fee schedule,,234.88,,,,fee schedule,,361.85,,,,fee schedule,,541.84,,,,fee schedule,,361.85,,,,fee schedule,,369.03,,,,fee schedule,,223.66,,,,fee schedule,,223.66,,,,fee schedule,,,1266.72,91,,percent of total billed charges,,,1322.4,95,,percent of total billed charges,,,1155.36,83,,percent of total billed charges,,,417.6,83,,percent of total billed charges,,361.85,,,,fee schedule,,361.85,,,,fee schedule,,,1155.36,83,,percent of total billed charges,,328.77,,,,fee schedule,,,1252.8,90,,percent of total billed charges,,,1252.8,90,,percent of total billed charges,,,1252.8,90,,percent of total billed charges,,,1252.8,90,,percent of total billed charges,,,1183.2,85,,percent of total billed charges,,223.66,1322.4,
"HYSTEROSCOPY, REMOVE FB",58562T,CDM,58562,CPT,,,both,T,197,197,380.21,,,,fee schedule,,,,,,,,361.85,,,,fee schedule,,,167.45,85,,percent of total billed charges,,424.95,,,,fee schedule,,234.88,,,,fee schedule,,361.85,,,,fee schedule,,541.84,,,,fee schedule,,361.85,,,,fee schedule,,369.03,,,,fee schedule,,223.66,,,,fee schedule,,223.66,,,,fee schedule,,,179.27,91,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,59.1,83,,percent of total billed charges,,361.85,,,,fee schedule,,361.85,,,,fee schedule,,,163.51,83,,percent of total billed charges,,328.77,,,,fee schedule,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,167.45,85,,percent of total billed charges,,59.1,541.84,
"HYSTEROSCOPY, ABLATION",58563,CDM,58563,CPT,,,both,,7769,7769,422.27,,,,fee schedule,,,,,,,,300.43,,,,fee schedule,,,6603.65,85,,percent of total billed charges,,423,,,,fee schedule,,387.71,,,,fee schedule,,300.43,,,,fee schedule,,639.99,,,,fee schedule,,300.43,,,,fee schedule,,409.85,,,,fee schedule,,248.39,,,,fee schedule,,248.39,,,,fee schedule,,,7069.79,91,,percent of total billed charges,,,7380.55,95,,percent of total billed charges,,,6448.27,83,,percent of total billed charges,,,2330.7,83,,percent of total billed charges,,300.43,,,,fee schedule,,300.43,,,,fee schedule,,,6448.27,83,,percent of total billed charges,,365.14,,,,fee schedule,,,6992.1,90,,percent of total billed charges,,,6992.1,90,,percent of total billed charges,,,6992.1,90,,percent of total billed charges,,,6992.1,90,,percent of total billed charges,,,6603.65,85,,percent of total billed charges,,248.39,7380.55,
"HYSTEROSCOPY, STERILIZATION",58565,CDM,58565,CPT,,,both,,7020,7020,793.84,,,,fee schedule,,,,,,,,327.45,,,,fee schedule,,,5967,85,,percent of total billed charges,,878.99,,,,fee schedule,,485.85,,,,fee schedule,,327.45,,,,fee schedule,,803.14,,,,fee schedule,,327.45,,,,fee schedule,,770.49,,,,fee schedule,,466.97,,,,fee schedule,,466.97,,,,fee schedule,,,6388.2,91,,percent of total billed charges,,,6669,95,,percent of total billed charges,,,5826.6,83,,percent of total billed charges,,,2106,83,,percent of total billed charges,,327.45,,,,fee schedule,,327.45,,,,fee schedule,,,5826.6,83,,percent of total billed charges,,686.44,,,,fee schedule,,,6318,90,,percent of total billed charges,,,6318,90,,percent of total billed charges,,,6318,90,,percent of total billed charges,,,6318,90,,percent of total billed charges,,,5967,85,,percent of total billed charges,,327.45,6669,
TLH W/T/O 250 G OR LESS,58571,CDM,58571,CPT,,,both,,6313,6313,1566.94,,,,fee schedule,,,,,,,,542.05,,,,fee schedule,,,5366.05,85,,percent of total billed charges,,1743.57,,,,fee schedule,,963.73,,,,fee schedule,,542.05,,,,fee schedule,,,,,,,,542.05,,,,fee schedule,,1520.86,,,,fee schedule,,921.73,,,,fee schedule,,921.73,,,,fee schedule,,,5744.83,91,,percent of total billed charges,,,5997.35,95,,percent of total billed charges,,,5239.79,83,,percent of total billed charges,,,1893.9,83,,percent of total billed charges,,542.05,,,,fee schedule,,542.05,,,,fee schedule,,,5239.79,83,,percent of total billed charges,,1354.95,,,,fee schedule,,,5681.7,90,,percent of total billed charges,,,5681.7,90,,percent of total billed charges,,,5681.7,90,,percent of total billed charges,,,5681.7,90,,percent of total billed charges,,,5366.05,85,,percent of total billed charges,,542.05,5997.35,
DIVISION OF FALLOPIAN TUBE,58600,CDM,58600,CPT,,,both,,2362,2362,642.91,,,,fee schedule,,,,,,,,327.45,,,,fee schedule,,,2007.7,85,,percent of total billed charges,,711.67,,,,fee schedule,,393.36,,,,fee schedule,,327.45,,,,fee schedule,,634.69,,,,fee schedule,,327.45,,,,fee schedule,,624,,,,fee schedule,,378.18,,,,fee schedule,,378.18,,,,fee schedule,,,2149.42,91,,percent of total billed charges,,,2243.9,95,,percent of total billed charges,,,1960.46,83,,percent of total billed charges,,,708.6,83,,percent of total billed charges,,327.45,,,,fee schedule,,327.45,,,,fee schedule,,,1960.46,83,,percent of total billed charges,,555.93,,,,fee schedule,,,2125.8,90,,percent of total billed charges,,,2125.8,90,,percent of total billed charges,,,2125.8,90,,percent of total billed charges,,,2125.8,90,,percent of total billed charges,,,2007.7,85,,percent of total billed charges,,327.45,2243.9,
DIVISION OF FALLOPIAN TUBE,58605,CDM,58605,CPT,,,both,,2037,2037,584.72,,,,fee schedule,,,,,,,,327.45,,,,fee schedule,,,1731.45,85,,percent of total billed charges,,648.81,,,,fee schedule,,358.62,,,,fee schedule,,327.45,,,,fee schedule,,576.33,,,,fee schedule,,327.45,,,,fee schedule,,567.53,,,,fee schedule,,343.96,,,,fee schedule,,343.96,,,,fee schedule,,,1853.67,91,,percent of total billed charges,,,1935.15,95,,percent of total billed charges,,,1690.71,83,,percent of total billed charges,,,611.1,83,,percent of total billed charges,,327.45,,,,fee schedule,,327.45,,,,fee schedule,,,1690.71,83,,percent of total billed charges,,505.61,,,,fee schedule,,,1833.3,90,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1833.3,90,,percent of total billed charges,,,1731.45,85,,percent of total billed charges,,327.45,1935.15,
LIGATE OVIDUCT(S) ADD-ON,58611,CDM,58611,CPT,,,both,,1098,1098,130.19,,,,fee schedule,,,,,,,,97.3,,,,fee schedule,,,933.3,85,,percent of total billed charges,,146.52,,,,fee schedule,,80.99,,,,fee schedule,,97.3,,,,fee schedule,,145.24,,,,fee schedule,,97.3,,,,fee schedule,,126.37,,,,fee schedule,,76.59,,,,fee schedule,,76.59,,,,fee schedule,,,999.18,91,,percent of total billed charges,,,1043.1,95,,percent of total billed charges,,,911.34,83,,percent of total billed charges,,,329.4,83,,percent of total billed charges,,97.3,,,,fee schedule,,97.3,,,,fee schedule,,,911.34,83,,percent of total billed charges,,112.58,,,,fee schedule,,,988.2,90,,percent of total billed charges,,,988.2,90,,percent of total billed charges,,,988.2,90,,percent of total billed charges,,,988.2,90,,percent of total billed charges,,,933.3,85,,percent of total billed charges,,76.59,1043.1,
OCCLUDE FALLOPIAN TUBE(S),58615,CDM,58615,CPT,,,both,,1967,1967,439.55,,,,fee schedule,,,,,,,,327.45,,,,fee schedule,,,1671.95,85,,percent of total billed charges,,487.97,,,,fee schedule,,269.72,,,,fee schedule,,327.45,,,,fee schedule,,468.22,,,,fee schedule,,327.45,,,,fee schedule,,426.62,,,,fee schedule,,258.56,,,,fee schedule,,258.56,,,,fee schedule,,,1789.97,91,,percent of total billed charges,,,1868.65,95,,percent of total billed charges,,,1632.61,83,,percent of total billed charges,,,590.1,83,,percent of total billed charges,,327.45,,,,fee schedule,,327.45,,,,fee schedule,,,1632.61,83,,percent of total billed charges,,380.08,,,,fee schedule,,,1770.3,90,,percent of total billed charges,,,1770.3,90,,percent of total billed charges,,,1770.3,90,,percent of total billed charges,,,1770.3,90,,percent of total billed charges,,,1671.95,85,,percent of total billed charges,,258.56,1868.65,
"LAPAROSCOPY, LYSIS",58660,CDM,58660,CPT,,,both,,3702,3702,1178.09,,,,fee schedule,,,,,,,,302.4,,,,fee schedule,,,3146.7,85,,percent of total billed charges,,1318.3,,,,fee schedule,,728.67,,,,fee schedule,,302.4,,,,fee schedule,,1187.14,,,,fee schedule,,302.4,,,,fee schedule,,1143.44,,,,fee schedule,,692.99,,,,fee schedule,,692.99,,,,fee schedule,,,3368.82,91,,percent of total billed charges,,,3516.9,95,,percent of total billed charges,,,3072.66,83,,percent of total billed charges,,,1110.6,83,,percent of total billed charges,,302.4,,,,fee schedule,,302.4,,,,fee schedule,,,3072.66,83,,percent of total billed charges,,1018.7,,,,fee schedule,,,3331.8,90,,percent of total billed charges,,,3331.8,90,,percent of total billed charges,,,3331.8,90,,percent of total billed charges,,,3331.8,90,,percent of total billed charges,,,3146.7,85,,percent of total billed charges,,302.4,3516.9,
"LAPAROSCOPY, REMOVE ADNEXA",58661,CDM,58661,CPT,,,both,,3896,3896,1126.82,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3311.6,85,,percent of total billed charges,,1256.96,,,,fee schedule,,694.76,,,,fee schedule,,480,,,,fee schedule,,1159.28,,,,fee schedule,,480,,,,fee schedule,,1093.68,,,,fee schedule,,662.83,,,,fee schedule,,662.83,,,,fee schedule,,,3545.36,91,,percent of total billed charges,,,3701.2,95,,percent of total billed charges,,,3233.68,83,,percent of total billed charges,,,1168.8,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3233.68,83,,percent of total billed charges,,974.37,,,,fee schedule,,,3506.4,90,,percent of total billed charges,,,3506.4,90,,percent of total billed charges,,,3506.4,90,,percent of total billed charges,,,3506.4,90,,percent of total billed charges,,,3311.6,85,,percent of total billed charges,,480,3701.2,
"LAPAROSCOPY, EXCISE LESIONS",58662,CDM,58662,CPT,,,both,,3874,3874,1229.94,,,,fee schedule,,,,,,,,302.4,,,,fee schedule,,,3292.9,85,,percent of total billed charges,,1370.04,,,,fee schedule,,757.27,,,,fee schedule,,302.4,,,,fee schedule,,1258.1,,,,fee schedule,,302.4,,,,fee schedule,,1193.76,,,,fee schedule,,723.49,,,,fee schedule,,723.49,,,,fee schedule,,,3525.34,91,,percent of total billed charges,,,3680.3,95,,percent of total billed charges,,,3215.42,83,,percent of total billed charges,,,1162.2,83,,percent of total billed charges,,302.4,,,,fee schedule,,302.4,,,,fee schedule,,,3215.42,83,,percent of total billed charges,,1063.53,,,,fee schedule,,,3486.6,90,,percent of total billed charges,,,3486.6,90,,percent of total billed charges,,,3486.6,90,,percent of total billed charges,,,3486.6,90,,percent of total billed charges,,,3292.9,85,,percent of total billed charges,,302.4,3680.3,
"LAPAROSCOPY, TUBAL CAUTERY",58670,CDM,58670,CPT,,,both,,2447,2447,644.06,,,,fee schedule,,,,,,,,363.45,,,,fee schedule,,,2079.95,85,,percent of total billed charges,,714.06,,,,fee schedule,,394.68,,,,fee schedule,,363.45,,,,fee schedule,,632.04,,,,fee schedule,,363.45,,,,fee schedule,,625.12,,,,fee schedule,,378.86,,,,fee schedule,,378.86,,,,fee schedule,,,2226.77,91,,percent of total billed charges,,,2324.65,95,,percent of total billed charges,,,2031.01,83,,percent of total billed charges,,,734.1,83,,percent of total billed charges,,363.45,,,,fee schedule,,363.45,,,,fee schedule,,,2031.01,83,,percent of total billed charges,,556.92,,,,fee schedule,,,2202.3,90,,percent of total billed charges,,,2202.3,90,,percent of total billed charges,,,2202.3,90,,percent of total billed charges,,,2202.3,90,,percent of total billed charges,,,2079.95,85,,percent of total billed charges,,363.45,2324.65,
"LAPAROSCOPY, TUBAL BLOCK",58671,CDM,58671,CPT,,,both,,2354,2354,644.06,,,,fee schedule,,,,,,,,363.45,,,,fee schedule,,,2000.9,85,,percent of total billed charges,,712.86,,,,fee schedule,,394.02,,,,fee schedule,,363.45,,,,fee schedule,,632.04,,,,fee schedule,,363.45,,,,fee schedule,,625.12,,,,fee schedule,,378.86,,,,fee schedule,,378.86,,,,fee schedule,,,2142.14,91,,percent of total billed charges,,,2236.3,95,,percent of total billed charges,,,1953.82,83,,percent of total billed charges,,,706.2,83,,percent of total billed charges,,363.45,,,,fee schedule,,363.45,,,,fee schedule,,,1953.82,83,,percent of total billed charges,,556.92,,,,fee schedule,,,2118.6,90,,percent of total billed charges,,,2118.6,90,,percent of total billed charges,,,2118.6,90,,percent of total billed charges,,,2118.6,90,,percent of total billed charges,,,2000.9,85,,percent of total billed charges,,363.45,2236.3,
REMOVAL OF FALLOPIAN TUBE,58700,CDM,58700,CPT,,,both,,3732,3732,1384.33,,,,fee schedule,,,,,,,,481.9,,,,fee schedule,,,3172.2,85,,percent of total billed charges,,1542.93,,,,fee schedule,,852.83,,,,fee schedule,,481.9,,,,fee schedule,,1293.92,,,,fee schedule,,481.9,,,,fee schedule,,1343.61,,,,fee schedule,,814.31,,,,fee schedule,,814.31,,,,fee schedule,,,3396.12,91,,percent of total billed charges,,,3545.4,95,,percent of total billed charges,,,3097.56,83,,percent of total billed charges,,,1119.6,83,,percent of total billed charges,,481.9,,,,fee schedule,,481.9,,,,fee schedule,,,3097.56,83,,percent of total billed charges,,1197.03,,,,fee schedule,,,3358.8,90,,percent of total billed charges,,,3358.8,90,,percent of total billed charges,,,3358.8,90,,percent of total billed charges,,,3358.8,90,,percent of total billed charges,,,3172.2,85,,percent of total billed charges,,481.9,3545.4,
REMOVAL OF OVARY/TUBE(S),58720,CDM,58720,CPT,,,both,,4020,4020,1310.59,,,,fee schedule,,,,,,,,525.85,,,,fee schedule,,,3417,85,,percent of total billed charges,,1456.4,,,,fee schedule,,805,,,,fee schedule,,525.85,,,,fee schedule,,1225.61,,,,fee schedule,,525.85,,,,fee schedule,,1272.04,,,,fee schedule,,770.93,,,,fee schedule,,770.93,,,,fee schedule,,,3658.2,91,,percent of total billed charges,,,3819,95,,percent of total billed charges,,,3336.6,83,,percent of total billed charges,,,1206,83,,percent of total billed charges,,525.85,,,,fee schedule,,525.85,,,,fee schedule,,,3336.6,83,,percent of total billed charges,,1133.27,,,,fee schedule,,,3618,90,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3618,90,,percent of total billed charges,,,3417,85,,percent of total billed charges,,525.85,3819,
REVISE FALLOPIAN TUBE(S),58740,CDM,58740,CPT,,,both,,4269,4269,1560.03,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,3628.65,85,,percent of total billed charges,,1737.92,,,,fee schedule,,960.61,,,,fee schedule,,480,,,,fee schedule,,1510.78,,,,fee schedule,,480,,,,fee schedule,,1514.15,,,,fee schedule,,917.67,,,,fee schedule,,917.67,,,,fee schedule,,,3884.79,91,,percent of total billed charges,,,4055.55,95,,percent of total billed charges,,,3543.27,83,,percent of total billed charges,,,1280.7,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,3543.27,83,,percent of total billed charges,,1348.97,,,,fee schedule,,,3842.1,90,,percent of total billed charges,,,3842.1,90,,percent of total billed charges,,,3842.1,90,,percent of total billed charges,,,3842.1,90,,percent of total billed charges,,,3628.65,85,,percent of total billed charges,,480,4055.55,
DRAINAGE OF OVARIAN CYST(S),58800,CDM,58800,CPT,,,both,,1714,1714,547.85,,,,fee schedule,,,,,,,,359.3,,,,fee schedule,,,1456.9,85,,percent of total billed charges,,605.04,,,,fee schedule,,334.42,,,,fee schedule,,359.3,,,,fee schedule,,494.09,,,,fee schedule,,359.3,,,,fee schedule,,531.74,,,,fee schedule,,322.27,,,,fee schedule,,322.27,,,,fee schedule,,,1559.74,91,,percent of total billed charges,,,1628.3,95,,percent of total billed charges,,,1422.62,83,,percent of total billed charges,,,514.2,83,,percent of total billed charges,,359.3,,,,fee schedule,,359.3,,,,fee schedule,,,1422.62,83,,percent of total billed charges,,473.73,,,,fee schedule,,,1542.6,90,,percent of total billed charges,,,1542.6,90,,percent of total billed charges,,,1542.6,90,,percent of total billed charges,,,1542.6,90,,percent of total billed charges,,,1456.9,85,,percent of total billed charges,,322.27,1628.3,
BIOPSY OF OVARY(S),58900,CDM,58900,CPT,,,both,,2387,2387,759.85,,,,fee schedule,,,,,,,,480,,,,fee schedule,,,2028.95,85,,percent of total billed charges,,838.3,,,,fee schedule,,463.35,,,,fee schedule,,480,,,,fee schedule,,678.46,,,,fee schedule,,480,,,,fee schedule,,737.5,,,,fee schedule,,446.97,,,,fee schedule,,446.97,,,,fee schedule,,,2172.17,91,,percent of total billed charges,,,2267.65,95,,percent of total billed charges,,,1981.21,83,,percent of total billed charges,,,716.1,83,,percent of total billed charges,,480,,,,fee schedule,,480,,,,fee schedule,,,1981.21,83,,percent of total billed charges,,657.05,,,,fee schedule,,,2148.3,90,,percent of total billed charges,,,2148.3,90,,percent of total billed charges,,,2148.3,90,,percent of total billed charges,,,2148.3,90,,percent of total billed charges,,,2028.95,85,,percent of total billed charges,,446.97,2267.65,
PARTIAL REMOVAL OF OVARY(S),58920,CDM,58920,CPT,,,both,,4133,4133,1238,,,,fee schedule,,,,,,,,529.95,,,,fee schedule,,,3513.05,85,,percent of total billed charges,,1378.59,,,,fee schedule,,761.99,,,,fee schedule,,529.95,,,,fee schedule,,1214.99,,,,fee schedule,,529.95,,,,fee schedule,,1201.59,,,,fee schedule,,728.24,,,,fee schedule,,728.24,,,,fee schedule,,,3761.03,91,,percent of total billed charges,,,3926.35,95,,percent of total billed charges,,,3430.39,83,,percent of total billed charges,,,1239.9,83,,percent of total billed charges,,529.95,,,,fee schedule,,529.95,,,,fee schedule,,,3430.39,83,,percent of total billed charges,,1070.51,,,,fee schedule,,,3719.7,90,,percent of total billed charges,,,3719.7,90,,percent of total billed charges,,,3719.7,90,,percent of total billed charges,,,3719.7,90,,percent of total billed charges,,,3513.05,85,,percent of total billed charges,,529.95,3926.35,
REMOVAL OF OVARIAN CYST(S),58925,CDM,58925,CPT,,,both,,3968,3968,1328.45,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,3372.8,85,,percent of total billed charges,,1479.04,,,,fee schedule,,817.51,,,,fee schedule,,524.4,,,,fee schedule,,1220.96,,,,fee schedule,,524.4,,,,fee schedule,,1289.37,,,,fee schedule,,781.44,,,,fee schedule,,781.44,,,,fee schedule,,,3610.88,91,,percent of total billed charges,,,3769.6,95,,percent of total billed charges,,,3293.44,83,,percent of total billed charges,,,1190.4,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,3293.44,83,,percent of total billed charges,,1148.72,,,,fee schedule,,,3571.2,90,,percent of total billed charges,,,3571.2,90,,percent of total billed charges,,,3571.2,90,,percent of total billed charges,,,3571.2,90,,percent of total billed charges,,,3372.8,85,,percent of total billed charges,,524.4,3769.6,
REMOVAL OF OVARY(S),58940,CDM,58940,CPT,,,both,,3104,3104,964.36,,,,fee schedule,,,,,,,,554.9,,,,fee schedule,,,2638.4,85,,percent of total billed charges,,1067.47,,,,fee schedule,,590.02,,,,fee schedule,,554.9,,,,fee schedule,,813.75,,,,fee schedule,,554.9,,,,fee schedule,,936,,,,fee schedule,,567.27,,,,fee schedule,,567.27,,,,fee schedule,,,2824.64,91,,percent of total billed charges,,,2948.8,95,,percent of total billed charges,,,2576.32,83,,percent of total billed charges,,,931.2,83,,percent of total billed charges,,554.9,,,,fee schedule,,554.9,,,,fee schedule,,,2576.32,83,,percent of total billed charges,,833.89,,,,fee schedule,,,2793.6,90,,percent of total billed charges,,,2793.6,90,,percent of total billed charges,,,2793.6,90,,percent of total billed charges,,,2793.6,90,,percent of total billed charges,,,2638.4,85,,percent of total billed charges,,554.9,2948.8,
RESECT OVARIAN MALIGNANCY,58950,CDM,58950,CPT,,,both,,6809,6809,1988.64,,,,fee schedule,,,,,,,,704.7,,,,fee schedule,,,5787.65,85,,percent of total billed charges,,2207.36,,,,fee schedule,,1220.08,,,,fee schedule,,704.7,,,,fee schedule,,1811.22,,,,fee schedule,,704.7,,,,fee schedule,,1930.15,,,,fee schedule,,1169.79,,,,fee schedule,,1169.79,,,,fee schedule,,,6196.19,91,,percent of total billed charges,,,6468.55,95,,percent of total billed charges,,,5651.47,83,,percent of total billed charges,,,2042.7,83,,percent of total billed charges,,704.7,,,,fee schedule,,704.7,,,,fee schedule,,,5651.47,83,,percent of total billed charges,,1719.59,,,,fee schedule,,,6128.1,90,,percent of total billed charges,,,6128.1,90,,percent of total billed charges,,,6128.1,90,,percent of total billed charges,,,6128.1,90,,percent of total billed charges,,,5787.65,85,,percent of total billed charges,,704.7,6468.55,
FETAL CONTRACT STRESS TEST,59020,CDM,59020,CPT,,,both,,243,243,121.55,,,,fee schedule,,,,,,,,33.7,,,,fee schedule,,,206.55,85,,percent of total billed charges,,65.64,,,,fee schedule,,39.88,,,,fee schedule,,33.7,,,,fee schedule,,112.75,,,,fee schedule,,33.7,,,,fee schedule,,117.98,,,,fee schedule,,71.5,,,,fee schedule,,71.5,,,,fee schedule,,,221.13,91,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,72.9,83,,percent of total billed charges,,33.7,,,,fee schedule,,33.7,,,,fee schedule,,,201.69,83,,percent of total billed charges,,105.11,,,,fee schedule,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,206.55,85,,percent of total billed charges,,33.7,230.85,
FETAL NON-STRESS TEST,59025,CDM,59025,CPT,,,both,,217,217,84.11,,,,fee schedule,,,,,,,,33.7,,,,fee schedule,,,184.45,85,,percent of total billed charges,,52.81,,,,fee schedule,,30.52,,,,fee schedule,,33.7,,,,fee schedule,,73.62,,,,fee schedule,,33.7,,,,fee schedule,,81.63,,,,fee schedule,,49.48,,,,fee schedule,,49.48,,,,fee schedule,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,65.1,83,,percent of total billed charges,,33.7,,,,fee schedule,,33.7,,,,fee schedule,,,180.11,83,,percent of total billed charges,,72.73,,,,fee schedule,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,30.52,206.15,
TREAT ECTOPIC PREGNANCY,59120,CDM,59120,CPT,,,both,,3076,3076,1418.31,,,,fee schedule,,,,,,,,540,,,,fee schedule,,,2614.6,85,,percent of total billed charges,,1505.94,,,,fee schedule,,880.05,,,,fee schedule,,540,,,,fee schedule,,1350.95,,,,fee schedule,,540,,,,fee schedule,,1376.6,,,,fee schedule,,834.3,,,,fee schedule,,834.3,,,,fee schedule,,,2799.16,91,,percent of total billed charges,,,2922.2,95,,percent of total billed charges,,,2553.08,83,,percent of total billed charges,,,922.8,83,,percent of total billed charges,,540,,,,fee schedule,,540,,,,fee schedule,,,2553.08,83,,percent of total billed charges,,1226.43,,,,fee schedule,,,2768.4,90,,percent of total billed charges,,,2768.4,90,,percent of total billed charges,,,2768.4,90,,percent of total billed charges,,,2768.4,90,,percent of total billed charges,,,2614.6,85,,percent of total billed charges,,540,2922.2,
TREAT ECTOPIC PREGNANCY,59151,CDM,59151,CPT,,,both,,2997,2997,1346.3,,,,fee schedule,,,,,,,,540,,,,fee schedule,,,2547.45,85,,percent of total billed charges,,1430.16,,,,fee schedule,,835.76,,,,fee schedule,,540,,,,fee schedule,,1341.67,,,,fee schedule,,540,,,,fee schedule,,1306.71,,,,fee schedule,,791.94,,,,fee schedule,,791.94,,,,fee schedule,,,2727.27,91,,percent of total billed charges,,,2847.15,95,,percent of total billed charges,,,2487.51,83,,percent of total billed charges,,,899.1,83,,percent of total billed charges,,540,,,,fee schedule,,540,,,,fee schedule,,,2487.51,83,,percent of total billed charges,,1164.16,,,,fee schedule,,,2697.3,90,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2697.3,90,,percent of total billed charges,,,2547.45,85,,percent of total billed charges,,540,2847.15,
D  C  AFTER DELIVERY,59160,CDM,59160,CPT,,,both,,1002,1002,328.37,,,,fee schedule,,,,,,,,199.95,,,,fee schedule,,,851.7,85,,percent of total billed charges,,346.46,,,,fee schedule,,202.46,,,,fee schedule,,199.95,,,,fee schedule,,363.44,,,,fee schedule,,199.95,,,,fee schedule,,318.71,,,,fee schedule,,193.16,,,,fee schedule,,193.16,,,,fee schedule,,,911.82,91,,percent of total billed charges,,,951.9,95,,percent of total billed charges,,,831.66,83,,percent of total billed charges,,,300.6,83,,percent of total billed charges,,199.95,,,,fee schedule,,199.95,,,,fee schedule,,,831.66,83,,percent of total billed charges,,283.94,,,,fee schedule,,,901.8,90,,percent of total billed charges,,,901.8,90,,percent of total billed charges,,,901.8,90,,percent of total billed charges,,,901.8,90,,percent of total billed charges,,,851.7,85,,percent of total billed charges,,193.16,951.9,
INSERT CERVICAL DILATOR,59200,CDM,59200,CPT,,,both,,311,311,76.04,,,,fee schedule,,,,,,,,27.8,,,,fee schedule,,,264.35,85,,percent of total billed charges,,82.07,,,,fee schedule,,47.96,,,,fee schedule,,27.8,,,,fee schedule,,84.89,,,,fee schedule,,27.8,,,,fee schedule,,73.81,,,,fee schedule,,44.73,,,,fee schedule,,44.73,,,,fee schedule,,,283.01,91,,percent of total billed charges,,,295.45,95,,percent of total billed charges,,,258.13,83,,percent of total billed charges,,,93.3,83,,percent of total billed charges,,27.8,,,,fee schedule,,27.8,,,,fee schedule,,,258.13,83,,percent of total billed charges,,65.75,,,,fee schedule,,,279.9,90,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,264.35,85,,percent of total billed charges,,27.8,295.45,
EPISIOTOMY OR VAGINAL REPAIR,59300,CDM,59300,CPT,,,both,,664,664,254.05,,,,fee schedule,,,,,,,,74.95,,,,fee schedule,,,564.4,85,,percent of total billed charges,,269.37,,,,fee schedule,,157.41,,,,fee schedule,,74.95,,,,fee schedule,,261.3,,,,fee schedule,,74.95,,,,fee schedule,,246.58,,,,fee schedule,,149.44,,,,fee schedule,,149.44,,,,fee schedule,,,604.24,91,,percent of total billed charges,,,630.8,95,,percent of total billed charges,,,551.12,83,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,74.95,,,,fee schedule,,74.95,,,,fee schedule,,,551.12,83,,percent of total billed charges,,219.68,,,,fee schedule,,,597.6,90,,percent of total billed charges,,,597.6,90,,percent of total billed charges,,,597.6,90,,percent of total billed charges,,,597.6,90,,percent of total billed charges,,,564.4,85,,percent of total billed charges,,74.95,630.8,
REVISION OF CERVIX,59320,CDM,59320,CPT,,,both,,1087,1087,260.39,,,,fee schedule,,,,,,,,282.45,,,,fee schedule,,,923.95,85,,percent of total billed charges,,278.34,,,,fee schedule,,162.65,,,,fee schedule,,282.45,,,,fee schedule,,285.18,,,,fee schedule,,282.45,,,,fee schedule,,252.73,,,,fee schedule,,153.17,,,,fee schedule,,153.17,,,,fee schedule,,,989.17,91,,percent of total billed charges,,,1032.65,95,,percent of total billed charges,,,902.21,83,,percent of total billed charges,,,326.1,83,,percent of total billed charges,,282.45,,,,fee schedule,,282.45,,,,fee schedule,,,902.21,83,,percent of total billed charges,,225.16,,,,fee schedule,,,978.3,90,,percent of total billed charges,,,978.3,90,,percent of total billed charges,,,978.3,90,,percent of total billed charges,,,978.3,90,,percent of total billed charges,,,923.95,85,,percent of total billed charges,,153.17,1032.65,
REPAIR OF UTERUS,59350,CDM,59350,CPT,,,both,,970,970,480.45,,,,fee schedule,,,,,,,,540,,,,fee schedule,,,824.5,85,,percent of total billed charges,,514.78,,,,fee schedule,,300.83,,,,fee schedule,,540,,,,fee schedule,,529.24,,,,fee schedule,,540,,,,fee schedule,,466.32,,,,fee schedule,,282.62,,,,fee schedule,,282.62,,,,fee schedule,,,882.7,91,,percent of total billed charges,,,921.5,95,,percent of total billed charges,,,805.1,83,,percent of total billed charges,,,291,83,,percent of total billed charges,,540,,,,fee schedule,,540,,,,fee schedule,,,805.1,83,,percent of total billed charges,,415.45,,,,fee schedule,,,873,90,,percent of total billed charges,,,873,90,,percent of total billed charges,,,873,90,,percent of total billed charges,,,873,90,,percent of total billed charges,,,824.5,85,,percent of total billed charges,,282.62,921.5,
OBSTETRICAL CARE,59400,CDM,59400,CPT,,,both,,5927,5927,4140.88,,,,fee schedule,,,,,,,,,,,,,,,5037.95,85,,percent of total billed charges,,3575.1,,,,fee schedule,,2464.15,,,,fee schedule,,,,,,,,2903.52,,,,fee schedule,,,,,,,,4019.09,,,,fee schedule,,2435.81,,,,fee schedule,,2435.81,,,,fee schedule,,,5393.57,91,,percent of total billed charges,,,5630.65,95,,percent of total billed charges,,,4919.41,83,,percent of total billed charges,,,1778.1,83,,percent of total billed charges,,,,,,,,,,,,,,,4919.41,83,,percent of total billed charges,,3580.64,,,,fee schedule,,,5334.3,90,,percent of total billed charges,,,5334.3,90,,percent of total billed charges,,,5334.3,90,,percent of total billed charges,,,5334.3,90,,percent of total billed charges,,,5037.95,85,,percent of total billed charges,,1778.1,5630.65,
OBSTETRICAL CARE,59409,CDM,59409,CPT,,,both,,2983,2983,1380.29,,,,fee schedule,,,,,,,,924.45,,,,fee schedule,,,2535.55,85,,percent of total billed charges,,1210.5,,,,fee schedule,,834.34,,,,fee schedule,,924.45,,,,fee schedule,,1456.4,,,,fee schedule,,924.45,,,,fee schedule,,1339.7,,,,fee schedule,,811.94,,,,fee schedule,,811.94,,,,fee schedule,,,2714.53,91,,percent of total billed charges,,,2833.85,95,,percent of total billed charges,,,2475.89,83,,percent of total billed charges,,,894.9,83,,percent of total billed charges,,924.45,,,,fee schedule,,924.45,,,,fee schedule,,,2475.89,83,,percent of total billed charges,,1193.55,,,,fee schedule,,,2684.7,90,,percent of total billed charges,,,2684.7,90,,percent of total billed charges,,,2684.7,90,,percent of total billed charges,,,2684.7,90,,percent of total billed charges,,,2535.55,85,,percent of total billed charges,,811.94,2833.85,
OBSTETRICAL CARE,59410,CDM,59410,CPT,,,both,,3426,3426,1828.49,,,,fee schedule,,,,,,,,924.45,,,,fee schedule,,,2912.1,85,,percent of total billed charges,,1595.29,,,,fee schedule,,1099.56,,,,fee schedule,,924.45,,,,fee schedule,,1627.51,,,,fee schedule,,924.45,,,,fee schedule,,1774.71,,,,fee schedule,,1075.58,,,,fee schedule,,1075.58,,,,fee schedule,,,3117.66,91,,percent of total billed charges,,,3254.7,95,,percent of total billed charges,,,2843.58,83,,percent of total billed charges,,,1027.8,83,,percent of total billed charges,,924.45,,,,fee schedule,,924.45,,,,fee schedule,,,2843.58,83,,percent of total billed charges,,1581.1,,,,fee schedule,,,3083.4,90,,percent of total billed charges,,,3083.4,90,,percent of total billed charges,,,3083.4,90,,percent of total billed charges,,,3083.4,90,,percent of total billed charges,,,2912.1,85,,percent of total billed charges,,924.45,3254.7,
ANTEPARTUM MANIPULATION,59412,CDM,59412,CPT,,,both,,546,546,176.86,,,,fee schedule,,,,,,,,72.95,,,,fee schedule,,,464.1,85,,percent of total billed charges,,154.33,,,,fee schedule,,106.37,,,,fee schedule,,72.95,,,,fee schedule,,193.66,,,,fee schedule,,72.95,,,,fee schedule,,171.66,,,,fee schedule,,104.03,,,,fee schedule,,104.03,,,,fee schedule,,,496.86,91,,percent of total billed charges,,,518.7,95,,percent of total billed charges,,,453.18,83,,percent of total billed charges,,,163.8,83,,percent of total billed charges,,72.95,,,,fee schedule,,72.95,,,,fee schedule,,,453.18,83,,percent of total billed charges,,152.93,,,,fee schedule,,,491.4,90,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,491.4,90,,percent of total billed charges,,,464.1,85,,percent of total billed charges,,72.95,518.7,
DLVR PLACENTA SPX,59414,CDM,59414,CPT,,,both,,493,493,156.12,,,,fee schedule,,,,,,,,67.5,,,,fee schedule,,,419.05,85,,percent of total billed charges,,135.99,,,,fee schedule,,93.73,,,,fee schedule,,67.5,,,,fee schedule,,174.42,,,,fee schedule,,67.5,,,,fee schedule,,151.53,,,,fee schedule,,91.83,,,,fee schedule,,91.83,,,,fee schedule,,,448.63,91,,percent of total billed charges,,,468.35,95,,percent of total billed charges,,,409.19,83,,percent of total billed charges,,,147.9,83,,percent of total billed charges,,67.5,,,,fee schedule,,67.5,,,,fee schedule,,,409.19,83,,percent of total billed charges,,135,,,,fee schedule,,,443.7,90,,percent of total billed charges,,,443.7,90,,percent of total billed charges,,,443.7,90,,percent of total billed charges,,,443.7,90,,percent of total billed charges,,,419.05,85,,percent of total billed charges,,67.5,468.35,
ANTEPARTUM CARE ONLY 4-6 VSTS,59425,CDM,59425,CPT,,,both,,1338,1338,747.75,,,,fee schedule,,,,,,,,,,,,,,,1137.3,85,,percent of total billed charges,,654.52,,,,fee schedule,,451.13,,,,fee schedule,,,,,,,,515.97,,,,fee schedule,,,,,,,,725.76,,,,fee schedule,,439.86,,,,fee schedule,,439.86,,,,fee schedule,,,1217.58,91,,percent of total billed charges,,,1271.1,95,,percent of total billed charges,,,1110.54,83,,percent of total billed charges,,,401.4,83,,percent of total billed charges,,,,,,,,,,,,,,,1110.54,83,,percent of total billed charges,,646.59,,,,fee schedule,,,1204.2,90,,percent of total billed charges,,,1204.2,90,,percent of total billed charges,,,1204.2,90,,percent of total billed charges,,,1204.2,90,,percent of total billed charges,,,1137.3,85,,percent of total billed charges,,401.4,1271.1,
ANTEPARTUM CARE ONLY 7+ VSTS,59426,CDM,59426,CPT,,,both,,2392,2392,1373.38,,,,fee schedule,,,,,,,,,,,,,,,2033.2,85,,percent of total billed charges,,1085.77,,,,fee schedule,,825.86,,,,fee schedule,,,,,,,,891.35,,,,fee schedule,,,,,,,,1332.99,,,,fee schedule,,807.87,,,,fee schedule,,807.87,,,,fee schedule,,,2176.72,91,,percent of total billed charges,,,2272.4,95,,percent of total billed charges,,,1985.36,83,,percent of total billed charges,,,717.6,83,,percent of total billed charges,,,,,,,,,,,,,,,1985.36,83,,percent of total billed charges,,1187.57,,,,fee schedule,,,2152.8,90,,percent of total billed charges,,,2152.8,90,,percent of total billed charges,,,2152.8,90,,percent of total billed charges,,,2152.8,90,,percent of total billed charges,,,2033.2,85,,percent of total billed charges,,717.6,2272.4,
POSTPARTUM CARE ONLY SPX,59430,CDM,59430,CPT,,,both,,414,414,309.93,,,,fee schedule,,,,,,,,50.15,,,,fee schedule,,,351.9,85,,percent of total billed charges,,246.08,,,,fee schedule,,187.17,,,,fee schedule,,50.15,,,,fee schedule,,236.76,,,,fee schedule,,50.15,,,,fee schedule,,300.82,,,,fee schedule,,182.31,,,,fee schedule,,182.31,,,,fee schedule,,,376.74,91,,percent of total billed charges,,,393.3,95,,percent of total billed charges,,,343.62,83,,percent of total billed charges,,,124.2,83,,percent of total billed charges,,50.15,,,,fee schedule,,50.15,,,,fee schedule,,,343.62,83,,percent of total billed charges,,268,,,,fee schedule,,,372.6,90,,percent of total billed charges,,,372.6,90,,percent of total billed charges,,,372.6,90,,percent of total billed charges,,,372.6,90,,percent of total billed charges,,,351.9,85,,percent of total billed charges,,50.15,393.3,
OB ANTEPARTUM CARE C DLVR  POSTPARTUM,59510,CDM,59510,CPT,,,both,,6404,6404,4581.58,,,,fee schedule,,,,,,,,,,,,,,,5443.4,85,,percent of total billed charges,,3967.99,,,,fee schedule,,2730.09,,,,fee schedule,,,,,,,,3290.83,,,,fee schedule,,,,,,,,4446.83,,,,fee schedule,,2695.05,,,,fee schedule,,2695.05,,,,fee schedule,,,5827.64,91,,percent of total billed charges,,,6083.8,95,,percent of total billed charges,,,5315.32,83,,percent of total billed charges,,,1921.2,83,,percent of total billed charges,,,,,,,,,,,,,,,5315.32,83,,percent of total billed charges,,3961.72,,,,fee schedule,,,5763.6,90,,percent of total billed charges,,,5763.6,90,,percent of total billed charges,,,5763.6,90,,percent of total billed charges,,,5763.6,90,,percent of total billed charges,,,5443.4,85,,percent of total billed charges,,1921.2,6083.8,
C DLVR ONLY,59514,CDM,59514,CPT,,,both,,3507,3507,1562.91,,,,fee schedule,,,,,,,,1070.45,,,,fee schedule,,,2980.95,85,,percent of total billed charges,,1805,,,,fee schedule,,945.73,,,,fee schedule,,1070.45,,,,fee schedule,,1719.03,,,,fee schedule,,1070.45,,,,fee schedule,,1516.94,,,,fee schedule,,919.36,,,,fee schedule,,919.36,,,,fee schedule,,,3191.37,91,,percent of total billed charges,,,3331.65,95,,percent of total billed charges,,,2910.81,83,,percent of total billed charges,,,1052.1,83,,percent of total billed charges,,1070.45,,,,fee schedule,,1070.45,,,,fee schedule,,,2910.81,83,,percent of total billed charges,,1351.46,,,,fee schedule,,,3156.3,90,,percent of total billed charges,,,3156.3,90,,percent of total billed charges,,,3156.3,90,,percent of total billed charges,,,3156.3,90,,percent of total billed charges,,,2980.95,85,,percent of total billed charges,,919.36,3331.65,
CESAREAN DELIVERY,59515,CDM,59515,CPT,,,both,,4128,4128,2250.75,,,,fee schedule,,,,,,,,1070.45,,,,fee schedule,,,3508.8,85,,percent of total billed charges,,1973.22,,,,fee schedule,,1357.63,,,,fee schedule,,1070.45,,,,fee schedule,,1940.54,,,,fee schedule,,1070.45,,,,fee schedule,,2184.56,,,,fee schedule,,1323.97,,,,fee schedule,,1323.97,,,,fee schedule,,,3756.48,91,,percent of total billed charges,,,3921.6,95,,percent of total billed charges,,,3426.24,83,,percent of total billed charges,,,1238.4,83,,percent of total billed charges,,1070.45,,,,fee schedule,,1070.45,,,,fee schedule,,,3426.24,83,,percent of total billed charges,,1946.24,,,,fee schedule,,,3715.2,90,,percent of total billed charges,,,3715.2,90,,percent of total billed charges,,,3715.2,90,,percent of total billed charges,,,3715.2,90,,percent of total billed charges,,,3508.8,85,,percent of total billed charges,,1070.45,3921.6,
VBAC DELIVERY,59610,CDM,59610,CPT,,,both,,6522,6522,4337.32,,,,fee schedule,,,,,,,,,,,,,,,5543.7,85,,percent of total billed charges,,3759.52,,,,fee schedule,,2586.66,,,,fee schedule,,,,,,,,3066.67,,,,fee schedule,,,,,,,,4209.76,,,,fee schedule,,2551.37,,,,fee schedule,,2551.37,,,,fee schedule,,,5935.02,91,,percent of total billed charges,,,6195.9,95,,percent of total billed charges,,,5413.26,83,,percent of total billed charges,,,1956.6,83,,percent of total billed charges,,,,,,,,,,,,,,,5413.26,83,,percent of total billed charges,,3750.51,,,,fee schedule,,,5869.8,90,,percent of total billed charges,,,5869.8,90,,percent of total billed charges,,,5869.8,90,,percent of total billed charges,,,5869.8,90,,percent of total billed charges,,,5543.7,85,,percent of total billed charges,,1956.6,6195.9,
VBAC DELIVERY ONLY,59612,CDM,59612,CPT,,,both,,3531,3531,1562.34,,,,fee schedule,,,,,,,,924.45,,,,fee schedule,,,3001.35,85,,percent of total billed charges,,1374.03,,,,fee schedule,,945.37,,,,fee schedule,,924.45,,,,fee schedule,,1634.14,,,,fee schedule,,924.45,,,,fee schedule,,1516.38,,,,fee schedule,,919.02,,,,fee schedule,,919.02,,,,fee schedule,,,3213.21,91,,percent of total billed charges,,,3354.45,95,,percent of total billed charges,,,2930.73,83,,percent of total billed charges,,,1059.3,83,,percent of total billed charges,,924.45,,,,fee schedule,,924.45,,,,fee schedule,,,2930.73,83,,percent of total billed charges,,1350.96,,,,fee schedule,,,3177.9,90,,percent of total billed charges,,,3177.9,90,,percent of total billed charges,,,3177.9,90,,percent of total billed charges,,,3177.9,90,,percent of total billed charges,,,3001.35,85,,percent of total billed charges,,919.02,3354.45,
TREATMENT OF MISCARRIAGE,59812,CDM,59812,CPT,,,both,,1246,1246,534.03,,,,fee schedule,,,,,,,,298.7,,,,fee schedule,,,1059.1,85,,percent of total billed charges,,542.98,,,,fee schedule,,329.92,,,,fee schedule,,298.7,,,,fee schedule,,496.08,,,,fee schedule,,298.7,,,,fee schedule,,518.32,,,,fee schedule,,314.13,,,,fee schedule,,314.13,,,,fee schedule,,,1133.86,91,,percent of total billed charges,,,1183.7,95,,percent of total billed charges,,,1034.18,83,,percent of total billed charges,,,373.8,83,,percent of total billed charges,,298.7,,,,fee schedule,,298.7,,,,fee schedule,,,1034.18,83,,percent of total billed charges,,461.78,,,,fee schedule,,,1121.4,90,,percent of total billed charges,,,1121.4,90,,percent of total billed charges,,,1121.4,90,,percent of total billed charges,,,1121.4,90,,percent of total billed charges,,,1059.1,85,,percent of total billed charges,,298.7,1183.7,
CARE OF MISCARRIAGE,59820,CDM,59820,CPT,,,both,,1982,1982,672.29,,,,fee schedule,,,,,,,,199.95,,,,fee schedule,,,1684.7,85,,percent of total billed charges,,673.02,,,,fee schedule,,408.93,,,,fee schedule,,199.95,,,,fee schedule,,563.73,,,,fee schedule,,199.95,,,,fee schedule,,652.51,,,,fee schedule,,395.46,,,,fee schedule,,395.46,,,,fee schedule,,,1803.62,91,,percent of total billed charges,,,1882.9,95,,percent of total billed charges,,,1645.06,83,,percent of total billed charges,,,594.6,83,,percent of total billed charges,,199.95,,,,fee schedule,,199.95,,,,fee schedule,,,1645.06,83,,percent of total billed charges,,581.33,,,,fee schedule,,,1783.8,90,,percent of total billed charges,,,1783.8,90,,percent of total billed charges,,,1783.8,90,,percent of total billed charges,,,1783.8,90,,percent of total billed charges,,,1684.7,85,,percent of total billed charges,,199.95,1882.9,
PARTIAL REMOVAL OF THYROID,60220,CDM,60220,CPT,,,both,,3072,3072,1221.29,,,,fee schedule,,,,,,,,703.3,,,,fee schedule,,,2611.2,85,,percent of total billed charges,,1435.99,,,,fee schedule,,750.23,,,,fee schedule,,703.3,,,,fee schedule,,1283.3,,,,fee schedule,,703.3,,,,fee schedule,,1185.37,,,,fee schedule,,718.41,,,,fee schedule,,718.41,,,,fee schedule,,,2795.52,91,,percent of total billed charges,,,2918.4,95,,percent of total billed charges,,,2549.76,83,,percent of total billed charges,,,921.6,83,,percent of total billed charges,,703.3,,,,fee schedule,,703.3,,,,fee schedule,,,2549.76,83,,percent of total billed charges,,1056.06,,,,fee schedule,,,2764.8,90,,percent of total billed charges,,,2764.8,90,,percent of total billed charges,,,2764.8,90,,percent of total billed charges,,,2764.8,90,,percent of total billed charges,,,2611.2,85,,percent of total billed charges,,703.3,2918.4,
REMOVE THYROID DUCT LESION,60280,CDM,60280,CPT,,,both,,2761,2761,787.5,,,,fee schedule,,,,,,,,718.7,,,,fee schedule,,,2346.85,85,,percent of total billed charges,,884.48,,,,fee schedule,,484.08,,,,fee schedule,,718.7,,,,fee schedule,,733.51,,,,fee schedule,,718.7,,,,fee schedule,,764.34,,,,fee schedule,,463.24,,,,fee schedule,,463.24,,,,fee schedule,,,2512.51,91,,percent of total billed charges,,,2622.95,95,,percent of total billed charges,,,2291.63,83,,percent of total billed charges,,,828.3,83,,percent of total billed charges,,718.7,,,,fee schedule,,718.7,,,,fee schedule,,,2291.63,83,,percent of total billed charges,,680.96,,,,fee schedule,,,2484.9,90,,percent of total billed charges,,,2484.9,90,,percent of total billed charges,,,2484.9,90,,percent of total billed charges,,,2484.9,90,,percent of total billed charges,,,2346.85,85,,percent of total billed charges,,463.24,2622.95,
"BRAIN ANEURYSM REPR, SIMPLE",61700,CDM,61700,CPT,,,both,,19964,19964,5874.31,,,,fee schedule,,,,,,,,1498.85,,,,fee schedule,,,16969.4,85,,percent of total billed charges,,6777.31,,,,fee schedule,,3750.35,,,,fee schedule,,1498.85,,,,fee schedule,,6023.9,,,,fee schedule,,1498.85,,,,fee schedule,,5701.54,,,,fee schedule,,3455.48,,,,fee schedule,,3455.48,,,,fee schedule,,,18167.24,91,,percent of total billed charges,,,18965.8,95,,percent of total billed charges,,,16570.12,83,,percent of total billed charges,,,5989.2,83,,percent of total billed charges,,1498.85,,,,fee schedule,,1498.85,,,,fee schedule,,,16570.12,83,,percent of total billed charges,,5079.55,,,,fee schedule,,,17967.6,90,,percent of total billed charges,,,17967.6,90,,percent of total billed charges,,,17967.6,90,,percent of total billed charges,,,17967.6,90,,percent of total billed charges,,,16969.4,85,,percent of total billed charges,,1498.85,18965.8,
SCAN PROC SPINAL,61783,CDM,61783,CPT,,,both,,1543,1543,398.07,,,,fee schedule,,,,,,,,149.77,,,,fee schedule,,,1311.55,85,,percent of total billed charges,,462.24,,,,fee schedule,,255.79,,,,fee schedule,,149.77,,,,fee schedule,,,,,,,,149.77,,,,fee schedule,,386.36,,,,fee schedule,,234.16,,,,fee schedule,,234.16,,,,fee schedule,,,1404.13,91,,percent of total billed charges,,,1465.85,95,,percent of total billed charges,,,1280.69,83,,percent of total billed charges,,,462.9,83,,percent of total billed charges,,149.77,,,,fee schedule,,149.77,,,,fee schedule,,,1280.69,83,,percent of total billed charges,,344.22,,,,fee schedule,,,1388.7,90,,percent of total billed charges,,,1388.7,90,,percent of total billed charges,,,1388.7,90,,percent of total billed charges,,,1388.7,90,,percent of total billed charges,,,1311.55,85,,percent of total billed charges,,149.77,1465.85,
EPIDURAL LYSIS MULT SESSIONS,62263,CDM,62263,CPT,,,both,,1937,1937,542.09,,,,fee schedule,,,,,,,,193.6,,,,fee schedule,,,1646.45,85,,percent of total billed charges,,598.62,,,,fee schedule,,331.26,,,,fee schedule,,193.6,,,,fee schedule,,645.96,,,,fee schedule,,193.6,,,,fee schedule,,526.15,,,,fee schedule,,318.88,,,,fee schedule,,318.88,,,,fee schedule,,,1762.67,91,,percent of total billed charges,,,1840.15,95,,percent of total billed charges,,,1607.71,83,,percent of total billed charges,,,581.1,83,,percent of total billed charges,,193.6,,,,fee schedule,,193.6,,,,fee schedule,,,1607.71,83,,percent of total billed charges,,468.75,,,,fee schedule,,,1743.3,90,,percent of total billed charges,,,1743.3,90,,percent of total billed charges,,,1743.3,90,,percent of total billed charges,,,1743.3,90,,percent of total billed charges,,,1646.45,85,,percent of total billed charges,,193.6,1840.15,
EPIDURAL LYSIS ON SINGLE DAY,62264,CDM,62264,CPT,,,both,,2560,2560,415.93,,,,fee schedule,,,,,,,,193.6,,,,fee schedule,,,2176,85,,percent of total billed charges,,469.3,,,,fee schedule,,259.69,,,,fee schedule,,193.6,,,,fee schedule,,405.22,,,,fee schedule,,193.6,,,,fee schedule,,403.7,,,,fee schedule,,244.67,,,,fee schedule,,244.67,,,,fee schedule,,,2329.6,91,,percent of total billed charges,,,2432,95,,percent of total billed charges,,,2124.8,83,,percent of total billed charges,,,768,83,,percent of total billed charges,,193.6,,,,fee schedule,,193.6,,,,fee schedule,,,2124.8,83,,percent of total billed charges,,359.66,,,,fee schedule,,,2304,90,,percent of total billed charges,,,2304,90,,percent of total billed charges,,,2304,90,,percent of total billed charges,,,2304,90,,percent of total billed charges,,,2176,85,,percent of total billed charges,,193.6,2432,
DRAIN SPINAL CORD CYST,62268,CDM,62268,CPT,,,both,,1703,1703,435.52,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,1447.55,85,,percent of total billed charges,,493.51,,,,fee schedule,,273.09,,,,fee schedule,,449.5,,,,fee schedule,,484.14,,,,fee schedule,,449.5,,,,fee schedule,,422.71,,,,fee schedule,,256.19,,,,fee schedule,,256.19,,,,fee schedule,,,1549.73,91,,percent of total billed charges,,,1617.85,95,,percent of total billed charges,,,1413.49,83,,percent of total billed charges,,,510.9,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,1413.49,83,,percent of total billed charges,,376.6,,,,fee schedule,,,1532.7,90,,percent of total billed charges,,,1532.7,90,,percent of total billed charges,,,1532.7,90,,percent of total billed charges,,,1532.7,90,,percent of total billed charges,,,1447.55,85,,percent of total billed charges,,256.19,1617.85,
"SPINAL FLUID TAP, DIAGNOSTIC",62270,CDM,62270,CPT,,,both,,630,630,107.15,,,,fee schedule,,,,,,,,53.7,,,,fee schedule,,,535.5,85,,percent of total billed charges,,121.6,,,,fee schedule,,67.29,,,,fee schedule,,53.7,,,,fee schedule,,117.39,,,,fee schedule,,53.7,,,,fee schedule,,104,,,,fee schedule,,63.03,,,,fee schedule,,63.03,,,,fee schedule,,,573.3,91,,percent of total billed charges,,,598.5,95,,percent of total billed charges,,,522.9,83,,percent of total billed charges,,,189,83,,percent of total billed charges,,53.7,,,,fee schedule,,53.7,,,,fee schedule,,,522.9,83,,percent of total billed charges,,92.65,,,,fee schedule,,,567,90,,percent of total billed charges,,,567,90,,percent of total billed charges,,,567,90,,percent of total billed charges,,,567,90,,percent of total billed charges,,,535.5,85,,percent of total billed charges,,53.7,598.5,
INJECT EPIDURAL PATCH,62273,CDM,62273,CPT,,,both,,1096,1096,192.41,,,,fee schedule,,,,,,,,74.9,,,,fee schedule,,,931.6,85,,percent of total billed charges,,217.98,,,,fee schedule,,120.62,,,,fee schedule,,74.9,,,,fee schedule,,198.96,,,,fee schedule,,74.9,,,,fee schedule,,186.75,,,,fee schedule,,113.18,,,,fee schedule,,113.18,,,,fee schedule,,,997.36,91,,percent of total billed charges,,,1041.2,95,,percent of total billed charges,,,909.68,83,,percent of total billed charges,,,328.8,83,,percent of total billed charges,,74.9,,,,fee schedule,,74.9,,,,fee schedule,,,909.68,83,,percent of total billed charges,,166.38,,,,fee schedule,,,986.4,90,,percent of total billed charges,,,986.4,90,,percent of total billed charges,,,986.4,90,,percent of total billed charges,,,986.4,90,,percent of total billed charges,,,931.6,85,,percent of total billed charges,,74.9,1041.2,
TREAT SPINAL CORD LESION,62281,CDM,62281,CPT,,,both,,1395,1395,271.33,,,,fee schedule,,,,,,,,81.1,,,,fee schedule,,,1185.75,85,,percent of total billed charges,,302.69,,,,fee schedule,,167.5,,,,fee schedule,,81.1,,,,fee schedule,,247.38,,,,fee schedule,,81.1,,,,fee schedule,,263.35,,,,fee schedule,,159.61,,,,fee schedule,,159.61,,,,fee schedule,,,1269.45,91,,percent of total billed charges,,,1325.25,95,,percent of total billed charges,,,1157.85,83,,percent of total billed charges,,,418.5,83,,percent of total billed charges,,81.1,,,,fee schedule,,81.1,,,,fee schedule,,,1157.85,83,,percent of total billed charges,,234.62,,,,fee schedule,,,1255.5,90,,percent of total billed charges,,,1255.5,90,,percent of total billed charges,,,1255.5,90,,percent of total billed charges,,,1255.5,90,,percent of total billed charges,,,1185.75,85,,percent of total billed charges,,81.1,1325.25,
TREAT SPINAL CANAL LESION,62282,CDM,62282,CPT,,,both,,1261,1261,241.38,,,,fee schedule,,,,,,,,158.2,,,,fee schedule,,,1071.85,85,,percent of total billed charges,,273.05,,,,fee schedule,,151.1,,,,fee schedule,,158.2,,,,fee schedule,,228.14,,,,fee schedule,,158.2,,,,fee schedule,,234.28,,,,fee schedule,,141.99,,,,fee schedule,,141.99,,,,fee schedule,,,1147.51,91,,percent of total billed charges,,,1197.95,95,,percent of total billed charges,,,1046.63,83,,percent of total billed charges,,,378.3,83,,percent of total billed charges,,158.2,,,,fee schedule,,158.2,,,,fee schedule,,,1046.63,83,,percent of total billed charges,,208.72,,,,fee schedule,,,1134.9,90,,percent of total billed charges,,,1134.9,90,,percent of total billed charges,,,1134.9,90,,percent of total billed charges,,,1134.9,90,,percent of total billed charges,,,1071.85,85,,percent of total billed charges,,141.99,1197.95,
INJECT FOR SPINE DISK X-RAY,62290,CDM,62290,CPT,,,both,,1548,1548,267.88,,,,fee schedule,,,,,,,,158.2,,,,fee schedule,,,1315.8,85,,percent of total billed charges,,308.09,,,,fee schedule,,170.49,,,,fee schedule,,158.2,,,,fee schedule,,307.06,,,,fee schedule,,158.2,,,,fee schedule,,260,,,,fee schedule,,157.58,,,,fee schedule,,157.58,,,,fee schedule,,,1408.68,91,,percent of total billed charges,,,1470.6,95,,percent of total billed charges,,,1284.84,83,,percent of total billed charges,,,464.4,83,,percent of total billed charges,,158.2,,,,fee schedule,,158.2,,,,fee schedule,,,1284.84,83,,percent of total billed charges,,231.64,,,,fee schedule,,,1393.2,90,,percent of total billed charges,,,1393.2,90,,percent of total billed charges,,,1393.2,90,,percent of total billed charges,,,1393.2,90,,percent of total billed charges,,,1315.8,85,,percent of total billed charges,,157.58,1470.6,
INJECT FOR SPINE DISK X-RAY,62291,CDM,62291,CPT,,,both,,1388,1388,248.29,,,,fee schedule,,,,,,,,158.2,,,,fee schedule,,,1179.8,85,,percent of total billed charges,,285.89,,,,fee schedule,,158.2,,,,fee schedule,,158.2,,,,fee schedule,,291.81,,,,fee schedule,,158.2,,,,fee schedule,,240.99,,,,fee schedule,,146.05,,,,fee schedule,,146.05,,,,fee schedule,,,1263.08,91,,percent of total billed charges,,,1318.6,95,,percent of total billed charges,,,1152.04,83,,percent of total billed charges,,,416.4,83,,percent of total billed charges,,158.2,,,,fee schedule,,158.2,,,,fee schedule,,,1152.04,83,,percent of total billed charges,,214.7,,,,fee schedule,,,1249.2,90,,percent of total billed charges,,,1249.2,90,,percent of total billed charges,,,1249.2,90,,percent of total billed charges,,,1249.2,90,,percent of total billed charges,,,1179.8,85,,percent of total billed charges,,146.05,1318.6,
"INJECT SPINE W/CATH, C/T",62318,CDM,62318,CPT,,,both,,1645,1645,,,,,,,,,,,,,,,,,,,,1398.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,187.02,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,1496.95,91,,percent of total billed charges,,,1562.75,95,,percent of total billed charges,,,1365.35,83,,percent of total billed charges,,,493.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1365.35,83,,percent of total billed charges,,,,,,,,,1480.5,90,,percent of total billed charges,,,1480.5,90,,percent of total billed charges,,,1480.5,90,,percent of total billed charges,,,1480.5,90,,percent of total billed charges,,,1398.25,85,,percent of total billed charges,,187.02,1562.75,
"Inject Spine Cerv/Thoracic, WITHOUT Imaging",62320,CDM,62320,CPT,,,both,,1388,1388,171.67,,,,fee schedule,,,,,,,,62.7,,,,fee schedule,,,1179.8,85,,percent of total billed charges,,193.32,,,,fee schedule,,106.98,,,,fee schedule,,62.7,,,,fee schedule,,,,,,,,62.7,,,,fee schedule,,166.62,,,,fee schedule,,100.98,,,,fee schedule,,100.98,,,,fee schedule,,,1263.08,91,,percent of total billed charges,,,1318.6,95,,percent of total billed charges,,,1152.04,83,,percent of total billed charges,,,416.4,83,,percent of total billed charges,,62.7,,,,fee schedule,,62.7,,,,fee schedule,,,1152.04,83,,percent of total billed charges,,148.45,,,,fee schedule,,,1249.2,90,,percent of total billed charges,,,1249.2,90,,percent of total billed charges,,,1249.2,90,,percent of total billed charges,,,1249.2,90,,percent of total billed charges,,,1179.8,85,,percent of total billed charges,,62.7,1318.6,
X ESI C-T Spine,62321,CDM,62321,CPT,,,both,,1415,1415,181.47,,,,fee schedule,,,,,,,,67.64,,,,fee schedule,,,1202.75,85,,percent of total billed charges,,206.27,,,,fee schedule,,114.14,,,,fee schedule,,67.64,,,,fee schedule,,,,,,,,67.64,,,,fee schedule,,176.13,,,,fee schedule,,106.74,,,,fee schedule,,106.74,,,,fee schedule,,,1287.65,91,,percent of total billed charges,,,1344.25,95,,percent of total billed charges,,,1174.45,83,,percent of total billed charges,,,424.5,83,,percent of total billed charges,,67.64,,,,fee schedule,,67.64,,,,fee schedule,,,1174.45,83,,percent of total billed charges,,156.91,,,,fee schedule,,,1273.5,90,,percent of total billed charges,,,1273.5,90,,percent of total billed charges,,,1273.5,90,,percent of total billed charges,,,1273.5,90,,percent of total billed charges,,,1202.75,85,,percent of total billed charges,,67.64,1344.25,
"Inject Spine Lumbar/Sacral, WITHOUT Imaging",62322,CDM,62322,CPT,,,both,,1115,1115,137.11,,,,fee schedule,,,,,,,,53.89,,,,fee schedule,,,947.75,85,,percent of total billed charges,,157.46,,,,fee schedule,,87.13,,,,fee schedule,,53.89,,,,fee schedule,,,,,,,,53.89,,,,fee schedule,,133.08,,,,fee schedule,,80.65,,,,fee schedule,,80.65,,,,fee schedule,,,1014.65,91,,percent of total billed charges,,,1059.25,95,,percent of total billed charges,,,925.45,83,,percent of total billed charges,,,334.5,83,,percent of total billed charges,,53.89,,,,fee schedule,,53.89,,,,fee schedule,,,925.45,83,,percent of total billed charges,,118.56,,,,fee schedule,,,1003.5,90,,percent of total billed charges,,,1003.5,90,,percent of total billed charges,,,1003.5,90,,percent of total billed charges,,,1003.5,90,,percent of total billed charges,,,947.75,85,,percent of total billed charges,,53.89,1059.25,
"Inject Spine Lumbar/Sacral, WITH Imaging",62323,CDM,62323,CPT,,,both,,1419,1419,168.22,,,,fee schedule,,,,,,,,61.58,,,,fee schedule,,,1206.15,85,,percent of total billed charges,,191.2,,,,fee schedule,,105.81,,,,fee schedule,,61.58,,,,fee schedule,,,,,,,,61.58,,,,fee schedule,,163.27,,,,fee schedule,,98.95,,,,fee schedule,,98.95,,,,fee schedule,,,1291.29,91,,percent of total billed charges,,,1348.05,95,,percent of total billed charges,,,1177.77,83,,percent of total billed charges,,,425.7,83,,percent of total billed charges,,61.58,,,,fee schedule,,61.58,,,,fee schedule,,,1177.77,83,,percent of total billed charges,,145.46,,,,fee schedule,,,1277.1,90,,percent of total billed charges,,,1277.1,90,,percent of total billed charges,,,1277.1,90,,percent of total billed charges,,,1277.1,90,,percent of total billed charges,,,1206.15,85,,percent of total billed charges,,61.58,1348.05,
"Inject Spine W/Cath Cervical/Thoracic, WITHOUT Imaging",62324,CDM,62324,CPT,,,both,,1645,1645,152.09,,,,fee schedule,,,,,,,,57.88,,,,fee schedule,,,1398.25,85,,percent of total billed charges,,173.71,,,,fee schedule,,96.13,,,,fee schedule,,57.88,,,,fee schedule,,,,,,,,57.88,,,,fee schedule,,147.61,,,,fee schedule,,89.46,,,,fee schedule,,89.46,,,,fee schedule,,,1496.95,91,,percent of total billed charges,,,1562.75,95,,percent of total billed charges,,,1365.35,83,,percent of total billed charges,,,493.5,83,,percent of total billed charges,,57.88,,,,fee schedule,,57.88,,,,fee schedule,,,1365.35,83,,percent of total billed charges,,131.51,,,,fee schedule,,,1480.5,90,,percent of total billed charges,,,1480.5,90,,percent of total billed charges,,,1480.5,90,,percent of total billed charges,,,1480.5,90,,percent of total billed charges,,,1398.25,85,,percent of total billed charges,,57.88,1562.75,
"NJX INTERLAMINAR CRV/THRC, WITH Imaging",62325,CDM,62325,CPT,,,both,,1255,1255,188.96,,,,fee schedule,,,,,,,,66.61,,,,fee schedule,,,1066.75,85,,percent of total billed charges,,215.23,,,,fee schedule,,119.1,,,,fee schedule,,66.61,,,,fee schedule,,,,,,,,66.61,,,,fee schedule,,183.4,,,,fee schedule,,111.15,,,,fee schedule,,111.15,,,,fee schedule,,,1142.05,91,,percent of total billed charges,,,1192.25,95,,percent of total billed charges,,,1041.65,83,,percent of total billed charges,,,376.5,83,,percent of total billed charges,,66.61,,,,fee schedule,,66.61,,,,fee schedule,,,1041.65,83,,percent of total billed charges,,163.39,,,,fee schedule,,,1129.5,90,,percent of total billed charges,,,1129.5,90,,percent of total billed charges,,,1129.5,90,,percent of total billed charges,,,1129.5,90,,percent of total billed charges,,,1066.75,85,,percent of total billed charges,,66.61,1192.25,
"Inject Spine W/Cath Lumbar/Sacral, WITHOUT Imaging",62326,CDM,62326,CPT,,,both,,1274,1274,146.32,,,,fee schedule,,,,,,,,56.49,,,,fee schedule,,,1082.9,85,,percent of total billed charges,,884,,,,fee schedule,,901.68,,,,fee schedule,,56.49,,,,fee schedule,,,,,,,,56.49,,,,fee schedule,,142.02,,,,fee schedule,,86.07,,,,fee schedule,,86.07,,,,fee schedule,,,1159.34,91,,percent of total billed charges,,,1210.3,95,,percent of total billed charges,,,1057.42,83,,percent of total billed charges,,,382.2,83,,percent of total billed charges,,56.49,,,,fee schedule,,56.49,,,,fee schedule,,,1057.42,83,,percent of total billed charges,,126.53,,,,fee schedule,,,1146.6,90,,percent of total billed charges,,,1146.6,90,,percent of total billed charges,,,1146.6,90,,percent of total billed charges,,,1146.6,90,,percent of total billed charges,,,1082.9,85,,percent of total billed charges,,56.49,1210.3,
"NJX INTERLAMINAR LMBR/SAC, WITH Imaging",62327,CDM,62327,CPT,,,both,,1350,1350,179.74,,,,fee schedule,,,,,,,,60.2,,,,fee schedule,,,1147.5,85,,percent of total billed charges,,884,,,,fee schedule,,901.68,,,,fee schedule,,60.2,,,,fee schedule,,,,,,,,60.2,,,,fee schedule,,174.45,,,,fee schedule,,105.73,,,,fee schedule,,105.73,,,,fee schedule,,,1228.5,91,,percent of total billed charges,,,1282.5,95,,percent of total billed charges,,,1120.5,83,,percent of total billed charges,,,405,83,,percent of total billed charges,,60.2,,,,fee schedule,,60.2,,,,fee schedule,,,1120.5,83,,percent of total billed charges,,155.42,,,,fee schedule,,,1215,90,,percent of total billed charges,,,1215,90,,percent of total billed charges,,,1215,90,,percent of total billed charges,,,1215,90,,percent of total billed charges,,,1147.5,85,,percent of total billed charges,,60.2,1282.5,
IMPLANT SPINAL CANAL CATH,62350,CDM,62350,CPT,,,both,,2678,2678,685.54,,,,fee schedule,,,,,,,,545.1,,,,fee schedule,,,2276.3,85,,percent of total billed charges,,773.55,,,,fee schedule,,428.06,,,,fee schedule,,545.1,,,,fee schedule,,781.26,,,,fee schedule,,545.1,,,,fee schedule,,665.38,,,,fee schedule,,403.26,,,,fee schedule,,403.26,,,,fee schedule,,,2436.98,91,,percent of total billed charges,,,2544.1,95,,percent of total billed charges,,,2222.74,83,,percent of total billed charges,,,803.4,83,,percent of total billed charges,,545.1,,,,fee schedule,,545.1,,,,fee schedule,,,2222.74,83,,percent of total billed charges,,592.79,,,,fee schedule,,,2410.2,90,,percent of total billed charges,,,2410.2,90,,percent of total billed charges,,,2410.2,90,,percent of total billed charges,,,2410.2,90,,percent of total billed charges,,,2276.3,85,,percent of total billed charges,,403.26,2544.1,
REMOVE SPINAL CANAL CATHETER,62355,CDM,62355,CPT,,,both,,1746,1746,475.84,,,,fee schedule,,,,,,,,180.3,,,,fee schedule,,,1484.1,85,,percent of total billed charges,,526.16,,,,fee schedule,,291.16,,,,fee schedule,,180.3,,,,fee schedule,,619.43,,,,fee schedule,,180.3,,,,fee schedule,,461.85,,,,fee schedule,,279.91,,,,fee schedule,,279.91,,,,fee schedule,,,1588.86,91,,percent of total billed charges,,,1658.7,95,,percent of total billed charges,,,1449.18,83,,percent of total billed charges,,,523.8,83,,percent of total billed charges,,180.3,,,,fee schedule,,180.3,,,,fee schedule,,,1449.18,83,,percent of total billed charges,,411.47,,,,fee schedule,,,1571.4,90,,percent of total billed charges,,,1571.4,90,,percent of total billed charges,,,1571.4,90,,percent of total billed charges,,,1571.4,90,,percent of total billed charges,,,1484.1,85,,percent of total billed charges,,180.3,1658.7,
INSERT SPINE INFUSION DEVICE,62360,CDM,62360,CPT,,,both,,1636,1636,550.73,,,,fee schedule,,,,,,,,545.1,,,,fee schedule,,,1390.6,85,,percent of total billed charges,,629.56,,,,fee schedule,,348.38,,,,fee schedule,,545.1,,,,fee schedule,,375.37,,,,fee schedule,,545.1,,,,fee schedule,,534.54,,,,fee schedule,,323.96,,,,fee schedule,,323.96,,,,fee schedule,,,1488.76,91,,percent of total billed charges,,,1554.2,95,,percent of total billed charges,,,1357.88,83,,percent of total billed charges,,,490.8,83,,percent of total billed charges,,545.1,,,,fee schedule,,545.1,,,,fee schedule,,,1357.88,83,,percent of total billed charges,,476.22,,,,fee schedule,,,1472.4,90,,percent of total billed charges,,,1472.4,90,,percent of total billed charges,,,1472.4,90,,percent of total billed charges,,,1472.4,90,,percent of total billed charges,,,1390.6,85,,percent of total billed charges,,323.96,1554.2,
IMPLANT SPINE INFUSION PUMP,62362,CDM,62362,CPT,,,both,,2544,2544,665.38,,,,fee schedule,,,,,,,,545.1,,,,fee schedule,,,2162.4,85,,percent of total billed charges,,749.2,,,,fee schedule,,414.59,,,,fee schedule,,545.1,,,,fee schedule,,831.66,,,,fee schedule,,545.1,,,,fee schedule,,645.81,,,,fee schedule,,391.4,,,,fee schedule,,391.4,,,,fee schedule,,,2315.04,91,,percent of total billed charges,,,2416.8,95,,percent of total billed charges,,,2111.52,83,,percent of total billed charges,,,763.2,83,,percent of total billed charges,,545.1,,,,fee schedule,,545.1,,,,fee schedule,,,2111.52,83,,percent of total billed charges,,575.35,,,,fee schedule,,,2289.6,90,,percent of total billed charges,,,2289.6,90,,percent of total billed charges,,,2289.6,90,,percent of total billed charges,,,2289.6,90,,percent of total billed charges,,,2162.4,85,,percent of total billed charges,,391.4,2416.8,
REMOVE SPINE INFUSION DEVICE,62365,CDM,62365,CPT,,,both,,1967,1967,512.71,,,,fee schedule,,,,,,,,162,,,,fee schedule,,,1671.95,85,,percent of total billed charges,,574.26,,,,fee schedule,,317.78,,,,fee schedule,,162,,,,fee schedule,,651.27,,,,fee schedule,,162,,,,fee schedule,,497.63,,,,fee schedule,,301.6,,,,fee schedule,,301.6,,,,fee schedule,,,1789.97,91,,percent of total billed charges,,,1868.65,95,,percent of total billed charges,,,1632.61,83,,percent of total billed charges,,,590.1,83,,percent of total billed charges,,162,,,,fee schedule,,162,,,,fee schedule,,,1632.61,83,,percent of total billed charges,,443.35,,,,fee schedule,,,1770.3,90,,percent of total billed charges,,,1770.3,90,,percent of total billed charges,,,1770.3,90,,percent of total billed charges,,,1770.3,90,,percent of total billed charges,,,1671.95,85,,percent of total billed charges,,162,1868.65,
ANALYZE SPINE INFUSION PUMP,62368,CDM,62368,CPT,,,both,,312,312,58.76,,,,fee schedule,,,,,,,,40.45,,,,fee schedule,,,265.2,85,,percent of total billed charges,,68.28,,,,fee schedule,,37.78,,,,fee schedule,,40.45,,,,fee schedule,,64.99,,,,fee schedule,,40.45,,,,fee schedule,,57.03,,,,fee schedule,,34.56,,,,fee schedule,,34.56,,,,fee schedule,,,283.92,91,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,93.6,83,,percent of total billed charges,,40.45,,,,fee schedule,,40.45,,,,fee schedule,,,258.96,83,,percent of total billed charges,,50.81,,,,fee schedule,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,265.2,85,,percent of total billed charges,,34.56,296.4,
NDSC DCMPRN 1 NTRSPC LUMBAR,62380,CDM,62380,CPT,,,both,,11393,11393,,,,,,,,,,,,,,,,,,,,9684.05,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10367.63,91,,percent of total billed charges,,,10823.35,95,,percent of total billed charges,,,9456.19,83,,percent of total billed charges,,,3417.9,83,,percent of total billed charges,,,,,,,,,,,,,,,9456.19,83,,percent of total billed charges,,,,,,,,,10253.7,90,,percent of total billed charges,,,10253.7,90,,percent of total billed charges,,,10253.7,90,,percent of total billed charges,,,10253.7,90,,percent of total billed charges,,,9684.05,85,,percent of total billed charges,,3417.9,10823.35,
REMOVAL OF SPINAL LAMINA,63003,CDM,63003,CPT,,,both,,6029,6029,2144.18,,,,fee schedule,,,,,,,,1102.95,,,,fee schedule,,,5124.65,85,,percent of total billed charges,,2445.1,,,,fee schedule,,1353.04,,,,fee schedule,,1102.95,,,,fee schedule,,1951.15,,,,fee schedule,,1102.95,,,,fee schedule,,2081.11,,,,fee schedule,,1261.28,,,,fee schedule,,1261.28,,,,fee schedule,,,5486.39,91,,percent of total billed charges,,,5727.55,95,,percent of total billed charges,,,5004.07,83,,percent of total billed charges,,,1808.7,83,,percent of total billed charges,,1102.95,,,,fee schedule,,1102.95,,,,fee schedule,,,5004.07,83,,percent of total billed charges,,1854.08,,,,fee schedule,,,5426.1,90,,percent of total billed charges,,,5426.1,90,,percent of total billed charges,,,5426.1,90,,percent of total billed charges,,,5426.1,90,,percent of total billed charges,,,5124.65,85,,percent of total billed charges,,1102.95,5727.55,
REMOVAL OF SPINAL LAMINA,63005,CDM,63005,CPT,,,both,,6324,6324,2084.84,,,,fee schedule,,,,,,,,1102.95,,,,fee schedule,,,5375.4,85,,percent of total billed charges,,2365.4,,,,fee schedule,,1308.94,,,,fee schedule,,1102.95,,,,fee schedule,,1866.26,,,,fee schedule,,1102.95,,,,fee schedule,,2023.52,,,,fee schedule,,1226.38,,,,fee schedule,,1226.38,,,,fee schedule,,,5754.84,91,,percent of total billed charges,,,6007.8,95,,percent of total billed charges,,,5248.92,83,,percent of total billed charges,,,1897.2,83,,percent of total billed charges,,1102.95,,,,fee schedule,,1102.95,,,,fee schedule,,,5248.92,83,,percent of total billed charges,,1802.78,,,,fee schedule,,,5691.6,90,,percent of total billed charges,,,5691.6,90,,percent of total billed charges,,,5691.6,90,,percent of total billed charges,,,5691.6,90,,percent of total billed charges,,,5375.4,85,,percent of total billed charges,,1102.95,6007.8,
REMOVAL OF SPINAL LAMINA,63012,CDM,63012,CPT,,,both,,7060,7060,2077.35,,,,fee schedule,,,,,,,,1404.2,,,,fee schedule,,,6001,85,,percent of total billed charges,,2360.29,,,,fee schedule,,1306.11,,,,fee schedule,,1404.2,,,,fee schedule,,1917.33,,,,fee schedule,,1404.2,,,,fee schedule,,2016.25,,,,fee schedule,,1221.97,,,,fee schedule,,1221.97,,,,fee schedule,,,6424.6,91,,percent of total billed charges,,,6707,95,,percent of total billed charges,,,5859.8,83,,percent of total billed charges,,,2118,83,,percent of total billed charges,,1404.2,,,,fee schedule,,1404.2,,,,fee schedule,,,5859.8,83,,percent of total billed charges,,1796.3,,,,fee schedule,,,6354,90,,percent of total billed charges,,,6354,90,,percent of total billed charges,,,6354,90,,percent of total billed charges,,,6354,90,,percent of total billed charges,,,6001,85,,percent of total billed charges,,1221.97,6707,
REMOVAL OF SPINAL LAMINA,63015,CDM,63015,CPT,,,both,,9829,9829,2573.94,,,,fee schedule,,,,,,,,1161.2,,,,fee schedule,,,8354.65,85,,percent of total billed charges,,2931.09,,,,fee schedule,,1621.97,,,,fee schedule,,1161.2,,,,fee schedule,,2376.27,,,,fee schedule,,1161.2,,,,fee schedule,,2498.23,,,,fee schedule,,1514.08,,,,fee schedule,,1514.08,,,,fee schedule,,,8944.39,91,,percent of total billed charges,,,9337.55,95,,percent of total billed charges,,,8158.07,83,,percent of total billed charges,,,2948.7,83,,percent of total billed charges,,1161.2,,,,fee schedule,,1161.2,,,,fee schedule,,,8158.07,83,,percent of total billed charges,,2225.7,,,,fee schedule,,,8846.1,90,,percent of total billed charges,,,8846.1,90,,percent of total billed charges,,,8846.1,90,,percent of total billed charges,,,8846.1,90,,percent of total billed charges,,,8354.65,85,,percent of total billed charges,,1161.2,9337.55,
NECK SPINE DISK SURGERY,63020,CDM,63020,CPT,,,both,,7638,7638,1903.95,,,,fee schedule,,,,,,,,,,,,,,,6492.3,85,,percent of total billed charges,,2282.95,,,,fee schedule,,1263.31,,,,fee schedule,,,,,,,,1860.96,,,,fee schedule,,,,,,,,1847.95,,,,fee schedule,,1119.97,,,,fee schedule,,1119.97,,,,fee schedule,,,6950.58,91,,percent of total billed charges,,,7256.1,95,,percent of total billed charges,,,6339.54,83,,percent of total billed charges,,,2291.4,83,,percent of total billed charges,,,,,,,,,,,,,,,6339.54,83,,percent of total billed charges,,1646.36,,,,fee schedule,,,6874.2,90,,percent of total billed charges,,,6874.2,90,,percent of total billed charges,,,6874.2,90,,percent of total billed charges,,,6874.2,90,,percent of total billed charges,,,6492.3,85,,percent of total billed charges,,1119.97,7256.1,
LOW BACK DISK SURGERY,63030,CDM,63030,CPT,,,both,,6302,6302,1585.95,,,,fee schedule,,,,,,,,1129.3,,,,fee schedule,,,5356.7,85,,percent of total billed charges,,1919.15,,,,fee schedule,,1029.7,,,,fee schedule,,1129.3,,,,fee schedule,,1545.93,,,,fee schedule,,1129.3,,,,fee schedule,,1539.31,,,,fee schedule,,932.91,,,,fee schedule,,932.91,,,,fee schedule,,,5734.82,91,,percent of total billed charges,,,5986.9,95,,percent of total billed charges,,,5230.66,83,,percent of total billed charges,,,1890.6,83,,percent of total billed charges,,1129.3,,,,fee schedule,,1129.3,,,,fee schedule,,,5230.66,83,,percent of total billed charges,,1371.38,,,,fee schedule,,,5671.8,90,,percent of total billed charges,,,5671.8,90,,percent of total billed charges,,,5671.8,90,,percent of total billed charges,,,5671.8,90,,percent of total billed charges,,,5356.7,85,,percent of total billed charges,,932.91,5986.9,
SPINAL DISK SURGERY ADD-ON,63035,CDM,63035,CPT,,,both,,1653,1653,401.53,,,,fee schedule,,,,,,,,,,,,,,,1405.05,85,,percent of total billed charges,,379.08,,,,fee schedule,,209.77,,,,fee schedule,,,,,,,,365.43,,,,fee schedule,,,,,,,,389.72,,,,fee schedule,,236.19,,,,fee schedule,,236.19,,,,fee schedule,,,1504.23,91,,percent of total billed charges,,,1570.35,95,,percent of total billed charges,,,1371.99,83,,percent of total billed charges,,,495.9,83,,percent of total billed charges,,,,,,,,,,,,,,,1371.99,83,,percent of total billed charges,,347.2,,,,fee schedule,,,1487.7,90,,percent of total billed charges,,,1487.7,90,,percent of total billed charges,,,1487.7,90,,percent of total billed charges,,,1487.7,90,,percent of total billed charges,,,1405.05,85,,percent of total billed charges,,209.77,1570.35,
"LAMINOTOMY, SINGLE LUMBAR",63042,CDM,63042,CPT,,,both,,4635,4635,2242.69,,,,fee schedule,,,,,,,,1129.3,,,,fee schedule,,,3939.75,85,,percent of total billed charges,,2546.91,,,,fee schedule,,1409.38,,,,fee schedule,,1129.3,,,,fee schedule,,2179.3,,,,fee schedule,,1129.3,,,,fee schedule,,2176.73,,,,fee schedule,,1319.23,,,,fee schedule,,1319.23,,,,fee schedule,,,4217.85,91,,percent of total billed charges,,,4403.25,95,,percent of total billed charges,,,3847.05,83,,percent of total billed charges,,,1390.5,83,,percent of total billed charges,,1129.3,,,,fee schedule,,1129.3,,,,fee schedule,,,3847.05,83,,percent of total billed charges,,1939.27,,,,fee schedule,,,4171.5,90,,percent of total billed charges,,,4171.5,90,,percent of total billed charges,,,4171.5,90,,percent of total billed charges,,,4171.5,90,,percent of total billed charges,,,3939.75,85,,percent of total billed charges,,1129.3,4403.25,
REMOVAL OF SPINAL LAMINA,63045,CDM,63045,CPT,,,both,,7630,7630,2237.5,,,,fee schedule,,,,,,,,1129.3,,,,fee schedule,,,6485.5,85,,percent of total billed charges,,2545.03,,,,fee schedule,,1408.34,,,,fee schedule,,1129.3,,,,fee schedule,,2037.37,,,,fee schedule,,1129.3,,,,fee schedule,,2171.7,,,,fee schedule,,1316.18,,,,fee schedule,,1316.18,,,,fee schedule,,,6943.3,91,,percent of total billed charges,,,7248.5,95,,percent of total billed charges,,,6332.9,83,,percent of total billed charges,,,2289,83,,percent of total billed charges,,1129.3,,,,fee schedule,,1129.3,,,,fee schedule,,,6332.9,83,,percent of total billed charges,,1934.78,,,,fee schedule,,,6867,90,,percent of total billed charges,,,6867,90,,percent of total billed charges,,,6867,90,,percent of total billed charges,,,6867,90,,percent of total billed charges,,,6485.5,85,,percent of total billed charges,,1129.3,7248.5,
REMOVAL OF SPINAL LAMINA,63046,CDM,63046,CPT,,,both,,7917,7917,2133.23,,,,fee schedule,,,,,,,,1129.3,,,,fee schedule,,,6729.45,85,,percent of total billed charges,,2420.67,,,,fee schedule,,1339.52,,,,fee schedule,,1129.3,,,,fee schedule,,1951.82,,,,fee schedule,,1129.3,,,,fee schedule,,2070.49,,,,fee schedule,,1254.84,,,,fee schedule,,1254.84,,,,fee schedule,,,7204.47,91,,percent of total billed charges,,,7521.15,95,,percent of total billed charges,,,6571.11,83,,percent of total billed charges,,,2375.1,83,,percent of total billed charges,,1129.3,,,,fee schedule,,1129.3,,,,fee schedule,,,6571.11,83,,percent of total billed charges,,1844.62,,,,fee schedule,,,7125.3,90,,percent of total billed charges,,,7125.3,90,,percent of total billed charges,,,7125.3,90,,percent of total billed charges,,,7125.3,90,,percent of total billed charges,,,6729.45,85,,percent of total billed charges,,1129.3,7521.15,
REMOVAL OF SPINAL LAMINA,63047,CDM,63047,CPT,,,both,,6785,6785,1919.51,,,,fee schedule,,,,,,,,1129.3,,,,fee schedule,,,5767.25,85,,percent of total billed charges,,2177.02,,,,fee schedule,,1168.05,,,,fee schedule,,1129.3,,,,fee schedule,,1832.44,,,,fee schedule,,1129.3,,,,fee schedule,,1863.05,,,,fee schedule,,1129.12,,,,fee schedule,,1129.12,,,,fee schedule,,,6174.35,91,,percent of total billed charges,,,6445.75,95,,percent of total billed charges,,,5631.55,83,,percent of total billed charges,,,2035.5,83,,percent of total billed charges,,1129.3,,,,fee schedule,,1129.3,,,,fee schedule,,,5631.55,83,,percent of total billed charges,,1659.81,,,,fee schedule,,,6106.5,90,,percent of total billed charges,,,6106.5,90,,percent of total billed charges,,,6106.5,90,,percent of total billed charges,,,6106.5,90,,percent of total billed charges,,,5767.25,85,,percent of total billed charges,,1129.12,6445.75,
REMOVE SPINAL LAMINA ADD-ON,63048,CDM,63048,CPT,,,both,,1590,1590,360.63,,,,fee schedule,,,,,,,,,,,,,,,1351.5,85,,percent of total billed charges,,417.29,,,,fee schedule,,230.92,,,,fee schedule,,,,,,,,373.39,,,,fee schedule,,,,,,,,350.02,,,,fee schedule,,212.13,,,,fee schedule,,212.13,,,,fee schedule,,,1446.9,91,,percent of total billed charges,,,1510.5,95,,percent of total billed charges,,,1319.7,83,,percent of total billed charges,,,477,83,,percent of total billed charges,,,,,,,,,,,,,,,1319.7,83,,percent of total billed charges,,311.84,,,,fee schedule,,,1431,90,,percent of total billed charges,,,1431,90,,percent of total billed charges,,,1431,90,,percent of total billed charges,,,1431,90,,percent of total billed charges,,,1351.5,85,,percent of total billed charges,,212.13,1510.5,
LAM FACETC/FRMT ARTHRD LUM 1,63052,CDM,63052,CPT,,,both,,1545,1545,443.01,,,,fee schedule,,,,,,,,159.29,,,,fee schedule,,,1313.25,85,,percent of total billed charges,,512.24,,,,fee schedule,,283.46,,,,fee schedule,,159.29,,,,fee schedule,,,,,,,,159.29,,,,fee schedule,,429.98,,,,fee schedule,,260.59,,,,fee schedule,,260.59,,,,fee schedule,,,1405.95,91,,percent of total billed charges,,,1467.75,95,,percent of total billed charges,,,1282.35,83,,percent of total billed charges,,,463.5,83,,percent of total billed charges,,159.29,,,,fee schedule,,159.29,,,,fee schedule,,,1282.35,83,,percent of total billed charges,,383.07,,,,fee schedule,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1313.25,85,,percent of total billed charges,,159.29,1467.75,
LAM FACTC/FRMT ARTHRD LUM EA,63053,CDM,63053,CPT,,,both,,1339,1339,392.31,,,,fee schedule,,,,,,,,476.36,,,,fee schedule,,,1138.15,85,,percent of total billed charges,,382.97,,,,fee schedule,,211.92,,,,fee schedule,,476.36,,,,fee schedule,,,,,,,,476.36,,,,fee schedule,,380.77,,,,fee schedule,,230.77,,,,fee schedule,,230.77,,,,fee schedule,,,1218.49,91,,percent of total billed charges,,,1272.05,95,,percent of total billed charges,,,1111.37,83,,percent of total billed charges,,,401.7,83,,percent of total billed charges,,476.36,,,,fee schedule,,476.36,,,,fee schedule,,,1111.37,83,,percent of total billed charges,,339.23,,,,fee schedule,,,1205.1,90,,percent of total billed charges,,,1205.1,90,,percent of total billed charges,,,1205.1,90,,percent of total billed charges,,,1205.1,90,,percent of total billed charges,,,1138.15,85,,percent of total billed charges,,211.92,1272.05,
DECOMPRESS SPINAL CORD,63056,CDM,63056,CPT,,,both,,8459,8459,2586.61,,,,fee schedule,,,,,,,,1291.7,,,,fee schedule,,,7190.15,85,,percent of total billed charges,,2950.95,,,,fee schedule,,1632.96,,,,fee schedule,,1291.7,,,,fee schedule,,2484.37,,,,fee schedule,,1291.7,,,,fee schedule,,2510.53,,,,fee schedule,,1521.54,,,,fee schedule,,1521.54,,,,fee schedule,,,7697.69,91,,percent of total billed charges,,,8036.05,95,,percent of total billed charges,,,7020.97,83,,percent of total billed charges,,,2537.7,83,,percent of total billed charges,,1291.7,,,,fee schedule,,1291.7,,,,fee schedule,,,7020.97,83,,percent of total billed charges,,2236.66,,,,fee schedule,,,7613.1,90,,percent of total billed charges,,,7613.1,90,,percent of total billed charges,,,7613.1,90,,percent of total billed charges,,,7613.1,90,,percent of total billed charges,,,7190.15,85,,percent of total billed charges,,1291.7,8036.05,
NECK SPINE DISK SURGERY,63075,CDM,63075,CPT,,,both,,7262,7262,2352.72,,,,fee schedule,,,,,,,,1198.7,,,,fee schedule,,,6172.7,85,,percent of total billed charges,,2686.51,,,,fee schedule,,1441.41,,,,fee schedule,,1198.7,,,,fee schedule,,2384.23,,,,fee schedule,,1198.7,,,,fee schedule,,2283.52,,,,fee schedule,,1383.95,,,,fee schedule,,1383.95,,,,fee schedule,,,6608.42,91,,percent of total billed charges,,,6898.9,95,,percent of total billed charges,,,6027.46,83,,percent of total billed charges,,,2178.6,83,,percent of total billed charges,,1198.7,,,,fee schedule,,1198.7,,,,fee schedule,,,6027.46,83,,percent of total billed charges,,2034.41,,,,fee schedule,,,6535.8,90,,percent of total billed charges,,,6535.8,90,,percent of total billed charges,,,6535.8,90,,percent of total billed charges,,,6535.8,90,,percent of total billed charges,,,6172.7,85,,percent of total billed charges,,1198.7,6898.9,
REMOVAL OF VERTEBRAL BODY,63081,CDM,63081,CPT,,,both,,9162,9162,3044.6,,,,fee schedule,,,,,,,,1291.7,,,,fee schedule,,,7787.7,85,,percent of total billed charges,,3480.56,,,,fee schedule,,1867.45,,,,fee schedule,,1291.7,,,,fee schedule,,2876.33,,,,fee schedule,,1291.7,,,,fee schedule,,2955.05,,,,fee schedule,,1790.94,,,,fee schedule,,1790.94,,,,fee schedule,,,8337.42,91,,percent of total billed charges,,,8703.9,95,,percent of total billed charges,,,7604.46,83,,percent of total billed charges,,,2748.6,83,,percent of total billed charges,,1291.7,,,,fee schedule,,1291.7,,,,fee schedule,,,7604.46,83,,percent of total billed charges,,2632.68,,,,fee schedule,,,8245.8,90,,percent of total billed charges,,,8245.8,90,,percent of total billed charges,,,8245.8,90,,percent of total billed charges,,,8245.8,90,,percent of total billed charges,,,7787.7,85,,percent of total billed charges,,1291.7,8703.9,
REMOVAL OF VERTEBRAL BODY,63081AS,CDM,63081,CPT,,,both,AS,689,689,3044.6,,,,fee schedule,,,,,,,,1291.7,,,,fee schedule,,,585.65,85,,percent of total billed charges,,3480.56,,,,fee schedule,,1867.45,,,,fee schedule,,1291.7,,,,fee schedule,,2876.33,,,,fee schedule,,1291.7,,,,fee schedule,,2955.05,,,,fee schedule,,1790.94,,,,fee schedule,,1790.94,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,1291.7,,,,fee schedule,,1291.7,,,,fee schedule,,,571.87,83,,percent of total billed charges,,2632.68,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,3480.56,
EXCISE INTRASPINAL LESION,63267,CDM,63267,CPT,,,both,,7315,7315,2383.83,,,,fee schedule,,,,,,,,1198.7,,,,fee schedule,,,6217.75,85,,percent of total billed charges,,2714.28,,,,fee schedule,,1502,,,,fee schedule,,1198.7,,,,fee schedule,,2205.16,,,,fee schedule,,1198.7,,,,fee schedule,,2313.72,,,,fee schedule,,1402.25,,,,fee schedule,,1402.25,,,,fee schedule,,,6656.65,91,,percent of total billed charges,,,6949.25,95,,percent of total billed charges,,,6071.45,83,,percent of total billed charges,,,2194.5,83,,percent of total billed charges,,1198.7,,,,fee schedule,,1198.7,,,,fee schedule,,,6071.45,83,,percent of total billed charges,,2061.31,,,,fee schedule,,,6583.5,90,,percent of total billed charges,,,6583.5,90,,percent of total billed charges,,,6583.5,90,,percent of total billed charges,,,6583.5,90,,percent of total billed charges,,,6217.75,85,,percent of total billed charges,,1198.7,6949.25,
BIOPSY/EXCISE SPINAL TUMOR,63277,CDM,63277,CPT,,,both,,6769,6769,2717.38,,,,fee schedule,,,,,,,,1198.7,,,,fee schedule,,,5753.65,85,,percent of total billed charges,,3090.5,,,,fee schedule,,1710.19,,,,fee schedule,,1198.7,,,,fee schedule,,2531.46,,,,fee schedule,,1198.7,,,,fee schedule,,2637.46,,,,fee schedule,,1598.46,,,,fee schedule,,1598.46,,,,fee schedule,,,6159.79,91,,percent of total billed charges,,,6430.55,95,,percent of total billed charges,,,5618.27,83,,percent of total billed charges,,,2030.7,83,,percent of total billed charges,,1198.7,,,,fee schedule,,1198.7,,,,fee schedule,,,5618.27,83,,percent of total billed charges,,2349.74,,,,fee schedule,,,6092.1,90,,percent of total billed charges,,,6092.1,90,,percent of total billed charges,,,6092.1,90,,percent of total billed charges,,,6092.1,90,,percent of total billed charges,,,5753.65,85,,percent of total billed charges,,1198.7,6430.55,
IMPLANT NEUROELECTRODES,63650,CDM,63650,CPT,,,both,,6222,6222,706.85,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,5288.7,85,,percent of total billed charges,,797.34,,,,fee schedule,,441.22,,,,fee schedule,,524.4,,,,fee schedule,,692.39,,,,fee schedule,,524.4,,,,fee schedule,,686.06,,,,fee schedule,,415.8,,,,fee schedule,,415.8,,,,fee schedule,,,5662.02,91,,percent of total billed charges,,,5910.9,95,,percent of total billed charges,,,5164.26,83,,percent of total billed charges,,,1866.6,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,5164.26,83,,percent of total billed charges,,611.22,,,,fee schedule,,,5599.8,90,,percent of total billed charges,,,5599.8,90,,percent of total billed charges,,,5599.8,90,,percent of total billed charges,,,5599.8,90,,percent of total billed charges,,,5288.7,85,,percent of total billed charges,,415.8,5910.9,
REVISE/REM SPINAL ELECTRODE/ARRAY,63661,CDM,63661,CPT,,,both,,2508,2508,564.56,,,,fee schedule,,,,,,,,168.27,,,,fee schedule,,,2131.8,85,,percent of total billed charges,,637.04,,,,fee schedule,,352.52,,,,fee schedule,,168.27,,,,fee schedule,,,,,,,,168.27,,,,fee schedule,,547.96,,,,fee schedule,,332.09,,,,fee schedule,,332.09,,,,fee schedule,,,2282.28,91,,percent of total billed charges,,,2382.6,95,,percent of total billed charges,,,2081.64,83,,percent of total billed charges,,,752.4,83,,percent of total billed charges,,168.27,,,,fee schedule,,168.27,,,,fee schedule,,,2081.64,83,,percent of total billed charges,,488.18,,,,fee schedule,,,2257.2,90,,percent of total billed charges,,,2257.2,90,,percent of total billed charges,,,2257.2,90,,percent of total billed charges,,,2257.2,90,,percent of total billed charges,,,2131.8,85,,percent of total billed charges,,168.27,2382.6,
REVISE SPINE ELTRD PERQ ARAY,63663,CDM,63663,CPT,,,both,,5086,5086,772.53,,,,fee schedule,,,,,,,,265.27,,,,fee schedule,,,4323.1,85,,percent of total billed charges,,872.1,,,,fee schedule,,482.6,,,,fee schedule,,265.27,,,,fee schedule,,,,,,,,265.27,,,,fee schedule,,749.81,,,,fee schedule,,454.43,,,,fee schedule,,454.43,,,,fee schedule,,,4628.26,91,,percent of total billed charges,,,4831.7,95,,percent of total billed charges,,,4221.38,83,,percent of total billed charges,,,1525.8,83,,percent of total billed charges,,265.27,,,,fee schedule,,265.27,,,,fee schedule,,,4221.38,83,,percent of total billed charges,,668.01,,,,fee schedule,,,4577.4,90,,percent of total billed charges,,,4577.4,90,,percent of total billed charges,,,4577.4,90,,percent of total billed charges,,,4577.4,90,,percent of total billed charges,,,4323.1,85,,percent of total billed charges,,265.27,4831.7,
INSRT/REDO SPINE N GENERATOR,63685,CDM,63685,CPT,,,both,,4143,4143,624.47,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,3521.55,85,,percent of total billed charges,,702.32,,,,fee schedule,,388.64,,,,fee schedule,,599.35,,,,fee schedule,,808.45,,,,fee schedule,,599.35,,,,fee schedule,,606.11,,,,fee schedule,,367.34,,,,fee schedule,,367.34,,,,fee schedule,,,3770.13,91,,percent of total billed charges,,,3935.85,95,,percent of total billed charges,,,3438.69,83,,percent of total billed charges,,,1242.9,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,3438.69,83,,percent of total billed charges,,539.99,,,,fee schedule,,,3728.7,90,,percent of total billed charges,,,3728.7,90,,percent of total billed charges,,,3728.7,90,,percent of total billed charges,,,3728.7,90,,percent of total billed charges,,,3521.55,85,,percent of total billed charges,,367.34,3935.85,
REVISE/REMOVE NEURORECEIVER,63688,CDM,63688,CPT,,,both,,3210,3210,645.79,,,,fee schedule,,,,,,,,374.55,,,,fee schedule,,,2728.5,85,,percent of total billed charges,,723.72,,,,fee schedule,,400.48,,,,fee schedule,,374.55,,,,fee schedule,,648.62,,,,fee schedule,,374.55,,,,fee schedule,,626.79,,,,fee schedule,,379.88,,,,fee schedule,,379.88,,,,fee schedule,,,2921.1,91,,percent of total billed charges,,,3049.5,95,,percent of total billed charges,,,2664.3,83,,percent of total billed charges,,,963,83,,percent of total billed charges,,374.55,,,,fee schedule,,374.55,,,,fee schedule,,,2664.3,83,,percent of total billed charges,,558.42,,,,fee schedule,,,2889,90,,percent of total billed charges,,,2889,90,,percent of total billed charges,,,2889,90,,percent of total billed charges,,,2889,90,,percent of total billed charges,,,2728.5,85,,percent of total billed charges,,374.55,3049.5,
REPAIR SPINAL FLUID LEAKAGE,63707,CDM,63707,CPT,,,both,,5755,5755,1636.07,,,,fee schedule,,,,,,,,1198.7,,,,fee schedule,,,4891.75,85,,percent of total billed charges,,1844.96,,,,fee schedule,,1020.94,,,,fee schedule,,1198.7,,,,fee schedule,,1415.95,,,,fee schedule,,1198.7,,,,fee schedule,,1587.95,,,,fee schedule,,962.4,,,,fee schedule,,962.4,,,,fee schedule,,,5237.05,91,,percent of total billed charges,,,5467.25,95,,percent of total billed charges,,,4776.65,83,,percent of total billed charges,,,1726.5,83,,percent of total billed charges,,1198.7,,,,fee schedule,,1198.7,,,,fee schedule,,,4776.65,83,,percent of total billed charges,,1414.72,,,,fee schedule,,,5179.5,90,,percent of total billed charges,,,5179.5,90,,percent of total billed charges,,,5179.5,90,,percent of total billed charges,,,5179.5,90,,percent of total billed charges,,,4891.75,85,,percent of total billed charges,,962.4,5467.25,
REPAIR SPINAL FLUID LEAKAGE,63709,CDM,63709,CPT,,,both,,6531,6531,1937.37,,,,fee schedule,,,,,,,,1198.7,,,,fee schedule,,,5551.35,85,,percent of total billed charges,,2201.33,,,,fee schedule,,1218.15,,,,fee schedule,,1198.7,,,,fee schedule,,1771.42,,,,fee schedule,,1198.7,,,,fee schedule,,1880.38,,,,fee schedule,,1139.63,,,,fee schedule,,1139.63,,,,fee schedule,,,5943.21,91,,percent of total billed charges,,,6204.45,95,,percent of total billed charges,,,5420.73,83,,percent of total billed charges,,,1959.3,83,,percent of total billed charges,,1198.7,,,,fee schedule,,1198.7,,,,fee schedule,,,5420.73,83,,percent of total billed charges,,1675.25,,,,fee schedule,,,5877.9,90,,percent of total billed charges,,,5877.9,90,,percent of total billed charges,,,5877.9,90,,percent of total billed charges,,,5877.9,90,,percent of total billed charges,,,5551.35,85,,percent of total billed charges,,1139.63,6204.45,
"N BLOCK INJ, OCCIPITAL",64405,CDM,64405,CPT,,,both,,521,521,90.44,,,,fee schedule,,,,,,,,74.9,,,,fee schedule,,,442.85,85,,percent of total billed charges,,104.3,,,,fee schedule,,57.72,,,,fee schedule,,74.9,,,,fee schedule,,123.36,,,,fee schedule,,74.9,,,,fee schedule,,87.78,,,,fee schedule,,53.2,,,,fee schedule,,53.2,,,,fee schedule,,,474.11,91,,percent of total billed charges,,,494.95,95,,percent of total billed charges,,,432.43,83,,percent of total billed charges,,,156.3,83,,percent of total billed charges,,74.9,,,,fee schedule,,74.9,,,,fee schedule,,,432.43,83,,percent of total billed charges,,78.21,,,,fee schedule,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,442.85,85,,percent of total billed charges,,53.2,494.95,
"N BLOCK INJ, OCCIPITAL",64405P,CDM,64405,CPT,,,both,P,355,355,90.44,,,,fee schedule,,,,,,,,74.9,,,,fee schedule,,,301.75,85,,percent of total billed charges,,104.3,,,,fee schedule,,57.72,,,,fee schedule,,74.9,,,,fee schedule,,123.36,,,,fee schedule,,74.9,,,,fee schedule,,87.78,,,,fee schedule,,53.2,,,,fee schedule,,53.2,,,,fee schedule,,,323.05,91,,percent of total billed charges,,,337.25,95,,percent of total billed charges,,,294.65,83,,percent of total billed charges,,,106.5,83,,percent of total billed charges,,74.9,,,,fee schedule,,74.9,,,,fee schedule,,,294.65,83,,percent of total billed charges,,78.21,,,,fee schedule,,,319.5,90,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,319.5,90,,percent of total billed charges,,,301.75,85,,percent of total billed charges,,53.2,337.25,
"N BLOCK INJ, OCCIPITAL",64405T,CDM,64405,CPT,,,both,T,166,166,90.44,,,,fee schedule,,,,,,,,74.9,,,,fee schedule,,,141.1,85,,percent of total billed charges,,104.3,,,,fee schedule,,57.72,,,,fee schedule,,74.9,,,,fee schedule,,123.36,,,,fee schedule,,74.9,,,,fee schedule,,87.78,,,,fee schedule,,53.2,,,,fee schedule,,53.2,,,,fee schedule,,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,74.9,,,,fee schedule,,74.9,,,,fee schedule,,,137.78,83,,percent of total billed charges,,78.21,,,,fee schedule,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,49.8,157.7,
"N BLOCK INJ, BRACHIAL PLEXUS",64415,CDM,64415,CPT,,,both,,1236,1236,118.1,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,1050.6,85,,percent of total billed charges,,128.97,,,,fee schedule,,67.49,,,,fee schedule,,52.7,,,,fee schedule,,135.29,,,,fee schedule,,52.7,,,,fee schedule,,114.62,,,,fee schedule,,69.47,,,,fee schedule,,69.47,,,,fee schedule,,,1124.76,91,,percent of total billed charges,,,1174.2,95,,percent of total billed charges,,,1025.88,83,,percent of total billed charges,,,370.8,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,1025.88,83,,percent of total billed charges,,102.12,,,,fee schedule,,,1112.4,90,,percent of total billed charges,,,1112.4,90,,percent of total billed charges,,,1112.4,90,,percent of total billed charges,,,1112.4,90,,percent of total billed charges,,,1050.6,85,,percent of total billed charges,,52.7,1174.2,
"N BLOCK INJ, AXILLARY",64417,CDM,64417,CPT,,,both,,1085,1085,107.73,,,,fee schedule,,,,,,,,48.4,,,,fee schedule,,,922.25,85,,percent of total billed charges,,117.84,,,,fee schedule,,65.21,,,,fee schedule,,48.4,,,,fee schedule,,135.29,,,,fee schedule,,48.4,,,,fee schedule,,104.56,,,,fee schedule,,63.37,,,,fee schedule,,63.37,,,,fee schedule,,,987.35,91,,percent of total billed charges,,,1030.75,95,,percent of total billed charges,,,900.55,83,,percent of total billed charges,,,325.5,83,,percent of total billed charges,,48.4,,,,fee schedule,,48.4,,,,fee schedule,,,900.55,83,,percent of total billed charges,,93.15,,,,fee schedule,,,976.5,90,,percent of total billed charges,,,976.5,90,,percent of total billed charges,,,976.5,90,,percent of total billed charges,,,976.5,90,,percent of total billed charges,,,922.25,85,,percent of total billed charges,,48.4,1030.75,
"N BLOCK INJ, SUPRASCAPULAR",64418,CDM,64418,CPT,,,both,,541,541,95.05,,,,fee schedule,,,,,,,,47.15,,,,fee schedule,,,459.85,85,,percent of total billed charges,,109.1,,,,fee schedule,,60.37,,,,fee schedule,,47.15,,,,fee schedule,,122.03,,,,fee schedule,,47.15,,,,fee schedule,,92.26,,,,fee schedule,,55.91,,,,fee schedule,,55.91,,,,fee schedule,,,492.31,91,,percent of total billed charges,,,513.95,95,,percent of total billed charges,,,449.03,83,,percent of total billed charges,,,162.3,83,,percent of total billed charges,,47.15,,,,fee schedule,,47.15,,,,fee schedule,,,449.03,83,,percent of total billed charges,,82.19,,,,fee schedule,,,486.9,90,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,486.9,90,,percent of total billed charges,,,459.85,85,,percent of total billed charges,,47.15,513.95,
"N BLOCK INJ, INTERCOST, SNG",64420,CDM,64420,CPT,,,both,,388,388,99.66,,,,fee schedule,,,,,,,,43.25,,,,fee schedule,,,329.8,85,,percent of total billed charges,,113.68,,,,fee schedule,,62.9,,,,fee schedule,,43.25,,,,fee schedule,,112.08,,,,fee schedule,,43.25,,,,fee schedule,,96.73,,,,fee schedule,,58.62,,,,fee schedule,,58.62,,,,fee schedule,,,353.08,91,,percent of total billed charges,,,368.6,95,,percent of total billed charges,,,322.04,83,,percent of total billed charges,,,116.4,83,,percent of total billed charges,,43.25,,,,fee schedule,,43.25,,,,fee schedule,,,322.04,83,,percent of total billed charges,,86.18,,,,fee schedule,,,349.2,90,,percent of total billed charges,,,349.2,90,,percent of total billed charges,,,349.2,90,,percent of total billed charges,,,349.2,90,,percent of total billed charges,,,329.8,85,,percent of total billed charges,,43.25,368.6,
"N BLOCK INJ, INTERCOST, MLT",64421,CDM,64421,CPT,,,both,,1070,1070,41.48,,,,fee schedule,,,,,,,,56.4,,,,fee schedule,,,909.5,85,,percent of total billed charges,,48.29,,,,fee schedule,,26.72,,,,fee schedule,,56.4,,,,fee schedule,,153.86,,,,fee schedule,,56.4,,,,fee schedule,,40.26,,,,fee schedule,,24.4,,,,fee schedule,,24.4,,,,fee schedule,,,973.7,91,,percent of total billed charges,,,1016.5,95,,percent of total billed charges,,,888.1,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,56.4,,,,fee schedule,,56.4,,,,fee schedule,,,888.1,83,,percent of total billed charges,,35.87,,,,fee schedule,,,963,90,,percent of total billed charges,,,963,90,,percent of total billed charges,,,963,90,,percent of total billed charges,,,963,90,,percent of total billed charges,,,909.5,85,,percent of total billed charges,,24.4,1016.5,
"N BLOCK INJ, ILIO-ING/HYPOGI",64425,CDM,64425,CPT,,,both,,693,693,93.33,,,,fee schedule,,,,,,,,52.65,,,,fee schedule,,,589.05,85,,percent of total billed charges,,105.72,,,,fee schedule,,58.5,,,,fee schedule,,52.65,,,,fee schedule,,161.16,,,,fee schedule,,52.65,,,,fee schedule,,90.58,,,,fee schedule,,54.9,,,,fee schedule,,54.9,,,,fee schedule,,,630.63,91,,percent of total billed charges,,,658.35,95,,percent of total billed charges,,,575.19,83,,percent of total billed charges,,,207.9,83,,percent of total billed charges,,52.65,,,,fee schedule,,52.65,,,,fee schedule,,,575.19,83,,percent of total billed charges,,80.7,,,,fee schedule,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,623.7,90,,percent of total billed charges,,,589.05,85,,percent of total billed charges,,52.65,658.35,
"N BLOCK INJ, SCIATIC, SNG",64445,CDM,64445,CPT,,,both,,783,783,125.01,,,,fee schedule,,,,,,,,53.2,,,,fee schedule,,,665.55,85,,percent of total billed charges,,103.28,,,,fee schedule,,57.15,,,,fee schedule,,53.2,,,,fee schedule,,137.95,,,,fee schedule,,53.2,,,,fee schedule,,121.33,,,,fee schedule,,73.54,,,,fee schedule,,73.54,,,,fee schedule,,,712.53,91,,percent of total billed charges,,,743.85,95,,percent of total billed charges,,,649.89,83,,percent of total billed charges,,,234.9,83,,percent of total billed charges,,53.2,,,,fee schedule,,53.2,,,,fee schedule,,,649.89,83,,percent of total billed charges,,108.1,,,,fee schedule,,,704.7,90,,percent of total billed charges,,,704.7,90,,percent of total billed charges,,,704.7,90,,percent of total billed charges,,,704.7,90,,percent of total billed charges,,,665.55,85,,percent of total billed charges,,53.2,743.85,
"N BLOCK INJ FEM, SINGLE",64447,CDM,64447,CPT,,,both,,1118,1118,107.15,,,,fee schedule,,,,,,,,53.2,,,,fee schedule,,,950.3,85,,percent of total billed charges,,101.86,,,,fee schedule,,56.37,,,,fee schedule,,53.2,,,,fee schedule,,134.63,,,,fee schedule,,53.2,,,,fee schedule,,104,,,,fee schedule,,63.03,,,,fee schedule,,63.03,,,,fee schedule,,,1017.38,91,,percent of total billed charges,,,1062.1,95,,percent of total billed charges,,,927.94,83,,percent of total billed charges,,,335.4,83,,percent of total billed charges,,53.2,,,,fee schedule,,53.2,,,,fee schedule,,,927.94,83,,percent of total billed charges,,92.65,,,,fee schedule,,,1006.2,90,,percent of total billed charges,,,1006.2,90,,percent of total billed charges,,,1006.2,90,,percent of total billed charges,,,1006.2,90,,percent of total billed charges,,,950.3,85,,percent of total billed charges,,53.2,1062.1,
"N BLOCK INJ, LUMBAR PLEXUS",64449,CDM,64449,CPT,,,both,,1424,1424,105.42,,,,fee schedule,,,,,,,,81.4,,,,fee schedule,,,1210.4,85,,percent of total billed charges,,119.05,,,,fee schedule,,65.88,,,,fee schedule,,81.4,,,,fee schedule,,273.24,,,,fee schedule,,81.4,,,,fee schedule,,102.32,,,,fee schedule,,62.01,,,,fee schedule,,62.01,,,,fee schedule,,,1295.84,91,,percent of total billed charges,,,1352.8,95,,percent of total billed charges,,,1181.92,83,,percent of total billed charges,,,427.2,83,,percent of total billed charges,,81.4,,,,fee schedule,,81.4,,,,fee schedule,,,1181.92,83,,percent of total billed charges,,91.16,,,,fee schedule,,,1281.6,90,,percent of total billed charges,,,1281.6,90,,percent of total billed charges,,,1281.6,90,,percent of total billed charges,,,1281.6,90,,percent of total billed charges,,,1210.4,85,,percent of total billed charges,,62.01,1352.8,
"N BLOCK, OTHER PERIPHERAL",64450,CDM,64450,CPT,,,both,,358,358,71.43,,,,fee schedule,,,,,,,,38.95,,,,fee schedule,,,304.3,85,,percent of total billed charges,,119.81,,,,fee schedule,,45.12,,,,fee schedule,,38.95,,,,fee schedule,,124.68,,,,fee schedule,,38.95,,,,fee schedule,,69.33,,,,fee schedule,,42.02,,,,fee schedule,,42.02,,,,fee schedule,,,325.78,91,,percent of total billed charges,,,340.1,95,,percent of total billed charges,,,297.14,83,,percent of total billed charges,,,107.4,83,,percent of total billed charges,,38.95,,,,fee schedule,,38.95,,,,fee schedule,,,297.14,83,,percent of total billed charges,,61.77,,,,fee schedule,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,304.3,85,,percent of total billed charges,,38.95,340.1,
NJX AA&/STRD OTHER PN/BRANCH,64450P,CDM,64450,CPT,,,both,P,129,129,71.43,,,,fee schedule,,,,,,,,38.95,,,,fee schedule,,,109.65,85,,percent of total billed charges,,119.81,,,,fee schedule,,45.12,,,,fee schedule,,38.95,,,,fee schedule,,124.68,,,,fee schedule,,38.95,,,,fee schedule,,69.33,,,,fee schedule,,42.02,,,,fee schedule,,42.02,,,,fee schedule,,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,38.7,83,,percent of total billed charges,,38.95,,,,fee schedule,,38.95,,,,fee schedule,,,107.07,83,,percent of total billed charges,,61.77,,,,fee schedule,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,38.7,124.68,
NJX AA&/STRD OTHER PN/BRANCH,64450T,CDM,64450,CPT,,,both,T,229,229,71.43,,,,fee schedule,,,,,,,,38.95,,,,fee schedule,,,194.65,85,,percent of total billed charges,,119.81,,,,fee schedule,,45.12,,,,fee schedule,,38.95,,,,fee schedule,,124.68,,,,fee schedule,,38.95,,,,fee schedule,,69.33,,,,fee schedule,,42.02,,,,fee schedule,,42.02,,,,fee schedule,,,208.39,91,,percent of total billed charges,,,217.55,95,,percent of total billed charges,,,190.07,83,,percent of total billed charges,,,68.7,83,,percent of total billed charges,,38.95,,,,fee schedule,,38.95,,,,fee schedule,,,190.07,83,,percent of total billed charges,,61.77,,,,fee schedule,,,206.1,90,,percent of total billed charges,,,206.1,90,,percent of total billed charges,,,206.1,90,,percent of total billed charges,,,206.1,90,,percent of total billed charges,,,194.65,85,,percent of total billed charges,,38.95,217.55,
NJX AA&/STRD NRV NRVTG SI JT,64451,CDM,64451,CPT,,,both,,1382,1382,138.84,,,,fee schedule,,,,,,,,98.18,,,,fee schedule,,,1174.7,85,,percent of total billed charges,,156.99,,,,fee schedule,,86.87,,,,fee schedule,,98.18,,,,fee schedule,,,,,,,,98.18,,,,fee schedule,,134.75,,,,fee schedule,,81.67,,,,fee schedule,,81.67,,,,fee schedule,,,1257.62,91,,percent of total billed charges,,,1312.9,95,,percent of total billed charges,,,1147.06,83,,percent of total billed charges,,,414.6,83,,percent of total billed charges,,98.18,,,,fee schedule,,98.18,,,,fee schedule,,,1147.06,83,,percent of total billed charges,,120.05,,,,fee schedule,,,1243.8,90,,percent of total billed charges,,,1243.8,90,,percent of total billed charges,,,1243.8,90,,percent of total billed charges,,,1243.8,90,,percent of total billed charges,,,1174.7,85,,percent of total billed charges,,81.67,1312.9,
NJX AA&/STRD GNCLR NRV BRNCH,64454,CDM,64454,CPT,,,both,,1395,1395,139.41,,,,fee schedule,,,,,,,,100.96,,,,fee schedule,,,1185.75,85,,percent of total billed charges,,159.97,,,,fee schedule,,88.52,,,,fee schedule,,100.96,,,,fee schedule,,,,,,,,100.96,,,,fee schedule,,135.31,,,,fee schedule,,82.01,,,,fee schedule,,82.01,,,,fee schedule,,,1269.45,91,,percent of total billed charges,,,1325.25,95,,percent of total billed charges,,,1157.85,83,,percent of total billed charges,,,418.5,83,,percent of total billed charges,,100.96,,,,fee schedule,,100.96,,,,fee schedule,,,1157.85,83,,percent of total billed charges,,120.55,,,,fee schedule,,,1255.5,90,,percent of total billed charges,,,1255.5,90,,percent of total billed charges,,,1255.5,90,,percent of total billed charges,,,1255.5,90,,percent of total billed charges,,,1185.75,85,,percent of total billed charges,,82.01,1325.25,
"N BLOCK INJ,  PLANTAR DIGIT",64455,CDM,64455,CPT,,,both,,248,248,57.03,,,,fee schedule,,,,,,,,38.95,,,,fee schedule,,,210.8,85,,percent of total billed charges,,65.95,,,,fee schedule,,36.5,,,,fee schedule,,38.95,,,,fee schedule,,,,,,,,38.95,,,,fee schedule,,55.35,,,,fee schedule,,33.55,,,,fee schedule,,33.55,,,,fee schedule,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,74.4,83,,percent of total billed charges,,38.95,,,,fee schedule,,38.95,,,,fee schedule,,,205.84,83,,percent of total billed charges,,49.32,,,,fee schedule,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,33.55,235.6,
PVB THORACIC SINGLE INJ SITE,64461,CDM,64461,CPT,,,both,,363,363,133.08,,,,fee schedule,,,,,,,,53.23,,,,fee schedule,,,308.55,85,,percent of total billed charges,,153.4,,,,fee schedule,,84.89,,,,fee schedule,,53.23,,,,fee schedule,,,,,,,,53.23,,,,fee schedule,,129.16,,,,fee schedule,,78.28,,,,fee schedule,,78.28,,,,fee schedule,,,330.33,91,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,108.9,83,,percent of total billed charges,,53.23,,,,fee schedule,,53.23,,,,fee schedule,,,301.29,83,,percent of total billed charges,,115.07,,,,fee schedule,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,53.23,344.85,
INJ FORAMEN EPIDURAL C/T,64479,CDM,64479,CPT,,,both,,1723,1723,221.79,,,,fee schedule,,,,,,,,95.9,,,,fee schedule,,,1464.55,85,,percent of total billed charges,,251.26,,,,fee schedule,,139.04,,,,fee schedule,,95.9,,,,fee schedule,,214.88,,,,fee schedule,,95.9,,,,fee schedule,,215.27,,,,fee schedule,,130.47,,,,fee schedule,,130.47,,,,fee schedule,,,1567.93,91,,percent of total billed charges,,,1636.85,95,,percent of total billed charges,,,1430.09,83,,percent of total billed charges,,,516.9,83,,percent of total billed charges,,95.9,,,,fee schedule,,95.9,,,,fee schedule,,,1430.09,83,,percent of total billed charges,,191.78,,,,fee schedule,,,1550.7,90,,percent of total billed charges,,,1550.7,90,,percent of total billed charges,,,1550.7,90,,percent of total billed charges,,,1550.7,90,,percent of total billed charges,,,1464.55,85,,percent of total billed charges,,95.9,1636.85,
INJ FORAMEN EPIDURAL ADD-ON,64480,CDM,64480,CPT,,,both,,881,881,104.27,,,,fee schedule,,,,,,,,85.75,,,,fee schedule,,,748.85,85,,percent of total billed charges,,118.03,,,,fee schedule,,65.32,,,,fee schedule,,85.75,,,,fee schedule,,141.26,,,,fee schedule,,85.75,,,,fee schedule,,101.2,,,,fee schedule,,61.34,,,,fee schedule,,61.34,,,,fee schedule,,,801.71,91,,percent of total billed charges,,,836.95,95,,percent of total billed charges,,,731.23,83,,percent of total billed charges,,,264.3,83,,percent of total billed charges,,85.75,,,,fee schedule,,85.75,,,,fee schedule,,,731.23,83,,percent of total billed charges,,90.16,,,,fee schedule,,,792.9,90,,percent of total billed charges,,,792.9,90,,percent of total billed charges,,,792.9,90,,percent of total billed charges,,,792.9,90,,percent of total billed charges,,,748.85,85,,percent of total billed charges,,61.34,836.95,
X INJ FORAMEN EPIDURAL L/S,64483,CDM,64483,CPT,,,both,,1760,1760,188.38,,,,fee schedule,,,,,,,,88.25,,,,fee schedule,,,1496,85,,percent of total billed charges,,203.47,,,,fee schedule,,117.93,,,,fee schedule,,88.25,,,,fee schedule,,189.01,,,,fee schedule,,88.25,,,,fee schedule,,182.84,,,,fee schedule,,110.81,,,,fee schedule,,110.81,,,,fee schedule,,,1601.6,91,,percent of total billed charges,,,1672,95,,percent of total billed charges,,,1460.8,83,,percent of total billed charges,,,528,83,,percent of total billed charges,,88.25,,,,fee schedule,,88.25,,,,fee schedule,,,1460.8,83,,percent of total billed charges,,162.89,,,,fee schedule,,,1584,90,,percent of total billed charges,,,1584,90,,percent of total billed charges,,,1584,90,,percent of total billed charges,,,1584,90,,percent of total billed charges,,,1496,85,,percent of total billed charges,,88.25,1672,
INJ FORAMEN EPIDURAL ADD-ON,64484,CDM,64484,CPT,,,both,,984,984,87.56,,,,fee schedule,,,,,,,,83.2,,,,fee schedule,,,836.4,85,,percent of total billed charges,,99.63,,,,fee schedule,,55.13,,,,fee schedule,,83.2,,,,fee schedule,,118.71,,,,fee schedule,,83.2,,,,fee schedule,,84.99,,,,fee schedule,,51.51,,,,fee schedule,,51.51,,,,fee schedule,,,895.44,91,,percent of total billed charges,,,934.8,95,,percent of total billed charges,,,816.72,83,,percent of total billed charges,,,295.2,83,,percent of total billed charges,,83.2,,,,fee schedule,,83.2,,,,fee schedule,,,816.72,83,,percent of total billed charges,,75.72,,,,fee schedule,,,885.6,90,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,885.6,90,,percent of total billed charges,,,836.4,85,,percent of total billed charges,,51.51,934.8,
FACET/JOINT NERVE Cervial/Thoracic FIRST INJ,64490,CDM,64490,CPT,,,both,,1453,1453,178.59,,,,fee schedule,,,,,,,,61.54,,,,fee schedule,,,1235.05,85,,percent of total billed charges,,203.07,,,,fee schedule,,112.37,,,,fee schedule,,61.54,,,,fee schedule,,,,,,,,61.54,,,,fee schedule,,173.33,,,,fee schedule,,105.05,,,,fee schedule,,105.05,,,,fee schedule,,,1322.23,91,,percent of total billed charges,,,1380.35,95,,percent of total billed charges,,,1205.99,83,,percent of total billed charges,,,435.9,83,,percent of total billed charges,,61.54,,,,fee schedule,,61.54,,,,fee schedule,,,1205.99,83,,percent of total billed charges,,154.42,,,,fee schedule,,,1307.7,90,,percent of total billed charges,,,1307.7,90,,percent of total billed charges,,,1307.7,90,,percent of total billed charges,,,1307.7,90,,percent of total billed charges,,,1235.05,85,,percent of total billed charges,,61.54,1380.35,
FACET/JOINT NERVE C/T EA ADD INJ,64491,CDM,64491,CPT,,,both,,811,811,100.81,,,,fee schedule,,,,,,,,35.62,,,,fee schedule,,,689.35,85,,percent of total billed charges,,114.75,,,,fee schedule,,63.5,,,,fee schedule,,35.62,,,,fee schedule,,,,,,,,35.62,,,,fee schedule,,97.85,,,,fee schedule,,59.3,,,,fee schedule,,59.3,,,,fee schedule,,,738.01,91,,percent of total billed charges,,,770.45,95,,percent of total billed charges,,,673.13,83,,percent of total billed charges,,,243.3,83,,percent of total billed charges,,35.62,,,,fee schedule,,35.62,,,,fee schedule,,,673.13,83,,percent of total billed charges,,87.17,,,,fee schedule,,,729.9,90,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,729.9,90,,percent of total billed charges,,,689.35,85,,percent of total billed charges,,35.62,770.45,
Third And Any Additional Levels Inj,64492,CDM,64492,CPT,,,both,,797,797,102.54,,,,fee schedule,,,,,,,,37.07,,,,fee schedule,,,677.45,85,,percent of total billed charges,,115.97,,,,fee schedule,,64.18,,,,fee schedule,,37.07,,,,fee schedule,,,,,,,,37.07,,,,fee schedule,,99.53,,,,fee schedule,,60.32,,,,fee schedule,,60.32,,,,fee schedule,,,725.27,91,,percent of total billed charges,,,757.15,95,,percent of total billed charges,,,661.51,83,,percent of total billed charges,,,239.1,83,,percent of total billed charges,,37.07,,,,fee schedule,,37.07,,,,fee schedule,,,661.51,83,,percent of total billed charges,,88.67,,,,fee schedule,,,717.3,90,,percent of total billed charges,,,717.3,90,,percent of total billed charges,,,717.3,90,,percent of total billed charges,,,717.3,90,,percent of total billed charges,,,677.45,85,,percent of total billed charges,,37.07,757.15,
FACET/JOINT NERVE Lumbar/Sacral FIRST INJ,64493,CDM,64493,CPT,,,both,,1397,1397,153.81,,,,fee schedule,,,,,,,,52.13,,,,fee schedule,,,1187.45,85,,percent of total billed charges,,171.61,,,,fee schedule,,94.96,,,,fee schedule,,52.13,,,,fee schedule,,,,,,,,52.13,,,,fee schedule,,149.29,,,,fee schedule,,90.48,,,,fee schedule,,90.48,,,,fee schedule,,,1271.27,91,,percent of total billed charges,,,1327.15,95,,percent of total billed charges,,,1159.51,83,,percent of total billed charges,,,419.1,83,,percent of total billed charges,,52.13,,,,fee schedule,,52.13,,,,fee schedule,,,1159.51,83,,percent of total billed charges,,133,,,,fee schedule,,,1257.3,90,,percent of total billed charges,,,1257.3,90,,percent of total billed charges,,,1257.3,90,,percent of total billed charges,,,1257.3,90,,percent of total billed charges,,,1187.45,85,,percent of total billed charges,,52.13,1327.15,
FACET/JOINT NERVE L/S EA ADD INJ,64494,CDM,64494,CPT,,,both,,745,745,86.99,,,,fee schedule,,,,,,,,30.39,,,,fee schedule,,,633.25,85,,percent of total billed charges,,99.02,,,,fee schedule,,54.79,,,,fee schedule,,30.39,,,,fee schedule,,,,,,,,30.39,,,,fee schedule,,84.43,,,,fee schedule,,51.17,,,,fee schedule,,51.17,,,,fee schedule,,,677.95,91,,percent of total billed charges,,,707.75,95,,percent of total billed charges,,,618.35,83,,percent of total billed charges,,,223.5,83,,percent of total billed charges,,30.39,,,,fee schedule,,30.39,,,,fee schedule,,,618.35,83,,percent of total billed charges,,75.22,,,,fee schedule,,,670.5,90,,percent of total billed charges,,,670.5,90,,percent of total billed charges,,,670.5,90,,percent of total billed charges,,,670.5,90,,percent of total billed charges,,,633.25,85,,percent of total billed charges,,30.39,707.75,
FACET/JOINT NERVE L/S INJ 3 Or More,64495,CDM,64495,CPT,,,both,,702,702,88.14,,,,fee schedule,,,,,,,,31.5,,,,fee schedule,,,596.7,85,,percent of total billed charges,,100.24,,,,fee schedule,,55.47,,,,fee schedule,,31.5,,,,fee schedule,,,,,,,,31.5,,,,fee schedule,,85.55,,,,fee schedule,,51.85,,,,fee schedule,,51.85,,,,fee schedule,,,638.82,91,,percent of total billed charges,,,666.9,95,,percent of total billed charges,,,582.66,83,,percent of total billed charges,,,210.6,83,,percent of total billed charges,,31.5,,,,fee schedule,,31.5,,,,fee schedule,,,582.66,83,,percent of total billed charges,,76.22,,,,fee schedule,,,631.8,90,,percent of total billed charges,,,631.8,90,,percent of total billed charges,,,631.8,90,,percent of total billed charges,,,631.8,90,,percent of total billed charges,,,596.7,85,,percent of total billed charges,,31.5,666.9,
"N BLOCK, STELLATE GANGLION",64510,CDM,64510,CPT,,,both,,1060,1060,130.77,,,,fee schedule,,,,,,,,59.6,,,,fee schedule,,,901,85,,percent of total billed charges,,146.16,,,,fee schedule,,80.88,,,,fee schedule,,59.6,,,,fee schedule,,119.38,,,,fee schedule,,59.6,,,,fee schedule,,126.92,,,,fee schedule,,76.92,,,,fee schedule,,76.92,,,,fee schedule,,,964.6,91,,percent of total billed charges,,,1007,95,,percent of total billed charges,,,879.8,83,,percent of total billed charges,,,318,83,,percent of total billed charges,,59.6,,,,fee schedule,,59.6,,,,fee schedule,,,879.8,83,,percent of total billed charges,,113.08,,,,fee schedule,,,954,90,,percent of total billed charges,,,954,90,,percent of total billed charges,,,954,90,,percent of total billed charges,,,954,90,,percent of total billed charges,,,901,85,,percent of total billed charges,,59.6,1007,
"N BLOCK INJ, HYPOGAS PLXS",64517,CDM,64517,CPT,,,both,,874,874,214.88,,,,fee schedule,,,,,,,,64.4,,,,fee schedule,,,742.9,85,,percent of total billed charges,,241.84,,,,fee schedule,,133.83,,,,fee schedule,,64.4,,,,fee schedule,,210.9,,,,fee schedule,,64.4,,,,fee schedule,,208.56,,,,fee schedule,,126.4,,,,fee schedule,,126.4,,,,fee schedule,,,795.34,91,,percent of total billed charges,,,830.3,95,,percent of total billed charges,,,725.42,83,,percent of total billed charges,,,262.2,83,,percent of total billed charges,,64.4,,,,fee schedule,,64.4,,,,fee schedule,,,725.42,83,,percent of total billed charges,,185.81,,,,fee schedule,,,786.6,90,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,786.6,90,,percent of total billed charges,,,742.9,85,,percent of total billed charges,,64.4,830.3,
"N BLOCK, LUMBAR/THORACIC",64520,CDM,64520,CPT,,,both,,1181,1181,143.44,,,,fee schedule,,,,,,,,56.2,,,,fee schedule,,,1003.85,85,,percent of total billed charges,,160.5,,,,fee schedule,,88.82,,,,fee schedule,,56.2,,,,fee schedule,,131.31,,,,fee schedule,,56.2,,,,fee schedule,,139.23,,,,fee schedule,,84.38,,,,fee schedule,,84.38,,,,fee schedule,,,1074.71,91,,percent of total billed charges,,,1121.95,95,,percent of total billed charges,,,980.23,83,,percent of total billed charges,,,354.3,83,,percent of total billed charges,,56.2,,,,fee schedule,,56.2,,,,fee schedule,,,980.23,83,,percent of total billed charges,,124.04,,,,fee schedule,,,1062.9,90,,percent of total billed charges,,,1062.9,90,,percent of total billed charges,,,1062.9,90,,percent of total billed charges,,,1062.9,90,,percent of total billed charges,,,1003.85,85,,percent of total billed charges,,56.2,1121.95,
"N BLOCK INJ, CELIAC PELUS",64530,CDM,64530,CPT,,,both,,1238,1238,161.3,,,,fee schedule,,,,,,,,58.7,,,,fee schedule,,,1052.3,85,,percent of total billed charges,,179.88,,,,fee schedule,,99.54,,,,fee schedule,,58.7,,,,fee schedule,,154.53,,,,fee schedule,,58.7,,,,fee schedule,,156.56,,,,fee schedule,,94.88,,,,fee schedule,,94.88,,,,fee schedule,,,1126.58,91,,percent of total billed charges,,,1176.1,95,,percent of total billed charges,,,1027.54,83,,percent of total billed charges,,,371.4,83,,percent of total billed charges,,58.7,,,,fee schedule,,58.7,,,,fee schedule,,,1027.54,83,,percent of total billed charges,,139.48,,,,fee schedule,,,1114.2,90,,percent of total billed charges,,,1114.2,90,,percent of total billed charges,,,1114.2,90,,percent of total billed charges,,,1114.2,90,,percent of total billed charges,,,1052.3,85,,percent of total billed charges,,58.7,1176.1,
APPLY NEUROSTIMULATOR,64550,CDM,64550,CPT,,,both,,71,71,,,,,,,,,,,,,,,,,,,,60.35,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,15.92,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,21.3,83,,percent of total billed charges,,,,,,,,,,,,,,,58.93,83,,percent of total billed charges,,,,,,,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,15.92,67.45,
APPLY NEUROSTIMULATOR,64550GP,CDM,64550,CPT,,,both,GP,71,71,,,,,,,,,,,,,,,,,,,,60.35,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,15.92,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,21.3,83,,percent of total billed charges,,,,,,,,,,,,,,,58.93,83,,percent of total billed charges,,,,,,,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,15.92,67.45,
IMPLANT NEUROELECTRODES,64555,CDM,64555,CPT,,,both,,997,997,555.92,,,,fee schedule,,,,,,,,60.8,,,,fee schedule,,,847.45,85,,percent of total billed charges,,630.58,,,,fee schedule,,348.94,,,,fee schedule,,60.8,,,,fee schedule,,242.73,,,,fee schedule,,60.8,,,,fee schedule,,539.57,,,,fee schedule,,327.01,,,,fee schedule,,327.01,,,,fee schedule,,,907.27,91,,percent of total billed charges,,,947.15,95,,percent of total billed charges,,,827.51,83,,percent of total billed charges,,,299.1,83,,percent of total billed charges,,60.8,,,,fee schedule,,60.8,,,,fee schedule,,,827.51,83,,percent of total billed charges,,480.71,,,,fee schedule,,,897.3,90,,percent of total billed charges,,,897.3,90,,percent of total billed charges,,,897.3,90,,percent of total billed charges,,,897.3,90,,percent of total billed charges,,,847.45,85,,percent of total billed charges,,60.8,947.15,
IMPLANT NEUROELECTRODES,64561,CDM,64561,CPT,,,both,,10875,10875,517.32,,,,fee schedule,,,,,,,,171.5,,,,fee schedule,,,9243.75,85,,percent of total billed charges,,587.51,,,,fee schedule,,325.11,,,,fee schedule,,171.5,,,,fee schedule,,663.87,,,,fee schedule,,171.5,,,,fee schedule,,502.11,,,,fee schedule,,304.31,,,,fee schedule,,304.31,,,,fee schedule,,,9896.25,91,,percent of total billed charges,,,10331.25,95,,percent of total billed charges,,,9026.25,83,,percent of total billed charges,,,3262.5,83,,percent of total billed charges,,171.5,,,,fee schedule,,171.5,,,,fee schedule,,,9026.25,83,,percent of total billed charges,,447.33,,,,fee schedule,,,9787.5,90,,percent of total billed charges,,,9787.5,90,,percent of total billed charges,,,9787.5,90,,percent of total billed charges,,,9787.5,90,,percent of total billed charges,,,9243.75,85,,percent of total billed charges,,171.5,10331.25,
NEUROELTRD STIM POST TIBIAL,64566,CDM,64566,CPT,,,both,,463,463,51.27,,,,fee schedule,,,,,,,,17.94,,,,fee schedule,,,393.55,85,,percent of total billed charges,,59.95,,,,fee schedule,,33.18,,,,fee schedule,,17.94,,,,fee schedule,,,,,,,,17.94,,,,fee schedule,,49.76,,,,fee schedule,,30.16,,,,fee schedule,,30.16,,,,fee schedule,,,421.33,91,,percent of total billed charges,,,439.85,95,,percent of total billed charges,,,384.29,83,,percent of total billed charges,,,138.9,83,,percent of total billed charges,,17.94,,,,fee schedule,,17.94,,,,fee schedule,,,384.29,83,,percent of total billed charges,,44.33,,,,fee schedule,,,416.7,90,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,393.55,85,,percent of total billed charges,,17.94,439.85,
NEUROELTRD STIM POST TIBIAL,64566P,CDM,64566,CPT,,,both,P,157,157,51.27,,,,fee schedule,,,,,,,,17.94,,,,fee schedule,,,133.45,85,,percent of total billed charges,,59.95,,,,fee schedule,,33.18,,,,fee schedule,,17.94,,,,fee schedule,,,,,,,,17.94,,,,fee schedule,,49.76,,,,fee schedule,,30.16,,,,fee schedule,,30.16,,,,fee schedule,,,142.87,91,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,47.1,83,,percent of total billed charges,,17.94,,,,fee schedule,,17.94,,,,fee schedule,,,130.31,83,,percent of total billed charges,,44.33,,,,fee schedule,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,133.45,85,,percent of total billed charges,,17.94,149.15,
NEUROELTRD STIM POST TIBIAL,64566T,CDM,64566,CPT,,,both,T,306,306,51.27,,,,fee schedule,,,,,,,,17.94,,,,fee schedule,,,260.1,85,,percent of total billed charges,,59.95,,,,fee schedule,,33.18,,,,fee schedule,,17.94,,,,fee schedule,,,,,,,,17.94,,,,fee schedule,,49.76,,,,fee schedule,,30.16,,,,fee schedule,,30.16,,,,fee schedule,,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,91.8,83,,percent of total billed charges,,17.94,,,,fee schedule,,17.94,,,,fee schedule,,,253.98,83,,percent of total billed charges,,44.33,,,,fee schedule,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,17.94,290.7,
INSRT/REDO PERPH N GENERATOR,64590,CDM,64590,CPT,,,both,,1137,1137,275.94,,,,fee schedule,,,,,,,,599.35,,,,fee schedule,,,966.45,85,,percent of total billed charges,,308.55,,,,fee schedule,,170.74,,,,fee schedule,,599.35,,,,fee schedule,,324.31,,,,fee schedule,,599.35,,,,fee schedule,,267.83,,,,fee schedule,,162.32,,,,fee schedule,,162.32,,,,fee schedule,,,1034.67,91,,percent of total billed charges,,,1080.15,95,,percent of total billed charges,,,943.71,83,,percent of total billed charges,,,341.1,83,,percent of total billed charges,,599.35,,,,fee schedule,,599.35,,,,fee schedule,,,943.71,83,,percent of total billed charges,,238.61,,,,fee schedule,,,1023.3,90,,percent of total billed charges,,,1023.3,90,,percent of total billed charges,,,1023.3,90,,percent of total billed charges,,,1023.3,90,,percent of total billed charges,,,966.45,85,,percent of total billed charges,,162.32,1080.15,
"DESTROY NERVE, FACE MUSCLE",64612,CDM,64612,CPT,,,both,,615,615,203.93,,,,fee schedule,,,,,,,,71.15,,,,fee schedule,,,522.75,85,,percent of total billed charges,,225.24,,,,fee schedule,,124.64,,,,fee schedule,,71.15,,,,fee schedule,,225.49,,,,fee schedule,,71.15,,,,fee schedule,,197.94,,,,fee schedule,,119.96,,,,fee schedule,,119.96,,,,fee schedule,,,559.65,91,,percent of total billed charges,,,584.25,95,,percent of total billed charges,,,510.45,83,,percent of total billed charges,,,184.5,83,,percent of total billed charges,,71.15,,,,fee schedule,,71.15,,,,fee schedule,,,510.45,83,,percent of total billed charges,,176.34,,,,fee schedule,,,553.5,90,,percent of total billed charges,,,553.5,90,,percent of total billed charges,,,553.5,90,,percent of total billed charges,,,553.5,90,,percent of total billed charges,,,522.75,85,,percent of total billed charges,,71.15,584.25,
CHEMODENERV MUSC MIGRAINE,64615,CDM,64615,CPT,,,both,,639,639,212,,,,fee schedule,,,,,,,,79.37,,,,fee schedule,,,543.15,85,,percent of total billed charges,,243.34,,,,fee schedule,,134.66,,,,fee schedule,,79.37,,,,fee schedule,,,,,,,,79.37,,,,fee schedule,,205.76,,,,fee schedule,,124.7,,,,fee schedule,,124.7,,,,fee schedule,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,191.7,83,,percent of total billed charges,,79.37,,,,fee schedule,,79.37,,,,fee schedule,,,530.37,83,,percent of total billed charges,,183.32,,,,fee schedule,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,79.37,607.05,
CHEMODENERV MUSC MIGRAINE,64615P,CDM,64615,CPT,,,both,P,470,470,212,,,,fee schedule,,,,,,,,79.37,,,,fee schedule,,,399.5,85,,percent of total billed charges,,243.34,,,,fee schedule,,134.66,,,,fee schedule,,79.37,,,,fee schedule,,,,,,,,79.37,,,,fee schedule,,205.76,,,,fee schedule,,124.7,,,,fee schedule,,124.7,,,,fee schedule,,,427.7,91,,percent of total billed charges,,,446.5,95,,percent of total billed charges,,,390.1,83,,percent of total billed charges,,,141,83,,percent of total billed charges,,79.37,,,,fee schedule,,79.37,,,,fee schedule,,,390.1,83,,percent of total billed charges,,183.32,,,,fee schedule,,,423,90,,percent of total billed charges,,,423,90,,percent of total billed charges,,,423,90,,percent of total billed charges,,,423,90,,percent of total billed charges,,,399.5,85,,percent of total billed charges,,79.37,446.5,
CHEMODENERV MUSC MIGRAINE,64615T,CDM,64615,CPT,,,both,T,169,169,212,,,,fee schedule,,,,,,,,79.37,,,,fee schedule,,,143.65,85,,percent of total billed charges,,243.34,,,,fee schedule,,134.66,,,,fee schedule,,79.37,,,,fee schedule,,,,,,,,79.37,,,,fee schedule,,205.76,,,,fee schedule,,124.7,,,,fee schedule,,124.7,,,,fee schedule,,,153.79,91,,percent of total billed charges,,,160.55,95,,percent of total billed charges,,,140.27,83,,percent of total billed charges,,,50.7,83,,percent of total billed charges,,79.37,,,,fee schedule,,79.37,,,,fee schedule,,,140.27,83,,percent of total billed charges,,183.32,,,,fee schedule,,,152.1,90,,percent of total billed charges,,,152.1,90,,percent of total billed charges,,,152.1,90,,percent of total billed charges,,,152.1,90,,percent of total billed charges,,,143.65,85,,percent of total billed charges,,50.7,243.34,
CHEMODENERV MUSC NECK DYSTON,64616,CDM,64616,CPT,,,both,,558,558,187.23,,,,fee schedule,,,,,,,,66.54,,,,fee schedule,,,474.3,85,,percent of total billed charges,,214.69,,,,fee schedule,,118.8,,,,fee schedule,,66.54,,,,fee schedule,,,,,,,,66.54,,,,fee schedule,,181.72,,,,fee schedule,,110.13,,,,fee schedule,,110.13,,,,fee schedule,,,507.78,91,,percent of total billed charges,,,530.1,95,,percent of total billed charges,,,463.14,83,,percent of total billed charges,,,167.4,83,,percent of total billed charges,,66.54,,,,fee schedule,,66.54,,,,fee schedule,,,463.14,83,,percent of total billed charges,,161.9,,,,fee schedule,,,502.2,90,,percent of total billed charges,,,502.2,90,,percent of total billed charges,,,502.2,90,,percent of total billed charges,,,502.2,90,,percent of total billed charges,,,474.3,85,,percent of total billed charges,,66.54,530.1,
CHEMODENERV MUSC NECK DYSTON,64616P,CDM,64616,CPT,,,both,P,391,391,187.23,,,,fee schedule,,,,,,,,66.54,,,,fee schedule,,,332.35,85,,percent of total billed charges,,214.69,,,,fee schedule,,118.8,,,,fee schedule,,66.54,,,,fee schedule,,,,,,,,66.54,,,,fee schedule,,181.72,,,,fee schedule,,110.13,,,,fee schedule,,110.13,,,,fee schedule,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,117.3,83,,percent of total billed charges,,66.54,,,,fee schedule,,66.54,,,,fee schedule,,,324.53,83,,percent of total billed charges,,161.9,,,,fee schedule,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,66.54,371.45,
CHEMODENERV MUSC NECK DYSTON,64616T,CDM,64616,CPT,,,both,T,167,167,187.23,,,,fee schedule,,,,,,,,66.54,,,,fee schedule,,,141.95,85,,percent of total billed charges,,214.69,,,,fee schedule,,118.8,,,,fee schedule,,66.54,,,,fee schedule,,,,,,,,66.54,,,,fee schedule,,181.72,,,,fee schedule,,110.13,,,,fee schedule,,110.13,,,,fee schedule,,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,50.1,83,,percent of total billed charges,,66.54,,,,fee schedule,,66.54,,,,fee schedule,,,138.61,83,,percent of total billed charges,,161.9,,,,fee schedule,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,50.1,214.69,
DSTRJ NULYT AGT GNCLR NRV,64624,CDM,64624,CPT,,,both,,2040,2040,248.29,,,,fee schedule,,,,,,,,179.8,,,,fee schedule,,,1734,85,,percent of total billed charges,,280.25,,,,fee schedule,,155.08,,,,fee schedule,,179.8,,,,fee schedule,,,,,,,,179.8,,,,fee schedule,,240.99,,,,fee schedule,,146.05,,,,fee schedule,,146.05,,,,fee schedule,,,1856.4,91,,percent of total billed charges,,,1938,95,,percent of total billed charges,,,1693.2,83,,percent of total billed charges,,,612,83,,percent of total billed charges,,179.8,,,,fee schedule,,179.8,,,,fee schedule,,,1693.2,83,,percent of total billed charges,,214.7,,,,fee schedule,,,1836,90,,percent of total billed charges,,,1836,90,,percent of total billed charges,,,1836,90,,percent of total billed charges,,,1836,90,,percent of total billed charges,,,1734,85,,percent of total billed charges,,146.05,1938,
DESTROY CERV/THOR FACET JOINT,64633,CDM,64633,CPT,,,both,,2258,2258,325.49,,,,fee schedule,,,,,,,,138.48,,,,fee schedule,,,1919.3,85,,percent of total billed charges,,367.68,,,,fee schedule,,203.46,,,,fee schedule,,138.48,,,,fee schedule,,,,,,,,138.48,,,,fee schedule,,315.91,,,,fee schedule,,191.46,,,,fee schedule,,191.46,,,,fee schedule,,,2054.78,91,,percent of total billed charges,,,2145.1,95,,percent of total billed charges,,,1874.14,83,,percent of total billed charges,,,677.4,83,,percent of total billed charges,,138.48,,,,fee schedule,,138.48,,,,fee schedule,,,1874.14,83,,percent of total billed charges,,281.45,,,,fee schedule,,,2032.2,90,,percent of total billed charges,,,2032.2,90,,percent of total billed charges,,,2032.2,90,,percent of total billed charges,,,2032.2,90,,percent of total billed charges,,,1919.3,85,,percent of total billed charges,,138.48,2145.1,
DESTROY CERV/THOR FACET JOINT ADDITIONAL,64634,CDM,64634,CPT,,,both,,1128,1128,113.49,,,,fee schedule,,,,,,,,167.36,,,,fee schedule,,,958.8,85,,percent of total billed charges,,129.27,,,,fee schedule,,71.54,,,,fee schedule,,167.36,,,,fee schedule,,,,,,,,167.36,,,,fee schedule,,110.15,,,,fee schedule,,66.76,,,,fee schedule,,66.76,,,,fee schedule,,,1026.48,91,,percent of total billed charges,,,1071.6,95,,percent of total billed charges,,,936.24,83,,percent of total billed charges,,,338.4,83,,percent of total billed charges,,167.36,,,,fee schedule,,167.36,,,,fee schedule,,,936.24,83,,percent of total billed charges,,98.13,,,,fee schedule,,,1015.2,90,,percent of total billed charges,,,1015.2,90,,percent of total billed charges,,,1015.2,90,,percent of total billed charges,,,1015.2,90,,percent of total billed charges,,,958.8,85,,percent of total billed charges,,66.76,1071.6,
DESTROY LUMB/SAC FACET JOINT,64635,CDM,64635,CPT,,,both,,2206,2206,326.06,,,,fee schedule,,,,,,,,135.68,,,,fee schedule,,,1875.1,85,,percent of total billed charges,,367.5,,,,fee schedule,,203.36,,,,fee schedule,,135.68,,,,fee schedule,,,,,,,,135.68,,,,fee schedule,,316.47,,,,fee schedule,,191.8,,,,fee schedule,,191.8,,,,fee schedule,,,2007.46,91,,percent of total billed charges,,,2095.7,95,,percent of total billed charges,,,1830.98,83,,percent of total billed charges,,,661.8,83,,percent of total billed charges,,135.68,,,,fee schedule,,135.68,,,,fee schedule,,,1830.98,83,,percent of total billed charges,,281.95,,,,fee schedule,,,1985.4,90,,percent of total billed charges,,,1985.4,90,,percent of total billed charges,,,1985.4,90,,percent of total billed charges,,,1985.4,90,,percent of total billed charges,,,1875.1,85,,percent of total billed charges,,135.68,2095.7,
DESTROY LUMB/SAC FACET JOINT ADDITIONAL,64636,CDM,64636,CPT,,,both,,1033,1033,100.24,,,,fee schedule,,,,,,,,145.4,,,,fee schedule,,,878.05,85,,percent of total billed charges,,115.36,,,,fee schedule,,63.16,,,,fee schedule,,145.4,,,,fee schedule,,,,,,,,145.4,,,,fee schedule,,97.29,,,,fee schedule,,58.96,,,,fee schedule,,58.96,,,,fee schedule,,,940.03,91,,percent of total billed charges,,,981.35,95,,percent of total billed charges,,,857.39,83,,percent of total billed charges,,,309.9,83,,percent of total billed charges,,145.4,,,,fee schedule,,145.4,,,,fee schedule,,,857.39,83,,percent of total billed charges,,86.68,,,,fee schedule,,,929.7,90,,percent of total billed charges,,,929.7,90,,percent of total billed charges,,,929.7,90,,percent of total billed charges,,,929.7,90,,percent of total billed charges,,,878.05,85,,percent of total billed charges,,58.96,981.35,
US Cryoanalgesia Inj,64640,CDM,64640,CPT,,,both,,3605,3605,201.63,,,,fee schedule,,,,,,,,90.5,,,,fee schedule,,,3064.25,85,,percent of total billed charges,,227.15,,,,fee schedule,,125.7,,,,fee schedule,,90.5,,,,fee schedule,,323.64,,,,fee schedule,,90.5,,,,fee schedule,,195.7,,,,fee schedule,,118.61,,,,fee schedule,,118.61,,,,fee schedule,,,3280.55,91,,percent of total billed charges,,,3424.75,95,,percent of total billed charges,,,2992.15,83,,percent of total billed charges,,,1081.5,83,,percent of total billed charges,,90.5,,,,fee schedule,,90.5,,,,fee schedule,,,2992.15,83,,percent of total billed charges,,174.35,,,,fee schedule,,,3244.5,90,,percent of total billed charges,,,3244.5,90,,percent of total billed charges,,,3244.5,90,,percent of total billed charges,,,3244.5,90,,percent of total billed charges,,,3064.25,85,,percent of total billed charges,,90.5,3424.75,
CHEMODENERV 1 EXTREMITY 1-4,64642,CDM,64642,CPT,,,both,,630,630,182.04,,,,fee schedule,,,,,,,,65.69,,,,fee schedule,,,535.5,85,,percent of total billed charges,,210.37,,,,fee schedule,,116.41,,,,fee schedule,,65.69,,,,fee schedule,,,,,,,,65.69,,,,fee schedule,,176.69,,,,fee schedule,,107.08,,,,fee schedule,,107.08,,,,fee schedule,,,573.3,91,,percent of total billed charges,,,598.5,95,,percent of total billed charges,,,522.9,83,,percent of total billed charges,,,189,83,,percent of total billed charges,,65.69,,,,fee schedule,,65.69,,,,fee schedule,,,522.9,83,,percent of total billed charges,,157.41,,,,fee schedule,,,567,90,,percent of total billed charges,,,567,90,,percent of total billed charges,,,567,90,,percent of total billed charges,,,567,90,,percent of total billed charges,,,535.5,85,,percent of total billed charges,,65.69,598.5,
CHEMODENERV 1 EXTREMITY 1-4,64642P,CDM,64642,CPT,,,both,P,461,461,182.04,,,,fee schedule,,,,,,,,65.69,,,,fee schedule,,,391.85,85,,percent of total billed charges,,210.37,,,,fee schedule,,116.41,,,,fee schedule,,65.69,,,,fee schedule,,,,,,,,65.69,,,,fee schedule,,176.69,,,,fee schedule,,107.08,,,,fee schedule,,107.08,,,,fee schedule,,,419.51,91,,percent of total billed charges,,,437.95,95,,percent of total billed charges,,,382.63,83,,percent of total billed charges,,,138.3,83,,percent of total billed charges,,65.69,,,,fee schedule,,65.69,,,,fee schedule,,,382.63,83,,percent of total billed charges,,157.41,,,,fee schedule,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,414.9,90,,percent of total billed charges,,,391.85,85,,percent of total billed charges,,65.69,437.95,
CHEMODENERV 1 EXTREMITY 1-4,64642T,CDM,64642,CPT,,,both,T,169,169,182.04,,,,fee schedule,,,,,,,,65.69,,,,fee schedule,,,143.65,85,,percent of total billed charges,,210.37,,,,fee schedule,,116.41,,,,fee schedule,,65.69,,,,fee schedule,,,,,,,,65.69,,,,fee schedule,,176.69,,,,fee schedule,,107.08,,,,fee schedule,,107.08,,,,fee schedule,,,153.79,91,,percent of total billed charges,,,160.55,95,,percent of total billed charges,,,140.27,83,,percent of total billed charges,,,50.7,83,,percent of total billed charges,,65.69,,,,fee schedule,,65.69,,,,fee schedule,,,140.27,83,,percent of total billed charges,,157.41,,,,fee schedule,,,152.1,90,,percent of total billed charges,,,152.1,90,,percent of total billed charges,,,152.1,90,,percent of total billed charges,,,152.1,90,,percent of total billed charges,,,143.65,85,,percent of total billed charges,,50.7,210.37,
INJECTION TREATMENT OF NERVE,64680,CDM,64680,CPT,,,both,,1178,1178,275.94,,,,fee schedule,,,,,,,,224.7,,,,fee schedule,,,1001.3,85,,percent of total billed charges,,307.62,,,,fee schedule,,170.23,,,,fee schedule,,224.7,,,,fee schedule,,280.54,,,,fee schedule,,224.7,,,,fee schedule,,267.83,,,,fee schedule,,162.32,,,,fee schedule,,162.32,,,,fee schedule,,,1071.98,91,,percent of total billed charges,,,1119.1,95,,percent of total billed charges,,,977.74,83,,percent of total billed charges,,,353.4,83,,percent of total billed charges,,224.7,,,,fee schedule,,224.7,,,,fee schedule,,,977.74,83,,percent of total billed charges,,238.61,,,,fee schedule,,,1060.2,90,,percent of total billed charges,,,1060.2,90,,percent of total billed charges,,,1060.2,90,,percent of total billed charges,,,1060.2,90,,percent of total billed charges,,,1001.3,85,,percent of total billed charges,,162.32,1119.1,
INJECTION TREATMENT OF NERVE,64681,CDM,64681,CPT,,,both,,907,907,379.64,,,,fee schedule,,,,,,,,116.11,,,,fee schedule,,,770.95,85,,percent of total billed charges,,429.81,,,,fee schedule,,237.85,,,,fee schedule,,116.11,,,,fee schedule,,389.97,,,,fee schedule,,116.11,,,,fee schedule,,368.47,,,,fee schedule,,223.32,,,,fee schedule,,223.32,,,,fee schedule,,,825.37,91,,percent of total billed charges,,,861.65,95,,percent of total billed charges,,,752.81,83,,percent of total billed charges,,,272.1,83,,percent of total billed charges,,116.11,,,,fee schedule,,116.11,,,,fee schedule,,,752.81,83,,percent of total billed charges,,328.28,,,,fee schedule,,,816.3,90,,percent of total billed charges,,,816.3,90,,percent of total billed charges,,,816.3,90,,percent of total billed charges,,,816.3,90,,percent of total billed charges,,,770.95,85,,percent of total billed charges,,116.11,861.65,
REVISE ARM/LEG NERVE,64708,CDM,64708,CPT,,,both,,3387,3387,868.16,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,2878.95,85,,percent of total billed charges,,967.43,,,,fee schedule,,535.35,,,,fee schedule,,524.4,,,,fee schedule,,789.88,,,,fee schedule,,524.4,,,,fee schedule,,842.62,,,,fee schedule,,510.68,,,,fee schedule,,510.68,,,,fee schedule,,,3082.17,91,,percent of total billed charges,,,3217.65,95,,percent of total billed charges,,,2811.21,83,,percent of total billed charges,,,1016.1,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,2811.21,83,,percent of total billed charges,,750.7,,,,fee schedule,,,3048.3,90,,percent of total billed charges,,,3048.3,90,,percent of total billed charges,,,3048.3,90,,percent of total billed charges,,,3048.3,90,,percent of total billed charges,,,2878.95,85,,percent of total billed charges,,510.68,3217.65,
REVISION OF ARM NERVE(S),64713,CDM,64713,CPT,,,both,,6229,6229,1377.41,,,,fee schedule,,,,,,,,647.9,,,,fee schedule,,,5294.65,85,,percent of total billed charges,,1542.14,,,,fee schedule,,853.37,,,,fee schedule,,647.9,,,,fee schedule,,1232.9,,,,fee schedule,,647.9,,,,fee schedule,,1336.9,,,,fee schedule,,810.24,,,,fee schedule,,810.24,,,,fee schedule,,,5668.39,91,,percent of total billed charges,,,5917.55,95,,percent of total billed charges,,,5170.07,83,,percent of total billed charges,,,1868.7,83,,percent of total billed charges,,647.9,,,,fee schedule,,647.9,,,,fee schedule,,,5170.07,83,,percent of total billed charges,,1191.06,,,,fee schedule,,,5606.1,90,,percent of total billed charges,,,5606.1,90,,percent of total billed charges,,,5606.1,90,,percent of total billed charges,,,5606.1,90,,percent of total billed charges,,,5294.65,85,,percent of total billed charges,,647.9,5917.55,
REVISE ULNAR NERVE AT ELBOW,64718,CDM,64718,CPT,,,both,,3707,3707,1048.47,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,3150.95,85,,percent of total billed charges,,1156.19,,,,fee schedule,,639.8,,,,fee schedule,,524.4,,,,fee schedule,,862.83,,,,fee schedule,,524.4,,,,fee schedule,,1017.63,,,,fee schedule,,616.75,,,,fee schedule,,616.75,,,,fee schedule,,,3373.37,91,,percent of total billed charges,,,3521.65,95,,percent of total billed charges,,,3076.81,83,,percent of total billed charges,,,1112.1,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,3076.81,83,,percent of total billed charges,,906.62,,,,fee schedule,,,3336.3,90,,percent of total billed charges,,,3336.3,90,,percent of total billed charges,,,3336.3,90,,percent of total billed charges,,,3336.3,90,,percent of total billed charges,,,3150.95,85,,percent of total billed charges,,524.4,3521.65,
REVISE ULNAR NERVE AT WRIST,64719,CDM,64719,CPT,,,both,,2570,2570,709.73,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,2184.5,85,,percent of total billed charges,,784.37,,,,fee schedule,,434.04,,,,fee schedule,,524.4,,,,fee schedule,,671.83,,,,fee schedule,,524.4,,,,fee schedule,,688.86,,,,fee schedule,,417.49,,,,fee schedule,,417.49,,,,fee schedule,,,2338.7,91,,percent of total billed charges,,,2441.5,95,,percent of total billed charges,,,2133.1,83,,percent of total billed charges,,,771,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,2133.1,83,,percent of total billed charges,,613.71,,,,fee schedule,,,2313,90,,percent of total billed charges,,,2313,90,,percent of total billed charges,,,2313,90,,percent of total billed charges,,,2313,90,,percent of total billed charges,,,2184.5,85,,percent of total billed charges,,417.49,2441.5,
CARPAL TUNNEL SURGERY,64721,CDM,64721,CPT,,,both,,2835,2835,760.43,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,2409.75,85,,percent of total billed charges,,836.85,,,,fee schedule,,463.09,,,,fee schedule,,524.4,,,,fee schedule,,687.08,,,,fee schedule,,524.4,,,,fee schedule,,738.06,,,,fee schedule,,447.31,,,,fee schedule,,447.31,,,,fee schedule,,,2579.85,91,,percent of total billed charges,,,2693.25,95,,percent of total billed charges,,,2353.05,83,,percent of total billed charges,,,850.5,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,2353.05,83,,percent of total billed charges,,657.55,,,,fee schedule,,,2551.5,90,,percent of total billed charges,,,2551.5,90,,percent of total billed charges,,,2551.5,90,,percent of total billed charges,,,2551.5,90,,percent of total billed charges,,,2409.75,85,,percent of total billed charges,,447.31,2693.25,
CARPAL TUNNEL SURGERY,64721AS,CDM,64721,CPT,,,both,AS,689,689,760.43,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,585.65,85,,percent of total billed charges,,836.85,,,,fee schedule,,463.09,,,,fee schedule,,524.4,,,,fee schedule,,687.08,,,,fee schedule,,524.4,,,,fee schedule,,738.06,,,,fee schedule,,447.31,,,,fee schedule,,447.31,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,571.87,83,,percent of total billed charges,,657.55,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,206.7,836.85,
INTERNAL NERVE REVISION,64727,CDM,64727,CPT,,,both,,1356,1356,306.48,,,,fee schedule,,,,,,,,524.4,,,,fee schedule,,,1152.6,85,,percent of total billed charges,,350.69,,,,fee schedule,,194.06,,,,fee schedule,,524.4,,,,fee schedule,,336.25,,,,fee schedule,,524.4,,,,fee schedule,,297.46,,,,fee schedule,,180.28,,,,fee schedule,,180.28,,,,fee schedule,,,1233.96,91,,percent of total billed charges,,,1288.2,95,,percent of total billed charges,,,1125.48,83,,percent of total billed charges,,,406.8,83,,percent of total billed charges,,524.4,,,,fee schedule,,524.4,,,,fee schedule,,,1125.48,83,,percent of total billed charges,,265.01,,,,fee schedule,,,1220.4,90,,percent of total billed charges,,,1220.4,90,,percent of total billed charges,,,1220.4,90,,percent of total billed charges,,,1220.4,90,,percent of total billed charges,,,1152.6,85,,percent of total billed charges,,180.28,1288.2,
REPAIR/TRANSPOSE NERVE,64856,CDM,64856,CPT,,,both,,6011,6011,1744.95,,,,fee schedule,,,,,,,,449.5,,,,fee schedule,,,5109.35,85,,percent of total billed charges,,1965.02,,,,fee schedule,,1087.38,,,,fee schedule,,449.5,,,,fee schedule,,1660.67,,,,fee schedule,,449.5,,,,fee schedule,,1693.63,,,,fee schedule,,1026.44,,,,fee schedule,,1026.44,,,,fee schedule,,,5470.01,91,,percent of total billed charges,,,5710.45,95,,percent of total billed charges,,,4989.13,83,,percent of total billed charges,,,1803.3,83,,percent of total billed charges,,449.5,,,,fee schedule,,449.5,,,,fee schedule,,,4989.13,83,,percent of total billed charges,,1508.87,,,,fee schedule,,,5409.9,90,,percent of total billed charges,,,5409.9,90,,percent of total billed charges,,,5409.9,90,,percent of total billed charges,,,5409.9,90,,percent of total billed charges,,,5109.35,85,,percent of total billed charges,,449.5,5710.45,
NERVOUS SYSTEM SURGERY,64999,CDM,64999,CPT,,,both,,1216,1216,,,,,,,,,,,,,,,,,,,,1033.6,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1106.56,91,,percent of total billed charges,,,1155.2,95,,percent of total billed charges,,,1009.28,83,,percent of total billed charges,,,364.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1009.28,83,,percent of total billed charges,,,,,,,,,1094.4,90,,percent of total billed charges,,,1094.4,90,,percent of total billed charges,,,1094.4,90,,percent of total billed charges,,,1094.4,90,,percent of total billed charges,,,1033.6,85,,percent of total billed charges,,364.8,1155.2,
REMOVE FOREIGN BODY FROM EYE,65205,CDM,65205,CPT,,,both,,270,270,49.54,,,,fee schedule,,,,,,,,58.15,,,,fee schedule,,,229.5,85,,percent of total billed charges,,53.59,,,,fee schedule,,30.04,,,,fee schedule,,58.15,,,,fee schedule,,68.97,,,,fee schedule,,58.15,,,,fee schedule,,48.09,,,,fee schedule,,29.14,,,,fee schedule,,29.14,,,,fee schedule,,,245.7,91,,percent of total billed charges,,,256.5,95,,percent of total billed charges,,,224.1,83,,percent of total billed charges,,,81,83,,percent of total billed charges,,58.15,,,,fee schedule,,58.15,,,,fee schedule,,,224.1,83,,percent of total billed charges,,42.84,,,,fee schedule,,,243,90,,percent of total billed charges,,,243,90,,percent of total billed charges,,,243,90,,percent of total billed charges,,,243,90,,percent of total billed charges,,,229.5,85,,percent of total billed charges,,29.14,256.5,
REMOVE FOREIGN BODY FROM EYE,65205P,CDM,65205,CPT,,,both,P,115,115,49.54,,,,fee schedule,,,,,,,,58.15,,,,fee schedule,,,97.75,85,,percent of total billed charges,,53.59,,,,fee schedule,,30.04,,,,fee schedule,,58.15,,,,fee schedule,,68.97,,,,fee schedule,,58.15,,,,fee schedule,,48.09,,,,fee schedule,,29.14,,,,fee schedule,,29.14,,,,fee schedule,,,104.65,91,,percent of total billed charges,,,109.25,95,,percent of total billed charges,,,95.45,83,,percent of total billed charges,,,34.5,83,,percent of total billed charges,,58.15,,,,fee schedule,,58.15,,,,fee schedule,,,95.45,83,,percent of total billed charges,,42.84,,,,fee schedule,,,103.5,90,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,97.75,85,,percent of total billed charges,,29.14,109.25,
REMOVE FOREIGN BODY FROM EYE,65205T,CDM,65205,CPT,,,both,T,155,155,49.54,,,,fee schedule,,,,,,,,58.15,,,,fee schedule,,,131.75,85,,percent of total billed charges,,53.59,,,,fee schedule,,30.04,,,,fee schedule,,58.15,,,,fee schedule,,68.97,,,,fee schedule,,58.15,,,,fee schedule,,48.09,,,,fee schedule,,29.14,,,,fee schedule,,29.14,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,58.15,,,,fee schedule,,58.15,,,,fee schedule,,,128.65,83,,percent of total billed charges,,42.84,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,29.14,147.25,
REMOVE FOREIGN BODY FROM EYE,65210,CDM,65210,CPT,,,both,,298,298,61.06,,,,fee schedule,,,,,,,,62.6,,,,fee schedule,,,253.3,85,,percent of total billed charges,,66.07,,,,fee schedule,,37.03,,,,fee schedule,,62.6,,,,fee schedule,,83.56,,,,fee schedule,,62.6,,,,fee schedule,,59.27,,,,fee schedule,,35.92,,,,fee schedule,,35.92,,,,fee schedule,,,271.18,91,,percent of total billed charges,,,283.1,95,,percent of total billed charges,,,247.34,83,,percent of total billed charges,,,89.4,83,,percent of total billed charges,,62.6,,,,fee schedule,,62.6,,,,fee schedule,,,247.34,83,,percent of total billed charges,,52.8,,,,fee schedule,,,268.2,90,,percent of total billed charges,,,268.2,90,,percent of total billed charges,,,268.2,90,,percent of total billed charges,,,268.2,90,,percent of total billed charges,,,253.3,85,,percent of total billed charges,,35.92,283.1,
REMOVE FOREIGN BODY FROM EYE,65220,CDM,65220,CPT,,,both,,388,388,70.86,,,,fee schedule,,,,,,,,73.5,,,,fee schedule,,,329.8,85,,percent of total billed charges,,76.35,,,,fee schedule,,42.8,,,,fee schedule,,73.5,,,,fee schedule,,68.97,,,,fee schedule,,73.5,,,,fee schedule,,68.77,,,,fee schedule,,41.68,,,,fee schedule,,41.68,,,,fee schedule,,,353.08,91,,percent of total billed charges,,,368.6,95,,percent of total billed charges,,,322.04,83,,percent of total billed charges,,,116.4,83,,percent of total billed charges,,73.5,,,,fee schedule,,73.5,,,,fee schedule,,,322.04,83,,percent of total billed charges,,61.27,,,,fee schedule,,,349.2,90,,percent of total billed charges,,,349.2,90,,percent of total billed charges,,,349.2,90,,percent of total billed charges,,,349.2,90,,percent of total billed charges,,,329.8,85,,percent of total billed charges,,41.68,368.6,
REMOVE FOREIGN BODY FROM EYE,65222,CDM,65222,CPT,,,both,,361,361,84.68,,,,fee schedule,,,,,,,,64.6,,,,fee schedule,,,306.85,85,,percent of total billed charges,,107.57,,,,fee schedule,,51.41,,,,fee schedule,,64.6,,,,fee schedule,,90.2,,,,fee schedule,,64.6,,,,fee schedule,,82.19,,,,fee schedule,,49.81,,,,fee schedule,,49.81,,,,fee schedule,,,328.51,91,,percent of total billed charges,,,342.95,95,,percent of total billed charges,,,299.63,83,,percent of total billed charges,,,108.3,83,,percent of total billed charges,,64.6,,,,fee schedule,,64.6,,,,fee schedule,,,299.63,83,,percent of total billed charges,,73.23,,,,fee schedule,,,324.9,90,,percent of total billed charges,,,324.9,90,,percent of total billed charges,,,324.9,90,,percent of total billed charges,,,324.9,90,,percent of total billed charges,,,306.85,85,,percent of total billed charges,,49.81,342.95,
REMOVE EYELID LESIONS,67805,CDM,67805,CPT,,,both,,802,802,277.67,,,,fee schedule,,,,,,,,99.05,,,,fee schedule,,,681.7,85,,percent of total billed charges,,295.66,,,,fee schedule,,165.72,,,,fee schedule,,99.05,,,,fee schedule,,263.96,,,,fee schedule,,99.05,,,,fee schedule,,269.5,,,,fee schedule,,163.34,,,,fee schedule,,163.34,,,,fee schedule,,,729.82,91,,percent of total billed charges,,,761.9,95,,percent of total billed charges,,,665.66,83,,percent of total billed charges,,,240.6,83,,percent of total billed charges,,99.05,,,,fee schedule,,99.05,,,,fee schedule,,,665.66,83,,percent of total billed charges,,240.1,,,,fee schedule,,,721.8,90,,percent of total billed charges,,,721.8,90,,percent of total billed charges,,,721.8,90,,percent of total billed charges,,,721.8,90,,percent of total billed charges,,,681.7,85,,percent of total billed charges,,99.05,761.9,
REMOVE EYELID LESION,67840,CDM,67840,CPT,,,both,,1218,1218,267.3,,,,fee schedule,,,,,,,,93.3,,,,fee schedule,,,1035.3,85,,percent of total billed charges,,283.85,,,,fee schedule,,159.1,,,,fee schedule,,93.3,,,,fee schedule,,251.36,,,,fee schedule,,93.3,,,,fee schedule,,259.44,,,,fee schedule,,157.24,,,,fee schedule,,157.24,,,,fee schedule,,,1108.38,91,,percent of total billed charges,,,1157.1,95,,percent of total billed charges,,,1010.94,83,,percent of total billed charges,,,365.4,83,,percent of total billed charges,,93.3,,,,fee schedule,,93.3,,,,fee schedule,,,1010.94,83,,percent of total billed charges,,231.14,,,,fee schedule,,,1096.2,90,,percent of total billed charges,,,1096.2,90,,percent of total billed charges,,,1096.2,90,,percent of total billed charges,,,1096.2,90,,percent of total billed charges,,,1035.3,85,,percent of total billed charges,,93.3,1157.1,
EXC RPR EYELID < ONE-4TH LID MRGN,67961,CDM,67961,CPT,,,both,,3822,3822,768.49,,,,fee schedule,,,,,,,,324.05,,,,fee schedule,,,3248.7,85,,percent of total billed charges,,814.98,,,,fee schedule,,456.81,,,,fee schedule,,324.05,,,,fee schedule,,732.18,,,,fee schedule,,324.05,,,,fee schedule,,745.89,,,,fee schedule,,452.06,,,,fee schedule,,452.06,,,,fee schedule,,,3478.02,91,,percent of total billed charges,,,3630.9,95,,percent of total billed charges,,,3172.26,83,,percent of total billed charges,,,1146.6,83,,percent of total billed charges,,324.05,,,,fee schedule,,324.05,,,,fee schedule,,,3172.26,83,,percent of total billed charges,,664.52,,,,fee schedule,,,3439.8,90,,percent of total billed charges,,,3439.8,90,,percent of total billed charges,,,3439.8,90,,percent of total billed charges,,,3439.8,90,,percent of total billed charges,,,3248.7,85,,percent of total billed charges,,324.05,3630.9,
DRAIN EXTERNAL EAR LESION,69000,CDM,69000,CPT,,,both,,599,599,216.03,,,,fee schedule,,,,,,,,42.4,,,,fee schedule,,,509.15,85,,percent of total billed charges,,219.87,,,,fee schedule,,128.3,,,,fee schedule,,42.4,,,,fee schedule,,194.32,,,,fee schedule,,42.4,,,,fee schedule,,209.68,,,,fee schedule,,127.08,,,,fee schedule,,127.08,,,,fee schedule,,,545.09,91,,percent of total billed charges,,,569.05,95,,percent of total billed charges,,,497.17,83,,percent of total billed charges,,,179.7,83,,percent of total billed charges,,42.4,,,,fee schedule,,42.4,,,,fee schedule,,,497.17,83,,percent of total billed charges,,186.8,,,,fee schedule,,,539.1,90,,percent of total billed charges,,,539.1,90,,percent of total billed charges,,,539.1,90,,percent of total billed charges,,,539.1,90,,percent of total billed charges,,,509.15,85,,percent of total billed charges,,42.4,569.05,
DRAIN OUTER EAR CANAL LESION,69020,CDM,69020,CPT,,,both,,622,622,250.6,,,,fee schedule,,,,,,,,44.6,,,,fee schedule,,,528.7,85,,percent of total billed charges,,253.84,,,,fee schedule,,148.13,,,,fee schedule,,44.6,,,,fee schedule,,242.73,,,,fee schedule,,44.6,,,,fee schedule,,243.23,,,,fee schedule,,147.41,,,,fee schedule,,147.41,,,,fee schedule,,,566.02,91,,percent of total billed charges,,,590.9,95,,percent of total billed charges,,,516.26,83,,percent of total billed charges,,,186.6,83,,percent of total billed charges,,44.6,,,,fee schedule,,44.6,,,,fee schedule,,,516.26,83,,percent of total billed charges,,216.69,,,,fee schedule,,,559.8,90,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,559.8,90,,percent of total billed charges,,,528.7,85,,percent of total billed charges,,44.6,590.9,
DRAIN OUTER EAR CANAL LESION,69020P,CDM,69020,CPT,,,both,P,428,428,250.6,,,,fee schedule,,,,,,,,44.6,,,,fee schedule,,,363.8,85,,percent of total billed charges,,253.84,,,,fee schedule,,148.13,,,,fee schedule,,44.6,,,,fee schedule,,242.73,,,,fee schedule,,44.6,,,,fee schedule,,243.23,,,,fee schedule,,147.41,,,,fee schedule,,147.41,,,,fee schedule,,,389.48,91,,percent of total billed charges,,,406.6,95,,percent of total billed charges,,,355.24,83,,percent of total billed charges,,,128.4,83,,percent of total billed charges,,44.6,,,,fee schedule,,44.6,,,,fee schedule,,,355.24,83,,percent of total billed charges,,216.69,,,,fee schedule,,,385.2,90,,percent of total billed charges,,,385.2,90,,percent of total billed charges,,,385.2,90,,percent of total billed charges,,,385.2,90,,percent of total billed charges,,,363.8,85,,percent of total billed charges,,44.6,406.6,
DRAIN OUTER EAR CANAL LESION,69020T,CDM,69020,CPT,,,both,T,194,194,250.6,,,,fee schedule,,,,,,,,44.6,,,,fee schedule,,,164.9,85,,percent of total billed charges,,253.84,,,,fee schedule,,148.13,,,,fee schedule,,44.6,,,,fee schedule,,242.73,,,,fee schedule,,44.6,,,,fee schedule,,243.23,,,,fee schedule,,147.41,,,,fee schedule,,147.41,,,,fee schedule,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,58.2,83,,percent of total billed charges,,44.6,,,,fee schedule,,44.6,,,,fee schedule,,,161.02,83,,percent of total billed charges,,216.69,,,,fee schedule,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,44.6,253.84,
PIERCE EARLOBES,69090,CDM,69090,CPT,,,both,,109,109,,,,,,,,,,,,,,,,,,,,92.65,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,32.7,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,,,,,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,32.7,103.55,
RMVL FB XTRNL AUD CANAL W/O ANES,69200,CDM,69200,CPT,,,both,,367,367,81.23,,,,fee schedule,,,,,,,,26.6,,,,fee schedule,,,311.95,85,,percent of total billed charges,,84.76,,,,fee schedule,,49.46,,,,fee schedule,,26.6,,,,fee schedule,,91.52,,,,fee schedule,,26.6,,,,fee schedule,,78.84,,,,fee schedule,,47.78,,,,fee schedule,,47.78,,,,fee schedule,,,333.97,91,,percent of total billed charges,,,348.65,95,,percent of total billed charges,,,304.61,83,,percent of total billed charges,,,110.1,83,,percent of total billed charges,,26.6,,,,fee schedule,,26.6,,,,fee schedule,,,304.61,83,,percent of total billed charges,,70.24,,,,fee schedule,,,330.3,90,,percent of total billed charges,,,330.3,90,,percent of total billed charges,,,330.3,90,,percent of total billed charges,,,330.3,90,,percent of total billed charges,,,311.95,85,,percent of total billed charges,,26.6,348.65,
CLEAR OUTER EAR CANAL,69200P,CDM,69200,CPT,,,both,P,300,300,81.23,,,,fee schedule,,,,,,,,26.6,,,,fee schedule,,,255,85,,percent of total billed charges,,84.76,,,,fee schedule,,49.46,,,,fee schedule,,26.6,,,,fee schedule,,91.52,,,,fee schedule,,26.6,,,,fee schedule,,78.84,,,,fee schedule,,47.78,,,,fee schedule,,47.78,,,,fee schedule,,,273,91,,percent of total billed charges,,,285,95,,percent of total billed charges,,,249,83,,percent of total billed charges,,,90,83,,percent of total billed charges,,26.6,,,,fee schedule,,26.6,,,,fee schedule,,,249,83,,percent of total billed charges,,70.24,,,,fee schedule,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,270,90,,percent of total billed charges,,,255,85,,percent of total billed charges,,26.6,285,
CLEAR OUTER EAR CANAL,69200T,CDM,69200,CPT,,,both,T,164,164,81.23,,,,fee schedule,,,,,,,,26.6,,,,fee schedule,,,139.4,85,,percent of total billed charges,,84.76,,,,fee schedule,,49.46,,,,fee schedule,,26.6,,,,fee schedule,,91.52,,,,fee schedule,,26.6,,,,fee schedule,,78.84,,,,fee schedule,,47.78,,,,fee schedule,,47.78,,,,fee schedule,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,49.2,83,,percent of total billed charges,,26.6,,,,fee schedule,,26.6,,,,fee schedule,,,136.12,83,,percent of total billed charges,,70.24,,,,fee schedule,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,26.6,155.8,
CLEAR OUTER EAR CANAL,69205,CDM,69205,CPT,,,both,,476,476,165.91,,,,fee schedule,,,,,,,,74.9,,,,fee schedule,,,404.6,85,,percent of total billed charges,,168.01,,,,fee schedule,,98.04,,,,fee schedule,,74.9,,,,fee schedule,,176.41,,,,fee schedule,,74.9,,,,fee schedule,,161.03,,,,fee schedule,,97.6,,,,fee schedule,,97.6,,,,fee schedule,,,433.16,91,,percent of total billed charges,,,452.2,95,,percent of total billed charges,,,395.08,83,,percent of total billed charges,,,142.8,83,,percent of total billed charges,,74.9,,,,fee schedule,,74.9,,,,fee schedule,,,395.08,83,,percent of total billed charges,,143.46,,,,fee schedule,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,428.4,90,,percent of total billed charges,,,404.6,85,,percent of total billed charges,,74.9,452.2,
CLEAR OUTER EAR CANAL,69205P,CDM,69205,CPT,,,both,P,312,312,165.91,,,,fee schedule,,,,,,,,74.9,,,,fee schedule,,,265.2,85,,percent of total billed charges,,168.01,,,,fee schedule,,98.04,,,,fee schedule,,74.9,,,,fee schedule,,176.41,,,,fee schedule,,74.9,,,,fee schedule,,161.03,,,,fee schedule,,97.6,,,,fee schedule,,97.6,,,,fee schedule,,,283.92,91,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,93.6,83,,percent of total billed charges,,74.9,,,,fee schedule,,74.9,,,,fee schedule,,,258.96,83,,percent of total billed charges,,143.46,,,,fee schedule,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,265.2,85,,percent of total billed charges,,74.9,296.4,
CLEAR OUTER EAR CANAL,69205T,CDM,69205,CPT,,,both,T,164,164,165.91,,,,fee schedule,,,,,,,,74.9,,,,fee schedule,,,139.4,85,,percent of total billed charges,,168.01,,,,fee schedule,,98.04,,,,fee schedule,,74.9,,,,fee schedule,,176.41,,,,fee schedule,,74.9,,,,fee schedule,,161.03,,,,fee schedule,,97.6,,,,fee schedule,,97.6,,,,fee schedule,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,49.2,83,,percent of total billed charges,,74.9,,,,fee schedule,,74.9,,,,fee schedule,,,136.12,83,,percent of total billed charges,,143.46,,,,fee schedule,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,49.2,176.41,
REMOVE IMPACTED EAR WAX BY LAVAGE/IRRIGATION UNI,69209,CDM,69209,CPT,,,both,,71,71,26.5,,,,fee schedule,,,,,,,,7.1,,,,fee schedule,,,60.35,85,,percent of total billed charges,,25.65,,,,fee schedule,,14.97,,,,fee schedule,,7.1,,,,fee schedule,,,,,,,,7.1,,,,fee schedule,,25.72,,,,fee schedule,,15.59,,,,fee schedule,,15.59,,,,fee schedule,,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,21.3,83,,percent of total billed charges,,7.1,,,,fee schedule,,7.1,,,,fee schedule,,,58.93,83,,percent of total billed charges,,22.91,,,,fee schedule,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,7.1,67.45,
RMVL IMPACTED CERUMEN BY INSTRUMENTATION SPX 1/BTH EARS,69210,CDM,69210,CPT,,,both,,151,151,55.88,,,,fee schedule,,,,,,,,21.4,,,,fee schedule,,,128.35,85,,percent of total billed charges,,64.06,,,,fee schedule,,34.88,,,,fee schedule,,21.4,,,,fee schedule,,59.03,,,,fee schedule,,21.4,,,,fee schedule,,54.24,,,,fee schedule,,32.87,,,,fee schedule,,32.87,,,,fee schedule,,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,21.4,,,,fee schedule,,21.4,,,,fee schedule,,,125.33,83,,percent of total billed charges,,48.32,,,,fee schedule,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,21.4,143.45,
REMOVE IMPACTED EAR WAX UNI,69210P,CDM,69210,CPT,,,both,P,106,106,55.88,,,,fee schedule,,,,,,,,21.4,,,,fee schedule,,,90.1,85,,percent of total billed charges,,64.06,,,,fee schedule,,34.88,,,,fee schedule,,21.4,,,,fee schedule,,59.03,,,,fee schedule,,21.4,,,,fee schedule,,54.24,,,,fee schedule,,32.87,,,,fee schedule,,32.87,,,,fee schedule,,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,31.8,83,,percent of total billed charges,,21.4,,,,fee schedule,,21.4,,,,fee schedule,,,87.98,83,,percent of total billed charges,,48.32,,,,fee schedule,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,21.4,100.7,
REMOVE IMPACTED EAR WAX UNI,69210T,CDM,69210,CPT,,,both,T,45,45,55.88,,,,fee schedule,,,,,,,,21.4,,,,fee schedule,,,38.25,85,,percent of total billed charges,,64.06,,,,fee schedule,,34.88,,,,fee schedule,,21.4,,,,fee schedule,,59.03,,,,fee schedule,,21.4,,,,fee schedule,,54.24,,,,fee schedule,,32.87,,,,fee schedule,,32.87,,,,fee schedule,,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,13.5,83,,percent of total billed charges,,21.4,,,,fee schedule,,21.4,,,,fee schedule,,,37.35,83,,percent of total billed charges,,48.32,,,,fee schedule,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,13.5,64.06,
CLEAN OUT MASTOID CAVITY,69220,CDM,69220,CPT,,,both,,393,393,88.14,,,,fee schedule,,,,,,,,28.5,,,,fee schedule,,,334.05,85,,percent of total billed charges,,90.75,,,,fee schedule,,52.96,,,,fee schedule,,28.5,,,,fee schedule,,108.1,,,,fee schedule,,28.5,,,,fee schedule,,85.55,,,,fee schedule,,51.85,,,,fee schedule,,51.85,,,,fee schedule,,,357.63,91,,percent of total billed charges,,,373.35,95,,percent of total billed charges,,,326.19,83,,percent of total billed charges,,,117.9,83,,percent of total billed charges,,28.5,,,,fee schedule,,28.5,,,,fee schedule,,,326.19,83,,percent of total billed charges,,76.22,,,,fee schedule,,,353.7,90,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,353.7,90,,percent of total billed charges,,,334.05,85,,percent of total billed charges,,28.5,373.35,
CLEAN OUT MASTOID CAVITY,69220P,CDM,69220,CPT,,,both,P,320,320,88.14,,,,fee schedule,,,,,,,,28.5,,,,fee schedule,,,272,85,,percent of total billed charges,,90.75,,,,fee schedule,,52.96,,,,fee schedule,,28.5,,,,fee schedule,,108.1,,,,fee schedule,,28.5,,,,fee schedule,,85.55,,,,fee schedule,,51.85,,,,fee schedule,,51.85,,,,fee schedule,,,291.2,91,,percent of total billed charges,,,304,95,,percent of total billed charges,,,265.6,83,,percent of total billed charges,,,96,83,,percent of total billed charges,,28.5,,,,fee schedule,,28.5,,,,fee schedule,,,265.6,83,,percent of total billed charges,,76.22,,,,fee schedule,,,288,90,,percent of total billed charges,,,288,90,,percent of total billed charges,,,288,90,,percent of total billed charges,,,288,90,,percent of total billed charges,,,272,85,,percent of total billed charges,,28.5,304,
CLEAN OUT MASTOID CAVITY,69220T,CDM,69220,CPT,,,both,T,73,73,88.14,,,,fee schedule,,,,,,,,28.5,,,,fee schedule,,,62.05,85,,percent of total billed charges,,90.75,,,,fee schedule,,52.96,,,,fee schedule,,28.5,,,,fee schedule,,108.1,,,,fee schedule,,28.5,,,,fee schedule,,85.55,,,,fee schedule,,51.85,,,,fee schedule,,51.85,,,,fee schedule,,,66.43,91,,percent of total billed charges,,,69.35,95,,percent of total billed charges,,,60.59,83,,percent of total billed charges,,,21.9,83,,percent of total billed charges,,28.5,,,,fee schedule,,28.5,,,,fee schedule,,,60.59,83,,percent of total billed charges,,76.22,,,,fee schedule,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,62.05,85,,percent of total billed charges,,21.9,108.1,
CLEAN OUT MASTOID CAVITY,69222,CDM,69222,CPT,,,both,,735,735,236.77,,,,fee schedule,,,,,,,,57.3,,,,fee schedule,,,624.75,85,,percent of total billed charges,,240.78,,,,fee schedule,,140.5,,,,fee schedule,,57.3,,,,fee schedule,,237.43,,,,fee schedule,,57.3,,,,fee schedule,,229.81,,,,fee schedule,,139.28,,,,fee schedule,,139.28,,,,fee schedule,,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,220.5,83,,percent of total billed charges,,57.3,,,,fee schedule,,57.3,,,,fee schedule,,,610.05,83,,percent of total billed charges,,204.74,,,,fee schedule,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,57.3,698.25,
CLEAN OUT MASTOID CAVITY,69222P,CDM,69222,CPT,,,both,P,554,554,236.77,,,,fee schedule,,,,,,,,57.3,,,,fee schedule,,,470.9,85,,percent of total billed charges,,240.78,,,,fee schedule,,140.5,,,,fee schedule,,57.3,,,,fee schedule,,237.43,,,,fee schedule,,57.3,,,,fee schedule,,229.81,,,,fee schedule,,139.28,,,,fee schedule,,139.28,,,,fee schedule,,,504.14,91,,percent of total billed charges,,,526.3,95,,percent of total billed charges,,,459.82,83,,percent of total billed charges,,,166.2,83,,percent of total billed charges,,57.3,,,,fee schedule,,57.3,,,,fee schedule,,,459.82,83,,percent of total billed charges,,204.74,,,,fee schedule,,,498.6,90,,percent of total billed charges,,,498.6,90,,percent of total billed charges,,,498.6,90,,percent of total billed charges,,,498.6,90,,percent of total billed charges,,,470.9,85,,percent of total billed charges,,57.3,526.3,
CLEAN OUT MASTOID CAVITY,69222T,CDM,69222,CPT,,,both,T,181,181,236.77,,,,fee schedule,,,,,,,,57.3,,,,fee schedule,,,153.85,85,,percent of total billed charges,,240.78,,,,fee schedule,,140.5,,,,fee schedule,,57.3,,,,fee schedule,,237.43,,,,fee schedule,,57.3,,,,fee schedule,,229.81,,,,fee schedule,,139.28,,,,fee schedule,,139.28,,,,fee schedule,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,54.3,83,,percent of total billed charges,,57.3,,,,fee schedule,,57.3,,,,fee schedule,,,150.23,83,,percent of total billed charges,,204.74,,,,fee schedule,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,54.3,240.78,
OTOPLASTY PROTRUDING EAR +-SIZE RDCTJ,69300,CDM,69300,CPT,,,both,,2838,2838,810.55,,,,fee schedule,,,,,,,,,,,,,,,2412.3,85,,percent of total billed charges,,833.35,,,,fee schedule,,486.29,,,,fee schedule,,,,,,,,748.76,,,,fee schedule,,,,,,,,786.71,,,,fee schedule,,476.79,,,,fee schedule,,476.79,,,,fee schedule,,,2582.58,91,,percent of total billed charges,,,2696.1,95,,percent of total billed charges,,,2355.54,83,,percent of total billed charges,,,851.4,83,,percent of total billed charges,,,,,,,,,,,,,,,2355.54,83,,percent of total billed charges,,700.89,,,,fee schedule,,,2554.2,90,,percent of total billed charges,,,2554.2,90,,percent of total billed charges,,,2554.2,90,,percent of total billed charges,,,2554.2,90,,percent of total billed charges,,,2412.3,85,,percent of total billed charges,,476.79,2696.1,
"Otoplasty, Unilat",6930001,CDM,69300,CPT,,,both,,2015,2015,810.55,,,,fee schedule,,,,,,,,,,,,,,,1712.75,85,,percent of total billed charges,,833.35,,,,fee schedule,,486.29,,,,fee schedule,,,,,,,,748.76,,,,fee schedule,,,,,,,,786.71,,,,fee schedule,,476.79,,,,fee schedule,,476.79,,,,fee schedule,,,1833.65,91,,percent of total billed charges,,,1914.25,95,,percent of total billed charges,,,1672.45,83,,percent of total billed charges,,,604.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1672.45,83,,percent of total billed charges,,700.89,,,,fee schedule,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1813.5,90,,percent of total billed charges,,,1712.75,85,,percent of total billed charges,,476.79,1914.25,
"Otoplasty,bilat",6930002,CDM,69300,CPT,,,both,,3059,3059,810.55,,,,fee schedule,,,,,,,,,,,,,,,2600.15,85,,percent of total billed charges,,833.35,,,,fee schedule,,486.29,,,,fee schedule,,,,,,,,748.76,,,,fee schedule,,,,,,,,786.71,,,,fee schedule,,476.79,,,,fee schedule,,476.79,,,,fee schedule,,,2783.69,91,,percent of total billed charges,,,2906.05,95,,percent of total billed charges,,,2538.97,83,,percent of total billed charges,,,917.7,83,,percent of total billed charges,,,,,,,,,,,,,,,2538.97,83,,percent of total billed charges,,700.89,,,,fee schedule,,,2753.1,90,,percent of total billed charges,,,2753.1,90,,percent of total billed charges,,,2753.1,90,,percent of total billed charges,,,2753.1,90,,percent of total billed charges,,,2600.15,85,,percent of total billed charges,,476.79,2906.05,
OUTER EAR SURGERY PROCEDURE,69399,CDM,69399,CPT,,,both,,52,52,,,,,,,,,,,,,,,,,,,,44.2,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,15.6,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,,,,,,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,15.6,49.4,
INCISION OF EARDRUM,69420,CDM,69420,CPT,,,both,,567,567,208.54,,,,fee schedule,,,,,,,,43.8,,,,fee schedule,,,481.95,85,,percent of total billed charges,,211.92,,,,fee schedule,,123.66,,,,fee schedule,,43.8,,,,fee schedule,,200.95,,,,fee schedule,,43.8,,,,fee schedule,,202.41,,,,fee schedule,,122.67,,,,fee schedule,,122.67,,,,fee schedule,,,515.97,91,,percent of total billed charges,,,538.65,95,,percent of total billed charges,,,470.61,83,,percent of total billed charges,,,170.1,83,,percent of total billed charges,,43.8,,,,fee schedule,,43.8,,,,fee schedule,,,470.61,83,,percent of total billed charges,,180.33,,,,fee schedule,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,510.3,90,,percent of total billed charges,,,481.95,85,,percent of total billed charges,,43.8,538.65,
INCISION OF EARDRUM,69420P,CDM,69420,CPT,,,both,P,210,210,208.54,,,,fee schedule,,,,,,,,43.8,,,,fee schedule,,,178.5,85,,percent of total billed charges,,211.92,,,,fee schedule,,123.66,,,,fee schedule,,43.8,,,,fee schedule,,200.95,,,,fee schedule,,43.8,,,,fee schedule,,202.41,,,,fee schedule,,122.67,,,,fee schedule,,122.67,,,,fee schedule,,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,63,83,,percent of total billed charges,,43.8,,,,fee schedule,,43.8,,,,fee schedule,,,174.3,83,,percent of total billed charges,,180.33,,,,fee schedule,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,43.8,211.92,
INCISION OF EARDRUM,69420T,CDM,69420,CPT,,,both,T,357,357,208.54,,,,fee schedule,,,,,,,,43.8,,,,fee schedule,,,303.45,85,,percent of total billed charges,,211.92,,,,fee schedule,,123.66,,,,fee schedule,,43.8,,,,fee schedule,,200.95,,,,fee schedule,,43.8,,,,fee schedule,,202.41,,,,fee schedule,,122.67,,,,fee schedule,,122.67,,,,fee schedule,,,324.87,91,,percent of total billed charges,,,339.15,95,,percent of total billed charges,,,296.31,83,,percent of total billed charges,,,107.1,83,,percent of total billed charges,,43.8,,,,fee schedule,,43.8,,,,fee schedule,,,296.31,83,,percent of total billed charges,,180.33,,,,fee schedule,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,321.3,90,,percent of total billed charges,,,303.45,85,,percent of total billed charges,,43.8,339.15,
INCISION OF EARDRUM,69421,CDM,69421,CPT,,,both,,644,644,263.85,,,,fee schedule,,,,,,,,56.6,,,,fee schedule,,,547.4,85,,percent of total billed charges,,268.73,,,,fee schedule,,156.82,,,,fee schedule,,56.6,,,,fee schedule,,267.94,,,,fee schedule,,56.6,,,,fee schedule,,256.09,,,,fee schedule,,155.2,,,,fee schedule,,155.2,,,,fee schedule,,,586.04,91,,percent of total billed charges,,,611.8,95,,percent of total billed charges,,,534.52,83,,percent of total billed charges,,,193.2,83,,percent of total billed charges,,56.6,,,,fee schedule,,56.6,,,,fee schedule,,,534.52,83,,percent of total billed charges,,228.15,,,,fee schedule,,,579.6,90,,percent of total billed charges,,,579.6,90,,percent of total billed charges,,,579.6,90,,percent of total billed charges,,,579.6,90,,percent of total billed charges,,,547.4,85,,percent of total billed charges,,56.6,611.8,
CREATE EARDRUM OPENING,69433,CDM,69433,CPT,,,both,,663,663,229.28,,,,fee schedule,,,,,,,,76.6,,,,fee schedule,,,563.55,85,,percent of total billed charges,,232.54,,,,fee schedule,,135.7,,,,fee schedule,,76.6,,,,fee schedule,,218.19,,,,fee schedule,,76.6,,,,fee schedule,,222.54,,,,fee schedule,,134.87,,,,fee schedule,,134.87,,,,fee schedule,,,603.33,91,,percent of total billed charges,,,629.85,95,,percent of total billed charges,,,550.29,83,,percent of total billed charges,,,198.9,83,,percent of total billed charges,,76.6,,,,fee schedule,,76.6,,,,fee schedule,,,550.29,83,,percent of total billed charges,,198.26,,,,fee schedule,,,596.7,90,,percent of total billed charges,,,596.7,90,,percent of total billed charges,,,596.7,90,,percent of total billed charges,,,596.7,90,,percent of total billed charges,,,563.55,85,,percent of total billed charges,,76.6,629.85,
CREATE EARDRUM OPENING,69433P,CDM,69433,CPT,,,both,P,489,489,229.28,,,,fee schedule,,,,,,,,76.6,,,,fee schedule,,,415.65,85,,percent of total billed charges,,232.54,,,,fee schedule,,135.7,,,,fee schedule,,76.6,,,,fee schedule,,218.19,,,,fee schedule,,76.6,,,,fee schedule,,222.54,,,,fee schedule,,134.87,,,,fee schedule,,134.87,,,,fee schedule,,,444.99,91,,percent of total billed charges,,,464.55,95,,percent of total billed charges,,,405.87,83,,percent of total billed charges,,,146.7,83,,percent of total billed charges,,76.6,,,,fee schedule,,76.6,,,,fee schedule,,,405.87,83,,percent of total billed charges,,198.26,,,,fee schedule,,,440.1,90,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,415.65,85,,percent of total billed charges,,76.6,464.55,
CREATE EARDRUM OPENING,69433T,CDM,69433,CPT,,,both,T,174,174,229.28,,,,fee schedule,,,,,,,,76.6,,,,fee schedule,,,147.9,85,,percent of total billed charges,,232.54,,,,fee schedule,,135.7,,,,fee schedule,,76.6,,,,fee schedule,,218.19,,,,fee schedule,,76.6,,,,fee schedule,,222.54,,,,fee schedule,,134.87,,,,fee schedule,,134.87,,,,fee schedule,,,158.34,91,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,52.2,83,,percent of total billed charges,,76.6,,,,fee schedule,,76.6,,,,fee schedule,,,144.42,83,,percent of total billed charges,,198.26,,,,fee schedule,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,52.2,232.54,
CREATE EARDRUM OPENING,69436,CDM,69436,CPT,,,both,,982,982,276.52,,,,fee schedule,,,,,,,,80.5,,,,fee schedule,,,834.7,85,,percent of total billed charges,,282.95,,,,fee schedule,,165.11,,,,fee schedule,,80.5,,,,fee schedule,,294.46,,,,fee schedule,,80.5,,,,fee schedule,,268.39,,,,fee schedule,,162.66,,,,fee schedule,,162.66,,,,fee schedule,,,893.62,91,,percent of total billed charges,,,932.9,95,,percent of total billed charges,,,815.06,83,,percent of total billed charges,,,294.6,83,,percent of total billed charges,,80.5,,,,fee schedule,,80.5,,,,fee schedule,,,815.06,83,,percent of total billed charges,,239.11,,,,fee schedule,,,883.8,90,,percent of total billed charges,,,883.8,90,,percent of total billed charges,,,883.8,90,,percent of total billed charges,,,883.8,90,,percent of total billed charges,,,834.7,85,,percent of total billed charges,,80.5,932.9,
REPAIR OF EARDRUM,69610,CDM,69610,CPT,,,both,,1307,1307,497.16,,,,fee schedule,,,,,,,,160.75,,,,fee schedule,,,1110.95,85,,percent of total billed charges,,515.91,,,,fee schedule,,301.05,,,,fee schedule,,160.75,,,,fee schedule,,533.88,,,,fee schedule,,160.75,,,,fee schedule,,482.54,,,,fee schedule,,292.45,,,,fee schedule,,292.45,,,,fee schedule,,,1189.37,91,,percent of total billed charges,,,1241.65,95,,percent of total billed charges,,,1084.81,83,,percent of total billed charges,,,392.1,83,,percent of total billed charges,,160.75,,,,fee schedule,,160.75,,,,fee schedule,,,1084.81,83,,percent of total billed charges,,429.9,,,,fee schedule,,,1176.3,90,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1176.3,90,,percent of total billed charges,,,1110.95,85,,percent of total billed charges,,160.75,1241.65,
REPAIR OF EARDRUM,69620,CDM,69620,CPT,,,both,,2875,2875,859.51,,,,fee schedule,,,,,,,,254.67,,,,fee schedule,,,2443.75,85,,percent of total billed charges,,882.2,,,,fee schedule,,514.79,,,,fee schedule,,254.67,,,,fee schedule,,838.29,,,,fee schedule,,254.67,,,,fee schedule,,834.24,,,,fee schedule,,505.6,,,,fee schedule,,505.6,,,,fee schedule,,,2616.25,91,,percent of total billed charges,,,2731.25,95,,percent of total billed charges,,,2386.25,83,,percent of total billed charges,,,862.5,83,,percent of total billed charges,,254.67,,,,fee schedule,,254.67,,,,fee schedule,,,2386.25,83,,percent of total billed charges,,743.23,,,,fee schedule,,,2587.5,90,,percent of total billed charges,,,2587.5,90,,percent of total billed charges,,,2587.5,90,,percent of total billed charges,,,2587.5,90,,percent of total billed charges,,,2443.75,85,,percent of total billed charges,,254.67,2731.25,
REVISE MIDDLE EAR & MASTOID,69641,CDM,69641,CPT,,,both,,7278,7278,1816.96,,,,fee schedule,,,,,,,,1048.85,,,,fee schedule,,,6186.3,85,,percent of total billed charges,,1872.54,,,,fee schedule,,1092.69,,,,fee schedule,,1048.85,,,,fee schedule,,1758.16,,,,fee schedule,,1048.85,,,,fee schedule,,1763.52,,,,fee schedule,,1068.8,,,,fee schedule,,1068.8,,,,fee schedule,,,6622.98,91,,percent of total billed charges,,,6914.1,95,,percent of total billed charges,,,6040.74,83,,percent of total billed charges,,,2183.4,83,,percent of total billed charges,,1048.85,,,,fee schedule,,1048.85,,,,fee schedule,,,6040.74,83,,percent of total billed charges,,1571.14,,,,fee schedule,,,6550.2,90,,percent of total billed charges,,,6550.2,90,,percent of total billed charges,,,6550.2,90,,percent of total billed charges,,,6550.2,90,,percent of total billed charges,,,6186.3,85,,percent of total billed charges,,1048.85,6914.1,
REVISE MIDDLE EAR & MASTOID,69645,CDM,69645,CPT,,,both,,6681,6681,2575.09,,,,fee schedule,,,,,,,,1048.85,,,,fee schedule,,,5678.85,85,,percent of total billed charges,,2657,,,,fee schedule,,1550.45,,,,fee schedule,,1048.85,,,,fee schedule,,2500.95,,,,fee schedule,,1048.85,,,,fee schedule,,2499.35,,,,fee schedule,,1514.76,,,,fee schedule,,1514.76,,,,fee schedule,,,6079.71,91,,percent of total billed charges,,,6346.95,95,,percent of total billed charges,,,5545.23,83,,percent of total billed charges,,,2004.3,83,,percent of total billed charges,,1048.85,,,,fee schedule,,1048.85,,,,fee schedule,,,5545.23,83,,percent of total billed charges,,2226.69,,,,fee schedule,,,6012.9,90,,percent of total billed charges,,,6012.9,90,,percent of total billed charges,,,6012.9,90,,percent of total billed charges,,,6012.9,90,,percent of total billed charges,,,5678.85,85,,percent of total billed charges,,1048.85,6346.95,
NPS SURG DILAT EUST TUBE UNI,69705,CDM,69705,CPT,,,both,,702,702,298.99,,,,fee schedule,,,,,,,,104.57,,,,fee schedule,,,596.7,85,,percent of total billed charges,,312.79,,,,fee schedule,,215.71,,,,fee schedule,,104.57,,,,fee schedule,,,,,,,,104.57,,,,fee schedule,,290.19,,,,fee schedule,,175.87,,,,fee schedule,,175.87,,,,fee schedule,,,638.82,91,,percent of total billed charges,,,666.9,95,,percent of total billed charges,,,582.66,83,,percent of total billed charges,,,210.6,83,,percent of total billed charges,,104.57,,,,fee schedule,,104.57,,,,fee schedule,,,582.66,83,,percent of total billed charges,,258.54,,,,fee schedule,,,631.8,90,,percent of total billed charges,,,631.8,90,,percent of total billed charges,,,631.8,90,,percent of total billed charges,,,631.8,90,,percent of total billed charges,,,596.7,85,,percent of total billed charges,,104.57,666.9,
INCISE INNER EAR,69801,CDM,69801,CPT,,,both,,1700,1700,213.73,,,,fee schedule,,,,,,,,75.95,,,,fee schedule,,,1445,85,,percent of total billed charges,,222.63,,,,fee schedule,,153.54,,,,fee schedule,,75.95,,,,fee schedule,,1240.2,,,,fee schedule,,75.95,,,,fee schedule,,207.44,,,,fee schedule,,125.72,,,,fee schedule,,125.72,,,,fee schedule,,,1547,91,,percent of total billed charges,,,1615,95,,percent of total billed charges,,,1411,83,,percent of total billed charges,,,510,83,,percent of total billed charges,,75.95,,,,fee schedule,,75.95,,,,fee schedule,,,1411,83,,percent of total billed charges,,184.81,,,,fee schedule,,,1530,90,,percent of total billed charges,,,1530,90,,percent of total billed charges,,,1530,90,,percent of total billed charges,,,1530,90,,percent of total billed charges,,,1445,85,,percent of total billed charges,,75.95,1615,
INCISE INNER EAR,69801 P,CDM,69801,CPT,,,both, P,675,675,213.73,,,,fee schedule,,,,,,,,75.95,,,,fee schedule,,,573.75,85,,percent of total billed charges,,222.63,,,,fee schedule,,153.54,,,,fee schedule,,75.95,,,,fee schedule,,1240.2,,,,fee schedule,,75.95,,,,fee schedule,,207.44,,,,fee schedule,,125.72,,,,fee schedule,,125.72,,,,fee schedule,,,614.25,91,,percent of total billed charges,,,641.25,95,,percent of total billed charges,,,560.25,83,,percent of total billed charges,,,202.5,83,,percent of total billed charges,,75.95,,,,fee schedule,,75.95,,,,fee schedule,,,560.25,83,,percent of total billed charges,,184.81,,,,fee schedule,,,607.5,90,,percent of total billed charges,,,607.5,90,,percent of total billed charges,,,607.5,90,,percent of total billed charges,,,607.5,90,,percent of total billed charges,,,573.75,85,,percent of total billed charges,,75.95,1240.2,
INCISE INNER EAR,69801 T,CDM,69801,CPT,,,both, T,1025,1025,213.73,,,,fee schedule,,,,,,,,75.95,,,,fee schedule,,,871.25,85,,percent of total billed charges,,222.63,,,,fee schedule,,153.54,,,,fee schedule,,75.95,,,,fee schedule,,1240.2,,,,fee schedule,,75.95,,,,fee schedule,,207.44,,,,fee schedule,,125.72,,,,fee schedule,,125.72,,,,fee schedule,,,932.75,91,,percent of total billed charges,,,973.75,95,,percent of total billed charges,,,850.75,83,,percent of total billed charges,,,307.5,83,,percent of total billed charges,,75.95,,,,fee schedule,,75.95,,,,fee schedule,,,850.75,83,,percent of total billed charges,,184.81,,,,fee schedule,,,922.5,90,,percent of total billed charges,,,922.5,90,,percent of total billed charges,,,922.5,90,,percent of total billed charges,,,922.5,90,,percent of total billed charges,,,871.25,85,,percent of total billed charges,,75.95,1240.2,
MICROSURGERY ADD-ON,69990,CDM,69990,CPT,,,both,,1475,1475,373.88,,,,fee schedule,,,,,,,,,,,,,,,1253.75,85,,percent of total billed charges,,402.94,,,,fee schedule,,277.88,,,,fee schedule,,,,,,,,403.23,,,,fee schedule,,,,,,,,362.88,,,,fee schedule,,219.93,,,,fee schedule,,219.93,,,,fee schedule,,,1342.25,91,,percent of total billed charges,,,1401.25,95,,percent of total billed charges,,,1224.25,83,,percent of total billed charges,,,442.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1224.25,83,,percent of total billed charges,,323.29,,,,fee schedule,,,1327.5,90,,percent of total billed charges,,,1327.5,90,,percent of total billed charges,,,1327.5,90,,percent of total billed charges,,,1327.5,90,,percent of total billed charges,,,1253.75,85,,percent of total billed charges,,219.93,1401.25,
XRAY Mandible 4V+,70110,CDM,70110,CPT,,,both,,415,415,33.98,,,,fee schedule,,,,,,,,31.3,,,,fee schedule,,,352.75,85,,percent of total billed charges,,27.26,,,,fee schedule,,14,,,,fee schedule,,31.3,,,,fee schedule,,70.11,,,,fee schedule,,31.3,,,,fee schedule,,72.69,,,,fee schedule,,44.05,,,,fee schedule,,44.05,,,,fee schedule,,,377.65,91,,percent of total billed charges,,,394.25,95,,percent of total billed charges,,,344.45,83,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,31.3,,,,fee schedule,,31.3,,,,fee schedule,,,344.45,83,,percent of total billed charges,,64.76,,,,fee schedule,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,373.5,90,,percent of total billed charges,,,352.75,85,,percent of total billed charges,,14,394.25,
XRAY Sinuses 3V+,70220,CDM,70220,CPT,,,both,,176,176,33.43,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,,149.6,85,,percent of total billed charges,,24.16,,,,fee schedule,,12.41,,,,fee schedule,,28.7,,,,fee schedule,,82.03,,,,fee schedule,,28.7,,,,fee schedule,,63.18,,,,fee schedule,,38.29,,,,fee schedule,,38.29,,,,fee schedule,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,52.8,83,,percent of total billed charges,,28.7,,,,fee schedule,,28.7,,,,fee schedule,,,146.08,83,,percent of total billed charges,,56.29,,,,fee schedule,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,12.41,167.2,
X-RAY EXAM CHEST 1 VIEW,7104526,CDM,71045,CPT,,,both,26,67,67,17.04,,,,fee schedule,,,,,,,,68.88,,,,fee schedule,,,56.95,85,,percent of total billed charges,,20.26,,,,fee schedule,,10.41,,,,fee schedule,,68.88,,,,fee schedule,,,,,,,,68.88,,,,fee schedule,,43.61,,,,fee schedule,,26.43,,,,fee schedule,,26.43,,,,fee schedule,,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,20.1,83,,percent of total billed charges,,68.88,,,,fee schedule,,68.88,,,,fee schedule,,,55.61,83,,percent of total billed charges,,38.86,,,,fee schedule,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,10.41,68.88,
X-RAY EXAM CHEST 1 VIEW,71045TC,CDM,71045,CPT,,,both,TC,407,407,17.04,,,,fee schedule,,,,,,,,68.88,,,,fee schedule,,,345.95,85,,percent of total billed charges,,20.26,,,,fee schedule,,10.41,,,,fee schedule,,68.88,,,,fee schedule,,,,,,,,68.88,,,,fee schedule,,43.61,,,,fee schedule,,26.43,,,,fee schedule,,26.43,,,,fee schedule,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,122.1,83,,percent of total billed charges,,68.88,,,,fee schedule,,68.88,,,,fee schedule,,,337.81,83,,percent of total billed charges,,38.86,,,,fee schedule,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,10.41,386.65,
X-RAY EXAM CHEST 2 VIEWS,71046,CDM,71046,CPT,,,both,,106,106,25.95,,,,fee schedule,,,,,,,,70,,,,fee schedule,,,90.1,85,,percent of total billed charges,,24.16,,,,fee schedule,,12.41,,,,fee schedule,,70,,,,fee schedule,,,,,,,,70,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,31.8,83,,percent of total billed charges,,70,,,,fee schedule,,70,,,,fee schedule,,,87.98,83,,percent of total billed charges,,50.31,,,,fee schedule,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,12.41,100.7,
X-RAY EXAM CHEST 2 VIEWS,7104626,CDM,71046,CPT,,,both,26,81,81,25.95,,,,fee schedule,,,,,,,,70,,,,fee schedule,,,68.85,85,,percent of total billed charges,,24.16,,,,fee schedule,,12.41,,,,fee schedule,,70,,,,fee schedule,,,,,,,,70,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,24.3,83,,percent of total billed charges,,70,,,,fee schedule,,70,,,,fee schedule,,,67.23,83,,percent of total billed charges,,50.31,,,,fee schedule,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,12.41,76.95,
X-RAY EXAM CHEST 2 VIEWS,71046TC,CDM,71046,CPT,,,both,TC,414,414,25.95,,,,fee schedule,,,,,,,,70,,,,fee schedule,,,351.9,85,,percent of total billed charges,,24.16,,,,fee schedule,,12.41,,,,fee schedule,,70,,,,fee schedule,,,,,,,,70,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,376.74,91,,percent of total billed charges,,,393.3,95,,percent of total billed charges,,,343.62,83,,percent of total billed charges,,,124.2,83,,percent of total billed charges,,70,,,,fee schedule,,70,,,,fee schedule,,,343.62,83,,percent of total billed charges,,50.31,,,,fee schedule,,,372.6,90,,percent of total billed charges,,,372.6,90,,percent of total billed charges,,,372.6,90,,percent of total billed charges,,,372.6,90,,percent of total billed charges,,,351.9,85,,percent of total billed charges,,12.41,393.3,
XRAY Ribs     side:,71100,CDM,71100,CPT,,,both,,457,457,27.84,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,388.45,85,,percent of total billed charges,,24.88,,,,fee schedule,,12.78,,,,fee schedule,,21.5,,,,fee schedule,,63.8,,,,fee schedule,,21.5,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,415.87,91,,percent of total billed charges,,,434.15,95,,percent of total billed charges,,,379.31,83,,percent of total billed charges,,,137.1,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,379.31,83,,percent of total billed charges,,55.29,,,,fee schedule,,,411.3,90,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,388.45,85,,percent of total billed charges,,12.78,434.15,
X-RAY EXAM OF RIBS,7110026,CDM,71100,CPT,,,both,26,90,90,27.84,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,76.5,85,,percent of total billed charges,,24.88,,,,fee schedule,,12.78,,,,fee schedule,,21.5,,,,fee schedule,,63.8,,,,fee schedule,,21.5,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,74.7,83,,percent of total billed charges,,55.29,,,,fee schedule,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,12.78,85.5,
X-RAY EXAM OF RIBS,71100TC,CDM,71100,CPT,,,both,TC,439,439,27.84,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,373.15,85,,percent of total billed charges,,24.88,,,,fee schedule,,12.78,,,,fee schedule,,21.5,,,,fee schedule,,63.8,,,,fee schedule,,21.5,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,399.49,91,,percent of total billed charges,,,417.05,95,,percent of total billed charges,,,364.37,83,,percent of total billed charges,,,131.7,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,364.37,83,,percent of total billed charges,,55.29,,,,fee schedule,,,395.1,90,,percent of total billed charges,,,395.1,90,,percent of total billed charges,,,395.1,90,,percent of total billed charges,,,395.1,90,,percent of total billed charges,,,373.15,85,,percent of total billed charges,,12.78,417.05,
XRAY Ribs W/PA CXR 3V+     side:,71101,CDM,71101,CPT,,,both,,526,526,33.76,,,,fee schedule,,,,,,,,24.8,,,,fee schedule,,,447.1,85,,percent of total billed charges,,29.57,,,,fee schedule,,15.19,,,,fee schedule,,24.8,,,,fee schedule,,75.72,,,,fee schedule,,24.8,,,,fee schedule,,71.01,,,,fee schedule,,43.04,,,,fee schedule,,43.04,,,,fee schedule,,,478.66,91,,percent of total billed charges,,,499.7,95,,percent of total billed charges,,,436.58,83,,percent of total billed charges,,,157.8,83,,percent of total billed charges,,24.8,,,,fee schedule,,24.8,,,,fee schedule,,,436.58,83,,percent of total billed charges,,63.26,,,,fee schedule,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,447.1,85,,percent of total billed charges,,15.19,499.7,
X-RAY EXAM OF RIBS/CHEST,7110126,CDM,71101,CPT,,,both,26,105,105,33.76,,,,fee schedule,,,,,,,,24.8,,,,fee schedule,,,89.25,85,,percent of total billed charges,,29.57,,,,fee schedule,,15.19,,,,fee schedule,,24.8,,,,fee schedule,,75.72,,,,fee schedule,,24.8,,,,fee schedule,,71.01,,,,fee schedule,,43.04,,,,fee schedule,,43.04,,,,fee schedule,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,31.5,83,,percent of total billed charges,,24.8,,,,fee schedule,,24.8,,,,fee schedule,,,87.15,83,,percent of total billed charges,,63.26,,,,fee schedule,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,15.19,99.75,
X-RAY EXAM OF RIBS/CHEST,71101TC,CDM,71101,CPT,,,both,TC,688,688,33.76,,,,fee schedule,,,,,,,,24.8,,,,fee schedule,,,584.8,85,,percent of total billed charges,,29.57,,,,fee schedule,,15.19,,,,fee schedule,,24.8,,,,fee schedule,,75.72,,,,fee schedule,,24.8,,,,fee schedule,,71.01,,,,fee schedule,,43.04,,,,fee schedule,,43.04,,,,fee schedule,,,626.08,91,,percent of total billed charges,,,653.6,95,,percent of total billed charges,,,571.04,83,,percent of total billed charges,,,206.4,83,,percent of total billed charges,,24.8,,,,fee schedule,,24.8,,,,fee schedule,,,571.04,83,,percent of total billed charges,,63.26,,,,fee schedule,,,619.2,90,,percent of total billed charges,,,619.2,90,,percent of total billed charges,,,619.2,90,,percent of total billed charges,,,619.2,90,,percent of total billed charges,,,584.8,85,,percent of total billed charges,,15.19,653.6,
XRAY Ribs Bilateral 3V+,71110,CDM,71110,CPT,,,both,,526,526,34.86,,,,fee schedule,,,,,,,,26.15,,,,fee schedule,,,447.1,85,,percent of total billed charges,,31.87,,,,fee schedule,,16.37,,,,fee schedule,,26.15,,,,fee schedule,,84.13,,,,fee schedule,,26.15,,,,fee schedule,,73.81,,,,fee schedule,,44.73,,,,fee schedule,,44.73,,,,fee schedule,,,478.66,91,,percent of total billed charges,,,499.7,95,,percent of total billed charges,,,436.58,83,,percent of total billed charges,,,157.8,83,,percent of total billed charges,,26.15,,,,fee schedule,,26.15,,,,fee schedule,,,436.58,83,,percent of total billed charges,,65.75,,,,fee schedule,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,447.1,85,,percent of total billed charges,,16.37,499.7,
XRAY Ribs BIL W/PA CXR 4V+,71111,CDM,71111,CPT,,,both,,630,630,45.46,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,,535.5,85,,percent of total billed charges,,34.97,,,,fee schedule,,17.96,,,,fee schedule,,28.7,,,,fee schedule,,96.75,,,,fee schedule,,28.7,,,,fee schedule,,88.34,,,,fee schedule,,53.54,,,,fee schedule,,53.54,,,,fee schedule,,,573.3,91,,percent of total billed charges,,,598.5,95,,percent of total billed charges,,,522.9,83,,percent of total billed charges,,,189,83,,percent of total billed charges,,28.7,,,,fee schedule,,28.7,,,,fee schedule,,,522.9,83,,percent of total billed charges,,78.71,,,,fee schedule,,,567,90,,percent of total billed charges,,,567,90,,percent of total billed charges,,,567,90,,percent of total billed charges,,,567,90,,percent of total billed charges,,,535.5,85,,percent of total billed charges,,17.96,598.5,
XRAY Sternum,71120,CDM,71120,CPT,,,both,,343,343,26.96,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,291.55,85,,percent of total billed charges,,21.85,,,,fee schedule,,11.22,,,,fee schedule,,21.5,,,,fee schedule,,68.01,,,,fee schedule,,21.5,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,312.13,91,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,102.9,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,284.69,83,,percent of total billed charges,,50.31,,,,fee schedule,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,291.55,85,,percent of total billed charges,,11.22,325.85,
X-RAY EXAM OF BREASTBONE,7112026,CDM,71120,CPT,,,both,26,87,87,26.96,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,73.95,85,,percent of total billed charges,,21.85,,,,fee schedule,,11.22,,,,fee schedule,,21.5,,,,fee schedule,,68.01,,,,fee schedule,,21.5,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,26.1,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,72.21,83,,percent of total billed charges,,50.31,,,,fee schedule,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,11.22,82.65,
X-RAY EXAM OF BREASTBONE,71120TC,CDM,71120,CPT,,,both,TC,435,435,26.96,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,369.75,85,,percent of total billed charges,,21.85,,,,fee schedule,,11.22,,,,fee schedule,,21.5,,,,fee schedule,,68.01,,,,fee schedule,,21.5,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,395.85,91,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,130.5,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,361.05,83,,percent of total billed charges,,50.31,,,,fee schedule,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,11.22,413.25,
XRAY Cervical/Thoracic/Lumbar Spine 1V    site:,72020,CDM,72020,CPT,,,both,,70,70,20.21,,,,fee schedule,,,,,,,,24.15,,,,fee schedule,,,59.5,85,,percent of total billed charges,,17.96,,,,fee schedule,,9.22,,,,fee schedule,,24.15,,,,fee schedule,,45.57,,,,fee schedule,,24.15,,,,fee schedule,,41.38,,,,fee schedule,,25.08,,,,fee schedule,,25.08,,,,fee schedule,,,63.7,91,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,21,83,,percent of total billed charges,,24.15,,,,fee schedule,,24.15,,,,fee schedule,,,58.1,83,,percent of total billed charges,,36.86,,,,fee schedule,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,9.22,66.5,
X-RAY EXAM OF SPINE,7202026,CDM,72020,CPT,,,both,26,65,65,20.21,,,,fee schedule,,,,,,,,24.15,,,,fee schedule,,,55.25,85,,percent of total billed charges,,17.96,,,,fee schedule,,9.22,,,,fee schedule,,24.15,,,,fee schedule,,45.57,,,,fee schedule,,24.15,,,,fee schedule,,41.38,,,,fee schedule,,25.08,,,,fee schedule,,25.08,,,,fee schedule,,,59.15,91,,percent of total billed charges,,,61.75,95,,percent of total billed charges,,,53.95,83,,percent of total billed charges,,,19.5,83,,percent of total billed charges,,24.15,,,,fee schedule,,24.15,,,,fee schedule,,,53.95,83,,percent of total billed charges,,36.86,,,,fee schedule,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,55.25,85,,percent of total billed charges,,9.22,61.75,
X-RAY EXAM OF SPINE,72020TC,CDM,72020,CPT,,,both,TC,407,407,20.21,,,,fee schedule,,,,,,,,24.15,,,,fee schedule,,,345.95,85,,percent of total billed charges,,17.96,,,,fee schedule,,9.22,,,,fee schedule,,24.15,,,,fee schedule,,45.57,,,,fee schedule,,24.15,,,,fee schedule,,41.38,,,,fee schedule,,25.08,,,,fee schedule,,25.08,,,,fee schedule,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,122.1,83,,percent of total billed charges,,24.15,,,,fee schedule,,24.15,,,,fee schedule,,,337.81,83,,percent of total billed charges,,36.86,,,,fee schedule,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,9.22,386.65,
XRAY Cervical Spine 2V,72040,CDM,72040,CPT,,,both,,107,107,30.85,,,,fee schedule,,,,,,,,24.15,,,,fee schedule,,,90.95,85,,percent of total billed charges,,23.02,,,,fee schedule,,12.78,,,,fee schedule,,24.15,,,,fee schedule,,65.9,,,,fee schedule,,24.15,,,,fee schedule,,66.54,,,,fee schedule,,40.33,,,,fee schedule,,40.33,,,,fee schedule,,,97.37,91,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,32.1,83,,percent of total billed charges,,24.15,,,,fee schedule,,24.15,,,,fee schedule,,,88.81,83,,percent of total billed charges,,59.28,,,,fee schedule,,,96.3,90,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,90.95,85,,percent of total billed charges,,12.78,101.65,
X-RAY EXAM OF NECK SPINE,7204026,CDM,72040,CPT,,,both,26,98,98,30.85,,,,fee schedule,,,,,,,,24.15,,,,fee schedule,,,83.3,85,,percent of total billed charges,,23.02,,,,fee schedule,,12.78,,,,fee schedule,,24.15,,,,fee schedule,,65.9,,,,fee schedule,,24.15,,,,fee schedule,,66.54,,,,fee schedule,,40.33,,,,fee schedule,,40.33,,,,fee schedule,,,89.18,91,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,29.4,83,,percent of total billed charges,,24.15,,,,fee schedule,,24.15,,,,fee schedule,,,81.34,83,,percent of total billed charges,,59.28,,,,fee schedule,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,83.3,85,,percent of total billed charges,,12.78,93.1,
X-RAY EXAM OF NECK SPINE,72040TC,CDM,72040,CPT,,,both,TC,484,484,30.85,,,,fee schedule,,,,,,,,24.15,,,,fee schedule,,,411.4,85,,percent of total billed charges,,23.02,,,,fee schedule,,12.78,,,,fee schedule,,24.15,,,,fee schedule,,65.9,,,,fee schedule,,24.15,,,,fee schedule,,66.54,,,,fee schedule,,40.33,,,,fee schedule,,40.33,,,,fee schedule,,,440.44,91,,percent of total billed charges,,,459.8,95,,percent of total billed charges,,,401.72,83,,percent of total billed charges,,,145.2,83,,percent of total billed charges,,24.15,,,,fee schedule,,24.15,,,,fee schedule,,,401.72,83,,percent of total billed charges,,59.28,,,,fee schedule,,,435.6,90,,percent of total billed charges,,,435.6,90,,percent of total billed charges,,,435.6,90,,percent of total billed charges,,,435.6,90,,percent of total billed charges,,,411.4,85,,percent of total billed charges,,12.78,459.8,
XRAY Cervical Spine 4V+,72050,CDM,72050,CPT,,,both,,561,561,41.56,,,,fee schedule,,,,,,,,35.25,,,,fee schedule,,,476.85,85,,percent of total billed charges,,28.02,,,,fee schedule,,15.56,,,,fee schedule,,35.25,,,,fee schedule,,96.05,,,,fee schedule,,35.25,,,,fee schedule,,89.46,,,,fee schedule,,54.22,,,,fee schedule,,54.22,,,,fee schedule,,,510.51,91,,percent of total billed charges,,,532.95,95,,percent of total billed charges,,,465.63,83,,percent of total billed charges,,,168.3,83,,percent of total billed charges,,35.25,,,,fee schedule,,35.25,,,,fee schedule,,,465.63,83,,percent of total billed charges,,79.7,,,,fee schedule,,,504.9,90,,percent of total billed charges,,,504.9,90,,percent of total billed charges,,,504.9,90,,percent of total billed charges,,,504.9,90,,percent of total billed charges,,,476.85,85,,percent of total billed charges,,15.56,532.95,
X-RAY EXAM OF NECK SPINE,7205026,CDM,72050,CPT,,,both,26,130,130,41.56,,,,fee schedule,,,,,,,,35.25,,,,fee schedule,,,110.5,85,,percent of total billed charges,,28.02,,,,fee schedule,,15.56,,,,fee schedule,,35.25,,,,fee schedule,,96.05,,,,fee schedule,,35.25,,,,fee schedule,,89.46,,,,fee schedule,,54.22,,,,fee schedule,,54.22,,,,fee schedule,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,39,83,,percent of total billed charges,,35.25,,,,fee schedule,,35.25,,,,fee schedule,,,107.9,83,,percent of total billed charges,,79.7,,,,fee schedule,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,15.56,123.5,
X-RAY EXAM OF NECK SPINE,72050TC,CDM,72050,CPT,,,both,TC,759,759,41.56,,,,fee schedule,,,,,,,,35.25,,,,fee schedule,,,645.15,85,,percent of total billed charges,,28.02,,,,fee schedule,,15.56,,,,fee schedule,,35.25,,,,fee schedule,,96.05,,,,fee schedule,,35.25,,,,fee schedule,,89.46,,,,fee schedule,,54.22,,,,fee schedule,,54.22,,,,fee schedule,,,690.69,91,,percent of total billed charges,,,721.05,95,,percent of total billed charges,,,629.97,83,,percent of total billed charges,,,227.7,83,,percent of total billed charges,,35.25,,,,fee schedule,,35.25,,,,fee schedule,,,629.97,83,,percent of total billed charges,,79.7,,,,fee schedule,,,683.1,90,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,645.15,85,,percent of total billed charges,,15.56,721.05,
XRAY Cervical Spine W/FLEX/EXT,72052,CDM,72052,CPT,,,both,,579,579,53.26,,,,fee schedule,,,,,,,,36.5,,,,fee schedule,,,492.15,85,,percent of total billed charges,,30.22,,,,fee schedule,,16.78,,,,fee schedule,,36.5,,,,fee schedule,,118.49,,,,fee schedule,,36.5,,,,fee schedule,,104.56,,,,fee schedule,,63.37,,,,fee schedule,,63.37,,,,fee schedule,,,526.89,91,,percent of total billed charges,,,550.05,95,,percent of total billed charges,,,480.57,83,,percent of total billed charges,,,173.7,83,,percent of total billed charges,,36.5,,,,fee schedule,,36.5,,,,fee schedule,,,480.57,83,,percent of total billed charges,,93.15,,,,fee schedule,,,521.1,90,,percent of total billed charges,,,521.1,90,,percent of total billed charges,,,521.1,90,,percent of total billed charges,,,521.1,90,,percent of total billed charges,,,492.15,85,,percent of total billed charges,,16.78,550.05,
X-RAY EXAM OF NECK SPINE,7205226,CDM,72052,CPT,,,both,26,163,163,53.26,,,,fee schedule,,,,,,,,36.5,,,,fee schedule,,,138.55,85,,percent of total billed charges,,30.22,,,,fee schedule,,16.78,,,,fee schedule,,36.5,,,,fee schedule,,118.49,,,,fee schedule,,36.5,,,,fee schedule,,104.56,,,,fee schedule,,63.37,,,,fee schedule,,63.37,,,,fee schedule,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,48.9,83,,percent of total billed charges,,36.5,,,,fee schedule,,36.5,,,,fee schedule,,,135.29,83,,percent of total billed charges,,93.15,,,,fee schedule,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,16.78,154.85,
X-RAY EXAM OF NECK SPINE,72052TC,CDM,72052,CPT,,,both,TC,856,856,53.26,,,,fee schedule,,,,,,,,36.5,,,,fee schedule,,,727.6,85,,percent of total billed charges,,30.22,,,,fee schedule,,16.78,,,,fee schedule,,36.5,,,,fee schedule,,118.49,,,,fee schedule,,36.5,,,,fee schedule,,104.56,,,,fee schedule,,63.37,,,,fee schedule,,63.37,,,,fee schedule,,,778.96,91,,percent of total billed charges,,,813.2,95,,percent of total billed charges,,,710.48,83,,percent of total billed charges,,,256.8,83,,percent of total billed charges,,36.5,,,,fee schedule,,36.5,,,,fee schedule,,,710.48,83,,percent of total billed charges,,93.15,,,,fee schedule,,,770.4,90,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,770.4,90,,percent of total billed charges,,,727.6,85,,percent of total billed charges,,16.78,813.2,
XRAY Thoracic Spine 2V,72070,CDM,72070,CPT,,,both,,196,196,28.94,,,,fee schedule,,,,,,,,22.8,,,,fee schedule,,,166.6,85,,percent of total billed charges,,20.88,,,,fee schedule,,11.59,,,,fee schedule,,22.8,,,,fee schedule,,69.41,,,,fee schedule,,22.8,,,,fee schedule,,55.35,,,,fee schedule,,33.55,,,,fee schedule,,33.55,,,,fee schedule,,,178.36,91,,percent of total billed charges,,,186.2,95,,percent of total billed charges,,,162.68,83,,percent of total billed charges,,,58.8,83,,percent of total billed charges,,22.8,,,,fee schedule,,22.8,,,,fee schedule,,,162.68,83,,percent of total billed charges,,49.32,,,,fee schedule,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,166.6,85,,percent of total billed charges,,11.59,186.2,
X-RAY EXAM OF THORACIC SPINE,7207026,CDM,72070,CPT,,,both,26,93,93,28.94,,,,fee schedule,,,,,,,,22.8,,,,fee schedule,,,79.05,85,,percent of total billed charges,,20.88,,,,fee schedule,,11.59,,,,fee schedule,,22.8,,,,fee schedule,,69.41,,,,fee schedule,,22.8,,,,fee schedule,,55.35,,,,fee schedule,,33.55,,,,fee schedule,,33.55,,,,fee schedule,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,22.8,,,,fee schedule,,22.8,,,,fee schedule,,,77.19,83,,percent of total billed charges,,49.32,,,,fee schedule,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,11.59,88.35,
X-RAY EXAM OF THORACIC SPINE,72070TC,CDM,72070,CPT,,,both,TC,457,457,28.94,,,,fee schedule,,,,,,,,22.8,,,,fee schedule,,,388.45,85,,percent of total billed charges,,20.88,,,,fee schedule,,11.59,,,,fee schedule,,22.8,,,,fee schedule,,69.41,,,,fee schedule,,22.8,,,,fee schedule,,55.35,,,,fee schedule,,33.55,,,,fee schedule,,33.55,,,,fee schedule,,,415.87,91,,percent of total billed charges,,,434.15,95,,percent of total billed charges,,,379.31,83,,percent of total billed charges,,,137.1,83,,percent of total billed charges,,22.8,,,,fee schedule,,22.8,,,,fee schedule,,,379.31,83,,percent of total billed charges,,49.32,,,,fee schedule,,,411.3,90,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,411.3,90,,percent of total billed charges,,,388.45,85,,percent of total billed charges,,11.59,434.15,
XRAY Thoracic Spine 3V,72072,CDM,72072,CPT,,,both,,246,246,31.69,,,,fee schedule,,,,,,,,20.95,,,,fee schedule,,,209.1,85,,percent of total billed charges,,24.95,,,,fee schedule,,12.81,,,,fee schedule,,20.95,,,,fee schedule,,75.72,,,,fee schedule,,20.95,,,,fee schedule,,65.98,,,,fee schedule,,39.99,,,,fee schedule,,39.99,,,,fee schedule,,,223.86,91,,percent of total billed charges,,,233.7,95,,percent of total billed charges,,,204.18,83,,percent of total billed charges,,,73.8,83,,percent of total billed charges,,20.95,,,,fee schedule,,20.95,,,,fee schedule,,,204.18,83,,percent of total billed charges,,58.78,,,,fee schedule,,,221.4,90,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,209.1,85,,percent of total billed charges,,12.81,233.7,
X-RAY EXAM OF THORACIC SPINE,7207226,CDM,72072,CPT,,,both,26,100,100,31.69,,,,fee schedule,,,,,,,,20.95,,,,fee schedule,,,85,85,,percent of total billed charges,,24.95,,,,fee schedule,,12.81,,,,fee schedule,,20.95,,,,fee schedule,,75.72,,,,fee schedule,,20.95,,,,fee schedule,,65.98,,,,fee schedule,,39.99,,,,fee schedule,,39.99,,,,fee schedule,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,30,83,,percent of total billed charges,,20.95,,,,fee schedule,,20.95,,,,fee schedule,,,83,83,,percent of total billed charges,,58.78,,,,fee schedule,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,12.81,95,
X-RAY EXAM OF THORACIC SPINE,72072TC,CDM,72072,CPT,,,both,TC,587,587,31.69,,,,fee schedule,,,,,,,,20.95,,,,fee schedule,,,498.95,85,,percent of total billed charges,,24.95,,,,fee schedule,,12.81,,,,fee schedule,,20.95,,,,fee schedule,,75.72,,,,fee schedule,,20.95,,,,fee schedule,,65.98,,,,fee schedule,,39.99,,,,fee schedule,,39.99,,,,fee schedule,,,534.17,91,,percent of total billed charges,,,557.65,95,,percent of total billed charges,,,487.21,83,,percent of total billed charges,,,176.1,83,,percent of total billed charges,,20.95,,,,fee schedule,,20.95,,,,fee schedule,,,487.21,83,,percent of total billed charges,,58.78,,,,fee schedule,,,528.3,90,,percent of total billed charges,,,528.3,90,,percent of total billed charges,,,528.3,90,,percent of total billed charges,,,528.3,90,,percent of total billed charges,,,498.95,85,,percent of total billed charges,,12.81,557.65,
X-RAY EXAM OF THORACIC SPINE,7207426,CDM,72074,CPT,,,both,26,112,112,37.75,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,95.2,85,,percent of total billed charges,,27.26,,,,fee schedule,,14,,,,fee schedule,,21.5,,,,fee schedule,,89.04,,,,fee schedule,,21.5,,,,fee schedule,,74.37,,,,fee schedule,,45.07,,,,fee schedule,,45.07,,,,fee schedule,,,101.92,91,,percent of total billed charges,,,106.4,95,,percent of total billed charges,,,92.96,83,,percent of total billed charges,,,33.6,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,92.96,83,,percent of total billed charges,,66.25,,,,fee schedule,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,95.2,85,,percent of total billed charges,,14,106.4,
X-RAY EXAM OF THORACIC SPINE,72074TC,CDM,72074,CPT,,,both,TC,606,606,37.75,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,515.1,85,,percent of total billed charges,,27.26,,,,fee schedule,,14,,,,fee schedule,,21.5,,,,fee schedule,,89.04,,,,fee schedule,,21.5,,,,fee schedule,,74.37,,,,fee schedule,,45.07,,,,fee schedule,,45.07,,,,fee schedule,,,551.46,91,,percent of total billed charges,,,575.7,95,,percent of total billed charges,,,502.98,83,,percent of total billed charges,,,181.8,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,502.98,83,,percent of total billed charges,,66.25,,,,fee schedule,,,545.4,90,,percent of total billed charges,,,545.4,90,,percent of total billed charges,,,545.4,90,,percent of total billed charges,,,545.4,90,,percent of total billed charges,,,515.1,85,,percent of total billed charges,,14,575.7,
X-RAY EXAM OF TRUNK SPINE,72080,CDM,72080,CPT,,,both,,224,224,31.68,,,,fee schedule,,,,,,,,25.4,,,,fee schedule,,,190.4,85,,percent of total billed charges,,23.36,,,,fee schedule,,12,,,,fee schedule,,25.4,,,,fee schedule,,70.81,,,,fee schedule,,25.4,,,,fee schedule,,58.15,,,,fee schedule,,35.24,,,,fee schedule,,35.24,,,,fee schedule,,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,67.2,83,,percent of total billed charges,,25.4,,,,fee schedule,,25.4,,,,fee schedule,,,185.92,83,,percent of total billed charges,,51.81,,,,fee schedule,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,12,212.8,
XRAY SCOLIOSIS,72081,CDM,72081,CPT,,,both,,200,200,32.66,,,,fee schedule,,,,,,,,22.01,,,,fee schedule,,,170,85,,percent of total billed charges,,28.77,,,,fee schedule,,14.78,,,,fee schedule,,22.01,,,,fee schedule,,,,,,,,22.01,,,,fee schedule,,71.57,,,,fee schedule,,43.38,,,,fee schedule,,43.38,,,,fee schedule,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,60,83,,percent of total billed charges,,22.01,,,,fee schedule,,22.01,,,,fee schedule,,,166,83,,percent of total billed charges,,63.76,,,,fee schedule,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,14.78,190,
X-RAY EXAM ENTIRE SPI 1 VW,7208126,CDM,72081,CPT,,,both,26,94,94,32.66,,,,fee schedule,,,,,,,,22.01,,,,fee schedule,,,79.9,85,,percent of total billed charges,,28.77,,,,fee schedule,,14.78,,,,fee schedule,,22.01,,,,fee schedule,,,,,,,,22.01,,,,fee schedule,,71.57,,,,fee schedule,,43.38,,,,fee schedule,,43.38,,,,fee schedule,,,85.54,91,,percent of total billed charges,,,89.3,95,,percent of total billed charges,,,78.02,83,,percent of total billed charges,,,28.2,83,,percent of total billed charges,,22.01,,,,fee schedule,,22.01,,,,fee schedule,,,78.02,83,,percent of total billed charges,,63.76,,,,fee schedule,,,84.6,90,,percent of total billed charges,,,84.6,90,,percent of total billed charges,,,84.6,90,,percent of total billed charges,,,84.6,90,,percent of total billed charges,,,79.9,85,,percent of total billed charges,,14.78,89.3,
X-RAY EXAM ENTIRE SPI 1 VW,72081TC,CDM,72081,CPT,,,both,TC,417,417,32.66,,,,fee schedule,,,,,,,,22.01,,,,fee schedule,,,354.45,85,,percent of total billed charges,,28.77,,,,fee schedule,,14.78,,,,fee schedule,,22.01,,,,fee schedule,,,,,,,,22.01,,,,fee schedule,,71.57,,,,fee schedule,,43.38,,,,fee schedule,,43.38,,,,fee schedule,,,379.47,91,,percent of total billed charges,,,396.15,95,,percent of total billed charges,,,346.11,83,,percent of total billed charges,,,125.1,83,,percent of total billed charges,,22.01,,,,fee schedule,,22.01,,,,fee schedule,,,346.11,83,,percent of total billed charges,,63.76,,,,fee schedule,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,375.3,90,,percent of total billed charges,,,354.45,85,,percent of total billed charges,,14.78,396.15,
XRAY Lumbar Spine 2-3V,72100,CDM,72100,CPT,,,both,,213,213,31.13,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,,181.05,85,,percent of total billed charges,,22.97,,,,fee schedule,,12.78,,,,fee schedule,,28.7,,,,fee schedule,,70.81,,,,fee schedule,,28.7,,,,fee schedule,,67.1,,,,fee schedule,,40.66,,,,fee schedule,,40.66,,,,fee schedule,,,193.83,91,,percent of total billed charges,,,202.35,95,,percent of total billed charges,,,176.79,83,,percent of total billed charges,,,63.9,83,,percent of total billed charges,,28.7,,,,fee schedule,,28.7,,,,fee schedule,,,176.79,83,,percent of total billed charges,,59.78,,,,fee schedule,,,191.7,90,,percent of total billed charges,,,191.7,90,,percent of total billed charges,,,191.7,90,,percent of total billed charges,,,191.7,90,,percent of total billed charges,,,181.05,85,,percent of total billed charges,,12.78,202.35,
X-RAY EXAM OF LOWER SPINE,7210026,CDM,72100,CPT,,,both,26,103,103,31.13,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,,87.55,85,,percent of total billed charges,,22.97,,,,fee schedule,,12.78,,,,fee schedule,,28.7,,,,fee schedule,,70.81,,,,fee schedule,,28.7,,,,fee schedule,,67.1,,,,fee schedule,,40.66,,,,fee schedule,,40.66,,,,fee schedule,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,30.9,83,,percent of total billed charges,,28.7,,,,fee schedule,,28.7,,,,fee schedule,,,85.49,83,,percent of total billed charges,,59.78,,,,fee schedule,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,12.78,97.85,
X-RAY EXAM OF LOWER SPINE,72100TC,CDM,72100,CPT,,,both,TC,524,524,31.13,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,,445.4,85,,percent of total billed charges,,22.97,,,,fee schedule,,12.78,,,,fee schedule,,28.7,,,,fee schedule,,70.81,,,,fee schedule,,28.7,,,,fee schedule,,67.1,,,,fee schedule,,40.66,,,,fee schedule,,40.66,,,,fee schedule,,,476.84,91,,percent of total billed charges,,,497.8,95,,percent of total billed charges,,,434.92,83,,percent of total billed charges,,,157.2,83,,percent of total billed charges,,28.7,,,,fee schedule,,28.7,,,,fee schedule,,,434.92,83,,percent of total billed charges,,59.78,,,,fee schedule,,,471.6,90,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,445.4,85,,percent of total billed charges,,12.78,497.8,
XRAY Lumbar Spine 4V+,72110,CDM,72110,CPT,,,both,,346,346,42.11,,,,fee schedule,,,,,,,,37.9,,,,fee schedule,,,294.1,85,,percent of total billed charges,,26.56,,,,fee schedule,,14.78,,,,fee schedule,,37.9,,,,fee schedule,,97.45,,,,fee schedule,,37.9,,,,fee schedule,,86.11,,,,fee schedule,,52.19,,,,fee schedule,,52.19,,,,fee schedule,,,314.86,91,,percent of total billed charges,,,328.7,95,,percent of total billed charges,,,287.18,83,,percent of total billed charges,,,103.8,83,,percent of total billed charges,,37.9,,,,fee schedule,,37.9,,,,fee schedule,,,287.18,83,,percent of total billed charges,,76.71,,,,fee schedule,,,311.4,90,,percent of total billed charges,,,311.4,90,,percent of total billed charges,,,311.4,90,,percent of total billed charges,,,311.4,90,,percent of total billed charges,,,294.1,85,,percent of total billed charges,,14.78,328.7,
X-RAY EXAM OF LOWER SPINE,7211026,CDM,72110,CPT,,,both,26,143,143,42.11,,,,fee schedule,,,,,,,,37.9,,,,fee schedule,,,121.55,85,,percent of total billed charges,,26.56,,,,fee schedule,,14.78,,,,fee schedule,,37.9,,,,fee schedule,,97.45,,,,fee schedule,,37.9,,,,fee schedule,,86.11,,,,fee schedule,,52.19,,,,fee schedule,,52.19,,,,fee schedule,,,130.13,91,,percent of total billed charges,,,135.85,95,,percent of total billed charges,,,118.69,83,,percent of total billed charges,,,42.9,83,,percent of total billed charges,,37.9,,,,fee schedule,,37.9,,,,fee schedule,,,118.69,83,,percent of total billed charges,,76.71,,,,fee schedule,,,128.7,90,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,128.7,90,,percent of total billed charges,,,121.55,85,,percent of total billed charges,,14.78,135.85,
X-RAY EXAM OF LOWER SPINE,72110TC,CDM,72110,CPT,,,both,TC,812,812,42.11,,,,fee schedule,,,,,,,,37.9,,,,fee schedule,,,690.2,85,,percent of total billed charges,,26.56,,,,fee schedule,,14.78,,,,fee schedule,,37.9,,,,fee schedule,,97.45,,,,fee schedule,,37.9,,,,fee schedule,,86.11,,,,fee schedule,,52.19,,,,fee schedule,,52.19,,,,fee schedule,,,738.92,91,,percent of total billed charges,,,771.4,95,,percent of total billed charges,,,673.96,83,,percent of total billed charges,,,243.6,83,,percent of total billed charges,,37.9,,,,fee schedule,,37.9,,,,fee schedule,,,673.96,83,,percent of total billed charges,,76.71,,,,fee schedule,,,730.8,90,,percent of total billed charges,,,730.8,90,,percent of total billed charges,,,730.8,90,,percent of total billed charges,,,730.8,90,,percent of total billed charges,,,690.2,85,,percent of total billed charges,,14.78,771.4,
X-RAY LUMBAR FLEXION EXTENSION,72120,CDM,72120,CPT,,,both,,265,265,36.63,,,,fee schedule,,,,,,,,37.9,,,,fee schedule,,,225.25,85,,percent of total billed charges,,24.88,,,,fee schedule,,12.78,,,,fee schedule,,37.9,,,,fee schedule,,87.64,,,,fee schedule,,37.9,,,,fee schedule,,68.21,,,,fee schedule,,41.34,,,,fee schedule,,41.34,,,,fee schedule,,,241.15,91,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,79.5,83,,percent of total billed charges,,37.9,,,,fee schedule,,37.9,,,,fee schedule,,,219.95,83,,percent of total billed charges,,60.77,,,,fee schedule,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,12.78,251.75,
XRAY Pelvis 1-2V,72170,CDM,72170,CPT,,,both,,371,371,25.21,,,,fee schedule,,,,,,,,15.7,,,,fee schedule,,,315.35,85,,percent of total billed charges,,19.47,,,,fee schedule,,10,,,,fee schedule,,15.7,,,,fee schedule,,54.69,,,,fee schedule,,15.7,,,,fee schedule,,46.97,,,,fee schedule,,28.47,,,,fee schedule,,28.47,,,,fee schedule,,,337.61,91,,percent of total billed charges,,,352.45,95,,percent of total billed charges,,,307.93,83,,percent of total billed charges,,,111.3,83,,percent of total billed charges,,15.7,,,,fee schedule,,15.7,,,,fee schedule,,,307.93,83,,percent of total billed charges,,41.84,,,,fee schedule,,,333.9,90,,percent of total billed charges,,,333.9,90,,percent of total billed charges,,,333.9,90,,percent of total billed charges,,,333.9,90,,percent of total billed charges,,,315.35,85,,percent of total billed charges,,10,352.45,
X-RAY EXAM OF PELVIS,7217026,CDM,72170,CPT,,,both,26,80,80,25.21,,,,fee schedule,,,,,,,,15.7,,,,fee schedule,,,68,85,,percent of total billed charges,,19.47,,,,fee schedule,,10,,,,fee schedule,,15.7,,,,fee schedule,,54.69,,,,fee schedule,,15.7,,,,fee schedule,,46.97,,,,fee schedule,,28.47,,,,fee schedule,,28.47,,,,fee schedule,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,24,83,,percent of total billed charges,,15.7,,,,fee schedule,,15.7,,,,fee schedule,,,66.4,83,,percent of total billed charges,,41.84,,,,fee schedule,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,10,76,
X-RAY EXAM OF PELVIS,72170TC,CDM,72170,CPT,,,both,TC,407,407,25.21,,,,fee schedule,,,,,,,,15.7,,,,fee schedule,,,345.95,85,,percent of total billed charges,,19.47,,,,fee schedule,,10,,,,fee schedule,,15.7,,,,fee schedule,,54.69,,,,fee schedule,,15.7,,,,fee schedule,,46.97,,,,fee schedule,,28.47,,,,fee schedule,,28.47,,,,fee schedule,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,122.1,83,,percent of total billed charges,,15.7,,,,fee schedule,,15.7,,,,fee schedule,,,337.81,83,,percent of total billed charges,,41.84,,,,fee schedule,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,10,386.65,
XRAY Pelvis 3V+,72190,CDM,72190,CPT,,,both,,427,427,37.43,,,,fee schedule,,,,,,,,35.25,,,,fee schedule,,,362.95,85,,percent of total billed charges,,27.98,,,,fee schedule,,14.37,,,,fee schedule,,35.25,,,,fee schedule,,70.11,,,,fee schedule,,35.25,,,,fee schedule,,71.01,,,,fee schedule,,43.04,,,,fee schedule,,43.04,,,,fee schedule,,,388.57,91,,percent of total billed charges,,,405.65,95,,percent of total billed charges,,,354.41,83,,percent of total billed charges,,,128.1,83,,percent of total billed charges,,35.25,,,,fee schedule,,35.25,,,,fee schedule,,,354.41,83,,percent of total billed charges,,63.26,,,,fee schedule,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,362.95,85,,percent of total billed charges,,14.37,405.65,
X-RAY EXAM OF PELVIS,7219026,CDM,72190,CPT,,,both,26,111,111,37.43,,,,fee schedule,,,,,,,,35.25,,,,fee schedule,,,94.35,85,,percent of total billed charges,,27.98,,,,fee schedule,,14.37,,,,fee schedule,,35.25,,,,fee schedule,,70.11,,,,fee schedule,,35.25,,,,fee schedule,,71.01,,,,fee schedule,,43.04,,,,fee schedule,,43.04,,,,fee schedule,,,101.01,91,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,33.3,83,,percent of total billed charges,,35.25,,,,fee schedule,,35.25,,,,fee schedule,,,92.13,83,,percent of total billed charges,,63.26,,,,fee schedule,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,94.35,85,,percent of total billed charges,,14.37,105.45,
X-RAY EXAM OF PELVIS,72190TC,CDM,72190,CPT,,,both,TC,533,533,37.43,,,,fee schedule,,,,,,,,35.25,,,,fee schedule,,,453.05,85,,percent of total billed charges,,27.98,,,,fee schedule,,14.37,,,,fee schedule,,35.25,,,,fee schedule,,70.11,,,,fee schedule,,35.25,,,,fee schedule,,71.01,,,,fee schedule,,43.04,,,,fee schedule,,43.04,,,,fee schedule,,,485.03,91,,percent of total billed charges,,,506.35,95,,percent of total billed charges,,,442.39,83,,percent of total billed charges,,,159.9,83,,percent of total billed charges,,35.25,,,,fee schedule,,35.25,,,,fee schedule,,,442.39,83,,percent of total billed charges,,63.26,,,,fee schedule,,,479.7,90,,percent of total billed charges,,,479.7,90,,percent of total billed charges,,,479.7,90,,percent of total billed charges,,,479.7,90,,percent of total billed charges,,,453.05,85,,percent of total billed charges,,14.37,506.35,
MRI PELVIS W/O & W/DYE,7219726,CDM,72197,CPT,,,both,26,698,698,514.37,,,,fee schedule,,,,,,,,452.3,,,,fee schedule,,,593.3,85,,percent of total billed charges,,240.85,,,,fee schedule,,123.7,,,,fee schedule,,452.3,,,,fee schedule,,2026.19,,,,fee schedule,,452.3,,,,fee schedule,,591.01,,,,fee schedule,,358.19,,,,fee schedule,,358.19,,,,fee schedule,,,635.18,91,,percent of total billed charges,,,663.1,95,,percent of total billed charges,,,579.34,83,,percent of total billed charges,,,209.4,83,,percent of total billed charges,,452.3,,,,fee schedule,,452.3,,,,fee schedule,,,579.34,83,,percent of total billed charges,,526.54,,,,fee schedule,,,628.2,90,,percent of total billed charges,,,628.2,90,,percent of total billed charges,,,628.2,90,,percent of total billed charges,,,628.2,90,,percent of total billed charges,,,593.3,85,,percent of total billed charges,,123.7,2026.19,
X-RAY EXAM SACROILIAC JOINTS,7220226,CDM,72202,CPT,,,both,26,62,62,29.68,,,,fee schedule,,,,,,,,22.8,,,,fee schedule,,,52.7,85,,percent of total billed charges,,24.95,,,,fee schedule,,12.81,,,,fee schedule,,22.8,,,,fee schedule,,64.5,,,,fee schedule,,22.8,,,,fee schedule,,65.98,,,,fee schedule,,39.99,,,,fee schedule,,39.99,,,,fee schedule,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,22.8,,,,fee schedule,,22.8,,,,fee schedule,,,51.46,83,,percent of total billed charges,,58.78,,,,fee schedule,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,12.81,65.98,
XRAY Sacrum And Coccyx,72220,CDM,72220,CPT,,,both,,211,211,24.95,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,179.35,85,,percent of total billed charges,,19.47,,,,fee schedule,,10,,,,fee schedule,,21.5,,,,fee schedule,,59.59,,,,fee schedule,,21.5,,,,fee schedule,,54.8,,,,fee schedule,,33.21,,,,fee schedule,,33.21,,,,fee schedule,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,63.3,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,175.13,83,,percent of total billed charges,,48.82,,,,fee schedule,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,10,200.45,
X-RAY EXAM OF TAILBONE,7222026,CDM,72220,CPT,,,both,26,81,81,24.95,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,68.85,85,,percent of total billed charges,,19.47,,,,fee schedule,,10,,,,fee schedule,,21.5,,,,fee schedule,,59.59,,,,fee schedule,,21.5,,,,fee schedule,,54.8,,,,fee schedule,,33.21,,,,fee schedule,,33.21,,,,fee schedule,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,24.3,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,67.23,83,,percent of total billed charges,,48.82,,,,fee schedule,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,10,76.95,
X-RAY EXAM OF TAILBONE,72220TC,CDM,72220,CPT,,,both,TC,441,441,24.95,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,374.85,85,,percent of total billed charges,,19.47,,,,fee schedule,,10,,,,fee schedule,,21.5,,,,fee schedule,,59.59,,,,fee schedule,,21.5,,,,fee schedule,,54.8,,,,fee schedule,,33.21,,,,fee schedule,,33.21,,,,fee schedule,,,401.31,91,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,132.3,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,366.03,83,,percent of total billed charges,,48.82,,,,fee schedule,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,374.85,85,,percent of total billed charges,,10,418.95,
EPIDUROGRAPHY,72275,CDM,72275,CPT,,,both,,927,927,,,,,,,,,,,,,,,,,,,,787.95,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,232.77,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,843.57,91,,percent of total billed charges,,,880.65,95,,percent of total billed charges,,,769.41,83,,percent of total billed charges,,,278.1,83,,percent of total billed charges,,,,,,,,,,,,,,,769.41,83,,percent of total billed charges,,,,,,,,,834.3,90,,percent of total billed charges,,,834.3,90,,percent of total billed charges,,,834.3,90,,percent of total billed charges,,,834.3,90,,percent of total billed charges,,,787.95,85,,percent of total billed charges,,232.77,880.65,
XRAY Clavicle     side:,73000,CDM,73000,CPT,,,both,,343,343,24.92,,,,fee schedule,,,,,,,,15,,,,fee schedule,,,291.55,85,,percent of total billed charges,,18.68,,,,fee schedule,,9.59,,,,fee schedule,,15,,,,fee schedule,,53.28,,,,fee schedule,,15,,,,fee schedule,,54.24,,,,fee schedule,,32.87,,,,fee schedule,,32.87,,,,fee schedule,,,312.13,91,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,102.9,83,,percent of total billed charges,,15,,,,fee schedule,,15,,,,fee schedule,,,284.69,83,,percent of total billed charges,,48.32,,,,fee schedule,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,291.55,85,,percent of total billed charges,,9.59,325.85,
X-RAY EXAM OF COLLAR BONE,7300026,CDM,73000,CPT,,,both,26,81,81,24.92,,,,fee schedule,,,,,,,,15,,,,fee schedule,,,68.85,85,,percent of total billed charges,,18.68,,,,fee schedule,,9.59,,,,fee schedule,,15,,,,fee schedule,,53.28,,,,fee schedule,,15,,,,fee schedule,,54.24,,,,fee schedule,,32.87,,,,fee schedule,,32.87,,,,fee schedule,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,24.3,83,,percent of total billed charges,,15,,,,fee schedule,,15,,,,fee schedule,,,67.23,83,,percent of total billed charges,,48.32,,,,fee schedule,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,9.59,76.95,
X-RAY EXAM OF COLLAR BONE,73000TC,CDM,73000,CPT,,,both,TC,385,385,24.92,,,,fee schedule,,,,,,,,15,,,,fee schedule,,,327.25,85,,percent of total billed charges,,18.68,,,,fee schedule,,9.59,,,,fee schedule,,15,,,,fee schedule,,53.28,,,,fee schedule,,15,,,,fee schedule,,54.24,,,,fee schedule,,32.87,,,,fee schedule,,32.87,,,,fee schedule,,,350.35,91,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,115.5,83,,percent of total billed charges,,15,,,,fee schedule,,15,,,,fee schedule,,,319.55,83,,percent of total billed charges,,48.32,,,,fee schedule,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,9.59,365.75,
XRAY Scapula     side:,73010,CDM,73010,CPT,,,both,,242,242,27.96,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,205.7,85,,percent of total billed charges,,20.19,,,,fee schedule,,10.37,,,,fee schedule,,21.5,,,,fee schedule,,54.69,,,,fee schedule,,21.5,,,,fee schedule,,39.7,,,,fee schedule,,24.06,,,,fee schedule,,24.06,,,,fee schedule,,,220.22,91,,percent of total billed charges,,,229.9,95,,percent of total billed charges,,,200.86,83,,percent of total billed charges,,,72.6,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,200.86,83,,percent of total billed charges,,35.37,,,,fee schedule,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,205.7,85,,percent of total billed charges,,10.37,229.9,
X-RAY EXAM OF SHOULDER BLADE,7301026,CDM,73010,CPT,,,both,26,89,89,27.96,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,75.65,85,,percent of total billed charges,,20.19,,,,fee schedule,,10.37,,,,fee schedule,,21.5,,,,fee schedule,,54.69,,,,fee schedule,,21.5,,,,fee schedule,,39.7,,,,fee schedule,,24.06,,,,fee schedule,,24.06,,,,fee schedule,,,80.99,91,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,26.7,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,73.87,83,,percent of total billed charges,,35.37,,,,fee schedule,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,10.37,84.55,
X-RAY EXAM OF SHOULDER BLADE,73010TC,CDM,73010,CPT,,,both,TC,424,424,27.96,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,360.4,85,,percent of total billed charges,,20.19,,,,fee schedule,,10.37,,,,fee schedule,,21.5,,,,fee schedule,,54.69,,,,fee schedule,,21.5,,,,fee schedule,,39.7,,,,fee schedule,,24.06,,,,fee schedule,,24.06,,,,fee schedule,,,385.84,91,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,127.2,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,351.92,83,,percent of total billed charges,,35.37,,,,fee schedule,,,381.6,90,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,10.37,402.8,
XRAY Shoulder 1V     side:,73020,CDM,73020,CPT,,,both,,283,283,20.49,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,240.55,85,,percent of total billed charges,,17.16,,,,fee schedule,,8.82,,,,fee schedule,,21.5,,,,fee schedule,,49.08,,,,fee schedule,,21.5,,,,fee schedule,,36.34,,,,fee schedule,,22.03,,,,fee schedule,,22.03,,,,fee schedule,,,257.53,91,,percent of total billed charges,,,268.85,95,,percent of total billed charges,,,234.89,83,,percent of total billed charges,,,84.9,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,234.89,83,,percent of total billed charges,,32.38,,,,fee schedule,,,254.7,90,,percent of total billed charges,,,254.7,90,,percent of total billed charges,,,254.7,90,,percent of total billed charges,,,254.7,90,,percent of total billed charges,,,240.55,85,,percent of total billed charges,,8.82,268.85,
X-RAY EXAM OF SHOULDER,7302026,CDM,73020,CPT,,,both,26,68,68,20.49,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,57.8,85,,percent of total billed charges,,17.16,,,,fee schedule,,8.82,,,,fee schedule,,21.5,,,,fee schedule,,49.08,,,,fee schedule,,21.5,,,,fee schedule,,36.34,,,,fee schedule,,22.03,,,,fee schedule,,22.03,,,,fee schedule,,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,56.44,83,,percent of total billed charges,,32.38,,,,fee schedule,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,8.82,64.6,
X-RAY EXAM OF SHOULDER,73020TC,CDM,73020,CPT,,,both,TC,407,407,20.49,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,345.95,85,,percent of total billed charges,,17.16,,,,fee schedule,,8.82,,,,fee schedule,,21.5,,,,fee schedule,,49.08,,,,fee schedule,,21.5,,,,fee schedule,,36.34,,,,fee schedule,,22.03,,,,fee schedule,,22.03,,,,fee schedule,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,122.1,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,337.81,83,,percent of total billed charges,,32.38,,,,fee schedule,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,8.82,386.65,
XRAY Shoulder 2V+     side:,73030,CDM,73030,CPT,,,both,,469,469,26.89,,,,fee schedule,,,,,,,,22.2,,,,fee schedule,,,398.65,85,,percent of total billed charges,,19.53,,,,fee schedule,,10.78,,,,fee schedule,,22.2,,,,fee schedule,,60.29,,,,fee schedule,,22.2,,,,fee schedule,,58.15,,,,fee schedule,,35.24,,,,fee schedule,,35.24,,,,fee schedule,,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,140.7,83,,percent of total billed charges,,22.2,,,,fee schedule,,22.2,,,,fee schedule,,,389.27,83,,percent of total billed charges,,51.81,,,,fee schedule,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,10.78,445.55,
X-RAY EXAM OF SHOULDER,7303026,CDM,73030,CPT,,,both,26,85,85,26.89,,,,fee schedule,,,,,,,,22.2,,,,fee schedule,,,72.25,85,,percent of total billed charges,,19.53,,,,fee schedule,,10.78,,,,fee schedule,,22.2,,,,fee schedule,,60.29,,,,fee schedule,,22.2,,,,fee schedule,,58.15,,,,fee schedule,,35.24,,,,fee schedule,,35.24,,,,fee schedule,,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,25.5,83,,percent of total billed charges,,22.2,,,,fee schedule,,22.2,,,,fee schedule,,,70.55,83,,percent of total billed charges,,51.81,,,,fee schedule,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,10.78,80.75,
X-RAY EXAM OF SHOULDER,73030TC,CDM,73030,CPT,,,both,TC,467,467,26.89,,,,fee schedule,,,,,,,,22.2,,,,fee schedule,,,396.95,85,,percent of total billed charges,,19.53,,,,fee schedule,,10.78,,,,fee schedule,,22.2,,,,fee schedule,,60.29,,,,fee schedule,,22.2,,,,fee schedule,,58.15,,,,fee schedule,,35.24,,,,fee schedule,,35.24,,,,fee schedule,,,424.97,91,,percent of total billed charges,,,443.65,95,,percent of total billed charges,,,387.61,83,,percent of total billed charges,,,140.1,83,,percent of total billed charges,,22.2,,,,fee schedule,,22.2,,,,fee schedule,,,387.61,83,,percent of total billed charges,,51.81,,,,fee schedule,,,420.3,90,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,396.95,85,,percent of total billed charges,,10.78,443.65,
XRAY Arthrogram Shoulder     side:,73040,CDM,73040,CPT,,,both,,1034,1034,90.49,,,,fee schedule,,,,,,,,23.5,,,,fee schedule,,,878.9,85,,percent of total billed charges,,58.12,,,,fee schedule,,32.08,,,,fee schedule,,23.5,,,,fee schedule,,207.53,,,,fee schedule,,23.5,,,,fee schedule,,221.42,,,,fee schedule,,134.19,,,,fee schedule,,134.19,,,,fee schedule,,,940.94,91,,percent of total billed charges,,,982.3,95,,percent of total billed charges,,,858.22,83,,percent of total billed charges,,,310.2,83,,percent of total billed charges,,23.5,,,,fee schedule,,23.5,,,,fee schedule,,,858.22,83,,percent of total billed charges,,197.26,,,,fee schedule,,,930.6,90,,percent of total billed charges,,,930.6,90,,percent of total billed charges,,,930.6,90,,percent of total billed charges,,,930.6,90,,percent of total billed charges,,,878.9,85,,percent of total billed charges,,23.5,982.3,
XRAY AC Joints,73050,CDM,73050,CPT,,,both,,427,427,34.92,,,,fee schedule,,,,,,,,20.15,,,,fee schedule,,,362.95,85,,percent of total billed charges,,19.53,,,,fee schedule,,10.78,,,,fee schedule,,20.15,,,,fee schedule,,69.41,,,,fee schedule,,20.15,,,,fee schedule,,48.09,,,,fee schedule,,29.14,,,,fee schedule,,29.14,,,,fee schedule,,,388.57,91,,percent of total billed charges,,,405.65,95,,percent of total billed charges,,,354.41,83,,percent of total billed charges,,,128.1,83,,percent of total billed charges,,20.15,,,,fee schedule,,20.15,,,,fee schedule,,,354.41,83,,percent of total billed charges,,42.84,,,,fee schedule,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,362.95,85,,percent of total billed charges,,10.78,405.65,
XRAY Humerus     side:,73060,CDM,73060,CPT,,,both,,429,429,24.95,,,,fee schedule,,,,,,,,15.7,,,,fee schedule,,,364.65,85,,percent of total billed charges,,16.71,,,,fee schedule,,9.22,,,,fee schedule,,15.7,,,,fee schedule,,59.59,,,,fee schedule,,15.7,,,,fee schedule,,54.24,,,,fee schedule,,32.87,,,,fee schedule,,32.87,,,,fee schedule,,,390.39,91,,percent of total billed charges,,,407.55,95,,percent of total billed charges,,,356.07,83,,percent of total billed charges,,,128.7,83,,percent of total billed charges,,15.7,,,,fee schedule,,15.7,,,,fee schedule,,,356.07,83,,percent of total billed charges,,48.32,,,,fee schedule,,,386.1,90,,percent of total billed charges,,,386.1,90,,percent of total billed charges,,,386.1,90,,percent of total billed charges,,,386.1,90,,percent of total billed charges,,,364.65,85,,percent of total billed charges,,9.22,407.55,
X-RAY EXAM OF HUMERUS,7306026,CDM,73060,CPT,,,both,26,78,78,24.95,,,,fee schedule,,,,,,,,15.7,,,,fee schedule,,,66.3,85,,percent of total billed charges,,16.71,,,,fee schedule,,9.22,,,,fee schedule,,15.7,,,,fee schedule,,59.59,,,,fee schedule,,15.7,,,,fee schedule,,54.24,,,,fee schedule,,32.87,,,,fee schedule,,32.87,,,,fee schedule,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,15.7,,,,fee schedule,,15.7,,,,fee schedule,,,64.74,83,,percent of total billed charges,,48.32,,,,fee schedule,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,9.22,74.1,
X-RAY EXAM OF HUMERUS,73060TC,CDM,73060,CPT,,,both,TC,407,407,24.95,,,,fee schedule,,,,,,,,15.7,,,,fee schedule,,,345.95,85,,percent of total billed charges,,16.71,,,,fee schedule,,9.22,,,,fee schedule,,15.7,,,,fee schedule,,59.59,,,,fee schedule,,15.7,,,,fee schedule,,54.24,,,,fee schedule,,32.87,,,,fee schedule,,32.87,,,,fee schedule,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,122.1,83,,percent of total billed charges,,15.7,,,,fee schedule,,15.7,,,,fee schedule,,,337.81,83,,percent of total billed charges,,48.32,,,,fee schedule,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,9.22,386.65,
XRAY Elbow 2V,73070,CDM,73070,CPT,,,both,,303,303,24.62,,,,fee schedule,,,,,,,,19.6,,,,fee schedule,,,257.55,85,,percent of total billed charges,,17.38,,,,fee schedule,,9.59,,,,fee schedule,,19.6,,,,fee schedule,,52.58,,,,fee schedule,,19.6,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,90.9,83,,percent of total billed charges,,19.6,,,,fee schedule,,19.6,,,,fee schedule,,,251.49,83,,percent of total billed charges,,43.84,,,,fee schedule,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,9.59,287.85,
X-RAY EXAM OF ELBOW,7307026,CDM,73070,CPT,,,both,26,80,80,24.62,,,,fee schedule,,,,,,,,19.6,,,,fee schedule,,,68,85,,percent of total billed charges,,17.38,,,,fee schedule,,9.59,,,,fee schedule,,19.6,,,,fee schedule,,52.58,,,,fee schedule,,19.6,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,24,83,,percent of total billed charges,,19.6,,,,fee schedule,,19.6,,,,fee schedule,,,66.4,83,,percent of total billed charges,,43.84,,,,fee schedule,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,9.59,76,
X-RAY EXAM OF ELBOW,73070TC,CDM,73070,CPT,,,both,TC,348,348,24.62,,,,fee schedule,,,,,,,,19.6,,,,fee schedule,,,295.8,85,,percent of total billed charges,,17.38,,,,fee schedule,,9.59,,,,fee schedule,,19.6,,,,fee schedule,,52.58,,,,fee schedule,,19.6,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,316.68,91,,percent of total billed charges,,,330.6,95,,percent of total billed charges,,,288.84,83,,percent of total billed charges,,,104.4,83,,percent of total billed charges,,19.6,,,,fee schedule,,19.6,,,,fee schedule,,,288.84,83,,percent of total billed charges,,43.84,,,,fee schedule,,,313.2,90,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,295.8,85,,percent of total billed charges,,9.59,330.6,
XRAY Elbow 3V+     side:,73080,CDM,73080,CPT,,,both,,420,420,28.8,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,357,85,,percent of total billed charges,,18.12,,,,fee schedule,,10,,,,fee schedule,,21.5,,,,fee schedule,,59.59,,,,fee schedule,,21.5,,,,fee schedule,,54.8,,,,fee schedule,,33.21,,,,fee schedule,,33.21,,,,fee schedule,,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,126,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,348.6,83,,percent of total billed charges,,48.82,,,,fee schedule,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,10,399,
X-RAY EXAM OF ELBOW,7308026,CDM,73080,CPT,,,both,26,92,92,28.8,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,78.2,85,,percent of total billed charges,,18.12,,,,fee schedule,,10,,,,fee schedule,,21.5,,,,fee schedule,,59.59,,,,fee schedule,,21.5,,,,fee schedule,,54.8,,,,fee schedule,,33.21,,,,fee schedule,,33.21,,,,fee schedule,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,27.6,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,76.36,83,,percent of total billed charges,,48.82,,,,fee schedule,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,10,87.4,
X-RAY EXAM OF ELBOW,73080TC,CDM,73080,CPT,,,both,TC,450,450,28.8,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,382.5,85,,percent of total billed charges,,18.12,,,,fee schedule,,10,,,,fee schedule,,21.5,,,,fee schedule,,59.59,,,,fee schedule,,21.5,,,,fee schedule,,54.8,,,,fee schedule,,33.21,,,,fee schedule,,33.21,,,,fee schedule,,,409.5,91,,percent of total billed charges,,,427.5,95,,percent of total billed charges,,,373.5,83,,percent of total billed charges,,,135,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,373.5,83,,percent of total billed charges,,48.82,,,,fee schedule,,,405,90,,percent of total billed charges,,,405,90,,percent of total billed charges,,,405,90,,percent of total billed charges,,,405,90,,percent of total billed charges,,,382.5,85,,percent of total billed charges,,10,427.5,
XRAY Forearm     side:,73090,CDM,73090,CPT,,,both,,503,503,24.1,,,,fee schedule,,,,,,,,18.3,,,,fee schedule,,,427.55,85,,percent of total billed charges,,16.71,,,,fee schedule,,9.22,,,,fee schedule,,18.3,,,,fee schedule,,53.28,,,,fee schedule,,18.3,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,457.73,91,,percent of total billed charges,,,477.85,95,,percent of total billed charges,,,417.49,83,,percent of total billed charges,,,150.9,83,,percent of total billed charges,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,417.49,83,,percent of total billed charges,,43.84,,,,fee schedule,,,452.7,90,,percent of total billed charges,,,452.7,90,,percent of total billed charges,,,452.7,90,,percent of total billed charges,,,452.7,90,,percent of total billed charges,,,427.55,85,,percent of total billed charges,,9.22,477.85,
X-RAY EXAM OF FOREARM,7309026,CDM,73090,CPT,,,both,26,144,144,24.1,,,,fee schedule,,,,,,,,18.3,,,,fee schedule,,,122.4,85,,percent of total billed charges,,16.71,,,,fee schedule,,9.22,,,,fee schedule,,18.3,,,,fee schedule,,53.28,,,,fee schedule,,18.3,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,43.2,83,,percent of total billed charges,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,119.52,83,,percent of total billed charges,,43.84,,,,fee schedule,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,9.22,136.8,
X-RAY EXAM OF FOREARM,73090P,CDM,73090,CPT,,,both,P,338,338,24.1,,,,fee schedule,,,,,,,,18.3,,,,fee schedule,,,287.3,85,,percent of total billed charges,,16.71,,,,fee schedule,,9.22,,,,fee schedule,,18.3,,,,fee schedule,,53.28,,,,fee schedule,,18.3,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,307.58,91,,percent of total billed charges,,,321.1,95,,percent of total billed charges,,,280.54,83,,percent of total billed charges,,,101.4,83,,percent of total billed charges,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,280.54,83,,percent of total billed charges,,43.84,,,,fee schedule,,,304.2,90,,percent of total billed charges,,,304.2,90,,percent of total billed charges,,,304.2,90,,percent of total billed charges,,,304.2,90,,percent of total billed charges,,,287.3,85,,percent of total billed charges,,9.22,321.1,
X-RAY EXAM OF FOREARM,73090T,CDM,73090,CPT,,,both,T,150,150,24.1,,,,fee schedule,,,,,,,,18.3,,,,fee schedule,,,127.5,85,,percent of total billed charges,,16.71,,,,fee schedule,,9.22,,,,fee schedule,,18.3,,,,fee schedule,,53.28,,,,fee schedule,,18.3,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,124.5,83,,percent of total billed charges,,43.84,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,9.22,142.5,
X-RAY EXAM OF FOREARM,73090TC,CDM,73090,CPT,,,both,TC,407,407,24.1,,,,fee schedule,,,,,,,,18.3,,,,fee schedule,,,345.95,85,,percent of total billed charges,,16.71,,,,fee schedule,,9.22,,,,fee schedule,,18.3,,,,fee schedule,,53.28,,,,fee schedule,,18.3,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,122.1,83,,percent of total billed charges,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,337.81,83,,percent of total billed charges,,43.84,,,,fee schedule,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,9.22,386.65,
XRAY UP EXT Infant     side:,73092,CDM,73092,CPT,,,both,,175,175,27.95,,,,fee schedule,,,,,,,,14.35,,,,fee schedule,,,148.75,85,,percent of total billed charges,,16.71,,,,fee schedule,,9.22,,,,fee schedule,,14.35,,,,fee schedule,,51.18,,,,fee schedule,,14.35,,,,fee schedule,,53.12,,,,fee schedule,,32.19,,,,fee schedule,,32.19,,,,fee schedule,,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,52.5,83,,percent of total billed charges,,14.35,,,,fee schedule,,14.35,,,,fee schedule,,,145.25,83,,percent of total billed charges,,47.32,,,,fee schedule,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,9.22,166.25,
XRAY Wrist 2V     side:,73100,CDM,73100,CPT,,,both,,180,180,27.93,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,153,85,,percent of total billed charges,,17.38,,,,fee schedule,,9.59,,,,fee schedule,,21.5,,,,fee schedule,,51.18,,,,fee schedule,,21.5,,,,fee schedule,,57.03,,,,fee schedule,,34.56,,,,fee schedule,,34.56,,,,fee schedule,,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,54,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,149.4,83,,percent of total billed charges,,50.81,,,,fee schedule,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,9.59,171,
X-RAY EXAM OF WRIST,7310026,CDM,73100,CPT,,,both,26,157,157,27.93,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,133.45,85,,percent of total billed charges,,17.38,,,,fee schedule,,9.59,,,,fee schedule,,21.5,,,,fee schedule,,51.18,,,,fee schedule,,21.5,,,,fee schedule,,57.03,,,,fee schedule,,34.56,,,,fee schedule,,34.56,,,,fee schedule,,,142.87,91,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,47.1,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,130.31,83,,percent of total billed charges,,50.81,,,,fee schedule,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,133.45,85,,percent of total billed charges,,9.59,149.15,
X-RAY EXAM OF WRIST,73100TC,CDM,73100,CPT,,,both,TC,407,407,27.93,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,345.95,85,,percent of total billed charges,,17.38,,,,fee schedule,,9.59,,,,fee schedule,,21.5,,,,fee schedule,,51.18,,,,fee schedule,,21.5,,,,fee schedule,,57.03,,,,fee schedule,,34.56,,,,fee schedule,,34.56,,,,fee schedule,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,122.1,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,337.81,83,,percent of total billed charges,,50.81,,,,fee schedule,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,9.59,386.65,
XRAY Wrist 3V+     side:,73110,CDM,73110,CPT,,,both,,216,216,32.38,,,,fee schedule,,,,,,,,22.2,,,,fee schedule,,,183.6,85,,percent of total billed charges,,18.12,,,,fee schedule,,10,,,,fee schedule,,22.2,,,,fee schedule,,55.39,,,,fee schedule,,22.2,,,,fee schedule,,68.77,,,,fee schedule,,41.68,,,,fee schedule,,41.68,,,,fee schedule,,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,64.8,83,,percent of total billed charges,,22.2,,,,fee schedule,,22.2,,,,fee schedule,,,179.28,83,,percent of total billed charges,,61.27,,,,fee schedule,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,10,205.2,
X-RAY EXAM OF WRIST,7311026,CDM,73110,CPT,,,both,26,103,103,32.38,,,,fee schedule,,,,,,,,22.2,,,,fee schedule,,,87.55,85,,percent of total billed charges,,18.12,,,,fee schedule,,10,,,,fee schedule,,22.2,,,,fee schedule,,55.39,,,,fee schedule,,22.2,,,,fee schedule,,68.77,,,,fee schedule,,41.68,,,,fee schedule,,41.68,,,,fee schedule,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,30.9,83,,percent of total billed charges,,22.2,,,,fee schedule,,22.2,,,,fee schedule,,,85.49,83,,percent of total billed charges,,61.27,,,,fee schedule,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,10,97.85,
X-RAY EXAM OF WRIST,73110TC,CDM,73110,CPT,,,both,TC,440,440,32.38,,,,fee schedule,,,,,,,,22.2,,,,fee schedule,,,374,85,,percent of total billed charges,,18.12,,,,fee schedule,,10,,,,fee schedule,,22.2,,,,fee schedule,,55.39,,,,fee schedule,,22.2,,,,fee schedule,,68.77,,,,fee schedule,,41.68,,,,fee schedule,,41.68,,,,fee schedule,,,400.4,91,,percent of total billed charges,,,418,95,,percent of total billed charges,,,365.2,83,,percent of total billed charges,,,132,83,,percent of total billed charges,,22.2,,,,fee schedule,,22.2,,,,fee schedule,,,365.2,83,,percent of total billed charges,,61.27,,,,fee schedule,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,374,85,,percent of total billed charges,,10,418,
XRAY HAND 2V  (DJD),73120,CDM,73120,CPT,,,both,,152,152,23.82,,,,fee schedule,,,,,,,,17,,,,fee schedule,,,129.2,85,,percent of total billed charges,,17.38,,,,fee schedule,,9.59,,,,fee schedule,,17,,,,fee schedule,,51.18,,,,fee schedule,,17,,,,fee schedule,,52.56,,,,fee schedule,,31.85,,,,fee schedule,,31.85,,,,fee schedule,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,45.6,83,,percent of total billed charges,,17,,,,fee schedule,,17,,,,fee schedule,,,126.16,83,,percent of total billed charges,,46.83,,,,fee schedule,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,9.59,144.4,
X-RAY EXAM OF HAND,7312026,CDM,73120,CPT,,,both,26,76,76,23.82,,,,fee schedule,,,,,,,,17,,,,fee schedule,,,64.6,85,,percent of total billed charges,,17.38,,,,fee schedule,,9.59,,,,fee schedule,,17,,,,fee schedule,,51.18,,,,fee schedule,,17,,,,fee schedule,,52.56,,,,fee schedule,,31.85,,,,fee schedule,,31.85,,,,fee schedule,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,17,,,,fee schedule,,17,,,,fee schedule,,,63.08,83,,percent of total billed charges,,46.83,,,,fee schedule,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,9.59,72.2,
XRAY Hand 3V+     side:,73130,CDM,73130,CPT,,,both,,245,245,27.98,,,,fee schedule,,,,,,,,18.3,,,,fee schedule,,,208.25,85,,percent of total billed charges,,18.12,,,,fee schedule,,10,,,,fee schedule,,18.3,,,,fee schedule,,55.39,,,,fee schedule,,18.3,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,222.95,91,,percent of total billed charges,,,232.75,95,,percent of total billed charges,,,203.35,83,,percent of total billed charges,,,73.5,83,,percent of total billed charges,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,203.35,83,,percent of total billed charges,,55.29,,,,fee schedule,,,220.5,90,,percent of total billed charges,,,220.5,90,,percent of total billed charges,,,220.5,90,,percent of total billed charges,,,220.5,90,,percent of total billed charges,,,208.25,85,,percent of total billed charges,,10,232.75,
X-RAY EXAM OF HAND,73130 26,CDM,73130,CPT,,,both,26,89,89,27.98,,,,fee schedule,,,,,,,,18.3,,,,fee schedule,,,75.65,85,,percent of total billed charges,,18.12,,,,fee schedule,,10,,,,fee schedule,,18.3,,,,fee schedule,,55.39,,,,fee schedule,,18.3,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,80.99,91,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,26.7,83,,percent of total billed charges,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,73.87,83,,percent of total billed charges,,55.29,,,,fee schedule,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,10,84.55,
X-RAY EXAM OF HAND,73130 TC,CDM,73130,CPT,,,both, TC,445,445,27.98,,,,fee schedule,,,,,,,,18.3,,,,fee schedule,,,378.25,85,,percent of total billed charges,,18.12,,,,fee schedule,,10,,,,fee schedule,,18.3,,,,fee schedule,,55.39,,,,fee schedule,,18.3,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,404.95,91,,percent of total billed charges,,,422.75,95,,percent of total billed charges,,,369.35,83,,percent of total billed charges,,,133.5,83,,percent of total billed charges,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,369.35,83,,percent of total billed charges,,55.29,,,,fee schedule,,,400.5,90,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,378.25,85,,percent of total billed charges,,10,422.75,
XRAY Finger    side/site:,73140,CDM,73140,CPT,,,both,,210,210,28.97,,,,fee schedule,,,,,,,,14.35,,,,fee schedule,,,178.5,85,,percent of total billed charges,,14.5,,,,fee schedule,,8,,,,fee schedule,,14.35,,,,fee schedule,,43.47,,,,fee schedule,,14.35,,,,fee schedule,,63.74,,,,fee schedule,,38.63,,,,fee schedule,,38.63,,,,fee schedule,,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,63,83,,percent of total billed charges,,14.35,,,,fee schedule,,14.35,,,,fee schedule,,,174.3,83,,percent of total billed charges,,56.79,,,,fee schedule,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,8,199.5,
X-RAY EXAM OF FINGER(S),7314026,CDM,73140,CPT,,,both,26,91,91,28.97,,,,fee schedule,,,,,,,,14.35,,,,fee schedule,,,77.35,85,,percent of total billed charges,,14.5,,,,fee schedule,,8,,,,fee schedule,,14.35,,,,fee schedule,,43.47,,,,fee schedule,,14.35,,,,fee schedule,,63.74,,,,fee schedule,,38.63,,,,fee schedule,,38.63,,,,fee schedule,,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,27.3,83,,percent of total billed charges,,14.35,,,,fee schedule,,14.35,,,,fee schedule,,,75.53,83,,percent of total billed charges,,56.79,,,,fee schedule,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,8,86.45,
X-RAY EXAM OF FINGER(S),73140TC,CDM,73140,CPT,,,both,TC,407,407,28.97,,,,fee schedule,,,,,,,,14.35,,,,fee schedule,,,345.95,85,,percent of total billed charges,,14.5,,,,fee schedule,,8,,,,fee schedule,,14.35,,,,fee schedule,,43.47,,,,fee schedule,,14.35,,,,fee schedule,,63.74,,,,fee schedule,,38.63,,,,fee schedule,,38.63,,,,fee schedule,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,122.1,83,,percent of total billed charges,,14.35,,,,fee schedule,,14.35,,,,fee schedule,,,337.81,83,,percent of total billed charges,,56.79,,,,fee schedule,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,8,386.65,
X-RAY EXAM HIP UNI 1 VIEW,73501,CDM,73501,CPT,,,both,,130,130,24.78,,,,fee schedule,,,,,,,,16.71,,,,fee schedule,,,110.5,85,,percent of total billed charges,,20.99,,,,fee schedule,,10.78,,,,fee schedule,,16.71,,,,fee schedule,,,,,,,,16.71,,,,fee schedule,,55.35,,,,fee schedule,,33.55,,,,fee schedule,,33.55,,,,fee schedule,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,39,83,,percent of total billed charges,,16.71,,,,fee schedule,,16.71,,,,fee schedule,,,107.9,83,,percent of total billed charges,,49.32,,,,fee schedule,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,10.78,123.5,
X-RAY EXAM HIP UNI 1 VIEW,7350126,CDM,73501,CPT,,,both,26,157,157,24.78,,,,fee schedule,,,,,,,,16.71,,,,fee schedule,,,133.45,85,,percent of total billed charges,,20.99,,,,fee schedule,,10.78,,,,fee schedule,,16.71,,,,fee schedule,,,,,,,,16.71,,,,fee schedule,,55.35,,,,fee schedule,,33.55,,,,fee schedule,,33.55,,,,fee schedule,,,142.87,91,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,47.1,83,,percent of total billed charges,,16.71,,,,fee schedule,,16.71,,,,fee schedule,,,130.31,83,,percent of total billed charges,,49.32,,,,fee schedule,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,133.45,85,,percent of total billed charges,,10.78,149.15,
X-RAY EXAM HIP UNI 1 VIEW,73501TC,CDM,73501,CPT,,,both,TC,814,814,24.78,,,,fee schedule,,,,,,,,16.71,,,,fee schedule,,,691.9,85,,percent of total billed charges,,20.99,,,,fee schedule,,10.78,,,,fee schedule,,16.71,,,,fee schedule,,,,,,,,16.71,,,,fee schedule,,55.35,,,,fee schedule,,33.55,,,,fee schedule,,33.55,,,,fee schedule,,,740.74,91,,percent of total billed charges,,,773.3,95,,percent of total billed charges,,,675.62,83,,percent of total billed charges,,,244.2,83,,percent of total billed charges,,16.71,,,,fee schedule,,16.71,,,,fee schedule,,,675.62,83,,percent of total billed charges,,49.32,,,,fee schedule,,,732.6,90,,percent of total billed charges,,,732.6,90,,percent of total billed charges,,,732.6,90,,percent of total billed charges,,,732.6,90,,percent of total billed charges,,,691.9,85,,percent of total billed charges,,10.78,773.3,
X-RAY EXAM HIP UNI 2-3 VIEWS,73502,CDM,73502,CPT,,,both,,520,520,34.46,,,,fee schedule,,,,,,,,23.23,,,,fee schedule,,,442,85,,percent of total billed charges,,24.88,,,,fee schedule,,12.78,,,,fee schedule,,23.23,,,,fee schedule,,,,,,,,23.23,,,,fee schedule,,78.84,,,,fee schedule,,47.78,,,,fee schedule,,47.78,,,,fee schedule,,,473.2,91,,percent of total billed charges,,,494,95,,percent of total billed charges,,,431.6,83,,percent of total billed charges,,,156,83,,percent of total billed charges,,23.23,,,,fee schedule,,23.23,,,,fee schedule,,,431.6,83,,percent of total billed charges,,70.24,,,,fee schedule,,,468,90,,percent of total billed charges,,,468,90,,percent of total billed charges,,,468,90,,percent of total billed charges,,,468,90,,percent of total billed charges,,,442,85,,percent of total billed charges,,12.78,494,
X-RAY EXAM HIP UNI 2-3 VIEWS,7350226,CDM,73502,CPT,,,both,26,188,188,34.46,,,,fee schedule,,,,,,,,23.23,,,,fee schedule,,,159.8,85,,percent of total billed charges,,24.88,,,,fee schedule,,12.78,,,,fee schedule,,23.23,,,,fee schedule,,,,,,,,23.23,,,,fee schedule,,78.84,,,,fee schedule,,47.78,,,,fee schedule,,47.78,,,,fee schedule,,,171.08,91,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,56.4,83,,percent of total billed charges,,23.23,,,,fee schedule,,23.23,,,,fee schedule,,,156.04,83,,percent of total billed charges,,70.24,,,,fee schedule,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,12.78,178.6,
X-RAY EXAM HIP UNI 2-3 VIEWS,73502TC,CDM,73502,CPT,,,both,TC,833,833,34.46,,,,fee schedule,,,,,,,,23.23,,,,fee schedule,,,708.05,85,,percent of total billed charges,,24.88,,,,fee schedule,,12.78,,,,fee schedule,,23.23,,,,fee schedule,,,,,,,,23.23,,,,fee schedule,,78.84,,,,fee schedule,,47.78,,,,fee schedule,,47.78,,,,fee schedule,,,758.03,91,,percent of total billed charges,,,791.35,95,,percent of total billed charges,,,691.39,83,,percent of total billed charges,,,249.9,83,,percent of total billed charges,,23.23,,,,fee schedule,,23.23,,,,fee schedule,,,691.39,83,,percent of total billed charges,,70.24,,,,fee schedule,,,749.7,90,,percent of total billed charges,,,749.7,90,,percent of total billed charges,,,749.7,90,,percent of total billed charges,,,749.7,90,,percent of total billed charges,,,708.05,85,,percent of total billed charges,,12.78,791.35,
X-RAY EXAM HIP UNI 4/> VIEWS,73503,CDM,73503,CPT,,,both,,313,313,43.11,,,,fee schedule,,,,,,,,29.06,,,,fee schedule,,,266.05,85,,percent of total billed charges,,30.29,,,,fee schedule,,15.56,,,,fee schedule,,29.06,,,,fee schedule,,,,,,,,29.06,,,,fee schedule,,99.53,,,,fee schedule,,60.32,,,,fee schedule,,60.32,,,,fee schedule,,,284.83,91,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,93.9,83,,percent of total billed charges,,29.06,,,,fee schedule,,29.06,,,,fee schedule,,,259.79,83,,percent of total billed charges,,88.67,,,,fee schedule,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,15.56,297.35,
X-RAY EXAM HIP UNI 4/> VIEWS,7350326,CDM,73503,CPT,,,both,26,77,77,43.11,,,,fee schedule,,,,,,,,29.06,,,,fee schedule,,,65.45,85,,percent of total billed charges,,30.29,,,,fee schedule,,15.56,,,,fee schedule,,29.06,,,,fee schedule,,,,,,,,29.06,,,,fee schedule,,99.53,,,,fee schedule,,60.32,,,,fee schedule,,60.32,,,,fee schedule,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,29.06,,,,fee schedule,,29.06,,,,fee schedule,,,63.91,83,,percent of total billed charges,,88.67,,,,fee schedule,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,15.56,99.53,
X-RAY EXAM HIP UNI 4/> VIEWS,73503TC,CDM,73503,CPT,,,both,TC,226,226,43.11,,,,fee schedule,,,,,,,,29.06,,,,fee schedule,,,192.1,85,,percent of total billed charges,,30.29,,,,fee schedule,,15.56,,,,fee schedule,,29.06,,,,fee schedule,,,,,,,,29.06,,,,fee schedule,,99.53,,,,fee schedule,,60.32,,,,fee schedule,,60.32,,,,fee schedule,,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,67.8,83,,percent of total billed charges,,29.06,,,,fee schedule,,29.06,,,,fee schedule,,,187.58,83,,percent of total billed charges,,88.67,,,,fee schedule,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,15.56,214.7,
X-RAY EXAM HIPS BI 2 VIEWS,73521,CDM,73521,CPT,,,both,,191,191,33.01,,,,fee schedule,,,,,,,,22.25,,,,fee schedule,,,162.35,85,,percent of total billed charges,,24.88,,,,fee schedule,,12.78,,,,fee schedule,,22.25,,,,fee schedule,,,,,,,,22.25,,,,fee schedule,,69.33,,,,fee schedule,,42.02,,,,fee schedule,,42.02,,,,fee schedule,,,173.81,91,,percent of total billed charges,,,181.45,95,,percent of total billed charges,,,158.53,83,,percent of total billed charges,,,57.3,83,,percent of total billed charges,,22.25,,,,fee schedule,,22.25,,,,fee schedule,,,158.53,83,,percent of total billed charges,,61.77,,,,fee schedule,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,162.35,85,,percent of total billed charges,,12.78,181.45,
X-RAY EXAM HIPS BI 2 VIEWS,7352126,CDM,73521,CPT,,,both,26,115,115,33.01,,,,fee schedule,,,,,,,,22.25,,,,fee schedule,,,97.75,85,,percent of total billed charges,,24.88,,,,fee schedule,,12.78,,,,fee schedule,,22.25,,,,fee schedule,,,,,,,,22.25,,,,fee schedule,,69.33,,,,fee schedule,,42.02,,,,fee schedule,,42.02,,,,fee schedule,,,104.65,91,,percent of total billed charges,,,109.25,95,,percent of total billed charges,,,95.45,83,,percent of total billed charges,,,34.5,83,,percent of total billed charges,,22.25,,,,fee schedule,,22.25,,,,fee schedule,,,95.45,83,,percent of total billed charges,,61.77,,,,fee schedule,,,103.5,90,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,97.75,85,,percent of total billed charges,,12.78,109.25,
X-RAY EXAM HIPS BI 2 VIEWS,73521TC,CDM,73521,CPT,,,both,TC,1490,1490,33.01,,,,fee schedule,,,,,,,,22.25,,,,fee schedule,,,1266.5,85,,percent of total billed charges,,24.88,,,,fee schedule,,12.78,,,,fee schedule,,22.25,,,,fee schedule,,,,,,,,22.25,,,,fee schedule,,69.33,,,,fee schedule,,42.02,,,,fee schedule,,42.02,,,,fee schedule,,,1355.9,91,,percent of total billed charges,,,1415.5,95,,percent of total billed charges,,,1236.7,83,,percent of total billed charges,,,447,83,,percent of total billed charges,,22.25,,,,fee schedule,,22.25,,,,fee schedule,,,1236.7,83,,percent of total billed charges,,61.77,,,,fee schedule,,,1341,90,,percent of total billed charges,,,1341,90,,percent of total billed charges,,,1341,90,,percent of total billed charges,,,1341,90,,percent of total billed charges,,,1266.5,85,,percent of total billed charges,,12.78,1415.5,
X-RAY EXAM HIPS BI 3-4 VIEWS,73522,CDM,73522,CPT,,,both,,314,314,40.85,,,,fee schedule,,,,,,,,27.54,,,,fee schedule,,,266.9,85,,percent of total billed charges,,32.6,,,,fee schedule,,16.74,,,,fee schedule,,27.54,,,,fee schedule,,,,,,,,27.54,,,,fee schedule,,90.02,,,,fee schedule,,54.56,,,,fee schedule,,54.56,,,,fee schedule,,,285.74,91,,percent of total billed charges,,,298.3,95,,percent of total billed charges,,,260.62,83,,percent of total billed charges,,,94.2,83,,percent of total billed charges,,27.54,,,,fee schedule,,27.54,,,,fee schedule,,,260.62,83,,percent of total billed charges,,80.2,,,,fee schedule,,,282.6,90,,percent of total billed charges,,,282.6,90,,percent of total billed charges,,,282.6,90,,percent of total billed charges,,,282.6,90,,percent of total billed charges,,,266.9,85,,percent of total billed charges,,16.74,298.3,
X-RAY EXAM HIPS BI 3-4 VIEWS,73522 26,CDM,73522,CPT,,,both,26,81,81,40.85,,,,fee schedule,,,,,,,,27.54,,,,fee schedule,,,68.85,85,,percent of total billed charges,,32.6,,,,fee schedule,,16.74,,,,fee schedule,,27.54,,,,fee schedule,,,,,,,,27.54,,,,fee schedule,,90.02,,,,fee schedule,,54.56,,,,fee schedule,,54.56,,,,fee schedule,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,24.3,83,,percent of total billed charges,,27.54,,,,fee schedule,,27.54,,,,fee schedule,,,67.23,83,,percent of total billed charges,,80.2,,,,fee schedule,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,16.74,90.02,
X-RAY EXAM HIPS BI 3-4 VIEWS,73522 TC,CDM,73522,CPT,,,both, TC,223,223,40.85,,,,fee schedule,,,,,,,,27.54,,,,fee schedule,,,189.55,85,,percent of total billed charges,,32.6,,,,fee schedule,,16.74,,,,fee schedule,,27.54,,,,fee schedule,,,,,,,,27.54,,,,fee schedule,,90.02,,,,fee schedule,,54.56,,,,fee schedule,,54.56,,,,fee schedule,,,202.93,91,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,66.9,83,,percent of total billed charges,,27.54,,,,fee schedule,,27.54,,,,fee schedule,,,185.09,83,,percent of total billed charges,,80.2,,,,fee schedule,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,16.74,211.85,
X-RAY EXAM HIPS BI 5/> VIEWS,73523,CDM,73523,CPT,,,both,,412,412,47.28,,,,fee schedule,,,,,,,,31.88,,,,fee schedule,,,350.2,85,,percent of total billed charges,,34.18,,,,fee schedule,,17.56,,,,fee schedule,,31.88,,,,fee schedule,,,,,,,,31.88,,,,fee schedule,,104,,,,fee schedule,,63.03,,,,fee schedule,,63.03,,,,fee schedule,,,374.92,91,,percent of total billed charges,,,391.4,95,,percent of total billed charges,,,341.96,83,,percent of total billed charges,,,123.6,83,,percent of total billed charges,,31.88,,,,fee schedule,,31.88,,,,fee schedule,,,341.96,83,,percent of total billed charges,,92.65,,,,fee schedule,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,350.2,85,,percent of total billed charges,,17.56,391.4,
X-RAY EXAM HIPS BI 5/> VIEWS,73523 P,CDM,73523,CPT,,,both, P,150,150,47.28,,,,fee schedule,,,,,,,,31.88,,,,fee schedule,,,127.5,85,,percent of total billed charges,,34.18,,,,fee schedule,,17.56,,,,fee schedule,,31.88,,,,fee schedule,,,,,,,,31.88,,,,fee schedule,,104,,,,fee schedule,,63.03,,,,fee schedule,,63.03,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,31.88,,,,fee schedule,,31.88,,,,fee schedule,,,124.5,83,,percent of total billed charges,,92.65,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,17.56,142.5,
X-RAY EXAM HIPS BI 5/> VIEWS,73523 T,CDM,73523,CPT,,,both, T,250,250,47.28,,,,fee schedule,,,,,,,,31.88,,,,fee schedule,,,212.5,85,,percent of total billed charges,,34.18,,,,fee schedule,,17.56,,,,fee schedule,,31.88,,,,fee schedule,,,,,,,,31.88,,,,fee schedule,,104,,,,fee schedule,,63.03,,,,fee schedule,,63.03,,,,fee schedule,,,227.5,91,,percent of total billed charges,,,237.5,95,,percent of total billed charges,,,207.5,83,,percent of total billed charges,,,75,83,,percent of total billed charges,,31.88,,,,fee schedule,,31.88,,,,fee schedule,,,207.5,83,,percent of total billed charges,,92.65,,,,fee schedule,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,225,90,,percent of total billed charges,,,212.5,85,,percent of total billed charges,,17.56,237.5,
X HIP ARTHROGRAM,73525,CDM,73525,CPT,,,both,,273,273,90.21,,,,fee schedule,,,,,,,,52.3,,,,fee schedule,,,232.05,85,,percent of total billed charges,,65.56,,,,fee schedule,,33.67,,,,fee schedule,,52.3,,,,fee schedule,,208.23,,,,fee schedule,,52.3,,,,fee schedule,,219.74,,,,fee schedule,,133.18,,,,fee schedule,,133.18,,,,fee schedule,,,248.43,91,,percent of total billed charges,,,259.35,95,,percent of total billed charges,,,226.59,83,,percent of total billed charges,,,81.9,83,,percent of total billed charges,,52.3,,,,fee schedule,,52.3,,,,fee schedule,,,226.59,83,,percent of total billed charges,,195.77,,,,fee schedule,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,232.05,85,,percent of total billed charges,,33.67,259.35,
X-RAY EXAM OF FEMUR 1 VIEW,73551,CDM,73551,CPT,,,both,,239,239,23.28,,,,fee schedule,,,,,,,,15.69,,,,fee schedule,,,203.15,85,,percent of total billed charges,,18.68,,,,fee schedule,,9.59,,,,fee schedule,,15.69,,,,fee schedule,,,,,,,,15.69,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,71.7,83,,percent of total billed charges,,15.69,,,,fee schedule,,15.69,,,,fee schedule,,,198.37,83,,percent of total billed charges,,43.84,,,,fee schedule,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,9.59,227.05,
X-RAY EXAM OF FEMUR 1,7355126,CDM,73551,CPT,,,both,26,47,47,23.28,,,,fee schedule,,,,,,,,15.69,,,,fee schedule,,,39.95,85,,percent of total billed charges,,18.68,,,,fee schedule,,9.59,,,,fee schedule,,15.69,,,,fee schedule,,,,,,,,15.69,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,14.1,83,,percent of total billed charges,,15.69,,,,fee schedule,,15.69,,,,fee schedule,,,39.01,83,,percent of total billed charges,,43.84,,,,fee schedule,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,9.59,49.2,
X-RAY EXAM OF FEMUR 1,73551P,CDM,73551,CPT,,,both,P,82,82,23.28,,,,fee schedule,,,,,,,,15.69,,,,fee schedule,,,69.7,85,,percent of total billed charges,,18.68,,,,fee schedule,,9.59,,,,fee schedule,,15.69,,,,fee schedule,,,,,,,,15.69,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,74.62,91,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,24.6,83,,percent of total billed charges,,15.69,,,,fee schedule,,15.69,,,,fee schedule,,,68.06,83,,percent of total billed charges,,43.84,,,,fee schedule,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,9.59,77.9,
X-RAY EXAM OF FEMUR 1,73551T,CDM,73551,CPT,,,both,T,150,150,23.28,,,,fee schedule,,,,,,,,15.69,,,,fee schedule,,,127.5,85,,percent of total billed charges,,18.68,,,,fee schedule,,9.59,,,,fee schedule,,15.69,,,,fee schedule,,,,,,,,15.69,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,15.69,,,,fee schedule,,15.69,,,,fee schedule,,,124.5,83,,percent of total billed charges,,43.84,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,9.59,142.5,
X-RAY EXAM OF FEMUR 1,73551TC,CDM,73551,CPT,,,both,TC,185,185,23.28,,,,fee schedule,,,,,,,,15.69,,,,fee schedule,,,157.25,85,,percent of total billed charges,,18.68,,,,fee schedule,,9.59,,,,fee schedule,,15.69,,,,fee schedule,,,,,,,,15.69,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,168.35,91,,percent of total billed charges,,,175.75,95,,percent of total billed charges,,,153.55,83,,percent of total billed charges,,,55.5,83,,percent of total billed charges,,15.69,,,,fee schedule,,15.69,,,,fee schedule,,,153.55,83,,percent of total billed charges,,43.84,,,,fee schedule,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,157.25,85,,percent of total billed charges,,9.59,175.75,
X-RAY EXAM OF FEMUR 2/>,73552,CDM,73552,CPT,,,both,,147,147,27.1,,,,fee schedule,,,,,,,,18.27,,,,fee schedule,,,124.95,85,,percent of total billed charges,,20.26,,,,fee schedule,,10.41,,,,fee schedule,,18.27,,,,fee schedule,,,,,,,,18.27,,,,fee schedule,,59.83,,,,fee schedule,,36.26,,,,fee schedule,,36.26,,,,fee schedule,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,44.1,83,,percent of total billed charges,,18.27,,,,fee schedule,,18.27,,,,fee schedule,,,122.01,83,,percent of total billed charges,,53.3,,,,fee schedule,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,10.41,139.65,
X-RAY EXAM OF FEMUR 2/>,7355226,CDM,73552,CPT,,,both,26,49,49,27.1,,,,fee schedule,,,,,,,,18.27,,,,fee schedule,,,41.65,85,,percent of total billed charges,,20.26,,,,fee schedule,,10.41,,,,fee schedule,,18.27,,,,fee schedule,,,,,,,,18.27,,,,fee schedule,,59.83,,,,fee schedule,,36.26,,,,fee schedule,,36.26,,,,fee schedule,,,44.59,91,,percent of total billed charges,,,46.55,95,,percent of total billed charges,,,40.67,83,,percent of total billed charges,,,14.7,83,,percent of total billed charges,,18.27,,,,fee schedule,,18.27,,,,fee schedule,,,40.67,83,,percent of total billed charges,,53.3,,,,fee schedule,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,41.65,85,,percent of total billed charges,,10.41,59.83,
X-RAY EXAM OF FEMUR 2/>,73552TC,CDM,73552,CPT,,,both,TC,93,93,27.1,,,,fee schedule,,,,,,,,18.27,,,,fee schedule,,,79.05,85,,percent of total billed charges,,20.26,,,,fee schedule,,10.41,,,,fee schedule,,18.27,,,,fee schedule,,,,,,,,18.27,,,,fee schedule,,59.83,,,,fee schedule,,36.26,,,,fee schedule,,36.26,,,,fee schedule,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,18.27,,,,fee schedule,,18.27,,,,fee schedule,,,77.19,83,,percent of total billed charges,,53.3,,,,fee schedule,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,10.41,88.35,
XRAY Knee 1-2V     side:,73560,CDM,73560,CPT,,,both,,448,448,27.13,,,,fee schedule,,,,,,,,19.6,,,,fee schedule,,,380.8,85,,percent of total billed charges,,18.68,,,,fee schedule,,9.59,,,,fee schedule,,19.6,,,,fee schedule,,54.69,,,,fee schedule,,19.6,,,,fee schedule,,57.59,,,,fee schedule,,34.9,,,,fee schedule,,34.9,,,,fee schedule,,,407.68,91,,percent of total billed charges,,,425.6,95,,percent of total billed charges,,,371.84,83,,percent of total billed charges,,,134.4,83,,percent of total billed charges,,19.6,,,,fee schedule,,19.6,,,,fee schedule,,,371.84,83,,percent of total billed charges,,51.31,,,,fee schedule,,,403.2,90,,percent of total billed charges,,,403.2,90,,percent of total billed charges,,,403.2,90,,percent of total billed charges,,,403.2,90,,percent of total billed charges,,,380.8,85,,percent of total billed charges,,9.59,425.6,
"X-RAY EXAM OF KNEE, 1 OR 2",7356026,CDM,73560,CPT,,,both,26,87,87,27.13,,,,fee schedule,,,,,,,,19.6,,,,fee schedule,,,73.95,85,,percent of total billed charges,,18.68,,,,fee schedule,,9.59,,,,fee schedule,,19.6,,,,fee schedule,,54.69,,,,fee schedule,,19.6,,,,fee schedule,,57.59,,,,fee schedule,,34.9,,,,fee schedule,,34.9,,,,fee schedule,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,26.1,83,,percent of total billed charges,,19.6,,,,fee schedule,,19.6,,,,fee schedule,,,72.21,83,,percent of total billed charges,,51.31,,,,fee schedule,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,9.59,82.65,
"X-RAY EXAM OF KNEE, 1 OR 2",73560TC,CDM,73560,CPT,,,both,TC,407,407,27.13,,,,fee schedule,,,,,,,,19.6,,,,fee schedule,,,345.95,85,,percent of total billed charges,,18.68,,,,fee schedule,,9.59,,,,fee schedule,,19.6,,,,fee schedule,,54.69,,,,fee schedule,,19.6,,,,fee schedule,,57.59,,,,fee schedule,,34.9,,,,fee schedule,,34.9,,,,fee schedule,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,122.1,83,,percent of total billed charges,,19.6,,,,fee schedule,,19.6,,,,fee schedule,,,337.81,83,,percent of total billed charges,,51.31,,,,fee schedule,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,9.59,386.65,
XRAY Knee 3V     side:,73562,CDM,73562,CPT,,,both,,474,474,32.67,,,,fee schedule,,,,,,,,20.2,,,,fee schedule,,,402.9,85,,percent of total billed charges,,20.99,,,,fee schedule,,10.78,,,,fee schedule,,20.2,,,,fee schedule,,60.29,,,,fee schedule,,20.2,,,,fee schedule,,68.21,,,,fee schedule,,41.34,,,,fee schedule,,41.34,,,,fee schedule,,,431.34,91,,percent of total billed charges,,,450.3,95,,percent of total billed charges,,,393.42,83,,percent of total billed charges,,,142.2,83,,percent of total billed charges,,20.2,,,,fee schedule,,20.2,,,,fee schedule,,,393.42,83,,percent of total billed charges,,60.77,,,,fee schedule,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,402.9,85,,percent of total billed charges,,10.78,450.3,
"X-RAY EXAM OF KNEE, 3",7356226,CDM,73562,CPT,,,both,26,100,100,32.67,,,,fee schedule,,,,,,,,20.2,,,,fee schedule,,,85,85,,percent of total billed charges,,20.99,,,,fee schedule,,10.78,,,,fee schedule,,20.2,,,,fee schedule,,60.29,,,,fee schedule,,20.2,,,,fee schedule,,68.21,,,,fee schedule,,41.34,,,,fee schedule,,41.34,,,,fee schedule,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,30,83,,percent of total billed charges,,20.2,,,,fee schedule,,20.2,,,,fee schedule,,,83,83,,percent of total billed charges,,60.77,,,,fee schedule,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,10.78,95,
"X-RAY EXAM OF KNEE, 3",73562TC,CDM,73562,CPT,,,both,TC,484,484,32.67,,,,fee schedule,,,,,,,,20.2,,,,fee schedule,,,411.4,85,,percent of total billed charges,,20.99,,,,fee schedule,,10.78,,,,fee schedule,,20.2,,,,fee schedule,,60.29,,,,fee schedule,,20.2,,,,fee schedule,,68.21,,,,fee schedule,,41.34,,,,fee schedule,,41.34,,,,fee schedule,,,440.44,91,,percent of total billed charges,,,459.8,95,,percent of total billed charges,,,401.72,83,,percent of total billed charges,,,145.2,83,,percent of total billed charges,,20.2,,,,fee schedule,,20.2,,,,fee schedule,,,401.72,83,,percent of total billed charges,,60.77,,,,fee schedule,,,435.6,90,,percent of total billed charges,,,435.6,90,,percent of total billed charges,,,435.6,90,,percent of total billed charges,,,435.6,90,,percent of total billed charges,,,411.4,85,,percent of total billed charges,,10.78,459.8,
XRAY Knee 4V+     side:,73564,CDM,73564,CPT,,,both,,507,507,38.01,,,,fee schedule,,,,,,,,22.2,,,,fee schedule,,,430.95,85,,percent of total billed charges,,24.88,,,,fee schedule,,12.78,,,,fee schedule,,22.2,,,,fee schedule,,67.31,,,,fee schedule,,22.2,,,,fee schedule,,78.28,,,,fee schedule,,47.44,,,,fee schedule,,47.44,,,,fee schedule,,,461.37,91,,percent of total billed charges,,,481.65,95,,percent of total billed charges,,,420.81,83,,percent of total billed charges,,,152.1,83,,percent of total billed charges,,22.2,,,,fee schedule,,22.2,,,,fee schedule,,,420.81,83,,percent of total billed charges,,69.74,,,,fee schedule,,,456.3,90,,percent of total billed charges,,,456.3,90,,percent of total billed charges,,,456.3,90,,percent of total billed charges,,,456.3,90,,percent of total billed charges,,,430.95,85,,percent of total billed charges,,12.78,481.65,
"X-RAY EXAM, KNEE, 4 OR MORE",7356426,CDM,73564,CPT,,,both,26,115,115,38.01,,,,fee schedule,,,,,,,,22.2,,,,fee schedule,,,97.75,85,,percent of total billed charges,,24.88,,,,fee schedule,,12.78,,,,fee schedule,,22.2,,,,fee schedule,,67.31,,,,fee schedule,,22.2,,,,fee schedule,,78.28,,,,fee schedule,,47.44,,,,fee schedule,,47.44,,,,fee schedule,,,104.65,91,,percent of total billed charges,,,109.25,95,,percent of total billed charges,,,95.45,83,,percent of total billed charges,,,34.5,83,,percent of total billed charges,,22.2,,,,fee schedule,,22.2,,,,fee schedule,,,95.45,83,,percent of total billed charges,,69.74,,,,fee schedule,,,103.5,90,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,97.75,85,,percent of total billed charges,,12.78,109.25,
"X-RAY EXAM, KNEE, 4 OR MORE",73564TC,CDM,73564,CPT,,,both,TC,688,688,38.01,,,,fee schedule,,,,,,,,22.2,,,,fee schedule,,,584.8,85,,percent of total billed charges,,24.88,,,,fee schedule,,12.78,,,,fee schedule,,22.2,,,,fee schedule,,67.31,,,,fee schedule,,22.2,,,,fee schedule,,78.28,,,,fee schedule,,47.44,,,,fee schedule,,47.44,,,,fee schedule,,,626.08,91,,percent of total billed charges,,,653.6,95,,percent of total billed charges,,,571.04,83,,percent of total billed charges,,,206.4,83,,percent of total billed charges,,22.2,,,,fee schedule,,22.2,,,,fee schedule,,,571.04,83,,percent of total billed charges,,69.74,,,,fee schedule,,,619.2,90,,percent of total billed charges,,,619.2,90,,percent of total billed charges,,,619.2,90,,percent of total billed charges,,,619.2,90,,percent of total billed charges,,,584.8,85,,percent of total billed charges,,12.78,653.6,
XRAY Knees AP BIL Upright,73565,CDM,73565,CPT,,,both,,312,312,31.26,,,,fee schedule,,,,,,,,33.4,,,,fee schedule,,,265.2,85,,percent of total billed charges,,19.4,,,,fee schedule,,9.96,,,,fee schedule,,33.4,,,,fee schedule,,52.58,,,,fee schedule,,33.4,,,,fee schedule,,67.1,,,,fee schedule,,40.66,,,,fee schedule,,40.66,,,,fee schedule,,,283.92,91,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,93.6,83,,percent of total billed charges,,33.4,,,,fee schedule,,33.4,,,,fee schedule,,,258.96,83,,percent of total billed charges,,59.78,,,,fee schedule,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,265.2,85,,percent of total billed charges,,9.96,296.4,
X-RAY EXAM OF KNEES,7356526,CDM,73565,CPT,,,both,26,95,95,31.26,,,,fee schedule,,,,,,,,33.4,,,,fee schedule,,,80.75,85,,percent of total billed charges,,19.4,,,,fee schedule,,9.96,,,,fee schedule,,33.4,,,,fee schedule,,52.58,,,,fee schedule,,33.4,,,,fee schedule,,67.1,,,,fee schedule,,40.66,,,,fee schedule,,40.66,,,,fee schedule,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,28.5,83,,percent of total billed charges,,33.4,,,,fee schedule,,33.4,,,,fee schedule,,,78.85,83,,percent of total billed charges,,59.78,,,,fee schedule,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,9.96,90.25,
X-RAY EXAM OF KNEES,73565TC,CDM,73565,CPT,,,both,TC,407,407,31.26,,,,fee schedule,,,,,,,,33.4,,,,fee schedule,,,345.95,85,,percent of total billed charges,,19.4,,,,fee schedule,,9.96,,,,fee schedule,,33.4,,,,fee schedule,,52.58,,,,fee schedule,,33.4,,,,fee schedule,,67.1,,,,fee schedule,,40.66,,,,fee schedule,,40.66,,,,fee schedule,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,122.1,83,,percent of total billed charges,,33.4,,,,fee schedule,,33.4,,,,fee schedule,,,337.81,83,,percent of total billed charges,,59.78,,,,fee schedule,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,9.96,386.65,
X-RAY EXAM OF LOWER LEG,73590,CDM,73590,CPT,,,both,,191,191,23.85,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,162.35,85,,percent of total billed charges,,17.96,,,,fee schedule,,9.22,,,,fee schedule,,21.5,,,,fee schedule,,54.69,,,,fee schedule,,21.5,,,,fee schedule,,53.12,,,,fee schedule,,32.19,,,,fee schedule,,32.19,,,,fee schedule,,,173.81,91,,percent of total billed charges,,,181.45,95,,percent of total billed charges,,,158.53,83,,percent of total billed charges,,,57.3,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,158.53,83,,percent of total billed charges,,47.32,,,,fee schedule,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,162.35,85,,percent of total billed charges,,9.22,181.45,
X-RAY EXAM OF LOWER LEG,73590 26,CDM,73590,CPT,,,both,26,76,76,23.85,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,64.6,85,,percent of total billed charges,,17.96,,,,fee schedule,,9.22,,,,fee schedule,,21.5,,,,fee schedule,,54.69,,,,fee schedule,,21.5,,,,fee schedule,,53.12,,,,fee schedule,,32.19,,,,fee schedule,,32.19,,,,fee schedule,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,63.08,83,,percent of total billed charges,,47.32,,,,fee schedule,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,9.22,72.2,
X-RAY EXAM OF LOWER LEG,73590 TC,CDM,73590,CPT,,,both, TC,414,414,23.85,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,351.9,85,,percent of total billed charges,,17.96,,,,fee schedule,,9.22,,,,fee schedule,,21.5,,,,fee schedule,,54.69,,,,fee schedule,,21.5,,,,fee schedule,,53.12,,,,fee schedule,,32.19,,,,fee schedule,,32.19,,,,fee schedule,,,376.74,91,,percent of total billed charges,,,393.3,95,,percent of total billed charges,,,343.62,83,,percent of total billed charges,,,124.2,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,343.62,83,,percent of total billed charges,,47.32,,,,fee schedule,,,372.6,90,,percent of total billed charges,,,372.6,90,,percent of total billed charges,,,372.6,90,,percent of total billed charges,,,372.6,90,,percent of total billed charges,,,351.9,85,,percent of total billed charges,,9.22,393.3,
XRAY Ankle 2V     side:,73600,CDM,73600,CPT,,,both,,303,303,24.92,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,257.55,85,,percent of total billed charges,,17.96,,,,fee schedule,,9.22,,,,fee schedule,,21.5,,,,fee schedule,,51.18,,,,fee schedule,,21.5,,,,fee schedule,,54.8,,,,fee schedule,,33.21,,,,fee schedule,,33.21,,,,fee schedule,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,90.9,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,251.49,83,,percent of total billed charges,,48.82,,,,fee schedule,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,9.22,287.85,
X-RAY EXAM OF ANKLE,7360026,CDM,73600,CPT,,,both,26,78,78,24.92,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,66.3,85,,percent of total billed charges,,17.96,,,,fee schedule,,9.22,,,,fee schedule,,21.5,,,,fee schedule,,51.18,,,,fee schedule,,21.5,,,,fee schedule,,54.8,,,,fee schedule,,33.21,,,,fee schedule,,33.21,,,,fee schedule,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,64.74,83,,percent of total billed charges,,48.82,,,,fee schedule,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,9.22,74.1,
X-RAY EXAM OF ANKLE,73600TC,CDM,73600,CPT,,,both,TC,407,407,24.92,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,345.95,85,,percent of total billed charges,,17.96,,,,fee schedule,,9.22,,,,fee schedule,,21.5,,,,fee schedule,,51.18,,,,fee schedule,,21.5,,,,fee schedule,,54.8,,,,fee schedule,,33.21,,,,fee schedule,,33.21,,,,fee schedule,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,122.1,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,337.81,83,,percent of total billed charges,,48.82,,,,fee schedule,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,9.22,386.65,
XRAY Ankle 3V+     side:,73610,CDM,73610,CPT,,,both,,407,407,28.8,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,,345.95,85,,percent of total billed charges,,18.02,,,,fee schedule,,10,,,,fee schedule,,28.7,,,,fee schedule,,55.39,,,,fee schedule,,28.7,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,122.1,83,,percent of total billed charges,,28.7,,,,fee schedule,,28.7,,,,fee schedule,,,337.81,83,,percent of total billed charges,,55.29,,,,fee schedule,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,10,386.65,
X-RAY EXAM OF ANKLE 3V+     side:,7361026,CDM,73610,CPT,,,both,26,92,92,28.8,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,,78.2,85,,percent of total billed charges,,18.02,,,,fee schedule,,10,,,,fee schedule,,28.7,,,,fee schedule,,55.39,,,,fee schedule,,28.7,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,27.6,83,,percent of total billed charges,,28.7,,,,fee schedule,,28.7,,,,fee schedule,,,76.36,83,,percent of total billed charges,,55.29,,,,fee schedule,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,10,87.4,
X-RAY EXAM OF ANKLE 3V+     side:,73610TC,CDM,73610,CPT,,,both,TC,445,445,28.8,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,,378.25,85,,percent of total billed charges,,18.02,,,,fee schedule,,10,,,,fee schedule,,28.7,,,,fee schedule,,55.39,,,,fee schedule,,28.7,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,404.95,91,,percent of total billed charges,,,422.75,95,,percent of total billed charges,,,369.35,83,,percent of total billed charges,,,133.5,83,,percent of total billed charges,,28.7,,,,fee schedule,,28.7,,,,fee schedule,,,369.35,83,,percent of total billed charges,,55.29,,,,fee schedule,,,400.5,90,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,400.5,90,,percent of total billed charges,,,378.25,85,,percent of total billed charges,,10,422.75,
XRAY Foot 2V     side:,73620,CDM,73620,CPT,,,both,,303,303,23.82,,,,fee schedule,,,,,,,,17,,,,fee schedule,,,257.55,85,,percent of total billed charges,,15.95,,,,fee schedule,,8.85,,,,fee schedule,,17,,,,fee schedule,,51.18,,,,fee schedule,,17,,,,fee schedule,,47.53,,,,fee schedule,,28.8,,,,fee schedule,,28.8,,,,fee schedule,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,90.9,83,,percent of total billed charges,,17,,,,fee schedule,,17,,,,fee schedule,,,251.49,83,,percent of total billed charges,,42.34,,,,fee schedule,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,8.85,287.85,
X-RAY EXAM OF FOOT,7362026,CDM,73620,CPT,,,both,26,74,74,23.82,,,,fee schedule,,,,,,,,17,,,,fee schedule,,,62.9,85,,percent of total billed charges,,15.95,,,,fee schedule,,8.85,,,,fee schedule,,17,,,,fee schedule,,51.18,,,,fee schedule,,17,,,,fee schedule,,47.53,,,,fee schedule,,28.8,,,,fee schedule,,28.8,,,,fee schedule,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,22.2,83,,percent of total billed charges,,17,,,,fee schedule,,17,,,,fee schedule,,,61.42,83,,percent of total billed charges,,42.34,,,,fee schedule,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,8.85,70.3,
XRAY Foot 3V+     side:,73630,CDM,73630,CPT,,,both,,365,365,27.15,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,310.25,85,,percent of total billed charges,,17.35,,,,fee schedule,,9.63,,,,fee schedule,,21.5,,,,fee schedule,,55.39,,,,fee schedule,,21.5,,,,fee schedule,,57.59,,,,fee schedule,,34.9,,,,fee schedule,,34.9,,,,fee schedule,,,332.15,91,,percent of total billed charges,,,346.75,95,,percent of total billed charges,,,302.95,83,,percent of total billed charges,,,109.5,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,302.95,83,,percent of total billed charges,,51.31,,,,fee schedule,,,328.5,90,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,328.5,90,,percent of total billed charges,,,310.25,85,,percent of total billed charges,,9.63,346.75,
X-RAY EXAM OF FOOT,7363026,CDM,73630,CPT,,,both,26,85,85,27.15,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,72.25,85,,percent of total billed charges,,17.35,,,,fee schedule,,9.63,,,,fee schedule,,21.5,,,,fee schedule,,55.39,,,,fee schedule,,21.5,,,,fee schedule,,57.59,,,,fee schedule,,34.9,,,,fee schedule,,34.9,,,,fee schedule,,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,25.5,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,70.55,83,,percent of total billed charges,,51.31,,,,fee schedule,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,9.63,80.75,
X-RAY EXAM OF FOOT,73630TC,CDM,73630,CPT,,,both,TC,436,436,27.15,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,370.6,85,,percent of total billed charges,,17.35,,,,fee schedule,,9.63,,,,fee schedule,,21.5,,,,fee schedule,,55.39,,,,fee schedule,,21.5,,,,fee schedule,,57.59,,,,fee schedule,,34.9,,,,fee schedule,,34.9,,,,fee schedule,,,396.76,91,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,130.8,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,361.88,83,,percent of total billed charges,,51.31,,,,fee schedule,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,9.63,414.2,
XRAY Heel (Calcaneous)     side:,73650,CDM,73650,CPT,,,both,,303,303,24.65,,,,fee schedule,,,,,,,,17,,,,fee schedule,,,257.55,85,,percent of total billed charges,,17.96,,,,fee schedule,,9.22,,,,fee schedule,,17,,,,fee schedule,,49.78,,,,fee schedule,,17,,,,fee schedule,,48.09,,,,fee schedule,,29.14,,,,fee schedule,,29.14,,,,fee schedule,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,90.9,83,,percent of total billed charges,,17,,,,fee schedule,,17,,,,fee schedule,,,251.49,83,,percent of total billed charges,,42.84,,,,fee schedule,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,9.22,287.85,
X-RAY EXAM OF HEEL,7365026,CDM,73650,CPT,,,both,26,77,77,24.65,,,,fee schedule,,,,,,,,17,,,,fee schedule,,,65.45,85,,percent of total billed charges,,17.96,,,,fee schedule,,9.22,,,,fee schedule,,17,,,,fee schedule,,49.78,,,,fee schedule,,17,,,,fee schedule,,48.09,,,,fee schedule,,29.14,,,,fee schedule,,29.14,,,,fee schedule,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,17,,,,fee schedule,,17,,,,fee schedule,,,63.91,83,,percent of total billed charges,,42.84,,,,fee schedule,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,9.22,73.15,
X-RAY EXAM OF HEEL,73650TC,CDM,73650,CPT,,,both,TC,407,407,24.65,,,,fee schedule,,,,,,,,17,,,,fee schedule,,,345.95,85,,percent of total billed charges,,17.96,,,,fee schedule,,9.22,,,,fee schedule,,17,,,,fee schedule,,49.78,,,,fee schedule,,17,,,,fee schedule,,48.09,,,,fee schedule,,29.14,,,,fee schedule,,29.14,,,,fee schedule,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,122.1,83,,percent of total billed charges,,17,,,,fee schedule,,17,,,,fee schedule,,,337.81,83,,percent of total billed charges,,42.84,,,,fee schedule,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,9.22,386.65,
XRAY Toes      side/site:,73660,CDM,73660,CPT,,,both,,303,303,26.22,,,,fee schedule,,,,,,,,14.35,,,,fee schedule,,,257.55,85,,percent of total billed charges,,14.85,,,,fee schedule,,7.63,,,,fee schedule,,14.35,,,,fee schedule,,43.47,,,,fee schedule,,14.35,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,90.9,83,,percent of total billed charges,,14.35,,,,fee schedule,,14.35,,,,fee schedule,,,251.49,83,,percent of total billed charges,,43.84,,,,fee schedule,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,7.63,287.85,
X-RAY EXAM OF TOE(S),7366026,CDM,73660,CPT,,,both,26,101,101,26.22,,,,fee schedule,,,,,,,,14.35,,,,fee schedule,,,85.85,85,,percent of total billed charges,,14.85,,,,fee schedule,,7.63,,,,fee schedule,,14.35,,,,fee schedule,,43.47,,,,fee schedule,,14.35,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,30.3,83,,percent of total billed charges,,14.35,,,,fee schedule,,14.35,,,,fee schedule,,,83.83,83,,percent of total billed charges,,43.84,,,,fee schedule,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,7.63,95.95,
X-RAY EXAM OF TOE(S),73660TC,CDM,73660,CPT,,,both,TC,407,407,26.22,,,,fee schedule,,,,,,,,14.35,,,,fee schedule,,,345.95,85,,percent of total billed charges,,14.85,,,,fee schedule,,7.63,,,,fee schedule,,14.35,,,,fee schedule,,43.47,,,,fee schedule,,14.35,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,122.1,83,,percent of total billed charges,,14.35,,,,fee schedule,,14.35,,,,fee schedule,,,337.81,83,,percent of total billed charges,,43.84,,,,fee schedule,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,7.63,386.65,
X-RAY EXAM ABDOMEN 1 VIEW,74018,CDM,74018,CPT,,,both,,183,183,23.22,,,,fee schedule,,,,,,,,62.6,,,,fee schedule,,,155.55,85,,percent of total billed charges,,20.26,,,,fee schedule,,10.41,,,,fee schedule,,62.6,,,,fee schedule,,,,,,,,62.6,,,,fee schedule,,50.32,,,,fee schedule,,30.5,,,,fee schedule,,30.5,,,,fee schedule,,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,54.9,83,,percent of total billed charges,,62.6,,,,fee schedule,,62.6,,,,fee schedule,,,151.89,83,,percent of total billed charges,,44.83,,,,fee schedule,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,10.41,173.85,
X-RAY EXAM ABDOMEN 1 VIEW,7401826,CDM,74018,CPT,,,both,26,69,69,23.22,,,,fee schedule,,,,,,,,62.6,,,,fee schedule,,,58.65,85,,percent of total billed charges,,20.26,,,,fee schedule,,10.41,,,,fee schedule,,62.6,,,,fee schedule,,,,,,,,62.6,,,,fee schedule,,50.32,,,,fee schedule,,30.5,,,,fee schedule,,30.5,,,,fee schedule,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,20.7,83,,percent of total billed charges,,62.6,,,,fee schedule,,62.6,,,,fee schedule,,,57.27,83,,percent of total billed charges,,44.83,,,,fee schedule,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,10.41,65.55,
X-RAY EXAM ABDOMEN 1 VIEW,74018TC,CDM,74018,CPT,,,both,TC,407,407,23.22,,,,fee schedule,,,,,,,,62.6,,,,fee schedule,,,345.95,85,,percent of total billed charges,,20.26,,,,fee schedule,,10.41,,,,fee schedule,,62.6,,,,fee schedule,,,,,,,,62.6,,,,fee schedule,,50.32,,,,fee schedule,,30.5,,,,fee schedule,,30.5,,,,fee schedule,,,370.37,91,,percent of total billed charges,,,386.65,95,,percent of total billed charges,,,337.81,83,,percent of total billed charges,,,122.1,83,,percent of total billed charges,,62.6,,,,fee schedule,,62.6,,,,fee schedule,,,337.81,83,,percent of total billed charges,,44.83,,,,fee schedule,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,366.3,90,,percent of total billed charges,,,345.95,85,,percent of total billed charges,,10.41,386.65,
X-RAY EXAM ABDOMEN 2 VIEWS,74019,CDM,74019,CPT,,,both,,223,223,28.33,,,,fee schedule,,,,,,,,38.2,,,,fee schedule,,,189.55,85,,percent of total billed charges,,25.67,,,,fee schedule,,13.19,,,,fee schedule,,38.2,,,,fee schedule,,,,,,,,38.2,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,202.93,91,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,66.9,83,,percent of total billed charges,,38.2,,,,fee schedule,,38.2,,,,fee schedule,,,185.09,83,,percent of total billed charges,,55.29,,,,fee schedule,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,13.19,211.85,
X-RAY EXAM ABDOMEN 2 VIEWS,7401926,CDM,74019,CPT,,,both,26,109,109,28.33,,,,fee schedule,,,,,,,,38.2,,,,fee schedule,,,92.65,85,,percent of total billed charges,,25.67,,,,fee schedule,,13.19,,,,fee schedule,,38.2,,,,fee schedule,,,,,,,,38.2,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,32.7,83,,percent of total billed charges,,38.2,,,,fee schedule,,38.2,,,,fee schedule,,,90.47,83,,percent of total billed charges,,55.29,,,,fee schedule,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,13.19,103.55,
X-RAY EXAM ABDOMEN 2 VIEWS,74019TC,CDM,74019,CPT,,,both,TC,109,109,28.33,,,,fee schedule,,,,,,,,38.2,,,,fee schedule,,,92.65,85,,percent of total billed charges,,25.67,,,,fee schedule,,13.19,,,,fee schedule,,38.2,,,,fee schedule,,,,,,,,38.2,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,32.7,83,,percent of total billed charges,,38.2,,,,fee schedule,,38.2,,,,fee schedule,,,90.47,83,,percent of total billed charges,,55.29,,,,fee schedule,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,13.19,103.55,
"CONTRST X-RAY, URINARY TRACT",74420,CDM,74420,CPT,,,both,,141,141,98.83,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,,119.85,85,,percent of total billed charges,,56.1,,,,fee schedule,,28.81,,,,fee schedule,,28.7,,,,fee schedule,,228.56,,,,fee schedule,,28.7,,,,fee schedule,,129.16,,,,fee schedule,,78.28,,,,fee schedule,,78.28,,,,fee schedule,,,128.31,91,,percent of total billed charges,,,133.95,95,,percent of total billed charges,,,117.03,83,,percent of total billed charges,,,42.3,83,,percent of total billed charges,,28.7,,,,fee schedule,,28.7,,,,fee schedule,,,117.03,83,,percent of total billed charges,,115.07,,,,fee schedule,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,119.85,85,,percent of total billed charges,,28.7,228.56,
CT Cardiac Scoring,75571,CDM,75571,CPT,,,both,,406,406,71.98,,,,fee schedule,,,,,,,,109.85,,,,fee schedule,,,345.1,85,,percent of total billed charges,,64.18,,,,fee schedule,,32.96,,,,fee schedule,,109.85,,,,fee schedule,,,,,,,,109.85,,,,fee schedule,,172.77,,,,fee schedule,,104.71,,,,fee schedule,,104.71,,,,fee schedule,,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,121.8,83,,percent of total billed charges,,109.85,,,,fee schedule,,109.85,,,,fee schedule,,,336.98,83,,percent of total billed charges,,153.93,,,,fee schedule,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,32.96,385.7,
CT HRT W/O DYE W/CA TEST,7557126,CDM,75571,CPT,,,both,26,359,359,71.98,,,,fee schedule,,,,,,,,109.85,,,,fee schedule,,,305.15,85,,percent of total billed charges,,64.18,,,,fee schedule,,32.96,,,,fee schedule,,109.85,,,,fee schedule,,,,,,,,109.85,,,,fee schedule,,172.77,,,,fee schedule,,104.71,,,,fee schedule,,104.71,,,,fee schedule,,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,107.7,83,,percent of total billed charges,,109.85,,,,fee schedule,,109.85,,,,fee schedule,,,297.97,83,,percent of total billed charges,,153.93,,,,fee schedule,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,32.96,341.05,
CTA CARDIAC W/CONTRAST & SCORE,75572,CDM,75572,CPT,,,both,,1950,1950,291.44,,,,fee schedule,,,,,,,,109.85,,,,fee schedule,,,1657.5,85,,percent of total billed charges,,191.02,,,,fee schedule,,98.11,,,,fee schedule,,109.85,,,,fee schedule,,,,,,,,109.85,,,,fee schedule,,393.07,,,,fee schedule,,238.23,,,,fee schedule,,238.23,,,,fee schedule,,,1774.5,91,,percent of total billed charges,,,1852.5,95,,percent of total billed charges,,,1618.5,83,,percent of total billed charges,,,585,83,,percent of total billed charges,,109.85,,,,fee schedule,,109.85,,,,fee schedule,,,1618.5,83,,percent of total billed charges,,350.19,,,,fee schedule,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1755,90,,percent of total billed charges,,,1657.5,85,,percent of total billed charges,,98.11,1852.5,
CT HRT W/3D IMAGE,7557226,CDM,75572,CPT,,,both,26,712,712,291.44,,,,fee schedule,,,,,,,,109.85,,,,fee schedule,,,605.2,85,,percent of total billed charges,,191.02,,,,fee schedule,,98.11,,,,fee schedule,,109.85,,,,fee schedule,,,,,,,,109.85,,,,fee schedule,,393.07,,,,fee schedule,,238.23,,,,fee schedule,,238.23,,,,fee schedule,,,647.92,91,,percent of total billed charges,,,676.4,95,,percent of total billed charges,,,590.96,83,,percent of total billed charges,,,213.6,83,,percent of total billed charges,,109.85,,,,fee schedule,,109.85,,,,fee schedule,,,590.96,83,,percent of total billed charges,,350.19,,,,fee schedule,,,640.8,90,,percent of total billed charges,,,640.8,90,,percent of total billed charges,,,640.8,90,,percent of total billed charges,,,640.8,90,,percent of total billed charges,,,605.2,85,,percent of total billed charges,,98.11,676.4,
CT HRT W/3D IMAGE CONGEN,7557326,CDM,75573,CPT,,,both,26,674,674,361.77,,,,fee schedule,,,,,,,,109.85,,,,fee schedule,,,572.9,85,,percent of total billed charges,,278.2,,,,fee schedule,,142.89,,,,fee schedule,,109.85,,,,fee schedule,,,,,,,,109.85,,,,fee schedule,,522.79,,,,fee schedule,,316.85,,,,fee schedule,,316.85,,,,fee schedule,,,613.34,91,,percent of total billed charges,,,640.3,95,,percent of total billed charges,,,559.42,83,,percent of total billed charges,,,202.2,83,,percent of total billed charges,,109.85,,,,fee schedule,,109.85,,,,fee schedule,,,559.42,83,,percent of total billed charges,,465.76,,,,fee schedule,,,606.6,90,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,606.6,90,,percent of total billed charges,,,572.9,85,,percent of total billed charges,,109.85,640.3,
CT ANGIO HRT W/3D IMAGE,7557426,CDM,75574,CPT,,,both,26,716,716,355.43,,,,fee schedule,,,,,,,,109.85,,,,fee schedule,,,608.6,85,,percent of total billed charges,,260.31,,,,fee schedule,,133.7,,,,fee schedule,,109.85,,,,fee schedule,,,,,,,,109.85,,,,fee schedule,,555.22,,,,fee schedule,,336.5,,,,fee schedule,,336.5,,,,fee schedule,,,651.56,91,,percent of total billed charges,,,680.2,95,,percent of total billed charges,,,594.28,83,,percent of total billed charges,,,214.8,83,,percent of total billed charges,,109.85,,,,fee schedule,,109.85,,,,fee schedule,,,594.28,83,,percent of total billed charges,,494.65,,,,fee schedule,,,644.4,90,,percent of total billed charges,,,644.4,90,,percent of total billed charges,,,644.4,90,,percent of total billed charges,,,644.4,90,,percent of total billed charges,,,608.6,85,,percent of total billed charges,,109.85,680.2,
CONTRAST X-RAY EXAM OF AORTA,75605,CDM,75605,CPT,,,both,,359,359,131.07,,,,fee schedule,,,,,,,,77.2,,,,fee schedule,,,305.15,85,,percent of total billed charges,,124.52,,,,fee schedule,,63.95,,,,fee schedule,,77.2,,,,fee schedule,,1040.44,,,,fee schedule,,77.2,,,,fee schedule,,201.85,,,,fee schedule,,122.33,,,,fee schedule,,122.33,,,,fee schedule,,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,107.7,83,,percent of total billed charges,,77.2,,,,fee schedule,,77.2,,,,fee schedule,,,297.97,83,,percent of total billed charges,,179.83,,,,fee schedule,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,63.95,1040.44,
CONTRAST X-RAY EXAM OF AORTA,75605P,CDM,75605,CPT,,,both,P,198,198,131.07,,,,fee schedule,,,,,,,,77.2,,,,fee schedule,,,168.3,85,,percent of total billed charges,,124.52,,,,fee schedule,,63.95,,,,fee schedule,,77.2,,,,fee schedule,,1040.44,,,,fee schedule,,77.2,,,,fee schedule,,201.85,,,,fee schedule,,122.33,,,,fee schedule,,122.33,,,,fee schedule,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,59.4,83,,percent of total billed charges,,77.2,,,,fee schedule,,77.2,,,,fee schedule,,,164.34,83,,percent of total billed charges,,179.83,,,,fee schedule,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,59.4,1040.44,
CONTRAST X-RAY EXAM OF AORTA,75605T,CDM,75605,CPT,,,both,T,161,161,131.07,,,,fee schedule,,,,,,,,77.2,,,,fee schedule,,,136.85,85,,percent of total billed charges,,124.52,,,,fee schedule,,63.95,,,,fee schedule,,77.2,,,,fee schedule,,1040.44,,,,fee schedule,,77.2,,,,fee schedule,,201.85,,,,fee schedule,,122.33,,,,fee schedule,,122.33,,,,fee schedule,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,48.3,83,,percent of total billed charges,,77.2,,,,fee schedule,,77.2,,,,fee schedule,,,133.63,83,,percent of total billed charges,,179.83,,,,fee schedule,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,48.3,1040.44,
CONTRAST X-RAY EXAM OF AORTA,75625,CDM,75625,CPT,,,both,,334,334,131.73,,,,fee schedule,,,,,,,,98.1,,,,fee schedule,,,283.9,85,,percent of total billed charges,,158.89,,,,fee schedule,,81.61,,,,fee schedule,,98.1,,,,fee schedule,,1039.74,,,,fee schedule,,98.1,,,,fee schedule,,211.35,,,,fee schedule,,128.09,,,,fee schedule,,128.09,,,,fee schedule,,,303.94,91,,percent of total billed charges,,,317.3,95,,percent of total billed charges,,,277.22,83,,percent of total billed charges,,,100.2,83,,percent of total billed charges,,98.1,,,,fee schedule,,98.1,,,,fee schedule,,,277.22,83,,percent of total billed charges,,188.3,,,,fee schedule,,,300.6,90,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,283.9,85,,percent of total billed charges,,81.61,1039.74,
CONTRAST X-RAY EXAM OF AORTA,75625P,CDM,75625,CPT,,,both,P,174,174,131.73,,,,fee schedule,,,,,,,,98.1,,,,fee schedule,,,147.9,85,,percent of total billed charges,,158.89,,,,fee schedule,,81.61,,,,fee schedule,,98.1,,,,fee schedule,,1039.74,,,,fee schedule,,98.1,,,,fee schedule,,211.35,,,,fee schedule,,128.09,,,,fee schedule,,128.09,,,,fee schedule,,,158.34,91,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,52.2,83,,percent of total billed charges,,98.1,,,,fee schedule,,98.1,,,,fee schedule,,,144.42,83,,percent of total billed charges,,188.3,,,,fee schedule,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,52.2,1039.74,
CONTRAST X-RAY EXAM OF AORTA,75625T,CDM,75625,CPT,,,both,T,160,160,131.73,,,,fee schedule,,,,,,,,98.1,,,,fee schedule,,,136,85,,percent of total billed charges,,158.89,,,,fee schedule,,81.61,,,,fee schedule,,98.1,,,,fee schedule,,1039.74,,,,fee schedule,,98.1,,,,fee schedule,,211.35,,,,fee schedule,,128.09,,,,fee schedule,,128.09,,,,fee schedule,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,48,83,,percent of total billed charges,,98.1,,,,fee schedule,,98.1,,,,fee schedule,,,132.8,83,,percent of total billed charges,,188.3,,,,fee schedule,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,48,1039.74,
"X-RAY AORTA, LEG ARTERIES",75630,CDM,75630,CPT,,,both,,485,485,157.19,,,,fee schedule,,,,,,,,130.8,,,,fee schedule,,,412.25,85,,percent of total billed charges,,219.4,,,,fee schedule,,112.69,,,,fee schedule,,130.8,,,,fee schedule,,1144.9,,,,fee schedule,,130.8,,,,fee schedule,,262.24,,,,fee schedule,,158.93,,,,fee schedule,,158.93,,,,fee schedule,,,441.35,91,,percent of total billed charges,,,460.75,95,,percent of total billed charges,,,402.55,83,,percent of total billed charges,,,145.5,83,,percent of total billed charges,,130.8,,,,fee schedule,,130.8,,,,fee schedule,,,402.55,83,,percent of total billed charges,,233.63,,,,fee schedule,,,436.5,90,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,436.5,90,,percent of total billed charges,,,412.25,85,,percent of total billed charges,,112.69,1144.9,
"X-RAY AORTA, LEG ARTERIES",75630P,CDM,75630,CPT,,,both,P,325,325,157.19,,,,fee schedule,,,,,,,,130.8,,,,fee schedule,,,276.25,85,,percent of total billed charges,,219.4,,,,fee schedule,,112.69,,,,fee schedule,,130.8,,,,fee schedule,,1144.9,,,,fee schedule,,130.8,,,,fee schedule,,262.24,,,,fee schedule,,158.93,,,,fee schedule,,158.93,,,,fee schedule,,,295.75,91,,percent of total billed charges,,,308.75,95,,percent of total billed charges,,,269.75,83,,percent of total billed charges,,,97.5,83,,percent of total billed charges,,130.8,,,,fee schedule,,130.8,,,,fee schedule,,,269.75,83,,percent of total billed charges,,233.63,,,,fee schedule,,,292.5,90,,percent of total billed charges,,,292.5,90,,percent of total billed charges,,,292.5,90,,percent of total billed charges,,,292.5,90,,percent of total billed charges,,,276.25,85,,percent of total billed charges,,97.5,1144.9,
"X-RAY AORTA, LEG ARTERIES",75630T,CDM,75630,CPT,,,both,T,160,160,157.19,,,,fee schedule,,,,,,,,130.8,,,,fee schedule,,,136,85,,percent of total billed charges,,219.4,,,,fee schedule,,112.69,,,,fee schedule,,130.8,,,,fee schedule,,1144.9,,,,fee schedule,,130.8,,,,fee schedule,,262.24,,,,fee schedule,,158.93,,,,fee schedule,,158.93,,,,fee schedule,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,48,83,,percent of total billed charges,,130.8,,,,fee schedule,,130.8,,,,fee schedule,,,132.8,83,,percent of total billed charges,,233.63,,,,fee schedule,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,48,1144.9,
X IR Angiography Pelvic,75736,CDM,75736,CPT,,,both,,8553,8553,147.05,,,,fee schedule,,,,,,,,91.45,,,,fee schedule,,,7270.05,85,,percent of total billed charges,,121.2,,,,fee schedule,,62.25,,,,fee schedule,,91.45,,,,fee schedule,,1039.74,,,,fee schedule,,91.45,,,,fee schedule,,239.31,,,,fee schedule,,145.04,,,,fee schedule,,145.04,,,,fee schedule,,,7783.23,91,,percent of total billed charges,,,8125.35,95,,percent of total billed charges,,,7098.99,83,,percent of total billed charges,,,2565.9,83,,percent of total billed charges,,91.45,,,,fee schedule,,91.45,,,,fee schedule,,,7098.99,83,,percent of total billed charges,,213.2,,,,fee schedule,,,7697.7,90,,percent of total billed charges,,,7697.7,90,,percent of total billed charges,,,7697.7,90,,percent of total billed charges,,,7697.7,90,,percent of total billed charges,,,7270.05,85,,percent of total billed charges,,62.25,8125.35,
US Thyroid/Soft Tissue Head or Neck,76536,CDM,76536,CPT,,,both,,634,634,103.08,,,,fee schedule,,,,,,,,68,,,,fee schedule,,,538.9,85,,percent of total billed charges,,63.31,,,,fee schedule,,32.52,,,,fee schedule,,68,,,,fee schedule,,159.15,,,,fee schedule,,68,,,,fee schedule,,187.31,,,,fee schedule,,113.52,,,,fee schedule,,113.52,,,,fee schedule,,,576.94,91,,percent of total billed charges,,,602.3,95,,percent of total billed charges,,,526.22,83,,percent of total billed charges,,,190.2,83,,percent of total billed charges,,68,,,,fee schedule,,68,,,,fee schedule,,,526.22,83,,percent of total billed charges,,166.88,,,,fee schedule,,,570.6,90,,percent of total billed charges,,,570.6,90,,percent of total billed charges,,,570.6,90,,percent of total billed charges,,,570.6,90,,percent of total billed charges,,,538.9,85,,percent of total billed charges,,32.52,602.3,
US EXAM OF HEAD AND NECK,7653626,CDM,76536,CPT,,,both,26,180,180,103.08,,,,fee schedule,,,,,,,,68,,,,fee schedule,,,153,85,,percent of total billed charges,,63.31,,,,fee schedule,,32.52,,,,fee schedule,,68,,,,fee schedule,,159.15,,,,fee schedule,,68,,,,fee schedule,,187.31,,,,fee schedule,,113.52,,,,fee schedule,,113.52,,,,fee schedule,,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,54,83,,percent of total billed charges,,68,,,,fee schedule,,68,,,,fee schedule,,,149.4,83,,percent of total billed charges,,166.88,,,,fee schedule,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,32.52,187.31,
US EXAM OF HEAD AND NECK,76536TC,CDM,76536,CPT,,,both,TC,454,454,103.08,,,,fee schedule,,,,,,,,68,,,,fee schedule,,,385.9,85,,percent of total billed charges,,63.31,,,,fee schedule,,32.52,,,,fee schedule,,68,,,,fee schedule,,159.15,,,,fee schedule,,68,,,,fee schedule,,187.31,,,,fee schedule,,113.52,,,,fee schedule,,113.52,,,,fee schedule,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,68,,,,fee schedule,,68,,,,fee schedule,,,376.82,83,,percent of total billed charges,,166.88,,,,fee schedule,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,32.52,431.3,
ULTRASOUND BREAST LIMITED,76642,CDM,76642,CPT,,,both,,573,573,75.52,,,,fee schedule,,,,,,,,50.91,,,,fee schedule,,,487.05,85,,percent of total billed charges,,74.99,,,,fee schedule,,38.52,,,,fee schedule,,50.91,,,,fee schedule,,,,,,,,50.91,,,,fee schedule,,143.14,,,,fee schedule,,86.75,,,,fee schedule,,86.75,,,,fee schedule,,,521.43,91,,percent of total billed charges,,,544.35,95,,percent of total billed charges,,,475.59,83,,percent of total billed charges,,,171.9,83,,percent of total billed charges,,50.91,,,,fee schedule,,50.91,,,,fee schedule,,,475.59,83,,percent of total billed charges,,127.52,,,,fee schedule,,,515.7,90,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,515.7,90,,percent of total billed charges,,,487.05,85,,percent of total billed charges,,38.52,544.35,
ULTRASOUND BREAST LIMITED,7664226,CDM,76642,CPT,,,both,26,246,246,75.52,,,,fee schedule,,,,,,,,50.91,,,,fee schedule,,,209.1,85,,percent of total billed charges,,74.99,,,,fee schedule,,38.52,,,,fee schedule,,50.91,,,,fee schedule,,,,,,,,50.91,,,,fee schedule,,143.14,,,,fee schedule,,86.75,,,,fee schedule,,86.75,,,,fee schedule,,,223.86,91,,percent of total billed charges,,,233.7,95,,percent of total billed charges,,,204.18,83,,percent of total billed charges,,,73.8,83,,percent of total billed charges,,50.91,,,,fee schedule,,50.91,,,,fee schedule,,,204.18,83,,percent of total billed charges,,127.52,,,,fee schedule,,,221.4,90,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,221.4,90,,percent of total billed charges,,,209.1,85,,percent of total billed charges,,38.52,233.7,
ULTRASOUND BREAST LIMITED,76642TC,CDM,76642,CPT,,,both,TC,327,327,75.52,,,,fee schedule,,,,,,,,50.91,,,,fee schedule,,,277.95,85,,percent of total billed charges,,74.99,,,,fee schedule,,38.52,,,,fee schedule,,50.91,,,,fee schedule,,,,,,,,50.91,,,,fee schedule,,143.14,,,,fee schedule,,86.75,,,,fee schedule,,86.75,,,,fee schedule,,,297.57,91,,percent of total billed charges,,,310.65,95,,percent of total billed charges,,,271.41,83,,percent of total billed charges,,,98.1,83,,percent of total billed charges,,50.91,,,,fee schedule,,50.91,,,,fee schedule,,,271.41,83,,percent of total billed charges,,127.52,,,,fee schedule,,,294.3,90,,percent of total billed charges,,,294.3,90,,percent of total billed charges,,,294.3,90,,percent of total billed charges,,,294.3,90,,percent of total billed charges,,,277.95,85,,percent of total billed charges,,38.52,310.65,
US Abdomen Complete,76700,CDM,76700,CPT,,,both,,1024,1024,114.9,,,,fee schedule,,,,,,,,75.9,,,,fee schedule,,,870.4,85,,percent of total billed charges,,88.91,,,,fee schedule,,45.67,,,,fee schedule,,75.9,,,,fee schedule,,224.35,,,,fee schedule,,75.9,,,,fee schedule,,196.26,,,,fee schedule,,118.94,,,,fee schedule,,118.94,,,,fee schedule,,,931.84,91,,percent of total billed charges,,,972.8,95,,percent of total billed charges,,,849.92,83,,percent of total billed charges,,,307.2,83,,percent of total billed charges,,75.9,,,,fee schedule,,75.9,,,,fee schedule,,,849.92,83,,percent of total billed charges,,174.85,,,,fee schedule,,,921.6,90,,percent of total billed charges,,,921.6,90,,percent of total billed charges,,,921.6,90,,percent of total billed charges,,,921.6,90,,percent of total billed charges,,,870.4,85,,percent of total billed charges,,45.67,972.8,
US EXAM ABDOM COMPLETE,7670026,CDM,76700,CPT,,,both,26,302,302,114.9,,,,fee schedule,,,,,,,,75.9,,,,fee schedule,,,256.7,85,,percent of total billed charges,,88.91,,,,fee schedule,,45.67,,,,fee schedule,,75.9,,,,fee schedule,,224.35,,,,fee schedule,,75.9,,,,fee schedule,,196.26,,,,fee schedule,,118.94,,,,fee schedule,,118.94,,,,fee schedule,,,274.82,91,,percent of total billed charges,,,286.9,95,,percent of total billed charges,,,250.66,83,,percent of total billed charges,,,90.6,83,,percent of total billed charges,,75.9,,,,fee schedule,,75.9,,,,fee schedule,,,250.66,83,,percent of total billed charges,,174.85,,,,fee schedule,,,271.8,90,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,271.8,90,,percent of total billed charges,,,256.7,85,,percent of total billed charges,,45.67,286.9,
US EXAM ABDOM COMPLETE,76700TC,CDM,76700,CPT,,,both,TC,722,722,114.9,,,,fee schedule,,,,,,,,75.9,,,,fee schedule,,,613.7,85,,percent of total billed charges,,88.91,,,,fee schedule,,45.67,,,,fee schedule,,75.9,,,,fee schedule,,224.35,,,,fee schedule,,75.9,,,,fee schedule,,196.26,,,,fee schedule,,118.94,,,,fee schedule,,118.94,,,,fee schedule,,,657.02,91,,percent of total billed charges,,,685.9,95,,percent of total billed charges,,,599.26,83,,percent of total billed charges,,,216.6,83,,percent of total billed charges,,75.9,,,,fee schedule,,75.9,,,,fee schedule,,,599.26,83,,percent of total billed charges,,174.85,,,,fee schedule,,,649.8,90,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,649.8,90,,percent of total billed charges,,,613.7,85,,percent of total billed charges,,45.67,685.9,
US Abdomen Limited (Specify),76705,CDM,76705,CPT,,,both,,764,764,91.32,,,,fee schedule,,,,,,,,62.7,,,,fee schedule,,,649.4,85,,percent of total billed charges,,65.69,,,,fee schedule,,33.74,,,,fee schedule,,62.7,,,,fee schedule,,161.95,,,,fee schedule,,62.7,,,,fee schedule,,148.17,,,,fee schedule,,89.8,,,,fee schedule,,89.8,,,,fee schedule,,,695.24,91,,percent of total billed charges,,,725.8,95,,percent of total billed charges,,,634.12,83,,percent of total billed charges,,,229.2,83,,percent of total billed charges,,62.7,,,,fee schedule,,62.7,,,,fee schedule,,,634.12,83,,percent of total billed charges,,132.01,,,,fee schedule,,,687.6,90,,percent of total billed charges,,,687.6,90,,percent of total billed charges,,,687.6,90,,percent of total billed charges,,,687.6,90,,percent of total billed charges,,,649.4,85,,percent of total billed charges,,33.74,725.8,
ECHO EXAM OF ABDOMEN,7670526,CDM,76705,CPT,,,both,26,222,222,91.32,,,,fee schedule,,,,,,,,62.7,,,,fee schedule,,,188.7,85,,percent of total billed charges,,65.69,,,,fee schedule,,33.74,,,,fee schedule,,62.7,,,,fee schedule,,161.95,,,,fee schedule,,62.7,,,,fee schedule,,148.17,,,,fee schedule,,89.8,,,,fee schedule,,89.8,,,,fee schedule,,,202.02,91,,percent of total billed charges,,,210.9,95,,percent of total billed charges,,,184.26,83,,percent of total billed charges,,,66.6,83,,percent of total billed charges,,62.7,,,,fee schedule,,62.7,,,,fee schedule,,,184.26,83,,percent of total billed charges,,132.01,,,,fee schedule,,,199.8,90,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,188.7,85,,percent of total billed charges,,33.74,210.9,
ECHO EXAM OF ABDOMEN,76705TC,CDM,76705,CPT,,,both,TC,542,542,91.32,,,,fee schedule,,,,,,,,62.7,,,,fee schedule,,,460.7,85,,percent of total billed charges,,65.69,,,,fee schedule,,33.74,,,,fee schedule,,62.7,,,,fee schedule,,161.95,,,,fee schedule,,62.7,,,,fee schedule,,148.17,,,,fee schedule,,89.8,,,,fee schedule,,89.8,,,,fee schedule,,,493.22,91,,percent of total billed charges,,,514.9,95,,percent of total billed charges,,,449.86,83,,percent of total billed charges,,,162.6,83,,percent of total billed charges,,62.7,,,,fee schedule,,62.7,,,,fee schedule,,,449.86,83,,percent of total billed charges,,132.01,,,,fee schedule,,,487.8,90,,percent of total billed charges,,,487.8,90,,percent of total billed charges,,,487.8,90,,percent of total billed charges,,,487.8,90,,percent of total billed charges,,,460.7,85,,percent of total billed charges,,33.74,514.9,
US Retroperitoneal Complete,76770,CDM,76770,CPT,,,both,,930,930,111.96,,,,fee schedule,,,,,,,,75.9,,,,fee schedule,,,790.5,85,,percent of total billed charges,,81.19,,,,fee schedule,,41.7,,,,fee schedule,,75.9,,,,fee schedule,,216.64,,,,fee schedule,,75.9,,,,fee schedule,,182.84,,,,fee schedule,,110.81,,,,fee schedule,,110.81,,,,fee schedule,,,846.3,91,,percent of total billed charges,,,883.5,95,,percent of total billed charges,,,771.9,83,,percent of total billed charges,,,279,83,,percent of total billed charges,,75.9,,,,fee schedule,,75.9,,,,fee schedule,,,771.9,83,,percent of total billed charges,,162.89,,,,fee schedule,,,837,90,,percent of total billed charges,,,837,90,,percent of total billed charges,,,837,90,,percent of total billed charges,,,837,90,,percent of total billed charges,,,790.5,85,,percent of total billed charges,,41.7,883.5,
US EXAM ABDO BACK WALL COMP,7677026,CDM,76770,CPT,,,both,26,277,277,111.96,,,,fee schedule,,,,,,,,75.9,,,,fee schedule,,,235.45,85,,percent of total billed charges,,81.19,,,,fee schedule,,41.7,,,,fee schedule,,75.9,,,,fee schedule,,216.64,,,,fee schedule,,75.9,,,,fee schedule,,182.84,,,,fee schedule,,110.81,,,,fee schedule,,110.81,,,,fee schedule,,,252.07,91,,percent of total billed charges,,,263.15,95,,percent of total billed charges,,,229.91,83,,percent of total billed charges,,,83.1,83,,percent of total billed charges,,75.9,,,,fee schedule,,75.9,,,,fee schedule,,,229.91,83,,percent of total billed charges,,162.89,,,,fee schedule,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,235.45,85,,percent of total billed charges,,41.7,263.15,
US EXAM ABDO BACK WALL COMP,76770TC,CDM,76770,CPT,,,both,TC,653,653,111.96,,,,fee schedule,,,,,,,,75.9,,,,fee schedule,,,555.05,85,,percent of total billed charges,,81.19,,,,fee schedule,,41.7,,,,fee schedule,,75.9,,,,fee schedule,,216.64,,,,fee schedule,,75.9,,,,fee schedule,,182.84,,,,fee schedule,,110.81,,,,fee schedule,,110.81,,,,fee schedule,,,594.23,91,,percent of total billed charges,,,620.35,95,,percent of total billed charges,,,541.99,83,,percent of total billed charges,,,195.9,83,,percent of total billed charges,,75.9,,,,fee schedule,,75.9,,,,fee schedule,,,541.99,83,,percent of total billed charges,,162.89,,,,fee schedule,,,587.7,90,,percent of total billed charges,,,587.7,90,,percent of total billed charges,,,587.7,90,,percent of total billed charges,,,587.7,90,,percent of total billed charges,,,555.05,85,,percent of total billed charges,,41.7,620.35,
US Retro-Peritoneal Limited,76775,CDM,76775,CPT,,,both,,733,733,91.85,,,,fee schedule,,,,,,,,62.7,,,,fee schedule,,,623.05,85,,percent of total billed charges,,64.18,,,,fee schedule,,32.96,,,,fee schedule,,62.7,,,,fee schedule,,161.25,,,,fee schedule,,62.7,,,,fee schedule,,98.97,,,,fee schedule,,59.98,,,,fee schedule,,59.98,,,,fee schedule,,,667.03,91,,percent of total billed charges,,,696.35,95,,percent of total billed charges,,,608.39,83,,percent of total billed charges,,,219.9,83,,percent of total billed charges,,62.7,,,,fee schedule,,62.7,,,,fee schedule,,,608.39,83,,percent of total billed charges,,88.17,,,,fee schedule,,,659.7,90,,percent of total billed charges,,,659.7,90,,percent of total billed charges,,,659.7,90,,percent of total billed charges,,,659.7,90,,percent of total billed charges,,,623.05,85,,percent of total billed charges,,32.96,696.35,
US EXAM ABDO BACK WALL LIM,7677526,CDM,76775,CPT,,,both,26,230,230,91.85,,,,fee schedule,,,,,,,,62.7,,,,fee schedule,,,195.5,85,,percent of total billed charges,,64.18,,,,fee schedule,,32.96,,,,fee schedule,,62.7,,,,fee schedule,,161.25,,,,fee schedule,,62.7,,,,fee schedule,,98.97,,,,fee schedule,,59.98,,,,fee schedule,,59.98,,,,fee schedule,,,209.3,91,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,69,83,,percent of total billed charges,,62.7,,,,fee schedule,,62.7,,,,fee schedule,,,190.9,83,,percent of total billed charges,,88.17,,,,fee schedule,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,32.96,218.5,
US AORTA LIMITED,76775A,CDM,76775,CPT,,,both,,204,204,91.85,,,,fee schedule,,,,,,,,62.7,,,,fee schedule,,,173.4,85,,percent of total billed charges,,64.18,,,,fee schedule,,32.96,,,,fee schedule,,62.7,,,,fee schedule,,161.25,,,,fee schedule,,62.7,,,,fee schedule,,98.97,,,,fee schedule,,59.98,,,,fee schedule,,59.98,,,,fee schedule,,,185.64,91,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,61.2,83,,percent of total billed charges,,62.7,,,,fee schedule,,62.7,,,,fee schedule,,,169.32,83,,percent of total billed charges,,88.17,,,,fee schedule,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,173.4,85,,percent of total billed charges,,32.96,193.8,
US AORTA SCAN - Technical,76775B,CDM,76775,CPT,,,both,,508,508,91.85,,,,fee schedule,,,,,,,,62.7,,,,fee schedule,,,431.8,85,,percent of total billed charges,,64.18,,,,fee schedule,,32.96,,,,fee schedule,,62.7,,,,fee schedule,,161.25,,,,fee schedule,,62.7,,,,fee schedule,,98.97,,,,fee schedule,,59.98,,,,fee schedule,,59.98,,,,fee schedule,,,462.28,91,,percent of total billed charges,,,482.6,95,,percent of total billed charges,,,421.64,83,,percent of total billed charges,,,152.4,83,,percent of total billed charges,,62.7,,,,fee schedule,,62.7,,,,fee schedule,,,421.64,83,,percent of total billed charges,,88.17,,,,fee schedule,,,457.2,90,,percent of total billed charges,,,457.2,90,,percent of total billed charges,,,457.2,90,,percent of total billed charges,,,457.2,90,,percent of total billed charges,,,431.8,85,,percent of total billed charges,,32.96,482.6,
"US EXAM ABDO BACK WALL, LIM",76775P,CDM,76775,CPT,,,both,P,562,562,91.85,,,,fee schedule,,,,,,,,62.7,,,,fee schedule,,,477.7,85,,percent of total billed charges,,64.18,,,,fee schedule,,32.96,,,,fee schedule,,62.7,,,,fee schedule,,161.25,,,,fee schedule,,62.7,,,,fee schedule,,98.97,,,,fee schedule,,59.98,,,,fee schedule,,59.98,,,,fee schedule,,,511.42,91,,percent of total billed charges,,,533.9,95,,percent of total billed charges,,,466.46,83,,percent of total billed charges,,,168.6,83,,percent of total billed charges,,62.7,,,,fee schedule,,62.7,,,,fee schedule,,,466.46,83,,percent of total billed charges,,88.17,,,,fee schedule,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,505.8,90,,percent of total billed charges,,,477.7,85,,percent of total billed charges,,32.96,533.9,
"US EXAM ABDO BACK WALL, LIM",76775T,CDM,76775,CPT,,,both,T,150,150,91.85,,,,fee schedule,,,,,,,,62.7,,,,fee schedule,,,127.5,85,,percent of total billed charges,,64.18,,,,fee schedule,,32.96,,,,fee schedule,,62.7,,,,fee schedule,,161.25,,,,fee schedule,,62.7,,,,fee schedule,,98.97,,,,fee schedule,,59.98,,,,fee schedule,,59.98,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,62.7,,,,fee schedule,,62.7,,,,fee schedule,,,124.5,83,,percent of total billed charges,,88.17,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,32.96,161.25,
US EXAM ABDO BACK WALL LIM,76775TC,CDM,76775,CPT,,,both,TC,363,363,91.85,,,,fee schedule,,,,,,,,62.7,,,,fee schedule,,,308.55,85,,percent of total billed charges,,64.18,,,,fee schedule,,32.96,,,,fee schedule,,62.7,,,,fee schedule,,161.25,,,,fee schedule,,62.7,,,,fee schedule,,98.97,,,,fee schedule,,59.98,,,,fee schedule,,59.98,,,,fee schedule,,,330.33,91,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,108.9,83,,percent of total billed charges,,62.7,,,,fee schedule,,62.7,,,,fee schedule,,,301.29,83,,percent of total billed charges,,88.17,,,,fee schedule,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,32.96,344.85,
"OB US, 1st Trimester <14 Wks, Single Fetus",76801,CDM,76801,CPT,,,both,,933,933,107.56,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,793.05,85,,percent of total billed charges,,108.24,,,,fee schedule,,55.59,,,,fee schedule,,71.9,,,,fee schedule,,251.7,,,,fee schedule,,71.9,,,,fee schedule,,197.94,,,,fee schedule,,119.96,,,,fee schedule,,119.96,,,,fee schedule,,,849.03,91,,percent of total billed charges,,,886.35,95,,percent of total billed charges,,,774.39,83,,percent of total billed charges,,,279.9,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,774.39,83,,percent of total billed charges,,176.34,,,,fee schedule,,,839.7,90,,percent of total billed charges,,,839.7,90,,percent of total billed charges,,,839.7,90,,percent of total billed charges,,,839.7,90,,percent of total billed charges,,,793.05,85,,percent of total billed charges,,55.59,886.35,
OB US < 14 WKS SINGLE FETUS,7680126,CDM,76801,CPT,,,both,26,281,281,107.56,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,238.85,85,,percent of total billed charges,,108.24,,,,fee schedule,,55.59,,,,fee schedule,,71.9,,,,fee schedule,,251.7,,,,fee schedule,,71.9,,,,fee schedule,,197.94,,,,fee schedule,,119.96,,,,fee schedule,,119.96,,,,fee schedule,,,255.71,91,,percent of total billed charges,,,266.95,95,,percent of total billed charges,,,233.23,83,,percent of total billed charges,,,84.3,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,233.23,83,,percent of total billed charges,,176.34,,,,fee schedule,,,252.9,90,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,238.85,85,,percent of total billed charges,,55.59,266.95,
OB Dating US,76801A,CDM,76801,CPT,,,both,,603,603,107.56,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,512.55,85,,percent of total billed charges,,108.24,,,,fee schedule,,55.59,,,,fee schedule,,71.9,,,,fee schedule,,251.7,,,,fee schedule,,71.9,,,,fee schedule,,197.94,,,,fee schedule,,119.96,,,,fee schedule,,119.96,,,,fee schedule,,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,180.9,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,500.49,83,,percent of total billed charges,,176.34,,,,fee schedule,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,55.59,572.85,
OB US < 14 WKS SINGLE FETUS,76801TC,CDM,76801,CPT,,,both,TC,624,624,107.56,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,530.4,85,,percent of total billed charges,,108.24,,,,fee schedule,,55.59,,,,fee schedule,,71.9,,,,fee schedule,,251.7,,,,fee schedule,,71.9,,,,fee schedule,,197.94,,,,fee schedule,,119.96,,,,fee schedule,,119.96,,,,fee schedule,,,567.84,91,,percent of total billed charges,,,592.8,95,,percent of total billed charges,,,517.92,83,,percent of total billed charges,,,187.2,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,517.92,83,,percent of total billed charges,,176.34,,,,fee schedule,,,561.6,90,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,561.6,90,,percent of total billed charges,,,530.4,85,,percent of total billed charges,,55.59,592.8,
"OB US < 14 WKS, ADD'L FETUS",76802,CDM,76802,CPT,,,both,,593,593,57.03,,,,fee schedule,,,,,,,,45.05,,,,fee schedule,,,504.05,85,,percent of total billed charges,,91.94,,,,fee schedule,,47.22,,,,fee schedule,,45.05,,,,fee schedule,,163.36,,,,fee schedule,,45.05,,,,fee schedule,,102.32,,,,fee schedule,,62.01,,,,fee schedule,,62.01,,,,fee schedule,,,539.63,91,,percent of total billed charges,,,563.35,95,,percent of total billed charges,,,492.19,83,,percent of total billed charges,,,177.9,83,,percent of total billed charges,,45.05,,,,fee schedule,,45.05,,,,fee schedule,,,492.19,83,,percent of total billed charges,,91.16,,,,fee schedule,,,533.7,90,,percent of total billed charges,,,533.7,90,,percent of total billed charges,,,533.7,90,,percent of total billed charges,,,533.7,90,,percent of total billed charges,,,504.05,85,,percent of total billed charges,,45.05,563.35,
OB US < 14 WKS ADDL FETUS,7680226,CDM,76802,CPT,,,both,26,212,212,57.03,,,,fee schedule,,,,,,,,45.05,,,,fee schedule,,,180.2,85,,percent of total billed charges,,91.94,,,,fee schedule,,47.22,,,,fee schedule,,45.05,,,,fee schedule,,163.36,,,,fee schedule,,45.05,,,,fee schedule,,102.32,,,,fee schedule,,62.01,,,,fee schedule,,62.01,,,,fee schedule,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,63.6,83,,percent of total billed charges,,45.05,,,,fee schedule,,45.05,,,,fee schedule,,,175.96,83,,percent of total billed charges,,91.16,,,,fee schedule,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,45.05,201.4,
OB US < 14 WKS ADDL FETUS,76802TC,CDM,76802,CPT,,,both,TC,363,363,57.03,,,,fee schedule,,,,,,,,45.05,,,,fee schedule,,,308.55,85,,percent of total billed charges,,91.94,,,,fee schedule,,47.22,,,,fee schedule,,45.05,,,,fee schedule,,163.36,,,,fee schedule,,45.05,,,,fee schedule,,102.32,,,,fee schedule,,62.01,,,,fee schedule,,62.01,,,,fee schedule,,,330.33,91,,percent of total billed charges,,,344.85,95,,percent of total billed charges,,,301.29,83,,percent of total billed charges,,,108.9,83,,percent of total billed charges,,45.05,,,,fee schedule,,45.05,,,,fee schedule,,,301.29,83,,percent of total billed charges,,91.16,,,,fee schedule,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,326.7,90,,percent of total billed charges,,,308.55,85,,percent of total billed charges,,45.05,344.85,
US OB 2nd/3rd Trimester,76805,CDM,76805,CPT,,,both,,895,895,122.7,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,760.75,85,,percent of total billed charges,,108.96,,,,fee schedule,,55.96,,,,fee schedule,,71.9,,,,fee schedule,,251.7,,,,fee schedule,,71.9,,,,fee schedule,,228.13,,,,fee schedule,,138.26,,,,fee schedule,,138.26,,,,fee schedule,,,814.45,91,,percent of total billed charges,,,850.25,95,,percent of total billed charges,,,742.85,83,,percent of total billed charges,,,268.5,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,742.85,83,,percent of total billed charges,,203.24,,,,fee schedule,,,805.5,90,,percent of total billed charges,,,805.5,90,,percent of total billed charges,,,805.5,90,,percent of total billed charges,,,805.5,90,,percent of total billed charges,,,760.75,85,,percent of total billed charges,,55.96,850.25,
OB US >= 14 WKS SNGL FETUS,7680526,CDM,76805,CPT,,,both,26,277,277,122.7,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,235.45,85,,percent of total billed charges,,108.96,,,,fee schedule,,55.96,,,,fee schedule,,71.9,,,,fee schedule,,251.7,,,,fee schedule,,71.9,,,,fee schedule,,228.13,,,,fee schedule,,138.26,,,,fee schedule,,138.26,,,,fee schedule,,,252.07,91,,percent of total billed charges,,,263.15,95,,percent of total billed charges,,,229.91,83,,percent of total billed charges,,,83.1,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,229.91,83,,percent of total billed charges,,203.24,,,,fee schedule,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,235.45,85,,percent of total billed charges,,55.96,263.15,
OB US >= 14 WKS SNGL FETUS,76805TC,CDM,76805,CPT,,,both,TC,618,618,122.7,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,525.3,85,,percent of total billed charges,,108.96,,,,fee schedule,,55.96,,,,fee schedule,,71.9,,,,fee schedule,,251.7,,,,fee schedule,,71.9,,,,fee schedule,,228.13,,,,fee schedule,,138.26,,,,fee schedule,,138.26,,,,fee schedule,,,562.38,91,,percent of total billed charges,,,587.1,95,,percent of total billed charges,,,512.94,83,,percent of total billed charges,,,185.4,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,512.94,83,,percent of total billed charges,,203.24,,,,fee schedule,,,556.2,90,,percent of total billed charges,,,556.2,90,,percent of total billed charges,,,556.2,90,,percent of total billed charges,,,556.2,90,,percent of total billed charges,,,525.3,85,,percent of total billed charges,,55.96,587.1,
"OB US >/= 14 WKS, ADDL FETUS",76810,CDM,76810,CPT,,,both,,865,865,82.76,,,,fee schedule,,,,,,,,45.05,,,,fee schedule,,,735.25,85,,percent of total billed charges,,107.44,,,,fee schedule,,55.19,,,,fee schedule,,45.05,,,,fee schedule,,184.39,,,,fee schedule,,45.05,,,,fee schedule,,148.17,,,,fee schedule,,89.8,,,,fee schedule,,89.8,,,,fee schedule,,,787.15,91,,percent of total billed charges,,,821.75,95,,percent of total billed charges,,,717.95,83,,percent of total billed charges,,,259.5,83,,percent of total billed charges,,45.05,,,,fee schedule,,45.05,,,,fee schedule,,,717.95,83,,percent of total billed charges,,132.01,,,,fee schedule,,,778.5,90,,percent of total billed charges,,,778.5,90,,percent of total billed charges,,,778.5,90,,percent of total billed charges,,,778.5,90,,percent of total billed charges,,,735.25,85,,percent of total billed charges,,45.05,821.75,
OB US >= 14 WKS ADDL FETUS,7681026,CDM,76810,CPT,,,both,26,312,312,82.76,,,,fee schedule,,,,,,,,45.05,,,,fee schedule,,,265.2,85,,percent of total billed charges,,107.44,,,,fee schedule,,55.19,,,,fee schedule,,45.05,,,,fee schedule,,184.39,,,,fee schedule,,45.05,,,,fee schedule,,148.17,,,,fee schedule,,89.8,,,,fee schedule,,89.8,,,,fee schedule,,,283.92,91,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,93.6,83,,percent of total billed charges,,45.05,,,,fee schedule,,45.05,,,,fee schedule,,,258.96,83,,percent of total billed charges,,132.01,,,,fee schedule,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,265.2,85,,percent of total billed charges,,45.05,296.4,
OB US >= 14 WKS ADDL FETUS,76810TC,CDM,76810,CPT,,,both,TC,553,553,82.76,,,,fee schedule,,,,,,,,45.05,,,,fee schedule,,,470.05,85,,percent of total billed charges,,107.44,,,,fee schedule,,55.19,,,,fee schedule,,45.05,,,,fee schedule,,184.39,,,,fee schedule,,45.05,,,,fee schedule,,148.17,,,,fee schedule,,89.8,,,,fee schedule,,89.8,,,,fee schedule,,,503.23,91,,percent of total billed charges,,,525.35,95,,percent of total billed charges,,,458.99,83,,percent of total billed charges,,,165.9,83,,percent of total billed charges,,45.05,,,,fee schedule,,45.05,,,,fee schedule,,,458.99,83,,percent of total billed charges,,132.01,,,,fee schedule,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,497.7,90,,percent of total billed charges,,,470.05,85,,percent of total billed charges,,45.05,525.35,
"OB US, DETAILED, SNGL FETUS, Unspecified Trimester",76811,CDM,76811,CPT,,,both,,938,938,159.33,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,797.3,85,,percent of total billed charges,,209.2,,,,fee schedule,,107.45,,,,fee schedule,,71.9,,,,fee schedule,,466.94,,,,fee schedule,,71.9,,,,fee schedule,,294.67,,,,fee schedule,,178.59,,,,fee schedule,,178.59,,,,fee schedule,,,853.58,91,,percent of total billed charges,,,891.1,95,,percent of total billed charges,,,778.54,83,,percent of total billed charges,,,281.4,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,778.54,83,,percent of total billed charges,,262.52,,,,fee schedule,,,844.2,90,,percent of total billed charges,,,844.2,90,,percent of total billed charges,,,844.2,90,,percent of total billed charges,,,844.2,90,,percent of total billed charges,,,797.3,85,,percent of total billed charges,,71.9,891.1,
US OB Limited,76815,CDM,76815,CPT,,,both,,688,688,76.37,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,584.8,85,,percent of total billed charges,,71.89,,,,fee schedule,,36.93,,,,fee schedule,,71.9,,,,fee schedule,,168.97,,,,fee schedule,,71.9,,,,fee schedule,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,626.08,91,,percent of total billed charges,,,653.6,95,,percent of total billed charges,,,571.04,83,,percent of total billed charges,,,206.4,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,571.04,83,,percent of total billed charges,,122.04,,,,fee schedule,,,619.2,90,,percent of total billed charges,,,619.2,90,,percent of total billed charges,,,619.2,90,,percent of total billed charges,,,619.2,90,,percent of total billed charges,,,584.8,85,,percent of total billed charges,,36.93,653.6,
OB US LIMITED FETUS(S),7681526,CDM,76815,CPT,,,both,26,225,225,76.37,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,191.25,85,,percent of total billed charges,,71.89,,,,fee schedule,,36.93,,,,fee schedule,,71.9,,,,fee schedule,,168.97,,,,fee schedule,,71.9,,,,fee schedule,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,67.5,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,186.75,83,,percent of total billed charges,,122.04,,,,fee schedule,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,36.93,213.75,
OB US LIMITED FETUS(S),76815TC,CDM,76815,CPT,,,both,TC,463,463,76.37,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,393.55,85,,percent of total billed charges,,71.89,,,,fee schedule,,36.93,,,,fee schedule,,71.9,,,,fee schedule,,168.97,,,,fee schedule,,71.9,,,,fee schedule,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,421.33,91,,percent of total billed charges,,,439.85,95,,percent of total billed charges,,,384.29,83,,percent of total billed charges,,,138.9,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,384.29,83,,percent of total billed charges,,122.04,,,,fee schedule,,,416.7,90,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,393.55,85,,percent of total billed charges,,36.93,439.85,
US OB Follow Up,76816,CDM,76816,CPT,,,both,,765,765,89.01,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,650.25,85,,percent of total billed charges,,94.25,,,,fee schedule,,48.41,,,,fee schedule,,71.9,,,,fee schedule,,166.86,,,,fee schedule,,71.9,,,,fee schedule,,183.96,,,,fee schedule,,111.49,,,,fee schedule,,111.49,,,,fee schedule,,,696.15,91,,percent of total billed charges,,,726.75,95,,percent of total billed charges,,,634.95,83,,percent of total billed charges,,,229.5,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,634.95,83,,percent of total billed charges,,163.89,,,,fee schedule,,,688.5,90,,percent of total billed charges,,,688.5,90,,percent of total billed charges,,,688.5,90,,percent of total billed charges,,,688.5,90,,percent of total billed charges,,,650.25,85,,percent of total billed charges,,48.41,726.75,
OB US FOLLOW-UP PER FETUS,7681626,CDM,76816,CPT,,,both,26,249,249,89.01,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,211.65,85,,percent of total billed charges,,94.25,,,,fee schedule,,48.41,,,,fee schedule,,71.9,,,,fee schedule,,166.86,,,,fee schedule,,71.9,,,,fee schedule,,183.96,,,,fee schedule,,111.49,,,,fee schedule,,111.49,,,,fee schedule,,,226.59,91,,percent of total billed charges,,,236.55,95,,percent of total billed charges,,,206.67,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,206.67,83,,percent of total billed charges,,163.89,,,,fee schedule,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,211.65,85,,percent of total billed charges,,48.41,236.55,
OB US FOLLOW-UP PER FETUS,76816TC,CDM,76816,CPT,,,both,TC,516,516,89.01,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,438.6,85,,percent of total billed charges,,94.25,,,,fee schedule,,48.41,,,,fee schedule,,71.9,,,,fee schedule,,166.86,,,,fee schedule,,71.9,,,,fee schedule,,183.96,,,,fee schedule,,111.49,,,,fee schedule,,111.49,,,,fee schedule,,,469.56,91,,percent of total billed charges,,,490.2,95,,percent of total billed charges,,,428.28,83,,percent of total billed charges,,,154.8,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,428.28,83,,percent of total billed charges,,163.89,,,,fee schedule,,,464.4,90,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,464.4,90,,percent of total billed charges,,,438.6,85,,percent of total billed charges,,48.41,490.2,
US OB Transvaginal Only,76817,CDM,76817,CPT,,,both,,794,794,84.61,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,674.9,85,,percent of total billed charges,,83.43,,,,fee schedule,,42.85,,,,fee schedule,,71.9,,,,fee schedule,,183.69,,,,fee schedule,,71.9,,,,fee schedule,,156,,,,fee schedule,,94.55,,,,fee schedule,,94.55,,,,fee schedule,,,722.54,91,,percent of total billed charges,,,754.3,95,,percent of total billed charges,,,659.02,83,,percent of total billed charges,,,238.2,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,659.02,83,,percent of total billed charges,,138.98,,,,fee schedule,,,714.6,90,,percent of total billed charges,,,714.6,90,,percent of total billed charges,,,714.6,90,,percent of total billed charges,,,714.6,90,,percent of total billed charges,,,674.9,85,,percent of total billed charges,,42.85,754.3,
TRANSVAGINAL US OBSTETRIC,7681726,CDM,76817,CPT,,,both,26,257,257,84.61,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,218.45,85,,percent of total billed charges,,83.43,,,,fee schedule,,42.85,,,,fee schedule,,71.9,,,,fee schedule,,183.69,,,,fee schedule,,71.9,,,,fee schedule,,156,,,,fee schedule,,94.55,,,,fee schedule,,94.55,,,,fee schedule,,,233.87,91,,percent of total billed charges,,,244.15,95,,percent of total billed charges,,,213.31,83,,percent of total billed charges,,,77.1,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,213.31,83,,percent of total billed charges,,138.98,,,,fee schedule,,,231.3,90,,percent of total billed charges,,,231.3,90,,percent of total billed charges,,,231.3,90,,percent of total billed charges,,,231.3,90,,percent of total billed charges,,,218.45,85,,percent of total billed charges,,42.85,244.15,
TRANSVAGINAL US OBSTETRIC,76817TC,CDM,76817,CPT,,,both,TC,537,537,84.61,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,456.45,85,,percent of total billed charges,,83.43,,,,fee schedule,,42.85,,,,fee schedule,,71.9,,,,fee schedule,,183.69,,,,fee schedule,,71.9,,,,fee schedule,,156,,,,fee schedule,,94.55,,,,fee schedule,,94.55,,,,fee schedule,,,488.67,91,,percent of total billed charges,,,510.15,95,,percent of total billed charges,,,445.71,83,,percent of total billed charges,,,161.1,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,445.71,83,,percent of total billed charges,,138.98,,,,fee schedule,,,483.3,90,,percent of total billed charges,,,483.3,90,,percent of total billed charges,,,483.3,90,,percent of total billed charges,,,483.3,90,,percent of total billed charges,,,456.45,85,,percent of total billed charges,,42.85,510.15,
US Biophysical Profile W/ NST,76818,CDM,76818,CPT,,,both,,954,954,105.25,,,,fee schedule,,,,,,,,63.95,,,,fee schedule,,,810.9,85,,percent of total billed charges,,115.88,,,,fee schedule,,59.52,,,,fee schedule,,63.95,,,,fee schedule,,224.35,,,,fee schedule,,63.95,,,,fee schedule,,195.7,,,,fee schedule,,118.61,,,,fee schedule,,118.61,,,,fee schedule,,,868.14,91,,percent of total billed charges,,,906.3,95,,percent of total billed charges,,,791.82,83,,percent of total billed charges,,,286.2,83,,percent of total billed charges,,63.95,,,,fee schedule,,63.95,,,,fee schedule,,,791.82,83,,percent of total billed charges,,174.35,,,,fee schedule,,,858.6,90,,percent of total billed charges,,,858.6,90,,percent of total billed charges,,,858.6,90,,percent of total billed charges,,,858.6,90,,percent of total billed charges,,,810.9,85,,percent of total billed charges,,59.52,906.3,
FETAL BIOPHYS PROFILE W/NST,7681826,CDM,76818,CPT,,,both,26,317,317,105.25,,,,fee schedule,,,,,,,,63.95,,,,fee schedule,,,269.45,85,,percent of total billed charges,,115.88,,,,fee schedule,,59.52,,,,fee schedule,,63.95,,,,fee schedule,,224.35,,,,fee schedule,,63.95,,,,fee schedule,,195.7,,,,fee schedule,,118.61,,,,fee schedule,,118.61,,,,fee schedule,,,288.47,91,,percent of total billed charges,,,301.15,95,,percent of total billed charges,,,263.11,83,,percent of total billed charges,,,95.1,83,,percent of total billed charges,,63.95,,,,fee schedule,,63.95,,,,fee schedule,,,263.11,83,,percent of total billed charges,,174.35,,,,fee schedule,,,285.3,90,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,285.3,90,,percent of total billed charges,,,269.45,85,,percent of total billed charges,,59.52,301.15,
FETAL BIOPHYS PROFILE W/NST,76818TC,CDM,76818,CPT,,,both,TC,637,637,105.25,,,,fee schedule,,,,,,,,63.95,,,,fee schedule,,,541.45,85,,percent of total billed charges,,115.88,,,,fee schedule,,59.52,,,,fee schedule,,63.95,,,,fee schedule,,224.35,,,,fee schedule,,63.95,,,,fee schedule,,195.7,,,,fee schedule,,118.61,,,,fee schedule,,118.61,,,,fee schedule,,,579.67,91,,percent of total billed charges,,,605.15,95,,percent of total billed charges,,,528.71,83,,percent of total billed charges,,,191.1,83,,percent of total billed charges,,63.95,,,,fee schedule,,63.95,,,,fee schedule,,,528.71,83,,percent of total billed charges,,174.35,,,,fee schedule,,,573.3,90,,percent of total billed charges,,,573.3,90,,percent of total billed charges,,,573.3,90,,percent of total billed charges,,,573.3,90,,percent of total billed charges,,,541.45,85,,percent of total billed charges,,59.52,605.15,
US Biophysical Profile W/O NST,76819,CDM,76819,CPT,,,both,,774,774,76.68,,,,fee schedule,,,,,,,,31.1,,,,fee schedule,,,657.9,85,,percent of total billed charges,,85.74,,,,fee schedule,,44.04,,,,fee schedule,,31.1,,,,fee schedule,,195.61,,,,fee schedule,,31.1,,,,fee schedule,,140.9,,,,fee schedule,,85.4,,,,fee schedule,,85.4,,,,fee schedule,,,704.34,91,,percent of total billed charges,,,735.3,95,,percent of total billed charges,,,642.42,83,,percent of total billed charges,,,232.2,83,,percent of total billed charges,,31.1,,,,fee schedule,,31.1,,,,fee schedule,,,642.42,83,,percent of total billed charges,,125.53,,,,fee schedule,,,696.6,90,,percent of total billed charges,,,696.6,90,,percent of total billed charges,,,696.6,90,,percent of total billed charges,,,696.6,90,,percent of total billed charges,,,657.9,85,,percent of total billed charges,,31.1,735.3,
FETAL BIOPHYS PROFIL W/O NST,7681926,CDM,76819,CPT,,,both,26,252,252,76.68,,,,fee schedule,,,,,,,,31.1,,,,fee schedule,,,214.2,85,,percent of total billed charges,,85.74,,,,fee schedule,,44.04,,,,fee schedule,,31.1,,,,fee schedule,,195.61,,,,fee schedule,,31.1,,,,fee schedule,,140.9,,,,fee schedule,,85.4,,,,fee schedule,,85.4,,,,fee schedule,,,229.32,91,,percent of total billed charges,,,239.4,95,,percent of total billed charges,,,209.16,83,,percent of total billed charges,,,75.6,83,,percent of total billed charges,,31.1,,,,fee schedule,,31.1,,,,fee schedule,,,209.16,83,,percent of total billed charges,,125.53,,,,fee schedule,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,226.8,90,,percent of total billed charges,,,214.2,85,,percent of total billed charges,,31.1,239.4,
FETAL BIOPHYS PROFIL W/O NST,76819TC,CDM,76819,CPT,,,both,TC,522,522,76.68,,,,fee schedule,,,,,,,,31.1,,,,fee schedule,,,443.7,85,,percent of total billed charges,,85.74,,,,fee schedule,,44.04,,,,fee schedule,,31.1,,,,fee schedule,,195.61,,,,fee schedule,,31.1,,,,fee schedule,,140.9,,,,fee schedule,,85.4,,,,fee schedule,,85.4,,,,fee schedule,,,475.02,91,,percent of total billed charges,,,495.9,95,,percent of total billed charges,,,433.26,83,,percent of total billed charges,,,156.6,83,,percent of total billed charges,,31.1,,,,fee schedule,,31.1,,,,fee schedule,,,433.26,83,,percent of total billed charges,,125.53,,,,fee schedule,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,469.8,90,,percent of total billed charges,,,443.7,85,,percent of total billed charges,,31.1,495.9,
UMBILICAL ARTERIAL DOPPLER,76820,CDM,76820,CPT,,,both,,517,517,34.67,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,439.45,85,,percent of total billed charges,,55.24,,,,fee schedule,,28.37,,,,fee schedule,,71.9,,,,fee schedule,,171.77,,,,fee schedule,,71.9,,,,fee schedule,,74.92,,,,fee schedule,,45.41,,,,fee schedule,,45.41,,,,fee schedule,,,470.47,91,,percent of total billed charges,,,491.15,95,,percent of total billed charges,,,429.11,83,,percent of total billed charges,,,155.1,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,429.11,83,,percent of total billed charges,,66.75,,,,fee schedule,,,465.3,90,,percent of total billed charges,,,465.3,90,,percent of total billed charges,,,465.3,90,,percent of total billed charges,,,465.3,90,,percent of total billed charges,,,439.45,85,,percent of total billed charges,,28.37,491.15,
UMBILICAL ARTERY ECHO,7682026,CDM,76820,CPT,,,both,26,165,165,34.67,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,140.25,85,,percent of total billed charges,,55.24,,,,fee schedule,,28.37,,,,fee schedule,,71.9,,,,fee schedule,,171.77,,,,fee schedule,,71.9,,,,fee schedule,,74.92,,,,fee schedule,,45.41,,,,fee schedule,,45.41,,,,fee schedule,,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,49.5,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,136.95,83,,percent of total billed charges,,66.75,,,,fee schedule,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,28.37,171.77,
UMBILICAL ARTERY ECHO,76820TC,CDM,76820,CPT,,,both,TC,352,352,34.67,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,299.2,85,,percent of total billed charges,,55.24,,,,fee schedule,,28.37,,,,fee schedule,,71.9,,,,fee schedule,,171.77,,,,fee schedule,,71.9,,,,fee schedule,,74.92,,,,fee schedule,,45.41,,,,fee schedule,,45.41,,,,fee schedule,,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,105.6,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,292.16,83,,percent of total billed charges,,66.75,,,,fee schedule,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,28.37,334.4,
US Pelvic Transvaginal Only,76830,CDM,76830,CPT,,,both,,737,737,64.07,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,626.45,85,,percent of total billed charges,,76.51,,,,fee schedule,,39.3,,,,fee schedule,,71.9,,,,fee schedule,,180.18,,,,fee schedule,,71.9,,,,fee schedule,,201.85,,,,fee schedule,,122.33,,,,fee schedule,,122.33,,,,fee schedule,,,670.67,91,,percent of total billed charges,,,700.15,95,,percent of total billed charges,,,611.71,83,,percent of total billed charges,,,221.1,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,611.71,83,,percent of total billed charges,,179.83,,,,fee schedule,,,663.3,90,,percent of total billed charges,,,663.3,90,,percent of total billed charges,,,663.3,90,,percent of total billed charges,,,663.3,90,,percent of total billed charges,,,626.45,85,,percent of total billed charges,,39.3,700.15,
TRANSVAGINAL US NON-OB,7683026,CDM,76830,CPT,,,both,26,216,216,64.07,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,183.6,85,,percent of total billed charges,,76.51,,,,fee schedule,,39.3,,,,fee schedule,,71.9,,,,fee schedule,,180.18,,,,fee schedule,,71.9,,,,fee schedule,,201.85,,,,fee schedule,,122.33,,,,fee schedule,,122.33,,,,fee schedule,,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,64.8,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,179.28,83,,percent of total billed charges,,179.83,,,,fee schedule,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,39.3,205.2,
TRANSVAGINAL US NON-OB,76830TC,CDM,76830,CPT,,,both,TC,521,521,64.07,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,442.85,85,,percent of total billed charges,,76.51,,,,fee schedule,,39.3,,,,fee schedule,,71.9,,,,fee schedule,,180.18,,,,fee schedule,,71.9,,,,fee schedule,,201.85,,,,fee schedule,,122.33,,,,fee schedule,,122.33,,,,fee schedule,,,474.11,91,,percent of total billed charges,,,494.95,95,,percent of total billed charges,,,432.43,83,,percent of total billed charges,,,156.3,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,432.43,83,,percent of total billed charges,,179.83,,,,fee schedule,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,442.85,85,,percent of total billed charges,,39.3,494.95,
US Pelvic,76856,CDM,76856,CPT,,,both,,809,809,105.09,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,687.65,85,,percent of total billed charges,,76.51,,,,fee schedule,,39.3,,,,fee schedule,,71.9,,,,fee schedule,,180.18,,,,fee schedule,,71.9,,,,fee schedule,,177.81,,,,fee schedule,,107.76,,,,fee schedule,,107.76,,,,fee schedule,,,736.19,91,,percent of total billed charges,,,768.55,95,,percent of total billed charges,,,671.47,83,,percent of total billed charges,,,242.7,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,671.47,83,,percent of total billed charges,,158.41,,,,fee schedule,,,728.1,90,,percent of total billed charges,,,728.1,90,,percent of total billed charges,,,728.1,90,,percent of total billed charges,,,728.1,90,,percent of total billed charges,,,687.65,85,,percent of total billed charges,,39.3,768.55,
US EXAM PELVIC COMPLETE,7685626,CDM,76856,CPT,,,both,26,238,238,105.09,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,202.3,85,,percent of total billed charges,,76.51,,,,fee schedule,,39.3,,,,fee schedule,,71.9,,,,fee schedule,,180.18,,,,fee schedule,,71.9,,,,fee schedule,,177.81,,,,fee schedule,,107.76,,,,fee schedule,,107.76,,,,fee schedule,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,71.4,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,197.54,83,,percent of total billed charges,,158.41,,,,fee schedule,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,39.3,226.1,
US EXAM PELVIC COMPLETE,76856TC,CDM,76856,CPT,,,both,TC,571,571,105.09,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,485.35,85,,percent of total billed charges,,76.51,,,,fee schedule,,39.3,,,,fee schedule,,71.9,,,,fee schedule,,180.18,,,,fee schedule,,71.9,,,,fee schedule,,177.81,,,,fee schedule,,107.76,,,,fee schedule,,107.76,,,,fee schedule,,,519.61,91,,percent of total billed charges,,,542.45,95,,percent of total billed charges,,,473.93,83,,percent of total billed charges,,,171.3,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,473.93,83,,percent of total billed charges,,158.41,,,,fee schedule,,,513.9,90,,percent of total billed charges,,,513.9,90,,percent of total billed charges,,,513.9,90,,percent of total billed charges,,,513.9,90,,percent of total billed charges,,,485.35,85,,percent of total billed charges,,39.3,542.45,
UL Bladder,76857,CDM,76857,CPT,,,both,,500,500,69,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,425,85,,percent of total billed charges,,53.79,,,,fee schedule,,27.63,,,,fee schedule,,71.9,,,,fee schedule,,160.55,,,,fee schedule,,71.9,,,,fee schedule,,81.63,,,,fee schedule,,49.48,,,,fee schedule,,49.48,,,,fee schedule,,,455,91,,percent of total billed charges,,,475,95,,percent of total billed charges,,,415,83,,percent of total billed charges,,,150,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,415,83,,percent of total billed charges,,72.73,,,,fee schedule,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,450,90,,percent of total billed charges,,,425,85,,percent of total billed charges,,27.63,475,
UL Bladder Only,7685726,CDM,76857,CPT,,,both,26,350,350,69,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,297.5,85,,percent of total billed charges,,53.79,,,,fee schedule,,27.63,,,,fee schedule,,71.9,,,,fee schedule,,160.55,,,,fee schedule,,71.9,,,,fee schedule,,81.63,,,,fee schedule,,49.48,,,,fee schedule,,49.48,,,,fee schedule,,,318.5,91,,percent of total billed charges,,,332.5,95,,percent of total billed charges,,,290.5,83,,percent of total billed charges,,,105,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,290.5,83,,percent of total billed charges,,72.73,,,,fee schedule,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,297.5,85,,percent of total billed charges,,27.63,332.5,
"US EXAM, PELVIC, LIMITED",76857P,CDM,76857,CPT,,,both,P,589,589,69,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,500.65,85,,percent of total billed charges,,53.79,,,,fee schedule,,27.63,,,,fee schedule,,71.9,,,,fee schedule,,160.55,,,,fee schedule,,71.9,,,,fee schedule,,81.63,,,,fee schedule,,49.48,,,,fee schedule,,49.48,,,,fee schedule,,,535.99,91,,percent of total billed charges,,,559.55,95,,percent of total billed charges,,,488.87,83,,percent of total billed charges,,,176.7,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,488.87,83,,percent of total billed charges,,72.73,,,,fee schedule,,,530.1,90,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,530.1,90,,percent of total billed charges,,,500.65,85,,percent of total billed charges,,27.63,559.55,
"US EXAM, PELVIC, LIMITED",76857T,CDM,76857,CPT,,,both,T,150,150,69,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,127.5,85,,percent of total billed charges,,53.79,,,,fee schedule,,27.63,,,,fee schedule,,71.9,,,,fee schedule,,160.55,,,,fee schedule,,71.9,,,,fee schedule,,81.63,,,,fee schedule,,49.48,,,,fee schedule,,49.48,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,124.5,83,,percent of total billed charges,,72.73,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,27.63,160.55,
US EXAM PELVIC LIMITED,76857TC,CDM,76857,CPT,,,both,TC,150,150,69,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,127.5,85,,percent of total billed charges,,53.79,,,,fee schedule,,27.63,,,,fee schedule,,71.9,,,,fee schedule,,160.55,,,,fee schedule,,71.9,,,,fee schedule,,81.63,,,,fee schedule,,49.48,,,,fee schedule,,49.48,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,124.5,83,,percent of total billed charges,,72.73,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,27.63,160.55,
US Scrotum,76870,CDM,76870,CPT,,,both,,737,737,105.08,,,,fee schedule,,,,,,,,49.7,,,,fee schedule,,,626.45,85,,percent of total billed charges,,71.1,,,,fee schedule,,36.52,,,,fee schedule,,49.7,,,,fee schedule,,175.28,,,,fee schedule,,49.7,,,,fee schedule,,169.98,,,,fee schedule,,103.02,,,,fee schedule,,103.02,,,,fee schedule,,,670.67,91,,percent of total billed charges,,,700.15,95,,percent of total billed charges,,,611.71,83,,percent of total billed charges,,,221.1,83,,percent of total billed charges,,49.7,,,,fee schedule,,49.7,,,,fee schedule,,,611.71,83,,percent of total billed charges,,151.44,,,,fee schedule,,,663.3,90,,percent of total billed charges,,,663.3,90,,percent of total billed charges,,,663.3,90,,percent of total billed charges,,,663.3,90,,percent of total billed charges,,,626.45,85,,percent of total billed charges,,36.52,700.15,
US EXAM SCROTUM,7687026,CDM,76870,CPT,,,both,26,216,216,105.08,,,,fee schedule,,,,,,,,49.7,,,,fee schedule,,,183.6,85,,percent of total billed charges,,71.1,,,,fee schedule,,36.52,,,,fee schedule,,49.7,,,,fee schedule,,175.28,,,,fee schedule,,49.7,,,,fee schedule,,169.98,,,,fee schedule,,103.02,,,,fee schedule,,103.02,,,,fee schedule,,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,64.8,83,,percent of total billed charges,,49.7,,,,fee schedule,,49.7,,,,fee schedule,,,179.28,83,,percent of total billed charges,,151.44,,,,fee schedule,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,36.52,205.2,
US EXAM SCROTUM,76870TC,CDM,76870,CPT,,,both,TC,521,521,105.08,,,,fee schedule,,,,,,,,49.7,,,,fee schedule,,,442.85,85,,percent of total billed charges,,71.1,,,,fee schedule,,36.52,,,,fee schedule,,49.7,,,,fee schedule,,175.28,,,,fee schedule,,49.7,,,,fee schedule,,169.98,,,,fee schedule,,103.02,,,,fee schedule,,103.02,,,,fee schedule,,,474.11,91,,percent of total billed charges,,,494.95,95,,percent of total billed charges,,,432.43,83,,percent of total billed charges,,,156.3,83,,percent of total billed charges,,49.7,,,,fee schedule,,49.7,,,,fee schedule,,,432.43,83,,percent of total billed charges,,151.44,,,,fee schedule,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,468.9,90,,percent of total billed charges,,,442.85,85,,percent of total billed charges,,36.52,494.95,
"US, TRANSRECTAL",76872,CDM,76872,CPT,,,both,,561,561,62,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,476.85,85,,percent of total billed charges,,73.91,,,,fee schedule,,37.96,,,,fee schedule,,71.9,,,,fee schedule,,215.24,,,,fee schedule,,71.9,,,,fee schedule,,337.16,,,,fee schedule,,204.34,,,,fee schedule,,204.34,,,,fee schedule,,,510.51,91,,percent of total billed charges,,,532.95,95,,percent of total billed charges,,,465.63,83,,percent of total billed charges,,,168.3,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,465.63,83,,percent of total billed charges,,300.38,,,,fee schedule,,,504.9,90,,percent of total billed charges,,,504.9,90,,percent of total billed charges,,,504.9,90,,percent of total billed charges,,,504.9,90,,percent of total billed charges,,,476.85,85,,percent of total billed charges,,37.96,532.95,
US TRANSRECTAL,76872P,CDM,76872,CPT,,,both,P,351,351,62,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,298.35,85,,percent of total billed charges,,73.91,,,,fee schedule,,37.96,,,,fee schedule,,71.9,,,,fee schedule,,215.24,,,,fee schedule,,71.9,,,,fee schedule,,337.16,,,,fee schedule,,204.34,,,,fee schedule,,204.34,,,,fee schedule,,,319.41,91,,percent of total billed charges,,,333.45,95,,percent of total billed charges,,,291.33,83,,percent of total billed charges,,,105.3,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,291.33,83,,percent of total billed charges,,300.38,,,,fee schedule,,,315.9,90,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,315.9,90,,percent of total billed charges,,,298.35,85,,percent of total billed charges,,37.96,337.16,
US TRANSRECTAL,76872T,CDM,76872,CPT,,,both,T,210,210,62,,,,fee schedule,,,,,,,,71.9,,,,fee schedule,,,178.5,85,,percent of total billed charges,,73.91,,,,fee schedule,,37.96,,,,fee schedule,,71.9,,,,fee schedule,,215.24,,,,fee schedule,,71.9,,,,fee schedule,,337.16,,,,fee schedule,,204.34,,,,fee schedule,,204.34,,,,fee schedule,,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,63,83,,percent of total billed charges,,71.9,,,,fee schedule,,71.9,,,,fee schedule,,,174.3,83,,percent of total billed charges,,300.38,,,,fee schedule,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,37.96,337.16,
US XTR NON-VASC COMPLETE,76881,CDM,76881,CPT,,,both,,609,609,103.12,,,,fee schedule,,,,,,,,66.08,,,,fee schedule,,,517.65,85,,percent of total billed charges,,69.16,,,,fee schedule,,35.52,,,,fee schedule,,66.08,,,,fee schedule,,,,,,,,66.08,,,,fee schedule,,90.02,,,,fee schedule,,54.56,,,,fee schedule,,54.56,,,,fee schedule,,,554.19,91,,percent of total billed charges,,,578.55,95,,percent of total billed charges,,,505.47,83,,percent of total billed charges,,,182.7,83,,percent of total billed charges,,66.08,,,,fee schedule,,66.08,,,,fee schedule,,,505.47,83,,percent of total billed charges,,80.2,,,,fee schedule,,,548.1,90,,percent of total billed charges,,,548.1,90,,percent of total billed charges,,,548.1,90,,percent of total billed charges,,,548.1,90,,percent of total billed charges,,,517.65,85,,percent of total billed charges,,35.52,578.55,
US COMPL JOINT R-T W/IMG,7688126,CDM,76881,CPT,,,both,26,149,149,103.12,,,,fee schedule,,,,,,,,66.08,,,,fee schedule,,,126.65,85,,percent of total billed charges,,69.16,,,,fee schedule,,35.52,,,,fee schedule,,66.08,,,,fee schedule,,,,,,,,66.08,,,,fee schedule,,90.02,,,,fee schedule,,54.56,,,,fee schedule,,54.56,,,,fee schedule,,,135.59,91,,percent of total billed charges,,,141.55,95,,percent of total billed charges,,,123.67,83,,percent of total billed charges,,,44.7,83,,percent of total billed charges,,66.08,,,,fee schedule,,66.08,,,,fee schedule,,,123.67,83,,percent of total billed charges,,80.2,,,,fee schedule,,,134.1,90,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,126.65,85,,percent of total billed charges,,35.52,141.55,
US COMPL JOINT R-T W/IMG,76881TC,CDM,76881,CPT,,,both,TC,442,442,103.12,,,,fee schedule,,,,,,,,66.08,,,,fee schedule,,,375.7,85,,percent of total billed charges,,69.16,,,,fee schedule,,35.52,,,,fee schedule,,66.08,,,,fee schedule,,,,,,,,66.08,,,,fee schedule,,90.02,,,,fee schedule,,54.56,,,,fee schedule,,54.56,,,,fee schedule,,,402.22,91,,percent of total billed charges,,,419.9,95,,percent of total billed charges,,,366.86,83,,percent of total billed charges,,,132.6,83,,percent of total billed charges,,66.08,,,,fee schedule,,66.08,,,,fee schedule,,,366.86,83,,percent of total billed charges,,80.2,,,,fee schedule,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,375.7,85,,percent of total billed charges,,35.52,419.9,
US NEEDLE PLACEMENT/BX OR ASPIRATION,76942,CDM,76942,CPT,,,both,,403,403,171.22,,,,fee schedule,,,,,,,,60.1,,,,fee schedule,,,342.55,85,,percent of total billed charges,,70.59,,,,fee schedule,,36.25,,,,fee schedule,,60.1,,,,fee schedule,,268.52,,,,fee schedule,,60.1,,,,fee schedule,,97.29,,,,fee schedule,,58.96,,,,fee schedule,,58.96,,,,fee schedule,,,366.73,91,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,120.9,83,,percent of total billed charges,,60.1,,,,fee schedule,,60.1,,,,fee schedule,,,334.49,83,,percent of total billed charges,,86.68,,,,fee schedule,,,362.7,90,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,342.55,85,,percent of total billed charges,,36.25,382.85,
ECHO GUIDE FOR BIOPSY,76942TC,CDM,76942,CPT,,,both,TC,389,389,171.22,,,,fee schedule,,,,,,,,60.1,,,,fee schedule,,,330.65,85,,percent of total billed charges,,70.59,,,,fee schedule,,36.25,,,,fee schedule,,60.1,,,,fee schedule,,268.52,,,,fee schedule,,60.1,,,,fee schedule,,97.29,,,,fee schedule,,58.96,,,,fee schedule,,58.96,,,,fee schedule,,,353.99,91,,percent of total billed charges,,,369.55,95,,percent of total billed charges,,,322.87,83,,percent of total billed charges,,,116.7,83,,percent of total billed charges,,60.1,,,,fee schedule,,60.1,,,,fee schedule,,,322.87,83,,percent of total billed charges,,86.68,,,,fee schedule,,,350.1,90,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,330.65,85,,percent of total billed charges,,36.25,369.55,
NEEDLE LOCALIZATION BY XRAY,77002,CDM,77002,CPT,,,both,,427,427,66.69,,,,fee schedule,,,,,,,,37.9,,,,fee schedule,,,362.95,85,,percent of total billed charges,,62.45,,,,fee schedule,,32.08,,,,fee schedule,,37.9,,,,fee schedule,,,,,,,,37.9,,,,fee schedule,,195.7,,,,fee schedule,,118.61,,,,fee schedule,,118.61,,,,fee schedule,,,388.57,91,,percent of total billed charges,,,405.65,95,,percent of total billed charges,,,354.41,83,,percent of total billed charges,,,128.1,83,,percent of total billed charges,,37.9,,,,fee schedule,,37.9,,,,fee schedule,,,354.41,83,,percent of total billed charges,,174.35,,,,fee schedule,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,384.3,90,,percent of total billed charges,,,362.95,85,,percent of total billed charges,,32.08,405.65,
FLUOROGUIDE FOR SPINE INJECT,77003,CDM,77003,CPT,,,both,,388,388,79.79,,,,fee schedule,,,,,,,,52.3,,,,fee schedule,,,329.8,85,,percent of total billed charges,,66.48,,,,fee schedule,,34.15,,,,fee schedule,,52.3,,,,fee schedule,,,,,,,,52.3,,,,fee schedule,,177.81,,,,fee schedule,,107.76,,,,fee schedule,,107.76,,,,fee schedule,,,353.08,91,,percent of total billed charges,,,368.6,95,,percent of total billed charges,,,322.04,83,,percent of total billed charges,,,116.4,83,,percent of total billed charges,,52.3,,,,fee schedule,,52.3,,,,fee schedule,,,322.04,83,,percent of total billed charges,,158.41,,,,fee schedule,,,349.2,90,,percent of total billed charges,,,349.2,90,,percent of total billed charges,,,349.2,90,,percent of total billed charges,,,349.2,90,,percent of total billed charges,,,329.8,85,,percent of total billed charges,,34.15,368.6,
X-RAY STRESS VIEW,77071,CDM,77071,CPT,,,both,,113,113,44.42,,,,fee schedule,,,,,,,,15.53,,,,fee schedule,,,96.05,85,,percent of total billed charges,,123.84,,,,fee schedule,,63.61,,,,fee schedule,,15.53,,,,fee schedule,,,,,,,,15.53,,,,fee schedule,,91.7,,,,fee schedule,,55.58,,,,fee schedule,,55.58,,,,fee schedule,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,33.9,83,,percent of total billed charges,,15.53,,,,fee schedule,,15.53,,,,fee schedule,,,93.79,83,,percent of total billed charges,,81.7,,,,fee schedule,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,15.53,123.84,
XRAY Bone Age,77072,CDM,77072,CPT,,,both,,188,188,20.05,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,,159.8,85,,percent of total billed charges,,21.06,,,,fee schedule,,10.82,,,,fee schedule,,21.5,,,,fee schedule,,,,,,,,21.5,,,,fee schedule,,43.61,,,,fee schedule,,26.43,,,,fee schedule,,26.43,,,,fee schedule,,,171.08,91,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,56.4,83,,percent of total billed charges,,21.5,,,,fee schedule,,21.5,,,,fee schedule,,,156.04,83,,percent of total billed charges,,38.86,,,,fee schedule,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,10.82,178.6,
CT OR X SCNOGRM (leg Length),77073,CDM,77073,CPT,,,both,,312,312,33.32,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,,265.2,85,,percent of total billed charges,,30.43,,,,fee schedule,,15.63,,,,fee schedule,,28.7,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,75.48,,,,fee schedule,,45.75,,,,fee schedule,,45.75,,,,fee schedule,,,283.92,91,,percent of total billed charges,,,296.4,95,,percent of total billed charges,,,258.96,83,,percent of total billed charges,,,93.6,83,,percent of total billed charges,,28.7,,,,fee schedule,,28.7,,,,fee schedule,,,258.96,83,,percent of total billed charges,,67.25,,,,fee schedule,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,280.8,90,,percent of total billed charges,,,265.2,85,,percent of total billed charges,,15.63,296.4,
"X-RAYS, BONE LENGTH STUDIES",7707326,CDM,77073,CPT,,,both,26,108,108,33.32,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,,91.8,85,,percent of total billed charges,,30.43,,,,fee schedule,,15.63,,,,fee schedule,,28.7,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,75.48,,,,fee schedule,,45.75,,,,fee schedule,,45.75,,,,fee schedule,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,32.4,83,,percent of total billed charges,,28.7,,,,fee schedule,,28.7,,,,fee schedule,,,89.64,83,,percent of total billed charges,,67.25,,,,fee schedule,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,15.63,102.6,
"X-RAYS, BONE LENGTH STUDIES",77073P,CDM,77073,CPT,,,both,P,157,157,33.32,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,,133.45,85,,percent of total billed charges,,30.43,,,,fee schedule,,15.63,,,,fee schedule,,28.7,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,75.48,,,,fee schedule,,45.75,,,,fee schedule,,45.75,,,,fee schedule,,,142.87,91,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,47.1,83,,percent of total billed charges,,28.7,,,,fee schedule,,28.7,,,,fee schedule,,,130.31,83,,percent of total billed charges,,67.25,,,,fee schedule,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,133.45,85,,percent of total billed charges,,15.63,149.15,
"X-RAYS, BONE LENGTH STUDIES",77073T,CDM,77073,CPT,,,both,T,155,155,33.32,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,,131.75,85,,percent of total billed charges,,30.43,,,,fee schedule,,15.63,,,,fee schedule,,28.7,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,75.48,,,,fee schedule,,45.75,,,,fee schedule,,45.75,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,28.7,,,,fee schedule,,28.7,,,,fee schedule,,,128.65,83,,percent of total billed charges,,67.25,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,15.63,147.25,
"X-RAYS, BONE LENGTH STUDIES",77073TC,CDM,77073,CPT,,,both,TC,917,917,33.32,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,,779.45,85,,percent of total billed charges,,30.43,,,,fee schedule,,15.63,,,,fee schedule,,28.7,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,75.48,,,,fee schedule,,45.75,,,,fee schedule,,45.75,,,,fee schedule,,,834.47,91,,percent of total billed charges,,,871.15,95,,percent of total billed charges,,,761.11,83,,percent of total billed charges,,,275.1,83,,percent of total billed charges,,28.7,,,,fee schedule,,28.7,,,,fee schedule,,,761.11,83,,percent of total billed charges,,67.25,,,,fee schedule,,,825.3,90,,percent of total billed charges,,,825.3,90,,percent of total billed charges,,,825.3,90,,percent of total billed charges,,,825.3,90,,percent of total billed charges,,,779.45,85,,percent of total billed charges,,15.63,871.15,
NM Myocardial Perfusion Cardiac Rest/Stress,78452,CDM,78452,CPT,,,both,,2072,2072,411.9,,,,fee schedule,,,,,,,,204.46,,,,fee schedule,,,1761.2,85,,percent of total billed charges,,175.44,,,,fee schedule,,90.11,,,,fee schedule,,204.46,,,,fee schedule,,,,,,,,204.46,,,,fee schedule,,733.03,,,,fee schedule,,444.26,,,,fee schedule,,444.26,,,,fee schedule,,,1885.52,91,,percent of total billed charges,,,1968.4,95,,percent of total billed charges,,,1719.76,83,,percent of total billed charges,,,621.6,83,,percent of total billed charges,,204.46,,,,fee schedule,,204.46,,,,fee schedule,,,1719.76,83,,percent of total billed charges,,653.06,,,,fee schedule,,,1864.8,90,,percent of total billed charges,,,1864.8,90,,percent of total billed charges,,,1864.8,90,,percent of total billed charges,,,1864.8,90,,percent of total billed charges,,,1761.2,85,,percent of total billed charges,,90.11,1968.4,
BASIC METABOLIC PANEL,80048,CDM,80048,CPT,,,both,,90,90,,,,,,,,,,,,,8.28,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.28,,,,fee schedule,,,,,,,,8.28,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,8.28,,,,fee schedule,,8.28,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
GENERAL HLTH PANEL,80050,CDM,80050,CPT,,,both,,271,271,,,,,,,,,,,,,,,,,,,,230.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,246.61,91,,percent of total billed charges,,,257.45,95,,percent of total billed charges,,,224.93,83,,percent of total billed charges,,,81.3,83,,percent of total billed charges,,,,,,,,,,,,,,,224.93,83,,percent of total billed charges,,,,,,,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,230.35,85,,percent of total billed charges,,3.5,257.45,
ELECTROLYTE PANEL,80051,CDM,80051,CPT,,,both,,64,64,,,,,,,,,,,,,6.86,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.86,,,,fee schedule,,,,,,,,6.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,6.86,,,,fee schedule,,6.86,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
COMPRE METAB PANEL,80053,CDM,80053,CPT,,,both,,123,123,,,,,,,,,,,,,10.36,,,,fee schedule,,,104.55,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.36,,,,fee schedule,,,,,,,,10.36,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,111.93,91,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,36.9,83,,percent of total billed charges,,10.36,,,,fee schedule,,10.36,,,,fee schedule,,,102.09,83,,percent of total billed charges,,,,,,,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,104.55,85,,percent of total billed charges,,3.5,116.85,
OB PANEL,80055,CDM,80055,CPT,,,both,,187,187,,,,,,,,,,,,,31.42,,,,fee schedule,,,158.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,31.42,,,,fee schedule,,,,,,,,31.42,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,56.1,83,,percent of total billed charges,,31.42,,,,fee schedule,,31.42,,,,fee schedule,,,155.21,83,,percent of total billed charges,,,,,,,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,3.5,177.65,
LIPID PANEL,80061,CDM,80061,CPT,,,both,,90,90,,,,,,,,,,,,,6.22,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.22,,,,fee schedule,,,,,,,,6.22,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,6.22,,,,fee schedule,,6.22,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
RNL FUNCJ PANEL,80069,CDM,80069,CPT,,,both,,90,90,,,,,,,,,,,,,8.52,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.52,,,,fee schedule,,,,,,,,8.52,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,8.52,,,,fee schedule,,8.52,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
AQT HEP PANEL,80074,CDM,80074,CPT,,,both,,220,220,,,,,,,,,,,,,38.48,,,,fee schedule,,,187,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,38.48,,,,fee schedule,,,,,,,,38.48,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,200.2,91,,percent of total billed charges,,,209,95,,percent of total billed charges,,,182.6,83,,percent of total billed charges,,,66,83,,percent of total billed charges,,38.48,,,,fee schedule,,38.48,,,,fee schedule,,,182.6,83,,percent of total billed charges,,,,,,,,,198,90,,percent of total billed charges,,,198,90,,percent of total billed charges,,,198,90,,percent of total billed charges,,,198,90,,percent of total billed charges,,,187,85,,percent of total billed charges,,3.5,209,
HEPATC FUNCJ PANEL,80076,CDM,80076,CPT,,,both,,90,90,,,,,,,,,,,,,7.98,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,7.98,,,,fee schedule,,,,,,,,7.98,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,7.98,,,,fee schedule,,7.98,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
DRUG SCR QUAL 1 DRUG CLASS METH EA DRUG CLASS,80101,CDM,80101,CPT,,,both,,90,90,,,,,,,,,,,,,,,,,,,,76.5,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,27,85.5,
ASSAY OF AMITRIPTYLINE,80152,CDM,80152,CPT,,,both,,92,92,,,,,,,,,,,,,,,,,,,,78.2,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,27.6,83,,percent of total billed charges,,,,,,,,,,,,,,,76.36,83,,percent of total billed charges,,,,,,,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,27.6,87.4,
ASSAY OF BENZODIAZEPINES,80154,CDM,80154,CPT,,,both,,92,92,,,,,,,,,,,,,,,,,,,,78.2,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,27.6,83,,percent of total billed charges,,,,,,,,,,,,,,,76.36,83,,percent of total billed charges,,,,,,,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,27.6,87.4,
CARBAMAZEPINE TOTAL (Diagnostic Lab),80156,CDM,80156,CPT,,,both,,78,78,,,,,,,,,,,,,17.72,,,,fee schedule,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.72,,,,fee schedule,,,,,,,,17.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,17.72,,,,fee schedule,,17.72,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
"ASSAY, CARBAMAZEPINE, FREE (Tegretol)",80157,CDM,80157,CPT,,,both,,176,176,,,,,,,,,,,,,15.6,,,,fee schedule,,,149.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.6,,,,fee schedule,,,,,,,,15.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,52.8,83,,percent of total billed charges,,15.6,,,,fee schedule,,15.6,,,,fee schedule,,,146.08,83,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,3.5,167.2,
ASSAY OF CYCLOSPORINE,80158,CDM,80158,CPT,,,both,,98,98,,,,,,,,,,,,,25.28,,,,fee schedule,,,83.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,25.28,,,,fee schedule,,,,,,,,25.28,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,89.18,91,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,29.4,83,,percent of total billed charges,,25.28,,,,fee schedule,,25.28,,,,fee schedule,,,81.34,83,,percent of total billed charges,,,,,,,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,83.3,85,,percent of total billed charges,,3.5,93.1,
DIGOXIN (Diagnostic Lab),80162,CDM,80162,CPT,,,both,,78,78,,,,,,,,,,,,,25.96,,,,fee schedule,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,25.96,,,,fee schedule,,,,,,,,25.96,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,25.96,,,,fee schedule,,25.96,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
"ASSAY, DIPROPYLACETIC ACID",80164,CDM,80164,CPT,,,both,,120,120,,,,,,,,,,,,,17.72,,,,fee schedule,,,102,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.72,,,,fee schedule,,,,,,,,17.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,36,83,,percent of total billed charges,,17.72,,,,fee schedule,,17.72,,,,fee schedule,,,99.6,83,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,3.5,114,
ASSAY OF ETHOSUXIMIDE,80168,CDM,80168,CPT,,,both,,70,70,,,,,,,,,,,,,22.64,,,,fee schedule,,,59.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,22.64,,,,fee schedule,,,,,,,,22.64,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,63.7,91,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,21,83,,percent of total billed charges,,22.64,,,,fee schedule,,22.64,,,,fee schedule,,,58.1,83,,percent of total billed charges,,,,,,,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,3.5,66.5,
GENTAMICIN,80170,CDM,80170,CPT,,,both,,90,90,,,,,,,,,,,,,11.76,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.76,,,,fee schedule,,,,,,,,11.76,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,11.76,,,,fee schedule,,11.76,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
ASSAY OF IMIPRAMINE,80174,CDM,80174,CPT,,,both,,77,77,,,,,,,,,,,,,,,,,,,,65.45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,23.1,73.15,
ASSAY OF LIDOCAINE,80176,CDM,80176,CPT,,,both,,84,84,,,,,,,,,,,,,1.72,,,,fee schedule,,,71.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,1.72,,,,fee schedule,,,,,,,,1.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,25.2,83,,percent of total billed charges,,1.72,,,,fee schedule,,1.72,,,,fee schedule,,,69.72,83,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,1.72,79.8,
"Levetiracetam, Serum or Plasma",80177,CDM,80177,CPT,,,both,,201,201,,,,,,,,,,,,,19.22,,,,fee schedule,,,170.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,19.22,,,,fee schedule,,,,,,,,19.22,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,182.91,91,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,60.3,83,,percent of total billed charges,,19.22,,,,fee schedule,,19.22,,,,fee schedule,,,166.83,83,,percent of total billed charges,,,,,,,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,3.5,190.95,
"Levetiracetam, Serum or Plasma",80177P,CDM,80177,CPT,,,both,P,50,50,,,,,,,,,,,,,19.22,,,,fee schedule,,,42.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,19.22,,,,fee schedule,,,,,,,,19.22,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,19.22,,,,fee schedule,,19.22,,,,fee schedule,,,41.5,83,,percent of total billed charges,,,,,,,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,3.5,47.5,
"Levetiracetam, Serum or Plasma",80177T,CDM,80177,CPT,,,both,T,151,151,,,,,,,,,,,,,19.22,,,,fee schedule,,,128.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,19.22,,,,fee schedule,,,,,,,,19.22,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,19.22,,,,fee schedule,,19.22,,,,fee schedule,,,125.33,83,,percent of total billed charges,,,,,,,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,3.5,143.45,
ASSAY OF LITHIUM,80178,CDM,80178,CPT,,,both,,62,62,,,,,,,,,,,,,12.92,,,,fee schedule,,,52.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.92,,,,fee schedule,,,,,,,,12.92,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,12.92,,,,fee schedule,,12.92,,,,fee schedule,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,3.5,58.9,
DRUG SCRN QUANT OXCARBAZEPIN,80183,CDM,80183,CPT,,,both,,177,177,,,,,,,,,,,,,17.66,,,,fee schedule,,,150.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.66,,,,fee schedule,,,,,,,,17.66,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,53.1,83,,percent of total billed charges,,17.66,,,,fee schedule,,17.66,,,,fee schedule,,,146.91,83,,percent of total billed charges,,,,,,,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,3.5,168.15,
PHENOBARBITAL (Diagnostic Lab),80184,CDM,80184,CPT,,,both,,78,78,,,,,,,,,,,,,17.72,,,,fee schedule,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.72,,,,fee schedule,,,,,,,,17.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,17.72,,,,fee schedule,,17.72,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
PHENYTOIN TOTAL (Diagostic Lab),80185,CDM,80185,CPT,,,both,,78,78,,,,,,,,,,,,,25.96,,,,fee schedule,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,25.96,,,,fee schedule,,,,,,,,25.96,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,25.96,,,,fee schedule,,25.96,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
"ASSAY OF PHENYTOIN, FREE",80186,CDM,80186,CPT,,,both,,64,64,,,,,,,,,,,,,27,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,27,,,,fee schedule,,,,,,,,27,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,27,,,,fee schedule,,27,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
ASSAY OF PRIMIDONE,80188,CDM,80188,CPT,,,both,,64,64,,,,,,,,,,,,,21.92,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,21.92,,,,fee schedule,,,,,,,,21.92,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,21.92,,,,fee schedule,,21.92,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
ASSAY OF PROCAINAMIDE,80192,CDM,80192,CPT,,,both,,90,90,,,,,,,,,,,,,18.44,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,18.44,,,,fee schedule,,,,,,,,18.44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,18.44,,,,fee schedule,,18.44,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
ASSAY OF QUINIDINE,80194,CDM,80194,CPT,,,both,,90,90,,,,,,,,,,,,,21,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,21,,,,fee schedule,,,,,,,,21,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,21,,,,fee schedule,,21,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
ASSAY OF SALICYLATE,80196,CDM,80196,CPT,,,both,,64,64,,,,,,,,,,,,,,,,,,,,54.4,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,,,,,,,,,,,,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,19.2,60.8,
ASSAY OF TACROLIMUS,80197,CDM,80197,CPT,,,both,,152,152,,,,,,,,,,,,,21,,,,fee schedule,,,129.2,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,21,,,,fee schedule,,,,,,,,21,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,45.6,83,,percent of total billed charges,,21,,,,fee schedule,,21,,,,fee schedule,,,126.16,83,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,3.5,144.4,
ASSAY OF THEOPHYLLINE,80198,CDM,80198,CPT,,,both,,77,77,,,,,,,,,,,,,18.44,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,18.44,,,,fee schedule,,,,,,,,18.44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,18.44,,,,fee schedule,,18.44,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
ASSAY OF TOBRAMYCIN,80200,CDM,80200,CPT,,,both,,78,78,,,,,,,,,,,,,17.56,,,,fee schedule,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.56,,,,fee schedule,,,,,,,,17.56,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,17.56,,,,fee schedule,,17.56,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
ASSAY OF TOPIRAMATE,80201,CDM,80201,CPT,,,both,,90,90,,,,,,,,,,,,,22.64,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,22.64,,,,fee schedule,,,,,,,,22.64,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,22.64,,,,fee schedule,,22.64,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
ASSAY OF VANCOMYCIN,80202,CDM,80202,CPT,,,both,,120,120,,,,,,,,,,,,,26.56,,,,fee schedule,,,102,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,26.56,,,,fee schedule,,,,,,,,26.56,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,36,83,,percent of total billed charges,,26.56,,,,fee schedule,,26.56,,,,fee schedule,,,99.6,83,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,3.5,114,
"QUANTITATIVE ASSAY, DRUG",80299,CDM,80299,CPT,,,both,,182,182,,,,,,,,,,,,,,,,,,,,154.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,54.6,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,,,,,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,3.5,172.9,
DRUG TEST PRSMV DIR OPT OBS,80305,CDM,80305,CPT,,,both,,71,71,,,,,,,,,,,,,8.98,,,,fee schedule,,,60.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.98,,,,fee schedule,,,,,,,,8.98,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,21.3,83,,percent of total billed charges,,8.98,,,,fee schedule,,8.98,,,,fee schedule,,,58.93,83,,percent of total billed charges,,,,,,,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,3.5,67.45,
DRUG TEST PRSMV INSTRMNT,80306,CDM,80306,CPT,,,both,,109,109,,,,,,,,,,,,,11.97,,,,fee schedule,,,92.65,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.97,,,,fee schedule,,,,,,,,11.97,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,32.7,83,,percent of total billed charges,,11.97,,,,fee schedule,,11.97,,,,fee schedule,,,90.47,83,,percent of total billed charges,,,,,,,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,3.5,103.55,
DRUG TEST PRSMV CHEM ANLYZR,80307,CDM,80307,CPT,,,both,,68,68,,,,,,,,,,,,,47.89,,,,fee schedule,,,57.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,47.89,,,,fee schedule,,,,,,,,47.89,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,47.89,,,,fee schedule,,47.89,,,,fee schedule,,,56.44,83,,percent of total billed charges,,,,,,,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,3.5,64.6,
ALKALOIDS NOS,80323,CDM,80323,CPT,,,both,,247,247,,,,,,,,,,,,,,,,,,,,209.95,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,224.77,91,,percent of total billed charges,,,234.65,95,,percent of total billed charges,,,205.01,83,,percent of total billed charges,,,74.1,83,,percent of total billed charges,,,,,,,,,,,,,,,205.01,83,,percent of total billed charges,,,,,,,,,222.3,90,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,209.95,85,,percent of total billed charges,,74.1,234.65,
ANTIPSYCHOTICS NOS 1-3,80342,CDM,80342,CPT,,,both,,292,292,,,,,,,,,,,,,,,,,,,,248.2,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,265.72,91,,percent of total billed charges,,,277.4,95,,percent of total billed charges,,,242.36,83,,percent of total billed charges,,,87.6,83,,percent of total billed charges,,,,,,,,,,,,,,,242.36,83,,percent of total billed charges,,,,,,,,,262.8,90,,percent of total billed charges,,,262.8,90,,percent of total billed charges,,,262.8,90,,percent of total billed charges,,,262.8,90,,percent of total billed charges,,,248.2,85,,percent of total billed charges,,87.6,277.4,
LAB PATHOLOGY CONSULTATION,80500,CDM,80500,CPT,,,both,,71,71,,,,,,,,,,,,,,,,,,,,60.35,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,35.81,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,21.3,83,,percent of total billed charges,,,,,,,,,,,,,,,58.93,83,,percent of total billed charges,,,,,,,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,21.3,67.45,
URNLS DIP STICK/TABLET RGNT NON-AUTO MIC,81000,CDM,81000,CPT,,,both,,19,19,,,,,,,,,,,,,5.24,,,,fee schedule,,,16.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.24,,,,fee schedule,,,,,,,,5.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,17.29,91,,percent of total billed charges,,,18.05,95,,percent of total billed charges,,,15.77,83,,percent of total billed charges,,,5.7,83,,percent of total billed charges,,5.24,,,,fee schedule,,5.24,,,,fee schedule,,,15.77,83,,percent of total billed charges,,,,,,,,,17.1,90,,percent of total billed charges,,,17.1,90,,percent of total billed charges,,,17.1,90,,percent of total billed charges,,,17.1,90,,percent of total billed charges,,,16.15,85,,percent of total billed charges,,3.5,18.05,
URNLS DIP STICK/TABLET RGNT AUTO MIC,81001,CDM,81001,CPT,,,both,,64,64,,,,,,,,,,,,,5.72,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.72,,,,fee schedule,,,,,,,,5.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,5.72,,,,fee schedule,,5.72,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MIC,81002,CDM,81002,CPT,,,both,,24,24,,,,,,,,,,,,,5.2,,,,fee schedule,,,20.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.2,,,,fee schedule,,,,,,,,5.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,7.2,83,,percent of total billed charges,,5.2,,,,fee schedule,,5.2,,,,fee schedule,,,19.92,83,,percent of total billed charges,,,,,,,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,3.5,22.8,
URNLS DIP STICK/TABLET RGNT AUTO W/O MIC,81003,CDM,81003,CPT,,,both,,48,48,,,,,,,,,,,,,4.36,,,,fee schedule,,,40.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.36,,,,fee schedule,,,,,,,,4.36,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,14.4,83,,percent of total billed charges,,4.36,,,,fee schedule,,4.36,,,,fee schedule,,,39.84,83,,percent of total billed charges,,,,,,,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,3.5,45.6,
PREGNANCY TEST - URINE - VIS COLOR CMPRSN METHS,81025,CDM,81025,CPT,,,both,,64,64,,,,,,,,,,,,,2.58,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,2.58,,,,fee schedule,,,,,,,,2.58,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,2.58,,,,fee schedule,,2.58,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,2.58,60.8,
URINE PREGNANCY TEST,81025P,CDM,81025,CPT,,,both,P,13,13,,,,,,,,,,,,,2.58,,,,fee schedule,,,11.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,2.58,,,,fee schedule,,,,,,,,2.58,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,3.9,83,,percent of total billed charges,,2.58,,,,fee schedule,,2.58,,,,fee schedule,,,10.79,83,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,2.58,12.35,
URINE PREGNANCY TEST,81025T,CDM,81025,CPT,,,both,T,51,51,,,,,,,,,,,,,2.58,,,,fee schedule,,,43.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,2.58,,,,fee schedule,,,,,,,,2.58,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,2.58,,,,fee schedule,,2.58,,,,fee schedule,,,42.33,83,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,2.58,48.45,
"URINALYSIS, VOLUME MEASURE",81050,CDM,81050,CPT,,,both,,20,20,,,,,,,,,,,,,5.12,,,,fee schedule,,,17,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.12,,,,fee schedule,,,,,,,,5.12,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,18.2,91,,percent of total billed charges,,,19,95,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,6,83,,percent of total billed charges,,5.12,,,,fee schedule,,5.12,,,,fee schedule,,,16.6,83,,percent of total billed charges,,,,,,,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,17,85,,percent of total billed charges,,3.5,19,
Factor V Leiden,81214,CDM,81214,CPT,,,both,,167,167,,,,,,,,,,,,,,,,,,,,141.95,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,50.1,83,,percent of total billed charges,,,,,,,,,,,,,,,138.61,83,,percent of total billed charges,,,,,,,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,50.1,158.65,
CFTR GENE COMMON VARIANTS,81220,CDM,81220,CPT,,,both,,271,271,,,,,,,,,,,,,333.96,,,,fee schedule,,,230.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,333.96,,,,fee schedule,,,,,,,,333.96,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,246.61,91,,percent of total billed charges,,,257.45,95,,percent of total billed charges,,,224.93,83,,percent of total billed charges,,,81.3,83,,percent of total billed charges,,333.96,,,,fee schedule,,333.96,,,,fee schedule,,,224.93,83,,percent of total billed charges,,,,,,,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,230.35,85,,percent of total billed charges,,3.5,333.96,
F2 GENE,81240,CDM,81240,CPT,,,both,,340,340,,,,,,,,,,,,,39.41,,,,fee schedule,,,289,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,39.41,,,,fee schedule,,,,,,,,39.41,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,309.4,91,,percent of total billed charges,,,323,95,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,102,83,,percent of total billed charges,,39.41,,,,fee schedule,,39.41,,,,fee schedule,,,282.2,83,,percent of total billed charges,,,,,,,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,289,85,,percent of total billed charges,,3.5,323,
Factor 5 Leiden GENE,81241,CDM,81241,CPT,,,both,,333,333,,,,,,,,,,,,,44.02,,,,fee schedule,,,283.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,44.02,,,,fee schedule,,,,,,,,44.02,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,99.9,83,,percent of total billed charges,,44.02,,,,fee schedule,,44.02,,,,fee schedule,,,276.39,83,,percent of total billed charges,,,,,,,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,3.5,316.35,
MOPATH PROCEDURE LEVEL 2,81401,CDM,81401,CPT,,,both,,321,321,,,,,,,,,,,,,82.2,,,,fee schedule,,,272.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,82.2,,,,fee schedule,,,,,,,,82.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,292.11,91,,percent of total billed charges,,,304.95,95,,percent of total billed charges,,,266.43,83,,percent of total billed charges,,,96.3,83,,percent of total billed charges,,82.2,,,,fee schedule,,82.2,,,,fee schedule,,,266.43,83,,percent of total billed charges,,,,,,,,,288.9,90,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,272.85,85,,percent of total billed charges,,3.5,304.95,
UNLISTED MOLECULAR PATHOLOGY,81479,CDM,81479,CPT,,,both,,1017,1017,,,,,,,,,,,,,,,,,,,,864.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,925.47,91,,percent of total billed charges,,,966.15,95,,percent of total billed charges,,,844.11,83,,percent of total billed charges,,,305.1,83,,percent of total billed charges,,,,,,,,,,,,,,,844.11,83,,percent of total billed charges,,,,,,,,,915.3,90,,percent of total billed charges,,,915.3,90,,percent of total billed charges,,,915.3,90,,percent of total billed charges,,,915.3,90,,percent of total billed charges,,,864.45,85,,percent of total billed charges,,3.5,966.15,
ASSAY OF ACETAMINOPHEN,82003,CDM,82003,CPT,,,both,,109,109,,,,,,,,,,,,,,,,,,,,92.65,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,32.7,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,,,,,,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,32.7,103.55,
ACETONE ASSAY,82010,CDM,82010,CPT,,,both,,53,53,,,,,,,,,,,,,6.88,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.88,,,,fee schedule,,,,,,,,6.88,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,6.88,,,,fee schedule,,6.88,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
ASSAY OF ACTH,82024,CDM,82024,CPT,,,both,,243,243,,,,,,,,,,,,,13.42,,,,fee schedule,,,206.55,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.42,,,,fee schedule,,,,,,,,13.42,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,221.13,91,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,72.9,83,,percent of total billed charges,,13.42,,,,fee schedule,,13.42,,,,fee schedule,,,201.69,83,,percent of total billed charges,,,,,,,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,206.55,85,,percent of total billed charges,,3.5,230.85,
ALBUMIN SERUM PLASMA/WHOLE BLOOD,82040,CDM,82040,CPT,,,both,,41,41,,,,,,,,,,,,,4.5,,,,fee schedule,,,34.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.5,,,,fee schedule,,,,,,,,4.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,4.5,,,,fee schedule,,4.5,,,,fee schedule,,,34.03,83,,percent of total billed charges,,,,,,,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,3.5,38.95,
ALBUMIN URINE MICROALBUMIN QUAN,82043,CDM,82043,CPT,,,both,,41,41,,,,,,,,,,,,,3.94,,,,fee schedule,,,34.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.94,,,,fee schedule,,,,,,,,3.94,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,3.94,,,,fee schedule,,3.94,,,,fee schedule,,,34.03,83,,percent of total billed charges,,,,,,,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,3.5,38.95,
MICROALBUMIN URINE MICROALBUMIN SEMIQUAN,82044,CDM,82044,CPT,,,both,,25,25,,,,,,,,,,,,,3.94,,,,fee schedule,,,21.25,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.94,,,,fee schedule,,,,,,,,3.94,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,22.75,91,,percent of total billed charges,,,23.75,95,,percent of total billed charges,,,20.75,83,,percent of total billed charges,,,7.5,83,,percent of total billed charges,,3.94,,,,fee schedule,,3.94,,,,fee schedule,,,20.75,83,,percent of total billed charges,,,,,,,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,21.25,85,,percent of total billed charges,,3.5,23.75,
ALCOHOL ANY SPEC XCPT BRTH,82055,CDM,82055,CPT,,,both,,90,90,,,,,,,,,,,,,,,,,,,,76.5,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,27,85.5,
ASSAY OF BREATH ETHANOL,82075,CDM,82075,CPT,,,both,,89,89,,,,,,,,,,,,,10.04,,,,fee schedule,,,75.65,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.04,,,,fee schedule,,,,,,,,10.04,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,80.99,91,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,26.7,83,,percent of total billed charges,,10.04,,,,fee schedule,,10.04,,,,fee schedule,,,73.87,83,,percent of total billed charges,,,,,,,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,3.5,84.55,
ASSAY OF ALDOLASE,82085,CDM,82085,CPT,,,both,,64,64,,,,,,,,,,,,,6.3,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.3,,,,fee schedule,,,,,,,,6.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,6.3,,,,fee schedule,,6.3,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
ASSAY OF ALDOSTERONE,82088,CDM,82088,CPT,,,both,,211,211,,,,,,,,,,,,,39.9,,,,fee schedule,,,179.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,39.9,,,,fee schedule,,,,,,,,39.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,63.3,83,,percent of total billed charges,,39.9,,,,fee schedule,,39.9,,,,fee schedule,,,175.13,83,,percent of total billed charges,,,,,,,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,3.5,200.45,
ALPHA-1-ANTITRYPSIN TOT,82103,CDM,82103,CPT,,,both,,78,78,,,,,,,,,,,,,8.86,,,,fee schedule,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.86,,,,fee schedule,,,,,,,,8.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,8.86,,,,fee schedule,,8.86,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
"ALPHA-1-ANTITRYPSIN, PHENO",82104,CDM,82104,CPT,,,both,,150,150,,,,,,,,,,,,,7.16,,,,fee schedule,,,127.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,7.16,,,,fee schedule,,,,,,,,7.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,7.16,,,,fee schedule,,7.16,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,3.5,142.5,
ALPHA-FETOPROTEIN SERUM,82105,CDM,82105,CPT,,,both,,120,120,,,,,,,,,,,,,16.42,,,,fee schedule,,,102,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,16.42,,,,fee schedule,,,,,,,,16.42,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,36,83,,percent of total billed charges,,16.42,,,,fee schedule,,16.42,,,,fee schedule,,,99.6,83,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,3.5,114,
AMINO ACIDS 6/> AMINO ACIDS QUAN EA SPEC,82139,CDM,82139,CPT,,,both,,187,187,,,,,,,,,,,,,34.86,,,,fee schedule,,,158.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,34.86,,,,fee schedule,,,,,,,,34.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,56.1,83,,percent of total billed charges,,34.86,,,,fee schedule,,34.86,,,,fee schedule,,,155.21,83,,percent of total billed charges,,,,,,,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,3.5,177.65,
AMMONIA,82140,CDM,82140,CPT,,,both,,90,90,,,,,,,,,,,,,14.32,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,14.32,,,,fee schedule,,,,,,,,14.32,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,14.32,,,,fee schedule,,14.32,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
AMYLASE,82150,CDM,82150,CPT,,,both,,135,135,,,,,,,,,,,,,25.52,,,,fee schedule,,,114.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,25.52,,,,fee schedule,,,,,,,,25.52,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,40.5,83,,percent of total billed charges,,25.52,,,,fee schedule,,25.52,,,,fee schedule,,,112.05,83,,percent of total billed charges,,,,,,,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,3.5,128.25,
ASSAY OF ANDROSTENEDIONE,82157,CDM,82157,CPT,,,both,,135,135,,,,,,,,,,,,,16.8,,,,fee schedule,,,114.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,16.8,,,,fee schedule,,,,,,,,16.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,40.5,83,,percent of total billed charges,,16.8,,,,fee schedule,,16.8,,,,fee schedule,,,112.05,83,,percent of total billed charges,,,,,,,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,3.5,128.25,
ASSAY OF ANGIOTENSIN II,82163,CDM,82163,CPT,,,both,,88,88,,,,,,,,,,,,,7.5,,,,fee schedule,,,74.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,7.5,,,,fee schedule,,,,,,,,7.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,26.4,83,,percent of total billed charges,,7.5,,,,fee schedule,,7.5,,,,fee schedule,,,73.04,83,,percent of total billed charges,,,,,,,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,3.5,83.6,
ACE,82164,CDM,82164,CPT,,,both,,66,66,,,,,,,,,,,,,7.16,,,,fee schedule,,,56.1,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,7.16,,,,fee schedule,,,,,,,,7.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,60.06,91,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,7.16,,,,fee schedule,,7.16,,,,fee schedule,,,54.78,83,,percent of total billed charges,,,,,,,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,3.5,62.7,
ASSAY OF APOLIPOPROTEIN,82172,CDM,82172,CPT,,,both,,130,130,,,,,,,,,,,,,36,,,,fee schedule,,,110.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,36,,,,fee schedule,,,,,,,,36,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,39,83,,percent of total billed charges,,36,,,,fee schedule,,36,,,,fee schedule,,,107.9,83,,percent of total billed charges,,,,,,,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,3.5,123.5,
ASSAY OF ARSENIC,82175,CDM,82175,CPT,,,both,,87,87,,,,,,,,,,,,,17.72,,,,fee schedule,,,73.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.72,,,,fee schedule,,,,,,,,17.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,26.1,83,,percent of total billed charges,,17.72,,,,fee schedule,,17.72,,,,fee schedule,,,72.21,83,,percent of total billed charges,,,,,,,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,3.5,82.65,
ASSAY OF ASCORBIC ACID,82180,CDM,82180,CPT,,,both,,98,98,,,,,,,,,,,,,5.02,,,,fee schedule,,,83.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.02,,,,fee schedule,,,,,,,,5.02,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,89.18,91,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,29.4,83,,percent of total billed charges,,5.02,,,,fee schedule,,5.02,,,,fee schedule,,,81.34,83,,percent of total billed charges,,,,,,,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,83.3,85,,percent of total billed charges,,3.5,93.1,
BETA-2 MICROGLOBULIN,82232,CDM,82232,CPT,,,both,,77,77,,,,,,,,,,,,,15.84,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.84,,,,fee schedule,,,,,,,,15.84,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,15.84,,,,fee schedule,,15.84,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
"BILE ACIDS, TOTAL",82239,CDM,82239,CPT,,,both,,181,181,,,,,,,,,,,,,16.76,,,,fee schedule,,,153.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,16.76,,,,fee schedule,,,,,,,,16.76,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,54.3,83,,percent of total billed charges,,16.76,,,,fee schedule,,16.76,,,,fee schedule,,,150.23,83,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,3.5,171.95,
BILIRUBIN TOT,82247,CDM,82247,CPT,,,both,,34,34,,,,,,,,,,,,,9.32,,,,fee schedule,,,28.9,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9.32,,,,fee schedule,,,,,,,,9.32,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,10.2,83,,percent of total billed charges,,9.32,,,,fee schedule,,9.32,,,,fee schedule,,,28.22,83,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,3.5,32.3,
BILIRUBIN DIR,82248,CDM,82248,CPT,,,both,,34,34,,,,,,,,,,,,,9.32,,,,fee schedule,,,28.9,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9.32,,,,fee schedule,,,,,,,,9.32,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,10.2,83,,percent of total billed charges,,9.32,,,,fee schedule,,9.32,,,,fee schedule,,,28.22,83,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,3.5,32.3,
Feces Occult Blood Screening,82270,CDM,82270,CPT,,,both,,41,41,,,,,,,,,,,,,2.48,,,,fee schedule,,,34.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,2.48,,,,fee schedule,,,,,,,,2.48,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,2.48,,,,fee schedule,,2.48,,,,fee schedule,,,34.03,83,,percent of total billed charges,,,,,,,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,2.48,38.95,
"OCCULT BLOOD, FECES, SINGLE",82271,CDM,82271,CPT,,,both,,27,27,,,,,,,,,,,,,2.04,,,,fee schedule,,,22.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,2.04,,,,fee schedule,,,,,,,,2.04,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,8.1,83,,percent of total billed charges,,2.04,,,,fee schedule,,2.04,,,,fee schedule,,,22.41,83,,percent of total billed charges,,,,,,,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,2.04,25.65,
Feces Occult Blood Diagnostic,82272,CDM,82272,CPT,,,both,,25,25,,,,,,,,,,,,,2.04,,,,fee schedule,,,21.25,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,2.04,,,,fee schedule,,,,,,,,2.04,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,22.75,91,,percent of total billed charges,,,23.75,95,,percent of total billed charges,,,20.75,83,,percent of total billed charges,,,7.5,83,,percent of total billed charges,,2.04,,,,fee schedule,,2.04,,,,fee schedule,,,20.75,83,,percent of total billed charges,,,,,,,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,21.25,85,,percent of total billed charges,,2.04,23.75,
BLD OCLT FECAL HGB DETER IA QUAL FECES 1-3,82274,CDM,82274,CPT,,,both,,78,78,,,,,,,,,,,,,10,,,,fee schedule,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10,,,,fee schedule,,,,,,,,10,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,10,,,,fee schedule,,10,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
ASSAY OF CADMIUM,82300,CDM,82300,CPT,,,both,,47,47,,,,,,,,,,,,,6.68,,,,fee schedule,,,39.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.68,,,,fee schedule,,,,,,,,6.68,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,14.1,83,,percent of total billed charges,,6.68,,,,fee schedule,,6.68,,,,fee schedule,,,39.01,83,,percent of total billed charges,,,,,,,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,3.5,44.65,
25 HYDROXY INCLUDES FRACTIONS IF PERFORMED,82306,CDM,82306,CPT,,,both,,150,150,,,,,,,,,,,,,8.86,,,,fee schedule,,,127.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.86,,,,fee schedule,,,,,,,,8.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,8.86,,,,fee schedule,,8.86,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,3.5,142.5,
ASSAY OF CALCITONIN,82308,CDM,82308,CPT,,,both,,162,162,,,,,,,,,,,,,18.9,,,,fee schedule,,,137.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,18.9,,,,fee schedule,,,,,,,,18.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,48.6,83,,percent of total billed charges,,18.9,,,,fee schedule,,18.9,,,,fee schedule,,,134.46,83,,percent of total billed charges,,,,,,,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,3.5,153.9,
CALCIUM TOT,82310,CDM,82310,CPT,,,both,,53,53,,,,,,,,,,,,,9.32,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9.32,,,,fee schedule,,,,,,,,9.32,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,9.32,,,,fee schedule,,9.32,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
ASSAY OF CALCIUM,82330,CDM,82330,CPT,,,both,,64,64,,,,,,,,,,,,,26.72,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,26.72,,,,fee schedule,,,,,,,,26.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,26.72,,,,fee schedule,,26.72,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
ASSAY OF CALCIUM IN URINE,82340,CDM,82340,CPT,,,both,,60,60,,,,,,,,,,,,,5.4,,,,fee schedule,,,51,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.4,,,,fee schedule,,,,,,,,5.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,18,83,,percent of total billed charges,,5.4,,,,fee schedule,,5.4,,,,fee schedule,,,49.8,83,,percent of total billed charges,,,,,,,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,3.5,57,
ST1 QUAN ALYS CHEM,82360,CDM,82360,CPT,,,both,,52,52,,,,,,,,,,,,,27.24,,,,fee schedule,,,44.2,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,27.24,,,,fee schedule,,,,,,,,27.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,15.6,83,,percent of total billed charges,,27.24,,,,fee schedule,,27.24,,,,fee schedule,,,43.16,83,,percent of total billed charges,,,,,,,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,3.5,49.4,
ST1 INFRARED SPECTROSCOPY,82365,CDM,82365,CPT,,,both,,84,84,,,,,,,,,,,,,13.98,,,,fee schedule,,,71.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.98,,,,fee schedule,,,,,,,,13.98,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,25.2,83,,percent of total billed charges,,13.98,,,,fee schedule,,13.98,,,,fee schedule,,,69.72,83,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,3.5,79.8,
"ASSAY, BLOOD CARBON DIOXIDE",82374,CDM,82374,CPT,,,both,,51,51,,,,,,,,,,,,,9.6,,,,fee schedule,,,43.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9.6,,,,fee schedule,,,,,,,,9.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,9.6,,,,fee schedule,,9.6,,,,fee schedule,,,42.33,83,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,3.5,48.45,
"ASSAY, BLOOD CARBON MONOXIDE",82375,CDM,82375,CPT,,,both,,100,100,,,,,,,,,,,,,4.66,,,,fee schedule,,,85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.66,,,,fee schedule,,,,,,,,4.66,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,30,83,,percent of total billed charges,,4.66,,,,fee schedule,,4.66,,,,fee schedule,,,83,83,,percent of total billed charges,,,,,,,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,3.5,95,
CARCINOEMBRYONIC AG,82378,CDM,82378,CPT,,,both,,139,139,,,,,,,,,,,,,26.84,,,,fee schedule,,,118.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,26.84,,,,fee schedule,,,,,,,,26.84,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,126.49,91,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,41.7,83,,percent of total billed charges,,26.84,,,,fee schedule,,26.84,,,,fee schedule,,,115.37,83,,percent of total billed charges,,,,,,,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,118.15,85,,percent of total billed charges,,3.5,132.05,
ASSAY OF CARNITINE,82379,CDM,82379,CPT,,,both,,187,187,,,,,,,,,,,,,11.62,,,,fee schedule,,,158.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.62,,,,fee schedule,,,,,,,,11.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,56.1,83,,percent of total billed charges,,11.62,,,,fee schedule,,11.62,,,,fee schedule,,,155.21,83,,percent of total billed charges,,,,,,,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,3.5,177.65,
ASSAY OF CAROTENE,82380,CDM,82380,CPT,,,both,,51,51,,,,,,,,,,,,,4.66,,,,fee schedule,,,43.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.66,,,,fee schedule,,,,,,,,4.66,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,4.66,,,,fee schedule,,4.66,,,,fee schedule,,,42.33,83,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,3.5,48.45,
"ASSAY, URINE CATECHOLAMINES",82382,CDM,82382,CPT,,,both,,81,81,,,,,,,,,,,,,15.16,,,,fee schedule,,,68.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.16,,,,fee schedule,,,,,,,,15.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,24.3,83,,percent of total billed charges,,15.16,,,,fee schedule,,15.16,,,,fee schedule,,,67.23,83,,percent of total billed charges,,,,,,,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,3.5,76.95,
"ASSAY, THREE CATECHOLAMINES",82384,CDM,82384,CPT,,,both,,127,127,,,,,,,,,,,,,30.32,,,,fee schedule,,,107.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,30.32,,,,fee schedule,,,,,,,,30.32,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,30.32,,,,fee schedule,,30.32,,,,fee schedule,,,105.41,83,,percent of total billed charges,,,,,,,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,3.5,120.65,
ASSAY OF CERULOPLASMIN,82390,CDM,82390,CPT,,,both,,78,78,,,,,,,,,,,,,8.86,,,,fee schedule,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.86,,,,fee schedule,,,,,,,,8.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,8.86,,,,fee schedule,,8.86,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
Invasive Trophoblast Antigen,82397,CDM,82397,CPT,,,both,,346,346,,,,,,,,,,,,,13.84,,,,fee schedule,,,294.1,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.84,,,,fee schedule,,,,,,,,13.84,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,314.86,91,,percent of total billed charges,,,328.7,95,,percent of total billed charges,,,287.18,83,,percent of total billed charges,,,103.8,83,,percent of total billed charges,,13.84,,,,fee schedule,,13.84,,,,fee schedule,,,287.18,83,,percent of total billed charges,,,,,,,,,311.4,90,,percent of total billed charges,,,311.4,90,,percent of total billed charges,,,311.4,90,,percent of total billed charges,,,311.4,90,,percent of total billed charges,,,294.1,85,,percent of total billed charges,,3.5,328.7,
ASSAY OF BLOOD CHLORIDE,82435,CDM,82435,CPT,,,both,,47,47,,,,,,,,,,,,,9,,,,fee schedule,,,39.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9,,,,fee schedule,,,,,,,,9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,14.1,83,,percent of total billed charges,,9,,,,fee schedule,,9,,,,fee schedule,,,39.01,83,,percent of total billed charges,,,,,,,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,3.5,44.65,
ASSAY OF URINE CHLORIDE,82436,CDM,82436,CPT,,,both,,62,62,,,,,,,,,,,,,4.66,,,,fee schedule,,,52.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.66,,,,fee schedule,,,,,,,,4.66,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,4.66,,,,fee schedule,,4.66,,,,fee schedule,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,3.5,58.9,
"ASSAY, BLD/SERUM CHOLESTEROL",82465,CDM,82465,CPT,,,both,,47,47,,,,,,,,,,,,,4.24,,,,fee schedule,,,39.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.24,,,,fee schedule,,,,,,,,4.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,14.1,83,,percent of total billed charges,,4.24,,,,fee schedule,,4.24,,,,fee schedule,,,39.01,83,,percent of total billed charges,,,,,,,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,3.5,44.65,
"ASSAY, SERUM CHOLINESTERASE",82480,CDM,82480,CPT,,,both,,77,77,,,,,,,,,,,,,14.32,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,14.32,,,,fee schedule,,,,,,,,14.32,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,14.32,,,,fee schedule,,14.32,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
CHROM QUAN COLUMN 1 ANAL NES,82491,CDM,82491,CPT,,,both,,124,124,,,,,,,,,,,,,,,,,,,,105.4,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,37.2,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,,,,,,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,37.2,117.8,
"CHROMOTOGRAPHY, QUANT, MULT",82492,CDM,82492,CPT,,,both,,232,232,,,,,,,,,,,,,,,,,,,,197.2,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,211.12,91,,percent of total billed charges,,,220.4,95,,percent of total billed charges,,,192.56,83,,percent of total billed charges,,,69.6,83,,percent of total billed charges,,,,,,,,,,,,,,,192.56,83,,percent of total billed charges,,,,,,,,,208.8,90,,percent of total billed charges,,,208.8,90,,percent of total billed charges,,,208.8,90,,percent of total billed charges,,,208.8,90,,percent of total billed charges,,,197.2,85,,percent of total billed charges,,69.6,220.4,
ASSAY OF CHROMIUM,82495,CDM,82495,CPT,,,both,,117,117,,,,,,,,,,,,,13.42,,,,fee schedule,,,99.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.42,,,,fee schedule,,,,,,,,13.42,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,106.47,91,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,35.1,83,,percent of total billed charges,,13.42,,,,fee schedule,,13.42,,,,fee schedule,,,97.11,83,,percent of total billed charges,,,,,,,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,99.45,85,,percent of total billed charges,,3.5,111.15,
ASSAY OF CITRATE,82507,CDM,82507,CPT,,,both,,90,90,,,,,,,,,,,,,5.4,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.4,,,,fee schedule,,,,,,,,5.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,5.4,,,,fee schedule,,5.4,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
COLLAGEN CROSS LINKS ANY METH,82523,CDM,82523,CPT,,,both,,100,100,,,,,,,,,,,,,,,,,,,,85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,30,83,,percent of total billed charges,,,,,,,,,,,,,,,83,83,,percent of total billed charges,,,,,,,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,3.5,95,
COPPR,82525,CDM,82525,CPT,,,both,,78,78,,,,,,,,,,,,,22.2,,,,fee schedule,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,22.2,,,,fee schedule,,,,,,,,22.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,22.2,,,,fee schedule,,22.2,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
"CORTISOL, FREE - 24 Hr Urine",82530,CDM,82530,CPT,,,both,,150,150,,,,,,,,,,,,,26.84,,,,fee schedule,,,127.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,26.84,,,,fee schedule,,,,,,,,26.84,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,26.84,,,,fee schedule,,26.84,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,3.5,142.5,
CORTISOL TOTAL - (BLOOD),82533,CDM,82533,CPT,,,both,,90,90,,,,,,,,,,,,,13.42,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.42,,,,fee schedule,,,,,,,,13.42,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,13.42,,,,fee schedule,,13.42,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
ASSAY OF CREATINE,82540,CDM,82540,CPT,,,both,,13,13,,,,,,,,,,,,,4.5,,,,fee schedule,,,11.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.5,,,,fee schedule,,,,,,,,4.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,3.9,83,,percent of total billed charges,,4.5,,,,fee schedule,,4.5,,,,fee schedule,,,10.79,83,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.5,12.35,
"COLUMN CHROMOTOGRAPHY, QUAL",82541,CDM,82541,CPT,,,both,,136,136,,,,,,,,,,,,,,,,,,,,115.6,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,123.76,91,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,40.8,83,,percent of total billed charges,,,,,,,,,,,,,,,112.88,83,,percent of total billed charges,,,,,,,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,40.8,129.2,
"COLUMN CHROMOTOGRAPHY, QUANT",82542,CDM,82542,CPT,,,both,,90,90,,,,,,,,,,,,,12.18,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.18,,,,fee schedule,,,,,,,,12.18,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,12.18,,,,fee schedule,,12.18,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
CREATINE KINASE TOT,82550,CDM,82550,CPT,,,both,,53,53,,,,,,,,,,,,,18.24,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,18.24,,,,fee schedule,,,,,,,,18.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,18.24,,,,fee schedule,,18.24,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
ASSAY OF CPK IN BLOOD,82552,CDM,82552,CPT,,,both,,141,141,,,,,,,,,,,,,18.9,,,,fee schedule,,,119.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,18.9,,,,fee schedule,,,,,,,,18.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,128.31,91,,percent of total billed charges,,,133.95,95,,percent of total billed charges,,,117.03,83,,percent of total billed charges,,,42.3,83,,percent of total billed charges,,18.9,,,,fee schedule,,18.9,,,,fee schedule,,,117.03,83,,percent of total billed charges,,,,,,,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,119.85,85,,percent of total billed charges,,3.5,133.95,
"CREATINE, MB FRACTION",82553,CDM,82553,CPT,,,both,,78,78,,,,,,,,,,,,,22.26,,,,fee schedule,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,22.26,,,,fee schedule,,,,,,,,22.26,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,22.26,,,,fee schedule,,22.26,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
CREATININE BLD,82565,CDM,82565,CPT,,,both,,46,46,,,,,,,,,,,,,9.32,,,,fee schedule,,,39.1,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9.32,,,,fee schedule,,,,,,,,9.32,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,13.8,83,,percent of total billed charges,,9.32,,,,fee schedule,,9.32,,,,fee schedule,,,38.18,83,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,3.5,43.7,
CREATININE CLEARANCE TEST,82575,CDM,82575,CPT,,,both,,101,101,,,,,,,,,,,,,9.22,,,,fee schedule,,,85.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9.22,,,,fee schedule,,,,,,,,9.22,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,30.3,83,,percent of total billed charges,,9.22,,,,fee schedule,,9.22,,,,fee schedule,,,83.83,83,,percent of total billed charges,,,,,,,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,3.5,95.95,
ASSAY OF CRYOGLOBULIN,82595,CDM,82595,CPT,,,both,,77,77,,,,,,,,,,,,,4.66,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.66,,,,fee schedule,,,,,,,,4.66,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,4.66,,,,fee schedule,,4.66,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
ASSAY OF CYANIDE,82600,CDM,82600,CPT,,,both,,28,28,,,,,,,,,,,,,6.68,,,,fee schedule,,,23.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.68,,,,fee schedule,,,,,,,,6.68,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,8.4,83,,percent of total billed charges,,6.68,,,,fee schedule,,6.68,,,,fee schedule,,,23.24,83,,percent of total billed charges,,,,,,,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,3.5,26.6,
CYANOCOBALAMIN,82607,CDM,82607,CPT,,,both,,90,90,,,,,,,,,,,,,12,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12,,,,fee schedule,,,,,,,,12,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,12,,,,fee schedule,,12,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
B-12 BINDING CAPACITY,82608,CDM,82608,CPT,,,both,,77,77,,,,,,,,,,,,,12.02,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.02,,,,fee schedule,,,,,,,,12.02,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,12.02,,,,fee schedule,,12.02,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
CYSTATIN C,82610,CDM,82610,CPT,,,both,,243,243,,,,,,,,,,,,,8.56,,,,fee schedule,,,206.55,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.56,,,,fee schedule,,,,,,,,8.56,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,221.13,91,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,72.9,83,,percent of total billed charges,,8.56,,,,fee schedule,,8.56,,,,fee schedule,,,201.69,83,,percent of total billed charges,,,,,,,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,206.55,85,,percent of total billed charges,,3.5,230.85,
DEHYDROEPIANDROSTERONE,82626,CDM,82626,CPT,,,both,,118,118,,,,,,,,,,,,,8.86,,,,fee schedule,,,100.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.86,,,,fee schedule,,,,,,,,8.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,107.38,91,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,35.4,83,,percent of total billed charges,,8.86,,,,fee schedule,,8.86,,,,fee schedule,,,97.94,83,,percent of total billed charges,,,,,,,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,3.5,112.1,
DEHYDROEPIANDROSTERONE-SULFATE,82627,CDM,82627,CPT,,,both,,150,150,,,,,,,,,,,,,7.96,,,,fee schedule,,,127.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,7.96,,,,fee schedule,,,,,,,,7.96,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,7.96,,,,fee schedule,,7.96,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,3.5,142.5,
DIHYDROTSTOSTERONE,82651,CDM,82651,CPT,,,both,,122,122,,,,,,,,,,,,,,,,,,,,103.7,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,36.6,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,,,,,,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,36.6,115.9,
1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED,82652,CDM,82652,CPT,,,both,,180,180,,,,,,,,,,,,,16.06,,,,fee schedule,,,153,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,16.06,,,,fee schedule,,,,,,,,16.06,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,163.8,91,,percent of total billed charges,,,171,95,,percent of total billed charges,,,149.4,83,,percent of total billed charges,,,54,83,,percent of total billed charges,,16.06,,,,fee schedule,,16.06,,,,fee schedule,,,149.4,83,,percent of total billed charges,,,,,,,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,162,90,,percent of total billed charges,,,153,85,,percent of total billed charges,,3.5,171,
"PANCREATIC ELASTASE, FECAL",82656,CDM,82656,CPT,,,both,,406,406,,,,,,,,,,,,,7.26,,,,fee schedule,,,345.1,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,7.26,,,,fee schedule,,,,,,,,7.26,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,369.46,91,,percent of total billed charges,,,385.7,95,,percent of total billed charges,,,336.98,83,,percent of total billed charges,,,121.8,83,,percent of total billed charges,,7.26,,,,fee schedule,,7.26,,,,fee schedule,,,336.98,83,,percent of total billed charges,,,,,,,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,365.4,90,,percent of total billed charges,,,345.1,85,,percent of total billed charges,,3.5,385.7,
ASSAY OF ERYTHROPOIETIN,82668,CDM,82668,CPT,,,both,,150,150,,,,,,,,,,,,,10.42,,,,fee schedule,,,127.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.42,,,,fee schedule,,,,,,,,10.42,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,10.42,,,,fee schedule,,10.42,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,3.5,142.5,
ESTRADIOL,82670,CDM,82670,CPT,,,both,,90,90,,,,,,,,,,,,,20.24,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,20.24,,,,fee schedule,,,,,,,,20.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,20.24,,,,fee schedule,,20.24,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
ASSAY OF ESTROGEN,82672,CDM,82672,CPT,,,both,,105,105,,,,,,,,,,,,,17.7,,,,fee schedule,,,89.25,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.7,,,,fee schedule,,,,,,,,17.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,31.5,83,,percent of total billed charges,,17.7,,,,fee schedule,,17.7,,,,fee schedule,,,87.15,83,,percent of total billed charges,,,,,,,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,3.5,99.75,
ASSAY OF ESTRIOL,82677,CDM,82677,CPT,,,both,,110,110,,,,,,,,,,,,,10.12,,,,fee schedule,,,93.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.12,,,,fee schedule,,,,,,,,10.12,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,100.1,91,,percent of total billed charges,,,104.5,95,,percent of total billed charges,,,91.3,83,,percent of total billed charges,,,33,83,,percent of total billed charges,,10.12,,,,fee schedule,,10.12,,,,fee schedule,,,91.3,83,,percent of total billed charges,,,,,,,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,93.5,85,,percent of total billed charges,,3.5,104.5,
ESTRONE,82679,CDM,82679,CPT,,,both,,150,150,,,,,,,,,,,,,10.12,,,,fee schedule,,,127.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.12,,,,fee schedule,,,,,,,,10.12,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,10.12,,,,fee schedule,,10.12,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,3.5,142.5,
"FATS/LIPIDS, FECES, QUAL",82705,CDM,82705,CPT,,,both,,90,90,,,,,,,,,,,,,2.56,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,2.56,,,,fee schedule,,,,,,,,2.56,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,2.56,,,,fee schedule,,2.56,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,2.56,85.5,
"FATS/LIPIDS, FECES, QUANT",82710,CDM,82710,CPT,,,both,,152,152,,,,,,,,,,,,,3.08,,,,fee schedule,,,129.2,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.08,,,,fee schedule,,,,,,,,3.08,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,45.6,83,,percent of total billed charges,,3.08,,,,fee schedule,,3.08,,,,fee schedule,,,126.16,83,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,3.08,144.4,
FERRITIN,82728,CDM,82728,CPT,,,both,,78,78,,,,,,,,,,,,,7.16,,,,fee schedule,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,7.16,,,,fee schedule,,,,,,,,7.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,7.16,,,,fee schedule,,7.16,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
ASSAY OF FETAL FIBRONECTIN,82731,CDM,82731,CPT,,,both,,438,438,,,,,,,,,,,,,36.78,,,,fee schedule,,,372.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,36.78,,,,fee schedule,,,,,,,,36.78,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,131.4,83,,percent of total billed charges,,36.78,,,,fee schedule,,36.78,,,,fee schedule,,,363.54,83,,percent of total billed charges,,,,,,,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,3.5,416.1,
FOLIC ACID SERUM,82746,CDM,82746,CPT,,,both,,84,84,,,,,,,,,,,,,11.46,,,,fee schedule,,,71.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.46,,,,fee schedule,,,,,,,,11.46,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,25.2,83,,percent of total billed charges,,11.46,,,,fee schedule,,11.46,,,,fee schedule,,,69.72,83,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,3.5,79.8,
"ASSAY OF FOLIC ACID, RBC",82747,CDM,82747,CPT,,,both,,86,86,,,,,,,,,,,,,13.28,,,,fee schedule,,,73.1,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.28,,,,fee schedule,,,,,,,,13.28,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,78.26,91,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,25.8,83,,percent of total billed charges,,13.28,,,,fee schedule,,13.28,,,,fee schedule,,,71.38,83,,percent of total billed charges,,,,,,,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,3.5,81.7,
GAMMAGLOBULIN IGA IGD IGG IGM EACH,82784,CDM,82784,CPT,,,both,,84,84,,,,,,,,,,,,,54.48,,,,fee schedule,,,71.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,54.48,,,,fee schedule,,,,,,,,54.48,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,25.2,83,,percent of total billed charges,,54.48,,,,fee schedule,,54.48,,,,fee schedule,,,69.72,83,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,3.5,79.8,
ASSAY OF GAMMAGLOBULIN IGE,82785,CDM,82785,CPT,,,both,,84,84,,,,,,,,,,,,,7.16,,,,fee schedule,,,71.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,7.16,,,,fee schedule,,,,,,,,7.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,25.2,83,,percent of total billed charges,,7.16,,,,fee schedule,,7.16,,,,fee schedule,,,69.72,83,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,3.5,79.8,
BLOOD GASES W/02 SATURATION,82805,CDM,82805,CPT,,,both,,131,131,,,,,,,,,,,,,21.76,,,,fee schedule,,,111.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,21.76,,,,fee schedule,,,,,,,,21.76,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,39.3,83,,percent of total billed charges,,21.76,,,,fee schedule,,21.76,,,,fee schedule,,,108.73,83,,percent of total billed charges,,,,,,,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,3.5,124.45,
ASSAY OF GASTRIN,82941,CDM,82941,CPT,,,both,,84,84,,,,,,,,,,,,,7.92,,,,fee schedule,,,71.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,7.92,,,,fee schedule,,,,,,,,7.92,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,25.2,83,,percent of total billed charges,,7.92,,,,fee schedule,,7.92,,,,fee schedule,,,69.72,83,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,3.5,79.8,
ASSAY OF GLUCAGON,82943,CDM,82943,CPT,,,both,,229,229,,,,,,,,,,,,,7.02,,,,fee schedule,,,194.65,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,7.02,,,,fee schedule,,,,,,,,7.02,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,208.39,91,,percent of total billed charges,,,217.55,95,,percent of total billed charges,,,190.07,83,,percent of total billed charges,,,68.7,83,,percent of total billed charges,,7.02,,,,fee schedule,,7.02,,,,fee schedule,,,190.07,83,,percent of total billed charges,,,,,,,,,206.1,90,,percent of total billed charges,,,206.1,90,,percent of total billed charges,,,206.1,90,,percent of total billed charges,,,206.1,90,,percent of total billed charges,,,194.65,85,,percent of total billed charges,,3.5,217.55,
GLUCOSE OTHER FLUID,82945,CDM,82945,CPT,,,both,,27,27,,,,,,,,,,,,,3.08,,,,fee schedule,,,22.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.08,,,,fee schedule,,,,,,,,3.08,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,8.1,83,,percent of total billed charges,,3.08,,,,fee schedule,,3.08,,,,fee schedule,,,22.41,83,,percent of total billed charges,,,,,,,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,3.08,25.65,
GLUC QUAN BLD,82947,CDM,82947,CPT,,,both,,34,34,,,,,,,,,,,,,3.82,,,,fee schedule,,,28.9,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.82,,,,fee schedule,,,,,,,,3.82,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,10.2,83,,percent of total billed charges,,3.82,,,,fee schedule,,3.82,,,,fee schedule,,,28.22,83,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,3.5,32.3,
GLUCOSE IN/OUT  BLD RGNT STRIP,82948,CDM,82948,CPT,,,both,,22,22,,,,,,,,,,,,,1.72,,,,fee schedule,,,18.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,1.72,,,,fee schedule,,,,,,,,1.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,20.02,91,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,6.6,83,,percent of total billed charges,,1.72,,,,fee schedule,,1.72,,,,fee schedule,,,18.26,83,,percent of total billed charges,,,,,,,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,1.72,20.9,
GLUC POST GLUC DOSE GLUC,82950,CDM,82950,CPT,,,both,,62,62,,,,,,,,,,,,,4.66,,,,fee schedule,,,52.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.66,,,,fee schedule,,,,,,,,4.66,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,4.66,,,,fee schedule,,4.66,,,,fee schedule,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,3.5,58.9,
GLUC TOLERANCE TST GTT 3 SPEC GLUC,82951,CDM,82951,CPT,,,both,,76,76,,,,,,,,,,,,,12.6,,,,fee schedule,,,64.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.6,,,,fee schedule,,,,,,,,12.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,12.6,,,,fee schedule,,12.6,,,,fee schedule,,,63.08,83,,percent of total billed charges,,,,,,,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,3.5,72.2,
GTT-ADDED SAMPLES,82952,CDM,82952,CPT,,,both,,22,22,,,,,,,,,,,,,11.46,,,,fee schedule,,,18.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.46,,,,fee schedule,,,,,,,,11.46,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,20.02,91,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,6.6,83,,percent of total billed charges,,11.46,,,,fee schedule,,11.46,,,,fee schedule,,,18.26,83,,percent of total billed charges,,,,,,,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,3.5,20.9,
ASSAY OF G6PD ENZYME,82955,CDM,82955,CPT,,,both,,64,64,,,,,,,,,,,,,8.62,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.62,,,,fee schedule,,,,,,,,8.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,8.62,,,,fee schedule,,8.62,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
TEST FOR G6PD ENZYME,82960,CDM,82960,CPT,,,both,,40,40,,,,,,,,,,,,,5.92,,,,fee schedule,,,34,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.92,,,,fee schedule,,,,,,,,5.92,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,12,83,,percent of total billed charges,,5.92,,,,fee schedule,,5.92,,,,fee schedule,,,33.2,83,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,3.5,38,
GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE,82962,CDM,82962,CPT,,,both,,18,18,,,,,,,,,,,,,1.68,,,,fee schedule,,,15.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,1.68,,,,fee schedule,,,,,,,,1.68,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,5.4,83,,percent of total billed charges,,1.68,,,,fee schedule,,1.68,,,,fee schedule,,,14.94,83,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,1.68,17.1,
GLUTAMYLTRASE GAMMA,82977,CDM,82977,CPT,,,both,,40,40,,,,,,,,,,,,,5.4,,,,fee schedule,,,34,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.4,,,,fee schedule,,,,,,,,5.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,12,83,,percent of total billed charges,,5.4,,,,fee schedule,,5.4,,,,fee schedule,,,33.2,83,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,3.5,38,
GLYCATED PROTEIN,82985,CDM,82985,CPT,,,both,,59,59,,,,,,,,,,,,,13.42,,,,fee schedule,,,50.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.42,,,,fee schedule,,,,,,,,13.42,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,17.7,83,,percent of total billed charges,,13.42,,,,fee schedule,,13.42,,,,fee schedule,,,48.97,83,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,3.5,56.05,
GONAD FOLLICLE STIMULATING HORM,83001,CDM,83001,CPT,,,both,,90,90,,,,,,,,,,,,,18.18,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,18.18,,,,fee schedule,,,,,,,,18.18,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,18.18,,,,fee schedule,,18.18,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
GONAD LTNZNG HORM,83002,CDM,83002,CPT,,,both,,90,90,,,,,,,,,,,,,8.86,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.86,,,,fee schedule,,,,,,,,8.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,8.86,,,,fee schedule,,8.86,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
"ASSAY OF HAPTOGLOBIN, QUANT",83010,CDM,83010,CPT,,,both,,95,95,,,,,,,,,,,,,8.86,,,,fee schedule,,,80.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.86,,,,fee schedule,,,,,,,,8.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,28.5,83,,percent of total billed charges,,8.86,,,,fee schedule,,8.86,,,,fee schedule,,,78.85,83,,percent of total billed charges,,,,,,,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,3.5,90.25,
"H PYLORI (C-13), BREATH",83013,CDM,83013,CPT,,,both,,307,307,,,,,,,,,,,,,8.62,,,,fee schedule,,,260.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.62,,,,fee schedule,,,,,,,,8.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,279.37,91,,percent of total billed charges,,,291.65,95,,percent of total billed charges,,,254.81,83,,percent of total billed charges,,,92.1,83,,percent of total billed charges,,8.62,,,,fee schedule,,8.62,,,,fee schedule,,,254.81,83,,percent of total billed charges,,,,,,,,,276.3,90,,percent of total billed charges,,,276.3,90,,percent of total billed charges,,,276.3,90,,percent of total billed charges,,,276.3,90,,percent of total billed charges,,,260.95,85,,percent of total billed charges,,3.5,291.65,
"QUANTITATIVE SCREEN, METALS",83018,CDM,83018,CPT,,,both,,193,193,,,,,,,,,,,,,32.62,,,,fee schedule,,,164.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,32.62,,,,fee schedule,,,,,,,,32.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,175.63,91,,percent of total billed charges,,,183.35,95,,percent of total billed charges,,,160.19,83,,percent of total billed charges,,,57.9,83,,percent of total billed charges,,32.62,,,,fee schedule,,32.62,,,,fee schedule,,,160.19,83,,percent of total billed charges,,,,,,,,,173.7,90,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,164.05,85,,percent of total billed charges,,3.5,183.35,
HEMOGLOBIN ELECTROPHORESIS,83020,CDM,83020,CPT,,,both,,77,77,,,,,,,,,,,,,17.24,,,,fee schedule,,,65.45,85,,percent of total billed charges,,26.46,,,,fee schedule,,18.7,,,,fee schedule,,17.24,,,,fee schedule,,,,,,,,17.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,17.24,,,,fee schedule,,17.24,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,17.24,73.15,
HEMOGLOBIN CHROMOTOGRAPHY,83021,CDM,83021,CPT,,,both,,54,54,,,,,,,,,,,,,24.36,,,,fee schedule,,,45.9,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,24.36,,,,fee schedule,,,,,,,,24.36,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,49.14,91,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,16.2,83,,percent of total billed charges,,24.36,,,,fee schedule,,24.36,,,,fee schedule,,,44.82,83,,percent of total billed charges,,,,,,,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,3.5,51.3,
Hb A1C IN/OUT,83036,CDM,83036,CPT,,,both,,84,84,,,,,,,,,,,,,6.3,,,,fee schedule,,,71.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.3,,,,fee schedule,,,,,,,,6.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,25.2,83,,percent of total billed charges,,6.3,,,,fee schedule,,6.3,,,,fee schedule,,,69.72,83,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,3.5,79.8,
BLOOD METHEMOGLOBIN ASSAY,83050,CDM,83050,CPT,,,both,,61,61,,,,,,,,,,,,,3,,,,fee schedule,,,51.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3,,,,fee schedule,,,,,,,,3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,55.51,91,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,18.3,83,,percent of total billed charges,,3,,,,fee schedule,,3,,,,fee schedule,,,50.63,83,,percent of total billed charges,,,,,,,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,3,57.95,
HOMOCSTEINE,83090,CDM,83090,CPT,,,both,,150,150,,,,,,,,,,,,,26.4,,,,fee schedule,,,127.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,26.4,,,,fee schedule,,,,,,,,26.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,26.4,,,,fee schedule,,26.4,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,3.5,142.5,
ASSAY OF CORTICOSTEROIDS,83491,CDM,83491,CPT,,,both,,106,106,,,,,,,,,,,,,7.16,,,,fee schedule,,,90.1,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,7.16,,,,fee schedule,,,,,,,,7.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,31.8,83,,percent of total billed charges,,7.16,,,,fee schedule,,7.16,,,,fee schedule,,,87.98,83,,percent of total billed charges,,,,,,,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,3.5,100.7,
ASSAY OF 5-HIAA,83497,CDM,83497,CPT,,,both,,74,74,,,,,,,,,,,,,12.64,,,,fee schedule,,,62.9,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.64,,,,fee schedule,,,,,,,,12.64,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,22.2,83,,percent of total billed charges,,12.64,,,,fee schedule,,12.64,,,,fee schedule,,,61.42,83,,percent of total billed charges,,,,,,,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,3.5,70.3,
ASSAY OF PROGESTERONE,83498,CDM,83498,CPT,,,both,,150,150,,,,,,,,,,,,,17.72,,,,fee schedule,,,127.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.72,,,,fee schedule,,,,,,,,17.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,17.72,,,,fee schedule,,17.72,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,3.5,142.5,
"ASSAY, TOTAL HYDROXYPROLINE",83505,CDM,83505,CPT,,,both,,271,271,,,,,,,,,,,,,17.7,,,,fee schedule,,,230.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.7,,,,fee schedule,,,,,,,,17.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,246.61,91,,percent of total billed charges,,,257.45,95,,percent of total billed charges,,,224.93,83,,percent of total billed charges,,,81.3,83,,percent of total billed charges,,17.7,,,,fee schedule,,17.7,,,,fee schedule,,,224.93,83,,percent of total billed charges,,,,,,,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,230.35,85,,percent of total billed charges,,3.5,257.45,
"Gliadin Antibody, IgA",83516,CDM,83516,CPT,,,both,,84,84,,,,,,,,,,,,,8.78,,,,fee schedule,,,71.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.78,,,,fee schedule,,,,,,,,8.78,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,25.2,83,,percent of total billed charges,,8.78,,,,fee schedule,,8.78,,,,fee schedule,,,69.72,83,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,3.5,79.8,
"Gliadin Antibody, IgG",83516a,CDM,83516,CPT,,,both,,79,79,,,,,,,,,,,,,8.78,,,,fee schedule,,,67.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.78,,,,fee schedule,,,,,,,,8.78,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,23.7,83,,percent of total billed charges,,8.78,,,,fee schedule,,8.78,,,,fee schedule,,,65.57,83,,percent of total billed charges,,,,,,,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,3.5,75.05,
Ribosomal P Antibody,83516b,CDM,83516,CPT,,,both,,116,116,,,,,,,,,,,,,8.78,,,,fee schedule,,,98.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.78,,,,fee schedule,,,,,,,,8.78,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,105.56,91,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,34.8,83,,percent of total billed charges,,8.78,,,,fee schedule,,8.78,,,,fee schedule,,,96.28,83,,percent of total billed charges,,,,,,,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,98.6,85,,percent of total billed charges,,3.5,110.2,
"Tissue Transglutaminase Antibody, IgA",83516c,CDM,83516,CPT,,,both,,150,150,,,,,,,,,,,,,8.78,,,,fee schedule,,,127.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.78,,,,fee schedule,,,,,,,,8.78,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,8.78,,,,fee schedule,,8.78,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,3.5,142.5,
IMMUNOASSAY ANALYTE QUAL/SEMIQUAL SINGLE STEP,83518,CDM,83518,CPT,,,both,,61,61,,,,,,,,,,,,,16.56,,,,fee schedule,,,51.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,16.56,,,,fee schedule,,,,,,,,16.56,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,55.51,91,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,18.3,83,,percent of total billed charges,,16.56,,,,fee schedule,,16.56,,,,fee schedule,,,50.63,83,,percent of total billed charges,,,,,,,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,3.5,57.95,
"IMMUNOASSAY, NONANTIBODY",83519,CDM,83519,CPT,,,both,,62,62,,,,,,,,,,,,,13.2,,,,fee schedule,,,52.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.2,,,,fee schedule,,,,,,,,13.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,13.2,,,,fee schedule,,13.2,,,,fee schedule,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,3.5,58.9,
IMMUNOASSAY ANALYTE QUANTITATIVE NOS,83520,CDM,83520,CPT,,,both,,187,187,,,,,,,,,,,,,12.68,,,,fee schedule,,,158.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.68,,,,fee schedule,,,,,,,,12.68,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,56.1,83,,percent of total billed charges,,12.68,,,,fee schedule,,12.68,,,,fee schedule,,,155.21,83,,percent of total billed charges,,,,,,,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,3.5,177.65,
INSULIN TOT,83525,CDM,83525,CPT,,,both,,113,113,,,,,,,,,,,,,8.86,,,,fee schedule,,,96.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.86,,,,fee schedule,,,,,,,,8.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,33.9,83,,percent of total billed charges,,8.86,,,,fee schedule,,8.86,,,,fee schedule,,,93.79,83,,percent of total billed charges,,,,,,,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,3.5,107.35,
ASSAY OF INSULIN,83527,CDM,83527,CPT,,,both,,64,64,,,,,,,,,,,,,8.86,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.86,,,,fee schedule,,,,,,,,8.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,8.86,,,,fee schedule,,8.86,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
IRON,83540,CDM,83540,CPT,,,both,,64,64,,,,,,,,,,,,,12.76,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.76,,,,fee schedule,,,,,,,,12.76,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,12.76,,,,fee schedule,,12.76,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
IRON BNDNG CAP,83550,CDM,83550,CPT,,,both,,64,64,,,,,,,,,,,,,8.56,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.56,,,,fee schedule,,,,,,,,8.56,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,8.56,,,,fee schedule,,8.56,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
ASSAY 17- KETOSTEROIDS,83586,CDM,83586,CPT,,,both,,64,64,,,,,,,,,,,,,6.56,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.56,,,,fee schedule,,,,,,,,6.56,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,6.56,,,,fee schedule,,6.56,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
LACTATE,83605,CDM,83605,CPT,,,both,,64,64,,,,,,,,,,,,,26.58,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,26.58,,,,fee schedule,,,,,,,,26.58,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,26.58,,,,fee schedule,,26.58,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
LACTATE DEHYD,83615,CDM,83615,CPT,,,both,,64,64,,,,,,,,,,,,,11.84,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.84,,,,fee schedule,,,,,,,,11.84,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,11.84,,,,fee schedule,,11.84,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
ASSAY OF LDH ENZYMES,83625,CDM,83625,CPT,,,both,,90,90,,,,,,,,,,,,,10.42,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.42,,,,fee schedule,,,,,,,,10.42,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,10.42,,,,fee schedule,,10.42,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
LEAD,83655,CDM,83655,CPT,,,both,,64,64,,,,,,,,,,,,,11.86,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.86,,,,fee schedule,,,,,,,,11.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,11.86,,,,fee schedule,,11.86,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
LIPASE,83690,CDM,83690,CPT,,,both,,64,64,,,,,,,,,,,,,13.44,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.44,,,,fee schedule,,,,,,,,13.44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,13.44,,,,fee schedule,,13.44,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
ASSAY OF LIPOPROTEIN(A),83695,CDM,83695,CPT,,,both,,84,84,,,,,,,,,,,,,8.14,,,,fee schedule,,,71.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.14,,,,fee schedule,,,,,,,,8.14,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,25.2,83,,percent of total billed charges,,8.14,,,,fee schedule,,8.14,,,,fee schedule,,,69.72,83,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,3.5,79.8,
ASSAY LIPOPROTEIN PLA2,83698,CDM,83698,CPT,,,both,,187,187,,,,,,,,,,,,,17.84,,,,fee schedule,,,158.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.84,,,,fee schedule,,,,,,,,17.84,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,56.1,83,,percent of total billed charges,,17.84,,,,fee schedule,,17.84,,,,fee schedule,,,155.21,83,,percent of total billed charges,,,,,,,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,3.5,177.65,
LIPOPROTEIN BLD HR SUBCLASSES,83701,CDM,83701,CPT,,,both,,96,96,,,,,,,,,,,,,15.6,,,,fee schedule,,,81.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.6,,,,fee schedule,,,,,,,,15.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,87.36,91,,percent of total billed charges,,,91.2,95,,percent of total billed charges,,,79.68,83,,percent of total billed charges,,,28.8,83,,percent of total billed charges,,15.6,,,,fee schedule,,15.6,,,,fee schedule,,,79.68,83,,percent of total billed charges,,,,,,,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,81.6,85,,percent of total billed charges,,3.5,91.2,
"LIPOPROTEIN, BLD, BY NMR",83704,CDM,83704,CPT,,,both,,189,189,,,,,,,,,,,,,19.84,,,,fee schedule,,,160.65,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,19.84,,,,fee schedule,,,,,,,,19.84,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,56.7,83,,percent of total billed charges,,19.84,,,,fee schedule,,19.84,,,,fee schedule,,,156.87,83,,percent of total billed charges,,,,,,,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,3.5,179.55,
ASSAY OF LIPOPROTEIN,83718,CDM,83718,CPT,,,both,,64,64,,,,,,,,,,,,,8.02,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.02,,,,fee schedule,,,,,,,,8.02,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,8.02,,,,fee schedule,,8.02,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
ASSAY OF BLOOD LIPOPROTEIN,83721,CDM,83721,CPT,,,both,,53,53,,,,,,,,,,,,,9.34,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9.34,,,,fee schedule,,,,,,,,9.34,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,9.34,,,,fee schedule,,9.34,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
MAGNESIUM,83735,CDM,83735,CPT,,,both,,64,64,,,,,,,,,,,,,26.24,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,26.24,,,,fee schedule,,,,,,,,26.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,26.24,,,,fee schedule,,26.24,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
BILE ACIDS FRACTIONATED,83789,CDM,83789,CPT,,,both,,87,87,,,,,,,,,,,,,14.32,,,,fee schedule,,,73.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,14.32,,,,fee schedule,,,,,,,,14.32,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,26.1,83,,percent of total billed charges,,14.32,,,,fee schedule,,14.32,,,,fee schedule,,,72.21,83,,percent of total billed charges,,,,,,,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,3.5,82.65,
ASSAY OF MERCURY,83825,CDM,83825,CPT,,,both,,441,441,,,,,,,,,,,,,15.84,,,,fee schedule,,,374.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.84,,,,fee schedule,,,,,,,,15.84,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,401.31,91,,percent of total billed charges,,,418.95,95,,percent of total billed charges,,,366.03,83,,percent of total billed charges,,,132.3,83,,percent of total billed charges,,15.84,,,,fee schedule,,15.84,,,,fee schedule,,,366.03,83,,percent of total billed charges,,,,,,,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,396.9,90,,percent of total billed charges,,,374.85,85,,percent of total billed charges,,3.5,418.95,
ASSAY OF METANEPHRINES,83835,CDM,83835,CPT,,,both,,127,127,,,,,,,,,,,,,26.84,,,,fee schedule,,,107.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,26.84,,,,fee schedule,,,,,,,,26.84,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,26.84,,,,fee schedule,,26.84,,,,fee schedule,,,105.41,83,,percent of total billed charges,,,,,,,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,3.5,120.65,
MYOGLOBIN,83874,CDM,83874,CPT,,,both,,78,78,,,,,,,,,,,,,12.64,,,,fee schedule,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.64,,,,fee schedule,,,,,,,,12.64,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,12.64,,,,fee schedule,,12.64,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
"ASSAY, MYELOPEROXIDASE",83876,CDM,83876,CPT,,,both,,176,176,,,,,,,,,,,,,22.72,,,,fee schedule,,,149.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,22.72,,,,fee schedule,,,,,,,,22.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,52.8,83,,percent of total billed charges,,22.72,,,,fee schedule,,22.72,,,,fee schedule,,,146.08,83,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,3.5,167.2,
NATRIURETIC PEPTIDE,83880,CDM,83880,CPT,,,both,,271,271,,,,,,,,,,,,,14.86,,,,fee schedule,,,230.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,14.86,,,,fee schedule,,,,,,,,14.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,246.61,91,,percent of total billed charges,,,257.45,95,,percent of total billed charges,,,224.93,83,,percent of total billed charges,,,81.3,83,,percent of total billed charges,,14.86,,,,fee schedule,,14.86,,,,fee schedule,,,224.93,83,,percent of total billed charges,,,,,,,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,230.35,85,,percent of total billed charges,,3.5,257.45,
"ASSAY, NEPHELOMETRY NOT SPEC",83883,CDM,83883,CPT,,,both,,256,256,,,,,,,,,,,,,10.44,,,,fee schedule,,,217.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.44,,,,fee schedule,,,,,,,,10.44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,232.96,91,,percent of total billed charges,,,243.2,95,,percent of total billed charges,,,212.48,83,,percent of total billed charges,,,76.8,83,,percent of total billed charges,,10.44,,,,fee schedule,,10.44,,,,fee schedule,,,212.48,83,,percent of total billed charges,,,,,,,,,230.4,90,,percent of total billed charges,,,230.4,90,,percent of total billed charges,,,230.4,90,,percent of total billed charges,,,230.4,90,,percent of total billed charges,,,217.6,85,,percent of total billed charges,,3.5,243.2,
ASSAY OF NICOTINE,83887,CDM,83887,CPT,,,both,,53,53,,,,,,,,,,,,,,,,,,,,45.05,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,15.9,50.35,
MOLECULE ISOLATE,83890,CDM,83890,CPT,,,both,,21,21,,,,,,,,,,,,,,,,,,,,17.85,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,6.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,,,,,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,6.3,19.95,
MOLEC ISOL/XTRJ HP NUCLEIC ACID EA TYPE,83891,CDM,83891,CPT,,,both,,21,21,,,,,,,,,,,,,,,,,,,,17.85,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,6.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,,,,,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,6.3,19.95,
MOLECULAR DIAGNOSTICS,83892,CDM,83892,CPT,,,both,,20,20,,,,,,,,,,,,,,,,,,,,17,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.2,91,,percent of total billed charges,,,19,95,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,6,83,,percent of total billed charges,,,,,,,,,,,,,,,16.6,83,,percent of total billed charges,,,,,,,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,17,85,,percent of total billed charges,,6,19,
MOLECULAR DX AMP TARGET MULTIPLEX 1ST 2 SEQ,83900,CDM,83900,CPT,,,both,,141,141,,,,,,,,,,,,,,,,,,,,119.85,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,128.31,91,,percent of total billed charges,,,133.95,95,,percent of total billed charges,,,117.03,83,,percent of total billed charges,,,42.3,83,,percent of total billed charges,,,,,,,,,,,,,,,117.03,83,,percent of total billed charges,,,,,,,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,119.85,85,,percent of total billed charges,,42.3,133.95,
MOLECULAR DX AMP TARGET MULTIPLEX EA ADDL SEQ,83901,CDM,83901,CPT,,,both,,61,61,,,,,,,,,,,,,,,,,,,,51.85,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,55.51,91,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,18.3,83,,percent of total billed charges,,,,,,,,,,,,,,,50.63,83,,percent of total billed charges,,,,,,,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,18.3,57.95,
MOLEC SEP   ID HR TQ,83909,CDM,83909,CPT,,,both,,71,71,,,,,,,,,,,,,,,,,,,,60.35,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,21.3,83,,percent of total billed charges,,,,,,,,,,,,,,,58.93,83,,percent of total billed charges,,,,,,,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,21.3,67.45,
MOLEC DX I/R,83912,CDM,83912,CPT,,,both,,22,22,,,,,,,,,,,,,,,,,,,,18.7,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.02,91,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,6.6,83,,percent of total billed charges,,,,,,,,,,,,,,,18.26,83,,percent of total billed charges,,,,,,,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,6.6,20.9,
ASSAY OF NUCLEOTIDASE,83915,CDM,83915,CPT,,,both,,100,100,,,,,,,,,,,,,5.4,,,,fee schedule,,,85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.4,,,,fee schedule,,,,,,,,5.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,30,83,,percent of total billed charges,,5.4,,,,fee schedule,,5.4,,,,fee schedule,,,83,83,,percent of total billed charges,,,,,,,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,3.5,95,
ORGANIC ACIDS TOT QUAN EA SPEC,83918,CDM,83918,CPT,,,both,,285,285,,,,,,,,,,,,,32.24,,,,fee schedule,,,242.25,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,32.24,,,,fee schedule,,,,,,,,32.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,259.35,91,,percent of total billed charges,,,270.75,95,,percent of total billed charges,,,236.55,83,,percent of total billed charges,,,85.5,83,,percent of total billed charges,,32.24,,,,fee schedule,,32.24,,,,fee schedule,,,236.55,83,,percent of total billed charges,,,,,,,,,256.5,90,,percent of total billed charges,,,256.5,90,,percent of total billed charges,,,256.5,90,,percent of total billed charges,,,256.5,90,,percent of total billed charges,,,242.25,85,,percent of total billed charges,,3.5,270.75,
ORGANIC ACIDS QUAL EA SPEC,83919,CDM,83919,CPT,,,both,,79,79,,,,,,,,,,,,,16.12,,,,fee schedule,,,67.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,16.12,,,,fee schedule,,,,,,,,16.12,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,23.7,83,,percent of total billed charges,,16.12,,,,fee schedule,,16.12,,,,fee schedule,,,65.57,83,,percent of total billed charges,,,,,,,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,3.5,75.05,
ORGANIC ACID 1 QUAN,83921,CDM,83921,CPT,,,both,,271,271,,,,,,,,,,,,,25.8,,,,fee schedule,,,230.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,25.8,,,,fee schedule,,,,,,,,25.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,246.61,91,,percent of total billed charges,,,257.45,95,,percent of total billed charges,,,224.93,83,,percent of total billed charges,,,81.3,83,,percent of total billed charges,,25.8,,,,fee schedule,,25.8,,,,fee schedule,,,224.93,83,,percent of total billed charges,,,,,,,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,230.35,85,,percent of total billed charges,,3.5,257.45,
ASSAY OF OPIATES,83925,CDM,83925,CPT,,,both,,211,211,,,,,,,,,,,,,,,,,,,,179.35,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,63.3,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,,,,,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,63.3,200.45,
ASSAY OF URINE OSMOLALITY,83935,CDM,83935,CPT,,,both,,64,64,,,,,,,,,,,,,9.32,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9.32,,,,fee schedule,,,,,,,,9.32,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,9.32,,,,fee schedule,,9.32,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
ASSAY OF OSTEOCALCIN,83937,CDM,83937,CPT,,,both,,74,74,,,,,,,,,,,,,13.42,,,,fee schedule,,,62.9,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.42,,,,fee schedule,,,,,,,,13.42,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,22.2,83,,percent of total billed charges,,13.42,,,,fee schedule,,13.42,,,,fee schedule,,,61.42,83,,percent of total billed charges,,,,,,,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,3.5,70.3,
ASSAY OF OXALATE,83945,CDM,83945,CPT,,,both,,145,145,,,,,,,,,,,,,6.16,,,,fee schedule,,,123.25,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.16,,,,fee schedule,,,,,,,,6.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,43.5,83,,percent of total billed charges,,6.16,,,,fee schedule,,6.16,,,,fee schedule,,,120.35,83,,percent of total billed charges,,,,,,,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,3.5,137.75,
PARATHORM,83970,CDM,83970,CPT,,,both,,271,271,,,,,,,,,,,,,62.24,,,,fee schedule,,,230.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,62.24,,,,fee schedule,,,,,,,,62.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,246.61,91,,percent of total billed charges,,,257.45,95,,percent of total billed charges,,,224.93,83,,percent of total billed charges,,,81.3,83,,percent of total billed charges,,62.24,,,,fee schedule,,62.24,,,,fee schedule,,,224.93,83,,percent of total billed charges,,,,,,,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,230.35,85,,percent of total billed charges,,3.5,257.45,
CALPROTECTIN FECAL,83993,CDM,83993,CPT,,,both,,93,93,,,,,,,,,,,,,12.34,,,,fee schedule,,,79.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.34,,,,fee schedule,,,,,,,,12.34,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,12.34,,,,fee schedule,,12.34,,,,fee schedule,,,77.19,83,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,3.5,88.35,
ASSAY OF PHENOTHIAZINE,84022,CDM,84022,CPT,,,both,,187,187,,,,,,,,,,,,,,,,,,,,158.95,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,56.1,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,,,,,,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,56.1,177.65,
ASSAY PROSTATE PHOSPHATASE,84066,CDM,84066,CPT,,,both,,70,70,,,,,,,,,,,,,3.08,,,,fee schedule,,,59.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.08,,,,fee schedule,,,,,,,,3.08,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,63.7,91,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,21,83,,percent of total billed charges,,3.08,,,,fee schedule,,3.08,,,,fee schedule,,,58.1,83,,percent of total billed charges,,,,,,,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,3.08,66.5,
PHOSPHATASE ALKALINE,84075,CDM,84075,CPT,,,both,,53,53,,,,,,,,,,,,,10.04,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.04,,,,fee schedule,,,,,,,,10.04,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,10.04,,,,fee schedule,,10.04,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
ASSAY ALKALINE PHOSPHATASES,84080,CDM,84080,CPT,,,both,,127,127,,,,,,,,,,,,,8.86,,,,fee schedule,,,107.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.86,,,,fee schedule,,,,,,,,8.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,8.86,,,,fee schedule,,8.86,,,,fee schedule,,,105.41,83,,percent of total billed charges,,,,,,,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,3.5,120.65,
PHOSPHORUS INORGANIC,84100,CDM,84100,CPT,,,both,,64,64,,,,,,,,,,,,,13.98,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.98,,,,fee schedule,,,,,,,,13.98,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,13.98,,,,fee schedule,,13.98,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
ASSAY OF URINE PHOSPHORUS,84105,CDM,84105,CPT,,,both,,20,20,,,,,,,,,,,,,2.26,,,,fee schedule,,,17,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,2.26,,,,fee schedule,,,,,,,,2.26,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,18.2,91,,percent of total billed charges,,,19,95,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,6,83,,percent of total billed charges,,2.26,,,,fee schedule,,2.26,,,,fee schedule,,,16.6,83,,percent of total billed charges,,,,,,,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,17,85,,percent of total billed charges,,2.26,19,
PORPHOBILINOGEN URINE QUAN,84110,CDM,84110,CPT,,,both,,49,49,,,,,,,,,,,,,4.66,,,,fee schedule,,,41.65,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.66,,,,fee schedule,,,,,,,,4.66,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,44.59,91,,percent of total billed charges,,,46.55,95,,percent of total billed charges,,,40.67,83,,percent of total billed charges,,,14.7,83,,percent of total billed charges,,4.66,,,,fee schedule,,4.66,,,,fee schedule,,,40.67,83,,percent of total billed charges,,,,,,,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,41.65,85,,percent of total billed charges,,3.5,46.55,
ASSAY OF URINE PORPHYRINS,84120,CDM,84120,CPT,,,both,,187,187,,,,,,,,,,,,,13.42,,,,fee schedule,,,158.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.42,,,,fee schedule,,,,,,,,13.42,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,56.1,83,,percent of total billed charges,,13.42,,,,fee schedule,,13.42,,,,fee schedule,,,155.21,83,,percent of total billed charges,,,,,,,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,3.5,177.65,
ASSAY OF FECES PORPHYRINS,84126,CDM,84126,CPT,,,both,,501,501,,,,,,,,,,,,,21.9,,,,fee schedule,,,425.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,21.9,,,,fee schedule,,,,,,,,21.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,455.91,91,,percent of total billed charges,,,475.95,95,,percent of total billed charges,,,415.83,83,,percent of total billed charges,,,150.3,83,,percent of total billed charges,,21.9,,,,fee schedule,,21.9,,,,fee schedule,,,415.83,83,,percent of total billed charges,,,,,,,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,450.9,90,,percent of total billed charges,,,425.85,85,,percent of total billed charges,,3.5,475.95,
POTASSIUM SERUM PLASMA/WHOLE BLOOD,84132,CDM,84132,CPT,,,both,,41,41,,,,,,,,,,,,,13.5,,,,fee schedule,,,34.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.5,,,,fee schedule,,,,,,,,13.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,13.5,,,,fee schedule,,13.5,,,,fee schedule,,,34.03,83,,percent of total billed charges,,,,,,,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,3.5,38.95,
ASSAY OF URINE POTASSIUM,84133,CDM,84133,CPT,,,both,,53,53,,,,,,,,,,,,,8.4,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.4,,,,fee schedule,,,,,,,,8.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,8.4,,,,fee schedule,,8.4,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
ASSAY OF PREALBUMIN,84134,CDM,84134,CPT,,,both,,77,77,,,,,,,,,,,,,5.58,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.58,,,,fee schedule,,,,,,,,5.58,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,5.58,,,,fee schedule,,5.58,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
ASSAY OF PREGNANEDIOL,84135,CDM,84135,CPT,,,both,,68,68,,,,,,,,,,,,,7.92,,,,fee schedule,,,57.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,7.92,,,,fee schedule,,,,,,,,7.92,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,7.92,,,,fee schedule,,7.92,,,,fee schedule,,,56.44,83,,percent of total billed charges,,,,,,,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,3.5,64.6,
ASSAY OF PREGNENOLONE,84140,CDM,84140,CPT,,,both,,97,97,,,,,,,,,,,,,8.86,,,,fee schedule,,,82.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.86,,,,fee schedule,,,,,,,,8.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,29.1,83,,percent of total billed charges,,8.86,,,,fee schedule,,8.86,,,,fee schedule,,,80.51,83,,percent of total billed charges,,,,,,,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,3.5,92.15,
ASSAY OF 17-HYDROXYPREGNENO,84143,CDM,84143,CPT,,,both,,50,50,,,,,,,,,,,,,18.44,,,,fee schedule,,,42.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,18.44,,,,fee schedule,,,,,,,,18.44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,18.44,,,,fee schedule,,18.44,,,,fee schedule,,,41.5,83,,percent of total billed charges,,,,,,,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,3.5,47.5,
PROGST,84144,CDM,84144,CPT,,,both,,95,95,,,,,,,,,,,,,9.22,,,,fee schedule,,,80.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9.22,,,,fee schedule,,,,,,,,9.22,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,28.5,83,,percent of total billed charges,,9.22,,,,fee schedule,,9.22,,,,fee schedule,,,78.85,83,,percent of total billed charges,,,,,,,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,3.5,90.25,
ASSAY OF PROLACTIN,84146,CDM,84146,CPT,,,both,,95,95,,,,,,,,,,,,,40.26,,,,fee schedule,,,80.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,40.26,,,,fee schedule,,,,,,,,40.26,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,28.5,83,,percent of total billed charges,,40.26,,,,fee schedule,,40.26,,,,fee schedule,,,78.85,83,,percent of total billed charges,,,,,,,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,3.5,90.25,
"ASSAY OF PSA, COMPLEXED",84152,CDM,84152,CPT,,,both,,130,130,,,,,,,,,,,,,14.4,,,,fee schedule,,,110.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,14.4,,,,fee schedule,,,,,,,,14.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,39,83,,percent of total billed charges,,14.4,,,,fee schedule,,14.4,,,,fee schedule,,,107.9,83,,percent of total billed charges,,,,,,,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,3.5,123.5,
PRST8 SPEC AG TOT,84153,CDM,84153,CPT,,,both,,95,95,,,,,,,,,,,,,13.2,,,,fee schedule,,,80.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.2,,,,fee schedule,,,,,,,,13.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,28.5,83,,percent of total billed charges,,13.2,,,,fee schedule,,13.2,,,,fee schedule,,,78.85,83,,percent of total billed charges,,,,,,,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,3.5,90.25,
PRST8 SPEC AG FR,84154,CDM,84154,CPT,,,both,,95,95,,,,,,,,,,,,,13.2,,,,fee schedule,,,80.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.2,,,,fee schedule,,,,,,,,13.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,28.5,83,,percent of total billed charges,,13.2,,,,fee schedule,,13.2,,,,fee schedule,,,78.85,83,,percent of total billed charges,,,,,,,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,3.5,90.25,
PROTEIN XCPT REFRACTOMETRY SERUM PLASMA/WHL BLD,84155,CDM,84155,CPT,,,both,,53,53,,,,,,,,,,,,,3.6,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.6,,,,fee schedule,,,,,,,,3.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,3.6,,,,fee schedule,,3.6,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
PROTEIN TOT XCPT REFRACTOMETRY URINE,84156,CDM,84156,CPT,,,both,,62,62,,,,,,,,,,,,,2.3,,,,fee schedule,,,52.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,2.3,,,,fee schedule,,,,,,,,2.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,2.3,,,,fee schedule,,2.3,,,,fee schedule,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,2.3,58.9,
"ASSAY OF PROTEIN, OTHER",84157,CDM,84157,CPT,,,both,,62,62,,,,,,,,,,,,,6.9,,,,fee schedule,,,52.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.9,,,,fee schedule,,,,,,,,6.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,6.9,,,,fee schedule,,6.9,,,,fee schedule,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,3.5,58.9,
PROTEIN ELECTROP FXJ  QUAN SERUM,84165,CDM,84165,CPT,,,both,,62,62,,,,,,,,,,,,,10.5,,,,fee schedule,,,52.7,85,,percent of total billed charges,,26.46,,,,fee schedule,,18.7,,,,fee schedule,,10.5,,,,fee schedule,,,,,,,,10.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,10.5,,,,fee schedule,,10.5,,,,fee schedule,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,10.5,58.9,
PROTEIN E-PHORESIS/URINE/CSF,84166,CDM,84166,CPT,,,both,,135,135,,,,,,,,,,,,,22.44,,,,fee schedule,,,114.75,85,,percent of total billed charges,,26.46,,,,fee schedule,,18.7,,,,fee schedule,,22.44,,,,fee schedule,,,,,,,,22.44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,40.5,83,,percent of total billed charges,,22.44,,,,fee schedule,,22.44,,,,fee schedule,,,112.05,83,,percent of total billed charges,,,,,,,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,18.7,128.25,
ASSAY RBC PROTOPORPHYRIN,84202,CDM,84202,CPT,,,both,,59,59,,,,,,,,,,,,,3.52,,,,fee schedule,,,50.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.52,,,,fee schedule,,,,,,,,3.52,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,17.7,83,,percent of total billed charges,,3.52,,,,fee schedule,,3.52,,,,fee schedule,,,48.97,83,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,3.5,56.05,
ASSAY OF VITAMIN B-6,84207,CDM,84207,CPT,,,both,,162,162,,,,,,,,,,,,,12,,,,fee schedule,,,137.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12,,,,fee schedule,,,,,,,,12,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,48.6,83,,percent of total billed charges,,12,,,,fee schedule,,12,,,,fee schedule,,,134.46,83,,percent of total billed charges,,,,,,,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,3.5,153.9,
"ASSAY, NONENDOCRINE RECEPTOR",84238,CDM,84238,CPT,,,both,,358,358,,,,,,,,,,,,,60.06,,,,fee schedule,,,304.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,60.06,,,,fee schedule,,,,,,,,60.06,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,325.78,91,,percent of total billed charges,,,340.1,95,,percent of total billed charges,,,297.14,83,,percent of total billed charges,,,107.4,83,,percent of total billed charges,,60.06,,,,fee schedule,,60.06,,,,fee schedule,,,297.14,83,,percent of total billed charges,,,,,,,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,304.3,85,,percent of total billed charges,,3.5,340.1,
ASSAY OF VITAMIN B-2,84252,CDM,84252,CPT,,,both,,187,187,,,,,,,,,,,,,2.62,,,,fee schedule,,,158.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,2.62,,,,fee schedule,,,,,,,,2.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,56.1,83,,percent of total billed charges,,2.62,,,,fee schedule,,2.62,,,,fee schedule,,,155.21,83,,percent of total billed charges,,,,,,,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,2.62,177.65,
ASSAY OF SEROTONIN,84260,CDM,84260,CPT,,,both,,127,127,,,,,,,,,,,,,5.02,,,,fee schedule,,,107.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.02,,,,fee schedule,,,,,,,,5.02,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,5.02,,,,fee schedule,,5.02,,,,fee schedule,,,105.41,83,,percent of total billed charges,,,,,,,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,3.5,120.65,
SEX HORM BNDNG GLOBULIN,84270,CDM,84270,CPT,,,both,,109,109,,,,,,,,,,,,,16.38,,,,fee schedule,,,92.65,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,16.38,,,,fee schedule,,,,,,,,16.38,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,32.7,83,,percent of total billed charges,,16.38,,,,fee schedule,,16.38,,,,fee schedule,,,90.47,83,,percent of total billed charges,,,,,,,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,3.5,103.55,
SODIUM SERUM PLASMA OR WHOLE BLOOD,84295,CDM,84295,CPT,,,both,,41,41,,,,,,,,,,,,,13.98,,,,fee schedule,,,34.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.98,,,,fee schedule,,,,,,,,13.98,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,13.98,,,,fee schedule,,13.98,,,,fee schedule,,,34.03,83,,percent of total billed charges,,,,,,,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,3.5,38.95,
ASSAY OF URINE SODIUM,84300,CDM,84300,CPT,,,both,,64,64,,,,,,,,,,,,,8.48,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.48,,,,fee schedule,,,,,,,,8.48,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,8.48,,,,fee schedule,,8.48,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
SOMATOMEDIN,84305,CDM,84305,CPT,,,both,,127,127,,,,,,,,,,,,,15.08,,,,fee schedule,,,107.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.08,,,,fee schedule,,,,,,,,15.08,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,15.08,,,,fee schedule,,15.08,,,,fee schedule,,,105.41,83,,percent of total billed charges,,,,,,,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,3.5,120.65,
"SUGARS, SINGLE, QUAL",84376,CDM,84376,CPT,,,both,,64,64,,,,,,,,,,,,,5.4,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.4,,,,fee schedule,,,,,,,,5.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,5.4,,,,fee schedule,,5.4,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
ASSAY OF URINE SULFATE,84392,CDM,84392,CPT,,,both,,235,235,,,,,,,,,,,,,4.66,,,,fee schedule,,,199.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.66,,,,fee schedule,,,,,,,,4.66,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,213.85,91,,percent of total billed charges,,,223.25,95,,percent of total billed charges,,,195.05,83,,percent of total billed charges,,,70.5,83,,percent of total billed charges,,4.66,,,,fee schedule,,4.66,,,,fee schedule,,,195.05,83,,percent of total billed charges,,,,,,,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,211.5,90,,percent of total billed charges,,,199.75,85,,percent of total billed charges,,3.5,223.25,
TSTOSTERONE FR,84402,CDM,84402,CPT,,,both,,150,150,,,,,,,,,,,,,18.34,,,,fee schedule,,,127.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,18.34,,,,fee schedule,,,,,,,,18.34,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,18.34,,,,fee schedule,,18.34,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,3.5,142.5,
TSTOSTERONE TOT,84403,CDM,84403,CPT,,,both,,135,135,,,,,,,,,,,,,50.56,,,,fee schedule,,,114.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,50.56,,,,fee schedule,,,,,,,,50.56,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,40.5,83,,percent of total billed charges,,50.56,,,,fee schedule,,50.56,,,,fee schedule,,,112.05,83,,percent of total billed charges,,,,,,,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,3.5,128.25,
THIAMINE,84425,CDM,84425,CPT,,,both,,96,96,,,,,,,,,,,,,12.82,,,,fee schedule,,,81.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.82,,,,fee schedule,,,,,,,,12.82,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,87.36,91,,percent of total billed charges,,,91.2,95,,percent of total billed charges,,,79.68,83,,percent of total billed charges,,,28.8,83,,percent of total billed charges,,12.82,,,,fee schedule,,12.82,,,,fee schedule,,,79.68,83,,percent of total billed charges,,,,,,,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,81.6,85,,percent of total billed charges,,3.5,91.2,
ASSAY OF THIOCYANATE,84430,CDM,84430,CPT,,,both,,132,132,,,,,,,,,,,,,7.16,,,,fee schedule,,,112.2,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,7.16,,,,fee schedule,,,,,,,,7.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,39.6,83,,percent of total billed charges,,7.16,,,,fee schedule,,7.16,,,,fee schedule,,,109.56,83,,percent of total billed charges,,,,,,,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,3.5,125.4,
ASSAY OF THYROGLOBULIN,84432,CDM,84432,CPT,,,both,,77,77,,,,,,,,,,,,,15.72,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.72,,,,fee schedule,,,,,,,,15.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,15.72,,,,fee schedule,,15.72,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
THYROXINE TOT,84436,CDM,84436,CPT,,,both,,53,53,,,,,,,,,,,,,6.72,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.72,,,,fee schedule,,,,,,,,6.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,6.72,,,,fee schedule,,6.72,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
THYROXINE FR,84439,CDM,84439,CPT,,,both,,77,77,,,,,,,,,,,,,8.86,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.86,,,,fee schedule,,,,,,,,8.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,8.86,,,,fee schedule,,8.86,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
ASSAY OF THYROID ACTIVITY,84442,CDM,84442,CPT,,,both,,110,110,,,,,,,,,,,,,8.86,,,,fee schedule,,,93.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.86,,,,fee schedule,,,,,,,,8.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,100.1,91,,percent of total billed charges,,,104.5,95,,percent of total billed charges,,,91.3,83,,percent of total billed charges,,,33,83,,percent of total billed charges,,8.86,,,,fee schedule,,8.86,,,,fee schedule,,,91.3,83,,percent of total billed charges,,,,,,,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,93.5,85,,percent of total billed charges,,3.5,104.5,
THYR STIMULATING HORM,84443,CDM,84443,CPT,,,both,,111,111,,,,,,,,,,,,,16.42,,,,fee schedule,,,94.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,16.42,,,,fee schedule,,,,,,,,16.42,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,101.01,91,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,33.3,83,,percent of total billed charges,,16.42,,,,fee schedule,,16.42,,,,fee schedule,,,92.13,83,,percent of total billed charges,,,,,,,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,94.35,85,,percent of total billed charges,,3.5,105.45,
ASSAY OF VITAMIN E,84446,CDM,84446,CPT,,,both,,53,53,,,,,,,,,,,,,8.86,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.86,,,,fee schedule,,,,,,,,8.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,8.86,,,,fee schedule,,8.86,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
TRANSFERASE ASPARTATE AMINO,84450,CDM,84450,CPT,,,both,,59,59,,,,,,,,,,,,,5.02,,,,fee schedule,,,50.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.02,,,,fee schedule,,,,,,,,5.02,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,17.7,83,,percent of total billed charges,,5.02,,,,fee schedule,,5.02,,,,fee schedule,,,48.97,83,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,3.5,56.05,
TRANSFERASE ALANINE AMINO,84460,CDM,84460,CPT,,,both,,53,53,,,,,,,,,,,,,5.18,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.18,,,,fee schedule,,,,,,,,5.18,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,5.18,,,,fee schedule,,5.18,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
ASSAY OF TRANSFERRIN,84466,CDM,84466,CPT,,,both,,44,44,,,,,,,,,,,,,8.78,,,,fee schedule,,,37.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.78,,,,fee schedule,,,,,,,,8.78,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,13.2,83,,percent of total billed charges,,8.78,,,,fee schedule,,8.78,,,,fee schedule,,,36.52,83,,percent of total billed charges,,,,,,,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,3.5,41.8,
TRIGLYCERIDES,84478,CDM,84478,CPT,,,both,,53,53,,,,,,,,,,,,,5.4,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.4,,,,fee schedule,,,,,,,,5.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,5.4,,,,fee schedule,,5.4,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
THYR HORM UPTK/THYR HORM BNDNG RATIO,84479,CDM,84479,CPT,,,both,,64,64,,,,,,,,,,,,,6.38,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.38,,,,fee schedule,,,,,,,,6.38,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,6.38,,,,fee schedule,,6.38,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
TRIIODOTHYRO9 T3 TOT,84480,CDM,84480,CPT,,,both,,100,100,,,,,,,,,,,,,9.56,,,,fee schedule,,,85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9.56,,,,fee schedule,,,,,,,,9.56,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,30,83,,percent of total billed charges,,9.56,,,,fee schedule,,9.56,,,,fee schedule,,,83,83,,percent of total billed charges,,,,,,,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,3.5,95,
TRIIODOTHYRO9 T3 FR,84481,CDM,84481,CPT,,,both,,78,78,,,,,,,,,,,,,10.12,,,,fee schedule,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.12,,,,fee schedule,,,,,,,,10.12,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,10.12,,,,fee schedule,,10.12,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
T3 REVERSE,84482,CDM,84482,CPT,,,both,,100,100,,,,,,,,,,,,,6.82,,,,fee schedule,,,85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.82,,,,fee schedule,,,,,,,,6.82,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,30,83,,percent of total billed charges,,6.82,,,,fee schedule,,6.82,,,,fee schedule,,,83,83,,percent of total billed charges,,,,,,,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,3.5,95,
TROPONIN QUAN,84484,CDM,84484,CPT,,,both,,127,127,,,,,,,,,,,,,14.84,,,,fee schedule,,,107.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,14.84,,,,fee schedule,,,,,,,,14.84,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,14.84,,,,fee schedule,,14.84,,,,fee schedule,,,105.41,83,,percent of total billed charges,,,,,,,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,3.5,120.65,
UREA N QUAN,84520,CDM,84520,CPT,,,both,,41,41,,,,,,,,,,,,,15.44,,,,fee schedule,,,34.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.44,,,,fee schedule,,,,,,,,15.44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,15.44,,,,fee schedule,,15.44,,,,fee schedule,,,34.03,83,,percent of total billed charges,,,,,,,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,3.5,38.95,
URIC ACID BLD,84550,CDM,84550,CPT,,,both,,53,53,,,,,,,,,,,,,4.42,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.42,,,,fee schedule,,,,,,,,4.42,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,4.42,,,,fee schedule,,4.42,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
ASSAY OF URINE/URIC ACID,84560,CDM,84560,CPT,,,both,,53,53,,,,,,,,,,,,,5.24,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.24,,,,fee schedule,,,,,,,,5.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,5.24,,,,fee schedule,,5.24,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
ASSAY OF URINE VMA,84585,CDM,84585,CPT,,,both,,90,90,,,,,,,,,,,,,15.16,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.16,,,,fee schedule,,,,,,,,15.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,15.16,,,,fee schedule,,15.16,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
ASSAY OF VIP,84586,CDM,84586,CPT,,,both,,305,305,,,,,,,,,,,,,28.92,,,,fee schedule,,,259.25,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,28.92,,,,fee schedule,,,,,,,,28.92,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,277.55,91,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,91.5,83,,percent of total billed charges,,28.92,,,,fee schedule,,28.92,,,,fee schedule,,,253.15,83,,percent of total billed charges,,,,,,,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,3.5,289.75,
ASSAY OF VASOPRESSIN,84588,CDM,84588,CPT,,,both,,305,305,,,,,,,,,,,,,9.32,,,,fee schedule,,,259.25,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9.32,,,,fee schedule,,,,,,,,9.32,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,277.55,91,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,91.5,83,,percent of total billed charges,,9.32,,,,fee schedule,,9.32,,,,fee schedule,,,253.15,83,,percent of total billed charges,,,,,,,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,3.5,289.75,
ASSAY OF VITAMIN A,84590,CDM,84590,CPT,,,both,,64,64,,,,,,,,,,,,,4.66,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.66,,,,fee schedule,,,,,,,,4.66,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,4.66,,,,fee schedule,,4.66,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
ASSAY OF NOS VITAMIN,84591,CDM,84591,CPT,,,both,,117,117,,,,,,,,,,,,,9.08,,,,fee schedule,,,99.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9.08,,,,fee schedule,,,,,,,,9.08,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,106.47,91,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,35.1,83,,percent of total billed charges,,9.08,,,,fee schedule,,9.08,,,,fee schedule,,,97.11,83,,percent of total billed charges,,,,,,,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,99.45,85,,percent of total billed charges,,3.5,111.15,
ASSAY OF VITAMIN K,84597,CDM,84597,CPT,,,both,,147,147,,,,,,,,,,,,,5.02,,,,fee schedule,,,124.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.02,,,,fee schedule,,,,,,,,5.02,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,44.1,83,,percent of total billed charges,,5.02,,,,fee schedule,,5.02,,,,fee schedule,,,122.01,83,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,3.5,139.65,
ZINC,84630,CDM,84630,CPT,,,both,,70,70,,,,,,,,,,,,,20.16,,,,fee schedule,,,59.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,20.16,,,,fee schedule,,,,,,,,20.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,63.7,91,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,21,83,,percent of total billed charges,,20.16,,,,fee schedule,,20.16,,,,fee schedule,,,58.1,83,,percent of total billed charges,,,,,,,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,3.5,66.5,
ASSAY OF C-PEPTIDE,84681,CDM,84681,CPT,,,both,,152,152,,,,,,,,,,,,,12.82,,,,fee schedule,,,129.2,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.82,,,,fee schedule,,,,,,,,12.82,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,45.6,83,,percent of total billed charges,,12.82,,,,fee schedule,,12.82,,,,fee schedule,,,126.16,83,,percent of total billed charges,,,,,,,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,3.5,144.4,
HCG PREGNANCY -  LAB TEST - SERUM,84702,CDM,84702,CPT,,,both,,90,90,,,,,,,,,,,,,17.72,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.72,,,,fee schedule,,,,,,,,17.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,17.72,,,,fee schedule,,17.72,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
GONAD CHORNC QUAL,84703,CDM,84703,CPT,,,both,,64,64,,,,,,,,,,,,,7.16,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,7.16,,,,fee schedule,,,,,,,,7.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,7.16,,,,fee schedule,,7.16,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
AUTOMATED DIFF WBC COUNT,85004,CDM,85004,CPT,,,both,,31,31,,,,,,,,,,,,,6.8,,,,fee schedule,,,26.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.8,,,,fee schedule,,,,,,,,6.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,9.3,83,,percent of total billed charges,,6.8,,,,fee schedule,,6.8,,,,fee schedule,,,25.73,83,,percent of total billed charges,,,,,,,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,3.5,29.45,
BLD# HEMATOCRIT,85014,CDM,85014,CPT,,,both,,28,28,,,,,,,,,,,,,4.64,,,,fee schedule,,,23.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.64,,,,fee schedule,,,,,,,,4.64,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,8.4,83,,percent of total billed charges,,4.64,,,,fee schedule,,4.64,,,,fee schedule,,,23.24,83,,percent of total billed charges,,,,,,,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,3.5,26.6,
BLOOD HEMOGLOBIN LAB TEST,85018,CDM,85018,CPT,,,both,,28,28,,,,,,,,,,,,,4.64,,,,fee schedule,,,23.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.64,,,,fee schedule,,,,,,,,4.64,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,8.4,83,,percent of total billed charges,,4.64,,,,fee schedule,,4.64,,,,fee schedule,,,23.24,83,,percent of total billed charges,,,,,,,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,3.5,26.6,
BLD  COMPL AUTO HHRWP/AUTO DIFFIAL,85025,CDM,85025,CPT,,,both,,62,62,,,,,,,,,,,,,11.48,,,,fee schedule,,,52.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.48,,,,fee schedule,,,,,,,,11.48,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,11.48,,,,fee schedule,,11.48,,,,fee schedule,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,3.5,58.9,
BLD# COMPL AUTO HHRWP,85027,CDM,85027,CPT,,,both,,90,90,,,,,,,,,,,,,11.48,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.48,,,,fee schedule,,,,,,,,11.48,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,11.48,,,,fee schedule,,11.48,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
AUTOMATED RBC COUNT,85041,CDM,85041,CPT,,,both,,27,27,,,,,,,,,,,,,3.44,,,,fee schedule,,,22.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.44,,,,fee schedule,,,,,,,,3.44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,8.1,83,,percent of total billed charges,,3.44,,,,fee schedule,,3.44,,,,fee schedule,,,22.41,83,,percent of total billed charges,,,,,,,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,3.44,25.65,
MANUAL RETICULOCYTE COUNT,85044,CDM,85044,CPT,,,both,,29,29,,,,,,,,,,,,,3.5,,,,fee schedule,,,24.65,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,26.39,91,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,8.7,83,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,24.07,83,,percent of total billed charges,,,,,,,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,3.5,27.55,
BLD# RETICULOCYTE AUTO,85045,CDM,85045,CPT,,,both,,41,41,,,,,,,,,,,,,2.62,,,,fee schedule,,,34.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,2.62,,,,fee schedule,,,,,,,,2.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,2.62,,,,fee schedule,,2.62,,,,fee schedule,,,34.03,83,,percent of total billed charges,,,,,,,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,2.62,38.95,
AUTOMATED LEUKOCYTE COUNT,85048,CDM,85048,CPT,,,both,,28,28,,,,,,,,,,,,,3.44,,,,fee schedule,,,23.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.44,,,,fee schedule,,,,,,,,3.44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,8.4,83,,percent of total billed charges,,3.44,,,,fee schedule,,3.44,,,,fee schedule,,,23.24,83,,percent of total billed charges,,,,,,,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,3.44,26.6,
AUTOMATED PLATELET COUNT,85049,CDM,85049,CPT,,,both,,40,40,,,,,,,,,,,,,4.68,,,,fee schedule,,,34,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.68,,,,fee schedule,,,,,,,,4.68,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,12,83,,percent of total billed charges,,4.68,,,,fee schedule,,4.68,,,,fee schedule,,,33.2,83,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,3.5,38,
BLD SMR PRPH INTERPJ PHYS WRTTN REPRT,85060,CDM,85060,CPT,,,both,,46,46,42.1,,,,fee schedule,,,,,,,,4.5,,,,fee schedule,,,39.1,85,,percent of total billed charges,,35.42,,,,fee schedule,,25.04,,,,fee schedule,,4.5,,,,fee schedule,,43.11,,,,fee schedule,,4.5,,,,fee schedule,,39.7,,,,fee schedule,,24.06,,,,fee schedule,,24.06,,,,fee schedule,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,13.8,83,,percent of total billed charges,,4.5,,,,fee schedule,,4.5,,,,fee schedule,,,38.18,83,,percent of total billed charges,,35.37,,,,fee schedule,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,4.5,43.7,
BLOOD CLOT FACTOR V TEST,85220,CDM,85220,CPT,,,both,,113,113,,,,,,,,,,,,,17.72,,,,fee schedule,,,96.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.72,,,,fee schedule,,,,,,,,17.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,33.9,83,,percent of total billed charges,,17.72,,,,fee schedule,,17.72,,,,fee schedule,,,93.79,83,,percent of total billed charges,,,,,,,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,3.5,107.35,
BLOOD CLOT FACTOR VII TEST,85230,CDM,85230,CPT,,,both,,85,85,,,,,,,,,,,,,17.72,,,,fee schedule,,,72.25,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.72,,,,fee schedule,,,,,,,,17.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,25.5,83,,percent of total billed charges,,17.72,,,,fee schedule,,17.72,,,,fee schedule,,,70.55,83,,percent of total billed charges,,,,,,,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,3.5,80.75,
BLOOD CLOT FACTOR VIII TEST,85240,CDM,85240,CPT,,,both,,147,147,,,,,,,,,,,,,17.72,,,,fee schedule,,,124.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.72,,,,fee schedule,,,,,,,,17.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,44.1,83,,percent of total billed charges,,17.72,,,,fee schedule,,17.72,,,,fee schedule,,,122.01,83,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,3.5,139.65,
BLOOD CLOT FACTOR VIII TEST,85246,CDM,85246,CPT,,,both,,155,155,,,,,,,,,,,,,14.4,,,,fee schedule,,,131.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,14.4,,,,fee schedule,,,,,,,,14.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,14.4,,,,fee schedule,,14.4,,,,fee schedule,,,128.65,83,,percent of total billed charges,,,,,,,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,3.5,147.25,
BLOOD CLOT FACTOR IX TEST,85250,CDM,85250,CPT,,,both,,70,70,,,,,,,,,,,,,17.72,,,,fee schedule,,,59.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.72,,,,fee schedule,,,,,,,,17.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,63.7,91,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,21,83,,percent of total billed charges,,17.72,,,,fee schedule,,17.72,,,,fee schedule,,,58.1,83,,percent of total billed charges,,,,,,,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,3.5,66.5,
BLOOD CLOT FACTOR X TEST,85260,CDM,85260,CPT,,,both,,113,113,,,,,,,,,,,,,17.72,,,,fee schedule,,,96.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.72,,,,fee schedule,,,,,,,,17.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,33.9,83,,percent of total billed charges,,17.72,,,,fee schedule,,17.72,,,,fee schedule,,,93.79,83,,percent of total billed charges,,,,,,,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,3.5,107.35,
BLOOD CLOT FACTOR XII TEST,85280,CDM,85280,CPT,,,both,,59,59,,,,,,,,,,,,,17.72,,,,fee schedule,,,50.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.72,,,,fee schedule,,,,,,,,17.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,17.7,83,,percent of total billed charges,,17.72,,,,fee schedule,,17.72,,,,fee schedule,,,48.97,83,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,3.5,56.05,
BLOOD CLOT FACTOR XIII TEST,85290,CDM,85290,CPT,,,both,,74,74,,,,,,,,,,,,,17.72,,,,fee schedule,,,62.9,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.72,,,,fee schedule,,,,,,,,17.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,22.2,83,,percent of total billed charges,,17.72,,,,fee schedule,,17.72,,,,fee schedule,,,61.42,83,,percent of total billed charges,,,,,,,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,3.5,70.3,
ANTITHROMBIN III TEST,85300,CDM,85300,CPT,,,both,,147,147,,,,,,,,,,,,,17.72,,,,fee schedule,,,124.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.72,,,,fee schedule,,,,,,,,17.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,44.1,83,,percent of total billed charges,,17.72,,,,fee schedule,,17.72,,,,fee schedule,,,122.01,83,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,3.5,139.65,
BLOOD CLOT INHIBITOR ANTIGEN,85302,CDM,85302,CPT,,,both,,261,261,,,,,,,,,,,,,23.56,,,,fee schedule,,,221.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,23.56,,,,fee schedule,,,,,,,,23.56,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,237.51,91,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,78.3,83,,percent of total billed charges,,23.56,,,,fee schedule,,23.56,,,,fee schedule,,,216.63,83,,percent of total billed charges,,,,,,,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,221.85,85,,percent of total billed charges,,3.5,247.95,
BLOOD CLOT INHIBITOR TEST,85303,CDM,85303,CPT,,,both,,150,150,,,,,,,,,,,,,23.4,,,,fee schedule,,,127.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,23.4,,,,fee schedule,,,,,,,,23.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,23.4,,,,fee schedule,,23.4,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,3.5,142.5,
BLOOD CLOT INHIBITOR ASSAY,85305,CDM,85305,CPT,,,both,,158,158,,,,,,,,,,,,,22.64,,,,fee schedule,,,134.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,22.64,,,,fee schedule,,,,,,,,22.64,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,143.78,91,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,47.4,83,,percent of total billed charges,,22.64,,,,fee schedule,,22.64,,,,fee schedule,,,131.14,83,,percent of total billed charges,,,,,,,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,3.5,150.1,
BLOOD CLOT INHIBITOR TEST,85306,CDM,85306,CPT,,,both,,84,84,,,,,,,,,,,,,23.4,,,,fee schedule,,,71.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,23.4,,,,fee schedule,,,,,,,,23.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,25.2,83,,percent of total billed charges,,23.4,,,,fee schedule,,23.4,,,,fee schedule,,,69.72,83,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,3.5,79.8,
ASSAY ACTIVATED PROTEIN C,85307,CDM,85307,CPT,,,both,,165,165,,,,,,,,,,,,,24,,,,fee schedule,,,140.25,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,24,,,,fee schedule,,,,,,,,24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,49.5,83,,percent of total billed charges,,24,,,,fee schedule,,24,,,,fee schedule,,,136.95,83,,percent of total billed charges,,,,,,,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,3.5,156.75,
"FIBRIN DEGRADE, SEMIQUANT",85378,CDM,85378,CPT,,,both,,33,33,,,,,,,,,,,,,13.96,,,,fee schedule,,,28.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.96,,,,fee schedule,,,,,,,,13.96,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,30.03,91,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,9.9,83,,percent of total billed charges,,13.96,,,,fee schedule,,13.96,,,,fee schedule,,,27.39,83,,percent of total billed charges,,,,,,,,,29.7,90,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,28.05,85,,percent of total billed charges,,3.5,31.35,
"FIBRIN DEGRADATION, QUANT",85379,CDM,85379,CPT,,,both,,62,62,,,,,,,,,,,,,15,,,,fee schedule,,,52.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15,,,,fee schedule,,,,,,,,15,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,15,,,,fee schedule,,15,,,,fee schedule,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,3.5,58.9,
FIBRINOLYTIC PLASMINOGEN,85415,CDM,85415,CPT,,,both,,295,295,,,,,,,,,,,,,17.24,,,,fee schedule,,,250.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.24,,,,fee schedule,,,,,,,,17.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,268.45,91,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,88.5,83,,percent of total billed charges,,17.24,,,,fee schedule,,17.24,,,,fee schedule,,,244.85,83,,percent of total billed charges,,,,,,,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,3.5,280.25,
WBC ALKALINE PHOSPHATASE,85540,CDM,85540,CPT,,,both,,53,53,,,,,,,,,,,,,3.52,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.52,,,,fee schedule,,,,,,,,3.52,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,3.52,,,,fee schedule,,3.52,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
RBC OSMOTIC FRAGILITY,85555,CDM,85555,CPT,,,both,,384,384,,,,,,,,,,,,,4.66,,,,fee schedule,,,326.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.66,,,,fee schedule,,,,,,,,4.66,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,349.44,91,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,115.2,83,,percent of total billed charges,,4.66,,,,fee schedule,,4.66,,,,fee schedule,,,318.72,83,,percent of total billed charges,,,,,,,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,326.4,85,,percent of total billed charges,,3.5,364.8,
PLTLT NEUTRALIZATION,85597,CDM,85597,CPT,,,both,,87,87,,,,,,,,,,,,,5.48,,,,fee schedule,,,73.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.48,,,,fee schedule,,,,,,,,5.48,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,26.1,83,,percent of total billed charges,,5.48,,,,fee schedule,,5.48,,,,fee schedule,,,72.21,83,,percent of total billed charges,,,,,,,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,3.5,82.65,
HEXAGNAL PHOSP PLTLT NEUTRAL,85598,CDM,85598,CPT,,,both,,68,68,,,,,,,,,,,,,15.18,,,,fee schedule,,,57.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.18,,,,fee schedule,,,,,,,,15.18,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,15.18,,,,fee schedule,,15.18,,,,fee schedule,,,56.44,83,,percent of total billed charges,,,,,,,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,3.5,64.6,
PROTHROMBIN TIME IN/OUT,85610,CDM,85610,CPT,,,both,,53,53,,,,,,,,,,,,,3.82,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.82,,,,fee schedule,,,,,,,,3.82,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,3.82,,,,fee schedule,,3.82,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
RUSSELL VIPR VENOM TM DILD,85613,CDM,85613,CPT,,,both,,38,38,,,,,,,,,,,,,7.02,,,,fee schedule,,,32.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,7.02,,,,fee schedule,,,,,,,,7.02,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,34.58,91,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,11.4,83,,percent of total billed charges,,7.02,,,,fee schedule,,7.02,,,,fee schedule,,,31.54,83,,percent of total billed charges,,,,,,,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,3.5,36.1,
SEDIMENTATION RATE RBC NON-AUTO,85651,CDM,85651,CPT,,,both,,29,29,,,,,,,,,,,,,4.6,,,,fee schedule,,,24.65,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.6,,,,fee schedule,,,,,,,,4.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,26.39,91,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,8.7,83,,percent of total billed charges,,4.6,,,,fee schedule,,4.6,,,,fee schedule,,,24.07,83,,percent of total billed charges,,,,,,,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,3.5,27.55,
SEDIMENTATION RATE RBC AUTO,85652,CDM,85652,CPT,,,both,,44,44,,,,,,,,,,,,,2.62,,,,fee schedule,,,37.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,2.62,,,,fee schedule,,,,,,,,2.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,13.2,83,,percent of total billed charges,,2.62,,,,fee schedule,,2.62,,,,fee schedule,,,36.52,83,,percent of total billed charges,,,,,,,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,2.62,41.8,
RBC SICKLE CELL TEST,85660,CDM,85660,CPT,,,both,,40,40,,,,,,,,,,,,,4.66,,,,fee schedule,,,34,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.66,,,,fee schedule,,,,,,,,4.66,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,12,83,,percent of total billed charges,,4.66,,,,fee schedule,,4.66,,,,fee schedule,,,33.2,83,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,3.5,38,
"THROMBIN TIME, PLASMA",85670,CDM,85670,CPT,,,both,,38,38,,,,,,,,,,,,,9.32,,,,fee schedule,,,32.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9.32,,,,fee schedule,,,,,,,,9.32,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,34.58,91,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,11.4,83,,percent of total billed charges,,9.32,,,,fee schedule,,9.32,,,,fee schedule,,,31.54,83,,percent of total billed charges,,,,,,,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,3.5,36.1,
THROMBOPLASTIN INHIBITION,85705,CDM,85705,CPT,,,both,,175,175,,,,,,,,,,,,,8.7,,,,fee schedule,,,148.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.7,,,,fee schedule,,,,,,,,8.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,52.5,83,,percent of total billed charges,,8.7,,,,fee schedule,,8.7,,,,fee schedule,,,145.25,83,,percent of total billed charges,,,,,,,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,3.5,166.25,
THROMBOPLASTIN TM PRTL PLSM/WHL BLD,85730,CDM,85730,CPT,,,both,,53,53,,,,,,,,,,,,,5.88,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.88,,,,fee schedule,,,,,,,,5.88,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,5.88,,,,fee schedule,,5.88,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
"THROMBOPLASTIN TIME, PARTIAL",85732,CDM,85732,CPT,,,both,,38,38,,,,,,,,,,,,,25.52,,,,fee schedule,,,32.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,25.52,,,,fee schedule,,,,,,,,25.52,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,34.58,91,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,11.4,83,,percent of total billed charges,,25.52,,,,fee schedule,,25.52,,,,fee schedule,,,31.54,83,,percent of total billed charges,,,,,,,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,3.5,36.1,
ALLERGEN SPECIFIC IGE,86003,CDM,86003,CPT,,,both,,28,28,,,,,,,,,,,,,58.65,,,,fee schedule,,,23.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,58.65,,,,fee schedule,,,,,,,,58.65,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,8.4,83,,percent of total billed charges,,58.65,,,,fee schedule,,58.65,,,,fee schedule,,,23.24,83,,percent of total billed charges,,,,,,,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,3.5,58.65,
ALLERGEN SPECIFIC IGE,86005,CDM,86005,CPT,,,both,,38,38,,,,,,,,,,,,,10.4,,,,fee schedule,,,32.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.4,,,,fee schedule,,,,,,,,10.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,34.58,91,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,11.4,83,,percent of total billed charges,,10.4,,,,fee schedule,,10.4,,,,fee schedule,,,31.54,83,,percent of total billed charges,,,,,,,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,3.5,36.1,
WBC ANTIBODY IDENTIFICATION,86021,CDM,86021,CPT,,,both,,141,141,,,,,,,,,,,,,6.2,,,,fee schedule,,,119.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.2,,,,fee schedule,,,,,,,,6.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,128.31,91,,percent of total billed charges,,,133.95,95,,percent of total billed charges,,,117.03,83,,percent of total billed charges,,,42.3,83,,percent of total billed charges,,6.2,,,,fee schedule,,6.2,,,,fee schedule,,,117.03,83,,percent of total billed charges,,,,,,,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,119.85,85,,percent of total billed charges,,3.5,133.95,
PLATELET ANTIBODIES,86022,CDM,86022,CPT,,,both,,321,321,,,,,,,,,,,,,19.05,,,,fee schedule,,,272.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,19.05,,,,fee schedule,,,,,,,,19.05,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,292.11,91,,percent of total billed charges,,,304.95,95,,percent of total billed charges,,,266.43,83,,percent of total billed charges,,,96.3,83,,percent of total billed charges,,19.05,,,,fee schedule,,19.05,,,,fee schedule,,,266.43,83,,percent of total billed charges,,,,,,,,,288.9,90,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,272.85,85,,percent of total billed charges,,3.5,304.95,
ANA,86038,CDM,86038,CPT,,,both,,64,64,,,,,,,,,,,,,15.8,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.8,,,,fee schedule,,,,,,,,15.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,15.8,,,,fee schedule,,15.8,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
ANTINUCLEAR ANTIBODIES (ANA),86039,CDM,86039,CPT,,,both,,64,64,,,,,,,,,,,,,10.7,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.7,,,,fee schedule,,,,,,,,10.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,10.7,,,,fee schedule,,10.7,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
ANTISTREPTOLYSIN 0 TITER,86060,CDM,86060,CPT,,,both,,64,64,,,,,,,,,,,,,8.6,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.6,,,,fee schedule,,,,,,,,8.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,8.6,,,,fee schedule,,8.6,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
C-REACTIVE PROTEIN,86140,CDM,86140,CPT,,,both,,41,41,,,,,,,,,,,,,4.7,,,,fee schedule,,,34.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.7,,,,fee schedule,,,,,,,,4.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,4.7,,,,fee schedule,,4.7,,,,fee schedule,,,34.03,83,,percent of total billed charges,,,,,,,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,3.5,38.95,
C-REACTIVE PROTEIN HI SENSITIVITY,86141,CDM,86141,CPT,,,both,,113,113,,,,,,,,,,,,,16.9,,,,fee schedule,,,96.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,16.9,,,,fee schedule,,,,,,,,16.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,33.9,83,,percent of total billed charges,,16.9,,,,fee schedule,,16.9,,,,fee schedule,,,93.79,83,,percent of total billed charges,,,,,,,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,3.5,107.35,
GLYCOPROTEIN ANTIBODY,86146,CDM,86146,CPT,,,both,,123,123,,,,,,,,,,,,,79.8,,,,fee schedule,,,104.55,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,79.8,,,,fee schedule,,,,,,,,79.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,111.93,91,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,36.9,83,,percent of total billed charges,,79.8,,,,fee schedule,,79.8,,,,fee schedule,,,102.09,83,,percent of total billed charges,,,,,,,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,104.55,85,,percent of total billed charges,,3.5,116.85,
CARDIOLIPIN ANTIBODY,86147,CDM,86147,CPT,,,both,,64,64,,,,,,,,,,,,,50.8,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,50.8,,,,fee schedule,,,,,,,,50.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,50.8,,,,fee schedule,,50.8,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
PHOSPHOLIPID ANTIBODY,86148,CDM,86148,CPT,,,both,,88,88,,,,,,,,,,,,,12.7,,,,fee schedule,,,74.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.7,,,,fee schedule,,,,,,,,12.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,26.4,83,,percent of total billed charges,,12.7,,,,fee schedule,,12.7,,,,fee schedule,,,73.04,83,,percent of total billed charges,,,,,,,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,3.5,83.6,
"COLD AGGLUTININ, TITER",86157,CDM,86157,CPT,,,both,,59,59,,,,,,,,,,,,,6.6,,,,fee schedule,,,50.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.6,,,,fee schedule,,,,,,,,6.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,17.7,83,,percent of total billed charges,,6.6,,,,fee schedule,,6.6,,,,fee schedule,,,48.97,83,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,3.5,56.05,
COMPLEMENT AG EA COMPONENT,86160,CDM,86160,CPT,,,both,,147,147,,,,,,,,,,,,,37,,,,fee schedule,,,124.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,37,,,,fee schedule,,,,,,,,37,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,44.1,83,,percent of total billed charges,,37,,,,fee schedule,,37,,,,fee schedule,,,122.01,83,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,3.5,139.65,
COMPLEMENT/FUNCTION ACTIVITY,86161,CDM,86161,CPT,,,both,,27,27,,,,,,,,,,,,,30.9,,,,fee schedule,,,22.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,30.9,,,,fee schedule,,,,,,,,30.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,8.1,83,,percent of total billed charges,,30.9,,,,fee schedule,,30.9,,,,fee schedule,,,22.41,83,,percent of total billed charges,,,,,,,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,3.5,30.9,
"COMPLEMENT, TOTAL (CH50)",86162,CDM,86162,CPT,,,both,,100,100,,,,,,,,,,,,,17.9,,,,fee schedule,,,85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.9,,,,fee schedule,,,,,,,,17.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,30,83,,percent of total billed charges,,17.9,,,,fee schedule,,17.9,,,,fee schedule,,,83,83,,percent of total billed charges,,,,,,,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,3.5,95,
CCP Antibodies IgG/IgA,86200,CDM,86200,CPT,,,both,,120,120,,,,,,,,,,,,,10.85,,,,fee schedule,,,102,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.85,,,,fee schedule,,,,,,,,10.85,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,36,83,,percent of total billed charges,,10.85,,,,fee schedule,,10.85,,,,fee schedule,,,99.6,83,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,3.5,114,
"DEOXYRIBONUCLEASE, ANTIBODY",86215,CDM,86215,CPT,,,both,,77,77,,,,,,,,,,,,,11.8,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.8,,,,fee schedule,,,,,,,,11.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,11.8,,,,fee schedule,,11.8,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
DNA ANTB NATIVE/2 STRANDED,86225,CDM,86225,CPT,,,both,,70,70,,,,,,,,,,,,,11.8,,,,fee schedule,,,59.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.8,,,,fee schedule,,,,,,,,11.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,63.7,91,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,21,83,,percent of total billed charges,,11.8,,,,fee schedule,,11.8,,,,fee schedule,,,58.1,83,,percent of total billed charges,,,,,,,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,3.5,66.5,
"DNA ANTIBODY, SINGLE STRAND",86226,CDM,86226,CPT,,,both,,59,59,,,,,,,,,,,,,13.35,,,,fee schedule,,,50.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.35,,,,fee schedule,,,,,,,,13.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,17.7,83,,percent of total billed charges,,13.35,,,,fee schedule,,13.35,,,,fee schedule,,,48.97,83,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,3.5,56.05,
XTRCABLE NUC AG ANTB ANY METH EA ANTB,86235,CDM,86235,CPT,,,both,,90,90,,,,,,,,,,,,,11.8,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.8,,,,fee schedule,,,,,,,,11.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,11.8,,,,fee schedule,,11.8,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
FLUORESCENT NONNFCT AGT ANTB SCR EA ANTB,86255,CDM,86255,CPT,,,both,,150,150,,,,,,,,,,,,,7.2,,,,fee schedule,,,127.5,85,,percent of total billed charges,,26.46,,,,fee schedule,,18.7,,,,fee schedule,,7.2,,,,fee schedule,,,,,,,,7.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,7.2,,,,fee schedule,,7.2,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,7.2,142.5,
"FLUORESCENT ANTIBODY, TITER",86256,CDM,86256,CPT,,,both,,94,94,,,,,,,,,,,,,11.8,,,,fee schedule,,,79.9,85,,percent of total billed charges,,26.46,,,,fee schedule,,18.7,,,,fee schedule,,11.8,,,,fee schedule,,,,,,,,11.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,85.54,91,,percent of total billed charges,,,89.3,95,,percent of total billed charges,,,78.02,83,,percent of total billed charges,,,28.2,83,,percent of total billed charges,,11.8,,,,fee schedule,,11.8,,,,fee schedule,,,78.02,83,,percent of total billed charges,,,,,,,,,84.6,90,,percent of total billed charges,,,84.6,90,,percent of total billed charges,,,84.6,90,,percent of total billed charges,,,84.6,90,,percent of total billed charges,,,79.9,85,,percent of total billed charges,,11.8,89.3,
"IMMUNOASSAY, TUMOR, CA 15-3",86300,CDM,86300,CPT,,,both,,74,74,,,,,,,,,,,,,43.4,,,,fee schedule,,,62.9,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,43.4,,,,fee schedule,,,,,,,,43.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,22.2,83,,percent of total billed charges,,43.4,,,,fee schedule,,43.4,,,,fee schedule,,,61.42,83,,percent of total billed charges,,,,,,,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,3.5,70.3,
IA TUM AG QUAN CA 19-9,86301,CDM,86301,CPT,,,both,,97,97,,,,,,,,,,,,,21.7,,,,fee schedule,,,82.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,21.7,,,,fee schedule,,,,,,,,21.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,29.1,83,,percent of total billed charges,,21.7,,,,fee schedule,,21.7,,,,fee schedule,,,80.51,83,,percent of total billed charges,,,,,,,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,3.5,92.15,
IA TUM AG QUAN CA 125,86304,CDM,86304,CPT,,,both,,100,100,,,,,,,,,,,,,21.7,,,,fee schedule,,,85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,21.7,,,,fee schedule,,,,,,,,21.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,30,83,,percent of total billed charges,,21.7,,,,fee schedule,,21.7,,,,fee schedule,,,83,83,,percent of total billed charges,,,,,,,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,3.5,95,
"IMMUNOASSAY, TUMOR, CA 125",86304P,CDM,86304,CPT,,,both,P,49,49,,,,,,,,,,,,,21.7,,,,fee schedule,,,41.65,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,21.7,,,,fee schedule,,,,,,,,21.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,44.59,91,,percent of total billed charges,,,46.55,95,,percent of total billed charges,,,40.67,83,,percent of total billed charges,,,14.7,83,,percent of total billed charges,,21.7,,,,fee schedule,,21.7,,,,fee schedule,,,40.67,83,,percent of total billed charges,,,,,,,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,41.65,85,,percent of total billed charges,,3.5,46.55,
"IMMUNOASSAY, TUMOR, CA 125",86304T,CDM,86304,CPT,,,both,T,51,51,,,,,,,,,,,,,21.7,,,,fee schedule,,,43.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,21.7,,,,fee schedule,,,,,,,,21.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,21.7,,,,fee schedule,,21.7,,,,fee schedule,,,42.33,83,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,3.5,48.45,
HTROPHL ANTIBODIES SCR,86308,CDM,86308,CPT,,,both,,48,48,,,,,,,,,,,,,4.8,,,,fee schedule,,,40.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.8,,,,fee schedule,,,,,,,,4.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,14.4,83,,percent of total billed charges,,4.8,,,,fee schedule,,4.8,,,,fee schedule,,,39.84,83,,percent of total billed charges,,,,,,,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,3.5,45.6,
"IMMUNOASSAY, TUMOR OTHER",86316,CDM,86316,CPT,,,both,,146,146,,,,,,,,,,,,,30.3,,,,fee schedule,,,124.1,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,30.3,,,,fee schedule,,,,,,,,30.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,43.8,83,,percent of total billed charges,,30.3,,,,fee schedule,,30.3,,,,fee schedule,,,121.18,83,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,3.5,138.7,
"IMMUNOASSAY,INFECTIOUS AGENT",86317,CDM,86317,CPT,,,both,,24,24,,,,,,,,,,,,,,,,,,,,20.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,7.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,,,,,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,3.5,22.8,
"IMMUNOASSAY,INFECTIOUS AGENT",86318,CDM,86318,CPT,,,both,,60,60,,,,,,,,,,,,,,,,,,,,51,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,18,83,,percent of total billed charges,,,,,,,,,,,,,,,49.8,83,,percent of total billed charges,,,,,,,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,3.5,57,
"IMMUNOFIX E-PHORESIS, SERUM",86334,CDM,86334,CPT,,,both,,103,103,,,,,,,,,,,,,27.9,,,,fee schedule,,,87.55,85,,percent of total billed charges,,26.46,,,,fee schedule,,18.7,,,,fee schedule,,27.9,,,,fee schedule,,,,,,,,27.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,30.9,83,,percent of total billed charges,,27.9,,,,fee schedule,,27.9,,,,fee schedule,,,85.49,83,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,18.7,97.85,
IMMUNFIX E-PHORSIS/URINE/CSF,86335,CDM,86335,CPT,,,both,,127,127,,,,,,,,,,,,,49.2,,,,fee schedule,,,107.95,85,,percent of total billed charges,,26.46,,,,fee schedule,,18.7,,,,fee schedule,,49.2,,,,fee schedule,,,,,,,,49.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,49.2,,,,fee schedule,,49.2,,,,fee schedule,,,105.41,83,,percent of total billed charges,,,,,,,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,18.7,120.65,
INHIBIN,86336,CDM,86336,CPT,,,both,,147,147,,,,,,,,,,,,,21.75,,,,fee schedule,,,124.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,21.75,,,,fee schedule,,,,,,,,21.75,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,44.1,83,,percent of total billed charges,,21.75,,,,fee schedule,,21.75,,,,fee schedule,,,122.01,83,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,3.5,139.65,
INTRINSIC FACTOR ANTIBODY,86340,CDM,86340,CPT,,,both,,93,93,,,,,,,,,,,,,11.8,,,,fee schedule,,,79.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.8,,,,fee schedule,,,,,,,,11.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,11.8,,,,fee schedule,,11.8,,,,fee schedule,,,77.19,83,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,3.5,88.35,
ISLET CELL ANTIBODY,86341,CDM,86341,CPT,,,both,,83,83,,,,,,,,,,,,,11.8,,,,fee schedule,,,70.55,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.8,,,,fee schedule,,,,,,,,11.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,11.8,,,,fee schedule,,11.8,,,,fee schedule,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,3.5,78.85,
T CELLS ABSOLUTE CD4   CD8 CNT RATIO,86360,CDM,86360,CPT,,,both,,217,217,,,,,,,,,,,,,9.7,,,,fee schedule,,,184.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9.7,,,,fee schedule,,,,,,,,9.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,65.1,83,,percent of total billed charges,,9.7,,,,fee schedule,,9.7,,,,fee schedule,,,180.11,83,,percent of total billed charges,,,,,,,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,3.5,206.15,
MICROSOMAL ANTIBODIES EA,86376,CDM,86376,CPT,,,both,,78,78,,,,,,,,,,,,,16.8,,,,fee schedule,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,16.8,,,,fee schedule,,,,,,,,16.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,16.8,,,,fee schedule,,16.8,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
"NEUTRALIZATION TEST, VIRAL",86382,CDM,86382,CPT,,,both,,61,61,,,,,,,,,,,,,21.6,,,,fee schedule,,,51.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,21.6,,,,fee schedule,,,,,,,,21.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,55.51,91,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,18.3,83,,percent of total billed charges,,21.6,,,,fee schedule,,21.6,,,,fee schedule,,,50.63,83,,percent of total billed charges,,,,,,,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,3.5,57.95,
PARTICLE AGGLUTINATION TEST,86403,CDM,86403,CPT,,,both,,21,21,,,,,,,,,,,,,6,,,,fee schedule,,,17.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6,,,,fee schedule,,,,,,,,6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,6.3,83,,percent of total billed charges,,6,,,,fee schedule,,6,,,,fee schedule,,,17.43,83,,percent of total billed charges,,,,,,,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,3.5,19.95,
RHEUMATOID FACTOR QUAL,86430,CDM,86430,CPT,,,both,,53,53,,,,,,,,,,,,,12.4,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.4,,,,fee schedule,,,,,,,,12.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,12.4,,,,fee schedule,,12.4,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
RHEUMATOID FACTOR QUAN,86431,CDM,86431,CPT,,,both,,53,53,,,,,,,,,,,,,14.5,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,14.5,,,,fee schedule,,,,,,,,14.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,14.5,,,,fee schedule,,14.5,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
"TB TEST, CELL IMMUN MEASURE",86480,CDM,86480,CPT,,,both,,248,248,,,,,,,,,,,,,51.95,,,,fee schedule,,,210.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,51.95,,,,fee schedule,,,,,,,,51.95,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,74.4,83,,percent of total billed charges,,51.95,,,,fee schedule,,51.95,,,,fee schedule,,,205.84,83,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,3.5,235.6,
HISTOPLASMOSIS SKIN TEST,86510,CDM,86510,CPT,,,both,,30,30,13.05,,,,fee schedule,,,,,,,,5.15,,,,fee schedule,,,25.5,85,,percent of total billed charges,,10.32,,,,fee schedule,,7.29,,,,fee schedule,,5.15,,,,fee schedule,,22.55,,,,fee schedule,,5.15,,,,fee schedule,,12.3,,,,fee schedule,,7.46,,,,fee schedule,,7.46,,,,fee schedule,,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,9,83,,percent of total billed charges,,5.15,,,,fee schedule,,5.15,,,,fee schedule,,,24.9,83,,percent of total billed charges,,10.96,,,,fee schedule,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,5.15,28.5,
SKN TST TUBERCULOSIS ID,86580,CDM,86580,CPT,,,both,,26,26,17.79,,,,fee schedule,,,,,,,,4,,,,fee schedule,,,22.1,85,,percent of total billed charges,,14.49,,,,fee schedule,,10.24,,,,fee schedule,,4,,,,fee schedule,,17.91,,,,fee schedule,,4,,,,fee schedule,,16.77,,,,fee schedule,,10.17,,,,fee schedule,,10.17,,,,fee schedule,,,23.66,91,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,7.8,83,,percent of total billed charges,,4,,,,fee schedule,,4,,,,fee schedule,,,21.58,83,,percent of total billed charges,,14.94,,,,fee schedule,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,4,24.7,
TB INTRADERMAL TEST,86580P,CDM,86580,CPT,,,both,P,14,14,17.79,,,,fee schedule,,,,,,,,4,,,,fee schedule,,,11.9,85,,percent of total billed charges,,14.49,,,,fee schedule,,10.24,,,,fee schedule,,4,,,,fee schedule,,17.91,,,,fee schedule,,4,,,,fee schedule,,16.77,,,,fee schedule,,10.17,,,,fee schedule,,10.17,,,,fee schedule,,,12.74,91,,percent of total billed charges,,,13.3,95,,percent of total billed charges,,,11.62,83,,percent of total billed charges,,,4.2,83,,percent of total billed charges,,4,,,,fee schedule,,4,,,,fee schedule,,,11.62,83,,percent of total billed charges,,14.94,,,,fee schedule,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,11.9,85,,percent of total billed charges,,4,17.91,
TB INTRADERMAL TEST,86580T,CDM,86580,CPT,,,both,T,50,50,17.79,,,,fee schedule,,,,,,,,4,,,,fee schedule,,,42.5,85,,percent of total billed charges,,14.49,,,,fee schedule,,10.24,,,,fee schedule,,4,,,,fee schedule,,17.91,,,,fee schedule,,4,,,,fee schedule,,16.77,,,,fee schedule,,10.17,,,,fee schedule,,10.17,,,,fee schedule,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,4,,,,fee schedule,,4,,,,fee schedule,,,41.5,83,,percent of total billed charges,,14.94,,,,fee schedule,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,4,47.5,
SYPHILIS TEST NON TREPONEMAL ANTIBODY QUAL,86592,CDM,86592,CPT,,,both,,53,53,,,,,,,,,,,,,8,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8,,,,fee schedule,,,,,,,,8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,8,,,,fee schedule,,8,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
ADENOVIRUS ANTIBODY,86603,CDM,86603,CPT,,,both,,64,64,,,,,,,,,,,,,29.6,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,29.6,,,,fee schedule,,,,,,,,29.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,29.6,,,,fee schedule,,29.6,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
ASPERGILLUS ANTIBODY,86606,CDM,86606,CPT,,,both,,27,27,,,,,,,,,,,,,10.2,,,,fee schedule,,,22.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.2,,,,fee schedule,,,,,,,,10.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,8.1,83,,percent of total billed charges,,10.2,,,,fee schedule,,10.2,,,,fee schedule,,,22.41,83,,percent of total billed charges,,,,,,,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,3.5,25.65,
BACTERIUM ANTIBODY,86609,CDM,86609,CPT,,,both,,27,27,,,,,,,,,,,,,10.25,,,,fee schedule,,,22.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.25,,,,fee schedule,,,,,,,,10.25,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,8.1,83,,percent of total billed charges,,10.25,,,,fee schedule,,10.25,,,,fee schedule,,,22.41,83,,percent of total billed charges,,,,,,,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,3.5,25.65,
BARTONELLA ANTIBODY,86611,CDM,86611,CPT,,,both,,40,40,,,,,,,,,,,,,10.6,,,,fee schedule,,,34,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.6,,,,fee schedule,,,,,,,,10.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,12,83,,percent of total billed charges,,10.6,,,,fee schedule,,10.6,,,,fee schedule,,,33.2,83,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,3.5,38,
BLASTOMYCES ANTIBODY,86612,CDM,86612,CPT,,,both,,40,40,,,,,,,,,,,,,20.4,,,,fee schedule,,,34,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,20.4,,,,fee schedule,,,,,,,,20.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,12,83,,percent of total billed charges,,20.4,,,,fee schedule,,20.4,,,,fee schedule,,,33.2,83,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,3.5,38,
BORDETELLA ANTIBODY,86615,CDM,86615,CPT,,,both,,106,106,,,,,,,,,,,,,11.9,,,,fee schedule,,,90.1,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.9,,,,fee schedule,,,,,,,,11.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,31.8,83,,percent of total billed charges,,11.9,,,,fee schedule,,11.9,,,,fee schedule,,,87.98,83,,percent of total billed charges,,,,,,,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,3.5,100.7,
LYME DISEASE ANTIBODY,86617,CDM,86617,CPT,,,both,,68,68,,,,,,,,,,,,,40.4,,,,fee schedule,,,57.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,40.4,,,,fee schedule,,,,,,,,40.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,40.4,,,,fee schedule,,40.4,,,,fee schedule,,,56.44,83,,percent of total billed charges,,,,,,,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,3.5,64.6,
ANTB BORRELIA BURGDORFERI LYME DISEASE,86618,CDM,86618,CPT,,,both,,110,110,,,,,,,,,,,,,44.4,,,,fee schedule,,,93.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,44.4,,,,fee schedule,,,,,,,,44.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,100.1,91,,percent of total billed charges,,,104.5,95,,percent of total billed charges,,,91.3,83,,percent of total billed charges,,,33,83,,percent of total billed charges,,44.4,,,,fee schedule,,44.4,,,,fee schedule,,,91.3,83,,percent of total billed charges,,,,,,,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,93.5,85,,percent of total billed charges,,3.5,104.5,
BRUCELLA ANTIBODY,86622,CDM,86622,CPT,,,both,,59,59,,,,,,,,,,,,,10.2,,,,fee schedule,,,50.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.2,,,,fee schedule,,,,,,,,10.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,17.7,83,,percent of total billed charges,,10.2,,,,fee schedule,,10.2,,,,fee schedule,,,48.97,83,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,3.5,56.05,
CAMPYLOBACTER ANTIBODY,86625,CDM,86625,CPT,,,both,,62,62,,,,,,,,,,,,,19.4,,,,fee schedule,,,52.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,19.4,,,,fee schedule,,,,,,,,19.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,19.4,,,,fee schedule,,19.4,,,,fee schedule,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,3.5,58.9,
CHLAMYDIA ANTIBODY,86631,CDM,86631,CPT,,,both,,40,40,,,,,,,,,,,,,15.4,,,,fee schedule,,,34,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.4,,,,fee schedule,,,,,,,,15.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,12,83,,percent of total billed charges,,15.4,,,,fee schedule,,15.4,,,,fee schedule,,,33.2,83,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,3.5,38,
COCCIDIOIDES ANTIBODY,86635,CDM,86635,CPT,,,both,,88,88,,,,,,,,,,,,,10.2,,,,fee schedule,,,74.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.2,,,,fee schedule,,,,,,,,10.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,26.4,83,,percent of total billed charges,,10.2,,,,fee schedule,,10.2,,,,fee schedule,,,73.04,83,,percent of total billed charges,,,,,,,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,3.5,83.6,
CMV ANTIBODY,86644,CDM,86644,CPT,,,both,,70,70,,,,,,,,,,,,,13.35,,,,fee schedule,,,59.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.35,,,,fee schedule,,,,,,,,13.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,63.7,91,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,21,83,,percent of total billed charges,,13.35,,,,fee schedule,,13.35,,,,fee schedule,,,58.1,83,,percent of total billed charges,,,,,,,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,3.5,66.5,
"CMV ANTIBODY, IGM",86645,CDM,86645,CPT,,,both,,80,80,,,,,,,,,,,,,18.25,,,,fee schedule,,,68,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,18.25,,,,fee schedule,,,,,,,,18.25,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,24,83,,percent of total billed charges,,18.25,,,,fee schedule,,18.25,,,,fee schedule,,,66.4,83,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,3.5,76,
DIPHTHERIA ANTIBODY,86648,CDM,86648,CPT,,,both,,73,73,,,,,,,,,,,,,38.4,,,,fee schedule,,,62.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,38.4,,,,fee schedule,,,,,,,,38.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,66.43,91,,percent of total billed charges,,,69.35,95,,percent of total billed charges,,,60.59,83,,percent of total billed charges,,,21.9,83,,percent of total billed charges,,38.4,,,,fee schedule,,38.4,,,,fee schedule,,,60.59,83,,percent of total billed charges,,,,,,,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,62.05,85,,percent of total billed charges,,3.5,69.35,
ENCEPHALITIS ANTIBODY,86653,CDM,86653,CPT,,,both,,30,30,,,,,,,,,,,,,31.2,,,,fee schedule,,,25.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,31.2,,,,fee schedule,,,,,,,,31.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,9,83,,percent of total billed charges,,31.2,,,,fee schedule,,31.2,,,,fee schedule,,,24.9,83,,percent of total billed charges,,,,,,,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,3.5,31.2,
ENTEROVIRUS ANTIBODY,86658,CDM,86658,CPT,,,both,,144,144,,,,,,,,,,,,,17,,,,fee schedule,,,122.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17,,,,fee schedule,,,,,,,,17,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,43.2,83,,percent of total billed charges,,17,,,,fee schedule,,17,,,,fee schedule,,,119.52,83,,percent of total billed charges,,,,,,,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,3.5,136.8,
EPSTEIN-BARR ANTIBODY,86663,CDM,86663,CPT,,,both,,62,62,,,,,,,,,,,,,34.3,,,,fee schedule,,,52.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,34.3,,,,fee schedule,,,,,,,,34.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,34.3,,,,fee schedule,,34.3,,,,fee schedule,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,3.5,58.9,
EPSTEIN-BARR ANTIBODY,86664,CDM,86664,CPT,,,both,,88,88,,,,,,,,,,,,,35.2,,,,fee schedule,,,74.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,35.2,,,,fee schedule,,,,,,,,35.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,26.4,83,,percent of total billed charges,,35.2,,,,fee schedule,,35.2,,,,fee schedule,,,73.04,83,,percent of total billed charges,,,,,,,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,3.5,83.6,
EPSTEIN-BARR ANTIBODY,86665,CDM,86665,CPT,,,both,,88,88,,,,,,,,,,,,,38.4,,,,fee schedule,,,74.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,38.4,,,,fee schedule,,,,,,,,38.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,26.4,83,,percent of total billed charges,,38.4,,,,fee schedule,,38.4,,,,fee schedule,,,73.04,83,,percent of total billed charges,,,,,,,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,3.5,83.6,
EHRLICHIA ANTIBODY,86666,CDM,86666,CPT,,,both,,182,182,,,,,,,,,,,,,10.6,,,,fee schedule,,,154.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.6,,,,fee schedule,,,,,,,,10.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,54.6,83,,percent of total billed charges,,10.6,,,,fee schedule,,10.6,,,,fee schedule,,,151.06,83,,percent of total billed charges,,,,,,,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,3.5,172.9,
FUNGUS ANTIBODY,86671,CDM,86671,CPT,,,both,,173,173,,,,,,,,,,,,,16.02,,,,fee schedule,,,147.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,16.02,,,,fee schedule,,,,,,,,16.02,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,51.9,83,,percent of total billed charges,,16.02,,,,fee schedule,,16.02,,,,fee schedule,,,143.59,83,,percent of total billed charges,,,,,,,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,3.5,164.35,
GIARDIA LAMBLIA ANTIBODY,86674,CDM,86674,CPT,,,both,,77,77,,,,,,,,,,,,,30.6,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,30.6,,,,fee schedule,,,,,,,,30.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,30.6,,,,fee schedule,,30.6,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
ANTB HELICOBACTER PYLORI,86677,CDM,86677,CPT,,,both,,81,81,,,,,,,,,,,,,45,,,,fee schedule,,,68.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,45,,,,fee schedule,,,,,,,,45,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,24.3,83,,percent of total billed charges,,45,,,,fee schedule,,45,,,,fee schedule,,,67.23,83,,percent of total billed charges,,,,,,,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,3.5,76.95,
HTLV/HIV CONFIRMATORY TEST,86689,CDM,86689,CPT,,,both,,209,209,,,,,,,,,,,,,44.78,,,,fee schedule,,,177.65,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,44.78,,,,fee schedule,,,,,,,,44.78,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,62.7,83,,percent of total billed charges,,44.78,,,,fee schedule,,44.78,,,,fee schedule,,,173.47,83,,percent of total billed charges,,,,,,,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,3.5,198.55,
ANTB HERPES SMPLX NON-SPEC TYP TST,86694,CDM,86694,CPT,,,both,,88,88,,,,,,,,,,,,,26.7,,,,fee schedule,,,74.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,26.7,,,,fee schedule,,,,,,,,26.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,26.4,83,,percent of total billed charges,,26.7,,,,fee schedule,,26.7,,,,fee schedule,,,73.04,83,,percent of total billed charges,,,,,,,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,3.5,83.6,
"HSV 1, IgG Ab",86695,CDM,86695,CPT,,,both,,76,76,,,,,,,,,,,,,30.6,,,,fee schedule,,,64.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,30.6,,,,fee schedule,,,,,,,,30.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,30.6,,,,fee schedule,,30.6,,,,fee schedule,,,63.08,83,,percent of total billed charges,,,,,,,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,3.5,72.2,
"HSV 2, IgG AB",86696,CDM,86696,CPT,,,both,,76,76,,,,,,,,,,,,,40.4,,,,fee schedule,,,64.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,40.4,,,,fee schedule,,,,,,,,40.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,40.4,,,,fee schedule,,40.4,,,,fee schedule,,,63.08,83,,percent of total billed charges,,,,,,,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,3.5,72.2,
ANTB HISTOPLSM,86698,CDM,86698,CPT,,,both,,61,61,,,,,,,,,,,,,48.9,,,,fee schedule,,,51.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,48.9,,,,fee schedule,,,,,,,,48.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,55.51,91,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,18.3,83,,percent of total billed charges,,48.9,,,,fee schedule,,48.9,,,,fee schedule,,,50.63,83,,percent of total billed charges,,,,,,,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,3.5,57.95,
ANTB HIV-1,86701,CDM,86701,CPT,,,both,,46,46,,,,,,,,,,,,,25.92,,,,fee schedule,,,39.1,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,25.92,,,,fee schedule,,,,,,,,25.92,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,13.8,83,,percent of total billed charges,,25.92,,,,fee schedule,,25.92,,,,fee schedule,,,38.18,83,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,3.5,43.7,
ANTB HIV-2,86702,CDM,86702,CPT,,,both,,64,64,,,,,,,,,,,,,20.4,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,20.4,,,,fee schedule,,,,,,,,20.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,20.4,,,,fee schedule,,20.4,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
ANTB HIV-1/HIV-2 1 ASSAY,86703,CDM,86703,CPT,,,both,,77,77,,,,,,,,,,,,,20.02,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,20.02,,,,fee schedule,,,,,,,,20.02,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,20.02,,,,fee schedule,,20.02,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
HEP B CORE ANTB HBCAB TOT,86704,CDM,86704,CPT,,,both,,90,90,,,,,,,,,,,,,15.7,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.7,,,,fee schedule,,,,,,,,15.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,15.7,,,,fee schedule,,15.7,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
HEP B CORE ANTB HBCAB IGM ANTB,86705,CDM,86705,CPT,,,both,,76,76,,,,,,,,,,,,,15.4,,,,fee schedule,,,64.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.4,,,,fee schedule,,,,,,,,15.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,15.4,,,,fee schedule,,15.4,,,,fee schedule,,,63.08,83,,percent of total billed charges,,,,,,,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,3.5,72.2,
HEP B SURF ANTB HBSAB,86706,CDM,86706,CPT,,,both,,64,64,,,,,,,,,,,,,28,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,28,,,,fee schedule,,,,,,,,28,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,28,,,,fee schedule,,28,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
HEP BE ANTB HBEAB,86707,CDM,86707,CPT,,,both,,61,61,,,,,,,,,,,,,19.1,,,,fee schedule,,,51.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,19.1,,,,fee schedule,,,,,,,,19.1,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,55.51,91,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,18.3,83,,percent of total billed charges,,19.1,,,,fee schedule,,19.1,,,,fee schedule,,,50.63,83,,percent of total billed charges,,,,,,,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,3.5,57.95,
HEP ANTB HAAB TOT,86708,CDM,86708,CPT,,,both,,100,100,,,,,,,,,,,,,9.55,,,,fee schedule,,,85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9.55,,,,fee schedule,,,,,,,,9.55,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,30,83,,percent of total billed charges,,9.55,,,,fee schedule,,9.55,,,,fee schedule,,,83,83,,percent of total billed charges,,,,,,,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,3.5,95,
HEP ANTB HAAB IGM ANTB,86709,CDM,86709,CPT,,,both,,90,90,,,,,,,,,,,,,5.55,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.55,,,,fee schedule,,,,,,,,5.55,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,5.55,,,,fee schedule,,5.55,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
INFLUENZA VIRUS ANTIBODY,86710,CDM,86710,CPT,,,both,,70,70,,,,,,,,,,,,,17.7,,,,fee schedule,,,59.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,17.7,,,,fee schedule,,,,,,,,17.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,63.7,91,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,21,83,,percent of total billed charges,,17.7,,,,fee schedule,,17.7,,,,fee schedule,,,58.1,83,,percent of total billed charges,,,,,,,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,3.5,66.5,
LEGIONELLA ANTIBODY,86713,CDM,86713,CPT,,,both,,91,91,,,,,,,,,,,,,15.75,,,,fee schedule,,,77.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.75,,,,fee schedule,,,,,,,,15.75,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,27.3,83,,percent of total billed charges,,15.75,,,,fee schedule,,15.75,,,,fee schedule,,,75.53,83,,percent of total billed charges,,,,,,,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,3.5,86.45,
ANTB MUMPS-IgG,86735,CDM,86735,CPT,,,both,,76,76,,,,,,,,,,,,,12.7,,,,fee schedule,,,64.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.7,,,,fee schedule,,,,,,,,12.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,12.7,,,,fee schedule,,12.7,,,,fee schedule,,,63.08,83,,percent of total billed charges,,,,,,,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,3.5,72.2,
ANTB MUMPS-IgM,86735b,CDM,86735,CPT,,,both,,91,91,,,,,,,,,,,,,12.7,,,,fee schedule,,,77.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.7,,,,fee schedule,,,,,,,,12.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,27.3,83,,percent of total billed charges,,12.7,,,,fee schedule,,12.7,,,,fee schedule,,,75.53,83,,percent of total billed charges,,,,,,,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,3.5,86.45,
MYCOPLASMA ANTIBODY,86738,CDM,86738,CPT,,,both,,78,78,,,,,,,,,,,,,20.4,,,,fee schedule,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,20.4,,,,fee schedule,,,,,,,,20.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,20.4,,,,fee schedule,,20.4,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
ANTB PARVOVIRUS,86747,CDM,86747,CPT,,,both,,77,77,,,,,,,,,,,,,39.2,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,39.2,,,,fee schedule,,,,,,,,39.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,39.2,,,,fee schedule,,39.2,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
RICKETTSIA ANTIBODY,86757,CDM,86757,CPT,,,both,,110,110,,,,,,,,,,,,,20.2,,,,fee schedule,,,93.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,20.2,,,,fee schedule,,,,,,,,20.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,100.1,91,,percent of total billed charges,,,104.5,95,,percent of total billed charges,,,91.3,83,,percent of total billed charges,,,33,83,,percent of total billed charges,,20.2,,,,fee schedule,,20.2,,,,fee schedule,,,91.3,83,,percent of total billed charges,,,,,,,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,93.5,85,,percent of total billed charges,,3.5,104.5,
ANTB RUBELLA,86762,CDM,86762,CPT,,,both,,51,51,,,,,,,,,,,,,16.4,,,,fee schedule,,,43.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,16.4,,,,fee schedule,,,,,,,,16.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,16.4,,,,fee schedule,,16.4,,,,fee schedule,,,42.33,83,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,3.5,48.45,
ANTB RUBEOLA,86765,CDM,86765,CPT,,,both,,78,78,,,,,,,,,,,,,8.2,,,,fee schedule,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.2,,,,fee schedule,,,,,,,,8.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,8.2,,,,fee schedule,,8.2,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
TETANUS ANTIBODY,86774,CDM,86774,CPT,,,both,,90,90,,,,,,,,,,,,,38.6,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,38.6,,,,fee schedule,,,,,,,,38.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,38.6,,,,fee schedule,,38.6,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
TOXOPLASMA ANTIBODY,86777,CDM,86777,CPT,,,both,,77,77,,,,,,,,,,,,,25.4,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,25.4,,,,fee schedule,,,,,,,,25.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,25.4,,,,fee schedule,,25.4,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
"TOXOPLASMA ANTIBODY, IGM",86778,CDM,86778,CPT,,,both,,77,77,,,,,,,,,,,,,37.6,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,37.6,,,,fee schedule,,,,,,,,37.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,37.6,,,,fee schedule,,37.6,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
Treponema Pallidum FTA/ABS,86780,CDM,86780,CPT,,,both,,74,74,,,,,,,,,,,,,34.58,,,,fee schedule,,,62.9,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,34.58,,,,fee schedule,,,,,,,,34.58,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,22.2,83,,percent of total billed charges,,34.58,,,,fee schedule,,34.58,,,,fee schedule,,,61.42,83,,percent of total billed charges,,,,,,,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,3.5,70.3,
ANTB VARICELLA-ZOSTER,86787,CDM,86787,CPT,,,both,,76,76,,,,,,,,,,,,,30,,,,fee schedule,,,64.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,30,,,,fee schedule,,,,,,,,30,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,30,,,,fee schedule,,30,,,,fee schedule,,,63.08,83,,percent of total billed charges,,,,,,,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,3.5,72.2,
"WEST NILE VIRUS AB, IGM",86788,CDM,86788,CPT,,,both,,70,70,,,,,,,,,,,,,28.24,,,,fee schedule,,,59.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,28.24,,,,fee schedule,,,,,,,,28.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,63.7,91,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,21,83,,percent of total billed charges,,28.24,,,,fee schedule,,28.24,,,,fee schedule,,,58.1,83,,percent of total billed charges,,,,,,,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,3.5,66.5,
THYROGLOBULIN ANTIBODY,86800,CDM,86800,CPT,,,both,,77,77,,,,,,,,,,,,,11.8,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.8,,,,fee schedule,,,,,,,,11.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,11.8,,,,fee schedule,,11.8,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
HEP C ANTB,86803,CDM,86803,CPT,,,both,,90,90,,,,,,,,,,,,,33.7,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,33.7,,,,fee schedule,,,,,,,,33.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,33.7,,,,fee schedule,,33.7,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
HLA TYPING B/C 1 AG,86812,CDM,86812,CPT,,,both,,127,127,,,,,,,,,,,,,6.2,,,,fee schedule,,,107.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.2,,,,fee schedule,,,,,,,,6.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,6.2,,,,fee schedule,,6.2,,,,fee schedule,,,105.41,83,,percent of total billed charges,,,,,,,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,3.5,120.65,
RBC ANTIBODY SCREEN,86850,CDM,86850,CPT,,,both,,53,53,,,,,,,,,,,,,16.95,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,16.95,,,,fee schedule,,,,,,,,16.95,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,16.95,,,,fee schedule,,16.95,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
RBC ANTIBODY ELUTION,86860,CDM,86860,CPT,,,both,,100,100,,,,,,,,,,,,,23.8,,,,fee schedule,,,85,85,,percent of total billed charges,,46.93,,,,fee schedule,,29.77,,,,fee schedule,,23.8,,,,fee schedule,,,,,,,,23.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,30,83,,percent of total billed charges,,23.8,,,,fee schedule,,23.8,,,,fee schedule,,,83,83,,percent of total billed charges,,,,,,,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,23.8,95,
RBC ANTIBODY IDENTIFICATION,86870,CDM,86870,CPT,,,both,,77,77,,,,,,,,,,,,,14.35,,,,fee schedule,,,65.45,85,,percent of total billed charges,,64.47,,,,fee schedule,,40.9,,,,fee schedule,,14.35,,,,fee schedule,,,,,,,,14.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,14.35,,,,fee schedule,,14.35,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,14.35,73.15,
"COOMBS TEST, DIRECT",86880,CDM,86880,CPT,,,both,,34,34,,,,,,,,,,,,,5.8,,,,fee schedule,,,28.9,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.8,,,,fee schedule,,,,,,,,5.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,10.2,83,,percent of total billed charges,,5.8,,,,fee schedule,,5.8,,,,fee schedule,,,28.22,83,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,3.5,32.3,
"COOMBS TEST, INDIRECT, QUAL",86885,CDM,86885,CPT,,,both,,55,55,,,,,,,,,,,,,18.3,,,,fee schedule,,,46.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,18.3,,,,fee schedule,,,,,,,,18.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,16.5,83,,percent of total billed charges,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,45.65,83,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,3.5,52.25,
BLD TYPING ABO,86900,CDM,86900,CPT,,,both,,28,28,,,,,,,,,,,,,3.5,,,,fee schedule,,,23.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,8.4,83,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,23.24,83,,percent of total billed charges,,,,,,,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,3.5,26.6,
BLD TYPING RH D,86901,CDM,86901,CPT,,,both,,28,28,,,,,,,,,,,,,4.7,,,,fee schedule,,,23.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.7,,,,fee schedule,,,,,,,,4.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,8.4,83,,percent of total billed charges,,4.7,,,,fee schedule,,4.7,,,,fee schedule,,,23.24,83,,percent of total billed charges,,,,,,,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,3.5,26.6,
"BLOOD TYPING, RBC ANTIGENS",86905,CDM,86905,CPT,,,both,,40,40,,,,,,,,,,,,,4.95,,,,fee schedule,,,34,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.95,,,,fee schedule,,,,,,,,4.95,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,12,83,,percent of total billed charges,,4.95,,,,fee schedule,,4.95,,,,fee schedule,,,33.2,83,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,3.5,38,
"BLOOD TYPING, RH PHENOTYPE",86906,CDM,86906,CPT,,,both,,40,40,,,,,,,,,,,,,4.6,,,,fee schedule,,,34,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.6,,,,fee schedule,,,,,,,,4.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,12,83,,percent of total billed charges,,4.6,,,,fee schedule,,4.6,,,,fee schedule,,,33.2,83,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,3.5,38,
"BB Cross Match, Immediate Spin",86920,CDM,86920,CPT,,,both,,47,47,,,,,,,,,,,,,4.7,,,,fee schedule,,,39.95,85,,percent of total billed charges,,52.09,,,,fee schedule,,33.04,,,,fee schedule,,4.7,,,,fee schedule,,,,,,,,4.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,14.1,83,,percent of total billed charges,,4.7,,,,fee schedule,,4.7,,,,fee schedule,,,39.01,83,,percent of total billed charges,,,,,,,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,4.7,52.09,
"COMPATIBILITY TEST, INCUBATE",86921,CDM,86921,CPT,,,both,,167,167,,,,,,,,,,,,,18.8,,,,fee schedule,,,141.95,85,,percent of total billed charges,,46.93,,,,fee schedule,,29.77,,,,fee schedule,,18.8,,,,fee schedule,,,,,,,,18.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,50.1,83,,percent of total billed charges,,18.8,,,,fee schedule,,18.8,,,,fee schedule,,,138.61,83,,percent of total billed charges,,,,,,,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,18.8,158.65,
"BB-Crossmatch, Antigloublin",86922,CDM,86922,CPT,,,both,,88,88,,,,,,,,,,,,,9.4,,,,fee schedule,,,74.8,85,,percent of total billed charges,,55.7,,,,fee schedule,,35.33,,,,fee schedule,,9.4,,,,fee schedule,,,,,,,,9.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,26.4,83,,percent of total billed charges,,9.4,,,,fee schedule,,9.4,,,,fee schedule,,,73.04,83,,percent of total billed charges,,,,,,,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,9.4,83.6,
SPECIMEN CONCENTRATION,87015,CDM,87015,CPT,,,both,,27,27,,,,,,,,,,,,,7.2,,,,fee schedule,,,22.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,7.2,,,,fee schedule,,,,,,,,7.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,8.1,83,,percent of total billed charges,,7.2,,,,fee schedule,,7.2,,,,fee schedule,,,22.41,83,,percent of total billed charges,,,,,,,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,3.5,25.65,
BLOOD CULTURE FOR BACTERIA,87040,CDM,87040,CPT,,,both,,65,65,,,,,,,,,,,,,27,,,,fee schedule,,,55.25,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,27,,,,fee schedule,,,,,,,,27,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,59.15,91,,percent of total billed charges,,,61.75,95,,percent of total billed charges,,,53.95,83,,percent of total billed charges,,,19.5,83,,percent of total billed charges,,27,,,,fee schedule,,27,,,,fee schedule,,,53.95,83,,percent of total billed charges,,,,,,,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,55.25,85,,percent of total billed charges,,3.5,61.75,
CUL BACT STL AERC ISOL SALMONELLA  SHIGELLA,87045,CDM,87045,CPT,,,both,,98,98,,,,,,,,,,,,,36.9,,,,fee schedule,,,83.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,36.9,,,,fee schedule,,,,,,,,36.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,89.18,91,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,29.4,83,,percent of total billed charges,,36.9,,,,fee schedule,,36.9,,,,fee schedule,,,81.34,83,,percent of total billed charges,,,,,,,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,83.3,85,,percent of total billed charges,,3.5,93.1,
CUL BACT STL AERC ADDL PATHOGENS/ID EA,87046,CDM,87046,CPT,,,both,,53,53,,,,,,,,,,,,,2.4,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,2.4,,,,fee schedule,,,,,,,,2.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,2.4,,,,fee schedule,,2.4,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,2.4,50.35,
CULTURE - BACTERIA EXCLUDE-URINE/BLD/STL AERC ISOL,87070,CDM,87070,CPT,,,both,,64,64,,,,,,,,,,,,,18.6,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,18.6,,,,fee schedule,,,,,,,,18.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,18.6,,,,fee schedule,,18.6,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
CULTURE - BACTERIA EXCLUDE,87070-90,CDM,87070,CPT,,,both,,64,64,,,,,,,,,,,,,18.6,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,18.6,,,,fee schedule,,,,,,,,18.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,18.6,,,,fee schedule,,18.6,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
CUL BACT BLD ANAERC ISOL,87075,CDM,87075,CPT,,,both,,109,109,,,,,,,,,,,,,12.35,,,,fee schedule,,,92.65,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.35,,,,fee schedule,,,,,,,,12.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,32.7,83,,percent of total billed charges,,12.35,,,,fee schedule,,12.35,,,,fee schedule,,,90.47,83,,percent of total billed charges,,,,,,,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,3.5,103.55,
CUL BACT AERC ADDL METHS DEFINITIVE EA ISOL,87077,CDM,87077,CPT,,,both,,78,78,,,,,,,,,,,,,,,,,,,,66.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,3.5,74.1,
Culture Screening For Specific Organism,87081,CDM,87081,CPT,,,both,,88,88,,,,,,,,,,,,,5.8,,,,fee schedule,,,74.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.8,,,,fee schedule,,,,,,,,5.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,26.4,83,,percent of total billed charges,,5.8,,,,fee schedule,,5.8,,,,fee schedule,,,73.04,83,,percent of total billed charges,,,,,,,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,3.5,83.6,
CULTURE SCREEN ONLY,87081P,CDM,87081,CPT,,,both,P,36,36,,,,,,,,,,,,,5.8,,,,fee schedule,,,30.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.8,,,,fee schedule,,,,,,,,5.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,10.8,83,,percent of total billed charges,,5.8,,,,fee schedule,,5.8,,,,fee schedule,,,29.88,83,,percent of total billed charges,,,,,,,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,3.5,34.2,
CULTURE SCREEN ONLY,87081T,CDM,87081,CPT,,,both,T,52,52,,,,,,,,,,,,,5.8,,,,fee schedule,,,44.2,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.8,,,,fee schedule,,,,,,,,5.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,15.6,83,,percent of total billed charges,,5.8,,,,fee schedule,,5.8,,,,fee schedule,,,43.16,83,,percent of total billed charges,,,,,,,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,3.5,49.4,
CULTURE OF SPECIMEN BY KIT,87084,CDM,87084,CPT,,,both,,24,24,,,,,,,,,,,,,12,,,,fee schedule,,,20.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12,,,,fee schedule,,,,,,,,12,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,7.2,83,,percent of total billed charges,,12,,,,fee schedule,,12,,,,fee schedule,,,19.92,83,,percent of total billed charges,,,,,,,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,3.5,22.8,
CUL BACT QUAN COLONY CNT URINE,87086,CDM,87086,CPT,,,both,,64,64,,,,,,,,,,,,,31.5,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,31.5,,,,fee schedule,,,,,,,,31.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,31.5,,,,fee schedule,,31.5,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
CULTURE BCT ISOL  PRSMPTV ID ISOLATE EA URINE,87088,CDM,87088,CPT,,,both,,41,41,,,,,,,,,,,,,11.31,,,,fee schedule,,,34.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.31,,,,fee schedule,,,,,,,,11.31,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,11.31,,,,fee schedule,,11.31,,,,fee schedule,,,34.03,83,,percent of total billed charges,,,,,,,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,3.5,38.95,
CUL FNGI MOLD/YEAST PRSMPTV ID OTH XCPT BLD,87102,CDM,87102,CPT,,,both,,110,110,,,,,,,,,,,,,6.2,,,,fee schedule,,,93.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.2,,,,fee schedule,,,,,,,,6.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,100.1,91,,percent of total billed charges,,,104.5,95,,percent of total billed charges,,,91.3,83,,percent of total billed charges,,,33,83,,percent of total billed charges,,6.2,,,,fee schedule,,6.2,,,,fee schedule,,,91.3,83,,percent of total billed charges,,,,,,,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,93.5,85,,percent of total billed charges,,3.5,104.5,
BLOOD FUNGUS CULTURE,87103,CDM,87103,CPT,,,both,,106,106,,,,,,,,,,,,,18.6,,,,fee schedule,,,90.1,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,18.6,,,,fee schedule,,,,,,,,18.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,31.8,83,,percent of total billed charges,,18.6,,,,fee schedule,,18.6,,,,fee schedule,,,87.98,83,,percent of total billed charges,,,,,,,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,3.5,100.7,
CUL CHLAMYDIA ANY SRC,87110,CDM,87110,CPT,,,both,,110,110,,,,,,,,,,,,,33.7,,,,fee schedule,,,93.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,33.7,,,,fee schedule,,,,,,,,33.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,100.1,91,,percent of total billed charges,,,104.5,95,,percent of total billed charges,,,91.3,83,,percent of total billed charges,,,33,83,,percent of total billed charges,,33.7,,,,fee schedule,,33.7,,,,fee schedule,,,91.3,83,,percent of total billed charges,,,,,,,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,93.5,85,,percent of total billed charges,,3.5,104.5,
MYCOBACTERIA CULTURE,87116,CDM,87116,CPT,,,both,,77,77,,,,,,,,,,,,,23.4,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,23.4,,,,fee schedule,,,,,,,,23.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,23.4,,,,fee schedule,,23.4,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
"CULTURE TYPE, NUCLEIC ACID",87149,CDM,87149,CPT,,,both,,90,90,,,,,,,,,,,,,,,,,,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
MACROSCOPIC EXAM PARASITE,87169,CDM,87169,CPT,,,both,,32,32,,,,,,,,,,,,,9,,,,fee schedule,,,27.2,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9,,,,fee schedule,,,,,,,,9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,9.6,83,,percent of total billed charges,,9,,,,fee schedule,,9,,,,fee schedule,,,26.56,83,,percent of total billed charges,,,,,,,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,3.5,30.4,
PINWORM EXAM,87172,CDM,87172,CPT,,,both,,41,41,,,,,,,,,,,,,9,,,,fee schedule,,,34.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9,,,,fee schedule,,,,,,,,9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,9,,,,fee schedule,,9,,,,fee schedule,,,34.03,83,,percent of total billed charges,,,,,,,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,3.5,38.95,
"TISSUE HOMOGENIZATION, CULTR",87176,CDM,87176,CPT,,,both,,22,22,,,,,,,,,,,,,15.4,,,,fee schedule,,,18.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.4,,,,fee schedule,,,,,,,,15.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,20.02,91,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,6.6,83,,percent of total billed charges,,15.4,,,,fee schedule,,15.4,,,,fee schedule,,,18.26,83,,percent of total billed charges,,,,,,,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,3.5,20.9,
OVA  PARASITS DIR SMRS CONCENTRATION/ID,87177,CDM,87177,CPT,,,both,,53,53,,,,,,,,,,,,,21.6,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,21.6,,,,fee schedule,,,,,,,,21.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,21.6,,,,fee schedule,,21.6,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
"MICROBE SUSCEPTIBLE, DIFFUSE",87181,CDM,87181,CPT,,,both,,23,23,,,,,,,,,,,,,6.2,,,,fee schedule,,,19.55,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.2,,,,fee schedule,,,,,,,,6.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,20.93,91,,percent of total billed charges,,,21.85,95,,percent of total billed charges,,,19.09,83,,percent of total billed charges,,,6.9,83,,percent of total billed charges,,6.2,,,,fee schedule,,6.2,,,,fee schedule,,,19.09,83,,percent of total billed charges,,,,,,,,,20.7,90,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,19.55,85,,percent of total billed charges,,3.5,21.85,
SC ANTMCRB MICRODIL/AGAR EA MULTI-ANTMCRB PLATE,87186,CDM,87186,CPT,,,both,,53,53,,,,,,,,,,,,,11.3,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,11.3,,,,fee schedule,,,,,,,,11.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,11.3,,,,fee schedule,,11.3,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
"SMEAR, GRAM STAIN",87205,CDM,87205,CPT,,,both,,48,48,,,,,,,,,,,,,10.5,,,,fee schedule,,,40.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.5,,,,fee schedule,,,,,,,,10.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,14.4,83,,percent of total billed charges,,10.5,,,,fee schedule,,10.5,,,,fee schedule,,,39.84,83,,percent of total billed charges,,,,,,,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,3.5,45.6,
"SMEAR, FLUORESCENT/ACID STAI",87206,CDM,87206,CPT,,,both,,64,64,,,,,,,,,,,,,4.2,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.2,,,,fee schedule,,,,,,,,4.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,4.2,,,,fee schedule,,4.2,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
SMR PRIM SRC CPLX SPEC STAIN OVA  PARASITS,87209,CDM,87209,CPT,,,both,,87,87,,,,,,,,,,,,,15.06,,,,fee schedule,,,73.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.06,,,,fee schedule,,,,,,,,15.06,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,26.1,83,,percent of total billed charges,,15.06,,,,fee schedule,,15.06,,,,fee schedule,,,72.21,83,,percent of total billed charges,,,,,,,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,3.5,82.65,
SMR PRIM SRC WET MOUNT NFCT AGT,87210,CDM,87210,CPT,,,both,,53,53,,,,,,,,,,,,,4.7,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.7,,,,fee schedule,,,,,,,,4.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,4.7,,,,fee schedule,,4.7,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT,87220,CDM,87220,CPT,,,both,,58,58,,,,,,,,,,,,,14.1,,,,fee schedule,,,49.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,14.1,,,,fee schedule,,,,,,,,14.1,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,52.78,91,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,17.4,83,,percent of total billed charges,,14.1,,,,fee schedule,,14.1,,,,fee schedule,,,48.14,83,,percent of total billed charges,,,,,,,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,3.5,55.1,
TISSUE EXAM FOR FUNGI,87220P,CDM,87220,CPT,,,both,P,8,8,,,,,,,,,,,,,14.1,,,,fee schedule,,,6.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,14.1,,,,fee schedule,,,,,,,,14.1,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,7.28,91,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,2.4,83,,percent of total billed charges,,14.1,,,,fee schedule,,14.1,,,,fee schedule,,,6.64,83,,percent of total billed charges,,,,,,,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.8,85,,percent of total billed charges,,2.4,14.1,
TISSUE EXAM FOR FUNGI,87220T,CDM,87220,CPT,,,both,T,50,50,,,,,,,,,,,,,14.1,,,,fee schedule,,,42.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,14.1,,,,fee schedule,,,,,,,,14.1,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,14.1,,,,fee schedule,,14.1,,,,fee schedule,,,41.5,83,,percent of total billed charges,,,,,,,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,3.5,47.5,
"VIRUS INOCULATION, TISSUE",87252,CDM,87252,CPT,,,both,,122,122,,,,,,,,,,,,,12.8,,,,fee schedule,,,103.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.8,,,,fee schedule,,,,,,,,12.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,36.6,83,,percent of total billed charges,,12.8,,,,fee schedule,,12.8,,,,fee schedule,,,101.26,83,,percent of total billed charges,,,,,,,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,3.5,115.9,
"VIRUS INOCULATION, SHELL VIA",87254,CDM,87254,CPT,,,both,,100,100,,,,,,,,,,,,,6.4,,,,fee schedule,,,85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.4,,,,fee schedule,,,,,,,,6.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,30,83,,percent of total billed charges,,6.4,,,,fee schedule,,6.4,,,,fee schedule,,,83,83,,percent of total billed charges,,,,,,,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,3.5,95,
VIRUS ID NON-IMMUNOLOGIC OTH/THN CYTOPATHIC,87255,CDM,87255,CPT,,,both,,168,168,,,,,,,,,,,,,47.32,,,,fee schedule,,,142.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,47.32,,,,fee schedule,,,,,,,,47.32,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,50.4,83,,percent of total billed charges,,47.32,,,,fee schedule,,47.32,,,,fee schedule,,,139.44,83,,percent of total billed charges,,,,,,,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,3.5,159.6,
"GIARDIA AG, IF",87269,CDM,87269,CPT,,,both,,77,77,,,,,,,,,,,,,10.05,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.05,,,,fee schedule,,,,,,,,10.05,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,10.05,,,,fee schedule,,10.05,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
"CRYPTOSPORIDIUM AG, IF",87272,CDM,87272,CPT,,,both,,62,62,,,,,,,,,,,,,15.7,,,,fee schedule,,,52.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.7,,,,fee schedule,,,,,,,,15.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,15.7,,,,fee schedule,,15.7,,,,fee schedule,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,3.5,58.9,
"CLOSTRIDIUM AG, EIA",87324,CDM,87324,CPT,,,both,,135,135,,,,,,,,,,,,,15.7,,,,fee schedule,,,114.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.7,,,,fee schedule,,,,,,,,15.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,40.5,83,,percent of total billed charges,,15.7,,,,fee schedule,,15.7,,,,fee schedule,,,112.05,83,,percent of total billed charges,,,,,,,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,3.5,128.25,
"CRYPTOCOCCUS NEOFORM AG, EIA",87327,CDM,87327,CPT,,,both,,87,87,,,,,,,,,,,,,12.5,,,,fee schedule,,,73.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.5,,,,fee schedule,,,,,,,,12.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,26.1,83,,percent of total billed charges,,12.5,,,,fee schedule,,12.5,,,,fee schedule,,,72.21,83,,percent of total billed charges,,,,,,,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,3.5,82.65,
"GIARDIA AG, EIA",87329,CDM,87329,CPT,,,both,,57,57,,,,,,,,,,,,,10.05,,,,fee schedule,,,48.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,10.05,,,,fee schedule,,,,,,,,10.05,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,17.1,83,,percent of total billed charges,,10.05,,,,fee schedule,,10.05,,,,fee schedule,,,47.31,83,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,3.5,54.15,
"HPYLORI, STOOL, EIA",87338,CDM,87338,CPT,,,both,,179,179,,,,,,,,,,,,,18.8,,,,fee schedule,,,152.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,18.8,,,,fee schedule,,,,,,,,18.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,53.7,83,,percent of total billed charges,,18.8,,,,fee schedule,,18.8,,,,fee schedule,,,148.57,83,,percent of total billed charges,,,,,,,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,3.5,170.05,
IAAD EIA HPYLORI,87339,CDM,87339,CPT,,,both,,67,67,,,,,,,,,,,,,12.5,,,,fee schedule,,,56.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.5,,,,fee schedule,,,,,,,,12.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,20.1,83,,percent of total billed charges,,12.5,,,,fee schedule,,12.5,,,,fee schedule,,,55.61,83,,percent of total billed charges,,,,,,,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,3.5,63.65,
IAAD EIA HEP B SURF AG,87340,CDM,87340,CPT,,,both,,64,64,,,,,,,,,,,,,13.5,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,13.5,,,,fee schedule,,,,,,,,13.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,13.5,,,,fee schedule,,13.5,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
IAAD EIA HEP BE AG,87350,CDM,87350,CPT,,,both,,64,64,,,,,,,,,,,,,15.05,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.05,,,,fee schedule,,,,,,,,15.05,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,15.05,,,,fee schedule,,15.05,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
IAAD EIA HISTOPLSM CAPSULATUM,87385,CDM,87385,CPT,,,both,,59,59,,,,,,,,,,,,,15.7,,,,fee schedule,,,50.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.7,,,,fee schedule,,,,,,,,15.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,17.7,83,,percent of total billed charges,,15.7,,,,fee schedule,,15.7,,,,fee schedule,,,48.97,83,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,3.5,56.05,
HIV-1 AG W/HIV-1 & HIV-2 AB,87389,CDM,87389,CPT,,,both,,167,167,,,,,,,,,,,,,81.8,,,,fee schedule,,,141.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,81.8,,,,fee schedule,,,,,,,,81.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,50.1,83,,percent of total billed charges,,81.8,,,,fee schedule,,81.8,,,,fee schedule,,,138.61,83,,percent of total billed charges,,,,,,,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,3.5,158.65,
"INFLUENZA A/B, AG, EIA",87400,CDM,87400,CPT,,,both,,63,63,,,,,,,,,,,,,12.4,,,,fee schedule,,,53.55,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.4,,,,fee schedule,,,,,,,,12.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,18.9,83,,percent of total billed charges,,12.4,,,,fee schedule,,12.4,,,,fee schedule,,,52.29,83,,percent of total billed charges,,,,,,,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,3.5,59.85,
"ROTAVIRUS AG, EIA",87425,CDM,87425,CPT,,,both,,64,64,,,,,,,,,,,,,15.7,,,,fee schedule,,,54.4,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,15.7,,,,fee schedule,,,,,,,,15.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,15.7,,,,fee schedule,,15.7,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,3.5,60.8,
COVID Rapid,87426,CDM,87426,CPT,,,both,,206,206,,,,,,,,,,,,,,,,,,,,175.1,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,61.8,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,3.5,195.7,
IAAD EIA SHIGA-LIKE TOXIN,87427,CDM,87427,CPT,,,both,,120,120,,,,,,,,,,,,,12.5,,,,fee schedule,,,102,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.5,,,,fee schedule,,,,,,,,12.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,36,83,,percent of total billed charges,,12.5,,,,fee schedule,,12.5,,,,fee schedule,,,99.6,83,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,3.5,114,
SARS COVID INFLUENZA TESTING,87428,CDM,87428,CPT,,,both,,220,220,,,,,,,,,,,,,,,,,,,,187,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,200.2,91,,percent of total billed charges,,,209,95,,percent of total billed charges,,,182.6,83,,percent of total billed charges,,,66,83,,percent of total billed charges,,,,,,,,,,,,,,,182.6,83,,percent of total billed charges,,,,,,,,,198,90,,percent of total billed charges,,,198,90,,percent of total billed charges,,,198,90,,percent of total billed charges,,,198,90,,percent of total billed charges,,,187,85,,percent of total billed charges,,3.5,209,
"AG DETECT NOS, EIA, MULT",87449,CDM,87449,CPT,,,both,,145,145,,,,,,,,,,,,,47.04,,,,fee schedule,,,123.25,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,47.04,,,,fee schedule,,,,,,,,47.04,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,43.5,83,,percent of total billed charges,,47.04,,,,fee schedule,,47.04,,,,fee schedule,,,120.35,83,,percent of total billed charges,,,,,,,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,3.5,137.75,
"CANDIDA, DNA, AMP PROBE",87481,CDM,87481,CPT,,,both,,200,200,,,,,,,,,,,,,45.8,,,,fee schedule,,,170,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,45.8,,,,fee schedule,,,,,,,,45.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,60,83,,percent of total billed charges,,45.8,,,,fee schedule,,45.8,,,,fee schedule,,,166,83,,percent of total billed charges,,,,,,,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,3.5,190,
IADNA CHLAMYDIA TRACHOMATIS DIR PRB,87490,CDM,87490,CPT,,,both,,95,95,,,,,,,,,,,,,26.2,,,,fee schedule,,,80.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,26.2,,,,fee schedule,,,,,,,,26.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,86.45,91,,percent of total billed charges,,,90.25,95,,percent of total billed charges,,,78.85,83,,percent of total billed charges,,,28.5,83,,percent of total billed charges,,26.2,,,,fee schedule,,26.2,,,,fee schedule,,,78.85,83,,percent of total billed charges,,,,,,,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,85.5,90,,percent of total billed charges,,,80.75,85,,percent of total billed charges,,3.5,90.25,
IADNA CHLAMYDIA TRACHOMATIS AMP PRB,87491,CDM,87491,CPT,,,both,,163,163,,,,,,,,,,,,,45.8,,,,fee schedule,,,138.55,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,45.8,,,,fee schedule,,,,,,,,45.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,48.9,83,,percent of total billed charges,,45.8,,,,fee schedule,,45.8,,,,fee schedule,,,135.29,83,,percent of total billed charges,,,,,,,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,3.5,154.85,
"CYTOMEG, DNA, QUANT",87497,CDM,87497,CPT,,,both,,271,271,,,,,,,,,,,,,45.63,,,,fee schedule,,,230.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,45.63,,,,fee schedule,,,,,,,,45.63,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,246.61,91,,percent of total billed charges,,,257.45,95,,percent of total billed charges,,,224.93,83,,percent of total billed charges,,,81.3,83,,percent of total billed charges,,45.63,,,,fee schedule,,45.63,,,,fee schedule,,,224.93,83,,percent of total billed charges,,,,,,,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,230.35,85,,percent of total billed charges,,3.5,257.45,
"ENTEROVIRUS, DNA, AMP PROBE",87498,CDM,87498,CPT,,,both,,150,150,,,,,,,,,,,,,45.83,,,,fee schedule,,,127.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,45.83,,,,fee schedule,,,,,,,,45.83,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,45.83,,,,fee schedule,,45.83,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,3.5,142.5,
"HEPATITIS C, RNA, AMP PROBE",87521,CDM,87521,CPT,,,both,,291,291,,,,,,,,,,,,,45.8,,,,fee schedule,,,247.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,45.8,,,,fee schedule,,,,,,,,45.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,264.81,91,,percent of total billed charges,,,276.45,95,,percent of total billed charges,,,241.53,83,,percent of total billed charges,,,87.3,83,,percent of total billed charges,,45.8,,,,fee schedule,,45.8,,,,fee schedule,,,241.53,83,,percent of total billed charges,,,,,,,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,247.35,85,,percent of total billed charges,,3.5,276.45,
"HEPATITIS C, RNA, QUANT",87522,CDM,87522,CPT,,,both,,430,430,,,,,,,,,,,,,55.9,,,,fee schedule,,,365.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,55.9,,,,fee schedule,,,,,,,,55.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,391.3,91,,percent of total billed charges,,,408.5,95,,percent of total billed charges,,,356.9,83,,percent of total billed charges,,,129,83,,percent of total billed charges,,55.9,,,,fee schedule,,55.9,,,,fee schedule,,,356.9,83,,percent of total billed charges,,,,,,,,,387,90,,percent of total billed charges,,,387,90,,percent of total billed charges,,,387,90,,percent of total billed charges,,,387,90,,percent of total billed charges,,,365.5,85,,percent of total billed charges,,3.5,408.5,
"HSV, DNA, AMP PROBE",87529,CDM,87529,CPT,,,both,,110,110,,,,,,,,,,,,,45.8,,,,fee schedule,,,93.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,45.8,,,,fee schedule,,,,,,,,45.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,100.1,91,,percent of total billed charges,,,104.5,95,,percent of total billed charges,,,91.3,83,,percent of total billed charges,,,33,83,,percent of total billed charges,,45.8,,,,fee schedule,,45.8,,,,fee schedule,,,91.3,83,,percent of total billed charges,,,,,,,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,99,90,,percent of total billed charges,,,93.5,85,,percent of total billed charges,,3.5,104.5,
"HIV-1, DNA, AMP PROBE",87535,CDM,87535,CPT,,,both,,491,491,,,,,,,,,,,,,45.8,,,,fee schedule,,,417.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,45.8,,,,fee schedule,,,,,,,,45.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,446.81,91,,percent of total billed charges,,,466.45,95,,percent of total billed charges,,,407.53,83,,percent of total billed charges,,,147.3,83,,percent of total billed charges,,45.8,,,,fee schedule,,45.8,,,,fee schedule,,,407.53,83,,percent of total billed charges,,,,,,,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,417.35,85,,percent of total billed charges,,3.5,466.45,
IADNA HIV-1 QUAN,87536,CDM,87536,CPT,,,both,,491,491,,,,,,,,,,,,,86.9,,,,fee schedule,,,417.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,86.9,,,,fee schedule,,,,,,,,86.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,446.81,91,,percent of total billed charges,,,466.45,95,,percent of total billed charges,,,407.53,83,,percent of total billed charges,,,147.3,83,,percent of total billed charges,,86.9,,,,fee schedule,,86.9,,,,fee schedule,,,407.53,83,,percent of total billed charges,,,,,,,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,417.35,85,,percent of total billed charges,,3.5,466.45,
"N.GONORRHOEAE, DNA, DIR PROB",87590,CDM,87590,CPT,,,both,,90,90,,,,,,,,,,,,,26.2,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,26.2,,,,fee schedule,,,,,,,,26.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,26.2,,,,fee schedule,,26.2,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
IADNA NEISSERIA GONORRHOEAE AMP PRB,87591,CDM,87591,CPT,,,both,,163,163,,,,,,,,,,,,,45.8,,,,fee schedule,,,138.55,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,45.8,,,,fee schedule,,,,,,,,45.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,48.9,83,,percent of total billed charges,,45.8,,,,fee schedule,,45.8,,,,fee schedule,,,135.29,83,,percent of total billed charges,,,,,,,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,3.5,154.85,
"Orthopox/monkey Pox Virus Dna,pcr",87593,CDM,87593,CPT,,,both,,103,103,,,,,,,,,,,,,30.79,,,,fee schedule,,,87.55,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,30.79,,,,fee schedule,,,,,,,,30.79,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,30.9,83,,percent of total billed charges,,30.79,,,,fee schedule,,30.79,,,,fee schedule,,,85.49,83,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,3.5,97.85,
HPV HIGH-RISK TYPES,87624,CDM,87624,CPT,,,both,,340,340,,,,,,,,,,,,,28.66,,,,fee schedule,,,289,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,28.66,,,,fee schedule,,,,,,,,28.66,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,309.4,91,,percent of total billed charges,,,323,95,,percent of total billed charges,,,282.2,83,,percent of total billed charges,,,102,83,,percent of total billed charges,,28.66,,,,fee schedule,,28.66,,,,fee schedule,,,282.2,83,,percent of total billed charges,,,,,,,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,306,90,,percent of total billed charges,,,289,85,,percent of total billed charges,,3.5,323,
HPV TYPES 16 & 18 ONLY,87625,CDM,87625,CPT,,,both,,229,229,,,,,,,,,,,,,28.66,,,,fee schedule,,,194.65,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,28.66,,,,fee schedule,,,,,,,,28.66,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,208.39,91,,percent of total billed charges,,,217.55,95,,percent of total billed charges,,,190.07,83,,percent of total billed charges,,,68.7,83,,percent of total billed charges,,28.66,,,,fee schedule,,28.66,,,,fee schedule,,,190.07,83,,percent of total billed charges,,,,,,,,,206.1,90,,percent of total billed charges,,,206.1,90,,percent of total billed charges,,,206.1,90,,percent of total billed charges,,,206.1,90,,percent of total billed charges,,,194.65,85,,percent of total billed charges,,3.5,217.55,
"STREP A, DNA, DIR PROBE",87650,CDM,87650,CPT,,,both,,185,185,,,,,,,,,,,,,26.2,,,,fee schedule,,,157.25,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,26.2,,,,fee schedule,,,,,,,,26.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,168.35,91,,percent of total billed charges,,,175.75,95,,percent of total billed charges,,,153.55,83,,percent of total billed charges,,,55.5,83,,percent of total billed charges,,26.2,,,,fee schedule,,26.2,,,,fee schedule,,,153.55,83,,percent of total billed charges,,,,,,,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,157.25,85,,percent of total billed charges,,3.5,175.75,
"STREP A, DNA, DIR PROBE",8765026,CDM,87650,CPT,,,both,26,55,55,,,,,,,,,,,,,26.2,,,,fee schedule,,,46.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,26.2,,,,fee schedule,,,,,,,,26.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,16.5,83,,percent of total billed charges,,26.2,,,,fee schedule,,26.2,,,,fee schedule,,,45.65,83,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,3.5,52.25,
"STREP A, DNA, DIR PROBE",87650P,CDM,87650,CPT,,,both,P,55,55,,,,,,,,,,,,,26.2,,,,fee schedule,,,46.75,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,26.2,,,,fee schedule,,,,,,,,26.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,16.5,83,,percent of total billed charges,,26.2,,,,fee schedule,,26.2,,,,fee schedule,,,45.65,83,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,3.5,52.25,
"STREP A, DNA, DIR PROBE",87650T,CDM,87650,CPT,,,both,T,130,130,,,,,,,,,,,,,26.2,,,,fee schedule,,,110.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,26.2,,,,fee schedule,,,,,,,,26.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,39,83,,percent of total billed charges,,26.2,,,,fee schedule,,26.2,,,,fee schedule,,,107.9,83,,percent of total billed charges,,,,,,,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,3.5,123.5,
"Trichomonas vaginalis, amplified probe technique",87661,CDM,87661,CPT,,,both,,92,92,,,,,,,,,,,,,28.72,,,,fee schedule,,,78.2,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,28.72,,,,fee schedule,,,,,,,,28.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,27.6,83,,percent of total billed charges,,28.72,,,,fee schedule,,28.72,,,,fee schedule,,,76.36,83,,percent of total billed charges,,,,,,,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,3.5,87.4,
Histoplasma DNA PCR,87798,CDM,87798,CPT,,,both,,513,513,,,,,,,,,,,,,595.79,,,,fee schedule,,,436.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,595.79,,,,fee schedule,,,,,,,,595.79,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,466.83,91,,percent of total billed charges,,,487.35,95,,percent of total billed charges,,,425.79,83,,percent of total billed charges,,,153.9,83,,percent of total billed charges,,595.79,,,,fee schedule,,595.79,,,,fee schedule,,,425.79,83,,percent of total billed charges,,,,,,,,,461.7,90,,percent of total billed charges,,,461.7,90,,percent of total billed charges,,,461.7,90,,percent of total billed charges,,,461.7,90,,percent of total billed charges,,,436.05,85,,percent of total billed charges,,3.5,595.79,
"DETECT AGENT NOS, DNA, QUANT",87799,CDM,87799,CPT,,,both,,539,539,,,,,,,,,,,,,155.67,,,,fee schedule,,,458.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,155.67,,,,fee schedule,,,,,,,,155.67,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,490.49,91,,percent of total billed charges,,,512.05,95,,percent of total billed charges,,,447.37,83,,percent of total billed charges,,,161.7,83,,percent of total billed charges,,155.67,,,,fee schedule,,155.67,,,,fee schedule,,,447.37,83,,percent of total billed charges,,,,,,,,,485.1,90,,percent of total billed charges,,,485.1,90,,percent of total billed charges,,,485.1,90,,percent of total billed charges,,,485.1,90,,percent of total billed charges,,,458.15,85,,percent of total billed charges,,3.5,512.05,
IADNA MLT ORGANISMS DIR PRB,87800,CDM,87800,CPT,,,both,,185,185,,,,,,,,,,,,,20.95,,,,fee schedule,,,157.25,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,20.95,,,,fee schedule,,,,,,,,20.95,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,168.35,91,,percent of total billed charges,,,175.75,95,,percent of total billed charges,,,153.55,83,,percent of total billed charges,,,55.5,83,,percent of total billed charges,,20.95,,,,fee schedule,,20.95,,,,fee schedule,,,153.55,83,,percent of total billed charges,,,,,,,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,166.5,90,,percent of total billed charges,,,157.25,85,,percent of total billed charges,,3.5,175.75,
"DETECT AGNT MULT, DNA, AMPLI",87801,CDM,87801,CPT,,,both,,305,305,,,,,,,,,,,,,36.6,,,,fee schedule,,,259.25,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,36.6,,,,fee schedule,,,,,,,,36.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,277.55,91,,percent of total billed charges,,,289.75,95,,percent of total billed charges,,,253.15,83,,percent of total billed charges,,,91.5,83,,percent of total billed charges,,36.6,,,,fee schedule,,36.6,,,,fee schedule,,,253.15,83,,percent of total billed charges,,,,,,,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,274.5,90,,percent of total billed charges,,,259.25,85,,percent of total billed charges,,3.5,289.75,
CLOSTRIDIUM TOXIN A W/OPTIC,87803,CDM,87803,CPT,,,both,,77,77,,,,,,,,,,,,,46.95,,,,fee schedule,,,65.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,46.95,,,,fee schedule,,,,,,,,46.95,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,46.95,,,,fee schedule,,46.95,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,3.5,73.15,
INFLUENZA A/B (IN)- IAADIADOO INF,87804,CDM,87804,CPT,,,both,,59,59,,,,,,,,,,,,,31.3,,,,fee schedule,,,50.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,31.3,,,,fee schedule,,,,,,,,31.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,17.7,83,,percent of total billed charges,,31.3,,,,fee schedule,,31.3,,,,fee schedule,,,48.97,83,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,3.5,56.05,
RSV ASSAY W/OPTIC,87807,CDM,87807,CPT,,,both,,65,65,,,,,,,,,,,,,20.12,,,,fee schedule,,,55.25,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,20.12,,,,fee schedule,,,,,,,,20.12,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,59.15,91,,percent of total billed charges,,,61.75,95,,percent of total billed charges,,,53.95,83,,percent of total billed charges,,,19.5,83,,percent of total billed charges,,20.12,,,,fee schedule,,20.12,,,,fee schedule,,,53.95,83,,percent of total billed charges,,,,,,,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,55.25,85,,percent of total billed charges,,3.5,61.75,
STREP SCREEN - IAADIADOO STREPTOCOCCUS GRP,87880,CDM,87880,CPT,,,both,,62,62,,,,,,,,,,,,,31.4,,,,fee schedule,,,52.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,31.4,,,,fee schedule,,,,,,,,31.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,31.4,,,,fee schedule,,31.4,,,,fee schedule,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,3.5,58.9,
AGENT NOS ASSAY W/OPTIC,87899,CDM,87899,CPT,,,both,,53,53,,,,,,,,,,,,,9.89,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,9.89,,,,fee schedule,,,,,,,,9.89,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,9.89,,,,fee schedule,,9.89,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
"GENOTYPE, DNA, HEPATITIS C",87902,CDM,87902,CPT,,,both,,759,759,,,,,,,,,,,,,168.05,,,,fee schedule,,,645.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,168.05,,,,fee schedule,,,,,,,,168.05,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,690.69,91,,percent of total billed charges,,,721.05,95,,percent of total billed charges,,,629.97,83,,percent of total billed charges,,,227.7,83,,percent of total billed charges,,168.05,,,,fee schedule,,168.05,,,,fee schedule,,,629.97,83,,percent of total billed charges,,,,,,,,,683.1,90,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,683.1,90,,percent of total billed charges,,,645.15,85,,percent of total billed charges,,3.5,721.05,
SIALIDASE ENZYME ASSAY,87905,CDM,87905,CPT,,,both,,82,82,,,,,,,,,,,,,21.08,,,,fee schedule,,,69.7,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,21.08,,,,fee schedule,,,,,,,,21.08,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,74.62,91,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,24.6,83,,percent of total billed charges,,21.08,,,,fee schedule,,21.08,,,,fee schedule,,,68.06,83,,percent of total billed charges,,,,,,,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,3.5,77.9,
SIALIDASE ENZYME ASSAY,87905P,CDM,87905,CPT,,,both,P,31,31,,,,,,,,,,,,,21.08,,,,fee schedule,,,26.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,21.08,,,,fee schedule,,,,,,,,21.08,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,9.3,83,,percent of total billed charges,,21.08,,,,fee schedule,,21.08,,,,fee schedule,,,25.73,83,,percent of total billed charges,,,,,,,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,3.5,29.45,
SIALIDASE ENZYME ASSAY,87905T,CDM,87905,CPT,,,both,T,51,51,,,,,,,,,,,,,21.08,,,,fee schedule,,,43.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,21.08,,,,fee schedule,,,,,,,,21.08,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,21.08,,,,fee schedule,,21.08,,,,fee schedule,,,42.33,83,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,3.5,48.45,
MICROBIOLOGY PROCEDURE,87999,CDM,87999,CPT,,,both,,206,206,,,,,,,,,,,,,,,,,,,,175.1,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,61.8,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,61.8,195.7,
CYTOLOGY OF BODY FLUIDS,88108,CDM,88108,CPT,,,both,,247,247,116.83,,,,fee schedule,,,,,,,,8.9,,,,fee schedule,,,209.95,85,,percent of total billed charges,,35.87,,,,fee schedule,,22.75,,,,fee schedule,,8.9,,,,fee schedule,,120.04,,,,fee schedule,,8.9,,,,fee schedule,,110.15,,,,fee schedule,,66.76,,,,fee schedule,,66.76,,,,fee schedule,,,224.77,91,,percent of total billed charges,,,234.65,95,,percent of total billed charges,,,205.01,83,,percent of total billed charges,,,74.1,83,,percent of total billed charges,,8.9,,,,fee schedule,,8.9,,,,fee schedule,,,205.01,83,,percent of total billed charges,,98.13,,,,fee schedule,,,222.3,90,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,209.95,85,,percent of total billed charges,,8.9,234.65,
CYTP URNE 3-5 PROBES EA SPEC,88120,CDM,88120,CPT,,,both,,150,150,1056.77,,,,fee schedule,,,,,,,,518.96,,,,fee schedule,,,127.5,85,,percent of total billed charges,,92.92,,,,fee schedule,,58.94,,,,fee schedule,,518.96,,,,fee schedule,,,,,,,,518.96,,,,fee schedule,,996.39,,,,fee schedule,,603.87,,,,fee schedule,,603.87,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,518.96,,,,fee schedule,,518.96,,,,fee schedule,,,124.5,83,,percent of total billed charges,,887.69,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,45,1056.77,
CYTP C/V REQ INTERPJ PHYS,88141,CDM,88141,CPT,,,both,,59,59,40.33,,,,fee schedule,,,,,,,,3.5,,,,fee schedule,,,50.15,85,,percent of total billed charges,,34.97,,,,fee schedule,,22.18,,,,fee schedule,,3.5,,,,fee schedule,,39.13,,,,fee schedule,,3.5,,,,fee schedule,,38.02,,,,fee schedule,,23.04,,,,fee schedule,,23.04,,,,fee schedule,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,17.7,83,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,48.97,83,,percent of total billed charges,,33.87,,,,fee schedule,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,3.5,56.05,
CYTP C/V FLU AUTO THIN MNL PHYS,88142,CDM,88142,CPT,,,both,,96,96,,,,,,,,,,,,,3.35,,,,fee schedule,,,81.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.35,,,,fee schedule,,,,,,,,3.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,87.36,91,,percent of total billed charges,,,91.2,95,,percent of total billed charges,,,79.68,83,,percent of total billed charges,,,28.8,83,,percent of total billed charges,,3.35,,,,fee schedule,,3.35,,,,fee schedule,,,79.68,83,,percent of total billed charges,,,,,,,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,81.6,85,,percent of total billed charges,,3.35,91.2,
"CYTOPATH, C/V, THIN LAYER",88142P,CDM,88142,CPT,,,both,P,20,20,,,,,,,,,,,,,3.35,,,,fee schedule,,,17,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.35,,,,fee schedule,,,,,,,,3.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,18.2,91,,percent of total billed charges,,,19,95,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,6,83,,percent of total billed charges,,3.35,,,,fee schedule,,3.35,,,,fee schedule,,,16.6,83,,percent of total billed charges,,,,,,,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,17,85,,percent of total billed charges,,3.35,19,
"CYTOPATH, C/V, THIN LAYER",88142T,CDM,88142,CPT,,,both,T,76,76,,,,,,,,,,,,,3.35,,,,fee schedule,,,64.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.35,,,,fee schedule,,,,,,,,3.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,3.35,,,,fee schedule,,3.35,,,,fee schedule,,,63.08,83,,percent of total billed charges,,,,,,,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,3.35,72.2,
CYTOPATH C/V THIN LAYER REDO,88143,CDM,88143,CPT,,,both,,96,96,,,,,,,,,,,,,3.5,,,,fee schedule,,,81.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,87.36,91,,percent of total billed charges,,,91.2,95,,percent of total billed charges,,,79.68,83,,percent of total billed charges,,,28.8,83,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,79.68,83,,percent of total billed charges,,,,,,,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,81.6,85,,percent of total billed charges,,3.5,91.2,
"CYTOPATH, C/V, AUTOMATED",88147,CDM,88147,CPT,,,both,,53,53,,,,,,,,,,,,,3.5,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
"CYTOPATH, C/V, AUTO RESCREEN",88148,CDM,88148,CPT,,,both,,53,53,,,,,,,,,,,,,3.5,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
CYTP SLIDES C/V MNL SCR UNDER PHYS,88150,CDM,88150,CPT,,,both,,88,88,,,,,,,,,,,,,3.5,,,,fee schedule,,,74.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,26.4,83,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,73.04,83,,percent of total billed charges,,,,,,,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,3.5,83.6,
"CYTOPATH, C/V, MANUAL",88150P,CDM,88150,CPT,,,both,P,12,12,,,,,,,,,,,,,3.5,,,,fee schedule,,,10.2,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,3.6,83,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,9.96,83,,percent of total billed charges,,,,,,,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,3.5,11.4,
"CYTOPATH, C/V, MANUAL",88150T,CDM,88150,CPT,,,both,T,76,76,,,,,,,,,,,,,3.5,,,,fee schedule,,,64.6,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,63.08,83,,percent of total billed charges,,,,,,,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,3.5,72.2,
"CYTOPATH SMEAR, OTHER SOURCE",88160,CDM,88160,CPT,,,both,,150,150,132.84,,,,fee schedule,,,,,,,,47.2,,,,fee schedule,,,127.5,85,,percent of total billed charges,,40.81,,,,fee schedule,,25.89,,,,fee schedule,,47.2,,,,fee schedule,,90.86,,,,fee schedule,,47.2,,,,fee schedule,,125.25,,,,fee schedule,,75.91,,,,fee schedule,,75.91,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,47.2,,,,fee schedule,,47.2,,,,fee schedule,,,124.5,83,,percent of total billed charges,,111.58,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,25.89,142.5,
CYTP SMRS ANY OTH SRC PREPJ SCR  INTERPJ,88161,CDM,88161,CPT,,,both,,166,166,135.8,,,,fee schedule,,,,,,,,45,,,,fee schedule,,,141.1,85,,percent of total billed charges,,40.29,,,,fee schedule,,25.56,,,,fee schedule,,45,,,,fee schedule,,98.15,,,,fee schedule,,45,,,,fee schedule,,128.04,,,,fee schedule,,77.6,,,,fee schedule,,77.6,,,,fee schedule,,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,45,,,,fee schedule,,45,,,,fee schedule,,,137.78,83,,percent of total billed charges,,114.07,,,,fee schedule,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,25.56,157.7,
CYTP SLIDES C/V MNL SCR PHYS,88164,CDM,88164,CPT,,,both,,59,59,,,,,,,,,,,,,3.5,,,,fee schedule,,,50.15,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,17.7,83,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,48.97,83,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,3.5,56.05,
"CYTOPATH EVAL, FNA, REPORT",88173,CDM,88173,CPT,,,both,,133,133,285.25,,,,fee schedule,,,,,,,,84,,,,fee schedule,,,113.05,85,,percent of total billed charges,,112.22,,,,fee schedule,,71.19,,,,fee schedule,,84,,,,fee schedule,,238.75,,,,fee schedule,,84,,,,fee schedule,,268.95,,,,fee schedule,,163,,,,fee schedule,,163,,,,fee schedule,,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,39.9,83,,percent of total billed charges,,84,,,,fee schedule,,84,,,,fee schedule,,,110.39,83,,percent of total billed charges,,239.61,,,,fee schedule,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,39.9,285.25,
CYTP C/V AUTO THIN LYR PREPJ SCR SYS PHYS,88174,CDM,88174,CPT,,,both,,127,127,,,,,,,,,,,,,14.93,,,,fee schedule,,,107.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,14.93,,,,fee schedule,,,,,,,,14.93,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,14.93,,,,fee schedule,,14.93,,,,fee schedule,,,105.41,83,,percent of total billed charges,,,,,,,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,3.5,120.65,
CYTP C/V AUTO THIN LYR PREPJ SCR MNL RESCR PHYS,88175,CDM,88175,CPT,,,both,,127,127,,,,,,,,,,,,,18.41,,,,fee schedule,,,107.95,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,18.41,,,,fee schedule,,,,,,,,18.41,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,18.41,,,,fee schedule,,18.41,,,,fee schedule,,,105.41,83,,percent of total billed charges,,,,,,,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,3.5,120.65,
"FLOWCYTOMETRY/ TC, 1 MARKER",88184,CDM,88184,CPT,,,both,,232,232,131.65,,,,fee schedule,,,,,,,,2.1,,,,fee schedule,,,197.2,85,,percent of total billed charges,,103.45,,,,fee schedule,,65.63,,,,fee schedule,,2.1,,,,fee schedule,,88.87,,,,fee schedule,,2.1,,,,fee schedule,,124.13,,,,fee schedule,,75.23,,,,fee schedule,,75.23,,,,fee schedule,,,211.12,91,,percent of total billed charges,,,220.4,95,,percent of total billed charges,,,192.56,83,,percent of total billed charges,,,69.6,83,,percent of total billed charges,,2.1,,,,fee schedule,,2.1,,,,fee schedule,,,192.56,83,,percent of total billed charges,,110.59,,,,fee schedule,,,208.8,90,,percent of total billed charges,,,208.8,90,,percent of total billed charges,,,208.8,90,,percent of total billed charges,,,208.8,90,,percent of total billed charges,,,197.2,85,,percent of total billed charges,,2.1,220.4,
"FLOWCYTOMETRY/TC, ADD-ON",88185,CDM,88185,CPT,,,both,,64,64,42.1,,,,fee schedule,,,,,,,,25.2,,,,fee schedule,,,54.4,85,,percent of total billed charges,,29.94,,,,fee schedule,,20.94,,,,fee schedule,,25.2,,,,fee schedule,,43.77,,,,fee schedule,,25.2,,,,fee schedule,,39.7,,,,fee schedule,,24.06,,,,fee schedule,,24.06,,,,fee schedule,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,25.2,,,,fee schedule,,25.2,,,,fee schedule,,,53.12,83,,percent of total billed charges,,35.37,,,,fee schedule,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,19.2,60.8,
"TISSUE CULTURE, LYMPHOCYTE",88230,CDM,88230,CPT,,,both,,1588,1588,,,,,,,,,,,,,181.6,,,,fee schedule,,,1349.8,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,181.6,,,,fee schedule,,,,,,,,181.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,1445.08,91,,percent of total billed charges,,,1508.6,95,,percent of total billed charges,,,1318.04,83,,percent of total billed charges,,,476.4,83,,percent of total billed charges,,181.6,,,,fee schedule,,181.6,,,,fee schedule,,,1318.04,83,,percent of total billed charges,,,,,,,,,1429.2,90,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1429.2,90,,percent of total billed charges,,,1349.8,85,,percent of total billed charges,,3.5,1508.6,
"CYTOGENETICS, DNA PROBE",88271,CDM,88271,CPT,,,both,,491,491,,,,,,,,,,,,,18.9,,,,fee schedule,,,417.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,18.9,,,,fee schedule,,,,,,,,18.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,446.81,91,,percent of total billed charges,,,466.45,95,,percent of total billed charges,,,407.53,83,,percent of total billed charges,,,147.3,83,,percent of total billed charges,,18.9,,,,fee schedule,,18.9,,,,fee schedule,,,407.53,83,,percent of total billed charges,,,,,,,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,417.35,85,,percent of total billed charges,,3.5,466.45,
"CYTOGENETICS, 3-5",88272,CDM,88272,CPT,,,both,,53,53,,,,,,,,,,,,,33.05,,,,fee schedule,,,45.05,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,33.05,,,,fee schedule,,,,,,,,33.05,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,33.05,,,,fee schedule,,33.05,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,3.5,50.35,
"CYTOGENETICS, 25-99",88274,CDM,88274,CPT,,,both,,430,430,,,,,,,,,,,,,45.4,,,,fee schedule,,,365.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,45.4,,,,fee schedule,,,,,,,,45.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,391.3,91,,percent of total billed charges,,,408.5,95,,percent of total billed charges,,,356.9,83,,percent of total billed charges,,,129,83,,percent of total billed charges,,45.4,,,,fee schedule,,45.4,,,,fee schedule,,,356.9,83,,percent of total billed charges,,,,,,,,,387,90,,percent of total billed charges,,,387,90,,percent of total billed charges,,,387,90,,percent of total billed charges,,,387,90,,percent of total billed charges,,,365.5,85,,percent of total billed charges,,3.5,408.5,
"CYTOGENETICS, 100-300",88275,CDM,88275,CPT,,,both,,157,157,,,,,,,,,,,,,52.4,,,,fee schedule,,,133.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,52.4,,,,fee schedule,,,,,,,,52.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,142.87,91,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,47.1,83,,percent of total billed charges,,52.4,,,,fee schedule,,52.4,,,,fee schedule,,,130.31,83,,percent of total billed charges,,,,,,,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,133.45,85,,percent of total billed charges,,3.5,149.15,
CYTOGENETICS/MOLEC CYTOGENETICS I/R,88291,CDM,88291,CPT,,,both,,182,182,56.93,,,,fee schedule,,,,,,,,5.25,,,,fee schedule,,,154.7,85,,percent of total billed charges,,53.22,,,,fee schedule,,33.76,,,,fee schedule,,5.25,,,,fee schedule,,47.09,,,,fee schedule,,5.25,,,,fee schedule,,53.68,,,,fee schedule,,32.53,,,,fee schedule,,32.53,,,,fee schedule,,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,54.6,83,,percent of total billed charges,,5.25,,,,fee schedule,,5.25,,,,fee schedule,,,151.06,83,,percent of total billed charges,,47.82,,,,fee schedule,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,5.25,172.9,
LVL I-SURG PATH GROSS XM ONLY,88300,CDM,88300,CPT,,,both,,48,48,28.47,,,,fee schedule,,,,,,,,26.1,,,,fee schedule,,,40.8,85,,percent of total billed charges,,7.26,,,,fee schedule,,4.6,,,,fee schedule,,26.1,,,,fee schedule,,36.48,,,,fee schedule,,26.1,,,,fee schedule,,26.84,,,,fee schedule,,16.27,,,,fee schedule,,16.27,,,,fee schedule,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,14.4,83,,percent of total billed charges,,26.1,,,,fee schedule,,26.1,,,,fee schedule,,,39.84,83,,percent of total billed charges,,23.91,,,,fee schedule,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,4.6,45.6,
TISSUE EXAM BY PATHOLOGIST,88302,CDM,88302,CPT,,,both,,145,145,58.12,,,,fee schedule,,,,,,,,41.9,,,,fee schedule,,,123.25,85,,percent of total billed charges,,11.11,,,,fee schedule,,7.05,,,,fee schedule,,41.9,,,,fee schedule,,78.92,,,,fee schedule,,41.9,,,,fee schedule,,54.8,,,,fee schedule,,33.21,,,,fee schedule,,33.21,,,,fee schedule,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,43.5,83,,percent of total billed charges,,41.9,,,,fee schedule,,41.9,,,,fee schedule,,,120.35,83,,percent of total billed charges,,48.82,,,,fee schedule,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,7.05,137.75,
LEVEL III-SURG PATH GROSS  MICROSCOPIC XM,88304,CDM,88304,CPT,,,both,,192,192,75.31,,,,fee schedule,,,,,,,,37.35,,,,fee schedule,,,163.2,85,,percent of total billed charges,,18.27,,,,fee schedule,,11.59,,,,fee schedule,,37.35,,,,fee schedule,,104.12,,,,fee schedule,,37.35,,,,fee schedule,,71.01,,,,fee schedule,,43.04,,,,fee schedule,,43.04,,,,fee schedule,,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,57.6,83,,percent of total billed charges,,37.35,,,,fee schedule,,37.35,,,,fee schedule,,,159.36,83,,percent of total billed charges,,63.26,,,,fee schedule,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,11.59,182.4,
LVL IV-SURG PATH GROSS  MCRSCP XM,88305,CDM,88305,CPT,,,both,,318,318,125.72,,,,fee schedule,,,,,,,,328.8,,,,fee schedule,,,270.3,85,,percent of total billed charges,,62.24,,,,fee schedule,,37.8,,,,fee schedule,,328.8,,,,fee schedule,,181.06,,,,fee schedule,,328.8,,,,fee schedule,,118.54,,,,fee schedule,,71.84,,,,fee schedule,,71.84,,,,fee schedule,,,289.38,91,,percent of total billed charges,,,302.1,95,,percent of total billed charges,,,263.94,83,,percent of total billed charges,,,95.4,83,,percent of total billed charges,,328.8,,,,fee schedule,,328.8,,,,fee schedule,,,263.94,83,,percent of total billed charges,,105.61,,,,fee schedule,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,270.3,85,,percent of total billed charges,,37.8,328.8,
TISSUE EXAM BY PATHOLOGIST,88305P,CDM,88305,CPT,,,both,P,160,160,125.72,,,,fee schedule,,,,,,,,328.8,,,,fee schedule,,,136,85,,percent of total billed charges,,62.24,,,,fee schedule,,37.8,,,,fee schedule,,328.8,,,,fee schedule,,181.06,,,,fee schedule,,328.8,,,,fee schedule,,118.54,,,,fee schedule,,71.84,,,,fee schedule,,71.84,,,,fee schedule,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,48,83,,percent of total billed charges,,328.8,,,,fee schedule,,328.8,,,,fee schedule,,,132.8,83,,percent of total billed charges,,105.61,,,,fee schedule,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,37.8,328.8,
TISSUE EXAM BY PATHOLOGIST,88305T,CDM,88305,CPT,,,both,T,158,158,125.72,,,,fee schedule,,,,,,,,328.8,,,,fee schedule,,,134.3,85,,percent of total billed charges,,62.24,,,,fee schedule,,37.8,,,,fee schedule,,328.8,,,,fee schedule,,181.06,,,,fee schedule,,328.8,,,,fee schedule,,118.54,,,,fee schedule,,71.84,,,,fee schedule,,71.84,,,,fee schedule,,,143.78,91,,percent of total billed charges,,,150.1,95,,percent of total billed charges,,,131.14,83,,percent of total billed charges,,,47.4,83,,percent of total billed charges,,328.8,,,,fee schedule,,328.8,,,,fee schedule,,,131.14,83,,percent of total billed charges,,105.61,,,,fee schedule,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,142.2,90,,percent of total billed charges,,,134.3,85,,percent of total billed charges,,37.8,328.8,
TISSUE EXAM BY PATHOLOGIST,88307,CDM,88307,CPT,,,both,,280,280,512.37,,,,fee schedule,,,,,,,,43.6,,,,fee schedule,,,238,85,,percent of total billed charges,,131.27,,,,fee schedule,,83.27,,,,fee schedule,,43.6,,,,fee schedule,,322.32,,,,fee schedule,,43.6,,,,fee schedule,,483.1,,,,fee schedule,,292.79,,,,fee schedule,,292.79,,,,fee schedule,,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,84,83,,percent of total billed charges,,43.6,,,,fee schedule,,43.6,,,,fee schedule,,,232.4,83,,percent of total billed charges,,430.39,,,,fee schedule,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,43.6,512.37,
TISSUE EXAM BY PATHOLOGIST,88309,CDM,88309,CPT,,,both,,404,404,772.71,,,,fee schedule,,,,,,,,142.2,,,,fee schedule,,,343.4,85,,percent of total billed charges,,230.27,,,,fee schedule,,146.08,,,,fee schedule,,142.2,,,,fee schedule,,451.64,,,,fee schedule,,142.2,,,,fee schedule,,728.56,,,,fee schedule,,441.55,,,,fee schedule,,441.55,,,,fee schedule,,,367.64,91,,percent of total billed charges,,,383.8,95,,percent of total billed charges,,,335.32,83,,percent of total billed charges,,,121.2,83,,percent of total billed charges,,142.2,,,,fee schedule,,142.2,,,,fee schedule,,,335.32,83,,percent of total billed charges,,649.08,,,,fee schedule,,,363.6,90,,percent of total billed charges,,,363.6,90,,percent of total billed charges,,,363.6,90,,percent of total billed charges,,,363.6,90,,percent of total billed charges,,,343.4,85,,percent of total billed charges,,121.2,772.71,
SPECIAL STAINS: Group I,88312,CDM,88312,CPT,,,both,,220,220,198.66,,,,fee schedule,,,,,,,,11.8,,,,fee schedule,,,187,85,,percent of total billed charges,,42.04,,,,fee schedule,,26.67,,,,fee schedule,,11.8,,,,fee schedule,,138.61,,,,fee schedule,,11.8,,,,fee schedule,,187.31,,,,fee schedule,,113.52,,,,fee schedule,,113.52,,,,fee schedule,,,200.2,91,,percent of total billed charges,,,209,95,,percent of total billed charges,,,182.6,83,,percent of total billed charges,,,66,83,,percent of total billed charges,,11.8,,,,fee schedule,,11.8,,,,fee schedule,,,182.6,83,,percent of total billed charges,,166.88,,,,fee schedule,,,198,90,,percent of total billed charges,,,198,90,,percent of total billed charges,,,198,90,,percent of total billed charges,,,198,90,,percent of total billed charges,,,187,85,,percent of total billed charges,,11.8,209,
SPECIAL STAINS: Group II,88313,CDM,88313,CPT,,,both,,139,139,144.7,,,,fee schedule,,,,,,,,6.7,,,,fee schedule,,,118.15,85,,percent of total billed charges,,19.4,,,,fee schedule,,12.31,,,,fee schedule,,6.7,,,,fee schedule,,100.14,,,,fee schedule,,6.7,,,,fee schedule,,136.43,,,,fee schedule,,82.68,,,,fee schedule,,82.68,,,,fee schedule,,,126.49,91,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,41.7,83,,percent of total billed charges,,6.7,,,,fee schedule,,6.7,,,,fee schedule,,,115.37,83,,percent of total billed charges,,121.55,,,,fee schedule,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,118.15,85,,percent of total billed charges,,6.7,144.7,
IMMUNOHISTO ANTIBODY SLIDE,88341,CDM,88341,CPT,,,both,,463,463,152.41,,,,fee schedule,,,,,,,,340.38,,,,fee schedule,,,393.55,85,,percent of total billed charges,,44.71,,,,fee schedule,,28.36,,,,fee schedule,,340.38,,,,fee schedule,,,,,,,,340.38,,,,fee schedule,,143.7,,,,fee schedule,,87.09,,,,fee schedule,,87.09,,,,fee schedule,,,421.33,91,,percent of total billed charges,,,439.85,95,,percent of total billed charges,,,384.29,83,,percent of total billed charges,,,138.9,83,,percent of total billed charges,,340.38,,,,fee schedule,,340.38,,,,fee schedule,,,384.29,83,,percent of total billed charges,,128.02,,,,fee schedule,,,416.7,90,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,416.7,90,,percent of total billed charges,,,393.55,85,,percent of total billed charges,,28.36,439.85,
IMMUNOHISTOCHEMISTRY,88342,CDM,88342,CPT,,,both,,315,315,176.72,,,,fee schedule,,,,,,,,40.35,,,,fee schedule,,,267.75,85,,percent of total billed charges,,55.21,,,,fee schedule,,35.02,,,,fee schedule,,40.35,,,,fee schedule,,156.52,,,,fee schedule,,40.35,,,,fee schedule,,166.62,,,,fee schedule,,100.98,,,,fee schedule,,100.98,,,,fee schedule,,,286.65,91,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,94.5,83,,percent of total billed charges,,40.35,,,,fee schedule,,40.35,,,,fee schedule,,,261.45,83,,percent of total billed charges,,148.45,,,,fee schedule,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,35.02,299.25,
TUMOR IMMUNOHISTOCHEM/MANUAL,88360,CDM,88360,CPT,,,both,,173,173,208.75,,,,fee schedule,,,,,,,,61.83,,,,fee schedule,,,147.05,85,,percent of total billed charges,,66.27,,,,fee schedule,,42.04,,,,fee schedule,,61.83,,,,fee schedule,,192.99,,,,fee schedule,,61.83,,,,fee schedule,,196.82,,,,fee schedule,,119.28,,,,fee schedule,,119.28,,,,fee schedule,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,51.9,83,,percent of total billed charges,,61.83,,,,fee schedule,,61.83,,,,fee schedule,,,143.59,83,,percent of total billed charges,,175.35,,,,fee schedule,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,42.04,208.75,
BILIRUBIN TOTAL TRANSCUT,88720,CDM,88720,CPT,,,both,,41,41,,,,,,,,,,,,,4.4,,,,fee schedule,,,34.85,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,4.4,,,,fee schedule,,,,,,,,4.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,4.4,,,,fee schedule,,4.4,,,,fee schedule,,,34.03,83,,percent of total billed charges,,,,,,,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,3.5,38.95,
C-CNT MISC BDY FLUS XCPT BLD DIFFIAL CNT,89051,CDM,89051,CPT,,,both,,49,49,,,,,,,,,,,,,12.4,,,,fee schedule,,,41.65,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,12.4,,,,fee schedule,,,,,,,,12.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,44.59,91,,percent of total billed charges,,,46.55,95,,percent of total billed charges,,,40.67,83,,percent of total billed charges,,,14.7,83,,percent of total billed charges,,12.4,,,,fee schedule,,12.4,,,,fee schedule,,,40.67,83,,percent of total billed charges,,,,,,,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,41.65,85,,percent of total billed charges,,3.5,46.55,
WBC ASSMT FECAL QUAL/SEMIQUAN,89055,CDM,89055,CPT,,,both,,38,38,,,,,,,,,,,,,5.96,,,,fee schedule,,,32.3,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,5.96,,,,fee schedule,,,,,,,,5.96,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,34.58,91,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,11.4,83,,percent of total billed charges,,5.96,,,,fee schedule,,5.96,,,,fee schedule,,,31.54,83,,percent of total billed charges,,,,,,,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,3.5,36.1,
CRYSTAL ID LIGHT MIC ALYS TISSUE/ANY FLU,89060,CDM,89060,CPT,,,both,,64,64,,,,,,,,,,,,,18.7,,,,fee schedule,,,54.4,85,,percent of total billed charges,,29.48,,,,fee schedule,,26.32,,,,fee schedule,,18.7,,,,fee schedule,,,,,,,,18.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,58.24,91,,percent of total billed charges,,,60.8,95,,percent of total billed charges,,,53.12,83,,percent of total billed charges,,,19.2,83,,percent of total billed charges,,18.7,,,,fee schedule,,18.7,,,,fee schedule,,,53.12,83,,percent of total billed charges,,,,,,,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,57.6,90,,percent of total billed charges,,,54.4,85,,percent of total billed charges,,18.7,60.8,
PATHOLOGY LAB PROCEDURE,89240,CDM,89240,CPT,,,both,,29,29,,,,,,,,,,,,,,,,,,,,24.65,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.39,91,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,8.7,83,,percent of total billed charges,,,,,,,,,,,,,,,24.07,83,,percent of total billed charges,,,,,,,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,8.7,27.55,
SEMEN ALYS MOTILITY/CNT X W/HUHNER TST,89310,CDM,89310,CPT,,,both,,57,57,,,,,,,,,,,,,6.7,,,,fee schedule,,,48.45,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,6.7,,,,fee schedule,,,,,,,,6.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,17.1,83,,percent of total billed charges,,6.7,,,,fee schedule,,6.7,,,,fee schedule,,,47.31,83,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,3.5,54.15,
"SEMEN ANALYSIS, COMPLETE",89320,CDM,89320,CPT,,,both,,49,49,,,,,,,,,,,,,,,,,,,,41.65,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.59,91,,percent of total billed charges,,,46.55,95,,percent of total billed charges,,,40.67,83,,percent of total billed charges,,,14.7,83,,percent of total billed charges,,,,,,,,,,,,,,,40.67,83,,percent of total billed charges,,,,,,,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,41.65,85,,percent of total billed charges,,3.5,46.55,
SEMEN ANALYSIS & MOTILITY,89321,CDM,89321,CPT,,,both,,103,103,,,,,,,,,,,,,8.43,,,,fee schedule,,,87.55,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,8.43,,,,fee schedule,,,,,,,,8.43,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,30.9,83,,percent of total billed charges,,8.43,,,,fee schedule,,8.43,,,,fee schedule,,,85.49,83,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,3.5,97.85,
IM ADM ANY ROUTE 1ST VAC/TOX,90460,CDM,90460,CPT,,,both,,127,127,10,,,,fee schedule,,,,,,,,,,,,,,,107.95,85,,percent of total billed charges,,6,,,,fee schedule,,6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,37.46,,,,fee schedule,,22.7,,,,fee schedule,,22.7,,,,fee schedule,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,,,,,,,,,,,,,,105.41,83,,percent of total billed charges,,33.38,,,,fee schedule,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,6,120.65,
INADM ANY ROUTE ADDL VAC/TOX,90461,CDM,90461,CPT,,,both,,34,34,5,,,,fee schedule,,,,,,,,,,,,,,,28.9,85,,percent of total billed charges,,4,,,,fee schedule,,4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,16.77,,,,fee schedule,,10.17,,,,fee schedule,,10.17,,,,fee schedule,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,10.2,83,,percent of total billed charges,,,,,,,,,,,,,,,28.22,83,,percent of total billed charges,,14.94,,,,fee schedule,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,4,32.3,
IM ADM <8YR PHYS CNSL EA NJX PR D,90466,CDM,90466,CPT,,,both,,24,24,,,,,,,,,,,,,,,,,,,,20.4,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,7.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,,,,,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,7.2,22.8,
IM ADM PRQ ID SUBQ/IM NJXS 1 VACC,90471,CDM,90471,CPT,,,both,,46,46,10,,,,fee schedule,,,,,,,,,,,,,,,39.1,85,,percent of total billed charges,,15,,,,fee schedule,,15,,,,fee schedule,,,,,,,,,,,,,,,,,,,,33.55,,,,fee schedule,,20.33,,,,fee schedule,,20.33,,,,fee schedule,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,13.8,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,29.89,,,,fee schedule,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,10,43.7,
IM ADM PRQ ID SUBQ/IM NJXS EA VACC,90472,CDM,90472,CPT,,,both,,30,30,10,,,,fee schedule,,,,,,,,,,,,,,,25.5,85,,percent of total billed charges,,8,,,,fee schedule,,5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,9,83,,percent of total billed charges,,,,,,,,,,,,,,,24.9,83,,percent of total billed charges,,21.42,,,,fee schedule,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,5,28.5,
IM ADM INTRANSL/ORAL 1 VACC,90473,CDM,90473,CPT,,,both,,43,43,3,,,,fee schedule,,,,,,,,,,,,,,,36.55,85,,percent of total billed charges,,15,,,,fee schedule,,15,,,,fee schedule,,,,,,,,,,,,,,,,,,,,27.4,,,,fee schedule,,16.6,,,,fee schedule,,16.6,,,,fee schedule,,,39.13,91,,percent of total billed charges,,,40.85,95,,percent of total billed charges,,,35.69,83,,percent of total billed charges,,,12.9,83,,percent of total billed charges,,,,,,,,,,,,,,,35.69,83,,percent of total billed charges,,24.41,,,,fee schedule,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,36.55,85,,percent of total billed charges,,3,40.85,
IM ADM INTRANSL/ORAL EA VACC,90474,CDM,90474,CPT,,,both,,31,31,3,,,,fee schedule,,,,,,,,,,,,,,,26.35,85,,percent of total billed charges,,8,,,,fee schedule,,5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,19.57,,,,fee schedule,,11.86,,,,fee schedule,,11.86,,,,fee schedule,,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,9.3,83,,percent of total billed charges,,,,,,,,,,,,,,,25.73,83,,percent of total billed charges,,17.43,,,,fee schedule,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,3,29.45,
MENACWY-TT VACCINE IM,90619,CDM,90619,CPT,,,both,,218,218,,,,,,,,,,,,,142.17,,,,fee schedule,,,185.3,85,,percent of total billed charges,,183.65,,,,fee schedule,,183.65,,,,fee schedule,,142.17,,,,fee schedule,,,,,,,,142.17,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,65.4,83,,percent of total billed charges,,142.17,,,,fee schedule,,142.17,,,,fee schedule,,,180.94,83,,percent of total billed charges,,,,,,,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,65.4,207.1,
MENB RP W/OMV VACCINE IM,90620,CDM,90620,CPT,,,both,,348,348,182.71,,,,fee schedule,,,,,,,,192.44,,,,fee schedule,,,295.8,85,,percent of total billed charges,,248.64,,,,fee schedule,,248.64,,,,fee schedule,,192.44,,,,fee schedule,,,,,,,,192.44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,316.68,91,,percent of total billed charges,,,330.6,95,,percent of total billed charges,,,288.84,83,,percent of total billed charges,,,104.4,83,,percent of total billed charges,,192.44,,,,fee schedule,,192.44,,,,fee schedule,,,288.84,83,,percent of total billed charges,,,,,,,,,313.2,90,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,313.2,90,,percent of total billed charges,,,295.8,85,,percent of total billed charges,,104.4,330.6,
CHOLERA VACCINE LIVE ORAL,90625,CDM,90625,CPT,,,both,,3037,3037,229.5,,,,fee schedule,,,,,,,,,,,,,,,2581.45,85,,percent of total billed charges,,278.1,,,,fee schedule,,278.1,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2763.67,91,,percent of total billed charges,,,2885.15,95,,percent of total billed charges,,,2520.71,83,,percent of total billed charges,,,911.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2520.71,83,,percent of total billed charges,,,,,,,,,2733.3,90,,percent of total billed charges,,,2733.3,90,,percent of total billed charges,,,2733.3,90,,percent of total billed charges,,,2733.3,90,,percent of total billed charges,,,2581.45,85,,percent of total billed charges,,229.5,2885.15,
FLU VACC IIV4 NO PRESERV ID,90630,CDM,90630,CPT,,,both,,36,36,18.2,,,,fee schedule,,,,,,,,,,,,,,,30.6,85,,percent of total billed charges,,21.41,,,,fee schedule,,21.41,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,10.8,83,,percent of total billed charges,,,,,,,,,,,,,,,29.88,83,,percent of total billed charges,,,,,,,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,10.8,34.2,
HEPATITIS A VACCINE ADULT IM,90632,CDM,90632,CPT,,,both,,147,147,58.44,,,,fee schedule,,,,,,,,70.98,,,,fee schedule,,,124.95,85,,percent of total billed charges,,91,,,,fee schedule,,91,,,,fee schedule,,70.98,,,,fee schedule,,,,,,,,70.98,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,44.1,83,,percent of total billed charges,,70.98,,,,fee schedule,,70.98,,,,fee schedule,,,122.01,83,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,44.1,139.65,
HEPATITIS A VACCINE PEDIATRICS,90633,CDM,90633,CPT,,,both,,60,60,33.83,,,,fee schedule,,,,,,,,,,,,,,,51,85,,percent of total billed charges,,43.86,,,,fee schedule,,43.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,18,83,,percent of total billed charges,,,,,,,,,,,,,,,49.8,83,,percent of total billed charges,,,,,,,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,18,57,
"HEP A VACC, PED/ADOL, 3 DOSE",90634,CDM,90634,CPT,,,both,,56,56,30.75,,,,fee schedule,,,,,,,,,,,,,,,47.6,85,,percent of total billed charges,,43,,,,fee schedule,,43,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,16.8,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,,,,,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,16.8,53.2,
HEPATITIS A/B VACCINE HEPA-HEPB ADULT IM,90636,CDM,90636,CPT,,,both,,766,766,111.05,,,,fee schedule,,,,,,,,111.65,,,,fee schedule,,,651.1,85,,percent of total billed charges,,144.05,,,,fee schedule,,144.05,,,,fee schedule,,111.65,,,,fee schedule,,,,,,,,111.65,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,697.06,91,,percent of total billed charges,,,727.7,95,,percent of total billed charges,,,635.78,83,,percent of total billed charges,,,229.8,83,,percent of total billed charges,,111.65,,,,fee schedule,,111.65,,,,fee schedule,,,635.78,83,,percent of total billed charges,,,,,,,,,689.4,90,,percent of total billed charges,,,689.4,90,,percent of total billed charges,,,689.4,90,,percent of total billed charges,,,689.4,90,,percent of total billed charges,,,651.1,85,,percent of total billed charges,,111.05,727.7,
HILUS INFLUENZA B VACCINE PRP-OMP 3 DOSE IM,90647,CDM,90647,CPT,,,both,,65,65,26.63,,,,fee schedule,,,,,,,,,,,,,,,55.25,85,,percent of total billed charges,,34.52,,,,fee schedule,,34.52,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,59.15,91,,percent of total billed charges,,,61.75,95,,percent of total billed charges,,,53.95,83,,percent of total billed charges,,,19.5,83,,percent of total billed charges,,,,,,,,,,,,,,,53.95,83,,percent of total billed charges,,,,,,,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,55.25,85,,percent of total billed charges,,19.5,61.75,
HEMOPHILUS INFLUENZA B VACCINE PRP-T 4 DOSE IM,90648,CDM,90648,CPT,,,both,,65,65,11.25,,,,fee schedule,,,,,,,,,,,,,,,55.25,85,,percent of total billed charges,,14.68,,,,fee schedule,,14.68,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,59.15,91,,percent of total billed charges,,,61.75,95,,percent of total billed charges,,,53.95,83,,percent of total billed charges,,,19.5,83,,percent of total billed charges,,,,,,,,,,,,,,,53.95,83,,percent of total billed charges,,,,,,,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,55.25,85,,percent of total billed charges,,11.25,61.75,
HPV VACCINE QUADRIV 3 DOSE IM (Gardasil),90649,CDM,90649,CPT,,,both,,288,288,163.24,,,,fee schedule,,,,,,,,,,,,,,,244.8,85,,percent of total billed charges,,202.07,,,,fee schedule,,202.07,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,262.08,91,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,86.4,83,,percent of total billed charges,,,,,,,,,,,,,,,239.04,83,,percent of total billed charges,,,,,,,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,244.8,85,,percent of total billed charges,,86.4,273.6,
HPV VACCINE NON VALENT IM (Gardasil 9),90651,CDM,90651,CPT,,,both,,526,526,232.36,,,,fee schedule,,,,,,,,256.95,,,,fee schedule,,,447.1,85,,percent of total billed charges,,313.3,,,,fee schedule,,313.3,,,,fee schedule,,256.95,,,,fee schedule,,,,,,,,256.95,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,478.66,91,,percent of total billed charges,,,499.7,95,,percent of total billed charges,,,436.58,83,,percent of total billed charges,,,157.8,83,,percent of total billed charges,,256.95,,,,fee schedule,,256.95,,,,fee schedule,,,436.58,83,,percent of total billed charges,,,,,,,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,447.1,85,,percent of total billed charges,,157.8,499.7,
FLU VACCINE ADJUVANT IM,90653,CDM,90653,CPT,,,both,,34,34,59.53,,,,fee schedule,,,,,,,,50.04,,,,fee schedule,,,28.9,85,,percent of total billed charges,,61.41,,,,fee schedule,,61.41,,,,fee schedule,,50.04,,,,fee schedule,,,,,,,,50.04,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,10.2,83,,percent of total billed charges,,50.04,,,,fee schedule,,50.04,,,,fee schedule,,,28.22,83,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,10.2,61.41,
INFLUENZA VIRUS VACC SPLIT PRSRV FREE 6-35 MO IM,90655,CDM,90655,CPT,,,both,,41,41,16.3,,,,fee schedule,,,,,,,,,,,,,,,34.85,85,,percent of total billed charges,,14.84,,,,fee schedule,,14.84,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,,,,,,,,,,,,,,34.03,83,,percent of total billed charges,,,,,,,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,12.3,38.95,
INFLUENZA VIRUS VACC SPLIT PRSRV FR 3 YEARS + IM,90656,CDM,90656,CPT,,,both,,36,36,17.69,,,,fee schedule,,,,,,,,,,,,,,,30.6,85,,percent of total billed charges,,20.81,,,,fee schedule,,20.81,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,10.8,83,,percent of total billed charges,,,,,,,,,,,,,,,29.88,83,,percent of total billed charges,,,,,,,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,10.8,34.2,
INFLUENZA VIRUS VACCINE SPLIT VIRUS 6-35 MO IM,90657,CDM,90657,CPT,,,both,,41,41,9.5,,,,fee schedule,,,,,,,,,,,,,,,34.85,85,,percent of total billed charges,,6.34,,,,fee schedule,,6.34,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,,,,,,,,,,,,,,34.03,83,,percent of total billed charges,,,,,,,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,6.34,38.95,
INFLUENZA VIRUS VACCINE SPLIT VIRUS 3 YEARS + IM,90658,CDM,90658,CPT,,,both,,43,43,16.32,,,,fee schedule,,,,,,,,15.41,,,,fee schedule,,,36.55,85,,percent of total billed charges,,19.2,,,,fee schedule,,19.2,,,,fee schedule,,15.41,,,,fee schedule,,,,,,,,15.41,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,39.13,91,,percent of total billed charges,,,40.85,95,,percent of total billed charges,,,35.69,83,,percent of total billed charges,,,12.9,83,,percent of total billed charges,,15.41,,,,fee schedule,,15.41,,,,fee schedule,,,35.69,83,,percent of total billed charges,,,,,,,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,36.55,85,,percent of total billed charges,,12.9,40.85,
INFLUENZA VIRUS VACCINE LIVE INTRANASAL,90660,CDM,90660,CPT,,,both,,87,87,0.01,,,,fee schedule,,,,,,,,,,,,,,,73.95,85,,percent of total billed charges,,25,,,,fee schedule,,25,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,26.1,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,,,,,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,0.01,82.65,
FLU VACC PRSV FREE INC ANTIG,90662,CDM,90662,CPT,,,both,,34,34,60.98,,,,fee schedule,,,,,,,,69.94,,,,fee schedule,,,28.9,85,,percent of total billed charges,,72.15,,,,fee schedule,,67.32,,,,fee schedule,,69.94,,,,fee schedule,,,,,,,,69.94,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,10.2,83,,percent of total billed charges,,69.94,,,,fee schedule,,69.94,,,,fee schedule,,,28.22,83,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,10.2,72.15,
"PREVNAR/PNEUMOCOCCAL VACC, PED < PCV13",90670,CDM,90670,CPT,,,both,,442,442,230.14,,,,fee schedule,,,,,,,,257.99,,,,fee schedule,,,375.7,85,,percent of total billed charges,,279.72,,,,fee schedule,,279.72,,,,fee schedule,,257.99,,,,fee schedule,,,,,,,,257.99,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,402.22,91,,percent of total billed charges,,,419.9,95,,percent of total billed charges,,,366.86,83,,percent of total billed charges,,,132.6,83,,percent of total billed charges,,257.99,,,,fee schedule,,257.99,,,,fee schedule,,,366.86,83,,percent of total billed charges,,,,,,,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,375.7,85,,percent of total billed charges,,132.6,419.9,
PCV15 VACCINE IM,90671,CDM,90671,CPT,,,both,,412,412,,,,,,,,,,,,,246.2,,,,fee schedule,,,350.2,85,,percent of total billed charges,,266.92,,,,fee schedule,,266.92,,,,fee schedule,,246.2,,,,fee schedule,,,,,,,,246.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,374.92,91,,percent of total billed charges,,,391.4,95,,percent of total billed charges,,,341.96,83,,percent of total billed charges,,,123.6,83,,percent of total billed charges,,246.2,,,,fee schedule,,246.2,,,,fee schedule,,,341.96,83,,percent of total billed charges,,,,,,,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,350.2,85,,percent of total billed charges,,123.6,391.4,
FLU VACCINE 4 VALENT NASAL (Flumist),90672,CDM,90672,CPT,,,both,,34,34,26.88,,,,fee schedule,,,,,,,,26.88,,,,fee schedule,,,28.9,85,,percent of total billed charges,,27.72,,,,fee schedule,,26.99,,,,fee schedule,,26.88,,,,fee schedule,,,,,,,,26.88,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,10.2,83,,percent of total billed charges,,26.88,,,,fee schedule,,26.88,,,,fee schedule,,,28.22,83,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,10.2,32.3,
FLU VACC RIV3 NO PRESERV,90673,CDM,90673,CPT,,,both,,36,36,36.34,,,,fee schedule,,,,,,,,,,,,,,,30.6,85,,percent of total billed charges,,42.75,,,,fee schedule,,42.75,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,10.8,83,,percent of total billed charges,,,,,,,,,,,,,,,29.88,83,,percent of total billed charges,,,,,,,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,10.8,42.75,
"Influenza Virus Vaccine, Quadrivalent (ccIIV4) 0.5",90674,CDM,90674,CPT,,,both,,34,34,29.23,,,,fee schedule,,,,,,,,32.28,,,,fee schedule,,,28.9,85,,percent of total billed charges,,33.3,,,,fee schedule,,30.89,,,,fee schedule,,32.28,,,,fee schedule,,,,,,,,32.28,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,10.2,83,,percent of total billed charges,,32.28,,,,fee schedule,,32.28,,,,fee schedule,,,28.22,83,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,10.2,33.3,
RABIES VACCINE INTRAMUSCULAR,90675,CDM,90675,CPT,,,both,,639,639,303.24,,,,fee schedule,,,,,,,,348.53,,,,fee schedule,,,543.15,85,,percent of total billed charges,,468.5,,,,fee schedule,,468.5,,,,fee schedule,,348.53,,,,fee schedule,,,,,,,,348.53,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,191.7,83,,percent of total billed charges,,348.53,,,,fee schedule,,348.53,,,,fee schedule,,,530.37,83,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,191.7,607.05,
PCV20 VACCINE IM,90677,CDM,90677,CPT,,,both,,269,269,,,,,,,,,,,,,283.72,,,,fee schedule,,,228.65,85,,percent of total billed charges,,307.61,,,,fee schedule,,307.61,,,,fee schedule,,283.72,,,,fee schedule,,,,,,,,283.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,244.79,91,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,80.7,83,,percent of total billed charges,,283.72,,,,fee schedule,,283.72,,,,fee schedule,,,223.27,83,,percent of total billed charges,,,,,,,,,242.1,90,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,80.7,307.61,
ROTAVIRUS VACCINE PENTAVALENT 3 DOSE LIVE0 ORAL,90680,CDM,90680,CPT,,,both,,223,223,86.1,,,,fee schedule,,,,,,,,,,,,,,,189.55,85,,percent of total billed charges,,111.7,,,,fee schedule,,111.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,202.93,91,,percent of total billed charges,,,211.85,95,,percent of total billed charges,,,185.09,83,,percent of total billed charges,,,66.9,83,,percent of total billed charges,,,,,,,,,,,,,,,185.09,83,,percent of total billed charges,,,,,,,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,200.7,90,,percent of total billed charges,,,189.55,85,,percent of total billed charges,,66.9,211.85,
ROTAVIRUS VACC HUMAN ATTENUATED 2 DOSE LIVE ORAL,90681,CDM,90681,CPT,,,both,,228,228,126.92,,,,fee schedule,,,,,,,,,,,,,,,193.8,85,,percent of total billed charges,,161.53,,,,fee schedule,,161.53,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,207.48,91,,percent of total billed charges,,,216.6,95,,percent of total billed charges,,,189.24,83,,percent of total billed charges,,,68.4,83,,percent of total billed charges,,,,,,,,,,,,,,,189.24,83,,percent of total billed charges,,,,,,,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,205.2,90,,percent of total billed charges,,,193.8,85,,percent of total billed charges,,68.4,216.6,
RIV4 VACC RECOMBINANT DNA IM,90682,CDM,90682,CPT,,,both,,61,61,60.98,,,,fee schedule,,,,,,,,69.94,,,,fee schedule,,,51.85,85,,percent of total billed charges,,72.15,,,,fee schedule,,67.32,,,,fee schedule,,69.94,,,,fee schedule,,,,,,,,69.94,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,55.51,91,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,18.3,83,,percent of total billed charges,,69.94,,,,fee schedule,,69.94,,,,fee schedule,,,50.63,83,,percent of total billed charges,,,,,,,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,18.3,72.15,
FLU VAC NO PRSV 4 VAL 6-35M,90685,CDM,90685,CPT,,,both,,34,34,21.13,,,,fee schedule,,,,,,,,,,,,,,,28.9,85,,percent of total billed charges,,22.32,,,,fee schedule,,22.32,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,10.2,83,,percent of total billed charges,,,,,,,,,,,,,,,28.22,83,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,10.2,32.3,
FLU VAC NO PRSV 4 VAL 3 YRS+,90686,CDM,90686,CPT,,,both,,34,34,19.58,,,,fee schedule,,,,,,,,21.52,,,,fee schedule,,,28.9,85,,percent of total billed charges,,22.2,,,,fee schedule,,21.17,,,,fee schedule,,21.52,,,,fee schedule,,,,,,,,21.52,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,10.2,83,,percent of total billed charges,,21.52,,,,fee schedule,,21.52,,,,fee schedule,,,28.22,83,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,10.2,32.3,
FLU VACCINE 4 VAL 6-35 MO IM,90687,CDM,90687,CPT,,,both,,34,34,9.58,,,,fee schedule,,,,,,,,,,,,,,,28.9,85,,percent of total billed charges,,10.56,,,,fee schedule,,10.27,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,10.2,83,,percent of total billed charges,,,,,,,,,,,,,,,28.22,83,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,9.58,32.3,
FLU VACC 4 VAL 3 YRS PLUS IM,90688,CDM,90688,CPT,,,both,,34,34,19.17,,,,fee schedule,,,,,,,,20.48,,,,fee schedule,,,28.9,85,,percent of total billed charges,,21.13,,,,fee schedule,,20.53,,,,fee schedule,,20.48,,,,fee schedule,,,,,,,,20.48,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,10.2,83,,percent of total billed charges,,20.48,,,,fee schedule,,20.48,,,,fee schedule,,,28.22,83,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,10.2,32.3,
"TYPHOID VACCINE, ORAL",90690,CDM,90690,CPT,,,both,,230,230,87.71,,,,fee schedule,,,,,,,,,,,,,,,195.5,85,,percent of total billed charges,,106.29,,,,fee schedule,,106.29,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,209.3,91,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,69,83,,percent of total billed charges,,,,,,,,,,,,,,,190.9,83,,percent of total billed charges,,,,,,,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,69,218.5,
TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE IM,90691,CDM,90691,CPT,,,both,,230,230,75.16,,,,fee schedule,,,,,,,,,,,,,,,195.5,85,,percent of total billed charges,,123.68,,,,fee schedule,,123.68,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,209.3,91,,percent of total billed charges,,,218.5,95,,percent of total billed charges,,,190.9,83,,percent of total billed charges,,,69,83,,percent of total billed charges,,,,,,,,,,,,,,,190.9,83,,percent of total billed charges,,,,,,,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,207,90,,percent of total billed charges,,,195.5,85,,percent of total billed charges,,69,218.5,
DTAP-IPV WHEN ADMIN PTS AGE 4-6 YRS IM,90696,CDM,90696,CPT,,,both,,94,94,54.18,,,,fee schedule,,,,,,,,,,,,,,,79.9,85,,percent of total billed charges,,68.16,,,,fee schedule,,68.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.54,91,,percent of total billed charges,,,89.3,95,,percent of total billed charges,,,78.02,83,,percent of total billed charges,,,28.2,83,,percent of total billed charges,,,,,,,,,,,,,,,78.02,83,,percent of total billed charges,,,,,,,,,84.6,90,,percent of total billed charges,,,84.6,90,,percent of total billed charges,,,84.6,90,,percent of total billed charges,,,84.6,90,,percent of total billed charges,,,79.9,85,,percent of total billed charges,,28.2,89.3,
DTAP-IPV-HIB-HEPB VACCINE IM,90697,CDM,90697,CPT,,,both,,187,187,,,,,,,,,,,,,,,,,,,,158.95,85,,percent of total billed charges,,166.34,,,,fee schedule,,166.34,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,56.1,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,,,,,,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,56.1,177.65,
DTAP-HIB-IPV VACCINE IM,90698,CDM,90698,CPT,,,both,,167,167,101.19,,,,fee schedule,,,,,,,,,,,,,,,141.95,85,,percent of total billed charges,,127.37,,,,fee schedule,,127.37,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,50.1,83,,percent of total billed charges,,,,,,,,,,,,,,,138.61,83,,percent of total billed charges,,,,,,,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,50.1,158.65,
"DTAP Vaccine, < 7 Yrs, IM",90700,CDM,90700,CPT,,,both,,42,42,25.51,,,,fee schedule,,,,,,,,,,,,,,,35.7,85,,percent of total billed charges,,32.05,,,,fee schedule,,32.05,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,38.22,91,,percent of total billed charges,,,39.9,95,,percent of total billed charges,,,34.86,83,,percent of total billed charges,,,12.6,83,,percent of total billed charges,,,,,,,,,,,,,,,34.86,83,,percent of total billed charges,,,,,,,,,37.8,90,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,35.7,85,,percent of total billed charges,,12.6,39.9,
DIPHTHERIA TETANUS TOXOID ADSORBED < 7 YR IM,90702,CDM,90702,CPT,,,both,,66,66,58.14,,,,fee schedule,,,,,,,,,,,,,,,56.1,85,,percent of total billed charges,,73.89,,,,fee schedule,,73.89,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.06,91,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,,,,,,,,,,,,,,54.78,83,,percent of total billed charges,,,,,,,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,19.8,73.89,
"TETANUS VACCINE, IM",90703,CDM,90703,CPT,,,both,,92,92,,,,,,,,,,,,,,,,,,,,78.2,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,27.6,83,,percent of total billed charges,,,,,,,,,,,,,,,76.36,83,,percent of total billed charges,,,,,,,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,27.6,87.4,
MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ,90707,CDM,90707,CPT,,,both,,183,183,79.87,,,,fee schedule,,,,,,,,85.91,,,,fee schedule,,,155.55,85,,percent of total billed charges,,107.46,,,,fee schedule,,107.46,,,,fee schedule,,85.91,,,,fee schedule,,,,,,,,85.91,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,54.9,83,,percent of total billed charges,,85.91,,,,fee schedule,,85.91,,,,fee schedule,,,151.89,83,,percent of total billed charges,,,,,,,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,54.9,173.85,
Proquad-MMR Varicella,90710,CDM,90710,CPT,,,both,,509,509,228.92,,,,fee schedule,,,,,,,,,,,,,,,432.65,85,,percent of total billed charges,,308.4,,,,fee schedule,,308.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,463.19,91,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,152.7,83,,percent of total billed charges,,,,,,,,,,,,,,,422.47,83,,percent of total billed charges,,,,,,,,,458.1,90,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,152.7,483.55,
POLIOVIRUS VACCINE INACTIVATED SUBQ/IM,90713,CDM,90713,CPT,,,both,,93,93,35.74,,,,fee schedule,,,,,,,,37.04,,,,fee schedule,,,79.05,85,,percent of total billed charges,,47.73,,,,fee schedule,,47.73,,,,fee schedule,,37.04,,,,fee schedule,,,,,,,,37.04,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,37.04,,,,fee schedule,,37.04,,,,fee schedule,,,77.19,83,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,27.9,88.35,
TD TOXOIDS ADSORBED PRSRV FR 7 YR + IM,90714,CDM,90714,CPT,,,both,,61,61,25.27,,,,fee schedule,,,,,,,,28.01,,,,fee schedule,,,51.85,85,,percent of total billed charges,,31.99,,,,fee schedule,,31.99,,,,fee schedule,,28.01,,,,fee schedule,,,,,,,,28.01,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,55.51,91,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,18.3,83,,percent of total billed charges,,28.01,,,,fee schedule,,28.01,,,,fee schedule,,,50.63,83,,percent of total billed charges,,,,,,,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,18.3,57.95,
TDAP VACCINE 7 YR And Older IM,90715,CDM,90715,CPT,,,both,,78,78,34.28,,,,fee schedule,,,,,,,,38.28,,,,fee schedule,,,66.3,85,,percent of total billed charges,,53.37,,,,fee schedule,,53.37,,,,fee schedule,,38.28,,,,fee schedule,,,,,,,,38.28,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,38.28,,,,fee schedule,,38.28,,,,fee schedule,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,23.4,74.1,
VARICELLA VIRUS VACCINE LIVE SUBQ,90716,CDM,90716,CPT,,,both,,331,331,138.31,,,,fee schedule,,,,,,,,152.95,,,,fee schedule,,,281.35,85,,percent of total billed charges,,186.45,,,,fee schedule,,186.45,,,,fee schedule,,152.95,,,,fee schedule,,,,,,,,152.95,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,301.21,91,,percent of total billed charges,,,314.45,95,,percent of total billed charges,,,274.73,83,,percent of total billed charges,,,99.3,83,,percent of total billed charges,,152.95,,,,fee schedule,,152.95,,,,fee schedule,,,274.73,83,,percent of total billed charges,,,,,,,,,297.9,90,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,281.35,85,,percent of total billed charges,,99.3,314.45,
"YELLOW FEVER VACCINE, SC",90717,CDM,90717,CPT,,,both,,337,337,143.47,,,,fee schedule,,,,,,,,,,,,,,,286.45,85,,percent of total billed charges,,173.85,,,,fee schedule,,173.85,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,306.67,91,,percent of total billed charges,,,320.15,95,,percent of total billed charges,,,279.71,83,,percent of total billed charges,,,101.1,83,,percent of total billed charges,,,,,,,,,,,,,,,279.71,83,,percent of total billed charges,,,,,,,,,303.3,90,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,286.45,85,,percent of total billed charges,,101.1,320.15,
DTAP-HEPB-IPV VACCINE INTRAMUSCULAR,90723,CDM,90723,CPT,,,both,,134,134,83.94,,,,fee schedule,,,,,,,,,,,,,,,113.9,85,,percent of total billed charges,,110.52,,,,fee schedule,,110.52,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,121.94,91,,percent of total billed charges,,,127.3,95,,percent of total billed charges,,,111.22,83,,percent of total billed charges,,,40.2,83,,percent of total billed charges,,,,,,,,,,,,,,,111.22,83,,percent of total billed charges,,,,,,,,,120.6,90,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,113.9,85,,percent of total billed charges,,40.2,127.3,
PNEUMOCOCCAL POLYSAC VACCINE 23-V 2 YR + SUBQ/IM,90732,CDM,90732,CPT,,,both,,232,232,119.92,,,,fee schedule,,,,,,,,133.47,,,,fee schedule,,,197.2,85,,percent of total billed charges,,144.72,,,,fee schedule,,144.72,,,,fee schedule,,133.47,,,,fee schedule,,,,,,,,133.47,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,211.12,91,,percent of total billed charges,,,220.4,95,,percent of total billed charges,,,192.56,83,,percent of total billed charges,,,69.6,83,,percent of total billed charges,,133.47,,,,fee schedule,,133.47,,,,fee schedule,,,192.56,83,,percent of total billed charges,,,,,,,,,208.8,90,,percent of total billed charges,,,208.8,90,,percent of total billed charges,,,208.8,90,,percent of total billed charges,,,208.8,90,,percent of total billed charges,,,197.2,85,,percent of total billed charges,,69.6,220.4,
MENINGOCOCCAL POLYSAC VACCINE SUBCUTANEOUS,90733,CDM,90733,CPT,,,both,,218,218,125.5,,,,fee schedule,,,,,,,,,,,,,,,185.3,85,,percent of total billed charges,,155.03,,,,fee schedule,,155.03,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,65.4,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,,,,,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,65.4,207.1,
MENINGOCOCCAL CONJ VACCINE TETRAVALENT,90734,CDM,90734,CPT,,,both,,232,232,130.82,,,,fee schedule,,,,,,,,135.47,,,,fee schedule,,,197.2,85,,percent of total billed charges,,174.99,,,,fee schedule,,174.99,,,,fee schedule,,135.47,,,,fee schedule,,,,,,,,135.47,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,211.12,91,,percent of total billed charges,,,220.4,95,,percent of total billed charges,,,192.56,83,,percent of total billed charges,,,69.6,83,,percent of total billed charges,,135.47,,,,fee schedule,,135.47,,,,fee schedule,,,192.56,83,,percent of total billed charges,,,,,,,,,208.8,90,,percent of total billed charges,,,208.8,90,,percent of total billed charges,,,208.8,90,,percent of total billed charges,,,208.8,90,,percent of total billed charges,,,197.2,85,,percent of total billed charges,,69.6,220.4,
ZOSTER SHINGLES VACCINE LIVE SUBCUTANEOUS,90736,CDM,90736,CPT,,,both,,603,603,216.92,,,,fee schedule,,,,,,,,213.3,,,,fee schedule,,,512.55,85,,percent of total billed charges,,262.86,,,,fee schedule,,262.86,,,,fee schedule,,213.3,,,,fee schedule,,,,,,,,213.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,548.73,91,,percent of total billed charges,,,572.85,95,,percent of total billed charges,,,500.49,83,,percent of total billed charges,,,180.9,83,,percent of total billed charges,,213.3,,,,fee schedule,,213.3,,,,fee schedule,,,500.49,83,,percent of total billed charges,,,,,,,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,542.7,90,,percent of total billed charges,,,512.55,85,,percent of total billed charges,,180.9,572.85,
INACTIVATED JE VACC IM,90738,CDM,90738,CPT,,,both,,686,686,259.85,,,,fee schedule,,,,,,,,,,,,,,,583.1,85,,percent of total billed charges,,314.88,,,,fee schedule,,314.88,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,624.26,91,,percent of total billed charges,,,651.7,95,,percent of total billed charges,,,569.38,83,,percent of total billed charges,,,205.8,83,,percent of total billed charges,,,,,,,,,,,,,,,569.38,83,,percent of total billed charges,,,,,,,,,617.4,90,,percent of total billed charges,,,617.4,90,,percent of total billed charges,,,617.4,90,,percent of total billed charges,,,617.4,90,,percent of total billed charges,,,583.1,85,,percent of total billed charges,,205.8,651.7,
HEP B VACC ADULT 2 DOSE IM,90739,CDM,90739,CPT,,,both,,140,140,131.1,,,,fee schedule,,,,,,,,152.08,,,,fee schedule,,,119,85,,percent of total billed charges,,156.35,,,,fee schedule,,156.35,,,,fee schedule,,152.08,,,,fee schedule,,,,,,,,152.08,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,42,83,,percent of total billed charges,,152.08,,,,fee schedule,,152.08,,,,fee schedule,,,116.2,83,,percent of total billed charges,,,,,,,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,42,156.35,
"HEP B VACC, ADOL, 2 DOSE, IM",90743,CDM,90743,CPT,,,both,,446,446,62.31,,,,fee schedule,,,,,,,,,,,,,,,379.1,85,,percent of total billed charges,,77.75,,,,fee schedule,,77.75,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,405.86,91,,percent of total billed charges,,,423.7,95,,percent of total billed charges,,,370.18,83,,percent of total billed charges,,,133.8,83,,percent of total billed charges,,,,,,,,,,,,,,,370.18,83,,percent of total billed charges,,,,,,,,,401.4,90,,percent of total billed charges,,,401.4,90,,percent of total billed charges,,,401.4,90,,percent of total billed charges,,,401.4,90,,percent of total billed charges,,,379.1,85,,percent of total billed charges,,62.31,423.7,
HEPATITIS B VACCINE PEDIATRIC 3 DOSE IM,90744,CDM,90744,CPT,,,both,,76,76,28.21,,,,fee schedule,,,,,,,,,,,,,,,64.6,85,,percent of total billed charges,,31.49,,,,fee schedule,,31.49,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,,,,,,,,,,,,,,63.08,83,,percent of total billed charges,,,,,,,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,22.8,72.2,
HEPATITIS B VACCINE ADULT DOSAGE INTRAMU0SCULAR,90746,CDM,90746,CPT,,,both,,142,142,69.65,,,,fee schedule,,,,,,,,70.38,,,,fee schedule,,,120.7,85,,percent of total billed charges,,77.75,,,,fee schedule,,77.75,,,,fee schedule,,70.38,,,,fee schedule,,,,,,,,70.38,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,129.22,91,,percent of total billed charges,,,134.9,95,,percent of total billed charges,,,117.86,83,,percent of total billed charges,,,42.6,83,,percent of total billed charges,,70.38,,,,fee schedule,,70.38,,,,fee schedule,,,117.86,83,,percent of total billed charges,,,,,,,,,127.8,90,,percent of total billed charges,,,127.8,90,,percent of total billed charges,,,127.8,90,,percent of total billed charges,,,127.8,90,,percent of total billed charges,,,120.7,85,,percent of total billed charges,,42.6,134.9,
"HEPB VACC, ILL PAT 4 DOSE IM",90747,CDM,90747,CPT,,,both,,339,339,140.76,,,,fee schedule,,,,,,,,140.75,,,,fee schedule,,,288.15,85,,percent of total billed charges,,158.65,,,,fee schedule,,158.65,,,,fee schedule,,140.75,,,,fee schedule,,,,,,,,140.75,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,308.49,91,,percent of total billed charges,,,322.05,95,,percent of total billed charges,,,281.37,83,,percent of total billed charges,,,101.7,83,,percent of total billed charges,,140.75,,,,fee schedule,,140.75,,,,fee schedule,,,281.37,83,,percent of total billed charges,,,,,,,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,288.15,85,,percent of total billed charges,,101.7,322.05,
HZV VACC RECOMBINANT IM NJXHZV VACC RECOMBINANT IM NJX,90750,CDM,90750,CPT,,,both,,177,177,154.44,,,,fee schedule,,,,,,,,164.02,,,,fee schedule,,,150.45,85,,percent of total billed charges,,212.06,,,,fee schedule,,212.06,,,,fee schedule,,164.02,,,,fee schedule,,,,,,,,164.02,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,53.1,83,,percent of total billed charges,,164.02,,,,fee schedule,,164.02,,,,fee schedule,,,146.91,83,,percent of total billed charges,,,,,,,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,53.1,212.06,
"THER/PROPH/DIAG INJ, SC/IM",90772,CDM,90772,CPT,,,both,,30,30,,,,,,,,,,,,,,,,,,,,25.5,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,9,83,,percent of total billed charges,,,,,,,,,,,,,,,24.9,83,,percent of total billed charges,,,,,,,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,9,28.5,
PSYTX COMPLEX INTERACTIVE,90785,CDM,90785,CPT,,,both,,31,31,15.02,,,,fee schedule,,,,,,,,,,,,,,,26.35,85,,percent of total billed charges,,21.16,,,,fee schedule,,21.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,21.81,,,,fee schedule,,13.22,,,,fee schedule,,13.22,,,,fee schedule,,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,9.3,83,,percent of total billed charges,,,,,,,,,,,,,,,25.73,83,,percent of total billed charges,,19.43,,,,fee schedule,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,9.3,29.45,
PSYCH DIAGNOSTIC EVALUATION,90791,CDM,90791,CPT,,,both,,359,359,143.43,,,,fee schedule,,,,,,,,122.11,,,,fee schedule,,,305.15,85,,percent of total billed charges,,253.81,,,,fee schedule,,190.7,,,,fee schedule,,122.11,,,,fee schedule,,,,,,,,122.11,,,,fee schedule,,248.82,,,,fee schedule,,150.8,,,,fee schedule,,150.8,,,,fee schedule,,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,107.7,83,,percent of total billed charges,,122.11,,,,fee schedule,,122.11,,,,fee schedule,,,297.97,83,,percent of total billed charges,,221.67,,,,fee schedule,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,107.7,341.05,
TELEHEALTH PSYCH DIAGNOSTIC EVALUATION,90791VV,CDM,90791,CPT,,,both,,359,359,143.43,,,,fee schedule,,,,,,,,122.11,,,,fee schedule,,,305.15,85,,percent of total billed charges,,253.81,,,,fee schedule,,190.7,,,,fee schedule,,122.11,,,,fee schedule,,,,,,,,122.11,,,,fee schedule,,248.82,,,,fee schedule,,150.8,,,,fee schedule,,150.8,,,,fee schedule,,,326.69,91,,percent of total billed charges,,,341.05,95,,percent of total billed charges,,,297.97,83,,percent of total billed charges,,,107.7,83,,percent of total billed charges,,122.11,,,,fee schedule,,122.11,,,,fee schedule,,,297.97,83,,percent of total billed charges,,221.67,,,,fee schedule,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,323.1,90,,percent of total billed charges,,,305.15,85,,percent of total billed charges,,107.7,341.05,
PSYCH DIAG EVAL W MED SRVCS,90792,CDM,90792,CPT,,,both,,580,580,158.4,,,,fee schedule,,,,,,,,124.44,,,,fee schedule,,,493,85,,percent of total billed charges,,284.11,,,,fee schedule,,213.47,,,,fee schedule,,124.44,,,,fee schedule,,,,,,,,124.44,,,,fee schedule,,284.04,,,,fee schedule,,172.15,,,,fee schedule,,172.15,,,,fee schedule,,,527.8,91,,percent of total billed charges,,,551,95,,percent of total billed charges,,,481.4,83,,percent of total billed charges,,,174,83,,percent of total billed charges,,124.44,,,,fee schedule,,124.44,,,,fee schedule,,,481.4,83,,percent of total billed charges,,253.06,,,,fee schedule,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,493,85,,percent of total billed charges,,124.44,551,
TLEHEALTH PSYCH DIAG EVAL W/MED SRVCS,90792VV,CDM,90792,CPT,,,both,,580,580,158.4,,,,fee schedule,,,,,,,,124.44,,,,fee schedule,,,493,85,,percent of total billed charges,,284.11,,,,fee schedule,,213.47,,,,fee schedule,,124.44,,,,fee schedule,,,,,,,,124.44,,,,fee schedule,,284.04,,,,fee schedule,,172.15,,,,fee schedule,,172.15,,,,fee schedule,,,527.8,91,,percent of total billed charges,,,551,95,,percent of total billed charges,,,481.4,83,,percent of total billed charges,,,174,83,,percent of total billed charges,,124.44,,,,fee schedule,,124.44,,,,fee schedule,,,481.4,83,,percent of total billed charges,,253.06,,,,fee schedule,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,493,85,,percent of total billed charges,,124.44,551,
INITIAL PSYCH EVAL/INTAKE,90801,CDM,90801,CPT,,,both,,370,370,,,,,,,,,,,,,,,,,,,,314.5,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,237.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,336.7,91,,percent of total billed charges,,,351.5,95,,percent of total billed charges,,,307.1,83,,percent of total billed charges,,,111,83,,percent of total billed charges,,,,,,,,,,,,,,,307.1,83,,percent of total billed charges,,,,,,,,,333,90,,percent of total billed charges,,,333,90,,percent of total billed charges,,,333,90,,percent of total billed charges,,,333,90,,percent of total billed charges,,,314.5,85,,percent of total billed charges,,111,351.5,
INDIVIDUAL THERAPY 20-30 MIN,90804,CDM,90804,CPT,,,both,,162,162,,,,,,,,,,,,,,,,,,,,137.7,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,101.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,48.6,83,,percent of total billed charges,,,,,,,,,,,,,,,134.46,83,,percent of total billed charges,,,,,,,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,48.6,153.9,
INDIVIDUAL THERAPY 45-50 MIN,90806,CDM,90806,CPT,,,both,,248,248,,,,,,,,,,,,,,,,,,,,210.8,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,156.95,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,74.4,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,74.4,235.6,
INDIVIDUAL THERAPY W/ MED MNGT 45-50 MIN,90807,CDM,90807,CPT,,,both,,321,321,,,,,,,,,,,,,,,,,,,,272.85,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,168.83,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,292.11,91,,percent of total billed charges,,,304.95,95,,percent of total billed charges,,,266.43,83,,percent of total billed charges,,,96.3,83,,percent of total billed charges,,,,,,,,,,,,,,,266.43,83,,percent of total billed charges,,,,,,,,,288.9,90,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,272.85,85,,percent of total billed charges,,96.3,304.95,
INDIVIDUAL THERAPY 75-80 MIN,90808,CDM,90808,CPT,,,both,,307,307,,,,,,,,,,,,,,,,,,,,260.95,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,235.12,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,279.37,91,,percent of total billed charges,,,291.65,95,,percent of total billed charges,,,254.81,83,,percent of total billed charges,,,92.1,83,,percent of total billed charges,,,,,,,,,,,,,,,254.81,83,,percent of total billed charges,,,,,,,,,276.3,90,,percent of total billed charges,,,276.3,90,,percent of total billed charges,,,276.3,90,,percent of total billed charges,,,276.3,90,,percent of total billed charges,,,260.95,85,,percent of total billed charges,,92.1,291.65,
INDIVIDUAL THERAPY W/ MED MNGT 75-80 MIN,90809,CDM,90809,CPT,,,both,,467,467,,,,,,,,,,,,,,,,,,,,396.95,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,247,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,424.97,91,,percent of total billed charges,,,443.65,95,,percent of total billed charges,,,387.61,83,,percent of total billed charges,,,140.1,83,,percent of total billed charges,,,,,,,,,,,,,,,387.61,83,,percent of total billed charges,,,,,,,,,420.3,90,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,420.3,90,,percent of total billed charges,,,396.95,85,,percent of total billed charges,,140.1,443.65,
PSYTX PT FAMILY 30 MINUTES,90832,CDM,90832,CPT,,,both,,438,438,102.95,,,,fee schedule,,,,,,,,29.48,,,,fee schedule,,,372.3,85,,percent of total billed charges,,110.83,,,,fee schedule,,112.09,,,,fee schedule,,29.48,,,,fee schedule,,,,,,,,29.48,,,,fee schedule,,109.59,,,,fee schedule,,66.42,,,,fee schedule,,66.42,,,,fee schedule,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,131.4,83,,percent of total billed charges,,29.48,,,,fee schedule,,29.48,,,,fee schedule,,,363.54,83,,percent of total billed charges,,97.64,,,,fee schedule,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,29.48,416.1,
TELEHEALTH PSYTX W PT 30 MINUTES,90832VV,CDM,90832,CPT,,,both,,438,438,102.95,,,,fee schedule,,,,,,,,29.48,,,,fee schedule,,,372.3,85,,percent of total billed charges,,110.83,,,,fee schedule,,112.09,,,,fee schedule,,29.48,,,,fee schedule,,,,,,,,29.48,,,,fee schedule,,109.59,,,,fee schedule,,66.42,,,,fee schedule,,66.42,,,,fee schedule,,,398.58,91,,percent of total billed charges,,,416.1,95,,percent of total billed charges,,,363.54,83,,percent of total billed charges,,,131.4,83,,percent of total billed charges,,29.48,,,,fee schedule,,29.48,,,,fee schedule,,,363.54,83,,percent of total billed charges,,97.64,,,,fee schedule,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,394.2,90,,percent of total billed charges,,,372.3,85,,percent of total billed charges,,29.48,416.1,
PSYTX PT FAM W EM 30 MIN,90833,CDM,90833,CPT,,,both,,99,99,96.12,,,,fee schedule,,,,,,,,24.62,,,,fee schedule,,,84.15,85,,percent of total billed charges,,101.3,,,,fee schedule,,102.46,,,,fee schedule,,24.62,,,,fee schedule,,,,,,,,24.62,,,,fee schedule,,102.32,,,,fee schedule,,62.01,,,,fee schedule,,62.01,,,,fee schedule,,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,29.7,83,,percent of total billed charges,,24.62,,,,fee schedule,,24.62,,,,fee schedule,,,82.17,83,,percent of total billed charges,,91.16,,,,fee schedule,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,24.62,102.46,
TELEHEALTH PSYTX W PT W E/M 30 MIN,90833VV,CDM,90833,CPT,,,both,,99,99,96.12,,,,fee schedule,,,,,,,,24.62,,,,fee schedule,,,84.15,85,,percent of total billed charges,,101.3,,,,fee schedule,,102.46,,,,fee schedule,,24.62,,,,fee schedule,,,,,,,,24.62,,,,fee schedule,,102.32,,,,fee schedule,,62.01,,,,fee schedule,,62.01,,,,fee schedule,,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,29.7,83,,percent of total billed charges,,24.62,,,,fee schedule,,24.62,,,,fee schedule,,,82.17,83,,percent of total billed charges,,91.16,,,,fee schedule,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,24.62,102.46,
PSYTX PT FAMILY 45 MINUTES,90834,CDM,90834,CPT,,,both,,527,527,136.57,,,,fee schedule,,,,,,,,88.4,,,,fee schedule,,,447.95,85,,percent of total billed charges,,146.24,,,,fee schedule,,147.91,,,,fee schedule,,88.4,,,,fee schedule,,,,,,,,88.4,,,,fee schedule,,145.38,,,,fee schedule,,88.11,,,,fee schedule,,88.11,,,,fee schedule,,,479.57,91,,percent of total billed charges,,,500.65,95,,percent of total billed charges,,,437.41,83,,percent of total billed charges,,,158.1,83,,percent of total billed charges,,88.4,,,,fee schedule,,88.4,,,,fee schedule,,,437.41,83,,percent of total billed charges,,129.52,,,,fee schedule,,,474.3,90,,percent of total billed charges,,,474.3,90,,percent of total billed charges,,,474.3,90,,percent of total billed charges,,,474.3,90,,percent of total billed charges,,,447.95,85,,percent of total billed charges,,88.11,500.65,
TELEHEALTH PSYTX W PT 45 MINUTES,90834VV,CDM,90834,CPT,,,both,,527,527,136.57,,,,fee schedule,,,,,,,,88.4,,,,fee schedule,,,447.95,85,,percent of total billed charges,,146.24,,,,fee schedule,,147.91,,,,fee schedule,,88.4,,,,fee schedule,,,,,,,,88.4,,,,fee schedule,,145.38,,,,fee schedule,,88.11,,,,fee schedule,,88.11,,,,fee schedule,,,479.57,91,,percent of total billed charges,,,500.65,95,,percent of total billed charges,,,437.41,83,,percent of total billed charges,,,158.1,83,,percent of total billed charges,,88.4,,,,fee schedule,,88.4,,,,fee schedule,,,437.41,83,,percent of total billed charges,,129.52,,,,fee schedule,,,474.3,90,,percent of total billed charges,,,474.3,90,,percent of total billed charges,,,474.3,90,,percent of total billed charges,,,474.3,90,,percent of total billed charges,,,447.95,85,,percent of total billed charges,,88.11,500.65,
PSYTX PT FAM W EM 45 MIN,90836,CDM,90836,CPT,,,both,,161,161,121.86,,,,fee schedule,,,,,,,,40.24,,,,fee schedule,,,136.85,85,,percent of total billed charges,,127.77,,,,fee schedule,,129.23,,,,fee schedule,,40.24,,,,fee schedule,,,,,,,,40.24,,,,fee schedule,,129.72,,,,fee schedule,,78.62,,,,fee schedule,,78.62,,,,fee schedule,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,48.3,83,,percent of total billed charges,,40.24,,,,fee schedule,,40.24,,,,fee schedule,,,133.63,83,,percent of total billed charges,,115.57,,,,fee schedule,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,40.24,152.95,
TELEHEALTH PSYTX W PT W E/M 45 MIN,90836vv,CDM,90836,CPT,,,both,,161,161,121.86,,,,fee schedule,,,,,,,,40.24,,,,fee schedule,,,136.85,85,,percent of total billed charges,,127.77,,,,fee schedule,,129.23,,,,fee schedule,,40.24,,,,fee schedule,,,,,,,,40.24,,,,fee schedule,,129.72,,,,fee schedule,,78.62,,,,fee schedule,,78.62,,,,fee schedule,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,48.3,83,,percent of total billed charges,,40.24,,,,fee schedule,,40.24,,,,fee schedule,,,133.63,83,,percent of total billed charges,,115.57,,,,fee schedule,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,40.24,152.95,
PSYTX PT FAMILY 60 MINUTES,90837,CDM,90837,CPT,,,both,,580,580,200.65,,,,fee schedule,,,,,,,,133.42,,,,fee schedule,,,493,85,,percent of total billed charges,,214.48,,,,fee schedule,,198.34,,,,fee schedule,,133.42,,,,fee schedule,,,,,,,,133.42,,,,fee schedule,,213.59,,,,fee schedule,,129.45,,,,fee schedule,,129.45,,,,fee schedule,,,527.8,91,,percent of total billed charges,,,551,95,,percent of total billed charges,,,481.4,83,,percent of total billed charges,,,174,83,,percent of total billed charges,,133.42,,,,fee schedule,,133.42,,,,fee schedule,,,481.4,83,,percent of total billed charges,,190.29,,,,fee schedule,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,493,85,,percent of total billed charges,,129.45,551,
TELEHEALTH PSYTX W PT 60 MINUTES,90837VV,CDM,90837,CPT,,,both,,580,580,200.65,,,,fee schedule,,,,,,,,133.42,,,,fee schedule,,,493,85,,percent of total billed charges,,214.48,,,,fee schedule,,198.34,,,,fee schedule,,133.42,,,,fee schedule,,,,,,,,133.42,,,,fee schedule,,213.59,,,,fee schedule,,129.45,,,,fee schedule,,129.45,,,,fee schedule,,,527.8,91,,percent of total billed charges,,,551,95,,percent of total billed charges,,,481.4,83,,percent of total billed charges,,,174,83,,percent of total billed charges,,133.42,,,,fee schedule,,133.42,,,,fee schedule,,,481.4,83,,percent of total billed charges,,190.29,,,,fee schedule,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,493,85,,percent of total billed charges,,129.45,551,
PSYTX PT FAM W EM 60 MIN,90838,CDM,90838,CPT,,,both,,259,259,161.78,,,,fee schedule,,,,,,,,64.64,,,,fee schedule,,,220.15,85,,percent of total billed charges,,168,,,,fee schedule,,169.92,,,,fee schedule,,64.64,,,,fee schedule,,,,,,,,64.64,,,,fee schedule,,172.21,,,,fee schedule,,104.37,,,,fee schedule,,104.37,,,,fee schedule,,,235.69,91,,percent of total billed charges,,,246.05,95,,percent of total billed charges,,,214.97,83,,percent of total billed charges,,,77.7,83,,percent of total billed charges,,64.64,,,,fee schedule,,64.64,,,,fee schedule,,,214.97,83,,percent of total billed charges,,153.43,,,,fee schedule,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,220.15,85,,percent of total billed charges,,64.64,246.05,
TELEHEALTH PSYTX W PT W E/M 60 MIN,90838VV,CDM,90838,CPT,,,both,,259,259,161.78,,,,fee schedule,,,,,,,,64.64,,,,fee schedule,,,220.15,85,,percent of total billed charges,,168,,,,fee schedule,,169.92,,,,fee schedule,,64.64,,,,fee schedule,,,,,,,,64.64,,,,fee schedule,,172.21,,,,fee schedule,,104.37,,,,fee schedule,,104.37,,,,fee schedule,,,235.69,91,,percent of total billed charges,,,246.05,95,,percent of total billed charges,,,214.97,83,,percent of total billed charges,,,77.7,83,,percent of total billed charges,,64.64,,,,fee schedule,,64.64,,,,fee schedule,,,214.97,83,,percent of total billed charges,,153.43,,,,fee schedule,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,233.1,90,,percent of total billed charges,,,220.15,85,,percent of total billed charges,,64.64,246.05,
PSYTX CRISIS INITIAL 60 MIN,90839,CDM,90839,CPT,,,both,,660,660,193.82,,,,fee schedule,,,,,,,,66.71,,,,fee schedule,,,561,85,,percent of total billed charges,,205.17,,,,fee schedule,,259.99,,,,fee schedule,,66.71,,,,fee schedule,,,,,,,,66.71,,,,fee schedule,,206.32,,,,fee schedule,,125.04,,,,fee schedule,,125.04,,,,fee schedule,,,600.6,91,,percent of total billed charges,,,627,95,,percent of total billed charges,,,547.8,83,,percent of total billed charges,,,198,83,,percent of total billed charges,,66.71,,,,fee schedule,,66.71,,,,fee schedule,,,547.8,83,,percent of total billed charges,,183.81,,,,fee schedule,,,594,90,,percent of total billed charges,,,594,90,,percent of total billed charges,,,594,90,,percent of total billed charges,,,594,90,,percent of total billed charges,,,561,85,,percent of total billed charges,,66.71,627,
PSYTX CRISIS INITIAL 60 MIN,90839VV,CDM,90839,CPT,,,both,,660,660,193.82,,,,fee schedule,,,,,,,,66.71,,,,fee schedule,,,561,85,,percent of total billed charges,,205.17,,,,fee schedule,,259.99,,,,fee schedule,,66.71,,,,fee schedule,,,,,,,,66.71,,,,fee schedule,,206.32,,,,fee schedule,,125.04,,,,fee schedule,,125.04,,,,fee schedule,,,600.6,91,,percent of total billed charges,,,627,95,,percent of total billed charges,,,547.8,83,,percent of total billed charges,,,198,83,,percent of total billed charges,,66.71,,,,fee schedule,,66.71,,,,fee schedule,,,547.8,83,,percent of total billed charges,,183.81,,,,fee schedule,,,594,90,,percent of total billed charges,,,594,90,,percent of total billed charges,,,594,90,,percent of total billed charges,,,594,90,,percent of total billed charges,,,561,85,,percent of total billed charges,,66.71,627,
PSYTX CRISIS EA ADDL 30 MIN,90840,CDM,90840,CPT,,,both,,198,198,97.17,,,,fee schedule,,,,,,,,,,,,,,,168.3,85,,percent of total billed charges,,102.75,,,,fee schedule,,104.07,,,,fee schedule,,,,,,,,,,,,,,,,,,,,103.44,,,,fee schedule,,62.69,,,,fee schedule,,62.69,,,,fee schedule,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,59.4,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,92.16,,,,fee schedule,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,59.4,188.1,
PSYCHOANALYSIS,90845,CDM,90845,CPT,,,both,,414,414,129.74,,,,fee schedule,,,,,,,,,,,,,,,351.9,85,,percent of total billed charges,,138.34,,,,fee schedule,,140.12,,,,fee schedule,,,,,,,,148.82,,,,fee schedule,,,,,,,,138.11,,,,fee schedule,,83.7,,,,fee schedule,,83.7,,,,fee schedule,,,376.74,91,,percent of total billed charges,,,393.3,95,,percent of total billed charges,,,343.62,83,,percent of total billed charges,,,124.2,83,,percent of total billed charges,,,,,,,,,,,,,,,343.62,83,,percent of total billed charges,,123.04,,,,fee schedule,,,372.6,90,,percent of total billed charges,,,372.6,90,,percent of total billed charges,,,372.6,90,,percent of total billed charges,,,372.6,90,,percent of total billed charges,,,351.9,85,,percent of total billed charges,,83.7,393.3,
FAMILY PSYTX WO PATIENT,90846,CDM,90846,CPT,,,both,,350,350,147.6,,,,fee schedule,,,,,,,,,,,,,,,297.5,85,,percent of total billed charges,,189.09,,,,fee schedule,,142.84,,,,fee schedule,,,,,,,,158.2,,,,fee schedule,,,,,,,,157.12,,,,fee schedule,,95.22,,,,fee schedule,,95.22,,,,fee schedule,,,318.5,91,,percent of total billed charges,,,332.5,95,,percent of total billed charges,,,290.5,83,,percent of total billed charges,,,105,83,,percent of total billed charges,,,,,,,,,,,,,,,290.5,83,,percent of total billed charges,,139.98,,,,fee schedule,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,297.5,85,,percent of total billed charges,,95.22,332.5,
BEHAVORIAL HEALTH FAMILY COUPLE THERAPY,90847,CDM,90847,CPT,,,both,,580,580,153.9,,,,fee schedule,,,,,,,,61.2,,,,fee schedule,,,493,85,,percent of total billed charges,,195.78,,,,fee schedule,,147.89,,,,fee schedule,,61.2,,,,fee schedule,,188.84,,,,fee schedule,,61.2,,,,fee schedule,,163.83,,,,fee schedule,,99.29,,,,fee schedule,,99.29,,,,fee schedule,,,527.8,91,,percent of total billed charges,,,551,95,,percent of total billed charges,,,481.4,83,,percent of total billed charges,,,174,83,,percent of total billed charges,,61.2,,,,fee schedule,,61.2,,,,fee schedule,,,481.4,83,,percent of total billed charges,,145.96,,,,fee schedule,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,493,85,,percent of total billed charges,,61.2,551,
MULTIPLE FAMILY GROUP PSYTX,90849,CDM,90849,CPT,,,both,,193,193,44.65,,,,fee schedule,,,,,,,,61.2,,,,fee schedule,,,164.05,85,,percent of total billed charges,,69.24,,,,fee schedule,,49.92,,,,fee schedule,,61.2,,,,fee schedule,,53.15,,,,fee schedule,,61.2,,,,fee schedule,,47.53,,,,fee schedule,,28.8,,,,fee schedule,,28.8,,,,fee schedule,,,175.63,91,,percent of total billed charges,,,183.35,95,,percent of total billed charges,,,160.19,83,,percent of total billed charges,,,57.9,83,,percent of total billed charges,,61.2,,,,fee schedule,,61.2,,,,fee schedule,,,160.19,83,,percent of total billed charges,,42.34,,,,fee schedule,,,173.7,90,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,164.05,85,,percent of total billed charges,,28.8,183.35,
BEHAVORIAL HEALTH GROUP THERAPY,90853,CDM,90853,CPT,,,both,,323,323,36.24,,,,fee schedule,,,,,,,,33.7,,,,fee schedule,,,274.55,85,,percent of total billed charges,,54.53,,,,fee schedule,,39.32,,,,fee schedule,,33.7,,,,fee schedule,,52.53,,,,fee schedule,,33.7,,,,fee schedule,,38.58,,,,fee schedule,,23.38,,,,fee schedule,,23.38,,,,fee schedule,,,293.93,91,,percent of total billed charges,,,306.85,95,,percent of total billed charges,,,268.09,83,,percent of total billed charges,,,96.9,83,,percent of total billed charges,,33.7,,,,fee schedule,,33.7,,,,fee schedule,,,268.09,83,,percent of total billed charges,,34.37,,,,fee schedule,,,290.7,90,,percent of total billed charges,,,290.7,90,,percent of total billed charges,,,290.7,90,,percent of total billed charges,,,290.7,90,,percent of total billed charges,,,274.55,85,,percent of total billed charges,,23.38,306.85,
MEDICATION GROUP,90857,CDM,90857,CPT,,,both,,198,198,,,,,,,,,,,,,,,,,,,,168.3,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,56.28,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,180.18,91,,percent of total billed charges,,,188.1,95,,percent of total billed charges,,,164.34,83,,percent of total billed charges,,,59.4,83,,percent of total billed charges,,,,,,,,,,,,,,,164.34,83,,percent of total billed charges,,,,,,,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,178.2,90,,percent of total billed charges,,,168.3,85,,percent of total billed charges,,56.28,188.1,
PHARMACOLOGIC MGMT W PSYTX,90863,CDM,90863,CPT,,,both,,217,217,37.29,,,,fee schedule,,,,,,,,,,,,,,,184.45,85,,percent of total billed charges,,15,,,,fee schedule,,15,,,,fee schedule,,,,,,,,,,,,,,,,,,,,39.7,,,,fee schedule,,24.06,,,,fee schedule,,24.06,,,,fee schedule,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,65.1,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,35.37,,,,fee schedule,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,15,206.15,
PSYCHOPHYSIOLOGICAL THERAPY,90875,CDM,90875,CPT,,,both,,222,222,90.87,,,,fee schedule,,,,,,,,28.7,,,,fee schedule,,,188.7,85,,percent of total billed charges,,87.64,,,,fee schedule,,62.99,,,,fee schedule,,28.7,,,,fee schedule,,106.3,,,,fee schedule,,28.7,,,,fee schedule,,96.73,,,,fee schedule,,58.62,,,,fee schedule,,58.62,,,,fee schedule,,,202.02,91,,percent of total billed charges,,,210.9,95,,percent of total billed charges,,,184.26,83,,percent of total billed charges,,,66.6,83,,percent of total billed charges,,28.7,,,,fee schedule,,28.7,,,,fee schedule,,,184.26,83,,percent of total billed charges,,86.18,,,,fee schedule,,,199.8,90,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,188.7,85,,percent of total billed charges,,28.7,210.9,
"BIOFEEDBACK TRAIN, ANY METH",90901,CDM,90901,CPT,,,both,,215,215,29.41,,,,fee schedule,,,,,,,,,,,,,,,182.75,85,,percent of total billed charges,,38.18,,,,fee schedule,,19.81,,,,fee schedule,,,,,,,,35.64,,,,fee schedule,,,,,,,,31.31,,,,fee schedule,,18.98,,,,fee schedule,,18.98,,,,fee schedule,,,195.65,91,,percent of total billed charges,,,204.25,95,,percent of total billed charges,,,178.45,83,,percent of total billed charges,,,64.5,83,,percent of total billed charges,,,,,,,,,,,,,,,178.45,83,,percent of total billed charges,,27.9,,,,fee schedule,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,182.75,85,,percent of total billed charges,,18.98,204.25,
"BIOFEEDBACK TRAIN, ANY METH",90901GP,CDM,90901,CPT,,,both,GP,215,215,29.41,,,,fee schedule,,,,,,,,,,,,,,,182.75,85,,percent of total billed charges,,38.18,,,,fee schedule,,19.81,,,,fee schedule,,,,,,,,35.64,,,,fee schedule,,,,,,,,31.31,,,,fee schedule,,18.98,,,,fee schedule,,18.98,,,,fee schedule,,,195.65,91,,percent of total billed charges,,,204.25,95,,percent of total billed charges,,,178.45,83,,percent of total billed charges,,,64.5,83,,percent of total billed charges,,,,,,,,,,,,,,,178.45,83,,percent of total billed charges,,27.9,,,,fee schedule,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,182.75,85,,percent of total billed charges,,18.98,204.25,
"BIOFEEDBACK TRAIN, ANY METH",90901GPKX,CDM,90901,CPT,,,both,,215,215,29.41,,,,fee schedule,,,,,,,,,,,,,,,182.75,85,,percent of total billed charges,,38.18,,,,fee schedule,,19.81,,,,fee schedule,,,,,,,,35.64,,,,fee schedule,,,,,,,,31.31,,,,fee schedule,,18.98,,,,fee schedule,,18.98,,,,fee schedule,,,195.65,91,,percent of total billed charges,,,204.25,95,,percent of total billed charges,,,178.45,83,,percent of total billed charges,,,64.5,83,,percent of total billed charges,,,,,,,,,,,,,,,178.45,83,,percent of total billed charges,,27.9,,,,fee schedule,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,182.75,85,,percent of total billed charges,,18.98,204.25,
BFB TRAINING 1ST 15 MIN,90912,CDM,90912,CPT,,,both,,251,251,66.18,,,,fee schedule,,,,,,,,26.93,,,,fee schedule,,,213.35,85,,percent of total billed charges,,85.87,,,,fee schedule,,44.55,,,,fee schedule,,26.93,,,,fee schedule,,,,,,,,26.93,,,,fee schedule,,70.45,,,,fee schedule,,42.7,,,,fee schedule,,42.7,,,,fee schedule,,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,26.93,,,,fee schedule,,26.93,,,,fee schedule,,,208.33,83,,percent of total billed charges,,62.77,,,,fee schedule,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,26.93,238.45,
G-ESOPH REFLX TST W/ELECTROD,91035,CDM,91035,CPT,,,both,,1740,1740,728,,,,fee schedule,,,,,,,,255.62,,,,fee schedule,,,1479,85,,percent of total billed charges,,213.17,,,,fee schedule,,83.95,,,,fee schedule,,255.62,,,,fee schedule,,782.26,,,,fee schedule,,255.62,,,,fee schedule,,774.97,,,,fee schedule,,469.68,,,,fee schedule,,469.68,,,,fee schedule,,,1583.4,91,,percent of total billed charges,,,1653,95,,percent of total billed charges,,,1444.2,83,,percent of total billed charges,,,522,83,,percent of total billed charges,,255.62,,,,fee schedule,,255.62,,,,fee schedule,,,1444.2,83,,percent of total billed charges,,690.42,,,,fee schedule,,,1566,90,,percent of total billed charges,,,1566,90,,percent of total billed charges,,,1566,90,,percent of total billed charges,,,1566,90,,percent of total billed charges,,,1479,85,,percent of total billed charges,,83.95,1653,
G-ESOPH REFLX TST W/ELECTROD,9103526,CDM,91035,CPT,,,both,26,430,430,728,,,,fee schedule,,,,,,,,255.62,,,,fee schedule,,,365.5,85,,percent of total billed charges,,213.17,,,,fee schedule,,83.95,,,,fee schedule,,255.62,,,,fee schedule,,782.26,,,,fee schedule,,255.62,,,,fee schedule,,774.97,,,,fee schedule,,469.68,,,,fee schedule,,469.68,,,,fee schedule,,,391.3,91,,percent of total billed charges,,,408.5,95,,percent of total billed charges,,,356.9,83,,percent of total billed charges,,,129,83,,percent of total billed charges,,255.62,,,,fee schedule,,255.62,,,,fee schedule,,,356.9,83,,percent of total billed charges,,690.42,,,,fee schedule,,,387,90,,percent of total billed charges,,,387,90,,percent of total billed charges,,,387,90,,percent of total billed charges,,,387,90,,percent of total billed charges,,,365.5,85,,percent of total billed charges,,83.95,782.26,
ESOPH BALLOON DISTENSION TST,91040,CDM,91040,CPT,,,both,,1986,1986,829.9,,,,fee schedule,,,,,,,,248.27,,,,fee schedule,,,1688.1,85,,percent of total billed charges,,129.95,,,,fee schedule,,51.18,,,,fee schedule,,248.27,,,,fee schedule,,764.13,,,,fee schedule,,248.27,,,,fee schedule,,883.44,,,,fee schedule,,535.42,,,,fee schedule,,535.42,,,,fee schedule,,,1807.26,91,,percent of total billed charges,,,1886.7,95,,percent of total billed charges,,,1648.38,83,,percent of total billed charges,,,595.8,83,,percent of total billed charges,,248.27,,,,fee schedule,,248.27,,,,fee schedule,,,1648.38,83,,percent of total billed charges,,787.06,,,,fee schedule,,,1787.4,90,,percent of total billed charges,,,1787.4,90,,percent of total billed charges,,,1787.4,90,,percent of total billed charges,,,1787.4,90,,percent of total billed charges,,,1688.1,85,,percent of total billed charges,,51.18,1886.7,
ESOPH BALLOON DISTENSION TST,9104026,CDM,91040,CPT,,,both,26,373,373,829.9,,,,fee schedule,,,,,,,,248.27,,,,fee schedule,,,317.05,85,,percent of total billed charges,,129.95,,,,fee schedule,,51.18,,,,fee schedule,,248.27,,,,fee schedule,,764.13,,,,fee schedule,,248.27,,,,fee schedule,,883.44,,,,fee schedule,,535.42,,,,fee schedule,,535.42,,,,fee schedule,,,339.43,91,,percent of total billed charges,,,354.35,95,,percent of total billed charges,,,309.59,83,,percent of total billed charges,,,111.9,83,,percent of total billed charges,,248.27,,,,fee schedule,,248.27,,,,fee schedule,,,309.59,83,,percent of total billed charges,,787.06,,,,fee schedule,,,335.7,90,,percent of total billed charges,,,335.7,90,,percent of total billed charges,,,335.7,90,,percent of total billed charges,,,335.7,90,,percent of total billed charges,,,317.05,85,,percent of total billed charges,,51.18,883.44,
GI TRACT CAPSULE ENDOSCOPY,91110,CDM,91110,CPT,,,both,,2748,2748,1172.89,,,,fee schedule,,,,,,,,704.9,,,,fee schedule,,,2335.8,85,,percent of total billed charges,,295.73,,,,fee schedule,,116.46,,,,fee schedule,,704.9,,,,fee schedule,,1624.55,,,,fee schedule,,704.9,,,,fee schedule,,1248.56,,,,fee schedule,,756.7,,,,fee schedule,,756.7,,,,fee schedule,,,2500.68,91,,percent of total billed charges,,,2610.6,95,,percent of total billed charges,,,2280.84,83,,percent of total billed charges,,,824.4,83,,percent of total billed charges,,704.9,,,,fee schedule,,704.9,,,,fee schedule,,,2280.84,83,,percent of total billed charges,,1112.35,,,,fee schedule,,,2473.2,90,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2473.2,90,,percent of total billed charges,,,2335.8,85,,percent of total billed charges,,116.46,2610.6,
GI TRACT CAPSULE ENDOSCOPY,91110P,CDM,91110,CPT,,,both,P,1667,1667,1172.89,,,,fee schedule,,,,,,,,704.9,,,,fee schedule,,,1416.95,85,,percent of total billed charges,,295.73,,,,fee schedule,,116.46,,,,fee schedule,,704.9,,,,fee schedule,,1624.55,,,,fee schedule,,704.9,,,,fee schedule,,1248.56,,,,fee schedule,,756.7,,,,fee schedule,,756.7,,,,fee schedule,,,1516.97,91,,percent of total billed charges,,,1583.65,95,,percent of total billed charges,,,1383.61,83,,percent of total billed charges,,,500.1,83,,percent of total billed charges,,704.9,,,,fee schedule,,704.9,,,,fee schedule,,,1383.61,83,,percent of total billed charges,,1112.35,,,,fee schedule,,,1500.3,90,,percent of total billed charges,,,1500.3,90,,percent of total billed charges,,,1500.3,90,,percent of total billed charges,,,1500.3,90,,percent of total billed charges,,,1416.95,85,,percent of total billed charges,,116.46,1624.55,
GI TRACT CAPSULE ENDOSCOPY,91110T,CDM,91110,CPT,,,both,T,1081,1081,1172.89,,,,fee schedule,,,,,,,,704.9,,,,fee schedule,,,918.85,85,,percent of total billed charges,,295.73,,,,fee schedule,,116.46,,,,fee schedule,,704.9,,,,fee schedule,,1624.55,,,,fee schedule,,704.9,,,,fee schedule,,1248.56,,,,fee schedule,,756.7,,,,fee schedule,,756.7,,,,fee schedule,,,983.71,91,,percent of total billed charges,,,1026.95,95,,percent of total billed charges,,,897.23,83,,percent of total billed charges,,,324.3,83,,percent of total billed charges,,704.9,,,,fee schedule,,704.9,,,,fee schedule,,,897.23,83,,percent of total billed charges,,1112.35,,,,fee schedule,,,972.9,90,,percent of total billed charges,,,972.9,90,,percent of total billed charges,,,972.9,90,,percent of total billed charges,,,972.9,90,,percent of total billed charges,,,918.85,85,,percent of total billed charges,,116.46,1624.55,
GI WIRELESS CAPSULE MEASURE,91112,CDM,91112,CPT,,,both,,4314,4314,2596.32,,,,fee schedule,,,,,,,,652.19,,,,fee schedule,,,3666.9,85,,percent of total billed charges,,278.24,,,,fee schedule,,109.58,,,,fee schedule,,652.19,,,,fee schedule,,,,,,,,652.19,,,,fee schedule,,2763.82,,,,fee schedule,,1675.04,,,,fee schedule,,1675.04,,,,fee schedule,,,3925.74,91,,percent of total billed charges,,,4098.3,95,,percent of total billed charges,,,3580.62,83,,percent of total billed charges,,,1294.2,83,,percent of total billed charges,,652.19,,,,fee schedule,,652.19,,,,fee schedule,,,3580.62,83,,percent of total billed charges,,2462.32,,,,fee schedule,,,3882.6,90,,percent of total billed charges,,,3882.6,90,,percent of total billed charges,,,3882.6,90,,percent of total billed charges,,,3882.6,90,,percent of total billed charges,,,3666.9,85,,percent of total billed charges,,109.58,4098.3,
GI WIRELESS CAPSULE MEASURE,9111226,CDM,91112,CPT,,,both,26,778,778,2596.32,,,,fee schedule,,,,,,,,652.19,,,,fee schedule,,,661.3,85,,percent of total billed charges,,278.24,,,,fee schedule,,109.58,,,,fee schedule,,652.19,,,,fee schedule,,,,,,,,652.19,,,,fee schedule,,2763.82,,,,fee schedule,,1675.04,,,,fee schedule,,1675.04,,,,fee schedule,,,707.98,91,,percent of total billed charges,,,739.1,95,,percent of total billed charges,,,645.74,83,,percent of total billed charges,,,233.4,83,,percent of total billed charges,,652.19,,,,fee schedule,,652.19,,,,fee schedule,,,645.74,83,,percent of total billed charges,,2462.32,,,,fee schedule,,,700.2,90,,percent of total billed charges,,,700.2,90,,percent of total billed charges,,,700.2,90,,percent of total billed charges,,,700.2,90,,percent of total billed charges,,,661.3,85,,percent of total billed charges,,109.58,2763.82,
GI WIRELESS CAPSULE MEASURE,91112P,CDM,91112,CPT,,,both,P,4038,4038,2596.32,,,,fee schedule,,,,,,,,652.19,,,,fee schedule,,,3432.3,85,,percent of total billed charges,,278.24,,,,fee schedule,,109.58,,,,fee schedule,,652.19,,,,fee schedule,,,,,,,,652.19,,,,fee schedule,,2763.82,,,,fee schedule,,1675.04,,,,fee schedule,,1675.04,,,,fee schedule,,,3674.58,91,,percent of total billed charges,,,3836.1,95,,percent of total billed charges,,,3351.54,83,,percent of total billed charges,,,1211.4,83,,percent of total billed charges,,652.19,,,,fee schedule,,652.19,,,,fee schedule,,,3351.54,83,,percent of total billed charges,,2462.32,,,,fee schedule,,,3634.2,90,,percent of total billed charges,,,3634.2,90,,percent of total billed charges,,,3634.2,90,,percent of total billed charges,,,3634.2,90,,percent of total billed charges,,,3432.3,85,,percent of total billed charges,,109.58,3836.1,
GI WIRELESS CAPSULE MEASURE,91112T,CDM,91112,CPT,,,both,T,276,276,2596.32,,,,fee schedule,,,,,,,,652.19,,,,fee schedule,,,234.6,85,,percent of total billed charges,,278.24,,,,fee schedule,,109.58,,,,fee schedule,,652.19,,,,fee schedule,,,,,,,,652.19,,,,fee schedule,,2763.82,,,,fee schedule,,1675.04,,,,fee schedule,,1675.04,,,,fee schedule,,,251.16,91,,percent of total billed charges,,,262.2,95,,percent of total billed charges,,,229.08,83,,percent of total billed charges,,,82.8,83,,percent of total billed charges,,652.19,,,,fee schedule,,652.19,,,,fee schedule,,,229.08,83,,percent of total billed charges,,2462.32,,,,fee schedule,,,248.4,90,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,248.4,90,,percent of total billed charges,,,234.6,85,,percent of total billed charges,,82.8,2763.82,
EYE EXAM ESTABLISHED PAT,92012,CDM,92012,CPT,,,both,,150,150,78.26,,,,fee schedule,,,,,,,,23.3,,,,fee schedule,,,127.5,85,,percent of total billed charges,,80.78,,,,fee schedule,,50.29,,,,fee schedule,,23.3,,,,fee schedule,,61.28,,,,fee schedule,,23.3,,,,fee schedule,,83.31,,,,fee schedule,,50.49,,,,fee schedule,,50.49,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,23.3,,,,fee schedule,,23.3,,,,fee schedule,,,124.5,83,,percent of total billed charges,,74.22,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,23.3,142.5,
EYE EXAM ESTABLISHED PAT,92012P,CDM,92012,CPT,,,both,P,96,96,78.26,,,,fee schedule,,,,,,,,23.3,,,,fee schedule,,,81.6,85,,percent of total billed charges,,80.78,,,,fee schedule,,50.29,,,,fee schedule,,23.3,,,,fee schedule,,61.28,,,,fee schedule,,23.3,,,,fee schedule,,83.31,,,,fee schedule,,50.49,,,,fee schedule,,50.49,,,,fee schedule,,,87.36,91,,percent of total billed charges,,,91.2,95,,percent of total billed charges,,,79.68,83,,percent of total billed charges,,,28.8,83,,percent of total billed charges,,23.3,,,,fee schedule,,23.3,,,,fee schedule,,,79.68,83,,percent of total billed charges,,74.22,,,,fee schedule,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,86.4,90,,percent of total billed charges,,,81.6,85,,percent of total billed charges,,23.3,91.2,
EYE EXAM ESTABLISHED PAT,92012T,CDM,92012,CPT,,,both,T,54,54,78.26,,,,fee schedule,,,,,,,,23.3,,,,fee schedule,,,45.9,85,,percent of total billed charges,,80.78,,,,fee schedule,,50.29,,,,fee schedule,,23.3,,,,fee schedule,,61.28,,,,fee schedule,,23.3,,,,fee schedule,,83.31,,,,fee schedule,,50.49,,,,fee schedule,,50.49,,,,fee schedule,,,49.14,91,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,16.2,83,,percent of total billed charges,,23.3,,,,fee schedule,,23.3,,,,fee schedule,,,44.82,83,,percent of total billed charges,,74.22,,,,fee schedule,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,16.2,83.31,
VISUAL FIELD EXAMINATION(S),92081,CDM,92081,CPT,,,both,,102,102,52,,,,fee schedule,,,,,,,,20.45,,,,fee schedule,,,86.7,85,,percent of total billed charges,,25.14,,,,fee schedule,,16.09,,,,fee schedule,,20.45,,,,fee schedule,,82.54,,,,fee schedule,,20.45,,,,fee schedule,,55.35,,,,fee schedule,,33.55,,,,fee schedule,,33.55,,,,fee schedule,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,30.6,83,,percent of total billed charges,,20.45,,,,fee schedule,,20.45,,,,fee schedule,,,84.66,83,,percent of total billed charges,,49.32,,,,fee schedule,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,16.09,96.9,
INTERNAL EYE PHOTOGRAPHY,92287,CDM,92287,CPT,,,both,,288,288,226.38,,,,fee schedule,,,,,,,,69.3,,,,fee schedule,,,244.8,85,,percent of total billed charges,,71.61,,,,fee schedule,,45.84,,,,fee schedule,,69.3,,,,fee schedule,,71.29,,,,fee schedule,,69.3,,,,fee schedule,,240.99,,,,fee schedule,,146.05,,,,fee schedule,,146.05,,,,fee schedule,,,262.08,91,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,86.4,83,,percent of total billed charges,,69.3,,,,fee schedule,,69.3,,,,fee schedule,,,239.04,83,,percent of total billed charges,,214.7,,,,fee schedule,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,244.8,85,,percent of total billed charges,,45.84,273.6,
INTERNAL EYE PHOTOGRAPHY,92287P,CDM,92287,CPT,,,both,P,157,157,226.38,,,,fee schedule,,,,,,,,69.3,,,,fee schedule,,,133.45,85,,percent of total billed charges,,71.61,,,,fee schedule,,45.84,,,,fee schedule,,69.3,,,,fee schedule,,71.29,,,,fee schedule,,69.3,,,,fee schedule,,240.99,,,,fee schedule,,146.05,,,,fee schedule,,146.05,,,,fee schedule,,,142.87,91,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,47.1,83,,percent of total billed charges,,69.3,,,,fee schedule,,69.3,,,,fee schedule,,,130.31,83,,percent of total billed charges,,214.7,,,,fee schedule,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,133.45,85,,percent of total billed charges,,45.84,240.99,
INTERNAL EYE PHOTOGRAPHY,92287T,CDM,92287,CPT,,,both,T,131,131,226.38,,,,fee schedule,,,,,,,,69.3,,,,fee schedule,,,111.35,85,,percent of total billed charges,,71.61,,,,fee schedule,,45.84,,,,fee schedule,,69.3,,,,fee schedule,,71.29,,,,fee schedule,,69.3,,,,fee schedule,,240.99,,,,fee schedule,,146.05,,,,fee schedule,,146.05,,,,fee schedule,,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,39.3,83,,percent of total billed charges,,69.3,,,,fee schedule,,69.3,,,,fee schedule,,,108.73,83,,percent of total billed charges,,214.7,,,,fee schedule,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,39.3,240.99,
MODIFICATION OF CONTACT LENS,92325,CDM,92325,CPT,,,both,,52,52,70.91,,,,fee schedule,,,,,,,,,,,,,,,44.2,85,,percent of total billed charges,,69.66,,,,fee schedule,,44.59,,,,fee schedule,,,,,,,,25.64,,,,fee schedule,,,,,,,,75.48,,,,fee schedule,,45.75,,,,fee schedule,,45.75,,,,fee schedule,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,15.6,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,67.25,,,,fee schedule,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,15.6,75.48,
EYE SERVICE OR PROCEDURE,92499,CDM,92499,CPT,,,both,,11,11,,,,,,,,,,,,,,,,,,,,9.35,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,3.3,83,,percent of total billed charges,,,,,,,,,,,,,,,9.13,83,,percent of total billed charges,,,,,,,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,3.3,10.45,
EAR MICROSCOPY EXAMINATION,92504,CDM,92504,CPT,,,both,,121,121,14.71,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,102.85,85,,percent of total billed charges,,13.34,,,,fee schedule,,9.5,,,,fee schedule,,37.4,,,,fee schedule,,17.51,,,,fee schedule,,37.4,,,,fee schedule,,15.66,,,,fee schedule,,9.49,,,,fee schedule,,9.49,,,,fee schedule,,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,36.3,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,100.43,83,,percent of total billed charges,,13.95,,,,fee schedule,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,9.49,114.95,
EAR MICROSCOPY EXAMINATION,92504P,CDM,92504,CPT,,,both,P,106,106,14.71,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,90.1,85,,percent of total billed charges,,13.34,,,,fee schedule,,9.5,,,,fee schedule,,37.4,,,,fee schedule,,17.51,,,,fee schedule,,37.4,,,,fee schedule,,15.66,,,,fee schedule,,9.49,,,,fee schedule,,9.49,,,,fee schedule,,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,31.8,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,87.98,83,,percent of total billed charges,,13.95,,,,fee schedule,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,9.49,100.7,
EAR MICROSCOPY EXAMINATION,92504T,CDM,92504,CPT,,,both,T,15,15,14.71,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,12.75,85,,percent of total billed charges,,13.34,,,,fee schedule,,9.5,,,,fee schedule,,37.4,,,,fee schedule,,17.51,,,,fee schedule,,37.4,,,,fee schedule,,15.66,,,,fee schedule,,9.49,,,,fee schedule,,9.49,,,,fee schedule,,,13.65,91,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,4.5,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,12.45,83,,percent of total billed charges,,13.95,,,,fee schedule,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,4.5,37.4,
SPEECH/HEARING THERAPY,92507,CDM,92507,CPT,,,both,,491,491,119.76,,,,fee schedule,,,,,,,,19.85,,,,fee schedule,,,417.35,85,,percent of total billed charges,,120.44,,,,fee schedule,,78.53,,,,fee schedule,,19.85,,,,fee schedule,,48.15,,,,fee schedule,,19.85,,,,fee schedule,,127.48,,,,fee schedule,,77.26,,,,fee schedule,,77.26,,,,fee schedule,,,446.81,91,,percent of total billed charges,,,466.45,95,,percent of total billed charges,,,407.53,83,,percent of total billed charges,,,147.3,83,,percent of total billed charges,,19.85,,,,fee schedule,,19.85,,,,fee schedule,,,407.53,83,,percent of total billed charges,,113.58,,,,fee schedule,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,441.9,90,,percent of total billed charges,,,417.35,85,,percent of total billed charges,,19.85,466.45,
NASOPHARYNGOSCOPY,92511,CDM,92511,CPT,,,both,,478,478,58.83,,,,fee schedule,,,,,,,,112.4,,,,fee schedule,,,406.3,85,,percent of total billed charges,,73.03,,,,fee schedule,,38.3,,,,fee schedule,,112.4,,,,fee schedule,,103.18,,,,fee schedule,,112.4,,,,fee schedule,,62.62,,,,fee schedule,,37.95,,,,fee schedule,,37.95,,,,fee schedule,,,434.98,91,,percent of total billed charges,,,454.1,95,,percent of total billed charges,,,396.74,83,,percent of total billed charges,,,143.4,83,,percent of total billed charges,,112.4,,,,fee schedule,,112.4,,,,fee schedule,,,396.74,83,,percent of total billed charges,,55.79,,,,fee schedule,,,430.2,90,,percent of total billed charges,,,430.2,90,,percent of total billed charges,,,430.2,90,,percent of total billed charges,,,430.2,90,,percent of total billed charges,,,406.3,85,,percent of total billed charges,,37.95,454.1,
NASOPHARYNGOSCOPY,92511P,CDM,92511,CPT,,,both,P,420,420,58.83,,,,fee schedule,,,,,,,,112.4,,,,fee schedule,,,357,85,,percent of total billed charges,,73.03,,,,fee schedule,,38.3,,,,fee schedule,,112.4,,,,fee schedule,,103.18,,,,fee schedule,,112.4,,,,fee schedule,,62.62,,,,fee schedule,,37.95,,,,fee schedule,,37.95,,,,fee schedule,,,382.2,91,,percent of total billed charges,,,399,95,,percent of total billed charges,,,348.6,83,,percent of total billed charges,,,126,83,,percent of total billed charges,,112.4,,,,fee schedule,,112.4,,,,fee schedule,,,348.6,83,,percent of total billed charges,,55.79,,,,fee schedule,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,378,90,,percent of total billed charges,,,357,85,,percent of total billed charges,,37.95,399,
NASOPHARYNGOSCOPY,92511T,CDM,92511,CPT,,,both,T,58,58,58.83,,,,fee schedule,,,,,,,,112.4,,,,fee schedule,,,49.3,85,,percent of total billed charges,,73.03,,,,fee schedule,,38.3,,,,fee schedule,,112.4,,,,fee schedule,,103.18,,,,fee schedule,,112.4,,,,fee schedule,,62.62,,,,fee schedule,,37.95,,,,fee schedule,,37.95,,,,fee schedule,,,52.78,91,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,17.4,83,,percent of total billed charges,,112.4,,,,fee schedule,,112.4,,,,fee schedule,,,48.14,83,,percent of total billed charges,,55.79,,,,fee schedule,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,17.4,112.4,
LARYNGEAL FUNCTION STUDIES,92520,CDM,92520,CPT,,,both,,392,392,61.98,,,,fee schedule,,,,,,,,30.5,,,,fee schedule,,,333.2,85,,percent of total billed charges,,77.61,,,,fee schedule,,40.71,,,,fee schedule,,30.5,,,,fee schedule,,73.79,,,,fee schedule,,30.5,,,,fee schedule,,65.98,,,,fee schedule,,39.99,,,,fee schedule,,39.99,,,,fee schedule,,,356.72,91,,percent of total billed charges,,,372.4,95,,percent of total billed charges,,,325.36,83,,percent of total billed charges,,,117.6,83,,percent of total billed charges,,30.5,,,,fee schedule,,30.5,,,,fee schedule,,,325.36,83,,percent of total billed charges,,58.78,,,,fee schedule,,,352.8,90,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,352.8,90,,percent of total billed charges,,,333.2,85,,percent of total billed charges,,30.5,372.4,
EVALUATION OF SPEECH FLUENCY,92521,CDM,92521,CPT,,,both,,238,238,208,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,202.3,85,,percent of total billed charges,,191.27,,,,fee schedule,,136.19,,,,fee schedule,,37.4,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,221.42,,,,fee schedule,,134.19,,,,fee schedule,,134.19,,,,fee schedule,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,71.4,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,197.54,83,,percent of total billed charges,,197.26,,,,fee schedule,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,37.4,226.1,
EVALUATE SPEECH PRODUCTION,92522,CDM,92522,CPT,,,both,,736,736,173.86,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,625.6,85,,percent of total billed charges,,160.9,,,,fee schedule,,114.57,,,,fee schedule,,37.4,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,185.07,,,,fee schedule,,112.17,,,,fee schedule,,112.17,,,,fee schedule,,,669.76,91,,percent of total billed charges,,,699.2,95,,percent of total billed charges,,,610.88,83,,percent of total billed charges,,,220.8,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,610.88,83,,percent of total billed charges,,164.88,,,,fee schedule,,,662.4,90,,percent of total billed charges,,,662.4,90,,percent of total billed charges,,,662.4,90,,percent of total billed charges,,,662.4,90,,percent of total billed charges,,,625.6,85,,percent of total billed charges,,37.4,699.2,
SPEECH SOUND LANG COMPREHEN,92523,CDM,92523,CPT,,,both,,736,736,356.65,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,625.6,85,,percent of total billed charges,,326.04,,,,fee schedule,,232.16,,,,fee schedule,,37.4,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,379.66,,,,fee schedule,,230.09,,,,fee schedule,,230.09,,,,fee schedule,,,669.76,91,,percent of total billed charges,,,699.2,95,,percent of total billed charges,,,610.88,83,,percent of total billed charges,,,220.8,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,610.88,83,,percent of total billed charges,,338.24,,,,fee schedule,,,662.4,90,,percent of total billed charges,,,662.4,90,,percent of total billed charges,,,662.4,90,,percent of total billed charges,,,662.4,90,,percent of total billed charges,,,625.6,85,,percent of total billed charges,,37.4,699.2,
BEHAVRAL QUALIT ANALYS VOICE,92524,CDM,92524,CPT,,,both,,354,354,171.76,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,300.9,85,,percent of total billed charges,,158.6,,,,fee schedule,,112.93,,,,fee schedule,,37.4,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,182.84,,,,fee schedule,,110.81,,,,fee schedule,,110.81,,,,fee schedule,,,322.14,91,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,106.2,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,293.82,83,,percent of total billed charges,,162.89,,,,fee schedule,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,300.9,85,,percent of total billed charges,,37.4,336.3,
ORAL FUNCTION THERAPY,92526,CDM,92526,CPT,,,both,,216,216,132.89,,,,fee schedule,,,,,,,,,,,,,,,183.6,85,,percent of total billed charges,,147.44,,,,fee schedule,,86.83,,,,fee schedule,,,,,,,,48.15,,,,fee schedule,,,,,,,,141.46,,,,fee schedule,,85.73,,,,fee schedule,,85.73,,,,fee schedule,,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,64.8,83,,percent of total billed charges,,,,,,,,,,,,,,,179.28,83,,percent of total billed charges,,126.03,,,,fee schedule,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,48.15,205.2,
CALORIC VSTBLR TEST W/REC,92537,CDM,92537,CPT,,,both,,126,126,63.03,,,,fee schedule,,,,,,,,23.66,,,,fee schedule,,,107.1,85,,percent of total billed charges,,62.06,,,,fee schedule,,31.76,,,,fee schedule,,23.66,,,,fee schedule,,,,,,,,23.66,,,,fee schedule,,67.1,,,,fee schedule,,40.66,,,,fee schedule,,40.66,,,,fee schedule,,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,37.8,83,,percent of total billed charges,,23.66,,,,fee schedule,,23.66,,,,fee schedule,,,104.58,83,,percent of total billed charges,,59.78,,,,fee schedule,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,23.66,119.7,
CALORIC VSTBLR TEST W/REC,92537P,CDM,92537,CPT,,,both,P,49,49,63.03,,,,fee schedule,,,,,,,,23.66,,,,fee schedule,,,41.65,85,,percent of total billed charges,,62.06,,,,fee schedule,,31.76,,,,fee schedule,,23.66,,,,fee schedule,,,,,,,,23.66,,,,fee schedule,,67.1,,,,fee schedule,,40.66,,,,fee schedule,,40.66,,,,fee schedule,,,44.59,91,,percent of total billed charges,,,46.55,95,,percent of total billed charges,,,40.67,83,,percent of total billed charges,,,14.7,83,,percent of total billed charges,,23.66,,,,fee schedule,,23.66,,,,fee schedule,,,40.67,83,,percent of total billed charges,,59.78,,,,fee schedule,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,41.65,85,,percent of total billed charges,,14.7,67.1,
CALORIC VSTBLR TEST W/REC,92537T,CDM,92537,CPT,,,both,T,77,77,63.03,,,,fee schedule,,,,,,,,23.66,,,,fee schedule,,,65.45,85,,percent of total billed charges,,62.06,,,,fee schedule,,31.76,,,,fee schedule,,23.66,,,,fee schedule,,,,,,,,23.66,,,,fee schedule,,67.1,,,,fee schedule,,40.66,,,,fee schedule,,40.66,,,,fee schedule,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,23.66,,,,fee schedule,,23.66,,,,fee schedule,,,63.91,83,,percent of total billed charges,,59.78,,,,fee schedule,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,23.1,73.15,
"Vestibular Function Test, With Recording",92540,CDM,92540,CPT,,,both,,734,734,170.18,,,,fee schedule,,,,,,,,53.5,,,,fee schedule,,,623.9,85,,percent of total billed charges,,155.75,,,,fee schedule,,79.72,,,,fee schedule,,53.5,,,,fee schedule,,,,,,,,53.5,,,,fee schedule,,181.16,,,,fee schedule,,109.79,,,,fee schedule,,109.79,,,,fee schedule,,,667.94,91,,percent of total billed charges,,,697.3,95,,percent of total billed charges,,,609.22,83,,percent of total billed charges,,,220.2,83,,percent of total billed charges,,53.5,,,,fee schedule,,53.5,,,,fee schedule,,,609.22,83,,percent of total billed charges,,161.4,,,,fee schedule,,,660.6,90,,percent of total billed charges,,,660.6,90,,percent of total billed charges,,,660.6,90,,percent of total billed charges,,,660.6,90,,percent of total billed charges,,,623.9,85,,percent of total billed charges,,53.5,697.3,
"Vestibular Funtion Test, With Recording",9254026,CDM,92540,CPT,,,both,26,446,446,170.18,,,,fee schedule,,,,,,,,53.5,,,,fee schedule,,,379.1,85,,percent of total billed charges,,155.75,,,,fee schedule,,79.72,,,,fee schedule,,53.5,,,,fee schedule,,,,,,,,53.5,,,,fee schedule,,181.16,,,,fee schedule,,109.79,,,,fee schedule,,109.79,,,,fee schedule,,,405.86,91,,percent of total billed charges,,,423.7,95,,percent of total billed charges,,,370.18,83,,percent of total billed charges,,,133.8,83,,percent of total billed charges,,53.5,,,,fee schedule,,53.5,,,,fee schedule,,,370.18,83,,percent of total billed charges,,161.4,,,,fee schedule,,,401.4,90,,percent of total billed charges,,,401.4,90,,percent of total billed charges,,,401.4,90,,percent of total billed charges,,,401.4,90,,percent of total billed charges,,,379.1,85,,percent of total billed charges,,53.5,423.7,
"Vestibular Funtion Test, With Recording",92540tc,CDM,92540,CPT,,,both,tc,288,288,170.18,,,,fee schedule,,,,,,,,53.5,,,,fee schedule,,,244.8,85,,percent of total billed charges,,155.75,,,,fee schedule,,79.72,,,,fee schedule,,53.5,,,,fee schedule,,,,,,,,53.5,,,,fee schedule,,181.16,,,,fee schedule,,109.79,,,,fee schedule,,109.79,,,,fee schedule,,,262.08,91,,percent of total billed charges,,,273.6,95,,percent of total billed charges,,,239.04,83,,percent of total billed charges,,,86.4,83,,percent of total billed charges,,53.5,,,,fee schedule,,53.5,,,,fee schedule,,,239.04,83,,percent of total billed charges,,161.4,,,,fee schedule,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,259.2,90,,percent of total billed charges,,,244.8,85,,percent of total billed charges,,53.5,273.6,
SPONTANEOUS NYSTAGMUS TEST,92541,CDM,92541,CPT,,,both,,353,353,39.39,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,300.05,85,,percent of total billed charges,,64.53,,,,fee schedule,,21.32,,,,fee schedule,,22.15,,,,fee schedule,,91.92,,,,fee schedule,,22.15,,,,fee schedule,,41.94,,,,fee schedule,,25.42,,,,fee schedule,,25.42,,,,fee schedule,,,321.23,91,,percent of total billed charges,,,335.35,95,,percent of total billed charges,,,292.99,83,,percent of total billed charges,,,105.9,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,292.99,83,,percent of total billed charges,,37.36,,,,fee schedule,,,317.7,90,,percent of total billed charges,,,317.7,90,,percent of total billed charges,,,317.7,90,,percent of total billed charges,,,317.7,90,,percent of total billed charges,,,300.05,85,,percent of total billed charges,,21.32,335.35,
POSITIONAL NYSTAGMUS TEST,92542,CDM,92542,CPT,,,both,,356,356,45.17,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,302.6,85,,percent of total billed charges,,77.18,,,,fee schedule,,25.49,,,,fee schedule,,22.15,,,,fee schedule,,93.8,,,,fee schedule,,22.15,,,,fee schedule,,48.09,,,,fee schedule,,29.14,,,,fee schedule,,29.14,,,,fee schedule,,,323.96,91,,percent of total billed charges,,,338.2,95,,percent of total billed charges,,,295.48,83,,percent of total billed charges,,,106.8,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,295.48,83,,percent of total billed charges,,42.84,,,,fee schedule,,,320.4,90,,percent of total billed charges,,,320.4,90,,percent of total billed charges,,,320.4,90,,percent of total billed charges,,,320.4,90,,percent of total billed charges,,,302.6,85,,percent of total billed charges,,22.15,338.2,
CALORIC VESTIBULAR TEST,92543,CDM,92543,CPT,,,both,,323,323,,,,,,,,,,,,,,,,,,,,274.55,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,43.15,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,293.93,91,,percent of total billed charges,,,306.85,95,,percent of total billed charges,,,268.09,83,,percent of total billed charges,,,96.9,83,,percent of total billed charges,,,,,,,,,,,,,,,268.09,83,,percent of total billed charges,,,,,,,,,290.7,90,,percent of total billed charges,,,290.7,90,,percent of total billed charges,,,290.7,90,,percent of total billed charges,,,290.7,90,,percent of total billed charges,,,274.55,85,,percent of total billed charges,,43.15,306.85,
CALORIC VESTIBULAR TEST,9254326,CDM,92543,CPT,,,both,26,90,90,,,,,,,,,,,,,,,,,,,,76.5,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,43.15,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,27,85.5,
OPTOKINETIC NYSTAGMUS TEST,92544,CDM,92544,CPT,,,both,,321,321,27.84,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,272.85,85,,percent of total billed charges,,28.7,,,,fee schedule,,14.69,,,,fee schedule,,22.15,,,,fee schedule,,74.41,,,,fee schedule,,22.15,,,,fee schedule,,29.63,,,,fee schedule,,17.96,,,,fee schedule,,17.96,,,,fee schedule,,,292.11,91,,percent of total billed charges,,,304.95,95,,percent of total billed charges,,,266.43,83,,percent of total billed charges,,,96.3,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,266.43,83,,percent of total billed charges,,26.4,,,,fee schedule,,,288.9,90,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,288.9,90,,percent of total billed charges,,,272.85,85,,percent of total billed charges,,14.69,304.95,
OSCILLATING TRACKING TEST,92545,CDM,92545,CPT,,,both,,303,303,26.26,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,257.55,85,,percent of total billed charges,,26.66,,,,fee schedule,,13.65,,,,fee schedule,,22.15,,,,fee schedule,,66.28,,,,fee schedule,,22.15,,,,fee schedule,,27.96,,,,fee schedule,,16.94,,,,fee schedule,,16.94,,,,fee schedule,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,90.9,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,251.49,83,,percent of total billed charges,,24.91,,,,fee schedule,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,13.65,287.85,
SINUSOIDAL VER AXIS ROTATIONAL TSTG,92546,CDM,92546,CPT,,,both,,552,552,199.07,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,469.2,85,,percent of total billed charges,,21.64,,,,fee schedule,,15.41,,,,fee schedule,,22.15,,,,fee schedule,,143.82,,,,fee schedule,,22.15,,,,fee schedule,,211.91,,,,fee schedule,,128.43,,,,fee schedule,,128.43,,,,fee schedule,,,502.32,91,,percent of total billed charges,,,524.4,95,,percent of total billed charges,,,458.16,83,,percent of total billed charges,,,165.6,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,458.16,83,,percent of total billed charges,,188.8,,,,fee schedule,,,496.8,90,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,469.2,85,,percent of total billed charges,,15.41,524.4,
SINUSOIDAL ROTATIONAL TEST,9254626,CDM,92546,CPT,,,both,26,318,318,199.07,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,270.3,85,,percent of total billed charges,,21.64,,,,fee schedule,,15.41,,,,fee schedule,,22.15,,,,fee schedule,,143.82,,,,fee schedule,,22.15,,,,fee schedule,,211.91,,,,fee schedule,,128.43,,,,fee schedule,,128.43,,,,fee schedule,,,289.38,91,,percent of total billed charges,,,302.1,95,,percent of total billed charges,,,263.94,83,,percent of total billed charges,,,95.4,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,263.94,83,,percent of total billed charges,,188.8,,,,fee schedule,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,270.3,85,,percent of total billed charges,,15.41,302.1,
SINUSOIDAL ROTATIONAL TEST,92546tc,CDM,92546,CPT,,,both,tc,234,234,199.07,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,198.9,85,,percent of total billed charges,,21.64,,,,fee schedule,,15.41,,,,fee schedule,,22.15,,,,fee schedule,,143.82,,,,fee schedule,,22.15,,,,fee schedule,,211.91,,,,fee schedule,,128.43,,,,fee schedule,,128.43,,,,fee schedule,,,212.94,91,,percent of total billed charges,,,222.3,95,,percent of total billed charges,,,194.22,83,,percent of total billed charges,,,70.2,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,194.22,83,,percent of total billed charges,,188.8,,,,fee schedule,,,210.6,90,,percent of total billed charges,,,210.6,90,,percent of total billed charges,,,210.6,90,,percent of total billed charges,,,210.6,90,,percent of total billed charges,,,198.9,85,,percent of total billed charges,,15.41,222.3,
POSTUROGRAPHY,92548,CDM,92548,CPT,,,both,,399,399,74.06,,,,fee schedule,,,,,,,,39.35,,,,fee schedule,,,339.15,85,,percent of total billed charges,,66.78,,,,fee schedule,,35.02,,,,fee schedule,,39.35,,,,fee schedule,,181.34,,,,fee schedule,,39.35,,,,fee schedule,,78.84,,,,fee schedule,,47.78,,,,fee schedule,,47.78,,,,fee schedule,,,363.09,91,,percent of total billed charges,,,379.05,95,,percent of total billed charges,,,331.17,83,,percent of total billed charges,,,119.7,83,,percent of total billed charges,,39.35,,,,fee schedule,,39.35,,,,fee schedule,,,331.17,83,,percent of total billed charges,,70.24,,,,fee schedule,,,359.1,90,,percent of total billed charges,,,359.1,90,,percent of total billed charges,,,359.1,90,,percent of total billed charges,,,359.1,90,,percent of total billed charges,,,339.15,85,,percent of total billed charges,,35.02,379.05,
POSTUROGRAPHY,92548P,CDM,92548,CPT,,,both,P,237,237,74.06,,,,fee schedule,,,,,,,,39.35,,,,fee schedule,,,201.45,85,,percent of total billed charges,,66.78,,,,fee schedule,,35.02,,,,fee schedule,,39.35,,,,fee schedule,,181.34,,,,fee schedule,,39.35,,,,fee schedule,,78.84,,,,fee schedule,,47.78,,,,fee schedule,,47.78,,,,fee schedule,,,215.67,91,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,71.1,83,,percent of total billed charges,,39.35,,,,fee schedule,,39.35,,,,fee schedule,,,196.71,83,,percent of total billed charges,,70.24,,,,fee schedule,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,35.02,225.15,
POSTUROGRAPHY,92548T,CDM,92548,CPT,,,both,T,162,162,74.06,,,,fee schedule,,,,,,,,39.35,,,,fee schedule,,,137.7,85,,percent of total billed charges,,66.78,,,,fee schedule,,35.02,,,,fee schedule,,39.35,,,,fee schedule,,181.34,,,,fee schedule,,39.35,,,,fee schedule,,78.84,,,,fee schedule,,47.78,,,,fee schedule,,47.78,,,,fee schedule,,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,48.6,83,,percent of total billed charges,,39.35,,,,fee schedule,,39.35,,,,fee schedule,,,134.46,83,,percent of total billed charges,,70.24,,,,fee schedule,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,35.02,181.34,
TYMPANOMETRY & REFLEX THRESH,92550,CDM,92550,CPT,,,both,,68,68,34.67,,,,fee schedule,,,,,,,,11.65,,,,fee schedule,,,57.8,85,,percent of total billed charges,,43.65,,,,fee schedule,,22.89,,,,fee schedule,,11.65,,,,fee schedule,,,,,,,,11.65,,,,fee schedule,,36.9,,,,fee schedule,,22.37,,,,fee schedule,,22.37,,,,fee schedule,,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,11.65,,,,fee schedule,,11.65,,,,fee schedule,,,56.44,83,,percent of total billed charges,,32.88,,,,fee schedule,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,11.65,64.6,
"PURE TONE HEARING TEST, AIR",92551,CDM,92551,CPT,,,both,,57,57,18.91,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,48.45,85,,percent of total billed charges,,16,,,,fee schedule,,10.91,,,,fee schedule,,15.2,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,20.13,,,,fee schedule,,12.2,,,,fee schedule,,12.2,,,,fee schedule,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,17.1,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,47.31,83,,percent of total billed charges,,17.93,,,,fee schedule,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,10.91,54.15,
"PURE TONE HEARING TEST, AIR",92551P,CDM,92551,CPT,,,both,P,7,7,18.91,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,5.95,85,,percent of total billed charges,,16,,,,fee schedule,,10.91,,,,fee schedule,,15.2,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,20.13,,,,fee schedule,,12.2,,,,fee schedule,,12.2,,,,fee schedule,,,6.37,91,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,2.1,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,5.81,83,,percent of total billed charges,,17.93,,,,fee schedule,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,2.1,20.13,
"PURE TONE HEARING TEST, AIR",92551T,CDM,92551,CPT,,,both,T,50,50,18.91,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,42.5,85,,percent of total billed charges,,16,,,,fee schedule,,10.91,,,,fee schedule,,15.2,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,20.13,,,,fee schedule,,12.2,,,,fee schedule,,12.2,,,,fee schedule,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,41.5,83,,percent of total billed charges,,17.93,,,,fee schedule,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,10.91,47.5,
"PURE TONE AUDIOMETRY, AIR",92552,CDM,92552,CPT,,,both,,90,90,55.68,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,76.5,85,,percent of total billed charges,,46.32,,,,fee schedule,,31.6,,,,fee schedule,,15.2,,,,fee schedule,,30.01,,,,fee schedule,,15.2,,,,fee schedule,,59.27,,,,fee schedule,,35.92,,,,fee schedule,,35.92,,,,fee schedule,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,74.7,83,,percent of total billed charges,,52.8,,,,fee schedule,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,15.2,85.5,
"PURE TONE AUDIOMETRY, AIR",92552P,CDM,92552,CPT,,,both,P,40,40,55.68,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,34,85,,percent of total billed charges,,46.32,,,,fee schedule,,31.6,,,,fee schedule,,15.2,,,,fee schedule,,30.01,,,,fee schedule,,15.2,,,,fee schedule,,59.27,,,,fee schedule,,35.92,,,,fee schedule,,35.92,,,,fee schedule,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,12,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,33.2,83,,percent of total billed charges,,52.8,,,,fee schedule,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,12,59.27,
"PURE TONE AUDIOMETRY, AIR",92552T,CDM,92552,CPT,,,both,T,50,50,55.68,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,42.5,85,,percent of total billed charges,,46.32,,,,fee schedule,,31.6,,,,fee schedule,,15.2,,,,fee schedule,,30.01,,,,fee schedule,,15.2,,,,fee schedule,,59.27,,,,fee schedule,,35.92,,,,fee schedule,,35.92,,,,fee schedule,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,41.5,83,,percent of total billed charges,,52.8,,,,fee schedule,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,15,59.27,
PURE TONE AUDIOMTRY AIR  B1,92553,CDM,92553,CPT,,,both,,123,123,68.28,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,104.55,85,,percent of total billed charges,,56.12,,,,fee schedule,,39.36,,,,fee schedule,,15.2,,,,fee schedule,,45.02,,,,fee schedule,,15.2,,,,fee schedule,,72.69,,,,fee schedule,,44.05,,,,fee schedule,,44.05,,,,fee schedule,,,111.93,91,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,36.9,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,102.09,83,,percent of total billed charges,,64.76,,,,fee schedule,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,104.55,85,,percent of total billed charges,,15.2,116.85,
"AUDIOMETRY, AIR & BONE",92553P,CDM,92553,CPT,,,both,P,47,47,68.28,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,39.95,85,,percent of total billed charges,,56.12,,,,fee schedule,,39.36,,,,fee schedule,,15.2,,,,fee schedule,,45.02,,,,fee schedule,,15.2,,,,fee schedule,,72.69,,,,fee schedule,,44.05,,,,fee schedule,,44.05,,,,fee schedule,,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,14.1,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,39.01,83,,percent of total billed charges,,64.76,,,,fee schedule,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,14.1,72.69,
"AUDIOMETRY, AIR & BONE",92553T,CDM,92553,CPT,,,both,T,76,76,68.28,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,64.6,85,,percent of total billed charges,,56.12,,,,fee schedule,,39.36,,,,fee schedule,,15.2,,,,fee schedule,,45.02,,,,fee schedule,,15.2,,,,fee schedule,,72.69,,,,fee schedule,,44.05,,,,fee schedule,,44.05,,,,fee schedule,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,63.08,83,,percent of total billed charges,,64.76,,,,fee schedule,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,15.2,72.69,
SPEECH THRESHOLD AUDIOMETRY,92555,CDM,92555,CPT,,,both,,51,51,43.07,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,43.35,85,,percent of total billed charges,,35.12,,,,fee schedule,,24.63,,,,fee schedule,,15.2,,,,fee schedule,,26.26,,,,fee schedule,,15.2,,,,fee schedule,,45.85,,,,fee schedule,,27.79,,,,fee schedule,,27.79,,,,fee schedule,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,42.33,83,,percent of total billed charges,,40.85,,,,fee schedule,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,15.2,48.45,
"SPEECH AUDIOMETRY, COMPLETE",92556,CDM,92556,CPT,,,both,,74,74,66.71,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,62.9,85,,percent of total billed charges,,55.18,,,,fee schedule,,38.7,,,,fee schedule,,15.2,,,,fee schedule,,39.39,,,,fee schedule,,15.2,,,,fee schedule,,71.01,,,,fee schedule,,43.04,,,,fee schedule,,43.04,,,,fee schedule,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,22.2,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,61.42,83,,percent of total billed charges,,63.26,,,,fee schedule,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,15.2,71.01,
COMPREHENSIVE HEARING TEST,92557,CDM,92557,CPT,,,both,,111,111,49.37,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,94.35,85,,percent of total billed charges,,47.57,,,,fee schedule,,33.36,,,,fee schedule,,37.4,,,,fee schedule,,81.92,,,,fee schedule,,37.4,,,,fee schedule,,52.56,,,,fee schedule,,31.85,,,,fee schedule,,31.85,,,,fee schedule,,,101.01,91,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,33.3,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,92.13,83,,percent of total billed charges,,46.83,,,,fee schedule,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,94.35,85,,percent of total billed charges,,31.85,105.45,
COMPREHENSIVE HEARING TEST,92557P,CDM,92557,CPT,,,both,P,60,60,49.37,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,51,85,,percent of total billed charges,,47.57,,,,fee schedule,,33.36,,,,fee schedule,,37.4,,,,fee schedule,,81.92,,,,fee schedule,,37.4,,,,fee schedule,,52.56,,,,fee schedule,,31.85,,,,fee schedule,,31.85,,,,fee schedule,,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,18,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,49.8,83,,percent of total billed charges,,46.83,,,,fee schedule,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,18,81.92,
COMPREHENSIVE HEARING TEST,92557T,CDM,92557,CPT,,,both,T,51,51,49.37,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,43.35,85,,percent of total billed charges,,47.57,,,,fee schedule,,33.36,,,,fee schedule,,37.4,,,,fee schedule,,81.92,,,,fee schedule,,37.4,,,,fee schedule,,52.56,,,,fee schedule,,31.85,,,,fee schedule,,31.85,,,,fee schedule,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,42.33,83,,percent of total billed charges,,46.83,,,,fee schedule,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,15.3,81.92,
EVOKED AUDITORY TEST QUAL,92558,CDM,92558,CPT,,,both,,68,68,13.13,,,,fee schedule,,,,,,,,12.2,,,,fee schedule,,,57.8,85,,percent of total billed charges,,12.03,,,,fee schedule,,8.81,,,,fee schedule,,12.2,,,,fee schedule,,,,,,,,12.2,,,,fee schedule,,13.98,,,,fee schedule,,8.47,,,,fee schedule,,8.47,,,,fee schedule,,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,12.2,,,,fee schedule,,12.2,,,,fee schedule,,,56.44,83,,percent of total billed charges,,12.45,,,,fee schedule,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,8.47,64.6,
LOUDNESS BALANCE TEST,92562,CDM,92562,CPT,,,both,,58,58,75.11,,,,fee schedule,,,,,,,,7.6,,,,fee schedule,,,49.3,85,,percent of total billed charges,,60.88,,,,fee schedule,,44.59,,,,fee schedule,,7.6,,,,fee schedule,,28.14,,,,fee schedule,,7.6,,,,fee schedule,,79.96,,,,fee schedule,,48.46,,,,fee schedule,,48.46,,,,fee schedule,,,52.78,91,,percent of total billed charges,,,55.1,95,,percent of total billed charges,,,48.14,83,,percent of total billed charges,,,17.4,83,,percent of total billed charges,,7.6,,,,fee schedule,,7.6,,,,fee schedule,,,48.14,83,,percent of total billed charges,,71.23,,,,fee schedule,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,52.2,90,,percent of total billed charges,,,49.3,85,,percent of total billed charges,,7.6,79.96,
TONE DECAY HEARING TEST,92563,CDM,92563,CPT,,,both,,48,48,52,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,40.8,85,,percent of total billed charges,,68.24,,,,fee schedule,,30.85,,,,fee schedule,,15.2,,,,fee schedule,,26.26,,,,fee schedule,,15.2,,,,fee schedule,,55.35,,,,fee schedule,,33.55,,,,fee schedule,,33.55,,,,fee schedule,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,14.4,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,39.84,83,,percent of total billed charges,,49.32,,,,fee schedule,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,14.4,68.24,
"STENGER TEST, PURE TONE",92565,CDM,92565,CPT,,,both,,48,48,31.52,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,40.8,85,,percent of total billed charges,,25.15,,,,fee schedule,,18.42,,,,fee schedule,,15.2,,,,fee schedule,,27.51,,,,fee schedule,,15.2,,,,fee schedule,,33.55,,,,fee schedule,,20.33,,,,fee schedule,,20.33,,,,fee schedule,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,14.4,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,39.84,83,,percent of total billed charges,,29.89,,,,fee schedule,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,14.4,45.6,
TYMPANOMETRY,92567,CDM,92567,CPT,,,both,,74,74,16.81,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,62.9,85,,percent of total billed charges,,21.71,,,,fee schedule,,10.87,,,,fee schedule,,15.2,,,,fee schedule,,36.27,,,,fee schedule,,15.2,,,,fee schedule,,17.89,,,,fee schedule,,10.84,,,,fee schedule,,10.84,,,,fee schedule,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,22.2,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,61.42,83,,percent of total billed charges,,15.94,,,,fee schedule,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,10.84,70.3,
TYMPANOMETRY,92567P,CDM,92567,CPT,,,both,P,60,60,16.81,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,51,85,,percent of total billed charges,,21.71,,,,fee schedule,,10.87,,,,fee schedule,,15.2,,,,fee schedule,,36.27,,,,fee schedule,,15.2,,,,fee schedule,,17.89,,,,fee schedule,,10.84,,,,fee schedule,,10.84,,,,fee schedule,,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,18,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,49.8,83,,percent of total billed charges,,15.94,,,,fee schedule,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,10.84,57,
TYMPANOMETRY,92567T,CDM,92567,CPT,,,both,T,14,14,16.81,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,11.9,85,,percent of total billed charges,,21.71,,,,fee schedule,,10.87,,,,fee schedule,,15.2,,,,fee schedule,,36.27,,,,fee schedule,,15.2,,,,fee schedule,,17.89,,,,fee schedule,,10.84,,,,fee schedule,,10.84,,,,fee schedule,,,12.74,91,,percent of total billed charges,,,13.3,95,,percent of total billed charges,,,11.62,83,,percent of total billed charges,,,4.2,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,11.62,83,,percent of total billed charges,,15.94,,,,fee schedule,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,11.9,85,,percent of total billed charges,,4.2,36.27,
ACOUSTIC REFL THRESHOLD TST,92568,CDM,92568,CPT,,,both,,48,48,23.64,,,,fee schedule,,,,,,,,13.7,,,,fee schedule,,,40.8,85,,percent of total billed charges,,35.02,,,,fee schedule,,15.83,,,,fee schedule,,13.7,,,,fee schedule,,26.26,,,,fee schedule,,13.7,,,,fee schedule,,25.16,,,,fee schedule,,15.25,,,,fee schedule,,15.25,,,,fee schedule,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,14.4,83,,percent of total billed charges,,13.7,,,,fee schedule,,13.7,,,,fee schedule,,,39.84,83,,percent of total billed charges,,22.42,,,,fee schedule,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,13.7,45.6,
ACOUSTIC REFL THRESHOLD TST,92568P,CDM,92568,CPT,,,both,P,24,24,23.64,,,,fee schedule,,,,,,,,13.7,,,,fee schedule,,,20.4,85,,percent of total billed charges,,35.02,,,,fee schedule,,15.83,,,,fee schedule,,13.7,,,,fee schedule,,26.26,,,,fee schedule,,13.7,,,,fee schedule,,25.16,,,,fee schedule,,15.25,,,,fee schedule,,15.25,,,,fee schedule,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,7.2,83,,percent of total billed charges,,13.7,,,,fee schedule,,13.7,,,,fee schedule,,,19.92,83,,percent of total billed charges,,22.42,,,,fee schedule,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,7.2,35.02,
ACOUSTIC REFL THRESHOLD TST,92568T,CDM,92568,CPT,,,both,T,24,24,23.64,,,,fee schedule,,,,,,,,13.7,,,,fee schedule,,,20.4,85,,percent of total billed charges,,35.02,,,,fee schedule,,15.83,,,,fee schedule,,13.7,,,,fee schedule,,26.26,,,,fee schedule,,13.7,,,,fee schedule,,25.16,,,,fee schedule,,15.25,,,,fee schedule,,15.25,,,,fee schedule,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,7.2,83,,percent of total billed charges,,13.7,,,,fee schedule,,13.7,,,,fee schedule,,,19.92,83,,percent of total billed charges,,22.42,,,,fee schedule,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,7.2,35.02,
ACOUSTIC IMMITANCE TESTING,92570,CDM,92570,CPT,,,both,,79,79,45.17,,,,fee schedule,,,,,,,,16.9,,,,fee schedule,,,67.15,85,,percent of total billed charges,,41.76,,,,fee schedule,,30.59,,,,fee schedule,,16.9,,,,fee schedule,,,,,,,,16.9,,,,fee schedule,,48.09,,,,fee schedule,,29.14,,,,fee schedule,,29.14,,,,fee schedule,,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,23.7,83,,percent of total billed charges,,16.9,,,,fee schedule,,16.9,,,,fee schedule,,,65.57,83,,percent of total billed charges,,42.84,,,,fee schedule,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,16.9,75.05,
ACOUSTIC IMMITANCE TESTING,92570P,CDM,92570,CPT,,,both,P,39,39,45.17,,,,fee schedule,,,,,,,,16.9,,,,fee schedule,,,33.15,85,,percent of total billed charges,,41.76,,,,fee schedule,,30.59,,,,fee schedule,,16.9,,,,fee schedule,,,,,,,,16.9,,,,fee schedule,,48.09,,,,fee schedule,,29.14,,,,fee schedule,,29.14,,,,fee schedule,,,35.49,91,,percent of total billed charges,,,37.05,95,,percent of total billed charges,,,32.37,83,,percent of total billed charges,,,11.7,83,,percent of total billed charges,,16.9,,,,fee schedule,,16.9,,,,fee schedule,,,32.37,83,,percent of total billed charges,,42.84,,,,fee schedule,,,35.1,90,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,33.15,85,,percent of total billed charges,,11.7,48.09,
ACOUSTIC IMMITANCE TESTING,92570T,CDM,92570,CPT,,,both,T,40,40,45.17,,,,fee schedule,,,,,,,,16.9,,,,fee schedule,,,34,85,,percent of total billed charges,,41.76,,,,fee schedule,,30.59,,,,fee schedule,,16.9,,,,fee schedule,,,,,,,,16.9,,,,fee schedule,,48.09,,,,fee schedule,,29.14,,,,fee schedule,,29.14,,,,fee schedule,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,12,83,,percent of total billed charges,,16.9,,,,fee schedule,,16.9,,,,fee schedule,,,33.2,83,,percent of total billed charges,,42.84,,,,fee schedule,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,12,48.09,
"STENGER TEST, SPEECH",92577,CDM,92577,CPT,,,both,,43,43,32.04,,,,fee schedule,,,,,,,,12.2,,,,fee schedule,,,36.55,85,,percent of total billed charges,,24.7,,,,fee schedule,,18.09,,,,fee schedule,,12.2,,,,fee schedule,,49.4,,,,fee schedule,,12.2,,,,fee schedule,,34.11,,,,fee schedule,,20.67,,,,fee schedule,,20.67,,,,fee schedule,,,39.13,91,,percent of total billed charges,,,40.85,95,,percent of total billed charges,,,35.69,83,,percent of total billed charges,,,12.9,83,,percent of total billed charges,,12.2,,,,fee schedule,,12.2,,,,fee schedule,,,35.69,83,,percent of total billed charges,,30.39,,,,fee schedule,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,36.55,85,,percent of total billed charges,,12.2,49.4,
VISUAL AUDIOMETRY (VRA),92579,CDM,92579,CPT,,,both,,106,106,57.78,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,90.1,85,,percent of total billed charges,,53.13,,,,fee schedule,,38.91,,,,fee schedule,,22.15,,,,fee schedule,,49.4,,,,fee schedule,,22.15,,,,fee schedule,,61.51,,,,fee schedule,,37.28,,,,fee schedule,,37.28,,,,fee schedule,,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,31.8,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,87.98,83,,percent of total billed charges,,54.8,,,,fee schedule,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,22.15,100.7,
VISUAL AUDIOMETRY (VRA),92579P,CDM,92579,CPT,,,both,P,52,52,57.78,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,44.2,85,,percent of total billed charges,,53.13,,,,fee schedule,,38.91,,,,fee schedule,,22.15,,,,fee schedule,,49.4,,,,fee schedule,,22.15,,,,fee schedule,,61.51,,,,fee schedule,,37.28,,,,fee schedule,,37.28,,,,fee schedule,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,15.6,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,43.16,83,,percent of total billed charges,,54.8,,,,fee schedule,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,15.6,61.51,
VISUAL AUDIOMETRY (VRA),92579T,CDM,92579,CPT,,,both,T,54,54,57.78,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,45.9,85,,percent of total billed charges,,53.13,,,,fee schedule,,38.91,,,,fee schedule,,22.15,,,,fee schedule,,49.4,,,,fee schedule,,22.15,,,,fee schedule,,61.51,,,,fee schedule,,37.28,,,,fee schedule,,37.28,,,,fee schedule,,,49.14,91,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,16.2,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,44.82,83,,percent of total billed charges,,54.8,,,,fee schedule,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,16.2,61.51,
CONDITIONING PLAY AUDIOMETRY,92582,CDM,92582,CPT,,,both,,153,153,128.69,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,130.05,85,,percent of total billed charges,,102.11,,,,fee schedule,,74.79,,,,fee schedule,,22.15,,,,fee schedule,,49.4,,,,fee schedule,,22.15,,,,fee schedule,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,45.9,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,126.99,83,,percent of total billed charges,,122.04,,,,fee schedule,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,22.15,145.35,
SELECT PICTURE AUDIOMETRY,92583,CDM,92583,CPT,,,both,,90,90,85.09,,,,fee schedule,,,,,,,,15.15,,,,fee schedule,,,76.5,85,,percent of total billed charges,,66.69,,,,fee schedule,,48.84,,,,fee schedule,,15.15,,,,fee schedule,,60.65,,,,fee schedule,,15.15,,,,fee schedule,,90.58,,,,fee schedule,,54.9,,,,fee schedule,,54.9,,,,fee schedule,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,15.15,,,,fee schedule,,15.15,,,,fee schedule,,,74.7,83,,percent of total billed charges,,80.7,,,,fee schedule,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,15.15,90.58,
EVOKED AUDITORY TEST,92587,CDM,92587,CPT,,,both,,105,105,34.14,,,,fee schedule,,,,,,,,12.73,,,,fee schedule,,,89.25,85,,percent of total billed charges,,41.01,,,,fee schedule,,18.03,,,,fee schedule,,12.73,,,,fee schedule,,101.3,,,,fee schedule,,12.73,,,,fee schedule,,36.34,,,,fee schedule,,22.03,,,,fee schedule,,22.03,,,,fee schedule,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,31.5,83,,percent of total billed charges,,12.73,,,,fee schedule,,12.73,,,,fee schedule,,,87.15,83,,percent of total billed charges,,32.38,,,,fee schedule,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,12.73,101.3,
EVOKED AUDITORY TEST,92588,CDM,92588,CPT,,,both,,139,139,53.05,,,,fee schedule,,,,,,,,19.36,,,,fee schedule,,,118.15,85,,percent of total billed charges,,64.84,,,,fee schedule,,29.31,,,,fee schedule,,19.36,,,,fee schedule,,133.19,,,,fee schedule,,19.36,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,126.49,91,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,41.7,83,,percent of total billed charges,,19.36,,,,fee schedule,,19.36,,,,fee schedule,,,115.37,83,,percent of total billed charges,,50.31,,,,fee schedule,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,118.15,85,,percent of total billed charges,,19.36,133.19,
EVOKED AUDITORY TST COMPLETE,92588P,CDM,92588,CPT,,,both,P,86,86,53.05,,,,fee schedule,,,,,,,,19.36,,,,fee schedule,,,73.1,85,,percent of total billed charges,,64.84,,,,fee schedule,,29.31,,,,fee schedule,,19.36,,,,fee schedule,,133.19,,,,fee schedule,,19.36,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,78.26,91,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,25.8,83,,percent of total billed charges,,19.36,,,,fee schedule,,19.36,,,,fee schedule,,,71.38,83,,percent of total billed charges,,50.31,,,,fee schedule,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,19.36,133.19,
EVOKED AUDITORY TST COMPLETE,92588T,CDM,92588,CPT,,,both,T,53,53,53.05,,,,fee schedule,,,,,,,,19.36,,,,fee schedule,,,45.05,85,,percent of total billed charges,,64.84,,,,fee schedule,,29.31,,,,fee schedule,,19.36,,,,fee schedule,,133.19,,,,fee schedule,,19.36,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,19.36,,,,fee schedule,,19.36,,,,fee schedule,,,43.99,83,,percent of total billed charges,,50.31,,,,fee schedule,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,15.9,133.19,
"HEARING AID EXAM, ONE EAR",92590,CDM,92590,CPT,,,both,,106,106,,,,,,,,,,,,,37.4,,,,fee schedule,,,90.1,85,,percent of total billed charges,,76,,,,fee schedule,,76,,,,fee schedule,,37.4,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,31.8,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,87.98,83,,percent of total billed charges,,,,,,,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,31.8,100.7,
"HEARING AID EXAM, BOTH EARS",92591,CDM,92591,CPT,,,both,,157,157,,,,,,,,,,,,,37.4,,,,fee schedule,,,133.45,85,,percent of total billed charges,,76,,,,fee schedule,,76,,,,fee schedule,,37.4,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,142.87,91,,percent of total billed charges,,,149.15,95,,percent of total billed charges,,,130.31,83,,percent of total billed charges,,,47.1,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,130.31,83,,percent of total billed charges,,,,,,,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,141.3,90,,percent of total billed charges,,,133.45,85,,percent of total billed charges,,37.4,149.15,
"HEARING AID CHECK, ONE EAR",92592,CDM,92592,CPT,,,both,,53,53,,,,,,,,,,,,,15.2,,,,fee schedule,,,45.05,85,,percent of total billed charges,,76,,,,fee schedule,,26,,,,fee schedule,,15.2,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,15.2,76,
"HEARING AID CHECK, BOTH EARS",92593,CDM,92593,CPT,,,both,,89,89,,,,,,,,,,,,,15.2,,,,fee schedule,,,75.65,85,,percent of total billed charges,,76,,,,fee schedule,,26,,,,fee schedule,,15.2,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,80.99,91,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,26.7,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,73.87,83,,percent of total billed charges,,,,,,,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,15.2,84.55,
"ELECTRO HEARNG AID TEST, ONE",92594,CDM,92594,CPT,,,both,,45,45,,,,,,,,,,,,,15.2,,,,fee schedule,,,38.25,85,,percent of total billed charges,,76,,,,fee schedule,,76,,,,fee schedule,,15.2,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,13.5,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,37.35,83,,percent of total billed charges,,,,,,,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,13.5,76,
"ELECTRO HEARNG AID TST, BOTH",92595,CDM,92595,CPT,,,both,,45,45,,,,,,,,,,,,,15.2,,,,fee schedule,,,38.25,85,,percent of total billed charges,,76,,,,fee schedule,,76,,,,fee schedule,,15.2,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,13.5,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,37.35,83,,percent of total billed charges,,,,,,,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,13.5,76,
ORAL SPEECH DEVICE EVAL,92597,CDM,92597,CPT,,,both,,236,236,112.4,,,,fee schedule,,,,,,,,43.18,,,,fee schedule,,,200.6,85,,percent of total billed charges,,141.75,,,,fee schedule,,74.34,,,,fee schedule,,43.18,,,,fee schedule,,83.79,,,,fee schedule,,43.18,,,,fee schedule,,119.66,,,,fee schedule,,72.52,,,,fee schedule,,72.52,,,,fee schedule,,,214.76,91,,percent of total billed charges,,,224.2,95,,percent of total billed charges,,,195.88,83,,percent of total billed charges,,,70.8,83,,percent of total billed charges,,43.18,,,,fee schedule,,43.18,,,,fee schedule,,,195.88,83,,percent of total billed charges,,106.6,,,,fee schedule,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,200.6,85,,percent of total billed charges,,43.18,224.2,
NON-SPEECH DEVICE SERVICE,92606,CDM,92606,CPT,,,both,,105,105,106.1,,,,fee schedule,,,,,,,,24.9,,,,fee schedule,,,89.25,85,,percent of total billed charges,,104.77,,,,fee schedule,,72.55,,,,fee schedule,,24.9,,,,fee schedule,,,,,,,,24.9,,,,fee schedule,,112.95,,,,fee schedule,,68.45,,,,fee schedule,,68.45,,,,fee schedule,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,31.5,83,,percent of total billed charges,,24.9,,,,fee schedule,,24.9,,,,fee schedule,,,87.15,83,,percent of total billed charges,,100.62,,,,fee schedule,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,24.9,112.95,
"EX FOR SPEECH DEVICE RX, 1HR",92607,CDM,92607,CPT,,,both,,240,240,193.82,,,,fee schedule,,,,,,,,45.85,,,,fee schedule,,,204,85,,percent of total billed charges,,182.46,,,,fee schedule,,126.36,,,,fee schedule,,45.85,,,,fee schedule,,195.72,,,,fee schedule,,45.85,,,,fee schedule,,206.32,,,,fee schedule,,125.04,,,,fee schedule,,125.04,,,,fee schedule,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,72,83,,percent of total billed charges,,45.85,,,,fee schedule,,45.85,,,,fee schedule,,,199.2,83,,percent of total billed charges,,183.81,,,,fee schedule,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,45.85,228,
EX FOR SPEECH DEVICE RX ADDL,92608,CDM,92608,CPT,,,both,,89,89,76.16,,,,fee schedule,,,,,,,,9.25,,,,fee schedule,,,75.65,85,,percent of total billed charges,,72.25,,,,fee schedule,,50.04,,,,fee schedule,,9.25,,,,fee schedule,,37.52,,,,fee schedule,,9.25,,,,fee schedule,,81.08,,,,fee schedule,,49.14,,,,fee schedule,,49.14,,,,fee schedule,,,80.99,91,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,26.7,83,,percent of total billed charges,,9.25,,,,fee schedule,,9.25,,,,fee schedule,,,73.87,83,,percent of total billed charges,,72.23,,,,fee schedule,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,9.25,84.55,
USE OF SPEECH DEVICE SERVICE,92609,CDM,92609,CPT,,,both,,251,251,161.78,,,,fee schedule,,,,,,,,24.9,,,,fee schedule,,,213.35,85,,percent of total billed charges,,152.85,,,,fee schedule,,105.85,,,,fee schedule,,24.9,,,,fee schedule,,101.93,,,,fee schedule,,24.9,,,,fee schedule,,172.21,,,,fee schedule,,104.37,,,,fee schedule,,104.37,,,,fee schedule,,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,24.9,,,,fee schedule,,24.9,,,,fee schedule,,,208.33,83,,percent of total billed charges,,153.43,,,,fee schedule,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,24.9,238.45,
EVALUATE SWALLOWING FUNCTION,92610,CDM,92610,CPT,,,both,,636,636,109.25,,,,fee schedule,,,,,,,,18,,,,fee schedule,,,540.6,85,,percent of total billed charges,,141.24,,,,fee schedule,,72.18,,,,fee schedule,,18,,,,fee schedule,,219.48,,,,fee schedule,,18,,,,fee schedule,,116.3,,,,fee schedule,,70.49,,,,fee schedule,,70.49,,,,fee schedule,,,578.76,91,,percent of total billed charges,,,604.2,95,,percent of total billed charges,,,527.88,83,,percent of total billed charges,,,190.8,83,,percent of total billed charges,,18,,,,fee schedule,,18,,,,fee schedule,,,527.88,83,,percent of total billed charges,,103.61,,,,fee schedule,,,572.4,90,,percent of total billed charges,,,572.4,90,,percent of total billed charges,,,572.4,90,,percent of total billed charges,,,572.4,90,,percent of total billed charges,,,540.6,85,,percent of total billed charges,,18,604.2,
ENDOSCOPY SWALLOW TST (FEES),92612,CDM,92612,CPT,,,both,,547,547,103.47,,,,fee schedule,,,,,,,,30.25,,,,fee schedule,,,464.95,85,,percent of total billed charges,,99.5,,,,fee schedule,,68.91,,,,fee schedule,,30.25,,,,fee schedule,,123.19,,,,fee schedule,,30.25,,,,fee schedule,,110.15,,,,fee schedule,,66.76,,,,fee schedule,,66.76,,,,fee schedule,,,497.77,91,,percent of total billed charges,,,519.65,95,,percent of total billed charges,,,454.01,83,,percent of total billed charges,,,164.1,83,,percent of total billed charges,,30.25,,,,fee schedule,,30.25,,,,fee schedule,,,454.01,83,,percent of total billed charges,,98.13,,,,fee schedule,,,492.3,90,,percent of total billed charges,,,492.3,90,,percent of total billed charges,,,492.3,90,,percent of total billed charges,,,492.3,90,,percent of total billed charges,,,464.95,85,,percent of total billed charges,,30.25,519.65,
TINNITUS ASSESSMENT,92625,CDM,92625,CPT,,,both,,116,116,95.07,,,,fee schedule,,,,,,,,24.06,,,,fee schedule,,,98.6,85,,percent of total billed charges,,90.98,,,,fee schedule,,63,,,,fee schedule,,24.06,,,,fee schedule,,73.79,,,,fee schedule,,24.06,,,,fee schedule,,101.2,,,,fee schedule,,61.34,,,,fee schedule,,61.34,,,,fee schedule,,,105.56,91,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,34.8,83,,percent of total billed charges,,24.06,,,,fee schedule,,24.06,,,,fee schedule,,,96.28,83,,percent of total billed charges,,90.16,,,,fee schedule,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,98.6,85,,percent of total billed charges,,24.06,110.2,
TINNITUS ASSESSMENT,92625P,CDM,92625,CPT,,,both,P,63,63,95.07,,,,fee schedule,,,,,,,,24.06,,,,fee schedule,,,53.55,85,,percent of total billed charges,,90.98,,,,fee schedule,,63,,,,fee schedule,,24.06,,,,fee schedule,,73.79,,,,fee schedule,,24.06,,,,fee schedule,,101.2,,,,fee schedule,,61.34,,,,fee schedule,,61.34,,,,fee schedule,,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,18.9,83,,percent of total billed charges,,24.06,,,,fee schedule,,24.06,,,,fee schedule,,,52.29,83,,percent of total billed charges,,90.16,,,,fee schedule,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,18.9,101.2,
TINNITUS ASSESSMENT,92625T,CDM,92625,CPT,,,both,T,53,53,95.07,,,,fee schedule,,,,,,,,24.06,,,,fee schedule,,,45.05,85,,percent of total billed charges,,90.98,,,,fee schedule,,63,,,,fee schedule,,24.06,,,,fee schedule,,73.79,,,,fee schedule,,24.06,,,,fee schedule,,101.2,,,,fee schedule,,61.34,,,,fee schedule,,61.34,,,,fee schedule,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,24.06,,,,fee schedule,,24.06,,,,fee schedule,,,43.99,83,,percent of total billed charges,,90.16,,,,fee schedule,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,15.9,101.2,
AEP SCR AUDITORY POTENTIAL,92650,CDM,92650,CPT,,,both,,114,114,43.6,,,,fee schedule,,,,,,,,17.38,,,,fee schedule,,,96.9,85,,percent of total billed charges,,58.83,,,,fee schedule,,56.18,,,,fee schedule,,17.38,,,,fee schedule,,,,,,,,17.38,,,,fee schedule,,46.41,,,,fee schedule,,28.13,,,,fee schedule,,28.13,,,,fee schedule,,,103.74,91,,percent of total billed charges,,,108.3,95,,percent of total billed charges,,,94.62,83,,percent of total billed charges,,,34.2,83,,percent of total billed charges,,17.38,,,,fee schedule,,17.38,,,,fee schedule,,,94.62,83,,percent of total billed charges,,41.35,,,,fee schedule,,,102.6,90,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,102.6,90,,percent of total billed charges,,,96.9,85,,percent of total billed charges,,17.38,108.3,
AEP HEARING STATUS DETER I&R,92651,CDM,92651,CPT,,,both,,124,124,132.89,,,,fee schedule,,,,,,,,52.15,,,,fee schedule,,,105.4,85,,percent of total billed charges,,128.56,,,,fee schedule,,89.03,,,,fee schedule,,52.15,,,,fee schedule,,,,,,,,52.15,,,,fee schedule,,141.46,,,,fee schedule,,85.73,,,,fee schedule,,85.73,,,,fee schedule,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,37.2,83,,percent of total billed charges,,52.15,,,,fee schedule,,52.15,,,,fee schedule,,,102.92,83,,percent of total billed charges,,126.03,,,,fee schedule,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,37.2,141.46,
AEP THRSHLD EST MLT FREQ I&R,92652,CDM,92652,CPT,,,both,,155,155,177.54,,,,fee schedule,,,,,,,,68.77,,,,fee schedule,,,131.75,85,,percent of total billed charges,,169.66,,,,fee schedule,,117.5,,,,fee schedule,,68.77,,,,fee schedule,,,,,,,,68.77,,,,fee schedule,,188.99,,,,fee schedule,,114.54,,,,fee schedule,,114.54,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,68.77,,,,fee schedule,,68.77,,,,fee schedule,,,128.65,83,,percent of total billed charges,,168.37,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,46.5,188.99,
AEP NEURODIAGNOSTIC I&R,92653,CDM,92653,CPT,,,both,,119,119,132.36,,,,fee schedule,,,,,,,,50.14,,,,fee schedule,,,101.15,85,,percent of total billed charges,,125.76,,,,fee schedule,,87.09,,,,fee schedule,,50.14,,,,fee schedule,,,,,,,,50.14,,,,fee schedule,,140.9,,,,fee schedule,,85.4,,,,fee schedule,,85.4,,,,fee schedule,,,108.29,91,,percent of total billed charges,,,113.05,95,,percent of total billed charges,,,98.77,83,,percent of total billed charges,,,35.7,83,,percent of total billed charges,,50.14,,,,fee schedule,,50.14,,,,fee schedule,,,98.77,83,,percent of total billed charges,,125.53,,,,fee schedule,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,101.15,85,,percent of total billed charges,,35.7,140.9,
PRQ CARDIAC ANGIOPLAST 1 ART,92920,CDM,92920,CPT,,,both,,1498,1498,808.36,,,,fee schedule,,,,,,,,334.57,,,,fee schedule,,,1273.3,85,,percent of total billed charges,,826.61,,,,fee schedule,,560.97,,,,fee schedule,,334.57,,,,fee schedule,,,,,,,,334.57,,,,fee schedule,,860.51,,,,fee schedule,,521.52,,,,fee schedule,,521.52,,,,fee schedule,,,1363.18,91,,percent of total billed charges,,,1423.1,95,,percent of total billed charges,,,1243.34,83,,percent of total billed charges,,,449.4,83,,percent of total billed charges,,334.57,,,,fee schedule,,334.57,,,,fee schedule,,,1243.34,83,,percent of total billed charges,,766.64,,,,fee schedule,,,1348.2,90,,percent of total billed charges,,,1348.2,90,,percent of total billed charges,,,1348.2,90,,percent of total billed charges,,,1348.2,90,,percent of total billed charges,,,1273.3,85,,percent of total billed charges,,334.57,1423.1,
PRQ CARDIAC ANGIOPLAST 1 ART,92920P,CDM,92920,CPT,,,both,P,1304,1304,808.36,,,,fee schedule,,,,,,,,334.57,,,,fee schedule,,,1108.4,85,,percent of total billed charges,,826.61,,,,fee schedule,,560.97,,,,fee schedule,,334.57,,,,fee schedule,,,,,,,,334.57,,,,fee schedule,,860.51,,,,fee schedule,,521.52,,,,fee schedule,,521.52,,,,fee schedule,,,1186.64,91,,percent of total billed charges,,,1238.8,95,,percent of total billed charges,,,1082.32,83,,percent of total billed charges,,,391.2,83,,percent of total billed charges,,334.57,,,,fee schedule,,334.57,,,,fee schedule,,,1082.32,83,,percent of total billed charges,,766.64,,,,fee schedule,,,1173.6,90,,percent of total billed charges,,,1173.6,90,,percent of total billed charges,,,1173.6,90,,percent of total billed charges,,,1173.6,90,,percent of total billed charges,,,1108.4,85,,percent of total billed charges,,334.57,1238.8,
PRQ CARDIAC ANGIOPLAST 1 ART,92920T,CDM,92920,CPT,,,both,T,194,194,808.36,,,,fee schedule,,,,,,,,334.57,,,,fee schedule,,,164.9,85,,percent of total billed charges,,826.61,,,,fee schedule,,560.97,,,,fee schedule,,334.57,,,,fee schedule,,,,,,,,334.57,,,,fee schedule,,860.51,,,,fee schedule,,521.52,,,,fee schedule,,521.52,,,,fee schedule,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,58.2,83,,percent of total billed charges,,334.57,,,,fee schedule,,334.57,,,,fee schedule,,,161.02,83,,percent of total billed charges,,766.64,,,,fee schedule,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,58.2,860.51,
PRQ CARDIAC ANGIO ADDL ART,92921,CDM,92921,CPT,,,both,,803,803,,,,,,,,,,,,,,,,,,,,682.55,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,730.73,91,,percent of total billed charges,,,762.85,95,,percent of total billed charges,,,666.49,83,,percent of total billed charges,,,240.9,83,,percent of total billed charges,,,,,,,,,,,,,,,666.49,83,,percent of total billed charges,,,,,,,,,722.7,90,,percent of total billed charges,,,722.7,90,,percent of total billed charges,,,722.7,90,,percent of total billed charges,,,722.7,90,,percent of total billed charges,,,682.55,85,,percent of total billed charges,,240.9,762.85,
PRQ CARDIAC ANGIO ADDL ART,92921P,CDM,92921,CPT,,,both,P,629,629,,,,,,,,,,,,,,,,,,,,534.65,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,572.39,91,,percent of total billed charges,,,597.55,95,,percent of total billed charges,,,522.07,83,,percent of total billed charges,,,188.7,83,,percent of total billed charges,,,,,,,,,,,,,,,522.07,83,,percent of total billed charges,,,,,,,,,566.1,90,,percent of total billed charges,,,566.1,90,,percent of total billed charges,,,566.1,90,,percent of total billed charges,,,566.1,90,,percent of total billed charges,,,534.65,85,,percent of total billed charges,,188.7,597.55,
PRQ CARDIAC ANGIO ADDL ART,92921T,CDM,92921,CPT,,,both,T,174,174,,,,,,,,,,,,,,,,,,,,147.9,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,158.34,91,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,52.2,83,,percent of total billed charges,,,,,,,,,,,,,,,144.42,83,,percent of total billed charges,,,,,,,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,52.2,165.3,
PRQ CARD ANGIO/ATHRECT 1 ART,92924,CDM,92924,CPT,,,both,,1819,1819,965.94,,,,fee schedule,,,,,,,,397.78,,,,fee schedule,,,1546.15,85,,percent of total billed charges,,985.34,,,,fee schedule,,668.69,,,,fee schedule,,397.78,,,,fee schedule,,,,,,,,397.78,,,,fee schedule,,1028.26,,,,fee schedule,,623.19,,,,fee schedule,,623.19,,,,fee schedule,,,1655.29,91,,percent of total billed charges,,,1728.05,95,,percent of total billed charges,,,1509.77,83,,percent of total billed charges,,,545.7,83,,percent of total billed charges,,397.78,,,,fee schedule,,397.78,,,,fee schedule,,,1509.77,83,,percent of total billed charges,,916.08,,,,fee schedule,,,1637.1,90,,percent of total billed charges,,,1637.1,90,,percent of total billed charges,,,1637.1,90,,percent of total billed charges,,,1637.1,90,,percent of total billed charges,,,1546.15,85,,percent of total billed charges,,397.78,1728.05,
PRQ CARD ANGIO/ATHRECT 1 ART,92924P,CDM,92924,CPT,,,both,P,1616,1616,965.94,,,,fee schedule,,,,,,,,397.78,,,,fee schedule,,,1373.6,85,,percent of total billed charges,,985.34,,,,fee schedule,,668.69,,,,fee schedule,,397.78,,,,fee schedule,,,,,,,,397.78,,,,fee schedule,,1028.26,,,,fee schedule,,623.19,,,,fee schedule,,623.19,,,,fee schedule,,,1470.56,91,,percent of total billed charges,,,1535.2,95,,percent of total billed charges,,,1341.28,83,,percent of total billed charges,,,484.8,83,,percent of total billed charges,,397.78,,,,fee schedule,,397.78,,,,fee schedule,,,1341.28,83,,percent of total billed charges,,916.08,,,,fee schedule,,,1454.4,90,,percent of total billed charges,,,1454.4,90,,percent of total billed charges,,,1454.4,90,,percent of total billed charges,,,1454.4,90,,percent of total billed charges,,,1373.6,85,,percent of total billed charges,,397.78,1535.2,
PRQ CARD ANGIO/ATHRECT 1 ART,92924T,CDM,92924,CPT,,,both,T,203,203,965.94,,,,fee schedule,,,,,,,,397.78,,,,fee schedule,,,172.55,85,,percent of total billed charges,,985.34,,,,fee schedule,,668.69,,,,fee schedule,,397.78,,,,fee schedule,,,,,,,,397.78,,,,fee schedule,,1028.26,,,,fee schedule,,623.19,,,,fee schedule,,623.19,,,,fee schedule,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,60.9,83,,percent of total billed charges,,397.78,,,,fee schedule,,397.78,,,,fee schedule,,,168.49,83,,percent of total billed charges,,916.08,,,,fee schedule,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,60.9,1028.26,
PRQ CARD STENT W/ANGIO 1 VSL,92928,CDM,92928,CPT,,,both,,1705,1705,901.33,,,,fee schedule,,,,,,,,371.74,,,,fee schedule,,,1449.25,85,,percent of total billed charges,,919.85,,,,fee schedule,,624.24,,,,fee schedule,,371.74,,,,fee schedule,,,,,,,,371.74,,,,fee schedule,,959.48,,,,fee schedule,,581.5,,,,fee schedule,,581.5,,,,fee schedule,,,1551.55,91,,percent of total billed charges,,,1619.75,95,,percent of total billed charges,,,1415.15,83,,percent of total billed charges,,,511.5,83,,percent of total billed charges,,371.74,,,,fee schedule,,371.74,,,,fee schedule,,,1415.15,83,,percent of total billed charges,,854.81,,,,fee schedule,,,1534.5,90,,percent of total billed charges,,,1534.5,90,,percent of total billed charges,,,1534.5,90,,percent of total billed charges,,,1534.5,90,,percent of total billed charges,,,1449.25,85,,percent of total billed charges,,371.74,1619.75,
PRQ CARD STENT W/ANGIO 1 VSL,92928P,CDM,92928,CPT,,,both,P,1505,1505,901.33,,,,fee schedule,,,,,,,,371.74,,,,fee schedule,,,1279.25,85,,percent of total billed charges,,919.85,,,,fee schedule,,624.24,,,,fee schedule,,371.74,,,,fee schedule,,,,,,,,371.74,,,,fee schedule,,959.48,,,,fee schedule,,581.5,,,,fee schedule,,581.5,,,,fee schedule,,,1369.55,91,,percent of total billed charges,,,1429.75,95,,percent of total billed charges,,,1249.15,83,,percent of total billed charges,,,451.5,83,,percent of total billed charges,,371.74,,,,fee schedule,,371.74,,,,fee schedule,,,1249.15,83,,percent of total billed charges,,854.81,,,,fee schedule,,,1354.5,90,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1354.5,90,,percent of total billed charges,,,1279.25,85,,percent of total billed charges,,371.74,1429.75,
PRQ CARD STENT W/ANGIO 1 VSL,92928T,CDM,92928,CPT,,,both,T,200,200,901.33,,,,fee schedule,,,,,,,,371.74,,,,fee schedule,,,170,85,,percent of total billed charges,,919.85,,,,fee schedule,,624.24,,,,fee schedule,,371.74,,,,fee schedule,,,,,,,,371.74,,,,fee schedule,,959.48,,,,fee schedule,,581.5,,,,fee schedule,,581.5,,,,fee schedule,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,60,83,,percent of total billed charges,,371.74,,,,fee schedule,,371.74,,,,fee schedule,,,166,83,,percent of total billed charges,,854.81,,,,fee schedule,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,60,959.48,
PRQ CARD STENT W/ANGIO ADDL,92929,CDM,92929,CPT,,,both,,787,787,,,,,,,,,,,,,,,,,,,,668.95,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,716.17,91,,percent of total billed charges,,,747.65,95,,percent of total billed charges,,,653.21,83,,percent of total billed charges,,,236.1,83,,percent of total billed charges,,,,,,,,,,,,,,,653.21,83,,percent of total billed charges,,,,,,,,,708.3,90,,percent of total billed charges,,,708.3,90,,percent of total billed charges,,,708.3,90,,percent of total billed charges,,,708.3,90,,percent of total billed charges,,,668.95,85,,percent of total billed charges,,236.1,747.65,
PRQ CARD STENT W/ANGIO ADDL,92929P,CDM,92929,CPT,,,both,P,614,614,,,,,,,,,,,,,,,,,,,,521.9,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,558.74,91,,percent of total billed charges,,,583.3,95,,percent of total billed charges,,,509.62,83,,percent of total billed charges,,,184.2,83,,percent of total billed charges,,,,,,,,,,,,,,,509.62,83,,percent of total billed charges,,,,,,,,,552.6,90,,percent of total billed charges,,,552.6,90,,percent of total billed charges,,,552.6,90,,percent of total billed charges,,,552.6,90,,percent of total billed charges,,,521.9,85,,percent of total billed charges,,184.2,583.3,
PRQ CARD STENT W/ANGIO ADDL,92929T,CDM,92929,CPT,,,both,T,173,173,,,,,,,,,,,,,,,,,,,,147.05,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,51.9,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,,,,,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,51.9,164.35,
PRQ CARD STENT/ATH/ANGIO,92933,CDM,92933,CPT,,,both,,1975,1975,1010.06,,,,fee schedule,,,,,,,,415.7,,,,fee schedule,,,1678.75,85,,percent of total billed charges,,1031.84,,,,fee schedule,,700.25,,,,fee schedule,,415.7,,,,fee schedule,,,,,,,,415.7,,,,fee schedule,,1075.22,,,,fee schedule,,651.65,,,,fee schedule,,651.65,,,,fee schedule,,,1797.25,91,,percent of total billed charges,,,1876.25,95,,percent of total billed charges,,,1639.25,83,,percent of total billed charges,,,592.5,83,,percent of total billed charges,,415.7,,,,fee schedule,,415.7,,,,fee schedule,,,1639.25,83,,percent of total billed charges,,957.93,,,,fee schedule,,,1777.5,90,,percent of total billed charges,,,1777.5,90,,percent of total billed charges,,,1777.5,90,,percent of total billed charges,,,1777.5,90,,percent of total billed charges,,,1678.75,85,,percent of total billed charges,,415.7,1876.25,
PRQ CARD STENT/ATH/ANGIO,92933P,CDM,92933,CPT,,,both,P,1767,1767,1010.06,,,,fee schedule,,,,,,,,415.7,,,,fee schedule,,,1501.95,85,,percent of total billed charges,,1031.84,,,,fee schedule,,700.25,,,,fee schedule,,415.7,,,,fee schedule,,,,,,,,415.7,,,,fee schedule,,1075.22,,,,fee schedule,,651.65,,,,fee schedule,,651.65,,,,fee schedule,,,1607.97,91,,percent of total billed charges,,,1678.65,95,,percent of total billed charges,,,1466.61,83,,percent of total billed charges,,,530.1,83,,percent of total billed charges,,415.7,,,,fee schedule,,415.7,,,,fee schedule,,,1466.61,83,,percent of total billed charges,,957.93,,,,fee schedule,,,1590.3,90,,percent of total billed charges,,,1590.3,90,,percent of total billed charges,,,1590.3,90,,percent of total billed charges,,,1590.3,90,,percent of total billed charges,,,1501.95,85,,percent of total billed charges,,415.7,1678.65,
PRQ CARD STENT/ATH/ANGIO,92933T,CDM,92933,CPT,,,both,T,208,208,1010.06,,,,fee schedule,,,,,,,,415.7,,,,fee schedule,,,176.8,85,,percent of total billed charges,,1031.84,,,,fee schedule,,700.25,,,,fee schedule,,415.7,,,,fee schedule,,,,,,,,415.7,,,,fee schedule,,1075.22,,,,fee schedule,,651.65,,,,fee schedule,,651.65,,,,fee schedule,,,189.28,91,,percent of total billed charges,,,197.6,95,,percent of total billed charges,,,172.64,83,,percent of total billed charges,,,62.4,83,,percent of total billed charges,,415.7,,,,fee schedule,,415.7,,,,fee schedule,,,172.64,83,,percent of total billed charges,,957.93,,,,fee schedule,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,176.8,85,,percent of total billed charges,,62.4,1075.22,
PRQ CARD STENT/ATH/ANGIO,92934,CDM,92934,CPT,,,both,,785,785,,,,,,,,,,,,,,,,,,,,667.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,714.35,91,,percent of total billed charges,,,745.75,95,,percent of total billed charges,,,651.55,83,,percent of total billed charges,,,235.5,83,,percent of total billed charges,,,,,,,,,,,,,,,651.55,83,,percent of total billed charges,,,,,,,,,706.5,90,,percent of total billed charges,,,706.5,90,,percent of total billed charges,,,706.5,90,,percent of total billed charges,,,706.5,90,,percent of total billed charges,,,667.25,85,,percent of total billed charges,,235.5,745.75,
PRQ CARD STENT/ATH/ANGIO,92934P,CDM,92934,CPT,,,both,P,612,612,,,,,,,,,,,,,,,,,,,,520.2,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,556.92,91,,percent of total billed charges,,,581.4,95,,percent of total billed charges,,,507.96,83,,percent of total billed charges,,,183.6,83,,percent of total billed charges,,,,,,,,,,,,,,,507.96,83,,percent of total billed charges,,,,,,,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,550.8,90,,percent of total billed charges,,,520.2,85,,percent of total billed charges,,183.6,581.4,
PRQ CARD STENT/ATH/ANGIO,92934T,CDM,92934,CPT,,,both,T,173,173,,,,,,,,,,,,,,,,,,,,147.05,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,51.9,83,,percent of total billed charges,,,,,,,,,,,,,,,143.59,83,,percent of total billed charges,,,,,,,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,51.9,164.35,
PRQ REVASC BYP GRAFT 1 VSL,92937,CDM,92937,CPT,,,both,,1689,1689,900.28,,,,fee schedule,,,,,,,,371.35,,,,fee schedule,,,1435.65,85,,percent of total billed charges,,918.83,,,,fee schedule,,623.56,,,,fee schedule,,371.35,,,,fee schedule,,,,,,,,371.35,,,,fee schedule,,958.36,,,,fee schedule,,580.83,,,,fee schedule,,580.83,,,,fee schedule,,,1536.99,91,,percent of total billed charges,,,1604.55,95,,percent of total billed charges,,,1401.87,83,,percent of total billed charges,,,506.7,83,,percent of total billed charges,,371.35,,,,fee schedule,,371.35,,,,fee schedule,,,1401.87,83,,percent of total billed charges,,853.82,,,,fee schedule,,,1520.1,90,,percent of total billed charges,,,1520.1,90,,percent of total billed charges,,,1520.1,90,,percent of total billed charges,,,1520.1,90,,percent of total billed charges,,,1435.65,85,,percent of total billed charges,,371.35,1604.55,
PRQ REVASC BYP GRAFT 1 VSL,92937P,CDM,92937,CPT,,,both,P,1489,1489,900.28,,,,fee schedule,,,,,,,,371.35,,,,fee schedule,,,1265.65,85,,percent of total billed charges,,918.83,,,,fee schedule,,623.56,,,,fee schedule,,371.35,,,,fee schedule,,,,,,,,371.35,,,,fee schedule,,958.36,,,,fee schedule,,580.83,,,,fee schedule,,580.83,,,,fee schedule,,,1354.99,91,,percent of total billed charges,,,1414.55,95,,percent of total billed charges,,,1235.87,83,,percent of total billed charges,,,446.7,83,,percent of total billed charges,,371.35,,,,fee schedule,,371.35,,,,fee schedule,,,1235.87,83,,percent of total billed charges,,853.82,,,,fee schedule,,,1340.1,90,,percent of total billed charges,,,1340.1,90,,percent of total billed charges,,,1340.1,90,,percent of total billed charges,,,1340.1,90,,percent of total billed charges,,,1265.65,85,,percent of total billed charges,,371.35,1414.55,
PRQ REVASC BYP GRAFT 1 VSL,92937T,CDM,92937,CPT,,,both,T,200,200,900.28,,,,fee schedule,,,,,,,,371.35,,,,fee schedule,,,170,85,,percent of total billed charges,,918.83,,,,fee schedule,,623.56,,,,fee schedule,,371.35,,,,fee schedule,,,,,,,,371.35,,,,fee schedule,,958.36,,,,fee schedule,,580.83,,,,fee schedule,,580.83,,,,fee schedule,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,60,83,,percent of total billed charges,,371.35,,,,fee schedule,,371.35,,,,fee schedule,,,166,83,,percent of total billed charges,,853.82,,,,fee schedule,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,60,958.36,
PRQ REVASC BYP GRAFT ADDL,92938,CDM,92938,CPT,,,both,,923,923,,,,,,,,,,,,,,,,,,,,784.55,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,839.93,91,,percent of total billed charges,,,876.85,95,,percent of total billed charges,,,766.09,83,,percent of total billed charges,,,276.9,83,,percent of total billed charges,,,,,,,,,,,,,,,766.09,83,,percent of total billed charges,,,,,,,,,830.7,90,,percent of total billed charges,,,830.7,90,,percent of total billed charges,,,830.7,90,,percent of total billed charges,,,830.7,90,,percent of total billed charges,,,784.55,85,,percent of total billed charges,,276.9,876.85,
PRQ REVASC BYP GRAFT ADDL,92938P,CDM,92938,CPT,,,both,P,746,746,,,,,,,,,,,,,,,,,,,,634.1,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,678.86,91,,percent of total billed charges,,,708.7,95,,percent of total billed charges,,,619.18,83,,percent of total billed charges,,,223.8,83,,percent of total billed charges,,,,,,,,,,,,,,,619.18,83,,percent of total billed charges,,,,,,,,,671.4,90,,percent of total billed charges,,,671.4,90,,percent of total billed charges,,,671.4,90,,percent of total billed charges,,,671.4,90,,percent of total billed charges,,,634.1,85,,percent of total billed charges,,223.8,708.7,
PRQ REVASC BYP GRAFT ADDL,92938T,CDM,92938,CPT,,,both,T,177,177,,,,,,,,,,,,,,,,,,,,150.45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,53.1,83,,percent of total billed charges,,,,,,,,,,,,,,,146.91,83,,percent of total billed charges,,,,,,,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,53.1,168.15,
PRQ CARD REVASC MI 1 VSL,92941,CDM,92941,CPT,,,both,,1901,1901,1011.11,,,,fee schedule,,,,,,,,416.57,,,,fee schedule,,,1615.85,85,,percent of total billed charges,,1033.86,,,,fee schedule,,701.62,,,,fee schedule,,416.57,,,,fee schedule,,,,,,,,416.57,,,,fee schedule,,1076.34,,,,fee schedule,,652.33,,,,fee schedule,,652.33,,,,fee schedule,,,1729.91,91,,percent of total billed charges,,,1805.95,95,,percent of total billed charges,,,1577.83,83,,percent of total billed charges,,,570.3,83,,percent of total billed charges,,416.57,,,,fee schedule,,416.57,,,,fee schedule,,,1577.83,83,,percent of total billed charges,,958.92,,,,fee schedule,,,1710.9,90,,percent of total billed charges,,,1710.9,90,,percent of total billed charges,,,1710.9,90,,percent of total billed charges,,,1710.9,90,,percent of total billed charges,,,1615.85,85,,percent of total billed charges,,416.57,1805.95,
PRQ CARD REVASC MI 1 VSL,92941P,CDM,92941,CPT,,,both,P,1695,1695,1011.11,,,,fee schedule,,,,,,,,416.57,,,,fee schedule,,,1440.75,85,,percent of total billed charges,,1033.86,,,,fee schedule,,701.62,,,,fee schedule,,416.57,,,,fee schedule,,,,,,,,416.57,,,,fee schedule,,1076.34,,,,fee schedule,,652.33,,,,fee schedule,,652.33,,,,fee schedule,,,1542.45,91,,percent of total billed charges,,,1610.25,95,,percent of total billed charges,,,1406.85,83,,percent of total billed charges,,,508.5,83,,percent of total billed charges,,416.57,,,,fee schedule,,416.57,,,,fee schedule,,,1406.85,83,,percent of total billed charges,,958.92,,,,fee schedule,,,1525.5,90,,percent of total billed charges,,,1525.5,90,,percent of total billed charges,,,1525.5,90,,percent of total billed charges,,,1525.5,90,,percent of total billed charges,,,1440.75,85,,percent of total billed charges,,416.57,1610.25,
PRQ CARD REVASC MI 1 VSL,92941T,CDM,92941,CPT,,,both,T,206,206,1011.11,,,,fee schedule,,,,,,,,416.57,,,,fee schedule,,,175.1,85,,percent of total billed charges,,1033.86,,,,fee schedule,,701.62,,,,fee schedule,,416.57,,,,fee schedule,,,,,,,,416.57,,,,fee schedule,,1076.34,,,,fee schedule,,652.33,,,,fee schedule,,652.33,,,,fee schedule,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,61.8,83,,percent of total billed charges,,416.57,,,,fee schedule,,416.57,,,,fee schedule,,,170.98,83,,percent of total billed charges,,958.92,,,,fee schedule,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,61.8,1076.34,
PRQ CARD REVASC CHRONIC 1VSL,92943,CDM,92943,CPT,,,both,,1986,1986,1012.16,,,,fee schedule,,,,,,,,416.57,,,,fee schedule,,,1688.1,85,,percent of total billed charges,,1034,,,,fee schedule,,701.71,,,,fee schedule,,416.57,,,,fee schedule,,,,,,,,416.57,,,,fee schedule,,1077.46,,,,fee schedule,,653.01,,,,fee schedule,,653.01,,,,fee schedule,,,1807.26,91,,percent of total billed charges,,,1886.7,95,,percent of total billed charges,,,1648.38,83,,percent of total billed charges,,,595.8,83,,percent of total billed charges,,416.57,,,,fee schedule,,416.57,,,,fee schedule,,,1648.38,83,,percent of total billed charges,,959.92,,,,fee schedule,,,1787.4,90,,percent of total billed charges,,,1787.4,90,,percent of total billed charges,,,1787.4,90,,percent of total billed charges,,,1787.4,90,,percent of total billed charges,,,1688.1,85,,percent of total billed charges,,416.57,1886.7,
PRQ CARD REVASC CHRONIC 1VSL,92943P,CDM,92943,CPT,,,both,P,1778,1778,1012.16,,,,fee schedule,,,,,,,,416.57,,,,fee schedule,,,1511.3,85,,percent of total billed charges,,1034,,,,fee schedule,,701.71,,,,fee schedule,,416.57,,,,fee schedule,,,,,,,,416.57,,,,fee schedule,,1077.46,,,,fee schedule,,653.01,,,,fee schedule,,653.01,,,,fee schedule,,,1617.98,91,,percent of total billed charges,,,1689.1,95,,percent of total billed charges,,,1475.74,83,,percent of total billed charges,,,533.4,83,,percent of total billed charges,,416.57,,,,fee schedule,,416.57,,,,fee schedule,,,1475.74,83,,percent of total billed charges,,959.92,,,,fee schedule,,,1600.2,90,,percent of total billed charges,,,1600.2,90,,percent of total billed charges,,,1600.2,90,,percent of total billed charges,,,1600.2,90,,percent of total billed charges,,,1511.3,85,,percent of total billed charges,,416.57,1689.1,
PRQ CARD REVASC CHRONIC 1VSL,92943T,CDM,92943,CPT,,,both,T,208,208,1012.16,,,,fee schedule,,,,,,,,416.57,,,,fee schedule,,,176.8,85,,percent of total billed charges,,1034,,,,fee schedule,,701.71,,,,fee schedule,,416.57,,,,fee schedule,,,,,,,,416.57,,,,fee schedule,,1077.46,,,,fee schedule,,653.01,,,,fee schedule,,653.01,,,,fee schedule,,,189.28,91,,percent of total billed charges,,,197.6,95,,percent of total billed charges,,,172.64,83,,percent of total billed charges,,,62.4,83,,percent of total billed charges,,416.57,,,,fee schedule,,416.57,,,,fee schedule,,,172.64,83,,percent of total billed charges,,959.92,,,,fee schedule,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,176.8,85,,percent of total billed charges,,62.4,1077.46,
PRQ CARD REVASC CHRONIC ADDL,92944,CDM,92944,CPT,,,both,,1038,1038,,,,,,,,,,,,,,,,,,,,882.3,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,944.58,91,,percent of total billed charges,,,986.1,95,,percent of total billed charges,,,861.54,83,,percent of total billed charges,,,311.4,83,,percent of total billed charges,,,,,,,,,,,,,,,861.54,83,,percent of total billed charges,,,,,,,,,934.2,90,,percent of total billed charges,,,934.2,90,,percent of total billed charges,,,934.2,90,,percent of total billed charges,,,934.2,90,,percent of total billed charges,,,882.3,85,,percent of total billed charges,,311.4,986.1,
PRQ CARD REVASC CHRONIC ADDL,92944P,CDM,92944,CPT,,,both,P,857,857,,,,,,,,,,,,,,,,,,,,728.45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,779.87,91,,percent of total billed charges,,,814.15,95,,percent of total billed charges,,,711.31,83,,percent of total billed charges,,,257.1,83,,percent of total billed charges,,,,,,,,,,,,,,,711.31,83,,percent of total billed charges,,,,,,,,,771.3,90,,percent of total billed charges,,,771.3,90,,percent of total billed charges,,,771.3,90,,percent of total billed charges,,,771.3,90,,percent of total billed charges,,,728.45,85,,percent of total billed charges,,257.1,814.15,
PRQ CARD REVASC CHRONIC ADDL,92944T,CDM,92944,CPT,,,both,T,181,181,,,,,,,,,,,,,,,,,,,,153.85,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,54.3,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,,,,,,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,54.3,171.95,
HEART/LUNG RESUSCITATION CPR,92950,CDM,92950,CPT,,,both,,1428,1428,282.59,,,,fee schedule,,,,,,,,112.5,,,,fee schedule,,,1213.8,85,,percent of total billed charges,,399.68,,,,fee schedule,,192.84,,,,fee schedule,,112.5,,,,fee schedule,,313.9,,,,fee schedule,,112.5,,,,fee schedule,,300.82,,,,fee schedule,,182.31,,,,fee schedule,,182.31,,,,fee schedule,,,1299.48,91,,percent of total billed charges,,,1356.6,95,,percent of total billed charges,,,1185.24,83,,percent of total billed charges,,,428.4,83,,percent of total billed charges,,112.5,,,,fee schedule,,112.5,,,,fee schedule,,,1185.24,83,,percent of total billed charges,,268,,,,fee schedule,,,1285.2,90,,percent of total billed charges,,,1285.2,90,,percent of total billed charges,,,1285.2,90,,percent of total billed charges,,,1285.2,90,,percent of total billed charges,,,1213.8,85,,percent of total billed charges,,112.5,1356.6,
"CARDIOVERSION ELECTRIC, EXT",92960,CDM,92960,CPT,,,both,,905,905,167.56,,,,fee schedule,,,,,,,,112.4,,,,fee schedule,,,769.25,85,,percent of total billed charges,,230.17,,,,fee schedule,,111.05,,,,fee schedule,,112.4,,,,fee schedule,,218.86,,,,fee schedule,,112.4,,,,fee schedule,,178.37,,,,fee schedule,,108.1,,,,fee schedule,,108.1,,,,fee schedule,,,823.55,91,,percent of total billed charges,,,859.75,95,,percent of total billed charges,,,751.15,83,,percent of total billed charges,,,271.5,83,,percent of total billed charges,,112.4,,,,fee schedule,,112.4,,,,fee schedule,,,751.15,83,,percent of total billed charges,,158.91,,,,fee schedule,,,814.5,90,,percent of total billed charges,,,814.5,90,,percent of total billed charges,,,814.5,90,,percent of total billed charges,,,814.5,90,,percent of total billed charges,,,769.25,85,,percent of total billed charges,,108.1,859.75,
"CARDIOVERSION, ELECTRIC, INT",92961,CDM,92961,CPT,,,both,,678,678,376.08,,,,fee schedule,,,,,,,,112.4,,,,fee schedule,,,576.3,85,,percent of total billed charges,,536.56,,,,fee schedule,,258.88,,,,fee schedule,,112.4,,,,fee schedule,,435.21,,,,fee schedule,,112.4,,,,fee schedule,,400.34,,,,fee schedule,,242.63,,,,fee schedule,,242.63,,,,fee schedule,,,616.98,91,,percent of total billed charges,,,644.1,95,,percent of total billed charges,,,562.74,83,,percent of total billed charges,,,203.4,83,,percent of total billed charges,,112.4,,,,fee schedule,,112.4,,,,fee schedule,,,562.74,83,,percent of total billed charges,,356.67,,,,fee schedule,,,610.2,90,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,610.2,90,,percent of total billed charges,,,576.3,85,,percent of total billed charges,,112.4,644.1,
"INTRAVASC US, HEART ADD-ON",92978,CDM,92978,CPT,,,both,,318,318,,,,,,,,,,,,,120.7,,,,fee schedule,,,270.3,85,,percent of total billed charges,,206.43,,,,fee schedule,,99.6,,,,fee schedule,,120.7,,,,fee schedule,,460.85,,,,fee schedule,,120.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,289.38,91,,percent of total billed charges,,,302.1,95,,percent of total billed charges,,,263.94,83,,percent of total billed charges,,,95.4,83,,percent of total billed charges,,120.7,,,,fee schedule,,120.7,,,,fee schedule,,,263.94,83,,percent of total billed charges,,,,,,,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,286.2,90,,percent of total billed charges,,,270.3,85,,percent of total billed charges,,95.4,460.85,
"INTRAVASC US, HEART ADD-ON",92978P,CDM,92978,CPT,,,both,P,163,163,,,,,,,,,,,,,120.7,,,,fee schedule,,,138.55,85,,percent of total billed charges,,206.43,,,,fee schedule,,99.6,,,,fee schedule,,120.7,,,,fee schedule,,460.85,,,,fee schedule,,120.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,48.9,83,,percent of total billed charges,,120.7,,,,fee schedule,,120.7,,,,fee schedule,,,135.29,83,,percent of total billed charges,,,,,,,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,48.9,460.85,
"INTRAVASC US, HEART ADD-ON",92978T,CDM,92978,CPT,,,both,T,155,155,,,,,,,,,,,,,120.7,,,,fee schedule,,,131.75,85,,percent of total billed charges,,206.43,,,,fee schedule,,99.6,,,,fee schedule,,120.7,,,,fee schedule,,460.85,,,,fee schedule,,120.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,120.7,,,,fee schedule,,120.7,,,,fee schedule,,,128.65,83,,percent of total billed charges,,,,,,,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,46.5,460.85,
"INTRAVASC US, HEART ADD-ON",92979,CDM,92979,CPT,,,both,,227,227,,,,,,,,,,,,,74.2,,,,fee schedule,,,192.95,85,,percent of total billed charges,,164.7,,,,fee schedule,,79.46,,,,fee schedule,,74.2,,,,fee schedule,,280.14,,,,fee schedule,,74.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,206.57,91,,percent of total billed charges,,,215.65,95,,percent of total billed charges,,,188.41,83,,percent of total billed charges,,,68.1,83,,percent of total billed charges,,74.2,,,,fee schedule,,74.2,,,,fee schedule,,,188.41,83,,percent of total billed charges,,,,,,,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,204.3,90,,percent of total billed charges,,,192.95,85,,percent of total billed charges,,68.1,280.14,
"INTRAVASC US, HEART ADD-ON",92979P,CDM,92979,CPT,,,both,P,77,77,,,,,,,,,,,,,74.2,,,,fee schedule,,,65.45,85,,percent of total billed charges,,164.7,,,,fee schedule,,79.46,,,,fee schedule,,74.2,,,,fee schedule,,280.14,,,,fee schedule,,74.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,74.2,,,,fee schedule,,74.2,,,,fee schedule,,,63.91,83,,percent of total billed charges,,,,,,,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,23.1,280.14,
"INTRAVASC US, HEART ADD-ON",92979T,CDM,92979,CPT,,,both,T,150,150,,,,,,,,,,,,,74.2,,,,fee schedule,,,127.5,85,,percent of total billed charges,,164.7,,,,fee schedule,,79.46,,,,fee schedule,,74.2,,,,fee schedule,,280.14,,,,fee schedule,,74.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,74.2,,,,fee schedule,,74.2,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,45,280.14,
ECG ROUTINE ECG W/LEAST 12 LDS W/I/R,93000,CDM,93000,CPT,,,both,,215,215,22.59,,,,fee schedule,,,,,,,,66.45,,,,fee schedule,,,182.75,85,,percent of total billed charges,,32.34,,,,fee schedule,,14.47,,,,fee schedule,,66.45,,,,fee schedule,,44.4,,,,fee schedule,,66.45,,,,fee schedule,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,195.65,91,,percent of total billed charges,,,204.25,95,,percent of total billed charges,,,178.45,83,,percent of total billed charges,,,64.5,83,,percent of total billed charges,,66.45,,,,fee schedule,,66.45,,,,fee schedule,,,178.45,83,,percent of total billed charges,,21.42,,,,fee schedule,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,193.5,90,,percent of total billed charges,,,182.75,85,,percent of total billed charges,,14.47,204.25,
ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I/R,93005,CDM,93005,CPT,,,both,,123,123,9.98,,,,fee schedule,,,,,,,,33.15,,,,fee schedule,,,104.55,85,,percent of total billed charges,,13.38,,,,fee schedule,,5.99,,,,fee schedule,,33.15,,,,fee schedule,,29.39,,,,fee schedule,,33.15,,,,fee schedule,,10.62,,,,fee schedule,,6.44,,,,fee schedule,,6.44,,,,fee schedule,,,111.93,91,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,36.9,83,,percent of total billed charges,,33.15,,,,fee schedule,,33.15,,,,fee schedule,,,102.09,83,,percent of total billed charges,,9.46,,,,fee schedule,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,104.55,85,,percent of total billed charges,,5.99,116.85,
ELECTROCARDIOGRAM TRACING,93005T,CDM,93005,CPT,,,both,T,123,123,9.98,,,,fee schedule,,,,,,,,33.15,,,,fee schedule,,,104.55,85,,percent of total billed charges,,13.38,,,,fee schedule,,5.99,,,,fee schedule,,33.15,,,,fee schedule,,29.39,,,,fee schedule,,33.15,,,,fee schedule,,10.62,,,,fee schedule,,6.44,,,,fee schedule,,6.44,,,,fee schedule,,,111.93,91,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,36.9,83,,percent of total billed charges,,33.15,,,,fee schedule,,33.15,,,,fee schedule,,,102.09,83,,percent of total billed charges,,9.46,,,,fee schedule,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,104.55,85,,percent of total billed charges,,5.99,116.85,
ECG ROUTINE ECG W/LEAST 12 LDS I/R ONLY,93010,CDM,93010,CPT,,,both,,92,92,12.61,,,,fee schedule,,,,,,,,55.25,,,,fee schedule,,,78.2,85,,percent of total billed charges,,18.96,,,,fee schedule,,8.49,,,,fee schedule,,55.25,,,,fee schedule,,15.01,,,,fee schedule,,55.25,,,,fee schedule,,13.42,,,,fee schedule,,8.13,,,,fee schedule,,8.13,,,,fee schedule,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,27.6,83,,percent of total billed charges,,55.25,,,,fee schedule,,55.25,,,,fee schedule,,,76.36,83,,percent of total billed charges,,11.96,,,,fee schedule,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,8.13,87.4,
ELECTROCARDIOGRAM REPORT,93010P,CDM,93010,CPT,,,both,P,92,92,12.61,,,,fee schedule,,,,,,,,55.25,,,,fee schedule,,,78.2,85,,percent of total billed charges,,18.96,,,,fee schedule,,8.49,,,,fee schedule,,55.25,,,,fee schedule,,15.01,,,,fee schedule,,55.25,,,,fee schedule,,13.42,,,,fee schedule,,8.13,,,,fee schedule,,8.13,,,,fee schedule,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,27.6,83,,percent of total billed charges,,55.25,,,,fee schedule,,55.25,,,,fee schedule,,,76.36,83,,percent of total billed charges,,11.96,,,,fee schedule,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,8.13,87.4,
ELECTROCARDIOGRAM REPORT,93010T,CDM,93010,CPT,,,both,T,11,11,12.61,,,,fee schedule,,,,,,,,55.25,,,,fee schedule,,,9.35,85,,percent of total billed charges,,18.96,,,,fee schedule,,8.49,,,,fee schedule,,55.25,,,,fee schedule,,15.01,,,,fee schedule,,55.25,,,,fee schedule,,13.42,,,,fee schedule,,8.13,,,,fee schedule,,8.13,,,,fee schedule,,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,3.3,83,,percent of total billed charges,,55.25,,,,fee schedule,,55.25,,,,fee schedule,,,9.13,83,,percent of total billed charges,,11.96,,,,fee schedule,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,3.3,55.25,
CARDIOVASCULAR STRESS TEST,93015,CDM,93015,CPT,,,both,,556,556,110.3,,,,fee schedule,,,,,,,,67.9,,,,fee schedule,,,472.6,85,,percent of total billed charges,,147.63,,,,fee schedule,,71.23,,,,fee schedule,,67.9,,,,fee schedule,,178.21,,,,fee schedule,,67.9,,,,fee schedule,,117.42,,,,fee schedule,,71.16,,,,fee schedule,,71.16,,,,fee schedule,,,505.96,91,,percent of total billed charges,,,528.2,95,,percent of total billed charges,,,461.48,83,,percent of total billed charges,,,166.8,83,,percent of total billed charges,,67.9,,,,fee schedule,,67.9,,,,fee schedule,,,461.48,83,,percent of total billed charges,,104.61,,,,fee schedule,,,500.4,90,,percent of total billed charges,,,500.4,90,,percent of total billed charges,,,500.4,90,,percent of total billed charges,,,500.4,90,,percent of total billed charges,,,472.6,85,,percent of total billed charges,,67.9,528.2,
CARDIOVASCULAR STRESS TEST,93016,CDM,93016,CPT,,,both,,187,187,32.57,,,,fee schedule,,,,,,,,21.6,,,,fee schedule,,,158.95,85,,percent of total billed charges,,46.06,,,,fee schedule,,22.23,,,,fee schedule,,21.6,,,,fee schedule,,40.02,,,,fee schedule,,21.6,,,,fee schedule,,34.67,,,,fee schedule,,21.01,,,,fee schedule,,21.01,,,,fee schedule,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,56.1,83,,percent of total billed charges,,21.6,,,,fee schedule,,21.6,,,,fee schedule,,,155.21,83,,percent of total billed charges,,30.88,,,,fee schedule,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,21.01,177.65,
CARDIOVASCULAR STRESS TEST,93016P,CDM,93016,CPT,,,both,P,155,155,32.57,,,,fee schedule,,,,,,,,21.6,,,,fee schedule,,,131.75,85,,percent of total billed charges,,46.06,,,,fee schedule,,22.23,,,,fee schedule,,21.6,,,,fee schedule,,40.02,,,,fee schedule,,21.6,,,,fee schedule,,34.67,,,,fee schedule,,21.01,,,,fee schedule,,21.01,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,21.6,,,,fee schedule,,21.6,,,,fee schedule,,,128.65,83,,percent of total billed charges,,30.88,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,21.01,147.25,
CARDIOVASCULAR STRESS TEST,93016T,CDM,93016,CPT,,,both,T,32,32,32.57,,,,fee schedule,,,,,,,,21.6,,,,fee schedule,,,27.2,85,,percent of total billed charges,,46.06,,,,fee schedule,,22.23,,,,fee schedule,,21.6,,,,fee schedule,,40.02,,,,fee schedule,,21.6,,,,fee schedule,,34.67,,,,fee schedule,,21.01,,,,fee schedule,,21.01,,,,fee schedule,,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,9.6,83,,percent of total billed charges,,21.6,,,,fee schedule,,21.6,,,,fee schedule,,,26.56,83,,percent of total billed charges,,30.88,,,,fee schedule,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,9.6,46.06,
STRESS TEST,93017,CDM,93017,CPT,,,both,,219,219,56.2,,,,fee schedule,,,,,,,,27.9,,,,fee schedule,,,186.15,85,,percent of total billed charges,,70.92,,,,fee schedule,,34.22,,,,fee schedule,,27.9,,,,fee schedule,,111.93,,,,fee schedule,,27.9,,,,fee schedule,,59.83,,,,fee schedule,,36.26,,,,fee schedule,,36.26,,,,fee schedule,,,199.29,91,,percent of total billed charges,,,208.05,95,,percent of total billed charges,,,181.77,83,,percent of total billed charges,,,65.7,83,,percent of total billed charges,,27.9,,,,fee schedule,,27.9,,,,fee schedule,,,181.77,83,,percent of total billed charges,,53.3,,,,fee schedule,,,197.1,90,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,186.15,85,,percent of total billed charges,,27.9,208.05,
CARDIOVASCULAR STRESS TEST,93017 P,CDM,93017,CPT,,,both, P,102,102,56.2,,,,fee schedule,,,,,,,,27.9,,,,fee schedule,,,86.7,85,,percent of total billed charges,,70.92,,,,fee schedule,,34.22,,,,fee schedule,,27.9,,,,fee schedule,,111.93,,,,fee schedule,,27.9,,,,fee schedule,,59.83,,,,fee schedule,,36.26,,,,fee schedule,,36.26,,,,fee schedule,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,30.6,83,,percent of total billed charges,,27.9,,,,fee schedule,,27.9,,,,fee schedule,,,84.66,83,,percent of total billed charges,,53.3,,,,fee schedule,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,27.9,111.93,
CARDIOVASCULAR STRESS TEST,93017T,CDM,93017,CPT,,,both,T,117,117,56.2,,,,fee schedule,,,,,,,,27.9,,,,fee schedule,,,99.45,85,,percent of total billed charges,,70.92,,,,fee schedule,,34.22,,,,fee schedule,,27.9,,,,fee schedule,,111.93,,,,fee schedule,,27.9,,,,fee schedule,,59.83,,,,fee schedule,,36.26,,,,fee schedule,,36.26,,,,fee schedule,,,106.47,91,,percent of total billed charges,,,111.15,95,,percent of total billed charges,,,97.11,83,,percent of total billed charges,,,35.1,83,,percent of total billed charges,,27.9,,,,fee schedule,,27.9,,,,fee schedule,,,97.11,83,,percent of total billed charges,,53.3,,,,fee schedule,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,105.3,90,,percent of total billed charges,,,99.45,85,,percent of total billed charges,,27.9,111.93,
CARDIOVASCULAR STRESS TEST,93018,CDM,93018,CPT,,,both,,116,116,21.54,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,98.6,85,,percent of total billed charges,,30.64,,,,fee schedule,,14.78,,,,fee schedule,,22.15,,,,fee schedule,,26.26,,,,fee schedule,,22.15,,,,fee schedule,,22.92,,,,fee schedule,,13.89,,,,fee schedule,,13.89,,,,fee schedule,,,105.56,91,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,34.8,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,96.28,83,,percent of total billed charges,,20.42,,,,fee schedule,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,98.6,85,,percent of total billed charges,,13.89,110.2,
CARDIOVASCULAR STRESS TEST,93018P,CDM,93018,CPT,,,both,P,97,97,21.54,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,82.45,85,,percent of total billed charges,,30.64,,,,fee schedule,,14.78,,,,fee schedule,,22.15,,,,fee schedule,,26.26,,,,fee schedule,,22.15,,,,fee schedule,,22.92,,,,fee schedule,,13.89,,,,fee schedule,,13.89,,,,fee schedule,,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,29.1,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,80.51,83,,percent of total billed charges,,20.42,,,,fee schedule,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,13.89,92.15,
CARDIOVASCULAR STRESS TEST,93018T,CDM,93018,CPT,,,both,T,19,19,21.54,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,16.15,85,,percent of total billed charges,,30.64,,,,fee schedule,,14.78,,,,fee schedule,,22.15,,,,fee schedule,,26.26,,,,fee schedule,,22.15,,,,fee schedule,,22.92,,,,fee schedule,,13.89,,,,fee schedule,,13.89,,,,fee schedule,,,17.29,91,,percent of total billed charges,,,18.05,95,,percent of total billed charges,,,15.77,83,,percent of total billed charges,,,5.7,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,15.77,83,,percent of total billed charges,,20.42,,,,fee schedule,,,17.1,90,,percent of total billed charges,,,17.1,90,,percent of total billed charges,,,17.1,90,,percent of total billed charges,,,17.1,90,,percent of total billed charges,,,16.15,85,,percent of total billed charges,,5.7,30.64,
"ECG MONITOR/REPORT, UP TO 48 HRS",93224,CDM,93224,CPT,,,both,,696,696,113.98,,,,fee schedule,,,,,,,,180.3,,,,fee schedule,,,591.6,85,,percent of total billed charges,,154.36,,,,fee schedule,,74.48,,,,fee schedule,,180.3,,,,fee schedule,,273.26,,,,fee schedule,,180.3,,,,fee schedule,,121.33,,,,fee schedule,,73.54,,,,fee schedule,,73.54,,,,fee schedule,,,633.36,91,,percent of total billed charges,,,661.2,95,,percent of total billed charges,,,577.68,83,,percent of total billed charges,,,208.8,83,,percent of total billed charges,,180.3,,,,fee schedule,,180.3,,,,fee schedule,,,577.68,83,,percent of total billed charges,,108.1,,,,fee schedule,,,626.4,90,,percent of total billed charges,,,626.4,90,,percent of total billed charges,,,626.4,90,,percent of total billed charges,,,626.4,90,,percent of total billed charges,,,591.6,85,,percent of total billed charges,,73.54,661.2,
"ECG MONITOR/REPORT, UP TO 48 HRS",93224P,CDM,93224,CPT,,,both,P,525,525,113.98,,,,fee schedule,,,,,,,,180.3,,,,fee schedule,,,446.25,85,,percent of total billed charges,,154.36,,,,fee schedule,,74.48,,,,fee schedule,,180.3,,,,fee schedule,,273.26,,,,fee schedule,,180.3,,,,fee schedule,,121.33,,,,fee schedule,,73.54,,,,fee schedule,,73.54,,,,fee schedule,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,157.5,83,,percent of total billed charges,,180.3,,,,fee schedule,,180.3,,,,fee schedule,,,435.75,83,,percent of total billed charges,,108.1,,,,fee schedule,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,73.54,498.75,
"ECG MONITOR/REPORT, UP TO 48 HRS",93224T,CDM,93224,CPT,,,both,T,171,171,113.98,,,,fee schedule,,,,,,,,180.3,,,,fee schedule,,,145.35,85,,percent of total billed charges,,154.36,,,,fee schedule,,74.48,,,,fee schedule,,180.3,,,,fee schedule,,273.26,,,,fee schedule,,180.3,,,,fee schedule,,121.33,,,,fee schedule,,73.54,,,,fee schedule,,73.54,,,,fee schedule,,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,51.3,83,,percent of total billed charges,,180.3,,,,fee schedule,,180.3,,,,fee schedule,,,141.93,83,,percent of total billed charges,,108.1,,,,fee schedule,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,51.3,273.26,
ECG MONITOR/REPORT-Recording Only,93225,CDM,93225,CPT,,,both,,188,188,28.89,,,,fee schedule,,,,,,,,135.9,,,,fee schedule,,,159.8,85,,percent of total billed charges,,38.85,,,,fee schedule,,18.75,,,,fee schedule,,135.9,,,,fee schedule,,82.54,,,,fee schedule,,135.9,,,,fee schedule,,30.75,,,,fee schedule,,18.64,,,,fee schedule,,18.64,,,,fee schedule,,,171.08,91,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,56.4,83,,percent of total billed charges,,135.9,,,,fee schedule,,135.9,,,,fee schedule,,,156.04,83,,percent of total billed charges,,27.4,,,,fee schedule,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,18.64,178.6,
"ECG MONITOR/REPORT, 24 HRS",93226,CDM,93226,CPT,,,both,,388,388,56.73,,,,fee schedule,,,,,,,,44.4,,,,fee schedule,,,329.8,85,,percent of total billed charges,,76.14,,,,fee schedule,,36.74,,,,fee schedule,,44.4,,,,fee schedule,,145.07,,,,fee schedule,,44.4,,,,fee schedule,,60.39,,,,fee schedule,,36.6,,,,fee schedule,,36.6,,,,fee schedule,,,353.08,91,,percent of total billed charges,,,368.6,95,,percent of total billed charges,,,322.04,83,,percent of total billed charges,,,116.4,83,,percent of total billed charges,,44.4,,,,fee schedule,,44.4,,,,fee schedule,,,322.04,83,,percent of total billed charges,,53.8,,,,fee schedule,,,349.2,90,,percent of total billed charges,,,349.2,90,,percent of total billed charges,,,349.2,90,,percent of total billed charges,,,349.2,90,,percent of total billed charges,,,329.8,85,,percent of total billed charges,,36.6,368.6,
"ECG MONITOR/REVIEW, 24 HRS",93227,CDM,93227,CPT,,,both,,189,189,28.36,,,,fee schedule,,,,,,,,44.4,,,,fee schedule,,,160.65,85,,percent of total billed charges,,39.37,,,,fee schedule,,18.99,,,,fee schedule,,44.4,,,,fee schedule,,45.65,,,,fee schedule,,44.4,,,,fee schedule,,30.19,,,,fee schedule,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,171.99,91,,percent of total billed charges,,,179.55,95,,percent of total billed charges,,,156.87,83,,percent of total billed charges,,,56.7,83,,percent of total billed charges,,44.4,,,,fee schedule,,44.4,,,,fee schedule,,,156.87,83,,percent of total billed charges,,26.9,,,,fee schedule,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,170.1,90,,percent of total billed charges,,,160.65,85,,percent of total billed charges,,18.3,179.55,
"ECG MONITOR/REVIEW, UP TO 48 HRS",93227P,CDM,93227,CPT,,,both,P,39,39,28.36,,,,fee schedule,,,,,,,,44.4,,,,fee schedule,,,33.15,85,,percent of total billed charges,,39.37,,,,fee schedule,,18.99,,,,fee schedule,,44.4,,,,fee schedule,,45.65,,,,fee schedule,,44.4,,,,fee schedule,,30.19,,,,fee schedule,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,35.49,91,,percent of total billed charges,,,37.05,95,,percent of total billed charges,,,32.37,83,,percent of total billed charges,,,11.7,83,,percent of total billed charges,,44.4,,,,fee schedule,,44.4,,,,fee schedule,,,32.37,83,,percent of total billed charges,,26.9,,,,fee schedule,,,35.1,90,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,35.1,90,,percent of total billed charges,,,33.15,85,,percent of total billed charges,,11.7,45.65,
"ECG MONITOR/REVIEW, UP TO 48 HRS",93227T,CDM,93227,CPT,,,both,T,150,150,28.36,,,,fee schedule,,,,,,,,44.4,,,,fee schedule,,,127.5,85,,percent of total billed charges,,39.37,,,,fee schedule,,18.99,,,,fee schedule,,44.4,,,,fee schedule,,45.65,,,,fee schedule,,44.4,,,,fee schedule,,30.19,,,,fee schedule,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,44.4,,,,fee schedule,,44.4,,,,fee schedule,,,124.5,83,,percent of total billed charges,,26.9,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,18.3,142.5,
REMOTE 0-30 DAY ECG REV/REPORT,93228,CDM,93228,CPT,,,both,,111,111,39.39,,,,fee schedule,,,,,,,,21.6,,,,fee schedule,,,94.35,85,,percent of total billed charges,,54.8,,,,fee schedule,,26.44,,,,fee schedule,,21.6,,,,fee schedule,,,,,,,,21.6,,,,fee schedule,,41.94,,,,fee schedule,,25.42,,,,fee schedule,,25.42,,,,fee schedule,,,101.01,91,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,33.3,83,,percent of total billed charges,,21.6,,,,fee schedule,,21.6,,,,fee schedule,,,92.13,83,,percent of total billed charges,,37.36,,,,fee schedule,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,94.35,85,,percent of total billed charges,,21.6,105.45,
EXT ECG>72HR<7D RECORDING,93242,CDM,93242,CPT,,,both,,639,639,18.91,,,,fee schedule,,,,,,,,8.46,,,,fee schedule,,,543.15,85,,percent of total billed charges,,28.68,,,,fee schedule,,13.84,,,,fee schedule,,8.46,,,,fee schedule,,,,,,,,8.46,,,,fee schedule,,20.13,,,,fee schedule,,12.2,,,,fee schedule,,12.2,,,,fee schedule,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,191.7,83,,percent of total billed charges,,8.46,,,,fee schedule,,8.46,,,,fee schedule,,,530.37,83,,percent of total billed charges,,17.93,,,,fee schedule,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,8.46,607.05,
EXT ECG>72HR<7D REV&INTERPJ,93244,CDM,93244,CPT,,,both,,165,165,36.24,,,,fee schedule,,,,,,,,14.59,,,,fee schedule,,,140.25,85,,percent of total billed charges,,51.82,,,,fee schedule,,25,,,,fee schedule,,14.59,,,,fee schedule,,,,,,,,14.59,,,,fee schedule,,38.58,,,,fee schedule,,23.38,,,,fee schedule,,23.38,,,,fee schedule,,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,49.5,83,,percent of total billed charges,,14.59,,,,fee schedule,,14.59,,,,fee schedule,,,136.95,83,,percent of total billed charges,,34.37,,,,fee schedule,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,14.59,156.75,
EXT ECG>7D<15D RECORDING,93246,CDM,93246,CPT,,,both,,639,639,18.91,,,,fee schedule,,,,,,,,8.46,,,,fee schedule,,,543.15,85,,percent of total billed charges,,28.68,,,,fee schedule,,13.84,,,,fee schedule,,8.46,,,,fee schedule,,,,,,,,8.46,,,,fee schedule,,20.13,,,,fee schedule,,12.2,,,,fee schedule,,12.2,,,,fee schedule,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,191.7,83,,percent of total billed charges,,8.46,,,,fee schedule,,8.46,,,,fee schedule,,,530.37,83,,percent of total billed charges,,17.93,,,,fee schedule,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,8.46,607.05,
EXT ECG>7D<15D REV&INTERPJ,93248,CDM,93248,CPT,,,both,,165,165,39.92,,,,fee schedule,,,,,,,,16.02,,,,fee schedule,,,140.25,85,,percent of total billed charges,,56.89,,,,fee schedule,,27.45,,,,fee schedule,,16.02,,,,fee schedule,,,,,,,,16.02,,,,fee schedule,,42.49,,,,fee schedule,,25.75,,,,fee schedule,,25.75,,,,fee schedule,,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,49.5,83,,percent of total billed charges,,16.02,,,,fee schedule,,16.02,,,,fee schedule,,,136.95,83,,percent of total billed charges,,37.86,,,,fee schedule,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,16.02,156.75,
"ECG/REVIEW, INTERPRET ONLY",93272,CDM,93272,CPT,,,both,,155,155,37.29,,,,fee schedule,,,,,,,,21.6,,,,fee schedule,,,131.75,85,,percent of total billed charges,,52.62,,,,fee schedule,,25.39,,,,fee schedule,,21.6,,,,fee schedule,,45.65,,,,fee schedule,,21.6,,,,fee schedule,,39.7,,,,fee schedule,,24.06,,,,fee schedule,,24.06,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,21.6,,,,fee schedule,,21.6,,,,fee schedule,,,128.65,83,,percent of total billed charges,,35.37,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,21.6,147.25,
"ECG/REVIEW, INTERPRET ONLY",93272P,CDM,93272,CPT,,,both,P,63,63,37.29,,,,fee schedule,,,,,,,,21.6,,,,fee schedule,,,53.55,85,,percent of total billed charges,,52.62,,,,fee schedule,,25.39,,,,fee schedule,,21.6,,,,fee schedule,,45.65,,,,fee schedule,,21.6,,,,fee schedule,,39.7,,,,fee schedule,,24.06,,,,fee schedule,,24.06,,,,fee schedule,,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,18.9,83,,percent of total billed charges,,21.6,,,,fee schedule,,21.6,,,,fee schedule,,,52.29,83,,percent of total billed charges,,35.37,,,,fee schedule,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,18.9,59.85,
"ECG/REVIEW, INTERPRET ONLY",93272T,CDM,93272,CPT,,,both,T,92,92,37.29,,,,fee schedule,,,,,,,,21.6,,,,fee schedule,,,78.2,85,,percent of total billed charges,,52.62,,,,fee schedule,,25.39,,,,fee schedule,,21.6,,,,fee schedule,,45.65,,,,fee schedule,,21.6,,,,fee schedule,,39.7,,,,fee schedule,,24.06,,,,fee schedule,,24.06,,,,fee schedule,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,27.6,83,,percent of total billed charges,,21.6,,,,fee schedule,,21.6,,,,fee schedule,,,76.36,83,,percent of total billed charges,,35.37,,,,fee schedule,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,21.6,87.4,
"PM DEVICE PROGR EVAL,  SNGL",93279,CDM,93279,CPT,,,both,,170,170,106.63,,,,fee schedule,,,,,,,,31.65,,,,fee schedule,,,144.5,85,,percent of total billed charges,,67.04,,,,fee schedule,,32.34,,,,fee schedule,,31.65,,,,fee schedule,,,,,,,,31.65,,,,fee schedule,,113.51,,,,fee schedule,,68.79,,,,fee schedule,,68.79,,,,fee schedule,,,154.7,91,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,51,83,,percent of total billed charges,,31.65,,,,fee schedule,,31.65,,,,fee schedule,,,141.1,83,,percent of total billed charges,,101.12,,,,fee schedule,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,31.65,161.5,
"PM DEVICE PROGR EVAL,  DUAL",93280,CDM,93280,CPT,,,both,,197,197,125.01,,,,fee schedule,,,,,,,,37.21,,,,fee schedule,,,167.45,85,,percent of total billed charges,,81.11,,,,fee schedule,,39.13,,,,fee schedule,,37.21,,,,fee schedule,,,,,,,,37.21,,,,fee schedule,,133.08,,,,fee schedule,,80.65,,,,fee schedule,,80.65,,,,fee schedule,,,179.27,91,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,59.1,83,,percent of total billed charges,,37.21,,,,fee schedule,,37.21,,,,fee schedule,,,163.51,83,,percent of total billed charges,,118.56,,,,fee schedule,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,167.45,85,,percent of total billed charges,,37.21,187.15,
"ICD DEVICE PROG EVAL, 1 SNGL",93282,CDM,93282,CPT,,,both,,213,213,127.11,,,,fee schedule,,,,,,,,40.42,,,,fee schedule,,,181.05,85,,percent of total billed charges,,89.77,,,,fee schedule,,43.31,,,,fee schedule,,40.42,,,,fee schedule,,,,,,,,40.42,,,,fee schedule,,135.31,,,,fee schedule,,82.01,,,,fee schedule,,82.01,,,,fee schedule,,,193.83,91,,percent of total billed charges,,,202.35,95,,percent of total billed charges,,,176.79,83,,percent of total billed charges,,,63.9,83,,percent of total billed charges,,40.42,,,,fee schedule,,40.42,,,,fee schedule,,,176.79,83,,percent of total billed charges,,120.55,,,,fee schedule,,,191.7,90,,percent of total billed charges,,,191.7,90,,percent of total billed charges,,,191.7,90,,percent of total billed charges,,,191.7,90,,percent of total billed charges,,,181.05,85,,percent of total billed charges,,40.42,202.35,
"ICD DEVICE PROG EVAL, 1 SNGL",93282P,CDM,93282,CPT,,,both,P,87,87,127.11,,,,fee schedule,,,,,,,,40.42,,,,fee schedule,,,73.95,85,,percent of total billed charges,,89.77,,,,fee schedule,,43.31,,,,fee schedule,,40.42,,,,fee schedule,,,,,,,,40.42,,,,fee schedule,,135.31,,,,fee schedule,,82.01,,,,fee schedule,,82.01,,,,fee schedule,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,26.1,83,,percent of total billed charges,,40.42,,,,fee schedule,,40.42,,,,fee schedule,,,72.21,83,,percent of total billed charges,,120.55,,,,fee schedule,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,26.1,135.31,
"ICD DEVICE PROG EVAL, 1 SNGL",93282T,CDM,93282,CPT,,,both,T,126,126,127.11,,,,fee schedule,,,,,,,,40.42,,,,fee schedule,,,107.1,85,,percent of total billed charges,,89.77,,,,fee schedule,,43.31,,,,fee schedule,,40.42,,,,fee schedule,,,,,,,,40.42,,,,fee schedule,,135.31,,,,fee schedule,,82.01,,,,fee schedule,,82.01,,,,fee schedule,,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,37.8,83,,percent of total billed charges,,40.42,,,,fee schedule,,40.42,,,,fee schedule,,,104.58,83,,percent of total billed charges,,120.55,,,,fee schedule,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,37.8,135.31,
"ICD DEVICE PROGR EVAL, DUAL",93283,CDM,93283,CPT,,,both,,332,332,154.95,,,,fee schedule,,,,,,,,49.2,,,,fee schedule,,,282.2,85,,percent of total billed charges,,120.21,,,,fee schedule,,58,,,,fee schedule,,49.2,,,,fee schedule,,,,,,,,49.2,,,,fee schedule,,164.95,,,,fee schedule,,99.97,,,,fee schedule,,99.97,,,,fee schedule,,,302.12,91,,percent of total billed charges,,,315.4,95,,percent of total billed charges,,,275.56,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,49.2,,,,fee schedule,,49.2,,,,fee schedule,,,275.56,83,,percent of total billed charges,,146.95,,,,fee schedule,,,298.8,90,,percent of total billed charges,,,298.8,90,,percent of total billed charges,,,298.8,90,,percent of total billed charges,,,298.8,90,,percent of total billed charges,,,282.2,85,,percent of total billed charges,,49.2,315.4,
"ICD DEVICE PROGR EVAL, DUAL",93283P,CDM,93283,CPT,,,both,P,177,177,154.95,,,,fee schedule,,,,,,,,49.2,,,,fee schedule,,,150.45,85,,percent of total billed charges,,120.21,,,,fee schedule,,58,,,,fee schedule,,49.2,,,,fee schedule,,,,,,,,49.2,,,,fee schedule,,164.95,,,,fee schedule,,99.97,,,,fee schedule,,99.97,,,,fee schedule,,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,53.1,83,,percent of total billed charges,,49.2,,,,fee schedule,,49.2,,,,fee schedule,,,146.91,83,,percent of total billed charges,,146.95,,,,fee schedule,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,49.2,168.15,
"ICD DEVICE PROGR EVAL, DUAL",93283T,CDM,93283,CPT,,,both,T,155,155,154.95,,,,fee schedule,,,,,,,,49.2,,,,fee schedule,,,131.75,85,,percent of total billed charges,,120.21,,,,fee schedule,,58,,,,fee schedule,,49.2,,,,fee schedule,,,,,,,,49.2,,,,fee schedule,,164.95,,,,fee schedule,,99.97,,,,fee schedule,,99.97,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,49.2,,,,fee schedule,,49.2,,,,fee schedule,,,128.65,83,,percent of total billed charges,,146.95,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,46.5,164.95,
"ICD DEVICE PROGR EVAL, MULT",93284,CDM,93284,CPT,,,both,,370,370,167.03,,,,fee schedule,,,,,,,,57.53,,,,fee schedule,,,314.5,85,,percent of total billed charges,,130.36,,,,fee schedule,,62.9,,,,fee schedule,,57.53,,,,fee schedule,,,,,,,,57.53,,,,fee schedule,,177.81,,,,fee schedule,,107.76,,,,fee schedule,,107.76,,,,fee schedule,,,336.7,91,,percent of total billed charges,,,351.5,95,,percent of total billed charges,,,307.1,83,,percent of total billed charges,,,111,83,,percent of total billed charges,,57.53,,,,fee schedule,,57.53,,,,fee schedule,,,307.1,83,,percent of total billed charges,,158.41,,,,fee schedule,,,333,90,,percent of total billed charges,,,333,90,,percent of total billed charges,,,333,90,,percent of total billed charges,,,333,90,,percent of total billed charges,,,314.5,85,,percent of total billed charges,,57.53,351.5,
"ICD DEVICE PROGR EVAL, MULT",93284P,CDM,93284,CPT,,,both,P,210,210,167.03,,,,fee schedule,,,,,,,,57.53,,,,fee schedule,,,178.5,85,,percent of total billed charges,,130.36,,,,fee schedule,,62.9,,,,fee schedule,,57.53,,,,fee schedule,,,,,,,,57.53,,,,fee schedule,,177.81,,,,fee schedule,,107.76,,,,fee schedule,,107.76,,,,fee schedule,,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,63,83,,percent of total billed charges,,57.53,,,,fee schedule,,57.53,,,,fee schedule,,,174.3,83,,percent of total billed charges,,158.41,,,,fee schedule,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,57.53,199.5,
"ICD DEVICE PROGR EVAL, MULT",93284T,CDM,93284,CPT,,,both,T,160,160,167.03,,,,fee schedule,,,,,,,,57.53,,,,fee schedule,,,136,85,,percent of total billed charges,,130.36,,,,fee schedule,,62.9,,,,fee schedule,,57.53,,,,fee schedule,,,,,,,,57.53,,,,fee schedule,,177.81,,,,fee schedule,,107.76,,,,fee schedule,,107.76,,,,fee schedule,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,48,83,,percent of total billed charges,,57.53,,,,fee schedule,,57.53,,,,fee schedule,,,132.8,83,,percent of total billed charges,,158.41,,,,fee schedule,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,48,177.81,
PM DEVICE EVAL IN PERSON,93288,CDM,93288,CPT,,,both,,182,182,88.77,,,,fee schedule,,,,,,,,24.33,,,,fee schedule,,,154.7,85,,percent of total billed charges,,44.58,,,,fee schedule,,21.51,,,,fee schedule,,24.33,,,,fee schedule,,,,,,,,24.33,,,,fee schedule,,94.49,,,,fee schedule,,57.27,,,,fee schedule,,57.27,,,,fee schedule,,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,54.6,83,,percent of total billed charges,,24.33,,,,fee schedule,,24.33,,,,fee schedule,,,151.06,83,,percent of total billed charges,,84.19,,,,fee schedule,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,21.51,172.9,
ICD DEVICE INTERROGATE,93289,CDM,93289,CPT,,,both,,299,299,114.5,,,,fee schedule,,,,,,,,37.43,,,,fee schedule,,,254.15,85,,percent of total billed charges,,78.94,,,,fee schedule,,38.09,,,,fee schedule,,37.43,,,,fee schedule,,,,,,,,37.43,,,,fee schedule,,121.89,,,,fee schedule,,73.87,,,,fee schedule,,73.87,,,,fee schedule,,,272.09,91,,percent of total billed charges,,,284.05,95,,percent of total billed charges,,,248.17,83,,percent of total billed charges,,,89.7,83,,percent of total billed charges,,37.43,,,,fee schedule,,37.43,,,,fee schedule,,,248.17,83,,percent of total billed charges,,108.59,,,,fee schedule,,,269.1,90,,percent of total billed charges,,,269.1,90,,percent of total billed charges,,,269.1,90,,percent of total billed charges,,,269.1,90,,percent of total billed charges,,,254.15,85,,percent of total billed charges,,37.43,284.05,
ICD DEVICE INTERROGATE,9328926,CDM,93289,CPT,,,both,26,145,145,114.5,,,,fee schedule,,,,,,,,37.43,,,,fee schedule,,,123.25,85,,percent of total billed charges,,78.94,,,,fee schedule,,38.09,,,,fee schedule,,37.43,,,,fee schedule,,,,,,,,37.43,,,,fee schedule,,121.89,,,,fee schedule,,73.87,,,,fee schedule,,73.87,,,,fee schedule,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,43.5,83,,percent of total billed charges,,37.43,,,,fee schedule,,37.43,,,,fee schedule,,,120.35,83,,percent of total billed charges,,108.59,,,,fee schedule,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,37.43,137.75,
ICD DEVICE INTERROGATE,93289P,CDM,93289,CPT,,,both,P,145,145,114.5,,,,fee schedule,,,,,,,,37.43,,,,fee schedule,,,123.25,85,,percent of total billed charges,,78.94,,,,fee schedule,,38.09,,,,fee schedule,,37.43,,,,fee schedule,,,,,,,,37.43,,,,fee schedule,,121.89,,,,fee schedule,,73.87,,,,fee schedule,,73.87,,,,fee schedule,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,43.5,83,,percent of total billed charges,,37.43,,,,fee schedule,,37.43,,,,fee schedule,,,120.35,83,,percent of total billed charges,,108.59,,,,fee schedule,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,37.43,137.75,
ICD DEVICE INTERROGATE,93289T,CDM,93289,CPT,,,both,T,154,154,114.5,,,,fee schedule,,,,,,,,37.43,,,,fee schedule,,,130.9,85,,percent of total billed charges,,78.94,,,,fee schedule,,38.09,,,,fee schedule,,37.43,,,,fee schedule,,,,,,,,37.43,,,,fee schedule,,121.89,,,,fee schedule,,73.87,,,,fee schedule,,73.87,,,,fee schedule,,,140.14,91,,percent of total billed charges,,,146.3,95,,percent of total billed charges,,,127.82,83,,percent of total billed charges,,,46.2,83,,percent of total billed charges,,37.43,,,,fee schedule,,37.43,,,,fee schedule,,,127.82,83,,percent of total billed charges,,108.59,,,,fee schedule,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,138.6,90,,percent of total billed charges,,,130.9,85,,percent of total billed charges,,37.43,146.3,
ILR DEVICE INTERROGATE,93291,CDM,93291,CPT,,,both,,173,173,78.26,,,,fee schedule,,,,,,,,23.38,,,,fee schedule,,,147.05,85,,percent of total billed charges,,38.56,,,,fee schedule,,18.6,,,,fee schedule,,23.38,,,,fee schedule,,,,,,,,23.38,,,,fee schedule,,83.31,,,,fee schedule,,50.49,,,,fee schedule,,50.49,,,,fee schedule,,,157.43,91,,percent of total billed charges,,,164.35,95,,percent of total billed charges,,,143.59,83,,percent of total billed charges,,,51.9,83,,percent of total billed charges,,23.38,,,,fee schedule,,23.38,,,,fee schedule,,,143.59,83,,percent of total billed charges,,74.22,,,,fee schedule,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,155.7,90,,percent of total billed charges,,,147.05,85,,percent of total billed charges,,18.6,164.35,
PM DEVICE INTERROGATE REMOTE,93294,CDM,93294,CPT,,,both,,167,167,46.22,,,,fee schedule,,,,,,,,21.33,,,,fee schedule,,,141.95,85,,percent of total billed charges,,64.4,,,,fee schedule,,31.07,,,,fee schedule,,21.33,,,,fee schedule,,,,,,,,21.33,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,50.1,83,,percent of total billed charges,,21.33,,,,fee schedule,,21.33,,,,fee schedule,,,138.61,83,,percent of total billed charges,,43.84,,,,fee schedule,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,21.33,158.65,
PM DEVICE INTERROGATE REMOTE,93294P,CDM,93294,CPT,,,both,P,41,41,46.22,,,,fee schedule,,,,,,,,21.33,,,,fee schedule,,,34.85,85,,percent of total billed charges,,64.4,,,,fee schedule,,31.07,,,,fee schedule,,21.33,,,,fee schedule,,,,,,,,21.33,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,37.31,91,,percent of total billed charges,,,38.95,95,,percent of total billed charges,,,34.03,83,,percent of total billed charges,,,12.3,83,,percent of total billed charges,,21.33,,,,fee schedule,,21.33,,,,fee schedule,,,34.03,83,,percent of total billed charges,,43.84,,,,fee schedule,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,36.9,90,,percent of total billed charges,,,34.85,85,,percent of total billed charges,,12.3,64.4,
PM DEVICE INTERROGATE REMOTE,93294T,CDM,93294,CPT,,,both,T,126,126,46.22,,,,fee schedule,,,,,,,,21.33,,,,fee schedule,,,107.1,85,,percent of total billed charges,,64.4,,,,fee schedule,,31.07,,,,fee schedule,,21.33,,,,fee schedule,,,,,,,,21.33,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,37.8,83,,percent of total billed charges,,21.33,,,,fee schedule,,21.33,,,,fee schedule,,,104.58,83,,percent of total billed charges,,43.84,,,,fee schedule,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,21.33,119.7,
ICD DEVICE INTERROGAT REMOTE,93295,CDM,93295,CPT,,,both,,105,105,56.73,,,,fee schedule,,,,,,,,38.37,,,,fee schedule,,,89.25,85,,percent of total billed charges,,79.76,,,,fee schedule,,38.48,,,,fee schedule,,38.37,,,,fee schedule,,,,,,,,38.37,,,,fee schedule,,60.39,,,,fee schedule,,36.6,,,,fee schedule,,36.6,,,,fee schedule,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,31.5,83,,percent of total billed charges,,38.37,,,,fee schedule,,38.37,,,,fee schedule,,,87.15,83,,percent of total billed charges,,53.8,,,,fee schedule,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,31.5,99.75,
ICD DEVICE INTERROGAT REMOTE,93295P,CDM,93295,CPT,,,both,P,53,53,56.73,,,,fee schedule,,,,,,,,38.37,,,,fee schedule,,,45.05,85,,percent of total billed charges,,79.76,,,,fee schedule,,38.48,,,,fee schedule,,38.37,,,,fee schedule,,,,,,,,38.37,,,,fee schedule,,60.39,,,,fee schedule,,36.6,,,,fee schedule,,36.6,,,,fee schedule,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,38.37,,,,fee schedule,,38.37,,,,fee schedule,,,43.99,83,,percent of total billed charges,,53.8,,,,fee schedule,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,15.9,79.76,
ICD DEVICE INTERROGAT REMOTE,93295T,CDM,93295,CPT,,,both,T,52,52,56.73,,,,fee schedule,,,,,,,,38.37,,,,fee schedule,,,44.2,85,,percent of total billed charges,,79.76,,,,fee schedule,,38.48,,,,fee schedule,,38.37,,,,fee schedule,,,,,,,,38.37,,,,fee schedule,,60.39,,,,fee schedule,,36.6,,,,fee schedule,,36.6,,,,fee schedule,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,15.6,83,,percent of total billed charges,,38.37,,,,fee schedule,,38.37,,,,fee schedule,,,43.16,83,,percent of total billed charges,,53.8,,,,fee schedule,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,15.6,79.76,
ILR DEVICE INTERROGAT REMOTE,93298,CDM,93298,CPT,,,both,,146,146,40.44,,,,fee schedule,,,,,,,,17.11,,,,fee schedule,,,124.1,85,,percent of total billed charges,,56.42,,,,fee schedule,,27.22,,,,fee schedule,,17.11,,,,fee schedule,,,,,,,,17.11,,,,fee schedule,,43.05,,,,fee schedule,,26.09,,,,fee schedule,,26.09,,,,fee schedule,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,43.8,83,,percent of total billed charges,,17.11,,,,fee schedule,,17.11,,,,fee schedule,,,121.18,83,,percent of total billed charges,,38.36,,,,fee schedule,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,17.11,138.7,
ILR DEVICE INTERROGAT REMOTE,93298P,CDM,93298,CPT,,,both,P,54,54,40.44,,,,fee schedule,,,,,,,,17.11,,,,fee schedule,,,45.9,85,,percent of total billed charges,,56.42,,,,fee schedule,,27.22,,,,fee schedule,,17.11,,,,fee schedule,,,,,,,,17.11,,,,fee schedule,,43.05,,,,fee schedule,,26.09,,,,fee schedule,,26.09,,,,fee schedule,,,49.14,91,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,16.2,83,,percent of total billed charges,,17.11,,,,fee schedule,,17.11,,,,fee schedule,,,44.82,83,,percent of total billed charges,,38.36,,,,fee schedule,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,16.2,56.42,
ILR DEVICE INTERROGAT REMOTE,93298T,CDM,93298,CPT,,,both,T,92,92,40.44,,,,fee schedule,,,,,,,,17.11,,,,fee schedule,,,78.2,85,,percent of total billed charges,,56.42,,,,fee schedule,,27.22,,,,fee schedule,,17.11,,,,fee schedule,,,,,,,,17.11,,,,fee schedule,,43.05,,,,fee schedule,,26.09,,,,fee schedule,,26.09,,,,fee schedule,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,27.6,83,,percent of total billed charges,,17.11,,,,fee schedule,,17.11,,,,fee schedule,,,76.36,83,,percent of total billed charges,,38.36,,,,fee schedule,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,17.11,87.4,
ECHO TRANSTHORACIC Complete,93303,CDM,93303,CPT,,,both,,1266,1266,346.14,,,,fee schedule,,,,,,,,98.1,,,,fee schedule,,,1076.1,85,,percent of total billed charges,,132.04,,,,fee schedule,,63.71,,,,fee schedule,,98.1,,,,fee schedule,,369.56,,,,fee schedule,,98.1,,,,fee schedule,,368.47,,,,fee schedule,,223.32,,,,fee schedule,,223.32,,,,fee schedule,,,1152.06,91,,percent of total billed charges,,,1202.7,95,,percent of total billed charges,,,1050.78,83,,percent of total billed charges,,,379.8,83,,percent of total billed charges,,98.1,,,,fee schedule,,98.1,,,,fee schedule,,,1050.78,83,,percent of total billed charges,,328.28,,,,fee schedule,,,1139.4,90,,percent of total billed charges,,,1139.4,90,,percent of total billed charges,,,1139.4,90,,percent of total billed charges,,,1139.4,90,,percent of total billed charges,,,1076.1,85,,percent of total billed charges,,63.71,1202.7,
ECHO TRANSTHORACIC,9330326,CDM,93303,CPT,,,both,26,1079,1079,346.14,,,,fee schedule,,,,,,,,98.1,,,,fee schedule,,,917.15,85,,percent of total billed charges,,132.04,,,,fee schedule,,63.71,,,,fee schedule,,98.1,,,,fee schedule,,369.56,,,,fee schedule,,98.1,,,,fee schedule,,368.47,,,,fee schedule,,223.32,,,,fee schedule,,223.32,,,,fee schedule,,,981.89,91,,percent of total billed charges,,,1025.05,95,,percent of total billed charges,,,895.57,83,,percent of total billed charges,,,323.7,83,,percent of total billed charges,,98.1,,,,fee schedule,,98.1,,,,fee schedule,,,895.57,83,,percent of total billed charges,,328.28,,,,fee schedule,,,971.1,90,,percent of total billed charges,,,971.1,90,,percent of total billed charges,,,971.1,90,,percent of total billed charges,,,971.1,90,,percent of total billed charges,,,917.15,85,,percent of total billed charges,,63.71,1025.05,
ECHO TRANSTHORACIC,93303TC,CDM,93303,CPT,,,both,TC,187,187,346.14,,,,fee schedule,,,,,,,,98.1,,,,fee schedule,,,158.95,85,,percent of total billed charges,,132.04,,,,fee schedule,,63.71,,,,fee schedule,,98.1,,,,fee schedule,,369.56,,,,fee schedule,,98.1,,,,fee schedule,,368.47,,,,fee schedule,,223.32,,,,fee schedule,,223.32,,,,fee schedule,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,56.1,83,,percent of total billed charges,,98.1,,,,fee schedule,,98.1,,,,fee schedule,,,155.21,83,,percent of total billed charges,,328.28,,,,fee schedule,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,56.1,369.56,
US ECHO/COMPLETE,93306,CDM,93306,CPT,,,both,,403,403,307.8,,,,fee schedule,,,,,,,,91,,,,fee schedule,,,342.55,85,,percent of total billed charges,,148.2,,,,fee schedule,,71.51,,,,fee schedule,,91,,,,fee schedule,,,,,,,,91,,,,fee schedule,,327.66,,,,fee schedule,,198.58,,,,fee schedule,,198.58,,,,fee schedule,,,366.73,91,,percent of total billed charges,,,382.85,95,,percent of total billed charges,,,334.49,83,,percent of total billed charges,,,120.9,83,,percent of total billed charges,,91,,,,fee schedule,,91,,,,fee schedule,,,334.49,83,,percent of total billed charges,,291.91,,,,fee schedule,,,362.7,90,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,362.7,90,,percent of total billed charges,,,342.55,85,,percent of total billed charges,,71.51,382.85,
TTE W/DOPPLER COMPLETE,93306P,CDM,93306,CPT,,,both,P,291,291,307.8,,,,fee schedule,,,,,,,,91,,,,fee schedule,,,247.35,85,,percent of total billed charges,,148.2,,,,fee schedule,,71.51,,,,fee schedule,,91,,,,fee schedule,,,,,,,,91,,,,fee schedule,,327.66,,,,fee schedule,,198.58,,,,fee schedule,,198.58,,,,fee schedule,,,264.81,91,,percent of total billed charges,,,276.45,95,,percent of total billed charges,,,241.53,83,,percent of total billed charges,,,87.3,83,,percent of total billed charges,,91,,,,fee schedule,,91,,,,fee schedule,,,241.53,83,,percent of total billed charges,,291.91,,,,fee schedule,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,247.35,85,,percent of total billed charges,,71.51,327.66,
TTE W/DOPPLER COMPLETE,93306T,CDM,93306,CPT,,,both,T,112,112,307.8,,,,fee schedule,,,,,,,,91,,,,fee schedule,,,95.2,85,,percent of total billed charges,,148.2,,,,fee schedule,,71.51,,,,fee schedule,,91,,,,fee schedule,,,,,,,,91,,,,fee schedule,,327.66,,,,fee schedule,,198.58,,,,fee schedule,,198.58,,,,fee schedule,,,101.92,91,,percent of total billed charges,,,106.4,95,,percent of total billed charges,,,92.96,83,,percent of total billed charges,,,33.6,83,,percent of total billed charges,,91,,,,fee schedule,,91,,,,fee schedule,,,92.96,83,,percent of total billed charges,,291.91,,,,fee schedule,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,95.2,85,,percent of total billed charges,,33.6,327.66,
ECHO EXAM OF HEART,93307,CDM,93307,CPT,,,both,,1071,1071,214.83,,,,fee schedule,,,,,,,,91,,,,fee schedule,,,910.35,85,,percent of total billed charges,,94.29,,,,fee schedule,,45.5,,,,fee schedule,,91,,,,fee schedule,,337.04,,,,fee schedule,,91,,,,fee schedule,,228.69,,,,fee schedule,,138.6,,,,fee schedule,,138.6,,,,fee schedule,,,974.61,91,,percent of total billed charges,,,1017.45,95,,percent of total billed charges,,,888.93,83,,percent of total billed charges,,,321.3,83,,percent of total billed charges,,91,,,,fee schedule,,91,,,,fee schedule,,,888.93,83,,percent of total billed charges,,203.74,,,,fee schedule,,,963.9,90,,percent of total billed charges,,,963.9,90,,percent of total billed charges,,,963.9,90,,percent of total billed charges,,,963.9,90,,percent of total billed charges,,,910.35,85,,percent of total billed charges,,45.5,1017.45,
ECHO (Bubble) EXAM OF HEART,93308,CDM,93308,CPT,,,both,,171,171,154.42,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,145.35,85,,percent of total billed charges,,53.37,,,,fee schedule,,25.75,,,,fee schedule,,52.7,,,,fee schedule,,176.34,,,,fee schedule,,52.7,,,,fee schedule,,164.39,,,,fee schedule,,99.63,,,,fee schedule,,99.63,,,,fee schedule,,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,51.3,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,141.93,83,,percent of total billed charges,,146.45,,,,fee schedule,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,25.75,176.34,
ECHO TRANSESOPHAGEAL,93312,CDM,93312,CPT,,,both,,1170,1170,370.83,,,,fee schedule,,,,,,,,163.7,,,,fee schedule,,,994.5,85,,percent of total billed charges,,229.77,,,,fee schedule,,110.86,,,,fee schedule,,163.7,,,,fee schedule,,446.47,,,,fee schedule,,163.7,,,,fee schedule,,394.75,,,,fee schedule,,239.24,,,,fee schedule,,239.24,,,,fee schedule,,,1064.7,91,,percent of total billed charges,,,1111.5,95,,percent of total billed charges,,,971.1,83,,percent of total billed charges,,,351,83,,percent of total billed charges,,163.7,,,,fee schedule,,163.7,,,,fee schedule,,,971.1,83,,percent of total billed charges,,351.69,,,,fee schedule,,,1053,90,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,994.5,85,,percent of total billed charges,,110.86,1111.5,
ECHO TRANSESOPHAGEAL,9331226,CDM,93312,CPT,,,both,26,1170,1170,370.83,,,,fee schedule,,,,,,,,163.7,,,,fee schedule,,,994.5,85,,percent of total billed charges,,229.77,,,,fee schedule,,110.86,,,,fee schedule,,163.7,,,,fee schedule,,446.47,,,,fee schedule,,163.7,,,,fee schedule,,394.75,,,,fee schedule,,239.24,,,,fee schedule,,239.24,,,,fee schedule,,,1064.7,91,,percent of total billed charges,,,1111.5,95,,percent of total billed charges,,,971.1,83,,percent of total billed charges,,,351,83,,percent of total billed charges,,163.7,,,,fee schedule,,163.7,,,,fee schedule,,,971.1,83,,percent of total billed charges,,351.69,,,,fee schedule,,,1053,90,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,1053,90,,percent of total billed charges,,,994.5,85,,percent of total billed charges,,110.86,1111.5,
ECHO TRANSESOPHAGEAL,93313,CDM,93313,CPT,,,both,,389,389,17.33,,,,fee schedule,,,,,,,,111,,,,fee schedule,,,330.65,85,,percent of total billed charges,,24.48,,,,fee schedule,,11.81,,,,fee schedule,,111,,,,fee schedule,,76.29,,,,fee schedule,,111,,,,fee schedule,,18.45,,,,fee schedule,,11.18,,,,fee schedule,,11.18,,,,fee schedule,,,353.99,91,,percent of total billed charges,,,369.55,95,,percent of total billed charges,,,322.87,83,,percent of total billed charges,,,116.7,83,,percent of total billed charges,,111,,,,fee schedule,,111,,,,fee schedule,,,322.87,83,,percent of total billed charges,,16.44,,,,fee schedule,,,350.1,90,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,350.1,90,,percent of total billed charges,,,330.65,85,,percent of total billed charges,,11.18,369.55,
ECHO TRANSESOPHAGEAL,93314,CDM,93314,CPT,,,both,,849,849,357.7,,,,fee schedule,,,,,,,,94.3,,,,fee schedule,,,721.65,85,,percent of total billed charges,,194.05,,,,fee schedule,,93.63,,,,fee schedule,,94.3,,,,fee schedule,,365.18,,,,fee schedule,,94.3,,,,fee schedule,,380.77,,,,fee schedule,,230.77,,,,fee schedule,,230.77,,,,fee schedule,,,772.59,91,,percent of total billed charges,,,806.55,95,,percent of total billed charges,,,704.67,83,,percent of total billed charges,,,254.7,83,,percent of total billed charges,,94.3,,,,fee schedule,,94.3,,,,fee schedule,,,704.67,83,,percent of total billed charges,,339.23,,,,fee schedule,,,764.1,90,,percent of total billed charges,,,764.1,90,,percent of total billed charges,,,764.1,90,,percent of total billed charges,,,764.1,90,,percent of total billed charges,,,721.65,85,,percent of total billed charges,,93.63,806.55,
ECHO TRANSESOPHAGEAL,93315,CDM,93315,CPT,,,both,,849,849,,,,,,,,,,,,,163.7,,,,fee schedule,,,721.65,85,,percent of total billed charges,,269.62,,,,fee schedule,,130.09,,,,fee schedule,,163.7,,,,fee schedule,,,,,,,,163.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,772.59,91,,percent of total billed charges,,,806.55,95,,percent of total billed charges,,,704.67,83,,percent of total billed charges,,,254.7,83,,percent of total billed charges,,163.7,,,,fee schedule,,163.7,,,,fee schedule,,,704.67,83,,percent of total billed charges,,,,,,,,,764.1,90,,percent of total billed charges,,,764.1,90,,percent of total billed charges,,,764.1,90,,percent of total billed charges,,,764.1,90,,percent of total billed charges,,,721.65,85,,percent of total billed charges,,130.09,806.55,
ECHO TRANSESOPHAGEAL,93316,CDM,93316,CPT,,,both,,509,509,39.39,,,,fee schedule,,,,,,,,111,,,,fee schedule,,,432.65,85,,percent of total billed charges,,56.46,,,,fee schedule,,27.24,,,,fee schedule,,111,,,,fee schedule,,77.54,,,,fee schedule,,111,,,,fee schedule,,41.94,,,,fee schedule,,25.42,,,,fee schedule,,25.42,,,,fee schedule,,,463.19,91,,percent of total billed charges,,,483.55,95,,percent of total billed charges,,,422.47,83,,percent of total billed charges,,,152.7,83,,percent of total billed charges,,111,,,,fee schedule,,111,,,,fee schedule,,,422.47,83,,percent of total billed charges,,37.36,,,,fee schedule,,,458.1,90,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,458.1,90,,percent of total billed charges,,,432.65,85,,percent of total billed charges,,25.42,483.55,
ECHO TRANSESOPHAGEAL INTRAOP,93318,CDM,93318,CPT,,,both,,2559,2559,,,,,,,,,,,,,163.7,,,,fee schedule,,,2175.15,85,,percent of total billed charges,,219.9,,,,fee schedule,,106.1,,,,fee schedule,,163.7,,,,fee schedule,,,,,,,,163.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,2328.69,91,,percent of total billed charges,,,2431.05,95,,percent of total billed charges,,,2123.97,83,,percent of total billed charges,,,767.7,83,,percent of total billed charges,,163.7,,,,fee schedule,,163.7,,,,fee schedule,,,2123.97,83,,percent of total billed charges,,,,,,,,,2303.1,90,,percent of total billed charges,,,2303.1,90,,percent of total billed charges,,,2303.1,90,,percent of total billed charges,,,2303.1,90,,percent of total billed charges,,,2175.15,85,,percent of total billed charges,,106.1,2431.05,
US Echocardio/Stress Transthoracic W Or W/O Pharmalogical,93350,CDM,93350,CPT,,,both,,1003,1003,290.99,,,,fee schedule,,,,,,,,163.7,,,,fee schedule,,,852.55,85,,percent of total billed charges,,148.2,,,,fee schedule,,71.51,,,,fee schedule,,163.7,,,,fee schedule,,249.5,,,,fee schedule,,163.7,,,,fee schedule,,309.76,,,,fee schedule,,187.74,,,,fee schedule,,187.74,,,,fee schedule,,,912.73,91,,percent of total billed charges,,,952.85,95,,percent of total billed charges,,,832.49,83,,percent of total billed charges,,,300.9,83,,percent of total billed charges,,163.7,,,,fee schedule,,163.7,,,,fee schedule,,,832.49,83,,percent of total billed charges,,275.97,,,,fee schedule,,,902.7,90,,percent of total billed charges,,,902.7,90,,percent of total billed charges,,,902.7,90,,percent of total billed charges,,,902.7,90,,percent of total billed charges,,,852.55,85,,percent of total billed charges,,71.51,952.85,
STRESS TTE COMPLETE,93351,CDM,93351,CPT,,,both,,477,477,364,,,,fee schedule,,,,,,,,214.45,,,,fee schedule,,,405.45,85,,percent of total billed charges,,178.3,,,,fee schedule,,86.03,,,,fee schedule,,214.45,,,,fee schedule,,,,,,,,214.45,,,,fee schedule,,387.48,,,,fee schedule,,234.84,,,,fee schedule,,234.84,,,,fee schedule,,,434.07,91,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,143.1,83,,percent of total billed charges,,214.45,,,,fee schedule,,214.45,,,,fee schedule,,,395.91,83,,percent of total billed charges,,345.21,,,,fee schedule,,,429.3,90,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,86.03,453.15,
RIGHT HEART CATH,93451,CDM,93451,CPT,,,both,,982,982,1365.65,,,,fee schedule,,,,,,,,438.52,,,,fee schedule,,,834.7,85,,percent of total billed charges,,283.82,,,,fee schedule,,136.94,,,,fee schedule,,438.52,,,,fee schedule,,,,,,,,438.52,,,,fee schedule,,1453.76,,,,fee schedule,,881.07,,,,fee schedule,,881.07,,,,fee schedule,,,893.62,91,,percent of total billed charges,,,932.9,95,,percent of total billed charges,,,815.06,83,,percent of total billed charges,,,294.6,83,,percent of total billed charges,,438.52,,,,fee schedule,,438.52,,,,fee schedule,,,815.06,83,,percent of total billed charges,,1295.17,,,,fee schedule,,,883.8,90,,percent of total billed charges,,,883.8,90,,percent of total billed charges,,,883.8,90,,percent of total billed charges,,,883.8,90,,percent of total billed charges,,,834.7,85,,percent of total billed charges,,136.94,1453.76,
RIGHT HEART CATH,93451P,CDM,93451,CPT,,,both,P,803,803,1365.65,,,,fee schedule,,,,,,,,438.52,,,,fee schedule,,,682.55,85,,percent of total billed charges,,283.82,,,,fee schedule,,136.94,,,,fee schedule,,438.52,,,,fee schedule,,,,,,,,438.52,,,,fee schedule,,1453.76,,,,fee schedule,,881.07,,,,fee schedule,,881.07,,,,fee schedule,,,730.73,91,,percent of total billed charges,,,762.85,95,,percent of total billed charges,,,666.49,83,,percent of total billed charges,,,240.9,83,,percent of total billed charges,,438.52,,,,fee schedule,,438.52,,,,fee schedule,,,666.49,83,,percent of total billed charges,,1295.17,,,,fee schedule,,,722.7,90,,percent of total billed charges,,,722.7,90,,percent of total billed charges,,,722.7,90,,percent of total billed charges,,,722.7,90,,percent of total billed charges,,,682.55,85,,percent of total billed charges,,136.94,1453.76,
RIGHT HEART CATH,93451T,CDM,93451,CPT,,,both,T,179,179,1365.65,,,,fee schedule,,,,,,,,438.52,,,,fee schedule,,,152.15,85,,percent of total billed charges,,283.82,,,,fee schedule,,136.94,,,,fee schedule,,438.52,,,,fee schedule,,,,,,,,438.52,,,,fee schedule,,1453.76,,,,fee schedule,,881.07,,,,fee schedule,,881.07,,,,fee schedule,,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,53.7,83,,percent of total billed charges,,438.52,,,,fee schedule,,438.52,,,,fee schedule,,,148.57,83,,percent of total billed charges,,1295.17,,,,fee schedule,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,53.7,1453.76,
LEFT HRT CATH W/VENTRCLGRPHY,93452,CDM,93452,CPT,,,both,,1424,1424,1418.18,,,,fee schedule,,,,,,,,491.73,,,,fee schedule,,,1210.4,85,,percent of total billed charges,,516.61,,,,fee schedule,,249.26,,,,fee schedule,,491.73,,,,fee schedule,,,,,,,,491.73,,,,fee schedule,,1509.67,,,,fee schedule,,914.95,,,,fee schedule,,914.95,,,,fee schedule,,,1295.84,91,,percent of total billed charges,,,1352.8,95,,percent of total billed charges,,,1181.92,83,,percent of total billed charges,,,427.2,83,,percent of total billed charges,,491.73,,,,fee schedule,,491.73,,,,fee schedule,,,1181.92,83,,percent of total billed charges,,1344.98,,,,fee schedule,,,1281.6,90,,percent of total billed charges,,,1281.6,90,,percent of total billed charges,,,1281.6,90,,percent of total billed charges,,,1281.6,90,,percent of total billed charges,,,1210.4,85,,percent of total billed charges,,249.26,1509.67,
LEFT HRT CATH W/VENTRCLGRPHY,93452P,CDM,93452,CPT,,,both,P,1232,1232,1418.18,,,,fee schedule,,,,,,,,491.73,,,,fee schedule,,,1047.2,85,,percent of total billed charges,,516.61,,,,fee schedule,,249.26,,,,fee schedule,,491.73,,,,fee schedule,,,,,,,,491.73,,,,fee schedule,,1509.67,,,,fee schedule,,914.95,,,,fee schedule,,914.95,,,,fee schedule,,,1121.12,91,,percent of total billed charges,,,1170.4,95,,percent of total billed charges,,,1022.56,83,,percent of total billed charges,,,369.6,83,,percent of total billed charges,,491.73,,,,fee schedule,,491.73,,,,fee schedule,,,1022.56,83,,percent of total billed charges,,1344.98,,,,fee schedule,,,1108.8,90,,percent of total billed charges,,,1108.8,90,,percent of total billed charges,,,1108.8,90,,percent of total billed charges,,,1108.8,90,,percent of total billed charges,,,1047.2,85,,percent of total billed charges,,249.26,1509.67,
LEFT HRT CATH W/VENTRCLGRPHY,93452T,CDM,93452,CPT,,,both,T,192,192,1418.18,,,,fee schedule,,,,,,,,491.73,,,,fee schedule,,,163.2,85,,percent of total billed charges,,516.61,,,,fee schedule,,249.26,,,,fee schedule,,491.73,,,,fee schedule,,,,,,,,491.73,,,,fee schedule,,1509.67,,,,fee schedule,,914.95,,,,fee schedule,,914.95,,,,fee schedule,,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,57.6,83,,percent of total billed charges,,491.73,,,,fee schedule,,491.73,,,,fee schedule,,,159.36,83,,percent of total billed charges,,1344.98,,,,fee schedule,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,57.6,1509.67,
R&L HRT CATH W/VENTRICLGRPHY,93453,CDM,93453,CPT,,,both,,1798,1798,1803.71,,,,fee schedule,,,,,,,,643.4,,,,fee schedule,,,1528.3,85,,percent of total billed charges,,686.86,,,,fee schedule,,331.4,,,,fee schedule,,643.4,,,,fee schedule,,,,,,,,643.4,,,,fee schedule,,1920.08,,,,fee schedule,,1163.69,,,,fee schedule,,1163.69,,,,fee schedule,,,1636.18,91,,percent of total billed charges,,,1708.1,95,,percent of total billed charges,,,1492.34,83,,percent of total billed charges,,,539.4,83,,percent of total billed charges,,643.4,,,,fee schedule,,643.4,,,,fee schedule,,,1492.34,83,,percent of total billed charges,,1710.62,,,,fee schedule,,,1618.2,90,,percent of total billed charges,,,1618.2,90,,percent of total billed charges,,,1618.2,90,,percent of total billed charges,,,1618.2,90,,percent of total billed charges,,,1528.3,85,,percent of total billed charges,,331.4,1920.08,
R&L HRT CATH W/VENTRICLGRPHY,93453P,CDM,93453,CPT,,,both,P,1595,1595,1803.71,,,,fee schedule,,,,,,,,643.4,,,,fee schedule,,,1355.75,85,,percent of total billed charges,,686.86,,,,fee schedule,,331.4,,,,fee schedule,,643.4,,,,fee schedule,,,,,,,,643.4,,,,fee schedule,,1920.08,,,,fee schedule,,1163.69,,,,fee schedule,,1163.69,,,,fee schedule,,,1451.45,91,,percent of total billed charges,,,1515.25,95,,percent of total billed charges,,,1323.85,83,,percent of total billed charges,,,478.5,83,,percent of total billed charges,,643.4,,,,fee schedule,,643.4,,,,fee schedule,,,1323.85,83,,percent of total billed charges,,1710.62,,,,fee schedule,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1435.5,90,,percent of total billed charges,,,1355.75,85,,percent of total billed charges,,331.4,1920.08,
R&L HRT CATH W/VENTRICLGRPHY,93453T,CDM,93453,CPT,,,both,T,203,203,1803.71,,,,fee schedule,,,,,,,,643.4,,,,fee schedule,,,172.55,85,,percent of total billed charges,,686.86,,,,fee schedule,,331.4,,,,fee schedule,,643.4,,,,fee schedule,,,,,,,,643.4,,,,fee schedule,,1920.08,,,,fee schedule,,1163.69,,,,fee schedule,,1163.69,,,,fee schedule,,,184.73,91,,percent of total billed charges,,,192.85,95,,percent of total billed charges,,,168.49,83,,percent of total billed charges,,,60.9,83,,percent of total billed charges,,643.4,,,,fee schedule,,643.4,,,,fee schedule,,,168.49,83,,percent of total billed charges,,1710.62,,,,fee schedule,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,182.7,90,,percent of total billed charges,,,172.55,85,,percent of total billed charges,,60.9,1920.08,
CORONARY ARTERY ANGIO S&I,93454,CDM,93454,CPT,,,both,,1377,1377,1423.96,,,,fee schedule,,,,,,,,506.74,,,,fee schedule,,,1170.45,85,,percent of total billed charges,,522.9,,,,fee schedule,,252.29,,,,fee schedule,,506.74,,,,fee schedule,,,,,,,,506.74,,,,fee schedule,,1515.83,,,,fee schedule,,918.68,,,,fee schedule,,918.68,,,,fee schedule,,,1253.07,91,,percent of total billed charges,,,1308.15,95,,percent of total billed charges,,,1142.91,83,,percent of total billed charges,,,413.1,83,,percent of total billed charges,,506.74,,,,fee schedule,,506.74,,,,fee schedule,,,1142.91,83,,percent of total billed charges,,1350.46,,,,fee schedule,,,1239.3,90,,percent of total billed charges,,,1239.3,90,,percent of total billed charges,,,1239.3,90,,percent of total billed charges,,,1239.3,90,,percent of total billed charges,,,1170.45,85,,percent of total billed charges,,252.29,1515.83,
CORONARY ARTERY ANGIO S&I,93454P,CDM,93454,CPT,,,both,P,1186,1186,1423.96,,,,fee schedule,,,,,,,,506.74,,,,fee schedule,,,1008.1,85,,percent of total billed charges,,522.9,,,,fee schedule,,252.29,,,,fee schedule,,506.74,,,,fee schedule,,,,,,,,506.74,,,,fee schedule,,1515.83,,,,fee schedule,,918.68,,,,fee schedule,,918.68,,,,fee schedule,,,1079.26,91,,percent of total billed charges,,,1126.7,95,,percent of total billed charges,,,984.38,83,,percent of total billed charges,,,355.8,83,,percent of total billed charges,,506.74,,,,fee schedule,,506.74,,,,fee schedule,,,984.38,83,,percent of total billed charges,,1350.46,,,,fee schedule,,,1067.4,90,,percent of total billed charges,,,1067.4,90,,percent of total billed charges,,,1067.4,90,,percent of total billed charges,,,1067.4,90,,percent of total billed charges,,,1008.1,85,,percent of total billed charges,,252.29,1515.83,
CORONARY ARTERY ANGIO S&I,93454T,CDM,93454,CPT,,,both,T,191,191,1423.96,,,,fee schedule,,,,,,,,506.74,,,,fee schedule,,,162.35,85,,percent of total billed charges,,522.9,,,,fee schedule,,252.29,,,,fee schedule,,506.74,,,,fee schedule,,,,,,,,506.74,,,,fee schedule,,1515.83,,,,fee schedule,,918.68,,,,fee schedule,,918.68,,,,fee schedule,,,173.81,91,,percent of total billed charges,,,181.45,95,,percent of total billed charges,,,158.53,83,,percent of total billed charges,,,57.3,83,,percent of total billed charges,,506.74,,,,fee schedule,,506.74,,,,fee schedule,,,158.53,83,,percent of total billed charges,,1350.46,,,,fee schedule,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,162.35,85,,percent of total billed charges,,57.3,1515.83,
CORONARY ART/GRFT ANGIO S&I,93455,CDM,93455,CPT,,,both,,1544,1544,1586.26,,,,fee schedule,,,,,,,,591.02,,,,fee schedule,,,1312.4,85,,percent of total billed charges,,606.84,,,,fee schedule,,292.79,,,,fee schedule,,591.02,,,,fee schedule,,,,,,,,591.02,,,,fee schedule,,1688.6,,,,fee schedule,,1023.39,,,,fee schedule,,1023.39,,,,fee schedule,,,1405.04,91,,percent of total billed charges,,,1466.8,95,,percent of total billed charges,,,1281.52,83,,percent of total billed charges,,,463.2,83,,percent of total billed charges,,591.02,,,,fee schedule,,591.02,,,,fee schedule,,,1281.52,83,,percent of total billed charges,,1504.39,,,,fee schedule,,,1389.6,90,,percent of total billed charges,,,1389.6,90,,percent of total billed charges,,,1389.6,90,,percent of total billed charges,,,1389.6,90,,percent of total billed charges,,,1312.4,85,,percent of total billed charges,,292.79,1688.6,
CORONARY ART/GRFT ANGIO S&I,93455P,CDM,93455,CPT,,,both,P,1349,1349,1586.26,,,,fee schedule,,,,,,,,591.02,,,,fee schedule,,,1146.65,85,,percent of total billed charges,,606.84,,,,fee schedule,,292.79,,,,fee schedule,,591.02,,,,fee schedule,,,,,,,,591.02,,,,fee schedule,,1688.6,,,,fee schedule,,1023.39,,,,fee schedule,,1023.39,,,,fee schedule,,,1227.59,91,,percent of total billed charges,,,1281.55,95,,percent of total billed charges,,,1119.67,83,,percent of total billed charges,,,404.7,83,,percent of total billed charges,,591.02,,,,fee schedule,,591.02,,,,fee schedule,,,1119.67,83,,percent of total billed charges,,1504.39,,,,fee schedule,,,1214.1,90,,percent of total billed charges,,,1214.1,90,,percent of total billed charges,,,1214.1,90,,percent of total billed charges,,,1214.1,90,,percent of total billed charges,,,1146.65,85,,percent of total billed charges,,292.79,1688.6,
CORONARY ART/GRFT ANGIO S&I,93455T,CDM,93455,CPT,,,both,T,195,195,1586.26,,,,fee schedule,,,,,,,,591.02,,,,fee schedule,,,165.75,85,,percent of total billed charges,,606.84,,,,fee schedule,,292.79,,,,fee schedule,,591.02,,,,fee schedule,,,,,,,,591.02,,,,fee schedule,,1688.6,,,,fee schedule,,1023.39,,,,fee schedule,,1023.39,,,,fee schedule,,,177.45,91,,percent of total billed charges,,,185.25,95,,percent of total billed charges,,,161.85,83,,percent of total billed charges,,,58.5,83,,percent of total billed charges,,591.02,,,,fee schedule,,591.02,,,,fee schedule,,,161.85,83,,percent of total billed charges,,1504.39,,,,fee schedule,,,175.5,90,,percent of total billed charges,,,175.5,90,,percent of total billed charges,,,175.5,90,,percent of total billed charges,,,175.5,90,,percent of total billed charges,,,165.75,85,,percent of total billed charges,,58.5,1688.6,
R HRT CORONARY ARTERY ANGIO,93456,CDM,93456,CPT,,,both,,1739,1739,1771.67,,,,fee schedule,,,,,,,,634.39,,,,fee schedule,,,1478.15,85,,percent of total billed charges,,676.57,,,,fee schedule,,326.44,,,,fee schedule,,634.39,,,,fee schedule,,,,,,,,634.39,,,,fee schedule,,1885.98,,,,fee schedule,,1143.02,,,,fee schedule,,1143.02,,,,fee schedule,,,1582.49,91,,percent of total billed charges,,,1652.05,95,,percent of total billed charges,,,1443.37,83,,percent of total billed charges,,,521.7,83,,percent of total billed charges,,634.39,,,,fee schedule,,634.39,,,,fee schedule,,,1443.37,83,,percent of total billed charges,,1680.23,,,,fee schedule,,,1565.1,90,,percent of total billed charges,,,1565.1,90,,percent of total billed charges,,,1565.1,90,,percent of total billed charges,,,1565.1,90,,percent of total billed charges,,,1478.15,85,,percent of total billed charges,,326.44,1885.98,
R HRT CORONARY ARTERY ANGIO,93456P,CDM,93456,CPT,,,both,P,1538,1538,1771.67,,,,fee schedule,,,,,,,,634.39,,,,fee schedule,,,1307.3,85,,percent of total billed charges,,676.57,,,,fee schedule,,326.44,,,,fee schedule,,634.39,,,,fee schedule,,,,,,,,634.39,,,,fee schedule,,1885.98,,,,fee schedule,,1143.02,,,,fee schedule,,1143.02,,,,fee schedule,,,1399.58,91,,percent of total billed charges,,,1461.1,95,,percent of total billed charges,,,1276.54,83,,percent of total billed charges,,,461.4,83,,percent of total billed charges,,634.39,,,,fee schedule,,634.39,,,,fee schedule,,,1276.54,83,,percent of total billed charges,,1680.23,,,,fee schedule,,,1384.2,90,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1307.3,85,,percent of total billed charges,,326.44,1885.98,
R HRT CORONARY ARTERY ANGIO,93456T,CDM,93456,CPT,,,both,T,201,201,1771.67,,,,fee schedule,,,,,,,,634.39,,,,fee schedule,,,170.85,85,,percent of total billed charges,,676.57,,,,fee schedule,,326.44,,,,fee schedule,,634.39,,,,fee schedule,,,,,,,,634.39,,,,fee schedule,,1885.98,,,,fee schedule,,1143.02,,,,fee schedule,,1143.02,,,,fee schedule,,,182.91,91,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,60.3,83,,percent of total billed charges,,634.39,,,,fee schedule,,634.39,,,,fee schedule,,,166.83,83,,percent of total billed charges,,1680.23,,,,fee schedule,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,60.3,1885.98,
R HRT ART/GRFT ANGIO,93457,CDM,93457,CPT,,,both,,1763,1763,1930.3,,,,fee schedule,,,,,,,,718.74,,,,fee schedule,,,1498.55,85,,percent of total billed charges,,763.49,,,,fee schedule,,368.37,,,,fee schedule,,718.74,,,,fee schedule,,,,,,,,718.74,,,,fee schedule,,2054.84,,,,fee schedule,,1245.35,,,,fee schedule,,1245.35,,,,fee schedule,,,1604.33,91,,percent of total billed charges,,,1674.85,95,,percent of total billed charges,,,1463.29,83,,percent of total billed charges,,,528.9,83,,percent of total billed charges,,718.74,,,,fee schedule,,718.74,,,,fee schedule,,,1463.29,83,,percent of total billed charges,,1830.67,,,,fee schedule,,,1586.7,90,,percent of total billed charges,,,1586.7,90,,percent of total billed charges,,,1586.7,90,,percent of total billed charges,,,1586.7,90,,percent of total billed charges,,,1498.55,85,,percent of total billed charges,,368.37,2054.84,
R HRT ART/GRFT ANGIO,93457P,CDM,93457,CPT,,,both,P,1561,1561,1930.3,,,,fee schedule,,,,,,,,718.74,,,,fee schedule,,,1326.85,85,,percent of total billed charges,,763.49,,,,fee schedule,,368.37,,,,fee schedule,,718.74,,,,fee schedule,,,,,,,,718.74,,,,fee schedule,,2054.84,,,,fee schedule,,1245.35,,,,fee schedule,,1245.35,,,,fee schedule,,,1420.51,91,,percent of total billed charges,,,1482.95,95,,percent of total billed charges,,,1295.63,83,,percent of total billed charges,,,468.3,83,,percent of total billed charges,,718.74,,,,fee schedule,,718.74,,,,fee schedule,,,1295.63,83,,percent of total billed charges,,1830.67,,,,fee schedule,,,1404.9,90,,percent of total billed charges,,,1404.9,90,,percent of total billed charges,,,1404.9,90,,percent of total billed charges,,,1404.9,90,,percent of total billed charges,,,1326.85,85,,percent of total billed charges,,368.37,2054.84,
R HRT ART/GRFT ANGIO,93457T,CDM,93457,CPT,,,both,T,202,202,1930.3,,,,fee schedule,,,,,,,,718.74,,,,fee schedule,,,171.7,85,,percent of total billed charges,,763.49,,,,fee schedule,,368.37,,,,fee schedule,,718.74,,,,fee schedule,,,,,,,,718.74,,,,fee schedule,,2054.84,,,,fee schedule,,1245.35,,,,fee schedule,,1245.35,,,,fee schedule,,,183.82,91,,percent of total billed charges,,,191.9,95,,percent of total billed charges,,,167.66,83,,percent of total billed charges,,,60.6,83,,percent of total billed charges,,718.74,,,,fee schedule,,718.74,,,,fee schedule,,,167.66,83,,percent of total billed charges,,1830.67,,,,fee schedule,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,171.7,85,,percent of total billed charges,,60.6,2054.84,
L HRT ARTERY/VENTRICLE ANGIO,93458,CDM,93458,CPT,,,both,,6154,6154,1636.16,,,,fee schedule,,,,,,,,611.7,,,,fee schedule,,,5230.9,85,,percent of total billed charges,,642.62,,,,fee schedule,,310.05,,,,fee schedule,,611.7,,,,fee schedule,,,,,,,,611.7,,,,fee schedule,,1741.72,,,,fee schedule,,1055.59,,,,fee schedule,,1055.59,,,,fee schedule,,,5600.14,91,,percent of total billed charges,,,5846.3,95,,percent of total billed charges,,,5107.82,83,,percent of total billed charges,,,1846.2,83,,percent of total billed charges,,611.7,,,,fee schedule,,611.7,,,,fee schedule,,,5107.82,83,,percent of total billed charges,,1551.71,,,,fee schedule,,,5538.6,90,,percent of total billed charges,,,5538.6,90,,percent of total billed charges,,,5538.6,90,,percent of total billed charges,,,5538.6,90,,percent of total billed charges,,,5230.9,85,,percent of total billed charges,,310.05,5846.3,
L HRT ARTERY/VENTRICLE ANGIO,9345826,CDM,93458,CPT,,,both,26,1538,1538,1636.16,,,,fee schedule,,,,,,,,611.7,,,,fee schedule,,,1307.3,85,,percent of total billed charges,,642.62,,,,fee schedule,,310.05,,,,fee schedule,,611.7,,,,fee schedule,,,,,,,,611.7,,,,fee schedule,,1741.72,,,,fee schedule,,1055.59,,,,fee schedule,,1055.59,,,,fee schedule,,,1399.58,91,,percent of total billed charges,,,1461.1,95,,percent of total billed charges,,,1276.54,83,,percent of total billed charges,,,461.4,83,,percent of total billed charges,,611.7,,,,fee schedule,,611.7,,,,fee schedule,,,1276.54,83,,percent of total billed charges,,1551.71,,,,fee schedule,,,1384.2,90,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1384.2,90,,percent of total billed charges,,,1307.3,85,,percent of total billed charges,,310.05,1741.72,
L HRT ART/GRFT ANGIO,93459,CDM,93459,CPT,,,both,,1733,1733,1760.12,,,,fee schedule,,,,,,,,675.7,,,,fee schedule,,,1473.05,85,,percent of total billed charges,,729.19,,,,fee schedule,,351.83,,,,fee schedule,,675.7,,,,fee schedule,,,,,,,,675.7,,,,fee schedule,,1873.67,,,,fee schedule,,1135.56,,,,fee schedule,,1135.56,,,,fee schedule,,,1577.03,91,,percent of total billed charges,,,1646.35,95,,percent of total billed charges,,,1438.39,83,,percent of total billed charges,,,519.9,83,,percent of total billed charges,,675.7,,,,fee schedule,,675.7,,,,fee schedule,,,1438.39,83,,percent of total billed charges,,1669.27,,,,fee schedule,,,1559.7,90,,percent of total billed charges,,,1559.7,90,,percent of total billed charges,,,1559.7,90,,percent of total billed charges,,,1559.7,90,,percent of total billed charges,,,1473.05,85,,percent of total billed charges,,351.83,1873.67,
L HRT ART/GRFT ANGIO,93459P,CDM,93459,CPT,,,both,P,1532,1532,1760.12,,,,fee schedule,,,,,,,,675.7,,,,fee schedule,,,1302.2,85,,percent of total billed charges,,729.19,,,,fee schedule,,351.83,,,,fee schedule,,675.7,,,,fee schedule,,,,,,,,675.7,,,,fee schedule,,1873.67,,,,fee schedule,,1135.56,,,,fee schedule,,1135.56,,,,fee schedule,,,1394.12,91,,percent of total billed charges,,,1455.4,95,,percent of total billed charges,,,1271.56,83,,percent of total billed charges,,,459.6,83,,percent of total billed charges,,675.7,,,,fee schedule,,675.7,,,,fee schedule,,,1271.56,83,,percent of total billed charges,,1669.27,,,,fee schedule,,,1378.8,90,,percent of total billed charges,,,1378.8,90,,percent of total billed charges,,,1378.8,90,,percent of total billed charges,,,1378.8,90,,percent of total billed charges,,,1302.2,85,,percent of total billed charges,,351.83,1873.67,
L HRT ART/GRFT ANGIO,93459T,CDM,93459,CPT,,,both,T,201,201,1760.12,,,,fee schedule,,,,,,,,675.7,,,,fee schedule,,,170.85,85,,percent of total billed charges,,729.19,,,,fee schedule,,351.83,,,,fee schedule,,675.7,,,,fee schedule,,,,,,,,675.7,,,,fee schedule,,1873.67,,,,fee schedule,,1135.56,,,,fee schedule,,1135.56,,,,fee schedule,,,182.91,91,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,60.3,83,,percent of total billed charges,,675.7,,,,fee schedule,,675.7,,,,fee schedule,,,166.83,83,,percent of total billed charges,,1669.27,,,,fee schedule,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,60.3,1873.67,
R&L HRT ART/VENTRICLE ANGIO,93460,CDM,93460,CPT,,,both,,1975,1975,1954.99,,,,fee schedule,,,,,,,,723.93,,,,fee schedule,,,1678.75,85,,percent of total billed charges,,816.44,,,,fee schedule,,393.92,,,,fee schedule,,723.93,,,,fee schedule,,,,,,,,723.93,,,,fee schedule,,2081.11,,,,fee schedule,,1261.28,,,,fee schedule,,1261.28,,,,fee schedule,,,1797.25,91,,percent of total billed charges,,,1876.25,95,,percent of total billed charges,,,1639.25,83,,percent of total billed charges,,,592.5,83,,percent of total billed charges,,723.93,,,,fee schedule,,723.93,,,,fee schedule,,,1639.25,83,,percent of total billed charges,,1854.08,,,,fee schedule,,,1777.5,90,,percent of total billed charges,,,1777.5,90,,percent of total billed charges,,,1777.5,90,,percent of total billed charges,,,1777.5,90,,percent of total billed charges,,,1678.75,85,,percent of total billed charges,,393.92,2081.11,
R&L HRT ART/VENTRICLE ANGIO,93460P,CDM,93460,CPT,,,both,P,1767,1767,1954.99,,,,fee schedule,,,,,,,,723.93,,,,fee schedule,,,1501.95,85,,percent of total billed charges,,816.44,,,,fee schedule,,393.92,,,,fee schedule,,723.93,,,,fee schedule,,,,,,,,723.93,,,,fee schedule,,2081.11,,,,fee schedule,,1261.28,,,,fee schedule,,1261.28,,,,fee schedule,,,1607.97,91,,percent of total billed charges,,,1678.65,95,,percent of total billed charges,,,1466.61,83,,percent of total billed charges,,,530.1,83,,percent of total billed charges,,723.93,,,,fee schedule,,723.93,,,,fee schedule,,,1466.61,83,,percent of total billed charges,,1854.08,,,,fee schedule,,,1590.3,90,,percent of total billed charges,,,1590.3,90,,percent of total billed charges,,,1590.3,90,,percent of total billed charges,,,1590.3,90,,percent of total billed charges,,,1501.95,85,,percent of total billed charges,,393.92,2081.11,
R&L HRT ART/VENTRICLE ANGIO,93460T,CDM,93460,CPT,,,both,T,208,208,1954.99,,,,fee schedule,,,,,,,,723.93,,,,fee schedule,,,176.8,85,,percent of total billed charges,,816.44,,,,fee schedule,,393.92,,,,fee schedule,,723.93,,,,fee schedule,,,,,,,,723.93,,,,fee schedule,,2081.11,,,,fee schedule,,1261.28,,,,fee schedule,,1261.28,,,,fee schedule,,,189.28,91,,percent of total billed charges,,,197.6,95,,percent of total billed charges,,,172.64,83,,percent of total billed charges,,,62.4,83,,percent of total billed charges,,723.93,,,,fee schedule,,723.93,,,,fee schedule,,,172.64,83,,percent of total billed charges,,1854.08,,,,fee schedule,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,176.8,85,,percent of total billed charges,,62.4,2081.11,
R&L HRT ART/VENTRICLE ANGIO/CATH PLACEMENT IN BYPA,93461,CDM,93461,CPT,,,both,,2127,2127,2156.16,,,,fee schedule,,,,,,,,828.75,,,,fee schedule,,,1807.95,85,,percent of total billed charges,,902.14,,,,fee schedule,,435.27,,,,fee schedule,,828.75,,,,fee schedule,,,,,,,,828.75,,,,fee schedule,,2295.26,,,,fee schedule,,1391.07,,,,fee schedule,,1391.07,,,,fee schedule,,,1935.57,91,,percent of total billed charges,,,2020.65,95,,percent of total billed charges,,,1765.41,83,,percent of total billed charges,,,638.1,83,,percent of total billed charges,,828.75,,,,fee schedule,,828.75,,,,fee schedule,,,1765.41,83,,percent of total billed charges,,2044.87,,,,fee schedule,,,1914.3,90,,percent of total billed charges,,,1914.3,90,,percent of total billed charges,,,1914.3,90,,percent of total billed charges,,,1914.3,90,,percent of total billed charges,,,1807.95,85,,percent of total billed charges,,435.27,2295.26,
R&L HRT ART/VENTRICLE ANGIO/CATH PLACEMENT IN BYPA,93461P,CDM,93461,CPT,,,both,P,1915,1915,2156.16,,,,fee schedule,,,,,,,,828.75,,,,fee schedule,,,1627.75,85,,percent of total billed charges,,902.14,,,,fee schedule,,435.27,,,,fee schedule,,828.75,,,,fee schedule,,,,,,,,828.75,,,,fee schedule,,2295.26,,,,fee schedule,,1391.07,,,,fee schedule,,1391.07,,,,fee schedule,,,1742.65,91,,percent of total billed charges,,,1819.25,95,,percent of total billed charges,,,1589.45,83,,percent of total billed charges,,,574.5,83,,percent of total billed charges,,828.75,,,,fee schedule,,828.75,,,,fee schedule,,,1589.45,83,,percent of total billed charges,,2044.87,,,,fee schedule,,,1723.5,90,,percent of total billed charges,,,1723.5,90,,percent of total billed charges,,,1723.5,90,,percent of total billed charges,,,1723.5,90,,percent of total billed charges,,,1627.75,85,,percent of total billed charges,,435.27,2295.26,
R&L HRT ART/VENTRICLE ANGIO/CATH PLACEMENT IN BYPA,93461T,CDM,93461,CPT,,,both,T,212,212,2156.16,,,,fee schedule,,,,,,,,828.75,,,,fee schedule,,,180.2,85,,percent of total billed charges,,902.14,,,,fee schedule,,435.27,,,,fee schedule,,828.75,,,,fee schedule,,,,,,,,828.75,,,,fee schedule,,2295.26,,,,fee schedule,,1391.07,,,,fee schedule,,1391.07,,,,fee schedule,,,192.92,91,,percent of total billed charges,,,201.4,95,,percent of total billed charges,,,175.96,83,,percent of total billed charges,,,63.6,83,,percent of total billed charges,,828.75,,,,fee schedule,,828.75,,,,fee schedule,,,175.96,83,,percent of total billed charges,,2044.87,,,,fee schedule,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,190.8,90,,percent of total billed charges,,,180.2,85,,percent of total billed charges,,63.6,2295.26,
INSERT/PLACE HEART CATHETER,93503,CDM,93503,CPT,,,both,,1675,1675,135.51,,,,fee schedule,,,,,,,,149.8,,,,fee schedule,,,1423.75,85,,percent of total billed charges,,191.84,,,,fee schedule,,92.56,,,,fee schedule,,149.8,,,,fee schedule,,236.99,,,,fee schedule,,149.8,,,,fee schedule,,144.26,,,,fee schedule,,87.43,,,,fee schedule,,87.43,,,,fee schedule,,,1524.25,91,,percent of total billed charges,,,1591.25,95,,percent of total billed charges,,,1390.25,83,,percent of total billed charges,,,502.5,83,,percent of total billed charges,,149.8,,,,fee schedule,,149.8,,,,fee schedule,,,1390.25,83,,percent of total billed charges,,128.52,,,,fee schedule,,,1507.5,90,,percent of total billed charges,,,1507.5,90,,percent of total billed charges,,,1507.5,90,,percent of total billed charges,,,1507.5,90,,percent of total billed charges,,,1423.75,85,,percent of total billed charges,,87.43,1591.25,
INJECT SUPRVLV AORTOGRAPHY,93567,CDM,93567,CPT,,,both,,366,366,58.3,,,,fee schedule,,,,,,,,29.14,,,,fee schedule,,,311.1,85,,percent of total billed charges,,114.51,,,,fee schedule,,55.25,,,,fee schedule,,29.14,,,,fee schedule,,,,,,,,29.14,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,333.06,91,,percent of total billed charges,,,347.7,95,,percent of total billed charges,,,303.78,83,,percent of total billed charges,,,109.8,83,,percent of total billed charges,,29.14,,,,fee schedule,,29.14,,,,fee schedule,,,303.78,83,,percent of total billed charges,,55.29,,,,fee schedule,,,329.4,90,,percent of total billed charges,,,329.4,90,,percent of total billed charges,,,329.4,90,,percent of total billed charges,,,329.4,90,,percent of total billed charges,,,311.1,85,,percent of total billed charges,,29.14,347.7,
HEART FLOW RESERVE MEASURE,93571,CDM,93571,CPT,,,both,,443,443,,,,,,,,,,,,,115.65,,,,fee schedule,,,376.55,85,,percent of total billed charges,,157.12,,,,fee schedule,,75.81,,,,fee schedule,,115.65,,,,fee schedule,,458.98,,,,fee schedule,,115.65,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,403.13,91,,percent of total billed charges,,,420.85,95,,percent of total billed charges,,,367.69,83,,percent of total billed charges,,,132.9,83,,percent of total billed charges,,115.65,,,,fee schedule,,115.65,,,,fee schedule,,,367.69,83,,percent of total billed charges,,,,,,,,,398.7,90,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,398.7,90,,percent of total billed charges,,,376.55,85,,percent of total billed charges,,75.81,458.98,
HEART FLOW RESERVE MEASURE,93571P,CDM,93571,CPT,,,both,P,280,280,,,,,,,,,,,,,115.65,,,,fee schedule,,,238,85,,percent of total billed charges,,157.12,,,,fee schedule,,75.81,,,,fee schedule,,115.65,,,,fee schedule,,458.98,,,,fee schedule,,115.65,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,254.8,91,,percent of total billed charges,,,266,95,,percent of total billed charges,,,232.4,83,,percent of total billed charges,,,84,83,,percent of total billed charges,,115.65,,,,fee schedule,,115.65,,,,fee schedule,,,232.4,83,,percent of total billed charges,,,,,,,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,252,90,,percent of total billed charges,,,238,85,,percent of total billed charges,,75.81,458.98,
HEART FLOW RESERVE MEASURE,93571T,CDM,93571,CPT,,,both,T,163,163,,,,,,,,,,,,,115.65,,,,fee schedule,,,138.55,85,,percent of total billed charges,,157.12,,,,fee schedule,,75.81,,,,fee schedule,,115.65,,,,fee schedule,,458.98,,,,fee schedule,,115.65,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,48.9,83,,percent of total billed charges,,115.65,,,,fee schedule,,115.65,,,,fee schedule,,,135.29,83,,percent of total billed charges,,,,,,,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,48.9,458.98,
HEART FLOW RESERVE MEASURE,93572,CDM,93572,CPT,,,both,,331,331,,,,,,,,,,,,,105.5,,,,fee schedule,,,281.35,85,,percent of total billed charges,,115.66,,,,fee schedule,,55.8,,,,fee schedule,,105.5,,,,fee schedule,,275.76,,,,fee schedule,,105.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,301.21,91,,percent of total billed charges,,,314.45,95,,percent of total billed charges,,,274.73,83,,percent of total billed charges,,,99.3,83,,percent of total billed charges,,105.5,,,,fee schedule,,105.5,,,,fee schedule,,,274.73,83,,percent of total billed charges,,,,,,,,,297.9,90,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,281.35,85,,percent of total billed charges,,55.8,314.45,
HEART FLOW RESERVE MEASURE,93572P,CDM,93572,CPT,,,both,P,176,176,,,,,,,,,,,,,105.5,,,,fee schedule,,,149.6,85,,percent of total billed charges,,115.66,,,,fee schedule,,55.8,,,,fee schedule,,105.5,,,,fee schedule,,275.76,,,,fee schedule,,105.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,52.8,83,,percent of total billed charges,,105.5,,,,fee schedule,,105.5,,,,fee schedule,,,146.08,83,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,52.8,275.76,
HEART FLOW RESERVE MEASURE,93572T,CDM,93572,CPT,,,both,T,155,155,,,,,,,,,,,,,105.5,,,,fee schedule,,,131.75,85,,percent of total billed charges,,115.66,,,,fee schedule,,55.8,,,,fee schedule,,105.5,,,,fee schedule,,275.76,,,,fee schedule,,105.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,105.5,,,,fee schedule,,105.5,,,,fee schedule,,,128.65,83,,percent of total billed charges,,,,,,,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,46.5,275.76,
TILT TABLE EVALUATION,93660,CDM,93660,CPT,,,both,,741,741,251.07,,,,fee schedule,,,,,,,,69.3,,,,fee schedule,,,629.85,85,,percent of total billed charges,,196.17,,,,fee schedule,,94.65,,,,fee schedule,,69.3,,,,fee schedule,,274.51,,,,fee schedule,,69.3,,,,fee schedule,,267.27,,,,fee schedule,,161.98,,,,fee schedule,,161.98,,,,fee schedule,,,674.31,91,,percent of total billed charges,,,703.95,95,,percent of total billed charges,,,615.03,83,,percent of total billed charges,,,222.3,83,,percent of total billed charges,,69.3,,,,fee schedule,,69.3,,,,fee schedule,,,615.03,83,,percent of total billed charges,,238.11,,,,fee schedule,,,666.9,90,,percent of total billed charges,,,666.9,90,,percent of total billed charges,,,666.9,90,,percent of total billed charges,,,666.9,90,,percent of total billed charges,,,629.85,85,,percent of total billed charges,,69.3,703.95,
TILT TABLE EVALUATION,9366026,CDM,93660,CPT,,,both,26,412,412,251.07,,,,fee schedule,,,,,,,,69.3,,,,fee schedule,,,350.2,85,,percent of total billed charges,,196.17,,,,fee schedule,,94.65,,,,fee schedule,,69.3,,,,fee schedule,,274.51,,,,fee schedule,,69.3,,,,fee schedule,,267.27,,,,fee schedule,,161.98,,,,fee schedule,,161.98,,,,fee schedule,,,374.92,91,,percent of total billed charges,,,391.4,95,,percent of total billed charges,,,341.96,83,,percent of total billed charges,,,123.6,83,,percent of total billed charges,,69.3,,,,fee schedule,,69.3,,,,fee schedule,,,341.96,83,,percent of total billed charges,,238.11,,,,fee schedule,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,350.2,85,,percent of total billed charges,,69.3,391.4,
AMBULATORY BP MONITORING,93784,CDM,93784,CPT,,,both,,315,315,71.43,,,,fee schedule,,,,,,,,180.3,,,,fee schedule,,,267.75,85,,percent of total billed charges,,94.63,,,,fee schedule,,45.66,,,,fee schedule,,180.3,,,,fee schedule,,122.56,,,,fee schedule,,180.3,,,,fee schedule,,76.04,,,,fee schedule,,46.09,,,,fee schedule,,46.09,,,,fee schedule,,,286.65,91,,percent of total billed charges,,,299.25,95,,percent of total billed charges,,,261.45,83,,percent of total billed charges,,,94.5,83,,percent of total billed charges,,180.3,,,,fee schedule,,180.3,,,,fee schedule,,,261.45,83,,percent of total billed charges,,67.75,,,,fee schedule,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,283.5,90,,percent of total billed charges,,,267.75,85,,percent of total billed charges,,45.66,299.25,
AMBULATORY BP MONITORING,93784P,CDM,93784,CPT,,,both,P,160,160,71.43,,,,fee schedule,,,,,,,,180.3,,,,fee schedule,,,136,85,,percent of total billed charges,,94.63,,,,fee schedule,,45.66,,,,fee schedule,,180.3,,,,fee schedule,,122.56,,,,fee schedule,,180.3,,,,fee schedule,,76.04,,,,fee schedule,,46.09,,,,fee schedule,,46.09,,,,fee schedule,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,48,83,,percent of total billed charges,,180.3,,,,fee schedule,,180.3,,,,fee schedule,,,132.8,83,,percent of total billed charges,,67.75,,,,fee schedule,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,45.66,180.3,
AMBULATORY BP MONITORING,93784T,CDM,93784,CPT,,,both,T,155,155,71.43,,,,fee schedule,,,,,,,,180.3,,,,fee schedule,,,131.75,85,,percent of total billed charges,,94.63,,,,fee schedule,,45.66,,,,fee schedule,,180.3,,,,fee schedule,,122.56,,,,fee schedule,,180.3,,,,fee schedule,,76.04,,,,fee schedule,,46.09,,,,fee schedule,,46.09,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,180.3,,,,fee schedule,,180.3,,,,fee schedule,,,128.65,83,,percent of total billed charges,,67.75,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,45.66,180.3,
AMBULATORY BP RECORDING,93786,CDM,93786,CPT,,,both,,191,191,35.19,,,,fee schedule,,,,,,,,134.6,,,,fee schedule,,,162.35,85,,percent of total billed charges,,45.63,,,,fee schedule,,22.02,,,,fee schedule,,134.6,,,,fee schedule,,57.53,,,,fee schedule,,134.6,,,,fee schedule,,37.46,,,,fee schedule,,22.7,,,,fee schedule,,22.7,,,,fee schedule,,,173.81,91,,percent of total billed charges,,,181.45,95,,percent of total billed charges,,,158.53,83,,percent of total billed charges,,,57.3,83,,percent of total billed charges,,134.6,,,,fee schedule,,134.6,,,,fee schedule,,,158.53,83,,percent of total billed charges,,33.38,,,,fee schedule,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,171.9,90,,percent of total billed charges,,,162.35,85,,percent of total billed charges,,22.02,181.45,
AMBULATORY BP RECORDING,93786P,CDM,93786,CPT,,,both,P,35,35,35.19,,,,fee schedule,,,,,,,,134.6,,,,fee schedule,,,29.75,85,,percent of total billed charges,,45.63,,,,fee schedule,,22.02,,,,fee schedule,,134.6,,,,fee schedule,,57.53,,,,fee schedule,,134.6,,,,fee schedule,,37.46,,,,fee schedule,,22.7,,,,fee schedule,,22.7,,,,fee schedule,,,31.85,91,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,10.5,83,,percent of total billed charges,,134.6,,,,fee schedule,,134.6,,,,fee schedule,,,29.05,83,,percent of total billed charges,,33.38,,,,fee schedule,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,10.5,134.6,
AMBULATORY BP RECORDING,93786P,CDM,93786,CPT,,,both,P,40,40,35.19,,,,fee schedule,,,,,,,,134.6,,,,fee schedule,,,34,85,,percent of total billed charges,,45.63,,,,fee schedule,,22.02,,,,fee schedule,,134.6,,,,fee schedule,,57.53,,,,fee schedule,,134.6,,,,fee schedule,,37.46,,,,fee schedule,,22.7,,,,fee schedule,,22.7,,,,fee schedule,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,12,83,,percent of total billed charges,,134.6,,,,fee schedule,,134.6,,,,fee schedule,,,33.2,83,,percent of total billed charges,,33.38,,,,fee schedule,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,12,134.6,
AMBULATORY BP RECORDING,93786T,CDM,93786,CPT,,,both,T,150,150,35.19,,,,fee schedule,,,,,,,,134.6,,,,fee schedule,,,127.5,85,,percent of total billed charges,,45.63,,,,fee schedule,,22.02,,,,fee schedule,,134.6,,,,fee schedule,,57.53,,,,fee schedule,,134.6,,,,fee schedule,,37.46,,,,fee schedule,,22.7,,,,fee schedule,,22.7,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,134.6,,,,fee schedule,,134.6,,,,fee schedule,,,124.5,83,,percent of total billed charges,,33.38,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,22.02,142.5,
AMBULATORY BP ANALYSIS,93788,CDM,93788,CPT,,,both,,126,126,8.4,,,,fee schedule,,,,,,,,44.4,,,,fee schedule,,,107.1,85,,percent of total billed charges,,10.37,,,,fee schedule,,5,,,,fee schedule,,44.4,,,,fee schedule,,32.52,,,,fee schedule,,44.4,,,,fee schedule,,8.95,,,,fee schedule,,5.42,,,,fee schedule,,5.42,,,,fee schedule,,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,37.8,83,,percent of total billed charges,,44.4,,,,fee schedule,,44.4,,,,fee schedule,,,104.58,83,,percent of total billed charges,,7.97,,,,fee schedule,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,5,119.7,
AMBULATORY BP ANALYSIS,93788P,CDM,93788,CPT,,,both,P,32,32,8.4,,,,fee schedule,,,,,,,,44.4,,,,fee schedule,,,27.2,85,,percent of total billed charges,,10.37,,,,fee schedule,,5,,,,fee schedule,,44.4,,,,fee schedule,,32.52,,,,fee schedule,,44.4,,,,fee schedule,,8.95,,,,fee schedule,,5.42,,,,fee schedule,,5.42,,,,fee schedule,,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,9.6,83,,percent of total billed charges,,44.4,,,,fee schedule,,44.4,,,,fee schedule,,,26.56,83,,percent of total billed charges,,7.97,,,,fee schedule,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,5,44.4,
AMBULATORY BP ANALYSIS,93788P,CDM,93788,CPT,,,both,P,35,35,8.4,,,,fee schedule,,,,,,,,44.4,,,,fee schedule,,,29.75,85,,percent of total billed charges,,10.37,,,,fee schedule,,5,,,,fee schedule,,44.4,,,,fee schedule,,32.52,,,,fee schedule,,44.4,,,,fee schedule,,8.95,,,,fee schedule,,5.42,,,,fee schedule,,5.42,,,,fee schedule,,,31.85,91,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,10.5,83,,percent of total billed charges,,44.4,,,,fee schedule,,44.4,,,,fee schedule,,,29.05,83,,percent of total billed charges,,7.97,,,,fee schedule,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,5,44.4,
AMBULATORY BP ANALYSIS,93788T,CDM,93788,CPT,,,both,T,90,90,8.4,,,,fee schedule,,,,,,,,44.4,,,,fee schedule,,,76.5,85,,percent of total billed charges,,10.37,,,,fee schedule,,5,,,,fee schedule,,44.4,,,,fee schedule,,32.52,,,,fee schedule,,44.4,,,,fee schedule,,8.95,,,,fee schedule,,5.42,,,,fee schedule,,5.42,,,,fee schedule,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,44.4,,,,fee schedule,,44.4,,,,fee schedule,,,74.7,83,,percent of total billed charges,,7.97,,,,fee schedule,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,5,85.5,
AMBULATORY BP ANALYSIS,93788T,CDM,93788,CPT,,,both,T,91,91,8.4,,,,fee schedule,,,,,,,,44.4,,,,fee schedule,,,77.35,85,,percent of total billed charges,,10.37,,,,fee schedule,,5,,,,fee schedule,,44.4,,,,fee schedule,,32.52,,,,fee schedule,,44.4,,,,fee schedule,,8.95,,,,fee schedule,,5.42,,,,fee schedule,,5.42,,,,fee schedule,,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,27.3,83,,percent of total billed charges,,44.4,,,,fee schedule,,44.4,,,,fee schedule,,,75.53,83,,percent of total billed charges,,7.97,,,,fee schedule,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,5,86.45,
REVIEW/REPORT BP RECORDING,93790,CDM,93790,CPT,,,both,,119,119,27.84,,,,fee schedule,,,,,,,,44.4,,,,fee schedule,,,101.15,85,,percent of total billed charges,,38.62,,,,fee schedule,,18.64,,,,fee schedule,,44.4,,,,fee schedule,,32.52,,,,fee schedule,,44.4,,,,fee schedule,,29.63,,,,fee schedule,,17.96,,,,fee schedule,,17.96,,,,fee schedule,,,108.29,91,,percent of total billed charges,,,113.05,95,,percent of total billed charges,,,98.77,83,,percent of total billed charges,,,35.7,83,,percent of total billed charges,,44.4,,,,fee schedule,,44.4,,,,fee schedule,,,98.77,83,,percent of total billed charges,,26.4,,,,fee schedule,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,107.1,90,,percent of total billed charges,,,101.15,85,,percent of total billed charges,,17.96,113.05,
REVIEW/REPORT BP RECORDING,93790P,CDM,93790,CPT,,,both,P,25,25,27.84,,,,fee schedule,,,,,,,,44.4,,,,fee schedule,,,21.25,85,,percent of total billed charges,,38.62,,,,fee schedule,,18.64,,,,fee schedule,,44.4,,,,fee schedule,,32.52,,,,fee schedule,,44.4,,,,fee schedule,,29.63,,,,fee schedule,,17.96,,,,fee schedule,,17.96,,,,fee schedule,,,22.75,91,,percent of total billed charges,,,23.75,95,,percent of total billed charges,,,20.75,83,,percent of total billed charges,,,7.5,83,,percent of total billed charges,,44.4,,,,fee schedule,,44.4,,,,fee schedule,,,20.75,83,,percent of total billed charges,,26.4,,,,fee schedule,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,21.25,85,,percent of total billed charges,,7.5,44.4,
REVIEW/REPORT BP RECORDING,93790P,CDM,93790,CPT,,,both,P,28,28,27.84,,,,fee schedule,,,,,,,,44.4,,,,fee schedule,,,23.8,85,,percent of total billed charges,,38.62,,,,fee schedule,,18.64,,,,fee schedule,,44.4,,,,fee schedule,,32.52,,,,fee schedule,,44.4,,,,fee schedule,,29.63,,,,fee schedule,,17.96,,,,fee schedule,,17.96,,,,fee schedule,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,8.4,83,,percent of total billed charges,,44.4,,,,fee schedule,,44.4,,,,fee schedule,,,23.24,83,,percent of total billed charges,,26.4,,,,fee schedule,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,8.4,44.4,
REVIEW/REPORT BP RECORDING,93790T,CDM,93790,CPT,,,both,T,90,90,27.84,,,,fee schedule,,,,,,,,44.4,,,,fee schedule,,,76.5,85,,percent of total billed charges,,38.62,,,,fee schedule,,18.64,,,,fee schedule,,44.4,,,,fee schedule,,32.52,,,,fee schedule,,44.4,,,,fee schedule,,29.63,,,,fee schedule,,17.96,,,,fee schedule,,17.96,,,,fee schedule,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,44.4,,,,fee schedule,,44.4,,,,fee schedule,,,74.7,83,,percent of total billed charges,,26.4,,,,fee schedule,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,17.96,85.5,
REVIEW/REPORT BP RECORDING,93790T,CDM,93790,CPT,,,both,T,91,91,27.84,,,,fee schedule,,,,,,,,44.4,,,,fee schedule,,,77.35,85,,percent of total billed charges,,38.62,,,,fee schedule,,18.64,,,,fee schedule,,44.4,,,,fee schedule,,32.52,,,,fee schedule,,44.4,,,,fee schedule,,29.63,,,,fee schedule,,17.96,,,,fee schedule,,17.96,,,,fee schedule,,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,27.3,83,,percent of total billed charges,,44.4,,,,fee schedule,,44.4,,,,fee schedule,,,75.53,83,,percent of total billed charges,,26.4,,,,fee schedule,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,17.96,86.45,
PT/CAREGIVER TRAIN HOME INR,93792,CDM,93792,CPT,,,both,,313,313,110.3,,,,fee schedule,,,,,,,,,,,,,,,266.05,85,,percent of total billed charges,,128.28,,,,fee schedule,,61.89,,,,fee schedule,,,,,,,,,,,,,,,,,,,,117.42,,,,fee schedule,,71.16,,,,fee schedule,,71.16,,,,fee schedule,,,284.83,91,,percent of total billed charges,,,297.35,95,,percent of total billed charges,,,259.79,83,,percent of total billed charges,,,93.9,83,,percent of total billed charges,,,,,,,,,,,,,,,259.79,83,,percent of total billed charges,,104.61,,,,fee schedule,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,281.7,90,,percent of total billed charges,,,266.05,85,,percent of total billed charges,,61.89,297.35,
ANTICOAG MGMT PT WARFARIN,93793,CDM,93793,CPT,,,both,,61,61,17.86,,,,fee schedule,,,,,,,,7.13,,,,fee schedule,,,51.85,85,,percent of total billed charges,,23.75,,,,fee schedule,,11.46,,,,fee schedule,,7.13,,,,fee schedule,,,,,,,,7.13,,,,fee schedule,,19.01,,,,fee schedule,,11.52,,,,fee schedule,,11.52,,,,fee schedule,,,55.51,91,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,18.3,83,,percent of total billed charges,,7.13,,,,fee schedule,,7.13,,,,fee schedule,,,50.63,83,,percent of total billed charges,,16.94,,,,fee schedule,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,7.13,57.95,
US Carotid Arteries,93880,CDM,93880,CPT,,,both,,1113,1113,300.97,,,,fee schedule,,,,,,,,78.8,,,,fee schedule,,,946.05,85,,percent of total billed charges,,78.28,,,,fee schedule,,40.6,,,,fee schedule,,78.8,,,,fee schedule,,408.95,,,,fee schedule,,78.8,,,,fee schedule,,320.39,,,,fee schedule,,194.17,,,,fee schedule,,194.17,,,,fee schedule,,,1012.83,91,,percent of total billed charges,,,1057.35,95,,percent of total billed charges,,,923.79,83,,percent of total billed charges,,,333.9,83,,percent of total billed charges,,78.8,,,,fee schedule,,78.8,,,,fee schedule,,,923.79,83,,percent of total billed charges,,285.44,,,,fee schedule,,,1001.7,90,,percent of total billed charges,,,1001.7,90,,percent of total billed charges,,,1001.7,90,,percent of total billed charges,,,1001.7,90,,percent of total billed charges,,,946.05,85,,percent of total billed charges,,40.6,1057.35,
EXTRACRANIAL BILAT STUDY,9388026,CDM,93880,CPT,,,both,26,214,214,300.97,,,,fee schedule,,,,,,,,78.8,,,,fee schedule,,,181.9,85,,percent of total billed charges,,78.28,,,,fee schedule,,40.6,,,,fee schedule,,78.8,,,,fee schedule,,408.95,,,,fee schedule,,78.8,,,,fee schedule,,320.39,,,,fee schedule,,194.17,,,,fee schedule,,194.17,,,,fee schedule,,,194.74,91,,percent of total billed charges,,,203.3,95,,percent of total billed charges,,,177.62,83,,percent of total billed charges,,,64.2,83,,percent of total billed charges,,78.8,,,,fee schedule,,78.8,,,,fee schedule,,,177.62,83,,percent of total billed charges,,285.44,,,,fee schedule,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,192.6,90,,percent of total billed charges,,,181.9,85,,percent of total billed charges,,40.6,408.95,
EXTRACRANIAL BILAT STUDY,9388026,CDM,93880,CPT,,,both,26,247,247,300.97,,,,fee schedule,,,,,,,,78.8,,,,fee schedule,,,209.95,85,,percent of total billed charges,,78.28,,,,fee schedule,,40.6,,,,fee schedule,,78.8,,,,fee schedule,,408.95,,,,fee schedule,,78.8,,,,fee schedule,,320.39,,,,fee schedule,,194.17,,,,fee schedule,,194.17,,,,fee schedule,,,224.77,91,,percent of total billed charges,,,234.65,95,,percent of total billed charges,,,205.01,83,,percent of total billed charges,,,74.1,83,,percent of total billed charges,,78.8,,,,fee schedule,,78.8,,,,fee schedule,,,205.01,83,,percent of total billed charges,,285.44,,,,fee schedule,,,222.3,90,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,222.3,90,,percent of total billed charges,,,209.95,85,,percent of total billed charges,,40.6,408.95,
EXTRACRANIAL BILAT STUDY,93880TC,CDM,93880,CPT,,,both,TC,866,866,300.97,,,,fee schedule,,,,,,,,78.8,,,,fee schedule,,,736.1,85,,percent of total billed charges,,78.28,,,,fee schedule,,40.6,,,,fee schedule,,78.8,,,,fee schedule,,408.95,,,,fee schedule,,78.8,,,,fee schedule,,320.39,,,,fee schedule,,194.17,,,,fee schedule,,194.17,,,,fee schedule,,,788.06,91,,percent of total billed charges,,,822.7,95,,percent of total billed charges,,,718.78,83,,percent of total billed charges,,,259.8,83,,percent of total billed charges,,78.8,,,,fee schedule,,78.8,,,,fee schedule,,,718.78,83,,percent of total billed charges,,285.44,,,,fee schedule,,,779.4,90,,percent of total billed charges,,,779.4,90,,percent of total billed charges,,,779.4,90,,percent of total billed charges,,,779.4,90,,percent of total billed charges,,,736.1,85,,percent of total billed charges,,40.6,822.7,
EXTRACRANIAL BILAT STUDY,93880TC,CDM,93880,CPT,,,both,TC,866,866,300.97,,,,fee schedule,,,,,,,,78.8,,,,fee schedule,,,736.1,85,,percent of total billed charges,,78.28,,,,fee schedule,,40.6,,,,fee schedule,,78.8,,,,fee schedule,,408.95,,,,fee schedule,,78.8,,,,fee schedule,,320.39,,,,fee schedule,,194.17,,,,fee schedule,,194.17,,,,fee schedule,,,788.06,91,,percent of total billed charges,,,822.7,95,,percent of total billed charges,,,718.78,83,,percent of total billed charges,,,259.8,83,,percent of total billed charges,,78.8,,,,fee schedule,,78.8,,,,fee schedule,,,718.78,83,,percent of total billed charges,,285.44,,,,fee schedule,,,779.4,90,,percent of total billed charges,,,779.4,90,,percent of total billed charges,,,779.4,90,,percent of total billed charges,,,779.4,90,,percent of total billed charges,,,736.1,85,,percent of total billed charges,,40.6,822.7,
UL LOW EXT ART ABI/TCPO2 1-2 LVLS,93922,CDM,93922,CPT,,,both,,647,647,129.21,,,,fee schedule,,,,,,,,50.05,,,,fee schedule,,,549.95,85,,percent of total billed charges,,24.98,,,,fee schedule,,12.95,,,,fee schedule,,50.05,,,,fee schedule,,192.6,,,,fee schedule,,50.05,,,,fee schedule,,137.55,,,,fee schedule,,83.36,,,,fee schedule,,83.36,,,,fee schedule,,,588.77,91,,percent of total billed charges,,,614.65,95,,percent of total billed charges,,,537.01,83,,percent of total billed charges,,,194.1,83,,percent of total billed charges,,50.05,,,,fee schedule,,50.05,,,,fee schedule,,,537.01,83,,percent of total billed charges,,122.54,,,,fee schedule,,,582.3,90,,percent of total billed charges,,,582.3,90,,percent of total billed charges,,,582.3,90,,percent of total billed charges,,,582.3,90,,percent of total billed charges,,,549.95,85,,percent of total billed charges,,12.95,614.65,
US LOW EXT ART DUPLEX BIL,93925,CDM,93925,CPT,,,both,,1070,1070,378.18,,,,fee schedule,,,,,,,,78.8,,,,fee schedule,,,909.5,85,,percent of total billed charges,,76.83,,,,fee schedule,,39.85,,,,fee schedule,,78.8,,,,fee schedule,,484.61,,,,fee schedule,,78.8,,,,fee schedule,,402.58,,,,fee schedule,,243.99,,,,fee schedule,,243.99,,,,fee schedule,,,973.7,91,,percent of total billed charges,,,1016.5,95,,percent of total billed charges,,,888.1,83,,percent of total billed charges,,,321,83,,percent of total billed charges,,78.8,,,,fee schedule,,78.8,,,,fee schedule,,,888.1,83,,percent of total billed charges,,358.66,,,,fee schedule,,,963,90,,percent of total billed charges,,,963,90,,percent of total billed charges,,,963,90,,percent of total billed charges,,,963,90,,percent of total billed charges,,,909.5,85,,percent of total billed charges,,39.85,1016.5,
LOWER EXTREMITY STUDY,9392526,CDM,93925,CPT,,,both,26,192,192,378.18,,,,fee schedule,,,,,,,,78.8,,,,fee schedule,,,163.2,85,,percent of total billed charges,,76.83,,,,fee schedule,,39.85,,,,fee schedule,,78.8,,,,fee schedule,,484.61,,,,fee schedule,,78.8,,,,fee schedule,,402.58,,,,fee schedule,,243.99,,,,fee schedule,,243.99,,,,fee schedule,,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,57.6,83,,percent of total billed charges,,78.8,,,,fee schedule,,78.8,,,,fee schedule,,,159.36,83,,percent of total billed charges,,358.66,,,,fee schedule,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,39.85,484.61,
LOWER EXTREMITY STUDY,9392526,CDM,93925,CPT,,,both,26,224,224,378.18,,,,fee schedule,,,,,,,,78.8,,,,fee schedule,,,190.4,85,,percent of total billed charges,,76.83,,,,fee schedule,,39.85,,,,fee schedule,,78.8,,,,fee schedule,,484.61,,,,fee schedule,,78.8,,,,fee schedule,,402.58,,,,fee schedule,,243.99,,,,fee schedule,,243.99,,,,fee schedule,,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,67.2,83,,percent of total billed charges,,78.8,,,,fee schedule,,78.8,,,,fee schedule,,,185.92,83,,percent of total billed charges,,358.66,,,,fee schedule,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,39.85,484.61,
LOWER EXTREMITY STUDY,93925TC,CDM,93925,CPT,,,both,TC,846,846,378.18,,,,fee schedule,,,,,,,,78.8,,,,fee schedule,,,719.1,85,,percent of total billed charges,,76.83,,,,fee schedule,,39.85,,,,fee schedule,,78.8,,,,fee schedule,,484.61,,,,fee schedule,,78.8,,,,fee schedule,,402.58,,,,fee schedule,,243.99,,,,fee schedule,,243.99,,,,fee schedule,,,769.86,91,,percent of total billed charges,,,803.7,95,,percent of total billed charges,,,702.18,83,,percent of total billed charges,,,253.8,83,,percent of total billed charges,,78.8,,,,fee schedule,,78.8,,,,fee schedule,,,702.18,83,,percent of total billed charges,,358.66,,,,fee schedule,,,761.4,90,,percent of total billed charges,,,761.4,90,,percent of total billed charges,,,761.4,90,,percent of total billed charges,,,761.4,90,,percent of total billed charges,,,719.1,85,,percent of total billed charges,,39.85,803.7,
LOWER EXTREMITY STUDY,93925TC,CDM,93925,CPT,,,both,TC,846,846,378.18,,,,fee schedule,,,,,,,,78.8,,,,fee schedule,,,719.1,85,,percent of total billed charges,,76.83,,,,fee schedule,,39.85,,,,fee schedule,,78.8,,,,fee schedule,,484.61,,,,fee schedule,,78.8,,,,fee schedule,,402.58,,,,fee schedule,,243.99,,,,fee schedule,,243.99,,,,fee schedule,,,769.86,91,,percent of total billed charges,,,803.7,95,,percent of total billed charges,,,702.18,83,,percent of total billed charges,,,253.8,83,,percent of total billed charges,,78.8,,,,fee schedule,,78.8,,,,fee schedule,,,702.18,83,,percent of total billed charges,,358.66,,,,fee schedule,,,761.4,90,,percent of total billed charges,,,761.4,90,,percent of total billed charges,,,761.4,90,,percent of total billed charges,,,761.4,90,,percent of total billed charges,,,719.1,85,,percent of total billed charges,,39.85,803.7,
US Low Ext Art Duplex Unilateral     side:,93926,CDM,93926,CPT,,,both,,863,863,224.81,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,733.55,85,,percent of total billed charges,,46.87,,,,fee schedule,,24.31,,,,fee schedule,,52.7,,,,fee schedule,,294.52,,,,fee schedule,,52.7,,,,fee schedule,,239.31,,,,fee schedule,,145.04,,,,fee schedule,,145.04,,,,fee schedule,,,785.33,91,,percent of total billed charges,,,819.85,95,,percent of total billed charges,,,716.29,83,,percent of total billed charges,,,258.9,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,716.29,83,,percent of total billed charges,,213.2,,,,fee schedule,,,776.7,90,,percent of total billed charges,,,776.7,90,,percent of total billed charges,,,776.7,90,,percent of total billed charges,,,776.7,90,,percent of total billed charges,,,733.55,85,,percent of total billed charges,,24.31,819.85,
LOWER EXTREMITY STUDY,9392626,CDM,93926,CPT,,,both,26,148,148,224.81,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,125.8,85,,percent of total billed charges,,46.87,,,,fee schedule,,24.31,,,,fee schedule,,52.7,,,,fee schedule,,294.52,,,,fee schedule,,52.7,,,,fee schedule,,239.31,,,,fee schedule,,145.04,,,,fee schedule,,145.04,,,,fee schedule,,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,44.4,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,122.84,83,,percent of total billed charges,,213.2,,,,fee schedule,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,24.31,294.52,
LOWER EXTREMITY STUDY,9392626,CDM,93926,CPT,,,both,26,174,174,224.81,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,147.9,85,,percent of total billed charges,,46.87,,,,fee schedule,,24.31,,,,fee schedule,,52.7,,,,fee schedule,,294.52,,,,fee schedule,,52.7,,,,fee schedule,,239.31,,,,fee schedule,,145.04,,,,fee schedule,,145.04,,,,fee schedule,,,158.34,91,,percent of total billed charges,,,165.3,95,,percent of total billed charges,,,144.42,83,,percent of total billed charges,,,52.2,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,144.42,83,,percent of total billed charges,,213.2,,,,fee schedule,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,156.6,90,,percent of total billed charges,,,147.9,85,,percent of total billed charges,,24.31,294.52,
LOWER EXTREMITY STUDY,93926TC,CDM,93926,CPT,,,both,TC,689,689,224.81,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,585.65,85,,percent of total billed charges,,46.87,,,,fee schedule,,24.31,,,,fee schedule,,52.7,,,,fee schedule,,294.52,,,,fee schedule,,52.7,,,,fee schedule,,239.31,,,,fee schedule,,145.04,,,,fee schedule,,145.04,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,571.87,83,,percent of total billed charges,,213.2,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,24.31,654.55,
LOWER EXTREMITY STUDY,93926TC,CDM,93926,CPT,,,both,TC,689,689,224.81,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,585.65,85,,percent of total billed charges,,46.87,,,,fee schedule,,24.31,,,,fee schedule,,52.7,,,,fee schedule,,294.52,,,,fee schedule,,52.7,,,,fee schedule,,239.31,,,,fee schedule,,145.04,,,,fee schedule,,145.04,,,,fee schedule,,,626.99,91,,percent of total billed charges,,,654.55,95,,percent of total billed charges,,,571.87,83,,percent of total billed charges,,,206.7,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,571.87,83,,percent of total billed charges,,213.2,,,,fee schedule,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,620.1,90,,percent of total billed charges,,,585.65,85,,percent of total billed charges,,24.31,654.55,
US UP Ext Art Duplex Bilateral,93930,CDM,93930,CPT,,,both,,985,985,308.32,,,,fee schedule,,,,,,,,80.15,,,,fee schedule,,,837.25,85,,percent of total billed charges,,77.83,,,,fee schedule,,40.37,,,,fee schedule,,80.15,,,,fee schedule,,388.94,,,,fee schedule,,80.15,,,,fee schedule,,328.21,,,,fee schedule,,198.92,,,,fee schedule,,198.92,,,,fee schedule,,,896.35,91,,percent of total billed charges,,,935.75,95,,percent of total billed charges,,,817.55,83,,percent of total billed charges,,,295.5,83,,percent of total billed charges,,80.15,,,,fee schedule,,80.15,,,,fee schedule,,,817.55,83,,percent of total billed charges,,292.41,,,,fee schedule,,,886.5,90,,percent of total billed charges,,,886.5,90,,percent of total billed charges,,,886.5,90,,percent of total billed charges,,,886.5,90,,percent of total billed charges,,,837.25,85,,percent of total billed charges,,40.37,935.75,
UPPER EXTREMITY STUDY,9393026,CDM,93930,CPT,,,both,26,161,161,308.32,,,,fee schedule,,,,,,,,80.15,,,,fee schedule,,,136.85,85,,percent of total billed charges,,77.83,,,,fee schedule,,40.37,,,,fee schedule,,80.15,,,,fee schedule,,388.94,,,,fee schedule,,80.15,,,,fee schedule,,328.21,,,,fee schedule,,198.92,,,,fee schedule,,198.92,,,,fee schedule,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,48.3,83,,percent of total billed charges,,80.15,,,,fee schedule,,80.15,,,,fee schedule,,,133.63,83,,percent of total billed charges,,292.41,,,,fee schedule,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,40.37,388.94,
UPPER EXTREMITY STUDY,9393026,CDM,93930,CPT,,,both,26,190,190,308.32,,,,fee schedule,,,,,,,,80.15,,,,fee schedule,,,161.5,85,,percent of total billed charges,,77.83,,,,fee schedule,,40.37,,,,fee schedule,,80.15,,,,fee schedule,,388.94,,,,fee schedule,,80.15,,,,fee schedule,,328.21,,,,fee schedule,,198.92,,,,fee schedule,,198.92,,,,fee schedule,,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,57,83,,percent of total billed charges,,80.15,,,,fee schedule,,80.15,,,,fee schedule,,,157.7,83,,percent of total billed charges,,292.41,,,,fee schedule,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,40.37,388.94,
UPPER EXTREMITY STUDY,93930TC,CDM,93930,CPT,,,both,TC,795,795,308.32,,,,fee schedule,,,,,,,,80.15,,,,fee schedule,,,675.75,85,,percent of total billed charges,,77.83,,,,fee schedule,,40.37,,,,fee schedule,,80.15,,,,fee schedule,,388.94,,,,fee schedule,,80.15,,,,fee schedule,,328.21,,,,fee schedule,,198.92,,,,fee schedule,,198.92,,,,fee schedule,,,723.45,91,,percent of total billed charges,,,755.25,95,,percent of total billed charges,,,659.85,83,,percent of total billed charges,,,238.5,83,,percent of total billed charges,,80.15,,,,fee schedule,,80.15,,,,fee schedule,,,659.85,83,,percent of total billed charges,,292.41,,,,fee schedule,,,715.5,90,,percent of total billed charges,,,715.5,90,,percent of total billed charges,,,715.5,90,,percent of total billed charges,,,715.5,90,,percent of total billed charges,,,675.75,85,,percent of total billed charges,,40.37,755.25,
UPPER EXTREMITY STUDY,93930TC,CDM,93930,CPT,,,both,TC,795,795,308.32,,,,fee schedule,,,,,,,,80.15,,,,fee schedule,,,675.75,85,,percent of total billed charges,,77.83,,,,fee schedule,,40.37,,,,fee schedule,,80.15,,,,fee schedule,,388.94,,,,fee schedule,,80.15,,,,fee schedule,,328.21,,,,fee schedule,,198.92,,,,fee schedule,,198.92,,,,fee schedule,,,723.45,91,,percent of total billed charges,,,755.25,95,,percent of total billed charges,,,659.85,83,,percent of total billed charges,,,238.5,83,,percent of total billed charges,,80.15,,,,fee schedule,,80.15,,,,fee schedule,,,659.85,83,,percent of total billed charges,,292.41,,,,fee schedule,,,715.5,90,,percent of total billed charges,,,715.5,90,,percent of total billed charges,,,715.5,90,,percent of total billed charges,,,715.5,90,,percent of total billed charges,,,675.75,85,,percent of total billed charges,,40.37,755.25,
US UP Ext Art Duplex     side:,93931,CDM,93931,CPT,,,both,,765,765,194.34,,,,fee schedule,,,,,,,,53.2,,,,fee schedule,,,650.25,85,,percent of total billed charges,,48.14,,,,fee schedule,,24.96,,,,fee schedule,,53.2,,,,fee schedule,,253.88,,,,fee schedule,,53.2,,,,fee schedule,,206.88,,,,fee schedule,,125.38,,,,fee schedule,,125.38,,,,fee schedule,,,696.15,91,,percent of total billed charges,,,726.75,95,,percent of total billed charges,,,634.95,83,,percent of total billed charges,,,229.5,83,,percent of total billed charges,,53.2,,,,fee schedule,,53.2,,,,fee schedule,,,634.95,83,,percent of total billed charges,,184.31,,,,fee schedule,,,688.5,90,,percent of total billed charges,,,688.5,90,,percent of total billed charges,,,688.5,90,,percent of total billed charges,,,688.5,90,,percent of total billed charges,,,650.25,85,,percent of total billed charges,,24.96,726.75,
UPPER EXTREMITY STUDY,9393126,CDM,93931,CPT,,,both,26,121,121,194.34,,,,fee schedule,,,,,,,,53.2,,,,fee schedule,,,102.85,85,,percent of total billed charges,,48.14,,,,fee schedule,,24.96,,,,fee schedule,,53.2,,,,fee schedule,,253.88,,,,fee schedule,,53.2,,,,fee schedule,,206.88,,,,fee schedule,,125.38,,,,fee schedule,,125.38,,,,fee schedule,,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,36.3,83,,percent of total billed charges,,53.2,,,,fee schedule,,53.2,,,,fee schedule,,,100.43,83,,percent of total billed charges,,184.31,,,,fee schedule,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,24.96,253.88,
UPPER EXTREMITY STUDY,9393126,CDM,93931,CPT,,,both,26,144,144,194.34,,,,fee schedule,,,,,,,,53.2,,,,fee schedule,,,122.4,85,,percent of total billed charges,,48.14,,,,fee schedule,,24.96,,,,fee schedule,,53.2,,,,fee schedule,,253.88,,,,fee schedule,,53.2,,,,fee schedule,,206.88,,,,fee schedule,,125.38,,,,fee schedule,,125.38,,,,fee schedule,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,43.2,83,,percent of total billed charges,,53.2,,,,fee schedule,,53.2,,,,fee schedule,,,119.52,83,,percent of total billed charges,,184.31,,,,fee schedule,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,24.96,253.88,
UPPER EXTREMITY STUDY,93931TC,CDM,93931,CPT,,,both,TC,621,621,194.34,,,,fee schedule,,,,,,,,53.2,,,,fee schedule,,,527.85,85,,percent of total billed charges,,48.14,,,,fee schedule,,24.96,,,,fee schedule,,53.2,,,,fee schedule,,253.88,,,,fee schedule,,53.2,,,,fee schedule,,206.88,,,,fee schedule,,125.38,,,,fee schedule,,125.38,,,,fee schedule,,,565.11,91,,percent of total billed charges,,,589.95,95,,percent of total billed charges,,,515.43,83,,percent of total billed charges,,,186.3,83,,percent of total billed charges,,53.2,,,,fee schedule,,53.2,,,,fee schedule,,,515.43,83,,percent of total billed charges,,184.31,,,,fee schedule,,,558.9,90,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,527.85,85,,percent of total billed charges,,24.96,589.95,
UPPER EXTREMITY STUDY,93931TC,CDM,93931,CPT,,,both,TC,621,621,194.34,,,,fee schedule,,,,,,,,53.2,,,,fee schedule,,,527.85,85,,percent of total billed charges,,48.14,,,,fee schedule,,24.96,,,,fee schedule,,53.2,,,,fee schedule,,253.88,,,,fee schedule,,53.2,,,,fee schedule,,206.88,,,,fee schedule,,125.38,,,,fee schedule,,125.38,,,,fee schedule,,,565.11,91,,percent of total billed charges,,,589.95,95,,percent of total billed charges,,,515.43,83,,percent of total billed charges,,,186.3,83,,percent of total billed charges,,53.2,,,,fee schedule,,53.2,,,,fee schedule,,,515.43,83,,percent of total billed charges,,184.31,,,,fee schedule,,,558.9,90,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,558.9,90,,percent of total billed charges,,,527.85,85,,percent of total billed charges,,24.96,589.95,
US Low/Up Ext Ven Dop Bilateral     site:,93970,CDM,93970,CPT,,,both,,1147,1147,296.77,,,,fee schedule,,,,,,,,87.55,,,,fee schedule,,,974.95,85,,percent of total billed charges,,68.02,,,,fee schedule,,35.28,,,,fee schedule,,87.55,,,,fee schedule,,398.95,,,,fee schedule,,87.55,,,,fee schedule,,315.91,,,,fee schedule,,191.46,,,,fee schedule,,191.46,,,,fee schedule,,,1043.77,91,,percent of total billed charges,,,1089.65,95,,percent of total billed charges,,,952.01,83,,percent of total billed charges,,,344.1,83,,percent of total billed charges,,87.55,,,,fee schedule,,87.55,,,,fee schedule,,,952.01,83,,percent of total billed charges,,281.45,,,,fee schedule,,,1032.3,90,,percent of total billed charges,,,1032.3,90,,percent of total billed charges,,,1032.3,90,,percent of total billed charges,,,1032.3,90,,percent of total billed charges,,,974.95,85,,percent of total billed charges,,35.28,1089.65,
EXTREMITY STUDY,9397026,CDM,93970,CPT,,,both,26,221,221,296.77,,,,fee schedule,,,,,,,,87.55,,,,fee schedule,,,187.85,85,,percent of total billed charges,,68.02,,,,fee schedule,,35.28,,,,fee schedule,,87.55,,,,fee schedule,,398.95,,,,fee schedule,,87.55,,,,fee schedule,,315.91,,,,fee schedule,,191.46,,,,fee schedule,,191.46,,,,fee schedule,,,201.11,91,,percent of total billed charges,,,209.95,95,,percent of total billed charges,,,183.43,83,,percent of total billed charges,,,66.3,83,,percent of total billed charges,,87.55,,,,fee schedule,,87.55,,,,fee schedule,,,183.43,83,,percent of total billed charges,,281.45,,,,fee schedule,,,198.9,90,,percent of total billed charges,,,198.9,90,,percent of total billed charges,,,198.9,90,,percent of total billed charges,,,198.9,90,,percent of total billed charges,,,187.85,85,,percent of total billed charges,,35.28,398.95,
EXTREMITY STUDY,9397026,CDM,93970,CPT,,,both,26,255,255,296.77,,,,fee schedule,,,,,,,,87.55,,,,fee schedule,,,216.75,85,,percent of total billed charges,,68.02,,,,fee schedule,,35.28,,,,fee schedule,,87.55,,,,fee schedule,,398.95,,,,fee schedule,,87.55,,,,fee schedule,,315.91,,,,fee schedule,,191.46,,,,fee schedule,,191.46,,,,fee schedule,,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,76.5,83,,percent of total billed charges,,87.55,,,,fee schedule,,87.55,,,,fee schedule,,,211.65,83,,percent of total billed charges,,281.45,,,,fee schedule,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,35.28,398.95,
EXTREMITY STUDY,93970TC,CDM,93970,CPT,,,both,TC,892,892,296.77,,,,fee schedule,,,,,,,,87.55,,,,fee schedule,,,758.2,85,,percent of total billed charges,,68.02,,,,fee schedule,,35.28,,,,fee schedule,,87.55,,,,fee schedule,,398.95,,,,fee schedule,,87.55,,,,fee schedule,,315.91,,,,fee schedule,,191.46,,,,fee schedule,,191.46,,,,fee schedule,,,811.72,91,,percent of total billed charges,,,847.4,95,,percent of total billed charges,,,740.36,83,,percent of total billed charges,,,267.6,83,,percent of total billed charges,,87.55,,,,fee schedule,,87.55,,,,fee schedule,,,740.36,83,,percent of total billed charges,,281.45,,,,fee schedule,,,802.8,90,,percent of total billed charges,,,802.8,90,,percent of total billed charges,,,802.8,90,,percent of total billed charges,,,802.8,90,,percent of total billed charges,,,758.2,85,,percent of total billed charges,,35.28,847.4,
EXTREMITY STUDY,93970TC,CDM,93970,CPT,,,both,TC,892,892,296.77,,,,fee schedule,,,,,,,,87.55,,,,fee schedule,,,758.2,85,,percent of total billed charges,,68.02,,,,fee schedule,,35.28,,,,fee schedule,,87.55,,,,fee schedule,,398.95,,,,fee schedule,,87.55,,,,fee schedule,,315.91,,,,fee schedule,,191.46,,,,fee schedule,,191.46,,,,fee schedule,,,811.72,91,,percent of total billed charges,,,847.4,95,,percent of total billed charges,,,740.36,83,,percent of total billed charges,,,267.6,83,,percent of total billed charges,,87.55,,,,fee schedule,,87.55,,,,fee schedule,,,740.36,83,,percent of total billed charges,,281.45,,,,fee schedule,,,802.8,90,,percent of total billed charges,,,802.8,90,,percent of total billed charges,,,802.8,90,,percent of total billed charges,,,802.8,90,,percent of total billed charges,,,758.2,85,,percent of total billed charges,,35.28,847.4,
US Low/Up Ext Ven Dop     side/site:,93971,CDM,93971,CPT,,,both,,834,834,188.04,,,,fee schedule,,,,,,,,58.25,,,,fee schedule,,,708.9,85,,percent of total billed charges,,43.23,,,,fee schedule,,22.42,,,,fee schedule,,58.25,,,,fee schedule,,271.38,,,,fee schedule,,58.25,,,,fee schedule,,200.17,,,,fee schedule,,121.32,,,,fee schedule,,121.32,,,,fee schedule,,,758.94,91,,percent of total billed charges,,,792.3,95,,percent of total billed charges,,,692.22,83,,percent of total billed charges,,,250.2,83,,percent of total billed charges,,58.25,,,,fee schedule,,58.25,,,,fee schedule,,,692.22,83,,percent of total billed charges,,178.33,,,,fee schedule,,,750.6,90,,percent of total billed charges,,,750.6,90,,percent of total billed charges,,,750.6,90,,percent of total billed charges,,,750.6,90,,percent of total billed charges,,,708.9,85,,percent of total billed charges,,22.42,792.3,
EXTREMITY STUDY,9397126,CDM,93971,CPT,,,both,26,152,152,188.04,,,,fee schedule,,,,,,,,58.25,,,,fee schedule,,,129.2,85,,percent of total billed charges,,43.23,,,,fee schedule,,22.42,,,,fee schedule,,58.25,,,,fee schedule,,271.38,,,,fee schedule,,58.25,,,,fee schedule,,200.17,,,,fee schedule,,121.32,,,,fee schedule,,121.32,,,,fee schedule,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,45.6,83,,percent of total billed charges,,58.25,,,,fee schedule,,58.25,,,,fee schedule,,,126.16,83,,percent of total billed charges,,178.33,,,,fee schedule,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,22.42,271.38,
EXTREMITY STUDY,9397126,CDM,93971,CPT,,,both,26,178,178,188.04,,,,fee schedule,,,,,,,,58.25,,,,fee schedule,,,151.3,85,,percent of total billed charges,,43.23,,,,fee schedule,,22.42,,,,fee schedule,,58.25,,,,fee schedule,,271.38,,,,fee schedule,,58.25,,,,fee schedule,,200.17,,,,fee schedule,,121.32,,,,fee schedule,,121.32,,,,fee schedule,,,161.98,91,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,53.4,83,,percent of total billed charges,,58.25,,,,fee schedule,,58.25,,,,fee schedule,,,147.74,83,,percent of total billed charges,,178.33,,,,fee schedule,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,22.42,271.38,
EXTREMITY STUDY,93971TC,CDM,93971,CPT,,,both,TC,656,656,188.04,,,,fee schedule,,,,,,,,58.25,,,,fee schedule,,,557.6,85,,percent of total billed charges,,43.23,,,,fee schedule,,22.42,,,,fee schedule,,58.25,,,,fee schedule,,271.38,,,,fee schedule,,58.25,,,,fee schedule,,200.17,,,,fee schedule,,121.32,,,,fee schedule,,121.32,,,,fee schedule,,,596.96,91,,percent of total billed charges,,,623.2,95,,percent of total billed charges,,,544.48,83,,percent of total billed charges,,,196.8,83,,percent of total billed charges,,58.25,,,,fee schedule,,58.25,,,,fee schedule,,,544.48,83,,percent of total billed charges,,178.33,,,,fee schedule,,,590.4,90,,percent of total billed charges,,,590.4,90,,percent of total billed charges,,,590.4,90,,percent of total billed charges,,,590.4,90,,percent of total billed charges,,,557.6,85,,percent of total billed charges,,22.42,623.2,
EXTREMITY STUDY,93971TC,CDM,93971,CPT,,,both,TC,656,656,188.04,,,,fee schedule,,,,,,,,58.25,,,,fee schedule,,,557.6,85,,percent of total billed charges,,43.23,,,,fee schedule,,22.42,,,,fee schedule,,58.25,,,,fee schedule,,271.38,,,,fee schedule,,58.25,,,,fee schedule,,200.17,,,,fee schedule,,121.32,,,,fee schedule,,121.32,,,,fee schedule,,,596.96,91,,percent of total billed charges,,,623.2,95,,percent of total billed charges,,,544.48,83,,percent of total billed charges,,,196.8,83,,percent of total billed charges,,58.25,,,,fee schedule,,58.25,,,,fee schedule,,,544.48,83,,percent of total billed charges,,178.33,,,,fee schedule,,,590.4,90,,percent of total billed charges,,,590.4,90,,percent of total billed charges,,,590.4,90,,percent of total billed charges,,,590.4,90,,percent of total billed charges,,,557.6,85,,percent of total billed charges,,22.42,623.2,
"VENT MGMT INPAT, INIT DAY",94002,CDM,94002,CPT,,,both,,661,661,141.82,,,,fee schedule,,,,,,,,46.34,,,,fee schedule,,,561.85,85,,percent of total billed charges,,231.12,,,,fee schedule,,96.26,,,,fee schedule,,46.34,,,,fee schedule,,,,,,,,46.34,,,,fee schedule,,150.97,,,,fee schedule,,91.5,,,,fee schedule,,91.5,,,,fee schedule,,,601.51,91,,percent of total billed charges,,,627.95,95,,percent of total billed charges,,,548.63,83,,percent of total billed charges,,,198.3,83,,percent of total billed charges,,46.34,,,,fee schedule,,46.34,,,,fee schedule,,,548.63,83,,percent of total billed charges,,134.5,,,,fee schedule,,,594.9,90,,percent of total billed charges,,,594.9,90,,percent of total billed charges,,,594.9,90,,percent of total billed charges,,,594.9,90,,percent of total billed charges,,,561.85,85,,percent of total billed charges,,46.34,627.95,
PFT-SCREEN SPIROMETRY W/VC EXPIRATORY FLO+-MXML VOL VNTJ,94010,CDM,94010,CPT,,,both,,161,161,42.02,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,136.85,85,,percent of total billed charges,,20.37,,,,fee schedule,,8.49,,,,fee schedule,,37.4,,,,fee schedule,,54.4,,,,fee schedule,,37.4,,,,fee schedule,,44.73,,,,fee schedule,,27.11,,,,fee schedule,,27.11,,,,fee schedule,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,48.3,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,133.63,83,,percent of total billed charges,,39.85,,,,fee schedule,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,8.49,152.95,
PFT COMPLETE-BRNCDILAT RSPSE SPMTRY PRE/POST-BRNCDILAT ADMN (PFT),94060,CDM,94060,CPT,,,both,,260,260,60.4,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,221,85,,percent of total billed charges,,25.47,,,,fee schedule,,10.61,,,,fee schedule,,52.7,,,,fee schedule,,90.67,,,,fee schedule,,52.7,,,,fee schedule,,64.3,,,,fee schedule,,38.97,,,,fee schedule,,38.97,,,,fee schedule,,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,78,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,215.8,83,,percent of total billed charges,,57.29,,,,fee schedule,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,10.61,247,
PFT COMPLETE - EVALUATION OF WHEEZING,94060P,CDM,94060,CPT,,,both,P,102,102,60.4,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,86.7,85,,percent of total billed charges,,25.47,,,,fee schedule,,10.61,,,,fee schedule,,52.7,,,,fee schedule,,90.67,,,,fee schedule,,52.7,,,,fee schedule,,64.3,,,,fee schedule,,38.97,,,,fee schedule,,38.97,,,,fee schedule,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,30.6,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,84.66,83,,percent of total billed charges,,57.29,,,,fee schedule,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,10.61,96.9,
PFT COMPLETE - EVALUATION OF WHEEZING,94060P,CDM,94060,CPT,,,both,P,108,108,60.4,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,91.8,85,,percent of total billed charges,,25.47,,,,fee schedule,,10.61,,,,fee schedule,,52.7,,,,fee schedule,,90.67,,,,fee schedule,,52.7,,,,fee schedule,,64.3,,,,fee schedule,,38.97,,,,fee schedule,,38.97,,,,fee schedule,,,98.28,91,,percent of total billed charges,,,102.6,95,,percent of total billed charges,,,89.64,83,,percent of total billed charges,,,32.4,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,89.64,83,,percent of total billed charges,,57.29,,,,fee schedule,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,97.2,90,,percent of total billed charges,,,91.8,85,,percent of total billed charges,,10.61,102.6,
PFT COMPLETE - EVALUATION OF WHEEZING,94060T,CDM,94060,CPT,,,both,T,150,150,60.4,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,127.5,85,,percent of total billed charges,,25.47,,,,fee schedule,,10.61,,,,fee schedule,,52.7,,,,fee schedule,,90.67,,,,fee schedule,,52.7,,,,fee schedule,,64.3,,,,fee schedule,,38.97,,,,fee schedule,,38.97,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,124.5,83,,percent of total billed charges,,57.29,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,10.61,142.5,
PFT COMPLETE - EVALUATION OF WHEEZING,94060T,CDM,94060,CPT,,,both,T,152,152,60.4,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,129.2,85,,percent of total billed charges,,25.47,,,,fee schedule,,10.61,,,,fee schedule,,52.7,,,,fee schedule,,90.67,,,,fee schedule,,52.7,,,,fee schedule,,64.3,,,,fee schedule,,38.97,,,,fee schedule,,38.97,,,,fee schedule,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,45.6,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,126.16,83,,percent of total billed charges,,57.29,,,,fee schedule,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,10.61,144.4,
PFT FULL,94070,CDM,94070,CPT,,,both,,350,350,95.6,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,297.5,85,,percent of total billed charges,,69.42,,,,fee schedule,,28.92,,,,fee schedule,,52.7,,,,fee schedule,,96.92,,,,fee schedule,,52.7,,,,fee schedule,,101.76,,,,fee schedule,,61.67,,,,fee schedule,,61.67,,,,fee schedule,,,318.5,91,,percent of total billed charges,,,332.5,95,,percent of total billed charges,,,290.5,83,,percent of total billed charges,,,105,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,290.5,83,,percent of total billed charges,,90.66,,,,fee schedule,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,315,90,,percent of total billed charges,,,297.5,85,,percent of total billed charges,,28.92,332.5,
VITAL CAPACITY TEST,94150,CDM,94150,CPT,,,both,,81,81,38.87,,,,fee schedule,,,,,,,,7.6,,,,fee schedule,,,68.85,85,,percent of total billed charges,,9.4,,,,fee schedule,,3.92,,,,fee schedule,,7.6,,,,fee schedule,,35.02,,,,fee schedule,,7.6,,,,fee schedule,,41.38,,,,fee schedule,,25.08,,,,fee schedule,,25.08,,,,fee schedule,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,24.3,83,,percent of total billed charges,,7.6,,,,fee schedule,,7.6,,,,fee schedule,,,67.23,83,,percent of total billed charges,,36.86,,,,fee schedule,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,3.92,76.95,
VITAL CAPACITY TEST,94150P,CDM,94150,CPT,,,both,P,28,28,38.87,,,,fee schedule,,,,,,,,7.6,,,,fee schedule,,,23.8,85,,percent of total billed charges,,9.4,,,,fee schedule,,3.92,,,,fee schedule,,7.6,,,,fee schedule,,35.02,,,,fee schedule,,7.6,,,,fee schedule,,41.38,,,,fee schedule,,25.08,,,,fee schedule,,25.08,,,,fee schedule,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,8.4,83,,percent of total billed charges,,7.6,,,,fee schedule,,7.6,,,,fee schedule,,,23.24,83,,percent of total billed charges,,36.86,,,,fee schedule,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,3.92,41.38,
VITAL CAPACITY TEST,94150P,CDM,94150,CPT,,,both,P,30,30,38.87,,,,fee schedule,,,,,,,,7.6,,,,fee schedule,,,25.5,85,,percent of total billed charges,,9.4,,,,fee schedule,,3.92,,,,fee schedule,,7.6,,,,fee schedule,,35.02,,,,fee schedule,,7.6,,,,fee schedule,,41.38,,,,fee schedule,,25.08,,,,fee schedule,,25.08,,,,fee schedule,,,27.3,91,,percent of total billed charges,,,28.5,95,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,9,83,,percent of total billed charges,,7.6,,,,fee schedule,,7.6,,,,fee schedule,,,24.9,83,,percent of total billed charges,,36.86,,,,fee schedule,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,27,90,,percent of total billed charges,,,25.5,85,,percent of total billed charges,,3.92,41.38,
VITAL CAPACITY TEST,94150T,CDM,94150,CPT,,,both,T,50,50,38.87,,,,fee schedule,,,,,,,,7.6,,,,fee schedule,,,42.5,85,,percent of total billed charges,,9.4,,,,fee schedule,,3.92,,,,fee schedule,,7.6,,,,fee schedule,,35.02,,,,fee schedule,,7.6,,,,fee schedule,,41.38,,,,fee schedule,,25.08,,,,fee schedule,,25.08,,,,fee schedule,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,7.6,,,,fee schedule,,7.6,,,,fee schedule,,,41.5,83,,percent of total billed charges,,36.86,,,,fee schedule,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,3.92,47.5,
VITAL CAPACITY TEST,94150T,CDM,94150,CPT,,,both,T,51,51,38.87,,,,fee schedule,,,,,,,,7.6,,,,fee schedule,,,43.35,85,,percent of total billed charges,,9.4,,,,fee schedule,,3.92,,,,fee schedule,,7.6,,,,fee schedule,,35.02,,,,fee schedule,,7.6,,,,fee schedule,,41.38,,,,fee schedule,,25.08,,,,fee schedule,,25.08,,,,fee schedule,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,7.6,,,,fee schedule,,7.6,,,,fee schedule,,,42.33,83,,percent of total billed charges,,36.86,,,,fee schedule,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,3.92,48.45,
PULMONARY STRESS TESTING,94618,CDM,94618,CPT,,,both,,206,206,52.53,,,,fee schedule,,,,,,,,20.09,,,,fee schedule,,,175.1,85,,percent of total billed charges,,55.16,,,,fee schedule,,22.97,,,,fee schedule,,20.09,,,,fee schedule,,,,,,,,20.09,,,,fee schedule,,55.91,,,,fee schedule,,33.89,,,,fee schedule,,33.89,,,,fee schedule,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,61.8,83,,percent of total billed charges,,20.09,,,,fee schedule,,20.09,,,,fee schedule,,,170.98,83,,percent of total billed charges,,49.81,,,,fee schedule,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,20.09,195.7,
PRESS/N-PRESS INHLJ TX F/AAO/SPTM INDCTJ,94640,CDM,94640,CPT,,,both,,86,86,14.18,,,,fee schedule,,,,,,,,14.5,,,,fee schedule,,,73.1,85,,percent of total billed charges,,26.15,,,,fee schedule,,10.89,,,,fee schedule,,14.5,,,,fee schedule,,20.01,,,,fee schedule,,14.5,,,,fee schedule,,15.1,,,,fee schedule,,9.15,,,,fee schedule,,9.15,,,,fee schedule,,,78.26,91,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,25.8,83,,percent of total billed charges,,14.5,,,,fee schedule,,14.5,,,,fee schedule,,,71.38,83,,percent of total billed charges,,13.45,,,,fee schedule,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,9.15,81.7,
AERSL INHLJ PENTAMIDINE F/PCP TX/PROPH,94642,CDM,94642,CPT,,,both,,164,164,,,,,,,,,,,,,22.05,,,,fee schedule,,,139.4,85,,percent of total billed charges,,102.38,,,,fee schedule,,42.64,,,,fee schedule,,22.05,,,,fee schedule,,,,,,,,22.05,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,49.2,83,,percent of total billed charges,,22.05,,,,fee schedule,,22.05,,,,fee schedule,,,136.12,83,,percent of total billed charges,,,,,,,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,22.05,155.8,
AEROSOL INHALATION TREATMENT,94642P,CDM,94642,CPT,,,both,P,9,9,,,,,,,,,,,,,22.05,,,,fee schedule,,,7.65,85,,percent of total billed charges,,102.38,,,,fee schedule,,42.64,,,,fee schedule,,22.05,,,,fee schedule,,,,,,,,22.05,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,2.7,83,,percent of total billed charges,,22.05,,,,fee schedule,,22.05,,,,fee schedule,,,7.47,83,,percent of total billed charges,,,,,,,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,2.7,102.38,
AEROSOL INHALATION TREATMENT,94642P,CDM,94642,CPT,,,both,P,14,14,,,,,,,,,,,,,22.05,,,,fee schedule,,,11.9,85,,percent of total billed charges,,102.38,,,,fee schedule,,42.64,,,,fee schedule,,22.05,,,,fee schedule,,,,,,,,22.05,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,12.74,91,,percent of total billed charges,,,13.3,95,,percent of total billed charges,,,11.62,83,,percent of total billed charges,,,4.2,83,,percent of total billed charges,,22.05,,,,fee schedule,,22.05,,,,fee schedule,,,11.62,83,,percent of total billed charges,,,,,,,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,11.9,85,,percent of total billed charges,,4.2,102.38,
AEROSOL INHALATION TREATMENT,94642T,CDM,94642,CPT,,,both,T,150,150,,,,,,,,,,,,,22.05,,,,fee schedule,,,127.5,85,,percent of total billed charges,,102.38,,,,fee schedule,,42.64,,,,fee schedule,,22.05,,,,fee schedule,,,,,,,,22.05,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,22.05,,,,fee schedule,,22.05,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,22.05,142.5,
AEROSOL INHALATION TREATMENT,94642T,CDM,94642,CPT,,,both,T,150,150,,,,,,,,,,,,,22.05,,,,fee schedule,,,127.5,85,,percent of total billed charges,,102.38,,,,fee schedule,,42.64,,,,fee schedule,,22.05,,,,fee schedule,,,,,,,,22.05,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,22.05,,,,fee schedule,,22.05,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,22.05,142.5,
"POS AIRWAY PRESSURE, CPAP",94660,CDM,94660,CPT,,,both,,202,202,57.25,,,,fee schedule,,,,,,,,,,,,,,,171.7,85,,percent of total billed charges,,94.58,,,,fee schedule,,39.39,,,,fee schedule,,,,,,,,64.41,,,,fee schedule,,,,,,,,60.95,,,,fee schedule,,36.94,,,,fee schedule,,36.94,,,,fee schedule,,,183.82,91,,percent of total billed charges,,,191.9,95,,percent of total billed charges,,,167.66,83,,percent of total billed charges,,,60.6,83,,percent of total billed charges,,,,,,,,,,,,,,,167.66,83,,percent of total billed charges,,54.3,,,,fee schedule,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,171.7,85,,percent of total billed charges,,36.94,191.9,
"POS AIRWAY PRESSURE, CPAP",94660P,CDM,94660,CPT,,,both,P,71,71,57.25,,,,fee schedule,,,,,,,,,,,,,,,60.35,85,,percent of total billed charges,,94.58,,,,fee schedule,,39.39,,,,fee schedule,,,,,,,,64.41,,,,fee schedule,,,,,,,,60.95,,,,fee schedule,,36.94,,,,fee schedule,,36.94,,,,fee schedule,,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,21.3,83,,percent of total billed charges,,,,,,,,,,,,,,,58.93,83,,percent of total billed charges,,54.3,,,,fee schedule,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,21.3,94.58,
"POS AIRWAY PRESSURE, CPAP",94660P,CDM,94660,CPT,,,both,P,76,76,57.25,,,,fee schedule,,,,,,,,,,,,,,,64.6,85,,percent of total billed charges,,94.58,,,,fee schedule,,39.39,,,,fee schedule,,,,,,,,64.41,,,,fee schedule,,,,,,,,60.95,,,,fee schedule,,36.94,,,,fee schedule,,36.94,,,,fee schedule,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,,,,,,,,,,,,,,63.08,83,,percent of total billed charges,,54.3,,,,fee schedule,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,22.8,94.58,
"POS AIRWAY PRESSURE, CPAP",94660T,CDM,94660,CPT,,,both,T,125,125,57.25,,,,fee schedule,,,,,,,,,,,,,,,106.25,85,,percent of total billed charges,,94.58,,,,fee schedule,,39.39,,,,fee schedule,,,,,,,,64.41,,,,fee schedule,,,,,,,,60.95,,,,fee schedule,,36.94,,,,fee schedule,,36.94,,,,fee schedule,,,113.75,91,,percent of total billed charges,,,118.75,95,,percent of total billed charges,,,103.75,83,,percent of total billed charges,,,37.5,83,,percent of total billed charges,,,,,,,,,,,,,,,103.75,83,,percent of total billed charges,,54.3,,,,fee schedule,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,112.5,90,,percent of total billed charges,,,106.25,85,,percent of total billed charges,,36.94,118.75,
"POS AIRWAY PRESSURE, CPAP",94660T,CDM,94660,CPT,,,both,T,126,126,57.25,,,,fee schedule,,,,,,,,,,,,,,,107.1,85,,percent of total billed charges,,94.58,,,,fee schedule,,39.39,,,,fee schedule,,,,,,,,64.41,,,,fee schedule,,,,,,,,60.95,,,,fee schedule,,36.94,,,,fee schedule,,36.94,,,,fee schedule,,,114.66,91,,percent of total billed charges,,,119.7,95,,percent of total billed charges,,,104.58,83,,percent of total billed charges,,,37.8,83,,percent of total billed charges,,,,,,,,,,,,,,,104.58,83,,percent of total billed charges,,54.3,,,,fee schedule,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,113.4,90,,percent of total billed charges,,,107.1,85,,percent of total billed charges,,36.94,119.7,
DEMO/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IPPB,94664,CDM,94664,CPT,,,both,,101,101,26.79,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,85.85,85,,percent of total billed charges,,39.51,,,,fee schedule,,16.45,,,,fee schedule,,15.2,,,,fee schedule,,21.89,,,,fee schedule,,15.2,,,,fee schedule,,28.52,,,,fee schedule,,17.28,,,,fee schedule,,17.28,,,,fee schedule,,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,30.3,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,83.83,83,,percent of total billed charges,,25.41,,,,fee schedule,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,15.2,95.95,
EVALUATE PT USE OF INHALER,94664P,CDM,94664,CPT,,,both,P,23,23,26.79,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,19.55,85,,percent of total billed charges,,39.51,,,,fee schedule,,16.45,,,,fee schedule,,15.2,,,,fee schedule,,21.89,,,,fee schedule,,15.2,,,,fee schedule,,28.52,,,,fee schedule,,17.28,,,,fee schedule,,17.28,,,,fee schedule,,,20.93,91,,percent of total billed charges,,,21.85,95,,percent of total billed charges,,,19.09,83,,percent of total billed charges,,,6.9,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,19.09,83,,percent of total billed charges,,25.41,,,,fee schedule,,,20.7,90,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,19.55,85,,percent of total billed charges,,6.9,39.51,
EVALUATE PT USE OF INHALER,94664P,CDM,94664,CPT,,,both,P,25,25,26.79,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,21.25,85,,percent of total billed charges,,39.51,,,,fee schedule,,16.45,,,,fee schedule,,15.2,,,,fee schedule,,21.89,,,,fee schedule,,15.2,,,,fee schedule,,28.52,,,,fee schedule,,17.28,,,,fee schedule,,17.28,,,,fee schedule,,,22.75,91,,percent of total billed charges,,,23.75,95,,percent of total billed charges,,,20.75,83,,percent of total billed charges,,,7.5,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,20.75,83,,percent of total billed charges,,25.41,,,,fee schedule,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,21.25,85,,percent of total billed charges,,7.5,39.51,
EVALUATE PT USE OF INHALER,94664T,CDM,94664,CPT,,,both,T,75,75,26.79,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,63.75,85,,percent of total billed charges,,39.51,,,,fee schedule,,16.45,,,,fee schedule,,15.2,,,,fee schedule,,21.89,,,,fee schedule,,15.2,,,,fee schedule,,28.52,,,,fee schedule,,17.28,,,,fee schedule,,17.28,,,,fee schedule,,,68.25,91,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,22.5,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,62.25,83,,percent of total billed charges,,25.41,,,,fee schedule,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,15.2,71.25,
EVALUATE PT USE OF INHALER,94664T,CDM,94664,CPT,,,both,T,76,76,26.79,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,64.6,85,,percent of total billed charges,,39.51,,,,fee schedule,,16.45,,,,fee schedule,,15.2,,,,fee schedule,,21.89,,,,fee schedule,,15.2,,,,fee schedule,,28.52,,,,fee schedule,,17.28,,,,fee schedule,,17.28,,,,fee schedule,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,63.08,83,,percent of total billed charges,,25.41,,,,fee schedule,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,15.2,72.2,
PULM FUNCT TST PLETHYSMOGRAP,94726,CDM,94726,CPT,,,both,,294,294,85.09,,,,fee schedule,,,,,,,,30.08,,,,fee schedule,,,249.9,85,,percent of total billed charges,,29.7,,,,fee schedule,,12.37,,,,fee schedule,,30.08,,,,fee schedule,,,,,,,,30.08,,,,fee schedule,,90.58,,,,fee schedule,,54.9,,,,fee schedule,,54.9,,,,fee schedule,,,267.54,91,,percent of total billed charges,,,279.3,95,,percent of total billed charges,,,244.02,83,,percent of total billed charges,,,88.2,83,,percent of total billed charges,,30.08,,,,fee schedule,,30.08,,,,fee schedule,,,244.02,83,,percent of total billed charges,,80.7,,,,fee schedule,,,264.6,90,,percent of total billed charges,,,264.6,90,,percent of total billed charges,,,264.6,90,,percent of total billed charges,,,264.6,90,,percent of total billed charges,,,249.9,85,,percent of total billed charges,,12.37,279.3,
CO/MEMBANE DIFFUSE CAPACITY,94729,CDM,94729,CPT,,,both,,71,71,88.77,,,,fee schedule,,,,,,,,29.64,,,,fee schedule,,,60.35,85,,percent of total billed charges,,22.1,,,,fee schedule,,9.2,,,,fee schedule,,29.64,,,,fee schedule,,,,,,,,29.64,,,,fee schedule,,94.49,,,,fee schedule,,57.27,,,,fee schedule,,57.27,,,,fee schedule,,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,21.3,83,,percent of total billed charges,,29.64,,,,fee schedule,,29.64,,,,fee schedule,,,58.93,83,,percent of total billed charges,,84.19,,,,fee schedule,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,9.2,94.49,
N-INVAS EAR/PLS OXIMTRY F/O2 SAT 1 DETER,94760,CDM,94760,CPT,,,both,,60,60,3.68,,,,fee schedule,,,,,,,,4.4,,,,fee schedule,,,51,85,,percent of total billed charges,,5.73,,,,fee schedule,,2.39,,,,fee schedule,,4.4,,,,fee schedule,,3.75,,,,fee schedule,,4.4,,,,fee schedule,,3.91,,,,fee schedule,,2.37,,,,fee schedule,,2.37,,,,fee schedule,,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,18,83,,percent of total billed charges,,4.4,,,,fee schedule,,4.4,,,,fee schedule,,,49.8,83,,percent of total billed charges,,3.49,,,,fee schedule,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,2.37,57,
MEASURE BLOOD OXYGEN LEVEL,94760P,CDM,94760,CPT,,,both,P,8,8,3.68,,,,fee schedule,,,,,,,,4.4,,,,fee schedule,,,6.8,85,,percent of total billed charges,,5.73,,,,fee schedule,,2.39,,,,fee schedule,,4.4,,,,fee schedule,,3.75,,,,fee schedule,,4.4,,,,fee schedule,,3.91,,,,fee schedule,,2.37,,,,fee schedule,,2.37,,,,fee schedule,,,7.28,91,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,2.4,83,,percent of total billed charges,,4.4,,,,fee schedule,,4.4,,,,fee schedule,,,6.64,83,,percent of total billed charges,,3.49,,,,fee schedule,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.8,85,,percent of total billed charges,,2.37,7.6,
MEASURE BLOOD OXYGEN LEVEL,94760P,CDM,94760,CPT,,,both,P,10,10,3.68,,,,fee schedule,,,,,,,,4.4,,,,fee schedule,,,8.5,85,,percent of total billed charges,,5.73,,,,fee schedule,,2.39,,,,fee schedule,,4.4,,,,fee schedule,,3.75,,,,fee schedule,,4.4,,,,fee schedule,,3.91,,,,fee schedule,,2.37,,,,fee schedule,,2.37,,,,fee schedule,,,9.1,91,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,3,83,,percent of total billed charges,,4.4,,,,fee schedule,,4.4,,,,fee schedule,,,8.3,83,,percent of total billed charges,,3.49,,,,fee schedule,,,9,90,,percent of total billed charges,,,9,90,,percent of total billed charges,,,9,90,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.5,85,,percent of total billed charges,,2.37,9.5,
MEASURE BLOOD OXYGEN LEVEL,94760T,CDM,94760,CPT,,,both,T,50,50,3.68,,,,fee schedule,,,,,,,,4.4,,,,fee schedule,,,42.5,85,,percent of total billed charges,,5.73,,,,fee schedule,,2.39,,,,fee schedule,,4.4,,,,fee schedule,,3.75,,,,fee schedule,,4.4,,,,fee schedule,,3.91,,,,fee schedule,,2.37,,,,fee schedule,,2.37,,,,fee schedule,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,4.4,,,,fee schedule,,4.4,,,,fee schedule,,,41.5,83,,percent of total billed charges,,3.49,,,,fee schedule,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,2.37,47.5,
MEASURE BLOOD OXYGEN LEVEL,94760T,CDM,94760,CPT,,,both,T,50,50,3.68,,,,fee schedule,,,,,,,,4.4,,,,fee schedule,,,42.5,85,,percent of total billed charges,,5.73,,,,fee schedule,,2.39,,,,fee schedule,,4.4,,,,fee schedule,,3.75,,,,fee schedule,,4.4,,,,fee schedule,,3.91,,,,fee schedule,,2.37,,,,fee schedule,,2.37,,,,fee schedule,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,4.4,,,,fee schedule,,4.4,,,,fee schedule,,,41.5,83,,percent of total billed charges,,3.49,,,,fee schedule,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,2.37,47.5,
MEASURE BLOOD OXYGEN LEVEL,94761,CDM,94761,CPT,,,both,,63,63,5.78,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,53.55,85,,percent of total billed charges,,8.09,,,,fee schedule,,3.37,,,,fee schedule,,15.2,,,,fee schedule,,8.13,,,,fee schedule,,15.2,,,,fee schedule,,6.15,,,,fee schedule,,3.73,,,,fee schedule,,3.73,,,,fee schedule,,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,18.9,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,52.29,83,,percent of total billed charges,,5.48,,,,fee schedule,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,3.37,59.85,
MEASURE BLOOD OXYGEN LEVEL,94761P,CDM,94761,CPT,,,both,P,11,11,5.78,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,9.35,85,,percent of total billed charges,,8.09,,,,fee schedule,,3.37,,,,fee schedule,,15.2,,,,fee schedule,,8.13,,,,fee schedule,,15.2,,,,fee schedule,,6.15,,,,fee schedule,,3.73,,,,fee schedule,,3.73,,,,fee schedule,,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,3.3,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,9.13,83,,percent of total billed charges,,5.48,,,,fee schedule,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,3.3,15.2,
MEASURE BLOOD OXYGEN LEVEL,94761P,CDM,94761,CPT,,,both,P,13,13,5.78,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,11.05,85,,percent of total billed charges,,8.09,,,,fee schedule,,3.37,,,,fee schedule,,15.2,,,,fee schedule,,8.13,,,,fee schedule,,15.2,,,,fee schedule,,6.15,,,,fee schedule,,3.73,,,,fee schedule,,3.73,,,,fee schedule,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,3.9,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,10.79,83,,percent of total billed charges,,5.48,,,,fee schedule,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.37,15.2,
MEASURE BLOOD OXYGEN LEVEL,94761T,CDM,94761,CPT,,,both,T,50,50,5.78,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,42.5,85,,percent of total billed charges,,8.09,,,,fee schedule,,3.37,,,,fee schedule,,15.2,,,,fee schedule,,8.13,,,,fee schedule,,15.2,,,,fee schedule,,6.15,,,,fee schedule,,3.73,,,,fee schedule,,3.73,,,,fee schedule,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,41.5,83,,percent of total billed charges,,5.48,,,,fee schedule,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,3.37,47.5,
MEASURE BLOOD OXYGEN LEVEL,94761T,CDM,94761,CPT,,,both,T,50,50,5.78,,,,fee schedule,,,,,,,,15.2,,,,fee schedule,,,42.5,85,,percent of total billed charges,,8.09,,,,fee schedule,,3.37,,,,fee schedule,,15.2,,,,fee schedule,,8.13,,,,fee schedule,,15.2,,,,fee schedule,,6.15,,,,fee schedule,,3.73,,,,fee schedule,,3.73,,,,fee schedule,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,15.2,,,,fee schedule,,15.2,,,,fee schedule,,,41.5,83,,percent of total billed charges,,5.48,,,,fee schedule,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,3.37,47.5,
N-INVAS EAR/PLS OXIMTRY F/O2 SAT OVRNIT MNTR,94762,CDM,94762,CPT,,,both,,524,524,39.92,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,445.4,85,,percent of total billed charges,,61.5,,,,fee schedule,,25.62,,,,fee schedule,,22.15,,,,fee schedule,,35.64,,,,fee schedule,,22.15,,,,fee schedule,,42.49,,,,fee schedule,,25.75,,,,fee schedule,,25.75,,,,fee schedule,,,476.84,91,,percent of total billed charges,,,497.8,95,,percent of total billed charges,,,434.92,83,,percent of total billed charges,,,157.2,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,434.92,83,,percent of total billed charges,,37.86,,,,fee schedule,,,471.6,90,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,471.6,90,,percent of total billed charges,,,445.4,85,,percent of total billed charges,,22.15,497.8,
OVERNIGHT OXYGEN LEVEL,94762P,CDM,94762,CPT,,,both,P,358,358,39.92,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,304.3,85,,percent of total billed charges,,61.5,,,,fee schedule,,25.62,,,,fee schedule,,22.15,,,,fee schedule,,35.64,,,,fee schedule,,22.15,,,,fee schedule,,42.49,,,,fee schedule,,25.75,,,,fee schedule,,25.75,,,,fee schedule,,,325.78,91,,percent of total billed charges,,,340.1,95,,percent of total billed charges,,,297.14,83,,percent of total billed charges,,,107.4,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,297.14,83,,percent of total billed charges,,37.86,,,,fee schedule,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,304.3,85,,percent of total billed charges,,22.15,340.1,
OVERNIGHT OXYGEN LEVEL,94762P,CDM,94762,CPT,,,both,P,358,358,39.92,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,304.3,85,,percent of total billed charges,,61.5,,,,fee schedule,,25.62,,,,fee schedule,,22.15,,,,fee schedule,,35.64,,,,fee schedule,,22.15,,,,fee schedule,,42.49,,,,fee schedule,,25.75,,,,fee schedule,,25.75,,,,fee schedule,,,325.78,91,,percent of total billed charges,,,340.1,95,,percent of total billed charges,,,297.14,83,,percent of total billed charges,,,107.4,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,297.14,83,,percent of total billed charges,,37.86,,,,fee schedule,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,322.2,90,,percent of total billed charges,,,304.3,85,,percent of total billed charges,,22.15,340.1,
OVERNIGHT OXYGEN LEVEL,94762T,CDM,94762,CPT,,,both,T,150,150,39.92,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,127.5,85,,percent of total billed charges,,61.5,,,,fee schedule,,25.62,,,,fee schedule,,22.15,,,,fee schedule,,35.64,,,,fee schedule,,22.15,,,,fee schedule,,42.49,,,,fee schedule,,25.75,,,,fee schedule,,25.75,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,124.5,83,,percent of total billed charges,,37.86,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,22.15,142.5,
OVERNIGHT OXYGEN LEVEL,94762T,CDM,94762,CPT,,,both,T,166,166,39.92,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,141.1,85,,percent of total billed charges,,61.5,,,,fee schedule,,25.62,,,,fee schedule,,22.15,,,,fee schedule,,35.64,,,,fee schedule,,22.15,,,,fee schedule,,42.49,,,,fee schedule,,25.75,,,,fee schedule,,25.75,,,,fee schedule,,,151.06,91,,percent of total billed charges,,,157.7,95,,percent of total billed charges,,,137.78,83,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,137.78,83,,percent of total billed charges,,37.86,,,,fee schedule,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,149.4,90,,percent of total billed charges,,,141.1,85,,percent of total billed charges,,22.15,157.7,
BRONCHIAL ALLERGY TESTS,95070,CDM,95070,CPT,,,both,,139,139,54.1,,,,fee schedule,,,,,,,,105.4,,,,fee schedule,,,118.15,85,,percent of total billed charges,,73.52,,,,fee schedule,,34.55,,,,fee schedule,,105.4,,,,fee schedule,,143.82,,,,fee schedule,,105.4,,,,fee schedule,,57.59,,,,fee schedule,,34.9,,,,fee schedule,,34.9,,,,fee schedule,,,126.49,91,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,41.7,83,,percent of total billed charges,,105.4,,,,fee schedule,,105.4,,,,fee schedule,,,115.37,83,,percent of total billed charges,,51.31,,,,fee schedule,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,118.15,85,,percent of total billed charges,,34.55,143.82,
PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX,95115,CDM,95115,CPT,,,both,,67,67,15.76,,,,fee schedule,,,,,,,,6.5,,,,fee schedule,,,56.95,85,,percent of total billed charges,,19.7,,,,fee schedule,,9.26,,,,fee schedule,,6.5,,,,fee schedule,,25.64,,,,fee schedule,,6.5,,,,fee schedule,,16.77,,,,fee schedule,,10.17,,,,fee schedule,,10.17,,,,fee schedule,,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,20.1,83,,percent of total billed charges,,6.5,,,,fee schedule,,6.5,,,,fee schedule,,,55.61,83,,percent of total billed charges,,14.94,,,,fee schedule,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,6.5,63.65,
"IMMUNOTHERAPY, ONE INJECTION",95115P,CDM,95115,CPT,,,both,P,15,15,15.76,,,,fee schedule,,,,,,,,6.5,,,,fee schedule,,,12.75,85,,percent of total billed charges,,19.7,,,,fee schedule,,9.26,,,,fee schedule,,6.5,,,,fee schedule,,25.64,,,,fee schedule,,6.5,,,,fee schedule,,16.77,,,,fee schedule,,10.17,,,,fee schedule,,10.17,,,,fee schedule,,,13.65,91,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,4.5,83,,percent of total billed charges,,6.5,,,,fee schedule,,6.5,,,,fee schedule,,,12.45,83,,percent of total billed charges,,14.94,,,,fee schedule,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,4.5,25.64,
"IMMUNOTHERAPY, ONE INJECTION",95115P,CDM,95115,CPT,,,both,P,17,17,15.76,,,,fee schedule,,,,,,,,6.5,,,,fee schedule,,,14.45,85,,percent of total billed charges,,19.7,,,,fee schedule,,9.26,,,,fee schedule,,6.5,,,,fee schedule,,25.64,,,,fee schedule,,6.5,,,,fee schedule,,16.77,,,,fee schedule,,10.17,,,,fee schedule,,10.17,,,,fee schedule,,,15.47,91,,percent of total billed charges,,,16.15,95,,percent of total billed charges,,,14.11,83,,percent of total billed charges,,,5.1,83,,percent of total billed charges,,6.5,,,,fee schedule,,6.5,,,,fee schedule,,,14.11,83,,percent of total billed charges,,14.94,,,,fee schedule,,,15.3,90,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,15.3,90,,percent of total billed charges,,,14.45,85,,percent of total billed charges,,5.1,25.64,
"IMMUNOTHERAPY, ONE INJECTION",95115T,CDM,95115,CPT,,,both,T,50,50,15.76,,,,fee schedule,,,,,,,,6.5,,,,fee schedule,,,42.5,85,,percent of total billed charges,,19.7,,,,fee schedule,,9.26,,,,fee schedule,,6.5,,,,fee schedule,,25.64,,,,fee schedule,,6.5,,,,fee schedule,,16.77,,,,fee schedule,,10.17,,,,fee schedule,,10.17,,,,fee schedule,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,6.5,,,,fee schedule,,6.5,,,,fee schedule,,,41.5,83,,percent of total billed charges,,14.94,,,,fee schedule,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,6.5,47.5,
"IMMUNOTHERAPY, ONE INJECTION",95115T,CDM,95115,CPT,,,both,T,50,50,15.76,,,,fee schedule,,,,,,,,6.5,,,,fee schedule,,,42.5,85,,percent of total billed charges,,19.7,,,,fee schedule,,9.26,,,,fee schedule,,6.5,,,,fee schedule,,25.64,,,,fee schedule,,6.5,,,,fee schedule,,16.77,,,,fee schedule,,10.17,,,,fee schedule,,10.17,,,,fee schedule,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,6.5,,,,fee schedule,,6.5,,,,fee schedule,,,41.5,83,,percent of total billed charges,,14.94,,,,fee schedule,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,6.5,47.5,
PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS ADDITIONAL NJXS,95117,CDM,95117,CPT,,,both,,68,68,18.38,,,,fee schedule,,,,,,,,8.3,,,,fee schedule,,,57.8,85,,percent of total billed charges,,23.88,,,,fee schedule,,11.22,,,,fee schedule,,8.3,,,,fee schedule,,32.52,,,,fee schedule,,8.3,,,,fee schedule,,19.57,,,,fee schedule,,11.86,,,,fee schedule,,11.86,,,,fee schedule,,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,8.3,,,,fee schedule,,8.3,,,,fee schedule,,,56.44,83,,percent of total billed charges,,17.43,,,,fee schedule,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,8.3,64.6,
IMMUNOTHERAPY INJECTIONS,95117P,CDM,95117,CPT,,,both,P,16,16,18.38,,,,fee schedule,,,,,,,,8.3,,,,fee schedule,,,13.6,85,,percent of total billed charges,,23.88,,,,fee schedule,,11.22,,,,fee schedule,,8.3,,,,fee schedule,,32.52,,,,fee schedule,,8.3,,,,fee schedule,,19.57,,,,fee schedule,,11.86,,,,fee schedule,,11.86,,,,fee schedule,,,14.56,91,,percent of total billed charges,,,15.2,95,,percent of total billed charges,,,13.28,83,,percent of total billed charges,,,4.8,83,,percent of total billed charges,,8.3,,,,fee schedule,,8.3,,,,fee schedule,,,13.28,83,,percent of total billed charges,,17.43,,,,fee schedule,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,13.6,85,,percent of total billed charges,,4.8,32.52,
IMMUNOTHERAPY INJECTIONS,95117P,CDM,95117,CPT,,,both,P,18,18,18.38,,,,fee schedule,,,,,,,,8.3,,,,fee schedule,,,15.3,85,,percent of total billed charges,,23.88,,,,fee schedule,,11.22,,,,fee schedule,,8.3,,,,fee schedule,,32.52,,,,fee schedule,,8.3,,,,fee schedule,,19.57,,,,fee schedule,,11.86,,,,fee schedule,,11.86,,,,fee schedule,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,5.4,83,,percent of total billed charges,,8.3,,,,fee schedule,,8.3,,,,fee schedule,,,14.94,83,,percent of total billed charges,,17.43,,,,fee schedule,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,5.4,32.52,
IMMUNOTHERAPY INJECTIONS,95117T,CDM,95117,CPT,,,both,T,50,50,18.38,,,,fee schedule,,,,,,,,8.3,,,,fee schedule,,,42.5,85,,percent of total billed charges,,23.88,,,,fee schedule,,11.22,,,,fee schedule,,8.3,,,,fee schedule,,32.52,,,,fee schedule,,8.3,,,,fee schedule,,19.57,,,,fee schedule,,11.86,,,,fee schedule,,11.86,,,,fee schedule,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,8.3,,,,fee schedule,,8.3,,,,fee schedule,,,41.5,83,,percent of total billed charges,,17.43,,,,fee schedule,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,8.3,47.5,
IMMUNOTHERAPY INJECTIONS,95117T,CDM,95117,CPT,,,both,T,50,50,18.38,,,,fee schedule,,,,,,,,8.3,,,,fee schedule,,,42.5,85,,percent of total billed charges,,23.88,,,,fee schedule,,11.22,,,,fee schedule,,8.3,,,,fee schedule,,32.52,,,,fee schedule,,8.3,,,,fee schedule,,19.57,,,,fee schedule,,11.86,,,,fee schedule,,11.86,,,,fee schedule,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,8.3,,,,fee schedule,,8.3,,,,fee schedule,,,41.5,83,,percent of total billed charges,,17.43,,,,fee schedule,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,8.3,47.5,
"IMMUNOTHERAPY, ONE INJECTION",95120,CDM,95120,CPT,,,both,,113,113,,,,,,,,,,,,,6.5,,,,fee schedule,,,96.05,85,,percent of total billed charges,,20.34,,,,fee schedule,,10.55,,,,fee schedule,,6.5,,,,fee schedule,,,,,,,,6.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,33.9,83,,percent of total billed charges,,6.5,,,,fee schedule,,6.5,,,,fee schedule,,,93.79,83,,percent of total billed charges,,,,,,,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,6.5,107.35,
"IMMUNOTHERAPY, ONE INJECTION",95120P,CDM,95120,CPT,,,both,P,34,34,,,,,,,,,,,,,6.5,,,,fee schedule,,,28.9,85,,percent of total billed charges,,20.34,,,,fee schedule,,10.55,,,,fee schedule,,6.5,,,,fee schedule,,,,,,,,6.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,10.2,83,,percent of total billed charges,,6.5,,,,fee schedule,,6.5,,,,fee schedule,,,28.22,83,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,6.5,32.3,
"IMMUNOTHERAPY, ONE INJECTION",95120P,CDM,95120,CPT,,,both,P,37,37,,,,,,,,,,,,,6.5,,,,fee schedule,,,31.45,85,,percent of total billed charges,,20.34,,,,fee schedule,,10.55,,,,fee schedule,,6.5,,,,fee schedule,,,,,,,,6.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,11.1,83,,percent of total billed charges,,6.5,,,,fee schedule,,6.5,,,,fee schedule,,,30.71,83,,percent of total billed charges,,,,,,,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,6.5,35.15,
"IMMUNOTHERAPY, ONE INJECTION",95120T,CDM,95120,CPT,,,both,T,75,75,,,,,,,,,,,,,6.5,,,,fee schedule,,,63.75,85,,percent of total billed charges,,20.34,,,,fee schedule,,10.55,,,,fee schedule,,6.5,,,,fee schedule,,,,,,,,6.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,68.25,91,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,22.5,83,,percent of total billed charges,,6.5,,,,fee schedule,,6.5,,,,fee schedule,,,62.25,83,,percent of total billed charges,,,,,,,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,6.5,71.25,
"IMMUNOTHERAPY, ONE INJECTION",95120T,CDM,95120,CPT,,,both,T,76,76,,,,,,,,,,,,,6.5,,,,fee schedule,,,64.6,85,,percent of total billed charges,,20.34,,,,fee schedule,,10.55,,,,fee schedule,,6.5,,,,fee schedule,,,,,,,,6.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,6.5,,,,fee schedule,,6.5,,,,fee schedule,,,63.08,83,,percent of total billed charges,,,,,,,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,6.5,72.2,
"IMMUNOTHERAPY, MANY ANTIGENS",95125,CDM,95125,CPT,,,both,,150,150,,,,,,,,,,,,,8.3,,,,fee schedule,,,127.5,85,,percent of total billed charges,,24.24,,,,fee schedule,,12.58,,,,fee schedule,,8.3,,,,fee schedule,,,,,,,,8.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,8.3,,,,fee schedule,,8.3,,,,fee schedule,,,124.5,83,,percent of total billed charges,,,,,,,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,8.3,142.5,
"IMMUNOTHERAPY, MANY ANTIGENS",95125P,CDM,95125,CPT,,,both,P,55,55,,,,,,,,,,,,,8.3,,,,fee schedule,,,46.75,85,,percent of total billed charges,,24.24,,,,fee schedule,,12.58,,,,fee schedule,,8.3,,,,fee schedule,,,,,,,,8.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,16.5,83,,percent of total billed charges,,8.3,,,,fee schedule,,8.3,,,,fee schedule,,,45.65,83,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,8.3,52.25,
"IMMUNOTHERAPY, MANY ANTIGENS",95125P,CDM,95125,CPT,,,both,P,59,59,,,,,,,,,,,,,8.3,,,,fee schedule,,,50.15,85,,percent of total billed charges,,24.24,,,,fee schedule,,12.58,,,,fee schedule,,8.3,,,,fee schedule,,,,,,,,8.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,17.7,83,,percent of total billed charges,,8.3,,,,fee schedule,,8.3,,,,fee schedule,,,48.97,83,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,8.3,56.05,
"IMMUNOTHERAPY, MANY ANTIGENS",95125T,CDM,95125,CPT,,,both,T,90,90,,,,,,,,,,,,,8.3,,,,fee schedule,,,76.5,85,,percent of total billed charges,,24.24,,,,fee schedule,,12.58,,,,fee schedule,,8.3,,,,fee schedule,,,,,,,,8.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,8.3,,,,fee schedule,,8.3,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,8.3,85.5,
"IMMUNOTHERAPY, MANY ANTIGENS",95125T,CDM,95125,CPT,,,both,T,91,91,,,,,,,,,,,,,8.3,,,,fee schedule,,,77.35,85,,percent of total billed charges,,24.24,,,,fee schedule,,12.58,,,,fee schedule,,8.3,,,,fee schedule,,,,,,,,8.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,27.3,83,,percent of total billed charges,,8.3,,,,fee schedule,,8.3,,,,fee schedule,,,75.53,83,,percent of total billed charges,,,,,,,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,8.3,86.45,
CONT GLUC MNTR PT PROV EQP,95249,CDM,95249,CPT,,,both,,145,145,95.6,,,,fee schedule,,,,,,,,31.15,,,,fee schedule,,,123.25,85,,percent of total billed charges,,84.05,,,,fee schedule,,56.99,,,,fee schedule,,31.15,,,,fee schedule,,,,,,,,31.15,,,,fee schedule,,101.76,,,,fee schedule,,61.67,,,,fee schedule,,61.67,,,,fee schedule,,,131.95,91,,percent of total billed charges,,,137.75,95,,percent of total billed charges,,,120.35,83,,percent of total billed charges,,,43.5,83,,percent of total billed charges,,31.15,,,,fee schedule,,31.15,,,,fee schedule,,,120.35,83,,percent of total billed charges,,90.66,,,,fee schedule,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,130.5,90,,percent of total billed charges,,,123.25,85,,percent of total billed charges,,31.15,137.75,
"GLUCOSE MONITORING,  CONT",95250,CDM,95250,CPT,,,both,,337,337,227.96,,,,fee schedule,,,,,,,,67.87,,,,fee schedule,,,286.45,85,,percent of total billed charges,,211.92,,,,fee schedule,,143.68,,,,fee schedule,,67.87,,,,fee schedule,,257,,,,fee schedule,,67.87,,,,fee schedule,,242.67,,,,fee schedule,,147.07,,,,fee schedule,,147.07,,,,fee schedule,,,306.67,91,,percent of total billed charges,,,320.15,95,,percent of total billed charges,,,279.71,83,,percent of total billed charges,,,101.1,83,,percent of total billed charges,,67.87,,,,fee schedule,,67.87,,,,fee schedule,,,279.71,83,,percent of total billed charges,,216.19,,,,fee schedule,,,303.3,90,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,303.3,90,,percent of total billed charges,,,286.45,85,,percent of total billed charges,,67.87,320.15,
"GLUC MONITOR, CONT, PHYS I&R",95251,CDM,95251,CPT,,,both,,109,109,53.58,,,,fee schedule,,,,,,,,15.4,,,,fee schedule,,,92.65,85,,percent of total billed charges,,53.05,,,,fee schedule,,35.97,,,,fee schedule,,15.4,,,,fee schedule,,,,,,,,15.4,,,,fee schedule,,57.03,,,,fee schedule,,34.56,,,,fee schedule,,34.56,,,,fee schedule,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,32.7,83,,percent of total billed charges,,15.4,,,,fee schedule,,15.4,,,,fee schedule,,,90.47,83,,percent of total billed charges,,50.81,,,,fee schedule,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,15.4,103.55,
POLYSOM <6 YRS 4/> PARAMTRS,95782,CDM,95782,CPT,,,both,,692,692,1491.71,,,,fee schedule,,,,,,,,577.4,,,,fee schedule,,,588.2,85,,percent of total billed charges,,215.06,,,,fee schedule,,128.49,,,,fee schedule,,577.4,,,,fee schedule,,,,,,,,577.4,,,,fee schedule,,1587.95,,,,fee schedule,,962.4,,,,fee schedule,,962.4,,,,fee schedule,,,629.72,91,,percent of total billed charges,,,657.4,95,,percent of total billed charges,,,574.36,83,,percent of total billed charges,,,207.6,83,,percent of total billed charges,,577.4,,,,fee schedule,,577.4,,,,fee schedule,,,574.36,83,,percent of total billed charges,,1414.72,,,,fee schedule,,,622.8,90,,percent of total billed charges,,,622.8,90,,percent of total billed charges,,,622.8,90,,percent of total billed charges,,,622.8,90,,percent of total billed charges,,,588.2,85,,percent of total billed charges,,128.49,1587.95,
POLYSOM <6 YRS CPAP/BILVL,95783,CDM,95783,CPT,,,both,,799,799,1580.48,,,,fee schedule,,,,,,,,616.59,,,,fee schedule,,,679.15,85,,percent of total billed charges,,233.79,,,,fee schedule,,139.69,,,,fee schedule,,616.59,,,,fee schedule,,,,,,,,616.59,,,,fee schedule,,1682.45,,,,fee schedule,,1019.67,,,,fee schedule,,1019.67,,,,fee schedule,,,727.09,91,,percent of total billed charges,,,759.05,95,,percent of total billed charges,,,663.17,83,,percent of total billed charges,,,239.7,83,,percent of total billed charges,,616.59,,,,fee schedule,,616.59,,,,fee schedule,,,663.17,83,,percent of total billed charges,,1498.91,,,,fee schedule,,,719.1,90,,percent of total billed charges,,,719.1,90,,percent of total billed charges,,,719.1,90,,percent of total billed charges,,,719.1,90,,percent of total billed charges,,,679.15,85,,percent of total billed charges,,139.69,1682.45,
"SLEEP STUDY, UNATTENDED",95806,CDM,95806,CPT,,,both,,266,266,143.92,,,,fee schedule,,,,,,,,110.55,,,,fee schedule,,,226.1,85,,percent of total billed charges,,71.84,,,,fee schedule,,45.85,,,,fee schedule,,110.55,,,,fee schedule,,335.79,,,,fee schedule,,110.55,,,,fee schedule,,153.2,,,,fee schedule,,92.85,,,,fee schedule,,92.85,,,,fee schedule,,,242.06,91,,percent of total billed charges,,,252.7,95,,percent of total billed charges,,,220.78,83,,percent of total billed charges,,,79.8,83,,percent of total billed charges,,110.55,,,,fee schedule,,110.55,,,,fee schedule,,,220.78,83,,percent of total billed charges,,136.49,,,,fee schedule,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,239.4,90,,percent of total billed charges,,,226.1,85,,percent of total billed charges,,45.85,335.79,
"POLYSOMNOGRAPHY, 1-3",95808,CDM,95808,CPT,,,both,,538,538,861.94,,,,fee schedule,,,,,,,,193.3,,,,fee schedule,,,457.3,85,,percent of total billed charges,,140.88,,,,fee schedule,,89.92,,,,fee schedule,,193.3,,,,fee schedule,,1024.88,,,,fee schedule,,193.3,,,,fee schedule,,917.55,,,,fee schedule,,556.09,,,,fee schedule,,556.09,,,,fee schedule,,,489.58,91,,percent of total billed charges,,,511.1,95,,percent of total billed charges,,,446.54,83,,percent of total billed charges,,,161.4,83,,percent of total billed charges,,193.3,,,,fee schedule,,193.3,,,,fee schedule,,,446.54,83,,percent of total billed charges,,817.45,,,,fee schedule,,,484.2,90,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,484.2,90,,percent of total billed charges,,,457.3,85,,percent of total billed charges,,89.92,1024.88,
"SLEEP STUDY (POLYSOMNOGRAPHY, 4 OR MORE)",95810,CDM,95810,CPT,,,both,,527,527,953.33,,,,fee schedule,,,,,,,,261.6,,,,fee schedule,,,447.95,85,,percent of total billed charges,,267.43,,,,fee schedule,,122.62,,,,fee schedule,,261.6,,,,fee schedule,,1350.67,,,,fee schedule,,261.6,,,,fee schedule,,1014.84,,,,fee schedule,,615.05,,,,fee schedule,,615.05,,,,fee schedule,,,479.57,91,,percent of total billed charges,,,500.65,95,,percent of total billed charges,,,437.41,83,,percent of total billed charges,,,158.1,83,,percent of total billed charges,,261.6,,,,fee schedule,,261.6,,,,fee schedule,,,437.41,83,,percent of total billed charges,,904.13,,,,fee schedule,,,474.3,90,,percent of total billed charges,,,474.3,90,,percent of total billed charges,,,474.3,90,,percent of total billed charges,,,474.3,90,,percent of total billed charges,,,447.95,85,,percent of total billed charges,,122.62,1350.67,
SLEEP STUDY (POLYSOMNOGRAPHY W/CPAP),95811,CDM,95811,CPT,,,both,,529,529,997.45,,,,fee schedule,,,,,,,,272.3,,,,fee schedule,,,449.65,85,,percent of total billed charges,,277.39,,,,fee schedule,,127.18,,,,fee schedule,,272.3,,,,fee schedule,,1475.1,,,,fee schedule,,272.3,,,,fee schedule,,1061.8,,,,fee schedule,,643.52,,,,fee schedule,,643.52,,,,fee schedule,,,481.39,91,,percent of total billed charges,,,502.55,95,,percent of total billed charges,,,439.07,83,,percent of total billed charges,,,158.7,83,,percent of total billed charges,,272.3,,,,fee schedule,,272.3,,,,fee schedule,,,439.07,83,,percent of total billed charges,,945.97,,,,fee schedule,,,476.1,90,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,476.1,90,,percent of total billed charges,,,449.65,85,,percent of total billed charges,,127.18,1475.1,
"EEG, AWAKE AND DROWSY",95816,CDM,95816,CPT,,,both,,165,165,600.89,,,,fee schedule,,,,,,,,57.1,,,,fee schedule,,,140.25,85,,percent of total billed charges,,91.18,,,,fee schedule,,58.2,,,,fee schedule,,57.1,,,,fee schedule,,309.53,,,,fee schedule,,57.1,,,,fee schedule,,639.65,,,,fee schedule,,387.67,,,,fee schedule,,387.67,,,,fee schedule,,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,49.5,83,,percent of total billed charges,,57.1,,,,fee schedule,,57.1,,,,fee schedule,,,136.95,83,,percent of total billed charges,,569.87,,,,fee schedule,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,49.5,639.65,
"EEG, AWAKE AND ASLEEP",95819,CDM,95819,CPT,,,both,,222,222,697.01,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,188.7,85,,percent of total billed charges,,91.69,,,,fee schedule,,58.53,,,,fee schedule,,52.7,,,,fee schedule,,263.88,,,,fee schedule,,52.7,,,,fee schedule,,741.98,,,,fee schedule,,449.68,,,,fee schedule,,449.68,,,,fee schedule,,,202.02,91,,percent of total billed charges,,,210.9,95,,percent of total billed charges,,,184.26,83,,percent of total billed charges,,,66.6,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,184.26,83,,percent of total billed charges,,661.03,,,,fee schedule,,,199.8,90,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,188.7,85,,percent of total billed charges,,52.7,741.98,
NDL EMG 1 XTR +-RELATED PARASPI AREAS,95860,CDM,95860,CPT,,,both,,404,404,175.96,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,343.4,85,,percent of total billed charges,,81.72,,,,fee schedule,,52.16,,,,fee schedule,,37.4,,,,fee schedule,,153.2,,,,fee schedule,,37.4,,,,fee schedule,,187.31,,,,fee schedule,,113.52,,,,fee schedule,,113.52,,,,fee schedule,,,367.64,91,,percent of total billed charges,,,383.8,95,,percent of total billed charges,,,335.32,83,,percent of total billed charges,,,121.2,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,335.32,83,,percent of total billed charges,,166.88,,,,fee schedule,,,363.6,90,,percent of total billed charges,,,363.6,90,,percent of total billed charges,,,363.6,90,,percent of total billed charges,,,363.6,90,,percent of total billed charges,,,343.4,85,,percent of total billed charges,,37.4,383.8,
"MUSCLE TEST, ONE LIMB",9586026,CDM,95860,CPT,,,both,26,254,254,175.96,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,215.9,85,,percent of total billed charges,,81.72,,,,fee schedule,,52.16,,,,fee schedule,,37.4,,,,fee schedule,,153.2,,,,fee schedule,,37.4,,,,fee schedule,,187.31,,,,fee schedule,,113.52,,,,fee schedule,,113.52,,,,fee schedule,,,231.14,91,,percent of total billed charges,,,241.3,95,,percent of total billed charges,,,210.82,83,,percent of total billed charges,,,76.2,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,210.82,83,,percent of total billed charges,,166.88,,,,fee schedule,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,228.6,90,,percent of total billed charges,,,215.9,85,,percent of total billed charges,,37.4,241.3,
"MUSCLE TEST, ONE LIMB",9586026,CDM,95860,CPT,,,both,26,242,242,175.96,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,205.7,85,,percent of total billed charges,,81.72,,,,fee schedule,,52.16,,,,fee schedule,,37.4,,,,fee schedule,,153.2,,,,fee schedule,,37.4,,,,fee schedule,,187.31,,,,fee schedule,,113.52,,,,fee schedule,,113.52,,,,fee schedule,,,220.22,91,,percent of total billed charges,,,229.9,95,,percent of total billed charges,,,200.86,83,,percent of total billed charges,,,72.6,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,200.86,83,,percent of total billed charges,,166.88,,,,fee schedule,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,205.7,85,,percent of total billed charges,,37.4,229.9,
"MUSCLE TEST, ONE LIMB",95860P,CDM,95860,CPT,,,both,P,242,242,175.96,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,205.7,85,,percent of total billed charges,,81.72,,,,fee schedule,,52.16,,,,fee schedule,,37.4,,,,fee schedule,,153.2,,,,fee schedule,,37.4,,,,fee schedule,,187.31,,,,fee schedule,,113.52,,,,fee schedule,,113.52,,,,fee schedule,,,220.22,91,,percent of total billed charges,,,229.9,95,,percent of total billed charges,,,200.86,83,,percent of total billed charges,,,72.6,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,200.86,83,,percent of total billed charges,,166.88,,,,fee schedule,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,205.7,85,,percent of total billed charges,,37.4,229.9,
"MUSCLE TEST, ONE LIMB",95860P,CDM,95860,CPT,,,both,P,242,242,175.96,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,205.7,85,,percent of total billed charges,,81.72,,,,fee schedule,,52.16,,,,fee schedule,,37.4,,,,fee schedule,,153.2,,,,fee schedule,,37.4,,,,fee schedule,,187.31,,,,fee schedule,,113.52,,,,fee schedule,,113.52,,,,fee schedule,,,220.22,91,,percent of total billed charges,,,229.9,95,,percent of total billed charges,,,200.86,83,,percent of total billed charges,,,72.6,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,200.86,83,,percent of total billed charges,,166.88,,,,fee schedule,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,217.8,90,,percent of total billed charges,,,205.7,85,,percent of total billed charges,,37.4,229.9,
"MUSCLE TEST, ONE LIMB",95860T,CDM,95860,CPT,,,both,T,150,150,175.96,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,127.5,85,,percent of total billed charges,,81.72,,,,fee schedule,,52.16,,,,fee schedule,,37.4,,,,fee schedule,,153.2,,,,fee schedule,,37.4,,,,fee schedule,,187.31,,,,fee schedule,,113.52,,,,fee schedule,,113.52,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,124.5,83,,percent of total billed charges,,166.88,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,37.4,187.31,
"MUSCLE TEST, ONE LIMB",95860T,CDM,95860,CPT,,,both,T,162,162,175.96,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,137.7,85,,percent of total billed charges,,81.72,,,,fee schedule,,52.16,,,,fee schedule,,37.4,,,,fee schedule,,153.2,,,,fee schedule,,37.4,,,,fee schedule,,187.31,,,,fee schedule,,113.52,,,,fee schedule,,113.52,,,,fee schedule,,,147.42,91,,percent of total billed charges,,,153.9,95,,percent of total billed charges,,,134.46,83,,percent of total billed charges,,,48.6,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,134.46,83,,percent of total billed charges,,166.88,,,,fee schedule,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,145.8,90,,percent of total billed charges,,,137.7,85,,percent of total billed charges,,37.4,187.31,
"MUSCLE TEST, 2 LIMBS",95861,CDM,95861,CPT,,,both,,2075,2075,251.6,,,,fee schedule,,,,,,,,56.8,,,,fee schedule,,,1763.75,85,,percent of total billed charges,,131.33,,,,fee schedule,,83.83,,,,fee schedule,,56.8,,,,fee schedule,,193.22,,,,fee schedule,,56.8,,,,fee schedule,,267.83,,,,fee schedule,,162.32,,,,fee schedule,,162.32,,,,fee schedule,,,1888.25,91,,percent of total billed charges,,,1971.25,95,,percent of total billed charges,,,1722.25,83,,percent of total billed charges,,,622.5,83,,percent of total billed charges,,56.8,,,,fee schedule,,56.8,,,,fee schedule,,,1722.25,83,,percent of total billed charges,,238.61,,,,fee schedule,,,1867.5,90,,percent of total billed charges,,,1867.5,90,,percent of total billed charges,,,1867.5,90,,percent of total billed charges,,,1867.5,90,,percent of total billed charges,,,1763.75,85,,percent of total billed charges,,56.8,1971.25,
"MUSCLE TEST, 2 LIMBS",9586126,CDM,95861,CPT,,,both,26,833,833,251.6,,,,fee schedule,,,,,,,,56.8,,,,fee schedule,,,708.05,85,,percent of total billed charges,,131.33,,,,fee schedule,,83.83,,,,fee schedule,,56.8,,,,fee schedule,,193.22,,,,fee schedule,,56.8,,,,fee schedule,,267.83,,,,fee schedule,,162.32,,,,fee schedule,,162.32,,,,fee schedule,,,758.03,91,,percent of total billed charges,,,791.35,95,,percent of total billed charges,,,691.39,83,,percent of total billed charges,,,249.9,83,,percent of total billed charges,,56.8,,,,fee schedule,,56.8,,,,fee schedule,,,691.39,83,,percent of total billed charges,,238.61,,,,fee schedule,,,749.7,90,,percent of total billed charges,,,749.7,90,,percent of total billed charges,,,749.7,90,,percent of total billed charges,,,749.7,90,,percent of total billed charges,,,708.05,85,,percent of total billed charges,,56.8,791.35,
"MUSCLE TEST, 2 LIMBS",95861P,CDM,95861,CPT,,,both,P,1864,1864,251.6,,,,fee schedule,,,,,,,,56.8,,,,fee schedule,,,1584.4,85,,percent of total billed charges,,131.33,,,,fee schedule,,83.83,,,,fee schedule,,56.8,,,,fee schedule,,193.22,,,,fee schedule,,56.8,,,,fee schedule,,267.83,,,,fee schedule,,162.32,,,,fee schedule,,162.32,,,,fee schedule,,,1696.24,91,,percent of total billed charges,,,1770.8,95,,percent of total billed charges,,,1547.12,83,,percent of total billed charges,,,559.2,83,,percent of total billed charges,,56.8,,,,fee schedule,,56.8,,,,fee schedule,,,1547.12,83,,percent of total billed charges,,238.61,,,,fee schedule,,,1677.6,90,,percent of total billed charges,,,1677.6,90,,percent of total billed charges,,,1677.6,90,,percent of total billed charges,,,1677.6,90,,percent of total billed charges,,,1584.4,85,,percent of total billed charges,,56.8,1770.8,
"MUSCLE TEST, 2 LIMBS",95861P,CDM,95861,CPT,,,both,P,1864,1864,251.6,,,,fee schedule,,,,,,,,56.8,,,,fee schedule,,,1584.4,85,,percent of total billed charges,,131.33,,,,fee schedule,,83.83,,,,fee schedule,,56.8,,,,fee schedule,,193.22,,,,fee schedule,,56.8,,,,fee schedule,,267.83,,,,fee schedule,,162.32,,,,fee schedule,,162.32,,,,fee schedule,,,1696.24,91,,percent of total billed charges,,,1770.8,95,,percent of total billed charges,,,1547.12,83,,percent of total billed charges,,,559.2,83,,percent of total billed charges,,56.8,,,,fee schedule,,56.8,,,,fee schedule,,,1547.12,83,,percent of total billed charges,,238.61,,,,fee schedule,,,1677.6,90,,percent of total billed charges,,,1677.6,90,,percent of total billed charges,,,1677.6,90,,percent of total billed charges,,,1677.6,90,,percent of total billed charges,,,1584.4,85,,percent of total billed charges,,56.8,1770.8,
"MUSCLE TEST, 2 LIMBS",95861T,CDM,95861,CPT,,,both,T,150,150,251.6,,,,fee schedule,,,,,,,,56.8,,,,fee schedule,,,127.5,85,,percent of total billed charges,,131.33,,,,fee schedule,,83.83,,,,fee schedule,,56.8,,,,fee schedule,,193.22,,,,fee schedule,,56.8,,,,fee schedule,,267.83,,,,fee schedule,,162.32,,,,fee schedule,,162.32,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,56.8,,,,fee schedule,,56.8,,,,fee schedule,,,124.5,83,,percent of total billed charges,,238.61,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,45,267.83,
"MUSCLE TEST, 2 LIMBS",95861T,CDM,95861,CPT,,,both,T,211,211,251.6,,,,fee schedule,,,,,,,,56.8,,,,fee schedule,,,179.35,85,,percent of total billed charges,,131.33,,,,fee schedule,,83.83,,,,fee schedule,,56.8,,,,fee schedule,,193.22,,,,fee schedule,,56.8,,,,fee schedule,,267.83,,,,fee schedule,,162.32,,,,fee schedule,,162.32,,,,fee schedule,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,63.3,83,,percent of total billed charges,,56.8,,,,fee schedule,,56.8,,,,fee schedule,,,175.13,83,,percent of total billed charges,,238.61,,,,fee schedule,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,56.8,267.83,
"MUSCLE TEST, 3 LIMBS",95863,CDM,95863,CPT,,,both,,715,715,326.71,,,,fee schedule,,,,,,,,65.7,,,,fee schedule,,,607.75,85,,percent of total billed charges,,159.1,,,,fee schedule,,101.55,,,,fee schedule,,65.7,,,,fee schedule,,235.12,,,,fee schedule,,65.7,,,,fee schedule,,347.78,,,,fee schedule,,210.78,,,,fee schedule,,210.78,,,,fee schedule,,,650.65,91,,percent of total billed charges,,,679.25,95,,percent of total billed charges,,,593.45,83,,percent of total billed charges,,,214.5,83,,percent of total billed charges,,65.7,,,,fee schedule,,65.7,,,,fee schedule,,,593.45,83,,percent of total billed charges,,309.84,,,,fee schedule,,,643.5,90,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,643.5,90,,percent of total billed charges,,,607.75,85,,percent of total billed charges,,65.7,679.25,
"MUSCLE TEST, 3 LIMBS",9586326,CDM,95863,CPT,,,both,26,326,326,326.71,,,,fee schedule,,,,,,,,65.7,,,,fee schedule,,,277.1,85,,percent of total billed charges,,159.1,,,,fee schedule,,101.55,,,,fee schedule,,65.7,,,,fee schedule,,235.12,,,,fee schedule,,65.7,,,,fee schedule,,347.78,,,,fee schedule,,210.78,,,,fee schedule,,210.78,,,,fee schedule,,,296.66,91,,percent of total billed charges,,,309.7,95,,percent of total billed charges,,,270.58,83,,percent of total billed charges,,,97.8,83,,percent of total billed charges,,65.7,,,,fee schedule,,65.7,,,,fee schedule,,,270.58,83,,percent of total billed charges,,309.84,,,,fee schedule,,,293.4,90,,percent of total billed charges,,,293.4,90,,percent of total billed charges,,,293.4,90,,percent of total billed charges,,,293.4,90,,percent of total billed charges,,,277.1,85,,percent of total billed charges,,65.7,347.78,
"MUSCLE TEST, 3 LIMBS",95863P,CDM,95863,CPT,,,both,P,544,544,326.71,,,,fee schedule,,,,,,,,65.7,,,,fee schedule,,,462.4,85,,percent of total billed charges,,159.1,,,,fee schedule,,101.55,,,,fee schedule,,65.7,,,,fee schedule,,235.12,,,,fee schedule,,65.7,,,,fee schedule,,347.78,,,,fee schedule,,210.78,,,,fee schedule,,210.78,,,,fee schedule,,,495.04,91,,percent of total billed charges,,,516.8,95,,percent of total billed charges,,,451.52,83,,percent of total billed charges,,,163.2,83,,percent of total billed charges,,65.7,,,,fee schedule,,65.7,,,,fee schedule,,,451.52,83,,percent of total billed charges,,309.84,,,,fee schedule,,,489.6,90,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,462.4,85,,percent of total billed charges,,65.7,516.8,
"MUSCLE TEST, 3 LIMBS",95863P,CDM,95863,CPT,,,both,P,544,544,326.71,,,,fee schedule,,,,,,,,65.7,,,,fee schedule,,,462.4,85,,percent of total billed charges,,159.1,,,,fee schedule,,101.55,,,,fee schedule,,65.7,,,,fee schedule,,235.12,,,,fee schedule,,65.7,,,,fee schedule,,347.78,,,,fee schedule,,210.78,,,,fee schedule,,210.78,,,,fee schedule,,,495.04,91,,percent of total billed charges,,,516.8,95,,percent of total billed charges,,,451.52,83,,percent of total billed charges,,,163.2,83,,percent of total billed charges,,65.7,,,,fee schedule,,65.7,,,,fee schedule,,,451.52,83,,percent of total billed charges,,309.84,,,,fee schedule,,,489.6,90,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,489.6,90,,percent of total billed charges,,,462.4,85,,percent of total billed charges,,65.7,516.8,
"MUSCLE TEST, 3 LIMBS",95863T,CDM,95863,CPT,,,both,T,150,150,326.71,,,,fee schedule,,,,,,,,65.7,,,,fee schedule,,,127.5,85,,percent of total billed charges,,159.1,,,,fee schedule,,101.55,,,,fee schedule,,65.7,,,,fee schedule,,235.12,,,,fee schedule,,65.7,,,,fee schedule,,347.78,,,,fee schedule,,210.78,,,,fee schedule,,210.78,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,65.7,,,,fee schedule,,65.7,,,,fee schedule,,,124.5,83,,percent of total billed charges,,309.84,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,45,347.78,
"MUSCLE TEST, 3 LIMBS",95863T,CDM,95863,CPT,,,both,T,171,171,326.71,,,,fee schedule,,,,,,,,65.7,,,,fee schedule,,,145.35,85,,percent of total billed charges,,159.1,,,,fee schedule,,101.55,,,,fee schedule,,65.7,,,,fee schedule,,235.12,,,,fee schedule,,65.7,,,,fee schedule,,347.78,,,,fee schedule,,210.78,,,,fee schedule,,210.78,,,,fee schedule,,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,51.3,83,,percent of total billed charges,,65.7,,,,fee schedule,,65.7,,,,fee schedule,,,141.93,83,,percent of total billed charges,,309.84,,,,fee schedule,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,51.3,347.78,
"MUSCLE TEST, 4 LIMBS",95864,CDM,95864,CPT,,,both,,837,837,366.1,,,,fee schedule,,,,,,,,85.3,,,,fee schedule,,,711.45,85,,percent of total billed charges,,170.25,,,,fee schedule,,108.67,,,,fee schedule,,85.3,,,,fee schedule,,303.9,,,,fee schedule,,85.3,,,,fee schedule,,389.72,,,,fee schedule,,236.19,,,,fee schedule,,236.19,,,,fee schedule,,,761.67,91,,percent of total billed charges,,,795.15,95,,percent of total billed charges,,,694.71,83,,percent of total billed charges,,,251.1,83,,percent of total billed charges,,85.3,,,,fee schedule,,85.3,,,,fee schedule,,,694.71,83,,percent of total billed charges,,347.2,,,,fee schedule,,,753.3,90,,percent of total billed charges,,,753.3,90,,percent of total billed charges,,,753.3,90,,percent of total billed charges,,,753.3,90,,percent of total billed charges,,,711.45,85,,percent of total billed charges,,85.3,795.15,
"MUSCLE TEST, 4 LIMBS",9586426,CDM,95864,CPT,,,both,26,347,347,366.1,,,,fee schedule,,,,,,,,85.3,,,,fee schedule,,,294.95,85,,percent of total billed charges,,170.25,,,,fee schedule,,108.67,,,,fee schedule,,85.3,,,,fee schedule,,303.9,,,,fee schedule,,85.3,,,,fee schedule,,389.72,,,,fee schedule,,236.19,,,,fee schedule,,236.19,,,,fee schedule,,,315.77,91,,percent of total billed charges,,,329.65,95,,percent of total billed charges,,,288.01,83,,percent of total billed charges,,,104.1,83,,percent of total billed charges,,85.3,,,,fee schedule,,85.3,,,,fee schedule,,,288.01,83,,percent of total billed charges,,347.2,,,,fee schedule,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,312.3,90,,percent of total billed charges,,,294.95,85,,percent of total billed charges,,85.3,389.72,
"MUSCLE TEST, 4 LIMBS",95864P,CDM,95864,CPT,,,both,P,662,662,366.1,,,,fee schedule,,,,,,,,85.3,,,,fee schedule,,,562.7,85,,percent of total billed charges,,170.25,,,,fee schedule,,108.67,,,,fee schedule,,85.3,,,,fee schedule,,303.9,,,,fee schedule,,85.3,,,,fee schedule,,389.72,,,,fee schedule,,236.19,,,,fee schedule,,236.19,,,,fee schedule,,,602.42,91,,percent of total billed charges,,,628.9,95,,percent of total billed charges,,,549.46,83,,percent of total billed charges,,,198.6,83,,percent of total billed charges,,85.3,,,,fee schedule,,85.3,,,,fee schedule,,,549.46,83,,percent of total billed charges,,347.2,,,,fee schedule,,,595.8,90,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,562.7,85,,percent of total billed charges,,85.3,628.9,
"MUSCLE TEST, 4 LIMBS",95864P,CDM,95864,CPT,,,both,P,662,662,366.1,,,,fee schedule,,,,,,,,85.3,,,,fee schedule,,,562.7,85,,percent of total billed charges,,170.25,,,,fee schedule,,108.67,,,,fee schedule,,85.3,,,,fee schedule,,303.9,,,,fee schedule,,85.3,,,,fee schedule,,389.72,,,,fee schedule,,236.19,,,,fee schedule,,236.19,,,,fee schedule,,,602.42,91,,percent of total billed charges,,,628.9,95,,percent of total billed charges,,,549.46,83,,percent of total billed charges,,,198.6,83,,percent of total billed charges,,85.3,,,,fee schedule,,85.3,,,,fee schedule,,,549.46,83,,percent of total billed charges,,347.2,,,,fee schedule,,,595.8,90,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,595.8,90,,percent of total billed charges,,,562.7,85,,percent of total billed charges,,85.3,628.9,
"MUSCLE TEST, 4 LIMBS",95864T,CDM,95864,CPT,,,both,T,150,150,366.1,,,,fee schedule,,,,,,,,85.3,,,,fee schedule,,,127.5,85,,percent of total billed charges,,170.25,,,,fee schedule,,108.67,,,,fee schedule,,85.3,,,,fee schedule,,303.9,,,,fee schedule,,85.3,,,,fee schedule,,389.72,,,,fee schedule,,236.19,,,,fee schedule,,236.19,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,85.3,,,,fee schedule,,85.3,,,,fee schedule,,,124.5,83,,percent of total billed charges,,347.2,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,45,389.72,
"MUSCLE TEST, 4 LIMBS",95864T,CDM,95864,CPT,,,both,T,175,175,366.1,,,,fee schedule,,,,,,,,85.3,,,,fee schedule,,,148.75,85,,percent of total billed charges,,170.25,,,,fee schedule,,108.67,,,,fee schedule,,85.3,,,,fee schedule,,303.9,,,,fee schedule,,85.3,,,,fee schedule,,389.72,,,,fee schedule,,236.19,,,,fee schedule,,236.19,,,,fee schedule,,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,52.5,83,,percent of total billed charges,,85.3,,,,fee schedule,,85.3,,,,fee schedule,,,145.25,83,,percent of total billed charges,,347.2,,,,fee schedule,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,52.5,389.72,
MUSCLE TEST CRAN NERV UNILAT,95867,CDM,95867,CPT,,,both,,334,334,168.08,,,,fee schedule,,,,,,,,30.7,,,,fee schedule,,,283.9,85,,percent of total billed charges,,67.04,,,,fee schedule,,42.79,,,,fee schedule,,30.7,,,,fee schedule,,111.93,,,,fee schedule,,30.7,,,,fee schedule,,178.92,,,,fee schedule,,108.44,,,,fee schedule,,108.44,,,,fee schedule,,,303.94,91,,percent of total billed charges,,,317.3,95,,percent of total billed charges,,,277.22,83,,percent of total billed charges,,,100.2,83,,percent of total billed charges,,30.7,,,,fee schedule,,30.7,,,,fee schedule,,,277.22,83,,percent of total billed charges,,159.41,,,,fee schedule,,,300.6,90,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,300.6,90,,percent of total billed charges,,,283.9,85,,percent of total billed charges,,30.7,317.3,
MUSCLE TEST CRAN NERVE BILAT,95868,CDM,95868,CPT,,,both,,433,433,218.5,,,,fee schedule,,,,,,,,46.3,,,,fee schedule,,,368.05,85,,percent of total billed charges,,100.39,,,,fee schedule,,64.08,,,,fee schedule,,46.3,,,,fee schedule,,156.33,,,,fee schedule,,46.3,,,,fee schedule,,232.6,,,,fee schedule,,140.97,,,,fee schedule,,140.97,,,,fee schedule,,,394.03,91,,percent of total billed charges,,,411.35,95,,percent of total billed charges,,,359.39,83,,percent of total billed charges,,,129.9,83,,percent of total billed charges,,46.3,,,,fee schedule,,46.3,,,,fee schedule,,,359.39,83,,percent of total billed charges,,207.23,,,,fee schedule,,,389.7,90,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,389.7,90,,percent of total billed charges,,,368.05,85,,percent of total billed charges,,46.3,411.35,
"MUSCLE TEST, THOR PARASPINAL",95869,CDM,95869,CPT,,,both,,339,339,150.75,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,288.15,85,,percent of total billed charges,,31.86,,,,fee schedule,,20.34,,,,fee schedule,,52.7,,,,fee schedule,,48.77,,,,fee schedule,,52.7,,,,fee schedule,,160.47,,,,fee schedule,,97.26,,,,fee schedule,,97.26,,,,fee schedule,,,308.49,91,,percent of total billed charges,,,322.05,95,,percent of total billed charges,,,281.37,83,,percent of total billed charges,,,101.7,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,281.37,83,,percent of total billed charges,,142.97,,,,fee schedule,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,288.15,85,,percent of total billed charges,,20.34,322.05,
"MUSCLE TEST, THOR PARASPINAL",9586926,CDM,95869,CPT,,,both,26,76,76,150.75,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,64.6,85,,percent of total billed charges,,31.86,,,,fee schedule,,20.34,,,,fee schedule,,52.7,,,,fee schedule,,48.77,,,,fee schedule,,52.7,,,,fee schedule,,160.47,,,,fee schedule,,97.26,,,,fee schedule,,97.26,,,,fee schedule,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,63.08,83,,percent of total billed charges,,142.97,,,,fee schedule,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,20.34,160.47,
"MUSCLE TEST, THOR PARASPINAL",95869P,CDM,95869,CPT,,,both,P,179,179,150.75,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,152.15,85,,percent of total billed charges,,31.86,,,,fee schedule,,20.34,,,,fee schedule,,52.7,,,,fee schedule,,48.77,,,,fee schedule,,52.7,,,,fee schedule,,160.47,,,,fee schedule,,97.26,,,,fee schedule,,97.26,,,,fee schedule,,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,53.7,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,148.57,83,,percent of total billed charges,,142.97,,,,fee schedule,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,20.34,170.05,
"MUSCLE TEST, THOR PARASPINAL",95869P,CDM,95869,CPT,,,both,P,183,183,150.75,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,155.55,85,,percent of total billed charges,,31.86,,,,fee schedule,,20.34,,,,fee schedule,,52.7,,,,fee schedule,,48.77,,,,fee schedule,,52.7,,,,fee schedule,,160.47,,,,fee schedule,,97.26,,,,fee schedule,,97.26,,,,fee schedule,,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,54.9,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,151.89,83,,percent of total billed charges,,142.97,,,,fee schedule,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,20.34,173.85,
"MUSCLE TEST, THOR PARASPINAL",95869T,CDM,95869,CPT,,,both,T,150,150,150.75,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,127.5,85,,percent of total billed charges,,31.86,,,,fee schedule,,20.34,,,,fee schedule,,52.7,,,,fee schedule,,48.77,,,,fee schedule,,52.7,,,,fee schedule,,160.47,,,,fee schedule,,97.26,,,,fee schedule,,97.26,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,124.5,83,,percent of total billed charges,,142.97,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,20.34,160.47,
"MUSCLE TEST, THOR PARASPINAL",95869T,CDM,95869,CPT,,,both,T,156,156,150.75,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,132.6,85,,percent of total billed charges,,31.86,,,,fee schedule,,20.34,,,,fee schedule,,52.7,,,,fee schedule,,48.77,,,,fee schedule,,52.7,,,,fee schedule,,160.47,,,,fee schedule,,97.26,,,,fee schedule,,97.26,,,,fee schedule,,,141.96,91,,percent of total billed charges,,,148.2,95,,percent of total billed charges,,,129.48,83,,percent of total billed charges,,,46.8,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,129.48,83,,percent of total billed charges,,142.97,,,,fee schedule,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,132.6,85,,percent of total billed charges,,20.34,160.47,
"MUSCLE TEST, NONPARASPINAL",95870,CDM,95870,CPT,,,both,,273,273,130.79,,,,fee schedule,,,,,,,,210.8,,,,fee schedule,,,232.05,85,,percent of total billed charges,,31.35,,,,fee schedule,,20.01,,,,fee schedule,,210.8,,,,fee schedule,,48.77,,,,fee schedule,,210.8,,,,fee schedule,,139.23,,,,fee schedule,,84.38,,,,fee schedule,,84.38,,,,fee schedule,,,248.43,91,,percent of total billed charges,,,259.35,95,,percent of total billed charges,,,226.59,83,,percent of total billed charges,,,81.9,83,,percent of total billed charges,,210.8,,,,fee schedule,,210.8,,,,fee schedule,,,226.59,83,,percent of total billed charges,,124.04,,,,fee schedule,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,245.7,90,,percent of total billed charges,,,232.05,85,,percent of total billed charges,,20.01,259.35,
"GUIDE NERV DESTR, NEEDLE EMG",95874,CDM,95874,CPT,,,both,,245,245,121.33,,,,fee schedule,,,,,,,,16.06,,,,fee schedule,,,208.25,85,,percent of total billed charges,,31.2,,,,fee schedule,,19.91,,,,fee schedule,,16.06,,,,fee schedule,,,,,,,,16.06,,,,fee schedule,,129.16,,,,fee schedule,,78.28,,,,fee schedule,,78.28,,,,fee schedule,,,222.95,91,,percent of total billed charges,,,232.75,95,,percent of total billed charges,,,203.35,83,,percent of total billed charges,,,73.5,83,,percent of total billed charges,,16.06,,,,fee schedule,,16.06,,,,fee schedule,,,203.35,83,,percent of total billed charges,,115.07,,,,fee schedule,,,220.5,90,,percent of total billed charges,,,220.5,90,,percent of total billed charges,,,220.5,90,,percent of total billed charges,,,220.5,90,,percent of total billed charges,,,208.25,85,,percent of total billed charges,,16.06,232.75,
"Needle Electromyography, Ease Extremity With Relat",95885,CDM,95885,CPT,,,both,,283,283,97.17,,,,fee schedule,,,,,,,,125.08,,,,fee schedule,,,240.55,85,,percent of total billed charges,,29.56,,,,fee schedule,,18.87,,,,fee schedule,,125.08,,,,fee schedule,,,,,,,,125.08,,,,fee schedule,,103.44,,,,fee schedule,,62.69,,,,fee schedule,,62.69,,,,fee schedule,,,257.53,91,,percent of total billed charges,,,268.85,95,,percent of total billed charges,,,234.89,83,,percent of total billed charges,,,84.9,83,,percent of total billed charges,,125.08,,,,fee schedule,,125.08,,,,fee schedule,,,234.89,83,,percent of total billed charges,,92.16,,,,fee schedule,,,254.7,90,,percent of total billed charges,,,254.7,90,,percent of total billed charges,,,254.7,90,,percent of total billed charges,,,254.7,90,,percent of total billed charges,,,240.55,85,,percent of total billed charges,,18.87,268.85,
Needle Electromyography Each Extremity,9588526,CDM,95885,CPT,,,both,26,118,118,97.17,,,,fee schedule,,,,,,,,125.08,,,,fee schedule,,,100.3,85,,percent of total billed charges,,29.56,,,,fee schedule,,18.87,,,,fee schedule,,125.08,,,,fee schedule,,,,,,,,125.08,,,,fee schedule,,103.44,,,,fee schedule,,62.69,,,,fee schedule,,62.69,,,,fee schedule,,,107.38,91,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,35.4,83,,percent of total billed charges,,125.08,,,,fee schedule,,125.08,,,,fee schedule,,,97.94,83,,percent of total billed charges,,92.16,,,,fee schedule,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,18.87,125.08,
Needle Electromyography Each Extremity,9588526,CDM,95885,CPT,,,both,26,130,130,97.17,,,,fee schedule,,,,,,,,125.08,,,,fee schedule,,,110.5,85,,percent of total billed charges,,29.56,,,,fee schedule,,18.87,,,,fee schedule,,125.08,,,,fee schedule,,,,,,,,125.08,,,,fee schedule,,103.44,,,,fee schedule,,62.69,,,,fee schedule,,62.69,,,,fee schedule,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,39,83,,percent of total billed charges,,125.08,,,,fee schedule,,125.08,,,,fee schedule,,,107.9,83,,percent of total billed charges,,92.16,,,,fee schedule,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,18.87,125.08,
Needle Electromyography Each Extremity With Relate,95885TC,CDM,95885,CPT,,,both,TC,141,141,97.17,,,,fee schedule,,,,,,,,125.08,,,,fee schedule,,,119.85,85,,percent of total billed charges,,29.56,,,,fee schedule,,18.87,,,,fee schedule,,125.08,,,,fee schedule,,,,,,,,125.08,,,,fee schedule,,103.44,,,,fee schedule,,62.69,,,,fee schedule,,62.69,,,,fee schedule,,,128.31,91,,percent of total billed charges,,,133.95,95,,percent of total billed charges,,,117.03,83,,percent of total billed charges,,,42.3,83,,percent of total billed charges,,125.08,,,,fee schedule,,125.08,,,,fee schedule,,,117.03,83,,percent of total billed charges,,92.16,,,,fee schedule,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,119.85,85,,percent of total billed charges,,18.87,133.95,
Needle Electromyography Each Extremity With Relate,95885TC,CDM,95885,CPT,,,both,TC,153,153,97.17,,,,fee schedule,,,,,,,,125.08,,,,fee schedule,,,130.05,85,,percent of total billed charges,,29.56,,,,fee schedule,,18.87,,,,fee schedule,,125.08,,,,fee schedule,,,,,,,,125.08,,,,fee schedule,,103.44,,,,fee schedule,,62.69,,,,fee schedule,,62.69,,,,fee schedule,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,45.9,83,,percent of total billed charges,,125.08,,,,fee schedule,,125.08,,,,fee schedule,,,126.99,83,,percent of total billed charges,,92.16,,,,fee schedule,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,18.87,145.35,
MUSC TEST DONE W/N TEST COMP,95886,CDM,95886,CPT,,,both,,309,309,152.85,,,,fee schedule,,,,,,,,199.08,,,,fee schedule,,,262.65,85,,percent of total billed charges,,73.03,,,,fee schedule,,46.61,,,,fee schedule,,199.08,,,,fee schedule,,,,,,,,199.08,,,,fee schedule,,162.71,,,,fee schedule,,98.61,,,,fee schedule,,98.61,,,,fee schedule,,,281.19,91,,percent of total billed charges,,,293.55,95,,percent of total billed charges,,,256.47,83,,percent of total billed charges,,,92.7,83,,percent of total billed charges,,199.08,,,,fee schedule,,199.08,,,,fee schedule,,,256.47,83,,percent of total billed charges,,144.96,,,,fee schedule,,,278.1,90,,percent of total billed charges,,,278.1,90,,percent of total billed charges,,,278.1,90,,percent of total billed charges,,,278.1,90,,percent of total billed charges,,,262.65,85,,percent of total billed charges,,46.61,293.55,
MUSC TST DONE W/N TST NONEXT,95887,CDM,95887,CPT,,,both,,263,263,131.31,,,,fee schedule,,,,,,,,44.13,,,,fee schedule,,,223.55,85,,percent of total billed charges,,60.5,,,,fee schedule,,38.62,,,,fee schedule,,44.13,,,,fee schedule,,,,,,,,44.13,,,,fee schedule,,139.78,,,,fee schedule,,84.72,,,,fee schedule,,84.72,,,,fee schedule,,,239.33,91,,percent of total billed charges,,,249.85,95,,percent of total billed charges,,,218.29,83,,percent of total billed charges,,,78.9,83,,percent of total billed charges,,44.13,,,,fee schedule,,44.13,,,,fee schedule,,,218.29,83,,percent of total billed charges,,124.54,,,,fee schedule,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,236.7,90,,percent of total billed charges,,,223.55,85,,percent of total billed charges,,38.62,249.85,
EMG-MOTOR NERVE CONDUCTION W/O F WAVE,9590026,CDM,95900,CPT,,,both,26,46,46,,,,,,,,,,,,,,,,,,,,39.1,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,107.55,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,13.8,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,13.8,107.55,
EMG-MOTOR NERVE CONDUCTION W/O F WAVE,95900tc,CDM,95900,CPT,,,both,tc,68,68,,,,,,,,,,,,,,,,,,,,57.8,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,107.55,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,,,,,,,,,,,,,,56.44,83,,percent of total billed charges,,,,,,,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,20.4,107.55,
EMG-MOTOR NERVE CONDUCTION TEST,9590326,CDM,95903,CPT,,,both,26,65,65,,,,,,,,,,,,,,,,,,,,55.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,115.06,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,59.15,91,,percent of total billed charges,,,61.75,95,,percent of total billed charges,,,53.95,83,,percent of total billed charges,,,19.5,83,,percent of total billed charges,,,,,,,,,,,,,,,53.95,83,,percent of total billed charges,,,,,,,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,55.25,85,,percent of total billed charges,,19.5,115.06,
EMG-MOTOR NERVE CONDUCTION TEST,95903tc,CDM,95903,CPT,,,both,tc,68,68,,,,,,,,,,,,,,,,,,,,57.8,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,115.06,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,,,,,,,,,,,,,,56.44,83,,percent of total billed charges,,,,,,,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,20.4,115.06,
EMG-SENSE NERVE CONDUCTION TEST,9590426,CDM,95904,CPT,,,both,26,38,38,,,,,,,,,,,,,,,,,,,,32.3,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,91.92,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,34.58,91,,percent of total billed charges,,,36.1,95,,percent of total billed charges,,,31.54,83,,percent of total billed charges,,,11.4,83,,percent of total billed charges,,,,,,,,,,,,,,,31.54,83,,percent of total billed charges,,,,,,,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,34.2,90,,percent of total billed charges,,,32.3,85,,percent of total billed charges,,11.4,91.92,
EMG-SENSE NERVE CONDUCTION TEST,95904tc,CDM,95904,CPT,,,both,tc,62,62,,,,,,,,,,,,,,,,,,,,52.7,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,91.92,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,18.6,91.92,
Nerve Conduction Studies; 1-2 Studies,95907,CDM,95907,CPT,,,both,,374,374,140.24,,,,fee schedule,,,,,,,,53.96,,,,fee schedule,,,317.9,85,,percent of total billed charges,,85,,,,fee schedule,,54.25,,,,fee schedule,,53.96,,,,fee schedule,,,,,,,,53.96,,,,fee schedule,,149.29,,,,fee schedule,,90.48,,,,fee schedule,,90.48,,,,fee schedule,,,340.34,91,,percent of total billed charges,,,355.3,95,,percent of total billed charges,,,310.42,83,,percent of total billed charges,,,112.2,83,,percent of total billed charges,,53.96,,,,fee schedule,,53.96,,,,fee schedule,,,310.42,83,,percent of total billed charges,,133,,,,fee schedule,,,336.6,90,,percent of total billed charges,,,336.6,90,,percent of total billed charges,,,336.6,90,,percent of total billed charges,,,336.6,90,,percent of total billed charges,,,317.9,85,,percent of total billed charges,,53.96,355.3,
Nerve Conduction Studies; 3-4 Studies,95908,CDM,95908,CPT,,,both,,493,493,174.38,,,,fee schedule,,,,,,,,66.58,,,,fee schedule,,,419.05,85,,percent of total billed charges,,106.37,,,,fee schedule,,67.9,,,,fee schedule,,66.58,,,,fee schedule,,,,,,,,66.58,,,,fee schedule,,185.63,,,,fee schedule,,112.51,,,,fee schedule,,112.51,,,,fee schedule,,,448.63,91,,percent of total billed charges,,,468.35,95,,percent of total billed charges,,,409.19,83,,percent of total billed charges,,,147.9,83,,percent of total billed charges,,66.58,,,,fee schedule,,66.58,,,,fee schedule,,,409.19,83,,percent of total billed charges,,165.38,,,,fee schedule,,,443.7,90,,percent of total billed charges,,,443.7,90,,percent of total billed charges,,,443.7,90,,percent of total billed charges,,,443.7,90,,percent of total billed charges,,,419.05,85,,percent of total billed charges,,66.58,468.35,
Nerve Conduction Studies; 5-6 Studies,95909,CDM,95909,CPT,,,both,,642,642,209.58,,,,fee schedule,,,,,,,,79.84,,,,fee schedule,,,545.7,85,,percent of total billed charges,,127.9,,,,fee schedule,,81.64,,,,fee schedule,,79.84,,,,fee schedule,,,,,,,,79.84,,,,fee schedule,,223.1,,,,fee schedule,,135.21,,,,fee schedule,,135.21,,,,fee schedule,,,584.22,91,,percent of total billed charges,,,609.9,95,,percent of total billed charges,,,532.86,83,,percent of total billed charges,,,192.6,83,,percent of total billed charges,,79.84,,,,fee schedule,,79.84,,,,fee schedule,,,532.86,83,,percent of total billed charges,,198.76,,,,fee schedule,,,577.8,90,,percent of total billed charges,,,577.8,90,,percent of total billed charges,,,577.8,90,,percent of total billed charges,,,577.8,90,,percent of total billed charges,,,545.7,85,,percent of total billed charges,,79.84,609.9,
Nerve Conduction Studies; 7-8 Studies,95910,CDM,95910,CPT,,,both,,801,801,274.18,,,,fee schedule,,,,,,,,105.15,,,,fee schedule,,,680.85,85,,percent of total billed charges,,170.66,,,,fee schedule,,108.93,,,,fee schedule,,105.15,,,,fee schedule,,,,,,,,105.15,,,,fee schedule,,291.87,,,,fee schedule,,176.89,,,,fee schedule,,176.89,,,,fee schedule,,,728.91,91,,percent of total billed charges,,,760.95,95,,percent of total billed charges,,,664.83,83,,percent of total billed charges,,,240.3,83,,percent of total billed charges,,105.15,,,,fee schedule,,105.15,,,,fee schedule,,,664.83,83,,percent of total billed charges,,260.03,,,,fee schedule,,,720.9,90,,percent of total billed charges,,,720.9,90,,percent of total billed charges,,,720.9,90,,percent of total billed charges,,,720.9,90,,percent of total billed charges,,,680.85,85,,percent of total billed charges,,105.15,760.95,
Nerve Conduction Studies; 9-10 Studies,95911,CDM,95911,CPT,,,both,,1014,1014,330.91,,,,fee schedule,,,,,,,,127.49,,,,fee schedule,,,861.9,85,,percent of total billed charges,,211.72,,,,fee schedule,,135.14,,,,fee schedule,,127.49,,,,fee schedule,,,,,,,,127.49,,,,fee schedule,,352.26,,,,fee schedule,,213.49,,,,fee schedule,,213.49,,,,fee schedule,,,922.74,91,,percent of total billed charges,,,963.3,95,,percent of total billed charges,,,841.62,83,,percent of total billed charges,,,304.2,83,,percent of total billed charges,,127.49,,,,fee schedule,,127.49,,,,fee schedule,,,841.62,83,,percent of total billed charges,,313.83,,,,fee schedule,,,912.6,90,,percent of total billed charges,,,912.6,90,,percent of total billed charges,,,912.6,90,,percent of total billed charges,,,912.6,90,,percent of total billed charges,,,861.9,85,,percent of total billed charges,,127.49,963.3,
Nerve Conduction Studies; 11-12 Studies,95912,CDM,95912,CPT,,,both,,1091,1091,387.11,,,,fee schedule,,,,,,,,149.47,,,,fee schedule,,,927.35,85,,percent of total billed charges,,252.28,,,,fee schedule,,161.03,,,,fee schedule,,149.47,,,,fee schedule,,,,,,,,149.47,,,,fee schedule,,412.09,,,,fee schedule,,249.75,,,,fee schedule,,249.75,,,,fee schedule,,,992.81,91,,percent of total billed charges,,,1036.45,95,,percent of total billed charges,,,905.53,83,,percent of total billed charges,,,327.3,83,,percent of total billed charges,,149.47,,,,fee schedule,,149.47,,,,fee schedule,,,905.53,83,,percent of total billed charges,,367.13,,,,fee schedule,,,981.9,90,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,981.9,90,,percent of total billed charges,,,927.35,85,,percent of total billed charges,,149.47,1036.45,
Nerve Conduction Studies; 13 Or More Studies,95913,CDM,95913,CPT,,,both,,1371,1371,446.99,,,,fee schedule,,,,,,,,173.41,,,,fee schedule,,,1165.35,85,,percent of total billed charges,,299.58,,,,fee schedule,,191.22,,,,fee schedule,,173.41,,,,fee schedule,,,,,,,,173.41,,,,fee schedule,,475.83,,,,fee schedule,,288.38,,,,fee schedule,,288.38,,,,fee schedule,,,1247.61,91,,percent of total billed charges,,,1302.45,95,,percent of total billed charges,,,1137.93,83,,percent of total billed charges,,,411.3,83,,percent of total billed charges,,173.41,,,,fee schedule,,173.41,,,,fee schedule,,,1137.93,83,,percent of total billed charges,,423.92,,,,fee schedule,,,1233.9,90,,percent of total billed charges,,,1233.9,90,,percent of total billed charges,,,1233.9,90,,percent of total billed charges,,,1233.9,90,,percent of total billed charges,,,1165.35,85,,percent of total billed charges,,173.41,1302.45,
Testing of ANS funct; cardiovagal (parasymp fnc),95921,CDM,95921,CPT,,,both,,371,371,137.09,,,,fee schedule,,,,,,,,44.5,,,,fee schedule,,,315.35,85,,percent of total billed charges,,72.2,,,,fee schedule,,46.09,,,,fee schedule,,44.5,,,,fee schedule,,104.43,,,,fee schedule,,44.5,,,,fee schedule,,145.94,,,,fee schedule,,88.45,,,,fee schedule,,88.45,,,,fee schedule,,,337.61,91,,percent of total billed charges,,,352.45,95,,percent of total billed charges,,,307.93,83,,percent of total billed charges,,,111.3,83,,percent of total billed charges,,44.5,,,,fee schedule,,44.5,,,,fee schedule,,,307.93,83,,percent of total billed charges,,130.02,,,,fee schedule,,,333.9,90,,percent of total billed charges,,,333.9,90,,percent of total billed charges,,,333.9,90,,percent of total billed charges,,,333.9,90,,percent of total billed charges,,,315.35,85,,percent of total billed charges,,44.5,352.45,
AUTONOMIC NERV FUNCTION TEST,9592126,CDM,95921,CPT,,,both,26,216,216,137.09,,,,fee schedule,,,,,,,,44.5,,,,fee schedule,,,183.6,85,,percent of total billed charges,,72.2,,,,fee schedule,,46.09,,,,fee schedule,,44.5,,,,fee schedule,,104.43,,,,fee schedule,,44.5,,,,fee schedule,,145.94,,,,fee schedule,,88.45,,,,fee schedule,,88.45,,,,fee schedule,,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,64.8,83,,percent of total billed charges,,44.5,,,,fee schedule,,44.5,,,,fee schedule,,,179.28,83,,percent of total billed charges,,130.02,,,,fee schedule,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,44.5,205.2,
AUTONOMIC NERV FUNCTION TEST,95921P,CDM,95921,CPT,,,both,P,211,211,137.09,,,,fee schedule,,,,,,,,44.5,,,,fee schedule,,,179.35,85,,percent of total billed charges,,72.2,,,,fee schedule,,46.09,,,,fee schedule,,44.5,,,,fee schedule,,104.43,,,,fee schedule,,44.5,,,,fee schedule,,145.94,,,,fee schedule,,88.45,,,,fee schedule,,88.45,,,,fee schedule,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,63.3,83,,percent of total billed charges,,44.5,,,,fee schedule,,44.5,,,,fee schedule,,,175.13,83,,percent of total billed charges,,130.02,,,,fee schedule,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,44.5,200.45,
AUTONOMIC NERV FUNCTION TEST,95921T,CDM,95921,CPT,,,both,T,160,160,137.09,,,,fee schedule,,,,,,,,44.5,,,,fee schedule,,,136,85,,percent of total billed charges,,72.2,,,,fee schedule,,46.09,,,,fee schedule,,44.5,,,,fee schedule,,104.43,,,,fee schedule,,44.5,,,,fee schedule,,145.94,,,,fee schedule,,88.45,,,,fee schedule,,88.45,,,,fee schedule,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,48,83,,percent of total billed charges,,44.5,,,,fee schedule,,44.5,,,,fee schedule,,,132.8,83,,percent of total billed charges,,130.02,,,,fee schedule,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,44.5,152,
AUTONOMIC NERV FUNCTION TEST,95921TC,CDM,95921,CPT,,,both,TC,123,123,137.09,,,,fee schedule,,,,,,,,44.5,,,,fee schedule,,,104.55,85,,percent of total billed charges,,72.2,,,,fee schedule,,46.09,,,,fee schedule,,44.5,,,,fee schedule,,104.43,,,,fee schedule,,44.5,,,,fee schedule,,145.94,,,,fee schedule,,88.45,,,,fee schedule,,88.45,,,,fee schedule,,,111.93,91,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,36.9,83,,percent of total billed charges,,44.5,,,,fee schedule,,44.5,,,,fee schedule,,,102.09,83,,percent of total billed charges,,130.02,,,,fee schedule,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,104.55,85,,percent of total billed charges,,36.9,145.94,
Testing of ANS funct; vasomotor adrenergic (symp adrenergic funct),95922,CDM,95922,CPT,,,both,,184,184,151.8,,,,fee schedule,,,,,,,,44.5,,,,fee schedule,,,156.4,85,,percent of total billed charges,,75.57,,,,fee schedule,,48.24,,,,fee schedule,,44.5,,,,fee schedule,,113.18,,,,fee schedule,,44.5,,,,fee schedule,,161.59,,,,fee schedule,,97.93,,,,fee schedule,,97.93,,,,fee schedule,,,167.44,91,,percent of total billed charges,,,174.8,95,,percent of total billed charges,,,152.72,83,,percent of total billed charges,,,55.2,83,,percent of total billed charges,,44.5,,,,fee schedule,,44.5,,,,fee schedule,,,152.72,83,,percent of total billed charges,,143.96,,,,fee schedule,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,165.6,90,,percent of total billed charges,,,156.4,85,,percent of total billed charges,,44.5,174.8,
AUTONOMIC NERV FUNCTION TEST,9592226,CDM,95922,CPT,,,both,26,186,186,151.8,,,,fee schedule,,,,,,,,44.5,,,,fee schedule,,,158.1,85,,percent of total billed charges,,75.57,,,,fee schedule,,48.24,,,,fee schedule,,44.5,,,,fee schedule,,113.18,,,,fee schedule,,44.5,,,,fee schedule,,161.59,,,,fee schedule,,97.93,,,,fee schedule,,97.93,,,,fee schedule,,,169.26,91,,percent of total billed charges,,,176.7,95,,percent of total billed charges,,,154.38,83,,percent of total billed charges,,,55.8,83,,percent of total billed charges,,44.5,,,,fee schedule,,44.5,,,,fee schedule,,,154.38,83,,percent of total billed charges,,143.96,,,,fee schedule,,,167.4,90,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,167.4,90,,percent of total billed charges,,,158.1,85,,percent of total billed charges,,44.5,176.7,
AUTONOMIC NERV FUNCTION TEST,95922P,CDM,95922,CPT,,,both,P,105,105,151.8,,,,fee schedule,,,,,,,,44.5,,,,fee schedule,,,89.25,85,,percent of total billed charges,,75.57,,,,fee schedule,,48.24,,,,fee schedule,,44.5,,,,fee schedule,,113.18,,,,fee schedule,,44.5,,,,fee schedule,,161.59,,,,fee schedule,,97.93,,,,fee schedule,,97.93,,,,fee schedule,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,31.5,83,,percent of total billed charges,,44.5,,,,fee schedule,,44.5,,,,fee schedule,,,87.15,83,,percent of total billed charges,,143.96,,,,fee schedule,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,31.5,161.59,
AUTONOMIC NERV FUNCTION TEST,95922T,CDM,95922,CPT,,,both,T,79,79,151.8,,,,fee schedule,,,,,,,,44.5,,,,fee schedule,,,67.15,85,,percent of total billed charges,,75.57,,,,fee schedule,,48.24,,,,fee schedule,,44.5,,,,fee schedule,,113.18,,,,fee schedule,,44.5,,,,fee schedule,,161.59,,,,fee schedule,,97.93,,,,fee schedule,,97.93,,,,fee schedule,,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,23.7,83,,percent of total billed charges,,44.5,,,,fee schedule,,44.5,,,,fee schedule,,,65.57,83,,percent of total billed charges,,143.96,,,,fee schedule,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,23.7,161.59,
AUTONOMIC NERV FUNCTION TEST,95922TC,CDM,95922,CPT,,,both,TC,183,183,151.8,,,,fee schedule,,,,,,,,44.5,,,,fee schedule,,,155.55,85,,percent of total billed charges,,75.57,,,,fee schedule,,48.24,,,,fee schedule,,44.5,,,,fee schedule,,113.18,,,,fee schedule,,44.5,,,,fee schedule,,161.59,,,,fee schedule,,97.93,,,,fee schedule,,97.93,,,,fee schedule,,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,54.9,83,,percent of total billed charges,,44.5,,,,fee schedule,,44.5,,,,fee schedule,,,151.89,83,,percent of total billed charges,,143.96,,,,fee schedule,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,44.5,173.85,
IONM IN OPERATNG ROOM 15 MIN,95940,CDM,95940,CPT,,,both,,343,343,49.9,,,,fee schedule,,,,,,,,526.96,,,,fee schedule,,,291.55,85,,percent of total billed charges,,52.27,,,,fee schedule,,33.36,,,,fee schedule,,526.96,,,,fee schedule,,,,,,,,526.96,,,,fee schedule,,53.12,,,,fee schedule,,32.19,,,,fee schedule,,32.19,,,,fee schedule,,,312.13,91,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,102.9,83,,percent of total billed charges,,526.96,,,,fee schedule,,526.96,,,,fee schedule,,,284.69,83,,percent of total billed charges,,47.32,,,,fee schedule,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,291.55,85,,percent of total billed charges,,32.19,526.96,
CANALITH REPOSITIONING PROC,95992,CDM,95992,CPT,,,both,,181,181,56.2,,,,fee schedule,,,,,,,,,,,,,,,153.85,85,,percent of total billed charges,,59.16,,,,fee schedule,,37.76,,,,fee schedule,,,,,,,,,,,,,,,,,,,,59.83,,,,fee schedule,,36.26,,,,fee schedule,,36.26,,,,fee schedule,,,164.71,91,,percent of total billed charges,,,171.95,95,,percent of total billed charges,,,150.23,83,,percent of total billed charges,,,54.3,83,,percent of total billed charges,,,,,,,,,,,,,,,150.23,83,,percent of total billed charges,,53.3,,,,fee schedule,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,162.9,90,,percent of total billed charges,,,153.85,85,,percent of total billed charges,,36.26,171.95,
CANALITH REPOSITIONING PROC,95992P,CDM,95992,CPT,,,both,P,133,133,56.2,,,,fee schedule,,,,,,,,,,,,,,,113.05,85,,percent of total billed charges,,59.16,,,,fee schedule,,37.76,,,,fee schedule,,,,,,,,,,,,,,,,,,,,59.83,,,,fee schedule,,36.26,,,,fee schedule,,36.26,,,,fee schedule,,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,39.9,83,,percent of total billed charges,,,,,,,,,,,,,,,110.39,83,,percent of total billed charges,,53.3,,,,fee schedule,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,36.26,126.35,
CANALITH REPOSITIONING PROC,95992T,CDM,95992,CPT,,,both,T,48,48,56.2,,,,fee schedule,,,,,,,,,,,,,,,40.8,85,,percent of total billed charges,,59.16,,,,fee schedule,,37.76,,,,fee schedule,,,,,,,,,,,,,,,,,,,,59.83,,,,fee schedule,,36.26,,,,fee schedule,,36.26,,,,fee schedule,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,14.4,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,53.3,,,,fee schedule,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,14.4,59.83,
ASSESSMENT OF APHASIA,96105,CDM,96105,CPT,,,both,,339,339,152.32,,,,fee schedule,,,,,,,,52.7,,,,fee schedule,,,288.15,85,,percent of total billed charges,,172.18,,,,fee schedule,,101.04,,,,fee schedule,,52.7,,,,fee schedule,,121.31,,,,fee schedule,,52.7,,,,fee schedule,,162.15,,,,fee schedule,,98.27,,,,fee schedule,,98.27,,,,fee schedule,,,308.49,91,,percent of total billed charges,,,322.05,95,,percent of total billed charges,,,281.37,83,,percent of total billed charges,,,101.7,83,,percent of total billed charges,,52.7,,,,fee schedule,,52.7,,,,fee schedule,,,281.37,83,,percent of total billed charges,,144.46,,,,fee schedule,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,305.1,90,,percent of total billed charges,,,288.15,85,,percent of total billed charges,,52.7,322.05,
"DEVELOPMENTAL TEST, LIM",96110,CDM,96110,CPT,,,both,,57,57,16.81,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,48.45,85,,percent of total billed charges,,17.45,,,,fee schedule,,10.24,,,,fee schedule,,32.15,,,,fee schedule,,22.51,,,,fee schedule,,32.15,,,,fee schedule,,17.89,,,,fee schedule,,10.84,,,,fee schedule,,10.84,,,,fee schedule,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,17.1,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,47.31,83,,percent of total billed charges,,15.94,,,,fee schedule,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,10.24,54.15,
COGNITIVE TEST BY HC PRO,96125,CDM,96125,CPT,,,both,,304,304,160.2,,,,fee schedule,,,,,,,,,,,,,,,258.4,85,,percent of total billed charges,,181.23,,,,fee schedule,,106.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,170.54,,,,fee schedule,,103.36,,,,fee schedule,,103.36,,,,fee schedule,,,276.64,91,,percent of total billed charges,,,288.8,95,,percent of total billed charges,,,252.32,83,,percent of total billed charges,,,91.2,83,,percent of total billed charges,,,,,,,,,,,,,,,252.32,83,,percent of total billed charges,,151.93,,,,fee schedule,,,273.6,90,,percent of total billed charges,,,273.6,90,,percent of total billed charges,,,273.6,90,,percent of total billed charges,,,273.6,90,,percent of total billed charges,,,258.4,85,,percent of total billed charges,,91.2,288.8,
BRIEF EMOTIONAL/BEHAV ASSMT,96127,CDM,96127,CPT,,,both,,32,32,7.35,,,,fee schedule,,,,,,,,29.2,,,,fee schedule,,,27.2,85,,percent of total billed charges,,13.63,,,,fee schedule,,4.68,,,,fee schedule,,29.2,,,,fee schedule,,,,,,,,29.2,,,,fee schedule,,7.83,,,,fee schedule,,4.74,,,,fee schedule,,4.74,,,,fee schedule,,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,9.6,83,,percent of total billed charges,,29.2,,,,fee schedule,,29.2,,,,fee schedule,,,26.56,83,,percent of total billed charges,,6.97,,,,fee schedule,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,4.68,30.4,
PT-FOCUSED HLTH RISK ASSMT,96160,CDM,96160,CPT,,,both,,442,442,4.2,,,,fee schedule,,,,,,,,14.6,,,,fee schedule,,,375.7,85,,percent of total billed charges,,5.24,,,,fee schedule,,3.53,,,,fee schedule,,14.6,,,,fee schedule,,,,,,,,14.6,,,,fee schedule,,4.47,,,,fee schedule,,2.71,,,,fee schedule,,2.71,,,,fee schedule,,,402.22,91,,percent of total billed charges,,,419.9,95,,percent of total billed charges,,,366.86,83,,percent of total billed charges,,,132.6,83,,percent of total billed charges,,14.6,,,,fee schedule,,14.6,,,,fee schedule,,,366.86,83,,percent of total billed charges,,3.99,,,,fee schedule,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,397.8,90,,percent of total billed charges,,,375.7,85,,percent of total billed charges,,2.71,419.9,
PT-FOCUSED HLTH RISK ASSMT,96160P,CDM,96160,CPT,,,both,P,279,279,4.2,,,,fee schedule,,,,,,,,14.6,,,,fee schedule,,,237.15,85,,percent of total billed charges,,5.24,,,,fee schedule,,3.53,,,,fee schedule,,14.6,,,,fee schedule,,,,,,,,14.6,,,,fee schedule,,4.47,,,,fee schedule,,2.71,,,,fee schedule,,2.71,,,,fee schedule,,,253.89,91,,percent of total billed charges,,,265.05,95,,percent of total billed charges,,,231.57,83,,percent of total billed charges,,,83.7,83,,percent of total billed charges,,14.6,,,,fee schedule,,14.6,,,,fee schedule,,,231.57,83,,percent of total billed charges,,3.99,,,,fee schedule,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,237.15,85,,percent of total billed charges,,2.71,265.05,
PT-FOCUSED HLTH RISK ASSMT,96160T,CDM,96160,CPT,,,both,T,163,163,4.2,,,,fee schedule,,,,,,,,14.6,,,,fee schedule,,,138.55,85,,percent of total billed charges,,5.24,,,,fee schedule,,3.53,,,,fee schedule,,14.6,,,,fee schedule,,,,,,,,14.6,,,,fee schedule,,4.47,,,,fee schedule,,2.71,,,,fee schedule,,2.71,,,,fee schedule,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,48.9,83,,percent of total billed charges,,14.6,,,,fee schedule,,14.6,,,,fee schedule,,,135.29,83,,percent of total billed charges,,3.99,,,,fee schedule,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,2.71,154.85,
IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR,96360,CDM,96360,CPT,,,both,,225,225,50.95,,,,fee schedule,,,,,,,,19.11,,,,fee schedule,,,191.25,85,,percent of total billed charges,,63.77,,,,fee schedule,,43.31,,,,fee schedule,,19.11,,,,fee schedule,,,,,,,,19.11,,,,fee schedule,,54.24,,,,fee schedule,,32.87,,,,fee schedule,,32.87,,,,fee schedule,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,67.5,83,,percent of total billed charges,,19.11,,,,fee schedule,,19.11,,,,fee schedule,,,186.75,83,,percent of total billed charges,,48.32,,,,fee schedule,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,19.11,213.75,
"HYDRATION IV INFUSION, INIT",96360P,CDM,96360,CPT,,,both,P,73,73,50.95,,,,fee schedule,,,,,,,,19.11,,,,fee schedule,,,62.05,85,,percent of total billed charges,,63.77,,,,fee schedule,,43.31,,,,fee schedule,,19.11,,,,fee schedule,,,,,,,,19.11,,,,fee schedule,,54.24,,,,fee schedule,,32.87,,,,fee schedule,,32.87,,,,fee schedule,,,66.43,91,,percent of total billed charges,,,69.35,95,,percent of total billed charges,,,60.59,83,,percent of total billed charges,,,21.9,83,,percent of total billed charges,,19.11,,,,fee schedule,,19.11,,,,fee schedule,,,60.59,83,,percent of total billed charges,,48.32,,,,fee schedule,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,62.05,85,,percent of total billed charges,,19.11,69.35,
"HYDRATION IV INFUSION, INIT",96360T,CDM,96360,CPT,,,both,T,152,152,50.95,,,,fee schedule,,,,,,,,19.11,,,,fee schedule,,,129.2,85,,percent of total billed charges,,63.77,,,,fee schedule,,43.31,,,,fee schedule,,19.11,,,,fee schedule,,,,,,,,19.11,,,,fee schedule,,54.24,,,,fee schedule,,32.87,,,,fee schedule,,32.87,,,,fee schedule,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,45.6,83,,percent of total billed charges,,19.11,,,,fee schedule,,19.11,,,,fee schedule,,,126.16,83,,percent of total billed charges,,48.32,,,,fee schedule,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,19.11,144.4,
"HYDRATE IV INFUSION, ADD-ON",96361,CDM,96361,CPT,,,both,,97,97,19.96,,,,fee schedule,,,,,,,,152.9,,,,fee schedule,,,82.45,85,,percent of total billed charges,,24.19,,,,fee schedule,,16.43,,,,fee schedule,,152.9,,,,fee schedule,,,,,,,,152.9,,,,fee schedule,,21.25,,,,fee schedule,,12.88,,,,fee schedule,,12.88,,,,fee schedule,,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,29.1,83,,percent of total billed charges,,152.9,,,,fee schedule,,152.9,,,,fee schedule,,,80.51,83,,percent of total billed charges,,18.93,,,,fee schedule,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,12.88,152.9,
"HYDRATE IV INFUSION, ADD-ON",96361P,CDM,96361,CPT,,,both,P,22,22,19.96,,,,fee schedule,,,,,,,,152.9,,,,fee schedule,,,18.7,85,,percent of total billed charges,,24.19,,,,fee schedule,,16.43,,,,fee schedule,,152.9,,,,fee schedule,,,,,,,,152.9,,,,fee schedule,,21.25,,,,fee schedule,,12.88,,,,fee schedule,,12.88,,,,fee schedule,,,20.02,91,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,6.6,83,,percent of total billed charges,,152.9,,,,fee schedule,,152.9,,,,fee schedule,,,18.26,83,,percent of total billed charges,,18.93,,,,fee schedule,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,6.6,152.9,
"HYDRATE IV INFUSION, ADD-ON",96361T,CDM,96361,CPT,,,both,T,75,75,19.96,,,,fee schedule,,,,,,,,152.9,,,,fee schedule,,,63.75,85,,percent of total billed charges,,24.19,,,,fee schedule,,16.43,,,,fee schedule,,152.9,,,,fee schedule,,,,,,,,152.9,,,,fee schedule,,21.25,,,,fee schedule,,12.88,,,,fee schedule,,12.88,,,,fee schedule,,,68.25,91,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,22.5,83,,percent of total billed charges,,152.9,,,,fee schedule,,152.9,,,,fee schedule,,,62.25,83,,percent of total billed charges,,18.93,,,,fee schedule,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,12.88,152.9,
"THER/PROPH/DIAG IV INF, INIT",96365,CDM,96365,CPT,,,both,,279,279,100.32,,,,fee schedule,,,,,,,,19.11,,,,fee schedule,,,237.15,85,,percent of total billed charges,,98.95,,,,fee schedule,,85.26,,,,fee schedule,,19.11,,,,fee schedule,,,,,,,,19.11,,,,fee schedule,,106.8,,,,fee schedule,,64.72,,,,fee schedule,,64.72,,,,fee schedule,,,253.89,91,,percent of total billed charges,,,265.05,95,,percent of total billed charges,,,231.57,83,,percent of total billed charges,,,83.7,83,,percent of total billed charges,,19.11,,,,fee schedule,,19.11,,,,fee schedule,,,231.57,83,,percent of total billed charges,,95.15,,,,fee schedule,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,237.15,85,,percent of total billed charges,,19.11,265.05,
"THER/PROPH/DIAG IV INF, INIT",96365P,CDM,96365,CPT,,,both,P,127,127,100.32,,,,fee schedule,,,,,,,,19.11,,,,fee schedule,,,107.95,85,,percent of total billed charges,,98.95,,,,fee schedule,,85.26,,,,fee schedule,,19.11,,,,fee schedule,,,,,,,,19.11,,,,fee schedule,,106.8,,,,fee schedule,,64.72,,,,fee schedule,,64.72,,,,fee schedule,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,19.11,,,,fee schedule,,19.11,,,,fee schedule,,,105.41,83,,percent of total billed charges,,95.15,,,,fee schedule,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,19.11,120.65,
"THER/PROPH/DIAG IV INF, INIT",96365T,CDM,96365,CPT,,,both,T,152,152,100.32,,,,fee schedule,,,,,,,,19.11,,,,fee schedule,,,129.2,85,,percent of total billed charges,,98.95,,,,fee schedule,,85.26,,,,fee schedule,,19.11,,,,fee schedule,,,,,,,,19.11,,,,fee schedule,,106.8,,,,fee schedule,,64.72,,,,fee schedule,,64.72,,,,fee schedule,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,45.6,83,,percent of total billed charges,,19.11,,,,fee schedule,,19.11,,,,fee schedule,,,126.16,83,,percent of total billed charges,,95.15,,,,fee schedule,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,19.11,144.4,
THER/PROPH/DIAG IV INF ADDON,96366,CDM,96366,CPT,,,both,,216,216,32.04,,,,fee schedule,,,,,,,,152.9,,,,fee schedule,,,183.6,85,,percent of total billed charges,,31.18,,,,fee schedule,,26.87,,,,fee schedule,,152.9,,,,fee schedule,,,,,,,,152.9,,,,fee schedule,,34.11,,,,fee schedule,,20.67,,,,fee schedule,,20.67,,,,fee schedule,,,196.56,91,,percent of total billed charges,,,205.2,95,,percent of total billed charges,,,179.28,83,,percent of total billed charges,,,64.8,83,,percent of total billed charges,,152.9,,,,fee schedule,,152.9,,,,fee schedule,,,179.28,83,,percent of total billed charges,,30.39,,,,fee schedule,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,194.4,90,,percent of total billed charges,,,183.6,85,,percent of total billed charges,,20.67,205.2,
THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM,96372,CDM,96372,CPT,,,both,,100,100,22.06,,,,fee schedule,,,,,,,,9.81,,,,fee schedule,,,85,85,,percent of total billed charges,,33.34,,,,fee schedule,,20.48,,,,fee schedule,,9.81,,,,fee schedule,,,,,,,,9.81,,,,fee schedule,,23.48,,,,fee schedule,,14.23,,,,fee schedule,,14.23,,,,fee schedule,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,30,83,,percent of total billed charges,,9.81,,,,fee schedule,,9.81,,,,fee schedule,,,83,83,,percent of total billed charges,,20.92,,,,fee schedule,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,9.81,95,
"THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION",96372P,CDM,96372,CPT,,,both,P,25,25,22.06,,,,fee schedule,,,,,,,,9.81,,,,fee schedule,,,21.25,85,,percent of total billed charges,,33.34,,,,fee schedule,,20.48,,,,fee schedule,,9.81,,,,fee schedule,,,,,,,,9.81,,,,fee schedule,,23.48,,,,fee schedule,,14.23,,,,fee schedule,,14.23,,,,fee schedule,,,22.75,91,,percent of total billed charges,,,23.75,95,,percent of total billed charges,,,20.75,83,,percent of total billed charges,,,7.5,83,,percent of total billed charges,,9.81,,,,fee schedule,,9.81,,,,fee schedule,,,20.75,83,,percent of total billed charges,,20.92,,,,fee schedule,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,21.25,85,,percent of total billed charges,,7.5,33.34,
"THERAPEUTIC, PROPHYLACTIC, OR DIAGNOSTIC INJECTION",96372T,CDM,96372,CPT,,,both,T,75,75,22.06,,,,fee schedule,,,,,,,,9.81,,,,fee schedule,,,63.75,85,,percent of total billed charges,,33.34,,,,fee schedule,,20.48,,,,fee schedule,,9.81,,,,fee schedule,,,,,,,,9.81,,,,fee schedule,,23.48,,,,fee schedule,,14.23,,,,fee schedule,,14.23,,,,fee schedule,,,68.25,91,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,22.5,83,,percent of total billed charges,,9.81,,,,fee schedule,,9.81,,,,fee schedule,,,62.25,83,,percent of total billed charges,,20.92,,,,fee schedule,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,9.81,71.25,
THERAPEUTIC PROPHYLACTIC/DX NJX INTRA-ARTERIAL,96373,CDM,96373,CPT,,,both,,78,78,28.36,,,,fee schedule,,,,,,,,10.26,,,,fee schedule,,,66.3,85,,percent of total billed charges,,26.75,,,,fee schedule,,25.61,,,,fee schedule,,10.26,,,,fee schedule,,,,,,,,10.26,,,,fee schedule,,30.19,,,,fee schedule,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,10.26,,,,fee schedule,,10.26,,,,fee schedule,,,64.74,83,,percent of total billed charges,,26.9,,,,fee schedule,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,10.26,74.1,
"THER/PROPH/DIAG INJ, IA",96373P,CDM,96373,CPT,,,both,P,27,27,28.36,,,,fee schedule,,,,,,,,10.26,,,,fee schedule,,,22.95,85,,percent of total billed charges,,26.75,,,,fee schedule,,25.61,,,,fee schedule,,10.26,,,,fee schedule,,,,,,,,10.26,,,,fee schedule,,30.19,,,,fee schedule,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,8.1,83,,percent of total billed charges,,10.26,,,,fee schedule,,10.26,,,,fee schedule,,,22.41,83,,percent of total billed charges,,26.9,,,,fee schedule,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,8.1,30.19,
"THER/PROPH/DIAG INJ, IA",96373T,CDM,96373,CPT,,,both,T,51,51,28.36,,,,fee schedule,,,,,,,,10.26,,,,fee schedule,,,43.35,85,,percent of total billed charges,,26.75,,,,fee schedule,,25.61,,,,fee schedule,,10.26,,,,fee schedule,,,,,,,,10.26,,,,fee schedule,,30.19,,,,fee schedule,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,10.26,,,,fee schedule,,10.26,,,,fee schedule,,,42.33,83,,percent of total billed charges,,26.9,,,,fee schedule,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,10.26,48.45,
"THER/PROPH/DIAG INJ, IV PUSH",96374,CDM,96374,CPT,,,both,,201,201,58.3,,,,fee schedule,,,,,,,,29.55,,,,fee schedule,,,170.85,85,,percent of total billed charges,,57.62,,,,fee schedule,,55.17,,,,fee schedule,,29.55,,,,fee schedule,,,,,,,,29.55,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,182.91,91,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,60.3,83,,percent of total billed charges,,29.55,,,,fee schedule,,29.55,,,,fee schedule,,,166.83,83,,percent of total billed charges,,55.29,,,,fee schedule,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,29.55,190.95,
"THER/PROPH/DIAG INJ, IV PUSH",96374P,CDM,96374,CPT,,,both,P,51,51,58.3,,,,fee schedule,,,,,,,,29.55,,,,fee schedule,,,43.35,85,,percent of total billed charges,,57.62,,,,fee schedule,,55.17,,,,fee schedule,,29.55,,,,fee schedule,,,,,,,,29.55,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,29.55,,,,fee schedule,,29.55,,,,fee schedule,,,42.33,83,,percent of total billed charges,,55.29,,,,fee schedule,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,15.3,62.06,
"THER/PROPH/DIAG INJ, IV PUSH",96374T,CDM,96374,CPT,,,both,T,150,150,58.3,,,,fee schedule,,,,,,,,29.55,,,,fee schedule,,,127.5,85,,percent of total billed charges,,57.62,,,,fee schedule,,55.17,,,,fee schedule,,29.55,,,,fee schedule,,,,,,,,29.55,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,29.55,,,,fee schedule,,29.55,,,,fee schedule,,,124.5,83,,percent of total billed charges,,55.29,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,29.55,142.5,
THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG,96375,CDM,96375,CPT,,,both,,106,106,24.16,,,,fee schedule,,,,,,,,27.98,,,,fee schedule,,,90.1,85,,percent of total billed charges,,23.5,,,,fee schedule,,22.5,,,,fee schedule,,27.98,,,,fee schedule,,,,,,,,27.98,,,,fee schedule,,25.72,,,,fee schedule,,15.59,,,,fee schedule,,15.59,,,,fee schedule,,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,31.8,83,,percent of total billed charges,,27.98,,,,fee schedule,,27.98,,,,fee schedule,,,87.98,83,,percent of total billed charges,,22.91,,,,fee schedule,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,15.59,100.7,
TX/PRO/DX INJ NEW DRUG ADDON,96375P,CDM,96375,CPT,,,both,P,31,31,24.16,,,,fee schedule,,,,,,,,27.98,,,,fee schedule,,,26.35,85,,percent of total billed charges,,23.5,,,,fee schedule,,22.5,,,,fee schedule,,27.98,,,,fee schedule,,,,,,,,27.98,,,,fee schedule,,25.72,,,,fee schedule,,15.59,,,,fee schedule,,15.59,,,,fee schedule,,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,9.3,83,,percent of total billed charges,,27.98,,,,fee schedule,,27.98,,,,fee schedule,,,25.73,83,,percent of total billed charges,,22.91,,,,fee schedule,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,9.3,29.45,
TX/PRO/DX INJ NEW DRUG ADDON,96375T,CDM,96375,CPT,,,both,T,75,75,24.16,,,,fee schedule,,,,,,,,27.98,,,,fee schedule,,,63.75,85,,percent of total billed charges,,23.5,,,,fee schedule,,22.5,,,,fee schedule,,27.98,,,,fee schedule,,,,,,,,27.98,,,,fee schedule,,25.72,,,,fee schedule,,15.59,,,,fee schedule,,15.59,,,,fee schedule,,,68.25,91,,percent of total billed charges,,,71.25,95,,percent of total billed charges,,,62.25,83,,percent of total billed charges,,,22.5,83,,percent of total billed charges,,27.98,,,,fee schedule,,27.98,,,,fee schedule,,,62.25,83,,percent of total billed charges,,22.91,,,,fee schedule,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,67.5,90,,percent of total billed charges,,,63.75,85,,percent of total billed charges,,15.59,71.25,
THER/PROP/DIAG INJ/INF PROC,96379,CDM,96379,CPT,,,both,,197,197,,,,,,,,,,,,,,,,,,,,167.45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,179.27,91,,percent of total billed charges,,,187.15,95,,percent of total billed charges,,,163.51,83,,percent of total billed charges,,,59.1,83,,percent of total billed charges,,,,,,,,,,,,,,,163.51,83,,percent of total billed charges,,,,,,,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,177.3,90,,percent of total billed charges,,,167.45,85,,percent of total billed charges,,59.1,187.15,
IRRIG DRUG DELIVERY DEVICE,96523,CDM,96523,CPT,,,both,,109,109,39.92,,,,fee schedule,,,,,,,,,,,,,,,92.65,85,,percent of total billed charges,,51.51,,,,fee schedule,,26.17,,,,fee schedule,,,,,,,,,,,,,,,,,,,,42.49,,,,fee schedule,,25.75,,,,fee schedule,,25.75,,,,fee schedule,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,32.7,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,37.86,,,,fee schedule,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,25.75,103.55,
HOT/COLD PACKS TREATMENT,97010,CDM,97010,CPT,,,both,,140,140,9.98,,,,fee schedule,,,,,,,,4.4,,,,fee schedule,,,119,85,,percent of total billed charges,,3,,,,fee schedule,,6.18,,,,fee schedule,,4.4,,,,fee schedule,,7.5,,,,fee schedule,,4.4,,,,fee schedule,,10.62,,,,fee schedule,,6.44,,,,fee schedule,,6.44,,,,fee schedule,,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,42,83,,percent of total billed charges,,4.4,,,,fee schedule,,4.4,,,,fee schedule,,,116.2,83,,percent of total billed charges,,9.46,,,,fee schedule,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,3,133,
HOT OR COLD PACKS THERAPY,97010GP,CDM,97010,CPT,,,both,GP,140,140,9.98,,,,fee schedule,,,,,,,,4.4,,,,fee schedule,,,119,85,,percent of total billed charges,,3,,,,fee schedule,,6.18,,,,fee schedule,,4.4,,,,fee schedule,,7.5,,,,fee schedule,,4.4,,,,fee schedule,,10.62,,,,fee schedule,,6.44,,,,fee schedule,,6.44,,,,fee schedule,,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,42,83,,percent of total billed charges,,4.4,,,,fee schedule,,4.4,,,,fee schedule,,,116.2,83,,percent of total billed charges,,9.46,,,,fee schedule,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,3,133,
HOT OR COLD PACKS THERAPY,97010GPKX,CDM,97010,CPT,,,both,,140,140,9.98,,,,fee schedule,,,,,,,,4.4,,,,fee schedule,,,119,85,,percent of total billed charges,,3,,,,fee schedule,,6.18,,,,fee schedule,,4.4,,,,fee schedule,,7.5,,,,fee schedule,,4.4,,,,fee schedule,,10.62,,,,fee schedule,,6.44,,,,fee schedule,,6.44,,,,fee schedule,,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,42,83,,percent of total billed charges,,4.4,,,,fee schedule,,4.4,,,,fee schedule,,,116.2,83,,percent of total billed charges,,9.46,,,,fee schedule,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,3,133,
MECHANICAL TRACTION THERAPY,97012,CDM,97012,CPT,,,both,,168,168,22.59,,,,fee schedule,,,,,,,,7.7,,,,fee schedule,,,142.8,85,,percent of total billed charges,,19.82,,,,fee schedule,,13.88,,,,fee schedule,,7.7,,,,fee schedule,,24.39,,,,fee schedule,,7.7,,,,fee schedule,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,50.4,83,,percent of total billed charges,,7.7,,,,fee schedule,,7.7,,,,fee schedule,,,139.44,83,,percent of total billed charges,,21.42,,,,fee schedule,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,7.7,159.6,
MECHANICAL TRACTION THERAPY,97012GP,CDM,97012,CPT,,,both,GP,168,168,22.59,,,,fee schedule,,,,,,,,7.7,,,,fee schedule,,,142.8,85,,percent of total billed charges,,19.82,,,,fee schedule,,13.88,,,,fee schedule,,7.7,,,,fee schedule,,24.39,,,,fee schedule,,7.7,,,,fee schedule,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,50.4,83,,percent of total billed charges,,7.7,,,,fee schedule,,7.7,,,,fee schedule,,,139.44,83,,percent of total billed charges,,21.42,,,,fee schedule,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,7.7,159.6,
MECHANICAL TRACTION THERAPY,97012GP59,CDM,97012,CPT,,,both,,168,168,22.59,,,,fee schedule,,,,,,,,7.7,,,,fee schedule,,,142.8,85,,percent of total billed charges,,19.82,,,,fee schedule,,13.88,,,,fee schedule,,7.7,,,,fee schedule,,24.39,,,,fee schedule,,7.7,,,,fee schedule,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,50.4,83,,percent of total billed charges,,7.7,,,,fee schedule,,7.7,,,,fee schedule,,,139.44,83,,percent of total billed charges,,21.42,,,,fee schedule,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,7.7,159.6,
MECHANICAL TRACTION THERAPY W THCAP,97012GPKX,CDM,97012,CPT,,,both,,168,168,22.59,,,,fee schedule,,,,,,,,7.7,,,,fee schedule,,,142.8,85,,percent of total billed charges,,19.82,,,,fee schedule,,13.88,,,,fee schedule,,7.7,,,,fee schedule,,24.39,,,,fee schedule,,7.7,,,,fee schedule,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,152.88,91,,percent of total billed charges,,,159.6,95,,percent of total billed charges,,,139.44,83,,percent of total billed charges,,,50.4,83,,percent of total billed charges,,7.7,,,,fee schedule,,7.7,,,,fee schedule,,,139.44,83,,percent of total billed charges,,21.42,,,,fee schedule,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,151.2,90,,percent of total billed charges,,,142.8,85,,percent of total billed charges,,7.7,159.6,
TENS TREATMENT - UNATTENDED,97014,CDM,97014,CPT,,,both,,67,67,19.43,,,,fee schedule,,,,,,,,6.5,,,,fee schedule,,,56.95,85,,percent of total billed charges,,10,,,,fee schedule,,10,,,,fee schedule,,6.5,,,,fee schedule,,23.76,,,,fee schedule,,6.5,,,,fee schedule,,20.69,,,,fee schedule,,12.54,,,,fee schedule,,12.54,,,,fee schedule,,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,20.1,83,,percent of total billed charges,,6.5,,,,fee schedule,,6.5,,,,fee schedule,,,55.61,83,,percent of total billed charges,,18.43,,,,fee schedule,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,6.5,63.65,
ELECTRIC STIMULATION THERAPY (V0904),97014GP,CDM,97014,CPT,,,both,GP,67,67,19.43,,,,fee schedule,,,,,,,,6.5,,,,fee schedule,,,56.95,85,,percent of total billed charges,,10,,,,fee schedule,,10,,,,fee schedule,,6.5,,,,fee schedule,,23.76,,,,fee schedule,,6.5,,,,fee schedule,,20.69,,,,fee schedule,,12.54,,,,fee schedule,,12.54,,,,fee schedule,,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,20.1,83,,percent of total billed charges,,6.5,,,,fee schedule,,6.5,,,,fee schedule,,,55.61,83,,percent of total billed charges,,18.43,,,,fee schedule,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,6.5,63.65,
ELECTRIC STIMULATION THERAPY W THCAP,97014GPKX,CDM,97014,CPT,,,both,,161,161,19.43,,,,fee schedule,,,,,,,,6.5,,,,fee schedule,,,136.85,85,,percent of total billed charges,,10,,,,fee schedule,,10,,,,fee schedule,,6.5,,,,fee schedule,,23.76,,,,fee schedule,,6.5,,,,fee schedule,,20.69,,,,fee schedule,,12.54,,,,fee schedule,,12.54,,,,fee schedule,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,48.3,83,,percent of total billed charges,,6.5,,,,fee schedule,,6.5,,,,fee schedule,,,133.63,83,,percent of total billed charges,,18.43,,,,fee schedule,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,6.5,152.95,
VASOPNEUMATIC DEVICE THERAPY,97016,CDM,97016,CPT,,,both,,62,62,18.38,,,,fee schedule,,,,,,,,7,,,,fee schedule,,,52.7,85,,percent of total billed charges,,14.35,,,,fee schedule,,10.65,,,,fee schedule,,7,,,,fee schedule,,23.14,,,,fee schedule,,7,,,,fee schedule,,19.57,,,,fee schedule,,11.86,,,,fee schedule,,11.86,,,,fee schedule,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,7,,,,fee schedule,,7,,,,fee schedule,,,51.46,83,,percent of total billed charges,,17.43,,,,fee schedule,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,7,58.9,
VASOPNEUMATIC DEVICE THERAPY,97016GP,CDM,97016,CPT,,,both,GP,121,121,18.38,,,,fee schedule,,,,,,,,7,,,,fee schedule,,,102.85,85,,percent of total billed charges,,14.35,,,,fee schedule,,10.65,,,,fee schedule,,7,,,,fee schedule,,23.14,,,,fee schedule,,7,,,,fee schedule,,19.57,,,,fee schedule,,11.86,,,,fee schedule,,11.86,,,,fee schedule,,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,36.3,83,,percent of total billed charges,,7,,,,fee schedule,,7,,,,fee schedule,,,100.43,83,,percent of total billed charges,,17.43,,,,fee schedule,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,7,114.95,
VASOPNEUMATIC DEVICE THERAPY W THCAP,97016GPKX,CDM,97016,CPT,,,both,,121,121,18.38,,,,fee schedule,,,,,,,,7,,,,fee schedule,,,102.85,85,,percent of total billed charges,,14.35,,,,fee schedule,,10.65,,,,fee schedule,,7,,,,fee schedule,,23.14,,,,fee schedule,,7,,,,fee schedule,,19.57,,,,fee schedule,,11.86,,,,fee schedule,,11.86,,,,fee schedule,,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,36.3,83,,percent of total billed charges,,7,,,,fee schedule,,7,,,,fee schedule,,,100.43,83,,percent of total billed charges,,17.43,,,,fee schedule,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,7,114.95,
PARAFFIN BATH THERAPY,97018,CDM,97018,CPT,,,both,,45,45,8.93,,,,fee schedule,,,,,,,,5.95,,,,fee schedule,,,38.25,85,,percent of total billed charges,,14.08,,,,fee schedule,,5.14,,,,fee schedule,,5.95,,,,fee schedule,,10.63,,,,fee schedule,,5.95,,,,fee schedule,,9.51,,,,fee schedule,,5.76,,,,fee schedule,,5.76,,,,fee schedule,,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,13.5,83,,percent of total billed charges,,5.95,,,,fee schedule,,5.95,,,,fee schedule,,,37.35,83,,percent of total billed charges,,8.47,,,,fee schedule,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,5.14,42.75,
WHIRLPOOL THERAPY,97022,CDM,97022,CPT,,,both,,54,54,26.79,,,,fee schedule,,,,,,,,6.5,,,,fee schedule,,,45.9,85,,percent of total billed charges,,20.51,,,,fee schedule,,15.71,,,,fee schedule,,6.5,,,,fee schedule,,24.39,,,,fee schedule,,6.5,,,,fee schedule,,28.52,,,,fee schedule,,17.28,,,,fee schedule,,17.28,,,,fee schedule,,,49.14,91,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,16.2,83,,percent of total billed charges,,6.5,,,,fee schedule,,6.5,,,,fee schedule,,,44.82,83,,percent of total billed charges,,25.41,,,,fee schedule,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,6.5,51.3,
MAGNATHERM TREATMENT,97024,CDM,97024,CPT,,,both,,60,60,11.56,,,,fee schedule,,,,,,,,4.5,,,,fee schedule,,,51,85,,percent of total billed charges,,8.48,,,,fee schedule,,6.19,,,,fee schedule,,4.5,,,,fee schedule,,8.75,,,,fee schedule,,4.5,,,,fee schedule,,12.3,,,,fee schedule,,7.46,,,,fee schedule,,7.46,,,,fee schedule,,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,18,83,,percent of total billed charges,,4.5,,,,fee schedule,,4.5,,,,fee schedule,,,49.8,83,,percent of total billed charges,,10.96,,,,fee schedule,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,4.5,57,
INFRARED THERAPY,97026,CDM,97026,CPT,,,both,,48,48,10.51,,,,fee schedule,,,,,,,,4.4,,,,fee schedule,,,40.8,85,,percent of total billed charges,,7.7,,,,fee schedule,,5.9,,,,fee schedule,,4.4,,,,fee schedule,,8.13,,,,fee schedule,,4.4,,,,fee schedule,,11.18,,,,fee schedule,,6.78,,,,fee schedule,,6.78,,,,fee schedule,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,14.4,83,,percent of total billed charges,,4.4,,,,fee schedule,,4.4,,,,fee schedule,,,39.84,83,,percent of total billed charges,,9.96,,,,fee schedule,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,4.4,45.6,
ELECTRICAL STIMULATION,97032,CDM,97032,CPT,,,both,,146,146,22.59,,,,fee schedule,,,,,,,,7.4,,,,fee schedule,,,124.1,85,,percent of total billed charges,,17.71,,,,fee schedule,,13.57,,,,fee schedule,,7.4,,,,fee schedule,,26.26,,,,fee schedule,,7.4,,,,fee schedule,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,43.8,83,,percent of total billed charges,,7.4,,,,fee schedule,,7.4,,,,fee schedule,,,121.18,83,,percent of total billed charges,,21.42,,,,fee schedule,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,7.4,138.7,
ELECTRICAL STIMULATION (V0905),97032GP,CDM,97032,CPT,,,both,GP,146,146,22.59,,,,fee schedule,,,,,,,,7.4,,,,fee schedule,,,124.1,85,,percent of total billed charges,,17.71,,,,fee schedule,,13.57,,,,fee schedule,,7.4,,,,fee schedule,,26.26,,,,fee schedule,,7.4,,,,fee schedule,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,43.8,83,,percent of total billed charges,,7.4,,,,fee schedule,,7.4,,,,fee schedule,,,121.18,83,,percent of total billed charges,,21.42,,,,fee schedule,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,7.4,138.7,
"ELECT STIM ATTD, EA 15 MIN W THCAP",97032GPKX,CDM,97032,CPT,,,both,,146,146,22.59,,,,fee schedule,,,,,,,,7.4,,,,fee schedule,,,124.1,85,,percent of total billed charges,,17.71,,,,fee schedule,,13.57,,,,fee schedule,,7.4,,,,fee schedule,,26.26,,,,fee schedule,,7.4,,,,fee schedule,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,43.8,83,,percent of total billed charges,,7.4,,,,fee schedule,,7.4,,,,fee schedule,,,121.18,83,,percent of total billed charges,,21.42,,,,fee schedule,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,7.4,138.7,
ELECTRIC CURRENT THERAPY,97033,CDM,97033,CPT,,,both,,219,219,30.99,,,,fee schedule,,,,,,,,7.7,,,,fee schedule,,,186.15,85,,percent of total billed charges,,23.56,,,,fee schedule,,17.21,,,,fee schedule,,7.7,,,,fee schedule,,33.77,,,,fee schedule,,7.7,,,,fee schedule,,32.99,,,,fee schedule,,19.99,,,,fee schedule,,19.99,,,,fee schedule,,,199.29,91,,percent of total billed charges,,,208.05,95,,percent of total billed charges,,,181.77,83,,percent of total billed charges,,,65.7,83,,percent of total billed charges,,7.7,,,,fee schedule,,7.7,,,,fee schedule,,,181.77,83,,percent of total billed charges,,29.39,,,,fee schedule,,,197.1,90,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,186.15,85,,percent of total billed charges,,7.7,208.05,
IONTOPHORESIS EA 15 MIN,97033GP,CDM,97033,CPT,,,both,GP,219,219,30.99,,,,fee schedule,,,,,,,,7.7,,,,fee schedule,,,186.15,85,,percent of total billed charges,,23.56,,,,fee schedule,,17.21,,,,fee schedule,,7.7,,,,fee schedule,,33.77,,,,fee schedule,,7.7,,,,fee schedule,,32.99,,,,fee schedule,,19.99,,,,fee schedule,,19.99,,,,fee schedule,,,199.29,91,,percent of total billed charges,,,208.05,95,,percent of total billed charges,,,181.77,83,,percent of total billed charges,,,65.7,83,,percent of total billed charges,,7.7,,,,fee schedule,,7.7,,,,fee schedule,,,181.77,83,,percent of total billed charges,,29.39,,,,fee schedule,,,197.1,90,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,197.1,90,,percent of total billed charges,,,186.15,85,,percent of total billed charges,,7.7,208.05,
CONTRAST BATH THERAPY,97034,CDM,97034,CPT,,,both,,48,48,22.59,,,,fee schedule,,,,,,,,6.4,,,,fee schedule,,,40.8,85,,percent of total billed charges,,17.56,,,,fee schedule,,13.66,,,,fee schedule,,6.4,,,,fee schedule,,23.14,,,,fee schedule,,6.4,,,,fee schedule,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,14.4,83,,percent of total billed charges,,6.4,,,,fee schedule,,6.4,,,,fee schedule,,,39.84,83,,percent of total billed charges,,21.42,,,,fee schedule,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,6.4,45.6,
ULTRASOUND THERAPY,97035,CDM,97035,CPT,,,both,,139,139,22.59,,,,fee schedule,,,,,,,,5.5,,,,fee schedule,,,118.15,85,,percent of total billed charges,,17.18,,,,fee schedule,,13.36,,,,fee schedule,,5.5,,,,fee schedule,,20.01,,,,fee schedule,,5.5,,,,fee schedule,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,126.49,91,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,41.7,83,,percent of total billed charges,,5.5,,,,fee schedule,,5.5,,,,fee schedule,,,115.37,83,,percent of total billed charges,,21.42,,,,fee schedule,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,118.15,85,,percent of total billed charges,,5.5,132.05,
ULTRASOUND/PHONOP EA 15 MIN,97035GP,CDM,97035,CPT,,,both,GP,139,139,22.59,,,,fee schedule,,,,,,,,5.5,,,,fee schedule,,,118.15,85,,percent of total billed charges,,17.18,,,,fee schedule,,13.36,,,,fee schedule,,5.5,,,,fee schedule,,20.01,,,,fee schedule,,5.5,,,,fee schedule,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,126.49,91,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,41.7,83,,percent of total billed charges,,5.5,,,,fee schedule,,5.5,,,,fee schedule,,,115.37,83,,percent of total billed charges,,21.42,,,,fee schedule,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,118.15,85,,percent of total billed charges,,5.5,132.05,
ULTRASOUND THERAPY EA 15 MIN W THCAP,97035GPKX,CDM,97035,CPT,,,both,,139,139,22.59,,,,fee schedule,,,,,,,,5.5,,,,fee schedule,,,118.15,85,,percent of total billed charges,,17.18,,,,fee schedule,,13.36,,,,fee schedule,,5.5,,,,fee schedule,,20.01,,,,fee schedule,,5.5,,,,fee schedule,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,126.49,91,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,41.7,83,,percent of total billed charges,,5.5,,,,fee schedule,,5.5,,,,fee schedule,,,115.37,83,,percent of total billed charges,,21.42,,,,fee schedule,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,118.15,85,,percent of total billed charges,,5.5,132.05,
THERAPEUTIC EXERCISES,97110,CDM,97110,CPT,,,both,,208,208,46.22,,,,fee schedule,,,,,,,,10.4,,,,fee schedule,,,176.8,85,,percent of total billed charges,,39.47,,,,fee schedule,,27.71,,,,fee schedule,,10.4,,,,fee schedule,,46.27,,,,fee schedule,,10.4,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,189.28,91,,percent of total billed charges,,,197.6,95,,percent of total billed charges,,,172.64,83,,percent of total billed charges,,,62.4,83,,percent of total billed charges,,10.4,,,,fee schedule,,10.4,,,,fee schedule,,,172.64,83,,percent of total billed charges,,43.84,,,,fee schedule,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,176.8,85,,percent of total billed charges,,10.4,197.6,
THERAPEUTIC EXERCISE,9711059GP,CDM,97110,CPT,,,both,,208,208,46.22,,,,fee schedule,,,,,,,,10.4,,,,fee schedule,,,176.8,85,,percent of total billed charges,,39.47,,,,fee schedule,,27.71,,,,fee schedule,,10.4,,,,fee schedule,,46.27,,,,fee schedule,,10.4,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,189.28,91,,percent of total billed charges,,,197.6,95,,percent of total billed charges,,,172.64,83,,percent of total billed charges,,,62.4,83,,percent of total billed charges,,10.4,,,,fee schedule,,10.4,,,,fee schedule,,,172.64,83,,percent of total billed charges,,43.84,,,,fee schedule,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,176.8,85,,percent of total billed charges,,10.4,197.6,
THERAPEUTIC EXERCISE EA 15 MIN,97110GP,CDM,97110,CPT,,,both,GP,208,208,46.22,,,,fee schedule,,,,,,,,10.4,,,,fee schedule,,,176.8,85,,percent of total billed charges,,39.47,,,,fee schedule,,27.71,,,,fee schedule,,10.4,,,,fee schedule,,46.27,,,,fee schedule,,10.4,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,189.28,91,,percent of total billed charges,,,197.6,95,,percent of total billed charges,,,172.64,83,,percent of total billed charges,,,62.4,83,,percent of total billed charges,,10.4,,,,fee schedule,,10.4,,,,fee schedule,,,172.64,83,,percent of total billed charges,,43.84,,,,fee schedule,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,176.8,85,,percent of total billed charges,,10.4,197.6,
THERAPEUTIC EXERCISE EA 15 MIN W THCAP,97110GPKX,CDM,97110,CPT,,,both,,208,208,46.22,,,,fee schedule,,,,,,,,10.4,,,,fee schedule,,,176.8,85,,percent of total billed charges,,39.47,,,,fee schedule,,27.71,,,,fee schedule,,10.4,,,,fee schedule,,46.27,,,,fee schedule,,10.4,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,189.28,91,,percent of total billed charges,,,197.6,95,,percent of total billed charges,,,172.64,83,,percent of total billed charges,,,62.4,83,,percent of total billed charges,,10.4,,,,fee schedule,,10.4,,,,fee schedule,,,172.64,83,,percent of total billed charges,,43.84,,,,fee schedule,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,176.8,85,,percent of total billed charges,,10.4,197.6,
THER EX EA 15 MIN IPA U6,97110u6gp,CDM,97110,CPT,,,both,,208,208,46.22,,,,fee schedule,,,,,,,,10.4,,,,fee schedule,,,176.8,85,,percent of total billed charges,,39.47,,,,fee schedule,,27.71,,,,fee schedule,,10.4,,,,fee schedule,,46.27,,,,fee schedule,,10.4,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,189.28,91,,percent of total billed charges,,,197.6,95,,percent of total billed charges,,,172.64,83,,percent of total billed charges,,,62.4,83,,percent of total billed charges,,10.4,,,,fee schedule,,10.4,,,,fee schedule,,,172.64,83,,percent of total billed charges,,43.84,,,,fee schedule,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,187.2,90,,percent of total billed charges,,,176.8,85,,percent of total billed charges,,10.4,197.6,
NEUROMUSCULAR REEDUCATION,97112,CDM,97112,CPT,,,both,,225,225,53.05,,,,fee schedule,,,,,,,,10.9,,,,fee schedule,,,191.25,85,,percent of total billed charges,,41.19,,,,fee schedule,,30.13,,,,fee schedule,,10.9,,,,fee schedule,,48.77,,,,fee schedule,,10.9,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,67.5,83,,percent of total billed charges,,10.9,,,,fee schedule,,10.9,,,,fee schedule,,,186.75,83,,percent of total billed charges,,50.31,,,,fee schedule,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,10.9,213.75,
NEUROMUSC RE-EDEA 15 MIN,97112GP,CDM,97112,CPT,,,both,GP,225,225,53.05,,,,fee schedule,,,,,,,,10.9,,,,fee schedule,,,191.25,85,,percent of total billed charges,,41.19,,,,fee schedule,,30.13,,,,fee schedule,,10.9,,,,fee schedule,,48.77,,,,fee schedule,,10.9,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,67.5,83,,percent of total billed charges,,10.9,,,,fee schedule,,10.9,,,,fee schedule,,,186.75,83,,percent of total billed charges,,50.31,,,,fee schedule,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,10.9,213.75,
NEUROMUSC RE-ED EA 15 MIN W THCAP,97112GPKX,CDM,97112,CPT,,,both,,225,225,53.05,,,,fee schedule,,,,,,,,10.9,,,,fee schedule,,,191.25,85,,percent of total billed charges,,41.19,,,,fee schedule,,30.13,,,,fee schedule,,10.9,,,,fee schedule,,48.77,,,,fee schedule,,10.9,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,204.75,91,,percent of total billed charges,,,213.75,95,,percent of total billed charges,,,186.75,83,,percent of total billed charges,,,67.5,83,,percent of total billed charges,,10.9,,,,fee schedule,,10.9,,,,fee schedule,,,186.75,83,,percent of total billed charges,,50.31,,,,fee schedule,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,202.5,90,,percent of total billed charges,,,191.25,85,,percent of total billed charges,,10.9,213.75,
AQUATIC THERAPY/EXERCISES,97113,CDM,97113,CPT,,,both,,289,289,57.78,,,,fee schedule,,,,,,,,11.5,,,,fee schedule,,,245.65,85,,percent of total billed charges,,44.26,,,,fee schedule,,32.34,,,,fee schedule,,11.5,,,,fee schedule,,53.15,,,,fee schedule,,11.5,,,,fee schedule,,61.51,,,,fee schedule,,37.28,,,,fee schedule,,37.28,,,,fee schedule,,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,86.7,83,,percent of total billed charges,,11.5,,,,fee schedule,,11.5,,,,fee schedule,,,239.87,83,,percent of total billed charges,,54.8,,,,fee schedule,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,11.5,274.55,
AQUATIC THER EA 15 MIN,97113GP,CDM,97113,CPT,,,both,GP,289,289,57.78,,,,fee schedule,,,,,,,,11.5,,,,fee schedule,,,245.65,85,,percent of total billed charges,,44.26,,,,fee schedule,,32.34,,,,fee schedule,,11.5,,,,fee schedule,,53.15,,,,fee schedule,,11.5,,,,fee schedule,,61.51,,,,fee schedule,,37.28,,,,fee schedule,,37.28,,,,fee schedule,,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,86.7,83,,percent of total billed charges,,11.5,,,,fee schedule,,11.5,,,,fee schedule,,,239.87,83,,percent of total billed charges,,54.8,,,,fee schedule,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,11.5,274.55,
AQUATIC THER EA 15 MIN W THCAP,97113GPKX,CDM,97113,CPT,,,both,,289,289,57.78,,,,fee schedule,,,,,,,,11.5,,,,fee schedule,,,245.65,85,,percent of total billed charges,,44.26,,,,fee schedule,,32.34,,,,fee schedule,,11.5,,,,fee schedule,,53.15,,,,fee schedule,,11.5,,,,fee schedule,,61.51,,,,fee schedule,,37.28,,,,fee schedule,,37.28,,,,fee schedule,,,262.99,91,,percent of total billed charges,,,274.55,95,,percent of total billed charges,,,239.87,83,,percent of total billed charges,,,86.7,83,,percent of total billed charges,,11.5,,,,fee schedule,,11.5,,,,fee schedule,,,239.87,83,,percent of total billed charges,,54.8,,,,fee schedule,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,260.1,90,,percent of total billed charges,,,245.65,85,,percent of total billed charges,,11.5,274.55,
GAIT TRAINING THERAPY,97116,CDM,97116,CPT,,,both,,192,192,46.22,,,,fee schedule,,,,,,,,9.75,,,,fee schedule,,,163.2,85,,percent of total billed charges,,35.63,,,,fee schedule,,30.68,,,,fee schedule,,9.75,,,,fee schedule,,40.65,,,,fee schedule,,9.75,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,57.6,83,,percent of total billed charges,,9.75,,,,fee schedule,,9.75,,,,fee schedule,,,159.36,83,,percent of total billed charges,,43.84,,,,fee schedule,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,9.75,182.4,
GAIT TRAINING EA 15 MIN (V1209),97116GP,CDM,97116,CPT,,,both,GP,192,192,46.22,,,,fee schedule,,,,,,,,9.75,,,,fee schedule,,,163.2,85,,percent of total billed charges,,35.63,,,,fee schedule,,30.68,,,,fee schedule,,9.75,,,,fee schedule,,40.65,,,,fee schedule,,9.75,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,57.6,83,,percent of total billed charges,,9.75,,,,fee schedule,,9.75,,,,fee schedule,,,159.36,83,,percent of total billed charges,,43.84,,,,fee schedule,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,9.75,182.4,
GAIT TNG EA 15 MIN W THCAP,97116GPKX,CDM,97116,CPT,,,both,,192,192,46.22,,,,fee schedule,,,,,,,,9.75,,,,fee schedule,,,163.2,85,,percent of total billed charges,,35.63,,,,fee schedule,,30.68,,,,fee schedule,,9.75,,,,fee schedule,,40.65,,,,fee schedule,,9.75,,,,fee schedule,,49.2,,,,fee schedule,,29.82,,,,fee schedule,,29.82,,,,fee schedule,,,174.72,91,,percent of total billed charges,,,182.4,95,,percent of total billed charges,,,159.36,83,,percent of total billed charges,,,57.6,83,,percent of total billed charges,,9.75,,,,fee schedule,,9.75,,,,fee schedule,,,159.36,83,,percent of total billed charges,,43.84,,,,fee schedule,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,172.8,90,,percent of total billed charges,,,163.2,85,,percent of total billed charges,,9.75,182.4,
MASSAGE THERAPY WITH BIOFREEZE,97124,CDM,97124,CPT,,,both,,80,80,47.27,,,,fee schedule,,,,,,,,8.9,,,,fee schedule,,,68,85,,percent of total billed charges,,25.16,,,,fee schedule,,18.25,,,,fee schedule,,8.9,,,,fee schedule,,36.89,,,,fee schedule,,8.9,,,,fee schedule,,50.32,,,,fee schedule,,30.5,,,,fee schedule,,30.5,,,,fee schedule,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,24,83,,percent of total billed charges,,8.9,,,,fee schedule,,8.9,,,,fee schedule,,,66.4,83,,percent of total billed charges,,44.83,,,,fee schedule,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,8.9,76,
THER IVNTJ W/FOCUS COG FUNCJ,97127,CDM,97127,CPT,,,both,,62,62,,,,,,,,,,,,,,,,,,,,52.7,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,18.6,58.9,
MANUAL THERAPY,97140,CDM,97140,CPT,,,both,,202,202,42.55,,,,fee schedule,,,,,,,,11.8,,,,fee schedule,,,171.7,85,,percent of total billed charges,,25.16,,,,fee schedule,,16.87,,,,fee schedule,,11.8,,,,fee schedule,,43.77,,,,fee schedule,,11.8,,,,fee schedule,,45.29,,,,fee schedule,,27.45,,,,fee schedule,,27.45,,,,fee schedule,,,183.82,91,,percent of total billed charges,,,191.9,95,,percent of total billed charges,,,167.66,83,,percent of total billed charges,,,60.6,83,,percent of total billed charges,,11.8,,,,fee schedule,,11.8,,,,fee schedule,,,167.66,83,,percent of total billed charges,,40.35,,,,fee schedule,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,171.7,85,,percent of total billed charges,,11.8,191.9,
MANUAL THERAPY,9714059GP,CDM,97140,CPT,,,both,,202,202,42.55,,,,fee schedule,,,,,,,,11.8,,,,fee schedule,,,171.7,85,,percent of total billed charges,,25.16,,,,fee schedule,,16.87,,,,fee schedule,,11.8,,,,fee schedule,,43.77,,,,fee schedule,,11.8,,,,fee schedule,,45.29,,,,fee schedule,,27.45,,,,fee schedule,,27.45,,,,fee schedule,,,183.82,91,,percent of total billed charges,,,191.9,95,,percent of total billed charges,,,167.66,83,,percent of total billed charges,,,60.6,83,,percent of total billed charges,,11.8,,,,fee schedule,,11.8,,,,fee schedule,,,167.66,83,,percent of total billed charges,,40.35,,,,fee schedule,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,171.7,85,,percent of total billed charges,,11.8,191.9,
MANUAL THERAPY TQS EA 15 MIN W THCAP,97140GPKX,CDM,97140,CPT,,,both,,195,195,42.55,,,,fee schedule,,,,,,,,11.8,,,,fee schedule,,,165.75,85,,percent of total billed charges,,25.16,,,,fee schedule,,16.87,,,,fee schedule,,11.8,,,,fee schedule,,43.77,,,,fee schedule,,11.8,,,,fee schedule,,45.29,,,,fee schedule,,27.45,,,,fee schedule,,27.45,,,,fee schedule,,,177.45,91,,percent of total billed charges,,,185.25,95,,percent of total billed charges,,,161.85,83,,percent of total billed charges,,,58.5,83,,percent of total billed charges,,11.8,,,,fee schedule,,11.8,,,,fee schedule,,,161.85,83,,percent of total billed charges,,40.35,,,,fee schedule,,,175.5,90,,percent of total billed charges,,,175.5,90,,percent of total billed charges,,,175.5,90,,percent of total billed charges,,,175.5,90,,percent of total billed charges,,,165.75,85,,percent of total billed charges,,11.8,185.25,
PT EVAL LOW COMPLEX 20 MIN,97161,CDM,97161,CPT,,,both,,354,354,157.58,,,,fee schedule,,,,,,,,,,,,,,,300.9,85,,percent of total billed charges,,90.41,,,,fee schedule,,99.57,,,,fee schedule,,,,,,,,,,,,,,,,,,,,167.74,,,,fee schedule,,101.66,,,,fee schedule,,101.66,,,,fee schedule,,,322.14,91,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,106.2,83,,percent of total billed charges,,,,,,,,,,,,,,,293.82,83,,percent of total billed charges,,149.44,,,,fee schedule,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,300.9,85,,percent of total billed charges,,90.41,336.3,
PT EVAL LOW COMPLEX 20 MIN,97161GP,CDM,97161,CPT,,,both,GP,354,354,157.58,,,,fee schedule,,,,,,,,,,,,,,,300.9,85,,percent of total billed charges,,90.41,,,,fee schedule,,99.57,,,,fee schedule,,,,,,,,,,,,,,,,,,,,167.74,,,,fee schedule,,101.66,,,,fee schedule,,101.66,,,,fee schedule,,,322.14,91,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,106.2,83,,percent of total billed charges,,,,,,,,,,,,,,,293.82,83,,percent of total billed charges,,149.44,,,,fee schedule,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,300.9,85,,percent of total billed charges,,90.41,336.3,
PT EVAL LOW COMPLEX 20 MIN W THCAP,97161GPKX,CDM,97161,CPT,,,both,,354,354,157.58,,,,fee schedule,,,,,,,,,,,,,,,300.9,85,,percent of total billed charges,,90.41,,,,fee schedule,,99.57,,,,fee schedule,,,,,,,,,,,,,,,,,,,,167.74,,,,fee schedule,,101.66,,,,fee schedule,,101.66,,,,fee schedule,,,322.14,91,,percent of total billed charges,,,336.3,95,,percent of total billed charges,,,293.82,83,,percent of total billed charges,,,106.2,83,,percent of total billed charges,,,,,,,,,,,,,,,293.82,83,,percent of total billed charges,,149.44,,,,fee schedule,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,318.6,90,,percent of total billed charges,,,300.9,85,,percent of total billed charges,,90.41,336.3,
PT EVAL MOD COMPLEX 30 MIN,97162,CDM,97162,CPT,,,both,,368,368,157.58,,,,fee schedule,,,,,,,,,,,,,,,312.8,85,,percent of total billed charges,,100.46,,,,fee schedule,,99.57,,,,fee schedule,,,,,,,,,,,,,,,,,,,,167.74,,,,fee schedule,,101.66,,,,fee schedule,,101.66,,,,fee schedule,,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,110.4,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,149.44,,,,fee schedule,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,99.57,349.6,
PT EVAL MOD COMPLEX 30 MIN,97162GP,CDM,97162,CPT,,,both,GP,368,368,157.58,,,,fee schedule,,,,,,,,,,,,,,,312.8,85,,percent of total billed charges,,100.46,,,,fee schedule,,99.57,,,,fee schedule,,,,,,,,,,,,,,,,,,,,167.74,,,,fee schedule,,101.66,,,,fee schedule,,101.66,,,,fee schedule,,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,110.4,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,149.44,,,,fee schedule,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,99.57,349.6,
PT EVAL MOD COMPLEX 30 MIN W THCAP,97162GPKX,CDM,97162,CPT,,,both,,368,368,157.58,,,,fee schedule,,,,,,,,,,,,,,,312.8,85,,percent of total billed charges,,100.46,,,,fee schedule,,99.57,,,,fee schedule,,,,,,,,,,,,,,,,,,,,167.74,,,,fee schedule,,101.66,,,,fee schedule,,101.66,,,,fee schedule,,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,110.4,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,149.44,,,,fee schedule,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,99.57,349.6,
PT EVAL HIGH COMPLEX 45 MIN,97163,CDM,97163,CPT,,,both,,368,368,157.58,,,,fee schedule,,,,,,,,,,,,,,,312.8,85,,percent of total billed charges,,110.5,,,,fee schedule,,99.57,,,,fee schedule,,,,,,,,,,,,,,,,,,,,167.74,,,,fee schedule,,101.66,,,,fee schedule,,101.66,,,,fee schedule,,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,110.4,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,149.44,,,,fee schedule,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,99.57,349.6,
PT EVAL HIGH COMPLEX 45 MIN,97163GP,CDM,97163,CPT,,,both,GP,368,368,157.58,,,,fee schedule,,,,,,,,,,,,,,,312.8,85,,percent of total billed charges,,110.5,,,,fee schedule,,99.57,,,,fee schedule,,,,,,,,,,,,,,,,,,,,167.74,,,,fee schedule,,101.66,,,,fee schedule,,101.66,,,,fee schedule,,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,110.4,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,149.44,,,,fee schedule,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,99.57,349.6,
PT EVAL HIGH COMPLEX 45 MIN W THCAP,97163GPKX,CDM,97163,CPT,,,both,,368,368,157.58,,,,fee schedule,,,,,,,,,,,,,,,312.8,85,,percent of total billed charges,,110.5,,,,fee schedule,,99.57,,,,fee schedule,,,,,,,,,,,,,,,,,,,,167.74,,,,fee schedule,,101.66,,,,fee schedule,,101.66,,,,fee schedule,,,334.88,91,,percent of total billed charges,,,349.6,95,,percent of total billed charges,,,305.44,83,,percent of total billed charges,,,110.4,83,,percent of total billed charges,,,,,,,,,,,,,,,305.44,83,,percent of total billed charges,,149.44,,,,fee schedule,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,331.2,90,,percent of total billed charges,,,312.8,85,,percent of total billed charges,,99.57,349.6,
PT RE-EVAL EST PLAN CARE,97164,CDM,97164,CPT,,,both,,287,287,109.25,,,,fee schedule,,,,,,,,,,,,,,,243.95,85,,percent of total billed charges,,67.68,,,,fee schedule,,68.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,116.3,,,,fee schedule,,70.49,,,,fee schedule,,70.49,,,,fee schedule,,,261.17,91,,percent of total billed charges,,,272.65,95,,percent of total billed charges,,,238.21,83,,percent of total billed charges,,,86.1,83,,percent of total billed charges,,,,,,,,,,,,,,,238.21,83,,percent of total billed charges,,103.61,,,,fee schedule,,,258.3,90,,percent of total billed charges,,,258.3,90,,percent of total billed charges,,,258.3,90,,percent of total billed charges,,,258.3,90,,percent of total billed charges,,,243.95,85,,percent of total billed charges,,67.68,272.65,
PT RE-EVAL EST PLAN CARE,9716459GP,CDM,97164,CPT,,,both,,287,287,109.25,,,,fee schedule,,,,,,,,,,,,,,,243.95,85,,percent of total billed charges,,67.68,,,,fee schedule,,68.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,116.3,,,,fee schedule,,70.49,,,,fee schedule,,70.49,,,,fee schedule,,,261.17,91,,percent of total billed charges,,,272.65,95,,percent of total billed charges,,,238.21,83,,percent of total billed charges,,,86.1,83,,percent of total billed charges,,,,,,,,,,,,,,,238.21,83,,percent of total billed charges,,103.61,,,,fee schedule,,,258.3,90,,percent of total billed charges,,,258.3,90,,percent of total billed charges,,,258.3,90,,percent of total billed charges,,,258.3,90,,percent of total billed charges,,,243.95,85,,percent of total billed charges,,67.68,272.65,
PT RE-EVAL EST PLAN CARE,97164GP,CDM,97164,CPT,,,both,GP,287,287,109.25,,,,fee schedule,,,,,,,,,,,,,,,243.95,85,,percent of total billed charges,,67.68,,,,fee schedule,,68.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,116.3,,,,fee schedule,,70.49,,,,fee schedule,,70.49,,,,fee schedule,,,261.17,91,,percent of total billed charges,,,272.65,95,,percent of total billed charges,,,238.21,83,,percent of total billed charges,,,86.1,83,,percent of total billed charges,,,,,,,,,,,,,,,238.21,83,,percent of total billed charges,,103.61,,,,fee schedule,,,258.3,90,,percent of total billed charges,,,258.3,90,,percent of total billed charges,,,258.3,90,,percent of total billed charges,,,258.3,90,,percent of total billed charges,,,243.95,85,,percent of total billed charges,,67.68,272.65,
PT RE-EVAL EST PLAN CARE W THCAP,97164GPKX,CDM,97164,CPT,,,both,,287,287,109.25,,,,fee schedule,,,,,,,,,,,,,,,243.95,85,,percent of total billed charges,,67.68,,,,fee schedule,,68.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,116.3,,,,fee schedule,,70.49,,,,fee schedule,,70.49,,,,fee schedule,,,261.17,91,,percent of total billed charges,,,272.65,95,,percent of total billed charges,,,238.21,83,,percent of total billed charges,,,86.1,83,,percent of total billed charges,,,,,,,,,,,,,,,238.21,83,,percent of total billed charges,,103.61,,,,fee schedule,,,258.3,90,,percent of total billed charges,,,258.3,90,,percent of total billed charges,,,258.3,90,,percent of total billed charges,,,258.3,90,,percent of total billed charges,,,243.95,85,,percent of total billed charges,,67.68,272.65,
OT EVAL LOW COMPLEX 30 MIN,97165,CDM,97165,CPT,,,both,,578,578,157.58,,,,fee schedule,,,,,,,,,,,,,,,491.3,85,,percent of total billed charges,,99.4,,,,fee schedule,,100.21,,,,fee schedule,,,,,,,,,,,,,,,,,,,,167.74,,,,fee schedule,,101.66,,,,fee schedule,,101.66,,,,fee schedule,,,525.98,91,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,173.4,83,,percent of total billed charges,,,,,,,,,,,,,,,479.74,83,,percent of total billed charges,,149.44,,,,fee schedule,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,491.3,85,,percent of total billed charges,,99.4,549.1,
OT EVAL MOD COMPLEX 45 MIN,97166,CDM,97166,CPT,,,both,,578,578,157.58,,,,fee schedule,,,,,,,,,,,,,,,491.3,85,,percent of total billed charges,,99.4,,,,fee schedule,,129.82,,,,fee schedule,,,,,,,,,,,,,,,,,,,,167.74,,,,fee schedule,,101.66,,,,fee schedule,,101.66,,,,fee schedule,,,525.98,91,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,173.4,83,,percent of total billed charges,,,,,,,,,,,,,,,479.74,83,,percent of total billed charges,,149.44,,,,fee schedule,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,491.3,85,,percent of total billed charges,,99.4,549.1,
OT EVAL HIGH COMPLEX 60 MIN,97167,CDM,97167,CPT,,,both,,578,578,157.58,,,,fee schedule,,,,,,,,,,,,,,,491.3,85,,percent of total billed charges,,99.4,,,,fee schedule,,129.82,,,,fee schedule,,,,,,,,,,,,,,,,,,,,167.74,,,,fee schedule,,101.66,,,,fee schedule,,101.66,,,,fee schedule,,,525.98,91,,percent of total billed charges,,,549.1,95,,percent of total billed charges,,,479.74,83,,percent of total billed charges,,,173.4,83,,percent of total billed charges,,,,,,,,,,,,,,,479.74,83,,percent of total billed charges,,149.44,,,,fee schedule,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,520.2,90,,percent of total billed charges,,,491.3,85,,percent of total billed charges,,99.4,549.1,
OT RE-EVAL EST PLAN CARE,97168,CDM,97168,CPT,,,both,,170,170,108.73,,,,fee schedule,,,,,,,,,,,,,,,144.5,85,,percent of total billed charges,,83.49,,,,fee schedule,,71.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,115.74,,,,fee schedule,,70.15,,,,fee schedule,,70.15,,,,fee schedule,,,154.7,91,,percent of total billed charges,,,161.5,95,,percent of total billed charges,,,141.1,83,,percent of total billed charges,,,51,83,,percent of total billed charges,,,,,,,,,,,,,,,141.1,83,,percent of total billed charges,,103.12,,,,fee schedule,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,153,90,,percent of total billed charges,,,144.5,85,,percent of total billed charges,,51,161.5,
THERAPEUTIC ACTIVITIES,97530,CDM,97530,CPT,,,both,,236,236,58.3,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,200.6,85,,percent of total billed charges,,44.5,,,,fee schedule,,38.32,,,,fee schedule,,22.15,,,,fee schedule,,48.77,,,,fee schedule,,22.15,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,214.76,91,,percent of total billed charges,,,224.2,95,,percent of total billed charges,,,195.88,83,,percent of total billed charges,,,70.8,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,195.88,83,,percent of total billed charges,,55.29,,,,fee schedule,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,200.6,85,,percent of total billed charges,,22.15,224.2,
THERAPEUTIC ACTIVITIES (V1209),97530GP,CDM,97530,CPT,,,both,GP,236,236,58.3,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,200.6,85,,percent of total billed charges,,44.5,,,,fee schedule,,38.32,,,,fee schedule,,22.15,,,,fee schedule,,48.77,,,,fee schedule,,22.15,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,214.76,91,,percent of total billed charges,,,224.2,95,,percent of total billed charges,,,195.88,83,,percent of total billed charges,,,70.8,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,195.88,83,,percent of total billed charges,,55.29,,,,fee schedule,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,200.6,85,,percent of total billed charges,,22.15,224.2,
THERAPEUTIC ACTIVITIES W THCAP,97530GPKX,CDM,97530,CPT,,,both,,236,236,58.3,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,200.6,85,,percent of total billed charges,,44.5,,,,fee schedule,,38.32,,,,fee schedule,,22.15,,,,fee schedule,,48.77,,,,fee schedule,,22.15,,,,fee schedule,,62.06,,,,fee schedule,,37.61,,,,fee schedule,,37.61,,,,fee schedule,,,214.76,91,,percent of total billed charges,,,224.2,95,,percent of total billed charges,,,195.88,83,,percent of total billed charges,,,70.8,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,195.88,83,,percent of total billed charges,,55.29,,,,fee schedule,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,200.6,85,,percent of total billed charges,,22.15,224.2,
SENSORY INTEGRATION,97533,CDM,97533,CPT,,,both,,163,163,99.8,,,,fee schedule,,,,,,,,18.75,,,,fee schedule,,,138.55,85,,percent of total billed charges,,76.04,,,,fee schedule,,65.48,,,,fee schedule,,18.75,,,,fee schedule,,43.15,,,,fee schedule,,18.75,,,,fee schedule,,106.24,,,,fee schedule,,64.39,,,,fee schedule,,64.39,,,,fee schedule,,,148.33,91,,percent of total billed charges,,,154.85,95,,percent of total billed charges,,,135.29,83,,percent of total billed charges,,,48.9,83,,percent of total billed charges,,18.75,,,,fee schedule,,18.75,,,,fee schedule,,,135.29,83,,percent of total billed charges,,94.65,,,,fee schedule,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,146.7,90,,percent of total billed charges,,,138.55,85,,percent of total billed charges,,18.75,154.85,
SELF CARE MNGMENT TRAINING,97535,CDM,97535,CPT,,,both,,79,79,51.47,,,,fee schedule,,,,,,,,11.2,,,,fee schedule,,,67.15,85,,percent of total billed charges,,39.5,,,,fee schedule,,34.02,,,,fee schedule,,11.2,,,,fee schedule,,49.4,,,,fee schedule,,11.2,,,,fee schedule,,54.8,,,,fee schedule,,33.21,,,,fee schedule,,33.21,,,,fee schedule,,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,23.7,83,,percent of total billed charges,,11.2,,,,fee schedule,,11.2,,,,fee schedule,,,65.57,83,,percent of total billed charges,,48.82,,,,fee schedule,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,11.2,75.05,
COMMUNITY/WORK REINTEGRATION,97537,CDM,97537,CPT,,,both,,94,94,49.9,,,,fee schedule,,,,,,,,11,,,,fee schedule,,,79.9,85,,percent of total billed charges,,38.45,,,,fee schedule,,33.11,,,,fee schedule,,11,,,,fee schedule,,45.02,,,,fee schedule,,11,,,,fee schedule,,53.12,,,,fee schedule,,32.19,,,,fee schedule,,32.19,,,,fee schedule,,,85.54,91,,percent of total billed charges,,,89.3,95,,percent of total billed charges,,,78.02,83,,percent of total billed charges,,,28.2,83,,percent of total billed charges,,11,,,,fee schedule,,11,,,,fee schedule,,,78.02,83,,percent of total billed charges,,47.32,,,,fee schedule,,,84.6,90,,percent of total billed charges,,,84.6,90,,percent of total billed charges,,,84.6,90,,percent of total billed charges,,,84.6,90,,percent of total billed charges,,,79.9,85,,percent of total billed charges,,11,89.3,
WHEELCHAIR MNGMENT TRAINING,97542,CDM,97542,CPT,,,both,,71,71,49.9,,,,fee schedule,,,,,,,,7.55,,,,fee schedule,,,60.35,85,,percent of total billed charges,,38.45,,,,fee schedule,,32.46,,,,fee schedule,,7.55,,,,fee schedule,,46.27,,,,fee schedule,,7.55,,,,fee schedule,,53.12,,,,fee schedule,,32.19,,,,fee schedule,,32.19,,,,fee schedule,,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,21.3,83,,percent of total billed charges,,7.55,,,,fee schedule,,7.55,,,,fee schedule,,,58.93,83,,percent of total billed charges,,47.32,,,,fee schedule,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,7.55,67.45,
WORK HARDENING,97545,CDM,97545,CPT,,,both,,530,530,,,,,,,,,,,,,27,,,,fee schedule,,,450.5,85,,percent of total billed charges,,187.05,,,,fee schedule,,157.92,,,,fee schedule,,27,,,,fee schedule,,,,,,,,27,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,482.3,91,,percent of total billed charges,,,503.5,95,,percent of total billed charges,,,439.9,83,,percent of total billed charges,,,159,83,,percent of total billed charges,,27,,,,fee schedule,,27,,,,fee schedule,,,439.9,83,,percent of total billed charges,,,,,,,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,477,90,,percent of total billed charges,,,450.5,85,,percent of total billed charges,,27,503.5,
WORK HARDENING ADD-ON,97546,CDM,97546,CPT,,,both,,272,272,,,,,,,,,,,,,,,,,,,,231.2,85,,percent of total billed charges,,74.74,,,,fee schedule,,63.1,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,247.52,91,,percent of total billed charges,,,258.4,95,,percent of total billed charges,,,225.76,83,,percent of total billed charges,,,81.6,83,,percent of total billed charges,,,,,,,,,,,,,,,225.76,83,,percent of total billed charges,,,,,,,,,244.8,90,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,231.2,85,,percent of total billed charges,,63.1,258.4,
RMVL DEVITAL TISS SLCTV DBRDMT W/O ANES 20 CM,97597,CDM,97597,CPT,,,both,,213,213,55.15,,,,fee schedule,,,,,,,,27.78,,,,fee schedule,,,181.05,85,,percent of total billed charges,,36.45,,,,fee schedule,,37.79,,,,fee schedule,,27.78,,,,fee schedule,,80.66,,,,fee schedule,,27.78,,,,fee schedule,,58.71,,,,fee schedule,,35.58,,,,fee schedule,,35.58,,,,fee schedule,,,193.83,91,,percent of total billed charges,,,202.35,95,,percent of total billed charges,,,176.79,83,,percent of total billed charges,,,63.9,83,,percent of total billed charges,,27.78,,,,fee schedule,,27.78,,,,fee schedule,,,176.79,83,,percent of total billed charges,,52.3,,,,fee schedule,,,191.7,90,,percent of total billed charges,,,191.7,90,,percent of total billed charges,,,191.7,90,,percent of total billed charges,,,191.7,90,,percent of total billed charges,,,181.05,85,,percent of total billed charges,,27.78,202.35,
RMVL DEVITAL TISS SLCTV DBRDMT W/O ANES > 20 CM,97598,CDM,97598,CPT,,,both,,193,193,38.34,,,,fee schedule,,,,,,,,,,,,,,,164.05,85,,percent of total billed charges,,31.31,,,,fee schedule,,26.47,,,,fee schedule,,,,,,,,102.55,,,,fee schedule,,,,,,,,40.82,,,,fee schedule,,24.74,,,,fee schedule,,24.74,,,,fee schedule,,,175.63,91,,percent of total billed charges,,,183.35,95,,percent of total billed charges,,,160.19,83,,percent of total billed charges,,,57.9,83,,percent of total billed charges,,,,,,,,,,,,,,,160.19,83,,percent of total billed charges,,36.36,,,,fee schedule,,,173.7,90,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,173.7,90,,percent of total billed charges,,,164.05,85,,percent of total billed charges,,24.74,183.35,
WOUND(S) CARE NON-SELECTIVE,97602,CDM,97602,CPT,,,both,,139,139,,,,,,,,,,,,,28.35,,,,fee schedule,,,118.15,85,,percent of total billed charges,,94.83,,,,fee schedule,,80.15,,,,fee schedule,,28.35,,,,fee schedule,,,,,,,,28.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,126.49,91,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,41.7,83,,percent of total billed charges,,28.35,,,,fee schedule,,28.35,,,,fee schedule,,,115.37,83,,percent of total billed charges,,,,,,,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,118.15,85,,percent of total billed charges,,28.35,132.05,
WOUND(S) CARE NON-SELECTIVE,97602P,CDM,97602,CPT,,,both,P,48,48,,,,,,,,,,,,,28.35,,,,fee schedule,,,40.8,85,,percent of total billed charges,,94.83,,,,fee schedule,,80.15,,,,fee schedule,,28.35,,,,fee schedule,,,,,,,,28.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,14.4,83,,percent of total billed charges,,28.35,,,,fee schedule,,28.35,,,,fee schedule,,,39.84,83,,percent of total billed charges,,,,,,,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,14.4,94.83,
WOUND(S) CARE NON-SELECTIVE,97602T,CDM,97602,CPT,,,both,T,91,91,,,,,,,,,,,,,28.35,,,,fee schedule,,,77.35,85,,percent of total billed charges,,94.83,,,,fee schedule,,80.15,,,,fee schedule,,28.35,,,,fee schedule,,,,,,,,28.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,27.3,83,,percent of total billed charges,,28.35,,,,fee schedule,,28.35,,,,fee schedule,,,75.53,83,,percent of total billed charges,,,,,,,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,27.3,94.83,
"NEG PRESS WOUND TX, < 50 CM",97605,CDM,97605,CPT,,,both,,159,159,38.34,,,,fee schedule,,,,,,,,16.01,,,,fee schedule,,,135.15,85,,percent of total billed charges,,30.54,,,,fee schedule,,25.81,,,,fee schedule,,16.01,,,,fee schedule,,,,,,,,16.01,,,,fee schedule,,40.82,,,,fee schedule,,24.74,,,,fee schedule,,24.74,,,,fee schedule,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,47.7,83,,percent of total billed charges,,16.01,,,,fee schedule,,16.01,,,,fee schedule,,,131.97,83,,percent of total billed charges,,36.36,,,,fee schedule,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,16.01,151.05,
"NEG PRESS WOUND TX, > 50 CM",97606,CDM,97606,CPT,,,both,,195,195,41.49,,,,fee schedule,,,,,,,,17.95,,,,fee schedule,,,165.75,85,,percent of total billed charges,,33.43,,,,fee schedule,,28.26,,,,fee schedule,,17.95,,,,fee schedule,,,,,,,,17.95,,,,fee schedule,,44.17,,,,fee schedule,,26.77,,,,fee schedule,,26.77,,,,fee schedule,,,177.45,91,,percent of total billed charges,,,185.25,95,,percent of total billed charges,,,161.85,83,,percent of total billed charges,,,58.5,83,,percent of total billed charges,,17.95,,,,fee schedule,,17.95,,,,fee schedule,,,161.85,83,,percent of total billed charges,,39.35,,,,fee schedule,,,175.5,90,,percent of total billed charges,,,175.5,90,,percent of total billed charges,,,175.5,90,,percent of total billed charges,,,175.5,90,,percent of total billed charges,,,165.75,85,,percent of total billed charges,,17.95,185.25,
NEG PRESS WND TX </=50 SQ CM,97607,CDM,97607,CPT,,,both,,222,222,34.14,,,,fee schedule,,,,,,,,14.12,,,,fee schedule,,,188.7,85,,percent of total billed charges,,27.99,,,,fee schedule,,23.66,,,,fee schedule,,14.12,,,,fee schedule,,,,,,,,14.12,,,,fee schedule,,36.34,,,,fee schedule,,22.03,,,,fee schedule,,22.03,,,,fee schedule,,,202.02,91,,percent of total billed charges,,,210.9,95,,percent of total billed charges,,,184.26,83,,percent of total billed charges,,,66.6,83,,percent of total billed charges,,14.12,,,,fee schedule,,14.12,,,,fee schedule,,,184.26,83,,percent of total billed charges,,32.38,,,,fee schedule,,,199.8,90,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,199.8,90,,percent of total billed charges,,,188.7,85,,percent of total billed charges,,14.12,210.9,
NEG PRESS WND TX <=50 SQ CM,97607P,CDM,97607,CPT,,,both,P,187,187,34.14,,,,fee schedule,,,,,,,,14.12,,,,fee schedule,,,158.95,85,,percent of total billed charges,,27.99,,,,fee schedule,,23.66,,,,fee schedule,,14.12,,,,fee schedule,,,,,,,,14.12,,,,fee schedule,,36.34,,,,fee schedule,,22.03,,,,fee schedule,,22.03,,,,fee schedule,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,56.1,83,,percent of total billed charges,,14.12,,,,fee schedule,,14.12,,,,fee schedule,,,155.21,83,,percent of total billed charges,,32.38,,,,fee schedule,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,14.12,177.65,
NEG PRESS WND TX <=50 SQ CM,97607T,CDM,97607,CPT,,,both,T,35,35,34.14,,,,fee schedule,,,,,,,,14.12,,,,fee schedule,,,29.75,85,,percent of total billed charges,,27.99,,,,fee schedule,,23.66,,,,fee schedule,,14.12,,,,fee schedule,,,,,,,,14.12,,,,fee schedule,,36.34,,,,fee schedule,,22.03,,,,fee schedule,,22.03,,,,fee schedule,,,31.85,91,,percent of total billed charges,,,33.25,95,,percent of total billed charges,,,29.05,83,,percent of total billed charges,,,10.5,83,,percent of total billed charges,,14.12,,,,fee schedule,,14.12,,,,fee schedule,,,29.05,83,,percent of total billed charges,,32.38,,,,fee schedule,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,31.5,90,,percent of total billed charges,,,29.75,85,,percent of total billed charges,,10.5,36.34,
PHYSICAL PERFORMANCE TEST,97750,CDM,97750,CPT,,,both,,226,226,53.05,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,192.1,85,,percent of total billed charges,,40.23,,,,fee schedule,,34,,,,fee schedule,,22.15,,,,fee schedule,,49.4,,,,fee schedule,,22.15,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,67.8,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,187.58,83,,percent of total billed charges,,50.31,,,,fee schedule,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,22.15,214.7,
PHY PERFORMTEST/MEAS EA 15 MIN,97750GP,CDM,97750,CPT,,,both,GP,226,226,53.05,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,192.1,85,,percent of total billed charges,,40.23,,,,fee schedule,,34,,,,fee schedule,,22.15,,,,fee schedule,,49.4,,,,fee schedule,,22.15,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,67.8,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,187.58,83,,percent of total billed charges,,50.31,,,,fee schedule,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,22.15,214.7,
PHYS PERFORM TEST/MEAS EA 15 MIN W THCAP,97750GPKX,CDM,97750,CPT,,,both,,226,226,53.05,,,,fee schedule,,,,,,,,22.15,,,,fee schedule,,,192.1,85,,percent of total billed charges,,40.23,,,,fee schedule,,34,,,,fee schedule,,22.15,,,,fee schedule,,49.4,,,,fee schedule,,22.15,,,,fee schedule,,56.47,,,,fee schedule,,34.23,,,,fee schedule,,34.23,,,,fee schedule,,,205.66,91,,percent of total billed charges,,,214.7,95,,percent of total billed charges,,,187.58,83,,percent of total billed charges,,,67.8,83,,percent of total billed charges,,22.15,,,,fee schedule,,22.15,,,,fee schedule,,,187.58,83,,percent of total billed charges,,50.31,,,,fee schedule,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,203.4,90,,percent of total billed charges,,,192.1,85,,percent of total billed charges,,22.15,214.7,
ORTHOTIC MGMT AND TRAINING,97760,CDM,97760,CPT,,,both,,139,139,76.16,,,,fee schedule,,,,,,,,,,,,,,,118.15,85,,percent of total billed charges,,57.83,,,,fee schedule,,48.88,,,,fee schedule,,,,,,,,,,,,,,,,,,,,81.08,,,,fee schedule,,49.14,,,,fee schedule,,49.14,,,,fee schedule,,,126.49,91,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,41.7,83,,percent of total billed charges,,,,,,,,,,,,,,,115.37,83,,percent of total billed charges,,72.23,,,,fee schedule,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,118.15,85,,percent of total billed charges,,41.7,132.05,
PROSTHETIC TRAINING,97761,CDM,97761,CPT,,,both,,81,81,65.66,,,,fee schedule,,,,,,,,,,,,,,,68.85,85,,percent of total billed charges,,49.7,,,,fee schedule,,42.01,,,,fee schedule,,,,,,,,,,,,,,,,,,,,69.89,,,,fee schedule,,42.36,,,,fee schedule,,42.36,,,,fee schedule,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,24.3,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,62.27,,,,fee schedule,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,24.3,76.95,
ORTHC/PROSTC MGMT SBSQ ENC,97763,CDM,97763,CPT,,,both,,129,129,83.52,,,,fee schedule,,,,,,,,,,,,,,,109.65,85,,percent of total billed charges,,63.95,,,,fee schedule,,54.05,,,,fee schedule,,,,,,,,,,,,,,,,,,,,88.9,,,,fee schedule,,53.88,,,,fee schedule,,53.88,,,,fee schedule,,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,38.7,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,79.2,,,,fee schedule,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,38.7,122.55,
"MEDICAL NUTRITION, INDIV, IN",97802,CDM,97802,CPT,,,both,,84,84,50.42,,,,fee schedule,,,,,,,,,,,,,,,71.4,85,,percent of total billed charges,,43.58,,,,fee schedule,,32.95,,,,fee schedule,,,,,,,,30.01,,,,fee schedule,,,,,,,,53.68,,,,fee schedule,,32.53,,,,fee schedule,,32.53,,,,fee schedule,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,25.2,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,47.82,,,,fee schedule,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,25.2,79.8,
"MED NUTRITION, INDIV, SUBSEQ",97803,CDM,97803,CPT,,,both,,73,73,42.55,,,,fee schedule,,,,,,,,,,,,,,,62.05,85,,percent of total billed charges,,37.19,,,,fee schedule,,28.11,,,,fee schedule,,,,,,,,30.01,,,,fee schedule,,,,,,,,45.29,,,,fee schedule,,27.45,,,,fee schedule,,27.45,,,,fee schedule,,,66.43,91,,percent of total billed charges,,,69.35,95,,percent of total billed charges,,,60.59,83,,percent of total billed charges,,,21.9,83,,percent of total billed charges,,,,,,,,,,,,,,,60.59,83,,percent of total billed charges,,40.35,,,,fee schedule,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,62.05,85,,percent of total billed charges,,21.9,69.35,
OSTEOPATHIC MANIPULATIVE TX 1-2 BDY REGIONS,98925,CDM,98925,CPT,,,both,,141,141,36.24,,,,fee schedule,,,,,,,,12.55,,,,fee schedule,,,119.85,85,,percent of total billed charges,,34.52,,,,fee schedule,,24.41,,,,fee schedule,,12.55,,,,fee schedule,,38.14,,,,fee schedule,,12.55,,,,fee schedule,,38.58,,,,fee schedule,,23.38,,,,fee schedule,,23.38,,,,fee schedule,,,128.31,91,,percent of total billed charges,,,133.95,95,,percent of total billed charges,,,117.03,83,,percent of total billed charges,,,42.3,83,,percent of total billed charges,,12.55,,,,fee schedule,,12.55,,,,fee schedule,,,117.03,83,,percent of total billed charges,,34.37,,,,fee schedule,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,119.85,85,,percent of total billed charges,,12.55,133.95,
OSTEOPATHIC MANIPULATIVE TX 3-4 BDY REGIONS,98926,CDM,98926,CPT,,,both,,151,151,54.1,,,,fee schedule,,,,,,,,17.6,,,,fee schedule,,,128.35,85,,percent of total billed charges,,54.53,,,,fee schedule,,36.33,,,,fee schedule,,17.6,,,,fee schedule,,58.15,,,,fee schedule,,17.6,,,,fee schedule,,57.59,,,,fee schedule,,34.9,,,,fee schedule,,34.9,,,,fee schedule,,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,17.6,,,,fee schedule,,17.6,,,,fee schedule,,,125.33,83,,percent of total billed charges,,51.31,,,,fee schedule,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,17.6,143.45,
"SELF-MGMT EDUC & TRAIN, 1 PT",98960,CDM,98960,CPT,,,both,,116,116,45.7,,,,fee schedule,,,,,,,,,,,,,,,98.6,85,,percent of total billed charges,,42.15,,,,fee schedule,,28.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,48.65,,,,fee schedule,,29.48,,,,fee schedule,,29.48,,,,fee schedule,,,105.56,91,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,34.8,83,,percent of total billed charges,,,,,,,,,,,,,,,96.28,83,,percent of total billed charges,,43.34,,,,fee schedule,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,98.6,85,,percent of total billed charges,,28.2,110.2,
HC PRO PHONE CALL 5-10 MIN,98966,CDM,98966,CPT,,,both,,85,85,17.33,,,,fee schedule,,,,,,,,,,,,,,,72.25,85,,percent of total billed charges,,44,,,,fee schedule,,44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,18.45,,,,fee schedule,,11.18,,,,fee schedule,,11.18,,,,fee schedule,,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,25.5,83,,percent of total billed charges,,,,,,,,,,,,,,,70.55,83,,percent of total billed charges,,16.44,,,,fee schedule,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,11.18,80.75,
HC PRO PHONE CALL 11-20 MIN,98967,CDM,98967,CPT,,,both,,73,73,34.14,,,,fee schedule,,,,,,,,,,,,,,,62.05,85,,percent of total billed charges,,44,,,,fee schedule,,44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,36.34,,,,fee schedule,,22.03,,,,fee schedule,,22.03,,,,fee schedule,,,66.43,91,,percent of total billed charges,,,69.35,95,,percent of total billed charges,,,60.59,83,,percent of total billed charges,,,21.9,83,,percent of total billed charges,,,,,,,,,,,,,,,60.59,83,,percent of total billed charges,,32.38,,,,fee schedule,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,62.05,85,,percent of total billed charges,,21.9,69.35,
HC PRO PHONE CALL 21-30 MIN,98968,CDM,98968,CPT,,,both,,109,109,48.32,,,,fee schedule,,,,,,,,,,,,,,,92.65,85,,percent of total billed charges,,44,,,,fee schedule,,44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,51.44,,,,fee schedule,,31.18,,,,fee schedule,,31.18,,,,fee schedule,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,32.7,83,,percent of total billed charges,,,,,,,,,,,,,,,90.47,83,,percent of total billed charges,,45.83,,,,fee schedule,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,31.18,103.55,
REM THER MNTR 1ST SETUP&EDU,98975,CDM,98975,CPT,,,both,,52,52,29.94,,,,fee schedule,,,,,,,,,,,,,,,44.2,85,,percent of total billed charges,,29.01,,,,fee schedule,,22.1,,,,fee schedule,,,,,,,,,,,,,,,,,,,,31.87,,,,fee schedule,,19.32,,,,fee schedule,,19.32,,,,fee schedule,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,15.6,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,28.39,,,,fee schedule,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,15.6,49.4,
REM THER MNTR DV SPLY MSCSKL,98977,CDM,98977,CPT,,,both,,151,151,77.74,,,,fee schedule,,,,,,,,,,,,,,,128.35,85,,percent of total billed charges,,82.67,,,,fee schedule,,62.99,,,,fee schedule,,,,,,,,,,,,,,,,,,,,82.75,,,,fee schedule,,50.15,,,,fee schedule,,50.15,,,,fee schedule,,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,,,,,,,,,,,,,,125.33,83,,percent of total billed charges,,73.72,,,,fee schedule,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,45.3,143.45,
REM THER MNTR 1ST 20 MIN,98980,CDM,98980,CPT,,,both,,136,136,47.8,,,,fee schedule,,,,,,,,,,,,,,,115.6,85,,percent of total billed charges,,50.31,,,,fee schedule,,38.33,,,,fee schedule,,,,,,,,,,,,,,,,,,,,50.88,,,,fee schedule,,30.84,,,,fee schedule,,30.84,,,,fee schedule,,,123.76,91,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,40.8,83,,percent of total billed charges,,,,,,,,,,,,,,,112.88,83,,percent of total billed charges,,45.33,,,,fee schedule,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,30.84,129.2,
REM THER MNTR EA ADDL 20 MIN,98981,CDM,98981,CPT,,,both,,111,111,46.75,,,,fee schedule,,,,,,,,,,,,,,,94.35,85,,percent of total billed charges,,50.42,,,,fee schedule,,38.41,,,,fee schedule,,,,,,,,,,,,,,,,,,,,49.76,,,,fee schedule,,30.16,,,,fee schedule,,30.16,,,,fee schedule,,,101.01,91,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,33.3,83,,percent of total billed charges,,,,,,,,,,,,,,,92.13,83,,percent of total billed charges,,44.33,,,,fee schedule,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,94.35,85,,percent of total billed charges,,30.16,105.45,
DRUG SCREEN HANDLING FEE,99000,CDM,99000,CPT,,,both,,47,47,,,,,,,,,,,,,,,,,,,,39.95,85,,percent of total billed charges,,10.58,,,,fee schedule,,5.49,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,14.1,83,,percent of total billed charges,,,,,,,,,,,,,,,39.01,83,,percent of total billed charges,,,,,,,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,5.49,44.65,
DEVICE HANDLING,99002,CDM,99002,CPT,,,both,,22,22,,,,,,,,,,,,,,,,,,,,18.7,85,,percent of total billed charges,,13.16,,,,fee schedule,,6.83,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.02,91,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,6.6,83,,percent of total billed charges,,,,,,,,,,,,,,,18.26,83,,percent of total billed charges,,,,,,,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,6.6,20.9,
SVCS PRV OFFICE OTH/THN REG SCHEDD HRS,99050,CDM,99050,CPT,,,both,,83,83,,,,,,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,24.9,78.85,
OFFICE EMERGENCY CARE,99058,CDM,99058,CPT,,,both,,131,131,,,,,,,,,,,,,14.35,,,,fee schedule,,,111.35,85,,percent of total billed charges,,,,,,,,,,,,,,14.35,,,,fee schedule,,,,,,,,14.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,39.3,83,,percent of total billed charges,,14.35,,,,fee schedule,,14.35,,,,fee schedule,,,108.73,83,,percent of total billed charges,,,,,,,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,14.35,124.45,
OFFICE EMERGENCY CARE,99058P,CDM,99058,CPT,,,both,P,40,40,,,,,,,,,,,,,14.35,,,,fee schedule,,,34,85,,percent of total billed charges,,,,,,,,,,,,,,14.35,,,,fee schedule,,,,,,,,14.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,12,83,,percent of total billed charges,,14.35,,,,fee schedule,,14.35,,,,fee schedule,,,33.2,83,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,12,38,
OFFICE EMERGENCY CARE,99058T,CDM,99058,CPT,,,both,T,91,91,,,,,,,,,,,,,14.35,,,,fee schedule,,,77.35,85,,percent of total billed charges,,,,,,,,,,,,,,14.35,,,,fee schedule,,,,,,,,14.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,27.3,83,,percent of total billed charges,,14.35,,,,fee schedule,,14.35,,,,fee schedule,,,75.53,83,,percent of total billed charges,,,,,,,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,14.35,86.45,
SUPPLIES/MATERIALS PRV BY PHYS >ABOVE,99070,CDM,99070,CPT,,,both,,50,50,,,,,,,,,,,,,,,,,,,,42.5,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,,,,,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,15,47.5,
SPEC REPORTS > USUAL MED COMUNICAJ/STAND RPRTG,99080,CDM,99080,CPT,,,both,,32,32,,,,,,,,,,,,,,,,,,,,27.2,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,9.6,83,,percent of total billed charges,,,,,,,,,,,,,,,26.56,83,,percent of total billed charges,,,,,,,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,9.6,30.4,
"MOD CS BY SAME PHYS, < 5 YRS",99143,CDM,99143,CPT,,,both,,412,412,,,,,,,,,,,,,,,,,,,,350.2,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,374.92,91,,percent of total billed charges,,,391.4,95,,percent of total billed charges,,,341.96,83,,percent of total billed charges,,,123.6,83,,percent of total billed charges,,,,,,,,,,,,,,,341.96,83,,percent of total billed charges,,,,,,,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,350.2,85,,percent of total billed charges,,123.6,391.4,
"MOD CS BY SAME PHYS, 5 YRS +",99144,CDM,99144,CPT,,,both,,352,352,,,,,,,,,,,,,,,,,,,,299.2,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,105.6,83,,percent of total billed charges,,,,,,,,,,,,,,,292.16,83,,percent of total billed charges,,,,,,,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,105.6,334.4,
MOD CS BY SAME PHYS ADD-ON,99145,CDM,99145,CPT,,,both,,141,141,,,,,,,,,,,,,,,,,,,,119.85,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,128.31,91,,percent of total billed charges,,,133.95,95,,percent of total billed charges,,,117.03,83,,percent of total billed charges,,,42.3,83,,percent of total billed charges,,,,,,,,,,,,,,,117.03,83,,percent of total billed charges,,,,,,,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,119.85,85,,percent of total billed charges,,42.3,133.95,
MOD SEDAT PHYS/QHP <5 YRS,99151,CDM,99151,CPT,,,both,,412,412,37.82,,,,fee schedule,,,,,,,,14.45,,,,fee schedule,,,350.2,85,,percent of total billed charges,,34.39,,,,fee schedule,,26.37,,,,fee schedule,,14.45,,,,fee schedule,,,,,,,,14.45,,,,fee schedule,,40.26,,,,fee schedule,,24.4,,,,fee schedule,,24.4,,,,fee schedule,,,374.92,91,,percent of total billed charges,,,391.4,95,,percent of total billed charges,,,341.96,83,,percent of total billed charges,,,123.6,83,,percent of total billed charges,,14.45,,,,fee schedule,,14.45,,,,fee schedule,,,341.96,83,,percent of total billed charges,,35.87,,,,fee schedule,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,350.2,85,,percent of total billed charges,,14.45,391.4,
MOD SEDAT PHYS/QHP >5YRS,99152,CDM,99152,CPT,,,both,,352,352,19.43,,,,fee schedule,,,,,,,,7.49,,,,fee schedule,,,299.2,85,,percent of total billed charges,,17.67,,,,fee schedule,,13.55,,,,fee schedule,,7.49,,,,fee schedule,,,,,,,,7.49,,,,fee schedule,,20.69,,,,fee schedule,,12.54,,,,fee schedule,,12.54,,,,fee schedule,,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,105.6,83,,percent of total billed charges,,7.49,,,,fee schedule,,7.49,,,,fee schedule,,,292.16,83,,percent of total billed charges,,18.43,,,,fee schedule,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,7.49,334.4,
MOD SEDAT PHY/QHP EA 15 MIN,99153,CDM,99153,CPT,,,both,,141,141,17.33,,,,fee schedule,,,,,,,,55.53,,,,fee schedule,,,119.85,85,,percent of total billed charges,,14.19,,,,fee schedule,,10.88,,,,fee schedule,,55.53,,,,fee schedule,,,,,,,,55.53,,,,fee schedule,,18.45,,,,fee schedule,,11.18,,,,fee schedule,,11.18,,,,fee schedule,,,128.31,91,,percent of total billed charges,,,133.95,95,,percent of total billed charges,,,117.03,83,,percent of total billed charges,,,42.3,83,,percent of total billed charges,,55.53,,,,fee schedule,,55.53,,,,fee schedule,,,117.03,83,,percent of total billed charges,,16.44,,,,fee schedule,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,126.9,90,,percent of total billed charges,,,119.85,85,,percent of total billed charges,,10.88,133.95,
OCULAR FUNCTION SCREEN,99172,CDM,99172,CPT,,,both,,60,60,,,,,,,,,,,,,,,,,,,,51,85,,percent of total billed charges,,22.73,,,,fee schedule,,17.06,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,54.6,91,,percent of total billed charges,,,57,95,,percent of total billed charges,,,49.8,83,,percent of total billed charges,,,18,83,,percent of total billed charges,,,,,,,,,,,,,,,49.8,83,,percent of total billed charges,,,,,,,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,54,90,,percent of total billed charges,,,51,85,,percent of total billed charges,,17.06,57,
SCREENING,99173,CDM,99173,CPT,,,both,,43,43,4.73,,,,fee schedule,,,,,,,,7.45,,,,fee schedule,,,36.55,85,,percent of total billed charges,,4.13,,,,fee schedule,,3.1,,,,fee schedule,,7.45,,,,fee schedule,,,,,,,,7.45,,,,fee schedule,,5.03,,,,fee schedule,,3.05,,,,fee schedule,,3.05,,,,fee schedule,,,39.13,91,,percent of total billed charges,,,40.85,95,,percent of total billed charges,,,35.69,83,,percent of total billed charges,,,12.9,83,,percent of total billed charges,,7.45,,,,fee schedule,,7.45,,,,fee schedule,,,35.69,83,,percent of total billed charges,,4.48,,,,fee schedule,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,36.55,85,,percent of total billed charges,,3.05,40.85,
PHLEBOTOMY,99195,CDM,99195,CPT,,,both,,281,281,152.32,,,,fee schedule,,,,,,,,33.25,,,,fee schedule,,,238.85,85,,percent of total billed charges,,134.72,,,,fee schedule,,101.14,,,,fee schedule,,33.25,,,,fee schedule,,28.76,,,,fee schedule,,33.25,,,,fee schedule,,162.15,,,,fee schedule,,98.27,,,,fee schedule,,98.27,,,,fee schedule,,,255.71,91,,percent of total billed charges,,,266.95,95,,percent of total billed charges,,,233.23,83,,percent of total billed charges,,,84.3,83,,percent of total billed charges,,33.25,,,,fee schedule,,33.25,,,,fee schedule,,,233.23,83,,percent of total billed charges,,144.46,,,,fee schedule,,,252.9,90,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,252.9,90,,percent of total billed charges,,,238.85,85,,percent of total billed charges,,28.76,266.95,
PHLEBOTOMY,99195P,CDM,99195,CPT,,,both,P,130,130,152.32,,,,fee schedule,,,,,,,,33.25,,,,fee schedule,,,110.5,85,,percent of total billed charges,,134.72,,,,fee schedule,,101.14,,,,fee schedule,,33.25,,,,fee schedule,,28.76,,,,fee schedule,,33.25,,,,fee schedule,,162.15,,,,fee schedule,,98.27,,,,fee schedule,,98.27,,,,fee schedule,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,39,83,,percent of total billed charges,,33.25,,,,fee schedule,,33.25,,,,fee schedule,,,107.9,83,,percent of total billed charges,,144.46,,,,fee schedule,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,28.76,162.15,
PHLEBOTOMY,99195T,CDM,99195,CPT,,,both,T,151,151,152.32,,,,fee schedule,,,,,,,,33.25,,,,fee schedule,,,128.35,85,,percent of total billed charges,,134.72,,,,fee schedule,,101.14,,,,fee schedule,,33.25,,,,fee schedule,,28.76,,,,fee schedule,,33.25,,,,fee schedule,,162.15,,,,fee schedule,,98.27,,,,fee schedule,,98.27,,,,fee schedule,,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,33.25,,,,fee schedule,,33.25,,,,fee schedule,,,125.33,83,,percent of total billed charges,,144.46,,,,fee schedule,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,28.76,162.15,
"OFFICE/OUTPATIENT VISIT, NEW",99202,CDM,99202,CPT,,,both,,171,171,64.96,,,,fee schedule,,,,,,,,32,,,,fee schedule,,,145.35,85,,percent of total billed charges,,50.25,,,,fee schedule,,49.21,,,,fee schedule,,32,,,,fee schedule,,70.49,,,,fee schedule,,32,,,,fee schedule,,79.4,,,,fee schedule,,48.12,,,,fee schedule,,48.12,,,,fee schedule,,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,51.3,83,,percent of total billed charges,,32,,,,fee schedule,,32,,,,fee schedule,,,141.93,83,,percent of total billed charges,,70.74,,,,fee schedule,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,32,162.45,
"OFFICE/OUTPATIENT VISIT, NEW",99202P,CDM,99202,CPT,,,both,P,66,66,64.96,,,,fee schedule,,,,,,,,32,,,,fee schedule,,,56.1,85,,percent of total billed charges,,50.25,,,,fee schedule,,49.21,,,,fee schedule,,32,,,,fee schedule,,70.49,,,,fee schedule,,32,,,,fee schedule,,79.4,,,,fee schedule,,48.12,,,,fee schedule,,48.12,,,,fee schedule,,,60.06,91,,percent of total billed charges,,,62.7,95,,percent of total billed charges,,,54.78,83,,percent of total billed charges,,,19.8,83,,percent of total billed charges,,32,,,,fee schedule,,32,,,,fee schedule,,,54.78,83,,percent of total billed charges,,70.74,,,,fee schedule,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,59.4,90,,percent of total billed charges,,,56.1,85,,percent of total billed charges,,19.8,79.4,
"OFFICE/OUTPATIENT VISIT, NEW",99202T,CDM,99202,CPT,,,both,T,105,105,64.96,,,,fee schedule,,,,,,,,32,,,,fee schedule,,,89.25,85,,percent of total billed charges,,50.25,,,,fee schedule,,49.21,,,,fee schedule,,32,,,,fee schedule,,70.49,,,,fee schedule,,32,,,,fee schedule,,79.4,,,,fee schedule,,48.12,,,,fee schedule,,48.12,,,,fee schedule,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,31.5,83,,percent of total billed charges,,32,,,,fee schedule,,32,,,,fee schedule,,,87.15,83,,percent of total billed charges,,70.74,,,,fee schedule,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,31.5,99.75,
TELEHEALTH OFFICE/OUTPATIENT VISIT NEW-20 MIN,99202VV,CDM,99202,CPT,,,both,,171,171,64.96,,,,fee schedule,,,,,,,,32,,,,fee schedule,,,145.35,85,,percent of total billed charges,,50.25,,,,fee schedule,,49.21,,,,fee schedule,,32,,,,fee schedule,,70.49,,,,fee schedule,,32,,,,fee schedule,,79.4,,,,fee schedule,,48.12,,,,fee schedule,,48.12,,,,fee schedule,,,155.61,91,,percent of total billed charges,,,162.45,95,,percent of total billed charges,,,141.93,83,,percent of total billed charges,,,51.3,83,,percent of total billed charges,,32,,,,fee schedule,,32,,,,fee schedule,,,141.93,83,,percent of total billed charges,,70.74,,,,fee schedule,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,153.9,90,,percent of total billed charges,,,145.35,85,,percent of total billed charges,,32,162.45,
OFFICE OUTPT NEW 30 MIN,99203,CDM,99203,CPT,,,both,,253,253,112.08,,,,fee schedule,,,,,,,,41.6,,,,fee schedule,,,215.05,85,,percent of total billed charges,,85.94,,,,fee schedule,,84.16,,,,fee schedule,,41.6,,,,fee schedule,,108.58,,,,fee schedule,,41.6,,,,fee schedule,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,230.23,91,,percent of total billed charges,,,240.35,95,,percent of total billed charges,,,209.99,83,,percent of total billed charges,,,75.9,83,,percent of total billed charges,,41.6,,,,fee schedule,,41.6,,,,fee schedule,,,209.99,83,,percent of total billed charges,,122.04,,,,fee schedule,,,227.7,90,,percent of total billed charges,,,227.7,90,,percent of total billed charges,,,227.7,90,,percent of total billed charges,,,227.7,90,,percent of total billed charges,,,215.05,85,,percent of total billed charges,,41.6,240.35,
OFFICE OUTPT NEW 30 MIN,99203-25,CDM,99203,CPT,,,both,,253,253,112.08,,,,fee schedule,,,,,,,,41.6,,,,fee schedule,,,215.05,85,,percent of total billed charges,,85.94,,,,fee schedule,,84.16,,,,fee schedule,,41.6,,,,fee schedule,,108.58,,,,fee schedule,,41.6,,,,fee schedule,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,230.23,91,,percent of total billed charges,,,240.35,95,,percent of total billed charges,,,209.99,83,,percent of total billed charges,,,75.9,83,,percent of total billed charges,,41.6,,,,fee schedule,,41.6,,,,fee schedule,,,209.99,83,,percent of total billed charges,,122.04,,,,fee schedule,,,227.7,90,,percent of total billed charges,,,227.7,90,,percent of total billed charges,,,227.7,90,,percent of total billed charges,,,227.7,90,,percent of total billed charges,,,215.05,85,,percent of total billed charges,,41.6,240.35,
"OFFICE/OUTPATIENT VISIT, NEW",99203P,CDM,99203,CPT,,,both,P,109,109,112.08,,,,fee schedule,,,,,,,,41.6,,,,fee schedule,,,92.65,85,,percent of total billed charges,,85.94,,,,fee schedule,,84.16,,,,fee schedule,,41.6,,,,fee schedule,,108.58,,,,fee schedule,,41.6,,,,fee schedule,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,99.19,91,,percent of total billed charges,,,103.55,95,,percent of total billed charges,,,90.47,83,,percent of total billed charges,,,32.7,83,,percent of total billed charges,,41.6,,,,fee schedule,,41.6,,,,fee schedule,,,90.47,83,,percent of total billed charges,,122.04,,,,fee schedule,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,98.1,90,,percent of total billed charges,,,92.65,85,,percent of total billed charges,,32.7,136.99,
"OFFICE/OUTPATIENT VISIT, NEW",99203T,CDM,99203,CPT,,,both,T,144,144,112.08,,,,fee schedule,,,,,,,,41.6,,,,fee schedule,,,122.4,85,,percent of total billed charges,,85.94,,,,fee schedule,,84.16,,,,fee schedule,,41.6,,,,fee schedule,,108.58,,,,fee schedule,,41.6,,,,fee schedule,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,43.2,83,,percent of total billed charges,,41.6,,,,fee schedule,,41.6,,,,fee schedule,,,119.52,83,,percent of total billed charges,,122.04,,,,fee schedule,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,41.6,136.99,
TELEHEALTH OFFICE/OUTPATIENT VISIT NEW-30 MIN,99203VV,CDM,99203,CPT,,,both,,253,253,112.08,,,,fee schedule,,,,,,,,41.6,,,,fee schedule,,,215.05,85,,percent of total billed charges,,85.94,,,,fee schedule,,84.16,,,,fee schedule,,41.6,,,,fee schedule,,108.58,,,,fee schedule,,41.6,,,,fee schedule,,136.99,,,,fee schedule,,83.02,,,,fee schedule,,83.02,,,,fee schedule,,,230.23,91,,percent of total billed charges,,,240.35,95,,percent of total billed charges,,,209.99,83,,percent of total billed charges,,,75.9,83,,percent of total billed charges,,41.6,,,,fee schedule,,41.6,,,,fee schedule,,,209.99,83,,percent of total billed charges,,122.04,,,,fee schedule,,,227.7,90,,percent of total billed charges,,,227.7,90,,percent of total billed charges,,,227.7,90,,percent of total billed charges,,,227.7,90,,percent of total billed charges,,,215.05,85,,percent of total billed charges,,41.6,240.35,
OFFICE OUTPT NEW 45 MIN,99204,CDM,99204,CPT,,,both,,372,372,180.25,,,,fee schedule,,,,,,,,66.4,,,,fee schedule,,,316.2,85,,percent of total billed charges,,138.81,,,,fee schedule,,135.94,,,,fee schedule,,66.4,,,,fee schedule,,160.87,,,,fee schedule,,66.4,,,,fee schedule,,220.3,,,,fee schedule,,133.52,,,,fee schedule,,133.52,,,,fee schedule,,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,111.6,83,,percent of total billed charges,,66.4,,,,fee schedule,,66.4,,,,fee schedule,,,308.76,83,,percent of total billed charges,,196.27,,,,fee schedule,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,66.4,353.4,
"OFFICE/OUTPATIENT VISIT, NEW",99204P,CDM,99204,CPT,,,both,P,178,178,180.25,,,,fee schedule,,,,,,,,66.4,,,,fee schedule,,,151.3,85,,percent of total billed charges,,138.81,,,,fee schedule,,135.94,,,,fee schedule,,66.4,,,,fee schedule,,160.87,,,,fee schedule,,66.4,,,,fee schedule,,220.3,,,,fee schedule,,133.52,,,,fee schedule,,133.52,,,,fee schedule,,,161.98,91,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,53.4,83,,percent of total billed charges,,66.4,,,,fee schedule,,66.4,,,,fee schedule,,,147.74,83,,percent of total billed charges,,196.27,,,,fee schedule,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,53.4,220.3,
"OFFICE/OUTPATIENT VISIT, NEW",99204T,CDM,99204,CPT,,,both,T,194,194,180.25,,,,fee schedule,,,,,,,,66.4,,,,fee schedule,,,164.9,85,,percent of total billed charges,,138.81,,,,fee schedule,,135.94,,,,fee schedule,,66.4,,,,fee schedule,,160.87,,,,fee schedule,,66.4,,,,fee schedule,,220.3,,,,fee schedule,,133.52,,,,fee schedule,,133.52,,,,fee schedule,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,58.2,83,,percent of total billed charges,,66.4,,,,fee schedule,,66.4,,,,fee schedule,,,161.02,83,,percent of total billed charges,,196.27,,,,fee schedule,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,58.2,220.3,
TELEHEATH OFFICE/OUTPATIENT VISIT NEW-45 MIN,99204VV,CDM,99204,CPT,,,both,,372,372,180.25,,,,fee schedule,,,,,,,,66.4,,,,fee schedule,,,316.2,85,,percent of total billed charges,,138.81,,,,fee schedule,,135.94,,,,fee schedule,,66.4,,,,fee schedule,,160.87,,,,fee schedule,,66.4,,,,fee schedule,,220.3,,,,fee schedule,,133.52,,,,fee schedule,,133.52,,,,fee schedule,,,338.52,91,,percent of total billed charges,,,353.4,95,,percent of total billed charges,,,308.76,83,,percent of total billed charges,,,111.6,83,,percent of total billed charges,,66.4,,,,fee schedule,,66.4,,,,fee schedule,,,308.76,83,,percent of total billed charges,,196.27,,,,fee schedule,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,334.8,90,,percent of total billed charges,,,316.2,85,,percent of total billed charges,,66.4,353.4,
OFFICE OUTPT NEW 60 MIN,99205,CDM,99205,CPT,,,both,,474,474,244.75,,,,fee schedule,,,,,,,,70.85,,,,fee schedule,,,402.9,85,,percent of total billed charges,,188.22,,,,fee schedule,,184.33,,,,fee schedule,,70.85,,,,fee schedule,,213.74,,,,fee schedule,,70.85,,,,fee schedule,,299.14,,,,fee schedule,,181.3,,,,fee schedule,,181.3,,,,fee schedule,,,431.34,91,,percent of total billed charges,,,450.3,95,,percent of total billed charges,,,393.42,83,,percent of total billed charges,,,142.2,83,,percent of total billed charges,,70.85,,,,fee schedule,,70.85,,,,fee schedule,,,393.42,83,,percent of total billed charges,,266.51,,,,fee schedule,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,402.9,85,,percent of total billed charges,,70.85,450.3,
"OFFICE/OUTPATIENT VISIT, NEW",99205P,CDM,99205,CPT,,,both,P,310,310,244.75,,,,fee schedule,,,,,,,,70.85,,,,fee schedule,,,263.5,85,,percent of total billed charges,,188.22,,,,fee schedule,,184.33,,,,fee schedule,,70.85,,,,fee schedule,,213.74,,,,fee schedule,,70.85,,,,fee schedule,,299.14,,,,fee schedule,,181.3,,,,fee schedule,,181.3,,,,fee schedule,,,282.1,91,,percent of total billed charges,,,294.5,95,,percent of total billed charges,,,257.3,83,,percent of total billed charges,,,93,83,,percent of total billed charges,,70.85,,,,fee schedule,,70.85,,,,fee schedule,,,257.3,83,,percent of total billed charges,,266.51,,,,fee schedule,,,279,90,,percent of total billed charges,,,279,90,,percent of total billed charges,,,279,90,,percent of total billed charges,,,279,90,,percent of total billed charges,,,263.5,85,,percent of total billed charges,,70.85,299.14,
"OFFICE/OUTPATIENT VISIT, NEW",99205T,CDM,99205,CPT,,,both,T,164,164,244.75,,,,fee schedule,,,,,,,,70.85,,,,fee schedule,,,139.4,85,,percent of total billed charges,,188.22,,,,fee schedule,,184.33,,,,fee schedule,,70.85,,,,fee schedule,,213.74,,,,fee schedule,,70.85,,,,fee schedule,,299.14,,,,fee schedule,,181.3,,,,fee schedule,,181.3,,,,fee schedule,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,49.2,83,,percent of total billed charges,,70.85,,,,fee schedule,,70.85,,,,fee schedule,,,136.12,83,,percent of total billed charges,,266.51,,,,fee schedule,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,49.2,299.14,
TELEHEALTH OFFICE/OUTPATIENT VISIT NEW-60 MIN,99205VV,CDM,99205,CPT,,,both,,474,474,244.75,,,,fee schedule,,,,,,,,70.85,,,,fee schedule,,,402.9,85,,percent of total billed charges,,188.22,,,,fee schedule,,184.33,,,,fee schedule,,70.85,,,,fee schedule,,213.74,,,,fee schedule,,70.85,,,,fee schedule,,299.14,,,,fee schedule,,181.3,,,,fee schedule,,181.3,,,,fee schedule,,,431.34,91,,percent of total billed charges,,,450.3,95,,percent of total billed charges,,,393.42,83,,percent of total billed charges,,,142.2,83,,percent of total billed charges,,70.85,,,,fee schedule,,70.85,,,,fee schedule,,,393.42,83,,percent of total billed charges,,266.51,,,,fee schedule,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,426.6,90,,percent of total billed charges,,,402.9,85,,percent of total billed charges,,70.85,450.3,
OFFICE O/P EST 5 MIN,99211,CDM,99211,CPT,,,both,,82,82,11.89,,,,fee schedule,,,,,,,,12.3,,,,fee schedule,,,69.7,85,,percent of total billed charges,,9.11,,,,fee schedule,,8.92,,,,fee schedule,,12.3,,,,fee schedule,,13.64,,,,fee schedule,,12.3,,,,fee schedule,,14.54,,,,fee schedule,,8.81,,,,fee schedule,,8.81,,,,fee schedule,,,74.62,91,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,24.6,83,,percent of total billed charges,,12.3,,,,fee schedule,,12.3,,,,fee schedule,,,68.06,83,,percent of total billed charges,,12.95,,,,fee schedule,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,8.81,77.9,
"OFFICE/OUTPATIENT VISIT, EST",99211P,CDM,99211,CPT,,,both,P,31,31,11.89,,,,fee schedule,,,,,,,,12.3,,,,fee schedule,,,26.35,85,,percent of total billed charges,,9.11,,,,fee schedule,,8.92,,,,fee schedule,,12.3,,,,fee schedule,,13.64,,,,fee schedule,,12.3,,,,fee schedule,,14.54,,,,fee schedule,,8.81,,,,fee schedule,,8.81,,,,fee schedule,,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,9.3,83,,percent of total billed charges,,12.3,,,,fee schedule,,12.3,,,,fee schedule,,,25.73,83,,percent of total billed charges,,12.95,,,,fee schedule,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,8.81,29.45,
"OFFICE/OUTPATIENT VISIT, EST",99211T,CDM,99211,CPT,,,both,T,51,51,11.89,,,,fee schedule,,,,,,,,12.3,,,,fee schedule,,,43.35,85,,percent of total billed charges,,9.11,,,,fee schedule,,8.92,,,,fee schedule,,12.3,,,,fee schedule,,13.64,,,,fee schedule,,12.3,,,,fee schedule,,14.54,,,,fee schedule,,8.81,,,,fee schedule,,8.81,,,,fee schedule,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,12.3,,,,fee schedule,,12.3,,,,fee schedule,,,42.33,83,,percent of total billed charges,,12.95,,,,fee schedule,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,8.81,48.45,
TELEHEALTH OFFICE/OUTPATIENT VISIT EST,99211VV,CDM,99211,CPT,,,both,,82,82,11.89,,,,fee schedule,,,,,,,,12.3,,,,fee schedule,,,69.7,85,,percent of total billed charges,,9.11,,,,fee schedule,,8.92,,,,fee schedule,,12.3,,,,fee schedule,,13.64,,,,fee schedule,,12.3,,,,fee schedule,,14.54,,,,fee schedule,,8.81,,,,fee schedule,,8.81,,,,fee schedule,,,74.62,91,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,24.6,83,,percent of total billed charges,,12.3,,,,fee schedule,,12.3,,,,fee schedule,,,68.06,83,,percent of total billed charges,,12.95,,,,fee schedule,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,8.81,77.9,
OFFICE OUTPT EST 10 MIN,99212,CDM,99212,CPT,,,both,,130,130,48.04,,,,fee schedule,,,,,,,,24.25,,,,fee schedule,,,110.5,85,,percent of total billed charges,,37.31,,,,fee schedule,,36.54,,,,fee schedule,,24.25,,,,fee schedule,,36.38,,,,fee schedule,,24.25,,,,fee schedule,,58.71,,,,fee schedule,,35.58,,,,fee schedule,,35.58,,,,fee schedule,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,39,83,,percent of total billed charges,,24.25,,,,fee schedule,,24.25,,,,fee schedule,,,107.9,83,,percent of total billed charges,,52.3,,,,fee schedule,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,24.25,123.5,
"OFFICE/OUTPATIENT VISIT, EST",99212P,CDM,99212,CPT,,,both,P,53,53,48.04,,,,fee schedule,,,,,,,,24.25,,,,fee schedule,,,45.05,85,,percent of total billed charges,,37.31,,,,fee schedule,,36.54,,,,fee schedule,,24.25,,,,fee schedule,,36.38,,,,fee schedule,,24.25,,,,fee schedule,,58.71,,,,fee schedule,,35.58,,,,fee schedule,,35.58,,,,fee schedule,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,24.25,,,,fee schedule,,24.25,,,,fee schedule,,,43.99,83,,percent of total billed charges,,52.3,,,,fee schedule,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,15.9,58.71,
"OFFICE/OUTPATIENT VISIT, EST",99212T,CDM,99212,CPT,,,both,T,77,77,48.04,,,,fee schedule,,,,,,,,24.25,,,,fee schedule,,,65.45,85,,percent of total billed charges,,37.31,,,,fee schedule,,36.54,,,,fee schedule,,24.25,,,,fee schedule,,36.38,,,,fee schedule,,24.25,,,,fee schedule,,58.71,,,,fee schedule,,35.58,,,,fee schedule,,35.58,,,,fee schedule,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,24.25,,,,fee schedule,,24.25,,,,fee schedule,,,63.91,83,,percent of total billed charges,,52.3,,,,fee schedule,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,23.1,73.15,
TELEHEALTH OFFICE/OUTPATIENT VISIT EST,99212VV,CDM,99212,CPT,,,both,,130,130,48.04,,,,fee schedule,,,,,,,,24.25,,,,fee schedule,,,110.5,85,,percent of total billed charges,,37.31,,,,fee schedule,,36.54,,,,fee schedule,,24.25,,,,fee schedule,,36.38,,,,fee schedule,,24.25,,,,fee schedule,,58.71,,,,fee schedule,,35.58,,,,fee schedule,,35.58,,,,fee schedule,,,118.3,91,,percent of total billed charges,,,123.5,95,,percent of total billed charges,,,107.9,83,,percent of total billed charges,,,39,83,,percent of total billed charges,,24.25,,,,fee schedule,,24.25,,,,fee schedule,,,107.9,83,,percent of total billed charges,,52.3,,,,fee schedule,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,117,90,,percent of total billed charges,,,110.5,85,,percent of total billed charges,,24.25,123.5,
OFFICE OUTPT EST 15 MIN,99213,CDM,99213,CPT,,,both,,177,177,89.21,,,,fee schedule,,,,,,,,28.35,,,,fee schedule,,,150.45,85,,percent of total billed charges,,68.4,,,,fee schedule,,66.99,,,,fee schedule,,28.35,,,,fee schedule,,53.44,,,,fee schedule,,28.35,,,,fee schedule,,109.03,,,,fee schedule,,66.08,,,,fee schedule,,66.08,,,,fee schedule,,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,53.1,83,,percent of total billed charges,,28.35,,,,fee schedule,,28.35,,,,fee schedule,,,146.91,83,,percent of total billed charges,,97.14,,,,fee schedule,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,28.35,168.15,
"OFFICE/OUTPATIENT VISIT, EST",99213P,CDM,99213,CPT,,,both,P,89,89,89.21,,,,fee schedule,,,,,,,,28.35,,,,fee schedule,,,75.65,85,,percent of total billed charges,,68.4,,,,fee schedule,,66.99,,,,fee schedule,,28.35,,,,fee schedule,,53.44,,,,fee schedule,,28.35,,,,fee schedule,,109.03,,,,fee schedule,,66.08,,,,fee schedule,,66.08,,,,fee schedule,,,80.99,91,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,26.7,83,,percent of total billed charges,,28.35,,,,fee schedule,,28.35,,,,fee schedule,,,73.87,83,,percent of total billed charges,,97.14,,,,fee schedule,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,26.7,109.03,
"OFFICE/OUTPATIENT VISIT, EST",99213T,CDM,99213,CPT,,,both,T,88,88,89.21,,,,fee schedule,,,,,,,,28.35,,,,fee schedule,,,74.8,85,,percent of total billed charges,,68.4,,,,fee schedule,,66.99,,,,fee schedule,,28.35,,,,fee schedule,,53.44,,,,fee schedule,,28.35,,,,fee schedule,,109.03,,,,fee schedule,,66.08,,,,fee schedule,,66.08,,,,fee schedule,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,26.4,83,,percent of total billed charges,,28.35,,,,fee schedule,,28.35,,,,fee schedule,,,73.04,83,,percent of total billed charges,,97.14,,,,fee schedule,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,26.4,109.03,
TELEHEALTH OFFICE/OUTPATIENT VISIT EST,99213VV,CDM,99213,CPT,,,both,,178,178,89.21,,,,fee schedule,,,,,,,,28.35,,,,fee schedule,,,151.3,85,,percent of total billed charges,,68.4,,,,fee schedule,,66.99,,,,fee schedule,,28.35,,,,fee schedule,,53.44,,,,fee schedule,,28.35,,,,fee schedule,,109.03,,,,fee schedule,,66.08,,,,fee schedule,,66.08,,,,fee schedule,,,161.98,91,,percent of total billed charges,,,169.1,95,,percent of total billed charges,,,147.74,83,,percent of total billed charges,,,53.4,83,,percent of total billed charges,,28.35,,,,fee schedule,,28.35,,,,fee schedule,,,147.74,83,,percent of total billed charges,,97.14,,,,fee schedule,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,160.2,90,,percent of total billed charges,,,151.3,85,,percent of total billed charges,,28.35,169.1,
OFFICE OUTPT EST 25 MIN,99214,CDM,99214,CPT,,,both,,249,249,131.75,,,,fee schedule,,,,,,,,42.5,,,,fee schedule,,,211.65,85,,percent of total billed charges,,100.11,,,,fee schedule,,98.04,,,,fee schedule,,42.5,,,,fee schedule,,88.68,,,,fee schedule,,42.5,,,,fee schedule,,161.03,,,,fee schedule,,97.6,,,,fee schedule,,97.6,,,,fee schedule,,,226.59,91,,percent of total billed charges,,,236.55,95,,percent of total billed charges,,,206.67,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,42.5,,,,fee schedule,,42.5,,,,fee schedule,,,206.67,83,,percent of total billed charges,,143.46,,,,fee schedule,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,211.65,85,,percent of total billed charges,,42.5,236.55,
"OFFICE/OUTPATIENT VISIT, EST",99214P,CDM,99214,CPT,,,both,P,131,131,131.75,,,,fee schedule,,,,,,,,42.5,,,,fee schedule,,,111.35,85,,percent of total billed charges,,100.11,,,,fee schedule,,98.04,,,,fee schedule,,42.5,,,,fee schedule,,88.68,,,,fee schedule,,42.5,,,,fee schedule,,161.03,,,,fee schedule,,97.6,,,,fee schedule,,97.6,,,,fee schedule,,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,39.3,83,,percent of total billed charges,,42.5,,,,fee schedule,,42.5,,,,fee schedule,,,108.73,83,,percent of total billed charges,,143.46,,,,fee schedule,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,39.3,161.03,
"OFFICE/OUTPATIENT VISIT, EST",99214T,CDM,99214,CPT,,,both,T,118,118,131.75,,,,fee schedule,,,,,,,,42.5,,,,fee schedule,,,100.3,85,,percent of total billed charges,,100.11,,,,fee schedule,,98.04,,,,fee schedule,,42.5,,,,fee schedule,,88.68,,,,fee schedule,,42.5,,,,fee schedule,,161.03,,,,fee schedule,,97.6,,,,fee schedule,,97.6,,,,fee schedule,,,107.38,91,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,35.4,83,,percent of total billed charges,,42.5,,,,fee schedule,,42.5,,,,fee schedule,,,97.94,83,,percent of total billed charges,,143.46,,,,fee schedule,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,35.4,161.03,
TELEHEALTH OFFICE/OUTPATIENT VISIT EST,99214VV,CDM,99214,CPT,,,both,,249,249,131.75,,,,fee schedule,,,,,,,,42.5,,,,fee schedule,,,211.65,85,,percent of total billed charges,,100.11,,,,fee schedule,,98.04,,,,fee schedule,,42.5,,,,fee schedule,,88.68,,,,fee schedule,,42.5,,,,fee schedule,,161.03,,,,fee schedule,,97.6,,,,fee schedule,,97.6,,,,fee schedule,,,226.59,91,,percent of total billed charges,,,236.55,95,,percent of total billed charges,,,206.67,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,42.5,,,,fee schedule,,42.5,,,,fee schedule,,,206.67,83,,percent of total billed charges,,143.46,,,,fee schedule,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,211.65,85,,percent of total billed charges,,42.5,236.55,
OFFICE OUTPATIENT VISIT EST,99215,CDM,99215,CPT,,,both,,326,326,193.51,,,,fee schedule,,,,,,,,48,,,,fee schedule,,,277.1,85,,percent of total billed charges,,148.9,,,,fee schedule,,145.82,,,,fee schedule,,48,,,,fee schedule,,142.12,,,,fee schedule,,48,,,,fee schedule,,236.52,,,,fee schedule,,143.34,,,,fee schedule,,143.34,,,,fee schedule,,,296.66,91,,percent of total billed charges,,,309.7,95,,percent of total billed charges,,,270.58,83,,percent of total billed charges,,,97.8,83,,percent of total billed charges,,48,,,,fee schedule,,48,,,,fee schedule,,,270.58,83,,percent of total billed charges,,210.71,,,,fee schedule,,,293.4,90,,percent of total billed charges,,,293.4,90,,percent of total billed charges,,,293.4,90,,percent of total billed charges,,,293.4,90,,percent of total billed charges,,,277.1,85,,percent of total billed charges,,48,309.7,
"OFFICE/OUTPATIENT VISIT, EST",99215P,CDM,99215,CPT,,,both,P,187,187,193.51,,,,fee schedule,,,,,,,,48,,,,fee schedule,,,158.95,85,,percent of total billed charges,,148.9,,,,fee schedule,,145.82,,,,fee schedule,,48,,,,fee schedule,,142.12,,,,fee schedule,,48,,,,fee schedule,,236.52,,,,fee schedule,,143.34,,,,fee schedule,,143.34,,,,fee schedule,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,56.1,83,,percent of total billed charges,,48,,,,fee schedule,,48,,,,fee schedule,,,155.21,83,,percent of total billed charges,,210.71,,,,fee schedule,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,48,236.52,
"OFFICE/OUTPATIENT VISIT, EST",99215T,CDM,99215,CPT,,,both,T,139,139,193.51,,,,fee schedule,,,,,,,,48,,,,fee schedule,,,118.15,85,,percent of total billed charges,,148.9,,,,fee schedule,,145.82,,,,fee schedule,,48,,,,fee schedule,,142.12,,,,fee schedule,,48,,,,fee schedule,,236.52,,,,fee schedule,,143.34,,,,fee schedule,,143.34,,,,fee schedule,,,126.49,91,,percent of total billed charges,,,132.05,95,,percent of total billed charges,,,115.37,83,,percent of total billed charges,,,41.7,83,,percent of total billed charges,,48,,,,fee schedule,,48,,,,fee schedule,,,115.37,83,,percent of total billed charges,,210.71,,,,fee schedule,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,125.1,90,,percent of total billed charges,,,118.15,85,,percent of total billed charges,,41.7,236.52,
TELEHEALTH OFFICE/OUTPATIENT VISIT EST,99215VV,CDM,99215,CPT,,,both,,326,326,193.51,,,,fee schedule,,,,,,,,48,,,,fee schedule,,,277.1,85,,percent of total billed charges,,148.9,,,,fee schedule,,145.82,,,,fee schedule,,48,,,,fee schedule,,142.12,,,,fee schedule,,48,,,,fee schedule,,236.52,,,,fee schedule,,143.34,,,,fee schedule,,143.34,,,,fee schedule,,,296.66,91,,percent of total billed charges,,,309.7,95,,percent of total billed charges,,,270.58,83,,percent of total billed charges,,,97.8,83,,percent of total billed charges,,48,,,,fee schedule,,48,,,,fee schedule,,,270.58,83,,percent of total billed charges,,210.71,,,,fee schedule,,,293.4,90,,percent of total billed charges,,,293.4,90,,percent of total billed charges,,,293.4,90,,percent of total billed charges,,,293.4,90,,percent of total billed charges,,,277.1,85,,percent of total billed charges,,48,309.7,
OBS CARE DSCHRG D MGMT,99217,CDM,99217,CPT,,,both,,211,211,,,,,,,,,,,,,,,,,,,,179.35,85,,percent of total billed charges,,77.71,,,,fee schedule,,70.65,,,,fee schedule,,,,,,,,106.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,192.01,91,,percent of total billed charges,,,200.45,95,,percent of total billed charges,,,175.13,83,,percent of total billed charges,,,63.3,83,,percent of total billed charges,,,,,,,,,,,,,,,175.13,83,,percent of total billed charges,,,,,,,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,189.9,90,,percent of total billed charges,,,179.35,85,,percent of total billed charges,,63.3,200.45,
OBSERVATION CARE,99218,CDM,99218,CPT,,,both,,262,262,,,,,,,,,,,,,,,,,,,,222.7,85,,percent of total billed charges,,107.41,,,,fee schedule,,97.65,,,,fee schedule,,,,,,,,101.19,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,238.42,91,,percent of total billed charges,,,248.9,95,,percent of total billed charges,,,217.46,83,,percent of total billed charges,,,78.6,83,,percent of total billed charges,,,,,,,,,,,,,,,217.46,83,,percent of total billed charges,,,,,,,,,235.8,90,,percent of total billed charges,,,235.8,90,,percent of total billed charges,,,235.8,90,,percent of total billed charges,,,235.8,90,,percent of total billed charges,,,222.7,85,,percent of total billed charges,,78.6,248.9,
1ST OBS CARE PR D MODERATE SEVERITY,99219,CDM,99219,CPT,,,both,,360,360,,,,,,,,,,,,,,,,,,,,306,85,,percent of total billed charges,,144.91,,,,fee schedule,,131.75,,,,fee schedule,,,,,,,,168.26,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,327.6,91,,percent of total billed charges,,,342,95,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,108,83,,percent of total billed charges,,,,,,,,,,,,,,,298.8,83,,percent of total billed charges,,,,,,,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,306,85,,percent of total billed charges,,108,342,
1ST OBS CARE PR D HIGH SEVERITY,99220,CDM,99220,CPT,,,both,,513,513,,,,,,,,,,,,,,,,,,,,436.05,85,,percent of total billed charges,,195.58,,,,fee schedule,,177.81,,,,fee schedule,,,,,,,,236.48,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,466.83,91,,percent of total billed charges,,,487.35,95,,percent of total billed charges,,,425.79,83,,percent of total billed charges,,,153.9,83,,percent of total billed charges,,,,,,,,,,,,,,,425.79,83,,percent of total billed charges,,,,,,,,,461.7,90,,percent of total billed charges,,,461.7,90,,percent of total billed charges,,,461.7,90,,percent of total billed charges,,,461.7,90,,percent of total billed charges,,,436.05,85,,percent of total billed charges,,153.9,487.35,
INITIAL HOSPITAL CARE,99221,CDM,99221,CPT,,,both,,271,271,112.54,,,,fee schedule,,,,,,,,33.9,,,,fee schedule,,,230.35,85,,percent of total billed charges,,110.52,,,,fee schedule,,100.48,,,,fee schedule,,33.9,,,,fee schedule,,102.32,,,,fee schedule,,33.9,,,,fee schedule,,137.55,,,,fee schedule,,83.36,,,,fee schedule,,83.36,,,,fee schedule,,,246.61,91,,percent of total billed charges,,,257.45,95,,percent of total billed charges,,,224.93,83,,percent of total billed charges,,,81.3,83,,percent of total billed charges,,33.9,,,,fee schedule,,33.9,,,,fee schedule,,,224.93,83,,percent of total billed charges,,122.54,,,,fee schedule,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,230.35,85,,percent of total billed charges,,33.9,257.45,
1ST HOSP CARE PR D 50 MIN,99222,CDM,99222,CPT,,,both,,352,352,176.13,,,,fee schedule,,,,,,,,51.4,,,,fee schedule,,,299.2,85,,percent of total billed charges,,147.95,,,,fee schedule,,134.51,,,,fee schedule,,51.4,,,,fee schedule,,169.4,,,,fee schedule,,51.4,,,,fee schedule,,215.27,,,,fee schedule,,130.47,,,,fee schedule,,130.47,,,,fee schedule,,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,105.6,83,,percent of total billed charges,,51.4,,,,fee schedule,,51.4,,,,fee schedule,,,292.16,83,,percent of total billed charges,,191.78,,,,fee schedule,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,51.4,334.4,
1ST HOSP CARE PR D 70 MIN,99223,CDM,99223,CPT,,,both,,489,489,234.69,,,,fee schedule,,,,,,,,69,,,,fee schedule,,,415.65,85,,percent of total billed charges,,216.61,,,,fee schedule,,196.93,,,,fee schedule,,69,,,,fee schedule,,235.91,,,,fee schedule,,69,,,,fee schedule,,286.84,,,,fee schedule,,173.84,,,,fee schedule,,173.84,,,,fee schedule,,,444.99,91,,percent of total billed charges,,,464.55,95,,percent of total billed charges,,,405.87,83,,percent of total billed charges,,,146.7,83,,percent of total billed charges,,69,,,,fee schedule,,69,,,,fee schedule,,,405.87,83,,percent of total billed charges,,255.55,,,,fee schedule,,,440.1,90,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,440.1,90,,percent of total billed charges,,,415.65,85,,percent of total billed charges,,69,464.55,
Subsequent Observation Care 15 Minutes,99224,CDM,99224,CPT,,,both,,107,107,,,,,,,,,,,,,,,,,,,,90.95,85,,percent of total billed charges,,42.85,,,,fee schedule,,38.95,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,97.37,91,,percent of total billed charges,,,101.65,95,,percent of total billed charges,,,88.81,83,,percent of total billed charges,,,32.1,83,,percent of total billed charges,,,,,,,,,,,,,,,88.81,83,,percent of total billed charges,,,,,,,,,96.3,90,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,96.3,90,,percent of total billed charges,,,90.95,85,,percent of total billed charges,,32.1,101.65,
Subsequent Observation Care 25 Minutes,99225,CDM,99225,CPT,,,both,,179,179,,,,,,,,,,,,,,,,,,,,152.15,85,,percent of total billed charges,,77.49,,,,fee schedule,,70.45,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,53.7,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,,,,,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,53.7,170.05,
Subsequent Observation Care 35 Minutes,99226,CDM,99226,CPT,,,both,,267,267,,,,,,,,,,,,,,,,,,,,226.95,85,,percent of total billed charges,,110.21,,,,fee schedule,,100.19,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,242.97,91,,percent of total billed charges,,,253.65,95,,percent of total billed charges,,,221.61,83,,percent of total billed charges,,,80.1,83,,percent of total billed charges,,,,,,,,,,,,,,,221.61,83,,percent of total billed charges,,,,,,,,,240.3,90,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,226.95,85,,percent of total billed charges,,80.1,253.65,
SBSQ HOSP CARE PR D 15 MIN,99231,CDM,99231,CPT,,,both,,120,120,67.25,,,,fee schedule,,,,,,,,16.4,,,,fee schedule,,,102,85,,percent of total billed charges,,42.5,,,,fee schedule,,38.63,,,,fee schedule,,16.4,,,,fee schedule,,51.16,,,,fee schedule,,16.4,,,,fee schedule,,82.19,,,,fee schedule,,49.81,,,,fee schedule,,49.81,,,,fee schedule,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,36,83,,percent of total billed charges,,16.4,,,,fee schedule,,16.4,,,,fee schedule,,,99.6,83,,percent of total billed charges,,73.23,,,,fee schedule,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,16.4,114,
SBSQ HOSP CARE PR D 25 MIN,99232,CDM,99232,CPT,,,both,,188,188,107.05,,,,fee schedule,,,,,,,,24.9,,,,fee schedule,,,159.8,85,,percent of total billed charges,,77.84,,,,fee schedule,,70.76,,,,fee schedule,,24.9,,,,fee schedule,,83.56,,,,fee schedule,,24.9,,,,fee schedule,,130.84,,,,fee schedule,,79.3,,,,fee schedule,,79.3,,,,fee schedule,,,171.08,91,,percent of total billed charges,,,178.6,95,,percent of total billed charges,,,156.04,83,,percent of total billed charges,,,56.4,83,,percent of total billed charges,,24.9,,,,fee schedule,,24.9,,,,fee schedule,,,156.04,83,,percent of total billed charges,,116.57,,,,fee schedule,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,169.2,90,,percent of total billed charges,,,159.8,85,,percent of total billed charges,,24.9,178.6,
SBSQ HOSP CARE PR D 35 MIN,99233,CDM,99233,CPT,,,both,,283,283,161.03,,,,fee schedule,,,,,,,,35.05,,,,fee schedule,,,240.55,85,,percent of total billed charges,,111.81,,,,fee schedule,,101.65,,,,fee schedule,,35.05,,,,fee schedule,,118.81,,,,fee schedule,,35.05,,,,fee schedule,,196.82,,,,fee schedule,,119.28,,,,fee schedule,,119.28,,,,fee schedule,,,257.53,91,,percent of total billed charges,,,268.85,95,,percent of total billed charges,,,234.89,83,,percent of total billed charges,,,84.9,83,,percent of total billed charges,,35.05,,,,fee schedule,,35.05,,,,fee schedule,,,234.89,83,,percent of total billed charges,,175.35,,,,fee schedule,,,254.7,90,,percent of total billed charges,,,254.7,90,,percent of total billed charges,,,254.7,90,,percent of total billed charges,,,254.7,90,,percent of total billed charges,,,240.55,85,,percent of total billed charges,,35.05,268.85,
OBS/I/P HOSP CARE LOW SEVERITY,99234,CDM,99234,CPT,,,both,,361,361,133.58,,,,fee schedule,,,,,,,,69.55,,,,fee schedule,,,306.85,85,,percent of total billed charges,,142.89,,,,fee schedule,,129.9,,,,fee schedule,,69.55,,,,fee schedule,,203.51,,,,fee schedule,,69.55,,,,fee schedule,,163.27,,,,fee schedule,,98.95,,,,fee schedule,,98.95,,,,fee schedule,,,328.51,91,,percent of total billed charges,,,342.95,95,,percent of total billed charges,,,299.63,83,,percent of total billed charges,,,108.3,83,,percent of total billed charges,,69.55,,,,fee schedule,,69.55,,,,fee schedule,,,299.63,83,,percent of total billed charges,,145.46,,,,fee schedule,,,324.9,90,,percent of total billed charges,,,324.9,90,,percent of total billed charges,,,324.9,90,,percent of total billed charges,,,324.9,90,,percent of total billed charges,,,306.85,85,,percent of total billed charges,,69.55,342.95,
OBS/I/P HOSP CARE MODERATE SEVERITY,99235,CDM,99235,CPT,,,both,,488,488,215.47,,,,fee schedule,,,,,,,,76.65,,,,fee schedule,,,414.8,85,,percent of total billed charges,,180.74,,,,fee schedule,,164.32,,,,fee schedule,,76.65,,,,fee schedule,,268.31,,,,fee schedule,,76.65,,,,fee schedule,,263.35,,,,fee schedule,,159.61,,,,fee schedule,,159.61,,,,fee schedule,,,444.08,91,,percent of total billed charges,,,463.6,95,,percent of total billed charges,,,405.04,83,,percent of total billed charges,,,146.4,83,,percent of total billed charges,,76.65,,,,fee schedule,,76.65,,,,fee schedule,,,405.04,83,,percent of total billed charges,,234.62,,,,fee schedule,,,439.2,90,,percent of total billed charges,,,439.2,90,,percent of total billed charges,,,439.2,90,,percent of total billed charges,,,439.2,90,,percent of total billed charges,,,414.8,85,,percent of total billed charges,,76.65,463.6,
OBS/I/P HOSP CARE HIGH SEVERITY,99236,CDM,99236,CPT,,,both,,692,692,282.26,,,,fee schedule,,,,,,,,94.2,,,,fee schedule,,,588.2,85,,percent of total billed charges,,231.61,,,,fee schedule,,210.57,,,,fee schedule,,94.2,,,,fee schedule,,334.82,,,,fee schedule,,94.2,,,,fee schedule,,344.99,,,,fee schedule,,209.08,,,,fee schedule,,209.08,,,,fee schedule,,,629.72,91,,percent of total billed charges,,,657.4,95,,percent of total billed charges,,,574.36,83,,percent of total billed charges,,,207.6,83,,percent of total billed charges,,94.2,,,,fee schedule,,94.2,,,,fee schedule,,,574.36,83,,percent of total billed charges,,307.35,,,,fee schedule,,,622.8,90,,percent of total billed charges,,,622.8,90,,percent of total billed charges,,,622.8,90,,percent of total billed charges,,,622.8,90,,percent of total billed charges,,,588.2,85,,percent of total billed charges,,94.2,657.4,
HOSP DSCHRG D MGMT 30 MIN/<,99238,CDM,99238,CPT,,,both,,200,200,109.34,,,,fee schedule,,,,,,,,29.65,,,,fee schedule,,,170,85,,percent of total billed charges,,78.06,,,,fee schedule,,70.97,,,,fee schedule,,29.65,,,,fee schedule,,106.3,,,,fee schedule,,29.65,,,,fee schedule,,133.63,,,,fee schedule,,80.99,,,,fee schedule,,80.99,,,,fee schedule,,,182,91,,percent of total billed charges,,,190,95,,percent of total billed charges,,,166,83,,percent of total billed charges,,,60,83,,percent of total billed charges,,29.65,,,,fee schedule,,29.65,,,,fee schedule,,,166,83,,percent of total billed charges,,119.06,,,,fee schedule,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,180,90,,percent of total billed charges,,,170,85,,percent of total billed charges,,29.65,190,
HOSP DSCHRG D MGMT > 30 MIN,99239,CDM,99239,CPT,,,both,,295,295,155.08,,,,fee schedule,,,,,,,,39.05,,,,fee schedule,,,250.75,85,,percent of total billed charges,,114.07,,,,fee schedule,,103.71,,,,fee schedule,,39.05,,,,fee schedule,,144.96,,,,fee schedule,,39.05,,,,fee schedule,,189.55,,,,fee schedule,,114.88,,,,fee schedule,,114.88,,,,fee schedule,,,268.45,91,,percent of total billed charges,,,280.25,95,,percent of total billed charges,,,244.85,83,,percent of total billed charges,,,88.5,83,,percent of total billed charges,,39.05,,,,fee schedule,,39.05,,,,fee schedule,,,244.85,83,,percent of total billed charges,,168.87,,,,fee schedule,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,265.5,90,,percent of total billed charges,,,250.75,85,,percent of total billed charges,,39.05,280.25,
OFFICE CONSLTJ 15 MIN,99241,CDM,99241,CPT,,,both,,165,165,,,,,,,,,,,,,,,,,,,,140.25,85,,percent of total billed charges,,30.43,,,,fee schedule,,30.43,,,,fee schedule,,,,,,,,51.73,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,49.5,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,,,,,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,30.43,156.75,
OFFICE CONSULTATION,99241P,CDM,99241,CPT,,,both,P,112,112,,,,,,,,,,,,,,,,,,,,95.2,85,,percent of total billed charges,,30.43,,,,fee schedule,,30.43,,,,fee schedule,,,,,,,,51.73,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,101.92,91,,percent of total billed charges,,,106.4,95,,percent of total billed charges,,,92.96,83,,percent of total billed charges,,,33.6,83,,percent of total billed charges,,,,,,,,,,,,,,,92.96,83,,percent of total billed charges,,,,,,,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,95.2,85,,percent of total billed charges,,30.43,106.4,
OFFICE CONSULTATION,99241T,CDM,99241,CPT,,,both,T,53,53,,,,,,,,,,,,,,,,,,,,45.05,85,,percent of total billed charges,,30.43,,,,fee schedule,,30.43,,,,fee schedule,,,,,,,,51.73,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,15.9,51.73,
OFFICE CONSLTJ 30 MIN,99242,CDM,99242,CPT,,,both,,248,248,64.34,,,,fee schedule,,,,,,,,40.2,,,,fee schedule,,,210.8,85,,percent of total billed charges,,64.15,,,,fee schedule,,64.15,,,,fee schedule,,40.2,,,,fee schedule,,105.17,,,,fee schedule,,40.2,,,,fee schedule,,92.82,,,,fee schedule,,56.25,,,,fee schedule,,56.25,,,,fee schedule,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,74.4,83,,percent of total billed charges,,40.2,,,,fee schedule,,40.2,,,,fee schedule,,,205.84,83,,percent of total billed charges,,82.69,,,,fee schedule,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,40.2,235.6,
OFFICE CONSULTATION,99242P,CDM,99242,CPT,,,both,P,167,167,64.34,,,,fee schedule,,,,,,,,40.2,,,,fee schedule,,,141.95,85,,percent of total billed charges,,64.15,,,,fee schedule,,64.15,,,,fee schedule,,40.2,,,,fee schedule,,105.17,,,,fee schedule,,40.2,,,,fee schedule,,92.82,,,,fee schedule,,56.25,,,,fee schedule,,56.25,,,,fee schedule,,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,50.1,83,,percent of total billed charges,,40.2,,,,fee schedule,,40.2,,,,fee schedule,,,138.61,83,,percent of total billed charges,,82.69,,,,fee schedule,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,40.2,158.65,
OFFICE CONSULTATION,99242T,CDM,99242,CPT,,,both,T,81,81,64.34,,,,fee schedule,,,,,,,,40.2,,,,fee schedule,,,68.85,85,,percent of total billed charges,,64.15,,,,fee schedule,,64.15,,,,fee schedule,,40.2,,,,fee schedule,,105.17,,,,fee schedule,,40.2,,,,fee schedule,,92.82,,,,fee schedule,,56.25,,,,fee schedule,,56.25,,,,fee schedule,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,24.3,83,,percent of total billed charges,,40.2,,,,fee schedule,,40.2,,,,fee schedule,,,67.23,83,,percent of total billed charges,,82.69,,,,fee schedule,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,24.3,105.17,
OFFICE CONSLTJ 40 MIN,99243,CDM,99243,CPT,,,both,,333,333,89.4,,,,fee schedule,,,,,,,,51.3,,,,fee schedule,,,283.05,85,,percent of total billed charges,,90.45,,,,fee schedule,,90.44,,,,fee schedule,,51.3,,,,fee schedule,,140.98,,,,fee schedule,,51.3,,,,fee schedule,,146.49,,,,fee schedule,,88.78,,,,fee schedule,,88.78,,,,fee schedule,,,303.03,91,,percent of total billed charges,,,316.35,95,,percent of total billed charges,,,276.39,83,,percent of total billed charges,,,99.9,83,,percent of total billed charges,,51.3,,,,fee schedule,,51.3,,,,fee schedule,,,276.39,83,,percent of total billed charges,,130.51,,,,fee schedule,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,299.7,90,,percent of total billed charges,,,283.05,85,,percent of total billed charges,,51.3,316.35,
OFFICE CONSULTATION,99243P,CDM,99243,CPT,,,both,P,236,236,89.4,,,,fee schedule,,,,,,,,51.3,,,,fee schedule,,,200.6,85,,percent of total billed charges,,90.45,,,,fee schedule,,90.44,,,,fee schedule,,51.3,,,,fee schedule,,140.98,,,,fee schedule,,51.3,,,,fee schedule,,146.49,,,,fee schedule,,88.78,,,,fee schedule,,88.78,,,,fee schedule,,,214.76,91,,percent of total billed charges,,,224.2,95,,percent of total billed charges,,,195.88,83,,percent of total billed charges,,,70.8,83,,percent of total billed charges,,51.3,,,,fee schedule,,51.3,,,,fee schedule,,,195.88,83,,percent of total billed charges,,130.51,,,,fee schedule,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,200.6,85,,percent of total billed charges,,51.3,224.2,
OFFICE CONSULTATION,99243T,CDM,99243,CPT,,,both,T,97,97,89.4,,,,fee schedule,,,,,,,,51.3,,,,fee schedule,,,82.45,85,,percent of total billed charges,,90.45,,,,fee schedule,,90.44,,,,fee schedule,,51.3,,,,fee schedule,,140.98,,,,fee schedule,,51.3,,,,fee schedule,,146.49,,,,fee schedule,,88.78,,,,fee schedule,,88.78,,,,fee schedule,,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,29.1,83,,percent of total billed charges,,51.3,,,,fee schedule,,51.3,,,,fee schedule,,,80.51,83,,percent of total billed charges,,130.51,,,,fee schedule,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,29.1,146.49,
OFFICE CONSLTJ 60 MIN,99244,CDM,99244,CPT,,,both,,465,465,140.61,,,,fee schedule,,,,,,,,71.4,,,,fee schedule,,,395.25,85,,percent of total billed charges,,144.37,,,,fee schedule,,144.37,,,,fee schedule,,71.4,,,,fee schedule,,208.06,,,,fee schedule,,71.4,,,,fee schedule,,223.66,,,,fee schedule,,135.55,,,,fee schedule,,135.55,,,,fee schedule,,,423.15,91,,percent of total billed charges,,,441.75,95,,percent of total billed charges,,,385.95,83,,percent of total billed charges,,,139.5,83,,percent of total billed charges,,71.4,,,,fee schedule,,71.4,,,,fee schedule,,,385.95,83,,percent of total billed charges,,199.26,,,,fee schedule,,,418.5,90,,percent of total billed charges,,,418.5,90,,percent of total billed charges,,,418.5,90,,percent of total billed charges,,,418.5,90,,percent of total billed charges,,,395.25,85,,percent of total billed charges,,71.4,441.75,
OFFICE CONSULTATION,99244P,CDM,99244,CPT,,,both,P,327,327,140.61,,,,fee schedule,,,,,,,,71.4,,,,fee schedule,,,277.95,85,,percent of total billed charges,,144.37,,,,fee schedule,,144.37,,,,fee schedule,,71.4,,,,fee schedule,,208.06,,,,fee schedule,,71.4,,,,fee schedule,,223.66,,,,fee schedule,,135.55,,,,fee schedule,,135.55,,,,fee schedule,,,297.57,91,,percent of total billed charges,,,310.65,95,,percent of total billed charges,,,271.41,83,,percent of total billed charges,,,98.1,83,,percent of total billed charges,,71.4,,,,fee schedule,,71.4,,,,fee schedule,,,271.41,83,,percent of total billed charges,,199.26,,,,fee schedule,,,294.3,90,,percent of total billed charges,,,294.3,90,,percent of total billed charges,,,294.3,90,,percent of total billed charges,,,294.3,90,,percent of total billed charges,,,277.95,85,,percent of total billed charges,,71.4,310.65,
OFFICE CONSULTATION,99244T,CDM,99244,CPT,,,both,T,138,138,140.61,,,,fee schedule,,,,,,,,71.4,,,,fee schedule,,,117.3,85,,percent of total billed charges,,144.37,,,,fee schedule,,144.37,,,,fee schedule,,71.4,,,,fee schedule,,208.06,,,,fee schedule,,71.4,,,,fee schedule,,223.66,,,,fee schedule,,135.55,,,,fee schedule,,135.55,,,,fee schedule,,,125.58,91,,percent of total billed charges,,,131.1,95,,percent of total billed charges,,,114.54,83,,percent of total billed charges,,,41.4,83,,percent of total billed charges,,71.4,,,,fee schedule,,71.4,,,,fee schedule,,,114.54,83,,percent of total billed charges,,199.26,,,,fee schedule,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,124.2,90,,percent of total billed charges,,,117.3,85,,percent of total billed charges,,41.4,223.66,
OFFICE CONSLTJ 80 MIN,99245,CDM,99245,CPT,,,both,,580,580,201.95,,,,fee schedule,,,,,,,,92.8,,,,fee schedule,,,493,85,,percent of total billed charges,,178.84,,,,fee schedule,,178.84,,,,fee schedule,,92.8,,,,fee schedule,,276.84,,,,fee schedule,,92.8,,,,fee schedule,,299.14,,,,fee schedule,,181.3,,,,fee schedule,,181.3,,,,fee schedule,,,527.8,91,,percent of total billed charges,,,551,95,,percent of total billed charges,,,481.4,83,,percent of total billed charges,,,174,83,,percent of total billed charges,,92.8,,,,fee schedule,,92.8,,,,fee schedule,,,481.4,83,,percent of total billed charges,,266.51,,,,fee schedule,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,522,90,,percent of total billed charges,,,493,85,,percent of total billed charges,,92.8,551,
OFFICE CONSULTATION,99245P,CDM,99245,CPT,,,both,P,413,413,201.95,,,,fee schedule,,,,,,,,92.8,,,,fee schedule,,,351.05,85,,percent of total billed charges,,178.84,,,,fee schedule,,178.84,,,,fee schedule,,92.8,,,,fee schedule,,276.84,,,,fee schedule,,92.8,,,,fee schedule,,299.14,,,,fee schedule,,181.3,,,,fee schedule,,181.3,,,,fee schedule,,,375.83,91,,percent of total billed charges,,,392.35,95,,percent of total billed charges,,,342.79,83,,percent of total billed charges,,,123.9,83,,percent of total billed charges,,92.8,,,,fee schedule,,92.8,,,,fee schedule,,,342.79,83,,percent of total billed charges,,266.51,,,,fee schedule,,,371.7,90,,percent of total billed charges,,,371.7,90,,percent of total billed charges,,,371.7,90,,percent of total billed charges,,,371.7,90,,percent of total billed charges,,,351.05,85,,percent of total billed charges,,92.8,392.35,
OFFICE CONSULTATION,99245T,CDM,99245,CPT,,,both,T,167,167,201.95,,,,fee schedule,,,,,,,,92.8,,,,fee schedule,,,141.95,85,,percent of total billed charges,,178.84,,,,fee schedule,,178.84,,,,fee schedule,,92.8,,,,fee schedule,,276.84,,,,fee schedule,,92.8,,,,fee schedule,,299.14,,,,fee schedule,,181.3,,,,fee schedule,,181.3,,,,fee schedule,,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,50.1,83,,percent of total billed charges,,92.8,,,,fee schedule,,92.8,,,,fee schedule,,,138.61,83,,percent of total billed charges,,266.51,,,,fee schedule,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,50.1,299.14,
1ST INPT CONSLTJ 20 MIN,99251,CDM,99251,CPT,,,both,,206,206,,,,,,,,,,,,,,,,,,,,175.1,85,,percent of total billed charges,,53.66,,,,fee schedule,,48.79,,,,fee schedule,,,,,,,,54,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,61.8,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,48.79,195.7,
1ST INPT CONSLTJ 40 MIN,99252,CDM,99252,CPT,,,both,,272,272,68.94,,,,fee schedule,,,,,,,,33.95,,,,fee schedule,,,231.2,85,,percent of total billed charges,,80.76,,,,fee schedule,,73.42,,,,fee schedule,,33.95,,,,fee schedule,,108.58,,,,fee schedule,,33.95,,,,fee schedule,,118.54,,,,fee schedule,,71.84,,,,fee schedule,,71.84,,,,fee schedule,,,247.52,91,,percent of total billed charges,,,258.4,95,,percent of total billed charges,,,225.76,83,,percent of total billed charges,,,81.6,83,,percent of total billed charges,,33.95,,,,fee schedule,,33.95,,,,fee schedule,,,225.76,83,,percent of total billed charges,,105.61,,,,fee schedule,,,244.8,90,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,244.8,90,,percent of total billed charges,,,231.2,85,,percent of total billed charges,,33.95,258.4,
1ST INPT CONSLTJ 55 MIN,99253,CDM,99253,CPT,,,both,,360,360,104.53,,,,fee schedule,,,,,,,,46.45,,,,fee schedule,,,306,85,,percent of total billed charges,,125.6,,,,fee schedule,,114.19,,,,fee schedule,,46.45,,,,fee schedule,,148.37,,,,fee schedule,,46.45,,,,fee schedule,,165.51,,,,fee schedule,,100.31,,,,fee schedule,,100.31,,,,fee schedule,,,327.6,91,,percent of total billed charges,,,342,95,,percent of total billed charges,,,298.8,83,,percent of total billed charges,,,108,83,,percent of total billed charges,,46.45,,,,fee schedule,,46.45,,,,fee schedule,,,298.8,83,,percent of total billed charges,,147.45,,,,fee schedule,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,324,90,,percent of total billed charges,,,306,85,,percent of total billed charges,,46.45,342,
1ST INPT CONSLTJ 80 MIN,99254,CDM,99254,CPT,,,both,,469,469,150.25,,,,fee schedule,,,,,,,,66.4,,,,fee schedule,,,398.65,85,,percent of total billed charges,,180.66,,,,fee schedule,,164.25,,,,fee schedule,,66.4,,,,fee schedule,,213.17,,,,fee schedule,,66.4,,,,fee schedule,,230.37,,,,fee schedule,,139.62,,,,fee schedule,,139.62,,,,fee schedule,,,426.79,91,,percent of total billed charges,,,445.55,95,,percent of total billed charges,,,389.27,83,,percent of total billed charges,,,140.7,83,,percent of total billed charges,,66.4,,,,fee schedule,,66.4,,,,fee schedule,,,389.27,83,,percent of total billed charges,,205.23,,,,fee schedule,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,422.1,90,,percent of total billed charges,,,398.65,85,,percent of total billed charges,,66.4,445.55,
1ST INPT CONSLTJ 110 MIN,99255,CDM,99255,CPT,,,both,,604,604,187.25,,,,fee schedule,,,,,,,,87.1,,,,fee schedule,,,513.4,85,,percent of total billed charges,,218.89,,,,fee schedule,,199.01,,,,fee schedule,,87.1,,,,fee schedule,,293.9,,,,fee schedule,,87.1,,,,fee schedule,,308.64,,,,fee schedule,,187.06,,,,fee schedule,,187.06,,,,fee schedule,,,549.64,91,,percent of total billed charges,,,573.8,95,,percent of total billed charges,,,501.32,83,,percent of total billed charges,,,181.2,83,,percent of total billed charges,,87.1,,,,fee schedule,,87.1,,,,fee schedule,,,501.32,83,,percent of total billed charges,,274.97,,,,fee schedule,,,543.6,90,,percent of total billed charges,,,543.6,90,,percent of total billed charges,,,543.6,90,,percent of total billed charges,,,543.6,90,,percent of total billed charges,,,513.4,85,,percent of total billed charges,,87.1,573.8,
EMER DEPT SELF LIMITED/MINOR,99281,CDM,99281,CPT,,,both,,137,137,16.01,,,,fee schedule,,,,,,,,14.35,,,,fee schedule,,,116.45,85,,percent of total billed charges,,28.33,,,,fee schedule,,23,,,,fee schedule,,14.35,,,,fee schedule,,25.01,,,,fee schedule,,14.35,,,,fee schedule,,19.57,,,,fee schedule,,11.86,,,,fee schedule,,11.86,,,,fee schedule,,,124.67,91,,percent of total billed charges,,,130.15,95,,percent of total billed charges,,,113.71,83,,percent of total billed charges,,,41.1,83,,percent of total billed charges,,14.35,,,,fee schedule,,14.35,,,,fee schedule,,,113.71,83,,percent of total billed charges,,17.43,,,,fee schedule,,,123.3,90,,percent of total billed charges,,,123.3,90,,percent of total billed charges,,,123.3,90,,percent of total billed charges,,,123.3,90,,percent of total billed charges,,,116.45,85,,percent of total billed charges,,11.86,130.15,
EMER DEPT LOW TO MODERATE SEVERITY,99282,CDM,99282,CPT,,,both,,239,239,56.73,,,,fee schedule,,,,,,,,24.2,,,,fee schedule,,,203.15,85,,percent of total billed charges,,56.22,,,,fee schedule,,44.6,,,,fee schedule,,24.2,,,,fee schedule,,41.5,,,,fee schedule,,24.2,,,,fee schedule,,69.33,,,,fee schedule,,42.02,,,,fee schedule,,42.02,,,,fee schedule,,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,71.7,83,,percent of total billed charges,,24.2,,,,fee schedule,,24.2,,,,fee schedule,,,198.37,83,,percent of total billed charges,,61.77,,,,fee schedule,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,24.2,227.05,
EMER DEPT MODERATE SEVERITY,99283,CDM,99283,CPT,,,both,,477,477,97.44,,,,fee schedule,,,,,,,,32.2,,,,fee schedule,,,405.45,85,,percent of total billed charges,,91.9,,,,fee schedule,,76.04,,,,fee schedule,,32.2,,,,fee schedule,,93.23,,,,fee schedule,,32.2,,,,fee schedule,,119.1,,,,fee schedule,,72.18,,,,fee schedule,,72.18,,,,fee schedule,,,434.07,91,,percent of total billed charges,,,453.15,95,,percent of total billed charges,,,395.91,83,,percent of total billed charges,,,143.1,83,,percent of total billed charges,,32.2,,,,fee schedule,,32.2,,,,fee schedule,,,395.91,83,,percent of total billed charges,,106.1,,,,fee schedule,,,429.3,90,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,429.3,90,,percent of total billed charges,,,405.45,85,,percent of total billed charges,,32.2,453.15,
EMER DEPT HI SEVERITY/URGENT EVAL,99284,CDM,99284,CPT,,,both,,828,828,163.78,,,,fee schedule,,,,,,,,44,,,,fee schedule,,,703.8,85,,percent of total billed charges,,168.55,,,,fee schedule,,128.19,,,,fee schedule,,44,,,,fee schedule,,145.53,,,,fee schedule,,44,,,,fee schedule,,200.17,,,,fee schedule,,121.32,,,,fee schedule,,121.32,,,,fee schedule,,,753.48,91,,percent of total billed charges,,,786.6,95,,percent of total billed charges,,,687.24,83,,percent of total billed charges,,,248.4,83,,percent of total billed charges,,44,,,,fee schedule,,44,,,,fee schedule,,,687.24,83,,percent of total billed charges,,178.33,,,,fee schedule,,,745.2,90,,percent of total billed charges,,,745.2,90,,percent of total billed charges,,,745.2,90,,percent of total billed charges,,,745.2,90,,percent of total billed charges,,,703.8,85,,percent of total billed charges,,44,786.6,
EMER DEPT HIGH SEVERITY/THREAT FUNCJ,99285,CDM,99285,CPT,,,both,,1296,1296,238.35,,,,fee schedule,,,,,,,,69.25,,,,fee schedule,,,1101.6,85,,percent of total billed charges,,248.25,,,,fee schedule,,186.37,,,,fee schedule,,69.25,,,,fee schedule,,227.95,,,,fee schedule,,69.25,,,,fee schedule,,291.31,,,,fee schedule,,176.55,,,,fee schedule,,176.55,,,,fee schedule,,,1179.36,91,,percent of total billed charges,,,1231.2,95,,percent of total billed charges,,,1075.68,83,,percent of total billed charges,,,388.8,83,,percent of total billed charges,,69.25,,,,fee schedule,,69.25,,,,fee schedule,,,1075.68,83,,percent of total billed charges,,259.53,,,,fee schedule,,,1166.4,90,,percent of total billed charges,,,1166.4,90,,percent of total billed charges,,,1166.4,90,,percent of total billed charges,,,1166.4,90,,percent of total billed charges,,,1101.6,85,,percent of total billed charges,,69.25,1231.2,
CC E/M CRITICALLY ILL/INJURED 1ST 30-74 MIN,99291,CDM,99291,CPT,,,both,,923,923,288.67,,,,fee schedule,,,,,,,,84.9,,,,fee schedule,,,784.55,85,,percent of total billed charges,,241.01,,,,fee schedule,,219.12,,,,fee schedule,,84.9,,,,fee schedule,,311.52,,,,fee schedule,,84.9,,,,fee schedule,,352.82,,,,fee schedule,,213.83,,,,fee schedule,,213.83,,,,fee schedule,,,839.93,91,,percent of total billed charges,,,876.85,95,,percent of total billed charges,,,766.09,83,,percent of total billed charges,,,276.9,83,,percent of total billed charges,,84.9,,,,fee schedule,,84.9,,,,fee schedule,,,766.09,83,,percent of total billed charges,,314.33,,,,fee schedule,,,830.7,90,,percent of total billed charges,,,830.7,90,,percent of total billed charges,,,830.7,90,,percent of total billed charges,,,830.7,90,,percent of total billed charges,,,784.55,85,,percent of total billed charges,,84.9,876.85,
CC E/M CRITICALLY ILL/INJURED EA 30 MIN,99292,CDM,99292,CPT,,,both,,506,506,145.02,,,,fee schedule,,,,,,,,42.35,,,,fee schedule,,,430.1,85,,percent of total billed charges,,121.08,,,,fee schedule,,110.08,,,,fee schedule,,42.35,,,,fee schedule,,155.76,,,,fee schedule,,42.35,,,,fee schedule,,177.25,,,,fee schedule,,107.42,,,,fee schedule,,107.42,,,,fee schedule,,,460.46,91,,percent of total billed charges,,,480.7,95,,percent of total billed charges,,,419.98,83,,percent of total billed charges,,,151.8,83,,percent of total billed charges,,42.35,,,,fee schedule,,42.35,,,,fee schedule,,,419.98,83,,percent of total billed charges,,157.91,,,,fee schedule,,,455.4,90,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,455.4,90,,percent of total billed charges,,,430.1,85,,percent of total billed charges,,42.35,480.7,
1ST NF CARE PR D E/M LW SEVERITY,99304,CDM,99304,CPT,,,both,,202,202,108.88,,,,fee schedule,,,,,,,,27.55,,,,fee schedule,,,171.7,85,,percent of total billed charges,,120.27,,,,fee schedule,,90.4,,,,fee schedule,,27.55,,,,fee schedule,,,,,,,,27.55,,,,fee schedule,,133.08,,,,fee schedule,,80.65,,,,fee schedule,,80.65,,,,fee schedule,,,183.82,91,,percent of total billed charges,,,191.9,95,,percent of total billed charges,,,167.66,83,,percent of total billed charges,,,60.6,83,,percent of total billed charges,,27.55,,,,fee schedule,,27.55,,,,fee schedule,,,167.66,83,,percent of total billed charges,,118.56,,,,fee schedule,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,171.7,85,,percent of total billed charges,,27.55,191.9,
1ST NF CARE PR D E/M MOD SEVERITY,99305,CDM,99305,CPT,,,both,,267,267,180.25,,,,fee schedule,,,,,,,,36.1,,,,fee schedule,,,226.95,85,,percent of total billed charges,,173.31,,,,fee schedule,,130.27,,,,fee schedule,,36.1,,,,fee schedule,,,,,,,,36.1,,,,fee schedule,,220.3,,,,fee schedule,,133.52,,,,fee schedule,,133.52,,,,fee schedule,,,242.97,91,,percent of total billed charges,,,253.65,95,,percent of total billed charges,,,221.61,83,,percent of total billed charges,,,80.1,83,,percent of total billed charges,,36.1,,,,fee schedule,,36.1,,,,fee schedule,,,221.61,83,,percent of total billed charges,,196.27,,,,fee schedule,,,240.3,90,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,240.3,90,,percent of total billed charges,,,226.95,85,,percent of total billed charges,,36.1,253.65,
1ST NF CARE PR D E/M HI SEVERITY,99306,CDM,99306,CPT,,,both,,331,331,246.12,,,,fee schedule,,,,,,,,47.7,,,,fee schedule,,,281.35,85,,percent of total billed charges,,218.43,,,,fee schedule,,167.48,,,,fee schedule,,47.7,,,,fee schedule,,,,,,,,47.7,,,,fee schedule,,300.82,,,,fee schedule,,182.31,,,,fee schedule,,182.31,,,,fee schedule,,,301.21,91,,percent of total billed charges,,,314.45,95,,percent of total billed charges,,,274.73,83,,percent of total billed charges,,,99.3,83,,percent of total billed charges,,47.7,,,,fee schedule,,47.7,,,,fee schedule,,,274.73,83,,percent of total billed charges,,268,,,,fee schedule,,,297.9,90,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,297.9,90,,percent of total billed charges,,,281.35,85,,percent of total billed charges,,47.7,314.45,
SBSQ NF CARE PR D E/M STABLE,99307,CDM,99307,CPT,,,both,,100,100,53.52,,,,fee schedule,,,,,,,,14.8,,,,fee schedule,,,85,85,,percent of total billed charges,,59.91,,,,fee schedule,,44.15,,,,fee schedule,,14.8,,,,fee schedule,,,,,,,,14.8,,,,fee schedule,,65.42,,,,fee schedule,,39.65,,,,fee schedule,,39.65,,,,fee schedule,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,30,83,,percent of total billed charges,,14.8,,,,fee schedule,,14.8,,,,fee schedule,,,83,83,,percent of total billed charges,,58.28,,,,fee schedule,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,14.8,95,
SBSQ NF CARE PR D E/M MINOR COMPLCTJ,99308,CDM,99308,CPT,,,both,,149,149,100.64,,,,fee schedule,,,,,,,,18.91,,,,fee schedule,,,126.65,85,,percent of total billed charges,,92.97,,,,fee schedule,,69.7,,,,fee schedule,,18.91,,,,fee schedule,,,,,,,,18.91,,,,fee schedule,,123.01,,,,fee schedule,,74.55,,,,fee schedule,,74.55,,,,fee schedule,,,135.59,91,,percent of total billed charges,,,141.55,95,,percent of total billed charges,,,123.67,83,,percent of total billed charges,,,44.7,83,,percent of total billed charges,,18.91,,,,fee schedule,,18.91,,,,fee schedule,,,123.67,83,,percent of total billed charges,,109.59,,,,fee schedule,,,134.1,90,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,134.1,90,,percent of total billed charges,,,126.65,85,,percent of total billed charges,,18.91,141.55,
SBSQ NF CARE PR D E/M NEW PROBLEM,99309,CDM,99309,CPT,,,both,,194,194,144.11,,,,fee schedule,,,,,,,,23.4,,,,fee schedule,,,164.9,85,,percent of total billed charges,,122.26,,,,fee schedule,,91.66,,,,fee schedule,,23.4,,,,fee schedule,,,,,,,,23.4,,,,fee schedule,,176.13,,,,fee schedule,,106.74,,,,fee schedule,,106.74,,,,fee schedule,,,176.54,91,,percent of total billed charges,,,184.3,95,,percent of total billed charges,,,161.02,83,,percent of total billed charges,,,58.2,83,,percent of total billed charges,,23.4,,,,fee schedule,,23.4,,,,fee schedule,,,161.02,83,,percent of total billed charges,,156.91,,,,fee schedule,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,174.6,90,,percent of total billed charges,,,164.9,85,,percent of total billed charges,,23.4,184.3,
SBSQ NF CARE PR D E/M UNSTABLE/NEW PROBLEM,99310,CDM,99310,CPT,,,both,,277,277,207.24,,,,fee schedule,,,,,,,,32.05,,,,fee schedule,,,235.45,85,,percent of total billed charges,,182.79,,,,fee schedule,,135.18,,,,fee schedule,,32.05,,,,fee schedule,,,,,,,,32.05,,,,fee schedule,,253.29,,,,fee schedule,,153.51,,,,fee schedule,,153.51,,,,fee schedule,,,252.07,91,,percent of total billed charges,,,263.15,95,,percent of total billed charges,,,229.91,83,,percent of total billed charges,,,83.1,83,,percent of total billed charges,,32.05,,,,fee schedule,,32.05,,,,fee schedule,,,229.91,83,,percent of total billed charges,,225.66,,,,fee schedule,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,235.45,85,,percent of total billed charges,,32.05,263.15,
NF DSCHRG D MGMT 30 MIN/<,99315,CDM,99315,CPT,,,both,,159,159,110.25,,,,fee schedule,,,,,,,,26.55,,,,fee schedule,,,135.15,85,,percent of total billed charges,,79.56,,,,fee schedule,,73.35,,,,fee schedule,,26.55,,,,fee schedule,,92.66,,,,fee schedule,,26.55,,,,fee schedule,,134.75,,,,fee schedule,,81.67,,,,fee schedule,,81.67,,,,fee schedule,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,47.7,83,,percent of total billed charges,,26.55,,,,fee schedule,,26.55,,,,fee schedule,,,131.97,83,,percent of total billed charges,,120.05,,,,fee schedule,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,26.55,151.05,
NF DSCHRG D MGMT > 30 MIN,99316,CDM,99316,CPT,,,both,,236,236,177.5,,,,fee schedule,,,,,,,,34,,,,fee schedule,,,200.6,85,,percent of total billed charges,,113.85,,,,fee schedule,,104.98,,,,fee schedule,,34,,,,fee schedule,,122.79,,,,fee schedule,,34,,,,fee schedule,,216.95,,,,fee schedule,,131.48,,,,fee schedule,,131.48,,,,fee schedule,,,214.76,91,,percent of total billed charges,,,224.2,95,,percent of total billed charges,,,195.88,83,,percent of total billed charges,,,70.8,83,,percent of total billed charges,,34,,,,fee schedule,,34,,,,fee schedule,,,195.88,83,,percent of total billed charges,,193.28,,,,fee schedule,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,212.4,90,,percent of total billed charges,,,200.6,85,,percent of total billed charges,,34,224.2,
E/M PT INVG ANNUAL NF ASSMT,99318,CDM,99318,CPT,,,both,,204,204,,,,,,,,,,,,,,,,,,,,173.4,85,,percent of total billed charges,,128.79,,,,fee schedule,,96.52,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,185.64,91,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,61.2,83,,percent of total billed charges,,,,,,,,,,,,,,,169.32,83,,percent of total billed charges,,,,,,,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,173.4,85,,percent of total billed charges,,61.2,193.8,
DOM/R-HOME LW SEVERITY,99324,CDM,99324,CPT,,,both,,113,113,,,,,,,,,,,,,,,,,,,,96.05,85,,percent of total billed charges,,69.31,,,,fee schedule,,54.76,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,33.9,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,,,,,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,33.9,107.35,
DOM/R-HOME E/M NEW PT MOD SEVERITY,99325,CDM,99325,CPT,,,both,,161,161,,,,,,,,,,,,,,,,,,,,136.85,85,,percent of total billed charges,,104.78,,,,fee schedule,,80.33,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,48.3,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,,,,,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,48.3,152.95,
DOM/R-HOME E/M NEW PT MOD HI SEVERITY,99326,CDM,99326,CPT,,,both,,255,255,,,,,,,,,,,,,,,,,,,,216.75,85,,percent of total billed charges,,181.06,,,,fee schedule,,138.82,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,76.5,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,,,,,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,76.5,242.25,
DOM/R-HOME E/M NEW PT HI SEVERITY,99327,CDM,99327,CPT,,,both,,332,332,,,,,,,,,,,,,,,,,,,,282.2,85,,percent of total billed charges,,241.81,,,,fee schedule,,187.08,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,302.12,91,,percent of total billed charges,,,315.4,95,,percent of total billed charges,,,275.56,83,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,,,,,,,,,,,,,275.56,83,,percent of total billed charges,,,,,,,,,298.8,90,,percent of total billed charges,,,298.8,90,,percent of total billed charges,,,298.8,90,,percent of total billed charges,,,298.8,90,,percent of total billed charges,,,282.2,85,,percent of total billed charges,,99.6,315.4,
DOM/R-HOME E/M NEW PT SIGNIFICANT NEW PROBLEM,99328,CDM,99328,CPT,,,both,,352,352,,,,,,,,,,,,,,,,,,,,299.2,85,,percent of total billed charges,,278.87,,,,fee schedule,,220.33,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,320.32,91,,percent of total billed charges,,,334.4,95,,percent of total billed charges,,,292.16,83,,percent of total billed charges,,,105.6,83,,percent of total billed charges,,,,,,,,,,,,,,,292.16,83,,percent of total billed charges,,,,,,,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,316.8,90,,percent of total billed charges,,,299.2,85,,percent of total billed charges,,105.6,334.4,
DOM/R-HOME E/M EST PT SELF-LMTD/MINOR,99334,CDM,99334,CPT,,,both,,113,113,,,,,,,,,,,,,,,,,,,,96.05,85,,percent of total billed charges,,77.67,,,,fee schedule,,61.36,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,33.9,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,,,,,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,33.9,107.35,
DOM/R-HOME E/M EST PT LW MOD SEVERITY,99335,CDM,99335,CPT,,,both,,176,176,,,,,,,,,,,,,,,,,,,,149.6,85,,percent of total billed charges,,122.61,,,,fee schedule,,96.45,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,160.16,91,,percent of total billed charges,,,167.2,95,,percent of total billed charges,,,146.08,83,,percent of total billed charges,,,52.8,83,,percent of total billed charges,,,,,,,,,,,,,,,146.08,83,,percent of total billed charges,,,,,,,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,158.4,90,,percent of total billed charges,,,149.6,85,,percent of total billed charges,,52.8,167.2,
DOM/R-HOME E/M EST PT MOD HI SEVERITY,99336,CDM,99336,CPT,,,both,,237,237,,,,,,,,,,,,,,,,,,,,201.45,85,,percent of total billed charges,,173.52,,,,fee schedule,,136.51,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,215.67,91,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,71.1,83,,percent of total billed charges,,,,,,,,,,,,,,,196.71,83,,percent of total billed charges,,,,,,,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,71.1,225.15,
DOM/R-HOME E/M EST PT SIGNIFICANT NEW PROBLEM,99337,CDM,99337,CPT,,,both,,304,304,,,,,,,,,,,,,,,,,,,,258.4,85,,percent of total billed charges,,234.15,,,,fee schedule,,195.84,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,276.64,91,,percent of total billed charges,,,288.8,95,,percent of total billed charges,,,252.32,83,,percent of total billed charges,,,91.2,83,,percent of total billed charges,,,,,,,,,,,,,,,252.32,83,,percent of total billed charges,,,,,,,,,273.6,90,,percent of total billed charges,,,273.6,90,,percent of total billed charges,,,273.6,90,,percent of total billed charges,,,273.6,90,,percent of total billed charges,,,258.4,85,,percent of total billed charges,,91.2,288.8,
INDIV PHYS SUPVJ HOME/DOM/R-HOME MO 15-29 MIN,99339,CDM,99339,CPT,,,both,,324,324,,,,,,,,,,,,,,,,,,,,275.4,85,,percent of total billed charges,,92.8,,,,fee schedule,,77.61,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,294.84,91,,percent of total billed charges,,,307.8,95,,percent of total billed charges,,,268.92,83,,percent of total billed charges,,,97.2,83,,percent of total billed charges,,,,,,,,,,,,,,,268.92,83,,percent of total billed charges,,,,,,,,,291.6,90,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,291.6,90,,percent of total billed charges,,,275.4,85,,percent of total billed charges,,77.61,307.8,
INDIV PHYS SUPVJ HOME/DOM/R-HOME MO 30 MIN/>,99340,CDM,99340,CPT,,,both,,209,209,,,,,,,,,,,,,,,,,,,,177.65,85,,percent of total billed charges,,130.19,,,,fee schedule,,108.88,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,190.19,91,,percent of total billed charges,,,198.55,95,,percent of total billed charges,,,173.47,83,,percent of total billed charges,,,62.7,83,,percent of total billed charges,,,,,,,,,,,,,,,173.47,83,,percent of total billed charges,,,,,,,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,188.1,90,,percent of total billed charges,,,177.65,85,,percent of total billed charges,,62.7,198.55,
HOME VST NEW PT MOD SEVERITY,99342,CDM,99342,CPT,,,both,,384,384,105.22,,,,fee schedule,,,,,,,,37.4,,,,fee schedule,,,326.4,85,,percent of total billed charges,,106.23,,,,fee schedule,,78.27,,,,fee schedule,,37.4,,,,fee schedule,,129.04,,,,fee schedule,,37.4,,,,fee schedule,,128.6,,,,fee schedule,,77.94,,,,fee schedule,,77.94,,,,fee schedule,,,349.44,91,,percent of total billed charges,,,364.8,95,,percent of total billed charges,,,318.72,83,,percent of total billed charges,,,115.2,83,,percent of total billed charges,,37.4,,,,fee schedule,,37.4,,,,fee schedule,,,318.72,83,,percent of total billed charges,,114.57,,,,fee schedule,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,345.6,90,,percent of total billed charges,,,326.4,85,,percent of total billed charges,,37.4,364.8,
HOME VST NEW PT MOD TO HI SEVERITY,99343,CDM,99343,CPT,,,both,,707,707,,,,,,,,,,,,,,,,,,,,600.95,85,,percent of total billed charges,,169.43,,,,fee schedule,,127.37,,,,fee schedule,,,,,,,,188.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,643.37,91,,percent of total billed charges,,,671.65,95,,percent of total billed charges,,,586.81,83,,percent of total billed charges,,,212.1,83,,percent of total billed charges,,,,,,,,,,,,,,,586.81,83,,percent of total billed charges,,,,,,,,,636.3,90,,percent of total billed charges,,,636.3,90,,percent of total billed charges,,,636.3,90,,percent of total billed charges,,,636.3,90,,percent of total billed charges,,,600.95,85,,percent of total billed charges,,127.37,671.65,
HOME VST NEW PT HI SEVERITY,99344,CDM,99344,CPT,,,both,,391,391,194.43,,,,fee schedule,,,,,,,,70.55,,,,fee schedule,,,332.35,85,,percent of total billed charges,,241.7,,,,fee schedule,,183.09,,,,fee schedule,,70.55,,,,fee schedule,,246.71,,,,fee schedule,,70.55,,,,fee schedule,,237.63,,,,fee schedule,,144.02,,,,fee schedule,,144.02,,,,fee schedule,,,355.81,91,,percent of total billed charges,,,371.45,95,,percent of total billed charges,,,324.53,83,,percent of total billed charges,,,117.3,83,,percent of total billed charges,,70.55,,,,fee schedule,,70.55,,,,fee schedule,,,324.53,83,,percent of total billed charges,,211.71,,,,fee schedule,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,351.9,90,,percent of total billed charges,,,332.35,85,,percent of total billed charges,,70.55,371.45,
HOME VST NEW PT UNSTABLE/SIGNIFICANT NEW PROBLEM,99345,CDM,99345,CPT,,,both,,454,454,273.57,,,,fee schedule,,,,,,,,85.55,,,,fee schedule,,,385.9,85,,percent of total billed charges,,289.46,,,,fee schedule,,221.93,,,,fee schedule,,85.55,,,,fee schedule,,305.26,,,,fee schedule,,85.55,,,,fee schedule,,334.37,,,,fee schedule,,202.65,,,,fee schedule,,202.65,,,,fee schedule,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,85.55,,,,fee schedule,,85.55,,,,fee schedule,,,376.82,83,,percent of total billed charges,,297.89,,,,fee schedule,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,85.55,431.3,
HOME VST EST PT SELF LIMITED/MINOR,99347,CDM,99347,CPT,,,both,,120,120,60.39,,,,fee schedule,,,,,,,,24.25,,,,fee schedule,,,102,85,,percent of total billed charges,,73.9,,,,fee schedule,,55.38,,,,fee schedule,,24.25,,,,fee schedule,,68.22,,,,fee schedule,,24.25,,,,fee schedule,,73.81,,,,fee schedule,,44.73,,,,fee schedule,,44.73,,,,fee schedule,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,36,83,,percent of total billed charges,,24.25,,,,fee schedule,,24.25,,,,fee schedule,,,99.6,83,,percent of total billed charges,,65.75,,,,fee schedule,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,24.25,114,
HOME VST EST PT LOW TO MOD SEVERITY,99348,CDM,99348,CPT,,,both,,202,202,102.93,,,,fee schedule,,,,,,,,31.3,,,,fee schedule,,,171.7,85,,percent of total billed charges,,111.41,,,,fee schedule,,84.39,,,,fee schedule,,31.3,,,,fee schedule,,108.01,,,,fee schedule,,31.3,,,,fee schedule,,125.81,,,,fee schedule,,76.25,,,,fee schedule,,76.25,,,,fee schedule,,,183.82,91,,percent of total billed charges,,,191.9,95,,percent of total billed charges,,,167.66,83,,percent of total billed charges,,,60.6,83,,percent of total billed charges,,31.3,,,,fee schedule,,31.3,,,,fee schedule,,,167.66,83,,percent of total billed charges,,112.08,,,,fee schedule,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,171.7,85,,percent of total billed charges,,31.3,191.9,
HOME VST EST PT MOD TO HI SEVERITY,99349,CDM,99349,CPT,,,both,,237,237,172.47,,,,fee schedule,,,,,,,,47.5,,,,fee schedule,,,201.45,85,,percent of total billed charges,,169.4,,,,fee schedule,,129.88,,,,fee schedule,,47.5,,,,fee schedule,,167.13,,,,fee schedule,,47.5,,,,fee schedule,,210.8,,,,fee schedule,,127.75,,,,fee schedule,,127.75,,,,fee schedule,,,215.67,91,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,71.1,83,,percent of total billed charges,,47.5,,,,fee schedule,,47.5,,,,fee schedule,,,196.71,83,,percent of total billed charges,,187.8,,,,fee schedule,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,47.5,225.15,
HOME VST EST PT UNSTABLE/SIGNIFICANT NEW PROBLEM,99350,CDM,99350,CPT,,,both,,311,311,251.61,,,,fee schedule,,,,,,,,68.85,,,,fee schedule,,,264.35,85,,percent of total billed charges,,235.52,,,,fee schedule,,180.58,,,,fee schedule,,68.85,,,,fee schedule,,246.71,,,,fee schedule,,68.85,,,,fee schedule,,307.53,,,,fee schedule,,186.38,,,,fee schedule,,186.38,,,,fee schedule,,,283.01,91,,percent of total billed charges,,,295.45,95,,percent of total billed charges,,,258.13,83,,percent of total billed charges,,,93.3,83,,percent of total billed charges,,68.85,,,,fee schedule,,68.85,,,,fee schedule,,,258.13,83,,percent of total billed charges,,273.98,,,,fee schedule,,,279.9,90,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,279.9,90,,percent of total billed charges,,,264.35,85,,percent of total billed charges,,68.85,307.53,
"PROLONGED SERVICE, OFFICE",99354,CDM,99354,CPT,,,both,,271,271,,,,,,,,,,,,,,,,,,,,230.35,85,,percent of total billed charges,,138.71,,,,fee schedule,,122.64,,,,fee schedule,,,,,,,,142.68,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,246.61,91,,percent of total billed charges,,,257.45,95,,percent of total billed charges,,,224.93,83,,percent of total billed charges,,,81.3,83,,percent of total billed charges,,,,,,,,,,,,,,,224.93,83,,percent of total billed charges,,,,,,,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,230.35,85,,percent of total billed charges,,81.3,257.45,
"PROLONGED SERVICE, OFFICE",99354P,CDM,99354,CPT,,,both,P,140,140,,,,,,,,,,,,,,,,,,,,119,85,,percent of total billed charges,,138.71,,,,fee schedule,,122.64,,,,fee schedule,,,,,,,,142.68,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,42,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,,,,,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,42,142.68,
"PROLONGED SERVICE, OFFICE",99354T,CDM,99354,CPT,,,both,T,131,131,,,,,,,,,,,,,,,,,,,,111.35,85,,percent of total billed charges,,138.71,,,,fee schedule,,122.64,,,,fee schedule,,,,,,,,142.68,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,119.21,91,,percent of total billed charges,,,124.45,95,,percent of total billed charges,,,108.73,83,,percent of total billed charges,,,39.3,83,,percent of total billed charges,,,,,,,,,,,,,,,108.73,83,,percent of total billed charges,,,,,,,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,117.9,90,,percent of total billed charges,,,111.35,85,,percent of total billed charges,,39.3,142.68,
"PROLONGED SERVICE, OFFICE",99355,CDM,99355,CPT,,,both,,213,213,,,,,,,,,,,,,,,,,,,,181.05,85,,percent of total billed charges,,131.16,,,,fee schedule,,86.89,,,,fee schedule,,,,,,,,139.84,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,193.83,91,,percent of total billed charges,,,202.35,95,,percent of total billed charges,,,176.79,83,,percent of total billed charges,,,63.9,83,,percent of total billed charges,,,,,,,,,,,,,,,176.79,83,,percent of total billed charges,,,,,,,,,191.7,90,,percent of total billed charges,,,191.7,90,,percent of total billed charges,,,191.7,90,,percent of total billed charges,,,191.7,90,,percent of total billed charges,,,181.05,85,,percent of total billed charges,,63.9,202.35,
"PROLONGED SERVICE, INPATIENT",99356,CDM,99356,CPT,,,both,,269,269,,,,,,,,,,,,,,,,,,,,228.65,85,,percent of total billed charges,,137.14,,,,fee schedule,,91.93,,,,fee schedule,,,,,,,,136.43,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,244.79,91,,percent of total billed charges,,,255.55,95,,percent of total billed charges,,,223.27,83,,percent of total billed charges,,,80.7,83,,percent of total billed charges,,,,,,,,,,,,,,,223.27,83,,percent of total billed charges,,,,,,,,,242.1,90,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,242.1,90,,percent of total billed charges,,,228.65,85,,percent of total billed charges,,80.7,255.55,
"PROLONGED SERVICE, INPATIENT",99357,CDM,99357,CPT,,,both,,265,265,,,,,,,,,,,,,,,,,,,,225.25,85,,percent of total billed charges,,133.13,,,,fee schedule,,92.26,,,,fee schedule,,,,,,,,137.57,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,241.15,91,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,79.5,83,,percent of total billed charges,,,,,,,,,,,,,,,219.95,83,,percent of total billed charges,,,,,,,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,79.5,251.75,
"PROLONGED SERV, W/O CONTACT",99358,CDM,99358,CPT,,,both,,243,243,123.06,,,,fee schedule,,,,,,,,,,,,,,,206.55,85,,percent of total billed charges,,233.44,,,,fee schedule,,112.89,,,,fee schedule,,,,,,,,,,,,,,,,,,,,150.41,,,,fee schedule,,91.16,,,,fee schedule,,91.16,,,,fee schedule,,,221.13,91,,percent of total billed charges,,,230.85,95,,percent of total billed charges,,,201.69,83,,percent of total billed charges,,,72.9,83,,percent of total billed charges,,,,,,,,,,,,,,,201.69,83,,percent of total billed charges,,134,,,,fee schedule,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,218.7,90,,percent of total billed charges,,,206.55,85,,percent of total billed charges,,72.9,233.44,
PROLONG SERVICE W/O CONTACT,99358 P,CDM,99358,CPT,,,both, P,120,120,123.06,,,,fee schedule,,,,,,,,,,,,,,,102,85,,percent of total billed charges,,233.44,,,,fee schedule,,112.89,,,,fee schedule,,,,,,,,,,,,,,,,,,,,150.41,,,,fee schedule,,91.16,,,,fee schedule,,91.16,,,,fee schedule,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,36,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,134,,,,fee schedule,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,36,233.44,
PROLONG SERVICE W/O CONTACT,99358 T,CDM,99358,CPT,,,both, T,123,123,123.06,,,,fee schedule,,,,,,,,,,,,,,,104.55,85,,percent of total billed charges,,233.44,,,,fee schedule,,112.89,,,,fee schedule,,,,,,,,,,,,,,,,,,,,150.41,,,,fee schedule,,91.16,,,,fee schedule,,91.16,,,,fee schedule,,,111.93,91,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,36.9,83,,percent of total billed charges,,,,,,,,,,,,,,,102.09,83,,percent of total billed charges,,134,,,,fee schedule,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,104.55,85,,percent of total billed charges,,36.9,233.44,
"PROLONGED SERV, W/O CONTACT",99359,CDM,99359,CPT,,,both,,148,148,58.1,,,,fee schedule,,,,,,,,,,,,,,,125.8,85,,percent of total billed charges,,108.88,,,,fee schedule,,55.17,,,,fee schedule,,,,,,,,,,,,,,,,,,,,71.01,,,,fee schedule,,43.04,,,,fee schedule,,43.04,,,,fee schedule,,,134.68,91,,percent of total billed charges,,,140.6,95,,percent of total billed charges,,,122.84,83,,percent of total billed charges,,,44.4,83,,percent of total billed charges,,,,,,,,,,,,,,,122.84,83,,percent of total billed charges,,63.26,,,,fee schedule,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,133.2,90,,percent of total billed charges,,,125.8,85,,percent of total billed charges,,43.04,140.6,
PHYSICIAN STANDBY SERVICES,99360,CDM,99360,CPT,,,both,,282,282,79.14,,,,fee schedule,,,,,,,,,,,,,,,239.7,85,,percent of total billed charges,,84.68,,,,fee schedule,,62.39,,,,fee schedule,,,,,,,,,,,,,,,,,,,,96.73,,,,fee schedule,,58.62,,,,fee schedule,,58.62,,,,fee schedule,,,256.62,91,,percent of total billed charges,,,267.9,95,,percent of total billed charges,,,234.06,83,,percent of total billed charges,,,84.6,83,,percent of total billed charges,,,,,,,,,,,,,,,234.06,83,,percent of total billed charges,,86.18,,,,fee schedule,,,253.8,90,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,253.8,90,,percent of total billed charges,,,239.7,85,,percent of total billed charges,,58.62,267.9,
PHYS SUPVJ NF PT MO 15-29 MIN,99379,CDM,99379,CPT,,,both,,89,89,73.2,,,,fee schedule,,,,,,,,,,,,,,,75.65,85,,percent of total billed charges,,86.03,,,,fee schedule,,57.45,,,,fee schedule,,,,,,,,88.68,,,,fee schedule,,,,,,,,89.46,,,,fee schedule,,54.22,,,,fee schedule,,54.22,,,,fee schedule,,,80.99,91,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,26.7,83,,percent of total billed charges,,,,,,,,,,,,,,,73.87,83,,percent of total billed charges,,79.7,,,,fee schedule,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,26.7,89.46,
1ST PREVENTIVE MEDICINE NEW PATIENT < 1YR,99381,CDM,99381,CPT,,,both,,224,224,99.73,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,190.4,85,,percent of total billed charges,,106.98,,,,fee schedule,,76.24,,,,fee schedule,,32.15,,,,fee schedule,,96.07,,,,fee schedule,,32.15,,,,fee schedule,,121.89,,,,fee schedule,,73.87,,,,fee schedule,,73.87,,,,fee schedule,,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,67.2,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,185.92,83,,percent of total billed charges,,108.59,,,,fee schedule,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,32.15,212.8,
"PREV VISIT, NEW, INFANT",99381P,CDM,99381,CPT,,,both,P,97,97,99.73,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,82.45,85,,percent of total billed charges,,106.98,,,,fee schedule,,76.24,,,,fee schedule,,32.15,,,,fee schedule,,96.07,,,,fee schedule,,32.15,,,,fee schedule,,121.89,,,,fee schedule,,73.87,,,,fee schedule,,73.87,,,,fee schedule,,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,29.1,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,80.51,83,,percent of total billed charges,,108.59,,,,fee schedule,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,29.1,121.89,
"PREV VISIT, NEW, INFANT",99381T,CDM,99381,CPT,,,both,T,127,127,99.73,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,107.95,85,,percent of total billed charges,,106.98,,,,fee schedule,,76.24,,,,fee schedule,,32.15,,,,fee schedule,,96.07,,,,fee schedule,,32.15,,,,fee schedule,,121.89,,,,fee schedule,,73.87,,,,fee schedule,,73.87,,,,fee schedule,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,105.41,83,,percent of total billed charges,,108.59,,,,fee schedule,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,32.15,121.89,
1ST PREVENTIVE MEDICINE NEW PATIENT AGE 1-4 YRS,99382,CDM,99382,CPT,,,both,,239,239,106.13,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,203.15,85,,percent of total billed charges,,115.01,,,,fee schedule,,81.47,,,,fee schedule,,32.15,,,,fee schedule,,109.71,,,,fee schedule,,32.15,,,,fee schedule,,129.72,,,,fee schedule,,78.62,,,,fee schedule,,78.62,,,,fee schedule,,,217.49,91,,percent of total billed charges,,,227.05,95,,percent of total billed charges,,,198.37,83,,percent of total billed charges,,,71.7,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,198.37,83,,percent of total billed charges,,115.57,,,,fee schedule,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,215.1,90,,percent of total billed charges,,,203.15,85,,percent of total billed charges,,32.15,227.05,
"PREV VISIT, NEW, AGE 1-4",99382P,CDM,99382,CPT,,,both,P,111,111,106.13,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,94.35,85,,percent of total billed charges,,115.01,,,,fee schedule,,81.47,,,,fee schedule,,32.15,,,,fee schedule,,109.71,,,,fee schedule,,32.15,,,,fee schedule,,129.72,,,,fee schedule,,78.62,,,,fee schedule,,78.62,,,,fee schedule,,,101.01,91,,percent of total billed charges,,,105.45,95,,percent of total billed charges,,,92.13,83,,percent of total billed charges,,,33.3,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,92.13,83,,percent of total billed charges,,115.57,,,,fee schedule,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,99.9,90,,percent of total billed charges,,,94.35,85,,percent of total billed charges,,32.15,129.72,
"PREV VISIT, NEW, AGE 1-4",99382T,CDM,99382,CPT,,,both,T,128,128,106.13,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,108.8,85,,percent of total billed charges,,115.01,,,,fee schedule,,81.47,,,,fee schedule,,32.15,,,,fee schedule,,109.71,,,,fee schedule,,32.15,,,,fee schedule,,129.72,,,,fee schedule,,78.62,,,,fee schedule,,78.62,,,,fee schedule,,,116.48,91,,percent of total billed charges,,,121.6,95,,percent of total billed charges,,,106.24,83,,percent of total billed charges,,,38.4,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,106.24,83,,percent of total billed charges,,115.57,,,,fee schedule,,,115.2,90,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,108.8,85,,percent of total billed charges,,32.15,129.72,
1ST PREVENTIVE MEDICINE NEW PATIENT AGE 5-11 YRS,99383,CDM,99383,CPT,,,both,,240,240,112.54,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,204,85,,percent of total billed charges,,121.09,,,,fee schedule,,86.29,,,,fee schedule,,32.15,,,,fee schedule,,109.71,,,,fee schedule,,32.15,,,,fee schedule,,137.55,,,,fee schedule,,83.36,,,,fee schedule,,83.36,,,,fee schedule,,,218.4,91,,percent of total billed charges,,,228,95,,percent of total billed charges,,,199.2,83,,percent of total billed charges,,,72,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,199.2,83,,percent of total billed charges,,122.54,,,,fee schedule,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,216,90,,percent of total billed charges,,,204,85,,percent of total billed charges,,32.15,228,
"PREV VISIT, NEW, AGE 5-11",99383P,CDM,99383,CPT,,,both,P,113,113,112.54,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,96.05,85,,percent of total billed charges,,121.09,,,,fee schedule,,86.29,,,,fee schedule,,32.15,,,,fee schedule,,109.71,,,,fee schedule,,32.15,,,,fee schedule,,137.55,,,,fee schedule,,83.36,,,,fee schedule,,83.36,,,,fee schedule,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,33.9,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,93.79,83,,percent of total billed charges,,122.54,,,,fee schedule,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,32.15,137.55,
"PREV VISIT, NEW, AGE 5-11",99383T,CDM,99383,CPT,,,both,T,127,127,112.54,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,107.95,85,,percent of total billed charges,,121.09,,,,fee schedule,,86.29,,,,fee schedule,,32.15,,,,fee schedule,,109.71,,,,fee schedule,,32.15,,,,fee schedule,,137.55,,,,fee schedule,,83.36,,,,fee schedule,,83.36,,,,fee schedule,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,105.41,83,,percent of total billed charges,,122.54,,,,fee schedule,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,32.15,137.55,
1ST PREVENTIVE MEDICINE NEW PATIENT AGE 12-17 YR,99384,CDM,99384,CPT,,,both,,265,265,132.21,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,225.25,85,,percent of total billed charges,,145.3,,,,fee schedule,,102.93,,,,fee schedule,,32.15,,,,fee schedule,,123.92,,,,fee schedule,,32.15,,,,fee schedule,,161.59,,,,fee schedule,,97.93,,,,fee schedule,,97.93,,,,fee schedule,,,241.15,91,,percent of total billed charges,,,251.75,95,,percent of total billed charges,,,219.95,83,,percent of total billed charges,,,79.5,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,219.95,83,,percent of total billed charges,,143.96,,,,fee schedule,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,238.5,90,,percent of total billed charges,,,225.25,85,,percent of total billed charges,,32.15,251.75,
"PREV VISIT, NEW, AGE 12-17",99384P,CDM,99384,CPT,,,both,P,112,112,132.21,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,95.2,85,,percent of total billed charges,,145.3,,,,fee schedule,,102.93,,,,fee schedule,,32.15,,,,fee schedule,,123.92,,,,fee schedule,,32.15,,,,fee schedule,,161.59,,,,fee schedule,,97.93,,,,fee schedule,,97.93,,,,fee schedule,,,101.92,91,,percent of total billed charges,,,106.4,95,,percent of total billed charges,,,92.96,83,,percent of total billed charges,,,33.6,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,92.96,83,,percent of total billed charges,,143.96,,,,fee schedule,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,95.2,85,,percent of total billed charges,,32.15,161.59,
"PREV VISIT, NEW, AGE 12-17",99384T,CDM,99384,CPT,,,both,T,153,153,132.21,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,130.05,85,,percent of total billed charges,,145.3,,,,fee schedule,,102.93,,,,fee schedule,,32.15,,,,fee schedule,,123.92,,,,fee schedule,,32.15,,,,fee schedule,,161.59,,,,fee schedule,,97.93,,,,fee schedule,,97.93,,,,fee schedule,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,45.9,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,126.99,83,,percent of total billed charges,,143.96,,,,fee schedule,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,32.15,161.59,
1ST PREVENTIVE MEDICINE NEW PATIENT AGE 18-39YRS,99385,CDM,99385,CPT,,,both,,303,303,127.18,,,,fee schedule,,,,,,,,,,,,,,,257.55,85,,percent of total billed charges,,138.53,,,,fee schedule,,98.73,,,,fee schedule,,,,,,,,123.92,,,,fee schedule,,,,,,,,155.44,,,,fee schedule,,94.21,,,,fee schedule,,94.21,,,,fee schedule,,,275.73,91,,percent of total billed charges,,,287.85,95,,percent of total billed charges,,,251.49,83,,percent of total billed charges,,,90.9,83,,percent of total billed charges,,,,,,,,,,,,,,,251.49,83,,percent of total billed charges,,138.48,,,,fee schedule,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,272.7,90,,percent of total billed charges,,,257.55,85,,percent of total billed charges,,90.9,287.85,
"PREV VISIT, NEW, AGE 18-39",99385P,CDM,99385,CPT,,,both,P,150,150,127.18,,,,fee schedule,,,,,,,,,,,,,,,127.5,85,,percent of total billed charges,,138.53,,,,fee schedule,,98.73,,,,fee schedule,,,,,,,,123.92,,,,fee schedule,,,,,,,,155.44,,,,fee schedule,,94.21,,,,fee schedule,,94.21,,,,fee schedule,,,136.5,91,,percent of total billed charges,,,142.5,95,,percent of total billed charges,,,124.5,83,,percent of total billed charges,,,45,83,,percent of total billed charges,,,,,,,,,,,,,,,124.5,83,,percent of total billed charges,,138.48,,,,fee schedule,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,135,90,,percent of total billed charges,,,127.5,85,,percent of total billed charges,,45,155.44,
"PREV VISIT, NEW, AGE 18-39",99385T,CDM,99385,CPT,,,both,T,153,153,127.18,,,,fee schedule,,,,,,,,,,,,,,,130.05,85,,percent of total billed charges,,138.53,,,,fee schedule,,98.73,,,,fee schedule,,,,,,,,123.92,,,,fee schedule,,,,,,,,155.44,,,,fee schedule,,94.21,,,,fee schedule,,94.21,,,,fee schedule,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,45.9,83,,percent of total billed charges,,,,,,,,,,,,,,,126.99,83,,percent of total billed charges,,138.48,,,,fee schedule,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,45.9,155.44,
1ST PREVENTIVE MEDICINE NEW PATIENT AGE 40-64YRS,99386,CDM,99386,CPT,,,both,,338,338,154.17,,,,fee schedule,,,,,,,,66.4,,,,fee schedule,,,287.3,85,,percent of total billed charges,,167.84,,,,fee schedule,,119.61,,,,fee schedule,,66.4,,,,fee schedule,,151.78,,,,fee schedule,,66.4,,,,fee schedule,,188.43,,,,fee schedule,,114.2,,,,fee schedule,,114.2,,,,fee schedule,,,307.58,91,,percent of total billed charges,,,321.1,95,,percent of total billed charges,,,280.54,83,,percent of total billed charges,,,101.4,83,,percent of total billed charges,,66.4,,,,fee schedule,,66.4,,,,fee schedule,,,280.54,83,,percent of total billed charges,,167.87,,,,fee schedule,,,304.2,90,,percent of total billed charges,,,304.2,90,,percent of total billed charges,,,304.2,90,,percent of total billed charges,,,304.2,90,,percent of total billed charges,,,287.3,85,,percent of total billed charges,,66.4,321.1,
"PREV VISIT, NEW, AGE 40-64",99386P,CDM,99386,CPT,,,both,P,183,183,154.17,,,,fee schedule,,,,,,,,66.4,,,,fee schedule,,,155.55,85,,percent of total billed charges,,167.84,,,,fee schedule,,119.61,,,,fee schedule,,66.4,,,,fee schedule,,151.78,,,,fee schedule,,66.4,,,,fee schedule,,188.43,,,,fee schedule,,114.2,,,,fee schedule,,114.2,,,,fee schedule,,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,54.9,83,,percent of total billed charges,,66.4,,,,fee schedule,,66.4,,,,fee schedule,,,151.89,83,,percent of total billed charges,,167.87,,,,fee schedule,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,54.9,188.43,
"PREV VISIT, NEW, AGE 40-64",99386T,CDM,99386,CPT,,,both,T,155,155,154.17,,,,fee schedule,,,,,,,,66.4,,,,fee schedule,,,131.75,85,,percent of total billed charges,,167.84,,,,fee schedule,,119.61,,,,fee schedule,,66.4,,,,fee schedule,,151.78,,,,fee schedule,,66.4,,,,fee schedule,,188.43,,,,fee schedule,,114.2,,,,fee schedule,,114.2,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,66.4,,,,fee schedule,,66.4,,,,fee schedule,,,128.65,83,,percent of total billed charges,,167.87,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,46.5,188.43,
1ST PREVENTIVE MEDICINE NEW PATIENT AGE 65YRS>,99387,CDM,99387,CPT,,,both,,345,345,166.06,,,,fee schedule,,,,,,,,66.4,,,,fee schedule,,,293.25,85,,percent of total billed charges,,180.81,,,,fee schedule,,128.28,,,,fee schedule,,66.4,,,,fee schedule,,165.99,,,,fee schedule,,66.4,,,,fee schedule,,202.97,,,,fee schedule,,123.01,,,,fee schedule,,123.01,,,,fee schedule,,,313.95,91,,percent of total billed charges,,,327.75,95,,percent of total billed charges,,,286.35,83,,percent of total billed charges,,,103.5,83,,percent of total billed charges,,66.4,,,,fee schedule,,66.4,,,,fee schedule,,,286.35,83,,percent of total billed charges,,180.83,,,,fee schedule,,,310.5,90,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,310.5,90,,percent of total billed charges,,,293.25,85,,percent of total billed charges,,66.4,327.75,
"PREV VISIT, NEW, 65 & OVER",99387P,CDM,99387,CPT,,,both,P,190,190,166.06,,,,fee schedule,,,,,,,,66.4,,,,fee schedule,,,161.5,85,,percent of total billed charges,,180.81,,,,fee schedule,,128.28,,,,fee schedule,,66.4,,,,fee schedule,,165.99,,,,fee schedule,,66.4,,,,fee schedule,,202.97,,,,fee schedule,,123.01,,,,fee schedule,,123.01,,,,fee schedule,,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,57,83,,percent of total billed charges,,66.4,,,,fee schedule,,66.4,,,,fee schedule,,,157.7,83,,percent of total billed charges,,180.83,,,,fee schedule,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,57,202.97,
"PREV VISIT, NEW, 65 & OVER",99387T,CDM,99387,CPT,,,both,T,155,155,166.06,,,,fee schedule,,,,,,,,66.4,,,,fee schedule,,,131.75,85,,percent of total billed charges,,180.81,,,,fee schedule,,128.28,,,,fee schedule,,66.4,,,,fee schedule,,165.99,,,,fee schedule,,66.4,,,,fee schedule,,202.97,,,,fee schedule,,123.01,,,,fee schedule,,123.01,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,66.4,,,,fee schedule,,66.4,,,,fee schedule,,,128.65,83,,percent of total billed charges,,180.83,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,46.5,202.97,
PERIODIC PREVENTIVE MED ESTABLISHED PATIENT <1YR,99391,CDM,99391,CPT,,,both,,196,196,90.58,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,166.6,85,,percent of total billed charges,,98.87,,,,fee schedule,,70.04,,,,fee schedule,,32.15,,,,fee schedule,,82.43,,,,fee schedule,,32.15,,,,fee schedule,,110.71,,,,fee schedule,,67.1,,,,fee schedule,,67.1,,,,fee schedule,,,178.36,91,,percent of total billed charges,,,186.2,95,,percent of total billed charges,,,162.68,83,,percent of total billed charges,,,58.8,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,162.68,83,,percent of total billed charges,,98.63,,,,fee schedule,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,166.6,85,,percent of total billed charges,,32.15,186.2,
"PREV VISIT, EST, INFANT",99391P,CDM,99391,CPT,,,both,P,69,69,90.58,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,58.65,85,,percent of total billed charges,,98.87,,,,fee schedule,,70.04,,,,fee schedule,,32.15,,,,fee schedule,,82.43,,,,fee schedule,,32.15,,,,fee schedule,,110.71,,,,fee schedule,,67.1,,,,fee schedule,,67.1,,,,fee schedule,,,62.79,91,,percent of total billed charges,,,65.55,95,,percent of total billed charges,,,57.27,83,,percent of total billed charges,,,20.7,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,57.27,83,,percent of total billed charges,,98.63,,,,fee schedule,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,62.1,90,,percent of total billed charges,,,58.65,85,,percent of total billed charges,,20.7,110.71,
"PREV VISIT, EST, INFANT",99391T,CDM,99391,CPT,,,both,T,127,127,90.58,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,107.95,85,,percent of total billed charges,,98.87,,,,fee schedule,,70.04,,,,fee schedule,,32.15,,,,fee schedule,,82.43,,,,fee schedule,,32.15,,,,fee schedule,,110.71,,,,fee schedule,,67.1,,,,fee schedule,,67.1,,,,fee schedule,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,105.41,83,,percent of total billed charges,,98.63,,,,fee schedule,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,32.15,120.65,
PERIODIC PREVENTIVE MED EST PATIENT AGE 1-4YRS,99392,CDM,99392,CPT,,,both,,206,206,99.73,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,175.1,85,,percent of total billed charges,,109.78,,,,fee schedule,,76.24,,,,fee schedule,,32.15,,,,fee schedule,,96.07,,,,fee schedule,,32.15,,,,fee schedule,,121.89,,,,fee schedule,,73.87,,,,fee schedule,,73.87,,,,fee schedule,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,61.8,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,170.98,83,,percent of total billed charges,,108.59,,,,fee schedule,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,32.15,195.7,
"PREV VISIT, EST, AGE 1-4",99392P,CDM,99392,CPT,,,both,P,79,79,99.73,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,67.15,85,,percent of total billed charges,,109.78,,,,fee schedule,,76.24,,,,fee schedule,,32.15,,,,fee schedule,,96.07,,,,fee schedule,,32.15,,,,fee schedule,,121.89,,,,fee schedule,,73.87,,,,fee schedule,,73.87,,,,fee schedule,,,71.89,91,,percent of total billed charges,,,75.05,95,,percent of total billed charges,,,65.57,83,,percent of total billed charges,,,23.7,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,65.57,83,,percent of total billed charges,,108.59,,,,fee schedule,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,71.1,90,,percent of total billed charges,,,67.15,85,,percent of total billed charges,,23.7,121.89,
"PREV VISIT, EST, AGE 1-4",99392T,CDM,99392,CPT,,,both,T,127,127,99.73,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,107.95,85,,percent of total billed charges,,109.78,,,,fee schedule,,76.24,,,,fee schedule,,32.15,,,,fee schedule,,96.07,,,,fee schedule,,32.15,,,,fee schedule,,121.89,,,,fee schedule,,73.87,,,,fee schedule,,73.87,,,,fee schedule,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,105.41,83,,percent of total billed charges,,108.59,,,,fee schedule,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,32.15,121.89,
PERIODIC PREVENTIVE MED EST PATIENT AGE 5-11YRS,99393,CDM,99393,CPT,,,both,,210,210,99.73,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,178.5,85,,percent of total billed charges,,109.78,,,,fee schedule,,76.24,,,,fee schedule,,32.15,,,,fee schedule,,96.07,,,,fee schedule,,32.15,,,,fee schedule,,121.89,,,,fee schedule,,73.87,,,,fee schedule,,73.87,,,,fee schedule,,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,63,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,174.3,83,,percent of total billed charges,,108.59,,,,fee schedule,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,32.15,199.5,
PERIODIC PREVENTIVE MED EST PATIENT AGE 12-17YRS,99394,CDM,99394,CPT,,,both,,229,229,112.54,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,194.65,85,,percent of total billed charges,,122.48,,,,fee schedule,,86.29,,,,fee schedule,,32.15,,,,fee schedule,,109.71,,,,fee schedule,,32.15,,,,fee schedule,,137.55,,,,fee schedule,,83.36,,,,fee schedule,,83.36,,,,fee schedule,,,208.39,91,,percent of total billed charges,,,217.55,95,,percent of total billed charges,,,190.07,83,,percent of total billed charges,,,68.7,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,190.07,83,,percent of total billed charges,,122.54,,,,fee schedule,,,206.1,90,,percent of total billed charges,,,206.1,90,,percent of total billed charges,,,206.1,90,,percent of total billed charges,,,206.1,90,,percent of total billed charges,,,194.65,85,,percent of total billed charges,,32.15,217.55,
"PREV VISIT, EST, AGE 12-17",99394P,CDM,99394,CPT,,,both,P,101,101,112.54,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,85.85,85,,percent of total billed charges,,122.48,,,,fee schedule,,86.29,,,,fee schedule,,32.15,,,,fee schedule,,109.71,,,,fee schedule,,32.15,,,,fee schedule,,137.55,,,,fee schedule,,83.36,,,,fee schedule,,83.36,,,,fee schedule,,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,30.3,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,83.83,83,,percent of total billed charges,,122.54,,,,fee schedule,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,30.3,137.55,
"PREV VISIT, EST, AGE 12-17",99394T,CDM,99394,CPT,,,both,T,128,128,112.54,,,,fee schedule,,,,,,,,32.15,,,,fee schedule,,,108.8,85,,percent of total billed charges,,122.48,,,,fee schedule,,86.29,,,,fee schedule,,32.15,,,,fee schedule,,109.71,,,,fee schedule,,32.15,,,,fee schedule,,137.55,,,,fee schedule,,83.36,,,,fee schedule,,83.36,,,,fee schedule,,,116.48,91,,percent of total billed charges,,,121.6,95,,percent of total billed charges,,,106.24,83,,percent of total billed charges,,,38.4,83,,percent of total billed charges,,32.15,,,,fee schedule,,32.15,,,,fee schedule,,,106.24,83,,percent of total billed charges,,122.54,,,,fee schedule,,,115.2,90,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,108.8,85,,percent of total billed charges,,32.15,137.55,
PERIODIC PREVENTIVE MED EST PATIENT AGE 18-39YRS,99395,CDM,99395,CPT,,,both,,262,262,116.2,,,,fee schedule,,,,,,,,,,,,,,,222.7,85,,percent of total billed charges,,125.02,,,,fee schedule,,88.7,,,,fee schedule,,,,,,,,109.71,,,,fee schedule,,,,,,,,142.02,,,,fee schedule,,86.07,,,,fee schedule,,86.07,,,,fee schedule,,,238.42,91,,percent of total billed charges,,,248.9,95,,percent of total billed charges,,,217.46,83,,percent of total billed charges,,,78.6,83,,percent of total billed charges,,,,,,,,,,,,,,,217.46,83,,percent of total billed charges,,126.53,,,,fee schedule,,,235.8,90,,percent of total billed charges,,,235.8,90,,percent of total billed charges,,,235.8,90,,percent of total billed charges,,,235.8,90,,percent of total billed charges,,,222.7,85,,percent of total billed charges,,78.6,248.9,
"PREV VISIT, EST, AGE 18-39",99395P,CDM,99395,CPT,,,both,P,133,133,116.2,,,,fee schedule,,,,,,,,,,,,,,,113.05,85,,percent of total billed charges,,125.02,,,,fee schedule,,88.7,,,,fee schedule,,,,,,,,109.71,,,,fee schedule,,,,,,,,142.02,,,,fee schedule,,86.07,,,,fee schedule,,86.07,,,,fee schedule,,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,39.9,83,,percent of total billed charges,,,,,,,,,,,,,,,110.39,83,,percent of total billed charges,,126.53,,,,fee schedule,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,39.9,142.02,
"PREV VISIT, EST, AGE 18-39",99395T,CDM,99395,CPT,,,both,T,129,129,116.2,,,,fee schedule,,,,,,,,,,,,,,,109.65,85,,percent of total billed charges,,125.02,,,,fee schedule,,88.7,,,,fee schedule,,,,,,,,109.71,,,,fee schedule,,,,,,,,142.02,,,,fee schedule,,86.07,,,,fee schedule,,86.07,,,,fee schedule,,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,38.7,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,126.53,,,,fee schedule,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,38.7,142.02,
PERIODIC PREVENTIVE MED EST PATIENT AGE 40-64YRS,99396,CDM,99396,CPT,,,both,,279,279,125.81,,,,fee schedule,,,,,,,,42.5,,,,fee schedule,,,237.15,85,,percent of total billed charges,,137.91,,,,fee schedule,,97.7,,,,fee schedule,,42.5,,,,fee schedule,,123.92,,,,fee schedule,,42.5,,,,fee schedule,,153.76,,,,fee schedule,,93.19,,,,fee schedule,,93.19,,,,fee schedule,,,253.89,91,,percent of total billed charges,,,265.05,95,,percent of total billed charges,,,231.57,83,,percent of total billed charges,,,83.7,83,,percent of total billed charges,,42.5,,,,fee schedule,,42.5,,,,fee schedule,,,231.57,83,,percent of total billed charges,,136.99,,,,fee schedule,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,251.1,90,,percent of total billed charges,,,237.15,85,,percent of total billed charges,,42.5,265.05,
"PREV VISIT, EST, AGE 40-64",99396P,CDM,99396,CPT,,,both,P,151,151,125.81,,,,fee schedule,,,,,,,,42.5,,,,fee schedule,,,128.35,85,,percent of total billed charges,,137.91,,,,fee schedule,,97.7,,,,fee schedule,,42.5,,,,fee schedule,,123.92,,,,fee schedule,,42.5,,,,fee schedule,,153.76,,,,fee schedule,,93.19,,,,fee schedule,,93.19,,,,fee schedule,,,137.41,91,,percent of total billed charges,,,143.45,95,,percent of total billed charges,,,125.33,83,,percent of total billed charges,,,45.3,83,,percent of total billed charges,,42.5,,,,fee schedule,,42.5,,,,fee schedule,,,125.33,83,,percent of total billed charges,,136.99,,,,fee schedule,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,135.9,90,,percent of total billed charges,,,128.35,85,,percent of total billed charges,,42.5,153.76,
"PREV VISIT, EST, AGE 40-64",99396T,CDM,99396,CPT,,,both,T,128,128,125.81,,,,fee schedule,,,,,,,,42.5,,,,fee schedule,,,108.8,85,,percent of total billed charges,,137.91,,,,fee schedule,,97.7,,,,fee schedule,,42.5,,,,fee schedule,,123.92,,,,fee schedule,,42.5,,,,fee schedule,,153.76,,,,fee schedule,,93.19,,,,fee schedule,,93.19,,,,fee schedule,,,116.48,91,,percent of total billed charges,,,121.6,95,,percent of total billed charges,,,106.24,83,,percent of total billed charges,,,38.4,83,,percent of total billed charges,,42.5,,,,fee schedule,,42.5,,,,fee schedule,,,106.24,83,,percent of total billed charges,,136.99,,,,fee schedule,,,115.2,90,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,115.2,90,,percent of total billed charges,,,108.8,85,,percent of total billed charges,,38.4,153.76,
PERIODIC PREVENTIVE MED EST PATIENT AGE 65YRS>,99397,CDM,99397,CPT,,,both,,297,297,132.21,,,,fee schedule,,,,,,,,42.5,,,,fee schedule,,,252.45,85,,percent of total billed charges,,144.44,,,,fee schedule,,102.93,,,,fee schedule,,42.5,,,,fee schedule,,138.14,,,,fee schedule,,42.5,,,,fee schedule,,161.59,,,,fee schedule,,97.93,,,,fee schedule,,97.93,,,,fee schedule,,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,89.1,83,,percent of total billed charges,,42.5,,,,fee schedule,,42.5,,,,fee schedule,,,246.51,83,,percent of total billed charges,,143.96,,,,fee schedule,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,42.5,282.15,
"PREV VISIT, EST, 65 & OVER",99397P,CDM,99397,CPT,,,both,P,144,144,132.21,,,,fee schedule,,,,,,,,42.5,,,,fee schedule,,,122.4,85,,percent of total billed charges,,144.44,,,,fee schedule,,102.93,,,,fee schedule,,42.5,,,,fee schedule,,138.14,,,,fee schedule,,42.5,,,,fee schedule,,161.59,,,,fee schedule,,97.93,,,,fee schedule,,97.93,,,,fee schedule,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,43.2,83,,percent of total billed charges,,42.5,,,,fee schedule,,42.5,,,,fee schedule,,,119.52,83,,percent of total billed charges,,143.96,,,,fee schedule,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,42.5,161.59,
"PREV VISIT, EST, 65 & OVER",99397T,CDM,99397,CPT,,,both,T,153,153,132.21,,,,fee schedule,,,,,,,,42.5,,,,fee schedule,,,130.05,85,,percent of total billed charges,,144.44,,,,fee schedule,,102.93,,,,fee schedule,,42.5,,,,fee schedule,,138.14,,,,fee schedule,,42.5,,,,fee schedule,,161.59,,,,fee schedule,,97.93,,,,fee schedule,,97.93,,,,fee schedule,,,139.23,91,,percent of total billed charges,,,145.35,95,,percent of total billed charges,,,126.99,83,,percent of total billed charges,,,45.9,83,,percent of total billed charges,,42.5,,,,fee schedule,,42.5,,,,fee schedule,,,126.99,83,,percent of total billed charges,,143.96,,,,fee schedule,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,137.7,90,,percent of total billed charges,,,130.05,85,,percent of total billed charges,,42.5,161.59,
"PREVENTIVE COUNSELING, INDIV",99401,CDM,99401,CPT,,,both,,90,90,32.48,,,,fee schedule,,,,,,,,30,,,,fee schedule,,,76.5,85,,percent of total billed charges,,29.49,,,,fee schedule,,25.15,,,,fee schedule,,30,,,,fee schedule,,38.66,,,,fee schedule,,30,,,,fee schedule,,39.7,,,,fee schedule,,24.06,,,,fee schedule,,24.06,,,,fee schedule,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,30,,,,fee schedule,,30,,,,fee schedule,,,74.7,83,,percent of total billed charges,,35.37,,,,fee schedule,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,24.06,85.5,
"PREVENTIVE COUNSELING, INDIV",99402,CDM,99402,CPT,,,both,,164,164,64.96,,,,fee schedule,,,,,,,,,,,,,,,139.4,85,,percent of total billed charges,,63.38,,,,fee schedule,,51.45,,,,fee schedule,,,,,,,,77.88,,,,fee schedule,,,,,,,,79.4,,,,fee schedule,,48.12,,,,fee schedule,,48.12,,,,fee schedule,,,149.24,91,,percent of total billed charges,,,155.8,95,,percent of total billed charges,,,136.12,83,,percent of total billed charges,,,49.2,83,,percent of total billed charges,,,,,,,,,,,,,,,136.12,83,,percent of total billed charges,,70.74,,,,fee schedule,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,147.6,90,,percent of total billed charges,,,139.4,85,,percent of total billed charges,,48.12,155.8,
SMOKING AND TOBACCO COUNSELING 3 MIN UP TO 10 MIN,99406,CDM,99406,CPT,,,both,,74,74,16.01,,,,fee schedule,,,,,,,,7.19,,,,fee schedule,,,62.9,85,,percent of total billed charges,,14.55,,,,fee schedule,,12.43,,,,fee schedule,,7.19,,,,fee schedule,,,,,,,,7.19,,,,fee schedule,,19.57,,,,fee schedule,,11.86,,,,fee schedule,,11.86,,,,fee schedule,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,22.2,83,,percent of total billed charges,,7.19,,,,fee schedule,,7.19,,,,fee schedule,,,61.42,83,,percent of total billed charges,,17.43,,,,fee schedule,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,7.19,70.3,
SMOKING AND TOBACCO COUNSELING 3 MIN UP TO 10 MIN,99406P,CDM,99406,CPT,,,both,P,23,23,16.01,,,,fee schedule,,,,,,,,7.19,,,,fee schedule,,,19.55,85,,percent of total billed charges,,14.55,,,,fee schedule,,12.43,,,,fee schedule,,7.19,,,,fee schedule,,,,,,,,7.19,,,,fee schedule,,19.57,,,,fee schedule,,11.86,,,,fee schedule,,11.86,,,,fee schedule,,,20.93,91,,percent of total billed charges,,,21.85,95,,percent of total billed charges,,,19.09,83,,percent of total billed charges,,,6.9,83,,percent of total billed charges,,7.19,,,,fee schedule,,7.19,,,,fee schedule,,,19.09,83,,percent of total billed charges,,17.43,,,,fee schedule,,,20.7,90,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,19.55,85,,percent of total billed charges,,6.9,21.85,
SMOKING AND TOBACCO COUNSELING 3 MIN UP TO 10 MIN,99406T,CDM,99406,CPT,,,both,T,51,51,16.01,,,,fee schedule,,,,,,,,7.19,,,,fee schedule,,,43.35,85,,percent of total billed charges,,14.55,,,,fee schedule,,12.43,,,,fee schedule,,7.19,,,,fee schedule,,,,,,,,7.19,,,,fee schedule,,19.57,,,,fee schedule,,11.86,,,,fee schedule,,11.86,,,,fee schedule,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,7.19,,,,fee schedule,,7.19,,,,fee schedule,,,42.33,83,,percent of total billed charges,,17.43,,,,fee schedule,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,7.19,48.45,
Smoking And Tabacco Cessation Greater 10 Min,99407,CDM,99407,CPT,,,both,,87,87,33.85,,,,fee schedule,,,,,,,,15.29,,,,fee schedule,,,73.95,85,,percent of total billed charges,,30.84,,,,fee schedule,,26.2,,,,fee schedule,,15.29,,,,fee schedule,,,,,,,,15.29,,,,fee schedule,,41.38,,,,fee schedule,,25.08,,,,fee schedule,,25.08,,,,fee schedule,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,26.1,83,,percent of total billed charges,,15.29,,,,fee schedule,,15.29,,,,fee schedule,,,72.21,83,,percent of total billed charges,,36.86,,,,fee schedule,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,15.29,82.65,
Smoking And Tabacco Cessation Greater 10 Min,99407P,CDM,99407,CPT,,,both,P,36,36,33.85,,,,fee schedule,,,,,,,,15.29,,,,fee schedule,,,30.6,85,,percent of total billed charges,,30.84,,,,fee schedule,,26.2,,,,fee schedule,,15.29,,,,fee schedule,,,,,,,,15.29,,,,fee schedule,,41.38,,,,fee schedule,,25.08,,,,fee schedule,,25.08,,,,fee schedule,,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,10.8,83,,percent of total billed charges,,15.29,,,,fee schedule,,15.29,,,,fee schedule,,,29.88,83,,percent of total billed charges,,36.86,,,,fee schedule,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,10.8,41.38,
Smoking And Tabacco Cessation Greater 10 Min,99407T,CDM,99407,CPT,,,both,T,51,51,33.85,,,,fee schedule,,,,,,,,15.29,,,,fee schedule,,,43.35,85,,percent of total billed charges,,30.84,,,,fee schedule,,26.2,,,,fee schedule,,15.29,,,,fee schedule,,,,,,,,15.29,,,,fee schedule,,41.38,,,,fee schedule,,25.08,,,,fee schedule,,25.08,,,,fee schedule,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,15.29,,,,fee schedule,,15.29,,,,fee schedule,,,42.33,83,,percent of total billed charges,,36.86,,,,fee schedule,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,15.29,48.45,
"AUDIT/DAST, 15-30 MIN",99408,CDM,99408,CPT,,,both,,134,134,43,,,,fee schedule,,,,,,,,,,,,,,,113.9,85,,percent of total billed charges,,41.47,,,,fee schedule,,33.65,,,,fee schedule,,,,,,,,,,,,,,,,,,,,52.56,,,,fee schedule,,31.85,,,,fee schedule,,31.85,,,,fee schedule,,,121.94,91,,percent of total billed charges,,,127.3,95,,percent of total billed charges,,,111.22,83,,percent of total billed charges,,,40.2,83,,percent of total billed charges,,,,,,,,,,,,,,,111.22,83,,percent of total billed charges,,46.83,,,,fee schedule,,,120.6,90,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,120.6,90,,percent of total billed charges,,,113.9,85,,percent of total billed charges,,31.85,127.3,
"AUDIT/DAST, 15-30 MIN",99408P,CDM,99408,CPT,,,both,P,57,57,43,,,,fee schedule,,,,,,,,,,,,,,,48.45,85,,percent of total billed charges,,41.47,,,,fee schedule,,33.65,,,,fee schedule,,,,,,,,,,,,,,,,,,,,52.56,,,,fee schedule,,31.85,,,,fee schedule,,31.85,,,,fee schedule,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,17.1,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,46.83,,,,fee schedule,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,17.1,54.15,
"AUDIT/DAST, 15-30 MIN",99408T,CDM,99408,CPT,,,both,T,77,77,43,,,,fee schedule,,,,,,,,,,,,,,,65.45,85,,percent of total billed charges,,41.47,,,,fee schedule,,33.65,,,,fee schedule,,,,,,,,,,,,,,,,,,,,52.56,,,,fee schedule,,31.85,,,,fee schedule,,31.85,,,,fee schedule,,,70.07,91,,percent of total billed charges,,,73.15,95,,percent of total billed charges,,,63.91,83,,percent of total billed charges,,,23.1,83,,percent of total billed charges,,,,,,,,,,,,,,,63.91,83,,percent of total billed charges,,46.83,,,,fee schedule,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,69.3,90,,percent of total billed charges,,,65.45,85,,percent of total billed charges,,23.1,73.15,
"AUDIT/DAST, OVER 30 MIN",99409,CDM,99409,CPT,,,both,,124,124,86.01,,,,fee schedule,,,,,,,,,,,,,,,105.4,85,,percent of total billed charges,,85.34,,,,fee schedule,,67.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,105.12,,,,fee schedule,,63.71,,,,fee schedule,,63.71,,,,fee schedule,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,37.2,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,93.65,,,,fee schedule,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,37.2,117.8,
PROLNG OFF/OP E/M EA 15 MIN,99417,CDM,99417,CPT,,,both,,102,102,40.72,,,,fee schedule,,,,,,,,,,,,,,,86.7,85,,percent of total billed charges,,36.7,,,,fee schedule,,32.54,,,,fee schedule,,,,,,,,,,,,,,,,,,,,49.76,,,,fee schedule,,30.16,,,,fee schedule,,30.16,,,,fee schedule,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,30.6,83,,percent of total billed charges,,,,,,,,,,,,,,,84.66,83,,percent of total billed charges,,44.33,,,,fee schedule,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,30.16,96.9,
PRIN CARE MGMT STAFF 1ST 30,99426,CDM,99426,CPT,,,both,,118,118,66.33,,,,fee schedule,,,,,,,,,,,,,,,100.3,85,,percent of total billed charges,,59.57,,,,fee schedule,,52.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,81.08,,,,fee schedule,,49.14,,,,fee schedule,,49.14,,,,fee schedule,,,107.38,91,,percent of total billed charges,,,112.1,95,,percent of total billed charges,,,97.94,83,,percent of total billed charges,,,35.4,83,,percent of total billed charges,,,,,,,,,,,,,,,97.94,83,,percent of total billed charges,,72.23,,,,fee schedule,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,106.2,90,,percent of total billed charges,,,100.3,85,,percent of total billed charges,,35.4,112.1,
CHRNC CARE MGMT SVC EA ADDL,99439,CDM,99439,CPT,,,both,,76,76,47.12,,,,fee schedule,,,,,,,,,,,,,,,64.6,85,,percent of total billed charges,,51.48,,,,fee schedule,,37.84,,,,fee schedule,,,,,,,,,,,,,,,,,,,,57.59,,,,fee schedule,,34.9,,,,fee schedule,,34.9,,,,fee schedule,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,,,,,,,,,,,,,,63.08,83,,percent of total billed charges,,51.31,,,,fee schedule,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,22.8,72.2,
PHONE E/M BY PHYS 5-10 MIN,99441,CDM,99441,CPT,,,both,,55,55,47.12,,,,fee schedule,,,,,,,,,,,,,,,46.75,85,,percent of total billed charges,,44,,,,fee schedule,,44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,57.59,,,,fee schedule,,34.9,,,,fee schedule,,34.9,,,,fee schedule,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,16.5,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,51.31,,,,fee schedule,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,16.5,57.59,
PHONE E/M PHYS/QHP 5-10 MIN,99441 VV,CDM,99441,CPT,,,both,,55,55,47.12,,,,fee schedule,,,,,,,,,,,,,,,46.75,85,,percent of total billed charges,,44,,,,fee schedule,,44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,57.59,,,,fee schedule,,34.9,,,,fee schedule,,34.9,,,,fee schedule,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,16.5,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,51.31,,,,fee schedule,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,16.5,57.59,
PHONE E/M BY PHYS 11-20 MIN,99442,CDM,99442,CPT,,,both,,62,62,89.21,,,,fee schedule,,,,,,,,,,,,,,,52.7,85,,percent of total billed charges,,44,,,,fee schedule,,44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,109.03,,,,fee schedule,,66.08,,,,fee schedule,,66.08,,,,fee schedule,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,97.14,,,,fee schedule,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,18.6,109.03,
PHONE E/M PHYS/QHP 11-20 MIN,99442VV,CDM,99442,CPT,,,both,,62,62,89.21,,,,fee schedule,,,,,,,,,,,,,,,52.7,85,,percent of total billed charges,,44,,,,fee schedule,,44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,109.03,,,,fee schedule,,66.08,,,,fee schedule,,66.08,,,,fee schedule,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,97.14,,,,fee schedule,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,18.6,109.03,
PHONE E/M BY PHYS 21-30 MIN,99443,CDM,99443,CPT,,,both,,106,106,130.84,,,,fee schedule,,,,,,,,,,,,,,,90.1,85,,percent of total billed charges,,44,,,,fee schedule,,44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,159.91,,,,fee schedule,,96.92,,,,fee schedule,,96.92,,,,fee schedule,,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,31.8,83,,percent of total billed charges,,,,,,,,,,,,,,,87.98,83,,percent of total billed charges,,142.47,,,,fee schedule,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,31.8,159.91,
PHONE E/M PHYS/QHP 21-30 MIN,99443VV,CDM,99443,CPT,,,both,,62,62,130.84,,,,fee schedule,,,,,,,,,,,,,,,52.7,85,,percent of total billed charges,,44,,,,fee schedule,,44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,159.91,,,,fee schedule,,96.92,,,,fee schedule,,96.92,,,,fee schedule,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,142.47,,,,fee schedule,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,18.6,159.91,
INTERPROF PHONE/ONLINE 11-20,99447,CDM,99447,CPT,,,both,,161,161,48.04,,,,fee schedule,,,,,,,,21.74,,,,fee schedule,,,136.85,85,,percent of total billed charges,,,,,,,,,,,,,,21.74,,,,fee schedule,,,,,,,,21.74,,,,fee schedule,,58.71,,,,fee schedule,,35.58,,,,fee schedule,,35.58,,,,fee schedule,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,48.3,83,,percent of total billed charges,,21.74,,,,fee schedule,,21.74,,,,fee schedule,,,133.63,83,,percent of total billed charges,,52.3,,,,fee schedule,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,21.74,152.95,
DISABILITY EXAMINATION,99455,CDM,99455,CPT,,,both,,271,271,,,,,,,,,,,,,,,,,,,,230.35,85,,percent of total billed charges,,350,,,,fee schedule,,350,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,246.61,91,,percent of total billed charges,,,257.45,95,,percent of total billed charges,,,224.93,83,,percent of total billed charges,,,81.3,83,,percent of total billed charges,,,,,,,,,,,,,,,224.93,83,,percent of total billed charges,,,,,,,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,243.9,90,,percent of total billed charges,,,230.35,85,,percent of total billed charges,,81.3,350,
DISABILITY EXAMINATION,99455P,CDM,99455,CPT,,,both,P,142,142,,,,,,,,,,,,,,,,,,,,120.7,85,,percent of total billed charges,,350,,,,fee schedule,,350,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,129.22,91,,percent of total billed charges,,,134.9,95,,percent of total billed charges,,,117.86,83,,percent of total billed charges,,,42.6,83,,percent of total billed charges,,,,,,,,,,,,,,,117.86,83,,percent of total billed charges,,,,,,,,,127.8,90,,percent of total billed charges,,,127.8,90,,percent of total billed charges,,,127.8,90,,percent of total billed charges,,,127.8,90,,percent of total billed charges,,,120.7,85,,percent of total billed charges,,42.6,350,
DISABILITY EXAMINATION,99455T,CDM,99455,CPT,,,both,T,129,129,,,,,,,,,,,,,,,,,,,,109.65,85,,percent of total billed charges,,350,,,,fee schedule,,350,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,38.7,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,,,,,,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,38.7,350,
"INIT NB EM PER DAY, HOSP",99460,CDM,99460,CPT,,,both,,343,343,125.35,,,,fee schedule,,,,,,,,38.75,,,,fee schedule,,,291.55,85,,percent of total billed charges,,96.78,,,,fee schedule,,97.28,,,,fee schedule,,38.75,,,,fee schedule,,,,,,,,38.75,,,,fee schedule,,153.2,,,,fee schedule,,92.85,,,,fee schedule,,92.85,,,,fee schedule,,,312.13,91,,percent of total billed charges,,,325.85,95,,percent of total billed charges,,,284.69,83,,percent of total billed charges,,,102.9,83,,percent of total billed charges,,38.75,,,,fee schedule,,38.75,,,,fee schedule,,,284.69,83,,percent of total billed charges,,136.49,,,,fee schedule,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,308.7,90,,percent of total billed charges,,,291.55,85,,percent of total billed charges,,38.75,325.85,
"INIT NB EM PER DAY, NON-FAC",99461,CDM,99461,CPT,,,both,,202,202,83.26,,,,fee schedule,,,,,,,,16.4,,,,fee schedule,,,171.7,85,,percent of total billed charges,,79.43,,,,fee schedule,,64.51,,,,fee schedule,,16.4,,,,fee schedule,,,,,,,,16.4,,,,fee schedule,,101.76,,,,fee schedule,,61.67,,,,fee schedule,,61.67,,,,fee schedule,,,183.82,91,,percent of total billed charges,,,191.9,95,,percent of total billed charges,,,167.66,83,,percent of total billed charges,,,60.6,83,,percent of total billed charges,,16.4,,,,fee schedule,,16.4,,,,fee schedule,,,167.66,83,,percent of total billed charges,,90.66,,,,fee schedule,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,181.8,90,,percent of total billed charges,,,171.7,85,,percent of total billed charges,,16.4,191.9,
"SBSQ NB EM PER DAY, HOSP",99462,CDM,99462,CPT,,,both,,175,175,55.35,,,,fee schedule,,,,,,,,16.4,,,,fee schedule,,,148.75,85,,percent of total billed charges,,50.95,,,,fee schedule,,42.4,,,,fee schedule,,16.4,,,,fee schedule,,,,,,,,16.4,,,,fee schedule,,67.66,,,,fee schedule,,41,,,,fee schedule,,41,,,,fee schedule,,,159.25,91,,percent of total billed charges,,,166.25,95,,percent of total billed charges,,,145.25,83,,percent of total billed charges,,,52.5,83,,percent of total billed charges,,16.4,,,,fee schedule,,16.4,,,,fee schedule,,,145.25,83,,percent of total billed charges,,60.28,,,,fee schedule,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,157.5,90,,percent of total billed charges,,,148.75,85,,percent of total billed charges,,16.4,166.25,
SAME DAY NB DISCHARGE,99463,CDM,99463,CPT,,,both,,387,387,147.31,,,,fee schedule,,,,,,,,42.55,,,,fee schedule,,,328.95,85,,percent of total billed charges,,136.94,,,,fee schedule,,109.53,,,,fee schedule,,42.55,,,,fee schedule,,,,,,,,42.55,,,,fee schedule,,180.04,,,,fee schedule,,109.12,,,,fee schedule,,109.12,,,,fee schedule,,,352.17,91,,percent of total billed charges,,,367.65,95,,percent of total billed charges,,,321.21,83,,percent of total billed charges,,,116.1,83,,percent of total billed charges,,42.55,,,,fee schedule,,42.55,,,,fee schedule,,,321.21,83,,percent of total billed charges,,160.4,,,,fee schedule,,,348.3,90,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,348.3,90,,percent of total billed charges,,,328.95,85,,percent of total billed charges,,42.55,367.65,
ATTENDANCE AT DELIVERY,99464,CDM,99464,CPT,,,both,,735,735,98.36,,,,fee schedule,,,,,,,,83.7,,,,fee schedule,,,624.75,85,,percent of total billed charges,,125.95,,,,fee schedule,,76.4,,,,fee schedule,,83.7,,,,fee schedule,,,,,,,,83.7,,,,fee schedule,,120.21,,,,fee schedule,,72.86,,,,fee schedule,,72.86,,,,fee schedule,,,668.85,91,,percent of total billed charges,,,698.25,95,,percent of total billed charges,,,610.05,83,,percent of total billed charges,,,220.5,83,,percent of total billed charges,,83.7,,,,fee schedule,,83.7,,,,fee schedule,,,610.05,83,,percent of total billed charges,,107.1,,,,fee schedule,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,661.5,90,,percent of total billed charges,,,624.75,85,,percent of total billed charges,,72.86,698.25,
NB RESUSCITATION,99465,CDM,99465,CPT,,,both,,1471,1471,191.23,,,,fee schedule,,,,,,,,94.5,,,,fee schedule,,,1250.35,85,,percent of total billed charges,,255.1,,,,fee schedule,,148.99,,,,fee schedule,,94.5,,,,fee schedule,,,,,,,,94.5,,,,fee schedule,,233.72,,,,fee schedule,,141.65,,,,fee schedule,,141.65,,,,fee schedule,,,1338.61,91,,percent of total billed charges,,,1397.45,95,,percent of total billed charges,,,1220.93,83,,percent of total billed charges,,,441.3,83,,percent of total billed charges,,94.5,,,,fee schedule,,94.5,,,,fee schedule,,,1220.93,83,,percent of total billed charges,,208.22,,,,fee schedule,,,1323.9,90,,percent of total billed charges,,,1323.9,90,,percent of total billed charges,,,1323.9,90,,percent of total billed charges,,,1323.9,90,,percent of total billed charges,,,1250.35,85,,percent of total billed charges,,94.5,1397.45,
PED CRIT CARE TRANSPORT,99466,CDM,99466,CPT,,,both,,951,951,312.91,,,,fee schedule,,,,,,,,,,,,,,,808.35,85,,percent of total billed charges,,324.51,,,,fee schedule,,238.47,,,,fee schedule,,,,,,,,,,,,,,,,,,,,382.45,,,,fee schedule,,231.79,,,,fee schedule,,231.79,,,,fee schedule,,,865.41,91,,percent of total billed charges,,,903.45,95,,percent of total billed charges,,,789.33,83,,percent of total billed charges,,,285.3,83,,percent of total billed charges,,,,,,,,,,,,,,,789.33,83,,percent of total billed charges,,340.73,,,,fee schedule,,,855.9,90,,percent of total billed charges,,,855.9,90,,percent of total billed charges,,,855.9,90,,percent of total billed charges,,,855.9,90,,percent of total billed charges,,,808.35,85,,percent of total billed charges,,231.79,903.45,
SUPRV INTERFACILTY TRANSPORT,99485,CDM,99485,CPT,,,both,,424,424,99.73,,,,fee schedule,,,,,,,,,,,,,,,360.4,85,,percent of total billed charges,,101.99,,,,fee schedule,,82.95,,,,fee schedule,,,,,,,,,,,,,,,,,,,,121.89,,,,fee schedule,,73.87,,,,fee schedule,,73.87,,,,fee schedule,,,385.84,91,,percent of total billed charges,,,402.8,95,,percent of total billed charges,,,351.92,83,,percent of total billed charges,,,127.2,83,,percent of total billed charges,,,,,,,,,,,,,,,351.92,83,,percent of total billed charges,,108.59,,,,fee schedule,,,381.6,90,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,381.6,90,,percent of total billed charges,,,360.4,85,,percent of total billed charges,,73.87,402.8,
CHRON CARE MGMT SRVC 20 MIN,99490,CDM,99490,CPT,,,both,,101,101,68.16,,,,fee schedule,,,,,,,,,,,,,,,85.85,85,,percent of total billed charges,,59.09,,,,fee schedule,,62.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,83.31,,,,fee schedule,,50.49,,,,fee schedule,,50.49,,,,fee schedule,,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,30.3,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,74.22,,,,fee schedule,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,30.3,95.95,
CHRON CARE MGMT SRVC 20 MIN,99490P,CDM,99490,CPT,,,both,P,50,50,68.16,,,,fee schedule,,,,,,,,,,,,,,,42.5,85,,percent of total billed charges,,59.09,,,,fee schedule,,62.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,83.31,,,,fee schedule,,50.49,,,,fee schedule,,50.49,,,,fee schedule,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,74.22,,,,fee schedule,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,15,83.31,
CHRON CARE MGMT SRVC 20 MIN,99490T,CDM,99490,CPT,,,both,T,51,51,68.16,,,,fee schedule,,,,,,,,,,,,,,,43.35,85,,percent of total billed charges,,59.09,,,,fee schedule,,62.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,83.31,,,,fee schedule,,50.49,,,,fee schedule,,50.49,,,,fee schedule,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,74.22,,,,fee schedule,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,15.3,83.31,
TRANS CARE MGMT 14 DAY DISCH,99495,CDM,99495,CPT,,,both,,435,435,188.94,,,,fee schedule,,,,,,,,,,,,,,,369.75,85,,percent of total billed charges,,159.98,,,,fee schedule,,143.34,,,,fee schedule,,,,,,,,,,,,,,,,,,,,230.92,,,,fee schedule,,139.95,,,,fee schedule,,139.95,,,,fee schedule,,,395.85,91,,percent of total billed charges,,,413.25,95,,percent of total billed charges,,,361.05,83,,percent of total billed charges,,,130.5,83,,percent of total billed charges,,,,,,,,,,,,,,,361.05,83,,percent of total billed charges,,205.73,,,,fee schedule,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,391.5,90,,percent of total billed charges,,,369.75,85,,percent of total billed charges,,130.5,413.25,
TRANS CARE MGMT 14 DAY DISCH,99495P,CDM,99495,CPT,,,both,P,275,275,188.94,,,,fee schedule,,,,,,,,,,,,,,,233.75,85,,percent of total billed charges,,159.98,,,,fee schedule,,143.34,,,,fee schedule,,,,,,,,,,,,,,,,,,,,230.92,,,,fee schedule,,139.95,,,,fee schedule,,139.95,,,,fee schedule,,,250.25,91,,percent of total billed charges,,,261.25,95,,percent of total billed charges,,,228.25,83,,percent of total billed charges,,,82.5,83,,percent of total billed charges,,,,,,,,,,,,,,,228.25,83,,percent of total billed charges,,205.73,,,,fee schedule,,,247.5,90,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,247.5,90,,percent of total billed charges,,,233.75,85,,percent of total billed charges,,82.5,261.25,
TRANS CARE MGMT 14 DAY DISCH,99495T,CDM,99495,CPT,,,both,T,160,160,188.94,,,,fee schedule,,,,,,,,,,,,,,,136,85,,percent of total billed charges,,159.98,,,,fee schedule,,143.34,,,,fee schedule,,,,,,,,,,,,,,,,,,,,230.92,,,,fee schedule,,139.95,,,,fee schedule,,139.95,,,,fee schedule,,,145.6,91,,percent of total billed charges,,,152,95,,percent of total billed charges,,,132.8,83,,percent of total billed charges,,,48,83,,percent of total billed charges,,,,,,,,,,,,,,,132.8,83,,percent of total billed charges,,205.73,,,,fee schedule,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,144,90,,percent of total billed charges,,,136,85,,percent of total billed charges,,48,230.92,
TRANS CARE MGMT 7 DAY DISCH,99496,CDM,99496,CPT,,,both,,552,552,257.56,,,,fee schedule,,,,,,,,,,,,,,,469.2,85,,percent of total billed charges,,226.58,,,,fee schedule,,194.01,,,,fee schedule,,,,,,,,,,,,,,,,,,,,314.8,,,,fee schedule,,190.78,,,,fee schedule,,190.78,,,,fee schedule,,,502.32,91,,percent of total billed charges,,,524.4,95,,percent of total billed charges,,,458.16,83,,percent of total billed charges,,,165.6,83,,percent of total billed charges,,,,,,,,,,,,,,,458.16,83,,percent of total billed charges,,280.45,,,,fee schedule,,,496.8,90,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,496.8,90,,percent of total billed charges,,,469.2,85,,percent of total billed charges,,165.6,524.4,
TRANS CARE MGMT 7 DAY DISCH,99496P,CDM,99496,CPT,,,both,P,385,385,257.56,,,,fee schedule,,,,,,,,,,,,,,,327.25,85,,percent of total billed charges,,226.58,,,,fee schedule,,194.01,,,,fee schedule,,,,,,,,,,,,,,,,,,,,314.8,,,,fee schedule,,190.78,,,,fee schedule,,190.78,,,,fee schedule,,,350.35,91,,percent of total billed charges,,,365.75,95,,percent of total billed charges,,,319.55,83,,percent of total billed charges,,,115.5,83,,percent of total billed charges,,,,,,,,,,,,,,,319.55,83,,percent of total billed charges,,280.45,,,,fee schedule,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,346.5,90,,percent of total billed charges,,,327.25,85,,percent of total billed charges,,115.5,365.75,
TRANS CARE MGMT 7 DAY DISCH,99496T,CDM,99496,CPT,,,both,T,167,167,257.56,,,,fee schedule,,,,,,,,,,,,,,,141.95,85,,percent of total billed charges,,226.58,,,,fee schedule,,194.01,,,,fee schedule,,,,,,,,,,,,,,,,,,,,314.8,,,,fee schedule,,190.78,,,,fee schedule,,190.78,,,,fee schedule,,,151.97,91,,percent of total billed charges,,,158.65,95,,percent of total billed charges,,,138.61,83,,percent of total billed charges,,,50.1,83,,percent of total billed charges,,,,,,,,,,,,,,,138.61,83,,percent of total billed charges,,280.45,,,,fee schedule,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,150.3,90,,percent of total billed charges,,,141.95,85,,percent of total billed charges,,50.1,314.8,
ADVNCD CARE PLAN 30 MIN,99497,CDM,99497,CPT,,,both,,224,224,102.02,,,,fee schedule,,,,,,,,,,,,,,,190.4,85,,percent of total billed charges,,50,,,,fee schedule,,50,,,,fee schedule,,,,,,,,,,,,,,,,,,,,124.69,,,,fee schedule,,75.57,,,,fee schedule,,75.57,,,,fee schedule,,,203.84,91,,percent of total billed charges,,,212.8,95,,percent of total billed charges,,,185.92,83,,percent of total billed charges,,,67.2,83,,percent of total billed charges,,,,,,,,,,,,,,,185.92,83,,percent of total billed charges,,111.09,,,,fee schedule,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,201.6,90,,percent of total billed charges,,,190.4,85,,percent of total billed charges,,50,212.8,
ADVNCD CARE PLAN 30 MIN,99497P,CDM,99497,CPT,,,both,P,97,97,102.02,,,,fee schedule,,,,,,,,,,,,,,,82.45,85,,percent of total billed charges,,50,,,,fee schedule,,50,,,,fee schedule,,,,,,,,,,,,,,,,,,,,124.69,,,,fee schedule,,75.57,,,,fee schedule,,75.57,,,,fee schedule,,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,29.1,83,,percent of total billed charges,,,,,,,,,,,,,,,80.51,83,,percent of total billed charges,,111.09,,,,fee schedule,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,29.1,124.69,
ADVNCD CARE PLAN 30 MIN,99497T,CDM,99497,CPT,,,both,T,127,127,102.02,,,,fee schedule,,,,,,,,,,,,,,,107.95,85,,percent of total billed charges,,50,,,,fee schedule,,50,,,,fee schedule,,,,,,,,,,,,,,,,,,,,124.69,,,,fee schedule,,75.57,,,,fee schedule,,75.57,,,,fee schedule,,,115.57,91,,percent of total billed charges,,,120.65,95,,percent of total billed charges,,,105.41,83,,percent of total billed charges,,,38.1,83,,percent of total billed charges,,,,,,,,,,,,,,,105.41,83,,percent of total billed charges,,111.09,,,,fee schedule,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,114.3,90,,percent of total billed charges,,,107.95,85,,percent of total billed charges,,38.1,124.69,
ADVNCD CARE PLAN ADDL 30 MIN,99498,CDM,99498,CPT,,,both,,136,136,96.53,,,,fee schedule,,,,,,,,,,,,,,,115.6,85,,percent of total billed charges,,40,,,,fee schedule,,40,,,,fee schedule,,,,,,,,,,,,,,,,,,,,117.98,,,,fee schedule,,71.5,,,,fee schedule,,71.5,,,,fee schedule,,,123.76,91,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,40.8,83,,percent of total billed charges,,,,,,,,,,,,,,,112.88,83,,percent of total billed charges,,105.11,,,,fee schedule,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,40,129.2,
ADVNCD CARE PLAN ADDL 30 MIN,99498P,CDM,99498,CPT,,,both,P,84,84,96.53,,,,fee schedule,,,,,,,,,,,,,,,71.4,85,,percent of total billed charges,,40,,,,fee schedule,,40,,,,fee schedule,,,,,,,,,,,,,,,,,,,,117.98,,,,fee schedule,,71.5,,,,fee schedule,,71.5,,,,fee schedule,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,25.2,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,105.11,,,,fee schedule,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,25.2,117.98,
ADVNCD CARE PLAN ADDL 30 MIN,99498T,CDM,99498,CPT,,,both,T,52,52,96.53,,,,fee schedule,,,,,,,,,,,,,,,44.2,85,,percent of total billed charges,,40,,,,fee schedule,,40,,,,fee schedule,,,,,,,,,,,,,,,,,,,,117.98,,,,fee schedule,,71.5,,,,fee schedule,,71.5,,,,fee schedule,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,15.6,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,105.11,,,,fee schedule,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,15.6,117.98,
Sterile needle,A4215,CDM,A4215,HCPCS,,,both,,116,116,0.15,,,,fee schedule,,,,,,,,,,,,,,,98.6,85,,percent of total billed charges,,0.5,,,,fee schedule,,1,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,105.56,91,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,34.8,83,,percent of total billed charges,,,,,,,,,,,,,,,96.28,83,,percent of total billed charges,,,,,,,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,98.6,85,,percent of total billed charges,,0.15,110.2,
Intratubal occlusion device,A4264,CDM,A4264,HCPCS,,,both,,2787,2787,968.74,,,,fee schedule,,,,,,,,,,,,,,,2368.95,85,,percent of total billed charges,,3000,,,,fee schedule,,3000,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2536.17,91,,percent of total billed charges,,,2647.65,95,,percent of total billed charges,,,2313.21,83,,percent of total billed charges,,,836.1,83,,percent of total billed charges,,,,,,,,,,,,,,,2313.21,83,,percent of total billed charges,,,,,,,,,2508.3,90,,percent of total billed charges,,,2508.3,90,,percent of total billed charges,,,2508.3,90,,percent of total billed charges,,,2508.3,90,,percent of total billed charges,,,2368.95,85,,percent of total billed charges,,836.1,3000,
Insert tray w/o bag/cath,A4310,CDM,A4310,HCPCS,,,both,,22,22,3.2,,,,fee schedule,,,,,,,,,,,,,,,18.7,85,,percent of total billed charges,,7.18,,,,fee schedule,,4.96,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.02,91,,percent of total billed charges,,,20.9,95,,percent of total billed charges,,,18.26,83,,percent of total billed charges,,,6.6,83,,percent of total billed charges,,,,,,,,,,,,,,,18.26,83,,percent of total billed charges,,,,,,,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,19.8,90,,percent of total billed charges,,,18.7,85,,percent of total billed charges,,3.2,20.9,
Catheter w/o bag 2-way latex,A4311,CDM,A4311,HCPCS,,,both,,34,34,6.14,,,,fee schedule,,,,,,,,,,,,,,,28.9,85,,percent of total billed charges,,13.77,,,,fee schedule,,8.88,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,10.2,83,,percent of total billed charges,,,,,,,,,,,,,,,28.22,83,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,6.14,32.3,
Cath w/o bag 2-way silicone,A4312,CDM,A4312,HCPCS,,,both,,31,31,7.47,,,,fee schedule,,,,,,,,,,,,,,,26.35,85,,percent of total billed charges,,16.77,,,,fee schedule,,13.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,9.3,83,,percent of total billed charges,,,,,,,,,,,,,,,25.73,83,,percent of total billed charges,,,,,,,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,7.47,29.45,
Cath w/drainage 2-way latex,A4314,CDM,A4314,HCPCS,,,both,,45,45,10.47,,,,fee schedule,,,,,,,,,,,,,,,38.25,85,,percent of total billed charges,,23.51,,,,fee schedule,,18.56,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,13.5,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,,,,,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,10.47,42.75,
Irrigation tray,A4320,CDM,A4320,HCPCS,,,both,,9,9,2.21,,,,fee schedule,,,,,,,,,,,,,,,7.65,85,,percent of total billed charges,,4.63,,,,fee schedule,,3.32,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,2.7,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,,,,,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,2.21,8.55,
Indwelling catheter latex,A4338,CDM,A4338,HCPCS,,,both,,18,18,5.08,,,,fee schedule,,,,,,,,,,,,,,,15.3,85,,percent of total billed charges,,11.41,,,,fee schedule,,9.01,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,5.4,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,5.08,17.1,
Cath indw foley 2 way silicn,A4344,CDM,A4344,HCPCS,,,both,,13,13,6.63,,,,fee schedule,,,,,,,,,,,,,,,11.05,85,,percent of total billed charges,,12.78,,,,fee schedule,,10.26,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,3.9,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,3.9,12.78,
Straight tip urine catheter,A4351,CDM,A4351,HCPCS,,,both,,9,9,0.75,,,,fee schedule,,,,,,,,,,,,,,,7.65,85,,percent of total billed charges,,1.69,,,,fee schedule,,1.02,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,2.7,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,,,,,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,0.75,8.55,
Intermittent urinary cath,A4353,CDM,A4353,HCPCS,,,both,,7,7,2.9,,,,fee schedule,,,,,,,,,,,,,,,5.95,85,,percent of total billed charges,,6.51,,,,fee schedule,,4.19,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.37,91,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,2.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5.81,83,,percent of total billed charges,,,,,,,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,2.1,6.65,
Urinary leg or abdomen bag,A4358,CDM,A4358,HCPCS,,,both,,8,8,2.75,,,,fee schedule,,,,,,,,,,,,,,,6.8,85,,percent of total billed charges,,6.16,,,,fee schedule,,4.26,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7.28,91,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,2.4,83,,percent of total billed charges,,,,,,,,,,,,,,,6.64,83,,percent of total billed charges,,,,,,,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.8,85,,percent of total billed charges,,2.4,7.6,
Belt strap sleev grmnt cover,A4467,CDM,A4467,HCPCS,,,both,,55,55,21.93,,,,fee schedule,,,,,,,,,,,,,,,46.75,85,,percent of total billed charges,,80,,,,fee schedule,,80,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,16.5,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,16.5,80,
"Pessary, non rubber,any type",A4562,CDM,A4562,HCPCS,,,both,,67,67,22.16,,,,fee schedule,,,,,,,,,,,,,,,56.95,85,,percent of total billed charges,,47.35,,,,fee schedule,,30.22,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,20.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55.61,83,,percent of total billed charges,,,,,,,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,20.1,63.65,
Slings,A4565,CDM,A4565,HCPCS,,,both,,14,14,2.15,,,,fee schedule,,,,,,,,,,,,,,,11.9,85,,percent of total billed charges,,7.16,,,,fee schedule,,6.41,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.74,91,,percent of total billed charges,,,13.3,95,,percent of total billed charges,,,11.62,83,,percent of total billed charges,,,4.2,83,,percent of total billed charges,,,,,,,,,,,,,,,11.62,83,,percent of total billed charges,,,,,,,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,11.9,85,,percent of total billed charges,,2.15,13.3,
Shoulder Mobilizer,A4566,CDM,A4566,HCPCS,,,both,,84,84,51.12,,,,fee schedule,,,,,,,,,,,,,,,71.4,85,,percent of total billed charges,,193,,,,fee schedule,,193,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,25.2,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,25.2,193,
Splint,A4570,CDM,A4570,HCPCS,,,both,,63,63,5.36,,,,fee schedule,,,,,,,,,,,,,,,53.55,85,,percent of total billed charges,,48,,,,fee schedule,,48,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,18.9,83,,percent of total billed charges,,,,,,,,,,,,,,,52.29,83,,percent of total billed charges,,,,,,,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,5.36,59.85,
Hand-held PEFR meter,A4614,CDM,A4614,HCPCS,,,both,,65,65,9.85,,,,fee schedule,,,,,,,,,,,,,,,55.25,85,,percent of total billed charges,,22.12,,,,fee schedule,,14.11,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,59.15,91,,percent of total billed charges,,,61.75,95,,percent of total billed charges,,,53.95,83,,percent of total billed charges,,,19.5,83,,percent of total billed charges,,,,,,,,,,,,,,,53.95,83,,percent of total billed charges,,,,,,,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,55.25,85,,percent of total billed charges,,9.85,61.75,
"Diabetic shoe for density insert, Each",A5500,CDM,A5500,HCPCS,,,both,,106,106,43.37,,,,fee schedule,,,,,,,,,,,,,,,90.1,85,,percent of total billed charges,,59.13,,,,fee schedule,,51.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,31.8,83,,percent of total billed charges,,,,,,,,,,,,,,,87.98,83,,percent of total billed charges,,,,,,,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,31.8,100.7,
"Multi den insert direct form, Each",A5512,CDM,A5512,HCPCS,,,both,,25,25,11.37,,,,fee schedule,,,,,,,,,,,,,,,21.25,85,,percent of total billed charges,,24.11,,,,fee schedule,,17.77,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.75,91,,percent of total billed charges,,,23.75,95,,percent of total billed charges,,,20.75,83,,percent of total billed charges,,,7.5,83,,percent of total billed charges,,,,,,,,,,,,,,,20.75,83,,percent of total billed charges,,,,,,,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,21.25,85,,percent of total billed charges,,7.5,24.11,
Alginate dressing <=16 sq in,A6196,CDM,A6196,HCPCS,,,both,,21,21,3.05,,,,fee schedule,,,,,,,,,,,,,,,17.85,85,,percent of total billed charges,,6.85,,,,fee schedule,,5.41,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,6.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,,,,,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,3.05,19.95,
Alginate drsg >16 <=48 sq in,A6197,CDM,A6197,HCPCS,,,both,,37,37,6.8,,,,fee schedule,,,,,,,,,,,,,,,31.45,85,,percent of total billed charges,,15.29,,,,fee schedule,,12.07,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,11.1,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,,,,,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,6.8,35.15,
Impreg gauze no h20/sal/yard,A6266,CDM,A6266,HCPCS,,,both,,11,11,0.8,,,,fee schedule,,,,,,,,,,,,,,,9.35,85,,percent of total billed charges,,1.78,,,,fee schedule,,1.44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,3.3,83,,percent of total billed charges,,,,,,,,,,,,,,,9.13,83,,percent of total billed charges,,,,,,,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,0.8,10.45,
"Lt compres band <3/yd""",A6448,CDM,A6448,HCPCS,,,both,,13,13,0.48,,,,fee schedule,,,,,,,,,,,,,,,11.05,85,,percent of total billed charges,,1.07,,,,fee schedule,,0.85,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,3.9,83,,percent of total billed charges,,,,,,,,,,,,,,,10.79,83,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,0.48,12.35,
"Lt compres band >=3 <5/yd""""",A6449,CDM,A6449,HCPCS,,,both,,12,12,0.73,,,,fee schedule,,,,,,,,,,,,,,,10.2,85,,percent of total billed charges,,1.63,,,,fee schedule,,1.28,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,3.6,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,,,,,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,0.73,11.4,
"Lt compres band >=5/yd""",A6450,CDM,A6450,HCPCS,,,both,,16,16,4.5,,,,fee schedule,,,,,,,,,,,,,,,13.6,85,,percent of total billed charges,,1.63,,,,fee schedule,,1.63,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.56,91,,percent of total billed charges,,,15.2,95,,percent of total billed charges,,,13.28,83,,percent of total billed charges,,,4.8,83,,percent of total billed charges,,,,,,,,,,,,,,,13.28,83,,percent of total billed charges,,,,,,,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,13.6,85,,percent of total billed charges,,1.63,15.2,
Self-adher band 5 yd,A6455,CDM,A6455,HCPCS,,,both,,21,21,0.58,,,,fee schedule,,,,,,,,,,,,,,,17.85,85,,percent of total billed charges,,1.29,,,,fee schedule,,1.02,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,6.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,,,,,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,0.58,19.95,
"Zinc paste band w >=3<5""/yd""",A6456,CDM,A6456,HCPCS,,,both,,105,105,0.53,,,,fee schedule,,,,,,,,,,,,,,,89.25,85,,percent of total billed charges,,1.17,,,,fee schedule,,0.92,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,95.55,91,,percent of total billed charges,,,99.75,95,,percent of total billed charges,,,87.15,83,,percent of total billed charges,,,31.5,83,,percent of total billed charges,,,,,,,,,,,,,,,87.15,83,,percent of total billed charges,,,,,,,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,94.5,90,,percent of total billed charges,,,89.25,85,,percent of total billed charges,,0.53,99.75,
Aerosol mask used w nebulize,A7015,CDM,A7015,HCPCS,,,both,,11,11,0.78,,,,fee schedule,,,,,,,,,,,,,,,9.35,85,,percent of total billed charges,,1.16,,,,fee schedule,,0.87,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,3.3,83,,percent of total billed charges,,,,,,,,,,,,,,,9.13,83,,percent of total billed charges,,,,,,,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,0.78,10.45,
Vacuum drain bottle/tube kit,A7048,CDM,A7048,HCPCS,,,both,,147,147,18.88,,,,fee schedule,,,,,,,,,,,,,,,124.95,85,,percent of total billed charges,,103.58,,,,fee schedule,,103.58,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,133.77,91,,percent of total billed charges,,,139.65,95,,percent of total billed charges,,,122.01,83,,percent of total billed charges,,,44.1,83,,percent of total billed charges,,,,,,,,,,,,,,,122.01,83,,percent of total billed charges,,,,,,,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,132.3,90,,percent of total billed charges,,,124.95,85,,percent of total billed charges,,18.88,139.65,
Cryo Knee Pad,A9270,CDM,A9270,HCPCS,,,both,,37,37,0.01,,,,fee schedule,,,,,,,,,,,,,,,31.45,85,,percent of total billed charges,,79,,,,fee schedule,,79,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,11.1,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,,,,,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,0.01,79,
Cryo Shoulder Pad XL Strap,A9270XL,CDM,A9270,HCPCS,,,both,,54,54,0.01,,,,fee schedule,,,,,,,,,,,,,,,45.9,85,,percent of total billed charges,,79,,,,fee schedule,,79,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,49.14,91,,percent of total billed charges,,,51.3,95,,percent of total billed charges,,,44.82,83,,percent of total billed charges,,,16.2,83,,percent of total billed charges,,,,,,,,,,,,,,,44.82,83,,percent of total billed charges,,,,,,,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,48.6,90,,percent of total billed charges,,,45.9,85,,percent of total billed charges,,0.01,79,
"Lead, neurostimulator",C1778,CDM,C1778,HCPCS,,,both,,8748,8748,,,,,,,,,,,,,,,,,,,,7435.8,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,7960.68,91,,percent of total billed charges,,,8310.6,95,,percent of total billed charges,,,7260.84,83,,percent of total billed charges,,,2624.4,83,,percent of total billed charges,,,,,,,,,,,,,,,7260.84,83,,percent of total billed charges,,,,,,,,,7873.2,90,,percent of total billed charges,,,7873.2,90,,percent of total billed charges,,,7873.2,90,,percent of total billed charges,,,7873.2,90,,percent of total billed charges,,,7435.8,85,,percent of total billed charges,,2624.4,8310.6,
"Port, indwelling, imp",C1788,CDM,C1788,HCPCS,,,both,,1640,1640,,,,,,,,,,,,,,,,,,,,1394,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1492.4,91,,percent of total billed charges,,,1558,95,,percent of total billed charges,,,1361.2,83,,percent of total billed charges,,,492,83,,percent of total billed charges,,,,,,,,,,,,,,,1361.2,83,,percent of total billed charges,,,,,,,,,1476,90,,percent of total billed charges,,,1476,90,,percent of total billed charges,,,1476,90,,percent of total billed charges,,,1476,90,,percent of total billed charges,,,1394,85,,percent of total billed charges,,492,1558,
TEE w/contrast; monitor,C8927,CDM,C8927,HCPCS,,,both,,746,746,,,,,,,,,,,,,,,,,,,,634.1,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,678.86,91,,percent of total billed charges,,,708.7,95,,percent of total billed charges,,,619.18,83,,percent of total billed charges,,,223.8,83,,percent of total billed charges,,,,,,,,,,,,,,,619.18,83,,percent of total billed charges,,,,,,,,,671.4,90,,percent of total billed charges,,,671.4,90,,percent of total billed charges,,,671.4,90,,percent of total billed charges,,,671.4,90,,percent of total billed charges,,,634.1,85,,percent of total billed charges,,223.8,708.7,
Fluoride Varnish,D1206,CDM,D1206,HCPCS,,,both,,32,32,,,,,,,,,,,,,26,,,,fee schedule,,,27.2,85,,percent of total billed charges,,,,,,,,,,,,,,26,,,,fee schedule,,,,,,,,26,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,9.6,83,,percent of total billed charges,,26,,,,fee schedule,,26,,,,fee schedule,,,26.56,83,,percent of total billed charges,,,,,,,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,9.6,30.4,
Disabilty Forms,DF,CDM,,,,,both,,36,36,,,,,,,,,,,,,,,,,,,,30.6,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,10.8,83,,percent of total billed charges,,,,,,,,,,,,,,,29.88,83,,percent of total billed charges,,,,,,,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,10.8,34.2,
Crutch underarm pair no wood,E0114,CDM,E0114,HCPCS,,,both,,93,93,,,,,,,,,,,,,,,,,,,,79.05,85,,percent of total billed charges,,46.19,,,,fee schedule,,23.31,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,23.31,88.35,
Crutches Alum Adult Large,E0114AL,CDM,E0114,HCPCS,,,both,,50,50,,,,,,,,,,,,,,,,,,,,42.5,85,,percent of total billed charges,,46.19,,,,fee schedule,,23.31,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,45.5,91,,percent of total billed charges,,,47.5,95,,percent of total billed charges,,,41.5,83,,percent of total billed charges,,,15,83,,percent of total billed charges,,,,,,,,,,,,,,,41.5,83,,percent of total billed charges,,,,,,,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,45,90,,percent of total billed charges,,,42.5,85,,percent of total billed charges,,15,47.5,
Crutches Alum Medium,E0114Med,CDM,E0114,HCPCS,,,both,,48,48,,,,,,,,,,,,,,,,,,,,40.8,85,,percent of total billed charges,,46.19,,,,fee schedule,,23.31,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,14.4,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,,,,,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,14.4,46.19,
Crutches Alum Youth,E0114Youth,CDM,E0114,HCPCS,,,both,,84,84,,,,,,,,,,,,,,,,,,,,71.4,85,,percent of total billed charges,,46.19,,,,fee schedule,,23.31,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,76.44,91,,percent of total billed charges,,,79.8,95,,percent of total billed charges,,,69.72,83,,percent of total billed charges,,,25.2,83,,percent of total billed charges,,,,,,,,,,,,,,,69.72,83,,percent of total billed charges,,,,,,,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,75.6,90,,percent of total billed charges,,,71.4,85,,percent of total billed charges,,23.31,79.8,
Walker w trunk support,E0140,CDM,E0140,HCPCS,,,both,,78,78,,,,,,,,,,,,,,,,,,,,66.3,85,,percent of total billed charges,,331.18,,,,fee schedule,,181.17,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,23.4,331.18,
Heavy duty wheeled walker,E0149,CDM,E0149,HCPCS,,,both,,155,155,,,,,,,,,,,,,,,,,,,,131.75,85,,percent of total billed charges,,151.56,,,,fee schedule,,112.1,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,,,,,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,46.5,151.56,
Walker leg extenders set of4,E0158,CDM,E0158,HCPCS,,,both,,61,61,,,,,,,,,,,,,,,,,,,,51.85,85,,percent of total billed charges,,20.15,,,,fee schedule,,15.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,55.51,91,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,18.3,83,,percent of total billed charges,,,,,,,,,,,,,,,50.63,83,,percent of total billed charges,,,,,,,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,15.24,57.95,
Protector heel or elbow,E0191,CDM,E0191,HCPCS,,,both,,29,29,,,,,,,,,,,,,,,,,,,,24.65,85,,percent of total billed charges,,9.29,,,,fee schedule,,5.38,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.39,91,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,8.7,83,,percent of total billed charges,,,,,,,,,,,,,,,24.07,83,,percent of total billed charges,,,,,,,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,5.38,27.55,
Pump for water circulating p,E0236,CDM,E0236,HCPCS,,,both,,94,94,,,,,,,,,,,,,,,,,,,,79.9,85,,percent of total billed charges,,534.8,,,,fee schedule,,357.52,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,85.54,91,,percent of total billed charges,,,89.3,95,,percent of total billed charges,,,78.02,83,,percent of total billed charges,,,28.2,83,,percent of total billed charges,,,,,,,,,,,,,,,78.02,83,,percent of total billed charges,,,,,,,,,84.6,90,,percent of total billed charges,,,84.6,90,,percent of total billed charges,,,84.6,90,,percent of total billed charges,,,84.6,90,,percent of total billed charges,,,79.9,85,,percent of total billed charges,,28.2,534.8,
Non-elec oscillatory pep dvc,E0484,CDM,E0484,HCPCS,,,both,,140,140,,,,,,,,,,,,,,,,,,,,119,85,,percent of total billed charges,,34.34,,,,fee schedule,,19.88,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,42,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,,,,,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,19.88,133,
Patient lift sling or seat,E0621,CDM,E0621,HCPCS,,,both,,232,232,,,,,,,,,,,,,,,,,,,,197.2,85,,percent of total billed charges,,70.56,,,,fee schedule,,51.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,211.12,91,,percent of total billed charges,,,220.4,95,,percent of total billed charges,,,192.56,83,,percent of total billed charges,,,69.6,83,,percent of total billed charges,,,,,,,,,,,,,,,192.56,83,,percent of total billed charges,,,,,,,,,208.8,90,,percent of total billed charges,,,208.8,90,,percent of total billed charges,,,208.8,90,,percent of total billed charges,,,208.8,90,,percent of total billed charges,,,197.2,85,,percent of total billed charges,,51.62,220.4,
Tens two lead,E0720,CDM,E0720,HCPCS,,,both,,89,89,,,,,,,,,,,,,,,,,,,,75.65,85,,percent of total billed charges,,159.27,,,,fee schedule,,85.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,80.99,91,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,26.7,83,,percent of total billed charges,,,,,,,,,,,,,,,73.87,83,,percent of total billed charges,,,,,,,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,26.7,159.27,
Durable medical equipment mi,E1399,CDM,E1399,HCPCS,,,both,,14,14,,,,,,,,,,,,,,,,,,,,11.9,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.74,91,,percent of total billed charges,,,13.3,95,,percent of total billed charges,,,11.62,83,,percent of total billed charges,,,4.2,83,,percent of total billed charges,,,,,,,,,,,,,,,11.62,83,,percent of total billed charges,,,,,,,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,11.9,85,,percent of total billed charges,,4.2,13.3,
Durable medical equipment mi,E1399N,CDM,E1399,HCPCS,,,both,N,14,14,,,,,,,,,,,,,,,,,,,,11.9,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.74,91,,percent of total billed charges,,,13.3,95,,percent of total billed charges,,,11.62,83,,percent of total billed charges,,,4.2,83,,percent of total billed charges,,,,,,,,,,,,,,,11.62,83,,percent of total billed charges,,,,,,,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,11.9,85,,percent of total billed charges,,4.2,13.3,
SPS knee device,E1811,CDM,E1811,HCPCS,,,both,,217,217,,,,,,,,,,,,,,,,,,,,184.45,85,,percent of total billed charges,,1621.11,,,,fee schedule,,1306.33,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,65.1,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,,,,,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,65.1,1621.11,
Admin influenza virus vac,G0008,CDM,G0008,HCPCS,,,both,,46,46,,,,,,,,,,,,,,,,,,,,39.1,85,,percent of total billed charges,,15,,,,fee schedule,,15,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,13.8,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,13.8,43.7,
Admin pneumococcal vaccine,G0009,CDM,G0009,HCPCS,,,both,,46,46,,,,,,,,,,,,,,,,,,,,39.1,85,,percent of total billed charges,,15,,,,fee schedule,,15,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,13.8,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,13.8,43.7,
Admin hepatitis b vaccine,G0010,CDM,G0010,HCPCS,,,both,,49,49,,,,,,,,,,,,,,,,,,,,41.65,85,,percent of total billed charges,,15,,,,fee schedule,,15,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.59,91,,percent of total billed charges,,,46.55,95,,percent of total billed charges,,,40.67,83,,percent of total billed charges,,,14.7,83,,percent of total billed charges,,,,,,,,,,,,,,,40.67,83,,percent of total billed charges,,,,,,,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,41.65,85,,percent of total billed charges,,14.7,46.55,
Comm svcs by rhc/fqhc 5 min,G0071,CDM,G0071,HCPCS,,,both,,51,51,36.77,,,,fee schedule,,,,,,,,,,,,,,,43.35,85,,percent of total billed charges,,44,,,,fee schedule,,44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,39.14,,,,fee schedule,,23.72,,,,fee schedule,,23.72,,,,fee schedule,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,34.87,,,,fee schedule,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,15.3,48.45,
Telehealth Comm svcs by rhc/fqhc 5 min,G0071VV,CDM,G0071,HCPCS,,,both,,51,51,36.77,,,,fee schedule,,,,,,,,,,,,,,,43.35,85,,percent of total billed charges,,44,,,,fee schedule,,44,,,,fee schedule,,,,,,,,,,,,,,,,,,,,39.14,,,,fee schedule,,23.72,,,,fee schedule,,23.72,,,,fee schedule,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,34.87,,,,fee schedule,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,15.3,48.45,
CA screen;pelvic/breast exam,G0101,CDM,G0101,HCPCS,,,both,,106,106,43.07,,,,fee schedule,,,,,,,,32.86,,,,fee schedule,,,90.1,85,,percent of total billed charges,,58.82,,,,fee schedule,,29.02,,,,fee schedule,,32.86,,,,fee schedule,,42.45,,,,fee schedule,,32.86,,,,fee schedule,,45.85,,,,fee schedule,,27.79,,,,fee schedule,,27.79,,,,fee schedule,,,96.46,91,,percent of total billed charges,,,100.7,95,,percent of total billed charges,,,87.98,83,,percent of total billed charges,,,31.8,83,,percent of total billed charges,,32.86,,,,fee schedule,,32.86,,,,fee schedule,,,87.98,83,,percent of total billed charges,,40.85,,,,fee schedule,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,95.4,90,,percent of total billed charges,,,90.1,85,,percent of total billed charges,,27.79,100.7,
Prostate ca screening; Digital Rectal Exam,G0102,CDM,G0102,HCPCS,,,both,,56,56,13.66,,,,fee schedule,,,,,,,,28.35,,,,fee schedule,,,47.6,85,,percent of total billed charges,,18.59,,,,fee schedule,,9.17,,,,fee schedule,,28.35,,,,fee schedule,,15.92,,,,fee schedule,,28.35,,,,fee schedule,,14.54,,,,fee schedule,,8.81,,,,fee schedule,,8.81,,,,fee schedule,,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,16.8,83,,percent of total billed charges,,28.35,,,,fee schedule,,28.35,,,,fee schedule,,,46.48,83,,percent of total billed charges,,12.95,,,,fee schedule,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,8.81,53.2,
PSA Screening,G0103,CDM,G0103,HCPCS,,,both,,100,100,,,,,,,,,,,,,17.6,,,,fee schedule,,,85,85,,percent of total billed charges,,14.87,,,,fee schedule,,13.32,,,,fee schedule,,17.6,,,,fee schedule,,,,,,,,17.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,91,91,,percent of total billed charges,,,95,95,,percent of total billed charges,,,83,83,,percent of total billed charges,,,30,83,,percent of total billed charges,,17.6,,,,fee schedule,,17.6,,,,fee schedule,,,83,83,,percent of total billed charges,,,,,,,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,90,90,,percent of total billed charges,,,85,85,,percent of total billed charges,,13.32,95,
Colorectal scrn; hi risk ind,G0105,CDM,G0105,HCPCS,,,both,,3119,3119,284.69,,,,fee schedule,,,,,,,,214,,,,fee schedule,,,2651.15,85,,percent of total billed charges,,386.74,,,,fee schedule,,190.83,,,,fee schedule,,214,,,,fee schedule,,362.11,,,,fee schedule,,214,,,,fee schedule,,303.05,,,,fee schedule,,183.67,,,,fee schedule,,183.67,,,,fee schedule,,,2838.29,91,,percent of total billed charges,,,2963.05,95,,percent of total billed charges,,,2588.77,83,,percent of total billed charges,,,935.7,83,,percent of total billed charges,,214,,,,fee schedule,,214,,,,fee schedule,,,2588.77,83,,percent of total billed charges,,269.99,,,,fee schedule,,,2807.1,90,,percent of total billed charges,,,2807.1,90,,percent of total billed charges,,,2807.1,90,,percent of total billed charges,,,2807.1,90,,percent of total billed charges,,,2651.15,85,,percent of total billed charges,,183.67,2963.05,
Diab manage trn  per indiv,G0108,CDM,G0108,HCPCS,,,both,,129,129,85.09,,,,fee schedule,,,,,,,,,,,,,,,109.65,85,,percent of total billed charges,,55.46,,,,fee schedule,,56.33,,,,fee schedule,,,,,,,,55.71,,,,fee schedule,,,,,,,,90.58,,,,fee schedule,,54.9,,,,fee schedule,,54.9,,,,fee schedule,,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,38.7,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,80.7,,,,fee schedule,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,38.7,122.55,
Colon ca scrn not hi rsk ind,G0121,CDM,G0121,HCPCS,,,both,,3085,3085,285.21,,,,fee schedule,,,,,,,,214,,,,fee schedule,,,2622.25,85,,percent of total billed charges,,400.72,,,,fee schedule,,191.26,,,,fee schedule,,214,,,,fee schedule,,362.11,,,,fee schedule,,214,,,,fee schedule,,303.61,,,,fee schedule,,184.01,,,,fee schedule,,184.01,,,,fee schedule,,,2807.35,91,,percent of total billed charges,,,2930.75,95,,percent of total billed charges,,,2560.55,83,,percent of total billed charges,,,925.5,83,,percent of total billed charges,,214,,,,fee schedule,,214,,,,fee schedule,,,2560.55,83,,percent of total billed charges,,270.49,,,,fee schedule,,,2776.5,90,,percent of total billed charges,,,2776.5,90,,percent of total billed charges,,,2776.5,90,,percent of total billed charges,,,2776.5,90,,percent of total billed charges,,,2622.25,85,,percent of total billed charges,,184.01,2930.75,
Screen c/v thin layer by MD,G0124,CDM,G0124,HCPCS,,,both,,93,93,35.72,,,,fee schedule,,,,,,,,11.45,,,,fee schedule,,,79.05,85,,percent of total billed charges,,34.97,,,,fee schedule,,26.48,,,,fee schedule,,11.45,,,,fee schedule,,39.13,,,,fee schedule,,11.45,,,,fee schedule,,38.02,,,,fee schedule,,23.04,,,,fee schedule,,23.04,,,,fee schedule,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,11.45,,,,fee schedule,,11.45,,,,fee schedule,,,77.19,83,,percent of total billed charges,,33.87,,,,fee schedule,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,11.45,88.35,
TRIM NAIL(S),G0127,CDM,G0127,HCPCS,,,both,,76,76,11.56,,,,fee schedule,,,,,,,,14.35,,,,fee schedule,,,64.6,85,,percent of total billed charges,,14.96,,,,fee schedule,,9.35,,,,fee schedule,,14.35,,,,fee schedule,,16.58,,,,fee schedule,,14.35,,,,fee schedule,,12.3,,,,fee schedule,,7.46,,,,fee schedule,,7.46,,,,fee schedule,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,14.35,,,,fee schedule,,14.35,,,,fee schedule,,,63.08,83,,percent of total billed charges,,10.96,,,,fee schedule,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,7.46,72.2,
Wound closure by adhesive,G0168,CDM,G0168,HCPCS,,,both,,231,231,23.11,,,,fee schedule,,,,,,,,22.55,,,,fee schedule,,,196.35,85,,percent of total billed charges,,26.64,,,,fee schedule,,16.38,,,,fee schedule,,22.55,,,,fee schedule,,46.42,,,,fee schedule,,22.55,,,,fee schedule,,24.6,,,,fee schedule,,14.91,,,,fee schedule,,14.91,,,,fee schedule,,,210.21,91,,percent of total billed charges,,,219.45,95,,percent of total billed charges,,,191.73,83,,percent of total billed charges,,,69.3,83,,percent of total billed charges,,22.55,,,,fee schedule,,22.55,,,,fee schedule,,,191.73,83,,percent of total billed charges,,21.92,,,,fee schedule,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,207.9,90,,percent of total billed charges,,,196.35,85,,percent of total billed charges,,14.91,219.45,
Initial foot exam pt lops,G0245,CDM,G0245,HCPCS,,,both,,135,135,61.45,,,,fee schedule,,,,,,,,25.09,,,,fee schedule,,,114.75,85,,percent of total billed charges,,86.27,,,,fee schedule,,50.76,,,,fee schedule,,25.09,,,,fee schedule,,81.57,,,,fee schedule,,25.09,,,,fee schedule,,65.42,,,,fee schedule,,39.65,,,,fee schedule,,39.65,,,,fee schedule,,,122.85,91,,percent of total billed charges,,,128.25,95,,percent of total billed charges,,,112.05,83,,percent of total billed charges,,,40.5,83,,percent of total billed charges,,25.09,,,,fee schedule,,25.09,,,,fee schedule,,,112.05,83,,percent of total billed charges,,58.28,,,,fee schedule,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,121.5,90,,percent of total billed charges,,,114.75,85,,percent of total billed charges,,25.09,128.25,
Followup eval of foot pt lop,G0246,CDM,G0246,HCPCS,,,both,,82,82,30.99,,,,fee schedule,,,,,,,,12.6,,,,fee schedule,,,69.7,85,,percent of total billed charges,,42.44,,,,fee schedule,,24.97,,,,fee schedule,,12.6,,,,fee schedule,,41.78,,,,fee schedule,,12.6,,,,fee schedule,,32.99,,,,fee schedule,,19.99,,,,fee schedule,,19.99,,,,fee schedule,,,74.62,91,,percent of total billed charges,,,77.9,95,,percent of total billed charges,,,68.06,83,,percent of total billed charges,,,24.6,83,,percent of total billed charges,,12.6,,,,fee schedule,,12.6,,,,fee schedule,,,68.06,83,,percent of total billed charges,,29.39,,,,fee schedule,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,73.8,90,,percent of total billed charges,,,69.7,85,,percent of total billed charges,,12.6,77.9,
Routine footcare pt w lops,G0247,CDM,G0247,HCPCS,,,both,,102,102,33.62,,,,fee schedule,,,,,,,,14.27,,,,fee schedule,,,86.7,85,,percent of total billed charges,,36.4,,,,fee schedule,,22.83,,,,fee schedule,,14.27,,,,fee schedule,,48.41,,,,fee schedule,,14.27,,,,fee schedule,,35.78,,,,fee schedule,,21.69,,,,fee schedule,,21.69,,,,fee schedule,,,92.82,91,,percent of total billed charges,,,96.9,95,,percent of total billed charges,,,84.66,83,,percent of total billed charges,,,30.6,83,,percent of total billed charges,,14.27,,,,fee schedule,,14.27,,,,fee schedule,,,84.66,83,,percent of total billed charges,,31.88,,,,fee schedule,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,91.8,90,,percent of total billed charges,,,86.7,85,,percent of total billed charges,,14.27,96.9,
Inj for sacroiliac jt anesth,G0260,CDM,G0260,HCPCS,,,both,,1629,1629,,,,,,,,,,,,,31.8,,,,fee schedule,,,1384.65,85,,percent of total billed charges,,,,,,,,,,,,,,31.8,,,,fee schedule,,,,,,,,31.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,1482.39,91,,percent of total billed charges,,,1547.55,95,,percent of total billed charges,,,1352.07,83,,percent of total billed charges,,,488.7,83,,percent of total billed charges,,31.8,,,,fee schedule,,31.8,,,,fee schedule,,,1352.07,83,,percent of total billed charges,,,,,,,,,1466.1,90,,percent of total billed charges,,,1466.1,90,,percent of total billed charges,,,1466.1,90,,percent of total billed charges,,,1466.1,90,,percent of total billed charges,,,1384.65,85,,percent of total billed charges,,31.8,1547.55,
Elec stim other than wound,G0283,CDM,G0283,HCPCS,,,both,,161,161,18.91,,,,fee schedule,,,,,,,,,,,,,,,136.85,85,,percent of total billed charges,,9,,,,fee schedule,,9,,,,fee schedule,,,,,,,,19.9,,,,fee schedule,,,,,,,,20.13,,,,fee schedule,,12.2,,,,fee schedule,,12.2,,,,fee schedule,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,48.3,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,17.93,,,,fee schedule,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,9,152.95,
ELEC STIM (UNATTENDED),G0283GP,CDM,G0283,HCPCS,,,both,GP,161,161,18.91,,,,fee schedule,,,,,,,,,,,,,,,136.85,85,,percent of total billed charges,,9,,,,fee schedule,,9,,,,fee schedule,,,,,,,,19.9,,,,fee schedule,,,,,,,,20.13,,,,fee schedule,,12.2,,,,fee schedule,,12.2,,,,fee schedule,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,48.3,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,17.93,,,,fee schedule,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,9,152.95,
ELEC STIM (UNATTENDED) W THCAP,G0283GPKX,CDM,G0283,HCPCS,,,both,,161,161,18.91,,,,fee schedule,,,,,,,,,,,,,,,136.85,85,,percent of total billed charges,,9,,,,fee schedule,,9,,,,fee schedule,,,,,,,,19.9,,,,fee schedule,,,,,,,,20.13,,,,fee schedule,,12.2,,,,fee schedule,,12.2,,,,fee schedule,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,48.3,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,17.93,,,,fee schedule,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,9,152.95,
"Arthro, loose body + chondro",G0289,CDM,G0289,HCPCS,,,both,,1430,1430,132.89,,,,fee schedule,,,,,,,,,,,,,,,1215.5,85,,percent of total billed charges,,187.32,,,,fee schedule,,89.6,,,,fee schedule,,,,,,,,167.79,,,,fee schedule,,,,,,,,141.46,,,,fee schedule,,85.73,,,,fee schedule,,85.73,,,,fee schedule,,,1301.3,91,,percent of total billed charges,,,1358.5,95,,percent of total billed charges,,,1186.9,83,,percent of total billed charges,,,429,83,,percent of total billed charges,,,,,,,,,,,,,,,1186.9,83,,percent of total billed charges,,126.03,,,,fee schedule,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1287,90,,percent of total billed charges,,,1215.5,85,,percent of total billed charges,,85.73,1358.5,
Fecal blood scrn immunoassay,G0328,CDM,G0328,HCPCS,,,both,,80,80,,,,,,,,,,,,,13.33,,,,fee schedule,,,68,85,,percent of total billed charges,,18.05,,,,fee schedule,,18.05,,,,fee schedule,,13.33,,,,fee schedule,,,,,,,,13.33,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,24,83,,percent of total billed charges,,13.33,,,,fee schedule,,13.33,,,,fee schedule,,,66.4,83,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,13.33,76,
EKG tracing for initial prev,G0367,CDM,G0367,HCPCS,,,both,,67,67,,,,,,,,,,,,,,,,,,,,56.95,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,31.17,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,20.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55.61,83,,percent of total billed charges,,,,,,,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,20.1,63.65,
Alcohol/substance Abuse (Other Than Tobacco) 15-30mn,G0396,CDM,G0396,HCPCS,,,both,,152,152,48.85,,,,fee schedule,,,,,,,,21.34,,,,fee schedule,,,129.2,85,,percent of total billed charges,,64.55,,,,fee schedule,,33.62,,,,fee schedule,,21.34,,,,fee schedule,,,,,,,,21.34,,,,fee schedule,,52,,,,fee schedule,,31.52,,,,fee schedule,,31.52,,,,fee schedule,,,138.32,91,,percent of total billed charges,,,144.4,95,,percent of total billed charges,,,126.16,83,,percent of total billed charges,,,45.6,83,,percent of total billed charges,,21.34,,,,fee schedule,,21.34,,,,fee schedule,,,126.16,83,,percent of total billed charges,,46.33,,,,fee schedule,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,136.8,90,,percent of total billed charges,,,129.2,85,,percent of total billed charges,,21.34,144.4,
Alcohol/substance Abuse (Other Than Tobacco)  >30 min,G0397,CDM,G0397,HCPCS,,,both,,251,251,101.37,,,,fee schedule,,,,,,,,40.06,,,,fee schedule,,,213.35,85,,percent of total billed charges,,129.91,,,,fee schedule,,69.01,,,,fee schedule,,40.06,,,,fee schedule,,,,,,,,40.06,,,,fee schedule,,107.91,,,,fee schedule,,65.4,,,,fee schedule,,65.4,,,,fee schedule,,,228.41,91,,percent of total billed charges,,,238.45,95,,percent of total billed charges,,,208.33,83,,percent of total billed charges,,,75.3,83,,percent of total billed charges,,40.06,,,,fee schedule,,40.06,,,,fee schedule,,,208.33,83,,percent of total billed charges,,96.14,,,,fee schedule,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,225.9,90,,percent of total billed charges,,,213.35,85,,percent of total billed charges,,40.06,238.45,
Home sleep test/type 2 Porta,G0398,CDM,G0398,HCPCS,,,both,,628,628,,,,,,,,,,,,,,,,,,,,533.8,85,,percent of total billed charges,,71.84,,,,fee schedule,,46.77,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,571.48,91,,percent of total billed charges,,,596.6,95,,percent of total billed charges,,,521.24,83,,percent of total billed charges,,,188.4,83,,percent of total billed charges,,,,,,,,,,,,,,,521.24,83,,percent of total billed charges,,,,,,,,,565.2,90,,percent of total billed charges,,,565.2,90,,percent of total billed charges,,,565.2,90,,percent of total billed charges,,,565.2,90,,percent of total billed charges,,,533.8,85,,percent of total billed charges,,46.77,596.6,
Home sleep test/type 3 Porta,G0399,CDM,G0399,HCPCS,,,both,,525,525,,,,,,,,,,,,,,,,,,,,446.25,85,,percent of total billed charges,,71.84,,,,fee schedule,,45.85,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,477.75,91,,percent of total billed charges,,,498.75,95,,percent of total billed charges,,,435.75,83,,percent of total billed charges,,,157.5,83,,percent of total billed charges,,,,,,,,,,,,,,,435.75,83,,percent of total billed charges,,,,,,,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,472.5,90,,percent of total billed charges,,,446.25,85,,percent of total billed charges,,45.85,498.75,
INITIAL PREVENTIVE EXAM,G0402,CDM,G0402,HCPCS,,,both,,342,342,203.8,,,,fee schedule,,,,,,,,,,,,,,,290.7,85,,percent of total billed charges,,187.59,,,,fee schedule,,133.69,,,,fee schedule,,,,,,,,,,,,,,,,,,,,216.95,,,,fee schedule,,131.48,,,,fee schedule,,131.48,,,,fee schedule,,,311.22,91,,percent of total billed charges,,,324.9,95,,percent of total billed charges,,,283.86,83,,percent of total billed charges,,,102.6,83,,percent of total billed charges,,,,,,,,,,,,,,,283.86,83,,percent of total billed charges,,193.28,,,,fee schedule,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,307.8,90,,percent of total billed charges,,,290.7,85,,percent of total billed charges,,102.6,324.9,
INITIAL PREVENTIVE EXAM,G0402P,CDM,G0402,HCPCS,,,both,P,187,187,203.8,,,,fee schedule,,,,,,,,,,,,,,,158.95,85,,percent of total billed charges,,187.59,,,,fee schedule,,133.69,,,,fee schedule,,,,,,,,,,,,,,,,,,,,216.95,,,,fee schedule,,131.48,,,,fee schedule,,131.48,,,,fee schedule,,,170.17,91,,percent of total billed charges,,,177.65,95,,percent of total billed charges,,,155.21,83,,percent of total billed charges,,,56.1,83,,percent of total billed charges,,,,,,,,,,,,,,,155.21,83,,percent of total billed charges,,193.28,,,,fee schedule,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,168.3,90,,percent of total billed charges,,,158.95,85,,percent of total billed charges,,56.1,216.95,
INITIAL PREVENTIVE EXAM,G0402T,CDM,G0402,HCPCS,,,both,T,155,155,203.8,,,,fee schedule,,,,,,,,,,,,,,,131.75,85,,percent of total billed charges,,187.59,,,,fee schedule,,133.69,,,,fee schedule,,,,,,,,,,,,,,,,,,,,216.95,,,,fee schedule,,131.48,,,,fee schedule,,131.48,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,193.28,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,46.5,216.95,
EKG FOR INITIAL PREVENT EXAM,G0403,CDM,G0403,HCPCS,,,both,,81,81,22.59,,,,fee schedule,,,,,,,,,,,,,,,68.85,85,,percent of total billed charges,,30.56,,,,fee schedule,,14.47,,,,fee schedule,,,,,,,,,,,,,,,,,,,,24.04,,,,fee schedule,,14.57,,,,fee schedule,,14.57,,,,fee schedule,,,73.71,91,,percent of total billed charges,,,76.95,95,,percent of total billed charges,,,67.23,83,,percent of total billed charges,,,24.3,83,,percent of total billed charges,,,,,,,,,,,,,,,67.23,83,,percent of total billed charges,,21.42,,,,fee schedule,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,72.9,90,,percent of total billed charges,,,68.85,85,,percent of total billed charges,,14.47,76.95,
EKG TRACING FOR INITIAL PREV,G0404,CDM,G0404,HCPCS,,,both,,57,57,9.98,,,,fee schedule,,,,,,,,,,,,,,,48.45,85,,percent of total billed charges,,12.64,,,,fee schedule,,5.99,,,,fee schedule,,,,,,,,,,,,,,,,,,,,10.62,,,,fee schedule,,6.44,,,,fee schedule,,6.44,,,,fee schedule,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,17.1,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,9.46,,,,fee schedule,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,5.99,54.15,
EKG interpret/report preve,G0405,CDM,G0405,HCPCS,,,both,,57,57,12.61,,,,fee schedule,,,,,,,,,,,,,,,48.45,85,,percent of total billed charges,,17.92,,,,fee schedule,,8.49,,,,fee schedule,,,,,,,,,,,,,,,,,,,,13.42,,,,fee schedule,,8.13,,,,fee schedule,,8.13,,,,fee schedule,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,17.1,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,11.96,,,,fee schedule,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,8.13,54.15,
Dermal filler injection(s),G0429,CDM,G0429,HCPCS,,,both,,304,304,105.58,,,,fee schedule,,,,,,,,,,,,,,,258.4,85,,percent of total billed charges,,141.21,,,,fee schedule,,70.99,,,,fee schedule,,,,,,,,,,,,,,,,,,,,112.39,,,,fee schedule,,68.11,,,,fee schedule,,68.11,,,,fee schedule,,,276.64,91,,percent of total billed charges,,,288.8,95,,percent of total billed charges,,,252.32,83,,percent of total billed charges,,,91.2,83,,percent of total billed charges,,,,,,,,,,,,,,,252.32,83,,percent of total billed charges,,100.13,,,,fee schedule,,,273.6,90,,percent of total billed charges,,,273.6,90,,percent of total billed charges,,,273.6,90,,percent of total billed charges,,,273.6,90,,percent of total billed charges,,,258.4,85,,percent of total billed charges,,68.11,288.8,
Tobacco-use counsel 3-10 min,G0436,CDM,G0436,HCPCS,,,both,,61,61,,,,,,,,,,,,,,,,,,,,51.85,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,55.51,91,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,18.3,83,,percent of total billed charges,,,,,,,,,,,,,,,50.63,83,,percent of total billed charges,,,,,,,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,18.3,57.95,
Annual Wellness Medicare,G0438,CDM,G0438,HCPCS,,,both,,346,346,257.9,,,,fee schedule,,,,,,,,,,,,,,,294.1,85,,percent of total billed charges,,263.12,,,,fee schedule,,165.52,,,,fee schedule,,,,,,,,,,,,,,,,,,,,274.54,,,,fee schedule,,166.39,,,,fee schedule,,166.39,,,,fee schedule,,,314.86,91,,percent of total billed charges,,,328.7,95,,percent of total billed charges,,,287.18,83,,percent of total billed charges,,,103.8,83,,percent of total billed charges,,,,,,,,,,,,,,,287.18,83,,percent of total billed charges,,244.59,,,,fee schedule,,,311.4,90,,percent of total billed charges,,,311.4,90,,percent of total billed charges,,,311.4,90,,percent of total billed charges,,,311.4,90,,percent of total billed charges,,,294.1,85,,percent of total billed charges,,103.8,328.7,
Annual Wellness Medicare,G0438P,CDM,G0438,HCPCS,,,both,P,190,190,257.9,,,,fee schedule,,,,,,,,,,,,,,,161.5,85,,percent of total billed charges,,263.12,,,,fee schedule,,165.52,,,,fee schedule,,,,,,,,,,,,,,,,,,,,274.54,,,,fee schedule,,166.39,,,,fee schedule,,166.39,,,,fee schedule,,,172.9,91,,percent of total billed charges,,,180.5,95,,percent of total billed charges,,,157.7,83,,percent of total billed charges,,,57,83,,percent of total billed charges,,,,,,,,,,,,,,,157.7,83,,percent of total billed charges,,244.59,,,,fee schedule,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,171,90,,percent of total billed charges,,,161.5,85,,percent of total billed charges,,57,274.54,
Annual Wellness Medicare,G0438T,CDM,G0438,HCPCS,,,both,T,156,156,257.9,,,,fee schedule,,,,,,,,,,,,,,,132.6,85,,percent of total billed charges,,263.12,,,,fee schedule,,165.52,,,,fee schedule,,,,,,,,,,,,,,,,,,,,274.54,,,,fee schedule,,166.39,,,,fee schedule,,166.39,,,,fee schedule,,,141.96,91,,percent of total billed charges,,,148.2,95,,percent of total billed charges,,,129.48,83,,percent of total billed charges,,,46.8,83,,percent of total billed charges,,,,,,,,,,,,,,,129.48,83,,percent of total billed charges,,244.59,,,,fee schedule,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,140.4,90,,percent of total billed charges,,,132.6,85,,percent of total billed charges,,46.8,274.54,
Subsequent Annual Wellness Medicare,G0439,CDM,G0439,HCPCS,,,both,,277,277,201.7,,,,fee schedule,,,,,,,,,,,,,,,235.45,85,,percent of total billed charges,,206.56,,,,fee schedule,,128.81,,,,fee schedule,,,,,,,,,,,,,,,,,,,,214.71,,,,fee schedule,,130.13,,,,fee schedule,,130.13,,,,fee schedule,,,252.07,91,,percent of total billed charges,,,263.15,95,,percent of total billed charges,,,229.91,83,,percent of total billed charges,,,83.1,83,,percent of total billed charges,,,,,,,,,,,,,,,229.91,83,,percent of total billed charges,,191.29,,,,fee schedule,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,249.3,90,,percent of total billed charges,,,235.45,85,,percent of total billed charges,,83.1,263.15,
Subsequent Annual Wellness Medicare,G0439P,CDM,G0439,HCPCS,,,both,P,122,122,201.7,,,,fee schedule,,,,,,,,,,,,,,,103.7,85,,percent of total billed charges,,206.56,,,,fee schedule,,128.81,,,,fee schedule,,,,,,,,,,,,,,,,,,,,214.71,,,,fee schedule,,130.13,,,,fee schedule,,130.13,,,,fee schedule,,,111.02,91,,percent of total billed charges,,,115.9,95,,percent of total billed charges,,,101.26,83,,percent of total billed charges,,,36.6,83,,percent of total billed charges,,,,,,,,,,,,,,,101.26,83,,percent of total billed charges,,191.29,,,,fee schedule,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,109.8,90,,percent of total billed charges,,,103.7,85,,percent of total billed charges,,36.6,214.71,
Subsequent Annual Wellness Medicare,G0439T,CDM,G0439,HCPCS,,,both,T,155,155,201.7,,,,fee schedule,,,,,,,,,,,,,,,131.75,85,,percent of total billed charges,,206.56,,,,fee schedule,,128.81,,,,fee schedule,,,,,,,,,,,,,,,,,,,,214.71,,,,fee schedule,,130.13,,,,fee schedule,,130.13,,,,fee schedule,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,191.29,,,,fee schedule,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,46.5,214.71,
"Annual Alcohol Misuse Screening, 15 Min",G0442,CDM,G0442,HCPCS,,,both,,87,87,14.18,,,,fee schedule,,,,,,,,,,,,,,,73.95,85,,percent of total billed charges,,12.77,,,,fee schedule,,9.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,15.1,,,,fee schedule,,9.15,,,,fee schedule,,9.15,,,,fee schedule,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,26.1,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,13.45,,,,fee schedule,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,9.15,82.65,
"Brief alcohol misuse counsel, 15 Min",G0443,CDM,G0443,HCPCS,,,both,,124,124,35.72,,,,fee schedule,,,,,,,,,,,,,,,105.4,85,,percent of total billed charges,,38.35,,,,fee schedule,,24.38,,,,fee schedule,,,,,,,,,,,,,,,,,,,,38.02,,,,fee schedule,,23.04,,,,fee schedule,,23.04,,,,fee schedule,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,37.2,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,33.87,,,,fee schedule,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,23.04,117.8,
"Annual Depression Screening, 15 Minutes",G0444,CDM,G0444,HCPCS,,,both,,86,86,14.18,,,,fee schedule,,,,,,,,,,,,,,,73.1,85,,percent of total billed charges,,14.94,,,,fee schedule,,9.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,15.1,,,,fee schedule,,9.15,,,,fee schedule,,9.15,,,,fee schedule,,,78.26,91,,percent of total billed charges,,,81.7,95,,percent of total billed charges,,,71.38,83,,percent of total billed charges,,,25.8,83,,percent of total billed charges,,,,,,,,,,,,,,,71.38,83,,percent of total billed charges,,13.45,,,,fee schedule,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,77.4,90,,percent of total billed charges,,,73.1,85,,percent of total billed charges,,9.15,81.7,
"High intensity behavioral counseling STD, Semi-annual 30 Min",G0445,CDM,G0445,HCPCS,,,both,,124,124,35.19,,,,fee schedule,,,,,,,,,,,,,,,105.4,85,,percent of total billed charges,,36.84,,,,fee schedule,,23.73,,,,fee schedule,,,,,,,,,,,,,,,,,,,,37.46,,,,fee schedule,,22.7,,,,fee schedule,,22.7,,,,fee schedule,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,37.2,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,33.38,,,,fee schedule,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,22.7,117.8,
"Annual face to face intensive behavioral therapy for cardiovascular disease, ind",G0446,CDM,G0446,HCPCS,,,both,,124,124,35.72,,,,fee schedule,,,,,,,,,,,,,,,105.4,85,,percent of total billed charges,,37.86,,,,fee schedule,,24.87,,,,fee schedule,,,,,,,,,,,,,,,,,,,,38.02,,,,fee schedule,,23.04,,,,fee schedule,,23.04,,,,fee schedule,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,37.2,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,33.87,,,,fee schedule,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,23.04,117.8,
"Face To Face Behavioral Counseling For Obesity, 15 Min",G0447,CDM,G0447,HCPCS,,,both,,124,124,35.72,,,,fee schedule,,,,,,,,,,,,,,,105.4,85,,percent of total billed charges,,31.93,,,,fee schedule,,28.71,,,,fee schedule,,,,,,,,,,,,,,,,,,,,38.02,,,,fee schedule,,23.04,,,,fee schedule,,23.04,,,,fee schedule,,,112.84,91,,percent of total billed charges,,,117.8,95,,percent of total billed charges,,,102.92,83,,percent of total billed charges,,,37.2,83,,percent of total billed charges,,,,,,,,,,,,,,,102.92,83,,percent of total billed charges,,33.87,,,,fee schedule,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,111.6,90,,percent of total billed charges,,,105.4,85,,percent of total billed charges,,23.04,117.8,
Autologous prp for ulcers,G0460,CDM,G0460,HCPCS,,,both,,260,260,,,,,,,,,,,,,,,,,,,,221,85,,percent of total billed charges,,209.45,,,,fee schedule,,130.08,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,78,83,,percent of total billed charges,,,,,,,,,,,,,,,215.8,83,,percent of total billed charges,,,,,,,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,78,247,
Follow-up Assessment 0-60 Min,G0463,CDM,G0463,HCPCS,,,both,,329,329,,,,,,,,,,,,,,,,,,,,279.65,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,299.39,91,,percent of total billed charges,,,312.55,95,,percent of total billed charges,,,273.07,83,,percent of total billed charges,,,98.7,83,,percent of total billed charges,,,,,,,,,,,,,,,273.07,83,,percent of total billed charges,,,,,,,,,296.1,90,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,296.1,90,,percent of total billed charges,,,279.65,85,,percent of total billed charges,,98.7,312.55,
Follow-up Assessment 0-60 Min,G046301,CDM,G0463,HCPCS,,,both,,52,52,,,,,,,,,,,,,,,,,,,,44.2,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,15.6,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,,,,,,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,15.6,49.4,
Follow-up Assessment 0-60 Min,G046302,CDM,G0463,HCPCS,,,both,,78,78,,,,,,,,,,,,,,,,,,,,66.3,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,70.98,91,,percent of total billed charges,,,74.1,95,,percent of total billed charges,,,64.74,83,,percent of total billed charges,,,23.4,83,,percent of total billed charges,,,,,,,,,,,,,,,64.74,83,,percent of total billed charges,,,,,,,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,70.2,90,,percent of total billed charges,,,66.3,85,,percent of total billed charges,,23.4,74.1,
Follow-up Assessment 0-60 Min,G046303,CDM,G0463,HCPCS,,,both,,93,93,,,,,,,,,,,,,,,,,,,,79.05,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,27.9,88.35,
Follow-up Assessment 0-60 Min,G046304,CDM,G0463,HCPCS,,,both,,129,129,,,,,,,,,,,,,,,,,,,,109.65,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,117.39,91,,percent of total billed charges,,,122.55,95,,percent of total billed charges,,,107.07,83,,percent of total billed charges,,,38.7,83,,percent of total billed charges,,,,,,,,,,,,,,,107.07,83,,percent of total billed charges,,,,,,,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,116.1,90,,percent of total billed charges,,,109.65,85,,percent of total billed charges,,38.7,122.55,
Follow-up Assessment 0-60 Min,G046305,CDM,G0463,HCPCS,,,both,,155,155,,,,,,,,,,,,,,,,,,,,131.75,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,,,,,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,46.5,147.25,
Hep c screen high risk/other,G0472,CDM,G0472,HCPCS,,,both,,90,90,,,,,,,,,,,,,16.85,,,,fee schedule,,,76.5,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,16.85,,,,fee schedule,,,,,,,,16.85,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,16.85,,,,fee schedule,,16.85,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,3.5,85.5,
Drug test def 1-7 classes,G0480,CDM,G0480,HCPCS,,,both,,71,71,,,,,,,,,,,,,47.96,,,,fee schedule,,,60.35,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,47.96,,,,fee schedule,,,,,,,,47.96,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,64.61,91,,percent of total billed charges,,,67.45,95,,percent of total billed charges,,,58.93,83,,percent of total billed charges,,,21.3,83,,percent of total billed charges,,47.96,,,,fee schedule,,47.96,,,,fee schedule,,,58.93,83,,percent of total billed charges,,,,,,,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,63.9,90,,percent of total billed charges,,,60.35,85,,percent of total billed charges,,3.5,67.45,
Ccm/bhi by rhc/fqhc 20min mo,G0511,CDM,G0511,HCPCS,,,both,,67,67,69.33,,,,fee schedule,,,,,,,,,,,,,,,56.95,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,73.81,,,,fee schedule,,44.73,,,,fee schedule,,44.73,,,,fee schedule,,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,20.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55.61,83,,percent of total billed charges,,65.75,,,,fee schedule,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,20.1,73.81,
Remot image submit by pt,G2010,CDM,G2010,HCPCS,,,both,,27,27,14.18,,,,fee schedule,,,,,,,,,,,,,,,22.95,85,,percent of total billed charges,,12.61,,,,fee schedule,,9.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,15.1,,,,fee schedule,,9.15,,,,fee schedule,,9.15,,,,fee schedule,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,8.1,83,,percent of total billed charges,,,,,,,,,,,,,,,22.41,83,,percent of total billed charges,,13.45,,,,fee schedule,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,8.1,25.65,
Telehealth Remote Image/Vid submit by pt,G2010VV,CDM,G2010,HCPCS,,,both,,27,27,14.18,,,,fee schedule,,,,,,,,,,,,,,,22.95,85,,percent of total billed charges,,12.61,,,,fee schedule,,9.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,15.1,,,,fee schedule,,9.15,,,,fee schedule,,9.15,,,,fee schedule,,,24.57,91,,percent of total billed charges,,,25.65,95,,percent of total billed charges,,,22.41,83,,percent of total billed charges,,,8.1,83,,percent of total billed charges,,,,,,,,,,,,,,,22.41,83,,percent of total billed charges,,13.45,,,,fee schedule,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,24.3,90,,percent of total billed charges,,,22.95,85,,percent of total billed charges,,8.1,25.65,
Brief check in by md/qhp,G2012,CDM,G2012,HCPCS,,,both,,72,72,19.43,,,,fee schedule,,,,,,,,,,,,,,,61.2,85,,percent of total billed charges,,17.37,,,,fee schedule,,12.73,,,,fee schedule,,,,,,,,,,,,,,,,,,,,20.69,,,,fee schedule,,12.54,,,,fee schedule,,12.54,,,,fee schedule,,,65.52,91,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,21.6,83,,percent of total billed charges,,,,,,,,,,,,,,,59.76,83,,percent of total billed charges,,18.43,,,,fee schedule,,,64.8,90,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,12.54,68.4,
Teleahealth Brief check in by md/qhp,G2012 V V,CDM,G2012,HCPCS,,,both,,72,72,19.43,,,,fee schedule,,,,,,,,,,,,,,,61.2,85,,percent of total billed charges,,17.37,,,,fee schedule,,12.73,,,,fee schedule,,,,,,,,,,,,,,,,,,,,20.69,,,,fee schedule,,12.54,,,,fee schedule,,12.54,,,,fee schedule,,,65.52,91,,percent of total billed charges,,,68.4,95,,percent of total billed charges,,,59.76,83,,percent of total billed charges,,,21.6,83,,percent of total billed charges,,,,,,,,,,,,,,,59.76,83,,percent of total billed charges,,18.43,,,,fee schedule,,,64.8,90,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,64.8,90,,percent of total billed charges,,,61.2,85,,percent of total billed charges,,12.54,68.4,
Telehealth Services,G2025,CDM,G2025,HCPCS,,,both,,101,101,152.32,,,,fee schedule,,,,,,,,,,,,,,,85.85,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,162.15,,,,fee schedule,,98.27,,,,fee schedule,,98.27,,,,fee schedule,,,91.91,91,,percent of total billed charges,,,95.95,95,,percent of total billed charges,,,83.83,83,,percent of total billed charges,,,30.3,83,,percent of total billed charges,,,,,,,,,,,,,,,83.83,83,,percent of total billed charges,,144.46,,,,fee schedule,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,90.9,90,,percent of total billed charges,,,85.85,85,,percent of total billed charges,,30.3,162.15,
Prolong outpt/office vis,G2212,CDM,G2212,HCPCS,,,both,,98,98,48.32,,,,fee schedule,,,,,,,,,,,,,,,83.3,85,,percent of total billed charges,,43.59,,,,fee schedule,,31.94,,,,fee schedule,,,,,,,,,,,,,,,,,,,,51.44,,,,fee schedule,,31.18,,,,fee schedule,,31.18,,,,fee schedule,,,89.18,91,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,29.4,83,,percent of total billed charges,,,,,,,,,,,,,,,81.34,83,,percent of total billed charges,,45.83,,,,fee schedule,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,83.3,85,,percent of total billed charges,,29.4,93.1,
"Brief chkin by md/qhp, 11-20",G2252,CDM,G2252,HCPCS,,,both,,93,93,39.39,,,,fee schedule,,,,,,,,,,,,,,,79.05,85,,percent of total billed charges,,36.05,,,,fee schedule,,26.42,,,,fee schedule,,,,,,,,,,,,,,,,,,,,41.94,,,,fee schedule,,25.42,,,,fee schedule,,25.42,,,,fee schedule,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,,,,,,,,,,,,,,77.19,83,,percent of total billed charges,,37.36,,,,fee schedule,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,25.42,88.35,
PT INELIG NEG SCRN DEPRES,G8510,CDM,G8510,HCPCS,,,both,,43,43,,,,,,,,,,,,,,,,,,,,36.55,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.13,91,,percent of total billed charges,,,40.85,95,,percent of total billed charges,,,35.69,83,,percent of total billed charges,,,12.9,83,,percent of total billed charges,,,,,,,,,,,,,,,35.69,83,,percent of total billed charges,,,,,,,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,36.55,85,,percent of total billed charges,,12.9,40.85,
Pain doc pos and plan,G8730,CDM,G8730,HCPCS,,,both,,21,21,,,,,,,,,,,,,,,,,,,,17.85,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,6.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,,,,,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,6.3,19.95,
3 comp foot exam completed,G9226,CDM,G9226,HCPCS,,,both,,90,90,,,,,,,,,,,,,,,,,,,,76.5,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,,,,,,,,,,,,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,27,85.5,
MH svc plan dev by non-md,H0032,CDM,H0032,HCPCS,,,both,,120,120,,,,,,,,,,,,,,,,,,,,102,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,109.2,91,,percent of total billed charges,,,114,95,,percent of total billed charges,,,99.6,83,,percent of total billed charges,,,36,83,,percent of total billed charges,,,,,,,,,,,,,,,99.6,83,,percent of total billed charges,,,,,,,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,108,90,,percent of total billed charges,,,102,85,,percent of total billed charges,,36,114,
Oral med adm direct observe,H0033,CDM,H0033,HCPCS,,,both,,29,29,,,,,,,,,,,,,,,,,,,,24.65,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,26.39,91,,percent of total billed charges,,,27.55,95,,percent of total billed charges,,,24.07,83,,percent of total billed charges,,,8.7,83,,percent of total billed charges,,,,,,,,,,,,,,,24.07,83,,percent of total billed charges,,,,,,,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,26.1,90,,percent of total billed charges,,,24.65,85,,percent of total billed charges,,8.7,27.55,
Tetracyclin injection,J0120,CDM,J0120,HCPCS,,,both,,28,28,13.31,,,,fee schedule,,,,,,,,,,,,,,,23.8,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,8.4,83,,percent of total billed charges,,,,,,,,,,,,,,,23.24,83,,percent of total billed charges,,,,,,,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,8.4,26.6,
"Injection, adrenalin, epinephrine, 0.1 mg",J0171,CDM,J0171,HCPCS,,,both,,13,13,0.66,,,,fee schedule,,,,,,,,7.28,,,,fee schedule,,,11.05,85,,percent of total billed charges,,,,,,,,,,,,,,7.28,,,,fee schedule,,,,,,,,7.28,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,11.83,91,,percent of total billed charges,,,12.35,95,,percent of total billed charges,,,10.79,83,,percent of total billed charges,,,3.9,83,,percent of total billed charges,,7.28,,,,fee schedule,,7.28,,,,fee schedule,,,10.79,83,,percent of total billed charges,,,,,,,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.7,90,,percent of total billed charges,,,11.05,85,,percent of total billed charges,,0.66,12.35,
PenG benzathine/procaine inj,J0558,CDM,J0558,HCPCS,,,both,,400,400,10.98,,,,fee schedule,,,,,,,,316.15,,,,fee schedule,,,340,85,,percent of total billed charges,,,,,,,,,,,,,,316.15,,,,fee schedule,,,,,,,,316.15,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,364,91,,percent of total billed charges,,,380,95,,percent of total billed charges,,,332,83,,percent of total billed charges,,,120,83,,percent of total billed charges,,316.15,,,,fee schedule,,316.15,,,,fee schedule,,,332,83,,percent of total billed charges,,,,,,,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,340,85,,percent of total billed charges,,10.98,380,
Penicillin g benzathine inj,J0561,CDM,J0561,HCPCS,,,both,,40,40,13.78,,,,fee schedule,,,,,,,,401.59,,,,fee schedule,,,34,85,,percent of total billed charges,,,,,,,,,,,,,,401.59,,,,fee schedule,,,,,,,,401.59,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,36.4,91,,percent of total billed charges,,,38,95,,percent of total billed charges,,,33.2,83,,percent of total billed charges,,,12,83,,percent of total billed charges,,401.59,,,,fee schedule,,401.59,,,,fee schedule,,,33.2,83,,percent of total billed charges,,,,,,,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,36,90,,percent of total billed charges,,,34,85,,percent of total billed charges,,12,401.59,
Botulinum toxin a per unit,J0585,CDM,J0585,HCPCS,,,both,,16,16,5.77,,,,fee schedule,,,,,,,,2491.6,,,,fee schedule,,,13.6,85,,percent of total billed charges,,,,,,,,,,,,,,2491.6,,,,fee schedule,,,,,,,,2491.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,14.56,91,,percent of total billed charges,,,15.2,95,,percent of total billed charges,,,13.28,83,,percent of total billed charges,,,4.8,83,,percent of total billed charges,,2491.6,,,,fee schedule,,2491.6,,,,fee schedule,,,13.28,83,,percent of total billed charges,,,,,,,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,13.6,85,,percent of total billed charges,,4.8,2491.6,
Butorphanol tartrate 1 mg,J0595,CDM,J0595,HCPCS,,,both,,11,11,3.06,,,,fee schedule,,,,,,,,11.85,,,,fee schedule,,,9.35,85,,percent of total billed charges,,,,,,,,,,,,,,11.85,,,,fee schedule,,,,,,,,11.85,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,3.3,83,,percent of total billed charges,,11.85,,,,fee schedule,,11.85,,,,fee schedule,,,9.13,83,,percent of total billed charges,,,,,,,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,3.06,11.85,
Ceftriaxone sodium injection 250mg,J0696,CDM,J0696,HCPCS,,,both,,4,4,0.67,,,,fee schedule,,,,,,,,8.06,,,,fee schedule,,,3.4,85,,percent of total billed charges,,,,,,,,,,,,,,8.06,,,,fee schedule,,,,,,,,8.06,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,3.64,91,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,1.2,83,,percent of total billed charges,,8.06,,,,fee schedule,,8.06,,,,fee schedule,,,3.32,83,,percent of total billed charges,,,,,,,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,0.67,8.06,
Cefotaxime sodium injection,J0698,CDM,J0698,HCPCS,,,both,,8,8,2.11,,,,fee schedule,,,,,,,,5.72,,,,fee schedule,,,6.8,85,,percent of total billed charges,,,,,,,,,,,,,,5.72,,,,fee schedule,,,,,,,,5.72,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,7.28,91,,percent of total billed charges,,,7.6,95,,percent of total billed charges,,,6.64,83,,percent of total billed charges,,,2.4,83,,percent of total billed charges,,5.72,,,,fee schedule,,5.72,,,,fee schedule,,,6.64,83,,percent of total billed charges,,,,,,,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,7.2,90,,percent of total billed charges,,,6.8,85,,percent of total billed charges,,2.11,7.6,
Celestone/Betamethasone acet sod phosp,J0702,CDM,J0702,HCPCS,,,both,,63,63,6.94,,,,fee schedule,,,,,,,,34.08,,,,fee schedule,,,53.55,85,,percent of total billed charges,,,,,,,,,,,,,,34.08,,,,fee schedule,,,,,,,,34.08,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,57.33,91,,percent of total billed charges,,,59.85,95,,percent of total billed charges,,,52.29,83,,percent of total billed charges,,,18.9,83,,percent of total billed charges,,34.08,,,,fee schedule,,34.08,,,,fee schedule,,,52.29,83,,percent of total billed charges,,,,,,,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,56.7,90,,percent of total billed charges,,,53.55,85,,percent of total billed charges,,6.94,59.85,
DNU Betamethasone sod phosp/4 MG,J0704,CDM,J0704,HCPCS,,,both,,89,89,,,,,,,,,,,,,,,,,,,,75.65,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,80.99,91,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,26.7,83,,percent of total billed charges,,,,,,,,,,,,,,,73.87,83,,percent of total billed charges,,,,,,,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,26.7,84.55,
Ceftizoxime sodium / 500 MG,J0715,CDM,J0715,HCPCS,,,both,,16,16,4.56,,,,fee schedule,,,,,,,,,,,,,,,13.6,85,,percent of total billed charges,,7,,,,fee schedule,,7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.56,91,,percent of total billed charges,,,15.2,95,,percent of total billed charges,,,13.28,83,,percent of total billed charges,,,4.8,83,,percent of total billed charges,,,,,,,,,,,,,,,13.28,83,,percent of total billed charges,,,,,,,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,13.6,85,,percent of total billed charges,,4.56,15.2,
Clonidine hydrochloride,J0735,CDM,J0735,HCPCS,,,both,,2,2,24.66,,,,fee schedule,,,,,,,,22.39,,,,fee schedule,,,1.7,85,,percent of total billed charges,,,,,,,,,,,,,,22.39,,,,fee schedule,,,,,,,,22.39,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,1.82,91,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,0.6,83,,percent of total billed charges,,22.39,,,,fee schedule,,22.39,,,,fee schedule,,,1.66,83,,percent of total billed charges,,,,,,,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.7,85,,percent of total billed charges,,0.6,24.66,
Prochlorperazine injection,J0780,CDM,J0780,HCPCS,,,both,,36,36,5.4,,,,fee schedule,,,,,,,,8.39,,,,fee schedule,,,30.6,85,,percent of total billed charges,,,,,,,,,,,,,,8.39,,,,fee schedule,,,,,,,,8.39,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,10.8,83,,percent of total billed charges,,8.39,,,,fee schedule,,8.39,,,,fee schedule,,,29.88,83,,percent of total billed charges,,,,,,,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,5.4,34.2,
Cosyntropin cortrosyn inj,J0834,CDM,J0834,HCPCS,,,both,,201,201,41.57,,,,fee schedule,,,,,,,,93.17,,,,fee schedule,,,170.85,85,,percent of total billed charges,,,,,,,,,,,,,,93.17,,,,fee schedule,,,,,,,,93.17,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,182.91,91,,percent of total billed charges,,,190.95,95,,percent of total billed charges,,,166.83,83,,percent of total billed charges,,,60.3,83,,percent of total billed charges,,93.17,,,,fee schedule,,93.17,,,,fee schedule,,,166.83,83,,percent of total billed charges,,,,,,,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,180.9,90,,percent of total billed charges,,,170.85,85,,percent of total billed charges,,41.57,190.95,
"Epoetin alfa, non-esrd",J0885,CDM,J0885,HCPCS,,,both,,51,51,9.66,,,,fee schedule,,,,,,,,669.6,,,,fee schedule,,,43.35,85,,percent of total billed charges,,,,,,,,,,,,,,669.6,,,,fee schedule,,,,,,,,669.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,669.6,,,,fee schedule,,669.6,,,,fee schedule,,,42.33,83,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,9.66,669.6,
Denosumab injection (Prolia),J0897,CDM,J0897,HCPCS,,,both,,97,97,20.46,,,,fee schedule,,,,,,,,2701.2,,,,fee schedule,,,82.45,85,,percent of total billed charges,,,,,,,,,,,,,,2701.2,,,,fee schedule,,,,,,,,2701.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,29.1,83,,percent of total billed charges,,2701.2,,,,fee schedule,,2701.2,,,,fee schedule,,,80.51,83,,percent of total billed charges,,,,,,,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,20.46,2701.2,
Methylprednisolone 20 MG inj,J1020,CDM,J1020,HCPCS,,,both,,85,85,3.67,,,,fee schedule,,,,,,,,11.93,,,,fee schedule,,,72.25,85,,percent of total billed charges,,,,,,,,,,,,,,11.93,,,,fee schedule,,,,,,,,11.93,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,77.35,91,,percent of total billed charges,,,80.75,95,,percent of total billed charges,,,70.55,83,,percent of total billed charges,,,25.5,83,,percent of total billed charges,,11.93,,,,fee schedule,,11.93,,,,fee schedule,,,70.55,83,,percent of total billed charges,,,,,,,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,76.5,90,,percent of total billed charges,,,72.25,85,,percent of total billed charges,,3.67,80.75,
Methylprednisolone 40 MG inj,J1030,CDM,J1030,HCPCS,,,both,,89,89,6.23,,,,fee schedule,,,,,,,,29.81,,,,fee schedule,,,75.65,85,,percent of total billed charges,,,,,,,,,,,,,,29.81,,,,fee schedule,,,,,,,,29.81,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,80.99,91,,percent of total billed charges,,,84.55,95,,percent of total billed charges,,,73.87,83,,percent of total billed charges,,,26.7,83,,percent of total billed charges,,29.81,,,,fee schedule,,29.81,,,,fee schedule,,,73.87,83,,percent of total billed charges,,,,,,,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,80.1,90,,percent of total billed charges,,,75.65,85,,percent of total billed charges,,6.23,84.55,
Methylprednisolone 80mg Inj,J1040,CDM,J1040,HCPCS,,,both,,177,177,11.86,,,,fee schedule,,,,,,,,23.18,,,,fee schedule,,,150.45,85,,percent of total billed charges,,,,,,,,,,,,,,23.18,,,,fee schedule,,,,,,,,23.18,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,53.1,83,,percent of total billed charges,,23.18,,,,fee schedule,,23.18,,,,fee schedule,,,146.91,83,,percent of total billed charges,,,,,,,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,11.86,168.15,
Medroxyprogesterone acetate,J1050,CDM,J1050,HCPCS,,,both,,2,2,0.52,,,,fee schedule,,,,,,,,165.1,,,,fee schedule,,,1.7,85,,percent of total billed charges,,,,,,,,,,,,,,165.1,,,,fee schedule,,,,,,,,165.1,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,1.82,91,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,0.6,83,,percent of total billed charges,,165.1,,,,fee schedule,,165.1,,,,fee schedule,,,1.66,83,,percent of total billed charges,,,,,,,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.7,85,,percent of total billed charges,,0.52,165.1,
"Injection, testosterone cypionate, 1mg",J1071,CDM,J1071,HCPCS,,,both,,11,11,0.03,,,,fee schedule,,,,,,,,11.6,,,,fee schedule,,,9.35,85,,percent of total billed charges,,,,,,,,,,,,,,11.6,,,,fee schedule,,,,,,,,11.6,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,3.3,83,,percent of total billed charges,,11.6,,,,fee schedule,,11.6,,,,fee schedule,,,9.13,83,,percent of total billed charges,,,,,,,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,0.03,11.6,
Dexamethasone sodium phos,J1100,CDM,J1100,HCPCS,,,both,,3,3,0.14,,,,fee schedule,,,,,,,,5,,,,fee schedule,,,2.55,85,,percent of total billed charges,,,,,,,,,,,,,,5,,,,fee schedule,,,,,,,,5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,0.9,83,,percent of total billed charges,,5,,,,fee schedule,,5,,,,fee schedule,,,2.49,83,,percent of total billed charges,,,,,,,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,0.14,5,
Inj dihydroergotamine mesylt,J1110,CDM,J1110,HCPCS,,,both,,261,261,59.32,,,,fee schedule,,,,,,,,174.3,,,,fee schedule,,,221.85,85,,percent of total billed charges,,,,,,,,,,,,,,174.3,,,,fee schedule,,,,,,,,174.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,237.51,91,,percent of total billed charges,,,247.95,95,,percent of total billed charges,,,216.63,83,,percent of total billed charges,,,78.3,83,,percent of total billed charges,,174.3,,,,fee schedule,,174.3,,,,fee schedule,,,216.63,83,,percent of total billed charges,,,,,,,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,234.9,90,,percent of total billed charges,,,221.85,85,,percent of total billed charges,,59.32,247.95,
Diphenhydramine hcl injection,J1200,CDM,J1200,HCPCS,,,both,,26,26,0.69,,,,fee schedule,,,,,,,,2.34,,,,fee schedule,,,22.1,85,,percent of total billed charges,,,,,,,,,,,,,,2.34,,,,fee schedule,,,,,,,,2.34,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,23.66,91,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,7.8,83,,percent of total billed charges,,2.34,,,,fee schedule,,2.34,,,,fee schedule,,,21.58,83,,percent of total billed charges,,,,,,,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,0.69,24.7,
Garamycin gentamicin inj,J1580,CDM,J1580,HCPCS,,,both,,18,18,1.6,,,,fee schedule,,,,,,,,21.3,,,,fee schedule,,,15.3,85,,percent of total billed charges,,,,,,,,,,,,,,21.3,,,,fee schedule,,,,,,,,21.3,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,5.4,83,,percent of total billed charges,,21.3,,,,fee schedule,,21.3,,,,fee schedule,,,14.94,83,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,1.6,21.3,
Glucagon hydrochloride/1 MG,J1610,CDM,J1610,HCPCS,,,both,,436,436,163.68,,,,fee schedule,,,,,,,,340.66,,,,fee schedule,,,370.6,85,,percent of total billed charges,,,,,,,,,,,,,,340.66,,,,fee schedule,,,,,,,,340.66,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,396.76,91,,percent of total billed charges,,,414.2,95,,percent of total billed charges,,,361.88,83,,percent of total billed charges,,,130.8,83,,percent of total billed charges,,340.66,,,,fee schedule,,340.66,,,,fee schedule,,,361.88,83,,percent of total billed charges,,,,,,,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,392.4,90,,percent of total billed charges,,,370.6,85,,percent of total billed charges,,130.8,414.2,
Haloperidol injection,J1630,CDM,J1630,HCPCS,,,both,,16,16,0.96,,,,fee schedule,,,,,,,,1.62,,,,fee schedule,,,13.6,85,,percent of total billed charges,,,,,,,,,,,,,,1.62,,,,fee schedule,,,,,,,,1.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,14.56,91,,percent of total billed charges,,,15.2,95,,percent of total billed charges,,,13.28,83,,percent of total billed charges,,,4.8,83,,percent of total billed charges,,1.62,,,,fee schedule,,1.62,,,,fee schedule,,,13.28,83,,percent of total billed charges,,,,,,,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,13.6,85,,percent of total billed charges,,0.96,15.2,
Inj heparin sodium per 10 u,J1642,CDM,J1642,HCPCS,,,both,,14,14,0.01,,,,fee schedule,,,,,,,,,,,,,,,11.9,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.74,91,,percent of total billed charges,,,13.3,95,,percent of total billed charges,,,11.62,83,,percent of total billed charges,,,4.2,83,,percent of total billed charges,,,,,,,,,,,,,,,11.62,83,,percent of total billed charges,,,,,,,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,11.9,85,,percent of total billed charges,,0.01,13.3,
Tetanus immune globulin inj,J1670,CDM,J1670,HCPCS,,,both,,685,685,505.16,,,,fee schedule,,,,,,,,537.77,,,,fee schedule,,,582.25,85,,percent of total billed charges,,,,,,,,,,,,,,537.77,,,,fee schedule,,,,,,,,537.77,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,623.35,91,,percent of total billed charges,,,650.75,95,,percent of total billed charges,,,568.55,83,,percent of total billed charges,,,205.5,83,,percent of total billed charges,,537.77,,,,fee schedule,,537.77,,,,fee schedule,,,568.55,83,,percent of total billed charges,,,,,,,,,616.5,90,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,616.5,90,,percent of total billed charges,,,582.25,85,,percent of total billed charges,,205.5,650.75,
IRON DEXTRAN INJ 50MG,J1750,CDM,J1750,HCPCS,,,both,,67,67,14.02,,,,fee schedule,,,,,,,,826.25,,,,fee schedule,,,56.95,85,,percent of total billed charges,,,,,,,,,,,,,,826.25,,,,fee schedule,,,,,,,,826.25,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,20.1,83,,percent of total billed charges,,826.25,,,,fee schedule,,826.25,,,,fee schedule,,,55.61,83,,percent of total billed charges,,,,,,,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,14.02,826.25,
Insulin injection Per 5 Units,J1815,CDM,J1815,HCPCS,,,both,,45,45,0.66,,,,fee schedule,,,,,,,,,,,,,,,38.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.95,91,,percent of total billed charges,,,42.75,95,,percent of total billed charges,,,37.35,83,,percent of total billed charges,,,13.5,83,,percent of total billed charges,,,,,,,,,,,,,,,37.35,83,,percent of total billed charges,,,,,,,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,40.5,90,,percent of total billed charges,,,38.25,85,,percent of total billed charges,,0.66,42.75,
Ketorolac tromethamine inj,J1885,CDM,J1885,HCPCS,,,both,,14,14,0.71,,,,fee schedule,,,,,,,,2.54,,,,fee schedule,,,11.9,85,,percent of total billed charges,,,,,,,,,,,,,,2.54,,,,fee schedule,,,,,,,,2.54,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,12.74,91,,percent of total billed charges,,,13.3,95,,percent of total billed charges,,,11.62,83,,percent of total billed charges,,,4.2,83,,percent of total billed charges,,2.54,,,,fee schedule,,2.54,,,,fee schedule,,,11.62,83,,percent of total billed charges,,,,,,,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,11.9,85,,percent of total billed charges,,0.71,13.3,
Furosemide injection,J1940,CDM,J1940,HCPCS,,,both,,4,4,0.83,,,,fee schedule,,,,,,,,3.16,,,,fee schedule,,,3.4,85,,percent of total billed charges,,,,,,,,,,,,,,3.16,,,,fee schedule,,,,,,,,3.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,3.64,91,,percent of total billed charges,,,3.8,95,,percent of total billed charges,,,3.32,83,,percent of total billed charges,,,1.2,83,,percent of total billed charges,,3.16,,,,fee schedule,,3.16,,,,fee schedule,,,3.32,83,,percent of total billed charges,,,,,,,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.6,90,,percent of total billed charges,,,3.4,85,,percent of total billed charges,,0.83,3.8,
Lidocaine Injection,J2001,CDM,J2001,HCPCS,,,both,,5,5,0.02,,,,fee schedule,,,,,,,,0.75,,,,fee schedule,,,4.25,85,,percent of total billed charges,,,,,,,,,,,,,,0.75,,,,fee schedule,,,,,,,,0.75,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,4.55,91,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,1.5,83,,percent of total billed charges,,0.75,,,,fee schedule,,0.75,,,,fee schedule,,,4.15,83,,percent of total billed charges,,,,,,,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,0.02,4.75,
Lincomycin injection,J2010,CDM,J2010,HCPCS,,,both,,61,61,11.03,,,,fee schedule,,,,,,,,128.88,,,,fee schedule,,,51.85,85,,percent of total billed charges,,,,,,,,,,,,,,128.88,,,,fee schedule,,,,,,,,128.88,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,55.51,91,,percent of total billed charges,,,57.95,95,,percent of total billed charges,,,50.63,83,,percent of total billed charges,,,18.3,83,,percent of total billed charges,,128.88,,,,fee schedule,,128.88,,,,fee schedule,,,50.63,83,,percent of total billed charges,,,,,,,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,54.9,90,,percent of total billed charges,,,51.85,85,,percent of total billed charges,,11.03,128.88,
Lorazepam injection,J2060,CDM,J2060,HCPCS,,,both,,7,7,0.8,,,,fee schedule,,,,,,,,1.91,,,,fee schedule,,,5.95,85,,percent of total billed charges,,,,,,,,,,,,,,1.91,,,,fee schedule,,,,,,,,1.91,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,6.37,91,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,2.1,83,,percent of total billed charges,,1.91,,,,fee schedule,,1.91,,,,fee schedule,,,5.81,83,,percent of total billed charges,,,,,,,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,0.8,6.65,
Meperidine hydrochl /100 MG,J2175,CDM,J2175,HCPCS,,,both,,10,10,2.78,,,,fee schedule,,,,,,,,11.99,,,,fee schedule,,,8.5,85,,percent of total billed charges,,,,,,,,,,,,,,11.99,,,,fee schedule,,,,,,,,11.99,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,9.1,91,,percent of total billed charges,,,9.5,95,,percent of total billed charges,,,8.3,83,,percent of total billed charges,,,3,83,,percent of total billed charges,,11.99,,,,fee schedule,,11.99,,,,fee schedule,,,8.3,83,,percent of total billed charges,,,,,,,,,9,90,,percent of total billed charges,,,9,90,,percent of total billed charges,,,9,90,,percent of total billed charges,,,9,90,,percent of total billed charges,,,8.5,85,,percent of total billed charges,,2.78,11.99,
Meperidine/promethazine inj,J2180,CDM,J2180,HCPCS,,,both,,67,67,7.58,,,,fee schedule,,,,,,,,,,,,,,,56.95,85,,percent of total billed charges,,5,,,,fee schedule,,3.57,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,60.97,91,,percent of total billed charges,,,63.65,95,,percent of total billed charges,,,55.61,83,,percent of total billed charges,,,20.1,83,,percent of total billed charges,,,,,,,,,,,,,,,55.61,83,,percent of total billed charges,,,,,,,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,60.3,90,,percent of total billed charges,,,56.95,85,,percent of total billed charges,,3.57,63.65,
Orphenadrine injection,J2360,CDM,J2360,HCPCS,,,both,,74,74,5.6,,,,fee schedule,,,,,,,,4.07,,,,fee schedule,,,62.9,85,,percent of total billed charges,,,,,,,,,,,,,,4.07,,,,fee schedule,,,,,,,,4.07,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,22.2,83,,percent of total billed charges,,4.07,,,,fee schedule,,4.07,,,,fee schedule,,,61.42,83,,percent of total billed charges,,,,,,,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,4.07,70.3,
Ondansetron hcl injection,J2405,CDM,J2405,HCPCS,,,both,,3,3,0.1,,,,fee schedule,,,,,,,,1.38,,,,fee schedule,,,2.55,85,,percent of total billed charges,,,,,,,,,,,,,,1.38,,,,fee schedule,,,,,,,,1.38,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,0.9,83,,percent of total billed charges,,1.38,,,,fee schedule,,1.38,,,,fee schedule,,,2.49,83,,percent of total billed charges,,,,,,,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,0.1,2.85,
Penicillin g procaine inj,J2510,CDM,J2510,HCPCS,,,both,,42,42,31.87,,,,fee schedule,,,,,,,,141.18,,,,fee schedule,,,35.7,85,,percent of total billed charges,,,,,,,,,,,,,,141.18,,,,fee schedule,,,,,,,,141.18,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,38.22,91,,percent of total billed charges,,,39.9,95,,percent of total billed charges,,,34.86,83,,percent of total billed charges,,,12.6,83,,percent of total billed charges,,141.18,,,,fee schedule,,141.18,,,,fee schedule,,,34.86,83,,percent of total billed charges,,,,,,,,,37.8,90,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,35.7,85,,percent of total billed charges,,12.6,141.18,
Promethazine hcl injection,J2550,CDM,J2550,HCPCS,,,both,,6,6,2.45,,,,fee schedule,,,,,,,,2.94,,,,fee schedule,,,5.1,85,,percent of total billed charges,,,,,,,,,,,,,,2.94,,,,fee schedule,,,,,,,,2.94,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,1.8,83,,percent of total billed charges,,2.94,,,,fee schedule,,2.94,,,,fee schedule,,,4.98,83,,percent of total billed charges,,,,,,,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,1.8,5.7,
Metoclopramide hcl injection,J2765,CDM,J2765,HCPCS,,,both,,5,5,1.11,,,,fee schedule,,,,,,,,26.5,,,,fee schedule,,,4.25,85,,percent of total billed charges,,,,,,,,,,,,,,26.5,,,,fee schedule,,,,,,,,26.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,4.55,91,,percent of total billed charges,,,4.75,95,,percent of total billed charges,,,4.15,83,,percent of total billed charges,,,1.5,83,,percent of total billed charges,,26.5,,,,fee schedule,,26.5,,,,fee schedule,,,4.15,83,,percent of total billed charges,,,,,,,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.5,90,,percent of total billed charges,,,4.25,85,,percent of total billed charges,,1.11,26.5,
Rho d immune globulin 50 mcg,J2788,CDM,J2788,HCPCS,,,both,,93,93,25.81,,,,fee schedule,,,,,,,,23.19,,,,fee schedule,,,79.05,85,,percent of total billed charges,,,,,,,,,,,,,,23.19,,,,fee schedule,,,,,,,,23.19,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,84.63,91,,percent of total billed charges,,,88.35,95,,percent of total billed charges,,,77.19,83,,percent of total billed charges,,,27.9,83,,percent of total billed charges,,23.19,,,,fee schedule,,23.19,,,,fee schedule,,,77.19,83,,percent of total billed charges,,,,,,,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,83.7,90,,percent of total billed charges,,,79.05,85,,percent of total billed charges,,23.19,88.35,
Rho d immune globulin inj,J2790,CDM,J2790,HCPCS,,,both,,183,183,72.5,,,,fee schedule,,,,,,,,80.41,,,,fee schedule,,,155.55,85,,percent of total billed charges,,,,,,,,,,,,,,80.41,,,,fee schedule,,,,,,,,80.41,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,166.53,91,,percent of total billed charges,,,173.85,95,,percent of total billed charges,,,151.89,83,,percent of total billed charges,,,54.9,83,,percent of total billed charges,,80.41,,,,fee schedule,,80.41,,,,fee schedule,,,151.89,83,,percent of total billed charges,,,,,,,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,164.7,90,,percent of total billed charges,,,155.55,85,,percent of total billed charges,,54.9,173.85,
"Rho(D) immune globulin h, sd",J2792,CDM,J2792,HCPCS,,,both,,258,258,32.94,,,,fee schedule,,,,,,,,2433.75,,,,fee schedule,,,219.3,85,,percent of total billed charges,,,,,,,,,,,,,,2433.75,,,,fee schedule,,,,,,,,2433.75,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,234.78,91,,percent of total billed charges,,,245.1,95,,percent of total billed charges,,,214.14,83,,percent of total billed charges,,,77.4,83,,percent of total billed charges,,2433.75,,,,fee schedule,,2433.75,,,,fee schedule,,,214.14,83,,percent of total billed charges,,,,,,,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,232.2,90,,percent of total billed charges,,,219.3,85,,percent of total billed charges,,32.94,2433.75,
Methylprednisolone injection,J2920,CDM,J2920,HCPCS,,,both,,90,90,4.42,,,,fee schedule,,,,,,,,4.28,,,,fee schedule,,,76.5,85,,percent of total billed charges,,,,,,,,,,,,,,4.28,,,,fee schedule,,,,,,,,4.28,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,81.9,91,,percent of total billed charges,,,85.5,95,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,27,83,,percent of total billed charges,,4.28,,,,fee schedule,,4.28,,,,fee schedule,,,74.7,83,,percent of total billed charges,,,,,,,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,81,90,,percent of total billed charges,,,76.5,85,,percent of total billed charges,,4.28,85.5,
Methylprednisolone 125mg inj,J2930,CDM,J2930,HCPCS,,,both,,177,177,5.97,,,,fee schedule,,,,,,,,172.26,,,,fee schedule,,,150.45,85,,percent of total billed charges,,,,,,,,,,,,,,172.26,,,,fee schedule,,,,,,,,172.26,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,161.07,91,,percent of total billed charges,,,168.15,95,,percent of total billed charges,,,146.91,83,,percent of total billed charges,,,53.1,83,,percent of total billed charges,,172.26,,,,fee schedule,,172.26,,,,fee schedule,,,146.91,83,,percent of total billed charges,,,,,,,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,159.3,90,,percent of total billed charges,,,150.45,85,,percent of total billed charges,,5.97,172.26,
Sumatriptan succinate / 6 MG,J3030,CDM,J3030,HCPCS,,,both,,159,159,65.41,,,,fee schedule,,,,,,,,7.64,,,,fee schedule,,,135.15,85,,percent of total billed charges,,,,,,,,,,,,,,7.64,,,,fee schedule,,,,,,,,7.64,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,144.69,91,,percent of total billed charges,,,151.05,95,,percent of total billed charges,,,131.97,83,,percent of total billed charges,,,47.7,83,,percent of total billed charges,,7.64,,,,fee schedule,,7.64,,,,fee schedule,,,131.97,83,,percent of total billed charges,,,,,,,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,143.1,90,,percent of total billed charges,,,135.15,85,,percent of total billed charges,,7.64,151.05,
Tobramycin sulfate injection,J3260,CDM,J3260,HCPCS,,,both,,31,31,1.9,,,,fee schedule,,,,,,,,20.81,,,,fee schedule,,,26.35,85,,percent of total billed charges,,,,,,,,,,,,,,20.81,,,,fee schedule,,,,,,,,20.81,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,9.3,83,,percent of total billed charges,,20.81,,,,fee schedule,,20.81,,,,fee schedule,,,25.73,83,,percent of total billed charges,,,,,,,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,1.9,29.45,
TRIAMCINOLONE A INJ PRS-FREE,J3300,CDM,J3300,HCPCS,,,both,,24,24,3.61,,,,fee schedule,,,,,,,,156.16,,,,fee schedule,,,20.4,85,,percent of total billed charges,,,,,,,,,,,,,,156.16,,,,fee schedule,,,,,,,,156.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,7.2,83,,percent of total billed charges,,156.16,,,,fee schedule,,156.16,,,,fee schedule,,,19.92,83,,percent of total billed charges,,,,,,,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,3.61,156.16,
Triamcinolone acetonide inj 10mg/ml,J3301,CDM,J3301,HCPCS,,,both,,31,31,1.41,,,,fee schedule,,,,,,,,17.47,,,,fee schedule,,,26.35,85,,percent of total billed charges,,,,,,,,,,,,,,17.47,,,,fee schedule,,,,,,,,17.47,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,9.3,83,,percent of total billed charges,,17.47,,,,fee schedule,,17.47,,,,fee schedule,,,25.73,83,,percent of total billed charges,,,,,,,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,1.41,29.45,
Triamcinolone acetonide inj 40mg/1ml,J3301A,CDM,J3301,HCPCS,,,both,,31,31,1.41,,,,fee schedule,,,,,,,,17.47,,,,fee schedule,,,26.35,85,,percent of total billed charges,,,,,,,,,,,,,,17.47,,,,fee schedule,,,,,,,,17.47,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,9.3,83,,percent of total billed charges,,17.47,,,,fee schedule,,17.47,,,,fee schedule,,,25.73,83,,percent of total billed charges,,,,,,,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,1.41,29.45,
Diazepam injection,J3360,CDM,J3360,HCPCS,,,both,,65,65,6.41,,,,fee schedule,,,,,,,,26.31,,,,fee schedule,,,55.25,85,,percent of total billed charges,,,,,,,,,,,,,,26.31,,,,fee schedule,,,,,,,,26.31,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,59.15,91,,percent of total billed charges,,,61.75,95,,percent of total billed charges,,,53.95,83,,percent of total billed charges,,,19.5,83,,percent of total billed charges,,26.31,,,,fee schedule,,26.31,,,,fee schedule,,,53.95,83,,percent of total billed charges,,,,,,,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,58.5,90,,percent of total billed charges,,,55.25,85,,percent of total billed charges,,6.41,61.75,
"injection, hydroxyzine hcl, up to 25 mg",J3410,CDM,J3410,HCPCS,,,both,,21,21,8.3,,,,fee schedule,,,,,,,,45.34,,,,fee schedule,,,17.85,85,,percent of total billed charges,,,,,,,,,,,,,,45.34,,,,fee schedule,,,,,,,,45.34,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,6.3,83,,percent of total billed charges,,45.34,,,,fee schedule,,45.34,,,,fee schedule,,,17.43,83,,percent of total billed charges,,,,,,,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,6.3,45.34,
Thiamine hcl 100 mg,J3411,CDM,J3411,HCPCS,,,both,,76,76,2.68,,,,fee schedule,,,,,,,,2.88,,,,fee schedule,,,64.6,85,,percent of total billed charges,,,,,,,,,,,,,,2.88,,,,fee schedule,,,,,,,,2.88,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,69.16,91,,percent of total billed charges,,,72.2,95,,percent of total billed charges,,,63.08,83,,percent of total billed charges,,,22.8,83,,percent of total billed charges,,2.88,,,,fee schedule,,2.88,,,,fee schedule,,,63.08,83,,percent of total billed charges,,,,,,,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,68.4,90,,percent of total billed charges,,,64.6,85,,percent of total billed charges,,2.68,72.2,
Pyridoxine hcl 100 mg,J3415,CDM,J3415,HCPCS,,,both,,238,238,8.29,,,,fee schedule,,,,,,,,57.96,,,,fee schedule,,,202.3,85,,percent of total billed charges,,,,,,,,,,,,,,57.96,,,,fee schedule,,,,,,,,57.96,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,216.58,91,,percent of total billed charges,,,226.1,95,,percent of total billed charges,,,197.54,83,,percent of total billed charges,,,71.4,83,,percent of total billed charges,,57.96,,,,fee schedule,,57.96,,,,fee schedule,,,197.54,83,,percent of total billed charges,,,,,,,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,214.2,90,,percent of total billed charges,,,202.3,85,,percent of total billed charges,,8.29,226.1,
Vitamin b12 injection,J3420,CDM,J3420,HCPCS,,,both,,11,11,1.95,,,,fee schedule,,,,,,,,1.95,,,,fee schedule,,,9.35,85,,percent of total billed charges,,,,,,,,,,,,,,1.95,,,,fee schedule,,,,,,,,1.95,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,3.3,83,,percent of total billed charges,,1.95,,,,fee schedule,,1.95,,,,fee schedule,,,9.13,83,,percent of total billed charges,,,,,,,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,1.95,10.45,
Vitamin k phytonadione inj,J3430,CDM,J3430,HCPCS,,,both,,11,11,4.03,,,,fee schedule,,,,,,,,82.65,,,,fee schedule,,,9.35,85,,percent of total billed charges,,,,,,,,,,,,,,82.65,,,,fee schedule,,,,,,,,82.65,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,10.01,91,,percent of total billed charges,,,10.45,95,,percent of total billed charges,,,9.13,83,,percent of total billed charges,,,3.3,83,,percent of total billed charges,,82.65,,,,fee schedule,,82.65,,,,fee schedule,,,9.13,83,,percent of total billed charges,,,,,,,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.9,90,,percent of total billed charges,,,9.35,85,,percent of total billed charges,,3.3,82.65,
Zoledronic acid 1mg,J3489,CDM,J3489,HCPCS,,,both,,468,468,10.29,,,,fee schedule,,,,,,,,41.84,,,,fee schedule,,,397.8,85,,percent of total billed charges,,,,,,,,,,,,,,41.84,,,,fee schedule,,,,,,,,41.84,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,425.88,91,,percent of total billed charges,,,444.6,95,,percent of total billed charges,,,388.44,83,,percent of total billed charges,,,140.4,83,,percent of total billed charges,,41.84,,,,fee schedule,,41.84,,,,fee schedule,,,388.44,83,,percent of total billed charges,,,,,,,,,421.2,90,,percent of total billed charges,,,421.2,90,,percent of total billed charges,,,421.2,90,,percent of total billed charges,,,421.2,90,,percent of total billed charges,,,397.8,85,,percent of total billed charges,,10.29,444.6,
Normal saline solution infus 1000cc,J7030,CDM,J7030,HCPCS,,,both,,15,15,2.69,,,,fee schedule,,,,,,,,,,,,,,,12.75,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.65,91,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,4.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12.45,83,,percent of total billed charges,,,,,,,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,2.69,14.25,
"Normal saline solution infus, 500 ML",J7040,CDM,J7040,HCPCS,,,both,,15,15,1.35,,,,fee schedule,,,,,,,,,,,,,,,12.75,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.65,91,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,4.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12.45,83,,percent of total billed charges,,,,,,,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,1.35,14.25,
5% dextrose/normal saline,J7042,CDM,J7042,HCPCS,,,both,,15,15,1.15,,,,fee schedule,,,,,,,,,,,,,,,12.75,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.65,91,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,4.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12.45,83,,percent of total billed charges,,,,,,,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,1.15,14.25,
"Normal saline solution infus, 250 Cc",J7050,CDM,J7050,HCPCS,,,both,,14,14,0.67,,,,fee schedule,,,,,,,,,,,,,,,11.9,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.74,91,,percent of total billed charges,,,13.3,95,,percent of total billed charges,,,11.62,83,,percent of total billed charges,,,4.2,83,,percent of total billed charges,,,,,,,,,,,,,,,11.62,83,,percent of total billed charges,,,,,,,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,11.9,85,,percent of total billed charges,,0.67,13.3,
Lactated Ringers Infusion,J7120,CDM,J7120,HCPCS,,,both,,15,15,2.48,,,,fee schedule,,,,,,,,,,,,,,,12.75,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.65,91,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,4.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12.45,83,,percent of total billed charges,,,,,,,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,2.48,14.25,
"Kyleena, 19.5 mg",J7296,CDM,J7296,HCPCS,,,both,,2350,2350,953.51,,,,fee schedule,,,,,,,,1053.23,,,,fee schedule,,,1997.5,85,,percent of total billed charges,,,,,,,,,,,,,,1053.23,,,,fee schedule,,,,,,,,1053.23,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,2138.5,91,,percent of total billed charges,,,2232.5,95,,percent of total billed charges,,,1950.5,83,,percent of total billed charges,,,705,83,,percent of total billed charges,,1053.23,,,,fee schedule,,1053.23,,,,fee schedule,,,1950.5,83,,percent of total billed charges,,,,,,,,,2115,90,,percent of total billed charges,,,2115,90,,percent of total billed charges,,,2115,90,,percent of total billed charges,,,2115,90,,percent of total billed charges,,,1997.5,85,,percent of total billed charges,,705,2232.5,
Mirena,J7298,CDM,J7298,HCPCS,,,both,,2303,2303,953.51,,,,fee schedule,,,,,,,,1053.23,,,,fee schedule,,,1957.55,85,,percent of total billed charges,,,,,,,,,,,,,,1053.23,,,,fee schedule,,,,,,,,1053.23,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,2095.73,91,,percent of total billed charges,,,2187.85,95,,percent of total billed charges,,,1911.49,83,,percent of total billed charges,,,690.9,83,,percent of total billed charges,,1053.23,,,,fee schedule,,1053.23,,,,fee schedule,,,1911.49,83,,percent of total billed charges,,,,,,,,,2072.7,90,,percent of total billed charges,,,2072.7,90,,percent of total billed charges,,,2072.7,90,,percent of total billed charges,,,2072.7,90,,percent of total billed charges,,,1957.55,85,,percent of total billed charges,,690.9,2187.85,
Paragard Intraut copper contraceptive,J7300,CDM,J7300,HCPCS,,,both,,1167,1167,884.5,,,,fee schedule,,,,,,,,979.9,,,,fee schedule,,,991.95,85,,percent of total billed charges,,,,,,,,,,,,,,979.9,,,,fee schedule,,,,,,,,979.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,1061.97,91,,percent of total billed charges,,,1108.65,95,,percent of total billed charges,,,968.61,83,,percent of total billed charges,,,350.1,83,,percent of total billed charges,,979.9,,,,fee schedule,,979.9,,,,fee schedule,,,968.61,83,,percent of total billed charges,,,,,,,,,1050.3,90,,percent of total billed charges,,,1050.3,90,,percent of total billed charges,,,1050.3,90,,percent of total billed charges,,,1050.3,90,,percent of total billed charges,,,991.95,85,,percent of total billed charges,,350.1,1108.65,
Skyla IUD,J7301,CDM,J7301,HCPCS,,,both,,1429,1429,793.96,,,,fee schedule,,,,,,,,876.99,,,,fee schedule,,,1214.65,85,,percent of total billed charges,,,,,,,,,,,,,,876.99,,,,fee schedule,,,,,,,,876.99,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,1300.39,91,,percent of total billed charges,,,1357.55,95,,percent of total billed charges,,,1186.07,83,,percent of total billed charges,,,428.7,83,,percent of total billed charges,,876.99,,,,fee schedule,,876.99,,,,fee schedule,,,1186.07,83,,percent of total billed charges,,,,,,,,,1286.1,90,,percent of total billed charges,,,1286.1,90,,percent of total billed charges,,,1286.1,90,,percent of total billed charges,,,1286.1,90,,percent of total billed charges,,,1214.65,85,,percent of total billed charges,,428.7,1357.55,
Etonogestrel implant system (Nexplanon),J7307,CDM,J7307,HCPCS,,,both,,1544,1544,981.56,,,,fee schedule,,,,,,,,1044.41,,,,fee schedule,,,1312.4,85,,percent of total billed charges,,,,,,,,,,,,,,1044.41,,,,fee schedule,,,,,,,,1044.41,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,1405.04,91,,percent of total billed charges,,,1466.8,95,,percent of total billed charges,,,1281.52,83,,percent of total billed charges,,,463.2,83,,percent of total billed charges,,1044.41,,,,fee schedule,,1044.41,,,,fee schedule,,,1281.52,83,,percent of total billed charges,,,,,,,,,1389.6,90,,percent of total billed charges,,,1389.6,90,,percent of total billed charges,,,1389.6,90,,percent of total billed charges,,,1389.6,90,,percent of total billed charges,,,1312.4,85,,percent of total billed charges,,463.2,1466.8,
"Inj, durolane 3ml",J7318,CDM,J7318,HCPCS,,,both,,2534,2534,15.6,,,,fee schedule,,,,,,,,1111.92,,,,fee schedule,,,2153.9,85,,percent of total billed charges,,,,,,,,,,,,,,1111.92,,,,fee schedule,,,,,,,,1111.92,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,2305.94,91,,percent of total billed charges,,,2407.3,95,,percent of total billed charges,,,2103.22,83,,percent of total billed charges,,,760.2,83,,percent of total billed charges,,1111.92,,,,fee schedule,,1111.92,,,,fee schedule,,,2103.22,83,,percent of total billed charges,,,,,,,,,2280.6,90,,percent of total billed charges,,,2280.6,90,,percent of total billed charges,,,2280.6,90,,percent of total billed charges,,,2280.6,90,,percent of total billed charges,,,2153.9,85,,percent of total billed charges,,15.6,2407.3,
Hyalgan/supartz inj per dose,J7321,CDM,J7321,HCPCS,,,both,,705,705,84.6,,,,fee schedule,,,,,,,,153.92,,,,fee schedule,,,599.25,85,,percent of total billed charges,,,,,,,,,,,,,,153.92,,,,fee schedule,,,,,,,,153.92,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,641.55,91,,percent of total billed charges,,,669.75,95,,percent of total billed charges,,,585.15,83,,percent of total billed charges,,,211.5,83,,percent of total billed charges,,153.92,,,,fee schedule,,153.92,,,,fee schedule,,,585.15,83,,percent of total billed charges,,,,,,,,,634.5,90,,percent of total billed charges,,,634.5,90,,percent of total billed charges,,,634.5,90,,percent of total billed charges,,,634.5,90,,percent of total billed charges,,,599.25,85,,percent of total billed charges,,84.6,669.75,
Euflexxa inj per dose,J7323,CDM,J7323,HCPCS,,,both,,862,862,148.73,,,,fee schedule,,,,,,,,261.77,,,,fee schedule,,,732.7,85,,percent of total billed charges,,,,,,,,,,,,,,261.77,,,,fee schedule,,,,,,,,261.77,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,784.42,91,,percent of total billed charges,,,818.9,95,,percent of total billed charges,,,715.46,83,,percent of total billed charges,,,258.6,83,,percent of total billed charges,,261.77,,,,fee schedule,,261.77,,,,fee schedule,,,715.46,83,,percent of total billed charges,,,,,,,,,775.8,90,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,775.8,90,,percent of total billed charges,,,732.7,85,,percent of total billed charges,,148.73,818.9,
Synvisc inj per dose,J7325,CDM,J7325,HCPCS,,,both,,34,34,10.83,,,,fee schedule,,,,,,,,973.06,,,,fee schedule,,,28.9,85,,percent of total billed charges,,,,,,,,,,,,,,973.06,,,,fee schedule,,,,,,,,973.06,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,30.94,91,,percent of total billed charges,,,32.3,95,,percent of total billed charges,,,28.22,83,,percent of total billed charges,,,10.2,83,,percent of total billed charges,,973.06,,,,fee schedule,,973.06,,,,fee schedule,,,28.22,83,,percent of total billed charges,,,,,,,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,30.6,90,,percent of total billed charges,,,28.9,85,,percent of total billed charges,,10.2,973.06,
Gel-one,J7326,CDM,J7326,HCPCS,,,both,,3626,3626,1104,,,,fee schedule,,,,,,,,984.46,,,,fee schedule,,,3082.1,85,,percent of total billed charges,,,,,,,,,,,,,,984.46,,,,fee schedule,,,,,,,,984.46,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,3299.66,91,,percent of total billed charges,,,3444.7,95,,percent of total billed charges,,,3009.58,83,,percent of total billed charges,,,1087.8,83,,percent of total billed charges,,984.46,,,,fee schedule,,984.46,,,,fee schedule,,,3009.58,83,,percent of total billed charges,,,,,,,,,3263.4,90,,percent of total billed charges,,,3263.4,90,,percent of total billed charges,,,3263.4,90,,percent of total billed charges,,,3263.4,90,,percent of total billed charges,,,3082.1,85,,percent of total billed charges,,984.46,3444.7,
Albuterol unit dose,J7613,CDM,J7613,HCPCS,,,both,,28,28,0.04,,,,fee schedule,,,,,,,,0.18,,,,fee schedule,,,23.8,85,,percent of total billed charges,,,,,,,,,,,,,,0.18,,,,fee schedule,,,,,,,,0.18,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,8.4,83,,percent of total billed charges,,0.18,,,,fee schedule,,0.18,,,,fee schedule,,,23.24,83,,percent of total billed charges,,,,,,,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,0.04,26.6,
Albuterol/Ipratropium Bromide 2.5/0.5,J7620,CDM,J7620,HCPCS,,,both,,2,2,0.13,,,,fee schedule,,,,,,,,0.13,,,,fee schedule,,,1.7,85,,percent of total billed charges,,,,,,,,,,,,,,0.13,,,,fee schedule,,,,,,,,0.13,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,1.82,91,,percent of total billed charges,,,1.9,95,,percent of total billed charges,,,1.66,83,,percent of total billed charges,,,0.6,83,,percent of total billed charges,,0.13,,,,fee schedule,,0.13,,,,fee schedule,,,1.66,83,,percent of total billed charges,,,,,,,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.8,90,,percent of total billed charges,,,1.7,85,,percent of total billed charges,,0.13,1.9,
Ipratropium brom inh sol u d,J7644,CDM,J7644,HCPCS,,,both,,9,9,0.21,,,,fee schedule,,,,,,,,0.21,,,,fee schedule,,,7.65,85,,percent of total billed charges,,,,,,,,,,,,,,0.21,,,,fee schedule,,,,,,,,0.21,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,2.7,83,,percent of total billed charges,,0.21,,,,fee schedule,,0.21,,,,fee schedule,,,7.47,83,,percent of total billed charges,,,,,,,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,0.21,8.55,
Oral dexamethasone,J8540,CDM,J8540,HCPCS,,,both,,3,3,0.07,,,,fee schedule,,,,,,,,,,,,,,,2.55,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2.73,91,,percent of total billed charges,,,2.85,95,,percent of total billed charges,,,2.49,83,,percent of total billed charges,,,0.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2.49,83,,percent of total billed charges,,,,,,,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.7,90,,percent of total billed charges,,,2.55,85,,percent of total billed charges,,0.07,2.85,
Mechlorethamine hcl inj,J9230,CDM,J9230,HCPCS,,,both,,626,626,297.32,,,,fee schedule,,,,,,,,,,,,,,,532.1,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,569.66,91,,percent of total billed charges,,,594.7,95,,percent of total billed charges,,,519.58,83,,percent of total billed charges,,,187.8,83,,percent of total billed charges,,,,,,,,,,,,,,,519.58,83,,percent of total billed charges,,,,,,,,,563.4,90,,percent of total billed charges,,,563.4,90,,percent of total billed charges,,,563.4,90,,percent of total billed charges,,,563.4,90,,percent of total billed charges,,,532.1,85,,percent of total billed charges,,187.8,594.7,
Cerv flexible non-adjustable,L0120,CDM,L0120,HCPCS,,,both,,9,9,,,,,,,,,,,,,,,,,,,,7.65,85,,percent of total billed charges,,21.48,,,,fee schedule,,15.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,2.7,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,,,,,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,2.7,21.48,
Cerv col thermplas foam 2 pi,L0172,CDM,L0172,HCPCS,,,both,,140,140,,,,,,,,,,,,,,,,,,,,119,85,,percent of total billed charges,,115.05,,,,fee schedule,,84.42,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,42,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,,,,,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,42,133,
Thoracic rib belt,L0210,CDM,L0210,HCPCS,,,both,,88,88,,,,,,,,,,,,,,,,,,,,74.8,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,26.4,83,,percent of total billed charges,,,,,,,,,,,,,,,73.04,83,,percent of total billed charges,,,,,,,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,26.4,83.6,
Thor rib belt custom fabrica,L0220,CDM,L0220,HCPCS,,,both,,299,299,,,,,,,,,,,,,,,,,,,,254.15,85,,percent of total billed charges,,104.94,,,,fee schedule,,92.68,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,272.09,91,,percent of total billed charges,,,284.05,95,,percent of total billed charges,,,248.17,83,,percent of total billed charges,,,89.7,83,,percent of total billed charges,,,,,,,,,,,,,,,248.17,83,,percent of total billed charges,,,,,,,,,269.1,90,,percent of total billed charges,,,269.1,90,,percent of total billed charges,,,269.1,90,,percent of total billed charges,,,269.1,90,,percent of total billed charges,,,254.15,85,,percent of total billed charges,,89.7,284.05,
LO sagitt rigid panel prefab,L0627,CDM,L0627,HCPCS,,,both,,249,249,,,,,,,,,,,,,,,,,,,,211.65,85,,percent of total billed charges,,333.9,,,,fee schedule,,264.51,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,226.59,91,,percent of total billed charges,,,236.55,95,,percent of total billed charges,,,206.67,83,,percent of total billed charges,,,74.7,83,,percent of total billed charges,,,,,,,,,,,,,,,206.67,83,,percent of total billed charges,,,,,,,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,224.1,90,,percent of total billed charges,,,211.65,85,,percent of total billed charges,,74.7,333.9,
Ko elastic with joints,L1810,CDM,L1810,HCPCS,,,both,,237,237,,,,,,,,,,,,,,,,,,,,201.45,85,,percent of total billed charges,,83.63,,,,fee schedule,,64.08,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,215.67,91,,percent of total billed charges,,,225.15,95,,percent of total billed charges,,,196.71,83,,percent of total billed charges,,,71.1,83,,percent of total billed charges,,,,,,,,,,,,,,,196.71,83,,percent of total billed charges,,,,,,,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,213.3,90,,percent of total billed charges,,,201.45,85,,percent of total billed charges,,64.08,225.15,
"Knee orthosis, elastic W/joints, prefab, OTS",L1812,CDM,L1812,HCPCS,,,both,,103,103,,,,,,,,,,,,,,,,,,,,87.55,85,,percent of total billed charges,,63.77,,,,fee schedule,,56.32,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,30.9,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,30.9,97.85,
Playmaker Pop,L1815,CDM,L1815,HCPCS,,,both,,255,255,,,,,,,,,,,,,,,,,,,,216.75,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,232.05,91,,percent of total billed charges,,,242.25,95,,percent of total billed charges,,,211.65,83,,percent of total billed charges,,,76.5,83,,percent of total billed charges,,,,,,,,,,,,,,,211.65,83,,percent of total billed charges,,,,,,,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,229.5,90,,percent of total billed charges,,,216.75,85,,percent of total billed charges,,76.5,242.25,
Ko elas w/ condyle pads / jo,L1820,CDM,L1820,HCPCS,,,both,,52,52,,,,,,,,,,,,,,,,,,,,44.2,85,,percent of total billed charges,,115.45,,,,fee schedule,,86.22,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,15.6,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,,,,,,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,15.6,115.45,
Ko elastic knee cap,L1825,CDM,L1825,HCPCS,,,both,,31,31,,,,,,,,,,,,,,,,,,,,26.35,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,9.3,83,,percent of total billed charges,,,,,,,,,,,,,,,25.73,83,,percent of total billed charges,,,,,,,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,9.3,29.45,
Ko immobilizer canvas longit,L1830,CDM,L1830,HCPCS,,,both,,47,47,,,,,,,,,,,,,,,,,,,,39.95,85,,percent of total billed charges,,55.52,,,,fee schedule,,42.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,42.77,91,,percent of total billed charges,,,44.65,95,,percent of total billed charges,,,39.01,83,,percent of total billed charges,,,14.1,83,,percent of total billed charges,,,,,,,,,,,,,,,39.01,83,,percent of total billed charges,,,,,,,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,42.3,90,,percent of total billed charges,,,39.95,85,,percent of total billed charges,,14.1,55.52,
Knee orth pos locking joint,L1831,CDM,L1831,HCPCS,,,both,,362,362,,,,,,,,,,,,,,,,,,,,307.7,85,,percent of total billed charges,,239.09,,,,fee schedule,,204.94,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,329.42,91,,percent of total billed charges,,,343.9,95,,percent of total billed charges,,,300.46,83,,percent of total billed charges,,,108.6,83,,percent of total billed charges,,,,,,,,,,,,,,,300.46,83,,percent of total billed charges,,,,,,,,,325.8,90,,percent of total billed charges,,,325.8,90,,percent of total billed charges,,,325.8,90,,percent of total billed charges,,,325.8,90,,percent of total billed charges,,,307.7,85,,percent of total billed charges,,108.6,343.9,
KO adj jnt pos rigid support,L1832,CDM,L1832,HCPCS,,,both,,248,248,,,,,,,,,,,,,,,,,,,,210.8,85,,percent of total billed charges,,581.36,,,,fee schedule,,363.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,74.4,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,74.4,581.36,
Ko adj jnt pos r sup pre cst XL,L1832 XL,CDM,L1832,HCPCS,,,both,,248,248,,,,,,,,,,,,,,,,,,,,210.8,85,,percent of total billed charges,,581.36,,,,fee schedule,,363.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,225.68,91,,percent of total billed charges,,,235.6,95,,percent of total billed charges,,,205.84,83,,percent of total billed charges,,,74.4,83,,percent of total billed charges,,,,,,,,,,,,,,,205.84,83,,percent of total billed charges,,,,,,,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,223.2,90,,percent of total billed charges,,,210.8,85,,percent of total billed charges,,74.4,581.36,
Ko adj jnt pos r sup pre ots,L1833,CDM,L1833,HCPCS,,,both,,416,416,,,,,,,,,,,,,,,,,,,,353.6,85,,percent of total billed charges,,434.41,,,,fee schedule,,369.25,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,378.56,91,,percent of total billed charges,,,395.2,95,,percent of total billed charges,,,345.28,83,,percent of total billed charges,,,124.8,83,,percent of total billed charges,,,,,,,,,,,,,,,345.28,83,,percent of total billed charges,,,,,,,,,374.4,90,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,374.4,90,,percent of total billed charges,,,353.6,85,,percent of total billed charges,,124.8,434.41,
Rigid KO wo joints,L1836,CDM,L1836,HCPCS,,,both,,306,306,,,,,,,,,,,,,,,,,,,,260.1,85,,percent of total billed charges,,81.71,,,,fee schedule,,70.04,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,278.46,91,,percent of total billed charges,,,290.7,95,,percent of total billed charges,,,253.98,83,,percent of total billed charges,,,91.8,83,,percent of total billed charges,,,,,,,,,,,,,,,253.98,83,,percent of total billed charges,,,,,,,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,275.4,90,,percent of total billed charges,,,260.1,85,,percent of total billed charges,,70.04,290.7,
KO single upright custom fit,L1843,CDM,L1843,HCPCS,,,both,,2354,2354,,,,,,,,,,,,,,,,,,,,2000.9,85,,percent of total billed charges,,728.91,,,,fee schedule,,577.45,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2142.14,91,,percent of total billed charges,,,2236.3,95,,percent of total billed charges,,,1953.82,83,,percent of total billed charges,,,706.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1953.82,83,,percent of total billed charges,,,,,,,,,2118.6,90,,percent of total billed charges,,,2118.6,90,,percent of total billed charges,,,2118.6,90,,percent of total billed charges,,,2118.6,90,,percent of total billed charges,,,2000.9,85,,percent of total billed charges,,577.45,2236.3,
Ankle Game Day,L1902,CDM,L1902,HCPCS,,,both,,37,37,,,,,,,,,,,,,,,,,,,,31.45,85,,percent of total billed charges,,60.64,,,,fee schedule,,53.55,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,33.67,91,,percent of total billed charges,,,35.15,95,,percent of total billed charges,,,30.71,83,,percent of total billed charges,,,11.1,83,,percent of total billed charges,,,,,,,,,,,,,,,30.71,83,,percent of total billed charges,,,,,,,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,33.3,90,,percent of total billed charges,,,31.45,85,,percent of total billed charges,,11.1,60.64,
Afo multiligamentus ankle su,L1906,CDM,L1906,HCPCS,,,both,,260,260,,,,,,,,,,,,,,,,,,,,221,85,,percent of total billed charges,,91.35,,,,fee schedule,,71.78,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,236.6,91,,percent of total billed charges,,,247,95,,percent of total billed charges,,,215.8,83,,percent of total billed charges,,,78,83,,percent of total billed charges,,,,,,,,,,,,,,,215.8,83,,percent of total billed charges,,,,,,,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,234,90,,percent of total billed charges,,,221,85,,percent of total billed charges,,71.78,247,
Afo molded to patient plasti,L1940,CDM,L1940,HCPCS,,,both,,543,543,,,,,,,,,,,,,,,,,,,,461.55,85,,percent of total billed charges,,395.6,,,,fee schedule,,328.81,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,494.13,91,,percent of total billed charges,,,515.85,95,,percent of total billed charges,,,450.69,83,,percent of total billed charges,,,162.9,83,,percent of total billed charges,,,,,,,,,,,,,,,450.69,83,,percent of total billed charges,,,,,,,,,488.7,90,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,488.7,90,,percent of total billed charges,,,461.55,85,,percent of total billed charges,,162.9,515.85,
Afo pos solid ank plastic mo,L1960,CDM,L1960,HCPCS,,,both,,880,880,,,,,,,,,,,,,,,,,,,,748,85,,percent of total billed charges,,503.56,,,,fee schedule,,333.53,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,800.8,91,,percent of total billed charges,,,836,95,,percent of total billed charges,,,730.4,83,,percent of total billed charges,,,264,83,,percent of total billed charges,,,,,,,,,,,,,,,730.4,83,,percent of total billed charges,,,,,,,,,792,90,,percent of total billed charges,,,792,90,,percent of total billed charges,,,792,90,,percent of total billed charges,,,792,90,,percent of total billed charges,,,748,85,,percent of total billed charges,,264,836,
Suspension sleeve lower ext,L2397,CDM,L2397,HCPCS,,,both,,18,18,,,,,,,,,,,,,,,,,,,,15.3,85,,percent of total billed charges,,99.15,,,,fee schedule,,70.18,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,16.38,91,,percent of total billed charges,,,17.1,95,,percent of total billed charges,,,14.94,83,,percent of total billed charges,,,5.4,83,,percent of total billed charges,,,,,,,,,,,,,,,14.94,83,,percent of total billed charges,,,,,,,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,16.2,90,,percent of total billed charges,,,15.3,85,,percent of total billed charges,,5.4,99.15,
Knee control full kneecap,L2795,CDM,L2795,HCPCS,,,both,,179,179,,,,,,,,,,,,,,,,,,,,152.15,85,,percent of total billed charges,,66.62,,,,fee schedule,,58.4,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,162.89,91,,percent of total billed charges,,,170.05,95,,percent of total billed charges,,,148.57,83,,percent of total billed charges,,,53.7,83,,percent of total billed charges,,,,,,,,,,,,,,,148.57,83,,percent of total billed charges,,,,,,,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,161.1,90,,percent of total billed charges,,,152.15,85,,percent of total billed charges,,53.7,170.05,
Lower extremity orthosis NOS,L2999,CDM,L2999,HCPCS,,,both,,217,217,,,,,,,,,,,,,,,,,,,,184.45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,65.1,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,,,,,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,65.1,206.15,
Foot longitudinal arch suppo,L3010,CDM,L3010,HCPCS,,,both,,206,206,,,,,,,,,,,,,,,,,,,,175.1,85,,percent of total billed charges,,141.53,,,,fee schedule,,121.31,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,61.8,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,61.8,195.7,
Foot arch support remov prem,L3030,CDM,L3030,HCPCS,,,both,,218,218,,,,,,,,,,,,,,,,,,,,185.3,85,,percent of total billed charges,,61.99,,,,fee schedule,,49.11,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,65.4,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,,,,,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,49.11,207.1,
Foot arch supp longitud/meta,L3060,CDM,L3060,HCPCS,,,both,,26,26,,,,,,,,,,,,,,,,,,,,22.1,85,,percent of total billed charges,,59.92,,,,fee schedule,,49.03,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.66,91,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,7.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21.58,83,,percent of total billed charges,,,,,,,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,7.8,59.92,
Ambulatory surgical boot eac,L3260,CDM,L3260,HCPCS,,,both,,15,15,,,,,,,,,,,,,,,,,,,,12.75,85,,percent of total billed charges,,65,,,,fee schedule,,65,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,13.65,91,,percent of total billed charges,,,14.25,95,,percent of total billed charges,,,12.45,83,,percent of total billed charges,,,4.5,83,,percent of total billed charges,,,,,,,,,,,,,,,12.45,83,,percent of total billed charges,,,,,,,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,13.5,90,,percent of total billed charges,,,12.75,85,,percent of total billed charges,,4.5,65,
Shoe lift elev heel/sole neo,L3310,CDM,L3310,HCPCS,,,both,,92,92,,,,,,,,,,,,,,,,,,,,78.2,85,,percent of total billed charges,,66.14,,,,fee schedule,,56.69,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,83.72,91,,percent of total billed charges,,,87.4,95,,percent of total billed charges,,,76.36,83,,percent of total billed charges,,,27.6,83,,percent of total billed charges,,,,,,,,,,,,,,,76.36,83,,percent of total billed charges,,,,,,,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,82.8,90,,percent of total billed charges,,,78.2,85,,percent of total billed charges,,27.6,87.4,
Shoe lifts tapered to one-ha,L3332,CDM,L3332,HCPCS,,,both,,16,16,,,,,,,,,,,,,,,,,,,,13.6,85,,percent of total billed charges,,59.92,,,,fee schedule,,51.36,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,14.56,91,,percent of total billed charges,,,15.2,95,,percent of total billed charges,,,13.28,83,,percent of total billed charges,,,4.8,83,,percent of total billed charges,,,,,,,,,,,,,,,13.28,83,,percent of total billed charges,,,,,,,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,14.4,90,,percent of total billed charges,,,13.6,85,,percent of total billed charges,,4.8,59.92,
Shoe heel pad/depress for,L3480,CDM,L3480,HCPCS,,,both,,146,146,,,,,,,,,,,,,,,,,,,,124.1,85,,percent of total billed charges,,50.61,,,,fee schedule,,43.38,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,43.8,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,43.38,138.7,
Shlder fig 8 abduct restrain,L3650,CDM,L3650,HCPCS,,,both,,21,21,,,,,,,,,,,,,,,,,,,,17.85,85,,percent of total billed charges,,53.28,,,,fee schedule,,38.05,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,19.11,91,,percent of total billed charges,,,19.95,95,,percent of total billed charges,,,17.43,83,,percent of total billed charges,,,6.3,83,,percent of total billed charges,,,,,,,,,,,,,,,17.43,83,,percent of total billed charges,,,,,,,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,18.9,90,,percent of total billed charges,,,17.85,85,,percent of total billed charges,,6.3,53.28,
Abduct restrainer canvas&web,L3660,CDM,L3660,HCPCS,,,both,,196,196,,,,,,,,,,,,,,,,,,,,166.6,85,,percent of total billed charges,,76.39,,,,fee schedule,,65.48,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,178.36,91,,percent of total billed charges,,,186.2,95,,percent of total billed charges,,,162.68,83,,percent of total billed charges,,,58.8,83,,percent of total billed charges,,,,,,,,,,,,,,,162.68,83,,percent of total billed charges,,,,,,,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,176.4,90,,percent of total billed charges,,,166.6,85,,percent of total billed charges,,58.8,186.2,
Acromio/clavicular canvas&we,L3670,CDM,L3670,HCPCS,,,both,,103,103,,,,,,,,,,,,,,,,,,,,87.55,85,,percent of total billed charges,,84.05,,,,fee schedule,,68.77,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,93.73,91,,percent of total billed charges,,,97.85,95,,percent of total billed charges,,,85.49,83,,percent of total billed charges,,,30.9,83,,percent of total billed charges,,,,,,,,,,,,,,,85.49,83,,percent of total billed charges,,,,,,,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,92.7,90,,percent of total billed charges,,,87.55,85,,percent of total billed charges,,30.9,97.85,
Canvas vest SO,L3675,CDM,L3675,HCPCS,,,both,,218,218,,,,,,,,,,,,,,,,,,,,185.3,85,,percent of total billed charges,,129.77,,,,fee schedule,,103.65,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,198.38,91,,percent of total billed charges,,,207.1,95,,percent of total billed charges,,,180.94,83,,percent of total billed charges,,,65.4,83,,percent of total billed charges,,,,,,,,,,,,,,,180.94,83,,percent of total billed charges,,,,,,,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,196.2,90,,percent of total billed charges,,,185.3,85,,percent of total billed charges,,65.4,207.1,
Prefab elbow orthosis,L3701,CDM,L3701,HCPCS,,,both,,7,7,,,,,,,,,,,,,,,,,,,,5.95,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6.37,91,,percent of total billed charges,,,6.65,95,,percent of total billed charges,,,5.81,83,,percent of total billed charges,,,2.1,83,,percent of total billed charges,,,,,,,,,,,,,,,5.81,83,,percent of total billed charges,,,,,,,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,6.3,90,,percent of total billed charges,,,5.95,85,,percent of total billed charges,,2.1,6.65,
EO w/o joints CF,L3702,CDM,L3702,HCPCS,,,both,,601,601,,,,,,,,,,,,,,,,,,,,510.85,85,,percent of total billed charges,,213.49,,,,fee schedule,,182.99,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,546.91,91,,percent of total billed charges,,,570.95,95,,percent of total billed charges,,,498.83,83,,percent of total billed charges,,,180.3,83,,percent of total billed charges,,,,,,,,,,,,,,,498.83,83,,percent of total billed charges,,,,,,,,,540.9,90,,percent of total billed charges,,,540.9,90,,percent of total billed charges,,,540.9,90,,percent of total billed charges,,,540.9,90,,percent of total billed charges,,,510.85,85,,percent of total billed charges,,180.3,570.95,
"EO withjoint, Prefabricated",L3760,CDM,L3760,HCPCS,,,both,,182,182,,,,,,,,,,,,,,,,,,,,154.7,85,,percent of total billed charges,,369.75,,,,fee schedule,,292.92,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,165.62,91,,percent of total billed charges,,,172.9,95,,percent of total billed charges,,,151.06,83,,percent of total billed charges,,,54.6,83,,percent of total billed charges,,,,,,,,,,,,,,,151.06,83,,percent of total billed charges,,,,,,,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,163.8,90,,percent of total billed charges,,,154.7,85,,percent of total billed charges,,54.6,369.75,
Rigid EO wo joints,L3762,CDM,L3762,HCPCS,,,both,,73,73,,,,,,,,,,,,,,,,,,,,62.05,85,,percent of total billed charges,,79.49,,,,fee schedule,,68.13,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,66.43,91,,percent of total billed charges,,,69.35,95,,percent of total billed charges,,,60.59,83,,percent of total billed charges,,,21.9,83,,percent of total billed charges,,,,,,,,,,,,,,,60.59,83,,percent of total billed charges,,,,,,,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,65.7,90,,percent of total billed charges,,,62.05,85,,percent of total billed charges,,21.9,79.49,
Tennis Elbow Splint,L3762 TES,CDM,L3762,HCPCS,,,both,,14,14,,,,,,,,,,,,,,,,,,,,11.9,85,,percent of total billed charges,,79.49,,,,fee schedule,,68.13,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.74,91,,percent of total billed charges,,,13.3,95,,percent of total billed charges,,,11.62,83,,percent of total billed charges,,,4.2,83,,percent of total billed charges,,,,,,,,,,,,,,,11.62,83,,percent of total billed charges,,,,,,,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,11.9,85,,percent of total billed charges,,4.2,79.49,
EWHO rigid w/o jnts CF,L3763,CDM,L3763,HCPCS,,,both,,977,977,,,,,,,,,,,,,,,,,,,,830.45,85,,percent of total billed charges,,553.27,,,,fee schedule,,445.49,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,889.07,91,,percent of total billed charges,,,928.15,95,,percent of total billed charges,,,810.91,83,,percent of total billed charges,,,293.1,83,,percent of total billed charges,,,,,,,,,,,,,,,810.91,83,,percent of total billed charges,,,,,,,,,879.3,90,,percent of total billed charges,,,879.3,90,,percent of total billed charges,,,879.3,90,,percent of total billed charges,,,879.3,90,,percent of total billed charges,,,830.45,85,,percent of total billed charges,,293.1,928.15,
EWHFO w/joint(s) CF,L3766,CDM,L3766,HCPCS,,,both,,14,14,,,,,,,,,,,,,,,,,,,,11.9,85,,percent of total billed charges,,1003.87,,,,fee schedule,,801.79,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,12.74,91,,percent of total billed charges,,,13.3,95,,percent of total billed charges,,,11.62,83,,percent of total billed charges,,,4.2,83,,percent of total billed charges,,,,,,,,,,,,,,,11.62,83,,percent of total billed charges,,,,,,,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,12.6,90,,percent of total billed charges,,,11.9,85,,percent of total billed charges,,4.2,1003.87,
WHFO w/joint(s) custom fab,L3806,CDM,L3806,HCPCS,,,both,,591,591,,,,,,,,,,,,,,,,,,,,502.35,85,,percent of total billed charges,,335.82,,,,fee schedule,,287.85,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,537.81,91,,percent of total billed charges,,,561.45,95,,percent of total billed charges,,,490.53,83,,percent of total billed charges,,,177.3,83,,percent of total billed charges,,,,,,,,,,,,,,,490.53,83,,percent of total billed charges,,,,,,,,,531.9,90,,percent of total billed charges,,,531.9,90,,percent of total billed charges,,,531.9,90,,percent of total billed charges,,,531.9,90,,percent of total billed charges,,,502.35,85,,percent of total billed charges,,177.3,561.45,
"WHFO,no joint, prefabricated",L3807,CDM,L3807,HCPCS,,,both,,42,42,,,,,,,,,,,,,,,,,,,,35.7,85,,percent of total billed charges,,184.86,,,,fee schedule,,146.45,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,38.22,91,,percent of total billed charges,,,39.9,95,,percent of total billed charges,,,34.86,83,,percent of total billed charges,,,12.6,83,,percent of total billed charges,,,,,,,,,,,,,,,34.86,83,,percent of total billed charges,,,,,,,,,37.8,90,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,37.8,90,,percent of total billed charges,,,35.7,85,,percent of total billed charges,,12.6,184.86,
"WHFO, rigid w/o joints",L3808,CDM,L3808,HCPCS,,,both,,482,482,,,,,,,,,,,,,,,,,,,,409.7,85,,percent of total billed charges,,263.36,,,,fee schedule,,196.67,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,438.62,91,,percent of total billed charges,,,457.9,95,,percent of total billed charges,,,400.06,83,,percent of total billed charges,,,144.6,83,,percent of total billed charges,,,,,,,,,,,,,,,400.06,83,,percent of total billed charges,,,,,,,,,433.8,90,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,433.8,90,,percent of total billed charges,,,409.7,85,,percent of total billed charges,,144.6,457.9,
"Wrist hand finger orthosis, W/out joint(s), prefab",L3809,CDM,L3809,HCPCS,,,both,,59,59,,,,,,,,,,,,,,,,,,,,50.15,85,,percent of total billed charges,,184.86,,,,fee schedule,,163.25,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,17.7,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,17.7,184.86,
WHO w/nontorsion jnt(s) CF,L3905,CDM,L3905,HCPCS,,,both,,1256,1256,,,,,,,,,,,,,,,,,,,,1067.6,85,,percent of total billed charges,,733.17,,,,fee schedule,,585.58,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1142.96,91,,percent of total billed charges,,,1193.2,95,,percent of total billed charges,,,1042.48,83,,percent of total billed charges,,,376.8,83,,percent of total billed charges,,,,,,,,,,,,,,,1042.48,83,,percent of total billed charges,,,,,,,,,1130.4,90,,percent of total billed charges,,,1130.4,90,,percent of total billed charges,,,1130.4,90,,percent of total billed charges,,,1130.4,90,,percent of total billed charges,,,1067.6,85,,percent of total billed charges,,376.8,1193.2,
WHO w/o joints CF,L3906,CDM,L3906,HCPCS,,,both,,598,598,,,,,,,,,,,,,,,,,,,,508.3,85,,percent of total billed charges,,374.67,,,,fee schedule,,250.59,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,544.18,91,,percent of total billed charges,,,568.1,95,,percent of total billed charges,,,496.34,83,,percent of total billed charges,,,179.4,83,,percent of total billed charges,,,,,,,,,,,,,,,496.34,83,,percent of total billed charges,,,,,,,,,538.2,90,,percent of total billed charges,,,538.2,90,,percent of total billed charges,,,538.2,90,,percent of total billed charges,,,538.2,90,,percent of total billed charges,,,508.3,85,,percent of total billed charges,,179.4,568.1,
Wrist cock-up non-molded,L3908,CDM,L3908,HCPCS,,,both,,83,83,,,,,,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,54.21,,,,fee schedule,,34.85,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,24.9,78.85,
HFO w/o joints CF,L3913,CDM,L3913,HCPCS,,,both,,356,356,,,,,,,,,,,,,,,,,,,,302.6,85,,percent of total billed charges,,200.22,,,,fee schedule,,171.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,323.96,91,,percent of total billed charges,,,338.2,95,,percent of total billed charges,,,295.48,83,,percent of total billed charges,,,106.8,83,,percent of total billed charges,,,,,,,,,,,,,,,295.48,83,,percent of total billed charges,,,,,,,,,320.4,90,,percent of total billed charges,,,320.4,90,,percent of total billed charges,,,320.4,90,,percent of total billed charges,,,320.4,90,,percent of total billed charges,,,302.6,85,,percent of total billed charges,,106.8,338.2,
HO w/o joints CF,L3919,CDM,L3919,HCPCS,,,both,,349,349,,,,,,,,,,,,,,,,,,,,296.65,85,,percent of total billed charges,,200.22,,,,fee schedule,,171.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,317.59,91,,percent of total billed charges,,,331.55,95,,percent of total billed charges,,,289.67,83,,percent of total billed charges,,,104.7,83,,percent of total billed charges,,,,,,,,,,,,,,,289.67,83,,percent of total billed charges,,,,,,,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,314.1,90,,percent of total billed charges,,,296.65,85,,percent of total billed charges,,104.7,331.55,
HFO w/joint(s) CF,L3921,CDM,L3921,HCPCS,,,both,,400,400,,,,,,,,,,,,,,,,,,,,340,85,,percent of total billed charges,,237.49,,,,fee schedule,,189.68,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,364,91,,percent of total billed charges,,,380,95,,percent of total billed charges,,,332,83,,percent of total billed charges,,,120,83,,percent of total billed charges,,,,,,,,,,,,,,,332,83,,percent of total billed charges,,,,,,,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,360,90,,percent of total billed charges,,,340,85,,percent of total billed charges,,120,380,
HFO w/o joints PF,L3923,CDM,L3923,HCPCS,,,both,,204,204,,,,,,,,,,,,,,,,,,,,173.4,85,,percent of total billed charges,,71.42,,,,fee schedule,,51.01,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,185.64,91,,percent of total billed charges,,,193.8,95,,percent of total billed charges,,,169.32,83,,percent of total billed charges,,,61.2,83,,percent of total billed charges,,,,,,,,,,,,,,,169.32,83,,percent of total billed charges,,,,,,,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,183.6,90,,percent of total billed charges,,,173.4,85,,percent of total billed charges,,51.01,193.8,
Thumb Stabilizer,L3924,CDM,L3924,HCPCS,,,both,,146,146,,,,,,,,,,,,,,,,,,,,124.1,85,,percent of total billed charges,,71.42,,,,fee schedule,,63.07,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,132.86,91,,percent of total billed charges,,,138.7,95,,percent of total billed charges,,,121.18,83,,percent of total billed charges,,,43.8,83,,percent of total billed charges,,,,,,,,,,,,,,,121.18,83,,percent of total billed charges,,,,,,,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,131.4,90,,percent of total billed charges,,,124.1,85,,percent of total billed charges,,43.8,138.7,
FO pip/dip with joint/spring,L3925,CDM,L3925,HCPCS,,,both,,161,161,,,,,,,,,,,,,,,,,,,,136.85,85,,percent of total billed charges,,48.56,,,,fee schedule,,31.54,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,48.3,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,,,,,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,31.54,152.95,
FO pip/dip w/o joint/spring,L3927,CDM,L3927,HCPCS,,,both,,49,49,,,,,,,,,,,,,,,,,,,,41.65,85,,percent of total billed charges,,25.88,,,,fee schedule,,22.18,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,44.59,91,,percent of total billed charges,,,46.55,95,,percent of total billed charges,,,40.67,83,,percent of total billed charges,,,14.7,83,,percent of total billed charges,,,,,,,,,,,,,,,40.67,83,,percent of total billed charges,,,,,,,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,44.1,90,,percent of total billed charges,,,41.65,85,,percent of total billed charges,,14.7,46.55,
"HFO nontorsion joint, prefab",L3929,CDM,L3929,HCPCS,,,both,,123,123,,,,,,,,,,,,,,,,,,,,104.55,85,,percent of total billed charges,,67.53,,,,fee schedule,,58.32,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,111.93,91,,percent of total billed charges,,,116.85,95,,percent of total billed charges,,,102.09,83,,percent of total billed charges,,,36.9,83,,percent of total billed charges,,,,,,,,,,,,,,,102.09,83,,percent of total billed charges,,,,,,,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,110.7,90,,percent of total billed charges,,,104.55,85,,percent of total billed charges,,36.9,116.85,
Finger extension with wrist,L3930,CDM,L3930,HCPCS,,,both,,136,136,,,,,,,,,,,,,,,,,,,,115.6,85,,percent of total billed charges,,67.53,,,,fee schedule,,59.64,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,123.76,91,,percent of total billed charges,,,129.2,95,,percent of total billed charges,,,112.88,83,,percent of total billed charges,,,40.8,83,,percent of total billed charges,,,,,,,,,,,,,,,112.88,83,,percent of total billed charges,,,,,,,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,122.4,90,,percent of total billed charges,,,115.6,85,,percent of total billed charges,,40.8,129.2,
FO w/o joints CF,L3933,CDM,L3933,HCPCS,,,both,,291,291,,,,,,,,,,,,,,,,,,,,247.35,85,,percent of total billed charges,,157.75,,,,fee schedule,,135.21,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,264.81,91,,percent of total billed charges,,,276.45,95,,percent of total billed charges,,,241.53,83,,percent of total billed charges,,,87.3,83,,percent of total billed charges,,,,,,,,,,,,,,,241.53,83,,percent of total billed charges,,,,,,,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,261.9,90,,percent of total billed charges,,,247.35,85,,percent of total billed charges,,87.3,276.45,
FO nontorsion joint CF,L3935,CDM,L3935,HCPCS,,,both,,297,297,,,,,,,,,,,,,,,,,,,,252.45,85,,percent of total billed charges,,163.32,,,,fee schedule,,139.99,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,270.27,91,,percent of total billed charges,,,282.15,95,,percent of total billed charges,,,246.51,83,,percent of total billed charges,,,89.1,83,,percent of total billed charges,,,,,,,,,,,,,,,246.51,83,,percent of total billed charges,,,,,,,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,267.3,90,,percent of total billed charges,,,252.45,85,,percent of total billed charges,,89.1,282.15,
Ue fx orth shoul cap forearm,L3981,CDM,L3981,HCPCS,,,both,,1304,1304,,,,,,,,,,,,,,,,,,,,1108.4,85,,percent of total billed charges,,744.18,,,,fee schedule,,657.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1186.64,91,,percent of total billed charges,,,1238.8,95,,percent of total billed charges,,,1082.32,83,,percent of total billed charges,,,391.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1082.32,83,,percent of total billed charges,,,,,,,,,1173.6,90,,percent of total billed charges,,,1173.6,90,,percent of total billed charges,,,1173.6,90,,percent of total billed charges,,,1173.6,90,,percent of total billed charges,,,1108.4,85,,percent of total billed charges,,391.2,1238.8,
Upper ext fx orthosis rad/ul,L3982,CDM,L3982,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,290.42,,,,fee schedule,,243.27,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
Upper ext fx orthosis wrist,L3984,CDM,L3984,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
Boxers FX Brace Left Large,L3984BLL,CDM,L3984,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
Boxers FX Brace Left Medium,L3984BLM,CDM,L3984,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
Boxers FX Brace Left Small,L3984BLS,CDM,L3984,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
Boxers FX Brace Left XL,L3984BLXL,CDM,L3984,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
Boxers FX Brace Right Large,L3984BRL,CDM,L3984,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
Boxers FX Brace Right Medium,L3984BRM,CDM,L3984,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
Boxers FX Brace Right Small,L3984BRS,CDM,L3984,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
Boxers FX Brace Right XL,L3984BRXL,CDM,L3984,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
SAFB Left Large,L3984SLL,CDM,L3984,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
SAFB Left Medium,L3984SLM,CDM,L3984,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
SAFB Left Small,L3984SLS,CDM,L3984,HCPCS,,,both,,440,440,,,,,,,,,,,,,,,,,,,,374,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,400.4,91,,percent of total billed charges,,,418,95,,percent of total billed charges,,,365.2,83,,percent of total billed charges,,,132,83,,percent of total billed charges,,,,,,,,,,,,,,,365.2,83,,percent of total billed charges,,,,,,,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,396,90,,percent of total billed charges,,,374,85,,percent of total billed charges,,132,418,
SAFB Left XL,L3984SLXL,CDM,L3984,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
SAFB Right Large,L3984SRL,CDM,L3984,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
SAFB Right Medium,L3984SRM,CDM,L3984,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
SAFB Right Small,L3984SRS,CDM,L3984,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
SAFB Right XL,L3984SRXL,CDM,L3984,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
Long Thumb Spica II Left Large,L3984TLL,CDM,L3984,HCPCS,,,both,,526,526,,,,,,,,,,,,,,,,,,,,447.1,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,478.66,91,,percent of total billed charges,,,499.7,95,,percent of total billed charges,,,436.58,83,,percent of total billed charges,,,157.8,83,,percent of total billed charges,,,,,,,,,,,,,,,436.58,83,,percent of total billed charges,,,,,,,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,447.1,85,,percent of total billed charges,,157.8,499.7,
Long Thumb Spica II Left Medium,L3984TLM,CDM,L3984,HCPCS,,,both,,526,526,,,,,,,,,,,,,,,,,,,,447.1,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,478.66,91,,percent of total billed charges,,,499.7,95,,percent of total billed charges,,,436.58,83,,percent of total billed charges,,,157.8,83,,percent of total billed charges,,,,,,,,,,,,,,,436.58,83,,percent of total billed charges,,,,,,,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,447.1,85,,percent of total billed charges,,157.8,499.7,
Long Thumb Spica II Left Small,L3984TLS,CDM,L3984,HCPCS,,,both,,526,526,,,,,,,,,,,,,,,,,,,,447.1,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,478.66,91,,percent of total billed charges,,,499.7,95,,percent of total billed charges,,,436.58,83,,percent of total billed charges,,,157.8,83,,percent of total billed charges,,,,,,,,,,,,,,,436.58,83,,percent of total billed charges,,,,,,,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,447.1,85,,percent of total billed charges,,157.8,499.7,
Long Thumb Spica II Left XL,L3984TLXL,CDM,L3984,HCPCS,,,both,,526,526,,,,,,,,,,,,,,,,,,,,447.1,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,478.66,91,,percent of total billed charges,,,499.7,95,,percent of total billed charges,,,436.58,83,,percent of total billed charges,,,157.8,83,,percent of total billed charges,,,,,,,,,,,,,,,436.58,83,,percent of total billed charges,,,,,,,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,447.1,85,,percent of total billed charges,,157.8,499.7,
Long Thumb Spica II Right Large,L3984TRL,CDM,L3984,HCPCS,,,both,,526,526,,,,,,,,,,,,,,,,,,,,447.1,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,478.66,91,,percent of total billed charges,,,499.7,95,,percent of total billed charges,,,436.58,83,,percent of total billed charges,,,157.8,83,,percent of total billed charges,,,,,,,,,,,,,,,436.58,83,,percent of total billed charges,,,,,,,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,447.1,85,,percent of total billed charges,,157.8,499.7,
Long Thumb Spica II Right Medium,L3984TRM,CDM,L3984,HCPCS,,,both,,526,526,,,,,,,,,,,,,,,,,,,,447.1,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,478.66,91,,percent of total billed charges,,,499.7,95,,percent of total billed charges,,,436.58,83,,percent of total billed charges,,,157.8,83,,percent of total billed charges,,,,,,,,,,,,,,,436.58,83,,percent of total billed charges,,,,,,,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,447.1,85,,percent of total billed charges,,157.8,499.7,
Long Thumb Spica II Right Small,L3984TRS,CDM,L3984,HCPCS,,,both,,526,526,,,,,,,,,,,,,,,,,,,,447.1,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,478.66,91,,percent of total billed charges,,,499.7,95,,percent of total billed charges,,,436.58,83,,percent of total billed charges,,,157.8,83,,percent of total billed charges,,,,,,,,,,,,,,,436.58,83,,percent of total billed charges,,,,,,,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,447.1,85,,percent of total billed charges,,157.8,499.7,
Long Thumb Spica II Right XL,L3984TRXL,CDM,L3984,HCPCS,,,both,,526,526,,,,,,,,,,,,,,,,,,,,447.1,85,,percent of total billed charges,,255.83,,,,fee schedule,,217.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,478.66,91,,percent of total billed charges,,,499.7,95,,percent of total billed charges,,,436.58,83,,percent of total billed charges,,,157.8,83,,percent of total billed charges,,,,,,,,,,,,,,,436.58,83,,percent of total billed charges,,,,,,,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,473.4,90,,percent of total billed charges,,,447.1,85,,percent of total billed charges,,157.8,499.7,
Sock fracture or equal each,L3995,CDM,L3995,HCPCS,,,both,,44,44,,,,,,,,,,,,,,,,,,,,37.4,85,,percent of total billed charges,,30.35,,,,fee schedule,,25.82,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,13.2,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,,,,,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,13.2,41.8,
EXOS Undersleeve L XL,L3995ULXL,CDM,L3995,HCPCS,,,both,,44,44,,,,,,,,,,,,,,,,,,,,37.4,85,,percent of total billed charges,,30.35,,,,fee schedule,,25.82,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,13.2,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,,,,,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,13.2,41.8,
EXOS Undersleeve M,L3995UM,CDM,L3995,HCPCS,,,both,,44,44,,,,,,,,,,,,,,,,,,,,37.4,85,,percent of total billed charges,,30.35,,,,fee schedule,,25.82,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,13.2,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,,,,,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,13.2,41.8,
EXOS Undersleeve XS S,L3995UXSS,CDM,L3995,HCPCS,,,both,,44,44,,,,,,,,,,,,,,,,,,,,37.4,85,,percent of total billed charges,,30.35,,,,fee schedule,,25.82,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,13.2,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,,,,,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,13.2,41.8,
Wrist Finger Undersleeve L XL,L3995WLXL,CDM,L3995,HCPCS,,,both,,44,44,,,,,,,,,,,,,,,,,,,,37.4,85,,percent of total billed charges,,30.35,,,,fee schedule,,25.82,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,13.2,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,,,,,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,13.2,41.8,
Wrist Finger Under Sleeve M,L3995WM,CDM,L3995,HCPCS,,,both,,44,44,,,,,,,,,,,,,,,,,,,,37.4,85,,percent of total billed charges,,30.35,,,,fee schedule,,25.82,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,13.2,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,,,,,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,13.2,41.8,
Wrist Finger Undersleeve XS S,L3995WXSS,CDM,L3995,HCPCS,,,both,,44,44,,,,,,,,,,,,,,,,,,,,37.4,85,,percent of total billed charges,,30.35,,,,fee schedule,,25.82,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,40.04,91,,percent of total billed charges,,,41.8,95,,percent of total billed charges,,,36.52,83,,percent of total billed charges,,,13.2,83,,percent of total billed charges,,,,,,,,,,,,,,,36.52,83,,percent of total billed charges,,,,,,,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,39.6,90,,percent of total billed charges,,,37.4,85,,percent of total billed charges,,13.2,41.8,
Ankle control orthosi prefab,L4350,CDM,L4350,HCPCS,,,both,,32,32,,,,,,,,,,,,,,,,,,,,27.2,85,,percent of total billed charges,,78.6,,,,fee schedule,,55.12,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,9.6,83,,percent of total billed charges,,,,,,,,,,,,,,,26.56,83,,percent of total billed charges,,,,,,,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,9.6,78.6,
Pneumati walking boot prefab,L4360,CDM,L4360,HCPCS,,,both,,165,165,,,,,,,,,,,,,,,,,,,,140.25,85,,percent of total billed charges,,210.33,,,,fee schedule,,165.26,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,49.5,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,,,,,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,49.5,210.33,
Pneuma/vac walk boot pre ots,L4361,CDM,L4361,HCPCS,,,both,,518,518,,,,,,,,,,,,,,,,,,,,440.3,85,,percent of total billed charges,,210.33,,,,fee schedule,,185.74,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,471.38,91,,percent of total billed charges,,,492.1,95,,percent of total billed charges,,,429.94,83,,percent of total billed charges,,,155.4,83,,percent of total billed charges,,,,,,,,,,,,,,,429.94,83,,percent of total billed charges,,,,,,,,,466.2,90,,percent of total billed charges,,,466.2,90,,percent of total billed charges,,,466.2,90,,percent of total billed charges,,,466.2,90,,percent of total billed charges,,,440.3,85,,percent of total billed charges,,155.4,492.1,
Non-pneum walk boot prefab,L4386,CDM,L4386,HCPCS,,,both,,533,533,,,,,,,,,,,,,,,,,,,,453.05,85,,percent of total billed charges,,128.81,,,,fee schedule,,102.04,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,485.03,91,,percent of total billed charges,,,506.35,95,,percent of total billed charges,,,442.39,83,,percent of total billed charges,,,159.9,83,,percent of total billed charges,,,,,,,,,,,,,,,442.39,83,,percent of total billed charges,,,,,,,,,479.7,90,,percent of total billed charges,,,479.7,90,,percent of total billed charges,,,479.7,90,,percent of total billed charges,,,479.7,90,,percent of total billed charges,,,453.05,85,,percent of total billed charges,,102.04,506.35,
Non-pneum walk boot pre ots,L4387,CDM,L4387,HCPCS,,,both,,115,115,,,,,,,,,,,,,,,,,,,,97.75,85,,percent of total billed charges,,128.81,,,,fee schedule,,113.75,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,104.65,91,,percent of total billed charges,,,109.25,95,,percent of total billed charges,,,95.45,83,,percent of total billed charges,,,34.5,83,,percent of total billed charges,,,,,,,,,,,,,,,95.45,83,,percent of total billed charges,,,,,,,,,103.5,90,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,103.5,90,,percent of total billed charges,,,97.75,85,,percent of total billed charges,,34.5,128.81,
Static AFO,L4396,CDM,L4396,HCPCS,,,both,,381,381,,,,,,,,,,,,,,,,,,,,323.85,85,,percent of total billed charges,,136.33,,,,fee schedule,,108.89,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,346.71,91,,percent of total billed charges,,,361.95,95,,percent of total billed charges,,,316.23,83,,percent of total billed charges,,,114.3,83,,percent of total billed charges,,,,,,,,,,,,,,,316.23,83,,percent of total billed charges,,,,,,,,,342.9,90,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,342.9,90,,percent of total billed charges,,,323.85,85,,percent of total billed charges,,108.89,361.95,
O&P supply/accessory/service,L9900,CDM,L9900,HCPCS,,,both,,33,33,,,,,,,,,,,,,,,,,,,,28.05,85,,percent of total billed charges,,115,,,,fee schedule,,115,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,30.03,91,,percent of total billed charges,,,31.35,95,,percent of total billed charges,,,27.39,83,,percent of total billed charges,,,9.9,83,,percent of total billed charges,,,,,,,,,,,,,,,27.39,83,,percent of total billed charges,,,,,,,,,29.7,90,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,29.7,90,,percent of total billed charges,,,28.05,85,,percent of total billed charges,,9.9,115,
Medical Records,MDRC,CDM,,,,,both,,31,31,,,,,,,,,,,,,,,,,,,,26.35,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,9.3,83,,percent of total billed charges,,,,,,,,,,,,,,,25.73,83,,percent of total billed charges,,,,,,,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,9.3,29.45,
Obtaining screen pap smear,Q0091,CDM,Q0091,HCPCS,,,both,,51,51,28.36,,,,fee schedule,,,,,,,,,,,,,,,43.35,85,,percent of total billed charges,,30.82,,,,fee schedule,,19.55,,,,fee schedule,,,,,,,,35.15,,,,fee schedule,,,,,,,,30.19,,,,fee schedule,,18.3,,,,fee schedule,,18.3,,,,fee schedule,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,26.9,,,,fee schedule,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,15.3,48.45,
Wet mounts/ w preparations,Q0111,CDM,Q0111,HCPCS,,,both,,31,31,,,,,,,,,,,,,4.8,,,,fee schedule,,,26.35,85,,percent of total billed charges,,15.92,,,,fee schedule,,15.92,,,,fee schedule,,4.8,,,,fee schedule,,,,,,,,4.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,28.21,91,,percent of total billed charges,,,29.45,95,,percent of total billed charges,,,25.73,83,,percent of total billed charges,,,9.3,83,,percent of total billed charges,,4.8,,,,fee schedule,,4.8,,,,fee schedule,,,25.73,83,,percent of total billed charges,,,,,,,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,27.9,90,,percent of total billed charges,,,26.35,85,,percent of total billed charges,,4.8,29.45,
Potassium hydroxide preps,Q0112,CDM,Q0112,HCPCS,,,both,,6,6,,,,,,,,,,,,,4.8,,,,fee schedule,,,5.1,85,,percent of total billed charges,,5.83,,,,fee schedule,,5.83,,,,fee schedule,,4.8,,,,fee schedule,,,,,,,,4.8,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,1.8,83,,percent of total billed charges,,4.8,,,,fee schedule,,4.8,,,,fee schedule,,,4.98,83,,percent of total billed charges,,,,,,,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,1.8,5.83,
Ondansetron oral,Q0162,CDM,Q0162,HCPCS,,,both,,19,19,,,,,,,,,,,,,,,,,,,,16.15,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,17.29,91,,percent of total billed charges,,,18.05,95,,percent of total billed charges,,,15.77,83,,percent of total billed charges,,,5.7,83,,percent of total billed charges,,,,,,,,,,,,,,,15.77,83,,percent of total billed charges,,,,,,,,,17.1,90,,percent of total billed charges,,,17.1,90,,percent of total billed charges,,,17.1,90,,percent of total billed charges,,,17.1,90,,percent of total billed charges,,,16.15,85,,percent of total billed charges,,5.7,18.05,
Influenza Virus Vaccine (Afluria),Q2035,CDM,Q2035,HCPCS,,,both,,36,36,,,,,,,,,,,,,,,,,,,,30.6,85,,percent of total billed charges,,19.2,,,,fee schedule,,19.2,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,10.8,83,,percent of total billed charges,,,,,,,,,,,,,,,29.88,83,,percent of total billed charges,,,,,,,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,10.8,34.2,
Influenza Virus Vaccine (Flulaval),Q2036,CDM,Q2036,HCPCS,,,both,,36,36,,,,,,,,,,,,,,,,,,,,30.6,85,,percent of total billed charges,,12.68,,,,fee schedule,,12.68,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,10.8,83,,percent of total billed charges,,,,,,,,,,,,,,,29.88,83,,percent of total billed charges,,,,,,,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,10.8,34.2,
Influenza Virus Vaccine (Fluvirin),Q2037,CDM,Q2037,HCPCS,,,both,,36,36,,,,,,,,,,,,,,,,,,,,30.6,85,,percent of total billed charges,,18.62,,,,fee schedule,,18.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,10.8,83,,percent of total billed charges,,,,,,,,,,,,,,,29.88,83,,percent of total billed charges,,,,,,,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,10.8,34.2,
Influenza Virus Vaccine (Fluzone),Q2038,CDM,Q2038,HCPCS,,,both,,36,36,,,,,,,,,,,,,,,,,,,,30.6,85,,percent of total billed charges,,12.68,,,,fee schedule,,12.68,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,10.8,83,,percent of total billed charges,,,,,,,,,,,,,,,29.88,83,,percent of total billed charges,,,,,,,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,10.8,34.2,
Influenza Virus Vaccine (Not Otherwise Specified),Q2039,CDM,Q2039,HCPCS,,,both,,36,36,,,,,,,,,,,,,,,,,,,,30.6,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,32.76,91,,percent of total billed charges,,,34.2,95,,percent of total billed charges,,,29.88,83,,percent of total billed charges,,,10.8,83,,percent of total billed charges,,,,,,,,,,,,,,,29.88,83,,percent of total billed charges,,,,,,,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,32.4,90,,percent of total billed charges,,,30.6,85,,percent of total billed charges,,10.8,34.2,
Telehealth facility fee,Q3014,CDM,Q3014,HCPCS,,,both,,132,132,,,,,,,,,,,,,25,,,,fee schedule,,,112.2,85,,percent of total billed charges,,14,,,,fee schedule,,14,,,,fee schedule,,25,,,,fee schedule,,,,,,,,25,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,120.12,91,,percent of total billed charges,,,125.4,95,,percent of total billed charges,,,109.56,83,,percent of total billed charges,,,39.6,83,,percent of total billed charges,,25,,,,fee schedule,,25,,,,fee schedule,,,109.56,83,,percent of total billed charges,,,,,,,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,118.8,90,,percent of total billed charges,,,112.2,85,,percent of total billed charges,,14,125.4,
Cast sup long arm adult plst,Q4005,CDM,Q4005,HCPCS,,,both,,48,48,,,,,,,,,,,,,,,,,,,,40.8,85,,percent of total billed charges,,14.18,,,,fee schedule,,11.34,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,43.68,91,,percent of total billed charges,,,45.6,95,,percent of total billed charges,,,39.84,83,,percent of total billed charges,,,14.4,83,,percent of total billed charges,,,,,,,,,,,,,,,39.84,83,,percent of total billed charges,,,,,,,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,43.2,90,,percent of total billed charges,,,40.8,85,,percent of total billed charges,,11.34,45.6,
Cast sup long arm adult fbrg,Q4006,CDM,Q4006,HCPCS,,,both,,88,88,,,,,,,,,,,,,,,,,,,,74.8,85,,percent of total billed charges,,31.94,,,,fee schedule,,25.55,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,80.08,91,,percent of total billed charges,,,83.6,95,,percent of total billed charges,,,73.04,83,,percent of total billed charges,,,26.4,83,,percent of total billed charges,,,,,,,,,,,,,,,73.04,83,,percent of total billed charges,,,,,,,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,79.2,90,,percent of total billed charges,,,74.8,85,,percent of total billed charges,,25.55,83.6,
Cast sup long arm ped plster,Q4007,CDM,Q4007,HCPCS,,,both,,55,55,,,,,,,,,,,,,,,,,,,,46.75,85,,percent of total billed charges,,7.08,,,,fee schedule,,5.66,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.05,91,,percent of total billed charges,,,52.25,95,,percent of total billed charges,,,45.65,83,,percent of total billed charges,,,16.5,83,,percent of total billed charges,,,,,,,,,,,,,,,45.65,83,,percent of total billed charges,,,,,,,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,49.5,90,,percent of total billed charges,,,46.75,85,,percent of total billed charges,,5.66,52.25,
Cast sup long arm ped fbrgls,Q4008,CDM,Q4008,HCPCS,,,both,,57,57,,,,,,,,,,,,,,,,,,,,48.45,85,,percent of total billed charges,,15.96,,,,fee schedule,,12.77,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,17.1,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,12.77,54.15,
Cast sup sht arm adult fbrgl,Q4010,CDM,Q4010,HCPCS,,,both,,74,74,,,,,,,,,,,,,,,,,,,,62.9,85,,percent of total billed charges,,21.29,,,,fee schedule,,17.03,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,22.2,83,,percent of total billed charges,,,,,,,,,,,,,,,61.42,83,,percent of total billed charges,,,,,,,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,17.03,70.3,
Cast sup sht arm ped fbrglas,Q4012,CDM,Q4012,HCPCS,,,both,,51,51,,,,,,,,,,,,,,,,,,,,43.35,85,,percent of total billed charges,,10.67,,,,fee schedule,,8.54,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,8.54,48.45,
Cast sup gauntlet plaster,Q4013,CDM,Q4013,HCPCS,,,both,,80,80,,,,,,,,,,,,,,,,,,,,68,85,,percent of total billed charges,,17.23,,,,fee schedule,,13.78,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,24,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,13.78,76,
Cast sup gauntlet fiberglass,Q4014,CDM,Q4014,HCPCS,,,both,,74,74,,,,,,,,,,,,,,,,,,,,62.9,85,,percent of total billed charges,,29.05,,,,fee schedule,,23.24,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,67.34,91,,percent of total billed charges,,,70.3,95,,percent of total billed charges,,,61.42,83,,percent of total billed charges,,,22.2,83,,percent of total billed charges,,,,,,,,,,,,,,,61.42,83,,percent of total billed charges,,,,,,,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,66.6,90,,percent of total billed charges,,,62.9,85,,percent of total billed charges,,22.2,70.3,
Cast sup gauntlet ped plster,Q4015,CDM,Q4015,HCPCS,,,both,,23,23,,,,,,,,,,,,,,,,,,,,19.55,85,,percent of total billed charges,,8.63,,,,fee schedule,,6.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,20.93,91,,percent of total billed charges,,,21.85,95,,percent of total billed charges,,,19.09,83,,percent of total billed charges,,,6.9,83,,percent of total billed charges,,,,,,,,,,,,,,,19.09,83,,percent of total billed charges,,,,,,,,,20.7,90,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,20.7,90,,percent of total billed charges,,,19.55,85,,percent of total billed charges,,6.9,21.85,
Cast sup gauntlet ped fbrgls,Q4016,CDM,Q4016,HCPCS,,,both,,51,51,,,,,,,,,,,,,,,,,,,,43.35,85,,percent of total billed charges,,14.52,,,,fee schedule,,11.62,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,11.62,48.45,
Cast sup lng arm splint plst,Q4017,CDM,Q4017,HCPCS,,,both,,43,43,,,,,,,,,,,,,,,,,,,,36.55,85,,percent of total billed charges,,9.95,,,,fee schedule,,7.96,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.13,91,,percent of total billed charges,,,40.85,95,,percent of total billed charges,,,35.69,83,,percent of total billed charges,,,12.9,83,,percent of total billed charges,,,,,,,,,,,,,,,35.69,83,,percent of total billed charges,,,,,,,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,36.55,85,,percent of total billed charges,,7.96,40.85,
Cast sup lng arm splint fbrg,Q4018,CDM,Q4018,HCPCS,,,both,,70,70,,,,,,,,,,,,,,,,,,,,59.5,85,,percent of total billed charges,,15.87,,,,fee schedule,,12.7,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,63.7,91,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,21,83,,percent of total billed charges,,,,,,,,,,,,,,,58.1,83,,percent of total billed charges,,,,,,,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,12.7,66.5,
Cast sup lng arm splnt ped p,Q4019,CDM,Q4019,HCPCS,,,both,,20,20,,,,,,,,,,,,,,,,,,,,17,85,,percent of total billed charges,,4.99,,,,fee schedule,,3.99,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,18.2,91,,percent of total billed charges,,,19,95,,percent of total billed charges,,,16.6,83,,percent of total billed charges,,,6,83,,percent of total billed charges,,,,,,,,,,,,,,,16.6,83,,percent of total billed charges,,,,,,,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,18,90,,percent of total billed charges,,,17,85,,percent of total billed charges,,3.99,19,
Cast sup lng arm splnt ped f,Q4020,CDM,Q4020,HCPCS,,,both,,53,53,,,,,,,,,,,,,,,,,,,,45.05,85,,percent of total billed charges,,7.97,,,,fee schedule,,6.38,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,48.23,91,,percent of total billed charges,,,50.35,95,,percent of total billed charges,,,43.99,83,,percent of total billed charges,,,15.9,83,,percent of total billed charges,,,,,,,,,,,,,,,43.99,83,,percent of total billed charges,,,,,,,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,47.7,90,,percent of total billed charges,,,45.05,85,,percent of total billed charges,,6.38,50.35,
Cast sup sht arm splint plst,Q4021,CDM,Q4021,HCPCS,,,both,,51,51,,,,,,,,,,,,,,,,,,,,43.35,85,,percent of total billed charges,,7.37,,,,fee schedule,,5.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,5.9,48.45,
Cast sup sht arm splint fbrg,Q4022,CDM,Q4022,HCPCS,,,both,,52,52,,,,,,,,,,,,,,,,,,,,44.2,85,,percent of total billed charges,,13.3,,,,fee schedule,,10.64,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,47.32,91,,percent of total billed charges,,,49.4,95,,percent of total billed charges,,,43.16,83,,percent of total billed charges,,,15.6,83,,percent of total billed charges,,,,,,,,,,,,,,,43.16,83,,percent of total billed charges,,,,,,,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,46.8,90,,percent of total billed charges,,,44.2,85,,percent of total billed charges,,10.64,49.4,
Cast sup sht arm splnt ped p,Q4023,CDM,Q4023,HCPCS,,,both,,24,24,,,,,,,,,,,,,,,,,,,,20.4,85,,percent of total billed charges,,3.71,,,,fee schedule,,2.97,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,21.84,91,,percent of total billed charges,,,22.8,95,,percent of total billed charges,,,19.92,83,,percent of total billed charges,,,7.2,83,,percent of total billed charges,,,,,,,,,,,,,,,19.92,83,,percent of total billed charges,,,,,,,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,21.6,90,,percent of total billed charges,,,20.4,85,,percent of total billed charges,,2.97,22.8,
Cast sup sht arm splnt ped f,Q4024,CDM,Q4024,HCPCS,,,both,,46,46,,,,,,,,,,,,,,,,,,,,39.1,85,,percent of total billed charges,,6.66,,,,fee schedule,,5.33,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,41.86,91,,percent of total billed charges,,,43.7,95,,percent of total billed charges,,,38.18,83,,percent of total billed charges,,,13.8,83,,percent of total billed charges,,,,,,,,,,,,,,,38.18,83,,percent of total billed charges,,,,,,,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,41.4,90,,percent of total billed charges,,,39.1,85,,percent of total billed charges,,5.33,43.7,
Cast sup long leg fiberglass,Q4030,CDM,Q4030,HCPCS,,,both,,161,161,,,,,,,,,,,,,,,,,,,,136.85,85,,percent of total billed charges,,83.2,,,,fee schedule,,66.56,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,146.51,91,,percent of total billed charges,,,152.95,95,,percent of total billed charges,,,133.63,83,,percent of total billed charges,,,48.3,83,,percent of total billed charges,,,,,,,,,,,,,,,133.63,83,,percent of total billed charges,,,,,,,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,144.9,90,,percent of total billed charges,,,136.85,85,,percent of total billed charges,,48.3,152.95,
Cast sup lng leg ped fbrgls,Q4032,CDM,Q4032,HCPCS,,,both,,98,98,,,,,,,,,,,,,,,,,,,,83.3,85,,percent of total billed charges,,41.6,,,,fee schedule,,33.28,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,89.18,91,,percent of total billed charges,,,93.1,95,,percent of total billed charges,,,81.34,83,,percent of total billed charges,,,29.4,83,,percent of total billed charges,,,,,,,,,,,,,,,81.34,83,,percent of total billed charges,,,,,,,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,88.2,90,,percent of total billed charges,,,83.3,85,,percent of total billed charges,,29.4,93.1,
Cast sup lng leg cylinder fb,Q4034,CDM,Q4034,HCPCS,,,both,,144,144,,,,,,,,,,,,,,,,,,,,122.4,85,,percent of total billed charges,,73.31,,,,fee schedule,,58.65,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,131.04,91,,percent of total billed charges,,,136.8,95,,percent of total billed charges,,,119.52,83,,percent of total billed charges,,,43.2,83,,percent of total billed charges,,,,,,,,,,,,,,,119.52,83,,percent of total billed charges,,,,,,,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,129.6,90,,percent of total billed charges,,,122.4,85,,percent of total billed charges,,43.2,136.8,
Cast sup shrt leg plaster,Q4037,CDM,Q4037,HCPCS,,,both,,116,116,,,,,,,,,,,,,,,,,,,,98.6,85,,percent of total billed charges,,17.96,,,,fee schedule,,14.37,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,105.56,91,,percent of total billed charges,,,110.2,95,,percent of total billed charges,,,96.28,83,,percent of total billed charges,,,34.8,83,,percent of total billed charges,,,,,,,,,,,,,,,96.28,83,,percent of total billed charges,,,,,,,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,104.4,90,,percent of total billed charges,,,98.6,85,,percent of total billed charges,,14.37,110.2,
Cast sup shrt leg fiberglass,Q4038,CDM,Q4038,HCPCS,,,both,,133,133,,,,,,,,,,,,,,,,,,,,113.05,85,,percent of total billed charges,,45.05,,,,fee schedule,,36.04,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,121.03,91,,percent of total billed charges,,,126.35,95,,percent of total billed charges,,,110.39,83,,percent of total billed charges,,,39.9,83,,percent of total billed charges,,,,,,,,,,,,,,,110.39,83,,percent of total billed charges,,,,,,,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,119.7,90,,percent of total billed charges,,,113.05,85,,percent of total billed charges,,36.04,126.35,
Cast sup shrt leg ped plster,Q4039,CDM,Q4039,HCPCS,,,both,,59,59,,,,,,,,,,,,,,,,,,,,50.15,85,,percent of total billed charges,,9.02,,,,fee schedule,,7.22,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,53.69,91,,percent of total billed charges,,,56.05,95,,percent of total billed charges,,,48.97,83,,percent of total billed charges,,,17.7,83,,percent of total billed charges,,,,,,,,,,,,,,,48.97,83,,percent of total billed charges,,,,,,,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,53.1,90,,percent of total billed charges,,,50.15,85,,percent of total billed charges,,7.22,56.05,
Cast sup shrt leg ped fbrgls,Q4040,CDM,Q4040,HCPCS,,,both,,68,68,,,,,,,,,,,,,,,,,,,,57.8,85,,percent of total billed charges,,22.52,,,,fee schedule,,18.02,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,61.88,91,,percent of total billed charges,,,64.6,95,,percent of total billed charges,,,56.44,83,,percent of total billed charges,,,20.4,83,,percent of total billed charges,,,,,,,,,,,,,,,56.44,83,,percent of total billed charges,,,,,,,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,61.2,90,,percent of total billed charges,,,57.8,85,,percent of total billed charges,,18.02,64.6,
Cast sup lng leg splnt plstr,Q4041,CDM,Q4041,HCPCS,,,both,,57,57,,,,,,,,,,,,,,,,,,,,48.45,85,,percent of total billed charges,,21.87,,,,fee schedule,,17.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,51.87,91,,percent of total billed charges,,,54.15,95,,percent of total billed charges,,,47.31,83,,percent of total billed charges,,,17.1,83,,percent of total billed charges,,,,,,,,,,,,,,,47.31,83,,percent of total billed charges,,,,,,,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,51.3,90,,percent of total billed charges,,,48.45,85,,percent of total billed charges,,17.1,54.15,
Cast sup lng leg splnt fbrgl,Q4042,CDM,Q4042,HCPCS,,,both,,113,113,,,,,,,,,,,,,,,,,,,,96.05,85,,percent of total billed charges,,37.33,,,,fee schedule,,29.86,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,102.83,91,,percent of total billed charges,,,107.35,95,,percent of total billed charges,,,93.79,83,,percent of total billed charges,,,33.9,83,,percent of total billed charges,,,,,,,,,,,,,,,93.79,83,,percent of total billed charges,,,,,,,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,101.7,90,,percent of total billed charges,,,96.05,85,,percent of total billed charges,,29.86,107.35,
Cast sup lng leg splnt ped p,Q4043,CDM,Q4043,HCPCS,,,both,,26,26,,,,,,,,,,,,,,,,,,,,22.1,85,,percent of total billed charges,,10.94,,,,fee schedule,,8.75,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.66,91,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,7.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21.58,83,,percent of total billed charges,,,,,,,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,7.8,24.7,
Cast sup lng leg splnt ped f,Q4044,CDM,Q4044,HCPCS,,,both,,87,87,,,,,,,,,,,,,,,,,,,,73.95,85,,percent of total billed charges,,18.69,,,,fee schedule,,14.95,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,79.17,91,,percent of total billed charges,,,82.65,95,,percent of total billed charges,,,72.21,83,,percent of total billed charges,,,26.1,83,,percent of total billed charges,,,,,,,,,,,,,,,72.21,83,,percent of total billed charges,,,,,,,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,78.3,90,,percent of total billed charges,,,73.95,85,,percent of total billed charges,,14.95,82.65,
Cast sup sht leg splnt plstr,Q4045,CDM,Q4045,HCPCS,,,both,,43,43,,,,,,,,,,,,,,,,,,,,36.55,85,,percent of total billed charges,,12.7,,,,fee schedule,,10.16,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,39.13,91,,percent of total billed charges,,,40.85,95,,percent of total billed charges,,,35.69,83,,percent of total billed charges,,,12.9,83,,percent of total billed charges,,,,,,,,,,,,,,,35.69,83,,percent of total billed charges,,,,,,,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,38.7,90,,percent of total billed charges,,,36.55,85,,percent of total billed charges,,10.16,40.85,
Cast sup sht leg splnt fbrgl,Q4046,CDM,Q4046,HCPCS,,,both,,70,70,,,,,,,,,,,,,,,,,,,,59.5,85,,percent of total billed charges,,20.41,,,,fee schedule,,16.33,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,63.7,91,,percent of total billed charges,,,66.5,95,,percent of total billed charges,,,58.1,83,,percent of total billed charges,,,21,83,,percent of total billed charges,,,,,,,,,,,,,,,58.1,83,,percent of total billed charges,,,,,,,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,63,90,,percent of total billed charges,,,59.5,85,,percent of total billed charges,,16.33,66.5,
Cast sup sht leg splnt ped p,Q4047,CDM,Q4047,HCPCS,,,both,,25,25,,,,,,,,,,,,,,,,,,,,21.25,85,,percent of total billed charges,,6.32,,,,fee schedule,,5.06,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,22.75,91,,percent of total billed charges,,,23.75,95,,percent of total billed charges,,,20.75,83,,percent of total billed charges,,,7.5,83,,percent of total billed charges,,,,,,,,,,,,,,,20.75,83,,percent of total billed charges,,,,,,,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,22.5,90,,percent of total billed charges,,,21.25,85,,percent of total billed charges,,5.06,23.75,
Cast sup sht leg splnt ped f,Q4048,CDM,Q4048,HCPCS,,,both,,51,51,,,,,,,,,,,,,,,,,,,,43.35,85,,percent of total billed charges,,10.22,,,,fee schedule,,8.18,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,46.41,91,,percent of total billed charges,,,48.45,95,,percent of total billed charges,,,42.33,83,,percent of total billed charges,,,15.3,83,,percent of total billed charges,,,,,,,,,,,,,,,42.33,83,,percent of total billed charges,,,,,,,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,45.9,90,,percent of total billed charges,,,43.35,85,,percent of total billed charges,,8.18,48.45,
"Finger splint, static",Q4049,CDM,Q4049,HCPCS,,,both,,9,9,,,,,,,,,,,,,,,,,,,,7.65,85,,percent of total billed charges,,2.3,,,,fee schedule,,1.84,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,8.19,91,,percent of total billed charges,,,8.55,95,,percent of total billed charges,,,7.47,83,,percent of total billed charges,,,2.7,83,,percent of total billed charges,,,,,,,,,,,,,,,7.47,83,,percent of total billed charges,,,,,,,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,8.1,90,,percent of total billed charges,,,7.65,85,,percent of total billed charges,,1.84,8.55,
Hospice in patient home,Q5001,CDM,Q5001,HCPCS,,,both,,210,210,,,,,,,,,,,,,,,,,,,,178.5,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,191.1,91,,percent of total billed charges,,,199.5,95,,percent of total billed charges,,,174.3,83,,percent of total billed charges,,,63,83,,percent of total billed charges,,,,,,,,,,,,,,,174.3,83,,percent of total billed charges,,,,,,,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,189,90,,percent of total billed charges,,,178.5,85,,percent of total billed charges,,63,199.5,
"Injection, clindamycin phosp",S0077,CDM,S0077,HCPCS,,,both,,28,28,,,,,,,,,,,,,1.9,,,,fee schedule,,,23.8,85,,percent of total billed charges,,,,,,,,,,,,,,1.9,,,,fee schedule,,,,,,,,1.9,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,8.4,83,,percent of total billed charges,,1.9,,,,fee schedule,,1.9,,,,fee schedule,,,23.24,83,,percent of total billed charges,,,,,,,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,1.9,26.6,
Oral Ondansetron 4 mg,S0119,CDM,S0119,HCPCS,,,both,,26,26,,,,,,,,,,,,,,,,,,,,22.1,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.66,91,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,7.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21.58,83,,percent of total billed charges,,,,,,,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,7.8,24.7,
Bumetanide 0.5 mg,S0171,CDM,S0171,HCPCS,,,both,,6,6,,,,,,,,,,,,,,,,,,,,5.1,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5.46,91,,percent of total billed charges,,,5.7,95,,percent of total billed charges,,,4.98,83,,percent of total billed charges,,,1.8,83,,percent of total billed charges,,,,,,,,,,,,,,,4.98,83,,percent of total billed charges,,,,,,,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.4,90,,percent of total billed charges,,,5.1,85,,percent of total billed charges,,1.8,5.7,
End of life counseling,S0257,CDM,S0257,HCPCS,,,both,,28,28,,,,,,,,,,,,,,,,,,,,23.8,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,8.4,83,,percent of total billed charges,,,,,,,,,,,,,,,23.24,83,,percent of total billed charges,,,,,,,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,8.4,26.6,
"Medical home, initial plan",S0280,CDM,S0280,HCPCS,,,both,,326,326,,,,,,,,,,,,,,,,,,,,277.1,85,,percent of total billed charges,,277,,,,fee schedule,,277,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,296.66,91,,percent of total billed charges,,,309.7,95,,percent of total billed charges,,,270.58,83,,percent of total billed charges,,,97.8,83,,percent of total billed charges,,,,,,,,,,,,,,,270.58,83,,percent of total billed charges,,,,,,,,,293.4,90,,percent of total billed charges,,,293.4,90,,percent of total billed charges,,,293.4,90,,percent of total billed charges,,,293.4,90,,percent of total billed charges,,,277.1,85,,percent of total billed charges,,97.8,309.7,
Cnslt before screen colonosc,S0285,CDM,S0285,HCPCS,,,both,,217,217,,,,,,,,,,,,,,,,,,,,184.45,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,197.47,91,,percent of total billed charges,,,206.15,95,,percent of total billed charges,,,180.11,83,,percent of total billed charges,,,65.1,83,,percent of total billed charges,,,,,,,,,,,,,,,180.11,83,,percent of total billed charges,,,,,,,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,195.3,90,,percent of total billed charges,,,184.45,85,,percent of total billed charges,,65.1,206.15,
Annual Breast Exam,S0613,CDM,S0613,HCPCS,,,both,,121,121,,,,,,,,,,,,,,,,,,,,102.85,85,,percent of total billed charges,,5,,,,fee schedule,,5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,110.11,91,,percent of total billed charges,,,114.95,95,,percent of total billed charges,,,100.43,83,,percent of total billed charges,,,36.3,83,,percent of total billed charges,,,,,,,,,,,,,,,100.43,83,,percent of total billed charges,,,,,,,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,108.9,90,,percent of total billed charges,,,102.85,85,,percent of total billed charges,,5,114.95,
Removal of sutures,S0630,CDM,S0630,HCPCS,,,both,,91,91,,,,,,,,,,,,,24.35,,,,fee schedule,,,77.35,85,,percent of total billed charges,,76.06,,,,fee schedule,,46.77,,,,fee schedule,,24.35,,,,fee schedule,,,,,,,,24.35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,82.81,91,,percent of total billed charges,,,86.45,95,,percent of total billed charges,,,75.53,83,,percent of total billed charges,,,27.3,83,,percent of total billed charges,,24.35,,,,fee schedule,,24.35,,,,fee schedule,,,75.53,83,,percent of total billed charges,,,,,,,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,81.9,90,,percent of total billed charges,,,77.35,85,,percent of total billed charges,,24.35,86.45,
Deluxe item,S1001,CDM,S1001,HCPCS,,,both,,83,83,,,,,,,,,,,,,,,,,,,,70.55,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,75.53,91,,percent of total billed charges,,,78.85,95,,percent of total billed charges,,,68.89,83,,percent of total billed charges,,,24.9,83,,percent of total billed charges,,,,,,,,,,,,,,,68.89,83,,percent of total billed charges,,,,,,,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,74.7,90,,percent of total billed charges,,,70.55,85,,percent of total billed charges,,24.9,78.85,
Peak expiratory flow rate,S8110,CDM,S8110,HCPCS,,,both,,56,56,,,,,,,,,,,,,,,,,,,,47.6,85,,percent of total billed charges,,35,,,,fee schedule,,35,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,16.8,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,,,,,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,16.8,53.2,
Splint digit,S8450,CDM,S8450,HCPCS,,,both,,12,12,,,,,,,,,,,,,,,,,,,,10.2,85,,percent of total billed charges,,49,,,,fee schedule,,49,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,10.92,91,,percent of total billed charges,,,11.4,95,,percent of total billed charges,,,9.96,83,,percent of total billed charges,,,3.6,83,,percent of total billed charges,,,,,,,,,,,,,,,9.96,83,,percent of total billed charges,,,,,,,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.8,90,,percent of total billed charges,,,10.2,85,,percent of total billed charges,,3.6,49,
Splint wrist or ankle,S8451,CDM,S8451,HCPCS,,,both,,56,56,,,,,,,,,,,,,,,,,,,,47.6,85,,percent of total billed charges,,58,,,,fee schedule,,58,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,50.96,91,,percent of total billed charges,,,53.2,95,,percent of total billed charges,,,46.48,83,,percent of total billed charges,,,16.8,83,,percent of total billed charges,,,,,,,,,,,,,,,46.48,83,,percent of total billed charges,,,,,,,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,50.4,90,,percent of total billed charges,,,47.6,85,,percent of total billed charges,,16.8,58,
Clinic service,T1015,CDM,T1015,HCPCS,,,both,,80,80,,,,,,,,,,,,,,,,,,,,68,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,72.8,91,,percent of total billed charges,,,76,95,,percent of total billed charges,,,66.4,83,,percent of total billed charges,,,24,83,,percent of total billed charges,,,,,,,,,,,,,,,66.4,83,,percent of total billed charges,,,,,,,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,72,90,,percent of total billed charges,,,68,85,,percent of total billed charges,,24,76,
Targeted case management,T1017,CDM,T1017,HCPCS,,,both,,28,28,,,,,,,,,,,,,,,,,,,,23.8,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,25.48,91,,percent of total billed charges,,,26.6,95,,percent of total billed charges,,,23.24,83,,percent of total billed charges,,,8.4,83,,percent of total billed charges,,,,,,,,,,,,,,,23.24,83,,percent of total billed charges,,,,,,,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,25.2,90,,percent of total billed charges,,,23.8,85,,percent of total billed charges,,8.4,26.6,
Comm bh clinic svc per diem,T1040,CDM,T1040,HCPCS,,,both,,71.08,71.08,,,,,,,,,,,,,,,,,,,,60.42,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,64.68,91,,percent of total billed charges,,,67.53,95,,percent of total billed charges,,,59,83,,percent of total billed charges,,,21.32,83,,percent of total billed charges,,,,,,,,,,,,,,,59,83,,percent of total billed charges,,,,,,,,,63.97,90,,percent of total billed charges,,,63.97,90,,percent of total billed charges,,,63.97,90,,percent of total billed charges,,,63.97,90,,percent of total billed charges,,,60.42,85,,percent of total billed charges,,21.32,67.53,
Non-CDC Lab SARS-COV-2/2019-NCOV(COVID-19).,U0002,CDM,U0002,HCPCS,,,both,,206,206,,,,,,,,,,,,,,,,,,,,175.1,85,,percent of total billed charges,,3.5,,,,fee schedule,,3.5,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,61.8,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,3.5,195.7,
Assessment for hearing aid,V5010,CDM,V5010,HCPCS,,,both,,155,155,,,,,,,,,,,,,,,,,,,,131.75,85,,percent of total billed charges,,500,,,,fee schedule,,500,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,,,,,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,46.5,500,
Hearing aid fitting/checking,V5011,CDM,V5011,HCPCS,,,both,,165,165,,,,,,,,,,,,,,,,,,,,140.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,150.15,91,,percent of total billed charges,,,156.75,95,,percent of total billed charges,,,136.95,83,,percent of total billed charges,,,49.5,83,,percent of total billed charges,,,,,,,,,,,,,,,136.95,83,,percent of total billed charges,,,,,,,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,148.5,90,,percent of total billed charges,,,140.25,85,,percent of total billed charges,,49.5,156.75,
Hearing aid repair/modifying,V5014,CDM,V5014,HCPCS,,,both,,112,112,,,,,,,,,,,,,,,,,,,,95.2,85,,percent of total billed charges,,250,,,,fee schedule,,250,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,101.92,91,,percent of total billed charges,,,106.4,95,,percent of total billed charges,,,92.96,83,,percent of total billed charges,,,33.6,83,,percent of total billed charges,,,,,,,,,,,,,,,92.96,83,,percent of total billed charges,,,,,,,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,100.8,90,,percent of total billed charges,,,95.2,85,,percent of total billed charges,,33.6,250,
Hearing Aid Monaural In Ear Non Rechargeable,V5050 30 NRC,CDM,V5050,HCPCS,,,both,,1745,1745,,,,,,,,,,,,,,,,,,,,1483.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1587.95,91,,percent of total billed charges,,,1657.75,95,,percent of total billed charges,,,1448.35,83,,percent of total billed charges,,,523.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1448.35,83,,percent of total billed charges,,,,,,,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1483.25,85,,percent of total billed charges,,523.5,1657.75,
Hearing Aid Monaural In Ear Non Rechargeable,V5050 50 NRC,CDM,V5050,HCPCS,,,both,,2245,2245,,,,,,,,,,,,,,,,,,,,1908.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2042.95,91,,percent of total billed charges,,,2132.75,95,,percent of total billed charges,,,1863.35,83,,percent of total billed charges,,,673.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1863.35,83,,percent of total billed charges,,,,,,,,,2020.5,90,,percent of total billed charges,,,2020.5,90,,percent of total billed charges,,,2020.5,90,,percent of total billed charges,,,2020.5,90,,percent of total billed charges,,,1908.25,85,,percent of total billed charges,,673.5,2132.75,
Hearing Aid Monaural In Ear Non Rechargeable,V5050 70 NRC,CDM,V5050,HCPCS,,,both,,2745,2745,,,,,,,,,,,,,,,,,,,,2333.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2497.95,91,,percent of total billed charges,,,2607.75,95,,percent of total billed charges,,,2278.35,83,,percent of total billed charges,,,823.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2278.35,83,,percent of total billed charges,,,,,,,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2333.25,85,,percent of total billed charges,,823.5,2607.75,
Hearing Aid Monaural In Ear Non Rechargeable,V5050 90 NRC,CDM,V5050,HCPCS,,,both,,3245,3245,,,,,,,,,,,,,,,,,,,,2758.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2952.95,91,,percent of total billed charges,,,3082.75,95,,percent of total billed charges,,,2693.35,83,,percent of total billed charges,,,973.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2693.35,83,,percent of total billed charges,,,,,,,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2758.25,85,,percent of total billed charges,,973.5,3082.75,
Hearing Aid Monaural In Ear Rechargeable,V5050 Lvl 30,CDM,V5050,HCPCS,,,both,,1845,1845,,,,,,,,,,,,,,,,,,,,1568.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1678.95,91,,percent of total billed charges,,,1752.75,95,,percent of total billed charges,,,1531.35,83,,percent of total billed charges,,,553.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1531.35,83,,percent of total billed charges,,,,,,,,,1660.5,90,,percent of total billed charges,,,1660.5,90,,percent of total billed charges,,,1660.5,90,,percent of total billed charges,,,1660.5,90,,percent of total billed charges,,,1568.25,85,,percent of total billed charges,,553.5,1752.75,
Hearing Aid Monaural In Ear Rechargeable,V5050 Lvl 50,CDM,V5050,HCPCS,,,both,,2345,2345,,,,,,,,,,,,,,,,,,,,1993.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2133.95,91,,percent of total billed charges,,,2227.75,95,,percent of total billed charges,,,1946.35,83,,percent of total billed charges,,,703.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1946.35,83,,percent of total billed charges,,,,,,,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,1993.25,85,,percent of total billed charges,,703.5,2227.75,
Hearing Aid Monaural In Ear Rechargeable,V5050 Lvl 70,CDM,V5050,HCPCS,,,both,,2845,2845,,,,,,,,,,,,,,,,,,,,2418.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2588.95,91,,percent of total billed charges,,,2702.75,95,,percent of total billed charges,,,2361.35,83,,percent of total billed charges,,,853.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2361.35,83,,percent of total billed charges,,,,,,,,,2560.5,90,,percent of total billed charges,,,2560.5,90,,percent of total billed charges,,,2560.5,90,,percent of total billed charges,,,2560.5,90,,percent of total billed charges,,,2418.25,85,,percent of total billed charges,,853.5,2702.75,
Hearing Aid Monaural In Ear Rechargeable,V5050 Lvl 90,CDM,V5050,HCPCS,,,both,,3345,3345,,,,,,,,,,,,,,,,,,,,2843.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3043.95,91,,percent of total billed charges,,,3177.75,95,,percent of total billed charges,,,2776.35,83,,percent of total billed charges,,,1003.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2776.35,83,,percent of total billed charges,,,,,,,,,3010.5,90,,percent of total billed charges,,,3010.5,90,,percent of total billed charges,,,3010.5,90,,percent of total billed charges,,,3010.5,90,,percent of total billed charges,,,2843.25,85,,percent of total billed charges,,1003.5,3177.75,
Behind Ear Hearing Monaural Aid Non Rechargeable,V5060 30 NRC,CDM,V5060,HCPCS,,,both,,1745,1745,,,,,,,,,,,,,,,,,,,,1483.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1587.95,91,,percent of total billed charges,,,1657.75,95,,percent of total billed charges,,,1448.35,83,,percent of total billed charges,,,523.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1448.35,83,,percent of total billed charges,,,,,,,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1483.25,85,,percent of total billed charges,,523.5,1657.75,
Behind Ear Hearing Monaural Aid Non Rechargeable,V5060 50 NRC,CDM,V5060,HCPCS,,,both,,2245,2245,,,,,,,,,,,,,,,,,,,,1908.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2042.95,91,,percent of total billed charges,,,2132.75,95,,percent of total billed charges,,,1863.35,83,,percent of total billed charges,,,673.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1863.35,83,,percent of total billed charges,,,,,,,,,2020.5,90,,percent of total billed charges,,,2020.5,90,,percent of total billed charges,,,2020.5,90,,percent of total billed charges,,,2020.5,90,,percent of total billed charges,,,1908.25,85,,percent of total billed charges,,673.5,2132.75,
Behind Ear Hearing Monaural Aid Non Rechargeable,V5060 70 NRC,CDM,V5060,HCPCS,,,both,,2745,2745,,,,,,,,,,,,,,,,,,,,2333.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2497.95,91,,percent of total billed charges,,,2607.75,95,,percent of total billed charges,,,2278.35,83,,percent of total billed charges,,,823.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2278.35,83,,percent of total billed charges,,,,,,,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2333.25,85,,percent of total billed charges,,823.5,2607.75,
Behind Ear Hearing Monaural Aid Non Rechargeable,V5060 90 NRC,CDM,V5060,HCPCS,,,both,,3245,3245,,,,,,,,,,,,,,,,,,,,2758.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2952.95,91,,percent of total billed charges,,,3082.75,95,,percent of total billed charges,,,2693.35,83,,percent of total billed charges,,,973.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2693.35,83,,percent of total billed charges,,,,,,,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2758.25,85,,percent of total billed charges,,973.5,3082.75,
Behind Ear Hearing Monaural Aid ReChargeable,V5060 Lvl 70,CDM,V5060,HCPCS,,,both,,2845,2845,,,,,,,,,,,,,,,,,,,,2418.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2588.95,91,,percent of total billed charges,,,2702.75,95,,percent of total billed charges,,,2361.35,83,,percent of total billed charges,,,853.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2361.35,83,,percent of total billed charges,,,,,,,,,2560.5,90,,percent of total billed charges,,,2560.5,90,,percent of total billed charges,,,2560.5,90,,percent of total billed charges,,,2560.5,90,,percent of total billed charges,,,2418.25,85,,percent of total billed charges,,853.5,2702.75,
Behind Ear Hearing Monaural Aid Rechargeable,V5060 Lvl 90,CDM,V5060,HCPCS,,,both,,3345,3345,,,,,,,,,,,,,,,,,,,,2843.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3043.95,91,,percent of total billed charges,,,3177.75,95,,percent of total billed charges,,,2776.35,83,,percent of total billed charges,,,1003.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2776.35,83,,percent of total billed charges,,,,,,,,,3010.5,90,,percent of total billed charges,,,3010.5,90,,percent of total billed charges,,,3010.5,90,,percent of total billed charges,,,3010.5,90,,percent of total billed charges,,,2843.25,85,,percent of total billed charges,,1003.5,3177.75,
Behind Ear Hearing Monaural Aid Rechargeable,V5060 Lvl30,CDM,V5060,HCPCS,,,both,,1845,1845,,,,,,,,,,,,,,,,,,,,1568.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1678.95,91,,percent of total billed charges,,,1752.75,95,,percent of total billed charges,,,1531.35,83,,percent of total billed charges,,,553.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1531.35,83,,percent of total billed charges,,,,,,,,,1660.5,90,,percent of total billed charges,,,1660.5,90,,percent of total billed charges,,,1660.5,90,,percent of total billed charges,,,1660.5,90,,percent of total billed charges,,,1568.25,85,,percent of total billed charges,,553.5,1752.75,
Behind Ear Hearing Monaural Aid Rechargeable,V5060 Lvl50,CDM,V5060,HCPCS,,,both,,2345,2345,,,,,,,,,,,,,,,,,,,,1993.25,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2133.95,91,,percent of total billed charges,,,2227.75,95,,percent of total billed charges,,,1946.35,83,,percent of total billed charges,,,703.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1946.35,83,,percent of total billed charges,,,,,,,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,1993.25,85,,percent of total billed charges,,703.5,2227.75,
Hearing aid dispensing fee,V5090,CDM,V5090,HCPCS,,,both,,206,206,,,,,,,,,,,,,,,,,,,,175.1,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,187.46,91,,percent of total billed charges,,,195.7,95,,percent of total billed charges,,,170.98,83,,percent of total billed charges,,,61.8,83,,percent of total billed charges,,,,,,,,,,,,,,,170.98,83,,percent of total billed charges,,,,,,,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,185.4,90,,percent of total billed charges,,,175.1,85,,percent of total billed charges,,61.8,195.7,
Hearing aid dispensing fee,V5110,CDM,V5110,HCPCS,,,both,,454,454,,,,,,,,,,,,,,,,,,,,385.9,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,413.14,91,,percent of total billed charges,,,431.3,95,,percent of total billed charges,,,376.82,83,,percent of total billed charges,,,136.2,83,,percent of total billed charges,,,,,,,,,,,,,,,376.82,83,,percent of total billed charges,,,,,,,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,408.6,90,,percent of total billed charges,,,385.9,85,,percent of total billed charges,,136.2,431.3,
In Ear Binaural Hearing Aid  Non ReChargeable,V5130 30 NRC,CDM,V5130,HCPCS,,,both,,3490,3490,,,,,,,,,,,,,,,,,,,,2966.5,85,,percent of total billed charges,,2400,,,,fee schedule,,2400,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3175.9,91,,percent of total billed charges,,,3315.5,95,,percent of total billed charges,,,2896.7,83,,percent of total billed charges,,,1047,83,,percent of total billed charges,,,,,,,,,,,,,,,2896.7,83,,percent of total billed charges,,,,,,,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,2966.5,85,,percent of total billed charges,,1047,3315.5,
In Ear Binaural Hearing Aid Non ReChargeable,V5130 50 NRC,CDM,V5130,HCPCS,,,both,,4490,4490,,,,,,,,,,,,,,,,,,,,3816.5,85,,percent of total billed charges,,2400,,,,fee schedule,,2400,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4085.9,91,,percent of total billed charges,,,4265.5,95,,percent of total billed charges,,,3726.7,83,,percent of total billed charges,,,1347,83,,percent of total billed charges,,,,,,,,,,,,,,,3726.7,83,,percent of total billed charges,,,,,,,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,3816.5,85,,percent of total billed charges,,1347,4265.5,
In Ear Binaural Hearing Aid Non ReChargeable,V5130 70 NRC,CDM,V5130,HCPCS,,,both,,5490,5490,,,,,,,,,,,,,,,,,,,,4666.5,85,,percent of total billed charges,,2400,,,,fee schedule,,2400,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4995.9,91,,percent of total billed charges,,,5215.5,95,,percent of total billed charges,,,4556.7,83,,percent of total billed charges,,,1647,83,,percent of total billed charges,,,,,,,,,,,,,,,4556.7,83,,percent of total billed charges,,,,,,,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4666.5,85,,percent of total billed charges,,1647,5215.5,
In Ear Binaural Hearing Aid Non ReChargeable,V5130 90 NRC,CDM,V5130,HCPCS,,,both,,6490,6490,,,,,,,,,,,,,,,,,,,,5516.5,85,,percent of total billed charges,,2400,,,,fee schedule,,2400,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5905.9,91,,percent of total billed charges,,,6165.5,95,,percent of total billed charges,,,5386.7,83,,percent of total billed charges,,,1947,83,,percent of total billed charges,,,,,,,,,,,,,,,5386.7,83,,percent of total billed charges,,,,,,,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5516.5,85,,percent of total billed charges,,1947,6165.5,
In Ear Binaural Hearing Aid ReChargeable,V5130 Lvl 30,CDM,V5130,HCPCS,,,both,,3690,3690,,,,,,,,,,,,,,,,,,,,3136.5,85,,percent of total billed charges,,2400,,,,fee schedule,,2400,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3357.9,91,,percent of total billed charges,,,3505.5,95,,percent of total billed charges,,,3062.7,83,,percent of total billed charges,,,1107,83,,percent of total billed charges,,,,,,,,,,,,,,,3062.7,83,,percent of total billed charges,,,,,,,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3136.5,85,,percent of total billed charges,,1107,3505.5,
In Ear Binaural Hearing Aid ReChargeable,V5130 Lvl 50,CDM,V5130,HCPCS,,,both,,4690,4690,,,,,,,,,,,,,,,,,,,,3986.5,85,,percent of total billed charges,,2400,,,,fee schedule,,2400,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4267.9,91,,percent of total billed charges,,,4455.5,95,,percent of total billed charges,,,3892.7,83,,percent of total billed charges,,,1407,83,,percent of total billed charges,,,,,,,,,,,,,,,3892.7,83,,percent of total billed charges,,,,,,,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,3986.5,85,,percent of total billed charges,,1407,4455.5,
In Ear Binaural Hearing Aid ReChargeable,V5130 Lvl 70,CDM,V5130,HCPCS,,,both,,5690,5690,,,,,,,,,,,,,,,,,,,,4836.5,85,,percent of total billed charges,,2400,,,,fee schedule,,2400,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5177.9,91,,percent of total billed charges,,,5405.5,95,,percent of total billed charges,,,4722.7,83,,percent of total billed charges,,,1707,83,,percent of total billed charges,,,,,,,,,,,,,,,4722.7,83,,percent of total billed charges,,,,,,,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,4836.5,85,,percent of total billed charges,,1707,5405.5,
In Ear Binaural Hearing Aid ReChargeable,V5130 Lvl 90,CDM,V5130,HCPCS,,,both,,6690,6690,,,,,,,,,,,,,,,,,,,,5686.5,85,,percent of total billed charges,,2400,,,,fee schedule,,2400,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6087.9,91,,percent of total billed charges,,,6355.5,95,,percent of total billed charges,,,5552.7,83,,percent of total billed charges,,,2007,83,,percent of total billed charges,,,,,,,,,,,,,,,5552.7,83,,percent of total billed charges,,,,,,,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,5686.5,85,,percent of total billed charges,,2007,6355.5,
Behind Ear Binaural Hearing Aid Non Rechargeable,V5140 30 NRC,CDM,V5140,HCPCS,,,both,,3490,3490,,,,,,,,,,,,,,,,,,,,2966.5,85,,percent of total billed charges,,6800,,,,fee schedule,,6800,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3175.9,91,,percent of total billed charges,,,3315.5,95,,percent of total billed charges,,,2896.7,83,,percent of total billed charges,,,1047,83,,percent of total billed charges,,,,,,,,,,,,,,,2896.7,83,,percent of total billed charges,,,,,,,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,2966.5,85,,percent of total billed charges,,1047,6800,
Behind Ear Binaural Hearing Aid Non Rechargeable,V5140 50 NRC,CDM,V5140,HCPCS,,,both,,4490,4490,,,,,,,,,,,,,,,,,,,,3816.5,85,,percent of total billed charges,,6800,,,,fee schedule,,6800,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4085.9,91,,percent of total billed charges,,,4265.5,95,,percent of total billed charges,,,3726.7,83,,percent of total billed charges,,,1347,83,,percent of total billed charges,,,,,,,,,,,,,,,3726.7,83,,percent of total billed charges,,,,,,,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,3816.5,85,,percent of total billed charges,,1347,6800,
Behind Ear Binaural Hearing Aid Non Rechargeable,V5140 70 NRC,CDM,V5140,HCPCS,,,both,,5490,5490,,,,,,,,,,,,,,,,,,,,4666.5,85,,percent of total billed charges,,6800,,,,fee schedule,,6800,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4995.9,91,,percent of total billed charges,,,5215.5,95,,percent of total billed charges,,,4556.7,83,,percent of total billed charges,,,1647,83,,percent of total billed charges,,,,,,,,,,,,,,,4556.7,83,,percent of total billed charges,,,,,,,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4666.5,85,,percent of total billed charges,,1647,6800,
Behind Ear Binaural Hearing Aid Non Rechargeable,V5140 90 NRC,CDM,V5140,HCPCS,,,both,,6490,6490,,,,,,,,,,,,,,,,,,,,5516.5,85,,percent of total billed charges,,6800,,,,fee schedule,,6800,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5905.9,91,,percent of total billed charges,,,6165.5,95,,percent of total billed charges,,,5386.7,83,,percent of total billed charges,,,1947,83,,percent of total billed charges,,,,,,,,,,,,,,,5386.7,83,,percent of total billed charges,,,,,,,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5516.5,85,,percent of total billed charges,,1947,6800,
Behind Ear Binaural Hearing Aid Rechargeable,V5140 Lvl 50,CDM,V5140,HCPCS,,,both,,4690,4690,,,,,,,,,,,,,,,,,,,,3986.5,85,,percent of total billed charges,,6800,,,,fee schedule,,6800,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4267.9,91,,percent of total billed charges,,,4455.5,95,,percent of total billed charges,,,3892.7,83,,percent of total billed charges,,,1407,83,,percent of total billed charges,,,,,,,,,,,,,,,3892.7,83,,percent of total billed charges,,,,,,,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,3986.5,85,,percent of total billed charges,,1407,6800,
Behind Ear Binaural Hearing Aid Rechargeable,V5140 Lvl 70,CDM,V5140,HCPCS,,,both,,5690,5690,,,,,,,,,,,,,,,,,,,,4836.5,85,,percent of total billed charges,,6800,,,,fee schedule,,6800,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5177.9,91,,percent of total billed charges,,,5405.5,95,,percent of total billed charges,,,4722.7,83,,percent of total billed charges,,,1707,83,,percent of total billed charges,,,,,,,,,,,,,,,4722.7,83,,percent of total billed charges,,,,,,,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,4836.5,85,,percent of total billed charges,,1707,6800,
Behind Ear Binaural Hearing Aid Rechargeable,V5140 Lvl 90,CDM,V5140,HCPCS,,,both,,6690,6690,,,,,,,,,,,,,,,,,,,,5686.5,85,,percent of total billed charges,,6800,,,,fee schedule,,6800,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6087.9,91,,percent of total billed charges,,,6355.5,95,,percent of total billed charges,,,5552.7,83,,percent of total billed charges,,,2007,83,,percent of total billed charges,,,,,,,,,,,,,,,5552.7,83,,percent of total billed charges,,,,,,,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,5686.5,85,,percent of total billed charges,,2007,6800,
Behind Ear Binaural Hearing Aid Rechargeable,V5140 Lvl30,CDM,V5140,HCPCS,,,both,,3690,3690,,,,,,,,,,,,,,,,,,,,3136.5,85,,percent of total billed charges,,6800,,,,fee schedule,,6800,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3357.9,91,,percent of total billed charges,,,3505.5,95,,percent of total billed charges,,,3062.7,83,,percent of total billed charges,,,1107,83,,percent of total billed charges,,,,,,,,,,,,,,,3062.7,83,,percent of total billed charges,,,,,,,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3136.5,85,,percent of total billed charges,,1107,6800,
Hearing aid monaural ite,V5171,CDM,V5171,HCPCS,,,both,,639,639,,,,,,,,,,,,,,,,,,,,543.15,85,,percent of total billed charges,,2000,,,,fee schedule,,2000,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,191.7,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,191.7,2000,
Hearing aid monaural itc,V5172,CDM,V5172,HCPCS,,,both,,1545,1545,,,,,,,,,,,,,,,,,,,,1313.25,85,,percent of total billed charges,,1500,,,,fee schedule,,1500,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1405.95,91,,percent of total billed charges,,,1467.75,95,,percent of total billed charges,,,1282.35,83,,percent of total billed charges,,,463.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1282.35,83,,percent of total billed charges,,,,,,,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1313.25,85,,percent of total billed charges,,463.5,1500,
Hearing aid monaural bte,V5181,CDM,V5181,HCPCS,,,both,,1854,1854,,,,,,,,,,,,,,,,,,,,1575.9,85,,percent of total billed charges,,1500,,,,fee schedule,,1500,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1687.14,91,,percent of total billed charges,,,1761.3,95,,percent of total billed charges,,,1538.82,83,,percent of total billed charges,,,556.2,83,,percent of total billed charges,,,,,,,,,,,,,,,1538.82,83,,percent of total billed charges,,,,,,,,,1668.6,90,,percent of total billed charges,,,1668.6,90,,percent of total billed charges,,,1668.6,90,,percent of total billed charges,,,1668.6,90,,percent of total billed charges,,,1575.9,85,,percent of total billed charges,,556.2,1761.3,
Cros hearing aid dispens fee,V5200,CDM,V5200,HCPCS,,,both,,412,412,,,,,,,,,,,,,,,,,,,,350.2,85,,percent of total billed charges,,1000,,,,fee schedule,,1000,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,374.92,91,,percent of total billed charges,,,391.4,95,,percent of total billed charges,,,341.96,83,,percent of total billed charges,,,123.6,83,,percent of total billed charges,,,,,,,,,,,,,,,341.96,83,,percent of total billed charges,,,,,,,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,370.8,90,,percent of total billed charges,,,350.2,85,,percent of total billed charges,,123.6,1000,
Hearing aid binaural bte/bte,V5221,CDM,V5221,HCPCS,,,both,,3708,3708,,,,,,,,,,,,,,,,,,,,3151.8,85,,percent of total billed charges,,3295,,,,fee schedule,,3295,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3374.28,91,,percent of total billed charges,,,3522.6,95,,percent of total billed charges,,,3077.64,83,,percent of total billed charges,,,1112.4,83,,percent of total billed charges,,,,,,,,,,,,,,,3077.64,83,,percent of total billed charges,,,,,,,,,3337.2,90,,percent of total billed charges,,,3337.2,90,,percent of total billed charges,,,3337.2,90,,percent of total billed charges,,,3337.2,90,,percent of total billed charges,,,3151.8,85,,percent of total billed charges,,1112.4,3522.6,
Dispensing fee bicros,V5240,CDM,V5240,HCPCS,,,both,,639,639,,,,,,,,,,,,,,,,,,,,543.15,85,,percent of total billed charges,,425,,,,fee schedule,,425,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,581.49,91,,percent of total billed charges,,,607.05,95,,percent of total billed charges,,,530.37,83,,percent of total billed charges,,,191.7,83,,percent of total billed charges,,,,,,,,,,,,,,,530.37,83,,percent of total billed charges,,,,,,,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,575.1,90,,percent of total billed charges,,,543.15,85,,percent of total billed charges,,191.7,607.05,
"Dispensing fee, monaural",V5241,CDM,V5241,HCPCS,,,both,,382,382,,,,,,,,,,,,,,,,,,,,324.7,85,,percent of total billed charges,,350,,,,fee schedule,,350,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,347.62,91,,percent of total billed charges,,,362.9,95,,percent of total billed charges,,,317.06,83,,percent of total billed charges,,,114.6,83,,percent of total billed charges,,,,,,,,,,,,,,,317.06,83,,percent of total billed charges,,,,,,,,,343.8,90,,percent of total billed charges,,,343.8,90,,percent of total billed charges,,,343.8,90,,percent of total billed charges,,,343.8,90,,percent of total billed charges,,,324.7,85,,percent of total billed charges,,114.6,362.9,
"Hearing aid, prog, mon, bte",V5247,CDM,V5247,HCPCS,,,both,,3193,3193,,,,,,,,,,,,,,,,,,,,2714.05,85,,percent of total billed charges,,3100,,,,fee schedule,,3100,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2905.63,91,,percent of total billed charges,,,3033.35,95,,percent of total billed charges,,,2650.19,83,,percent of total billed charges,,,957.9,83,,percent of total billed charges,,,,,,,,,,,,,,,2650.19,83,,percent of total billed charges,,,,,,,,,2873.7,90,,percent of total billed charges,,,2873.7,90,,percent of total billed charges,,,2873.7,90,,percent of total billed charges,,,2873.7,90,,percent of total billed charges,,,2714.05,85,,percent of total billed charges,,957.9,3100,
Hearing Aid Binaural BTE Dig Program Non Rechargeable,V5253 30 NRC,CDM,V5253,HCPCS,,,both,,3490,3490,,,,,,,,,,,,,,,,,,,,2966.5,85,,percent of total billed charges,,1700,,,,fee schedule,,1700,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3175.9,91,,percent of total billed charges,,,3315.5,95,,percent of total billed charges,,,2896.7,83,,percent of total billed charges,,,1047,83,,percent of total billed charges,,,,,,,,,,,,,,,2896.7,83,,percent of total billed charges,,,,,,,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,2966.5,85,,percent of total billed charges,,1047,3315.5,
Hearing Aid Binaural BTE Dig Program Non Rechargeable,V5253 50 NRC,CDM,V5253,HCPCS,,,both,,4490,4490,,,,,,,,,,,,,,,,,,,,3816.5,85,,percent of total billed charges,,1700,,,,fee schedule,,1700,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4085.9,91,,percent of total billed charges,,,4265.5,95,,percent of total billed charges,,,3726.7,83,,percent of total billed charges,,,1347,83,,percent of total billed charges,,,,,,,,,,,,,,,3726.7,83,,percent of total billed charges,,,,,,,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,3816.5,85,,percent of total billed charges,,1347,4265.5,
Hearing Aid Binaural BTE Dig Program Non Rechargeable,V5253 70 NRC,CDM,V5253,HCPCS,,,both,,5490,5490,,,,,,,,,,,,,,,,,,,,4666.5,85,,percent of total billed charges,,1700,,,,fee schedule,,1700,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4995.9,91,,percent of total billed charges,,,5215.5,95,,percent of total billed charges,,,4556.7,83,,percent of total billed charges,,,1647,83,,percent of total billed charges,,,,,,,,,,,,,,,4556.7,83,,percent of total billed charges,,,,,,,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4666.5,85,,percent of total billed charges,,1647,5215.5,
Hearing Aid Binaural BTE Dig Program Non Rechargeable,V5253 90 NRC,CDM,V5253,HCPCS,,,both,,6490,6490,,,,,,,,,,,,,,,,,,,,5516.5,85,,percent of total billed charges,,1700,,,,fee schedule,,1700,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5905.9,91,,percent of total billed charges,,,6165.5,95,,percent of total billed charges,,,5386.7,83,,percent of total billed charges,,,1947,83,,percent of total billed charges,,,,,,,,,,,,,,,5386.7,83,,percent of total billed charges,,,,,,,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5516.5,85,,percent of total billed charges,,1700,6165.5,
Hearing Aid Binaural BTE Dig Program Rechargeable,V5253 Lvl 30,CDM,V5253,HCPCS,,,both,,3690,3690,,,,,,,,,,,,,,,,,,,,3136.5,85,,percent of total billed charges,,1700,,,,fee schedule,,1700,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3357.9,91,,percent of total billed charges,,,3505.5,95,,percent of total billed charges,,,3062.7,83,,percent of total billed charges,,,1107,83,,percent of total billed charges,,,,,,,,,,,,,,,3062.7,83,,percent of total billed charges,,,,,,,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3136.5,85,,percent of total billed charges,,1107,3505.5,
Hearing Aid Binaural BTE Dig Program Rechargeable,V5253 Lvl 50,CDM,V5253,HCPCS,,,both,,4690,4690,,,,,,,,,,,,,,,,,,,,3986.5,85,,percent of total billed charges,,1700,,,,fee schedule,,1700,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4267.9,91,,percent of total billed charges,,,4455.5,95,,percent of total billed charges,,,3892.7,83,,percent of total billed charges,,,1407,83,,percent of total billed charges,,,,,,,,,,,,,,,3892.7,83,,percent of total billed charges,,,,,,,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,3986.5,85,,percent of total billed charges,,1407,4455.5,
Hearing Aid Binaural BTE Dig Program Rechargeable,V5253 Lvl 70,CDM,V5253,HCPCS,,,both,,5690,5690,,,,,,,,,,,,,,,,,,,,4836.5,85,,percent of total billed charges,,1700,,,,fee schedule,,1700,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5177.9,91,,percent of total billed charges,,,5405.5,95,,percent of total billed charges,,,4722.7,83,,percent of total billed charges,,,1707,83,,percent of total billed charges,,,,,,,,,,,,,,,4722.7,83,,percent of total billed charges,,,,,,,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,4836.5,85,,percent of total billed charges,,1700,5405.5,
Hearing Aid Binaural BTE Dig Program Rechargeable,V5253 Lvl 90,CDM,V5253,HCPCS,,,both,,6690,6690,,,,,,,,,,,,,,,,,,,,5686.5,85,,percent of total billed charges,,1700,,,,fee schedule,,1700,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6087.9,91,,percent of total billed charges,,,6355.5,95,,percent of total billed charges,,,5552.7,83,,percent of total billed charges,,,2007,83,,percent of total billed charges,,,,,,,,,,,,,,,5552.7,83,,percent of total billed charges,,,,,,,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,5686.5,85,,percent of total billed charges,,1700,6355.5,
Hearing Aid Dig Monaural CIC Non Rechargeable,V5254 30 NRC,CDM,V5254,HCPCS,,,both,,1745,1745,,,,,,,,,,,,,,,,,,,,1483.25,85,,percent of total billed charges,,3475,,,,fee schedule,,3475,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1587.95,91,,percent of total billed charges,,,1657.75,95,,percent of total billed charges,,,1448.35,83,,percent of total billed charges,,,523.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1448.35,83,,percent of total billed charges,,,,,,,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1483.25,85,,percent of total billed charges,,523.5,3475,
Hearing Aid Dig Monaural CIC Non Rechargeable,V5254 50 NRC,CDM,V5254,HCPCS,,,both,,2245,2245,,,,,,,,,,,,,,,,,,,,1908.25,85,,percent of total billed charges,,3475,,,,fee schedule,,3475,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2042.95,91,,percent of total billed charges,,,2132.75,95,,percent of total billed charges,,,1863.35,83,,percent of total billed charges,,,673.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1863.35,83,,percent of total billed charges,,,,,,,,,2020.5,90,,percent of total billed charges,,,2020.5,90,,percent of total billed charges,,,2020.5,90,,percent of total billed charges,,,2020.5,90,,percent of total billed charges,,,1908.25,85,,percent of total billed charges,,673.5,3475,
Hearing Aid Dig Monaural CIC Non Rechargeable,V5254 70 NRC,CDM,V5254,HCPCS,,,both,,2745,2745,,,,,,,,,,,,,,,,,,,,2333.25,85,,percent of total billed charges,,3475,,,,fee schedule,,3475,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2497.95,91,,percent of total billed charges,,,2607.75,95,,percent of total billed charges,,,2278.35,83,,percent of total billed charges,,,823.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2278.35,83,,percent of total billed charges,,,,,,,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2333.25,85,,percent of total billed charges,,823.5,3475,
Hearing Aid Dig Monaural CIC Non Rechargeable,V5254 90 NRC,CDM,V5254,HCPCS,,,both,,3245,3245,,,,,,,,,,,,,,,,,,,,2758.25,85,,percent of total billed charges,,3475,,,,fee schedule,,3475,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2952.95,91,,percent of total billed charges,,,3082.75,95,,percent of total billed charges,,,2693.35,83,,percent of total billed charges,,,973.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2693.35,83,,percent of total billed charges,,,,,,,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2758.25,85,,percent of total billed charges,,973.5,3475,
Hearing Aid Dig Monaural CIC Rechargeable,V5254 Lvl 30,CDM,V5254,HCPCS,,,both,,1845,1845,,,,,,,,,,,,,,,,,,,,1568.25,85,,percent of total billed charges,,3475,,,,fee schedule,,3475,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1678.95,91,,percent of total billed charges,,,1752.75,95,,percent of total billed charges,,,1531.35,83,,percent of total billed charges,,,553.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1531.35,83,,percent of total billed charges,,,,,,,,,1660.5,90,,percent of total billed charges,,,1660.5,90,,percent of total billed charges,,,1660.5,90,,percent of total billed charges,,,1660.5,90,,percent of total billed charges,,,1568.25,85,,percent of total billed charges,,553.5,3475,
Hearing Aid Dig Monaural CIC Rechargeable,V5254 Lvl 50,CDM,V5254,HCPCS,,,both,,2345,2345,,,,,,,,,,,,,,,,,,,,1993.25,85,,percent of total billed charges,,3475,,,,fee schedule,,3475,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2133.95,91,,percent of total billed charges,,,2227.75,95,,percent of total billed charges,,,1946.35,83,,percent of total billed charges,,,703.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1946.35,83,,percent of total billed charges,,,,,,,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,1993.25,85,,percent of total billed charges,,703.5,3475,
Hearing Aid Dig Monaural CIC Rechargeable,V5254 Lvl 70,CDM,V5254,HCPCS,,,both,,2845,2845,,,,,,,,,,,,,,,,,,,,2418.25,85,,percent of total billed charges,,3475,,,,fee schedule,,3475,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2588.95,91,,percent of total billed charges,,,2702.75,95,,percent of total billed charges,,,2361.35,83,,percent of total billed charges,,,853.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2361.35,83,,percent of total billed charges,,,,,,,,,2560.5,90,,percent of total billed charges,,,2560.5,90,,percent of total billed charges,,,2560.5,90,,percent of total billed charges,,,2560.5,90,,percent of total billed charges,,,2418.25,85,,percent of total billed charges,,853.5,3475,
Hearing Aid Dig Monaural CIC Rechargeable,V5254 Lvl 90,CDM,V5254,HCPCS,,,both,,3345,3345,,,,,,,,,,,,,,,,,,,,2843.25,85,,percent of total billed charges,,3475,,,,fee schedule,,3475,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3043.95,91,,percent of total billed charges,,,3177.75,95,,percent of total billed charges,,,2776.35,83,,percent of total billed charges,,,1003.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2776.35,83,,percent of total billed charges,,,,,,,,,3010.5,90,,percent of total billed charges,,,3010.5,90,,percent of total billed charges,,,3010.5,90,,percent of total billed charges,,,3010.5,90,,percent of total billed charges,,,2843.25,85,,percent of total billed charges,,1003.5,3475,
"Hearing aid, digit, mon, itc",V5255,CDM,V5255,HCPCS,,,both,,1545,1545,,,,,,,,,,,,,,,,,,,,1313.25,85,,percent of total billed charges,,2400,,,,fee schedule,,2400,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1405.95,91,,percent of total billed charges,,,1467.75,95,,percent of total billed charges,,,1282.35,83,,percent of total billed charges,,,463.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1282.35,83,,percent of total billed charges,,,,,,,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1390.5,90,,percent of total billed charges,,,1313.25,85,,percent of total billed charges,,463.5,2400,
Hearing Aid Dig Monaural ITE Non Rechargeable,V5256 30 NRC,CDM,V5256,HCPCS,,,both,,1745,1745,,,,,,,,,,,,,,,,,,,,1483.25,85,,percent of total billed charges,,3500,,,,fee schedule,,3500,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1587.95,91,,percent of total billed charges,,,1657.75,95,,percent of total billed charges,,,1448.35,83,,percent of total billed charges,,,523.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1448.35,83,,percent of total billed charges,,,,,,,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1483.25,85,,percent of total billed charges,,523.5,3500,
Hearing Aid Dig Monaural ITE Non Rechargeable,V5256 50 NRC,CDM,V5256,HCPCS,,,both,,2245,2245,,,,,,,,,,,,,,,,,,,,1908.25,85,,percent of total billed charges,,3500,,,,fee schedule,,3500,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2042.95,91,,percent of total billed charges,,,2132.75,95,,percent of total billed charges,,,1863.35,83,,percent of total billed charges,,,673.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1863.35,83,,percent of total billed charges,,,,,,,,,2020.5,90,,percent of total billed charges,,,2020.5,90,,percent of total billed charges,,,2020.5,90,,percent of total billed charges,,,2020.5,90,,percent of total billed charges,,,1908.25,85,,percent of total billed charges,,673.5,3500,
Hearing Aid Dig Monaural ITE Non Rechargeable,V5256 70 NRC,CDM,V5256,HCPCS,,,both,,2745,2745,,,,,,,,,,,,,,,,,,,,2333.25,85,,percent of total billed charges,,3500,,,,fee schedule,,3500,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2497.95,91,,percent of total billed charges,,,2607.75,95,,percent of total billed charges,,,2278.35,83,,percent of total billed charges,,,823.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2278.35,83,,percent of total billed charges,,,,,,,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2333.25,85,,percent of total billed charges,,823.5,3500,
Hearing Aid Dig Monaural ITE Non Rechargeable,V5256 90 NRC,CDM,V5256,HCPCS,,,both,,3245,3245,,,,,,,,,,,,,,,,,,,,2758.25,85,,percent of total billed charges,,3500,,,,fee schedule,,3500,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2952.95,91,,percent of total billed charges,,,3082.75,95,,percent of total billed charges,,,2693.35,83,,percent of total billed charges,,,973.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2693.35,83,,percent of total billed charges,,,,,,,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2758.25,85,,percent of total billed charges,,973.5,3500,
Hearing Aid Dig Monaural ITE Rechargeable,V5256 Lvl 30,CDM,V5256,HCPCS,,,both,,1845,1845,,,,,,,,,,,,,,,,,,,,1568.25,85,,percent of total billed charges,,3500,,,,fee schedule,,3500,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1678.95,91,,percent of total billed charges,,,1752.75,95,,percent of total billed charges,,,1531.35,83,,percent of total billed charges,,,553.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1531.35,83,,percent of total billed charges,,,,,,,,,1660.5,90,,percent of total billed charges,,,1660.5,90,,percent of total billed charges,,,1660.5,90,,percent of total billed charges,,,1660.5,90,,percent of total billed charges,,,1568.25,85,,percent of total billed charges,,553.5,3500,
Hearing Aid Dig Monaural ITE Rechargeable,V5256 Lvl 50,CDM,V5256,HCPCS,,,both,,2345,2345,,,,,,,,,,,,,,,,,,,,1993.25,85,,percent of total billed charges,,3500,,,,fee schedule,,3500,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2133.95,91,,percent of total billed charges,,,2227.75,95,,percent of total billed charges,,,1946.35,83,,percent of total billed charges,,,703.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1946.35,83,,percent of total billed charges,,,,,,,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,1993.25,85,,percent of total billed charges,,703.5,3500,
Hearing Aid Dig Monaural ITE Rechargeable,V5256 Lvl 70,CDM,V5256,HCPCS,,,both,,2845,2845,,,,,,,,,,,,,,,,,,,,2418.25,85,,percent of total billed charges,,3500,,,,fee schedule,,3500,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2588.95,91,,percent of total billed charges,,,2702.75,95,,percent of total billed charges,,,2361.35,83,,percent of total billed charges,,,853.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2361.35,83,,percent of total billed charges,,,,,,,,,2560.5,90,,percent of total billed charges,,,2560.5,90,,percent of total billed charges,,,2560.5,90,,percent of total billed charges,,,2560.5,90,,percent of total billed charges,,,2418.25,85,,percent of total billed charges,,853.5,3500,
Hearing Aid Dig Monaural ITE Rechargeable,V5256 Lvl 90,CDM,V5256,HCPCS,,,both,,3345,3345,,,,,,,,,,,,,,,,,,,,2843.25,85,,percent of total billed charges,,3500,,,,fee schedule,,3500,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3043.95,91,,percent of total billed charges,,,3177.75,95,,percent of total billed charges,,,2776.35,83,,percent of total billed charges,,,1003.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2776.35,83,,percent of total billed charges,,,,,,,,,3010.5,90,,percent of total billed charges,,,3010.5,90,,percent of total billed charges,,,3010.5,90,,percent of total billed charges,,,3010.5,90,,percent of total billed charges,,,2843.25,85,,percent of total billed charges,,1003.5,3500,
Hearing Aid Dig Monaural BTE Non Rechargeable,V5257 30 NRC,CDM,V5257,HCPCS,,,both,,1745,1745,,,,,,,,,,,,,,,,,,,,1483.25,85,,percent of total billed charges,,3745,,,,fee schedule,,3745,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1587.95,91,,percent of total billed charges,,,1657.75,95,,percent of total billed charges,,,1448.35,83,,percent of total billed charges,,,523.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1448.35,83,,percent of total billed charges,,,,,,,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1570.5,90,,percent of total billed charges,,,1483.25,85,,percent of total billed charges,,523.5,3745,
Hearing Aid Dig Monaural BTE Non Rechargeable,V5257 50 NRC,CDM,V5257,HCPCS,,,both,,2245,2245,,,,,,,,,,,,,,,,,,,,1908.25,85,,percent of total billed charges,,3745,,,,fee schedule,,3745,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2042.95,91,,percent of total billed charges,,,2132.75,95,,percent of total billed charges,,,1863.35,83,,percent of total billed charges,,,673.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1863.35,83,,percent of total billed charges,,,,,,,,,2020.5,90,,percent of total billed charges,,,2020.5,90,,percent of total billed charges,,,2020.5,90,,percent of total billed charges,,,2020.5,90,,percent of total billed charges,,,1908.25,85,,percent of total billed charges,,673.5,3745,
Hearing Aid Dig Monaural BTE Non Rechargeable,V5257 70 NRC,CDM,V5257,HCPCS,,,both,,2745,2745,,,,,,,,,,,,,,,,,,,,2333.25,85,,percent of total billed charges,,3745,,,,fee schedule,,3745,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2497.95,91,,percent of total billed charges,,,2607.75,95,,percent of total billed charges,,,2278.35,83,,percent of total billed charges,,,823.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2278.35,83,,percent of total billed charges,,,,,,,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2470.5,90,,percent of total billed charges,,,2333.25,85,,percent of total billed charges,,823.5,3745,
Hearing Aid Dig Monaural BTE Non Rechargeable,V5257 90 NRC,CDM,V5257,HCPCS,,,both,,3245,3245,,,,,,,,,,,,,,,,,,,,2758.25,85,,percent of total billed charges,,3745,,,,fee schedule,,3745,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2952.95,91,,percent of total billed charges,,,3082.75,95,,percent of total billed charges,,,2693.35,83,,percent of total billed charges,,,973.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2693.35,83,,percent of total billed charges,,,,,,,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2920.5,90,,percent of total billed charges,,,2758.25,85,,percent of total billed charges,,973.5,3745,
Hearing Aid Dig Monaural BTE Rechargeable,V5257 Lvl 30,CDM,V5257,HCPCS,,,both,,1845,1845,,,,,,,,,,,,,,,,,,,,1568.25,85,,percent of total billed charges,,3745,,,,fee schedule,,3745,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1678.95,91,,percent of total billed charges,,,1752.75,95,,percent of total billed charges,,,1531.35,83,,percent of total billed charges,,,553.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1531.35,83,,percent of total billed charges,,,,,,,,,1660.5,90,,percent of total billed charges,,,1660.5,90,,percent of total billed charges,,,1660.5,90,,percent of total billed charges,,,1660.5,90,,percent of total billed charges,,,1568.25,85,,percent of total billed charges,,553.5,3745,
Hearing Aid Dig Monaural BTE Rechargeable,V5257 Lvl 50,CDM,V5257,HCPCS,,,both,,2345,2345,,,,,,,,,,,,,,,,,,,,1993.25,85,,percent of total billed charges,,3745,,,,fee schedule,,3745,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2133.95,91,,percent of total billed charges,,,2227.75,95,,percent of total billed charges,,,1946.35,83,,percent of total billed charges,,,703.5,83,,percent of total billed charges,,,,,,,,,,,,,,,1946.35,83,,percent of total billed charges,,,,,,,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,2110.5,90,,percent of total billed charges,,,1993.25,85,,percent of total billed charges,,703.5,3745,
Hearing Aid Dig Monaural BTE Rechargeable,V5257 Lvl 70,CDM,V5257,HCPCS,,,both,,2845,2845,,,,,,,,,,,,,,,,,,,,2418.25,85,,percent of total billed charges,,3745,,,,fee schedule,,3745,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,2588.95,91,,percent of total billed charges,,,2702.75,95,,percent of total billed charges,,,2361.35,83,,percent of total billed charges,,,853.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2361.35,83,,percent of total billed charges,,,,,,,,,2560.5,90,,percent of total billed charges,,,2560.5,90,,percent of total billed charges,,,2560.5,90,,percent of total billed charges,,,2560.5,90,,percent of total billed charges,,,2418.25,85,,percent of total billed charges,,853.5,3745,
Hearing Aid Dig Monaural BTE Rechargeable,V5257 Lvl 90,CDM,V5257,HCPCS,,,both,,3345,3345,,,,,,,,,,,,,,,,,,,,2843.25,85,,percent of total billed charges,,3745,,,,fee schedule,,3745,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3043.95,91,,percent of total billed charges,,,3177.75,95,,percent of total billed charges,,,2776.35,83,,percent of total billed charges,,,1003.5,83,,percent of total billed charges,,,,,,,,,,,,,,,2776.35,83,,percent of total billed charges,,,,,,,,,3010.5,90,,percent of total billed charges,,,3010.5,90,,percent of total billed charges,,,3010.5,90,,percent of total billed charges,,,3010.5,90,,percent of total billed charges,,,2843.25,85,,percent of total billed charges,,1003.5,3745,
Hearing Aid Dig Binaural CIC Non Rechargeable,V5258 30 NRC,CDM,V5258,HCPCS,,,both,,3490,3490,,,,,,,,,,,,,,,,,,,,2966.5,85,,percent of total billed charges,,7200,,,,fee schedule,,7200,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3175.9,91,,percent of total billed charges,,,3315.5,95,,percent of total billed charges,,,2896.7,83,,percent of total billed charges,,,1047,83,,percent of total billed charges,,,,,,,,,,,,,,,2896.7,83,,percent of total billed charges,,,,,,,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,2966.5,85,,percent of total billed charges,,1047,7200,
Hearing Aid Dig Binaural CIC Non Rechargeable,V5258 50 NRC,CDM,V5258,HCPCS,,,both,,4490,4490,,,,,,,,,,,,,,,,,,,,3816.5,85,,percent of total billed charges,,7200,,,,fee schedule,,7200,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4085.9,91,,percent of total billed charges,,,4265.5,95,,percent of total billed charges,,,3726.7,83,,percent of total billed charges,,,1347,83,,percent of total billed charges,,,,,,,,,,,,,,,3726.7,83,,percent of total billed charges,,,,,,,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,3816.5,85,,percent of total billed charges,,1347,7200,
Hearing Aid Dig Binaural CIC Non Rechargeable,V5258 70 NRC,CDM,V5258,HCPCS,,,both,,5490,5490,,,,,,,,,,,,,,,,,,,,4666.5,85,,percent of total billed charges,,7200,,,,fee schedule,,7200,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4995.9,91,,percent of total billed charges,,,5215.5,95,,percent of total billed charges,,,4556.7,83,,percent of total billed charges,,,1647,83,,percent of total billed charges,,,,,,,,,,,,,,,4556.7,83,,percent of total billed charges,,,,,,,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4666.5,85,,percent of total billed charges,,1647,7200,
Hearing Aid Dig Binaural CIC Non Rechargeable,V5258 90 NRC,CDM,V5258,HCPCS,,,both,,6490,6490,,,,,,,,,,,,,,,,,,,,5516.5,85,,percent of total billed charges,,7200,,,,fee schedule,,7200,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5905.9,91,,percent of total billed charges,,,6165.5,95,,percent of total billed charges,,,5386.7,83,,percent of total billed charges,,,1947,83,,percent of total billed charges,,,,,,,,,,,,,,,5386.7,83,,percent of total billed charges,,,,,,,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5516.5,85,,percent of total billed charges,,1947,7200,
Hearing Aid Dig Binaural CIC Rechargeable,V5258 Lvl 30,CDM,V5258,HCPCS,,,both,,3690,3690,,,,,,,,,,,,,,,,,,,,3136.5,85,,percent of total billed charges,,7200,,,,fee schedule,,7200,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3357.9,91,,percent of total billed charges,,,3505.5,95,,percent of total billed charges,,,3062.7,83,,percent of total billed charges,,,1107,83,,percent of total billed charges,,,,,,,,,,,,,,,3062.7,83,,percent of total billed charges,,,,,,,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3136.5,85,,percent of total billed charges,,1107,7200,
Hearing Aid Dig Binaural CIC Rechargeable,V5258 Lvl 50,CDM,V5258,HCPCS,,,both,,4690,4690,,,,,,,,,,,,,,,,,,,,3986.5,85,,percent of total billed charges,,7200,,,,fee schedule,,7200,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4267.9,91,,percent of total billed charges,,,4455.5,95,,percent of total billed charges,,,3892.7,83,,percent of total billed charges,,,1407,83,,percent of total billed charges,,,,,,,,,,,,,,,3892.7,83,,percent of total billed charges,,,,,,,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,3986.5,85,,percent of total billed charges,,1407,7200,
Hearing Aid Dig Binaural CIC Rechargeable,V5258 Lvl 70,CDM,V5258,HCPCS,,,both,,5690,5690,,,,,,,,,,,,,,,,,,,,4836.5,85,,percent of total billed charges,,7200,,,,fee schedule,,7200,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5177.9,91,,percent of total billed charges,,,5405.5,95,,percent of total billed charges,,,4722.7,83,,percent of total billed charges,,,1707,83,,percent of total billed charges,,,,,,,,,,,,,,,4722.7,83,,percent of total billed charges,,,,,,,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,4836.5,85,,percent of total billed charges,,1707,7200,
Hearing Aid Dig Binaural CIC Rechargeable,V5258 Lvl 90,CDM,V5258,HCPCS,,,both,,6690,6690,,,,,,,,,,,,,,,,,,,,5686.5,85,,percent of total billed charges,,7200,,,,fee schedule,,7200,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6087.9,91,,percent of total billed charges,,,6355.5,95,,percent of total billed charges,,,5552.7,83,,percent of total billed charges,,,2007,83,,percent of total billed charges,,,,,,,,,,,,,,,5552.7,83,,percent of total billed charges,,,,,,,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,5686.5,85,,percent of total billed charges,,2007,7200,
"Hearing aid, digit, bin, itc",V5259,CDM,V5259,HCPCS,,,both,,3657,3657,,,,,,,,,,,,,,,,,,,,3108.45,85,,percent of total billed charges,,8585,,,,fee schedule,,8585,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3327.87,91,,percent of total billed charges,,,3474.15,95,,percent of total billed charges,,,3035.31,83,,percent of total billed charges,,,1097.1,83,,percent of total billed charges,,,,,,,,,,,,,,,3035.31,83,,percent of total billed charges,,,,,,,,,3291.3,90,,percent of total billed charges,,,3291.3,90,,percent of total billed charges,,,3291.3,90,,percent of total billed charges,,,3291.3,90,,percent of total billed charges,,,3108.45,85,,percent of total billed charges,,1097.1,8585,
Hearing Aid Dig Binaural ITE Non Rechargeable,V5260 30 NRC,CDM,V5260,HCPCS,,,both,,3490,3490,,,,,,,,,,,,,,,,,,,,2966.5,85,,percent of total billed charges,,6080,,,,fee schedule,,6080,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3175.9,91,,percent of total billed charges,,,3315.5,95,,percent of total billed charges,,,2896.7,83,,percent of total billed charges,,,1047,83,,percent of total billed charges,,,,,,,,,,,,,,,2896.7,83,,percent of total billed charges,,,,,,,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,2966.5,85,,percent of total billed charges,,1047,6080,
Hearing Aid Dig Binaural ITE Non Rechargeable,V5260 50 NRC,CDM,V5260,HCPCS,,,both,,4490,4490,,,,,,,,,,,,,,,,,,,,3816.5,85,,percent of total billed charges,,6080,,,,fee schedule,,6080,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4085.9,91,,percent of total billed charges,,,4265.5,95,,percent of total billed charges,,,3726.7,83,,percent of total billed charges,,,1347,83,,percent of total billed charges,,,,,,,,,,,,,,,3726.7,83,,percent of total billed charges,,,,,,,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,3816.5,85,,percent of total billed charges,,1347,6080,
Hearing Aid Dig Binaural ITE Non Rechargeable,V5260 70 NRC,CDM,V5260,HCPCS,,,both,,5490,5490,,,,,,,,,,,,,,,,,,,,4666.5,85,,percent of total billed charges,,6080,,,,fee schedule,,6080,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4995.9,91,,percent of total billed charges,,,5215.5,95,,percent of total billed charges,,,4556.7,83,,percent of total billed charges,,,1647,83,,percent of total billed charges,,,,,,,,,,,,,,,4556.7,83,,percent of total billed charges,,,,,,,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4666.5,85,,percent of total billed charges,,1647,6080,
Hearing Aid Dig Binaural ITE Non Rechargeable,V5260 90 NRC,CDM,V5260,HCPCS,,,both,,6490,6490,,,,,,,,,,,,,,,,,,,,5516.5,85,,percent of total billed charges,,6080,,,,fee schedule,,6080,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5905.9,91,,percent of total billed charges,,,6165.5,95,,percent of total billed charges,,,5386.7,83,,percent of total billed charges,,,1947,83,,percent of total billed charges,,,,,,,,,,,,,,,5386.7,83,,percent of total billed charges,,,,,,,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5516.5,85,,percent of total billed charges,,1947,6165.5,
Hearing Aid Dig Binaural ITE Rechargeable,V5260 Lvl 30,CDM,V5260,HCPCS,,,both,,3690,3690,,,,,,,,,,,,,,,,,,,,3136.5,85,,percent of total billed charges,,6080,,,,fee schedule,,6080,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3357.9,91,,percent of total billed charges,,,3505.5,95,,percent of total billed charges,,,3062.7,83,,percent of total billed charges,,,1107,83,,percent of total billed charges,,,,,,,,,,,,,,,3062.7,83,,percent of total billed charges,,,,,,,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3136.5,85,,percent of total billed charges,,1107,6080,
Hearing Aid Dig Binaural ITE Rechargeable,V5260 Lvl 50,CDM,V5260,HCPCS,,,both,,4690,4690,,,,,,,,,,,,,,,,,,,,3986.5,85,,percent of total billed charges,,6080,,,,fee schedule,,6080,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4267.9,91,,percent of total billed charges,,,4455.5,95,,percent of total billed charges,,,3892.7,83,,percent of total billed charges,,,1407,83,,percent of total billed charges,,,,,,,,,,,,,,,3892.7,83,,percent of total billed charges,,,,,,,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,3986.5,85,,percent of total billed charges,,1407,6080,
Hearing Aid Dig Binaural ITE Rechargeable,V5260 Lvl 70,CDM,V5260,HCPCS,,,both,,5690,5690,,,,,,,,,,,,,,,,,,,,4836.5,85,,percent of total billed charges,,6080,,,,fee schedule,,6080,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5177.9,91,,percent of total billed charges,,,5405.5,95,,percent of total billed charges,,,4722.7,83,,percent of total billed charges,,,1707,83,,percent of total billed charges,,,,,,,,,,,,,,,4722.7,83,,percent of total billed charges,,,,,,,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,4836.5,85,,percent of total billed charges,,1707,6080,
Hearing Aid Dig Binaural ITE Rechargeable,V5260 Lvl 90,CDM,V5260,HCPCS,,,both,,6690,6690,,,,,,,,,,,,,,,,,,,,5686.5,85,,percent of total billed charges,,6080,,,,fee schedule,,6080,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6087.9,91,,percent of total billed charges,,,6355.5,95,,percent of total billed charges,,,5552.7,83,,percent of total billed charges,,,2007,83,,percent of total billed charges,,,,,,,,,,,,,,,5552.7,83,,percent of total billed charges,,,,,,,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,5686.5,85,,percent of total billed charges,,2007,6355.5,
Hearing Aid Dig Binaural BTE Non Rechargeable,V5261 30 NRC,CDM,V5261,HCPCS,,,both,,3490,3490,,,,,,,,,,,,,,,,,,,,2966.5,85,,percent of total billed charges,,4275,,,,fee schedule,,4275,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3175.9,91,,percent of total billed charges,,,3315.5,95,,percent of total billed charges,,,2896.7,83,,percent of total billed charges,,,1047,83,,percent of total billed charges,,,,,,,,,,,,,,,2896.7,83,,percent of total billed charges,,,,,,,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,3141,90,,percent of total billed charges,,,2966.5,85,,percent of total billed charges,,1047,4275,
Hearing Aid Dig Binaural BTE Non Rechargeable,V5261 50 NRC,CDM,V5261,HCPCS,,,both,,4490,4490,,,,,,,,,,,,,,,,,,,,3816.5,85,,percent of total billed charges,,4275,,,,fee schedule,,4275,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4085.9,91,,percent of total billed charges,,,4265.5,95,,percent of total billed charges,,,3726.7,83,,percent of total billed charges,,,1347,83,,percent of total billed charges,,,,,,,,,,,,,,,3726.7,83,,percent of total billed charges,,,,,,,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,4041,90,,percent of total billed charges,,,3816.5,85,,percent of total billed charges,,1347,4275,
Hearing Aid Dig Binaural BTE Non Rechargeable,V5261 70 NRC,CDM,V5261,HCPCS,,,both,,5490,5490,,,,,,,,,,,,,,,,,,,,4666.5,85,,percent of total billed charges,,4275,,,,fee schedule,,4275,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4995.9,91,,percent of total billed charges,,,5215.5,95,,percent of total billed charges,,,4556.7,83,,percent of total billed charges,,,1647,83,,percent of total billed charges,,,,,,,,,,,,,,,4556.7,83,,percent of total billed charges,,,,,,,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4941,90,,percent of total billed charges,,,4666.5,85,,percent of total billed charges,,1647,5215.5,
Hearing Aid Dig Binaural BTE Non Rechargeable,V5261 90 NRC,CDM,V5261,HCPCS,,,both,,6490,6490,,,,,,,,,,,,,,,,,,,,5516.5,85,,percent of total billed charges,,4275,,,,fee schedule,,4275,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5905.9,91,,percent of total billed charges,,,6165.5,95,,percent of total billed charges,,,5386.7,83,,percent of total billed charges,,,1947,83,,percent of total billed charges,,,,,,,,,,,,,,,5386.7,83,,percent of total billed charges,,,,,,,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5841,90,,percent of total billed charges,,,5516.5,85,,percent of total billed charges,,1947,6165.5,
Hearing Aid Dig Binaural BTE Rechargeable,V5261 Lvl 30,CDM,V5261,HCPCS,,,both,,3690,3690,,,,,,,,,,,,,,,,,,,,3136.5,85,,percent of total billed charges,,4275,,,,fee schedule,,4275,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,3357.9,91,,percent of total billed charges,,,3505.5,95,,percent of total billed charges,,,3062.7,83,,percent of total billed charges,,,1107,83,,percent of total billed charges,,,,,,,,,,,,,,,3062.7,83,,percent of total billed charges,,,,,,,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3321,90,,percent of total billed charges,,,3136.5,85,,percent of total billed charges,,1107,4275,
Hearing Aid Dig Binaural BTE Rechargeable,V5261 Lvl 50,CDM,V5261,HCPCS,,,both,,4690,4690,,,,,,,,,,,,,,,,,,,,3986.5,85,,percent of total billed charges,,4275,,,,fee schedule,,4275,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,4267.9,91,,percent of total billed charges,,,4455.5,95,,percent of total billed charges,,,3892.7,83,,percent of total billed charges,,,1407,83,,percent of total billed charges,,,,,,,,,,,,,,,3892.7,83,,percent of total billed charges,,,,,,,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,4221,90,,percent of total billed charges,,,3986.5,85,,percent of total billed charges,,1407,4455.5,
Hearing Aid Dig Binaural BTE Rechargeable,V5261 Lvl 70,CDM,V5261,HCPCS,,,both,,5690,5690,,,,,,,,,,,,,,,,,,,,4836.5,85,,percent of total billed charges,,4275,,,,fee schedule,,4275,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,5177.9,91,,percent of total billed charges,,,5405.5,95,,percent of total billed charges,,,4722.7,83,,percent of total billed charges,,,1707,83,,percent of total billed charges,,,,,,,,,,,,,,,4722.7,83,,percent of total billed charges,,,,,,,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,5121,90,,percent of total billed charges,,,4836.5,85,,percent of total billed charges,,1707,5405.5,
Hearing Aid Dig Binaural BTE Rechargeable,V5261 Lvl 90,CDM,V5261,HCPCS,,,both,,6690,6690,,,,,,,,,,,,,,,,,,,,5686.5,85,,percent of total billed charges,,4275,,,,fee schedule,,4275,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,6087.9,91,,percent of total billed charges,,,6355.5,95,,percent of total billed charges,,,5552.7,83,,percent of total billed charges,,,2007,83,,percent of total billed charges,,,,,,,,,,,,,,,5552.7,83,,percent of total billed charges,,,,,,,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,6021,90,,percent of total billed charges,,,5686.5,85,,percent of total billed charges,,2007,6355.5,
Ear mold/insert,V5264,CDM,V5264,HCPCS,,,both,,155,155,,,,,,,,,,,,,,,,,,,,131.75,85,,percent of total billed charges,,190,,,,fee schedule,,120,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,141.05,91,,percent of total billed charges,,,147.25,95,,percent of total billed charges,,,128.65,83,,percent of total billed charges,,,46.5,83,,percent of total billed charges,,,,,,,,,,,,,,,128.65,83,,percent of total billed charges,,,,,,,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,139.5,90,,percent of total billed charges,,,131.75,85,,percent of total billed charges,,46.5,190,
"Ear mold/insert, disp",V5265,CDM,V5265,HCPCS,,,both,,97,97,,,,,,,,,,,,,,,,,,,,82.45,85,,percent of total billed charges,,100,,,,fee schedule,,100,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,88.27,91,,percent of total billed charges,,,92.15,95,,percent of total billed charges,,,80.51,83,,percent of total billed charges,,,29.1,83,,percent of total billed charges,,,,,,,,,,,,,,,80.51,83,,percent of total billed charges,,,,,,,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,87.3,90,,percent of total billed charges,,,82.45,85,,percent of total billed charges,,29.1,100,
Battery for hearing device,V5266,CDM,V5266,HCPCS,,,both,,26,26,,,,,,,,,,,,,,,,,,,,22.1,85,,percent of total billed charges,,30,,,,fee schedule,,30,,,,fee schedule,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,23.66,91,,percent of total billed charges,,,24.7,95,,percent of total billed charges,,,21.58,83,,percent of total billed charges,,,7.8,83,,percent of total billed charges,,,,,,,,,,,,,,,21.58,83,,percent of total billed charges,,,,,,,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,23.4,90,,percent of total billed charges,,,22.1,85,,percent of total billed charges,,7.8,30,
"Alerting device, any type",V5269,CDM,V5269,HCPCS,,,both,,140,140,,,,,,,,,,,,,,,,,,,,119,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,127.4,91,,percent of total billed charges,,,133,95,,percent of total billed charges,,,116.2,83,,percent of total billed charges,,,42,83,,percent of total billed charges,,,,,,,,,,,,,,,116.2,83,,percent of total billed charges,,,,,,,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,126,90,,percent of total billed charges,,,119,85,,percent of total billed charges,,42,133,
"ALD, TV amplifier, any type",V5270,CDM,V5270,HCPCS,,,both,,356,356,,,,,,,,,,,,,,,,,,,,302.6,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,323.96,91,,percent of total billed charges,,,338.2,95,,percent of total billed charges,,,295.48,83,,percent of total billed charges,,,106.8,83,,percent of total billed charges,,,,,,,,,,,,,,,295.48,83,,percent of total billed charges,,,,,,,,,320.4,90,,percent of total billed charges,,,320.4,90,,percent of total billed charges,,,320.4,90,,percent of total billed charges,,,320.4,90,,percent of total billed charges,,,302.6,85,,percent of total billed charges,,106.8,338.2,
Ear impression,V5275,CDM,V5275,HCPCS,,,both,,62,62,,,,,,,,,,,,,,,,,,,,52.7,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,56.42,91,,percent of total billed charges,,,58.9,95,,percent of total billed charges,,,51.46,83,,percent of total billed charges,,,18.6,83,,percent of total billed charges,,,,,,,,,,,,,,,51.46,83,,percent of total billed charges,,,,,,,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,55.8,90,,percent of total billed charges,,,52.7,85,,percent of total billed charges,,18.6,58.9,
Ald FM/DM ear level receiver,V5284,CDM,V5284,HCPCS,,,both,,99,99,,,,,,,,,,,,,,,,,,,,84.15,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,90.09,91,,percent of total billed charges,,,94.05,95,,percent of total billed charges,,,82.17,83,,percent of total billed charges,,,29.7,83,,percent of total billed charges,,,,,,,,,,,,,,,82.17,83,,percent of total billed charges,,,,,,,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,89.1,90,,percent of total billed charges,,,84.15,85,,percent of total billed charges,,29.7,94.05,
Ald blu tooth fm/dm receiver,V5286,CDM,V5286,HCPCS,,,both,,371,371,,,,,,,,,,,,,,,,,,,,315.35,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,337.61,91,,percent of total billed charges,,,352.45,95,,percent of total billed charges,,,307.93,83,,percent of total billed charges,,,111.3,83,,percent of total billed charges,,,,,,,,,,,,,,,307.93,83,,percent of total billed charges,,,,,,,,,333.9,90,,percent of total billed charges,,,333.9,90,,percent of total billed charges,,,333.9,90,,percent of total billed charges,,,333.9,90,,percent of total billed charges,,,315.35,85,,percent of total billed charges,,111.3,352.45,
FACIAL,ZFACIAL,CDM,,,,,both,,32,32,,,,,,,,,,,,,,,,,,,,27.2,85,,percent of total billed charges,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,29.12,91,,percent of total billed charges,,,30.4,95,,percent of total billed charges,,,26.56,83,,percent of total billed charges,,,9.6,83,,percent of total billed charges,,,,,,,,,,,,,,,26.56,83,,percent of total billed charges,,,,,,,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,28.8,90,,percent of total billed charges,,,27.2,85,,percent of total billed charges,,9.6,30.4,